Management of diabetes and hypertension among Zulu traditional health practitioners: A study of focus group interviews

Introduction: On the African continent, the rising cost of Western medication that is accessible for the treatment of both diabetes and hypertension encourages people to rely on traditional medicine assisted by traditional health practitioners to mitigate the effects of these chronic conditions. This study was carried out to explore Zulu traditional health practitioners’ perspectives on managing both diabetes and hypertension. Methods: Five focus group discussions sessions were held in June 2018, using a semi-structured interview guide. Discussions were audiotaped and the content was thematically analysed. Sixty-seven traditional health practitioners (39 females and 28 males) were purposely selected from the three geospatial locations (urban, traditional or tribal, and farm areas) in uMshwathi (UMgungundlovu District) and Emnambithi/Ladysmith (uThukela District), KwaZulu-Natal, South Africa. Results: The majority of Zulu traditional health practitioners regarded diabetes and hypertension as the same condition, since one (having diabetes) leads to the other (hypertension).The following symptoms – weight loss, sweating easily, shortness of breath and eyesight problems – were the most commonly reported clinical features for both diabetes and hypertension by Zulu traditional health practitioners in this study. Although many traditional health practitioners were secretive about the recipes used in their practice, a few indicated using herbal mixtures containing Aloe vera and Allium sativum (garlic) for the management of both diabetes and hypertension. Conclusions: Some similarities exist between Zulu traditional health practitioners and orthodox conventional medicine in terms of the description of clinical features of diabetes and hypertension. Ethnopharmacological preparations consisted mainly of two medicinal plants, Aloe vera and Allium sativum, for the management of both diabetes and hypertension by Zulu traditional health practitioners. Ethiop. J. Health Dev. 2019; 33(4):219-228] Keywords: Diabetes,hypertension,polyherbal formulations,herbal mixtures,traditional health practitioner

Evaluation of concomitant use of prescribed antimicrobial medicines with traditional medicines in iLembe District, South Africa: A medical chart review

AbstractBackground: Antimicrobial resistance in South Africa is driven by many factors, such as the careless use of prescribed antimicrobial medicines and the use of traditional medicines, with the result that there is always the danger of misadministration, interaction, and toxicity. This study was conducted in two different public healthcare facilities in iLembe District, KwaZulu-Natal Province, South Africa to determine whether any interaction occurred among patients attending outpatient departments in selected healthcare facilities in terms of the concurrent use of traditional medicines and prescribed antimicrobial medicines. Methods: This study was a cross-sectional descriptive study using medical chart reviews. Antimicrobials prescribed alone or in association with traditional medicines were assessed and reported using descriptive statistics. Where applicable, associations were carried out; a p-value ˂0.05 was estimated as statistically significant. Results: A total of 400 outpatients’ medical records were documented from two different municipalities, revealing that many participants had viral infections (194/400, 48.5%). Overall, 12% of participants (48/400) had documented adverse effects (30/48) and interactions (18/48). A few participants (15/400) used traditional medicines in conjunction with prescribed medicines. After adjustment, negative clinical outcomes namely adverse effects and interactions were significantly more likely due to the use of traditional medicines (AOR=0.01, 95% CI:0.001-0.05) and (AOR=0.21, 95% CI: 0.37-1.23), respectively. Conclusions: Traditional medicine was used sparingly in conjunction with prescribed antimicrobials for infectious diseases. However, adverse effects and interactions, such as herbal intoxication, persistent rashes, and treatment failure, were documented in a few medical records. Further studies are needed to investigate the effects of the concurrent use of traditional medicine with antimicrobials or other prescribed medicines from the perspectives of traditional healers and biomedically healthcare professionals. [Ethiop. J. Health Dev. 2021; 35(1):58-71] Key words: Concomitant use, prescribed antimicrobials, traditional medicine, antimicrobial resistance, treatment failure, adverse effect

Concurrent use of Antiretroviral and African traditional medicines amongst people living with HIV/AIDS (PLWA) in the eThekwini Metropolitan area of KwaZulu Natal

Background: People living with HIV/AIDS (PLWA) often use African Traditional Medicines (ATM) either alone or in combination with Western medicines including Antiretrovirals (ARV).Objective: To explore the prevalence of concurrent Antiretrovirals (ARV) and African Traditional medicines (ATM) use and determine the effects of any concurrent use on the CD4+ Lymphocyte count and Viral Load (VL) of PLWA in the eThekwini Metropolitan area.Methods: A descriptive and exploratory study was carried out on 360 patients. Information was gathered on patients socioeconomic characteristics, ATM usage, outcome measures of HIV disease progression (CD4+ Count, VL). The data was analysed using descriptive statistics, univariate and multivariate analyses.Results: 4.98% (14/281) of the patients used ATM and ARV concurrently during the study period. Over 65% (185/281) reported ATM use before diagnosis with HIV whilst 77.6% (218/281) reported previous ATM use after their HIV diagnosis but before initiation with ARV. Place of residence (p=0.004), age (p<0.001) and education level (P=0.041) were found to be significantly and positively correlated with ATM use. There were no statistically significant changes in mean plasma CD4+ Count and inconclusive effects on VL during the period of the study in the group taking ARV alone when compared with the group using ARV and ATM concomitantly.Conclusion: Concurrent ARV and ATM use is quite low (4.98%) when compared to ATM use before HIV diagnosis and after HIV diagnosis but before initiation with ARV. This may point to efficient pre-counselling efforts before ARV initiation by health care professionals. This study also demonstrated that there were no significant differences in the CD4+ and inconclusive effects on VL, between patients taking both ARV and ATM concomitantly and those using ARV alone.Keywords: African traditional medicines, AIDS; ARV; complimentary medicines, Drug-Herb interactions, Herbal medicine,HIV; Indigenous medicine, Medical Pluralism, South Afric

Concurrent use of Antiretroviral and African traditional medicines amongst people living with HIV/AIDS (PLWA) in the eThekwini Metropolitan area of KwaZulu Natal

Background: People living with HIV/AIDS (PLWA) often use African Traditional Medicines (ATM) either alone or in combination with Western medicines including Antiretrovirals (ARV). Objective: To explore the prevalence of concurrent Antiretrovirals (ARV) and African Traditional medicines (ATM) use and determine the effects of any concurrent use on the CD4+ Lymphocyte count and Viral Load (VL) of PLWA in the eThekwini Metropolitan area. Methods: A descriptive and exploratory study was carried out on 360 patients. Information was gathered on patients socioeconomic characteristics, ATM usage, outcome measures of HIV disease progression (CD4+ Count, VL). The data was analysed using descriptive statistics, univariate and multivariate analyses. Results: 4.98% (14/281) of the patients used ATM and ARV concurrently during the study period. Over 65% (185/281) reported ATM use before diagnosis with HIV whilst 77.6% (218/281) reported previous ATM use after their HIV diagnosis but before initiation with ARV. Place of residence (p=0.004), age (p<0.001) and education level (P=0.041) were found to be significantly and positively correlated with ATM use. There were no statistically significant changes in mean plasma CD4+ Count and inconclusive effects on VL during the period of the study in the group taking ARV alone when compared with the group using ARV and ATM concomitantly. Conclusion: Concurrent ARV and ATM use is quite low (4.98%) when compared to ATM use before HIV diagnosis and after HIV diagnosis but before initiation with ARV. This may point to efficient pre-counselling efforts before ARV initiation by health care professionals. This study also demonstrated that there were no significant differences in the CD4+ and inconclusive effects on VL, between patients taking both ARV and ATM concomitantly and those using ARV alone

Phytochemical profile and in vitro antioxidant activity of Emelia M (EMB), Mshikazi and Delosma H herbal medicines as demonstrated in THP-1 and Jurkat leukaemia cell lines

Background: Three decoctions, namely Emelia M (EMB), Mshikazi and Delosma H are used by traditional health practitioners in KwaZulu-Natal, South Africa to treat and manage leukaemia and related conditionsObjectives: This study evaluated the in vitro antioxidant activity and phytochemical profile of the aqueous extracts of Emelia M (EMB), Mshikazi and Delosma H decoctions.Methods: Antioxidant activity of the extracts was evaluated using1-diphenyl-2-picrylhydrazyl (DPPH), glutathione (GSH), phosphomolybdate and thiobarbituric acid reactive substance (TBARS) assays. Phytochemical screening was used to determinethe presence of compounds.Results: The DPPH radical scavenging activity was similar to ascorbic acid for EMB and Delosma H, but not for Mshikazi. At 24 h, EMB increased GSH in both THP-1 and Jurkat cells similar to Delosma H while Mshikazi demonstrated the lowest activity. At 48 h, EMB and Delosma H revealed increased GSH in THP-1 cells with no significant decrease in GSH levels in Jurkat cells. However, EMB showed the lowest lipid peroxidation activity compared to Delosma H and Mshikazi after 24 h treatment of both cells. Phenols, flavonoids, terpenoids, saponins were present in all extracts.Conclusion: Extracts of the three decoctions possess both antioxidant and prooxidant properties through high scavenging activity and increased in lipid peroxidation. Keywords: Antioxidants; herbal medicines; Emelia M; Mshikazi; Delosma H

Evidence on collaboration of traditional and biomedical practitioners in the management of antimicrobial resistance in sub-Saharan Africa over 15 years : a systematic review protocol

BACKGROUND : The overuse of prescribed antimicrobials, concurrent use of traditional medicine, and prescribed antimicrobials have led to antimicrobial resistance. The absence of collaboration between traditional health practitioners and biomedically trained healthcare professionals can contribute to antimicrobial resistance, treatment failure, overdose, toxicity, and misadministration. This scoping review explores the evidence on collaboration between traditional health practitioners and biomedically trained healthcare professionals to reduce antimicrobial resistance and treatment failure in bacterial and viral diseases. METHODS : We will search for electronic databases such as Science Direct, Google Scholar, PubMed, and MEDLINE via EBSCOhost. We will also search reference lists of included studies. A two-stage mapping procedure will be carried out. Stage one (1) will consist of the title, abstracts, and full article screening, respectively. A pilot screening form guided by the defined eligibility criteria will be used. In stage two (2), data will be extracted from the included studies. Two reviewers will conduct parallel screening and data extraction. Mixed methods appraisal tool (MMAT) will be used to assess the quality of the included studies. NVIVO version 11 will be employed to aid pertinent thematic analysis. The outcomes of interest will be as follows: Primary outcome will be preventing and reducing antimicrobial resistance. The secondary effect is the effective collaboration between traditional healthcare practitioners and biomedically healthcare professionals. DISCUSSION : This review anticipates uncovering pertinent publications reporting the evidence of collaboration between traditional health practitioners and biomedically trained healthcare professionals to reduce antimicrobial resistance in sub-Saharan Africa. The sum-up of evidence acquired from the included studies will help guide future research. The result of the study will be print and electronically exposed.http://www.systematicreviewsjournal.comdm2022School of Health Systems and Public Health (SHSPH

Comorbidities and co-infections reported by study participants.

<p>Comorbidities and co-infections reported by study participants.</p

Association between variables and use of traditional medicine.

<p>Association between variables and use of traditional medicine.</p

Socio-demographic characteristics of participants.

<p>Socio-demographic characteristics of participants.</p