Views and experiences of healthcare professionals towards the use of African traditional, complementary and alternative medicines among patients with HIV infection: the case of eThekwini health district, South Africa

BMC Complementary and Alternative Medicine

Manimbulu Nlooto¹ 

[1] Discipline of Pharmaceutical Sciences, School of Health Sciences, University of KwaZulu-Natal, Westville Campus, Durban, South Africa

关键词: Communication;    Healthcare providers;    Traditional medicines;    Alternative;    Complementary;    HIV management;   

Others  :  1212021
DOI  :  10.1186/s12906-015-0687-3

 received in 2014-10-20, accepted in 2015-05-21,  发布年份 2015

【 摘 要 】

Background

Many patients with human immunodeficiency virus infection use traditional, complementary, and alternative medicines and other practices to combat the disease, with some also using prescribed antiretroviral therapy provided by the public health sector. This study aimed to establish the awareness of public sector biomedical health care providers on the use of traditional, complementary and alternative medicines by HIV-infected patients who also used highly active antiretroviral therapy, and to determine whether this was based on patients seen or cases being reported to them. Potential risks of interactions between the prescribed antiretroviral and non-prescribed medication therapies may pose safety and effectiveness issues in patients using both types of treatment.

Methods

A descriptive cross-sectional study, using a researcher administered semi-structured questionnaire, was conducted from June to August 2013 at ten public sector antiretroviral clinics in five regional, three specialised and two district hospitals in eThekwini Health District, South Africa. Questionnaires were administered through face-to face interview to 120 eligible participants consisting of doctors, nurses, pharmacists and post-basic pharmacist assistants in HIV clinical practice. The results are presented as percent or proportion with standard error (SE), or as frequency.

Results

Ninety-four respondents completed the questionnaire, yielding a response rate of 78.3 %. Almost half (48/94) were aware of patients using African traditional herbal medicines, over-the-counter supplements, unnamed complementary Ayurveda medicines and acupuncture. Twenty-three of the 94 respondents (24.4 %) said they had consulted patients who were using both antiretroviral therapy and certain types of non-prescribed medication in the previous three months.

Conclusions

Awareness among healthcare providers on patient use of traditional, complementary and alternative medicines was relatively high. Few respondents had seen patients who used mostly African traditional medicines, over-the counter supplements, and negligible complementary Ayurveda medicines and acupuncture, with caution being advised in the interpretation of the former. Further research is needed to investigate communication between healthcare providers and patients in this regard, and levels of acceptance of traditional, complementary and alternative medicines by biomedical health care workers in HIV public sector practice.

【 授权许可】

   
2015 Nlooto.

【 图 表 】

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【 参考文献 】

• [1]Venter F. HIV treatment in South Africa: The challenges of an increasingly successful antiretroviral programme. In South African Health Review. Edited by Health Systems Trust. Durban, edition 2012/13, 2013, Available on Google. Accessed on 10th April 2013.
• [2]Lohse N, Hansen AB, Pedessen G, Kronborg G, Gerstoff J, Sarensen HT et al.. Survival of persons with and without HIV infection in Denmark, 1995–2005. Ann Intern Med. 2007; 146(2):87-95.
• [3]Hoogbruin A. Complementary and alternative therapy(CAT) use and highly active antiretroviral therapy(HAART): current evidence in the literature, 2000–2009. J Clin Nurs. 2011; 20:925-939.
• [4]Peltzer K, Friend-du-Preez N, Ramlagan S, Fomundam H, Anderson J, Chanesta L. Antiretrovirals and the use of traditional, complementary and alternative medicine(TCAM) by HIV patients in Kwazulu-Natal, South Africa: a longitudinal study. Afr J TraditComplentAltern Med. 2011; 8(4):337-345.
• [5]Malangu NG. Self-reported adverse effects as barriers to adherence to antiretroviral therapy in HIV-infected patients in Pretoria. SA FamPract. 2008; 50(5):49.
• [6]Namuddu B, Kalyango JN, Karamagi C. Prevalence and factors associated with traditional herbal medicine use among patients on highly active antiretroviral therapy in Uganda. BMC Public Health. 2011; 11:855.
• [7]World Health Organization. Traditional Medicine Strategy 2002–2005. Geneva: WHO; 2002
• [8]World Health Organization. WHO Policy Perspectives on Medicine No. 2 May 2002, Traditional Medicine- Growing Needs and Potential. Geneva: WHO; 2002
• [9]Liu C, Yang Y, Gange SJ, Weber K, Sharp GB, Wilson TE et al.. Disclosure of complementary and alternative medicine to health care providers among HIV-infected women. AIDS Patient Care STDs. 2009; 23(11):965-971.
• [10]Hughes GD, Puoane TR, Clark BL, Wondwossen TL, Johnson Q, Folk W. Prevalence and predictors of traditional medicine utilization among persons living with AIDS(PLWA) on antiretroviral(ARV) and prophylaxis treatment in both rural and urban areas in South Africa. Afr J traditComplementAlternMed. 2012; 9(4):470-484.
• [11]Makoul G. Essential elements of communication in medical encounters: the Kalamazoo consensus statement. Acad Med. 2001; 78(4):390-393.
• [12]Sutcliffe KM, Lewton E, Rosenthal MM. Communication failures: an insidious contributor to medical mishaps. Acad Med, 2004, 79, No2/February 2004. Available at Google Scholar. Accessed on the 4th October 2014.
• [13]Avert. Alternative, complementary and traditional and HIV. Available online http://www.avert.org/alternative-hiv-treatment.htm. Accessed on the 24th October 2012.
• [14]Mills E, Montori V, Perri D, Phillips E, Koren G. Natural health product-HIV drug interactions: a systematic review. Int JSTD AIDS. 2005; 16:181.
• [15]Naidoo P. Focus group discussion with private sector doctors in the eThekwini Metro of KwaZulu-Natal on the management of HIV/AIDS patients. SAfrFamPract. 2011; 53(2):176-181.
• [16]Mbutho NP, Gqaleni N, Korporaal CM. Traditional, complementary and alternative medicine: knowledge, attitudes and practices of health care workers in HIV/AIDS clinics in Durban hospitals. Afr J tradit Complement Altern Med 2012; 9(3Suppl). Available at http://pubmedcentralcanada.ca/pmcc/articles/PMC3746618/. Accessed on the 28th July 2014.
• [17]Wade A. Study size. Sexually Transmitted infections. 2001;77:332–334. doi:10.1136/sti.77.5.332. Available at Google, Accessed on the 24th October 2014.
• [18]South Africa National department of health: Standard Treatment Guidelines and essential medicines list. Pretoria: The National Department of Health, Pretoria, South Africa; 2012.
• [19]Langlois-Klassen D, Kipp W, Rubaale T. Who’s talking? Communication between health providers and HIV -infected adults related to herbal medicine for AIDS treatment in western Uganda. Soc Sci Med. 2008; 67:165-176.
• [20]Lubinga S.J, Kintu A., Atuhaire J, Asiimwe S. Concomitant herbal medicine and antiretroviral therapy(ART) use among HIV patients in Western Uganda: a cross-sectional analysis magnitude and patterns of use, associated factors and impact on ART adherence. AIDS Care: Psychological and socio-medical aspects of AIDS/HIV, 2012;24(11):1375-1383. doi:10.1080/09540121.2011.648600. Epub 2012 Jan 31.
• [21]Grant M, Haskins L, Gaede B, Horwood C. Bridging the ga exploring the attitudes and beliefs of nurses and patients about coexisting traditional and biomedical healthcare systems in a rural setting in KwaZulu-Natal.S AfrFamPract2013;55(2):175–179. Available at http://www.safpj.co.za/index.php/safpj/article/view/3529. Accessed on the 07th May 2013.
• [22]Clement YN, Williams AF, Khan K, Bernard T, Botha S, Fortune M, et al: A gap between acceptance and knowledge of herbal remedies by physicians: The need for educational intervention. BMC Complement Altern Med 2005;5:20 Available at http://pubmedcentralcanada.ca/pmcc/articles/PMC1310610/. Accessed on the 28th July 2014.
• [23]Owen -Smith A, Diclemente R, Wingood G. [10.1080/09540120701203279] webcite Complementary and alternative medicine use decreases adherence to HAART in HIV-positive women. AIDS Care: Psychological and socio-medical Aspects of AIDS/HIV,19:5, 589–593, doi:. Available online http://www.tandfonline.com/doi/abs/10.1080/09540120701203279 webcite. Accessed on the 24th October 2013.
• [24]Ladenheim D, Horn O, Werneke U, Phillpot M, Murungi A, Theobald N, et al. Potential health risks of complementary alternative medicines in HIVpatients. Brit HIV Assoc HIV Med (2008) 9, 653–659 doi:10.1111/j.1468-1293.2008.006x. Available on Google Accessed on the 25th October 2013.
• [25]Bepe N, Madanhi N, Mudzviti T, Gavi S, Maponga C C, Morse D. The impact of herbal remedies on adverse effects and quality of life in HIV-infected individuals on antiretroviral therapy. J Infect DevCtries. 2011;5(1):48–53 Available at http://pubmedcentralcanada.ca/pmcc/articles/PMC3424263/. Accessed on the 28th July 2014.
• [26]Ajuoga E, Sansgiry SS, Ngo C, YehRF: Use /misuse of over the counter medications and associated adverse events among HIV-infected patients. Research in social and administrative pharmacy, 2008, 4, 3: 292–301 Available at http://www.rsap.org/article/S1551-7411(07)00088-5/pdf. Accessed on the 15th October 2014
• [27]Quartey NK, Ma PHX, Chung VCH, Griffiths SM. Complementary and alternative medicine education for medical professions: systematic review. Evidence Based complementary and Alternative Medicine 2012:656–812. doi:10.1155/2012/656812. Accessed on the 15th October 2014.
• [28]Fincham JE. Response rates and responsiveness for Surveys, Stantandards, and the Journal. Am J Pharma Educ 2008; 72(2) Article 43. Availavle at Google Scholar. Accessed on the 15th October 2014