Herbal mixtures towards malaria and typhoid
Nigerians have resorted to using eccentric combination of drugs to fight bad air, which kills a child every particular in Africa, writes ARUKAINO UMUKORO
Shivering malevolence the several layers of clothes he had in successi~, he was obviously weak from the ceaseless vomiting he had experienced in the hindmost 24 hours. Then, he decided consulting a drugstore ~ means of the corner of a roadside in Ketu, Lagos.
He needed anti-noxious exhalation drugs. “Give me Folic sharp, Vitamin B-Complex, Ferrous, Curefenac 50, Laridox tablets,” he told the ‘chemist.’
With qualified dexterity and with a teaspoon, she counted the drugs from unlike packs and put them inside faint nylon packs for the patient.
“Oga, it is N250. I added Chloroquine and Flagyl since you are stoolling,” she told him.
The ‘chemist’, who did not wish for to divulge where she learnt her ‘trade’ from, told SUNDAY PUNCH that of wholly illnesses she attends to daily, noxious exhalation drugs are in high demand.
“Nothing cures noxious exhalation like combining Folic acid (1 tablet); Vitamin B-Complex(1 tablet) Ferrous(1 pocket memorandum-book) or you can buy blood key-note if you can afford it, at that time, Curefenac 50, Laridox Sulfadoxine (500mg) and Pyrimethamine (25mg) tablets. Since ut~ malaria comes with vomiting and stooling, I likewise give patients Flagyl and Paracetamol,” she reeled extinguished with pride.
The roadside ‘chemists’
Meanwhile, in some place in the ever-busy Mile 12 place of traffic area of the state, Abdul carried his expressive shop around. Wearing a colourful horizontally-stripped shirt and faded livid jeans trousers, he did not divide the picture of a medical instructor. But with a big plastic bowl containing different kinds of medicine/drugs ~ dint of. his side, he is an person specially versed in hawking medicine.
His is a movable drug store and he is called ‘Doctor’ ~ the agency of the teeming ‘patients’, who care for him on a daily basis. When our corresponding asked for drugs to treat miasma, Abdul beamed. “Kai, malaria adequate supply for here,” he said from his ‘observatory.’
With of that kind deftness that could have only approach from regular practice, Abdul rummaged through some packs of tablets in a bowl, he shuffled it a few ages, like a pack of cards, and brought not at home a pack of a particular protoplast of drug each time – five types in sum. Then, he lectured this correspondent forward the uses of each.
“This is Antidar (Sulfadozine Pyrimethamine), anti-noxious exhalation tablet, and this is Zamba 500, it would relief the anti-malaria work very well, and it is righteous for body pain, dental pain and such on. This is Paracetamol, also during the term of body pain and headache. This is Amoxyl, every antibiotic, and this is blood key. When you use it, you won’t require malaria again. I don’t scarceness to give you too much as it will be overdose,” he said confidently.
The total cost of the connection of anti-malarial drugs was N150.
Abdul claimed he learnt common health education for about two years in Katsina State under the jurisdiction moving to Lagos two years past to ‘ply his trade.’
Although he sells other types of medicines – from aphrodisiac to heat drugs –Abdul said he had through the whole extent of 50 customers that ask for anti-noxious exhalation drugs every week.
“Malaria in ~ degree dey respect anybody oh. Oga, our drugs dey act well. You no go get malaria again,” said another roadside ‘chemist’, who gave his designate as John.
One of Abdul’s ‘customers’ is Sule Musa, a shop-keeper in Mile 12 market. In his 40s, Musa before-mentioned the anti-malarial drugs worked to a high degree well each time he bought them. When asked grant that he knew the names of the drugs he was given to enjoyment malaria, he said, “What would I achieve with their names? I just understand that the medicine works very well to remedy malaria. These drugs are also cheaper than the anti-miasma drugs those big chemist and hospital put up to sale.”
Mrs. Eno Johnson, a tradesman in Agege area of the explain, also shared Musa’s views. She told SUNDAY PUNCH that she exhausted a significant sum of her proceeds on buying malaria drugs from roadside chemists or at all pharmacy closest to her at the strict point she felt symptoms of malaria.
“I don’t know the names of the drugs. The singly thing I know is that they afore~ it treats malaria. It is a mix of different drugs. I just discern that it works,” she added.
Although Johnson declared she took her children to the hospital in ~ly cases whenever they developed malaria symptoms, she notable that she was also comfortable through self-care, as it works. “Sometimes, they exercise mosquito net too,” she notable.
Not everyone can afford a get though, which reduces malaria transmission ~ means of half. It is estimated that in a ~ degree than five per cent of children in sub-Saharan Africa generally sleep under any type of insecticide-treated net. Most homes in Nigeria do not hold regular electricity, supply or none at all, while there are inadequate health facilities in various towns and communities in the rustic.
Similarly, Mr. Chukwuma Ernest, a businessman in his 50s, uttered he sometimes asked for more conjunction of anti-malaria drugs depending in c~tinuance the symptoms he felt.
He declared, “I always know whenever I bring forth malaria. I start feeling weakness in my body, fever, headache, and sometimes cough, catarrh and slight chest pain. I make report the chemist to give me contrary types of drugs combination so that I would have existence sure that I treat the malaria completely then. Whenever I take these drugs, I procure to be well. Going to the hospital with respect to tests and all that is too expensive.
“Going to a hospital to manage malaria could cost between N3,000 and N10, 000, depending adhering the treatment prescribed, but I can just buy drugs worth about N500 to pleasure myself. I don’t have to circumstance to a hospital when I have power to buy malaria drugs anywhere, even from the roadside.
“Again, some of these hospitals would not crave to treat you immediately if you perform not pay them a deposit at the outset; while some public hospitals, even which time treatment is free, still ask some to pay for some drugs.”
The cost of a laboratory test ranges between N1,000 and N1,500.
The pertaining medicine practitioners
“You want ‘correct’ management for malaria, abi? No problem, you be obliged come to the right place.” With a qualified smile, the ‘doctor’ welcomed our answering into her shop in Ogba, Lagos.
The designate, ‘doctor,’ on the wall was all but hidden by the growing shrub of leaves beside her ‘inspection room.’
The concoction would replenish a five-litre gallon, she added. “It would require to be paid you N3,000, but I would prepare human being-litre for you for N1,000,” the matron, who gave her name as Mama Ronke, said.
It was a combination of across 15 different ‘things,’ including roots and foliage, she emphasised proudly. With that report, she went to work.
Mama Ronke deftly divide the roots and barks into pieces, and added other things into the person-litre plastic bottle. In about 15 minutes, she was completed. “Mix it with hot Seven-Up or Teem drink. You can even use water but allow it to be in a ~ for 24 hours. Then, take it two times a day, in the morning and at ignorance,” she instructed.
“How ~-spun should I take it and for what reason would I know when to close it?” this correspondent asked.
“You be possible to take it for about a month, and you would know when to stop it from the odour of the drink from some time,” she replied, adding that she had been a practising herbal ‘doctor’ for over 20 years. “I learnt it from my parents.”
Mama Ronke’s customers get to from within and outside Lagos. She declared she prepared herbal medicine for some ‘uncountable’ number of customers hebdomadal.
At another herbal medicine practitioner’s shop, the cost of malaria treatment was betwixt N3,000 and N5,000. “This is on this account that I will give you a association you can use for up to four months. We be able to prepare it for you or you have power to take it home and do it ~ means of yourself, and mix it with hasty gin,” he told SUNDAY PUNCH.
In Ikotun, a suburb of Lagos mainland, and at Akute, a bustling place in Ogun State, and many other places in the South-West, undivided could buy a malaria herbal concoction in favor of as low as N50/N100 or viewed like high as N3,000, depending in successi~ what the customer wants and the person’s soundness condition. Malaria and typhoid fever concoction require to be paid more.
Interestingly, most herbal medicine sellers and practitioners SUNDAY PUNCH spoke to were unwilling to share the components of their mixtures. “I’ve been doing this in spite of years. If I don’t perceive what I use, why am I in this trade?” one retorted and declined farther on comments. Another simply laughed and before-mentioned, “I know my business.”
“Maybe they don’t wish to give out their ‘mechanical employment secret’ so as not to ‘spoil’ their market,” one of their customers, who sincerely gave her name as Ify, distinguished.
Just like the aforementioned, many Nigerians patronise these pertaining sellers and practitioners to get miasm treatment. “I buy malaria hodge-podge from them because it is common and works very well. I don’t privation to know what is inside, taken in the character of long as it works,” a motorcycle additional clause added nonchalantly and walked away.
A certified traditive medical practitioner, Olajuwon Okubena, argued that defiance the controversy, herbal medicine could despatch the malaria parasite over time, by continued usage, especially when the wheedler might have become drug-resistant to of the true faith medicine.
He said, “It is trusty that there are charlatans in the pertaining medicine business who take advantage of people’s nescience, but these herbal mixtures were used ~ the agency of our forefathers, which we have uncorrupt replicated, but under better hygienic conditions.”
A herbal ‘doctor’
In places SUNDAY PUNCH visited, ut~ of these herbal medicine concoctions were prepared or sold in unhygienic provisions.
According to these ‘doctors’, herbal mixtures include roots and leaves of that kind as Dogonyaro leaves, Awopa (bark of a tree), protoxide of calcium, mango and pawpaw leaves, lemon grass, and in this way on. These are mixed and fermented by hot gin, soft drinks, pap get ~ or ordinary water.
Due to beggary, illiteracy, poor healthcare system, harsh housekeeping situation, culture and tradition, many Nigerians wary away from receiving proper hospital treatment for malaria. Instead, most prefer to patronise pertaining medicine sellers, or use a cocktail of anti-malaria drugs, self-prescribed or prescribed ~ the agency of a relative or a roadside chemist, to handle themselves at home.
These practices are indifferent, but not ideal, noted infectious distemper specialist, Dr. Joseph Onigbinde.
He uttered, “Going to a chemist to pervert with money drugs or engaging in self-medication is erroneous and dangerous. This is because in the greatest degree of the time, such persons could end up spending more than they had planned. Apart from that, what most of these chemists do is blameless guesswork, without carrying out a real laboratory test.
“Prevention is good in a higher degree than cure. Some of these unregulated treatments could be in advance of to complications such as liver and kidney failure, and strange to say death.”
Judith Duba, a polite servant in Gokana Local Government Area of Rivers State, learnt this the knotty way. Her husband of two years, Justice Duba, died in April, 2014 in imitation of taking anti-malaria drugs on self-medication.
Duba’s spend frugally, having felt some headache, pain and developed profound body temperature, went to a topical drug store, bought some drugs and placed himself steady what he believed was malaria handling.
“My husband lost weight drastically in which case he was taking medications for miasma; and instead of getting better, his freedom from disease condition worsened. We eventually took him to the Bori General Hospital at the topical government headquarters, where he was diagnosed by acute malaria, with traces of resembling typhus, and given adequate treatment,” she recalled by grief obvious in her eyes.
Although Justice initially responded to hospital management, his health had deteriorated so a great quantity that further medical tests had to exist carried out. It was discovered that he had developed a kidney enigma, and needed dialysis to stay in life.
“He was unable to express due to his failing health and was placed in c~tinuance oxygen, but we had no standard of value to carry out the dialysis,” Duba afore~. Justice later died same month.
Medical experts be in actual possession of also warned against getting treatment on the side of malaria without a professional doctor’s diagnosis and method of treating.
A public health expert, Dr. Sunday Aderibigbe, said, “Even if herbal medicine has been used in the place of thousands of years, but again, we don’t discern how many people have died from it, or kidneys that receive been damaged from it, because they are undocumented issues.
“The point to be solved we have with them (herbal remedial agent practitioners) is that they don’t have proper dosages, and we don’t be sure the active ingredients they use in preparing similar concoctions. Taking concoctions without proper dosage be possible to affect the kidney, the main organ which bears the brunt of altogether toxic materials in the body. So, these concoctions have power to cause kidney failure.”
Similarly, a druggist and logistic officer, National Malaria Elimination Programme, Rotimi Kunle, remarkable that herbal medicine for the method of treating of malaria is not ideal, noting that the downsides comprehend safety and hygiene concerns, and be destitute of of quality control.
He said, “Safety concerns are usually not their employment and their procedures are not regulated in ~ one way. But, most people are risking their soundness, exposing themselves and their organs to damaging chemicals from infectious such (herbal) mixtures. It is not advisable. It might be effective for some, but it is not right. A diligent recently developed complications from malaria and was and nothing else brought to the hospital two months subsequent taking herbal concoction to treat it. He died later. The sham hope such medications give actually complicates malaria cases.”
Nevertheless, many Nigerians check patronise herbal medicine sellers and practitioners because of traditional beliefs, as well during the time that the cost of getting proper curative treatment.
Experts opine that the recommended Artemisinine-based Combination Therapy drugs are quiescent out of reach for many in Nigeria, at which place more than half of its 170 the great body of the people people live on less than $2 (N400) a day. While a pack of notable and approved anti-malarial deaden with narcotics could cost between N500 and N3,500 in registered pharmacies.
Also, the appliance of chloroquine for the treatment of bad air is no longer recommended by the World Health Organisation in some countries, including Nigeria, because the miasm parasite had developed resistance to it.
Abdul at drudge
Kunle said, “Chloroquine is nay longer recommended by the WHO in treating malaria because, over the years, it was discovered that it was ~t one longer effective in managing malaria.
“Also, Sulphadoxine and Pyremethamine, popularly called SP in those days, were used because of the management of uncomplicated malaria multitude years ago. Now, because of check, that combination is no longer in application, although it is cheaper. The focus has shifted to other more efficacious forms of antimalarial. ACT is things being so what is recommended.”
Aderibigbe explained that Pryimethanimne and Sulfadoxine were supposed to exist used for the prevention, and not management of malaria, unlike the prevailing usage.
He added, “It is guilt to use these as treatment in spite of malaria. It is meant for obstruction. Also, WHO standard recommends two doses of Fansidar (which contains Pryimethanimne or Sulfadoxine) to preclude, not treat, malaria in a pregnant woman. For the management of malaria. Now, it is ACT.
“ACT mix with ~s combinations include AL (Artemether/Lumefantrine) and AA (Artesunate Amodiaquine). Many cases of miasma complications in hospitals degenerate into complicated malaria or cerebral malaria, which are the consequences of self-medication, and herbal medicine therapy.”
The malaria harass
Malaria, said to be one of the greatest part severe public health problems worldwide, occurs mostly in tropical and sub-tropical regions of the universe, like Nigeria. About 3.2 billion the bulk of mankind – almost half of the world’s populousness – are said to be at jeopardy of malaria, a life-threatening indisposition which is transmitted to people through mosquito bites.
According to WHO’s latest estimates, there are about 198 million cases of noxious exhalation in 2013 and an estimated 584,000 deaths. People mode of life in the poorest countries are likewise said to be the most capable of being wounded to malaria.
In Nigeria, poor electricity store, poor sanitary practices/ environmental conditions and the country’s metaphorical climate, provide perfect breeding ground during the term of the malaria parasite, plasmodium, which is transmitted to the vulgar through bites of infected female Anopheles mosquitoes.
With from hand to hand 170 million people, malaria is a greater health problem in Nigeria, which accounts notwithstanding the highest cases and deaths from noxious exhalation in the world. Alongside Nigeria, the Democratic Republic of Congo, Ethiopia, and Uganda, are before-mentioned account for nearly 50 per cent of the global miasm deaths.
In Nigeria, while malaria contributes to one estimated 11 per cent of motherly mortality, some experts claim that through an estimated 90 million malaria cases by over 250,000 deaths per year, in that place are more deaths from malaria in the region than deaths from HIV, leprosy and tuberculosis combined.
Similarly, bad air is said to be the backer leading cause of death (after HIV/AIDS) from pestiferous diseases in Africa. It is moreover estimated that a child dies every minute from malaria, although since year 2,000, malaria mortality rates among children in Africa are uttered to have fallen by 54 per cent and by 47 per cent globally. Ninety per cent of all malaria deaths occurred in the African clime, mostly among children under five years of st~ of life.
This is the more reason wherefore experts warn against self-medication to discourse malaria.
A paediatrician, Dr. Edem Duke, uttered, “Most symptoms simulate malaria in children, otherwise than that they may not actually be malaria. Fever is a universal symptom toward most infective illnesses – bacteria, viral and fungi. So, the well-adapted malaria symptoms could be a viral or bacterial corruption; meningitis, chest infection, pneumonia, or house infection. Not every fever symptoms is a sign of miasm.”
The symptoms of malaria take in loss of appetite, fever, headache, chills, at intervals joint pains, nausea, and vomiting in more cases, noted Kunle.
Duke said in greatest part cases, parents only come to the hospital at the time the cases that looked like malaria had worsened.
“Managing children have power to be quite challenging, but some parents get to to the hospital for tests at the time there are already complications. This is for they have gone to patronise roadside chemists and undertaken self-medication.
She further said, “That weakness or weariness in an adult’s body may deserved be a sign of stress, nevertheless the person would just decide to quick spring taking anti-malaria drugs unnecessarily whensoever this occurs. This could lead to the creation of a resistant strain.”
The other call to answer is the issue of sub-model or expired anti-malarial drugs in the mart. According to recent research published in a sanatory journal, PLOS ONE, a rigorous algebra of more than 3,000 anti-malarials purchased in Enugu State, South-East Nigeria, what one. has a population of about 3 the multitude, found about 10 per cent to be of poor quality.
The research, that was done by the drug mood team of the Artemisinin-based Combination Therapy Consortium at the London School of Hygiene & Tropical Medicine, analysed 3,024 anti-malarials containing artemisinin (the ~ part that makes malaria treatment effective) from Enugu Metropolis. This left patients at jeopard of not receiving the correct handling dose and potentially contributing to the growth of resistance to the main physic used to treat malaria. The bruit also noted that “poor gentry drugs were frequently found with unmistakable medicine vendors — known as remedy shops, the main source of handling for most patients — rather than in pharmacies.”
Study co-author, Prof. Obinna Onwujekwe, from the University of Nigeria, Enugu, uttered, “The results show that the health system actors should be eternally careful in Nigeria and in other countries to make secure that sub-standard drugs do not hinder or erode gains made in noxious exhalation treatment. Drug regulatory authorities and their partners should intensify drug quality monitoring activities with appropriate sanctions beneficial to defaulters.”
Similarly, a snap enumerate by NOIPolls, which works in connection with The Gallup Poll (USA), in February, showed that 18 by cent of Nigerians claimed they had ‘personally been victims of fake, fraudulent and substandard pharmaceutical products, medicines and drugs.’ Independent pharmacy/chemist (68 per cent) and drug hawkers (14 by means of cent) were identified as the pair main points of purchase of fake drugs in Nigeria.
Prevention, not specific
These issues have been major concerns instead of the Pharmaceutical Society of Nigeria, remarkable its president, Mr. Olumide Akintayo. This is individual of the reasons why the sanatory body places emphasis on the exigency for Nigerians to visit registered pharmacies, suppose that they chose not to visit the hospital despite malaria treatment.
He said, “From actual presentation, there are many health cases that be seized of symptomatic presentations of malaria, but they are not. This is wherefore the Pharmaceutical Society of Nigeria insists that each pharmacy consult should have a precise counselling office. It would enable peculiar and professional dialogue with a soundness consumer to convince them of the destitution for proper diagnosis before making ~ one clinical inferences.
“However, one cannot modify the prevailing culture in one age. So many things have gone ~ly in our health care system which we need to correct. Even clinicians mismanage a lot of this. This is for what cause we need the media to advance advocacy.”
Nigeria loses an estimated N130bn once a year due to loss of man hours and productivity due to malaria and its cost of handling. In the same vein, the WHO estimates that malaria costs an estimated $12bn in corrupt productivity in Africa.
While programmes like as the Roll Back Malaria campaign, limited and state government malaria initiatives, in the same proportion that well as the contributions from extraneous partners, and others, are helping in the battle against malaria, experts believe there is lull a lot more to be bestowed, in a country of over 170 the public people.
Onigbinde said despite the increase in public enlightenment and awareness programmes, administration should provide more mosquito nets by reason of the populace, and generally improve healthcare in the uncultivated. Similarly, Akintayo noted that, aside from the National Health Insurance Scheme, body politic should fast-track a community-based neighborly health insurance scheme. “Government be under the necessity of be bold enough to implement the NHIS. More indispensably to be done, as many Nigerians, especially children, are motionless dying from malaria,” he added.
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