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J Marwa K, Kadodo J, Iddi S, Kapesa A. Herbal medicines use among HIV/AIDS patients on antiretroviral therapy and its influence on viral suppression and CD4 count: A survey at a tertiary hospital in Tanzania. PUBLIC HEALTH IN PRACTICE 2024; 7:100492. [PMID: 38595639 PMCID: PMC11002646 DOI: 10.1016/j.puhip.2024.100492] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2023] [Revised: 03/13/2024] [Accepted: 03/22/2024] [Indexed: 04/11/2024] Open
Abstract
Objectives This study aimed to determine the magnitude of concurrent use of herbal medicines with ART, its associated factors and effect on viral load suppression and CD4 count among people living with HIV. Study design This was a cross-sectional study involving 375 HIV positive patients on ART attending at care and treatment clinic (CTC). Methods Data were obtained through face-to-face interviews using pre-structured questionnaires and patient's files through a checklist. Adherence was assessed though pill count method while CD4 count and viral load suppression were assessed using the Tanzania National guidelines for the management of HIV and AIDS. Data were analysed using STATA version 15. Independent predictors for herbal medicine use or viral suppression were assessed using univariate and multivariate logistic regression. Results Out of 375 PLHIV, 37 (35%) reported to use herbal medicines concurrently with ART. Predictors for herbal medicines use were existence of chronic disease (OR = 4.53; CI = 1.87-10.95) (p = 0.001), male gender (OR = 0.57; CI = 0.35-0.93) (p = 0.02) and HIV clinical stage (OR = 1.71; CI = 0.99-2.94) (p = 005). PLHIV who used herbal medicines along with ART did not have a significantly higher chance of achieving viral suppression than PLHIV who did not use herbal medicines (OR = 1.42; CI = 0.71-2.82). There was no statistically significant difference on CD4 count (p = 0.8943) and viral load (p = 0.8612) between herbal medicines users and non-users. Conclusion The utilization of herbal medicine among PLHIV on ART remains notably prevalent. Nonetheless, it is worth noting that despite the prevailing herbal medicine usage, there is no substantial effect on viral suppression. The primary determinants of the adoption of herbal medicines use were having chronic medical conditions and the stage of progression of the HIV infection.
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Affiliation(s)
- Karol J Marwa
- Department of Pharmacology, Catholic University of Health and Allied Sciences, Mwanza, Tanzania
| | - Josephine Kadodo
- School of Pharmacy, Catholic University of Health and Allied Sciences, Mwanza, Tanzania
| | - Shabani Iddi
- Department of Physiology, Catholic University of Health and Allied Sciences, Mwanza, Tanzania
| | - Anthony Kapesa
- School of Public Health, Catholic University of Health and Allied Sciences, Mwanza, Tanzania
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Tassew WC, Assefa GW, Zeleke AM, Ferede YA. Prevalence and associated factors of herbal medicine use among patients living with chronic disease in Ethiopia: A systematic review and meta-analysis. Metabol Open 2024; 21:100280. [PMID: 38455230 PMCID: PMC10918421 DOI: 10.1016/j.metop.2024.100280] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2024] [Revised: 02/22/2024] [Accepted: 02/22/2024] [Indexed: 03/09/2024] Open
Abstract
Background Complementary use of medicinal plants with prescribed drugs is becoming more widespread concern among people with chronic disease like cancer, HIV/AIDS, diabetes and hypertension. Consequently, the purpose of this review was to determine the prevalence and associated factors of herbal medicine use among patients suffering from chronic disease. Methods This systematic review and meta-analysis was conducted by searching articles from Cochrane library, Google scholar, PubMed and African journal online. Data was extracted using Microsoft excel format and imported in to Stata software version 11 (Stata Corp LLC, TX, USA) for analysis. Statistical heterogeneity across the studies was investigated using Cochran's Q chi-square test at the significance level of <0.05 and the I2 index. A random-effects model was used to estimate the pooled prevalence of herbal medicine use. Results Our systematic search yielded a total of 17,665 records from four databases (Google scholar (12,800), PubMed (3835), Cochrane library (30) and African journal online (12). The pooled estimate of herbal medicine use among patients with chronic disease in Ethiopia is found to be 56.94% (95% CI: 49.75, 64.12, P < 0.001). Being female (POR = 2.06, 95% CI = 1.55, 2.75, I2 = 10.0%), rural residence (POR = 2.80, 95% CI = 1.42, 5.52, I2 = 89.1%), duration of the disease greater than 5 years (POR = 6.42, 95% CI = 4.188, 9.84, I2 = 48.3%) and having complication (POR = 4.65, 95% CI = 3.75, 5.77, I2 = 0.0%) were factors associated with herbal medicine use among patients living with chronic disease. Conclusion The study found a high prevalence of herbal medicine use among patients living with chronic disease. Being female, rural residence, duration of disease greater than 5 years and having complication were factors that are significantly associated with herbal medicine use. The prevalence of herbal medicine use among persons with chronic disease in Ethiopia presents significant implications for healthcare practice. Healthcare professionals need to adopt a patient-centered strategy that promotes open, judgment-free discussions about herbal medicine usage. Prospero registration CRD42024498817.
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Affiliation(s)
- Worku Chekol Tassew
- Department of Medical Nursing, Teda Health Science College, Gondar, Ethiopia
| | - Getaw Wubie Assefa
- Department of CTID & HIV Medicine, Teda Health Science College, Gondar, Ethiopia
| | | | - Yeshiwas Ayal Ferede
- Department of Reproductive Health, Teda Health Science College, Gondar, Ethiopia
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Tuasha N, Fekadu S, Deyno S. Prevalence of herbal and traditional medicine in Ethiopia: a systematic review and meta-analysis of 20-year studies. Syst Rev 2023; 12:232. [PMID: 38093343 PMCID: PMC10717384 DOI: 10.1186/s13643-023-02398-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/08/2023] [Accepted: 11/22/2023] [Indexed: 12/17/2023] Open
Abstract
BACKGROUND The widely accepted prevalence of traditional medicine (TM) in Ethiopia was about 80 %, of which 95 % were sourced from plants. The purpose of this study was to update knowledge of the prevalence of herbal medicine or TM in Ethiopia and describe the characteristics of the population mostly relying on herbal medicine or TM to inform health policy-makers. METHODS PubMed, Google Scholar, Hinari, Scopus, and the Directory of Open Access Journals (DOAJ) were searched. The methodological quality of each included study was assessed using the quality assessment checklist for prevalence studies. Meta-analysis was conducted using STATA version 17, and the heterogeneity between studies was assessed using I2 test statistics based on the random effect model. Forest and funnel plots were used to present the data. Subgroup analysis was done by the study population, region, and setting. RESULTS Thirty-six studies with a total of 16,288 participants met the inclusion criteria. Meta-analysis of the study revealed that the prevalence of herbal medicine use in Ethiopia is 46 % (95 % CI, 37-54 %), with significant heterogeneity among the studies (I2 = 99.19 %). Egger's test for publication bias of herbal medicine use revealed significant results (Egger, P = 0.002) which indicates possible missing of small sample size studies. The prevalence of TM use in Ethiopia is 65 % (95 % CI, 52-77 %) with significant heterogeneity among the studies (I2 = 99.18 %). Egger's test for publication bias of TM use revealed non-significant results (Egger, P = 0.275). The subgroup analysis by the study setting and the region revealed variability amongst the studies. Community-based studies and Oromia National Regional State showed higher prevalence. By population type, a higher prevalence of TM use was observed amongst children and lowest amongst malaria suspects. CONCLUSIONS The current study revealed that TM/herbal medicine utilization remained an important source of primary healthcare in Ethiopia. In comparison to the commonly reported prevalence of TM/herbal medicine, there is a considerable decline in TM/herbal medicine prevalence. High TM/herbal medicine use tendency during pregnancy necessitates safety studies to optimize the utilization.
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Affiliation(s)
- Nigatu Tuasha
- Department of Biology, Hawassa College of Teacher Education, Sidama National Regional State, P. O. Box 115, Hawassa, Ethiopia.
| | - Sintayehu Fekadu
- School of Laboratory Sciences, College of Medicine and Health Sciences, Hawassa University, P. O. Box 1560, Hawassa, Ethiopia
| | - Serawit Deyno
- School of Pharmacy, College of Medicine and Health Sciences, Hawassa University, P. O. Box 1560, Hawassa, Ethiopia
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Feyissa M, Gedif Fenta T, Asres K, Gebremariam T. Prevalence, Perception and Predictors of Concomitant Herbal Medicine Use among HIV/AIDS and Tuberculosis Patients in Metekel Zone, Northwest Ethiopia: A Cross-Sectional Study. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE : ECAM 2022; 2022:8235229. [PMID: 36437829 PMCID: PMC9691294 DOI: 10.1155/2022/8235229] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/13/2022] [Revised: 10/31/2022] [Accepted: 11/03/2022] [Indexed: 12/18/2023]
Abstract
BACKGROUND The use of herbal medicine is common in Ethiopia. However, evidence on the extent and predictors of concomitant use of herbal medicine with conventional treatment among HIV/AIDS and tuberculosis patients is limited. OBJECTIVE To assess the extent of concomitant use of herbal medicine with conventional therapy and associated factors among HIV/AIDS and tuberculosis patients in Metekel Zone, Northwest Ethiopia. METHOD A cross-sectional study was conducted from January to March 2020. HIV/AIDS and tuberculosis patients who visited the health facilities during the study were interviewed face-to-face using a structured and pretested questionnaire. The descriptive statistics and univariate and multivariate logistic regression analyses were conducted using SPSS version 25. A P-value of <0.05 was considered significant. RESULTS 412 patients on conventional treatment were included in this study; 355 (86.2%) were HIV patients, and 57 (13.8%) were TB patients. More than half, 217 (52.7%) participants reported using herbal medicine while on conventional therapy. Among those who claimed to have used herbal medicines, 32 (14.7%) received herbal medicine from traditional healers. About four of five herbal users did not disclose their use to their healthcare providers. The type of health facility on follow-up (P=0.03), disease status (P=0.01), occupation (P=0.02), discontinuing ART (P=0.03), and encountering side (P=0.04) were the determinant factors for the use of herbal medicine among our study participants. CONCLUSION In the Metekel Zone, concomitant consumption of herbal medication is common among HIV/AIDS and tuberculosis patients. Furthermore, most patients did not disclose the healthcare practitioners about their herbal use. Therefore, healthcare practitioners must assess and counsel patients regarding the potential adverse effects and herb-drug interaction to optimize therapy.
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Affiliation(s)
- Mamo Feyissa
- Department of Pharmacology and Clinical Pharmacy, School of Pharmacy, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
| | - Teferi Gedif Fenta
- Department of Pharmaceutics and Social Pharmacy, School of Pharmacy, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
| | - Kaleab Asres
- Department of Pharmaceutical Chemistry and Pharmacognosy, School of Pharmacy, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
| | - Tsige Gebremariam
- Department of Pharmaceutics and Social Pharmacy, School of Pharmacy, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
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Fauk NK, Gesesew HA, Seran AL, Raymond C, Tahir R, Ward PR. Barriers to Accessing HIV Care Services in Host Low and Middle Income Countries: Views and Experiences of Indonesian Male Ex-Migrant Workers Living with HIV. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:14377. [PMID: 36361253 PMCID: PMC9654942 DOI: 10.3390/ijerph192114377] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/07/2022] [Revised: 10/31/2022] [Accepted: 11/01/2022] [Indexed: 06/16/2023]
Abstract
Migrant populations are one of the vulnerable groups to HIV transmission and its consequences. They are also reported to experience delayed entry or linkage into HIV services and have poorer HIV-related health outcomes. This study aimed to understand barriers to accessing HIV care services in host countries among Indonesian, male, former (returned) migrant workers living with HIV. The study was carried out from December 2020 to February 2021. It utilised a qualitative design employing in-depth interviews to collect data from twenty-two returned migrant workers from Eastern Indonesia, recruited using the snowball sampling technique. A qualitative data analysis framework was used to guide a step-by-step analysis of the findings. Findings demonstrated that limited host-country language proficiency, lack of knowledge regarding healthcare systems in host countries and having 'undocumented' worker status were barriers to accessing HIV care services. Data also revealed the unavailability of HIV care services nearby migrants' work locations, long-distance travel to healthcare facilities, and challenges in accessing public transportation as barriers that impeded their access to the services. Other factors limiting the participants' access to HIV services were identified as the transient and mobile nature of migrant work requiring frequent relocation and disrupting work-life stability. Additionally, in lieu of formal HIV services, many participants self-medicated by using over-the-counter herbal or 'traditional' medicines, often because of peer or social group influence regarding the selection of informal treatment options. Recommendations arising from this study demonstrate the need to improve pre-departure information for migrant workers regarding the healthcare system and access procedures in potential host countries. Data from this study also indicate that social services should be available to assist potential migrants to access legal channels for migrant work overseas, to ensure that Indonesian migrants can safely access healthcare services in the countries for which they are providing migrant labour. Future studies to understand barriers to accessing HIV care services among various migrant groups living with HIV are warranted to build evidence for potential social policy change.
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Affiliation(s)
- Nelsensius Klau Fauk
- Research Centre for Public Health, Equity and Human Flourishing, Torrens University Australia, Adelaide 5000, Australia
- Institute of Resource Governance and Social Change, Kupang 85227, Indonesia
| | - Hailay Abrha Gesesew
- Research Centre for Public Health, Equity and Human Flourishing, Torrens University Australia, Adelaide 5000, Australia
- College of Health Sciences, Mekelle University, Mekelle 1871, Ethiopia
| | - Alfonsa Liquory Seran
- Atapupu Public Health Centre, Health Department of Belu District, Atambua 85752, Indonesia
| | - Christopher Raymond
- Research Centre for Public Health, Equity and Human Flourishing, Torrens University Australia, Adelaide 5000, Australia
| | - Roheena Tahir
- College of Medicine and Public Health, Flinders University, Adelaide 5042, Australia
| | - Paul Russell Ward
- Research Centre for Public Health, Equity and Human Flourishing, Torrens University Australia, Adelaide 5000, Australia
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Medical and health science Students' knowledge, attitude, and practice towards complementary and alternative medicine in University of Gondar. CLINICAL EPIDEMIOLOGY AND GLOBAL HEALTH 2022. [DOI: 10.1016/j.cegh.2022.101148] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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Traditional Human Immunodeficiency Virus treatment and family and social influence as barriers to accessing HIV care services in Belu, Indonesia. PLoS One 2022; 17:e0264462. [PMID: 35877600 PMCID: PMC9312407 DOI: 10.1371/journal.pone.0264462] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2022] [Accepted: 07/11/2022] [Indexed: 11/22/2022] Open
Abstract
Access to HIV care services, including antiretroviral therapy (ART), is essential for improving health outcomes of people living with HIV (PLHIV) and reducing HIV transmission and AIDS-related deaths. As a part of a qualitative study in Belu, this paper describes the use of traditional medicines for HIV treatment and family and social influence as barriers to access to HIV care services among PLHIV. One-on-one in-depth interviews were employed to collect data from 46 PLHIV (26 women and 20 men) and 10 healthcare professionals. They were recruited using the snowball sampling technique. The study information sheets were initially posted on information boards in healthcare facilities. Potential participants who contacted to confirm their participation were recruited for an interview and then asked for help to distribute the information sheets to their eligible colleagues who might be willing to participate. Data analysis was performed using NVivo 12 software and guided by a qualitative data analysis framework. The findings showed that the use of traditional medicines, a well-known cultural practice in Belu, was a barrier to access to HIV care services among PLHIV. The influence of family in determining the use of traditional medicines for HIV treatment, supported by the lack of knowledge of ART, effectiveness of traditional medicines in treating other health issues, and social influence of relatives, neighbours, and friends, were also significant barriers to PLHIV’s access to HIV care services. The findings indicate the need for dissemination of HIV care-related information for PLHIV, family, and community members to increase their knowledge of the service, ART and its function, and to support and improve access to HIV care services especially ART by PLHIV.
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Healthcare Professionals' Knowledge and Behaviors Regarding Drug-Dietary Supplement and Drug-Herbal Product Interactions. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19074290. [PMID: 35409970 PMCID: PMC8998985 DOI: 10.3390/ijerph19074290] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 02/27/2022] [Revised: 03/29/2022] [Accepted: 04/01/2022] [Indexed: 12/07/2022]
Abstract
Given the widespread use of dietary supplements (DS) and herbal products (HP), healthcare professionals (HCPs) will increasingly encounter patients who use these preparations with conventional drugs and who need their services to reduce the consequences of adverse therapeutic outcomes. The aim of our survey was to assess the knowledge and behaviors of HCPs regarding the risk of potential drug−dietary supplement (DDSIs) and drug−herbal product (DHPIs) interactions. This cross-sectional survey collected data via on paper-based questionnaire among general practitioners (GPs) (n = 105), specialty doctors (n = 87) and nurses (n = 154). The HCPs were mostly familiar with the interaction of doxycycline with magnesium (83%) and were least familiar with interaction of warfarin with glucosamine (14%). The results on DDSIs and DHPIs knowledge showed that GPs scored significantly higher than nurses (p < 0.001 and p = 0.003, respectively), while specialty doctors scored significantly higher than nurses only on DDSIs knowledge (p < 0.001). Only 28% of respondents reported that they often or always ask patients on drug therapy about the use of DS or HP, and 25% of respondents record such data in the medical documentation of patients. Our results showed that HCPs have sufficient knowledge about most major DDSIs and DHPIs, but insufficient knowledge about most moderate interactions. However, their overall knowledge and behavior regarding the risk of these interactions indicate the need for further continuing education and training.
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Tizazu D, Workineh Y, Ayalew Y. Parental Traditional Medicine Use for Children and Associated Factors in North Mecha District, North West Ethiopia. PEDIATRIC HEALTH MEDICINE AND THERAPEUTICS 2020; 11:505-512. [PMID: 33364875 PMCID: PMC7751436 DOI: 10.2147/phmt.s275249] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 08/03/2020] [Accepted: 11/24/2020] [Indexed: 01/22/2023]
Abstract
Introduction Traditional medicine (TM) has existed in human societies before application of modern science to health. Even though there have been many studies conducted on adults' TMuse, there were limited studies done on the issue of parenteral TM use to children in Ethiopia. Therefore, this study aimed to assess the prevalence and associated factors of parental TM use for children in North Mecha District, North West Ethiopia. Methods A community-based cross-sectional study was conducted among 374 parents with children aged under 18 in the North Mecha District from March 1st to 30th, 2020. A multistage sampling technique was used. Kebeles were selected by using a simple random sampling method from the district. Then, the sample size was proportionally allocated to each kebele. Households were selected by using a table of random sampling technique from the kebele. An interviewer-administered questionnaire was used to collect the data. The bivariable and multivariable logistic regression models were used to assess the association between dependent and independent variables. Factors that had a statistically significant association with the dependent variable (p<0.05) were identified as significant in the multivariable logistic regression analysis. Results From 374 sampled participants, 351 of them were participated in the study making a response rate of 93.90%. The prevalence of parental TM use for children was 90.30%. Being non educated [AOR=5.65, 95% CI: (1.25, 25.50)], rural residence [AOR=6.33, 95% CI: (1.97, 20.32)], having good attitude [AOR=4.91, 95% CI: (1.90,12.65)], very poor wealth index [AOR=8.43, 95% CI: (3.08, 23.06)] and accessibility of TM [AOR=4.01, 95% CI: (1.11, 14.38)] were the determinants of TM utilization. Conclusion TM use was high in this study. TM utilization was affected by modifiable factors. Therefore, the government should give especial emphasis to factors of parental TM use for children under 18-year-old.
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Affiliation(s)
- Dawit Tizazu
- Department of Child Health Nursing, College of Medicine and Health Science, Bahir Dar University, Bahir Dar, Ethiopia
| | - Yinager Workineh
- Department of Child Health Nursing, College of Medicine and Health Science, Bahir Dar University, Bahir Dar, Ethiopia
| | - Yeneneh Ayalew
- Department of Child Health Nursing, College of Medicine and Health Science, Bahir Dar University, Bahir Dar, Ethiopia
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Shiferaw A, Baye AM, Amogne W, Feyissa M. <p>Herbal Medicine Use and Determinant Factors Among HIV/AIDS Patients on Antiretroviral Therapy in Tikur Anbessa Specialized Hospital, Addis Ababa, Ethiopia</p>. HIV AIDS (Auckl) 2020; 12:941-949. [PMID: 33364851 PMCID: PMC7751574 DOI: 10.2147/hiv.s283810] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2020] [Accepted: 12/03/2020] [Indexed: 11/23/2022] Open
Affiliation(s)
- Abebe Shiferaw
- Department of Pharmacy, Metu University, Metu, Oromia Region, Ethiopia
| | - Assefa Mulu Baye
- Department of Pharmacology and Clinical Pharmacy, School of Pharmacy, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
| | - Wondwossen Amogne
- Department of Internal Medicine, School of Medicine, College of Health Science, Addis Ababa University, Addis Ababa, Ethiopia
| | - Mamo Feyissa
- Department of Pharmacology and Clinical Pharmacy, School of Pharmacy, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
- Correspondence: Mamo Feyissa Department of Pharmacology and Clinical Pharmacy, School of Pharmacy, College of Health Sciences, Addis Ababa University, Addis Ababa, EthiopiaTel +251-913-423498 Email
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Tangkiatkumjai M, Boardman H, Walker DM. Potential factors that influence usage of complementary and alternative medicine worldwide: a systematic review. BMC Complement Med Ther 2020; 20:363. [PMID: 33228697 PMCID: PMC7686746 DOI: 10.1186/s12906-020-03157-2] [Citation(s) in RCA: 57] [Impact Index Per Article: 14.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2020] [Accepted: 11/12/2020] [Indexed: 02/06/2023] Open
Abstract
OBJECTIVES To determine similarities and differences in the reasons for using or not using complementary and alternative medicine (CAM) amongst general and condition-specific populations, and amongst populations in each region of the globe. METHODS A literature search was performed on Pubmed, ScienceDirect and EMBASE. KEYWORDS 'herbal medicine' OR 'herbal and dietary supplement' OR 'complementary and alternative medicine' AND 'reason' OR 'attitude'. Quantitative or qualitative original articles in English, published between 2003 and 2018 were reviewed. Conference proceedings, pilot studies, protocols, letters, and reviews were excluded. Papers were appraised using valid tools and a 'risk of bias' assessment was also performed. Thematic analysis was conducted. Reasons were coded in each paper, then codes were grouped into categories. If several categories reported similar reasons, these were combined into a theme. Themes were then analysed using χ2 tests to identify the main factors related to reasons for CAM usage. RESULTS 231 publications were included. Reasons for CAM use amongst general and condition-specific populations were similar. The top three reasons for CAM use were: (1) having an expectation of benefits of CAM (84% of publications), (2) dissatisfaction with conventional medicine (37%) and (3) the perceived safety of CAM (37%). Internal health locus of control as an influencing factor was more likely to be reported in Western populations, whereas the social networks was a common factor amongst Asian populations (p < 0.05). Affordability, easy access to CAM and tradition were significant factors amongst African populations (p < 0.05). Negative attitudes towards CAM and satisfaction with conventional medicine (CM) were the main reasons for non-use (p < 0.05). CONCLUSIONS Dissatisfaction with CM and positive attitudes toward CAM, motivate people to use CAM. In contrast, satisfaction with CM and negative attitudes towards CAM are the main reasons for non-use.
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Affiliation(s)
- Mayuree Tangkiatkumjai
- Department of Clinical Pharmacy, Faculty of Pharmacy, Srinakharinwirot University, Nakhonnayok, 26120 Thailand
| | - Helen Boardman
- Division of Pharmacy Practice and Policy, School of Pharmacy, University of Nottingham, Nottingham, UK
| | - Dawn-Marie Walker
- School of Health Sciences, University of Southampton, Southampton, UK
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Attention/Working Memory, Learning and Memory in Adult Cameroonians: Normative Data, Effects of HIV Infection and Viral Genotype. J Int Neuropsychol Soc 2020; 26:607-623. [PMID: 32066518 PMCID: PMC8582275 DOI: 10.1017/s1355617720000120] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
OBJECTIVE There is lack of Cameroonian adult neuropsychological (NP) norms, limited knowledge concerning HIV-associated neurocognitive disorders in Sub-Saharan Africa, and evidence of differential inflammation and disease progression based on viral subtypes. In this study, we developed demographically corrected norms and assessed HIV and viral genotypes effects on attention/working memory (WM), learning, and memory. METHOD We administered two tests of attention/WM [Paced Auditory Serial Addition Test (PASAT)-50, Wechsler Memory Scale (WMS)-III Spatial Span] and two tests of learning and memory [Brief Visuospatial Memory Test-Revised (BVMT-R), Hopkins Verbal Learning Test-Revised (HVLT-R)] to 347 HIV+ and 395 seronegative adult Cameroonians. We assessed the effects of viral factors on neurocognitive performance. RESULTS Compared to controls, people living with HIV (PLWH) had significantly lower T-scores on PASAT-50 and attention/WM summary scores, on HVLT-R total learning and learning summary scores, on HVLT-R delayed recall, BVMT-R delayed recall and memory summary scores. More PLWH had impairment in attention/WM, learning, and memory. Antiretroviral therapy (ART) and current immune status had no effect on T-scores. Compared to untreated cases with detectable viremia, untreated cases with undetectable viremia had significantly lower (worse) T-scores on BVMT-R total learning, BVMT-R delayed recall, and memory composite scores. Compared to PLWH infected with other subtypes (41.83%), those infected with HIV-1 CRF02_AG (58.17%) had higher (better) attention/WM T-scores. CONCLUSIONS PLWH in Cameroon have impaired attention/WM, learning, and memory and those infected with CRF02_AG viruses showed reduced deficits in attention/WM. The first adult normative standards for assessing attention/WM, learning, and memory described, with equations for computing demographically adjusted T-scores, will facilitate future studies of diseases affecting cognitive function in Cameroonians.
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Medicinal plants used by traditional medicine practitioners to boost the immune system in people living with HIV/AIDS in Uganda. Eur J Integr Med 2020. [DOI: 10.1016/j.eujim.2019.101011] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
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Anywar G, Kakudidi E, Byamukama R, Mukonzo J, Schubert A, Oryem-Origa H. Indigenous traditional knowledge of medicinal plants used by herbalists in treating opportunistic infections among people living with HIV/AIDS in Uganda. JOURNAL OF ETHNOPHARMACOLOGY 2020; 246:112205. [PMID: 31476442 DOI: 10.1016/j.jep.2019.112205] [Citation(s) in RCA: 41] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/25/2019] [Revised: 08/28/2019] [Accepted: 08/28/2019] [Indexed: 06/10/2023]
Abstract
ETHNOPHARMACOLOGICAL RELEVANCE Currently, more than two thirds of the world's 36.9 million people living with HIV/AIDS reside in Sub-Saharan Africa. Opportunistic infections (OI) associated with HIV are the single most important cause of mortality and morbidity among HIV/AIDS patients in poor countries. There is widespread use of medicinal plant species to manage the HIV infection and it's associated OI in Uganda, even by patients already on antiretroviral drugs (ARV). However, much of this information remains undocumented and unverified. AIM OF STUDY The aim of this study was to systematically and comprehensively document the traditional indigenous knowledge and practices associated with the management of HIV/AIDS infections by herbalists in Uganda. METHODS Ethnobotanical data were collected using semi-structured interviews and questionnaires. Ninety traditional medicine practitioners (TMP) or herbalists were interviewed in Arua, Dokolo, Mbale, Bushenyi, Iganga, Rakai, Luwero and Kaabong districts to gather information on the plant species used. Data were analysed and presented using descriptive statistics and the Informant Consensus Factor. RESULTS We documented 236 medicinal plant species from 70 families and 201 genera. Acacia was the most widely represented genus with five species. The most frequently used medicinal plant species for treating various OI were Erythrina abyssinica (45), Warburgia ugandensis (43), Zanthoxylum chalybeum (38), Acacia hockii (37), Mangifera indica (36), Aloe vera (35), Albizia coriaria (34), Azadirachta indica (32), Psorospermum febrifugum (27) Vernonia amygdalina (22) and Gymnosporia senegalensis (21). Some of the plant species were used for treating all the OI mentioned. There is a high degree of consensus among the TMP on which plant species they use for the different OI, even though they are geographically separated. Herbalists contribute to the widespread practice of simultaneously using herbal medicines and ARV. Some TMP are also engaged in dangerous practices like injecting patients with herbs and encouraging simultaneous use of herbs and ARV. Although the TMP relied on biomedical laboratory diagnoses for confirming the patients' HIV sero status, they were familiar with the signs and symptoms of HIV/AIDS. CONCLUSION There is wide spread use of a rich diversity of medicinal plants species and practices by TMP to manage OI in HIV/AIDS patients in Uganda.
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Affiliation(s)
- G Anywar
- Department of Plant Sciences, Microbiology & Biotechnology, College of Natural Sciences, Makerere University, P.O.Box 7062, Kampala, Uganda; Fraunhofer Institute for Cell Therapy & Immunology (IZI), Perlickstraße, 104103, Leipzig, Germany.
| | - E Kakudidi
- Department of Plant Sciences, Microbiology & Biotechnology, College of Natural Sciences, Makerere University, P.O.Box 7062, Kampala, Uganda
| | - R Byamukama
- Department of Chemistry, College of Natural Sciences, Makerere University, P.O.Box 7062, Kampala, Uganda
| | - J Mukonzo
- Department of Pharmacology & Therapeutics, College of Health Sciences, Makerere University, P.O.Box 7062, Kampala, Uganda
| | - A Schubert
- Fraunhofer Institute for Cell Therapy & Immunology (IZI), Perlickstraße, 104103, Leipzig, Germany
| | - H Oryem-Origa
- Department of Plant Sciences, Microbiology & Biotechnology, College of Natural Sciences, Makerere University, P.O.Box 7062, Kampala, Uganda
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Touré A, Cissé D, Kadio K, Camara A, Traoré FA, Delamou A, Sididé S, Kouyaté C, Bangoura IS, Diallo MM, Tounkara TM, Traoré F, Sow MS, Khanafer N, Cissé M. [Factors associated to loss of follow-up in patients underwent antiretroviral therapy in an ambulatory HIV treatment center at Conakry]. Rev Epidemiol Sante Publique 2018; 66:273-279. [PMID: 29807718 DOI: 10.1016/j.respe.2018.04.057] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2017] [Revised: 01/26/2018] [Accepted: 04/13/2018] [Indexed: 02/02/2023] Open
Abstract
BACKGROUND Late or inadequate therapeutic management increases the risk of mortality associated with HIV/AIDS. The aim of this study was to analyze the proportion and factors associated with loss of follow-up in HIV patients who receiving antiretroviral therapy at Conakry. METHODS A retrospective cohort study was conducted in HIV patients aged over 15 years and who receiving antiretroviral therapy. Between August 1, 2008 and July 31, 2015, all patients managed by the ambulatory treatment center of the Guinean Women Association against AIDS and sexually and transmissible infection were included. Loss of follow-up was defined as no follow-up visit within 3 months. Kaplan-Meier curves and multivariate Cox regression models were used to analyze factors associated with loss of follow-up. Analyses were performed by using Stata 13 software. RESULTS 614 patients aged 36.3±11.2 years, mainly females (68.4%) and living in Conakry (80.5%) were included. Among them, 104 were loss to follow-up, corresponding to a proportion rate of 16.9% (95% CI: 14.2-19.7%) or 5.79/100 person-years. The results of multivariate analyses showed that factors independently associated with loss of follow-up were malnutrition (AHR=7.05; 95% CI: 2.05-24.27; P=0.002) and CD4 cells account at the initiation of AHR (2.35; 95% CI: 1.61-6.39; P=0.016) in patients with 201-350 CD4/μL and 5.83 (95% CI: 2.85-11.90; P<0.001) in patients with less than 150CD4/μL. CONCLUSION Despite efforts of health care workers and free antiretroviral therapy, many patients were loss to follow-up. Multivariate analysis showed that malnutrition and low CD4 account were independently associated with loss to follow-up.
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Affiliation(s)
- A Touré
- Chaire de santé publique, faculté de médecine-pharmacie-odonto-stomatologie, université Gamal Abdel Nasser de Conakryf, BP, 1017, Conakry, Guinée.
| | - D Cissé
- Chaire de santé publique, faculté de médecine-pharmacie-odonto-stomatologie, université Gamal Abdel Nasser de Conakryf, BP, 1017, Conakry, Guinée
| | - Kjjo Kadio
- Chaire de santé publique, faculté de médecine-pharmacie-odonto-stomatologie, université Gamal Abdel Nasser de Conakryf, BP, 1017, Conakry, Guinée
| | - A Camara
- Chaire de santé publique, faculté de médecine-pharmacie-odonto-stomatologie, université Gamal Abdel Nasser de Conakryf, BP, 1017, Conakry, Guinée
| | - F A Traoré
- Service de maladies infectieuses et tropicales, hôpital national Donka, Conakry, Guinée
| | - A Delamou
- Chaire de santé publique, faculté de médecine-pharmacie-odonto-stomatologie, université Gamal Abdel Nasser de Conakryf, BP, 1017, Conakry, Guinée
| | - S Sididé
- Chaire de santé publique, faculté de médecine-pharmacie-odonto-stomatologie, université Gamal Abdel Nasser de Conakryf, BP, 1017, Conakry, Guinée
| | - C Kouyaté
- Association des femmes de Guinée pour la lutte contre les IST et le sida (ASFEGMASSI), Guinée
| | - I S Bangoura
- Association des femmes de Guinée pour la lutte contre les IST et le sida (ASFEGMASSI), Guinée
| | - M M Diallo
- Solidarité thérapeutique et initiative pour la santé (Solthis), Guinée
| | - T M Tounkara
- Service de dermatologie-vénérologie-MST, hôpital national Donka, Conakry, Guinée
| | - F Traoré
- Institut national de santé publique, Conakry, Guinée
| | - M S Sow
- Service de maladies infectieuses et tropicales, hôpital national Donka, Conakry, Guinée
| | - N Khanafer
- Epidemiology and Infection Control Unit, Edouard-Herriot Hospital, Hospices Civils de Lyon, 69003 Lyon, France
| | - M Cissé
- Service de dermatologie-vénérologie-MST, hôpital national Donka, Conakry, Guinée
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