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1.
J Surg Res ; 246: 236-242, 2020 02.
Artigo em Inglês | MEDLINE | ID: mdl-31610351

RESUMO

BACKGROUND: Peritonitis is an emergency which frequently requires surgical intervention. The aim of this study was to describe factors influencing seeking and reaching care for patients with peritonitis presenting to a tertiary referral hospital in Rwanda. METHODS: This was a cross-sectional study of patients with peritonitis admitted to University Teaching Hospital of Kigali. Data were collected on demographics, prehospital course, and in-hospital management. Delays were classified according to the Three Delays Model as delays in seeking or reaching care. Chi square test and logistic regression were used to determine associations between delayed presentation and various factors. RESULTS: Over a 9-month period, 54 patients with peritonitis were admitted. Twenty (37%) patients attended only primary school and 15 (28%) never went to school. A large number (n = 26, 48%) of patients were unemployed and most (n = 45, 83%) used a community-based health insurance. For most patients (n = 44, 81%), the monthly income was less than 10,000 Rwandan francs (RWF) (11.90 U.S. Dollars [USD]). Most (n = 51, 94%) patients presented to the referral hospital with more than 24 h of symptoms. More than half (n = 31, 60%) of patients had more than 4 d of symptoms on presentation. Most (n = 37, 69%) patients consulted a traditional healer before presentation at the health care system. Consultation with a traditional healer was associated with delayed presentation at the referral hospital (P < 0.001). Most (n = 29, 53%) patients traveled more than 2 h to reach a health facility and this was associated with delayed presentation (P = 0.019). The cost of transportation ranged between 5000 and 1000 RWF (5.95-11.90 USD) for most patients and was not associated with delayed presentation (P = 0.449). CONCLUSIONS: In this study, most patients with peritonitis present in a delayed fashion to the referral hospital. Factors associated with seeking and reaching care included sociodemographic characteristics, health-seeking behaviors, cost of care, and travel time. These findings highlight factors associated with delays in seeking and reaching care for patients with peritonitis.


Assuntos
Medicina Tradicional Africana/estatística & dados numéricos , Aceitação pelo Paciente de Cuidados de Saúde/estatística & dados numéricos , Peritonite/cirurgia , Procedimentos Cirúrgicos Operatórios/estatística & dados numéricos , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Estudos Transversais , Feminino , Gastos em Saúde/estatística & dados numéricos , Hospitais Universitários/economia , Hospitais Universitários/estatística & dados numéricos , Humanos , Masculino , Medicina Tradicional Africana/psicologia , Pessoa de Meia-Idade , Aceitação pelo Paciente de Cuidados de Saúde/psicologia , Peritonite/economia , Ruanda , Fatores Socioeconômicos , Procedimentos Cirúrgicos Operatórios/economia , Procedimentos Cirúrgicos Operatórios/psicologia , Centros de Atenção Terciária/economia , Centros de Atenção Terciária/estatística & dados numéricos , Tempo para o Tratamento/estatística & dados numéricos , Adulto Jovem
2.
J Ethnopharmacol ; 247: 112203, 2020 Jan 30.
Artigo em Inglês | MEDLINE | ID: mdl-31472271

RESUMO

ETHNOPHARMACOLOGICAL RELEVANCE: Combretum racemosum showed activity in previous ethnopharmacological investigations of some Combretum species used in malaria treatment in parts of West Africa. AIM OF THE STUDY: This study aimed at confirming the antimalarial potential of this plant by an activity-guided isolation of its active principles. MATERIALS AND METHODS: A crude methanolic leaf extract of Combretum racemosum and fractions thereof obtained by partition with chloroform and n-butanol were investigated for antiplasmodial activity against chloroquine-sensitive (D10) and chloroquine-resistant (W2) strains of Plasmodium falciparum. Repeated chromatographic separations were conducted on the chloroform fraction to isolate bioactive compounds for further tests on antiplasmodial activity. The characterization of the isolated substances was performed by applying NMR- and MS-techniques (ESI-MS, HR-ESIMS, 1D and 2D NMR). RESULTS: The chloroform fraction (D10: IC50 = 33.8 ±â€¯1.5 µg/mL and W2: IC50 = 27.8 ±â€¯2.9 µg/mL) exhibited better antiplasmodial activity than the n-butanol fraction (D10: IC50 = 78.1 ±â€¯7.3 µg/mL and W2: IC50 = 78 ±â€¯15 µg/mL) as well as the methanolic raw extract (D10: IC50 = 64.2 ±â€¯2.7 µg/mL and W2: IC50 = 65.8 ±â€¯14.9 µg/mL). Thus, the focus of the phytochemical investigation was laid on the chloroform fraction, which led to the identification of four ursane-type (19α-hydroxyasiatic acid (1), 6ß,23-dihydroxytormentic acid (4), madecassic acid (8), nigaichigoside F1 (10)) and four oleanane-type (arjungenin (2), combregenin (5), terminolic acid (7), arjunglucoside I (11)) triterpenes, as well as abscisic acid (9). Compounds 1 and 2, 4 and 5, 7 and 8 as well as 10 and 11 were isolated as isomeric mixtures in fractions CR-A, CR-C, CR-E and CR-H, respectively. All isolated compounds and mixtures exhibited moderate to low activity, with madecassic acid being most active (D10: IC50 = 28 ±â€¯12 µg/mL and W2: IC50 = 17.2 ±â€¯4.3 µg/mL). CONCLUSION: This paper reports for the first time antiplasmodial principles from C. racemosum and thereby gives reason to the traditional use of the plant.


Assuntos
Antimaláricos/farmacologia , Combretum/química , Extratos Vegetais/farmacologia , Plasmodium falciparum/efeitos dos fármacos , Triterpenos/farmacologia , África Ocidental , Animais , Antimaláricos/isolamento & purificação , Antimaláricos/uso terapêutico , Etnofarmacologia , Humanos , Malária/tratamento farmacológico , Malária/parasitologia , Medicina Tradicional Africana/métodos , Metanol/química , Testes de Sensibilidade Parasitária , Extratos Vegetais/isolamento & purificação , Extratos Vegetais/uso terapêutico , Triterpenos/isolamento & purificação , Triterpenos/uso terapêutico
3.
J Ethnopharmacol ; 246: 112205, 2020 Jan 10.
Artigo em Inglês | MEDLINE | ID: mdl-31476442

RESUMO

ETHNOPHARMACOLOGICAL RELEVANCE: Currently, more than two thirds of the world's 36.9 million people living with HIV/AIDS reside in Sub-Saharan Africa. Opportunistic infections (OI) associated with HIV are the single most important cause of mortality and morbidity among HIV/AIDS patients in poor countries. There is widespread use of medicinal plant species to manage the HIV infection and it's associated OI in Uganda, even by patients already on antiretroviral drugs (ARV). However, much of this information remains undocumented and unverified. AIM OF STUDY: The aim of this study was to systematically and comprehensively document the traditional indigenous knowledge and practices associated with the management of HIV/AIDS infections by herbalists in Uganda. METHODS: Ethnobotanical data were collected using semi-structured interviews and questionnaires. Ninety traditional medicine practitioners (TMP) or herbalists were interviewed in Arua, Dokolo, Mbale, Bushenyi, Iganga, Rakai, Luwero and Kaabong districts to gather information on the plant species used. Data were analysed and presented using descriptive statistics and the Informant Consensus Factor. RESULTS: We documented 236 medicinal plant species from 70 families and 201 genera. Acacia was the most widely represented genus with five species. The most frequently used medicinal plant species for treating various OI were Erythrina abyssinica (45), Warburgia ugandensis (43), Zanthoxylum chalybeum (38), Acacia hockii (37), Mangifera indica (36), Aloe vera (35), Albizia coriaria (34), Azadirachta indica (32), Psorospermum febrifugum (27) Vernonia amygdalina (22) and Gymnosporia senegalensis (21). Some of the plant species were used for treating all the OI mentioned. There is a high degree of consensus among the TMP on which plant species they use for the different OI, even though they are geographically separated. Herbalists contribute to the widespread practice of simultaneously using herbal medicines and ARV. Some TMP are also engaged in dangerous practices like injecting patients with herbs and encouraging simultaneous use of herbs and ARV. Although the TMP relied on biomedical laboratory diagnoses for confirming the patients' HIV sero status, they were familiar with the signs and symptoms of HIV/AIDS. CONCLUSION: There is wide spread use of a rich diversity of medicinal plants species and practices by TMP to manage OI in HIV/AIDS patients in Uganda.


Assuntos
Infecções por HIV/tratamento farmacológico , Conhecimentos, Atitudes e Prática em Saúde , Medicina Tradicional Africana , Infecções Oportunistas/tratamento farmacológico , Fitoterapia , Adulto , Idoso , Idoso de 80 Anos ou mais , Etnobotânica , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Preparações de Plantas/uso terapêutico , Plantas Medicinais , Uganda , Adulto Jovem
4.
J Ethnopharmacol ; 247: 112251, 2020 Jan 30.
Artigo em Inglês | MEDLINE | ID: mdl-31560992

RESUMO

ETHNOPHARMACOLOGICAL RELEVANCE: Crateva adansonii DC (Capparaceae) is a shrub used to treat tumors in Cameroon. In our previous reports, a Crateva adansonii dichloromethane-methanol (DCM/MeOH) extract was shown to prevent chemically induced tumors in Wistar rats. AIM OF STUDY: To determine the bioactive principle of Crateva adansonii extract and to elucidate its underlying mechanism. MATERIALS AND METHODS: An activity-guided fractionation was realized using MTT assay. To investigate if the bioactive compound daucosterol (CA2) accounted for the previously observed anticancer effects of the C. adansonii extract, it was tested on cell growth, cell proliferation, cell cycle, cell death mechanism and cell migration. In addition, cell cycle- and apoptosis-regulating proteins were assessed by Western blotting. RESULTS: Daucosterol (CA2), a steroid saponin, was identified as major anticancer principle of the C. adansonii extract. Daucosterol significantly inhibited LNCaP, DU145 and PC3 prostate carcinoma cell growth and proliferation at the optimal concentration of 1 µg/mL. It also significantly increased the number of late apoptotic (DU145) and apoptotic (PC3) cells. The number of cells in S phase increased in DU145, while the number of G0/G1 cells decreased. Cell cycle proteins (cdk1, pcdk1, cyclin A and B) were down-regulated in DU145 and PC3 cells, whereas only cdk2 was down-regulated in PC3 cells. Moreover, the anti-apoptotic Akt, pAKT and Bcl-2 proteins were down-regulated, while the pro-apoptotic protein Bax was up-regulated. CA2 induced anti-metastatic effects by decreasing chemotaxis and cell migration, while it increased cell adhesion to fibronectin and collagen matrix. CONCLUSION: These results suggest that daucosterol is the major active principle responsible at least in part for the anticancer effect of the extract of Crateva adansonii.


Assuntos
Capparaceae/química , Extratos Vegetais/farmacologia , Neoplasias da Próstata/tratamento farmacológico , Sitosteroides/farmacologia , Apoptose/efeitos dos fármacos , Bioensaio , Camarões , Linhagem Celular Tumoral , Proliferação de Células/efeitos dos fármacos , Fracionamento Químico , Quimiotaxia/efeitos dos fármacos , Regulação para Baixo/efeitos dos fármacos , Ensaios de Seleção de Medicamentos Antitumorais , Humanos , Masculino , Medicina Tradicional Africana/métodos , Invasividade Neoplásica/prevenção & controle , Extratos Vegetais/química , Extratos Vegetais/isolamento & purificação , Neoplasias da Próstata/patologia , Proteínas Proto-Oncogênicas c-akt/metabolismo , Proteínas Proto-Oncogênicas c-bcl-2/metabolismo , Sitosteroides/isolamento & purificação , Regulação para Cima/efeitos dos fármacos
5.
BMC Complement Altern Med ; 19(1): 353, 2019 Dec 05.
Artigo em Inglês | MEDLINE | ID: mdl-31806007

RESUMO

BACKGROUND: Plants have been used as a primary source of medicine since ancient times and about 80% of the world's population use herbal medicine to treat different ailments. Plant use knowledge differs in space and time and thus requires documentation to avoid its loss from one generation to another. METHODS: In order to accomplish the survey, semi-structured questionnaires were used. The data collected included names of plant species, parts used, ailments treated, growth habit, methods of preparation and mode of administration of the herbal remedies. Descriptive statistics were used to present the data in form of tables and a graph. RESULTS: Results showed that 50 plant species belonging to 26 families were utilized in the treatment of paediatric diseases of which Asteraceae and Lamiaceae were the most common. Leaves (80%) were the most commonly used and decoctions were the main method of preparation. Twenty nine health conditions were treated out of which digestive disorders, malaria and respiratory tract infections were predominant. Herbs and shrubs were equally dominant. CONCLUSION: Herbal remedies are an important source of treatment for paediatric diseases in Buhunga Parish. However, there is need for collaboration between herbal medicine users and scientific institutions to help in the discovery of new drugs based on indigenous knowledge. Scientists ought to explore suitable methods of preparation and dosage formulations in order to achieve the best benefits from herbal remedies.


Assuntos
Etnofarmacologia , Medicina Tradicional Africana , Preparações de Plantas/uso terapêutico , Plantas Medicinais , Criança , Doenças do Sistema Digestório/tratamento farmacológico , Feminino , Humanos , Malária/tratamento farmacológico , Masculino , Infecções Respiratórias/tratamento farmacológico , Uganda/etnologia
7.
BMC Oral Health ; 19(1): 204, 2019 09 02.
Artigo em Inglês | MEDLINE | ID: mdl-31477127

RESUMO

BACKGROUND: Ebiino, a form of Infant Oral Mutilation (IOM), involves the gauging or enucleation of primary canine tooth buds in infants, and is believed to be a form of remedy to a range of childhood diseases. The effects of this practice have ranged from the child experiencing excessive bleeding, opportunistic infections and even death, besides the potential negative dental effects on primary and the developing permanent dentition of the affected child. The purpose of the study was to establish the occurrence of Ebiino and its dental effects in a rural child-population in Uganda. METHODS: This study formed part of a larger descriptive cross-sectional study on dental caries and gingivitis, in which 432 children aged 3-5 years old from Nyakagyeme Sub-county, Rukungiri District, Uganda, participated. All the 432 participants (230 males and 202 females, mean age 4.1 SD = 0.8) who had been recruited through stratified random sampling procedure, and whose caregivers had provided a written informed consent, were included in the study. Initially the past dental history of each participant was obtained, and all the children had an oral examination carried out to establish their dental status. RESULTS: The data gathered were entered in a computer and analysed using Windows SPSS version 23.0. The results of the analysis showed the prevalence of missing teeth not due to reasons like caries or trauma was 8.1%, with the primary canine being the most commonly missing tooth. These unusual missing teeth were attributed to a traditional practice called Ebiino. Chi-square test showed no statistically significant association of Ebiino with gender and age (p = 0.352 and p = 0.909, respectively). Also found in the study were enamel hypoplasia or damage of some primary canines and/or the primary lateral incisors and first primary molars, as well as displacement of adjacent teeth, a result found to be associated with the practice. CONCLUSION: The practice of Ebiino appears to be endemic within the communities in Rukungiri region in spite of the negative impacts in form of hypoplasia, midline shift, trauma, dental displacement and missing adjacent teeth that it had on the primary dentition of the child.


Assuntos
Cárie Dentária/epidemiologia , Oclusão Dentária Traumática/etnologia , Mandíbula/cirurgia , Extração Dentária/efeitos adversos , Pré-Escolar , Estudos Transversais , Feminino , Humanos , Masculino , Má Oclusão/epidemiologia , Medicina Tradicional Africana , Prevalência , População Rural , Dente Decíduo , Uganda/epidemiologia
8.
Afr J Prim Health Care Fam Med ; 11(1): e1-e11, 2019 Aug 06.
Artigo em Inglês | MEDLINE | ID: mdl-31478738

RESUMO

BACKGROUND:  Medical male circumcision (MMC) and traditional male circumcision (TMC) are reportedly having negative and positive outcomes in the Eastern Cape province. Researchers show contradictory remedies; some advocate for abolishment of TMC and others call for the integration of both methods. AIM:  This study aimed to explore factors influencing the integration of TMC and MMC at different socio-ecological levels. SETTING:  The study was conducted at Ingquza Hill Local Municipality in the Eastern Cape province. METHODS:  An explorative qualitative study design, using in-depth interviews (IDIs) and focus group discussions (FGDs), was employed in this study. Purposive sampling was used to select the participants. A framework analysis approach was used to analyse the data, and the themes were developed in line with the socio-ecological model. RESULTS:  Four main themes emerged from the data as important in influencing the integration of TMC and MMC methods. These included: (1) individual factors, related to circumcision age eligibility and post-circumcision behaviour; (2) microsystem factors, related to alcohol and drug abuse, peer pressure, abuse of initiates, and family influence; (3) exosystem factors, related to financial gains associated with circumcision and the role of community forums; and (4) macrosystem factors, related to stigma and discrimination, and male youth dominance in circumcision practices. CONCLUSION:  Male circumcision in this area is influenced by complex factors at multiple social levels. Interventions directed at all of these levels are urgently needed to facilitate integration of the TMC and MMC methods.


Assuntos
Atitude do Pessoal de Saúde , Circuncisão Masculina/psicologia , Prestação Integrada de Cuidados de Saúde/métodos , Medicina Tradicional Africana/psicologia , Adulto , Idoso , Circuncisão Masculina/métodos , Fenômenos Ecológicos e Ambientais , Feminino , Grupos Focais , Humanos , Masculino , Pessoa de Meia-Idade , Infuência dos Pares , Pesquisa Qualitativa , Estigma Social , Fatores Socioeconômicos , África do Sul
9.
PLoS Negl Trop Dis ; 13(8): e0007221, 2019 08.
Artigo em Inglês | MEDLINE | ID: mdl-31369551

RESUMO

BACKGROUND: Worldwide, snakebite envenomations total ~2.7 million reported cases annually with ~100,000 fatalities. Since 2009, snakebite envenomation has intermittently been classified as a very important 'neglected tropical disease' by the World Health Organisation. Despite this emerging awareness, limited efforts have been geared towards addressing the serious public health implications of snakebites, particularly in sub-Saharan Africa, where baseline epidemiological and ecological data remain incomplete. Due to poverty as well as limited infrastructure and public health facilities, people in rural Africa, including Ghana, often have no other choice than to seek treatment from traditional medical practitioners (TMPs). The African 'snakebite crisis' is highlighted here using regionally representative complementary data from a community-based epidemiological and ecological study in the savanna zone of northern Ghana. METHODOLOGY AND FINDINGS: Our baseline study involved two data collection methods in the Savelugu-Nanton District (in 2019 the district was separated into Savelugu and Nanton districts) in northern Ghana, comprising a cross-sectional study of 1,000 residents and 24 TMPs between December 2008 and May 2009. Semi-structured interviews, as well as collection of retrospective snakebite and concurrent rainfall records from the Savelugu-Nanton District Hospital and Ghana Meteorological Authority respectively over 10-years (1999-2008) were used in the study. Variables tested included demography, human activity patterns, seasonality, snake ecology and clinical reports. Complementary data showed higher snakebite prevalence during the rainy season, and a hump-shaped correlation between rainfall intensity and snakebite incidences. Almost 6% of respondents had experienced a personal snakebite, whereas ~60% of respondents had witnessed a total of 799 snakebite cases. Out of a total of 857 reported snakebite cases, 24 (~2.8%) died. The highest snakebite prevalence was recorded for males in the age group 15-44 years during farming activities, with most bites occurring in the leg/foot region. The highest snakebite rate was within farmlands, most severe bites frequently caused by the Carpet viper (Echis ocellatus). CONCLUSION: The relatively high community-based prevalence of ~6%, and case fatality ratio of ~3%, indicate that snakebites represent an important public health risk in northern Ghana. Based on the high number of respondents and long recording period, we believe these data truly reflect the general situation in the rural northern savanna zone of Ghana and West Africa at large. We recommend increased efforts from both local and international health authorities to address the current snakebite health crisis generally compromising livelihoods and productivity of rural farming communities in West Africa.


Assuntos
Ecologia , Pradaria , Mordeduras de Serpentes/epidemiologia , Adolescente , Adulto , Animais , Estudos Transversais , Feminino , Gana/epidemiologia , Humanos , Incidência , Masculino , Medicina Tradicional Africana , Pobreza , Prevalência , Saúde Pública , Estudos Retrospectivos , População Rural , Estações do Ano , Mordeduras de Serpentes/terapia , Serpentes , Adulto Jovem
10.
BMC Complement Altern Med ; 19(1): 212, 2019 Aug 14.
Artigo em Inglês | MEDLINE | ID: mdl-31412866

RESUMO

BACKGROUND: Recently, there has been an increasing tendency to go back to nature in search of new medicines. To facilitate this, a great deal of effort has been made to compile information on natural products worldwide, and as a result, many ethnic-based traditional medicine databases have been developed. In Ethiopia, there are more than 80 ethnic groups, each having their indigenous knowledge on the use of traditional medicine. About 80% of the population uses traditional medicine for primary health care. Despite this, there is no structured online database for Ethiopian traditional medicine, which limits natural products based drug discovery researches using natural products from this country. DESCRIPTION: To develop ETM-DB, online research articles, theses, books, and public databases containing Ethiopian herbal medicine and phytochemicals information were searched. These resources were thoroughly inspected and the necessary data were extracted. Then, we developed a comprehensive online relational database which contains information on 1054 Ethiopian medicinal herbs with 1465 traditional therapeutic uses, 573 multi-herb prescriptions, 4285 compounds, 11,621 human target gene/proteins, covering 5779 herb-phenotype, 1879 prescription-herb, 16,426 herb-compound, 105,202 compound-phenotype, 162,632 compound-gene/protein, and 16,584 phenotype-gene/protein relationships. Using various cheminformatics tools, we obtained predicted physicochemical and absorption, distribution, metabolism, excretion, and toxicity (ADMET) properties of ETM-DB compounds. We also evaluated drug-likeness properties of these compounds using FAF-Drugs4 webserver. From the 4285 compounds, 4080 of them passed the FAF-Drugs4 input data curation stage, of which 876 were found to have acceptable drug-likeness properties. CONCLUSION: ETM-DB is the largest, freely accessible, web-based integrated resource on Ethiopian traditional medicine. It provides traditional herbal medicine entities and their relationships in well-structured forms including reference to the sources. The ETM-DB website interface allows users to search the entities using various options provided by the search menu. We hope that our database will expedite drug discovery and development researches from Ethiopian natural products as it contains information on the chemical composition and related human target gene/proteins. The current version of ETM-DB is openly accessible at http://biosoft.kaist.ac.kr/etm .


Assuntos
Bases de Dados Factuais , Medicina Herbária , Medicina Tradicional Africana , Extratos Vegetais/química , Plantas Medicinais/química , Bases de Dados Factuais/normas , Etiópia , Humanos , Extratos Vegetais/farmacologia
11.
J Ethnopharmacol ; 245: 112176, 2019 Dec 05.
Artigo em Inglês | MEDLINE | ID: mdl-31446074

RESUMO

ETHNOPHARMALOGICAL RELEVANCE: Malaria is one of the most prevalent and deadly parasitic diseases globally, with over 200 million new cases and nearly 500,000 deaths reported annually. It is estimated that approximately half of the world's population lives in malaria endemic areas. Malaria is substantially less prevalent in South Africa than in other African regions and the disease is limited to some regions of the Limpopo, Mpumalanga and KwaZulu-Natal provinces. However, it still has a significant impact on the health of the populations living in those regions. Traditional medicines have long been used in South Africa by multiple ethic groups and many people continue to rely on these natural therapies for their healthcare. The usage of South African medicinal plants in several traditional healing systems to treat malaria have been documented (particularly for Zulu and Venda traditional medicine), although ethnobotanical investigations of other ethnic groups living in endemic malaria areas remains relatively neglected. AIM OF THE STUDY: To document the use of South African medicinal plants known to be used traditionally to treat Plasmodium spp. infections. We also critically reviewed the literature on the therapeutic properties of these and other South African plants screened against Plasmodium spp. parasites with the aim of highlighting neglected studies and fostering future research in this area. MATERIALS AND METHODS: Books and ethnobotanical reviews were examined for medicinal plants used specifically for fever. Exclusion criteria were studies not involving southern African medicinal plants. Furthermore, while fever is a common symptom of malaria, if not accompanied by the term "malaria" it was not considered. Databases including PubMed, ScienceDirect, Scopus and Google Scholar were used to source research relevant to southern African plants and malaria. Exclusion criteria were those publications where full articles could not be accessed. RESULTS: Eighty South African plant species were identified as traditional therapies for malaria. The majority of these species were documented in Zulu ethnobotanical records, despite malaria occurring in only a relatively small portion of the Zulu's traditional territory. Surprisingly, far fewer species were reported to be used by Venda, Ndebele, northern Sotho, Tsonga, Tswana, and Pedi people, despite them living in endemic malaria areas. Interestingly many of the identified species have not been investigated further. This review summarises the available ethnobotanical and laboratory research in this field, with the aim of promoting and focusing research on priority areas. CONCLUSION: Although malaria remains a serious disease affecting millions of people, medicinal plants while used extensively, have not been given the attention warranted for further investigation.


Assuntos
Antimaláricos/uso terapêutico , Malária/tratamento farmacológico , Medicina Tradicional Africana , Fitoterapia , Preparações de Plantas/uso terapêutico , Animais , Antimaláricos/farmacologia , Quimioterapia Combinada , Humanos , Preparações de Plantas/farmacologia , Plantas Medicinais , Plasmodium/efeitos dos fármacos , África do Sul
12.
Stud Health Technol Inform ; 264: 1548-1549, 2019 Aug 21.
Artigo em Inglês | MEDLINE | ID: mdl-31438225

RESUMO

The purpose of this study is to describe the design and development of the first release of the West African Herbal based Traditional Medicine Knowledge Graph (WATRIMed). It is a resource containing Traditional Medicine (TM) related entities and linked with publicly available knowledge bases in order to facilitate bringing West African TM into the digital world. The core model comprises currently 556 concepts including 143 identified West African medicinal plants and 108 recipes used by tradi-practitioners to treat 110 diseases and symptoms which are commonly encountered in this part of the world.


Assuntos
Plantas Medicinais , Conhecimento , Medicina Tradicional Africana , Reconhecimento Automatizado de Padrão , Fitoterapia
13.
BMC Complement Altern Med ; 19(1): 224, 2019 Aug 22.
Artigo em Inglês | MEDLINE | ID: mdl-31438931

RESUMO

BACKGROUND: Commercial herbal medicines (CHMs) marketed as immune boosters are gaining wide popularity in South Africa, in the absence of control and regulatory guidelines. These commercially packaged and labelled herbal preparations, acquired in various retail outlets, are used without consulting either a conventional health provider or a traditional health practitioner. Although they are indicated for immune-boosting purposes, they might exert many other beneficial and unwanted effects on physiological systems. Platelets are crucial in haemostasis and important for the immunological system. The aim was to investigate the effect of the CHMs used to strengthen the immune system on the activity of human platelets. METHODS: Six CHMs commonly used as African traditional medicines in Pretoria, South Africa, were tested for their effects on healthy, isolated human platelets, using a bioluminescence method. The tested herbal medicines were Intlamba Zifo™, Maphilisa™ Herbal medicine, Matla™ African medicine for all diseases, Ngoma™ Herbal Tonic Immune Booster, Stametta™ Body Healing Liquid, and Vuka Uphile™ Immune Booster and serial-diluted standards of each from 10 to 10,000 times. The luminol-enhanced luminescence activity of the platelets was measured after incubation with the herbal medicines and activation with phorbol myristate acetate (PMA) or N-formyl-methionyl-leucyl-phenylalanine (fMLP). RESULTS: Five herbal medicines, namely Intlamba Zifo™, Maphilisa™ Herbal medicine, Matla™ African medicine for all diseases, Stametta™ Body Healing Liquid, and Vuka Uphile™ Immune Booster exerted comparable weak inhibitory effects on both PMA and fMLP-induced platelets, which were concentration dependent at high doses, and inversely related to concentration at low doses. Intlamba Zifo™, Matla™ African medicine for all diseases, Stametta™ Body Healing Liquid, and Vuka Uphile™ exhibited weak, but non-systematic stimulatory effects at low doses, which were not statistically significant. Ngoma™ Herbal Tonic Immune Booster had weak, inhibitory effects at high doses and weak stimulatory effects that were inversely related to concentration at low doses. CONCLUSION: The findings suggest a potential beneficial role of the CHMs in the suppression of platelets' reactivity and in enhancing the immune system. Caution, however, should be exercised as platelet inhibition and stimulation predispose to the risk of bleeding and thrombosis, respectively.


Assuntos
Plaquetas/efeitos dos fármacos , Medicina Tradicional Africana , Preparações de Plantas/farmacologia , Adulto , Células Cultivadas , Feminino , Humanos , Medições Luminescentes , Masculino , Ativação Plaquetária/efeitos dos fármacos , Acetato de Tetradecanoilforbol , Adulto Jovem
14.
Afr J Prim Health Care Fam Med ; 11(1): e1-e5, 2019 Jul 15.
Artigo em Inglês | MEDLINE | ID: mdl-31368321

RESUMO

BACKGROUND: For many people in African countries, various forms of health care are utilised for the treatment of illness. This pluralistic nature of health seeking includes the use of indigenous, faith and allopathic medicines for care. AIM: In this article, our aim was to gain insight into the existing knowledge on indigenous and faith healing in Ghana, with a particular focus on mental health care. We first examine the reported mental health beliefs and practices of Ghanaian alternative healers. Following this, we look at the use and purported preference for non-biomedical mental health care by patients. METHODS: Relevant literature was examined to explore the beliefs, practices and use of non-biomedical mental health care systems in GhanaResults: Evidence for the use and preference for non-biomedical mental health care is largely anecdotal. Similarly, the mental health beliefs of alternative healers have been documented in various small-scale studies. However, such information is important if mental health services in Ghana are to be improved. CONCLUSION: Integration of the different healthcare systems must be built on knowledge of beliefs and methods. A clearer understanding of the work of non-biomedical healers is important if appropriate recommendations are to be made for collaboration between biomedical and non-biomedical systems in Ghana.


Assuntos
Cura pela Fé/métodos , Serviços de Saúde do Indígena , Medicina Tradicional Africana/métodos , Serviços de Saúde Mental , Cultura , Gana , Humanos
15.
Afr J Prim Health Care Fam Med ; 11(1): e1-e5, 2019 Jul 22.
Artigo em Inglês | MEDLINE | ID: mdl-31368322

RESUMO

BACKGROUND: Health seeking in many African countries typically involves making use of multiple healing systems, including indigenous and faith systems, as well as biomedical healthcare systems. These different systems have co-existed for many years in Africa, including in Ghana. AIM: In this article, we examine the formalising processes that non-biomedical healthcare in Ghana has undergone in postcolonial times. We first present a brief historical analysis of the process of organising indigenous medical systems into formal bodies. We then conclude by exploring collaborative efforts that have been undertaken between biomedical and non-biomedical health systems in Ghana. METHOD: A historical analysis of formalised indigenous healing systems in Ghana was done through an examination of relevant literature. RESULTS: Formal groups of indigenous healers in Ghana who are organised into specific categories have undergone various transformations over the years. Evidence also exists of collaborative programmes developed with traditional healers in Ghana, although these have been largely for primary health partnerships. With regard to mental health collaborations, attempts at integration have been generally unsuccessful, with various factors identified as hindering successful partnerships. CONCLUSION: Indigenous healing is an important component of healthcare in Ghana. Collaboration between the different healthcare systems can be strengthened through accurate understandings of how key stakeholders are situated (and indeed situate themselves) in the conversation.


Assuntos
Cura pela Fé/organização & administração , Serviços de Saúde do Indígena/organização & administração , Colaboração Intersetorial , Medicina Tradicional Africana , Serviços de Saúde Mental/organização & administração , Cura pela Fé/métodos , Gana , Humanos
16.
Prim Health Care Res Dev ; 20: e71, 2019 08 09.
Artigo em Inglês | MEDLINE | ID: mdl-31397258

RESUMO

AIM: This paper examined the association between wealth and health insurance status and the use of traditional medicine (TM) among older persons in Ghana. BACKGROUND: There have been considerable efforts by sub-Saharan African countries to improve access to primary health care services, partly through the implementation of risk-pooling community or national health insurance schemes. The use of TM, which is often not covered under these insurance schemes, remains common in many countries, including Ghana. Understanding how health insurance and wealth influence the use of TM, or otherwise, is essential to the development of equitable health care policies. METHODS: The study used data from the first wave of the World Health Organisation's Study of Global Ageing and Adult Health conducted in Ghana in 2008. Descriptive statistics and negative loglog regression models were fitted to the data to examine the influence of insurance and wealth status on the use of TM, controlling for theoretically relevant factors. FINDINGS: Seniors who had health insurance coverage were also 17% less likely to frequently seek treatment from a TM healer relative to the uninsured. For older persons in the poorest income quintile, the odds of frequently seeking treatment from TM increased by 61% when compared to those in the richest quintile. This figure was 46%, 62% and 40% for older persons in poorer, middle and richer income quintiles, respectively, compared to their counterparts in the richest income quintile. CONCLUSION: The findings indicate that TM was primarily used by the poor and persons who were not enrolled in the National Health Insurance Scheme. TM continues to be a vital health care resource for the poor and uninsured older adults in Ghana.


Assuntos
Atitude Frente a Saúde , Assistência à Saúde/organização & administração , Comportamentos Relacionados com a Saúde , Seguro Saúde/organização & administração , Medicina Tradicional Africana/psicologia , Programas Nacionais de Saúde/organização & administração , Aceitação pelo Paciente de Cuidados de Saúde/psicologia , Adolescente , Adulto , Fatores Etários , Idoso , Idoso de 80 Anos ou mais , Assistência à Saúde/estatística & dados numéricos , Feminino , Gana , Humanos , Seguro Saúde/estatística & dados numéricos , Masculino , Medicina Tradicional Africana/estatística & dados numéricos , Pessoa de Meia-Idade , Programas Nacionais de Saúde/estatística & dados numéricos , Aceitação pelo Paciente de Cuidados de Saúde/estatística & dados numéricos , População Rural/estatística & dados numéricos , Fatores Socioeconômicos , Inquéritos e Questionários , Adulto Jovem
17.
J Ethnobiol Ethnomed ; 15(1): 34, 2019 Jul 09.
Artigo em Inglês | MEDLINE | ID: mdl-31288841

RESUMO

BACKGROUND: The use of animals and animal-derived materials in traditional medicine constitutes an important part of the belief systems of indigenous African cultures. It is believed to be rapidly expanding in South Africa, where traditional healers are estimated to outnumber western doctors by 2000:1 in some areas, with an overall clientele consisting of 60-80% of South African citizens. Despite concerns about the impact of the trade in traditional medicine on biodiversity, there has been only limited research on this topic in South Africa. METHODS: Traditional Xhosa and Sotho healers operating from impoverished, rural communities in the Boland Region of the Western Cape Province were consulted to provide a comprehensive inventory of the number and frequency of animals used and sold. Species richness estimators, diversity indices, and a relative cultural importance (RCI) index were used to highlight species of concern and assess market dynamics. RESULTS: A total of 26 broad use categories for 12 types of animal parts or products from 71 species or morphospecies were recorded. The most commonly sold items were skin pieces, oil or fat, and bones. Results showed that leopard, chacma baboon, Cape porcupine, monitor lizard species, puff adder, African rock python, and black-backed jackal were the species most used in the traditional medicinal trade. CONCLUSIONS: This study extends existing knowledge on the trade of animals in South African healing practices and provides the first attempt in the Western Cape to quantify wildlife use for cultural traditions. The results have relevance for setting conservation priorities and may assist in effective policy development inclusive of ecological sustainability priorities, as well as cultural demands.


Assuntos
Biodiversidade , Medicina Tradicional Africana/métodos , Zoologia/métodos , Animais , Etnobotânica , Feminino , Humanos , Masculino , Plantas Medicinais , Medição de Risco , População Rural , África do Sul , Resultado do Tratamento
18.
Afr J AIDS Res ; 18(2): 104-114, 2019 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-31282302

RESUMO

In South Africa, African traditional healers and biomedical practitioners play important roles in the management of HIV and AIDS, but provide healthcare services in isolation of each other, despite legislative recognition of both types of healing. An interpretive, qualitative research approach was employed to elicit the views of both groups regarding the feasibility of collaboration. Semi-structured interviews were conducted with a sample of 20 participants with 10 persons from each group. Key findings were that African traditional healers referred their patients to hospitals but never received referrals from biomedical health care practitioners. The traditional healers took precautions to avoid drug interactions between their medicines and antiretrovirals (ARVs). Biomedical healthcare practitioners recommended that traditional medicine only be used externally to avoid interaction with ARVs. Lack of shared knowledge, poor dosages and medical complications due to the use of African traditional medicine were viewed as threats to the collaboration between the two groups, while open communication, research into the efficacy, scientific administration and proper dosages of African traditional medicine were articulated as facilitating factors. The main conclusion was that biomedical practitioners, traditional healers and government officials responsible for formulating healthcare policies need to be involved in devising a framework that would facilitate ways of encouraging collaboration between these two healthcare systems.


Assuntos
Síndrome de Imunodeficiência Adquirida/terapia , Fármacos Anti-HIV/uso terapêutico , Infecções por HIV/terapia , Medicina Tradicional Africana , Síndrome de Imunodeficiência Adquirida/tratamento farmacológico , Síndrome de Imunodeficiência Adquirida/psicologia , Adolescente , Adulto , Criança , Pré-Escolar , Assistência à Saúde , Feminino , Infecções por HIV/tratamento farmacológico , Infecções por HIV/psicologia , Política de Saúde , Serviços de Saúde , Humanos , Masculino , Pesquisa Qualitativa , Encaminhamento e Consulta , África do Sul , Terapias Espirituais , Adulto Jovem
19.
Expert Rev Clin Pharmacol ; 12(9): 875-883, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31269818

RESUMO

Introduction: Drug-induced liver injury (DILI) has become the most frequent cause of acute liver failure in high-income countries. However, little is known about the determinants of DILI in sub-Saharan Africa (SSA), where the prescription of antimicrobials and the use of potentially hepatotoxic traditional medicine are common. Areas covered: Based on an extensive literature search, we summarize current data available on the epidemiology and risk factors of DILI in SSA. We discuss the most likely causes of DILI in the region, including antimicrobial therapies and traditional medicine. We also highlight research gaps as well as barriers to diagnosis and management of the condition, and explore ways to address these important challenges. Expert opinion: DILI is underestimated in SSA and several factors challenge its early diagnosis, including lack of information on the causes of DILI in the region, sub-optimal knowledge about the condition among clinicians, and structural difficulties faced by health care systems. In order to better prevent the occurrence of DILI and its complications, it is crucial to enhance awareness among health care providers and patients, adapt drug prescription habits and regulations, and improve current knowledge on the main risk factors for DILI, including host genetic and environmental determinants.


Assuntos
Anti-Infecciosos/efeitos adversos , Doença Hepática Induzida por Substâncias e Drogas/epidemiologia , Efeitos Colaterais e Reações Adversas Relacionados a Medicamentos/epidemiologia , África ao Sul do Saara , Anti-Infecciosos/administração & dosagem , Doença Hepática Induzida por Substâncias e Drogas/diagnóstico , Doença Hepática Induzida por Substâncias e Drogas/etiologia , Humanos , Medicina Tradicional Africana/efeitos adversos , Medicina Tradicional Africana/métodos , Fatores de Risco
20.
Planta Med ; 85(11-12): 1024-1033, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-31261420

RESUMO

Halimium halimifolium (Hh) is a shrub used in Algerian folk medicine to treat gastrointestinal pain. An UHPLC-PDA-ESI/MSn method was developed to identify the metabolic profile of the traditionally used infusion (Hh-A) from the aerial parts. The structures of flavanols were confirmed by NMR analysis after the isolation procedure from a hydrohalcolic extract (Hh-B) that also allowed for the identification of phenolic acids, an aryl butanol glucoside, and different derivatives of quercetin, myricetin, and kaempferol. Tiliroside isomers were the chemical markers of Hh-A and Hh-B (54.33 and 36.00 mg/g, respectively). Hh-A showed a significant scavenging activity both against the radicals 1,1-diphenyl-2-picrylhydrazyl and 2,2'-Azino-bis(3-ethylbenzothiazoline-6-sulfonic acid) (EC50 = 10.49 µg/mL and TEAC value = 1.98 mM Trolox/mg infusion) and the lipopolysaccharide-induced reactive oxygen species release in A375 and HeLa cells. Moreover, the antihyperglycemic properties, by inhibiting the α-amylase and α-glucosidase enzymes (IC50 = 0.82 mg/mL and 25.01 µg/mL, respectively), were demonstrated. To upgrade the therapeutic effect, a microencapsulation process is proposed as a strategy to optimize stability, handling, and delivery of bioactive components, avoiding the degradation and loss of the biological efficacy after oral intake. Hh-loaded microparticles were designed using cellulose acetate phthalate as the enteric coating material and spray drying as a production process. The results showed a satisfactory process yield (67.9%), encapsulation efficiency (96.7%), and micrometric characteristics of microparticles (laser-scattering, fluorescent, and scanning electron microscopy). In vitro dissolution studies (USPII-pH change method) showed that Hh-loaded microparticles are able to prevent the release and degradation of the bioactive components in the gastric tract, releasing them into the intestinal environment.


Assuntos
Cistaceae/química , Antioxidantes/isolamento & purificação , Antioxidantes/farmacologia , Linhagem Celular , Cistaceae/metabolismo , Suplementos Nutricionais , Composição de Medicamentos , Células HeLa , Humanos , Hipoglicemiantes/isolamento & purificação , Hipoglicemiantes/farmacologia , Espectroscopia de Ressonância Magnética , Medicina Tradicional Africana , Extratos Vegetais/isolamento & purificação , Extratos Vegetais/farmacologia , Plantas Medicinais/química , Plantas Medicinais/metabolismo
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