ANNALS OF IBADAN POSTGRADUATE MEDICINE
T. Ilori1,2, A.D. Akintayo3 , B.A. Adewale3 and E.O. Oyetola4
Background: Complementary and alternative medicine (CAM) is commonly used, but many physicians have limited knowledge of CAM despite its widespread use. Therefore, this study sought to assess the knowledge, attitude, and practice of medical students on complementary and alternative medicine in the management of COVID-19.
Methods: A descriptive cross-sectional study was conducted among 150 medical students from three Federal Universities in South West, Nigeria. A self-administered semi-structured online Google Forms questionnaire was used to collect information. Chi-squared and Fisher’s exact test was used to analyze the bivariate relationship between KAP status and sociodemographic characteristics. Spearman’s correlation coefficient matrix was computed to determine the association between knowledge, attitude, CAM, age, and religiosity practice.
Results: The median age was 22 years (interquartile range: [IQR]: 21-23 years). Median self-rated score for religion was 4.00 (IQR: 3.00-4.25). Median knowledge score was 4.00 (IQR: 3.75-5.00), median attitude score 2.75 (IQR: 2.38-3.00) and median practice score 2.00 (IQR: 1.00-2.00). Thirty-seven respondents (24.7%) were considered to have poor knowledge about CAM use in COVID-19 while the rest (75.3%) had good knowledge. Thirty-eight (25.3%) had a poor attitude towards using CAM in COVID-19 and 112 (74.7%) had a good attitude.
Conclusion: Medical students have good knowledge and a positive attitude towards CAM modalities as adjunct management for COVID-19. However, their practices do not reflect wide acceptability. There is a need for clinical trials on the efficacy of CAM as an adjunct treatment for COVID-19 to further inform its use.
Keywords: Knowledge, Attitude, Practice, COVID-19, Medical Students, Nigeria
Dr. T. Ilori
Dept. of Community Medicine,
University of Ibadan,
The novel Coronavirus disease-19(COVID-19) pandemic is unprecedented in several ways and posed a significant challenge to the global healthcare system and practices.1 The discovery of the zoonotic infection Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-COV-2) popularly called COVID-19 was the sequel to the cases confirmed by the seafood market Wuhan city of Hubei Province in China in December 2019. 2 On March 11 2020, the World Health Organization (WHO) declared COVID-19 a pandemic3 . Nigeria confirmed its first case on February 27 2020, and by December 28 2020, the disease was confirmed in 84,811 people countrywide.4 Globally, there is no definitive treatment for COVID-19, but prompt supportive management is useful, it is essential to be abreast of the various supportive treatments for COVID-19 patients. Health care can be modern (conventional, orthodox, western, mainstream, allopathic) or traditional (indigenous, non-mainstream, complementary, alternative or integrative).
The National Center for Complementary and Alternative Medicine (NCCAM) has defined Complementary and Alternative Medicine (CAM) as a group of medical and health care systems, practices and products that are not currently part of conventional medicine.5 When unconventional approach and products are also used with conventional medicine, it is termed complementary; but it becomes an alternative medicine when used in place of conventional medicine. Therefore, CAM is a general term used for both complementary and alternative health care practices5
CAM includes various approaches outside the conventional western medicine used to prevent and treat illnesses/diseases and promote health6 . The definition of what constitutes CAM, however, is culturally dependent7 . Several studies have assessed the validity and importance of holistic patients care health using CAM7,8. In a narrative review conducted by Kok et al., it was concluded that CAM prevention and treatment strategies could lead to the prescription and consumption of fewer antibiotics by improving patients’ immunity without drugs. Some have been shown to have promising treatment strategies for respiratory infections9 .
The coronavirus disease (COVID-19) pandemic is the most global pandemics in terms of its coverage and has challenged the health care systems. In a study conducted by Tillu et al., on the public health approach of CAM for COVID-19 prophylaxis, it was observed that improving patient’s immunity is a great tool in preventing and managing the disease10. Since the onset of the novel coronavirus (COVID-19) pandemic, there has been much information sharing on social media about using CAM treatment to fortify human immunity for supportive therapy against COVID-19 infection11. Commonly used CAM therapies include natural, biological plant-based products such as honey, lemon, lime ginger, garlic and herbal teas. There is evidence that nutritional supplements and herbal preparations present in CAM products help boost immunity and protect from infections 11. In a multicenter study conducted in Nigeria on herbal medicine among pregnant women, it was reported that among the various reasons why patients take herbal medicine includes the belief of higher efficacy and broader disease coverage, sociocultural belief and tradition, relatively low cost of the herbal products and sometimes increased availability12. In recognition of the widespread popularity of CAM, many academic institutions worldwide are increasingly incorporating CAM into medical education, clinical practice, and research13, 14. A descriptive survey conducted at Lagos University Teaching Hospital among resident doctors showed that 60.0% had a positive attitude towards herbal medicine. However, 40.7% reported that they would not encourage their patients to use such15. Therefore, this study was carried out to assess the knowledge, attitude, and perception of medical students about complementary and alternative medicine in the management of COVID19.