Phytotherapeutic information on plants used for the treatment of tuberculosis in eastern cape province, South Africa

Investigation of the antimycobacterial activity of African medicinal plants combined with chemometric analysis to identify potential leads

The emergence of drug-resistant Mycobacterium tuberculosis strains is a threat to global health necessitating the discovery of novel chemotherapeutic agents. Natural products drug discovery, which previously led to the discovery of rifamycins, is a valuable approach in this endeavor. Against this backdrop, we set out to investigate the in vitro antimycobacterial properties of medicinal plants from Ghana and South Africa, evaluating 36 extracts and their 252 corresponding solid phase extraction (SPE) generated fractions primarily against the non-pathogenic Mycobacterium smegmatis and Mycobacterium aurum species. The most potent fraction was further evaluated in vitro against infectious M. tuberculosis strain. Crinum asiaticum (bulb) (Amaryllidaceae) emerged as the most potent plant species with specific fractions showing exceptional, near equipotent activity against the non-pathogenic Mycobacterium species (0.39 µg/ml ≤ MIC ≤ 25 µg/ml) with one fraction being moderately active (MIC = 32.6 µg/ml) against M. tuberculosis. Metabolomic analysis led to the identification of eight compounds predicted to be active against M. smegmatis and M. aurum. In conclusion, from our comprehensive study, we generated data which provided an insight into the antimycobacterial properties of Ghanaian and South African plants. Future work will be focused on the isolation and evaluation of the compounds predicted to be active.

Survey and Antimicrobial Activity Study of Ethnomedicinal Plants in Selected Districts of North Shewa Zone, Oromia, Ethiopia

Background

The emergency of multidrug resistance due to the global burden of infectious diseases and drug misuse leads to an urgent identification of new medicines from medicinal plants. The study was designed to perform the documentation of ethno-medicinal plants usage, extraction, phytochemical screening and antimicrobial activities of the herbal extracts.

Methods

A cross-sectional study design was conducted in this study. Maceration of plant extraction, phytochemical screening and disc diffusion method for antimicrobial activity tests were employed.

Results

The results of the study indicated that Euphorbiaceae, Lamiaceae and Sapindaceae plant families have commonly used for the treatment of infectious diseases in the study areas. The antimicrobial activity test results indicated that Ostegia integrifolia Benth which was extracted with chloroform solvent showed equivalent inhibition zone as compared to standard drug, gentamicin. All the extracts could be considered as broad spectrum, have strong inhibition against E. coli, K. pneumoniae, S. aureus, P. aeruginosa and C. albicans. All extracts against C. albicans were also revealed strong inhibition activity as compared to fungal standard drug, contamazole.

Conclusion

Phytochemical screening showed the existence of secondary metabolites in the studied plants and thus, supports the traditional healers’ claim of such plants use for the treatment of diseases. The study also concluded that chloroform extracts of all plants showed promising antimicrobial activities against K. pneumonia, and C. albicans. Therefore, further in vitro and vivo antimicrobial activity study of chloroform extracts against these bacterial and fungal strains were recommended. Moreover, isolation and structural elucidation of bioactive compounds from chloroform extracts were also recommended.

Advances in adjunct therapy against tuberculosis: Deciphering the emerging role of phytochemicals

Eastern countries are a major source of medicinal plants, which set up a rich source of ethnopharmacologically known medicines used in the treatment of various diseases. These traditional medicines have been known as complementary, alternative, or nonconventional therapy across globe for ages. Tuberculosis (TB) poses a huge global burden and leads to maximum number of deaths due to an infectious agent. Treatment of TB using Directly Observed Treatment Short-course (DOTS) therapy comprises multiple antibiotics is quite lengthy and causes serious side-effects in different organs. The length of the TB treatment leads to withdrawal from the patients, which paves the way for the emergence of drug resistance in the bacterial population. These concerns related to therapy need serious and immediate interventions. Traditional medicines using phytochemicals has shown to provide tremendous potential in TB treatment, mainly in the eradication of Mycobacterium tuberculosis (M.tb), increasing natural immunity, and managing the side effects of anti-TB drugs. This review describes the antituberculosis potential of selected ethnopharmacologically important phytochemicals as potential immune-modulator and as an adjunct-therapy in TB. This review will be a useful reference for researchers working on ethnopharmacology and will open the door for the discovery of novel agents as an adjunct-therapy to tuberculosis.

Ethnobotanical plants used in the management of symptoms of tuberculosis in rural Uganda

BACKGROUND

Tuberculosis (TB) caused by Mycobacterium tuberculosis is the 13th leading cause of death worldwide. The emergence of multidrug-resistant TB (MDR-TB) poses a major health security threat. Plants have traditionally been used as a source of medicine, since olden days and 80% of the communities in Africa still rely on herbal medicines for their healthcare. In many parts of Uganda, some plants have shown ethno-pharmacological prospects for the treatment of TB, and yet they have not been fully researched.

AIM

This study aimed to document plant species used traditionally by the herbalists and non-herbalist communities of Kitgum and Pader districts for managing symptoms of TB.

METHODS

An ethnobotanical study was carried out in 42 randomly selected villages in Kitgum and Pader districts between August 2020 and January 2021. Information was obtained by administering semi-structured questionnaires to 176 respondents identified by snowball and random sampling methods. Data were analysed and presented using descriptive statistics and Informant Consensus Factor (ICF).

RESULTS

Overall, only 27% of the respondents were knowledgeable about plants used for managing symptoms of TB. Nine plant species belonging to six families (Mimosaceae, Apiaceae, Lamiaceae, Rutaceae, Loganiaceae and Rubiaceae) were used to manage symptoms of TB. The most representative family was Rutaceae with three species, followed by Rubiaceae (two species) and the rest of the families were represented by one species each. The most frequently recorded species were Steganotaenia araliacea Hochst. (8.5%), Gardenia ternifolia Schumach. & Thonn (6.8%) and Albizia adianthifolia (Schum.) W.Wight (6.8%). Most of the medicinal plants were trees, and roots (69%) were the most frequently plant part used, followed by the bark (16%) and leaves (15%). The most common method of preparation was by pounding and mixing concoction with water. The administration of the concoctions was mostly done orally.

CONCLUSIONS

The results established the existence of few medicinal plants for managing symptoms of TB among the Acholi communities which could be used in developing new, effective plant-based antimycobacterial drugs. The few plants mentioned might face conservation threats due to exploitations of the roots. Phytochemical and toxicological studies are recommended to identify active compounds responsible for antimycobacterial activity.

Traditional Medicinal Plants as a Source of Antituberculosis Drugs: A System Review

Medicinal plants are the chief components in the different oriental formulations in different traditional medical systems worldwide. As a thriving source of medicine, the medicinal plants with antituberculosis (TB) properties inspire the pharmacists to develop new drugs based on their active components or semimetabolites. In the present review, the anti-TB medicinal plants were screened from the scientific literatures, based on the botanical classification and the anti-TB activity. The obtained anti-TB medicinal plants were categorized into three different categories, viz., 159 plants critically examined with a total 335 isolated compounds, 131 plants with their crude extracts showing anti-TB activity, and 27 plants in literature with the prescribed formula by the traditional healers. Our systemic analysis on the medicinal plants can assist the discovery of novel and more efficacious anti-TB drugs.

Nigerian polyherbal-based hydrotherapy: a panacea to infectious diseases

A global society, including developed countries, continues to struggle with fatal diseases that are difficult to treat with Western medicine. A variety of infectious diseases have existed for ages, but in Africa they had been limited thanks to the Indigenous Knowledge System (IKS) prior to the introduction of cosmopolitan medicine. Influenza virus repression has been demonstrated by a number of herbal antivirals, yet the invaluable therapeutic potential of herbal medicine has been underestimated. Despite various reliable methods offered by Western medicine, the globally destructive COVID-19 pandemic requires a successful fight. The wisdom of African IKS used in tackling epidemics that have broken out in the past is brought to mind again. Pneumonia – a COVID-19 symptom, could be treated with polyherbal fomentation. Selected plants cultivated across Nigeria for hydrotherapy are under consideration to be used in proper doses. Given the potential associated with IKS, a multi-disciplinary approach involving experts in phytomedicine, ethnobotany, phytochemistry, plant physiology and ecology is necessary to unlock the therapeutic potential of traditional medicine.

Potent anti-mycobacterial and immunomodulatory activity of some bioactive molecules of Indian ethnomedicinal plants that have the potential to enter in TB management

Tuberculosis (TB) is one of the deadliest infectious diseases of human civilization. Approximately one-third of global population is latently infected with the TB pathogen Mycobacterium tuberculosis (M.tb). The discovery of anti-TB antibiotics leads to decline in death rate of TB. However, the evolution of antibiotic-resistant M.tb-strain and the resurgence of different immune-compromised diseases re-escalated the death rate of TB. WHO has already cautioned about the chances of pandemic situation in TB endemic countries until the discovery of new anti-tubercular drugs, that is, the need of the hour. Analysing the pathogenesis of TB, it was found that M.tb evades the host by altering the balance of immune response and affects either by killing the cells or by creating inflammation. In the pre-antibiotic era, traditional medicines were only therapeutic measures for different infectious diseases including tuberculosis. The ancient literatures of India or ample Indian traditional knowledge and ethnomedicinal practices are evidence for the treatment of TB using different indigenous plants. However, in the light of modern scientific approach, anti-TB effects of those plants and their bioactive molecules were not established thoroughly. In this review, focus has been given on five bioactive molecules of different traditionally used Indian ethnomedicinal plants for treatment of TB or TB-like symptom. These compounds are also validated with proper identification and their mode of action with modern scientific approaches. The effectiveness of these molecules for sensitive or drug-resistant TB pathogen in clinical or preclinical studies was also evaluated. Thus, our specific aim is to highlight such scientifically validated bioactive compounds having anti-mycobacterial and immunomodulatory activity for future use as medicine or adjunct-therapeutic molecule for TB management.

A narrative review of the ethnomedicinal usage of Cannabis sativa Linnaeus as traditional phytomedicine by folk medicine practitioners of Bangladesh

BACKGROUND

There is a worldwide interest in the use of Cannabis sativa for biomedicine purposes. Cannabis has ethnomedicinal usage as a natural medicine in Bangladesh and cultivated during the British Empire period for revenues.

OBJECTIVE

Folk medicine practitioners (FMPs) from different districts of Bangladesh have been using Cannabis sativa, but until now there have not been any compiled studies particularly regarding this practice. Hence, this review is an effort to retrieve the traditional usage of Cannabis sativa as a phytomedicine from published ethnomedicinal studies.

METHODS AND MATERIALS

Information was searched by using the search terms "ethnomedicinal Cannabis sativa and Bangladesh"; "Bangladesh cannabaceae and ethnomedicinal survey"; "ganja, bhang and folk medicine Bangladesh"; "tetrahydrocannabinol (THC), cannabinoid and therapeutic, clinical trial"; and "cannabis and pharmacological/biological" and retrieved from ethnobotanical articles available on PubMed, Scopus, Science Direct, and Google Scholar databases. A search of the relevant scientific literature also was conducted to assess the efficacy of the ethnomedicinal usage of Cannabis sativa.

RESULTS

While reviewing over 200 ethnomedicinal plants' survey articles, we found that FMPs of Bangladesh from 12 different districts used Cannabis sativa to treat cited ailments like sleep-associated problems (n=5), neuropsychiatric and CNS problems (n=5), and infections and respiratory problems (n=5) followed by rheumatism, gastrointestinal, gynecological (n=4 each), cancer, sexual, and other ailments including hypertension, headache, itch, increases bile secretion, abortifacient, dandruff, fever, and urinary problems (n=1 each). There are a total of 15 formulations identified from the 11 out of 18 ethnomedicinal plant survey reports. The leaf was the main plant part used (53.8%), followed by root (23%), seed (7.7%) and flower, inflorescence, resin, and all parts 3.8% respectively.

CONCLUSIONS

Sales and cultivation of Cannabis are illegal at present in Bangladesh, but the use of Cannabis sativa as a natural phytomedicine has been practiced traditionally by folk medicine practitioners of Bangladesh for many years and validated through relevant pharmacological justification. Although Cannabis sativa possesses ethnomedicinal properties in the folk medicine of Bangladesh, it is, furthermore, needed to conduct biological research to consolidate pharmacological justification about the prospects and challenges of Cannabis and cannabinoids' use in Bangladesh as safer biomedicine in the future.

Medicinal plants used in the treatment of tuberculosis - Ethnobotanical and ethnopharmacological approaches

Tuberculosis is a highly infectious disease declared a global health emergency by the World Health Organization, with approximately one third of the world's population being latently infected with Mycobacterium tuberculosis. Tuberculosis treatment consists in an intensive phase and a continuation phase. Unfortunately, the appearance of multi drug-resistant tuberculosis, mainly due to low adherence to prescribed therapies or inefficient healthcare structures, requires at least 20 months of treatment with second-line, more toxic and less efficient drugs, i.e., capreomycin, kanamycin, amikacin and fluoroquinolones. Therefore, there exists an urgent need for discovery and development of new drugs to reduce the global burden of this disease, including the multi-drug-resistant tuberculosis. To this end, many plant species, as well as marine organisms and fungi have been and continue to be used in various traditional healing systems around the world to treat tuberculosis, thus representing a nearly unlimited source of active ingredients. Besides their antimycobacterial activity, natural products can be useful in adjuvant therapy to improve the efficacy of conventional antimycobacterial therapies, to decrease their adverse effects and to reverse mycobacterial multi-drug resistance due to the genetic plasticity and environmental adaptability of Mycobacterium. However, even if some natural products have still been investigated in preclinical and clinical studies, the validation of their efficacy and safety as antituberculosis agents is far from being reached, and, therefore, according to an evidence-based approach, more high-level randomized clinical trials are urgently needed.

Ethnobotany, ethnopharmacology, and phytochemistry of traditional medicinal plants used in the management of symptoms of tuberculosis in East Africa: a systematic review

OBJECTIVE

Many studies on the treatment of tuberculosis (TB) using herbal medicines have been undertaken in recent decades in East Africa. The details, however, are highly fragmented. The purpose of this study was to provide a comprehensive overview of the reported medicinal plants used to manage TB symptoms, and to analyze scientific reports on their effectiveness and safety.

METHOD

A comprehensive literature search was performed in the major electronic databases regarding medicinal plants used in the management of TB in East Africa. A total of 44 reports were retrieved, and data were collected on various aspects of the medicinal plants such as botanical name, family, local names, part(s) used, method of preparation, efficacy, toxicity, and phytochemistry. The data were summarized into percentages and frequencies which were presented as tables and graphs.

RESULTS

A total of 195 species of plants belonging to 68 families and 144 genera were identified. Most encountered species were from Fabaceae (42.6%), Lamiaceae (19.1%), Asteraceae (16.2%), and Euphorbiaceae (14.7%) families. Only 36 medicinal plants (18.5%) have been screened for antimycobacterial activity. Out of these, 31 (86.1%) were reported to be bioactive with minimum inhibitory concentrations ranging from 47 to 12,500 μg/ml. Most tested plant extracts were found to have acceptable acute toxicity profiles with cytotoxic concentrations on normal mammalian cells greater than 200 μg/ml. The most commonly reported phytochemicals were flavonoids, terpenoids, alkaloids, saponins, cardiac glycosides, and phenols. Only Tetradenia riparia, Warburgia ugandensis, and Zanthoxylum leprieurii have further undergone isolation and characterization of the pure bioactive compounds.

CONCLUSION

East Africa has a rich diversity of medicinal plants that have been reported to be effective in the management of symptoms of TB. More validation studies are required to promote the discovery of antimycobacterial drugs and to provide evidence for standardization of herbal medicine use.

Changes of Anti-tuberculosis Herbs Formula During Past Three Decades in Contrast to Ancient Ones

OBJECTIVE

To investigate the evolution of herbal medicine in treating tuberculosis (TB) and encourage anti-TB drug discovery and development.

METHODS

In this study, 477 ancient traditional Chinese medicine formulae were collected from the Dictionary of Traditional Chinese Medicine Prescriptions and 172 modern Chinese medicine formulae (from 1986 to 2016) were collected by searching 4 databases: WanFang Data Knowledge Service Platform, China National Knowledge Infrastructure Database (CNKI), China Science and Technology Journal Database (VIP) and Chinese Bio-medical Literature and Retrieval System (SinoMed) in Chinese. We restricted the search to publications in Chinese. Further data analysis was done using the Traditional Chinese Medicine Inheritance Support System version 2 Software.

RESULTS

There were 425 herbs in the 477 ancient formulae and 257 herbs in the 172 modern formulae. Half of the top 30 herbs were shared by both modern and ancient prescriptions. They are Radix Ophiopogonis, Astragalus membranaceus, Fritillaria cirrhosa, Dried rehmannia glutinosa, Poria cocos, Angelica sinensis, Prepared rehmannia glutinosa, Platycodon Root, Radix paeoniae alba, Schisandra chinensis, Bighead atractylodes rhizome, Rhizoma anemarrhenae, Cortex lycii radicis and Radix Scutellariae. Only two groups of herbs with a high correlation coefficient were found in both modern and ancient prescriptions, the Dried rehmannia glutinosa with Radix ophiopogonis, and Radix ophiopogonis with Prepared rehmannia glutinosa. There were 9 and 15 core herb combinations in modern and ancient prescriptions, respectively, but no one was found simutaniously in both modern and ancient prescriptions.

CONCLUSIONS

Although there were wide variations in the herb groups and herb combinations in the formulae, half of the top 30 herbs were found in both modern and ancient prescriptions. The core herb combinations in modern and ancient prescriptions could help us to improve the priscription for treatment of TB.

Ziziphus mucronata Willd. (Rhamnaceae): it's botany, toxicity, phytochemistry and pharmacological activities

Ziziphus mucronata is an important multi-purpose plant species that has been used in African traditional medicine for ages in the treatment of various devastating human and animal infections. The current paper is aimed at providing an overview of uses, toxicology, pharmacological properties and phytochemistry of Z. mucronata. The information used in the current work was retrieved using various search engines, including Pubmed, Science Direct, Google Scholar, Scielo, SciFinder and Scopus. The key words used included Ziziphus mucronata, secondary metabolites, chemistry, biological activity and pharmacology, anti-inflammatory, antimicrobial, antifungal, antiviral, ethnobotanical survey, medicinal uses, safety, toxicology and other related words. Out of the 46 infections which the plant species is used to treat, the most common uses includes sexually transmitted infections, skin infections, diarrhoea and dysentery, respiratory and chest complaints and gynaecological complaints (citations ≥6). Pharmacologically, the plant species exhibited a potential antimicrobial activity yielding a minimum inhibitory concentration of <1 mg/ml against important pathogens which includes Mycobacterium tuberculosis, Moraxella catarrhalis, Staphylococcus aureus, Escherichia coli, Propionibacterium acnes, Candida albicans, Cryptoccoos neoformans amongst other microorganisms. Furthermore, the extracts and compounds from Z mucronata revealed potent antiviral, antioxidant, anti-inflammatory and other activities in vitro. Phytochemically, cyclo-peptide alkaloids (commonly called mucronines) dominates and in conjunction with triterpenes, flavonoids, phenolic acids and anthocyanins. Besides these compounds, the plant species exhibited the presence of important in minerals. These phytoconstituents may well explain the reported biological activities. Although the extracts revealed no cytotoxic effect to Vero cells, further toxicological characteristics of the plant species still needs to be explored. There is also a need to carry out the comprehensive safety profiles of the plant species, including heavy metal detection. Although the plant species revealed important biological activities, which includes antimicrobial, antiviral, anti-diabetic, anti-inflammatory, anti-oxidant, anti-plasmodial, anthelmintic, and anti-anaemic activity in vitro, further research is needed to explore the in vivo studies, other compounds responsible for such activities and the mechanisms of action thereof. Such activities validates the use of the plant species in traditional medicine. The data on the possible use of the plant species in the treatment of diarrhoea, sexually transmitted infections, skin related and gynaecological complaints are scant and still needs to be explored and validated both in vitro and in vivo. Furthermore, the anticancer and anthelmintic activity of the plant species also needs to be explored.

Artemisia afra, a controversial herbal remedy or a treasure trove of new drugs?

ETHNOPARMACOLOGICAL RELEVANCE

Artemisia afra is one of the most widely used herbal remedies in South Africa. This highly aromatic shrub is used to treat various disorders including coughs, colds, influenza, and malaria. Due to the long tradition of use and popularity of A. afra, it has been successfully commercialised and can currently be bought from various internet stores and pharmacies. The most notable indication is for the prophylaxis and treatment of Plasmodium falciparum infections. In 2013, the Medicine Control Council (MCC) of South Africa banned the sale of A. afra for the treatment of malaria because it lacks scientific evidence of efficacy. This resulted in a lawsuit being filed in 2017 against the MCC by an herbal company which claimed that artemisinin was responsible for A. afra's antiplasmodial activity. At the time, no scientific literature reported that A. afra contained artemisinin.

MATERIALS AND METHODS

This review aims to collate all available scientific literature regarding the phytochemistry and biological activity, focusing on antimalarial activity, of A. afra published from 2009 to 2019 and follows on our earlier review, which covered all literature until 2009. All scientific literature in English published between 2009 and June 2019 were retrieved from scientific databases (Scifinder scholar, Web of Science, Scopus, PubMed, Google scholar) and a number of books regarding medicinal plants in South Africa were also consulted.

RESULTS

In the last decade very few compounds have been identified in A. afra, none of which were novel compounds. Based on all the tests that have been conducted using extracts and compounds of A. afra in a disparate variety of in vitro and in vivo bioassays, the results indicate only weak biological activity. The activity of extracts, and in some cases pure compounds, exhibited IC₅₀ or MIC values of 1000-10 000 fold less active than the positive controls. In contrast, and quite surprisingly, two randomised controlled trials were recently conducted (Schistosoma mansoni and Plasmodium falciparum infected patients) and although criticised based on design, execution, statistical analysis and ethical concerns, showed remarkably positive results.

CONCLUSIONS

Pre-clinical in vitro and in vivo animal experiments failed to yield any promising drug leads. However, if the recent randomised controlled trials can be independently replicated in well-designed and executed clinical trials it might indicate that A. afra contain powerful 'prodrugs'. Future research on A. afra should therefore focus on reproducing the randomised controlled trials and on artificially metabolising A. afra extracts/compounds in order to identify the presence of any 'prodrugs'.

Antifungal, anti-oxidant activity and cytotoxicity of South African medicinal plants against mycotoxigenic fungi

Fungal strains belonging to genus Fusarium and Aspergillus are known to infect crops, resulting in threatened food security and less agricultural crop yields. The aim of the current work was to investigate the anti-mycotoxigenic activity, cytotoxic effect and antioxidant potential of selected South African medicinal plants extracts. The aqueous and organic extracts of the leaves from selected medicinal plants were investigated for their antifungal activity against various fungal strains that are known to infect crops and produce mycotoxins. Antioxidant activity, total phenolic and total flavonoids contents were also evaluated. Organic extract of Milletia grandis (E. Mey) Skeels revealed the lowest minimum inhibitory concentration (MIC) value of 0.01 mg/mL against Aspergillus ochraceous, Fusarium graminearum and Furasium oxysporum. Generally, organic extracts revealed significant antifungal activity compared to aqueous extracts. Carpobrutus eludis L. and Warburgia salutaris (G. Bertol) Chiov. revealed a potent cytotoxic effect yielding 50 % lethal concentration (LC50) value of 0.01 mg/mL against Bovine dermis and Vero cells respectively. Ricinus communis L. revealed a 50 % inhibitory concentration (IC50) value of 945 μg/mL against 2, 2 diphenyl-picryl-hydrazyl (DPPH). Generally, the plant species revealed lower flavonoids compared to phenolic contents. The biological activity of the selected plant extracts may be attributed to the high phenolic contents.

Ethno-medicinal documentation of polyherbal medicines used for the treatment of tuberculosis in Amathole District Municipality of the Eastern Cape Province, South Africa

CONTEXT

Tuberculosis (TB) has remained a devastating global public health problem. In the continuing search for effective treatment, polyherbal remedies used as alternative medicines in the Eastern Cape Province of South Africa were surveyed.

OBJECTIVE

The survey collected information and documents the list of ingredients such as the name of the plants used including the non-herbal inclusions, type and dosage of polyherbal formulations used for the treatment of TB.

MATERIALS AND METHODS

The survey was conducted over a period of 6 months using semi-structured questionnaires amidst informal conversations with the traditional healers in five communities in the study area. The chosen study area is the third infected Province with TB in South Africa.

RESULTS

A total of nine polyherbal preparations were collected. Information on the parts of the plant used, mode of preparation and the dosage used were documented. In total, the herbs belong to 20 families of which Apiaceae, Liliaceae, Strychnaceae, Rutaceae and Hypoxidaceae are the most prominent. However, members of Apiaceae were commonly mentioned for the preparation of the remedies. The two most frequently used plants were Allium sativum L. (Liliaceae) and Strychnos decussata (Pappe) Gilg. (Strychnaceae). Rhizome was the commonest parts used, followed by the roots and barks.

CONCLUSIONS

This paper provides significant ethno-medicinal information on polyherbal medicines used for the treatment of TB in the study area. The therapeutic claims made on medicinal plants used for the preparations are well supported by the literature, with many of the species having antimicrobial properties.

Anti-mycobacterium tuberculosis activity of polyherbal medicines used for the treatment of tuberculosis in Eastern Cape, South Africa

BACKGROUND

The emergence of drug-resistant strains of Mycobacterium tuberculosis has become a global public health problem. Polyherbal medicines offer great hope for developing alternative drugs for the treatment of tuberculosis.

OBJECTIVE

To evaluate the anti-tubercular activity of polyherbal medicines used for the treatment of tuberculosis.

METHODS

The remedies were screened against Mycobacterium tuberculosis H37Rv using Middlebrook 7H9 media and MGIT BACTEC 960 system. They were liquid preparations from King Williams Town site A (KWTa), King Williams Town site B (KWTb), King Williams Town site C (KWTc), Hogsback first site (HBfs), Hogsback second site (HBss), Hogsback third site (HBts), East London (EL), Alice (AL) and Fort Beaufort (FB).

RESULTS

The susceptibility testing revealed that all the remedies contain anti-tubercular activity with KWTa, KWTb, KWTc, HBfs, HBts, AL and FB exhibiting more activity at a concentration below 25 µl/ml. Furthermore, MIC values exhibited inhibitory activity with the most active remedies from KWTa, HBfs and HBts at 1.562 µg/ml. However, isoniazid showed more inhibitory activity against M. tuberculosis at 0.05 µg/ml when compare to the polyherbal remedies.

CONCLUSION

This study has indicated that these remedies could be potential sources of new anti-mycobacterial agents against M. tuberculosis. However, the activity of these preparations and their active principles still require in vivo study in order to assess their future as new anti-tuberculosis agents.

RETRACTED: Medicinal plants used in the treatment of tuberculosis - Ethnobotanical and ethnopharmacological approaches

Tuberculosis is a highly infectious disease declared a global health emergency by the World Health Organization, with approximately one third of the world's population being latently infected with Mycobacterium tuberculosis. Tuberculosis treatment consists in an intensive phase and a continuation phase. Unfortunately, the appearance of multi drug-resistant tuberculosis, mainly due to low adherence to prescribed therapies or inefficient healthcare structures, requires at least 20months of treatment with second-line, more toxic and less efficient drugs, i.e., capreomycin, kanamycin, amikacin and fluoroquinolones. Therefore, there exists an urgent need for discovery and development of new drugs to reduce the global burden of this disease, including the multi-drug-resistant tuberculosis. To this end, many plant species, as well as marine organisms and fungi have been and continue to be used in various traditional healing systems around the world to treat tuberculosis, thus representing a nearly unlimited source of active ingredients. Besides their antimycobacterial activity, natural products can be useful in adjuvant therapy to improve the efficacy of conventional antimycobacterial therapies, to decrease their adverse effects and to reverse mycobacterial multi-drug resistance due to the genetic plasticity and environmental adaptability of Mycobacterium. However, even if some natural products have still been investigated in preclinical and clinical studies, the validation of their efficacy and safety as antituberculosis agents is far from being reached, and, therefore, according to an evidence-based approach, more high-level randomized clinical trials are urgently needed.

Isolation of anti-mycobacterial compounds from Curtisia dentata (Burm.f.) C.A.Sm (Curtisiaceae)

BACKGROUND

Tuberculosis is counted amongst the most infectious and lethal illnesses worldwide and remains one of the major threats to human health. The aim of the current study was to isolate and characterize anti-mycobacterial compounds present in Curtisia dentata (Burm.f.) C.A.Sm , a medicinal plant reportedly used in the treatment of tuberculosis, stomach ailments and sexually transmitted infections.

METHODS

The bioassay guided principle was followed to isolate the anti-mycobacterial compounds. The crude ethanol extracts of the leaves was partitioned with various solvents four compounds such as β-sitosterol, betulinic acid, ursolic acid and lupeol were successfully isolated. The compounds and their derivatives were evaluated for anti-mycobacterial activity using Microplate Alamar Blue Assay (MABA) against Mycobacterium tuberculosis H37RV (ATCC 27294). Furthermore, the derivatives were investigated for their toxicity against HepG2 and HEK293 using the MTT assay.

RESULTS

The methanol fraction had the lowest minimum inhibitory concentration (MIC) of 22.2 μg/ml against the selected Mycobacterium strain when compared to other fractions. Ursolic acid acetate (UAA) was the most active compound with MIC value of 3.4 μg/ml. The derivatives had varying degrees of toxicity, but were generally non-toxic to the selected cell lines. Derivatives also exhibited highest selectivity index and offers a higher safety margin.

CONCLUSIONS

The derivatives had better antimicrobial activity and low cytotoxic effects compared to isolated compounds. These increased their selectivity. It appears that acetylation of both betulinic acid and ursolic acid increased their activity against the selected Mycobacterium species. The results obtained in this study gives a clear indication that Curtisia dentata may serve as major source of new alternative medicines that may be used to treat TB. Furthermore, there is a need to explore the activity of these tested plant against other pathogenic Mycobacterium species.

Phytomedical assessment of two Cymbopogon species found in Nkonkobe Municipality: toxicological effect on human Chang liver cell line

Background

Cymbopogon species are widely used as herbal remedies by the traditional healers living in Nkonkobe Municipality for the treatment and management of skin and respiratory infections. According to our survey, the plants seem to be very important because of the higher demands.

Methods

The leaves of C. validis and C. plurinodis were hydro-distilled and the resulted extracted oils were analyzed by GC/MS. Minimum inhibitory concentrations (MICs) ranging from 7.8 to 500.0 μg/ml of the extracted oils were tested against eight bacterial strains, using micro-well dilution method. The human Chang liver cell viability was determined using the CellTiter-Blue cell assay.

Results

GC-MS analysis of the C. validis essential oil amounted to 87.03%, major components identified were Linalyl alcohol (18.9%), 2-Nephthalenemethanol (6.67%), Longifolene (6.53%), Cubedol (6.08%). Total oil percentage of C. plurinodis was 81.47% and the main components were characterized as 3-Cyclohexane-1-ol (13.58%), Nerolidol (13.6%) and 2-Carene (12.6%). The essential oils from both plants were found to be active against the growth of Gram positive than the Gram negative bacterial tested. Lethal dose at 50 (LD₅₀) of both plants showed 74.87 ± 1.41 and 81.66 ± 1.40 degree of toxicity at 24 h.

Conclusion

Both plants extracts were toxic to human Chang liver cell lines.

Ethnobotanical survey of medicinal plants used to manage High Blood Pressure and Type 2 Diabetes Mellitus in Bitterfontein, Western Cape Province, South Africa

ETHNOPHARMACOLOGICAL RELEVANCE

The aim of this study was to identify and document medicinal plants used to manage High Blood Pressure and Type 2 Diabetes Mellitus in Bitterfontein, Western Cape Province, South Africa.

METHODS

One hundred and twelve (112) respondents were interviewed between August 2014 and September 2015 through semi-structured surveys to gather data on the percentage of people who had been diagnosed with High Blood Pressure and/or Type 2 Diabetes Mellitus and to determine the frequency of medicinal plant and allopathic medicine use. Twelve (12) key respondents were subsequently selected, using a non-probability snowball sampling method. They were interviewed in-depth concerning their plant practices and assisted with plant collection.

RESULTS

Twenty-four plant (24) species belonging to 15 families were identified for the management of High Blood Pressure and Type 2 Diabetes Mellitus. The most frequently reported families were Asteraceae (20.8%), Lamiaceae (16.67%), Crassulaceae (8.33%) and Aizoaceae (8.33%). The remaining (45.54%) were evenly split over eleven families- Fabaceae, Amaryllidaceae, Anacardiaceae, Capparaceae, Geraniaceae, Apiaceae, Convolvulaceae, Apocynaceae, Rutaceae, Asphodelaceae and Thymelaeaceae. The most commonly used plant species overall was Lessertia frutescens (96.55%). The most frequently used plant parts included leaves (57.63%) roots/bulbs (15.25%) and stems (11.86%), mostly prepared as infusions or decoctions for oral administration.

CONCLUSIONS

Medicinal plants are widely used by High Blood Pressure and Type 2 Diabetes Mellitus sufferers. They employ diverse plant species to manage both conditions. In addition, some sufferers often use prescribed allopathic medication, as well as medicinal plants, but at different intervals. Despite high usage the plants identified are not currently threatened (Red Data list status: least concern).

Identification of bacterial contaminants in polyherbal medicines used for the treatment of tuberculosis in Amatole District of the Eastern Cape Province, South Africa, using rapid 16S rRNA technique

BACKGROUND

Polyherbal medicines are used for the treatment of many diseases in many African and Asian communities. With the increasing use of these remedies, several investigations have shown that they are associated with a broad variety of residues and contaminants. This study investigates the presence of bacteria in the polyherbal medicines used for the treatment of tuberculosis (TB) in the Eastern Cape Province of South Africa.

METHODS

Bacterial DNA was extracted from the polyherbal medicines, and a fragment of the bacterial 16S rRNA gene was amplified by PCR with universal primers 27F and 518R. The amplicons were visualised on agarose gel electrophoresis, followed by end repair and adaptor ligation. They were further purified and quantified using Library Preparation kit NEBNext® UltraT DNA Library Prep Kit for Illumina, and the amplicons were run on illumina's MiSeq platform.

RESULTS

Different bacterial species were identified in all each of the polyherbal medicines. Generally, the most prominent and common bacteria recovered from all the samples were Bacillus sp., Enterobacter sp., Klebsiella sp., Rahnella sp., Paenibacillus sp., Clostridium sp. and Pantoea sp. Others are Pseudomonas sp., Raoultella ornithinolytica, Salmonella enterica and Eubacterium moniliforme.

CONCLUSIONS

This study, thus, revealed the presence of pathogenic and non-pathogenic bacteria in the polyherbal medicines used for the treatment of tuberculosis in the study area. The implications of the findings are discussed in relation to the health care of the patients of tuberculosis in the study area, having in mind that they are immunocompromised individuals.

MEDICINAL HERBS USED BY HIV-POSITIVE PEOPLE IN LESOTHO

BACKGROUND

The use of medicinal herbs whose efficacy and toxicities are not known by HIV-positive people in Lesotho is a threat to the effectiveness of antiretroviral treatment. This study explored some medicinal herbs used by HIV-positive people in Lesotho and the reasons for their use.

METHODS

This was a cross sectional study based on a questionnaire distributed to purposively-sampled HIV-positive people in Leribe and Maseru districts of Lesotho. The participants' socio-demographic and clinical variables were summarized using frequency tables in Stata version 13 statistical software. Data variables for medicinal herbs used, frequency of use, uses by the participants and in the literature, parts of plants used and the method of preparation were also explored.

RESULTS

Out of 400 questionnaires distributed to the participants, 389 were returned with data acceptable for analysis. Ages of the participants ranged from 18 to 75 years (Mean=43 + 11.6). Out of the 272 (69.9%) participants who conceded that they had used medicinal herbs at least once, 30 (7.7%) participants used medicinal herbs frequently while 242 (62.2 %) rarely used the herbs. At least 20 plant species belonging to 16 families were reportedly used by the participants. Asteraceae was the most common plant family reportedly used by the participants. Allium sativum and Dicoma anomala, reportedly used by 21.0% and 14.3% respectively, were the most commonly used medicinal herbs in this population. In addition, boosting the immune system and treating gastrointestinal ailments, apparently cited by 32% and 28% participants respectively, were the most commonly reported reasons for using medicinal herbs.

CONCLUSION

A considerable proportion (69.9%) of HIV-positive people use medicinal herbs in this population, and 7.7% use them frequently. At least 20 plant species belonging to 16 families were reportedly used by the participants. HIV counselling protocols in Lesotho should emphasize the dangers of using medicinal herbs whose safety and compatibility with antiretroviral drugs is not known. The efficacy and toxicity profiles of the medicinal plants identified in this study need to be investigated. Furthermore, the effects of these plants on antiretroviral treatment outcomes including herb-drug interactions need to be explored.