PREFACE The purpose of this study is to establish the link between THPs and modern medicine in order to integrate traditional heath practice with the modern medicine practice. Ngongongare village with its 6 neighboring villages were involved. The study adopted both descriptive and analytical approaches. Data were collected from sampled from the chosen Traditional Health Practitioners (THPs) identified from Ngongongare villages and from the neighboring villages surrounding CINS-AAP Project site such as Nkoanekoli, Mulala, Kilinga, Ngurdoto, Ngaranamyuki and Imbaseni.
A variety of data collection methods were employed these include, unstructured questionnaires, interviews and analysis of documents and records, also direct observation informal discussion, field investigation and consultations. This study has established the following; All the THPs has some understanding of the physiological functions of the body and was no THP who showed NOT at all understanding of the physiological functions of the human body parts as the Modern Medical Practitioner.
Most of the THPs treat their patients by using signs and symptoms definitions that the Modern Medical Practitioners [MMPs] use. It was clear from the study was that Already there is an informal link between the THPs and the MMPs. There are cases that are referred to medical clinics for confirmation of diagnoses and some specific treatments mostly surgical. 2 TABLE OF CONTENTS: 1. Title Page 2. Preface: acknowledgements, 3. Table of contents – topics 4.
List of graphs 5. List of tables 6. Definitions of concepts 7. Abstract 8. Introduction and Background a. Research objectives b. Background location of study 9. Study Design a. Study design selected 10. Data a. Data Collection Methods b. Data quality checks 11. Presenting Results Obtained From The Survey a. Reporting research findings b. Discussions of the findings 12. Study limitation 13. Conclusion And Recommendations 14. Attachments/Appendices 3.
LIST OF TABLES Table 1: AIDS Table 2: Table 3: Table 4: Table 5: Table 6: Table 7: Table 8: Table 9: Table 10: Table 11: Table 12: Table 13: Table 14: Table 15: Table 16: Table 17: Table 18: Table 19: Table 20: Table 21: Table 22: Table 23: Table 24: Table 25: Table 26: Anaemia Benign Prostate Hypertrophy Bronchial Asthma Cancer of the Skin Cancer of the Cervix Cholera Dysentery Enteric Fever Epilepsy Amenorrhea Helminthiasis Hepatitis Hypertension Impotence Lung Cancer Malaria Meningitis Otitis Media Pelvic Inflammatory Diseases Peptic Ulcer Pneumonia Summary of the Disease Statistics Human Anatomical Parts Definitions.
The Systemic Physiological Functions of the Body Relationship between Body Structures Physiology and Disease Processes. List of Graphs Graph No 1 Summary of the Disease Statistics Graph No 2 Human Anatomical Parts Definitions Graph No 3 The Systemic Physiological Functions of The Body Graph No 4 Relationship between Body Structures Physiology and Disease Processes 4 DEFINITIONS OF CONCEPTS 1. Same as Modern Medical Practice: At least 4 key signs and symptoms same THPs definitions, justifying initiation of treatment. 2.
Completely different from Modern Medical Practice: Signs and Symptoms completely different from MMP to justify the initiation of treatment. 3. Need confirmation from Modern Medical Practice: Signs and Symptoms not able to justify initiation of treatment. 4. Human anatomical Parts definitions. a. SIMILAR to MMPs: Most of the key parts of the body that are known to the Modern Medical Practitioners could be identified by the Local THPs. b. SOME Similarity: The THP could identify some Anatomical parts that are similar to Modern Medical Practitioners.
c. NOT similar to MMPs: Not any similarity between THPs Anatomical parts definitions with the Modern Medical Practitioners. 5. Understanding of the Systemic physiological functions of the body. a. No Understanding at all: The THPs has no understanding of the physiological functions of the human body parts as the Modern Medical Practitioner. b. Some understanding: Some of the THPs definitions about the physiological functions of the body show clear similarities with the Modern Medical Practice definition.
c. Negative Understanding: Most of the definitions about the physiological function of the body as defined by the THPs give an understanding that is quite opposite to the Modern Medical practice. 6. Relationship between body structures, Physiology and disease processes. a. No Relationship at all: The THPs have no understanding of the relationships between the physiological functions of the human body parts, physiology and the disease processes of the body as known by the Modern Medical Practitioner. b.
Some understanding: Some of the THPs definitions about the Anatomy and the physiological functions of the body as related to disease processes show clear understanding as compared to the Modern Medical Practice definitions. 5 ABSTRACT Various sources of information at all levels indicate that there is a correlation between Traditional methods of healing with modern methods, various variables such as disease vocabularies, anatomical and physiological definitions, and identification infection prevention method used by the Traditional Health Practitioners (THPs) as compared to those used by the Modern Medical professionals.
The purpose of this study is to establish a closer link between (THPs) and modern medicine in order to integrate traditional and modern medicine as practiced in Ngongongare village, a typical rural area in Arusha region, Tanzania. The ultimate objective is to integrate traditional medicine to modern medical practice. The study has also established the following 1. The Traditional Health Practitioners (THPs) treat their patients mostly by using signs and symptoms definitions that the Modern Medical Practitioners [MMPs] use. 2.
The Traditional Health Practitioners (THPs) have a minimal knowledge of the body’s anatomical parts and the human physiology to use in their practice. 3. The Traditional Health Practitioners (THPs) do not have a clear understanding of procedures of infection prevention in their practise. By developing tools for provision of appropriate Information, Education and Communication (IEC), we can modify or improve existing service delivery approaches of the Traditional Health Practitioners (THPs), who really attend many of our patients before and after they have been seen or attended by our Modern Medical Practitioners.
6 INTRODUCTION AND BACKGROUND. Studies indicate that for a long time in Tanzania, the health care has been offered by the Traditional Health Practitioners (The THPs). The THPs services usually offered near the people and at an affordable cost. And whereas these practitioners have no formal professional education and only recognized in a local setting, there is an apparent need to involve them in the modern service delivery system by recognizing their services.
Whereas there are evidences that many people recognize their services and attend their services it is also known that there are no known standard control measures that can check the quality of care of their services. The aim of this study is to establish a link between the Traditional Health Practitioners (THPs) and modern medicine in order to integrate traditional and modern medicinal practice. The following below are the expected results of the study. 1.
Relationship established between scientific and local definitions [Vocabularies] of illnesses by 31st, Oct, 2007. 2. The clinical outcome of treatment by THPs through follow up of patients is evaluated by November 31st, 2007. [Case study October 2007]. 3. The common definition of anatomical and physiological nomenclature of the human body is shared between modern clinician and THPs by November 30th, 2007. 4. The knowledge of THPs in matter of clinical general care (hygiene, emergency, side effects of drugs) is improved.
7 Background location of study The study was done at Ngongongare village with a population of 3500 inhabitants and from the neighboring villages surrounding CINS-AAF Project site such as Nkoanekoli, Mulala, Kilinga, Ngurdoto, and Ngarenamyuki with a population of more than 13,410 between October 2007 and November 2007 Objective of the study To establish the link between THPs and modern medicine in order to integrate traditional and modern medicine. Study design The study design selected is non experimental type.
Proper selection of the sample was made in order to ensure sample generalizability. Selection of true representation sample increases the researcher’s ability to draw conclusions that are valid. Respondents were asked the same set of questions in the same style to reduce the risk of getting incorrect observation or information. Research questions were relevant to entire population. Several research methods were used which helped to confirm or ascertain the results obtained (triangulation).
These were structured interview questionnaire, Individual In-depth Interviews, and physical observation Sampling A total of 5 interviewees were involved. This is about 40% of the entire population of THPs to be studied. The sample size was determined by resources available and also 8 adhering to the basic technical requirement, such as allowing for reliable analysis, providing for desired level of accuracy in estimates of proportions etc. Data Collection Methods The following were the methods used for collecting data and information.
The Individual In-depth Interview involved 5 persons who were given the interview guide was used structured interview questionnaire was also applied, whereby as stated above a total of 5 respondents were interviewed Study Limitations. Respondents are villagers that in some areas were not able to communicate properly in the national language. STUDY RESULTS Traditional Health Practitioners education range from No – formal education to Secondary education. The age of the THPs range from 50 to 70 years. 22 Diseases were sampled randomly among the full list of 68 diseases.
60% THPs were Females while 40% were males. In the study, see the summary [Table 23], it clearly shows that most of the THPs treat their patients mostly by using signs and symptoms definitions that the Modern Medical Practitioners [MMPs] use. 65% of the Definitions of the THPs signs and symptoms of diseases identified were compatible with the Modern Medicine practitioners, ome of the (THPs) Definitions had exaggerated symptoms that showed a little understanding of the anatomy and physiological functions of the body. There is an evidence of diversity of the 9.
definitions between the (THPs) themselves. The range of understanding of diseases varies greatly between one and the other (THPs). About 21% of (THPs) diseases, signs and symptoms definitions were quite different from (MMPs) definitions and also it was noticed that even with the (THPs) themselves had differing definitions of the signs and symptoms of the same disease. About 14 % of the diseases treated by the (THPs) need had to have confirmation from MMP, for confirmation of the disease, ranging from consultations, investigation such as X-Rays, Laboratory and etcetera.
(The table 24 and Chart 2): shows clearly that most of the (THPs) definitions for Human anatomical Parts differ to Medical Practitioners [MMPs] 20% (THPs) could not understand the essential parts of the body that are known to the Modern Medical Practitioners could be identified by the Local (THPs). 60% of the (THPs) could identify some Anatomical parts that are similar to Modern Medical Practitioners. 20% (THPs) did not identify any similarity between (THPs) Anatomical parts definitions with the Modern Medical Practitioners.
This shows that most of the THPs interviewed need to be given orientation that will give them a better understanding of the anatomy and physiological functions of the body, in order to improve their practice. There are evidences of diversity of the definitions between the THPs themselves. The range of understanding of anatomy and physiology doesn’t vary much between one and the other THP. 10 Table 25 and Chart 3 below analyses the understanding of the THPs on the physiological functions of the body as related to its anatomical parts as follows; 80% of the THPs definitions about the physiological functions of the body show clear similarities with the Modern Medical Practice definition.
20% on the other hand showed that, the definitions about the physiological function of the body as defined by the THPs give an understanding that is quite opposite to the Modern Medical practice. These statistics show that all the THPs has some understanding of the physiological functions of the body and was no THP who showed NOT at all understanding of the physiological functions of the human body parts as the Modern Medical Practitioner.
Table 26 and Chart 4 above analyses the understanding of the THPs on the Relationship between body Structures, Physiology and Disease processes including basic principles on infection prevention when dealing with their patients: All of the THPs (100%) showed SOME understanding about the relationship of the anatomical structures, physiological functions of the body as related to disease processes show clear understanding as compared to the Modern Medical Practice definitions.
11 RECOMMENDATIONS. Whereas the THPs have some skills in identifying some of the signs and symptoms of diseases, and whereas these definitions are compatible with the Modern Medical Practice definitions, There is a need for the (THPs) to be given more knowledge and skills trainings in order to draw up a common understanding of the disease and disease processes in order to up grade and update their knowledge and experiences in their practice.
Whereas the (THPs) have already established relationships with Modern Medical Practitioners especially in the area of confirmation of the diagnoses of some of the diseases before treatment; There is a need to establish a good linkage and referral systems between the (THPs) and the (MMPs). This will fill the existing gap whereby some of the therapies are done on trial basis.
Whereas the study shows that most THPs (60%) have some skills in identifying some of the essential parts of the body that are known to the Traditional Health Practitioners and whereas these definitions compatible with the Modern Medical Practice definitions, There is a need for the THPs to be given more knowledge and skills trainings in order to draw up a common understanding of the essential parts of the body in order to upgrade their knowledge, skills and practice, this will fill the existing gap whereby some of the therapies are done on trial basis.
Whereas the THPs have some skills in identifying some of the signs and symptoms of diseases, and whereas these definitions re compatible with the Modern Medical Practice definitions, There is a need for the THPs to be given more knowledge and skills trainings in order to draw up a common understanding of the disease and disease processes in order to up grade and update their knowledge and experiences in their practice.
Whereas there is clear evidence that the some of the drugs that the (THPs) use cure the diseases that they are prescribed for there is also evidence that the dosages used have no scientific basis, There is a need to do another study to analyze the medicaments dosages in order to assure safety of the users. 12 Tables TABLE 1 AIDS DISEASE signs and Symptoms THPs Number of Respondents Same as Modern Medical Practice. 1 Percentage 20% 0 80% 100% Completely different from Modern 0 Medical Practice. Need confirmation from Modern Medical Practice Total 4 5.
TABLE 2: Anemia DISEASE signs and Symptoms THPs Number of Respondents Same as Modern Medical Practice. 3 Percentage 60% 20% 20% 100% Completely different from Modern 1 Medical Practice. Need confirmation from 1 Modern Medical Practice Total 5 TABLE 3: Benin Prostate Hypertrophy DISEASE signs and Symptoms THPs Number of Respondents Same as Modern Medical Practice. 1 Percentage 20% 80% 0% 100% Completely different from Modern 4 Medical Practice. Need confirmation from 0 Modern Medical Practice Total 5 13 TABLE 4: Bronchial Asthma DISEASE signs and Symptoms THPs Number of Respondents Same as Modern Medical Practice.
4 Percentage 80% 20% 0% 100% Completely different from Modern 1 Medical Practice. Need confirmation from 0 Modern Medical Practice Total 5 TABLE 5: Cancer DISEASE signs and Symptoms THPs Number of Respondents Same as Modern Medical Practice. 2 Percentage 40% 40% 20% 100% Completely different from Modern 2 Medical Practice. Need confirmation from 1 Modern Medical Practice Total 5 TABLE 6: Cancer of the Cervix DISEASE signs and Symptoms THPs Number of Respondents Same as Modern Medical Practice. 2 Percentage 40% 0% 60% 100% Completely different from Modern 0 Medical Practice.
Need confirmation from 3 Modern Medical Practice Total 5 14 TABLE 7: Cholera DISEASE signs and Symptoms THPs Number of Respondents Same as Modern Medical Practice. 4 Percentage 80% 20% 0% 100% Completely different from Modern 1 Medical Practice. Need confirmation from 0 Modern Medical Practice Total 5 TABLE 8: Dysentery DISEASE signs and Symptoms THPs Number of Respondents Same as Modern Medical Practice. 4 Percentage 80% 20% 0% 100% Completely different from Modern 1 Medical Practice. Need confirmation from 0 Modern Medical Practice Total 5 TABLE 9: Enteric fever [Typhoid].
DISEASE signs and Symptoms THPs Number of Respondents Same as Modern Medical Practice. 1 Percentage 20% 80% 0% 100% Completely different from Modern 4 Medical Practice. Need confirmation from 0 Modern Medical Practice Total 5 15 TABLE 10: Epilepsy DISEASE signs and Symptoms THPs Number of Respondents Same as Modern Medical Practice. 4 Percentage 80% 20% 0% 100% Completely different from Modern 1 Medical Practice. Need confirmation from 0 Modern Medical Practice Total 5 TABLE 11: Gonorrhea DISEASE signs and Symptoms THPs Number of Respondents Same as Modern Medical Practice. 5 Percentage 100% 0% 0% 100%.
Completely different from Modern 0 Medical Practice. Need confirmation from 0 Modern Medical Practice Total 5 TABLE 12: Helminthiasis DISEASE signs and Symptoms THPs Number of Respondents Same as Modern Medical Practice. 3 Percentage 60% 0% 40% 100% Completely different from Modern 0 Medical Practice. Need confirmation from 2 Modern Medical Practice Total 5 16 TABLE 13: Hepatitis DISEASE signs and Symptoms THPs Number of Respondents Same as Modern Medical Practice. 1 Percentage 20% 80% 0% 100% Completely different from Modern 4 Medical Practice. Need confirmation from 0 Modern Medical Practice Total 5.
TABLE 14: Hypertension DISEASE signs and Symptoms THPs Number of Respondents Same as Modern Medical Practice. 3 Percentage 60% 40% 0% 100% Completely different from Modern 2 Medical Practice. Need confirmation from 0 Modern Medical Practice Total 5 TABLE 15: Impotence DISEASE signs and Symptoms THPs Number of Respondents Same as Modern Medical Practice. 3 Percentage 60% 40% 0% 100% Completely different from Modern 2 Medical Practice. Need confirmation from 0 Modern Medical Practice Total 5 17 TABLE 16: Lung Cancer DISEASE signs and Symptoms THPs Number of Respondents Same as Modern Medical Practice.
3 Percentage 60% 0% 40% 100% Completely different from Modern 0 Medical Practice. Need confirmation from 2 Modern Medical Practice Total 5 TABLE 17: Malaria DISEASE signs and Symptoms THPs Number of Respondents Same as Modern Medical Practice. 4 Percentage 80% 0% 20% 100% Completely different from Modern 0 Medical Practice. Need confirmation from 1 Modern Medical Practice Total 5 TABLE 18: Meningitis DISEASE signs and Symptoms THPs Number of Respondents Same as Modern Medical Practice. 4 Percentage 80% 20% 0% 100% Completely different from Modern 1 Medical Practice.
Need confirmation from 0 Modern Medical Practice Total 5 18 TABLE 19: Otitis media DISEASE signs and Symptoms THPs Number of Respondents Same as Modern Medical Practice. 4 Percentage 80% 20% 0% 100% Completely different from Modern 1 Medical Practice. Need confirmation from 0 Modern Medical Practice Total 5 TABLE 20: Pelvic Inflammatory Disease DISEASE signs and Symptoms THPs Number of Respondents Same as Modern Medical Practice. 5 Percentage 100% 0% 0% 100% Completely different from Modern 0 Medical Practice. Need confirmation from 0 Modern Medical Practice Total 5.
TABLE 21: Peptic Ulcers DISEASE signs and Symptoms THPs Number of Respondents Same as Modern Medical Practice. 3 Percentage 60% 40% 0% 100% Completely different from Modern 2 Medical Practice. Need confirmation from 0 Modern Medical Practice Total 5 19 TABLE 22: Pneumonia DISEASE signs and Symptoms THPs Number Respondents of Percentage Same as Modern Medical Practice. 4 80% 0% 20% 100% Completely different from Modern 0 Medical Practice. Need confirmation from 1 Modern Medical Practice Total 5 Table 23: Summary of Selected Diseases and their definitions. DISEASE Same as Modern Completely Need Medical different from confirmation Practice.
[MMP] MMP from MMP AIDS 20 0 80 Anemia 60 20 20 BPH 20 80 0 Asthma 80 20 0 Cancer (skin). 40 40 20 CA of the 40 0 60 Cervix Cholera 80 20 0 Dysentery 80 20 0 Enteric fever 80 20 0 Epilepsy 100 0 0 Gonorrhea 100 0 0 Helminthiasis 60 0 40 Hepatitis 20 80 0 Hypertension 60 40 0 Impotence 60 40 0 Lung Cancer 60 0 40 Malaria 80 0 20 Meningitis 80 20 0 Otitis media 80 20 0 PID 100 0 0 Peptic Ulcers 60 40 0 Pneumonia 80 0 20 Average 65% 21% 14% TOTAL 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100% 100%.
20 Table 24 Human anatomical Parts definitions. Human anatomical Parts definitions. SIMILAR to MMPs: SOME Similarity NOT similar to MMPs Total Number of Respondents 1 3 1 5 Percentage 20% 60% 20% 100% Table 25; Understanding of the Systemic physiological functions of the body Understanding of the Systemic Number of Respondents Percentage physiological functions of the body. No Understanding at all: Some understanding: Negative Understanding: Total Chart 3 Table 26; Relationship between body structures, Physiology and disease processes.
Relationship between body structures, Number Physiology and disease processes No Understanding at all: Some understanding: Total Respondents 0 5 5 0% 100% 100% of Percentage 0 4 1 5 0% 80% 20% 100% 21 GRAPH 1 Disease D efinition s TH Ps and MM Ps S ame as M odern Medical P ractice. 120 Com plet ely different from Modern Medic al P ract ice. Need c onfirm at ion f rom M odern Medical P ract ice T OT A L 100 Definition frequencies in % 80 60 40 20 0 ID S ne yp m \B e r ia ro tro nc ph hi y al C an A st ce hm C ro an a ft ce he ro sk ft in he C er vix GRAPH 2.
H um an An ato mi ca l D efi ni tio ns 7 0% 6 0% Percentage at Ngongongare Village 5 0% 4 0% 3 0% 2 0% 1 0% 0% S IM ILA R to M M Ps : S O ME S im i larit y R e lati on shi p b etw ee n TH P s a n d t he M M P s NO T s im il a r to M M Ps n [ T tery yp ho id ]. Ep i le p G o n sy or He rh ea lm in th ia si s He pa H yp t it is er te ns io Im n po te Lu nc ng e C an ce r M al Pe ar lv M ia ic en In in f la gi O m tis m t itis at or m e y d D ia is e as Pe e pt ic Ul ce P rs ne um on ia D iseases ho C E nt er A le D ic H te Be ni n P ro st a fe v er ys e A ra 22.
GRAPH 3 U n d e r s t an d i n g t h e S y s te m i c p h y s i o l o g i c a l F u n c t i o n o f th e b o d y 90% 80% 70% Percentage[Ngongongare THPs] 60% 50% S e r ie s 1 40% 30% 20% 10% 0% N o U n d er s ta n d in g a t a ll: S o m e u n d e r s t a n din g : C o m p a r e T H P s w it h M M P N e ga t iv e U n de r s ta n d in g: GRAPH 4 Relation ship betw een b ody structures Ph ysio logy and diseases 120% 100% Percentage of understanding. 80% 60% Series1 40% 20% 0% No Relationship at all: Some understanding: U nder stan ding of TH Ps as related to the MM P.
23 Case Study number 001 …Mrs. Y…. ………………. ………………….. Name of the Patient… Age of the patient………………38yrs…………………………………………………. Sex………………………………Female………………………………………………… Address………………University of Arusha (Ngongongare Village), P. O. Box 7, Usa –River, Arusha, Tanzania. HPI: Mrs. Y stated feeling itching of the face and upper chest in early 2004, then observed some skin rashes more to the face with extensive itching, went to different local clinics in Morogoro where she got oral medication and ointments(Antihistamines &antifungal respectively) with no relief.
She was the referred to a dermatologist at KCMC consultant hospital where she have been following up medications (2005 – 2007) but with very slight and temporary relief. It was a month ago when she learned about one traditional healer at Ngongongare village (M/s Fatuma) and decided to consult for treatment of her ailment. PM Hx: This is her first major illness and there is no history of any associated illness apart from her being a known Asthmatic patient since child hood.
Drugs used include [Gentiderm, Gentrisone and Clotrimazole creams, steroids and oral medications that she did not record]. SF Hx: Now a second year Business degree student at UOA, Married with a 15 years son. ROS: All other systems have no complaints PHYS Exam: A healthy looking middle aged lady, with normal vital signs, all systems examined within normal limits. LOCAL Exam: Healing marks of skin eruptions, with lichenification marks at the face and the upper chest wall.
LAB Exam Done at the consultant hospital, but non – contributory to the problem TENTATIVE D x Auto-immune Skin Allergie NOTES M/s Fatuma, a THP staying at Ngongongare Village, Treats several diseases including skin diseases. According to Fatuma, the disease Mrs. Y is suffering is a type of TAMBAZI and can be treated by Herbal mix called Naamoh oral drug and Thaqmooh skin ointment. Follow ups with THP medications: First week – All skin eruptions disappeared Second week – Sporadic itches Third week – No more itches. Up to date she is okay.
24 Case Study number 002 Name of the Patient…………………. MR X ……….. ………………. ………………….. Age of the patient………………50yrs…Wife 40years….. ………………………………. Sex………………………………Male & Female respectively…………………………… Address……………… Kimandolu, Arusha, Tanzania. HPI: Him and the wife Mrs. X, HIV Positive since More than 4 years. With severe pains – all the body. Not bed ridden. PM Hx: Started ARV Since January 2007, after CD 4 Count was found below 400, wife 500. SF Hx: Businessman in town, Married with 3years kids. Wife also HIV positive with the same Treatment.
ROS: All other systems have no complaints PHYS Exam:(On the day of interview). A healthy looking middle aged man, with normal vital signs, all systems examined within normal limits. LOCAL Exam: Non Significant. LAB Exam Done at the consultant hospital, but non – contributory to the problem TENTATIVE D x HIV/AIDS Infection NOTES M/s Fatuma, a THP staying at Ngongongare Village, Treats several diseases including skin diseases. According to Fatuma, The couples were already on medication after being confirmed that they were HIV positive from the government Hospital in Arusha town.
Mr. X and Wife had decided to try local traditional medications. Examination revealed skin rashes in parts of their bodies especially the husband and severe body weaknesses and body pains on both. Fatuma started treating them with Herbal mix called I-Naamoh oral drug 5 months ago Follow ups with THP medications: First month – All skin rashes disappeared Second Month – Pains on and off. Third Month – No more pains Went to check CD4. above750, wife more than 800 Up to date they are still taking the drug. 25.