Coronavirus disease (COVID-19) and Africa: Acclaimed home remedies

At last the WHO declared the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) now known as COVID-19 a pandemic. Amidst uncertainty both in the pathophysiology and the management of COVID-19, many African countries in the face of either over-stretched or non-existent healthcare infrastructure resorted to home remedies as immediate alternative or first line of action. The present study is a synoptic capture of these home remedies with an attempt to understand the pharmacological basis on which these choices are predicated. Literature was compiled from google, social media, Radio and Television commentaries and news with stringent inclusion and exclusion criteria. Natural spices (turmeric, ginger, garlic etc.) and leaves (neem, paw, guava, etc.) with notable antioxidant and anti-inflammatory properties were found to be beneficial. These home remedies may hold promise in the prophylaxis and cure of COVID-19 infection.


Introduction
Coronaviruses (family Coronaviridae and subfamily Orthocoronaviridae) are non-segmented positive-sense RNA viruses or ( + ) ssRNA virus) which are distributed in humans [19] . COVID19 uses positive sense single stranded RNA as its genetic material. Novel coronavirus disease 2019 (COVID-19) which took its root in Wuhan, China in December 2019 is caused by the corona virus that can spread between animals and humans. COVID-19 is a present crisis whose clinical and epidemiological characteristics are currently being documented [6,20] .
Hitherto, the primary source of infection remain pneumonia patients infected with COVID-19. Transmission of respiratory droplets is the main transmission route, which can also be transmitted by contact [5] . The most common symptoms of Coronavirus disease COVID-19 are fever, tiredness, and dry cough. It may be accompanied by aches and pains, nasal congestion, runny nose, sore throat or diarrhea in some people. At the moment, effective treatments modalities that target the coronavirus remain elusive and largely unknown. The therapeutic regimens and treatment modalities may require a while to be realised. This gap in knowledge and the quest for immediate credible solution has compelled governments and scientists to search for anti-COVID-19 remedies. Panicky developing nations including Africa in the phase of this wide spread and the predicted humanity and economic disasters resorted to home treatment of contacts and COVID-19 cases.
In Africa, the orientation has skewed towards exploring natural spices and natural compounds [2] . It has been reported that traditional remedies may alleviate the symptoms of COVID-19. This is a synoptic capture of acclaimed home remedies with proven efficacy employed in various countries of Africa within the first four months of the COVID-19 pandemic.

Methodology
Information from google, newspapers, magazines, different social media namely: facebook, twitter, whatsapp, testimonies of survivors through radios and televisions were gathered from February-May 2020. Sources that emphasised hospital treatment with orthodox medicines were excluded. Claims without dates and verifiable locations and identities were also excluded. Suspected postings by herbalists and traditional medical practitioners TMPs which could be viewed as promotional adverts were excluded. Socioeconomic status (education, employment etc.) of all claimants were also recorded. Table 1 is a summary of acclaimed remedies for the management of COVID-19. The following underlisted barks, leaves and roots of plant materials used as aqueous decoctions were the acclaimed anti-COVID −19 remedies. Decoctions of bark, leaves and root of Neem tree ( Azadirachta indica also called Dogoyaro ). Tetrapleura tetraptera (Schumach. And Thonn) Taub, Mimosaceae, commonly known as Aridan (fruit). The plant is called Prekese in the Twi language of Ghana. It is also called Uhio in the Igbo Language of Nigeria. Heliotropium indicum roots also called Indian Heliotrope belonging to the plant family Boraginaceae is a sweet-scented plant. ( egbo agogo igun in Yoruba). Khaya grandifoliol a bark. Khaya grandifoliola is also called African mahogany, Benin mahogany, large-leaved mahogany, or Senegal mahogany, is a species of plant in the family Meliaceae. Opuntia dillenii, a well-known member of the Cactaceae family, is used as a medicinal plant in various countries and grows in the desert, semi-desert, tropical and sub-tropical areas. Bird pepper or Capsicum frutescens (also called Ata Ijosin in Yoruba) is a tropical solanaceous plant. Turmeric root is a bright yellow-orange spice commonly used in curries and sauces. Ginger is a flowering plant whose rhizome, ginger root or ginger, is widely used as a spice. Garlic is a plant in the Allium (onion) family. The lemon is citrus like and a specie of small evergreen tree in the flowering plant family Rutaceae. Paw-paw, Asimina triloba, is a small deciduous tree. Other remedies include unripe pineapple and blackseed oil, black pepper, mango and guava leaves. The aqueous decoctions of these remedies especially the leaves were either taken orally or by steam inhalation. Since most of the home remedies are classified as 'generally regarded as safe' GRAS and in fact already used as food, dosing was not problematic. Generally, one teaspoonful of the powdered spices in 240-250 ml of warm water to be taken three times a day constituted daily routine throughout the period of treatment.

Results & discussion
About three months after it was officially recognised as a pandemic, the spread of the COVID-19 virus has continued, that urgent strong remedy is required, notwithstanding the paucity of knowledge on the life cycle of the virus and its mechanistic considerations (WHO 2019, [3,16] ). Currently there is no ideal anti-COVID-19 medications. An ideal anti-COVID-19 medication (or a combination of agents) should be safe for such patients while conferring three basic therapeutic effects (and/or preventive health benefits): enhancing the antiviral immunity, tissue-protection (and tissue repair) and exerting potent antiviral effects [4] . COVID-19 presents a vast public health challenge both in developed and developing nations.
The striking feature of most of the COVID-19 home remedies in Nigeria is their ability to restore physiological and psychological functions. Phenolic compounds and antioxidant properties of these remedies are known to contribute to their therapeutic effects. Consum ption of these Nigerian home remedies increase the anti-oxidant molecules and enzymes in the body and protect the cells and its membrane from being damaged by the toxic substances [ 1 , 18 ]. Phenolic moieties boost the body's immunity and defense against the threatening virus [17] . Scientists from the academia and Research Institutes have also supported the use of these home remedies as anti-COVID agents. In Madagascar a combination of artemisia, neem leaves, paw leaves, garlic, ginger, lime and oranges has been adopted as a notable anti-COVID agent. This combination is boiled for 30 min and steam-inhaled. Expectedly the steam inhalation clears the lungs of the virus. In fact, the Madagascar Institute of Applied Research has branded this decoction which can be also be taken orally as Covid-19 Organics CVO. Similar decoctions have been used in Nigeria and even by Nigerians who live in the diaspora. At inception COVID-19 was thought to be a lung disease but later evidence from autopsy reports tended to implicate Disseminated Intravascular Coagulation (DIC, Thrombosis). Regardless of the pathology, the African home remedies with their inherent antioxidant and anti-inflammatory properties may explain at least in part, the acclaimed protection, remission in symptoms, seroconversion and cure of COVID-19 in many parts of Africa.

Author contributions
OEO &CNO conceptualization, reviewed the draft manuscript and certified final manuscript. EON conducted the search, data extraction, drafting of manuscript.

Declaration of Competing Interest
The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.