Association between Khat (Catha edulis) use and the development of gastritis and infection with Helicobacter Pylori A case control study- Nairobi County

Abstract

Gastritis is an inflammation of the mucosal lining of the stomach, and has many possible causes. Gastritis affects millions of people around the globe. Gastritis is mainly caused by Helicobacter pylori, however the pathogenesis of the non-infectious gastritis remains elusive; it may be as result of a combination of environmental, genetic, and immunologic disorders. The clinical signs of gastritis include; nausea, vomiting, abdominal pain and diarrhoea. Fresh leaves and buds of the Khat plant (Catha edulis) contain cathinone, an amphetamine like alkaloid responsible for its pharmacological action. The main objective of this study was to determine the association of Khat chewing and the development of gastritis and infection with H. pylori among adults in Nairobi, Kenya. Chewing of Khat has been associated with gastrointestinal disorders in experimental studies. No studies have examined the effect of Khat chewing on gastritis and the exacerbation of the condition at the population level. An individual case-control study design was used, stratified by age and gender and matched with a control group similar to that of cases in Nairobi County occurring during the same period aimed at assessing the association of Khat chewing and development of gastritis and infection H. pylori. This matching of the control group to existing cases was done to mitigate the effect of confounders. Study participants were selected from chemists/pharmacies where they were buying antacids, H2 blockers and or proton pump inhibitors within the study area. A sample size of 186 (93 cases and 93 controls) was identified using the Rome III criteria for functional dyspepsia and further subjected to upper GIT endoscopy, histological examination of the gastric biopsies and stool antigen test. Data was cleaned, coded, entered into EpiData Version 3.1 and transferred and analyzed using SPSS computer software version 20. Khat chewing was associated with the presence of functional dyspepsia (OR 3.833, 95% CI 1.561 - 9.414). Among the 93 dyspepsia cases, 64.52% (60/93) were Khat chewers and 35.48% (33/93) were non-chewers. There was sufficient evidence that chewer and non-chewer cases differ with respect to GIT