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Effectiveness of Traditional Healers in Program to Control Leprosy in Nagan Raya District in Aceh.

ABSTRACT: Aceh Province had the highest rate of leprosy in Indonesia; in 2014, 436 new Multibacillary cases were reported. Nagan Raya was the District in Aceh with the highest number of cases; new cases in 2015 comprised 26 with Paucibacillary (PB) and 21 with Multibacillary (MB) with a total of 4.26% with Grade II disability. The phenomena of handling and treatment by the people in Nagan Raya involve treatment by traditional healers, "Tabib", to treat the leprosy, with treatments known as Peundang locally. The purpose of this study was to find out and to take steps to improve the effectiveness of the Tabib in controlling leprosy in Nagan Raya. The main object of this study, which used a quasi-experimental design, was to find out and to improve the treatment of leprosy patients by the Tabib who treat them there. Data was gathered using a questionnaire with an interview and the intervention was to provide training and a pocket book about leprosy and how to detect, control, and manage it there and the role that the Tabib can play in controlling leprosy in the future. The results of the study showed that there was a significant difference in knowledge about leprosy between the EG (Experimental Group) Tabib after they got the training including the pocket book and the Tabib in the Control Group (CG); i.e., that did not get any training nor the pocket book. Furthermore, after the training, there was also a significant difference in the attitude towards leprosy between the EG and the CG of Tabib. There was also a significant difference in the future role of the Tabibs to control the spread of leprosy between the EG and the CG. Based on these results, it is hoped that the District Health Department can implement a partnership model with the Tabib in Nagan Raya (and elsewhere) to use the pocket book with training to implement a program to control the spread of leprosy and also to always support the Tabib to improve their role in controlling and eliminating leprosy amongst the village people.

SUBMITTER: Alamsyah T

PROVIDER: S-EPMC6011098 | biostudies-literature |

REPOSITORIES: biostudies-literature

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Project description:IntroductionMalaria is an important parasitic disease that affects mostly the African continent. Traditional medicine is very important in Mozambique and traditional healers play a key role in the primary health care services, particularly in rural areas. We aim to report the results of an ethnobotanical survey undertaken in Mogovolas district, northern region of Mozambique. We recorded and identified the medicinal plants used by traditional healers for treatment of malaria, as well as the mode of preparation and administration.MethodsThe study was conducted in 14 villages from Mogovolas between June and August 2015. Sixteen traditional healers were interviewed using semi-structured questionnaires. Under their guidance, we collected medicinal plants and prepared herbarium specimens that were sent and kept at Eduardo Mondlane University Herbarium for scientific identification. We searched for information on the in vitro and in vivo studies of the cited plants for antiplasmodial activity.ResultsTraditional healers from Mogovolas district reported the use of 37 plants to treat malaria, belonging to 22 families. The most used species are Ochna kirkii Oliv. (5 citations), Ehretia amoena Klotzsch and Pteleopsis myrtifolia (M.A.Lawson) Engl. & Diels (both with 3 citations). These plants belong to Ochnaceae, Boraginaceae and Combretaceae families, respectively. The herbal remedies are prepared using leaves (22/37), roots (18/37), stem barks (16/37) and stems (3/37). The administration of the herbal remedies was made essentially by oral route and bathing.ConclusionThe ethnobotanical data resulted from this study can be the starting point for further chemical and pharmacological studies aiming to identify medicinal species with antimalarial activity, thus, open the insights for the discovery of new antimalarial substances, as well as better integration of the traditional medicine into the national health systems, particularly in developing countries, as the health system coverage is limited.

Project description:Traditional healers in Thailand are a primary source of health care for the Thai people. Highly experienced traditional healers are generally older people and they continue to pass away without recording or passing on their knowledge. Consequently, the cumulative knowledge held by traditional healers regarding the use of medicinal plants is being eroded and could be lost. In this study, we aimed to identify and document the medicinal plants and associated ethnobotanical knowledge held by traditional healers in Roi Et in northeastern Thailand. Data and plant specimens were collected from four traditional healers of the Phu Tai people. They were selected by purposive sampling and questioned using a semi-structured interview. The interviews covered their training, the ailments treated, treatment techniques, method of preparation and in addition, several healing sessions were observed. During field walks, we searched for the medicinal plants with the healers to review and document the availability of medicinal plants at each locality and in different habitats around the villages. Use values (UV) were calculated to estimate the importance of each medicinal plant and informant agreement ratios (IAR) were calculated to understand how widely known the uses were. The four Phu Tai traditional healers knew 162 medicinal plant species in 141 genera and 63 families. The family with the most medicinal plants was Leguminosae with 15 species. The plant part that they used most commonly was the stem, which was used for 82 species (49%). The most common preparation method was decoction, which was done for 124 species (75%). The most important and widely used medicinal plants were Rothmannia wittii, which had the highest use value (UV = 1.7). Most medicinal plants were used for treating tonic (34 species (21%)). Jaundice had the highest informant agreement ratio (IAR = 0.5). The most common life form among the medicinal plants was trees (56 species (34%)). The medicinal plants were mostly collected in community forests (81 species (49%)). Considering the richness of the healer's pharmacopeia, and the fact that their profession is not being perpetuated, this study points to the urgent need to document the traditional knowledge from the old herbalists before it disappears with the last practitioners from rural communities in Thailand.

Project description:Posyandu, or pos pelayanan terpadu (integrated service post), is a community-based activity for health services in Indonesia. According to the Indonesian Basic Health Survey, the prevalence of children under five in Indonesia who suffered from being underweight was 19.6 %. The wasting was 12.1 % and the stunting was 37.2 % in 2013, and these values have not changed greatly from 2007; much greater than the WHO targets of, less than 10 % underweight, 5 % wasting, and 20 % stunting. In Aceh were 26.6, 16.8, and 43.3 %, respectively. Also, the participation percentages of mothers to Posyandu was about 45 %, far below the national target of 100 %. In Aceh Province, the percentage was even lower (34 % in 2013). This study aimed to investigate the factors influencing participation of mothers in Posyandu.This research used a cross-sectional design with sample of mothers who had children under five. They were chosen by multistage random sampling. Sample size was determined by the WHO formula. Face-to-face interviews were carried out using a questionnaire. The questionnaire consisted of items about socio-demographic characteristics, satisfaction with Posyandu services, attitude towards Posyandu benefits, and intention to attend Posyandu. The collected data were analyzed by using EZR (version 1.21). Fisher's exact test was performed to examine the associations between the socio-demographic factors, attitude, satisfaction, and intention covariates with participation. Logistic regression was used to describe the strength of the relationship between the predictor variables and participation.There were no significant differences in age, marital status, education level, occupation, family size, and distance to Posyandu between low participation group except for the monthly household income. Among the socio-demographic factors, only monthly household income had a significant association with the frequency of mothers' participation. Satisfaction, attitude, and intention were associated with participation. The logistic regression showed that monitoring the nutritional status of children under five was the main reason that mothers participated in Posyandu. Mothers who were satisfied with the Posyandu services were more likely to attend than those who were dissatisfied. Respondents with intention to participate in Posyandu every month were more likely to attend than those who did not intend to attend every month. Households with low income were more likely to participate in Posyandu than households with high income.Household income, mothers' satisfaction with Posyandu services, attitude towards Posyandu benefits and intention to attend Posyandu affect the participation frequency of the mother. In addition, monitoring the nutritional status of children under five was the main reason respondents attend Posyandu. Improving the quality of Posyandu services and providing qualified resources are needed to promote mothers' participation.

Project description:BACKGROUND: Bapedi traditional healers play a vital role in the primary health care of rural inhabitants in the Limpopo Province, South Africa. However, literature profiling their social and demographic variables, as well as their traditional healing practices is lacking. METHODS: Convenience sampling were used to identify and select two traditional healers from 17 municipalities (resulting in 34 healers being used in this pilot survey) of the Limpopo Province in South Africa. Information on the social and demographic variables, and traditional healing practices of these healers was gathered from January 2013 to July 2013, using a semi-structured questionnaire, supplemented by field surveys for plant identification and collection used in the preparation of remedies. RESULTS: Males constituted nearly two-thirds of the participants. Forty eight percent of them became healers through the mentoring of another healer, while 38% acquired their traditional healing knowledge from parents and 14% from grandparents. In contrast to this, 62% of the females obtained theirs from their parents, 30% from fellow traditional healers, and 8% from grandparents. A total of 154 plant species were indicated as used by healers in the treatment of 52 health-related problems. A vast majority (89%) of these practitioners reported that prepared herbal remedies do expire, which is a temperature-dependent process. Determinations of the efficacy of remedies by most healers (67%) were via consultation with ancestors (90%). This study also found that none of the interviewees had any knowledge of provincial or national environmental legislation. CONCLUSIONS: The current study has shown that Bapedi traditional healers could play a leading role in both the preservation of indigenous knowledge and the primary health care sector. However, of concern is the traditional methods (via consulting ancestors) employed by most of these healers in determining efficacy of remedies, thus indicating a need for a scientific investigations to establish their safety and effectiveness. Equally, there is a need to educate traditional practitioners' regarding the significance of various conservation legislations in their traditional healing. By addressing these, the national and provincial legislators, medical fraternity as well as environmental agencies will be able to better integrate them in primary health care systems and environmental management.

Project description:BackgroundSnakebite is a neglected tropical disease (NTD) affecting rural and remote populations globally, who are additionally burdened by poverty and the lack of effective healthcare systems. Delayed healthcare and use of traditional treatments are very frequent. The purpose of our study was to explore perceptions of snakes, impact of snakebite, and knowledge and opinions of different snakebite treatments with the aim of identifying opportunities for improving snakebite management.MethodsThis is a qualitative descriptive study based on semi-structured interviews with 21 snakebite victims and 4 traditional healers in 4 villages of Akonolinga health district, Center Region, Cameroon. Analysis focused on describing participants' perceptions of snakes, the impact of snakebite on the victims' lives, and their opinions of different treatment options.ResultsRespondents were fearful of snakes and knowledgeable about envenoming symptoms and treatments. The experience of snakebite led to increased vigilance and avoidance behaviours, which sometimes resulted in financial loss for the victims. A range of traditional treatments were described, including tourniquets, black-stone application and medicinal plant decoctions. However, opinions were ambivalent regarding their efficacy, depending especially on previous personal experiences. Still, traditional treatments were said to be more available and cheaper than hospital care, and in particular, than antivenom. Nevertheless, most victims preferred hospital treatment if the financial and transportation barriers were lifted. Both snakebite victims and traditional healers were of the opinion that collaboration between health services and traditional healers could help to improve snakebite management and outcomes.ConclusionOur study shows that snakebite victims are in favour of using antivenom for the treatment of snakebite and would welcome better access to it. However, its current unavailability and high cost pushes them to turn to traditional treatments. On the other hand, traditional healers are in favour of collaborating with health facilities. These results are very encouraging for the improvement of snakebite management in Cameroon along the lines of the WHO Snakebite Envenoming Strategy for Prevention and Control: ensuring access to safe and effective treatment, and increasing partnership and coordination between communities, traditional healers, and conventional caregivers.

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Effectiveness of Traditional Healers in Program to Control Leprosy in Nagan Raya District in Aceh.

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