Stanifer John W, Patel Uptal D, Karia Francis, Thielman Nathan, Maro Venance, Shimbi Dionis, Kilaweh Humphrey, Lazaro Matayo, Matemu Oliver, Omolo Justin, Boyd David
Department of Medicine, Duke University, Durham, North Carolina, United States of America; Duke Global Health Institute, Duke University, Durham, North Carolina, United States of America.
Department of Medicine, Duke University, Durham, North Carolina, United States of America; Duke Clinical Research Institute, Duke University, Durham, North Carolina, United States of America.
PLoS One. 2015 Apr 7;10(4):e0122638. doi: 10.1371/journal.pone.0122638. eCollection 2015.
Traditional medicines are an important part of healthcare in sub-Saharan Africa, and building successful disease treatment programs that are sensitive to traditional medicine practices will require an understanding of their current use and roles, including from a biomedical perspective. Therefore, we conducted a mixed-method study in Northern Tanzania in order to characterize the extent of and reasons for the use of traditional medicines among the general population so that we can better inform public health efforts in the region.
Between December 2013 and June 2014 in Kilimanjaro, Tanzania, we conducted 5 focus group discussions and 27 in-depth interviews of key informants. The data from these sessions were analyzed using an inductive framework method with cultural insider-outsider coding. From these results, we developed a structured survey designed to test different aspects of traditional medicine use and administered it to a random sample of 655 adults from the community. The results were triangulated to explore converging and diverging themes.
Most structured survey participants (68%) reported knowing someone who frequently used traditional medicines, and the majority (56%) reported using them themselves in the previous year. The most common uses were for symptomatic ailments (42%), chronic diseases (15%), reproductive problems (11%), and malaria/febrile illnesses (11%). We identified five major determinants for traditional medicine use in Northern Tanzania: biomedical healthcare delivery, credibility of traditional practices, strong cultural identities, individual health status, and disease understanding.
In order to better formulate effective local disease management programs that are sensitive to TM practices, we described the determinants of TM use. Additionally, we found TM use to be high in Northern Tanzania and that its use is not limited to lower-income areas or rural settings. After symptomatic ailments, chronic diseases were reported as the most common reason for TM use which may be particularly important in Northern Tanzania where non-communicable diseases are a rapidly growing burden.
传统药物是撒哈拉以南非洲地区医疗保健的重要组成部分，要建立对传统医学实践敏感的成功疾病治疗方案，就需要了解其当前的使用情况和作用，包括从生物医学角度。因此，我们在坦桑尼亚北部开展了一项混合方法研究，以描述普通人群中传统药物的使用程度及原因，从而为该地区的公共卫生工作提供更充分的信息。
2013年12月至2014年6月期间，在坦桑尼亚的乞力马扎罗，我们进行了5次焦点小组讨论和对关键信息提供者的27次深入访谈。使用具有文化内部人 - 外部人编码的归纳框架方法对这些会议的数据进行分析。根据这些结果，我们制定了一项结构化调查，旨在测试传统药物使用的不同方面，并将其应用于来自社区的655名成年人的随机样本。对结果进行三角测量以探索趋同和分歧的主题。
大多数结构化调查参与者（68%）报告称认识经常使用传统药物的人，并且大多数（56%）报告自己在前一年使用过传统药物。最常见的用途是治疗症状性疾病（42%）、慢性病（15%）、生殖问题（11%）以及疟疾/发热性疾病（11%）。我们确定了坦桑尼亚北部使用传统药物的五个主要决定因素：生物医学医疗服务、传统实践的可信度、强烈的文化认同、个人健康状况以及对疾病的理解。
为了更好地制定对传统医学实践敏感的有效地方疾病管理方案，我们描述了传统药物使用的决定因素。此外，我们发现坦桑尼亚北部传统药物的使用率很高，并且其使用不限于低收入地区或农村地区。在症状性疾病之后，慢性病被报告为使用传统药物的最常见原因，这在非传染性疾病负担迅速增加的坦桑尼亚北部可能尤为重要。
