Phytopharmaceutical practices of traditional health practitioners in Burkina Faso: a cross-sectional study.

BACKGROUND: Traditional health practitioners constitute an important part of the health care system in Burkina Faso, particularly in the supply of traditional herbal medicines. Quality and safety of these medicines rely heavily on practices employed during their traditional development. However, traditional phytopharmaceutical practices are poorly described in Burkina Faso. This study aimed to describe the phytopharmaceutical practices of traditional medicine practitioners in Burkina Faso. METHODS: This was a cross-sectional descriptive ethno-pharmaceutical study, conducted from October 1 to November 30, 2020, among traditional practitioners in four randomly selected health districts: Nongr-Massom (Centre region), Tenkodogo (Centre-East region), Diapaga (East region) and Dafra (Hauts-Bassins region). An anonymous semi-structured face-to-face questionnaire was used to collect socio-demographic data and data on raw materials and finished products. RESULTS: Sixty-seven (67) traditional health practitioners, aged 56 years on average, including a majority of men (72%), participated in the study. Gathering of wild medicinal plants was the main source of raw materials acquisition (51.5%), which were usually leaves (32.3%). These raw materials were usually sun-dried (43.9%) and packaged mostly in plastic bags (37.2%). They were derived from 60 plant species belonging to 33 botanical families. Fabaceae was the most represented family (18.7%) and Khaya senegalensis Juss. (Meliaceae) the most cited plant species (5.2%). The finished products had an average shelf life of 17 months and were usually prepared as a decoction (31.7%) and administered most often orally (71.4%). Gastrointestinal disorders were the main predictable adverse events of the finished products (54%). CONCLUSION: This study showed that THPs have important knowledge in the use of medicinal plants, but several shortcomings are observed in their phytopharmaceutical and plant protection practices. Continuous improvement of these practices, through education and training of traditional health practitioners, is essential for the conservation of plant biodiversity and quality assurance of traditional herbal medicines.

Use of traditional medicines among conventional medicine practitioners in Burkina Faso / Utilisation des médicaments traditionnels chez les praticiens de la médecine conventionnelle au Burkina Faso

INTRODUCTION: The integration of traditional medicine into biomedical health care practice is highly dependent on its acceptability by conventional medical practitioners. Its use by conventional practitioners was previously unknown in Burkina Faso. PURPOSE OF RESEARCH: The purpose of this study was to estimate the prevalence of traditional medicine use and the frequency of occurrence of adverse events associated with this use among conventional medical practitioners in Burkina Faso. RESULTS: The majority of the practitioners surveyed were women (56.1%) and the average age was 39.7±7 years. Nurses (56.1%), midwives (31.4%) and physicians (8.2%) were the most represented professions. The prevalence of the use of traditional medicines in the 12 months preceding the survey was 75.6%. Malaria was the main medical reason for using traditional medicines (28%). The frequency of reported adverse events was 10% and mainly concerned gastrointestinal disorders (78.3%). CONCLUSIONS: The majority of conventional medical practitioners in Burkina Faso use traditional medicines for their health problems. This finding suggests the effective integration of traditional medicine into biomedical health care practice which could benefit from good acceptability by these professionals.

Introduction: L'intégration de la médecine traditionnelle dans le système de santé moderne est fortement dépendante de son acceptabilité par les praticiens de ce système. Leur recours à la médecine traditionnelle était jusque-là méconnu au Burkina Faso. But de l'étude: Le but de cette étude était d'estimer la prévalence de l'utilisation des médicaments traditionnels et la fréquence de survenue des événements indésirables parmi les praticiens de santé conventionnels au Burkina Faso. Résultats: La majorité des praticiens enquêtés étaient des femmes (56,1 %) et l'âge moyen s'établissait à 39,7 ±7 ans. Les infirmiers (56,1 %), les sages-femmes (31,4 %) et les médecins (8,2 %) étaient les professions les plus représentées. La prévalence de l'utilisation de médicaments traditionnels durant les douze mois précédant l'enquête était de 75,6 %. Le paludisme apparaissait comme la principale raison médicale du recours aux médicaments traditionnels (28 %). La fréquence des événements indésirables rapportés s'élevait à 10 % et concernaient principalement des troubles gastro-intestinaux (78,3 %). Conclusions: Les praticiens de la médecine conventionnelle ont largement recours aux médicaments traditionnels. Cela suggère l'intégration effective de la médecine traditionnelle dans la pratique biomédicale des soins et la surveillance des risques associés à cette utilisation.

Current Status and Challenges of Pharmacovigilance of Traditional Medicines in French-Speaking West African (UEMOA) Countries.

BACKGROUND: West African Economic and Monetary Union (UEMOA) countries are characterised by a high prevalence of informal use of medicinal plants and traditional medicines by their population for health care, requiring the establishment of pharmacovigilance, in order to monitor the associated health risks. However, the state of implementation of pharmacovigilance for traditional medicines in UEMOA countries is not known. OBJECTIVE: This study aimed to assess the state of implementation of pharmacovigilance for traditional medicines in the eight UEMOA countries, describing the relevant community provisions, assessing the integration of traditional medicines monitoring into national pharmacovigilance systems and identifying related national challenges. METHODS: This was a cross-sectional study using questionnaires, conducted between 1 May and 31 August 2022. A face-to-face questionnaire was administered to officials responsible for the issue within UEMOA and the West African Health Organisation (WAHO). A second online questionnaire was specifically sent to the pharmacovigilance focal points of the eight UEMOA countries. Questionnaires were designed using the WHO indicators for pharmacovigilance. The face-to-face questionnaire collected two types of data, namely community policies and regulations on pharmacovigilance and technical and financial support from sub-regional organisations to countries. The online questionnaire sent to countries collected four categories of data on the study issue: structural data, process data, impact data and data on national challenges. RESULTS: As a community provision, WAHO has a harmonised regulatory framework for phytovigilance. The monitoring of traditional medicines is not effectively implemented in the pharmacovigilance systems of UEMOA countries. Only two reports of adverse events due to traditional medicines have so far been recorded in the Union. The countries have neither funding nor sufficient human resources for pharmacovigilance in general. Monitoring of traditional medicines in the unregulated market, training of stakeholders, risk communication, and integration of traditional health practitioners in reporting systems are the main challenges of countries for the development of pharmacovigilance for traditional medicines. CONCLUSION: The effective compliance of WAHO's harmonised phytovigilance regulatory framework by UEMOA countries and addressing the challenges identified by the countries constitute the basis for the development of pharmacovigilance for traditional medicines within UEMOA.

[The Chair of the medical chemistry department at the Faculty of Medicine and the Chair of chemistry at the School of Pharmacy of Strasbourg (1794-1871)]. / La chaire de chimie médicale de la Faculté de médecine et la chaire de chimie de l'Ecole de pharmacie de Strasbourg (1794-1871).

Strasbourg occupied during the 19th century a privileged place in chemistry, as well in education as in research, and that in particular in three institutions created after the dissolution of the old University during the French Revolution: the Faculty of Sciences, the School then Faculty of Medicine created in 1794, and the School of Pharmacy created in 1804. In 1871, Alsace was annexed by Germany. The chair of medical chemistry in the Faculty of Medicine was successively occupied by: Pierre François Nicolas (1743-1816) in 1794-1795, Frédéric Louis Ehrmann (1741-1801) from 1796 to 1798, Gabriel Masuyer (1761-1849) from 1798 to 1838, and Amédée Cailliot (1805-1884) from 1838 to 1871. The chair of chemistry in the School of Pharmacy was successively occupied by: Louis Hecht (1771-1857)from 1804 to 1835, Jean François Persoz (1805-1868) from 1835 to 1852, Adrien Loir (1816-1899) from 1852 to 1855, Charles Frédéric Gerhardt and Eugène Théodore Jacquemin (1828-1909) from 1856 to 1871.

[The imperial School of the Service of military health of Strasbourg (1856-1870)]. / L'Ecole impériale du Service de santé militaire de Strasbourg (1856-1870).

Heiress of an important tradition of teaching, the School of Pharmacy from Strasbourg created in 1803 trained numerous chemists whose numerous held important positions in the Health Service of the armies. The creation of the imperial School of the military Health service in Strasbourg in 1856 and its difficult beginnings due to unsuitable premises represented from Strasbourg an economic opportunity and a chance for the Faculty of Medicine. The integration of the chemists into the imperial School in 1864 will confirm the distinguished role of the School of Pharmacy into the pharmaceutical teaching until 1870.

[Pharmacists at the imperial School of the Service of military health of Strasbourg (1856-1870)]. / Les pharmaciens à l'Ecole impériale du Service de santé militaire de Strasbourg (1856-1870).

The nineteenth century caused significant upheavals in numerous fields like techniques, in philosophy and in politics. Military pharmacy took advantage of this transition period. Military chemists became regular soldiers and officers: their training became resolutely scientific and their assignments covered extensive fields. Heiress of an important tradition of teaching, the School of Pharmacy from Strasbourg trained numerous chemists whose held important positions in the Health Service of the armies. The creation of the imperial School of the military Health service in Strasbourg in 1856 and the integration of the chemists in this School in 1864 represented the height of the pharmaceutical teaching in the Alsatian capital city. The attendance of the military students and their sacrifices during the siege in 1870 marked the memory of their contemporaries from Strasbourg.