Ligaba Bihonegn, Tareke Minale, Mamaru Almaz, Fentahun BirhanuAssefa
Department of Psychiatry, Akesta General Hospital, Amhara Regional Health Bureau, Akesta, Ethiopia.
Department of Psychiatry, College of Medical and Health Sciences, Bahir Dar University, Bahir Dar, Ethiopia.
BMC Psychiatry. 2025 Jul 29;25(1):738. doi: 10.1186/s12888-025-07167-7.
Khat is a commonly used psychoactive substance in East Africa and the Middle East, with rising use among adolescents. While general prevalence has been studied, there is a lack of research on problematic khat use (PKU), a harmful pattern that leads to distress or impairment. Few studies employ consistent assessment tools to distinguish casual use from problematic use, thus limiting our understanding of its specific attributes and hindering effective prevention and intervention efforts.
The aim of the study was to evaluate the prevalence of PKU and to identify factors that contribute to this issue among high school students.
A cross-sectional study was conducted at Legambo High School, Northeast Ethiopia, from April 26 to June 10, 2023. A total of 947 participants were selected through systematic random sampling. PKU was assessed using the Problematic Khat Use Screening Test (PKUST-17). Data were entered into Epi-Data version 4.6 and exported to SPSS version 26 for analysis. Binary logistic regression was used to identify factors associated with PKU. Variables with a p-value < 0.25 in the bivariate analysis were included in the multivariate logistic regression model using the enter method. Adjusted odds ratios (AOR) with 95% confidence intervals (CI) were calculated, and a p-value < 0.05 was considered statistically significant.
This study found that 19.7% of participants had PKU, accounting for 46.5% (95% CI: 41.7-51.5) of students who used khat, with an overall khat use prevalence of 42.3% (95% CI: 38.3-44.5) among high school students. Factors associated with PKU included exposure to traumatic events (AOR = 3.1, 95% CI: 1.7-4.9), age < 20 years (AOR = 4.9, 95% CI: 2.1-11.6), age 20-24 years (AOR = 3.2, 95% CI: 1.4-7.1), poor social support (AOR = 2.2, 95% CI: 1.1-4.3), depression (AOR = 0.4, 95% CI: 0.2-0.8), paternal substance use (AOR = 0.4, 95% CI: 0.2-0.6), and satisfactory academic performance (AOR = 3.1, 95% CI: 1.4-6.7).
In this study, nearly one in five participants exhibited PKU, linked to exposure to traumatic event, poor social support, and low parental education, while strong academic performance was protective. The study highlights the need for school-based mental health programs and standardized diagnostic criteria for PKU. Prevention efforts should prioritize youth exposed to trauma, with limited support, and from low-education households.
巧茶是东非和中东地区常用的精神活性物质，在青少年中的使用呈上升趋势。虽然已经对其总体流行情况进行了研究，但对于问题性巧茶使用（PKU）这一导致困扰或损害的有害模式，却缺乏相关研究。很少有研究使用一致的评估工具来区分偶尔使用和问题性使用，从而限制了我们对其具体特征的理解，并阻碍了有效的预防和干预措施。
本研究的目的是评估PKU的患病率，并确定高中生中导致这一问题的因素。
2023年4月26日至6月10日，在埃塞俄比亚东北部的莱甘博高中进行了一项横断面研究。通过系统随机抽样共选取了947名参与者。使用问题性巧茶使用筛查测试（PKUST - 17）评估PKU。数据录入Epi - Data 4.6版本，并导出到SPSS 26版本进行分析。采用二元逻辑回归来确定与PKU相关的因素。在双变量分析中p值<0.25的变量使用逐步进入法纳入多变量逻辑回归模型。计算调整后的优势比（AOR）及95%置信区间（CI），p值<0.05被认为具有统计学意义。
本研究发现19.7%的参与者存在PKU，占使用巧茶学生的46.5%（95% CI：41.7 - 51.5），高中生中巧茶总体使用率为42.3%（95% CI：38.3 - 44.5）。与PKU相关的因素包括经历创伤性事件（AOR = 3.1，95% CI：1.7 - 4.9）、年龄<20岁（AOR = 4.9，95% CI：2.1 - 11.6）、年龄20 - 24岁（AOR = 3.2，95% CI：1.4 - 7.1）、社会支持不足（AOR = 2.2，95% CI：1.1 - 4.3）、抑郁（AOR = 0.4，95% CI：0.2 - 0.8）、父亲使用物质（AOR = 0.4，95% CI：0.2 - 0.6）以及学业成绩良好（AOR = 3.1，95% CI：1.4 - 6.7）。
在本研究中，近五分之一的参与者表现出PKU，这与经历创伤性事件、社会支持不足和父母教育程度低有关，而良好的学业成绩具有保护作用。该研究强调了基于学校的心理健康项目以及PKU标准化诊断标准的必要性。预防工作应优先针对那些经历创伤、支持有限且来自低教育家庭的青少年。
