A randomized trial led by researchers at Columbia University Mailman School of Public Health found a significant and sustained reduction in alcohol use among residents of the Mantapala refugee settlement in northern Zambia, according to findings published on July 27 in Lancet Global Health. The study is the first known randomized trial of an alcohol-reduction intervention conducted in a humanitarian setting.
The Ukuundapwa Chapamo trial was carried out with partners across six countries and focused on Congolese refugees and Zambians living in Mantapala, a settlement established in 2018 for those fleeing conflict from the Democratic Republic of the Congo. Home-brewed alcohol is common within the settlement, where substance use often serves as a coping mechanism for trauma and daily stressors.
As part of the research, non-specialists from both refugee and host communities were trained to deliver mental health care under professional supervision. Participants were randomly assigned either to an intervention based on Screening, Brief Intervention, and Referral to Treatment (SBIRT) or to treatment as usual involving referral for basic counseling at local clinics. In the SBIRT group, staff assessed drinking patterns during a single session lasting 30-45 minutes; those with higher risk received up to twelve weekly cognitive behavioral therapy sessions.
Results showed that SBIRT reduced alcohol use by 64 percent over twelve months compared with controls. Secondary benefits included reduced symptoms of common mental disorders at six months, though these effects lessened after one year. No significant impact was observed regarding drug use. An economic analysis indicated that while this intervention cost less than similar models used in high-income countries, it would still require dedicated funding and adaptation for sustainability.
Twenty-four authors from universities, NGOs, and United Nations agencies contributed to the study. Some declared potential conflicts due to affiliations with organizations such as the World Health Organization or other groups involved with community health workers or humanitarian health services. The authors stated that their views do not necessarily represent those of their affiliated institutions.
