Factors affecting current khat chewing among male adults 15-59 years in Ethiopia, 2016: a multi-level analysis from Ethiopian Demographic Health Survey

Determinants of undernutrition among khat chewing and non-khat chewing male adults in Addis Ababa, Ethiopia: a comparative cross-sectional study

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.

Khat chewing and its associated factors among pregnant women in Chiro district, eastern Ethiopia: a community-based study

Introduction

Despite its deleterious consequences, khat chewing is escalating worldwide. However, there is a lack of evidence about the extent of khat chewing among pregnant women in Ethiopia, particularly in the current study area. Therefore, this study aimed to assess the prevalence of current khat chewing and its associated factors among pregnant women in Chiro district, eastern Ethiopia.

Methods

This community-based cross-sectional study was conducted in Chiro district from November 1 to 30, 2022 G.C. Study participants were selected using the systematic random sampling technique. An interview-administered structured questionnaire was used to collect data through a house-to-house survey. The data were entered into EpiData version 3.1 and analyzed in STATA 14 software. Characteristics of study participants were summarized using descriptive analysis, and binary logistic regression was used to identify determinants of khat chewing.

Results

A total of 409 pregnant women participated in this study, with a response rate of 99%. The overall prevalence of khat chewing was 60.4% (95% CI: 55.5%, 65.2%). Religion (AOR: 2.08; 95% CI: 1.13, 3.82), khat cultivation (AOR: 0.43; 95% CI: 0.25, 0.77), partner khat use (AOR: 5.54; 95% CI: 3.11, 9.88), pre-pregnancy khat use (AOR: 9.95; 95% CI: 5.55, 17.81), antenatal care (ANC) visit (AOR: 2.71; 95% CI: 1.41, 5.21), and mental distress (AOR: 4.89; 95% CI: 2.38, 10.02) were significantly associated with current khat chewing.

Conclusion

The majority of pregnant women in the study area practice khat chewing. Thus, accessible and comprehensive pre-conception and pre-natal care incorporating the prevention and management of antenatal khat chewing is crucial to overcome this problem. Provision of mental healthcare involving partners of pregnant women is also important to reduce the extent and impacts of khat chewing during pregnancy. Further longitudinal studies triangulated with qualitative designs are recommended.

Alcohol and khat dual use among male adults in Ethiopia: A multilevel multinomial analysis

INTRODUCTION

Substance use has been a long-standing global public health problem with detrimental physical, psychological, social, and economic consequences at individual and societal levels. Large-scale and gender-specific studies on the dual use of alcohol and khat are limited. This study aimed to estimate the prevalence of dual alcohol and khat use and identify associated factors among male adults in Ethiopia.

METHODS

The present study used data from the 2016 Ethiopian Demographic and Health Survey (EDHS). Prior to data analysis, the data were weighted to ensure a representative sample and obtain a reliable estimate. Multilevel multinomial logistic regression was used to identify the factors associated with alcohol and khat use. Adjusted Odds Ratios (AOR) with 95% confidence interval and P value ≤ 0.05 in the multivariable model were used to identify significant factors associated with alcohol and khat use.

RESULTS

This study included 12,688 participants, of which (80.29%) were from rural areas. The mean age of participants was 30.92 years old. The prevalence of neither Alcohol nor Khat users were (33.2%); 95% Confidence Interval (CI) (32.4-34.1) only Khat users (22.0%); 95% CI (21.2-22.7), only Alcohol users (35.6%); 95% CI (34.7-36.4), and dual Alcohol and Khat users were (9.0%); 95% CI (8.5-9.5). At the individual level: being in the age group of 15-29 years and 30-49years increases the odds of Khat chewing by AOR (95%CI) 2.27 (1.75, 2.89) and 1.55 (1.16, 2.07) times, respectively. At the community level: males from Amhara 3.49(1.91, 6.42), and Tigray 2.7(1.49, 5.05) regions were more likely to drink alcohol.

CONCLUSION

The high prevalence of dual alcohol and khat use implies for greater access to evidence-based treatment. Multiple factors are associated with alcohol and khat use at individual and community levels. All male adults would benefit from targeted preventive strategies.

A qualitative analysis of Ethiopian and Eritrean Americans' initiation and continuation of hookah smoking

Hookah smoking is emerging as a popular social practice and health behavior risk among Ethiopian and Eritrean Americans. This qualitative study was the second phase of a sequential exploratory mixed methods study and examined factors that enable the initiation and facilitate the continuation of hookah smoking among Ethiopian and Eritrean Americans. Semi-structured interviews were conducted with twenty-five Ethiopian and Eritrean American hookah smokers residing in the Washington, DC Metropolitan Area of the United States. Interview questions were guided by the Theory of Planned Behavior and addressed: (1) initiation of hookah smoking, (2) past and current patterns of hookah smoking, and (3) behavioral, control and normative beliefs toward hookah smoking. Several themes were identified under the core constructs of 'factors influencing hookah smoking initiation' and 'factors influencing hookah smoking continuation' such as curiosity, lack of health knowledge, socio-cultural acceptance, accessibility, flavor, physical dependence, physiological effects and social connections. Based on these findings, it is recommended that future prevention activities (e.g. health messages) be embedded into a comprehensive tobacco prevention approach to address individual misperceptions of harm and addiction, community social norms and environmental access around hookah smoking, which contribute to both initiation and continuation in the Ethiopian and Eritrean American populations.

Physical activity can improve diabetes patients' glucose control; A systematic review and meta-analysis

Background

Glycemic control is vital to patient care, and it is still the most important treatment goal for reducing organ damage and other complications associated with diabetes. Physical activity is one of the factors that affects glycemic management. Therefore, the aim of this systematic review and meta-analysis was to find, evaluate, and synthesize the best available information on the link between physical exercise and glycemic control in Ethiopian diabetes patients.

Methods

Pubmed, Science Direct, Google Scholar and African Journals Online were the databases searched. In addition, gray literature were explored. All papers chosen for inclusion in the review underwent a thorough critical appraisal utilizing the Joanna Briggs Institute's standardized critical appraisal instruments (JBI critical appraisal checklist-2017). For statistical analysis and descriptive synthesis, quantitative articles were combined. The Odds ratio and their 95% confidence intervals were generated. Papers that were of excellent quality but lacked the main outcome (physical activity) for meta-analysis were subjected to descriptive synthesis.

Results

The finding of this meta-analysis showed diabetes patients who were physically active had controlled their blood glucose levels by 2.4 times compared to their counter (Odds ratio = 2.40, 95% Confidence Interval = 1.57,3.69). The duration of disease was found to be the most commonly reported predictor for poor glycemic control followed by dietary habits, patients' sex and age.

Conclusion

Physical activity, which is a simple and inexpensive therapy for diabetes patients, can help them control their blood glucose levels. Patients with diabetes who have had it for a long time should be aware of the need of regular physical activity in maintaining blood glucose control.

Profiles and factors associated with schizophrenia in eastern Ethiopia: A matched case-control study

Background

Despite its strong hereditary and genetic connections, there are other factors reported to be linked to schizophrenia, but not well studied in eastern Ethiopia.

Objective

This study was aimed to investigating the potential profiles and factors associated with schizophrenia in eastern Ethiopia.

Materials and methods

A matched case-control study was conducted in two public hospitals from December 1, 2021, to January 30, 2022. Cases were patients with schizophrenia who visited the hospitals, and controls were healthy individuals without any mental illness who visited the same hospitals. A questionnaire was used to collect the data. Cases and controls were matched using age and sex. STATA-14 was used for analysis. A conditional logistic regression with an adjusted odds ratio (AOR) and a 95% confidence interval (CI) was applied to identify the determinants. P-values of <0.05 were used to build the final model as a measure of statistical significance.

Results

The mean age of the study participants group was 28.6 (±8.44) years, mean age for cases was 28.7(±8.5) ranging from 18 to 56 years and the mean age for the controls was 28.4 (±8.5), ranging from 18 to 60 years. About 181 (83.03%) of the participants were male. The odds of having schizophrenia was about 12.2 times higher among participants with family history of mental illness (AOR: 12.21; 95% CI: 4.83-30.00). The odds of having schizophrenia was 4.5 times higher among polysubstance users (AOR: 4.45; 95% CI: 1.28-5.45) and 2.8 times higher among khat consumers (AOR: 2.82; 95% CI: 1.23-6.45) compared to their counterparts.

Conclusion

Our findings show that genetic risk factors as well as some modifiable behaviors are associated to schizophrenia in eastern Ethiopia. At all levels, special attention should be given to those who are at risk.

Prevalence and associated factors of sleep deprivation among Haramaya University students, Ethiopia, 2021: cross-sectional study

Background

Sleep deprivation is the lack of sleep that is associated with an increased risk of cardiovascular illness, diabetes, obesity, cognitive impairment, vehicle accidents, and workplace accidents, as well as being a direct source of daily dysfunction. Despite the fact that some studies have been undertaken, there is a shortage of data on the incidence of sleep deprivation and associated factors among university students in Africa, particularly in Ethiopia, where the study area is located. As a result, the purpose of this study was to determine the incidence of sleep deprivation and its associated factors among Haramaya University students in Eastern Ethiopia.

Methods

A cross-sectional study design was employed among Haramaya University students. A total of 624 students participated in this study. A multistage sampling technique was used to select the participants. A pretested structured self-administered questionnaire was used to collect data. Using Epi Data Version 3.1, the data was checked, coded, entered, and cleaned before being exported to SPSS Version 20 for analysis. Bivariate and multivariate logistic regression analysis was undertaken. For statistical significance, P ≤ 0.001 was used as the cutoff point.

Results

In this study, 586 study participants were participated, with a response rate of 96.2%. Among participants, the majority of 324(55.3%) were males, and the majority of 311(53.1%) were in the age range of 17–20 years with a median age of 19. Most of the study participants were single 561(95.7%). The overall prevalence of sleep deprivation was 68.4% (95% CI: 64.8–72.4). Coffee/tea drinkers (AOR = 2.83, 95% CI:1.17–6.86), Khat chewers (AOR = 2.33, 95%CI: 1.20–4.50), participants with stress (AOR = 3.49,95% CI: 1.22–9.95), participants exposed to moderate stage of anxiety (AOR = 2.87,95% CI:1.14–7.18), and being in the third and fourth study years (AOR = 0.33,95% CI:0.13–0.85) were significantly associated factors with sleep deprivation.

Conclusion

The prevalence of sleep deprivation was found to be high in this study. Coffee/tea users, khat chewers, being stressed, exposed to moderate levels of anxiety, and being in the third and fourth study years were all found to be significantly associated with sleep deprivation.

Geographical variation and correlates of substance use among married men in Ethiopia: spatial and multilevel analysis from Ethiopian Demographic and Health Survey 2016

OBJECTIVE

The use of substances has become one of the world's most serious public health and socioeconomic issues. Most nations in sub-Saharan Africa, including Ethiopia, are undergoing significant economic transitions, creating a favourable environment for socially destructive substance use. This study aimed to determine the geographical variation, prevalence and correlates of substance use among ever-married men in Ethiopia.

DESIGN

A community-based cross-sectional survey was undertaken from 18 January 2016 to 27 June 2016.

DATA SOURCE

Data were used from the 2016 Ethiopian Demographic and Health Survey (EDHS).

DATA EXTRACTION AND ANALYSIS

Data from the 2016 EDHS was used, and a total of 7793 ever-married men were involved in the analysis. The spatial autocorrelation statistic (Global Moran's I) was used to determine whether substance use was dispersed, clustered or randomly distributed. A multilevel logistic regression model was used to identify the correlates with substance use, and statistical significance was declared at p<0.05 and 95% CI.

RESULTS

Of all ever-married men, 72.5% (95% CI 71.5% to 73.4%) were currently using at least one of the three substances (alcohol, cigarettes and chat). The highest hotspot areas of substance use were observed in Ahmara and Tigray regions. The age (adjusted OR, AOR 1.80; 95% CI 1.32 to 2.45), educational status (AOR 0.64; 95% CI 0.51 to 0.82), occupation (AOR 1.36; 95% CI 1.05 to 1.76), watching television (AOR 1.50; 95% CI 1.25 to 1.81) and living in the city (AOR 2.25; 95% CI to 1.36 to 3.74) were individual and community-level correlates found to have a statistically significant association with substance use.

CONCLUSION

In this study, nearly three-fourths of married men used one of the three substances. Given these findings, it is critical to reducing the problem by improving modifiable individual-level variables such as educational status and reducing substance advertising.

Khat Chewing Practice and Associated Factors among Medical Students in Gondar Town, Ethiopia, 2019

Background:

Globally, khat chewing practice becoming an alarming and common among the youth generation, especially in higher educational institutions. It may also lead to frequent misbehavior, poor academic performance, and memory impairment among students. This study aimed to determine the prevalence of khat chewing practice and associated factors among medical students in Gondar town, Ethiopia, 2019.

Method:

A cross-sectional study was employed on 422 medical students. Data were collected using a self-administered questionnaire and analyzed using SPSS 20 software. Stratified followed by random sampling was employed to select the samples. A multivariable logistic regression model was fitted to identify the predictors. P ⩽ .05 was used to select statistically significant factors.

Result:

The current prevalence of khat chewing practice among medical students was 21.5%. The odds of khat chewing practice was higher among males (AOR = 3.353; 95%CI [1.460-7.701]), Muslims (AOR = 6.390; 95%CI [1.903-21.460]), fifth and 6 year students (AOR = 3.391; 95%CI [1.354-8.488]), smokers (AOR = 5.081; 95%CI [1.898-13.601]), alcohol users (AOR = 4.872; 95%CI [2.094-11.332]), students who had khat chewer close friends (AOR = 30.645; 95%CI [12.261-76.589]).

Conclusion:

Since a significant proportion of students were found to be khat chewers, continuous awareness creation on the impact of khat chewing and counseling services are recommended.

Identifying Risk Factors of Breast Cancer Among Women Attending Selected Hospitals of Addis Ababa City: Hospital-Based Unmatched Case-Control Study

Background

Breast cancer, one of the chronic diseases, is the most common cancer among women in the world. In Ethiopia, late-stage breast cancer is widely diagnosed and women have very little access to adequate medication, pain relief, or palliative care. In addition, there are few research on risk factors for breast cancer in Ethiopia. A safer way out of this is to concentrate on prevention; one of the prevention methods is to recognize risk factors sooner. The study therefore aimed to establish risk factors for breast cancer among women in hospitals in the city of Addis Ababa.

Methods

Hospital-based, unmatched case-control research conducted in selected Addis Ababa hospitals from April to September 2017 (Case=110 and Control=110). Data were collected by standardized questionnaires for both cases and controls. Cases were initially detected by mammography screening accompanied by histopathological examinations, while controls were those women who were negative by mammogram testing, stress levels were assessed by perceived stress scale (PSS) and body mass index measured by WHO norm. Summary statistics Computed and binary logistic regression analysis to classify risk factors for breast cancer modified odds ratio (AOR) with 95% confidence interval (CI) calculated.

Results

The participants’ mean age of was 43.80 years (SD ±12.63) and 39.64 years (SD ±12.91) for cases and controls, respectively. Physical activity (AOR=0.2, 95% CI: 0.10, 0.41) was correlated with lower probability of breast cancer, while never breastfeed (AOR=3.4, 95% CI: 1.21, 9.67); menopausal state (AOR=6.8, 95% CI: 1.92, 24.16), and body mass index above 25. 1 kg/m² (AOR=5.9, 95% CI: 2.16, 16.48) were factors risk factors for breast cancer.

Conclusion

This research shows the importance of physical exercise, breastfeeding, menopausal status, and nutritional status in the occurrence of breast cancer. Actions aimed at increasing physical activity, breastfeeding habits and keeping a balanced diet will help to minimize the incidence of breast cancer.

Cone beam computed tomography findings in temporomandibular joint of chronic qat chewers: Dimensional and osteoarthritic changes

The social habit of chewing qat (also known as khat) is widely practised in East Africa and the Arabian Peninsula. It has been linked with various oro-facial conditions, including temporomandibular joint disorders (TMD). This cross-sectional, comparative study sought to investigate the effects of qat chewing on temporomandibular joint (TMJ), using cone beam computed tomography (CBCT). A total of 85 Yemeni males were included. The participants were divided into two groups: Qat chewers (QC; n = 41) and non-qat chewers (NQC; n = 44). Relevant data were obtained using a structured questionnaire and standardised clinical examination. Additionally, CBCT images of the TMJs were obtained, and then, osteoarthritic changes and TMJ dimensions were analysed. SPSS 21 was used for statistical analyses, with a significant level was set at 0.05. Compared to NQC, a significantly higher proportion of QC presented with clinical signs of TMDs. The qualitative CBCT findings revealed significantly higher osteoarthritic changes in QC than in NQC: osteophyte (51.2% vs 22.7%; P = .008), subcortical sclerosis (48.8% vs 27.3%; P = .047), articular surface flattening (46.3% vs 6.8%; P = .009) and subcortical cysts (43.9% vs 4.5%; P < .001). However, CBCT quantitative findings (condylar dimensions) did not show significant differences between the two groups. The chewing side of the QC group showed slightly more changes compared to the non-chewing side. The results demonstrate that qat chewing has detrimental effects on TMJ manifested mainly as osteoarthritic changes. Further large-scale studies are recommended.

Magnitude and predictors of khat use among patients with tuberculosis in Southwest Ethiopia: A longitudinal study

INTRODUCTION

Tuberculosis (TB) is a leading cause of morbidity and mortality in low and middle-income countries. Substance use negatively affects TB treatment outcomes. Our recent study has found that khat use predicted poorer adherence to anti-TB medications. However, there is scarce longitudinal study on predictors of khat use among outpatients with TB, and this study aimed at addressing this research gap.

METHODS

From October 2017 to October 2018, 268 outpatients with tuberculosis on DOTs were enrolled in a longitudinal study from 26 health institutions in Southwest Ethiopia. Structured questionnaires translated into local languages (Afaan Oromoo and Amharic) were used to assess khat use. Patients were followed for six months, and data were collected on three occasions during the follow-up. A generalized linear mixed model was used to identify the relation between khat use and predictors. Model fitness was checked using the Bayesian Information Criterion (BIC). Odds ratio (OR) and 95% CI were used to describe the strength of association between the outcome variable and predictors.

RESULTS

The overall prevalence of khat use at baseline and first follow up was 39.2% while it was 37.3% at second follow up. Of this, 77.1% and 96.2% of them believed that khat use reduces the side effects of anti-TB medications and symptoms of tuberculosis respectively. In the final model, being male (aOR = 7.0, p-value = 0.001), being government employee (aOR = 0.03, p-value≤0.001) and presence of alcohol use disorders (AUD) (aOR = 2.0, p-value≤0.001) predicted khat use among outpatients with tuberculosis.

CONCLUSION

A considerable proportion of patients with TB used khat throughout DOTs and wrongly perceived that it had health benefits. The finding implies that all patients diagnosed with TB should be screened for khat use, and a particular emphasis should be given to males and individuals with a history of alcohol use. Moreover, further studies are needed to assess patients' beliefs regarding the benefits of khat use so that interventions can be developed.