Prevalence and pattern of traditional medical therapy utilisation in Kumasi Metropolis and Sekyere South District, Ghana

Traditional healers' perception on scabies causation and management in Ghana

INTRODUCTION

Scabies is an underdiagnosed skin infestation caused by the Sarcoptes scabiei mite. The infection causes severe itching and a skin rash but can be effectively treated using topical or systemic drugs. Scabies outbreaks are commonly reported in resource-poor countries, including Ghana. Traditional healers play an important role in primary care in rural areas. The role of these traditional healers in the management of scabies has so far not been explored. The aim of this study was therefore to investigate the perceptions of traditional healers regarding the causation and management of scabies.

METHODS

A phenomenological qualitative approach was employed. Traditional healers in the Asante Akim North and Central districts in Ghana were approached with an interview request. Using a semi-structured interview protocol, 15 traditional healers were interviewed. The results were coded and analysed, after which seven themes were extrapolated.

RESULTS

Scabies infections were frequently reported by traditional healers. Itching and skin rash were unanimously regarded as the major symptoms of scabies. The majority acknowledged the infectious nature of scabies, but no participant reported the causative organism. A dichotomous disease classification was noted, consisting of 'natural' and 'spiritual' variants each with a unique disease profile and management requirements, as reported by the traditional healers. All but two traditional healers reported to treat scabies using almost exclusively herbs and spiritual rituals.

CONCLUSION

The majority of traditional healers were open to collaboration with allopathic healthcare providers. Collaboration could broaden the primary care network in rural areas, but mistrust and lack of transparency form potential barriers to collaboration. We, therefore, emphasise the need for additional efforts to investigate strategies for future collaboration.

A systematic review of communication about Complementary and Integrative Health (CIH) in global biomedical settings

OBJECTIVES

A systematic review to analyze communication rates of complementary and integrative health (CIH) and analyze how communication terms, such as "disclosure," are measured and operationalized.

METHODS

We searched seven databases for studies published between 2010 and 2018 with quantitative measurements of patients' communication of CIH to a biomedical clinician. We analyzed communication terms used to describe patients reporting CIH usage. We also examined the conceptual and operational definitions of CIH provided and whether those terms were explicitly operationalized. We aggregated the percentage, rate, or ratio of CIH users that communicated about CIH with their clinicians by disease type and geographical region.

RESULTS

7882 studies were screened and 89 included in the review. Studies used a wide range of conceptual and operational definitions for CIH, as well as 23 different terms to report communication related to reporting CIH usage. Usage varied by disease type and geographical region.

CONCLUSIONS

Studies of CIH and CIH communication may measure different kinds of social and communicative phenomena, which makes comparison across international studies challenging.

PRACTICE IMPLICATIONS

Future studies should employ standardized, replicable measures for defining CIH and for reporting CIH communication. Clinicians can incorporate questions about prior, current, and future CIH use during the medical visit.

Utilization of complementary and alternative medicine for the prevention of COVID-19 infection in Ghana: A national cross-sectional online survey

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82.5% of all participants reported CAM use during the COVID-19 pandemic period.

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69.1% of CAM users intended it for COVID-19 infection prevention.

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Commonly used CAM include vitamins, spiritual healing/prayer, minerals and herbals.

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Age, sex and COVID-19 illness perception significantly predicted CAM use.

Complementary and alternative medicine (CAM) use is widespread and has played critical roles in preventing infections, including previous coronaviruses. This study sought to document current practices in the use of CAM for the prevention of COVID-19 disease in Ghana. An anonymous electronic survey was conducted from February 1, 2021 to April 30, 2021. Data on demographic characteristics, basic clinical information, illness perceptions about COVID-19, and CAM use during the pandemic period were generated. While about 82.5% (986/1195) of the participants used CAM during the COVID-19 period, 69.1% (681/986) of CAM users intented it for COVID-19 infection prevention. Vitamin supplements (88.1%, 869/986), spiritual healing/prayer (23.3%, 230/986), mineral supplements (22.3%, 220/986), botanical/herbal medicines (22.2%, 219/986), and diet therapy (19.4%, 191/986) were the main types of CAM used. From the adjusted binary logistic regression model, current age (aOR: 1.03, 95%CI: 1.01–1.05), sex (aOR: 1.41, 95%CI: 1.02–1.95), participants’ perceptions of consequences (aOR: 1.10, 95%CI: 1.04–1.17), identity (aOR: 1.15, 95%CI: 1.06–1.25) and concerns about COVID-19 (aOR: 0.91, 95%CI: 0.85–0.97) were statistically significant predictors of CAM use. These results suggest the need for appropriate public health policy on COVID-19 and CAM use in addition to directing further research initiatives toward an optimized COVID-19 prevention scheme using clinically validated CAM treatments. Research to validate the clinical efficacy of these products, especially the herbs, for COVID-19 prevention while isolating lead compounds that could be optimized and used for the treatment and prevention of COVID-19 is also recommended.

Perceptions and Experiences of Orthodox Health Practitioners and Hospital Administrators towards Integrating Traditional Medicine into the Ghanaian Health System

The government of Ghana has been piloting traditional medicine (TM) integration in 17 health facilities across the country. However, the nature of current practice of integrated healthcare has not been thoroughly explored. This paper sought to explore the experiences and recommendations of orthodox health practitioners and hospital administrators in the Ashanti region regarding the practice of integrated healthcare in Ghana. The study adopted a qualitative, phenomenological approach involving 22 interviews. Purposive sampling technique was used in selecting study participants. Framework analysis was used to draw on the experiences of participants relating to TM integration. Participants were knowledgeable about the existence of integrated health facilities and stated that TM integration has created options in health services. However, participants deemed the integrated system ineffective and attributed the inefficiency to poor processing and certification of TM products, opposition of medical doctors to TM usage, absence of a protocol to guide the integration process, and inadequate publicity. Professional training of TM practitioners and inclusion of TM in medical school curriculum could improve collaboration between the health practitioners. Future research should focus on assessing the opinions and involvements of TM practitioners regarding the integration of traditional therapies into national health systems.

Self-reported medicinal plant use by Ghanaian women during pregnancy is associated with poor neonatal health

BACKGROUND

More than a third of pregnant women in Africa use medicinal plants (hereafter, 'herbs') during pregnancy, yet little is known about herb use among urban African women, or about the potential impact on newborns.

METHODS

This cross-sectional study of 504 women giving birth at an urban government hospital in Kumasi, Ghana (May-July 2018) collected data via chart reviews and maternal interviews. Data were analyzed using conditional logistic regression.

RESULTS

Of 380 singleton births with complete data, 102 mothers (26.84%) reported using herbs during pregnancy and/or delivery. Herb users and non-users did not differ significantly across a range of sociodemographic variables. Controlling for age, education, neonatal birthweight and household running water (socioeconomic status (SES) indicator), herb-using women were twice as likely to have their newborn admitted to the hospital (odds ratio (OR) = 2.05; confidence interval (CI) 95% 1.17, 3.60) and four times as likely to bear a child with a low Apgar score (OR = 4.09; CI 95% 1.66, 10.07) compared with non-users.

CONCLUSION

Urban-dwelling Ghanaian women from diverse backgrounds use herbs during pregnancy. Maternal herb use was associated with poor neonatal outcomes, regardless of the baby's birthweight and mother's age, education or SES, suggesting the importance of educating all women about the possible negative impacts of herb use during pregnancy and delivery.

Parental Traditional Medicine Use for Children and Associated Factors in North Mecha District, North West Ethiopia

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.

Utilization of traditional medicine in primary health care in low- and middle-income countries: a systematic review

This paper reports the findings from the first systematic review of the utilization of traditional medicine (TM) in primary health care (PHC) in low- and middle-income countries (LMICs). PHC is an important component of health care and essential for achieving universal health coverage (UHC). For countries where there is a gap in PHC, TM plays a vital role. It is widely used and has the potential to increase the coverage of PHC and UHC. Hence in situations where TM is recognized in a considerable magnitude, there are scarce evidence and minimal regulation on it and TM practitioners (TMPs). This study aims to identify the current situation in the utilization of TM in PHC or UHC in LMICs. A systematic review and thematic synthesis of qualitative and quantitative studies have been conducted. A total of 56 articles met the criteria and were included in the review. In all, 14 analytic themes have been developed including the current use of TM in PHC, higher accessibility of TM, medical pluralism, national health system, national health policy and national health insurance to include TM, including TMPs in the referral system, utilizing TMPs as community health workers, the needs of scientific research on TM and the need for training both TMPs and conventional medical staffs for better collaboration. The study concluded that it is necessary to further focus on TM in the macro level on strengthening the referral system by including TM to establish a comprehensive service delivery network under UHC and in the micro level to focus on training the TMPs and conventional medicine health workers on both areas to attain more in-depth understanding of each other, which can lead to better collaboration and quality patient care.

'I treat it but I don't know what this disease is': a qualitative study on noma (cancrum oris) and traditional healing in northwest Nigeria

Background

Noma, a neglected disease mostly affecting children, with a 90% mortality rate if untreated, is an orofacial gangrene that disintegrates the tissues of the face in <1 wk. Noma can become inactive with early stage antibiotic treatment. Traditional healers, known as mai maganin gargajiya in Hausa, play an important role in the health system and provide care to noma patients.

Methods

We conducted 12 in-depth interviews with caretakers who were looking after noma patients admitted at the Noma Children's Hospital and 15 traditional healers in their home villages in Sokoto state, northwest Nigeria. We explored perceptions of noma, relationship dynamics, healthcare practices and intervention opportunities. Interviews were audiorecorded, transcribed and translated. Manual coding and thematic analysis were utilised.

Results

Traditional healers offered specialised forms of care for specific conditions and referral guidance. They viewed the stages of noma as different conditions with individualised remedies and were willing to refer noma patients. Caretakers trusted traditional healers.

Conclusions

Traditional healers could play a crucial role in the early detection of noma and the health-seeking decision-making process of patients. Intervention programmes should include traditional healers through training and referral partnerships. This collaboration could save lives and reduce the severity of noma complications.

Herbal medicine use during breastfeeding: a cross-sectional study among mothers visiting public health facilities in the Western area of Sierra Leone

BACKGROUND

The use of medications, including herbal medicines during breastfeeding is always a concern among women. Currently, there is no published evidence on whether Sierra Leonean women use herbal medicine during breastfeeding. This study investigates the prevalence, correlates and pattern of herbal medicine use during breastfeeding.

METHODOLOGY

We conducted a cross-sectional study among 378 current breastfeeding mothers visiting public healthcare facilities within the Western area of Sierra Leone. Descriptive statistics and logistic regression analysis were used for data analysis.

RESULTS

Over a third of mothers (n = 140, 37.0%) used herbal medicine during breastfeeding. However, very few herbal medicine users (2.1%, n = 3) used herbal medicine to augment breastfeeding. Dietary changes were the most common method used to increase breast milk supply (93.9%, n = 355) with cassava leaves sauce and tubers being the most common dietary addition. Mothers with children more than six months old were more likely to use herbal medicine than mothers with younger children (OR:1.8; CI:1.13-2.85,p = 0.013). Among herbal medicine users, only 11.4% (n = 16) disclosed their herbal medicine use to their conventional healthcare providers.

CONCLUSION

The use of herbal medicine among breastfeeding mothers attending public health facilities in the Western area of Sierra Leone is common. Whilst this use is not usually specific to increasing breast milk supply, our study indicates that herbal medicines may be used to 'cleanse' initial breast milk.

'We are nothing without herbs': a story of herbal remedies use during pregnancy in rural Ghana

BACKGROUND

Herbal medicine has become the panacea for many rural pregnant women in Ghana despite the modern western antenatal care which has developed in most parts of the country. To our knowledge, previous studies investigating herbal medicine use have primarily reported general attitudes and perceptions of use, overlooking the standpoint of pregnant women and their attitudes, and utilisation of herbal medicine in Ghana. Knowledge of herbal medicine use among rural pregnant women and the potential side effects of many herbs in pregnancy are therefore limited in the country; this qualitative study attempts to address this gap by exploring the perceptions of herbal medicine usage among pregnant women in rural Ghana.

METHODS

A sample of 30, conveniently selected pregnant women, were involved in this study from April 11 to June 22, 2017. Data from three different focus group discussions were thematically analysed and presented based on an a posteriori inductive reduction approach.

RESULTS

The main findings were that pregnant women used herbal medicine, most commonly ginger, peppermint, thyme, chamomile, aniseeds, green tea, tealeaf, raspberry, and echinacea leaf consistently throughout the three trimesters of pregnancy. Cultural norms and health beliefs in the form of personal philosophies, desire to manage one's own health, illness perceptions, and a holistic healing approach were ascribed to the widespread use of herbs.

CONCLUSION

We recommend public education and awareness on disclosure of herbal medicine use to medical practitioners among pregnant women.

Disclosure of complementary medicine use to medical providers: a systematic review and meta-analysis

Concomitant complementary medicine (CM) and conventional medicine use is frequent and carries potential risks. Yet, CM users frequently neglect to disclose CM use to medical providers. Our systematic review examines rates of and reasons for CM use disclosure to medical providers. Observational studies published 2003-2016 were searched (AMED, CINAHL, MEDLINE, PsycINFO). Eighty-six papers reporting disclosure rates and/or reasons for disclosure/non-disclosure of CM use to medical providers were reviewed. Fourteen were selected for meta-analysis of disclosure rates of biologically-based CM. Overall disclosure rates varied (7-80%). Meta-analysis revealed a 33% disclosure rate (95%CI: 24% to 43%) for biologically-based CM. Reasons for non-disclosure included lack of inquiry from medical providers, fear of provider disapproval, perception of disclosure as unimportant, belief providers lacked CM knowledge, lacking time, and belief CM was safe. Reasons for disclosure included inquiry from medical providers, belief providers would support CM use, belief disclosure was important for safety, and belief providers would give advice about CM. Disclosure appears to be influenced by the nature of patient-provider communication. However, inconsistent definitions of CM and lack of a standard measure for disclosure created substantial heterogeneity between studies. Disclosure of CM use to medical providers must be encouraged for safe, effective patient care.

Traditional, complementary and alternative medicine use in Sub-Saharan Africa: a systematic review

Background

The WHO estimates that a considerable number of people in Sub-Saharan Africa (SSA) rely on traditional, complementary and alternative medicine (TCAM) to meet their primary healthcare needs, yet there remains a dearth of research evidence on the overall picture of TCAM utilisation in the region.

Methods

We conducted a literature search of original articles examining TCAM use in SSA between 1 January 2006 and 28 February 2017, employing Medline, Cumulative Index to Nursing and Allied Health Literature, Allied and Complementary Medicine Database, Scopus, ProQuest, PubMed, Embase and African Journals Online databases. A critical appraisal of relevant articles reporting a quantitative or mixed-method design was undertaken.

Results

Despite the heterogeneity and general low quality of the identified literature, the review highlights a relatively high use of TCAM alone or in combination with orthodox medicine, in both general population and in specific health conditions in SSA. TCAM users compared with non-TCAM users are more likely to be of low socioeconomic and educational status, while there were inconsistencies in age, sex, spatial location and religious affiliation between TCAM users and non-TCAM users. Most TCAM users (55.8%–100%) in SSA fail to disclose TCAM use to their healthcare providers, with the main reasons for non-disclosure being fear of receiving improper care, healthcare providers’ negative attitude and a lack of enquiry about TCAM use from healthcare providers.

Conclusion

TCAM use in SSA is significant, although most studies emerge from a few countries. Factors associated with TCAM use in SSA are similar to those observed in other regions, but further research may be required to further elucidate challenges and opportunities related to TCAM use specific to SSA.

Integration for coexistence? Implementation of intercultural health care policy in Ghana from the perspective of service users and providers

OBJECTIVE

In spite of the World Health Organization's recommendations over the past decades, Ghana features pluralistic rather than truly integrated medical system. Policies about the integration of complementary medicine into the national health care delivery system need to account for individual-level involvement and cultural acceptability of care rendered by health care providers. Studies in Ghana, however, have glossed over the standpoint of the persons of the illness episode about the intercultural health care policy framework. This paper explores the health care users, and providers' experiences and attitudes towards the implementation of intercultural health care policy in Ghana.

METHODS

In-depth interviews, augmented with informal conversations, were conducted with 16 health service users, 7 traditional healers and 6 health professionals in the Sekyere South District and Kumasi Metropolis in the Ashanti Region of Ghana. Data were thematically analysed and presented based on the a posteriori inductive reduction approach.

RESULTS

Findings reveal a widespread positive attitude to, and support for integrative medical care in Ghana. However, inter-provider communication in a form of cross-referrals and collaborative mechanisms between healers and health professionals seldom occurs and remains unofficially sanctioned. Traditional healers and health care professionals are skeptical about intercultural health care policy mainly due to inadequate political commitment for provider education. The medical practitioners have limited opportunity to undergo training for integrative medical practice. We also find a serious mistrust between the practitioners due to the "diversity of healing approaches and techniques." Weak institutional support, lack of training to meet standards of practice, poor registration and regulatory measures as well as negative perception of the integrative medical policy inhibit its implementation in Ghana.

CONCLUSION

In order to advance any useful intercultural health care policy in Ghana, the government's total commitment in informed training and provider education, enforcement of regulatory instrument and improved community engagement is needed. Evidence-based incorporation of traditional medical therapies into clinical practice will provide safer, faster and more effective health care for the underserved and resource-poor, particularly in the rural areas.

Stuck in the Clinic: Vernacular Healing and Medical Anthropology in Contemporary sub-Saharan Africa

While vernacular therapeutics had long been a topic of interest to many writing about medicine and healing in Africa, with a few exceptions most recent anthropological writings on medicine in Africa are focused on biomedicine. In this article, I trace this shift back to the turn of the millennium and the convergence of three events: the emergence of global health, the accession of the occult economies paradigm, and critiques of culturalism in medical anthropology. I argue that these three shifts led to research projects and priorities that looked different from those defined and undertaken as late as the late 1990s. While seeking to avoid the errors that could come with writing about vernacular therapeutic traditions in Africa as bounded comprehensive systems, I argue that there are empirical, political, and practical reasons why medical anthropologists may want to reconsider our collective research priorities.

Unmasking the Practices of Nurses and Intercultural Health in Sub-Saharan Africa: A Useful Way to Improve Health Care?

In 2001 and 2013, the World Health Organization (WHO) published the WHO Traditional Medicine Strategy 2002-2005 and 2014-2023, respectively, to address policy, ethics, quality, and integration of complementary health therapies (CHT). Despite the adoption of these strategic frameworks, sub-Saharan African (SSA) countries largely run dualistic and inclusive health care system. A recent article published in Complementary Therapies in Clinical Practice analyzed the role of practicing nurses in CHT integration and intercultural health in an SSA country setting. Drawing on the Complementary and Alternative Medicine Health Belief Questionnaire, the study specifically examined nurses’ knowledge, practices, and attitudes toward CHT. The study revealed that nurses had low knowledge about CHT, which reflected in their ineptitude to engage in professional practices of CHT. In spite of the knowledge deficit, nurses generally held favorable attitudes toward CHT and the majority supported the need for “safe” and evidence-based integrative model. Efforts to improve CHT-related knowledge of nurses may enhance medical integration in SSA. This commentary proposes novel political will and investment in CHT education and research as well as an inclusion of CHT modules in the nurses’ training programs; viabilities to achieve intercultural health and improved care in SSA.

The Capabilities of Nurses for Complementary and Traditional Medicine Integration in Africa

OBJECTIVE

Despite the political commitment of national governments and collaborative efforts by the World Health Organization (WHO) toward the actualization of intercultural healthcare system over the past decades, sub-Saharan African countries feature medical cohabitation rather than a truly integrated medical system. This hospital-based cross-sectional study analyzed the capabilities of nurses for complementary and traditional medicine (CTM) integration in Africa.

METHOD

Practicing nurses (n = 210) were recruited to respond to the CTM Health Belief Questionnaire (CHBQ) in December 2016. Normality of data was evaluated using Kolmogorov-Smirnov statistic with a Lilliefors significance correction. The authors assessed the relationship among nurses' knowledge, personal use, and clinical practice of CTM, using Spearman's Rank Order Correlation (rho). The differences and associations in continuous and categorical baseline variables were determined with Mann-Whitney U test/Kruskal-Wallis H test and Pearson's Chi-square test, respectively, at p < 0.05 as statistically significant.

RESULTS

The overall mean score of nurses' knowledge of CTM therapies was 38 (interquartile range [IQR] 16). This low CTM-related knowledge reflected in the poor mean performance score of 30 (IQR 17) and 22 (IQR 6) for personal use and clinical practice of CTM, respectively, among nurses. Nurses, therefore, lacked the confidence to recommend CTM therapies to patients. Yet, nurses exhibited a high positive attitude to CTM (72.7 ± 12.5). In addition to significant associations among CTM-related knowledge, education (p = 0.023), and religion (p < 0.001), the study found a positive and statistically significant correlation among CTM-related knowledge, personal use (r = 0.556, p < 0.001), and professional practice of CTM (r = 0.349, p < 0.001).

CONCLUSION

Given their substantial role in the primary and public healthcare system, improving nurses' knowledge of CTM through evidence-based nursing education and training remains the surest way to achieve appropriate CTM integration in Africa as outlined in the WHO Traditional Medicine Strategy 2014-2023.

Nurses' knowledge, clinical practice and attitude towards unconventional medicine: Implications for intercultural healthcare

OBJECTIVE

The aim of this hospital-based, cross-sectional study was to examine nurses' knowledge, personal and professional practices and attitude towards complementary and alternative medical therapies in urban Ghana.

METHOD

Using convenience sampling technique, cross-sectional data were collected from 210 registered and practicing nurses with self-administered questionnaire based on the Complementary and Alternative Medicine (CAM) Health Belief Questionnaire (CHBQ). Descriptive statistics and the associations between variables were calculated using Pearson's Chi-square test and/or Fisher's exact test with p < 0.05.

RESULTS

The mean score of nurses' knowledge on CAM therapies was low (mean ± SD, 38.39 ± 10.11; possible range, 18-72) which was built on nurses' personal experiences. Nurses, therefore, lacked the confidence to recommend CAM therapies to patients. Despite the isolated cases of non-herbal supplements, relaxation techniques, massage and prayer healing, the study found an overall low personal use of CAM (mean ± SD, 32.97 ± 10.78; possible range, 18-72) among nurses over the last 12 months. Yet, nurses exhibited a positive attitude towards CAM (mean ± SD, 72.7 ± 12.5, possible range, 67-110). We observed significant associations among nurses' CAM knowledge and education [χ² (2) = 6.69, p = 0.035] and religion [χ² (2) = 7.96, p = 0.019]; nurses' personal use of CAM and income [χ² (2) = 16.07, p < 0.001] and religion [χ² (2) = 18.65, p < 0.001]; and nurses' clinical CAM use and income [χ² (2) = 7.01, p = 0.030].

CONCLUSION

Despite the overall positive attitude towards CAM therapies, Ghanaian nurses do not perceive themselves to have sufficient knowledge of CAM. Integrating CAM education into the nurses' training curriculum can improve CAM knowledge and professional practice among nurses, and in turn, enhance evidence-based patient care within the framework of intercultural healthcare system in Ghana.

Traditional treatment of human and animal salmonelloses in Southern Benin: Knowledge of farmers and traditherapists

AIM

This study aimed to report medicinal plants that are likely to be used in the control of salmonellosis.

MATERIALS AND METHODS

A cross-sectional study was conducted in Southern Benin. Semi-structured questionnaires were administered to 150 farmers and 100 traditional therapists in seven high municipalities. This step helped to collect plants that are used in the treatment of animal salmonellosis and typhoid fever in human.

RESULTS

The results revealed a low level of use of medicinal plants among breeders who prefer antibiotics such as oxytetracycline (53.55%), tylosine + sulfadimerazine (15.30%), and alphaceryl (19.13%). However, plants such as Moringa oleifera (leaves), Carica papaya (leaves and seeds), and Vernonia amygdalina (leaves) were mostly used by some farmers. From traditional therapists, 57 plant species of 32 families were identified as typhoid fever cures; among which Leguminosae, Asteraceae, and Euphorbiaceae were predominant. Persea americana (22.72%), V. amygdalina (7.57%), and Corchorus olitorius (7.57%) were the most cited by traditherapists for the treatment of typhoid fever in human.

CONCLUSION

This study provides a database for further studies on the in vitro and in vivo efficacy of Benin plant species on Salmonellaspp. These evaluations will guarantee the availability of new therapeutic solutions for populations.

Unconventional medical practices among Ghanaian students: A university-based survey

Research on unconventional medical practices among students has proliferated lately in the global space, hitherto, little is known explicitly in Ghana. This paper teases out insights for recent utilisation patterns of traditional medical therapies at Kwame Nkrumah University of Science and Technology (KNUST), Ghana. A sample of 754, randomly selected undergraduates were involved in a retrospective cross-sectional survey. Data were analysed using multivariate logistic regression and Pearson's χ² test with p < 0.05 as significant. Overall prevalence of traditional therapies consumption was 89.1% in the last 12 months. Herbal-based products (67%), prayer healing (15%) and body-mind therapies (11%) were principally used and, accessed through purchases from pharmacy shops (29%) and encounter with faith healers (26%). Although students' knowledge on traditional therapies was acquired through family members (50%) and media (23%), literary materials remained significant information routes for Science related students compared to the Non-science related counterparts (p < 0.001). Pursuing Non-science-related programme [odds ratio (OR) 6.154 (95% confidence interval (CI) 3.745-10.111; p < 0.001)] and having Christian faith [OR 2.450 (95% CI 1.359-4.415; p = 0.003)] were strongly associated with students' traditional therapies use. Although students exhibited positive attitude towards unconventional therapies, there is an urgent need to validate the quality of traditional therapies through randomised clinical trials and regulatory practices to ensure quality control. Health forces should intensify efforts towards intercultural health care system in Ghana.

Pulled in or pushed out? Understanding the complexities of motivation for alternative therapies use in Ghana

The impact of strong cultural beliefs on specific reasons for traditional medicine (TRM) use among individuals and populations has long been advanced in health care and spatio-medical literature. Yet, little has been done in Ghana and the Ashanti Region in particular to bring out the precise “pull” and “push” relative influences on TRM utilization. With a qualitative research approach involving rural and urban character, the study explored health beliefs and motivations for TRM use in Kumasi Metropolis and Sekyere South District, Ghana. The study draws on data from 36 in-depth interviews with adults, selected through theoretical sampling. We used the a posteriori inductive reduction model to derive broad themes and subthemes. The “pull factors”—perceived benefits in TRM use vis-à-vis the “push factors”—perceived poor services of the biomedical treatments contributed to the growing trends in TRM use. The result however indicates that the “pull factors,” viz.—personal health beliefs, desire to take control of one's health, perceived efficacy, and safety of various modalities of TRM—were stronger in shaping TRM use. Poor access to conventional medicine accounted for the differences in TRM use between rural and urban areas. Understanding the treatment and health-seeking behaviour of a cultural-related group is critical for developing and sustaining traditional therapy in Ghana.

Relationship between Health Insurance Status and the Pattern of Traditional Medicine Utilisation in Ghana

This paper examines the relationship between national health insurance status and the pattern of traditional medicine (TRM) use among the general population in Ghana. A retrospective cross-sectional survey of randomly sampled adults, aged ≥18 years (N = 324), was conducted. The results indicate that TRM use was high with prevalence of over 86%. The study found no statistically significant association between national health insurance status and TRM utilisation (P > 0.05). Paradoxically, major sources of TRM, frequency of TRM use, comedical administration, and disclosure of TRM use to health care professionals differed significantly between the insured and uninsured subgroups (P < 0.001). Whereas effectiveness of TRM predicted its use for both insured [odds ratio (OR) = 4.374 (confidence interval (CI): 1.753-10.913; P = 0.002)] and uninsured [OR = 3.383 CI: 0.869-13.170; P = 0.039)], work experience predicted TRM use for the insured [OR = 1.528 (95% CI: 1.309-1.900; P = 0.019)]. Cultural specific variables and health philosophies rather than health insurance status may influence health care-seeking behaviour and TRM use. The enrollment of herbal-based therapies on the national health insurance medicine plan is exigent to ensure monitoring and rational use of TRM towards intercultural health care system in Ghana.