Comorbidity of alcohol use disorders and non-communicable diseases in low- and middle-income countries

Objective: The aim of this systematic review is to understand the relationship between alcohol use disorders (AUDs) and three non-communicable diseases [NCD] (cardiovascular diseases, respiratory diseases, and diabetes) in low- and middle-income countries (LMICs). Methods: We searched the following databases using a systematic search strategy: Medline, EMBASE, PsycINFO, Global Health, LILACS (Latin American and Caribbean Health Sciences Literature), and AJOL (African Journal Online). Results: We identified 1431 references through the database search and through a systematic screening process identified 13 studies that met our eligibility criteria. Amongst those with any kind of AUD, depending on the type of NCD, the prevalence ranged from 14% (diabetes) to 58% (hypertension). Amongst those with the selected NCDs, depending on the type of AUD, the prevalence ranged from 1.8% (diabetes) to 27.4% (ST-segment-elevation myocardial infarction). A range of AUDs were associated with hypertension in men, cardiovascular diseases, left ventricular hypertrophy, and diabetes mellitus. In some studies, inverse associations were observed between AUD and two NCDs–hypertension and diabetes. Conclusion: The burden of comorbid AUDs and NCDs in LMICs is high, and this should be countered through appropriate public health response such as policy interventions to control availability of alcohol, and through screening and brief interventions in primary care.