RESUMO
AIM OF THE STUDY: We present and discuss a particular group of plants used by a diversity of healers in the initiation process and apprenticeship of traditional medicine, as practiced by Amazonian societies in East-Central Peru. Often, these plants are locally called plantas con madre (plants with a mother), and are thought to guide initiates in the process of seeking sacred knowledge, learning about plant usage, and understanding traditional medicine practices. We illustrate the diversity of plants used in the apprenticeship and practice of traditional medicine, and nurture the discussion to better understand the terminology used by Indigenous healers to describe plant uses and their practices. MATERIALS AND METHODS: The study was conducted between 2003 and 2008 with the participation of 29 curanderos (healers; 23 men, 6 women), 3 apprentices and 4 herbalists. The participants belonged to four ethnic groups: 17 Mestizos, 15 Shipibo-Konibo, 1 Ashaninka, and 1 Matsiguenga; a Spanish apprentice and an Italian herbalist were also included in the study. The field data were collected using semi-structured interviews, participant observation, and the witnessing of numerous healing sessions. Oral informed consent was obtained from each participant. RESULTS: We identified 55 plant species belonging to 26 botanical families, which are used in initiation processes and apprenticeships of traditional medicine. This group of plants is administered under strict conditions during training and healing sessions called dietas (shamanic diets), with the supervision of one or more maestros curanderos (master healers). We observed that during the shamanic diets, maestros curanderos administered plants depending on the teachings or tools he/she was passing on, and were based on a particular sequence during the initiation process: (I) purification and cleansing species; (II) sensitivity and intuition; (III) strengthening; and (IV) protection and defence. CONCLUSIONS: Traditional healers continue to be a primary source of health care for the majority of the population in the Amazon region. Our research suggests that the system of dietas and the plantas con madre are fundamental components of the everyday practice of traditional medicine, maintenance of cultural continuity and Indigenous cosmovisions in the Amazonian societies in East-Central Peru. This paper contributes to filling the gap in the understanding of the process of initiation among healers in this area of the world. The study offers evidence of the need to collaborate with Indigenous healers to improve the recognition of their medical practices, role in their societies, and the value of their tools and medicines. A respectful attitude and open exchange of ideas and information may contribute to a better understanding of the language used by traditional medical practitioners, their practice, and their worldviews.
Assuntos
Plantas Medicinais , Xamanismo , Etnobotânica , Feminino , Humanos , Masculino , PeruRESUMO
OBJECTIVE: The Honduran HIV/AIDS Program began to scale up access to HIV therapy in 2002. Up to May 2008, more than 6000 patients received combination antiretroviral therapy (cART). As HIV drug resistance is the major obstacle for effective treatment, the purpose of this study was to assess the prevalence of antiretroviral drug resistance in Honduran HIV-1-infected individuals. METHODS: We collected samples from 138 individuals (97 adults and 41 children) on cART with virological, immunological or clinical signs of treatment failure. HIV-1 pol sequences were obtained using an in-house method. Resistance mutations were identified according to the 2007 International AIDS Society (IAS)-USA list and predicted susceptibility to cART was scored using the ANRS algorithm. RESULTS: Resistance mutations were detected in 112 patients (81%), 74% in adults and 98% in children. Triple-, dual- and single-class drug resistance was documented in 27%, 43% and 11% of the study subjects, respectively. Multiple logistic regression showed that resistance was independently associated with type of treatment failure [virological failure (odds ratio (OR) = 1) vs. immunological failure (OR = 0.11; 95% confidence interval (CI) 0.030-0.43) vs. clinical failure (OR = 0.037; 95% CI 0.0063-0.22)], route of transmission (OR = 42.8; 95% CI 3.73-491), and years on therapy (OR = 1.81; 95% CI 1.11-2.93). CONCLUSION: The prevalence of antiretroviral resistance was high in Honduran HIV-infected patients with signs of treatment failure. A majority of study subjects showed dual- or triple-class resistance to nucleoside reverse transcriptase inhibitors, nonnucleoside reverse transcriptase inhibitors and protease inhibitors. Virologically defined treatment failure was a strong predictor of resistance, indicating that viral load testing is needed to correctly identify patients with treatment failure attributable to resistance.
Assuntos
Antirretrovirais/uso terapêutico , Farmacorresistência Viral Múltipla/genética , Genes pol/genética , Infecções por HIV/tratamento farmacológico , HIV-1/genética , Adolescente , Adulto , Contagem de Linfócito CD4 , Criança , Pré-Escolar , Quimioterapia Combinada , Feminino , Genótipo , Infecções por HIV/virologia , HIV-1/classificação , Honduras , Humanos , Masculino , Adesão à Medicação , Análise de Sequência de DNA/métodos , Falha de Tratamento , Carga ViralRESUMO
Research on the ethnobotany of Mestizos in Suni Miraño in 1994 documented 60 plant species used for medicinal purposes. Some cultural data on traditional healing and etiology were also collected. Of these 60 species, 31 were submitted to antibacterial and antifungal assays in the presence and absence of UV light and a number of species were shown to be active.