The contribution of traditional healers' clinics to public health care system in Addis Ababa, Ethiopia: a cross-sectional study

Background

In practically every human culture, the use of arthropods as medicinal resources has been reported. In Mexico, the Mayan people mainly use plants but occasionally also animals and minerals in their medicine. This article is the first to report the traditional use of the tarantula Brachypelma vagans by medicine men in the Chol community, an ancient indigenous group that inhabits the southeastern part of Mexico. We also describe the utility of such arachnids in traditional medicine.

Methods

This study was carried out in different Chol communities in the states of Chiapas and Campeche (southeastern Mexico) from 2003 until 2007. We interviewed the local medicine men, patients and non-Chol people in each village visited to collect information about the rituals involved and the effectiveness of this traditional medicine and also their opinion of this traditional medicine.

Results

In all independent villages, the people who present an illness called 'aire de tarantula' or tarantula wind with symptoms including chest pain, coughing and asthma, were treated by the medicine man (called 'hierbatero') with a tarantula-based beverage. From village to village, the beverage has a similar base composition but some variations occur in additional ingredients depending on the individual medicine man. Like in all traditional Mayan medicine, the ritual of the ceremony consists of drinking the tarantula-based beverage and this is principally accompanied by chants and burning of incense.

Conclusions

The recipe of the tarantula-based beverage and the procedure of this ritual ceremony were fairly constant in all the villages visited. Our work shows that despite the tarantula's bad image in several cultures, in others positive use is made of these spiders, as in modern medicine.     

Epilation for Minor Trachomatous Trichiasis: Four-Year Results of a Randomised Controlled Trial

BackgroundTrachomatous trichiasis (TT) needs to be managed to reduce the risk of vision loss. The long-term impact of epilation (a common traditional practice of repeated plucking of lashes touching the eye) in preventing visual impairment and corneal opacity from TT is unknown. We conducted a randomized controlled trial of epilation versus surgery for the management of minor TT (fewer than six lashes touching the eye) in Ethiopia. Here we report the four-year outcome and the effect on vision and corneal opacity.

Methodology/ Principal Findings

1300 individuals with minor TT were recruited and randomly assigned to quality trichiasis surgery or repeated epilation using high quality epilation forceps by a trained person with good near vision. Participants were examined six-monthly for two-years, and then at four-years after randomisation. At two-years all epilation arm participants were offered free surgery. At four-years 1151 (88.5%) were re-examined: 572 (88%) and 579 (89%) from epilation and surgery arms, respectively. At that time, 21.1% of the surgery arm participants had recurrent TT; 189/572 (33%) of the epilation arm had received surgery, while 383 (67%) declined surgery and had continued epilating (“epilation-only”). Among the epilation-only group, 207 (54.1%) fully controlled their TT, 166 (43.3%) had minor TT and 10 (2.6%) had major TT (>5 lashes). There were no differences between participants in the epilation-only, epilation-to-surgery and surgery arm participants in changes in visual acuity and corneal opacity between baseline and four-years.

Conclusions/ Significance

Most minor TT participants randomised to the epilation arm continued epilating and controlled their TT. Change in vision and corneal opacity was comparable between surgery and epilation-only participants. This suggests that good quality epilation with regular follow-up is a reasonable second-line alternative to surgery for minor TT for individuals who either decline surgery or do not have immediate access to surgical treatment.     

Commercialisation of entomopathogenic nematodes: should import regulations be revised?

Entomopathogenic nematodes (EPNs) in the families Steinernematidae and Heterorhabditidae are obligate insect pathogens. Their favourable characteristics as biocontrol agents have resulted in some species of EPNs being released globally and widely used for the control of diverse insect pests. In this review, we consider the occurrence of currently described EPN species, including those that have been released globally for commercial purposes. We also discuss the contribution of regulation policies to the global distribution of these species and issues that influence import regulations. Possible non-target effects, the use of commercial versus native EPNs and the possible interaction between these species are considered. Finally, we provide a view as to whether existing policies adequately deal with the risks associated with the global movement of EPNs and we suggest future directions that should be considered for the use of EPNs as biological control agents.