Chewing Khat Habit among Students of Dire Dawa University Ethiopia

Chewing Khat is one of the leading causes of mental disorders in Ethiopia. An alarming increase in Khat chewing among adults since the early 1990s was reported. Studies have shown that starting chewing Khat early in life is associated with an increased risk of adverse health effects. The objective of the study: This study was conducted to measure the increase in Khat chewing among students at Dire Dawa University students in Dire Dawa City, identify the natural causes of the problem, and demonstrate students' knowledge of the effects of Khat chewing. Material and Methods: The study was separate. Dated February 2021. Students during study time (n = 302) were included. The information was collected through personal interviews and completed a list of questions prepared after reviewing. RESULTS: Male (88.2%) of responding students chewed Khat with a significant difference (P <0.001) between males and females in terms of chewing. The year of student study, academic achievement, and family history of chewing Khat had a significant impact (P <0.05) on chewer students. Of the Khat chewer students who read 35.6% reported chewing both morning and afternoon. 66.7% of students who chewed reported that they had intentions to stop chewing and 82.4% considered chewing to be dangerous. CONCLUSION: Khat chewing gum among students is considered a problem and efforts are needed to help students stop chewing and this is considered a way to prevent Khat chewing among students.

Khat Chewing and Relapse in Peoples With Serious Mental Illness At Amanuel Mental Specialized Hospital: Comparative Study

Background people with serious mental illness using illicit drug exhibit poorer outcomes. But until now little is known about the impact of khat in thiss patient group. This study tried to assess the effect of khat chewing on relapse in people with serious mental illness. Method This is cross sectional comparative study involving 405 khat chewers and 400 non chewer people with serious mental illness. The study took three month involving interview (patient and care giver) and chart review. The study used Oslo Social Support Scale; Alcohol, Smoking, Substance Involvement Screening Test and questionnaire which include sociodemographic characteristics, illness related factors and relapse history. Result The study found that prevalence of relapse was higher in khat chewes than in non chewers (22% Vs 13%, p = 0.001) in people with serious mental illness. Additionally, the prevalence of relapse was also increased as the risk from use of khat was increased. In the khat chewer group previous hospitalization histories and presence of stressful life situation were the factor associated with relapse. On the otherhand treatment interruption, sleep disorder and previous hospitalization were the factors associated with relapse in non khat chewer people with serious mental illness. Conclusion Khat chewing poses additional burden for the already debilitating disease. Patient care should consider khat chewing as one of the components for intervention.

Habitual khat chewing alters urinary inorganic profile in adult healthy males

Objectives Khat (Catha edulis) is a stimulant plant, and it is abusive to induce euphoria, alertness and activity. Concomitant use of medications and khat chewing predisposes to the appearance of drug interactions result in treatment failure or toxicity. This study determined the changes in the urinary inorganic profile in adult healthy males who are chewing khat compared with non-khat chewer males. Methods A total of 40 adult non-smoker healthy males (20 khat chewer and 20 non-khat chewer) aged 24–30 years were selected. Khat chewer samples were positive for cathinone and cathine and negative for other drug of abuse, while non-khat chewer samples were negative for drug of abuse include cathinone and cathine. Samples were selected according to their results in immunoassay and gas chromatography mass spectrometry (GCMS) analysis. Cathine and cathinone were confirmed using liquid chromatography mass spectrometry (LC-MSMS) analysis. Inorganic profile includes titanium (Ti), cobalt (Co), copper (Cu), zinc (Zn), cadmium (Cd), and lead (Pb) were determined by using inductively coupled plasma-mass spectrometry (ICP-MS). Results The levels of Ti, Co, Zn, Cd, and Pb in urine were significantly higher among the khat chewer group compared with non-khat chewer. Ti, Cd, Co, Pb and Zn urine levels were 0.5-, 1.5-, 1.15-, 5-, and 8.2-fold higher in the khat chewer group compared to non-khat chewer, respectively. Conclusions We suggested that continuous khat chewing has a long term effect on metabolic pathway of therapeutic drugs that result in toxicity or failure of therapy.

Mathematical Modeling and Analysis of Khat-Chewing Dynamics

Khat is a green leaf and greenish plant where its branches and leaves are chewed to discharge liquid having active chemicals that change the user’s mood. The purpose of this article is to develop and analyze a mathematical model that can be used to understand the dynamics of chewing Khat. The proposed model monitors the dynamics of five compartments, namely, a group of people who do not chew Khat, designated as N t ; a group of people who are surrounded by Khat chewers but do not chew at present and may chew Khat in the future, denoted this as Σ t ; a group of people who chew Khat, which is represented in C t ; a group of people contains individuals who consumed Khat quite temporarily for social, spiritual, and recreational purposes, and we describe this group in T t ; and a group of people those who constantly chew Khat, and they are denoted by H t . We determined the Khat chewing generation number R c 0 using the next-generation matrix method, and we have examined the biological meaningfulness, mathematical wellposedness, and stability of both Khat chewing-free and Khat chewing-present equilibrium points of the model analytically. Numerical simulations were presented by solving our dynamical system using Matlabode45 to check the analytical results by considering parameter estimations. The results of this study show that, for R c 0 = .00039 , the Khat chewing-free equilibrium point is stable, and it is unstable for R c 0 = 1.194 , and the Khat chewing-present equilibrium point is stable if R c 0 = 1.194 , and it is unstable if R c 0 = .00039 . The stability of both equilibrium points implies that, for a high rate of conversion from non-Khat chewer to exposed groups ρ , the inflow of an insignificant number of Khat chewers to the community produces a significant number of Khat chewers , and if the return back from Khat chewing to the exposed group because of socio-economic, environmental, and religious influences α 2 grows exponentially, the inflow of an insignificant number of Khat chewers to the community produces an insignificant number of Khat chewers. It is found that increasing the rate of conversion from non-Khat chewer to exposed groups ρ makes the disease eradication more challenging. We, therefore, strongly urge religious leaders, social committee leaders, elders, and health experts to teach their followers to reduce their Khat-chewing habits.

Effect of Regular Khat Chewing on Serum Fasting Sugar Level in Diabetic patients versus Healthy Individuals; A comparative study

Background: Khat chewing is a long standing social-cultural habit in several countries. Even though many people chew khat simply for its pleasurable and stimulatory effect, evidence showed widely-held belief among khat chewers in Ethiopia and other part of the world that khat helps to lower blood glucose while some studies are contradicted on the effect of khat. There is limited data about khat’s effect on blood glucose especially in our setting, Harar estern Ethiopia. Objective: Primarily the present study aims to compare fasting blood sugar level among khat chewer diabetic and healthy individuals, and to asses risk factors associated with poor glycemic control in diabetic subjects. Method: A cross-sectional study included 200 confirmed diabetic and healthy subjects. Fasting blood sugar was determined by enzymatic method glucose oxidase and glucose hexokinase. Glycemic control was also determined for diabetic subjects based on the last 2-month diabetic clinic visits and current measurement. Result: (Median ± IQR [interquartile range]) fasting blood sugar difference among Khat chewer and non khat chewer were 159 ± 83 mg/dl and 202 ± 79 mg/dl respectively in diabetic subjects when tested by glucose oxidase. Similarly, in healthy non khat chewer and khat chewer, khat chewers has lower (Median ± IQR) fasting blood glucose level 82 ± 18 mg/dl than non khat chewers 94 ± 13 mg/dl when tested by glucose oxidase. Regarding risk factors associated with poor glycemic control in diabetic subjects, positive parental diabetes history, insulin medication, being overweight, obese were significantly associated with poor glycemic control. Conclusion: There was significant effect of khat on median FBS among khat chewers in diabetic and healthy individuals. And the proportion of glycemic control was high among diabetic subjects. Recommendation: Health care professional and patients should manage the risk factors to delay disease progression and restrain the damage. More studies should be conducted in randomized control trial manner to further elucidate khat effect on blood sugar level so that the actual effect of khat can be identified unlike in cross sectional where there may not be strong causal relationship.

The occurrence of urinary tract infection and determinant factors among diabetic patients at Dessie Referral Hospital, South Wollo, Northeast Ethiopia

Introduction: Diabetic patients have a higher tendency of developing all infections, especially infections of the genitourinary tract. Urinary tract infections cause considerable disorders in diabetic patients, and if complicated, can cause renal failure. In Ethiopia, the magnitude of diabetes mellitus-associated urinary tract infections increased from 7.1% in 2005 to 33.9% in 2019. The successful management of patients suffering from urinary tract infections in diabetic patients depends upon the identification of risk factors. This study aimed to determine the magnitude and factors affecting the urinary tract infections among diabetic patients which enable professionals to prevent infections and manage them effectively. Methods: Hospital-based cross-sectional study was conducted with 365 diabetic patients selected by systematic sampling technique from March to April 2020. Data were collected by trained BSc nurses via face-to-face interview and patient chart review. Urine microscopy was done to diagnose urinary tract infections. Data were coded and entered using Epi data version 3.1 and exported to Statistical Package of Social Sciences version 26 for analysis. Variables with p-value < 0.25 in bivariable logistic regression were included multivariable logistic regression and variables with a p-value < 0.05 were considered statistically significant. Results: The magnitude of urinary tract infections was 22.3% (95% confidence interval: 18–27). The odds of being infected by urinary tract infections were significantly higher in diabetic females (adjusted odds ratio: 2.46; 95% confidence interval: 1.40–4.32), duration of diabetes mellitus diagnosis of ⩾5 years (adjusted odds ratio: 1.98; 95% confidence interval: 1.05–3.72), with comorbidity (adjusted odds ratio: 4.87; 95% confidence interval: 2.76–8.59) and khat chewer (adjusted odds ratio: 1.84; 95% confidence interval: 1.04–3.24) compared with their counter. Conclusion and recommendation: Urinary tract infections were high among diabetic patients. Predictors like sex, duration of diagnosis, comorbidity, and khat chewer were found to be associated with urinary tract infections. Improvement of the regular screening of patients with diabetes mellitus for urinary tract infections will provide more effective measures in prevention and management.

The Severity and Extent of Coronary Artery Disease in Khat User Yemeni Patients

Background: Khat is the leaves of the Catha Edulis plant, contains cathinone, ephedrine, epinephrine, and other substances. Khat chewing is one of the major social habits in Yemen and some studies reported that the khat chewing is associated with worse outcome in patients with acute coronary syndrome compared with non-khat users but there are limited data about the effect of khat and the severity of coronary artery disease. Objectives: This study was performed to determine the extent and severity of coronary artery disease in khat chewer patients in Yemen. Patients and Method: Patients who underwent coronary angiography as a planned procedure at the cardiac center of Al-Thawra Modern General Hospital over six months duration were included in this cross-sectional prospective study. A well-designed questionnaire was filled which including complete personal and clinical history for each patient, the presence of CHD risk factors, echocardiography, and coronary angiography findings. The data after that were analyzed using the SPSS program and different correlations were statistically established among variables. Results: The total number of patients admitted with a diagnosis of ischemic heart disease and planned for coronary angiography were 365 patients in which khat chewer patients group were 306 (84%) compared with 59 (16%) of non-khat chewers. The mean ages were (55+ -10 vs. 57+ -9, P=0.396). History of smoking was (83% vs. 17%, P<0.001) in khat chewers and non-khat chewers respectively. The prevalence of DM & HTN were (44% vs. 36%, P=0.243) & (30% VS. 39%, P=0.I194) in comparing both groups respectively. The history of the acute coronary syndrome was more prevalent among the khat chewer patients group (54% vs. 24%, P<0.001). Impaired LV systolic function was more prevalent among khat chewer patients group associated with a significant statistical difference & EF<50% was(39% vs. 23%, P=0.024) in both groups respectively. The significant coronary stenosis was more frequent in the khat chewer patients group (66% vs. 45%, P=0.O42). The khat chewer patients group also had more atherosclerotic coronary arteries (64% vs. 50%, P=0.056), more prevalence of multi-vessel disease (27% vs. 22%, P=0.090), and more frequent of type C coronary artery lesions complexity (20% vs. 12%, P=0.011). On the other hand, the history of recurrent stable angina was more prevalent among the non-khat chewer patients group (76% vs. 45%, P<0.001) & the normal coronary arteries were more frequent among the non-khat chewer patients group (46% vs. 29%, P<0.001). Conclusion: Khat chewer patients had more atherosclerotic coronary arteries, more lesion complexity, a severe form of coronary artery disease, and more prevalence of the multi-vessel disease. Finally, we concluded that khat chewing is one of the risk factors of coronary artery disease in Yemen.

Oral Biofilm on Dental Materials Among Khat Chewers

Background: Nowadays khat chewing habit is increasing among population in southern part of Saudi Arabia, Jazan and till date there is no literature investigating the effect of khat on oral biofilm on dental materials. Objective: To evaluate and compare the bacterial biofilm on different types of dental restorative materials used in replacing missing tooth structures among khat chewers and non-khat chewers. Materials and Methods: Hundred and twenty biofilm samples were collected from different dental restorations, such as All-ceramic (AL), Metal Ceramic (MC), Metal crowns or bridges (M), Composite (C), Glass Ionomer (GI) and Amalgam (A) restorations in non-khat and khat chewers (K). DNA extraction was done and subjected to PCR. Bacterial species, such as Streptococcus, Neisseria, Bacillus, Granulicatella and Veillonella were identified and counted. PCR products were also sequenced to detect similarity. Association between bacterial type and dental materials among non-khat and khat chewers were tested with Chi-Square test (Fishers Exact test). Results: he frequency and percentage of Streptococcus species were marginally higher among khat chewers (42; 70%) compared with non-khat chewers (38; 63.3%) group. But the Veillonella species were higher among non-khat chewers (9: 15%), compared to the khat chewers group (7; 11.7%). No statistically significant difference was detected among species in both groups. In non-khat and khat chewer group, the maximum hits were related to Streptococcus spp. in glass ionomer, amalgam, and composite (restorative materials), followed by metal ceramic and metal (prosthetic materials). Veillonella spp. showed maximum hits in the metal group among non-khat chewers and in all-ceramic among khat chewers. Statically significant differences were recorded among composite and amalgam samples with p values 0.047 and 0.036 in khat chewer group. Conclusion: Khat chewers showed statistically significant differences in oral biofilm in the composite and amalgam restorative materials, but there were no significant differences found among any materials and species between the groups.

Khat chewing prevalence and correlates among university staff in Ethiopia: a cross-sectional study

Objectives Khat is an herbal cultivated plant growing mainly in Eastern Africa and Arabians. Chronic khat chewing leads to the development of liver toxicity, cardiovascular disease, sleeping disorder, psychosis, memory impairment, poor academic performance and variety of social and economic problems affecting the consumers and their families. Therefore, this study aimed to determine the prevalence of khat chewing and associated factors among Jimma university staff. An institution-based cross-sectional study was employed on 354 university staff. A self-administered questionnaire was used to collect the data. The analysis was done using Stata 14. A multivariable logistic regression model was used to identify associated factors of khat chewing among university staff. p ≤ 0.05 was employed to declare statistically significant factors. Results The lifetime prevalence of khat chewing among university staff was 41.0% (95% CI 35.9–46.1%). The odds of khat chewing was higher among males (AOR = 2.66 95%, CI 1.52–4.68), participants who had khat chewer friends (AOR = 2.15 95% CI 1.18–3.93), alcohol users (AOR = 9.02, 95% CI 4.96–16.42) and participants who had khat chewer family member (AOR = 4.03, 95% CI 1.16–13.99). Since a significant proportion of staff chew khat, appropriate measures need to be taken to reduce its prevalence and adverse social and health consequences.