Prevalence and predictors of khat chewing among Ethiopian university students: A systematic review and meta-analysis

Abstract

BackgroundKhat chewing has become a common practice among university students in developing countries like Ethiopia. It has a potential effect on physical, mental, social and cognitive aspects of student functioning. In Ethiopia, study findings regarding the prevalence of khat chewing were highly dispersed and inconsistent. Therefore, this systematic review and meta-analysis estimates the pooled prevalence of khat chewing and its predictors among Ethiopian university students.MethodA systematic review and meta-analysis was conducted to assess the prevalence and predictors of khat chewing among university students in Ethiopia. We searched literature from the databases of PubMed, Google Scholar, Science Direct, and the Cochrane Library. A total of 24 Ethiopian studies reporting the prevalence of khat chewing among university students were included. Data were extracted using a standardized data extraction format prepared in Microsoft Excel and the analysis was done using STATA 14 statistical software. To assess heterogeneity, the Cochrane Q test statistics and I2 test were used. Since the included studies exhibit high heterogeneity, a random effect meta-analysis model was computed to estimate the pooled prevalence of khat chewing. Moreover, the association between predictor variables, and khat chewing practice were examined.ResultsThe meta-analysis of 24 studies revealed that the pooled prevalence of khat chewing among university students in Ethiopia was 23.22% (95% CI: 19.5, 27.0). In the subgroup analysis, the highest prevalence was observed in Oromia region (31.6%; 95CI: 21.2, 41.9) whereas the lowest prevalence was observed in Amhara region (18.1%; 95%CI: 12.4, 23.8). Being male OR: 2.76 (95% CI 1.64, 4.63), family khat chewing practice OR: 2.91 (95% CI 1.06, 7.98), friend khat chewing habit OR: 4.74 (95% CI 3.48, 13.06), alcohol drinking OR: 7.06 (95% CI 5.65, 8.82) and cigarette smoking habit OR: 15.11 (95% CI 8.96, 25.51) were found to be predictors of khat chewing.ConclusionThe study found that the prevalence of khat chewing among university students was quite common, with slightly more than 1 in 5 students engaging in the use of this substance. Being male, family khat chewing practice, friend’s khat chewing habit, alcohol drinking, and cigarette smoking were found to be predictors of khat chewing practice among university students.

Prevalence and risk factors for khat use among youth students in Ethiopia: systematic review and meta-analysis, 2018

“…A meta-analysis study previously completed on University students found that 23.22% (95% CI 19.5, 27.0%) of these students were chewers, which is a bit higher than our findings [43]. This discrepancy might be due to differences in study population, while ours considered young students on high school and university, the former one focused on university students, these students couldn't afford to buy the khat and they might not use.…”

“…Having chewer friends was strong predictor of chewing which is similar to other studies [2,41,43,45,49,50,53], khat use by family member was associated with increased odds of use among participants. This finding was similar with studies conducted on substance abuse [2,36,48,49].…”

“…This significant difference between male and female may be justified as; females are less exposed to chewing practice than males. Moreover, we found that being Muslim by religion had a significant role to be user than others [2,36,41,43,51,52].…”

“…All the analyses were conducted using Comprehensive Meta analysis software (version 3) [42]. The overall pooled prevalence of khat chewing was estimated using a random-effects meta-analysis [43]. First, using a fixed-effects model, heterogeneity among the studies was determined.…”

“…First, using a fixed-effects model, heterogeneity among the studies was determined. A Q test and an I 2 heterogeneity test [43] were used to declare heterogeneity at p < 0.05. The prevalence of statistical heterogeneity between the studies was assessed using I 2 statistics, with 25%, 50% and 75% representing low, medium and high heterogeneity, respectively [44].…”