Reviewing and Evaluating Interventions for Khat use Reduction.

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1 Reviewing and Evaluating Interventions for Khat use Reduction. Prof. AbdulwahabZakari Professor of Public Health, Faculty of Public Health & Tropical Medicine Principal Investigator of the Khat Research Project Supported by SARC, Jazan University

2 Introduction Khat(Catha edulis) is consumed by - chewing leaves of the evergreen shrub that grows in East Africa and Arabic Peninsula. Efforts had been exerted to reduce Khat- use in Jazanregion and other countries in the region. However, effective intervention strategies are still lacking, but sorely needed.

3 KhatHealth Effects -Khatimpacts are severe on people s physical and psychological health and their socio-economic conditions and their countries as Somalia and Yemen. - Increased levels of alertness, ability to concentrate, confidence, friendliness, contentment, and flow of ideas. Chewing session is followed by excessive tension, anxiety, emotional instability, irritability, and restlessness within 2 hours. Later experience includes feelings of low mood, lack of concentration, sluggishness, and insomnia.

4 Prevalence & Research -In Jazan: A study ( May 2006) in the colleges and secondary schools in Jazanregion it was found that the overall prevalence of Khatchewing was 21.4%. There was a less remarkable 3.8 female khatchewers and a remarkable 37.7% male Khatchewers. The use of Khatis significantly associated with age, residence and school and college. The prevalence was different in different colleges and indifferent provinces in Jazan region with a significance of P<0.05 ( Elsonusi, Ageely et al. Eurojurnals 2011).

5 Prevalence & Research 80 to 90% of men and 10 to 60% of women in - Yemen & East Africa are regular khatusers. The availability of khatin the United States has been increasing since According to the Federal-wide Drug Seizure System (FDSS), law enforcement seizures of khatincreased from 14 metric tons in 1995 to over 37 metric tons in During the first six months of 2002, nearly 30 metric tons of khatwas seized. ( Source: US Drug Enforcement Administration)- Recent reports indicated that Khatis also used by - immigrants in Europe, Asia and other countries.

6 Efforts for khat use reduction in KSA Historically the khatreduction efforts started with the establishment of the Fefa Development Project (FDP) 34 years ago (in 1398 Hijri). Nine years later the BaniMalekMountains area was included in the project.

7 INTERNATIONAL EFFORTS FOR KHAT CONTROL # WHO Lab prooves and decision to include khatin the List of Drugs # NIH KRP USA # U s effortskimmigrants from the Horn of Africa and Yemen Preparation for tomorrow s action # SOMALIA # YEMEN Gov. efforts - NGO # Kingdom of Saudi Arabia

15 Efforts for khat use reduction in KSA The Royal Government of KSA efforts to reduce khat use in the Southern Province of Saudi Arabia was tremendous. FEFA Development Project (FDP) aimed to substitute khat plantations with cash crops and fruits. E.g coffee oranges, apples, and pomegranates. There was also a sound financial compensation given for each khattree replaced with fruit tree. This process has been going for more than 30 years.

16 The new efforts of the Saudi government taken recently coupled with direct visits and supervision of HRH Prince Mohammed bin Naserbin AbdulAzizto all areas where khatplantations are available including Abha, Al-Rraith, BaniMalekand Fefa, have yielded recently great results. The Sheikhs, leaders and citizens from all these mentioned areas came voluntarily to the supreme court in JazanCity and presented their consent and approval for khattrees removal from their areas and official documents were presented to HRH the Prince of Jazan. More recently 140,000 Khat tress have been removed

17 A High level Committee was established to follow up on the implementation and to ensure its continuity with great success.

18 PROJECT PLAN SYSTEMATICALLY REVIEW PREVIOUS INTERVENTION EFFORTS THAT HAVE BEEN TRIED IN SOME COUNTRIES IN AFRICA AND YEMEN. EVALUATE THE EFFECTIVENESS OF THESE EFFORTS AT THE INDIVIDUAL AND SOCIETAL LEVELS. INDICATIONS OF ANY SUCCESS WILL BE HIGHLIGHTED. COUNTRIES WHERE EFFORTS TO CONTROL KHATUSE HAVE BEEN ATTEMPTED INCLUDE ETHIOPIA, YEMEN, KSA FEFAPROJECT, AND KENYA. THE METHODS OF INTERVENTION WILL BE REVIEWED AND EVALUATED:

19 Expected Outcome and Results 1. Publishable Scientific Review To propose efforts geared to assist in building an intervention program to prevent khatchewing at Jazan area 2. Access to expertise. One outcome of this project will be to provide Jazan University access to a network of experts on this topic and other topics related to substance use and behavioral medicine 3. Translation and dissemination. We also plan to translate the work from this project and disseminate the final products to other countries in the region.

20 In conclusion, the KRP international team is uniquely positioned to conduct and help Jazan University establish a strong and credible research program on khatand substance use. The team possesses a combination of research and training expertise in multiple disciplines and has access to a wide network of scientists and research leaders around the world. The KRP will be working in collaboration with other partners under SARC supervision

21 Thank You Uloof أ وف را

Investigating Trait-Anger in Habitual Khat Chewers in Yemen and Germany*

Investigating Trait-Anger in Habitual Khat Chewers in Yemen and Germany* Stephan Bongard & Mustafa al Absi Goethe-University Frankfurt, Germany University of Minnesota Medial School, Duluth, MN, USA *)