Alemu Wondale Getinet, Zeleke Tadele Amare, Takele Wubet Worku, Mekonnen Shegaye Shumet
1Department of Psychiatry, College of Medicine and Health Science, University of Gondar, Gondar, Ethiopia.
2Department of Community Health Nursing, School of Nursing, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia.
Ann Gen Psychiatry. 2020 Mar 9;19:16. doi: 10.1186/s12991-020-00265-8. eCollection 2020.
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.
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.
The pooled prevalence of khat use among students was 16.7% (13.7-19.7%). In the subgroup analysis, the highest prevalence was observed in the Oromia region, at 21.1% (15.5%, 26.7%), and an almost equal prevalence of 14.8% (10.6, 18.9) and 14.3% (10.3, 18.3) was observed in Amhara and the Southern Nation, Nationalities, and People's Region of Ethiopia, respectively. Being male (OR: 2.43 (1.73, 3.13)), being a Muslim religion follower (OR: 2.22 (1.6, 2.8)), being an alcohol user (OR: 2.3 (1.5, 3.0)), khat use by a family member (OR: 1.8 (1.4, 2.2)), peer pressure (OR: 4.4 (3.1, 5.6)), and being a cigarette smoker (OR: 8.5 (5.3, 11.7)) were found to be risk factors for khat chewing.
Khat use is a common problem among students. Health promotion, awareness on effect of khat, set policy on khat and substance use on the male sex, Muslim religion, alcohol user, having a family-member khat user, peer pressure, and being a cigarette smoker as possible risk factors for khat use among students.
Irrespective of time restriction, all studies conducted in Ethiopia are included and cross-sectional in nature. Protocol no. CRD-42017081886.
恰特草的使用是一个广泛传播的公共卫生问题，影响着埃塞俄比亚经济最具生产力的人口区域。学生使用恰特草与心理、身体、社交和心理问题有关。由于公布的发生率各不相同，尚未确定可靠的流行率。本系统评价和荟萃分析的目的是综合埃塞俄比亚恰特草使用流行率及潜在风险因素的证据。
我们共找到284项研究，其中分别有266项因重复、主题不相关及其他原因被排除。纳入所有在埃塞俄比亚开展的、不论时间范围的关于学生嚼恰特草的研究。随后，18项研究用于流行率的综合分析。数据从已发表的报告中提取，如有任何缺失信息则向研究者索取。采用纽卡斯尔 - 渥太华量表（NOS）评估纳入文献的质量。使用随机效应荟萃分析汇总流行率。通过P值和相应95%置信区间的比值比来判定关联的存在。
学生中恰特草使用的合并流行率为16.7%（13.7 - 19.7%）。在亚组分析中，奥罗米亚地区的流行率最高，为21.1%（15.5%，26.7%），阿姆哈拉地区和埃塞俄比亚南方民族地区的流行率几乎相同，分别为14.8%（10.6，18.9）和14.3%（10.3，18.3）。男性（比值比：2.43（1.73，3.13））、穆斯林信徒（比值比：2.22（1.6，2.8））、饮酒者（比值比：2.3（1.5，3.0））、家庭成员使用恰特草（比值比：1.8（1.4，2.2））、同伴压力（比值比：4.4（3.1，5.6））以及吸烟者（比值比：8.5（5.3，11.7））被发现是嚼恰特草的风险因素。
恰特草的使用在学生中是一个常见问题。应开展健康促进活动，提高对恰特草影响的认识，针对男性、穆斯林宗教信徒、饮酒者、有家庭成员使用恰特草者、同伴压力以及吸烟者等可能作为学生使用恰特草风险因素的情况，制定关于恰特草及物质使用的政策。
不论时间限制，纳入了所有在埃塞俄比亚开展的研究，且这些研究本质上均为横断面研究。方案编号：CRD - 42017081886。
