Use of traditional complementary and alternative medicine for HIV patients in KwaZulu-Natal, South Africa

Peltzer, Karl; Preez, Natalie Friend-du; Ramlagan, Shandir; Fomundam, Henry

doi:10.1186/1471-2458-8-255

Cited by 148 publications

(145 citation statements)

References 39 publications

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“…Our findings revealed a strong belief in the possible role of CAM for HIV management, consistent with an earlier Malaysian study by Hasan et al reported 30%-100% use of CAM among PLWHA. [19] This substantial prevalence of CAM use among HIV population has also been reported elsewhere [15,29,[31][32][33][34][35], including the developed countries. [16] Remarkably, most participants believed in CAM use to complement conventional ARTs but not to replace it, and were of the opinion that the best time to use CAM is when ARTs are yet to be initiated.…”

Section: Discussionmentioning

confidence: 79%

“…[47] In order to address this issue and to make ARTs use safer, a routine screening at the commencement of ARTs and during follow-ups is inevitable. [33] For this pharmacists as the drug experts could have a potential role and responsibility [48]; because patients' perceived lack of physicians knowledge and interests are the often found reasons for CAM non-disclosure [49]. In addition, interventions involving both physicians and patients may enhance communication of CAM use, avoid potential adverse events and drug interactions as well as could enhance ARTs adherence.…”

Section: Discussionmentioning

confidence: 99%

“…Interestingly, most of these influencing aspects are similar to what has been reported in other parts of the world. Social, cultural and governmental factors [32], alleviating daily discomforts and side effects of ARTs [30,32], pain, symptom and stress relieves [33] as well as immune boosting effects [41] were often regarded as the main driving forces to CAM use among PLWHA. In this context, it is important to understand that many of these driven factors are often aligned, with strong cultural and/or religious beliefs.…”

Section: Discussionmentioning

confidence: 99%

See 2 more Smart Citations

Beliefs and practices of complementary and alternative medicine (CAM) among HIV/AIDS patients: A qualitative exploration

Ahmed

Sulaiman

Thiruchelvam

et al. 2016

European Journal of Integrative Medicine

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Section: Discussionmentioning

confidence: 79%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Beliefs and practices of complementary and alternative medicine (CAM) among HIV/AIDS patients: A qualitative exploration

Ahmed

Sulaiman

Thiruchelvam

et al. 2016

European Journal of Integrative Medicine

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“…They fear HIV testing , have a poor understanding of HIV and ART, and sometimes families choose to visit traditional healers or the church before the clinics. 9,17,19,28 If a mother tests HIV-positive her initial reactions may include anxiety, fear, disbelief and worry, and it may take her some time to accept her diagnosis. 29,30 The association of poor attendance with the mother as the primary caregiver suggests that the mother herself could be sick from HIV or struggling to accept and disclose her own status.…”

Section: Discussionmentioning

confidence: 99%

“…[14][15][16] Poor patient experience makes it more likely that patients will seek help from traditional medicine and delay starting ART. 17 Stigma has also been associated with reduced utilisation of health services. 18 Even in settings with a high testing rate there is still much fear of the consequences of a HIVpositive result, such as the reactions of the partner and the community, as well as the implications for sickness and death.…”

Section: Introductionmentioning

confidence: 99%

How children access antiretroviral treatment at Kgapane District Hospital, Limpopo, South Africa

Railton

Mash

2012

South African Family Practice

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Background: At Kgapane Hospital, Limpopo Province, only 20% of eligible children initiated antiretroviral treatment (ART) in 2007. The aim of this study was to improve the ART programme by assessing how children were accessing ART, and to explore the factors that facilitate or obstruct this access.Method: Mixed methods were used in a descriptive study of human immunodeficiency virus (HIV)-infected children admitted to the hospital over a seven-month period and their caregivers. Children's subsequent attendance for ART was tracked and caregivers were interviewed about factors influencing access and attendance.Results: Of 132 children initially admitted, 14 (10.6%) subsequently died and 13 (9.8%) relocated. Sixty of the remaining 105 (57.1%) returned within one month to the antiretroviral clinic, three (2.9%) attended later and 42 (40.0%) did not return at all. Quantitative data associated with poor attendance were younger age, higher CD4 count, maternal caregiver, no income and participation in the prevention of mother-to-child transmission program. Qualitative factors included a lack of money for transport, poor social support, and mothers who struggled to accept their diagnosis, had poor understanding of HIV and strong traditional beliefs. Primary care providers delayed HIV testing and referral, displayed poor attitudes, and were insufficient in number. Quantitative factors significantly associated with good attendance were prior knowledge of the child/mother's HIV status, mother's ART treatment and referral to the dietician. Conclusion:There are serious deficiencies in the prevention, diagnosis and treatment of HIV in children. Factors were identified to improve health services and these highlight the need for broader strategies aimed at addressing poverty, stigma and education.Peer reviewed.

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Potential pharmacokinetic interactions between antiretrovirals and medicinal plants used as complementary and African traditional medicines

Müller

Kanfer

2011

Biopharm & Drug Disp

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The use of traditional/complementary/alternate medicines (TCAMs) in HIV/AIDS patients who reside in Southern Africa is quite common. Those who use TCAMs in addition to antiretroviral (ARV) treatment may be at risk of experiencing clinically significant pharmacokinetic (PK) interactions, particularly between the TCAMs and the protease inhibitors (PIs) and non-nucleoside reverse transcriptase inhibitors (NNRTIs). Mechanisms of PK interactions include alterations to the normal functioning of drug efflux transporters, such as P-gp and/or CYP isoenzymes, such a CYP3A4 that mediate the absorption and elimination of drugs in the small intestine and liver. Specific mechanisms include inhibition and activation of these proteins and induction via the pregnane X receptor (PXR). Several clinical studies and case reports involving ARV-herb PK interactions have been reported. St John's Wort, Garlic and Cat's Claw exhibited potentially significant interactions, each with a PI or NNRTI. The potential for these herbs to induce PK interactions with drugs was first identified in reports of in vitro studies. Other in vitro studies have shown that several African traditional medicinal (ATM) plants and extracts may also demonstrate PK interactions with ARVs, through effects on CYP3A4, P-gp and PXR. The most complex effects were exhibited by Hypoxis hemerocallidea, Sutherlandia frutescens, Cyphostemma hildebrandtii, Acacia nilotica, Agauria salicifolia and Elaeodendron buchananii. Despite a high incidence of HIV/AIDs in the African region, only one clinical study, between efavirenz and Hypoxis hemerocallidea has been conducted. However, several issues/concerns still remain to be addressed and thus more studies on ATMs are warranted in order for more meaningful data to be generated and the true potential for such interactions to be determined.

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Use of traditional complementary and alternative medicine for HIV patients in KwaZulu-Natal, South Africa

Cited by 148 publications

References 39 publications

Beliefs and practices of complementary and alternative medicine (CAM) among HIV/AIDS patients: A qualitative exploration

Beliefs and practices of complementary and alternative medicine (CAM) among HIV/AIDS patients: A qualitative exploration

How children access antiretroviral treatment at Kgapane District Hospital, Limpopo, South Africa

Potential pharmacokinetic interactions between antiretrovirals and medicinal plants used as complementary and African traditional medicines

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