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Gosadi IM, Makeen AM, Alqassim AY, Aqeeli AA, Ryani MA, Bahri AA, Suwaydi HA, Najmi AA, Abualgasem MM. Khat chewing among parents and their children: A potential transgenerational effect. J Family Med Prim Care 2024; 13:903-910. [PMID: 38736817 PMCID: PMC11086802 DOI: 10.4103/jfmpc.jfmpc_1415_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2023] [Revised: 09/26/2023] [Accepted: 10/03/2023] [Indexed: 05/14/2024] Open
Abstract
Background Khat has a stimulating and addictive effect and can induce consequences on the health and socioeconomic status of khat chewers. Objectives This study aims to assess knowledge, attitude, and practice of khat chewing among parents in Jazan and its consequential effect on their children. Methods This cross-sectional investigation was conducted in the Jazan region of Saudi Arabia. Data was collected via a web-based, self-administered questionnaire measuring demographics, knowledge, attitudes, and practices concerning khat chewing. The Chi-square test or Fisher's exact test was used to assess factors associated with khat chewing among parents and its consequential effect on their children. Results A total of 724 parents were included. The sample had an overall good knowledge about the health hazards of khat chewing and an attitude against khat chewing. Nonetheless, the number of parents who reported that they had ever tried khat chewing was 200 (27.6%) and 106 parents (14.6%) confirmed that their children were khat chewers. Additionally, 98 (13.5%) parents declared that they practiced khat chewing in front of their children. Higher frequencies of parents who reported providing khat to their children were identified among parents with higher attitude levels that favor khat chewing (P value = 0.04). Conclusions Efforts should be made to develop targeted preventive and educational strategies to reduce khat chewing among parents who have favorable attitudes toward khat chewing.
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Affiliation(s)
- Ibrahim M. Gosadi
- Department of Family and Community Medicine, College of Medicine, Jazan University, Jazan, Saudi Arabia
| | - Anwar M. Makeen
- Department of Family and Community Medicine, College of Medicine, Jazan University, Jazan, Saudi Arabia
| | - Ahmad Y. Alqassim
- Department of Family and Community Medicine, College of Medicine, Jazan University, Jazan, Saudi Arabia
| | - Abdulwahab A. Aqeeli
- Department of Family and Community Medicine, College of Medicine, Jazan University, Jazan, Saudi Arabia
| | - Majed A. Ryani
- Department of Family and Community Medicine, College of Medicine, Jazan University, Jazan, Saudi Arabia
| | - Ahmed A. Bahri
- Department of Family and Community Medicine, College of Medicine, Jazan University, Jazan, Saudi Arabia
| | - Hassan A. Suwaydi
- Department of Public Health in Jazan, Ministry of Health, Saudi Arabia, Jazan, Saudi Arabia
| | - Abdullah A. Najmi
- Department of Obstetrics and Gynecology, King Fahad Central Hospital, Jazan, Saudi Arabia
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Ferdjallah A, Hassan M. Traditional Somali Diaspora Medical Practices in the USA: A Scoping Review. JOURNAL OF RELIGION AND HEALTH 2023; 62:2412-2435. [PMID: 34812997 DOI: 10.1007/s10943-021-01456-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 10/30/2021] [Indexed: 06/13/2023]
Abstract
Minnesota has the largest Somali diaspora in the world. Uniquely, the Minnesotan Somali diaspora utilizes traditional healing practices along with Western medicine. Therefore, medical providers who regularly interact with Somali patients must be aware of traditional healing practices. A scoping review inclusive of three databases (Embase Classic + Embase, Ovid MEDLINE, PsychINFO) was conducted. Fifty-eight studies met established criteria. Traditional medicine is performed with conventional medicine. Illnesses are acknowledged to be caused by a malfunctioning body, evil eye, and/or zar (possession). Examples of the utilization of dawo dhaqmeed (traditional practices) included ilko dacowo (dental enucleation), khat (catha edulis), guboow (use of a fire-heated object), cupping, xoq (scraping), xidhayn (female genital mutilation), duugto (massage), baan (nutrition), herbs, caano geel (camel milk), Qur'anic healing, prayer, zam zam (holy water), tahliil liquid (blessed water), and amulets. Practices ranged from benign to harmful. Identifying Somali traditional healing practices is the first step in understanding the health of the Somali community in Minnesota.
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Affiliation(s)
- Asmaa Ferdjallah
- Department of Pediatric Hematology/Oncology, University of Minnesota, Minneapolis, USA.
| | - Mohamed Hassan
- Division of Gastroenterology Hepatology and Nutrition, University of Minnesota, Minneapolis, USA
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Im H, Swan LET. Trauma exposure, social functioning, and common mental health disorders in Somali refugee male and female youth: An SEM analysis. Int J Soc Psychiatry 2022; 68:1539-1551. [DOI: https:/doi.org/10.1177/00207640211037726] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/22/2023]
Abstract
Background: Refugee youth often face numerous adversities before and during forced migration. Although experiences vary across settings and subpopulations, common mental disorders are prevalent among refugee youth who are displaced in low- and middle-income countries. It is important to examine how risk factors are intricately linked and contribute to common mental health issues to inform clinical practice and social policy. Aims: This study aims to test the pathways from risk factors previously identified as determinants of Somali refugee youth mental health (i.e. trauma exposure, substance use, social functioning, aggression) to symptoms of PTSD, depression, anxiety, and somatic pains. Method: We collected survey data in 2013, using snowball sampling to recruit Somali refugee youth (15–35 years old) living in Eastleigh, Kenya. We ran three structural equation models to assess paths from trauma exposure to mental health symptoms, through psychosocial factors including substance use, aggression, and functional impairment. We first conducted this analysis with a mixed-gender sample ( N = 305) and then assessed gender differences by running one model for male participants ( n = 124) and another for female participants ( n = 181). Results: In the mixed-gender sample, trauma exposure directly predicted substance use and both directly and indirectly predicted aggression, functional impairment, and mental health symptoms. Substance use directly predicted aggression and functional impairment, and substance use both directly and indirectly predicted mental health symptoms. The split-gender models revealed gender differences, with only functional impairment directly predicting mental health symptoms in the male sample and with many significant direct and indirect pathways in the female sample. Conclusions: This study shows the role of trauma exposure, substance use, aggression, and social functioning in determining mental health outcomes among refugee youth and how CMD symptoms are differently manifested across genders in this population.
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Affiliation(s)
- Hyojin Im
- Virginia Commonwealth University, Richmond, USA
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Atnafie SA, Muluneh NY, Getahun KA, Woredekal AT, Kahaliw W. Depression, Anxiety, Stress, and Associated Factors among Khat Chewers in Amhara Region, Northwest Ethiopia. DEPRESSION RESEARCH AND TREATMENT 2020; 2020:7934892. [PMID: 33062330 PMCID: PMC7533749 DOI: 10.1155/2020/7934892] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/18/2020] [Revised: 08/06/2020] [Accepted: 08/08/2020] [Indexed: 11/18/2022]
Abstract
Individuals with substance use disorder are prone to develop different psychiatric disorders. Substance abuse and associated problems are of current global concern that leads to mental health disorders which contributed about 14% of the global burden of the disease. It has become an epidemic in some parts of the African region with adolescents being the main victims of the ill health and social effects of substance use. This study is aimed at assessing the prevalence of depression, anxiety, and stress and associated factors among khat chewers in the Amhara region, 2019. A community-based cross-sectional study was done from February 14 to April 15, 2019. A purposive sampling technique was used to enroll the subjects. Data was collected using the face-to-face interview technique using the Depression Anxiety Stress Scale 21 (DASS-21) questionnaire. Descriptive statistics and bivariate and multivariate logistic regression were used to summarize the results. p value < 0.05 was considered statistically significant. A total of 478 participants were enrolled in the study with a response rate of 94.1%. The overall prevalence of depression, anxiety, and stress was 27.4%, 40.6%, and 18.8%, respectively. Around 43% of the respondents develop dependency from khat chewing. Working in a private sector, being self-employed, being jobless, spending 90 to 180 minutes and more, chewing 51-100 g and more, and chewing khat more than once per week were positively associated with stress. On the other hand, being a private sector worker, being jobless, completing secondary education, earning 1001-5000 ETB per month, chewing khat more than once per week, being khat dependent, and the presence of chronic illness were positively associated with anxiety. History of chronic illness and being khat dependent were positively associated with depression. The prevalence of depression, anxiety, and stress was high among khat chewers in the Amhara region. Special attention has to be given to khat chewers since khat chewing will double the burden of mental illness. Proper awareness and evaluation activities will reduce the impact of the problem.
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Affiliation(s)
- Seyfe Asrade Atnafie
- Department of Pharmacology, School of Pharmacy, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Niguse Yigzaw Muluneh
- Department of Psychiatry, School of Medicine, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Kefyalew Ayalew Getahun
- Department of Pharmacology, School of Pharmacy, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Asegedech Tsegaw Woredekal
- Department of Pharmacology, School of Pharmacy, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Wubayehu Kahaliw
- Department of Pharmacology, School of Pharmacy, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
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Badedi M, Darraj H, Hummadi A, Najmi A, Solan Y, Zakry I, Khawaji A, Zaylai S, Rajeh N, Alhafaf H, Hakami W, Bakkari A, Kriry M, Dagreri A, Haddad E. Khat Chewing and Type 2 Diabetes Mellitus. Diabetes Metab Syndr Obes 2020; 13:307-312. [PMID: 32104027 PMCID: PMC7024885 DOI: 10.2147/dmso.s240680] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/01/2019] [Accepted: 01/17/2020] [Indexed: 01/05/2023] Open
Abstract
OBJECTIVE Knowledge about the effects of khat chewing on type 2 diabetes mellitus (T2DM) development and glycemic control is very sparse. Emerging data suggest that khat chewing may increase the risk of T2DM occurrence. Therefore, this study aimed to measure the prevalence of khat chewing in Saudi people with T2DM in Jazan, Saudi Arabia and to determine the association of khat chewing with T2DM development and glycemic control in T2DM. METHODS This is an analytical, cross-sectional study that included 472 Saudi participants selected randomly from primary healthcare centers in Jazan, Saudi Arabia. A chi-square test and logistic regression were performed in the statistical analysis. RESULTS The prevalence of khat chewing in Saudi patients with T2DM in Jazan was 29.3%. After adjusting for covariates, khat chewing was significantly associated with T2DM (odds ratio 3.5), indicating that khat chewers had a more than three times higher risk of developing T2DM than those who do not chew khat. However, there was no association between khat chewing and glycemic control in T2DM. CONCLUSION Khat chewing was highly prevalent in Saudi people with T2DM in Jazan, Saudi Arabia. There was an association between khat chewing and the development of T2DM. Establishing the causal association of khat chewing with T2DM development and glycemic control and clarifying the biological role of khat in T2DM are important aims for future studies.
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Affiliation(s)
- Mohammed Badedi
- Jazan Diabetes and Endocrine Center, Ministry of Health, Jazan, Saudi Arabia
| | - Hussain Darraj
- Jazan Diabetes and Endocrine Center, Ministry of Health, Jazan, Saudi Arabia
| | - Abdulrahman Hummadi
- Jazan Diabetes and Endocrine Center, Ministry of Health, Jazan, Saudi Arabia
| | - Abdullah Najmi
- Jazan Health Affairs, Ministry of Health, Jazan, Saudi Arabia
| | - Yahiya Solan
- Jazan Diabetes and Endocrine Center, Ministry of Health, Jazan, Saudi Arabia
| | - Ibrahim Zakry
- Jazan Diabetes and Endocrine Center, Ministry of Health, Jazan, Saudi Arabia
| | - Abdullah Khawaji
- Jazan Diabetes and Endocrine Center, Ministry of Health, Jazan, Saudi Arabia
| | - Sayedah Zaylai
- Jazan Diabetes and Endocrine Center, Ministry of Health, Jazan, Saudi Arabia
| | - Norah Rajeh
- Jazan Diabetes and Endocrine Center, Ministry of Health, Jazan, Saudi Arabia
| | - Hassan Alhafaf
- Jazan Diabetes and Endocrine Center, Ministry of Health, Jazan, Saudi Arabia
| | - Wali Hakami
- Jazan Diabetes and Endocrine Center, Ministry of Health, Jazan, Saudi Arabia
| | - Awaji Bakkari
- Jazan Diabetes and Endocrine Center, Ministry of Health, Jazan, Saudi Arabia
| | - Maryam Kriry
- Jazan Diabetes and Endocrine Center, Ministry of Health, Jazan, Saudi Arabia
| | - Abdulraheem Dagreri
- Jazan Diabetes and Endocrine Center, Ministry of Health, Jazan, Saudi Arabia
| | - Ebrahim Haddad
- Jazan Diabetes and Endocrine Center, Ministry of Health, Jazan, Saudi Arabia
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Berihu BA, Asfeha GG, Welderufael AL, Debeb YG, Zelelow YB, Beyene HA. Toxic effect of khat ( Catha edulis) on memory: Systematic review and meta-analysis. J Neurosci Rural Pract 2019; 8:30-37. [PMID: 28149078 PMCID: PMC5225718 DOI: 10.4103/0976-3147.193524] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023] Open
Abstract
BACKGROUND People use khat (Catha edulis) for its pleasant stimulant effect of physical activity, consciousness, motor, and mental functions. Although there are reports assessing the effect of khat on memory, there was no study based on formal systematic review and meta-analysis. OBJECTIVE We have therefore conducted this meta-analysis to determine the level of evidence for the effect of khat (C. edulis Forsk) on memory discrepancy. METHODS MEDLINE, Cochrane Library, PubMed, Academic Search Complete, SPORTDiscus, ScienceDirect, Scopus, Web of Science, and Google Scholar were searched to retrieve the papers for this review. Keywords utilized across database search were khat, cat, chat, long-term memory, short-term memory, memory deficit, randomized control trial, and cross-sectional survey. The search was limited to studies in humans and rodents; published in English language. RESULT Finding of various studies included in our meta-analysis showed that the effect of acute, and subchronic exposure to khat showed that short-term memory appears to be affected depending on the duration of exposure. However, does not have any effect on long-term memory. CONCLUSION Although a number of studies regarding the current topic are limited, the evidenced showed that khat (C. edulis) induced memory discrepancy.
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Affiliation(s)
- Birhane Alem Berihu
- Department of Anatomy and Histology, Institute of Bio-Medical Sciences, College of Health Sciences, Mekelle University, Mekelle, Ethiopia
| | - Gebrekidan Gebregzabher Asfeha
- Department of Biochemistry and Molecular Biology, Institute of Bio-Medical Sciences, College of Health Sciences, Mekelle University, Mekelle, Ethiopia
| | - Abadi Leul Welderufael
- Department of Pediatrics and Gynecology, School of Medicine, College of Health Sciences, Mekelle University, Mekelle, Ethiopia
| | - Yared Godefa Debeb
- Department of Physiology, Institute of Bio-Medical Sciences, College of Health Sciences, Mekelle University, Mekelle, Ethiopia
| | - Yibrah Berhe Zelelow
- Department of Pediatrics and Gynecology, School of Medicine, College of Health Sciences, Mekelle University, Mekelle, Ethiopia
| | - Hafte Assefa Beyene
- Department of Anatomy and Histology, Institute of Bio-Medical Sciences, College of Health Sciences, Mekelle University, Mekelle, Ethiopia
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Lim SYM, Binti Azidin AR, Ung YT, Al-Shagga M, Alshawsh MA, Mohamed Z, Ong CE, Pan Y. Effect of 95% Ethanol Khat Extract and Cathinone on in vitro Human Recombinant Cytochrome P450 (CYP) 2C9, CYP2D6, and CYP3A4 Activity. Eur J Drug Metab Pharmacokinet 2018; 44:423-431. [DOI: 10.1007/s13318-018-0518-2] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
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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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Nordgren J. “It’s not only Somalis who chew” – Talking through and talking back to khat use discourses in Swedish–Somali organisations. DRUGS-EDUCATION PREVENTION AND POLICY 2017. [DOI: 10.1080/09687637.2017.1336510] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
- Johan Nordgren
- Department of Social Work, Malmo Hogskola, Malmo, Sweden
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Nordgren J. Targeting Khat or Targeting Somalis? A Discourse Analysis of Project Evaluations on Khat Abuse among Somali Immigrants in Scandinavia. NORDIC STUDIES ON ALCOHOL AND DRUGS 2017. [DOI: 10.1515/nsad-2015-0038] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Background In Denmark, Norway and Sweden, the use of the psychoactive plant khat is widely seen as a social and health problem exclusively affecting the Somali immigrant population. Several projects by governmental and municipal bodies and agencies have been initiated to reduce khat use and abuse within this target population. Aim This article analyses the khat abuse discourse as it is presented in evaluation reports describing projects initiated by the social services to reduce khat abuse. Methods Six publicly available and formally evaluated khat projects conducted in the Scandinavian countries were found, and these evaluation reports were subjected to a Foucauldian discourse analysis. The “What's the problem represented to be?” approach was used to generate questions, which were then applied to the material. Results & CONCLUSIONS The problem of khat abuse is represented to be that it is the cause of unemployment, lack of integration and relationship issues among Somali immigrants. The analysis shows that the notion of cultural competence is used instrumentally to govern the target population and that the Somali immigrant group is exclusively targeted. This instrumental use of cultural competence partly places the onus on the “Somali community” itself to reduce khat use, which may engender stigmatisation of Somali immigrants in general. The author maintains that an overreliance on cultural explanations overlooks socioeconomic issues and that the focus should be on potentially problematic patterns of khat use rather than Somali immigrants in general.
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Kassim S, Dalsania A, Nordgren J, Klein A, Hulbert J. Before the ban--an exploratory study of a local khat market in East London, U.K. Harm Reduct J 2015; 12:19. [PMID: 26066043 PMCID: PMC4465728 DOI: 10.1186/s12954-015-0048-z] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2015] [Accepted: 05/13/2015] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Khat is a green leaf with amphetamine-like effects. It is primarily used among people in Africa, the Middle East and in the diaspora communities from these countries. Prior to the prohibition of khat in the UK on 24 June 2014, there was almost no information available on key aspects of the local khat market. METHODS A cross-sectional study was conducted in 2012 using snowball sampling, Privileged Access Interviewing and area mapping in order to identify khat sale establishments. Data was collected via face-to-face interviews using mixed methods for data collection. This included information about the establishments selling khat, khat pricing and its use among different ethnic minority groups, in addition to the potential sale of khat to children and risk assessment (e.g., use of pesticides on khat). RESULTS Five out of seven sellers identified agreed to participate. Sellers described their khat sale establishments as 'community centres' which included, for example, a restaurant basement. The sellers' history of selling khat ranged between 1-15 years and khat's sale took place between 2pm-10pm. Miraa (e.g., Lara) from Kenya was the most popularly used khat variety, sold in pre-wrapped bundles of approximately 250 g costing £3 each and delivered four days a week. Harari (e.g., Owdi) from Ethiopia was sold in 200 g, 400 g and 1 kg bundles, priced between £5 and £20 and delivered two days a week. The primary benefit of khat use was reported to be social interaction. The customers were predominantly adult males of Somali origin. Most sellers claimed a self-imposed ban on sales to children under 18 years old. Khat bundles had no labelling describing variety or weight and sellers had no knowledge of the use of pesticides on khat and did not advertise the risks associated with khat use. CONCLUSIONS Khat selling establishments were businesses that did not adhere to trade standards regulations (e.g., labelling khat bundles). They claimed to provide a community service (facilitating social interaction) to their predominately Somali customers. Without a better understanding of the dynamics of the khat market there is a risk that both health and social needs of the vulnerable populations involved in the market continue to go unaddressed. Future research should track changes in the now illicit khat market in order to evaluate the social and public health implications following the recent changes to the current U.K. regulatory environment regarding khat.
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Affiliation(s)
- Saba Kassim
- Queen Mary, University of London, Barts and The London School of Medicine and Dentistry, Institute of Dentistry, 4 Newark Street, London, E1 2AT, UK.
| | - Asha Dalsania
- Queen Mary, University of London, Barts and The London School of Medicine and Dentistry, Institute of Dentistry, 4 Newark Street, London, E1 2AT, UK.
| | - Johan Nordgren
- Department of Social Work, Malmö University, Malmö, Sweden.
| | - Axel Klein
- Project Office with Egmont, Institute for International Relations, Brussels, Belgium.
| | - Josh Hulbert
- Drugscience, the Independent Scientific Committee on Drugs, London, UK.
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El-Menyar A, Mekkodathil A, Al-Thani H, Al-Motarreb A. Khat use: history and heart failure. Oman Med J 2015; 30:77-82. [PMID: 25960830 DOI: 10.5001/omj.2015.18] [Citation(s) in RCA: 42] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2014] [Accepted: 02/01/2015] [Indexed: 12/15/2022] Open
Abstract
Recent reports suggest that 20 million people worldwide are regularly using khat as a stimulant, even though the habit of chewing khat is known to cause serious health issues. Historical evidence suggests khat use has existed since the 13th century in Ethiopia and the southwestern Arabian regions even before the cultivation and use of coffee. In the past three decades, its availability and use spread all over the world including the United States and Europe. Most of the consumers in the Western world are immigrant groups from Eastern Africa or the Middle East. The global transport and availability of khat has been enhanced by the development of synthetic forms of its active component. The World Health Organization considers khat a drug of abuse since it causes a range of health problems. However, it remains lawful in some countries. Khat use has long been a part of Yemeni culture and is used in virtually every social occasion. The main component of khat is cathinone, which is structurally and functionally similar to amphetamine and cocaine. Several studies have demonstrated that khat chewing has unfavorable cardiovascular effects. The effect on the myocardium could be explained by its effect on the heart rate, blood pressure, its vasomotor effect on the coronary vessels, and its amphetamine-like effects. However, its direct effect on the myocardium needs further elaboration. To date, there are few articles that contribute death among khat chewers to khat-induced heart failure. Further studies are needed to address the risk factors in khat chewers that may explain khat-induced cardiotoxicity, cardiomyopathy, and heart failure.
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Affiliation(s)
- Ayman El-Menyar
- Clinical Medicine, Weill Cornell Medical College, Doha, Qatar ; Cardiology Unit, Ahmed Maher Teaching Hospital, Egypt ; Clinical Research, Hamad Medical Corporation, Doha, Qatar
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Khat Use: What Is the Problem and What Can Be Done? BIOMED RESEARCH INTERNATIONAL 2015; 2015:472302. [PMID: 26064915 PMCID: PMC4433649 DOI: 10.1155/2015/472302] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 07/18/2014] [Revised: 11/05/2014] [Accepted: 12/09/2014] [Indexed: 12/02/2022]
Abstract
The chewing of khat leaves is an established tradition in East Africa but is much less prevalent in other areas of the world and is mostly limited to Somali communities. However, our understanding of what constitutes problematic khat use in the Somali community in Victoria, Australia, is limited. The objectives of this study were to better understand the views of Somali community representatives and primary care practitioners regarding problematic khat use, to consider relevant harm minimisation strategies, and to develop resources to assist individuals with problematic khat use and their families. Qualitative research methods were used to investigate the experiences and perceptions of khat use among Somalis and mainstream primary care practitioners. Six focus groups were conducted with 37 members of the Somali community and 11 primary care practitioners. Thematic analysis was used to analyse transcripts. Various indicators of the problematic use of khat were identified, including adverse physical and mental health effects, social isolation, family breakdown, and neglect of social responsibilities. Potential harm minimisation strategies were identified including the adoption of health promotion through education, outreach to the community, and the use of universal harm minimisation strategies specifically tailored to khat use.
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Bongard S, Nakajima M, al'Absi M. Khat chewing and acculturation in East-African migrants living in Frankfurt am Main/Germany. JOURNAL OF ETHNOPHARMACOLOGY 2015; 164:223-228. [PMID: 25655998 DOI: 10.1016/j.jep.2015.01.034] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/06/2014] [Revised: 01/20/2015] [Accepted: 01/25/2015] [Indexed: 06/04/2023]
Abstract
ETHNOPHARMACOLOGICAL RELEVANCE Khat (Catha edulis, Forsk) is a drug widely used in countries around the Red Sea (East-Africa and Arabian Peninsula). In Germany khat chewing is illegal but nevertheless an often observed habit in immigrants from this region. This study investigates the interrelation between immigrants acculturation processes and traditional khat chewing habits. MATERIALS AND METHODS Sixty-one khat chewers (14 female) from East-African countries were interviewed about their khat chewing habits and acculturation strategy using standardized questionnaires. RESULTS Results indicate that immigrants׳ khat chewing behaviors are similar to what is common in countries with traditional khat use. But khat chewing tended to be less among immigrants who were relatively more oriented towards their cultures of origin. Chewing khat was subjectively considered to help coping with problems, to forget bad memories and to concentrate better. CONCLUSIONS It was concluded that khat chewing serves a functional use of coping with stressful events in the present or in the past within this sample.
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Affiliation(s)
- Stephan Bongard
- Dept. of Psychology Goethe-University Frankfurt, Theodor-W.-Adorno-Platz, PEG, 60323 Frankfurt am Main Germany..
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Alsanusy R, El-Setouhy M. Why would khat chewers quit? An in-depth, qualitative study on Saudi Khat quitters. Subst Abus 2014; 34:389-95. [PMID: 24159910 PMCID: PMC3827665 DOI: 10.1080/08897077.2013.783526] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
Background: Khat chewing, which has many adverse health and social consequences, is highly prevalent and socially accepted in the Jazan region of the Kingdom of Saudi Arabia. Methods: A qualitative study was conducted with 47 adult male former khat users regarding their khat initiation, continuance, and cessation, the amounts of khat they had used, and the health and social consequences of their use and cessation of use. Results: Participants noted a desire to show maturity, ease of availability of khat, and peer pressure as reasons for initiating khat chewing. Many noted long leisure times with little to do as a reason for continuing use. Negative consequences of khat use were seen in economic, health, familial, and sexual areas of their lives. After quitting khat use, participants saw improvements in all of these areas. Conclusions: A comprehensive community development program (CCDP) tackling, among other issues, the normalization of khat use, substantial leisure times with few positive activities, and misinformation about the “benefits” of khat use, as well as developing peer and family training programs to help prevent or stop khat use, would be useful to reduce khat chewing in this community.
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Affiliation(s)
- Rashad Alsanusy
- a Substance Abuse Research Center (SARC) , Jazan University , Jazan , Kingdom of Saudi Arabia
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Sheikh KA, El-Setouhy M, Yagoub U, Alsanosy R, Ahmed Z. Khat chewing and health related quality of life: cross-sectional study in Jazan region, Kingdom of Saudi Arabia. Health Qual Life Outcomes 2014; 12:44. [PMID: 24708622 PMCID: PMC3977689 DOI: 10.1186/1477-7525-12-44] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2013] [Accepted: 03/29/2014] [Indexed: 12/04/2022] Open
Abstract
Background The 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. Methods A 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. Results The 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). Conclusions This 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.
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Thomas S, Williams T. Khat (Catha edulis): A systematic review of evidence and literature pertaining to its harms to UK users and society. ACTA ACUST UNITED AC 2013. [DOI: 10.1177/2050324513498332] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
The use of khat ( Catha edulis) has been associated with a large number of physiological and societal harms, leading to calls for it to be controlled in the UK. The evidence of these harms is often equivocal, limited by confounding factors, or entirely anecdotal: high-powered, quality-controlled studies are lacking. Regardless, the body of relevant literature indicates that the once socially-regulated use of khat has been eroded. Some individuals have developed excessive consumption patterns, either using khat daily or in binge-sessions, though daily consumption is not necessarily problematic per se. The majority of users seem to use khat in moderation, where the associated harms appear low. For excessive users, harms associated with khat are greater, particularly relating to mental health. Social harms also seem to be largely related to excessive khat use rather than khat use itself. Even in cases of excessive khat use, however, causal relationships between chewing and harms have not been described. More research is required to establish the role of khat in liver disease, coronary problems, cancers of the digestive tract and incidents of domestic violence. Studies should consider the likeliness that certain users are more vulnerable to developing patterns of excessive khat use due to an interwoven set of factors such as social health determinants and pre- and post-migration experiences.
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Nordgren J. The moral entrepreneurship of anti‐khat campaigners in Sweden – a critical discourse analysis. DRUGS AND ALCOHOL TODAY 2013. [DOI: 10.1108/17459261311310817] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Kumar R, Einstein G. Cardiovascular Disease in Somali Women in the Diaspora. CURRENT CARDIOVASCULAR RISK REPORTS 2012. [DOI: 10.1007/s12170-012-0233-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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