Background: The World Health Organization estimates that over 80% of injury related deaths occur in low and middle-income Countries, including Tanzania. Alcohol and illicit drugs are major contributing factors leading to severe injuries by impairing motor and cognitive functions.In Tanzania, the use of alcohol and illicit drugs among injured patients has not yet been studied Objective: To describe the prevalence of alcohol and illicit drug use among injured patients presenting to the Emergency Medicine Department of Muhimbili National Hospital (EMD-MNH) in Dar es Salaam, Tanzania. Materials and methods: This was a prospective descriptive cohort study of a consecutive convenience sample of patients aged 18 years and above presenting to the EMD-MNH with injury related complaints between October 2015 and November 2015. Structured data sheet was used to record demographic information, nature of injury, clinical presentation, alcohol and illicit drug test results, EMD outcome and disposition. Patients‟ alcohol level and illicit drug levels were tested by breathalyser device or swab stick alcohol test and 5-multidrug panel check respectively. Patients were followed up for 24 hours and 30days using ward-chats and phone call. We presents the descriptive statistics, sensitivity and specificity, and relative risk were used as appropriate. Results: We screened 1011 patients and we enrolled 143 (14.1%) patients who met our inclusion criteria. Most 123 (86%) were male, and the median age was 30 years (IQR: 23-36). The most frequent mechanism of injury was road traffic accident 106 (74.1%) followed by assault 22 (15.4%). All 143 patients were tested for alcohol, while 122 were also tested for illicit drugs. 67 (47%) of patients tested positive for alcohol. 44 (36.1%) of the 122 patients tested for illicit drugs, tested positive for drug(s). 29 (26.1%) of injured patients tested positive for both alcohol and illicit drug(s). The most frequently illicit drug was Marijuana 30 (68%) of the positive illicit drugs tests. At 24 hours, 88 (61.5%) had underwent major surgery, 135 (94%) were admitted, and 6 (4.1%) died. Among 53 patients with positive alcohol test 30 (57%) denied the use of alcohol and among the 25 patients with positive illicit drug test, 22 (88%) denied the use of substance abuse. At 30 viii days follow-up, 8 (5.5%) injured patients with positive test for alcohol and illicit drugs had died and 73 (54%) had not yet returned to their baseline activities. Conclusion and recommendations: The prevalence of alcohol and illicit drugs is very high in patients presenting to the EMD-MNH with injury. Most patients who are affected are young males and the majority of the injured patients who had used drugs or alcohol before their injury had not returned to baseline functional level at 30 days post injury. Further studies are needed to generalise the results in Tanzania. Public health initiatives to decrease drinking and driving should be implemented
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