Anti-protozoan activities of Harungana madagascariensis stem bark extract on trichomonads and malaria

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.

Targeted screening of the synergistic components in Artemisia annua L. leading to enhanced antiplasmodial potency of artemisinin based on a "top down" PD-PK approach

ETHNOPHARMACOLOGICAL RELEVANCE

Artemisinin (ART) showed enhanced antimalarial potency in the herb Artemisia annua L. (A. annua), from which ART is isolated. Increased absorption of ART with inhibited metabolism in the plant matrix is an underlying mechanism. Several synergistic components have been reported based on a "bottom-up" approach, i.e., traditional isolation followed by pharmacokinetic and/or pharmacodynamic evaluation.

AIM OF THE STUDY

In this study, we employed a "top-down" approach based on in vivo antimalarial and pharmacokinetic studies to identify synergistic components in A. annua.

MATERIALS AND METHODS

Two A. annua extracts in different chemical composition were obtained by extraction using ethyl acetate (EA) and petroleum ether (PE). The synergistic antimalarial activity of ART in two extracts was compared both in vitro (Plasmodium falciparum) and in vivo (murine Plasmodium yoelii). For the PD-PK correlation analysis, the pharmacokinetic profiles of ART and its major metabolite (ART-M) were investigated in healthy rats after a single oral administration of pure ART (20 mg/kg) or equivalent ART in each A. annua extract. A liquid chromatography-tandem high-resolution mass spectrometry (LC-HRMS)-based analytical strategy was then applied for efficient component classification and structural characterization of the differential components in the targeted extract with a higher antimalarial potency. Major components isolated from the targeted extract were then evaluated for their synergistic effect in the same proportion.

RESULTS

Compared with pure ART (ED50, 5.6 mg/kg), ART showed enhanced antimalarial potency in two extracts in vivo (ED50 of EA, 2.9 mg/kg; ED50 of PE, 1.6 mg/kg), but not in vitro (IC50, 15.0-20.0 nM). A significant increase (1.7-fold) in ART absorption (AUC0-t) was found in rats after a single oral dose of equivalent ART in PE but not in EA; however, no significant change in the metabolic capability (AUCART-M/AUCART) was found for ART in either extract. The differential component analysis of the two extracts showed a higher composition of sesquiterpene compounds, especially component AB (3.0% in PE vs. 0.9% in EA) and component AA (14.1% in PE vs. 5.1% in EA). Two target sesquiterpenes were isolated and identified as arteannuin B (AB) and artemisinic acid (AA). The synergism between ART and AB/AA in the same proportion with PE extract (20:1.6:7.6, mg/kg) was verified by a pharmacokinetic study in rats.

CONCLUSIONS

A "top-down" strategy based on PD-PK studies was successfully employed to identify synergistic components for ART in A. annua. Two sesquiterpene compounds (arteannuin B and artemisinic acid) could enhance the antimalarial potency of ART by increasing its absorption.

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.

Bioassay-Guided Isolation of Antiplasmodial Compounds from Hypericum lanceolatum Lam. (Hypericaceae) and Their Cytotoxicity and Molecular Docking

In Cameroon, malaria is still the cause of several deaths yearly and leading to the continued search for new potent leads to fight against Plasmodium falciparum. Medicinal plants like Hypericum lanceolatum Lam. are introduced in local preparations for the treatment of affected people. The bioassay-guided fractionation of the crude extract of the twigs and stem bark of H. lanceolatum Lam. led to the identification of the dichloromethane-soluble fraction as the most active (with 32.6% of the parasite P. falciparum 3D7 survival) which was further purified by successive column chromatography to obtain four compounds identified by their spectrometric data as two xanthones 1,6-dihydroxyxanthone (1) and norathyriol (2) and two triterpenes betulinic acid (3) and ursolic acid (4). In the antiplasmodial assay against P. falciparum 3D7, the triterpenoids 3 and 4 displayed the most significant potencies with IC50 values of 2.8 ± 0.8 μg/mL and 11.8 ± 3.2 μg/mL, respectively. Furthermore, both compounds were also the most cytotoxic against P388 cell lines with IC50 values of 6.8 ± 2.2 μg/mL and 2.5 ± 0.6 μg/mL, respectively. Further insights on the inhibition method of the bioactive compounds and their drug-likeness were obtained from their molecular docking and ADMET studies. The results obtained help in identifying additional antiplasmodial agents from H. lanceolatum and support its use in folk medicine for the treatment of malaria. The plant might be considered as a promising source of new antiplasmodial candidates in new drug discovery.

Anti-Trichomonas gallinae activity of essential oils and main compounds from Lamiaceae and Asteraceae plants

Trichomonas gallinae is a flagellated protozoan that parasitizes the upper digestive tract of various bird species and causes avian trichomonosis. The emergence of resistant strains to the standard treatment, based on nitroimidazoles, increases the need to find alternative therapies. In this study, 36 essential oils (EOs) from Lamiaceae and Asteraceae plant families were tested against T. gallinae trophozoites using the 3-(4,5-dimethylthiazol-2-yl-)-2,5-dipheniltetrazolium bromide (MTT) reduction assay. Among them, EOs from distinct species of Lamiaceae, including the genera Lavandula, Salvia, Thymus, Origanum, and Satureja were the ones reporting better anti-trichomonal activity, and were selected for further analysis, including chemical composition and in vitro assays. The chemical composition of the selected EOs was determined by gas chromatography followed by mass spectrometry and 19 pure compounds were tested against the protozoa, according to their higher abundance in the active EOs. Pure compounds which displayed the highest activity against T. gallinae trophozoites, ordered by highest to lowest activity, were α and β-thujones, camphene, β-pinene, linalyl acetate, thymol, 4-terpineol, γ-terpinene, α-pinene, p-cymene, D-fenchone and β-caryophyllene. A dose dependent effect was observed in most of the EOs and pure compounds tested. The toxicity test conducted in eukaryotic cell cultures with the anti-trichomonal active pure compounds showed that β-caryophyllene, camphene, α-pinene, and β-pinene were slightly toxic for Vero cells, and the selectivity index was calculated. Based on the anti-trichomonal activity and the absence of cytotoxicity results, natural products from Lamiaceae plants could be useful as alternative therapy against avian trichomonosis, mainly those containing linalyl acetate, thymol, 4-terpinenol, γ-terpinene, p-cymene and D-fenchone.

A Harungana madagascariensis extract with retinol-like properties - Gene upregulations and protein expressions in human fibroblasts and skin explants

OBJECTIVE

Because they limit, even reverse, age-induced skin alterations, retinoids became a staple in cosmetology. However, their use can result in undesired secondary effects and there is a demand for natural sources of compounds with retinoid like effects. A preliminary screening identified a Harungana madagascariensis plant extract (HME) as possibly inducing genes stimulated by retinol. We analysed its effect on gene and protein expression, comparing it to retinoids.

METHODS

Gene expression was analysed by real-time qPCR on RNA from isolated fibroblasts subjected to retinol or the plant extract for 6, 48 or 96 hours. Skin markers were quantified in fibroblasts cultured with retinol or extract containing medium, and UV-aged skin explants subjected to topical applications of creams containing retinol, retinaldehyde or HME.

RESULTS

Real-time qPCR show that the extract induced all RARs and RXRs, even RXRγ that was not induced by retinol. Eighty-eight percent of the 25 early retinoid reaction genes induced by a concentration of retinol are induced by the extract. In fibroblasts, only the extract increased collagen III labelling, while collagen I and fibronectin labelling are increased by retinol and the extract, with higher levels for the extract. When topically applied to UV-aged skin explants, only the cream containing the HME led to increased labelling of CRABP1 in the epidermis. CRABP2 and Ki67 are induced by all three creams and no effect was detected on RXRs. In the dermis the extract containing cream increased CRABP2, total collagen, procollagen I and collagen I while creams with retinol or retinaldehyde only affected some of these proteins.

CONCLUSIONS

The HME induces an overall retinol-like gene induction profile in isolated fibroblasts and retinoid-like stimulation of protein synthesis in both isolated fibroblasts and photoaged skin explants.

Antiplasmodial, antimalarial activities and toxicity of African medicinal plants: a systematic review of literature

BACKGROUND

Malaria still constitutes a major public health menace, especially in tropical and subtropical countries. Close to half a million people mainly children in Africa, die every year from the disease. With the rising resistance to frontline drugs (artemisinin-based combinations), there is a need to accelerate the discovery and development of newer anti-malarial drugs. A systematic review was conducted to identify the African medicinal plants with significant antiplasmodial and/or anti-malarial activity, toxicity, as wells as assessing the variation in their activity between study designs (in vitro and in vivo).

METHODS

Key health-related databases including Google Scholar, PubMed, PubMed Central, and Science Direct were searched for relevant literature on the antiplasmodial and anti-malarial activities of African medicinal plants.

RESULTS

In total, 200 research articles were identified, a majority of which were studies conducted in Nigeria. The selected research articles constituted 722 independent experiments evaluating 502 plant species. Of the 722 studies, 81.9%, 12.4%, and 5.5% were in vitro, in vivo, and combined in vitro and in vivo, respectively. The most frequently investigated plant species were Azadirachta indica, Zanthoxylum chalybeum, Picrilima nitida, and Nauclea latifolia meanwhile Fabaceae, Euphorbiaceae, Annonaceae, Rubiaceae, Rutaceae, Meliaceae, and Lamiaceae were the most frequently investigated plant families. Overall, 248 (34.3%), 241 (33.4%), and 233 (32.3%) of the studies reported very good, good, and moderate activity, respectively. Alchornea cordifolia, Flueggea virosa, Cryptolepis sanguinolenta, Zanthoxylum chalybeum, and Maytenus senegalensis gave consistently very good activity across the different studies. In all, only 31 (4.3%) of studies involved pure compounds and these had significantly (p = 0.044) higher antiplasmodial activity relative to crude extracts. Out of the 198 plant species tested for toxicity, 52 (26.3%) demonstrated some degree of toxicity, with toxicity most frequently reported with Azadirachta indica and Vernonia amygdalina. These species were equally the most frequently inactive plants reported. The leaves were the most frequently reported toxic part of plants used. Furthermore, toxicity was observed to decrease with increasing antiplasmodial activity.

CONCLUSIONS

Although there are many indigenous plants with considerable antiplasmodial and anti-malarial activity, the progress in the development of new anti-malarial drugs from African medicinal plants is still slothful, with only one clinical trial with Cochlospermum planchonii (Bixaceae) conducted to date. There is, therefore, the need to scale up anti-malarial drug discovery in the African region.

Further prenylated anthranoids from Harungana madagascariensis

Ten undescribed anthranoids, including three anthraquinone acetals as racemic mixtures, (±)-kenganthranol G-I, and seven prenylated anthranols, (±)-kenganthranol J-M and harunganol G-I, together with thirteen known compounds, were isolated from the stem bark of Harungana madagascariensis. The structures of (±)-kenganthranol G and (±)-kenganthranol J were confirmed by X-ray crystallography. (±)-Kenganthranol G was separated into (+)-kenganthranol G and (-)-kenganthranol G by chiral HPLC and their absolute configurations were established by electronic circular dichroism. (±)-Kenganthranol L displayed α-glucosidase inhibitory activity with an IC₅₀ of 4.4 μM.

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.

Cytotoxic activity of medicinal plants of the Kakamega County (Kenya) against drug-sensitive and multidrug-resistant cancer cells

ETHNOPHARMACOLOGICAL RELEVANCE

The geographical location of Kakamega County proximal to the Kakamega Rain Forest in Kenya and its rich flora represents an interesting resource of traditional medicinal plants. The medicinal plants in the present study are traditionally used to treat cancer in Kakamega County as recorded in published literature.

AIM OF THE STUDY

Due to multidrug resistance (MDR) and severe side effects of currently used drugs in clinical oncology, new candidate compounds are urgently required to improve treatment outcome. The present study explored the in vitro cytotoxic potential of 34 organic and 19 aqueous extracts of Kakamega medicinal plants towards sensitive and multidrug-resistant cancer cell lines.

METHODS AND RESULTS

The cytotoxicity was determined using the resazurin assay. Eight organic and two aqueous plant extracts inhibited the growth of CCRF-CEM leukemia cells by more than 50%. The organic extracts were Harungana madagascariensis Lam. ex poir (6.6% of untreated control), Prunus africana (Hook.f.) Kalkman (19.4%), Entada abyssinica Steud. ex A. Rich (38.6%), Phyllanthus fischeri Pax (40.7%), Shirakiopsis elliptica (Hochst.) Esser Synonym: Sapium ellipticum (Hochst. kraus) Pax (41.8%), Bridelia micrantha (Hochst.) Baill (45.4%) and Futumia africana Benth. (45.8%) and Microglossa pyrifolia (Lam.) Kuntze (48%). The aqueous extracts were Bridelia micrantha (Hochst.) Baill (31.3%) and Shirakiopsis elliptica (Hochst.) Esser Synonym: Sapium ellipticum (Hochst. Kraus) Pax (48.2%). In addition to P-glycoprotein-expressing tumor cells, we also investigated other mechanisms of drug resistance, i.e. BCRP- or EGFR-transfected and TP53-knockout tumor cells. Some extracts also showed considerable cytotoxic activity against these drug-resistant cell lines. As demonstrated for selected examples, some extracts exhibited enhanced cytotoxicity towards cancer cells, if applied in combination with other extracts.

DISCUSSION

The panel of medicinal plants used in the Kakamega County for cancer treatment revealed indeed cytotoxicity to various extent towards cancer cells in vitro. Hence, our results may at least in part substantiate the traditional use of these compounds to treat cancer. Even more interesting, several extracts inhibited otherwise drug-resistant tumor cell lines with similar or even better efficacy than their drug-sensitive counterparts. This provides an attractive perspective for further exploration of their anticancer potential to combat drug resistance of refractory tumors.

Medicinal plants for in vitro antiplasmodial activities: A systematic review of literature

The increasing resistance of malaria to drugs raise the need to new antimalarial agents. Antiplasmodial herbs and their active compounds are the most promising source the new antimalarial agents. This study aimed to identify the medicinal plants with very good in vitro antiplasmodial activities, with half-maximal inhibitory concentration (IC₅₀)≤1μg/ml, and to determine trends in the process of screening their antiplasmodial activities. A total of 58 reports published in the English language were retrieved from the bibliographical databases. Screening and data extraction were performed by two independent reviewers. The herbs were categorized as very good, good, moderate and inactive if the IC₅₀ values were <0.1μg/ml, 0.1-1μg/ml, >1-5μg/ml and >5μg/ml respectively. We documented 752 medicinal plants belonging to 254 genera. The majority of the plants were reported from Africa followed by Asia. The traditional use for malaria treatment was the most common reason for the selection of the plants for investigation. About 80% of the plants experimented were reported to be inactive. Among plants identified as having very good to good antiplasmodial crude extracts are Harungana madagascariensis, Quassia africana, and Brucea javanica, while Picrolemma spruce, Aspidosperma vargasi, Aspidosperma desmanthum, and Artemisia annua were reported to have individual compound isolates with very good antiplasmodial activities. In conclusion, the number of plant species assessed so far is still small compared with the stock in nature's plant library. A mechanism of systematically approaching and exploring the untouched plant genera needs to be designed.

Anti-Trichomonas vaginalis activity of nano Micana cordifolia and Metronidazole: an in vitro study

Trichomonas vaginalis is a flagellate parasite living in the genital tract and it is accounted as a sexually transmitted disease. The clinical symptoms vary from the asymptomatic to the severe form which is usually associated with the irritation, itching and infertility in some severe cases. Many drugs have been applied to treat this disease and Metronidazole is the gold standard for treatment; however, it has also detected that this medicine has many side-effects which it has been motivated the researchers to find an appropriate alternative for this medicine. One of the treatment options is the use of the herbal medicines and natural compounds. Thus, the aim of this study was to compare the in vitro anti-T. vaginalis activity of nano-emulsion of Micana cordifolia and Metronidazole. In this study, T. vaginalis was isolated from the clinical samples and were cultured on a modified Dorsate medium. The nano-emulsion of M. cordifolia was prepared by heating technique. The effect of nano-emulsion of M. cordifolia was separately investigated on the T. vaginalis at the times of 12, 24 and 72 h and the obtained data were analyzed by the Spss 20 using the ANOVA test. The results indicated that the concentration of 100 ppm of nano-emulsion of M. cordifolia at the times of 12, 24 and 72 h has the anti-T. vaginalis activity of 44 ± 1.66, 37 ± 1 and 25 ± 2, respectively. It is also observed that the concentration of 500 ppm of the extract has the best effect and was able to eliminate the 85% of T. vaginalis. Furthermore, the anti-T. vaginalis activity of nano M. cordifolia was observed to be 100% in the concentrations of 1000 ppm. It can be concluded, based on the results, that the nano M. cordifolia has acceptable efficacy on the elimination of T. vaginalis and it can be a suitable alternative for Metronidazole after implementation of complementary tests on laboratory animals and human cells.

Medicinal plants used for management of malaria among the Luhya community of Kakamega East sub-County, Kenya

BACKGROUND

Malaria remains a major health problem worldwide especially in sub-Saharan Africa. In Kenya, 80% of the population is at risk of contracting the disease. Pregnant mothers and children under five years are the most affected by this disease. Antimalarial drug resistance poses a major threat in the fight against malaria necessitating continuous search for new antimalarial drugs. Due to inadequate and inaccessible health facilities, majority of people living in rural communities heavily depend on traditional medicine which involves the use of medicinal plants for the management of malaria. Most of these indigenous knowledge is undocumented and risks being lost yet such information could be useful in the search of new antimalarial agents.

AIM OF STUDY

An ethnobotanical survey was carried out among the Luhya community of Kakamega East sub-County, a malaria epidemic region, with the aim of documenting the plants used in the management of malaria.

MATERIALS AND METHODS

Semi-structured questionnaires were used to collect information from 21 informants who included traditional medicine practitioners and other caregivers who had experience in use of plants in management of malaria. These were drawn from 4 villages located in Kakamega East sub-county, within Kakamega County based on their differences in topography. Information recorded included plant names, parts used, mode of preparation and administration and the sources of plant materials. A literature search was conducted using PubMed and google scholar to identify the reported traditional uses of these plants and studied antiplasmodial activities.

RESULTS

In this study, 57% of the informants were aged above 50 years and a total of 61% had either no formal education or had only attained primary school education. A total of 42 plant species belonging to 24 families were identified. Most plants used in the management of malaria in this community belonged to Lamiaceae (18%), Leguminosae (9%) and Compositae (9%) plant families. Plants mostly used included Melia azedarach L, Aloe spp, Ajuga integrifolia Buch. Ham, Vernonia amygdalina Del., Rotheca myricoides (Hochst.) Steane and Mabb, Fuerstia africana T.C.E.Fr., Zanthoxylum gilletii (De Wild.) P.G.Waterman and Leucas calostachys Oliv. Rumex steudelii Hochst.ex A. Rich and Phyllanthus sepialis Müll. Arg are reported for the first time in the management of malaria. Although Clerodendrum johnstonii Oliv. (Jeruto et al., 2011) and Physalis peruviana L.(Ramadan et al., 2015) are reported in other studies for management of malaria, no studies have been carried out to demonstrate their antiplasmodial activity. The plant parts mostly used were the leaves (36%) and stem barks (26%). Majority of these plants were prepared as decoctions by boiling and allowed to cool before administration (66%) while infusions accounted for 28% of the preparations. The literature mined supports the use of these plants for the management of malaria since most of them have demonstrated in-vitro and in-vivo antiplasmodial activities.

CONCLUSION

Most of the reported plant species in this study have been investigated for antiplasmodial activity and are in agreement with the ethnomedical use. Two (2) plants are reported for the first time in the management of malaria. There is need for documentation and preservation of the rich ethnomedical knowledge within this community given that most of the practitioners are advanced in age and less educated. There is also the danger of over-exploitation of plant species as most of them are obtained from the wild, mainly Kakamega forest. Therefore, there is need for determining the economically and medicinally important plants in this community and planning for their preservation.

Ethnomedical and ethnobotanical investigations on the response capacities of Guinean traditional health practioners in the management of outbreaks of infectious diseases: The case of the Ebola virus epidemic

ETHNOPHARMACOLOGICAL RELEVANCE

The recent outbreak of Ebola virus infections has mostly remained confined to the West African countries Guinea-Conakry, Sierra-Leone and Liberia. Due to intense national and international mobilizations, a significant reduction in Ebola virus transmission has been recorded. While international efforts focus on new vaccines, medicines and diagnostics, no coherent national or international approach exists to integrate the potential of the traditional health practitioners (THPs) in the management of infectious diseases epidemics. Nevertheless, the first contact of most of the Ebola infected patients is with the THPs since the symptoms are similar to those of common traditionally treated diseases or symptoms such as malaria, hemorrhagic syndrome, typhoid or other gastrointestinal diseases, fever and vomiting.

MATERIALS AND METHODS

In an ethnomedical survey conducted in the 4 main Guinean regions contacts were established with a total of 113 THPs. The socio-demographic characteristics, the professional status and the traditional perception of Ebola Virus Disease (EVD) were recorded.

RESULTS

The traditional treatment of the main symptoms was based on 47 vegetal recipes which were focused on the treatment of diarrhea (22 recipes), fever (22 recipes), vomiting (2 recipes), external antiseptic (2 recipes), hemorrhagic syndrome (2 recipes), convulsion and dysentery (one recipe each). An ethnobotanical survey led to the collection of 54 plant species from which 44 identified belonging to 26 families. The most represented families were Euphorbiaceae, Caesalpiniaceae and Rubiaceae. Literature data on the twelve most cited plant species tends to corroborate their traditional use and to highlight their pharmacological potential.

CONCLUSIONS

It is worth to document all available knowledge on the traditional management of EVD-like symptoms in order to evaluate systematically the anti-Ebola potential of Guinean plant species.

Antityphoid properties and toxicity evaluation of Harungana madagascariensis Lam (Hypericaceae) aqueous leaf extract

CONTEXT

Harungana madagascariensis Lam is commonly used in Cameroonian folk medicine for the treatment of malaria and typhoid fever.

OBJECTIVE

To investigate the therapeutic potentials of H. madagascariensis aqueous leaf extract for the treatment of salmonellosis (e.g. typhoid fever, gastroenteritis).

MATERIALS AND METHODS

A Salmonella Typhimurium-infected rat model was used. The faeces of these rats were analysed for viable Salmonella Typhimurium before and after infection, and during the treatment period. The physiological, biochemical and histopathological markers of possible side effects of the extract were also studied using standard methods and kits.

RESULTS AND DISCUSSION

The in vivo antisalmonellal study revealed that this extract significantly (P<0.05) reduced the number of viable Salmonella Typhimurium recovered from faeces, and could stop salmonellosis after 10 days of treatment for male and female rats, with non-toxic doses. However, the biochemical and histological analyses revealed that at relatively high-doses (≥100mg/kg for females and 200mg/kg for males) the extract could induce liver damage, as illustrated by a rise of serum transaminases (ALT and AST), significant inflammation of the parenchyma and portal vein, as well as cell necrosis. There were also increases in cholesterol levels in both sexes. No significant unwanted side effect of the extract was observed on the kidney, as shown by both serum and urinary creatinine, and urinary protein levels.

CONCLUSION

The results obtained showed that H. madagascariensis has a promising antisalmonellal effect and, therefore, the potential to provide an effective treatment against salmonellosis, including typhoid fever.

Plants as antimalarial agents in Sub-Saharan Africa

Although the burden of malaria is decreasing, parasite resistance to current antimalarial drugs and resistance to insecticides by vector mosquitoes threaten the prospects of malaria elimination in endemic areas. Corollary, there is a scientific departure to discover new antimalarial agents from nature. Because the two antimalarial drugs quinine and artemisinin were discovered through improved understanding of the indigenous knowledge of plants, bioprospecting Sub-Saharan Africa's enormous plant biodiversity may be a source of new and better drugs to treat malaria. This review analyses the medicinal plants used to manage malaria in Sub-Saharan Africa. Chemical compounds with antiplasmodial activity are described. In the Sub-Saharan African countries cited in this review, hundreds of plants are used as antimalarial remedies. While the number of plant species is not exhaustive, plants used in more than one country probably indicate better antimalarial efficacy and safety. The antiplasmodial data suggest an opportunity for inventing new antimalarial drugs from Sub-Saharan-African flora.

Medicinal plants and traditional healing practices in Ehotile people, around the Aby Lagoon (eastern littoral of Côte d'Ivoire)

BACKGROUND

Access to useful plants is a growing problem in Africa, increased by the loss of natural vegetation and the erosion of traditional knowledge. Ethnobotany contributes to promote these indigenous knowledge. Despite the large diversity of ethnic groups in Côte d'Ivoire, few ethnomedicine researches have targeted these groups. Among the great Akan group, the Ehotile people are one of the smallest and oldest ethnic group around the Aby Lagoon. The goal of this study was to analyze the level of knowledge and use of medicinal plants by the Ehotile people, and moreover, contribute to build a database about useful plants of first Ivorian people.

METHODS

Two sets of surveys were conducted in four Ehotile villages: a house-to-house freelist interview and an individual walk-in-the woods interview with some key informants identified by the community. Frequency of citation, Smith's index, Use value and Informant Consensus Factor were used to estimate the local knowledge of medicinal plants.

RESULTS

Medicinal plants are widely used by Ehotile people. Some were used in addition to modern prescriptions while for some disorders commonly called "African diseases" only plants are used. 123 species employed in the treatment of 57 diseases were listed. Specifically, the most common indications included malaria, sexual asthenia, troubles linked to pregnancy, dysmenorrhoea and haemorrhoids. Analysis of freelists suggested that Ehotile people has a good knowledge of medicinal plants and the most salient included Harungana madagascariensis, Alstonia boonei, Ocimum gratissimum and Xylopia acutiflora. Regarding the consensus among key informants, ICF values were low (<0.5), however category of infectious and parasitic diseases obtained the best agreement (ICF = 0.42). Following the local experts, 4 types of plants availability were distinguished: Abundant plants easy to collect, abundant plants difficult to harvest, scarce plants and endangered plants.

CONCLUSIONS

Despite the virtual disappearance of natural formations in Ehotile land, medicinal plants are important in the Ehotile health system. Medicinal plants are known and used alone or in addition to medical prescriptions to treat several ailments. However, some of them are becoming rare, and it is feared that this scarcity will result in the inevitable loss of associated knowledge and practices.

In vitro antiprotozoal and cytotoxic activity of 33 ethonopharmacologically selected medicinal plants from Democratic Republic of Congo

ETHNOPHARMACOLOGICAL RELEVANCE

The antiprotozoal and cytotoxic activity of the aqueous extracts from 33 medicinal plants, used by traditional healers for the treatment of various parasitic diseases and collected after an ethnopharmacological inventory conducted in the Bolongo area, Bandundu province in DR Congo, was evaluated.

MATERIALS AND METHODS

Decoctions were prepared, lyophilized and evaluated for in vitro antiprotozoal activity against Trypanosoma b. brucei, Trypanosoma cruzi, Leishmania infantum, and the chloroquine- and pyrimethamine-resistant K1 strain of Plasmodium falciparum. Cytotoxicity against MRC-5 cells was included to assess selectivity of activity.

RESULTS

Most of the tested extracts exhibited pronounced (IC(50)≤5μg/ml) or good (5<IC(50)≤10μg/ml) antiprotozoal activity against one or more of the selected protozoa. A total of 19 plant extracts inhibited Trypanosoma b. brucei, especially the extract from Isolona hexaloba stem bark (IC(50)=1.95μg/ml, SI=16.5); 8 plant extracts were active against Trypanosoma cruzi, the extracts from Enanatia chlorantha stem bark and Quassia africana root bark being the most active with IC(50) values of 1.87 and 1.88μg/ml, respectively (SI=3.0 and 3.3, respectively); 8 plant extracts showed activity against Leishmania infantum, with extracts from Napoleona vogelii stem bark and Quassia africana root bark as the most active with IC(50) values of 5.66 and 5.04μg/ml (SI=11.3 and 1.2). Finally, 9 plant extracts inhibited Plasmodium falciparum K1 with the extracts from Quassia africana (root bark and stem bark) being the most active ones with IC(50) values of 0.46 and 1.27μg/ml (SI=13.7 and 13.6). Extracts from Enantia chlorantha stem bark, Piptadeniastrum africanum stem bark and Quassia africana root bark were cytotoxic for MRC-5 cells (CC(50)<10μg/ml).

CONCLUSIONS

These results can partly support and justify the traditional use of some of these plant species for the treatment of parasitic diseases.

Potential antimalarials from Nigerian plants: a review

Malaria, caused by parasites of the genus Plasmodium, is one of the leading infectious diseases in many tropical regions, including Nigeria, a West African country where transmission occurs all year round. Many of the inhabitants use plants as remedies against fever and other symptoms of acute malaria, as reported herein. Some of these plants have their antimalarial efficacies scientifically demonstrated and the active compounds isolated with their probable mechanisms of action studied. Medicinal plants are used to treat diseases also where the biodiversity of plants occur in parallel with endemic transmission of malaria. This review focuses on medicinal plants which are used to treat malaria in Nigeria, and on antimalarial testing of extracts and purified compounds from plants. Some show intense activity against malaria parasites in vitro and in experimentally infected mice. The search for new drugs based on plants is important due to the emergence and widespread of chloroquine-resistant and multiple drug-resistant malaria parasites, which require the development of new antimalarials. An acquaintance with antimalarial plants may be a springboard for new phytotherapies that could be affordable to treat malaria, especially among the less privileged native people living in endemic areas of the tropics, mostly at risk of this devastating disease.

Plant-derived antimalarial agents: new leads and efficient phytomedicines. Part II. Non-alkaloidal natural products

Malaria is still the most destructive and dangerous parasitic infection in many tropical and subtropical countries. The burden of this disease is getting worse, mainly due to the increasing resistance of Plasmodium falciparum against the widely available antimalarial drugs. There is an urgent need for new, more affordable and accessible antimalarial agents possessing original modes of action. Natural products have played a dominant role in the discovery of leads for the development of drugs to treat human diseases, and this fact anticipates that new antimalarial leads may certainly emerge from tropical plant sources. This present review covers most of the recently-published non-alkaloidal natural compounds from plants with antiplasmodial and antimalarial properties, belonging to the classes of terpenes, limonoids, flavonoids, chromones, xanthones, anthraquinones, miscellaneous and related compounds, besides the majority of papers describing antiplasmodial crude extracts published in the last five years not reviewed before. In addition, some perspectives and remarks on the development of new drugs and phytomedicines for malaria are succinctly discussed.