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Brubacher LJ, Berrang-Ford L, Clark SN, Patterson K, Lwasa S, Namanya D, Twesigomwe S, Harper SL. Place, displacement, and health-seeking behaviour among the Ugandan Batwa: A qualitative study. PLOS GLOBAL PUBLIC HEALTH 2024; 4:e0003321. [PMID: 38865306 PMCID: PMC11168611 DOI: 10.1371/journal.pgph.0003321] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/23/2023] [Accepted: 05/15/2024] [Indexed: 06/14/2024]
Abstract
For many Indigenous Peoples, relationships to the land are inherent in identity and culture, and to all facets of health and wellbeing, physically, emotionally, psychologically, and spiritually. The Batwa are Indigenous Peoples of rural, southwest Uganda who have experienced tremendous social and economic upheaval, due to relatively recent forced displacement and land dispossession. This loss of physical connection to their ancestral lands has significantly impacted Batwa health, and also affected available healthcare options for Batwa. This exploratory study (1) identified and characterized factors that influence Batwa health-seeking behaviour, using acute gastrointestinal illness, a critical public health issue, as a focal point for analysis; and (2) explored possible intersections between the Batwa's connection to place-and displacement-and their health-seeking behaviour for acute gastrointestinal illness. Twenty focus group discussions, stratified by gender, were conducted in ten Batwa settlements in Kanungu District, Uganda and eleven semi-structured interviews were conducted with primary healthcare workers, community health coordinators, clinical officers, and development program coordinators. Qualitative data were thematically analyzed using a constant comparative method. Batwa identified several significant motivators to engage with Indigenous and/or biomedical forms of healthcare, including transition to life outside the forest and their reflections on health in the forest; 'intellectual access' to care and generational knowledge-sharing on the use of Indigenous medicines; and Batwa identity and way of life. These nuanced explanations for health-seeking behaviour underscore the significance of place-and displacement-to Batwa health and wellbeing, and its relationship to their health-seeking behaviour for acute gastrointestinal illness. As such, the results of this study can be used to inform healthcare practice and policy and support the development of a culturally- and contextually-appropriate healthcare system, as well as to reduce the burden of acute gastrointestinal illness among Batwa.
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Affiliation(s)
- Laura Jane Brubacher
- Department of Population Medicine, University of Guelph, Guelph, Ontario, Canada
| | - Lea Berrang-Ford
- School of Earth and Environment, University of Leeds, Leeds, United Kingdom
| | - Sierra Nicole Clark
- Environmental and Social Epidemiology Section, Population Health Research Institute, St. George’s, University of London, London, United Kingdom
| | - Kaitlin Patterson
- Department of Population Medicine, University of Guelph, Guelph, Ontario, Canada
| | - Shuaib Lwasa
- Department of Geography, Makerere University, Kampala, Uganda
| | - Didacus Namanya
- Ugandan Ministry of Health, Kampala, Uganda
- Faculty of Health Sciences, Uganda Martyrs University, Kampala, Uganda
| | | | | | - Sherilee L. Harper
- Department of Population Medicine, University of Guelph, Guelph, Ontario, Canada
- School of Public Health, University of Alberta, Edmonton, Alberta, Canada
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Fattahi Ardakani M, Salahshouri A, Sotoudeh A, Fard MR, Dashti S, Ahmadi Chenari H, Baumann SL. A Study of the Use of Medicinal Plants by Persons With Type 2 Diabetes in Iran. Nurs Sci Q 2024; 37:168-172. [PMID: 38491885 DOI: 10.1177/08943184231224454] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/18/2024]
Abstract
Medicinal plants are used by many people with Type 2 diabetes in Iran. The aim of this study was to explore why this is so, from their perspective. Sixteen persons with Type 2 diabetes in Yazd City, Iran, were interviewed in April and May 2020 for this study. A thematic analysis of the transcripts of those interviews was done using MAXQDA 10 software. Six themes were identified: beliefs about medicinal plants, psychological factors, accessibility and economic barriers, patients' knowledge and awareness, social pressure, and the role of family culture. The recommendation of the study is that health counselors and specialists should provide needed information and skills for the proper use of medicinal plants, and the pharmaceutical infrastructures need to be expanded to provide enough drugs to facilitate better access to needed medication and reduce reliance on medicinal plants for persons with Type 2 diabetes.
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Affiliation(s)
| | - Arash Salahshouri
- Department of Health Education and Promotion, School of Public Health, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Ahmad Sotoudeh
- Department of Public Health, School of Public Health, Bushehr University of Medical Sciences, Bushehr, Iran
| | - Mohammad Rafati Fard
- Research, Health Science/Physiology, Clinical Research Development Unit, Hajar Hospital, Shahrekord University of Medical Sciences, Shahrekord, Iran
| | - Saeed Dashti
- Department of Public Health, Ferdows School of Allied Medicine and Public Health, Birjand University of Medical Sciences, Birjand, Iran
| | - Hadi Ahmadi Chenari
- Department of Nursing, Ferdows School of Allied Medicine and Public Health, Birjand University of Medical Sciences, Birjand, Iran
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Sriraman S, Sreejith D, Andrew E, Okello I, Willcox M. Use of herbal medicines for the management of type 2 diabetes: A systematic review of qualitative studies. Complement Ther Clin Pract 2023; 53:101808. [PMID: 37977099 DOI: 10.1016/j.ctcp.2023.101808] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2023] [Revised: 10/21/2023] [Accepted: 10/25/2023] [Indexed: 11/19/2023]
Abstract
BACKGROUND Many people with Type 2 Diabetes Mellitus (T2DM) use herbal medicines, some of which can improve glycaemic control. Providing evidence-based advice on herbal medicines could be an effective intervention to improve control of diabetes, if it is designed to address key needs and concerns of T2DM patients. AIM To understand the views and experiences of patients and health professionals on herbal treatments for self-management of T2DM. METHOD MEDLINE, EMBASE, CINAHL, SOCIOFILE and Google Scholar were searched for qualitative studies in T2DM patients about their views on herbal medicines. Included papers were analysed using thematic synthesis. RESULTS Thirty-one papers (about 30 studies) were included: 20 from low-and-middle income countries, 10 from high income countries, and 1 internet-based study. Almost all studies from high income countries focussed on ethnic minorities. Many people with T2DM wanted a "cure", and often took advice from friends and family, but also traditional healers and mass media. However, they were reluctant to discuss herbal medicines with health professionals, whom they perceived as "closed-minded". They based their treatment decisions on personal experience (from "trial-and-error"), availability, cost and convenience of both herbal and conventional medicines. Most health professionals were reluctant to discuss herbal medicines, or recommended against their use, because of lack of knowledge and concerns about their quality, efficacy and potential interactions. CONCLUSION Evidence-based information could help to overcome the current lack of communication about herbal medicines between people with T2DM and health professionals.
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Affiliation(s)
- Shraddha Sriraman
- Primary Care Research Centre, School of Primary Care, Population Sciences and Medical Education, Faculty of Medicine, University of Southampton, UK
| | - Devika Sreejith
- Primary Care Research Centre, School of Primary Care, Population Sciences and Medical Education, Faculty of Medicine, University of Southampton, UK
| | - Evie Andrew
- Primary Care Research Centre, School of Primary Care, Population Sciences and Medical Education, Faculty of Medicine, University of Southampton, UK
| | - Immaculate Okello
- Primary Care Research Centre, School of Primary Care, Population Sciences and Medical Education, Faculty of Medicine, University of Southampton, UK
| | - Merlin Willcox
- Primary Care Research Centre, School of Primary Care, Population Sciences and Medical Education, Faculty of Medicine, University of Southampton, UK.
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Roy S, Teron R, Nikku Linga R. PhytoSelectDBT: A database for the molecular models of anti-diabetic targets docked with bioactive peptides from selected ethno-medicinal plants. Bioinformation 2023; 19:908-917. [PMID: 37928486 PMCID: PMC10625370 DOI: 10.6026/97320630019908] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2023] [Revised: 09/30/2023] [Accepted: 09/30/2023] [Indexed: 11/07/2023] Open
Abstract
It is of interest to assess the effectiveness of bioactive peptides derived from 41 ethno-medicinal plants, classify them according to their anti-diabetic protein targets (DPP-IV, alpha-amylase, alpha-glucosidase, GRK2, GSK3B, GLP-1R, and AdipoR1), and create a web tool named PhytoSelectDBT by using the top seven peptides per target. If one of the target-based medicinal plant suggestions made by PhytoSelectDBT is unsuccessful, alternative target-based possibilities are presented by PhytoSelectDBT for treating the condition and any other related complications. The results provide a useful resource for the management of type 2 diabetes and emphasize the significance of utilising ethnomedical knowledge for the identification of potent anti-diabetic plants and their peptides. We used molecular docking to investigate interactions between anti-diabetic targets (DPP-IV, alpha-amylase, alpha-glucosidase, GRK2, GSK3B, GLP-1R, and AdipoR1) and projected bioactive peptides from 41 ethnomedicinal plants. All bioactive peptides were cross-checked against several databases to determine their allergenicity, toxicity, and cross-reactivity. The presence of B and T cell epitopes was also examined in all simulated digested bioactive peptides for reference. This data is archived at the PhytoselectDBT database.
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Affiliation(s)
- Susanta Roy
- Department of Life Science, Assam University - Diphu Campus, Diphu, Karbi Anglong, ASSAM - 782 462
| | - Robindra Teron
- North Eastern Institute of Ayurveda and Folk Medicine Research (NEIAFMR) Pasighat, East Siang District, Arunachal Pradesh - 791102
| | - Raju Nikku Linga
- Department of Life Science, Assam University - Diphu Campus, Diphu, Karbi Anglong, ASSAM - 782 462
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Logie CH, Okumu M, Loutet MG, Coelho M, Berry I, Gittings L, Odong Lukone S, Kisubi N, Atama M, Kyambadde P. Todurujo na Kadurok (empowering youth): study protocol of an HIV self-testing and edutainment comic cluster randomised trial among refugee youth in a humanitarian setting in Uganda. BMJ Open 2022; 12:e065452. [PMID: 36418143 PMCID: PMC9685005 DOI: 10.1136/bmjopen-2022-065452] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
INTRODUCTION Refugees experience HIV vulnerabilities due to the confluence of displacement, violence and poverty. HIV self-testing, understudied with refugees, is a promising method to increase testing uptake, yet challenges remain with linkages to confirmatory testing following a positive HIV self-test. This study aims to evaluate the effectiveness of HIV self-testing kits and 'edutainment' comics in increasing HIV testing and HIV status knowledge among refugee youth aged 16-24 years in Bidi Bidi Refugee Settlement, Uganda. METHODS AND ANALYSIS This study will be conducted in Bidi Bidi. We conducted a qualitative formative phase with focus groups (n=40) to generate knowledge of barriers and facilitators of HIV prevention, testing and care among refugee youth (aged 16-24) in Bidi Bidi. These findings were used to create comic scenarios aligning with edutainment approaches to health promotion and inform a four-arm cluster randomised controlled trial in Bidi Bidi using a 2×2 factorial design: (1) HIV self-testing alongside edutainment comics, (2) HIV self-testing alone, (3) edutainment comic alone and (4) standard of care. The target sample size will be 120 youth (30 per arm), who will be enrolled in the trial and followed for 3 months. Data will be collected at baseline and 3 months after enrolment. The primary outcomes (HIV testing frequency, HIV status knowledge) and secondary outcomes (linkage to confirmatory HIV testing, HIV care linkage, HIV self-test kit use, HIV-related stigma, HIV knowledge, safer sex efficacy, condom use, adolescent sexual and reproductive health (SRH) stigma, sexual relationship power, access to SRH services) will be evaluated using descriptive statistics and regression analyses. ETHICS AND DISSEMINATION This study was approved by the University of Toronto Research Ethics Board, Mildmay Uganda Research Ethics Committee and the Uganda National Council for Science and Technology. Results will be shared in peer-reviewed publications and community knowledge sharing. TRIAL REGISTRATION NUMBER NCT05213689.
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Affiliation(s)
- Carmen H Logie
- Factor-Inwentash Faculty of Social Work, University of Toronto, Toronto, Ontario, Canada
- Women's College Research Institute, University of Toronto, Toronto, Ontario, Canada
- United Nations University Institute for Water, Environment and Health (UNU-INWEH), Hamilton, Ontario, Canada
- Centre for Gender & Sexual Health Equity, Vancouver, British Columbia, Canada
| | - Moses Okumu
- School of Social Work, University of Illinois-Champaign, Urbana, Illinois, USA
- School of Social Sciences, Uganda Christian University, Mukono, Uganda
| | - Miranda G Loutet
- Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
| | - Madelaine Coelho
- Department of Sociology, University of Toronto, Toronto, Ontario, Canada
| | - Isha Berry
- Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
| | - Lesley Gittings
- Factor-Inwentash Faculty of Social Work, University of Toronto, Toronto, Ontario, Canada
- University of Cape Town, Rondebosch, South Africa
- School of Health Studies, Faculty of Health Sciences, Western University, London, ON, Canada
| | | | - Nelson Kisubi
- Uganda Refugee and Disaster Management Council, Yumbe, Uganda
| | - Malon Atama
- Yumbe Regional Referral Hospital, Yumbe, Uganda
| | - Peter Kyambadde
- Most at Risk Population Initiative, Mulago Hospital, Kampala, Uganda
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Sodi T, Quarshie ENB, Oppong Asante K, Radzilani-Makatu M, Makgahlela M, Nkoana S, Mutambara J. Mental health literacy of school-going adolescents in sub-Saharan Africa: a regional systematic review protocol. BMJ Open 2022; 12:e063687. [PMID: 36127093 PMCID: PMC9490578 DOI: 10.1136/bmjopen-2022-063687] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
INTRODUCTION Assessing mental health literacy has implications for the identification and treatment of mental health problems. Adolescents have been identified as a particularly important target group for initiating and improving mental health literacy. However, much of what we know about adolescent mental health literacy comes from high-income countries. This proposed review seeks to synthesise the available published primary evidence from sub-Saharan Africa on the status and measurement of mental health literacy among school-going adolescents. METHODS AND ANALYSIS We will perform a systematic review reported in line with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement (PRISMA-2020). We will systematically search selected global databases (EMBASE, PsycINFO, PubMed and MEDLINE) and regional electronic databases (African Index Medicus and African Journals OnLine) up to December 2021 for observational and qualitative studies published in English and French. The standard quality assessment criteria for evaluating primary research papers from a variety of fields (QualSyst criteria) will be used to appraise the methodological quality of the included studies. The Petticrew-Roberts 3-step approach to narrative synthesis will be applied to the included studies. ETHICS AND DISSEMINATION We will not seek ethical approval from an institutional review board, as this is a systematic review of available and accessible literature. When completed, the full report of this review will be submitted to a journal for peer-reviewed publication; the key findings will be presented at local and international conferences with-partial or full-focus on (adolescent) mental health (literacy). PROSPERO REGISTRATION NUMBER CRD42021229011.
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Affiliation(s)
- Tholene Sodi
- Psychology Department, University of Limpopo, Sovenga, South Africa
| | - Emmanuel Nii-Boye Quarshie
- Department of Psychology, College of Humanities, University of Ghana, Accra, Ghana
- School of Psychology, University of Leeds, Leeds, UK
| | - Kwaku Oppong Asante
- Department of Psychology, College of Humanities, University of Ghana, Accra, Ghana
- Department of Psychology, University of the Free State, Bloemfontein, South Africa
| | | | | | - Shai Nkoana
- Psychology Department, University of Limpopo, Sovenga, South Africa
| | - Julia Mutambara
- Department of Psychiatry, Midlands State University, Gweru, Zimbabwe
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Bolarinwa OA, Ahinkorah BO, Okyere J, Seidu AA, Olagunju OS. A multilevel analysis of prevalence and factors associated with female child marriage in Nigeria using the 2018 Nigeria Demographic and Health Survey data. BMC Womens Health 2022; 22:158. [PMID: 35538527 PMCID: PMC9092767 DOI: 10.1186/s12905-022-01733-x] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2021] [Accepted: 04/25/2022] [Indexed: 01/10/2023] Open
Abstract
Background Globally, there has been a decline in female child marriage (FCM) from 1 in 4 girls married a decade ago to approximately 1 in 5 currently. However, this decline is not homogenous because some regions are still experiencing a high prevalence of FCM. As such, the United Nations reiterated the need for concentrated efforts towards ending FCM to avoid more than 120 million girls getting married before their eighteenth birthday by 2030. Following this, we examined the prevalence and factors associated with FCM in Nigeria using multi-level analysis. Methods We used cross-sectional data from the women’s file of the Nigeria Demographic and Health Survey (NDHS) conducted in 2018. A sample of 4143 young women aged 20–24 was included in the study. Our analysis involved descriptive, chi-square (χ2) and multi-level analyses. Results were presented in percentages, frequencies, and adjusted odds ratios (aOR) with their respective confidence intervals (CIs). Results The prevalence of FCM in 2018 was 65.30%. Young Muslim women aged 20–24 [aOR = 1.40; 95% CI (4.73–7.52)], those with parity between one and two [aOR = 5.96, 95% CI 4.73–7.52], those residing in North East [aOR = 1.55; 95% CI (1.19–2.10)] and North West [aOR = 1.59; 95% CI (1.18–2.16)] had a higher odd of practicing FCM respondents with secondary education and above [aOR = 0.36; 95% CI (0.29–0.46)], those within the richer wealth index [aOR = 0.35; 95% CI (0.23–0.54)] and young women living in communities with high literacy level [aOR = 0.74; 95% CI (0.59–0.92)] were less likely to get married before age 18 years. Conclusion Our findings indicate that FCM is high in Nigeria. Formal education, being rich and living in communities with high literacy levels were some protective factors that can be strengthened to ensure that FCM is reduced or eliminated in Nigeria. On the other hand, residing in North-East or North-West and having children between one and two were some prevailing factors that exacerbated the odds of experiencing FCM in Nigeria. Therefore, attention should be channelled towards mitigating these prevailing negative factors.
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Affiliation(s)
- Obasanjo Afolabi Bolarinwa
- Department of Public Health Medicine, School of Nursing and Public Health, University of KwaZulu-Natal, Durban, South Africa. .,Department of Demography and Social Statistics, Faculty of Social Sciences, Obafemi Awolowo University, Ile-Ife, Nigeria.
| | | | - Joshua Okyere
- Department of Population and Health, University of Cape Coast, Cape Coast, Ghana
| | - Abdul-Aziz Seidu
- Department of Population and Health, University of Cape Coast, Cape Coast, Ghana.,College of Public Health, Medical and Veterinary Services, James Cook University, Townsville, Australia
| | - Olalekan Seun Olagunju
- Department of Demography and Social Statistics, Faculty of Social Sciences, Obafemi Awolowo University, Ile-Ife, Nigeria
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John NA, Adebayo A, Boychuk NA, OlaOlorun F. Intimate partner violence (IPV) prevention using a cross-sectoral couple-based intervention: results from a cluster randomised control trial in Ibadan, Nigeria. BMJ Glob Health 2022; 7:bmjgh-2021-007192. [PMID: 35140139 PMCID: PMC8830218 DOI: 10.1136/bmjgh-2021-007192] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2021] [Accepted: 01/20/2022] [Indexed: 11/04/2022] Open
Abstract
INTRODUCTION Intimate partner violence (IPV) is the most common form of violence women experience globally. Economic empowerment interventions have been implemented across countries to prevent and address IPV, with mixed results. A sociological 'male-backlash' model suggests that addressing unequal gender norms is crucial to reduce IPV. This study evaluates the impact of a multipronged intervention among heterosexual couples in urban and periurban Ibadan that aimed at reducing IPV by increasing financial and reproductive literacy, fostering gender equality and improving relationship quality. METHODS A four-arm mixed-methods cluster randomised control trial was employed. Baseline data and end line data six months postintervention were collected to estimate changes in key outcomes. In-depth interviews were conducted with 15 couples 2 years postintervention to explore the drivers of changes in outcomes. Difference-in-differences regression models were estimated to compare changes in IPV levels across the three intervention arms and control arm, and thematic analysis was conducted to understand drivers of change in IPV outcomes. RESULTS Physical IPV decreased significantly in the gender socialisation (GS) (β: -4.63 (SE: 2.12)) and GS and financial literacy (β: -4.61 (SE: 2.02)) groups as compared with the control group. Changes in emotional and sexual IPV were marginally significant or insignificant, respectively, suggesting that the intervention did not have an impact on non-physical forms of IPV. In the in-depth interviews, couples reported improved communication and trust, enhanced conflict management skills, and increased mutual respect as a result of participation across intervention arms, which may have facilitated the reduction of violence in their relationships. CONCLUSION This study highlights the potential utility of gender transformative interventions for improving physical IPV outcomes. Future research should seek to understand the mechanisms that influence sexual and emotional IPV as their aetiology may be different from physical violence. TRAIL REGISTRATION NUMBER The study protocol was registered at ClinicalTrials.gov (ID: NCT03888495).
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Affiliation(s)
- Neetu A John
- Heilbrunn Department of Population and Family Health, Columbia University Mailman School of Public Health, New York, New York, USA
| | - Ayodeji Adebayo
- Department of Community Medicine, College of Medicine, University of Ibadan, Ibadan, Oyo, Nigeria
| | - Natalie A Boychuk
- Heilbrunn Department of Population and Family Health, Columbia University Mailman School of Public Health, New York, New York, USA
| | - Funmilola OlaOlorun
- Department of Community Medicine, College of Medicine, University of Ibadan, Ibadan, Oyo, Nigeria
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Khan A, Ali S, Murad W, Hayat K, Siraj S, Jawad M, Khan RA, Uddin J, Al-Harrasi A, Khan A. Phytochemical and pharmacological uses of medicinal plants to treat cancer: A case study from Khyber Pakhtunkhwa, North Pakistan. JOURNAL OF ETHNOPHARMACOLOGY 2021; 281:114437. [PMID: 34391861 DOI: 10.1016/j.jep.2021.114437] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/16/2021] [Revised: 07/16/2021] [Accepted: 07/17/2021] [Indexed: 06/13/2023]
Abstract
ETHNOPHARMACOLOGICAL RELEVANCE Cancer is the top death causing disease in the world, due to its occurrence through various mechanism and form. Medicinal plants have been extensively used for the purifications and isolations of phytochemicals for the treatment and prevention of cancer. OBJECTIVES Consequently, this research was designed to document the traditional practices of anti-cancer plants and its phytochemical essay across the districts of KP, Pakistan. MATERIALS AND METHODS Semi-structured interviews were conducted in 24 districts from the informants mostly the traditional herbalists (key informants). The information were compared with the publish data using various authentic search engines including, google, researchgate, google scholar and NCBI. RESULTS One hundred and fifty-four (154) anti-cancer plants were recognized belonging to 69 families among all, Lamiaceae (13 sp.), Asteraceae (12 sp.) and Solanaceae (9 sp.) were the preferred families. The local inhabitants in the area typically prepare ethnomedicinal recipes from leaves (33.70%) and whole plants (23.37%) in the form of decoction and powder (24.67%), respectively. Herbs stayed the most preferred life form (61.68%) followed by shrub (21.4%). Similarly, breast (29.22%) and lung cancer (14.83%) was the common disease type. Literature study also authorize that, the medicinal plants of the research area were rich in phytochemical like quercetin, coumarine, kaempferol, apigenin, colchicine, alliin, rutin, lupeol, allicin, berbarine, lutolin, vanilic acid, urocilic acid and solamargine have revealed significant activates concerning the cancer diseases, that replicating the efficacy of these plants as medicines. CONCLUSION The Khyber Pakhtunkhwa is rural area and the local inhabitants have very strong traditional knowledge about the medicinal plants for different diseases like cancer. The medicinal plants for significant ranked disorder might be pharmacologically and phtyochemicaly explored to demonstrate their efficacy. Moreover, the local flora especially medicinal plants facing overgrazing, overexploitation and inappropriate way of collection, however, proper management strategies like reforestation, controlled grazing, proper permission from concerned department and rangeland strategies among others may be assumed to enhance the proper usage of medicinal plants.
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Affiliation(s)
- Asif Khan
- Department of Botany, Garden Campus Abdul Wali Khan University, Mardan, Pakistan
| | - Sajid Ali
- Department of Botany, Garden Campus Abdul Wali Khan University, Mardan, Pakistan
| | - Waheed Murad
- Department of Botany, Garden Campus Abdul Wali Khan University, Mardan, Pakistan.
| | - Khizar Hayat
- Key Laboratory of Plant Ecology, Northeast Forestry University, Harbin, China
| | - Shumaila Siraj
- Department of Botany, Garden Campus Abdul Wali Khan University, Mardan, Pakistan
| | - Muhammad Jawad
- Center of Geographical Information System, University of Punjab, Pakistan
| | | | - Jalal Uddin
- Department of Pharmaceutical Chemistry, College of Pharmacy, King Khalid University, Abha, Saudi Arabia
| | - Ahmed Al-Harrasi
- Natural and Medical Sciences Research Center, University of Nizwa, Birkat Al Mauz, Nizwa, Oman.
| | - Ajmal Khan
- Natural and Medical Sciences Research Center, University of Nizwa, Birkat Al Mauz, Nizwa, Oman.
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Chen J, Farah N, Dong RK, Chen RZ, Xu W, Yin J, Chen BZ, Delios AY, Miller S, Wan X, Ye W, Zhang SX. Mental Health during the COVID-19 Crisis in Africa: A Systematic Review and Meta-Analysis. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph182010604. [PMID: 34682357 DOI: 10.1101/2021.04.19.21255755] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/05/2021] [Revised: 09/17/2021] [Accepted: 09/26/2021] [Indexed: 05/27/2023]
Abstract
We aim to provide a systematic review and meta-analysis of the prevalence rates of mental health symptoms among major African populations during the COVID-19 pandemic. We include articles from PubMed, Embase, Web of Science, PsycINFO, and medRxiv between 1 February 2020 and 6 February 2021, and pooled data using random-effects meta-analyses. We identify 28 studies and 32 independent samples from 12 African countries with a total of 15,071 participants. The pooled prevalence of anxiety was 37% in 27 studies, of depression was 45% in 24 studies, and of insomnia was 28% in 9 studies. The pooled prevalence rates of anxiety, depression, and insomnia in North Africa (44%, 55%, and 31%, respectively) are higher than those in Sub-Saharan Africa (31%, 30%, and 24%, respectively). We find (a) a scarcity of studies in several African countries with a high number of COVID-19 cases; (b) high heterogeneity among the studies; (c) the extent and pattern of prevalence of mental health symptoms in Africa is high and differs from elsewhere-more African adults suffer from depression rather than anxiety and insomnia during COVID 19 compared to adult populations in other countries/regions. Hence, our findings carry crucial implications and impact future research to enable evidence-based medicine in Africa.
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Affiliation(s)
- Jiyao Chen
- College of Business, Oregon State University, Corvallis, OR 97330, USA
| | - Nusrat Farah
- College of Business and Analytics, Southern Illinois University Carbondale, Carbondale, IL 62901, USA
| | - Rebecca Kechen Dong
- Business School, University of South Australia, Adelaide, SA 5001, Australia
| | | | - Wen Xu
- International Business and Management Department, Nottingham University Business School China, University of Nottingham Ningbo China, Ningbo 315100, China
| | - Jin Yin
- School of Humanities, Southeast University, Nanjing 211189, China
| | - Bryan Z Chen
- Crescent Valley High School, Corvallis, OR 97330, USA
| | | | - Saylor Miller
- College of Business, Oregon State University, Corvallis, OR 97330, USA
| | - Xue Wan
- School of Economics and Management, Tongji University, Shanghai 200092, China
| | - Wenping Ye
- Department of Business Administration, School of Management, Jinan University, Guangzhou 510632, China
| | - Stephen X Zhang
- Department of Psychology, University of Adelaide, Adelaide, SA 5001, Australia
- Faculty of Professions, Entrepreneurship, Commercialization and Innovation Center, University of Adelaide, Adelaide, SA 5005, Australia
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11
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Edussuriya A, Subhashini S, Amarasinghe K, Kumari G, Perera K, Munidasa K. Experiences of Patients on Natural Herbal Treatments for Diabetes Mellitus at the Diabetes Clinic in Base Hospital - Matara, Sri Lanka. J Patient Exp 2021; 8:23743735211039313. [PMID: 34541303 PMCID: PMC8445526 DOI: 10.1177/23743735211039313] [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] [Indexed: 11/17/2022] Open
Abstract
The prevalence of diabetes mellitus has become a global public health issue. Natural herbal treatments for type 2 diabetes mellitus have been widely used in traditional societies but has recently become popular among western societies as well. The aim of this study was to explore the experience of type 2 patients with diabetes mellitus who are currently on natural herbal treatment. A qualitative, phenomenological design has been used. Twelve participants from both males and females, aged between 25 and 75 years, who were on medical treatment, were selected for sampling. In-depth interviews were conducted at the diabetes clinic in a selected hospital in southern Sri Lanka. The athematic analysis was conducted, and 6 themes were derived. The majority of participants (75%) were motivated to use natural herbal treatments other than oral glycemic therapy. Experiences have been identified as the most influential factors in the use of natural herbal treatments. The need for educational interventions on natural herbal treatments and to propose the integration of herbal medicine into current medical systems is recommended.
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Affiliation(s)
| | | | | | - G.S.D. Kumari
- The Open University of Sri Lanka, Nugegoda, Sri Lanka
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12
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Kifle ZD, Bayleyegn B, Yimer Tadesse T, Woldeyohanins AE. Prevalence and associated factors of herbal medicine use among adult diabetes mellitus patients at government hospital, Ethiopia: An institutional-based cross-sectional study. Metabol Open 2021; 11:100120. [PMID: 34485891 PMCID: PMC8403751 DOI: 10.1016/j.metop.2021.100120] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2021] [Revised: 08/05/2021] [Accepted: 08/24/2021] [Indexed: 11/28/2022] Open
Abstract
BACKGROUND Diabetes mellitus (DM) is a group of metabolic diseases characterized by hyperglycemia resulting from defects in insulin secretion, insulin action, or both. Thus, this study aimed to assess the prevalence and factors associated with HM use among DM patients. METHODS A hospital-based cross-sectional study was conducted on 395 diabetic patients visiting the diabetes care service of Debre Tabor General Hospitalfrom August 1 to September 28, 2020. Interview guided self-administered questionnaire was used for data collection. RESULTS Out of 395 diabetic patients, 231(58.5%) participants were used herbal medicine. The most dominant herbal products used were M.stenoptela (53.2%), N. sativa (42.0%), Z. officinale (32.5%), A. sativum (20.8%), A. vera (13.4%), P.gracilis(10.4%), T.schimperi(7.5%), V. amygdalina (5.2%), T. foenumgraecum(3.5%),and D.penninervum(2.2%).The odds of HM use in female participants were 1.98 times (AOR=1.98, 95% CI=1.72, 3.25) higher compared to male participants. The odds of HM use among participants who develop DM complications were 1.77 times (AOR=1.77, 95% CI=1.03, 2.83) higher than in participants without DM complications. The odds of HM use among participants with a family history of DM were 2.89 times (AOR=2.89, 95% CI=1.42, 3.19) higher than in participants without a family history of DM. CONCLUSION The prevalence of herbal medicine use among diabetic patients was high. Educational level, gender, residence, educational level, duration of DM, presence of DM complication, and family history of DMwere the independent predictors' of HM use.
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Affiliation(s)
- Zemene Demelash Kifle
- Department of Pharmacology, School of Pharmacy, College of Medicine and Health Science, University of Gondar, Gondar, Ethiopia
| | - Biruk Bayleyegn
- Department of Hematology and Immunohematology, School of Biomedical and Laboratory Sciences, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Tesfaye Yimer Tadesse
- Department of Pharmacy, College of Health Science, Debretabor University, Debretabor, Ethiopia
| | - Alem Endeshaw Woldeyohanins
- Department of Pharmaceutics and Social Pharmacy, School of Pharmacy, University of Gondar College of Medicine and Health Sciences, Gondar, Ethiopia
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13
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Obi-Jeff C, Garcia C, Onuoha O, Adewumi F, David W, Bamiduro T, Aliyu AB, Labrique A, Wonodi C. Designing an SMS reminder intervention to improve vaccination uptake in Northern Nigeria: a qualitative study. BMC Health Serv Res 2021; 21:844. [PMID: 34416906 PMCID: PMC8379866 DOI: 10.1186/s12913-021-06728-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2021] [Accepted: 07/08/2021] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND Penta3 coverage in Nigeria was low at 33 % in 2017. The most reported reason for non-vaccination was lack of knowledge about the immunization place, time, and need. To address knowledge gaps and improve vaccination uptake, we designed an Immunization Reminder and Information SMS System (IRISS) to educate and remind parents/caregivers about immunization using SMS. A formative study was conducted to understand the contextual and behavioural factors that would inform the IRISS intervention design and implementation. METHODS We conducted the study in four Local Government Areas (LGAs) of Kebbi State Nigeria in October 2018, amongst a diverse selection of participants. Data on social norms about vaccinations, barriers to immunization uptake, mobile phone use, SMS message testing, and willingness to accept SMS reminders were collected from focus group discussions (N = 11), in-depth interviews (N = 12), and key informant interviews (N = 13). In addition, we assessed 33 messages covering schedule reminders, normative, motivational, educational, and informative contents for clarity, comprehensibility, relevance, cultural appropriateness, and ability to motivate action among community members from Argungu and Fakai LGAs. All interviews were analyzed using a thematic analysis approach. RESULTS We interviewed 135 people, and 90 % were community members. While we found positive perceptions about immunizations among those interviewed, pockets of misconceptions existed among community members. Lack of awareness on the importance of vaccination was a consistent reason for under-vaccination across the LGAs. In addition, most community members do not own phones, could not read SMS messages, and were unaware of how to check/open text messages received. Despite concerns about low literacy levels and phone ownership, community members still saw a role in SMS reminders when phone owners receive messages. For instance, community leaders can disseminate said messages to community members through existing channels such as town announcers and religious gatherings. Therefore, the SMS becomes a source of information, with phone owners acting as a conduit to community dissemination mechanisms. We generally found the tested messages to be relevant, motivating, and culturally acceptable. CONCLUSIONS SMS reminders have the potential to bridge the information gap in community awareness for vaccination, which can translate to improved immunization uptake. In rural communities with low literacy levels and phone ownership, immunization information can be disseminated when existing community leadership structures are engaged.
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Affiliation(s)
- Chisom Obi-Jeff
- Department of Research, Direct Consulting and Logistics Limited, Abuja, Federal Capital Territory, Nigeria.
| | - Cristina Garcia
- Department of International Health, International Vaccine Access Center, Johns Hopkins Bloomberg School of Public Health Baltimore, MD, Baltimore, USA
| | - Obinna Onuoha
- Department of Research, Direct Consulting and Logistics Limited, Abuja, Federal Capital Territory, Nigeria
| | - Funmi Adewumi
- Department of Research, Direct Consulting and Logistics Limited, Abuja, Federal Capital Territory, Nigeria
| | - Winnie David
- Department of Research, Direct Consulting and Logistics Limited, Abuja, Federal Capital Territory, Nigeria
| | - Tobi Bamiduro
- Department of Research, Direct Consulting and Logistics Limited, Abuja, Federal Capital Territory, Nigeria
| | - Abdulrasheed Bello Aliyu
- Department of Primary Health Care System Development, Kebbi State Primary Health Care Development Agency, Birnin Kebbi, Kebbi State, Nigeria
| | - Alain Labrique
- Department of International Health and Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health Baltimore, MD, Baltimore, USA
| | - Chizoba Wonodi
- Department of International Health, International Vaccine Access Center, Johns Hopkins Bloomberg School of Public Health Baltimore, MD, Baltimore, USA
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14
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Mwaka AD, Achan J, Adoch W, Wabinga H. From their own perspectives: a qualitative study exploring the perceptions of traditional health practitioners in northern Uganda regarding cancers, their causes and treatments. BMC FAMILY PRACTICE 2021; 22:155. [PMID: 34275446 PMCID: PMC8287672 DOI: 10.1186/s12875-021-01505-w] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 02/13/2021] [Accepted: 07/01/2021] [Indexed: 12/13/2022]
Abstract
Background Many cancer patients in the low- and middle-income countries seek care with traditional health practitioners (THPs) and use traditional and complementary medicines (T&CMs) for treatment of cancers. Little is known about the perceptions and influence of THPs on cancer patients’ help-seeking and treatment decisions. We aimed to explore perceptions of THPs regarding cancers, cancer causes, and preferred treatments for cancers, in order to identify aspects that can inform interventions to improve cancer outcomes in Uganda. Methods We conducted this ethnographic study in northern Uganda. In-depth interviews were conducted at the respondents’ homes in quiet, open places, and in the absence of none- respondents. Interviews were audio-recorded and transcribed verbatim within a week of the interviews. Thematic qualitative analysis approaches were used to identify themes and subthemes. Results We included 21 respondents in the study; most were male (16/21), married, with median age of 59 years (range 39 – 80). Most respondents perceived cancer as a new and challenging disease, while one respondent thought of cancer as a result of an imbalance within the body. Most confessed unawareness of the causes of cancers, but believed that cancer could result from the interplay of a number of factors including poor diets, ingestions of chemical agents, and assaults by the spirits of the dead. Some reported that cancers (especially of women’s genital tracts) were sexually transmitted, or caused by accumulation of dirt. Only few healers treated cancers. Most respondents reported that they referred cancer patients to biomedical facilities, sometimes after they have first used their medicines. Most respondents hoped that collaborative research with scientists could help them identify potent T&CMs that cure cancers. Conclusion Traditional health practitioners require training on cancer causes, symptoms and signs, and the necessity for prompt initiation of effective treatments in order to improve cancer outcomes. The predisposition of the majority of respondents to refer cancer patients to biomedical services sets a fertile ground for meaningful cooperation between biomedical and traditional health practices. The national health system in the low- and middle-income countries could formally recognize traditional health practices as a component of the national healthcare system, and encourage the two to practice side by side. Supplementary Information The online version contains supplementary material available at 10.1186/s12875-021-01505-w.
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Affiliation(s)
- Amos Deogratius Mwaka
- Department of Medicine, School of Medicine, College of Health Sciences, Makerere University, P.O Box 7072, Kampala, Uganda.
| | - Jennifer Achan
- School of Public Health, College of Health Sciences, Makerere University, Kampala, Uganda
| | - Winnie Adoch
- School of Public Health, College of Health Sciences, Makerere University, Kampala, Uganda
| | - Henry Wabinga
- Kampala Cancer Registry, Department of Pathology, School of Biomedical Sciences, Makerere University, Kampala, Uganda
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15
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Brubacher LJ, Berrang-Ford L, Clark S, Patterson K, Lwasa S, Namanya DB, Twesigomwe S, Harper SL. 'We don't use the same ways to treat the illness:' A qualitative study of heterogeneity in health-seeking behaviour for acute gastrointestinal illness among the Ugandan Batwa. Glob Public Health 2021; 17:1757-1772. [PMID: 34097579 DOI: 10.1080/17441692.2021.1937273] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
The Batwa (Twa), an Indigenous People of southwest Uganda, were evicted from their ancestral forest lands in 1991 due to establishment of the Bwindi Impenetrable Forest. This land dispossession forced Batwa to transition from a semi-nomadic, hunting-gathering livelihood to an agricultural livelihood; eliminated access to Indigenous food, medicines, and shelter; and shifted their healthcare options. Therefore, this exploratory study investigated why Batwa choose Indigenous or biomedical treatment, or no treatment, when experiencing acute gastrointestinal illness. Ten gender-stratified focus groups were conducted in five Batwa settlements in Kanungu District, Uganda (n = 63 participants), alongside eleven semi-structured interviews (2014). Qualitative data were analysed thematically, using a constant comparative method. Batwa emphasised that health-seeking behaviour for acute gastrointestinal illness was diverse: some Batwa used only Indigenous or biomedical healthcare, while others preferred a combination, or no healthcare. Physical and economic access to care, and also perceived efficacy and quality of care, influenced their healthcare decisions. This study provides insight into the Kanungu District Batwa's perceptions of biomedical and Indigenous healthcare, and barriers they experience to accessing either. This study is intended to inform public health interventions to reduce their burden of acute gastrointestinal illness and ensure adequate healthcare, biomedical or Indigenous, for Batwa.
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Affiliation(s)
| | | | - Sierra Clark
- Department of Epidemiology and Biostatistics, Imperial College London, London, UK
| | - Kaitlin Patterson
- Department of Population Medicine, University of Guelph, Guelph, Canada
| | - Shuaib Lwasa
- Department of Geography, Makerere University, Kampala, Uganda
| | - Didacus B Namanya
- Ugandan Ministry of Health, Kampala, Uganda.,Faculty of Health Sciences, Uganda Martyrs University, Kampala, Uganda
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- School of Public Health, University of Alberta, Edmonton, Canada
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16
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Mostafavi F, Alavijeh FZ, Salahshouri A, Mahaki B. The psychosocial barriers to medication adherence of patients with type 2 diabetes: a qualitative study. Biopsychosoc Med 2021; 15:1. [PMID: 33461565 PMCID: PMC7812642 DOI: 10.1186/s13030-020-00202-x] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/04/2020] [Accepted: 11/11/2020] [Indexed: 11/25/2022] Open
Abstract
Background The adherence of diabetic patients to their medication regimen is associated with many psychosocial factors that are still unknown. Therefore, the present study aims to identify the psychosocial barriers to medication adherence of patients with type2 diabetes (T2D). Methodology This descriptive qualitative study was done in Isfahan, Iran by conducting in-depth unstructured interviews with 23 purposively selected patients with T2D and 10 healthcare providers (HCPs). The participants were interviewed face-to-face between November 2017 and June 2018 at the patient’s home, a Health Care Center, or at the diabetes clinic. Data analysis was performed using MAXQDA-10 software and the conventional content analysis. Results The analysis of the data led to six categories of perceived psychosocial barriers: 1) fear, concern and distress, 2) exhaustion and burnout, 3) the children’s issues being the priority, 4) poor financial support, 5) communication challenges, and 6) poor work conditions. Conclusions This study identified some of the psychosocial barriers to medication adherence of patients with T2D, which will be of great help to researchers and HCPs in designing and implementing effective interventions to overcome these barriers and change patient self-care behaviors and increase their medication adherence.
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Affiliation(s)
- Firoozeh Mostafavi
- Department of Health Education and Promotion, School of Health, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Fereshteh Zamani Alavijeh
- Department of Health Education and Promotion, School of Health, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Arash Salahshouri
- Department of Health Education and Promotion, School of Health, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, 61357 - 15751, Iran.
| | - Behzad Mahaki
- Department of Biostatistics, School of Health, Kermanshah University of Medical Sciences, Kermanshah, Iran
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17
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Stein E, Pulle J, Zimmerman M, Otim I, Atala J, Rwebembera J, Oyella LM, Harik N, Okello E, Sable C, Beaton A. Previous Traditional Medicine Use for Sore Throat among Children Evaluated for Rheumatic Fever in Northern Uganda. Am J Trop Med Hyg 2020; 104:842-847. [PMID: 33319727 PMCID: PMC7941849 DOI: 10.4269/ajtmh.20-0288] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2020] [Accepted: 11/01/2020] [Indexed: 11/07/2022] Open
Abstract
Timely diagnosis of group A streptococcal (GAS) sore throat coupled with appropriate antibiotic treatment is necessary to prevent serious post-streptococcal complications, including rheumatic fever (RF) and rheumatic heart disease (RHD). Traditional medicine (TM) is a known common adjunct to formal medical care in sub-Saharan Africa. A better understanding of health-seeking behavior for sore throat both within and outside the formal medical system is critical to improving primary prevention efforts of RF and RHD. A prospective mixed-methods study on the use of TM for sore throat was embedded within a larger epidemiological study of RF in Northern Uganda. Children presenting with symptoms of RF were interviewed about recent TM use as well as health services use for sore throat. One hundred children with a median age of 10 years (interquartile range: 6.8-13 years) completed the TM interview with their parent/guardian as part of a research study of RF. Seventeen, or 17%, accessed a TM provider for sore throat as part of the current illness, and 70% accessed TM for sore throat in the past (73% current or past use). Of the 20 parents who witnessed the TM visit, 100% reported use of crude tonsillectomy. Penicillin was the most frequently prescribed medication by TM providers in 52% of participants who were seen by a TM provider. The use of TM among children presenting with symptoms of sore throat in northern Uganda is common and frequently used in tandem with diagnostic services offered through the formal healthcare system. Engagement with TM practitioners may provide an important avenue for designing effective primary prevention and management strategies of RF and reduce the global burden of RHD.
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Affiliation(s)
- Elizabeth Stein
- University of Washington School of Medicine, Seattle, Washington
- Children’s National Heart Institute, Children’s National Hospital, Washington, District of Columbia
| | - Jafesi Pulle
- Uganda Heart Institute, Mulago National Referral Hospital, Kampala, Uganda
| | | | - Isaac Otim
- Uganda Heart Institute, Mulago National Referral Hospital, Kampala, Uganda
| | - Jenifer Atala
- Uganda Heart Institute, Mulago National Referral Hospital, Kampala, Uganda
| | - Joselyn Rwebembera
- Uganda Heart Institute, Mulago National Referral Hospital, Kampala, Uganda
| | - Linda Mary Oyella
- Uganda Heart Institute, Mulago National Referral Hospital, Kampala, Uganda
| | - Nada Harik
- Division of Infectious Diseases, Children’s National Hospital, Washington, District of Columbia
| | - Emmy Okello
- Uganda Heart Institute, Mulago National Referral Hospital, Kampala, Uganda
| | - Craig Sable
- Children’s National Heart Institute, Children’s National Hospital, Washington, District of Columbia
| | - Andrea Beaton
- Cincinnati Children’s Hospital Medical Center, University of Cincinnati Medical School, Cincinnati, Ohio
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18
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Bavuma CM, Musafiri S, Rutayisire PC, Ng'ang'a LM, McQuillan R, Wild SH. Socio-demographic and clinical characteristics of diabetes mellitus in rural Rwanda: time to contextualize the interventions? A cross-sectional study. BMC Endocr Disord 2020; 20:180. [PMID: 33302939 PMCID: PMC7731466 DOI: 10.1186/s12902-020-00660-y] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/04/2019] [Accepted: 11/30/2020] [Indexed: 01/03/2023] Open
Abstract
BACKGROUND Existing prevention and treatment strategies target the classic types of diabetes yet this approach might not always be appropriate in some settings where atypical phenotypes exist. This study aims to assess the socio-demographic and clinical characteristics of people with diabetes in rural Rwanda compared to those of urban dwellers. METHODS A cross-sectional, clinic-based study was conducted in which individuals with diabetes mellitus were consecutively recruited from April 2015 to April 2016. Demographic and clinical data were collected from patient interviews, medical files and physical examinations. Chi-square tests and T-tests were used to compare proportions and means between rural and urban residents. RESULTS A total of 472 participants were recruited (mean age 40.2 ± 19.1 years), including 295 women and 315 rural residents. Compared to urban residents, rural residents had lower levels of education, were more likely to be employed in low-income work and to have limited access to running water and electricity. Diabetes was diagnosed at a younger age in rural residents (mean ± SD 32 ± 18 vs 41 ± 17 years; p < 0.001). Physical inactivity, family history of diabetes and obesity were significantly less prevalent in rural than in urban individuals (44% vs 66, 14.9% vs 28.7 and 27.6% vs 54.1%, respectively; p < 0.001). The frequency of fruit and vegetable consumption was lower in rural than in urban participants. High waist circumference was more prevalent in urban than in rural women and men (75.3% vs 45.5 and 30% vs 6%, respectively; p < 0.001). History of childhood under-nutrition was more frequent in rural than in urban individuals (22.5% vs 6.4%; p < 0.001). CONCLUSIONS Characteristics of people with diabetes in rural Rwanda appear to differ from those of individuals with diabetes in urban settings, suggesting that sub-types of diabetes exist in Rwanda. Generic guidelines for diabetes prevention and management may not be appropriate in different populations.
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Affiliation(s)
- Charlotte M Bavuma
- School of Medicine and Pharmacy, College of Medicine and Health Sciences, University of Rwanda, Kigali, Rwanda.
| | - Sanctus Musafiri
- School of Medicine and Pharmacy, College of Medicine and Health Sciences, University of Rwanda, Kigali, Rwanda
| | | | | | - Ruth McQuillan
- School of Medicine and Pharmacy, College of Medicine and Health Sciences, University of Rwanda, Kigali, Rwanda
- Usher Institute, University of Edinburgh, Edinburgh, UK
| | - Sarah H Wild
- School of Medicine and Pharmacy, College of Medicine and Health Sciences, University of Rwanda, Kigali, Rwanda
- Usher Institute, University of Edinburgh, Edinburgh, UK
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19
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Guo J, Low KS, Mei L, Li JH, Qu W, Guan G. Use of traditional medicine for dental care by different ethnic groups in New Zealand. BMC Oral Health 2020; 20:280. [PMID: 33046025 PMCID: PMC7552356 DOI: 10.1186/s12903-020-01272-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2020] [Accepted: 10/05/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND There is an increasing public interest in the use of TM internationally, yet there is a paucity of research on the use of TM by the public in the dental setting. This study aimed to explore the views, use of and access to TM in dentistry among different ethnic groups residing in New Zealand. METHODS Qualitative study and in-depth interviews were used. An individual semi-structured questionnaire was used to collect data. Interviews were recorded, transcribed, and analysed using an inductive approach to identify the main themes. RESULTS Three main themes were extracted from interviews with 14 participants from diverse cultural backgrounds: [1] the perspectives of TM varied among different ethnic groups and included the involvement of spirituality, the environment, knowledge and usage of TM. [2] The TM that was used by different ethnic groups included plants, herbs, massage, and other forms of healing. Reasons for choosing traditional or western medicines generally included family tradition, access to TM, and finding a competent traditional healer. [3] The barriers in accessing TM included the paucity of traditional healers, difficulty accessing plants and cost, therefore most would look for a substitution or alternative treatment. CONCLUSION Even though the access to these TM in New Zealand was a challenge for the majority of the participants, they are still considered the first-line treatment for the majority. This study provided dental practitioners an insight into the different sort of TM used by the population. By understanding and acknowledging the use of TM, dental practitioners could create a supportive environment for patients to disclose their use of TM and allow them to educate patients on the use of TM.
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Affiliation(s)
- Jun Guo
- Department of Stomatology, Sichuan Academy of Medical Sciences and Sichuan Provincial People's Hospital, 32# West Section 2, 1st Ring Road, Chengdu, 610072, China
| | - Kah Seng Low
- Department of Oral Sciences, Sir John Walsh Research Institute, Faculty of Dentistry, University of Otago, Dunedin, New Zealand
| | - Li Mei
- Department of Oral Sciences, Sir John Walsh Research Institute, Faculty of Dentistry, University of Otago, Dunedin, New Zealand.
| | - Jia Hui Li
- School of Pharmacy, University of Otago, Dunedin, New Zealand
| | - Wenwen Qu
- Department of Gynaecology, West China Second University Hospital, Sichuan University, Chengdu, 610041, China
| | - Guangzhao Guan
- Department of Oral Diagnostic and Surgical Sciences, Faculty of Dentistry, University of Otago, 310 Great King Street, Dunedin, 9016, New Zealand.
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Langat S, Njuguna F, Kaspers G, Mostert S. Health insurance coverage for vulnerable children: two HIV orphans with Burkitt lymphoma and their quest for health insurance coverage in Kenya. BMJ Case Rep 2020; 13:13/8/e230508. [PMID: 32843443 DOI: 10.1136/bcr-2019-230508] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
The United Nations and WHO have summoned governments from low-income and middle-income countries to institute universal health coverage and thereby improve their population's healthcare access and outcomes. Until now, few countries responded favourably to this international plea. The HIV/AIDS epidemic, a major global public health challenge, resulted in over 11 million orphans in sub-Saharan Africa. Extended families have taken responsibility for more than 90% of these children. HIV orphans are likely to be poorer and less healthy. Burkitt lymphoma is the most common childhood cancer in sub-Saharan Africa. If orphans need lifesaving chemotherapy, appointing legal guardians becomes necessary to access health insurance. However, rules and regulations involved may be unclear and costly. This hinders its access for poor families who need it most. Uninsured children risk hospital detention over unpaid medical bills and have lower survival. Our case report depicts the quest for health insurance coverage of two HIV orphans with Burkitt lymphoma in Kenya.
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Affiliation(s)
- Sandra Langat
- Department of Pediatrics, Moi Teaching and Referral Hospital, Eldoret, Kenya
| | - Festus Njuguna
- Department of Pediatrics, Moi Teaching and Referral Hospital, Eldoret, Kenya
| | - Gertjan Kaspers
- Department of Pediatric Oncology-Hematology, Amsterdam University Medical Center, Amsterdam, The Netherlands.,Princess Máxima Center for Pediatric Oncology, Utrecht, The Netherlands
| | - Saskia Mostert
- Department of Pediatric Oncology-Hematology, Amsterdam University Medical Center, Amsterdam, The Netherlands .,Princess Máxima Center for Pediatric Oncology, Utrecht, The Netherlands
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21
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Arentz S, Hunter J, Deed G. Integrating Traditional and Complementary Medicine Recommendations into Clinical Practice Guidelines for People with Diabetes in Need of Palliative and End-of-Life Care: A Scoping Review. J Altern Complement Med 2020; 26:571-591. [PMID: 32673080 DOI: 10.1089/acm.2020.0028] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
Abstract
Objectives: This study was conducted before an evidence review on Traditional and Complementary Medicine (TCM) to update the clinical practice guidelines (CPGs): "Deciding palliative and end-of-life (P/EoL) care for people with diabetes." The aim was to frame the PICO (population/problems, interventions/comparisons, and outcomes), ascertain their importance, and identify other modifying factors for grading recommendations. Design: A systematic scoping review mapped information about diabetes P/EoL problems and outcomes, TCM use, provision, benefits and risks, and stakeholder preferences and values. Thirteen electronic databases were searched in 2017/18 until no new information was identified. Relevant data were extracted, rated for quality, directness, and relevance, and synthesized using triangulation methods. Excluded was diabetes prevention or treatment, as this is not an important P/EoL problem. Results: Of the 228 included articles, except for diabetes P/EoL problems, insufficient direct evidence led to data being extrapolated from either adults with diabetes or any P/EoL diagnosis. The findings affirmed that caring for people with diabetes in need of P/EoL care is complex due to multiple fluctuating needs that are influenced by the P/EoL trajectories (stable, unstable, deteriorating, terminal, or bereaved), multimorbidity, and difficult-to-manage chronic and acute problems. The only problem specific to diabetes P/EoL care, was unstable glycemia. Over 50 TCM interventions commonly used by patients and/or provided by services were identified, of which, many might simultaneously address multiple problems and 18 had been appraised in systematic reviews. Physical and psychologic symptom reliefs were most often evaluated; however, these were only one aspect of a "good death." Other important outcomes were the quality and location of care, personal agency, relationships, preparations for the dying process, spirituality, and affirmation of the whole person. Other important modifying factors included opportunity costs, affordability, availability, preferences, cultural appropriateness, and alignment with beliefs about the meaning of illness and death. Conclusions: There is a role for TCM in the multidisciplinary holistic P/EoL care of people with diabetes. Due to the paucity of evidence specific to this population, the generalizability of some of these results is broader and the updated CPG will also need to consider indirect evidence from other patient groups. Along with recommendations about indications for TCM use, the CGP should provide guidance on ceasing unnecessary interventions, reducing polypharmacy and managing unstable glycemia is required. Before ceasing a TCM, a broader risk-benefit analysis is recommended, as unlike many conventional therapies, there may be multiple benefits warranting its continuation.
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Affiliation(s)
- Susan Arentz
- NICM Health Research Institute, Western Sydney University, Penrith, Australia
| | - Jennifer Hunter
- NICM Health Research Institute, Western Sydney University, Penrith, Australia
| | - Gary Deed
- Metabolism Ageing Genomics, School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
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Tusubira AK, Akiteng AR, Nakirya BD, Nalwoga R, Ssinabulya I, Nalwadda CK, Schwartz JI. Accessing medicines for non-communicable diseases: Patients and health care workers' experiences at public and private health facilities in Uganda. PLoS One 2020; 15:e0235696. [PMID: 32634164 PMCID: PMC7340292 DOI: 10.1371/journal.pone.0235696] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2020] [Accepted: 06/20/2020] [Indexed: 12/15/2022] Open
Abstract
Background Non-communicable diseases (NCDs) are increasingly prevalent in low- and middle-income countries. Successful management requires consistent access to appropriate medicines. Availability of NCD medicines is generally low, especially in the public sector, however, little is known about other factors affecting access. We explored barriers and facilitators of access to medicines for diabetes and hypertension at public and private health facilities in Uganda. Methods We conducted a qualitative descriptive study at six public hospitals and five private health facilities in different regions of Uganda. Data collection included 36 in-depth interviews and 14 focus group discussions (n = 128) among purposively selected adult outpatients with diabetes and/or hypertension and 26 key informant interviews with healthcare workers and patient association leaders. Transcripts were coded and emerging themes identified using the Framework method. Results Four main themes emerged: Stocking of medicines and supplies, Financial factors, Individual behaviour and attitudes, and Service delivery at health facilities. Stocking of medicines and supplies mainly presented barriers to access at public facilities including frequent stockouts, failure to stock certain medicines and low quality brands often rejected by patients. Financial factors, especially high cost of medicines and limited insurance coverage, were barriers in private facilities. Free service provision was a facilitator at public facilities. Patients’ confusion resulting from mixed messages and their preference for herbal treatments were cross-sector barriers. While flexibility in NCD service provision was a facilitator at private facilities, provider burnout and limited operating hours were barriers in public facilities. Patient-driven associations exist at some public facilities and help mitigate inadequate medicine stock. Conclusion Access to NCD medicines in Uganda is influenced by both health system and patient factors. Some factors are sector-specific, while others cross-cutting between public and private sectors. Due to commonalities in barriers, potential strategies for overcoming them may include patient-driven associations, public-private partnerships, and multi-modal health education platforms.
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Affiliation(s)
- Andrew K. Tusubira
- Uganda Initiative for Integrated Management of Non-Communicable Diseases, Kampala, Uganda
- * E-mail:
| | - Ann R. Akiteng
- Uganda Initiative for Integrated Management of Non-Communicable Diseases, Kampala, Uganda
| | - Brenda D. Nakirya
- Uganda Initiative for Integrated Management of Non-Communicable Diseases, Kampala, Uganda
| | - Ritah Nalwoga
- Uganda Initiative for Integrated Management of Non-Communicable Diseases, Kampala, Uganda
| | - Isaac Ssinabulya
- Uganda Initiative for Integrated Management of Non-Communicable Diseases, Kampala, Uganda
- Uganda Heart Institute, Mulago National Referral Hospital, Kampala, Uganda
- Department of Medicine, Makerere University College of Health Sciences, Kampala, Uganda
| | - Christine K. Nalwadda
- Uganda Initiative for Integrated Management of Non-Communicable Diseases, Kampala, Uganda
- Department of Community Health and Behavioural Sciences, School of Public Health, College of Health Sciences Makerere University, Kampala, Uganda
| | - Jeremy I. Schwartz
- Uganda Initiative for Integrated Management of Non-Communicable Diseases, Kampala, Uganda
- Section of General Internal Medicine, Yale University School of Medicine, New Haven, CT, United States of America
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Tariq A, Sadia S, Fan Y, Ali S, Amber R, Mussarat S, Ahmad M, Murad W, Zafar M, Adnan M. Herbal medicines used to treat diabetes in Southern regions of Pakistan and their pharmacological evidence. J Herb Med 2020. [DOI: 10.1016/j.hermed.2019.100323] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
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Mwaka AD, Abbo C, Kinengyere AA. Traditional and Complementary Medicine Use Among Adult Cancer Patients Undergoing Conventional Treatment in Sub-Saharan Africa: A Scoping Review on the Use, Safety and Risks. Cancer Manag Res 2020; 12:3699-3712. [PMID: 32547206 PMCID: PMC7246319 DOI: 10.2147/cmar.s251975] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/29/2020] [Accepted: 04/29/2020] [Indexed: 12/30/2022] Open
Abstract
Background Use of traditional and complementary medicine (T&CM) is very common among patients in sub-Saharan Africa (SSA). However, there are limited data on concurrent use of T&CM with conventional cancer therapies. In this scoping review, we sought to describe the (i) prevalence of use, (ii) types of medicine, (iii) reasons for taking T&CM, (iv) current knowledge on safety and risks, (v) characteristics of adult cancer patients who use T&CM, and (vi) perceived treatment outcomes among cancer patients undergoing conventional cancer treatment in SSA. Methods We conducted a systematic literature search for articles published in the English language in three scientific databases (PubMed, Embase and Web of Science). We used a scoping review approach to map relevant literature on T&CM use among cancer patients undergoing conventional cancer treatments. We assessed 96 articles based on titles and abstracts, and 23 articles based on full text. Twelve articles fulfilled preset eligibility criteria. Results More than half of the included articles were from only two countries in SSA: Nigeria and Uganda. Median prevalence of use of T&CM was 60.0% (range: 14.1-79.0%). Median percent disclosure of use of T&CM to attending healthcare professionals was low at 32% (range: 15.3-85.7%). The most common reasons for non-disclosure were: the doctor did not ask, the doctor would rebuke them for using T&CM, and the doctors do not know much about T&CM and so there is no need to share the issue of use with them. T&CM used by cancer patients included herbs, healing prayers and massage. Reported reasons for use of T&CM in 8 of 12 articles included the wish to get rid of cancer symptoms, especially pain, cure cancer, improve physical and psychological well-being, treat toxicity of conventional cancer therapies and improve immunity. There were limited data on safety and risk profiles of T&CM among cancer patients in SSA. Conclusion Use of traditional and complementary medicines is common among cancer patients undergoing conventional cancer treatments. Healthcare professionals caring for cancer patients ought to inquire and communicate effectively regarding the use of T&CM in order to minimize the risks of side effects from concurrent use of T&CM and biomedicines.
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Affiliation(s)
- Amos Deogratius Mwaka
- Department of Medicine, School of Medicine, College of Health Sciences, Makerere University, Kampala, Uganda
| | - Catherine Abbo
- Department of Psychiatry, School of Medicine, College of Health Sciences, Makerere University, Kampala, Uganda
| | - Alison Annet Kinengyere
- Albert Cook Medical Library, College of Health Sciences, Makerere University, Kampala, Uganda
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James PB, Wardle J, Steel A, Adams J. Ebola survivors' healthcare-seeking experiences and preferences of conventional, complementary and traditional medicine use: A qualitative exploratory study in Sierra Leone. Complement Ther Clin Pract 2020; 39:101127. [PMID: 32379665 DOI: 10.1016/j.ctcp.2020.101127] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2019] [Revised: 02/27/2020] [Accepted: 02/28/2020] [Indexed: 12/13/2022]
Abstract
BACKGROUND and Purpose: This study explores Ebola survivors' healthcare-seeking experiences within the context of Sierra Leone's free healthcare initiative (FHCI) and comprehensive package for Ebola survivors (CPES) program while also exploring the enablers and barriers to their use of informal healthcare. MATERIALS AND METHODS We employed an inductive, exploratory qualitative approach using focus group discussion with 41 adults Ebola survivors in the four administrative regions of Sierra Leone. RESULTS Biomedical care was the first choice of treatment option for most survivors immediately following post-ETC discharge. Survivors' healthcare-seeking experience varies before and after their inclusion into FHCI and the establishment of the CPES program. Personal and health system factors influenced survivors' decision to seek multiple healthcare approaches, especially T&CM. CONCLUSION Our findings suggest the determinants of Ebola survivors' healthcare-seeking experiences should be considered when developing and implementing programs aimed at improving the current health status of Ebola survivors in Sierra Leone.
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Affiliation(s)
- Peter Bai James
- Australian Research Centre in Complementary and Integrative Medicine, Faculty of Health, University of Technology Sydney, Ultimo, NSW, 2007, Sydney, Australia; Faculty of Pharmaceutical Sciences, College of Medicine and Allied Health Sciences, University of Sierra Leone, Sierra Leone.
| | - Jon Wardle
- Australian Research Centre in Complementary and Integrative Medicine, Faculty of Health, University of Technology Sydney, Ultimo, NSW, 2007, Sydney, Australia; National Centre for Naturopathic Medicine, Southern Cross University, Lismore, NSW, 2480, Australia
| | - Amie Steel
- Australian Research Centre in Complementary and Integrative Medicine, Faculty of Health, University of Technology Sydney, Ultimo, NSW, 2007, Sydney, Australia
| | - Jon Adams
- Australian Research Centre in Complementary and Integrative Medicine, Faculty of Health, University of Technology Sydney, Ultimo, NSW, 2007, Sydney, Australia
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Rutebemberwa E, Ssemugabo C, Tweheyo R, Turyagaruka J, Pariyo GW. Biomedical drugs and traditional treatment in care seeking pathways for adults with epilepsy in Masindi district, Western Uganda: a household survey. BMC Health Serv Res 2020; 20:17. [PMID: 31907036 PMCID: PMC6945646 DOI: 10.1186/s12913-019-4879-2] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2019] [Accepted: 12/27/2019] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND Many patients with epilepsy in sub-Saharan Africa do not receive adequate treatment. The purpose of the study was to identify the health care providers where patients with epilepsy sought care and what treatment they received. METHODS A cross sectional study was conducted across 87 out of 312 villages in Masindi district. A total of 305 households having patients with epilepsy were surveyed using an interviewer administered questionnaire. Data was entered and analysed in Epi-info ver 7 for univariate and bivariate analysis, and in Stata SE ver 15.0 for multivariable analysis. Sequences of health providers consulted in care seeking, rationale and drugs used, and factors associated with choice of provider were assessed. RESULTS A total of 139 out of 305 (45.6%) households offered some treatment regimen at home when patients got symptoms of epilepsy with 44.6% (62/139) giving herbs and 18.0% (25/139) offering prayers. Eight different types of providers were consulted as first contact providers for treatment of epilepsy. Health centres received the highest percentage 35.4% (108/305) followed by hospitals 20.9% (64/305). A total of 192 of 305 (63.0%) households received anti-epileptic drugs, 13.1% (40/305) received prayers and 21.6% (66/305) received herbs at the first contact care seeking. Compared to a health centre as the first choice provider, other facilities more significantly visited were; hospitals if they were perceived as nearer (adj. Coeff 2.16, 95%CI 0.74, 3.59, p = 0.003), churches / mosques if cure for epilepsy was expected (adj. Coeff 1.91, 95%CI 0.38, 3.48, p = 0.014), and traditional healer for those aged ≥46 years (adj. Coeff 5.83, 95%CI 0.67, 10.99, p = 0.027), and friends/neighbour for traders (adj. Coeff 2.87, 95%CI 0.71, 5.04, p = 0.009). CONCLUSION Patients with epilepsy seek treatment from multiple providers with the public sector attending to the biggest proportion of patients. Engaging the private sector and community health workers, conducting community outreaches and community sensitization with messages tailored for audiences including the young, older epileptics, traditional healers as stakeholders, and traders could increase access to appropriate treatment for epilepsy.
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Affiliation(s)
- Elizeus Rutebemberwa
- Department of Health Policy, Planning and Management, Makerere University School of Public Health, Kampala, Uganda. .,African Centre for Health and Environmental Studies, Kampala, Uganda.
| | - Charles Ssemugabo
- Department of Disease Control and Environmental Sciences, Makerere University School of Public Health, Kampala, Uganda
| | - Raymond Tweheyo
- Department of Health Policy, Planning and Management, Makerere University School of Public Health, Kampala, Uganda.,Department of Public Health, Lira University, Lira, Uganda
| | - John Turyagaruka
- District Health Office, Masindi District Local Government, Masindi, Uganda
| | - George William Pariyo
- Johns Hopkins Bloomberg School of Public Health, Department of International Health, Baltimore, MD, USA
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Alsawalha M, Al-Subaie AM, Al-Jindan RY, Bolla SR, Balakrishna JP, Ravi PK, Gollapalli SSR, Veeraraghavan VP, Pillai AA, Joseph JP, Mohan SK. Effect of Litsea lancifolia Leaf Extract on Glucose Transporter 4 Translocation and Glucose Uptake in 3T3L1 Cell Line. J Pharm Bioallied Sci 2019; 11:240-247. [PMID: 31555030 PMCID: PMC6662047 DOI: 10.4103/jpbs.jpbs_53_19] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Background: Numerous synthetic drugs have been recommended as a remedy for diabetes, but their role in hypoglycemic effects are diverse. The side effects associated with these drugs due to their extended use led scientists to find unconventional medicines with no or little side effects. Aim: This study was aimed at assessment of in vitro antidiabetic activities of methanolic extract of Litsea lancifolia leaves by using 3T3L1 cell line. Materials and Methods: The cytotoxic effect of the leaf extract was determined by 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide (MTT) assay. The glucose uptake–inducing capabilities and its correlation with glucose transporter 4 (GLUT4) translocation were measured by flow cytometry in 3T3L1 cells. In addition, the inhibitory effect of L. lancifolia leaf extract on α-amylase activity and α-glucosidase activity was determined by colorimetric methods. Results: Different concentrations of L. lancifolia leaf extract did not show any toxicity on 3T3L1 cells, after the treatment for 24h. On stimulation with leaf extract, 60.22% and 86.26% of 3T3L1 cells showed glucose uptake and GLUT4 expression, respectively. The colorimetric assays showed that the methanolic leaf extract of L. lancifolia has a significant inhibitory effect on the activity of α-amylase enzyme and α-glucosidase enzyme with inhibitory concentration (IC50) value of 248.65 µg/mL and 229.61 µg/mL, respectively. Conclusion: On the basis of the results of this study, it is evident that L. lancifolia leaf extract showed promising anti-diabetic effect when compared to the standard drugs metformin and acarbose and was nontoxic to 3T3L1 cells. Thus, it can be further investigated to recommend as a possible alternative treatment in antidiabetic applications.
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Affiliation(s)
- Murad Alsawalha
- Department of Chemical and Process Engineering Technology, Jubail Industrial College (JIC), P.O.Box 10099, Jubail Industrial City 31961, Kingdom of Saudi Arabia
| | - Abeer Mohammed Al-Subaie
- Department of Clinical Laboratory Sciences, College of Applied Medical Sciences, Imam Abdulrahman Bin Faisal University, P.O.Box 2435, Dammam 31441, Kingdom of Saudi Arabia
| | - Reem Yousuf Al-Jindan
- Department of Microbiology, College of Medicine, Imam Abdulrahman Bin Faisal University, P.O.Box 2114, Dammam 31451, Kingdom of Saudi Arabia
| | - Srinivasa Rao Bolla
- Department of Anatomy, College of Medicine, Imam Abdulrahman Bin Faisal University, P.O.Box 2114, Dammam 31451, Kingdom of Saudi Arabia
| | - Janardhana Papayya Balakrishna
- Department of Biotechnology, Stellixir Biotech Private Ltd, Peenya 2nd Stage Industrial Area, Bangalore-560058, Karnataka, India
| | - Padma Kanchi Ravi
- Department of Biotechnology, Sri Padmavati Mahila Visvavidyalayam, Padmvathi Nagar, Tirupati, Andhra Pradesh, India
| | - Shiva Shankar Reddy Gollapalli
- Department of Biotechnology, Stellixir Biotech Private Ltd, Peenya 2nd Stage Industrial Area, Bangalore-560058, Karnataka, India
| | - Vishnu Priya Veeraraghavan
- Department of Biochemistry, Saveetha Dental College, Saveetha Institute of Medical and Technical Sciences (SIMATS), Saveetha University, 162, P. H. Road, Velappanchavadi, Chennai - 600 077, Tamil Nadu, India
| | - Aruthra Arumugam Pillai
- Department of Biotechnology, Stellixir Biotech Private Ltd, Peenya 2nd Stage Industrial Area, Bangalore-560058, Karnataka, India
| | - Joel Palpath Joseph
- Department of Biotechnology, Stellixir Biotech Private Ltd, Peenya 2nd Stage Industrial Area, Bangalore-560058, Karnataka, India
| | - Surapaneni Krishna Mohan
- Department of Medical Biochemistry, College of Applied Medical Sciences in Jubail (CAMSJ), Imam Abdulrahman Bin Faisal University, P.O.Box 4030, Al Ansar Rd, Deffi, Jubail Industrial City, Al Jubail 35816, Kingdom of Saudi Arabia
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Mwaka AD, Tusabe G, Garimoi CO, Vohra S, Ibingira C. Integration of traditional and complementary medicine into medical school curricula: a survey among medical students in Makerere University, Uganda. BMJ Open 2019; 9:e030316. [PMID: 31488487 PMCID: PMC6731838 DOI: 10.1136/bmjopen-2019-030316] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
OBJECTIVE To describe the disposition and sociodemographic characteristics of medical students associated with inclusion of traditional and complementary medicine in medical school curricula in Uganda. DESIGN A cross-sectional study conducted during May 2017. A pretested questionnaire was used to collect data. Disposition to include principles of traditional and complementary medicine into medical school curricula was determined as proportion and associated factors determined through multivariate logistic regression. PARTICIPANTS AND SETTING Medical students in their second to fifth years at the College of Health Sciences, Makerere University, Uganda. Makerere University is the oldest public university in the East African region. RESULTS 393 of 395 participants responded. About 60% (192/325) of participants recommended inclusion of traditional and complementary medicine principles into medical school curricula in Uganda. The disposition to include traditional and complementary medicine into medical school curricula was not associated with sex, age group or region of origin of the students. However, compared with the second year students, the third (OR 0.34; 95% CI 0.17 to 0.66) and fifth (OR 0.39; 95% CI 0.16 to 0.93) year students were significantly less likely to recommend inclusion of traditional and complementary medicine into the medical school curricula. Participants who hold positive attributes and believe in effectiveness of traditional and complementary medicine were statistically significantly more likely to recommend inclusion into the medical school curricula in Uganda. CONCLUSIONS Inclusion of principles of traditional and complementary medicine into medical school curricula to increase knowledge, inform practice and research, and moderate attitudes of physicians towards traditional medicine practice is acceptable by medical students at Makerere University. These findings can inform review of medical schools' curricula in Uganda.
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Affiliation(s)
- Amos Deogratius Mwaka
- Department of Internal Medicine, Makerere University College of Health Sciences, Kampala, Uganda
| | - Gersave Tusabe
- Department of Philosophy, Makerere University College of Humanities and Social Sciences, Kampala, Uganda
| | - Christopher Orach Garimoi
- Department of Community Health and Behavioural Sciences, Makerere University College of Health Sciences, Kampala, Uganda
| | - Sunita Vohra
- Departments of Paediatrics, Medicine, and Psychiatry, University of Alberta, Edmonton, Alberta, Canada
| | - Charles Ibingira
- Department of Anatomy, Makerere University College of Health Sciences, Kampala, Uganda
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Cawich SO, Naraynsingh V, Jonallagadda R, Wilkinson C. Caribbean “substitution culture” is a barrier to effective treatment of persons with diabetic foot infections. World J Surg Proced 2019; 9:12-18. [DOI: 10.5412/wjsp.v9.i2.12] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/26/2019] [Revised: 06/15/2019] [Accepted: 07/17/2019] [Indexed: 02/06/2023] Open
Abstract
Diabetes-related amputation rates are high in the Caribbean. Many authorities have identified independent risk factors for diabetes-related amputations, but cultural factors remain underappreciated. We coined the term “Caribbean substitution culture” to describe the attitude of patients with diabetic foot infections in which they refuse to access medical care, instead voluntarily choosing to substitute “bush medicines” or other alternative therapies in the place of conventional treatment. Recognizing that the Caribbean substitution culture is a barrier to effective treatment of diabetic foot infections is the first step in curbing these practices. In this paper, we discuss the issues related to the Caribbean substitution culture, including the demographics of the population at risk, the alternative therapeutic practices and potential public health strategies to combat this practice.
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Affiliation(s)
- Shamir O Cawich
- Department of Clinical Surgical Sciences, University of the West Indies, St. Augustine, Trinidad & Tobago, West Indies
| | - Vijay Naraynsingh
- Department of Clinical Surgical Sciences, University of the West Indies, St. Augustine, Trinidad & Tobago, West Indies
| | - Ramesh Jonallagadda
- Department of Surgery, University of the West Indies, Cave Hill, Barbados, West Indies
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Cawich SO, Naraynsingh V, Jonallagadda R, Wilkinson C. Caribbean “substitution culture” is a barrier to effective treatment of persons with diabetic foot infections. World J Surg Proced 2019. [DOI: 10.5412/wjsp.v9.i2.0000] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
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Kasole R, Martin HD, Kimiywe J. Traditional Medicine and Its Role in the Management of Diabetes Mellitus: "Patients' and Herbalists' Perspectives". EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE : ECAM 2019; 2019:2835691. [PMID: 31354852 PMCID: PMC6637672 DOI: 10.1155/2019/2835691] [Citation(s) in RCA: 43] [Impact Index Per Article: 8.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/08/2019] [Revised: 05/01/2019] [Accepted: 06/17/2019] [Indexed: 11/17/2022]
Abstract
BACKGROUND Diabetes mellitus is a complicated health condition with multiple causes and many treatment options. Various myths may influence diabetics' health-seeking behavior, and they may use traditional medicines, which include normal foods and herbs, for primary health care. The aim of this study was to determine patients' and herbalists' practices and perspectives regarding the use of traditional medicines and the role of traditional medicines in the management of diabetes. METHODS AND FINDINGS We conducted a cross-sectional study with a mixed-methods design. We interviewed 140 patients attending diabetic clinics using a structured questionnaire, conducted focus group discussions with an additional 20 diabetic patients, and conducted in-depth interviews with 8 local herbalists. The majority of the diabetic participants believed that diabetes is caused by a high-carbohydrate diet. Of the 140 participants who answered the questionnaire, 67.2% reported using traditional medicines to manage their diabetes, including 58.6% who reported using both conventional medicines and traditional medicines. Some participants believed that combining conventional and traditional medicines improved the effectiveness of treatment. Reasons given for using traditional medicines included the high cost of conventional treatment and the availability and accessibility of the traditional medicines. The most commonly used traditional medicines were indigenous vegetables and medicinal plant products including amalanth leaves, hare lettuce leaves, nightshade leaves, spider plant leaves, okra pods, moringa leaves and seeds, soursop leaves, black plum back, avocado seed, and lemongrass. CONCLUSION Patients and herbalists provided a range of perspectives regarding the use of traditional medicines to treat diabetes. Further research is needed to identify bioactive compounds present in commonly used traditional medicines and their efficacy.
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Affiliation(s)
- Rose Kasole
- Department of Food Biotechnology and Nutritional Sciences, The Nelson Mandela African Institution of Science and Technology (NM-AIST), Arusha, Tanzania
- Department of Economic and Productive Sector, Iringa Regional Secretariat (RAS), P.O. Box 858, Iringa, Tanzania
| | - Haikael D. Martin
- Department of Food Biotechnology and Nutritional Sciences, The Nelson Mandela African Institution of Science and Technology (NM-AIST), Arusha, Tanzania
| | - Judith Kimiywe
- Department of Food, Nutrition and Dietetics, Kenyatta University (KU), Nairobi, Kenya
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Rutebemberwa E, Bagonza J, Tweheyo R. Pathways to diabetic care at hospitals in rural Eastern Uganda: a cross sectional study. BMC Health Serv Res 2019; 19:33. [PMID: 30642309 PMCID: PMC6332678 DOI: 10.1186/s12913-019-3873-z] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2018] [Accepted: 01/04/2019] [Indexed: 11/30/2022] Open
Abstract
Background Prompt access to appropriate treatment reduces early onset of complications to chronic illnesses. Our objective was to document the health providers that patients with diabetes in rural areas seek treatment from before reaching hospitals. Methods Patients attending diabetic clinics in two hospitals of Iganga and Bugiri in rural Eastern Uganda were asked the health providers they went to for treatment before they started attending the diabetic clinics at these hospitals. An exploratory sequential data analysis was used to evaluate the sequential pattern of the types of providers whom patients went to and how they transitioned from one type of provider to another. Results Out of 496 patients assessed, 248 (50.0%) went first to hospitals, 104 (21.0%) to private clinics, 73 (14.7%) to health centres, 44 (8.9%) to drug shops and 27 (5.4%) to other types of providers like community health workers, neighbours and traditional healers. However, a total of 295 (59.5%) went to a second provider, 99 (20.0%) to a third, 32 (6.5%) to a fourth and 15 (3.0%) to a fifth before being enrolled in the hospitals’ diabetic clinics. Although community health workers, drug shops and household neighbours were utilized by 65 (13.1%) patients for treatment first, nobody went to these as a second provider. Instead patients went to hospitals, private clinics and health centres with very few patients going to herbalists. There is no clear pathway from one type of provider to another. Conclusions Patients consult many types of providers before appropriate medical care is received. Communities need to be sensitized on seeking care early from hospitals. Health centres and private clinics need to be equipped to manage diabetes or at least diagnose it and refer patients to hospitals early enough since some patients go to these health centres first for treatment.
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Affiliation(s)
- Elizeus Rutebemberwa
- Department of Health Policy, Planning and Management, Makerere University School of Public Health, Kampala, Uganda. .,African Centre for Health and Environmental Studies, Kampala, Uganda.
| | - James Bagonza
- Department of Health Policy, Planning and Management, Makerere University School of Public Health, Kampala, Uganda.,Migration Health Department, International Organization for Migration, Freetown, Sierra Leone
| | - Raymond Tweheyo
- Department of Health Policy, Planning and Management, Makerere University School of Public Health, Kampala, Uganda.,Department of Public Health, Lira University, Lira, Uganda
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Belue R, Hammond N, Elewonibi B, Moise R, Leuenberger L, Hughes G. Traditional healers in Senegal: Characteristics and beliefs about treatment of diabetes. INTERNATIONAL JOURNAL OF NONCOMMUNICABLE DISEASES 2019. [DOI: 10.4103/jncd.jncd_3_19] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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Mwaka AD, Tusabe G, Orach Garimoi C, Vohra S. Turning a blind eye and a deaf ear to traditional and complementary medicine practice does not make it go away: a qualitative study exploring perceptions and attitudes of stakeholders towards the integration of traditional and complementary medicine into medical school curriculum in Uganda. BMC MEDICAL EDUCATION 2018; 18:310. [PMID: 30563506 PMCID: PMC6299601 DOI: 10.1186/s12909-018-1419-4] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/04/2018] [Accepted: 12/03/2018] [Indexed: 06/09/2023]
Abstract
BACKGROUND A substantial proportion of healthcare professionals have inadequate understanding of traditional and complementary medicine and often consider their use inappropriate. METHODS We conducted a qualitative study to understand the perceptions and attitudes of medical students, medical school faculty and traditional and complementary medicine practitioners. In-depth interviews and focus group discussions were used to collect data. Thematic approach was used in data analysis to identify emerging themes and sub themes. Data analysis was supported with use of Atlas.ti v6.1.1. RESULTS The majority of participants commended the inclusion of traditional and complementary medicine principles into medical school curricula. The main reasons advanced were that: patients are already using these medicines and doctors need to understand them; doctors would be more accommodating to use and not rebuke patients, thereby minimizing delays in care due to pursuit of alternative therapies; promote patient safety; foster therapeutic alliance and adherence to therapy; uphold patients' right to self-determination; lead to discovery of new drugs from traditional medicines; and set ground for regulation of practices and quality control. However, participants anticipated operational and ethical challenges that include inadequate number of faculty to teach the subject, congested curricula, increased costs in research and development to produce evidence-base data, obstruction by pharmaceutical companies, inaccessibility to and depletion of medicinal plants, and potential conflicts due to diversity in culture and values. A substantial minority of participants thought traditional medicine need not be taught in medical schools because there is lack of scientific evidence on efficacy, safety, and side effects profiles. These shortfalls could make the determination of benefits (beneficence) and harm (maleficence) difficult, as well as compromise the ability of physicians to adequately disclose benefits and harms to patients and family, thereby undermining the process of informed consent and patient autonomy. CONCLUSIONS Training medical students in principles of traditional and complementary medicine is considered reasonable, feasible, and acceptable; and could lead to improvement in health outcomes. There are anticipated challenges to implementing a hybrid medical school curricula, but these are surmountable and need not delay introducing traditional and complementary medicine principles into medical school curricula in Uganda.
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Affiliation(s)
- Amos Deogratius Mwaka
- Department of Medicine, School of Medicine, College of Health Sciences, Makerere University, P.O Box 7072, Kampala, Uganda
- Cancer Awareness and Early Detection Coalition (CAEDCO), Kampala, Uganda
| | - Gervase Tusabe
- Department of Philosophy, School of Liberal and Performing Arts, College of Humanities and Social Sciences, Makerere University, Kampala, Uganda
| | - Christopher Orach Garimoi
- Department of Community Health and Behavioural Sciences, School of Public Health, College of Health Sciences, Makerere University, Kampala, Uganda
| | - Sunita Vohra
- Departments of Paediatrics, Medicine, and Psychiatry, University of Alberta, Edmonton, Canada
- Faculty of Medicine & Dentistry, Integrative Health Institute, University of Alberta, Edmonton, Canada
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James PB, Wardle J, Steel A, Adams J. Traditional, complementary and alternative medicine use in Sub-Saharan Africa: a systematic review. BMJ Glob Health 2018; 3:e000895. [PMID: 30483405 PMCID: PMC6231111 DOI: 10.1136/bmjgh-2018-000895] [Citation(s) in RCA: 171] [Impact Index Per Article: 28.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2018] [Revised: 08/26/2018] [Accepted: 08/27/2018] [Indexed: 12/31/2022] Open
Abstract
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.
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Affiliation(s)
- Peter Bai James
- Australian Research Centre in Complementary and Integrative Medicine, Faculty of Health, University of Technology Sydney, Sydney, New South Wales, Australia
- Faculty of Pharmaceutical Sciences, College of Medicine and Allied Health Sciences, University of Sierra Leone, Freetown, Sierra Leone
| | - Jon Wardle
- Australian Research Centre in Complementary and Integrative Medicine, Faculty of Health, University of Technology Sydney, Sydney, New South Wales, Australia
| | - Amie Steel
- Australian Research Centre in Complementary and Integrative Medicine, Faculty of Health, University of Technology Sydney, Sydney, New South Wales, Australia
- Office of Research, Endeavour College of Natural Health, Brisbane, Queensland, Australia
| | - Jon Adams
- Australian Research Centre in Complementary and Integrative Medicine, Faculty of Health, University of Technology Sydney, Sydney, New South Wales, Australia
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Langmagne S, Tenkorang EY, Asampong E, Osafo J, Bingenheimer JB. Approaches to Regulating Adolescent Sexual Behavior in Ghana: Qualitative Evidence from Somanya and Adidome. ARCHIVES OF SEXUAL BEHAVIOR 2018; 47:1779-1790. [PMID: 29616424 DOI: 10.1007/s10508-018-1161-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/25/2017] [Revised: 12/27/2017] [Accepted: 01/25/2018] [Indexed: 06/08/2023]
Abstract
This article examines perceptions of why HIV infection is severe among adolescents in Somanya and less so in Adidome-two seemingly similar communities in Ghana-through analysis of the social control measures employed by these communities to regulate adolescent sexual initiation. Using focus group discussions with parents and caregivers of adolescent children, the study found that parents in Somanya and Adidome used different regulatory mechanisms to influence adolescent sexual initiation. While parents in Somanya relied largely on parental monitoring, parents in Adidome depended more on a combination of neighborhood monitoring and community barriers (informal rules) to control adolescent sexual onset. The study findings showed that contextual factors (socioeconomic and cultural) shaped the social realities of people in these two communities accounting for the differences in HIV prevalence.
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Affiliation(s)
- Susan Langmagne
- Department of Sociology, University of Saskatchewan, Saskatoon, SK, S7N 5A5, Canada.
| | - Eric Y Tenkorang
- Department of Sociology, Memorial University, St. John's, NL, Canada
| | - Emmanuel Asampong
- Department of Social and Behavioural Sciences, School of Public Health, University of Ghana, Accra, Ghana
| | - Joseph Osafo
- Department of Psychology, University of Ghana, Accra, Ghana
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Te V, Floden N, Hussain S, Brolan CE, Hill PS. What did the Go4Health policy research project contribute to the policy discourse on the sustainable development goals? A reflexive review. Global Health 2018; 14:51. [PMID: 29769100 PMCID: PMC5956956 DOI: 10.1186/s12992-018-0367-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2018] [Accepted: 05/01/2018] [Indexed: 11/10/2022] Open
Abstract
Background In 2012, the European Commission funded Go4Health—Goals and Governance for Global Health, a consortium of 13 academic research and human rights institutions from both Global North and South—to track the evolution of the Sustainable Development Goals (SDGs), and provide ongoing policy advice. This paper reviews the research outputs published between 2012 and 2016, analyzing the thematic content of the publications, and the influence on global health and development discourse through citation metrics. Findings and discussion Analysis of the 54 published papers showed 6 dominant themes related to the SDGs: the formulation process for the SDG health goal; the right to health; Universal Health Coverage; voices of marginalized peoples; global health governance; and the integration of health across the other SDGs. The papers combined advocacy---particularly for the right to health and its potential embodiment in Universal Health Coverage—with qualitative research and analysis of policy and stakeholders. Go4Health’s publications on the right to health, global health governance and the voices of marginalized peoples in relation to the SDGs represented a substantial proportion of papers published for these topics. Go4Health analysis of the right to health clarified its elements and their application to Universal Health Coverage, global health governance, financing the SDGs and access to medicines. Qualitative research identified correspondence between perceptions of marginalized peoples and right to health principles, and reluctance among multilateral organizations to explicitly represent the right to health in the goals, despite their acknowledgement of their importance. Citation metrics analysis confirmed an average of 5.5 citations per paper, with a field-weighted citation impact of 2.24 for the 43 peer reviewed publications. Citations in the academic literature and UN policy documents confirmed the impact of Go4Health on the global discourse around the SDGs, but within the Go4Health consortium there was also evidence of two epistemological frames of analysis—normative legal analysis and empirical research—that created productive synergies in unpacking the health SDG and the right to health. Conclusion The analysis offers clear evidence for the contribution of funded programmatic research—such as the Go4Health project—to the global health discourse.
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Affiliation(s)
- Vannarath Te
- School of Public Health, The University of Queensland, Herston Road, Brisbane, Australia.,National Institute of Public Health, Ministry of Health, Phnom Penh, Cambodia
| | - Nadia Floden
- School of Public Health, The University of Queensland, Herston Road, Brisbane, Australia
| | - Sameera Hussain
- School of Public Health, The University of Queensland, Herston Road, Brisbane, Australia.,Canadian Society for International Health, Ottawa, Canada.,School of Epidemiology and Public Health, University of Ottawa, Ottawa, Canada
| | - Claire E Brolan
- School of Public Health, The University of Queensland, Herston Road, Brisbane, Australia.,Dalla Lana School of Public Health, University of Toronto, Toronto, Canada
| | - Peter S Hill
- School of Public Health, The University of Queensland, Herston Road, Brisbane, Australia.
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Haenssgen MJ, Charoenboon N, Zanello G, Mayxay M, Reed-Tsochas F, Jones COH, Kosaikanont R, Praphattong P, Manohan P, Lubell Y, Newton PN, Keomany S, Wertheim HFL, Lienert J, Xayavong T, Warapikuptanun P, Khine Zaw Y, U-Thong P, Benjaroon P, Sangkham N, Wibunjak K, Chai-In P, Chailert S, Thavethanutthanawin P, Promsutt K, Thepkhamkong A, Sithongdeng N, Keovilayvanh M, Khamsoukthavong N, Phanthasomchit P, Phanthavong C, Boualaiseng S, Vongsavang S, Greer RC, Althaus T, Nedsuwan S, Intralawan D, Wangrangsimakul T, Limmathurotsakul D, Ariana P. Antibiotics and activity spaces: protocol of an exploratory study of behaviour, marginalisation and knowledge diffusion. BMJ Glob Health 2018; 3:e000621. [PMID: 29629190 PMCID: PMC5884330 DOI: 10.1136/bmjgh-2017-000621] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2017] [Revised: 02/01/2018] [Accepted: 02/14/2018] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND Antimicrobial resistance (AMR) is a global health priority. Leading UK and global strategy papers to fight AMR recognise its social and behavioural dimensions, but current policy responses to improve the popular use of antimicrobials (eg, antibiotics) are limited to education and awareness-raising campaigns. In response to conceptual, methodological and empirical weaknesses of this approach, we study people's antibiotic-related health behaviour through three research questions.RQ1: What are the manifestations and determinants of problematic antibiotic use in patients' healthcare-seeking pathways?RQ2: Will people's exposure to antibiotic awareness activities entail changed behaviours that diffuse or dissipate within a network of competing healthcare practices?RQ3: Which proxy indicators facilitate the detection of problematic antibiotic behaviours across and within communities? METHODS We apply an interdisciplinary analytical framework that draws on the public health, medical anthropology, sociology and development economics literature. Our research involves social surveys of treatment-seeking behaviour among rural dwellers in northern Thailand (Chiang Rai) and southern Lao PDR (Salavan). We sample approximately 4800 adults to produce district-level representative and social network data. Additional 60 cognitive interviews facilitate survey instrument development and data interpretation. Our survey data analysis techniques include event sequence analysis (RQ1), multilevel regression (RQ1-3), social network analysis (RQ2) and latent class analysis (RQ3). DISCUSSION Social research in AMR is nascent, but our unprecedentedly detailed data on microlevel treatment-seeking behaviour can contribute an understanding of behaviour beyond awareness and free choice, highlighting, for example, decision-making constraints, problems of marginalisation and lacking access to healthcare and competing ideas about desirable behaviour. TRIAL REGISTRATION NUMBER NCT03241316; Pre-results.
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Affiliation(s)
- Marco J Haenssgen
- Centre for Tropical Medicine and Global Health, Nuffield Department of Clinical Medicine, University of Oxford, Oxford, UK
- CABDyN Complexity Centre, Saïd Business School, University of Oxford, Oxford, UK
- Green Templeton College, University of Oxford, Oxford, UK
- Mahidol Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand
| | - Nutcha Charoenboon
- Mahidol Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand
| | - Giacomo Zanello
- School of Agriculture, Policy and Development, University of Reading, Reading, UK
| | - Mayfong Mayxay
- Lao Oxford Mahosot Wellcome Trust Research Unit (LOMWRU), Mahidol Oxford Tropical Medicine Research Unit (MORU), Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand
- Faculty of Postgraduate Studies, University of Health Sciences, Vientiane, Laos
| | - Felix Reed-Tsochas
- CABDyN Complexity Centre, Saïd Business School, University of Oxford, Oxford, UK
- Institute for New Economic Thinking, Oxford Martin School, University of Oxford, Oxford, UK
- Department of Sociology, University of Oxford, Oxford, UK
| | - Caroline O H Jones
- Centre for Tropical Medicine and Global Health, Nuffield Department of Clinical Medicine, University of Oxford, Oxford, UK
- Department of Health System and Research Ethics, KEMRI Wellcome Trust Research Programme, Kilifi, Kenya
| | - Romyen Kosaikanont
- School of Social Innovation, Mae Fah Luang University, Chiang Rai, Thailand
| | | | - Pathompong Manohan
- School of Social Innovation, Mae Fah Luang University, Chiang Rai, Thailand
| | - Yoel Lubell
- Centre for Tropical Medicine and Global Health, Nuffield Department of Clinical Medicine, University of Oxford, Oxford, UK
- Mahidol Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand
| | - Paul N Newton
- Centre for Tropical Medicine and Global Health, Nuffield Department of Clinical Medicine, University of Oxford, Oxford, UK
- Lao Oxford Mahosot Wellcome Trust Research Unit (LOMWRU), Mahidol Oxford Tropical Medicine Research Unit (MORU), Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand
| | | | - Heiman F L Wertheim
- Oxford University Clinical Research Unit (OUCRU), Ho Chi Minh City, Vietnam
- Medical Microbiology Department, Radboudumc, Nijmegen, The Netherlands
| | - Jeffrey Lienert
- CABDyN Complexity Centre, Saïd Business School, University of Oxford, Oxford, UK
- National Human Genome Research Institute, National Institutes of Health, Bethesda, Maryland, USA
| | - Thipphaphone Xayavong
- Mahidol Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand
| | - Penporn Warapikuptanun
- Mahidol Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand
| | - Yuzana Khine Zaw
- Mahidol Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand
- Department of Global Health and Development, London School of Hygiene & Tropical Medicine, London, UK
| | - Patchapoom U-Thong
- Mahidol Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand
| | - Patipat Benjaroon
- Mahidol Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand
| | - Narinnira Sangkham
- Mahidol Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand
| | - Kanokporn Wibunjak
- Mahidol Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand
| | - Poowadon Chai-In
- Mahidol Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand
| | - Sirirat Chailert
- Mahidol Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand
| | | | - Krittanon Promsutt
- Mahidol Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand
| | - Amphayvone Thepkhamkong
- Mahidol Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand
| | - Nicksan Sithongdeng
- Mahidol Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand
| | - Maipheth Keovilayvanh
- Mahidol Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand
| | - Nid Khamsoukthavong
- Mahidol Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand
| | - Phaengnitta Phanthasomchit
- Mahidol Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand
| | - Chanthasone Phanthavong
- Mahidol Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand
| | - Somsanith Boualaiseng
- Mahidol Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand
| | - Souksakhone Vongsavang
- Mahidol Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand
| | - Rachel C Greer
- Centre for Tropical Medicine and Global Health, Nuffield Department of Clinical Medicine, University of Oxford, Oxford, UK
- Mahidol Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand
| | - Thomas Althaus
- Centre for Tropical Medicine and Global Health, Nuffield Department of Clinical Medicine, University of Oxford, Oxford, UK
- Mahidol Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand
| | - Supalert Nedsuwan
- Primary Care Department, Chiangrai Prachanukroh Hospital, Chiang Rai, Thailand
| | - Daranee Intralawan
- Primary Care Department, Chiangrai Prachanukroh Hospital, Chiang Rai, Thailand
| | - Tri Wangrangsimakul
- Centre for Tropical Medicine and Global Health, Nuffield Department of Clinical Medicine, University of Oxford, Oxford, UK
- Mahidol Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand
| | - Direk Limmathurotsakul
- Mahidol Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand
| | - Proochista Ariana
- Centre for Tropical Medicine and Global Health, Nuffield Department of Clinical Medicine, University of Oxford, Oxford, UK
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Ezeani C, Ezenyi I, Okoye T, Okoli C. Ocimum basilicum extract exhibits antidiabetic effects via inhibition of hepatic glucose mobilization and carbohydrate metabolizing enzymes. JOURNAL OF COMPLEMENTARY MEDICINE RESEARCH 2017; 6:22-28. [PMID: 28163956 PMCID: PMC5289084 DOI: 10.5455/jice.20161229054825] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2016] [Indexed: 12/25/2022]
Abstract
Aim: Ocimum basilicum L (Lamiaceae) is used as a traditional remedy for different ailments, including diabetes mellitus. This study investigated the antidiabetic effects of an extract of aerial parts of O. basilicum. Methods: Antihyperglycemic effect of the extract was determined by its effects on α-amylase and α-glucosidase in vitro, while antidiabetic properties were studied in alloxan induced diabetic rats treated for 28 days with extract and compared to those treated with oral metformin (150 mg/kg). The study and analysis was conducted between 2014 and 2015. Results: The treatment with 100 and 200 mg/kg extract significantly (P < 0.05) reduced fasting blood glucose concentration and slightly increased mean body weight in treated groups. Oral glucose tolerance was also significantly (P < 0.05, 0.001) improved in 100 and 400 mg/kg extract-treated groups. The extract caused a dose-dependent increase in liver glycogen content, while it decreased alanine transferase (18.9-30.56%) and aspartate transferase (6.48-34.3%) levels in a non-dose-dependent manner. A dose of 100 mg/kg also reduced serum cholesterol and triglycerides by 19.3 and 39.54%, compared to a 2.6% reduction of cholesterol seen in the metformin-treated group. The extract was observed to produce significant (P < 0.001) concentration-dependent inhibition of α-glucosidase (35.71-100%) and also α-amylase (23.55-81.52%), with estimated inhibitory concentration values of 1.62 and 3.86 mg/mL, respectively. Conclusions: The antidiabetic properties of the extract may be due to its ability to suppress endogenous glucose release, inhibit glycogenolysis and/or stimulate glycogenesis.
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Affiliation(s)
- Chinelo Ezeani
- Department of Pharmacology & Toxicology, Faculty of Pharmaceutical Sciences, University of Nigeria, Nsukka 410001, Enugu State, Nigeria
| | - Ifeoma Ezenyi
- Department of Pharmacology and Toxicology, NIPRD, Abuja, Nigeria
| | - Theophine Okoye
- Department of Pharmacology & Toxicology, Faculty of Pharmaceutical Sciences, University of Nigeria, Nsukka 410001, Enugu State, Nigeria
| | - Charles Okoli
- Department of Pharmacology & Toxicology, Faculty of Pharmaceutical Sciences, University of Nigeria, Nsukka 410001, Enugu State, Nigeria
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Christiani Y, Dhippayom T, Chaiyakunapruk N. Assessing evidence of inequalities in access to medication for diabetic populations in low- and middle-income countries: a systematic review. Glob Health Action 2016; 9:32505. [PMID: 27938647 PMCID: PMC5148807 DOI: 10.3402/gha.v9.32505] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2016] [Revised: 11/02/2016] [Accepted: 11/04/2016] [Indexed: 11/18/2022] Open
Abstract
Background Inequalities in access to medications among people diagnosed with diabetes inlow- and middle-income countries (LMICs) is a public health concern since untreated diabetes can lead to severe complications and premature death. Objective To assess evidence of inequalities in access to medication for diabetes in adult populations of people with diagnosed diabetes in LMICs. Design We conducted a systematic review of the literature using the PRISMA-Equity guidelines. A search of five databases – PubMed, Cochrane, CINAHL, PsycINFO, and EMBASE – was conducted from inception to November 2015. Using deductive content analysis, information extracted from the selected articles was analysed according to the PRISMA-Equity guidelines, based on exposure variables (place of residence, race/ethnicity, occupation, gender, religion, education, socio-economic status, social capital, and others). Results Fifteen articles (seven quantitative and eight qualitative studies) are included in this review. There were inconsistent findings between studies conducted in different countries and regions although financial and geographic barriers generally contributed to inequalities in access to diabetes medications. The poor, those with relatively low education, and people living in remote areas had less access to diabetes medications. Furthermore, we found that the level of government political commitment through primary health care and in the provision of essential medicines was an important factor in promoting access to medications. Conclusions The review indicates that inequalities exist in accessing medication among diabetic populations, although this was not evident in all LMICs. Further research is needed to assess the social determinants of health and medication access for people with diabetes in LMICs.
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Affiliation(s)
- Yodi Christiani
- Priority Research Centre for Generational Health and Ageing, Hunter Medical Research Institute, University of Newcastle, Newcastle, Australia.,CREDOS (Creative Development Strategies) Institute, Jakarta, Indonesia
| | - Teerapon Dhippayom
- Pharmaceutical Care Research Unit, Faculty of Pharmaceutical Sciences, Naresuan University, Phitsanulok, Thailand
| | - Nathorn Chaiyakunapruk
- Center of Pharmaceutical Outcomes Research, Faculty of Pharmaceutical Sciences, Naresuan University, Phitsanulok, Thailand.,School of Pharmacy, Monash University Malaysia, Bandar Sunway, Malaysia.,School of Pharmacy, University of Wisconsin, Madison, WI, USA.,School of Population Health, University of Queensland, Brisbane, QLD, Australia;
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O'Hara EG, Nuche-Berenguer B, Kirui NK, Cheng SY, Chege PM, Buckwalter V, Laktabai J, Pastakia SD. Diabetes in rural Africa: what can Kenya show us? Lancet Diabetes Endocrinol 2016; 4:807-9. [PMID: 27344101 DOI: 10.1016/s2213-8587(16)30086-9] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/09/2016] [Accepted: 05/10/2016] [Indexed: 11/29/2022]
Affiliation(s)
- Elizabeth G O'Hara
- USAID-Academic Model Providing Access to Healthcare (AMPATH)/Moi Teaching and Referral Moi University School of Medicine, Eldoret 30100, Kenya; University of Washington, Seattle, WA, USA
| | - Bernardo Nuche-Berenguer
- National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, Bethesda, MD, USA
| | - Nicholas K Kirui
- USAID-Academic Model Providing Access to Healthcare (AMPATH)/Moi Teaching and Referral Moi University School of Medicine, Eldoret 30100, Kenya
| | | | - Patrick M Chege
- Webuye District Hospital, Webuye, Kenya; Moi University School of Medicine, Eldoret, Kenya
| | | | - Jeremiah Laktabai
- USAID-Academic Model Providing Access to Healthcare (AMPATH)/Moi Teaching and Referral Moi University School of Medicine, Eldoret 30100, Kenya; Moi University School of Medicine, Eldoret, Kenya
| | - Sonak Dinesh Pastakia
- USAID-Academic Model Providing Access to Healthcare (AMPATH)/Moi Teaching and Referral Moi University School of Medicine, Eldoret 30100, Kenya; Purdue University College of Pharmacy, Indianapolis, IN, USA; Webuye District Hospital, Webuye, Kenya; Moi University School of Medicine, Eldoret, Kenya.
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Gum arabic improves semen quality and oxidative stress capacity in alloxan induced diabetes rats. ASIAN PACIFIC JOURNAL OF REPRODUCTION 2016. [DOI: 10.1016/j.apjr.2016.07.014] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
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Atim P, Ochola E, Ssendagire S, Rutebemberwa E. Health Seeking Behaviours among Caretakers of Children with Nodding Syndrome in Pader District - Northern Uganda: A Mixed Methods Study. PLoS One 2016; 11:e0159549. [PMID: 27471850 PMCID: PMC4966934 DOI: 10.1371/journal.pone.0159549] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2015] [Accepted: 07/04/2016] [Indexed: 11/18/2022] Open
Abstract
Background Nodding syndrome is a neurological disorder which had affected about 3000 children with over 170 deaths in northern Uganda by 2012. With limited data on health seeking, the study aimed to assess the health seeking behavior and associated factors among caretakers of children with nodding syndrome in Pader district. Methods A mixed methods cross sectional study was conducted in July 2013 among 249 caretakers of children with nodding syndrome in three sub-counties of Pader. Respondents were consecutively interviewed using semi-structured questionnaires. Eleven key informants were additionally interviewed. We determined the associations of various factors with health care seeking and obtained adjusted odds ratios and 95% confidence intervals using logistic regression model. Quantitative data was analysed using Stata version 12 while qualitative data was analysed manually and quotes reported. Results Most caretakers, 78.3% (195/249) sought care first from a health facility, 12.9% (32/249) visited traditional healers and 8.8% (22/249) self-medicated. Of those who sought care from a health facility, 50% sought care after a month. Factors associated with improved care seeking included: Time taken to reach care 1–3 hours; adjusted odds ratio = 6.4 (95% CI = 2.96–14.03), time spent in care above five years; adjusted odds ratio = 12.0 (95% CI: 1.24–117.73) and changed care seeking place; adjusted odds ratio = 17.2 (95% CI: 3.64–81.67). Conclusion/ Recommendation Caretakers sought care from multiple places. One in five caretakers still sought care outside a formal health facility. Many respondents who sought care first from health facilities went late, at least one month after symptoms onset. Factors associated with health seeking included distance, duration in treatment and not having changing care provider. There is need for massive sensitization of community to enhance prompt care seeking. More research is needed to elucidate the cause, thus finding the treatment for nodding syndrome, to prevent "wandering in hope".
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Affiliation(s)
- Pamela Atim
- Department of Health Policy, Planning and Management, Makerere University School of Public Health, Kampala, Uganda
- Department of Public Health, Gulu University Faculty of Medicine, Gulu, Uganda
| | - Emmanuel Ochola
- Department of Public Health, Gulu University Faculty of Medicine, Gulu, Uganda
- Department of HIV, Research and Documentation, St. Mary's Hospital Lacor, Gulu, Uganda
- * E-mail:
| | - Stephen Ssendagire
- Department of Health Policy, Planning and Management, Makerere University School of Public Health, Kampala, Uganda
| | - Elizeus Rutebemberwa
- Department of Health Policy, Planning and Management, Makerere University School of Public Health, Kampala, Uganda
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Balogun FO, Tshabalala NT, Ashafa AOT. Antidiabetic Medicinal Plants Used by the Basotho Tribe of Eastern Free State: A Review. J Diabetes Res 2016; 2016:4602820. [PMID: 27437404 PMCID: PMC4942634 DOI: 10.1155/2016/4602820] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/31/2016] [Revised: 03/09/2016] [Accepted: 03/31/2016] [Indexed: 01/16/2023] Open
Abstract
Diabetes mellitus (DM) belongs to the group of five leading important diseases causing death globally and remains a major health problem in Africa. A number of factors such as poverty, poor eating habit, and hormonal imbalance are responsible for the occurrence of the disease. It poses a major health challenge in Africa continent today and the prevalence continues to increase at an alarming rate. Various treatment options particularly the usage of herbs have been effective against diabetes because they have no adverse effects. Interestingly, South Africa, especially the Basotho tribe, is blessed with numerous medicinal plants whose usage in the treatment of DM has been effective since the conventional drugs are expensive and often unaffordable. The present study attempted to update the various scientific evidence on the twenty-three (23) plants originating from different parts of the world but widely used by the Sotho people in the management of DM. Asteraceae topped the list of sixteen (16) plant families and remained the most investigated according to this review. Although limited information was obtained on the antidiabetic activities of these plants, it is however anticipated that government parastatals and scientific communities will pay more attention to these plants in future research.
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Affiliation(s)
- Fatai Oladunni Balogun
- Phytomedicine and Phytopharmacology Research Group, Department of Plant Sciences, University of the Free State, Qwaqwa Campus, Private Bag X 13, Phuthaditjhaba 9866, South Africa
| | - Natu Thomas Tshabalala
- Phytomedicine and Phytopharmacology Research Group, Department of Plant Sciences, University of the Free State, Qwaqwa Campus, Private Bag X 13, Phuthaditjhaba 9866, South Africa
| | - Anofi Omotayo Tom Ashafa
- Phytomedicine and Phytopharmacology Research Group, Department of Plant Sciences, University of the Free State, Qwaqwa Campus, Private Bag X 13, Phuthaditjhaba 9866, South Africa
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Devakumar D, Yates R. Medical Hostages: Detention of Women and Babies in Hospitals. Health Hum Rights 2016; 18:277-282. [PMID: 27781016 PMCID: PMC5070697] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Affiliation(s)
- Delan Devakumar
- Clinical Lecturer in Public Health, University College London, London, UK
| | - Rob Yates
- Health Economist and Senior Fellow, Chatham House, London, UK
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Atwine F, Hjelm K. Healthcare-seeking behaviour and management of type 2 diabetes: From Ugandan traditional healers’ perspective. INTERNATIONAL JOURNAL OF AFRICA NURSING SCIENCES 2016. [DOI: 10.1016/j.ijans.2016.09.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
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Ames H, Njang DM, Glenton C, Fretheim A, Kaufman J, Hill S, Oku A, Cliff J, Cartier Y, Bosch-Capblanch X, Rada G, Muloliwa A, Oyo-Ita A, Lewin S. Mapping how information about childhood vaccination is communicated in two regions of Cameroon: What is done and where are the gaps? BMC Public Health 2015; 15:1264. [PMID: 26691846 PMCID: PMC4687068 DOI: 10.1186/s12889-015-2557-9] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2015] [Accepted: 12/01/2015] [Indexed: 11/16/2022] Open
Abstract
Background The ‘Communicate to vaccinate’ (COMMVAC) project builds research evidence for improving communication with parents and communities about childhood vaccinations in low- and middle-income countries. Understanding and mapping the range of vaccination communication strategies used in different settings is an important component of this work. In this part of the COMMVAC project, our objectives were: (1) to identify the vaccination communication interventions used in two regions of Cameroon; (2) to apply the COMMVAC taxonomy, a global taxonomy of vaccination communication interventions, to these communication interventions to help us classify these interventions, including their purposes and target audiences; and identify whether gaps in purpose or target audiences exist; (3) to assess the COMMVAC taxonomy as a research tool for data collection and analysis. Methods We used the following qualitative methods to identify communication strategies in the Central and North West Regions of Cameroon in the first half of 2014: interviews with program managers, non-governmental organizations, vaccinators, parents and community members; observations and informal conversations during routine immunization clinics and three rounds of the National Polio Immunization Campaign; and document analysis of reports and mass media communications about vaccination. A survey of parents and caregivers was also done. We organised the strategies using the COMMVAC taxonomy and produced a map of Cameroon-specific interventions, which we presented to local stakeholders for feedback. Results Our map of the interventions used in Cameroon suggests that most childhood vaccination communication interventions focus on national campaigns against polio rather than routine immunisation. The map also indicates that most communication interventions target communities more broadly, rather than parents, and that very few interventions target health workers. The majority of the communication interventions aimed to inform or educate or remind or recall members of the community about vaccination. The COMMVAC taxonomy provided a useful framework for quickly and simply mapping existing vaccination communication strategies. Conclusions By identifying the interventions used in Cameroon and developing an intervention map, we allowed stakeholders to see where they were concentrating their communication efforts and where gaps exist, allowing them to reflect on whether changes are needed to the communication strategies they are using. Electronic supplementary material The online version of this article (doi:10.1186/s12889-015-2557-9) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Heather Ames
- Global Health Unit, Norwegian Knowledge Centre for the Health Services, Boks 7004, St Olavs plass, N/0130, Oslo, Norway.
| | - Diangha Mabel Njang
- Department of Anthropology, University of Yaoundé 1, BP 337, Yaoundé, Central Province, Cameroon, Africa.
| | - Claire Glenton
- Global Health Unit, Norwegian Knowledge Centre for the Health Services, Boks 7004, St Olavs plass, N/0130, Oslo, Norway.
| | - Atle Fretheim
- Global Health Unit, Norwegian Knowledge Centre for the Health Services, Boks 7004, St Olavs plass, N/0130, Oslo, Norway. .,Institute of Health and Society, University of Oslo, P.O box 1130 Blindern 0318, Oslo, Norway.
| | - Jessica Kaufman
- Centre for Health Communication and Participation, C/o Department of Human Biosciences, College of Science, Health and Engineering, La Trobe University, Melbourne campus, 3086, VIC, Australia.
| | - Sophie Hill
- Centre for Health Communication and Participation, C/o Department of Human Biosciences, College of Science, Health and Engineering, La Trobe University, Melbourne campus, 3086, VIC, Australia.
| | - Afiong Oku
- University of Calabar, Nigeria, P.M.B 1115, Calabar Municipal, Cross River State, Nigeria.
| | - Julie Cliff
- Faculdade de Medicina, Universidade Eduardo Mondlane, Maputo, Mozambique, Africa.
| | - Yuri Cartier
- International Union for Health Promotion and Education, 42 Blvd. de la Libération, 95203 St, Denis, Cedex, France.
| | - Xavier Bosch-Capblanch
- Swiss Tropical and Public Health Institute, Socinstrasse 57, 4051, Basel, Switzerland. .,University of Basel, Petersplatz 1, 4003, Basel, Switzerland.
| | - Gabriel Rada
- Evidence-based Healthcare Program, Pontificia Universidad Católica de Chile, Avda. Libertador Bernardo O'Higgins 340, Santiago, Chile.
| | - Artur Muloliwa
- Direcção Provincial de Saúde de Nampula, Departamento de Saúde, Av. Samora Machel n° 1016 R/C, C.P. N° 14, Nampula-Moçambique, Africa.
| | - Angela Oyo-Ita
- University of Calabar, Nigeria, P.M.B 1115, Calabar Municipal, Cross River State, Nigeria.
| | - Simon Lewin
- Global Health Unit, Norwegian Knowledge Centre for the Health Services, Boks 7004, St Olavs plass, N/0130, Oslo, Norway. .,Health Systems Research Unit, South African Medical Research Council, Francie van Zijl Drive, Parowvallei, Cape Town, PO Box 19070, 7505, Tygerberg, South Africa.
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Chege IN, Okalebo FA, Guantai AN, Karanja S, Derese S. Management of Type 2 Diabetes Mellitus by Traditional Medicine Practitioners in Kenya--Key Informant Interviews. Pan Afr Med J 2015; 22:90. [PMID: 26848337 PMCID: PMC4732638 DOI: 10.11604/pamj.2015.22.90.6485] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2015] [Accepted: 09/23/2015] [Indexed: 11/11/2022] Open
Abstract
INTRODUCTION Worldwide, plant based medicines are increasing in popularity due to perceptions of safety and efficacy. Herbalists in Kenya are widely consulted for the management of many diseases including Type 2 Diabetes Mellitus (T2DM). This study investigated the level of knowledge of the herbalists in management of T2DM. METHODS Purposive sampling was used to identify 4 herbalists working in the urban areas who actively manage T2DM. Key informant interviews were used to gather data about the management of T2DM. It was analyzed using a content thematic approach. RESULTS Diverse management methods which included both pharmacological and non- pharmacological were noted. Glycemic control was assessed with the help of a glucometer. In addition, presenting signs and symptoms were key in diagnosing T2DM. The herbalists used various herbs, minerals and animals as medicinal sources. The drugs were dispensed as decoctions with excipients being added appropriately. Adverse effects were recorded. The herbalists acknowledged that patients use both herbal and allopathic medicine together. A level of record keeping was observed but patient follow-up was poor. The cost of the herbal drugs was perceived to be excessive. CONCLUSION Some similarities exist in the management of T2DM between allopathic and traditional medicine practitioners. Training of herbalists is required to improve the quality of care given to patients.
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Affiliation(s)
- Irene Njeri Chege
- College of Health Sciences, Jomo Kenyatta University of Agriculture and Technology, Nairobi, Kenya
| | - Faith Apolot Okalebo
- School of Pharmacy, College of Health Sciences, University of Nairobi, Nairobi, Kenya
| | | | - Simon Karanja
- College of Health Sciences, Jomo Kenyatta University of Agriculture and Technology, Nairobi, Kenya
| | - Solomon Derese
- Department of Chemistry, University of Nairobi, Nairobi, Kenya
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Mwaka AD, Okello ES, Abbo C, Odwong FO, Olango W, Etolu JW, Oriyabuzu R, Lagoro DK, Mutamba BB, Idro R, Opar BT, Aceng JR, Lukwago A, Neema S. Is the glass half full or half empty? A qualitative exploration on treatment practices and perceived barriers to biomedical care for patients with nodding syndrome in post-conflict northern Uganda. BMC Res Notes 2015; 8:386. [PMID: 26318338 PMCID: PMC4552991 DOI: 10.1186/s13104-015-1323-5] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2014] [Accepted: 08/11/2015] [Indexed: 12/03/2022] Open
Abstract
Background Nodding syndrome has increasingly become an issue of public health concern internationally. The etiology of the disorder is still unknown and there are yet no curative treatments. We explored perceptions about treatment practices and barriers to health seeking for nodding syndrome in Pader and Kitgum districts in northern Uganda in order to provide data necessary for informing policy on treatment adherence and rehabilitations. Methods We used focus group discussions and individual interviews to gain deep insights into help-seeking and treatment practices for nodding syndrome. Purposive sampling was used to identify information-rich participants that included village health teams, community members not directly affected with nodding syndrome, district leaders, healthcare professionals, and caregivers of children affected with nodding syndrome. We used qualitative content analysis to analyze data and presented findings under distinct categories and themes. Results Caregivers and communities sought care from multiple sources including biomedical facilities, traditional healers, traditional rituals from shrines, and spiritual healing. Nodding syndrome affected children reportedly have showed no enduring improvement with traditional medicines, traditional rituals, and prayers. A substantial minority of participants reported minimal improvements in symptoms of convulsions with use of western medicines. Challenges involved in health seeking included; (1) health system factors e.g. long distances to facilities, frequent unavailability of medicines, few healthcare providers, and long waiting times; (2) contextual and societal challenges e.g. lack of money for transport and medical bills, overburdening nature of the illness that does not allow time for other activities, and practical difficulties involved in transporting the physically deformed and mentally retarded children to the health facilities. Conclusions Help-seeking for nodding syndrome is pluralistic and include use of traditional and biomedical practices. Western medicines admittedly showed at least short term control on nodding syndrome symptoms, especially convulsions and led in a few cases to regain of functional abilities. However, multiple barriers hinder health seeking and interfere with adherence to biomedical treatments. Regarding cure, there are hitherto no treatments participants perceive cure nodding syndrome.
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Affiliation(s)
- Amos Deogratius Mwaka
- Department of Medicine, Mulago Hospital and the School of Medicine, College of Health Sciences, Makerere University, P.O Box 7072, Kampala, Uganda.
| | - Elialilia S Okello
- Department of Psychiatry, Mulago Hospital and the School of Medicine, College of Healthcare Sciences, Makerere University, Kampala, Uganda.
| | - Catherine Abbo
- Department of Psychiatry, Mulago Hospital and the School of Medicine, College of Healthcare Sciences, Makerere University, Kampala, Uganda.
| | | | | | | | - Rachel Oriyabuzu
- Department of Psychiatry, Mulago Hospital and the School of Medicine, College of Healthcare Sciences, Makerere University, Kampala, Uganda.
| | | | - Byamah Brian Mutamba
- Department of Psychiatry, Mulago Hospital and the School of Medicine, College of Healthcare Sciences, Makerere University, Kampala, Uganda. .,Butabika National Mental Referral Hospital, Kampala, Uganda.
| | - Richard Idro
- Department of Paediatrics and Child Health, Mulago Hospital and the School of Medicine, College of Health Sciences, Makerere University, Kampala, Uganda. .,Centre for Tropical Medicine and Global Health, University of Oxford, Oxford, UK.
| | | | | | | | - Stella Neema
- Department of Sociology and Anthropology, Makerere University, Kampala, Uganda.
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Whyte SR. Knowing hypertension and diabetes: Conditions of treatability in Uganda. Health Place 2015; 39:219-25. [PMID: 26233676 DOI: 10.1016/j.healthplace.2015.07.002] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/19/2014] [Revised: 05/17/2015] [Accepted: 07/13/2015] [Indexed: 10/23/2022]
Abstract
In Uganda, hypertension and diabetes have only recently been included in the health policy agenda. As they become treatable disorders, they take on more distinct contours in people's minds. This article relates knowledge about these two conditions to health institutions and technology for diagnosing and treating them. The response to the AIDS epidemic in Uganda provides an important context for, and contrast with, the emergence of hypertension and diabetes as social phenomena. Ethnographic fieldwork shows the interplay between experience of these conditions and the political economy of treatability.
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Affiliation(s)
- Susan Reynolds Whyte
- Department of Anthropology, University of Copenhagen, Øster Farimagsgade 5, DK-1353 Copenhagen, Denmark.
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