Traditional health practitioners’ perceptions, herbal treatment and management of HIV and related opportunistic infections

Abstract

BackgroundIn South Africa, traditional health practitioners’ (THPs) explanatory frameworks concerning illness aetiologies are much researched. However there is a gap in the literature on how THPs understand HIV-related opportunistic infections (OIs), i.e. tuberculosis, candidiasis and herpes zoster. This study aimed to comprehend THPs’ understandings of the aforementioned; to ascertain and better understand the treatment methods used by THPs for HIV and OIs, while also contributing to the documentation of South African medicinal plants for future conservation.MethodsThe study was conducted in two locations: Strand, Western Cape where THPs are trained and Mpoza village, Mount Frere, Eastern Cape from where medicinal plants are ordered or collected. Semi-structured interviews were conducted with 53 THPs of whom 36 were diviners (amagrirha: isangoma) and 17 herbalists (inyanga). THPs were selected through a non-probability “snowball” method. Data were analysed using a thematic content analysis approach. An ethnobotanical survey was conducted and plants used to manage HIV and OIs were collected. A complete set of voucher specimens was deposited at the University of the Western Cape Herbarium for identification. Plant names were checked and updated with Kew’s online website http://www.theplantlist.org.ResultsTHPs conceptualise the aetiology of HIV and OIs at two related levels. The first involves the immediate manifestation of the illness/condition because of a viral infection in the blood (HIV), the presence of bacteria in the lungs (tuberculosis), or weakened state of the body making it susceptible to OIs. The presence of OIs is indicative of the probable presence of HIV. The second level of causation affects the first, which includes pollution, changes in cultural sexual norms, witchcraft, environmental factors, and lack of adherence to ancestral rituals. THPs reported using 17 plants belonging to 12 families. Remedies included mixes of up to five plants.ConclusionThis study explored the THPs’ perspectives on HIV and commonly associated OIs and their herbal treatment methods. THPs generally rely on biomedical diagnosis before treating a client. They also seek guidance from the ancestors for a particular diagnosis, the plants to use for a specific treatment, when to harvest, and how to administer herbal remedies.Electronic supplementary materialThe online version of this article (doi:10.1186/1746-4269-10-77) contains supplementary material, which is available to authorized users.

Lippia javanica (Burm.f.) Spreng.: Traditional and Commercial Uses and Phytochemical and Pharmacological Significance in the African and Indian Subcontinent

“…According to Sõukand and Kalle [87], herbal tea or tisane is an English term used to denote a decoction or infusion made of herbs for medicinal purposes. When L. javanica is used as medicinal herbal tea, it is consumed for a limited number of days to treat a specific condition like asthma in Zimbabwe [14], bronchitis in South Africa [19], chest pains in Zimbabwe and South Africa [14, 24], colds in Kenya, South Africa, and Zimbabwe [19, 20, 28–30], cough in South Africa and Zimbabwe [19, 20, 30, 53], and other diseases (see Table 1). From literature, it seems L. javanica herbal tea evolved over the years from medicinal tea decoctions or infusions to nonmedicinal uses, where the herbal tea is now drunk for recreation and enjoyment.…”

“…The different parts of L. javanica , for example, the leaves and twigs, are used for the treatment of asthma, coughs, colds, influenza, pneumonia, tuberculosis, and bronchial problems in Bangladesh, Botswana, Ethiopia, Kenya, South Africa, and Zimbabwe [14–16, 19, 20, 23, 25, 26, 28–32, 53, 112]. In Bangladesh, leaf infusion of L. javanica is taken orally mixed with 3-4 pieces of cloves of A. sativum , 2-3 times daily as remedy for chest pains [23].…”

“…In Kenya, leaves are sniffed [31] or half glass of hot leaf infusion is taken orally three times a day [28, 29] as remedy for colds and cough. Research done by Davids et al [19] in South Africa revealed that about 50 g of leaves is added to a cup of boiling water to produce an infusion which is taken orally as remedy for coughs, colds, and bronchial problems or the infusion is applied to the skin or mixed with Vaseline to make an ointment. In South Africa, leaf or twig decoction is taken orally for asthma, colds, and cough [16, 53], leaves are used in washes and poultices for chest pains [25], and leaves are boiled for 5 minutes and one cup of extract is taken orally thrice a day for chest pains and tuberculosis [24, 42].…”

“…Little is known about the HIV RT activity of L. javanica extracts or compounds, but flavonoids are known to be active against viral RT and also as potent inhibitors of the cellular alpha and beta DNA polymerase [83], while luteolin 12 is active against HIV RT [164, 165]. Lippia javanica is traditionally used to treat HIV/AIDS symptoms in South Africa [65, 66] and several viral and HIV/AIDS opportunistic diseases and infections such as bronchitis [15, 19–22], chicken pox [50], diarrhoea [17, 34, 37, 44, 113], measles [14, 20, 38], pneumonia [14], shingles [15], and venereal diseases [44]. Despite significant advances in the utilization of L. javanica in southern Africa over the years for numerous viral diseases (Table 1), very little antiviral evaluations have been done on crude extracts and purified compounds of the species.…”

The content of delusions in a sample of South African Xhosa people with schizophrenia

“…One of these is “isidliso” or poisoning by ingestion which may result in physical symptoms such as chronic coughing, chest pain and blood in the sputum, much like Tuberculosis [26, 29]. Bewitchment also takes the form of possessions by evil spirits, the manifestation of which may be consistent with mental illness.…”