project - use of herbal drugs

8/10/2019 Project - Use of Herbal Drugs

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CHAPTER ONE

1.0 INTRODUCTION

Herbal medicine also called botanical medicine or phyto-medicine refers to

using a plants seeds, berries, roots, leaved, barks or flowers for medicinal

purposes. Herbalism has a long tradition of use outside of conventional, medicine.It is becoming more main-stream as improvements in analysis and quality control

along with advances in clinical research show that value of herbal medicine in the

treating and preventing disease.

Plants had been used for medicinal purposes long before recorded history. Ancient

Chinese and Egyptians papyrus writings describe medicinal uses for plants as

early as 3,000 BC. Indigenous cultures (such as African and Native American)

used herbs in their healing rituals, while others developed traditional medical

systems (such as Ayurveda and Traditional Chinese Medicine) in which herbaltherapies were used. Researchers found that people in different parts of the world

tended to use the same or similar plants for the same purposes.

In the early 19thcentury, when chemical analysis first became available, scientists

began to extract and modify the active ingredients from plants. Later, chemists

began making their own version of plant compounds and, over time, the use of

drugs is derived from botanicals.

Recently, the World Health Organization estimated that 80% of people worldwide

rely on herbal medicines for some part of their primary health care. In Germany,

about 600 700 plant based medicines are available and are prescribed by some

70% of German physicians. In the past 20 years in the United States, public

dissatisfaction with the cost of prescription medications, combined with an interest

in returning to natural or organic remedies, has led to an increase in herbal

medicine use.

1.1

RESEARCH OBJECTIVES

The general objective of the research is to determine the factors affecting the

opinion of Lagos State Residents on the use of herbal drugs. The specific objectiveincludes:

i.

To determine the effect of:

a.

Occupation on the use of herbal drugs.

b.

Educational qualification on the use of herbal drugs

c.

Age of the use of herbal drugs

ii To identify problems associated with the use of herbal drugs.


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1.2

SCOPE OF STUDY

The research considers the Lagos populace as to see their view on the use of

herbal drugs. Samples were taken from the following local governments:

1.2.1 Alimosho LG

Alimosho is a Local Government Area in Ikeja Division, Lagos State,Nigeria. It is the largest local government in Lagos with 1,277,714

inhabitants according to the official 2006 Census (however, the Lagos State

Government disputes the official Census figures and claims a population

within the LGA of more than 2 million residents). It has now been

subdivided between several Local Community Development Areas (LCDA).

1.2.2 Ajeromi-Ifelodun LG

Ajeromi-Ifelodun is a Local Government Area in Badagry Division, Lagos

State. It has some 57,276.3 inhabitants/km2

, among if not the world densest.

1.2.3 Kosofe LG

Kosofe is a Local Government Area of Lagos State, Nigeria. Its headquarters

are in the town of Kosofe. It has an area of 81km2 and a population of

665,393 at the 2006 census.

1.2.4 Mushin LG

Mushin is a suburb of Lagos, located in Lagos State, Nigeria, and is one of

Nigerias 774 Local Government Areas. It is located 10km north of the Lagos

city core, adjacent to the main road to Ikeja, and is a largely a congested

residential area with inadequate sanitation and low-quality housing. It had

633,009 inhabitants at the 2006 census.

1.2.5 Oshodi-Isolo LG

Oshodi-Isolo is a Local Government Area (LGA) within Lagos State. It was

formed by the second republic Governor of Lagos State, Alhaji Lateef

Kayode Jakande, also known as Baba Kekere and the first Executive

Chairman of the Local Government was Late Chief Isaac Ademolu Banjoko.

The LGA is part of the Ikeja Division of Lagos State, Nigeria. At the 2006

census it had a population of 621,509 people, and an area of 45km2.

The research studies education, occupation and age as it affects the usage of

herbal drugs and the significance of probable problems to its usage.


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1.3

LITERATURE REVIEW

Tabuti et al (1993) in an article on traditional herbal drugs presented an inventory

of the medicinal plants of Bulamogi country in Uganda, including their medicinal

use, preparation and administration modes. Fieldwork for this study was

conducted between June 2000 and June 2001 using semi-structured interviews,questionnaires, and participant observation as well as transects walks in wild

herbal plant collection areas. They recorded 229 plant species belonging to 168

genera in 68 families with medicinal properties. A large proportion of these plants

are herbaceous. The medicinal plants are mainly collected from the wild. Some

species, such as Sarcocephalus latifoliys (Smith) Bruce, are believed by the

community to be threatened y unsustainable intensities of use and patterns of

harvesting. Particularly vulnerable are said to be the woody or the slow growing

species. Herbal medicines are prepared as decoctions, infusions, powders, or as

ash, and are administered in a variety of ways. Other concoctions consist of juicesand saps. The purported therapeutic claims await validation. Validation in our

opinion can help to promote confidence among users of traditional medicine, and

also to create opportunities for the marketing of herbal medicines and generate

incomes for the community. The processing packaging and storage of herbal

medicines is substandard and require improvement.

Yang et al (1999) in an article on rapidly progressive fibrosing interstitial

nephritis associated with Chinese herbal drugs noted that rapidly progress

fibrosing interstitial nephritis after a slimming regimen containing aristolochicacid has been identified as Chinese herbs nephropathy (CHNP). From 1995 to

1998, we observed 12 Chinese people from different areas of Taiwan who

underwent renal biopsy for unexplained renal failure. Medical history gave no clue

to the causes of impaired renal function except for the ingestion of traditional

Chinese herbs. Although these patients ingested herbal drugs from various sources

for different purposes, their renal biopsy samples showed amazingly similar

histological findings, with extensive hypocellular interstitial fibrosis and atrophy

and loss of tubules in all cases. Glomeruli were apparently intact. They also had

similar clinical features, such as normal or mildly elevated blood pressure, earlyand severe anemia, low-grade proteinuria, glycosuria, and insignificant urinary

sediments. Renal function deteriorated rapidly in most patients despite

discontinuation of the herbal medicines. Seven patients underwent dialysis, and

the remainder experienced slowly progressive renal failure. Bladder carcinoma

was found in one patient. Morphologically and clinically, the nephropathy in our

patients was similar to CHNP, reported in Belgium. Because of the complexity


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and unknown types of herbs used in different clinical situations, unidentified

phytotoxins other than aritolochic acid might be responsible for this unique

disease entity. We conclude that the relation of this nephropathy to the

consumption of Chinese herbs is striking. Using uncontrolled herbal remedies

carries a high risk for developing interstitial renal fibrosing and urothelia

malignancy.

Joshi and Kaul (2001)in a journal on herbal drugs were of the view that among

alternative therapeutic approaches that have shown global popularity during the

past decades, herbal medicine stands out as a major concern in the countries where

allopathic medicine prevails. The sales of herbal products as health care adjuvant

in these countries have increased exponentially. Lack of quality control,

commercial profiteering and exploitation leading to adulterations, lack proper

knowledge about the herbs and their contents that may exhibit drug-drug

interactions and other adverse side-effect, and inappropriate usage of the herbal

products have become a cause for concern in the health care professions,

particularly in the United States. This review provides an incisive description of

the known chemical, pharmacological, clinical and toxicological profiles of four of

the most widely used herbal products.

Choi et al (2002)in a journal on regulation and quality control of herbal drugs in

Korea pointed out that Korea has a great diversity in resources of medicinal plants.

The traditional herbal medicines and their preparations have been widely used in

Korea as well as in China and Japan for thousands of years. One of the

characteristics of Korean herbal medicine preparations is that all the herbal

medicines are incorporated into extractor at the same time and extracted with

boiling water during the decoction process. In this process, a variety of

interactions between the active components of several herbal drugs is more

difficult than that of western herbal drug. In this paper, we would like to present

an overview of the characteristics of regulation and quality control of herbal

medicines in Korea.

Jia et al (2003)in a book on antidiabetic herbal drugs in China stated that over the

centuries, Chinese herbal drugs have served as a major source of medicines for the

prevention of and treatment of disease including diabetes mellitus (known as

Xiao-ke). It is estimated that more than 200 species of plants exhibit

hypoglycaemic properties, including many common plants, such as pumpkin.

Wheat, celery, wax, guard, lotus root and bitter melon. To date, hundreds of herbs

and traditional Chinese medicine formulas have been reported to have been used


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(total aerobic mesophilic count, enterobacteria, coliforms, aerobic sporeformers,

yeasts and moulds, enterococci, lactobacilli, pseudomonades and aeromades) and

selective methods for detection of indicator microorganisms pathogens (E. coli,

enterohaemorrhagic E.coli (EHEC), Salmonella, Campylobacter jejuni,

Psudomonas aeruginosa, Bacillus cereus, Clostridium perfringens, Listeria,

coagulase-positive staphylococci, Candida albicans, potentially aflatoxigenic

moulds) were applied. The microbial load of the samples varied considerably.

While none of the samples contained EHEC, Salmonellae, Pseudomonas,

aeruginosa, Listeriae, Staphylococcus aureus or Candida albicans, four samples

were E.coli positive, two samples were presumptively Campylobacter jejuni

positive and none herbal drugs contained a potentially aflatoxigenic mould flora.

Further details regarding different viable count classes as well as preparation

techniques are discussed.

Ernst (2008) in an article on the adverse effect of herbal drugs in dermatology

noted that herbal treatments are becoming increasingly popular, and are often used

for dermatological conditions. Thus dermatologists should know about their

potential to cause adverse events. This review is aimed at addressing this area in a

semisystematic fashion. Some agents, particularly Chinese herbal creams, have

been shown repeatedly to be adulterated with corticosteroids. Virtually all herbal

remedies can cause allergic reactions and several can be responsible for

photosensitization. Some herbal medicines, in particular Ayurvedic remedies,

contain arsenic or mercury that can produce typical skin lesions. Other popular

remedies that can cause dermatological side-effects include St Johns Wort, Kava,

aloe vera, eucalyptus, camphor, henna and yohimbine. Finally, there are some

herbal treatments used specifically for dermatological conditions, e.g. Chinese oral

herbal remedies for atopic eczema, which have the potential to cause systemic

adverse effects. It is concluded that adverse effects of herbal medicines are an

important albeit neglected subject in dermatology, which deserves further

systematic investigation.

Stedman (2012) in an article on herbal hepatoxicity noted that herbal

hepatotoxicity is increasingly recognized as herbal medicines become more

popular in industrialized societies. Some herbal products may potentially benefit

people with liver disease; however, these benefits remain generally unproved in

humans, and a greater awareness of potential adverse effects is required. Herbal

use is often not disclosed, and this may result in a diagnostic delay and

perpetuation or exacerbation of liver injury. Female gender may predispose to


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hepatotoxicity, and concomitant agents that induce cytochrome P450 enzymes

may also increase individual susceptibility. The range of liver injury includes

minor transaminase elevations, acute and chronic hepatitis, steatosis, zonal or

diffuse hepatic necrosis, hepatic fibrosis and cirrhosis,veno-occlusive disease, and

acute liver failure requiring transplantation. In addition to potential for

hepatotoxicity, drug-drug interactions between herbal medicines and conventional

agents may affect the efficacy and safety of concurrent medical therapy. This

review focuses on emerging hepatotoxin and patterns of liver injury, potential risk

factors for herbal hepatotoxicity, and herb-drug interactions. Appropriate reporting

and regulatory systems to monitor herbal toxicity are required, in conjunction with

ongoing scientific evaluation of the potential benefits of phytotherapy.


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CHAPTER TWO

DATA COLLECTION

2.1

RESEARCH DESIGN

Survey design was used in the study. The data collected was primarily through the

use of a well defined questionnaire. The sampling technique where the entire

population is divided into groups, or clusters and a random sample of these

clusters are selected. All observations in the selected clusters are included in the

sample.

This method was used as the researcher cannot get a complete list of the

population of the state but can get a complete list of groups or clusters or local

government of the state.

This sampling technique was used as it is more practical and/or economical thansimple random sampling or stratified sampling.

2.2 SAMPLE SIZE

A sample size of 100 people was taken from five (5) randomly selected clusters

(local government) in Lagos State. Hence, the population considered in the

research is 500 people.

2.3 DATA COLLECTION METHOD

The type of data to be used as said earlier is primary data, and this would be

collected through the use of questionnaire (Appendix 1).

2.4 PROBLEMS OF DATA COLLECTION

Although the main tool to any research work, the process of getting statistical data

for analysis is always challenging and pains-taking. Quite a number of problems

arose but the core ones are:

i.

Although the data was collected during weekends when most of the targetrespondents will be available, convincing the respondent to respond to the

questionnaire was really cumbersome.

ii. Also, the choice of sample area (Local Government) was not easily made as

detailed information on each LGs in the State was collected and sampling

criteria considered.


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iii.

Finally, the cost of transportation and printing out the questionnaire was

also a problem.

2.5 ANALYTICAL METHOD

The methods considered in the research include:

Chi-Square: It is used to test frequency. The respondents has different options of opinion

to the question which will be presented as frequencies. Hence, the test was used.

Kruskal-walis: The questionnaire captured major likely problem affecting the great use of

herbal drug in Lagos. The kruskal-walis test compares samples from the same population

to see if theres a significant difference.

Wilcoxon Signed- Rank: This test is employed when the null hypothesis in the kruskal-

walis which always supports uniformity of the samples is rejected. It is used to identify

the sample(s) that have different performance.


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CHAPTER THREE

DATA ANALYSIS

It is claiming that individual of different occupation and educations are rapidly embracing

the idea of the use of herbal drugs as it offers cure for a wide range of diseases. The claim

also covers that more and more people are going into the production and sales of herbal

drugs as it is economical and easily-found.

3.1 HYPOTHESIS TESTING

3.1.1 Hypothesis One

Ho: Use of herbal drugs is independent on occupation

Hi: Use of herbal drugs is dependent on occupation

Decision Rule: Accept H0if -value < 0.05, otherwise reject.

Table 3.1.1: Test Statistics

Occupation

Chi-Square

df

symp.Sig.

209.631

5

.000

a.

0 cells (0.0%) have expected

Frequencies less than 5.

The minimum expected cell

frequency is 81.8.

2cal = 209.631and = 0.00

Conclusion: Occupation in Lagos state influence the use of herbal drugs.


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3.1.2 Hypothesis Two

Ho: Use of herbal drugs is independent on education

Hi: Use of herbal drugs is dependent on education


Table 3.1.2: Test Statistics

Education

Chi-Square

df

symp.Sig.

303.11

5

.000

b.

0 cells (0.0%) have expectedfrequencies less than 5.


frequency is 81.8.

2cal = 303.11and = 0.000

Conclusion: Education in Lagos state influence the use of herbal drugs.


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3.1.3 Hypothesis Three

Ho: Use of herbal drugs is independent on age of usage

Hi: Use of herbal drugs is dependent on age of usage


Table 3.1.3b: Test Statistics

age

Chi-Square

df

symp.Sig.

46.109a

1

.000

c.

0 cells (0.0%) have expectedFrequencies less than 5.


frequency is 250.0

2cal = 46.109and = 0.000

Conclusion: Age of usage in Lagos state influence the use of herbal drugs.


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3.2 TEST ON PROBLEMS WITH HERBAL DRUGS

RS = Repulsive Smell, BT = Bitter Taste, LoD = Lack of Dosage, PQC = Poor

Quality Control and PAP = Poor Appearance Package

= i = 1, 2, 3, . . ., n

SD =

Table 3.2a: Descriptive Statistics

N Mean Std. Deviation Minimum Maximum

RS

BT

LoD

PQC

PAP

5

5

5

5

5

96.0000

89.0000

91.4000

92.0000

94.2000

122.57039

120.39103

81.08206

60.86050

50.42519

2.00

3.00

13.00

5.00

26.00

262.00

258.00

225.00

166.00

165.00

Ho: Pvi~N(0,1)

Hi: Piv N(0,1)


X 1n

n - 1


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Table 3.2b: One-Sample Kolmogorov-Smirnov Test

RS BT LoD PQC PAPN

MeanNormal Parameters

a,b

Std. Deviation

Absolute

Most Extreme Differences Positive

Negative

Kolmogorov-Smirnov-z

Asymp.Sig. (2-tailed)

5

96.0000

122.57039

.348

.348

-.222

.779

.579

5

89.0000

120.39103

.360

.360

-.238

.805

.536

5

91.4000

81.08206

.248

.248

-.167

.555

.918

5

92.0000

60.86050

.159

.124

-.159

.355

1.000

5

94.2000

50.42519

.231

.231

-.161

.516

.953

a. Test distribution is Normal.

b.

Calculate from data.

Conclusion: Reject H0that the associated problems (RS, BT, LoD, PQC and PAP) do not

follow the normal distribution (Asymp. Sig. 0.597, 0.536, 0.918, 1 and 0.953 > 0.05).

Hence the non-parametric analysis.


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3.2.1 Kruskal-Wallis Test

H0: RS = BT = LoD =PQC = PAP = 0

vs

H1: Tis 0 (for at least an i)

KN = - 3(N + 1) ~ KN


3.2.1a: Test Statistics

a.

Kruskal Wallis Test

b.

Grouping Variable Response

Conclusion: Theres a statistically significant difference between the associated problems

of using herbal drugs (2cal= 4.000, = 0.406)

RS BT LoD PQC PAP

Chi-Square

df

symp.Sig.

4.000

4

.406

4.000

4

.406

4.000

4

.406

4.000

4

.406

4.000

4

.406

i = 1

R12

k

12

N (N+1)


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3.2.2 Wilcoxon Signed- Rank Post-Hoc Test

H0: T1= TK = 0 vs

H1: Tis Tk 0 (for at least an i and k)

Table 3.2.2a: Test Statistics

a.

Wilcoxon Signed Ranks Test

b.

Based on positive ranksc.

Based on negative ranks

Table 3.2.2b: Table of Significance

Pair Z-value

Asymp. Sig. (2-

tailed) Conclusion

RS-BT

RS-LoD

RS-PQCRS-PAP

BT-LoD

BT-PQC

BT-PAP

LoD-PQC

LoD-PAP

PQC-PAP

-1.735

-0.135

-0.405-0,405

-0.135

-0.405

-0.135

-0.674

-0.368

-0.405

0.08

0.893

0.6860.686

0.893

0.686

0.893

0.5

0.713

0.686

Significant difference

No Significant difference

No Significant differenceNo Significant difference







BT-RS

LoD- RS

PQC -RS

PAP- RS

LoD- BT

PQC -BT

PAP- BT

PQC -LoD

PAP-

LoD

PAP -PQC

z

Asymp.Sig.

(2-tailed)

-1.753

.080

-.135

.893

-.405

.686

-.405

.686

-.135

.893

-.405

.686

-.135

.893

-.674

.500

-.368

.713

-.405

.686


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CHAPTER FOUR

SUMMARY, CONCULISON AND RECOMMENDATIONS

4.1 SUMMARY

The research was carried-out to determine rate of herbal drugs usage in Lagos

State using a well-defined questionnaire. The state was divided into clusters (Local

Governments) and a random sample of 100peoples each was taken from five (5)

randomly selected clusters. The response was analyzed using SPSS V21.

4.2 CONCLUSION

Analysis led to the following conclusions:

i. The education, occupation and age of Lagosians positively affect the use of herbal

drugs in that order.

ii.

The associated problems considered (Repulsive smell, Bitter taste, Lack of

Dosage, Poor Quality Control and Poor Appearance Packaging) significantly

contributes to the poor use of herbal drugs in the state.

iii.

The taste and smell of these drugs contributed more than other identified problem

to the poor use of herbal drugs.

4.3 RECOMMENDATIONS

In view of the analysis carried out to improve the spread and appreciation of the

use of herbal drugs i.e her best use, the following suggestions are strongly

recommended.

i.

Other factors responsible for the use of herbal drugs should be sought out like that

is the status of respondents.ii.

The taste and smell of herbal drugs should be considered

iii. A further research is advisable as cases of different sickness springs-out on daily

basis.


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APPENDIX 1

General Response

Response Repulsivesmell

Bitter taste Lack of dosage Poor QualityControl

PoorAppearance of

Packaging

Strongly agreed 193 176 102 166 102

Agreed 262 258 225 123 165

Disagreed 9 4 62 65 75

Stronglydisagreed

14 3 55 101 103

Undecided 2 4 13 5 26

Response Occupation Response Educational

qualification

Response Age

Civil servant 193 FSLC 181 Single 303

Self

employed

262 O LEVEL 97 married 197

Politician 9 Diploma/ON/NCE 102

student 14 BSc/BEd 542 Masters 39

PHD 18

Total 480 Total 491 Total 500


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APPENDIX 2

N-Par Tables

Chi-Square table on Occupation

Observed N Expected N Residual

1.00

2.00

3.00

4.00

Total

103

175

69

134

481

120.3

120.3

120.3

120.3

-17.3

54.8

-51.3

13.8

Chi-Square table on Education


1.00

2.00

3.00

4.00

5.00

6.00

Total

181

97

102

54

39

18

491

81.8

81.8

81.8

81.8

81.8

81.8

-99.2

15.2

20.2

-27.8

-42.8

-63.8

Chi-Square table on Age


1.00

2.00

Total

303

197

500

250.0

250.0

53.0

-53.0


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APPENDIX 3

Kruskal wallis Test Table

Ranks

Response N Mean

Rank

RS

1.00

2.00

3.00

4.00

5.00

Total

1 4.00

1 5.00

1 2.00

1 3.00

1 1.005

BT

1.00

2.00

3.00

4.00

5.00

Total

1 4.00

1 5.00

1 2.50

1 1.00

1 2.50

5

LoD

1.00

2.00

3.004.00

5.00

Total

1 4.00

1 5.00

1 3.001 2.00

1 1.00

5

PQC

1.00

2.00

3.00

4.00

5.00

Total

1 5.00

1 4.00

1 2.00

1 3.00

1 1.00

5

PAP

1.002.00

3.00

4.00

5.00

Total

1 3.001 5.00

1 2.00

1 4.00

1 1.00

5


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APPENDIX 4

Descriptive StatisticsN Percentiles

25th 50th (Median) 75th

RSBTLoD

PQCPAP

555

55

5.50003.5000

34.0000

53.000050.0000

14.00004.0000

62.0000

123.0000102.0000

227.5000217.0000163.5000

165.5000134.0000

RanksN Mean Rank Sum. of Ranks

BTRS

Negative Ranks

Positive Ranks

TilesTotal

4a

1b

0

c

5

2d

3e

0f

5

2g

3h

0i

5

2j

3k

0i

5

2m3n

0o

5

2p

3q

0r

5

2s

3t

0u

5

2v

3w0x

5

1y

3z

1aa

5

3.50

1.00

3.50

2.67

3.00

3.00

4.50

2.00

3.502.67

3.00

3.00

3.50

2.67

2.50

3.33

4.00

2.00

14.00

1.00

7.00

8.00

6.00

9.00

9.00

6.00

7.008.00

6.00

9.00

7.00

8.00

5.00

10.00

4.00

6.00

LoDRS

Negative Ranks

Positive Ranks

Tiles

Total

PQCRS

Negative Ranks

Positive Ranks

Tiles

Total

PAPRS

Negative Ranks

Positive Ranks

Tiles

Total

LoDBT

Negative Ranks

Positive Ranks

Tiles

Total

PQC- BT

Negative Ranks

Positive Ranks

Tiles

Total

PAP- BT Negative Ranks

Positive Ranks

Tiles

Total

PQCLoD

Negative Ranks

Positive RanksTiles

Total

PAPLoD

Negative Ranks

Positive Ranks

Tiles

Total


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PAP - PQC

Negative Ranks

Positive Ranks

Tiles

Total

2ab

3ac

0ad

5

4.50

2.00

9.00

6.00


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STUDENT RESEARCH QUESTIONNAIRE

Please, I am a final year student of University of Nigeria, Nsukka. I really need your

assistance in carrying out a research on A Statistical Analysis of Opinion of Lagos State

Residents on the use of herbal drugs. Please be assured that the information given will

be treated with high confidentially.

Age:------------------------------------------------------------------------------------------------

Educational Level:-------------------------------------------------------------------------------

Occupation:----------------------------------------------------------------------------------------

Age:-------------------------------------------------------------------------------------

Place of Work:------------------------------------------------------------------------------------

Tick the following according to your opinion on the statement.

USAGE OF HERBAL DRUGS SA A SD D U

We use herbal drugs in my family

Herbal drugs are effective

Herbal drugs are expensive

Herbal drugs are common

Herbal drugs should be taken by people above 18yrs

PROBLEMS ASSOCIATED WITH THE USE OF

HERBAL DRUGS

SA A SD D U

Herbal drugs have a repulsive smell

Herbal drugs have a bitter taste

Herbal drugs do not have proper dosage

Herbal drugs do not have quality control

Herbal drugs are not properly package

project - use of herbal drugs

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