The Relationship Between Khat Use Disorder and Post-Traumatic Stress Disorder Among Prisoners with Life Time Trauma Exposure in Ethiopia: A Cross-Sectional Study

BACKGROUND: Problematic khat use is an emerging health problem worldwide. Trauma experience, crime, and substance misuse is closely related. However, there is lack of evidence whether post-traumatic stress disorder (PTSD) and life time trauma exposure has a relationship with problematic khat use among prisoners in our country Ethiopia, or elsewhere. Therefore, this study assessed the relationship between PTSD and life time trauma exposure with khat use disorder among newly admitted prisoners in Bench Shako and West Omo zone correctional institution, Mizan Aman, Ethiopia. METHODS: A cross-sectional study was conducted among 411 (N=422) prisoners from April 20 to July 19, 2019, by using a consecutive sampling technique. Trauma exposure and post-traumatic stress disorder were assessed with a life event check list and Post-traumatic stress disorder – civilian version (PCL-C), respectively. The WHO ASSIST tool was used to assess khat, alcohol, and tobacco use disorder. Antisocial personality disorder, criminal, and clinical history were also assessed. The data were entered into Epi-data version 3.1 and then exported to Statistical Package for Social Science version 21. A logistic regression model was used and variables with a p-value less than 0.05 in the final fitting model were stated as independent predictors of PTSD. RESULTS: Nearly one out of four prisoners exposed to life time trauma exposure developed PTSD, and the prevalence of khat use disorder among prisoners with life time trauma exposure and PTSD was 45% and 85%, respectively. Prisoners with khat use disorder had more than 5 times higher odds of association with PTSD than their counterparts (AOR=5.3, 95% CI=2.4–11.8). In addition, antisocial personality disorder (AOR=2.8, 95% CI=1.6–5.5), criminal recidivism (AOR=2.5, 95% CI=1.5–4.3), and being a driver (AOR=2, 95% CI=1.2–3.3) were positively associated with PTSD. CONCLUSION: Khat use disorder was higher among prisoners with life time trauma exposure and PTSD, and khat use disorder was positively associated with PTSD.