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1.  Traditional Medicine and Childcare in Western Africa: Mothers’ Knowledge, Folk Illnesses, and Patterns of Healthcare-Seeking Behavior 
PLoS ONE  2014;9(8):e105972.
In spite of the strong role of traditional medicine in childcare in the pluralistic healthcare system in Western Africa, little information is known on mothers’ domestic plant knowledge. Identifying local perspectives and treatments of children’s illnesses, including folk illnesses, is essential to having a comprehensive understanding of how mothers make healthcare treatment decisions. We aimed to identify which infant illnesses Beninese and Gabonese mothers knew to treat with medicinal plants and for which illnesses they sought biomedical care or traditional healers.
We conducted 81 questionnaires with mothers in Bénin and Gabon and made 800 botanical specimens of cited medicinal plants. We calculated the number of species cited per illness and the proportion of participants knowledgeable on at least one herbal remedy per illness. Using qualitative data, we described folk illnesses in each country and summarized responses on preferences for each of the three healthcare options.
Participants from both countries were most knowledgeable on plants to treat respiratory illnesses, malaria, diarrhea, and intestinal ailments. Mothers also frequently mentioned the use of plants to encourage children to walk early, monitor the closure of fontanels, and apply herbal enemas. Major folk illnesses were atita and ka in Bénin and la rate and fesses rouges in Gabon. Traditional healers were reported to have specialized knowledge of cultural bound illnesses. Malaria was frequently cited as an illness for which mothers would directly seek biomedical treatment.
Mothers largely saw the three systems as complementary, seamlessly switching between different healing options until a remedy was found. Folk illnesses were found to give insight into local treatments and may reveal important neglected diseases. Due to high reported levels of knowledge on treating top statistical causes of infant mortality and folk illnesses, mothers’ medicinal plant knowledge should be included in the analysis of healthcare-seeking behavior for childcare.
PMCID: PMC4141852  PMID: 25147924
2.  Melastoma malabathricum (L.) Smith Ethnomedicinal Uses, Chemical Constituents, and Pharmacological Properties: A Review 
Melastoma malabathricum L. (Melastomataceae) is one of the 22 species found in the Southeast Asian region, including Malaysia. Considered as native to tropical and temperate Asia and the Pacific Islands, this commonly found small shrub has gained herbal status in the Malay folklore belief as well as the Indian, Chinese, and Indonesian folk medicines. Ethnopharmacologically, the leaves, shoots, barks, seeds, and roots of M. malabathricum have been used to treat diarrhoea, dysentery, hemorrhoids, cuts and wounds, toothache, and stomachache. Scientific findings also revealed the wide pharmacological actions of various parts of M. malabthricum, such as antinociceptive, anti-inflammatory, wound healing, antidiarrheal, cytotoxic, and antioxidant activities. Various types of phytochemical constituents have also been isolated and identifed from different parts of M. malabathricum. Thus, the aim of the present review is to present comprehensive information on ethnomedicinal uses, phytochemical constituents, and pharmacological activities of M. malabathricum.
PMCID: PMC3254175  PMID: 22242040
3.  Ethnomedicine and ethnobotany of fright, a Caribbean culture-bound psychiatric syndrome 
"Fright" is an English-speaking Caribbean idiom for an illness, or ethnomedical syndrome, of persistent distress. A parallel ethnopsychiatric idiom exists in the French Antilles as sésisma. Fright is distinct from susto among Hispanics, though both develop in the wake of traumatic events. West Indian ethnophysiology (ethnoanatomy) theorizes that an overload of stressful emotions (fear, panic, anguish or worry) causes a cold humoral state in which blood coagulates causing prolonged distress and increased risks of other humorally cold illnesses.
Qualitative data on local explanatory models and treatment of fright were collected using participant-observation, informal key informant interviews and a village health survey. Ethnobotanical and epidemiological data come from freelist (or "free-list") tasks, analyzed for salience, with nearly all adults (N = 112) of an eastern village in Dominica, and a village survey on medicinal plant recognition and use (N = 106).
Along with prayer and exercise, three herbs are salient fright treatments: Gossypium barbadense L., Lippia micromera Schauer, and, Plectranthus [Coleus] amboinicus [Loureiro] Sprengel. The survey indicated that 27% of village adults had medicated themselves for fright. Logistic regression of fright suffering onto demographic variables of age, education, gender, parental status and wealth measured in consumer goods found age to be the only significant predictor of having had fright. The probability of having (and medicating for) fright thus increases with every year.
While sufferers are often uncomfortable recalling personal fright experiences, reporting use of medicinal plants is less problematic. Inquiry on fright medical ethnobotany (or phytotherapies) serves as a proxy measurement for fright occurrence. Cross-cultural and ethnopharmacology literature on the medicinal plants suggests probable efficacy in accord with Dominican ethnomedical notions of fright. Further, the cultural salience and beliefs about these medicines may give these medications extra psychoneuroimmune (i.e. mind-body) benefits, or placebo-like effects, for this stress-related folk illness.
PMCID: PMC3583188  PMID: 20163730
4.  Fauna used in popular medicine in Northeast Brazil 
Animal-based remedies constitute an integral part of Brazilian Traditional Medicine. Due to its long history, zootherapy has in fact become an integral part of folk medicine both in rural and urban areas of the country. In this paper we summarize current knowledge on zootherapeutic practices in Northeast of Brazil, based on information compiled from ethnobiological scientific literature.
In order to examine the diversity of animals used in traditional medicine in Northeast of Brazil, all available references or reports of folk remedies based on animals sources were examined. 34 sources were analyzed. Only taxa that could be identified to species level were included in assessment of medicinal animal species. Scientific names provided in publications were updated.
The review revealed that at least 250 animal species (178 vertebrates and 72 invertebrates) are used for medicinal purposes in Northeast of Brazil. The inventoried species comprise 10 taxonomic categories and belong to 141 Families. The groups with the greatest number of species were fishes (n = 58), mammals (n = 47) and reptiles (n = 37). The zootherapeutical products are used for the treatment of different illnesses. The most widely treated condition were asthma, rheumatism and sore throat, conditions, which had a wide variety of animals to treat them with. Many animals were used for the treatment of multiple ailments. Beyond the use for treating human diseases, zootherapeutical resources are also used in ethnoveterinary medicine
The number of medicinal species catalogued was quite expressive and demonstrate the importance of zootherapy as alternative therapeutic in Northeast of Brazil. Although widely diffused throughout Brazil, zootherapeutic practices remain virtually unstudied. There is an urgent need to examine the ecological, cultural, social, and public health implications associated with fauna usage, including a full inventory of the animal species used for medicinal purposes and the socio-cultural context associated with their consumption.
PMCID: PMC2628872  PMID: 19128461
5.  Health traditions of Sikkim Himalaya 
Ancient medical systems are still prevalent in Sikkim, popularly nurtured by Buddhist groups using the traditional Tibetan pharmacopoeia overlapping with Ayurvedic medicine. Traditional medical practices and their associated cultural values are based round Sikkim’s three major communities, Lepcha, Bhutia and Nepalis. In this study, a semi-structured questionnaire was prepared for folk healers covering age and sex, educational qualification, source of knowledge, types of practices, experience and generation of practice, and transformation of knowledge. These were administered to forty-eight folk healers identified in different parts of Sikkim.
490 medicinal plants find their habitats in Sikkim because of its large variations in altitude and climate. For 31 commonly used by these folk healers, we present botanical name, family, local name, distribution, and parts used, together with their therapeutic uses, mostly Rheumatoid arthritis, Gout, Gonorrhea, Fever, Viral flu, asthma, Cough and Cold, indigestion, Jaundice etc. A case treated by a folk healer is also recounted. This study indicates that, in the studied area, Sikkim’s health traditions and folk practices are declining due to shifts in socio-economic patterns, and unwillingness of the younger generation to adopt folk healing as a profession.
PMCID: PMC3087370  PMID: 21547046
Ayurveda; folk healers; medicinal plant; tibetan medicine
6.  Use of the evidence base in substance abuse treatment programs for American Indians and Alaska natives: pursuing quality in the crucible of practice and policy 
A variety of forces are now shaping a passionate debate regarding the optimal approaches to improving the quality of substance abuse services for American Indian and Alaska Native communities. While there have been some highly successful efforts to meld the traditions of American Indian and Alaska Native tribes with that of 12-step approaches, some American Indian and Alaska Natives remain profoundly uncomfortable with the dominance of this Euro-American approach to substance abuse treatment in their communities. This longstanding tension has now been complicated by the emergence of a number of evidence-based treatments that, while holding promise for improving treatment for American Indian and Alaska Natives with substance use problems, may conflict with both American Indian and Alaska Native and 12-step healing traditions.
We convened a panel of experts from American Indian and Alaska Native communities, substance abuse treatment programs serving these communities, and researchers to discuss and analyze these controversies in preparation for a national study of American Indian and Alaska Native substance abuse services. While the panel identified programs that are using evidence-based treatments, members still voiced concerns about the cultural appropriateness of many evidence-based treatments as well as the lack of guidance on how to adapt them for use with American Indians and Alaska Natives. The panel concluded that the efforts of federal and state policymakers to promote the use of evidence-based treatments are further complicating an already-contentious debate within American Indian and Alaska Native communities on how to provide effective substance abuse services. This external pressure to utilize evidence-based treatments is particularly problematic given American Indian and Alaska Native communities' concerns about protecting their sovereign status.
Broadening this conversation beyond its primary focus on the use of evidence-based treatments to other salient issues such as building the necessary research evidence (including incorporating American Indian and Alaska Native cultural values into clinical practice) and developing the human and infrastructural resources to support the use of this evidence may be far more effective for advancing efforts to improve substance abuse services for American Indian and Alaska Native communities.
PMCID: PMC3145574  PMID: 21679438
7.  Utilisation of Pangolin (Manis sps) in traditional Yorubic medicine in Ijebu province, Ogun State, Nigeria 
Concern about the use of endangered and threatened species in traditional medicine escalated as populations of many species plummeted because of poaching for the medicinal trade. Nigeria is known for a long and valued tradition of using wild animals and plants for medicinal purposes. Despite this, studies on medicinal animals are still scarce when compared to those focusing on medicinal plants. Utilisation of wild animals in traditional Yorubic medical practices was indiscriminate as it involved threatened species. By touting the medicinal properties of these species, traditional medicine fuel continuing demand, thereby subjecting such species to further threats. This paper examined the use and commercialisation of pangolins for traditional medicinal purposes amongst the Ijebus, South-western Nigeria, and the implications of this utilisation for the conservation of this species.
Traditional Yorubic medical practitioners (tymps) (16) and dealers in traditional medicinal ingredients (56) in public markets in Ijebu province, Nigeria, were interviewed using open-ended questionnaires. The dynamic stock movement of pangolins in the stalls of dealers was also monitored to determine quantity of pangolins sold into the traditional Yorubic medicinal practices. Specific conditions treated and the parts required were also documented.
A total of 178 whole pangolin carcasses were sold into traditional medical practices. Above 55% of respondents had just primary education, over 90% of respondents were not aware of either the conservation status of this species or the existence of any legal machinery regulating its trade and utilisation, while 14% admitted to giving contracts to hunters for deliberate search for this animal when needed. More than 98% of respondents have no other means of livelihood. The trade was female dominated while the healing practice had more males. Pangolins were used in various preparations to treat a total of 42 conditions. These include infertility, gastro-intestinal disorders, safe parturition, stomach ulcers, rheumatism and fibroid. Traditional Yorubic medicine also accommodated some situations that are out of the range of conventional medicine like boosting sales, conferring invisibility, removing bad luck, appeasing/wading off witches cum evil forces and money rituals. Some of these situations specifically require juvenile, or even pregnant female animals.
Traditional Yorubic medical practices eats deep into the reproductive base of the species, presently listed in Appendix II of CITES and Schedule I of the Nigerian Decree 11 (1985), both of which recommended strict control in sales and utilisation of this species. Its numerous medicinal values, folk culture and financial benefits of these activities are the main factors promoting the commercialisation and use of this species. Pharmacological studies on the various preparations are required to identify the bioactive compounds in them. There is a need for improved and urgent measures to conserve populations of this species in-situ. Massive education and enlightenment is urgently needed for the populace to have the necessary awareness and orientation about the conservation of this species.
PMCID: PMC2797502  PMID: 19961597
8.  Animal-based remedies as complementary medicines in Santa Cruz do Capibaribe, Brazil 
The use of animal products in healing is an ancient and widespread cross-cultural practice. In northeastern Brazil, especially in the semi-arid region, animals and plants are widely used in traditional medicine and play significant roles in healing practices. Zootherapies form an integral part of these cultures, and information about animals is passed from generation to generation through oral folklore. Nevertheless, studies on medicinal animals are still scarce in northeastern Brazil, especially when compared to those focusing on medicinal plants. This paper examines the use and commercialization of animals for medicinal purposes in Brazil's semi-arid caatinga region.
Data was obtained through field surveys conducted in the public markets in the city of Santa Cruz do Capibaribe, Pernambuco State, Brazil. We interviewed 16 merchants (9 men and 7 women) who provided information regarding folk remedies based on animal products.
A total of 37 animal species (29 families), distributed among 7 taxonomic categories were found to be used to treat 51 different ailments. The most frequently cited treatments focused on the respiratory system, and were mainly related to problems with asthma. Zootherapeutic products are prescribed as single drugs or are mixed with other ingredients. Mixtures may include several to many more valuable medicinal animals added to other larger doses of more common medicinal animals and plants. The uses of certain medicinal animals are associated with popular local beliefs known as 'simpatias'. We identified 2 medicinal species (Struthio camelus and Nasutitermes macrocephalus) not previously documented for Brazil. The use of animals as remedies in the area surveyed is associated with socio economic and cultural factors. Some of the medicinal animal species encountered in this study are included in lists of endangered species.
Our results demonstrate that a large variety of animals are used in traditional medicinal practices in Brazil's semi-arid northeastern region. In addition to the need for pharmacological investigations in order to confirm the efficiency of these folk medicines, the present study emphasizes the importance of establishing conservation priorities and sustainable production of the various medicinal animals used. The local fauna, folk culture, and monetary value of these activities are key factors influencing the use and commercialization of animal species for therapeutic purposes.
PMCID: PMC2503950  PMID: 18647413
9.  Local knowledge in community-based approaches to medicinal plant conservation: lessons from India 
Community-based approaches to conservation of natural resources, in particular medicinal plants, have attracted attention of governments, non governmental organizations and international funding agencies. This paper highlights the community-based approaches used by an Indian NGO, the Rural Communes Medicinal Plant Conservation Centre (RCMPCC). The RCMPCC recognized and legitimized the role of local medicinal knowledge along with other knowledge systems to a wider audience, i.e. higher levels of government.
Besides a review of relevant literature, the research used a variety of qualitative techniques, such as semi-structured, in-depth interviews and participant observations in one of the project sites of RCMPCC.
The review of local medicinal plant knowledge systems reveals that even though medicinal plants and associated knowledge systems (particularly local knowledge) are gaining wider recognition at the global level, the efforts to recognize and promote the un-codified folk systems of medicinal knowledge are still inadequate. In country like India, such neglect is evident through the lack of legal recognition and supporting policies. On the other hand, community-based approaches like local healers' workshops or village biologist programs implemented by RCMPCC are useful in combining both local (folk and codified) and formal systems of medicine.
Despite the high reliance on the local medicinal knowledge systems for health needs in India, the formal policies and national support structures are inadequate for traditional systems of medicine and almost absent for folk medicine. On the other hand, NGOs like the RCMPCC have demonstrated that community-based and local approaches such as local healer's workshops and village biologist program can synergistically forge linkages between local knowledge with the formal sciences (in this case botany and ecology) and generate positive impacts at various levels.
PMCID: PMC1459109  PMID: 16603082
10.  Dermatological remedies in the traditional pharmacopoeia of Vulture-Alto Bradano, inland southern Italy 
Dermatological remedies make up at least one-third of the traditional pharmacopoeia in southern Italy. The identification of folk remedies for the skin is important both for the preservation of traditional medical knowledge and in the search for novel antimicrobial agents in the treatment of skin and soft tissue infection (SSTI). Our goal is to document traditional remedies from botanical, animal, mineral and industrial sources for the topical treatment of skin ailments. In addition to SSTI remedies for humans, we also discuss certain ethnoveterinary applications.
Field research was conducted in ten communities in the Vulture-Alto Bradano area of the Basilicata province, southern Italy. We randomly sampled 112 interviewees, stratified by age and gender. After obtaining prior informed consent, we collected data through semi-structured interviews, participant-observation, and small focus groups techniques. Voucher specimens of all cited botanic species were deposited at FTG and HLUC herbaria located in the US and Italy.
We report the preparation and topical application of 116 remedies derived from 38 plant species. Remedies are used to treat laceration, burn wound, wart, inflammation, rash, dental abscess, furuncle, dermatitis, and other conditions. The pharmacopoeia also includes 49 animal remedies derived from sources such as pigs, slugs, and humans. Ethnoveterinary medicine, which incorporates both animal and plant derived remedies, is addressed. We also examine the recent decline in knowledge regarding the dermatological pharmacopoeia.
The traditional dermatological pharmacopoeia of Vulture-Alto Bradano is based on a dynamic folk medical construct of natural and spiritual illness and healing. Remedies are used to treat more than 45 skin and soft tissue conditions of both humans and animals. Of the total 165 remedies reported, 110 have never before been published in the mainland southern Italian ethnomedical literature.
PMCID: PMC2275234  PMID: 18254949
11.  Wild plant folk nomenclature of the Mongol herdsmen in the Arhorchin national nature reserve, Inner Mongolia, PR China 
Folk names of plants are the root of traditional plant biodiversity knowledge. In pace with social change and economic development, Mongolian knowledge concerning plant diversity is gradually vanishing. Collection and analysis of Mongolian folk names of plants is extremely important. During 2008 to 2012, the authors have been to the Arhorchin National Nature Reserve area 5 times. Fieldwork was done in 13 villages, with 56 local Mongol herdsmen being interviewed. This report documents plant folk names, analyzes the relationship between folk names and scientific names, looks at the structure and special characteristics of folk names, plant use information, and comparative analysis were also improved.
Ethnobotanical interviewing methods of free-listing and open-ended questionnaires were used. Ethnobotanical interview and voucher specimen collection were carried out in two ways as local plant specimens were collected beforehand and then used in interviews, and local Mongol herdsmen were invited to the field and interviewed while collecting voucher specimens. Mongolian oral language was used as the working language and findings were originally recorded in Mongolian written language. Scientific names of plants are defined through collection and identification of voucher specimens by the methods of plant taxonomy.
A total of 146 folk names of local plants are recorded. Plant folk names corresponded with 111 species, 1 subspecies, 7 varieties, 1 form, which belong to 42 families and 88 genera. The correspondence between plant folk names and scientific names may be classified as one to one correspondence, two or three to one correspondence, and one to multitude correspondence. The structure of folk names were classified as primary names, secondary names and borrowed names. There were 12 folk names that contain animal names and they have correspondence with 15 species. There are nine folk names that contain usage information and they have correspondence with 10 species in which five species and one variety of plant are still used by the local people. The results of comparative analysis on the Mongol herdsmen in the Arhorchin National Nature Reserve and the Mongolians in the Ejina desert area shows that there are some similarities, as well as many differences whether in language or in the structure.
In the corresponding rate between plant folk names and scientific names yielded a computational correspondence of 82.19%, which can be considered as a high level of consistency between scientific knowledge and traditional knowledge in botanical nomenclature. Primary names have most cultural significance in the plant folk names. Special characteristic of plant folk names were focused on the physical characteristics of animals which were closely related to their traditional animal husbandry and environment. Plant folk names are not only a code to distinguish between different plant species, but also a kind of culture rich in a deep knowledge concerning nature. The results of comparative analysis shows that Mongolian culture in terms of plant nomenclature have characteristics of diversity between the different regions and different tribes.
PMCID: PMC3649933  PMID: 23628479
Wild plants; The Mongol herdsmen; Folk nomenclature; Arhorchin National Nature Reserve; Inner Mongolia
12.  Knowledge and Uses of African Pangolins as a Source of Traditional Medicine in Ghana 
PLoS ONE  2015;10(1):e0117199.
Traditional medicine has been practised in Ghana for centuries with the majority of Ghanaians still patronising the services of traditional healers. Throughout Africa a large number of people use pangolins as a source of traditional medicine, however, there is a dearth of information on the use of animals in folk medicine in Ghana, in particular the use of pangolins. The aim of this study was to determine the prevalent use of pangolins and the level of knowledge of pangolin use among traditional healers in Ghana for the treatment of human ailments. Data was gathered from 48 traditional healers using semi-structured interviews on the traditional medicinal use of pangolin body parts in the Kumasi metropolis of Ghana. The cultural importance index, relative frequency of citation, informant agreement ratio and use agreement values were calculated to ascertain the most culturally important pangolin body part as well as the level of knowledge dissemination among traditional healers with regards pangolin body parts. Our study revealed that 13 body parts of pangolins are used to treat various medicinal ailments. Pangolin scales and bones were the most prevalent prescribed body parts and indicated the highest cultural significance among traditional healing practices primarily for the treatment of spiritual protection, rheumatism, financial rituals and convulsions. Despite being classified under Schedule 1 of Ghana’s Wildlife Conservation Act of 1971 (LI 685), that prohibits anyone from hunting or being in possession of a pangolin, our results indicated that the use of pangolins for traditional medicinal purposes is widespread among traditional healers in Ghana. A study on the population status and ecology of the three species of African pangolins occurring in Ghana is urgently required in order to determine the impact this harvest for traditional medical purposes has on their respective populations as current levels appear to be unmonitored and unsustainable.
PMCID: PMC4300090  PMID: 25602281
13.  Folk taxonomy and use of mushrooms in communities around Ngorongoro and Serengeti National Park, Tanzania 
Maasai and Kurya form two main communities around the Serengeti National Park in Tanzania which are mainly pastoralists. Changing climate to excessive drought, have recently forced them to start practicing subsistence farming which is severely affected by wild animals. This study explored status of the folk taxonomy and uses of mushrooms in the two communities as a pave way for possibilities of introducing mushroom cultivation, an alternative crop which is hardly affected by wild animals.
Folk taxonomy and use mushrooms by the Kurya and Maasai communities were investigated. Information was collected by face to face interviews with 150 individuals in 6 selected villages. Using descriptive statistics by Statistic Package for the Social Science (SPSS) version 17.0, the demographic characteristics of informants were evaluated and cross relationships with the recorded data were analysed.
Kurya are mycophilic with 94% of the informants recognizing utilization of the wild mushroom either as foodstuff or as tonics while the Maasai are mycophobic with 99% being unaware of the edibility of mushroom although 28% recognized mushrooms as tonic. For both communities, the knowledge of mushroom utilization and folk taxonomy increased with age of the informants, while it decreases with formal education level of the informants which imply that the basis of knowledge is mainly traditional. Comparing the two communities, the Maasai use mushrooms only for medicinal purposes and never sought them for food while the Kurya were well knowledgeable on the edibility and folk classification especially the Termitomyces species. Characters used in folkal taxonomy included color and size of the basidiomata, shape and size of the pseudorrhiza, habitats and edibility information. A new use of ascospores whereby they anaesthaesia bees during honey harvesting was discovered, and mushroom cultivation was widely welcomed (94.7%) as an alternative crop which is rarely affected by wild animals.
In order to salvage a noted tremendous decrease of knowledge in mushroom utilization and folk taxonomy from vanishing, there is a need to document it throughout, and incorporate it in lower levels of our education system. Mushroom cultivation may possibly be the best alternative crop for the two communities thus should be advocated for improving livelihood and reduce human wildlife conflicts. The new recorded use of ascospores to anaesthaesia the bees during honey harvesting should be exploited and scaled up for sustainable integrated bee keeping and mushroom farming.
PMCID: PMC3539888  PMID: 22999253
Ethnomycology; Kurya; Maasai; Tonic; Serengeti national park
14.  Use of complementary and alternative medicine by patients with hematological diseases experience at a university hospital in northeast Mexico 
Complementary and alternative medicine includes a diverse group of medical and healthcare systems, practices and products not considered part of conventional medicine. Although there is information on unconventional practices in oncological diseases, specific data regarding the use of complementary and alternative medicine by hematology patients is scarce.
The aim of this study is to document the prevalence of this modality of unconventional therapy in patients with malignant and benign hematological diseases, particularly children with acute lymphoblastic leukemia.
An observational study of adult patients and guardians of children with malignant or benign hematological diseases was carried out by applying a structured questionnaire detailing the use and results of the most prevalent complementary and alternative medicine practices.
One hundred and twenty patients were included; 104 had malignant and 16 had benign hematological diseases. The use of complementary and alternative medicine was greater in benign diseases but the difference was not statistically significant (64.7% versus 41.7%; p-value = 0.08). Patients and guardians with high school or college educations used these alternative practices more than patients with less schooling (60.7% versus 54.7%; p-value = 0.032). The use of folk remedies was most prevalent followed by herbal preparations and spiritual healing. Sixty-four percent of patients that used these unconventional practices reported improvement in their symptoms and increased capacity to perform daily activities.
No significant difference was documented between patients with malignant or benign hematological diseases using these alternative practices. The majority of complementary and alternative medicine users reported improvement of the disease or chemotherapy-related symptoms.
PMCID: PMC3459389  PMID: 23049401
Complementary therapies; Herbal medicine; Medicine, traditional; Hematologic
15.  Traditional healing practice and folk medicines used by Mishing community of North East India 
Assam and Arunachal Pradesh have very rich tradition of herbal medicines used in the treatment of various ailments. Tribal communities practice different types of traditional healing practices. Enough documentation is available on the healing practices in other tribal communities except Mishing community of Assam and foot hill of East Siang district of Arunachal Pradesh hence the attempt was made for the same. A survey on folk medicinal plants and folk healers of Mishing tribe was conducted in few places of Lakhimpur and Dhemaji district of Assam and East Siang district of Arunachal Pradesh, where this ethnic group is living since time immemorial. All information was collected based on interview and field studies with local healers within the community. The identification of medicinal plants collected with help of indigenous healers was done. Such medicines have been shown to have significant healing power, either in their natural state or as the source of new products processed by them. This study is mainly concentrated with plants used to cure diseases and to enquire about different healing systems. Detail note on the method of preparation of precise dose, the part/parts of plants used and method of application is given.
PMCID: PMC3487237  PMID: 23125508
Ethno-medicines; ethnic groups; herbal practitioners
Journal of community health  2000;25(1):35-46.
A bilingual survey was developed to collect information regarding socio-demographics, access to medical and dental care, health insurance coverage, perceived health status, and use of folk medicine providers from 70 adults presenting to a health fair in South Los Angeles County. Ninety-seven percent of respondents were foreign-born. Seventy-nine percent reported having no health insurance during the year prior to survey. Of the uninsured, 61 percent lacked a doctor visit and 76 percent lacked a dental visit during the previous year. The high cost of care was the most frequently cited barrier to seeking medical (58 percent) and dental (67 percent) care even when respondents felt it was necessary. Respondents who felt they needed medical attention but did not seek it had a lower perceived health status (7.0 ± 2.2) than those who did (8.0 ± 2.0). Among respondents perceiving themselves in poor health, only 17 percent were insured. Relatively few respondents (7.2 percent) reported seeing a folk healer during the past year. Our results support the argument that the medically indigent in some localities face serious financial, as well as less salient, barriers to access. These local conditions reflect inadequate enforcement by local governments in correcting the difficult problems indigent populations face in accessing medical and dental care.
PMCID: PMC1781363  PMID: 10706208
17.  The relevance of traditional knowledge systems for ethnopharmacological research: theoretical and methodological contributions 
Ethnopharmacology is at the intersection of the medical, natural, and social sciences. Despite its interdisciplinary nature, most ethnopharmacological research has been based on the combination of the chemical, biological, and pharmacological sciences. Far less attention has been given to the social sciences, including anthropology and the study of traditional knowledge systems.
I reviewed the literature on traditional knowledge systems highlighting its potential theoretical and methodological contributions to ethnopharmacology.
I discuss three potential theoretical contributions of traditional knowledge systems to ethnopharmacological research. First, while many plants used in indigenous pharmacopoeias have active compounds, those compounds do not always act alone in indigenous healing systems. Research highlights the holistic nature of traditional knowledge systems and helps understand plant's efficacy in its cultural context. Second, research on traditional knowledge systems can improve our understanding of how ethnopharmacological knowledge is distributed in a society, and who benefits from it. Third, research on traditional knowledge systems can enhance the study of the social relations that enable the generation, maintenance, spread, and devolution of cultural traits and innovations, including ethnopharmacological knowledge.
At a methodological level, some ethnopharmacologists have used anthropological tools to understand the context of plant use and local meanings of health and disease.
I discuss two more potential methodological contributions of research on traditional knowledge systems to ethnopharmacological research. First, traditional knowledge systems research has developed methods that would help ethnopharmacologists understand how people classify illnesses and remedies, a fundamental aspect of folk medicinal plant selection criteria. Second, ethnopharmacologists could also borrow methods derived from cultural consensus theory to have a broader look at intracultural variation and at the analysis of transmission and loss of traditional ethnopharmacological knowledge.
Ethical considerations in the ethnopharmacology of the 21st century should go beyond the recognition of the Intellectual Property Rights or the acquisition of research permits, to include considerations on the healthcare of the original holders of ethnopharmacological knowledge. Ethnopharmacology can do more than speed up to recover the traditional knowledge of indigenous peoples to make it available for the development of new drugs. Ethnopharmacologists can work with health care providers in the developing world for the local implementation of ethnopharmacological research results.
PMCID: PMC2993655  PMID: 21083913
18.  Cultural Aspects of Major Mental Disorders: A Critical Review from an Indian Perspective 
Major mental disorders such as schizophrenia and affective disorders are highly disabling illnesses. The cultural factors that influence the diagnosis and treatment of these disorders are of paramount clinical significance. We attempted to critically review the cultural factors in relation to the epidemiology, phenomenology, treatment, and outcome of major mental disorders from an Indian perspective, and tried to compare these with the cultural factors identified in major international studies. The clinical expression of major mental disorders was noted to vary across cultures in the review. In addition, the outcome of major mental disorders is reported to be better in developing nations than in the developed countries. Transcultural variations are also noted to exist in pharmacokinetics, pharmacodynamics, traditional healing practices, and psychotherapeutic approaches. The role of cultural factors in severe mental illnesses needs adequate attention from mental health professionals. Continued research on the cultural aspects is required to understand the interplay of all social, cultural, and biological factors. It is important to consider other cultural, traditional, and folk methods for understanding and management of mental illnesses.
PMCID: PMC3662125  PMID: 23723536
Bipolar; culture; schizophrenia
19.  Indigenous knowledge, use and on-farm management of enset (Ensete ventricosum (Welw.) Cheesman) diversity in Wolaita, Southern Ethiopia 
Ensete ventricosum (Welw.) Cheesman is a major food security crop in Southern Ethiopia, where it was originally domesticated and during millennia became pivotal crop around which an entire farming system has developed. Although its cultivation is highly localized, the enset-based farming system provides sustenance to more than 20 million people. Precise ethnobotanical information of intra-specific enset diversity and local knowledge on how communities maintain, manage and benefit from enset genetic resources is imperative for the promotion, conservation and improvement of this crop and its farming system.
This study was conducted in Southern Ethiopia among the Wolaita 'enset culture' community. The research sample consisted of 270 households from 12 Kebeles (villages) representing three agro-ecological ranges. By establishing Participatory Rural Appraisal (PRA) based interactions and applying ethnobotanical interviewing methods of free-listing and open-ended questionnaires, information on the use and management of enset diversity, and its associated folk-biosystematics, food traditions and material culture was collected and analyzed.
While enset agriculture is seen as cultural heritage and identity for the Wolaita, enset intra-specific diversity holds scenic, prestige and symbolic values for the household. In the present study we recorded 67 enset landraces under cultivation, and through a comprehensive literature review we identified 28 landraces reported from other areas of Wolaita, but not encountered in our survey. Landraces, identified using 11 descriptors primarily related to agro-morphological traits, are named after perceived places of origin, agro-morphological characteristics and cooking quality attributes. Folk classification of enset is based on its domestication status, 'gender', agro-ecological adaptability and landrace suitability for different food and other uses (fiber, feed, medicinal). Enset as a food crop is used to prepare 10 different dishes in Wolaita, 8 of which are exclusively prepared using enset, and their consumption ranges from daily staple to specialty food in festive occasions and ceremonies. On-farm landrace diversity and richness is guided by household needs; its dynamics is managed through regular propagation, harvesting restrain, control of landrace composition and arrangement in the enset homegardens.
This study reported on the knowledge system, socio-cultural process and community practices that drive the maintenance of intra-specific on-farm enset diversity in Wolaita, Southern Ethiopia. The information is crucial for developing community based complementary in situ and ex situ conservation strategies to foster conservation of enset genetic resources and associated indigenous knowledge system.
PMCID: PMC4025559  PMID: 24885715
Enset; Intra-specific diversity; Indigenous knowledge; Landraces; On-farm conservation; Wolaita; Ethiopia
20.  Determination of Water-Soluble Components of Abdominal Secretion of Grasshopper (Chorthippus spp.) by GC/MS/MS in Search for Potential Wound Healing Agents 
Chromatographia  2014;77(15-16):1091-1102.
Wound healing is still a serious medical problem due to process complexity and lack of effective medicaments. This is particularly true in the treatment of wounds arising in the course of such diseases as AIDS or diabetes. Therefore, scientific efforts are focused on the search for new compounds of natural origin, which could be used as medicines or evaluated for subsequent drug design. In folk medicine, grasshopper (Chorthippus spp.) abdominal secretion has been used to accelerate the wound healing process. In this context, the knowledge of the composition of grasshopper abdominal secretion is crucial. The aim of this study was to determine the main water-soluble components of grasshopper abdominal secretion with the use of GC/MS/MS. Liquid–liquid extraction was used as a pretreatment method to clean up, concentrate and fractionate compounds from the complex insect matrix. To obtain more stable and volatile compounds, necessary for GC/MS/MS analysis, a double-step derivatization process was carried out with the use of methoxyamine hydrochloride and a mixture of bis-N,O-trimethylsilyl trifluoroacetamide and chlorotrimethylsilane. As a result, 2,108 compounds were identified, mainly as amino acids, carbohydrates and organic acids. Some of the identified compounds are emphasized due to antimicrobial, antifungal or antioxidant activities reported in the literature. Moreover, a set of compounds characteristic for Chorthippus spp. samples has been selected. In the last part of the study, a statistical analysis was performed to demonstrate differences in composition of aqueous fractions of abdominal secretions from grasshoppers collected at two distant locations: Starogard Gdański and Łubianka meadows.
PMCID: PMC4111860  PMID: 25089050
GC/MS/MS; Chorthippus spp.; Grasshoppers’ abdominal secretion; Metabolomics; Water-soluble compounds; Wound healing
21.  The Role of Spirituality Healing with Perceptions of the Medical Encounter among Latinos 
Journal of General Internal Medicine  2009;24(Suppl 3):542-547.
Little is known about the relationship between spirituality healing and perceptions about the medical encounter among Latinos.
To examine the association between spirituality healing and attitudes of self-reported perceptions about the medical encounter.
A cross-sectional telephone survey.
3,728 Latinos aged ≥18 years residing in the United States from Wave 1 of the Pew Hispanic Center/Robert Wood Johnson Foundation Latino Health Survey.
Dependent variables were ever prayed for healing (yes/no), ever asked others to pray for healing (yes/no), considered important spiritual healing (very vs. somewhat or not important), and ever consulted a ‘curandero’ (folk healer in Latin America) (yes/no). The primary independent variables were feelings about the last time seeing a Doctor (confused by information given, or frustrated by lack of information) and perception of quality of medical care (excellent, good, fair or poor) within the past 12 months.
Six percent of individuals reported that they had ever consulted a curandero, 60% prayed for healing, 49% asked others to pray for healing, and 69% considered spiritual healing as very important. In multivariable analyses, feeling confused was associated with increased odds of consulting a curandero (OR = 1.58; 95% CI, 1.02–2.45), praying for healing (OR = 1.30; 95% CI, 1.03–1.64), asking others to pray for healing (OR = 1.29; 95% CI, 1.03–1.62), and considering spiritual healing as very important (OR = 1.30; 95% CI, 1.01–1.66). Feeling frustrated by a lack of information was associated with asking others to pray for healing (OR = 1.29; 95% CI, 1.04–1.60). A better perception of quality of medical care was associated with lower odds of consulting a curandero (OR = 0.83; 95% CI, 0.70–0.98).
Feelings about the medical encounter were associated with spirituality healing, praying for healing, and asking others to pray for healing. Feeling confused and perception of poor quality of medical care were associated with consulting a curandero.
PMCID: PMC2764036  PMID: 19842004
Latinos; medical encounter; spirituality healing; praying for healing; curanderos
22.  The prevalence, patterns of usage and people's attitude towards complementary and alternative medicine (CAM) among the Indian community in Chatsworth, South Africa 
The purpose of this study was to determine, among the Indian community of Chatsworth, South Africa, the prevalence and utilisation patterns of complementary and alternative medicine (CAM), attitudes associated with CAM use and communication patterns of CAM users with their primary care doctors.
Face-to-face structured interviews were conducted in Chatsworth, a suburb of Durban in which South Africans of Indian origin predominantly reside. Participants were 200 randomly selected adult English-speaking Indian residents.
The prevalence of CAM usage for period 2000/2001 was 38.5% (95% confidence interval 31.7% to 45.6%). Spiritual healing and herbal/natural medicines, including vitamins were the most common types of CAM used, accounting for 42.8% and 48.1% respectively of overall CAM usage. People used CAM to treat conditions including diabetes mellitus, headaches, arthritis and joint pains, stress, skin disorders, backaches, hypertension and nasal disorders. Half of the CAM users used allopathic medicines concurrently. The cost of CAM utilization over this 1-year period, incurred by 80.5% of users for the duration of therapy for their most troublesome condition was below R500 (approximately US$50). Age, sex, marital status, religion, level of education and income were shown not to influence the use of CAM. Greater than half (51.9%) of CAM users did so either upon the advice of someone they knew, or after noticing a CAM advertisement in the local press. Seventy-nine percent of CAM users indicated that they had positive outcomes with their treatments. Fifty four percent of CAM users (excluding those using spiritual healing only) failed to inform their doctors that they used CAM. The main reason given by half of this group was that informing their doctors did not seem necessary.
The prevalence of CAM in Chatsworth is similar to findings in other parts of the world. Although CAM was used to treat many different ailments, this practice could not be attributed to any particular demographic profile. The majority of CAM users were satisfied with the effects of CAM. Findings support a need for greater integration of allopathic medicine and CAM, as well as improved communication between patients and caregivers regarding CAM usage.
PMCID: PMC356921  PMID: 15018622
23.  Resources, attitudes and culture: an understanding of the factors that influence the functioning of accountability mechanisms in primary health care settings 
District level health system governance is recognised as an important but challenging element of health system development in low and middle-income countries. Accountability is a more recent focus in health system debates. Accountability mechanisms are governance tools that seek to regulate answerability between the health system and the community (external accountability) and/or between different levels of the health system (bureaucratic accountability). External accountability has attracted significant attention in recent years, but bureaucratic accountability mechanisms, and the interactions between the two forms of accountability, have been relatively neglected. This is an important gap given that webs of accountability relationships exist within every health system. There is a need to strike a balance between achieving accountability upwards within the health system (for example through information reporting arrangements) while at the same time allowing for the local level innovation that could improve quality of care and patient responsiveness.
Using a descriptive literature review, this paper examines the factors that influence the functioning of accountability mechanisms and relationships within the district health system, and draws out the implications for responsiveness to patients and communities. We also seek to understand the practices that might strengthen accountability in ways that improve responsiveness – of the health system to citizens’ needs and rights, and of providers to patients.
The review highlights the ways in which bureaucratic accountability mechanisms often constrain the functioning of external accountability mechanisms. For example, meeting the expectations of relatively powerful managers further up the system may crowd out efforts to respond to citizens and patients. Organisational cultures characterized by supervision and management systems focused on compliance to centrally defined outputs and targets can constrain front line managers and providers from responding to patient and population priorities.
Findings suggest that it is important to limit the potential negative impacts on responsiveness of new bureaucratic accountability mechanisms, and identify how these or other interventions might leverage the shifts in organizational culture necessary to encourage innovation and patient-centered care.
PMCID: PMC3844434  PMID: 23953492
Accountability; Governance; Primary health care; Low and middle income settings
24.  In vitro antibacterial activity of Tabernaemontana alternifolia (Roxb) stem bark aqueous extracts against clinical isolates of methicillin resistant Staphylococcus aureus 
The rise of antibiotic resistance among methicillin resistant Staphylococcus aureus (MRSA), have caused concerns for the treatment of MRSA infections. Hence, search for an alternative therapy for these infections is inevitable. Folk Indian medicine refers to the use of leaf and stem bark powder of Tabernaemontana alternifolia (Roxb) in treatment of skin infections, but no scientific report establishes its antibacterial activity.
Direct aqueous extracts and sequential aqueous extracts of the stem bark of T. alternifolia (using petroleum ether and ethyl acetate as other solvents) were prepared by soxhlet extraction. The antibiotic sensitivity profiles of the clinical isolates were determined against 18 antibiotics using disc diffusion method. The isolates were identified by 16S rRNA gene sequencing. The methicillin resistance among S. aureus (MRSA) was confirmed by PCR amplification of mecA gene. The disc diffusion method was used to determine the antibacterial activity of the extracts. The micro-dilution method was used to determine the minimum inhibitory concentration (MIC) of the extract against the test organism. To further evaluate the therapeutic potential of the extract, cell cytotoxicity was checked on Vero cells by MTT assay. Chemical profiling of the extract was done by HPTLC method.
The aqueous extracts of T. alternifolia stem bark exhibited antibacterial activity against Gram-positive microorganisms, particularly against clinical isolates of MRSA and vancomycin resistant S. aureus (VRSA). The minimum inhibitory concentration (MIC) of extract against the isolates ranged from 600–800 μg/ml. The extract did not exhibit cytotoxic activity against Vero cells even at the concentration of 4 mg/ml. The chemical profiling revealed presence of alkaloids, flavonoids, coumarins, saponins and steroids. Petroleum ether and ethyl acetate extracts did not exhibit antibacterial activity.
Our results offer a scientific basis for the traditional use of T. alternifolia in the treatment of skin infections, showing that the plant extract has an enormous potential as a prospective alternative therapy against MRSA skin infections. The present study lays the basis for future studies, to validate the possible use of T. alternifolia as a candidate in the treatment of MRSA infections.
PMCID: PMC3851168  PMID: 24066905
Tabernaemontana alternifolia (Roxb); Anti-MRSA; Cytotoxicity; Plant extract; Antimicrobial
25.  Isolation and Purification of Water Soluble Proteins from Ginger Root (Zingiber officinale) by Two Dimensional Liquid Chromatography 
The RI-INBRE Centralized Core Facility was established in 2003 and participates annually in Undergraduate Summer Research Program. It provides students hands on research experience in key technologies in biomedical sciences. We present here the isolation and purification of water soluble proteins from ginger, a rhizome of the plant, Zingiber officinale. It is an important ingredient of species used in traditional South Asian cuisines. In Indian, Pakistani and Chinese folk medicine, ginger is used for gastro-intestinal disorders, nausea, vomiting, inflammatory diseases, muscle and joint pain. Limited studies have been reported on the bioactive proteins from ginger extract. The water soluble proteins were extracted from ginger root and successfully purified to homogeneity by using two-dimensional liquid chromatography (FPLC/RP-HPLC) approach. The ginger root was washed with distilled water; skin removed and then emulsified using an electric blender. Sample was stirred for four days at 4°C with and without protease inhibitor. Purification of a 42kDa protein was achieved by employing gel filtration, ion-exchange and reversed phase HPLC. The homogeneity of the protein was confirmed by SDS-PAGE gel electrophoresis and MALDI-TOF mass spectrometry. Future work will be conducted on the protein characterization using mass spectrometry and Edman protein sequencing. Supported by grant 5P20GM103430 from the National Institute of General Medical Sciences, NIH, USA.
PMCID: PMC4162210

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