{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,30]],"date-time":"2026-07-30T18:06:23Z","timestamp":1785434783715,"version":"3.56.0"},"reference-count":49,"publisher":"Public Library of Science (PLoS)","issue":"7","license":[{"start":{"date-parts":[[2026,7,30]],"date-time":"2026-07-30T00:00:00Z","timestamp":1785369600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS One"],"abstract":"<jats:sec id=\"sec001\">\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Globally, 85% of the population uses traditional medicine. Ethiopia is a country with various traditional medicinal practices. However, various studies also reported traditional medicine used in children by their parents has had adverse outcomes and hospitalized them with complications. Various studies had also reported that traditional medicine use was high during COVID-19. Despite the fact that, children are particularly vulnerable population, limited studies exists regarding the prevalence, types, and determinants of parental TM use during COVID-19. In addition the existing studies were also confined to quantitative methods. Therefore, this study uses a mixed study design to explore indigenous methods of traditional medicine knowledge acquisition, preservation, preparation, storage, and dosage of herbs; barriers of disclosure; and prevalence of concomitant use.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec002\">\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A community-based concurrent mixed study design was conducted among 941 randomly selected parents from Dec 01\/2023 to March 01\/2024. The data was cleaned, coded, and entered in Epi-Data version 4.6 and transferred to Stata version 14.1 for analysis. Finally, an AOR with a 95% CI was computed, and variables with a p-value\u2009&lt;\u20090.05 in the multivariable analysis were taken as significant factors. The qualitative data was collected from 16 selected key informants by in-depth face-to-face interviews and analyzed by using thematic analysis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec003\">\n                    <jats:title>Result<\/jats:title>\n                    <jats:p>The prevalence of parental TM use for children was 87.6%. Sibling relation to child (AOR: 0.45, 95% CI, 0.01\u20130.77), religion (AOR: 0.11, 95% CI, 0.04\u20130.29), parental TM use for themselves (AOR: 6.55, 95% CI, 1.67\u201325.69), easy accessibility (AOR: 2.72, 95% CI, 1.16\u20136.40), safety &amp; efficacy (AOR: 4.53, 95% CI, 2.3\u201313.61), and TM skill in the family (AOR: 0.47, 95% CI, 0.19\u20130.84) were determinants of TM utilization. Lack of awareness, misperception of TM, lack of trust in HCP and negative judgment from HCP were the main-barriers for non-disclosure of TM use.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec004\">\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>This result indicated traditional medicine use was high; nearly 9 out of 10 parents had used TM for their children during COVID-19. There was high concomitant utilization (90.6%) and high non-disclosure rate (98.1%) of traditional medicine use to health workers. Hence, it is better to give priority to strengthening the implementation of TM policy and manage accordingly.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1371\/journal.pone.0354889","type":"journal-article","created":{"date-parts":[[2026,7,30]],"date-time":"2026-07-30T17:44:31Z","timestamp":1785433471000},"page":"e0354889","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":0,"title":["Determinants of parental traditional medicine use for children during COVID-19 in Dire Dawa city administration, Eastern Ethiopia, 2023\/24: Mixed community based cross-sectional study design"],"prefix":"10.1371","volume":"21","author":[{"given":"Mohammed","family":"Kebede","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gudeta","family":"Kusheta","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mehammedamin","family":"Jemal","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kedir","family":"Abdurehman","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4275-1200","authenticated-orcid":true,"given":"Netsanet","family":"Melkamu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yakob","family":"Tadese","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"340","published-online":{"date-parts":[[2026,7,30]]},"reference":[{"key":"pone.0354889.ref001","first-page":"188","volume-title":"Who traditional medicine strategy. 2014-2023","author":"Z Qi","year":"2013"},{"key":"pone.0354889.ref002","unstructured":"Organization WH. WHO global report on traditional and complementary medicine 2019. World Health Organization; 2019."},{"key":"pone.0354889.ref003","unstructured":"Organization WH. Traditional medicine in the WHO South-East Asia region: Review of progress 2014\u20132019. Traditional medicine in the WHO South-East Asia Region: review of progress 2014\u20132019. 2020."},{"issue":"1","key":"pone.0354889.ref004","first-page":"122","article-title":"Knowledge, attitude and practice towards traditional medicinal plants utilization along socio-cultural and agroecological-gradient in Southwest Ethiopia","volume":"10","author":"K Tadele","year":"2024","journal-title":"Arabian Journal of Medicinal and Aromatic Plants"},{"key":"pone.0354889.ref005","doi-asserted-by":"crossref","first-page":"505","DOI":"10.2147\/PHMT.S275249","article-title":"Parental Traditional Medicine Use for Children and Associated Factors in North Mecha District, North West Ethiopia","volume":"11","author":"D Tizazu","year":"2020","journal-title":"Pediatric Health Med Ther"},{"issue":"179","key":"pone.0354889.ref006","first-page":"2","article-title":"Prevalence and factors associated with parental traditional medicine use for children in Motta Town, Amhara Regional State, Ethiopia, 2014","volume":"4","author":"TG Melesse","year":"2015","journal-title":"Altern Integr Med"},{"issue":"1","key":"pone.0354889.ref007","doi-asserted-by":"crossref","first-page":"72","DOI":"10.1186\/s43094-021-00223-5","article-title":"Ethnomedicinal herbs in African traditional medicine with potential activity for the prevention, treatment, and management of coronavirus disease 2019","volume":"7","author":"OA Adeleye","year":"2021","journal-title":"Futur J Pharm Sci"},{"key":"pone.0354889.ref008","unstructured":"Berle-Keys CA. Investigation into the incidence of adverse events associated with the use of Chinese Herbal Medicine (CHM): University of Technology Sydney (Australia); 2023."},{"key":"pone.0354889.ref009","doi-asserted-by":"crossref","first-page":"96","DOI":"10.15406\/jpnc.2022.12.00463","article-title":"Pediatrics pharmacokinetics and dose calculation","volume":"12","author":"G Bereda","year":"2022","journal-title":"J Pediatr Neonatal Cares"},{"key":"pone.0354889.ref010","author":"A Promkot","year":"2019"},{"issue":"6","key":"pone.0354889.ref011","doi-asserted-by":"crossref","DOI":"10.1542\/peds.2017-0062","article-title":"Herbal Medicines for Gastrointestinal Disorders in Children and Adolescents: A Systematic Review","volume":"139","author":"D Anheyer","year":"2017","journal-title":"Pediatrics"},{"key":"pone.0354889.ref012","doi-asserted-by":"crossref","first-page":"46","DOI":"10.1186\/1746-4269-10-46","article-title":"Use and management of traditional medicinal plants by Maale and Ari ethnic communities in southern Ethiopia","volume":"10","author":"B Kidane","year":"2014","journal-title":"J Ethnobiol Ethnomed"},{"issue":"1","key":"pone.0354889.ref013","doi-asserted-by":"crossref","first-page":"9","DOI":"10.1186\/s40748-021-00130-w","article-title":"Traditional medicine utilisation and maternal complications during antenatal care among women in Bulilima, Plumtree, Zimbabwe","volume":"7","author":"N Mudonhi","year":"2021","journal-title":"Matern Health Neonatol Perinatol"},{"key":"pone.0354889.ref014","article-title":"Creencias tradicionales en el manejo y prevenci\u00f3n de la ictericia neonatal en Ado-Ekiti (Nigeria)","volume":"32","author":"DT Esan","year":"2022","journal-title":"Enfermer\u00eda Cl\u00ednica"},{"key":"pone.0354889.ref015","doi-asserted-by":"crossref","first-page":"1392330","DOI":"10.3389\/fphar.2024.1392330","article-title":"Traditional herbal medicine regulatory implementation in Ethiopia: a qualitative study","volume":"15","author":"RE Usure","year":"2024","journal-title":"Front Pharmacol"},{"issue":"2","key":"pone.0354889.ref016","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pone.0286233","article-title":"Traditional herbal medicine use doubled the risk of multi-organ dysfunction syndrome in children: A prospective cohort study","volume":"19","author":"NW Teshager","year":"2024","journal-title":"PLoS One"},{"issue":"4","key":"pone.0354889.ref017","doi-asserted-by":"crossref","DOI":"10.1136\/bmjopen-2015-010417","article-title":"Traditional medicine used in childbirth and for childhood diarrhoea in Nigeria\u2019s Cross River State: interviews with traditional practitioners and a statewide cross-sectional study","volume":"6","author":"I Sarmiento","year":"2016","journal-title":"BMJ Open"},{"issue":"4","key":"pone.0354889.ref018","doi-asserted-by":"crossref","first-page":"437","DOI":"10.2174\/18756417MTExfMTQ1z","article-title":"Herbal Medicines for Diabetes Management and its Secondary Complications","volume":"17","author":"S Kumar","year":"2021","journal-title":"Curr Diabetes Rev"},{"issue":"2","key":"pone.0354889.ref019","doi-asserted-by":"crossref","first-page":"86","DOI":"10.5694\/mja16.00614","article-title":"What risks do herbal products pose to the Australian community?","volume":"206","author":"RW Byard","year":"2017","journal-title":"Med J Aust"},{"issue":"2","key":"pone.0354889.ref020","doi-asserted-by":"crossref","first-page":"491","DOI":"10.1111\/bcp.15193","article-title":"Pharmacovigilance in low- and middle-income countries: A review with particular focus on Africa","volume":"89","author":"R Kiguba","year":"2023","journal-title":"Br J Clin Pharmacol"},{"key":"pone.0354889.ref021","doi-asserted-by":"crossref","unstructured":"Zhang J, Onakpoya IJ, Posadzki P, Eddouks M. The safety of herbal medicine: from prejudice to evidence. Evidence-based complementary and alternative medicine: eCAM. 2015;2015:316706.","DOI":"10.1155\/2015\/316706"},{"issue":"5","key":"pone.0354889.ref022","doi-asserted-by":"crossref","DOI":"10.1136\/bmjgh-2018-000895","article-title":"Traditional, complementary and alternative medicine use in Sub-Saharan Africa: a systematic review","volume":"3","author":"PB James","year":"2018","journal-title":"BMJ Glob Health"},{"key":"pone.0354889.ref023","unstructured":"Jepsen J. Prevalence and Perceptions of Herbal Medicine Use in Eastern Jamaica. 2021."},{"key":"pone.0354889.ref024","unstructured":"Dawit Teshome Gebregeorgise DTG, Arebu Issa Bilal AIB, Bruck Messele Habte BMH, Zelalem Tilahun ZT, Teferi Gedif Fenta TGF, Mariamawit Yonathan Yeshak MYY. Concomitant use of medicinal plants and conventional medicines among hypertensive patients in five hospitals in Ethiopia. 2019."},{"key":"pone.0354889.ref025","unstructured":"Getnet S. Assessment of concomitant use of herbal and conventional medicines among patients with diabetes in public hospitals of Addis Ababa, Ethiopia: Addis Ababa University; 2017."},{"key":"pone.0354889.ref026","unstructured":"Kasilo OM, Lusamba-Dikassa PS, Mwikisa Ngenda C, Trapsida J-M. An overview of the traditional medicine situation in the African region. Afr health monit(Online). 2010:7\u201315."},{"key":"pone.0354889.ref027","doi-asserted-by":"crossref","first-page":"115","DOI":"10.4314\/ajtcam.v8i5S.5","article-title":"Trends and challenges of traditional medicine in Africa","volume":"8","author":"AA Abdullahi","year":"2011","journal-title":"Afr J Tradit Complement Altern Med"},{"issue":"1","key":"pone.0354889.ref028","doi-asserted-by":"crossref","first-page":"1300","DOI":"10.1080\/22221751.2020.1775132","article-title":"COVID-19 pandemic - an African perspective","volume":"9","author":"SA Lone","year":"2020","journal-title":"Emerg Microbes Infect"},{"issue":"3","key":"pone.0354889.ref029","doi-asserted-by":"crossref","DOI":"10.5812\/iji.107090","article-title":"COVID-19 Pandemic: The Role of Traditional Medicine","volume":"7","author":"F Muhammad","year":"2020","journal-title":"Int J Infect"},{"issue":"1","key":"pone.0354889.ref030","first-page":"4","article-title":"A rapid advice guideline for the diagnosis and treatment of 2019 novel coronavirus (2019-nCoV) infected pneumonia (standard version)","volume":"7","author":"Y-H Jin","year":"2020","journal-title":"Mil Med Res"},{"issue":"3","key":"pone.0354889.ref031","doi-asserted-by":"crossref","first-page":"100465","DOI":"10.1016\/j.imr.2020.100465","article-title":"Herbal medicine for the management of COVID-19 during the medical observation period: A review of guidelines","volume":"9","author":"L Ang","year":"2020","journal-title":"Integr Med Res"},{"issue":"1","key":"pone.0354889.ref032","doi-asserted-by":"crossref","first-page":"181","DOI":"10.1080\/01652176.2021.1921311","article-title":"SARS-CoV-2 in animals: potential for unknown reservoir hosts and public health implications","volume":"41","author":"K Sharun","year":"2021","journal-title":"Vet Q"},{"key":"pone.0354889.ref033","article-title":"Evaluating traditional and complementary medicines: Where do we go from here?","volume":"37","author":"LW Lin","year":"2021","journal-title":"Int J Technol Assess Health Care"},{"key":"pone.0354889.ref034","doi-asserted-by":"crossref","first-page":"39","DOI":"10.1186\/1746-4269-7-39","article-title":"The contribution of traditional healers\u2019 clinics to public health care system in Addis Ababa, Ethiopia: a cross-sectional study","volume":"7","author":"W Birhan","year":"2011","journal-title":"J Ethnobiol Ethnomed"},{"key":"pone.0354889.ref035","doi-asserted-by":"crossref","first-page":"2050312120978008","DOI":"10.1177\/2050312120978008","article-title":"Factors associated with parental traditional medicine use for children in Fagita Lekoma Woreda Northwest Ethiopia: A cross-sectional study","volume":"8","author":"D Asrat","year":"2020","journal-title":"SAGE Open Med"},{"key":"pone.0354889.ref036","doi-asserted-by":"crossref","first-page":"138073","DOI":"10.1155\/2015\/138073","article-title":"Knowledge, Attitude, and Utilization of Traditional Medicine among the Communities of Merawi Town, Northwest Ethiopia: A Cross-Sectional Study","volume":"2015","author":"SM Wassie","year":"2015","journal-title":"Evid Based Complement Alternat Med"},{"issue":"1","key":"pone.0354889.ref037","doi-asserted-by":"crossref","first-page":"125","DOI":"10.1186\/s12906-020-02928-1","article-title":"Determinants of traditional medicine utilization for children: a parental level study in Tole District, Oromia, Ethiopia","volume":"20","author":"F Hailu","year":"2020","journal-title":"BMC complementary medicine and therapies"},{"issue":"4","key":"pone.0354889.ref038","doi-asserted-by":"crossref","DOI":"10.26717\/BJSTR.2018.04.0001097","article-title":"Influence of Storage Conditions on Quality Attributes of Medicinal Plants","volume":"4","author":"CF Lisboa","year":"2018","journal-title":"BJSTR"},{"key":"pone.0354889.ref039","doi-asserted-by":"crossref","first-page":"4871459","DOI":"10.1155\/2020\/4871459","article-title":"Concomitant Use of Herbal and Conventional Medicines among Patients with Diabetes Mellitus in Public Hospitals of Addis Ababa, Ethiopia: A Cross-Sectional Study","volume":"2020","author":"SG Meshesha","year":"2020","journal-title":"Evid Based Complement Alternat Med"},{"key":"pone.0354889.ref040","doi-asserted-by":"crossref","first-page":"74","DOI":"10.37871\/jbres1402","article-title":"Prevalence and patterns of herbal medicine use among Type 2 Diabetes Mellitus patients at the University Teaching Hospitals in Lusaka","volume":"3","author":"CNa Hikaambo","year":"2022","journal-title":"J Biomed Res Environ Sci"},{"issue":"1","key":"pone.0354889.ref041","doi-asserted-by":"crossref","first-page":"1852716","DOI":"10.1080\/23311932.2020.1852716","article-title":"Ethnobotanical study of medicinal plants, its utilization, and conservation by indigenous people of Gera district, Ethiopia","volume":"6","author":"N Gonfa","year":"2020","journal-title":"Cogent Food & Agriculture"},{"key":"pone.0354889.ref042","doi-asserted-by":"crossref","first-page":"1020097","DOI":"10.3389\/fphar.2022.1020097","article-title":"Ethnobotanical study of endemic and non-endemic medicinal plants used by indigenous people in environs of Gullele botanical garden Addis Ababa, central Ethiopia: A major focus on Asteraceae family","volume":"13","author":"MM Woldeamanuel","year":"2022","journal-title":"Front Pharmacol"},{"issue":"1","key":"pone.0354889.ref043","first-page":"40","article-title":"Traditional herbal medicines used in neonates and infants less than six months old in Lagos Nigeria","volume":"43","author":"O Nwaiwu","year":"2016","journal-title":"Nig J Paed"},{"issue":"2","key":"pone.0354889.ref044","doi-asserted-by":"crossref","first-page":"40","DOI":"10.4314\/evj.v21i2.4","article-title":"Ethnobotanical knowledge and practices of traditional healers in Harar, Haramaya, Bati and Garamuleta, Eastern Ethiopia","volume":"21","author":"N Mekonnen","year":"2017","journal-title":"Ethiop Vet J"},{"key":"pone.0354889.ref045","doi-asserted-by":"crossref","first-page":"18","DOI":"10.1186\/1746-4269-10-18","article-title":"Ethnomedicinal plants used to treat human ailments in the prehistoric place of Harla and Dengego valleys, eastern Ethiopia","volume":"10","author":"A Belayneh","year":"2014","journal-title":"J Ethnobiol Ethnomed"},{"issue":"1","key":"pone.0354889.ref046","doi-asserted-by":"crossref","first-page":"137","DOI":"10.54386\/jam.v23i1.100","article-title":"Seasonal variations in the nutritional quality of drumstick","volume":"23","author":"K Anitta Judy","year":"2021","journal-title":"J Agrometeorol"},{"issue":"3","key":"pone.0354889.ref047","doi-asserted-by":"crossref","first-page":"584","DOI":"10.1542\/peds.111.3.584","article-title":"Use of complementary and alternative medical therapies among children with special health care needs in southern Arizona","volume":"111","author":"H Sanders","year":"2003","journal-title":"Pediatrics"},{"issue":"2","key":"pone.0354889.ref048","doi-asserted-by":"crossref","first-page":"225","DOI":"10.1542\/peds.2012-1220","article-title":"Complementary and alternative medicine use by pediatric specialty outpatients","volume":"131","author":"D Adams","year":"2013","journal-title":"Pediatrics"},{"issue":"5","key":"pone.0354889.ref049","doi-asserted-by":"crossref","first-page":"429","DOI":"10.1367\/A03-091R1.1","article-title":"Visits to complementary and alternative medicine providers by children and adolescents in the United States","volume":"4","author":"SM Yussman","year":"2004","journal-title":"Ambul Pediatr"}],"container-title":["PLOS One"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pone.0354889","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,7,30]],"date-time":"2026-07-30T17:44:40Z","timestamp":1785433480000},"score":1,"resource":{"primary":{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pone.0354889"}},"subtitle":[],"editor":[{"given":"Jenny","family":"Wilkinson","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"editor"}]}],"short-title":[],"issued":{"date-parts":[[2026,7,30]]},"references-count":49,"journal-issue":{"issue":"7","published-online":{"date-parts":[[2026,7,30]]}},"URL":"https:\/\/doi.org\/10.1371\/journal.pone.0354889","relation":{},"ISSN":["1932-6203"],"issn-type":[{"value":"1932-6203","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,7,30]]}}}