Traditional medicine use in surgical patients in a South African tertiary hospital

Abstract

Background: The use of traditional medicine (TM) in South Africa is reportedly high. TM use in a South African surgical population presenting for elective surgery is unknown. Aim: The study aim was to survey the perioperative usage of TM in a South African population presenting for elective surgery at a tertiary hospital. Methods: A prospective, contextual and descriptive study was carried out on adults presenting for elective surgery at a tertiary South African hospital. Results: During a 2 month study period 495 patients were interviewed (97% response rate). The mean age was 46.6 years (SD 14.8) with 34% male and 66% female. Patients underwent orthopaedic (42%), general (32%) and gynaecological (26%) surgery. Fifty per cent of the participants were on chronic medication. Thirty-nine per cent of participants reported past TM use and 7% admitted to current TM use. The most common reason for TM was for cleansing purposes (41%) followed by pain (17%). Seven (4%) participants reported adverse events attributed to TM use with 46% unsure whether an adverse event occurred. Factors associated with current TM use were planned surgical procedure (p-value = 0.009), known positive HIV status (p-value = 0.04), and current arthritic medication use (p-value = 0.002). Conclusion: Perioperative TM use is clinically relevant and should be considered in elective surgical patients. However, TM use in the current survey was found to be lower than that quoted in the literature.

Traditional, complementary and alternative medicine use in Sub-Saharan Africa: a systematic review

“…In the Nigerian study, 40% of 60 patients surveyed used herbal medicine during their preoperative period, 145 while in the South African study 7% of 495 surgical patients had used TCAM in the preceding 6 weeks. 146 …”

“…112 Among surgical patients in South Africa, close to one-third (30%) paid less than US$60 for TCAM services. 146 …”

Traditional, complementary and alternative medicine use in Sub-Saharan Africa: a systematic review

“…In the Nigerian study, 40% of 60 patients surveyed used herbal medicine during their preoperative period, 145 while in the South African study 7% of 495 surgical patients had used TCAM in the preceding 6 weeks. 146 Others (infantile colic, tuberculosis, oral health and mycetoma) A study in Nigeria reported that 32.8% and 3.1% use TCAM product and visited a traditional birth attendant to manage infantile colic, respectively. 147 Also, studies conducted in Nigeria reported that 10% and 19.8% of patients suffering from tuberculosis 148 and toothache 149 had consulted with a traditional medicine practitioner, respectively.…”

“…112 Among surgical patients in South Africa, close to one-third (30%) paid less than US$60 for TCAM services. 146 Findings from studies that assessed the cost per month of TCAM use alone reported an average of US$47.5 (US$12.60-US$96.88). 21 25 47 55 167 In comparison between self-treatment and TCAM practitioner use, the average financial cost in Burkina Faso for TCAM self-care (US$2.85) was almost half of that for practitioner use (US$4.77).…”

Peripartum traditional medicine use and surgical site infections: A prospective cohort of women delivering via cesarean section in rural Rwanda

“…Factors associated with traditional medicine use in Africa include lower educational status, knowledge of traditional medicine, low socioeconomic status, older age, large family size, unemployment, and rural residence [6,23,19,35] There is limited information about the use of traditional medicine by women delivering via csection in sub-Saharan Africa. Some patients undergoing other surgeries, including orthopedic, general, and gynecology surgeries, in South Africa reported using traditional medicine during recovery [33]. Additionally, some literature in sub-Saharan Africa reports that women use traditional medicines to get pregnant or during their pregnancies, and there has been an association between traditional medicine use and poor pregnancy outcomes [14,16].…”