Miraa, qat, chat, cat, ghat or khat (Catha edulis), is a shrub indigenous to Eastern Africa and Arabic countries. It is currently being cultivated in most Africa countries. Chewed miraa, has sympathomimetic and euphoric effects and its chewing is a popular habit among various populations in Kenya. Habitual miraa chewing has been associated with oral lesions including oral cancer. It has also been associated with various toxic effects of the central nervous system, cardiovascular and reproductive system. In Kenya no data exist among the population that chew miraa of oral mucosal changes associated with miraa chewing.

Study Objective: To determine cytological changes of the oral mucosa among habitual miraa chewers in Meru Kenya.

Setting: Recruitment will be done in miraa selling and chewing joints in Meru town. Sample collection and specimen processing will be done at Meru level V hospital and KNH/UON cytology laboratory  respectively.

Subjects:Two hundred and seventeen (217) consenting participants aged 18 years and above with a history of chewing miraa for more than three years will be recruited.

Design and method: This will be a cross-sectional study. Recruiting a total of 217 consenting adults who meet the inclusion criteria. Snowball sampling technique will also be used to hasten enrollement. Buccal smears will be collected using cytobrush and examined to determine oral mucosal cytological changes while face to face interviews used to collect social demographic data as well as risk factors for oral mucosal disease.

Data management and statistical analysis: Frequency and percentages will be used to describe the patterns of oral mucosal cytological including the occurrence of neoplastic lesions. Bivariate and multivariate analyses will be used to determine factors associated with oral lesions at the significance level of p ≤ 0.05. All statistical analyses will be performed using STATA version 12 (StataCorp LP, Texas, USA).

Expected results: This study expects to determine prevalence and risk factors of oral mucosal cytological changes associated with habitual miraa chewing. These results may be vital in formulating policy to regulate use.

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