Association between early alcohol use and academic achievement among primary school children in Uganda: a cross-sectional study

Child alcohol use is a public health concern in Uganda. This study assessed academic achievement skills and their association with alcohol use among primary school children in Mbale district, Uganda. This cross-sectional study assessed academic achievement skills (word reading, sentence comprehension, spelling, and math computation) in 6–13-year-old primary school children using the Wide Range Achievement Test, Fifth Edition (WRAT-5). Participants from grades 1–7, were randomly selected from 38 primary schools. Raw WRAT-5 scores were standardized to age- and sex-adjusted z-scores to enable meaningful comparisons across subgroups. Alcohol use was assessed using the validated Uganda–Lumasaaba version of the CRAFFT screening tool, while socio-demographic information was obtained through a structured questionnaire previously employed in studies using the same dataset. Data analysis was conducted in STATA 18. Multiple linear regression models were applied to examine the association between alcohol use and academic outcomes, adjusting for demographic, familial, and school-related factors. Of the 460 primary school children assessed, 25.2% reported alcohol use in the past 12 months; 56.6% were girls, and 70.9% were aged 10–13 years. Children who reported alcohol use performed significantly worse than non-users in multiple academic domains, with lower scores in word reading (–0.98, 95% CI: − 1.69 to − 0.28), spelling (–1.23, 95% CI: − 2.44 to − 0.14), and sentence comprehension (–0.14, 95% CI: − 0.59 to − 0.02). No significant differences were observed between the two groups in math computation scores. Among alcohol users, male gender, rural residence, and informal caregiver employment were associated with lower academic achievement. Among non-users, harmful parental drinking was a risk factor, while higher parental education appeared to be protective. Alcohol use among primary school children was associated with poorer academic achievement in word reading, spelling, and sentence comprehension, within the broader context of family and socioeconomic adversity. Targeted school- and community-based interventions are recommended to prevent early alcohol use and promote academic achievement, focusing on rural settings and vulnerable households. Longitudinal studies are needed to clarify the causal link between alcohol use and academic performance.