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1.
BMC Complement Med Ther ; 21(1): 68, 2021 Feb 19.
Artigo em Inglês | MEDLINE | ID: mdl-33607994

RESUMO

BACKGROUND: Despite the growing conventional healthcare coverage in Eritrea, traditional medicine (TM) remains an essential source of healthcare service to the population. This study, therefore, aims at exploring the attitude, societal dependence, and pattern of TM use of the Gash-Barka community. METHODS: A cross-sectional study was conducted between December 2018 and January 2019 in Gash-Barka region, one of the six regions of Eritrea. Two-stage stratified cluster sampling design was used to provide representative sample of households. The data collected through face-to-face interview using a structured questionnaire was entered twice and analyzed using CSPro7.2 and SPSS 23, respectively. Both descriptive and analytical analyses were performed to test statistical significance. RESULTS: Of the total 210 participants, 202 completed the interview with a response rate of 96.2%. Almost 97% of the respondents were aware of the general existence of TM. About half of the respondents (47.4%) had visited traditional health practitioners (THPs) at least once in their lifetime. The majority of the respondents claimed their medical condition had been improved (63.2%), were satisfied with the outcome (76.8%), and had not encountered complications (95.2%) due to TM use. Around 40% of the respondents admitted they do not disclose previous TM use to conventional health practitioners. Females are more likely to have had ever visited THPs (AOR = 1.85, CI: 1.01, 3.38) and use TM in the future (AOR = 2.26, CI: 0.92, 5.14) than males. Moreover, those who had visited THPs before (COR = 8.30, CI: 3.25, 21.20) are more likely to use TM as a primary treatment choice and prefer to use TM in the future (AOR = 4.40, CI: 1.97, 9.83) than those who had never visited THPs. About 61% of the total families claimed they had circumcised at least one female child, and 96.8% disclosed they had circumcised at least one male child. Out of which, 89.2% of the circumcisions were done by THPs. CONCLUSION: TM is popular and widely relayed upon by Gash-Barka residents with exposure of children to harmful TM practices. Since the reliance of the community on TM is expected to continue, further representative studies are recommended to inform regulatory interventions and integrate TM into the health system.


Assuntos
Assistência à Saúde , Medicina Tradicional Africana , Aceitação pelo Paciente de Cuidados de Saúde , Adulto , Atitude , Criança , Circuncisão Feminina , Estudos Transversais , Revelação , Eritreia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Características de Residência , Inquéritos e Questionários
2.
J Biol Dyn ; 15(1): 137-150, 2021 12.
Artigo em Inglês | MEDLINE | ID: mdl-33538240

RESUMO

Self-medication is an important initial response to illness in Africa. This mode of medication is often done with the help of African traditional medicines. Because of the misconception that African traditional medicines can cure/prevent all diseases, some Africans may opt for COVID-19 prevention and management by self-medicating. Thus to efficiently predict the dynamics of COVID-19 in Africa, the role of the self-medicated population needs to be taken into account. In this paper, we formulate and analyse a mathematical model for the dynamics of COVID-19 in Cameroon. The model is represented by a system of compartmental age-structured ODEs that takes into account the self-medicated population and subdivides the human population into two age classes relative to their current immune system strength. We use our model to propose policy measures that could be implemented in the course of an epidemic in order to better handle cases of self-medication.


Assuntos
/terapia , Modelos Estatísticos , Automedicação , /epidemiologia , Camarões , Humanos , Medicina Tradicional Africana , /isolamento & purificação
4.
BMC Complement Med Ther ; 21(1): 64, 2021 Feb 15.
Artigo em Inglês | MEDLINE | ID: mdl-33588819

RESUMO

BACKGROUND: The disparity of harvesting locations can influence the chemical composition of a plant species, which could affect its quality and bioactivity. Terminalia albida is widely used in traditional Guinean medicine whose activity against malaria has been validated in vitro and in murine models. The present work investigated the antimalarial properties and chemical composition of two samples of T. albida collected from different locations in Guinea. METHOD: T. albida samples were collected in different locations in Guinea, in Dubréka prefecture (West maritime Guinea) and in Kankan prefecture (eastern Guinea). The identity of the samples was confirmed by molecular analysis. In vitro antiplasmodial activity of the two extracts was determined against the chloroquine resistant strain PfK1. In vivo, extracts (100 mg/kg) were tested in two experimental murine models, respectively infected with P. chabaudi chabaudi and P. berghei ANKA. The chemical composition of the two samples was assessed by ultra-high-performance liquid chromatography coupled to high resolution mass spectrometry. RESULTS: In vitro, the Dubréka sample (TaD) was more active with an IC50 of 1.5 µg/mL versus 8.5 µg/mL for the extract from Kankan (TaK). In vivo, the antiparasitic effect of TaD was substantial with 56% of parasite inhibition at Day 10 post-infection in P. chabaudi infection and 61% at Day 8 in P. berghei model, compared to 14 and 19% inhibition respectively for the treatment with TaK. In addition, treatment with TaD further improved the survival of P. berghei infected-mice by 50% at Day 20, while the mortality rate of mice treated with Tak was similar to the untreated group. The LC/MS analysis of the two extracts identified 38 compounds, 15 of which were common to both samples while 9 and 14 other compounds were unique to TaD and TaK respectively. CONCLUSION: This study highlights the variability in the chemical composition of the species T. albida when collected in different geographical locations. These chemical disparities were associated with variable antimalarial effects. From a public health perspective, these results underline the importance of defining chemical fingerprints related to botanical species identification and to biological activity, for the plants most commonly used in traditional medicine.


Assuntos
Antimaláricos/química , Malária/tratamento farmacológico , Fitoterapia , Extratos Vegetais/química , Plasmodium/efeitos dos fármacos , Terminalia/química , Animais , Antimaláricos/farmacologia , Antimaláricos/uso terapêutico , Feminino , Guiné , Malária/parasitologia , Masculino , Medicina Tradicional Africana , Camundongos Endogâmicos C57BL , Extratos Vegetais/farmacologia , Extratos Vegetais/uso terapêutico , Especificidade da Espécie , Terminalia/classificação
5.
AIDS Patient Care STDS ; 35(2): 56-62, 2021 02.
Artigo em Inglês | MEDLINE | ID: mdl-33471578

RESUMO

In HIV-endemic areas, traditional healers are frequently used with, or instead of, biomedical resources for health care needs. Studies show healers are interested in and capable of supporting patients in the HIV care cascade. However, adults who receive care from healers have low engagement with HIV services. To achieve epidemic control, we must understand gaps between the needs of HIV-endemic communities and the potential for healers to improve HIV service uptake. This study's objective was to characterize stakeholder perspectives on barriers to HIV testing and approaches to mitigate barriers in a medically pluralistic, HIV-endemic region. This study was conducted in Mbarara District, a rural area of southwestern Uganda with high HIV prevalence. Participants included HIV clinical staff, traditional healers, and adults receiving care from healers. Fifty-six participants [N = 30 females (52%), median age 40 years (interquartile range, 32-51.5)] were recruited across three stakeholder groups for minimally structured interviews. Themes were identified using an inductive, grounded theory approach and linked together to create a framework explaining stakeholder perspectives on HIV testing. Stakeholders described the "road" to HIV testing as time-consuming, expensive, and stigmatizing. All agreed healers could mitigate barriers by delivering HIV testing at their practices. Collaborations between biomedical and traditional providers were considered essential to a successful healer-delivered HIV testing program. This work describes a novel approach to "shorten the road" to HIV testing, suggesting that traditional healer-delivered HIV testing holds promise to expand uptake of testing among communities with limited access to existing programs.


Assuntos
Infecções por HIV/diagnóstico , Aceitação pelo Paciente de Cuidados de Saúde , Adulto , Idoso , Feminino , Infecções por HIV/epidemiologia , Infecções por HIV/terapia , Humanos , Entrevistas como Assunto , Masculino , Medicina Tradicional Africana , Pessoa de Meia-Idade , Pesquisa Qualitativa , População Rural , Uganda
6.
J Ethnopharmacol ; 266: 113427, 2021 Feb 10.
Artigo em Inglês | MEDLINE | ID: mdl-33022339

RESUMO

ETHNOPHARMACOLOGICAL RELEVANCE: Malaria is caused by infection with some species of Plasmodium parasite which leads to adverse alterations in physical and hematological features of infected persons and ultimately results in death. Antrocaryon micraster is used to treat malaria in Ghanaian traditional medicine. However, there is no scientific validation of its anti-malaria properties. The plant does not also have any chemical fingerprint or standardization parameters. AIM OF THE STUDY: This study sought to evaluate the anti-malaria activity of standardized A. micraster stem bark extract (AMSBE) and its effect on mean survival time (MST) and body weight reduction of Plasmodiumberghei infested mice. And to study the effect of treatment of AMSBE on hematological indices of the P. berghei infested mice in order to partly elucidate its anti-malarial mechanism of action. MATERIALS AND METHODS: Malaria was induced in female ICR mice by infecting them with 0.2 mL of blood (i.p.) containing 1.0 × 107P. berghei-infested RBCs from a donor mouse and leaving them without treatment for 3 days. AMSBE or Lonart (standard control) was then orally administered at 50, 200 and 400 mg/kg or 10 mg/kg once daily for 4 consecutive days. The untreated control received sterile water. Malaria parasitemia reduction, anti-malarial activity, mean change in body weight and MST of the parasitized mice were evaluated. Furthermore, changes in white blood cells (WBCs), red blood cells (RBCs), platelets count, hemoglobin (HGB), hematocrit (HCT) and mean corpuscular volume (MCV) were also determined in the healthy animals before infection as baseline and on days 3, 5 and 8 after infection by employing complete blood count. Standardization of AMSBE was achieved by quantification of its constituents and chemical fingerprint analysis using UHPLC-MS. RESULTS: Administration of AMSBE, standardized to 41.51% saponins and 234.960 ± 0.026 mg/g of GAE phenolics, produced significant (P < 0.05) reduction of parasitemia development, maximum anti-malaria activity of 46.01% (comparable to 32.53% produced by Lonart) and significantly (P < 0.05) increased body weight and MST of P. berghei infected mice compared to the untreated control. Moreover, there were significant (P > 0.05) elevation in WBCs, RBCs, HGB, HCT and platelets in the parasitized-AMSBE (especially at 400 mg/kg p.o.) treated mice compared to their baseline values. Whereas, the non-treated parasitized control recorded significant reduction (P < 0.05) in all the above-mentioned parameters compared to its baseline values. The UHPLC-MS fingerprint of AMSBE revealed four compounds with their retention times, percentage composition in their chromatograms and m/z of the molecular ions and fragments in the spectra. CONCLUSIONS: These results show that A. micraster stem bark possessed significant anti-malaria effect and also has the ability to abolish body weight loss, leucopenia, anemia and thrombocytopenia in P. berghei infected mice leading to prolonged life span. The UHPLC-MS fingerprint developed for AMSBE can be used for rapid authentication and standardization of A. micraster specimens and herbal preparations produced from its hydroethanolic stem bark extract to ensure consistent biological activity. The results justify A. micraster's use as anti-malaria agent.


Assuntos
Anacardiaceae/química , Antimaláricos/farmacologia , Malária/tratamento farmacológico , Extratos Vegetais/farmacologia , Plasmodium berghei/efeitos dos fármacos , Animais , Antimaláricos/administração & dosagem , Relação Dose-Resposta a Droga , Feminino , Gana , Malária/parasitologia , Medicina Tradicional Africana , Camundongos , Camundongos Endogâmicos ICR , Parasitemia/tratamento farmacológico , Parasitemia/parasitologia , Casca de Planta , Extratos Vegetais/administração & dosagem
7.
J Ethnopharmacol ; 266: 113459, 2021 Feb 10.
Artigo em Inglês | MEDLINE | ID: mdl-33039627

RESUMO

ETHNOPHARMACOLOGICAL RELEVANCE: In sub-Saharan Africa, African ginger (Siphonochilus aethiopicus) is used for treating common illnesses including colds, coughs, inflammation and related symptoms. The available literature survey on this plant provided scarce anecdotal information, particularly in western and eastern Africa, with a few reports on its bioactivity. In addition, the indigenous knowledge and conservation strategies of this economically important and critically endangered species are currently fragmented. AIM OF THE REVIEW: This review entails a critical appraisal of existing literature on the ethnomedicinal uses, biological activities, phytochemicals, research opportunities and prospects for the sustainable use of S. aethiopicus. MATERIALS AND METHODS: This review was conducted using a comprehensive literature search on the ethnomedicinal uses, biological activities and phytochemistry of S. aethiopicus throughout its distributional range. The conservation status and associated bio-economy potential of African ginger were also assessed. We searched different online databases (e.g. Google Scholar, ScienceDirect, PubMed and Scopus) for peer-reviewed journals, conference outputs, international, regional and national organizational reports, published books and theses. RESULTS: We established that S. aethiopicus is used to treat a wide variety of ailments such as respiratory problems (including cough, influenza), pain, inflammation and malaria. Extracts of African ginger are used as an ingredient in some commercialised products for nutraceutical, cosmeceutical and pharmaceutical purposes. The rhizome extract demonstrated anti-asthmatic, anti-inflammatory, and antiplasmodial activities, which led to the development of a patented novel extract for treating asthma and allergies. Phytochemical analysis of leaf, root and rhizome extracts of African ginger revealed the presence of flavonoids, phenolic acids, volatile and essential oils as the major constituents. These phytochemicals are known to possess bioactivities such as antimicrobial and anti-inflammatory activities. Particularly, the bioactive compounds, siphonochilone and eucalyptol, found in the roots and rhizomes have demonstrated potential to be used in remedies for treating asthma and allergic reactions. Furthermore, extracts of S. aethiopicus contained natural anti-inflammatory mediators with potential to combat and manage chronic inflammation. This plant is classified on the Red List of South African Plants as a critically endangered plant. Its high risk of extinction due to its unsustainable harvesting and exploitation necessitates its rapid propagation and cultivation to meet its increasing demand. CONCLUSIONS: The review highlights the therapeutic potential of S. aethiopicus and rational prioritization of this plant species with the potential for isolating new bioactive compounds. In the light of the use of this plant extract in traditional medicine and many commercial products, there is a heightened need to explore the mechanism(s) of action of the identified extracts and bioactive compounds in order to fully understand their pharmacokinetics and probably elucidate the pathways of their activities.


Assuntos
Medicina Tradicional Africana , Extratos Vegetais/farmacologia , Zingiberaceae/química , Animais , Humanos , Compostos Fitoquímicos/química , Compostos Fitoquímicos/isolamento & purificação , Compostos Fitoquímicos/farmacologia , Fitoterapia , Extratos Vegetais/química
8.
J Ethnopharmacol ; 265: 113359, 2021 Jan 30.
Artigo em Inglês | MEDLINE | ID: mdl-32891813

RESUMO

ETHNOPHARMACOLOGICAL RELEVANCE: Cancer represents a major health burden and drain on the global healthcare systems. Traditional African medicine widely use a variety of plant species for treatment of different kinds of cancer. A previous systematic survey by traditional healers in the Ashanti region of Ghana revealed a good overview on the plant species and herbal materials used for the different types of cancer. AIMS OF THE STUDY: The following study aimed to investigate 18 herbal materials from 10 plant species based on the cancer survey in Ghana regarding potential cytotoxicity against different cancer cell lines under in vitro conditions followed by subsequent bioassay-guided fractionation towards the active principle. MATERIALS AND METHODS: Ethanol-water (1:1) extracts were tested (1-100 µg/mL) against a panel of cancer cell lines according to their respective traditional use. Selected extracts with relevant cytotoxicity in this screening were also tested against common pediatric malignancies (leukemias (HL-60, REH) and Ewing sarcoma (RD-ES and CADO-ES1)). Bioassay-guided fractionation of the hydroalcoholic extract from Alstonia boonei was performed by liquid-liquid chromatography and preparative HPLC. Preliminary mechanistic studies on the mode of action were performed by flow cytometric cell cycle analysis as well as apoptosis and necrosis staining. RESULTS: Screening of plant extracts revealed relevant cytotoxicity against all tested cancer cell lines for Alstonia boonei leaves and stem of Paulinia pinnata. The A. boonei extract was additionally found to be active against common pediatric tumor types (leukemias and Ewing sarcoma). Bioassay-guided fractionation of the A. boonei extract revealed the presence of 15-hydroxyangustilobine A 1 as the active principle (IC50 26 µM against MCF-7 cells). This is the first report of this compound in A. boonei. 1 was shown to lead to cell cycle arrest in the G2/M-phase (MCF-7 cells), triggering cells at least partially into apoptosis. CONCLUSION: In summary, an appreciable in vitro activity was revealed for the leaf extract from A. boonei and the isolated vallesamine type indole alkaloid 1, which has to be investigated in future studies towards a potential clinical use.


Assuntos
Antineoplásicos Fitogênicos/farmacologia , Neoplasias/tratamento farmacológico , Extratos Vegetais/farmacologia , Plantas Medicinais/química , Alstonia/química , Animais , Antineoplásicos Fitogênicos/química , Antineoplásicos Fitogênicos/isolamento & purificação , Linhagem Celular Tumoral , Cromatografia Líquida de Alta Pressão , Relação Dose-Resposta a Droga , Gana , Humanos , Concentração Inibidora 50 , Medicina Tradicional Africana , Neoplasias/patologia , Extratos Vegetais/administração & dosagem , Extratos Vegetais/química
9.
J Ethnopharmacol ; 265: 113417, 2021 Jan 30.
Artigo em Inglês | MEDLINE | ID: mdl-32980483

RESUMO

ETHNOPHARMACOLOGICAL RELEVANCE: Plant parts are often used by local people to treat their affections. This study addressed the Traditional Medicinal Knowledge of woody species in Benin and the dependence of medicinal use of woody species on climatic zones. AIM OF THE STUDY: It reports (i) the main diseases categories treated with medicinal use of woody species in Benin and changes across climatic zones by inferring their epidemiological status, and (ii) the woody species involved and their distribution according to climate conditions. MATERIALS AND METHODS: Ethnobotanical interviews were undertaken using a semi-structured questionnaire. Five hundred and ninety medicinal plant professionals (healers, traders …) were interviewed in the whole country. Frequency of citation and informant consensus factor were calculated to highlight the main human diseases categories and woody species used for their treatment. A principal component analysis was performed to determine the occurrence of diseases categories in different climatic zones. RESULTS: About 94% of international diseases categories were treated using medicinal woody species in Benin. Nighty-seven ailments in 16 diseases categories were identified. Among them, 5 diseases categories (General and unspecified, Digestive, Skin, Neurological, and Musculoskeletal) were highlighted as important. The Sudano-Guinean zone showed the highest diseases frequencies, whereas the Sudanian zone showed the lowest. The epidemiological status of some phytodistricts was worrisome. In our study, 123 woody species belonging to 93 genera and 35 families were reported, and among them, 16 were the most used as treatments. CONCLUSIONS: There is a lack of consensus among traditional healers about which woody species to use. Many different species were used to treat a given diseases category. Also, information concerning their organ composition was not available in the literature, for the majority of species. Biological and chemical investigations are thus needed for a better valorization of the most frequently used plants in the future.


Assuntos
Conhecimentos, Atitudes e Prática em Saúde , Medicina Tradicional Africana , Preparações de Plantas/farmacologia , Plantas Medicinais/química , Adulto , Idoso , Idoso de 80 Anos ou mais , Benin , Clima , Etnobotânica , Etnofarmacologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Análise de Componente Principal , Inquéritos e Questionários , Adulto Jovem
10.
J Ethnopharmacol ; 264: 113234, 2021 Jan 10.
Artigo em Inglês | MEDLINE | ID: mdl-32768640

RESUMO

ETHNOPHARMACOLOGICAL RELEVANCE: Diabetes mellitus (DM) is one of the most prevalent diseases globally and is of considerable concern to global health. Approximately 425 million people are estimated to have DM globally and this is predicted to increase to >642 million by 2040. Whilst the prevalence of DM in South Africa is slightly lower than the global average, it is expected to rise rapidly in future years as more South Africans adopt a high calorie "westernised" diet. Traditional medicines offer an alternative for the development of new medicines to treat DM and the usage of South African plants is relatively well documented. AIM OF THE STUDY: To critically review the literature on the anti-diabetic properties of South African plants and to document plant species used for the treatment of DM. Thereafter, a thorough examination of the related research will highlight where research is lacking in the field. MATERIALS AND METHODS: A review of published ethnobotanical books, reviews and primary scientific studies was undertaken to identify plants used to treat DM in traditional South African healing systems and to identify gaps in the published research. The study was non-biased, without taxonomic preference and included both native and introduced species. To be included, species must be recorded in the pharmacopeia of at least one South African ethnic group for the treatment of DM. RESULTS: One hundred and thirty-seven species are recorded as therapies for DM, with leaves and roots most commonly used. The activity of only 43 of these species have been verified by rigorous testing, and relatively few studies have examined the mechanism of action. CONCLUSION: Despite relatively extensive ethnobotanical records and a diverse flora, the anti-diabetic properties of South African medicinal plants is relatively poorly explored. The efficacy of most plants used traditionally to treat DM are yet to be verified and few mechanistic studies are available. Further research is required in this field.


Assuntos
Glicemia/efeitos dos fármacos , Diabetes Mellitus/sangue , Diabetes Mellitus/tratamento farmacológico , Medicina Tradicional Africana/métodos , Extratos Vegetais/uso terapêutico , Plantas Medicinais , Glicemia/metabolismo , Diabetes Mellitus/etnologia , Humanos , Medicina Tradicional Africana/tendências , Extratos Vegetais/isolamento & purificação , Extratos Vegetais/farmacologia , África do Sul/etnologia
11.
PLoS Negl Trop Dis ; 14(12): e0008919, 2020 12.
Artigo em Inglês | MEDLINE | ID: mdl-33382717

RESUMO

BACKGROUND: Ghana is endemic for some neglected tropical diseases (NTDs) including schistosomiasis, onchocerciasis and lymphatic filariasis. The major intervention for these diseases is mass drug administration of a few repeatedly recycled drugs which is a cause for major concern due to reduced efficacy of the drugs and the emergence of drug resistance. Evidently, new treatments are needed urgently. Medicinal plants, on the other hand, have a reputable history as important sources of potent therapeutic agents in the treatment of various diseases among African populations, Ghana inclusively, and provide very useful starting points for the discovery of much-needed new or alternative drugs. METHODOLOGY/PRINCIPAL FINDINGS: In this study, extracts of fifteen traditional medicines used for treating various NTDs in local communities were screened in vitro for efficacy against schistosomiasis, onchocerciasis and African trypanosomiasis. Two extracts, NTD-B4-DCM and NTD-B7-DCM, prepared from traditional medicines used to treat schistosomiasis, displayed the highest activity (IC50 = 30.5 µg/mL and 30.8 µg/mL, respectively) against Schistosoma mansoni adult worms. NTD-B2-DCM, also obtained from an antischistosomal remedy, was the most active against female and male adult Onchocera ochengi worms (IC50 = 76.2 µg/mL and 76.7 µg/mL, respectively). Antitrypanosomal assay of the extracts against Trypanosoma brucei brucei gave the most promising results (IC50 = 5.63 µg/mL to 18.71 µg/mL). Incidentally, NTD-B4-DCM and NTD-B2-DCM, also exhibited the greatest antitrypanosomal activities (IC50 = 5.63 µg/mL and 7.12 µg/mL, respectively). Following the favourable outcome of the antitrypanosomal screening, this assay was selected for bioactivity-guided fractionation. NTD-B4-DCM, the most active extract, was fractionated and subsequent isolation of bioactive constituents led to an eupatoriochromene-rich oil (42.6%) which was 1.3-fold (IC50 <0.0977 µg/mL) more active than the standard antitrypanosomal drug, diminazene aceturate (IC50 = 0.13 µg/mL). CONCLUSION/SIGNIFICANCE: These findings justify the use of traditional medicines and demonstrate their prospects towards NTDs drug discovery.


Assuntos
Filaricidas/farmacologia , Onchocerca/efeitos dos fármacos , Schistosoma mansoni/efeitos dos fármacos , Esquistossomicidas/farmacologia , Tripanossomicidas/farmacologia , Trypanosoma brucei brucei/efeitos dos fármacos , Animais , Gana , Medicina Tradicional Africana , Doenças Negligenciadas/tratamento farmacológico , Doenças Negligenciadas/parasitologia , Extratos Vegetais/química , Extratos Vegetais/farmacologia , Plantas Medicinais/química
12.
RECIIS (Online) ; 14(3): 644-655, jul.-set. 2020.
Artigo em Português | LILACS | ID: biblio-1121790

RESUMO

O presente artigo aborda a cultura e a medicina dos povos tradicionais afro-brasileiros como determinantes sociais da saúde em diferentes grupos étnicos, suas relações existentes com processos comunicativos e a efetivação de políticas públicas, especialmente a denominada Política Nacional de Práticas Integrativas em Saúde e Complementares no Sistema Único de Saúde, assim como o campo da educação patrimonial em saúde. A partir das análises de narrativas do projeto na área de comunicação e saúde por meio das linguagens das artes, realizado na Fundação Oswaldo Cruz entre 2004 e 2008, em articulação com as questões da tese de doutorado sobre as memórias da diversidade sociocultural dos povos tradicionais em suas artes de cura na Jurema Sagrada, em desenvolvimento na Pós-Graduação em Memória Social da Universidade Federal do Rio de Janeiro, este texto indica pontos importantes acerca dos processos de comunicação na educação em saúde mediante o mapeamento dos territórios do saber como estratégias de memórias e resistências de grupos étnicos.


This article examines both culture and medicine practice by the traditional Afro-Brazilian people as health social determinants in different ethnic groups, their relations with communicative processes and the implementation of public policies, specially the Política Nacional de Práticas Integrativas em Saúde e Complementares no SUS (National policy of integrative and complementary health practice by SUS), and the field of heritage of health education. It is based on the narrative analysis of the project developed by Fundação Oswaldo Cruz (Fiocruz) from 2004 to 2008 in the communication and health area by means of art languages, related to issues proposed on PhD thesis about memories of the cultural and social diversity revealed by traditional people in its cure arts in Jurema Sagrada, in phase of development through the Programa de Pós-Graduação em Memória Social (Postgraduate program in social memory at Unirio - Universidade Federal do Rio de Janeiro. This text points out important issues about communication processes in health education through mapping of knowledge territories as strategies for memory and resistance of ethnic groups.


Este artículo analiza la cultura y la medicina de los pueblos tradicionales afro-brasileños como determinantes sociales de la salud en diferentes grupos étnicos, sus relaciones existentes con procesos comunicativos y la implementación de políticas públicas, especialmente la Política Nacional de Práticas Integrativas em Saúde e Complementares no SUS (Política nacional de prácticas integrales y complentarias de salud en el SUS) y el campo de la educación patrimonial de la salud. Él se basa en el análisis de narrativas del proyecto en comunicación y salud a través de los lenguajes de las artes, realizado en la Fundação Oswaldo Cruz (Fiocruz) en el periodo de 2004 hasta 2008, relacionado con las cuestiones de tesis doctoral sobre las memorias de la diversidad sociocultural de pueblos tradicionales revelada en sus artes curativas en Jurema Sagrada, en desarrollo en el Programa de Pós-Graduação em Memória Social (Programa de posgrado en memoria social) de la Universidade Federal do Rio de Janeiro (Unirio). El presente texto apunta cuestiones importantes sobre los procesos de comunicación en la educación en salud a través de la esquematización de los territorios del saber como estrategias de memorias e resistencia de los grupos étnicos.


Assuntos
Humanos , Educação em Saúde , Medicina Tradicional Africana , Comunicação , Terapias Espirituais , Determinantes Sociais da Saúde , Sistema Único de Saúde , Narração , Comunicação em Saúde
13.
Lancet ; 396(10251): 612-622, 2020 08 29.
Artigo em Inglês | MEDLINE | ID: mdl-32861306

RESUMO

BACKGROUND: Traditional and faith healers (TFH) provide care to a large number of people with psychosis in many sub-Saharan African countries but they practise outside the formal mental health system. We aimed to assess the effectiveness and cost-effectiveness of a collaborative shared care model for psychosis delivered by TFH and primary health-care providers (PHCW). METHODS: In this cluster-randomised trial in Kumasi, Ghana and Ibadan, Nigeria, we randomly allocated clusters (a primary care clinic and neighbouring TFH facilities) 1:1, stratified by size and country, to an intervention group or enhanced care as usual. The intervention included a manualised collaborative shared care delivered by trained TFH and PHCW. Eligible participants were adults (aged ≥18 years) newly admitted to TFH facilities with active psychotic symptoms (positive and negative syndrome scale [PANSS] score ≥60). The primary outcome, by masked assessments at 6 months, was the difference in psychotic symptom improvement as measured with the PANSS in patients in follow-up at 3 and 6 months. Patients exposure to harmful treatment practices, such as shackling, were also assessed at 3 and 6 months. Care costs were assessed at baseline, 3-month and 6-month follow-up, and for the entire 6 months of follow-up. This trial was registered with the National Institutes of Health Clinical Trial registry, NCT02895269. FINDINGS: Between Sept 1, 2016, and May 3, 2017, 51 clusters were randomly allocated (26 intervention, 25 control) with 307 patients enrolled (166 [54%] in the intervention group and 141 [46%] in the control group). 190 (62%) of participants were men. Baseline mean PANSS score was 107·3 (SD 17·5) for the intervention group and 108·9 (18·3) for the control group. 286 (93%) completed the 6-month follow-up at which the mean total PANSS score for intervention group was 53·4 (19·9) compared with 67·6 (23·3) for the control group (adjusted mean difference -15·01 (95% CI -21·17 to -8·84; 0·0001). Harmful practices decreased from 94 (57%) of 166 patients at baseline to 13 (9%) of 152 at 6 months in the intervention group (-0·48 [-0·60 to -0·37] p<0·001) and from 59 (42%) of 141 patients to 13 (10%) of 134 in the control group (-0·33 [-0·45 to -0·21] p<0·001), with no significant difference between the two groups. Greater reductions in overall care costs were seen in the intervention group than in the control group. At the 6 month assessment, greater reductions in total health service and time costs were seen in the intervention group; however, cumulative costs over this period were higher (US $627 per patient vs $526 in the control group). Five patients in the intervention group had mild extrapyramidal side effects. INTERPRETATION: A collaborative shared care delivered by TFH and conventional health-care providers for people with psychosis was effective and cost-effective. The model of care offers the prospect of scaling up improved care to this vulnerable population in settings with low resources. FUNDING: US National Institute of Mental Health.


Assuntos
Cura pela Fé/organização & administração , Medicina Tradicional Africana , Atenção Primária à Saúde/organização & administração , Transtornos Psicóticos/terapia , Adulto , Análise por Conglomerados , Análise Custo-Benefício , Feminino , Gana , Humanos , Colaboração Intersetorial , Masculino , Pessoa de Meia-Idade , Nigéria , Resultado do Tratamento , Adulto Jovem
14.
Stud Health Technol Inform ; 270: 791-795, 2020 Jun 16.
Artigo em Inglês | MEDLINE | ID: mdl-32570491

RESUMO

In traditional West African medicine, most practitioners are illiterate for official languages. 1127 local languages exist in this region. The transmission of knowledge in this traditional medicine is notoriously oral. In order to enable practitioners to communicate and preserve this knowledge, we are building SysMEDTRAD, a traditional medicine management system, based on a formal ontology of traditional medicine called ontoMEDTRAD. To overcome the language and illiteracy barriers, we propose to combine realistic photographs of plants with formal iconic descriptions of plants and recipes. This paper presents the formal and automatized representation of traditional African medicine recipes.


Assuntos
Medicina Tradicional Africana , Conhecimento , Idioma
15.
BMC Complement Med Ther ; 20(1): 182, 2020 Jun 11.
Artigo em Inglês | MEDLINE | ID: mdl-32527245

RESUMO

BACKGROUND: African Potato (hypoxis hemerocallidea), is used for enhancing immune system in Southern Africa. It is among the plants of intense commercial and scientific interest; hence, the aim of this study was to describe its chemistry and pharmacology. METHODS: PubMed, Cochrane Controlled Trials Register (CENTRAL) and Google Scholar were searched independently for relevant literature. The last search occurred in October 2018. Other research material was obtained from Google. The following search terms were used, but not limited to: "African Potato", "hypoxis", "hemerocallidea", "rooperol." Articles that were explaining the chemistry and pharmacology of hypoxis hemerocallidea were included. RESULTS: Thirty articles from PubMed, Cochrane and Google Scholar were eligible. Three webpages were included from Google. Results showed that the tuberous rootstock (corm) of African Potato is used traditionally to treat wasting diseases, testicular tumours, insanity, barrenness, impotency, bad dreams, intestinal parasites, urinary infection, cardiac disease and enhancing immunity. The plant contains hypoxoside, which is converted rapidly to a potent antioxidant, rooperol in the gut. The corm contains sterols, sterol glycosides, stanols, terpenoids, saponins, cardiac glycosides, tannins and reducing sugars. A dose of 15 mg/kg/day of hypoxoside is reportedly therapeutic. Preclinical studies of African Potato have shown immunomodulation, antioxidant, antinociceptive, hypoglycaemic, anti-inflammatory, anticonvulsant, antibacterial, uterolytic, antimotility, spasmolytic and anticholinergic effects. The common side effects of African Potato are nausea and vomiting, which subside over time. In vitro, African Potato demonstrated inhibitory effects on CYP1A2, 2C9, 2D6, 3A4, 3A5, CYP19-metabolism and induction of P-glycoprotein. In vivo, it did not alter the pharmacokinetics of efavirenz or lopinavir/ritonavir. CONCLUSION: African Potato is mainly used as an immunostimulant. The exact mechanisms of action for all the pharmacological actions are unknown. More research is required to substantiate claims regarding beneficial effects. There are many research gaps that require investigation including pharmacokinetic interactions with conventional drugs, especially those used in HIV/AIDS.


Assuntos
Hypoxis/química , Medicina Tradicional Africana/métodos , Extratos Vegetais/química , Extratos Vegetais/farmacologia , Plantas Medicinais/química , África , Catecóis , Humanos
16.
Int Health ; 12(3): 177-183, 2020 05 01.
Artigo em Inglês | MEDLINE | ID: mdl-32374407

RESUMO

BACKGROUND: Seeking care from traditional healers for injury is a common practice in low- and middle-income countries, including Sudan. As little is known about specific patterns of the practice in the country, we aimed to investigate associated factors and the role of professional injury care availability. METHODS: We used Sudan Household Health Survey 2010 data from a national stratified multistage cluster sample of 15 000 households. A multivariable Poisson regression (PR) model with robust variance was used to test potential associations of receiving care from a traditional healer in the first week after injury with age, gender, urban/rural residence, wealth index, educational attainment, cause of injury, time of injury occurrence and state-level injury-care bed density. RESULTS: Of 1432 injured participants who sought some form of healthcare, 38% received care from a traditional healer. A significant negative association was found with educational attainment, age and wealth. The association between injury-care bed density and receiving care from a traditional healer was consistently evident only when the injury was caused by a road traffic accident (PR = 0.90, 95% CI 0.85 to 0.96). CONCLUSIONS: Merely increasing the affordability or availability of injury care facilities may not impact reliance on traditional healers for all causes of injury. Therefore, injury care policies need to consider the role of traditional healers as part of the healthcare system.


Assuntos
Assistência à Saúde , Medicina Tradicional Africana , Aceitação pelo Paciente de Cuidados de Saúde , Ferimentos e Lesões/terapia , Acidentes de Trânsito , Adolescente , Adulto , Fatores Etários , Criança , Estudos Transversais , Países em Desenvolvimento , Características da Família , Feminino , Pessoal de Saúde , Acesso aos Serviços de Saúde , Inquéritos Epidemiológicos , Humanos , Renda , Masculino , População Rural , Classe Social , Sudão , Ferimentos e Lesões/etiologia
17.
Am J Trop Med Hyg ; 103(1): 501-507, 2020 07.
Artigo em Inglês | MEDLINE | ID: mdl-32458776

RESUMO

Febrile illnesses, such as malaria and pneumonia, are among the most common causes of mortality in children younger than 5 years in Uganda outside of the neonatal period. Their impact could be mitigated through earlier diagnosis and treatment at biomedical facilities; however, it is estimated that a large percentage of Ugandans (70-80%) seek traditional healers for their first line of medical care. This study sought to characterize individual and structural influences on health care-seeking behaviors for febrile children. Minimally structured, qualitative interviews were conducted for 34 caregivers of children presenting to biomedical and traditional healer sites, respectively. We identified six themes that shape the pathway of care for febrile children: 1) peer recommendations, 2) trust in biomedicine, 3) trust in traditional medicine, 4) mistrust in providers and therapies, 5) economic resources and access to health care, and 6) perceptions of child health. Biomedical providers are preferred by those who value laboratory testing and formal medical training, whereas traditional healer preference is heavily influenced by convenience, peer recommendations, and firm beliefs in traditional causes of illness. However, most caregivers concurrently use both biomedical and traditional therapies for their child during the same illness cycle. The biomedical system is often considered as a backup when traditional healing "fails." Initiatives seeking to encourage earlier presentation to biomedical facilities must consider the individual and structural forces that motivate seeking traditional healers. Educational programs and cooperation with traditional healers may increase biomedical referrals and decrease time to appropriate care and treatment for vulnerable/susceptible children.


Assuntos
Cuidadores , Hospitais , Medicina Tradicional Africana , Aceitação pelo Paciente de Cuidados de Saúde , Adulto , Criança , Pré-Escolar , Tomada de Decisões , Feminino , Instalações de Saúde , Acesso aos Serviços de Saúde , Humanos , Lactente , Recém-Nascido , Masculino , Pessoa de Meia-Idade , Motivação , Pesquisa Qualitativa , Confiança , Uganda , Adulto Jovem
18.
BMC Complement Med Ther ; 20(1): 81, 2020 Mar 12.
Artigo em Inglês | MEDLINE | ID: mdl-32164701

RESUMO

BACKGROUND: Skin-related diseases affect every individual irrespective of age, gender or social status. Since time immemorial, humans have explored natural resources from their environment for the maintenance of the skin. This explorative survey was conducted to document the natural resources (plant and non-plant materials) used for folk cosmeceuticals by rural communities in Vhembe district municipality, Limpopo province, South Africa. METHODS: The research was conducted in six communities namely: Tshakuma, Shigalo, Tshamutilikwa, Luvhimbi (Masikhwa), Khakhanwa, and Folovhodwe in Vhembe district. Random and convenient sampling was used to access the target population. Semi-structured questionnaires were used to interview 71 participants that comprised traditional practitioners, herbalists and laypeople from the study area. Collected data were analysed using both quantitative (for e.g. frequency, use-value and relative frequency of citation) and qualitative (thematic) analytical methods. RESULTS: A total of 52 plants from 27 families and 22 non-plant materials were used as folk cosmeceuticals in the study area. The most cited plants included Dicerocaryum zanguebarium (Pedaliaceae), Ricinus communis (Euphorbiaceae) and Helinus integrifolius (Rhamnaceae). Trees and shrubs were the most common plant-life form while leaves were the most popular plant part. Pig fats, red ochre (Luvhundi soil) and ashes were the most cited non-plant materials. These documented natural resources are frequently prepared by crushing and mostly used to heal wounds. CONCLUSION: Traditional knowledge concerning folk cosmeceuticals is mostly held by elders. The high number of natural resources documented is an indication that Vhembe district is rich in ethnopharmacological knowledge. Scientific investigation of the efficacies and safety of these natural resources is highly recommended as a drive aimed at innovations with benefits to the rural communities who are the custodians of this valuable knowledge.


Assuntos
Cosmecêuticos/uso terapêutico , Etnofarmacologia , Medicina Tradicional Africana , Recursos Naturais , Fitoterapia , Dermatopatias/tratamento farmacológico , Adulto , Idoso , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , População Rural , África do Sul , Inquéritos e Questionários
19.
BMC Complement Med Ther ; 20(1): 93, 2020 Mar 20.
Artigo em Inglês | MEDLINE | ID: mdl-32192455

RESUMO

BACKGROUND: Previous research has revealed high rates of traditional medicine usage in Nigeria. Reports of widespread contamination of herbal medicine products and higher rates of noncompliance with Western medications among traditional medicine users have raised concerns about the safety of traditional medicine use. Few studies have explored how demographic factors predict rates of traditional medicine use in the general population. METHODS: We conducted interviews of 748 adult women recruited from the communities in the city of Ibadan, Nigeria from 2013 to 2015. A structured questionnaire was created to collect data on rates of traditional medicine use and demographic factors such as age, education, ethnicity, and occupation. Multivariate logistic regressions were run to examine factors related to traditional medicine use, and the effects were measured with odds ratios (OR) along with 95% confidence interval (95%CI). RESULTS: The overall proportion of traditional medicine use was 81.6%. Women from the Ibo and Hausa ethnic groups were significantly less likely to use traditional medicine than the majority Yoruba group (OR 0.25, 95%CI 0.10-0.63;, OR 0.43, 95%CI 0.24-0.76) respectively). In addition, educated women were less likely than their non-educated counterparts to have used traditional medicine, with the biggest effect seen in women with a secondary education (OR 0.42, 95%CI 0.21-0.85). CONCLUSIONS: We found a high rate of traditional medicine usage, consistent with that found in prior research. A novel finding was the significance of ethnicity as a predictor for usage rates.


Assuntos
Demografia/estatística & dados numéricos , Grupos Étnicos/estatística & dados numéricos , Medicina Tradicional Africana/estatística & dados numéricos , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Estudos Transversais , Feminino , Humanos , Pessoa de Meia-Idade , Nigéria , Fatores Socioeconômicos , Inquéritos e Questionários , Adulto Jovem
20.
BMC Complement Med Ther ; 20(1): 19, 2020 Jan 23.
Artigo em Inglês | MEDLINE | ID: mdl-32020866

RESUMO

BACKGROUND: In Mozambique, bacterial and parasitic diseases contribute to a high burden of mortality and morbidity. These infectious diseases are treated with antibiotics, antihelmintic or antiparasitic drugs. However, misuse of these has been affecting the potential to treat ailments. It has been reported that many people from Maputo city and province apart from the existing contemporary medicine, still use medicinal plants for treatment of diseases due to traditional heritage and beliefs. It is, therefore, important to register this knowledge in order to use it for future pharmacological studies. This study aimed to identify the medicinal plants sold in Xipamanine, Xiquelene and Mazambane markets for treatment of bacterial and parasitic diseases. METHODS: An ethnobotanical survey, using interviews, was conducted to the main vendors of the markets. Data about the plant name, part used, mode of preparation and administration route were collected. RESULTS: A total of 64 medicinal plants belonging to 32 families were listed as sold for treatment of bacterial and parasitic diseases in the three markets. Terminalia sericea, Elephantorrhiza elephantina, Tiliacora funifera and Hypoxis hemerocallidea were the most cited plants. Roots were the most often sold suggesting it is the most used part. We also found out that medicinal plants trade is still common in Maputo markets. This suggests that people still use plant-based herbal medicines for their basic health care. CONCLUSIONS: Several medicinal plants were sold in Maputo city's markets for treatment of bacterial and parasitic diseases, with more emphasis on diarrhea and helminthiases. These plants were commonly bought by local residents and play an important role in the subsistence of vendors. Pharmacological studies are needed in order to isolate the plants active principles and understand their mechanism of action, so that new drugs can be developed.


Assuntos
Infecções Bacterianas/tratamento farmacológico , Comércio , Medicina Tradicional Africana , Doenças Parasitárias/tratamento farmacológico , Plantas Medicinais/classificação , Adulto , Etnobotânica , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Moçambique
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