Critical Assessment of the Implications of Self-medication With Natural Products During Disease Outbreaks Among People in Developing Countries
Authors: ADEBIYI Salem Kivos 
Published: August 2023

Abstract
Background: Self-medication with natural products during disease outbreaks is a major public health challenge in developing countries. Unlike self-medication with Over the counter (OTC) medication which receives significant attention in published literature, natural products have significant health implications, especially during times of disease outbreaks which are yet to be fully explored. Not backed by scientific evidence, the act can lead to a false sense of security among people, leading to a further spread of the disease amongst other implications. People need to be informed about self-medication risks and the professionally prescribed benefits of natural products and to seek appropriate medical care when necessary.
Objectives: The purpose of this dissertation is to assess the implications of self-medication with natural products during disease outbreaks among people in developing countries. It tries to answer the following questions: (1) what is the state and quality of evidence in current literature (2) what are the gaps in literature (3) what are the determinants and contributing factors to self-medication with natural products during disease outbreaks among people in developing countries (4) what are the implications and (5) what are the possible solutions?
Method: This dissertation was conducted using a modified systematic literature review methodology. The search protocol utilised for the search and selection of relevant materials from literature used in synthesising the findings of the study was documented using the PRISMA. The database search result was selected for review after the application of limiters, duplicate removals, exclusion and inclusion criteria, full-text review, and screening. The final selected articles were assessed for quality and bias using the 20 points system in AXIS critical evaluation tool. Data were extracted into themes using a Microsoft word table from which findings were synthesised.
Findings: The initial database search yielded 1,683 reports from which 20 articles were selected for the review. Overall, 71.4% of the 14 articles assessed for quality and bias accrued 15 or more points on the 20 points system in AXIS critical evaluation tool, indicating that they were relatively of good quality. While all twenty (20) articles mentioned at least three or more factors or determinants of self-medication with natural products during disease outbreaks, only six (6) articles mentioned one or more implications, therefore demonstrating that there is a dearth in literature in this regard, which needs more exploration. The findings indicate that women are more likely to self-medicate with natural products than men, acquisition and ideological factors had the most influence on self-medication while the most common side effects were Diarrhoea, Stomach pain, Sweating, Headache, and Nausea/vomiting. Findings indicate that steam inhalation and herbal baths increased the risk of COVID-19 infection and people who self-medicate with natural products are more withdrawn and had less communication with their physicians. These people may suffer side effects not reported to their doctor and this might account for the paucity of reports on the implications of natural products used during disease outbreaks.
Conclusion and implication of key finding:The use of natural products for self-medication during disease outbreak is a rampant practice in developing countries. While natural products may be more readily available, accessible, and affordable, there are potential risks and implications of natural products' use for self-medication. People need to be informed about this, encouraged to speak about their predicaments and seek appropriate medical care and support when necessary.