Determinants of the use of traditional herbal remedies among type 2 diabetes mellitus patients in Myanmar

다국어 초록 (Multilingual Abstract)

Background
Chronic disease like Diabetes Mellitus required virtually life-long therapy which favored patients to look for complementary and alternative remedies apart from conventional therapy. The consumption of herbal remedies is very common in type 2 DM patients in Myanmar though popular remedies that they used were hardly proven for its safety as well as its efficacy on maintaining blood glucose at required level. Yet, self-perceived satisfaction over traditional herbal remedies use and negative perception on conventional medicine further steer them toward the use of traditional herbal remedies. This study explored the relationship between diabetes patients’ perception and practice on the use of traditional herbal remedies as well as prevalence, characteristics and possible predictors of using herbal remedies among type 2 DM patients in Myanmar.
Method
A cross-sectional study with 359 of type 2 diabetes patients attending humanitarian aids out-patient’s clinics in Mandalay, Myanmar. Using structured questionnaires containing (39) items, data were collected by face-to-face interview after attaining informed consent from participating patients. Descriptive analysis along with univariate and multivariable analysis were done to determine the traditional herbal remedies use among participants based on their characteristics.


Results
This study revealed (182, 50.7%) of type 2 diabetes mellitus use traditional herbal remedies for managing DM especially for controlling blood glucose level (120, 67.4%). The commonest type of herbs used among users are Sambung Nyawa (Gynura procumbens) (51, 28.5%), Moonseed vine (Cocculus Menispermum) (36, 20.1%), and King of bitters (Andrographis paniculata) (35, 19.6%). Almost three quarter (n=132, 72.9%) of those who used traditional herbal remedies believe that it helped them maintain their blood sugar level and (23, 17.2%) regarded it helped them very much and (65, 48.5%) respondents as it has effect to some extent. More than (80%) failed to inform their doctors about the use of herbal remedies. In a chi square test, higher use of traditional herbal remedies among type 2 DM patients were associated with middle education level group (43.4%, p= 0.002), urban and peri-urban dweller ((38.5% & 35.2%, p=0.041) and patients who made self-pay for medical care (44.0%, p= <0.001) and negative self-perceived effectiveness over the DM treatment (oral medication) (80%, p=0.011).
Conclusion
Significant proportion of type 2 DM patients is using traditional herbal remedies. The reason was that they believe these remedies could help maintain their blood glucose level. However, the users never inform their physician about the use of traditional herbal remedies which were scarcely proven scientifically for its effectiveness. Besides, the negative impression on the conventional treatment may affect their compliance with diabetes medications for the control of diabetes mellitus. Behaviors and practices of using traditional herbal remedies among type 2 DM are not to be neglected as they can impose the outcome of conventional treatment and in preventing complication.

목차 (Table of Contents)

• ACKNOWLEDGEMENT i
• DEDICATION ii
• TABLE OF CONTENTS iii
• LIST OF ABBREVIATIONS viii
• LIST OF TABLES ix
• LIST OF FIGURES xi
• ABSTRACT xii
• CHAPTER 1. INTRODUCTION 1
• CHAPTER 2. LITERATURE REVIEW 7
• CHAPTER 3. HEALTH SYSTEM IN MYANMAR 29
• CHAPTER 4. RESEARCH METHODOLOGY 37
• CHAPTER 5. RESULTS OF STUDY 44
• CHAPTER 6. DISSCUSION 64
• CHAPTER 7. CONCLUSION 75
• CHAPTER 8. POLICY IMPLICATION 77
• REFERENCES 78
• APPENDICE 85