Charles David Parry

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Verified

Charles verified their affiliation via an institutional email.

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• MA, MSc, PhD
• Research Director at South African Medical Research Council

Limited alcohol-related injury data in hospital settings globally underscore the need for routine monitoring to inform policy formulation for injury prevention, especially in addressing violence and road traffic injuries. COVID-19 and the related alcohol sales bans in South Africa in 2020–21 brought the impact of alcohol on trauma presenting to hea...

Background Adverse drug reactions (ADRs) to tuberculosis (TB) medications make treatment completion challenging. We investigated the impact of alcohol, human immunodeficiency virus (HIV), and other patient determinants on ADRs and treatment adherence. Methods We administered monthly ADR questionnaires to participants with TB in Worcester, South Af...

Aims: To assess changes in total alcohol consumed over time, changes in consumption of different alcoholic beverages and the utility of industry sales data to evaluate the impact of policy changes related to a packaging ban on wine products in September 2007 and bans on alcohol sales during the Covid-19 pandemic in 2020 and 2021 in South Africa. De...

Background The COVID-19 pandemic negatively impacted tuberculosis (TB) treatment services, including directly observed therapy (DOT) programs used to promote medication adherence. We compared DOT adherence embedded in a research study before and after COVID-19 lockdowns in South Africa. Methods We analyzed data from 263 observational study partici...

South Africa has one of the highest prevalence rates globally for fetal alcohol spectrum disorders. Despite this, few interventions are routinely available for countering the adverse effects of perinatal drinking. The current study used the ADAPT-ITT framework to guide the development of a behavioral intervention with remote alcohol use monitoring...

Background The Western Cape region of South Africa has one of the highest global rates of Fetal Alcohol Spectrum Disorder (FASD), underscoring the urgent need for effective interventions. This qualitative study explores pregnant and lactating participants’ perceptions and experiences of a text message and contingency management (CM) intervention....

Background In South Africa, an estimated 11% of the population have high alcohol use, a major risk factor for TB. Alcohol and other substance use are also associated with poor treatment response, with a potential mechanism being altered TB drug pharmacokinetics. Objectives To investigate the impact of alcohol and illicit substance use on the pharm...

Background South Africa has the highest rate of fetal alcohol spectrum disorders (FASD) globally. As with alcohol use during pregnancy, alcohol consumption while breastfeeding adversely impacts infant development. We pilot tested an incentive‐based text‐messaging intervention to reduce alcohol use during pregnancy and lactation in South Africa. Me...

The population of older persons in South Africa is increasing. With the accompanying health conditions that come with ageing, it is critical to understand the burden, risk factors, and useful interventions that will promote healthy ageing and overall well-being of older persons in the country. The goal of this study was to map the research conducte...

Background South Africa has one of the world’s highest rates of foetal alcohol spectrum disorders (FASD). Recent evidence also showed that alcohol use during lactation significantly compromises child development in children exposed to alcohol through breastfeeding, independent of prenatal alcohol exposure. This study explored perceptions of perinat...

Background The burden of alcohol use among patients with trauma and the relative injury risks is not routinely measured in South Africa. Given the prominent burden of alcohol on hospital trauma departments, South Africa needs practical, cost-effective, and accurate alcohol diagnostic tools for testing, surveillance, and clinical management of patie...

Alcohol use disorders (AUD) among people living with HIV (PLHIV) are associated with poor health outcomes. This cross-sectional study examined current alcohol use and AUD among 300 PLHIV on ART at four HIV care centres in Northwest Tanzania. Participants' data were collected using questionnaires. Alcohol use was assessed using Alcohol Use Disorders...

Background A variety of maternal risk factors for fetal alcohol spectrum disorders (FASD) have been described in the literature. Here, we conducted a multivariate analysis of a large array of potential distal influences on FASD risk. Methods Interviews were conducted with 2515 mothers of first‐grade students whose children were evaluated to assess...

Introduction Alcohol consumption is a key driver of the burden of violence and injury in South Africa (SA). Hence, we aim to validate various alcohol assessment tools against a blood test to assess their utility for improving national health practice and policy. Methods We conducted a cross-sectional pilot study from 3 to 19 August 2022 at Groote...

COVID-19-related alcohol sales bans and stay-at-home orders prompted the alcohol industry in South Africa to increase their online alcohol sales promotions. We investigated changes in alcohol-related behaviour and the drivers of illegal alcohol sales through a self-reported Facebook survey that ran from July to November 2020. Questions included soc...

Background The COVID-19 pandemic negatively impacted all levels of tuberculosis (TB) treatment services, including directly observed therapy (DOT) programs used to promote medication adherence. We compared the rate of adherence to DOT before and during the pandemic among observational research study participants on drug-susceptible (DS)-TB therapy...

We conducted a study to present the profile of non-natural deaths in South Africa during 2020/21 (2020/21 IMS). Overall, the all-cause injury mortality rate appeared to decrease across the three surveys (2009 IMS, 2017 IMS and 2020/21 IMS); however the decrease in 2020/21 may be linked to the coronavirus disease (COVID-19) and related restrictions....

Although alcohol use is associated with depression, it is unclear if brief alcohol reduction interventions can ameliorate depression and psychological distress among people with HIV (PWH). We use data from a two-arm randomised controlled trial to examine this question. PWH on antiretroviral treatment (ART) were randomly assigned to receive a brief...

Objective To explore and analyze the significance of proximal influences of maternal and paternal traits associated with bearing a child with a fetal alcohol spectrum disorder (FASD). Methods Aggregated, maternal interview‐collected data (N = 2515) concerning alcohol, tobacco, and other drug use were examined to determine risk for FASD from seven...

BACKGROUND The burden of alcohol use among trauma patients and the relative injury risks is not routinely measured in South Africa (SA). Given the prominent burden of alcohol on hospital trauma departments, SA needs practical, cost-effective and accurate alcohol diagnostic tools for testing, surveillance and clinical management of trauma patients....

Maternal dietary intake is likely a contributing factor to fetal alcohol spectrum disorders (FASD). Two, 24-hour dietary recalls were completed by pregnant women (n=196) in South African communities with high rates of FASD. More than 50% of all women in this study were below the Estimated Average Requirement for pregnancy for vitamins A, C, D, E, r...

Background and aims: Reduction of alcohol consumption is important for people undergoing treatment for HIV. We tested the efficacy of a brief intervention for reducing the average volume of alcohol consumed among patients on HIV antiretroviral therapy (ART). Design, setting and participants: This study used a two-arm multi-centre randomized cont...

Introduction: Unhealthy alcohol use is associated with a range of adverse outcomes among people with HIV (PWH). Testing the efficacy and promoting the availability of effective interventions to address unhealthy alcohol use among PWH is thus a priority. Alcohol use outcomes in intervention studies are often measured by self-report alone, which can...

BACKGROUND: Smoking of illicit drugs may lead to more rapid TB disease progression or late treatment presentation, yet research on this topic is scant. We examined the association between smoked drug use and bacterial burden among patients newly initiated on drug-susceptible TB (DS-TB) therapy.METHODS: Data from 303 participants initiating DS-TB tr...

Background Alcohol policies stand out among other noncommunicable disease‐relevant policies for the lack of uptake. Composite indicators have been developed to measure the effects of alcohol control policy. We investigated whether drinking patterns among demographic groups from general population samples of drinkers from diverse countries are assoc...

A public health perspective on zero-and low-alcohol beverages. Brief 10 (Snapshot series on alcohol control policies and practice) ISBN 978-92-4-007215-2 (electronic version) ISBN 978-92-4-007216-9 (print version)

In the literature on alcohol use biomarkers, there has been debate as to what a valid and/or utilitarian cut off level should be for various research applications. In this manuscript, we assessed the sensitivity and specificity of multiple cutoff values for phosphatidylethanol (PEth) from bloodspots relative to self-report, the Alcohol Use Disorder...

Background Accurately quantifying alcohol use among persons with HIV (PWH) is important for validly assessing the efficacy of alcohol reduction interventions. Methods We used data from a randomized controlled trial of an intervention to reduce alcohol use among PWH who were receiving antiretroviral therapy in Tshwane, South Africa. We calculated a...

Background Pregnant women participated in multifaceted case management (MCM) to prevent Fetal Alcohol Spectrum Disorders (FASD). Methods Women recruited from antenatal clinics for a longitudinal child development study were screened for alcohol use. Forty-four pregnant women were defined as high-risk drinkers on the Alcohol Use Disorder Identifica...

Background: Health economic models aim to provide decision makers with information that is contextually relevant, understandable and credible. This requires ongoing engagement throughout the research project between the modeller and end-users. Objectives: We aim to reflect on how a public health economic model of minimum unit pricing of alcohol...

This manuscript describes a process to develop a set of indicators to monitor and evaluate the implementation of the Western Cape Alcohol-Related Harms Reduction (AHR) White Paper in South Africa and provide a final set of indicators. Drawing on the framework in Andréasson et al. (2009), a logic model with categories and types of indicators (i.e. p...

Introduction The burden of alcohol use among trauma patients and the relative injury risks is not routinely measured in South Africa (SA). Given the prominent burden of alcohol on hospital trauma departments, SA needs practical, cost-effective and accurate alcohol diagnostic tools for testing, surveillance and clinical management of trauma patients...

Prenatal alcohol exposure can produce offspring growth deficits and is a leading cause of neurodevelopmental disability. We used untargeted metabolomics to generate mechanistic insight into how alcohol impairs fetal development. In the Western Cape Province of South Africa, 52 women between gestational weeks 5–36 (mean 18.5 ± 6.5) were recruited, a...

Alcohol is one of the most widely consumed psychoactive drugs globally. Hazardous drinking, defined by quantity and frequency of consumption, is associated with acute and chronic morbidity. Alcohol use disorders (AUDs) are psychiatric syndromes characterized by impaired control over drinking and other symptoms. Contemporary aetiological perspective...

Introduction: Alcohol abstinence remains common among adults globally, although low and middle-income countries are experiencing declines in abstention. The effect of alcohol policies on lifetime abstinence is poorly understood. The International Alcohol Control (IAC) policy index was developed to benchmark and monitor the uptake of effective alco...

Background This study is the ninth cross‐sectional community study of fetal alcohol spectrum disorders (FASD) conducted by the multidisciplinary Fetal Alcohol Syndrome Epidemiology Research team in the Western Cape Province of South Africa. It is the third comprehensive study of FASD in a rural, agricultural region of South Africa. Methods Populat...

Background. Alcohol use was one of the leading contributors to South Africa (SA)’s disease burden in 2000, accounting for 7% of deaths and disability-adjusted life years (DALYs) in the first South African Comparative Risk Assessment Study (SACRA1). Since then, patterns of alcohol use have changed, as has the epidemiological evidence pertaining to t...

This paper evaluates the impact of a sudden and unexpected nation-wide alcohol sales ban in South Africa. We find that this policy causally reduced injury-induced mortality in the country by at least 14%. We argue that this estimate constitutes a lower bound on the true impact of alcohol on injury-induced mortality. We also document a sharp drop in...

Background The health risks associated with moderate alcohol consumption continue to be debated. Small amounts of alcohol might lower the risk of some health outcomes but increase the risk of others, suggesting that the overall risk depends, in part, on background disease rates, which vary by region, age, sex, and year. Methods For this analysis,...

Supplementary data

Background Mothers of children with fetal alcohol spectrum disorders tend to have lower weight compared to other mothers. Yet how alcohol and maternal weight may predispose infants to poorer physical growth and neurodevelopmental trajectories is relatively unexplained. Methods South African mothers (n=406) were recruited prenatally and their offsp...

This study developed a measurement tool to assess stringency and ‘on-the-ground’ impact of four key alcohol policy domains to create an alcohol policy index suitable for benchmarking alcohol policy and assessing change over time in middle- and high-income countries. It involved a collaboration between researchers in 12 diverse countries: New Zealan...

Background: South Africa has a high prevalence of heavy episodic drinking (HED). Due to the high levels of alcohol misuse and violence, public hospital intensive care units were often overrun during the COVID-19 pandemic. This research investigated alcohol intake behaviour change during differing levels of lockdown restrictions, which included ban...

Background Over the last 30 years, South Africa has experienced four ‘colliding epidemics’ of HIV and tuberculosis, chronic illness and mental health, injury and violence, and maternal, neonatal, and child mortality, which have had substantial effects on health and well-being. Using data from the 2019 Global Burden of Diseases, Injuries and Risk Fa...

Introduction South Africa experiences significant levels of alcohol-related harm. Recent research suggests minimum unit pricing (MUP) for alcohol would be an effective policy, but high levels of income inequality raise concerns about equity impacts. This paper quantifies the equity impact of MUP on household health and finances in rich and poor dri...

Substance use is a recognized risk factor for HIV acquisition, transmission and progression in South Africa. Persons who use drugs (PWUD) and access specialist substance abuse treatment centers (SSATCs) are a potentially critical target group for HIV services because of the severity of their substance use and associated health risks. SSATCs represe...

Objective To investigate gestational age and growth at birth as predictors of fetal alcohol spectrum disorders (FASD). Methods The sample analyzed here comprises 737 randomly selected children who were assessed for growth, dysmorphology, and neurobehavior at 7 years of age. Maternal interviews were conducted to ascertain prenatal alcohol exposure...

Objectives To quantify the potential impact of minimum unit pricing (MUP) for alcohol on alcohol consumption, spending and health in South Africa. We provide these estimates disaggregated by different drinker groups and wealth quintiles. Design We developed an epidemiological policy appraisal model to estimate the effects of MUP across sex, drinke...

Background: Coronavirus disease-19 (COVID-19) restrictions, particularly relating to the sale of alcohol and hours of curfew, have had a marked effect on the temporal pattern of unnatural deaths in South Africa. Methods. Death data were collected over 68 weeks from January 2020 to April 2021, together with information on the nature of restrictions...

Background: South Africa temporarily banned alcohol and tobacco sales for about 20 weeks during the COVID-19 lockdown. We described changes in alcohol and tobacco consumption after implementation of these restrictions among a small number of participants in a tuberculosis treatment cohort. Method: The timeline follow-back procedure and Fägerstro...

Introduction The objective of this study was to examine the relationship between trauma volume and alcohol prohibition during the COVID‐19 lockdown in South Africa. Methods This was a retrospective analysis of trauma volume from Worcester Regional Hospital in South Africa from 1 January to 28 December 2020. We compared total volume and incidence r...

Background Sexual reproductive health communication between parents and children has been shown to promote safer sexual choices. In many South African households, third-generation female caregivers, often grandmothers or other older females, locally known as gogos , are primary caregivers of children due to parents being deceased or absent. Subsequ...

Issues Sub‐Saharan Africa (SSA) has long been characterised as a region with weak alcohol policies, high proportions of abstainers and heavy episodic drinkers (among drinkers), and as a target for market expansion by global alcohol producers. However, inter‐regional analyses of these issues are seldom conducted. Approach Focusing mainly on the per...

Background: In response to the coronavirus pandemic, lockdown restrictions and a ban on alcohol sales were introduced in South Africa. Objectives. To investigate the impact of lockdown measures on the number of patients who visited a tertiary urban trauma centre. Methods. The period of investigation was from 1 February to 30 June 2020 and was segm...

Introduction and Aims Alcohol use is among the leading risk factors for premature death and morbidity in South Africa. This study sought to identify factors associated with drinking behaviour in on‐ and off‐licensed premises (typical occasion quantity and frequency) among adults in the City of Tshwane, South Africa. Design and Methods A household...

Background Prevalence and characteristics of fetal alcohol spectrum disorders (FASD) have been described previously in this community. Methods Active case ascertainment methods were employed in a new cross-sectional study with Revised Institute of Medicine criteria among first grade students (n = 735) via dysmorphology examinations and neurobehavi...

Summary Background Rigorous analysis of levels and trends in exposure to leading risk factors and quantification of their effect on human health are important to identify where public health is making progress and in which cases current efforts are inadequate. The Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2019 provides a sta...

Background: In an era of shifting global agendas and expanded emphasis on non-communicable diseases and injuries along with communicable diseases, sound evidence on trends by cause at the national level is essential. The Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) provides a systematic scientific assessment of published, publ...

Background Rigorous analysis of levels and trends in exposure to leading risk factors and quantification of their effect on human health are important to identify where public health is making progress and in which cases current efforts are inadequate. The Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2019 provides a standardise...

The authors correctly conclude that the burden from alcohol in Canada is substantially greater than it is from COVID-19, and thus, alcohol should be given more attention. However, they fail to mention that in some countries, with the rise in COVID-19-related hospital admissions, competition can occur between COVID-19 and trauma patients for scarce...

Aims: The objective of the present study was to analyse self-reported and measured chronic diseases and their association with alcohol consumption. Furthermore, the study examined the intensity and patterns of alcohol consumption by lifestyle and socio-demographic characteristics among respondents with chronic diseases.Methods: Secondary data were...

Introduction South Africa has seen a sharp increase in treatment admission trends for opioids despite beliefs that rates of opioid use remain low and do not represent a major problem. To advocate for the extension of Opioid Use Disorder (OUD) treatment and harm minimisation services in South Africa, better estimates of the extent of opioid use is n...

Background: In South Africa, interventions are needed to address the impact of hazardous drinking on antiretroviral therapy among people living with HIV (PLWH). Participant feedback about these interventions can identify ways to enhance their acceptability. We interviewed participants in a randomized controlled trial of a brief motivational interv...

Background This paper examines the degree of agreement among simple dichotomous self-report, validated screening results, and biochemical screening results of prenatal alcohol and other drug use among pregnant women. Method Secondary analysis was conducted on a cohort of pregnant women 16 years or older, presenting for prenatal care in the greater...

In July 2018, under our guidance, IJERPH put out a call for papers to be considered for publication in a Special Issue on “Alcohol and Public Health” [...]

In South Africa, little is known about alcohol consumption patterns, such as drinks consumed, container size, salience of alcohol price, affordability and availability, and perceptions of alcohol policies as potential predictors of heavy episodic alcohol (HED) use among young people. This paper examines predictors of HED among young people with spe...

Sexual reproductive health communication between parents and children has been shown to promote safer sexual choices. Where third generation female caregivers, often grandmothers or other older females, commonly called gogos in South Africa, are primary care givers, the responsibility of talking about sex and related issues has shifted to them. Thi...

Background Sexual reproductive health communication between parents and children has been shown to promote safer sexual choices. Where third generation female caregivers, often grandmothers or other older females, commonly called gogos in South Africa, are primary care givers, the responsibility of talking about sex and related issues has shifted t...

Based on a literature search undertaken to determine the impacts of past public health crises, and a systematic review of the effects of past economic crises on alcohol consumption, two main scenarios—with opposite predictions regarding the impact of the current COVID‐19 pandemic on the level and patterns of alcohol consumption—are introduced. The...

The prevalence and risk factors associated with peripartum psychological distress-a unifying factor among common mental disorders (CMDs)-are not widely understood in underresourced settings. Cross-sectional data were collected from 664 pregnant women who reported for antenatal care at any of one of the 11 midwife and obstetrics units in Cape Town,...

Background: In South Africa, like other low-and middle-income countries, interventions are needed to address the impact of hazardous drinking on adherence to antiretroviral therapy among people living with HIV (PLWH). Participant feedback about these interventions can identify ways to enhance their acceptability and potential impact. As part of a r...

Health promotion - keeping people healthy - is critical to ensuring that South Africa (SA)'s National Health Insurance (NHI) services and funding will not be overwhelmed by having to service and pay for large numbers of people with avoidable disease. Although the 2019 NHI Bill mentions health promotion, its lack of emphasis and the narrow approach...

Background: Medical treatment and detoxification from opiate disorders includes oral administration of opioid agonists. Dihydrocodeine (DHC) substitution treatment is typically low threshold and therefore has the capacity to reach wider groups of opiate users. Decisions to prescribe DHC to patients with less severe opiate disorders centre on its p...

Background Alcohol use has increased globally, with varying trends in different parts of the world. This study investigates gender, age, and geographical differences in the alcohol-attributable burden of disease from 2000 to 2016. Methods This comparative risk assessment study estimated the alcohol-attributable burden of disease. Population-attrib...

Alcohol use is associated with increased risk of developing tuberculosis (TB) disease, yet the impact of alcohol use on TB treatment outcomes has not been summarized. We aimed to quantitatively review evidence of the relationship between alcohol use and poor TB treatment outcomes. We conducted a systematic review of PubMed, EMBASE, and Web of Scien...

Background: People living with HIV (PLWH) who drink alcohol and use tobacco are particularly vulnerable to tobacco-induced diseases due to an already compromised immune system. This study investigated the prevalence and factors associated with tobacco use (cigarette and snuff) among PLWH who drink heavily. Methods: Participants (n = 623) on anti...

Background: Alcohol is one of the highest risk factors for death and disability in South Africa (SA). Objective. To explore the trajectory of empirical research on alcohol in SA between 1969 and 2019, with an emphasis on South African Medical Research Council (SAMRC) authored publications. Methods. We reviewed published research (Pubmed and Africa...