Ethnobotanical Survey of Medicinal Plants Used in Breast Cancer Treatment by Traditional Health Practitioners in Central Uganda.

Purpose: The study aimed to document the existing knowledge and practices related to breast cancer recognition and treatment using medicinal plants by traditional health practitioners in Central Uganda. Methods: This cross-sectional exploratory survey, conducted between February and August 2020, applied a mixed methods research approach. A semi-structured questionnaire was administered to 119 traditional health practitioners (THPs) in Kampala, Wakiso and Mukono. Content analysis of qualitative data was done. Quantitative ethnobotanical survey indices, namely user reports (Nur), percentage of respondents with knowledge (PRK), informant consensus factor (Fic), fidelity level (FL), preference ranks (PR) and direct matrix ranking (DMR) were determined. Results: Most THPs recognized breast cancer by breast swelling (n=74, 62.2%) and breast pain (n=29, 24.4%). They cited 30 plants from 30 genera in 23 families (Fic 0.75 on breast cancer). Asteraceae, Apocynaceae, Euphorbiaceae, Fabaceae, Lamiaceae and Rutaceae were the predominant families. The ten most cited plants were Annona muricata L. (Nur=24), Rhoicissus tridentata (L.f.) Wild & R.B.Drumm (Nur =19), Erythrococca bongensis Pax (Nur=11), Ficus sp. (Nur=10), Cannabis sativa L. (Nur=8), Ipomoea wightii (Wall.) Choisy (Nur=7), Erythrina abyssinica DC. (Nur=5), Leucas martinicensis (Jacq.) R.Br. (Nur=4), Abelmoschus esculentus (L.) Moench (Nur=4) and Zanthoxylum chalybeum Engl. (Nur=3). Annona muricata L. was highly preferred by THPs (PR 1), Ficus sp. had highest fidelity level (FL=77%) and Zanthoxylum chalybeum Engl. ranked as the highest multipurpose plant (DMR 1). Herbs (n=14, 47%) were the most commonly used life forms besides trees (n=11, 37%) and shrubs (n=5, 16%). THPs mostly used leaves (46%), prepared decoctions (82%) and applied residues on the breast. Conclusion: THPs in Central Uganda recognized breast cancer by symptoms. Medicinal plants applied in its folk treatment have been documented and the claims of cure by THPs merit further investigation.

Antimicrobial Bioactivity and GC-MS Analysis of Different Extracts of Corchorus olitorius L Leaves.

Results: Crude extracts of Corchorus olitorius L leaves and their TLC-separated components demonstrated bioactivity against Staphylococcus aureus (14 mm), Streptococcus pneumoniae (16 mm), and Escherichia coli (11 mm) but neither against Candida albicans nor Mycobacteria tuberculosis. However, the overall zones of inhibition were smaller compared to the positive control (≥18 mm). GC-MS analysis of the active components revealed the presence of methyl esters. Conclusion: Corchorus olitorius L is bioactive against both Gram-negative and Gram-positive bacteria but neither against fungi nor mycobacteria. The bioactivity is attributable to the presence of methyl esters. Since methyl esters already have proven bioactivity in some studies, they could be further studied and optimized for possible pharmaceutical use. Further, to provide a more comprehensive antimicrobial spectrum of Corchorus olitorius L in Uganda, purified active components could be investigated using a wider range of organisms.

Traditional Medicinal Vegetables in Northern Uganda: An Ethnobotanical Survey.

BACKGROUND: A wide range of indigenous vegetables grow in Uganda especially during rainy seasons but scarcely during droughts, except those that are commercially grown. Although a number of these vegetables have medicinal values, they have not been satisfactorily studied besides conservation. Therefore, we conducted a cross-sectional ethnobotanical survey in Northern Uganda in order to document traditional medicinal vegetables and their uses. METHODS: Qualitative and quantitative approaches of data collection and analysis were employed using semistructured, interviewer-administered questionnaires as well as key informant interviews following international ethical codes. Fidelity levels and informant consensus factors were also calculated. RESULTS: 13 traditional vegetables belonging to 10 families were reported to serve as folk medicines. The most dominant families were Fabaceae (23.08%) and Solanaceae (15.38%). The most often used vegetables were Corchorus spp., Hibiscus spp., and Asystasiagangeticafor musculoskeletal (51%), gastrointestinal (34.3%), and malaria (31.8%). The vegetables were cultivated in the backyard and the leaves stewed for the different ailments. The informant consensus factor was the highest for Corchorus spp., in the treatment of joint pain/stiffness (0.92-1) while the highest fidelity level was (60.42%) for Amaranthus spp., in the management of anemia. CONCLUSIONS: Northern Uganda has numerous traditional vegetables with medicinal benefits. Diseases treated range from gastrointestinal to reproductive through musculoskeletal abnormalities. The community obtains vegetable leaves from the backyard and stews them regularly for the medicinal purposes with no specific dosage. Therefore, we recommend studies to verify in laboratory models the efficacy of these vegetables and standardize the dosages.

Total polyphenols and antihyperglycemic activity of aqueous fruits extract of Abelmoschus esculentus: Modeling and optimization of extraction conditions.

Aqueous fruits extract of Abelmoschus esculentus (L.) Moench (Malvaceae) has been used traditionally in several communities to alleviate elevated blood glucose levels. However, optimized extraction conditions have not been reported. Thus, this study determined the optimal extraction conditions for extracting polyphenols from A. esculentus fruits and evaluated antihyperglycemic activity in vivo. Extraction time, temperature, and solid-to-solvent ratio were optimized using Response Surface Methodology (RSM). Total polyphenols and flavonoids were quantified using the Folin-Ciocalteu and aluminium chloride colorimetric methods, respectively. The fingerprint and quantification of quercetin-a major flavonoid with an antihyperglycemic effect was done using the chromatographic method. The antihyperglycemic activity was determined in a high-fat diet-Streptozotocin rat model. The rats were assigned to five groups (n = 6): Group 1 and 2 were normal and diabetic control received distilled water 1 mL/100g; Treatment group 3 and 4 received standardized A. esculentus fruit extract (AEFE) at a dose of 100 and 200 mg/kg, respectively; Group 5 received 5 mg/kg glibenclamide. All treatments were given orally for 14 days. Measurements of fasting plasma glucose (FPG) and body weight were done weekly. The RSM quadratic model predicted total polyphenols of 22.16 mg GAE/g DW. At optimal conditions of a solid-to-solvent ratio of 5%, extraction time 1 h, and extraction temperature of 70°C, confirmation experiments yield 20.2 [95% CI; 16.7 to 27.6] mg GAE/g DW, implying the model successfully predicted total polyphenols. The extract HPLC fingerprint showed 13 characteristic peaks with 0.45 ± 0.02 µg/g DW of quercetin. Compared with diabetic control, the standardized AEFE reduced FPG level dose-dependently (P < 0.001) with an EC50 of 141.4 mg/kg. Together, at optimal extraction conditions, extract with a high content of total polyphenols and good antihyperglycemic activity can be obtained. Studies are needed to identify additional polyphenolic compounds and determine their antidiabetic effects.

Pharmacological reflection of plants traditionally used to manage diabetes mellitus in Tanzania.

ETHNOPHARMACOLOGICAL RELEVANCE: The increasing national prevalence of diabetes mellitus (DM) and its complications have overstretched the health care system in Tanzania and influenced patients to use herbal medicines as alternative therapeutic strategies. Therefore, an urgent need exists to validate the safety and efficacy of plants used locally. AIM OF THE STUDY: To identify plants used for the management of DM in Tanzania and analyses their pharmacological, phytochemistry, and safety evidence with a special focus on the mechanism of action. METHODS: Researchers searched Medline, web of science, and Scopus for published articles. Also, specialized herbarium documents of Muhimbili Institute of traditional medicine were reviewed. Articles were assessed for relevance, quality, and taxonomical accuracy before being critically reviewed. RESULTS: We identified 62 plant species used locally for DM management. Moringa oleifera Lam. and Cymbopogon citratus (D.C) stapf were the most mentioned. Fifty-four phytochemicals from 13 species had DM activities. These were mainly; polyphenolics, phytosterols, and triterpenoids. Extracts, fractions, and pure compounds from 18 species had in vitro antidiabetic activities of which 14 had α-glucosidase and α-amylase inhibition effects. The most studied -Momordica charantia L. increased; glucose uptake and adiponectin release in 3T3-L1 adipocytes, insulin secretion, insulin receptor substrate-1 (IRS-1), GLUT-4 translocation, and GLP-1 secretion; and inhibited protein tyrosine phosphatase 1 B (PTP1B). Preclinical studies reported 30 species that lower plasma glucose with molecular targets in the liver, skeletal muscles, adipose tissues, pancreases, and stomach. While three species; Aspilia mossambiscensis (Oliv.) Willd, Caesalpinia bonduc (L.) Roxb, and Phyllanthus amarus Schumach. & Thonn. had mild toxicity in animals, 33 had no report of their efficacy in DM management or toxicity. CONCLUSION: Local communities in Tanzania use herbal medicine for the management of DM. However, only a fraction of such species has scientific evidence. A. mossambiscensis, C. bonduc., and P. amarus had mild toxicity in animals. Together, our findings call for future researches to focus on in vitro, in vivo, and phytochemical investigation of plant species for which their use in DM among the local communities in Tanzania have not been validated.

The safety and efficacy of Momordica charantia L. in animal models of type 2 diabetes mellitus: A systematic review and meta-analysis.

Type 2 diabetes mellitus is a chronic hyperglycemic condition due to progressively impaired glucose regulation. Momordica charantia L. could potentially improve hyperglycemia because its fruit extracts can alleviate insulin resistance, beta-cell dysfunction, and increase serum insulin level. We evaluated the effect of M. charantia L. in comparison with a vehicle on glycemic control in animal models of type 2 diabetes mellitus. MEDLINE, Web of Science, Scopus, and CINAHL databases were searched without language restriction through April 2019. About 66 studies involving 1861 animals that examined the effect of M. charantia L. on type 2 diabetes mellitus were included. Fruits and seed extracts reduced fasting plasma glucose (FPG) and glycosylated hemoglobin A1c in comparison to vehicle control: (42 studies, 815 animals; SMD, -6.86 [95% CI; -7.95, -5.77], 3 studies, 59 animals; SMD; -7.76 [95% CI; -12.50, -3.01]) respectively. Also, the extracts have hepato-renal protective effects at varying doses and duration of administration. Despite the observed significant glycemic control effect, poor methodological quality calls for future researches to focus on standardizing extract based on chemical markers and adopt measures to improve the quality of preclinical studies such as sample size calculation, randomization, and blinding.

Medicinal plants used to treat "African" diseases by the local communities of Bwambara sub-county in Rukungiri District, Western Uganda.

ETHNOPHARMACOLOGICAL RELEVANCE: In Africa, traditional medicine encompasses a diverse range of practices, including herbalism and spiritualism, where some diseases are believed to be "African" since they can only be traditionally treated. Indigenous knowledge on the management of "African" diseases using medicinal plants is still handed down orally from generation to generation by tribal societies of tropical Africa, and with the rapid westernization of these societies there is a pressing need to record local knowledge before it is lost forever. AIM: This study documented medicinal plant species associated with the management of "African" diseases by the local communities of Bwambara sub-county in Rukungiri district, Western Uganda. METHODS: A cross-sectional study was conducted using semi-structured questionnaires and interviews. The data collected included names of plant species, plant parts used, diseases treated, methods of preparation, and mode of administration of the herbal remedies. A total of 196 informants participated in the study. Data were analyzed and presented using descriptive statistics and the Informant consensus factor. RESULTS: We documented 67 medicinal plant species distributed over 27 families and 62 genera. The most commonly reported species belong to Asteraceae family. The most frequently used medicinal species were Chenopodium opulifolium (27), Sesbania sesban (26), Thevetia peruviana (25), Leonotis nepetifolia (23), Momordica foetida (23), Euphorbia hirta (21) and Cassia mimosoides (20). Leaves were the most commonly used plants parts and decoctions were the main method of preparation. Water was the main medium used for the preparation of the remedies which were administered orally while petroleum jelly was the main medium for those which were used as ointments. The medicinal plant species reported are used to treat 39 conditions which were clustered into 10 International Classification of Primary Care (ICPC) disease categories. There is a high degree of consensus among the informants on which medicinal plant species they use for different diseases especially disorders in the following categories: neurological (FIC = 0.90), general and unspecified (FIC = 0.87), digestive (FIC = 0.86) and female genital (FIC = 0.82). CONCLUSION: Local communities of Bwambara sub-county in Rukungiri district, Western Uganda use a rich diversity of medicinal plant species in the management of various "African" diseases. Therefore, collaboration between users of medicinal plants and scientists is paramount, to help in the discovery of new drugs based on indigenous knowledge.

Systematic review and meta-analysis protocol for efficacy and safety of Momordica charantia L. on animal models of type 2 diabetes mellitus.

BACKGROUND: Studies on several preclinical models of type 2 diabetes mellitus have been conducted to establish the hypoglycemic activity of Momordica charantia L. Concerned with appropriateness of these models, we designed a systematic review to establish the efficacy and safety of M. charantia L. in preclinical models of type 2 diabetes mellitus. METHODS: Review authors will search without language restriction in MEDLINE/PubMed, Web of Science, Embase, Scopus, and CINAHL databases through April 2019. Search filters will be applied to enhance search efficiency. The authors will search for gray literature in Google and Google Scholar, OpenGrey, and ProQuest Dissertations & Theses. Two authors will evaluate full texts, extract data, and asses risk of bias independently. The review will include randomized or non-randomized studies that assessed the efficacy or safety of M. charantia L. with vehicle control group. The primary endpoint will be fasting blood glucose level. We will use Egger's test to assess publication biases. Chi-square test and I2 will be used to assess heterogeneity in effect size of the primary outcome. Using RevMan software version 5.3, the authors will perform a meta-analysis of quantitative data. DISCUSSION: The strength of evidence will be rated as high, moderate, low, or very low using GRADE framework for animal studies. This systematic review will potentially improve research practice by identifying risks of bias and design features that compromise translatability and contribute to evidence-based clinical trial design. SYSTEMATIC REVIEW REGISTRATION: PROSPERO CRD42019119181.

Medicinal plant species used by local communities around Queen Elizabeth National Park, Maramagambo Central Forest Reserve and Ihimbo Central Forest Reserve, South western Uganda.

ETHNOPHARMACOLOGICAL RELEVANCE: The application of ethnobotanical indigenous knowledge is very important in improving primary healthcare systems among the local communities living around and within protected areas in South Western Uganda. In this area, there are biodiversity endowed Queen Elizabeth National Park (QENP), Maramagambo Central Forest Reserve (MCFR) and Ihimbo Central Forest Reserve (ICFR). Despite the rich floral diversity and cultural heritage, there is no published documentation on the use of medicinal plants in this area. This information can be used as a basis for the selection of medicinal plants for further phytochemical and pharmacological studies. STUDY AIM: This study identified and documented the use of medicinal plants, plant parts used, and mode of preparation and administration by the local communities living around and within QENP, MCFR and ICFR. MATERIALS AND METHODS: A cross-sectional study was used to collect data from 202 informants using semi-structured questionnaires, open interviews and field visits. Ethnobotanical data was analyzed using use reports (UR), frequency of citation (FC) and Informant Consensus Factor (FIC). The plants species were identified by botanists and voucher specimens were deposited. RESULTS: A total of 302 medicinal plant species were mentioned by informants, out of which only 211 species belonging to 65 families and 165 genera were collected, identified and documented. The remaining 91 species were not available for collection and informants stated that they had become very rare within the study area. Herbs (35.8%) were the main source of herbal medicine. Leaves (60.4%) were the most commonly used plant parts used in the preparation of herbal remedies. Most of the medicinal plants were harvested from the wild, either growing in abundance (41%) or as rare species (21%). The most common mode of administration was oral, while other exceptional modes such as touching with bare hands and sweeping over the affected part were reported for the first time. The medicinal plant species were reported to treat 134 physical ailments, which were grouped into 16 ICPC-2 disease categories. Digestive disorders (854 UR) and general and unspecified disorders (507) scored the highest FIC value of 0.83. The highest number of medicinal plants (146 plant species) was used for treatment of digestive disorders. Among the species with higher use reports, Gouania longispicata had the highest frequency of citation (FC = 174) and was mentioned to be used to treat 41 physical ailments. The most important ailment treated by Gouania longispicata was allergy with 102 use reports. CONCLUSIONS: A variety of medicinal plants are used by communities living near protected areas in South Western Uganda. Most species were used in the treatment of digestive disorders, followed by general and unspecified disorders. Much as allergy has not been identified as a major threat by the health sector in Uganda, the study found out that it is one of the prevalent ailments in the study area. While the therapeutic value of some of the documented medicinal plant species, especially those with higher frequency of citation have been scientifically validated, the efficacy and safety of other species with wide application need to be investigated. In this study, we recommend further scientific studies on Gouania longispicata to validate its wide usage in the study area.