Integration of traditional herbal medicines among the indigenous communities in Thiruvarur District of Tamil Nadu, India

Background: Ethnobotanical studies are recognized as effective methods of finding locally importantplants for discovery of crude drugs. Siddha medicinal system is prevailed in south Indian states principally in Tamil Nadu and gaining recognition as alternative medicine among the indigenous communitiesfor their primary healthcare needs.Objectives: The study was aimed to explore and document folk medicinal plant knowledge among thelocal people in Puliyankudi village of Thiruvarur District, Tamil Nadu, India.Materials and methods: An ethnobotanical study was carried out during February 2016 to January 2017among the local people in study area. Traditional healers, traders, local vendors and local people who arepracticing herbal medicines were approached for documentation of folk medicinal uses. Acquired resultswere further analyzed with descriptive statistical methods such as use value (UV) and informantconsensus factor (ICF).Results: During the survey, a total 116 plant species from 49 families and 103 genera were recorded totreat 73 types of ailments. Among the plant parts used for preparation of medicine, leaves (73 reports)are often used and predominant method of preparation of medicine is paste (56 reports). Limoniaacidissima was reported by all the interviewed informants with an UV of 0.98 and kidney problems havehighest ICF value of 0.91.Conclusion: Plants with highest use values in the study indicates possible occurrence of valuable metabolites and should be investigated for associated pharmacological activities which leads to development of potential new drugs to treat various ailments.© 2017 Transdisciplinary University, Bangalore and World Ayurveda Foundation. Publishing Services byElsevier B.V. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/)

Ethno-medicinal Use of Crotalaria retusa L. (Fabaceae), a Pyrrolizidine Alkaloid Toxic Plant

Objective:This current study was designed to investigate the ethno-medicinal uses of C. retusaand to learn about the knowledges of its toxicity. Methods: Questionnaires were administered to herbalists and traditional healers from Ouagadougou town in national language Mooré or Dioula. Data on the ethno-medicinal use of C. retusa, the plant part used, the modes of preparation and administration and the knowledges on its toxicity were collected for each interviewed respondents. Relative frequency of citation of each disease was calculated using Microsoft Excel softwareResults: C. retusais mentioned by all the respondents to be used in the folklore system of medicine for the treat of various diseases including infectious and psychotropic diseases. Nine (09) diseases treated with C. retusa have been cited by respondents. The most diseases cited were congenital syphilis (72.5%) followed by malaria (7.5%)and hallucinations (7.5%). The whole plantis more used and the decoction is the main form of preparation. The main modes of the administration of the drug were purgative, drink and bath. The toxicity of C. retusa hasn’t been stated by no respondents.Conclusion:C. retusa is a potent medicinal plant of the folklore system medicine of Burkina Faso.A general lack of knowledge on the potential toxicity of this plant among the herbalists and traditional healers is also evident. Further investigations are necessary to inform about the toxicity of this plant and preventive measures to undertake for the prevention of any intoxication.

Interpretações locais sobre a malária e o discurso sobre os provedores tradicionais de cuidados de saúde no sul de Moçambique / Local interpretations on malaria and the discourse on the traditional health care providers in southern Mozambique

As narrativas sobre o diagnóstico e as causas da malária são diversas e aparentemente ambíguas, sendo baseadas para além do corpo, nas relações sociais estabelecidas entre pares, os seus antepassados e a natureza. Com base num estudo qualitativo e na permanência em Moçambique durante quatro anos, este artigo pretende analisar os discursos dos pacientes e praticantes biomédicos sobre os provedores de cuidados de saúde tradicionais, isto é, tinyanga e pastores ziones, articulando-os com as terminologias locais da malária, num distrito rural no sul de Moçambique. No atual contexto de pluralismo terapêutico e elevada mobilidade, a falta de compaixão e solidariedade atribuída aos tinyanga é fundamentada pela monetarização e comoditização dos seus saberes e rituais medicinais, bem como pela competição com outros provedores na captação de doentes. A implantação das igrejas ziones, de cariz cristão e com práticas terapêuticas semelhantes às dos tinyanga, apresenta-se como uma solução local vantajosa devido à forte ligação comunitária, ao consolo e reciprocidade entre os seus membros e aos resultados terapêuticos a baixo custo. No nível das políticas de saúde e da prática clínica, a invisibilidade dos pastores ziones e o papel subalterno dos tinyanga é gerido à medida dos interesses, das ideias vagas e dos preconceitos que os provedores biomédicos possuem sobre esses provedores terapêuticos. A implementação de políticas de saúde que atendam à diversidade local, às relações de poder existentes e aos conhecimentos e práticas médicas podem fortalecer os cuidados biomédicos prestados e harmonizar as relações entre os provedores e a população.

The narratives on the diagnosis and causes of malaria are diverse and apparently ambiguous, being based beyond the body, on the social relations among peers, their ancestors, and nature. Based on a qualitative study and a four-year stay in Mozambique, this article analyzes the discourses of patients and biomedical practitioners on traditional health care providers, i.e., tinyanga and zion pastors, linking them to local terminology of malaria, in a rural district in southern Mozambique. In the current context of therapeutic pluralism and high mobility, the lack of solidarity and compassion attributed to tinyanga is supported by the monetization and commodification of their medicinal rituals and knowledge, as well as by competition with other providers in attracting patients. The implementation of zion churches, of Christian nature and performing therapeutic practices similar to tinyanga, is presented as a local advantageous solution due to the strong community connection, the comfort and reciprocity among the members, and the therapeutic results at low cost. In terms of health care policies and clinical practice, the invisibility of zion pastors and the subordinate role of healers is managed according to interests, based on vague ideas and prejudices from biomedical providers. The implementation of health policies that address the local diversity, the existing power relations and medical knowledge and practices can strengthen the biomedical care services and harmonize relations between the providers and the population.

Screening Utility, Local Perceptions, and Care-seeking for Reported Jaundeesh among Respondents Lacking Signs of Icterus in Rural Bangladesh.

In rural Bangladesh, acute viral hepatitis presents a significant burden on the public-health system. As part of the formative work for a large epidemiologic study of hepatitis E in rural Bangladesh, we sought to identify local terms that could be used for population-based screening of acute viral hepatitis. Exploration of the local term jaundeesh for screening utility identified a high burden of reported jaundeesh among individuals without symptoms of icterus. Recognizing that local perceptions of illness may differ from biomedical definitions of disease, we also sought to characterize the perceived aetiology, care-seeking patterns, diagnostic symptoms, and treatments for reported jaundeesh in the absence of icteric symptoms to inform future population-based studies on reported morbidities. We conducted a cross-sectional survey among 1,441 randomly-selected subjects to identify the prevalence of reported jaundeesh and to test the validity of this local term to detect signs of icterus. To characterize the perceived aetiology and care-seeking patterns for jaundeesh among the majority of respondents, we conducted in-depth interviews with 100 respondents who self-reported jaundeesh but lacked clinical signs of icterus. To describe diagnostic symptoms and treatments, in-depth interviews were also performed with 25 kabirajs or traditional faith healers commonly visited for jaundeesh. Of the 1,441 randomly-selected participants, one-fourth (n=361) reported jaundeesh, with only a third (n=122) reporting yellow eyes or skin, representative of icterus; Jaundeesh had a positive predictive value of 34% for detection of yellow eyes or skin. Anicteric patients with reported jaundeesh perceived their illnesses to result from humoral imbalances, most commonly treated by amulets, ritual handwashing, and bathing with herbal medicines. Jaundeesh patients primarily sought folk and spiritual remedies from informal care providers, with only 19% visiting allopathic care providers. Although the local term jaundeesh appeared to have limited epidemiologic utility to screen for acute symptomatic viral hepatitis, this term described a syndrome perceived to occur frequently in this population. Future population-based studies conducting surveillance for acute hepatitis should use caution in the use and interpretation of self-reported jaundeesh. Further study of jaundeesh may provide insight into the appropriate public-health response to this syndrome.

Health Seeking Behaviour and MCH Care Practices in Fishermen Community.

Background: All people, whether rural or urban, have their own beliefs and practices concerning health and disease. It is now widely recognized that cultural factors are deeply involved in all affairs of man, including health and sickness. The problem affecting the health of the mother and the child are multi-factorial. Despite current efforts, the health of the mother and the child still constitutes one of the most serious health problems affecting the community, particularly in the developing countries. Objectives: The following study was carried out to find the: i) Health seeking behaviour of mother for illnesses in children; ii) Status of antenatal care and postnatal care amongst women of fishermen community. Materials and Methods: Women of fishermen community in the Macchipura area of Khambat falling in the age group of 15-45 and having at least one child in the age group 1-2 year (above 1year and less than 2 years) were selected for the study. Results and Conclusions: A total of 64(87.6 %) mothers would like to go to a doctor in case of medical needs. 22(30.13%) mothers took ANC. All the 22 mothers were given TT injection as well as Iron folic acid tablets. Blood pressure was measured in 21 women and also the weight was taken in these women. 66 (90.41%) deliveries were conducted by trained dai in that area. Antenatal and postnatal care services need to be strengthened for these fisherwomen. The good thing was that a good proportion of mothers were willing to go to a doctor besides having an inclination to practice the traditional ways.

‘First we go to the small doctor’: First contact for curative health care sought by rural communities in Andhra Pradesh & Orissa, India.

Background & objectives: Against the backdrop of insufficient public supply of primary care and reports of informal providers, the present study sought to collect descriptive evidence on 1st contact curative health care seeking choices among rural communities in two States of India - Andhra Pradesh (AP) and Orissa. Methods: The cross-sectional study design combined a Household Survey (1,810 households in AP; 5,342 in Orissa), 48 Focus Group Discussions (19 in AP; 29 in Orissa), and 61 Key Informant Interviews with healthcare providers (22 in AP; 39 in Orissa). Results: In AP, 69.5 per cent of respondents accessed non-degree allopathic practitioners (NDAPs) practicing in or near their village; in Orissa, 40.2 per cent chose first curative contact with NDAPs and 36.2 per cent with traditional healers. In AP, all NDAPs were private practitioners, in Orissa some pharmacists and nurses employed in health facilities, also practiced privately. Respondents explained their choice by proximity and providers’ readiness to make house-calls when needed. Less than a quarter of respondents chose qualified doctors as their first point of call: mostly private practitioners in AP, and public practitioners in Orissa. Amongst those who chose a qualified practitioner, the most frequent reason was doctors’ quality rather than proximity. Interpretation & conclusions: The results of this study show that most rural persons seek first level of curative healthcare close to home, and pay for a composite convenient service of consulting-cum-dispensing of medicines. NDAPs fill a huge demand for primary curative care which the public system does not satisfy, and are the de facto first level access in most cases.

Effect of aqueous extract of Terminalia catappa leaves on the glycaemia of rabbits.

Diabetes is a disease which affects 5% of Côte-d’Ivoire population. This is a worrying prevalence rate. Our search for means of fighting this affection made us to develop an herbal medicine from decoction of Terminalia catappa leaves. During the experience we carried out, rabbits received, orally, a solution of glucose (4 g/l). As treatment, the hyperglycaemic rabbits were given, glibenclamide (0.25 mg/ml) and herbal medicine to drink, 0.6 ml per 20 grams of body weight. Before administration of glucose overload, the animals had a basal glycaemia of 1.11 g/l. The not treated rabbits’ glycaemia increased and reached 1.39 g/l. The oral administration of glibenclamide lowers blood sugar at 0.86 g/l, after 180 minutes. At 2.5 mg/ml, the herbal medicine does not induce a significant hypoglycaemic effect. At 10 mg/ml, it decreases the hyperglycaemia to 1.05 g/l. At 40 mg/ml, it induces a significant decrease in blood glucose. A fall of 30% was observed. At 40 mg/ml, its effect on hyperglycaemic rabbits is compared to glibenclamide (0.25 mg/ml). The glibenclamide exerts on normoglycaemic rabbits a significant basal glucose-lowering effect unlike herbal medicine. The herbal medicine appears like an antidiabetic and produces its hypoglycaemic effect mainly through alkaloids, sterols or triterpens.

Effect of aqueous extract of boerhavia diffusa leaves on the glycaemia of rabbits.

Diabetes touches approximately 5% of Côte-d’Ivoire population. This is a worrying prevalence rate. Our search for means of fighting this affection made us to develop an herbal medicine from decoction of Boerhavia diffusa leaves. An ethnopharmacological survey conducted in villages of Côted’Ivoire, made us discovered that Boerhavia diffusa is used by traditional healers as antidiabetic. In Laboratory, during the experience we carried out, rabbits received, orally, a solution of glucose (4 g/l). Before administration of glucose, the animals had a basal glycaemia of 1.11 ± 0.04 g/l. The not treated rabbits’ glycaemia increased and reached 1.39 g/l. The oral administration of glibenclamide lowers blood sugar at about 0.86 g/l, after 180 minutes. The others hyperglycaemic rabbits were given herbal medicine to drink, 0.6 ml per 20 grams of body weight. At 2.5 mg/ml, the phytomedicine does not induce hypoglycaemic effect. At 10 mg/ml, it makes the hyperglycaemia go down from 1.17 g/l to 0.91 g/l. At 40 mg/ml, it induces a significant decrease in blood glucose. A fall of 34 % was observed, 180 minutes later. The glibenclamide exerts a significant basal glucose-lowering effect. The herbal medicine exerts on basal glycaemia a deep action and can induce, at 40 mg/ml, a hypoglycaemic coma. The effect of herbal medicine (40 mg/ml) on hyperglycaemic rabbits is compared to glibenclamide (0.25 mg/ml). The herbal medicine has a hypoglycemic effect and appears like an antidiabetic and produces its hypoglycaemic effect mainly through alkaloids, sterols or triterpens.

¿Colonialismo biomédico o autonomía de lo local? Sanadores tradicionales contra la tuberculosis / Biomedical colonialism or local autonomy? Local healers in the fight against tuberculosis

Analiza el papel de los agentes médicos autóctonos y sus conocimientos en las campañas antituberculosas contemporáneas en el África subsahariana. Sitúa la medicina contemporánea, llevada a cabo en África en la herencia cultural de la medicina colonial, para comprender el marco histórico en el que se desarrollaron, a partir de los años setenta del siglo XX, las estrategias de la Organización Mundial de la Salud de promoción y desarrollo de las medicinas 'tradicionales'. En los proyectos sanitarios analizados, se evalúan las prácticas médicas locales y se entrenan a los agentes autóctonos para integrarlos en actividades estrictamente biomédicas: identificación de síntomas, remisión a hospitales o supervisión de tratamientos farmacológicos.

The article explores the role played by indigenous medical agents, and their knowledge, within contemporary tuberculosis campaigns in sub-Saharan Africa. To understand the historical framework within which the World Health Organization devised its strategies to promote and develop traditional medicine as of the 1970s, the article contextualizes contemporary medicine as a cultural legacy of colonial medicine. Under the public healthcare projects analyzed in the article, local medical practices were assessed and indigenous agents trained so they could take part in strictly biomedical activities, like symptom identification, referrals to hospitals, or supervision of drug treatments.