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von Schoen-Angerer T, Manchanda RK, Lloyd I, Wardle J, Szöke J, Benevides I, Martinez NSA, Tolo F, Nicolai T, Skaling-Klopstock C, Parker T, Suswardany DL, van Haselen R, Liu J. Traditional, complementary and integrative healthcare: global stakeholder perspective on WHO's current and future strategy. BMJ Glob Health 2023; 8:e013150. [PMID: 38050407 PMCID: PMC10693890 DOI: 10.1136/bmjgh-2023-013150] [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] [Received: 06/15/2023] [Accepted: 11/12/2023] [Indexed: 12/06/2023] Open
Abstract
As the 'WHO Traditional Medicine Strategy: 2014-2023' is entering its final phase, reflection is warranted on progress and the focus for a new strategy. We used WHO documentation to analyse progress across the objectives of the current strategy, adding the role of traditional, complementary and integrative healthcare (TCIH) to address specific diseases as a dimension absent in the current strategy. Our analysis concludes on five areas. First, TCIH research is increasing but is not commensurate with TCIH use. TCIH research needs prioritisation and increased funding in national research policies and programmes. Second, WHO guidance for training and practice provides useful minimum standards but regulation of TCIH practitioners also need to reflect the different nature of formal and informal practices. Third, there has been progress in the regulation of herbal medicines but TCIH products of other origin still need addressing. A risk-based regulatory approach for the full-range of TCIH products seems appropriate and WHO should provide guidance in this regard. Fourth, the potential of TCIH to help address specific diseases is often overlooked. The development of disease strategies would benefit from considering the evidence and inclusion of TCIH practices, as appropriate. Fifth, inclusion of TCIH in national health policies differs between countries, with some integrating TCIH practices and others seeking to restrict them. We encourage a positive framework in all countries that enshrines the role of TCIH in the achievement of universal health coverage. Finally, we encourage seeking the input of stakeholders in the development of the new WHO Traditional Medicine Strategy.
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Affiliation(s)
- Tido von Schoen-Angerer
- International Federation of Anthroposophic Medical Associations, Brussels, Belgium
- Division of General Pediatrics, Geneva University Hospitals, Geneve, Switzerland
| | - Raj Kumar Manchanda
- Health and Family Welfare Department, Government of Delhi, Directorate of Ayush, Delhi, India
| | - Iva Lloyd
- World Naturopathic Federation, Toronto, Ontario, Canada
| | - Jon Wardle
- National Centre for Naturopathic Medicine, Southern Cross University, Lismore, New South Wales, Australia
| | - Janka Szöke
- International Federation of Anthroposophic Medical Associations, Brussels, Belgium
| | - Iracema Benevides
- RedePICS Brasil, Brazilian Network of Integrative and Complementary Practices in Healthcare, Belo Horizonte, Brazil
| | | | - Festus Tolo
- Keny Medical Research Institute, Nairobi, Kenya
| | | | | | - Tabatha Parker
- Academy of Integrated Health and Medicine, La Jolla, California, USA
| | - Dwi Linna Suswardany
- Indonesian Public Health Association, Jakarta, Indonesia
- Department of Public Health, University of Muhammadiyah Surakarta, Jakarta, Indonesia
| | | | - Jianping Liu
- Center for Evidence-Based Chinese Medicine, Beijing University of Chinese Medicine, Beijing, China
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Omondi CJ, Odongo D, Otambo WO, Ochwedo KO, Otieno A, Lee MC, Kazura JW, Githeko AK, Yan G. Malaria diagnosis in rural healthcare facilities and treatment-seeking behavior in malaria endemic settings in western Kenya. PLOS GLOBAL PUBLIC HEALTH 2023; 3:e0001532. [PMID: 37471336 PMCID: PMC10358955 DOI: 10.1371/journal.pgph.0001532] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/04/2023] [Accepted: 05/10/2023] [Indexed: 07/22/2023]
Abstract
Accurate malaria diagnosis and timely treatment are requirements for effective management of the disease. However, treatment efficacy may be significantly reduced in resource-constrained healthcare facilities with poorly equipped laboratories and frequent drug and rapid diagnostic test kit (RDT) stock-outs. Furthermore, patient may avoid seeking treatment from such facilities. The study's goal was to determine treatment-seeking behavior, malaria diagnosis and treatment quality, and likely treatment-seeking determinants in the local population. Passive case detection, which targeted all patients with suspected malaria cases, was conducted in ten public healthcare facilities over a three-month period. Monthly malaria cases, methods of diagnosis and antimalarial drug availability were assessed. A household-based survey was also carried out. Structured questionnaires were used to collect knowledge, attitude and practice (KAP) data from household heads. Malaria knowledge, treatment seeking behavior, and predictors of malaria treatment-seeking were all determined. Three of the seven dispensaries lacked a laboratory to conduct microscopy- diagnosis. These three dispensaries also experienced frequent RDT stock-outs, which resulted in depending on clinical signs as diagnosis for malaria. The majority of local residents with fever (50.3%) purchased antimalarial drugs from a chemist. About 37% of fever patients sought treatment at healthcare facility while the remaining 12.7% did not treat their fevers. In irrigated areas, 45.5% (46/64) of fever patients sought treatment at healthcare facilities, compared to 25% (18/64) in non-irrigated areas (p = 0.009). Most children aged below 5 who had fever (77.7%) were taken to healthcare facility for treatment compared to 31.4% of children aged 5-14 years or 20.9% of adults (0.0001). Predictors of treatment seeking included access to healthcare facility (OR = 16.23, 95% CI: 2.74-96.12), and ability to pay hospital bills (OR = 10.6, 95% CI: 1.97-57). Other factors that influenced health-seeking behavior included the severity of symptoms, the age of the patient and knowledge of malaria symptoms.
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Affiliation(s)
- Collince J. Omondi
- Department of Biology, Faculty of Science and Technology, University of Nairobi, Nairobi, Kenya
- Sub-Saharan International Center of Excellence for Malaria Research, Homa Bay, Kenya
| | - David Odongo
- Department of Biology, Faculty of Science and Technology, University of Nairobi, Nairobi, Kenya
| | - Wilfred O. Otambo
- Sub-Saharan International Center of Excellence for Malaria Research, Homa Bay, Kenya
- Department of Zoology, Maseno University, Kisumu, Kenya
| | - Kevin O. Ochwedo
- Department of Biology, Faculty of Science and Technology, University of Nairobi, Nairobi, Kenya
- Sub-Saharan International Center of Excellence for Malaria Research, Homa Bay, Kenya
| | - Antony Otieno
- Department of Biology, Faculty of Science and Technology, University of Nairobi, Nairobi, Kenya
| | - Ming-Chieh Lee
- Sub-Saharan International Center of Excellence for Malaria Research, Homa Bay, Kenya
- Program in Public Health, College of Health Sciences, University of California, Irvine, Irvine, California, United States of America
| | - James W. Kazura
- Center for Global Health and Diseases, Case Western Reserve University, Cleveland, Ohio, United States of America
| | - Andrew K. Githeko
- Sub-Saharan International Center of Excellence for Malaria Research, Homa Bay, Kenya
- Climate and Human Health Research Unit, Center for Global Health Research, Kenya Medical Research Institute, Kisumu, Kenya
| | - Guiyun Yan
- Program in Public Health, College of Health Sciences, University of California, Irvine, Irvine, California, United States of America
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Naserrudin NA, Lin PYP, Monroe A, Culleton R, Baumann SE, Sato S, Adhikari B, Fornace KM, Hod R, Jeffree MS, Ahmed K, Hassan MR. Exploring barriers to and facilitators of malaria prevention practices: a photovoice study with rural communities at risk to Plasmodium knowlesi malaria in Sabah, Malaysia. BMC Public Health 2023; 23:1316. [PMID: 37430300 DOI: 10.1186/s12889-023-16173-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2023] [Accepted: 06/22/2023] [Indexed: 07/12/2023] Open
Abstract
BACKGROUND The control of Plasmodium knowlesi malaria remains challenging due to the presence of macaque monkeys and predominantly outdoor-biting Anopheles mosquitoes around human settlements. This study aims to explore the barriers and facilitators related to prevention of mosquito bites among rural communities living in Sabah, Malaysia using the participatory visual method, photovoice. METHODS From January through June 2022, 26 participants were recruited from four villages in Kudat, Sabah, using purposive sampling. Participants were male and female villagers, aged > 18 years old. After photovoice training in the villages, participants documented facilitators of and barriers related to avoiding mosquito bites using their own smartphone cameras, and provided narratives for their photos. Twelve Focus Group Discussions (FGDs) sessions in three rounds were held to share and discuss the photos, and to address challenges to the avoidance of mosquito bites. All discussions were conducted in the Sabah Malay dialect, and were video and audio recorded, transcribed, and analyzed using reflexive thematic analysis. The Ideation Model, a meta-theoretical model of behaviour change, underpinned this study. RESULTS The most common types of barriers identified by participants included (I) intrapersonal factors such as low perceived threat of malaria, (II) livelihood and lifestyle activities consisting of the local economy and socio-cultural activities, and (III) physical and social environment. The facilitators were categorized into (I) intrapersonal reasons, including having the opportunity to stay indoors, especially women who are housewives, (II) social support by the households, neaighbours and healthcare workers, and (III) support from healthcare services and malaria awareness program. Participants emphasized the importance of stakeholder's support in implementing feasible and affordable approaches to P. knowlesi malaria control. CONCLUSION Results provided insights regarding the challenges to preventing P. knowlesi malaria in rural Kudat, Sabah. The participation of communities in research was valuable in expanding knowledge of local challenges and highlighting possible ways to overcome barriers. These findings may be used to improve strategies for zoonotic malaria control, which is critical for advancing social change and minimizing health disparities in malaria prevention.
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Affiliation(s)
- Nurul Athirah Naserrudin
- Department of Public Health Medicine, Faculty of Medicine, Universiti Kebangsaan Malaysia, 56000, Kuala Lumpur, Malaysia
- Faculty of Medicine and Health Sciences, Borneo Medical and Health Research Centre, Universiti Malaysia, 88400, Sabah, Kota Kinabalu, Malaysia
- Sabah State Health Department, Ministry of Health, 88590, Kota Kinabalu, Malaysia
| | - Pauline Yong Pau Lin
- Faculty of Social Sciences and Humanities, Universiti Malaysia Sabah, 88400, Kota Kinabalu, Malaysia
| | - April Monroe
- Johns Hopkins Center for Communication Programs, Baltimore, MD, USA
| | - Richard Culleton
- Division of Molecular Parasitology, Proteo-Science Center, Ehime University, Toon, Ehime, 791-0295, Japan
| | - Sara Elizabeth Baumann
- Department of Behavioral and Community Health Sciences, School of Public Health, University of Pittsburgh, Pittsburgh, PA, 15261, USA
| | - Shigeharu Sato
- Faculty of Medicine and Health Sciences, Borneo Medical and Health Research Centre, Universiti Malaysia, 88400, Sabah, Kota Kinabalu, Malaysia
- Department of Pathology and Microbiology, Faculty of Medicine and Health Sciences, Universiti Malaysia Sabah, 88400, Kota Kinabalu, Malaysia
| | - Bipin Adhikari
- Mahidol Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand
- Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford, Oxford, UK
| | - Kimberly M Fornace
- School of Biodiversity, One Health and Veterinary Medicine, University of Glasgow, Glasgow, UK
- Faculty of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, London, UK
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore, Singapore
| | - Rozita Hod
- Department of Public Health Medicine, Faculty of Medicine, Universiti Kebangsaan Malaysia, 56000, Kuala Lumpur, Malaysia.
| | - Mohammad Saffree Jeffree
- Faculty of Medicine and Health Sciences, Borneo Medical and Health Research Centre, Universiti Malaysia, 88400, Sabah, Kota Kinabalu, Malaysia
- Department of Public Health Medicine, Faculty of Medicine and Health Sciences, Universiti Malaysia Sabah, 88400, Kota Kinabalu, Malaysia
| | - Kamruddin Ahmed
- Faculty of Medicine and Health Sciences, Borneo Medical and Health Research Centre, Universiti Malaysia, 88400, Sabah, Kota Kinabalu, Malaysia
- Department of Pathology and Microbiology, Faculty of Medicine and Health Sciences, Universiti Malaysia Sabah, 88400, Kota Kinabalu, Malaysia
| | - Mohd Rohaizat Hassan
- Department of Public Health Medicine, Faculty of Medicine, Universiti Kebangsaan Malaysia, 56000, Kuala Lumpur, Malaysia.
- Faculty of Medicine and Health Sciences, Borneo Medical and Health Research Centre, Universiti Malaysia, 88400, Sabah, Kota Kinabalu, Malaysia.
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Cardona-Arias JA. Synthesis of Qualitative Evidence on Malaria in Pregnancy, 2005-2022: A Systematic Review. Trop Med Infect Dis 2023; 8:tropicalmed8040235. [PMID: 37104360 PMCID: PMC10145031 DOI: 10.3390/tropicalmed8040235] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2023] [Revised: 04/11/2023] [Accepted: 04/17/2023] [Indexed: 04/28/2023] Open
Abstract
Qualitative research on malaria in pregnancy (MiP) is incipient, therefore its contextual, experiential and symbolic associated factors are unknown. This study systematizes the qualitative research on MiP, describes knowledge, perceptions and behaviors about MiP, and compiles individual, socioeconomic, cultural and health system determinants of MiP through a meta-synthesis in 10 databases. A total of 48 studies were included with 2600 pregnant women, 1300 healthcare workers, and 2200 relatives or community members. Extensive knowledge was demonstrated on ITN and case management, but it was lacking on SP-IPTp, risks and consequences of MiP. Attitudes were negative towards ANC and MiP prevention. There were high trustfulness scores and preference for traditional medicine and distrust in the safety of drugs. The main determinants of the Health System were rationing, copayments, delay in payment to clinics, high out-of-pocket expenses, shortage, low workforce and work overload, shortcomings in care quality, low knowledges of healthcare workers on MiP and negative attitude in care. The socioeconomic and cultural determinants were poverty and low educational level of pregnant women, distance to the hospital, patriarchal-sexist gender roles, and predominance of local conceptions on maternal-fetal-neonatal health. The meta-synthesis demonstrates the difficulty to detect MiP determinants and the importance of performed qualitative research before implementing MiP strategies to understand the multidimensionality of the disease.
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Affiliation(s)
- Jaiberth Antonio Cardona-Arias
- Research Group Salud y Comunidad-César Uribe Piedrahita, School of Microbiology, Universidad de Antioquia UdeA, Calle 70 No. 52-21, Medellin 050010, Colombia
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Hasabo EA, Khalid RI, Mustafa GE, Taha RE, Abdalla RS, Mohammed RA, Haroun MS, Adil R, Khalil RA, Mansour RM, Mohamed RK, Awadalla H. Treatment-seeking behaviour, awareness and preventive practice toward malaria in Abu Ushar, Gezira state, Sudan: a household survey experience from a rural area. Malar J 2022; 21:182. [PMID: 35690814 PMCID: PMC9188226 DOI: 10.1186/s12936-022-04207-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2022] [Accepted: 05/27/2022] [Indexed: 12/01/2022] Open
Abstract
Background Usage of mosquito bed nets and the practice of other prevention methods are essential for the prevention of malaria in endemic areas. Proper community knowledge about malaria and prompt treatment-seeking behaviour for early diagnosis and treatment are crucial for eliminating the disease. This study aimed to assess the awareness, treatment-seeking behaviour, and prevention practices towards malaria in Abu Ushar, Gezira State, Sudan. Methods A community-based, cross-sectional study was conducted in March 2021, including 310 households in Abu Ushar, Aljazeera, Sudan. Data were collected through face-to-face interviews with head of the household using an interviewer-administered questionnaire. Data were entered and analysed using R software. Results A total of 310 households were enrolled in this study. Sixty per cent had children under the age of 5 years. The majority of these households (94.8%) had a history of malaria in the past 12 months. Overall, awareness of malaria was good; 197 (63.5%) households had bed nets in their houses; 75.8% of total households identified fever with shivering as a symptom of malaria. Regarding treatment-seeking behaviour, 77.9% seek treatment from the nearby primary health centre, and 60% seek treatment within the first day. Only 45.3% stated that everyone in the household sleeps under bed nets. Conclusion High awareness about malaria and preventive measures was found among participants in households. Most households had previous infections with malaria. Therefore, an interventional programme should be established in this area to reduce this high rate of malaria.
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Affiliation(s)
| | - Rawan I Khalid
- Faculty of Medicine, University of Khartoum, Khartoum, Sudan
| | | | - Ruaa E Taha
- Faculty of Medicine, University of Khartoum, Khartoum, Sudan
| | - Riham S Abdalla
- Faculty of Medicine, University of Khartoum, Khartoum, Sudan
| | | | - Mazin S Haroun
- Faculty of Medicine, University of Khartoum, Khartoum, Sudan
| | - Rawaa Adil
- Faculty of Medicine, University of Khartoum, Khartoum, Sudan
| | - Riham A Khalil
- Faculty of Medicine, University of Khartoum, Khartoum, Sudan
| | - Rawaa M Mansour
- Faculty of Medicine, University of Khartoum, Khartoum, Sudan
| | - Reham K Mohamed
- Faculty of Medicine, University of Khartoum, Khartoum, Sudan
| | - Heitham Awadalla
- Department of Community Medicine, Faculty of Medicine, University of Khartoum, Khartoum, Sudan
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Ching SSY, Kwok WYY, Ng JTD, Zhang LW, Ho CSW, Cheung K. University Staff's Perceptions of Community College Transfer Students' Transition Experiences Within a "2+2" Pathway in an Asian Educational Context. Front Psychol 2022; 13:808179. [PMID: 35310272 PMCID: PMC8931273 DOI: 10.3389/fpsyg.2022.808179] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2021] [Accepted: 01/24/2022] [Indexed: 11/13/2022] Open
Abstract
Various countries have alternative pathway policies for 2-year community college graduates to articulate to 2-year university study, forming a "2+2" pathway. However, few studies have explored university staff members' perceptions of this "2+2" transfer pathway and their understanding of transfer students' (TSs) transition experiences. This descriptive qualitative study addressed this research gap. Forty-two academic and supporting staff participated in the focus group interviews. Specifically, the study explored the assets and challenges of the "2+2" pathway from the university staff perspective in Hong Kong. The articulation pathway and TSs are highly recognized for their prior learning, academic performances, and the value of the second chance. However, while the university staff were sympathetic to the challenges filling these transfer pathways, their offering of help was limited by government funding and policies restrictions. It is recommended that policies should be established at government and university levels to recognize and tackle TSs' unique needs to alleviate their heavy workloads through better articulation between community college and university studies. Improving articulation will allow TSs time for social involvement in university life and thus enhance their mental well-being.
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Affiliation(s)
| | | | | | | | | | - Kin Cheung
- School of Nursing, The Hong Kong Polytechnic University, Kowloon, Hong Kong SAR, China
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Guntur RD, Kingsley J, Islam FMA. Malaria treatment-seeking behaviour and its associated factors: A cross-sectional study in rural East Nusa Tenggara Province, Indonesia. PLoS One 2022; 17:e0263178. [PMID: 35120136 PMCID: PMC8815915 DOI: 10.1371/journal.pone.0263178] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2021] [Accepted: 01/13/2022] [Indexed: 11/18/2022] Open
Abstract
Introduction The World Health Organization recommends seeking medical treatment within 24 hours after transmission of malaria to reduce the risk of severe complications and its onwards spread. However, in some parts of Indonesia, including East Nusa Tenggara Province (ENTP), this adherence is not achieved for a range of reasons including delays in visiting health centres. This study aims to determine factors related to the poor understanding of appropriate malaria treatment-seeking behaviour (AMTSB) of rural adults in ENTP. AMTSB was defined as seeking treatment at professional health facilities within 24 hours of the onset of malaria symptoms. Methods A cross-sectional study was conducted in the East Sumba, Belu, and East Manggarai district of ENTP between October and December 2019. A multi-stage cluster sampling procedure was applied to enrol 1503 participants aged between 18 and 89 years of age. Data were collected through face-to-face interviews. Multivariable logistic regression analyses were used to assess significant factors associated with the poor understanding of AMTSB. Results Eighty-six percent of participants were found to be familiar with the term malaria. However, poor understanding level of AMTSB in rural adults of ENTP achieved 60.4% with a 95% confidence interval (CI): 56.9–63.8. Poor understanding of AMTSB was significantly higher for adults with no education (adjusted odds ratio (AOR) 3.42, 95% CI: 1.81, 6.48) compared to those with a diploma or above education level; having low SES (AOR: 1.87, 95% CI: 1.19, 2.96) compared to those having high SES; residing at least three kilometres (km) away from the nearest health facilities (AOR: 1.73, 95% CI: 1.2, 2.5) compared to those living within one km from the nearest health service; and working as farmer (AOR: 1.63, 95% CI: 1.01–2.63) compared to those working at government or non-government sector. Whilst, other factors such as ethnicity and family size were not associated with the poor understanding of AMTSB. Conclusion The proportion of rural adults having a poor understanding of AMTSB was high leading to ineffective implementation of artemisinin-based combination therapies as the method to treat malaria in ENTP. Improving awareness of AMTSB for rural adults having low level education, low SES, working as a farmer, and living at least three km from the nearest health facilities is critical to support the efficacy of malaria treatment in ENTP. This method will support the Indonesian government’s objective to achieve malaria elimination by 2030.
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Affiliation(s)
- Robertus Dole Guntur
- Department of Health Science and Biostatistics, Swinburne University of Technology, Hawthorn, Victoria, Australia
- Department of Mathematics, Faculty of Science and Engineering, Nusa Cendana University, Kupang, NTT, Indonesia
- * E-mail:
| | - Jonathan Kingsley
- Department of Health Science and Biostatistics, Swinburne University of Technology, Hawthorn, Victoria, Australia
- Centre of Urban Transitions, Swinburne University of Technology, Hawthorn, Victoria, Australia
| | - Fakir M. Amirul Islam
- Department of Health Science and Biostatistics, Swinburne University of Technology, Hawthorn, Victoria, Australia
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Ong KIC, Khattignavong P, Keomalaphet S, Iwagami M, Brey P, Kano S, Jimba M. Health-seeking behaviours in a malaria endemic district in Lao People's Democratic Republic: a mixed methods study. BMJ Open 2021; 11:e055350. [PMID: 34903551 PMCID: PMC8671991 DOI: 10.1136/bmjopen-2021-055350] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
OBJECTIVES This mixed methods study was conducted to explore the barriers and facilitators for health-seeking behaviours in a malaria endemic district in Lao PDR. DESIGN A convergent mixed methods design. SETTING Two malaria endemic villages in Thapangthong district, Savannakhet Province, Lao PDR. PARTICIPANTS Villagers and healthcare workers in the two villages in Thapangthong district. METHODS In the quantitative part, a pretested questionnaire was used to identify the health-seeking behaviours of the villagers. In the qualitative part, focus group discussions were employed to explore health-seeking behaviours of the villagers and in-depth interviews were used to explore the perceptions of the healthcare workers. Descriptive statistics were computed and multiple logistic regressions were used to identify the factors associated with perceived severity and perceived susceptibility. Thematic analysis was used to analyse the qualitative data. Quantitative and qualitative results were integrated in joint displays. RESULTS In the quantitative part, data were collected from 313 villagers from both villages. For malaria, 96.0% and 98.2% of villagers from villages A and B, respectively, would first seek treatment at public health facilities. Villagers who have not experienced malaria before were more likely to perceive that the consequences of malaria were serious compared with those who have experienced malaria before (adjusted OR=1.69, 95% CI: 1.03 to 2.75). However, qualitative data showed that villagers faced problems such as lack of medicines and medical equipment. Healthcare workers also mentioned the lack of manpower and equipment in the in-depth interviews. Nevertheless, villagers still preferred to seek treatment at the health center as the National Health Insurance was introduced. CONCLUSIONS Public health facility usage was high but barriers existed. Effective policy and enabling environment such as the introduction of the National Health Insurance could help accelerate the progress towards the malaria elimination goal. Moreover, the benefits could go beyond the context of malaria.
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Affiliation(s)
- Ken Ing Cherng Ong
- Department of Community and Global Health, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | | | | | - Moritoshi Iwagami
- Institut Pasteur du Laos, Vientiane, Lao People's Democratic Republic
- Department of Tropical Medicine and Malaria, National Center for Global Health and Medicine, Research Institute, Tokyo, Japan
| | - Paul Brey
- Institut Pasteur du Laos, Vientiane, Lao People's Democratic Republic
| | - Shigeyuki Kano
- Institut Pasteur du Laos, Vientiane, Lao People's Democratic Republic
- Department of Tropical Medicine and Malaria, National Center for Global Health and Medicine, Research Institute, Tokyo, Japan
| | - Masamine Jimba
- Department of Community and Global Health, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
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Damien BG, Baxerres C, Apetoh E, Le Hesran JY. Between traditional remedies and pharmaceutical drugs: prevention and treatment of "Palu" in households in Benin, West Africa. BMC Public Health 2020; 20:1425. [PMID: 32948153 PMCID: PMC7501613 DOI: 10.1186/s12889-020-09479-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2020] [Accepted: 08/31/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND In Benin, malaria clinical cases, including the larger popular entity called "Palu" are evoked when people get fever. "Palu" is often self-diagnosed and self-medicated at home. This study aimed to describe the use of herbal medicine, and/or pharmaceutical medicines for prevention and treatment of malaria at home and the factors associated with this usage. METHODS A cross-sectional survey was conducted in Benin in an urban and in a rural area in 2016. Around 600 households in each place were selected by using a random sampling of houses GPS coordinates of the families. The association between socio demographic characteristics and the use of herbal medicine was tested by using logistic regression models. RESULTS In Cotonou (urban), 43.64% of households reported using herbal or pharmaceutical medicine to prevent "Palu", while they were 53.1% in Lobogo (rural). To treat "Palu" in Cotonou, 5.34% of households reported using herbal medicine exclusively, 33.70% pharmaceutical medicine exclusively and 60.96% reported using both. In Lobogo, 4% reported using herbal medicine exclusively, 6.78% pharmaceutical medicine exclusively and 89.22% reported using both. In Cotonou, the factors "age of respondent", "participation to a traditional form of savings" and "low socioeconomic level of the household" were associated with the use of herbal medicine. CONCLUSIONS This study shows the strong use of herbal medicine to prevent "Palu" or even treat it, and in this case it is mostly associated with the use of pharmaceutical medicine. It also highlights the fact that malaria control and care seeking behaviour with herbal medicine remain closely linked to household low-income status but also to cultural behaviour. The interest of this study is mostly educational, with regards to community practices concerning "Palu", and to the design of adapted behaviour change communication strategies. Finally, there is a need to take into account the traditional habits of populations in malaria control and define a rational and risk-free use of herbal medicine as WHO-recommended.
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Affiliation(s)
| | - Carine Baxerres
- UMR261 - MERIT, French National Research Institute for Sustainable Development (IRD), University of Paris Descartes, Paris, France
- Centre Norbert Elias EHESS-Campus Marseille La Vieille Charité, 2 Rue de la Charité, 13002 Marseille, France
| | - Edwige Apetoh
- UMR261 - MERIT, French National Research Institute for Sustainable Development (IRD), University of Paris Descartes, Paris, France
- Ecole doctorale Pierre Louis de santé publique, ED 393 - Santé publique: Epidémiologie et Sciences de l’Information Biomédicale, Paris, France
| | - Jean-Yves Le Hesran
- UMR261 - MERIT, French National Research Institute for Sustainable Development (IRD), University of Paris Descartes, Paris, France
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van Eijk AM, Mannan AS, Sullivan SA, Carlton JM. Defining symptoms of malaria in India in an era of asymptomatic infections. Malar J 2020; 19:237. [PMID: 32631326 PMCID: PMC7339403 DOI: 10.1186/s12936-020-03310-9] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2020] [Accepted: 06/26/2020] [Indexed: 01/04/2023] Open
Abstract
Background Malaria is a major public health problem in India. Data from surveys totaling 3031 participants at three sites revealed a high proportion of asymptomatic infections, complicating diagnosis. The aim of this study was to identify differences in complaints and symptoms between sites, and factors associated with asymptomatic Plasmodium infections. Methods Published data from community-based cross-sectional studies conducted between 2012 and 2015 in Nadiad (Gujarat), Chennai (Tamil Nadu), and Rourkela (Odisha) as part of the Center for the Study of Complex Malaria in India were analysed. Complaints and symptoms were systematically recorded, and Plasmodium infections confirmed using microscopy, rapid diagnostic tests (RDTs), and polymerase chain reaction (PCR). Multivariate analyses were conducted to determine the association between general symptoms and age, season, or gender, and factors associated with asymptomatic Plasmodium infections were assessed. Results Complaints of any illness were lowest in Chennai (17.7%), 30.6% in Rourkela and 42.7% in Nadiad. Complaints were more often reported for children; gender differences were noted in Rourkela only. In Nadiad, 7.0% of 796 participants were positive for malaria by PCR (32% Plasmodium falciparum); 78.6% had a history of fever or documented fever, 14.3% had other symptoms, and 7.1% were “truly asymptomatic”. For Chennai this was 29.2%, 4.2% and 66.7% respectively, with a malaria prevalence of 2.6% by PCR of 928 participants (29% P. falciparum). In Rourkela, with 7.7% of 1307 participants positive for malaria by PCR (82% P. falciparum), the percentages were 35.6%, 24.8% and 39.6%, respectively. In Rourkela, asymptomatic infections were associated with young age and male gender (microscopy or RDT), and with rainy season (PCR). In the same site, participants with Plasmodium vivax were more likely to be asymptomatic (11/18 or 61.1%) than persons with P. falciparum mono-infections (27/78 or 34.6%); gametocytes for P. falciparum were evenly distributed between symptomatic and asymptomatic infections (2/53 vs. 2/49, respectively). The addition of the symptoms “headache”, “aches” and “chills” to fever improved the case-definition of symptomatic malaria. Conclusion There were considerable differences in complaints at the three sites in India. Malaria and asymptomatic infections differ by region, indicating that malaria elimination will require localized approaches.
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Affiliation(s)
- Anna Maria van Eijk
- Center for Genomics and Systems Biology, Department of Biology, New York University, New York, NY, 10003, USA.
| | - Asad S Mannan
- Center for Genomics and Systems Biology, Department of Biology, New York University, New York, NY, 10003, USA
| | - Steven A Sullivan
- Center for Genomics and Systems Biology, Department of Biology, New York University, New York, NY, 10003, USA
| | - Jane M Carlton
- Center for Genomics and Systems Biology, Department of Biology, New York University, New York, NY, 10003, USA
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Straschil U, Witmer K, Delves MJ, Marks SD, Baum J. Screen of traditional soup broths with reported antipyretic activity towards the discovery of potential antimalarials. Arch Dis Child 2019; 104:1138-1142. [PMID: 31744794 PMCID: PMC6900245 DOI: 10.1136/archdischild-2019-317590] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/21/2019] [Revised: 10/15/2019] [Accepted: 10/15/2019] [Indexed: 11/06/2022]
Abstract
OBJECTIVE The global impact of artemisinin-based combination therapies on malaria-associated mortality and their origins in ancient Chinese medicine has heightened interest in the natural discovery of future antimalarials. METHODS A double-blind study to identify potential ingredients with antimalarial activity from traditional remedies with reported antipyretic properties. Recipes of clear broths, passed down by tradition in families of diverse ethnic origin, were sourced by school children. Broths were then tested for their ability to arrest malaria parasite asexual growth or sexual stage development in vitro. Clear broth extract was incubated with in vitro cultures of Plasmodium falciparum asexual or mature sexual stage cultures and assayed for parasite viability after 72 hours. RESULTS Of the 56 broths tested, 5 were found to give >50% in vitro growth inhibition against P. falciparum asexual blood stages, with 2 having comparable inhibition to that seen with dihydroartemisinin, a leading antimalarial. Four other broths were found to have >50% transmission blocking activity, preventing male parasite sexual stage development. After unblinding, two active broths were found to be from siblings from different classes, who had brought in the same vegetarian soup, demonstrating assay robustness. CONCLUSIONS This screening approach succeeded in finding broths with activity against malaria parasite in vitro growth, arising from complex vegetable and/or meat-based broths. This represented a successful child education exercise, in teaching about the interface between natural remedies, traditional medicine and evidence-based drug discovery.
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Affiliation(s)
| | - Ursula Straschil
- Department of Life Sciences, Imperial College London, London, UK
| | - Kathrin Witmer
- Department of Life Sciences, Imperial College London, London, UK
| | - Michael J Delves
- Department of Life Sciences, Imperial College London, London, UK
| | - Stephen D Marks
- Department of Paediatric Nephrology, Great Ormond Street Hospital for Children NHS Trust, London, UK
| | - Jake Baum
- Department of Life Sciences, Imperial College London, London, UK
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Aracil A, Green J. Plants with antimalarial properties: A systematic review of the current clinical evidence. Eur J Integr Med 2019. [DOI: 10.1016/j.eujim.2019.04.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Abstract
Background Malaria is an increasing concern in Indonesia. Socio-demographic factors were found to strongly influence malaria prevalence. This research aimed to explore the associations between socio-demographic factors and malaria prevalence in Indonesia. Methods The study used a cross-sectional design and analysed relationships among the explanatory variables of malaria prevalence in five endemic provinces using multivariable logistic regression. Results The analysis of baseline socio-demographic data revealed the following independent risk variables related to malaria prevalence: gender, age, occupation, knowledge of the availability of healthcare services, measures taken to protect from mosquito bites, and housing condition of study participants. Multivariable analysis showed that participants who were unaware of the availability of health facilities were 4.2 times more likely to have malaria than those who were aware of the health facilities (adjusted odds ratio = 4.18; 95% CI 1.52–11.45; P = 0.005). Conclusions Factors that can be managed and would favour malaria elimination include a range of prevention behaviours at the individual level and using the networks at the community level of primary healthcare centres. This study suggests that improving the availability of a variety of health facilities in endemic areas, information about their services, and access to these is essential. Electronic supplementary material The online version of this article (10.1186/s12936-019-2760-8) contains supplementary material, which is available to authorized users.
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Sukanan D, Anthony BP. Community attitudes towards bears, bear bile use, and bear conservation in Luang Prabang, Lao PDR. JOURNAL OF ETHNOBIOLOGY AND ETHNOMEDICINE 2019; 15:15. [PMID: 30808395 PMCID: PMC6390540 DOI: 10.1186/s13002-019-0292-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/17/2018] [Accepted: 01/28/2019] [Indexed: 06/09/2023]
Abstract
BACKGROUND Bear bile is widely believed across much of Asia to have medicinal properties. As a result, great numbers of bears have been poached from the wild and numerous bear farms have been set up to drain the animals' bile on a regular basis. Although most such farms are now illegal, they continue to exist in countries such as Lao PDR. A new bear sanctuary is under construction in Luang Prabang in the northern part of the country with the aim of providing shelter to bears rescued from these farms. Understanding the level and nature of local communities' support for this sanctuary is vital for the long-term success of conservation efforts in the area, including outreach. METHODS This research, drawing from both ethnozoological and conservation frameworks, comprises a household survey (n = 263) administered in five villages surrounding the sanctuary and in-depth interviews conducted with key community leaders and institutional representatives. The questionnaire assessed local socio-economic status and attitudes towards bears, bear bile use, and bear conservation in general. RESULTS Respondents have generally positive attitudes towards bears and bear conservation. Age, gender, ethnicity, village, and household size have significant influence on attitudes towards bear bile use, which may also be determined by the expansion of sources for the supply of the traditional medicine market in neighboring China. However, many locals lack knowledge about the current status of wild and captive bears. This may be due to inadequate outreach involving community incentives for positively influencing attitudes. We argue that local communities will need to be integrated into conservation efforts while enhancing knowledge of conservation issues through improved outreach and communication. CONCLUSION Positive attitudes towards bears appear prevalent in the communities surrounding the new sanctuary. Villagers are familiar with laws regarding wildlife conservation but lack a deeper understanding of the status and plight of wild bears in the country, particularly how bear farming is a threat to the species. Conservation efforts must entail culturally relevant co-educational initiatives to garner further support from local communities.
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Affiliation(s)
- Darunee Sukanan
- Central European University, Nádor u. 9, Budapest, 1051 Hungary
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Canaway R, Leach M, Hunter J. Setting an agenda for strengthening the evidence-base for traditional and complementary medicines: Perspectives from an expert forum in Australia. ADVANCES IN INTEGRATIVE MEDICINE 2018. [DOI: 10.1016/j.aimed.2018.06.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
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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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Ahmed SM, Nordeng H, Sundby J, Aragaw YA, de Boer HJ. The use of medicinal plants by pregnant women in Africa: A systematic review. JOURNAL OF ETHNOPHARMACOLOGY 2018; 224:297-313. [PMID: 29842963 DOI: 10.1016/j.jep.2018.05.032] [Citation(s) in RCA: 33] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/06/2018] [Revised: 05/22/2018] [Accepted: 05/23/2018] [Indexed: 06/08/2023]
Abstract
ETHNOPHARMACOLOGICAL RELEVANCE Medicinal plant (MP) use during pregnancy is common in Africa and may have profound effects on both the mother and the developing foetus. A lack of overview complicates monitoring and regulating the use of MPs during pregnancy. AIM OF THE STUDY This systematic review analyses prevalence of use of MPs during pregnancy, regional distribution, types and prevalence, MP properties, potential health risks, and consensus of MPs use, and suggests relevant measures to mitigate negative effects on pregnancy. MATERIALS AND METHODS A search was undertaken using a range of scientific databases (Medline, Embase, African Journals OnLine, Google Scholar and Biological Abstracts), non-governmental organisations, various African universities and regulatory websites for original published and unpublished studies that assess and indicate the prevalence of use of MPs during pregnancy in Africa. Additional articles were located by exploring pertinent bibliographies, and contacting experts. RESULTS A total of 3659 MP-use studies were found, but only 303 articles received full-text assessment for eligibility and finally only 50 scientific papers were eligible for the systematic review. The prevalence of MP use by pregnant women varied widely from 2% to 100%. Twenty-eight studies (56%) specified one or more plant species used as MP during pregnancy. The major reasons for MP use were relief of nausea and vomiting during pregnancy (NVP), stimulation of labour, and facilitation of childbirth. The most commonly cited MP species were Zingiber officinale Roscoe, Allium sativum L. and Cucurbita pepo L. and these were used for relief of NVP, motion sickness and as a nutritional supplement. Route of administration was most commonly oral, and few adverse effects were reported. CONCLUSIONS The use of MPs among pregnant women in Africa is prevalent, and the most commonly used plant species are not known to have harmful foetal effects during pregnancy. However, many of the MP species are poorly studied and teratogenic effects cannot be ruled out. Collaboration between healthcare providers and traditional practitioners to inform about the safe use of MPs may promote safer pregnancies and better health for mothers and infants.
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Affiliation(s)
- Seid Mussa Ahmed
- Department of Community Medicine and Global Health, Institute of Health and Society, Faculty of Medicine, University of Oslo, Norway.
| | - Hedvig Nordeng
- Pharmacoepidemiology and Drug Safety Research Group, School of Pharmacy, Faculty of Mathematics and Natural Sciences, University of Oslo, Norway.
| | - Johanne Sundby
- Department of Community Medicine and Global Health, Institute of Health and Society, Faculty of Medicine, University of Oslo, Norway.
| | - Yesuf Ahmed Aragaw
- Department of Obstetrics and Gynaecology, Faculty of Medical Sciences, Jimma Institute of Health, Jimma University, Ethiopia.
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Sabin L, Hecht EMS, Brooks MI, Singh MP, Yeboah-Antwi K, Rizal A, Wylie BJ, Bondzie PA, Banos M, Tuchman J, Singh N, Hamer DH. Prevention and treatment of malaria in pregnancy: what do pregnant women and health care workers in East India know and do about it? Malar J 2018; 17:207. [PMID: 29776369 PMCID: PMC5960115 DOI: 10.1186/s12936-018-2339-9] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2017] [Accepted: 05/04/2018] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Limited qualitative research has been performed in India to investigate views and behaviours of pregnant women regarding malaria despite the threat of malaria-related adverse maternal and neonatal outcomes. To address this gap, a comprehensive study on malaria prevention and treatment attitudes, knowledge and behaviour among pregnant women in India was conducted. METHODS Pregnant women and healthcare workers (HCWs), encompassing clinic-based providers, traditional birth attendants, and auxiliary nurse-midwives were enrolled for in-depth interviews (IDIs) at 7 hospital sites and nearby communities in Jharkhand and Chhattisgarh States. Questions addressed health concerns and attitudes, knowledge and practices regarding malaria prevention and treatment; probing covered modern and traditional approaches. Data were analyzed using a thematic approach. RESULTS A total of 83 pregnant women and 119 HCWs participated in 202 IDIs, 90 in Jharkhand and 112 in Chhattisgarh. A majority of Jharkhand respondents, but only one-fourth in Chhattisgarh, named malaria among top health issues for pregnant women. Just over half of pregnant women were willing to try new prevention methods (especially insecticide-treated bed nets), although cost-related barriers to such methods were stressed. Most respondents voiced concerns about malaria treatment during pregnancy, mainly citing potential harm to the baby. Most knew that mosquitoes transmitted malaria, but a substantial minority, including among HCWs, described incorrect transmission modes. Most knew a proven prevention method (usually bed nets or coils); a few knew other methods. A minority of pregnant women, but most HCWs, knew about malaria treatment, although some HCWs described unproven treatments. Most respondents described use of modern prevention methods in their communities, typically bed nets, although probing revealed irregular use. Half (especially in Jharkhand and particularly HCWs) described use of traditional prevention approaches such as burning leaves and rubbing oils on the body; traditional remedies for malaria treatment were common, and varied by site and population. CONCLUSIONS Understanding of malaria varied as a concern for pregnant women, continued use of unproven malaria prevention and treatment strategies was evident in this population in India. These results highlight the need to educate both pregnant women and HCWs about effective malaria methods to protect pregnant women and their babies from malaria.
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Affiliation(s)
- Lora Sabin
- Department of Global Health, Boston University School of Public Health, 801 Massachusetts Ave, Boston, MA, USA.
| | - Evan M S Hecht
- Department of Global Health, Boston University School of Public Health, 801 Massachusetts Ave, Boston, MA, USA
| | - Mohamad I Brooks
- Pathfinder, International, 9 Galen Street, Suite 217, Watertown, MA, USA
| | - Mrigendra P Singh
- ICMR-National Institute of Malaria Research Field Station, IDVC Mission Medical College Campus, Jabalpur, India
| | - Kojo Yeboah-Antwi
- Department of Global Health, Boston University School of Public Health, 801 Massachusetts Ave, Boston, MA, USA
| | - Abanish Rizal
- Harvard University, Massachusetts Hall, Cambridge, MA, USA
| | - Blair J Wylie
- Department of Obstetrics, Gynecology, and Reproductive Biology, Beth Israel Deaconess Medical Center, 330 Brookline Ave, Boston, MA, USA
| | - Philip A Bondzie
- Boston University School of Medicine, 72 East Concord St, Boston, MA, USA
| | - Matthew Banos
- Department of Global Health, Boston University School of Public Health, 801 Massachusetts Ave, Boston, MA, USA
| | - Jordan Tuchman
- Abt Associates, 4550 Montgomery Ave, #800N, Bethesda, MA, USA
| | - Neeru Singh
- ICMR-National Institute of Malaria Research Field Station, IDVC Mission Medical College Campus, Jabalpur, India
| | - Davidson H Hamer
- Department of Global Health, Boston University School of Public Health, 801 Massachusetts Ave, Boston, MA, USA.,Section of Infectious Diseases, Department of Medicine, Boston University School of Medicine, Boston, MA, USA
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Pearson H, Fleming T, Chhoun P, Tuot S, Brody C, Yi S. Prevalence of and factors associated with utilization of herbal medicines among outpatients in primary health centers in Cambodia. BMC COMPLEMENTARY AND ALTERNATIVE MEDICINE 2018; 18:114. [PMID: 29609580 PMCID: PMC5879807 DOI: 10.1186/s12906-018-2181-1] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 07/19/2017] [Accepted: 03/20/2018] [Indexed: 02/06/2023]
Abstract
BACKGROUND Traditional, complementary and alternative medicine (TCAM) is seen as a way to provide healthcare in both developed and developing countries across the world. In Cambodia, there is a long tradition of using TCAM. However, scant studies have been conducted on the extent of Cambodian TCAM use and how it interacts with allopathic health care to date. In this study, we examined the prevalence of and factors associated with utilization of herbal medicines among patients with chronic diseases in primary health care settings in Cambodia. METHODS A cross-sectional survey was conducted in 2015 with outpatients receiving treatment and care for chronic diseases in two urban and two rural primary health centers purposively selected from Phnom Penh, Kampong Cham and Siem Reap. Every eligible patient was randomly selected at the health centers using a systematic sampling procedure. I-CAM-Q was used to measure TCAM use. A multivariate logistic regression model was constructed to identify factors associated with herbal medicine use. RESULTS In total, 1602 patients were included in this study, of whom 77.7% were female, and 51.2% were recruited from urban primary health centers with a mean age of 46.5 years (SD = 15.2). Of total, 27.0% reported at least one consultation with a TCAM provider in the past 12 months. The most common modality of TCAM used was herbal medicine (89%). Herbs were obtained at drug or folk stores (36.9%), from herbalists directly (28.5%) or from their own gardens (18.6%). Of herb users, 55.2% reported that herbs were somewhat helpful. After adjustment, herb users were significantly more likely to be female (AOR = 1.42, 95% CI = 1.12-2.67), have completed less schooling (AOR = 0.66, 95% CI = 0.45-0.96), were unemployed or homemakers (AOR = 0.23, 95% CI = 0.13-0.52) and have a gastrointestinal illness (AOR = 0.49, 95% CI = 0.39-0.62). CONCLUSIONS Herbal medicines are broadly used among chronic disease patients in Cambodia. Understanding TCAM use in the general population will support health care practitioners and policy makers to make informed decisions about the use of TCAM. Integration of TCAM into the primary health system should be further explored.
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Suswardany DL, Sibbritt DW, Supardi S, Pardosi JF, Chang S, Adams J. A cross-sectional analysis of traditional medicine use for malaria alongside free antimalarial drugs treatment amongst adults in high-risk malaria endemic provinces of Indonesia. PLoS One 2017; 12:e0173522. [PMID: 28329019 PMCID: PMC5362041 DOI: 10.1371/journal.pone.0173522] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2016] [Accepted: 02/21/2017] [Indexed: 01/21/2023] Open
Abstract
Background The level of traditional medicine use, particularly Jamu use, in Indonesia is substantial. Indonesians do not always seek timely treatment for malaria and may seek self-medication via traditional medicine. This paper reports findings from the first focused analyses of traditional medicine use for malaria in Indonesia and the first such analyses worldwide to draw upon a large sample of respondents across high-risk malaria endemic areas. Methods A sub-study of the Indonesia Basic Health Research/Riskesdas Study 2010 focused on 12,226 adults aged 15 years and above residing in high-risk malaria-endemic provinces. Logistic regression was undertaken to determine the significant associations for traditional medicine use for malaria symptoms. Findings Approximately one in five respondents use traditional medicine for malaria symptoms and the vast majority experiencing multiple episodes of malaria use traditional medicine alongside free antimalarial drug treatments. Respondents consuming traditional medicine for general health/common illness purposes every day (odds ratio: 3.75, 95% Confidence Interval: 2.93 4.79), those without a hospital in local vicinity (odds ratio: 1.31, 95% Confidence Interval: 1.10 1.57), and those living in poorer quality housing, were more likely to use traditional medicine for malaria symptoms. Conclusion A substantial percentage of those with malaria symptoms utilize traditional medicine for treating their malaria symptoms. In order to promote safe and effective malaria treatment, all providing malaria care in Indonesia need to enquire with their patients about possible traditional medicine use.
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Affiliation(s)
- Dwi Linna Suswardany
- Australian Research Centre in Complementary and Integrative Medicine (ARCCIM), Faculty of Health, University of Technology Sydney, Sydney, New South Wales, Australia
- Universitas Muhammadiyah Surakarta, Central Java, Indonesia
| | - David W. Sibbritt
- Australian Research Centre in Complementary and Integrative Medicine (ARCCIM), Faculty of Health, University of Technology Sydney, Sydney, New South Wales, Australia
| | - Sudibyo Supardi
- National Institute of Health Research and Development, Ministry of Health, Indonesia
| | - Jerico F. Pardosi
- National Institute of Health Research and Development, Ministry of Health, Indonesia
- School of Public Health and Community Medicine, University of New South Wales, Australia
| | - Sungwon Chang
- Australian Research Centre in Complementary and Integrative Medicine (ARCCIM), Faculty of Health, University of Technology Sydney, Sydney, New South Wales, Australia
| | - Jon Adams
- Australian Research Centre in Complementary and Integrative Medicine (ARCCIM), Faculty of Health, University of Technology Sydney, Sydney, New South Wales, Australia
- * E-mail:
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Pradeepkumar P, Govindaraj D, Jeyaraj M, Munusamy MA, Rajan M. Assembling of multifunctional latex-based hybrid nanocarriers from Calotropis gigantea for sustained (doxorubicin) DOX releases. Biomed Pharmacother 2017; 87:461-470. [DOI: 10.1016/j.biopha.2016.12.133] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2016] [Revised: 12/31/2016] [Accepted: 12/31/2016] [Indexed: 11/15/2022] Open
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