A global survey on changes in the supply, price, and use of illicit drugs and alcohol, and related complications during the 2020 COVID-19 pandemic

Background and Aims : COVID-19 has infected more than 77 million people worldwide and impacted the lives of many more, with a particularly devastating impact on vulnerable populations, including people with substance use disorders (SUDs). Quarantines, travel bans, regulatory changes, social distancing, and "lockdown" measures have affected drug and alcohol supply chains and subsequently their availability, price, and use patterns, with possible downstream effects on presentations of SUDs and demand for treatment. Given the lack of multicentric epidemiologic studies, we conducted a rapid global survey within the International Society of Addiction Medicine (ISAM) network in order to understand the status of substance-use patterns during the current pandemic. Design : Cross-sectional survey. Setting : Worldwide. Participants : Starting on April 4, 2020 during a 5-week period, the survey received 185 responses from 77 countries. Measurements : To assess addiction medicine professionals' perceived changes in drug and alcohol supply, price, use pattern, and related complications during the COVID-19 pandemic. Findings : Participants reported (among who answered "decreased" or "increased") a decrease in drug supply (69.0%) and at the same time an increase in price (95.3%) globally. With respect to changes in use patterns, an increase in alcohol (71.7%), cannabis (63.0%), prescription opioids (70.9%), and sedative/hypnotics (84.6%) use was reported, while the use of amphetamines (59.7%), cocaine (67.5%), and opiates (58.2%) was reported to decrease overall. Conclusions : The global report on changes in the availability, use patterns, and complications of alcohol and drugs during the COVID-19 pandemic should be considered in making new policies and in developing mitigating measures and guidelines during the current pandemic (and probable future ones) in order to minimize risks to people with SUD.Publisher PDFPeer reviewe

Psychopathy and associated factors among newly admitted prisoners in correctional institution located in Bench Sheko and West Omo Zone, South West Ethiopia : a cross-sectional study

Background: Psychopathy is an emerging health and behavioral problem worldwide. Psychopathy is linked to risk substance use, maltreatment, violence, crime, and reoffending, but little is known about psychopathy in low income countries like Ethiopia. Therefore, we assessed the prevalence and factors associated with psychopathy among newly-admitted prisoners in Bench Sheko and West Omo zone correctional center, Mizan Aman, Ethiopia. Methods: A cross-sectional study was conducted from April 20 to July 19, 2019, among 411 (N=422) newly-admitted Bench Sheko and West Omo zone correctional center prisoners by using a consecutive sampling technique. A semi-structured and interviewer administered psychopathy checklist revised tool was used for screening psychopathy. WHO, ASSIST tool was used for screening risk use of khat, tobacco, and alcohol. Trauma, maltreatment, and social support were assessed with a life event checklist, adverse life experience screening tool, and Oslo social support scale, respectively. In addition, Criminal and clinical history of the prisoner was also assessed. The data was entered into Epi-data 3.1 and exported to Statistical Package for Social Science (SPSS) Version 21 for statistical analysis. A logistic regression model was used. Variables with a p-value less than 0.05 in the final fitting model were declared as independent predictors of psychopathy. Results: The prevalence of psychopathy was 24.3%. Childhood maltreatment (AOR=6, 95% CI=2.2-17.5), risky khat use (AOR=4.6, 95% CI=2.4-8.7), poor social support (AOR=3.5, 95% CI=1.9-6.6), family history of imprisonment (AOR=3, 95% CI=1.5-6), history of trauma (AOR=2.3, 95% CI=1.1-4.8), and reoffending (AOR=2, 95% CI=1.1-3.8) were positively associated variables with psychopathy. Conclusion: Psychopathy is highly prevalent among newly-admitted prisoners. Integrated efforts involving relevant stakeholders are needed to design strategies for early screening of psychopathy to prevent reoffending, and management of risk substance use at admission is crucial

The presentation and treatment response of catatonia in patients admitted to the psychiatric inpatient unit at Jimma University Medical Center, Ethiopia

Background. Catatonia is among the most mysterious and poorly understood neuropsychiatric syndrome. It is underresearched and virtually forgotten but still a frequent neuropsychiatric phenotype in both developed and low-income countries. Catatonia is associated with a number of medical complications like pulmonary embolism, dehydration, or pneumonia if it is not treated and managed adequately. In Ethiopia, however, almost no studies are available to describe the symptoms and the response to treatment in patients with catatonia. The aim of this retrospective study was therefore to describe the symptom profile of catatonia and to evaluate the treatment and outcome of catatonia in patients admitted to the psychiatric inpatient unit at Jimma University, Ethiopia. Method. Detailed treatment records of all inpatients were reviewed for the period from May 2018 to April 2019. All patients with catatonia at the inpatient unit of Jimma University Medical Center were assessed with the Bush-Francis Catatonia Rating Scale (BFCRS), and all comorbid psychiatric diagnoses were made according to the criteria of the Diagnostic Statistical Manual V. The presence and severity of catatonia were assessed by using the BFCRS at baseline and at discharge from the hospital. Result. In the course of one year, a total of 18 patients with the diagnosis of catatonia were admitted. The mean age of the participants was 22.8 years (SD 5.0; range: 15 to 34 years). The most common diagnosis associated with catatonia was schizophrenia (; 66.7%), followed by severe depressive disorders (; 22.2%). Mutism, posture, and withdrawal were registered in all patients (, 100%). All patients received an injection of diazepam and had improved at discharge. Conclusion. Our study provides further evidence that catatonia is most commonly associated with schizophrenia, followed by major depressive disorder, and that mutism, posturing, and withdrawal are the most common signs and symptoms of catatonia

Magnitude of Khat use and associated factors among women attending antenatal care in Gedeo zone health centers, southern Ethiopia : a facility based cross sectional study

Background Khat (Catha edulis) is a fresh green leave commonly chewed for recreational purpose and its euphoric effect as a result of dopamine activities stimulation effect of Khat. Women may use Khat during their pregnancy to tolerate their pregnancy related distress. Khat has biological, social or psychological complications; adverse pregnancy outcomes and negatively affects the health of the mother and the fetus. However, magnitude, pattern and associated factors of Khat use are not well addressed among pregnant women in Ethiopia. The aim of this study was to address this gap by assessing the magnitude and associated factors of Khat use among women attending antenatal care service at Gedeo zone rural health centers. Methods This was a facility based cross-sectional study conducted at rural health centers in Gedeo zone from June 1(st) to August 1(st), 2017. The data were collected through structured interview using an interview guide developed from different literatures. A total of 718 pregnant women attending antenatal care service participated in the study using multi stage sampling technique. Bivariable and multivariable analysis were used to identify associated factors of Khat use among women during their current pregnancy period. In the multivariable analysis, variables with P-Values of less than 0.05 were considered as statistically significant correlates of Khat use. The strength of the association was also measured with adjusted odds ratio at a corresponding 95% confidence interval. Results The lifetime and current prevalence of khat use among pregnant women were 11.0% (95%CI: 8.8-13.2) and 9.9% (95% CI: 7.7-12), respectively. The odds of being khat user was higher among those who had khat user partner [AOR = 3.450, 95% C.I (1.907-6.244)], respondents with alcohol use behavior [AOR = 3.235, 95% C.I (1.573-6.659)] and mental distress [AOR = 3.575, 95% C.I (2.067-6.189)]. Conclusion Significant proportions of pregnant women were experiencing khat chewing during pregnancy. Having khat user partner, alcohol use behavior and metal distress were significantly associated with khat use of pregnant women. This demonstrates a need to integrate the prevention, early identification and intervention of Khat use as a component of treatment modality for pregnant women during their antenatal visit

Mental health of healthcare professionals during the early stage of the COVID-19 pandemic in Ethiopia

Background The coronavirus (COVID-19) pandemic causes healthcare professionals to suffer mental health problems such as psychological distress, anxiety, depression, denial and fear. However, studies are lacking related to Ethiopia and to Africa in general. Aims To study the mental health of healthcare professionals during the COVID-19 pandemic in Ethiopia. Method A hospital-based cross-sectional study was conducted at Jimma University Medical Center among 249 healthcare professionals. The data were collected using self-administered questionnaires between 22 and 28 March 2020. The psychological impact was assessed using the Impact of Event Scale - Revised (IES-R) and symptoms of insomnia were measured using the Insomnia Severity Index (ISI). Social support was evaluated using the three-item Oslo Social Support Scale. Data were analysed using logistic regression to examine mutually adjusted associations, expressed as adjusted odds ratios. The psychosocial status of the healthcare professionals was predicted using a classification tree model supported by the genetic search method. Results The prevalence of psychological distress among healthcare professionals was 78.3%. The mean IES-R score was 34.2 (s.d. = 19.4). The ISI score indicated that the prevalence of insomnia was 50.2%. Higher psychological distress was associated with younger age, having insomnia, not having a daily update on COVID-19, and feeling stigmatised and rejected in the neighbourhood because of hospital work. Conclusions This study indicates that, in Ethiopia, the prevalence of psychological distress among healthcare professionals is high and associated with specific sociodemographic risks

The effects of khat use during pregnancy on perinatal and maternal outcomes: a meta-analysis

Chewing khat during pregnancy adversely afects maternal and fetal health, but available studies are scarce and inconsistent, and it is difcult to conclude the relationship between khat consumption and perinatal outcomes. We aimed to investigate the available studies on the efect of khat use during pregnancy on perinatal and maternal outcomes. For this meta-analysis, we conducted a thorough search of articles published in PubMed, Embase, Scopus, and Web of Science up to the date this search was undertaken (03.01.2022). We used random efect model with the Mantel–Haenszel method to calculate the pooled odds ratio and mean diference. We found that khat use during pregnancy was signifcantly associated with increased odds of low birth weight (OR:2.51; 95% CI: 1.60 to 3.94), congenital anomalies (OR:3.17; 95% CI: 1.30 to 7.73), premature rupture of membrane (OR: 1.99; 95% CI: 1.59 to 2.50), perinatal mortality (OR: 1.95; 95% CI: 1.26 to 3.03), and lower APGAR scores at the ffth minute (MD: −1.7; 95% CI: −2.32 to −1.07). Also, increased odds for developing maternal psychological stress and anemia were reported in women using khat during pregnancy. There were no statistically signifcant diferences in stillbirth and preterm birth between women using khat during pregnancy and their counterparts. Since prenatal khat use is associated with adverse perinatal and maternal outcomes, we strongly recommend equitable and easily accessible health services through the implementation of integrated addiction treatment with maternity services to address khat use during pregnancy and encourage the practice of healthy behavior of women

Trauma exposure and alcohol use disorder among prisoners in Jimma Zone correctional institution, Southwest Ethiopia : a cross-sectional study

Objective: Trauma exposure and alcohol use are closely related, and large proportion of trauma-exposed individuals use alcohol. The data presented in this paper were obtained as part of a study on substance use disorder and associated factors among prisoners in the correctional institution in Jimma, Southwest Ethiopia. Therefore, in this study we examined comorbidity of traumatic life experiences and alcohol use disorder in inmates of correctional institution in Jimma, Southwest Ethiopia. Results: The overall prevalence of lifetime alcohol use disorder was 40.1%, and the prevalence of alcohol use disorder among prisoners with lifetime trauma exposure was 44.0%. Participants with multiple trauma exposures had 2.5-fold higher odds of association for alcohol use disorder than their counterparts (AOR = 2.47 [1.23-4.94]). Living in urban areas (AOR = 4.86 [2.38-9.94]), presence of psychopathy (AOR = 3.33 [1.25-8.86]), khat abuse (AOR = 7.39 [3.99-13.68]), and nicotine dependence (AOR = 2.49 [1.16-5.34]) were also positively associated with alcohol use disorder. The prevalence of alcohol use disorder was higher among prisoners with lifetime trauma exposure. Also, this study indicates that prisoners with multiple trauma exposures had higher odds of association for alcohol use disorder than those with no trauma exposure. A public health intervention targeting survivors of traumatic experiences needs to be designed and implemented

Psychological impact of COVID-19 outbreak among Jimma University Medical Centre visitors in Southwestern Ethiopia : a cross-sectional study

Background COVID-19 has posed several medical, psychosocial and economic impacts among the majority of the society. The ambiguity of its transmission, the intense desire of self-protection, family, and friends, the unknown impact of catching the disease itself, unstoppable spread, the panic and outright misinformation lead to acute stress reaction syndrome. However, reliable data related to this contagion lack the prevalence of acute stress reaction syndrome and associated factors among Jimma University Medical Centre hospital visitors in Southwestern Ethiopia. Aims The main objective of the study was to assess the prevalence and factors associated with acute stress reaction syndrome during the COVID-19 outbreak among Jimma University Medical Centre Hospital visitors, Ethiopia. Methods An interviewer-administered cross-sectional study was conducted among 247 visitors of the Jimma University Medical Centre in Ethiopia. The study was conducted within 2 weeks of the first COVID-19 cases detected on 13 March 2020 in Ethiopia. Data on demographic and socioeconomic status were collected during the interview using structured questionnaires. The psychological impact was assessed using the Impact of Event Scale-Revised, and symptoms of insomnia were measured using the Insomnia Severity Index. Social support was evaluated using Oslo three-item Social Support Scale. Logistic regression was employed to determine the associations between dependent and independent variables. Besides, psychosocial stress score was generated using principal component analysis. A paired permutation test was also performed to determine the variability of psychosocial stress between groups. Results The mean age of participants was 30.47 years, and 76.5% of the participants were male. Acute stress reaction syndrome was detected in 44.1% of hospital visitors. Of the participants, 38.5%, 17.4%, 8.5% and 35.6% had a minimal, mild, moderate and severe psychological impact, respectively. Factors positively associated with acute stress reaction syndrome were individuals who perceived that COVID-19 leads to stigma (adjusted OR (AOR): 3.24, 95% CI 1.11 to 9.45), mild insomnia (AOR: 14.74, 95% CI 6.14 to 35.40), moderate to severe insomnia (AOR: 35.1, 95% CI 10.76 to 114.66), low social support (AOR: 4.08, 95% CI 1.31 to 12.67) and governmental employees (AOR: 8.09, 95% CI 1.38 to 47.18). Conclusion The study revealed the existence of a high prevalence of acute stress reaction syndrome during the COVID-19 outbreak among different groups of the community. Therefore, our results will contribute to the global awareness of the psychological impact of the COVID-19 outbreak

Psychological distress during the COVID-19 pandemic in Ethiopia : an online cross-sectional study to identify the need for equal attention of intervention

Background The COVID-19 pandemic led individuals to suffer from different levels of mental health problems such as psychological distress, anxiety, depression, denial, panic, and fear. This study aimed at determining the prevalence of psychological distress and associated factors among the Ethiopian population during the COVID-19 pandemic. Methods A cross-sectional study was performed through an online survey using different online platforms. The questionnaire was created through Google Form and the survey link was administered by e-mail, LinkedIn, Telegram, and Facebook. Educated Ethiopian population who have access to the internet were invited to participate through an online survey and addressed to 929 respondents. The study participants completed the survey anonymously without any personal identifier. The psychological distress was assessed using the Kessler 10-item tool to measure psychological distress. Data were analyzed using SPSS and logistic regression to examine mutually adjusted associations, expressed as adjusted odds ratios. A generalized additive model was also employed to identify additional predictors using R. Results The prevalence of high psychological distress among the study population was 236 (25.5%). Of all respondents, 421 (45.1%) had low psychological distress, 274 (29.4%) had moderate psychological distress, 164 (17.6%) had high psychological distress, and 72 (7.3%) had very high psychological distress. Psychological distress increased with being at young and middle-aged adults, getting information from social media, and not correctly practicing infection prevention and control measures to prevent COVID-19 infection. Respondents with high perceived severity had increased psychological distress. On the contrary, those with the highest score of perceived response efficacy had low distress. Conclusion Prevalence of psychological distress was substantial. The need for intervention of psychological distress inline with the prevention of COVID-19 is critically essential. The intervention target groups are those whose information sources are from social media, young and middle-aged adults, and those who do not correctly practice infection prevention and control measures against COVID-19 infection