Antiplasmodial potential of traditional antimalarial phytotherapy remedies used by the Kwale community of the Kenyan Coast

doi:10.1016/j.jep.2015.05.024

Journal of Ethnopharmacology

Volume 170, 21 July 2015, Pages 148-157

https://doi.org/10.1016/j.jep.2015.05.024 Get rights and content

Abstract

Ethnopharmacological relevance

In Kenya, 22 million people are at risk of malaria, 70% of them are in rural areas and most of these people use traditional plant based medicines to treat malaria. The aim of the study was to escalate documentation, from an earlier study of medicinal plants, traditionally used to treat malaria by the Digo community of Kwale County, taking cognizance of their pharmacological information by evaluating their antiplasmodial efficacies.

Materials and methods

The study was carried out in Kwale County at Shimba Hills Game Reserve and adjoining part of Kinango. Traditional health practitioners (THP) were interviewed with a standard questionnaire to obtain information on medicinal plants traditionally used for management of malaria. Group interviews were also held among THPs and members of the community. The plant samples collected were tested for antiplasmodial activity against chloroquine sensitive (D6) and resistant (W2) Plasmodium falciparum using the ability of extracts, prepared from the plant species, to inhibit the incorporation of [G-3H] hypoxanthine into the malaria parasites.

Results

Fifty seven (57) species in forty eight (48) genera and thirty (30) families were documented and evaluated for in vitro antiplasmodial activity. Apocynaceae, Euphorbiaceae, and Rubiaceae families had each about 12% of the plant species reported as antimalarial remedy and represented the species that are most commonly used. Twelve species (21.1%) showed antiplasmodial efficacy of IC₅₀<5 µg/ml and these were Boscia salicifolia, Cissampelos mucronata, Clerodendrum myricoides, Commiphora schimperi, Flueggea virosa, Maytenus undata, Maytenus senegalensis, Maytenus putterlickioides, Vernonia amygdalina, Warburgia stuhlmannii, Zanthoxylum chalybeum and Tabernaemontana pachysiphon.

Conclusions

These results seem to indicate that ethnopharmacological inquiry used in search for new herbal remedies as predictive and could form the basis of an ethnopharmacopoeia and search for new active principles. This is the first report on traditional use of T. pachysiphon for malaria and its antiplasmodial activity.

Graphical abstract

Antimalarial plants of Kwale County.

Introduction

Malaria is a major tropical parasitic disease responsible for significant morbidity and mortality and in the absence of practical preventive measures; the current options are chemoprophylaxis and chemotherapy (Hardie and Dürrheim, 2013). The chemotherapy of malaria is one of the medicinal fields that are known to use pharmaceuticals originating from natural product research; examples are quinine from Cinchona succirubra and artemisinin from Artemisia annua (Kayser and Atta-ur-Rahman, 2002, Renslo, 2013). The use of natural product-derived drugs and drugs from other sources in combating malaria has however been faced with several challenges, including the emergence of drug resistance parasites. This has made many of the first line drugs such as chloroquine (CQ) not effective. The need for new drugs, preferably with new mode of action is therefore urgently needed (Jansen et al., 2012).

In Kenya, 22 million people are at risk of malaria, 70% of them are in rural areas. About 34,000 Kenyan children die every year from malaria compared to a total estimate of 42,000 people dead (DMS, 2006). Due to either limited availability or affordability of pharmaceutical medicines in many tropical countries, about 80% of the rural population in Africa depends on traditional herbal remedies (WHO, 2002b, Zirihi et al., 2005). Although there is widespread use of traditional herbal remedies in the management of malaria (Gessler et al., 1995), scientific understanding of the plants is, however, largely unexplored (WHO, 2002a) and therefore, there is a need to collect ethnobotanical information on antimalarial plants which is essential for further evaluation of the efficacy and safety of the plants as antimalarial remedies. To meet the criteria of efficacy, safety and quality control like synthetic drug products (Wagner, 1997); the pharmacological, toxicological and phytochemical profiles of the extracts have to be scientifically evaluated.

Malaria is endemic in Kwale and prevalent in many other communities in Kenya. The situation has become worse with increasing drug resistance by the malaria parasite, Plasmodium falciparum (WHO, 2001). Western style healthcare provided by the government has been expanded in the last decades, but is often not readily available and many regions remain completely underserved. Subsequently, most communities still use herbal remedies as readily and cheaply available alternative. Many tribes in Africa have much elaborated plant knowledge (Barrow, 1996). Most knowledge on medicinal plants is transferred orally in many communities (Fratkin, 1996) and there is therefore the danger of losing this precious cultural heritage. In view of the rapid loss of natural habitats, traditional community life, cultural diversity and knowledge of medicinal plants, an increasing number of ethnobotanical inventories need to be established (Van Wyk et al., 2002). In most parts of Kwale, the traditional way of life and customary beliefs are however, quite intact and the acceptability of antimalarial and other medicinal plants as claimed effective remedies is quite high among the population of this area.

The Kaya forests were the traditional social–cultural focal point of the Digo community in Kwale County, one of the nine deeply traditional ethnic groups that form the Mijikenda community of the coast province. More than half of the Kenyan׳s rare plants grow in the coastal region; most have been identified within the Kaya forest patches, which comprise about 10% of the Kenya׳s coastal forest. The traditional medicinal knowledge from the resources of these forests, in possession of a few traditional healers, requires documentation for the benefit of current and future scientific research on the plants to determine their efficacy, safety and phytochemical properties. As a follow up of an earlier ethnobotanical study, twenty-five (25) species in twenty one (21) genera and sixteen (16) families (Muthaura et al., 2007a) were encountered; in the present study this escalated to fifty seven (57) species in forty eight (48) genera and thirty (30) families were documented. In addition, the in vitro antiplasmodial efficacy of the plant species was carried out as a step in proposing appropriate scientific measures through ethnopharmacological evaluation of the plant extracts for further pharmacological and phytochemical studies.

Section snippets

Study area

In Kwale County, the study area centered around at 4°12׳ S and 39°25׳ E in the Shimba Hills Forest Game Reserve and in Kinango division (Fig. 1). The area is hot and humid all year round with annual mean temperatures ranging between 23 °C and 34 °C and the average relative humidity ranging between 60% and 80%. The Coastal uplands commonly known as Shimba Hills rise steeply from the Coastal belt to 462 m above sea level. The soils are made of sandstone and grit and are fairly fertile for

Ethnopharmacological study

Table 1 shows a documentation of plant species collected from the study area (Fig. 1) based on traditional reputation for their use as antimalarials. The plant species are listed in alphabetical order, with their respective families and voucher specimen number in parenthesis in the first column. Subsequent columns indicate the plant part used for herbal preparation, the type of extract prepared for the test, and the antiplasmodial efficacy with different strains of P. falciparum. The

Conclusion

Among the fifty seven species tested, 21.1% were identified as having good antimalarial effects (IC₅₀<5 μg/ml), 63.2% with moderate effects (5 μg/ml<IC₅₀≤50 μg/ml), and 15.8% as inactive (IC₅₀>50 μg/ml). The documented antimalarial plants could be developed into a database for compilation of material medica or herbal pharmacopeia that would contribute to value addition of traditional medicine, conservation and search for new active principles. The traditional use of T. pachysiphon for treatment of

Acknowledgments

This work received financial support from UNICEF/UNDP/World Bank/WHO Special Programme for Research and Training in Tropical Diseases (TDR). We thank the Director, KEMRI for allowing publication of this study.

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Antiplasmodial potential of traditional antimalarial phytotherapy remedies used by the Kwale community of the Kenyan Coast

Abstract

Ethnopharmacological relevance

Materials and methods

Results

Conclusions

Graphical abstract

Introduction

Section snippets

Study area

Ethnopharmacological study

Conclusion

Acknowledgments

Biochem. Syst. Ecol.

J. Ethnopharmacol.

S. Afr. J. Bot.

J. Ethnopharmacol.

J. Ethnopharmacol.

J. Ethnopharmacol.

Acta Trop.

J. Ethnopharmacol.

S. Afr. J. Bot.

J. Ethnopharmacol.

. Bioorg. Med. Chem.

J. Ethnopharmacol.

J. Ethnopharmacol.

J. Ethnopharmacol.

J. Ethnopharmacol.

J. Ethnopharmacol.

J. Ethnopharmacol.

J. Ethnopharmacol.

J. Ethnopharmacol.

J. Ethnopharmacol.

J. Ethnopharmacol.

J. Ethnopharmacol.

J. Ethnopharmacol.

J. Ethnopharmacol.

The Dry Lands of Africa: Local Participation in Tree Management

Antiplasmodial activity of leaf extracts of Zanthoxylum chalybeum Engl

Br. J. Pharm. Res.

Applied Ethnobotany; People, Wild Plant Use and Conservation

Quantitative assessment of antimalarial activity in vitro by a semi-automated microdilution technique

Antimicrob. Agents Chemother.

Pfnek-1, a NIMA-related kinase from the human malaria parasite Plasmodium falciparum; biochemical properties and possible involvement in MAPK regulation

Eur. J. Biochem.