Medical pluralism on Mfangano Island: Use of medicinal plants among persons living with HIV/AIDS in Suba District, Kenya

Jason M. Nagata, Alan R. Jew, John M. Kimeu, Charles R. Salmen, Elizabeth A. Bukusi, Craig R. Cohen

Research output: Contribution to journalArticlepeer-review

36 Scopus citations

Abstract

Ethnopharmacological relevance: Given the increasing coverage of antiretroviral therapy (ART) for HIV/AIDS treatment as well as the high utilization of herbal medicine, many persons living with HIV/AIDS in sub-Saharan Africa are thought to practice medical pluralism, or the adoption of more than one medical system for their care and treatment. Using a cross-sectional study we sought to document and identify the herbal medicines used by persons living with HIV/AIDS on Mfangano Island, Suba District, Nyanza Province, Kenya. Materials and methods: We interviewed herbalists and knowledgeable mothers to obtain information regarding medicinal plants, particularly for HIV/AIDS-related symptoms, HIV/AIDS, and chira (an illness concept with similarities to HIV/AIDS regarding sexual transmission and wasting symptoms). Using systematic sampling, 67 persons living with HIV/AIDS (49 of whom were receiving ART) were selected from an Mfangano Island health clinic and participated in semi-structured interviews. Results: Interviews with herbalists and mothers identified 40 plant species in 37 genera and 29 families that a person with HIV/AIDS or chira could use for herbal remedies. Overall, 70.1% of persons living with HIV/AIDS had used medicinal plants after HIV diagnosis, most commonly to treat symptoms related to HIV/AIDS. In addition to common vegetables and fruits that can serve medicinal purposes, Azadirachta indica A. Juss. (Meliaceae), Carissa edulis (Forssk.) Vahl (Apocynaceae), and Ximenia americana L. (Olacaceae) were the most frequently cited medicinal plants used by persons living with HIV/AIDS. Conclusions: Collaboration and communication between biomedical clinicians and herbalists should be encouraged given high rates of concomitant ART-herb usage. Pharmacological, toxicological, and ART-herb interaction studies based on the plants identified in this study and their constituent ingredients should be considered.

Original languageEnglish (US)
Pages (from-to)501-509
Number of pages9
JournalJournal of Ethnopharmacology
Volume135
Issue number2
DOIs
StatePublished - May 17 2011
Externally publishedYes

Bibliographical note

Funding Information:
A cross-sectional, mixed method study design was used in this investigation, which included qualitative and quantitative components. Ethnographic qualitative data included participant observation and in-depth open-ended interviews while quantitative data included semi-structured questionnaires conducted in March to April 2009. Ethical approval for this research was provided by the Central University Research Ethics Committee at the University of Oxford and the Suba District Medical Officer of Health.

Funding Information:
Thanks to Annika Terrana, Merlin Willcox, Nadine Levin, Elisabeth Hsu, and Caroline Potter for advice, assistance, and editorial guidance. Insights into Luo and Suba culture and on-site guidance in Mfangano Island were greatly appreciated from Joel Oguta, Eve Oguta, Richard Magarenge, Agnetta Ouma, Samwel Ouma, and the FACES, Ministry of Health, Organic Health Response, and Ekialo Kiona Center staff. This research was made possible by grants from the E.O. James Bequest, All Souls College, University of Oxford, as well as the Dean's Summer Research Fellowship, the Pathways to Discovery Student Research Fellowship in the Social and Behavioral Sciences, and the Global Health Framework Program, University of California, San Francisco.

Keywords

  • Africa
  • Ethnobotany
  • HIV/AIDS
  • Herbal medicine
  • Herbalists
  • Kenya
  • Luo
  • Medicinal plants
  • Nyanza Province
  • Suba
  • Traditional remedies

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