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Effect of substance use on academic achievement of health officer and medical students of Jimma University, Southwest Ethiopia

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BACKGROUND: Khat (Catha edulis Forsk) chewing habit is becoming a national concern. The habit is spreading at an alarming rate among the young generation especially in high schools and higher institutions in Ethiopia. Students in universities and colleges commonly use khat, cigarette, coffee and other substances to get mental alertness. The objective of this study was to determine the prevalence and socio-demographic description of substance use and its effect on academic achievement of students in Jimma University. METHODS: A cross sectional study was conducted among 248 sampled Medical and health officer students from September 16 to 20, 2008 using stratified random sampling method. Data were collected using self-administered structured questionnaire and analyzed using SPSS for Windows version 16. Statistical association was done when appropriate and level of significance was taken at 5%. RESULt: Out of 248 sampled subjects, 239 responded giving a response rate of 96.4%. Of these 207 (86.6%) were males, 115 (48.1%) Oromos, 129 (54.0%) Orthodox Christian, 214 (89.5) in the age group between 20-24 years, and 152 (63.6%) medical students. The mean age of the study subjects was 23 (±1.6) years. The current prevalence of khat chewing was 33.1%. More males (37.2%) than females, Muslims (71.8%) than other religions, Oromos (40.9%) than other ethnic group, age group 25 - 30 (86.7%) more than other age groups and final year medical students (61.5%) than other class years were found to be khat chewers. The current prevalence of cigarette smoking, alcohol intake and coffee drinking were found to be 21.3%, 36.4%, and 87.9%, respectively. About 68% of the chewers were smoking cigarette during khat chewing. Eighty eight percent of chewers drink coffee. Forty percent of them used to take alcohol after khat chewing and 8.9% of the chewers took other substances like hashish, diazepam and shisha during chewing. Khat chewing had a significant association with high income (p<0.001), with smoking habit (p<0.001) and with coffee drinking habit (p<0.05). There was statistically significant difference (p<0.05) between the mean CGPA of chewers (2.77± 0.43) and non-chewers (2.89±0.40); smokers (2.70±0.45) and non-smokers (2.9±0.4); alcohol users (2.77±0.44) and non-users (2.9±0.4). But no remarkable difference is seen between the mean CGPA coffee users and non users (p = 0.439, 95% CI [0.23- 0.01]). CONCLUSION: The current prevalence of different substance use was found to be high. Sex, age, religion and income have shown significant association with the habit of khat chewing, cigarette smoking, coffee usage and alcohol intake. This study also showed that khat chewing, smoking and alcohol intake have a significant negative influence on academic achievements of university students.
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Effect of Substance Use on Academic Achievement of Health Officer Kalayu M. et al
155
ORIGINAL ARTICLE
EFFECT OF SUBSTANCE USE ON ACADEMIC ACHIEVEMENT
OF HEALTH OFFICER AND MEDICAL STUDENTS OF JIMMA
UNIVERSITY, SOUTHWEST ETHIOPIA
Kalayu Meressa
1
, MD, Andualem Mossie
2
, PhD, Yeshigeta Gelaw
3
, MD
ABSTRACT
BACKGROUND: Khat (Catha edulis Forsk) chewing habit is becoming a national concern. The habit is spreading
at an alarming rate among the young generation especially in high schools and higher institutions in Ethiopia.
Students in universities and colleges commonly use khat, cigarette, coffee and other substances to get mental
alertness. The objective of this study was to determine the prevalence and socio-demographic description of
substance use and its effect on academic achievement of students in Jimma University.
METHODS: A cross sectional study was conducted among 248 sampled Medical and health officer students from
September 16 to 20, 2008 using stratified random sampling method. Data were collected using self-administered
structured questionnaire and analyzed using SPSS for Windows version 16. Statistical association was done when
appropriate and level of significance was taken at 5%.
RESULt: Out of 248 sampled subjects, 239 responded giving a response rate of 96.4%. Of these 207 (86.6%) were
males, 115 (48.1%) Oromos, 129 (54.0%) Orthodox Christian, 214 (89.5) in the age group between 20-24 years, and
152 (63.6%) medical students. The mean age of the study subjects was 23 (±1.6) years. The current prevalence of
khat chewing was 33.1%. More males (37.2%) than females, Muslims (71.8%) than other religions, Oromos
(40.9%) than other ethnic group, age group 25 - 30 (86.7%) more than other age groups and final year medical
students (61.5%) than other class years were found to be khat chewers. The current prevalence of cigarette
smoking, alcohol intake and coffee drinking were found to be 21.3%, 36.4%, and 87.9%, respectively. About 68% of
the chewers were smoking cigarette during khat chewing. Eighty eight percent of chewers drink coffee. Forty
percent of them used to take alcohol after khat chewing and 8.9% of the chewers took other substances like
hashish, diazepam and shisha during chewing. Khat chewing had a significant association with high income
(p<0.001), with smoking habit (p<0.001) and with coffee drinking habit (p<0.05). There was statistically significant
difference (p<0.05) between the mean CGPA of chewers (2.77± 0.43) and non-chewers (2.89±0.40); smokers
(2.70±0.45) and non-smokers (2.9±0.4); alcohol users (2.77±0.44) and non-users (2.9±0.4). But no remarkable
difference is seen between the mean CGPA coffee users and non users (p = 0.439, 95% CI [0.23- 0.01]).
CONCLUSION: The current prevalence of different substance use was found to be high. Sex, age, religion and
income have shown significant association with the habit of khat chewing, cigarette smoking, coffee usage and
alcohol intake. This study also showed that khat chewing, smoking and alcohol intake have a significant negative
influence on academic achievements of university students.
KEY WORDS: Prevalence, Khat, Cigarette, alcohol, coffee, academic achievement, Jimma.
INTRODUCTION
Substance use and associated problems are of current
global concern. It has become an epidemic in some parts
of the African region with adolescents being the main
victims of health problems due to substance addiction
(1). The common substances abused in most African
countries including Ethiopia are alcohol, tobacco,
cannabis or marihuana and khat (2, 3). Reports showed
that these substances are widely used among students of
Ethiopia both in colleges and high schools (4).
1---------------------------------------------------
2
Department of Physiology, Medical School, Jimma University), P.O. Box 378, e-mail: andualemm2000@gmail.com
Telephone: 0912051945 or 0471 110118
3
Department of Ophthalmology, Medical School, Jimma University)
2
Corresponding author
Ethiop J. Health Sci Vol. 19, No. 3 November 2009
156
Khat (Catha edulis Forsk, Celastriaceae family) is an
evergreen flowering tree or shrub, widely cultivated in
East Africa both for domestic usage and for
commercial purposes (5). Catha edulis Now-a- days, it
is referred to khat in literatures consistently (6). In the
USA, khat is classified as a schedule IV substance and
cathinone classified as a schedule I substance by the
Drug enforcement agency (4, 5).
Khat contains a substance that stimulates the CNS.
The key constituent of khat responsible for its euphoric
effect is called cathine or norseudoephedrine (7, 8).
Another compound with a powerful CNS stimulant
termed as cathinone (a-aminopropiophenone) (10).
Besides the khatmines, several others compounds have
been isolated from khat. These nutrients include
ascorbic acid, β-carotene, calcium and iron, which
constitute 161 mg, 1.8 mg, 290 mg and 18.5 mg per
100g of fresh consumable leave of khat respectively (9,
10).
Studies suggested that cathinone has positive
inotropic and chronotropic effect on heart, a pressor
effect on arteries, increases blood pressure, respiratory
rate and metabolic rate transiently (3, 6). Reduced
birth weight and inhibition of lactation have been
reported in khat chewing mothers, possibly resulting
from increased dopamine production (7, 13). Regular
khat chewing is a predisposing risk factor for gastritis
and peptic ulcer disease, mental illness, cardiac
arrhythmia, tooth decay and constipation (15).
Contrary to the popular belief that khat chewing helps
students to concentrate while studying, a study conduct
in Jimma University revealed that chewers have lower
academic achievements than non-chewers (11, 12).
Smoking accounts about 10% of deaths world wide,
mainly through cancer especially lung cancer, of which
about 90% of cases are smoking related, ischemic heart
disease and chronic bronchitis (13). Smoking in
pregnancy reduces birth weight and retards child hood
development. It also increases abortion and prenatal
mortality (14). Tobacco products are used primarily to
stimulate the nervous system and to get mental
alertness and to improve memory (16).
Alcoholism is an international problem and had
touched every corner of the world, both developed and
developing countries (14, 16). Physical effects seen in
sexual activity with excessive use of alcohol is
degeneration and dysfunction of sexual glands though
a smaller amount can lower inhibition and make the
person more relaxed and more apt or eager to engage
in social and sexual activity (17). There is direct
relationship between heavy alcohol drinking and
hypertension (15).
Long-term alcohol use cause liver disease,
progression to cirrhosis and liver failure. It also results
in neurological degeneration resulting in dementia and
peripheral neuropathies (19). Excessive consumption
in pregnancy causes impaired fetal development,
associated with small size, abnormal facial
development and other physical abnormalities and
mental retardation (16, 20). Thus, these and other
abused substance in addition to the above described
health problems they cause potential socio-economic
problems to support their habit of drugs and these
abused substances make addicted individuals to
commit criminal activities (18, 21, 22). Studies done
among university students reported that significant
number of students consume khat, coffee and other
substances to increase concentration, alertness and to
keep awake for study during exam periods. However,
this period of stimulation lasts for approximately 3
hours; a depressive phase, including insomnia, malaise,
and a lack of concentration occur as latter effects (2,
8). Thus, the main aim of the present study is, to
determine the magnitude and effect of substance use
on academic performance of students.
SUBJECTS AND METHODS
A cross sectional study was conducted in Jimma
University, Jimma from August 10-September 14,
2008 among sampled medical and health officer
students using self-administered questionnaire.
The required sample size was estimated using formula
for single population proportion with 95% confidence
coefficient and considering the habit of khat chewing
of 30%.
The sampled students were recruited using
multistage sampling techniques based on their
disciplines (health officer and medicine), list in each
class year, and proportion of students in each class
year. Samples were proportionally allocate first the
two disciplines and then years of training. Subjects
were then selected by systematic random sampling
from each class year. The sampling sample size was
allocated to each school and class year as follows:
Effect of Substance Use on Academic Achievement of Health Officer Kalayu M. et al
157
Source population (N = 1079)
Figure 1. A tree showing sample allocation.
A structured questionnaire modified from WHO format
was utilized to collect data from the sampled study
population. The questionnaire included variables like
khat chewing habit with use of other substances, health
risks, peer pressure, attitude towards substance use,
cumulative Grade point average (CGPA) and socio-
demographic characteristics.
Data was collected using self administered
structured questionnaire, where students were asked to
respond genuinely to study variables including their
CGPA. The questionnaire was pre-tested on ten
randomly selected medical students who were excluded
from the study.
After checking the collected data for completeness,
it was analyzed using SPSS for Windows version 16.0.
Statistical significance testing was done and level of
significance was taken at 5%. Independent student t-test
and two-way ANOVA were employed to compare
variables when appropriate.
The study was approved by the Medical Science
Faculty of Jimma University. Informed consent was
taken from the study subjects during the data collection
and participation was totally voluntary. Confidentiality
regarding their habit and CGPA was kept unanimously.
The following definitions were used for the study.
Substance: any of the drugs used by subjects such as
khat, tobacco, coffee or alcohol
Substance abuse: Persistent or sporadic extensive use of
drugs in consistent or unrelated to acceptable medical
practice.
Life time prevalence of chewing/ smoking/ alcohol
use: the proportion of the study population who had ever
chewed khat/smoked/drunk in their lifetime.
Current prevalence of chewing/ smoking/ alcohol use:
the proportion of the study population who are chewing
khat/smoking / drinking in the last 30 days preceding the
study time.
Previous use: history of khat/ cigarette /alcohol use in
lifetime but not in the past 30 days.
Habitual use: refers to use of khat on a daily or more
frequently, otherwise referred as occasional use
Heavy smoking: smoking more than 10 cigarette per day
Substance abuse: Persistent or sporadic extensive use of
drugs in consistent or unrelated to acceptable medical
practice.
RESULT
Out of 248 sampled subjects, 239 responded giving a
response rate of 96.4% but nine questionnaires were
incomplete and so only 230 analyzed. The mean age was
23(±1.6) years. Two hundred seven (86.6%) of the
respondents were males, 115 (48.1%) Oromo, 129
(54.0%) Orthodox Christian, 214(89.2 %) in the age
group of 20-24 years and 151(63.2%) of the students
came from rural area (Table 1).
27
Year II Year III Year IV Year V interns
39 28 38 22 29
Year II
32
Health
officers (N
1
= 398)
Medical
Students
(N
2
= 681)
n
1
=92
n
2
=156
Year III Year IV
33
Ethiop J. Health Sci Vol. 19, No. 3 November 2009
158
Table 1. Prevalence and Socio-demographic characteristics of khat chewing in medical and health officer students of
JU, Southwestern Ethiopia, 2008
** These rows are not included in chi-square calculation as the cells contain expected values less than 5.
¥ Others include Catholic, Jehovah, Adventist
The current prevalence of khat chewing was 33.1%.
More khat use was seen among males (37.2%), Muslims
(71.8%), Oromos (40.9%), students in the age group 25 -
30 (86.7%), medical students (58%) and final year
medical students (61.5%). Thirty eight (48.1%) of the
Chewers smoke cigarette, 70 (88.6%) drank coffee and
7(8.9%) take other substances like hashish, diazepam and
shisha during chewing. Twenty (25.3%) reported to
drink alcohol after khat chewing. Twenty three (76.7%)
of the respondents who were getting >500Birr per month
were khat chewers (Table 1).
Among khat chewers 40 (50.6%) of them were
daily chewers and 22 (27.8%) of them have been
chewing for 2-4 years before the study. Twenty three
(29.1%) of the chewers consume khat that costs 15-20
Birr, 26 (32.9 %), spent more than four hours per session
(Table 2). Forty seven (59.5%) were from khat chewing
families.
Variables
Population
(n = 239)
Khat chewers
(n = 79)
Non
chewers
(n = 160)
X
2
P
-
value
No (%)
No (%)
No (%)
Sex
Male
Female
207 (86.6)
32 (13.4)
77 (37.2)
130 (62.8)
12.0
0.001
2 (6.2)
30 (93.8)
15
-
19**
10 (4.2)
2 (20.0)
8 (80)
20
-
24
214 (89.5)
64 (30.0)
150 (70.0)
25
-
30
15 (6.3)
13 (86.7)
2 (1.3)
Religion
Orthodox
129 (54.0)
30 (23.3)
99 (76.7)
34.51
<0.001
Muslim
39 (16.3)
28 (71.8)
11 (27.2)
Protestant
47 (19.7)
11 (23.4)
36 (75.6)
Others ¥
24 (10)
10 (41.7)
14 (58.3)
Ethnicity
Oromo
115 (48.1)
47 (40.9)
68 (59.1)
3.94
0
.1395
Amhara
71 (29.7)
20 (28.2)
51 (71.8)
Tigrie
25 (10.4)
7 (28.0)
18 (72.0)
Gurage **
14 (5.9)
2 (14.3)
12 (85.7)
Other **
14 (5.9)
3 (21.4
11 (78.6)
Field of
study
Medical
152 (63.6)
57 (37.5)
95 (62.5)
3.2
0.0736
Health officer
8
7 (36.4)
22 (25.3)
65 (74.7)
Income/mn
< 100
100 (41.8)
25 (25.0)
75 (75)
29.77
<0.0001
100
-
500
109 (45.6)
31 (28.4)
78 (71.6)
>500
30 (12.6)
23 (76.7)
7 (23.3)
Place of
upbringing
Rural
151(63.2)
40 (44.3)
48 (55.7)
8.81
0.003
Urban
88 (3
6.8)
39 (26.5)
112 (73.5)
Effect of Substance Use on Academic Achievement of Health Officer Kalayu M. et al
159
Table 2. Pattern of khat chewing in medical and health officer students of JU, Southwestern Ethiopia, 2008.
Chewing pattern(n=79)
Frequency
N
o
%
Chewing frequency
Daily
40
50.6
2
-
3
times a week
20
25.3
Once a week
11
14.0
Occasionally
8
10.1
Duration of chewing
< 1 month
8
10.1
1
-
12 month
10
12.7
1
-
2 year
9
11.4
2
-
4 year
30
38.0
>
4 year
22
27.8
Price of Khat chewed/session (Birr)
5
-
10
21
26.5
10
-
15
17
21.5
15
-
20
23
29.1
> 20
18
22.8
Time spent /session (hours)
< 1
10
12.7
1
-
2
18
22.8
2
-
3
25
31.6
>
4
26
32.9
Additional substances used during and
after Khat
Smoking
38
48.1
Coffee
70
88.6
Alcohol
20
25.3
*Other
7
8.9%
*Other: hashish, shisha and diazepam
Relief from academic stress 41(51.8%), for relaxation 27
(34.1%) and socialization 17 (21.5%) were among the
reasons for khat chewing. Thirty six (46%) of the
chewers believed that they can stop chewing in the future
and out of these 23 (59.0%) said they will stop after
graduation. All of the respondents said that khat chewing
has health risk. Sleep disturbance 177 (74.0%),
psychosis 167 (70%) and PUD 100 (41.8%) were few
among others health problems reported by respondents,
considered to be the result of khat Chewing.
Table 4. Association among khat chewing, cigarette smoking alcohol and coffee usage in medical and health officer
students of JU, Southwestern Ethiopia, 2008
Variables
Khat
X
2
P-value
chewers
Non chewers
Total
Smoking
Yes
38
13
51
48
< 0.001
No
41
147
188
Coffee usage
Yes
76
134
210
10
< 0.05
No
3
26
29
Alcohol intake
Yes
31
5
36
No
48
107
155
34.39
< 0.001
Ethiop J. Health Sci Vol. 19, No. 3 November 2009
160
The prevalence of cigarette smoking was 21.3%.
Cigarette smoking was common among males (23.6%),
age group 25-30 years 9(60%), Muslims 16(41%),
Oromo 27(23.5%), and those from urban 27(30.7%) were
smokers. Among the smokers 11(21.6%) smoked greater
than nine cigarettes, 22(43.1%) smoked 4-9 cigarettes
and 14(27.5%) smoked 1-3 cigarettes per day. Of the
total smokers, 20(33.9%) used to smoke for the last 2-4
years and 31(52.5%) of the smokers said that they will
stop smoking in the future. Cigarette smoking has a
positive association with age, sex, religion, income and
place of up bringing (p<0.05). But no significant
association of cigarette smoking was observed with
ethnicity and field of study (p>0.05) (Table 3). Almost
all participants cited that cigarette smoking is a risk for
lung cancer (96.7%), hypertension (71.9 %) and coronary
artery disease (68.2%). As shown in figure 2, 58.6% of
medical interns and 50.0% of fifth year medical students
were found to be khat chewers than the other class years.
The prevalence of alcohol intake was 36.4%.
Alcohol intake was greater in males 81(39.1%), age
group 25-30 years 10 (61.5%), Orthodox 55(42.6%),
Tigrie 15(60.0%), those who earned >500 Birr/month
16(53.4%) and those from urban 37(42.0%). Age, sex
and ethnicity were significantly associated with alcohol
drinking (p < 0.05).
Most of the students 181(87.4%) drink at least one
cup of coffee per day. Hundred (47.6%), 78 (37.1%), 23
(11.0%) and 9 (4.3%) of them drink 1, 2, 3 and 4 cups
per day, respectively. There statistically associated
variable with coffee drinking, while khat chewing was
significantly associated with smoking, coffee drinking
and alcohol intake (p < 0.05) (Table 4).
Table 3. Prevalence and Socio-demographic characteristics of cigarette smoking in medical and health officer
students of JU, Southwestern Ethiopia, 2008
variables
Population
(239)
Smokers
(51)
Non smokers
(188)
X
2
P
-
value
No (%)
No (%)
No (%)
Sex
Male
207 (86.6)
49 (23.6)
1
58 (76.3)
4.03
0.0447
Female
32 (13.4)
2 (6.2)
30 (93.8)
15
-
19 **
4 (1.6)
0
4 (100.0)
7.21
0.0072
Age
20
-
24
224 (92.1)
42 (19.1)
178 (80.9)
25
-
30
15 (6.3)
9 (60)
6 (40)
Religion
Orthodox
129 (54.0)
23 (17.8)
106 (82.2)
13.47
0.00012
Muslim
39 (16.3)
16 (41.0)
23 (59.0)
Protestant
47 (19.7)
5 (10.7)
42 (89.3)
Others
24 (10)
7 (29.2)
17 (70.8)
Ethnicity
Oromo
115 (48.1)
27 (23.5)
88 (76.5)
1.02
0.6005
Amhara
71 (29.7)
12 (16.9)
59 (83.1)
Tigrie
25 (10.4)
5 (20.0)
20 (80.0)
Gurage **
14 (5.9)
3 (21.4)
11 (78.6)
Other **
14 (5.9)
4 (28.6)
10 (71.4)
Field of study
Medical
152 (63.6)
38 (25.0)
114 (75.0)
2.76
0.0966
HO
87 (36.4)
13 (15.0)
74 (85.0)
Income
< 100
100 (41.8)
17 (17.0)
83 (83.0)
10.05
0.0066
100
-
5
00
109 (45.6)
21 (19.3)
88 (80.7)
>500
30 (12.6)
13 (43.4)
17 (56.6)
Place of
upbringing
Rural
151 (63.2)
24 (15.9)
127 (84.1)
6.39
0.0115
Urban
88 (36.8)
27 (30.7)
61 (69.3)
** These rows are not included in chi-square calculation as the cells contain expected values less than 5.
Out of the total respondents 94(39.3%) mentioned that
use of substance helped them for better academic
achievement. Coffee 48 (58.5%), khat 39 (48.0%),
cigarette 5 (6.0%) and alcohol 2 (2.4%) were mentioned
to help their academic achievement.
Effect of Substance Use on Academic Achievement of Health Officer Kalayu M. et al
161
56
12
40
15
41
24
11
11
12
17
0
10
20
30
40
50
60
70
Year II Year III Year IV Year V Interns
Class Year
Frequency of chewers and non
chewers
Non-Chewers
Chewers
Table 5. Association among Khat chewing, cigarette smoking, coffee usage with academic performance (CGPA) in
medical and health officer students of JU, Jimma, Southwestern Ethiopia, Sept.2008
Substance use
Mean
CGPA ± SD
t
-
test for equality of means
t
p-value
95% confidence internal
of the difference
Mean
difference
Lower
Upper
Khat chewing
Yes
2.77
± 0.43
2.32
0.021
0.13
0.246
0.020
No
2.89 ± 0.4
Cigarette smoking
Yes
2.
70 ± 0.45
2.94
0.004
0.20
0.320
0.06
No
2.90 ± 0.40
Alcohol intake
Yes
2.77 ± 0.44
2.41
0.016
0.13
0.245
0.025
No
2.90 ± 0.40
Coffee usage
Yes
2.85 ± 041
0.78
0.439
0.06
0.229
0.009
No
2.91 ± 0.47
Significant difference has been seen in the mean CGPA
of khat chewers versus non chewers (p = 0.021, 95%CI
0.246 and 0.02); smokers versus nonsmokers (p = 0.004,
95%CI 0.32 and 0.06) and the mean CGPA of those who
drink alcohol versus non users (p = 0.016, 95%CI 0.245
and 0.025. But no remarkable difference was seen
between the mean CGPA coffee users and non users (p =
0.439, 95%CI 0.229 and 0.009) (Table 5).
DISCUSSION
The prevalence of khat chewing among medical and
health officer students was 33.1% which is almost
comparable to the one that was reported for Jimma
University students 24.79% (24).
Similar studies among pharmacy and technology
students of Addis Ababa University in 2004(13) and
college students of Northwest Ethiopia in 2002 (20)
found prevalence of khat chewing 14.4% and 17.5%,
respectively which are lower than the current finding.
These could be explained by the availability of khat,
social acceptance to the habit and study time difference
which may contribute to the higher prevalence among JU
medical and health officer students than those in North
West Ethiopia and Addis Ababa University.
This study showed that the habit of khat chewing
was higher in males than females, which is in line with
research findings reported for Jimma University students
in 2004(24). This could be because females are culturally
more restricted than males.
In this study khat chewing has shown significant
association with religion and Muslim students were
found to be khat chewers as compared with students of
other religion. The possible explanation could be
because the habit of khat chewing is socially accepted
among Muslim communities. Thus, Muslim students
may adopt the habit from their society. This finding is
Fig. 2:
Distribution of chat chewing in relation to class year among medical and health officer
students of Jimma University, Southwest Ethiopia, 2008.
Ethiop J. Health Sci Vol. 19, No. 3 November 2009
162
supported by similar studies done in Jimma University
(24), Jimma town (12) and Butajira (1).
In the present study, ethnicity and khat chewing
have shown significant association. More Students of
Oromo ethnic group were found to be chewers than other
ethnic backgrounds. The possible reason could be that
khat is cultivated abundantly in Oromia region and the
society in this area might use it for different purposes and
students may have learned the habit from their
community.
In this study a significant association was found
between smoking and sex, income, religion and place of
up bringing. This is because due to cultural influence on
females and the high income.
Habits of khat chewing and smoking have a strong
association with monthly income. Most of the students
whose monthly income >500 birr were found to be
chewers and smokers compared to those with lower
income. This indicates that having money encourages
students to develop new habits like khat chewing,
cigarette smoking.
The prevalence of alcohol in take in this study was
36.4% which is comparable with that of pharmacy and
technology students of Addis Ababa University (13).
More than half of respondents who had sexual contact
following use of substance
There was statistically significant difference
between the mean CGPA of chewers and non-chewers;
smokers and non-smokers ; alcohol users and non-users
This finding is in agreement with other studies (25). This
shows that substance use has a negative influence on
academic performance of students. The possible
explanation is that the associated valuable time and
energy wastage for khat ceremony and possibly Mirkana
Chebsi despite the fact that khat chewing increases
mental alertness/concentration and keeps students awake
(2, 3).
In conclusion, the current prevalence of different
substance use was found to be high. Sex, age, religion
and income have shown significant association with the
habit of khat chewing, cigarette smoking, coffee usage
and alcohol intake. This study also showed that khat
chewing, smoking and alcohol intake have a significant
negative influence on academic achievements of
university students.
Therefore, Jimma University should teach and
counsel students on advantages and disadvantages of
substance use. Health institution and policy makers
should control the production and distribution of khat,
coffee and tobacco plants. Rules and regulations should
be set by universities/colleges in order to prevent
development of such habits to produce motivated and
hard working students with high academic performance.
ACKNOWLEDGEMENTS
The authors are grateful to the student research program
(SRP) of Jimma University for funding this research
project.
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... Students have been studied extensively by public health researchers for their substance use patterns. Earlier research revealed high substance consumption among students and observed the estimates to be linked with various characteristics including age, gender, religion, family members' substance abuse, personal pleasure, peer pressure and poor academic achievement (Aklog et al., 2013;Cox et al., 2007;Salgado García et al., 2020;Makanjuola et al., 2007;Mekonen et al., 2017;Meressa et al., 2009). ...
... The results show that male scholars are significantly more likely to consume alcohol than their female counterparts. These findings align with previous studies which have found the gender of the students to be significantly associated with substance use (Aklog et al., 2013;Makanjuola et al., 2007;Meressa et al., 2009). Earlier studies have also documented that alcohol use among males is more socially acceptable than for females (Chaiyasong et al., 2018;Leung et al., 2019). ...
... Our study found that 34% of research scholars have daily smoking habits, much higher than the national estimates (GATS, 2017;Rani, 2003). Similar to alcohol consumption, males are more likely to smoke than females, aligning with previous literature which documents that society finds men smoking more acceptable (Aklog et al., 2013;Meressa et al., 2009). The primarily Muslim AMU scholars dominated the overall prevalence of smoking. ...
Article
Full-text available
Purpose Alcohol and tobacco consumption are significant public health concerns and considered some of the riskiest behaviors among students. Despite strong indications of heavy consumption of these substances, certain sections of the student population remain unexplored regarding their consumption patterns and associated factors, including research scholars pursuing Doctor of Philosophy degrees. This study aims to explore the patterns and correlations of consumption of alcohol and tobacco among doctoral students in three Indian universities. Design/methodology/approach A cross-sectional study was conducted on a total of 530 scholars from three central universities, Aligarh Muslim University, Banaras Hindu University and Jawahar Lal Nehru University, and focused on two substances (alcohol and tobacco) frequently used by students in India. Bi-variate analysis and penalized logistic regressions were applied to analyse the prevalence and associated factors of alcohol, smoking and smokeless tobacco among doctoral students. Findings Tobacco consumption was observed to be the dominant form of substance use among doctoral students. Findings revealed that 34% of scholars smoked and 25% consumed smokeless tobacco daily and around 14% consumed alcohol at least once a week. Major significant correlates of substance consumption among scholars were found to be gender, religion, parental mortality, dissatisfaction with academic performance and stress about future career/employment. Significant variation in substance use patterns was observed among universities. Originality/value This study provides first-hand evidence on substance use patterns and the correlates among doctoral students in three Indian universities. Findings indicate the implementation of specific intervention programs for mental health and counselling for this section of students to prevent substance use addiction would be beneficial.
... [12][13][14]17,34,35 Khat chewing-a common practice in the Horn of Africa and Middle East Countries, 36 the prevalence in Ethiopian students ranged from 3.7% to 33.1%. [12][13][14]17,18,27,34,35,37,38 This shows there is no scarcity but comprehensive and accurate evidence on current substance use among students in Ethiopia, and this warrants a systematic review and meta-analysis. The results of this systematic review are imports for developing policies at the national and institutional level to mitigate and control the increasingly rampant use of substances in the young population in school settings. ...
... 20,31,50 There was a wide sample size difference among the studies ranging from 193 56 to 3001. 44 The highest prevalence of current use of any substance was 47.9%, 32 33.1% for khat consumption, 38 44.2% for alcohol, 20 and 29.5% for smoking cigarettes. 56 All studies were conducted between 2002 and 2019 in high schools, preparatory schools, colleges, and Universities. ...
... 56 All studies were conducted between 2002 and 2019 in high schools, preparatory schools, colleges, and Universities. Eight studies were conducted among high and preparatory schools, 15,16,32,47,49,54,55,58 23 studies conducted among university students [12][13][14][17][18][19][20][21]30,31,33,37,38,[44][45][46]48,[50][51][52][53]56,57 1 study was conducted among polytechnic college. 43 The mean age of the study participants ranges from 15.6 to 23 years ( Table 1). ...
Article
Full-text available
Background The use of psychoactive substances is one of the main public health issues worldwide. However, there is a lack of evidence on the magnitude of current substance use among students in Ethiopia. Therefore, this study aimed to provide comprehensive views of the current prevalence of substance use among students in Ethiopia. Methods We searched PubMed/Medline, Health InterNetwork Access to Research Initiative (HINARI), Google Scholar, and gray literature sources between 2000 and 2019. The prevalence of current substances with a 95% confidence interval (CI) was estimated using the random-effects model. The results were presented using forest plots, and Cochrane Q-test and I ² were used to measure the extents of between-study variations. Results A total of 1543 study articles were identified from electronic databases, and 32 cross-sectional studies were included in the meta-analysis. The prevalence of current use of at least 1 substance was 37.63% (95% CI: 33.66, 41.69), alcohol 27.61% (95% CI: 22.10, 33.48), khat 17.20% (95% CI: 14.03, 20.62), and smoking 9.74% (95% CI: 7.17, 12.64). The prevalence of any substance use in high school students versus university/college students was 41.55% (95% CI: 38.83, 44.29) versus 36.24% (95% CI: 32.37, 40.20), alcohol 24.21% (95% CI: 14.05, 36.11) versus 25.27% (95% CI: 19.76, 31.20), khat 13.82% (95% CI: 8.61, 20.02) versus 17.30% (95% CI:13.75, 21.16), and cigarette 8.30% (95% CI: 1.89, 18.60) versus 9.80% (95% CI: 7.32, 12.58). Meta-regression analysis revealed publication year, sample size, female proportion, and age were not significantly associated with the current use of substances. Conclusion Overall, the current substance use of any substance, alcohol, chewing khat, and smoking cigarettes was relatively high. A significant proportion of high school students were already using substances at an early age. Policymakers should formulate and implement regulations to control the pervasive use of substances by young people around educational institutions at all levels. Protocol Registration The protocol has been registered on 19 August 2019 on the International Prospective Register of Systematic Reviews (PROSPERO) with ID: CDR42019130560.
... [16][17][18][19][20] Prior research conducted in Ethiopia on a small and large scale found that substance use ranged from 23.86% to 62.50%. [21][22][23][24][25] On the other hand, social mobility, accessibility, low wealth, low level of education, lower socioeconomic groupings, increasing age, employment and stressful life events were factors of substance use (chat, cigarettes and alcohol). Other motivations for substance use have been discovered, such as improved well-being, excitement, social participation, increased alertness, stress reduction, increased capacity to focus and addiction. ...
... Other motivations for substance use have been discovered, such as improved well-being, excitement, social participation, increased alertness, stress reduction, increased capacity to focus and addiction. [22][23][24][25][26][27][28] Substance abuse endangers people's health and their social and economic well-being. 5 29 30 Ethiopia's government implemented a mandatory policy to counteract these dangers and raised taxes on regularly used substances. ...
Article
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Objective: The use of substances has become one of the world's most serious public health and socioeconomic issues. Most nations in sub-Saharan Africa, including Ethiopia, are undergoing significant economic transitions, creating a favourable environment for socially destructive substance use. This study aimed to determine the geographical variation, prevalence and correlates of substance use among ever-married men in Ethiopia. Design: A community-based cross-sectional survey was undertaken from 18 January 2016 to 27 June 2016. Data source: Data were used from the 2016 Ethiopian Demographic and Health Survey (EDHS). Data extraction and analysis: Data from the 2016 EDHS was used, and a total of 7793 ever-married men were involved in the analysis. The spatial autocorrelation statistic (Global Moran's I) was used to determine whether substance use was dispersed, clustered or randomly distributed. A multilevel logistic regression model was used to identify the correlates with substance use, and statistical significance was declared at p<0.05 and 95% CI. Results: Of all ever-married men, 72.5% (95% CI 71.5% to 73.4%) were currently using at least one of the three substances (alcohol, cigarettes and chat). The highest hotspot areas of substance use were observed in Ahmara and Tigray regions. The age (adjusted OR, AOR 1.80; 95% CI 1.32 to 2.45), educational status (AOR 0.64; 95% CI 0.51 to 0.82), occupation (AOR 1.36; 95% CI 1.05 to 1.76), watching television (AOR 1.50; 95% CI 1.25 to 1.81) and living in the city (AOR 2.25; 95% CI to 1.36 to 3.74) were individual and community-level correlates found to have a statistically significant association with substance use. Conclusion: In this study, nearly three-fourths of married men used one of the three substances. Given these findings, it is critical to reducing the problem by improving modifiable individual-level variables such as educational status and reducing substance advertising.
... The overall prevalence of substance use among University students in Ethiopia ranged from 16.7% to 72.6% [1,[8][9][10][11][12][13][14][15][16][17][18][19][20][21][22][23][24][25][26] whereas the overall prevalence of substance use varies from 24.6% to 47.9% among high school students [27][28][29][30][31]. The lifetime prevalence of Khat chewing, Alcohol consumption and cigarette smoking varies from 7% to 65%, 13%-28%, 4.8%-5.4% and 4.2-50%, 0.8 to 67 and 0.8 to 12 among college and University students respectively [1,[9][10][11][13][14][15][16][19][20][21][22][23]26,[31][32][33][34][35]. ...
... Based on the number of substances consumed the lifetime prevalence of more than two substance abuse was 39% (95% confidence interval (CI), 30 to 48). This finding is in line with studies conducted among college and university student in Ethiopia [1,[9][10][11][13][14][15][16][19][20][21][22][23]26,[31][32][33][34][35]. ...
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Background Substance uses were seen in 18–25 years old age groups who are more than 40% world population, from which Africa was the region with the highest proportion accounting 60% in 2016. This review aimed to assess the burden of substance abuse among students in Ethiopia. Methods A comprehensive search was conducted in PubMed/Medline; Science direct and African Online Journal without language and date restriction. The Heterogeneity among the included studies was checked with forest plot, χ2 test, I2 test, and the p-values. All cross-sectional studies reporting rate of prevalence of psychoactive substance among students were included and the rest were excluded. Result A total of 545 articles were identified from different databases and 42 articles were selected for evaluation. Twenty-nine Articles with 22, 012 participants were included. The overall prevalence of psychoactive substance abuse was 32.28% (95% confidence interval (CI): 26.74 to 37.82). Conclusion The review revealed that one-third of the high school and higher education students used different psychoactive substances in Ethiopia. Registration This Systematic Review and Meta-Analysis was registered in Prospero international prospective register of systemic reviews (CRD42020146656) on April 28/2020.
... 42 Current Alcohol intake is defined as having consumed alcohol at least once in the past 30 days. 43 Khat Chewing is defined as individually considered chewing khat at least once in the 30 days preceding 44 High DDS is defined as the highest tertile of the one-week count intake food group, and Low DDS is defined as the lower two tertiles of the one-week count intake food group. 40 Self-reported NCD is defined as Doctor has told you that suffered from this disease and/or advised treatment for the same. ...
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Background: Central obesity (CO) is a medical problem in which extra fat is accumulated in the abdomen and stomach extent that it may harm health. Furthermore, previous studies in Ethiopia predominantly relied on body mass index used to measure obesity and do not show distribution of fat. However, there is a paucity of information on the measurement of central obesity using waist circumference and associated factors in Ethiopia particularly in the study area. Hence, the purpose of this study is to assess the prevalence of central obesity and associated factors among urban adults in Dire Dawa, administrative city, Eastern Ethiopia. Methods: A community-based cross-sectional study was conducted among 633 adults in selected kebeles of administrative city from October 15 to November 15, 2020. A multistage and systematic sampling procedure was used to select study participants. Central obesity is defined as a condition with waist circumference ≥83.7 cm for men and ≥78 cm for women with or without general obesity (GO). Odds ratio along with 95% confidence interval was estimated to identify factors associated with central obesity using multiple logistic regression analysis. Results: The overall prevalence of central obesity was 76.1%; at 95% CI (73%, 80%). Associated factors of central obesity were age 45 years and above [AOR = 3.75, 95% CI (1.86, 7.55)], being female [AOR = 2.52, 95% CI: (1.62, 3.94)], alcohol consumption [AOR = 2.61, 95% CI: (1.69, 4.05], physical inactivity [AOR = 2.05, 95% CI: (1.23, 3.42)], and two hour and more time spent on watching television [AOR = 3.30, 95% CI: (1.59, 6.82)]. Conclusion: The study shows central obesity was high in the study area. Age 45 years and above, being females, married, physically inactive, alcohol consumption, and spending a long time watching television was associated with central obesity. Having regular physical activity, limiting alcohol drinking, and limiting time spent watching television were recommended to prevent central obesity and associated risk among adults.
... In our opinion the reason for majority group of alcohol consumers was they were not having enough knowledge about the health problem related to alcohol. Studies conducted worldwide have estimated a prevalence rate of substance abuse to be around 20-40% among students which was higher than the prevalence rate of substance abuse among our participants which is 9.8% [18,19,20,21,22]. In our opinion the reason for this less prevalence was most the participants about 94% were aware about the physical and the mental illness caused by drug addiction. ...
Article
Introduction: It is well documented that tobacco, alcohol and drug use can be detrimental to health. However, little is known about the impact of smoking, alcohol and substance abuse on human among students. The aim of this study was to study the effect of smoking, alcohol and substance abuse on human among students. Methods: The study was carried out on 51 students comprising of 26 M.B.B.S and 25 non-M.B.B.S students. The students were given a pretested questionnaire and asked to fill up the questions. The responses were collected and analyzed using appropriate statistical tools for parametric and non-parametric data with the help of SPSS for Windows version 22 software. Results: The knowledge of participants on Effects of smoking, alcohol and substance abuse was 73%. The participants had a positive attitude towards the complete ban of advertising of tobacco products and most of them (58%) had a positive attitude towards the complete ban of tobacco usage. 19.6% of participants consumed alcohol and 22.2% had at least once smoked a cigarette and 9.8% practiced substance abuse. Conclusion: The study concludes that there is a definitive and palpable practice of smoking, alcohol and substance abuse among students. To prevent such practices awareness must spread among the students.
... Increasing intake among younger age groups as part of daily habit has also been reported [6] ( (Mathewson et al., 2013). The beliefs that khat may enhance concentration [7] (Richard Hoffman & Mustafa al'Absi, 2011), performance motivation and strengthen their socialization, attract many adolescents of high schools and secondary school students to consume khat [8] (Meressa Kalayu et al., 2009). ...
Article
Full-text available
Introduction: Khat is a flowering plant with stimulant effect on the nervous system and produce psychological dependence. Despite its harmful effects, the ingestion of khat has been part of cultural norms and the legality of khat varies by region. Objective: This systematic review aimed at critically evaluating the available evidence on the risk factors of khat chewing among adolescents. Methods: A systematic review was conducted on published research studies from five databases Scopus, PubMed, Science-direct, Ovid and google scholar using keywords khat chewing OR qat chewing AND associated factors OR risk factors OR contributing factors AND adolescents OR teenagers. Articles included were either cross-sectional, cohort, case-control or qualitative studies which were published between the year 1990 till present. Excluded articles were the non-English written articles, descriptive studies and irrelevant topics being studied. Results: Out of 2617 records identified and screened, six were included for the analysis and interpretation of the data. All included studies were cross-sectional study design. All six studies reported having family members who chewed khat significantly predict khat chewing among adolescents, followed by five articles for friends or peers who also chewed khat and four articles for male gender. Smoking was also found to have the highest odds (OR = 18.2; 95% CI: 12.95-25.72) for khat chewing among adolescents. Conclusion: The review highlights the crucial role of family members, friends or peers and male gender to predict khat chewing among adolescents. Effectiveness of health promotion programs to educate and reduce khat chewing among adolescents will require active participation of family members and friends.
... 3,4 However, these restrict themselves to tobacco or alcohol use and many of these are gender-biased. [5][6][7][8][9][10][11] Hence, the present study was undertaken to estimate the prevalence of substance abuse among medical students in a medical college situated in an urban region of Eastern India. ...
Article
Full-text available
Ab s t rac t Background: Substance abuse and its associated problems are a global concern. Substances, such as tobacco, alcohol, cannabis, and various allopathic drugs have been widely abused by students for various reasons despite their known ill effects. Aim and objective: Prevalence and pattern of substance abuse among the medical students in a medical college of Kolkata during coronavirus disease (COVID-19) pandemic. Material and methods: It is a hospital-based, cross-sectional study. This is carried out in ESI-PGIMSR, ESIC Medical College and Hospital, Joka, Kolkata. Data were collected after obtaining due consent from the Institutional Ethics Committee of our institute. Students pursuing MBBS constitute the study population. A structured questionnaire created by Google forms, designed, and validated in-house was circulated online to obtain the information. Results: Details of the demographic pattern showed 72 of them were female students and the rest were male and their age group varied between 21 and 23 years. Thirty-four of them were staying in the rural area whereas the rest were urban pupils. Most of the participation came from 1st-year students (83) and the least came from final year (4th or 3rd Prof Part 2) students. The number of participants was only 10. A significant statistical association was found between male gender and marijuana abuse (p = 0.043), and male gender with smoking (p = 0.002). The association of the status of being a hostelite with marijuana abuse (p = 0.015), alcohol abuse (p = 0.065), and with smoking (p = 0.012) was also found to be statistically significant. The prevalence of smoking and marijuana abuse was observed to progressively increase from the 1st year (3.61%) to the final year (smoking = 40%, marijuana = 50%). Conclusion: Further research is needed from Eastern India to understand patterns of substance use among medical students, to identify important determinants, and reinforce protective factors. Keywords: Drug, Eastern India, Medical students, Substance abuse. Bengal Physician Journal (2021
... It has become an epidemic in some parts of the African region with adolescents being the main victims of health problems due to substance addiction. The common substances abused in most African countries including Ethiopia are alcohol, khat and tobacco which are reported to be abused widely among students in colleges and high schools [7][8][9]. gastrointestinal effects [10,11]. Medical problems associated with khat intoxication include psychiatric manifestations such as deterioration of psychophysical function and schizophrenia form psychoses. ...
Article
Full-text available
Background: Substance abuse is self-administration of drugs for non-medical reasons, in quantities and frequencies which may impair an individual’s ability to function effectively and which may result in social, physical and emotional problems. Substance abuse is becoming a serious ongoing public health problem; it affects almost every community and family in some way. The common substances abused in most African countries including Ethiopia are alcohol, chat and tobacco Objective:To assess Knewledge, attitude and practice toward substance abuse abuse among the community of kebele 08 community, ShenkorWereda, Harar town, Eastern Ethiopia from December 10, 2020 – February 1, 2021. Methodology: Community based cross-sectional study using a pre-tested structured self-administered questionnaire was conducted from December10, 2020 to February 01, 2021.Simple random sampling technique was used to select 379 respondents from kebele 08, Shenkorworede, Harar town, Eastern Ethiopia residents. The data collection was done using a self-administered structured questionnaire and the data was entered and analyzed by using statistical package for social science version 24. The result is presented in tables and figures. Result: In this study 379 respondents were included. The 206 (54.4%) of the respondents were abused to drinking alcohol, while 61.5%, 32.7% and 13.7% of the respondents were abused to chewing khat, smoking cigarettes and hashish respectively.The 201(53%), 55 (14.5%), 48 (12.7%),30(7.9%),32(8.4%) of participants responded that smoking causes heart attack, diabetic ulcer, impotency, bladder cancer and poor wound healing respectively. The health risks of khat chewing reported by the participants were constipation 58(24.1%), loss of appetite 34(14.1%), gastritis 33(13.7%) and teeth problem 22(9.1%) respectively.In the current study age [AOR=19, 95% CI: 2.46-19.46] and educational status [AOR=43.19, 95%CI: 8.42-187.84] are associated with knowledge about substance abuse. Conclusion and Recommendation: Despite high level of knowledge regarding substance abuse, the prevalence of substance abuse among community remains high.
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The menace of drug abuse among students in Nigeria's higher institution of learning has been receiving increasing attention in recent time. However, the causes of drug abuse among them has not really been identified to the extent that it can offer suggestion to adequate policy measures. This is largely because of institutional or locational peculiarities, and to a large extent differential effects of drug on students' academic performance, health and social relationship, among others, are yet to be adequately interrogated. This study was therefore, conducted to ascertain the prevalence, causes and effects of drug abuse among students with special focus on students of the University of Abuja. Primary data was collected with the aid of structured questionnaires using simple random sampling method. A total of 150 questionnaires were distributed and retrieved for the study. Data collected were analyzed using simple means and percentages. Respondents were made up of males and females, age between 16 and 40 years and spread across three faculties namely, Arts, Science and Social Science. Findings of the study revealed that drug abuse among students was common in the University of Abuja The types of Drugs abused include marijuana, alcohol, codeine, cannabis, cocaine, inhalants, stimulants, hallucinogens, sedatives and narcotics. The consequences of drugs' abuse were found to include poor academic performance, criminality, mental disorder, violence, family problem/disharmony, low self-esteem, physical injury and death. Peer pressure, lack of parental guidance, frustration, availability of drugs, to increased alertness, self-satisfaction, possession of money for buying drugs, stress relief and self-medication, physical sensation and curiosity were identified as causes of drug abuse among the students. The study therefore recommended among others, effective educational awareness, effective parenting and guidance, counselling/rehabilitation, jailing of offenders, and capital punishment, as possible solutions to drug abuse.
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Khat (fresh leaves and shoots of Catha edulis), cigarette and alcohol are widely used in Ethiopia; particularly the use of khat among students is increasing. The objective of this study is to determine the extent of the use of khat, cigarettes and alcohol among students of technology and pharmacy, Addis Ababa University. A cross- sectional study was conducted between April 18 - August 1, 2006, in the Faculty of Technology and School of Pharmacy, Addis Ababa University. Students from each department and year of study were selected using random sampling proportionate to size technique. Information on the use of khat, cigarette and alcohol was obtained by self- administered questionnaires. The study revealed lifetime prevalence of 31.9%, 16.8% and 56.7% for khat chewing, cigarette smoking and alcohol drinking, respectively. The current prevalence of khat chewing was 14.4%, cigarette smoking 6.1% and that of alcohol drinking was 31.1%. Increased frequencies of chewing khat, smoking and drinking were seen among male students, students with no religion and with increasing year/level of study. The University should devise mechanisms to develop the awareness of students on the health and social impacts of khat chewing, cigarette smoking and alcohol drinking.
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Background : The magnitude of HIV/AIDS in Ethiopia is ever increasing. It is also believed that the use of substances is increasing in some major towns including Addis Ababa. However, data regarding the relation of substance abuse and HIV infection is lacking. Objective : A case-control study was carried out in Addis Ababa to explore the association between substance abuse and HIV infection and to determine factors related to substance abuse among people visiting HIV counseling and testing centers. Methods : Cases and controls were compared by socio demographic, socio economic, exposure to substances and risky behaviors that predispose them to HIV infection. Result : In the study, alcohol drinking was found to be associated with serum HIV positivity. While young age of 15 to 24 years and being single were found to be associated with serum HIV positivity, having income was found to be protective. Being male and having sex with commercial sex workers were related to both alcohol drinking and khat chewing. Conclusion and recommendations : Alcohol was found to be a significant risk factor for HIV infection in the study population. The need for health education to bring about behavioral changes and further study to identify the prevalence and role of substance in exposure to HIV infection in the community is recommended. ( Ethiop.J.Health Dev. 2005;19(2):116-125)
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Objectives To show the subjective and cardiovascular effects of khat leaves having a standardized content of cathinone.Background The main effect of khat is an increase of energy and alertness. This effect is thought to be attributable to the phenylalkylamine cathinone, but no controlled clinical trials have been published.DesignThe design was balanced and double blind. Six drug-naïve volunteers received a single dose of khat corresponding to 0.8 mg/kg body weight, as well as alkaloid-free khat as a placebo. Psychologic effects were evaluated by the Addiction Research Center Inventory (ARCI) and visual analog scales. Physiologic measures were systolic blood pressure, diastolic blood pressure, and heart rate. Plasma concentrations of cathinone and its metabolites norephedrine and R,R-(—) norpseudoephedrine were determined by HPLC.ResultsMaximal plasma concentrations of cathinone (127 ± 53 [SD] ng/ml) were attained after 127 ± 30 minutes. The area under the plasma concentration—time curve from 0 to 9 hours was 415 ± 207 ng/ml · hr, and the terminal elimination half-life was 260 ± 102 minutes. An effect of khat was observed in the ARCI scales Abuse Potential (p < 0.01), Motor Stimulation (p < 0.02), Amphetamine-Like Effect (p < 0.005), and Stimulation-Euphoria (p < 0.005), as well as in the visual analog scales Excited-Calm (p < 0.001) and Energetic-Lethargic (p < 0.001).Conclusions Our results provide objective evidence for the amphetamine-like stimulatory effects of khat leaves. These effects were closely similar to those observed after cathinone, 0.5 mg/kg body weight, although peak plasma concentrations of cathinone after khat were delayed.Clinical Pharmacology and Therapeutics (1994) 55, 556-562; doi:10.1038/clpt.1994.69
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