Use of Complementary and Alternative Medicine Interventions in the Management of HIV/AIDS in Kisii County, Kenya: a Qualitative Study of Traditional Healers

Document Type : Original Article

Authors

1 Department of Pharmacognosy and Pharmaceutical Chemistry, School of Pharmacy, Kenyatta University, Kenya

2 Department of Linguistics and Languages, School of Humanities and Social Sciences, Machakos University, Machakos, Kenya

3 Department of Communications, School of Humanities and Social sciences, Chuka university, Chuka, Kenya

Abstract

Background: The use of traditional medicine among people living with HIV/AIDS in Kisii County Kenya is high. There is need for more knowledge on how these therapies are concomitantly used with conventional antiretroviral therapy in the county.
Objective: The current study aimed at exploring the traditional healers’ experiences in managing HIV/AIDS using alternative and complementary interventions.
Setting: The study was carried out in Kisii County Kenya where HIV/AIDS prevalence is relatively high and anti-retroviral therapy (ART) coverage low compared to the national average.
Design and participants: The study took a qualitative approach specifically phenomenological where 12 registered traditional healers were purposively sampled from a registered total of 22 in the county. Two focus group discussions of six participants each were held in addition to follow up interviews for each of the participants. Data was analyzed qualitatively by taking significant statements, textural descriptions and transcripts from participant experiences in managing HIV/AIDS.
Results: Traditional healers dispensed herbal remedies to boost immunity, treat antiretroviral therapy side effects and opportunistic infections such as gastritis, diarrhea and sexually transmitted infections. Counselling, prayer and faith helped eliminate stigma and enhance the will to live among patients. Among the remedies dispensed were Aloe vera, Carissa edulis, Leonotis nepetifolia, Maesa lanceolate and Prunus africanus.
Conclusion: Concomitant use of ART with herbal and nutritional therapy may contribute to immune boosting, reduced opportunistic infections and side effects related to antiretroviral therapy. Counselling, spiritual guidance, prayer and faith may be applied to reduce HIV/AIDS related stigma and improve the will to live.

Keywords


1. WHO (2019), WHO global report on traditional and complementary medicine 2019, Geneva.
2. Onyambu MO, Gikonyo NK, Nyambaka HN and Thoithi GN (2019) A review of trends in herbal drugs standardization, regulation and integration to the national healthcare systems in Kenya and the globe. International journal of Pharmacognosy and Chinese medicine Vol. 3 (2)
3. Kenya health act (2017) No. 21 of 2017 HealthActNo.21of2017.pdf (kenyalaw.org) retrieved 20th December 2019
4. Constitution of Kenya (2010), National council for law reporting ConstitutionofKenya-2010.pdf (museums.or.ke) retrieved 20th December 2019
5. County integrated development plan (2018-2022) Kisii county government ;2018-2022 Kisii County CIDP.pdf (kippra.or.ke) retrieved 20th December 2019
6. Maroko, G.M., Mokua, G.N., Nyakundi, A.O. (2020). A Conceptual Analysis of Metaphors Engendering HIV and AIDS-Related Stigma and Discrimination in Kisii County, Kenya. Language Circle 14 (2): 137-147.
7. HIV estimates (2018), Ministry of health Kenya www.nacc.or.ke
8. Moser, A. & Korstjens, I. (2018), Practical guidelines to qualitative research part 3: sampling, data collection &analysis. European journal of general practice 24;1, 9-18
9. Parton, M.Q. (1999) Enhancing the quality and credibility of qualitative analysis, Health services research 34:5 part II
10. Butera, D.; Tesoriere, L.; di Gaudio, F.; Bongiorno, A.; Allegra, M.; Pintaudi, A.M.; Kohen, R.;Livrea, M.A (2002) Antioxidant activities of sicilian prickly pear ( Opuntia ficus indica ) fruit extracts and reducing properties of its betalains: Betanin and indicaxanthin. J. Agric. Food Chem. 2002,50, 6895–6901.
11. Kuti, J.O (2004) Antioxidant compounds from four Opuntia cactus pear fruit varieties. Food Chem. 2004, 85, 527–533.
12. Msoffe, P.L.M. & Mbilu, Z.M. (2009) The efficacy of crude extract of Aloe secundiflora on Candida albicans. Afr J. Tradit Complement. Altern Med 6 (4): 592-595.
13. Teshome Nedi, Negussu Mekonnen, Kelbessa urga (2004) Diuretic effects of the crude extracts of Carissa edulis in rats. Journal of ethnopharmacology 95 (1) 57-61
14. Yalemtsehay M, Teferra W, Gebremichael G and Yemana T (2011-2014) Exploring medicinal plants for better health; Antiplasmodial properties of Clerodendrum myricoides and Dodonaea angustifolia. Exploring traditional medicine, college of natural and computational sciences, addis ababa university (2011-2014)
15. Sobolewska, D., Pasko, P., Galanty, A., Makowska-Was, J., Padlo, K., Wasilak,W ( 2012).Preliminary phytochemical and biological screening of methanolic and acetone extracts from Leonotis nepetifolia (L.) R.Br.J.Med. Plants Res.6, 4582–4585.
16. Okemo O Paul, Harsh palbais, Jorge M Vivanco (2003) invitro activities of Maesa lanceolate extracts against fungal plant Pathogens. Fitoterapia. 2003 Apr;74(3):312-6.
17. Bii CC, Korir R, Rugutt J & Mutai C. (2010). The potential use of Prunus africana for the control, treatment and management of commonfungal and bacterial infections. Journal of Medicinal Plants Research 4 (11).
18. Charlebois D (2007) Elderberry as a medicinal plant. Issues in new plants and uses. ASHS press, Alexandria VA.
19. WHO (2006) world health organization monograph on good agricultural and collection practices (GACP) for Artemisia annua (l), WHO Geneva.
20. Sanjeeb Kalita, Gaurav Kumar, Loganathan karthk (2012) A review on medicinal properties of Lantana camara (Linn) Research J Pharm and tech 5(6). June 2012.
21. Rosham A Chikari, Naveen Kumar HN, shruthi SD (2012) A review on medicinal importance of Basella alba L. International journal of pharmaceutical sciences and drug research 2012: 4(2): 110-114.
22. Abdul Razis AF, Ibrahim MD, Kntayya SB (2014) Health benefits of Moringa oleifera: Asian pacific journal of Cancer prevention 15(20) 8571-6
23. Armadoa, Armarillis S, Sofia R, Lorena Z, Eddy L, Federico NC (1992) Pharmacologic properties of Moringa oleifera: Screening for antispasmodic, anti-inflammatory and diuretic activity. Journal of ethnopharmacology 36(3) 233-237
24. Dorota Kregiel, Ewelina Pauliowska & Hubert Antolak (2018) Urtica spp. Ordinary plants with extraordinary properties. Molecules Jul: 23(7) 1664
25. Mohammad A. Alzohiry (2016) Therapeutic role of Azadiracta indica (Neem) and their active constituents in disease prevention and treatment. Evidence based complementary and alternative medicine. HIndawi publishing corporation.
26. Ifeoluwa T Oyeyemi, Akimbiyi A, Akinlabi, Adenike Adewumi, Ambibola O. Aleshinloye, Oyetunde T. Oyeyemi (2018) Vernonia amygdala; a forkloric herb with antihelminthic properties. Beni-suef University Journal of basic and applied sciences 7(1) 43-49.
27. Onyango JA, Josia o. Omolo, Alice WNjue, Joseph W Matofari (2012) antimicrobial activity of the root extracts of Tylosema fassoglensis sweinf ( Caesalpinaceae) scince journal of microbiology. Science journal publications volume 2012
28. Rachel Dangerembizi, Kennedy H Erlwanger, Davison Moyo & Eliton Chivandi (2013) Phytochemistry, Pharmacology and ethnomedical uses of Ficus thonningii (Moraceae), a review. Afr J Tradit Complement Altern Med. 10(2):203-12.
29. Wube, A.A., Bucar, F. Gibbons, S. A ,K.,Rattray,L.,Croft,S.L.,2010.Antiprotozoal activity of drimane and coloratane sesquiterpenes towards Trypanosoma brucei rhodesiense and Plasmodium falciparum in vitro.Phytother.Res.24,1468–1472.
30. Jalal Bayati Zadeh and Nasroallal Moradikor (2014) Physiological and Pharmaceutical effects of ginger (Zingiber officinale) as a valuable medicinal plant; European journal of experimental biology 4(1):87-90
31. Rosa martha perez, Gutierrez Sylvia Mitchell, Rosario vargas solis (2008) Psidium guajava . a review of its traditional uses, phytochemistry and pharmacology. Journal of ethnopharmacology 117 (2208) 1-7.
32. Silva, J., Abebew, W., Duarte, V.C., Machando, M.L., & Matos, F.J. (2003). Analgesic and anti-inflammatory effects of essential oils from eucalyptus. J ethnopharmacology 89(2- 3) 27-83
33. Tarum Viji, Yash Prasher (2015) a review on medicinal properties of carica papaya linn; Asian pacific journal of tropical diseases 5 (1) 1-6
34. Bhakta Prasad Gaire, Lalita Subedi (2013) a review on the Pharmacological and toxicological aspects of Datura stramonium L, Journal of integrative medicine. 11(2) 73-79
35. Omwenga E.O. A .Hensel, A. Shitandi, F.M. Goycoolea (2015) Ethnobotanical survey of traditionally used medicinal plants for infections of skin, gastrointestinal tract, urinary tract and the oral cavity in Borabu sub-county, Nyamira county, Kenya. Journal of Ethnopharmacology176(2015)508–514
36. Leyla Bayan, Peir Hossain Kouliv and Ali Gorji (2014) Garlic: a review of potential therapeutic effects; Avicenna J Phytomed 4 (1) 1-4
37. Gagan Shah, Richa shri, vivek Panchal, Nrenda sharma, Bharpur Sing & asman (2011) Scientific basis for the therapeutic use of Cymbopogon citratus stapf (lemon gras). Journal of advanced pharmaceutical technology & research. 2 (1) 3-8
38. MohanraJ R, Sivasankurs (2014) sweet potatoe ( Ipomea batatas L), a valuable medicinal food, a review. Med food 17 (7) 733-41
39. Sharangi AB (2009) Medicinal and therapeutic potentialities of tea (Camelia sinensis L)A review food research international 42(529-535)
40. Eva Brigitta Patay, Timea benefik Nora Papp (2016) phytochemical overview and medicinal importance of coffea species from past until now. Asian journal of tropical medicine 9(12) 1127-1135
41. Waseem Mohammed Abdul, Nahid H Hajrah1, Jamal S.M. Sabir, Saleh M Al-Garni, Meshaal J Sabir, Saleh A Kabli, Kulvinder Singh Saini, Roop Singh Bora (2018) Therapeutic role of Ricinus communis L. and its bioactive compounds in disease prevention and treatment. Asian pacific journal of tropical medicine 11 (3) 177-185
42. Jadhav VM,RM Thora T, VJ Kadam and NS Sathe (2009) Traditional medicinal uses of Hibiscus rosa-sinensis. Journal of Pharmacol Research 2(8):1220-1222
43. Mary Barner Bridgeman and Daniel T Abazia (2017) medicinal cannabis History, pharmacology and implications for the acute care setting: Pharmacy and therapeutics 42(3) 180-188
44. Natasha R. Ryz, David J Remillard and Ethan B. Russo (2017) Cannabis roots: a traditional therapy with future Potential for treating inflammation and pain Cannabis and cannabinoids research, vol. 2.1
45. Kumar Sunil, Rashmi Malhotra & Dinesh Kumar (2010) Euphobia Hirta: Its chemistry, traditional and medicinal uses and pharmacological activities. Pharmacognosy Review 4(7) 58-61
46. Michael Buerno Adinortey, Isaack Galyuon & Nicholas Oteng Asamoah (2013) Trema orientalis Linn Blume: A potential for prospecting for drugs for various uses. Pharmacognosy review 7(13) 67-72
47. Christina M Puchalski (2001) the role of spirituality in healthcare (BUMC proceedings 201; 14: 352-357
48. Foglio JP, Brody H (1998) Religion, faith and family medicine. J Fam. Prac. 27:473-474
49. Strawbridge WJ, Cohen RD, Sharma SJ and Kaplan GA (1997). Frequent attendance at religious services and mortality over 28 years. AM J Public health 87: 957-961
50. Yates JW, Chalmer BJ, St James P, Follansbee M, MCkegney FP (1981) Religion in Patients with advanced cancer. Med. Pediatr Oncol 9:121-128
51. Harris RC, Dew MA,Lee a, Amaya M, Buches L, Reetz D, Coleman C (1995) The role of religion in heart transplant recipients long-term health and well-being. Journal of religion & health 34 (1) 17-32.
52. Cameron, A., Even, M., Ross-Degnan, D., Bail, D., & Laing, R. (2008). Medicine prices availability and affordability in 36 developing middle income countries. A secondary analysis-Geneva WHO 2008
53. Fairfield KM, Eisenberg DM, Davis RB, Libman H, Phillips RS (1998) Patterns of use, expenditures, and perceived efficacy of complementary and alternative therapies in HIV-infected patients. Arch Intern Med. 158:2257–2264.
54. Babb DA, Pemba L, Seatlanyane P, Charalambous S, Curchyard G, Grant AD (2004). Use of traditional medicinen the era of antiretroviral therapy: experience from South Africa. eJIAS 2004, MedGenMed. 2004;6:B10640. [eJIAS. 2004 Jul 11;1(1):B10640]. [Google Scholar]
55. UNAIDS 2010
56. Chan (2013). Speech by WHO director general Dr. Margaret Chan at the international conference on traditional medicine for South East Asian countries. New Delhi India, 12-15 February 2013
57. Lewal, O.A., Banjo A.D. (2007). A survey of usage of arthropods in traditional medicine in south west Nigeria. J. Entomol. 4, 104-112.
58. Southern African Development Community (SADC), (2003) Ministerial Consultative meeting on Nutrition and HIV/AIDS. Johannesburg, South Africa; Jan 20–21, 2003.
59. Betty Namuddu, Joan N kalyango and paul Waako (2011) Prevalence and factors associated with traditional herbal medicine use among patients on highly active antiretroviral therapy in Uganda. BMC public health: 11(1) 855
60. Fleming J (1995) Mozambican healers join government in fight against AIDS. J Int Assoc Physicians AIDS Care. 1:32.
61. Peters EJ, Immananagha KK, Essien OE, Ekott JU (2004). Traditional healers’ practices and the spread of HIV/AIDS in south eastern Nigeria. Trop Doct. 34:79–82.
62. Syed Amin Tabish (2008) Complementary& alternative healthcare: Is it evidence-based? International journal of health sciences, Qassim University, 2(1) V-IX
63. National Center for Complementary and Alternative Medicine. “Manipulative and Body-Based Practices: An Overview.” http://nccam.nih.gov/health/backgrounds/manipulative.htm (accessed sep, 2020).
64. Helane Wahbeh, Siegward-M Elsas, Barry S. Oken (2008), Mind body interventions, applications in neurology; Neurology journal June 2008;70 (24)
65. Nyakundi, A.O., Maroko, G.M., Mokua, G.N. & Onyambu, M.O. (2019). Communication strategies in the management of HIV and Aids in kisii county, kenya: successes and gaps. International Journal of Communication Research Vol 9, (4): 339-350.