Consumption of illegal home-made alcohol in Malawi: A neglected public health threat

Abstract This study assessed the ethanol and methanol contents of home-made spirit (Kachasu) sold in Blantyre, Malawi. The likelihood of ethanol and methanol toxicity, respectively, was determined through Monte Carlo simulations using reported Kachasu intake volumes of twenty-one consumers and the determined methanol and ethanol contents. Ethanol concentration, in samples from twenty different distillers, ranged from 11 to 55% v/v. Methanol was detected in 10 of the 20 samples (0.01 to 0.28% v/v). The likely mean ethanol intake of drinkers in Blantyre was found to be 214 ± 93 mL per day (90% CI, 6.2 - 472 mL) and mean methanol intake was 0.44 ± 0.37 mL (90% CI, 0 - 2.6 mL). The intake values translated to mean blood ethanol and methanol concentrations of 38 ± 16 mg per mL and 0.05 ± 0.04 mg per mL, respectively. Therefore, the risk of methanol toxicity was considered as negligible. However, there was a high risk of ethanol toxicity. Since production and selling of Kachasu are already illegal in Malawi, enforcement of regulations should be strengthened to reverse the current situation where Kachasu is being distilled and sold openly even within cities. Consumers should also be sensitized about the likely risks associated with consumption of Kachasu in Malawi so that they can make informed choices.