Harmful alcohol use results in over 3 million deaths and annually with an impact that is disproportionately high in Africa. Road traffic injury, HIV medication non-adherence, intimate partner violence, liver disease, hypertension and cancer are among the serious problems faced by developing countries and worsened by alcohol.13 In Rwanda, alcohol consumption is near the highest in Africa. Three of the top 10 causes of death are linked to alcohol, and alcohol is among the top 4 modifiable risk factors driving death and disability.

Beginning in 2020, with support from the Rhode Island Foundation Medical Research Grant, our team completed the first Rwanda-focused adaptation of screening instruments for the detection of alcohol use disorder (AUD), including the Alcohol Use Disorder Identification Tool (AUDIT), now allowing for AUD screening. Our initial data show high levels of AUD, especially among emergency department (ED) patients. We used innovative Audio Computer Assisted Self-Interviewing (ACASI)22 for AUD screening in Rwanda, which consists of touchscreen interface and voice recordings, has shown excellent acceptability and feasibility, even among patients without prior computer familiarity, and expands access to those with limited literacy.

Continuing objectives for this project include adaptation to the Rwandan context an established brief intervention (BI) to reduce hazardous drinking among at-risk ED patients.