Factors affecting family medicine programmes in Sub-Saharan Africa: a narrative review of recent literature

Objectives: This study sought to assess the level of anti-glycaemic medication-taking and its predictors among adults living with diabetes receiving treatment at Cape Coast Teaching Hospital (CCTH). Design: This was a cross-sectional study carried out among adults living with diabetes and receiving care at CCTH. Data on socio-demographic characteristics and anti-glycaemic medication-taking were gathered using a structured questionnaire. A scale consisting of 4 domains (filling prescribed medication; taking medications appropriately ac-cording to the instructions of healthcare professionals; practising behavioural modifications, and showing up for fol-low-up appointments) and eight items was used to measure the level of anti-glycaemic medication-taking. Descriptive statistics, chi-square test (and Fisher's exact test where appropriate), bivariate and multivariate logistic regression models were used in analysing the data. Setting: The study was carried out in the diabetes clinic in Cape Coast Teaching Hospital. Participants: The total enumerative sampling technique was used to select 250 adults living with diabetes and receiv-ing care at CCTH.Main outcome measures: Anti-glycaemic medication-taking Results: Out of 250 participants studied, 42% had high anti-glycaemic medication-taking. Predictors of anti-glycae-mic medication-taking included; forgetfulness (aOR=0.02, 95% CI: 0.00-0.64, p<0.001), patient's involvement in treatment plan (aOR=0.12, 95% CI: 0.02-0.64, p=0.014) and having good knowledge about one's medication (aOR=2.34, 95% CI: 1.10-4.98, p=0.028). Conclusion: Less than half of the sample population (42%) had high anti-glycaemic medication-taking, with forget-fulness, involvement in the treatment plan and good knowledge about anti-glycaemic medications, predicting medi-cation-taking

The effect of CAM comprehensive nursing interventions on the improvement of quality of life to patients with breast cancer and gynaecological tumours

Breastcancerin females, which is consideredthe most dreadfuldisease in India andthe worldas compared toother gynaecological cancers,demands extensive care and proper medicationin order to control itsprogressive growth. In addition to the conventional care ofthe patients, Complementary andAlternative Medicine(CAM)is administeredin a controlled way through proper guidance and counselling in orderto attainimprovedphysical andmental health forthe patients.Objective: The aim of the study wasto assess the effectiveness of CAMcomprehensive nursing interventionsand their benefit forpatients who havebreast cancer and gynaecological tumours.Methods: Statistical data was used to map the adult womendiagnosed with breast and gynaecological cancer and who were set to start new chemotherapy treatments. A total of 450 patients from different states of East India were enrolled in the studyover a period of four years. The patients wereselectedbased on their preference for undergoing CAM.The research was conducted usingacross-sectionalanonymous self-administered questionnaireto examine women's perspectivestowards the use of CAM and itseffect on their mental andphysical health.Results:42%of the women preferred theuseofCAM astheir alternative treatment. Breast cancer patients disclosed that 48.1% of them had used CAM and 39% of women with gynaecological cancersstated that they had usedCAM. The results further indicated a less frequent deteriorationin the health of CAM users(38.4%) thantonon-users(55%). In terms of those who utilizedvitamins and nutritional diets,60% of the participants reported using a proper diet, including antioxidants, minerals, vitamins and herbs etc. 37% opted for spiritual healing through yoga, 26% utilized energy healing, 42.4% utilized acupuncture,72% preferred massagesand 23% of patients utilized chiropractic methods.The use of CAM was foundmainlyin the patients with proper education and awareness and those with a family history of cancer who were not receiving the necessary care from their previous primary physician.Conclusion:CAM still requiresextensive research in terms of its applications in dealing with patients and in orderto successfully launch programmes aimed at promoting its useworldwide andto eradicate all the other false notions about it.[Ethiop. J. Health Dev. 2022; 36(2):000-000]Keywords: Breast Cancerand gynaecological tumours,Complementary And Alternative Medicine (CAM), Complementary Oncology,Quality Of Life, Nutritional Diet and Spiritual Healing, HRQL (Health-Related Quality Of Life).IntroductionCancer has been the primaryconcern in Indiafrom the onset,resulting in thousands of deaths due to the lack of adequatemedication and therapy.Breast cancer is considered to bea common invasive form of cancer which is responsible for the second highest mortality rate among the primaryfatal conditions of cancer-causing deaths in women. Under the National Cancer Registry Program,the breast, cervix, uteri,and oral cavity(7)are the most common cancer sitesin women. According to statistics, 50-60% of all cancers amongIndian women are commonly found inthe cervix uteri, breast, corpus uteri and ovaries,which are the main organs forcancer invasion. The percentage of women who experience these types of cancer is increases, with more women becoming susceptible to breast cancer, in women up to 3-8% suffer fromovarian cancer,0.5-4.8%have cancer of the corpus uteri, 1-3% have vulva and/or gestational trophoblastic tumours and a staggering75,000 or more women have breast cancer. With the advancements of the disease through time,research programs were also improved in order to enable the improvement of existing measures and/or the development of new measures aimed at combating the diseas and decreasing mortality rates. Apart from the conventional chemotherapy technique,various other programs have been introduced andencorporated into treatment regimes in order to improve the lives of those who are affected by cancer.Complementary andAlternative Medicine (CAM) emphasizesthe methods and practices that are therapeutic and which help diagnose or curethe disease,these methods are intended tocomplement the conventional methods and can be used in place of mainstream medicine. Women with breast cancer and other gynaecological tumoursare increasingly inclined towards the use of CAM. With the increasing number of cancer reports in Indiaand the world,and with the principal amount leading to mortality, women with proper education and awareness are inclined to choosealternative methods rather than the old conventional ones. The side-effects resulting from the chemotherapy are immense and toxic,which is one of the reasons women are inclined to choose.Various research projects and cumulative studies have been conducted in order to review and discoverthe

Building the foundation for universal healthcare: Academic family medicine's ability to train family medicine practitioners to meet the needs of their community across the globe

Background: The Declaration of Astana marked a revived global interest in investing in primary care as a means to achieve universal healthcare. Family medicine clinicians are uniquely trained to provide high-quality, comprehensive primary care throughout the lifespan. Yet little focus has been placed on understanding the needs of family medicine training programs. Aim: This study aims to assess broad patterns of strengths and resource challenges faced by academic programs that train family medicine clinicians. Methods: An anonymous online survey was sent to family medicine faculty using World Organization of Family Doctors (WONCA) listservs. Results: Twenty-nine representatives of academic family medicine programs from around the globe answered the survey. Respondents cited funding for the program and/or individual trainees as one of either their greatest resources or greatest limitations. Frequently available resources included quality and quantity of faculty and reliable clinical training sites. Frequently noted limitations included recruitment capacity and social capital. Over half of respondents reported their program had at some point faced a disruption or gap in its ability to recruit or train, most often because of loss of government recognition. Reflecting on these patterns, respondents expressed strong interest in partnerships focusing on faculty development and research collaboration. Lessons learnt: This study provides a better understanding of the challenges family medicine training programs face and how to contribute to their sustainability and growth, particularly in terms of areas for investment, opportunities for government policy and action and areas of collaboration.

Mastering Your Fellowship: Part 4, 2022

The 'Mastering Your Fellowship' series provides examples of the question format encountered in the written and clinical examinations, Part A of the Fellowship of the College of Family Physicians of South Africa examination. The series is aimed at helping family medicine registrars prepare for this examination.

Medical student satisfaction and confidence in simulation-based learning in Rwanda ­ Pre and post-simulation survey research

Introduction: Simulation-based learning (SBL) has been shown to effectively improve medical knowledge, procedural proficiency, comfort with undertaking taught tasks, inter-professional communication, teamwork and teaching skills. This study aimed to evaluate Rwandan medical students' attitudes, satisfaction and confidence level with SBL. Methods: Fifth year medical students at the University of Rwanda were given a short course on paediatric acute care using simulation. The simulation sessions were locally developed cases based on the pRRAPID materials, developed at the University of Leeds (UK). Equipment included low fidelity infant mannequins, basic airway devices, IV access, and monitoring. A four-part, Likert-scale questionnaire was distributed to medical students before and after their four-week simulation program. Results: 57 pre-simulation and 49 post-simulation questionnaires were completed. Confidence in skills increased in all fifteen domains of the questionnaire with the total skill confidence score rising from 44.0 (±12.3) to 56.2 (±8.8) after the simulation-based intervention (p<0.001). Satisfaction and attitudes towards simulation-based learning in this setting were very positive. Conclusion: The simulation-based intervention was well received by students in this setting. Satisfaction was high and the simulation exercise increased the students' confidence. Previous research has demonstrated that SBL is effective and the results of this study now demonstrate that it is well received in our setting. As we move from knowledge-based education to a competency-based education culture, faculties in this setting should invest in providing SBL opportunities throughout the medical school curriculum

The influence of physicians' specialty on prescribing patterns at a general medicine out-patients clinic

Background: Several factors have been identified that influence physicians' prescribing habits. The influence of physician's specialty has not been studied. This study is to determine if there are differences in the prescribing patterns amongst these various specialities that run a general medicine clinic at a tertiary hospital in Ghana. Methods: Data collected from the out-patients clinic attendance records were analysed using WHO Rational Use of Medicines indicators. Analysis of Variance Test was carried out to establish if there was any variance in the prescribing indicators amongst 4 units of Physicians. Results: 678 patient encounters were utilised for this study. The average number of drugs prescribed per encounter was 4.4, drugs prescribed by generic name was 86.9%, patient encounters in which antibiotics prescribed were 6.5% (n= 44) and injections were prescribed in 3.2% (n=22) of patient encounters. 64.0% of all drugs prescribed were from the Ghanaian EML. The unit of the physician did not have a significant effect on the average number of medicines prescribed per patient encounter (F (3, 674) = 2.19, p = 0.088), and the percentage of medicines that were prescribed from the Essential Medicines List (F (3, 674) = 1.52, p = 0.207). The unit the physician belonged to however did have a significant effect at p < 0.05 on the prescription of generic medications (F (3, 674) = 4.79, p = 0.003). Conclusion: The physician units did not differ in their prescribing patterns at the general medicine clinic except for prescription of drugs by their generic names

Medicine use among HIV/AIDS Patients in public hospitals, Kwara State

Background: The prognosis of HIV/AIDS and HIV-related comorbidities has been revolutionized by the use of medicines. However, World Health Organization reported that 50% of patients do not use their medicines as prescribed.Objective: To assess HIV/AIDS patients' knowledge of the use of medicines dispensed to them.Method: This study was conducted in seven public hospitals in six local government areas, Kwara State. Exit interviews of 780 eligible HIV/AIDS patients were conducted through use of structured questionnaire. Additionally, there were exit observational checks of medicines dispensed to these patients. Descriptive statistics and Fisher Exact test were used for data analyses.Results: Of the 780 study participants, 36.1% had no formal education, 99.9% knew the 'quantity' of medicines to be administered, while 99.2% knew the frequency of administration. All the patients knew the route of administration, 96.7% and 94.3% knew the general precautions to avoid concomitant use of dispensed medicines with alcohol or herbal products respectively, while 93.7% of those who received co-trimoxazole knew of the precaution to use "plenty of water" as the vehicle for its administration. There were no significant associations between the patients' knowledge of these precautions and duration of antiretroviral therapy (P>0.05). However, the patients lacked knowledge of specific precautions of some dispensed medicines.Conclusion: Most of the patients knew of the administration and the general precautions of dispensed medicines. However, lack of knowledge of specific precautions of some dispensed medicines calls for intervention

Traditional Herbal Medicines used in Neonates and Infants less than Six Months Old in Lagos Nigeria

Background: Herbal medicine use in children; adults and other groups have been documented but little information is known about the use herbal medicine mixtures in neonates and infants less than six months old. This is important because pharmacokinetics and pharmacodynamics changes between infants and adults may result in age-related differences in drug metabolism. This study was carried out to document the herbal medicines used for common ailments in neonates and infants less than six months in Lagos; Nigeria.Methods: With the aid of questionnaires and personal interviews during field trips to herbal medicine markets and infant welfare clinics a survey was undertaken to collect information on herbal medicine use by neonates and infants less than six months from traditional healers and nursing mothers during July and September 2014. Demographic Information and types of herbal medicines used by the respondents; indications for their use and adverse effects of the herbal medicines they used were obtained.Results: Medicinal plant species used for the treatment of common ailments including diarrhea ; abdominal cramps ; skin rashes; Fever (malaria) ; jaundice; convulsions; Insomnia and weight loss in neonates and infants less than 6months were documented. A high percentage of the mothers (72%) agreed they used herbal medicines in neonates and infants; although 96% of them did not notice any adverse effect while 100% of the mothers perceived the herbs to be efficacious. Herbal medicines are administered as a polyherbal compound; containing 4-6 plants Conclusion: The use of herbal medicines is common amongst neonates and infants less than six months old . Further studies on the efficacy and safety of these medicines which are administered as polyherbal mixtures is recommended

If the Doctors see that they don't know how to Cure the Disease; they say it's AIDS': How Older Women in Rural South Africa Make Sense of the HIV/AIDS Epidemic

South Africa; like other sub-Saharan African countries; is in the midst of the AIDS epidemic. Older women; here defined as aged 60 years and older; while at lower risk of infection than those aged 20-50; are amongst those deeply 'affected' by the epidemic. In rural areas; older women; who have always played central roles in social reproduction in South African households and families; bear the brunt of care giving for the sick and dying. For this reason; it is important to explore how these women understand the epidemic. In South Africa; the prominence of traditional healers and medicine alongside biomedicine has led to multiple ways of perceiving; explaining and treating illness. This paper explores the various discourses older women in rural South Africa employ to make sense of the HIV/ AIDS epidemic in their daily lives. The aim is to better understand how these women construct the epidemic and how this knowledge can be used to benefit education and treatment endeavours in similar contexts. This paper draws on interview data collected as part of the Gogo Project conducted in the Medical Research Council (MRC)/Wits Rural Public Health and Health Transitions Research Unit. Sixty women between the ages of 60 and 75 years living in the rural Agincourt sub-district participated in three in-depth; semi-structured interviews. The respondents in this study relied on a variety of discourses to make sense of the HIV/AIDS epidemic. They displayed a high level of knowledge based on biomedical education; however; they expressed ideas; often simultaneously; that seemed to contradict this education. Their ability to employ seemingly contradictory discourses represents the need to place the epidemic within familiar 'explanatory models' that are based on these women's life experiences and local knowledge.

La cartographie des medecins specialistes dans les quatre grandes disciplines cliniques ainsi que l'anesthesie reanimation en Republique Democratique du Congo (RDC): etat des lieux

Introduction : La carence en specialistes en medecine est une realite connue et vecue dans plusieurs pays africains dont la RDC. Une etude a ete menee pour faire la cartographie des medecins specialistes afin de faire un etat des lieux et tirer des conclusions qui s'imposent eu regard au programme poursuivi par notre gouvernement.Materiel et Methodes : L'etude a ete menee dans les 11 provinces de la RDC en Juin 2013. Les coordonnees suivantes de chaque medecin specialiste ont ete recoltees: identification; sa specialite et le lieu de travail. Tous les specialistes non congolais ont ete exclus. Des donnees geographiques et demographiques ont ete recoltees par province. Pour la Ville de Kinshasa; 11 grands hopitaux ont ete choisis. Pour la formation des specialistes; nous avions pris ceux formes a l'UNIKIS (Universite de Kisangani) depuis sa creation. Resultats: Nous n'avons que 339 specialistes dans les 4 grandes disciplines cliniques et 33 anesthesistes. 49;9 (169/339) des specialistes travaillent a Kinshasa. 91;7 (311/339) des specialistes travaillent dans les capitales provinciales et a Kinshasa; c'est-a-dire en milieux urbains. Il n'y a que 5;6de femmes (19/339). 49 diplomes de specialistes ont ete delivres a l'UNIKIS dans ces disciplines cliniques.Conclusion : Le manque des specialistes; la non couverture de la population tant urbaine que rurale par un personnel medical qualifie et la non disponibilite des structures valables pour la formation des specialistes est une realite en RDC. Une solution a long terme est de former localement les medecins qui veulent se specialiser dans une discipline medicale

Bridging the Gap: Exploring the Atitudes and Beliefs of Nurses and Patients about Coexisting Traditional and Biomedical Healthcare Systems in a Rural Setting in KwaZulu-Natal

Objectives: Health care in South Africa takes place within a diverse cultural context and includes perceptions about health that strongly link to cultural beliefs and values. Biomedical healthcare professionals; particularly nurses; are exposed to and expected to cope with cultural challenges on a daily basis; with little or no training on how to do so. In this paper; we explore nurse and patient attitudes to and beliefs about how the systems of health care coexist; what issues this raises and how nurses and patients address these issues in their daily practice. Design: The study employed an exploratory; qualitative research design. Setting and subjects: Four in-depth focus group discussions were conducted with nurses and patients at a deep rural; district hospital in northern KwaZulu-Natal. Participants were selected based on their availability and willingness to contribute to the discussion. Results: Traditional and biomedical healthcare systems coexist and are used simultaneously with the healthcare-seeking pattern of patients traversing multiple systems of care. Currently; patients and nurses have developed strategies to address this by steering a pragmatic course to minimise risks; and by doing so; bridging the gap between the two healthcare mediums. Conclusion: Further research is required to understand which illnesses are primarily seen as traditional; how this gap can be effectively addressed; and how different healthcare co-delivery models can best be utilised and evaluated

Five-year Audit of Spirometry at the Lasuth; Ikeja; South-West Nigeria

Spirometry is a non-invasive tool of importance in respiratory medicine. There is an enormous burden ofpulmonary disease worldwide, including in Nigeria.This retrospective study was done to determine the utilisation of spirometry services in the Lagos StateUniversity Teaching Hospital (LASUTH). It determined the sources of referral, indications, and pattern of pulmonary abnormalities.This is a retrospective study. An audit was done on the data collected at the Pulmonary Function Laboratory of the LASUTH between September 2006 and October 2011. Spirometry was done using the Gold Standard Vitalograph spirometer. The demographic characteristics of the patients who had spirometry as well as FEV1, (forced expiratory volume in 1 second)FVC (forced vital capacity), and their predicted values were noted.A total of 849 patients had spirometry done over the 5-year period. Slightly more than half were male patients. The mean age of the patient was 50±19 years. There was a steady increase in the number of spirometry tests performed from 2006 reaching a peak in 2009. Thereafter, a sharp decline was seen in 2010 with a steady rise in the first 10 months of 2011.The most common indication for spirometry was in the evaluation and assessment of asthma in 487 patients (57%). Most of the referrals for spirometry were from the medical department of the hospital representing 532 (63%) patients; 202 (24%) of the request were from the general out-patient department by family physicians, while 115 (13%) came from the surgical department. The outcome of the ventilatory abnormalities showed that 372 (44%) had normal ventilatory indices, 206 (24%) had obstructive patterns,169 (20%) had mixed type, while restrictive patterns were seen in 102 (12%).We concluded that although spirometry is frequently used in our clinical practice, this can be improved upon

The Potential of Involving Traditional Practitioners in the Scaling Up of Male Circumcision in the Context of HIV Prevention in Tanzania

Abstract:Male circumcision (MC) has been practiced worldwide for religious; cultural; social and medical reasons. Recent studies in Africa have indicated that MC to be highly protective against HIV transmission. However; incorporating MC in HIV/AIDS prevention programme will increase its demand in Tanzania where traditional male circumcision is common and the health care system is weak. The objective of this study was to determine the challenges and opportunities of involving traditional practitioners in scaling up safe MC in the context of HIV prevention in Tanzania. The study was conducted in Monduli; Bahi and Mkuranga districts of Tanzania. Both quantitative and qualitative methods were employed. Household survey involved community members from the selected villages. Indepth interviews involved traditional practitioners and key informants at national; district and facility levels. A total of 601 householders were interviewed. Most (71.4) household respondents preferred traditional MC as it was part of their culture and tradition. A similar response was obtained from other respondents. It was mostly preferred because it was used as an initiation school; turning of boys to warriors and sense of social cohesion. Only 228 (37.9) of the respondents were aware of the adverse events associated with MC. The most frequently mentioned adverse effects were severe bleeding (65.0); delayed wound healing (17.5) and wound sepsis (8.4). The risk of acquiring HIV through male circumcision practice was poorly known among community members except medical respondents. Single unsterilized local surgical equipment was used to circumcise several initiates. It was observed that interference with traditional values associated with circumcision to be the main hindrance of linkage between traditional and conventional practitioners. On the other hand it was reported that there was no policy or guidelines on Traditional MC (TMC). Most of respondents supported the efforts to establish and promote formal linkages between traditional and conventional practitioners. In conclusion; under the current HIV pandemic and TMC being prevalent in Tanzania; it is high time for the government to establish a linkage between traditional and conventional practitioners for safe practices in order to minimize HIV transmission

Health Seeking Behaviour among Adult Residents of Yenagoa City; Nigeria

Introduction: Health seeking behaviour and measures taken to promote health or prevent/treat ill-health among residents of Yenagoa; were investigated. This is against the backdrop of diversity in cause(s) of ill-health and a plethora of alternatives for restoring health among the populace. Materials and Method: Structured questionnaire consisting of two sections was administered to 300 residents aged above 18 years. Section A contains demographic information while Section B contains enquires into knowledge of health; causation/prevention of ill-health and actions taken to restore health. Seven prevalent diseases namely; malaria; typhoid; HIV/AIDS; hypertension; diabetes; hepatitis and sexual impotence were used as representative conditions to elicit behavioural responses from participants. The sampled diseases although not exhaustive of all diseases; are representative of commonly encountered diseases and cover an ideal spectrum in terms of prevalence and severity. Results and Discussion: Out of the 300 questionnaires administered; 262 (87.3) were retrieved. Of the respondents; 147 (56.0) were females while 115 (44.0) were males. On causal factors for ill-health; 110 (42.0) respondents highlighted religion/culture as important; 67 (25.6) respondents highlighted biogenic (medical/scientific) factors as important; 85 (32.4) respondents highlighted socio-economic factors as important. Over 90of the respondents wait for sickness cue(s) before seeking for help reflecting poor health-check habit. Only 40 (15.3will seek help immediately when ill/sick. One hundred and thirty (49.6) respondents utilise orthodox medicine gotten from traditional/herbal healers; 33 (13.0) respondents utilise unorthodox medicine gotten from hospitals; clinics and pharmacies while 99 (37.8) utilise spiritual means indicating tremendous religious influence on health seeking behaviour

Review of the Practice of Traditional Bone Setting in Nigeria

Background: The practice of traditional bone setting (TBS) is extensive in Nigeria and it enjoys enormous patronage by the populace. However; the outcome of the intervention of TBS treatment is usually poor with profound effects on the patient. There are many publications highlighting different aspects of this subject but none has summarized the entire practice and problems as a single publication. Objective: This work aims at reviewing the entire subject of traditional bone setting in Nigeria in a single article to enable easy understanding and appreciation of the practice and problems of traditional bone setting by orthodox practitioners. Method: A total of thirty-one relevant published original scientific research papers involving all aspects of the subject were reviewed and the practices and problems were documented. Results: The results showed that the origin of the practice is shrouded in mystery but passed on by practitioners from one generation to another. There is no formal training of bonesetters. Though the methods of treatment vary; the problems caused by them are usually similar with extremity gangrene being the worst. When attempts have been made to train the bone setters; improvement have been noted in their performance. Conclusion: In other to prevent some of the most debilitating outcomes like amputation; it is suggested that the TBS practitioners undergo some training from orthopaedic practitioners

Incidence and Risk Factors for Traditional Eye Medicine Use among Patients at a Tertiary Eye Hospital in Nigeria

Objective: To determine the incidence and risk factors for traditional eye medicine use among patients at the Guinness Eye Center Onitsha; Nigeria. Materials and Methods: Consecutive new adult ophthalmic patients seen at the Guinness Eye Center Onitsha between January and April 2007 were interviewed on the use of traditional eye medicines and the type of traditional eye medicine used. Results: Of the 500 patients interviewed; 66 (13.2) had used traditional eye medicines (TEM). The 66 patients; aged 18-84; were made up of 32 males and 34 females. The commonly used TEM were liquid from plant leaves and roots and other concoctions of unknown origin. Conjunctivitis and cataract constituted 54.5of the ocular problems; 15(22.7) patients had visual impairment while 5(7.6) other patients were blind. Risk factors for TEM use include age above 50 years (P0.001); residence outside Onitsha metropolis (P0.001) or 0.05); chronic nature (P0.05) or painfulness of the ocular disease (P0.05). Conclusions: Traditional eye medicine is highly patronized by the people. Health education programmes with emphasis on safe eye care practices need be intensified in traditional healers and among the groups at risk

Documentation on Medicinal Plants Sold in Markets in Publications; Nigeria

Purpose: To document the medicinal values; local names; method of preparation; dosage forms and parts of common medicinal plants sold in some markets in Abeokuta; Nigeria. Methods: Ethnobotanical data were collected by oral interview and with the aid of a structured questionnaire administered to men; women and young girls. The data from respondents from the five local markets surveyed were documented. Results: The results show that a total of 60 medicinal plant species are commonly used by the people of Abeokuta in their traditional health care system. Most of the plant materials were in dried form and sold singly or in combination with other plants and are used in the treatment of various ailments such as malaria; hypertension; typhoid; jaundice; hyperthermia; skin irritations; dysentery; anaemia; gonorrhea; cough; measles and fibroid. A majority of the plants were trees. The respondents were women (64.3); young girls (28.5) and men (7.14). Conclusion: The findings support the need to encourage domestication and cultivation of medicinal plants as well as put in place conservation measures to ensure sustainable source of medicinal plants

Antimicrobial Activity of 23 Endemic Plants in Madagascar

Purpose: To screen the crude methanol extracts obtained from 23 endemic plants in Madagascar for antimicrobial activity. Methods: In order to assess the antimicrobial properties of the extracts; their minimum inhibitory concentrations (MICs) were obtained using the broth microdilution method. The six test pathogenic species used were Bacillus subtilis; Staphylococcus aureus; Escherichia coli; Salmonella typhi; Pseudomonas aeruginosa and Candida albicans. Bioautography agar overlay test and phytochemical screening were also performed on the most active extracts. Results: From the 23 plants tested; 16 of which are used in traditional medicine; Poivrea phaneropetala Combretaceae); Koehneria madagascariensis (Lythraceae) and Rhopalopilia perrieri (Opiliaceae) exhibited the broad spectrum of activity; being active against all the test organisms; while Monoporus clusiifolius (Myrsinaceae) showed the strongest antifungal activity against Candida albicans with a minimal inhibitory concentration of 0.250 mg/ml. Bioautography and phytochemical analysis of the five active extracts against bacterial strains and of one active extract against C. albicans indicate that the active compounds responsible for antimicrobial activity may be mainly flavonoids and/or terpenes. Conclusion: These preliminary results are the first antimicrobial studies on these of some of them in traditional medicine

An Overview of the Traditional Medicine Situation in the African Region

"WHO estimates that about 80of the population in developing countries depends on traditional medicine for their Primary Health Care (PHC) needs. Traditional medicine and its practitioners were officially recognized by the Alma Ata Declaration in 1978 as important resources for achieving Health for All. Since then; member states and WHO governing bodies have adopted a number of resolutions and declarations on traditional medicine. Notable among these are resolution on ""Promoting the role of traditional medicine in health systems: A Strategy for the African Region"" adopted by the WHO Regional Committee for Africa in Ouagadougou; Burkina Faso; in 2000 and the declaration on the Decade of African Traditional Medicine (2001-2010) by the Heads of State and government in Lusaka in 2001. This article will focus on the achievements of countries in the implementation of the priority interventions of the Regional strategy since its adoption in 2000. The article will also cover the challenges countries are facing in implementing the Regional strategy and propose the way forward."