Abstract:
Background: Traditional remedies have been used for many years in Africa to treat various ailments before the introduction of conventional medicines into the continent. Concurrent use of traditional herbal medicines (THM) with highly active antiretroviral therapy (HAART) is widespread among HIV infected patients. Studies done in different parts of the world show conflicting health outcomes among HIV positive patients using HAART and herbal medicine concurrently with some reporting better health outcomes while others report increased risk of adverse drug reactions. However, the extent of THM use is not known in most settings in Sub-Saharan Africa Kenya included. This study aimed to determine the prevalence and factors associated with THM use among HIV infected patients on highly active antiretroviral therapy (HAART) attending two comprehensive care centers in Nairobi County.
Methods: A descriptive cross-sectional study was conducted at Kenyatta National Teaching and Referral Hospital and Mbagathi District Hospital. From the two centers a total of 370 participants were selected via systematic random sampling. The participants included were those aged 18 years and above, on HAART, and had consented to participate in the study. Data was collected using an interviewer-administered semi-structured questionnaire seeking information on herbal medicine use, socio-demographic and economic factors associated with herbal medicine use and the association between herbal medicine use and occurrence of adverse drug reactions. THM use referred to someone who had ever used or was currently using herbal medicine while on highly active antiretroviral therapy (HAART) by the time of the study. Data was captured in excel sheet and exported to STATA for analysis.
Results: The study established that the prevalence of herbal medicine use among HIV positive patients taking HAART was 15.5%. About 77.8% of the patients who had used herbal medicine had never disclosed to the doctor or any health care worker at the CCC about their herbal medicine use. Herbal medicine use led to decreased adherence to HAART. The longer the duration between HIV diagnosis and HAART start, the more likely a HIV positive patient was to use herbal medicine. Patients who use herbal medicine with HAART were more likely to experience adverse drug reactions. There were 59.7% participants who had good /fair adherence while 40.3% had poor adherence. Majority of those who had poor adherence had significantly higher proportion of side effects as compared to those had good/fair adherence.
Conclusion: The prevalence of THM use among participants on HAART was high. This raises clinical and pharmacological concerns that need attention by the health care service providers.