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Faculty of Health Sciences

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Start date: 2020Subject: search.filters.subject.Traditional medicine

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Now showing 1 - 5 of 5
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    An exploration of the adoption of personal nonpharmaceutical intervention measures by students at a university of technology in response to the COVID-19 pandemic
    (2024) Kell, Colette Melissa; Haffejee, Firoza; Jinabhai, Champaklal C.
    Background In March 2020 the World Health Organisation (WHO) declared coronavirus disease (COVID-19) to be a global pandemic. Due to the novel nature of the virus, there was no effective vaccine or established treatment methods, and public health officials turned to the personal non-pharmaceutical protective intervention (NPI) measures of physical distancing, hand sanitisation and the wearing of masks to interrupt disease transmission and ‘flatten’ the pandemic curve. Despite the WHO recommendation that NPIs should be included as part of any pandemic response, prior to the COVID-19 pandemic, little behavioural science research had been conducted on how to improve NPI adoption. During the COVID-19 pandemic, many Knowledge, Attitude and Practice (KAP) surveys investigated NPI compliance, but there is a dearth of qualitative literature to provide insight into the barriers and facilitators to adoption in specific populations. Over the past two decades, the South African Higher education sector has largely been transformed to accommodate students from poor and rural backgrounds. As a result, students requiring accommodation in the urban centres where universities are often based, has dramatically increased. During the COVID-19 pandemic these students effectively became mobile members of their households, returning home at various times and lockdown levels, potentially spreading the disease to relatively isolated areas. In addition, studies have consistently found that young people were more likely to be considered non adopters of the COVID-19 NPIs, partly due to the increase in risk taking behaviour associated with adolescence. In South Africa, the risk behaviour of young people is also of significant public health concern in the context of HIV/AIDS, teenage pregnancy, substance abuse and violence, this is compounded by the limited success of large research interventions. Yet, despite the acknowledgement of the need for specificity in designing youth targeted interventions, there has been little exploration of how and why South African adolescents adopt positive behaviours. Knowledge of which would be useful to better understand behaviour motivation and inform strategies for positive behaviour change. Aim This study aimed to gain an understanding of the factors influencing the adoption of the personal NPIs in response to the COVID-19 pandemic, among students at a University of Technology (UOT). Insight into these factors was used to develop guidelines to inform the design of targeted interventions to promote positive behaviour change by South African adolescents. Methodology This exploratory, qualitative study sought to understand behaviour change using the Capability, Opportunity, Motivation, Behaviour (COM-B) model. Eighteen student participants at a UOT were selected using purposive, maximum variability sampling. Each participant was interviewed individually via Microsoft Teams. Data was transcribed verbatim and analysed both deductively and inductively. Deductive analysis was guided by Theoretical Domains Framework which was developed to integrate with the COM-B model. Where possible, participant statements were coded to the appropriate domain, statements relevant to the aim of the study but did not align with the TDF domains which were inductively analysed using the Tesch approach to qualitative analysis and Braun and Clarke (2006) thematic approach. Findings This study found that NPI adoption among students evolved over time, closely aligned to the available published literature regarding NPI efficacy and WHO recommendations, but not necessarily aligned to or in compliance with government regulations. A notable exception was the reduced compliance when interacting with loved ones. In these circumstances, despite high levels of both the psychological and physical capability to perform the protective behaviours, the participants lacked the social opportunity and emotional motivation to do so. Notable factors that facilitated NPI adoption included trust in international health organisations, personal experience of COVID-19 and an altruistic desire to protect others. Factors that acted as barriers to NPI adoption included in-group trust, government distrust and social disapproval for adoption. The major themes that emerged included the need for autonomy in adolescent health decision making, the importance of social connection, the influence of social media, and the need to include young people in the development of targeted behaviour change interventions (BCIs). Conclusion This study contributes to the limited body of knowledge regarding the factors that served as barriers and facilitators to the adoption of positive health behaviours by South African adolescents in the context of the COVID-19 pandemic. These factors contributed to the development of guidelines which can be utilised by the relevant stakeholders when designing BCIs targeting this group.
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    Allopathic medicine practitioners' experiences with non-disclosure of traditional medicine use
    (AOSIS, 2024-01-31) Gumede, Lindiwe; Nkosi, Pauline B.; Sibiya, Maureen Nokuthula
    A pertinent issue impacting patient treatment outcomes is the nondisclosure of traditional medicine (TM) use to Allopathic medicine practitioners (AMPs). For years, TM has been a controversial practice, with patients often using it alongside allopathic medicine without disclosing their use. It is imperitive to learn and understand the experiences of AMPs regarding the disclosure of TM use in Gauteng province to enable them to provide the best possible treatment outcomes for patients who use TM.

    Aim

    This study aimed to explore the experiences of AMPs regarding non-disclosure of TM use in Gauteng province.

    Setting

    This study was conducted in four district hospitals where outpatient care and services are rendered in Gauteng Province.

    Methods

    An interpretive phenomenological analysis (IPA) design was followed. Fourteen purposefully sampled AMPs participated in face-to-face, one-on-one, and semi-structured interviews. Interpretive phenomenological analysis in Atlas.ti was conducted.

    Results

    Three themes emerged: bedside manner of AMPs; stigmatising TM use; and individual belief systems. The belief of patients' disclosure hesitancy because of fear of judgment by the AMPs underpinned these themes.

    Conclusion

    Allopathic medicine practitioners are aware that patients who use TM could feel guilty and stigmatised. They acknowledged that patients use TM because of cultural and ethnic reasons, which should not be disregarded.

    Contribution

    The study highlighted that patients do not disclose their TM use because of AMPs' attitudes, stigmatising TM use, and their prejudices against the cultural beliefs of patients. Allopathic medicine practitioners should establish good communication with patients by providing patient-centred communication to facilitate disclosure of TM use.
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    Guidelines for disclosure of traditional medicine use to allopathic medicine practitioners by patients who use both traditional and allopathic medicines at selected hospitals in Gauteng, South Africa
    (2022-11) Gumede, Lindiwe; Nkosi, Pauline Busisiwe; Sibiya, Maureen Nokuthula
    Background Within the South African context, the concurrent use of traditional medicine (TM) and allopathic medicine (AM) is often not disclosed to allopathic medicine practitioners (AMPs) during a consultation. It is quite common for patients to consult with traditional health practitioners (THPs) prior to reaching out to AMPs for further assistance. When compared to AM, TM used by patients who use both TM and AM has on many occasions been perceived as a sub-standard treatment option. Non-disclosure of TM use by patients who use both TM and AM may render the AM prescribed by the AMPs ineffective if not detected in a timely manner. While there is literature that identifies the reasons why patients who use both TM and AM do not disclose this to AMPs during a consultation, no guidelines have been developed to focus on facilitating disclosure by these patients. Aim The aim of the research was to explore and describe the perceptions of AMPs regarding disclosure of TM use to AMPs by patients who use both TM and AM and ultimately to develop guidelines for disclosure of TM use to AMPs at selected hospitals in Gauteng. Methodology An exploratory, descriptive, qualitative research design was employed. The opinions of AMPs who met the non-probability, purposive sampling inclusion criteria were explored and described. Data was gathered through one-on-one, masked semi-structured interviews and qualitative observations of AMPs in their natural environment. The findings were triangulated and integrated with Petronio's communication privacy management (CPM) theory as a theoretical framework informing the study to help delineate correspondence concerning the phenomenon. Findings The findings of the one-on-one, semi-structured interviews reveal that the practice of AMPs in Gauteng regarding the concurrent use of TM and AM by patients they consult with is limited by their knowledge of the TM used by these patients. Secondary elements of non-disclosure include stigma, AMP attitudes, AMP training, belief systems, lack of knowledge, lack of communication skills, scoffing at TM and prejudice. The research findings prompted the development of guidelines and recommendations for stakeholders involved in patient care and management in Gauteng.
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    Prevalence, traditional medicine use and co-morbidities among type 2 diabetes mellitus in outpatients - a cross sectional hospital-based survey in KwaZulu-Natal
    (2022-09-29) Chetty, Lauren; Reddy, Poovendhree; Govender, Nalini
    Throughout the world, diabetes mellitus (DM) affects people of all ages, irrespective of gender and ethnicity, and impacts both rural and urban areas, as well as developing and developed countries. The prevalence of DM in sub-Saharan Africa is a significant public health burden which is attributed to inadequate health care funding, limited medicinal access and the disproportionate provision of resources between private and public health care. Approximately 451 million adults worldwide have diabetes, with predictions of 693 million cases by 2045. Moreover, Type II diabetes mellitus (T2DM) accounts for approximately 90% of diabetics, making it the most common type. Premature morbidity and mortality are associated with it, leading to micro- and macrovascular complications. There is a growing trend for patients to use traditional medicine (TM) commonly known as complementary and alternative medicine in most countries, in an attempt to eliminate or minimize the consequences of their illnesses and improve their general health. Therefore, this study aimed to determine the prevalence and, extent of traditional medicine use and co-morbidities among T2DM in a regional hospital in KwaZulu-Natal. This was a quantitative and cross-sectional study made up of 2 phases. Phase 1 was based on a retrospective chart review of all outpatients who were treated for T2DM between August 2018- January 2019. Demographic data and existing comorbidities were obtained from the hospital registers. Phase 2 involved the prospective recruitment of participants using a structured questionnaire, to determine their use of home remedies/ traditional medicine for T2DM and their co-morbidities thereof. Data from phase 1 revealed significantly more female patients (3072) compared to male patients (1050) (p<0.001). Majority of the outpatients (77.42%) presenting with T2DM over the 6-month period were between the ages of 45 years and 74 years. There was a significant correlation between Indian female patients who presented with T2DM compared with African female patients (p<0.05). The more frequent comorbidities experienced by patients were hypertension (3212) and cardiovascular problems (460) with a prevalence of 77.9% and 11.16%, respectively. The likelihood of presenting with comorbidities increased significantly with age. Logistic regression test found that female patients with T2DM were at significantly higher risk of presenting with hypertension (odds ratio [OR] = 1.44, 95% CI:1.20;1.71), arthritis (OR = 2.20, 95% CI:1.51;3.20) and anaemia (OR = 2.42, 95% CI:1.40;4.19), whilst their risk for cardiovascular problems was significantly lower compared to male patients (OR = 0.67, 95% CI: 0.54;0.83). The results obtained in phase 2 indicated that out of a total of 340 participants (n=244) included, 72% of them were female. T2DM was most prevalent in those aged 45 to 59 (47.94%). Out of 340 participants, only 92 (27%) used TM most often, with Indians (58.24%) being the most frequent users. Nearly 78 % of patients (n = 101) were using TM in conjunction with hospital medication. Families and friends were the most common sources of TM knowledge. Lemon and honey, Aloe vera, bitter gourd or karela, green tea, cinnamon, curry leaves and tulsi leaves were reported as the most commonly used TM. Traditional medicine use was predicted by various factors, including gender, race, age, education, residence, and presence of DM, however, no significant predictors for TM usage was noted among the variables tested. Traditional medicine use among African participants was 0.56 times (OR=0.56, 95% CI=0.34, 0.93), lower than that of Indian participants. Demographic factors, such as gender, ethnicity, and age, influenced the prevalence of T2DM and comorbidities. To allocate medical resources effectively and according to the true burden of disease from complications caused by T2DM, flexible and adaptive approaches are needed for prevention and management of T2DM cases. Furthermore, the study highlighted a low prevalence rate of TM usage (27.06%) in T2DM patients. Traditional medicine was predominately used among females and ethnicity was found to be a significant predictor of TM usage. The data from this study can be used to develop a tracking system, which will inform the health care systems with current information and may reduce the exponential rise of the number of patients suffering from DM. Future research is needed to determine if herbal therapies are effective therapeutic options in managing T2DM due to their safety and multiple targeting effects. Traditional medicine/ home remedies may be more effective in the development of anti-diabetic drugs if systematic data regarding their structure, activity, and mode of action is collected.
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    A comparative study of the relationship between the applications of Erythrina lysistemon (Umsinsi) within the traditional African and homeopathic medicinal systems
    (2021-05-27) Nyoni, Linnet; Ross, Ashley Hilton Adrian
    Traditional practices are highly respected and prioritized by a greater part of the black population in South Africa. There is a gap between the scientific evidence and the limited documentation of these practices due to knowledge that is being passed down from generation to generation through teachings, observations, and experience. This study sought to explore the different aspects of traditional African medicine, including the transmission of the indigenous knowledge and its relationship to homoeopathic medicine with respect to the applications of the medicinal plant Erythrina lysistemon. The study’s main aim was to explore the relationships in terms of similarities and /or differences existing between the African traditional and homoeopathic medicinal systems of the plant Erythrina lysistemon with reference to its pharmacology. A qualitative research methodology was employed to explore the understanding of the African traditional medicinal applications of Erythrina lysistemon by traditionalhealers from the Durban Warwick Triangle Muthi market. Semi-structured interviews were conducted on twelve traditional healers with the use of an interview guide and a voice recorder. The interviews were conducted in IsiZulu, after which they were transcribed verbatim and translated into English. The NVivo qualitative software was used for data analysis where themes were derived and analysed. Data on the homoeopathic applications of Erythrina lysistemon was derived from its homoeopathic materia medica which was formulated following a proving of the bark of Erythrina lysistemon in 2007. A desktop review of the plant’s pharmacology and toxicology was also conducted in comparison to its effectivity. The results obtained from the arising themes within the two medicinal systems were subjected to a comparative analysis, noting the differences and/or similarities presented. The field interviews conducted produced data that confirmed most of the documented uses of Erythrina lysistemon and further produced undocumented indications. A desktop review of the pharmacology and toxicology of Erythrina lysistemon also offered an understanding for some of its application properties. The prenylated flavonoids of Erythrina lysistemon have antimicrobial properties which render the herb effective in abscesses and infection, its application in sprains and other musculoskeletal complaints is due to its analgesic properties and the alkaloids produce estrogenic effects, accounting for its effect on the female reproductive system. The comparative analysis revealed areas of definite similarities between African traditional and homoeopathic applications of Erythrina lysistemon. The main areas of overlap were highlighted under the following headings: Head, Stomach, Abdomen, Urinary system, Female complaints, musculoskeletal system, Skin, Earache, Nausea and Vomiting, Stool, Wounds, Mental and Metaphysical symptoms. There were areas where no overlap was observed such as the Sleep, and Eye sections that were only accounted for in the materia medica but not in the African traditional medicinal application data. Both the physical and metaphysical indications of Erythrina lysistemon in traditional medicine were discussed and the metaphysical indications were compared in reference to some of the materia medica mental symptoms. The study concluded that there are definite areas of overlap between the applications of Erythrina lysistemon within the two discussed medicinal systems. The effectivity of Erythrina lysistemon in treating physical ailments in African traditional medicine can also be credited to some of its toxicological/pharmacological attributes. Furthermore, recommendations have been made for future studies.