Khat chewing increases the risk for developing chronic liver disease: A hospital-based case-control study

Abstract

The chewing of the leaves of Catha edulis (khat) has been implicated in the development of liver disease, but no controlled observations have been undertaken. The objective of the present study was to determine whether khat chewing is associated with development of chronic liver disease (CLD). A case-control study was conducted at two public hospitals in Harar, Ethiopia, between April 2015 and April 2016. A consecutive sample of 150 adult hospital attendees with CLD were included as cases, and 300 adult hospital attendees without clinical or laboratory evidence of CLD were included as controls. Khat consumption was quantified in khat years; one khat year was defined as daily use of 200 grams of fresh khat for one year. A logistic regression model was used to control for confounders. There was a significant association between chewing khat and the risk for developing CLD (crude odds ratio [OR] 2.64; 95% CI 1.56-4.58). In men, this risk, following adjustment for age, alcohol use, and chronic hepatitis B/C infection, increased with increasing khat exposure; thus, compared to never users the adjusted OR for low khat exposure was 3.58 (95% CI 1.05-12.21), moderate khat exposure 5.90 (95% CI 1.79-19.44), and high khat exposure 13.03 (95% CI 3.61-47.02). The findings were robust in a post-hoc sensitivity analysis in which individuals with identifiable risk factors for CLD were excluded. Conclusion: A significant association was observed between chewing khat and the risk for developing CLD. In men, the association was strong and dose-dependent, suggesting a causal relationship. As the prevalence of khat chewing is increasing worldwide, these findings have major public health implications.

A Path to Ending Hepatitis C in Ethiopia: A Phased Public Health Approach to Achieve Micro-Elimination

“…15 Another study found a 1.3% HCV prevalence in these patients. 51 Hepatitis C virus infection in chronic hepatitis patients is a source of healthcare-associated HCV infection between patients, healthcare workers, and other susceptible individuals. Diagnosis and treatment of HCV infection in this population is vital to improve the quality of life and disease progression of the patients themselves.…”

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“…Chewing is associated with the development of chronic liver disease (CLD). The research was carried out on 150 patients in 2015 and 2016 and another trial of 150 adult hospital patients with CLD and 300 adult hospital participants without clinical or laboratory evidence of CLD were included as controls [104]. Khat use was quantified in "khat years"; 1 year khat was defined as the daily use of 200 g fresh khat for 1 year.…”

“…It is estimated that tobacco-related diseases are now the cause of every tenth death in the world. No other single, equally deadly agent is known, a virus, a bacterium or a genetic defect that would cause so many illnesses and deaths [104,105]. Nicotine activity in tobacco products is stimulant and then infectious on connections in the nerve ganglia, and especially on the Deadly dose from 50 mg, which corresponds to 2-3 cigarettes taken orally.…”

Khat Chewing and Lipid Profile in Human and Experimental Animals

“…Chewing khat is a social and cultural habit practiced by Yemeni and East African peoples [2]. The tender, reddishgreen leaves and the young shoots (Figure 1) are chewed for several hours daily to get the desired effects [3]. Generally, people chew khat for its stimulant effects on nervous system and reducing fatigue and restore mental and physical activity [4].…”