DINEO NKHOLISE. M Sc Research proposal SOUTH AFRICAN HERBAL SCIENCE AND MEDICINE INSTITUTE UNIVERSITY OF THE WESTERN CAPE

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1 THE ROLE OF TRADITIONAL HERBAL MEDICINE (THM) IN CONJUNCTION WITH ALLOPATHIC MEDICINE FOR THE MANAGEMENT OF DIABETES IN URBAN AND RURAL COMMUNITIES OF SOUTH AFRICA DINEO NKHOLISE M Sc Research proposal SOUTH AFRICAN HERBAL SCIENCE AND MEDICINE INSTITUTE UNIVERSITY OF THE WESTERN CAPE Supervisor: Professor Gail Hughes Co Supervisor: Professor Thandi Puoane

2 OUTLINE BACKGROUND STUDY OBJECTIVES METHODOLOGY PROPOSED TIME LINE ANTICIPATED STUDY LIMITATIONS ACKNOWLEDGEMENTS

3 BACKGROUND Non-communicable diseases (NCD s) have become more prevalent and have increased alarmingly globally with estimates that by the year 2020 they will account for 80% of the global disease burden. The WHO estimates that by 2020, NCD s will cause 79% of mortalities in developing countries.

4 BACKGROUND (continued) Diabetes is one of the leading NCD s and estimates show that by2020, diabetes would have affected 366 million people of which 298 million will be from developing countries. SADA stats show that approximately 6,5 million people in SA have diabetes. Diabetes is key because it is an underlying disease factor for the development of other NCD s. Lifestyle is a major determinant in the development of diabetes and most at risk are communities undergoing rapid lifestyle changes. Black communities are severely affected with an indication of the onset of diabetes among black people between years. WHO Media report (Diabetes) International Diabetes Federation [online 2011] Diabetes South Africa [Online 2011]

5 BACKGROUND (Traditional Medicine) According to the WHO, 80% of Africans still rely on Traditional herbal medicine (THM) as a primary source of health. Even with the availability of free health care, there has been an observed increase among traditional medicine users. People who suffer from severe life altering diseases such as diabetes, have been shown to use multiple forms of therapy. Medical pluralism is a known practice and with the increased disease burden this trend has been on the rise. Lack of literature on issues surrounding diabetes treatment, management and usage of THM.

6 RESEARCH QUESTION & STUDY OBJECTIVES What is the prevalence of people with diabetes using THM and allopathic medicine? To document the prevalence of traditional herbal medicines use in the management of diabetes. To investigate the concurrent use of traditional herbal medicine and allopathic medicine among diabetes patients. To understand patient decisions behind the use of traditional medicine.

7 METHODOLOGY Methods to be used are from the PURE study. A multi-country longitudinal study involving 17 High, middle and low income countries The study hypothesizes epidemiologic transition as the cause of some chronic diseases of lifestyle (CDL). It is estimated that 80% of CDLs will occur in Low and middle-income countries but remains the leading cause in high income countries.

8 Objectives of the PURE study METHODOLOGY Whether changes in urbanization are associated with variations in lifestyles and risk factors How changes in individual (lifestyle) are affected by changes in community level factors (e.g. mechanization, access to health care) are related to variations in risk factors and disease rates/disability How the above vary in different regions of a country or across countries Identify predictors of disease. To track risk factor changes and disease rates over time in the communities studied.

9 METHODOLGY (continued) South Africa is part of this study Two Sites Urban Site (Langa) in the Western Cape Province Rural Site (Mount Frere) Eastern Cape Province 2000participants recruited from each site Inclusion criteria men or women aged 18 years and older. Patients living within the study area. A diagnosis of diabetes.

10 STUDY DESIGN Method Quantitative cross-sectional descriptive study Population and setting Study cohort: Adult males and females will be recruited from the PURE Study cohort from the 2 sites Langa- urban township in Cape Town in the Western Cape Province. Mount Frere- rural community in the Eastern Cape Province. Structures questionnaires collected information on: Demographics THM use for diabetes Type of THM use Duration of THM use Reasons for coutilization of THM and allopathic medicine

11 METHODOLOGY (Continued) Ethical Considerations Ethical clearance for the study will be obtained from the Senate research committee of the University of the Western Cape. Data Analysis Data will be analysed using SPSS version 17.0 for windows. Standard descriptive measures along with univariate and bivariate analysis will be performed. p-value of <0.05 was considered statistically significant. All percent distributions are calculated based on non-missing values.

12 PROPOSED TIME LINE TIME ACTIVITY Feb Mar April May June July Aug Sep Oct Nov Feb Apr May July Aug Sep Nov Literature review Proposal Writing Ethical approval application process Thesis write up Field data collection Data analysis Thesis Submission

13 ANTICIPATED STUDY LIMITATIONS Limited number of participants from the non-random selection process. Pure data has uneven number of participants in the two areas.

14 ACKNOWLEDGEMENTS Professor Gail Hughes (Supervisor) Professor Thandi Puoane Dr O. Aboyade SAHSMI SACEMA

15 THANK YOU!!