by Professor Onohuean Hope; Department of Pharmacology and Toxicology, Kampala International University, Uganda, and Professor Frasia Oosthuizen who holds a BPharm, MSc (Pharmacology) and PhD (Pharmacology) qualifications, all obtained from PU for CHE (now North-West University). Published: March 7, 2025 in the journal PLOS One (stylized PLOS ONE, and formerly PLoS ONE) is a peer-reviewed open access mega journal published by the Public Library of Science (PLOS) since 2006.
Published: March 7, 2025
ABSTRACT
Introduction
There is an ongoing global upsurge of opioid misuse, fatal overdose and other related
disorders, significantly affecting the African continent, due to resource-limited settings and
poor epidemiological surveillance systems. This scoping review maps scientific evidence
on epidemiological data on unlawful opioid use to identify knowledge gaps and policy
shortcomings.
Method
The databases (PubMed, Scopus, Web of Sciences) and references were searched
guided by Population, Concept, and Context (PCC) and PRISMA-ScR. The extracted
characteristics examined were author/year, African country, epidemiological distribution,
age group (year), gender, study design and setting, common opioid/s abused, sources of
drugs, reasons for misuse, summary outcomes and future engagement.
Results
A population of 55132 participated in the included studies of 68 articles, with the
largest sample size of 17260 (31.31%) in a study done in South Africa, 11281(20.46%)
in a study from Egypt and 4068 (7.38%) in a study from Ethiopia. The gender of the
participants was indicated in 65(95.59%) papers. The mean and median age reported
in 57(83.82%) papers were 15.9-38, and 22-31years. The majority of study-designs
were cross-sectional, 44(64.71%), and the most used opioids were heroin, 14articles
(20.59%), tramadol, 8articles (11.76%), and tramadol & heroin, 6 articles (8.82%)
articles. Study-settings included urban community 15(22.06%), hospital 15(22.06%),
university students 11(16.18%), and secondary school learners 6(8.82%). The highest
epidemiological distributions were recorded in the South African study, 19615(35.60%),
Egyptian study, 14627(26.54%), and Nigerian study 5895(10.70%). Nine (13.24%)
papers reported major opioid sources as black market, friends, and drug dealers. To
relieve stress, physical pain and premature ejaculation, improve mood and sleep-related
PLOS ONE | https://doi.org/10.1371/journal.pone.0317036 March 7, 2025 2 / 24
PLOS ONE The burden of unlawful use of opioid and associated epidemiological characteristics in Africa
problems and help to continue work, were the major reasons for taking these drugs as
reported in twenty articles (29.41%).
Conclusion
The findings of this scoping review show significant knowledge gaps on opioid usage in
the African continent. The epidemiological distribution of unlawful use of opioids among
young adults, drivers, and manual labourers in both genders is evident in the findings.
The reason for use necessity scrutinises the role of social interaction, friends and family
influence on illicit opiate use. Therefore, there is a need for regular epidemiological
surveillance and investigations into multilevel, value-based, comprehensive, and strategic
long-term intervention plans to curb the opioid problem in the region.
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