Hematological and Platelet Indices Alterations Associated with Khat Chewing Among University Students in Conflict-Affected Yemen: A Cross-Sectional Study

Background: Khat chewing is prevalent among Yemeni youth; however, its impact on hematological parameters in conflict settings remains underexplored.
Objective: To assess the association between khat chewing and complete blood count (CBC) parameters, particularly platelet indices, among university students in Al-Dhale’e, Yemen.
Methods: A cross-sectional study was conducted with 226 undergraduate students. Khat use was assessed using a structured questionnaire, and CBC was analyzed using an automated hematology analyzer. Statistical analyses included independent t-tests, Mann-Whitney U tests, and multiple linear regression adjusted for age, sex, smoking, body mass index (BMI), caffeine intake, and psychological stress score.
Results: The prevalence of khat chewing was 77.9% (176/226). Compared with non-chewers, chewers had significantly higher mean platelet volume (MPV: 9.7 vs. 8.8 fL; p < 0.001; d = 0.78), higher platelet distribution width (PDW: 16.1 vs. 15.0%; p = 0.003; d = 0.48), higher white blood cell count (WBC: 7.6 vs. 6.8 × 109/L; p = 0.004; d = 0.46), and lower hemoglobin (13.7 vs. 14.3 g dL; p = 0.006; d = -0.46). Regression analysis confirmed khat as an independent predictor of elevated MPV (β = 0.85, p < 0.001), elevated WBC (β = 0.78, p = 0.008), and reduced hemoglobin levels (β = -0.52, p = 0.012). Trend analysis suggested graded associations with the frequency and duration of use.
Conclusion: Khat chewing is independently associated with elevated MPV and WBC, suggesting a possible proinflammatory state and reduced hemoglobin levels. Routine CBC monitoring should be considered for habitual khat users in resource-limited settings.