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BMC Pregnancy and Childbirth

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01-12-2020 | Research article

Factors associated with local herb use during pregnancy and labor among women in Kigoma region, Tanzania, 2014–2016

Authors: R. Fukunaga, D. Morof, C. Blanton, A. Ruiz, G. Maro, F. Serbanescu

Published in: BMC Pregnancy and Childbirth | Issue 1/2020

Abstract

Background

Despite research suggesting an association between certain herb use during pregnancy and delivery and postnatal complications, herbs are still commonly used among pregnant women in sub-Sahara Africa (SSA). This study examines the factors and characteristics of women using local herbs during pregnancy and/or labor, and the associations between local herb use and postnatal complications in Kigoma, Tanzania.

Methods

We analyzed data from the 2016 Kigoma Tanzania Reproductive Health Survey (RHS), a regionally representative, population-based survey of reproductive age women (15–49 years). We included information on each woman’s most recent pregnancy resulting in a live birth during January 2014–September 2016. We calculated weighted prevalence estimates and used multivariable logistic regression to calculate adjusted odds ratios (aOR) and 95% confidence intervals (CI) for factors associated with use of local herbs during pregnancy and/or labor, as well as factors associated with postnatal complications.

Results

Of 3530 women, 10.9% (CI: 9.0–13.1) used local herbs during their last pregnancy and/or labor resulting in live birth. The most common reasons for taking local herbs included stomach pain (42.9%) and for the health of the child (25.5%). Adjusted odds of local herb use was higher for women reporting a home versus facility-based delivery (aOR: 1.6, CI: 1.1–2.2), having one versus three or more prior live births (aOR: 1.8, CI: 1.4–2.4), and having a household income in the lowest versus the highest wealth tercile (aOR: 1.4, CI: 1.1–1.9). Adjusted odds of postnatal complications were higher among women who used local herbs versus those who did not (aOR: 1.5, CI: 1.2–1.9), had four or more antenatal care visits versus fewer (aOR: 1.4, CI: 1.2–1.2), and were aged 25–34 (aOR: 1.1, CI: 1.0–1.3) and 35–49 (aOR: 1.3, CI: 1.0–1.6) versus < 25 years.

Conclusions

About one in ten women in Kigoma used local herbs during their most recent pregnancy and/or labor and had a high risk of postnatal complications. Health providers may consider screening pregnant women for herb use during antenatal and delivery care as well as provide information about any known risks of complications from herb use.

Available only for authorised users

World Health Organization. WHO: traditional medicine strategy 2014–2023. Geneva: World Health Organization; 2013.

World Health Organization. WHO: guidelines for assessing quality of herbal medicines with references to contaminants and residues. Geneva: World Health Organization; 2007.

Johns T, Sibeko L. Pregnancy outcomes in women using herbal therapies. Birth Defects Res B. 2003. https://doi.org/10.1002/bdrb.10052.PubMedCrossRef

Borins M. The dangers of using herbs: what your patients need to know. Postgrad Med. 1998. https://doi.org/10.3810/pgm.1998.07.535.PubMedCrossRef

Dugoua JJ, Mills E, Perri D, Koren G. Safety and efficacy of ginkgo (Ginkgo biloba) during pregnancy and lactation. Can J Clin Pharmacol. 2006;13:e277–84.PubMed

Rasch V, Kipingili R. Unsafe abortion in urban and rural Tanzania: method, provider and consequences. Tropical Med Int Health. 2009. https://doi.org/10.1111/j.1365-3156.2009.02327.x.CrossRef

Chuang CH, Doyle P, Wang JD, Chang PJ, Lai JN, Chen PC. Herbal medicines used during the first trimester and major congenital malformations. Drug Saf. 2006. https://doi.org/10.2165/00002018-200629060-00006.PubMedCrossRef

Jones TK, Lawson BM. Profound neonatal congestive heart failure caused by maternal consumption of blue cohosh herbal medication. J Pediatr. 1998. https://doi.org/10.1016/S0022-3476(98)70041-1.PubMedCrossRef

Rahman AA, Ahmad Z, Naing L, Sulaiman SA, Hamid AM, Daud WNW. The use of herbal medicines during pregnancy and perinatal mortality in Tumpat District, Kelantan, Malaysia. Southeast Asian J Trop Med Public Health. 2007;38:1150–7.

10.

United Republic of Tanzania. The national traditional and traditional birth attendants Implementation Policy Guidelines. Tanzania, Dar-es-Salaam: Ministry of Health; 2000.

11.

World Health Organization. General guidelines for methodologies on research and evaluation of traditional medicine. Geneva: World Health Organization; 2000.

12.

Mahonge CPI, Nsenga JV, Mtengeti EJ, Mattee AZ. Utilization of medicinal plants by Waluguru people in east Ulunguru mountains Tanzania. Afr J Tradit Complementary Altern Med. 2006;3:121–34.

13.

Kayombo EJ, Uiso FC, Mbwambo ZH, Mahunnah RL, Moshi MJ, Mgonda YH. Experience of initiating collaboration of traditional healers in managing HIV and AIDS in Tanzania. J Ethnobiol Ethnomed. 2007. https://doi.org/10.1186/1746-4269-3-6.

14.

Kisangau DP, Lyaruu HVM, Hosea KM, Joseph CC. Use of traditional medicines in the management of HIV/AIDS opportunistic infections in Tanzania: a case in the Bukoba rural district. J Ethnobiol Ethnomed. 2007. https://doi.org/10.1186/1746-4269-3-29.

15.

Gessler MC, Msuya DE, Nkunya MH, Mwasumbi LB, Schär A, Heinrich M, et al. Traditional healers in Tanzania: the treatment of malaria with plant remedies. J Ethnopharmacol. 1995. https://doi.org/10.1016/0378-8741(95)01293-M.PubMedCrossRef

16.

Liwa A, Roediger R, Jaka H, Bougaila A, Smart L, Langwick S, Peck R. Herbal and alternative medicine use in Tanzanian adults admitted with hypertension-related diseases: a mixed-methods study. Int J Hypertens. 2017. https://doi.org/10.1155/2017/5692572.CrossRef

17.

Maregesi SM, Ngassapa OD, Pieters L, Vlietinck AJ. Ethnopharmacological survey of the Bunda district, Tanzania: plants used to treat infectious diseases. J Ethnopharmacol. 2007. https://doi.org/10.1016/j.jep.2007.07.006.PubMedCrossRef

18.

Kayombo, EJ. Traditional methods of protecting the infant and child illness/disease among the Wazigua at Mvomero Ward, Morogoro, Region, Tanzania. Altern Integ Med. 2013; doi: https://doi.org/10.4172/2327-5162.1000103.

19.

Liwa AC, Smart LR, Frumkin A, Epstein HAB, Fitzgerald DW, Peck RN. Traditional herbal medicine use among hypertensive patients in sub-Saharan Africa: a systematic review. Curr Hypertens Rep. 2014. https://doi.org/10.1007/s11906-014-0437-9.

20.

Mbura Q, et al. The use of oral herbal medicine by women attending antenatal clinics in urban and rural Tanga district in Tanzania. East Afr Med J. 1985;62:540–50.PubMed

21.

Kitula RA. Use of medicinal plants for human health in Udzungwa Mountains forests: a case study of new Dabaga Ulongambi Forest reserve. Tanzania J Ethnobiol Ethnomed. 2007. https://doi.org/10.1186/1746-4269-3-7.PubMedPubMedCentralCrossRef

22.

Kayombo EJ. Traditional birth attendants (TBAs) and maternal health Care in Tanzania. In: Kalipen E, Thiuri P, editors. Issues and perspectives on health Care in Contemporary sub - Saharan Africa by studies in Africa health and medicine. Queenston: Lampeter; 1997. p. 288–305.

23.

Marcus DM, Snodgrass WR. Do no harm: avoidance of herbal medicines during pregnancy. Obstet Gynecol. 2005. https://doi.org/10.1097/01.AOG.0000158858.79134.ea.CrossRef

24.

Hepner DL, Harnett M, Segal S, Camann W, Bader A, Tsen L. Herbal use in parturients. Anesth Analg. 2002. https://doi.org/10.1097/00000539-200203000-00039.CrossRef

25.

Tsui B, Dennehy CE, Tsourounis C. A survey of dietary supplement use during pregnancy at an academic medical center. Am J Obstet Gynecol. 2001. https://doi.org/10.1067/mob.2001.116688.PubMedCrossRef

26.

Ernst E. Herbal medicinal products during pregnancy: are they safe? 2003. https://doi.org/10.1111/j.1471-0528.2002.t01-1-01009.x.CrossRef

27.

Cuzzolin L., Benoni G. Safety issues of Phytomedicines in pregnancy and Paediatrics. In: Ramawat K., editors. Herbal drugs: Ethnomedicine to modern medicine. Heidelberg: Springer, 2009. P381–396.

28.

Nordeng CB, Uwakwe KA, Chinomnso NC, Mbachi II, Diwe KC, Agunwa CC, et al. Socio-demographic Determinants of Herbal Medicine Use in Pregnancy Among Nigerian Women Attending Clinics in a Tertiary Hospital in Imo State, South-East, Nigeria. Am J Med Sci. 2016. https://doi.org/10.12691/ajms-4-1-1.

29.

Nordeng H, Haven GC. Impact of socio-demographic factors, knowledge and altitude on the use of herbal drugs in pregnancy. Acta Obstet Gynecol Scand. 2005. https://doi.org/10.1111/j.0001-6349.2005.00648.x.PubMedCrossRef

30.

Holst L, Wright D, Haavik S, Nordeng H. The use of the user of herbal remedies during pregnancy. J Altern Complement Med. 2009. https://doi.org/10.1089/acm.2008.0467.PubMedCrossRef

31.

Broussard CS, Louik C, Honein MA, Mitchel AA, and the National Birth Defects Prevention Study. Herbal use before and during pregnancy. Am J Obstet Gynecol. 2009; doi: https://doi.org/10.1016/j.ajog.2009.10.865.CrossRef

32.

Orief YI, Farghaly NF, Ibrahim MIA. Use of herbal medicines among pregnant women attending family health centers in Alexandria. Middle East Fertil Soc. 2014. https://doi.org/10.1016/j.mefs.2012.02.007.CrossRef

33.

Fakeye TO, Adisa R, Musa IE. Attitude and use of herbal medicines among pregnant women in Nigeria. BMC Complement Altern Med. 2009. https://doi.org/10.1186/1472-6882-9-53.

34.

Nordeng H, Harven G. Use of herbal drugs in pregnancy: a survey among 400 Norwegian women. Pharmacoepidemiol Drug Saf. 2004. https://doi.org/10.1002/pds.945.PubMedCrossRef

35.

Gharoro EP, Igbafe AA. Pattern of drug use amongst antenatal patients in Benin City. Nigeria Med Sci Monit. 2000;6:CR84–7.

36.

Duru CB, Uwakwe KA, Chinomnso NC, Mbachi II, Diwe KC, Agunwa CC, et al. Socio-demographic Determinants of Herbal Medicine Use in Pregnancy Among Nigerian Women Attending Clinics in a Tertiary Hospital in Imo State, South-East, Nigeria. Am J Med Sci. 2016. https://doi.org/10.12691/ajms-4-1-1.

37.

Ndyomugyenyi R, Neema S, Magnussen P. The use of formal and informal services for antenatal care and malaria treatment in rural Uganda. Health Policy Plan. 1998. https://doi.org/10.1093/heapol/13.1.94.CrossRef

38.

Ajaari J, Masanja H, Weiner R, Abokyi SA, Owusu-Agyei S. Impact of place of delivery on neonatal mortality in rural Tanzania. Int J MCH AIDS. 2012;1:49–59.PubMedPubMedCentralCrossRef

39.

Adams J, Sibbritt D, Lui CW. The urban-rural divide in complementary and alternative medicine use: a longitudinal study of 10,638 women. BMC Complement Altern Med. 2011. https://doi.org/10.1186/1472-6882-11-2.

40.

Robinson A, Chesters J. Rural diversity in CAM usage: the relationship between rural diversity and the use of complementary and alternative medicine modalities. Rural Soc. 2008. https://doi.org/10.5172/rsj.351.18.1.64.CrossRef

41.

Wilkinson JM, Simpson MD. High use of complementary therapies in a New South Wales rural community. Aust J Rural Health. 2001. https://doi.org/10.1046/j.1038-5282.2001.00351.x.PubMedCrossRef

42.

National Bureau of Statistics & Office of Chief Government Statistician. 2012 Population and Housing Census: Population Distribution by Administrative Areas. Dar es Salaam and Zanzibar, Tanzania: NBS Office of Chief Government Statistician; 2013.

43.

U.S. Centers for Disease Control and Prevention. Reducing Maternal Mortality in Tanzania: Selected Pregnancy Outcomes Findings from Kigoma Region, Tanzania. Atlanta, GA: Centers for Disease Control and Prevention; 2016.

44.

U.S. Centers for Disease Control and Prevention. Kigoma reproductive health survey: Kigoma region, Tanzania. Atlanta, GA: Centers for Disease Control and Prevention; 2016. p. 2017.

45.

United Republic of Tanzania: Ministry of Health, Community Development, Gender, Elderly and Children. The National Road Map Strategic Plan to Improve Reproductive, Maternal, Newborn, Child & Adolescent Health in Tanzania (2016–2020): One Plan II. 2016; Dar es Salaam, Tanzania: Author.

46.

Cavazos-Rehg PA, Krauss MJ, Spitznagel EL, Bommarito K, Madden T, Olsen MA, et al. Maternal age and risk of labor and delivery complications. Matern Child Health J. 2015. https://doi.org/10.1007/s10995.

47.

SAS Institute. SAS/ACCESS® 9.4 Interface to ADABAS: Reference. 2013. Cary. NC: SAS Institute Inc.

48.

Shewamene Z, Dune T, Smith CA. The use of traditional medicine in maternity care among African women in Africa and the diaspora: a systematic review. BMC Complement Altern Med. 2017. https://doi.org/10.1186/s12906-017-1886-x.

49.

Gibson PMS, Powrie R, Star J. Herbal and alternative medicine use during pregnancy: a cross-sectional survey. Obstet Gynecol. 2001. https://doi.org/10.1016/S0029-7844(01)01250-9.CrossRef

50.

Rashmi S, Bhuvneshvar K, Ujala V. Drug utilization pattern during pregnancy in North India. Indian J Med Sci. 2006;60:277–87.CrossRef

51.

Moussalhy K, Oraichi D, Berard A. Herbal products use pregnancy: prevalence and predictors. Pharmacoepidemiol Drug Saf. 2008. https://doi.org/10.1002/pds.1731.PubMedCrossRef

52.

Foster DA, Denning A, Wills G, Bolger M, McCarthy E. Herbal medicine use during pregnancy in a group of Australian women. BMC Pregnancy Childb. 2006. https://doi.org/10.1186/1471-2393-6-21.

53.

Henry A, Crowder C. Patterns of medication use during and prior to pregnancy: the MAP study. Aust Nz J Obstet Gyn. 2000. https://doi.org/10.1111/j.1479-828X.2000.tb01140.x.PubMedCrossRef

54.

Usta IM, Nassar AH. Advanced maternal age Part I: obstetric complications Am J Perinatol. 2008. https://doi.org/10.1055/s-0028-1085620.PubMedCrossRef

55.

Skouteris H, Wertheim EH, Rallis S, Paxton SJ, Kelly L, Milgrom J. Use of complementary and alternative medicines by a sample of Australian women during pregnancy. Aust N Z J Obstet Gynaecol. 2008. https://doi.org/10.1111/j.1479-828X.2008.00865.x.PubMedCrossRef

56.

Szreter S, Woolcock M. Health by association? Social capital, social theory, and the political economy of public health. Int J Epidemiol. 2004. https://doi.org/10.1093/ije/dyh013.PubMedCrossRef

57.

Navarro V, Muntaner C, Borrell C, Benach J, Quiroga Á, Rodríguez-Sanz M, et al. Politics and health outcomes. Lancet. 2006. https://doi.org/10.1016/S0140-6736(06)69341-0.CrossRef

58.

Flaskerud JH, Winslow BJ. Conceptualizing vulnerable populations health-related research. Nur Res. 1998;47:69–78.CrossRef

59.

Pachter LM. Culture and clinical care: folk illness beliefs and behaviors and their implications for health care delivery. JAMA. 1994;271:690–4.PubMedCrossRef

60.

Rogers SM, Miller HG, Turner CF. Effects of interview mode on bias in survey measurements of drug use: do respondent characteristics make a difference? Subst Use Misuse. 1998;33:2179–200.PubMedCrossRef

61.

Ssegawa P, Kasenene JM. Medicinal plant diversity and uses in the Sango bay area. Southern Uganda J Ethnopharmacol. 2007. https://doi.org/10.1016/j.jep.2007.07.014.PubMedCrossRef

62.

Steenkamp V. Traditional herbal remedies used by south African women for gynaecological complaints. J Ethnopharmacol. 2003. https://doi.org/10.1016/S0378-8741(03)00053-9.PubMedCrossRef

63.

Tripathi V, Stanton C, Anderson FW. Traditional preparations used as uterotonics in sub-Saharan Africa and their pharmacologic effects. Int J Gynecol Obstet. 2013. https://doi.org/10.1016/j.ijgo.2012.06.020.CrossRef

64.

Kreuter MW, McClure SM. The role of culture in health communication. Annu Rev Public Health. 2004. https://doi.org/10.1146/annurev.publhealth.25.101802.123000.PubMedCrossRef

Title: Factors associated with local herb use during pregnancy and labor among women in Kigoma region, Tanzania, 2014–2016
Authors: R. Fukunaga
D. Morof
C. Blanton
A. Ruiz
G. Maro
F. Serbanescu
Publication date: 01-12-2020
Publisher: BioMed Central
Published in: BMC Pregnancy and Childbirth / Issue 1/2020
Electronic ISSN: 1471-2393
DOI: https://doi.org/10.1186/s12884-020-2735-3

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Factors associated with local herb use during pregnancy and labor among women in Kigoma region, Tanzania, 2014–2016

Abstract

Background

Methods

Results

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Methods

Results

Conclusions

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