Prevalence of Khat chewing and associated factors in Ethiopia: Findings from the 2015 national Non-communicable diseases STEPS survey

Abstract

Background: Chewing of the leaves of the plant khat (Catha edulis Forsk) is a common habit in some countries of East Africa and the Arabian Peninsula. Khat is chewed by an estimated 20 million population every day in the Arabian Peninsula and in Eastern Africa region including Ethiopia. Ethiopia is believed to be the country of origin of khat where millions chew khat on a daily bases. Khat is also one of Ethiopia's biggest export commodities. This particular study assessed the prevalence of khat chewing and its predictors in Ethiopia.
Method: We used a community based cross-sectional data collected in 2015 as part of the National STEPs survey on NCD risk factors. .. The target population for this survey was all men and women aged 15-69 years who had been living at their place of residence for at least six months prior to the survey. A mix of stratified, three-stage cluster and simple random sampling were used to the study setting or clusters and households. The sampling frame was based on the population and housing census conducted in Ethiopia in 2007. A total of 10,260 households were selected from the 513 enumeration areas. Data were collected using WHO STEPS questionnaire and a locally constructed structured questionnaire to collect data on life time and current khat chewing and associated factors. Data were analyzed using SPSS Version 20, descriptive statistics as well as association tests were carried out.
Result: Nineteen percent of the respondents had ever chewed khat where among these, the majority (83%) were current khat chewers giving an overall prevalence of current khat chewing rate of 15.8% (21.1% of males and 9.4% of females). Khat was significantly higher in Afar [AOR and (95% CI)] [7.23 (2.01-26.01)], Dire Dawa [AOR and (95% CI)] [5.945 (2.116-16.706)], Harari [AOR and (95% CI)] [5.83 (1.49-22.87)] and Somali [AOR and (95% CI)] [4.315 (1.36-13.71)] among others. Similarly, the odds of khat chewing in urban areas [AOR and (95% CI)] [1.726 (1.18-2.53)] and current users of tobacco [AOR and (95% CI)] [2.882 (1.744 to 4.764)] were higher than their counterparts. Those who were in the third and fourth quartile income ranges [AOR and (95% CI)] 0.612 (0.384-0.974)], [AOR and (95% CI)] [0.508(0.309-0.84)] and those in high school education [AOR and (95% CI)] [0.386 (0.213-0.70)] were less likely to use Khat respectively.
Conclusion: Almost 1 out of 5 respondents had ever chewed khat and among these, the vast majority, more than 80%, reported to have been current khat chewers. Being educated and in a better economic status were the protective factors for current khat chewing. Current tobacco use was associated with khat chewing increasing the risk to NCDs. Hence, policy measures aiming at prevention of khat chewing are recommended. Further studies aiming at problematic khat chewing and associated psychosocial and physical health problems is recommended. [Ethiop. J. Health Dev. 2017;31(Special Issue):320-230]

Key words: Ethiopia, Risk Factors, Khat, NCD, Protective Factors, Tobacco