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Knowledge, Attitudes and Practices on the Use of Botanical Medicines in a Rural Caribbean Territory

ABSTRACT: The worldwide use of medicinal plant products has been steadily increasing over the past few decades, whereas the traditional knowledge and practices of these botanical medicines appears to be diminishing. Considering the need to conserve and document these traditions, the objective of this study was to understand the knowledge, attitudes, and practices of people who are familiar with botanical medicines, as well as any factors that may influence the perceptions and behaviours associated with the use of medicinal plants. A previously validated survey instrument assessing knowledge, attitudes, and practices on the use medicinal plants was randomly administered to residents of three rural Barbadian communities. The data was analyzed using descriptive statistics and cross tabulations (Chi-Square Test, Fisher’s Exact Test), with a confidence level of 95% and significance level of p < 0.05. One hundred and fifty-four participants completed the survey with a response rate of 96%. From participant responses we found that over 75% of the study population used botanical medicines. Key findings included a diverse repertoire of traditional knowledge on the use of medicinal plants, which included a total of 29 medicinal applications cited across 69 different plant species and 39 families. The most popular species among respondents (irrespective of use) were Pimenta racemosa (Mill.) J.W. Moore (FC = 30, RFC = 0.26), Momordica charantia L. (FC = 28, RFC = 0.24), Zingiber officinale Roscoe (FC = 22, RFC = 0.19) and Annona muricata L. (FC = 21, RFC = 0.18). The findings also show the persistence of medico-cultural concepts such as cleansing and cooling, and identified significant associations between the use of botanical medicines and related practices with demographic variables such as education (p = 0.05; Fisher’s Exact Test) and health insurance, χ2 (1, n = 152) = 4.645, p = 0.003. The findings of this study can be used in the identification and archiving of the medicinal plant practices in Barbados and the wider Caribbean, as well as for the larger purposes of biocultural exploration, preservation and further scientific assessment of botanical medicine practices.

SUBMITTER: Vujicic T

PROVIDER: S-EPMC8579079 | biostudies-literature |

REPOSITORIES: biostudies-literature

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Project description:BACKGROUND:Despite rapid upscale of insecticide-treated nets (ITNs) and indoor residual spraying (IRS), malaria remains a major source of morbidity and mortality in Zambia. Uptake and utilization of these and novel interventions are often affected by knowledge, attitudes and practices (KAP) amongst persons living in malaria-endemic areas. The aims of this study were to assess malaria KAP of primary caregivers and explore trends in relation to ITN use, IRS acceptance and mosquito density in two endemic communities in Luangwa and Nyimba districts, Zambia. METHODS:A cohort of 75 primary caregivers were assessed using a cross-sectional, forced-choice malaria KAP survey on ITN use, IRS acceptance and initial perception of a novel spatial repellent (SR) product under investigation. Entomological sampling was performed in participant homes using CDC Miniature Light Traps to relate indoor mosquito density with participant responses. RESULTS:Ninety-nine percent of participants cited bites of infected mosquitoes as the route of malaria transmission although other routes were also reported including drinking dirty water (64%) and eating contaminated food (63%). All caregivers agreed that malaria was a life-threatening disease with the majority of caregivers having received malaria information from health centers (86%) and community health workers (51%). Cumulatively, self-reported mosquito net use was 67%. Respondents reportedly liked the SR prototype product but improvements on color, shape and size were suggested. Overall, 398 mosquitoes were captured from light-trap collections, including 49 anophelines and 349 culicines. Insecticide treated nets use was higher in households from which at least one mosquito was captured. CONCLUSIONS:The current study identified misconceptions in malaria transmission among primary caregivers indicating remaining knowledge gaps in educational campaigns. Participant responses also indicated a misalignment between a low perception of IRS efficacy and high stated acceptance of IRS, which should be further examined to better understand uptake and sustainability of other vector control strategies. While ITNs were found to be used in study households, misperceptions between presence of mosquitoes and bite protection practices did exist. This study highlights the importance of knowledge attitudes and practice surveys, with integration of entomological sampling, to better guide malaria vector control product development, strategy acceptance and compliance within endemic communities.

Project description:BACKGROUND:Irrational use of antibiotics is a major driver of antimicrobial resistance (AMR) worldwide. Sub-Saharan Africa, where the risk of spread of AMR is highest, lacks data on the knowledge, attitudes and practices regarding antibiotic prescription and use. This is the first study in Mozambique to address this gap. METHODS:A cross-sectional study was conducted in 2016 in 1091 adults (age ?18 years) living in five districts in peri-urban areas of Maputo City. Three stage cluster sampling was used to select the households. A semi-structured questionnaire was used to collect information on the knowledge, attitudes and practices regarding antibiotics and their use and socio-demographic data. RESULTS:Of the 1091 participants, 20.9% (228/1091) had used non-prescribed antibiotics. Most of the non-prescribed antibiotics were purchased in pharmacies (199/228; 87.3%). The proportion of use of non-prescribed antibiotics was higher in those who purchased from informal markets (82.6%; 14/17) and home stores (66.7%; 12/18), compared to pharmacies (24.6%; 199/810) (p = 0.000). Variables significantly associated with use of non-prescribed antibiotics were male gender (p = 0.004), living in the Central A (p<0.001), Aeroporto B (p<0.001) or 25 de Junho (p<0.001) neighborhoods, purchase of antibiotics in informal markets (p<0.002) or obtaining from home stores (p = 0.026), not completing the course (p<0.001) and having poor knowledge on the use of antibiotics (p<0.001). Main reasons for use of non-prescribed antibiotics were a perception that there was no need to attend a health facility (26.8%), followed by someone else's advice (7.7%), symptoms similar to a previous episode (6.2%) and poor quality of care in health facilities (6.7%). CONCLUSIONS:Our study shows for the first time that knowledge regarding antibiotics is poor in Maputo City. Purchase of non-prescribed antibiotics is a common practice and most are sold in pharmacies, indicating deficient inspection. Interventions to reinforce adherence by pharmacies to current legislation for dispensing antibiotics, combined with community education are urgently needed.

Project description:BACKGROUND: The purpose of the study was to investigate parents' perceptions of antibiotic use for their children, interactions between parents and physicians regarding treatment with antibiotics, and factors associated with parents self-medicating children with antibiotics. METHODS: A cross-sectional study was conducted in vaccination clinics in two rural Chinese counties. Primary caregivers (the child's parents in 97% of cases) visiting these clinics for the vaccination of their young children were given a 55-item structured questionnaire to collect information on the parents' knowledge and attitudes regarding when, why, and how to use antibiotics and on their practices of purchasing antibiotics and medicating children. RESULTS: Of the 854 participating primary caregivers, 79% thought antibiotics could cure viral infections, and half believed that antibiotics could shorten the duration of upper respiratory tract infection. Parents reported a median of two hospital visits for their children during the previous 6 months, equal to the median number of antibiotic prescriptions received from physicians. Sixty-two percent of the parents had self-medicated their children with antibiotics. Living in rural villages (Adj OR?=?1.643, 95% CI: 1.108-2.436), raising more than one child (Adj OR?=?2.174, 95% CI: 1.485-3.183), increasing age of child (Adj OR?=?1.146, 95% CI: 1.037-1.266), purchasing antibiotics without a prescription (Adj OR?=?6.264, 95% CI: 4.144-9.469), storing antibiotics at home (Adj OR?=?2.792, 95% CI: 1.961-3.975) and good adherence to physicians' advice (Adj OR?=?0.639, 95% CI: 0.451-0.906) were independently associated with self-medicating behavior. CONCLUSIONS: Low levels of knowledge on the use of antibiotics and a high prevalence of self-medicating children with antibiotics were observed among parents in rural China. Interventions for the rational use of antibiotics in children should focus on strengthening mass health education, improving effective communication between physicians and patients, and enforcing supervision of the sale of antibiotics in retail pharmacies.

Project description:ObjectivesUnderstanding the knowledge, attitudes and practices (KAP) of COVID-19 within distinct populations may aid further public health messaging. This study's aims were to explore KAP towards COVID-19 in rural Bangladesh and identify any potential links to sociodemographics, existing clinical conditions and sources of information.DesignCross-sectional community-based study.SettingParticipants were recruited from 18 villages using multistage cluster random sampling.MethodsData were collected through face-to-face interviews, from June to November 2021, using a structured questionnaire. Data included sociodemographics, clinical conditions, sources of information and KAP of COVID-19 questions. Χ2 test, multiple logistic regression and correlation analyses were performed.ResultsA total of 1603 participants were included with mean ages of 42.3±14.2 years, ranging from 18 to 60 years. Of these, 51% were male, 42.2% had secondary education and 45% had comorbidities. Television was the main source of COVID-19 information (55.8%). The overall correct response rate of KAP questions was 90%, 78% and 59%, respectively. In stepwise multiple logistic regression, good knowledge was associated with higher education (adjusted OR (AOR): 4.61, 95% CI: 2.40 to 8.85, p<0.001), employment, high body mass index (overweight and obese) and trust in the sources of information. Being female (AOR: 1.48, 95% CI: 1.19 to 1.85, p<0.001), having depression (AOR: 1.80, 95% CI: 1.34 to 2.43, p<0.001), being a past smoker and sources of information (family members/friends/relatives/neighbours) were associated with positive attitudes. Good practices were associated with older age (AOR: 1.52, 95% CI: 1.10 to 2.11, p=0.01), higher education (AOR: 2.78, 95% CI: 1.58 to 4.89, p<0.001) and having anxiety, while current smokers and fully vaccinated people were less likely to be engaged in good practices. Positive significant correlations between domains of KAP were observed as well as between past vaccination KAP and COVID-19 KAP.ConclusionThis study uncovered gaps in understanding and practices, and identified targeted intervention especially for young and less educated people using mass media to promote updated knowledge regarding COVID-19 and the efficacy of preventive practices.

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Knowledge, Attitudes and Practices on the Use of Botanical Medicines in a Rural Caribbean Territory

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