Complementary and alternative medicine utilization for malaria prevention: A multi-site community-based cross-sectional study in Ghana

Abstract Background In many countries, particularly in sub-Saharan Africa, medical pluralism and utilization of multiple therapeutic approaches for managing diseases, including malaria, are common. Ghana's antimalarial medicine policy has recommended herbal medications for treating uncomplicated malaria. While this is in line with complementary and alternative medicine (CAM) use for the treatment of malaria, exploring CAM for malaria prevention could be an important consideration for public health initiatives towards malaria elimination efforts. This study assessed the prevalence, perceptions, and attitudes on CAM use for malaria prevention in the general population and associated factors. Methods A community-based cross-sectional analytic survey was conducted among 3064 adult residents sampled between September and November 2023. A multi-stage sampling method was used to select participants from 18 sub-districts drawn from 6 districts and 6 regions in Ghana. Data on CAM use for malaria prevention, attitudes about CAM, perceptions about malaria, and sociodemographic factors were collected. The primary outcome was reported CAM use for malaria prevention within the 12months preceding the survey, measured as a binary outcome. Multiple logistic regression analyses were performed to identify the predictors of CAM use for malaria prevention. Results A total of 3,064 household respondents were involved in the analysis, with 51.2% (n=1,570) females and a median age of 31 years (IQR: 24-42 years). The use of CAM for malaria prevention in the last 12 months was 31.6% (95% CI: 30.0-33.3%). The most common types of CAM used included botanical/herbal medicine (21.8%), vitamin supplements (12.3%), mineral supplements (10.7%), and spiritual healing/prayers (9.6%). Increased CAM use for malaria prevention was associated with education and perceptions, such as concerns and consequences about malaria. Factors associated with decreased odds of CAM use included formal employment and having a skeptical and indifferent attitude about CAM. Conclusion Over a third of the population used CAM for malaria prevention in the last year, highlighting its role in public health. Integrating herbal medicine into prevention strategies could enhance community acceptance and help with efforts toward malaria elimination. However, further research is needed to validate clinical efficacy, establish potential drug-herb interactions, and isolate lead compounds for optimized malaria prevention therapy.