This study investigated the preventive and promotive health care in the practice of indigenous healers. It focussed on specific aspects of primary health care. The objectives of the study were to describe the current practice of indigenous healers with regard to preventive and promotive health care. The study also identified specific areas in which indigenous healers practices with regard to preventive and promotive health care can be enhanced. It also intended to describe the effect of a short training course for indigenous healers based on the assessment, with regard to their knowledge, beliefs and practice. The study was a qualitative multi-phased research project which ircluded three phases. The researcher's target population ccnsisted of indigenous healers in Region D of KwaZulu-Natal. The researcher targeted indigenous healers living at Vryheid District Under Hlahlindlela tribal Authority. Sisters at the clinics in Vryheid and Pietermaritzburg participated in the present study as well as western medical practitioners and nurses at Edendale hospital. Focus group discussions and individual interviews were conducted. A template method of data analysis was used. Results revealed that indigenous healers practices were claracterized by preventive and promotive health measures which were, to a greater extent African -culture related. Areas of concern where indigenous healers practices would be enhanced were intensified by the formal health care workers. A short training course was designed and implemented by the researcher. Evaluation of the training course revealed that it was to a greater extent effective. / Thesis (M.N.)-University of Natal, Durban, 2003.

No abstract available. / Thesis (M.D.)-University of KwaZulu-Natal, Durban, 2007.

This study aimed at investigating the knowledge, perceptions and attitudes of both the community and traditional healers with regard to the diagnosis and treatment of malaria in KwaZulu Natal with special reference to Ndumu in the magisterial district of Ingwavuma. Ingwavuma is one of the two northern magisterial district of KwaZulu Natal Province which is regarded as the highest malaria risk district in South Africa as a whole. The area has a warm temperature, 27-32°C, which is favourable for the development of the Anopheles mosquito. The factors predisposing the community to malaria infections were the socio-economic status of the area which is characterised by poverty. unemployment, poor housing and illiteracy, cross border migration, drug resistance, the agricultural development and irrigation scheme. Efficient control measures like house spraying a residual insecticide to control malaria vector mosquitoes, passive surveillance and active case detection with definitive diagnosis and treatment in place to prevent and control the upsurge of the disease The objectives of the study were to ascertain the knowledge. attitudes and perceptions of traditional healers in regard to malaria diagnosis and treatment and that of the community in relation to malaria treatment and diagnosis by traditional healers. The ultimate objective was to identify possible forms of collaboration between the traditional and the modern health services. The study was conducted from sections 2 - 10 of Ndumu where the population was 13 047 and 1300 households. A random sample of 173 respondents from the community and 70 traditional healers were selected for interview. Qualitative and quantitative methodologies were used in order to collect numerical and descriptive information. Data was collected using semi- structured questions and two sets were made: for traditional healers and the community. The study showed that the community was well aware of the signs of malaria but their knowledge was not supported by definitive testing and diagnosis of the condition. It came out that there are forms of health services available at grass root levels for example. self - help. where an individual tried on his own to combat he offending symptoms of the disease, family support systems, where family members especially the elder member gave support and assisted during the times of ill-health, the use of traditional healers, the malaria control camp, clinics and the hospital. The community supported the idea of collaboration between healers and the malaria control team and expressed their willingness to attend the services of a trained healer. Traditional healers confirmed the fact that some community members utilize traditional healers services and also expressed their wish to see the two forms of health services working together to control malaria. / Thesis (M.Sc.)-University of Natal, Durban, 2000.

This study was undertaken as a result of the occurrence of a large number of deaths among the local Black population from the use of herbal medicines prepared from the rootstock of Callilepis laureola known to the Zulus as impila. The salient clinico-pathological features in these cases were hypoglycaemia, centrilobular zonal liver necrosis and acute renal tubular necrosis. The purpose of this study was to investigate fully the clinical, biochemical and pathological aspects of the toxicity produced by Callilepis laureola (impila). The first part of the investigation consisted of an assessment of all cases of death due to acute liver necrosis diagnosed by necropsy at King Edward VIII Hospital, Durban. A review of clinical and necropsy records of 21687 consecutive post-mortems performed on Black patients during a 20 year period showed that acute liver necrosis was the major contributing cause of death in 447 patients. In 263 cases the hepatic lesion was centri lobular zonal necrosis with associated acute tubular necrosis (Group A); while in 184 cases the I iver necrosis was of the massive or submassive type (Group B). A comparative assessment of these two groups as regards necropsy prevalence, age and sex distribution and the clinical, biochemical and pathological findings was undertaken. This study shows that the combination of hypoglycaemia, centri lobular zonal liver necrosis and acute renal tubular necrosis due to Callilepis laureola (impila) poisoning is a distinct clinico-pathological entity and differentiates this group from cases of acute massive and submassive liver necrosis resulting in most cases from fulminant viral hepatitis. In the search for the toxic components of the root of Callilepsis laureola several compounds were isolated. These were atractyloside, carboxyatractyloside, two thymol related oils and a carbohydrate. The thymol related oils as well as the carbohydrate were found to be non-toxic in laboratory rats. The crude methanol extract of the root of Callilepsis laureola, when injected intraperitoneally into laboratory rats, produced centrilobular zonal liver necrosis and acute renal tubular necrosis, the lesions identical to those seen in patients who had died after intake of impila prescribed by witchdoctors and other dispensers of herbal medicines. On the other hand intraperitoneal injections of the purified compound atractyloside caused acute renal tubular necrosis and hypoglycaemia in laboratory rats but failed to produce liver necrosis. Carboxyatractyloside also failed to cause liver necrosis. This indicated that there may be at least two toxins contained in the rootstock of Callilepsis laureola, one causing the liver lesion and the other (atractyloside) causing nephrotoxicity and hypoglycaemia. Repeated attempts at isolating the hepatotoxin have failed; the liver toxin or toxins being lost during the process of extraction and purification. Identification of the hepatotoxin awaits further investigation. It is possible that the liver necrosis may be caused by a metabolite or that it may be a synergistic effect of two or more compounds. / Thesis (MD)-University of Natal, 1983.

The purpose of this study was to get a better sense of what collaborative efforts between the allopathic and indigenous health systems to address HIV/ AIDS look like 'on the ground' with the hope that revealed successes and failures could inform other initiatives. The pilot investigation took the form of a small case study of the Community Health and HIV/AIDS project at the Valley Trust in KwaZulu Natal's Valley of a Thousand Hills where HIV/AIDS collaboration with traditional healers has taken primarily three forms: 1) incorporation in the formal primary health care system as CHWs (TH/CHWs); 2) formal short-term HIV/AIDS training (Trained); and 3) informal second-hand HIV/AIDS training or information sharing (Untrained). The investigation focused primarily on how the indigenous healers' involvement in the Valley Trust's varying training programs affected their knowledge ofthe disease, their engagement in HIV/ AIDS awareness and prevention efforts, their treatment of HIV/AIDS patients, and their perception and relationship with the formal medical system. The findings show that collaboration between traditional and formal health services, in the form of the Valley Trust's training, results in 'better' HIV/AIDS work by participating traditional healers through enhanced performance on HIV/AIDS knowledge tests. As indicated by their superior performance on correlating knowledge indices, TH/CHWs engaged in the most effectual community prevention activities of the three groups. Additionally, the TH/CHW group appeared to have the most confidence and experience in treating patients with HIV/AIDS. Additionally as compared to the other two groups, their treatment methods were more varied, induding psycho-spiritual ceremonies, diet, traditional medicinal herbs, and support of biomedical efforts. Given the comparative success of TH/CHWs, it was ironic that only the healers' themselves indicated wanting more izangomas to serve as Community Health Workers. As leaders among participating healers, TH/CHWs were critical to the success of the Valley Trust's collaborative project. The findings of this case study suggest that the nature of the varying trainings offered by the Valley Trust accounted for the primary difference in the effectiveness of the healers' subsequent HIV/AIDS work. The study implies that both the skills-based nature and long-term supervision of the CHW training were instrumental in their superior performance. These findings point to the fact that indigenous healers can not function effectively as extension services without investment in infrastructure development and ongoing support. In terms of the collaboration between biomedical and indigenous health systems operating at the Valley Trust, the primary point of contention between the participating parties was the collaboration's unidirectional referral system (healers would refer patients to the clinic and not vice versa). Discrepancies in the collaborative partners' perceptions of one another, which were revealed in the study, point to the need for greater dialogue and formal linkages between participating groups. A referral system of some content and magnitude appears to be the most critical and pressing issue the new structure needs to address. / Thesis (M.Dev. Studies)-University of Natal, Durban, 2002.

Traditional medicine in South Africa is part of the culture of the people and has been in existence for a long-time. Although animal components form part of the ingredients used, plant material constitutes the major component. South Africa is endowed with vast resources of medicinal and aromatic plants which have been employed for treatment against various diseases for decades. A large number of South Africans still depend on traditional medicine for their healthcare needs due to its affordability, accessibility and cultural importance. Helminth infections are among the variety of diseases treated by traditional healers. These infections are regarded as neglected tropical diseases (NTDs) due to their high prevalence among the economically disadvantaged living in rural areas in different regions of the world. / Thesis (M.Sc.)-University of KwaZulu-Natal, Pietermaritzburg, 2009.

Introduction Willingness to participate in clinical trials is a crucial element in recruitment of suitable participants for intervention trials. Measurement of willingness to participate assists in determining community preparedness for clinical trials, such as HIV vaccine trials. Therefore, researchers have developed a Clinical Research Involvement Scale (CRIS) to assess willingness to participate modelled on the Theory of Reasoned Action. The CRIS was tested in the USA and was noted that it would benefit from additional testing in other populations. Aim The purpose of this study is to determine whether racial differences exist in willingness to participate and explore potential factors associated with willingness to participate in HIV prevention research. Methods A cross sectional analytic study was conducted. The CRIS was administered to university students aged 18-45 at the University of KwaZulu-Natal in South Africa. The CRIS was administered online with a demographic questionnaire to facilitate evaluation of possible associations between willingness to participate and age, gender, relationship status, parity, religion, education status, student status, employment status and access to private health care. Participation was once-off at the time of completing the scale. Results The study enrolled 636 participants, two thirds being female. An effective sample size of 509 was considered for analysis after data was cleaned for accuracy and completeness. The results indicated that all students across all race groups were willing to participate in HIV prevention research. However, when considering factors that affected willingness to participate, statistically significant differences were noted. Based on the differences amongst these factors, Black students expressed greater intention to participate compared to White and Indian students. The CRIS was deemed a reliable instrument in this population; however in its current structure it did not show strong validity. Validity improved if the factors of motivation to comply and outcome evaluations were removed in this population. Discussion The study findings are specific to students of the University of KwaZulu-Natal and cannot be generalized to other populations. The racial differences in factors that affect willingness to participate indicate differences in risk perception and seeking access to better quality healthcare. Recommendations The CRIS should be used in other student populations to assess its validity. (350 words) / Thesis (M.Med.Sc.)-University of KwaZulu-Natal, Durban, 2013.

AIDS has had a negative impact on developing countries. Because most developing countries cannot afford the new antiretroviral drug therapies, it has been suggested that preventive vaccines might reduce the spread of the HIV/AIDS epidemic (Bloom, 1998). The clinical trials of AIDS vaccines do, however, present with complex ethical issues such as informed consent. Informed consent is primarily grounded on the Western principle of respect for individuals as autonomous agents. This may be at variance, however, with African societies' emphasis on the social embeddedness of the individual. The current study forms part of the HIVNET vaccine trials to be conducted in Hlabisa, in Northern Zululand, under the auspices of the South African Medical Research Council. The main aim of the study was to explore key informants' cultural conceptions of research and informed consent in order to facilitate community consultation and cultural sensitivity. Maximum variation sampling was used to select twenty-three key informants, who are in leadership positions within Hlabisa. An interview guide was used to facilitate narrative disclosure of cultural conceptions of research and informed consent. Perceptions of research, conceptions of the informed consent process, and projected motivations for why individuals agree to participate in studies were explored during interviews. Results suggest that members of the Hlabisa community have a limited understanding of the Western research process. Community education about research is therefore warranted. Informants indicated that community members would value the establishment of a relationship characterised by mutual respect for cultural differences between researchers and participants. This was perceived as likely to facilitate shared decision-making, and the reduction of the power differentials that exist between researchers and participants. While the involvement of key community leaders and family members was recommended by most informants, a few informants felt that participants could also make individual decisions about participation. The theoretical implications of the study are considered last. / Thesis (M.A.)-University of Natal, Pietermaritzburg, 1999.