Medicinal plants used by traditional healers for the treatment of malaria in the Chipinge district in Zimbabwe

A comprehensive review of antimalarial medicinal plants used by Tanzanians

CONTEXT

Tanzania has rich medicinal plant (MP) resources, and most rural inhabitants rely on traditional healing practices for their primary healthcare needs. However, available research evidence on antimalarial MPs is highly fragmented in the country.

OBJECTIVE

This systematic review compiles ethnomedicinal research evidence on MPs used by Tanzanians as antimalarials.

MATERIALS AND METHODS

A systematic web search was conducted using various electronic databases and grey materials to gather relevant information on antimalarial MPs utilized by Tanzanians. The review was per the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement. The data were collected from 25 articles, and MS Excel software was used to analyse relevant ethnobotanical information using descriptive statistics.

RESULTS

A total of 227 MPs belonging to 67 botanical families and 180 genera were identified. Fabaceae (15.9%) is the most frequently utilized family. The ethnobotanical recipes analysis indicated leaves (40%) and trees (44%) are the preferred MPs part and life form, respectively. Decoctions (67%) are the dominant preparation method of remedies. Of the recorded MPs, 25.9% have been scientifically investigated for antimalarial activities with positive results. However, 74.1% of MPs have no scientific records on antimalarial activities, but they could be potential sources of remedies.

CONCLUSIONS

The study discloses a wealth of antimalarial MPs possessed by Tanzanians and suggests a need for research to authenticate the healing potential of antimalarial compounds from the unstudied MPs. Additionally, it indicates that some of the presented MPs are potential sources for developing safe, effective and affordable antimalarial drugs.

Ethnomedicinal Plants and Herbal Preparations Used by Rural Communities in Tehsil Hajira (Poonch District of Azad Kashmir, Pakistan)

The present study emphasizes the importance of documenting ethnomedicinal plants and herbal practices of the local rural communities of Tehsil Hajira (Pakistan). The aim was to document, explore and quantify the traditional ethnomedicinal knowledge. Ethnobotanical data were collected using semi-structured questionnaires and analyzed using various quantitative indices. The results showed that 144 medicinal plant species from 70 families and 128 genera play an important role in herbal preparations. The most common type of preparation was powder (19.0%), followed by paste (16.7%), aqueous extract (15.7%), decoction (14.7%) and juice (11.0%). Fragaria nubicola (0.94) and Viola canescens (0.93) had the highest relative frequency of mention (RFC), while Berberis lycium (1.22) and Fragaria nubicola (1.18) had the highest use value (UV). Geranium wallichianum (85.5), Ligustrum lucidum (83) and Indigofera heterantha (71.5) were the most important species in the study area with the highest relative importance (RI) value. The diseases treated were categorized into 17 classes, with diseases of the digestive system and liver having the highest Informant Consensus Factor (ICF) value, followed by diseases of the oropharynx and musculoskeletal system. Important plants mentioned for the treatment of various diseases of the gastrointestinal tract are Zanthoxylum alatum, Berberis lycium, Mentha longifolia, Punica granatum, Rubus ellipticus and Viola canescens. New applications of rarely documented plants from this area are: Oxalis corniculata paste of the whole plant to treat vitiligo, Carthamus tinctorius flowers to treat chicken pox, Dioscorea deltoidea tuber powder to treat productive cough, Inula cappa root decoction to treat miscarriage, Habenaria digitata tuber juice for the treatment of fever, Viola canescens leaves and flowers for the treatment of sore throat and Achillea millefolium root and leaf juice for the treatment of pneumonia. These plants may contain interesting biochemical compounds and should be subjected to further pharmacological studies to develop new drugs. Traditional medicinal knowledge in the area under study is mainly limited to the elderly, traditional healers and midwives. Therefore, resource conservation strategies and future pharmacological studies are strongly recommended.

An imprecise probability approach-based determination of over-represented southern African plant genera and families used in ethnopharmacology

ETHNOPHARMACOLOGICAL RELEVANCE

The analyses of patterns of over-representation of southern African traditional medicinal plants at the genus and family level provide information about the differences in plant use among southern African countries and disease categories. 'Over-representation' refers to the phenomenon whereby the proportion of plants belonging to a taxonomic group is higher in ethnobotanical pharmacopoeia than in the total flora.

AIM OF THE STUDY

This study aimed to use the Imprecise Dirichlet Model (IDM) to analyse data from ten southern African countries to establish how over-represented medicinal plant families compare with over-represented genera, how over-represented medicinal taxa differ among countries in this region of Africa, and how over-represented taxa differ among six major disease categories.

MATERIALS AND METHODS

Floral data for the total species composition of each country were obtained from online databases. Medicinal plant species lists were generated from published surveys, inventories, and books. IDM calculations were executed using the inverse of the cumulative beta probability density function in Microsoft Excel™. Python programming language source code was used to calculate Pearson correlation (r) values and Jaccard coefficients (J).

RESULTS

Nine of forty-two over-represented medicinal plant families in southern Africa (group 1) do not have over-represented genera. Seven of the forty genera with the highest margins of over-representation belong to under-represented families. Nineteen of the forty-two over-represented families have margins of over-representation smaller than the cumulative margins of their over-represented genera. Groups of countries with similar overall flora (J ≥ 0.333) are Botswana and Namibia (group 2), Malawi, Mozambique, Zambia and Zimbabwe (group 3). The families and genera with the highest margins of over-representation are Loganiaceae and Albizia in group 1, Combretaceae and Vachellia in group 2, Dioscoreaceae and Senna in group 3, and Sapotaceae and Solanum in group 4 (South Africa). The families and genera with the highest margins of over-representation across disease categories are Ebenaceae and Albizia, Canellaceae and Dicoma, Combretaceae and Pterocelastrus, Ebenaceae and Bersama, Francoaceae and Erythrina, and Aristolochiaceae and Strychnos for plants used in the treatment of STIs, febrile and mosquito-vector diseases, microbial infections, pain, skin conditions, and female sexual/reproductive problems, respectively.

CONCLUSIONS

Genus-level calculations are more efficient in generating taxonomic lists that can be used for ethnopharmacological investigations due to the exclusion of under-represented genera. Limiting the size of geographical areas from which medicinal plant lists are sampled and targeting plants used to treat specific types of disease prevents the underestimation of niche over-represented taxa.

Indigenous medicinal plants used in folk medicine for malaria treatment in Kwara State, Nigeria: an ethnobotanical study

BACKGROUND

Folk medicine is crucial to healthcare delivery in the underdeveloped countries. It is frequently used as a primary treatment option or as a complementary therapy for malaria. Malaria is a deadly disease which greatly threatens global public health, claiming incredible number of lives yearly. The study was aimed at documenting the medicinal plants used for malaria treatment in folk medicine in Kwara State, Nigeria.

METHODS

Ethnobotanical information was collected from selected consenting registered traditional medicine practitioners (TMPs) through oral face-to-face interviews using in-depth, semi-structured interview guide. The ethnobotanical data were analysed, and descriptive statistical methods were used to compile them.

RESULTS

Sixty-two indigenous medicinal plants, including 13 new plants, used for malaria treatment were identified in this study. The TMPs preferred decoction in aqueous solvent (34%) and steeping in decaffeinated soft drink (19%) for herbal preparations. Oral administration (74%) was the main route of administration, while leaves (40%) and stem barks (32%) were the most dominant plant parts used in herbal preparations. The most cited families were Fabaceae (15%) and Rutaceae (6%), while Mangifera indica (77.14%), Enantia chlorantha (65.71%), Alstonia boonei (57.14%) followed by Cymbopogon citratus (54.29%) were the most used plants. Besides, the antimalarial activities of many of the plants recorded and their isolated phytocompounds have been demonstrated. Furthermore, the conservation status of 4 identified plants were Vulnerable.

CONCLUSION

The study showed strong ethnobotanical knowledge shared by the TMPs in the State and provides preliminary information that could be explored for the discovery of more potent antimalarial compounds.

Ethnomedicinal plants used for malaria treatment in Rukungiri District, Western Uganda

BACKGROUND

Malaria remains a major global health challenge and a serious cause of morbidity and mortality in sub-Saharan Africa. In Uganda, limited access to medical facilities has perpetuated the reliance of indigenous communities on herbal medicine for the prevention and management of malaria. This study was undertaken to document ethnobotanical knowledge on medicinal plants prescribed for managing malaria in Rukungiri District, a meso-endemic malaria region of Western Uganda.

METHODS

An ethnobotanical survey was carried out between May 2022 and December 2022 in Bwambara Sub-County, Rukungiri District, Western Uganda using semi-structured questionnaire. A total of 125 respondents (81 females and 44 males) were randomly selected and seven (7) key informants were engaged in open interviews. In all cases, awareness of herbalists on malaria, treatment-seeking behaviour and herbal treatment practices were obtained. The ethnobotanical data were analyzed using descriptive statistics, informant consensus factor and preference ranking.

RESULTS

The study identified 48 medicinal plants belonging to 47 genera and 23 families used in the treatment of malaria and its symptoms in the study area. The most frequently cited species were Vernonia amygdalina, Aloe vera and Azadirachta indica. Leaves (74%) was the most used plant organ, mostly for preparation of decoctions (41.8%) and infusions (23.6%) which are administered orally (89.6%) or used for bathing (10.4%).

CONCLUSIONS

Indigenous knowledge of medicinal plants used as prophylaxis and for treatment of malaria still exist among the local communities of Bwambara Sub-County. However, there is a need to investigate the antimalarial efficacy, phytochemical composition and safety of species (such as Digitaria abyssinica and Berkheya barbata) with high percentage use values to validate their use.

Medicinal plants used for treatment of malaria by indigenous communities of Tororo District, Eastern Uganda

BACKGROUND

Malaria remains the leading cause of death in sub-Saharan Africa. Although recent developments such as malaria vaccine trials inspire optimism, the search for novel antimalarial drugs is urgently needed to control the mounting resistance of Plasmodium species to the available therapies. The present study was conducted to document ethnobotanical knowledge on the plants used to treat symptoms of malaria in Tororo district, a malaria-endemic region of Eastern Uganda.

METHODS

An ethnobotanical study was carried out between February 2020 and September 2020 in 12 randomly selected villages of Tororo district. In total, 151 respondents (21 herbalists and 130 non-herbalists) were selected using multistage random sampling method. Their awareness of malaria, treatment-seeking behaviour and herbal treatment practices were obtained using semi-structured questionnaires and focus group discussions. Data were analysed using descriptive statistics, paired comparison, preference ranking and informant consensus factor.

RESULTS

A total of 45 plant species belonging to 26 families and 44 genera were used in the preparation of herbal medicines for management of malaria and its symptoms. The most frequently mentioned plant species were Vernonia amygdalina, Chamaecrista nigricans, Aloe nobilis, Warburgia ugandensis, Abrus precatorius, Kedrostis foetidissima, Senna occidentalis, Azadirachta indica and Mangifera indica. Leaves (67.3%) were the most used plant part while maceration (56%) was the major method of herbal remedy preparation. Oral route was the predominant mode of administration with inconsistencies in the posology prescribed.

CONCLUSION

This study showed that the identified medicinal plants in Tororo district, Uganda, are potential sources of new antimalarial drugs. This provides a basis for investigating the antimalarial efficacy, phytochemistry and toxicity of the unstudied species with high percentage use values to validate their use in the management of malaria.

Rotenoids and Isoflavones from Xeroderris stuhlmannii (Taub.) Mendonça & E.P. Souza and Their Biological Activities

The phytochemical study of the ethanolic extract of the leaf of Xeroderris stuhlmannii led to the isolation of five hitherto unreported compounds including two isoflavones (1-2), and three rotenoids (3-5), along with eight known isoflavonoid derivatives (6-13) and one pterocarpan derivative (14). The structures of the new compounds and those of the known ones were established by the spectroscopic (1D and 2D NMR) and spectrometric (HRESIMS) techniques as well as a comparison of their spectroscopic data with those reported in the literature. The leaf extract, fractions, and isolated compounds were tested for their antibacterial effects against nine bacterial strains. Compounds 3, 8, 11, and 12 showed a significant antibacterial effect, with a minimum inhibitory concentration (MIC) value of 62.5 µg/mL each, against Salmonella typhi, Staphylococcus aureus, Klessiella pneumonae, and Escherichia coli, respectively. In addition, the leaf extract, fractions, and isolated compounds were tested for their antifungal effects against four fungal strains. The hexane fraction showed a significant antifungal effect with an MIC value of 125 µg/mL against Candida parasilosis, whereas compounds 3, 8, and 12 showed significant antifungal activity with an MIC value of 62.5 µg/mL, each against Candida parasilosis, Candida albicans, and Candida krusei, respectively.

Medicinal Uses of the Fabaceae Family in Zimbabwe: A Review

The current study is aimed at providing a systematic review of the ethnomedicinal, phytochemical and pharmacological properties of Fabaceae species used as sources of traditional medicinies in Zimbabwe. Fabaceae is one of the well-known plant families of ethnopharmacological importance. Of the approximately 665 species of the Fabaceae family occurring in Zimbabwe, about 101 are used for medicinal purposes. Many communities in the country, mainly in peri-urban, rural and marginalized areas with limited access to healthcare facilities, rely on traditional medicines as their primary healthcare. The study reviewed research studies undertaken on Zimbabwe's Fabaceae species during 1959 to 2022. Information was gathered from literature sourced from Google Scholar, Science Direct, Scopus, PubMed, books, dissertations, theses and scientific reports. This study showed that 101 species are traditionally used to manage human and animal diseases in Zimbabwe. The genera with the highest number of medicinal uses are Indigofera, Senna, Albizia, Rhynchosia and Vachellia. Species of these genera are used as traditional medicines against 134 medical conditions, mainly gastrointestinal conditions, female reproductive conditions, respiratory conditions and sexually transmitted infections. Shrubs (39.0%), trees (37.0%) and herbs (18.0%) are the primary sources of traditional medicines, while roots (80.2%), leaves (36.6%), bark (27.7%) and fruits (8.9%) are the most widely used plant parts. Many of Zimbabwe's Fabaceae species used as sources of traditional medicines have been assessed for their phytochemical and pharmacological properties, corroborating their medicinal uses. However, there is a need to unravel the therapeutic potential of the family through further ethnopharmacological research focusing on toxicological studies, in vitro and in vivo models, biochemical assays and pharmacokinetic studies.

Attitudes and perceptions of traditional health practitioners towards documentation of patient health information in their practice in eThekwini Municipality, KwaZulu-Natal, Natal Province, South Africa

BACKGROUND

Documentation of patient health information in the form of patient medical records (PMRs) is an essential, ethical and regulatory requirement in any healthcare system. African traditional medicine (ATM) exists parallel to biomedicine and continues to play a significant role in primary healthcare of the majority of South Africans. The World Health Organization (WHO) has promoted the integration of ATM into the national health system of South Africa. Patient health information documentation can facilitate this integration, and PMRs promote communication between the two health systems through referrals. Documentation in biomedicine is a clear, compulsory, routine activity, but does not occur regularly or routinely in ATM.

OBJECTIVE

To examine the attitudes and perceptions of traditional health practitioners (THPs) towards documentation of patient health information in their practice.

METHODS

This quantitative cross-sectional survey involved snowball sampling to recruit THPs in Umlazi Township and rural parts surrounding the township, in Durban, South Africa. A semi-structured questionnaire was used. Quantitative data were analysed using SPSS 25 and the Relative Importance Index (RII) and qualitative data were analysed using Excel for themes.

RESULTS

Sampling resulted in 248 THPs of whom 178 (72%) were females. The RII ranked the factors that negatively influenced the participants' attitudes towards documentation of patient health information. Of the 178 females who participated in the study, 129 (72.5%) showed their willingness to introduce documentation in their practice. Of the 127 participants with less than 10 years of practice experience, 126 (99.2%) agreed to the importance of introducing PMRs in their practice. The majority of participants perceived documentation of patient health information as vital to improve their practice. A prominent theme was that the THPs regarded documenting patient health information as important and effective in their practice.

CONCLUSION

More than half of participants showed positive attitudes and perceptions towards documenting of patient health information in ATM. The majority of the participants in this study acknowledged the importance of introducing documentation of patient health information in their practice even though they lacked experience and more knowledge. This reflects a need for essential intervention in developing specialised tools to begin promoting documentation of patient health information in ATM.

Medicinal plants used for the management of respiratory diseases in Zimbabwe: Review and perspectives potential management of COVID-19

Respiratory diseases have in the recent past become a health concern globally. More than 523 million cases of coronavirus disease (COVID19), a recent respiratory diseases have been reported, leaving more than 6 million deaths worldwide since the start of the pandemic. In Zimbabwe, respiratory infections have largely been managed using traditional (herbal) medicines, due to their low cost and ease of accessibility. This review highlights the plants' toxicological and pharmacological evaluation studies explored. It seeks to document plants that have been traditionally used in Zimbabwe to treat respiratory ailments within and beyond the past four decades. Extensive literature review based on published papers and abstracts retrieved from the online bibliographic databases, books, book chapters, scientific reports and theses available at Universities in Zimbabwe, were used in this study. From the study, there were at least 58 plant families comprising 160 medicinal plants widely distributed throughout the country. The Fabaceae family had the highest number of medicinal plant species, with a total of 21 species. A total of 12 respiratory ailments were reportedly treatable using the identified plants. From a total of 160 plants, colds were reportedly treatable with 56, pneumonia 53, coughs 34, chest pain and related conditions 29, asthma 25, tuberculosis and spots in lungs 22, unspecified respiratory conditions 20, influenza 13, bronchial problems 12, dyspnoea 7, sore throat and infections 5 and sinus clearing 1 plant. The study identified potential medicinal plants that can be utilised in future to manage respiratory infections.

Insecticidal effects of some selected plant extracts against Anopheles stephensi (Culicidae: Diptera)

BACKGROUND

The use of synthetic insecticides against mosquitoes may lead to resistance development and potential health hazards in humans and the environment. Consequently, a paradigm needs to shift towards the alternative use of botanical insecticides that could strengthen an insecticide resistance management programme. This study aimed to assess the insecticidal effects aqueous, hexane, and methanol crude leaf extracts of Calpurnia aurea, Momordica foetida, and Zehneria scabra on an insectary colony of Anopheles stephensi larvae and adults.

METHODS

Fresh leaves of C. aurea, M. foetida and Z. scabra were collected and dried, then separately ground to powder. Powdered leaves of test plants were extracted using sonication with aqueous, hexane, and methanol solvents. The extracts were concentrated, and a stock solution was prepared. For comparison, Temephos (Abate®) and control solutions (a mixture of water and emulsifier) were used as the positive and negative controls, respectively. Different test concentrations for the larvae and the adults were prepared and tested according to WHO (2005) and CDC (2010) guidelines to determine lethal concentration (LC) values. Mortality was observed after 24 h exposure. The statistical analyses were performed using Statistical Package for the Social Sciences (SPSS) software (Kruskal-Wallis test) and R software (a generalized linear model was used to determine LC₅₀ and LC₉₀ values of the extracts).

RESULTS

The lowest LC₅₀ values were observed in aqueous extracts of M. foetida followed by Z. scabra extract and C. aurea leaves at 34.61, 35.85, and 38.69 ppm, respectively, against the larvae. Larval mortality was not observed from the hexane extracts and negative control, while the standard larvicide (temephos) achieved 100% mortality. Further, the adulticidal efficacy was greatest for aqueous extract of Z. scabra with LC₅₀ = 176.20 ppm followed by aqueous extract of C. aurea (LC₅₀ = 297.75 ppm).

CONCLUSION

The results suggest that the leaf extracts of the three test plants have the potential of being used for the control of vector An. stephensi larvae and adult instead of synthetic mosquitocides. Further studies need to be conducted to identify the active ingredients and their mode of action.

Phytochemical, Antiplasmodial, and Cytotoxic Investigation of Euclea natalensis A.DC. subsp. natalensis Leaves

Previous research shows that the root and bark extracts of Euclea natalensis have antiplasmodial activity, but the leaves have not been examined yet. This study investigated the phytochemical, antiplasmodial, and cytotoxic properties of the plant leaves. The activity against 3D7 Plasmodium falciparum was determined using the parasite lactate dehydrogenase assay, and the cytotoxicity against Vero and HeLa cells was evaluated using the MTT and resazurin assays, respectively. The bioactive compounds were isolated by chromatography, and their structures were established with spectroscopic and spectrometric techniques. The extract showed antiplasmodial activity (IC₅₀ =25.6 μg/mL) and was not cytotoxic against Vero cells (IC₅₀ =403.7 μg/mL). Purification of the extract afforded six flavonoid glycosides, four triterpenoids, and a coumarin. The glycosides showed antiplasmodial and cytotoxic activities, against HeLa cells, at 50 μg/mL, but the activity was reduced at 10 μg/mL. Naphthoquinones, which are among the predominant phytochemicals in the root and root bark of E. natalensis, were not detected in the leaves.

In vitro evaluation of the antibacterial and cytotoxic activities of the Euclea natalensis crude extract and fractions against oral infection agents

OBJECTIVE

This study aimed (i) to evaluate the antibacterial and cytotoxic activities of the crude extract and fractions obtained from Euclea natalensis A.D.C. roots against bacteria that cause periodontal disease and caries and (ii) to identify the isolated compounds.

DESIGN

The minimum inhibitory concentration (MIC) and the minimum bactericidal concentration (MBC) of the extract and fractions were determined by the microplate dilution assay. The cytotoxicity of the extract and fractions was evaluated by using the XTT colorimetric assay and normal human fibroblast cells (GM07492A, lung fibroblasts). The compounds present in the most promising fraction were determined by qualitative analysis through liquid chromatography coupled to mass spectrometry (HPLC-MS-ESI).

RESULTS

The MIC results ranged from 25 to > 400 μg/mL for the extract and from 1.56 to > 400 μg/mL for the fractions. To evaluate cytotoxicity, the tested concentrations of the extract and fractions ranged from 19.5 to 2500 μg/mL; IC₅₀ values between 625 and 1250 μg/mL were obtained. Analysis of the main bioactive fraction by HPLC-MS-ESI identified phenolic acids, coumarins, naphthoquinones, lignans, and fatty acids.

CONCLUSIONS

The E. natalensis root extract and fractions displayed good antibacterial activity against periodontal pathogenic and cariogenic bacteria. The antibacterial activity may be due to compounds present in the extract and fractions, which also showed low cytotoxicity to normal human cells. These data are relevant and encourage further research into this plant species, which may contribute to the discovery of new herbal medicines that will help to mitigate the problems caused by oral pathogenic bacteria.

Practices of herbal management of malaria among trading mothers in Shai Osudoku District, Accra

Background

Malaria is one of the leading causes of morbidity in the world. It is a significant health concern in most developing countries, including Ghana. Even though there are several orthodox medications used for decades in treating malaria effectively, a substantial number of individuals in developing countries are resorting to the use of herbs in the treatment of malaria. The study aim at exploring the practices of herbal management of malaria among trading mothers in Shai Osudoku District, Accra.

Methods

A qualitative approach with an exploratory, descriptive design was adopted in analyzing the research problem. Purposive sampling technique was used to select twenty (20) participants to partake in a face-face interview, guided by a semi-structured interview guide. The data were transcribed verbatim and analysed by adopting content analysis.

Results

Two significant themes and seven subthemes were generated following the analysis of this study. The main themes were; preferences for herbal malaria treatment and the practices and effectiveness of herbal medicine used for malaria treatment. It was worth noting that the women’s cultural beliefs did not influence their preference for herbal malaria treatment. The main challenge associated with the herbal malaria treatment was inappropriate dosage specification.

Conclusion

This study discovered that several factors influenced participants’ preferences for malaria treatment. Participants further listed some traditional ways of treating malaria which implies that there is herbal malaria practice. However, literature in this area is inadequate, and most herbs lack specifications for use. It is therefore recommended that future research focus on scientific herbal malaria treatment. Also, regulating bodies should ensure that quality herbal drugs are sold for consumption.

Rediscovery of Traditional Plant Medicine: An Underestimated Anticancer Drug of Chelerythrine

In many studies, the extensive and significant anticancer activity of chelerythrine (CHE) was identified, which is the primary natural active compound in four traditional botanical drugs and can be applied as a promising treatment in various solid tumors. So this review aimed to summarize the anticancer capacities and the antitumor mechanism of CHE. The literature searches revolving around CHE have been carried out on PubMed, Web of Science, ScienceDirect, and MEDLINE databases. Increasing evidence indicates that CHE, as a benzophenanthridine alkaloid, exhibits its excellent anticancer activity as CHE can intervene in tumor progression and inhibit tumor growth in multiple ways, such as induction of cancer cell apoptosis, cell cycle arrest, prevention of tumor invasion and metastasis, autophagy-mediated cell death, bind selectively to telomeric G-quadruplex and strongly inhibit the telomerase activity through G-quadruplex stabilization, reactive oxygen species (ROS), mitogen-activated protein kinase (MAPK), and PKC. The role of CHE against diverse types of cancers has been investigated in many studies and has been identified as the main antitumor drug candidate in drug discovery programs. The current complex data suggest the potential value in clinical application and the future direction of CHE as a therapeutic drug in cancer. Furthermore, the limitations and the present problems are also highlighted in this review. Despite the unclearly delineated molecular targets of CHE, extensive research in this area provided continuously fresh data exploitable in the clinic while addressing the present requirement for further studies such as toxicological studies, combination medication, and the development of novel chemical methods or biomaterials to extend the effects of CHE or the development of its derivatives and analogs, contributing to the effective transformation of this underestimated anticancer drug into clinical practice. We believe that this review can provide support for the clinical application of a new anticancer drug in the future.

Alien woody plants are more versatile than native, but both share similar therapeutic redundancy in South Africa

Understanding why alien plant species are incorporated into the medicinal flora in several local communities is central to invasion biology and ethnobiology. Theories suggest that alien plants are incorporated in local pharmacopoeias because they are more versatile or contribute unique secondary chemistry which make them less therapeutically redundant, or simply because they are locally more abundant than native species. However, a lack of a comprehensive test of these hypotheses limits our understanding of the dynamics of plants knowledge, use and potential implications for invasion. Here, we tested the predictions of several of these hypotheses using a unique dataset on the woody medicinal flora of southern Africa. We found that the size of a plant family predicts the number of medicinal plants in that family, a support for the non-random hypothesis of medicinal plant selection. However, we found no support for the diversification hypothesis: i) both alien and native plants were used in the treatment of similar diseases; ii) significantly more native species than alien contribute to disease treatments particularly of parasitic infections and obstetric-gynecological diseases, and iii) alien and native species share similar therapeutic redundancy. However, we found support for the versatility hypothesis, i.e., alien plants were more versatile than natives. These findings imply that, although alien plant species are not therapeutically unique, they do provide more uses than native plants (versatility), thus suggesting that they may not have been introduced primarily for therapeutic reasons. We call for similar studies to be carried out on alien herbaceous plants for a broader understanding of the integration of alien plants into the pharmacopoeias of the receiving communities.

Traditional medicinal knowledge of woody species across climatic zones in Benin (West Africa)

ETHNOPHARMACOLOGICAL RELEVANCE

Plant parts are often used by local people to treat their affections. This study addressed the Traditional Medicinal Knowledge of woody species in Benin and the dependence of medicinal use of woody species on climatic zones.

AIM OF THE STUDY

It reports (i) the main diseases categories treated with medicinal use of woody species in Benin and changes across climatic zones by inferring their epidemiological status, and (ii) the woody species involved and their distribution according to climate conditions.

MATERIALS AND METHODS

Ethnobotanical interviews were undertaken using a semi-structured questionnaire. Five hundred and ninety medicinal plant professionals (healers, traders …) were interviewed in the whole country. Frequency of citation and informant consensus factor were calculated to highlight the main human diseases categories and woody species used for their treatment. A principal component analysis was performed to determine the occurrence of diseases categories in different climatic zones.

RESULTS

About 94% of international diseases categories were treated using medicinal woody species in Benin. Nighty-seven ailments in 16 diseases categories were identified. Among them, 5 diseases categories (General and unspecified, Digestive, Skin, Neurological, and Musculoskeletal) were highlighted as important. The Sudano-Guinean zone showed the highest diseases frequencies, whereas the Sudanian zone showed the lowest. The epidemiological status of some phytodistricts was worrisome. In our study, 123 woody species belonging to 93 genera and 35 families were reported, and among them, 16 were the most used as treatments.

CONCLUSIONS

There is a lack of consensus among traditional healers about which woody species to use. Many different species were used to treat a given diseases category. Also, information concerning their organ composition was not available in the literature, for the majority of species. Biological and chemical investigations are thus needed for a better valorization of the most frequently used plants in the future.

Vhavenda Herbal Remedies as Sources of Antihypertensive Drugs: Ethnobotanical and Ethnopharmacological Studies

Hypertension is a dominant risk factor for the development of cardiovascular, kidney, and eye diseases. In Africa, it increasingly leads to hospitalisation and a strain on the public health system. However, rather than modern medicine, African traditional healers are the first choice for most South Africans. Therefore, this study is aimed at gathering information on herbal remedies traditionally used for the treatment of high blood pressure in Vhavenda, South Africa, and comparing this information with reports in the literature regarding plants used to manage high blood pressure. An ethnobotanical survey was carried out in Vhembe district and its environs with 53 herbalists and indigenous people aged between 36 and 66 years from January to October 2019 using a semistructured questionnaire. The plants were collected with each respondent; they were authenticated and kept in herbarium. A total of 51 different plants were mentioned as being most commonly used for hypertension treatment. Of these, 44 plants were identified, with those from the Fabaceae family followed by plants from the Celastraceae family being commonly mentioned. Of these, the Elaeodendron transvaalense, Tabernaemontana elegans, Elephantorrhiza elephantina, and Aloe vossii were commonly cited species. According to the literature data, most of the identified plants are yet to be scientifically investigated for the treatment of hypertension, whereas only preliminary investigations have been carried out on other plants, suggesting that these preliminary investigations may have highlight promising antihypertensive activities in vitro that are indicative of their potential as antihypertensive drugs. Therefore, there is a need to scientifically investigate the antihypertensive potentials of these plants as a potential source of antihypertensive treatment and compounds.

Ethnobotanical study of plants used by the traditional healers to treat malaria in Mogovolas district, northern Mozambique

INTRODUCTION

Malaria is an important parasitic disease that affects mostly the African continent. Traditional medicine is very important in Mozambique and traditional healers play a key role in the primary health care services, particularly in rural areas. We aim to report the results of an ethnobotanical survey undertaken in Mogovolas district, northern region of Mozambique. We recorded and identified the medicinal plants used by traditional healers for treatment of malaria, as well as the mode of preparation and administration.

METHODS

The study was conducted in 14 villages from Mogovolas between June and August 2015. Sixteen traditional healers were interviewed using semi-structured questionnaires. Under their guidance, we collected medicinal plants and prepared herbarium specimens that were sent and kept at Eduardo Mondlane University Herbarium for scientific identification. We searched for information on the in vitro and in vivo studies of the cited plants for antiplasmodial activity.

RESULTS

Traditional healers from Mogovolas district reported the use of 37 plants to treat malaria, belonging to 22 families. The most used species are Ochna kirkii Oliv. (5 citations), Ehretia amoena Klotzsch and Pteleopsis myrtifolia (M.A.Lawson) Engl. & Diels (both with 3 citations). These plants belong to Ochnaceae, Boraginaceae and Combretaceae families, respectively. The herbal remedies are prepared using leaves (22/37), roots (18/37), stem barks (16/37) and stems (3/37). The administration of the herbal remedies was made essentially by oral route and bathing.

CONCLUSION

The ethnobotanical data resulted from this study can be the starting point for further chemical and pharmacological studies aiming to identify medicinal species with antimalarial activity, thus, open the insights for the discovery of new antimalarial substances, as well as better integration of the traditional medicine into the national health systems, particularly in developing countries, as the health system coverage is limited.

The use of antimalarial plants as traditional treatment in Papua Island, Indonesia

The residents of the Eastern part of Indonesia, specifically, Papua and West Papua provinces, are dependent on traditional medicines with the use of plants, which includes treating malaria. However, there are limited information on the diversity of medicinal plants in Papua Island. Hence, the Indonesian Ministry of Health put together a database of all the natural plant-based raw materials in Indonesia, to address part of the issues encountered as a result of the limited information on the diversity of plants. Based on this background, the aim of the research was to analyze the information on medicinal plants used by the traditional healers in Papua Island based on the results of research on medicinal plants and Jamu (RISTOJA), especially in treating malaria. Data were obtained through ethnomedicine research conducted in 2012 and 2017 involving 54 ethnicities in Papua. Based on the results, 72 species of medicinal plants from 67 genera and 40 families were used traditionally in treating malaria on Papua Island. The most common medicinal plants used as traditional antimalarial concoction are Alstonia scholaris (L.) R. Br., Carica papaya L., Andrographis paniculata (Burm. f.) Nees, and Physalis minima L. Similar to other ethnobotany research, the leaves were the most used plant parts in preparing the various traditional concoctions.

The Effectiveness of Varying Combination Ratios of A. cordifolia and M. indica against Field and Laboratory Strains of P. falciparum In Vitro

Background

Drug resistance in malaria is a global problem, with reports of Plasmodium parasites resistant to the current first-line antimalarial drug, artemisinin, expanding from Southeast Asia to Africa. There is therefore an urgent need to identify new drug candidates that will be effective against the existing malaria parasites. Drug combination therapy presents a myriad of advantages over monotherapy including delayed onset of resistance, potentiation, and synergism. This present study explored the effectiveness of combinations of aqueous extracts of Alchornea cordifolia (A. cordifolia) and Mangifera indica (M. indica) at clearing both laboratory and field isolates of P. falciparum.

Methods

Synchronized ring stage cultures of field (FA08) and laboratory strains (NF54 and CamWT_C580Y) of P. falciparum were subjected to combinations of different concentrations and ratios of aqueous extracts of A. cordifolia and M. indica. The growth inhibition of the individual plant extracts and their combinatory effects were studied in vitro using SYBR Green I drug assay.

Results

The A. cordifolia extract exhibited 50% inhibitory concentration (IC₅₀) of 2.71, 7.80, and 3.56 μg/mL against the NF54, CamWT_C580Y, and FA08 parasite strains, respectively. Mangifera indica exhibited IC₅₀ of 18.11, 20.08, and 10.23 μg/mL against the NF54, CamWT_C580Y, and FA08 parasite strains, respectively. Additive, synergistic and antagonistic interactions were observed at different combinations of A. cordifolia and M. indica extracts.

Conclusion

A combination product containing A. cordifolia and M. indica has the potential to serve as an effective antimalarial as majority of the tested combinations of aqueous extracts of A. cordifolia and M. indica extracts exhibited synergistic effects in vitro against the NF54, CamWT_C580Y, and FA08 P. falciparum strains.

Medicinal plants used by 'root doctors', local traditional healers in Bié province, Angola

ETHNOPHARMACOLOGICAL RELEVANCE

This study is one of the first post-civil war efforts to document traditional botanical knowledge in Bié province, central Angola, in a first step to bring more studies on the use of medicinal plant resources in this area so as to bring new insights into Angolan bio-cultural diversity.

AIM OF THE STUDY

Examine the variety of plant species used for medical purposes, as well as characterize their social and cultural values. Also, it is aimed to compare their uses in the studied region with those in Sub-Saharan Africa and report new ethnomedicinal uses.

MATERIALS AND METHODS

We documented traditional medicinal plant knowledge among professional herbalists in two areas in Bié province through participatory observation, semi-structured interviews and transect walks. Ethnobotanical information was quantified based on Use Reports to (1) rate traditional knowledge; and (2) determine most useful taxa.

RESULTS

In total, 10 traditional healers shared information on their knowledge. A total of 87 plant species distributed among 57 genera and 36 botanical families were documented with Fabaceae being the best-represented family with 18 species, followed by Phyllanthaceae (6), Apocynaceae (5), Asteraceae (5), Rubiaceae (5), Lamiaceae (4), and Ochnaceae (3). Most medicinal plants are usually gathered at a distance from human settlements because of the belief in the higher efficacy of 'wild' plants shared by all herbalists. Roots are the most common plant part used (79%), explaining why the consulted herbalists call themselves 'root doctors'.

CONCLUSIONS

The culturally most important medicinal species identified in this study, i.e. Securidaca longepedunculata, Garcinia huillensis, Annona stenophylla, Afzelia quanzensis and Strychnos cocculoides, were previously reported for the same use in neighbouring countries and elsewhere in Africa. Our study also indicates that there are several locally valuable species that have not yet been studied for their medical potential, to name a few: Alvesia rosmarinifolia, Diplorhynchus condylocarpon, Eriosema affine, Paropsia brazzaeana, Rhus squalida, Sclerocroton cornutus or Xylopia tomentosa. Moreover, the ethnomedicinal use of 26 species was reported for the first time to sub-Saharan Africa.

CLASSIFICATION

Ethnopharmacological field studies.

Metabolic Diversity and Therapeutic Potential of Holarrhena pubescens: An Important Ethnomedicinal Plant

Holarrhena pubescens is an important medicinal plant of the Apocynaceae family that is widely distributed over the Indian subcontinent. The plant is extensively used in Ayurveda and other traditional medicinal systems without obvious adverse effects. Beside notable progress in the biological and phytochemical evaluation of this plant over the past few years, comprehensive reviews of H. pubescens are limited in scope. It has economic importance due to the extensive use of seeds as an antidiabetic. Furthermore, the plant is extensively reported in traditional uses among the natives of Asia and Africa, while scientifical validation for various ailments has not been studied either in vitro or in vivo. This review aims to summarize information on the pharmacology, traditional uses, active constituents, safety and toxicity of H. pubescens. Chemical analysis of H. pubescens extracts revealed the presence of several bioactive compounds, such as conessine, isoconnessine, conessimine, conimine, conessidine, conkurchicine, holarrhimine, conarrhimine, mokluangin A-D and antidysentericine. Overall, this review covers the ethnopharmacology, phytochemical composition, and pharmacological potential of H. pubescens, with a critical discussion of its toxicity, biological activities (in vitro and in vivo), the mechanism of action, as well as suggestions for further basic and clinical research.

Medicinal plants used in managing diseases of the respiratory system among the Luo community: an appraisal of Kisumu East Sub-County, Kenya

BACKGROUND

Poor access to healthcare in rural communities causes many people to seek herbalists who use medicinal plants for the treatment of various disease conditions. Most knowledge of traditional herbal medicine makes use of indigenous remedies which are often undocumented and are at risk of being lost. The preservation of this knowledge may facilitate scientific inquiry into promising new therapeutic molecules.

METHODS

Semi-structured questionnaires were used to collect the sociodemographic information of 30 herbalists in Kisumu East Sub County. The local names of medicinal plants used in managing illnesses of the respiratory system, their habit, active parts, indications, methods of preparation, routes of administration, scientific identity, and conservation status were also recorded. Other reported traditional uses, pharmacological activities, and toxicological data were identified via a literature search.

RESULTS

Most herbalists were female (86.7%), aged between 61 and 70 years (43.3%) with no formal education (56.7%), and had 21-30 years of practice (30%). 44 plant species, belonging to 43 genera and 28 families were identified. Leguminosae and Rutaceae plant families were predominant, leaves were frequently used (33%), and trees were the most common habit (44.4%). Most plants were collected in the wild (79.2%), preparation was mainly by decoction (68.8%), and the administration was mainly orally. The main indication was cough and 79.5% of all documented plant species had previously been reported to have a pharmacological activity relevant to the mitigation of respiratory illnesses. Toxicological data was available for 84.1% of the plant species identified.

CONCLUSIONS

The predominant use of roots, root barks, and root tubers by herbalists in Kisumu East Sub County threatens to negatively impact the ecological survival of some plant species. The preservation of herbalists' knowledge of medicinal plants in the study area is a pressing concern considering their advanced age and little formal education. There is a need to conserve some of the medicinal plants documented in this study. The medicinal claims made by herbalists also warrant scientific scrutiny.

Medicinal plants utilized for hepatic disorders in Ethiopian traditional medical practices: a review

Background

Ethiopia is among the top floral biodiversity rich countries in the world. More than 7000 species of plants, 15% of they are endemic, are reported in the country. Accessibility, cultural enrichment, and cheapness make 80% of the Ethiopian people used indigenous plants for various health ailments and diseases in their traditional medical practices. Therefore, the current review examined the use patterns of medicinal plants utilized for hepatic disorders in Ethiopian traditional medical practices for further scientific investigations.

Methods

Ethnobotanical and related studies on medicinal plants utilized for hepatic disorders in Ethiopia were reviewed. Ethiopian university websites, Google, Google Scholar, PubMed, Medline, and other online internet search engines were used to access literature articles. The number of plant species and families, used parts, used conditions, modes of preparation, and routes of administration were tabulated and summarized using Excel spreadsheet and descriptive statistics, respectively.

Results

The current review showed that 276 plant species belonging to 89 families were used for hepatic disorders in Ethiopian traditional medical practices. The commonly utilized plant families were Asteraceae (10.14%), Fabaceae (9.08%), Euphorbiaceae (7.61%), Laminaceae (4.35%), Solanaceae (3.99%), and Aloaceae (2.90%). Justicia schimperiana (34.34%), Croton macrostachyus, and Phytolacca dodecandra (each 20.20%), Cordia africana, Cucumis ficifolius, and Rumex abyssinica (each 10.10%) were among the most utilized plant species. They were mainly distributed in Oromo (58%), southern (36%), and Amhara (35.5%) regions. Herbs (47.10%), shrubs (26.09%) and trees (20.65%) were their primary growth forms, while leaves (34.30%) and roots (33.06%) were their commonly utilized parts. Pounding (24.59%), decoction (19.67%), powdering (9.84%), and concoction (9.13%) were their major modes of preparations. Water was the most utilized solvent (48.26%) for the remedy preparations, which were mainly administered orally (76.35%).

Conclusions

This review showed that many claimed medicinal plants were utilized for the treatment of hepatic disorders in Ethiopian traditional medical practices. Hence, further experimental investigation is recommended to standardize their quality and phytochemistry and validate their safety and efficacy. Documentation and conservation of indigenous herbal knowledge have also been strengthened.

Antimalarial Plants Used across Kenyan Communities

Malaria is one of the serious health problems in Africa, Asia, and Latin America. Its treatment has been met with chronic failure due to pathogenic resistance to the currently available drugs. This review attempts to compile phytotherapeutical information on antimalarial plants in Kenya based on electronic data. A comprehensive web search was conducted in multidisciplinary databases, and a total of 286 plant species from 75 families, distributed among 192 genera, were retrieved. Globally, about 139 (48.6%) of the species have been investigated for antiplasmodial (18%) or antimalarial activities (97.1%) with promising results. However, there is no record on the antimalarial activity of about 51.4% of the species used although they could be potential sources of antimalarial remedies. Analysis of ethnomedicinal recipes indicated that mainly leaves (27.7%) and roots (19.4%) of shrubs (33.2%), trees (30.1%), and herbs (29.7%) are used for preparation of antimalarial decoctions (70.5%) and infusions (5.4%) in Kenya. The study highlighted a rich diversity of indigenous antimalarial plants with equally divergent herbal remedy preparation and use pattern. Further research is required to validate the therapeutic potential of antimalarial compounds from the unstudied claimed species. Although some species were investigated for their antimalarial efficacies, their toxicity and safety aspects need to be further investigated.

Antimalarial herbal remedies of Bukavu and Uvira areas in DR Congo: An ethnobotanical survey

ETHNOPHARMACOLOGICAL RELEVANCE

The main objective of the present study was to collect and gather information on herbal remedies traditionally used for the treatment of malaria in Bukavu and Uvira, two towns of the South Kivu province in DRC.

MATERIAL AND METHODS

Direct interview with field enquiries allowed collecting ethnobotanical data; for each plant, a specimen was harvested in the presence of the interviewed traditional healers (THs). The recorded information included vernacular names, morphological parts of plants, methods of preparation and administration of remedies, dosage and treatment duration. Plants were identified with the help of botanists in the herbaria of INERA/KIPOPO (DRC) and the Botanic Garden of Meise (Belgium), where voucher specimens have been deposited. The results were analysed and discussed in the context of previous published data.

RESULTS

Interviewees cited 45 plant species belonging to 41 genera and 21 families used for the treatment of malaria. These plants are used in the preparation of 52 recipes, including 25 multi-herbal recipes and 27 mono-herbal recipes. Apart of Artemisia annua L. (Asteraceae; % Citation frequency = 34%) and Carica papaya L. (Caricaceae; % Citation frequency = 34%), the study has highlighted that the most represented families are Asteraceae with 12 species (26%), followed by Fabaceae with 7 species (16%) and Rubiaceae with 4 species (9%). For a majority of plants, herbal medicines are prepared from the leaves in the form of decoction and administered by oral route.

CONCLUSION

Literature data indicate that part of cited species are already known (38%) and/or studied (30%) for antimalarial properties, which gives credit to the experience of Bukavu and Uvira interviewees and some level of confidence on collected information. The highly cited plants should be investigated in details for the isolation and identification of active ingredients, a contribution to the discovery of new possibly effective antimalarials.

Cytotoxic and Antioxidant Effects of Antimalarial Herbal Mixtures

Many developing countries depend on herbal mixtures as the first line and cost-effective therapy for malaria. These mixtures with such curative tendencies may also be a source of toxicity to host cells. On the other hand, these mixtures may have anticancer potential activity characterized by cytotoxicity to cancer cells. The aim of the study was to determine the cytotoxic and antioxidant effects of five different antimalarial herbal mixtures. Five antimalarial herbal mixtures commonly used in Ghana (coded as STF, SMH, SMM, SGM, and STT) were purchased and freeze-dried. The dried samples were tested on human acute T-cell leukemia (Jurkat) and breast adenocarcinoma (MCF-7) cell lines. Cytotoxicity was assessed using the tetrazolium-based colorimetric (MTT) assay while antioxidant activity was determined using DPPH free-radical scavenging assay. Among the mixtures, SMM and SGM exhibited the strongest cytotoxicity towards Jurkat cells (IC₅₀ values 59.17 μg/ml and 49.57 μg/ml, respectively), whereas STT showed the weakest cytotoxicity (IC₅₀ = 244.94 μg/ml). Cytotoxic effect of SMM was also strongest towards MCF-7 cells whilst the least cytotoxic sample was SGM (IC₅₀ > 1000 μg/ml). SMM had the highest antioxidant percentage (EC₅₀ = 1.05 mg/ml). The increasing order of antioxidant percentage among the five herbal mixtures is SMM > SMH > STT > STF > SGM. The herbal mixtures may be potential sources of toxic agents to host cells. Therefore, further toxicity studies must be performed to safeguard health of the public. Interestingly, cytotoxicities exhibited by SMM and SGM suggest the presence of anticancer constituents in them which warrant further studies.

Potential use of extract of the plant Schwartiza brasiliensis (choisy) bedell ex gir.-Cañas against the toxic effects of the venom of Bothrops jararaca or B. jararacussu

Envenomation by snakes is a worldwide health public issue, and antivenoms are less efficient in neutralizing local toxic effects. Thus, more efficient therapies to treat patients deserve attention, and plants have been extensively tested. So, the aim of this work was to evaluate the effect of the aqueous fraction of the plant Schwartzia brasiliensis to inhibit some toxic activities of Bothrops jararaca or B. jararacussu venom. S. brasiliensis inhibited coagulant, hemolytic, proteolytic, hemorrhagic, edematogenic, and lethal activities of both venoms, regardless if plant was mixed together with venoms or injected after them as well as the route of administration (intravenous, oral or subcutaneous) of the plant. The S. brasiliensis extract showed no toxicity to mice or red blood cells. Thus, S. brasiliensis may be useful as an alternative treatment for snakebite envenomation and aid antivenom therapy to neutralize relevant toxic activities in patients bitten by Bothrops species.

Knowledge and documentation of patient health information among traditional health practitioners in urban and peri-urban areas of eThekwini Municipality, KwaZulu-Natal Province, South Africa

BACKGROUND

Documentation of patient health information (PHI) is a regulatory requirement and hence a standard procedure in allopathic healthcare practice. The opposite is true for African traditional medicine (ATM) in most African countries, including South Africa, despite legal and policy frameworks that recognise and mandate the institutionalisation of ATM. Developing good practice standards for PHI documentation is an essential step in the institutionalisation of ATM.

OBJECTIVE

This study examined the knowledge and practices of documentation of PHI by traditional health practitioners (THPs) in Durban, eThekwini Municipality, KwaZulu-Natal Province, South Africa.

METHODS

In this quantitative cross-sectional study, snowball sampling was used to identify and recruit THPs. An interviewer-administered questionnaire was used to gather data. Chi-square tests and logistic regression were used to assess associations of knowledge and practice of documentation of PHI with potential predictors; age, gender, education, type of practitioner, experience, number of patients seen per day and location of the practice.

RESULTS

Of the 248 THPs who participated, 71.8% were female. Mean (SD) age was 47.4 (14.2), ranging 18-81 years. The majority (65.7%) were Izangoma (diviners). Overall, 42.9% of the THPs reported knowledge of patient medical records (PMRs). In logistic regression, only number of patients seen per day remained a significant predictor of knowledge about PMR. THPs who reported seeing 6-10 patients were five times more likely (Odds Ratio (OR): 5.164, 95% Confidence Interval (CI): 1.270-20.996; p = 0.022) to report knowledge of PMR than those seeing <6 patients per day. Overall, 25.0% of THPs reported that they were documenting some PHI. Documentation was associated with having knowledge of PMR (OR: 29.323, 95% CI: 10.455-82.241; p < 0.0001) and being an Isangoma (OR: 3.251, 95% CI: 1.092-9.679; p = 0.02). Not knowing what (56.5%) and how (50.5%) to record were the most commonly cited reasons for not documenting.

CONCLUSION

Knowledge of PMR is low, and the practice of documenting PHI is even lower among THPs in eThekwini. That knowledge of PMR was a strong predictor of documentation practice, and the most common reason for not documenting was lack of knowledge about what and how to document suggests that training could improve PHI documentation in traditional medicine practice.

A review of the traditional use of southern African medicinal plants for the treatment of malaria

ETHNOPHARMALOGICAL RELEVANCE

Malaria is one of the most prevalent and deadly parasitic diseases globally, with over 200 million new cases and nearly 500,000 deaths reported annually. It is estimated that approximately half of the world's population lives in malaria endemic areas. Malaria is substantially less prevalent in South Africa than in other African regions and the disease is limited to some regions of the Limpopo, Mpumalanga and KwaZulu-Natal provinces. However, it still has a significant impact on the health of the populations living in those regions. Traditional medicines have long been used in South Africa by multiple ethic groups and many people continue to rely on these natural therapies for their healthcare. The usage of South African medicinal plants in several traditional healing systems to treat malaria have been documented (particularly for Zulu and Venda traditional medicine), although ethnobotanical investigations of other ethnic groups living in endemic malaria areas remains relatively neglected.

AIM OF THE STUDY

To document the use of South African medicinal plants known to be used traditionally to treat Plasmodium spp. infections. We also critically reviewed the literature on the therapeutic properties of these and other South African plants screened against Plasmodium spp. parasites with the aim of highlighting neglected studies and fostering future research in this area.

MATERIALS AND METHODS

Books and ethnobotanical reviews were examined for medicinal plants used specifically for fever. Exclusion criteria were studies not involving southern African medicinal plants. Furthermore, while fever is a common symptom of malaria, if not accompanied by the term "malaria" it was not considered. Databases including PubMed, ScienceDirect, Scopus and Google Scholar were used to source research relevant to southern African plants and malaria. Exclusion criteria were those publications where full articles could not be accessed.

RESULTS

Eighty South African plant species were identified as traditional therapies for malaria. The majority of these species were documented in Zulu ethnobotanical records, despite malaria occurring in only a relatively small portion of the Zulu's traditional territory. Surprisingly, far fewer species were reported to be used by Venda, Ndebele, northern Sotho, Tsonga, Tswana, and Pedi people, despite them living in endemic malaria areas. Interestingly many of the identified species have not been investigated further. This review summarises the available ethnobotanical and laboratory research in this field, with the aim of promoting and focusing research on priority areas.

CONCLUSION

Although malaria remains a serious disease affecting millions of people, medicinal plants while used extensively, have not been given the attention warranted for further investigation.

Ethnobotanical Survey of Medicinal Plants Used to Treat Mental Illnesses in the Berea, Leribe, and Maseru Districts of Lesotho

Mental illnesses (MIs) such as anxiety, epilepsy, major depression, schizophrenia, sleep disorder, and pain influence the quality of life severely. According to the World Health Organization Atlas for Mental Health (2014), the formal health sector in Lesotho has only 13.7 mental health workers per 100 000 of the population, which breaks down to 0.1 psychiatrist and other medical doctors, 0.3 psychologists, 4.7 nurses, and 5.2 social workers. Traditional health practitioners (THPs) have always played a significant role in the prevention and treatment of MIs, via utilization of Lesotho’s vast diversity of plants. This investigation aims to determine which medicinal plants are used for the treatment of MIs in the Berea, Leribe, and Maseru districts of Lesotho. A combination of unstructured and semistructured one-on-one interviews were conducted with 27 THPs. They were interviewed about the status of MIs in Lesotho, diagnostic methods, medicinal plants used, and preparation and administration of the herbal remedies in the treatment of MIs. A total of 43 different plant species (indigenous and exotic) were indicated by the THPs as commonly used to treat neurological disorders. With the exception of one unidentified plant, the plants represented 26 families and 42 genera. The most common families are the Asteraceae (9 species), Fabaceae (5 species), and Rosaceae (3 species). The most cited plant species were Morella serrata (Myricaceae) (26%), followed by Xysmalobium undulatum (Asclepiadaceae) (22%), and Afroaster hispidus (Asteraceae) (15%). This survey provides, for the first time, a database of Lesotho’s medicinal plants that are used to treat MIs.

Local Knowledge and Conservation Priorities of Medicinal Plants near a Protected Area in Brazil

We investigated the influence of socioeconomic factors (age, gender, and occupation) on the local knowledge of medicinal plants in the Araripe National Forest, Brazil, and the priority of conservation of the species as perceived by people. Additionally, priority species for in situ conservation were identified by calculating conservation priority (CP). Initially, free lists were developed with 152 informants in order to identify the plants known and used by them. Based on the most cited plants in these lists, a salience analysis was performed to identify the ten most prominent tree species. In a second moment, through a participatory workshop, these ten species were classified by the perception of local experts as to their environmental availability and intensity of exploitation. Then, the population size of the forest plant species was quantified through a phytosociological sampling and the conservation priority index (CP) of the species was calculated. A total of 214 ethnospecies were cited by the informants, which were identified in 167 species. Local knowledge was influenced by socioeconomic factors, with positive correlation between age and local knowledge and difference in knowledge among professions. Among the ten most prominent tree species in terms of their medicinal importance, Hancornia speciosa was highlighted as a priority for conservation in the experts' perception because it has low environmental availability and a high exploitation rate. The ten species were ordered by the CP differently from the ordering made by the local experts' perception, indicating that people's perception of species conservation status may not correspond to the actual situation in which they are found in the forests. Conservationist measures based on the perception of informants need complementary ecological studies on the species accessed.

An ethnobotanical survey and antifungal activity of Piper guineense used for the treatment of fungal infections in West-African traditional medicine

ETHNOBOTANICAL RELEVANCE

Piper guineense occurs commonly in West Africa where it is used for fungal infections instead of the costly and not always accessible conventional antifungals. Fungal, yeast-based diseases are common in West-Africa especially among those living with HIV/AIDS, and thus this study was performed in Imo state, South-Eastern Nigeria, where P. guineense is predominantly used for the treatment of fungal diseases, such as skin rashes, oral thrush and vaginosis.

AIM OF STUDY

The scarce number of previous studies on the documentation of the traditional uses of P. guineense extracts for the treatment of fungal infections in Nigeria prompted this survey. The investigation focused on how traditional healers recognize and diagnose fungal infections, how P. guineense is collected, on the various parts used for the treatments, methods of preparations, administrations and treatments. In addition, an in vitro antifungal screening of P. guineense fruit and leaf extracts of various polarities, and piperine and piperlongumine, representing the main constituents in these extracts, were performed.

METHODS

A house to house ethnobotanical survey was conducted using questionnaires. Twenty traditional medical practitioners (TMP) and herb sellers from ten villages were interviewed. Four human pathogenic strains of yeast and Cryptococcus neoformans, a yeast-like basidiomycete causing meningitis in immunocompromised individuals, were used for the antifungal screening.

RESULTS

The traditional medical practitioners (TMP) and herb sellers explained that the leaves and fruits are the most commonly used plant parts for the treatments. The oral intake of the extracts in locally produced bamboo alcohol (Kai-kai) is the most common method of administration. In accordance with these recorded traditional uses, we found that extracts of P. guineense were growth inhibitory against the fungal strains with MIC values ranging from 39 to 2500 µg/mL. The lowest MIC value of 39 µg/mL was recorded for a methanol fruit extract against Candida albicans, C. glabrata and C. tropicalis. In addition, ethanol and hexane fruit extracts were effective against the growth of C. albicans and C. glabrata, respectively, with a MIC of 78 µg/mL. Piperlongumine and piperine were active against C. albicans with MIC values of 39 and 78 µg/mL respectively.

CONCLUSION

P. guineense fruit and leaf extracts, as well as their piperamide alkaloid constituents piperine and piperlongumine, have interesting antifungal properties and could have potential as new antifungal scaffolds. Our results warrant further in-depth investigations to isolate and characterize piperamide alkaloids and other compounds responsible for the antifungal activity in the extracts.

Medicinal Plants Used in the Ejisu-Juaben Municipality, Southern Ghana: An Ethnobotanical Study

Background: The in-depth traditional knowledge of medicinal plants is at risk of extinction due to the dependency on oral transmission, and as such, there is an urgent need to document such knowledge. This study aimed to document indigenous uses of medicinal plants among community members in the Ejisu-Juaben Municipality. Methods: Data was collected in 2016 from community members and local herbalists in the Ejisu-Juaben Municipality through a semi-structured questionnaire. Statistical tools and ethnobotanical indices, i.e., informant consensus factor (ICF), fidelity level (FL), and use value (UV) were used to analyse the data. Results: One hundred and six medicinal plants belonging to 45 families were reported to cure 68 different human diseases. The most frequently used plant part in this study was the leaves (52%). Decoction (57.5%) and oral administration (58.3%) were the most utilised herbal preparation and administration route respectively. Cleistopholis patens had the highest UV (0.54) with pain &amp; fevers and skin diseases having the highest ICF values (0.88 and 0.85 respectively). Furthermore, new medicinal uses of Hilleria latifolia and ten other species were recorded for the treatment of the traditional local disease, aseram. Conclusions: The current knowledge and uses of medicinal plants are still high in the study area based on the high degree of consensus among informants. This study could allow for the preservation of knowledge and biodiversity of medicinal plants, both of which are threatened with extinction.

Cytotoxic and Hepatocurative Effect of Aqueous Fraction of Tapinanthus bangwensis Against Paracetamol-Induced Hepatotoxicity

Medicinal plants over time have proven to have potential to manage a huge number of diseases and disorders and thus have become a great source of pharmaceutical drugs. One of such plants is Tapinanthus bangwensis (African mistletoe). It is a semiparasitic and epiphytic plant growing on citrus tree, obtaining its food photosynthetically while its nutrient and water is got from the host plant. The aim of this study was to determine the cytotoxicological and hepatocurative effect of aqueous fraction of T bangwensis in acetaminophen (paracetamol)-induced Wistar rats. The antioxidant potential of the plant was determined by 2,2-diphenyl-1-picrylhydrazine scavenging and ferric reducing power assays. The cytotoxic effect was determined using Allium cepa test while the liver biochemical indices were determined by standard protocols. Data obtained were analyzed by 2-way analysis of variance at 95% confidence level and reported as mean ± standard deviation. The concentrated aqueous fraction of T bangwensis was found to be 23.3 g (58.25%). Quantitative determination of some vital phytochemicals revealed the following: flavonoid (84.6 ± 0.41 mg/100 g), phenol (147.5 ± 1.07 mg/100 g), tannin (31 ± 0.85 mg/ 100 g), alkaloid (23.45 ± 0.09 mg/100 g), and saponin (0.146 ± 0.0 mg/100 g). Treatment of rats with the aqueous extract of T bangwensis significantly decreased paracetamol-induced elevation of activities of liver function indices, alkaline phosphatase, alanine aminotransferase, aspartate aminotransferase, triglyceride, total cholesterol level and increased the albumin, total protein, and high-density lipoprotein levels. The plant extract also attenuated the paracetamol elevated lipid peroxidation product, malondialdehyde. The research findings suggest that aqueous extract of T bangwensis is slightly cytotoxic, possesses appreciable antioxidant property and exhibited hepatocurative effect against paracetamol-induced hepatoxicity.

Medicinal plants used by the people of Nsukka Local Government Area, south-eastern Nigeria for the treatment of malaria: An ethnobotanical survey

ETHNOBOTANICAL RELEVANCE

Malaria is a serious public health problem especially in sub-Saharan African countries such as Nigeria. The causative parasite is increasingly developing resistance to the existing drugs. There is urgent need for alternative and affordable therapy from medicinal plants which have been used by the indigenous people for many years.

AIM OF STUDY

This study was conducted to document the medicinal plant species traditionally used by the people of Nsukka Local Government Area in south-eastern Nigeria for the treatment of malaria.

METHODS

A total of 213 respondents, represented by women (59.2%) and men (40.8%), were interviewed using a semi-structured questionnaire. The results were analysed and discussed in the context of previously published information on anti-malarial and phytochemical studies of the identified plants.

RESULTS

The survey revealed that 50 plant species belonging to 30 botanical families were used in this region for the treatment of malaria. The most cited families were Apocynaceae (13.3%), Annonaceae (10.0%), Asteraceae (10.0%), Lamiaceae (10.0%), Poaceae (10.0%), Rubiaceae (10.0%) and Rutaceae (10.0%). The most cited plant species were Azadirachta indica (11.3%), Mangifera indica (9.1%), Carica papaya (8.5%), Cymbopogon citratus (8.5%) and Psidium guajava (8.5%).

CONCLUSION

The present findings showed that the people of Nsukka use a large variety of plants for the treatment of malaria. The identified plants are currently undergoing screening for anti-malarial, toxicity and chemical studies in our laboratory.

The apoptotic effects of Brucea javanica fruit extract against HT29 cells associated with p53 upregulation and inhibition of NF-κB translocation

Background

Brucea javanica (L.) Merr. is a plant from the genus Brucea, which is used in local traditional medicine to treat various diseases. Recent studies revealed an impressive anticancer efficiency of B. javanica extract in different types of cancer cells.

Purpose

In this study, we have investigated the cytotoxic effects of the B. javanica hexane, ethanolic extracts against colon cancer cells. HT29 colon cells were selected as an in vitro cancer model to evaluate the anticancer activity of B. javanica ethanolic extract (BJEE) and the possible mechanisms of action that induced apoptosis.

Methods

3-(4,5-dimethylthiazol-2-yl)-2, 5,-diphenyltetrazolium bromide (MTT), lactate dehydrogenase, acridine orange/propidium iodide, and annexin-V-fluorescein isothiocyanate assays were performed to determine the antiproliferative and apoptosis validation of BJEE on cancer cells. Measurement of reactive oxygen species (ROS) production, caspase activities, nucleus factor-κB activity, and gene expression experiments was done to investigate the potential mechanisms of action in the apoptotic process.

Results

The results obtained from this study illustrated the significant antiproliferative effect of BJEE on colorectal cancer cells, with a concentration value that inhibits 50% of the cell growth of 25±3.1 µg/mL after 72 h of treatment. MTT assay demonstrated that the BJEE is selectively toxic to cancer cells, and BJEE induced cell apoptosis via activation of caspase-8 along with modulation of apoptosis-related proteins such as Fas, CD40, tumor necrosis factor-related apoptosis-inducing ligands, and tumor necrosis factor receptors, which confirmed the contribution of extrinsic pathway. Meanwhile, increased ROS production in treated cells subsequently activated caspase-9 production, which triggered the intrinsic pathways. In addition, overexpression of cytochrome-c, Bax, and Bad proteins along with suppression of Bcl-2 illustrated that mitochondrial-dependent pathway also contributed to BJEE-induced cell death. Consistent with the findings from this study, BJEE-induced cancer cell death proceeds via extrinsic and intrinsic mitochondrial-dependent and -independent events.

Conclusion

From the evidence obtained from this study, it is concluded that the BJEE is a promising natural extract to combat colorectal cancer cells (HT29 cells) via induction of apoptosis through activation of extrinsic and intrinsic pathways.

Review of Ethnomedicinal Uses, Phytochemistry and Pharmacological Properties of Euclea natalensis A.DC

Euclea natalensis is traditionally used as herbal medicine for several human diseases and ailments in tropical Africa. This study reviews information on ethnomedicinal uses, botany, phytochemical constituents, pharmacology and toxicity of E. natalensis. Results of this study are based on literature search from several sources including electronic databases, books, book chapters, websites, theses and conference proceedings. This study showed that E. natalensis is used as traditional medicine in 57.1% of the countries where it is indigenous. Euclea natalensis has a high degree of consensus on abdominal pains, antidote for snake bites, diabetes, diarrhoea, malaria, roundworms, stomach problems, toothache, venereal diseases and wounds. Several ethnopharmacological studies have shown that crude extracts and chemical compounds from E. natalensis demonstrated many biological activities both in vitro and in vivo, which included antibacterial, antidiabetic, antifungal, antimycobacterial, antiviral, antioxidant, antiplasmodial, larvicidal, antischistosomal, molluscicidal, dentin permeability and hepatoprotective activities. Future studies should focus on the mechanism of biological activities of both crude extracts and chemical compounds from the species, as well as structure-function relationships of bioactive constituents of the species.

In vitro antiplasmodial activity and prophylactic potentials of extract and fractions of Trema orientalis (Linn.) stem bark

BACKGROUND

Trema orientalis (T. orientalis Linn) has been used in the management of malaria in the western part of Nigeria and despite its application in ethnomedicine, there is dearth of scientific evidence to justify the acclaimed prophylactic antimalarial usage of the plant. The aim of this study is to assess the in vitro antiplasmodial cell-free assay and chemopreventive efficacy of the methanol extract of the stem bark of T. orientalis and its fractions as a prophylactic regimen for malaria prevention. Also, the antimicrobial activities of the extract and the fractions were investigated.

METHOD

Vacuum liquid chromatography was used to obtain dichloromethane, ethylacetate and methanol fractions from the methanol extract of T. orientalis. The fractions were tested for their prophylactic and cell-free antimalarial activity using murine models and β-hematin formation assay respectively. Disc diffusion method was used to determine the antibacterial activity of the extract and its fractions against both Gram-positive and Gram-negative bacteria.

RESULTS

In the prophylactic experiment, dichloromethane (DCMF), methanol fraction (MF) and extract (ME) (in this order) showed significant chemopreventive effects against P. berghei invasion of the red blood cells when compared with both Sulfadoxine-Pyrimethamine (SP) and untreated controls. Results of the in vitro study showed that the DCMF had the highest effect in preventing the formation of β-hematin when compared with other fractions. The DCMF also had the highest percentage inhibition of β-hematin formation when compared with chloroquine. The extract and fractions showed a concentration dependent antibacterial activity. Methanol extract had a pronounced inhibitory effect on Enterobacter cloaca ATCC 13047 and Enterococcus faecalis ATCC 29212. Serratia mercescens ATCC 9986 and Pseudomonas aeruginosa ATCC 19582 were the most susceptible bacteria.

CONCLUSION

The results obtained showed that both extract and fractions of T. orientalis possessed antiplasmodial and antimicrobial activity.