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

Abstract

Background: Khat use is a widely spreading public health problem affecting the most economically productive population areas in Ethiopia. Khat use among students has been linked with mental, physical, social, and psychological problems. Reliable prevalence has not been recognized because of varying published rates. The objective of this systematic review and meta-analysis is to synthesize evidence on the prevalence and potential risk factors of khat use in Ethiopia. Methods:We found 284 studies of which 266 were removed due to duplication, irrelevant topics, and other reasons, respectively. All studies conducted in Ethiopia on khat chewing among students irrespective of time frame were included. Subsequently, 18 studies were used for synthesis of prevalence. Figures were extracted from published reports, and any lost information was requested from investigators. The quality of the included literature was evaluated by using the Newcastle-Ottawa Scale (NOS). Prevalence was pooled using random-effects meta-analyses. The presence of association was declared using P-values and an odds ratio with a corresponding 95% CI.

A systematic review on risk factors for khat chewing among adolescents in the African continent and Arabian Peninsula

“…There has been argument on the similarity ways of consumption between khat and tobacco smoking [ 37 ] (Douglas & Hersi, 2010), and substance intake is frequently observed among men compared to women [ 38 ] (Becker, McClellan & Reed, 2017). Available evidence also showed that the habit of khat chewing reinforces the development of other habits such as cigarette smoking [ 39 ] (Birhane, 2014), as well as the effect of the khat consumption are enhanced mutually with cigarette smoking [ 12 ] (Alemu et al, 2020). The underlying psychobiological mechanisms of this link remain unclear, although it is possible that social cues and pharmacological priming associated with khat use may increase the likelihood and reinforcing effects of smoking [ 35 ] (Nakajima et al, 2013).…”

“…Many adverse effects have been linked with khat chewing which include impairment of mental [ 37 – 40 ] (Douglas & Hersi, 2010; Becker, McClellan & Reed, 2017; Birhane, 2014; Muluneh, 2018) and physical health such as myocardial infarction [ 10 ] (Al-Motarreb et al, 2002), ischemic heart disease [ 11 ] (Mega & Dabe, 2017), manic-like schizophrenia [ 12 ] (Alemu et al, 2020), erectile dysfunction [ 13 ] (Hassan, Gunaid & Murray Lyon, 2007), psychotic experiences [ 15 ] (Odenwald & Khatkonsum, 2008), oesophageal cancer [ 16 ] (Bozzuto, Ruggieri & Molinari, 2010), stroke, gastritis and hepatitis [ 40 ] (Muluneh, 2018). The urgent need to create better awareness on the potential negative consequences of khat chewing malpractice have been reported in several studies [ 23 , 40 – 43 ] (Alsanosy, Mahfouz & Gaffar, 2013; Muluneh, 2018; Odenwald et al, 2007; Odenwald & Al’ansi, 2017; Wedegaertner et al, 2010).…”

“…The amphetamine-rich nature of khat leaves resulted in symptoms such as tachycardia, hyperthermia, dryness of the month, tachypnoea, mydriasis, and restlessness [ 9 ] (Dhaifalah & Santavý, 2004). Chronic ingestion of khat exposes the chewers to thrombocytosis, which may lead to myocardial infarction [ 10 ] (Al-Motarreb et al, 2002), ischemic heart disease, cardiogenic shock, arrhythmia [ 11 ] (Mega & Dabe, 2017), manic-like schizophrenia and distress secondary to withdrawal [ 12 ] (Alemu et al, 2020). Other reported adverse effects include erectile dysfunction [ 13 ] (Hassan, Gunaid & Murray Lyon, 2007), involvement in unsafe sex [ 14 ] (Lifson et al, 2017), psychotic experiences [ 15 ] (Odenwald & Khatkonsum, 2008), oesophageal cancer [ 16 ] (Bozzuto, Ruggieri & Molinari, 2010), low birth weight [ 17 ] (Khawaja Al-Nsour & Saad, 2008) among pregnant mother chewers, and lactation problem [ 18 ] (Glenice & Hagen, 2003) postnatally.…”

Knowledge and practice regarding the behavioural risks of cancer among college students in Ethiopia

“…Risky behaviours including alcohol consumption and cigarette smoking are higher among college students than the general population [14][15][16][17][18]. School-based intervention programmes and policy setting on substance use and other risky behaviours are important to reduce the modifiable risk factors of cancer [17]. Therefore, studies at various levels and contexts are important to insight policy makers on the potential area of interventions.…”

Socio Demographic Profile of Late Childhood and Adolescence Abusing Cannabis

“…Adolescence is a period of ongoing neurodevelopment that is linked with an increase in risk-taking behaviours, including the onset of substance use. [1][2][3][4][5][6][7][8][9][10][11][12] Substance use causes problems related to increased mortality and morbidity among adolescents and contributes to various forms of mental illness and social complications. [13][14][15][16] Moreover adolescence is a period with significant brain development.…”