Abstract
BackgroundKhat use is a widely spreading public health problem affecting the most economically productive population areas in Ethiopia. Khat use among students has been linked with mental, physical, social, and psychological problems. Reliable prevalence has not been recognized because of varying published rates. The objective of this systematic review and meta-analysis is to synthesize evidence on the prevalence and potential risk factors of khat use in Ethiopia.MethodsWe found 284 studies of which 266 were removed due to duplication, irrelevant topics, and other reasons, respectively. All studies conducted in Ethiopia on khat chewing among students irrespective of time frame were included. Subsequently, 18 studies were used for synthesis of prevalence. Figures were extracted from published reports, and any lost information was requested from investigators. The quality of the included literature was evaluated by using the Newcastle–Ottawa Scale (NOS). Prevalence was pooled using random-effects meta-analyses. The presence of association was declared using P-values and an odds ratio with a corresponding 95% CI.ResultsThe pooled prevalence of khat use among students was 16.7% (13.7–19.7%). In the subgroup analysis, the highest prevalence was observed in the Oromia region, at 21.1% (15.5%, 26.7%), and an almost equal prevalence of 14.8% (10.6, 18.9) and 14.3% (10.3, 18.3) was observed in Amhara and the Southern Nation, Nationalities, and People’s Region of Ethiopia, respectively. Being male (OR: 2.43 (1.73, 3.13)), being a Muslim religion follower (OR: 2.22 (1.6, 2.8)), being an alcohol user (OR: 2.3 (1.5, 3.0)), khat use by a family member (OR: 1.8 (1.4, 2.2)), peer pressure (OR: 4.4 (3.1, 5.6)), and being a cigarette smoker (OR: 8.5 (5.3, 11.7)) were found to be risk factors for khat chewing.ConclusionsKhat use is a common problem among students. Health promotion, awareness on effect of khat, set policy on khat and substance use on the male sex, Muslim religion, alcohol user, having a family-member khat user, peer pressure, and being a cigarette smoker as possible risk factors for khat use among students.LimitationsIrrespective of time restriction, all studies conducted in Ethiopia are included and cross-sectional in nature. Protocol no. CRD-42017081886.
Highlights
Khat use is a widely spreading public health problem affecting the most economically productive population areas in Ethiopia
The remaining 18 articles were used to determine the pooled prevalence of khat chewing in Ethiopia
The pooled prevalence of Khat use was found to be different across regions; it was highest in the Oromia region, 21.10% (15.52, 26.68), and we found a similar prevalence in the Amhara and SNNPs regions, 14.78 (10.6, 18.9) and 14.3 (10.3, 18.3), respectively
Summary
Khat use is a widely spreading public health problem affecting the most economically productive population areas in Ethiopia. Khat has a stimulant effect on the body [5, 6]. The fresh green leaves and young buds are chewed [7] This stimulates both the peripheral and vital nervous system, causing, for instance, insomnia, alertness, anorexia, and increased respiration, body temperature, blood pressure, and heart rate [8]. Khat use has appeared to be a male habit, but women practise it as well [10]. Users start chewing at an early age and develop an uncontrollable habit lasting throughout the lifespan [11]. It is practised based on local customs and traditions [12] and carried out in religious ceremonies [13, 14]
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