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Demis A, Altaye BM, Emiru M, Tefera M. Prevalence of Self-Medication Practice and Associated Factors among Pregnant Women Who Attended Antenatal Care at Public Hospitals of North Shewa Zone, Amhara Region, Ethiopia. Adv Pharmacol Pharm Sci 2024; 2024:6668480. [PMID: 39149722 PMCID: PMC11325016 DOI: 10.1155/2024/6668480] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2022] [Revised: 06/21/2024] [Accepted: 07/18/2024] [Indexed: 08/17/2024] Open
Abstract
Background Self-medication practice is the use of medicine without consulting health professionals to treat self-recognized illness by the general population including pregnant women. Inappropriate self-medication practice during pregnancy may pose harmful consequences for the fetus as well as the mother. There is not given much attention on the practice of self-medication among pregnant women in our setting. Therefore, this study aimed to assess the prevalence of self-medication practice and associated factors among pregnant women who attended antenatal care at North Shewa Zone public hospitals. Methods An institution-based cross-sectional study was conducted from June 01, 2022 to July 30, 2022, among 650 pregnant women who attended antenatal care at North Shewa Zone public hospitals. A multistage sampling technique was employed. The questionnaires were pretested. A structured interviewer-administered questionnaire and reviewed medical records were used for data collection. Epi-data version 4.6.2 and SPSS version 20 were utilized for data entry and analysis, respectively. Bivariate and multivariable logistic regression was done to identify associated factors, and P values less than 0.05 were considered statistically significant. Results The prevalence of self-medication practice among pregnant women was 65.38%. Housewives (AOR = 0.097 95% CI 0.030, 0.310), farmers (AOR = 0.117, 95% CI 0.028, 0.493), people with health insurance (AOR = 0.507, 95% CI 0.300, 0.858), and people in preconception care (AOR = 0.038, 95% CI 0.011-0.135) were less likely to practice self-medication, while people with primary education (AOR = 3.00, 95% CI 1.217, 7.435), income less than 3,000 birr (AOR = 5.46, 95% CI 1.41, 21.1), participants in the first (AOR = 4.183, 95% CI 2.12, 8.24) and second trimesters (AOR = 2.05, 95% CI 1.18, 3.56), pregnant women who lived in rural areas (AOR = 1.579, 95% CI 1.103-2.260), and people who previously practiced self-medication (AOR = 8.2, 95% CI 5.04, 13.3) were more likely to practice self-medication. Conclusion From the present finding, it can be concluded that self-medication among pregnant women is high. Previous self-medication practice, gestation period, educational status, monthly income, no preconception care, no health insurance, being a housewife, farmer, and place of residence were significantly associated with self-medication practice. Therefore, preventive measures such as proper counseling during dispensing, awareness creation programs on preconception care, and enrolling in health insurance programs to minimize the practice of self-medication are necessary.
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Affiliation(s)
- Abrham Demis
- Department of Midwifery Debre Birhan Health Science College, Debre Birhan, Ethiopia
| | | | - Mulugeta Emiru
- Department of Nursing School of Nursing and Midwifery Asrat Woldeyes Health Science Campus Debre Birhan University, Debre Birhan, Ethiopia
| | - Mitiku Tefera
- Department of Midwifery Debre Birhan Health Science College, Debre Birhan, 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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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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Seid J, Mohammed E, Muktar Y. Factors associated with perinatal substance use among Ethiopian women: an institutional-based cross-sectional study. ADVANCES IN DRUG AND ALCOHOL RESEARCH 2023; 3:11913. [PMID: 38389813 PMCID: PMC10880761 DOI: 10.3389/adar.2023.11913] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/12/2023] [Accepted: 09/27/2023] [Indexed: 02/24/2024]
Abstract
Introduction: Substance use during the perinatal period is a significant public health concern, as it can have potential adverse effects on maternal and neonatal health outcomes. Unexpectedly, no previous studies have been conducted to assess the prevalence of substance use during the perinatal period among Ethiopian women. Therefore, this study aimed to determine the magnitude of substance use and its determinant factors during the perinatal period. Method: We conducted a hospital-based descriptive cross-sectional study among a systematically selected sample of 418 women who attended perinatal care between May and July 2022. Data were collected using an interviewer-administered structured questionnaire. Multivariate logistic regression analysis, with a 95% confidence interval and p-values less than 0.05, was employed to identify factors associated with substance use behavior. Result: The prevalence of perinatal substance use was found to be 38.3% (95% CI: 33.5-43.5). Of the women who used substances, 109 (26.1%) reported using chat, 46 (11.0%) reported alcohol consumption, and 5 (1.20%) reported using shisha. Factors significantly associated with substance use behavior during the perinatal period included a history of obstetric complications (AOR = 1.722, 95% CI: 1.022-2.902), the presence of chronic medical conditions (AOR = 3.784, 95% CI: 2.164-6.615), experiencing physical abuse (AOR = 5.323, 95% CI: 2.171-13.050), depression (AOR = 1.963, 95% CI: 1.028-3.749), and experiencing sleep disturbances (AOR = 2.016, 95% CI: 0.975-4.168). Conversely, giving birth to a live baby was found to be a protective factor against substance use behavior (AOR = 0.389, 95% CI: 0.187-0.810). Discussion: This study highlights a high prevalence of substance abuse among women during the perinatal period. In light of these findings, a comprehensive approach is recommended to address perinatal substance use among Ethiopian women. This should include the integration of preventive educational programs into perinatal care.
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Affiliation(s)
- Jemal Seid
- Department of Psychiatry, College of Medicine and Health Science, Wollo University, Dessie, Ethiopia
| | - Emam Mohammed
- Department of Public Health, Kutaber Health Center, Kutaber, Ethiopia
| | - Yimer Muktar
- School of Veterinary Medicine, Woldia University, Woldia, Ethiopia
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Geremew H, Kebede FA, Negash A, Mengstie MA, Geremew D. Khat chewing and its associated factors among pregnant women in Chiro district, eastern Ethiopia: a community-based study. Front Psychiatry 2023; 14:1253128. [PMID: 38034922 PMCID: PMC10684754 DOI: 10.3389/fpsyt.2023.1253128] [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: 07/05/2023] [Accepted: 10/27/2023] [Indexed: 12/02/2023] Open
Abstract
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.
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Affiliation(s)
- Habtamu Geremew
- College of Health Science, Oda Bultum University, Chiro, Ethiopia
| | - Fekadu Abera Kebede
- Department of Nursing, College of Health Science, Oda Bultum University, Chiro, Ethiopia
| | - Abraham Negash
- School of Nursing and Midwifery, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Misganaw Asmamaw Mengstie
- Department of Biochemistry, College of Medicine and Health Sciences, Debre Tabor University, Debre Tabor, Ethiopia
| | - Demeke Geremew
- Immunology and Molecular Biology Unit, Department of Medical Laboratory Sciences, College of Medicine and Health Sciences, Bahir Dar University, Bahir Dar, Ethiopia
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Wondemagegn AT, Bekana M, Bekuretsion Y, Afework M. Magnitude and associated factors of chewing khat during pregnancy in Eastern Ethiopia, 2022: a mixed method cross-sectional study. Pan Afr Med J 2023; 46:66. [PMID: 38282772 PMCID: PMC10822099 DOI: 10.11604/pamj.2023.46.66.39872] [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: 03/30/2023] [Accepted: 09/11/2023] [Indexed: 01/30/2024] Open
Abstract
Introduction khat (Catha edulis Forsk), is an evergreen flowering tree or shrub widely produced and consumed in East Africa and the Arabian Peninsula. In Ethiopia, it is largely produced, freely marketed and consumed by almost all segments of the population. This is more pronounced in the Eastern part of the country. However, there exists little scientific information on the level and associated factors of khat use among pregnant women in Ethiopia, despite a few available evidences indicated its adverse effect on pregnancy outcomes. Moreover, the perceived reasons for chewing khat during pregnancy were not yet explored qualitatively to triangulate the quantitative findings. Hence, the aim of the present study was to determine the magnitude and associated factors of chewing khat during pregnancy in Eastern Ethiopia, 2022, in a Mixed Method study approach. Methods an institution-based cross-sectional study was conducted from August 1st to 14th, 2022 using both quantitative and qualitative methods. Two hundred forty-two pregnant mothers on Antenatal care (ANC) were included in the study. Moreover, 18 purposively selected pregnant mothers on ANC were also considered for qualitative data. Analysis of quantitative data was performed on Statistical Package for the Social Sciences (SPSS) version 27 and thematic framework analysis was performed for qualitative data. Univariable and multivariable logistic regression analysis was performed to identify variables which are significantly associated with khat chewing during pregnancy and to estimate the variable's crude and adjusted odds' ratio with corresponding 95% CI. The statistically significant association was declared at p-value of less than 5. Results the overall magnitude of chewing khat during pregnancy in the present study was 27.4% (95% CI: 22.2-33.0). Variables which significantly associated with chewing khat during pregnancy in this study were being >26 years [adjusted odds' ratio (AOR)=2.81 95% CI: 1.19-6.59], being a rural resident (AOR=2.82 95% CI: 1.19-6.69), being illiterate (AOR=4.31 95% CI: 1.02-18.20), participants having chewer husbands (AOR=3.51 95% CI: 1.33-9.24) and respondents having other chewer family members (AOR=3.05 95% CI: 1.19-7.77). In addition, the perceived reasons for chewing khat explored through in-depth interviews were for socialization, to obey tradition, to be happy with friends, husbands and families, to be free from tensioned situations, to be effective in performing daily activities, and due to lack of knowledge of its harm. Conclusion in the present study, a relatively higher proportion of mothers chewed khat during their current pregnancy. Being older age, living in rural areas, being illiterate, having khat chewer husbands and other family members were statistically significant variables associated with khat chewing during pregnancy. Moreover, pregnant mothers are practicing chewing of khat in the current study area due to deep-rooted sociocultural issues. Hence, creation of awareness on possible harm of chewing khat during pregnancy especially for those found to be at significantly increased risk of consumption in this study is highly recommended during their antenatal care visits. In addition, creation of awareness out of health institutions, at household and community level, is highly recommended, probably using community volunteers (health development armies) in the present study area. At last, we highly also recommend the local government and religious leaders to work on how to stop the chewing practice especially during pregnancy. For example, the local government and religious leaders can work on averting consideration of chewing by the community as culturally accepted practices.
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Affiliation(s)
- Amsalu Taye Wondemagegn
- Department of Anatomy, School of Medicine, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
- Department of Biomedical Sciences, School of Medicine, Debre Markos University, Debre Markos, Ethiopia
| | - Miressa Bekana
- Department of Obstetrics and Gynecology, School of Medicine, College of Health Sciences, Haramaya University, Harar, Ethiopia
| | - Yonas Bekuretsion
- Department of Pathology, School of Medicine, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
| | - Mekbeb Afework
- Department of Anatomy, School of Medicine, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
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Wogayehu B, Demissie T, Wolka E, Alemayehu M, Daka K. The epidemiology of khat (catha edulis) chewing and alcohol consumption among pregnant women in Ethiopia: A systematic review and meta-analysis. PLOS GLOBAL PUBLIC HEALTH 2023; 3:e0002248. [PMID: 37713384 PMCID: PMC10503716 DOI: 10.1371/journal.pgph.0002248] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/12/2023] [Accepted: 07/16/2023] [Indexed: 09/17/2023]
Abstract
The use of khat (Catha edulis) and alcohol during pregnancy is a serious public health problem that has been associated with a number of harmful outcomes for both the fetus and the mother's health. There has been no systematic review with meta-analysis to determine risk factors associated with khat and alcohol use among pregnant women in Ethiopia. Therefore, we aimed to determine the pooled prevalence and risk factors of khat and alcohol use during pregnancy in Ethiopia. This review has been registered in PROSPERO with protocol ID: CRD42023395115. Studies identified from PubMed, Google Scholar, the WHO African Index Medicus, the Cochrane Library, African Journal Online, and Science Direct. Articles published from January 1, 2000 to February 10, 2023 were included. We searched for articles that included any combination of the following key terms: "khat", "qat", "alcohol", "ethanol", "prevalence", "factors", "pregnant" and "Ethiopia". Two reviewers worked independently to screen studies and extract data. A funnel plot and Egger's regression test were used to test publication bias. A forest plot was used to present the pooled prevalence and odds ratio with a 95% confidence interval (CI) using the random effect model. I2 metrics were used to assess heterogeneity. The meta-analysis was carried out with Stata 14.0 software. Nine hundred sixty-two records were retrieved from different sources, and 23 studies were included in the final analysis. The pooled prevalence of khat use and alcohol drinking during pregnancy was 26.6% (95% CI 17.8, 35.5) and 31.65% (95% CI: 21.8, 41.5), respectively. Partner khat use (OR 5.9 [95% CI (2.4, 14.5)]) was associated factor for khat use during pregnancy. Low educational level (OR 2.54 [95% CI (1.8, 3.5)]), pre-pregnancy alcohol use (OR 3.5 [95% CI (2.6, 4.7)]), unplanned pregnancy (OR 2.7 [95% CI (1.8, 4.0)]), history of abortion (OR 2.3 [95% CI (1.4, 3.7)]), poor social support (OR 3.3 [95% CI (2.0, 5.3)]), and mental distress (OR 2.6 [95% CI (2.0, 3.3)]) were associated factors for alcohol drinking during pregnancy. This review indicated that the magnitude of khat and alcohol use during pregnancy in Ethiopia was high. Targeted interventions for groups of pregnant women at high risk of khat and alcohol use are urgently needed. Community-based health education interventions and point-of-sale warnings are essential to reduce the burden. Future studies should consider the influence of community-level factors on khat and alcohol use during pregnancy.
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Affiliation(s)
- Biruk Wogayehu
- Department of Public Health, Arbaminch College of Health Sciences, Arbaminch Town, Ethiopia
- Department of Public Health, School of Public Health, College of Medicine and Health Sciences, Wolaita Sodo University, Sodo Town, Ethiopia
| | - Tsegaye Demissie
- Department of Public Health, School of Public Health, College of Medicine and Health Sciences, Wolaita Sodo University, Sodo Town, Ethiopia
| | - Eskinder Wolka
- Department of Public Health, School of Public Health, College of Medicine and Health Sciences, Wolaita Sodo University, Sodo Town, Ethiopia
| | - Mekuriaw Alemayehu
- Department of Epidemiology and Biostatistics, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar Town, Ethiopia
| | - Kassa Daka
- Department of Public Health, School of Public Health, College of Medicine and Health Sciences, Wolaita Sodo University, Sodo Town, Ethiopia
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Yitayih Y, Vanderplasschen W, Vandewalle S, Rita VD, Gilbert L. The effects of khat use during pregnancy on perinatal and maternal outcomes: a meta-analysis. Arch Womens Ment Health 2023; 26:11-27. [PMID: 36689029 DOI: 10.1007/s00737-023-01293-5] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/06/2022] [Accepted: 01/11/2023] [Indexed: 01/24/2023]
Abstract
Chewing khat during pregnancy adversely affects maternal and fetal health, but available studies are scarce and inconsistent, and it is difficult to conclude the relationship between khat consumption and perinatal outcomes. We aimed to investigate the available studies on the effect of khat use during pregnancy on perinatal and maternal outcomes. For this meta-analysis, we conducted a thorough search of articles published in PubMed, Embase, Scopus, and Web of Science up to the date this search was undertaken (03.01.2022). We used random effect model with the Mantel-Haenszel method to calculate the pooled odds ratio and mean difference. We found that khat use during pregnancy was significantly associated with increased odds of low birth weight (OR:2.51; 95% CI: 1.60 to 3.94), congenital anomalies (OR:3.17; 95% CI: 1.30 to 7.73), premature rupture of membrane (OR: 1.99; 95% CI: 1.59 to 2.50), perinatal mortality (OR: 1.95; 95% CI: 1.26 to 3.03), and lower APGAR scores at the fifth minute (MD: -1.7; 95% CI: -2.32 to -1.07). Also, increased odds for developing maternal psychological stress and anemia were reported in women using khat during pregnancy. There were no statistically significant differences in stillbirth and preterm birth between women using khat during pregnancy and their counterparts. Since prenatal khat use is associated with adverse perinatal and maternal outcomes, we strongly recommend equitable and easily accessible health services through the implementation of integrated addiction treatment with maternity services to address khat use during pregnancy and encourage the practice of healthy behavior of women.
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Affiliation(s)
- Yimenu Yitayih
- Department of Head and Skin - Psychiatry and Medical Psychology, Faculty of Medicine and Health Sciences, Ghent University, C. Heymanslaan 10. B 9000 Gent, Ghent, Belgium.
| | - Wouter Vanderplasschen
- Department of Special Needs Education, Faculty of Psychology and Educational Sciences, Ghent University, Ghent, Belgium
| | - Sarah Vandewalle
- Department of Special Needs Education, Faculty of Psychology and Educational Sciences, Ghent University, Ghent, Belgium
| | - Van Damme Rita
- Department of Head and Skin - Psychiatry and Medical Psychology, Faculty of Medicine and Health Sciences, Ghent University, C. Heymanslaan 10. B 9000 Gent, Ghent, Belgium
- Center for Perinatal Mental Health, Department of Psychiatry, Ghent University Hospital, Ghent, Belgium
| | - Lemmens Gilbert
- Department of Head and Skin - Psychiatry and Medical Psychology, Faculty of Medicine and Health Sciences, Ghent University, C. Heymanslaan 10. B 9000 Gent, Ghent, Belgium
- Center for Perinatal Mental Health, Department of Psychiatry, Ghent University Hospital, Ghent, Belgium
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Misgana T, Tesfaye D, Alemu D, Gebremichael B, Tamiru D, Tariku M, Weldesenbet AB, Dheresa M. Khat use and associated factors during pregnancy in eastern Ethiopia: A community-based cross-sectional study. Front Glob Womens Health 2022; 3:941300. [PMID: 36532956 PMCID: PMC9757490 DOI: 10.3389/fgwh.2022.941300] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2022] [Accepted: 11/07/2022] [Indexed: 12/02/2023] Open
Abstract
INTRODUCTION Women of reproductive age are increasingly using khat. The use of khat is associated with prelabor rupture of membranes, anemia among pregnant women, and other problems related to motherhood and infanthood. Most of the previous studies performed at the facility level revealed that different factors were associated with khat use among pregnant women. Lower educational status, low wealth index, and the age of the mother were the factors significantly associated with maternal khat use. Partner substance use also has a significant association with maternal khat use. However, there is limited information about khat use and its associated factors among pregnant women in the study area. OBJECTIVE This study aims at assessing the prevalence of khat use and associated factors among pregnant women in Kersa and Haramaya Health and Demographic Surveillance System Sites, eastern Ethiopia. METHODS A community-based cross-sectional study design was employed among randomly selected 1,015 pregnant women from an open cohort from Kersa and Haramaya Health and Demographic Surveillance System Sites in Ethiopia. Data were collected through face-to-face interviews from January 30 to April 30, 2021, using Open Data Kit (ODK) software and analyzed using SPSS v-26. Descriptive statistics were used to summarize the characteristics of pregnant women. Factors associated with khat use were identified by bivariate and multivariable logistic regression analyses; an adjusted odds ratio (AOR) with a 95% confidence interval (CI) was estimated. Statistical significance was declared at p < 0.05. RESULTS The prevalence of khat use among pregnant women was 15.5% (95% CI, 13.3-17.7). Age of the pregnant women; being in the age group between 25 and 35 years (AOR = 2.27, 95% CI, 1.33-4.89) and 35 years and greater (AOR = 2.33, 95% CI, 1.29-4.20); having a chronic medical illness (AOR = 3.28, 95% CI, 1.27-8.48); and having a history of abortion (AOR = 2.87 95% CI, 1.73-4.76) significantly increased the likelihood of khat use among pregnant women. CONCLUSION The current study revealed a relatively high magnitude of khat use in pregnant women as compared with previous studies. The age of the pregnant women, history of medical illness, and history of abortion were significantly associated with khat use during pregnancy.
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Affiliation(s)
- Tadesse Misgana
- Department of Psychiatry, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Dejene Tesfaye
- Department of Psychiatry, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Daniel Alemu
- Department of Psychiatry, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Berhe Gebremichael
- School of Public Health, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Dawit Tamiru
- Department of Midwifery, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Mandaras Tariku
- Department of Psychiatry, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Adisu Birhanu Weldesenbet
- School of Public Health, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Merga Dheresa
- School of Nursing and Midwifery, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
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Dagnaw FT, Addis WD, Tesfa D, Desale AT, Issa NA, Belachew YY, Yitbarek GY, Belay AT, Chanie ES, Hailemeskel HS. Determinants of postpartum depression among mothers in Debre Tabor town, North-central, Ethiopia: Community-based unmatched case-control study. Front Glob Womens Health 2022; 3:910506. [PMID: 36312871 PMCID: PMC9596969 DOI: 10.3389/fgwh.2022.910506] [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: 04/01/2022] [Accepted: 07/25/2022] [Indexed: 06/16/2023] Open
Abstract
Background Postpartum depression (PPD) is a non-psychotic depressive disorder of variable severity, and it can begin as early as 2 weeks after delivery and can persist indefinitely if left untreated. In Ethiopia, the prevalence of postpartum depression is high. There is a dearth of literature to determine factors associated with postpartum depression in Ethiopia, specifically in the study area. Objective This study aimed to identify factors associated with postpartum depression among mothers in Debre Tabor Town, Northcentral Ethiopia. Method A community-based unmatched case-control study was conducted among mothers who were living in Debre Tabor Town and fulfilled the inclusion criteria. Postpartum mothers were selected using a simple random sampling technique from the listed sampling frame at the health center. Then, the sample cases and controls were interviewed until the sample size was fulfilled by using a consecutive sampling method. The data were entered into the EPI data version 4.6 and then imported and analyzed using SPSS version 25. Descriptive statistics of different variables were done by cross-tabulation. Binary logistic regression was used to assess the determinant factors with the outcome variable. A P-value of < 0.05 was considered to declare statistical significance. Results A total of 308 postnatal mothers living in Debre Tabor Town were included, with a 97.5% response rate. History of substance use in the previous 3 months (AOR: 6.47, 95% CI; 2.61, 15.74), current baby illness (AOR: 3.9, 95% CI; 1.5, 10.12), marital dissatisfaction (AOR: 2.41, 95% CI; 1.22, 4.75), unplanned current pregnancy (AOR: 3.46, 95% CI; 1.32, 9.12), and breastfeeding (AOR: 0.22, 95% CI; 0.09, 0.55) were independent factors that affected the occurrence of PPD. Conclusion This study revealed that a recent history of substance use (in the past 3 months), current baby illness, marital satisfaction, unplanned current pregnancy, and breastfeeding were associated with postpartum depression. Healthcare providers working in maternal and child health clinics and health extension workers should give special attention to postpartum mothers who have had a history of substance use, current baby illness, unplanned pregnancy, non-breastfeeding mothers, and mothers with poor marital satisfaction.
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Affiliation(s)
- Fentaw Teshome Dagnaw
- Department of Public Health, College of Health Sciences, Debre Tabor University, Debre Tabor, Ethiopia
| | - Wondimnew Desalegn Addis
- Department of Public Health, College of Health Sciences, Debre Tabor University, Debre Tabor, Ethiopia
| | - Desalegn Tesfa
- Department of Public Health, College of Health Sciences, Debre Tabor University, Debre Tabor, Ethiopia
| | - Aragaw Tesfaw Desale
- Department of Public Health, College of Health Sciences, Debre Tabor University, Debre Tabor, Ethiopia
| | - Nurayine Abubeker Issa
- Department of Medicine, College of Health Sciences, Debre Tabor University, Debre Tabor, Ethiopia
| | - Yismaw Yimam Belachew
- Department of Medicine, College of Health Sciences, Debre Tabor University, Debre Tabor, Ethiopia
| | - Getachew Yideg Yitbarek
- Department of Biomedical Sciences, College of Health Sciences, Debre Tabor University, Debre Tabor, Ethiopia
| | - Alebachew Taye Belay
- Department of Statistics, College of Natural and Computational Sciences, Debre Tabor University, Debre Tabor, Ethiopia
| | - Ermias Sisay Chanie
- Department of Pediatrics and Neonatal Nursing, College of Health Sciences, Debre Tabor University, Debre Tabor, Ethiopia
| | - Habtamu Shimels Hailemeskel
- Department of Pediatrics and Neonatal Nursing, College of Health Sciences, Debre Tabor University, Debre Tabor, Ethiopia
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Bayih WA, Ayalew MY, Tadege M, Mekie M, Kiros T, Alemu EM, Alemnew EF, Getacher L, Belay DM, Birhane BM, Alemu DKD, Yitbarek GY, Kefale B. The Burden of Adverse Neonatal Outcome among Antenatal Substance Users in Ethiopia: A Systematic Review and Meta-Analysis. Glob Pediatr Health 2021; 8:2333794X211019699. [PMID: 34104698 PMCID: PMC8161854 DOI: 10.1177/2333794x211019699] [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: 04/21/2021] [Revised: 05/07/2021] [Accepted: 05/01/2021] [Indexed: 12/02/2022] Open
Abstract
Background. Substances mainly khat, alcohol and cigarette are used during pregnancy in Ethiopia. However, to this date, there is no pooled evidence about the burden of adverse neonatal outcomes among the substance users during pregnancy in the country. Methods. Eligible primary studies were accessed from 4 international data bases (Google Scholar, Science Direct, Scopus, and PubMed). The required data were extracted from these studies and then exported to stata version 14 for analysis. Subgroup analyses were conducted for evidence of heterogeneity. Results. A total of 2298 neonates were included from 7 studies. Among these neonates, 530(23.06%) were those whose mothers used substance during pregnancy (exposed group) whereas 1768 neonates were those whose mothers didn’t use substance during pregnancy (controls group). The pooled prevalence of adverse neonatal outcome among the exposed mothers was 38.32% (95% CI: 29.48%, 47.16%; I2 = 76.3%) whereas it was 16.29% (95% CI: 9.45%, 23.13%) among the controls. Adverse neonatal outcome was most burdensome among cigarette smokers 45.20% (95% CI: 37.68%, 52.73%; I2 = .00%) when compared with khat chewers 34.00% (95% CI: 20.87%, 47.13%) and alcohol drinkers 38.47% (95% CI: 17.96%, 58.98%). Low birth weight 42.00% (95% CI: 18.01%, 65.99%; I2 = 91.8%) was the most common adverse birth outcome. Conclusion. It was found that adverse neonatal outcomes were much more burdensome among antenatal substance users than the controls. Therefore, mothers should be enabled to quit using substance before pregnancy. Besides, strict comprehensive screening of every pregnant mother should be made at antenatal care clinics for early identification and management of antenatal substance use.
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Affiliation(s)
- Wubet Alebachew Bayih
- Debre Tabor University, Debre Tabor, Ethiopia.,Master of Science degree in Maternity and Neonatal Health Nursing
| | - Metadel Yibeltal Ayalew
- Bahir Dar University, Bahir Dar, Ethiopia.,Bachelor of Science degree in Comprehensive Nursing
| | - Melaku Tadege
- Debre Tabor University, Debre Tabor, Ethiopia.,Assistant Professor of Human Nutrition
| | - Maru Mekie
- Debre Tabor University, Debre Tabor, Ethiopia.,Master of Public Health degree in Reproductive Health
| | - Teklehaimanot Kiros
- Debre Tabor University, Debre Tabor, Ethiopia.,Master of Science degree in Medical Micro-Biology
| | - Eshetie Molla Alemu
- Debre Tabor University, Debre Tabor, Ethiopia.,Master of Public Health degree in Reproductive Health
| | - Efrem Fenta Alemnew
- Debre Tabor University, Debre Tabor, Ethiopia.,Master of Science degree in Advanced Clinical Anesthesia
| | - Lemma Getacher
- Debre Berhan University, Debre Berhan, Ethiopia.,Master of Public Health degree in Human Nutrition
| | - Demeke Mesfin Belay
- Debre Tabor University, Debre Tabor, Ethiopia.,Master of Science degree in Pediatrics and Child Health Nursing
| | - Binyam Minuye Birhane
- Debre Tabor University, Debre Tabor, Ethiopia.,Master of Science degree in Maternity and Neonatal Health Nursing
| | | | - Getachew Yideg Yitbarek
- Debre Tabor University, Debre Tabor, Ethiopia.,Master of Science degree in Medical Physiology
| | - Belayneh Kefale
- Debre Tabor University, Debre Tabor, Ethiopia.,Master of Science degree in Clinical Pharmacy
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