INTRODUCTION:
Alcohol use disorder (AUD) imposes a substantial burden on public health and the economy globally, particularly in low- and middle-income countries (LMICs) like Ethiopia. Traditional fermented beverages such as Tella, Tej, and Areki are widely consumed in Ethiopia, but lack standardized measurement, making it challenging to quantify alcohol intake accurately in research and clinical settings. This study aims to assess the ethanol content of traditional Ethiopian alcoholic beverages and to develop a contextually appropriate method for converting local drink volumes into standard drinks (SDs).

METHODS:
A review of 10 studies was conducted using PubMed and Google Scholar, targeting literature on the alcohol content of Ethiopian traditional beverages. Fieldwork was conducted in Debre Berhan to measure the volume of local drinking vessels and calculate SDs using WHO conversion formulas.

RESULTS:
Ethanol content varied widely across beverage types and regions. The average alcohol contents of Tella, Tej, and Areki were 1.6%-11.5%, 7.0%-13.4%, and 22.0%-51.2%, respectively. This finding implies that ethanol concentration is equivalent to beer, wine, and spirits. Show cards illustrating SD equivalents were developed and integrated into the AUDIT tool for enhanced data collection.

CONCLUSIONS:
Standardizing the measurement of traditional drinks is essential for improving the accuracy of alcohol consumption estimates. Expanding this work nationally will strengthen alcohol-related research, surveillance, and interventions in Ethiopia.