Systematic review on traditional medicinal plants used for the treatment of malaria in Ethiopia: trends and perspectives

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.

Medicinal plants used by traditional medicine practitioners in treatment of alcohol-related disorders in Bushenyi District, southwestern Uganda

Background

Alcohol-related disorders rank seventh among risk factors for morbidity and mortality globally, posing a significant public health burden. In Africa, including Uganda, there is limited availability and utilization of pharmacotherapies to treat alcohol-related disorders. This study documented medicinal plant species, plant parts used, and the methods of preparation and administration utilized by Traditional Medicine Practitioners (TMPs) in treating alcohol-related disorders in southwestern Uganda.

Methods

A descriptive cross-sectional ethnopharmacological survey was conducted among TMPs within Bushenyi District, southwestern Uganda. Data was collected with key informant interviews using semi-structured questionnaires. The TMPs identified medicinal plants by local names. Plant specimens were collected and deposited at the Department of Biology, Faculty of Science, Mbarara University for identification and voucher numbers allocated. The plant scientific names and species were identified based on the International Plant Names Index. Plant species, family, life form, number of mentions, method of collection, preparation and administration were analyzed using descriptive statistics in Microsoft Excel. The survey data were utilized to compute Frequency of Citation, Relative Frequency of Citation, and Informant Consensus Factor.

Results

We enrolled 50 traditional medicine practitioners aged between 34 and 98 years, with a mean age of 67. Approximately two-thirds were female (66%, 33/50), and mean experience in traditional healing was 31 years. The total number of plants identified were 25 belonging to 20 families. The most prevalent plant life form was herbs (36%) while grasses (4%), were the least. Leaves (48%) were the most utilized plant parts with the least utilized being the barks. The most prevalent method, adopted by approximately one-third of the TMPs, involved drying the plant material in the sun. The Informant Consensus Factor was 0.67.

Conclusion

The study shows that the traditional medicine practitioners in Bushenyi district use a wide diversity of plants species to treat alcohol related disorders. The relatively high Informant Consensus Factor suggests a significant level of agreement among TMPs regarding the use of the identified plants. We recommend further investigations into phytochemistry, safety, efficacy, and mechanisms of action of the identified plants.

Phytochemical evaluation of Ziziphus mucronata and Xysmalobium undulutum towards the discovery and development of anti-malarial drugs

BACKGROUND

The development of resistance by Plasmodium falciparum is a burdening hazard that continues to undermine the strides made to alleviate malaria. As such, there is an increasing need to find new alternative strategies. This study evaluated and validated 2 medicinal plants used in traditional medicine to treat malaria.

METHODS

Inspired by their ethnobotanical reputation of being effective against malaria, Ziziphus mucronata and Xysmalobium undulutum were collected and sequentially extracted using hexane (HEX), ethyl acetate (ETA), Dichloromethane (DCM) and methanol (MTL). The resulting crude extracts were screened for their anti-malarial and cytotoxic potential using the parasite lactate dehydrogenase (pLDH) and 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide (MTT) assay, respectively. This was followed by isolating the active compounds from the DCM extract of Z. mucronata using silica gel chromatography and structural elucidation using spectroscopic techniques (NMR: 1H, 12C, and DEPT). The active compounds were then targeted against P. falciparum heat shock protein 70-1 (PfHsp70-1) using Autodock Vina, followed by in vitro validation assays using ultraviolet-visible (UV-VIS) spectroscopy and the malate dehydrogenase (MDH) chaperone activity assay.

RESULTS

The extracts except those of methanol displayed anti-malarial potential with varying IC50 values, Z. mucronata HEX (11.69 ± 3.84 µg/mL), ETA (7.25 ± 1.41 µg/mL), DCM (5.49 ± 0.03 µg/mL), and X. undulutum HEX (4.9 ± 0.037 µg/mL), ETA (17.46 ± 0.024 µg/mL) and DCM (19.27 ± 0.492 µg/mL). The extracts exhibited minimal cytotoxicity except for the ETA and DCM of Z. mucronata with CC50 values of 10.96 and 10.01 µg/mL, respectively. Isolation and structural characterization of the active compounds from the DCM extracts revealed that betulinic acid (19.95 ± 1.53 µg/mL) and lupeol (7.56 ± 2.03 µg/mL) were responsible for the anti-malarial activity and had no considerable cytotoxicity (CC50 > µg/mL). Molecular docking suggested strong binding between PfHsp70-1, betulinic acid (- 6.8 kcal/mol), and lupeol (- 6.9 kcal/mol). Meanwhile, the in vitro validation assays revealed the disruption of the protein structural elements and chaperone function.

CONCLUSION

This study proves that X undulutum and Z. mucronata have anti-malarial potential and that betulinic acid and lupeol are responsible for the activity seen on Z. mucronata. They also make a case for guided purification of new phytochemicals in the other extracts and support the notion of considering medicinal plants to discover new anti-malarials.

A scoping review on efficacy and safety of medicinal plants used for the treatment of diarrhea in sub-Saharan Africa

BACKGROUND

In sub-Saharan Africa (SSA), significant morbidity and mortality have been linked to diarrhea, which is frequently caused by microorganisms. A rise in antimicrobial-resistant pathogens has reignited the search for alternative therapies. This scoping review aims to map the literature on medicinal plants in relation to their anti-diarrheal potential from SSA.

METHODS

Studies published from 1990 until April 2022 on medicinal plants used for the treatment of diarrhea from each country in SSA were searched on Scopus, Web of Science, Science Direct and PubMed. The selection of articles was based on the availability of data on the in vitro and/or in vivo, ethnobotanical, and cross-sectional studies on the efficacy of medicinal plants against diarrhea. A total of 67 articles (ethnobotanical (n = 40); in vitro (n = 11), in vivo (n = 7), cross-sectional (n = 3), in vitro and in vivo (n = 2) and ethnobotanical and in vitro (n = 2), were considered for the descriptive analysis, which addressed study characteristics, herbal intervention information, phytochemistry, outcome measures, and toxicity findings.

RESULTS

A total of 587 different plant species (from 123 families) used for diarrhea treatment were identified. Most studies were conducted on plants from the Fabaceae family. The plants with the strongest antimicrobial activity were Indigofera daleoides and Punica granatum. Chromatographic methods were used to isolate six pure compounds from ethyl acetate extract of Hydnora johannis, and spectroscopic methods were used to determine their structures. The majority of anti-diarrheal plants were from South Africa (23.9%), Ethiopia (16.4%), and Uganda (9%). This study highlights the value of traditional remedies in treating common human diseases such as diarrhea in SSA.

CONCLUSION

Baseline knowledge gaps were identified in various parts of SSA. It is therefore recommended that future ethnobotanical studies document the knowledge held by other countries in SSA that have so far received less attention. Additionally, we recommend that future studies conduct phytochemical investigations, particularly on the widely used medicinal plants for the treatment of diarrheal illnesses, which can serve as a foundation for future research into the development of contemporary drugs.

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.

Antimalarial potential of Moringa oleifera Lam. (Moringaceae): A review of the ethnomedicinal, pharmacological, toxicological, and phytochemical evidence

Several regions of the world frequently use the species Moringa oleifera Lam. (Moringaceae) in traditional medicine. This situation is even more common in African countries. Many literature reports point to the antimalarial potential of this species, indicating the efficacy of its chemical compounds against malaria-causing parasites of the genus Plasmodium. From this perspective, the present study reviews the ethnobotanical, pharmacological, toxicological, and phytochemical (flavonoids) evidence of M. oleifera, focusing on the treatment of malaria. Scientific articles were retrieved from Google Scholar, PubMed^®, ScienceDirect^®, and SciELO databases. Only articles published between 2002 and 2022 were selected. After applying the inclusion and exclusion criteria, this review used a total of 72 articles. These documents mention a large use of M. oleifera for the treatment of malaria in African and Asian countries. The leaves (63%) of this plant are the main parts used in the preparation of herbal medicines. The in vivo antimalarial activity of M. oleifera was confirmed through several studies using polar and nonpolar extracts, fractions obtained from the extracts, infusion, pellets, and oils obtained from this plant and tested in rodents infected by the following parasites of the genus Plasmodium: P. berghei, P. falciparum, P. yoelii, and P. chabaudi. Extracts obtained from M. oleifera showed no toxicity in preclinical tests. A total of 46 flavonoids were identified in the leaves and seeds of M. oleifera by different chromatography and mass spectrometry methods. Despite the scarcity of research on the antimalarial potential of compounds isolated from M. oleifera, the positive effects against malaria-causing parasites in previous studies are likely to correlate with the flavonoids that occur in this species.

Zero malaria: a mirage or reality for populations of sub-Saharan Africa in health transition

The global burden of malaria continues to be a significant public health concern. Despite advances made in therapeutics for malaria, there continues to be high morbidity and mortality associated with this infectious disease. Sub-Saharan Africa continues to be the most affected by the disease, but unfortunately the region is burdened with indigent health systems. With the recent increase in lifestyle diseases, the region is currently in a health transition, complicating the situation by posing a double challenge to the already ailing health sector. In answer to the continuous challenge of malaria, the African Union has started a "zero malaria starts with me” campaign that seeks to personalize malaria prevention and bring it down to the grass-root level. This review discusses the contribution of sub-Saharan Africa, whose population is in a health transition, to malaria elimination. In addition, the review explores the challenges that health systems in these countries face, that may hinder the attainment of a zero-malaria goal.

In Vivo Antimalarial Activity of the Leaf Extract of Osyris quadripartita Salzm. ex Decne and Its Major Compound (–) Catechin

Background

The leaves of Osyris quadripartita Salzm. ex Decne, endemic to Ethiopia, are traditionally used for the treatment of malaria. Previous phytochemical investigations of Osyris species showed the presence of flavonoids, anthracene derivatives, and sesquiterpene lactones as the main constituents. The aim of the present study was to investigate the antimalarial activity of the leaf extract of O. quadripartita and its isolated constituent against mice infected with Plasmodium berghei.

Methods

Isolation of a compound was carried out on silica gel column chromatography of the extract eluting with gradient mixtures of CHCl₃/MeOH. Structural elucidation of the isolated compound was achieved by ESI-MS and 1D-and 2D-NMR spectral data. Peter's 4-day suppressive test method was used to determine the antimalarial activity of the test substances. Level of parasitemia, survival time, and body weight change were used to determine the antimalarial activity of the test substances.

Results

(–) Catechin was isolated and characterized from the hydroalcoholic extract of O. quadripartita. At a concentration of 400 mg/kg, both the extract and (–) catechin exhibited antimalarial activity with the highest chemosuppression values of 70.61% and 64.26%, respectively.

Conclusion

These findings indicate that O. quadripartita is endowed with genuine antimalarial activity attributed in part, to its (–) catechin content. Hence, the present study may validate the traditional use of the plant for the treatment of malaria.

A Review on Medicinal Plants Used in the Management of Respiratory Problems in Ethiopia over a Twenty-Year Period (2000–2021)

This review is aimed at assessing and compiling the different ethnomedicinal studies in different parts of Ethiopia used to treat respiratory diseases. The data were collected from different published research papers through searching the web sources such as PubMed, Science Direct, Google Scholar, and other related websites. The important search terminologies included ethnobotany, respiratory diseases, medicinal plants, and Ethiopia. For this, a total of 65 articles of recent publications (from 2000 to May 2021 years) that provided full information about the use of medicinal plant species to treat respiratory disorder diseases in Ethiopia were consulted. Based on this, a total of 96 medicinal plants belonging to 57 families were reviewed. The commonly recorded families used to manage respiratory problems were Asteraceae, Lamiaceae, Solanaceae, and Fabaceae. Herbs and shrubs were the dominant plant growth forms. Due to the easiest form of their preparation for treating respiratory disorders, leaves are the most cited plant parts followed by roots. Crushing and pounding are useful methods of remedy preparation to treat respiratory diseases. This review concluded that different medicinal plants have a significant contribution in combating serious respiratory problems in Ethiopia. Hence, the complied review of medicinal plants on the treatment of respiratory problems would play a great role in further pharmacological and phytochemical investigations in developing new drugs used for the treatment of respiratory problems and in the conservation of these important medicinal plants.

Medicinal Plants Used to Treat Human and Livestock Ailments in Basona Werana District, North Shewa Zone, Amhara Region, Ethiopia

This study was conducted on medicinal plants used for the treatment of human and livestock ailments in Basona Werana District, North Shewa Zone, Amhara Region. Data were collected through semi-structured interviews, field walk observation, preference, and direct matrix ranking with randomly and purposefully selected informants. A total of 80 respondents (46 men and 14 women) and 20 (16 men and 4 women) traditional healers participated in this study. A total of 76 plant species distributed in 75 genera and 45 families were collected and identified. Of the 76 medicinal plants collected from the study area, 85.5% were used to treat human ailments. The Lamiaceae came out as a leading family with 8 (10.5%) species followed by Asteraceae and 7 (9%) medicinal plant species each, while Solanaceae followed with 6 (7.8%) species. The majority of medicinal plants were collected from wild habitat and accounted for 56 plant species (73.6%). The result of growth form analysis showed that herbs constituted the highest proportion of medicinal plants represented by 33 species (43.4%), followed by shrubs with 30 species (39.4%) and trees with 10 species (13.1%). The medicinal plants were administered through oral, which accounts for 54 species (48.1%), followed by dermal with 38 species (33.9%) and nasal with 9 species (8%), respectively. Leaves were the most frequently used plant parts for the preparation of traditional herbal medicines in the study area. Crushing was the widely used preparation method (33.9%) followed by pounding (16%). Cucumis ficifolius A. Rich. was the most preferred plant used to treat stomachache. Phytochemical and pharmacological studies of this type of plant are recommended to get the most out of the plant.

A Systematic Review of Medicinal Plants of Kenya used in the Management of Bacterial Infections

Kenya’s vision 2030 partly aims at ensuring adequate health care for all, and the integration of traditional healthcare practices into the national healthcare system would present a more rapid alternative towards the realization of universal health coverage in Kenya. Currently, research on Kenyan medicinal plants with potential antibacterial activity remains vastly fragmented across numerous literature studies and databases; thus, it is imperative to collate and appraise these data for the ease of future research and possible clinical application. Objective. This review aims at exploring and compiling research evidence on medicinal plants used in the management of bacterial infections in Kenya, with a focus on their efficacy and safety. Methodology. A comprehensive web-based systematic review using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines was executed to highlight the Kenyan medicinal plants used for the management of bacterial infections in Kenya. This review includes studies published until January 2021 from the PubMed, Science Direct, AJOL, and Google Scholar databases. Results. A total of 105 Kenyan medicinal plants belonging to 43 families have their in vitro activity against various human pathogenic bacteria evaluated. Plants from the Lamiaceae, Rutaceae, and Fabaceae families were the most commonly studied. Aloe secundiflora, Toddalia asiatica, Senna didymobotrya, Warbugia ugandensis, Tithonia diversifolia, Fuerstia africana, Olea africana, and Harrisonia abyssinica were the plants frequently evaluated within Kenya. The plants with the strongest antimicrobial activities were Toddalia asiatica, Hagenia abyssinica, Ocimum gratissimum, Harrisonia abyssinica, Senna didymobotrya, Olea Africana, Camellia sinensis, and Tarmarindus indica. Conclusion. Based on a published work, it is evident that traditional medicine is seemingly an acceptable and efficient system among Kenyan communities in the management of bacterial infections. Kenya’s rich biodiversity with diverse secondary metabolites presents a promising source of new therapeutic alternatives with possibly different mechanisms of action against bacteria.

Ethnobotanical Survey of Local Flora Used for Medicinal Purposes among Indigenous People in Five Areas in Lagos State, Nigeria

Traditional medicine is typically the most accessible primary healthcare for a large proportion of the people in Nigeria. However, its potential remains under-explored, especially with regards to their documentation. This research investigated and documented the use of medicinal plants in the management of various health conditions/diseases among local populations in Lagos State. This study was conducted in five (5) locations of Lagos State i.e., Alimosho, Badagry, Eti-Osa, and Epe (including Ijebu and Imota). Ethnobotanical information from 100 participants was obtained using semi-structured questionnaires. Frequency of citation (FC), relative frequency of citation (RFC), fidelity level (FL), and informant consensus factor (ICF) were used to assess the importance of plants utilised for various health conditions/diseases. We identified 183 plants from 61 plant families with the highest number (24) of plants belonging to Fabaceae. Based on the high FC, the top-five popular plants used for managing health conditions/diseases in the study areas were Mangifera indica (95%), Waltheria indica (93%), Zingiber officinale (87%), Alchornea cordifolia (83%) and Ipomoea involucrata (81%). Furthermore, Rauvolfia vomitoria, Urena lobata and Waltheria indica were recognised as the most adaptable plants, as they were used to treat five different health conditions/diseases. The most commonly used life-forms were herbs (34%) and woody species (shrubs; 30%, and trees; 22%). The most regularly used plant parts were leaves. The calculated RFC values for all medicinal plant species ranged from 0.01 to 0.95, while FL values ranged from 7.14 to 100%. We found 14 health conditions/diseases, with ICF values ranging from 0.88 to 0.95. Insomnia, insanity, convulsion, nervousness, and muscle relaxants had the lowest (ICF = 0.88) agreement, while malaria/fevers, stomach, and respiratory-related diseases had the most (ICF = 0.95) agreement. The documented therapeutic uses of the plants provide basic data for further research aimed at pharmacological and conservation studies of the most important flora existing in the study areas.

Anti-malarial plants in Ethiopia and their activities on drug resistant malaria

In Ethiopia, the impacts of malaria continue to cause a many number of morbidity and mortality that accounts to most outpatient observations. Ethiopia recently designed to attain nationwide malaria control by 2030 by beginning sub-national elimination in districts with low malaria transmission. However, the rises of drug-resistant parasites, especially Plasmodium falciparum hinder the malaria containment strategies. Plasmodium falciparum and Plasmodium vivax, dispersed all over the Ethiopia and accounting for 60% and 40% of malaria cases respectively. The aim of this report was to overview the phytochemical constituents, diversity and effect of some compound extracts on drug resistant plasmodium species. Many plant species, a total 200 identified by 82 studies, are used in traditional malaria treatments throughout the country. Allium sativum, Croton macrostachyus and Carica papaya were the more frequently used medicinal plants species. There are so many phytochemicals constituents found in medicinal plants used to treat malaria. Alkaloids, Flavonoids, Phenolics, Terpenoid and Glycosides are the most reported for their effective activity on drug resistant malaria.

Anti-malarial activity in a Chinese herbal supplement containing Inonotus obliquus and Panax notoginseng

Plasmodium falciparum, the most virulent human malaria parasite, causes serious diseases among the infected patients in the world and is particularly important in African regions. Although artemisinin combination therapy is recommended by the WHO for treatment of P. falciparum-malaria, the emergence of artemisinin-resistant parasites has become a serious issue which underscores the importance of sustained efforts to obtain novel chemotherapeutic agents against malaria. As a part of such efforts, thirty-nine herbal extracts from traditional Chinese medicine (TCM) were assayed for their anti-malarial activity using 3D7 strain of P. falciparum. Three herbal supplements appeared to possess higher specific anti-malarial activity than the others. One of them (D3) was separated by two sequential fractionations with reverse-phase (the first step) and normal-phase (the second step) liquid chromatography, in which some fractions resulted in higher specific activities than those of D3 or the previous fractions. Cell toxicity assay was performed with the fractions of the first fractionation and demonstrated no obvious cell toxicity. These results suggest that structure determination of the major compound for the anti-malarial activity in D3 may help the development of more potent chemicals in the future.

Community knowledge, perceptions, and practices regarding malaria and its control in Jabi Tehnan district, Amhara Region, Northwest Ethiopia

Background

Use of long-lasting insecticidal nets (LLINs), indoor residual spraying (IRS), community-based malaria education, prompt diagnosis and treatment are key programme components of malaria prevention and control in Ethiopia. However, the effectiveness of these interventions is often undermined by various challenges, including insecticide and drug resistance, the plasticity of malaria vectors feeding and biting behaviour, and certain household factors that lead to misuse and poor utilization of LLINs. The primary objective of this study was to document households’ perceptions towards malaria and assess the prevalence of the disease and the constraints related to the ongoing interventions in Ethiopia (LLINs, IRS, community mobilization house screening).

Methods

The study was conducted in Jabi Tehnan district, Northwestern Ethiopia, from November 2019 to March 2020. A total of 3010 households from 38 villages were randomly selected for socio-economic and demographic survey. Focus group discussions (FGDs) were conducted in 11 different health clusters considering agro-ecological differences. A total of 1256 children under 10 years of age were screened for malaria parasites using microscopy to determine malaria prevalence. Furthermore, 5-year malaria trend analysis was undertaken based on data obtained from the district health office to understand the disease dynamics.

Results

Malaria knowledge in the area was high as all FGD participants correctly identified mosquito bites during the night as sources of malaria transmission. Delayed health-seeking behaviour remains a key behavioural challenge in malaria control as it took patients on average 4 days before reporting the case at the nearby health facility. On average, households lost 2.53 working days per person-per malaria episode and they spent US$ 18 per person per episode. Out of the 1256 randomly selected under 10 children tested for malaria parasites, 11 (0.89%) were found to be positive. Malaria disproportionately affected the adult segment of the population more, with 50% of the total cases reported from households being from among individuals who were 15 years or older. The second most affected group was the age group between 5 and 14 years followed by children aged under 5, with 31% and 14% burden, respectively.

Conclusion

Despite the achievement of universal coverage in terms of LLINs access, utilization of vector control interventions in the area remained low. Using bed nets for unintended purposes remained a major challenge. Therefore, continued community education and communication work should be prioritized in the study area to bring about the desired behavioural changes.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12936-021-03996-5.

In Vivo Antimalarial Activity of Polyalthia longifolia (Annonaceae) Leaf Extract and Assessment of Its Formulated Oral Dosage Forms

Plant medicine is commonly employed to treat malaria and other infections in Ghana. However, many of these phytomedicines have not been scientifically investigated to justify their use. This study therefore sought to investigate the antimalarial property of Polyalthia longifolia leaves and to formulate suitable dosage forms for ease of administration. A four-day antiplasmodial suppressive and curative study was conducted on ethanol extract of P. longifolia leaves (PLE) using Plasmodium berghei infected albino mice. Tablet and suspension dosage forms of PLE were formulated and evaluated for quality and stability. Statistically significant (P < 0.05) parasitaemia suppression (61.25%) and cure (58.78%) were achieved at a PLE dose of 100 mg/kg, and increases in hematological indices (P < 0.001) were also observed in the PLE-treated mice as compared to the untreated group. The tablets passed the tests for uniformity of weight, friability (<1%), hardness, disintegration (<15 minutes), and in vitro dissolution (>70% release in 45 minutes). The sedimentation volume, rheology, viscosity, and pH of the formulated suspension were within the official specifications. The dosage forms showed consistency in PLE content (85-105%) and no changes in physicochemical properties over the six months period of stability study. The in vivo antimalarial activity of PLE has been established and oral dosage forms that conformed to Pharmacopoeial standards are formulated for use in the management of malaria.

Medicinal Plants for Mitigating Pain and Inflammatory-Related Conditions: An Appraisal of Ethnobotanical Uses and Patterns in South Africa

In South Africa, traditional medicine remains the first point of call for a significant proportion of the population seeking primary healthcare needs. This is particularly important for treating common conditions including pain and inflammation which are often associated with many disease conditions. This review focuses on the analysis of the trend and pattern of plants used for mitigating pain and inflammatory-related conditions in South African folk medicine. An extensive search was conducted using various scientific databases and popular ethnobotanical literature focusing on South African ethnobotany. Based on the systematic analysis, 38 sources were selected to generate the inventory of 495 plants from 99 families that are considered as remedies for pain and inflammatory-related conditions (e.g., headache, toothache, backache, menstrual pain, and rheumatism) among different ethnic groups in South Africa. The majority (55%) of the 38 studies were recorded in three provinces, namely, KwaZulu-Natal, Limpopo, and Western Cape. In terms of the number of mentions, the most popular plants used for pain and inflammatory-related conditions in South Africa were Ricinus communis L. (10), Aloe ferox Mill. (8), Pentanisia prunelloides subsp. latifolia (Hochst.) Verdc. (8), Dodonaea viscosa Jacq var. angustifolia (L.f) Benth. (8), (L.) W.T.Aiton. (7) Ruta graveolens L. (7), and Solanum aculeastrum Dunal. (7). The top five plant families represented were Asteraceae (13%), Fabaceae (8%), Apocynaceae (4.3%), Asparagaceae (4%), and Lamiaceae (4%). An estimated 54% of the recorded plants were woody (trees and shrubs) in nature, while the leaves (27%) and roots (25%) were the most dominant plant parts. The use of plants for alleviating pain and inflammatory-related conditions remains popular in South African folk medicine. The lagging ethnobotanical information from provinces such as North West, Gauteng, and Free State remains a gap that needs to be pursued meticulously in order to have a complete country-wide database.

In vivo antiplasmodial activity of hydromethanolic leaf extract and solvent fractions of Maytenus gracilipes (Celastraceae) against Plasmodium berghei in mice

BACKGROUND

The incidence of resistance among currently available antimalarial drugs, as well as the high economic cost of malaria, has prompted researchers to look for novel antimalarial molecules. As a result, the current study was proposed to evaluate the antiplasmodial activity (in vivo) of Maytenus gracilipes based on the plant's traditional claims.

METHODS

A cold maceration procedure using 80% methanol as a solvent was employed to obtain a crude extract from M. gracilipes leaves. Chloroform, n-butanol, and pure water were used to fractionate the hydromethanolic extract. Standard procedures were followed for an acute oral toxicity test. The antimalarial effects of the plant at 200, 400, and 600 mg/kg doses were investigated using three rodent malaria models (4-day suppressive, rane's, and repository tests). Thirty mice were utilized in each experiment (3 treatment and 2 control groups, each with six mice). Parasitemia, survival time, body weight, temperature, and packed cell volume were all used to assess the extracts' antiplasmodial activity. To compare results between groups, a one-way ANOVA with Post Hoc Tukey's HSD was used.

RESULTS

In a 4-day suppressive investigation, all doses of the crude extract and fractions suppressed parasitemia significantly (P < 0.001) as compared to the negative control. The crude extract had the greatest chemosuppressive effect (74.15%) at 600 mg/kg dose. Chloroform had the greatest parasitemia suppression among the fractions; however it was less than the crude extract. In Rane's test, all doses of the crude extract produced substantial (P < 0.001) curative effects as compared to the negative control.

CONCLUSION

According to this study, the crude extract and solvent fractions of M. gracilipes leaves contain antimalarial activity with a substantial suppressive effect. The antiplasmodial effects were more active in the chloroform and n-butanol fractions, indicating that the plant's non-polar and medium polar constituents are responsible. Nonetheless, further analysis is required to isolate and characterize the active compounds responsible for the study plant's antimalarial activity.

Studies on Activities and Chemical Characterization of Medicinal Plants in Search for New Antimalarials: A Ten Year Review on Ethnopharmacology

Malaria is an endemic disease that affected 229 million people and caused 409 thousand deaths, in 2019. Disease control is based on early diagnosis and specific treatment with antimalarial drugs since no effective vaccines are commercially available to prevent the disease. Drug chemotherapy has a strong historical link to the use of traditional plant infusions and other natural products in various cultures. The research based on such knowledge has yielded two drugs in medicine: the alkaloid quinine from Cinchona species, native in the Amazon highland rain forest in South America, and artemisinin from Artemisia annua, a species from the millenary Chinese medicine. The artemisinin-based combination therapies (ACTs), proven to be highly effective against malaria parasites, and considered as “the last bullet to fight drug-resistant malaria parasites,” have limited use now due to the emergence of multidrug resistance. In addition, the limited number of therapeutic options makes urgent the development of new antimalarial drugs. This review focuses on the antimalarial activities of 90 plant species obtained from a search using Pubmed database with keywords “antimalarials,” “plants” and “natural products.” We selected only papers published in the last 10 years (2011–2020), with a further analysis of those which were tested experimentally in malaria infected mice. Most plant species studied were from the African continent, followed by Asia and South America; their antimalarial activities were evaluated against asexual blood parasites, and only one species was evaluated for transmission blocking activity. Only a few compounds isolated from these plants were active and had their mechanisms of action delineated, thereby limiting the contribution of these medicinal plants as sources of novel antimalarial pharmacophores, which are highly necessary for the development of effective drugs. Nevertheless, the search for bioactive compounds remains as a promising strategy for the development of new antimalarials and the validation of traditional treatments against malaria. One species native in South America, Ampelozyzyphus amazonicus, and is largely used against human malaria in Brazil has a prophylactic effect, interfering with the viability of sporozoites in in vitro and in vivo experiments.

Evaluation of the Antimalarial Activity of Crude Extract of Eucalyptus globulus Labill. Leaf against Plasmodium berghei in Mice

Introduction

Traditional medicinal plants are used as a common source of developing new and effective antimalarial drugs. E. globulus leaf has been used in the traditional management of malaria in different countries, including Ethiopia. However, there is no in vivo study done on the antimalarial activity of the plant. Thus, this study aimed to evaluate the antimalarial activity of crude extract of E. globulus Labill. leaf in P. berghei-infected mice.

Method

The fresh leaves of E. globulus were collected, washed, air-dried, and made as coarse powder. Either sex of mice aged 6 to 8 weeks was used in the experiment. The antimalarial activity of the crude extract was tested in four-day suppressive, curative (Rane's), and prophylactic (repository) tests. The parameters like level of parasitemia, packed cell volume, body weight, rectal temperature, and mean survival time were recorded. The analysis of the data was done with SPSS version 20 with a 95% confidence interval in one-way ANOVA followed by Tukey's post hoc test.

Results

In all three antimalarial test models, the extract of leaf of E. globulus at all three doses suppressed the level of parasitemia significantly (p < 0.001), increased survival time (p < 0.05 to p < 0.001), and prevented a decrease in body weight as compared to the negative control. The middle and large doses of the extract also decreased loss of body temperature (p < 0.05 to p < 0.001) compared to the negative control. Reduction of packed cell volume was prevented within the three test doses of the extract in both curative and prophylactic tests and middle and large doses in the 4-day suppressive test compared to the negative control.

Conclusion

The crude extract of the plant showed promising antimalarial activity. This supports the traditional use and the in vitro test result of the plant.

A Review on Medicinal Plants Used in the Management of Headache in Africa

The use of medicinal plants in the management of diverse ailments is entrenched in the culture of indigenous people in African communities. This review provides a critical appraisal of the ethnobotanical uses of medicinal plants for the management of headache in Africa. Research articles published from 2010 (Jan) to 2021 (July) with keywords such as Africa, ethnobotany, headache, medicinal plant and traditional medicine were assessed for eligibility based on sets of pre-defined criteria. A total of 117 plants, representing 56 families, were documented from the 87 eligible studies. Asteraceae (10%), Fabaceae (10%), Lamiaceae (9%) and Mimosaceae (5%) were the most represented plant families. The most popular plant species used in the management of headache were Ocimum gratissimum L. (n = 7), Allium sativum L. (n = 3), Ricinus communis L. (n = 3) and Artemisia afra Jack. ex. Wild (n = 2). The leaves (49%), roots (20%) and bark (12%) were the most common plant parts used. Decoction (40%) and infusion (16%) were the preferred methods of preparation, whereas the oral route (52%) was the most preferred route of administration. The data revealed that medicinal plants continue to play vital roles in the management of headache in African communities. In an attempt to fully explore the benefits from the therapeutic potential of indigenous flora for common ailments, further studies are essential to generate empirical evidence on their efficacies, using appropriate test systems/models. This approach may assist with the ongoing drive towards the integration of African traditional medicine within mainstream healthcare systems.

Isolation and identification of carotenoid-producing yeast and evaluation of antimalarial activity of the extracted carotenoid(s) against P. falciparum

Plasmodial resistance to a variety of plant-based antimalarial drugs has led toward the discovery of more effective antimalarial compounds having chemical or biological origin. Since natural compounds are considered as safer drugs, in this study, yeast strains were identified and compared for the production of carotenoids that are well-known antioxidants and this metabolite was tested for its antiparasitic activity. Plasmodium falciparum 3D7 strain was selected as the target parasite for evaluation of antimalarial activity of yeast carotenoids using in vitro studies. Data were analyzed by FACS (fluorescence-activated cell sorter) and counted via gold standard Giemsa-stained smears. The extracted yeast carotenoids showed a profound inhibitory effect at a concentration of 10^-3 µg/µl and 10^-4 µg/µl when compared to β- carotene as control. SYBR Green1 fluorescent dye was used to confirm the decrease in parasitaemia at given range of concentration. Egress assay results suggested that treated parasite remained stalled at schizont stage with constricted morphology and were darkly stained. Non-toxicity of carotenoids on erythrocytes and on human liver hepatocellular carcinoma cells (HepG2 cells) was shown at a given concentration. This report provides strong evidence for antimalarial effects of extracted yeast carotenoids, which can be produced via a sustainable and cost-effective strategy and may be scaled up for industrial application.

Ethnoveterinary Knowledge and Biological Evaluation of Plants Used for Mitigating Cattle Diseases: A Critical Insight Into the Trends and Patterns in South Africa

Cattle farming is a traditional agricultural system that contribute to the rural economic, social and cultural values of the communities. Cattle as common with other livestock, are affected by many diseases that cause mortality and economic losses. In many rural households, the use of plants and associated knowledge are popular for managing cattle diseases especially in areas experiencing challenges with conventional veterinary medicine. Evidence on the documentation of indigenous knowledge and biological evaluation of plants used against cattle diseases remain understudied and fragmented. The aim of the review is to collate and analyse the ethnoveterinary knowledge and biological evaluation of plants used against cattle diseases in South Africa. Different scientific databases were systematically explored to extract data from 37 eligible studies. A total of 310 medicinal plants from 81 families used to treat 10 categories of cattle diseases across seven (7) provinces in South Africa. Leguminosae (Fabaceae), Compositae (Astereceae), Asparagaceae, and Xanthorrhoeaceae were the most frequently used plant families. Common plant parts used were leaves and roots. Twenty-seven (27) combination remedies involving 2–6 plants were identified as treatment regimes against cattle diseases. Common preparation methods were infusion and decoction while the administration mode was predominantly unspecified (52%) while oral and topical contributed 26 and 22%, respectively. In terms of diseases, the most treated ones were general systems infection, reproduction disorders and gastrointestinal problems. Currently, an estimated 21% of the 310 plants have been evaluated for diverse biological activities using relevant bioassays related to cattle diseases. Antibacterial activity remained the most studied biological activity. Evidence from the review revealed the significance of ethnoveterinary medicine against cattle diseases especially in rural areas of South Africa. Nevertheless, the use of plants for cattle diseases among other ethnic groups, particularly in the Northern Cape and Western Cape, remain under-studied.

Structure Differences of Water Soluble Polysaccharides in Astragalus membranaceus Induced by Origin and Their Bioactivity

Astragalus membranaceus is a functional food with multiple bioactivities. It presents differentiated health benefits due to origins. Polysaccharides (APS) are the leading bioactive macromolecules of A. membranaceus, which are highly related to its health benefits. However, the effect of origin on the structural characteristics of APSs remains unclear. In this work, polysaccharides from four origins were isolated and identified by NMR. The results showed APSs of four origins had identical monosaccharide composition and glycosidic linkage. Rhamnogalacturonan II pectins and α-(1→4)-glucan were the dominant polysaccharides. However, the level of methyl ester in pectins varied to a large extent. The molecular weight profiles of APSs were also different. Inner Mongolia APS had the largest percentage of 20-40 kDa polysaccharides. Molecular weight and methyl ester level were two important parameters determining the difference of APSs from four origins. These results were helpful to recognize the origin-related quality of A. membranaceus.

Antimalarial Activity of Seed Extracts of Schinus molle Against Plasmodium berghei in Mice

Background.

Malaria is a major public health problem in developing countries. In Ethiopian, the seeds of Schinus molle are used for the management of malaria. Therefore, the current study aimed to evaluate in vivo antimalarial activity of hydro-alcoholic crude extract and solvent fractions of Schinus molle seeds in Plasmodium berghei infected mice.

Methods.

An 80 percent of methanolic crude extract and solvent fractions of Schinus molle seeds were tested for antimalarial activity at 100, 200 and 400 mg/kg doses. The parasitemia level, packed cell volume, body weight, survival of date and rectal temperature were used to evaluate the anti-malarial activity of the extracts. One-way ANOVA followed by post hoc Tukey’s HSD multiple comparison test was employed and the result was expressed in mean ± SEM (standard error of the mean).

Results.

The curative activity of the highest dose of crude extract and aqueous fraction of Schinus molle seeds was 69.86% and 73.82% (p < 0.001), respectively. In the prophylactic test, aqueous fraction had 72.39% (p < 0.001) suppression antimalarial activity. Among solvent fractions, only chloroform fraction was significantly attenuated packed cell volume reduction. The mice treated with crude extract and aqueous fraction had longer survival date than vehicle-treated mice (p < 0.001).

Conclusion.

The experiment finding showed that the crude extract and solvent fractions of Schinus molle seeds had significant curative and prophylaxis anti-plasmodial activity. This result revealed that the Schinus molle seeds extract has promising antimalarial activity against Plasmodium berghei. However, further confirmatory studies, isolation and characterization of the active constituents are recommended.

Critical review of the Withania somnifera (L.) Dunal: ethnobotany, pharmacological efficacy, and commercialization significance in Africa

BACKGROUND

Withania somnifera (L.) Dunal (W. somnifera) is a herb commonly known by its English name as Winter Cherry. Africa is indigenous to many medicinal plants and natural products. However, there is inadequate documentation of medicinal plants, including W. somnifera, in Africa. There is, therefore, a need for a comprehensive compilation of research outcomes of this reviewed plant as used in traditional medicine in different regions of Africa.

METHODOLOGY

Scientific articles and publications were scooped and sourced from high-impact factor journals and filtered with relevant keywords on W. somnifera. Scientific databases, including GBIF, PubMed, NCBI, Google Scholar, Research Gate, Science Direct, SciFinder, and Web of Science, were accessed to identify the most influential articles and recent breakthroughs published on the contexts of ethnography, ethnomedicinal uses, phytochemistry, pharmacology, and commercialization of W. somnifera.

RESULTS

This critical review covers the W. somnifera ethnography, phytochemistry, and ethnomedicinal usage to demonstrate the use of the plant in Africa and elsewhere to prevent or alleviate several pathophysiological conditions, including cardiovascular, neurodegenerative, reproductive impotence, as well as other chronic diseases.

CONCLUSION

W. somnifera is reportedly safe for administration in ethnomedicine as several research outcomes confirmed its safety status. The significance of commercializing this plant in Africa for drug development is herein thoroughly covered to provide the much-needed highlights towards its cultivations economic benefit to Africa.

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.

Current Management Strategies of Chronic Kidney Disease in Resource-Limited Countries

The incidence and prevalence of chronic kidney disease (CKD) and kidney failure continues to increase worldwide, especially in resource-limited countries. Many countries in this category already have a massive burden of communicable diseases, as well as socio-economic and socio-demographic challenges. The rising CKD burden and exorbitant economic cost associated with treatment are mainly responsible for the alarming mortality rate associated with kidney disease in these regions. There is often poor risk factor (diabetes and hypertension) and CKD awareness in these countries and limited availability and affordability of treatment options. Given these observations, early disease detection and preventive measures remain the best options for disease management in resource-limited settings. Primary, secondary and tertiary preventive strategies need to be enhanced and should particularly include measures to increase awareness, regular assessment to detect hypertension, diabetes and albuminuria, options for early referral of identified patients to a nephrologist and options for conservative kidney management where kidney replacement therapies may not be available or indicated. Much is still needed to be done by governments in these regions, especially regarding healthcare funding, improving the primary healthcare systems and enhancing non-communicable disease detection and treatment programs as these will have effects on kidney care in these regions.

In Vivo Antimalarial Activity of Crude Fruit Extract of Capsicum frutescens Var. Minima (Solanaceae) against Plasmodium berghei-Infected Mice

BACKGROUND

The alarming spread of parasite resistance to current antimalarial agents is threatening malaria controlling efforts. This, consequently, urged the scientific community to discover novel antimalarial drugs. Successful and most potent antimalarial drugs were obtained from medicinal plants. Capsicum frutescens is claimed to possess an antiplasmodial activity in Ethiopian and Ugandan folkloric medicine. However, there is a lack of pharmacological evidence for its antiplasmodial activity. This study, hence, was aimed at evaluating the in vivo antiplasmodial activity of C. frutescens in a mouse model.

METHODS

The dried fruits of the plant were extracted with 80% methanol using cold maceration. A 4-day suppressive test was employed to ascertain the claimed antiplasmodial effect of the plant. Following inoculation with P. berghei, mice in treatment groups were provided with three dose levels (100, 200, and 400 mg/kg) of the extract, while 2% Tween 80 and chloroquine served as the negative and positive controls, respectively. Weight, temperature, packed cell volume, parasitemia, and survival time were then monitored.

RESULTS

The acute oral toxicity study revealed that the crude extract caused no mortality and revealed no overt sign of toxicity. In the 4-day suppressive test, all dose levels of the extract were found to exhibit a significant (p < 0.05) inhibition of parasitemia compared to those of the negative control. Maximum parasite suppression (93.28%) was exerted by the highest dose (400 mg/kg/day) of extract. Also, the extract significantly (p < 0.05) prolonged survival time and prevented body weight loss and reduction in temperature and anemia compared to the vehicle-treated group.

CONCLUSION

This investigation found strong evidence that the fruit extract of C. frutescens is endowed with promising antiplasmodial activity. Hence, the plant could serve as a potential source of a newer antimalarial agent.

Ethnobotanical study of selected medicinal plants traditionally used in the rural Greater Mpigi region of Uganda

ETHNOPHARMACOLOGICAL RELEVANCE

This study provides the first report on selected traditional medicinal plant use, including parts used and methods of preparation, in the Greater Mpigi region of Uganda. This data supports the conservation of local traditional ecological knowledge and will facilitate future drug discovery research.

AIM OF THE STUDY

Our study aimed to conserve culturally and scientifically-valuable medical knowledge of 16 plant species traditionally used in the Greater Mpigi region in Uganda, namely Albizia coriaria, Cassine buchananii, Combretum molle, Erythrina abyssinica, Ficus saussureana, Harungana madagascariensis, Leucas calostachys, Microgramma lycopodioides, Morella kandtiana, Plectranthus hadiensis, Securidaca longipedunculata, Sesamum calycinum subsp. angustifolium, Solanum aculeastrum, Toddalia asiatica, Warburgia ugandensis and Zanthoxylum chalybeum. An additional objective of the study was an ethnological investigation of the socio-cultural background and medical understanding of diseases treated by traditional healers in the study area.

MATERIALS AND METHODS

A pilot survey in the study area revealed that 16 plant species were frequently used in treatment of a variety of medical disorders. In order to obtain more complete information, we conducted a broader ethnobotanical survey using structured interviews with 39 traditional healers from 29 villages, specifically asking about the traditional uses of these 16 medicinal species.

RESULTS

Results of the survey confirmed a high level of traditional use of these species in the Greater Mpigi region. In addition, various other traditional uses and methods of preparation were recorded, most of them for the first time. In total, 75 different medical disorders treated with the plants were documented.

CONCLUSIONS

Conservation of traditional knowledge for future generations is vital, as loss has already been recorded due to multiple causes. The need for novel and more effective drugs derived from natural products is more important than ever, making future studies on herbal remedies both justified and urgently required. The traditional healers surveyed in this project also have expectations of the research - they would like to be updated about any resulting studies into the pharmacological efficacy of medicinal plants so that the research findings can inform their confidence in each herbal remedy.

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.

The potential of anti-malarial compounds derived from African medicinal plants: a review of pharmacological evaluations from 2013 to 2019

Background

African Traditional Medicine (ATM) is used for the healthcare of about 80% of the rural populations of the continent of Africa. The practices of ATM make use of plant-products, which are known to contain plant-based secondary metabolites or natural products (NPs), likely to play key roles in drug discovery, particularly as lead compounds. For various reasons, including resistance of strains of Plasmodium to known anti-malarial drugs, local African populations often resort to plant-based treatments and/or a combination of this and standard anti-malarial regimens. Emphasis has been laid in this review to present the anti-malarial virtue of the most recently published phytochemicals or natural products, which have been tested by in vitro and in vivo assays.

Methods

The data was based on the current version of the African Compound Libraries, which are constantly being updated based on inputs from journal articles and student theses (M.Sc/Ph.D) from African University libraries. Emphasis was laid on data published after 2012. In order to carry out the original data collection, currently being included in the African Compounds Database, individual journal websites were queried using the country names in Africa as search terms. Over 40,000 articles “hits” were originally retrieved, then reduced to about 9000 articles. The retained articles/theses was further queried with the search terms “malaria”, “malarial”, “plasmodium”, “plasmodial” and a combination of them, resulting in over 500 articles. Those including compounds with anti-malarial activities for which the measured activities fell within the established cut off values numbered 55, which were all cited in the review as relevant references.

Results and discussion

Pure compounds derived from African medicinal plants with demonstrated anti-malarial/antiplasmodial properties with activities ranging from “very active” to “weakly active” have been discussed. The majority of the 187 natural products were terpenoids (30%), followed by flavonoids (22%), alkaloids (19%) and quinones (15%), with each of the other compound classes being less than 5% of the entire compound collection. It was also observed that most of the plant species from which the compounds were identified were of the families Rubiaceae, Meliaceae and Asphodelaceae. The review is intended to continue laying the groundwork for an African-based anti-malarial drug discovery project.

Antimalarial Activity of Aqueous and 80% Methanol Crude Seed Extracts and Solvent Fractions of Schinus molle Linnaeus (Anacardiaceae) in Plasmodium berghei-Infected Mice

BACKGROUND

Malaria is among the leading causes of mortality and morbidity. Moreover, the emergence of resistance to antimalarial drugs is a major problem in controlling the disease. This makes the development of novel antimalarial drugs a necessity. Medicinal plants are important sources in discovering antimalarial drugs. Schinus molle is claimed for its antimalarial effect in Ethiopian folkloric medicine and endowed with in vitro antiplasmodial activity. In the present study, the in vivo antimalarial activity of the plant was investigated.

METHODS

Acute toxicity was carried out using a standard procedure. To screen the in vivo antimalarial activity of the plant was investigated. S. molle against Plasmodium berghei (ANKA), a 4-day suppressive test was employed. The extracts and fractions were given to infected mice by oral gavage at 100, 200, and 400 mg/kg/day for four consecutive days. Parameters such as parasitemia were then evaluated.

RESULTS

Any sign of toxicity was not observed in the oral acute toxicity test. The crude extracts and solvent fractions exerted a significant (p < 0.05) inhibition of parasite load compared to the negative control. The highest inhibition (66.91%) was exhibited by the 400 mg/kg/day dose of 80% methanolic crude extract. Among the fractions, chloroform fraction demonstrated maximal chemosuppressive effect (55.60%). Moreover, crude extracts and solvent fractions prevented body weight loss, reduction in temperature, and anemia compared to the negative control. Except the aqueous fraction, the tested plant extracts were able to significantly prolong the survival time of infected mice.

CONCLUSION

The findings of the present study confirmed the safety and a promising in vivo antimalarial activity of S. molle, thus supporting the traditional claim and in vitro efficacy. In-depth investigations on the plant, however, are highly recommended.in vivo antimalarial activity of the plant was investigated. S. molle against in vitro antiplasmodial activity. In the present study, the.

In Vivo Antimalarial Activity of 80% Methanol and Aqueous Bark Extracts of Terminalia brownii Fresen. (Combretaceae) against Plasmodium berghei in Mice

BACKGROUND

Despite a substantial scientific progress over the past two decades, malaria continues to be a worldwide burden. Evergrowing resistance towards the currently available antimalarial drugs is a challenge to combat malaria. Medicinal plants are a promising source of new drugs to tackle this problem. Thus, the present study aimed at evaluating the antiplasmodial activity of Terminalia brownii in Plasmodium berghei infected mice.

METHODS

A 4-day suppressive test was employed to evaluate the antimalarial effect of 80% methanol and aqueous bark extracts of T. brownii against P. berghei in Swiss albino mice.

RESULTS

The in vivo acute toxicity test indicated that both extracts of T. brownii against p < 0.001) compared to negative control. The maximum level of chemosuppression (60.2%) was exhibited at 400 mg/kg dose of 80% methanol extract. Moreover, the 80% methanol extract showed a significant (p < 0.001) compared to negative control. The maximum level of chemosuppression (60.2%) was exhibited at 400 mg/kg dose of 80% methanol extract. Moreover, the 80% methanol extract showed a significant (.

CONCLUSION

The present study indicated that hydromethanolic and aqueous bark extracts of T. brownii possess a promising antimalarial activity, with higher effect exhibited by the hydromethanolic extract.T. brownii against.

Medicinal Plants of the Maasai of Kenya: A Review

The use of medicinal plants for treatment of humans and animals is entrenched in the Maasai culture and traditional knowledge related to it is passed on from one generation to the next. A handful of researchers have in the past decades documented this knowledge. No single study has documented medicinal plant uses of the Maasai community as a whole. This review provides a consolidated database of the diversity and uses of medicinal plants among the Maasai in Kenya. The study will help conserve traditional medicinal plant knowledge that is valuable for the development of modern medicine. Relevant information on medicinal plants used by the Maasai of Kenya was extracted from journals, books, M.Sc., and Ph.D. dissertations. We found evidence of 289 plant species used by the Maasai of Kenya in traditional medicine. Most species were used to treat health conditions in the categories gastrointestinal and respiratory system disorders. The most used families were Leguminosae, Asteraceae, Malvaceae, Euphorbiaceae, and Lamiaceae. Medicines were commonly prepared as a decoction and administered through oral ingestion, with roots reported to be the preferred plant part for medication. The Maasai preference for roots compared to other plant parts may be unsustainable and could threaten species availability in the future.

The Use of Medicinal Plants for the Treatment of Toothache in Ethiopia

This paper presents a review of relevant medicinal plants used for toothache treatment in Ethiopia. This finding is based on a review of the literature published in scientific journals. A total of 130 medicinal plants, distributed in 117 genera and 62 families, are reported in the reviewed literature. Of the 130 species of medicinal plants reported in the literature, ninety-two (70.7%) were obtained from the wild whereas twelve (9.2%) were from home gardens. Shrubs (34.6%) were the primary source of medicinal plants, followed by herbs (30%). The Asteraceae came out as a leading family with 12 medicinal species while the Fabaceae followed with nine. Some findings include the predominance of root material used (31%), followed by leaves (29%). This study demonstrates the importance of traditional medicines in the treatment of toothache in Ethiopia. It is essential for the health of users to phytochemically demonstrate the effects of medicinal plants for their possible therapeutic applications. Hence, future phytochemical and pharmaceutical studies should give due consideration on frequently reported medicinal plants in order to produce natural drugs that could be effective in toothache treatment and without side effects.

Chemical Constituents of Root Barks of Gnidia involucrata and Evaluation for Antibacterial and Antioxidant Activities

The genus Gnidia, with species close to 152, is traditionally used to treat wide ranges of ailments in humans and animals. Gnidia involucrata is one of the species found in Ethiopia and traditionally used as a laxative, antirheumatic agent, insecticide, antibacterial agent, and antimalarial agent. In view of its traditional use, the root bark was sequentially extracted with n-hexane, EtOAc, and MeOH to afford 0.78%, 4%, and 6% crude extracts, respectively. The chromatographic separation of the EtOAc extract using silica gel column chromatography yielded three pure compounds: tetratriacontanyl caffeate (1), 12-O-dodeca-2,4-dienoylphorbol-13-acetate (2), and naringenin (3). This is the first report of the isolation of 1 and its kind from the genus and most probably from the Thymelaeaceae family. The structures of these compounds were characterized and identified by NMR and mass spectrometric analyses and comparison with literature data. The EtOAc extract and isolated compounds were assessed for their in vitro antibacterial and antioxidant activities. The EtOAc extract (1.5 mg/mL) showed significant inhibitory activity against S. aureus, E. coli, P. mirabilis, and K. pneumonia bacterial strains with the highest inhibition zone observed against S. aureus (23 mm), which is even greater than that of the reference drug ciprofloxacin (22 mm). However, the inhibition displayed on these bacterial strains for the three pure compounds was marginal with variable degrees of potency between the compounds. The better activity of the crude extract could be due to the synergistic interactions of several phytochemicals present in the extract, which cannot be the case when pure compounds are evaluated alone. The antioxidant activities of the extracts and isolated compounds were evaluated using DPPH and ferric thiocyanate methods. The EtOAc and MeOH extracts and compounds 1 and 2 were found to inhibit the DPPH radical by 70.7, 66.9, 85.8, and 52.8%, respectively. The EtOAc extract and compound 1 inhibited peroxidation of lipids by 84 and 86%, respectively. The radical scavenging displayed by compound 1 was significant compared with that displayed by ascorbic acid, indicating the strong antilipid peroxidation potential of the extract of root barks of G. involucrata. Therefore, the extracts of the root bark of G. involucrata can be used as a remedy in combating diseases caused by bacteria and free radicals provided that further comprehensive evaluation could be recommended for the conclusive decision on potential candidacy of this plant.

Anti-malarial activity of the root extract of Euphorbia abyssinica (Euphorbiaceae) against Plasmodium berghei infection in mice

BACKGROUND

More than 200 medicinal plants including Euphorbia abyssinica are utilized for treatment of malaria in Ethiopian traditional medical practices. However, the safety, efficacy and quality of these medicinal plants are largely unknown. Pharmacological and toxicological investigations of these plants are among the prioritized issues in every country. The aim of this study was, therefore, to evaluate the anti-malarial activity of Euphorbia abyssinica root extract against Plasmodium berghei infection in mice.

METHODS

The fresh roots of Euphorbia abyssinica were identified and collected. They were dried and extracted by 80% methanol using maceration. Acute toxicity of the extract was done using female Swiss albino mice. Anti-malarial activity of the extract was done by a standard 4-day suppressive test using chloroquine-sensitive Plasmodium berghei. Twenty-five male Swiss albino mice were randomly grouped into 5 groups of 5 mice each. Group I was treated with distilled water (10 ml/kg), group II, III, and IV were treated with 200, 400, and 600 mg/kg of extract, respectively and group V was treated with chloroquine (25 mg/kg). The level of parasitaemia, survival time, and variation in weight were utilized to determine the anti-malarial activity of the extract. Data was analysed using ANOVA followed by Tukey test.

RESULTS

The plant extract did not show any sign of toxicity and mortality at 2000 mg/kg. The 4-day chemosuppressive anti-malarial activities produced by the crude extract were 66.87% (P < 0.001), 84.94% (P < 0.001) and 93.69% (P < 0.001) at 200, 400 and 600 mg/kg extract, respectively, compared to distilled water treated group. Mice treated with 400 mg/kg (P < 0.01), and 600 mg/kg extract (P < 0.001) showed significant chemosuppressive anti-malarial activity variations as compared to mice treated with 200 mg/kg extract. Mice treated with 600 mg/kg extract significantly (P < 0.001) lived longer than distilled water treated mice. However, the crude extract did not cause any significant change on body weights of mice.

CONCLUSIONS

From this study, it can be concluded that the root of Euphorbia abyssinica showed very good 4-day chemosuppressive anti-malarial activity. The plant might contain biologically active compounds which are relevant for treatment of malaria. Further phytochemical, toxicological and pharmacological investigations are, therefore, required to evaluate its anti-malarial potential.

Phytochemical Screening and In Vivo Antimalarial Activity of Two Traditionally Used Medicinal Plants of Afar Region, Ethiopia, against Plasmodium berghei in Swiss Albino Mice

The objective of the present study was to investigate phytochemical components, antiplasmodial activity (in vivo) and evaluate the toxicity of two local medicinal plants, namely, Salvadora persica L. and Balanites rotundifolia (Van Tiegh.) used in Afar ethnomedicine for the treatment of malaria. In this study, phytochemical screening has been done using standard methods and the existence of antiplasmodial compounds was detected in these plant extracts. Four-day Peter's test was used to determine parasite inhibition, PCV was determined by Wintrob's method, and effects against loss of body weight and improvements on survival time were determined. LD50s of the crude extracts have been also done. Acute toxicity studies of the extracts were carried out in Swiss albino mice prior to antimalarial activity test. All extracts revealed no obvious acute toxicities on mice up to the highest (5000mg/kg) dose given. The crude extract was estimated to have oral median lethal dose higher than 5,000 mg/kg. With the 4-day suppressive test, both plant extracts demonstrated dose-dependent significant reduction in parasitemia level at all test doses compared to the negative control: in the extract of B. rotundifolia 500 mg/kg extract (60.59±3.25%), 350 mg/kg extract (48.1±1.4), and 200 mg/kg extract (41.33±1.1%) were found. And in case of S. Persica 500 mg/kg extract (50.6±4.01%), 350 mg/kg extract (35.85±0.89), and 200 mg/kg extract (27.69±1.14%) were found. The results of this study provide support for the traditional therapeutic value and the reported antimalarial activity.

Orally Effective Aminoalkyl 10H-Indolo[3,2-b]quinoline-11-carboxamide Kills the Malaria Parasite by Inhibiting Host Hemoglobin Uptake

A series of indolo[3,2-b]quinoline-C11-carboxamides were synthesized by incorporation of aminoalkyl side chains into the core of indolo[3,2-b]quinoline-C11-carboxylic acid. Their in vitro antiplasmodial evaluation against Plasmodium falciparum led to the identification of a 2-(piperidin-1-yl)ethanamine-linked analogue {2-bromo-N-[2-(piperidin-1-yl)ethyl]-10H-indolo[3,2-b]quinoline-11-carboxamide (3 g)} (IC₅₀ =1.3 μm) as the most promising compound exhibiting good selectivity indices against mammalian cell lines. The kill kinetics on erythrocytic-stage parasites revealed that 3 g caused complete killing of only the trophozoite-stage parasites. Mechanistic studies showed that 3 g targets the food vacuole of the parasite and inhibits hemoglobin uptake, β-hematin formation, and the basic endocytic processes of the parasite. Analogue 3 g was found to be orally bioavailable, and its curative antimalarial studies at 50 mg per kg p.o. against a Plasmodium berghei (ANKA)-infected mouse model revealed that mice treated with 3 g showed 27-35 % suppression of parasitemia with an increase in life span relative to untreated, control mice. Thus, the present work demonstrated a proof of concept for the oral efficacy of indolo[3,2-b]quinoline-C11-carboxamides.

The use of medicinal plants by pregnant women in Africa: A systematic review

ETHNOPHARMACOLOGICAL RELEVANCE

Medicinal plant (MP) use during pregnancy is common in Africa and may have profound effects on both the mother and the developing foetus. A lack of overview complicates monitoring and regulating the use of MPs during pregnancy.

AIM OF THE STUDY

This systematic review analyses prevalence of use of MPs during pregnancy, regional distribution, types and prevalence, MP properties, potential health risks, and consensus of MPs use, and suggests relevant measures to mitigate negative effects on pregnancy.

MATERIALS AND METHODS

A search was undertaken using a range of scientific databases (Medline, Embase, African Journals OnLine, Google Scholar and Biological Abstracts), non-governmental organisations, various African universities and regulatory websites for original published and unpublished studies that assess and indicate the prevalence of use of MPs during pregnancy in Africa. Additional articles were located by exploring pertinent bibliographies, and contacting experts.

RESULTS

A total of 3659 MP-use studies were found, but only 303 articles received full-text assessment for eligibility and finally only 50 scientific papers were eligible for the systematic review. The prevalence of MP use by pregnant women varied widely from 2% to 100%. Twenty-eight studies (56%) specified one or more plant species used as MP during pregnancy. The major reasons for MP use were relief of nausea and vomiting during pregnancy (NVP), stimulation of labour, and facilitation of childbirth. The most commonly cited MP species were Zingiber officinale Roscoe, Allium sativum L. and Cucurbita pepo L. and these were used for relief of NVP, motion sickness and as a nutritional supplement. Route of administration was most commonly oral, and few adverse effects were reported.

CONCLUSIONS

The use of MPs among pregnant women in Africa is prevalent, and the most commonly used plant species are not known to have harmful foetal effects during pregnancy. However, many of the MP species are poorly studied and teratogenic effects cannot be ruled out. Collaboration between healthcare providers and traditional practitioners to inform about the safe use of MPs may promote safer pregnancies and better health for mothers and infants.