Medicinal plants used by Tanzanian traditional healers in the management of Candida infections

Ethnomedicinal Uses, Phytochemistry and Pharmacological Properties of Suregada Genus: A Review

Plants of the Suregada Roxb. ex Rottler (formerly Gelonium Roxb. ex Willd) are utilized to treat various ailments, namely, hepatic, gum diseases, pyrexia, eczema, and venereal diseases. This review links the reported compounds to ethnomedicinal uses through pharmacological activities. The compounds possess anticancer, anti-allergic, antibacterial, anti-inflammatory, antioxidant, and anti-HIV properties. From the previous reports, 32 known species of the Suregada genus have been investigated morphologically, and nine were investigated for their phytochemistry and pharmacology. Phytochemistry, ethnomedicinal, and pharmacological uses of the other 23 Suregada species are not known and/or not reported. In this review, abietane diterpenoids are the main compounds expressed by the Suregada, accounting for 71 of the 114 reported compounds. Ten triterpenoids and sterols, one aliphatic, two lignans, five flavonoids, and twenty-one nitrogen-containing compounds have been reported from the genus.

An Inventory of South African Medicinal Plants Used in the Management of Sexually Transmitted and Related Opportunistic Infections: An Appraisal and Some Scientific Evidence (1990-2020)

The current work is aimed at generating the first inventory of South African medicinal plants used in the treatment of sexually transmitted and related opportunistic infections associated with HIV-AIDS. This is important in assisting researchers to access a list of plant species to evaluate for potential phytocompounds, as this area of research is greatly lagging in South Africa. A total of 335 medicinal plants from 103 families have been documented in the current work. The most represented families are Fabaceae (11.64%) and Asteraceae (6.27%). Herbs constitute 36.53%, trees 32.34%, shrubs 29.04%, climbers 1.80% and parasites 0.30%. It is worrying that on the plant parts used, the roots constitute 47.18%, while leaves and stem bark yield 16.62 and 15.01%, respectively. Catharanthus roseus exhibited the highest number of citations (19), while Peltophorum africanum had 14 and both Carica papaya and Vachelia karoo had 12. In the mode of administration of the reported medicinal plant species, most of the plants are boiled and taken orally (48.22%), while other plant species are used as mouth washes (3.25%). Although there is reasonable in vitro activity of some of the plant species, validating the relevance of use, there is still a need to explore the mode of action of such plant species; isolated compounds and possible derivatives thereof are of paramount importance and need to be explored as well. Furthermore, toxicological aspects of such plant species need to be explored.

Ethnotherapeutic Uses and Phytochemical Composition of Physalis peruviana L.: An Overview

Background

Plant-derived medicines are widespread and continue to increase in traditional and modern medicine, especially in developing countries. Physalis peruviana L. is among the most used plants in conventional medication worldwide. This review aimed to highlight the ethnotherapeutic uses and phytochemical status of identified compounds in P. peruviana.

Methods

Data were collected from Google Scholar, PubMed/Medline, SciFinder, Science Direct, Scopus, the Wiley Online Library, Web of Science, and any other helpful search engine using Physalis peruviana as the primary keyword.

Results

Some countries, worldwide, use P. peruviana in their traditional medicine system to manage diverse ailments, mainly diseases and gastrointestinal tract disorders (25.33%). Leaf was the mostly used part (49.28%), prepared by decoction (31.58%) and overall administrated orally (53.57%) as the main route of admission. Around 502 phytoconstituents were identified in different plant parts, especially fruit (38.19%) ethanol/ethyl acetate extract. In most cases (36.17%), the solvent of the extract was not specified. Several phytochemical classes were found in the plant, especially terpenes (26.09%) and phenolic compounds (14.94%). Esters were also abundant (11.55%). In the terpenes category, carotenoids were the most abundant (11.15% followed by monoterpenes (8.76%) and diterpenes (3.18%). However, flavonoids (5.17%) followed by cinnamic acid derivatives (3.99%), monophenolic compounds (1.79%), and phenolic acids (1.33 M) are the most reported phenolic compounds. Hexadecanoic acid (palmitic acid) was the most cited (five times).

Conclusion

P. peruviana plays an essential role in managing diseases in some countries and is rich in chemical compounds, which need to be isolated and investigated pharmacologically before clinical trials.

Plant species of the genus Uvaria: ethnobotanical uses, biological activities and phytochemistry

The genus Uvaria (Annonaceae) comprises of climbing or trailing shrubs and rarely trees. Its plant species are widely distributed across tropical Africa, Asia and Australia. The genus Uvaria is known for various ethnobotanical uses including the treatment of tumours and the control of fever. Some of plant species in this genus have been studied for their ethnobotanical uses, biological activities and phytochemistry. The aim of the present study is to give a comprehensive review of plant species from the genus Uvaria in terms of their ethnobotanical uses, biological activities and phytochemistry. This review is expected to lay a foundation for further studies of this genus in terms of ethnobotanical applicability, biological activities and phytochemistry. Since many compounds currently known from the genus Uvaria have not yet been investigated for their biological activities, this review will be useful for future studies in the phytochemical investigations of lead compounds from this genus.

Tablet of Ximenia Americana L. Developed from Mucoadhesive Polymers for Future Use in Oral Treatment of Fungal Infections

The use of biocompatible polymers such as Hydroxypropylmethylcellulose (HPMC), Hydroxyethylcellulose (HEC), Carboxymethylcellulose (CMC), and Carbopol in solid formulations results in mucoadhesive systems capable of promoting the prolonged and localized release of Active Pharmaceutical Ingredients (APIs). This strategy represents a technological innovation that can be applied to improving the treatment of oral infections, such as oral candidiasis. Therefore, the aim of this study was to develop a tablet of Ximenia americana L. from mucoadhesive polymers for use in the treatment of oral candidiasis. An X. americana extract (MIC of 125 μg·mL-1) was obtained by turbolysis at 50% of ethanol, a level that demonstrated activity against Candida albicans. Differential Thermal Analysis and Fourier Transform Infrared Spectroscopy techniques allowed the choice of HPMC as a mucoadhesive agent, besides polyvinylpyrrolidone, magnesium stearate, and mannitol to integrate the formulation of X. americana. These excipients were granulated with an ethanolic solution 70% v/v at PVP 5%, and a mucoadhesive tablet was obtained by compression. Finally, mucoadhesive strength was evaluated, and the results demonstrated good mucoadhesive forces in mucin disk and pig buccal mucosa. Therefore, the study allowed a new alternative to be developed for the treatment of buccal candidiasis, one which overcomes the inconveniences of common treatments, costs little, and facilitates patients' adhesion.

A review of the traditional and modern uses of Salvadora persica L. (Miswak): Toothbrush tree of Prophet Muhammad

ETHNOPHARMACOLOGICAL RELEVANCE

Salvadora persica L., also known as Arak (in Arabic) and Peelu (in Urdu), is the most common traditional source of tooth or chewing stick (miswak) highly recommended by Prophet Muhammad. To date, extensive studies have probed primarily into the validation of its traditional uses in oral care. Nonetheless, there is still a dearth of updated compilation and critical analysis of other potential ethnopharmacological properties of S. persica. This review therefore aims to provide an up-to-date detailed structured description of the traditional uses of S. persica and a critical analysis of its modern uses, highlighting its phytochemistry, pharmacological properties, and bioapplications.

MATERIALS AND METHODS

Various databases (Science Direct, PubMed, Wiley Online Library, and Google Scholar), books, and relevant primary sources were probed, surveyed, analysed, and included in this review. The literature cited in this review dated from 1979 to 2017.

RESULTS

S. persica was found to possess a plethora of bioactive compounds and broad pharmacological properties, including antimicrobial, antioxidant, enzyme inhibitory activity, antiulcer, anticonvulsant, sedative, analgesic, anti-inflammatory, hypoglycemic, hypolipidemic, antiosteoporosis, and antitumor activities. Studies also revealed the potential use of S. persica as a natural food preservative and a novel functional food ingredient. In addition, improvement in growth and reproductive performances have been observed by the introduction of S. persica in animal feed. Lastly, S. persica has also been used in the green synthesis of nanoparticles showing potential biotechnological applications.

CONCLUSION

S. persica showed a wide scope of application and its uses have been extended far beyond the initial traditional uses of its roots, stems, and twigs in oral care. We found a number of other ethnopharmacological uses and potential bioapplications of different parts of S. persica that warrants further investigations. Though widely studied using several in vitro and in vivo models, and tested clinically for oral hygiene mainly, several gaps and research priorities have been identified which needs to be addressed in future.

An ethnobotanical survey of medicinal plants used by communities of Northern Kordofan region, Sudan

ETHNOPHARMACOLOGICAL RELEVANCE

The present study provides significant ethnopharmacological information on plant species used in North Kordofan region, western Sudan. The study was undertaken with an aim to document the medicinal uses of the species known to some Northern Kordofan communities.

MATERIAL AND METHODS

The study was conducted between 2012 and 2013. The plants were identified and voucher specimens prepared. Information was collected by means of semi-structured interviews with 258 informants (195 men and 63 women). In addition, the use value (UV) of the species was determined and the informant consensus factor (ICF) was calculated for the medicinal plants researched in the study. Further analysis was carried out to compare results with previous studies from the study area and other regions of Sudan.

RESULTS

A total of 44 plant species representing 24 families were found to be commonly used in the treatment of 73 different human health problems. The families most represented were Leguminosae (18%), Caesalpiniaceae (9%), Malvaceae (9%), Asclepiadaceae (6.8%) and Combretaceae (6.8%). The highest number of plant species are used against digestive system disorders (23 species) followed by microbial infections (21 species) and dermatology (19 species). Among all the plant parts leaves (20%), roots (19%), fruits and bark (14% each) were the most preferred plant parts used by the informants. There was strong agreement among the informants as to the usages of the plants (informant consensus factor 0.63-0.93). The most important plants on the basis of use-value were Acacia nilotica, Acacia seyal, Balanites aegyptiaca, Cassia occidentalis, Cassia senna, Guiera senegalensis and Tamarindus indica.

CONCLUSION

This study has helped to document information that may otherwise be lost to future generations. This is the first ethnobotanical study in which statistical calculations about plants are carried out by means of the ICF and UV methods in the study area. Plants with high ICF and UV values should be subjected for further phytochemical and pharmacological investigation for scientific validation.

The traditional use of plants to manage candidiasis and related infections in Venda, South Africa

ETHNOPHARMACOLOGICAL RELEVANCE

This paper presents results of an ethnobotanical survey of medicinal plants used for the management of candidiasis and related fungal infections in the Venda area, South Africa.

MATERIALS AND METHODS

Ethnobotanical data about the uses of plants were gathered from eleven rural traditional healers using semi-structured interviews.

RESULTS

A total of 45 species belonging to 24 different families were identified, of which the dominant family was the Fabaceae with 13 species (28.9%) followed by the Asteraceae and Solanaceae with 3 species each (6.7 %). A total of 28 of these plant species (62.2%) have been shown to have anticandidal activity and 14 species (31%) have been recorded for antifungal uses in the literature. Amongst the 45 species recorded, 51% were trees, 33% were shrubs, and 16% were herbs. The most widely used plant species were Acacia caffra, Clerodendrum glabrum, Croton gratissimus, Elaeodendron transvaalense, Faurea saligna, Hippocratea longipetiolata, Osyris lanceolata, Richardia brasiliensis, Schkuhria pinnata, Schotia brachypetala, Spilanthes acmella, Strychnos potatorum, Vangueria infausta subsp. infausta and Withania somnifera. The plant parts mostly used in the therapeutic preparations were roots (27.7%), bark (23.2%), and a combination of roots, bark (18.7%) and leaves (14.3%). Decoctions (44.4%), infusions (20%), macerations (17.7%), burning (11.4%) and paste (6.5%) were used. Most of the herbal remedies were administered orally. The main factors threatening the conservation status of these plants are unsustainable methods of harvesting, logging for firewood, building materials and crafts.

CONCLUSION

The Venda area is rich in plant diversity and local indigenous knowledge of medicinal plants can play an important role as a model for low cost primary health care. Further studies are in progress to validate the indigenous plants recorded as traditional remedies in this area.

In vitro antifungal activities of Euphorbia macroclada and fluconazole against pathogenic Candida species

BACKGROUND AND PURPOSE

Candida species constitute an important group of opportunistic fungi, which cause various clinical diseases. Considering the resistance of some Candida species to conventional antifungal agents, treatment of such cases may be challenging and complicated. The purpose of this study was to evaluate and compare the antifungal activities of Euphorbia macroclada latex and fluconazole against different Candida species.

MATERIALS AND METHODS

A total of 150 Candida isolates including C. albicans (n=77), C. glabrata (n=28), C. parapsilosis (n=23), C. tropicalis (n=15), C. krusei (n=4), C. famata (n=1), C. kefyr (n=1) and C. inconspicua (n=1) were included in this study. In vitro antifungal activities of Euphorbia macroclada latex and fluconazole against these Candida species were evaluated, according to M27-A2 protocol on broth macrodilution method by the Clinical and Laboratory Standards Institute (CLSI).

RESULTS

Among 150 Candida isolates, 98 isolates (65.33%), i.e., C. albicans (n=41), C. glabrata (n=23), C. tropicalis (n=12) and C. parapsilosis (n=22) with minimal inhibitory concentration (MIC) ≤ 8 μg/ml were susceptible to fluconazole. Resistance to fluconazole was noted in 15 isolates, i.e., C. albicans (n=10), C. glabrata (n=2), C. krusei (n=1), C. kefyr (n=1), and C. inconspicua (n=1), with MICs of 64 µg/ml. The remaining isolates (n=37) including C. albicans (n=26), C. glabrata (n=3), C. tropicalis (n=3), C. parapsilosis (n=1), C. krusei (n=3) and C. famata (n=1) with MIC= 16-32 µg/ml showed dose-dependent susceptibility. The latex of Euphorbia macroclada was able to inhibit the growth of 30 out of 150 tested Candida isolates with MIC range of 128-512 µg/ml. These isolates were as follows: C. albicans (n=2), C. glabrata (n=4), C. parapsilosis (n=19), C. krusei (n=2) and C. tropicalis (n=3). Compared to other isolates, higher MIC values were noted for C. albicans and C. glabrata (512 µg/ml), respectively.

CONCLUSION

The latex of Euphorbia macroclada showed notable antifungal activities against some pathogenic Candida species. Therefore, it can be potentially used as an alternative antifungal agent in future. However, further research is required to identify its active components.

Comparative efficacy of herbal essences with amphotricin B and ketoconazole on Candida albicans in the in vitro condition

Background

The Candida species are the most important factors of fungal infections in humans and animals. It is necessary to prepare antifungal or antimicrobial drugs because of increasing drug resistance. The natural treatment of diseases of bacterial origin using medicinal plants is important. In this study the effect of antimicrobial medicinal herbal essential oils and conventional antifungal drugs were evaluated on Candida albicans in vitro.

Methods

Disc diffusion assay and the microbroth dilution method were used to investigate the anticandidal effects of Foeniculum vulgare Mill, Satureja hortensis L, Cuminum cyminum, and Zataria multiflora Boiss essential oils. The anticandidal effect of these essential oils was compared with that of amphotricin B and ketoconazole in vitro. We then measured the chemical composition of the studied essential oils using gas chromatography–mass spectroscopy.

Results

Z. multiflora Boiss essential oil at the minimum inhibitory concentration (MIC) of 34 μg/mL and minimal lethal concentration [i.e., minimal fungicidal concentration (MFC)] of 64 μg/mL had more powerful anti-Candida activity than the other essential oils. C. cyminum essential oil showed the least effect on the tested fungus. A comparison of the effect of the studied essential oils and antifungal drugs showed that the antifungal effect on the C. albicans fungus was better with the fungicides than with the essential oils.

Conclusion

In the present study, essential oils with different components showed antifungal activity (especially Z. multiflora Boiss essential oil). They can therefore be used as new antifungal substances.

Exploration of the anticandidal mechanism of Cassia spectabilis in debilitating candidiasis

Candida albicans has become resistant to the commercially available, toxic, and expensive anti-Candida agents that are on the market. These factors force the search for new antifungal agents from natural resources. Cassia spectabilis had been traditionally employed by healers for many generations. The possible mechanisms of the C. spectabilis leaf extract were determined by potassium leakage study and the effect of the extract on the constituents of the cell wall and enzymes as well as the morphological changes on C. albicans cells were studied along with cytotoxicity assays. The cytotoxicity result indicated that the extract is nontoxic as was clearly substantiated by a half maximal inhibitory concentration (IC₅₀) value of 59.10 μg/mL. The treated cells (C. spectabilis extract) demonstrated potassium leakage of 1039 parts per million (ppm) compared to Amphotericin B (AmpB)-treated cells with a released potassium value of 1115 ppm. The effects of the extract on the cell wall proteins illustrated that there were three major types of variations in the expression of treated cell wall proteins: the presence of new proteins, the absence of proteins, and the amount of expressed protein. The activities of two enzymes, α-glucosidase and proteinase, were determined to be significantly high, thereby not fully coinciding with the properties of the antifungal reaction triggered by C. spectabilis. The morphology of C. albicans cells treated with the C. spectabilis extract showed that the cells had abnormalities and were damaged or detached within the microcolonies. Our study verifies C. spectabilis leaf extract as an effective anti-C. albicans agent.

The chemistry and bioactivity of Southern African flora II: flavonoids, quinones and minor compound classes

This review is intended to highlight the relevance of natural products in drug discovery paying particular attention to those derived from Southern African medicinal plants with diverse biological activities.

Plants traditionally used individually and in combination to treat sexually transmitted infections in northern Maputaland, South Africa: antimicrobial activity and cytotoxicity

ETHNOPHARMACOLOGICAL RELEVANCE

Although medicinal plants are used extensively to treat sexually transmitted infections (STIs) in rural northern Maputaland, KwaZulu-Natal, the efficacy and safety of these plants have not previously been evaluated.

AIM OF STUDY

A study was designed to investigate the in vitro antimicrobial activity and cytotoxicity profiles of a selection (individual plants and selected combinations) of traditionally used plants in this study area.

MATERIALS AND METHODS

Aqueous and organic (dichloromethane: methanol, 1:1) extracts were prepared. Antimicrobial activity was assessed using the minimum inhibitory concentration (MIC) assay against the STI associated pathogens; Candida albicans ATCC 10231, Ureaplasma urealyticum clinical strain, Oligella ureolytica ATCC 43534, Trichomonas vaginalis clinical strain, Gardnerella vaginalis ATCC 14018 and Neisseria gonorrhoeae ATCC 19424. For the combination study, interactions were assessed using the fractional inhibitory concentration (ΣFIC). The plant species were assessed for safety using the 3-[4,5-dimethyl-2-thiazol-yl]-2,5-diphenyl-2H-tetrazolium bromide (MTT) cellular viability assay on the human embryonic kidney epithelial (Graham, HEK-293) cell line.

RESULTS

For the antimicrobial studies, U. urealyticum was the most sensitive of the six test organisms, with the aqueous extract of Ranunculus multifidus (0.02mg/ml) and the organic extract of Peltophorum africanum (0.04mg/ml) being the most antimicrobially active plant species studied. Sclerocarya birrea was found to have the broadest spectrum of activity (mean MIC of 0.89mg/ml). The only plant species to exhibit some degree of cytotoxicity against the kidney epithelial cell line was Kigelia africana (100µg/ml), with 22% and 16% cell death for the aqueous and organic extracts, respectively. Of the 13 combinations studied, several synergistic combinations were evident, the most prominent being the combination of Albizia adianthifolia and Trichilia dregeana (aqueous extract) with an ΣFIC value of 0.15 against O. ureolytica. Synergistic interactions were observed regardless of the ratio of the aqueous mixtures of the two plants. Syzygium cordatum and S. birrea (aqueous extract) was also a combination of interest, demonstrating synergistic (ΣFIC=0.42) interactions against O. ureolytica. This combination, however, also displayed some cytotoxicity towards the human epithelial cell line.

CONCLUSION

This study demonstrated that anecdotal evidence of plant use does not always correlate with in vitro activity. Furthermore, the toxicological profiling is of utmost importance as if not combined in its correct ratio can lead to potential adverse effects.

The utilization and management of plant resources in rural areas of the Limpopo Province, South Africa

BACKGROUND

Most rural people in the Limpopo Province depend on plant resources to meet their livelihood needs. However, there is insufficient recorded information regarding their use and management. The current study therefore was carried out in selected villages of the Limpopo Province, to close this knowledge gap.

METHODS

Information was collected from 60 people residing in two villages, using a semi-structured questionnaire, supplemented with field observations.

RESULTS

A total of 47 wild plant species (95% indigenous and 5% exotics) from 27 families, mostly from the Fabaceae (17%), Anacardiaceae (9%), and Combretaceae (9%) were documented. These species were used primarily for firewood (40%), food (36%) and medicine (29%). Significantly used species included Sclerocarya birrea (85%), Combretum kraussii (35%) and Harpephyllum caffrum (35%). Local traditional rules and regulations including taboos, social beliefs and fines are in place to aid in the management of communal resources. However, a significant number (67%) of participants mentioned that they were not pleased with these rules and regulations.

CONCLUSION

The current study concluded that plant resources still play an important role in the surveyed rural areas of the Limpopo Province. Furthermore, for sustainable utilization and long-term conservation of plants in these areas the government should assist communities in the management of their plant resources.

Interventions for prevention and treatment of vulvovaginal candidiasis in women with HIV infection

BACKGROUND

Vulvovaginal candidiasis (VVC) is one of the most common fungal infections that recur frequently in HIV infected women. Symptoms of VVC are pruritis, discomfort, dyspareunia, and dysuria. Vulval infection presents as a morbiliform rash that may extend to the thighs. Vaginal infection is associated with white discharge, and plaques are seen on erythematous vaginal walls.Even though rarely or never resulting in systemic fungal infection or mortality, left untreated these lesions contribute considerably to the morbidity associated with HIV infection. Prevention and treatment of this condition is an essential part of maintaining the quality of life for these individuals.

OBJECTIVES

-To compare the efficacy of various antifungals given vaginally or orally for the treatment and prophylaxis of VVC in HIV-infected women and to evaluate the risks of the same.

SEARCH STRATEGY

The search strategy was comprehensive, iterative and based on that of the HIV/AIDS Cochrane Review Group. The aim was to locate all relevant trials, irrespective of publication status or language. Electronic databases :CENTRAL,Medline, EMBASE, LILACS and CINAHL were searched for randomised controlled trials for the years 1980 to 1st October 2010. WHO ICTRP site and other relevant web sites were also searched for conference abstracts.

SELECTION CRITERIA

Randomised controlled trials (RCTs) of palliative, preventative or curative therapy were considered. Participants were HIV positive women receiving one or more of the following:treatment / prophylaxis for VVC or HAART(Highly Active Antiretroviral Therapy).

DATA COLLECTION AND ANALYSIS

Three authors independently assessed the methodological quality of the trials and extracted data. The quality of the evidence generated was graded using the GRADE PRO approach.

MAIN RESULTS

Our search did not yield any trial investigating treatment of VVC in HIV positive women.Two trials dealing with prophylaxis were eligible for inclusion.One trial (n= 323) favoured the use of weekly Fluconazole as compared to placebo (RR 0.68; 95% CI 0.47 to 0.97).The second trial with three arms of comparison;Clotrimazole,Lactobacillus and Placebo gave no definitive results in preventing an episode of VVC. Clotrimazole against placebo (RR 0.49; 95% CI 0.22 to 1.09), Clotrimazole against lactobacillus (RR 1.11; 95% CI 0.45 to 2.76) and lactobacillus against placebo (RR 0.54 ;95% CI 0.26 to 1.13).

AUTHORS' CONCLUSIONS

Implications for practiceNo trials were found addressing treatment of VVC in HIV positive women.In comparison to placebo,Fluconazole was found to be an effective preventative intervention. However, the potential for resistant Candida organisms to develop might impact the feasibility of implementation.Direction of findings suggests that Clotrimazole and Lactobacillus improved the prophylactic outcomes when compared to placebo.Implications for research There is a need to evaluate drugs and drug regimens for VVC treatment and prophylaxis in HIV positive women through randomised clinical trials. Development of resistance to azoles remains under-studied and more work must be done in this area, so as to determine whether routine prophylaxis for VVC is at all needed or whether adequate ART would be sufficient to prevent recurrent VVC. The viral load in vaginal secretions with or without treatment or prophylaxis has not been studied, this is very relevant to the spread of HIV.

Traditional medicines, HIV, and related infections: workshop 2C

Traditional medicines are an integral part of health care worldwide, even though their efficacy has not been scientifically proven. HIV-infected individuals may use them singularly or in combination with conventional medicines. Many in vitro studies have proven the anti-HIV, anti-Candida, and anti-herpes simplex virus potential of traditional plants and identified some of the mechanisms of action. Very few in vivo studies are available that involve a small number of participants and show controversial results. In addition, knowledge is limited of the role of traditional medicines in the enhancement of the immune system. The use of traditional medicines with antiretroviral drugs (ARVs) has created a problem because drug interactions compromise the efficacy of ARVs. Several currently popular plants have been studied in the laboratory for their interaction with ARVs, with disadvantageous results. Unfortunately, no clinical trials are available. The science of traditional medicines is relatively new and is at present being modernized worldwide. However, there are still ethical issues regarding traditional medicines that need to be addressed-for example, regulations regarding quality control and standardization of medicines, regulation and education of healers who deliver these medicines, and unregulated clinical trials. The workshop addressed the following questions about traditional medicine and their use in HIV infection: What are the mechanisms of action of anti-HIV traditional medicines? Should traditional medicines be used in conjunction with ARV? Do traditional medicines enhance the immune system? Should medicinal plants be used for the control of oral infections associated with HIV? What are the ethical issues surrounding the use of traditional medicines for the treatment of HIV and associated infections?

Keeping leeches at bay: field evaluation of plant-derived extracts against terrestrial blood-sucking leeches (Haemadipsidae) in Lao PDR

Terrestrial blood-sucking leeches (Haemadipsidae) are common in the damp forests of the subtropical and tropical Indo-Pacific region. Members of the genus Haemadipsa are abundant in Laos and adjacent countries of Southeast Asia, and discomfort to people and livestock. Plant-derived repellents against arthropods and leeches are common in Lao PDR, and have been used by Lao ethnic groups for generations. Numerous studies have been conducted on the efficacy of traditional plant-derived repellents against mosquitoes but only a few on repellents against terrestrial blood-sucking leeches. Field experiments were conducted to evaluate the leech repellent activities of aqueous extracts of three traditionally used plant species, Sapindus rarak DC., Catunaregam spathulifolia Tirv. and Vernonia elaeagnifolia DC. Stockings impregnated with aqueous extracts exhibited moderate to high leech repellent activity, C. spathulifolia (62.6%), V. elaeagnifolia (63.0%), and S. rarak (82.6%). The corresponding repellencies of deltamethrin and DEET were 73.1% and 88.4%, respectively. An aqueous extract of S. rarak applied on cloth at a concentration of 1.9 mg/cm(2) is an effective and practical prevention method significantly reducing the number of blood-feeding leeches recorded on stockings worn by humans. This plant species is common in Southeast Asia and can be obtained at limited or no cost.

Ethnodiagnostic skills of the digo community for malaria: a lead to traditional bioprospecting

Malaria is a major public health problem that is presently complicated by the development of resistance by Plasmodium falciparum to the mainstay drugs. Thus, new drugs with unique structures and mechanism of action are required to treat drug-resistant strains of malaria. Historically, compounds containing a novel structure from natural origin represent a major source for the discovery and development of new drugs for several diseases. This paper presents ethnophytotherapeutic remedies, ethnodiagnostic skills, and related traditional knowledge utilized by the Digo community of the Kenyan Coast to diagnose malaria as a lead to traditional bioprospecting. The current study was carried out in three Digo villages of Diani sub-location between May 2009 and December 2009. Data was collected using semi-structured interviews, and open and close-ended questionnaires. A total of 60 respondents (34 men and 26 women) provided the targeted information. The results show that the indigenous knowledge of Digo community on malaria encompasses not only the symptoms of malaria but also the factors that are responsible for causing malaria, attributes favoring the breeding of mosquitoes and practices employed to guard against mosquito bites or to protect households against malaria. This knowledge is closely in harmony with scientific approaches to the treatment and control of the disease. The Digo community uses 60 medicinal plants distributed in 52 genera and 27 families to treat malaria. The most frequently mentioned symptoms were fever, joint pains, and vomiting while the most frequently mentioned practices employed to guard against mosquito bites and/or to protect households against malaria was burning of herbal plants such as Ocimum suave and ingestion of herbal decoctions and concoctions. The Digo community has abundant ethnodiagnostic skills for malaria which forms the basis of their traditional bioprospecting techniques.

Traditional antimalarial phytotherapy remedies used by the South Coast community, Kenya

AIM OF THE STUDY

This study was conducted to document herbal medicines used in the treatment of malaria as well as the existing knowledge, attitudes and practices related to malaria recognition, control and treatment in South Coast, Kenya.

METHODS

Data was collected using semistructured questionnaires and interviews. A focused group discussion held with the community members, one in each of the study villages supplemented the interview and questionnaire survey.

RESULTS

The respondents were found to have a good understanding of malaria and could distinguish it from other fever types. They were also aware that malaria was spread by mosquitoes. Malaria prevalence was high, and affected individuals an average of four times a year. Community members avoided mosquito bites by using mosquito nets, clearing bushes around their homesteads and burning plant parts to generate smoke. They prevented and treated malaria by taking decoctions or concoctions of traditional herbal remedies. Forty plant species in thirty-five genera distributed in twenty-four families were used as antimalarials in the study area. Five plant species, namely; Heeria insignis Del. (Anacardiaceae), Rottboelia exaltata L.F (Gramineae), Pentanisia ouranogyne S. Moore (Rubiaceae), Agathisanthenum globosum (A. Rich) Hiern (Rubiaceae), and Grewia trichocarpa Hochst ex A. Rich (Tiliaceae) are documented for the first time in South Coast, Kenya, for the treatment of malaria.

CONCLUSIONS

The plants documented in the current study are a potential source for new bioactive compounds of therapeutic value in malaria treatment. The results provide data for further pharmacological and toxicological studies and development of commercial antimalarial phytotherapy products.

Sclerocarya birrea (A. Rich) Hochst. ['Marula'] (Anacardiaceae): a review of its phytochemistry, pharmacology and toxicology and its ethnomedicinal uses

A plethora of ethnotherapeutic properties and pharmacological actions have been attributed to Sclerocarya birrea (family: Anacardiaceae). It is one of the most highly valued indigenous trees of southern Africa. Reports in biomedical literature have indicated the presence of medicinally-important chemical constituents in the plant, notably: polyphenols, tannins, coumarins, flavonoids, triterpenoids, phytosterols, and so forth. Pharmacological studies by various groups of investigators have shown that S. birrea possesses antidiarrhoeal, antidiabetic, anti-inflammatory, antimicrobial, antiplasmodial, antihypertensive, anticonvulsant, antinociceptive and antioxidant properties, thus lending pharmacological support to the plant's folkloric, ethnotherapeutic uses in South African traditional medicine. In view of the immense medicinal importance of the plant, this review aimed at compiling all currently available information on S. birrea's chemical constituents, as well as its ethnomedicinal, pharmacological and toxicological properties.

Antimalarial herbal remedies of Msambweni, Kenya

Malaria is a serious cause of mortality globally. The disease is of regional concern in Africa and of national interest in Kenya due to its high morbidity and mortality as a result of development of resistant strains of Plasmodium falciparum to many existing drugs such as chloroquine. Alternative medicine using herbal remedies are commonly used to treat malaria in Kenya. However, plants used in some rural areas in Kenya are not documented. Many antimalarial drugs have been derived from plants. This study was conducted to document medicinal plants that are traditionally used by the Msambweni community of Kenyan South Coast to treat malaria, where the disease is endemic. Herbalists were interviewed by administration of semistructured questionnaires in order to obtain information on medicinal plants traditionally used for the treatment of malaria. Focused group discussions held with the herbalists supplemented the interview and questionnaire survey. Twenty-seven species of plants in 24 genera distributed in 20 families were reported to be used in this region for the treatment of malaria. Labiatae, Rutaceae and Liliaceae families had each eleven percent of the plant species reported and represented the species that are most commonly used. Thirteen plant species, namely; Aloe deserti Berger (Liliaceae), Launea cornuta (Oliv and Hiern) C. Jeffrey (Compositae), Ocimum bacilicum L. (Labiatae), Teclea simplicifolia (Eng) Verdoon (Rutaceae), Gerranthus lobatus (Cogn.) Jeffrey (Cucurbitaceae), Grewia hexaminta Burret. (Tiliaceae), Canthium glaucum Hiern. (Rubiaceae), Amaranthus hybridus L. (Amaranthaceae), Combretum padoides Engl and Diels. (Combretaceae), Senecio syringitolius O. Hoffman. (Compositae), Ocimum suave Willd (Labiatae), Aloe macrosiphon Bak. (Liliaceae) and Laudolphia buchananii (Hall.f) Stapf. (Apocynaceae) are documented from this region for the first time for the treatment of malaria. These results become a basis for selection of plants for further pharmacological, toxicological and phytochemical studies in developing new plant based antimalarial drugs.

Phytochemical investigation and medicinal evaluation of fixed oil of Balanites aegyptiaca fruits (Balantiaceae)

ETHNOPHARMACOLOGICAL RELEVANCE

Balanites aegyptiaca (Balantiaceae), mainly the fruit, is used by traditional healers and herbalists for treating many diseases in Africa and Asia.

AIM OF THE STUDY

Investigation of fixed oil composition of fruits and evaluation of its biological activity.

MATERIALS AND METHODS

Oil content was identified using GC and GC/MS. In vitro examination of the oil biological activity (including cytotoxicity, antimutagenicity, antiparasitic, antiviral and antimicrobial activities) was performed.

RESULTS

The oil contained 54.53% unsaturated fatty acids and 1.14% sterols. The oil exhibited anticancer activity against lung, liver and brain human carcinoma cell lines. It also had antimutagenic activity against Fasciola gigantica induced mutagenicity besides anthelmintic activity against hepatic worms (Schistosoma mansoni and Fasciola gigantica). Preliminary screening showed that the oil had antiviral activity against Herpes simplex virus. It also had antimicrobial activity against selected strains of Gram-positive bacteria, Gram-negative bacteria and Candida.

CONCLUSION

The results showed remarkable biological activity of Balanites aegyptiaca fixed oil and proved its importance as natural bioactive source.

Substrates and modulators of the multidrug transporter Cdr1p of Candida albicans in antifungal extracts of medicinal plants

The effective treatment of infections caused by the most frequent human fungal pathogens Candida albicans and Candida glabrata is hindered by a limited number of available antifungals and development of resistance. In this study, we identified new extracts of medicinal plants inhibiting the growth of C. glabrata, a species generally showing low sensitivity to azoles. The methanolic extract of Anacardium occidentalis with an MIC of 80 microg ml(-1) proved to be the most active. In contrast to higher azole sensitivity, C. albicans showed increased resistance to several extracts. Investigation of the possible contribution of the multidrug transporter of the ATP-binding cassette superfamily Cdr1p of C. albicans to extract tolerance revealed a differential response upon overproduction of this protein in Saccharaomyces cerevisiae. Whereas the growth inhibitory activity of many extracts was not affected by CDR1 overexpression, increased sensitivity to some of them was observed. In contrast, extracts showing no detectable anticandidal activity including the ethyl acetate extract of Trichilia emetica were detoxified by Cdr1p. The presence of a non-toxic Cdr1p-mediated ketoconazole resistance modulator accompanying growth-inhibitory Cdr1p substrates in this extract was revealed by further fractionation experiments.

Ethnopharmacological survey of the Bunda district, Tanzania: plants used to treat infectious diseases

An ethnobotanical study was carried out in six villages in the Bunda district, Mara Region, Tanzania, where the use of plants still has a special meaning to the society, in the treatment of various diseases. Information was obtained from the traditional healers and other experienced persons, having some knowledge on medicinal plants. Fifty-two plants were reported for use in the treatment of various infectious diseases. These plants belong to 29 families, with Papilionaceae being the most represented. Leaves ranked the highest, especially for use in topical preparations. Oral administration was the most frequently used route of administration. Twenty-one percent of the recorded plants were reported for treating venereal diseases, with syphilis and gonorrhea being the most commonly mentioned. Information providers requested feedback with regard to the plants proven scientifically to be toxic in order to avoid risks while offering their services. From this work it was found out that, people in this area commonly use medicinal plants with trust they have built on the curative outcome witnessed. As the first ethnobotanical study in Bunda district recording 52 plants in a small area covered, publication of this work is expected to open up more studies to record many useful medicinal plants unfolded.