Differences in Symptom Severity and Quality of Life among Patients with Cancer Using Conventional Therapies with/without Herbal Medicines in Uganda: A Cross-Sectional Study.

OBJECTIVE: Patients with cancer experience numerous symptoms related to cancer and treatment side effects that reduce their quality of life (QOL). Although herbal medicine (HM) is used to manage such symptoms by patients in sub-Saharan Africa, data on patients' perceived clinical outcomes are limited. We compared differences in QOL and symptom severity between patients with cancer using HM plus conventional therapies (i.e., chemotherapy, hormonal therapy, radiotherapy, surgery) and those using conventional therapies alone. METHODS: This cross-sectional study included patients with cancer aged >18 years who were consecutively sampled and completed a researcher-administered questionnaire between December 2022 and January 2023. Specifically, data was collected using The European Organization for Research and Treatment of Cancer Quality of Life Questionnaire (EORTC QLQ-C30) and the MD Anderson Symptom Inventory for Traditional Chinese Medicine (MDASI-TCM). Data were analyzed using descriptive statistics and chi-square and logistic regression analyses. RESULTS: Of 400 participants (67.5% female), 49% (n=195) used HM plus conventional therapies and 51% (n=205) used conventional therapies alone. Most participants were aged >38 years (73.3%; median age 47 years). A univariate analysis showed the HM plus conventional therapies group had better mean scores for most QOL and symptom severity measures than the conventional therapies alone group. However, only role functioning significantly differed (p=0.046) in the bivariate analysis. There were no statistically significant differences between the two groups after confounder adjustment for all others measures of symptom severity and QOL. CONCLUSION: HM plus conventional therapies may offer minimal benefits or differences for clinical outcomes among patients with cancer. However, our findings have clinical, research, and public health implications for Uganda and other sub-Saharan African settings.

The meaning of caring for patients with cancer among traditional medicine practitioners in Uganda: A grounded theory approach.

Traditional medicine practitioners (TMPs) are a critical part of healthcare systems in many sub-Saharan African countries and play vital roles in caring for patients with cancer. Despite some progress in describing TMPs' caring experiences in abstract terms, literature about practice models in Africa remains limited. This study aimed to develop a substantive theory to clarify the care provided by TMPs to patients with cancer in Uganda. This study adhered to the principal features of the modified Straussian grounded theory design. Participants were 18 TMPs caring for patients with cancer from 10 districts in Uganda, selected by purposive and theoretical sampling methods. Researcher-administered in-depth interviews were conducted, along with three focus group discussions. Data were analyzed using constant comparative analysis. The core category that represented TMPs' meaning of caring for patients with cancer was "Restoring patients' hope in life through individualizing care." TMPs restored patients' hope through five main processes: 1) ensuring continuity in the predecessors' role; 2) having full knowledge of a patient's cancer disease; 3) restoring hope in life; 4) customizing or individualizing care, and 5) improving the patient's condition/health. Despite practice challenges, the substantive theory suggests that TMPs restore hope for patients with cancer in a culturally sensitive manner, which may partly explain why patients with cancer continue to seek their services. The findings of this study may guide research, education, and public health policy to advance traditional medicine in sub-Saharan Africa.

Ethnobotanical survey of medicinal plant species used by communities around Mabira Central Forest Reserve, Uganda.

BACKGROUND: An ethnobotanical study of medicinal plants was carried out in 14 villages adjacent to Mabira Central Forest Reserve (CFR) in Central Uganda between August 2013 and March 2014. METHODS: Information was obtained through interviews using semi- structured questionnaires. Field excursions with traditional healers and herbal medicine collectors were carried out. Descriptive statistics were used to present the data. Fidelity ratios and Informant consensus agreements were calculated. RESULTS: A total of 190 plant species in 61 families and 152 genera were reported in the treatment of various health conditions. Family Fabaceae was dominant representing 14 % of the plant species documented. Vernonia amygdalina was the preferred species for treating malaria. Leaves (68 %) were the most frequently used parts in preparing herbal remedies. Decoctions (29 %) and oral route (53 %) of administration were commonly used method of herbal medicine preparation and administration respectively. Fifty-eight health conditions grouped in 25 categories were treated using medicinal plants. Informant consensus agreement was highest for blood system disorders (0.9) that included anaemia, hypertension and blood cleansing indicating homogeneity of informant's knowledge about remedies used. Vernonia amygdalina and Erythrina abyssinica had 100 % fidelity level for treatment of malaria and vomiting respectively. CONCLUSION: The diversity of medicinal plant species used and the associated indigenous knowledge are of great value to the local community and their conservation and preservation is paramount. The therapeutic uses of the documented plants provides basic data for further research focused on pharmacological studies and conservation of the most important species.

Medicinal plants of Otwal and Ngai Sub Counties in Oyam district, Northern Uganda.

BACKGROUND: An ethnobotanical study was carried out in four parishes in the Ngai and Otwal Sub Counties in Oyam district, Northern Uganda, where insurgency has been prevalent for the past 20 years. Documenting medicinal plant species used in treating various health conditions among the local people. METHODS: Information was obtained from mainly the local population, the traditional healers and other experienced persons through interviews, formal and informal discussions and field excursions. RESULTS: Seventy one plant species were reported for use in the treatment of various diseases in the study area. These plant species belongs to 41 families, with Asteraceae being the most represented. Roots were ranked the commonest plant part used. Oral administration was the most frequently used route of administration. A total of 41 different health conditions were reported to be treated by use of medicinal plant species. Thirty nine percent of the recorded plant species were reported for treating stomach related ailments. CONCLUSION: The use of medicinal plants in primary healthcare is still a common practice in Ngai and Otwal Sub Counties. The trust they have is built on the curative outcome properties claimed, poverty and armed conflict that lead to inadequate healthcare facilities. The generation gap caused by the over 20 years of insurgency in the area has brought about knowledge gap on the usage of medicinal plant species between the young and the older generation.