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

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.

Medicinal Herbs Used by Hiv-Positive People in Lesotho

“…A study in Kenya which reported similar results found that more than 25% of HIV-positive people used Allium sativum (Nagata et al, 2011). The current study also concurs with Langlois-Klassen et al cytochrome-P enzymes, including CYP1A2, CYP2C9, CYP2C19, CYP2D6, and CYP3A4 (Müller & Kanfer, 2011).…”

Azadirachta indica

“…In the south coast community, Kenya, the stem and root barks and leaves are used as antimalarial remedies (Nguta et al 2010 ). In the Suba district, Kenya, decoctions or steam bath of the leaves and bark is used to treat skin rashes, malaria and opportunistic infection from HIV/ AIDS and leaves and bark rubbed on teeth and gums (Nagata et al 2011 ). In Guinea Conakry, decoction of the leaves is used as an antiseptic against infection (Magassouba et al 2007 ).…”

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“…In India, the inflorescence infusions of coconut are used for the oral treatment of menstrual cycle disorders 5 . White flesh of the coconut fruit is used to treat fever and malaria 6 , it is also used to relieve skin rashes caused by HIV infection 7 . Coconut Shell oil had higher number of secondary metabolites and they reported to have many biological and therapeutic properties 8 .…”