Knowledge and practices of traditional management of child malnutrition and associated pathologies in Benin.

BACKGROUND: Child malnutrition is a major public health challenge, affecting millions of children worldwide, with alarming proportions of children under five in Benin. The complexity of managing this condition is increased by its potential association with opportunistic pathologies. An interesting approach arises from the use of medicinal plants, to address child malnutrition and its associated pathologies. This study aimed to document the knowledge and practices of Beninese mothers and traditional practitioners with regard to the use of medicinal plants to treat child malnutrition and associated diseases. METHODS: A total of 844 Beninese mothers and 201 traditional healers were surveyed between March 2022 and August 2023 in the communes of Karimama, Bopa and Za-Kpota in Benin. The respondents' knowledge of child malnutrition and associated pathologies was explored. The ethnobotanical data collected from the subjects concerned the medicinal recipes used to treat child malnutrition, the medicinal plants that make them up and the methods of use. These data were analyzed using ethnobotanical indices such as the Informant Consensus Factor, the frequency of citation of medicinal recipes types and medicinal plants, and the contribution of plants to medicinal recipes. RESULTS: All respondents cited a total of 82 plant species used to treat child malnutrition and associated diseases. These plants were grouped into 37 botanical families, the most common of which were Fabaceae, Malvaceae and Annonaceae. The leaves were the most commonly used part of the plant species identified. The mothers shared 122 medicinal recipes, ranging from recipes based on a single plant to more complex compositions involving five plants. The most notable plants were Moringa oleifera Lam, Phyllanthus amarus Schumach & Thonn, Senna siamea (Lam.) H.S.Irwin & Barneby, Carica papaya L. and Ocimum gratissimum L. Traditional healers provided 52 plants in 71 recipes, with Moringa oleifera featuring prominently in both single-plant and multiplant formulations. CONCLUSION: This study made it possible to constitute a rich base of medicinal recipes used against malnutrition and associated pathologies, with the preponderant involvement of certain plant species. It is therefore necessary to deepen research on these different identified species in order to scientifically assess their potential.

Traditional Eye Practices: Economics and Visual Status of Users in North Central Nigeria.

BACKGROUND: Traditional medicine is a constellation of practices, approaches, knowledge, and beliefs, which encompass material-based medicines, spiritual therapies, and manual techniques applied individually or combined. AIM: This study seeks to determine the cost and visual status of traditional eye treatments users among new patients at a health facility. MATERIALS AND METHODS: This is part of the study titled "Traditional eye practices: A facility-based study in North Central Nigeria." It is a cross-sectional, facility-based study conducted between July 2013 and June 2014 on new patients seen in the eye unit of Church of Christ in the Nations Rehabilitation Center, Mangu. Interviewer-administered structured questionnaire was used to gather information on patient demographics; cost of traditional eye medication and manipulations and visual status of new patients were recorded. RESULTS: The use of traditional eye treatment was reported by 134 (4.3%) of the 3113 new patients. Traditional operative couching of lens was more expensive than using traditional eye medications (P < 0.001). Payment modality varied, and poor visual status was significantly higher among traditional eye treatment users (P < 0.001). CONCLUSION: Since most respondents who had their eyes couched or used traditional eye medicine were able to pay such high price with dissatisfaction and poorer visual status, they should be able to pay for modern cataract surgery with good outcome. There is a need for health education of the general public about the deleterious effects of traditional eye treatment.

Experiences of traditional health practitioners in the management of female infertility in Harare urban areas: A qualitative study.

Female infertility is a health and social problem that traditional health practitioners (THPs) have been managing in African communities. This study explored the experiences of THPs in the management of female infertility, specifically focusing on their understanding, diagnosis, and treatment methods for female infertility. This was a qualitative study targeting six THPs in Harare urban areas registered with the Traditional Medical Practitioners Council (TMPC) in Zimbabwe. The Consolidated Criteria for Reporting Qualitative Research (COREQ) guidelines were followed in the description of the study design, analysis and presentation of findings. The findings revealed that the etiology of female infertility was attributed to biomedical, lifestyle, spiritual, and male factors. Management of infertility depended on the type of THP. Spirit mediums relied on divination and dreams to diagnose and treat female infertility. Herbalists focused on the physical evidence provided by the client through history taking. THPs had a client referral system within their TMPC network. All THPs ultimately used medicinal plants for treating female infertility. THPs play an important role in the management of female infertility. Understanding their contributions to the management of female infertility provides an opportunity to obtain insight into their practices, thus identifying areas that responsible Ministries can use to strengthen traditional health care systems and ultimately improve reproductive health care for women in African communities.

L'infertilité féminine est un problème sanitaire et social que les tradipraticiens (PTS) gèrent dans les communautés africaines. Cette étude a exploré les expériences des THP dans la gestion de l'infertilité féminine, en se concentrant spécifiquement sur leur compréhension, leur diagnostic et leurs méthodes de traitement de l'infertilité féminine. Il s'agissait d'une étude qualitative ciblant six PTH des zones urbaines de Harare enregistrés auprès du Conseil des médecins traditionnels (TMPC) au Zimbabwe. Les lignes directrices COREQ (Consolidated Criteria for Reporting Qualitative Research) ont été suivies dans la description de la conception de l'étude, de l'analyse et de la présentation des résultats. Les résultats ont révélé que l'étiologie de l'infertilité féminine était attribuée à des facteurs biomédicaux, liés au mode de vie, spirituels et masculins. La prise en charge de l'infertilité dépendait du type de THP. Les médiums spirituels s'appuyaient sur la divination et les rêves pour diagnostiquer et traiter l'infertilité féminine. Les herboristes se sont concentrés sur les preuves matérielles fournies par le client grâce à l'anamnèse. Les THP disposaient d'un système de référencement des clients au sein de leur réseau TMPC. Tous les THP utilisaient finalement des plantes médicinales pour traiter l'infertilité féminine. Les THP jouent un rôle important dans la gestion de l'infertilité féminine. Comprendre leurs contributions à la gestion de l'infertilité féminine offre l'opportunité d'avoir un aperçu de leurs pratiques, identifiant ainsi les domaines que les ministères responsables peuvent utiliser pour renforcer les systèmes de santé traditionnels et, à terme, améliorer les soins de santé reproductive pour les femmes des communautés africaines.

An ethnopharmacological survey of medicinal plants traditionally used by the BaKalanga people of the Tutume subdistrict in Central Botswana to manage HIV/AIDS, HIV-associated conditions, and other health conditions.

ETHNOPHARMACOLOGICAL RELEVANCE: While access to antiretroviral therapy (ART) continues to improve worldwide, HIV infection and AIDS persist as serious health challenges, particularly in sub-Saharan Africa. Complementary and Alternative Medicines (CAM), as part of indigenous and pluralistic medical systems, are important contributors to primary health care worldwide. However, this knowledge remains relatively undocumented in many parts of sub-Saharan Africa such as the Tutume subdistrict of Central Botswana, where CAM is widely used including potentially for HIV/AIDS and HIV-associated conditions. AIM OF THE STUDY: To explore the extent to which CAM is used by the BaKalanga Peoples of the Tutume subdistrict, we performed an exploratory community-based project to record medicinal plant use from this relatively undocumented region, with a particular focus on species used for management of HIV/AIDS and HIV-associated conditions. MATERIALS AND METHODS: Using the snowball sampling technique, we recruited 13 Traditional Health Practitioners (THPs) and conducted in-depth interviews to explore medicinal plant uses and treatment regimens. Plant specimens were collected and bio-authenticated. RESULTS: We documented 83 plant species used as CAM to treat or manage a variety of conditions including HIV/AIDS, HIV-associated conditions, and other health conditions. Plants from the family Leguminosae were most frequently reported, comprising 21 species (25.3%), followed by 5 from both Euphorbiaceae and Combretaceae families (6.0%). Four plants (4.8%) were used specifically to manage HIV (Lannea edulis (Sond.) Engl. root, Aloe zebrina Baker root, Myrothamnus flabellifolia Welw. whole plant, and Harpagophytum procumbens var. subulobatum (Engl.) tuber), while an additional 7 (8.4%) were reported specifically for treating combinations of HIV-related symptoms. Notably, 25 (30.1%) have not been reported previously as CAM and/or lack reported bioactivity data. CONCLUSIONS: To our knowledge, this is the first detailed ethnobotanical survey of CAM used by the BaKalanga Peoples of the Tutume subdistrict to manage HIV/AIDS and HIV-associated and other health conditions.

Perceived causes, diagnosis methods and treatment practices of mental illness among traditional healers of the Berta community in Assosa, Ethiopia.

INTRODUCTION: Mental illness is a non-communicable disease that is increasingly contributing to the global burden of diseases and disability. It affects a person's feelings, thinking, behavior, and daily life functioning. OBJECTIVES: The purpose of this study was to explore perceived causes of mental illness, techniques for identifying mental illness, and treatment methods used by traditional healers in the Berta community. METHODS: The study employed a qualitative research method. Data were collected using semi-structured in-depth interviews with seven traditional healers who were selected purposefully. We used thematic analysis to present and analyze the data. RESULTS: The findings of this study indicated that witchcraft, supernatural power, hereditary, substance use, and food poising as the main perceived causes of mental illness among traditional healers in the Berta community. The traditional healers identify mental illness using different techniques such as patient observation, interviews with a patient's family, use of religious books, and use of herbals. The traditional healers in the Berta community identify mental illness based on behavioral symptoms like talking about things that don't make sense, laughing alone, taking off clothes in public places, collecting and carrying dirty materials, eating dirty foods, and harming or intention to harm others. CONCLUSIONS: The traditional healers in the Berta community use herbals, religious books, and bone divination to guide their treatment of persons with mental illnesses. Some of these traditional healing practices options are peculiar to the Berta Community that are used to diagnosize and treat mental illnesses. RECOMMENDATIONS: The traditional healing practices of the Berta community should be recognized, licensed, and supported by the Ministry of Health and the Ethiopian Food and Drug Administration and Control Authority.

Indigenous knowledge system associated with the uses of insects for therapeutic or medicinal purposes in two main provinces of Burkina Faso, West Africa.

BACKGROUND: Some insects are harmful to humans, plants and animals, but some of them can also be a source of proteins, fats, vitamins and minerals and be of therapeutic value. The therapeutic potential requires that medicinal insects and their derived products need to be scrutinized. This study highlights the indigenous knowledge related to their use of medicinal insects in peri-urban and urban areas of Burkina Faso. METHODS: The survey was carried out among 60 traditional healers spread across two phytogeographical zones of Burkina Faso. The questionnaire focused on medicinal insects used by experienced traditional healers. Chi-square tests and principal component analysis were performed to test for significant differences regarding knowledge of how insects in phytogeographically different areas were used therapeutically in connection with different disease categories. RESULTS: A total of 19 species of medicinal insects belonging to 6 orders were cited in connection with treatments of at least 78 pathologies and symptoms. Most frequently mentioned was gastroenteritis. Our study showed that 48.78% of the insects and their products were associated with 46 plant species for the treatment of pathologies. In addition, honey, beeswax and nests were the most widely insect products used. CONCLUSION: The current study allows us to identify medicinal insects as well as their products used in the treatment of pathologies and symptoms, suggesting the presence of a considerable diversity of therapeutically important insect species. These insects are used alone and/or with their products but often in association with medicinal plants. The results constitute a useful database for future studies of medicinal insects in central and western parts of Burkina Faso.

"If it weren't for my traditional healer, I would be dead": Engaging traditional healers to support people living with HIV in rural Mozambique.

Across rural sub-Saharan Africa, people living with HIV (PLHIV) commonly seek out treatment from traditional healers. We report on the clinical outcomes of a community health worker intervention adapted for traditional healers with insight into our results from qualitative interviews. We employed a pre-post intervention study design and used sequential mixed methods to assess the impact of a traditional healer support worker intervention in Zambézia province, Mozambique. After receiving a positive test result, 276 participants who were newly enrolled in HIV treatment and were interested in receiving home-based support from a traditional healer were recruited into the study. Those who enrolled from February 2016 to August 2016 received standard of care services, while those who enrolled from June 2017 to May 2018 received support from a traditional healer. We conducted interviews among healers and participants to gain insight into fidelity of study activities, barriers to support, and program improvement. Medication possession ratio at home (based on pharmacy pick-up dates) was not significantly different between pre- and post-intervention participants (0.80 in the pre-intervention group compared to 0.79 in the post-intervention group; p = 0.96). Participants reported receiving educational and psychosocial support from healers. Healers adapted their support protocol to initiate directly observed therapy among participants with poor adherence. Traditional healers can provide community-based psychosocial support, education, directly observed therapy, and disclosure assistance for PLHIV. Multiple factors may hinder patients' desire and ability to remain adherent to treatment, including poverty, confusion about medication side effects, and frustration with wait times at the health facility.

Traditionally used polyherbals in a southern African therapeutic context.

ETHNOPHARMACOLOGICAL RELEVANCE: In African traditional medicine, there are several plant species that are used in combination with either other plant species or non-plant derived combinations such as sugar and honey, salt and vinegar, milk, fat etc. This review examines the role of these combinations and postulates the scientific and therapeutic validation of such combinations. AIM OF THE STUDY: This study reviewed the ethnopharmacological literature and documented the use of southern African plant combinations to find a scientific rationale for such combinations, and provide recommendations for future studies. MATERIALS AND METHODS: Ethnobotanical books and online databases such as Scopus, ScienceDirect, PubMed and Google Scholar were used to find ethnobotanical studies within the southern African context that focus on the combinations of plants with other plants or various additional ingredients. The scientific literature was examined to determine if evidence was available to substantiate such combinations. RESULTS: One hundred and eighty-seven medicinal plant (plant-to-plant) combinations that are used in the southern African traditional healing system were recorded. These plant combinations were used against infections of the gastrointestinal tract, respiratory tract, and skin as well other non-infectious diseases such as reproductive and psychiatric disorders. Respiratory infections were the most documented infections to be treated using plant combinations. The plant that was documented to be most commonly used in combination with other plants was Artemisia afra Jacq. ex Willd. While plant-plant combinations have drawn a marked interest, comparatively, plant-adjuvant (e.g. milk, sugar, honey, salt, vinegar, fats) combinations have attracted less research interest. Milk was reported as the most used additional ingredient in combination with medicinal plants. The combination of animal urine and dung with medicinal plants has been reported as a treatment for treat prostate infections, the human immunodeficiency virus (HIV). Other ingredients such as clay and flour were also documented, and these are often mixed with medicinal plants to treat fever, stomach ailments, sexually transmitted infections (STI) and skin conditions. Although combination therapy has been frequently reported in ethnobotanical records, over 90% of the combinations reviewed still need to be scientifically validated. CONCLUSION: Scientific reports on the antimicrobial, anti-oxidant, anti-inflammatory and other pharmacological effects of these combinations may offer an understanding of traditional combination therapy. In addition, investigation into the mechanisms of action of these combinations are also recommended to supplement the findings. Nonetheless, the use of plant combinations is still an untapped research area in southern Africa and there is a need to validate the use of those documented combinations to obtain a better understanding of combined traditional medicinal plant use.

Health benefits and biological activities of spiny monkey orange (Strychnos spinosa Lam.): An African indigenous fruit tree.

ETHNOPHARMACOLOGICAL RELEVANCE: Spiny monkey orange (Strychnos spinosa Lam.) is an African endemic fruit tree that is widely consumed by humans and animals for its nutritional value. In folk medicine, different parts of S. spinosa are widely used for the management of the health and well-being of humans and livestock. AIM: We provide a critical appraisal on the ethnobotanical uses, nutritional and pytochemical as well as the biological activities of S. spinosa. METHODS: Articles were mined from online databases such as Google Scholar, PubMed, Science Direct, SciELO and SpringerLink. We captured research outputs that aligned with the scope of the review. RESULTS: Strychnos spinosa remains a commonly consumed fruit due to its high nutritional (e.g. carbohydrates, crude protein and fats) content and energy. In folk medicine, different parts of S. spinosa are prescribed as remedy for diverse medical conditions especially for treating malaria, diabetes, snakebites, skin-related conditions and sexually transmitted infections in humans as well as sleeping sickness in livestock. Together with essential oils, more than 25 compounds have been profiled using Gas chromatography-mass spectrometry (GC-MS), and approximately 45 compounds have been isolated and structurally elucidated using diverse spectroscopic techniques such as UV-visible, Infrared (IR), Nuclear Magnetic Resonance (NMR) and mass spectroscopy (MS). Strychnos spinosa exerts varying degrees of biological activities against different microorganisms (bacteria and fungi) and parasites (plasmodia, trypanosomes and ticks) responsible for many diseases in humans and livestock. Furthermore, low to moderate enzyme-inhibitory effects of S. spinosa extracts suggest its ability to mitigate pains, inflammations and diabetics as well as snakebite venom. Increasing evidence from the in vivo studies support the use of the plant as a popular remedy for managing diabetics in folk medicine. The low cytotoxic effect of the plant extracts against different cell lines could be an indication of its relative safety. CONCLUSION: Strychnos spinosa exhibits various health-promoting benefits due to its diverse nutritional and phytochemical constituents. Given that the majority of the existing evidence on these aforementioned therapeutic properties and safety are in vitro-based, the clinical significance of these results remain limited.

Invasive alien plants and weeds in South Africa: A review of their applications in traditional medicine and potential pharmaceutical properties.

ETHNOPHARMACOLOGICAL RELEVANCE: Traditional pharmacopoeias are constantly evolving and adapting, hence the assimilation of alien plants and weeds into traditional systems of healing. Invasive plants are detrimental to the ecosystem, however they are also potential sources of secondary metabolites with useful biological activities. AIM OF THE REVIEW: The aim of this review was to investigate published reports of traditional use and biological activity of declared invasive alien plants and other weeds in South Africa. MATERIALS AND METHODS: Information was retrieved from scientific databases including Scopus, Web of Science, ScienceDirect, Google Scholar, PubMed, Chemical Abstracts Services and books, theses, dissertations and technical reports. Keywords used for the search engines were "South Africa" or "southern Africa" in conjunction with "(native weeds OR alien invasive)" AND "medicinal". Separate searches were conducted on the individual invasive plant species recorded as having been used in ethnobotanical surveys to determine their known biological activities and chemical components. RESULTS: A total of 89 plant species regarded as invasive species or weeds in South Africa were identified as being used in traditional medicine. The most commonly mentioned plant family was the Asteraceae with a total of 15 species followed by the Fabaceae and Solanaceae with 6 species each. Of the 89 species recorded, 68% were reported to have traditional usage with both phytochemical and biological data available. A history of traditional usage coupled with biological data was available for 12% of species. Records of traditional usage alone were linked to 11% of species. Invasive alien species comprised 61% of recorded species, while native and non-invasive alien weeds formed the remaining 39%. CONCLUSIONS: The exploration of alternative uses for weeds and particularly invasive plants, whether native or alien, as medicines for possible commercialisation may lead to innovative mechanisms for putting such species to good use.

Medicinal Plants for Anti-neurodegenerative diseases in West Africa.

ETHNOPHARMACOLOGICAL RELEVANCE: Neurodegenerative diseases are neuronal diseases that affect the brain components by degenerating the structure and function of the central or peripheral nervous system progressively. It is a leading cause of death and affects huge amount of people worldwide. Plant-based medicines have been utilised in the therapies for many illnesses that have defied western treatments, including neurodegenerative diseases. AIM OF THIS REVIEW: This review presents an overview of the major neurodegenerative diseases and reported prominent medicinal plants used in managing those diseases in West Africa. METHODS: Scientific articles regarding medicinal plants and their usefulness in managing neurodegenerative diseases in West Africa were pooled from different scientific databases. We used the Preferred Reporting Items for Systematic Reviews and Meta-Analyses to filter articles based on their relevance. Pharmacological activity, plant parts used, experimental models, and some isolated chemical compounds of those plants were summarised. RESULTS: In the West Africa region, Fabaceae (19%) and Solanaceae (13%) have the highest representation of plant families used to treat neurological diseases, while Apocynaceae, Asteraceae, Euphorbiaceae have also been utilised. Flavonoids, alkaloids, phenolic compounds, terpenoids, coumarins present in those plants and their derivatives are reported to possess neuro-protective effects. Biochemical enzymes correlating to antioxidants, anti-inflammatory effects are the potential targets against neurodegenerative diseases. CONCLUSION: Medicinal plants for anti-neurodegenerative diseases in West Africa have been documented with their neuropharmacological activities. Plant families such as Fabaceae, Solanaceae, Apocynaceae, Asteraceae, and Euphorbiaceae could be a major natural source for discovery of anti-neurodegenerative drugs, thus the metabolites from them should be given priority for neurological research. This review will provide clues for further investigations on the screening and development of anti-neurodegenerative natural products from West African medicinal plants.

A review of the traditional use of southern African medicinal plants for the treatment of inflammation and inflammatory pain.

ETHNOPHARMACOLOGICAL RELEVANCE: Inflammation is a serious global concern due to its debilitating symptoms, resulting in considerable suffering and lost productivity. Chronic and auto-immune inflammatory diseases are of particular concern. Several pharmaceutical therapies are already available. However, the use of non-steroidal anti-inflammatory drugs (NSAID's) is accompanied by harmful and toxic side effects. Hence, the search for safer alternative therapeutics with limited side effects is imperative. The use of medicinal plants is common practice amongst the southern African population and may provide targets for drug development. AIM OF THE STUDY: This study aims to review and document the medicinal uses and pharmacological properties of southern African medicinal plants used for inflammation and pain-related ailments. MATERIAL AND METHODS: An extensive literature review was undertaken to identify southern African plants used traditionally to treat inflammation. A variety of ethnobotanical books and grey literature, as well as ScienceDirect, Google Scholar and Scopus search engines were used as sources of information. RESULTS: This review identified 555 medicinal plants from 118 families which were traditionally used in southern Africa to treat inflammation and pain. Fabaceae was the most prominent family with 63 species, followed by Asteraceae (54 species) and Apocynaceae (33 species). The top category of ailments indicated include non-specific inflammation with 150 species, followed by inflammatory pain (148 species), headache (114 species) and toothache (114 species). CONCLUSION: Despite a large number of southern African medicinal plants used to treat inflammation and pain, relatively few have been screened for their anti-inflammatory properties. Furthermore, biologically active plant extracts have been tested against relatively few inflammatory markers and considerable further work is required.

Ethnoveterinary study of galactogenic recipes used by ruminant breeders to improve milk production of local cows in Benin Republic.

ETHNOPHARMACOLOGICAL RELEVANCE: In Benin, traditional recipes are used to improve livestock dairy performance, but they are not sufficient documented. The study aimed to inventory the galactogenic recipes used by herders to improve production in cow farming. AIM OF THE STUDY: The study aimed to inventory the galactogenic recipes used by herders to improve production in cow farming. MATERIAL AND METHODS: We conducted semi-structured interviews among 65 peuls camps, 4 bioclimatic zones, and 565 farmers dialogue partners, including agro-pastoralist, healers and pastoralists from the rainy season April and May 2019. Detailed information about homemade herbal remedies of galactogenic recipes (plant species, plant part, manufacturing process) and the corresponding use reports (dialogue partner, category of use and route of administration) was collected. Then other to classify the various recipes identified into homogeneneous groups according to their effectiveness in stimulating milk, a numerical classification was carried out on the recipes taking into account the milk gain. RESULTS: They showed that Peuls and Gandos sociocultural groups have a better knowledge of galactogenic recipes. Of the 295 recipes inventoried, 102 frequently cited recipes were divided into two groups. Group 2, consisting of 16 recipes, had a significantly (p < 0.001) higher milk yield than group 1. Vigna unguiculata (L.) Walp. and Arachis hypogaea L. were the main ingredients of the recipes (respectively 56 and 31% of incorporation rate). The composition of the recipes varied according to the agro-ecological zones. Herders in Northern Benin used more recipes based on Bobgunnia madagascariensis (Harms) J.H.Kirkbr. & Wiersema, Saba comorensis (Bojer ex A.DC.) Pichon and Euphorbia balsamifera Aiton. Those in Southern Benin mainly used recipes based on Gardenia aqualla associated with Vigna unguiculata (L.) Walp or Arachis hypogaea L.. To improve the effectiveness of galactogenic recipes, socio-cultural and magical-religious practices are used when procuring the plant material to be used, preparing the galactogen and administering the recipe to the animals. These include pronounced incantations or recited Koranic verses. The most commonly used route of administration is the oral route with an average treatment duration not exceeding 5 days. CONCLUSION: The study reveals that the majority of breeders (90%) opt for the use of galactogenic plants rather than synthetic products to improve milk production.

Views and experiences of traditional and Western medicine practitioners on potential collaboration in the care of people living with mental illness in Malawi.

Introduction: Collaboration between traditional and biomedical medicine can lead to holistic care and improved health outcomes for people with mental illnesses. The current study aimed to explore the views and experiences of traditional and western medicine practitioners on potential collaboration in the care of people living with mental illness in Blantyre, Malawi. Method: A phenomenological qualitative research design was used. Data were collected using both one-on-one in-depth interviews (IDIs) and focus group discussions (FGDs). Participants were traditional healers and western medicine practitioners in Blantyre, Malawi. We conducted 10 in-depth interviews with traditional healers, 4 focus group discussions (2 for traditional healers and 2 for western medicine practitioners) and 6 key informant interviews with leaders of the two groups. The sample was determined based on data saturation. Thematic analysis was used to analyse the data. We used a combination of deductive and inductive coding. Results: Five broad themes were identified from the data: experiences with collaboration, views on collaboration, models of collaboration, barriers to collaboration, and factors that can facilitate collaboration. participants had no experience of formal collaboration between traditional healers and western healthcare workers in the management of mental illness. However, some reported experience of successful collaborations in other health areas such as safe motherhood, tuberculosis and HIV/AIDS. Many participants showed a positive attitude toward collaboration and were in support of it. Barriers to collaboration included negative attitudes and a lack of resources. Factors that can facilitate collaboration were dialogue, training and respect. Referral and training were the preferred forms of collaboration. Conclusion: With proper structures and respectful dialogue, a collaboration between traditional and western medicine practitioners is possible in Blantyre, Malawi.

Percentage Destabilization Effect of Some West African Medicinal Plants on the Outer Membrane of Various Bacteria Involved in Infectious Diarrhea.

Previous work stated that Khaya senegalensis, Anacardium ouest L., Pterocarpus erinaceus, Diospyros mespiliformis, Ocimum gratissimum, Manihot esculenta, Vernonia amygdalina Delile, and Daniellia oliveri have a great potential for the fight against infectious diarrhea. However, data on their antibacterial activity on strains of bacteria responsible for infectious diarrhea are not available. This study is aimed at elucidating the mechanism of action of the antibacterial effect of these plants on some bacterial strains responsible for diarrheal infections. The design of the study included first evaluating the degree of sensitivity of Salmonella typhimurium 14028, Escherichia coli ATCC 25922, Shigella spp., and Salmonella spp. strains to aqueous and hydroethanolic extracts of each plant, followed by the determination of minimum inhibitory concentration (MIC), minimum bactericidal concentration (MBC), and antibiotic power (Pa). This screening was completed with the evaluation of the possible mode of action of the extracts by testing the membrane permeability of these bacterial strains. The data collected indicate that the bacterial strains tested were sensitive to the extracts to varying degrees, except Cassia sieberiana DC and Pseudocedrela kotschyi extracts. For the active extracts, inhibition diameters ranged from 18.33 mm to 7 mm. With the exception of Escherichia coli, all strains were sensitive to the aqueous and hydroethanolic extracts of Anacardium occidentale. MICs vary between 3.37 and 25 mg/ml. Membrane permeability test data show that all active extracts affect the bacterial strains tested by attacking the stability of their outer membrane. For all active extracts, the high percentage of membrane destabilization of the bacteria is significantly (p < 0.05) better than that of cefixime used as a reference. Thus, it appears that these extracts can destroy Gram-negative bacteria and increase the fluidity and permeability of their cytoplasmic membrane. The knowledge of the mechanism of action of these extracts is an interesting contribution to the fundamental knowledge on the alternative that medicinal plants represent to antibiotics. These extracts can be used in the management of infectious diarrhea.

Sceletium tortuosum: A review on its phytochemistry, pharmacokinetics, biological and clinical activities.

ETHNOPHARMACOLOGICAL RELEVANCE: Sceletium tortuosum (L.) N.E.Br, the most sought after and widely researched species in the genus Sceletium is a succulent forb endemic to South Africa. Traditionally, this medicinal plant is mainly masticated or smoked and used for the relief of toothache, abdominal pain, and as a mood-elevator, analgesic, hypnotic, anxiolytic, thirst and hunger suppressant, and for its intoxicating/euphoric effects. Sceletium tortuosum is currently of widespread scientific interest due to its clinical potential in treating anxiety and depression, relieving stress in healthy individuals, and enhancing cognitive functions. These pharmacological actions are attributed to its phytochemical constituents referred to as mesembrine-type alkaloids. AIM OF THE REVIEW: The aim of this review was to comprehensively summarize and critically evaluate recent research advances on the phytochemistry, pharmacokinetics, biological and clinical activities of the medicinal plant S. tortuosum. Additionally, current ongoing research and future perspectives are also discussed. METHODS: All relevant scientific articles, books, MSc and Ph.D. dissertations on botany, behavioral pharmacology, traditional uses, and phytochemistry of S. tortuosum were retrieved from different databases (including Science Direct, PubMed, Google Scholar, Scopus and Web of Science). For pharmacokinetics and pharmacological effects of S. tortuosum, the focus fell on relevant publications published between 2009 and 2021. RESULTS: Twenty-five alkaloids belonging to four structural classes viz: mesembrine, Sceletium A4, joubertiamine, and tortuosamine, have been identified from S. tortuosum, of which the mesembrine class is predominant. The crude extracts and commercially available standardized extracts of S. tortuosum have displayed a wide spectrum of biological activities (e.g. antimalarial, anti-oxidant, immunomodulatory, anti-HIV, neuroprotection, enhancement of cognitive function) in in vitro or in vivo studies. This plant has not yet been studied in a clinical population, but has potential for enhancing cognitive function, and managing anxiety and depression. CONCLUSION: As an important South African medicinal plant, S. tortuosum has garnered many research advances on its phytochemistry and biological activities over the last decade. These scientific studies have shown that S. tortuosum has various bioactivities. The findings have further established the link between the phytochemistry and pharmacological application, and support the traditional use of S. tortuosum in the indigenous medicine of South Africa.

Impact of Traditional Healers on the HIV Care Cascade in Senegal, West Africa: A Longitudinal Study.

Consultation with traditional healers (THs) is common among people living with HIV in sub-Saharan Africa. We conducted a prospective longitudinal study to determine the association between consultation with THs and HIV outcomes following 12 months of antiretroviral therapy (ART). HIV-infected individuals presenting for care and initiation of ART in Dakar and Ziguinchor, Senegal were eligible for enrollment. Data were collected using interviews, clinical evaluations, laboratory analyses, and chart reviews at enrollment, 6 months after ART initiation, and 12 months after ART initiation. Among the 186 participants, 35.5% consulted a TH. The most common reason for consulting a TH was "mystical" concerns (18%). Those who consulted a TH before ART initiation were more likely to present with a CD4 count < 200 cells/mm3 (44% versus 28%; P = 0.04) and WHO stage 3 or 4 disease (64% versus 46%; P = 0.03), and they were less likely to disclose their HIV status (44% versus 65%; P = 0.04). Those who consulted a TH more than 6 months after ART initiation were more likely to report poor adherence to ART (57% versus 4%; P < 0.01). The strongest predictor of virologic failure was consulting a TH more than 6 months after ART initiation (odd ratio [OR], 7.43; 95% CI, 1.22-45.24). The strongest predictors of mortality were consulting a TH before ART initiation (OR, 3.53; 95% CI, 1.25-9.94) and baseline CD4 count < 200 cells/mm3 (OR, 3.15; 95% CI, 1.12-8.89). Our findings reveal multiple opportunities to strengthen the HIV care cascade through partnerships between THs and biomedical providers. Future studies to evaluate the impact of these strategies on HIV outcomes are warranted.

Assessment of the Diversity of Medico-Magic Knowledge on Four Herbaceous Species in Benin.

BACKGROUND: Ethnobotanical knowledge on four herbaceous species, Acmella uliginosa (Sw.) Cass., Momordica charantia L., Phyllanthus amarus Schumach. & Thonn., and Scoparia dulcis L., in Benin was investigated. METHODS: Herbal medicine traders in six different markets were interviewed using a semi-structured questionnaire. The linear regression test was performed to check for the influence of respondent's age on ethnobotanical uses they hold. Relative frequency citation, fidelity level, use value, and Rahman similarity index were calculated to assess the diversity of medico-magic knowledge. The Informant Consensus Factor is not applicable in this study since we are dealing neither with the diversity of medicinal plants used by a community of people nor with a great number of plant species used for medicinal purposes, nor the diversity of plant species used in the treatment of a specific or group of ailments. RESULTS: The respondent's age did not influence the ethnobotanical uses they hold on the species. All thirty-six informants surveyed traded Phyllanthus amarus Schumach. & Thonn., Momordica charantia L., and Scoparia dulcis L., and the majority traded Acmella uliginosa (Sw.) Cass. The respondent's age does not influence the diversity of ethnobotanical uses they hold on the study species. Purchase in traders' own markets was the predominant source of Phyllanthus amarus Schumach. & Thonn., Momordica charantia L., and Scoparia dulcis L. while Acmella uliginosa (Sw.) Cass. was mostly purchased in other more distant markets. A noticeable proportion of traders also collect Phyllanthus amarus Schumach. & Thonn. and Momordica charantia L. from wild populations. Phyllanthus amarus Schumach. & Thonn. was the species most demanded by customers followed by Momordica charantia L. Traders confirmed the scarcity of all species in recent years and climate change and destruction of natural habitats for logging were the most cited causes. The entire plant of Phyllanthus amarus Schumach. & Thonn. was used mainly to treat malaria, diabetes, and constipation, and decoction with oral administration was the most frequent preparation for malaria treatment. To treat diabetes, informants mixed Phyllanthus amarus Schumach. & Thonn. with Momordica charantia L. used as a decoction with oral administration. Momordica charantia L. was also used to treat measles and chicken pox. Acmella uliginosa (Sw.) Cass. and Scoparia dulcis L. were mostly used for their spiritual use for luck, predominantly by chewing fresh leaves or flowers, and by bathing with the ground plant mixed with soap, respectively. Overall, Momordica charantia L. had the greatest use value followed by Phyllanthus amarus Schumach. & Thonn. The majority of traders do not plant the species. CONCLUSIONS: The harvesting and trade of the species threaten their natural populations and urgent tools, including in situ and ex situ conservation, are needed to ensure their long-term sustainable exploitation.

Ethiopian Medicinal Plants Traditionally Used for the Treatment of Cancer; Part 3: Selective Cytotoxic Activity of 22 Plants against Human Cancer Cell Lines.

Medicinal plants have been traditionally used to treat cancer in Ethiopia. However, very few studies have reported the in vitro anticancer activities of medicinal plants that are collected from different agro-ecological zones of Ethiopia. Hence, the main aim of this study was to screen the cytotoxic activities of 80% methanol extracts of 22 plants against human peripheral blood mononuclear cells (PBMCs), as well as human breast (MCF-7), lung (A427), bladder (RT-4), and cervical (SiSo) cancer cell lines. Active extracts were further screened against human large cell lung carcinoma (LCLC-103H), pancreatic cancer (DAN-G), ovarian cancer (A2780), and squamous cell carcinoma of the esophagus (KYSE-70) by using the crystal violet cell proliferation assay, while the vitality of the acute myeloid leukemia (HL-60) and histiocytic lymphoma (U-937) cell lines was monitored in the 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyl-2H-tetrazolium bromide (MTT) microtiter assay. Euphorbia schimperiana, Acokanthera schimperi, Kniphofia foliosa, and Kalanchoe petitiana exhibited potent antiproliferative activity against A427, RT-4, MCF-7, and SiSo cell lines, with IC50 values ranging from 1.85 ± 0.44 to 17.8 ± 2.31 µg/mL. Furthermore, these four extracts also showed potent antiproliferative activities against LCLC-103H, DAN-G, A2780, KYSE-70, HL-60, and U-937 cell lines, with IC50 values ranging from 0.086 to 27.06 ± 10.8 µg/mL. Hence, further studies focusing on bio-assay-guided isolation and structural elucidation of active cytotoxic compounds from these plants are warranted.