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Treatment outcomes for substance use disorders across the African continent : a systematic review

Claire Biribawa (UGent) , Nazarius Mbona Tumwesigye, Deborah Louise Sinclair (UGent) , Duncan Kabiito Matovu, Greg Swensen, Florian De Meyer (UGent) , Moses Mukasa (UGent) , David Kalema (UGent) , Byamah Brian Mutamba and Wouter Vanderplasschen (UGent)
(2025) BMC PSYCHOLOGY. 13(1).
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Abstract
Background: Substance use disorders (SUDs) are increasingly recognized as a significant public health concern in Africa, placing considerable strain on the economy, healthcare system, and society at large. Given the dual disease burden of both infectious and non-communicable diseases, African countries may not prioritize addressing the emerging epidemic of SUDs. There is a paucity of scientific literature on SUD treatment outcomes following their management across the African continent. Therefore, this systematic review aimed to address this gap. Methods: We conducted an electronic search of Web of Science, CINAHL, Embase, Medline (PubMed interface), Scopus, and PsycArticles. We included studies with participants who were diagnosed and treated for SUDs following internationally recognized diagnostic criteria in the African region as defined by geographical boundaries and had at least one treatment outcome measured and reported. Studies were assessed for risk of bias using the Joanna Briggs Institute critical appraisal tool. This systematic review was registered in the PROSPERO database (CRD42022362926). Results Thirteen research studies were included across four African countries (South Africa −8, Uganda −2, Zambia −2, and the Democratic Republic of Congo −1). The treatment completion rates across all treatment modalities averaged 71.4%. A reduction in substance use was reported in nine of the 13 studies, with significant decreases observed in measures such as heavy drinking days and substance use severity scores. However, relapse rates ranged from 23 to 92%, with predictors including low recovery capital and poor social support. Substitution behaviours, such as increased alcohol or crystal methamphetamine use, were noted in some studies following abstinence from primary substances. Conclusions The findings suggest varying levels of efficacy for SUD treatment modalities in Africa, including reductions in substance use in some studies and moderate treatment completion rates. However, the high relapse rates underscore the need for comprehensive, resource-adapted interventions. The limited geographical scope of the literature, with studies predominantly from South Africa, points to a critical gap in research from other African countries and emphasizes the need for expanded research across the continent to inform scalable, evidence-based solutions for SUD management.

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MLA
Biribawa, Claire, et al. “Treatment Outcomes for Substance Use Disorders across the African Continent : A Systematic Review.” BMC PSYCHOLOGY, vol. 13, no. 1, 2025, doi:10.1186/s40359-025-02978-5.
APA
Biribawa, C., Tumwesigye, N. M., Sinclair, D. L., Matovu, D. K., Swensen, G., De Meyer, F., … Vanderplasschen, W. (2025). Treatment outcomes for substance use disorders across the African continent : a systematic review. BMC PSYCHOLOGY, 13(1). https://doi.org/10.1186/s40359-025-02978-5
Chicago author-date
Biribawa, Claire, Nazarius Mbona Tumwesigye, Deborah Louise Sinclair, Duncan Kabiito Matovu, Greg Swensen, Florian De Meyer, Moses Mukasa, David Kalema, Byamah Brian Mutamba, and Wouter Vanderplasschen. 2025. “Treatment Outcomes for Substance Use Disorders across the African Continent : A Systematic Review.” BMC PSYCHOLOGY 13 (1). https://doi.org/10.1186/s40359-025-02978-5.
Chicago author-date (all authors)
Biribawa, Claire, Nazarius Mbona Tumwesigye, Deborah Louise Sinclair, Duncan Kabiito Matovu, Greg Swensen, Florian De Meyer, Moses Mukasa, David Kalema, Byamah Brian Mutamba, and Wouter Vanderplasschen. 2025. “Treatment Outcomes for Substance Use Disorders across the African Continent : A Systematic Review.” BMC PSYCHOLOGY 13 (1). doi:10.1186/s40359-025-02978-5.
Vancouver
1.
Biribawa C, Tumwesigye NM, Sinclair DL, Matovu DK, Swensen G, De Meyer F, et al. Treatment outcomes for substance use disorders across the African continent : a systematic review. BMC PSYCHOLOGY. 2025;13(1).
IEEE
[1]
C. Biribawa et al., “Treatment outcomes for substance use disorders across the African continent : a systematic review,” BMC PSYCHOLOGY, vol. 13, no. 1, 2025.
@article{01JZ5CQK3YQWB7J2DK2WX3P3Y7,
  abstract     = {{Background:
Substance use disorders (SUDs) are increasingly recognized as a significant public health concern in 
Africa, placing considerable strain on the economy, healthcare system, and society at large. Given the dual disease 
burden of both infectious and non-communicable diseases, African countries may not prioritize addressing the 
emerging epidemic of SUDs. There is a paucity of scientific literature on SUD treatment outcomes following their 
management across the African continent. Therefore, this systematic review aimed to address this gap.

Methods:
We conducted an electronic search of Web of Science, CINAHL, Embase, Medline (PubMed interface), 
Scopus, and PsycArticles. We included studies with participants who were diagnosed and treated for SUDs following internationally recognized diagnostic criteria in the African region as defined by geographical boundaries and had at least one treatment outcome measured and reported. Studies were assessed for risk of bias using the Joanna Briggs Institute critical appraisal tool. This systematic review was registered in the PROSPERO database (CRD42022362926).

Results 
Thirteen research studies were included across four African countries (South Africa −8, Uganda −2, Zambia 
−2, and the Democratic Republic of Congo −1). The treatment completion rates across all treatment modalities 
averaged 71.4%. A reduction in substance use was reported in nine of the 13 studies, with significant decreases 
observed in measures such as heavy drinking days and substance use severity scores. However, relapse rates ranged from 23 to 92%, with predictors including low recovery capital and poor social support. Substitution behaviours, such as increased alcohol or crystal methamphetamine use, were noted in some studies following abstinence from primary substances.

Conclusions 
The findings suggest varying levels of efficacy for SUD treatment modalities in Africa, including 
reductions in substance use in some studies and moderate treatment completion rates. However, the high relapse 
rates underscore the need for comprehensive, resource-adapted interventions. The limited geographical scope of 
the literature, with studies predominantly from South Africa, points to a critical gap in research from other African 
countries and emphasizes the need for expanded research across the continent to inform scalable, evidence-based 
solutions for SUD management.}},
  articleno    = {{662}},
  author       = {{Biribawa, Claire and Tumwesigye, Nazarius Mbona and Sinclair, Deborah Louise and Matovu, Duncan Kabiito and Swensen, Greg and De Meyer, Florian and Mukasa, Moses and Kalema, David and Mutamba, Byamah Brian and Vanderplasschen, Wouter}},
  issn         = {{2050-7283}},
  journal      = {{BMC PSYCHOLOGY}},
  language     = {{eng}},
  number       = {{1}},
  pages        = {{16}},
  title        = {{Treatment outcomes for substance use disorders across the African continent : a systematic review}},
  url          = {{http://doi.org/10.1186/s40359-025-02978-5}},
  volume       = {{13}},
  year         = {{2025}},
}
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