The effect of possible mediators on the association between chewing khat during pregnancy and fetal growth and newborn size at birth in Eastern Ethiopia.

INTRODUCTION: Restriction in the growth of the fetus is a leading cause of stillbirth, neonatal mortality, and short- and long-term morbidity. Documented existing scientific evidence have shown the effects of maternal drugs use, alcohol drinking, tobacco smoking, cocaine use and heroin use on fetal growth restriction. However, data is lacking on the effects of khat chewing during pregnancy on fetal growth status and newborn size at birth. Therefore, the aim of the present study was to measure the effect of chewing khat during pregnancy on fetal growth and size at birth in eastern Ethiopia. METHOD: A cohort study was conducted in selected health institutions in eastern Ethiopia. All pregnant women fulfilled the eligibility criteria in the selected health institutions was the source population. The calculated sample size of exposed and unexposed groups included in the study, in total, was 344. Data collection was performed prospectively by interviewers administered questionnaires, and anthropometric, clinical and ultrasound measurements. Data was analyzed using SPSS version 27 and STATA version 16 software. The survival analysis (cox proportional hazards model) and generalized linear model (GLM) for the binomial family analysis were performed to estimate the crude and adjusted relative risk and attributable risk (AR) with corresponding 95% CI of chewing khat on fetal growth restriction. The mediation effect has been examined through Generalized Structural Equation Modeling (GSEM) analysis using the Stata 'gsem' command. Statistically significant association was declared at p-value less than 5%. RESULTS: In the present study, the incidence of fetal growth restriction (FGR) among the study cohorts was 95 (29.7%); of this, 81 (85.3%) were among khat chewer cohorts. The relative risk of fetal growth restriction among khat chewer cohort mothers was significantly higher (aRR = 4.32; 95%CI 2.62-7.12). Moreover, the incidence of small for gestational age at birth among the present study cohorts was 100 (31.3%); 84 (84%) were from khat chewer cohorts' deliveries. More importantly, in the present study, 98.95% of the ultrasound-identified fetuses with FGR were found to be SGA at birth. Hence, in the current study, FGR was highly associated with SGA at birth. In additional analysis, the regression coefficient of khat chewing during pregnancy on fetal growth restriction has been decreased in size from path o, ß = 0.43, p < 0.001 to path o', ß = 0.32, p < 0.001, after adjusting for gestational hypertension and maternal anemia. CONCLUSION: In sum, the present study showed khat chewing during pregnancy is not simply affected the mothers, but it also affected the unborn fetuses. Therefore, the health workers as well as the local community and religious leaders should give high emphasis on provision of health education regarding the damage of chewing khat by pregnant mothers, with especial focus of the effects on their fetuses.

Apparent Khat chewers exposure to DDT in Ethiopia and its potential toxic effects: A scoping review.

Dichlorodiphenyltrichloroethane (DDT) is an insecticide, a member of dirty dozen persistent organic pollutants, used widely in the world until it was banned in the 1970s.The banning of DDT was strengthened by the Stockholm Convention in 2001. DDT is allowed only for malaria control in Ethiopia. However, farmers are misusing DDT and applying it to Khat (Catha edulis) farming. So, this review analyzes available data in the literature on the current trend, application, occurrence, fate and effects of DDT and its metabolites, dichlorodiphenyldichloroethane (DDD), dichlorodiphenyldichloroethylene (DDE), in the chewable parts of Khat. Generally, the concentration level of DDT, DDD, and DDE, designated as DDTs, is detected in different farmlands of Ethiopia. Some of the DDTs concentrations detected are very high (141.2-973 µg/kg (Gelemso), 194.4-999 µg/kg (Aseno) and 6253-8413.3 µg/kg (Gurage), and these concentrations may indicate increasing recent unmonitored application of DDT on Khat leaves. Some of the detected concentrations of DDT in the literature were above the maximum residue limit (MRL) set by FAO/WHO (100 µg/kg) and the European Commission 10 µg/kg in vegetables and 50 µg/kg in cereals. DDT exposure of Khat chewers linked to the concentration of DDT on Khat leaves and the amount of Khat consumed. DDT might pose health risks to chewers due to chronic toxicity, bioaccumulation, persistent and endocrine disruption properties.

MnOx-Coffea arabica Husk and Catha edulis Leftover Biochar Nanocomposites for Removal of Methylene Blue from Wastewater.

In this study, we investigated the use of manganese oxide-biochar nanocomposites (MnOx-BNC), synthesized from coffee husk (CH) and khat leftover (KL) for the removal of methylene blue (MB) from wastewater. Pristine biochars of each biomass (CH and KL) as well as their corresponding biochar-based nanocomposites were synthesized by pyrolyzing at 300°C for 1 h. The biochar-based nanocomposites were synthesized by pretreating 25 g of each biomass with 12.5 mmol of KMnO4. To assess the MB removal efficiency, we conducted preliminary tests using 0.2 g of each adsorbent, 20 mL of 20 mg·L-1 MB, pH 7.5, and shaking the mixture at 200 rpm and for 2 h at 25°C. The results showed that the pristine biochar of CH and KL removed 39.08% and 75.26% of MB from aqueous solutions, respectively. However, the MnOx-BNCs removed 99.27% with manganese oxide-coffee husk biochar nanocomposite (MnOx-CHBNC) and 98.20% with manganese oxide-khat leftover biochar nanocomposite (MnOx-KLBNC) of the MB, which are significantly higher than their corresponding pristine biochars. The adsorption process followed the Langmuir isotherm and a pseudo-second-order model, indicating favorable monolayer adsorption. The MnOx-CHBNC and MnOx-KLBNC demonstrated satisfactory removal efficiencies even after three and six cycles of reuse, respectively, indicating their potential effectiveness for alternative use in removing MB from wastewater.

Vortex-assisted dispersive micro-solid-phase extraction using silica-supported Fe2O3-modified khat (Catha edulis) biochar nanocomposite followed by GC-MS for the determination of organochlorine pesticides in juice samples.

In this paper, dispersive micro-solid phase extraction technique was developed for the purpose of extracting and preconcentrating organochlorine pesticide residues in juice samples before their separation and quantitative analysis by gas chromatography-mass spectrometry. A sorbent composed of a silica-supported Fe2O3-modified khat leftover biochar nanocomposite (SiO2-Fe2O3-KLBNC) was implemented in the process. To improve the dispersion of the sorbent in the solution, vortex mixer was employed. Experimental parameters influencing the performance of the method were optimized, and the optimal conditions were established. With these conditions, linear dynamic ranges ranged from 0.003 to 100.0 ng/mL were achieved, with a correlation coefficient (r2) ≥ 0.9981. The limits of detection and quantification, determined by signal-to-noise ratios of 3 and 10, respectively, were found to be in the ranges of 0.001-0.006 ng/mL and 0.003-0.020 ng/mL. Intra- and inter-day precision, values ranging from 0.3-4.8% and 1.7-5.2% were obtained, respectively. The matrix-matched extraction recoveries demonstrated favorable outcomes, falling within the range of 83.4-108.3%. The utilization of khat leftover as an adsorbent in contemporary sample preparation methodologies offers a cost-effective alternative to the currently available, yet expensive, adsorbents. This renders it economically viable, particularly in resource-constrained regions, and is anticipated to witness widespread adoption in the coming future.

A Narrative Review of the Toxic Effects on Male Reproductive and Sexual Health of Chewing the Psychostimulant, Catha edulis (Khat).

Khat (Catha edulis Forsk) is a stimulating narcotic grown mainly in East and Southern Africa. The plant has a long history as a popular social behavior within these regions, and its active ingredient, cathinone, has been thought to cause an array of physical, psychological, and mental health complications. In 1980, the World Health Organization (WHO) classified it as an illicit substance due to the potential for psychological dependence. Subsequent investigations have found that its regular consumption can negatively impact the human central nervous system (CNS), systemic blood pressure, genitourinary system, and psychological health. This narrative review aims to discuss the reproductive toxicity and sexual dysfunction (SD) caused by regular khat usage in humans and experimental animals. Animal studies found dose-dependent impacts on male reproductive health: low levels increased testosterone production, whereas high levels had the opposite effects. Moderate intake was associated with reduced luteinizing hormone (LH) levels and heightened cortisol in blood plasma. In human studies, chronic users had dramatically lower semen volume, sperm motility, and count, as well as reduced libido or erectile dysfunction (ED). Khat can have serious implications for male fertility and sexual health: therefore, better understanding of its effects is paramount. This article aims to review the toxic effects on the male reproductive and sexual health of chewing the psychostimulant, Catha edulis (khat).

Violence against housemaids in an Ethiopian town during the early phase of the COVID-19 pandemic: a cross-sectional study.

BACKGROUND: Violence against women is a global public health problem that has numerous adverse effects. However, published literature regarding violence against housemaids during the COVID-19 pandemic in Ethiopia is lacking. The current study aims to explore the experiences of violence and associated factors among housemaids in Ethiopia. The findings may be useful to the design appropriate policies, programs and strategies to reduce the problem. METHODS: A community-based cross-sectional study was conducted from January to March, 2021 in Kombolcha Town, Ethiopia. A total of 215 housemaids aged 14 years and older were included in the study using a simple random sampling technique. A multivariable logistic regression model with 95% CI (confidence interval) was applied to identify significant factors of physical and sexual violence. Variables with a P-value < 0.05 were declared as factors significantly associated with violence. RESULTS: Among 215 housemaids, 33.49% (95% CI: 27.13-39.85%) reported physical violence and 21.4% (95% CI: 15.87-26.92) reported sexual violence during the COVID-19 pandemic. Thus, housemaids aged 19-23 years (AOR = 2.64, 95% CI: 1.01-6.89), who had a male employer (AOR = 2.39, 95% CI: 1.05-5.45), whose employers chewed chat (Catha edulis) (AOR = 3.78, 95% CI: 1.73-8.29), or drank alcohol (AOR = 2.90, 95% CI: 1.17-7.17) experienced more physical violence. Sexual violence was also associated with employers' alcohol consumption (AOR = 9.72, 95% CI: 3.12-20.31), employers' chat chewing (AOR = 7.40, 95% CI: 2.26-14.21) and male employers (AOR = 3.23, 95% CI: 1.22-8.52). CONCLUSION: The findings indicate that one in five housemaids and one in three housemaids experienced sexual violence and physical violence, respectively. Housemaids aged 19-23 years, having a male employer, having an employer who chewed chat (Catha edulis) or who drank alcohol were factors associated with physical violence, whereas employers' alcohol consumption, employers' chat chewing and male employers were factors associated with sexual violence.

The effects of khat use during pregnancy on perinatal and maternal outcomes: a meta-analysis.

Chewing khat during pregnancy adversely affects maternal and fetal health, but available studies are scarce and inconsistent, and it is difficult to conclude the relationship between khat consumption and perinatal outcomes. We aimed to investigate the available studies on the effect of khat use during pregnancy on perinatal and maternal outcomes. For this meta-analysis, we conducted a thorough search of articles published in PubMed, Embase, Scopus, and Web of Science up to the date this search was undertaken (03.01.2022). We used random effect model with the Mantel-Haenszel method to calculate the pooled odds ratio and mean difference. We found that khat use during pregnancy was significantly associated with increased odds of low birth weight (OR:2.51; 95% CI: 1.60 to 3.94), congenital anomalies (OR:3.17; 95% CI: 1.30 to 7.73), premature rupture of membrane (OR: 1.99; 95% CI: 1.59 to 2.50), perinatal mortality (OR: 1.95; 95% CI: 1.26 to 3.03), and lower APGAR scores at the fifth minute (MD: -1.7; 95% CI: -2.32 to -1.07). Also, increased odds for developing maternal psychological stress and anemia were reported in women using khat during pregnancy. There were no statistically significant differences in stillbirth and preterm birth between women using khat during pregnancy and their counterparts. Since prenatal khat use is associated with adverse perinatal and maternal outcomes, we strongly recommend equitable and easily accessible health services through the implementation of integrated addiction treatment with maternity services to address khat use during pregnancy and encourage the practice of healthy behavior of women.

Prevalence and associated factors of early initiation of sexual intercourse among youth in Ethiopia: systematic review and meta-analysis.

BACKGROUND: Early sexual initiation refers to engaging in sexual activity at a young age, typically before the age of 18. Even though many studies have been conducted in Ethiopia, the result is inconsistent between studies. In the study area, the pooled prevalence and associated factors of early initiation of sexual intercourse among youth were not done before. Therefore, this study aimed to determine the pooled prevalence and associated factors of early initiation of sexual intercourse among Youth in Ethiopia. METHODS: This study used a systematic review and meta-analysis of studies conducted from 2008 to 2022, in Ethiopia. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines were followed. PubMed, Cochrane Library, Hinari, and Google Scholar electronic databases were searched. The analysis was performed using STATA 17 software. Heterogeneity and publication bias were assessed using forest plots, I2, Cochran's Q statistics and Funnel plots, Egger test, and Begg rank tests respectively. Duval and Tweedie's 'trim and fill' method was also performed to adjust the pooled estimate. Pooled analysis was conducted using the inverse-variance fixed-effects model. RESULTS: A total of 10 articles were included in this systematic review and meta-analysis. The pooled prevalence of early initiation of sexual intercourse among youth in Ethiopia was 24.7% (95%CI: 10.4, 38.9). Being female (AOR = 3.57; 95% CI: 1.387, 5.743), having poor knowledge of HIV/AIDS prevention (AOR = 3.65; 95% CI: 1.981,5.309), alcohol use (AOR = 2.05; 95% CI: 1.415, 2.679), khat chewing (AOR = 3.03; 95% CI: 1.800, 4.254), Viewed pornographic film(AOR = 4.21, 95% CI: 2.135, 6.283), Cigarette smoking (AOR = 2.74; 95% CI: 2.102, 3.370) and Poor family controls (AOR = 4.39; 95% CI: 2.572, 6.199)were associated factors of early initiation of sexual intercourse. CONCLUSIONS: The pooled prevalence of early initiation of sexual intercourse among Youth in Ethiopia was high. Being female, poor knowledge of HIV/AIDS prevention, alcohol use, khat chewing, Viewing pornographic films, Cigarette smoking, and poor family controls were associated factors of early initiation of sexual intercourse. It is recommended that targeted interventions be put in place to address the high prevalence of early initiation of sexual intercourse among youth in Ethiopia. These interventions should focus on addressing the associated factors such as poor knowledge of HIV/AIDS prevention, alcohol use, khat chewing, viewing pornographic films, cigarette smoking, and poor family controls. It is important that these interventions are gender-sensitive and take into consideration the unique challenges faced by females in accessing sexual and reproductive health services.

Prevalence and risk factors for tobacco, khat, and alcohol consumption among high school students in Ethiopia.

BACKGROUND: Tobacco, khat, alcohol, and marijuana are the main risk factors for non-communicable diseases. There are limited studies on substance use in Ethiopia, especially among secondary school students. This study aims to determine the epidemiology of substance use among secondary school students in Ethiopia. METHODS: This cross-sectional study was conducted in March 2020 in four large regions of Ethiopia and the capital Addis Ababa. We collected data from 3,355 grade 9 and grade 10 students in 36 randomly selected high schools. Data were collected on tobacco, khat, alcohol and other substances. Mixed effect logistic regression models were fitted to determine the predictors of cigarette smoking. RESULTS: 157 (4.7%) of the participants ever smoked cigarettes and 81 (2.4%) were current smokers. 106 (3.2%) ever used smokeless tobacco, 1,342 (41.8%) had ever drunk alcohol, 290 (8.7%) ever used khat, 137 (4.8%) chewed khat regularly and 76 (2.3%) ever used marijuana. There was a significant regional variation in substance use patterns; cigarette and khat use was the highest in southern regions, whereas alcohol use was highest in the northern areas. Availability of cigarette and khat shops within a 100-meter radius of the school compound was reported by 1,229 (37.5%) and 816 (25%) students, respectively. Three hundred fifty-four (10.9%) students had ever seen someone smoking a cigarette in the school compound. Ever use of smokeless tobacco (Adjusted Odds Ratio (AOR) = 9.4, 95%CI: 4.9-17.9), ever use of shisha (AOR = 8, 95% CI: 3.9-16.3), ever use of khat (AOR = 4.1, 95%CI: 2.5-6.8), ever use of alcohol (AOR = 2.3, 95%CI: 1.4-3.7), having a friend who smoked a cigarette (AOR = 2, 95%CI: 1.2-3.5), and ever seen someone smoking a cigarette in the school compound (AOR = 1.9, 95%CI: 1.1-3.4) were associated with ever use of cigarettes. CONCLUSION: Substance use prevalence in Ethiopia has regional variations and prevention strategies should be tailored to the needs of the regions. Although this study reported a lower prevalence of cigarette smoking, students could access cigarettes and khat in nearby school areas. The existing tobacco control laws that prohibit selling tobacco products to children and adolescents under 21 years of age and ban establishing tobacco shops close to school compounds should be enforced.

Exploring the perception of key stakeholders toward khat policy approaches in Ethiopia: a qualitative study.

BACKGROUND: Khat is an amphetamine-like plant, produced and commonly chewed in Ethiopia by a large group of the population. Although significant multidimensional harms of khat use have been reported, currently, there are no policies or organized activities against khat use in Ethiopia. Therefore, the current study aimed to explore the perception of key stakeholders toward khat policy approaches for Ethiopia. METHODS: A qualitative study was conducted using focus group discussion (FGD) and in-depth interview (IDI). Ten stakeholders participated in the IDIs, and another 15 individuals participated in the FGDs. Key stakeholders were appropriately mapped and purposively selected based on their experience related to khat use and khat harm reduction. Interviews and FGDs were led by the study authors and were audio-recorded. The audio-recorded data were transcribed verbatim and then translated into English language. The data were analyzed using thematic analysis approach. RESULTS: Participants preferred prevention and law regulation measures for khat policy approaches for Ethiopia. Proposed prevention and law regulation measures included regulating the transportation of khat, limiting the minimum age to buy and sell khat, prohibiting khat use at some public places, banning khat advertising and promotion, and imposing excise tax. Individual level khat harm reduction strategies were also proposed to be useful. However, the participants asserted that total khat ban in Ethiopia is not likely to be feasible and acceptable. CONCLUSION: Prevention, treatment or care for individuals with problematic khat use, law regulation, and harm reduction were preferred approaches by stakeholders for khat policy in Ethiopia instead of total banning.

Perceived harms and protective behavioural strategies among khat chewers: a qualitative study in Jimma, Ethiopia.

BACKGROUND: While there have been many previous studies focusing on the adverse effects of khat chewing, attempts to investigate the protective behavioural strategies (PBS) employed by the khat using population are rare. PBS are strategies that substance users employ to minimize or alleviate the possible negative consequences related to the behaviour. This study focuses on the harms that chewers associate with khat use, and the behavioural strategies they practise to prevent or minimize these harms. METHODS: A community-based qualitative study was conducted using a snowball sampling technique to recruit a diverse sample of khat chewing participants (N = 102) in Jimma city, Ethiopia. Face-to-face in-depth interviews were carried out with the participants. RESULTS: Participants identified a variety of harms likely to result from chewing khat. These include impacts on their finances, work, social life and health. The PBS that participants employed to avoid or minimize the risks were classified into four themes based on their temporal sequence with khat chewing sessions: prior to chewing, during chewing, after chewing and general PBS covering the whole of their khat chewing career. The PBS enable khat chewers to prevent or minimize the adverse health consequences of chewing, socialize and work without or with fewer difficulties and manage their economy successfully. CONCLUSION: The study participants believe that khat-related harms are avoidable if khat users implement appropriate strategies prior to, during and after chewing, and if they apply PBS to khat-related factors (e.g. type, amount and frequency), set factors (e.g. reason for using and health behaviour) and setting factors (e.g. place of use, when used, with whom used and social norms) covering the whole of their khat chewing career.

Parental khat use and early childhood growth status in Eastern Ethiopia.

BACKGROUND: Adult chewing of the stimulant plant khat (Catha edulis) has an unclear relationship with child growth outcomes. Contradictory study conclusions because habitual khat chewing covary with increased household income from khat production. AIM: Disentangling the association of parental khat use, household khat production, and child nutritional status and growth markers. METHODS: Bayesian analysis was applied to survey data for 2340 households containing 2760 children aged 24-60 months in a population-representative geographic sampling of two districts in Eastern Ethiopia, a khat chewing and producing region. RESULTS: Stunting effects were more evident than wasting; the negative child growth effect of khat chewing persisted regardless of household khat production; maternal chewing particularly mattered for child growth delays. CONCLUSIONS: This exploratory analysis suggests that future studies should target the interactions of khat chewing practices with gendered performances of child care/feeding responsibilities.

Clavulanic Acid Improves Memory Dysfunction and Anxiety Behaviors through Upregulating Glutamatergic Transporters in the Nucleus Accumbens of Mice Repeatedly Exposed to Khat Extract.

Khat (Catha edulis) is an evergreen shrub whose buds and leaves give a state of delight and euphoria when chewed. Cathinone, an amphetamine-like stimulant that is among the active ingredients in khat, is able to downregulate glutamate transporter subtype I (GLT-1). Neurobehavioral dysfunctions such as altered locomotor activity, anorexia, and nociception have been observed in animals exposed to cathinone. Interestingly, treatment with a ß-lactam antibiotic such as ceftriaxone, which upregulates GLT-1, normalizes cathinone-induced conditioned place preference, and alters repetitive movements in rats. However, little is known about the role of the glutamatergic system in memory dysfunction and anxiety-like behaviors in mice exposed to khat. We found here that clavulanic acid, a ß-lactam-containing compound and GLT-1 upregulator, would modulate the neurobehavioral changes, including memory impairment and anxiety-like behaviors, associated with repeated exposure of mice to khat. Our data supported that clavulanic acid could improve memory impairment and anxiety-like behaviors through upregulating GLT-1 in the nucleus accumbens (NAc), an effect abolished with a selective GLT-1 blocker. This upregulation was associated with restored glutamate/cystine antiporter expression in the NAc using a Western blotting assay. Cathine and cathinone were identified in khat extract using the gas chromatography technique. Our work provides preclinical insight into the efficacy of ß-lactam-containing compounds for the attenuation of neurobehavioral changes induced by khat exposure.

Effect of khat extract on color stability of digitally and manually fabricated provisional restorations: an in vitro comparative study.

BACKGROUND: The aim of this in vitro study was to evaluate the effect of khat extract on the color stability of five different provisional restorative materials (PRMs). METHODS: In this study, 50 specimens were fabricated from five different PRMs with different techniques. Twenty specimens were digitally fabricated of poly-methyl methacrylate (PMMA) CAD/CAM milling and 3D printing PRMs, while the other thirty specimens were manually fabricated of three different PRMs: PMMA self-cured (SC) acrylic resin, light-cured (LC) composite, and Bis-acrylic SC composite. Milling and 3D printing machines were used to fabricate the digital specimens, while the manual specimens were fabricated using a metallic mold. The material was placed in the mold, covered by a polyester stripe, and held between two glass slabs with a constant load for 30 s. After setting, the specimens were removed and checked. Ten disc-shaped specimens with 2 ± 0.3 mm thickness and 10 ± 0.3 mm diameter were prepared from each of the tested PRM. Then all the specimens were polished. Five specimens of each PRM were immersed in khat extract, while the other five were immersed in distilled water medium as a control group. The color measurements were recorded before and after 1 and 7 days of immersion using a spectrophotometer. The immersion media were renewed every 24 h and kept along with the specimens at 37 °C. The T test, paired T test, and ANOVA analysis of variance were used to analyze the results. The Bonferroni test was used for post-hoc multiple comparisons. RESULTS: The interaction between the tested PRMs, the media, and the duration of immersion time was statistically significant (p < 0.05). PMMA CAD/CAM milling PRM was the most stable in color, and this was statistically significant (p < 0.05). The LC composite PRM composite was the least stable in color and was statistically insignificant (p > 0.05) when compared to the 3D printing and Bis-acrylic SC composite PRMs, respectively. CONCLUSIONS: This study demonstrated that khat extract medium has a high staining ability on the tested PRMs. CAD/CAM milling PRM was the most stable in color and could therefore be used as a long-term provisional. The increase in immersion time was a significant factor in the color change of the tested PRMs. The color of the 3D-printed PRM was the most affected over time.

Drug-related problems and its predictors among hospitalized heart failure patients at Jimma Medical Center, South West Ethiopia: prospective interventional study.

BACKGROUND: Drug-related problems are associated with high mortality, complications, prolonged hospital stay, compromised quality of life, and increased healthcare costs. This problem is high in patients hospitalized with chronic conditions such as heart failure. However, there are limited studies conducted on this area, particularly in Ethiopia. OBJECTIVE: To evaluate drug-related problems, their predictors, and clinical pharmacist intervention among hospitalized heart failure patients at Jimma Medical Center, Ethiopia. METHODS AND PARTICIPANTS: A prospective interventional study was conducted among hospitalized heart failure patients from September 30, 2020, to May 28, 2021, at Jimma Medical Center. Drug-related problems were sorted based on the Pharmaceutical Care Network Europe drug classification tool version 9.0. Patient's specific data were collected using a structured questionnaire. Data was analyzed using statistical software package version 23.0. Multivariate logistic regression analysis was used to identify independent predictors of drug-related problems occurrence and statistical significance was considered at a p value < 0.05. RESULTS: A total of 237 heart failure patients were included in this study. The mean (SD) age was 49.06 + 17.79. About two-thirds (66.2%) of study patients had at least one drug-related problem during their hospital stay. A total of 283 drug-related problems were identified among 157 patients. Treatment effectiveness-related problem (55.48%) was the most common observed drug-related problem. The independent predictors of drug-related problems were khat chewing [AOR = 3.25, 95% CI = (1.46-7.23)], hospital stay > 18 days [AOR = 3.77, 95% CI = (1.93-7.37)]; presence of comorbid condition [AOR = 2.59, 95% CI = (1.35-4.96)] and polypharmacy [AOR = 2.94, 95% CI = (1.54-5.61)]. CONCLUSION: The prevalence of drug-related problems was high among hospitalized heart failure patients in the study area. Chewing khat, prolonged hospital stay, comorbidity, and polypharmacy were the predictors of drug-related problems. Hence, to overcome these problems, clinical pharmacists, physicians, and other health professionals have to work in collaboration.

Work-related stress and associated factors among employees of Hawassa industrial park, southern Ethiopia: an institutional based cross-sectional study.

BACKGROUND: Work-related stress (WRS) is becoming an alarmingly growing public health concern worldwide. Due to globalization and changes in working conditions, people in low-income countries face growing work-relates stress. However, despite high prevalence globally, work-related stress among industrial park workers is not well studied in Ethiopia.Thus; the aim of this study was to assess work-related stress and associated factors among employees of Hawassa industrial park, southern Ethiopia. METHODS: An institutional-based cross-sectional study was employed among 419 employees of Hawassa industrial park using an interviewer-administered structured questionnaire. Study participants were selected using simple random sampling technique. Data was collected by face-to-face interview. A workplace stress scale (WPSS) was used to assess work-related stress. The collected data were coded and entered into EPI data 4.6 and exported to SPSS version 26 for analysis. Multivariable logistic regression analysis was conducted to identify associated factors. The statistical significance was considered at P-value < 0.05. RESULT: The Overall prevalence of work-related stress was 47.5, 95% CI (43.2, 52.1). Variables such as temporary employment [AOR = 0.41, 95% CI (0.26-0.64)], poor working condition [AOR = 2.12, 95% CI (1.32-3.43)], work experience less than two and half years [AOR = 3.11, 95% CI (1.95-4.96)], poor learning opportunity [AOR = 1.82, 95% CI (1.10-2.30)], poor organizational support [AOR = 1.70, 95% CI (1.10-2.62)], current use of khat [AOR = 2.52, 95% CI (1.28-4.99)] and current use of alcohol [AOR = 2.27, 95% CI (1.44-3.58)] were significantly associated with work-related stress. CONCLUSION AND RECOMMENDATION: The study found high prevalence of work-related stress among employees of Hawassa industrial park. Temporary employment, poor working conditions, work experience < 21/2 years, poor learning opportunities, poor organizational support, current khat use, and current use of alcohol were significantly associated with work-related stress. Our study finding is recommending enhancing stress management skills and primary prevention on identified risk factors to industry employees.

Work-related stress and associated factors among garment workers in Bole Lemi Industrial Park of Addis Ababa, Ethiopia: a multi-center institution-based cross-sectional study.

BACKGROUND: Work-related stress (WRS) is a growing problem around the world that affects the health and well-being of employees. However, evidence of work-related stress in Ethiopia, particularly among garment industry employees, is scarce. This study aimed to assess the prevalence and associated factors of work-related stress among garment workers in the Bole Lemi industrial park in Addis Ababa, Ethiopia. METHODS: A multi-center institutional-based cross-sectional study was conducted from February 01 to March 31, 2021. A total of 605 study participants were selected using a stratified random sampling technique. A pre-tested, interviewer-administered standardized questionnaire was used to collect data. The logistic regression model was employed to identify determinant factors for work-related stress, and statistical significance was declared at a p-value < 0.05. RESULTS: The magnitude of work-related stress in garment workers was 44.1% (95% CI: 40.0, 48.0). Being within the age group of 25 - 34 years (AOR = 0.57, 95% CI: 0.36, 0.90) and receiving induction training (AOR = 0.35, CI: 0.20, 0.62) were protective factors with stress. Whereas lack of family support (AOR = 2.72, CI: 1.60, 4.64), lack of job satisfaction (AOR = 4.26, CI: 2.77, 6.57), and khat chewing (AOR = 3.14, CI: 1.35, 7.32) were positively associated with work-related stress. CONCLUSION: Work-related stress is prevalent among garment workers in the study setting. Being between the ages of 25-34 years and receiving induction training were protective factors against stress, while a lack of family support, a lack of job satisfaction, and khat chewing practices were positively associated with work-related stress. Therefore, improving family support and job satisfaction, providing induction training during employment, and providing psychological support for substance users to bring about changes are mandatory in Bole Lemi Industrial Park, Ethiopia.

Prevalence and associated factors of depression, anxiety, and stress among high school students in, Northwest Ethiopia, 2021.

BACKGROUND: Many studies have revealed that students' performance in school, is affected by symptoms of depression, anxiety, and stress, which may impair their academic achievement, and lead to school dropout. However, to date, no studies have evaluated these three disorders among high school students in Africa. Therefore, in this study, we aimed to assess the prevalence of depression, anxiety, stress, and their associated factors among high school students in Northwest Ethiopia. METHODS: An institution-based cross-sectional study was conducted. A simple random sampling technique was used to select 849 participants from six high schools in Northwest Ethiopia. A self-administered Depression, Anxiety, and Stress Scale (DASS-21) questionnaire was used to collect the data. Data were analyzed using SPSS Version 25.0 software to identify factors associated with DAS, and bi-variable and multi-variable analyses were performed. RESULTS: The prevalence of depression, anxiety, and stress was 41.4, 66.7, and 52.2% respectively. Being female (AOR = 1.304, 95% CI = 1.006-1.849), higher risky khat chewers (AOR = 5.595, 95% CI = 2.357-11.132), having social phobia (AOR = 1.416, 95% CI = 1.045-1.919) were associated with depression. Being higher risky cigarette smokers (AOR = 4.777, 95% CI = 1.407-7304), having a history of chronic medical illness (AOR = 2.099, 95% CI = 1.045-4.218), and having a family history of mental illness (AOR = 1.777, 95% CI = 1.028-3.073) associated with anxiety. Stress was associated with high-risk alcohol drinkers (AOR = 1.828, 95% CI = 1.012-3.303), rural residency (AOR = 1.395, 95%CI = 1.010-1.925), and low social support (AOR 1.7391, 95% CI = 1.203-2.515). CONCLUSION: The burden of DAS among high school students was found to be high. Female sex, chewing khat, and having social phobia are associated with depression. Conversely, smoking cigarettes, having a chronic medical illness, and having a family history of mental illness are all linked to anxiety. Being a highly risky alcoholic drinker, having poor social support, and being a rural resident are positively associated with stress. Therefore, extending mental health services to all high schools, and strengthening the existing counseling services, are recommended.

Magnitude and predictors of common mental disorders among residents in south Gondar Zone, Northwest Ethiopia: a community-based, cross-sectional study.

BACKGROUND: Common mental disorders such as depression, anxiety, and somatic symptoms are a major public health concern because it is prevalent and chronic, and its impact on physical health, psychological and economic consequences is very serious. Evidence on the prevalence and predictors of common mental disorders is very limited in Ethiopia. This study aims to determine the prevalence and associated factors with common mental disorders. METHODS: A community-based cross-sectional study was conducted among 731 south Gondar zone residents recruited with a multistage sampling method. Data were collected by face-to-face interviews on socio-demographic, clinical, and psychosocial factors. Common mental disorders (CMD) were assessed using a self-reporting questionnaire (SRQ-20). A-List of Threatening Experiences and the Oslo social support instruments were used to identify the factors. We used bivariate and multivariable binary logistic regressions to identify factors associated with common mental disorders. Statistical significance was declared at P-value < 0.05. RESULTS: The prevalence of common mental disorders over the last four weeks was found to be 29.7% with 95% of confidence interval (CI) (26.4-33.1). After adjusting possible confounders, female sex, [AOR = 2.47, 95% CI (1.68, 3.62)], poor social support [AOR = 2.34, 95% CI (1.50, 3.64)], family history of mental illness [AOR = 2.15, (1.32-3.51)], rural resident [AOR = 2.01, 95% CI (1.35, 3.01)], current use of khat [AOR = 1.69, 95% CI (1 0.07, 2.64)] current use of tobacco (AOR = 1.71, 95% CI (1.04-2.84) and unemployment [AOR = 1.762, 95% CI; 1.193, 2.602)] were significantly associated with common mental disorders. CONCLUSION: The prevalence of common mental disorders was high, especially in Female sex, current substance use (khat chewing (leaves) and tobacco smoking), unemployment, rural residence, family history mental illness, and poor social support are the main determinants of common mental disorders. Early detection and appropriate intervention for common mental disorders in the community level should be promoted. Governmental strategies should be focused on implementing substance rehabilitation centers to treat Khat and tobacco might be helpful to minimize the burden of CMD in Ethiopia.

Towards a better understanding of the psychosocial determinants associated with adults' use of smokeless tobacco in the Jazan Region of Saudi Arabia: a qualitative study.

BACKGROUND: Most diagnosed oral cancer cases in Saudi Arabia are in the Jazan region. A common type of smokeless tobacco "Shammah" is prevalent in this region. This study aimed to gain an in-depth understanding of the possible psychosocial determinants of Shammah consumption among adult Shammah users in Jazan region. METHODS: A qualitative study was conducted by means of one-on-one interviews among thirty adult Shammah users. Participants were recruited by means of a purposive sampling technique. Data were collected using a semi-structured interview guide utilizing face-to-face and phone-call interviews. Thematic analysis with hybrid approach was used to analyze the dataset. RESULTS: Twenty-four sub-codes within four overarching themes were generated. Participants revealed uncertainty related to Shammah composition, how to quit knowledge and Shammah prevention/cessation programs. Shammah use identified as a normal phenomenon in society. Its use was frequently reported in participants' close network but most users faced family and peers' disapproval. Some users expressed joy, happiness and focused when using Shammah. Others were disgusted or neutral. Many users believed Shammah causes cancer and tears oral tissues. Others believed it relieves toothache or has no effect. Majority of users were confident to quit and recalled some quitting aids. Toothache, craving, drinking tea and chewing Khat (leaves of Catha edulis plant that causes moderate euphoria) perceived to be triggers to use Shammah. Availability of Shammah, withdrawal symptoms, stress, lack of support, seeing others using Shammah, losing part of routine and toothache were barriers to quit. CONCLUSIONS: Shammah use was associated with uncertainty about Shammah composition and quitting knowledge, social acceptability, influence from family/friends, a range of positive and negative attitudinal beliefs toward its use and high quitting efficacy beliefs. Future interventions targeting Shammah should address the acknowledged triggers and barriers in the present study including the dual use of Shammah and Khat.