title: Health effects of kava use in an eastern Arnhem Land Aboriginal community.
abstract: BACKGROUND
  Heavy kava use in Aboriginal communities has been linked to various health effects, including anecdotes of sudden cardiac deaths.
  
  
  OBJECTIVE
  To examine associations between kava use and potential health effects.
  
  
  METHODS
  A cross-sectional study was carried out within a kava-using east Arnhem Land Aboriginal community in tropical northern Australia. One-hundred-and-one adults who were current, recent or non-users of kava were enrolled in March 2000. Main outcome measures were physical, anthropometric, biochemical, haematological, immunological and neurocognitive assessments.
  
  
  RESULTS
  Kava users more frequently showed a characteristic dermopathy (P<0.001). They had increased levels of gamma-glutamyl transferase and alkaline phosphatase (P<0.001). Lymphocyte counts were significantly lower in kava users (P<0.001). Fibrinogen, plasminogen activator inhibitor-1 and neurocognitive tests were not different between kava use categories. IgE and IgG antibodies were elevated across the whole group, as were C-reactive protein and homocysteine.
  
  
  CONCLUSIONS
  Kava use was associated with dermopathy, liver function abnormalities and decreased lymphocytes. If kava continues to be used by Aboriginal populations, monitoring should focus on the health consequences of these findings, including a possible increase in serious infections. The interaction between kava, alcohol and other substances requires further study. Although markers of cardiovascular risk are increased across the population, these were not higher in kava users, and this increase may be linked to the large infectious pathogen burden reflective of the socioeconomic disadvantage seen in many remote Aboriginal communities.
authors.affiliation: Menzies School of Health Research, Northern Territory University, Melbourne, Victoria, Australia.
authors.forename: A R
authors.initials: AR
authors.lastname: Clough
authors.forename: S P
authors.initials: SP
authors.lastname: Jacups
authors.forename: Z
authors.initials: Z
authors.lastname: Wang
authors.forename: C B
authors.initials: CB
authors.lastname: Burns
authors.forename: R S
authors.initials: RS
authors.lastname: Bailie
authors.forename: S J
authors.initials: SJ
authors.lastname: Cairney
authors.forename: A
authors.initials: A
authors.lastname: Collie
authors.forename: T
authors.initials: T
authors.lastname: Guyula
authors.forename: S P
authors.initials: SP
authors.lastname: McDonald
authors.forename: B J
authors.initials: BJ
authors.lastname: Currie
mesh_terms: D000328:Adult; D000469:Alkaline Phosphatase / Q000097:blood; D000906:Antibodies / Q000097:blood; D002097:C-Reactive Protein / Q000032:analysis; D003071:Cognition / Q000187:drug effects; D003430:Cross-Sectional Studies; D005340:Fibrinogen / Q000032:analysis; D006801:Humans; D007073:Immunoglobulin E / Q000097:blood; D007074:Immunoglobulin G / Q000097:blood; D020901:Kava / Q000009:adverse effects*; D018655:Lymphocyte Count; D008297:Male; D015876:Northern Territory; D017395:Plasminogen Activator Inhibitor 1 / Q000097:blood; D012871:Skin Diseases / Q000139:chemically induced; D005723:gamma-Glutamyltransferase / Q000097:blood
chemical_list: D000906:Antibodies; D007074:Immunoglobulin G; D017395:Plasminogen Activator Inhibitor 1; D007073:Immunoglobulin E; D005340:Fibrinogen; D002097:C-Reactive Protein; D005723:gamma-Glutamyltransferase; D000469:Alkaline Phosphatase