Department of Anthropology, University College London, London, UK.
UMR 152 Pharmadev, IRD, Université de Toulouse, France; Center for the Study of Human Health, Emory University, Atlanta, GA, USA.
J Ethnopharmacol. 2020 Mar 1;249:112187. doi: 10.1016/j.jep.2019.112187. Epub 2019 Aug 30.
Malaria is still a highly challenging public health issue in southern Lao PDR, with increasing cases of artemisinin resistance and Plasmodium vivax infections which are more complicated to treat. Traditional medicine has a long history of use in Laos, and is primarily practised by traditional village healers, who possess unique bodies of transmitted knowledge focused on herbal prescriptions, including those for the treatment of malaria. Villagers also use plants for healthcare in the home. The aim of the study is to document local fever concepts and use of herbal remedies, and examine whether they may have potential as complementary treatments against malaria.
The study took place in Champasak province in the far south of Laos, in primarily lowland areas. First, 35 traditional healers across the 10 districts of the province were interviewed to elicit details about knowledge and treatment of fevers. Second, a household survey was conducted in a village in a malaria-endemic area; 97 households were interviewed on fever incidence, differentiation, treatment-seeking behaviour and knowledge of plant-based remedies for fevers. Plants indicated by both healers and villagers were collected and voucher specimens deposited in the herbarium of the National University of Laos for identification.
Malaria is a well-known pathology among the healers and villagers of lowland Champasak province; biomedical treatments are preferentially used, but traditional medicine is a popular complementary method, especially in chronic cases with additional symptoms. 30 different fever types were recorded, which were usually named symptomatically, and grouped into 12 categories. Some were described as forms of malaria, which was conceived as a dynamic, changing pathology affecting many body systems. Healers formulate treatments based on symptoms and the person's constitution, and with the intention of creating specific pharmacological actions associated with temperature or flavours. 11 of the healers gave prescriptions for malaria (27 in total), including 47 identified plant species. The most-used plants (4 or more use-reports) were also the most cited in the literature for use against malaria, demonstrating a correspondence between Lao healers and other traditional medical systems. Furthermore, some of these species show promising results for future research, especially Amorphophallus paeniifolius (Dennst.) Nicolson and Alocasia macrorrhizos (L.) G. Don.
Traditional healers are important actors in the treatment of malaria in southern Laos, and herbal remedies should be evaluated further by the use of reverse treatment outcome trials, especially those which may be of use as complementary remedies in treating P. vivax. Initiatives on knowledge transmission, medicinal plant conservation and healthcare integration are also urgently needed.
疟疾仍然是老挝南部高度具有挑战性的公共卫生问题，青蒿素耐药性和间日疟原虫感染病例不断增加，治疗更为复杂。传统医学在老挝有着悠久的使用历史，主要由传统乡村治疗师实践，他们拥有独特的知识体系，专注于草药处方，包括治疗疟疾的处方。村民也在家中使用植物进行医疗保健。本研究的目的是记录当地发热概念和草药疗法的使用情况，并探讨它们是否具有作为疟疾辅助治疗的潜力。
该研究在老挝南部偏远的占巴塞省进行，主要在低地地区。首先，对全省 10 个区的 35 名传统治疗师进行了访谈，以了解他们对发热的知识和治疗方法。其次，在一个疟疾流行地区的村庄进行了家庭调查；对 97 户家庭进行了发热发生率、鉴别、求医行为以及植物性发热疗法知识的调查。由治疗师和村民共同指出的植物被采集，并将标本存放在老挝国立大学的标本馆中以供鉴定。
疟疾是占巴塞省低地地区的治疗师和村民熟知的一种病理学；生物医学治疗是首选方法，但传统医学是一种受欢迎的补充方法，尤其是在伴有其他症状的慢性病例中。记录了 30 种不同的发热类型，这些类型通常是根据症状命名的，并分为 12 类。其中一些被描述为疟疾的形式，疟疾被认为是一种影响许多身体系统的动态、变化的病理学。治疗师根据症状和人的体质制定治疗方案，并意图产生与温度或味道相关的特定药理作用。11 位治疗师开了疟疾处方（总共 27 种），其中包括 47 种鉴定的植物物种。使用次数最多的植物（有 4 次或以上的使用报告）也在文献中被引用最多，用于治疗疟疾，这表明老挝治疗师与其他传统医疗体系之间存在一致性。此外，这些物种中的一些显示出有前途的研究结果，特别是 Amorphophallus paeniifolius（Dennst.）Nicolson 和 Alocasia macrorrhizos（L.）G. Don。
传统治疗师在老挝南部治疗疟疾方面发挥着重要作用，草药疗法应通过反向治疗结果试验进一步评估，尤其是那些可能作为治疗间日疟原虫的补充疗法。此外，还迫切需要开展知识传播、药用植物保护和医疗保健整合方面的举措。
