RESUMEN
OBJECTIVE: This study was carried out to evaluate the potential effectiveness of herbal treatments used for herpes zoster (HZ) by a great number of people living with acquired immunodeficiency syndrome (PLWAs) in Uganda. SETTING: Kampala, Uganda. Clinics of indigenous traditional healers, at the Department of Medicine of Mulago Hospital, Makerere University, and at The AIDS Support Organization (TASO) Clinic, providing primary care to people living with HIV and AIDS. DESIGN, PATIENTS, AND PARTICIPANTS: Nonrandomized, nonplacebo controlled, observational study in two phases. Inclusion criteria included HIV seropositivity and a recent HZ attack. In phase 1, 52 patients were enrolled, treated, and followed for up to 3 months at three healers' clinics, and compared to 52 TASO Clinic controls receiving ambulatory care. Phase 2 was similar in design to phase 1, but lasted longer (6-month follow-up) and involved 154 hospital outpatients treated with herbal medicine and 55 TASO controls. In both phases, healer patients were given herbal treatment according to healers' prescriptions, while controls received either symptomatic treatment or acyclovir. RESULTS: Healer patients and controls experienced similar rates of resolution of their HZ attacks. Fewer healer patients than controls experienced superinfection in phase 1 (18% versus 42%, p < 0.02) and fewer healer patients showed keloid formation in either phase. This difference was not statistically significant. In both phases, zoster-associated pain resolved substantially faster among healer patients with a higher degree of significance in phase 2 where the progression of pain over time could be seen because of the longer follow-up (phase 1: maximum p value (pmax) < pmax < 0.02 at 1 month, pmax < 0.005 at 2 months, pmax < 0.0001 at 3 months). CONCLUSION: Herbal treatment is an important local and affordable primary care alternative for the management of HZ in HIV-infected patients in Uganda and similar settings.
Asunto(s)
Seropositividad para VIH/complicaciones , Herpes Zóster/terapia , Medicinas Tradicionales Africanas , Fitoterapia , Adolescente , Adulto , Femenino , Herpes Zóster/complicaciones , Humanos , Masculino , Persona de Mediana Edad , Proyectos Piloto , Resultado del Tratamiento , UgandaRESUMEN
"Background: Kabarole district; situated in western Uganda; and with a population of 863;263; has 44 health units. Despite the high number of health units in the district; only 4of women aged 15-49 years utilise family services available to them; 13 of deliveries take place in the health units and only 46 of children under 5 years of age use out-patient facilities. Mental illnesses account for 0.05-0.09of children under 5 years of age use out-patient facilities. Mental illnesses account for 0.05-0.09 of total out-patient attendances. Objective : This study was carried out to determine the magnitude of mental health problems as perceived by the communities in Kabarole district. Methods: The study was a descriptive cross-sectional one counducted in four out of eight counties in the district. The countries; sub-countries; parishes and households involved in the study were selected using multi-stage simple random sampling procedure. A semi-structured questionnaire was administered to the household heads of 96 households from each of the counties. Qualitative data was collected ofrom one focus group discussion involving both males and females from each of 42 parishes. Further information was gathered from 27 key informants purposely selected from the district health department and the community. Results: the community's perceiced problems included human diseases; poverty; crop diseases; unprotected water sources; lack of market for agricultural produce and icreased rate of crimes. Mental illnesses ranked six among the top ten human diseases; mentioned by or 8.6of total out-patient attendances of respondents. Only 47.2 of respondents recognised mental illnesses to be a community problem; and 25.8 of hosueholds reported having had a patient with the condition in the previous year. There are no services for the mentally ill in the community and affected persons are either secluded from the mainstream of societal life; or are neglected and left to the ""mercy of God"". Conclusion: Mental illness is perhaps emerging as a community problem. Recommendations: The community needs a well designed programme of education on mental health problems. The development of community mental health programme in Kabarole District will need to be integrated with other programmes targeting high priority community defined problems"