Problematic Khat Use Among Prisoners in Debre Berhan Prison, Ethiopia: A Cross-Sectional Study

Abstract Background Cathine and cathinone which are the main psychostimulant components of khat, a green leaf chewed by many people in Yemen and East Africa for recreational purposes are controlled drugs by the UN, but khat chewing is legal in those countries. There are reports on the prevalence of khat use and its association with some health problems and alteration of behavior in communities of those countries. However, there is lack of evidence on the prevalence and associated factors of problematic khat use (PKU) among prisoners. This study aimed to assess the prevalence and associated factors of PKU among prisoners of Debre Berhan prison in Ethiopia. Methods A cross-sectional study was conducted to assess history of PKU among prisoners before imprisonment at Debre Berhan prison. Randomly selected 347 prisoners were interviewed using Drug Abuse Screening Test (DAST) to screen for PKU in May 2017. Data were entered using Epi-Data version 3.1 and analyzed using Stata version 13 software. Bivariate and multivariable binary logistic regressions were conducted. Crude odds ratio and adjusted odds ratio (AOR), with 95% confidence interval (CI), are reported. Variables with p-value of < 0.05 were reported to be significantly associated with PKU. Results About one-third (28.5%) of the prisoners had PKU before imprisonment. Factors significantly associated with increased odds of PKU included being non-Orthodox Christian in religion (AOR = 18.1; 95% CI= (3.8, 85.8)), infrequent visit to worship place irrespective of religion (AOR = 2.9; 95% CI= (1.1, 7.9)), being urban resident (AOR = 22.0; 95% CI= (7.7, 62.9)), perception that the current offence is related to using the substance (AOR = 6.0; 95% CI= (2.8, 12.8)), family history of substance use (AOR = 4.1; 95% CI= (1.2, 14.6)), and living alone before imprisonment (AOR = 3.55; 95% CI= (1.2, 10.7)). Whereas, being married was significantly associated with lower odds of PKU (AOR = 0.3; 95% CI= (0.0, 0.8)). Conclusion Higher prevalence of PKU before imprisonment is reported in this population. In addition to other socio-demographic factors that showed association with use of the substance, current offence that led to imprisonment was also perceived as related to PKU. To prevent crime and health-related consequences of PKU in the community integrated action is recommended.