Prevalence of khat chewing during pregnancy in Ethiopia: a systematic review and meta-analysis

Abstract

Abstract Background Khat (Catha edulis) is a flowering green plant mainly chewed for recreational. Khat chewing is becoming on rising at alarming rate and adversely affects the socio-economic, psycho-social, and physical health including the health of the fetus. Thus, this study aimed to determine the pooled prevalence of khat chewing during pregnancy and its associated factors. Methods Databases: PubMed/Medline, CINAHL, SCOPUS and AJOL were searched. Weighted inverse variance random-effects model was used to calculate the pooled prevalence of depression. Heterogeneity across the studies was assessed by Cochrane chi-square and quantified by I2 statistics test. Funnel plots and Egger’s test were used to determine publication bias. Sensitivity test and subgroup analysis were also performed. Results In this study, a total of 9,915 study participants were included from 22 studies. The pooled prevalence of khat chewing was found to be 20% (95% CI; 14%-27%). Tests of heterogeneity demonstrated evidence of heterogeneity (I2 = 98.46%, p < 0.001). However, the analysis of sensitivity tests and publication bias showed absence of influential study and publication bias [Egger’s test (P = 0.02)]. Factors such as: being Muslim, lower educational status, family history of mental illness, and partner previous history of khat chewing were associated with khat chewing. Conclusion One in five pregnant women has history of khat chewing. Thus, authors’ suggest the need of screening for khat chewing as an integrated part of Antenatal care.