Matiwos Soboka

Alcohol use disorders and associated factors among people living with HIV who are attending services in south west Ethiopia

BackgroundAlcohol use disorders (AUDs) in persons living with human immunodeficiency virus (PLHIV) in high-income countries have been associated with poor adherence to antiretroviral medications and worse HIV-related outcomes. Little is known about AUDs among people attending HIV services in sub-Saharan Africa.MethodsAcross-sectional study was carried out among PLHIV who attended HIV services at Jimma University Specialized Hospital in September 2012. The World Health Organization’s Alcohol Use Disorders Identification Tool (AUDIT) was used to measure probable hazardous, harmful and dependent use of alcohol (‘alcohol use disorders’). Associations between AUDs and other variables were explored using logistic regression analysis. All variables associated with AUDs with a p value <0.25 were included in the final multivariable model.ResultsThe overall prevalence of AUDs was 32.6%, with hazardous use, harmful use and alcohol dependence accounting for 24.7%, 2.8% and 5.1% of the total, respectively. There was no significant difference in the prevalence of AUDs in persons receiving antiretroviral treatment compared to those who were antiretroviral therapy naïve (32.6% vs. 38.6%). AUDs were identified in 26.0% and 44.1% of females and males, respectively. Male gender, smoking cigarettes and psychological distress were positively associated independently with AUDs.ConclusionThe high prevalence of AUDs detected in our facility-based survey of PLHIV in Ethiopia highlights the need to integrate delivery of effective and feasible interventions for AUDs into HIV care.

Khat use in people living with HIV: a facility-based cross-sectional survey from South West Ethiopia

BackgroundKhat is an evergreen plant with leaves containing the amphetamine-like compounds cathinone and cathine. Many people in the Horn of Africa use khat on a regular basis. Adverse health and social consequences of khat use have been described but little is known about the use of khat in people living with Human Immunodeficiency Virus (PLHIV) in Ethiopia. This study aimed to assess the prevalence of khat use and factors associated with khat use among PLHIV who are in contact with HIV services in a hospital in south-west Ethiopia.MethodsA cross-sectional study was conducted among 389 PLHIV who attended HIV services at Jimma University Specialized Hospital in September 2012. A structured questionnaire, translated into the local languages, was used to ask about the frequency of khat use and potential risk factors and consequences of khat use in this patient group. Logistic regression analysis was used for bivariate and multivariable analysis.ResultsThe overall prevalence of current khat use among people living with HIV was 23.0%. The prevalence was 18.3% in females and 33.6% in males. Christians were less likely to use khat when compared to Muslims (adjusted Odds Ratio (aOR) 0.26, 95% CI = 0.13, 0.55). There was a positive association between khat use and mental distress (aOR 1.84, 95% CI = 1.01, 3.36), smoking cigarettes (aOR 21.21, 95% CI = 7.19, 62.51), alcohol use disorders (aOR 2.16, 95% CI = 1.10, 4.21), CD4 count ≤200 cells/mm3 (aOR 3.46, 95% CI = 1.60, 7.50) and missing at least one dose of antiretroviral medication in the preceding month (ART) (aOR 4.2, 95% CI = 1.80, 5.75).ConclusionIn this study there was a high prevalence of khat use among people living with HIV which was associated with poorer adherence to ART. There is a need to adapt and evaluate feasible and acceptable interventions to reduce khat use in people living with HIV.

Factors Associated with Khat Chewing among High School Students in JimmaTown Southwest Ethiopia

Background: Khat is a large green shrub grown in Eastern to Southern Africa and extends to Arabian Peninsula. Khat has its own impact on mental and physical health of the chewers. Studies revealed that khat chewing was associated with frequent absenteeism from class and poor academic performance among students. Although khat has harmful consequences, little is known about factors associated with khat chewing among high school students in Ethiopia. Methods: A cross-sectional study design was conducted on 296 high school students in Jimma city using a structured questionnaire. Khat and risky sexual behavior were assessed using the questionnaire. A structured self-reported questionnaire (SRQ-20) which was developed by the World Health Organization (WHO) was used to assess mental distress. The questionnaire was translated into local language was used to assess khat chewing pattern. Logistic regression analysis was used to determine associations between independent variables and khat chewing. Variables with p-value of less than 0.05 in multivariate logistic regression were declared to have statistically significant association with the outcome variable. Result: The life time prevalence of khat chewing among Jimma city high school students was nearly 16%. The current prevalence of khat chewing among these students was 14.2%. Out of this, 71.4% and 28.6% of them were male and females respectively. Out of the students who had mental distress, 22.2% of them were khat chewers. Being in an age group between 19-23 years ((AOR 4.42, 95% CI=1.25, 15.67), being male (AOR 3.76, 95% CI=1.57, 9.02), having suicidal ideation (AOR 3.65, 95% CI=1.3-10.20) and having ever had a sexual contact (AOR, 13.42, 95% CI=2.76-65.16) were positively associated with khat chewing. Conclusion: In this study there was high prevalence of khat chewing which was associated with risky sexual behavior and suicidal ideation that needs necessary action to tackle the problems.

Prevalence of depression and its associated factors among primary caregivers of patients with severe mental illness in southwest, Ethiopia

BackgroundDepression is a serious mental illness that affects patients’ treatment outcome and caregiver’s day to day life. The prevalence of depression among caregivers of patients with severe mental illness is greater than the general population. Little is known about depression among primary caregivers of patients with severe mental illness in Ethiopia. This study is aimed at assessing prevalence of depression and associated factors among primary caregivers of patients with mental illness.MethodsA cross-sectional study was conducted among primary caregivers of patients with severe mental illness in Jimma University Teaching Hospital. Patient health questionnaire (PHQ-9) was used to assess depression. A multidimensional scale of perceived social support (MSPSS) was used to assess perceived social support; Cut down, Annoyed, Guilty, Eye opener (CAGE) scale was used to assess alcohol use disorder. After conducting descriptive analyses, logistic regression analysis was finally used for bivariate and multivariable analysis.ResultThe overall prevalence of depression among primary caregivers of patients with mental illness was 12 (19%). Out of those caregivers with depressions, 11.3, 3.5 and 4.2% had moderate, moderately severe and severe types of depression respectively. The prevalence of depression among female primary caregivers was 25% (n = 40). Being single (aOR 2.62, 95% CI = 1.07, 6.41), giving care more than six hours per day (aOR 3.75, 95% CI = 1.51, 9.33) and caring for a patient who had more than once episodes of suicidal attempts (aOR 1.48, 95% CI = 1.07, 3.42) were positively associated with depression among caregivers of patients with mental illness.ConclusionWe found that the prevalence of depression among primary caregivers was high. Depression among caregivers was associated with giving care more than six hours per day and caring for a patient who had two or more episodes of suicidal attempts. The prevalence of depression among female caregivers was higher than that of the male caregivers. Therefore, special focus should be given to primary caregivers spending long hours for providing care, those with low perceived social support; caregivers of patients with suicidal ideation and female caregivers.

Khat use and occurrence of psychotic symptoms in the general male population in Southwestern Ethiopia: evidence for sensitization by traumatic experiences

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Khat abuse as risk factor for development of psychotic symptoms in trauma patients : a feasibility study for further genetico-epidemiological studies in the GGFRC, ethiopia

Background The Jimma University in southwestern Ethiopia has a unique health and demographic surveillance system called „Gilgel Gibe Field Research Center” (GGFRC) with a catchment area of about 50.000 people. In this setting, we studied the effect of khat use as risk factor for the development and the stability of psychotic symptoms among young men in the community. Our aim was to validate pilot data by testing the hypothesis, whether objective biological data on khat abuse are related in a meaningful way to behavioral self-reports of study participants and psychiatric symptom presentation assessed by trained interviewers. We assumed that khat alkaloids in urine samples of respondents are related to a higher probability of psychotic symptom presentation, especially in the subgroup with high trauma load. Furthermore, we wanted to demonstrate the reliability and validity of research methods that are necessary for future genetic epidemiological studies, i.e. the validity and reliability of pharmacological screening tests as well as assessments performed by trained local interviewers. Methods In this prospective study, trained local interviewers screened a representative cohort of young men twice within a period of nine months (T1: dry season, N=852, T3: rainy season, N=693) to determine the presence and stability of distinct psychiatric symptoms (CIDI) and to assess traumatic experiences (LEC-5). As part of the screening, urine samples were collected and analyzed for khat alkaloids by immunoassay tests for amphetamine. In a clinical validation interview (T2, N=126) mental health specialist reassessed the psychiatric symptom presentation (BPRS) in a randomly selected subgroup of 126 individuals of those persons who had been screened at T1. The validation study took also urine of this subgroup in order to validate the urine screening by a more extensive analysis of khat alkaloids (HPLC). Results Our results on the association between biological objective data and information on psychiatric symptoms assessed by interviews were related in a meaningful way: The proportion of khat-related psychotic symptoms was highest among respondents with positive khat tests and with high trauma load. This tendency was strongest during rainy season (T3) where the market availability and the use of khat was higher (Chi2 = 14.800, df 1, p Discussion By showing these meaningful variations, this pilot study suggest that important theories on the development of psychosis can be further studied in epidemiological and longitudinal designs among khat users. Our project can be seen as a pilot and feasibility study to prepare a comprehensive population-based genetico-epidemiological study on various gene-environment interactions that should be carried out in the very next future. The infrastructure of GGFRC offers us a unique opportunity to build collectives of multiple-thousand people in a shortest period of time and to perform genetic studies as they have not yet been taken in Africa in this form so far. The population is ideally suited to study the impact of polygenic risk profiles of various psychiatric disorders on behavioral traits and their interaction with environment.

The impact of maternal postnatal depression on infant growth in sub-Saharan African countries: a systematic review protocol.

REVIEW QUESTION/OBJECTIVE The objective of this review is to examine the effect of maternal postnatal depression on the growth of infants aged one or under in sub-Saharan African countries.