Adverse effects associated with the use of South African traditional folk remedies

Although the toxicity of traditional folk remedies is well known in Africa, it is a subject which is surrounded by secrecy and has not been comprehensively studied.

The aims of this study are to describe the clinical features of patients admitted to hospital with a confirmed history of using folk remedies, and to gather data on their toxicity in a systematic fashion.

Prospective case series.

Paediatric and adult wards of academic hospitals in Johannesburg, South Africa.

The study population included 103 patients ranging from one day to 75 years of age, all of whom had recent folk remedy use.

All available clinical data were analysed. Primary outcomes were the presence of renal and liver dysfunction, death or discharge from hospital.

The most common clinical features on presentation were dehydration (51%), vomiting (46%), jaundice (40%), diarrhoea (39%), altered mental status (37%) and oligoanuria (30%). Renal dysfunction was present in 76% of patients and liver dysfunction in 48%. The overall mortality was 34%. The odds ratio of death was 5.1 (95% CI 1.41 to 18.5) in patients with renal dysfunction (p = 0.0077) and 5.35 (95% CI 1.99 to 14.4) in patients with liver dysfunction (p = 0.0006).

Renal and liver dysfunction are frequently associated with use of folk remedies, and mortality in these patients is high. In view of the large numbers of African individuals living in the United States and Europe, it is important for physicians elsewhere to be aware of the potential toxicity of African folk remedies, and to inquire about their use.