Profile of drinking behaviour and comparison of self-report with the CAGE questionnaire and carbohydrate-deficient transferrin in a rural Lesotho community

This paper aims to: (1) profile the drinking behaviour of a rural Lesotho c ommunity facing relocation; (2) compare the following measures of hazardous drinking in this community: quantity/frequency self-report, the CAGE quest ionnaire and carbohydrate-deficient transferrin (CDT) levels; (3) describe community awareness of, and attitude towards, treatment services. As part o f a larger baseline survey of community health status, households in 29 vil lages in Lesotho were randomly sampled. Consenting adults (n = 348) partici pated in a face-to-face interview about alcohol use, which included the CAG E. Blood was taken from participants for CDT determination. Fifty-three per cent of men (37/69) and 19% of women (53/279) reported drinking alcohol. T hirty-six per cent of men (25/69) and 9% of women (251279) were classified as hazardous drinkers defined as drinking 350 g (males) or 225 g (females) of alcohol/week, or 'engaged in bouts of heavy drinking 1 to 2 days a month or more during the past 12 months'. Hazardous drinkers were significantly more likely to be male and older, but did not differ from the rest of the s ample on marital status. Using hazardous drinking as the standard, CAGE (sc ore greater than or equal to2) had a positive predictive value (PPV) of 75% for men and 62% for women. The parameters for CDT must be interpreted with caution as the cut-offs for hazardous drinking, especially for women's dri nking, were lower than the usual cut-offs in published CDT studies. However , the high specificities for CDT in men (100%; 19/19) and in women (77%; 11 0/142) are consistent with other studies, but the low PPV of 14% (5/37) for men and women combined suggests that CDT is not effective as a predictor o f hazardous drinking in this population. There was high awareness of availa ble treatment services among participants, and most believed treatment to b e beneficial. Overall, the study provides a comprehensive baseline profile of drinking behaviour in this community, but did not show the CAGE question naire or CDT profile to be useful in in this community.