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

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.

Keywords: Homeless youth; resource-constrained settings; street children; substance use; systematic review; volatile solvent use.

Figure 1

Flow diagram of study selection

Figure 2

Figure 2a Life-time substance use among street-involved children and youth from 27 studies in 13 countries Figure 2b Inhalant use by street-involved children and youth from 27 studies representing 14 resource-constrained countries

Figure 2

Figure 2a Life-time substance use among street-involved children and youth from 27 studies in 13 countries Figure 2b Inhalant use by street-involved children and youth from 27 studies representing 14 resource-constrained countries