Khat (Catha edulis) Use is Associated with the Development of Gastritis among Adults in Nairobi County, Kenya

Abstract

Background: Khat (Catha edulis) chewing leads to a number of health related problems in the gastro-intestinal tract (GIT). Few studies have examined the effects of regular Khat chewing in relation to gastritis. Experimental studies with animals have shown that an association exists between Khat chewing and the incidence of gastritis.

Objective: To compare the prevalence of Khat chewing among cases with gastritis cases and cases without gastritis.

Design: Individual matched case control study.

Setting: Kenya Medical Research Institute's Centre for Clinical Research (CCR) and St. Michael’s Digestive Disease and Medical Care.

Subjects: Ninety three cases were selected using Rome III criteria for functional dyspepsia, and the controls (n=93) were matched on age and gender.

Results: Among the 93 dyspepsia cases, 64.5% were Khat chewers and 35.5% were nonchewers. Khat chewing was associated with the presence of functional dyspepsia (OR 3.8, 95% CI 1.6- 9.4). Of the 60 Khat chewers, 60% (36/60) had erosions in the upper GIT. Chewing Khat was associated with upper GIT erosions (OR 4.095% CI: 1.6, 10.1) It was determined that Khat chewers are four times more likely to have upper GIT erosions than non-chewers.. Khat chewers are 5.5 times (OR 5.5 95% CI: 1.9, 22.0)) more likely to have OGD (Oesophagitis, Gastritis and Duodenitis) compared to non-chewers. Among cases and controls, smoker  (p-value<0.001) and non-smoker (p-value<0.001) Khat chewers were significantly different. The prevalence of H. pylori among Khat chewers was significantly found to be higher (62.9%, p = 0.042); the two groups (Khat
chewers and non-chewers) showed significant difference

Conclusion: These results reveal that regular Khat chewing is positively associated with gastritis, which is consistent with previous experimental studies on animals.