The epidemiology of substance use among street children in resource-constrained settings: a systematic review and meta-analysis

Authors

  • Lonnie Embleton,

    1. College of Health Sciences, Department of Medicine, Moi University, Eldoret, Kenya
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  • Ann Mwangi,

    1. College of Health Sciences, School of Medicine, Department of Behavioral Sciences, Moi University, Eldoret, Kenya
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  • Rachel Vreeman,

    1. College of Health Sciences, School of Medicine, Department of Pediatrics, Moi University, Eldoret, Kenya
    2. School of Medicine, Department of Pediatrics, Indiana University, Indianapolis, IN, USA
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  • David Ayuku,

    1. College of Health Sciences, School of Medicine, Department of Behavioral Sciences, Moi University, Eldoret, Kenya
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  • Paula Braitstein

    Corresponding author
    1. School of Medicine, Department of Medicine, Indiana University, Indianapolis, IN, USA
    2. Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada
    3. Regenstrief Institute, Inc., Indianapolis, IN, USA
    • College of Health Sciences, Department of Medicine, Moi University, Eldoret, Kenya
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Correspondence to: Paula Braitstein, Indiana University, Department of Medicine, 1001 West 10th Street, OPW M200, Indianapolis, IN 46202, USA. E-mail: pbraitst@iupui.edu

Abstract

Aims

To compile and analyze critically the literature published on street children and substance use in resource-constrained settings.

Methods

We searched the literature systematically and used meta-analytical procedures to synthesize literature that met the review's inclusion criteria. Pooled-prevalence estimates and 95% confidence intervals (CI) were calculated using the random-effects model for life-time substance use by geographical region as well as by type of substance used.

Results

Fifty studies from 22 countries were included into the review. Meta-analysis of combined life-time substance use from 27 studies yielded an overall drug use pooled-prevalence estimate of 60% (95% CI = 51–69%). Studies from 14 countries contributed to an overall pooled prevalence for street children's reported inhalant use of 47% (95% CI = 36–58%). This review reveals significant gaps in the literature, including a dearth of data on physical and mental health outcomes, HIV and mortality in association with street children's substance use.

Conclusions

Street children from resource-constrained settings reported high life-time substance use. Inhalants are the predominant substances used, followed by tobacco, alcohol and marijuana.

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