Review Article Traditional Medicines in Africa: An …downloads.hindawi.com/journals/ecam/2013/617459.pdfReview Article Traditional Medicines in Africa: An Appraisal of Ten Potent

Hindawi Publishing CorporationEvidence-Based Complementary and Alternative MedicineVolume 2013 Article ID 617459 14 pageshttpdxdoiorg1011552013617459

Review ArticleTraditional Medicines in Africa An Appraisal ofTen Potent African Medicinal Plants

M Fawzi Mahomoodally

Department of Health Sciences Faculty of Science University of Mauritius 230 Reduit Mauritius

Correspondence should be addressed to M Fawzi Mahomoodally fmahomoodallyuomacmu

Received 23 May 2013 Revised 27 September 2013 Accepted 10 October 2013

Academic Editor John R S Tabuti

Copyright copy 2013 M Fawzi Mahomoodally This is an open access article distributed under the Creative Commons AttributionLicense which permits unrestricted use distribution and reproduction in any medium provided the original work is properlycited

The use of medicinal plants as a fundamental component of the African traditional healthcare system is perhaps the oldest andthe most assorted of all therapeutic systems In many parts of rural Africa traditional healers prescribing medicinal plants arethe most easily accessible and affordable health resource available to the local community and at times the only therapy thatsubsists Nonetheless there is still a paucity of updated comprehensive compilation of promising medicinal plants from the Africancontinent The major focus of the present review is to provide an updated overview of 10 promising medicinal plants from theAfrican biodiversity which have short- as well as long-term potential to be developed as future phytopharmaceuticals to treat andormanage panoply of infectious and chronic conditions In this endeavour key scientific databases have been probed to investigatetrends in the rapidly increasing number of scientific publications on African traditional medicinal plants Within the framework ofenhancing the significance of traditional African medicinal plants aspects such as traditional use phytochemical profile in vitroin vivo and clinical studies and also future challenges pertaining to the use of these plants have been explored

1 Introduction

Traditional medicine is the sum total of knowledge skillsand practices based on the theories beliefs and experiencesindigenous to different cultures that are used to maintainhealth as well as to prevent diagnose improve or treatphysical and mental illnesses [1] Traditional medicine thathas been adopted by other populations (outside its indige-nous culture) is often termed complementary or alternativemedicine (CAM) [1 2]

The World Health Organization (WHO) reported that80 of the emerging worldrsquos population relies on traditionalmedicine for therapy During the past decades the developedworld has also witnessed an ascending trend in the utilizationof CAM particularly herbal remedies [3] Herbal medicinesinclude herbs herbal materials herbal preparations andfinished herbal products that contain parts of plants orother plant materials as active ingredients While 90 of thepopulation in Ethiopia use herbal remedies for their primaryhealthcare surveys carried out in developed countries likeGermany and Canada tend to show that at least 70 oftheir population have tried CAM at least once [2 3] It is

likely that the profound knowledge of herbal remedies intraditional cultures developed through trial and error overmany centuries along with the most important cures wascarefully passed on verbally from one generation to anotherIndeed modern allopathic medicine has its roots in thisancient medicine and it is likely that many important newremedies will be developed and commercialized in the futurefrom the African biodiversity as it has been till now byfollowing the leads provided by traditional knowledge andexperiences [2ndash5]

The extensive use of traditional medicine in Africa com-posed mainly of medicinal plants has been argued to belinked to cultural and economic reasons This is why theWHO encourages African member states to promote andintegrate traditional medical practices in their health system[1] Plants typically contain mixtures of different phytochem-icals also known as secondary metabolites that may actindividually additively or in synergy to improve healthIndeed medicinal plants unlike pharmacological drugscommonly have several chemicals working together catalyt-ically and synergistically to produce a combined effect thatsurpasses the total activity of the individual constituents

2 Evidence-Based Complementary and Alternative Medicine

The combined actions of these substances tend to increasethe activity of the main medicinal constituent by speedingup or slowing down its assimilation in the body Secondarymetabolites from plantrsquos origins might increase the stabilityof the active compound(s) or phytochemicals minimize therate of undesired adverse side effects and have an additivepotentiating or antagonistic effect It has been postulatedthat the enormous diversity of chemical structures found inthese plants is not waste products but specialized secondarymetabolites involved in the relationship of the organismwith the environment for example attractants of pollinatorssignal products defensive substances against predators andparasites or in resistance against pests and diseases A singleplant may for example contain bitter substances that stim-ulate digestion and possess anti-inflammatory compoundsthat reduce swellings and pain phenolic compounds thatcan act as an antioxidant and venotonics antibacterial andantifungal tannins that act as natural antibiotics diureticsubstances that enhance the elimination of waste productsand toxins and alkaloids that enhance mood and give asense of well-being [1ndash5] Although some may view theisolation of phytochemicals and their use as single chemicalentities as a better alternative and which have resulted in thereplacement of plant extractsrsquo use nowadays a view that theremay be some advantages of the medical use of crude andorstandardized extracts as opposed to isolated single compoundis gaining much momentum in the scientific community

2 African Traditional Medicine

African traditional medicine is the oldest and perhaps themost assorted of all therapeutic systems Africa is consideredto be the cradle of mankind with a rich biological andcultural diversity marked by regional differences in healingpractices [2 6] African traditional medicine in its variedforms is holistic involving both the body and the mindThe traditional healer typically diagnoses and treats thepsychological basis of an illness before prescribingmedicinesparticularly medicinal plants to treat the symptoms [2 6ndash8]The sustained interest in traditional medicine in the Africanhealthcare system can be justified by two major reasonsThe first one is inadequate access to allopathic medicinesand western forms of treatments whereby the majority ofpeople in Africa cannot afford access to modern medicalcare either because it is too costly or because there are nomedical service providers Second there is a lack of effectivemodernmedical treatment for some ailments such asmalariaandor HIVAIDS which although global in distributiondisproportionately affect Africa more than other areas in theworld

The most common traditional medicine in commonpractice across the African continent is the use of medicinalplants In many parts of Africa medicinal plants are the mosteasily accessible health resource available to the communityIn addition they are most often the preferred option forthe patients For most of these people traditional healersoffer information counseling and treatment to patients andtheir families in a personal manner as well as having anunderstanding of their patientrsquos environment [2 6 7] Indeed

Africa is blessed with enormous biodiversity resources andit is estimated to contain between 40 and 45000 species ofplant with a potential for development and out of which5000 species are used medicinally This is not surprisingsince Africa is located within the tropical and subtropicalclimate and it is a known fact that plants accumulate impor-tant secondary metabolites through evolution as a naturalmeans of surviving in a hostile environment [9] Becauseof her tropical conditions Africa has an unfair share ofstrong ultraviolet rays of the tropical sunlight and numerouspathogenic microbes including several species of bacteriafungi and viruses suggesting that African plants couldaccumulate chemopreventive substances more than plantsfrom the northern hemisphere Interestingly Abegaz et al[10] have observed that of all species ofDorstenia (Moraceae)analysed only the African species Dorstenia mannii Hookfa perennial herb growing in the tropical rain forest of CentralAfrica contained more biological activity than related species[9ndash11]

Nonetheless the documentation of medicinal uses ofAfrican plants and traditional systems is becoming a pressingneed because of the rapid loss of the natural habitats ofsome of these plants due to anthropogenic activities and alsodue to an erosion of valuable traditional knowledge It hasbeen reported that Africa has some 216 million hectares offorest but the African continent is also notorious to have oneof the highest rates of deforestation in the world with acalculated loss through deforestation of 1 per annum [712] Interestingly the continent also has the highest rate ofendemism with the Republic of Madagascar topping the listby 82 and it is worth to emphasize that Africa alreadycontributes nearly 25 of the world trade in biodiversityNonetheless the paradox is that in spite of this huge potentialand diversity the African continent has only few drugscommercialized globally [2 12 13]

The scientific literature has witnessed a growing numberof publications geared towards evaluating the efficacy ofmedicinal plants from Africa which are believed to have animportant contribution in the maintenance of health and inthe introduction of new treatments Nonetheless there is stilla dearth of updated comprehensive compilation of promisingmedicinal plants from the African continent

The main aim of the present review is to highlight theimportance and potential of medicinal plants from theAfrican biodiversity which have short- as well as long-termpotential to be developed as future phytopharmaceuticals totreat andormanage panoply of infectious and chronic condi-tionsThe reviewmight also provide a starting point for futurestudies aimed at isolation purification and characterizationof bioactive compounds present in these plants as well asexploring the potential niche market of these plants In thisendeavor major scientific databases such as EBSCOhostPubMed Central Scopus (Elsevier) and Emerald amongstothers have been probed to investigate trends in the rapidlyincreasing number of scientific publications onAfrican tradi-tional medicinal plants Tenmedicinal plants (Acacia senegalAloe ferox Artemisia herba-alba Aspalathus linearis Centellaasiatica Catharanthus roseus Cyclopia genistoides Harpago-phytum procumbensMomordica charantia and Pelargonium

Evidence-Based Complementary and Alternative Medicine 3

sidoides) of special interest were chosen for more detailedreviews based on the following criteria medicinal plants thatform part of African herbal pharmacopeia with commercialimportance and those plants fromwhichmodern phytophar-maceuticals have been derived

21 Acacia senegal (L) Willd (Leguminosae Mimosoideae)mdashGum Arabic Acacia senegal also known as gum Arabic isnative to semidesert and drier regions of sub-Saharan Africabut widespread from Southern to Northern Africa It is usedas amedicinal plant in parts ofNorthernNigeriaWestAfricaNorthAfrica and other parts of the world [8]The use of gumarabic (or gumacacia) which is derived froman exudate fromthe bark dates from the first Egyptian Dynasty (3400 BC)It was used in the production of ink which was made from amixture of carbon gum andwater Inscriptions from the 18thDynasty refer to this gum as ldquokomirdquo or ldquokommerdquo Gum arabichas been used for at least 4000 years by local people for thepreparation of food in human and veterinary medicine incrafts and as a cosmeticThe gum ofA senegal has been usedmedicinally for centuries and various parts of the plant areused to treat infections such as bleeding bronchitis diarrheagonorrhea leprosy typhoid fever and upper respiratory tractinfections African herbalists use gum acacia to bind pillsand to stabilize emulsions It is also used in aromatherapy forapplying essential oils [8 14ndash16]

Currently A senegal is an important naturally occurringoil-in-water emulsifier which is in regular use in the foodand pharmaceutical industries Medicinally gum arabic isused extensively in pharmaceutical preparations and is afood additive approved as toxicologically safe by the CodexAlimentarius It has been used as demulcent skin protectiveagent and pharmaceutical aids such as emulsifier and sta-bilizer of suspensions and additives for solid formulationsIt is sometimes used to treat bacterial and fungal infectionsof the skin and mouth It has been reported to soothe themucous membranes of the intestines and to treat inflamedskin [17 18]The demulcent emollient gum is used internallyagainst inflammation of intestinal mucosa and externally tocover inflamed surfaces as burns sore nipples and nodularleprosy Additionally it has also been documented to be usedas antitussive expectorant astringent catarrh and againstcolds coughs diarrhea dysentery gonorrhea hemorrhagesore throat typhoid and for urinary tract ailments [18] Thegum of A senegal has been pharmaceutically used mainlyin the manufacture of emulsions and in making pills andtroches (as an excipient) as demulcent for inflammations ofthe throat or stomach and as masking agent for acrid tastingsubstances such as capsicum and also as a film-forming agentin peel-off masks Gum arabic is also used widely as aningredient in foods like candies and soft drinks as the gumhasthe properties of glue that is safe to eat Gum acacia is widelyused in organic products as natural alternative to chemicalbinders and is used in commercial emulsification for theproduction of beverages and flavor concentrates [8 17ndash19]

Recently it has been reported that A senegal barkextracts were evaluated in vitro for their antimicrobialpotential against human pathogenic isolates (Escherichia coliStaphylococcus aureus Streptococcus pneumoniae Klebsiella

pneumoniae Shigella dysenteriae Salmonella typhi Strepto-coccus pyogenes Pseudomonas aeruginosa and Proteus vul-garis) The extract was found to exhibit significant antibac-terial activity which was suggested to be due to the presenceof tannins and saponins in the plant It was also reported thatthe plant extract may not be toxic to man following in vitrocytotoxicity evaluation [18]

22 Aloe ferox Mill (Xanthorrhoeaceae)mdashBitter Aloe or CapeAloe Aloe ferox is native to South Africa and Lesotho andis considered to be the most common Aloe species in SouthAfricaA ferox has been used since time immemorial and hasa well-documented history of use as an alternative medicineand is one of the few plants depicted in San rock paintingsThe bitter latex known as Cape aloe is used as laxativemedicine in Africa and Europe and is considered to havebitter tonic antioxidant anti-inflammatory antimicrobialand anticancer properties [8 19ndash23]

The use ofA ferox as amultipurpose traditionalmedicinehas been translated into several commercial applications andit is a highly valued plant in the pharmaceutical naturalhealth food and cosmetic industries A ferox is consideredSouth Africarsquos main wild harvested commercially tradedspecies The finished product obtained from aloe tappingaloe bitters has remained a key South African export productsince 1761 when it was first exported to Europe The aloetapping industry is the livelihood of many rural communitiesand formalization of the industry in the formof establishmentof cooperatives and trade agreements It has been suggestedthat its trade may have an extensive poverty alleviation effectin Africa [19 24 25]

A ferox has many traditional and documented medicinaluses It is most popularly used for its laxative effect and as atopical application to the skin eyes and mucous mem-branes Scientific studies conducted have verifiedmany of thetraditional uses More recently the cosmetic industry hasshown interest in A ferox gel [8 19] It has been reportedthat A ferox gel contains at least 130 medicinal agents withanti-inflammatory analgesic calming antiseptic germicidalantiviral antiparasitic antitumour and anticancer effectsencompassing all of the traditional uses and scientific studiesdone on A ferox and its constituents [8 24ndash31]

Awide variety of phenolic compounds (chromones anth-raquinones anthrone anthrone-C-glycosides and other phe-nolic compounds) are present within A ferox and these com-pounds have been well documented to possess biologicalactivity [21 24ndash31] The gel polysaccharides are known tobe of the arabinogalactan and rhamnogalacturonan typesThe leaf gel composition still remains unknown and itsclaimed biological activities still remain to be investigatedThe active ingredient (purgative principle) is a chemical com-pound known as Aloin (also called Barbaloin) [19] The gelhas also been found to be rich in antioxidant polyphenolsindoles and alkaloids Tests carried out have shown that thenonflavonoid polyphenols contribute to the majority of thetotal polyphenol content With this phytochemical profileA ferox leaf gel has been identified to be very promisingin alleviating symptoms associated withor prevention of


common noncommunicable diseases such as cardiovasculardiseases cancer neurodegeneration and diabetes [32]

The leaves have been reported to contain two juices theyellow bitter sap is used as laxative while the white aloe gel isused in health drinks and skin care products This purgativedrug is used for stomach complaints mainly as a laxative toldquopurifyrdquo the stomach and also as a bitter tonic (amarum) invarious digestives and stomachics (such as ldquoLewensessensrdquoand ldquoSwedish Bittersrdquo) Usually a small crystal of the drug(005ndash02 g) is taken orally as a laxative Half the laxativedose is suggested for arthritis The fresh bitter sap is instilleddirectly against conjunctivitis and sinusitis [24 25] It is wellknown that bitter substances stimulate the flow of gastricjuices and in so doing improve digestionThe fresh juice ema-nating from the cut leaf is also applied on burn wounds [33]A ferox is claimed to detoxify the damaged surface area andexhibit analgesic and anesthetic properties while promotingnew tissue formation (granulation) which fills the wound Itwas demonstrated that A ferox enriched with aloins caninhibit collagenase and metalloprotease activity which candegrade collagen connective tissues The effect of A feroxwhole leaf juice on wound healing and skin repair was inves-tigated in an animal model and its safety was evaluated Theresults showed that the A ferox whole leaf juice preparationaccelerates wound closure and selectively inhibits microbialgrowth No dermal toxicity or side effects were observedduring the experimental period [23]

23 Artemisia herba-alba Asso (Med)mdashAsteraceaemdashWorm-wood Artemisia herba-alba is commonly known as worm-wood or desert wormwood (known in Arabic as shih and asArmoise blanche in French) It is a greyish strongly aromaticperennial dwarf shrub native to the Northern Africa ArabianPeninsula and Western Asia [34] A herba-alba has beenused in folkmedicine bymany cultures since ancient times InMoroccan folk medicine it is used to treat arterial hyperten-sion and diabetes and in Tunisia it is used to treat diabetesbronchitis diarrhea hypertension and neuralgias [34 35]Herbal tea from A herba-alba has been used as analgesicantibacterial antispasmodic and hemostatic agents in folkmedicines [34ndash39] During an ethnopharmacological surveycarried out among the Bedouins of the Negev desert itwas found that A herba-alba was used to mitigate stomachdisorders This plant is also suggested to be important as afodder for sheep and for livestock in the plateau regions ofAlgeria where it grows abundantly It has also been reportedthat Ascaridae from hogs and ground worms were killed bythe oil of the Libyan A herba-alba in a short time [34ndash42]

Oral administration of 039 gkg body weight of theaqueous extract of the leaves or barks of A herba-alba hasbeen documented to produce a significant reduction in bloodglucose level while the aqueous extract of roots and meth-anolic extract of the aerial parts of the plant produce almostno reduction in blood glucose level The extract of the aerialparts of the plant seems to have minimal adverse effect andhigh LD

50value [19 30]

Among A herba-alba phytochemical constituents ess-ential oils have been extensively studied with severalchemotypes being recognized The variability from the

essential oils isolated from A herba-alba collected in Alge-ria Israel Morocco and Spain was revised by Dob andBenabdelkader [43 44] but since then many other studieshave reinforced its high chemical polymorphism Recentlyfifty components were identified in A herba-alba oilsoxygen-containing monoterpenes being dominant in allcases (72ndash80) Camphor (17ndash33) 120572-thujone (7ndash28) andchrysanthenone (4ndash19) were the major oil componentsDespite the similarity inmain components three types of oilscould be defined (a) 120572-thujone camphor (23ndash28 17ndash28)(b) camphor chrysanthenone (33 12) and (c) 120572-thu-jone camphor chrysanthenone (24 19 19) [43]

The antifungal activity ofArtemisia herba-albawas foundto be associated with two major volatile compounds isolatedfrom the fresh leaves of the plant Carvone and piperitonewere isolated from Artemisia herba-alba The antifungalactivity of the purified compounds carvone and piperitonewas estimated to be 5 120583gmL and 2 120583gmL against Penicilliumcitrinum and 7 120583gmL and 15 120583gmL against Mucor rouxiirespectively In another study the antifungal activity of theconstituents and biological activities of Artemisia herba-albaessential oils of 25 Moroccan medicinal plants includingA herba-alba against Penicillium digitatum Phytophthoracitrophthora Geotrichum citri-aurantii and Botrytis cinereahave been reported [42 43]

24 Aspalathus linearis (Brumf) R Dahlg (Fabaceae)mdashRooibos Aspalathus linearis an endemic South African fyn-bos species is cultivated to produce the well-known herbaltea also commonly known as rooibos Its caffeine-free andcomparatively low tannin status combined with its poten-tial health-promoting properties most notably antioxidantactivity has contributed to its popularity and consumeracceptance globallyThe utilization of rooibos has alsomovedbeyond a herbal tea to intermediate value-added productssuch as extracts for the beverage food nutraceuticals andcosmetic markets [45ndash52]

Rooibos is used traditionally throughout Africa in num-erous ways It has been used as a refreshment drink andas a healthy tea beverage [8 19] It was only after the discoverythat an infusion of rooibos when administered to her colickybaby cured the chronic restlessness vomiting and stomachcramps that rooibos became well known as a ldquohealthyrdquobeverage leading to a broader consumer base Many babiessince then have been nurtured with rooibosmdasheither added totheir milk or given as a weak brew [8 16 45ndash52]

Animal studies have suggested that it has potent antioxi-dant immunomodulating and chemopreventive effects Theplant is rich in minerals and low in tannins Among theflavonoids present are the unique C-glucoside dihydrochal-cones aspalathin and nothofagin and with aspalathin beingthe most abundant In vitro data has shown that the dailyintake of the alkaline extracts of the red rooibos tea couldsuppress HIV infections in the extract though clinical eval-uation has yet to be conducted [8 45] There is growingevidence that the flavonoids present in the plant contributesubstantially to a reduction in cardiovascular disease andother ailments associated with ageing Recent studies haveshown that aspalathin has beneficial effects on glucose


homeostasis in Type 2 diabetes through stimulating glu-cose uptake in muscle tissues and insulin secretion frompancreatic beta-cells [8 48] The unfermented rooibos hasbeen found to have greater chemoprotective effects than thefermented variety [49] Aspalathin has free-radical capturingproperties and is absorbed through the small intestine as such[50]

The bronchodilator antispasmodic and blood pressurelowering effects of rooibos tea have been confirmed invitro and in vivo It has also been reported that the anti-spasmodic effect of the rooibos is mediated predominantlythrough potassium ionchannel activation [51 52] There isalso increasing evidence of antimutagenic effects Animalstudy suggested the prevention of age-related accumulationof lipid peroxidases in the brain [19 26 47]

Rooibos is becoming more popular in western countriesparticularly among health-conscious consumers due to theabsence of alkaloids and low tannin content It is also reportedto have a high level of antioxidants such as aspalathin andnothofagin The antioxidative effect has also been attributedto the presence of water-soluble polyphenols such as rutinand quercetin [53] Rooibos is purported to assist nervoustension allergies and digestive problems

Rooibos extracts usually combined with other ingredi-ents are available in pill form but these products fall inthe category of dietary supplements Recent research hasunderscored the potential of aspalathin and selected rooibosextracts such as an aspalathin-enriched green rooibos extractas antidiabetic agents [54ndash68] A patent application for theuse of aspalathin in this context was filed in Japan while aplacebo-controlled trial application was filed for the use ofrooibos extract as an antidiabetic agent [66] It is claimed thatrooibos extract and a hetero-dimer containing aspalathinisolated from rooibos could be used as a drug for thetreatment of neurological and psychiatric disorders of thecentral nervous system [19 68] Other opportunities may liewith topical skin products Two studies concerning inhibitionof COX-2 in mouse skin [67] and inhibition of mouse skintumor promotion tend to support the role of the topicalapplication of rooibos extract Nonetheless more researchwould be needed to explore its potential in preventing skincancer in humans [67]

25 Centella asiatica (L) Urb (Apiaceae)mdashCentella Centellaasiatica is a medicinal plant that has been used since pre-historic times It has a pan-tropical distribution and is usedin many healing cultures including Ayurvedic medicineChinese traditional medicine Kampo (Japanese traditionalmedicine) and African traditional medicine [19 69] To dateit continues to be used within the structure of folk medicineand is increasingly being located at the interface betweentraditional and modern scientifically oriented medicineTraditionally C asiatica is used mainly for wound healingburns ulcers leprosy tuberculosis lupus skin diseases eyediseases fever inflammation asthma hypertension rheuma-tism syphilis epilepsy diarrhea and mental illness and isalso eaten as a vegetable or used as a spice In Mauritiusthe application of C asiatica in the treatment of leprosy wasreported for the first time in 1852 while the clinical use of

C asiatica as a therapeutic agent suitable for the treatmentof leprous lesions has been documented since 1887 [19]

The active constituents are characterized by their clinicaleffects in the treatment of chronic venous disease woundhealing and cognitive functions amongst others [19] C asi-atica contains a variety of pentacyclic triterpenoids that havebeen extensively studied Asiaticoside andmadecassoside arethe two most important active compounds that are used indrug preparations Both are commercially used mainly aswound-healing agent based on their anti-inflammatoryeffects One of the main active constituents of C asiatica isthe ursane-type triterpene saponin asiaticoside which isresponsible for wound healing properties [19 70 71] and isknown to stimulate type 1 collagen synthesis in fibroblastcells [72] Plants collected from various geographical regionsand locations in India Madagascar Malaysia Sri LankaAndaman Islands and South Africa have yielded concen-trations of asiaticoside ranging from 0006 to 642 of dryweight [73 74] C asiatica also contains several other triter-pene saponins Madecassoside always co-occurs with asiati-coside as a main compound and other saponins have beenreported such as asiaticosides A to G centelloside brahmo-side and many others [19 75] Madagascar plays a majorrole in C asiatica trade It is the first producer of C asiaticaproducts worldwide and due to a higher Asiaticoside contentof dried leavesMalagasy origin is appreciated by industry [9]

The ethyl acetate fraction of C asiatica has been reportedto increase the effect of the ip administrated antiepilepticdrugs phenytoin valproate and gabapentin [75 76] andwas found to decrease the pentylenetetrazol- (PTZ-) kindledinduced seizures in rats [75 77] This effect might be dueto an increase in gamma-aminobutyric acid (GABA) levelscaused by the extract as reported by Chatterjee et al [78]The neuroprotective properties of the plant in monosodiumglutamate treated rats were investigated by Ramanathan etal [79] The general behavior locomotor activity and theCA1 region of the hippocampus were protected by C asiaticaextracts The levels of catalase superoxide dismutase andlipid peroxidase in the hippocampus and striatum wereimproved indicating a neuroprotective property of the extract[74] Additionally the effect of C asiatica on cognitivefunction of healthy elderly volunteer was evaluated in a ran-domized placebo-controlled double-blind study involving28 healthy elderly participantsThe subjects have received theplant extract at various doses ranging from 250 to 500 and750mg once daily for 2 months and cognitive performanceand mood modulation were assessed It was found thathigh dose of the plant extract enhanced working memoryand increased N100 component amplitude of event-relatedpotential Improvements of self-rated mood were also foundfollowing the C asiatica treatment The high dose of Casiatica used in the study was suggested to increase calmnessand alertness after 1 and 2 months of treatment Howeverthe precisemechanism(s) underlying these effects still requirefurther investigation [72]

26 Catharanthus roseus (L) G Don (Apocynaceae)mdashMadagascan Periwinkle Catharanthus roseus (Madagascar


periwinkle) is a well-known medicinal plant that has itsroot from the African continent The interest in this speciesarises from its therapeutic role as it is the source of theanticancer alkaloids vincristine and vinblastine whose com-plexity renders them impossible to be synthesized in thelaboratory the leaves of this species are still today the onlysource [8 12 19 80] C roseus originates from Madagascarbut now has a wide distribution throughout the tropicsand the story on the traditional utilisation of this plant canbe retraced to Madagascar where healers have been usingit extensively to treat panoply of ailments It is commonlyused in traditional medicine as a bitter tonic galactogogueand emetic Application for treatment of rheumatism skindisorders and venereal diseases has also been reported [8 1019]

C roseus has been found to contain a plethora of phy-tochemicals (as many as 130 constituents) and the prin-cipal component is vindoline (up to 05) Other bio-logically active compounds are serpentine catharanthineajmalicine (raubasine) akuammine lochnerine lochner-icine and tetrahydroalstonine The plant is also rich inbisindole alkaloids vindoline and catharanthine are found invery small amounts vincristine (=leurocristine) in up to3 gt of dried drug and vinblastine (=vincaleucoblastine) ina slightly larger amount [8 12 19 81ndash84]

The oral administration of water-soluble fractions andethanolic extracts of the leaves have been found to showsignificant dose-dependent reduction in the blood sugar at4 h by 262 314 356 and 334 respectively in normal ratsIn addition oral administration of 500mgkg 35 h beforeoral glucose tolerance test (10mgkg) and 72 h after STZadministration (50mgkg IP) in rats showed significant anti-hyperglycaemic effects No gross behavioural changes andtoxic effects were observed up to 4mgkg IP [85]

Extract at dose of 500mgkg given orally for 7 and 15 daysshowed 486 and 576 hypoglycemic activity respectivelyPrior treatment at the same dose for 30 days providedcomplete protection against streptozotocin (STZ) challenge(75mgkgip times 1) Enzymatic activities of glycogen synthaseglucose 6-phosphate-dehydrogenase succinate dehydroge-nase and malate dehydrogenase were decreased in liver ofdiabetic animals in comparison to normal ones and weresignificantly improved after treatment with extract at dose of500mgkg po for 7 days Results indicate increased metab-olization of glucose in treated rats Increased levels of lipidperoxidation measured as 2-thiobarbituric acid reactive sub-stances indicative of oxidative stress in diabetic rats were alsonormalized by treatment with the extract [2]

Vincristine and Vinblastine are antimitotics as they bindto tubulin and prevent the formation of microtubules thatassist in the formation of the mitotic spindle in this way theyblock mitosis in the metaphase These alkaloids are highlytoxic they both have neurotoxic activity (especially vin-cristine) because themicrotubule assembly also plays a role inneurotransmission Their peripheral neurotoxic effects areneuralgia myalgia paresthesia loss of the tendon reflexesdepression and headache and their central neurotoxic effectsare convulsive episodes and respiratory difficulties Otherside effects are multiple and include alopecia gastrointestinal

distress including constipation ulcerations of the mouthamenorrhoea and azoospermia [10 19 80 84 85]

Recently new phenolics in different plant parts (leavesstems seeds and petals) including flavonoids and phenolicacids were reported [10 19 82] In addition a phytochemicalstudy concerning several classes of metabolites was per-formed and bioactivitywas assessed [81ndash84]Thehigh antiox-idant potential of C roseus was demonstrated in vitro usingthe radicals DPPH superoxide and nitric oxide [19 81]

27 Cyclopia genistoides (L) Vent (Fabaceae)mdashHoneybushCyclopia genistoides is an indigenous herbal tea to SouthAfrica and considered as a health food Traditionally the leafyshoots and flowers were fermented and dried to prepare teaIt has also been used since early times for its direct positiveeffects on the urinary system and is valued as a stomachicthat aids weak digestion without affecting the heart It is adrink that ismainly used as a tea substitute because it containsno harmful substances such as caffeine It is one of thefew indigenous South African plants that made the transitionfrom the wild to a commercial product during the past 100years Research activities during the past 20 years have beengeared towards propagation production genetic improve-ment processing composition and the potential for valueadding [19 25ndash31 45]

A decoction of honeybushwas used as a restorative and asan expectorant in chronic catarrh and pulmonary tuberculo-sis [25ndash31 86] Drinking an infusion of honeybush apparentlyalso increases the appetite but no indication is given of thespecific species [87] According to Marloth [88] honeybushwas praised by many colonists as being wholesome valuingit as a stomachic that aids weak digestion without producingany serious stimulating effects on the heart It also alleviatesheartburn and nausea [25ndash31] Anecdotal evidence suggeststhat it stimulates milk production in breast-feeding womenand treats colic in babies [89]

Modern use of honeybush is prepared as an infusion andat times taken together with rooibos The tea bags usuallycontain a larger percentage of rooibos than honeybush Partsof other indigenous South African plants and fruits mixedwith honeybush include dried buchu leaves pieces of Africanpotato (Hypoxis hemerocallidea) corms and dried marula(Sclerocarya birrea) fruitThe ready-to-drink honeybush icedtea market is not developed to the same extent as that ofrooibos while honeybush ldquoespressordquo amongst others has notbeen tried [10 19]

Honeybush is well known as caffeine-free low tanninaromatic herbal tea with a wealth of polyphenolic com-pounds associated with its health-promoting properties Theexact biologically active phytochemicals from honeybush areunknown but the beneficial effects have been justified basedon phenolic compounds The major compounds present inall species analyzed to date are the xanthones mangiferinand isomangiferin and the flavanone hesperidin Recentlytwo benzophenone derivatives 3-C-120573-glucosides of maclurinand iriflophenone were isolated for the first time fromC genistoides and were tested for pro-apoptotic activitytoward synovial fibroblasts isolated from rheumatoid arthritispatients The strongest proapoptotic activity was obtained


for isomangiferin and iriflophenone 3-C-120573-glucoside whichwere not previously evaluated as potential antiarthriticagents Proapoptotic effects were recorded formangiferin andhesperidin which are major polyphenols in all commerciallyused honeybush plants Recently C genistoides has attractedmuch attention for the production of an antioxidant producthigh in mangiferin content The latter and its sustainabilitymake C genistoides an attractive source of mangiferin Otherpotential applications are for the prevention of skin canceralleviation of menopausal symptoms and lowering of bloodglucose levels [10 19 45 90]

28 Harpagophytum procumbens (Burch) DC (Pedaliaceae)mdashDevilrsquos Claw Harpagophytum procumbens is native to thered sand areas in the Transvaal of South Africa Botswanaand Namibia It has spread throughout the Kalahari andSavannah desert regions The indigenous San and Khoi peo-ples of Southern Africa have used Devilrsquos Claw medicinallyfor centuries if not millennia [8 19 91] Harpagophytumprocumbens has an ancient history of multiple indigenoususes and is one of themost highly commercialized indigenoustraditional medicines from Africa with bulk exports mainlyto Europe where it is made into a large number of healthproducts such as teas tablets capsules and topical gels andpatches [92]

Traditional uses recorded include allergies analgesiaanorexia antiarrhythmic antidiabetic antiphlogistic anti-pyretic appetite stimulant arteriosclerosis bitter tonic blooddiseases boils (topical) childbirth difficulties cholereticdiuretic climacteric (change of life) problems dysmenor-rhea dyspepsia edema fever fibromyalgia fibrositis gas-trointestinal disorders headache heartburn indigestionliver and gall bladder tonic malaria migraines myalgianeuralgia nicotine poisoning sedative skin cancer (topical)skin ulcers (topical) sores (topical) tendonitis urinary tractinfections and vulnerary for skin injuries The major clinicaluses for Devilrsquos claw are as an anti-inflammatory and anal-gesic in joint diseases back pain and headache Evidencefrom scientific studies in animals and humans has resultedin widespread use of standardized Devilrsquos claw as a mildanalgesic for joint pain in Europe [8 12 19 91ndash95]

Chemical constituents according to the published liter-ature include potentially (co)active chemical constituentsiridoid glycosides (22 total weight) harpagoside (05ndash16) 8-p-coumaroylharpagide 8-feruloyl-harpagide 8-cin-namoylmyoporoside pagoside acteoside isoacteoside 61015840-O-acetylacteoside 26-diacetylacteoside cinnamic acid caffeicacid procumbide and procumboside The constituent 6-acetylacteoside being present in H procumbens and absentin H zeyheri allows users to distinguish between thetwo species Other compounds include flavonoids fattyacids aromatic acids harpagoquinone stigmasterol beta-sitosterol triterpenes sugars (over 50) and gum resins[8 12 19 91ndash95] Harpagoside isolated from H procum-bens varies within the plant and is the highest in thesecondary tubers with lower levels in the primary roots Theflowers stems and leaves appear to be devoid of activecompounds Iridoid glycosides isolated from H procum-bens tend to show dose-dependent anti-inflammatory and

analgesic effects equivalent to phenylbutazone they areapparently inactivated by gastric acids Harpagoside is themost effective when given parenterally and loses potencymarkedly when given by mouth enteric coated preparationsmight maintain efficacy despite exposure to gastric acidsHarpagoside has also been reported to inhibit arachidonicacid metabolism through both cyclooxygenase and lipoxyge-nase pathways [9 91ndash96]

There are varying and contradictory opinions regardingthe anti-inflammatory and analgesic effects of Devilrsquos clawin the treatment of arthritic diseases and low back pain Thecontroversy revolves around the active constituent of Devilrsquosclaw and its mechanism of action as it appears to be differentthan that of nonsteroidal anti-inflammatory drugs (NSAID)The evidence from scientific studies in animals and humanshas resulted in widespread use of standardized Devilrsquos claw asa mild analgesic for joint pain in Europe [8 12 19 91ndash96]

Several clinical studies have been performed to deter-mine the effectiveness of H procumbens for its use as anti-inflammatory general analgesic (commonly for lower backpain) and anti-rheumatic agent To determine the effective-ness on lower back pain Harpagophytum extract WS1351was administered in two daily doses of 600 and 1200mgcontaining 50 and 100mg of harpagoside respectively andcompared to placebo This randomized double-blind studytook place over 4 weeks and subjects (119899 = 197) withchronic susceptibility to back pain and current exacerbationswith intense pain were included Out of 183 subjects thatcompleted the trial six in the 600mg and 10 in the 1200mgwere reported ldquopain-freerdquo without using Tramadol (rescuepain medication) However data analyses suggested that the600mg group reaped more benefits where less severe painand no radiation or neurological deficit was present Thepatients with more severe pain tended to use more Tramadolbut not to the maximum permitted dose [92]

29 Momordica charantia Linn (Cucurbitaceae)mdashBitterMelon Momordica charantia also known as bitter melonis a tropical vegetable grown throughout Africa The leafmay be made into a tea called ldquocerassierdquo and the juiceextracted from the various plant parts (fruit pulp seedsleaves and whole plant) is very common folklore remedyfor diabetes [2] M charantia has a long history of use as afolklore hypoglycemic agent where the plant extract has beenreferred to as vegetable insulin [97]

Several active compounds have been isolated from Mcharantia and somemechanistic studies have been done [98ndash101] Khanna et al [102] have reported the isolation fromfruits seeds and tissue culture of seedlings of ldquopolypeptide-prdquo a 17-amino acid 166-residue polypeptide which did notcross-react in an immunoassay for bovine insulin Galactosebinding lectin with a molecular weight of 124000 isolatedfrom the seeds of M charantia has been evaluated for itsantilipolytic and lipogenic activities in isolated rat adipocytesand found comparable to insulin [103 104] Extracts offruit pulp seed leaves and whole plant of M charantiahave shown hypoglycemic effect in various animal models[103 104] Karunanayake et al [105] found a significantimprovement in glucose tolerance and hyperglycemia when


the fruit juice of bitter melon was administered orally torats Fresh as well as freeze-dried M charantia was found toimprove glucose tolerance significantly in normal rats andnoninsulin dependent diabetics (NIDDM) [105ndash108] It washypothesized that M charantia fruit contains more thanone type of hypoglycemic component These may includean active principle called ldquocharantinrdquo a homogenous mix-ture of 120573-sitosterol-glucoside and 2-5-stigmatadien-3-120573-ol-glucoside that can produce a hypoglycemic effect in normalrabbits [109] Shibib et al [110] in a study administered theethanolic extract of the fruit of bitter melon to STZ diabeticrats orally at a dose equivalent to 200mg extract per kgbody weight Ninety minutes after the administration theyfound that blood glucose levels had been reduced by 22Theglucogenic enzymes-glucose-6-phosphatase and fructose1 6-bisphosphatase in the liver were also depressed Furtherevidence for a beneficial chronic effect is that an improvementin both glucose tolerance and fasting blood glucose levels wasobserved in 8 NIDDM patients following 7 weeks of dailyconsumption of powered M charantia fruit [97] Althoughsome authors have indicated that the effect ofM charantia isnot associated with an increase in circulating insulin Weli-hinda et al [111] and Welihinda and Karunanayake [112]demonstrated that an aqueous extract from the fruit of Mcharantia was a potent stimulator of insulin release from 120573-cell-rich pancreatic islets isolated fromobese-hyperglycaemicmice Recently Matsuura et al [113] have isolated an 120572-glucosidase inhibitor from M charantia seeds which can bea potential drug therapy for postprandial hyperglycaemia(PPHG) However Dubey et al [104] found that the aqueousmethanolic and saline extracts of M charantia produceda significant hypoglycaemic effect in rats In addition themethanol and saline extracts also prevented adrenaline-induced hyperglycaemia

When tested on laboratory animals bitter melon hasshown hypoglycaemic as well as antihyperglycaemic activi-ties Polypeptide-p isolated from fruit seeds and tissue of bit-termelon showed potent hypoglycaemic effects when admin-istered subcutaneously to gerbils langurs and humans Theaqueous extracts of M charantia improved oral glucosetolerance test (OGTT) after 8 h in normal mice and reducedhyperglycaemia by 50 after 5 h in STZ diabetic mice Inaddition chronic oral administration of extract to normalmice for 13 days improved OGTT while no significant effectwas seen on plasma insulin levels We recently reported thatM charantia fruit extracts have a direct impact on transportof glucose in vitro [99 114ndash117]

210 Pelargonium sidoides DC (Geraniaceae)mdashUmckaloaboPelargonium sidoides is native to the coastal regions of SouthAfrica and available ethnobotanical information shows thatthe tuberous P sidoides is an important traditional medicinewith a rich ethnobotanical history [19]

P sidoides root extract EPs 7630 also known as Umck-aloabo is a herbal remedy thought to be effective in thetreatment of acute respiratory infectionsThere are numerousstudies about P sidoides and respiratory tract infections [118119] These studies showed that P sidoidesmay be effective inalleviating symptoms of acute rhinosinusitis and the common

cold in adults but doubt exists It may be effective in relievingsymptoms of acute bronchitis in adults and children andsinusitis in adults [118] EPs 7630 significantly reduced bron-chitis symptom scores in patients with acute bronchitis byday 7 [119] No serious adverse events were reported EPs7630 has a positive effect on phagocytosis oxidative burstand intracellular killing of cells [120ndash125] P sidoides extractmodulates the production of secretory immunoglobulin A insaliva both interleukin-15 and interleukin-6 in serum andinterleukin-15 in the nasal mucosa [19 126]

In one research P sidoides was documented to representan effective treatment against common cold It was reportedto significantly reduce the severity of symptoms and shortensthe duration of the common cold compared with placeboBecause of these effects the authors have aimed at estab-lishing whether or not P sidoides could affect the asthmaattack frequency after upper respiratory tract viral infectionResults for some 20 clinical trials have been published 7 ofwhich were observational studies and the remaining 13 wererandomized double-blind and placebo-controlled For 6 ofthose 13 trials only preliminary results have been publishedAll trials have been carried out using EPs 7630 in liquidor solid forms The data derived from these trials has beenevaluated in 2 reviews [19 118 119]

Antibacterial activity of extracts and isolated constituentsof P sidoides was evaluated by Kayser [127] against threegram-positive and five gram-negative bacteria Most com-pounds exhibited antibacterial activities Further investiga-tions by Lewu et al [128] have supported these findings EPs7630 has been found to show a synergistic indirect antibacte-rial effect in group A-streptococci (GAS) through inhibitionof bacterial adhesion to human epithelial cells as well asinduction of bacterial adhesion to buccal epithelial cells[8 129] Wittschier et al [130] and Beil and Kilian [131]confirmed the antiadhesive effect of EPs 7630 for Helicobac-ter pylori growth and adhesion to gastric epithelial cellsUmckaloabo has been documented to significantly stimu-late phagocytosis oxidative burst and intracellular killingwhichwas also enhanced [120ndash125] It was proposed thatmodulation of epithelial-cell bacteria interaction throughEPs7630 may protect mucous membranes from microorganismsevading host defense mechanisms These findings tend toprovide a rationale for the treatment of upper respiratory tractinfections with EPs 7630 [131 132]

Taylor et al [133] have recently established the antimy-cobacterial activity for hexane extracts of roots of P reniformeand P sidoides Godecke et al [134] have reported no sig-nificant effect on the bacterial growth of two strains of myco-bacteria by extracts and fractions of P sidoides An antituber-cular effect may thus be achieved indirectly by stimulationof immune response This assumption was supported byMativandlela et al [135] as none of the compounds isolatedfrom P sidoides showed any significant activity against Mtuberculosis

Kayser et al [136] have investigated into extracts andisolated constituents of P sidoides for their effects on non-specific immune functions in various bioassays They foundindirect activity possibly through activation of macrophagefunctions Activation was confirmed through the presence


of tumor necrosis factor (TNF-alpha) and inorganic nitricoxides (iNO) Kolodziej [137 138] also observed TNF-inducing potencies for EPs 7630 as well as interferon-likeactivities Koch et al [139] observed interferon- (IFN-) betaproduction increased and natural killer cell mediated cyto-toxicity enhanced in MG-63 human osteosarcoma cellspreincubated with Umckaloabo [19 139] Kolodziej [137 138]investigated polyphenol-containing extracts of P sidoidesand simple phenols flavan-3-ols proanthocyanidins andhydrolysable tannins for gene expressions (iNOS IL-1 IL-10IL-12 IL-18 TNF-alpha and IFN-alphagamma) All extractsand compounds were capable of enhancing the iNOS andcytokine mRNA levels in parasitised cells

3 Discussion

Medicinal plants are an integral part of the African health-care system since time immemorial Interest in traditionalmedicine can be explained by the fact that it is a fundamentalpart of the culture of the people who use it and also dueto the economic challenge on one side the pharmaceuticaldrugs are not accessible to the poor and on the other sidethe richness and diversity of the fauna and flora of Africa arean inexhaustible source of therapies for panoply of ailments[140] Nonetheless there is still a paucity of clinical evidenceto show that they are effective and safe for humans Withoutthis information users of traditional medicinal plants inAfrica and elsewhere remain skeptical about the value ofsuch therapies This denies people the freedom to chooseplants that are potentially less costly and are more accessibleAnother issue concerning the use of botanical remedies isthe need to understand the safety of these therapies Forthese reasons information about efficacy and safety of tra-ditional medicines is urgently required The present paperhas endeavoured to overview just a few common medicinalplants from the African continent which have short- as wellas long-term potential to be developed as future phytophar-maceuticals to treat andor manage panoply of infectious andchronic conditions Within the framework of enhancing thesignificance of traditional African medicinal plants aspectssuch as traditional use phytochemical composition and invitro in vivo and clinical studies pertaining to the use of theseplants have been explored

During the last few decades it has become evident thatthere exists a plethora of plants with medicinal potential andit is increasingly being accepted that the African traditionalmedicinal plants might offer potential template molecules inthe drug discovery processMany of the plants presented hereshow very promising medicinal properties thus warrantingfurther clinical investigations Nonetheless only few of themhave robust scientific and clinical proofs and with a signifi-cant niche market (egAloe feroxArtemisia afraAspalathuslinearis Centella asiatica and Pelargonium sidoides) and a lotmore have yet to be explored and proved before reaching theglobal market [7 8 12 19]

In the light of modern science significant effortsshould be geared to identify and characterize the bioactiveconstituents from these plants Indeed the discovery oftherapeutic compounds from traditional medicinal plant

remedies remains a medically and potentially challengingtask For adventure in such an attempt highly reproducibleand robust innovative bioassays are needed in view of ourlimited understanding of the multifactorial pathogenicity ofdiseases Innovative strategies to improve the process of plantcollection are needed especially with the legal and politicalissues surrounding benefit-sharing agreements Since drugdiscovery from medicinal plants has traditionally been sotime-consuming it is also of uttermost importance forinvestigators to embark and devise new automated bioassayswith special emphasis on high throughput procedures thatcan screen isolate and process data from an array of phyto-chemicals within shorter time lapse for product developmentAdditionally these procedures should also attempt to ruleout false positive hits and dereplication methods to removenuisance compounds [7]

Nonetheless despite continuous comprehensive andmechanism-orientated evaluation of medicinal plants fromthe African flora there is still a dearth of literature comingfrom the last decadersquos investigations addressing proceduresto be adopted for quality assurance authentication andstandardization of crude plant products Appropriate stan-dardization could be achieved via proper management ofraw material extraction procedures and final product for-mulation Without effective quality control consistency andmarket value of the herbal product may be compromisedIndeed one of themain constraints to the growth of amodernAfrican phytomedicine industry has also been identified asthe lack of proper validation of traditional knowledge andalso the lack of technical specifications and quality con-trol standards This makes it extremely difficult for buyerswhether national or international to evaluate the safety andefficacy of plants and extracts or compare batches of productsfrom different places or from year to year This is in markedcontrast with Europe andAsiawhere traditionalmethods andformulations have been recorded and evaluated both at thelocal and national levels This would also tend to justify whythe level of trade of phytomedicines in Asia and Europe isblooming more than those in Africa [7]

It is also imperative that potential risk factors for exam-ple the contamination of medicinal plant products withheavy metals from African traditional medicine products beaddressed and that regulatory guidelines are not only care-fully developed but also enforced Controlled growth (underGACP) and processing environments (under Good Man-ufacturing Practice) need to ensure that contamination ofmedicinal plant material is kept to a minimum For themedicinal plant industry cultivated plant material is pre-ferred as it is easier to control the supply chain plus contami-nation is nominal [141] On the other hand proper identifica-tion of a medicinal plant material is fundamental to the qual-ity control process it must be established unmistakably thatthe source of the plant material is genuine Following thismicrobial contamination (fungal bacterial and any potentialhuman pathogens) must be checked during the stages ofprocessing of the material Chemical pharmacological andtoxicological evaluations conducted according to the prin-ciples of Good Laboratory Practices (GLPs) will certify thebioactive properties of the material undergoing processing


These tests also are often the predictors of safety of the prod-ucts manufactured Clinical safety and efficacy will need tobe established through exhaustive and usually lengthy trialsduring the early stages of the development of a therapeuticagent After that so long as the standard operating proceduresare adhered to then the unit dosage forms produced will beconsidered safe Notwithstanding this quality assurance pro-cedures must be instituted so that the products coming fromthe factory are of good quality safety and efficacy [142] Tothis effect during the development stage product standard-ization quality control and assurance double-blind placebo-controlled and randomized clinical controlled trials usingstandardized products or products containing pure plantextracts are essential components that need to be perfectedin order to translate the potential of African botanicals into areality for human to benefit [7 142]

4 Conclusions

It is evident from the literature that there is currently arenewed interest in African-plant-based medicines in theprevention and cure of various pathologies Medicinal plantsstill play an important role in healthcare system in Africancountries Nonetheless there are still many major challengesthat need to be overcome and addressed for its full potential tobe realized as the effective treatment of diseases with plantproducts has not been validated thoroughly with robustscientific criteria to compete with existing conventionaltherapies Additionally other issues that need to be addressedare that of access and benefit sharing following the Nagoyaagreement Local laws need to be TRIPS compliant if trade ofAfrican herbal products is to increase and at the same timeissues of sustainable use and development of plant productsneed to be addressed

References

[1] WHO Fact sheetN∘134 2008 httpwwwwhointmediacentrefactsheets2003fs134en

[2] A Gurib-Fakim ldquoMedicinal plants traditions of yesterday anddrugs of tomorrowrdquo Molecular Aspects of Medicine vol 27 no1 pp 1ndash93 2006

[3] V Chintamunnee and M F Mahomoodally ldquoHerbal medicinecommonly used against infectious diseases in the tropical islandof Mauritiusrdquo Journal of Herbal Medicine vol 2 pp 113ndash1252012

[4] H Nunkoo and M F Mahomoodally ldquoEthnopharmacologi-cal survey of native remedies commonly used against infec-tious diseases in the tropical island of Mauritiusrdquo Journal ofEthnopharmacology vol 143 no 2 pp 548ndash564 2012

[5] S Shohawon and M F Mahomoodally ldquoComplementary andalternative medicine use among Mauritian womenrdquo Comple-mentary Therapies in Clinical Practice vol 19 no 1 pp 36ndash432013

[6] Aone Mokaila 2001 httpwwwblackherbalscomatcNews-letter913pdf

[7] A Gurib-Fakim and M F Mahomoodally ldquoAfrican flora aspotential sources of medicinal plants towards the chemother-apy of major parasitic and other infectious diseases- a reviewrdquoJordan Journal of Biological Sciences vol 6 pp 77ndash84 2013

[8] A Gurib-Fakim T Brendler L D Phillips and L N EloffGreen GoldmdashSuccess Stories Using Southern African Plant Spe-cies AAMPS Publishing Mauritius 2010

[9] C Manach A Scalbert C Morand C Remesy and L JimenezldquoPolyphenols food sources and bioavailabilityrdquo American Jour-nal of Clinical Nutrition vol 79 no 5 pp 727ndash747 2004

[10] B M Abegaz B T Ngadjui G N Folefoc et al ldquoPreny-lated flavonoids monoterpenoid furanocoumarins and otherconstituents from the twigs of Dorstenia elliptica (Moraceae)rdquoPhytochemistry vol 65 no 2 pp 221ndash226 2004

[11] N R Farnsworth O Akerele A S Bingel D D Soejarto and ZGuo ldquoMedicinal plants in therapyrdquo Bulletin of the World HealthOrganization vol 63 no 6 pp 965ndash981 1985

[12] Association of African Medicinal Plants Standards (AAMPS)httpwwwaampsorg

[13] S E Atawodi ldquoAntioxidant potential of African medicinalplantsrdquo African Journal of Biotechnology vol 4 no 2 pp 128ndash133 2005

[14] S O Okoro A H Kawo and A H Arzai ldquoPhytochemicalscreening antibacterial and toxicological activities of Acaciasenegal extractsrdquo Bayero Journal of Pure and Applied Sciencesvol 5 no 1 pp 163ndash1170 2011

[15] R Jain P Sharma T Bhagchandani and S C Jain ldquoPhytochem-ical investigation and antimicrobial activity of Acacia senegalroot heartwoodrdquo Journal Pharmaceutical Research vol 5 pp4934ndash4938 2012

[16] A Gurib-Fakim andM J Kasilo Promoting AfricanMedicinalPlants through anAfricanHerbal Pharmacopoeia Special Issue14 Decade of African Traditional Medicine 2001ndash2010

[17] B S Aliyu Common Ethnomedicinal Plants of the SemiaridRegions of West Africa Triumph Publishing Kano Nigeria2006


[19] T Brendler L N Eloff A Gurib-Fakim and L D PhillipsAfrican Herbal Pharmacopeia AAMPS Publishing Mauritius2010

[20] B-E van Wyk ldquoA broad review of commercially importantsouthernAfricanmedicinal plantsrdquo Journal of Ethnopharmacol-ogy vol 119 no 3 pp 342ndash355 2008

[21] B E Van Wyk and M Wink Medicinal Plants of the WorldAn Illustrated Scientific Guide to importantMedicinal Plants andTheir Uses Briza Publications Pretoria South Africa 2004

[22] Y Jia G Zhao and J Jia ldquoPreliminary evaluation the effectsof Aloe ferox Miller and Aloe arborescens Miller on woundhealingrdquo Journal of Ethnopharmacology vol 120 no 2 pp 181ndash189 2008

[23] W Chen B-E Van Wyk I Vermaak and A M ViljoenldquoCape aloesmdasha review of the phytochemistry pharmacologyand commercialisation of Aloe feroxrdquo Phytochemistry Lettersvol 5 no 1 pp 1ndash12 2012

[24] A Melin A bitter pill to swallow a case study of the trade ampharvest of Aloe ferox in the Eastern Cape South Africa [MSthesis] Imperial College 2009

[25] B E VanWyk and N Gericke Peoplersquos Plants A Guide to UsefulPlants of Southern Africa Briza Publications Pretoria SouthAfrica 2000



[27] B EVanWyk andG F SmithGuide to theAloes of SouthAfricaBriza Publications Pretoria South Africa 1996


[29] B E Van Wyk B Van Oudtshoorn and N Gericke MedicinalPlants of South Africa Briza Publications Pretoria SouthAfrica 2nd edition 2009

[30] B-E Van Wijk M C B Van Rheede Van Oudtshoorn and GF Smith ldquoGeographical variation in the major compounds ofAloe ferox leaf exudaterdquo Planta Medica vol 61 no 3 pp 250ndash253 1995

[31] B E Van Wyk A Yenesew and E Dagne ldquoChemotaxonomicsurvey of anthraquinones and pre-anthraquinones in roots ofAloe speciesrdquo Biochemical Systematics and Ecology vol 23 no3 pp 267ndash275 1995

[32] T L Du FHVanDerWesthuizen and L Botes ldquoAloe ferox leafgel phytochemical content antioxidant capacity and possiblehealth benefitsrdquo Journal of Agricultural and Food Chemistry vol55 no 17 pp 6891ndash6896 2007

[33] F A Andersen ldquoFinal report on the safety assessment of Aloeandongensis extract Aloe andongensis leaf juice Aloe arbor-escens leaf extract Aloe arborescens leaf juice Aloe arborescensleaf protoplastsAloe barbadensis flower extractAloe barbaden-sis leaf Aloe barbadensis leaf extract Aloe barbadensis leafjuice Aloe barbadensis leaf polysaccharides Aloe barbadensisleaf water Aloe ferox ferox leaf extractrdquo International Journal ofToxicology vol 26 no 2 pp 1ndash50 2007

[34] R Segal I Feuerstein and A Danin ldquoChemotypes ofArtemisiaherba-alba in Israel based on their sesquiterpene lactone andessential oil constitutionrdquo Biochemical Systematics and Ecologyvol 15 no 4 pp 411ndash416 1987

[35] A Ziyyat A Legssyer H Mekhfi A Dassouli M SerhrouchniandW Benjelloun ldquoPhytotherapy of hypertension and diabetesin oriental Moroccordquo Journal of Ethnopharmacology vol 58 no1 pp 45ndash54 1997

[36] A Tahraoui J El-Hilaly Z H Israili and B Lyoussi ldquoEth-nopharmacological survey of plants used in the traditionaltreatment of hypertension and diabetes in south-easternMorocco (Errachidia province)rdquo Journal of Ethnopharmacologyvol 110 no 1 pp 105ndash117 2007

[37] N-A Zeggwagh O Farid J B Michel and M EddouksldquoCardiovascular effect of Artemisia herba alba aqueous extractin spontaneously hypertensive ratsrdquo Methods and Findings inExperimental and Clinical Pharmacology vol 30 no 5 pp 375ndash381 2008

[38] M Laid M-E F Hegazy A A Ahmed K Ali D Belkacemiand S Ohta ldquoSesquiterpene lactones from Algerian Artemisiaherba-albardquoPhytochemistry Letters vol 1 no 2 pp 85ndash88 2008

[39] J Friedman Z YanivADafni andD Palewitch ldquoApreliminaryclassification of the healing potential of medicinal plantsbased on a rational analysis of an ethnopharmacological fieldsurvey among Bedouins in the Negev Desert Israelrdquo Journal ofEthnopharmacology vol 16 no 2-3 pp 275ndash287 1986

[40] F Fenardji M Klur C Fourlon and R Ferrando ldquoWhiteArtemisia (Artemisia herba alba L)rdquo Revue drdquoelevage et demedecine veterinaire des pays tropicaux vol 27 no 2 pp 203ndash206 1974

[41] A Benmansur S A Taleb-Bendiab N Mashev and G VasilevldquoStudies on the chemical composition of Artemisia (Artemisiaherba-alba)rdquo Bolgarskoi Akademii Nauk vol 43 no 8 pp 65ndash67 1990

[42] A E-H H Mohamed M A El-Sayed M E Hegazy S EHelaly A M Esmail and N S Mohamed ldquoChemical constit-uents and biological activities of Artemisia herba-albardquo Recordsof Natural Products vol 4 no 1 pp 1ndash25 2010

[43] R Belhattab L Amor J G Barroso L G Pedro and A CFigueiredo ldquoEssential oil fromArtemisia herba-albaAsso grownwild in Algeria variability assessment and comparison with anupdated literature surveyrdquoArabian Journal of Chemistry vol 57no 4 pp 603ndash619 2012

[44] T Dob and T Benabdelkader ldquoChemical composition of theessential oil of Artemisia herba-albaAsso grown in AlgeriardquoJournal of Essential Oil Research vol 18 no 6 pp 685ndash6902006

[45] E Joubert and D de Beer ldquoRooibos (Aspalathus linearis)beyond the farm gate from herbal tea to potential phytophar-maceuticalrdquo South African Journal of Botany vol 77 no 4 pp869ndash886 2011

[46] F R Van Heerden B-E Van Wyk A M Viljoen and PA Steenkamp ldquoPhenolic variation in wild populations ofAspalathus linearis (rooibos tea)rdquo Biochemical Systematics andEcology vol 31 no 8 pp 885ndash895 2003

[47] B E Van Wyk and G H Verdoorn ldquoAlkaloids of the gen-era Aspalathus Rafnia and Wiborgia (Fabaceae-Crotalarieae)rdquoSouth African Journal of Botany vol 55 pp 520ndash522 1989

[48] A Kawano H Nakamura S-I Hata M Minakawa Y Miuraand K Yagasaki ldquoHypoglycemic effect of aspalathin a rooibostea component from Aspalathus linearis in type 2 diabeticmodel dbdb micerdquo Phytomedicine vol 16 no 5 pp 437ndash4432009

[49] J L Marnewick F H van der Westhuizen E Joubert SSwanevelder P Swart and W C A Gelderblom ldquoChemopro-tective properties of rooibos (Aspalathus linearis) honeybush(Cyclopia intermedia) herbal and green and black (Camelliasinensis) teas against cancer promotion induced by fumonisinB1 in rat liverrdquo Food and Chemical Toxicology vol 47 no 1 pp220ndash229 2009

[50] S Kreuz E Joubert K-H Waldmann and W Ternes ldquoAspal-athin a flavonoid in Aspalathus linearis (rooibos) is absorbedby pig intestine as a C-glycosiderdquoNutrition Research vol 28 no10 pp 690ndash701 2008

[51] A H Gilani A-U Khan M N Ghayur S F Ali and JW Herzig ldquoAntispasmodic effects of Rooibos tea (Aspalathuslinearis) is mediated predominantly through K+-channel acti-vationrdquoBasic and Clinical Pharmacology and Toxicology vol 99no 5 pp 365ndash373 2006

[52] A-U Khan and A H Gilani ldquoSelective bronchodilatory effectof Rooibos tea (Aspalathus linearis) and its flavonoid chrysoe-riolrdquo European Journal of Nutrition vol 45 no 8 pp 463ndash4692006

[53] R Fukasawa A Kanda and S Hara ldquoAnti-oxidative effects ofrooibos tea extract on autoxidation and thermal oxidation oflipidsrdquo Journal of Oleo Science vol 58 no 6 pp 275ndash283 2009

[54] E Joubert ldquoEffect of batch extraction conditions on yield ofsoluble solids from rooibos teardquo International Journal of FoodScience and Technology vol 23 pp 43ndash47 1988

[55] E Joubert ldquoChemical and sensory analyses of spray- and freeze-dried extracts of rooibos tea (Aspalathus linearis)rdquo InternationalJournal of Food Science and Technology vol 25 pp 344ndash3491990


[56] E Joubert ldquoEffect of batch extraction conditions on yield ofpolyphenols from rooibos tea (Aspalathus linearis)rdquo Interna-tional Journal of Food Science and Technology vol 25 pp 339ndash343 1990

[57] E Joubert ldquoTristimulus colour measurement of rooibos teaextracts as an objective colour quality parameterrdquo InternationalJournal of Food Science and Technology vol 30 pp 783ndash7921995

[58] E Joubert M Manley and M Botha ldquoEvaluation of spec-trophotometric methods for screening of green rooibos (Aspal-athus linearis) and green honeybush (Cyclopia genistoides)extracts for high levels of bio-active compoundsrdquoPhytochemicalAnalysis vol 19 no 2 pp 169ndash178 2008

[59] E Joubert and R Muller ldquoA small-scale rotary fermentationunit for rooibos teardquo International Journal of Food Science andTechnology vol 32 no 2 pp 135ndash139 1997

[60] E Joubert F Otto S Gruner and B Weinreich ldquoReversed-phase HPLC determination of mangiferin isomangiferin andhesperidin in Cyclopia and the effect of harvesting date onthe phenolic composition of C genistoidesrdquo European FoodResearch and Technology vol 216 no 3 pp 270ndash273 2003

[61] E Joubert E S Richards J D Van Der Merwe D De Beer MManley and W C A Gelderblom ldquoEffect of species variationand processing on phenolic composition and in vitro antioxi-dant activity of aqueous extracts of Cyclopia spp (Honeybushtea)rdquo Journal of Agricultural and Food Chemistry vol 56 no 3pp 954ndash963 2008

[62] E Joubert and H Schulz ldquoProduction and quality aspects ofrooibos tea and related products A reviewrdquo Journal of AppliedBotany and Food Quality vol 80 no 2 pp 138ndash144 2006

[63] E Joubert J D Van der Merwe W C A Gelderblom and MManley ldquoImplication of CYP450 stabilization in the evaluationof in vitro antimutagenicity of the herbal teas Cyclopia spp(honeybush) and Aspalathus linearis (rooibos) and selectedpolyphenolsrdquo in Proceedings of the Polyphenols Communications2006 Abstracts of 23rd International Conference on Polyphenolspp 505ndash506 Manitoba Canada 2006

[64] E Joubert PWinterton T J Britz and D Ferreira ldquoSuperoxideanion and 120572 120572-diphenyl-120573-picrylhydrazyl radical scavengingcapacity of rooibos (Aspalathus linearis) aqueous extractscrude phenolic fractions tannin and flavonoidsrdquo Food ResearchInternational vol 37 no 2 pp 133ndash138 2004

[65] E Joubert P Winterton T J Britz and W C A GelderblomldquoAntioxidant and pro-oxidant activities of aqueous extracts andcrude polyphenolic fractions of rooibos (Aspalathus linearis)rdquoJournal of Agricultural and Food Chemistry vol 53 no 26 pp10260ndash10267 2005

[66] P Mose Larsen S J Fey J Louw and L Joubert ldquoAn anti-diabetic extract of Rooibosrdquo PCT Application PCTEP2008052861 (WO 2008110551 A1) 2008

[67] H-K Na K S Mossanda J-Y Lee and Y-J Surh ldquoInhibitionof phorbol ester-induced COX-2 expression by some edibleAfrican plantsrdquo BioFactors vol 21 no 1ndash4 pp 149ndash153 2004

[68] F Bruno and W Dimpfel ldquoAspalathin-like dihydrochalconeextracts from unfermented rooibos and process for prepar-ationrdquo PCT Patent Application PCTEP2008007279 (WO2009052895) 2009

[69] B Brinkhaus M Lindner D Schuppan and E G HahnldquoChemical pharmacological and clinical profile of the EastAsian medical plant Centella asiaticardquo Phytomedicine vol 7 no5 pp 427ndash448 2000

[70] W-J Kim J Kim B Veriansyah et al ldquoExtraction of bioactivecomponents from Centella asiatica using subcritical waterrdquoJournal of Supercritical Fluids vol 48 no 3 pp 211ndash216 2009

[71] A Shukla AM Rasik G K Jain R Shankar D K Kulshresthaand B N Dhawan ldquoIn vitro and in vivo wound healingactivity of asiaticoside isolated from Centella asiaticardquo Journalof Ethnopharmacology vol 65 no 1 pp 1ndash11 1999

[72] J Lee E Jung Y Kim et al ldquoAsiaticoside induces humancollagen I synthesis through TGF120573 receptor I kinase (T120573RIkinase)-independent Smad signalingrdquo Planta Medica vol 72no 4 pp 324ndash328 2006

[73] M T Thomas R Kurup A J Johnson et al ldquoElite geno-typeschemotypes with high contents of madecassoside andasiaticoside from sixty accessions of Centella asiatica of southIndia and the Andaman Islands for cultivation and utility incosmetic and herbal drug applicationsrdquo Industrial Crops andProducts vol 32 no 3 pp 545ndash550 2010

[74] H S Long M A Stander and B E Van Wyk ldquoNotes onthe occurrence and significance of triterpenoids (asiaticosideand related compounds) and caffeoylquinic acids in Centellaspeciesrdquo South African Journal of Botany vol 82 pp 53ndash592012

[75] G I Stafford M E Pedersen J van Staden and A KJager ldquoReview on plants with CNS-effects used in traditionalSouth African medicine against mental diseasesrdquo Journal ofEthnopharmacology vol 119 no 3 pp 513ndash537 2008

[76] A Gurib-Fakim M Sewraj J Gueho and E Dulloo ldquoMed-icalethnobotany of some weeds of Mauritius and RodriguesrdquoJournal of Ethnopharmacology vol 39 no 3 pp 175ndash185 1993

[77] Y K Gupta M H Veerendra Kumar and A K SrivastavaldquoEffect of Centella asiatica on pentylenetetrazole-induced kin-dling cognition and oxidative stress in ratsrdquo PharmacologyBiochemistry and Behavior vol 74 no 3 pp 579ndash585 2003

[78] T K Chatterjee A Chakraborty M Pathak and G C Sen-gupta ldquoEffects of plant extract Centella asiatica (Linn) on coldrestraint stress ulcer in ratsrdquo Indian Journal of ExperimentalBiology vol 30 no 10 pp 889ndash891 1992

[79] M Ramanathan S Sivakumar P R Anandvijayakumar CSaravanababu and P R Pandian ldquoNeuroprotective evaluationof standardized extract of centella asciatica in monosodiumglutamate treated ratsrdquo Indian Journal of Experimental Biologyvol 45 no 5 pp 425ndash431 2007

[80] DM Pereira J Faria L Gaspar et al ldquoExploitingCatharanthusroseus roots source of antioxidantsrdquo Food Chemistry vol 121no 1 pp 56ndash61 2010

[81] A Gurib-Fakim J Gueho and M D Sewraj Plantes Medici-nales de Maurice Editions Le Printemps Rose Hill Mauritius1995

[82] F Ferreres D M Pereira P Valentao P B Andrade RM Seabra and M Sottomayor ldquoNew phenolic compoundsand antioxidant potential of Catharanthus roseusrdquo Journal ofAgricultural and Food Chemistry vol 56 no 21 pp 9967ndash99742008

[83] D M Pereira F Ferreres J Oliveira P Valentao P B Andradeand M Sottomayor ldquoTargeted metabolite analysis of Catha-ranthus roseus and its biological potentialrdquo Food and ChemicalToxicology vol 47 no 6 pp 1349ndash1354 2009

[84] R van der Heijden D I Jacobs W Snoeijer D Hallard and RVerpoorte ldquoThe Catharanthus alkaloids pharmacognosy andbiotechnologyrdquo Current Medicinal Chemistry vol 11 no 5 pp607ndash628 2004


[85] J K Grover S Yadav and V Vats ldquoMedicinal plants of Indiawith anti-diabetic potentialrdquo Journal of Ethnopharmacology vol81 no 1 pp 81ndash100 2002

[86] J Bowie ldquoSketches of the botany of South Africardquo South AfricanQuarterly Journal pp 27ndash36 1830

[87] J M Watt and M G Breyer-Brandwijk Medicinal and Poi-sonous Plants of Southern and Eastern Africa EampS LivingstoneEdinburgh UK 2nd edition 1962

[88] R Marloth The Flora of South Africa with Synoptical Tables ofthe Genera of the Higher Plants Darter Bros amp Co Cape TownSouth Africa 1925

[89] B Rood Uit Die Veldapteek Tafelberg-Uitgewers Bpk CapeTown South Africa 1994

[90] A Kokotkiewicz M Luczkiewicz J Pawlowska et al ldquoIsolationof xanthone and benzophenone derivatives fromCyclopia genis-toides (L)Vent (honeybush) and their pro-apoptotic activity onsynoviocytes from patients with rheumatoid arthritisrdquo Fitoter-apia vol 90 pp 199ndash208 2013

[91] M L Andersen E H R Santos M D L V Seabra A A BDa Silva and S Tufik ldquoEvaluation of acute and chronic treat-ments with Harpagophytum procumbens on Freundrsquos adjuvant-induced arthritis in ratsrdquo Journal of Ethnopharmacology vol 91no 2-3 pp 325ndash330 2004

[92] N Mncwangi W Chen I Vermaak A M Viljoen and N Ger-icke ldquoDevilrsquos Claw-A review of the ethnobotany Phytochem-istry and biological activity of Harpagophytum procumbensrdquoJournal of Ethnopharmacology vol 143 pp 755ndash771 2012

[93] S Chrubasik and P R Bradley ldquoAddendum to the ESCOPmonograph on Harpagophytum procumbens (multiple letter)rdquoPhytomedicine vol 11 no 7-8 pp 691ndash695 2004

[94] T Wegener and N-P Lupke ldquoTreatment of Patients withArthrosis of Hip or Knee with an Aqueous Extract ofDevilrsquos Claw (Harpagophytum procumbens DC)rdquo PhytotherapyResearch vol 17 no 10 pp 1165ndash1172 2003

[95] E Ernst and S Chrubasik ldquoPhyto-anti-inflammatories a sys-temic review of randomized placebo- controlled double-blindtrialsrdquo Rheumatic Disease Clinics of North America vol 26 no1 pp 13ndash27 2000

[96] P Wenzel and T Wegener ldquoHarpagophytum procumbensmdashaplant antirheumatic agentrdquo Deutsche Apotheker Zeitung vol135 no 13 pp 15ndash28 1995

[97] N Ahmad M R Hassan H Halder and K S BennoorldquoEffect of Momordica charantia (Karolla) extracts on fastingand postprandial serum glucose levels in NIDDM patientsrdquoBangladesh Medical Research Council Bulletin vol 25 no 1 pp11ndash13 1999

[98] Y Kimura Y Minami T Tokuda S Nakajima S Takagi andG Funatsu ldquoPrimary structures of N-linked oligosaccharides ofmomordin-a a ribosome-inactivating protein fromMomordicacharantia seedsrdquo Agricultural and Biological Chemistry vol 55no 8 pp 2031ndash2036 1991

[99] M F Mahomoodally A Gurib-Fakim and A H SubrattyldquoA kinetic model for in vitro intestinal uptake of l-tyrosineand d(+)-glucose across rat everted gut sacs in the presenceof Momordica charantia a medicinal plant used in traditionalmedicine against diabetes mellitusrdquo Journal of Cell and Molecu-lar Biology vol 3 pp 39ndash44 2004

[100] H Matsuda Y Li T Murakami N Matsumura J Yama-hara and M Yoshikawa ldquoAntidiabetic principles of naturalmedicines III Structure-related inhibitory activity and actionmode of oleanolic acid glycosides on hypoglycemic activityrdquo

Chemical and Pharmaceutical Bulletin vol 46 no 9 pp 1399ndash1403 1998

[101] H Matsuura C Asakawa M Kurimoto and J Mizutanildquo120572-Glucosidase inhibitor from the seeds of balsam pear(Momordica charantia) and the fruit bodies ofGrifola frondosardquoBioscience Biotechnology and Biochemistry vol 66 no 7 pp1576ndash1578 2002

[102] P Khanna S C Jain A Panagariya and V P Dixit ldquoHypo-glycemic activity of polypeptide-p from a plant sourcerdquo Journalof Natural Products vol 44 no 6 pp 648ndash655 1981

[103] M S Akhtar M A Athar and M Yaqub ldquoEffect ofMomordicacharantia on blood glucose level of normal and alloxan-diabeticrabbitsrdquo Planta Medica vol 42 no 3 pp 205ndash212 1981

[104] D K Dubey A R Biswas J S Bapna and S C PradhanldquoHypoglycaemic and antihyperglycaemic effects of Momordicacharantia seed extracts in albino ratsrdquo Fitoterapia vol 58 no 6pp 387ndash390 1987

[105] E H Karunanayake J Welihinda S R Sirimanne and GSinnadorai ldquoOral hypoglycaemic activity of some medicinalplants of Sri Lankardquo Journal of Ethnopharmacology vol 11 no2 pp 223ndash231 1984

[106] A P Jayasooriya M Sakono C Yukizaki M Kawano KYamamoto and N Fukuda ldquoEffects of Momordica charantiapowder on serum glucose levels and various lipid parametersin rats fed with cholesterol-free and cholesterol- enriched dietsrdquoJournal of Ethnopharmacology vol 72 no 1-2 pp 331ndash336 2000

[107] S Sarkar M Pranava and R A Marita ldquoDemonstration ofthe hypoglycemic action ofMomordica charantia in a validatedanimal model of diabetesrdquo Pharmacological Research vol 33no 1 pp 1ndash4 1996

[108] E Yesilada I Gurbuz and H J Shibata ldquoMomordica charantiaan overviewrdquo Journal of Ethnopharmacology vol 66 pp 289ndash293 1999

[109] A Raman and C Lau ldquoAntidiabetic properties and phyto-chemistry of Momordica charantia L (Cucurbitaceae)rdquo Phy-tomedicine vol 2 pp 349ndash362 1996

[110] B A Shibib L A Khan and R Rahman ldquoHypoglycaemicactivity of Coccinia indica andMomordica charantia in diabeticrats depression of the hepatic gluconeogenic enzymes glucose-6-phosphatase and fructose-16-bisphosphatase and elevationof both liver and red-cell shunt enzyme glucose-6-phosphatedehydrogenaserdquo Biochemical Journal vol 292 no 1 pp 267ndash270 1993

[111] J Welihinda G Avidson E Gylte B Hellman and E KarlsonldquoThe insulin-releasing activity of the tropical plant Momordicacharantiardquo Acta Biology Medicinal Germany vol 41 pp 1229ndash1239 1981

[112] J Welihinda and E H Karunanayake ldquoExtra-pancreatic effectsofMomordica charantia in ratsrdquo Journal of Ethnopharmacologyvol 17 no 3 pp 247ndash255 1986


[114] A H Subratty A Gurib-Fakim and F Mahomoodally ldquoBittermelon an exotic vegetablewithmedicinal valuesrdquoNutrition andFood Science vol 35 no 3 pp 143ndash147 2005

[115] M F Mahomoodally A-G Fakim and A H SubrattyldquoMomordica charantia extracts inhibit uptake of monosaccha-ride and amino acid across rat everted gut sacs in vitrordquo


Biological and Pharmaceutical Bulletin vol 27 no 2 pp 216ndash218 2004

[116] M F Mahomoodally A Gurib-Fakim and A H SubrattyldquoExperimental evidence for in vitro fluid transport in the pres-ence of a traditional medicinal fruit extract across rat evertedintestinal sacsrdquo Fundamental and Clinical Pharmacology vol 19no 1 pp 87ndash92 2005

[117] M F Mahomoodally A Gurib Fakim and A H SubrattyldquoStimulatory effects of Antidesma madagascariense on D-glucose L-tyrosine fluid and electrolyte transport across rateverted intestine comparable to insulin action in vitrordquo BritishJournal of Biomedical Science vol 63 no 1 pp 12ndash17 2006

[118] A Timmer J Gunther G Rucker E Motschall G Antes andW V Kern ldquoPelargonium sidoides extract for acute respiratorytract infectionsrdquo Cochrane Database of Systematic Reviews no3 Article ID CD006323 2008

[119] T B Agbabiaka R Guo and E Ernst ldquoPelargonium sidoidesfor acute bronchitis a systematic review and meta-analysisrdquoPhytomedicine vol 15 no 5 pp 378ndash385 2008

[120] A Conrad C Hansmann I Engels F D Daschner andU Frank ldquoExtract of Pelargonium sidoides (EPs) improvesphagocytosis oxidative burst and intracellular killing of humanperipheral blood phagocytes in vitrordquoPhytomedicine vol 14 no1 pp 46ndash51 2007

[121] A Conrad I Jung D Tioua et al ldquoExtract of Pelargoniumsidoides (EPs) inhibits the interactions of group A-streptococciand host epithelia in vitrordquo Phytomedicine vol 14 no 1 pp 52ndash59 2007

[122] A Conrad H Kolodziej and V Schulz ldquoPelargonium sidoides-extract (EPs 7630) registration confirms efficacy and safetyrdquoWiener Medizinische Wochenschrift vol 157 no 13-14 pp 331ndash336 2007

[123] A Conrad and U Frank ldquoExtract of Pelargonium sidoides (EPs7630) displays anti-infective properties by enhanced phagocy-tosis and differential modulation of host-bacteria interactionsrdquoPlanta Medica vol 74 no 6 pp 682ndash685 2008

[124] A Conrad D Bauer C Hansmann I Engels and U FrankldquoExtract of Pelargonium sidoides (EPs 7630) improves phagocy-tosis oxidative burst and intracellular killing of human periph-eral blood phagocytes in vitrordquoZeitschrift fur Phytotherapie vol29 no 1 pp 15ndash18 2008

[125] A Conrad D Bauer I Jung et al ldquoExtract of Pelargoniumsidoides (EPs 7630) inhibits the interactions of group A-streptococci and host epitheliardquo Zeitschrift fur Phytotherapievol 29 no 1 pp 19ndash22 2008

[126] T Brendler and B-E van Wyk ldquoA historical scientific andcommercial perspective on the medicinal use of Pelargoniumsidoides (Geraniaceae)rdquo Journal of Ethnopharmacology vol 119no 3 pp 420ndash433 2008

[127] O Kayser Phenolische Inhaltsstoffe von Pelargonium sidoidesDC und Untersuchungen zur Wirksamkeit der Umcka-Droge(Pelargonium sidoides DC und Pelargonium reniforme Curt)[PhD thesis] University of Berlin 1997

[128] F B Lewu D S Grierson and A J Afolayan ldquoExtracts fromPelargonium sidoides inhibit the growth of bacteria and fungirdquoPharmaceutical Biology vol 44 no 4 pp 279ndash282 2006

[129] F Daschner A Dorfmuller I Engels and U Frank ldquoUnter-suchungen zum antibakteriellen Wirkmechanismus vonEPs7630rdquo Phytopharmaka und Phytotherapie Abstract vol 152004

[130] N Wittschier G Faller and A Hensel ldquoAn extract of Pelargo-nium sidoides (EPs 7630) inhibits in situ adhesion ofHelicobac-ter pylori to human stomachrdquo Phytomedicine vol 14 no 4 pp285ndash288 2007

[131] W Beil and P Kilian ldquoEPs an extract from Pelargonium sido-ides roots inhibits adherence of Helicobacter pylori to gastricepithelial cellsrdquo Phytomedicine vol 14 no 1 pp 5ndash8 2007

[132] NWittschier C Lengsfeld S Vorthems et al ldquoLargemoleculesas anti-adhesive compounds against pathogensrdquo Journal ofPharmacy and Pharmacology vol 59 no 6 pp 777ndash786 2007

[133] P Taylor S Maalim and S Coleman ldquoThe strange story ofumckaloabordquo Pharmaceutical Journal vol 275 no 7381 pp790ndash792 2005

[134] T Godecke M Kaloga and H Kolodziej ldquoA phenol gluco-side uncommon coumarins and flavonoids from Pelargoniumsidoides DCrdquo Zeitschrift fur Naturforschung vol 60 no 6 pp677ndash682 2005

[135] S P N Mativandlela J J M Meyer A A Hussein andN Lall ldquoAntitubercular activity of compounds isolated fromPelargonium sidoidesrdquo Pharmaceutical Biology vol 45 no 8 pp645ndash650 2007

[136] O Kayser K N Masihi and A F Kiderlen ldquoNatural prod-ucts and synthetic compounds as immunomodulatorsrdquo ExpertReview of Anti-InfectiveTherapy vol 1 no 2 pp 319ndash335 2003

[137] H Kolodziej ldquoTraditionally used Pelargonium species chem-istry and biological activity of umckaloabo extracts and theirconstituentsrdquo Current Topics in Phytochemistry vol 3 pp 77ndash93 2000

[138] H Kolodziej ldquoFascinating metabolic pools of Pelargoniumsidoides and Pelargonium reniforme traditional and phytome-dicinal sources of the herbal medicine Umckaloabordquo Phy-tomedicine vol 14 no 1 pp 9ndash17 2007

[139] E Koch H Hauer and K H Stumpf Use of Pelargoniumsidoides and Pelargonium reniforme root extracts World PatentWO2006002837 (European Patent EP1651244 United StatesPatent 20060263448) 2006

[140] W R Sawadogo M Schumacher M Teiten M Dicato and MDiederich ldquoTraditionalWest African pharmacopeia plants andderived compounds for cancer therapyrdquo Biochemical Pharma-cology vol 84 pp 1225ndash1240 2012

[141] R Gautam A Saklani and S M Jachak ldquoIndian medicinalplants as a source of antimycobacterial agentsrdquo Journal of Eth-nopharmacology vol 110 no 2 pp 200ndash234 2007

[142] O M J Kasilo and J M Trapsida ldquoRegulation of traditionalmedicine in the WHO African regionrdquo The African HealthMonitor vol 13 pp 25ndash31 2010

Submit your manuscripts athttpwwwhindawicom

Stem CellsInternational

Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014


MEDIATORSINFLAMMATION

of


Behavioural Neurology

EndocrinologyInternational Journal of



Disease Markers


BioMed Research International

OncologyJournal of



Oxidative Medicine and Cellular Longevity


PPAR Research

The Scientific World JournalHindawi Publishing Corporation httpwwwhindawicom Volume 2014

Immunology ResearchHindawi Publishing Corporationhttpwwwhindawicom Volume 2014

Journal of

ObesityJournal of



Computational and Mathematical Methods in Medicine

OphthalmologyJournal of


Diabetes ResearchJournal of



Research and TreatmentAIDS


Gastroenterology Research and Practice


Parkinsonrsquos Disease

Evidence-Based Complementary and Alternative Medicine

Volume 2014Hindawi Publishing Corporationhttpwwwhindawicom


The combined actions of these substances tend to increasethe activity of the main medicinal constituent by speedingup or slowing down its assimilation in the body Secondarymetabolites from plantrsquos origins might increase the stabilityof the active compound(s) or phytochemicals minimize therate of undesired adverse side effects and have an additivepotentiating or antagonistic effect It has been postulatedthat the enormous diversity of chemical structures found inthese plants is not waste products but specialized secondarymetabolites involved in the relationship of the organismwith the environment for example attractants of pollinatorssignal products defensive substances against predators andparasites or in resistance against pests and diseases A singleplant may for example contain bitter substances that stim-ulate digestion and possess anti-inflammatory compoundsthat reduce swellings and pain phenolic compounds thatcan act as an antioxidant and venotonics antibacterial andantifungal tannins that act as natural antibiotics diureticsubstances that enhance the elimination of waste productsand toxins and alkaloids that enhance mood and give asense of well-being [1ndash5] Although some may view theisolation of phytochemicals and their use as single chemicalentities as a better alternative and which have resulted in thereplacement of plant extractsrsquo use nowadays a view that theremay be some advantages of the medical use of crude andorstandardized extracts as opposed to isolated single compoundis gaining much momentum in the scientific community

2 African Traditional Medicine

African traditional medicine is the oldest and perhaps themost assorted of all therapeutic systems Africa is consideredto be the cradle of mankind with a rich biological andcultural diversity marked by regional differences in healingpractices [2 6] African traditional medicine in its variedforms is holistic involving both the body and the mindThe traditional healer typically diagnoses and treats thepsychological basis of an illness before prescribingmedicinesparticularly medicinal plants to treat the symptoms [2 6ndash8]The sustained interest in traditional medicine in the Africanhealthcare system can be justified by two major reasonsThe first one is inadequate access to allopathic medicinesand western forms of treatments whereby the majority ofpeople in Africa cannot afford access to modern medicalcare either because it is too costly or because there are nomedical service providers Second there is a lack of effectivemodernmedical treatment for some ailments such asmalariaandor HIVAIDS which although global in distributiondisproportionately affect Africa more than other areas in theworld

The most common traditional medicine in commonpractice across the African continent is the use of medicinalplants In many parts of Africa medicinal plants are the mosteasily accessible health resource available to the communityIn addition they are most often the preferred option forthe patients For most of these people traditional healersoffer information counseling and treatment to patients andtheir families in a personal manner as well as having anunderstanding of their patientrsquos environment [2 6 7] Indeed

Africa is blessed with enormous biodiversity resources andit is estimated to contain between 40 and 45000 species ofplant with a potential for development and out of which5000 species are used medicinally This is not surprisingsince Africa is located within the tropical and subtropicalclimate and it is a known fact that plants accumulate impor-tant secondary metabolites through evolution as a naturalmeans of surviving in a hostile environment [9] Becauseof her tropical conditions Africa has an unfair share ofstrong ultraviolet rays of the tropical sunlight and numerouspathogenic microbes including several species of bacteriafungi and viruses suggesting that African plants couldaccumulate chemopreventive substances more than plantsfrom the northern hemisphere Interestingly Abegaz et al[10] have observed that of all species ofDorstenia (Moraceae)analysed only the African species Dorstenia mannii Hookfa perennial herb growing in the tropical rain forest of CentralAfrica contained more biological activity than related species[9ndash11]

Nonetheless the documentation of medicinal uses ofAfrican plants and traditional systems is becoming a pressingneed because of the rapid loss of the natural habitats ofsome of these plants due to anthropogenic activities and alsodue to an erosion of valuable traditional knowledge It hasbeen reported that Africa has some 216 million hectares offorest but the African continent is also notorious to have oneof the highest rates of deforestation in the world with acalculated loss through deforestation of 1 per annum [712] Interestingly the continent also has the highest rate ofendemism with the Republic of Madagascar topping the listby 82 and it is worth to emphasize that Africa alreadycontributes nearly 25 of the world trade in biodiversityNonetheless the paradox is that in spite of this huge potentialand diversity the African continent has only few drugscommercialized globally [2 12 13]

The scientific literature has witnessed a growing numberof publications geared towards evaluating the efficacy ofmedicinal plants from Africa which are believed to have animportant contribution in the maintenance of health and inthe introduction of new treatments Nonetheless there is stilla dearth of updated comprehensive compilation of promisingmedicinal plants from the African continent

The main aim of the present review is to highlight theimportance and potential of medicinal plants from theAfrican biodiversity which have short- as well as long-termpotential to be developed as future phytopharmaceuticals totreat andormanage panoply of infectious and chronic condi-tionsThe reviewmight also provide a starting point for futurestudies aimed at isolation purification and characterizationof bioactive compounds present in these plants as well asexploring the potential niche market of these plants In thisendeavor major scientific databases such as EBSCOhostPubMed Central Scopus (Elsevier) and Emerald amongstothers have been probed to investigate trends in the rapidlyincreasing number of scientific publications onAfrican tradi-tional medicinal plants Tenmedicinal plants (Acacia senegalAloe ferox Artemisia herba-alba Aspalathus linearis Centellaasiatica Catharanthus roseus Cyclopia genistoides Harpago-phytum procumbensMomordica charantia and Pelargonium
















50value [19 30]



















































3 Discussion









4 Conclusions


References


























































































































































of






Disease Markers



OncologyJournal of





PPAR Research



Journal of

ObesityJournal of































50value [19 30]



















































3 Discussion









4 Conclusions


References


























































































































































of






Disease Markers



OncologyJournal of





PPAR Research



Journal of

ObesityJournal of





















50value [19 30]



















































3 Discussion









4 Conclusions


References


























































































































































of






Disease Markers



OncologyJournal of





PPAR Research



Journal of

ObesityJournal of




























































3 Discussion









4 Conclusions


References


























































































































































of






Disease Markers



OncologyJournal of





PPAR Research



Journal of

ObesityJournal of


















































3 Discussion









4 Conclusions


References


























































































































































of






Disease Markers



OncologyJournal of





PPAR Research



Journal of

ObesityJournal of






































3 Discussion









4 Conclusions


References


























































































































































of






Disease Markers



OncologyJournal of





PPAR Research



Journal of

ObesityJournal of




























3 Discussion









4 Conclusions


References


























































































































































of






Disease Markers



OncologyJournal of





PPAR Research



Journal of

ObesityJournal of


















3 Discussion









4 Conclusions


References


























































































































































of






Disease Markers



OncologyJournal of





PPAR Research



Journal of

ObesityJournal of


















4 Conclusions


References


























































































































































of






Disease Markers



OncologyJournal of





PPAR Research



Journal of

ObesityJournal of















































































































































of






Disease Markers



OncologyJournal of





PPAR Research



Journal of

ObesityJournal of

















































































































of






Disease Markers



OncologyJournal of





PPAR Research



Journal of

ObesityJournal of



















































































of






Disease Markers



OncologyJournal of





PPAR Research



Journal of

ObesityJournal of


















































of






Disease Markers



OncologyJournal of





PPAR Research



Journal of

ObesityJournal of





















of






Disease Markers



OncologyJournal of





PPAR Research



Journal of

ObesityJournal of
















Documents

Review Article Traditional Medicines in Africa: An …downloads.hindawi.com/journals/ecam/2013/617459.pdfReview Article Traditional Medicines in Africa: An Appraisal of Ten Potent