Use Of Indigenous Medicine Research Articles

Place, displacement, and health-seeking behaviour among the Ugandan Batwa: A qualitative study.

For many Indigenous Peoples, relationships to the land are inherent in identity and culture, and to all facets of health and wellbeing, physically, emotionally, psychologically, and spiritually. The Batwa are Indigenous Peoples of rural, southwest Uganda who have experienced tremendous social and economic upheaval, due to relatively recent forced displacement and land dispossession. This loss of physical connection to their ancestral lands has significantly impacted Batwa health, and also affected available healthcare options for Batwa. This exploratory study (1) identified and characterized factors that influence Batwa health-seeking behaviour, using acute gastrointestinal illness, a critical public health issue, as a focal point for analysis; and (2) explored possible intersections between the Batwa's connection to place-and displacement-and their health-seeking behaviour for acute gastrointestinal illness. Twenty focus group discussions, stratified by gender, were conducted in ten Batwa settlements in Kanungu District, Uganda and eleven semi-structured interviews were conducted with primary healthcare workers, community health coordinators, clinical officers, and development program coordinators. Qualitative data were thematically analyzed using a constant comparative method. Batwa identified several significant motivators to engage with Indigenous and/or biomedical forms of healthcare, including transition to life outside the forest and their reflections on health in the forest; 'intellectual access' to care and generational knowledge-sharing on the use of Indigenous medicines; and Batwa identity and way of life. These nuanced explanations for health-seeking behaviour underscore the significance of place-and displacement-to Batwa health and wellbeing, and its relationship to their health-seeking behaviour for acute gastrointestinal illness. As such, the results of this study can be used to inform healthcare practice and policy and support the development of a culturally- and contextually-appropriate healthcare system, as well as to reduce the burden of acute gastrointestinal illness among Batwa.

Mercury and Movement Disorders: The Toxic Legacy Continues

ABSTRACT:Mercury (Hg) exists in the environment as inorganic (metallic Hg vapor, mercurous and mercuric salts) or organic (bonded to a structure containing carbon atoms) forms. Neurotoxic effect of Hg is known for years. While the organic form (methylmercury (meHg)) led to the Minamata incidence in Japan and “wonder-wheat” disaster in Iraq, the “mad hatters” and “Danbury shakes” were related to the inorganic elemental form (Hg vapor). Human exposure to toxic Hg continues in the modern world to a large extent by artisanal gold mining, biomass combustion, chloralkali production, and indigenous medicine use to name a few. Heavy industrial use of Hg contaminates air and landfills, affecting the aquatic ecosystem and marine food chain. A detailed social and occupational history with a high index of clinical suspicion is required to not miss this toxic etiology for movement disorders like ataxia, tremor, or myoclonus. In this review, we have discussed the past and present global health impact of Hg from a movement disorder perspective. The connection of Hg with neurodegeneration and autoimmunity has been highlighted. We have also discussed the role of chelating agents and the preventive strategies to combat the neurotoxic effects of Hg in the modern world.

The Use of Indigenous Medicine Among Women During Pregnancy and Labour in Rural Ghana

The increasing use of herbal medicine and related products in pregnancy has been noticed all over the world, however, the safety of these medicines becomes particularly important among pregnant women and children. In spite of the insufficient data to justify herbal use during pregnancy, exposure to herbal products in unspecified quantities among pregnant women is of great concern. This study assessed the determinants of herbal use (Kaligu-tim), a known local oxytocin and its impact on the maternal birth outcomes in a rural district in Ghana. Descriptive cross-sectional study design was used. It consisted of 339 women attending postnatal care and child welfare clinics across the district. Data collection was done using a structured questionnaire. The selection of respondents was done using a systematic sampling technique. The data were coded and entered into SPSS version 22.0 for analysis. From the study, 64.9% and 45.4% of respondents had used local oxytocin in their previous and current pregnancies respectively; 5.5% did so during the first trimester, 26.8% in the second trimester and 67.7% in the third trimester. The study found a significant relationship between the use of herbal medicine and health service-related challenges, maternal age, the gestational term at delivery, parity of the respondents and mothers’ ethnicity. Previous and current use of Kaligu-tim reduced birth weight by 26g and 34.3g respectively, though these were not statistically significant. However, the previous history of Kaligu-tim was significantly associated with perinatal asphyxia, postpartum haemorrhage, obstructed labour and foetal distress in their subsequent deliveries. It can be concluded that the use of this Kaligu-tim possesses a greater long term health challenge for mothers and their babies.

Acute Kidney Injury in Tropical Countries

Acute kidney injury (AKI) in tropical countries is strikingly different from that in countries with a temperate climate. Tropical regions are characterised by year-round high temperatures and the absence of frost, which supports the propagation of infections that can potentially cause AKI. The aetiology and presentation of AKI reflects the ethnicity, socioeconomic factors, and ecological conditions in tropical countries. Apart from infections, other causes of AKI include exposure to animal toxins, ingestion of plant toxins or chemicals, poisoning, and obstetric complications. The low income status, poor access to treatment, and sociocultural practices (use of indigenous medicines) contribute to poor outcomes of patients with AKI. The exact aetiologic diagnosis often cannot be made due to lack of appropriate laboratory services. The epidemiology of AKI in tropical regions is changing over time. Renal replacement therapy is inaccessible to the majority and late presentation with delayed treatment add to the risk for future development of chronic kidney disease. AKI is often the primary cause of chronic kidney disease in the developing world, which increases demand for renal replacement therapy and transplantation. Most causes of AKI in developing countries are preventable and strategies to improve the public health and increased access to effective medical care are the need of the hour. This review offers comprehensive ideas about epidemiology, aetio-pathogenesis, clinical presentation, diagnosis, treatment, and prevention of community-acquired AKI in the tropics, with special reference to the Indian subcontinent. AKI is an under-recognised cause of morbidity and mortality in developing countries and even small, simple interventions could have an impact on its outcome.

Understanding usage and preference for health care therapies in a Ghanaian context: A pluralistic perspective

ABSTRACTStudies of health care and health-care seeking behaviour in Ghana have mainly shown that many patients tend to use indigenous medicine to address their health care needs. These studies have cited affordability, acceptability, availability, and accessibility as major factors behind the predominant use of indigenous medicine. Nevertheless, in these studies, researchers often ignore the third health care option – self-care, usually subjugated under the indigenous medical system. Since the mid-1980s, both biomedical and indigenous health care systems have witnessed transformations that have shaped and changed their modes of operation, as well as the cost of treatment. In light of this, the author seeks to understand the motivations behind the preference for and use of self-care, professional biomedical care, and indigenous forms of care in the context of Ghana’s health care system. A qualitative, in-depth interview technique was used for data gathering. Findings from the study revealed that time and cost of treatment were major factors accounting for the predominant use of self-care. The author concludes that the findings challenge the long-held belief that biomedicine is not widely accepted by people in Ghana compared with indigenous medicine.

Utilization of Novel Technologies in Natural Product Research: Radical Progress

Present day health care scientists are engaged in development of herbal formulations for all kind of health related problems as an alternative to modern medicine which show high level of side effects. Now a day’s use of indigenous medicines from plant origin has enormously increased worldwide. The world market for herbal drugs, herbal products and raw materials is estimated as US $80-90 billion and is expected to grow [1] to US $5 trillion by the year 2050. India is known for immense wealth of long established acquaintance and perception in the use of herbal medicines since ancient time. Indian herbal formulation industry is growing enormously every year with widespread market growth per annum. The increased global demand for herbal plants and their various constituents opened a new avenue to expand the Indian trade and commerce [2]. The scientific validation and technological standardization of herbal drugs may be achieved using a safe path of reverse pharmacology approach based on traditional knowledge database [3]. This may help in drug discovery, development and therapeutics, more than all, may help in dealing with a distinctive Western bias against Indian traditional medicine [4].

The use of indigenous medicine for the treatment of hypertension by a rural community in northern Maputaland, South Africa

Worldwide, the occurrence of hypertension is the highest in the African WHO Region where 46% of adults above the age of 24years suffer from hypertension. This study was undertaken to document the plants used by lay persons in a rural community for the treatment of hypertension, and to determine to what extent they use these plants concurrently with prescribed drugs for hypertension. A total of one hundred lay people with knowledge on antihypertension plants were interviewed using structured questionnaires. Information regarding vernacular plant names, plant parts used, preparation, and dosages was collected, as well as some health information with reference to hypertension. It was found that a total of 28 plant species were used singularly or in 17 different plant combinations in decoctions to treat hypertension. Twenty plant species have never been documented before for the treatment of hypertension. The species most used were: Momordica balsamina (by 44 interviewees), Aloe marlothii (32), Hypoxis hemerocallidea (17), Musa acuminata (10), Strychnos madagascariensis (10), and Senecio serratuloides (9). Thirty-one of the 50 people who had been diagnosed with hypertension were supplementing their prescribed hypertension drugs with medicinal plants. None of them had revealed to their healthcare practitioners that they were also using herbal medicines. Although none of the interviewees were aware of the possible consequences of drug interactions, they were mindful of some side effects caused by the medicinal plants they used for the treatment of hypertension. According to the majority of the interviewees, hypertension is caused by unhappiness and stress. Information from the community was cited as their main source of which plants to use to treat hypertension. It is clear from this survey that medicinal plant remedies play a vital role in the treatment of not just communicable diseases but also in the treatment of chronic ailments like hypertension by the lay persons in this deep rural area. The findings suggested that there is no awareness of the risks that may accompany the simultaneous use of conventional medication and medicinal plants. There is a definitive need to educate health practitioners and patients of the risks they are taking in using both prescribed hypertension drugs and medicinal plants.

Authors' Reply to Sibel Yöntem and Colleagues' Comment on "Indigenous Medicine Use for Sex Selection During Pregnancy and Risk of Congenital Malformations: A Population-Based Case-Control Study in Haryana, India".

Authors' Reply to Sibel Yöntem and Colleagues' Comment on "Indigenous Medicine Use for Sex Selection During Pregnancy and Risk of Congenital Malformations: A Population-Based Case-Control Study in Haryana, India".

Walking the Fine Line between Science and Culture.

Our abilities to evaluate pregnant women for fetal abnormalities have greatly expanded seemingly overnight as result of advances mostly facilitated by the completion of the Human Genome Project. From the incorporation of cell-free nucleic acid technologies into screening algorithms for fetal chromosomal and select genomic abnormalities to the increasing use of microarrays to detect cytogenetic and genomic abnormalities from amniotic fluid or chorionic villus samples, our capabilities to detect fetal abnormalities have markedly improved over the past 5 years. When combining these improved molecular diagnostics with improving imaging technologies and expertise, we can now accurately detect a wide range of fetal abnormalities, many of which were not detectable a decade ago. However, before we congratulate ourselves on our accomplishments, it is equally important to recognize that our advancements in diagnostics have not kept pace with our understanding of the etiologies of many, if not most fetal abnormalities. Indeed, the long-standing struggle of genetics vs. environment has actually never been more complicated and blurred. It seems that as we learn more about genetic and epigenetic phenomena, the dogma that has supported our beliefs concerning etiology of fetal anomalies becomes weaker and weaker, leaving us with improved abilities to detect these problems but with a far less definitive understanding of what causes these problems, and thus a seemingly increasing inability to offer sage advice to prevent such problems in the future. Certain conditions such as Mendelian disorders are clearly genetic in nature whereas fetal anomalies resulting from prenatal exposure to teratogenetic agents such as thalidomide and alcohol are mostly mediated by environmental exposure, though the phenotypic expression of such conditions are also impacted by genetic and genomic factors. Indeed, the impact of novel cultural practices, including the ingestion or avoidance of certain foods and medicines before and during pregnancy, can impact fetal development and well-being as is evident in the paper ‘‘Indigenous medicine use during pregnancy for sex selection and risk of congenital malformations: a population-based case-control study in Haryana, India’’ by Sutapa B. Neogi and colleagues, published in this edition of Drug Safety [1]. It is important to accept the notion that culture-specific practices are not automatically bad, harmful, or unnecessary; we tend to consider current approaches to healthcare invariably superior to those from even 20 years ago, let alone those that date back centuries or millennia. However, we should all take a collective deep breath and consider the very recent pharmacotherapeutic advancement in the treatment of methicillin-resistant Staphylococcus This is a commentary on the paper by Neogi et al. ‘‘Indigenous medicine use for sex selection during pregnancy and risk of congenital malformations: a population-based case-control study in Haryana, India,’’ doi:10.1007/s40264-015-0309-5.

Indigenous Medicine Use for Sex Selection During Pregnancy and Risk of Congenital Malformations: A Population-Based Case-Control Study in Haryana, India.

Congenital malformations (CMFs) are a major public health problem in India. Consanguineous marriages, infections during pregnancy, folic acid deficiency during the periconceptional period, exposure to pesticides and a history of intake of drugs during pregnancy have been hypothesized as risk factors. Drugs include oral contraceptive pills, progesterone analogues, medications for ailments and indigenous drugs to bear male offspring. It is important to analyze the risk factors in order to implement preventive measures. The prime objective of this study was to study the risk factors of visible structural CMFs, with a focus on indigenous medicines for sex selection. A population-based, case-control study was undertaken in Haryana state. Cases included children (0-18months) with any apparent structural deformity as reported by various Government sources. A consecutive birth from the same area as the case was labelled and included as the control. The sample size calculated was 175 in each group. Mothers of every case and control were interviewed at their respective homes using a structured tool. Descriptive analysis, bivariate analysis, followed by logistic regression was conducted to establish the association between risk factors and CMFs. The sociodemographic profiles of the cases and controls were similar. Among the various risk factors studied, more than two living children (unadjusted odds ratio [OR] 1.6, 95% CI 1.04-2.4) and intake of sex-selection drugs (unadjusted OR 2.8, 95% CI 1.6-5.1) were significant risk factors on bivariate and regression analyses. The risk of having a child with CMFs was threefold more among mothers with a history of intake of indigenous medicines for sex selection (adjusted OR 3; 95% CI 1.7-5.6). The intake of indigenous drugs during pregnancy increased the risk of CMFs almost threefold. This has social as well as economic implications, and hence needs further investigation.

Prevalence of and Risk Factors for Lead Poisoning in Young Children in Bangladesh

Lead poisoning is a major public-health problem in Bangladesh. A cross-sectional study was conducted to determine the extent of and risk factors for elevated blood lead levels (BLLs) in children in Bangladesh during September 2007-July 2009. The study included 919 children aged less than 16 years. The children were recruited from six urban locations in Dhaka and one rural area in Chirirbandar, Dinajpur. In total, 495 (54%) children had high BLLs (> 10 microg/dL), with higher BLLs observed among children aged 5-9 years compared to children of other ages (p < 0.001). The BLLs among children in urban Dhaka were significantly higher than those in rural areas (13.45 +/- 8.21 microg/dL vs 7.29 +/- 6.25 microg/dL, p < 0.001). The high BLLs correlated with low body mass index (r = -0.23, p < 0.001) and low haemoglobin status (r = -0.10, p = 0.02). On bivariate analysis, proximity to industry (p < 0.001), drinking-water from municipal supply or tubewell (p < 0.001), brass or lead water-taps (p < 0.001), use of melamine plate (p = 0.001), and indigenous medicinal (kabiraji) treatments (p = 0.004) significantly correlated with higher BLLs. Proximity to industry and the use of indigenous medicines remained significant predictors of high BLLs after controlling for the confounders. Several risk factors appropriate for future educational interventions to prevent exposure to lead poisoning were identified.

Sex ratio at birth in India, its relation to birth order, sex of previous children and use of indigenous medicine.

ObjectiveSex-ratio at birth in families with previous girls is worse than those with a boy. Our aim was to prospectively study in a large maternal and child unit sex-ratio against previous birth sex and use of traditional medicines for sex selection.Main Outcome MeasuresSex-ratio among mothers in families with a previous girl and in those with a previous boy, prevalence of indigenous medicine use and sex-ratio in those using medicines for sex selection.ResultsOverall there were 806 girls to 1000 boys. The sex-ratio was 720∶1000 if there was one previous girl and 178∶1000 if there were two previous girls. In second children of families with a previous boy 1017 girls were born per 1000 boys. Sex-ratio in those with one previous girl, who were taking traditional medicines for sex selection, was 928∶1000.ConclusionEvidence from the second children clearly shows the sex-ratio is being manipulated by human interventions. More mothers with previous girls tend to use traditional medicines for sex selection, in their subsequent pregnancies. Those taking such medication do not seem to be helped according to expectations. They seem to rely on this method and so are less likely use more definitive methods like sex selective abortions. This is the first such prospective investigation of sex ratio in second children looked at against the sex of previous children. More studies are needed to confirm the findings.

Primary Health Care and Medical Pluralism Exemplified in Nepal: A Proposal for Maximizing Health Care Benefit

Abstract Primary Health Care (PHC) has been the thrust of most developing countries in an attempt to improve the overall health status of the general population. PHC, however, faces a number of problems. One of the most important, according to this paper, is due to the widespread presence and use of indigenous medicine. Several social scientists have stressed the incorporation of modern (PHC) and indigenous health care services, and a number of strategies have been suggested time to time. This paper argues that these strategies overlooked certain basic issues. It proposes a new approach that focuses on using limited health resources in developing countries for implementing intensive public health including health education measures, and using modern health services as a supplement to indigenous health care resources.