Intervention Review

Interventions for educating traditional healers about STD and HIV medicine

  1. Katherine Sorsdahl1,*,
  2. Jonathan C Ipser2,
  3. Dan J Stein3

Editorial Group: Cochrane HIV/AIDS Group

Published Online: 7 OCT 2009

Assessed as up-to-date: 30 NOV 2008

DOI: 10.1002/14651858.CD007190.pub2


How to Cite

Sorsdahl K, Ipser JC, Stein DJ. Interventions for educating traditional healers about STD and HIV medicine. Cochrane Database of Systematic Reviews 2009, Issue 4. Art. No.: CD007190. DOI: 10.1002/14651858.CD007190.pub2.

Author Information

  1. 1

    University of Cape Town, Cape Town, South Africa

  2. 2

    University of Stellenbosch, MRC Research Unit for Anxiety and Stress Disorders, Tygerberg, Western Cape, South Africa

  3. 3

    University of Cape Town, Department of Psychiatry and Mental Health, Cape Town, South Africa

*Katherine Sorsdahl, University of Cape Town, Cape Town, South Africa. kattsorsdahl@gmail.com.

Publication History

  1. Publication Status: New
  2. Published Online: 7 OCT 2009

SEARCH

 

Abstract

  1. Top of page
  2. Abstract
  3. Plain language summary
  4. 摘要

Background

For the treatment of HIV/AIDS, individuals may consult traditional healers because they possess a shared sociocultural background, meet the needs and expectations of the patients, and pay special attention to social and spiritual matters. Various intervention strategies have been adopted to educate traditional healers in various aspects of Western medicine, with a particular focus on HIV/AIDS.

Objectives

To evaluate the effectiveness of interventions for educating traditional healers in the fundamentals of sexually transmitted infection (STI) and HIV medicine.

Search methods

We searched the Cochrane Register of Controlled Trials, Pubmed, Embase, Gatway and AIDSearch from the period of 1980 to 2008. We also handsearched the reference lists of the retrieved articles, located conference proceedings of international conferences related to AIDS
studies and contacted key personnel and organizations working in HIV/AIDS intervention programs in developing countries.

Selection criteria

All intervention studies using a controlled design that have evaluated the effect of educational interventions on any one of the outcome measures specified were included.

Data collection and analysis

Two reviewers independently assessed the eligibility of potentially relevant studies and extracted data from and assessed study quality of included studies. A meta-analysis of study outcomes was not possible given the small number of included studies and the heterogeneity in methodological designs and outcome measures.

Main results

We included two studies (one RCT and one CBA study) in this review (n = 311). Both of these studies indicated that a training workshop increased the knowledge about HIV/AIDS of traditional healers. With regards to behaviour change, Peltzer 2006 detected a significant difference in traditional healers' reports of managing their patients; however, there was no evidence of a reduction of HIV/STI risk behaviours and referral practices, as assessed by self-report. The study by Poudyal 2003 did not assess this outcome.

Authors' conclusions

Two studies met the inclusion criteria for this review. Although these studies reported some positive outcomes, the few studies and methodological heterogeneity limits the conclusions that can be drawn about the effectiveness of HIV training programs aimed at traditional healers. More rigorous studies (i.e. those employing rigorous randomisation procedures, reliable outcome measures and larger sample sizes) are needed to provide better evidence of the impact of HIV training programs aimed at traditional healers.

 

Plain language summary

  1. Top of page
  2. Abstract
  3. Plain language summary
  4. 摘要

Interventions for educating traditional healers about STD and HIV medicine

There is a strong argument for the importance of collaborating with traditional healers in the management of STIs such as HIV/AIDS. Political and health care systems have failed adequately to cope with the pandemic, and engaging every available resource is therefore crucial. One such potential resource is treatment by traditional healers. Certain traditional healer practices, however, could contribute to the spread of HIV/AIDS. Training and educational programmes have been developed as a possible way to improve traditional healer practices.

This review found four studies that evaluated the effectiveness of HIV/AIDS training programs aimed at traditional healers; information about two of these studies is not yet available. Both of these studies found that workshops improved traditional healer knowledge about HIV/AIDS. However, an assessment of behaviour change in one study found that a training program improved traditional healer behaviour in terms of managing patients, but not in reducing risky behaviours and referral practices.

Although the studies evaluated reported some positive outcomes, they were not of high quality. It is therefore difficult to be certain about the efficacy of interventions for educating traditional healers in the fundamentals of STI and HIV medicine.

 

摘要

  1. Top of page
  2. Abstract
  3. Plain language summary
  4. 摘要

背景

對於傳統醫療治療者教導有關性病以及愛滋病醫學之教育工作

許多愛滋病患者或帶原者常常會向傳統醫療治療者尋求醫療治療,主要的原因是因為他們和患者擁有相同的社會文化背景、符核病患的需求與期待、且關心社會與心靈事件。特別是針對愛滋病患或帶原者,以採納各種介入性策略,作為教導傳統治療者各方面的西方醫學。

目標

評估對於傳統醫療治療者教導有關性病感染以及愛滋病的基本知識後的影響效果。

搜尋策略

我們搜尋1980年到2008年一些資料庫內容包括: Cochrane Register of Controlled Trials, Pubmed, Embase, Gatway and AIDSearch。此外,我們同時手動搜尋選取的相關文獻所附註的參考文獻、確認國際會議有關愛滋病患內容紀錄,此外,諮詢開發中國家中,有關愛滋病患或帶原者的工作人員或機構人員相關的研究計畫。

選擇標準

所有的研究指標皆是利用對照試驗方式來做評估教育性計畫在任何特定預後測量的效果,均納入評量。

資料收集與分析

由兩位校閱者獨立評估符合潛在性相關之研究,並擷取與評估所納入研究資料的品質。由於相關文獻數量不足,以及各文獻方法設計與預後測定的差異性,無法依照統合分析(metaanalysis) 的方法來評估預後。

主要結論

我們納入兩研究 (一篇為隨機臨床對照試驗,另一篇為前後對照試驗), 總人數為311人。這兩篇指出 經過訓練研討會後,會增加傳統醫療治療者有關愛滋病及帶原者之相關知識。有關行為改變方面,在2006年Peltzer發現傳統醫療治療者對於患者的治療模式的報告內容有明顯改變;不過,並沒有研究證據顯示在自我評估的報告中,會減少感染愛滋帶原及性病的危險行為與相關措施。 Poudyl 於2003年的研究並未評估這預後。

作者結論

有兩篇文獻完全符合我們的選取條件。雖然這些文獻報告一些正面的預後,不過由於較少研究文獻,及方法差異性,限制結論內容:針對傳統醫療治療者執行愛滋帶員訓練課程的效果。未來需要有更嚴格的研究(包括:應用更嚴格隨機選取步驟、可靠性預後測量方法、以及更大量的樣本),來提供針對傳統醫療治療者有關愛滋帶原者訓練課程之影響更好證據。

翻譯人

本摘要由臺北榮民總醫院許敬暉翻譯。

此翻譯計畫由臺灣國家衛生研究院(National Health Research Institutes, Taiwan)統籌。

總結

教育傳統醫療治療者有關性病傳染及愛滋帶原醫學之介入課程: 對於是否將教育傳統醫療治療者納入性病傳染與愛滋病醫學防護體系的重要性,仍存在強烈爭議。目前在政策以及衛生相關體系並沒有全面性的將所能納入的資源予以整合。 而其中傳統醫療治療者即是潛在性 所能納入的資源,相反地,這些傳統醫療治療者可能會更增加愛滋病與帶原者的散播。對於這些傳統醫療治療者,已經有一些訓練與教育性課程可能作為改善傳統醫療治療者的執業內容。本篇回顧文獻發現有四篇 評估傳統醫療治療者對愛滋病與愛滋帶原訓練課程的效果,有兩篇研究尚無法取得結果。有兩篇研究指出:對於傳統醫療治療者提供愛滋病與愛滋帶原醫學相關訓練課程,的確可以增進這些治療者對於疾病的認識。不過有一篇研究指出這些訓練課程可以改善傳統醫療治療者在處制治療病人方面的行為模式,但不會減少一些可能散佈愛滋病的危險行為。雖然納入研究報告有某些正向的預後,但這些研究並非高品質。因此,目前仍困難確認有關對於傳統醫療治療者提供性病傳染與愛滋帶原者的醫學教育訓練課程,是否真的呈現切確的效果。