Herbal medicine used for the treatment of diarrhea and cough in Kampala city, Uganda

Anti-diarrheal effect of piperine possibly through the interaction with inflammation inducing enzymes: In vivo and in silico studies

Piperine is a natural alkaloid that possesses a variety of therapeutic properties, including anti-inflammatory, antioxidant, antibacterial, and anticarcinogenic activities. The present study aims to assess the medicinal benefits of piperine as an anti-diarrheal agent in a chick model by utilizing in vivo and in silico techniques. For this, castor oil was administered orally to 2-day-old chicks to cause diarrhea. Bismuth subsalicylate (10 mg/kg), loperamide (3 mg/kg), and nifedipine (2.5 mg/kg) were used as positive controls, while the vehicle was utilized as a negative control. Two different doses (25 and 50 mg/kg b.w.) of the test sample (piperine) were administered orally, and the highest dose was tested with standards to investigate the synergistic activity of the test sample. In our findings, piperine prolonged the latent period while reducing the number of diarrheal feces in the experimental chicks during the monitoring period (4 h). At higher doses, piperine appears to reduce diarrheal secretion while increasing latency in chicks. Throughout the combined pharmacotherapy, piperine outperformed bismuth subsalicylate and nifedipine in terms of anti-diarrheal effects with loperamide. In molecular docking, piperine exhibited higher binding affinities towards different inflammatory enzymes such as cyclooxygenase 1 (-7.9 kcal/mol), cyclooxygenase 2 (-8.4 kcal/mol), nitric oxide synthases (-8.9 kcal/mol), and L-type calcium channel (-8.8 kcal/mol), indicating better interaction of PP with these proteins. In conclusion, piperine showed a potent anti-diarrheal effect in castor oil-induced diarrheal chicks by suppressing the inflammation and calcium ion influx induced by castor oil.

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.

Exploring the operations of itinerant medicine sellers within urban bus terminals in Kumasi, Ghana

This paper explores Itinerant Medicine Sellers' (IMSs) operations at loading bays within bus terminals in the Kumasi metropolis. The paper examines how the sellers negotiated access into the loading bays, how they marketed their medicines, where they sourced their medicines from, and the challenges they faced. An exploratory qualitative survey design was adopted for the study. Through convenience sampling, 18 IMSs operating within the bus terminals in the Kumasi metropolis participated in this study. In-depth interviews were conducted, audio-recorded and transcribed. The transcripts were thematically analysed. The study found that these hawkers negotiated access to the loading bays through multiple informal gatekeepers and employed direct customer engagement in marketing their medicines. It was further revealed that the IMSs sourced their medicines from both formal and informal sources for different reasons, such as affordability and informality of medicines acquisition. The participants operated outside government-prescribed regulations and faced challenges of low capital and sales revenue, poor reception by prospective clients, and government clampdown. The study concludes that medicine hawking is an illegal livelihood strategy and a public health concern. As a phenomenon outside government's policy guidelines, it is recommended that government intensifies its clampdown activities on these hawkers and engage in public health education on the negative implications of accessing medicines from these IMSs.

Medicinal plants used in the management of cancers by residents in the Elgon Sub-Region, Uganda

BACKGROUND

In Uganda, medicinal plants have been utilized to treat a variety of ailments, including cancer. However, there is little information available about the medicinal plants used to treat cancer in the Elgon subregion. As a result, the current study documented the plant species used in the management of cancer in the Elgon sub-region.

METHODS

Data were gathered by observation, self-administered questionnaires, interview guides, and guided field trips. Analyzing descriptive statistics and creating graphs were done using SPSS (version 21.0) and GraphPad Prism® version 9.0.0, respectively. Well-established formulae were used to calculate quantitative indices. The narratives were interpreted using major theories and hypotheses in ethnobotany.

RESULTS

A total of 50 plant species from 36 families were documented, and herbal knowledge was mainly acquired through inheritance. Fabaceae and Asteraceae comprised more plant species used in herbal preparation. Most plants were collected from forest reserves (63%); herbal therapies were made from herbs (45%); and leaves were primarily decocted (43%). The most frequently used plants were Tylosema fassoglensis, Hydnora abyssinica, Azidarachata indica, Prunus Africana, Kigelia africana, Syzygium cumini, Hydnora africana, Rhoicissus tridentata, Albizia coriaria, and Plectranthus cuanneus. All the most commonly used plants exhibited a high preference ranking (60-86%) and reliability level (74.1-93.9%). Generally, the ICF for all the cancers treated by medicinal plants was close to 1 (0.84-0.95).

CONCLUSIONS

The ten most commonly utilized plants were favored, dependable, and most important for treating all known cancers. As a result, more investigation is required to determine their phytochemistry, toxicity, and effectiveness in both in vivo and in vitro studies. This could be a cornerstone for the pharmaceutical sector to develop new anticancer medications.

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.

Medically important bacteria isolated from commercial herbal medicines in Kampala city indicate the need to enhance safety frameworks

The high global bacterial infection burden has created need to investigate the neglected potential drivers of pathogenic bacteria, to inform disease prevention. Kampala is facing a proliferation of herbalists, selling herbal medicine (HM), of largely unregulated microbiological quality. We evaluated the bacterial contamination burden in HM sold in Kampala, to support evidence-based redress. The total viable loads (TVL), total coliform counts (TCC), E. coli counts, and prevalence of selected bacterial strains in 140 HM were examined using conventional culture, following the guidelines of World Health Organization (WHO), and Uganda National Drug Authority (NDA). Data were analyzed using D'Agostino-Pearson test, frequencies, proportions, Chi-square, and Mann-Whitney U test with STATA version-15.0. Fifty (35.7%), fifty-nine (42.1%), and twelve (8.6%) HM were unsafe for human use because they exceeded WHO's permissible limits for TVL, TCC, and E. coli counts respectively. Solids had significantly higher mean TVL than liquids. Violation of NDA's guidelines was significantly associated with high TVL. Fifty-nine bacteria, viz., Klebsiella pneumoniae (n = 34; 57.6%), Escherichia. coli (12; 20.3%), Staphylococcus aureus (7; 11.9%), Klebsiella oxytoca (3; 5.1%), Bacillus cereus, Pseudomonas aeruginosa, and Enterobacter spp. (1; 1.7% each), were isolated from 45 (32.1%) samples. These bacteria can cause severe clinical diseases, and promote deterioration of HM potency.