Reducing Khat use among Somalis living in Kenya

A controlled pilot study on the modified Assist-linked brief intervention delivered in the community

Bibliographic Data

ID15357261
AuthorsMarina Widmann (0000-0002-5589-9346, International Solar Energy Research Center Konstanz, corresponding author), Bernice Apondi (Practical Action), Abednego Musau (0000-0001-5979-1191, Africa Mental Health Foundation), Abdulkadir Hussein Warsame, Maimuna Isse, Victoria Mutiso (0000-0002-8395-6707, Africa Mental Health Foundation), Clemens Veltrup, Inga Schalinski (0000-0003-1665-7640, Universität der Bundeswehr München), David M Ndetei (0000-0001-6891-4990, Africa Mental Health Foundation), David Ndetei, Michael Odenwald (0000-0002-7335-3400, International Solar Energy Research Center Konstanz)
Year2022
Volume22
Issue1
Publication date2022-12-05
Peer ReviewedYes
Open AccessYes
TypeARTICLE
VenueBMC Public Health (JOURNAL)
Journal identifiersISSN: 1471-2458 • E-ISSN: 1471-2458
PublisherBioMed Central (PUBLISHER • GB)
DOI10.1186/s12889-022-14681-w
OpenAlexW4311287890
LanguageEN
Citations received2
References cited37

Background During recent decades, the consumption of the stimulant khat ( catha edulis ) has profoundly changed in countries around the Horn of Africa, and excessive use patterns have emerged—especially evident among displaced Somalis. This is related to the development of severe somatic and psychiatric disorders. There are currently no preventive or interventional studies targeting khat use. This study’s aim was to test screening and brief intervention (SBI) to reduce khat use among urban Somali refugees living in Kenya with limited access to public healthcare. Methods In this controlled study, 330 male Somali khat users from the community were either assigned to SBI (161) or an assessment-only control condition (AC; 169); due to field conditions a rigorous experimental design could not be implemented. The World Health Organization’s (WHO) Alcohol, Smoking and Substance Involvement Screening Test (ASSIST)-linked brief intervention was adapted to khat and Somali culture. Trained local counselors administered the intervention. The amount and frequency of khat use was assessed using the time-line-follow-back method. We compared the month before the intervention (t1) to the two months after it (t2, t3). Baseline differences in khat use frequency were corrected by partial matching and mixed effect models used to evaluate intervention effects. Results SBI was well accepted and feasible for khat users. Over the complete observation period and from t1 to t2, khat use amount and frequency decreased ( p < .001) and the intervention group showed a greater reduction (group x time effects with p ≤ .030). From t2 to t3, no further reduction and no group differences emerged. Conclusion The results provide preliminary evidence that khat use amount and frequency can be reduced in community settings by SBI, requiring little resources. Thorough assessment alone might have intervention-like effects. The non-treatment-seeking community sample and the non-professional counselors are distinct from SBI studies with other substances in other countries, but support the feasibility of this approach in khat use countries and especially in Somali populations with limited access to healthcare. Future studies that employ rigorous experimental design are needed. Trial registration ClinicalTrials.gov identifier: NCT02253589. Date of first registration 01/10/2014, retrospectively registered https://clinicaltrials.gov/ct2/show/NCT02253589 . First participant 16/09/2014

Biostatistics · Environmental health · Intervention (counseling · Khat · Psychiatry · Public health · Somali · Stimulant · Traditional medicine · Forensic Toxicology and Drug Analysis · Medicine · Neurotransmitter Receptor Influence on Behavior · Nursing · Substance Abuse Treatment and Outcomes