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Atawi R, Ayed A, Batran A. Traditional eye medicine practice and its determinant factors among ophthalmic patients in the West Bank. J Public Health Res 2024; 13:22799036241243267. [PMID: 38577243 PMCID: PMC10993683 DOI: 10.1177/22799036241243267] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2023] [Accepted: 03/14/2024] [Indexed: 04/06/2024] Open
Abstract
Background Traditional eye medicine (TEM) is becoming more widely used across the world. Depending on the drugs used, TEM usage can be considered harmful or innocuous. The therapy may induce infection or irreparable blindness in the already injured eye.The aim of the study was to determine the proportion of traditional eye medicine practices and associated factors among adult ophthalmic patients attending ophthalmic clinics in the governmental hospitals in the West Bank. Design and methods A cross-sectional study conducted on 300 patients. The data was collected using a structured, self-administered questionnaire. Results The results of the study revealed that 65.7% of people use TEM. The most common symptoms that necessitated the use of traditional eye practice were inflammatory symptoms of the eye (49.2%), blurred vision (15.7%), and allergic conjunctivitis (10.7%). The most common TEM used was tea (34.0%), followed by herbal products (25.4%) and vegetable slices (potato, cucumber, and onion) (14.7%). The most traditional eye treatment was the topical route (92.9%). The majority of prescribers of traditional eye practice were traditional healers (48.7%). Furthermore, the current study found that occupation and the income were predictors of using traditional eye practice among ophthalmic patients attending ophthalmic clinics in selected West Bank hospitals. Conclusion The proportion of traditional eye medicine practice was high among ophthalmic patients in the West Bank. The predictors of using traditional eye treatment were occupation and the income. The most common TEM used was tea, followed by herbal products and vegetable slices (potato, cucumber, and onion).
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Affiliation(s)
- Raghda Atawi
- Faculty of Graduate Studies, Arab American University, Jenin, Palestine
| | - Ahmad Ayed
- Faculty of Nursing, Arab American University, Jenin, Palestine
| | - Ahmad Batran
- Faculty of Allied Medical Sciences, Department of Nursing, Palestine Ahliya University, Bethlehem, Palestine
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Wubu KA, Ngatie AH, Haylie TA, Osman AD. Ethnobotanical study of traditional medicinal plants in Kebridehar and Shekosh districts, Korahi zone, Somali Region, Ethiopia. Heliyon 2023; 9:e22152. [PMID: 38125516 PMCID: PMC10730430 DOI: 10.1016/j.heliyon.2023.e22152] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2023] [Revised: 11/04/2023] [Accepted: 11/05/2023] [Indexed: 12/23/2023] Open
Abstract
This study was conducted in Kebridehar and Shekosh districts, Ethiopia, to investigate an ethnobotanical study on traditional medicinal plants. Systematic random sampling techniques were used for data collection. Preference ranking, paired comparison, informant consensus factor, direct matrix ranking, and jaccard comparison were used for data analysis. A total of 44 medicinal plant species from 34 genera and 23 families have been documented as being used to treat 38 human, 5 livestock, and 1 both human and livestock ailment. The shrub category was the dominant growth form in the study area. The study showed that the most frequently used plant parts for the preparation of traditional medicine were roots (45.45 %), followed by leaves, glue, and liquid (11.36 % each). The most common route of administration was oral (30.77 %), followed by dermal (20.51 %). Jaccard's Coefficient of Similarity for Kebridehar and Shekosh for the reported traditional medicinal plants were 0.21, indicating some trend towards using common plants. Methanol extracts were more effective than ethanol extracts. The results of this study provide an insight into the anti-bacterial properties of the extracts of Aloe megalacantha, Ephorbiarobecchi, and Oppiliacampestris. This in vitro study demonstrated that these three folklore medicinal plants have good potential. In conclusion, the main threat to medicinal plants in the study area was drought. Therefore, it is recommended that the cultivation of medicinal plants be encouraged in home gardens.
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Affiliation(s)
- Kassaw Awoke Wubu
- Kebridehar University, Department of Biology, P.O. Box 250, Ethiopia
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3
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Ngongo CJ, Raassen TJ, Mahendeka M, Lombard L, van Roosmalen J, Temmerman M. Rare causes of genital fistula in nine African countries: a retrospective review. BMC Womens Health 2022; 22:497. [PMID: 36474228 PMCID: PMC9724406 DOI: 10.1186/s12905-022-02050-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2022] [Accepted: 11/07/2022] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND Most genital fistulas result from prolonged, obstructed labor or surgical complications. Other causes include trauma (from accidents, traditional healers, or sexual violence), radiation, carcinoma, infection, unsafe abortion, and congenital malformation. METHODS This retrospective records review focuses on rare fistula causes among 6,787 women who developed fistula after 1980 and sought treatment between 1994 and 2017 in Tanzania, Uganda, Kenya, Malawi, Zambia, Rwanda, Ethiopia, Somalia, and South Sudan. We compare fistula etiologies across countries and assess associations between rare causes and type of incontinence (urine, feces, or both). RESULTS Rare fistula accounted for 1.12% (76/6,787) of all fistulas, including traumatic accidents (19/6,787, 0.28%), traumatic sexual violence (15/6,787, 0.22%), traumatic injuries caused by traditional healers (13/6,787, 0.19%), unsafe abortion (10/6,791, 0.15%), radiation (8/6,787, 0.12%), complications of HIV infection (6/6,787, 0.09%), and congenital abnormality (5/6,787, 0.07%). Trauma caused by traditional healers was a particular problem among Somali women. CONCLUSION Fistulas attributable to rare causes illuminate a variety of risks confronting women. Fistula repair training materials should distinguish trauma caused by traditional healers as a distinct fistula etiology. Diverse causes of fistula call for multi-pronged strategies to reduce fistula incidence.
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Affiliation(s)
- Carrie J. Ngongo
- grid.62562.350000000100301493Global Health Division, RTI International, Research Triangle Park, USA
| | | | - Marietta Mahendeka
- grid.413123.60000 0004 0455 9733Bugando Medical Centre, Mwanza, Tanzania
| | | | - Jos van Roosmalen
- grid.10419.3d0000000089452978Leiden University Medical Centre and Athena Institute VU University, Amsterdam, the Netherlands
| | - Marleen Temmerman
- grid.470490.eCentre of Excellence in Women and Child Health, Aga Khan University, Nairobi, Kenya ,grid.5342.00000 0001 2069 7798Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium
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4
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Bejiga G. Bilateral house advancement flap anoplasty for severe anal stenosis secondary to traditional medicine application with excellent outcome: "Case report". Int J Surg Case Rep 2021; 90:106725. [PMID: 34968983 PMCID: PMC8717220 DOI: 10.1016/j.ijscr.2021.106725] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2021] [Revised: 12/15/2021] [Accepted: 12/19/2021] [Indexed: 11/18/2022] Open
Abstract
Introduction and importance Anal stenosis is narrowing of anal canal that may result from true anatomic stricture or functional stenosis. Anal stenosis from irritant chemical application for hemorrhoid is rare and tends to be more severe. There is scarcity of data in the literature regarding anal stenosis secondary to traditional medicine application for the treatment of hemorrhoid. This case report can create awareness to promote health education and health advancement, especially in areas with wide spread use of traditional medicine. In addition, it can motivate general surgeons to prepare themselves to handle such cases in the absence of colorectal surgeons. Presentation of the case A 75 years old male farmer presented with worsening of difficulty of passing feces and flatus and intermittent abdominal distention of 3 months. The patient has history of application of irritant chemical by traditional healer for treatment of hemorrhoid. Physical examination led to diagnosis of severe anal stenosis. Bilateral house advancement flap anoplasty done by a general surgeon with excellent result. Discussion The commonest cause of anal stenosis is hemorrhoidectomy. Other causes include other anorectal surgeries, anorectal diseases, and radiotherapy. Diagnosis of anal stenosis is by physical examination. Treatment is conservative for mild cases and advancement flap anoplasty for moderate to severe cases. Conclusion Health education and health advancement can create awareness, hence preventing people from having wrong treatments. House advancement flap anoplasty is a good option for the treatment of anal stenosis in resource limited setup, as it is easy to do and has good outcome. Anal stenosis as a complication of traditional medicine application for hemorrhoid is rare. House advancement flap anoplasty is a good option for moderate to severe anal stenosis. Anal stenosis following irritant chemical application to perineum tends to be severe.
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Affiliation(s)
- Gosa Bejiga
- Adama Hospital Medical College, Adama, P.O. Box: 84, Ethiopia.
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5
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Pengpid S, Peltzer K. Utilization of complementary and traditional medicine practitioners among middle-aged and older adults in India: results of a national survey in 2017-2018. BMC Complement Med Ther 2021; 21:262. [PMID: 34654424 PMCID: PMC8518220 DOI: 10.1186/s12906-021-03432-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2021] [Accepted: 09/24/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Lack of information exists about the use of traditional and complementary medicine (TCM) use among middle-aged and older adults in India, which led to studying the estimates of past-12-month Ayurveda/Yoga/Naturopathy/Unani/Siddha/Homeopathy (AYUSH) practitioner and traditional health practitioner (THP) utilization in India. METHODS The study included 72,262 individuals (45 years and older) from the cross-sectional 2017-2018 Longitudinal Ageing Study in India (LASI) Wave 1. RESULTS The prevalence of past 12-month AYUSH practitioner utilization was 6.5%, THP use 7.0%, and AYUSH or THP use 13.0%. The rate of AYUSH practitioner utilization was determined by older age (≥60 years) (Adjusted Odds Ratio-AOR: 1.20, 95% Confidence Interval-CI: 1.07-1.34), having pain (AOR: 1.48, 95% CI: 1.29-1.69), any bone or joint diseases (AOR: 1.57, 95% CI: 1.35-1.82), current tobacco use (AOR: 1.30, 95% CI: 1.12-1.50), male sex (AOR: 0.76, 95% CI: 0.68-0.85), high subjective socioeconomic status (AOR: 0.72, 95% CI: 0.60-0.87), urban residence (AOR: 0.71, 95% CI: 0.57-0.88), diabetes (AOR: 0.66, 95% CI: 0.55-0.81), chronic heart disease (AOR: 0.52, 95% CI: 0.37-0.73), and having a health insurance cover (AOR: 0.36, 95% CI: 0.30-0.44). The rate of THP utilization was determined by depressive symptoms (AOR: 1.17, 95% CI: 1.01-1.35), sleep problems (AOR: 1.28, 95% CI: 1.08-1.51), having pain (AOR: 1.82, 95% CI: 1.55-2.15), current tobacco use (AOR: 1.35, 95% CI: 1.22-1.51), having health insurance cover (AOR: 0.41, 95% CI: 0.33-0.51), hypertension (AOR: 0.82, 95% CI: 0.71-0.95), diabetes (AOR: 0.50, 95% CI: 0.39-0.65), urban residence (AOR: 0.25, 95% CI: 0.19-0.34), and high subjective socioeconomic status (AOR: 0.70, 95% CI: 0.58-0.85). CONCLUSION A moderate prevalence of AYUSH practitioner and THP use among middle-aged and older adults in India was found and several factors associated with AYUSH practitioner and THP use were identified.
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Affiliation(s)
- Supa Pengpid
- ASEAN Institute for Health Development, Mahidol University, Salaya, Phutthamonthon, Nakhon Pathom, Thailand.,Department of Research Administration and Development, University of Limpopo, Turfloop, South Africa
| | - Karl Peltzer
- Department of Research Administration and Development, University of Limpopo, Turfloop, South Africa. .,Department of Psychology, College of Medical and Health Science, Asia University, Taichung, Taiwan.
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Pullen SJ, Herman AR, Lange BC, Christian-Brathwaite N, Ulloa M, Kempeh MP, Karnga DG, Fallah MP, Menyongai J, Harris B, Alonso Y, Henderson DC, Borba CP. Towards a better understanding of attitudes and beliefs held by traditional healers and recipients of traditional medicine concerning mental health conditions in post-conflict Liberia: a qualitative investigation. Afr Health Sci 2021; 21:1396-1409. [PMID: 35222605 PMCID: PMC8843300 DOI: 10.4314/ahs.v21i3.51] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Background A better understanding of attitudes and beliefs held by traditional healers and utilizers of traditional medicine concerning mental health conditions in Liberia is important as Liberia seeks to improve its delivery of mental healthcare in the context of scarce resources and recovery from civil war. Methods A qualitative research design was used to collect data from 24 Liberian traditional healers, and 11 utilizers of Liberian traditional medicine. Participants were queried about mental health problems in Liberia, treatments, and attitudes towards modern healthcare. Qualitative data were probed and aggregated using content analysis. Results Mental health problems described by study participants included: Open Mole, African Science, Epilepsy, Depression and Mental Illness (trauma/substance use). Mental health problems were often associated with socioeconomic distress, and participants described their attitudes and beliefs concerning mental healthcare, traditional medicine, and modern healthcare. Conclusion Traditional medicine is an important part of mental healthcare in Africa. Mental illness, social factors, and healthcare access were important problems in Liberia. Mental health problems blended local cultural beliefs with Westernized nosology and social factors. Traditional healer's attitudes towards Western medicine reflected ambivalence. There is a desire for collaboration with ‘modern’ health care providers, but this will require reciprocal trust-building.
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Affiliation(s)
- Samuel J Pullen
- Duke University School of Medicine, Department of Psychiatry and Behavioral Sciences, Division of Child and Family Mental Health and Community Psychiatry, Durham, NC.,Johns Hopkins Bloomberg School of Public Health, Baltimore
| | | | - Brittany Cl Lange
- University of Oxford - Department of Social Policy and Intervention, Oxford, England
| | | | - Melissa Ulloa
- New York University Steinhardt School of Culture, Education, and Human Development, 82 Washington Square E, New York, NY 10003
| | - Michael P Kempeh
- A.M. Dogliotti College of Medicine, University of Liberia, Monrovia, Liberia, College of Medicine University of Liberia, Monrovia, Liberia, West Africa
| | - Dyujay G Karnga
- A.M. Dogliotti College of Medicine, University of Liberia, Monrovia, Liberia, College of Medicine University of Liberia, Monrovia, Liberia, West Africa
| | - Mosoka P Fallah
- A.M. Dogliotti College of Medicine, University of Liberia, Monrovia, Liberia, College of Medicine University of Liberia, Monrovia, Liberia, West Africa.,National Public Health Institute of Liberia, Monrovia, Liberia
| | | | - Benjamin Harris
- A.M. Dogliotti College of Medicine, University of Liberia, Monrovia, Liberia, College of Medicine University of Liberia, Monrovia, Liberia, West Africa
| | - Yadira Alonso
- Boston University School of Medicine, Department of Psychiatry, Boston Medical Center, Boston, MA
| | - David C Henderson
- Boston University School of Medicine, Department of Psychiatry, Boston Medical Center, Boston, MA
| | - Christina Pc Borba
- Boston University School of Medicine, Department of Psychiatry, Boston Medical Center, Boston, MA
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Tan M, Otake Y, Tamming T, Akuredusenge V, Uwinama B, Hagenimana F. Local experience of using traditional medicine in northern Rwanda: a qualitative study. BMC Complement Med Ther 2021; 21:210. [PMID: 34389011 PMCID: PMC8362288 DOI: 10.1186/s12906-021-03380-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2020] [Accepted: 07/19/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The popular use of traditional medicine in low-income settings has previously been attributed to poverty, lack of education, and insufficient accessibility to conventional health service. However, in many countries, including in Rwanda, the use of traditional medicine is still popular despite the good accessibility and availability of conventional health services. This study aims to explore why traditional medicine is popularly used in Rwanda where it has achieved universal health coverage. METHODS The qualitative study, which included in-depth interviews and participant observations, investigated the experience of using traditional medicine as well as the perceived needs and reasons for its use in the Musanze district of northern Rwanda. We recruited 21 participants (15 community members and 6 traditional healers) for in-depth interviews. Thematic analysis was conducted to generate common themes and coding schemes. RESULTS Our findings suggest that the characteristics of traditional medicine are responding to community members' health, social and financial needs which are insufficiently met by the current conventional health services. Participants used traditional medicine particularly to deal with culture-specific illness - uburozi. To treat uburozi appropriately, referrals from hospitals to traditional healers took place spontaneously. CONCLUSIONS In Rwanda, conventional health services universally cover diseases that are diagnosed by the standard of conventional medicine. However, this universal health coverage may not sufficiently respond patients' social and financial needs arising from the health needs. Given this, integrating traditional medicine into national health systems, with adequate regulatory framework for quality control, would be beneficial to meet patients' needs.
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Affiliation(s)
- Mengxin Tan
- London School of Hygiene and Tropical Medicine, London, UK.
| | - Yuko Otake
- University of Oxford, School of Anthropology and Museum Ethnography, Oxford, UK
| | - Teisi Tamming
- London School of Hygiene and Tropical Medicine, London, UK
| | | | - Beatha Uwinama
- Abavuzi Gakondo Rwanda Network - Rwandan Traditional Healers Association, Ruhengeri, Rwanda
| | - Fabien Hagenimana
- Institut d'Enseignement Superieur (INES-Ruhengeri), Ruhengeri, Rwanda
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Bapolisi WA, Karemere H, Ndogozi F, Cikomola A, Kasongo G, Ntambwe A, Bisimwa G. First recourse for care-seeking and associated factors among rural populations in the eastern Democratic Republic of the Congo. BMC Public Health 2021; 21:1367. [PMID: 34246245 PMCID: PMC8272345 DOI: 10.1186/s12889-021-11313-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2020] [Accepted: 06/18/2021] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND Access to quality healthcare is a global fundamental human right. However, in the Democratic Republic of the Congo, several parameters affect the choices of health service users in fragile, rural contexts (zones). The overarching aim of this study was to identify the first recourse of healthcare-seeking and the determinants of utilization of health centers (primary health care structures) in the rural health zones of Katana and Walungu. METHODS A cross-sectional survey was conducted from June to September 2017. Consenting respondents comprised 1751 adults. Continuous data were summarized using means (standard deviation) and medians (interquartile range). We used Pearson's chi-square test and Fisher exact test to compare proportions. Logistic regression was run to assess socio-determinants of health center utilization. RESULTS The morbidity rate of the sample population for the previous month was 86.4% (n = 1501) of which 60% used health centers for their last morbid episode and 20% did not. 5.3% of the respondents patronized prayer rooms and 7.9% resorted to self-medication principally because the cost was low, or the services were fast. Being female (OR: 1.51; p = 0.005) and a higher level of education (OR: 1.79; p = 0.032) were determinants of the use of health centers in Walungu. Only the level of education was associated with the use of health centers in Katana (OR: 2.78; p = 0.045). CONCLUSION Our findings suggest that health centers are the first recourse for the majority of the population during an illness. However, a significant percentage of patients are still using traditional healers or prayer rooms because the cost is low. Our results suggest that future interventions to encourage integrated health service use should target those with lower levels of education.
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Affiliation(s)
- Wyvine Ansima Bapolisi
- Ecole Régionale de Santé Publique de Bukavu, Université Catholique de Bukavu, Bukavu, Democratic Republic of the Congo.
| | - Hermès Karemere
- Ecole Régionale de Santé Publique de Bukavu, Université Catholique de Bukavu, Bukavu, Democratic Republic of the Congo
| | - Freddy Ndogozi
- Division provincial de la Santé du Sud-Kivu, Bukavu, Democratic Republic of the Congo
| | - Aimé Cikomola
- Ecole Régionale de Santé Publique de Bukavu, Université Catholique de Bukavu, Bukavu, Democratic Republic of the Congo.,Division provincial de la Santé du Sud-Kivu, Bukavu, Democratic Republic of the Congo.,Programme RIPSEC (Renforcement Institutionnel des Institutions pour les Politiques de santé basées sur l'évidence en République Démocratique du Congo), Lubumbashi, Democratic Republic of the Congo
| | - Ghislain Kasongo
- Bureau central de la zone de santé de Walungu, Walungu, Democratic Republic of the Congo
| | - Albert Ntambwe
- Programme RIPSEC (Renforcement Institutionnel des Institutions pour les Politiques de santé basées sur l'évidence en République Démocratique du Congo), Lubumbashi, Democratic Republic of the Congo.,Ecole de santé Publique de l'Université de Lubumbashi, Lubumbashi, Democratic Republic of the Congo
| | - Ghislain Bisimwa
- Ecole Régionale de Santé Publique de Bukavu, Université Catholique de Bukavu, Bukavu, Democratic Republic of the Congo.,Programme RIPSEC (Renforcement Institutionnel des Institutions pour les Politiques de santé basées sur l'évidence en République Démocratique du Congo), Lubumbashi, Democratic Republic of the Congo
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Chuat M, Alcoba G, Eyong J, Wanda F, Comte E, Nkwescheu A, Chappuis F, Hudelson P. Dealing with snakebite in rural Cameroon: A qualitative investigation among victims and traditional healers. Toxicon X 2021; 9-10:100072. [PMID: 34337385 PMCID: PMC8313737 DOI: 10.1016/j.toxcx.2021.100072] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2021] [Revised: 06/28/2021] [Accepted: 07/07/2021] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND Snakebite is a neglected tropical disease (NTD) affecting rural and remote populations globally, who are additionally burdened by poverty and the lack of effective healthcare systems. Delayed healthcare and use of traditional treatments are very frequent. The purpose of our study was to explore perceptions of snakes, impact of snakebite, and knowledge and opinions of different snakebite treatments with the aim of identifying opportunities for improving snakebite management. METHODS This is a qualitative descriptive study based on semi-structured interviews with 21 snakebite victims and 4 traditional healers in 4 villages of Akonolinga health district, Center Region, Cameroon. Analysis focused on describing participants' perceptions of snakes, the impact of snakebite on the victims' lives, and their opinions of different treatment options. RESULTS Respondents were fearful of snakes and knowledgeable about envenoming symptoms and treatments. The experience of snakebite led to increased vigilance and avoidance behaviours, which sometimes resulted in financial loss for the victims. A range of traditional treatments were described, including tourniquets, black-stone application and medicinal plant decoctions. However, opinions were ambivalent regarding their efficacy, depending especially on previous personal experiences. Still, traditional treatments were said to be more available and cheaper than hospital care, and in particular, than antivenom. Nevertheless, most victims preferred hospital treatment if the financial and transportation barriers were lifted. Both snakebite victims and traditional healers were of the opinion that collaboration between health services and traditional healers could help to improve snakebite management and outcomes. CONCLUSION Our study shows that snakebite victims are in favour of using antivenom for the treatment of snakebite and would welcome better access to it. However, its current unavailability and high cost pushes them to turn to traditional treatments. On the other hand, traditional healers are in favour of collaborating with health facilities. These results are very encouraging for the improvement of snakebite management in Cameroon along the lines of the WHO Snakebite Envenoming Strategy for Prevention and Control: ensuring access to safe and effective treatment, and increasing partnership and coordination between communities, traditional healers, and conventional caregivers.
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Affiliation(s)
- Manon Chuat
- Faculty of Medicine, University of Geneva, Rue Michel-Servet 1, 1206, Genève, Geneva, Switzerland
| | - Gabriel Alcoba
- Division of Tropical and Humanitarian Medicine, Geneva University Hospitals, Rue Gabrielle-Perret-Gentil 4, 1205, Genève, Geneva, Switzerland
- Medical Department, Médecins Sans Frontières, Rue de Lausanne 78, 1211, Genève, Geneva, Switzerland
| | - Justin Eyong
- Centre International de Recherches, D'Enseignements et de Soins en Milieu Tropical (CIRES), CIRES BP 11, Akonolinga, Akonolinga, Cameroon
- Cameroon Society of Epidemiology (CaSE), Yaoundé, BP, 1411, Yaoundé, Cameroon
| | - Franck Wanda
- Centre International de Recherches, D'Enseignements et de Soins en Milieu Tropical (CIRES), CIRES BP 11, Akonolinga, Akonolinga, Cameroon
| | - Eric Comte
- Centre International de Recherches, D'Enseignements et de Soins en Milieu Tropical (CIRES), CIRES BP 11, Akonolinga, Akonolinga, Cameroon
| | - Armand Nkwescheu
- Cameroon Society of Epidemiology (CaSE), Yaoundé, BP, 1411, Yaoundé, Cameroon
- Faculty of Medicine and Biomedical Science, University of Yaoundé 1, Melen, Yaoundé, BP, 1364, Yaoundé, Yaoundé, Cameroon
| | - François Chappuis
- Division of Tropical and Humanitarian Medicine, Geneva University Hospitals, Rue Gabrielle-Perret-Gentil 4, 1205, Genève, Geneva, Switzerland
| | - Patricia Hudelson
- Department of Primary Care, Geneva University Hospitals, Rue Gabrielle-Perret-Gentil 4, 1205, Genève, Geneva, Switzerland
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Abstract
Despite extensive ethnographic and qualitative research on traditional healers in Nepal, the role of traditional healers in relation to mental health has not been synthesized. We focused on the following clinically based research question, "What are the processes by which Nepali traditional healers address mental well-being?" We adopted a scoping review methodology to maximize the available literature base and conducted a modified thematic analysis rooted in grounded theory, ethnography, and phenomenology. We searched five databases using terms related to traditional healers and mental health. We contacted key authors and reviewed references for additional literature. Our scoping review yielded 86 eligible studies, 65 of which relied solely on classical qualitative study designs. The reviewed literature suggests that traditional healers use a wide range of interventions that utilize magico-religious explanatory models to invoke symbolic transference, manipulation of local illness narratives, roles, and relationships, cognitive restructuring, meaning-making, and catharsis. Traditional healers' perceived impact appears greatest for mild to moderate forms of psychological distress. However, the methodological and sample heterogeneity preclude uniform conclusions about traditional healing. Further research should employ methods which are both empirically sound and culturally adapted to explore the role of traditional healers in mental health.
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Affiliation(s)
- Tony V Pham
- Department of Psychiatry and Behavioral Sciences, Duke University, 2301 Erwin Road, Durham, NC, 27701, USA.
- Duke Global Health Institute, Durham, NC, USA.
| | - Bonnie N Kaiser
- Duke Global Health Institute, Durham, NC, USA
- Department of Anthropology and Global Health Program, University of California San Diego, La Jolla, CA, USA
| | - Rishav Koirala
- Transcultural Psychosocial Organization Nepal, Kathmandu, Nepal
- University of Oslo, Oslo, Norway
- Brain and Neuroscience Center Nepal, Kathmandu, Nepal
| | | | | | - Lauren Franz
- Department of Psychiatry and Behavioral Sciences, Duke University, 2301 Erwin Road, Durham, NC, 27701, USA
- Duke Global Health Institute, Durham, NC, USA
- Division of Child and Adolescent Psychiatry, University of Cape Town, Cape Town, South Africa
| | - Brandon A Kohrt
- Department of Psychiatry and Behavioral Sciences, Duke University, 2301 Erwin Road, Durham, NC, 27701, USA
- Duke Global Health Institute, Durham, NC, USA
- Transcultural Psychosocial Organization Nepal, Kathmandu, Nepal
- Department of Psychiatry and Behavioral Sciences, George Washington, Washington, DC, USA
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Bounlu M, Auditeau E, Vorachit S, Chivorakoun P, Souvong V, Soukhasem T, Sannikone S, Preux PM, Boumediene F. Management of epilepsy in Laos: Perceptions of healthcare professionals from Vientiane Capital province and traditional healers in Southern Laos. J Tradit Complement Med 2021; 11:46-52. [PMID: 33511061 PMCID: PMC7817710 DOI: 10.1016/j.jtcme.2019.12.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2019] [Revised: 12/21/2019] [Accepted: 12/26/2019] [Indexed: 11/03/2022] Open
Abstract
Background and aim Traditional practices are deeply rooted in Lao people's perceptions and beliefs about health and illness.The objective of the study was to understand the perceptions of healthcare professionals and traditional healers regarding the management of epilepsy in Laos, and their reciprocal views. Experimental procedure An observational study was carried out in two areas of Laos from February to May 2017. Semi directive questionnaires were used to collect quantitative and qualitative data. Semiotic square was carried out to highlight relationships between attitudes of traditional healers and healthcare professionals. For quantitative approach, the proportions were reported, and the test used was Fisher's test for nominal variables. The mean and standard deviation expressed the continuous variables and the Student's t-test was used. Results and conclusion Epilepsy was cited by 90.9% of traditional healers as a convulsive disease with saliva or urine, and herbal medicines were predominantly used (86.4%) to treat it. Few healthcare professionals (26.5%) pointed out that they knew remedies to treat epilepsy other than antiepileptic drugs (AEDs), and 76.5% of healthcare professionals mentioned that epilepsy was a disease which only AEDs could treat. On the other hand, 54.5% of traditional healers confirmed a traditional remedy could cure completely epilepsy through long-term use. Ninety percent of traditional healers said the collaboration with healthcare professionals was a good idea and 44.1% of the healthcare professionals group said was complicated.The combination of these medicines for the management of epilepsy needs to be adapted to Lao's medical context.
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Affiliation(s)
- Mayoura Bounlu
- INSERM U1094, Univ. Limoges, CHU Limoges, IRD, U1094, Tropical Neuroepidemiology, Institute of Epidemiology and Tropical Neurology, GEIST, Limoges, France.,Association for Patient with Epilepsy in Laos (Lao APE), Vientiane, Lao People's Democratic Republic
| | - Emilie Auditeau
- INSERM U1094, Univ. Limoges, CHU Limoges, IRD, U1094, Tropical Neuroepidemiology, Institute of Epidemiology and Tropical Neurology, GEIST, Limoges, France
| | - Somchit Vorachit
- Association for Patient with Epilepsy in Laos (Lao APE), Vientiane, Lao People's Democratic Republic
| | - Phetvongsinh Chivorakoun
- INSERM U1094, Univ. Limoges, CHU Limoges, IRD, U1094, Tropical Neuroepidemiology, Institute of Epidemiology and Tropical Neurology, GEIST, Limoges, France.,Association for Patient with Epilepsy in Laos (Lao APE), Vientiane, Lao People's Democratic Republic
| | - Vimalay Souvong
- Association for Patient with Epilepsy in Laos (Lao APE), Vientiane, Lao People's Democratic Republic
| | - Thidachanh Soukhasem
- Association for Patient with Epilepsy in Laos (Lao APE), Vientiane, Lao People's Democratic Republic
| | - Sonesimmaly Sannikone
- Association for Patient with Epilepsy in Laos (Lao APE), Vientiane, Lao People's Democratic Republic
| | - Pierre-Marie Preux
- INSERM U1094, Univ. Limoges, CHU Limoges, IRD, U1094, Tropical Neuroepidemiology, Institute of Epidemiology and Tropical Neurology, GEIST, Limoges, France
| | - Farid Boumediene
- INSERM U1094, Univ. Limoges, CHU Limoges, IRD, U1094, Tropical Neuroepidemiology, Institute of Epidemiology and Tropical Neurology, GEIST, Limoges, France
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Benzekri NA, Sambou JF, Ndong S, Tamba IT, Faye D, Diallo MB, Diatta JP, Faye K, Sall I, Sall F, Manga NM, Malomar JJ, Ndour CT, Hawes SE, Seydi M, Gottlieb GS. Prevalence, predictors, and management of advanced HIV disease among individuals initiating ART in Senegal, West Africa. BMC Infect Dis 2019; 19:261. [PMID: 30876400 PMCID: PMC6420737 DOI: 10.1186/s12879-019-3826-5] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2018] [Accepted: 02/15/2019] [Indexed: 01/01/2023] Open
Abstract
BACKGROUND The WHO guidelines for the management of advanced HIV disease recommend a package of care consisting of rapid initiation of antiretroviral therapy (ART), enhanced screening and diagnosis of tuberculosis (TB) and cryptococcal meningitis, co-trimoxazole prophylaxis, isoniazid preventive therapy (IPT), fluconazole pre-emptive therapy, and adherence support. The goals of this study were to determine the prevalence of advanced HIV disease among individuals initiating ART in Senegal, to identify predictors of advanced disease, and to evaluate adherence to the WHO guidelines. METHODS This study was conducted among HIV-positive individuals initiating ART in Dakar and Ziguinchor, Senegal. Clinical evaluations, laboratory analyses, questionnaires and chart review were conducted. Logistic regression was used to identify predictors of advanced disease. RESULTS A total of 198 subjects were enrolled; 70% were female. The majority of subjects (71%) had advanced HIV disease, defined by the WHO as a CD4 count < 200 cells/mm3 or clinical stage 3 or 4. The median CD4 count was 185 cells/mm3. The strongest predictors of advanced disease were age ≥ 35 (OR 5.80, 95%CI 2.35-14.30) and having sought care from a traditional healer (OR 3.86, 95%CI 1.17-12.78). Approximately one third of subjects initiated ART within 7 days of diagnosis. Co-trimoxazole prophylaxis was provided to 65% of subjects with CD4 counts ≤350 cells/mm3 or stage 3 or 4 disease. TB symptom screening was available for 166 subjects; 54% reported TB symptoms. Among those with TB symptoms, 39% underwent diagnostic evaluation. Among those eligible for IPT, one subject received isoniazid. No subjects underwent CrAg screening or received fluconazole to prevent cryptococcal meningitis. CONCLUSIONS This is the first study to report an association between seeking care from a traditional healer and presentation with WHO defined advanced disease in sub-Saharan Africa. Given the widespread use of traditional healers in sub-Saharan Africa, future studies to further explore this finding are indicated. Although the majority of individuals in this study presented with advanced disease and warranted management according to WHO guidelines, there were numerous missed opportunities to prevent HIV-associated morbidity and mortality. Programmatic evaluation is needed to identify barriers to implementation of the WHO guidelines and enhanced funding for operational research is indicated.
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Affiliation(s)
- Noelle A Benzekri
- Department of Medicine, University of Washington, Box 358061, 750 Republican St, Seattle, WA, 98109-4725, USA.
| | | | - Sanou Ndong
- Service des Maladies Infectieuses et Tropicales, Centre Hospitalier National Universitaire (CHNU) de Fann, Dakar, Senegal
| | | | | | - Mouhamadou Baïla Diallo
- Service des Maladies Infectieuses et Tropicales, Centre Hospitalier National Universitaire (CHNU) de Fann, Dakar, Senegal
| | | | - Khadim Faye
- Service des Maladies Infectieuses et Tropicales, Centre Hospitalier National Universitaire (CHNU) de Fann, Dakar, Senegal
| | | | - Fatima Sall
- Service des Maladies Infectieuses et Tropicales, Centre Hospitalier National Universitaire (CHNU) de Fann, Dakar, Senegal
| | | | | | - Cheikh T Ndour
- Division de Lutte contre le Sida et les IST, Ministère de la Santé et de l'Action Sociale, Dakar, Sénégal
| | - Stephen E Hawes
- Department of Epidemiology, University of Washington, Seattle, WA, USA.,Department of Global Health, University of Washington, Seattle, WA, USA
| | - Moussa Seydi
- Service des Maladies Infectieuses et Tropicales, Centre Hospitalier National Universitaire (CHNU) de Fann, Dakar, Senegal
| | - Geoffrey S Gottlieb
- Department of Medicine, University of Washington, Box 358061, 750 Republican St, Seattle, WA, 98109-4725, USA.,Department of Global Health, University of Washington, Seattle, WA, USA
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13
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Faruque MO, Feng G, Khan MNA, Barlow JW, Ankhi UR, Hu S, Kamaruzzaman M, Uddin SB, Hu X. Qualitative and quantitative ethnobotanical study of the Pangkhua community in Bilaichari Upazilla, Rangamati District, Bangladesh. J Ethnobiol Ethnomed 2019; 15:8. [PMID: 30722779 PMCID: PMC6364474 DOI: 10.1186/s13002-019-0287-2] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/09/2018] [Accepted: 01/16/2019] [Indexed: 05/30/2023]
Abstract
BACKGROUND The present study documents the ethnomedicinal knowledge among the traditional healers of the Pangkhua indigenous community of Bangladesh. The documented data from this area was quantitatively analyzed for the first time. We aimed to record ethnomedicinal information from both the traditional healers and also the elderly men and women of the community, in order to compile and document all available information concerning plant use and preserve it for the coming generations. We aimed to compare how already known species are used compared to elsewhere and particularly to highlight new ethnomedicinal plant species alongside their therapeutic use(s). METHODS All ethnomedicinal information was collected following established techniques. Open-ended and semi-structured techniques were primarily utilized. Data was analyzed using different quantitative indices. The level of homogeneity between information provided by different informants was calculated using the Informant Consensus Factor. All recorded plant species are presented in tabular format, alongside corresponding ethnomedicinal usage information. RESULTS This investigation revealed the traditional use of 117 plant species, distributed among 104 genera and belonging to 54 families. There was strong agreement among the informants regarding ethnomedicinal uses of plants, with Factor of Informant Consensus (FIC) values ranging from 0.50 to 0.66, with the highest number of species (49) being used for the treatment of digestive system disorders (FIC 0.66). In contrast, the least agreement (FIC = 0.50) between informants regarding therapeutic uses was observed for plants used to treat urinary disorders. The present study was compared with 43 prior ethnomedicinal studies, conducted both nationally and in neighboring countries, and the results revealed that the Jaccard index (JI) ranged from 1.65 to 33.00. The highest degree of similarity (33.00) was found with another study conducted in Bangladesh, while the lowest degree of similarity (1.65) was found with a study conducted in Pakistan. This study recorded 12 new ethnomedicinal plant species, of which 6 have never been studied pharmacologically to date. CONCLUSIONS This study showed that the Pangkhua community still depends substantially on ethnomedicinal plants for the treatment of various ailments and diseases and that several of these plants are used in novel ways or represented their first instances of use for medicinal applications.
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Affiliation(s)
- Mohammad Omar Faruque
- Ethnobotany and Pharmacognosy Lab, Department of Botany, University of Chittagong, Chittagong, 4331 Bangladesh
- Laboratory of Drug Discovery and Molecular Engineering, Department of Medicinal Plants, College of Plant Science and Technology, Huazhong Agricultural University, Wuhan, 430070 China
- National-Regional Joint Engineering Research Center in Hubei for Medicinal Plant Breeding and Cultivation, Wuhan, 430070 China
- Medicinal Plant Engineering Research Center of Hubei Province, Huazhong Agricultural University, Wuhan, China
| | - Gang Feng
- Wuhan Fourth Hospital, Puai Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430034 China
| | | | - James W. Barlow
- Department of Chemistry, Royal College of Surgeons in Ireland, Dublin, Ireland
| | - Umme Ruman Ankhi
- Ethnobotany and Pharmacognosy Lab, Department of Botany, University of Chittagong, Chittagong, 4331 Bangladesh
| | - Sheng Hu
- Hubei Cancer Hospital, Wuhan, 430034 China
| | - M. Kamaruzzaman
- The State Key Laboratory of Agricultural Microbiology, Ministry of Education, Department of Plant Pathology, Collage of Plant Science and Technology, Huazhong Agricultural University, Wuhan, Hubei China
| | - Shaikh Bokhtear Uddin
- Ethnobotany and Pharmacognosy Lab, Department of Botany, University of Chittagong, Chittagong, 4331 Bangladesh
| | - Xuebo Hu
- Laboratory of Drug Discovery and Molecular Engineering, Department of Medicinal Plants, College of Plant Science and Technology, Huazhong Agricultural University, Wuhan, 430070 China
- National-Regional Joint Engineering Research Center in Hubei for Medicinal Plant Breeding and Cultivation, Wuhan, 430070 China
- Medicinal Plant Engineering Research Center of Hubei Province, Huazhong Agricultural University, Wuhan, China
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14
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Quandt SA, Sandberg JC, Graham A, Mora DC, Stub T, Arcury TA. Mexican Sobadores in North Carolina: Manual Therapy in a New Settlement Context. J Immigr Minor Health 2018; 19:1186-1195. [PMID: 27449216 DOI: 10.1007/s10903-016-0466-3] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Latino immigrants to the New Settlement area of the southeastern United States face structural and cultural obstacles to accessing the conventional health care system, and come from areas with long traditions of medical treatments from healers without professional training or licensure. Little is known about the use of such healers in New Settlement areas. This study focuses on sobadores, healers who use manipulative therapy. Goals were to describe sobadores practicing in North Carolina, including their background, conditions treated, and their understanding of the pathophysiology of their patients' conditions and how their treatments work. The paper also describes who sobadores treat and sobadores' understanding of where their treatment fits into patients' pursuit of relief from symptoms. This focused ethnography draws from in-depth, semi-structured interviews conducted with six sobadores from Mexico practicing in North Carolina. These sobadores appear to meet both structural and cultural needs for healthcare in the immigrant Latino population.
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Affiliation(s)
- Sara A Quandt
- Department of Epidemiology and Prevention, Division of Public Health Sciences, Medical Center Boulevard, Wake Forest School of Medicine, Winston-Salem, NC, 27157, USA.
| | - Joanne C Sandberg
- Department of Family and Community Medicine, Wake Forest School of Medicine, Winston-Salem, NC, 27157, USA
| | - Alan Graham
- Graham Chiropractic PLLC, 1300 Ashley Square, Winston-Salem, NC, 27103, USA
| | - Dana C Mora
- Department of Family and Community Medicine, Wake Forest School of Medicine, Winston-Salem, NC, 27157, USA
| | - Trine Stub
- Department of Epidemiology and Prevention, Division of Public Health Sciences, Medical Center Boulevard, Wake Forest School of Medicine, Winston-Salem, NC, 27157, USA.,UiT The Arctic University of Norway, Sykehusveien 23, 9037, Tromsø, Norway
| | - Thomas A Arcury
- Department of Family and Community Medicine, Wake Forest School of Medicine, Winston-Salem, NC, 27157, USA
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15
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Keikelame MJ, Swartz L. "By working together and caring for one another we can win this fight": A qualitative exploration of a traditional healer's perspectives of care of people with epilepsy in a South African urban township in Cape Town. Epilepsy Behav 2018; 79:230-233. [PMID: 29249449 DOI: 10.1016/j.yebeh.2017.10.026] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/30/2017] [Accepted: 10/22/2017] [Indexed: 10/18/2022]
Abstract
There is a gap in knowledge about the construction of care in the Global South where biomedical care remains largely inaccessible to many people, resulting in people seeking health care from the indigenous sector of health care. As part of a larger study, in this, article we present findings from a single individual interview with an indigenous healer using a semi-structured interview guide that was based on Kleinman's Explanatory Model Framework. Key themes that emerged from the thematic analysis of our indigenous healer's audio-recorded transcribed transcript were about "care". The four overarching subthemes were the following: (i) care in the family, (ii) care in the community, (iii) care in the health system, and (iv) respondents' construction of care. A key feature of care, for this healer, is its explicit location in lineages of community - care is seen not as an individual or organizational issue, but part of the shared social fabric. We argue that it is crucial to attend to the lay understandings and practices of care which reflect diverse ways of understanding care and relationality in context. Future research is needed to close this gap.
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Affiliation(s)
- Mpoe Johannah Keikelame
- Department of Psychology, Stellenbosch University, Private Bag X1, Matieland, 7602 Cape Town, South Africa.
| | - Leslie Swartz
- Department of Psychology, Stellenbosch University, Private Bag X1, Matieland, 7602 Cape Town, South Africa.
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16
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Pallangyo P, Nicholaus P, Mayala H, Kabeho A, Nkinda A, Janabi M. Human immunodeficiency virus infection acquired through a traditional healer's ritual: a case report. J Med Case Rep 2017; 11:301. [PMID: 29070083 PMCID: PMC5657111 DOI: 10.1186/s13256-017-1458-1] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2017] [Accepted: 09/18/2017] [Indexed: 11/29/2022] Open
Abstract
Background Globally, over 36 million people were infected with human immunodeficiency virus by the end of 2015. The Sub-Saharan African region home to less than one-fifth of the global population disproportionately harbors over two-thirds of the total infections and related deaths. Residents of Sub-Saharan Africa continue to face limited access to allopathic medicine and it is estimated that over 80% of primary health care needs in the region are met through traditional healing practices. It is known that some of these practices are performed in groups and the use of unsterilized instruments is common thus potentiating the transmission of human immunodeficiency virus. Case presentation A 29-year-old business woman of African origin residing in rural Tanzania presented at a screening event to confirm her human immunodeficiency virus status. Her past medical history was unremarkable and so were two past pregnancies. As per the antenatal clinic card for the second pregnancy, her human immunodeficiency virus serostatus was negative. She reported that she had been taken to a traditional healer to take an oath of remaining faithful during her husband’s absence. The oath involved cutting of the healer’s skin followed by hers using the same instrument. Approximately 4 months following this traditional ritual she developed a febrile illness accompanied by enlarged lymph nodes of her neck. She was investigated for malaria, typhoid fever, and urinary tract infection which were negative but she tested positive for human immunodeficiency virus. Owing to her disbelief regarding the human immunodeficiency virus status, she went to three other care and treatment clinics and the results remained similar. She denied any history of transfusion or extramarital affairs. She tested positive at the screening event and enzyme-linked immunosorbent assay for human immunodeficiency virus performed at our institution was reactive. Tenofovir, lamivudine, and efavirenz antiretroviral combination was initiated. Conclusions Persistence of cultural norms involving exposure of bodily fluids and use of unsterilized instruments especially in the developing world remains a viable source of human immunodeficiency virus transmission especially in rural areas.
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Affiliation(s)
- Pedro Pallangyo
- Department of Cardiovascular Medicine, Jakaya Kikwete Cardiac Institute, P.O Box 65141, Dar es Salaam, Tanzania.
| | - Paulina Nicholaus
- Department of Cardiovascular Medicine, Jakaya Kikwete Cardiac Institute, P.O Box 65141, Dar es Salaam, Tanzania
| | - Henry Mayala
- Department of Cardiovascular Medicine, Jakaya Kikwete Cardiac Institute, P.O Box 65141, Dar es Salaam, Tanzania
| | - Andrew Kabeho
- Department of Cardiovascular Medicine, Jakaya Kikwete Cardiac Institute, P.O Box 65141, Dar es Salaam, Tanzania
| | - Anna Nkinda
- Department of Cardiovascular Medicine, Jakaya Kikwete Cardiac Institute, P.O Box 65141, Dar es Salaam, Tanzania
| | - Mohamed Janabi
- Department of Cardiovascular Medicine, Jakaya Kikwete Cardiac Institute, P.O Box 65141, Dar es Salaam, Tanzania
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Tchuenkam LW, Ndame EK, Guifo ML, Danwang C, Kalla GC, Essomba A. An unusual complication of the traditional treatment of a closed fracture - generalized tetanus: a case report. J Med Case Rep 2017; 11:298. [PMID: 29061192 PMCID: PMC5654018 DOI: 10.1186/s13256-017-1477-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2017] [Accepted: 09/25/2017] [Indexed: 12/03/2022] Open
Abstract
Background Tetanus is a severe infectious disease that can lead to death. The clinical manifestations are due to an exotoxin secreted by Clostridium tetani, a spore-producing Gram-positive bacillus. The penetration of the germ is made through a skin opening, independently of the size of the wound. Case presentation A 13-year-old black African boy of the Bantu ethnic group with unknown tetanus vaccination status presented to our pediatric emergency room for the management of chest and vertebral pains which started a few days after traditional treatment by scarification and herbal and leaf ointment. The treatment was initiated by a traditional healer and indicated for a closed fracture of our patient’s left forearm sustained during a fight. The diagnosis of generalized tetanus was made on the basis of generalized contractures with opisthotonus, trismus, and autonomic nervous system dysfunction. Despite prompt intensive care management, he died a few hours after admission. Conclusion This case emphasizes the permanent threat of tetanus in our environment especially after cultural and traditional acts like scarification that in this specific case was for a therapeutic purpose.
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Affiliation(s)
- Landry W Tchuenkam
- Faculty of Medicine and Biomedical Sciences, University of Yaounde I, Yaounde, Cameroon.
| | - Emmanuel K Ndame
- Faculty of Medicine and Biomedical Sciences, University of Yaounde I, Yaounde, Cameroon
| | - Marc L Guifo
- Department of Surgery and Specialties, Faculty of Medicine and Biomedical Sciences, University of Yaounde I, Yaounde University Hospital Center, Yaounde, Cameroon
| | - Celestin Danwang
- Faculty of Medicine and Biomedical Sciences, University of Yaounde I, Yaounde, Cameroon
| | - Ginette C Kalla
- Department of Pediatric, Faculty of Medicine and Biomedical Sciences, University of Yaounde I, Yaounde University Hospital Center, Yaounde, Cameroon
| | - Arthur Essomba
- Department of Surgery and Specialties, Faculty of Medicine and Biomedical Sciences, University of Yaounde I, Yaounde University Hospital Center, Yaounde, Cameroon
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18
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Moshabela M, Bukenya D, Darong G, Wamoyi J, McLean E, Skovdal M, Ddaaki W, Ondeng'e K, Bonnington O, Seeley J, Hosegood V, Wringe A. Traditional healers, faith healers and medical practitioners: the contribution of medical pluralism to bottlenecks along the cascade of care for HIV/AIDS in Eastern and Southern Africa. Sex Transm Infect 2017; 93:sextrans-2016-052974. [PMID: 28736393 PMCID: PMC5739844 DOI: 10.1136/sextrans-2016-052974] [Citation(s) in RCA: 44] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2016] [Revised: 05/03/2017] [Accepted: 05/06/2017] [Indexed: 11/04/2022] Open
Abstract
OBJECTIVES There are concerns that medical pluralism may delay patients' progression through the HIV cascade-of-care. However, the pathways of impact through which medical pluralism influence the care of people living with HIV (PLHIV) in African settings remain unclear. We sought to establish the manifestation of medical pluralism among PLHIV, and explore mechanisms through which medical pluralism contributes bottlenecks along the HIV care cascade. METHODS We conducted a multicountry exploratory qualitative study in seven health and demographic surveillance sites in six eastern and southern African countries: Uganda, Kenya, Tanzania, Malawi, Zimbabwe and South Africa. We interviewed 258 PLHIV at different stages of the HIV cascade-of-care, 48 family members of deceased PLHIV and 53 HIV healthcare workers. Interviews were conducted using shared standardised topic guides, and data managed through NVIVO 8/10/11. We conducted a thematic analysis of healthcare pathways and bottlenecks related to medical pluralism. RESULTS Medical pluralism, manifesting across traditional, faith-based and biomedical health-worlds, contributed to the care cascade bottlenecks for PLHIV through three pathways of impact. First, access to HIV treatment was delayed through the nature of health-related beliefs, knowledge and patient journeys. Second, HIV treatment was interrupted by availability of alternative options, perceived failed treatment and exploitation of PLHIV by opportunistic traders and healers. Lastly, the mixing of biomedical healthcare providers and treatment with traditional and faith-based options fuelled tensions driven by fear of drug-to-drug interactions and mistrust between providers operating in different health-worlds. CONCLUSION Medical pluralism contributes to delays and interruptions of care along the HIV cascade, and mistrust between health providers. Region-wide interventions and policies are urgently needed in sub-Saharan Africa to minimise potential harm and consequences of medical pluralism for PLHIV. The role of sociocultural beliefs in mediating bottlenecks necessitate adoption of culture-sensitive approaches intervention designs and policy reforms appropriate to the context of sub-Saharan Africa.
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Affiliation(s)
- Mosa Moshabela
- Department of Rural Health, School of Nursing and Public Health, University of KwaZulu-Natal, Durban, South Africa.,Africa Health Research Institute, KwaZulu-Natal, South Africa
| | | | - Gabriel Darong
- Africa Health Research Institute, KwaZulu-Natal, South Africa
| | - Joyce Wamoyi
- Tanzanian National Institute of Medical Research, Mwanza, Tanzania
| | - Estelle McLean
- Malawi Epidemiology and Intervention Research Unit, Karonga, Malawi.,London School of Hygiene and Tropical Medicine, London, UK
| | - Morten Skovdal
- Department of Public Health, University of Copenhagen, Copenhagen, Denmark.,Biomedical Research and Training Institute, Harare, Zimbabwe
| | | | - Kenneth Ondeng'e
- Kenya Medical Research Institute, Centre for Global Health Research, Kisumu, Kenya
| | | | - Janet Seeley
- Africa Health Research Institute, KwaZulu-Natal, South Africa.,MRC/UVRI Uganda Research Unit on AIDS, Entebbe, Uganda.,London School of Hygiene and Tropical Medicine, London, UK
| | - Victoria Hosegood
- Africa Health Research Institute, KwaZulu-Natal, South Africa.,University of Southampton, Southampton, UK
| | - Alison Wringe
- London School of Hygiene and Tropical Medicine, London, UK
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Sandberg JC, Quandt SA, Graham A, Stub T, Mora DC, Arcury TA. Medical Pluralism in the Use of Sobadores among Mexican Immigrants to North Carolina. J Immigr Minor Health 2018; 20:1197-205. [PMID: 28994002 DOI: 10.1007/s10903-017-0660-y] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
Mexican immigrants have a rich history of traditional healers. This analysis describes the conditions for which Mexican immigrants seek treatment from sobadores, and delineates factors that influence seeking treatment from a sobador or a biomedical doctor. This systematic qualitative analysis uses interview data collected with 24 adult Mexican immigrants to North Carolina who had been treated by a sobador in the previous 2 years. Immigrants are engaged in medical pluralism, seeking care from sobadores and biomedical doctors based on the complaint and patient's age. Using a hierarchy of resort, adults seek treatment from sobadores for musculoskeletal pain not involving a fracture. Doctors are first consulted when treating children; sobadores are consulted if doctors do not provide culturally appropriate treatment. Mexican immigrants seek care that addresses their culturally determined health concerns. The need to improve access to culturally competent biomedical health care for vulnerable immigrant populations continues.
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20
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Audet CM, Ngobeni S, Wagner RG. Traditional healer treatment of HIV persists in the era of ART: a mixed methods study from rural South Africa. BMC Complement Altern Med 2017; 17:434. [PMID: 28854905 PMCID: PMC5577748 DOI: 10.1186/s12906-017-1934-6] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 10/26/2016] [Accepted: 08/18/2017] [Indexed: 11/10/2022]
Abstract
BACKGROUND Human immunodeficiency virus (HIV) substantially contributes to the burden of disease and health care provision in sub-Saharan Africa, where traditional healers play a major role in care, due to both their accessibility and acceptability. In rural, northeastern South Africa, people living with HIV often ping-pong between traditional healers and allopathic providers. METHODS We conducted 27 in-depth interviews and 133 surveys with a random sample of traditional healers living in Bushbuckridge, South Africa, where anti-retroviral therapy (ART) is publicly available, to learn: (1) healer perspectives about which HIV patients they choose to treat; (2) the type of treatment offered; (3) outcomes expected, and; (4) the cost of delivering treatment. RESULTS Healers were mostly female (77%), older (median: 58.0 years; interquartile range [IQR]: 50-67), with low levels of formal education (median: 3.7 years; IQR: 3.2-4.2). Thirty-nine healers (30%) reported being able to cure HIV in an adult patients whose (CD4) count was >350cells/mm3. If an HIV-infected patient preferred traditional treatment, healers differentiated two categories of known HIV-infected patients, CD4+ cell counts <350 or ≥350 cells/mm3. Patients with low CD4 counts were routinely referred back to the health facility. Healers who reported offering/performing a traditional cure for HIV had practiced for less time (mean = 16.9 vs. 22.8 years; p = 0.03), treated more patients (mean 8.7 vs. 4.8 per month; p = 0.03), and had lower levels of education (mean = 2.8 vs. 4.1 years; p = 0.017) when compared to healers who reported not treating HIV-infected patients. Healers charged a median of 92 USD to treat patients with HIV. CONCLUSION Traditional healers referred suspected HIV-infected patients to standard allopathic care, yet continued to treat HIV-infected patients with higher CD4 counts. A greater emphasis on patient education and healer engagement is warranted.
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Musyimi CW, Mutiso VN, Nayak SS, Ndetei DM, Henderson DC, Bunders J. Quality of life of depressed and suicidal patients seeking services from traditional and faith healers in rural Kenya. Health Qual Life Outcomes 2017; 15:95. [PMID: 28482849 PMCID: PMC5422872 DOI: 10.1186/s12955-017-0657-1] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2016] [Accepted: 04/13/2017] [Indexed: 11/27/2022] Open
Abstract
Background In rural Kenya, traditional and faith healers provide an alternative pathway to health care, including mental health care. However, not much is known about the characteristics of the populations they serve. The purpose of this study was to determine the relationship between depression, suicidal ideation, and socio-demographic variables with Quality of Life (QoL) indicators in a sample seeking mental health services from traditional and faith healers in rural Kenya. Understanding QoL in this sample can help develop mental health policy and training to improve the well-being of this population. Method This was a cross-sectional epidemiological survey (n = 443) conducted over a period of 3 months among adult patients seeking care from traditional and faith healers in rural Kenya. Data were collected using the Beck Depression Inventory II (BDI-II), Beck Scale for Suicide Ideation (BSS) and WHO Quality of Life Survey- BREF (WHOQOL-BREF), and analyzed using correlation analyses, parametric tests, and regression analyses. Results Increasing levels of depression were associated with lower QoL among patients seeking care from traditional and faith healers. BSS scores were significantly negatively correlated with overall, physical, psychological, and environmental QoL, p < .05. There was a statistically significant difference between mean scores for overall QoL between depressed (M = 2.35, SD = 0.76) and non-depressed participants (M = 3.03, SD = 0.67), t(441) = 8.899, p < .001. Overall life satisfaction for depressed participants (M = 2.23, SD = 0.69) was significantly lower than non-depressed participants. Regression analyses indicated that depression, suicidal ideation, and being married predicted lower overall QoL controlling for other variables. Post hoc tests and subgroup analysis by gender revealed significant differences for females only. Depression, and older age predicted lower life satisfaction whereas being self-employed predicted higher life satisfaction, when controlling for other variables. Conclusion This study sheds light on correlates of QoL in depressed and non-depressed patients in rural Kenya. Evidence suggests that traditional and faith healers treat patients with a variety of QoL issues. Further research should focus on understanding how these issues tie into QoL, and how these healers can target these to improve care.
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Affiliation(s)
- Christine W Musyimi
- Africa Mental Health Foundation, Nairobi, Kenya.,Vrije Universiteit, Amsterdam, Netherlands
| | | | | | - David M Ndetei
- Africa Mental Health Foundation, Nairobi, Kenya. .,University of Nairobi, Nairobi, Kenya.
| | - David C Henderson
- Boston University School of Medicine, Boston, USA.,Harvard Medical School, Boston, USA
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Afungchwi GM, Hesseling PB, Ladas EJ. The role of traditional healers in the diagnosis and management of Burkitt lymphoma in Cameroon: understanding the challenges and moving forward. BMC Complement Altern Med 2017; 17:209. [PMID: 28399870 PMCID: PMC5387296 DOI: 10.1186/s12906-017-1719-y] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/10/2017] [Accepted: 04/05/2017] [Indexed: 11/25/2022]
Abstract
BACKGROUND Burkittlymphoma(BL) is the most common childhood cancer in Cameroon with a reported incidence of 3 per 100,000 children under 15 years in the Northwest region. Treatment at three Baptist mission hospitals has a recorded cure rate of over 50%. Traditional medicine(TM) is recognized by the national health system, but its scope is undefined and entraps children with BL. The aim of this study was to investigate the attitudes and practices of parents and traditional healers (TH) towards TM in children with BL in order to develop recommendations for an integrative approach and improved access to life-saving treatment for children with BL. METHODS This is a descriptive case series of children diagnosed with BL treated at Banso, Mbingo, and Mutengene Baptist Hospitals between 2003 and 2014. A questionnaire was used to obtain the following information: demographic information, religion, the rate of use of TM, reasons why guardians chose to use TM, the diagnoses made by the TH, treatment offered, and the type of payment requested, based on the accounts of patient caregivers. Data was analyzed using Center for Disease Control Epi Info 7. RESULTS Three hundred eighty-seven questionnaires were completed by parents/guardians. 55% had consulted a TH, of whom 76.1% consulted the TH as first choice. Common diagnoses provided by TH included liver problem, abscess, witchcraft, poison, hernia, side pain, mushroom in the belly and toothache. Methods of management included massage, cuts, concoctions, and incantations. The fee for these services included chickens, farm tools, and cash ranging from 200FCFA (0.4USD) to 100,000FCFA(200USD). The choice of TM was based on accessibility, failed clinic/hospital attendance, recommendation of relatives, and belief in TM. CONCLUSIONS TH are involved in BL management in Cameroon. TH are ignorant about BL, resulting in non-referral, and thus delay in diagnosis and treatment. Collaboration with TH could reduce late diagnosis and improve cure rates of BL and other childhood cancers.
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Affiliation(s)
- Glenn M. Afungchwi
- Banso Baptist Hospital, Bui Division, Northwest region, Kumbo, Republic of Cameroon
| | - Peter B. Hesseling
- Department of paediatrics and child health, Tygerberg children’s Hospital, Stellenbosch University, Cape Town, South Africa
| | - Elena J. Ladas
- Division of Pediatric Hematology/Oncology/Stem Cell Transplant and Institute of Human Nutrition, Columbia University Medical Centre, 3959 Broadway, New York, New York CHN 10-06A USA
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