April 2025: Paper of the Month by Adebiyi et al – Critical assessment of the implications of self-medication with natural products during disease outbreaks among people in developing countries.

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April 2025: Paper of the Month by Adebiyi et al – Critical assessment of the implications of self-medication with natural products during disease outbreaks among people in developing countries.

A recent study by Adebiyi et al. (2023) titled “Critical assessment of the implications of self-medication with natural products during disease outbreaks among people in developing countries.” published in Research Square reveals that 40 multi-species corridors connect South Africa’s mega-reserves, enhancing connectivity, guiding conservation, and informing protected area expansion.

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The belief that natural products are inherently safe has transformed self-medication into a silent public health risk—one that not only masks symptoms but also fuels misinformation, underreporting, and heightened vulnerability during outbreaks– Adebiyi et al. 2023

The study titled “Critical assessment of the implications of self-medication with natural products during disease outbreaks among people in developing countries.” aimed to explore self-medication with natural products which remains a deeply embedded practice in developing countries, particularly during times of health crises. Across Africa, Asia, and Latin America, individuals often rely on herbal remedies, plant extracts, and other traditional products when confronted with disease outbreaks such as COVID-19, Ebola, and cholera. These practices are frequently motivated by limited access to healthcare facilities, affordability of alternatives, and long-standing cultural traditions that equate “natural” with “safe.” In contexts where formal health systems are overstretched or inaccessible, natural remedies become the first recourse for many households.

However, the widespread reliance on these products raises pressing concerns for public health. The assumption that natural products are inherently harmless disregards the reality that many can be toxic, ineffective, or even exacerbate disease risks when used improperly. For example, during the COVID-19 pandemic, the use of steam inhalation and herbal baths was not only ineffective but also associated with heightened risks of infection transmission. Furthermore, misinformation spread rapidly through social media and community networks, fueling the use of unproven remedies while discouraging individuals from seeking professional medical advice.

This study presents a critical evaluation of self-medication with natural products during disease outbreaks in developing countries, offering important insights into an often-overlooked dimension of global health. Through a modified systematic literature review informed by PRISMA and AXIS tools, the author identified that women disproportionately engage in self-medication, driven by affordability, cultural beliefs, and misinformation. Although these practices are perceived as safe, they were linked to adverse effects and increased risks, including greater susceptibility to COVID-19. The research also revealed a significant literature gap, with very few studies examining the actual health implications of natural product use.

By recommending public education, regulatory reforms, proactive healthcare engagement, and community-driven awareness, the study provides a roadmap for safer integration of traditional medicine into formal health systems. Importantly, the author highlights the need to protect vulnerable populations who rely on natural products in the absence of accessible healthcare. In doing so, this research fills a critical gap and contributes to evidence-based decision-making in global public health.

How the Study was Conducted

The study adopted a modified systematic literature review guided by the PRISMA framework. Using the PEO (Population, Exposure, Outcome) model, the authors framed their research question around people in developing countries, disease outbreaks, and the implications of self-medication with natural products. Literature was drawn from peer-reviewed databases such as MEDLINE, APA PsycINFO, SocINDEX, and Academic Search Complete, as well as grey literature including dissertations and government reports. Search strategies incorporated Boolean operators, truncators, and key terms such as “self-medication,” “natural products,” and “disease outbreaks.” Articles were screened using strict inclusion criteria, excluding those focused on alcohol, substance abuse, or unrelated health practices. Data were extracted into four themes—sources, determinants, implications, and solutions—and analyzed through a mixed-methods approach combining descriptive statistics with narrative synthesis. The AXIS critical evaluation tool was employed to assess study quality, and findings were documented via a PRISMA flow diagram.

What the Authors Found

The study revealed a complex and multifaceted picture of self-medication with natural products in developing countries during disease outbreaks. Several key themes emerged from the literature review, each highlighting the prevalence, determinants, risks, and knowledge gaps associated with this phenomenon.

Prevalence and Demographic Trends

The review found that self-medication with natural products is highly prevalent across developing regions, particularly in sub-Saharan Africa, South Asia, and parts of Latin America. During outbreaks such as COVID-19 and Ebola, reliance on natural products increased significantly as populations sought accessible and affordable remedies. Demographically, women were consistently more likely than men to engage in self-medication practices. This trend has been attributed to women’s roles as primary caregivers in many households, cultural norms that position women as custodians of family health, and their higher reliance on traditional remedies for managing both acute and chronic illnesses.

Determinants of Self-Medication

The determinants of self-medication were both structural and cultural.

Structural determinants included limited access to formal healthcare, high costs of biomedical treatments, and shortages of healthcare professionals—particularly acute during outbreaks when health systems were overwhelmed. Natural products offered an affordable and readily available alternative.

Cultural and ideological determinants included long-standing beliefs that natural products are “safe” because of their organic origin, advice from family and community elders, and reliance on anecdotal evidence from prior positive experiences.

Informational determinants played a crucial role. Misinformation, particularly spread through social media platforms, amplified the adoption of untested remedies. For instance, claims about herbal teas or steam inhalation “curing” COVID-19 spread rapidly during the pandemic, leading to widespread, uncritical use.

Common Practices and Remedies

The review documented a range of natural products and practices commonly used during outbreaks. These included herbal teas made from local plants, steam inhalation with leaves and roots, herbal baths, consumption of garlic and ginger mixtures, and application of plant-based poultices. While some of these remedies are harmless or may provide symptomatic relief, others were linked to harmful outcomes or increased risk of infection transmission.

Health Implications and Adverse Effects

One of the most critical findings was the association between self-medication and a variety of adverse health effects. Commonly reported outcomes included gastrointestinal disturbances such as diarrhea, stomach pain, and nausea, as well as headaches and excessive sweating. In more serious cases, certain unregulated products carried risks of toxicity, organ damage, or interference with prescribed biomedical treatments.
Of particular concern was the use of steam inhalation and herbal baths during the COVID-19 pandemic. While these practices were widely promoted in community networks and on social media, evidence showed that they increased the risk of viral transmission due to close contact and poor hygienic practices during group sessions.

Patterns of Healthcare Avoidance

A recurring finding was that individuals who self-medicated with natural products were less likely to seek medical consultation. This avoidance of healthcare professionals resulted in underreporting of adverse effects, thereby limiting the ability of public health systems to assess the full extent of risks associated with these practices. Such patterns of healthcare avoidance also delayed timely diagnosis and treatment of diseases, potentially worsening clinical outcomes.

Gaps in the Literature

Out of the 20 reviewed articles, all addressed the determinants of self-medication, underscoring the well-documented cultural and structural factors driving the practice. However, only six studies explored the direct health implications of self-medication with natural products during outbreaks. This reveals a significant gap in research, as the biomedical consequences remain underexamined relative to the sociocultural motivations. Moreover, few studies employed robust methodologies such as clinical trials or longitudinal surveys, highlighting the need for more rigorous evidence.

Quality of Evidence

Despite these gaps, the quality appraisal using the AXIS critical evaluation tool showed that 71.4% of the 14 assessed studies scored ≥15, indicating moderate to high quality. This suggests that while there is limited literature on health outcomes, the existing body of work is reasonably reliable and methodologically sound. Nevertheless, the lack of comprehensive reporting on adverse effects and the dominance of cross-sectional studies limit the generalizability of findings.

Critical Reflection on Findings

Taken together, the findings paint a picture of self-medication with natural products as a double-edged sword. On one hand, it provides an accessible and culturally familiar coping strategy during times of crisis when formal healthcare is inaccessible or distrusted. On the other hand, it introduces substantial risks—both in terms of individual health outcomes and broader public health challenges such as underreporting, misinformation, and disease transmission. The limited focus on health implications in existing research underscores an urgent need for future studies to address this blind spot, particularly in light of the increasing global reliance on complementary and alternative medicine.

What the Authors Recommended

The authors proposed a comprehensive set of recommendations aimed at mitigating the risks associated with self-medication with natural products. Public education campaigns were identified as a critical intervention, designed to dispel myths and misconceptions surrounding the safety and efficacy of natural remedies. Such campaigns should leverage trusted community leaders, healthcare professionals, and even social media influencers to counteract misinformation.

Policy development was another key recommendation, with emphasis on the need for governments to strengthen the regulatory oversight of traditional and complementary medicines. Regulatory frameworks should ensure that natural products meet safety and efficacy standards before being distributed to the public.

The study also urged healthcare providers to play a proactive role by inquiring about patients’ use of natural products. By integrating discussions of traditional medicine into clinical consultations, providers can better detect potential interactions and adverse effects.

Finally, the authors highlighted the importance of community engagement. Public health professionals and local leaders must work collaboratively to promote evidence-based practices and foster dialogue between traditional medicine and formal healthcare systems.