Traditional medicine in Lofa county, Liberia: Self-reported use among patients admitted to a rural district hospital

Introduction: The use of traditional healers and herbal medicines is pervasive throughout West Africa. The objective of this study is to document the characteristics and clinical outcomes of traditional medicine use among patients admitted to the inpatient department of a rural district hospital in Liberia.

Methods: Between August 2005 and July 2007 all inpatient admissions to a rural district hospital were asked a “yes” or “no” screening question regarding their use of traditional medicines in relation to one's presenting symptom(s). A retrospective chart review was conducted and patient clinical and demographic data was tabulated. Pearson Chi-square tests were used to compare cases of self-reported traditional medicine use to reported non-use.

Results: During the two-year study period, 3157 separate inpatient admissions occurred. Of those, 94 (2.98% of total admissions) reported traditional medicine use. Overall use was roughly similar in men (46.8%) and women (53.2%). Clinical diagnoses among patients reporting traditional medicine use were extremely varied. Compared to all other patient admits, traditional medicine cases were less likely to have access to functioning local health centers (p<0.01), and more likely to have adverse outcomes including mortality (p<0.0001), and to sub therapeutic care secondary to leaving against medical advice (p<0.0001).

Conclusions: Patients who self-report traditional medicine use at an allopathic health center are more likely to suffer adverse outcomes. Reported use of traditional medicines in a rural hospital setting are well below published percentages of general population use, indicating a distinct divide between the two forms of care.