Indigenous knowledge systems for the treatment of hypertension in Lusaka, Zambia: perceptions, knowledge and practice

Abstract

Background: A significant number of patients suffering from hypertension, a major risk factor for cardiovascular morbidity, are said to access traditional medicine (TM) for their disease management. Traditional medicine, originating from indigenous knowledge that has been passed on from generation to generation, has remained largely under-researched. There is paucity of information on the efficacy and toxicity of these remedies. Indigenous knowledge systems (IKS) as utilised in healthcare provision in primary care settings have remained largely understudied in Zambia.

Objectives: The study aimed to determine the knowledge of aetiology, risk factors, diagnosis, mode of treatment and complications of hypertension among Traditional Health Practitioners (THP) in Lusaka.

Methods: A descriptive cross-sectional study was conducted of THPs registered with the Traditional Healers & Practitioners Association of Zambia (THPAZ) operating from within Lusaka district who provided treatment for hypertension using indigenous TM. A structured interviewer-administered questionnaire was utilised to gather quantitative and qualitative data. A total of twelve (12) THPs were interviewed.

Results: Majority (11/12) of THPs had limited basic knowledge of some causes of hypertension although three (3) of them mentioned bewitchment as one of the causes. Divination was the preferred method of diagnosis for 6 (50%) of them. Most of them described and identified common risk factors and complications of hypertension. In this study, all THPs (100%) used indigenous traditional herbal remedies, usually mixtures of various plants and/or different parts of plants to treat hypertension. There were no unified modes of monitoring efficacy and safety of the medicaments administered to patients.

Conclusion: This study reveals severe gaps in the knowledge, perception and practice of THPs who still rely largely on spiritual divination to make the diagnosis of hypertension, with a few of them ascribing the pathophysiology to witchcraft. Use of indigenous traditional herbal remedies by THPs was widely practiced. There is need to subject the available remedies to more scientific evaluation to determine their possible efficacy and safety for managing hypertension.