Traditional Complementary and Alternative Medicine: Knowledge, Attitudes and Practices of Health Care Workers in HIV and Aids Clinics in Durban Hospitals

Traditional complementary and alternative medicine (TCAM) has been reported to be commonly used among individuals with HIV and AIDS disease. However a lack of communication between health care workers (HCWs) and patients as well as between HCWs and TCAM practitioners has been identified as one of the challenges that may adversely affect treatment of HIV and AIDS patients. With improved and sustained communication HCWs, patients and TCAM practitioners would be able to make informed decisions with regards to best treatment practices based on the knowledge of what is safe, effective and what is not. In order to establish a baseline understanding of the current status of interaction and communication between HCWs and TCAM profession in Durban, South Africa, the purpose of the study was to investigate the knowledge, attitudes and practices of HCWs in the HIV and AIDS clinics towards TCAM professions. Data was collected by means of anonymous self-administered questionnaire which was distributed to HCWs in the HIV and AIDS clinics. Out of 161 HCWs in the HIV and AIDS clinics 81 HCWs returned the questionnaires resulting in 50% response rate. The results showed that participants did not possess a basic knowledge of TCAM. Out of 81 participants 23 (28%) scored zero in a true or false knowledge assessment question.Keywords: Traditional Complementary and Alternative medicine, Health care workers, knowledge attitude and practices, HIV and AIDS

Best practice programme in the standardisation of traditional medicines: Evaluation of an immune booster formulated by traditional healers of the Vaal Triangle, South Africa

Background: Regulation and standardization of African traditional medicines (ATM) prescribed by traditional healers in South Africa is still far from being implemented. This is despite the fact that more people are using ATM products than ever. In an effort to demonstrate that collaboration with traditional health practitioners (THPs) can yield standardized TM products, this study aimed to evaluate the immunomodulatory effects of an herbal immune booster formulated by traditional healers from the Vaal Region, South Africa.Materials and Methods: Using normal and lipopolysaccharide (LPS) stimulated human peripheral blood mononuclear cells (PBMCs) models, doses of the immune booster ranging from 1000 to 10 μg/mL were evaluated for their cytotoxicity, inflammatory cytokines and chemokines secretion, nitric oxide (NO) secretion, malondialdehyde (MDA) assay, and 1,1-diphenyl-2-picrylhydrazyl (DPPH) assay.Results: The immune booster induced a dose dependent cytotoxic effect on both normal and LPS stimulated PBMCs with higher doses showing cytotoxicity while lower dose from 100μg/mL did not show any cytotoxicity. When re-dissolved in aqueous PBS immune booster doses up to 100 μg/mL showed better DPPH radical inhibition (41%) than ascorbic acid at 40μg/mL (33%). The immune booster also decreased lipid peroxides significantly (p< 0.05) and this was comparable to ascorbic acid. There was also a significant (p< 0.05) increase in nitrite (NO) after treatment of LPS stimulated PBMCs with immune booster doses when compared to untreated samples. The immune booster stimulated inflammatory cytokines secretion in normal PBMCs (IL 1α, IL 1β, IL 6, IL 10 and TNFα while showing a decrease in IFNγ at the higher dose) while in LPS stimulated PBMCs some cytokines were decreased (IL 1α, IL 17α and at lower doses IL 10 and TNFα) and others were increased (IFNγ, TNFα and GM-CSF) depending on the dose used. In both normal and LPS stimulated PBMCs the immune booster significantly (p< 0.05) increased (MIP 1α) while causing significant (p< 0.05) decreases in IP 10 (high dose), I-TAC and MIG secretion.Conclusions: This immune booster showed potential immunostimulatory effects by increasing nitric oxide, inflammatory cytokines and chemokines secretion in both normal and LPS stimulated PBMCs. This TM also showed promising antioxidant potential in the MDA and DPPH assays. Further in vitro and animal studies are warranted.Keywords: Traditional healers, traditional medicines, regulation, standardization, immune stimulatio

Effects of Sutherlandia frutescens Extracts on Normal T-Lymphocytes In Vitro

Sutherlandia frutescens (SF), a popular traditional medicinal plant found in various parts of southern Africa, is used for treatment or management of HIV/AIDS and other diseases including cancer. However, its toxicity profile has not been fully established. The aims of this study were to examine the effects of 70% ethanol (SFE) and deionised water (SFW) extracts on normal isolated human T cells. An experimental study on normal human lymphocytes treated with doses SF extract doses ranging from 0.25 to 2.5 mg/ml. Untreated, vehicle-treated (Ethanol) and camptothecin (CPT) treated normal T cells were used as controls. Induction of cell death, changes in intracellular ATP, caspase-3/-7 activity and nuclear changes were analysed using flow cytometry, luminometry and nuclear staining (Hoechst) respectively. The highest concentration (2.5 mg/ml) of SFE extract induced significant necrosis (95%), depletion of ATP (76%), and inhibition of caspase-3/-7 activity (11%) following a 24 hour incubation period (p< 0.001). The 2.5 mg/ml concentration of SFW showed the same trend but were less effective (necrosis- 26%, ATP- 91%, & caspase-3/-7- 15%). These effects showed a time-dependence over 48 hours of incubation, with high doses of SFE extracts eliminating viable cells by necrosis, depleting ATP levels and decreasing caspase-3/-7 activity (p< 0.001). The activity of SFE extract was independent of ethanol. The SFW extract dilutions were less toxic than the SFE extracts. Significant DNA fragmentation as demonstrated by Hoechst staining was also seen over 48-hour incubation for high doses of both types of SF extracts. These results showed that although high concentrations of SF extracts can be toxic to normal T cells in vitro, SFW fractions were relatively safe for use.Keywords: Sutherlandia frutescens, T lymphocytes, flow cytometry, luminometry, necrosis, apoptosi

Description of a strain from an atypical population of Aspergillus parasiticus that produces aflatoxins B only, and the impact of temperature on fungal growth and mycotoxin production

In this study, an atypical strain of Aspergillus parasiticus is described. This strain, reported from Portuguese almonds, was named Aspergillus parasiticus B strain. The strain is herein characterised at the morphological and physiological levels, and compared with the typical A. parasiticus strain and other similar species in section Flavi. Previously published morphological and molecular data support that the B strain is very closely related to the A. parasiticus type strain. However, while A. parasiticus typically produces aflatoxins B and G, B strain produces aflatoxins B only. Furthermore, this atypical strain showed to differ from the typical strain in the fact that higher growth (colony diameter) and strain. This strain can become a major food safety concern in colder regions where the typical A. parasiticus strains are not well adapted.NORTE-07-0124-FEDER-000028PEst-OE/EQB/LA0023/2013PEst-OE/AGR/UI0690/201

A review of the integration of traditional, complementary and alternative medicine into the curriculum of South African medical schools

Background: Traditional, complementary and alternative (TCAM) medicine is consumed by a large majority of the South African population. In the context of increasing overall demand for healthcare this paper investigates the extent to which South African medical schools have incorporated TCAM into their curriculum because of the increased legislative and policy interest in formally incorporating TCAM into the health care system since democracy in 1994. Methods: Heads of School from seven South African medical schools were surveyed telephonically. Results: One school was teaching both Traditional African Medicine (TM) and CAM, five were teaching either TM or CAM and another was not teaching any aspect of TCAM. Conclusions: In conclusion, there is a paucity of curricula which incorporate TCAM. Medical schools have not responded to government policies or the contextual realities by incorporating TCAM into the curriculum for their students. South African medical schools need to review their curricula to increase their students' knowledge of TCAM given the demands of the population and the legislative realities