full article:Dear Editor
The continent of Africa has an extraordinary richness of flora, and a tradition of herbal or traditional medicines1. The low cost and high acceptance2 of, and ease of access3 to such 'therapies' make them the most common form of African alternative medicine. However, only a relatively small number of plant species and their extracts have been studied4, with minimal information available regarding their safety and efficacy in treating human ailments. In Nigeria, where there is low access to basic primary health care in many parts of the country, consumer preference for consultations with traditional herbal practitioners is increasing5. However, few of the traditional practitioners are literate.
On 30 September 1992, the government of Nigeria promulgated the Medical and Dental Practitioners (Amendment) Decree No. 78, which placed natural medicine (traditional and alternative medicine) side by side with orthodox medicine. Since then, traditional/herbal medical practitioners have become outspoken advocates against orthodox medicine, including an unparalleled increase in the volume and type of advertising by Nigeria herbal practitioners. Their claims are often assisted by sensational and misleading news items on health related issues in the news media. Even the most incorrect and ignorant claims by herbal practitioners are unchallenged by any regulating body, to the disadvantage of patients who suffer the consequences of incorrectly treated, or neglected disease.
One extraordinary claim, for example, relates to the Gram-positive bacterium Staphylococcus, which is not, and never has been, a disease but has become a national phenomenon amongst the Nigerian herbal practitioners as 'Staphylococcus disease'. Their ignorant, inflammatory and deceptive advertising presents this simple organism as, among other conditions, 'the deadliest sexually transmitted disease'6. Many outrageous and unscientific claims are made about the effect of Staphylococcus on fertility, sexual function and even potency, associating it with an array of STI7,8-11. Further, it is even suggested that 'staph' is an hereditary disease, or that it can be contracted from using a pit toilet or a pubic swimming pool, and that it is responsible for a wide variety of systemic symptoms. Traditional practitioners advise that only they possess the remedy (herbal) to rid the body of this 'scourge'6,8.
Alarmingly, these practitioners also advocate against the use of medications such as antibiotics7,12, which are required to treat legitimate staphylococcal infections, such as staphylococcal pneumonia13 or wound infections14. This is especially dangerous misinformation in the event of a multi-resistant Staphylococcus aureus (MRSA) infection14 in susceptible individuals in the population, such as those suffering from diabetes, malnourishment, the elderly, and those with other chronic diseases15.
Sexually transmitted infections (STI), as well as reproductive tract infections have become an increasingly serious public health problem among African communities in recent years, in part because of changing sexual behaviors16. This includes an alarming rise in HIV/AIDS, and Nigeria is no exception. A belief in the claims of herbalists could result in a delay in diagnosis and treatment of an STI, with tragic results.
It is important to expose the ignorance of many Nigerian traditional practitioners, especially those peddling herbal potions. The media must be cautioned to uphold the tenets of journalism, especially when reporting health issues. The Nigerian government must regulate the activities of the traditional herbal/alternative practitioners, including the imposition and enforcement of penalties for false advertising. The National Agency for Food and Drug Administration Control (NAFDAC) should determine the required quality of so-called herbal medications and impose regulatory controls. More resources should go into improving access to primary health care. And, finally, the general public in this and other developing counties should be educated to obtain medical attention from appropriate practitioners. Such interventions will not only promote health, but also protect lives.
Adenike O Ogunshe, PhD
Lecturer, Applied Microbiology and Infectious Diseases Unit
Department of Botany & Microbiology, University of Ibadan, Nigeria
1. Wilt TJ, Ishani A, Rutks I, MacDonald R. Phytotherapy for benign prostatic hyperplasia. Public Health Nutrition 2000; 3: 459-472.
2. Ogunshe AAO, Fasola TR, Egunyomi A. Bacterial profiles and consumer preference of some indigenous orally consumed herbal medications in Nigeria. Journal of Rural and Tropical Public Health 2006; 5: 27-33.
3. Langyan NK, Ahuja M. Estimation of nickel and cobalt in herbal products. In, Proceedings 141st British Pharmaceutical Conference Science. 26-28 September, 2005; Manchester, UK; 2005; 220.
4. Tyler VE, Robbers JE, Tyler VE. Tyler's herbs of choice: the therapeutic use of phytomedicinals, 2nd edition. Binghamton, NY: Haworth Herbal Press, 1999.
5. Ogunshe AAO, Kolajo TT. In vitro phenotypic antibiotic resistance in bacterial flora of some indigenous orally consumed herbal medications in Nigeria. Journal of Rural and Tropical Public Health 2006; 5: 9-15.
6. Thar AB. Get rid of your Staph aureus very fast. Weekend Vanguard newspaper, 1 September 2001; 27.
7. Labeeb Alh. Free yourself totally from Staphylococcus this millennium. TELL magazine, 16 July 2001; 26.
8. Shiek A. Flush Staphylococcus out permanently with powerful herbs and enjoy Good. FAME magazine, 22 May 2001; 22.
9. Kukab Alh. Beware: Staphylococcus disease could ruin your love life. TEMPO magazine. 12 September 2001; 13.
10. Tibar AB. Get well with Tibar therapy. There's permanent cure for your Staph Aureus and weak erection. Sunday SUN newspaper, 7 August 2005; 45.
11. Qumas A. Beware Staphylococcus could render you impotent. TELL magazine, 28 July 2001b; 10.
12. Shiek A. Flush Staphylococcus out permanently with powerful herbs and enjoy good health. FAME magazine, 23 July 2001; 22.
13. Klodkowaska-Farner E, Zwolska-Kwiet Z, Wojciechowka M, Bestry I, Pacocha W, Podsiadlo B et al. Pneumonia in patients after extra corporal circulation. Pneumonologia i Alergologia Polska 1995; 63: 371 - 377.
14. Tuo P, Montobbio G, Callarino R, Tumolo M, Calero MG, Massone MA. Nosocomial infection caused by multi-resistant staphylococci in a neonatal and pediatric intensive care unit. Paediatric Medicine and Clinic 1995; 17: 117 - 122.
15. Lowy FD. Staphylococcus aureus infections. New England Journal of Medicine 1998; 339: 520-532.
16. Burnett GW, Henry WS, Schuster SG. Staphylococcus and staphylococcal infections. In: GW Burnett, HW Scherp (Eds). Oral microbiology and infectious disease, 1st edn. Baltimore, MD: Williams and Wilkins, 1996; 405-416.
Correction: A change was made to reference 16 on 24 September 2007. Previous reference 16 cited as: World Health Organization. Global prevalence and incidence of selected curable sexually transmitted infections. Overview and estimates. Geneva: WHO, 2001.