Incidence of Severe Malaria Syndromes and Status of Immune Responses among Khat Chewer Malaria Patients in Ethiopia

Abstract

Although more emphasis has been given to the genetic and environmental factors that determine host vulnerability to malaria, other factors that might have a crucial role in burdening the disease have not been evaluated yet. Therefore, this study was designed to assess the effect of khat chewing on the incidence of severe malaria syndromes and immune responses during malaria infection in an area where the two problems co-exist. Clinical, physical, demographic, hematological, biochemical and immunological data were collected from Plasmodium falciparum mono-infected malaria patients (age ≥ 10 years) seeking medication in Halaba Kulito and Jimma Health Centers. In addition, incidences of severe malaria symptoms were assessed. The data were analyzed using SPSS (version 20) software. Prevalence of current khat chewer malaria patients was 57.38% (95%CI =53-61.56%). Malaria symptoms such as hyperpyrexia, prostration and hyperparasitemia were significantly lower (P<0.05) among khat chewer malaria patients. However, relative risk to jaundice and renal failure were significantly higher (P<0.05) in khat chewers than in non-khat chewer malaria patients. Longer duration of khat use was positively associated with incidence of anemia. IgM and IgG antibody titers were significantly higher (P<0.05) among khat chewer malaria patients than among malaria positive non-chewers. Although levels of IgG subclasses in malaria patients did not show significant differences (P>0.05), IgG3 antibody was significantly higher (P<0.001) among khat chewer malaria patients. Moreover, IgM, IgG, IgG1and IgG3 antibodies had significant negative association (P<0.001) with parasite burden and clinical manifestations of severe malaria symptoms, but not with severe anemia and hypoglycemia. Additionally, a significant increment (P<0.05) in CD4+ T-lymphocyte population was observed among khat users. Khat might be an important risk factor for incidence of some severe malaria complications. Nevertheless, it can enhance induction of humoral immune response and CD4+ T-lymphocyte population during malaria infection. This calls for further investigation on the effect of khat on parasite or antigen-specifc protective malaria immunity and analysis of cytokines released upon malaria infection among khat chewers.

Phytochemical Screening and Cytotoxic Properties of Ethanolic Extract of Young and Mature Khat Leaves

“…Khat (Catha edulis) has culturally been used in many parts of Africa and the Arabian Peninsula, including Saudi Arabia and Yemen, but it is believed to be a globally growing problem [1][2][3]. Khat is mainly used to increase mental capacity [4], physical strength [5], and social entertainment [6] and enhance cheerfulness [7] and sexual orgasms [8].…”

Hepatotoxicity Induced by “the 3Ks”: Kava, Kratom and Khat

“…Khat proved to be a poor anti-plasmodial, suppressing only 10% of the parasites without lessening the main symptoms of the disease. Another study of Ketema et al [ 69 ], aimed to evaluate the chewing of khat, the onset of severe malaria syndromes, and the immune response during the disease in areas where malaria and this drug, coexist. The IgM and IgG antibody titers and the incidence of jaundice and kidney failure were higher among the consumers, compared to non chewers.…”

Malaria Parasitaemia and the use of insecticide-treated nets (INTs) for malaria control amongst under-5 year old children in Calabar, Nigeria

“…Febrile illness is the most common and important component of malaria syndrome in sub-Saharan Africa [ 1 ]. Malaria remains one of the most widespread diseases affecting human race in tropical and sub-tropical regions of the world [ 2 ]. According to World malaria report, an estimated 3.3 billion people were at risk of malaria in 2010.…”