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Wood EA, Case SJ, Collins SL, Stark H, Wilfong T. From traditional to transactional: exploration of khat use in Ethiopia through an interpretative phenomenological analysis. BMC Public Health 2024; 24:1887. [PMID: 39010030 PMCID: PMC11247750 DOI: 10.1186/s12889-024-19357-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2024] [Accepted: 07/04/2024] [Indexed: 07/17/2024] Open
Abstract
Khat, a naturally growing stimulant, has seen a significant increase in both consumption and cultivation in eastern Ethiopia. This reliance on khat in the region comes despite its known physiological complications, with users unable to restrict khat use due to its pervasive impact on their livelihood. This qualitative study sought to understand the meaning that those in eastern Ethiopia attribute to khat and explore their firsthand experiences with the substance. In June and July of 2023, six unstructured interviews were conducted among residents of the Haramaya District in Ethiopia. To promote a holistic comprehension of the participants' lived experiences, an interpretative phenomenological analysis approach was employed when collecting and analyzing the data. Participant responses were coded independently from one another by two different researchers identifying superordinate and corresponding subordinate themes. Among the participants, six superordinate themes were captured: economic backbone of the region, market disruption & fluctuation, pesticide use, societal relationships around khat, applications of khat, and access to healthcare. The participants' responses indicated that the normalization of khat use, coupled with the downplaying of its addictive potential, has established a framework where khat consumption is not only allowed but, in some cases, even encouraged. The unique interplay between communal practice and individual preservation creates a cyclical effect of using khat to supplement energy to farm khat and then sell or stimulate further work on their farm. This study illuminates the transitionfrom what was once the traditional or spiritual use of khat, to a more practical use for ensuring economic livelihood.
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Affiliation(s)
- Elizabeth A Wood
- Eck Institute for Global Health, University of Notre Dame, 921 Flanner Hall, Notre Dame, IN, 46556, USA.
| | - Stuart J Case
- Department of Epidemiology, College of Public Health & Health Professions, University of Florida, 1225 Center Drive, Gainesville, FL, 32611, USA
| | - Sarah L Collins
- Department of Health, Sport & Exercise Sciences, School of Education & Human Sciences, University of Kansas, Lawrence, KS, USA
| | - Heather Stark
- Department of Epidemiology, College of Public Health & Health Professions, University of Florida, 1225 Center Drive, Gainesville, FL, 32611, USA
| | - Tara Wilfong
- School of Public Health, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
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Wood EA, Stark H, Case SJ, Sousa B, Moreno M, Motuma A, Wilfong T. Khat use and related determinants among pregnant women within Haramaya, Ethiopia: a mixed methods study. Front Glob Womens Health 2024; 5:1359689. [PMID: 38784944 PMCID: PMC11112567 DOI: 10.3389/fgwh.2024.1359689] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2023] [Accepted: 04/30/2024] [Indexed: 05/25/2024] Open
Abstract
Introduction Khat, a green leafy plant grown in East Africa and throughout the Arabian Peninsula, is chewed for its psychoactive and amphetamine-like effects, serving as a significant aspect of culture, economic livelihood, and global trade. Khat consumption during pregnancy has been associated with adverse effects, including anemia, premature rupture of membranes, and low birth weight, among others. Methods This cross-sectional, explanatory sequential mixed methods study was conducted in the Haramaya District of eastern Ethiopia using a questionnaire and focus group discussions. Questionnaires assessed socio-demographic information, pregnancy history, and diet, including khat use. Data were analyzed using SPSS v28 to include descriptive statistics, proportions, odds ratios, binary logistic regression, and chi-square analysis. FGDs expanded on the knowledge, attitudes, and practices of khat in the region, including pregnant or lactating women from two different kebeles. Two independent reviewers conducted a qualitative content analysis to examine the qualitative findings from the FGDs. Transcripts from the focus groups were entered into NVivo 14 to aid in capturing salient themes. Results A total of 444 pregnant women with a median age of 25 years completed the questionnaire. Two-thirds of the women, 66.9%, reported currently consuming khat while pregnant, and 72.7% of them reported daily consumption. The FGD analysis resulted in the discovery of five themes: Economic Livelihood, Maternal Significance, Medicinal Implications of Khat, Pesticide Use, and Social and Cultural Applications. Discussion This study revealed an alarming high prevalence of khat consumption among pregnant women in the Haramaya District, highlighting the pressing need for long-term studies to assess the health consequences. The role of khat as both an economic staple and an energy source for daily activities underscores the challenges in curbing its use. The documented health risks associated with the chemicals used in khat cultivation, including cancer, call for interventions to enhance safe agricultural practices in households involved in khat farming.
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Affiliation(s)
- Elizabeth A. Wood
- Eck Institute for Global Health, University of Notre Dame, Notre Dame, IN, United States
| | - Heather Stark
- College of Public Health & Health Professions, University of Florida, Gainesville, FL, United States
| | - Stuart J. Case
- College of Public Health & Health Professions, University of Florida, Gainesville, FL, United States
| | - Barbara Sousa
- College of Public Health & Health Professions, University of Florida, Gainesville, FL, United States
| | - Melanie Moreno
- College of Public Health & Health Professions, University of Florida, Gainesville, FL, United States
| | - Aboma Motuma
- School of Nursing and Midwifery, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Tara Wilfong
- School of Public Health, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
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Hailesellasie G, Oumer A, Asfaw A. Determinants of undernutrition among khat chewing and non-khat chewing male adults in Addis Ababa, Ethiopia: a comparative cross-sectional study. Sci Rep 2024; 14:4679. [PMID: 38409396 PMCID: PMC10897126 DOI: 10.1038/s41598-024-54471-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2023] [Accepted: 02/13/2024] [Indexed: 02/28/2024] Open
Abstract
Khat chewing is a deep-rooted socio-cultural tradition that affects appetite, gastric emptying, and food intake, ultimately influencing nutritional status. Moreover, there is significant variation in lifestyles and ways of living among khat chewing and non-chewing people. However, there is limited evidence on the disaggregated determinants of undernutrition among khat chewers and non-chewers in Ethiopia. A community-based comparative cross-sectional study was conducted with 253 Khat-chewing and 249 non-chewing male adults in Addis Ababa, Ethiopia. Weight and height were measured under standard procedure and used to calculate the body mass index (BMI < 18.5 kg/m2 indicates undernutrition). Variables with p-values below 0.25 in the bi-variable analysis were entered into a multivariable logistic regression model to identify factors associated with undernutrition and to control confounding respectively. An adjusted odds ratio with 95% confidence interval was used to declare the presence and the strength of association between the independent and outcome variable. Statistical significance was declared at a p value of 0.05. In this study, a total of 138 (27.5%: 23.6-31.6%) adult males were undernourished; among them, 78 (32.0%) were khat chewers and 60 (23.9%) were non chewers. Christian religion (AOR = 1.49; 1.02-2.30), vegetable consumption (AOR = 1.69; 95% CI 1.12-2.55) and khat chewing (AOR = 1.60; 1.04-2.45) were independent risk factors for undernutrition. However, none of the above factors showed a statistically significant association among non-khat chewer male adults. In conclusion, undernutrition was a public health concern in male adults in the study area. Frequent consumption of fruits, vegetables and family size of the households were the independent predictors of undernutrition. The practical implication of identifying risk factors of undernutrition among chewers and non-chewers could be helpful in depicting the relevant risk factors by exposure category and helping to further refine intervention packages. In addition, focusing on interventions which can increase the availability and accessibility of fruits and vegetables are important to improve the nutritional status of adult male populations.
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Affiliation(s)
- Genene Hailesellasie
- Department of Public Health, College of Medicine and Health Sciences, Wolkite University, P.O. Box: 07, Gubre, Ethiopia
| | - Abdu Oumer
- School of Public Health, College of Medicine and Health Science, Haramaya University, Harar, Ethiopia
| | - Agize Asfaw
- Department of Public Health, College of Medicine and Health Sciences, Wolkite University, P.O. Box: 07, Gubre, Ethiopia.
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Wogayehu B, Demissie T, Wolka E, Alemayehu M, Daka K. Individual and community-level factors associated with khat ( Catha edulis) use among women of reproductive age in Halaba zone, South Ethiopia: a multilevel mixed effect analysis. Front Psychiatry 2024; 15:1333556. [PMID: 38439793 PMCID: PMC10910081 DOI: 10.3389/fpsyt.2024.1333556] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/05/2023] [Accepted: 01/30/2024] [Indexed: 03/06/2024] Open
Abstract
Introduction There is a paucity of data on factors associated with khat chewing among women of reproductive age using multilevel analysis. Furthermore, the effects of some potential factors like stressful life events, knowledge about and attitude toward the effects of khat have been given little attention and are not well understood. Therefore, this study aimed to examine the prevalence and multilevel factors associated with khat use among women of reproductive age in Halaba zone, South Ethiopia. Methods A community-based cross sectional study was conducted in Halaba zone from February to July, 2023. Systematic random sampling technique was used to include 1573 study participants. The dependent variable was current khat use, which is operationalized as using khat within 30 days preceding the study. An interviewer administered questionnaire was used for the data collection. Results The prevalence of current khat use among women of reproductive age was 65.9% [95%CI (63.5-68.2%)]. Factors significantly associated with khat use were; ages of women 35 and above years [Adjusted Odds Ratio (AOR) = 6.35, 95% CI: (3.62, 11.13)], ever married [AOR = 2.41, 95% CI: (1.10, 5.31)], secondary and above education [AOR = 0.28, 95% CI: (0.15, 0.49)], belong to richer household [AOR = 1.75, 95% CI: (1.12, 2.75)], mass media use [AOR = 3.12, 95% CI: (1.85, 4.81)], low knowledge about khat effects [AOR = 3.12, 95% CI: (1.85, 5.24)], positive attitude towards khat use [AOR = 11.55, 95% CI: (6.76, 19.71)], and strong social support [AOR = 0.43, 95% CI: (0.28, 0.64)] and non-user friend [AOR = 0.31, 95% CI: (0.20, 0.48)]. From the community level variables: rural residence [AOR = 5.06, 95% CI: (1.82, 14.09)] was significantly associated with khat use. Conclusion Khat use among women of reproductive age was found to be very high. From individual-level factors: advanced ages of women, secondary and above education, live in the richer wealth quintile, mass media exposure, low knowledge on khat effects, positive attitude towards khat use, strong social support, and from community-level variables: residing in rural area were significantly associated with khat use. Khat use screening for all women of childbearing age, as well as referral to substance use disorder centers for those women identified as having khat use disorder, should become a standard of care in all health facilities.
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Affiliation(s)
- Biruk Wogayehu
- Department of Public Health, Arbaminch College of Health Sciences, Arbaminch, South Region, Ethiopia
- Department of Public Health, School of Public Health, College of Medicine and Health Sciences, Wolaita Sodo University, Sodo, South Region, Ethiopia
| | - Tsegaye Demissie
- Department of Public Health, School of Public Health, College of Medicine and Health Sciences, Wolaita Sodo University, Sodo, South Region, Ethiopia
| | - Eskinder Wolka
- Department of Public Health, School of Public Health, College of Medicine and Health Sciences, Wolaita Sodo University, Sodo, South Region, Ethiopia
| | - Mekuriaw Alemayehu
- Department of Epidemiology and Biostatistics, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Amhara Region, Ethiopia
| | - Kassa Daka
- Department of Public Health, School of Public Health, College of Medicine and Health Sciences, Wolaita Sodo University, Sodo, South Region, Ethiopia
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Olani AB, Gerbaba M, Getnet M, Soboka M, Decorte T. Is chewing khat associated with mental health disorders? A scoping review of the content and quality of the current evidence base. Subst Abuse Treat Prev Policy 2023; 18:39. [PMID: 37370160 DOI: 10.1186/s13011-023-00545-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2023] [Accepted: 06/05/2023] [Indexed: 06/29/2023] Open
Abstract
BACKGROUND Khat (Catha edulis) is a plant commonly found in the horn of Africa whose leaves are chewed for their psycho-stimulant effects. Several studies have demonstrated the association between khat use and mental health problems. Nevertheless, evidence is mixed and inconsistent, warranting further review of available studies. This scoping review is aimed at investigating the content and quality of evidence base on the associations between khat use and mental health disorders and suggesting avenues for further research. METHODS We used a scoping review methodology to map the existing evidence using PubMed, SCOPUS, Embase, and CINAHL databases. Primary studies focusing on the association between any pattern of khat use and any form of mental health disorders are included. The review focused on all age groups, any study design, all geographical locations, and any publication year. The terms used for searching eligible studies include khat, mental disorders, and various alternative terminologies. Narrative review is employed to present findings. RESULTS 7,121 articles were found, of which 108 were eligible, conducted across 12 different countries. The majority of the studies was done during the last ten years and the studies mostly employed cross-sectional design. About 10 different categories of mental health disorders have been identified as showing associations with khat use. Despite many contradictory findings between the studies, most of the evidence base suggests that khat use is associated with mental health disorders. Non-specific psychological distress is the most frequently mentioned mental health problem (reported in 26.9% of the studies). Khat use as a predictor variable is mostly assessed using a 'yes/no' category, and as a result, dose-dependent effects of khat use on mental health are not given much consideration. CONCLUSION Although most of the studies associate khat use with mental health disorders, the causal relationships are inconclusive given the cross-sectional design of the studies, and the presence of potential confounders and several forms of biases. Available studies also report contradictory findings. Further studies are recommended using prospective designs, standardized and valid measures of khat use, and focusing on specific types of mental health disorders.
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Affiliation(s)
- Amanti Baru Olani
- Institute for Social Drug Research, Department of Criminology, Criminal Law and Social Law, Ghent University, Universiteitstraat 4, Ghent, 9000, Belgium.
- Department of Sociology, Jimma University, Jimma, P.O.Box 378, Ethiopia.
| | - Mulusew Gerbaba
- Department of Epidemiology, Institute of Health, Jimma University, Jimma, P.O.Box 378, Ethiopia
| | - Masrie Getnet
- Department of Epidemiology, Institute of Health, Jimma University, Jimma, P.O.Box 378, Ethiopia
| | - Matiwos Soboka
- Department of Psychiatry, Institute of Health, Jimma University, Jimma, P.O.Box 378, Ethiopia
| | - Tom Decorte
- Institute for Social Drug Research, Department of Criminology, Criminal Law and Social Law, Ghent University, Universiteitstraat 4, Ghent, 9000, Belgium
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Halboub E, Alamri AA, Kamili G, Alqahtani AS. Dental caries experience among qat chewers in dental college clinics, Jazan, Saudi Arabia. BMC Oral Health 2023; 23:114. [PMID: 36803499 PMCID: PMC9940438 DOI: 10.1186/s12903-023-02804-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2022] [Accepted: 02/09/2023] [Indexed: 02/22/2023] Open
Abstract
AIMS There is a considerable debate on the impact of qat chewing on dental and oral health. Thereby, this study aimed at assessing the dental caries among qat chewers (QC) and non-qat chewers (NQC) who attend outpatient dental clinics, College of Dentistry, Jazan, Saudi Arabia. MATERIALS AND METHODS A sample of 100 QC and 100 NQC were recruited amongst those attended dental clinics, college of dentistry, Jazan University during the 2018-2019 academic year. Their dental health was assessed by three pre-calibrated male interns using DMFT index. The Care Index, Restorative Index and Treatment Index were calculated. Comparisons between both subgroups were done using independent t test. Multiple linear regression analyses were further conducted to stand on the independent determinants of the oral health among this population. RESULTS QC were unintentionally older (36.55 ± 8.74 years) than NQC (32.96 ± 8.49 years; P = 0.004). Fifty-six percent of QC reported brushing their teeth compared to only 35% (P = 0.001). NQC with university and postgraduate educational levels were more than QC. The mean Decayed [5.91 (5.16)] and DMFT [9.15 (5.87)] were higher among QC compared to NQC [3.73 (3.62) and 6.7 (4.58); P = 0.001 and 0.001, respectively]. The other indices were not different between both subgroups. The multiple linear regression revealed that qat chewing and age, individually or together, as independent determinants for the dental decay, missing, DMFT and TI. CONCLUSION Qat chewing habit has a detrimental impact on dental health. It is associated with higher dental caries and missing teeth, and a lower treatment index.
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Affiliation(s)
- Esam Halboub
- grid.411831.e0000 0004 0398 1027Department of Oral and Maxillofacial Surgery and Diagnostics Sciences, College of Dentistry, Jazan University, Jazan, Saudi Arabia
| | - Abdulwahab Ahmed Alamri
- grid.411831.e0000 0004 0398 1027Dental Intern, Internship Program, College of Dentistry, Jazan University, Jazan, Saudi Arabia
| | - Ghazi Kamili
- grid.411831.e0000 0004 0398 1027Dental Intern, Internship Program, College of Dentistry, Jazan University, Jazan, Saudi Arabia
| | - Ahmed Shaher Alqahtani
- Department of Oral and Maxillofacial Surgery and Diagnostics Sciences, College of Dentistry, Jazan University, Jazan, Saudi Arabia.
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Hirpa S, Fogarty AW, Addissie A, Bauld L, Frese T, Unverzagt S, Kantelhardt EJ, Getachew S, Deressa W. Prevalence and risk factors for tobacco, khat, and alcohol consumption among high school students in Ethiopia. BMC Public Health 2023; 23:226. [PMID: 36732737 PMCID: PMC9893175 DOI: 10.1186/s12889-023-15088-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2022] [Revised: 01/13/2023] [Accepted: 01/18/2023] [Indexed: 02/04/2023] Open
Abstract
BACKGROUND Tobacco, khat, alcohol, and marijuana are the main risk factors for non-communicable diseases. There are limited studies on substance use in Ethiopia, especially among secondary school students. This study aims to determine the epidemiology of substance use among secondary school students in Ethiopia. METHODS This cross-sectional study was conducted in March 2020 in four large regions of Ethiopia and the capital Addis Ababa. We collected data from 3,355 grade 9 and grade 10 students in 36 randomly selected high schools. Data were collected on tobacco, khat, alcohol and other substances. Mixed effect logistic regression models were fitted to determine the predictors of cigarette smoking. RESULTS 157 (4.7%) of the participants ever smoked cigarettes and 81 (2.4%) were current smokers. 106 (3.2%) ever used smokeless tobacco, 1,342 (41.8%) had ever drunk alcohol, 290 (8.7%) ever used khat, 137 (4.8%) chewed khat regularly and 76 (2.3%) ever used marijuana. There was a significant regional variation in substance use patterns; cigarette and khat use was the highest in southern regions, whereas alcohol use was highest in the northern areas. Availability of cigarette and khat shops within a 100-meter radius of the school compound was reported by 1,229 (37.5%) and 816 (25%) students, respectively. Three hundred fifty-four (10.9%) students had ever seen someone smoking a cigarette in the school compound. Ever use of smokeless tobacco (Adjusted Odds Ratio (AOR) = 9.4, 95%CI: 4.9-17.9), ever use of shisha (AOR = 8, 95% CI: 3.9-16.3), ever use of khat (AOR = 4.1, 95%CI: 2.5-6.8), ever use of alcohol (AOR = 2.3, 95%CI: 1.4-3.7), having a friend who smoked a cigarette (AOR = 2, 95%CI: 1.2-3.5), and ever seen someone smoking a cigarette in the school compound (AOR = 1.9, 95%CI: 1.1-3.4) were associated with ever use of cigarettes. CONCLUSION Substance use prevalence in Ethiopia has regional variations and prevention strategies should be tailored to the needs of the regions. Although this study reported a lower prevalence of cigarette smoking, students could access cigarettes and khat in nearby school areas. The existing tobacco control laws that prohibit selling tobacco products to children and adolescents under 21 years of age and ban establishing tobacco shops close to school compounds should be enforced.
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Affiliation(s)
- Selamawit Hirpa
- Department of Preventive Medicine, School of Public Health, Addis Ababa University, Addis Ababa, Ethiopia.
- General Practice and Family Medicine, Martin-Luther-University Halle-Wittenberg, Halle, Germany.
- Global Health Working Group, Martin Luther University Halle-Wittenberg, Halle (Saale), Germany.
| | - Andrew W Fogarty
- Division of Epidemiology and Public Health, University of Nottingham, Nottingham, UK
| | - Adamu Addissie
- Department of Preventive Medicine, School of Public Health, Addis Ababa University, Addis Ababa, Ethiopia
- Institute for Medical Epidemiology, Biostatics and Informatics, Martin-Luther-University, Halle-Wittenberg, Germany
| | - Linda Bauld
- Usher institute and SPECTRUM Consortium, University of Edinburgh, Edinburgh, UK
| | - Thomas Frese
- General Practice and Family Medicine, Martin-Luther-University Halle-Wittenberg, Halle, Germany
| | - Susanne Unverzagt
- General Practice and Family Medicine, Martin-Luther-University Halle-Wittenberg, Halle, Germany
| | - Eva J Kantelhardt
- Institute for Medical Epidemiology, Biostatics and Informatics, Martin-Luther-University, Halle-Wittenberg, Germany
- Global Health Working Group, Martin Luther University Halle-Wittenberg, Halle (Saale), Germany
| | - Sefonias Getachew
- Department of Preventive Medicine, School of Public Health, Addis Ababa University, Addis Ababa, Ethiopia
- Institute for Medical Epidemiology, Biostatics and Informatics, Martin-Luther-University, Halle-Wittenberg, Germany
- Global Health Working Group, Martin Luther University Halle-Wittenberg, Halle (Saale), Germany
| | - Wakgari Deressa
- Department of Preventive Medicine, School of Public Health, Addis Ababa University, Addis Ababa, Ethiopia
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Tofu DA, Wolka K. Climate change induced a progressive shift of livelihood from cereal towards Khat (Chata edulis) production in eastern Ethiopia. Heliyon 2023; 9:e12790. [PMID: 36685463 PMCID: PMC9850187 DOI: 10.1016/j.heliyon.2022.e12790] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2022] [Revised: 12/29/2022] [Accepted: 12/30/2022] [Indexed: 01/07/2023] Open
Abstract
Global climate change affects smallholders in sub-Saharan Africa. To cope with the changing situation, farmers employ adaptation strategies such as adjusting their livelihoods. The objective of this research was to evaluate the effects of climate change on the gradual transition in livelihood from cereal production to Khat plantation in west Harareghe, Ethiopia. Data was gathered through interviews with 273 households, 8, focus groups, and 12 key informants. Descriptive statistics and an econometric model were used to analyze quantitative data, whereas content analysis with step preprocesses was utilized to analyze and report qualitative data. . The farm households responded that climatic extremes are posing severe impacts on soil fertility (80%), crop production (93%), livestock production (91%), water scarcity (92%), and adaptive capacity of the farmers (81%). As a result, about 86% of the farmers' have been putting more emphasis and progressively shifting their livelihood from cereal to Khat (Chata edulis) crop plantation. Asides from the shrinking livelihood due to climatic shocks, high market access with better price and profitability, drought and water scarcity tolerance, ability to grow in degraded land, suitability for intercropping and three to five times harvest in a year are mentioned as the blessings attracted farmers' to shift to Khat production. To reduce susceptibility to climate change impacts, approximately 81%, 78%, and 77% of framers, respectively, used managerial (e.g., intercropping and petty trade), technological (e.g., terracing and improved crop variety), and policy-driven (i.e., productive safety net program) strategies. In addition to this, agro-ecology, yield reduction, wealth, perceived on set of rain, soil infertility, access to markets and credit, institutional participation, land size, dependency ratio, irrigation, and access to early warning systems were found to significantly influence the adoption decision of farmers in the study area. Therefore, policy makers and planners are advised to design techniques to manage climate-induced extreme episodes and produce area specific strategies capable to increase the productivity of cereal crop and livestock.
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Affiliation(s)
- Daniel Assefa Tofu
- School of Natural Resource, Ambo University, Ethiopia,Corresponding author.
| | - Kebede Wolka
- Wondo Genet College of Forestry & Natural Resource, Hawassa University, Ethiopia
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Magalhães M, Ojeda A, Mechlowitz K, Brittain K, Daniel J, Roba KT, Hassen JY, Manary MJ, Gebreyes WA, Havelaar AH, McKune SL. Socioecological predictors of breastfeeding practices in rural eastern Ethiopia. Int Breastfeed J 2022; 17:93. [PMID: 36578078 PMCID: PMC9795740 DOI: 10.1186/s13006-022-00531-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/02/2022] [Accepted: 12/11/2022] [Indexed: 12/29/2022] Open
Abstract
BACKGROUND Estimates by the World Health Organization indicate that over 800,000 global neonatal deaths each year are attributed to deviations from recommended best practices in infant feeding. Identifying factors promoting ideal breastfeeding practices may facilitate efforts to decrease neonatal and infant death rates and progress towards achieving the Sustainable Development Goals set for 2030. Though numerous studies have identified the benefits of breastfeeding in reducing the risk of childhood undernutrition, infection and illness, and mortality in low- and middle-income countries, no studies have explored predictors of breastfeeding practices in rural eastern Ethiopia, where undernutrition is widespread. The aim of this study is to examine predictors of infant feeding practices in Haramaya, Ethiopia, using a multi-level conceptual framework. METHODS This study uses data collected from household questionnaires during the Campylobacter Genomics and Environmental Enteric Dysfunction (CAGED) project among 102 households in the Haramaya woreda, Eastern Hararghe Zone, Eastern Ethiopia, and investigates factors influencing breastfeeding practices: early initiation, prelacteal feeding, and untimely complementary feeding. RESULTS Nearly half (47.9%) of infants in this study were non-exclusively breastfed (n = 96). Generalized liner mixed effects models of breastfeeding practices revealed that prelacteal feeding may be a common practice in the region (43.9%, n = 98) and characterized by gender differences (p = .03). No factors evaluated were statistically significantly predictive of early initiation and untimely complementary feeding (82% and 14%, respectively). Severely food insecure mothers had more than 72% lower odds of early breastfeeding initiation, and participants who self-reported as being illiterate had 1.53 times greater odds of untimely complementary feeding (95% CI, [0.30,7.69]) followed by male children having 1.45 greater odds of being untimely complementary fed compared to female (95% CI,[0.40,5.37]). CONCLUSIONS This study found high rates of prelacteal feeding and low prevalence of exclusive breastfeeding, with girls more likely to be exclusively breastfed. While no predictors evaluated in this multi-level framework were associated with prevalence of early initiation or complementary feeding, rates may be clinically meaningful in a region burdened by undernutrition. Findings raise questions about gendered breastfeeding norms, the under-examined role of khat consumption on infant feeding, and the complex factors that affect breastfeeding practices in this region. This information may be used to guide future research questions and inform intervention strategies.
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Affiliation(s)
- Marina Magalhães
- grid.15276.370000 0004 1936 8091Department of Biobehavioral Nursing Science, College of Nursing, University of Florida, Gainesville, USA ,grid.168010.e0000000419368956Present address: Department of Pediatrics, Stanford University School of Medicine, Stanford, CA USA
| | - Amanda Ojeda
- grid.15276.370000 0004 1936 8091Department of Animal Sciences, Institute of Food and Agricultural Sciences, University of Florida, Gainesville, USA ,grid.15276.370000 0004 1936 8091Department of Microbiology and Cell Science, University of Florida, Gainesville, USA
| | - Karah Mechlowitz
- grid.15276.370000 0004 1936 8091Department of Environmental and Global Health, College of Public Health, University of Florida, 1225 Center Dr., Gainesville, FL 32603 USA
| | - Kaitlin Brittain
- grid.15276.370000 0004 1936 8091Department of Environmental and Global Health, College of Public Health, University of Florida, 1225 Center Dr., Gainesville, FL 32603 USA
| | - Jenna Daniel
- grid.189967.80000 0001 0941 6502Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, USA
| | - Kedir Teji Roba
- grid.192267.90000 0001 0108 7468School of Nursing and Midwifery, College of Health and Medical Sciences, Haramaya University, Dire Dawa, Ethiopia
| | - Jemal Yousuf Hassen
- grid.192267.90000 0001 0108 7468Department of Rural Development and Agricultural Extension, College of Agriculture and Environmental Sciences, Haramaya University, Dire Dawa, Ethiopia
| | - Mark J. Manary
- grid.4367.60000 0001 2355 7002Department of Pediatrics, School of Medicine, Washington University, St. Louis, USA
| | - Wondwossen A. Gebreyes
- grid.261331.40000 0001 2285 7943Global One Health Initiative, The Ohio State University, Columbus, USA
| | - Arie H. Havelaar
- grid.15276.370000 0004 1936 8091Department of Animal Sciences, Institute of Food and Agricultural Sciences, University of Florida, Gainesville, USA ,grid.15276.370000 0004 1936 8091Emerging Pathogens Institute, University of Florida, Gainesville, USA ,grid.15276.370000 0004 1936 8091Institute for Sustainable Food Systems, University of Florida, Gainesville, USA
| | - Sarah L. McKune
- grid.15276.370000 0004 1936 8091Department of Environmental and Global Health, College of Public Health, University of Florida, 1225 Center Dr., Gainesville, FL 32603 USA ,grid.15276.370000 0004 1936 8091Center for African Studies, University of Florida, Gainesville, USA
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Edwards B, Atkins N. Exploring the association between khat use and psychiatric symptoms: a systematic review. BMJ Open 2022; 12:e061865. [PMID: 35879018 PMCID: PMC9328084 DOI: 10.1136/bmjopen-2022-061865] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
OBJECTIVES Consumption of the drug khat is high across East Africa and the South-Western Arabian Peninsula despite evidence for its adverse psychiatric effects. This systematic review aims to explore cross-sectional research in the field to determine the strength of the association between khat use and psychiatric symptoms METHODS: Six databases were searched in October 2021-Ovid Medline, Embase, APA PsycINFO, CINAHL, Scopus and Proquest-using the following search terms: "khat" OR "qat" OR "qaad" OR "catha" OR "miraa" OR "mairungi" AND "depression" OR "anxiety" OR "mania" OR "psych*" OR "schiz*" OR "mental" OR "hallucinations" OR "delusions" OR "bipolar". Eligible studies were cross-sectional studies of any population or setting comparing the prevalence of psychiatric symptoms in long term or dependent khat users with non-users. The quality of each study was appraised by the Newcastle-Ottawa scale. A meta-analysis was planned using a random effects model to produce an OR with 95% CIs-using the Mantel-Haenszel method-alongside an I2 statistic to represent heterogeneity. The quality of this meta-analysis was appraised using the Grading of Recommendations, Assessment, Development and Evaluations (GRADE) scoring system. RESULTS 35 studies were eligible for inclusion (total participants=31 893), spanning 5 countries (Ethiopia, Somalia, Kenya, Saudi Arabia, UK). Meta-analysis suggests that khat use is associated with an 122% increased prevalence of psychiatric symptoms (OR 2.22, 95% CIs 1.76 to 2.79, p<0.00001, GRADE score: 'very low'). CONCLUSIONS The high heterogeneity of the meta-analysis is likely due to the wide variation between the studies within the evidence base. To perform a more accurate systematic review, further primary studies are needed with standardised measurements of variables, particularly khat consumption. PROSPERO REGISTRATION NUMBER CRD42020224510.
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Affiliation(s)
- Betsy Edwards
- College of Medical and Dental Sciences, University of Birmingham, Birmingham, UK
| | - Naomi Atkins
- College of Medical and Dental Sciences, University of Birmingham, Birmingham, UK
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11
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Hussein YZ, Wondimagegnhu BA, Misganaw GS. The effect of khat cultivation on rural households' income in Bahir Dar Zuria District, Northwest Ethiopia. GEOJOURNAL 2022; 88:1369-1388. [PMID: 35789673 PMCID: PMC9243962 DOI: 10.1007/s10708-022-10697-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Accepted: 05/26/2022] [Indexed: 05/03/2023]
Abstract
The study was conducted to evaluate the effect of khat cultivation on rural households' income in the Bahir Dar Zuria district using cross-sectional data collected from 180 randomly selected respondents, and supported by focus group discussions in two districts of northwest Ethiopia. The data were analyzed by simple descriptive statistics and beta regression. Results from descriptive statistics show that khat contributes the largest (51%) of farmers' income, followed by crop sale (33%), sale of livestock and their products (9%), and off-farm and non-farm activities (7%), Empirical findings from the Beta regression model also show that farming experience, education status, the proportion of land allocated for khat cultivation, total working capital of the household, the density of khat trees planted per hectare, and participation in off-farm and non-farm activity have a significant and positive effect on the proportion of khat income of the households. On the contrary, livestock holding, total asset ownership, and access to mobile phones have a significant and negative influence on the proportion of annual khat income of the households. Hence, the cultivation of khat can have a significant effect on the improvement of rural households' income and standard of living in the districts. However, increased khat production have also serious implications on the market, water resources, and human health. Thus, policymakers need to come up together to understand and devise proper running mechanisms for these controversies of khat production in association with economic, social, and health implications.
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Affiliation(s)
- Yemiamerew Z. Hussein
- Faculty of Agriculture and Environmental Sciences, Debre Tabor University, Debre Tabor, Ethiopia
| | | | - Girmachew S. Misganaw
- College of Agriculture and Environmental Sciences, Bahir Dar University, Bahir Dar, Ethiopia
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12
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Making the “Unthinkable” Thinkable: Fostering Sustainable Development for Youth in Ethiopia’s Lowlands. SUSTAINABILITY 2022. [DOI: 10.3390/su14074239] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Ethiopia’s economic, social, and environmental risks are not distributed equally. Its lowland areas lag behind its upland plateau on myriad development indicators, and they are at much greater risk of climate change impacts. Attending to this imbalance is critical if Ethiopia is to deliver on the Sustainable Development Goals (SDGs) and takes on heightened import given the size of its youth population. This paper draws on qualitative, longitudinal data collected between 2017 and 2022 to explore the diverse and interwoven risks facing adolescents (and their families) living in the lowland areas of the Oromia and Afar regions. While risks—including drought, invasive species, population growth, and restrictive gender norms—are similar across research locations, differences in traditional livelihoods and government investments mean that outcomes are highly varied. In agriculturalist Oromia, improved access to transportation infrastructure in particular has resulted in such improved livelihoods that it is not uncommon for households to prioritise earning over learning. This is especially true for girls. In pastoralist Afar, where many communities have extremely limited access to potable water and education, current and future lives and livelihoods remain truncated. The paper concludes that sustainable development requires that the government of Ethiopia and its partners invest in a twin-track approach that supports households to meet current needs and to invest in the education that positions young people to thrive in the future.
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Perkins JM, Kakuhikire B, Baguma C, Meadows M, Evans CQ, Jurinsky J, Rasmussen JD, Satinsky EN, Ayebare P, Kyokunda V, Juliet M, Bangsberg DR, Tsai AC. Perceived and misperceived norms about khat and/or cannabis use among adults in southwest Uganda. THE INTERNATIONAL JOURNAL OF DRUG POLICY 2022; 101:103527. [PMID: 34890907 PMCID: PMC9272912 DOI: 10.1016/j.drugpo.2021.103527] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2021] [Revised: 10/31/2021] [Accepted: 11/01/2021] [Indexed: 11/19/2022]
Abstract
BACKGROUND Studies from high-income contexts have found evidence that norms about substance use are misperceived. The accuracy of perceived norms about khat and cannabis use in Uganda have not previously been described. METHODS We conducted a population-based study targeting all resident adults across eight villages in southwestern Uganda. Personal khat and/or cannabis use frequency was based on self-report. We measured perceived norms about substance use by eliciting individuals' perceptions about how often most other adult men and most other adult women in their villages used these substances. We compared perceived norms to aggregated village rates of use to assess the extent to which norms were misperceived. We used multivariable Poisson regression to estimate correlates of misperceived norms. RESULTS Among 1626 participants (91% response rate), only 29 men (4%) and 9 women (1%) reported any lifetime use of khat and/or cannabis. However, 695 participants (43%) did not think lifetime abstinence was the norm among men in their villages, and 256 participants (16%) did not think lifetime abstinence was the norm among women. Moreover, 219 participants (13%) incorrectly believed most men in their village regularly used khat and/or cannabis (≥4 times per week). Misperceived norms were present across subgroups and were correlated with larger social networks, symptoms of depression, loneliness, and younger age. CONCLUSION In this study of all adults across 8 villages in rural Uganda, many participants misperceived norms about khat and/or cannabis use. Providing accurate information about prevailing norms in the local population may help prevent initiation of khat and/or cannabis use among adults in this context.
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Affiliation(s)
- Jessica M Perkins
- Peabody College, Vanderbilt University, 230 Appleton Place, Nashville, TN 37203, USA; Vanderbilt Institute of Global Health, 2525 West End Avenue, Nashville, TN 37203, USA.
| | - Bernard Kakuhikire
- Mbarara University of Science and Technology, P.O BOX 1410, Mbarara, Uganda
| | - Charles Baguma
- Mbarara University of Science and Technology, P.O BOX 1410, Mbarara, Uganda
| | - Meredith Meadows
- Peabody College, Vanderbilt University, 230 Appleton Place, Nashville, TN 37203, USA
| | - Claire Q Evans
- Peabody College, Vanderbilt University, 230 Appleton Place, Nashville, TN 37203, USA
| | - Jordan Jurinsky
- Peabody College, Vanderbilt University, 230 Appleton Place, Nashville, TN 37203, USA
| | | | - Emily N Satinsky
- Center for Global Health, Massachusetts General Hospital, 125 Nashua St, Boston, MA 02114, USA
| | - Patience Ayebare
- Mbarara University of Science and Technology, P.O BOX 1410, Mbarara, Uganda
| | - Viola Kyokunda
- Mbarara University of Science and Technology, P.O BOX 1410, Mbarara, Uganda
| | - Mercy Juliet
- Mbarara University of Science and Technology, P.O BOX 1410, Mbarara, Uganda
| | - David R Bangsberg
- Mbarara University of Science and Technology, P.O BOX 1410, Mbarara, Uganda; Oregon Health & Science University-Portland State University School of Public Health, 1880 SW 6th Ave, Portland, OR 97201, USA
| | - Alexander C Tsai
- Mbarara University of Science and Technology, P.O BOX 1410, Mbarara, Uganda; Center for Global Health, Massachusetts General Hospital, 125 Nashua St, Boston, MA 02114, USA; Harvard Medical School, 25 Shattuck St, Boston, MA 02115, USA; Mongan Institute, Massachusetts General Hospital, 100 Cambridge St Suite 1600, Boston, MA 02114, USA
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Khat, a Cultural Chewing Drug: A Toxicokinetic and Toxicodynamic Summary. Toxins (Basel) 2022; 14:toxins14020071. [PMID: 35202099 PMCID: PMC8875844 DOI: 10.3390/toxins14020071] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2021] [Revised: 01/05/2022] [Accepted: 01/17/2022] [Indexed: 12/10/2022] Open
Abstract
Khat (Catha edulis) is a recreational, chewed herbal drug that has been used as a psychostimulant for centuries in East Africa and the Arabian Peninsula, namely in Somalia, Ethiopia, and Yemen. However, the growing worldwide availability of khat has produced widespread concern. The plant comprises a large number of active substances, among which cathinone, cathine, and norephedrine are the main constituents, which can be included in the group of sympathomimetics of natural origin. In fact, these compounds are amphetamine analogues, and, as such, they have amphetamine-like nervous system stimulant effects. Chewing the leaves gives people a sensation of well-being and increases energy, alertness, and self-confidence. The chronic use of khat is, however, associated with severe cardiac, neurological, psychological, and gastrointestinal complications. The psychological dependence and withdrawal symptoms of khat are the reasons for its prolonged use. The aim of this paper is to review current knowledge on the khat plant with toxicokinetic and toxicodynamic perspectives. Namely, this review paper addresses in vitro, in vivo, and human studies. The models used, as well as the concentrations and doses with the respective biological effects, are discussed. Additionally, the main drug interactions involved with khat are described.
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15
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Al-Duais MA, Al-Awthan YS. Khat Chewing and Lipid Profile in Human and Experimental Animals. BIOMED RESEARCH INTERNATIONAL 2021; 2021:6001885. [PMID: 34977243 PMCID: PMC8719995 DOI: 10.1155/2021/6001885] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/25/2021] [Accepted: 12/01/2021] [Indexed: 12/28/2022]
Abstract
BACKGROUND Catha edulis, also known as khat or qat, is a plant that grows in East Africa and southern Arabia. Several millions of people chew the leaves and twigs of khat plant for their central stimulating amphetamine-like effects. Khat chewing is becoming more common in Europe and the United States, owing to worldwide migration. OBJECTIVE This review examines the khat ingredients, global prevalence, and legal status as well as its effects on lipid profile. Methodology. A literature search was performed using PubMed, Scopus, and Google Scholar to collect information within articles published up to April 2021 with the goal of identifying relevant studies. The proposed mechanisms of cathinone effects on total cholesterol and triglyceride were also discussed. CONCLUSION The khat chewing habit is considered as a serious economic and health issue that needs specialized programs to assist those people to quit or reducing this habit.
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Affiliation(s)
- Mohammed A. Al-Duais
- Department of Biochemistry, Faculty of Science, University of Tabuk, Tabuk, Saudi Arabia
- Biochemistry Unit, Chemistry Department, Faculty of Science, Ibb University, Ibb, Yemen
| | - Yahya S. Al-Awthan
- Department of Biology, Faculty of Science, University of Tabuk, Tabuk, Saudi Arabia
- Department of Biology, Faculty of Science, Ibb University, Ibb, Yemen
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16
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Tamene A. Occupational Contact Dermatitis in Employees of Large-Scale Narcotic Crop Farms of Ethiopia: Prevalence and Risk Factors. A Self-Reported Study Using the Nordic Occupational Skin Questionnaire. ENVIRONMENTAL HEALTH INSIGHTS 2021; 15:11786302211048378. [PMID: 34658622 PMCID: PMC8511918 DOI: 10.1177/11786302211048378] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/26/2021] [Accepted: 09/06/2021] [Indexed: 06/13/2023]
Abstract
BACKGROUND Occupational skin diseases are the second leading occupational disease, accounting for almost 25% of all missed workdays. Occupational contact dermatitis (OCD) accounts for 70% to 90% of all skin disorders in the workplace. Only a few occupational epidemiology studies have looked into the prevalence and risk factors of occupation-induced dermatitis among narcotic crop farm workers around the world. Related studies in Ethiopia are even fewer. METHODS A cross-sectional survey was conducted in the Dirashe district of Southern Ethiopia from March 23 to April 12, 2021. Data was collected using a standardized interviewer-administered questionnaire. The history of contact dermatitis was determined using the standardized Nordic Occupational Skin Questionnaire version 2002 (NOSQ-2002). A total of 578 farm laborers took part in the study, which was conducted using a systematic random sampling. Descriptive statistics and multivariable regression were used to characterize the data and identify factors associated with occupational contact dermatitis. RESULT The prevalence of self-reported occupational contact dermatitis in the past 12 months among workers of large-scale Khat farms was (AOR: 67.80%, 95% CI [61.00, 76.23]). In the multivariable regression, being older (AOR: 5.51, 95% CI [1.79, 7.24]), working as a bundle binder (AOR: 5.74, 95% CI [2.12, 15.55]), not wearing personal protective equipment (PPE) (AOR: 2.50, 95% CI [1.64, 3.81]), and having poor knowledge of pesticides use, storage, and disposal methods (AOR: 2.50, 95% CI [1.64, 3.81]) were associated with occupational contact dermatitis. CONCLUSION Contact dermatitis caused by work is very common among Khat farm laborers. Measures to promote safe practices and reduce exposure to hazards, such as removing expired and/or banned chemicals, purchasing alternative pesticides that meet legislative requirements, job rotation and routine training of staff on safe practices, increasing safety signage, and performing risk assessments, as well as improving the quantity and quality of institutional protective equipment supplies may thus contribute to the enhancement of safe work practices.
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Affiliation(s)
- Aiggan Tamene
- Aiggan Tamene, Environmental Health Unit,
School of Public Health, College of Medicine and Health Sciences, Wachemo
University, P.O. Box 667, Hosaena, B51, Ethiopia.
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Woldetsadik D, Simon MP, Knuth D, Hailu H, Gebresilassie A, Dejen A, Düring RA. Exposure to DDT and HCH congeners and associated potential health risks through khat (Catha edulis) consumption among adults in South Wollo, Ethiopia. ENVIRONMENTAL GEOCHEMISTRY AND HEALTH 2021; 43:3597-3613. [PMID: 33594639 PMCID: PMC7886647 DOI: 10.1007/s10653-021-00846-w] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/06/2020] [Accepted: 01/27/2021] [Indexed: 06/12/2023]
Abstract
Khat (Catha edulis) chewing is widespread in the region of East Africa. Even low levels of organochlorine pesticides (OCPs) in khat could induce public health concern. In a market-based study, from five popular khat varieties, a total of 35 composite khat samples were analyzed for dichlorodiphenyltrichloroethane (DDT) and its main transformation products, and four hexachlorocyclohexane (HCH) isomers. Extraction was carried out by quick, easy, cheap, effective, rugged and safe method (QuEChERS). OCP concentrations were determined by head space solid phase microextraction coupled to gas chromatography-mass spectrometry (HS-SPME-GC-MS). Every sample contained β-HCH above the maximum residue limit set by the European Commission. For total DDT, this was the case for 25.7% of the samples. The ratios of (p,p'-DDD + p,p'-DDE) to p,p'-DDT were less than one for 85% of khat samples, demonstrating recent use of DDT in khat farmlands. Conversely, the ratio of β-HCH to total HCH varied from 0.56 to 0.96, implying historical input of technical HCH. Assuming a daily chewable portion of 100 g, dietary intakes of p,p'-DDT, total DDT and total HCH by adults ranged from 3.12 to 57.9, 6.49 to 80.2 and 39.2 to 51.9 ng (kg body weight)-1 day-1, respectively. These levels are below acceptable levels suggested by international organizations. Chewing khat showed lower non-cancer health risk, but showed relatively higher cancer risk in terms of OCPs. Because khat is chewed without being subjected to any treatment, uncertainties associated with estimated intakes and health risks should be low. Therefore, this practice is of great concern.
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Affiliation(s)
- Desta Woldetsadik
- Department of Soil and Water Resources Management, Wollo University, Dessie, Ethiopia
| | - Marcel Pierre Simon
- Department of Soil Science and Soil Conservation, Research Centre for BioSystems, Land Use and Nutrition (iFZ), Justus Liebig University Giessen, Giessen, Germany
| | - Dennis Knuth
- Department of Soil Science and Soil Conservation, Research Centre for BioSystems, Land Use and Nutrition (iFZ), Justus Liebig University Giessen, Giessen, Germany
| | - Hillette Hailu
- Department of Soil and Water Resources Management, Wollo University, Dessie, Ethiopia
| | - Araya Gebresilassie
- Department of Zoological Sciences, Addis Ababa University, Addis Ababa, Ethiopia
| | - Asmare Dejen
- Department of Plant Science, Wollo University, Dessie, Ethiopia
| | - Rolf-Alexander Düring
- Department of Soil Science and Soil Conservation, Research Centre for BioSystems, Land Use and Nutrition (iFZ), Justus Liebig University Giessen, Giessen, Germany
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Rather RA, Berhanu S, Abaynah L, Sultan M. Prevalence of Khat ( Catha edulis) Chewing and Its Determinants: A Respondent-Driven Survey from Hossana, Ethiopia. Subst Abuse Rehabil 2021; 12:41-48. [PMID: 34429682 PMCID: PMC8375584 DOI: 10.2147/sar.s324711] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2021] [Accepted: 08/03/2021] [Indexed: 12/11/2022] Open
Abstract
BACKGROUND Ethiopia is a leading khat producer in East Africa, and almost all regions are involved in khat production. Hossana, a small town in Southern Ethiopia, is also actively involved in khat production and its use. However, very few studies have been conducted to investigate the habit of khat chewing in this area. This study was conducted to assess the prevalence and predictors of khat chewing among Hossana residents. METHODS The study was conducted on 1700 individuals in Hossana town from March 2018 to June 2019. A structured pre-tested self-administered questionnaire was designed and used for data collection. Descriptive statistics and logistic regression were carried out to study the prevalence and predictors of khat chewing in the study area. RESULTS The overall prevalence of khat chewing among the respondents was 58.0% (95% CI 53.4-63.3) of which 68.4% were daily khat users and 31.5% used it occasionally. About 24.7% of females and 75.2% of males had chewed khat. Muslim religion (AOR 2.37; 95% CI 1.58-4.32), male gender (AOR 3.48; 95% CI 2.16-5.61), Older age (AOR 1.36; 95% CI 0.84-2.21), participants having habitual khat chewing friends or a khat chewer family associate (OR 1.70; 95% CI 1.17-2.20) were found to be independent predictors of chewing. CONCLUSION Significant portion of the population in the study area chew khat. Khat use is significantly associated with the Muslim religion, gender, age, and habit of family and friends. Further studies with larger demographic area are warranted from the study area to reproduce these findings.
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Affiliation(s)
- Riyaz Ahmad Rather
- Department of Biotechnology, College of Natural and Computational Science, Wachemo University, Hossana, Ethiopia
| | - Solomon Berhanu
- Department of Biotechnology, College of Natural and Computational Science, Wachemo University, Hossana, Ethiopia
| | - Lemma Abaynah
- Department of Biotechnology, College of Natural and Computational Science, Wachemo University, Hossana, Ethiopia
| | - Mohammed Sultan
- Department of Statistics, College of Natural and Computational Science, Wachemo University, Hossana, Ethiopia
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19
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Ahmed A, Ruiz MJ, Cohen Kadosh K, Patton R, Resurrección DM. Khat and neurobehavioral functions: A systematic review. PLoS One 2021; 16:e0252900. [PMID: 34111184 PMCID: PMC8192015 DOI: 10.1371/journal.pone.0252900] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2021] [Accepted: 05/24/2021] [Indexed: 12/09/2022] Open
Abstract
Background Khat is a plant that is used for its amphetamine-like stimulant properties. However, although khat is very popular in Eastern Africa, Arabian Peninsula, and the Middle East, there is still a lack of studies researching the possible neurobehavioral impairment derived from khat use. Methods A systematic review was conducted to identify studies that assessed the effects of khat use on neurobehavioral functions. MedLine, Scopus, Cochrane, Web of Science and Open Grey literature were searched for relevant publications from inception to December 2020. Search terms included (a) khat and (b) several cognitive domains. References from relevant publications and grey literature were also reviewed to identify additional citations for inclusion. Results A total of 142 articles were reviewed, 14 of which met the inclusion criteria (nine human and five rodent studies). Available human studies suggest that long term khat use is associated with significant deficits in several cognitive domains, including learning, motor speed/coordination, set-shifting/response inhibition functions, cognitive flexibility, short term/working memory, and conflict resolution. In addition, rodent studies indicated daily administration of khat extract resulted in dose-related impairments in behavior such as motor hyperactivity and decreased cognition, mainly learning and memory. Conclusions The findings presented in this review indicates that long-term khat use may be contributing to an impairment of neurobehavioral functions. However, gaps in literature were detected that future studies could potentially address to better understand the health consequences of khat use.
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Affiliation(s)
- Ayan Ahmed
- Faculty of Health and Medical Sciences, School of Psychology, University of Surrey, Guildford, Surrey, United Kingdom
- * E-mail:
| | - Manuel J. Ruiz
- Department of Psychology, University of Extremadura, Badajoz, Badajoz, Spain
| | - Kathrin Cohen Kadosh
- Faculty of Health and Medical Sciences, School of Psychology, University of Surrey, Guildford, Surrey, United Kingdom
| | - Robert Patton
- Faculty of Health and Medical Sciences, School of Psychology, University of Surrey, Guildford, Surrey, United Kingdom
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Tailor A, Pemberton MN, Murphy R, Hegarty AM. Plasma cell mucositis related to qat chewing: a report of 2 cases and review of the literature. Oral Surg Oral Med Oral Pathol Oral Radiol 2020; 131:e65-e70. [PMID: 33158807 DOI: 10.1016/j.oooo.2020.09.009] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2020] [Revised: 09/11/2020] [Accepted: 09/21/2020] [Indexed: 10/23/2022]
Abstract
Plasma cell mucositis is a rare, benign mucosal condition with characteristic histological features of a dense polyclonal plasmacytic infiltrate. A variety of mucosal sites are affected and the presentation varies from a cobblestone to an intensely erythematous, lobulated appearance. Idiopathic cases are well documented and it has been attempted to define the entity as a hypersensitivity reaction, however reports show inconsistencies. The last two decades have highlighted an emerging association between qat (khat) chewing and plasma cell mucositis. This report provides a review of the most pertinent literature and describes two cases intimately related to qat chewing, whereby resolution occurred upon qat cessation. One case requiring systemic steroidal therapy due to severe symptoms. This highlights the need for an increased awareness amongst clinicians of a potential aetiological link between qat and plasma cell mucositis, emphasises the benefit of qat cessation and the scenarios whereby systemic steroidal therapy should be considered.
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Affiliation(s)
- Artysha Tailor
- Specialist Registrar in Oral and Maxillofacial Pathology. Guy's and St Thomas' NHS Foundation Trust, London, UK.
| | - Michael N Pemberton
- University Dental Hospital of Manchester, Manchester University NHS Foundation Trust, Manchester, England
| | - Ruth Murphy
- Consultant in Dermatology, Sheffield Teaching Hospitals NHS Foundation Trust, Royal Hallamshire Hospital, Sheffield, England
| | - Anne M Hegarty
- Oral Medicine, Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, England
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21
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Roba HS, Beyene AS, Irenso AA, Gebremichael B. Prevalence of lifetime substances use among students in Ethiopia: a systematic review and meta-analysis. Syst Rev 2019; 8:326. [PMID: 31837700 PMCID: PMC6911280 DOI: 10.1186/s13643-019-1217-z] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/22/2018] [Accepted: 11/04/2019] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND The use of substances is a growing concern in Ethiopia, and their impacts on younger generation have been a concern of different professionals. Even though students are at high-risk of substance abuse, there is lack of comprehensive evidence for policy decision on substance use among students. Therefore, the aim of this systematic review and meta-analysis was to estimate the prevalence of common substances among students in Ethiopia. METHOD A comprehensive literature searches were done from biomedical databases: PubMed/Medline, African Journal Online, HINARI, Science Direct, and Google Scholar for article published until Dcember 31, 2017, and Addis Ababa Uiversity's electronic library search of unpublished thesis and dissertations. Two authors autonomously selected studies, extracted data, and evaluated quality of studies. The prevalence of lifetime substances use was estimated using the random effects model. Q and I2 statistics were computed to measure the extents of heterogeneity. RESULTS A total 676 study articles were identified from electronic databases, and 28 of them were included in meta-analysis. The analysis revealed that the lifetime prevalence of any substance use was 52.5% (95% CI 42.4-62.4%), khat 24.7% (95% CI 21.8-27.7%), alcohol 46.2% (95% CI 40.3-52.2%), and smoking cigarette 14.7% (95% CI 11.3-18.5%). Significant heterogeneity was observed but there was no significant publication bias. The lifetime prevalence of khat, alcohol, and cigarette smoking among high school vs university students was 22.5% (95% CI 15.2-30.7%) vs 25.1% (95% CI 21.9-28.5%), 41.4% (95% CI 22.1-62.1%) vs 47.8% (95% CI 39.9-55.7%), and 21.5% (95% CI 12.6-32.1%) vs 12.9% (95% CI 10.1-16.0%), respectively. CONCLUSION This meta-analysis highlighted the extent of lifetime prevalence of any substance, khat, alcohol, and cigarettes smoking among students in Ethiopia. Significant percent of high school students have exposed to substances. Policy makers should devise and implement strictly binding regulation to curb widespread of substances around educational institution premises at national level. Priority should be given to intervention strategies that help delay first use of substance to prevent problems later in life. Besides, the problem warrants regular national-level educational institutions based studies focusing on the magnitude, trajectory, and consequences of substance use among students. Systematic review registration: PROSPERO CRD42018082635.
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Affiliation(s)
- Hirbo Shore Roba
- School of Public Health, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Addisu Shunu Beyene
- School of Public Health, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
- Research Center for Generational Health and Ageing, School of Medicine and Public Health, Faculty of Health and Medicine, University of Newcastle, Newcastle, Australia
| | - Asnake Ararsa Irenso
- School of Public Health, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
- Deakin University, School of Exercise and Nutrition Sciences, Burwood, Australia
| | - Berhe Gebremichael
- School of Public Health, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
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An assessment of khat consumption habit and its linkage to household economies and work culture: The case of Harar city. PLoS One 2019; 14:e0224606. [PMID: 31689323 PMCID: PMC6830813 DOI: 10.1371/journal.pone.0224606] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2019] [Accepted: 10/18/2019] [Indexed: 12/16/2022] Open
Abstract
Background This study investigates khat consumption habits and its linkage to the economy of a household and works culture in its ‘homeland,’ Harar. Khat consumption habit includes practices that are performed before, during, and after consuming khat. In Harar, it has permeated the local economy, social, political and spiritual lives. To evaluate how khat consumption habit is related to the economy of a household, this study compares the living standard and characteristics of khat consumers and non-consumers. Methods Both qualitative and quantitative approaches were used. Cluster sampling and lottery methods were used to identify respondents. Data were gathered through individual interviews and non-participant observation. Results The results of the study indicate that khat consumption habit affects the economy of the consumer household by negatively influencing their income usage and time management. Consumer households have significant, additional burdens on their income and time. The average monthly expenditure of a household on khat ceremonies is 1,800 ETB (30% of their income) and consumers spend an average of 112.5 hours monthly on khat related activities only. The habit of khat consumption also negatively associated with the work culture of consumers, as they leave for lunch break early and come back to work late. Conclusion Khat consumption habit does have a linkage to the bad economic situation of consumer households. It places a significant financial and time burdens on individuals, and as a result society. The work and saving culture of khat consumers are negatively affected. Khat consumption forces many into a cycle of borrowing and indebtedness. Concerned bodies should not underestimate the impacts of khat consumption on individuals and society.
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Juju DB, Sekiyama M, Saito O. Food Security of Adolescents in Selected Khat- and Coffee-Growing Areas in the Sidama Zone, Southern Ethiopia. Nutrients 2018; 10:E980. [PMID: 30060510 PMCID: PMC6115914 DOI: 10.3390/nu10080980] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2018] [Revised: 07/19/2018] [Accepted: 07/25/2018] [Indexed: 01/22/2023] Open
Abstract
Whilst pervasive food insecurity exists among adolescents in Ethiopia, the available information is scant and inconsistent. Therefore, the main objective of this cross-sectional study was to contribute to these gaps by assessing the food security of adolescents in the selected khat- and coffee-growing areas. We selected 234 (117 girls and 117 boys) adolescents aged 12⁻18 years via stratified random sampling. We measured the height and weight of the adolescents and asked about their food insecurity experiences. We assessed the prevalence of stunting and thinness using the WHO 2007 growth reference standards. Out of the total, 17 (7.3%) and 30 (12.8%) adolescents were stunted and thin, respectively. In addition, 89 (38.0%) adolescents reported food insecurity experiences and nine (3.8%) were overweight. A regression analyses showed that the stunting was associated with the age of the adolescents and maternal education. Thinness was associated with area, gender, and the number of meals. Food insecurity experiences were associated with health problems in the past 30 days. In general, adolescents from the khat-growing area have better food security than those from the coffee-growing area, and the same is true, gender-wise, for girls compared to boys. We recommend possible interventions primarily for adolescents in coffee-growing areas.
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Affiliation(s)
- Denabo Billo Juju
- United Nations University Institute for the Advanced Study of Sustainability, Tokyo 150-8925, Japan.
| | - Makiko Sekiyama
- National Institute for Environmental Studies, Tsukuba 305-0053, Japan.
| | - Osamu Saito
- United Nations University Institute for the Advanced Study of Sustainability, Tokyo 150-8925, Japan.
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Nakajima M, Molla K, Belachew B, Mohammed A, Hassan A, Kroll J, al'Absi M. Khat Use is Associated with Tobacco, Alcohol, and Illicit Drug Use: A Cross-Sectional Examination in the United States. J Psychoactive Drugs 2017; 49:413-419. [PMID: 28699844 DOI: 10.1080/02791072.2017.1342155] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
No study has systematically examined khat (Catha edulis) use and its linkages with other substance use in the United States. This study provides novel findings related to the associations of khat with other substance use among immigrants in metropolitan areas of Minnesota where large East African communities reside. Using a convenience sampling, a total of 261 individuals completed a brief face-to-face interview during which demographic information and substance use were assessed. The proportion of lifetime and current use were 30% and 6.6% for khat, 35% and 18% for tobacco, 35% and 21% for alcohol, and 13% and 10% for other illicit drugs. Self-report history of khat use was associated with tobacco, alcohol, and other drug use. Tobacco use was related to alcohol and use of other drugs. The results suggest that a history of khat use is useful in identifying individuals who are vulnerable to substance-use-related problems. The findings indicate the need for more research on khat in the U.S.
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Affiliation(s)
- Motohiro Nakajima
- a Assistant Professor, Department of Biobehavioral Health and Population Sciences , University of Minnesota Medical School , Duluth , MN , USA
| | - Kalkidan Molla
- b Research Assistant, Department of Biobehavioral Health and Population Sciences , University of Minnesota Medical School , Duluth , MN , USA
| | - Brook Belachew
- b Research Assistant, Department of Biobehavioral Health and Population Sciences , University of Minnesota Medical School , Duluth , MN , USA
| | - Abduselam Mohammed
- b Research Assistant, Department of Biobehavioral Health and Population Sciences , University of Minnesota Medical School , Duluth , MN , USA
| | - Abdikadir Hassan
- b Research Assistant, Department of Biobehavioral Health and Population Sciences , University of Minnesota Medical School , Duluth , MN , USA
| | - Jerome Kroll
- c Professor Emeritus, Department of Psychiatry , University of Minnesota Medical School , Duluth , MN , USA
| | - Mustafa al'Absi
- d Professor, Department of Biobehavioral Health and Population Sciences , University of Minnesota Medical School , Duluth , MN , USA
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Rhodes T, Abdool R. Drug harms and drug policies in Sub-Saharan Africa: Implementation science and HIV epidemics. THE INTERNATIONAL JOURNAL OF DRUG POLICY 2016; 30:1-6. [PMID: 26997543 DOI: 10.1016/j.drugpo.2016.02.025] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Affiliation(s)
- Tim Rhodes
- London School of Hygiene and Tropical Medicine, UK; National Centre for Social Research on Health, University of New South Wales, Australia.
| | - Reychad Abdool
- Senior HIV Consultant, formerly United Nations Office of Drugs and Crime, Nairobi, Kenya
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