A cross-sectional analysis of traditional medicine use for malaria alongside free antimalarial drugs treatment amongst adults in high-risk malaria endemic provinces of Indonesia

Abstract

BackgroundThe level of traditional medicine use, particularly Jamu use, in Indonesia is substantial. Indonesians do not always seek timely treatment for malaria and may seek self-medication via traditional medicine. This paper reports findings from the first focused analyses of traditional medicine use for malaria in Indonesia and the first such analyses worldwide to draw upon a large sample of respondents across high-risk malaria endemic areas.MethodsA sub-study of the Indonesia Basic Health Research/Riskesdas Study 2010 focused on 12,226 adults aged 15 years and above residing in high-risk malaria-endemic provinces. Logistic regression was undertaken to determine the significant associations for traditional medicine use for malaria symptoms.FindingsApproximately one in five respondents use traditional medicine for malaria symptoms and the vast majority experiencing multiple episodes of malaria use traditional medicine alongside free antimalarial drug treatments. Respondents consuming traditional medicine for general health/common illness purposes every day (odds ratio: 3.75, 95% Confidence Interval: 2.93 4.79), those without a hospital in local vicinity (odds ratio: 1.31, 95% Confidence Interval: 1.10 1.57), and those living in poorer quality housing, were more likely to use traditional medicine for malaria symptoms.ConclusionA substantial percentage of those with malaria symptoms utilize traditional medicine for treating their malaria symptoms. In order to promote safe and effective malaria treatment, all providing malaria care in Indonesia need to enquire with their patients about possible traditional medicine use.

Traditional medicine use in Timor-Leste

“…Broadly speaking traditional medicine use is common amongst people of all levels of education, community size and place of residence. This level of traditional medicine use is comparable with other studies from the region and elsewhere [11][12][13]. Research by Suswardany in neighbouring Indonesia found that respondents used traditional medicine for general health/common illness purposes every day [13].…”

Health-Seeking Behavior of People in Indonesia: A Narrative Review

“…Indonesian people consider themselves healthy if they can perform their everyday activities without disruption. Thus, people generally sought help when symptoms hindered these [21,22,25,28,37,39,42,45,51,56,66,67,71,77]. For example, Eeuwijk [71] described that most older people sought care from health professionals for rheumatism because it hindered their activities.…”

“…Age, household size, education, and economic status determine people's choices of health providers [65,74,94]. Poorer households were more likely to use traditional medicines for treating malaria [25], older people and those in rural areas were more likely to seek traditional and alternative treatment [84,89,96]. Women were also more likely to seek health care for tuberculosis-related symptoms [21].…”

“…These practices have been passed down for generations, and this embedded culture cannot be ignored. They are commonly used for treating most diseases, including malaria [25,44,61,69], tuberculosis [21,39,51,59,67,72], leprosy [46], rheumatoid arthritis [76], cancer [28,38,45], hypertension [93], stroke [56], and diabetes [95]. Traditional remedies are also used for promoting health and preventing disease.…”

Traditional and complementary treatments do have a role to play in global health, but probably not in emerging pandemics

“…This is not to say that TCIM may not have a role in infectious disease treatment. Current evidence suggests TCIM is being used to manage and treat malaria, tuberculosis and HIV/AIDSthough importantly these are usually integrated as part of a suite of bestpractice care and are usually focused on chronic, ongoing postinfection symptoms [3][4][5][6]. Alongside growing evidence of use, antiviral activity of TCIM products against dengue [7] and chikungunya [8] has been reported, and preclinical reports or phase one clinical trials suggest some TCIM may be effective in treating these viral infections [9][10][11].…”