Nutritional status of khat (Catha-edulis) chewing adult males in Nakawa division, Kampala city, Uganda

Abstract

Khat (Catha edulis) also known as “Mairungi” in Uganda, is a green shrub whose leaves are chewed in social gatherings and designated hotspots mainly for its euphoric effect. The socio-economic and health impacts of khat have been previously reported. However, the nutritional implications of khat chewing need to be investigated. A cross-sectional study with a descriptive approach was done to assess the nutritional status of adult male users of khat in the Nakawa division, Kampala city. Using chain sampling, khat users and hot spots were mapped, identified, and listed. Using simple random sampling, 100 khat users were targeted to consent for structured interviews and an assessment of nutritional status over a 3-month persuasion period. Anthropometric data were used to compute the Body Mass Index (BMI) and dietary information was assessed based on food groups consumed and thresholds of Recommended Dietary Allowances (RDA). The degree of relationship among variables was statistically evaluated using, chi-square analyses and the ANOVA test. Statistical significance was considered at P < 0.05. Confidentiality was observed by the use of anonymous questionnaires and coded datasheets. The majority of khat users chewed khat daily 56.0% and mixed khat chewing with other intoxicants such as alcohol 35.0%, cigarettes 15.0%, and cannabis 12.0%. The main driver towards khat chewing in Nakawa was peer pressure 60.0%. The Dietary Diversity Score (DDS) was low, medium and high among 20.0%, 57.0% and 23.0% of khat users, respectively. The DDS was significantly associated with the hours spent on khat chewing X2(4) 10.156, P = 0.025 with most users spending more than four hours, and the frequency of khat chewing X2(4)14.423, P = 0.038. Of the 100 respondents, 26.0% were underweight and 3.0% were overweight. The BMI was significantly associated with age P = 0.029, marital status P = 0.023, frequency of khat chewing P = 0.038, the number of meals P = 0.013 and the dietary diversity scores P < 0.001 in khat users. Khat chewing and its associated habits predispose khat users to a double jeopardy of malnutrition and non-communicable diseases (NCDs). There should be tighter control of khat use through policy and legislation with community-based measures to regulate its demand and supply. Key words: Khat Chewing, Mairungi, Nutritional Status, Body Mass Index, Nakawa, Uganda