Anti-sickling potential of a Nigerian herbal formula (ajawaron HF) and the major plant component (Cissus populnea L. CPK).

The anti-sickling activities of the extracts of the roots of a plant Cissus populnea L. (CPK) (a major constituent of a herbal formula Ajawaron HF used in the management of sickle cell disease in south-west Nigeria) has been examined. Phytochemical examination of the extract showed the presence of anthraquinone derivatives, steroidal glycosides and cardiac glycosides. Alkaloids and tannins were completely absent in the CPK extracts. Evaluation of the anti-sickling activity involved the use of both positive (p-hydroxybenzoic acid, 5 microg/mL) and negative control (normal saline) for each set of experiments aimed at the inhibition of sodium metabisulphite-induced sickling of the HbSS red blood cells obtained from confirmed non-crisis state sickle-cell patients. The chloroform and water partitioned fractions of the cold methanol extracts of CPK exhibited a 62.2% and 52.9% inhibition of sickling, respectively, at 180 min. The herbal formula (HF) aqueous extract showed the highest anti-sickling activity on a weight by weight basis of all the extracts and fractions tested, giving a 71.4% inhibition of sickling at the end of 180 min incubation when compared with the normal saline control. The maximum percentage inhibition of sickling exhibited by the p-hydroxybenzoic acid control was 46.0% at 90 min incubation.

Comparative efficacy of intramuscular artemether and intravenous quinine in Nigerian children with cerebral malaria.

The efficacy of a 5-day treatment with intramuscular artemether (3.2-mg/kg loading dose followed by 1.6 mg/kg daily) was compared to that of the standard 7-day treatment with quinine (20-mg/kg loading dose followed by 10 mg/kg every 8 h) in a randomised clinical trial including 103 children aged 12-60 months with cerebral malaria between 1994 and 1996. No statistical difference of immediate efficacy was found between the two treatments. There were 11 (20%) deaths in the artemether group and 14 (28%) in the children who received quinine. The respective artemether versus quinine median fever clearance times (h) were 39 (interquartile ranges [IQ] 30-54) vs. 48 (IQ 30-60), and parasite clearance 42 (IQ 24-60) vs. 36 (IQ 30-48). However, one patient who received artemether had a recrudescence on day 14, which was successfully treated with sulphadoxine-pyrimethamine. Times to recovery from coma were 24 h (IQ 18-45) and 33 h (IQ 19-57), respectively. The occurrence of transient neurological sequelae including motor disabilities, cortical blindness, and afebrile seizures was also similar in the two groups. No adverse reactions to the two drugs were recorded during the study period. Artemether represents an important option in the management of cerebral malaria in Nigeria especially in rural areas where facilities for intravenous administration may not yet be optimal.