The prevalence of areca nut consumption among the rural communities in Karachi, Pakistan: A community-based cross-sectional study

Title : The prevalence of areca nut consumption among the rural communities in Karachi, Pakistan: A community-based cross-sectional study

Abstract:

Background: The seed of the areca palm is chewed recreationally by approximately 600 million people globally. Chewing areca is strongly associated with oral cancers. In Karachi, Pakistan, the practice is common, with one study reporting 34.3% to 50% use of areca nut products and areca nut mixed with tobacco products in a squatter settlement. In Pakistan, oral cancers are second only to breast cancer in prevalence. Oral cancers are highly preventable; the high prevalence represents an unmet public health need. Further, local prevalence statistics are needed to inform successful prevention interventions to target the most vulnerable populations.
Methods: We enrolled 760 participants among the rural population of Karachi, Pakistan, between December 2021 and February 2022. This cross-sectional study assessed the prevalence of self-reported areca nut use, prevalence of self-reported oral cancers, and awareness of adverse health effects stratified by age, gender, and ethnicity.
Results: 74% of the overall study population were areca nut users. There were significant associations with oral cancer based on gender, and non-significant differences with ethnicity. The rate of daily areca nut consumption among adults was 76.5% (males 87%, females 53%), and among children (male and female, ages 5-13 years) was 60% . By age, the highest rate was among 18-34 year-olds at 89%; the lowest was among children at 60% and people 65 years and older at 62%. Among ethnic groups, the Sindhi population had the highest rate of areca nut consumption (79%); Balochis the lowest (55%). The overall self-reported oral cancers among the study population were 10.3%. Among areca nut users, 12.2% had self- reported oral cancers compared to 6.6% among non-areca nut users. The self-reported cancer prevalence was higher among females (17.5%) than males (9%). The overall awareness rate regarding adverse health impacts among the study population was 11%.
Discussion & Conclusion: Areca nut use appears to be common in this rural population, with an overall prevalence higher than the national reported rate. There appears to be a positive correlation between areca nut consumption and self-reported oral cancers. There is room to improve population awareness of adverse health impacts. Gender, age, and ethnic distinctions suggest where to focus public health efforts.
Key words: Areca nut, oral cancer, rural community, addictive substance.

Biography:

Laraib Saleem is a Certified Public Health Professional, and a Public Health Educator at the New York City Department of Health and Mental Hygiene, Bureau of Environmental Disease and Injury Prevention. He is also a part of Anti-Racism Environmental Justice program at the Mount Sinai, Department of Environmental Health and Medicine to promote community advocacy on environmental and social justice among underserved communities of East Harlem Neighborhood. He worked on different global public health research projects during his academic and professional experience.  He was a former Asthma/COPD Community Health Liaison at the New York City Health and Hospitals. He had received his Masters in Public Health at the Icahn School of Medicine at Mount Sinai in Environmental Health Science and Medicine specialization in 2023. He is a Sustaining/Emerging Professional Member of American Public Health Association, National Environmental Health Association, and New York State Public Health Association. Laraib’s Masters research manuscript on a cross-sectional study of areca nut consumption and self-reported oral cancers conducted in Karachi, Pakistan between 2020 to 2021, has motivated the underserved communities from local to global on the importance of social determinants of health, one health and basic human rights.