Use of Complementary and Alternative Medicine among clients with diabetes at Mzuzu Central Hospital in Malawi: A cross-sectional study

Elsevier

Available online 5 July 2023

Advances in Integrative MedicineAuthor links open overlay panel, , ABSTRACTBackground

The prevalence of CAM use among populations with diabetes worldwide varies widely, depending on the country or geographic region. In the general population, some of the characteristics that are associated with CAM use are; gender, race, age and education. In addition other predictors of CAM use include poor perceived health status and the presence of multiple health complaints. Besides, diabetes has been discovered to be an independent predictor of CAM use in the general population and in individuals with diabetes. The primary aim of this study was to assess utilisation of complementary and alternative medicine among patients with diabetes at Mzuzu Central Hospital in Malawi.

Methods

A descriptive cross sectional quantitative study was conducted among 385 clients with diabetes seeking care at Mzuzu Central Hospital who were diagnosed with diabetes for at least one month prior to conducting this study. Participants were recruited through simple random sampling technique. Data was collected using a structured interviewer administered questionnaire. A chi-square test was performed to establish the association between CAM use and socio-demographic factors. Bivariate and multivariate (controlling for socio-demographic factors) logistic regression was done to find predictors of CAM in diabetes. The p-value was set at 0.05 with 95% CI.

Results

The study found that 54% of the participants used CAM in managing their condition with the point prevalence of 151 per 1000 patients; however, cumulative prevalence was estimated at 538 per 1000 patients. Age, educational level, occupation, duration of diabetes, no health insurance, family history of CAM use and cultural or religious beliefs were factors influencing use of CAM.

Conclusion

The study findings confirm use of CAM among clients with diabetes at Mzuzu Central Hospital in Malawi.

Section snippetsBackground

A global estimate of diabetes prevalence for 2010 was around 6.4% and is expected to increase to 7.7% by 2030[1]. In Africa, the prevalence rate has been reported to be at 4.4% in low-income, 5.0% in lower-middle income and 7.0% in upper-middle income countries [2]. Malawi has a diabetes prevalence rate of 5.6%, however most cases remain undiagnosed, untreated or inadequately controlled [3].

Complementary and Alternative Medicine (CAM) use has been prevalent worldwide mainly to improve health

Design and sample size

This research study utilised a descriptive cross sectional quantitative design and data collection took place at Mzuzu Central Hospital. The researcher obtained permission from Mzuzu Central Hospital Directorate by writing a request and was issued an authorisation letter. The researcher then recruited participants from the facility by using a systematic random sampling technique. Prospective participants were provided with an information letter explaining the purpose and procedure of the study,

Ethics

Ethical approval to conduct the study was obtained from College of Medicine Research and Ethics Committee (COMREC), with approval number P.04/19/2645.Clearance was obtained from Mzuzu Central Hospital Directorate. Information sheet was read to participants who were willing to participate. Written consent was obtained from each participant before data collection. Where minors were involved, parents or guardians gave consent. Before the interview a consent form was signed by the participant after

RESULTS

For socio-demographic data participants were asked about age, tribe, sex, marital status, religious religion, occupation and education. Participants were also asked about participants’ condition since diagnosis in relation to the use of complementary and alternative medicine. Finally, participants were asked about what prompted them to use CAM (factors associated with CAM use). There were a total of 385 patients who successfully responded to the questionnaire representing 100% response rate.

DISCUSSION

The study found that 54% of the participants acknowledged to have ever used CAM in managing their condition. This justifies the idea that many clients with diabetes use CAM. These findings are close to the prevalence of CAM usage for control of hyperglycemia in other countries which range from 17% the UK study to 72.8% in the USA [17]. In Africa the prevalence of CAM use among people living with diabetes is estimated to be as high as 80% [8]. Variations in prevalence occur due to different

CONCLUSION

Complementary and Alternative Medicine use was found to be prevalent among clients with diabetes (54%) who were interviewed in the study with a point prevalence of 151 per 1000 clients. Age, education level, patients who work as professionals, longer duration of diabetes since diagnosis, no health insurance, having a family member using CAM and if culture or religion accept use of CAM were found to be associated with use of CAM. Herbal medicines were the mostly preferred CAM among participants.

Ethics approval and consent to participate

The Ethical approval was sort from COMREC with approval numberP.04/19/2645. Written informed consent was obtained from participants.

Funding

None

Ethical statement

Ethical approval to conduct the study was obtained from College of Medicine Research and Ethics Committee (COMREC), with approval number P.04/19/2645.Clearance was obtained from Mzuzu Central Hospital Directorate. Information sheet was read to participants who were willing to participate. Written consent was obtained from each participant before data collection. Where minors were involved, parents or guardians gave consent. Before the interview a consent form was signed by the participant after

CRediT authorship contribution statement

LMM & ET contributed to conception, design and implementation of the study. All authors contributed to interpretation of study findings, drafting, and writing the manuscript and approving the final draft. Their carrier background played important roles. All authors read and approved the manuscript.

Declaration of Competing Interest

The authors declare that they have no competing interest

Acknowledgements

Authors would like to acknowledge Samir Simkonda for editing the English language.

Consent for publication

This was obtained from COMREC and participants

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