Prevalence of herbal and traditional medicine in Ethiopia: a systematic review and meta-analysis of 20-year studies

BACKGROUND

The widely accepted prevalence of traditional medicine (TM) in Ethiopia was about 80 %, of which 95 % were sourced from plants. The purpose of this study was to update knowledge of the prevalence of herbal medicine or TM in Ethiopia and describe the characteristics of the population mostly relying on herbal medicine or TM to inform health policy-makers.

METHODS

PubMed, Google Scholar, Hinari, Scopus, and the Directory of Open Access Journals (DOAJ) were searched. The methodological quality of each included study was assessed using the quality assessment checklist for prevalence studies. Meta-analysis was conducted using STATA version 17, and the heterogeneity between studies was assessed using I2 test statistics based on the random effect model. Forest and funnel plots were used to present the data. Subgroup analysis was done by the study population, region, and setting.

RESULTS

Thirty-six studies with a total of 16,288 participants met the inclusion criteria. Meta-analysis of the study revealed that the prevalence of herbal medicine use in Ethiopia is 46 % (95 % CI, 37-54 %), with significant heterogeneity among the studies (I2 = 99.19 %). Egger's test for publication bias of herbal medicine use revealed significant results (Egger, P = 0.002) which indicates possible missing of small sample size studies. The prevalence of TM use in Ethiopia is 65 % (95 % CI, 52-77 %) with significant heterogeneity among the studies (I2 = 99.18 %). Egger's test for publication bias of TM use revealed non-significant results (Egger, P = 0.275). The subgroup analysis by the study setting and the region revealed variability amongst the studies. Community-based studies and Oromia National Regional State showed higher prevalence. By population type, a higher prevalence of TM use was observed amongst children and lowest amongst malaria suspects.

CONCLUSIONS

The current study revealed that TM/herbal medicine utilization remained an important source of primary healthcare in Ethiopia. In comparison to the commonly reported prevalence of TM/herbal medicine, there is a considerable decline in TM/herbal medicine prevalence. High TM/herbal medicine use tendency during pregnancy necessitates safety studies to optimize the utilization.

A review on pathogenicity of Aeromonas hydrophila and their mitigation through medicinal herbs in aquaculture

Aeromonas hydrophila is a freshwater, facultatively anaerobic, chemo-organoheterotrophic bacterium that distressed fishes with gastroenteritis, septicemia and causes a disease known as Motile Aeromonas Septicemia (MAS), which affects the aquatic environment. Haemolysin, aerolysin, cytosine, gelatinase, enterotoxin and antimicrobial peptides have been identified as virulence factors in A. hydrophila. Medicinal herbs/plants and their uses are the instant, easily available, cost-effective, efficient and eco-friendly approach for socio-economic, sustainable development of modern aquaculture practice. Phytotherapy either through a dip or by incorporation into the diets is an alternative approach to synthetic pharmaceuticals to diminish the pathogenicity of aquatic environmental pathogens. Due to the presence of remarkable phytoconstituents like flavonoids, alkaloids, pigments, terpenoids, steroids and essential oils, the medicinal plant exhibits anti-microbial, appetite-stimulating, anti-stress, growth-promoting and immunostimulatory activities. Aqua-industry preferred phytotherapy-based techniques/compounds to develop resistance against a variety of aquatic pathogens in culturable fishes because they are inexpensive and environment-friendly. As a result, this review elaborates on the diverse applications of phytotherapy as a promising tool for disease management in aquaculture and a major step toward organic aquaculture.

Traditional medicine among people of Pakistani descent in the capital region of Copenhagen

ETHNOPHARMACOLOGICAL RELEVANCE

Studies show that ethnic minorities continue to use their cultural traditional medicines also after migration to the West. Research in this field is necessary, given that little is known about traditional medicines' impact on health-related problems. This study sheds light on the issue through a qualitative study among ethnic Pakistanis residing in Denmark.

AIM OF THE STUDY

The study addresses perception, knowledge and attitudes regarding the use of medicinal plants among Pakistanis living in Copenhagen. We furthermore document and identify the medicinal plants used in households.

MATERIALS AND METHODS

Data were collected through in-depth, semi-structured interviews with sixteen ethnic Pakistanis aged 30-80 years. Interviews were transcribed verbatim and analysed through Emerson's two-phased analysis method. Medicinal plant products in the interviewees' households were collected, photographed, identified and deposited at Museum of Natural Medicine at University of Copenhagen.

RESULTS

A total number of 121 Pakistani traditional medicines were identified, and found to represent both medicinal plants and foods. The average number of quoted Pakistani Traditional Medicines was 18 (N=16). Interviewees independently reported the same traditions for preparation and consumption of Pakistani traditional medicines. Factors that play a role in choosing to use Pakistani traditional medicines are frequent visits to Pakistan, belief in the healing power of totkas (homemade medicinal preparation), religious knowledge and the occurrence of recent illness within the family. Further, the upkeep of traditional use depends on the availability of Pakistani traditional medicines.

CONCLUSION

The study enhanced understanding of ethnic Pakistanis' perception and continued use of traditional medicines within the household after migration to the West. In the context of Western biomedicine, little is known of the potential toxicity and side-effects of many of the Pakistani traditional medicines found to be used in households in Copenhagen.

Complementary and alternative medicines for diabetes mellitus management in ASEAN countries

AIM

The aim of this study was to explore complementary or alternative practices used to promote health and reduce complications of patients with diabetes mellitus (DM).

DESIGN

This qualitative, interpretative study recruited 30 adults including practitioners (n=15) and DM patients (n=15). The participants reside in the northeast of Thailand and in Vientiane of Lao People's Democratic Republic, and they have undergone treatment with at least a kind of complementary and alternative medicines (CAMs) for the care and management of DM. They were interviewed about their experiences, and the data were analyzed thematically. The study methodology was informed by hermeneutic phenomenology.

RESULT

After several years of ineffective treatments, practitioners looked for an alternative to conventional health care to treat patients on long-term antidiabetic drugs, yet the patients suffered from progressive complications. They sought out health care that would more effectively meet their self-perceived needs in treatment particularly of a chronic disease such as DM. The result suggested that CAMs such as acupuncture, massage, exercise, and herbalism were able to meet their requirement in terms of health-care effectiveness obtained from experiences, additional cheap cost and availability in their community, and in accordance with the culture and lifestyles in the context of the ASEAN (Association of Southeast Asian Nations) community.

CONCLUSION

The study explored and revealed the social perceptions of practitioners and patients using Chinese acupuncture, Thai massage, stretching exercise, and herbalism, as CAMs for DM management. The perceptions attributed to patient-practitioner consensus can hold a key to a more comprehensive health care, as a means to expand the boundaries for contemporary health-care provision. However, more study is needed in the future clinical trial research.

Herbal therapies used by hypertensive patients in Turkey

The purpose of this study was to determine herbal therapies used by the patients for regulation of blood pressure. This descriptive study was conducted in three districts of Izmir, Turkey. The study group included 193 patients with hypertension diagnosis who admitted to a primary care center and accepted to participate in the study. Data were collected through an investigator-made questionnaire including questions about socio-demographic features and herbal therapies used for regulation of blood pressure. Percentiles and chi-square statistics tests were used to evaluate the data through SPSS 11.0 program. The subjects included in the study had suffered from hypertension for 8.28 ± 7.92 years, and 95.9% of them received medication to treat their hypertension. Of all hypertensive patients, 51.3% used herbal therapies for the treatment of hypertension. The patients used herbal therapies most commonly when they felt ill. There were no statistically significant difference between the use of herbal therapies and gender, education, marital status, having health insurance and income level. Health professionals who provide primary health services, especially nurses, need to follow patients regularly and provide patient education on antihypertensive therapy. Nurses must plan the necessary training programs by evaluating the data about, whether the hypertension patients use herbal therapies that can affect their health negatively or not.