Pharmacoepidemiology of herbal drugs in Addis Ababa and Butajira, Central Ethiopia.

1
(No Transcript)
2
Pharmacoepidemiology of herbal drugs in Addis
Ababa and Butajira, Central Ethiopia. Gedif Fenta
T, Hahn JH
3
I. IntroductionEthiopia
AA

• Population
• - over 61m,
• - 46 under 15 and 4 over 65 years of age
• -85 live in rural areas
• Economy agriculture
• Half of GDP
• 43 Exports
• 85 total employment

BJ
4
Modern Health Care in Ethiopia

• MHC started 1508-1540
• Ministry of Health established in 1949
• Coverage is 51
• Currently the Health Care System is organized as
  a four tire referral system.
• Specialized Hospitals
• Regional Hospitals
• District Hospitals
• Primary Health Care Units

5
Health Problems Indicators

• Communicable Diseases
• Indicators

6
II. The objectives of the Study

• To determine the extent to which people use
  herbal drugs either in self care basis or
  prescribed by the healers
• To describe how healers perceive about the causes
  and symptoms of malaria.
• Identify the commonly used plants in the
  treatment of malaria.

7
III. Methodology

• Study Design
• - Sources of information Herbalists Mothers.
• - In-depth interview, observations.
• - Cross-sectional HH survey structured
  questionnaire.
• Sampling Data Collection
• - Convenient sampling technique- to identify
  healers.
• - Systematic random sampling technique using HH
  as the final sampling units.

8
Methodology Contd.

• Description of study areas
• Addis Ababa
• Butajira
• Data entry and analysis
• EPI-Info 6.04
• Qualitative responses manually

9
IV. Results HH Survey

• Illness centered approach.
• 1197 HHS (600 in AA 597 in BJ).
• 6377 (3172 3205) persons were living in the hhs
• Prevalence of perceived illnesses were 8 in AA
  and 4 in BJ
• 94 in AA and 89 in BJ took action for their
  illnesses.
• Prevalence of herbal drug use was 29.5 (37 and
  15.4)

10
Results Continued
Use of herbal drugs in self-care
35.4 in AA 12.4 in BJ- self care with
herbs More females practiced self care with
herbs than males Top commonly used herbs in self
care- Zingiber officinale, Ocimum lamifolium,
Allium sativum, Ruta chalepensis Linum
usitatissum. 12.9(11.3 in AA and 14.6 in BJ)
of the HHs reported hoarding Herbal drugs.
11
Results In depth interview of healers

• Demographic characteristics
• - 81.1 were males, 72.2 with age gt 45 years
• Half of the healers had no any form of education
• 17 had church/adult education
• 17.3 had more than 15 years of education
• Mode of Service Delivery
• 86.4 practiced on par time basis and full time
  practice was observed in AA only
• Average no. of patient seen per week was 7.
• 59 did not have fixed payment rate for their
  services

Sources of Herbalistic Knowledge
12
Herbalists perceived causes and symptoms of
malaria

• Perceived causes
• Perceived symptoms

Top five plants used for treating
malaria -Carica papaja ( Caricaceae) -Adhatoda
schimperiana (Acanthaceae) -Vernonia amygdalina
(Compositeae) -Artimisia rehan (Compositeae) -Crot
on macrostachys (Euphorbiaceae)
13
V. Conclusion and Recommendations

• Herbal remedies still play a pivotal role in the
  treatment of large segment of both rural and
  urban population of Ethiopia either in self-care
  basis or prescribed by traditional practitioners.
• To promote researches on plants used
  traditionally, a prior recording of ethno
  pharmacological knowledge is important. In light
  of this, the results of the present study will
  serve as a basis of information for future
  projects to evaluate the potential contribution
  of herbalists and their remedies in improving the
  Ethiopian health care delivery system.

14
Summary
-Prevalence of herbal drug use was 29.5. -35.4
in AA 12.5 in Butajira used herbal drugs for
self care -Inaccessibility of MM and perceived
efficacy were major reasons for choosing HM as
health care option. -Herbal drug hoarding was
reported by 12.9 of the HHs. - Most Herbalists
practice TM on par time basis - Patient load 7
per week -Herbalists did not largely have fixed
payment rate -16 plants have been reported to be
in use to treat malaria and used singly or
constituents of composite remedies.
15
Pharmacoepidemiological studies of herbal
medicine Methodological Challenges

• TMPs in developing countries consider their
  knowledge as an esoteric and hesitant to pass to
  any one except their off springs. As the result,
  it is difficult to get sufficient number of
  healers who are willing to participate in ethno
  botanical studies.
• In most cases data collectors are with some
  modern education, and hence informants tend to
  refrain to give answers which they think may not
  be acceptable by the interviewers, sort of social
  desirability bias.
• Incomparability of survey results due to
  differences in recall periods, seasons in which
  the study is conducted and discrepant definition
  of herbs.
• Recall bias.

Acknowledgment This study was funded by the
German Catholic Academic Foreign Service (KAAD).