Mathews J D, Riley M D, Fejo L, Munoz E, Milns N R, Gardner I D, Powers J R, Ganygulpa E, Gununuwawuy B J
Menzies School of Health Research, Casuarina.
Med J Aust. 1988 Jun 6;148(11):548-55. doi: 10.5694/j.1326-5377.1988.tb93809.x.
Health status was assessed in 39 kava users and 34 non-users in a coastal Aboriginal community in Arnhem Land. Twenty (27%) respondents were very heavy (mean consumption, 440 g/week) users of kava; 15 (21%) respondents were heavy (310 g/week) users of kava and four (5%) respondents were occasional (100 g/week) users of kava. Kava users were more likely to complain of poor health and a "puffy" face, and were more likely to have a typical scaly rash, and slightly-increased patellar reflexes. Very heavy users of kava were 20% underweight and their levels of gamma-glutamyl transferase were increased greatly. Albumin, plasma protein, urea and bilirubin levels were decreased in kava users, and high-density lipoprotein cholesterol levels were increased. Kava users were more likely to show haematuria, and to have urine which was poorly acidified and of low specific gravity. The use of kava was also associated with an increased red-cell volume, with a decreased platelet volume and with a decreased lymphocyte count. Shortness of breath in kava users was associated with tall P waves on a resting electrocardiogram, which provided suggestive evidence of pulmonary hypertension. In common with other Aboriginal communities, there was evidence of decreased lung volumes, a high carriage rate of hepatitis B surface antigen, and of other morbidity that was unrelated to the use of kava. On the basis of these findings, there is a strong rationale for urgent social action to improve health in Aboriginal communities and, in particular, to reduce the consumption of kava and to improve the nutritional status of kava users.
在阿纳姆地一个沿海原住民社区，对39名卡瓦使用者和34名非使用者的健康状况进行了评估。20名（27%）受访者是卡瓦的重度使用者（平均消费量为每周440克）；15名（21%）受访者是卡瓦的大量使用者（每周310克），4名（5%）受访者是卡瓦的偶尔使用者（每周100克）。卡瓦使用者更有可能抱怨健康状况不佳和脸部“浮肿”，更有可能出现典型的鳞状皮疹，髌反射略有增强。卡瓦的重度使用者体重低于标准20%，其γ-谷氨酰转移酶水平大幅升高。卡瓦使用者的白蛋白、血浆蛋白、尿素和胆红素水平降低，高密度脂蛋白胆固醇水平升高。卡瓦使用者更有可能出现血尿，尿液酸化程度低且比重低。使用卡瓦还与红细胞体积增加、血小板体积减少和淋巴细胞计数减少有关。卡瓦使用者的呼吸急促与静息心电图上高耸的P波有关，这为肺动脉高压提供了提示性证据。与其他原住民社区一样，有证据表明肺容量减少、乙肝表面抗原携带率高以及存在与使用卡瓦无关的其他发病率。基于这些发现，有充分的理由采取紧急社会行动来改善原住民社区的健康状况，特别是减少卡瓦的消费并改善卡瓦使用者的营养状况。
