Khat Chewer Research Articles

Disparities in risky sexual behavior among khat chewer and non- chewer college students in Southern Ethiopia: a comparative cross-sectional study

BackgroundRisky sexual behavior (RSB) and its consequence among school adolescents and youths have been well understood. It is still a common practice among college and university students living away from their controlling families compounded with the ever-worsening khat chewing habits. However, the relation between khat chewing and RSB is not well studied particularly among college students in Ethiopia. Hence, this study contributes to the literature by examining disparities of RSB among khat chewer and non-chewer students in Southern Ethiopia with the purpose of improving adolescent and youth health.MethodsAn institution-based comparative cross-sectional study was conducted among 1211 college students at Arba Minch town in March 2015. Respondents were selected by employing a simple random sampling technique. Data was collected by using a pre-tested, structured, self- administered questionnaire. The data was entered into Epidata version 3.1 and analyzed using IBM SPSS statistics version 21. Level of statistical significance was declared at a p- value of < 0.05.ResultsThe prevalence of lifetime and current RSB among college students was 40.8 and 36.5% respectively. The lifetime and current prevalence of RSB among khat chewers (82.2 and 30.9%) was significantly higher than non-chewers (74.2 and 27.6%) respectively (P-value = 0.001). Male sex (AOR = 1.82; 95% CI = 1.28, 2.6), urban residence (AOR = 1.63,95% CI = 1.17, 2.28), age of students (AOR = 1.18; 95% CI = 1.09,1.28), living away from family (AOR = 2.45, 95% CI = 1.62,3.7), having high peer pressure (AOR = 2.58, 95% CI = 1.85–3.59), an increase in average grade point (AOR = 0.98, 95% CI = 0.96–0.99), regular attendance of religious institutions (AOR = 0.24, 95%CI = 0.12, 0.42), watching pornographic movies (AOR = 2.51, 95% CI = 1.79,3.51), khat chewing (AOR = 3.02, 95% CI:=1.91,4.76) and alcohol drinking (AOR = 2.26, 95% CI = 1.54,3.35) were factors associated with RSB.ConclusionsConsiderable proportions of students were engaged in khat chewing and RSB. RSB was significantly higher among khat chewers as compared to non- chewers. Comprehensive sexuality education was recommended to college communities and by extension to the ministry of health and education to address the identified factors so that RSB can be reshaped.

Factors Affecting the Virological Response Among Chronic Hepatitis C Virus Patients in Yemen.

Hepatitis C virus (HCV) infection is increasingly seen as a major public health problem, threat, and concern worldwide. In Yemen about 1.7% of the population is infected with chronic hepatitis C. This study aimed to detect the predictors for response to pegylated interferon and ribavirin (Peg-IFN/RBV) in chronic HCV Yemeni patients. The study was conducted on 100 patients with chronic HCV who received Peg-IFN/RBV in the 48th Military Hospital in Sana'a Yemen, from 2011 to 2013. All patients were subjected to complete history taking, thorough clinical examinations, routine laboratory investigation, and abdominal ultrasonography. The HCV RNA was assessed at week 72 of treatment to detect whether the patient achieved sustained virological response (SVR). The SVR was achieved in 64% of the samples. Age above 40, Khat chewing, and obesity were the sociodemographic factors that predict good response for Peg-IFN/RBV combined therapy. Platelet count, alpha feto-protein (AFP), aspartate transaminase (AST), and alanine transaminase (ALT) levels were the basic laboratory investigations that gave favorable response. Significant predictors of sustained response included: older than 40 years (OR = 0.136, P = 0.042), Khat chewer (OR = 0.016, P = 0.008), body mass index (BMI) (OR = 0.055, P = 0.029) and increase in fasting blood glucose (OR = 0.925, P = 0.004), alkaline phosphatase (OR = 0.969, P = 0.001), total and bilirubin (OR = 0.058, P = 0.017), AST (OR = 1.033, P = 0.002), and albumin (OR = 6.490, P = 0.021). Studying the independent variables of response, we revealed that male gender, BMI, ALT >40, AFP >10, viremia >600, and hemoglobin and thyroid stimulating hormone (TSH) levels are variables associated with failure of end of treatment response (ETR) and SVR.

Depression, anxiety, stress, and their associated factors among Jimma University staff, Jimma, Southwest Ethiopia, 2016: a cross-sectional study.

BackgroundWorldwide, approximately 450 million people suffer from mental disorders. Of these, approximately 150 million are affected with depression. Depression, anxiety, and stress have an impact on productivity, motivation to work, sleep behavior of the individual, and outcome of different chronic diseases. However, till date, there are no studies which evaluated mental health problems among university staff in Ethiopia. Therefore, in this study, we aimed to assess the prevalence of depression, anxiety, stress, and their associated factors among Jimma University staff.MethodsAn institution-based cross-sectional study was conducted among 354 staff of Jimma University from March 24 to April 24, 2016. Stratified simple random sampling technique was used. Pretested interviewer-administered Depression, Anxiety and Stress Scale (DASS-21) questionnaire was used to collect the data. Data were analyzed using SPSS Version 20.0 software.ResultsThe prevalence of depression, anxiety, and stress in this study was found to be approximately 22.9%, 19.2%, and 28.2%, respectively. Being female (adjusted odds ratio [AOR] =2.43, 95% confidence interval [CI] =1.22–4.77), no job satisfaction (AOR =10.59, 95% CI =4.88–22.98), presence of conflict with colleagues (AOR =2.33, 95% CI =1.21–4.49), and khat chewing (AOR =4.99, 95% CI =2.57–9.69) were associated with depression. Presence of conflict with colleagues (AOR =2.46, 95% CI =1.25–4.85), no job satisfaction (AOR =7.12, 95% CI =3.29–15.45), and khat chewing (AOR =2.94, 95% CI =1.52–5.66) were associated with anxiety. Being widowed (AOR =7.46, 95% CI =1.11–50.15), female (AOR =2.72, 95% CI =1.40–5.28), no job satisfaction (AOR =6.69, 95% CI =3.46–12.97), khat chewing (AOR =2.78, 95% CI =1.49–5.21), and presence of conflict with colleagues (AOR =2.93, 95% CI =1.57–5.46) were associated with stress.ConclusionThe burden of depression, anxiety, and stress among Jimma University staff was found to be high. Being female, widowed, or khat chewer or having a history of conflict with colleagues and no job satisfaction were predictors of depression, anxiety, and stress. Therefore, it is recommended to design preventive strategies to reduce the risk of these problems and to minimize the disease burden.

Khat chewing habit produces a significant adverse effect onperiodontal, oral health: A systematic review and meta-analysis.

Although there is a general agreement that a khat chewing habit produces clinicopathological changes in the oral mucosa. However there is no reliable evidence of the effects of a khat chewing habit on the periodontal tissues. Thus, authors aimed to investigate the influence of khat chewing habits on periodontal, oral health, by comparing khat chewers to non-chewers in respect of gingival recession, periodontal pocketing depth and loss of attachment. A systematic review and meta-analysis were conducted based on the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. We searched PubMed, the Cochrane Library, Web of Science, Scopus and grey literature. The inclusion criteria were all studies with aims of comparing khat chewers and/or sides to non-chewers and/or sides in respect of gingival recession, periodontal pocketing depth and loss of attachment. For continuous data, we computed weighted mean difference or standard mean difference analyses. An odds ratio using a random effect model was used if heterogeneity was detected; otherwise, a fixed effects model with a 95% confidence interval was used for continuous data. Two subgroups were analysed: khat chewers vs non-chewers and khat chewer sides vs non-chewer sides of the chewer's individuals. A total of 6373 participants were enrolled in 12 studies (khat chewers=3812, non-chewers=2561). There were statistically significant differences between khat and non-chewers in both subgroup analyses regarding gingival recession, periodontal pocketing depth and loss of attachment (P<.05). The odds ratios for khat chewers compared to non-chewers, in respect of depth of periodontal pocket and gingival recession were 4.797 and 6.853 respectively. The results of this meta-analysis have shown that the khat chewing habit produces a destructive and adverse effect on periodontal, oral health.

Incidence of Severe Malaria Syndromes and Status of Immune Responses among Khat Chewer Malaria Patients in Ethiopia.

Although more emphasis has been given to the genetic and environmental factors that determine host vulnerability to malaria, other factors that might have a crucial role in burdening the disease have not been evaluated yet. Therefore, this study was designed to assess the effect of khat chewing on the incidence of severe malaria syndromes and immune responses during malaria infection in an area where the two problems co-exist. Clinical, physical, demographic, hematological, biochemical and immunological data were collected from Plasmodium falciparum mono-infected malaria patients (age ≥ 10 years) seeking medication in Halaba Kulito and Jimma Health Centers. In addition, incidences of severe malaria symptoms were assessed. The data were analyzed using SPSS (version 20) software. Prevalence of current khat chewer malaria patients was 57.38% (95%CI =53-61.56%). Malaria symptoms such as hyperpyrexia, prostration and hyperparasitemia were significantly lower (P<0.05) among khat chewer malaria patients. However, relative risk to jaundice and renal failure were significantly higher (P<0.05) in khat chewers than in non-khat chewer malaria patients. Longer duration of khat use was positively associated with incidence of anemia. IgM and IgG antibody titers were significantly higher (P<0.05) among khat chewer malaria patients than among malaria positive non-chewers. Although levels of IgG subclasses in malaria patients did not show significant differences (P>0.05), IgG3 antibody was significantly higher (P<0.001) among khat chewer malaria patients. Moreover, IgM, IgG, IgG1and IgG3 antibodies had significant negative association (P<0.001) with parasite burden and clinical manifestations of severe malaria symptoms, but not with severe anemia and hypoglycemia. Additionally, a significant increment (P<0.05) in CD4+ T-lymphocyte population was observed among khat users. Khat might be an important risk factor for incidence of some severe malaria complications. Nevertheless, it can enhance induction of humoral immune response and CD4+ T-lymphocyte population during malaria infection. This calls for further investigation on the effect of khat on parasite or antigen-specifc protective malaria immunity and analysis of cytokines released upon malaria infection among khat chewers.

Khat Chewing During Pregnancy: an Insight on an Ancient Problem Impact of Chewing Khat on Maternal and Fetal Outcome among Yemeni Pregnant Women

This study was conducted to clarify the impact of Khat chewing on maternal and fetal outcomes during pregnancy of Yemeni women. Khat chewing during pregnancy can affect maternal health with a damaging effect on the baby’s health and wellbeing. This study was conducted to clarify the impact of Khat chewing on maternal and fetal outcomes during pregnancy of Yemeni women. This prospective study enrolled 60 regular Khat chewing pregnant women and 120 non-Khat chewing pregnant women, selected from those attended with singleton pregnancy in their first or second trimester from the ANC unit of AL-Gamhouri Teaching Hospital in Taiz (Republic of Yemen). Khat chewer pregnant women were having statistically significant risk of 6 times for preterm labor, 3.83 times for labor induction and statistically insignificant risk of 4.10 times for preeclampsia, 2.78 for blood transfusion and fetal distress, 2.05 for PROM, 2.03 for PPH and perineal tears and 2.02 for IUFD. There is significant lower mean hemoglobin concentration at delivery when compared with the control. Khat chewer pregnant women were having statistically significant risk of 6.56 times for breech presentation; 8.94 times to deliver fetuses with low birth weight (< 2500 gm); 6.0 times for neonatal admission to the ICU and statistically insignificant risk of 3.54 times for perinatal mortality and 2.02 times for congenital malformations. This study concluded that Khat chewing is globally associated with a negative impact on maternal and fetal wellbeing.

Oromandibular dystonia in yemeni patients with khat chewing: a response to botulinum toxin treatment.

Khat-(Catha edulis)related oromandibular dystonia is a difficult-to-treat subset of movement disorders that involve masticatory muscles with diverse and incapacitating manifestations. The aim of this study was to evaluate the efficacy of Botulinum toxin-type A therapy in khat chewer Yemeni patients with oromandibular dystonia. This prospective study included 18 khat-chewers Yemeni patients with refractory oromandibular dystonia, who were subjected to Botulinum toxin-A injection and followed up for 3 months thereafter. Primary efficacy outcome was the global impression scale, and secondary outcome measure was the Unified Dystonia Rating Scale. Patients showed improvement of both efficacy measures, maximum satisfactory responses were detected at the forth week after injection. No major adverse events were detected. Botulinum toxin-A is considered an effective and safe treatment option for refractory oromandibular dystonia in khat-chewers

Khat chewing and health related quality of life: cross-sectional study in Jazan region, Kingdom of Saudi Arabia

BackgroundThe chewing of Khat leaves, a natural psychoactive substance is widely chewed in countries of East Africa and the southern Arabian Peninsula, and is reported to be associated with a range of unfavorable health outcomes including khat dependence. The impact of Khat chewing on Health Related Quality of Life is yet to be explored. Aims: to measure and compare the quality of life of the khat chewers and non-khat chewers using a short form health survey (SF36), and to assess factors associated with Khat chewing using SF36 in a sample of adult population in Jazan region, Kingdom of Saudi Arabia.MethodsA total of 630 participants from two independent male populations of khat chewers and non-khat chewers were recruited into a cross-sectional survey study. A self administrative survey based on the SF-36 questionnaire was used to collect data on measures of health-related quality of life (HRQoL). Socioeconomic data of the respondents were also collected for detailed analysis. Data analysis include: descriptive statistics, reliability tests (Cronbach’s alpha and intraclass correlation coefficient), and bivariate analysis (Chi square and Mann–Whitney U-test) to compare HRQoL of Khat chewers and non-Khat chewers.ResultsThe odds of being a khat chewer were higher in respondents with a lower socioeconomic status. The SF-36 scores were significantly lower in all domains for respondents with khat chewing, indicating that non-khat chewers had higher health perceptions compared with those chewing khat. The overall mean score of HRQoL for non-khat chewers was 92.7% (SD 5.53) compared with 63.5% (SD 21.73) for the khat chewing group. The study had shown good internal consistency and reproducibility across the eight subscales of SF-36 questionnaire (α 0.74-0.95). The Mann–Whitney U-test showed a significant difference between khat chewers and non-khat chewers (P < 0.001).ConclusionsThis study measured and compared the quality of life of khat chewers and non-khat chewers using a generic health survey (SF36). The study had shown that khat chewing is associated with lower quality of life (HRQoL) and lower socioeconomic status. However in future a more refined SF36 developed especially for Khat chewers can provide more useful information.

Khat Chewing among Students of Higher Education in Jazan Region, Saudi Arabia: Prevalence, Pattern, and Related Factors

Objectives. (1) To estimate the prevalence and behavioral patterns of Khat chewing and (2) to investigate factors that influenced the pattern of Khat use among undergraduate students in different higher education institutions in Jazan region, Saudi Arabia. Materials and Methods. A cross-sectional study using a pretested structured self-administered quantitative questionnaire was used to collect data. SPSS version 17 software program was used for data analysis. Results. The overall current Khat chewing prevalence among higher education students was found to be 23.1%, significantly higher among males at 38.5% than among females at 2.1% (P < 0.001). Lifetime Khat chewer students were 24.8% for males at 40.5%, significantly higher compared with females at 3.7% (P < 0.001). Univariate analysis revealed that the gender of student, smoking status of student, a friend's smoking, and Khat chewing were associated with a significant high risk of Khat chewing (P < 0.001 for all). Conclusions. The use of Khat trend is increasing among higher education students in Jazan region. A multilevel, value based, comprehensive, and strategic long-term intervention plan is needed. The comprehensive plan may include social interventions geared by creating recreations alternatives and opportunities for youth and a critical review for current authorities' interventions and services.

Tooth mortality in khat and non khat chewer in Sana'a Yemen

Many health problems of Yemen have been associated with khat. There is a wide spread belief that periodontal disease is more severe in khat chewers than non-chewers. The present investigation was designed to examine tooth mortality and the patterns of tooth loss in khat chewer and non- khat chewer in a selected population in Sana’a -Yemen. A total of 2506 individuals, 1216 males and 1290 females ranging in age from 15 to 64 years were examined. The status of every present permanent tooth was assessed. Individuals who chewed one or two times a week for five years were considered as khat chewer. Individuals with no khat chewing history or chewed less than 5 times in their lifetimes were considered as non-chewer. Female khat chewers had significantly higher teeth loss compared to other sub-groups, irrespective of whether they chewed khat or not. In the 15 to 24 age category, there was no significant difference between male khat and non- khat chewers. Female khat chewers had the highest teeth loss in this age group and it was significantly higher than any other sub-group in this age group. Male khat chewers also had significantly higher teeth loss compared to male non- khat chewers. Female khat chewers had a significantly more lower teeth loss than female non- khat chewers. Present study has shown that khat chewing is a one of the risk factors associated with teeth loss. Khat chewers had significantly higher tooth loss as compared to non khat-chewers. Female khat chewers had a significantly higher teeth loss compared to non- khat chewers (especially in age group 55 to 64). Male khat -chewers had significantly more lower teeth loss compared to other groups. Key words: Tooth mortality, Khat- chewers, Khat- nonchewers, Yemen.

The Prevalence of Khat –Induced Psychotic Reactions among College Students: A Case in Jimma University College of Agriculture

As it may prolong energy and mental alertness, khat has gained popularity among college students. However, many undesirable psychoactive effects khat use are not reported. A dorm-to-dorm survey was carried out from May 5-15, 2006 to investigate the prevalence of khat –induced psychotic reactions among habitual khat chewer students of Jimma University College of Agriculture (JUCA). A total of 210 male students who are habitual khat chewers were identified through dorm-to-dorm survey and who were voluntary to participate were taken for the study. The prevalence of short-lived psychiatric manifestations and other psychological problems following the use of khat are clearly reported by some subjects. Hallucinations are reported by 7.1%, depression by 43.8% and 33.3% of the habitual khat chewers reported the frequent incidence of anxiety following the euphoric sessions. The majority (65.7%) of the samples also mentioned that they are mostly subjected to grandiose fantasies. While 33.3% of the habitual Khat chewers reported the frequency of insomnia, the majority (40.5%) responded that they are free from lack of sleep. Out of 107 sexually active subjects, only 28(16.7%) reported the frequent episode of loss of sexual desire during khat use.42.9% of the habitual khat chewers started khat chewing practice so as to increase their concentration and to help them stay alert through the night. The other 32.9% mentioned that they started it because their friends urged them, while the remaining subjects began khat chewing because of some religious and cultural reasons. While 40% of the subjects are now using khat to overcome stressful academic works, the other 31.4% reported that they are using khat mostly to enjoy with their friends. The rest 23.8% of the habitual khat chewers reported that they are using khat most of the time to be free from anxiety. The case study, involved in this research, had observable and frequent psychiatric manifestations. The subject\'s hospital record showed that he didn\'t have a past psychiatric history or family history of psychiatric illness. As he is subjected to khat–induced psychoses, he was advised to quit khat chewing so that the resolution of symptoms usually occurs within a short period. However, due to his inability to withstand the withdrawal symptoms (such as insomnia, irritability, weakness, dizziness, and the like), he could stop khat use. He was living with clear psychotic reactions by the time this research was conducted. Generally, this research findings implied that khat use has some potential dangers; so, its use needs to be discouraged. Especially, individuals with some psychological disorders should be careful to avoid it, for it may worsen depressive, manic, or psychotic behaviors. Ethiopian Journal of Education and Science Vol. 2 (1) 2006: pp. 63-84