Universiti Brunei Darussalam, Brunei Darussalam
Dr. Nurolaini Kifli has completed her PhD at the age of 28 years from Cardiff University, United Kingdom. She is a registered pharmacist in the UK and a Member of the Royal Pharmaceutical Society in Great Britain (UK) since 1999 until now. She is a Senior Lecturer and Deputy Dean (Acdemic, Research and Global Affairs) at a National Premier University in Brunei (Universiti Brunei Darussalam). She has published papers in reputed International journals. She was a lead researcher /co-researcher for various Health-related researches such as study on Use of Traditional Medicines in Brunei, Water Quality in Kg Ayer, Pap smear test Questionnaire and Survival of Cervical Cancer patients in Brunei awarded by the University’s Science and Technology fund and the Ministry of Development’s fund.
Background: The use of traditional medicines (TM) & Complementary Alternative Medicines (CAM) are common in Asian countries including Brunei. The prevalence and predictive factors of CAM in Brunei was reported by Chong VH et al (Singapore Med J. 2008 Dec; 49(12):1012-6) . Our cross-sectional study assessed the prevalence of TM use amongst Bruneians which will include the predictive factors, the perceptions, attitudes and practices of TM for the whole country. WHO defines traditional medicine as “diverse health practices, approaches, knowledge and beliefs incorporating plant, animal, and/or mineral based medicines, spiritual therapies, manual techniques and exercises applied singularly or in combination to maintain well-being, as well as to treat, diagnose or prevent illness”.
Aim: 1. To investigate the extent of TM usage in Brunei 2. To study Bruneian’s perception, attitude, knowledge & practices on the use of TM 3. To compare the practices on the use of TM with Conventional Medicines; & 4. To address the cost implication with the use of TM.
Methods: This study was done in October 2007 to October 2008. It was a cross-sectional study using a structured self-administered questionnaire which was pre-tested from the pilot study. Questionnaires were randomly administered to all patients attending the tertiary hospitals and health centres in all 4 districts in Brunei. The questionnaires are bilingual and consists of 27-item questions. Both sexes were included in the study, and participants had to be mentally competent and of age between 16 years and 85 years. Data entry and analysis were done using SPSS. Information leaflets were given to participants, and their written-informed consent was obtained.
Results: There were 2,400 respondent for this study of which 32% (n=777) were male and 68% (n=1,623) were female, 85 % were Malays, and 55% were in employment status. The proportion of Bruneians who have used some form of TM during their lifetime was 59%, (n = 1,396). Use of TM is equal in proportion among Chinese (62%) and Malay ethnicities (59%). Use of TM was highest in the 56 years and above age group (71%), p<0.01. It was higher amongst female respondents compared to males p <0.001. Sixty four percent of the respondents indicated that TM was safe. Seventy six percent (n= 1,804) of respondents answered that TM are easily available. Majority of TM users (91%) used local herbs and 63% used TM for general health and vitality. Forty three percent of users of prescribed medicines (common cold remedies, antipyretics and antibiotics) reported using TM as well. Seventy three percent of respondents did not report their use of TM to their doctors. Ninety four percent (n = 1,284) of the respondents claimed that there were no adverse effects accompanying use of TM. Sixty two percent perceived TM is safe due to the traditional practices & natural sources Eighty two percent of TM users spend less than BND $ 50 on TM every month.
Conclusions: We concluded from this study that there is a high prevalence of TM use in Brunei despite the free health care system provided in the country. Doctors need to understand TM better and communicate more with their patients regarding TM use. This can be due to their use as maintenance of health rather than for treatment of illness. TM is also easily available and perceived to be safe because it had been used for generations and of natural sources despite their limited scientific evidence. The lack of regulation and perceptions of TM being safe needs extra cautions to avoid any potential serious adverse herb-drug interactions. Therefore, medical and health care workers should not ignore this perceptions and patients’ education is utmost important.