Prevalence and factors associated with traditional herbal medicine use among patients on highly active antiretroviral therapy in Uganda

Clinical Epidemiological Unit, Department of Medicine, College of Health Sciences, Makerere University, Kampala, Uganda.
BMC Public Health (Impact Factor: 2.26). 11/2011; 11(1):855. DOI: 10.1186/1471-2458-11-855
Source: PubMed


In Africa, herbal medicines are often used as primary treatment for Human immunodeficiency virus (HIV) related problems. Concurrent use of traditional herbal medicines (THM) with antiretroviral drugs (ARVs) is widespread among HIV infected patients. However, the extent of THM use is not known in most settings in Sub-Saharan Africa. This study aimed at determining the prevalence and factors associated with THM use among HIV infected patients on highly active antiretroviral therapy (HAART) attending The AIDS Support Organization (TASO) in Uganda. TASO is a non-governmental organization devoted to offering HIV/AIDS care and treatment services in the population.
This was a cross-sectional study carried out in two TASO treatment centres in Uganda among 401 randomly selected eligible participants. We included participants who were 18 years and above, were enrolled on HAART, and consented to participate in the study. Data was collected using an interviewer-administered semi-structured questionnaire. THM use referred to someone who had ever used or was currently using herbal medicine while on highly active antiretroviral therapy (HAART) by the time of the study. Data was captured in Epi-data version 3.1 and exported to STATA version 9.0 for analysis.
The prevalence of THM use was 33.7%. Patients on HAART for < 4 years were more likely to use THM (OR = 5.98, 95% CI 1.13 - 31.73) as well as those who experienced HAART side effects (OR = 3.66, 95% CI: 1.15 - 11.68). Older patients (≥39 years) were less likely to use THM (OR = 0.26 95% CI: 0.08 - 0.83). Participants with HAART adherence levels > 95% were less likely to use THM (OR = 0.09, 95% CI 0.01 - 0.65).
The prevalence of THM use among participants on HAART was high. This raises clinical and pharmacological concerns that need attention by the health care service providers.

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    • "Religious beliefs and interactions with other individuals using alternative medicine have been associated with the discontinuation of antiretroviral therapy (ART) in Kenya (Unge et al., 2011). Individuals taking ART commonly supplement treatment with herbal remedies, often without their physician's knowledge (Langlois-Klassen, Kipp, Jhangri, & Rubaale, 2007; Langlois-Klassen, Kipp, & Rubaale, 2008; Namuddu et al., 2011; Peltzer, Preez, Ramlagan, & Fomundam, 2008; Peltzer, Preez, Ramlagan, Fomundam, & Anderson, 2010). These supplemental treatments can result in dangerous herb–drug interactions and other complications (Auerbach et al., 2012; Bessong, 2008; Luyckx, Steenkamp, & Stewart, 2005). "
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    ABSTRACT: This study's objective was to describe awareness of, access to, belief in, and utilization of the healing tea Kikombe cha babu and other alternative treatments for HIV in Tanzania. Associations with HIV testing, treatment, and prevention behaviors are also explored. A survey with questions about alternative medicine was administered to a sample in Tanzania using a stratified, multistage random selection method. Adults were interviewed face-to-face. Items concerning alternative HIV treatments addressed awareness, access, beliefs, and treatment-seeking behaviors. Questions about HIV prevention and treatment were also asked. Results showed participants indicated a high awareness of alternative treatments available in Tanzania, with 95.3% of 2313 adults having heard of these treatments. Of those, 6.0% had actually sought the treatment, and 46.8% had an acquaintance seek it. However, 81.0% indicated these treatments were not easily accessible. There is a high level of belief in the ability of these alternative treatments to cure HIV, with 44.0% of people who had heard of these treatments indicating they believe such treatments can cure HIV. Additionally, many people indicated having these alternative treatments available would result in decreased condom use (15.6%), no need to use condoms (94.9%), and no need to take antiretroviral therapy (81.7%). However, 57.4% indicated they would be more likely to get tested for HIV if alternative treatments were available. Belief in the ability of alternative treatments to cure HIV in Tanzania is high and should be further explored due to its implications for potentially sidelining HIV prevention and treatment initiatives.
    AIDS Care 07/2014; 26(12):1-5. DOI:10.1080/09540121.2014.936815 · 1.60 Impact Factor
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    • "Since most of the parents surveyed in this study were low-and middle-income earners, the present cost of the CM is substantial and may add to the financial burden on the parents. CM therapy has been used for HIV-infected patients to treat weight loss [20], to improve immunity [15] [19]; to relief pain and stress or improve their overall well-being [19]; to reduce fever and treat cough [45]; and to treat other symptoms of the infection [44]. It is therefore not surprising to see the parents used CM symptomatically to treat their children for weight loss, cold, fever, cough, and skin rashes. "
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    ABSTRACT: Complementary medicine (CM) use is common among children with chronic illnesses such as epilepsy and asthma. Lack of data on the profile of CM use among children with human immunodeficiency virus (HIV) infection necessitated this study. Parents or caregivers of HIV-infected children attending the paediatric HIV-clinic in a teaching hospital in Lagos, Nigeria, were randomly selected and interviewed with a semi-structured (open- and close-ended) questionnaire. Clinical details of the patients were extracted from their case files. A total of 187 parents/caregivers were interviewed. Most of the parents/caregivers (181; 96.8%) have used CMs for their children. Mind-body interventions (181; 36.6%) and biological products (179; 36.2%) were frequently used. Relatives, friends and neighbours influenced CM use in 37.1% of the children. CMs were used mostly to treat weight loss (79; 43.7%), cold (40; 22.1%), and fever (39; 21.6%). CM use is common among HIV-infected children in Lagos.
    Complementary therapies in clinical practice 05/2014; 20(2):118-24. DOI:10.1016/j.ctcp.2013.12.001
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    • "Although we did not specifically ask what medications they were worried about using concurrently with ARV drugs, some of them may have been taking cotrimoxazole prophylaxis and/or herbal or traditional medicines of unknown therapeutic efficacy and interactions [28]. In Uganda, use of traditional herbal medications is common and in one study 33.7% of patients on ART were also reported to be using herbal medications for HIV associated symptoms [29]. Although we found no association between concurrent use of herbal treatment and ART adherence, other studies found that use of herbal medications was associated with ART non-adherence, though their use significantly declined after six months on ART [30-32]. "
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    ABSTRACT: Background In HIV-infected persons, good adherence to antiretroviral therapy (ART) is essential for successful treatment outcomes. Patients’ worries before starting ART may affect their ART adherence and treatment outcomes. Methods Between 2004 and 2009, HIV-infected individuals in a prospective cohort study in rural Uganda were assessed for ART eligibility. A counsellor explained the ART eligibility criteria, adherence and side effects, and recorded the patients’ worries related to ART. Every quarter, patients who initiated ART had clinical, immunological (CD4 cell counts) and virological (viral loads) assessments, and data were collected on ART adherence using patients’ self-reports and pill counts. We describe the patients’ worries and examine their association with ART adherence, and immunological and virological outcomes. Results We assessed 421 patients, 271 (64%) were females, 318 (76%) were aged 30 years and above and 315 (75%) were eligible for ART. 277 (66%) reported any worry, and the proportions were similar by sex, age group and ART eligibility status. The baseline median CD4 counts and viral loads were similar among patients with any worry and those with no worry. The commonest worries were: fear of HIV serostatus disclosure; among 69 (16%) participants, lack of food when appetite improved after starting ART; 50 (12%), concurrent use of other medications; 33 (8%), adherence to ART; 28 (7%) and problems concerning condom use; 27 (6%). After 24 months or more on ART, patients who reported any worry had made more scheduled ART refill visits than patients who reported no worry (p<0.01), but the annual CD4 cell increases were similar (p=0.12). After one year on ART, patients who reported any worry had greater virological suppression than patients who reported no worry (p<0.05). Conclusions Despite the lack of significant associations of worries with unfavourable ART outcomes, physicians and counsellors should assist patients in overcoming their worries that can cause stress and discomfort. Food supplements may be desirable for some patients initiating ART.
    BMC Research Notes 05/2013; 6(1):187. DOI:10.1186/1756-0500-6-187
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