1
|
Momanyi RK, Kwobah EK, Owiti P, Nyamogoba H, Atwoli L. Psychiatric morbidity among patients on treatment for tuberculosis at a tertiary referral hospital in Western Kenya. PLoS One 2024; 19:e0302744. [PMID: 38748751 PMCID: PMC11095705 DOI: 10.1371/journal.pone.0302744] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2023] [Accepted: 04/11/2024] [Indexed: 05/19/2024] Open
Abstract
BACKGROUND Mental disorders account for nine percent of the overall global burden of disease and are among the top ten leading causes of disability. Mental illness and tuberculosis share risk factors including poverty, overcrowding, stigma, poor nutrition, substance use and retro-viral disease co-infection. Presence of mental illness in tuberculosis delays health-seeking, affects drug adherence, increases cost of treatment, prolongs disease duration, lowers quality of life, and increases mortality. Early diagnosis, linkage, and treatment of psychiatric morbidity among patients with tuberculosis would improve outcomes for both. This study thus aimed to determine the prevalence and factors associated with psychiatric morbidity among patients on treatment for tuberculosis at a low- middle- income country. METHODS A cross-sectional study carried out at the tuberculosis clinic at Moi Teaching and Referral Hospital (MTRH), Eldoret, Kenya. 367 participants on TB treatment were interviewed using Mini-International Neuropsychiatric Interview (MINI) tool. The key outcome was presence of psychiatric illness. Pearson's Chi-square and logistic regression were used to assess relationships at bivariate and multivariate level respectively. RESULTS Majority of the respondents were male (61.3%) and overall median age was 33 years. About half of participants (48.5%) had at least one psychiatric illness. Common disorders were alcohol use disorder (30.3%), depression (23.4%), substance use disorder (12.8%) and suicidality (8.2%). Odds of 'any psychiatric illness' were increased by being male (aOR = 1.92; P = 0.04), being separated or divorced (aOR = 6.86; P = 0.002), using alcohol (aOR = 3.2; P<0.001), having been previously treated for tuberculosis (aOR = 2.76; P = 0.01), having other medical comorbidities (aOR = 4.2; P = 0.004) and family history of mental illness (aOR = 2.4; P = 0.049). CONCLUSION Almost half of the patients on treatment for tuberculosis had at least one psychiatric illness. Introduction of protocols for screening for mental illness and integration of mental health services with tuberculosis care would aid prompt diagnosis, referral, and quality of care.
Collapse
Affiliation(s)
- Robina Kerubo Momanyi
- Department of Mental Health and Behavioural Sciences, School of Medicine Moi University, Kenya
| | | | - Philip Owiti
- National Tuberculosis Program, Ministry of Health, Kenya
| | - Henry Nyamogoba
- Department of Medical Microbiology and Parasitology, School of Medicine Moi University, Kenya
| | - Lukoye Atwoli
- Department of Mental Health and Behavioural Sciences, School of Medicine Moi University, Kenya
- Department of Medicine, Medical College East Africa, Aga Khan University, Kenya
- Brain and Mind Institute Aga Khan University, Kenya
| |
Collapse
|
2
|
Olani AB, Gerbaba M, Getnet M, Soboka M, Decorte T. Is chewing khat associated with mental health disorders? A scoping review of the content and quality of the current evidence base. Subst Abuse Treat Prev Policy 2023; 18:39. [PMID: 37370160 DOI: 10.1186/s13011-023-00545-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2023] [Accepted: 06/05/2023] [Indexed: 06/29/2023] Open
Abstract
BACKGROUND Khat (Catha edulis) is a plant commonly found in the horn of Africa whose leaves are chewed for their psycho-stimulant effects. Several studies have demonstrated the association between khat use and mental health problems. Nevertheless, evidence is mixed and inconsistent, warranting further review of available studies. This scoping review is aimed at investigating the content and quality of evidence base on the associations between khat use and mental health disorders and suggesting avenues for further research. METHODS We used a scoping review methodology to map the existing evidence using PubMed, SCOPUS, Embase, and CINAHL databases. Primary studies focusing on the association between any pattern of khat use and any form of mental health disorders are included. The review focused on all age groups, any study design, all geographical locations, and any publication year. The terms used for searching eligible studies include khat, mental disorders, and various alternative terminologies. Narrative review is employed to present findings. RESULTS 7,121 articles were found, of which 108 were eligible, conducted across 12 different countries. The majority of the studies was done during the last ten years and the studies mostly employed cross-sectional design. About 10 different categories of mental health disorders have been identified as showing associations with khat use. Despite many contradictory findings between the studies, most of the evidence base suggests that khat use is associated with mental health disorders. Non-specific psychological distress is the most frequently mentioned mental health problem (reported in 26.9% of the studies). Khat use as a predictor variable is mostly assessed using a 'yes/no' category, and as a result, dose-dependent effects of khat use on mental health are not given much consideration. CONCLUSION Although most of the studies associate khat use with mental health disorders, the causal relationships are inconclusive given the cross-sectional design of the studies, and the presence of potential confounders and several forms of biases. Available studies also report contradictory findings. Further studies are recommended using prospective designs, standardized and valid measures of khat use, and focusing on specific types of mental health disorders.
Collapse
Affiliation(s)
- Amanti Baru Olani
- Institute for Social Drug Research, Department of Criminology, Criminal Law and Social Law, Ghent University, Universiteitstraat 4, Ghent, 9000, Belgium.
- Department of Sociology, Jimma University, Jimma, P.O.Box 378, Ethiopia.
| | - Mulusew Gerbaba
- Department of Epidemiology, Institute of Health, Jimma University, Jimma, P.O.Box 378, Ethiopia
| | - Masrie Getnet
- Department of Epidemiology, Institute of Health, Jimma University, Jimma, P.O.Box 378, Ethiopia
| | - Matiwos Soboka
- Department of Psychiatry, Institute of Health, Jimma University, Jimma, P.O.Box 378, Ethiopia
| | - Tom Decorte
- Institute for Social Drug Research, Department of Criminology, Criminal Law and Social Law, Ghent University, Universiteitstraat 4, Ghent, 9000, Belgium
| |
Collapse
|
3
|
Shamebo T, Mekesha S, Getahun M, Gumi B, Petros B, Ameni G. Prevalence of pulmonary tuberculosis in homeless individuals in the Addis Ababa City, Ethiopia. Front Public Health 2023; 11:1128525. [PMID: 37089500 PMCID: PMC10117819 DOI: 10.3389/fpubh.2023.1128525] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2022] [Accepted: 03/27/2023] [Indexed: 04/08/2023] Open
Abstract
BackgroundHomeless individuals are at a high risk of infection with Mycobacterium tuberculosis (M. tuberculosis) as compared to the general population. The number of homeless individuals has been increasing in Addis Ababa City during the last three decades due to the migration of rural inhabitants to the City for better living conditions. The objective of this study was to estimate the prevalence of pulmonary tuberculosis (PTB) and evaluate associated risk factors in homeless individuals in Addis Ababa City.MethodsA total of 5,600 homeless individuals were screened for PTB symptoms using WHO guideline between February 2019 and December 2020. Sputum samples were cultured from individuals with symptoms of PTB for mycobacterial isolation. Logistic regression analysis was used to identify factors associated with PTB.ResultsThe prevalence of bacteriologically confirmed cases was 1.1% (59/5,600) or 10.54 per 1000 population. Multinomial logistic regression analysis showed that being homeless for more than 5 years, body mass index (BMI) < 18.5, smoking cigarette, living in a group of more than five individuals, close contact with chronic coughers, imprisonment and HIV infection were significantly associated with the prevalence of PTB in homeless individuals (P < 0.05).ConclusionIn conclusion, the result of this study indicated that the prevalence of PTB in homeless individuals was higher than the prevalence of PTB in the general population of Addis Ababa City requiring for the inclusion of the homeless individuals in the TB control program.
Collapse
Affiliation(s)
- Tsegaye Shamebo
- Department of Microbial, Cellular and Molecular Biology, College of Natural and Computational Sciences, Addis Ababa University, Addis Ababa, Ethiopia
| | - Sindew Mekesha
- Ethiopian National Tuberculosis Reference Laboratory, Ethiopian Public Health Institute, Addis Ababa, Ethiopia
| | - Muluwork Getahun
- Ethiopian National Tuberculosis Reference Laboratory, Ethiopian Public Health Institute, Addis Ababa, Ethiopia
| | - Balako Gumi
- Aklilu Lemma Institute of Pathobiology, Addis Ababa University, Addis Ababa, Ethiopia
| | - Beyene Petros
- Department of Microbial, Cellular and Molecular Biology, College of Natural and Computational Sciences, Addis Ababa University, Addis Ababa, Ethiopia
| | - Gobena Ameni
- Aklilu Lemma Institute of Pathobiology, Addis Ababa University, Addis Ababa, Ethiopia
- Department of Veterinary Medicine, College of Agriculture and Veterinary Medicine, United Arab Emirates University, Al Ain, United Arab Emirates
- *Correspondence: Gobena Ameni ;
| |
Collapse
|
4
|
Lim SYM, Loo JSE, Alshagga M, Alshawsh MA, Ong CE, Pan Y. Protein-Ligand Identification and In Vitro Inhibitory Effects of Cathine on 11 Major Human Drug Metabolizing Cytochrome P450s. Int J Toxicol 2022; 41:355-366. [PMID: 35658727 PMCID: PMC9411691 DOI: 10.1177/10915818221103790] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
Cathine is the stable form of cathinone, the major active compound found in khat (Catha edulis Forsk) plant. Khat was found to inhibit major phase I drug metabolizing cytochrome P450 (CYP) enzyme activities in vitro and in vivo. With the upsurge of khat consumption and the potential use of cathine to combat obesity, efforts should be channelled into understanding potential cathine-drug interactions, which have been rather limited. The present study aimed to assess CYPs activity and inhibition by cathine in a high-throughput in vitro fluorescence-based enzyme assay and molecular docking analysis to identify how cathine interacts within various CYPs’ active sites. The half maximal inhibitory concentration (IC50) values of cathine determined for CYP2A6 and CYP3A4 were 80 and 90 μM, while CYP1A2, CYP2B6, CYP2C8, CYP2C9, CYP2C19, CYP2D6, CYP2E1, CYP2J2 and CYP3A5 showed no significant inhibition. Furthermore, in Ki analysis, the Lineweaver-Burk plots depicted non-competitive mixed inhibition of cathine on both CYP2A6 and CYP3A4 with Ki value of 63 and 100 μM, respectively. Cathine showed negligible time-dependent inhibition on CYPs. Further, molecular docking studies showed that cathine was bound to CYP2A6 via hydrophobic, hydrogen and π-stacking interactions and formed hydrophobic and hydrogen bonds with active site residues in CYP3A4. Both molecular docking prediction and in vitro outcome are in agreement, granting more detailed insights for predicting CYPs metabolism besides the possible cathine-drug interactions. Cathine-drug interactions may occur with concomitant consumption of khat or cathine-containing products with medications metabolized by CYP2A6 and CYP3A4.
Collapse
Affiliation(s)
- Sharoen Y. M. Lim
- Division of Biomedical Sciences, School of Pharmacy, University of Nottingham Malaysia, Semenyih, Malaysia
- Sharoen Y. M. Lim, Division of Biomedical Sciences, School of Pharmacy, University of Nottingham - Malaysia Campus, Jalan Broga, Semenyih 43500, Malaysia.
| | - Jason Siau Ee Loo
- Centre for Drug Discovery and Molecular Pharmacology, Faculty of Health and Medical Sciences, Taylor’s University, Selangor, Malaysia
| | - Mustafa Alshagga
- Division of Biomedical Sciences, School of Pharmacy, University of Nottingham Malaysia, Semenyih, Malaysia
| | - Mohammed A. Alshawsh
- Department of Pharmacology, Faculty of Medicine, Universiti Malaya, Kuala Lumpur, Malaysia
| | - Chin E. Ong
- School of Pharmacy, International Medical University, Kuala Lumpur, Malaysia
| | - Yan Pan
- Division of Biomedical Sciences, School of Pharmacy, University of Nottingham Malaysia, Semenyih, Malaysia
| |
Collapse
|
5
|
Identifying Hotspots of People Diagnosed of Tuberculosis with Addiction to Alcohol, Tobacco, and Other Drugs through a Geospatial Intelligence Application in Communities from Southern Brazil. Trop Med Infect Dis 2022; 7:tropicalmed7060082. [PMID: 35736961 PMCID: PMC9231266 DOI: 10.3390/tropicalmed7060082] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2022] [Revised: 05/18/2022] [Accepted: 05/19/2022] [Indexed: 11/21/2022] Open
Abstract
(1) Background: tuberculosis (TB) is considered one of the leading causes of death worldwide by a single infectious agent. This study aimed to identify hotspots of people diagnosed with tuberculosis and abusive use of alcohol, tobacco, and other drugs in communities through a geospatial intelligence application; (2) Methods: an ecological study with a spatio-temporal approach. We considered tuberculosis cases diagnosed and registered in the Notifiable Diseases Information System, which presented information on alcoholism, smoking, and drug abuse. Spatial Variations in Temporal Trends (SVTT) and scan statistics were applied for the identification of Hotspots; (3) Results: between the study period, about 29,499 cases of tuberculosis were reported. When we applied the SVTT for alcoholism, three Hotspots were detected, one of which was protective (RR: 0.08–CI95%: 0.02–0.32) and two at risk (RR: 1.42–CI95%: 1.11–1.73; RR: 1.39–CI95%: 1.28–1.50). Regarding smoking, two risk clusters were identified (RR: 1.15–CI95%: 1.01–1.30; RR: 1.68–CI95%: 1.54–1.83). For other drugs, a risk cluster was found (RR: 1.13–CI95%: 0.99–1.29) and two protections (RR: 0.70–CI95%: 0.63–0.77; RR: 0.76–CI95%: 0.65–0.89); (4) Conclusion: it was evidenced that in the communities being studied, there exists a problem of TB with drug addiction. The disordered use of these substances may harm a person’s brain and behavior and lead to an inability to continue their treatment, putting the community at further risk for TB.
Collapse
|
6
|
In vitro and In Silico Studies of Interactions of Cathinone with Human Recombinant Cytochrome P450 CYP(1A2), CYP2A6, CYP2B6, CYP2C8, CYP2C19, CYP2E1, CYP2J2, and CYP3A5. Toxicol Rep 2022; 9:759-768. [DOI: 10.1016/j.toxrep.2022.03.040] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2021] [Revised: 03/27/2022] [Accepted: 03/28/2022] [Indexed: 11/21/2022] Open
|
7
|
Laycock KM, Enane LA, Steenhoff AP. Tuberculosis in Adolescents and Young Adults: Emerging Data on TB Transmission and Prevention among Vulnerable Young People. Trop Med Infect Dis 2021; 6:148. [PMID: 34449722 PMCID: PMC8396328 DOI: 10.3390/tropicalmed6030148] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2021] [Revised: 07/30/2021] [Accepted: 07/31/2021] [Indexed: 02/01/2023] Open
Abstract
Adolescents and young adults (AYA, ages 10-24 years) comprise a uniquely important but understudied population in global efforts to end tuberculosis (TB), the leading infectious cause of death by a single agent worldwide prior to the COVID-19 pandemic. While TB prevention and care strategies often overlook AYA by grouping them with either children or adults, AYA have particular physiologic, developmental, and social characteristics that require dedicated approaches. This review describes current evidence on the prevention and control of TB among AYA, including approaches to TB screening, dynamics of TB transmission among AYA, and management challenges within the context of unique developmental needs. Challenges are considered for vulnerable groups of AYA such as migrants and refugees; AYA experiencing homelessness, incarceration, or substance use; and AYA living with HIV. We outline areas for needed research and implementation strategies to address TB among AYA globally.
Collapse
Affiliation(s)
- Katherine M. Laycock
- Division of Infectious Diseases, Department of Pediatrics, Children’s Hospital of Philadelphia, Philadelphia, PA 19104, USA;
| | - Leslie A. Enane
- The Ryan White Center for Pediatric Infectious Disease and Global Health, Department of Pediatrics, Indiana University School of Medicine, Indianapolis, IN 46202, USA;
| | - Andrew P. Steenhoff
- Division of Infectious Diseases, Department of Pediatrics, Children’s Hospital of Philadelphia, Philadelphia, PA 19104, USA;
- Department of Pediatrics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA
- Global Health Center, Children’s Hospital of Philadelphia, Philadelphia, PA 19146, USA
| |
Collapse
|