Patterns of Traditional Medicine use for the treatment of Hypertension, Diabetes Mellitus, and High Cholesterol in Low and Middle-income Countries: a cross-sectional study of 71 nationally representative surveys

Mubarak Ayodeji  Sulola; Abla M.  Sibai; Albertino  Damasceno; Alpamys  Issanov; Antonio  Sarria-Santamera; Binur  Orazumbekova; Bolormaa Norov; Bicaba Brice; Corine Houehanou; David Guwatudde; Gibson B Kagaruki; Gladwell Gathecha; Jutta M A  Jorgensen; Joseph Kibachio Mwangi; Kokou Agoudavi; Lela Sturua; Mary T Mayige; Mongal  Gurung; Nahla Hwalla; Nuno  Lunet; Omar Mwalim; Roy Wong-McClure; Sarah Quesnel-Crooks; Silver Bahendeka; Rifat Atun; Till W Bärnighausen; Justine Davies; David  Flood; Pascal Geldsetzer; Lindsay M Jaacks; Jennifer Manne-Goehler; Michaela Theilmann; Sebastian Vollmer; Maja-Emilia  Marcus

Patterns of Traditional Medicine use for the treatment of Hypertension, Diabetes Mellitus, and High Cholesterol in Low and Middle-income Countries: a cross-sectional study of 71 nationally representative surveys

Mubarak Ayodeji Sulola
, Abla M. Sibai
, Albertino Damasceno
, Alpamys Issanov
, Antonio Sarria-Santamera
, Binur Orazumbekova
, Bolormaa Norov
, Bicaba Brice
, Corine Houehanou
, David Guwatudde
, Gibson B Kagaruki
, Gladwell Gathecha
, Jutta M A Jorgensen
, Joseph Kibachio Mwangi
, Kokou Agoudavi
, Lela Sturua
, Mary T Mayige
, Mongal Gurung
, Nahla Hwalla
, Nuno Lunet

Omar Mwalim, Roy Wong-McClure, Sarah Quesnel-Crooks, Silver Bahendeka, Rifat Atun, Till W Bärnighausen, Justine Davies, David Flood, Pascal Geldsetzer, Lindsay M Jaacks, Jennifer Manne-Goehler, Michaela Theilmann, Sebastian Vollmer, Maja-Emilia Marcus ^*

^*Corresponding author for this work

Applied Health Sciences

Research output: Contribution to journal › Article › peer-review

Abstract

Objective To assess the pattern of traditional medicine use globally for treating hypertension, diabetes and high cholesterol.

Methods We pooled individual-level data from 309 745 non-pregnant people aged ≥ 15 years from 71 nationally representative surveys conducted in low- and middle-income countries between 2005 and 2021. We identified individuals with diagnosed hypertension, diabetes and high cholesterol who reported use of traditional medicine. For each condition, we estimated the prevalence of traditional medicine use at the global, regional and country-income level and the proportion co-using traditional medicine and conventional medicine. We estimated the association between traditional medicine use and individual characteristics.

Findings The prevalence of traditional medicine use was 14.7% (95% confidence interval, CI: 12.7–16.9) for diabetes, 12.4% (95% CI: 10.0–15.3) for high cholesterol and 8.1% (95% CI: 7.3–9.0) for hypertension. Most individuals using traditional medicine for diabetes or high cholesterol co-used conventional medicine. Associations between sociodemographic characteristics and traditional medicine use varied between regions and health conditions. In the Western Pacific Region, traditional medicine use for diabetes was significantly higher in males and younger adults, whereas use for hypertension was significantly higher in females and older adults. In the African Region, traditional medicine use for diabetes and hypertension was higher in males and individuals with lower education.

Conclusion Our study shows a high prevalence of traditional medicine use for treating hypertension, diabetes and high cholesterol in low- and middle-income countries. Our results highlight the need to better understand the clinical interactions and risks of traditional medicine for improved cardiometabolic treatment.

Original language	English
Article number	BLT.25.293665
Journal	Bulletin of the World Health Organization
Early online date	29 Sept 2025
Publication status	E-pub ahead of print - 29 Sept 2025

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

SDG 3 Good Health and Well-being

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Sulola, M. A., Sibai , A. M., Damasceno , A., Issanov, A., Sarria-Santamera, A., Orazumbekova, B., Norov, B., Brice, B., Houehanou, C., Guwatudde, D., Kagaruki, G. B., Gathecha, G., Jorgensen, J. M. A., Mwangi, J. K., Agoudavi, K., Sturua, L., Mayige, M. T., Gurung, M., Hwalla, N., ... Marcus , M.-E. (2025). Patterns of Traditional Medicine use for the treatment of Hypertension, Diabetes Mellitus, and High Cholesterol in Low and Middle-income Countries: a cross-sectional study of 71 nationally representative surveys. Bulletin of the World Health Organization, Article BLT.25.293665. Advance online publication.

@article{fc7e5a9c33eb45888d66a825a8f27cdd,

title = "Patterns of Traditional Medicine use for the treatment of Hypertension, Diabetes Mellitus, and High Cholesterol in Low and Middle-income Countries: a cross-sectional study of 71 nationally representative surveys",

abstract = "Objective To assess the pattern of traditional medicine use globally for treating hypertension, diabetes and high cholesterol. Methods We pooled individual-level data from 309 745 non-pregnant people aged ≥ 15 years from 71 nationally representative surveys conducted in low- and middle-income countries between 2005 and 2021. We identified individuals with diagnosed hypertension, diabetes and high cholesterol who reported use of traditional medicine. For each condition, we estimated the prevalence of traditional medicine use at the global, regional and country-income level and the proportion co-using traditional medicine and conventional medicine. We estimated the association between traditional medicine use and individual characteristics. Findings The prevalence of traditional medicine use was 14.7\% (95\% confidence interval, CI: 12.7–16.9) for diabetes, 12.4\% (95\% CI: 10.0–15.3) for high cholesterol and 8.1\% (95\% CI: 7.3–9.0) for hypertension. Most individuals using traditional medicine for diabetes or high cholesterol co-used conventional medicine. Associations between sociodemographic characteristics and traditional medicine use varied between regions and health conditions. In the Western Pacific Region, traditional medicine use for diabetes was significantly higher in males and younger adults, whereas use for hypertension was significantly higher in females and older adults. In the African Region, traditional medicine use for diabetes and hypertension was higher in males and individuals with lower education. Conclusion Our study shows a high prevalence of traditional medicine use for treating hypertension, diabetes and high cholesterol in low- and middle-income countries. Our results highlight the need to better understand the clinical interactions and risks of traditional medicine for improved cardiometabolic treatment.",

author = "Sulola, \{Mubarak Ayodeji\} and Sibai, \{Abla M.\} and Albertino Damasceno and Alpamys Issanov and Antonio Sarria-Santamera and Binur Orazumbekova and Bolormaa Norov and Bicaba Brice and Corine Houehanou and David Guwatudde and Kagaruki, \{Gibson B\} and Gladwell Gathecha and Jorgensen, \{Jutta M A\} and Mwangi, \{Joseph Kibachio\} and Kokou Agoudavi and Lela Sturua and Mayige, \{Mary T\} and Mongal Gurung and Nahla Hwalla and Nuno Lunet and Omar Mwalim and Roy Wong-McClure and Sarah Quesnel-Crooks and Silver Bahendeka and Rifat Atun and B{\"a}rnighausen, \{Till W\} and Justine Davies and David Flood and Pascal Geldsetzer and Jaacks, \{Lindsay M\} and Jennifer Manne-Goehler and Michaela Theilmann and Sebastian Vollmer and Maja-Emilia Marcus",

year = "2025",

month = sep,

day = "29",

language = "English",

journal = "Bulletin of the World Health Organization",

issn = "0042-9686",

publisher = "World Health Organization",

}

Sulola, MA, Sibai , AM, Damasceno , A, Issanov, A, Sarria-Santamera, A, Orazumbekova, B, Norov, B, Brice, B, Houehanou, C, Guwatudde, D, Kagaruki, GB, Gathecha, G, Jorgensen, JMA, Mwangi, JK, Agoudavi, K, Sturua, L, Mayige, MT, Gurung, M, Hwalla, N, Lunet, N, Mwalim, O, Wong-McClure, R, Quesnel-Crooks, S, Bahendeka, S, Atun, R, Bärnighausen, TW, Davies, J, Flood, D, Geldsetzer, P, Jaacks, LM, Manne-Goehler, J, Theilmann, M, Vollmer, S & Marcus , M-E 2025, 'Patterns of Traditional Medicine use for the treatment of Hypertension, Diabetes Mellitus, and High Cholesterol in Low and Middle-income Countries: a cross-sectional study of 71 nationally representative surveys', Bulletin of the World Health Organization.

Patterns of Traditional Medicine use for the treatment of Hypertension, Diabetes Mellitus, and High Cholesterol in Low and Middle-income Countries: a cross-sectional study of 71 nationally representative surveys. / Sulola, Mubarak Ayodeji ; Sibai , Abla M. ; Damasceno , Albertino et al.
In: Bulletin of the World Health Organization, 29.09.2025.

Research output: Contribution to journal › Article › peer-review

TY - JOUR

T1 - Patterns of Traditional Medicine use for the treatment of Hypertension, Diabetes Mellitus, and High Cholesterol in Low and Middle-income Countries

T2 - a cross-sectional study of 71 nationally representative surveys

AU - Sulola, Mubarak Ayodeji

AU - Sibai , Abla M.

AU - Damasceno , Albertino

AU - Issanov, Alpamys

AU - Sarria-Santamera, Antonio

AU - Orazumbekova, Binur

AU - Norov, Bolormaa

AU - Brice, Bicaba

AU - Houehanou, Corine

AU - Guwatudde, David

AU - Kagaruki, Gibson B

AU - Gathecha, Gladwell

AU - Jorgensen, Jutta M A

AU - Mwangi, Joseph Kibachio

AU - Agoudavi, Kokou

AU - Sturua, Lela

AU - Mayige, Mary T

AU - Gurung, Mongal

AU - Hwalla, Nahla

AU - Lunet, Nuno

AU - Mwalim, Omar

AU - Wong-McClure, Roy

AU - Quesnel-Crooks, Sarah

AU - Bahendeka, Silver

AU - Atun, Rifat

AU - Bärnighausen, Till W

AU - Davies, Justine

AU - Flood, David

AU - Geldsetzer, Pascal

AU - Jaacks, Lindsay M

AU - Manne-Goehler, Jennifer

AU - Theilmann, Michaela

AU - Vollmer, Sebastian

AU - Marcus , Maja-Emilia

PY - 2025/9/29

Y1 - 2025/9/29

N2 - Objective To assess the pattern of traditional medicine use globally for treating hypertension, diabetes and high cholesterol. Methods We pooled individual-level data from 309 745 non-pregnant people aged ≥ 15 years from 71 nationally representative surveys conducted in low- and middle-income countries between 2005 and 2021. We identified individuals with diagnosed hypertension, diabetes and high cholesterol who reported use of traditional medicine. For each condition, we estimated the prevalence of traditional medicine use at the global, regional and country-income level and the proportion co-using traditional medicine and conventional medicine. We estimated the association between traditional medicine use and individual characteristics. Findings The prevalence of traditional medicine use was 14.7% (95% confidence interval, CI: 12.7–16.9) for diabetes, 12.4% (95% CI: 10.0–15.3) for high cholesterol and 8.1% (95% CI: 7.3–9.0) for hypertension. Most individuals using traditional medicine for diabetes or high cholesterol co-used conventional medicine. Associations between sociodemographic characteristics and traditional medicine use varied between regions and health conditions. In the Western Pacific Region, traditional medicine use for diabetes was significantly higher in males and younger adults, whereas use for hypertension was significantly higher in females and older adults. In the African Region, traditional medicine use for diabetes and hypertension was higher in males and individuals with lower education. Conclusion Our study shows a high prevalence of traditional medicine use for treating hypertension, diabetes and high cholesterol in low- and middle-income countries. Our results highlight the need to better understand the clinical interactions and risks of traditional medicine for improved cardiometabolic treatment.

AB - Objective To assess the pattern of traditional medicine use globally for treating hypertension, diabetes and high cholesterol. Methods We pooled individual-level data from 309 745 non-pregnant people aged ≥ 15 years from 71 nationally representative surveys conducted in low- and middle-income countries between 2005 and 2021. We identified individuals with diagnosed hypertension, diabetes and high cholesterol who reported use of traditional medicine. For each condition, we estimated the prevalence of traditional medicine use at the global, regional and country-income level and the proportion co-using traditional medicine and conventional medicine. We estimated the association between traditional medicine use and individual characteristics. Findings The prevalence of traditional medicine use was 14.7% (95% confidence interval, CI: 12.7–16.9) for diabetes, 12.4% (95% CI: 10.0–15.3) for high cholesterol and 8.1% (95% CI: 7.3–9.0) for hypertension. Most individuals using traditional medicine for diabetes or high cholesterol co-used conventional medicine. Associations between sociodemographic characteristics and traditional medicine use varied between regions and health conditions. In the Western Pacific Region, traditional medicine use for diabetes was significantly higher in males and younger adults, whereas use for hypertension was significantly higher in females and older adults. In the African Region, traditional medicine use for diabetes and hypertension was higher in males and individuals with lower education. Conclusion Our study shows a high prevalence of traditional medicine use for treating hypertension, diabetes and high cholesterol in low- and middle-income countries. Our results highlight the need to better understand the clinical interactions and risks of traditional medicine for improved cardiometabolic treatment.

UR - https://www.who.int/publications/journals/bulletin

UR - https://cdn.who.int/media/docs/default-source/bulletin/online-first/blt.25.293665.pdf

UR - https://www.who.int/publications/journals/bulletin/online-first

M3 - Article

SN - 0042-9686

JO - Bulletin of the World Health Organization

JF - Bulletin of the World Health Organization

M1 - BLT.25.293665

ER -

Sulola MA, Sibai AM, Damasceno A, Issanov A, Sarria-Santamera A, Orazumbekova B et al. Patterns of Traditional Medicine use for the treatment of Hypertension, Diabetes Mellitus, and High Cholesterol in Low and Middle-income Countries: a cross-sectional study of 71 nationally representative surveys. Bulletin of the World Health Organization. 2025 Sept 29;BLT.25.293665. Epub 2025 Sept 29.