Undernutrition among khat-chewer and non-chewer lactating women in Chiro district, eastern Ethiopia: Comparative cross-sectional study

Objectives: This study aims to assess the prevalence of undernutrition and factors associated with it among khat-chewer and non-chewer lactating women at Chiro district, west Hararghe zone, eastern Ethiopia. Methods: A community-based comparative cross-sectional study was conducted among 446 (223 khat chewers and 223 non-chewers) randomly selected lactating women who have children aged 6 and 23 months. Data were collected through face-to-face interviews using structured questionnaires followed by weight and height measurements to calculate and categorize nutritional status based on body mass index (kg/m(2)). Data were entered into EpiData version 3.1 and analyzed using STATA version 14.2. A binary logistic regression model was fitted to check the association between independent variables and undernutrition. The level of statistical significance was declared at a p-value less than 0.05. Results: The overall prevalence of undernutrition among lactating women was 30.7% (95% confidence interval = 26.6, 35.2). Undernutrition was significantly higher among khat chewers, 39.0% (95% confidence interval = 32.8, 45.6) than non-chewers, 22.4% (95% confidence interval = 17.4, 28.4), (chi(2) (degree of freedom) = 14.4231, p < 0.0001). Chewing daily (adjusted odds ratio = 3.14, 95% confidence interval = 1.08, 9.15), reducing number of meals after chewing (adjusted odds ratio = 3.45, 95% confidence interval = 1.29, 9.20), and unavailability of latrine (adjusted odds ratio = 2.98, 95% confidence interval = 1.02, 8.75) were significantly associated with undernutrition among khat-chewer lactating women. Furthermore, age at first pregnancy (<18 years) (adjusted odds ratio = 3.17, 95% confidence interval = 1.17, 8.60), not taking any additional meals (adjusted odds ratio = 3.41, 95% confidence interval = 1.08, 10.7), and hand washing after toilet use (adjusted odds ratio = 6.10, 95% confidence interval = 2.51, 14.8) were significantly associated with undernutrition among non-chewer lactating women. Conclusion: The overall prevalence of undernutrition is higher than previous studies and is alarming among khat-chewer lactating mothers. Thus, nutritional and public health interventions should target khat-chewer lactating mothers particularly focusing on daily chewer either to improve their dietary practice during and after chewing or to stop khat chewing if possible, in order to reduce the effect of khat on food absorption. Besides, improving latrine coverage and use, and prevention of early pregnancy are of paramount importance in reducing undernutrition among lactating mothers.