| Journal of Ethnobiology and Ethnomedicine | |
| Traditional health practitioners’ perceptions, herbal treatment and management of HIV and related opportunistic infections | |
| Gail Hughes1  Charlotte Van’t Klooster3  Joop T De Jong3  Diana Gibson2  Oluwaseyi Aboyade1  Tarryn Blouws1  Denver Davids2  | |
| [1] South African Herbal Science and Medicine Institute, University of the Western Cape, Bellville, South Africa;Department of Anthropology and Sociology, University of the Western Cape, Bellville, South Africa;Amsterdam Institute for Social Science Research (AISSR), University of Amsterdam, Amsterdam, The Netherlands | |
| 关键词: Medicinal plants; Traditional health practitioners; TB; HIV; | |
| Others : 1230077 DOI : 10.1186/1746-4269-10-77 |
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| received in 2014-04-08, accepted in 2014-11-27, 发布年份 2014 | |
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【 摘 要 】
Background
In South Africa, traditional health practitioners’ (THPs) explanatory frameworks concerning illness aetiologies are much researched. However there is a gap in the literature on how THPs understand HIV-related opportunistic infections (OIs), i.e. tuberculosis, candidiasis and herpes zoster. This study aimed to comprehend THPs’ understandings of the aforementioned; to ascertain and better understand the treatment methods used by THPs for HIV and OIs, while also contributing to the documentation of South African medicinal plants for future conservation.
Methods
The study was conducted in two locations: Strand, Western Cape where THPs are trained and Mpoza village, Mount Frere, Eastern Cape from where medicinal plants are ordered or collected. Semi-structured interviews were conducted with 53 THPs of whom 36 were diviners (amagrirha: isangoma) and 17 herbalists (inyanga). THPs were selected through a non-probability “snowball” method. Data were analysed using a thematic content analysis approach. An ethnobotanical survey was conducted and plants used to manage HIV and OIs were collected. A complete set of voucher specimens was deposited at the University of the Western Cape Herbarium for identification. Plant names were checked and updated with Kew’s online website http://www.theplantlist.org webcite.
Results
THPs conceptualise the aetiology of HIV and OIs at two related levels. The first involves the immediate manifestation of the illness/condition because of a viral infection in the blood (HIV), the presence of bacteria in the lungs (tuberculosis), or weakened state of the body making it susceptible to OIs. The presence of OIs is indicative of the probable presence of HIV. The second level of causation affects the first, which includes pollution, changes in cultural sexual norms, witchcraft, environmental factors, and lack of adherence to ancestral rituals. THPs reported using 17 plants belonging to 12 families. Remedies included mixes of up to five plants.
Conclusion
This study explored the THPs’ perspectives on HIV and commonly associated OIs and their herbal treatment methods. THPs generally rely on biomedical diagnosis before treating a client. They also seek guidance from the ancestors for a particular diagnosis, the plants to use for a specific treatment, when to harvest, and how to administer herbal remedies.
【 授权许可】
2014 Davids et al.; licensee BioMed Central Ltd.
【 预 览 】
| Files | Size | Format | View |
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| 20151103094016560.pdf | 951KB | ||
| Figure 4. | 37KB | Image | |
| Figure 3. | 40KB | Image | |
| Figure 2. | 19KB | Image | |
| Figure 1. | 45KB | Image |
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【 参考文献 】
- [1]Van der Linda I: Plenary Session 3, 20 June 2013- “HIV/AIDS in South Africa: At Last the Glass is Half Full.”. http://www.hsrc.ac.za/en/media-briefs/hiv-aids-stis-and-tb/plenary-session-3-20-june-2013-hiv-aids-in-south-africa-at-last-the-glass-is-half-full webcite
- [2]WHO: Global Tuberculosis Report 2012. Geneva: World Health Organization; 2012. http://apps.who.int/iris/bitstream/10665/75938/1/9789241564502_eng.pdf webcite
- [3]Norman R, Bradshaw D, Schneider M, Pieterse D, Groenewald P: Revised Burden of Disease Estimates for the Comparative Risk Factor Assessment, South Africa 2000. Cape Town: South African Medical Research Council; 2006.
- [4]Granich R, Crowley S, Vitorial M, Lo Y, Souteyrand Y, Gilks C, Guerma T, De Cock KM, Williams B: Highly active antiretroviral treatment for the prevention of HIV transmission. J Int AIDS Soc 2010, 13:1. BioMed Central Full Text
- [5]Kayne SB: Introduction to Traditional Medicine. In Traditional Medicine: A Global Perspective. Edited by Kayne SB. London: Pharmaceutical Press; 2009:1-24.
- [6]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. AJTCAM 2012, 9(4):470-484.
- [7]Puoane TR, Hughes GD, Uwimana J, Johnson Q, Folk WR: Why HIV positive patients on Antiretroviral treatment and/or cotrimoxazole prophylaxis use traditional medicine: perceptions of health workers, traditional healers and patients: a study in two provinces of South Africa. AJTCAM 2012, 9(4):495-502.
- [8]Van Niekerk J: Traditional healers formalised? S Afr Med J 2012, 102(3):105-106.
- [9]D Pemba L, Seatlanyane P, Charalambous S, Churchyard G, Grant A: Use of traditional medicine by HIV-infected individuals in South Africa in the era of antiretroviral therapy. Psychol Health Med 2007, 12(3):314-320.
- [10]Walwyn D: The role of South African traditional health practitioners in the treatment of HIV/AIDS: a study of their practices and use of herbal medicines. South Afr J HIV Med 2010, 11(2):11-17.
- [11]Ross E: Traditional healing in South Africa: ethical implications for social work. Soc Work Health Care 2008, 46(2):15-33.
- [12]Tugendhaft A: Medical Pluralism and HIV/AIDS in South Africa: What are the Barriers to Collaboration Between Traditional Healers and Medical Doctors? Masters Thesis. Johannesburg: University of Witwatersrand, South Africa, Department Health Sociology; 2010.
- [13]Bateman C: HIV training of traditional healers limps along. SAMJ 2004, 94(10):804-806.
- [14]Hsiao A, Wong M, Kanouse D, Collins R, Liu H, Andersen R, Gifford A, McCutchan A, Bozzette S, Shapiro M, Wenger N: Complementary and alternative medicine use and substitution for conventional therapy by HIV-infected patients. J Acquir Immune Defic Syndr 2003, 33(2):157-165.
- [15]Milan F, Julia Arnsten H, Klein R, Schoenbaum E, Moskaleva G, Buono D, Webber M: Use of complementary and alternative medicine in inner-city persons with or at risk for HIV infection. AIDS Patient Care STDS 2008, 22(10):811-816.
- [16]Liddell C, Barrett L, Bydawell M: Indigenous representations of illness and AIDS in Sub-Saharan Africa. Soc Sci Med 2005, 60(4):691-700.
- [17]Nxumalo N, Alaba O, Harris B, Chersich M, Goudge J: Utilization of traditional healers in South Africa and costs to patients: findings from a national household survey. J Publ Health Pol 2011, 32:124-136.
- [18]SA Info: Health Care in South Africa. http://www.southafrica.info/about/health/health.htm#.UWLaLlddl9M webcite
- [19]Truter I: African traditional healers: cultural and religious beliefs intertwined in a holistic way. S Afr Pharm J 2007, 74(8):56-60.
- [20]Government Gazettehttp://www.pmg.org.za/files/docs/080725health-traditionalmedicinepolicy.pdf webcite
- [21]Philander L: Hunting knowledge and gathering herbs: Rastafari Bush doctors in the western cape, South Africa. J Ethnobiol 2012, 32(2):134-156.
- [22]Government gazette: Draft Policy on African Traditional Healers No 31265 (Notice 906 of 2008). http://www.pmg.org.za/files/docs/080725health-traditionalmedicinepolicy.pdf webcite
- [23]Thornton R: Transmission of knowledge in South African traditional healing. Africa 2009, 79(1):17-34.
- [24]Peltzer K, Mngqundaniso N, Petros G: HIV/AIDS/STI/TB knowledge, beliefs and practices of traditional healers in KwaZulu-Natal, South Africa. AIDS Care 2006, 18(6):608-613.
- [25]UNAIDS: Collaboration With Traditional Healers in HIV/AIDS Prevention and Care in sub-Saharan Africa, A Literature Review. Geneva: The Joint United Nations Programme on HIV and AIDS; 2000. http://data.unaids.org/publications/irc-pub01/jc299-tradheal_en.pdf webcite
- [26]Ritcher M: Traditional Medicines and Traditional Healers in South Africa. http://www.tac.org.za/Documents/ResearchPapers/Traditional_Medicine_briefing.pdf webcite
- [27]Wreford J: Negotiating Relationships Between Biomedicine and Sangoma: Fundamental Misunderstandings, Avoidable Mistakes. Cape Town: Centre for Social science Research, University of Cape Town; 2005.
- [28]Ndhlalambi M: Strengthening the Capacity of Traditional Health Practitioners to Respond to HIV/AIDS and TB in Kwazulu Natal, South Africa. Nairobi Kenya: AMREF Case Studies; 2009.
- [29]Heckathorn DD: Comment: snowball versus respondent-driven sampling. Socio Meth 2011, 41:355-366.
- [30]Shisana O, Rehle T, Simbayi LC, Zuma K, Jooste S, Pillay-van-Wyk V, Mbelle N, Van Zyl J, Parker W, Zungu NP, Pezi S, SABSSM III Implementation Team: South African National Prevalence, Incidence, Behaviour and Commuication Surver 2008: A Turning Tide Among Teenagers?. Cape Town: HSRC Press; 2009.
- [31]SA Places. http://www.places.co.za/html/strand.html webcite
- [32]Helderberg District Plan: Spatial Development Plan & Environmental Management: Technical Report. Cape Town: City of Cape Town; 2012. http://www.capetown.gov.za/en/Planningportal/Documents/Helderberg_D_P_Tech_Report_FINAL.pdf webcite
- [33]Mount Frere. http://census.adrianfrith.com/place/23817 webcite
- [34]Skuse A, Cousins T: Information Society Research Group Working Paper No. 1 Managing Distance: the Social Dynamics of Rural Telecommunications Access and Use in the Eastern Cape, South Africa. 2005. http://r4d.dfid.gov.uk/PDF/Outputs/Mis_SPC/R8232-ISRGWP1.pdf webcite
- [35]Carlese G, Carlese B, Gelnton C: What about N? A methodological study of sample-size reporting in focus group studies. BMC Med Res Methodol 2011, 11:26. http://www.biomedcentral.com/1471-2288/11/26 webcite) BioMed Central Full Text
- [36]Kerr C, Nixon A, Wild D: Assessing and demonstrating data saturation in qualitative inquiry supporting patient-reported outcomes research. Expert Rev Pharmacoecon Outcomes Res 2010, 10(3):269-281.
- [37]Stephen G, MacQueen K, Namey E: Applied Thematic Analysis. 2011. Thousand Oaks, CA: Sage Publications; 2011.
- [38]Green J, Thorogood N: Qualitative Methods for Health Research. 2nd edition. London: Sage; 2009.
- [39]Dickinson D: Traditional healer, HIV/AIDS and companies programmes in South Africa. Afr J AIDS Res 2008, 7(3):281-291.
- [40]Foster G: Disease Etiologies in Non-Western Medical Systems. In The Art of Medical Anthropology. Edited by Van der Geest S, Rienks A. Amsterdam: Het Spinhuis; 1998:141-149.
- [41]Waldstein A, Addams C: The interface between medical anthropology and medical ethnobiology. J R Anthropol Inst 2006, 12(Suppl s1):S95-S118.
- [42]Kleinman A: Concepts and a model for the comparison of medical systems as cultural systems. Soc Sci Med 1978, 12(2B):85-93.
- [43]Kleinman A: Patients and Healers in the Context of Culture. Berkeley: University of California Press; 1980.
- [44]Young JC, Garro LY: Variation in the choice of treatment in two Mexican communities. Soc Sci Med 1982, 16(16):1463-1465.
- [45]Fabrega H: Disease and Social Behaviour: An Interdisciplinary Perspective. Cambridge, MA: Massachusetts Institute of Technology Press; 1974.
- [46]Wreford J: Working With Spirit: Experiencing Izangoma Healing in Contemporary South Africa. London/NY: Berghahn Books; 2008.
- [47]Wreford J: Worlds Apart? Religious Interpretations and Witchcraft in the Negotiation of Health Strategies for HIV/AIDS in South Africa. http://www.arhap.uct.ac.za/downloads/Wed_Wreford_paper.pdf webcite
- [48]Mills E, Cooper C, Seely D, Kanfer I: African herbal medicines in the treatment of HIV: hypoxis and sutherlandia, an overview of evidence and pharmacology. Nutr J 2005, 4:19-24. BioMed Central Full Text
- [49]Ashforth A: Witchcraft, Violence and Democracy in South Africa. Chicago: University of Chicago Press; 2005.
- [50]LeBeau D: Dealing With Disorder: Traditional and Western Medicine in Katutura (Namibia). Cologne: Rudiger Koppe; 2003.
- [51]Knox P: AIDS, Ancestors and Salvation: Local Beliefs in Christian Ministry to the Sick. Kenya, Nairobi: Paulines Publications; 2008.
- [52]Rödlach A: Witches, Westerners and HIV: Cultures of Blame in Africa. Walnut Creek, California: Left Coast Press; 2006.
- [53]Glick L: Medicine as an ethnographic category: the Gimi of the New Guinea highlands. Ethnology 1967, 6:31-56.
- [54]Bodibe K: Of Treatments and Cures. http://www.health-e.org.za/2008/11/28/of-treatments-and-cures/ webcite
- [55]Bessong P, Obi C, Igumbor E, Andreola M, Litvak S: In vitro activity of three selected South African medicinal plants against human immunodeficiency virus type 1 reverse transcriptase. AJB 2004, 3(10):555-559.
- [56]Ontang WM, Grierson DS, Ndip RN: Ethnobotanical survey of medicinal plants used in the management of opportunistic fungal infections in HIV/AIDS patients in the Amathole District of the Eastern Cape Province, South Africa. JMPR 2012, 6(11):2071-2080.
- [57]Tshikalange T, Meyer J, Lall N, Muñoz E, Sancho R, Van de Venter M, Oosthuizen V: In vitro anti-HIV-1 properties of ethnobotanically selected South African plants used in the treatment of sexually transmitted diseases. J Ethnopharmacol 2008, 119:478-481.
- [58]McGaw LJ, Lall N, Meyer JJM, Eloff JN: The potential of South African plants against Mycobacterium infections. J Ethnopharmacol 2008, 119:482-500.
- [59]Faleshini MT: A Phytochemical and Biological Investigation of Sutherlandia Frutescens. Masters’ Thesis. Pretoria: University of South Africa, Life Sciences; 2011.
- [60]Klos M, van de Venter M, Milne PJ, Traore HN, Meyer D, Oosthuizen V: In vitro anti-HIV activity of five selected South African medicinal plant extracts. J Ethnopharmacol 2009, 124(2):182-188.
- [61]Watson RR, Stanaway DJ: African Medicinal Plants for the Treatment of HIV/AIDS. In Botanical Medicine in Clinical Practice. Edited by Watson RR, Preddy PR. Wallingford: GAB International; 2008:13-30.
- [62]Moolla A, Viljoen AM: ‘Buchu’—Agathosma betulina and A. crenulata Rutaceae): a review. J Ethnopharmacol 2008, 119:413-419.
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