Alcohol diagnostic validation for injury-related trauma: Findings from a pilot study

Megan Prinsloo; Petal Petersen Williams; Ian Neethling; Shibe X Mhlongo; Sithombo Maqungo; Margaret M Peden; Charles Parry; Richard Matzopoulos

doi:10.1177/20552076231218138

Alcohol diagnostic validation for injury-related trauma: Findings from a pilot study

Digit Health. 2023 Dec 3:9:20552076231218138. doi: 10.1177/20552076231218138. eCollection 2023 Jan-Dec.

Authors

Megan Prinsloo^{1

2

3}, Petal Petersen Williams^{4

5

6}, Ian Neethling^{1

2}, Shibe X Mhlongo⁷, Sithombo Maqungo⁸, Margaret M Peden^{9

10}, Charles Parry^{4

11}, Richard Matzopoulos^{1

3}

Affiliations

¹ Burden of Disease Research Unit, South African Medical Research Council, Cape Town, South Africa.
² Institute for Lifecourse Development, Faculty of Education, Health & Human Sciences, University of Greenwich, UK.
³ School of Public Health, University of Cape Town, Cape Town, South Africa.
⁴ Mental Health, Alcohol, Substance Use and Tobacco Research Unit, South African Medical Research Council, Cape Town, South Africa.
⁵ Department of Psychiatry and Mental Health, University of Cape Town, South Africa.
⁶ Institute for Life Course Health Research, Department of Global Health, Stellenbosch University, South Africa.
⁷ Gender and Health Research Unit, South African Medical Research Council, Cape Town, South Africa.
⁸ Orthopaedic Trauma Service, Groote Schuur Hospital, University of Cape Town, South Africa.
⁹ George Institute for Global Health, Imperial College London, UK.
¹⁰ WHO Collaborating Centre on Injury Prevention and Trauma Care, Geneva, Switzerland.
¹¹ Department of Psychiatry, Stellenbosch University, Cape Town, South Africa.

Abstract

Introduction: Alcohol consumption is a key driver of the burden of violence and injury in South Africa (SA). Hence, we aim to validate various alcohol assessment tools against a blood test to assess their utility for improving national health practice and policy.

Methods: We conducted a cross-sectional pilot study from 3 to 19 August 2022 at Groote Schuur Hospital in Cape Town, SA. This was to test logistics for the time of venous blood centrifugation and validation of alcohol assessment tools used in injured patients ahead of the main validation study. Adults aged 18 years and older, who were injured <8 h before arrival were included. Consent was obtained for venous blood alcohol testing to validate, as the gold standard, against the following: active- and passive breath alcohol testing, clinical screening and a finger prick test. Descriptive statistics were reported for the pilot study.

Results: The active breath alcohol test's digital reading and the passive test's 'yes/no' results corresponded well against the venous blood alcohol results. The average time to centrifugation was within the laboratory's 2-h cut-off requirement to preserve the alcohol in the serum.

Discussion and conclusion: The pilot study was helpful in identifying challenges with one of the alcohol assessment tools and prevented further costs ahead of the main validation study. We also determined that the selected tertiary hospital site caused a delay in recruiting eligible patients due to other hospital referrals. Hence, the main validation study is in progress at a district-level hospital for a larger sample of eligible patients for testing.

Keywords: South Africa; alcohol assessment tools; alcohol consumption; blood alcohol; breathalyzer; evidentiary breath alcohol testing; injury; violence.