Systematic review on traditional medicinal plants used for the treatment of malaria in Ethiopia: trends and perspectives

Investigators at Jigjiga University conducted a systematic web search analysis and review of research literature pertaining to medicinal plants used for traditional malaria treatment in Ethiopia.

Writing in Malaria Journal, the authors note that antimalarial ethnomedicinal research in Ethiopia remains limited:

“Despite the remarkable historic success of traditional medicinal practices and abundance of indigenous medicinal plant resources, anti-malarial ethno-pharmacological research in Ethiopia remains at primitive stage, with scope limited to evaluating crude extracts from various anti-malarial plants against Plasmodium berghei. A prominent gap is evident with regard to research geared towards identifying plant bioactive entities, and establishing the efficacy and safety of medical plants through in vitro assays using human Plasmodium parasites, in vivo assay involving higher animal models and randomized clinical trials. Absence of favourable medicinal plant research and development impedes optimum exploitation of potential economic benefits. Thus, despite holding one of the richest (diversity and quantity) resources in the continent, large-scale production and export of medicinal plants has remained limited in Ethiopia. Prevailing scenarios underscore a pressing need for enhancing pre-clinical and clinical research aimed at developing safe, effective and affordable alternative anti-malarial agents from indigenous plant resources. This requires collaborative engagement involving government bodies, researchers, traditional healers, and prospective business investors.”

Decoction, concoction, eating/chewing, infusion, and pounding represented the most common methods of preparation. Some of the medicinal products were prepared from mixtures of two or more different plant species and various other additives were also used in some of the treatments:

“Additives were mostly used to moderate the power and/or improve the taste and enhance the efficacy and healing conditions of the remedy. This could possibly be attributed to synergistic effects of the mixtures that might contain a range of pharmacologically active compounds potentially augmenting the chance of the drug interacting with numerous, varied biological targets. Their interaction might influence selectivity, availability, absorption and displacement (distribution) of the remedy, and bioactivity, including enzyme activities. Thus, such traditional practices could provide the opportunity to understand drug interaction and mechanisms of actions, and pave the way to discovering lead structures for the development of novel anti-malarial drugs.”

Many of the species identified in the study have previously demonstrated promising antimalarial potential in preclinical and clinical investigations, among them Artemisia annua, Ajuga remota, Azadirachta indica, Argemone mexicana, Vernonia amygdalina, Asparagus africanus, Uvaria leptocladon, and Gossypium spp. In addition, promising candidate antimalarial compounds have been identified from some of the plants.

In their conclusion, the authors recommend coordinated multidisciplinary research to further develop the therapeutic potential of anti-malarial compounds from plant species used for the treatment of malaria in Ethiopia:

“Ethno-medicinal research on distribution and usage pattern of anti-malarial plants shows substantial variability across a spectrum of geographic and social strata in the country. Baseline information gaps are evident in key geographic settings, such as the Beshangul Gumuz and Gambella regions. Divergent preparation and use patterns of anti-malarial herbal remedies, as well as associated toxicity risks and countermeasures, generally demand deeper, exhaustive investigations. Experimental research and advanced chemical analysis are required to identify and validate the therapeutic potential of anti-malarial chemical compounds from promising plant species, with due consideration to efficacy and safety issues. Sustainable development and exploitation of indigenous medicinal plant resources entails coordinated multidisciplinary research programmes that give due credit to traditional practitioners and engage with commercial investors.”

Read the complete article at PubMed Central.

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