Traditional Medicine

Traditional medicine (TM) is defined as "the sum total of knowledge, skills and practices based on the theories, beliefs and experiences indigenous to different cultures that are used to maintain health, as well as to prevent, diagnose, improve or treat physical and mental illnesses" [1].

From: Medicinal Plant Research in Africa , 2013

Traditional Medicine

C.-T. Che , ... K. Andrae-Marobela , in Pharmacognosy, 2017

Abstract

Traditional medicine, as defined by the World Health Organization, is the sum total of the knowledge, skills, and practices based on the theories, beliefs, and experiences indigenous to different cultures, whether explicable or not, used in the maintenance of health as well as in the prevention, diagnosis, improvement, or treatment of physical and mental illness. Some traditional medicine systems are supported by huge volumes of literature and records of the theoretical concepts and practical skills; others pass down from generation to generation through verbal teaching. To date, in some parts of the world, the majority of the population continue to rely on their own traditional medicine to meet their primary health care needs. When adopted outside of its traditional culture, traditional medicine is often referred as "complementary and alternative medicine." Among others, the most widely used traditional medicine systems today include those of China, India, and Africa. In this chapter, the Chinese, Indian, and African systems of traditional medicine are described.

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Legislation on Medicinal Plants in Africa

Mainen Julius Moshi , Paulo Peter Mhame , in Medicinal Plant Research in Africa, 2013

23.3.5.2.9 Mali

Traditional medicines in Mali have a high level of support from the government, and research and development in this area are managed under the Department for Traditional Medicine within the National Institute for Research on Public Health, which is part of the Ministry of Health. The main policy emphasis is on the use of improved traditional medicines, also referred to as Material Transfer Agreements (MTAs) [35], and for regulatory purposes, traditional medicines have been classified into four categories:

Category 1: Traditional medicines that are prepared by a traditional health practitioner for an individual patient with fresh or dried raw materials, with a short shelf life.

Category 2: Traditional medicines currently used in the community that are prepared in advance and composed of crude raw plant materials.

Category 3: Standardized plant extracts prepared in advance and supported by scientific research.

Category 4: Isolated pure compound molecules from traditional medicines following scientific research.

The improved traditional medicines are recognized on the basis of having pharmacological evidence of safety and efficacy, development of standardized dosage forms, and quality control [30]. Marketing authorization is given after a dossier of information on a remedy's safety and efficacy has been submitted to the Commission Nationale d'Autorisation de Mise sur le Marché of the Ministry of Health. The information needed for dossier submission in order to get regulatory approval varies depending on the category of traditional medicines.

Currently, there are seven improved traditional medicines, and these are included in the Malian Essential Drugs List and the Malian National Formulary alongside conventional medicines, and they are distributed in pharmacies [35,36].

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Medicinal plants and their traditional uses in different locations

Juan José Maldonado Miranda , in Phytomedicine, 2021

2 Traditional medicine

Traditional medicine is the set of knowledge, skills (ability to employ empirical knowledge), and practices based on theories, beliefs, and experiences of different cultures, whether they are explicable or not and used for the maintenance of health and for the prevention, diagnosis, improvement, or treatment of physical or mental illness ( WHO, 2017). Generally the use of herbal medicine is highly frequent in traditional medicine for the treatment of diseases. However, traditional medicine is a wider area, where the use of animals, fungi, or other components of nature (rocks, minerals, etc.) can also be included for the treatment of conditions or diseases.

Across the world, traditional medicine either is the mainstay of healthcare delivery or serves as a complement to it. In some countries, traditional medicine or nonconventional medicine may be termed complementary medicine (WHO, 2013) for its, more recently, popular use in parallel with allopathic medicine, especially for the treatment and control of chronically diseases.

Diffusion and the increasing use of traditional medicine have created challenges in public health from the point of view of politics, safety, efficacy, quality, access, and rational use (WHO, 2013). Mainly because for some ethnic groups, traditional medicine has represented the only option for disease prevention and cure; this is mainly due to exclusion and extreme poverty in which they live, as well as the lack of health services (http://www.udg.mx/, 2011).

Traditional medicine is an important healthcare component in low-income countries. The prevalence of traditional medicine use in low-income countries is estimated to be between 40% and 71% (Bodeker & Kronenberg, 2002), for example, in sub-Saharan Africa, it is estimated at 58.2% on average in the general population, but prevalence rates vary widely among studies (James, Wardle, Steel, & Adams, 2018).

The high prevalence of traditional medicine use in low-income countries has important clinical implications, especially when traditional medicine and conventional treatments are used concurrently. Traditional medicine use has important historical and cultural significance in diverse settings and populations and may provide benefit when used safely and appropriately (Hill et al., 2019).

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State of Play and Review of Major Cooperation Initiatives

Pierre-Louis Lezotre MS, PhD , in International Cooperation, Convergence and Harmonization of Pharmaceutical Regulations, 2014

I-1.1.5.9) Traditional Medicines

Traditional medicines y have been used in many countries throughout the world over many centuries. Today, these medicines still represent an important part of healthcare in some countries. z For example, more than 100 countries have regulations for herbal medicines, but practices of traditional medicine vary greatly from country to country and from region to region, as they are influenced by factors such as culture, history, personal attitudes, and philosophy. However, while it is often necessary to tailor legislation and delivery to reflect the needs and traditions of the individual countries, a number of themes and issues are common, such as the importance of practitioner training, the issues related to safety, the need to enhance research into both products and practices, and the importance of labeling.

Also, the use of traditional medicines has expanded globally and has gained popularity in the last few decades. Specifically, these practices have not only continued to be used for primary healthcare of the poor in developing countries, but have also been used in other countries where conventional medicines are predominant in the national healthcare system. aa With this tremendous expansion in the use of traditional medicines worldwide, safety and efficacy as well as quality control of herbal medicines and traditional procedure-based therapies have become important concerns for many of these countries. For this reason, WHO has been increasingly involved in developing international standards and technical guidelines for these types of medicines, and also in increasing communication and cooperation between countries [67]. The challenge now is to ensure that traditional medicines are used properly, and to determine how research and the evaluation of traditional medicines should be carried out.

Supported by several WHA and Executive Board resolutions, WHO has developed and issued a series of technical guidelines (e.g., guidelines for the assessment of herbal medicines, research guidelines for evaluating the safety and efficacy of herbal medicines, and guidelines for clinical acupuncture research). In 1997, WHO developed draft guidelines for "methodology on research and evaluation of traditional medicine" that was finally approved in April 2000 [68]. The purpose of this document is to promote the proper development, registration, and use of traditional medicines and to harmonize the use of certain terms in traditional medicine. Moreover, in 2006, WHO established a global network (called the International Regulatory Cooperation for Herbal Medicines [IRCH]) to allow communication and exchange between worldwide regulatory authorities responsible for the regulation of herbal medicines.

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Saffron in Persian traditional medicine

Mahdi Yousefi , Khosro Shafaghi , in Saffron, 2020

24.1 Introduction

Iranian traditional medicine (TM) is one of the famous traditional medical systems, which is occasionally called Unani medicine, Arabic medicine, humor medicine, or Islamic medicine. For 30 years now, the World Health Organization (WHO) has supported the development of TM in order to implement the slogan "Health for all by the year AD 2000." The decision to support TM was based on two foundations: first, lack of access of a great number of people (up to 80% in some countries) to primary healthcare and second, dissatisfaction from the outcomes of treatments by modern medicine, especially in relation to chronic diseases and the side effects of chemical drugs ( WHO, 2002). In 2002, the WHO described TM in more detail and used TM as a comprehensive term to refer both to TM systems such as traditional Chinese medicine, Indian Ayurveda, and Arabic-Unani medicine, as well as to various other forms of indigenous medicine. In TM, therapies consist of both medication and nonmedication. Medications in TM include herbal medicines, animal parts, and/or minerals. Nonmedication therapies are carried out primarily without the use of medication as in the cases of acupuncture, manual therapies, and spiritual therapies (WHO, 1978, 2002).

In order to use traditional therapeutic methods, understanding and deep insight about principles, fundamentals, and methods is necessary. Thus, a short review on history, principles, and drug terminology in Iranian TM is necessary. The Iran Ministry of Health and Medical Education has replaced the phrase "Iranian traditional medicine" with "Persian medicine," thus it will be used here.

In this chapter, after a brief review of the history and principles of Persian medicine (PM), data on the medicinal uses of saffron, which were obtained from major books on PM, will be discussed. The selected books were the most important sources of medical science and materia medica for more than one thousand years. These resources were searched for information regarding the nature, general properties, therapeutic applications, undesirable effects, and toxicity of saffron.

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Medicinal Plants Market and Industry in Africa

Jean P. Dzoyem , ... Victor Kuete , in Medicinal Plant Research in Africa, 2013

24.2.2 African Traditional Medicine System

Traditional medicine is defined by the WHO as the sum total of knowledge or practices, whether explicable or inexplicable, used in diagnosing, preventing, or eliminating a physical, mental, or social disease, which may rely exclusively on past experience or observations handed down from generation to generation, verbally or in writing. It also comprises therapeutic practices that have been in existence, often for hundreds of years before the development of modern scientific medicine and are still in use today without any documented evidence of adverse effects [8]. African traditional medicine is a holistic discipline that uses indigenous herbalism combined with some aspects of spirituality; it is deeply rooted in a sociocultural milieu that varies from one community to another. Practices of traditional medicine vary greatly from country to country, and from region to region, as they are influenced by factors such as culture, history, personal attitudes, and philosophy. The explicable form of traditional medicine can be described as the simplified scientific and the direct application of plant, animal, or mineral materials for healing purposes and which can be investigated, rationalized, and explained scientifically [7]. Traditional medicine includes a diversity of health practices, approaches, knowledge, and beliefs incorporating plant, animal, and/or mineral-based medicines, spiritual therapies, manual techniques, and exercises, applied singly or in combination to maintain well-being through treating, diagnosing, or preventing illnesses. The comprehensiveness of the term "traditional medicine" and the wide range of practices it encompasses make it difficult to define or describe, especially in a global context. Traditional medical knowledge may be passed on orally from generation to generation, in some cases with families specializing in specific treatments, or it may be taught in officially recognized universities. Sometimes, its practice is quite restricted geographically, and it may also be found in diverse regions of the world. However, in most cases, a medical system is called "traditional" when it is practiced within the country of origin. The term complementary or alternative medicine is used in some countries to refer to a broad set of health care practices that are not part of the country's own tradition and are not integrated into the dominant health care system [8]. Traditional knowledge related to the health of humans and animals exists in all African countries. Every region has had, at one time in its history, a form of traditional medicine. Each African community has its own particular approach to health and disease, even at the level of ethno-pathogenic perceptions of diseases and therapeutic behavior. Traditional healers and remedies made from plants play an important role in the health of millions of people [12].

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Herbal Supplements in Pregnancy: Effects on Conceptions and Delivery

Fabio Facchinetti MD , ... Isabella Neri MD , in Handbook of Fertility, 2015

Traditional medicine: Introduction

Traditional medicine (TM) is the sum total of the knowledge, skills, and practices based on the theories, beliefs, and experiences indigenous to different cultures, whether explicable or not, used in the maintenance of health, as well as in the prevention, diagnosis, improvement, or treatment of physical and mental illnesses. The terms complementary/alternative/nonconventional medicine (CAM) are used interchangeably with traditional medicine in some countries.

Traditional medication involves the use of herbal remedies (HR), animal parts, and minerals. Herbal medicines are the most widely used of the three and include herbs, herbal materials, herbal preparations, and finished herbal products that contain as active ingredients parts of plants or other plant materials, or combinations.

Despite its existence and continued use over many centuries, and its popularity and extensive use during the last decade, TM has not been officially recognized in most countries. Consequently, education, training, and research in this area have not been accorded due attention and support. The quantity and quality of the safety and efficacy data on TM are far from sufficient to meet the criteria needed to support its use worldwide. The reasons for the lack of research data are due not only to health care policies, but also to a lack of adequate or accepted research methodology for evaluating traditional medicine. It should also be noted that there are data on research in traditional medicine in various countries, but further research in safety and efficacy should be promoted, and the quality of the research should be improved [1].

Health care consumers have increasingly turned to TM, which they perceive as being more effective for chronic, emotional conditions and having fewer side effects than pharmaceuticals. Several data demonstrated an increase of CAM usage from 1990 through 2006 [2].

Use of HR has been documented among different patient groups and in the general population to promote health [3,4]. Multiple surveys have shown that women, especially those of white ethnicity, middle-aged, with high levels of education and income, are more likely to be users [5,6].

There has been an unprecedented explosion in the popularity of herbal preparations during the last few decades, especially in developed countries [7]. This phenomenon has stimulated considerable public health concern among physicians who are sometimes uncertain about the safety of herbs [8,9]. Despite these concerns, the global prevalence of use of medicinal herbs continues to rise as patients self-medicate with or without informing their physicians [1].

The suggested reasons for not reporting this use to doctors are that doctors themselves do not address this topic; patients may not think it necessary or be fearful of the doctor's reaction [10,11].

In this setting, the attitudes and knowledge of physicians would impact on the doctor–patient relationship and affect the overall quality of health care delivery, particularly with respect to issues such as possible adverse herb effects and herb–drug interactions [10,12].

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General and Global Situation

Amaia Iriondo-DeHond , ... María Dolores del Castillo , in Encyclopedia of Food Security and Sustainability, 2019

Traditional Medicine

Traditional medicine refers to health practices, approaches, knowledge and beliefs incorporating plant, animal and mineral based medicines, spiritual therapies, manual techniques and exercises, applied singularly or in combination to treat, diagnose and prevent illnesses or maintain well-being ( Fokunang et al., 2011). The study of traditional medicine is a much neglected aspect of global health care and it faces the following challenges (Cordell and Colvard, 2012):

1.

Nations typically have no policies or regulations relating to all of the aspects of traditional medicine as an integral part of their overall health care system. This results in a minimal commitment to research and development funding.

2.

The breadth and depth of the issues related to the quality control of traditional medicine products and practices may not be known to regulators, producers, and scientists.

3.

Global attention (fiscal and human resources) is insufficient to enhance the basic, applied, and clinical sciences behind traditional medicine. This results in major deficiencies in the scientific evidence regarding the quality, safety, effectiveness, and/or health benefits of traditional medicine. Costs of traditional medicines may increase as investment is made to enhance product validity.

4.

The literature and knowledge regarding traditional medicine are highly scattered, or are in library collections and databases that are not easily accessible.

5.

Scientific and clinical research on traditional medicines does not always fit the Western model for medical research, which may make publication of results difficult. Health insurance coverage is very difficult to justify if traditional medicine products and practices are not evidence based.

Medicinal plants represent one of the most important fields of traditional medicine all over the world and are a natural source of nutraceuticals (Singh and Geetanjali, 2013). A crucial factor in medicinal plant research and in clinical practice is sustainability. The term "sustainable medicines" describes the importance of considering the long-term use of both traditional medicines and synthetic drugs from a perspective of reliable and non-destructive sourcing for the future (Cordell, 2009). This is of great importance since the population and the use of traditional medicines are growing fast, globalization of products is in increasing demand, and climate change may affect the growing of traditional medicines (Cordell and Colvard, 2012). In this sense, "ecopharmacognosy" becomes a research priority since it is the study of sustainable biologically active natural products, from sustainable plant materials (Cordell, 2014).

Traditional medicine, sustainable medicines and ecopharmacognosy contribute to achieve a sustainable health. Del Castillo et al. (2018) have defined "sustainable health" as: "a healthy and active ageing avoiding the risk of diseases". Sustainable health may be accomplished by delivering high quality care and improved public health without exhausting natural resources or causing severe ecological damage (del Castillo et al., 2018). This can also be achieved by protecting and improving health now and for future generations using different strategies such as a healthy nutrition based on functional foods and the use of traditional sustainable medicines.

Herbs and Botanicals

Numerous drugs are originated from herbs or natural substances. Herbal and natural therapies have been employed for their diuretic and renal protective actions for centuries and the use of these substances may prevent the risk of CKD or complement current treatments (Wojcikowski et al., 2006).

Some plant extracts can be effective in the protection against CKD. Ecklonia cava has shown anti-inflammatory and antioxidative effects, and its effect on renal damage of high fat diet induced obese mice has been investigated (Eo et al., 2017). Natural agents that possess antioxidant and anti-inflammatory effects are expected to possess a renal protective effect. Treatment of obese mice with different doses of E. cava extract for 12 weeks lowered protein levels related to lipid accumulation (SREBP1c, ACC & FAS), inflammation (NLRP3 inflammasome, NFκB, MCP-1, TNF-α & CRP), and oxidative stress (Nrf2, HO-1, MnSOD, NQO1, GPx, 4-HNE and protein carbonyls). Moreover, this extract also significantly up-regulated renal SIRT1, PGC-1α, and AMPK, which are associated with renal energy metabolism (Eo et al., 2017). These results provide novel insights into the anti-inflammatory roles of E. cava in obesity-induced renal inflammation.

Grover et al. (2001) investigated the effects of daily oral feeding of traditional Indian herbs (Momordica charantia (MC), Eugenia jambolana (EJ), Mucuna pruriens (MP) and Tinospora cordifolia (TC)) for 40 days on blood glucose concentrations and kidney functions in streptozotocin (STZ)-diabetic rats. Plasma glucose concentrations in STZ-diabetic mice were reduced by the administration of extracts of MC, EJ, TC and MP by 24.4, 20.84, 7.45% and 9.07%, respectively. Urine volume was significantly higher in diabetic controls and Indian herb extracts prevented polyuria. After 10 days of STZ administration urinary albumin levels (UAE) were over 6 fold higher in diabetic controls as compared to normal controls. Treatment with MC, EJ, MP and TC significantly prevented the rise in UAE levels from day 0 to 40 when compared to diabetic controls. Renal hypertrophy was significantly higher in diabetic controls as compared to non-diabetic controls. Among the studied extracts, only MC and EJ prevented renal hypertrophy as compared to diabetic controls (Grover et al., 2001). Results indicate that plant extracts have the potential in the prevention of renal damage associated with diabetes.

Aster koraiensis, a vegetable and medicinal plant in traditional Korean medicine, has also been studied on the damage of renal podocytes in streptozotocin (STZ)-induced diabetic rats for 13 weeks (Sohn et al., 2010). Blood glucose, glycated haemoglobin (HbA1c), proteinuria and albuminuria were examined. Kidney histopathology, AGEs accumulation, apoptosis, and expression of Bax and Bcl-2 also were examined. In STZ-induced diabetic rats, severe hyperglycemia developed, and proteinuria and albuminuria were markedly increased. A . koraiensis extract reduced proteinuria and albuminuria in diabetic rats, and AKE prevented AGE deposition and podocyte apoptosis. Expression of Bax and Bcl-2 protein in the renal cortex were restored by treatment with the extract (Sohn et al., 2010). Since this extract showed an inhibitory effect of AGE accumulation and an anti-apoptotic effect in the glomeruli of diabetic rats, it could be beneficial in preventing the progression of diabetic nephropathy.

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Ethnomedicine and Drug Discovery

Chioma Obijiofor , in Advances in Phytomedicine, 2002

III. Traditional or 'alternative' medicine?

Traditional medicine, as described in the introductory chapter in this volume, is a system of health practice based on indigenous knowledge. In most industrialized countries, because traditional medicine had become largely a very minor component of health practice, it is often described as 'folk medicine'. There has been, however, a resurgence of interest in non-Western medicine during the last three decades that such medical practices have now come to be recognized as credible forms of healthcare. The term most often used to describe this form of healthcare in most industrialized countries is 'alternative medicine'. The synonyms used for alternative medicine include 'complementary medicine', a British term, that emphasizes the joint use of conventional and alternative therapies, and 'Holistic', which is derived from holos, a Greek word meaning 'whole' was coined in 1926 and revived in the 1970s. It denotes an approach that addresses the uniqueness of each individual that sought to understand whole people in their total environments and that employed a wide range of conventional and alternative therapies. Most recently, the term 'new medicine' has been used because it suggests a synthesis of the wisdom of ancient healing traditions, such as classical Chinese medicine and Indian Ayurveda medicine, and the critical perspective and technology of modern science. This new medicine includes an appreciation of the power of modern biomedicine and an understanding that it is one step in, and not the end point of, medical evolution.

Murray and Rubel 5 defined alternative medicine as a set of practices offered as an alternative to conventional medicine for the preservation of health and the treatment of health-related problems. Eisenberg et al. 6 classified alternative medicine as a broad range of modalities, including relaxation technique, chiropractic, massage, imagery, spiritual healing and commercial weight-loss programs as well as the use of herbs, vitamins, diets, hypnosis, energy, biofeedback, acupuncture, homeopathy, folk remedies, and self-help. 7 Since the word 'alternative' is simply a descriptive term used to denote non-Western medicine relative to the dominant modern healthcare system, it would be inappropriate to describe 'traditional medicine' as alternative medicine in countries and communities where traditional medicine is the primary healthcare system that is readily available to the population. According to the World Health Organization, 70–80% of Africans today depend either totally or partially on traditional or alternative medicine. This form of treatment, which is referred to as ethnomedicine, is sometimes the only kind of healthcare available to the rural population. The use of the terms 'alternative' or 'complementary' in this chapter when dealing with traditional medicine is purely normative and meant to situate these healthcare systems within what is known as 'complementary and alternative medicine' (CAM).

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Antibacterial, Antifungal, and Antiviral Activities of African Medicinal Plants

Ashwell R. Ndhlala , ... Johannes Van Staden , in Medicinal Plant Research in Africa, 2013

16.1 Introduction

Traditional medicine (TM) is defined as "the sum total of knowledge, skills and practices based on the theories, beliefs and experiences indigenous to different cultures that are used to maintain health, as well as to prevent, diagnose, improve or treat physical and mental illnesses" [1]. Its significance and impact on the African continent is huge, with an estimated 80% of the population depending on TM and medical practices, referred to as complementary or alternative medicine for primary health care purposes [1]. The reliance of such a large proportion of these populations on TM for primary health care needs has been attributed to a number of factors, including availability and accessibility, affordability, and extensive traditional knowledge and expertise within local communities [2]. Herbal medicines, which include herbs, herbal materials, herbal preparations, and finished herbal products that contain parts of plants or other plant materials as active ingredients, are the most popular and lucrative forms of TM [1]. Figure 16.1 illustrates different forms and species of medicinal plants used in TM in South Africa.

Figure 16.1. Illustration of different forms and types of medicinal plants used in traditional medicine in South Africa. Pictures were taken at an open markert in Nongoma, Zululand, South Africa. (A) W. salutaris and other species bark. (B) Hypoxis hemerocallidea corms under display. (C) An assortment of fresh and dried plant material on sale. (D) Semiprocessed (by drying and chopping) and raw wild-harvested plant materials.

Africa is home to two floral kingdoms: the Paleotropical Kingdom of Central Africa and the Capensis Kingdom of the Western Cape province of South Africa, the latter of which contains around 10,000 species, representing roughly 20% of Africa's floral biodiversity, forming the Cape herbal medicine [3]. This southern tip, together with the northwestern part of Africa, is characterized by winter rainfall. The southern tip of Africa also forms part of the traditional home of the Khoi/San, who have a long history of medicinal plant usage. Another important culture to mention is the Arab medicine, which is practiced in the northeastern parts of Africa. Arab medicine is, however, greatly influenced by Greek scientific and philosophical works.

Given the popularity of TMs on the African cultural landscape and its abundant floral biodiversity, allied to the chemotherapeutic potential of many of its representatives, the continent presents a relatively untapped reservoir for phytochemical prospecting and drug discovery. Microbial infections, including bacterial, fungal, and viral infections, are among the most commonly encountered diseases worldwide. Despite the extensive use of antibiotics and vaccination programs, these diseases continue to be a leading cause of morbidity and mortality worldwide [4]. This is exacerbated by widespread antibiotic resistance, the emergence of new pathogens in addition to the resurgence of old ones, and the lack of effective new therapeutics [4]. In this regard, African traditional medicines (ATMs) provide an exciting frontier to ease this particular burden of disease on the conventional health care sector. ATMs used specifically for these purposes (i.e., microbial infections) are too numerous to categorize for a single report, and thus, for the purpose of this chapter, we chose a collection selected as "Africa's top 50 medicinal plants" as outlined in the African Herbal Pharmacopoeia edited by Brendler et al. [5] to survey for such properties. These plants, which were chosen based on their widespread traditional appeal and medicinal usage, were seen to be endemic to eight distinct geographical zones within Africa, namely, Sahara; Sub-Sahara; West Africa; East Africa; Central Africa; Southern Africa; Madagascar, Mauritius, and the Mascarenes as a collective; and Continental Africa itself [5]. Furthermore, 31 plant families are represented in the list, of which the Apocynaceae (5 species), Asclepiadaceae (4 species), Asteraceae (3 species), Fabaceae (3 species), and Leguminosae (3 species) are the most represented [5]. Information gathered on the plants during this review include their medicinal uses, plant parts used in TM, extracts used in the microbial assays, microbial activity, and constituents responsible for activity. As given in Table 16.1, most of these plants are exploited in ethnic medicine for treatment of wounds and infections. In addition, some of these plants are administered for viral-borne diseases such as influenza, measles, chicken pox, and, importantly, human immunodeficiency virus/acquired immunodeficiency syndrome (HIV/AIDS). The literature also revealed that the majority of these plants have been pharmacologically examined for microbial activity, especially against Escherichia coli, Staphylococcus aureus, and Candida albicans [5]. Figure 16.2 presents some of the medicinal plants commonly used for bacterial, fungal, and viral infections throughout Africa. Based on these findings, it was possible to graphically compare activities for the 10 most efficacious plants within the list against these pathogens, which provides insights into their potential for clinical development. Furthermore, given the scourge of the HIV/AIDS pandemic on the continent, this survey also sheds light on the ethnic usage and pharmacological investigation of plants used for this disease, which may prove significant in the strategies directed at identifying possible chemotherapeutic candidates.

Table 16.1. Antibacterial Activity of Some African Medicinal Plants Recorded from Various Research Projects

Family Species Medicinal Uses Plant Part Tested Extract Tested Activity Bioactivity of Isolated Compounds References
Gram-Positive Bacteria Gram-Negative Bacteria
Annonaceae Centella asiatica (Linn.) Urban Skin diseases, dyspeptic complaints, worms, wound healing, fever, insomnia Leaves Ethanol S.a. 10   mg/mL (MIC) – – [6,7]
Leaves Water S.a. 5   mg/mL (MIC) – –
X. aethiopica A. Rich Antiseptic, bronchitis, cough, dysentery, female sterility, hypoglycemia, rheumatism Fruits Water S.a. 27   mm (ZI), B.c. 27   mm (ZI) E.c. 32   mm (ZI), E.f. 25.5   mm (ZI) – [8,9]
Apocynaceae C. roseus (L.) G. Don f. albus Pich Venereal diseases, leukemia, diabetes, fever, diarrhea, stomach problems Leaves Ethanol S.a. 256   μg/mL (MIC) K.p. 1024   μg/mL (MIC) – [10–12]
Leaves Methanol S.a. 512   μg/mL (MIC) – –
Stems Ethanol S.a. 512   μg/mL (MIC) E.c. 1024   μg/mL (MIC) –
Roots Ethanol S.a. 512   μg/mL (MIC) – –
Roots Methanol S.a. 256   μg/mL (MIC) – –
Roots Dichloromethane:methanol – O.u. 500   μg/mL (MIC), N.g. 4   mg/mL (MIC) –
Mondia whitei (Hook.f.) Skeels Abdominal pains, nausea, fever, bilharzia, sexual dysfunction, induce labor, anthelmintic, asthma, skin diseases Roots Water S.h. 50   mg/mL (MIC) – – [13–15]
R. vomitoria Afz. For treating venereal disease, neuropsychiatry disorders, jaundice, gastrointestinal problems, sexual complaints, measles, fever, malaria Leaves Methanol – – 3β-Hexadecanoyloxy-lup-20(29)-en-21-ol (E.c. 256   μg/mL MIC; S.a, S.t. 512   μg/mL MIC)
Roots Methanol S.a. 17.5   mm (ZI at 10   mg/mL) P.a., P.m 20, 28   mm, respectively (ZI at 10   mg/mL) – [16,17]
V. africana Stapf ex Scott-Elliot Poison, stimulant, leprosy, diarrhea, mental disorders, ulcers, gonorrhea, psychedelic Root bark Water S.a. 31.3   μg/mL (MIC) E.c. 31.3   μg/mL, E.p. 31.3   μg/mL, C.d. 62.5   μg/mL, K.p. 62.5   μg/mL, P.a. 62.5   μg/mL, S.e. 62.5   μg/mL, S.f. 31.3   μg/mL (MIC) – [18,19]
Asclepiadaceae C. sanguinolenta (Lindl.) Schlechter Diarrhea, fever, malaria, respiratory and urinary tract infections, venereal diseases, rheumatism Roots Ethanol – – Cryptolepine (E.c., C.j. 25   μg/mL; M.a. 2   μg/mL; M.b. 12.5   μg/mL; M.f. 16   μg/mL; M.s. 8   μg/mL; S.a. 62.5   μg/mL; S.p. <8   μg/mL MIC) [20–23]
Asphodelaceae Bulbine frutescens (L.) Willd. Wounds, cuts, grazes, burns, sores, rashes, itches, cracked lips, mosquito bites, ringworm, herpes Leaves Water B.s., M.k. 2.0, 3.0   mg/mL, respectively (MIC) – Phenylanthraquinones knipholone, aloctin A and B (also found in Aloe arborescens) [24,25]
Roots Water B.s., M.k. 3.0, 4.0   mg/mL, respectively (MIC) – –
Rhizomes Water M.k. 5.0   mg/mL (MIC) – –
Asteraceae Artemisia afra Jacq. ex Willd. Respiratory tract infections, cold, influenza, stomach ailments, analgesic, anthelmintic, blocked nose Leaves Ethanol B.s. 0.2   mg/mL, S.a. 0.25   mg/mL (MIC) – – [26–29]
Leaves Dichloromethane M.t. 1.9   μg/mL (MIC) M.a. IC50 0.25   mg/mL, M.t. IC50 0.27   mg/mL (MIC) –
Vernonia amygdalina Delile Diarrhea, dysentery, gastroenteritis, malaria, hepatitis, worms Roots Water S.g. 9.5   mm (ZI) P.a. 9   mm (ZI), P.g. 13.5   mm (ZI), P.n. 14.5   mm (ZI) – [30,31]
Cough, pneumonia, diarrhoea, boils, tonic Leaves Ethanol S.a. 1.56   mg/mL (MIC), B.s. 0.78   mg/mL (MIC) E.c. 1.56   mg/mL (MIC),K.p. 0.78   mg/mL (MIC) Sesquiterpene lactones, vernolide, vernodalin (MIC 0.1–0.5   mg/mL against S.a. and B.s.) [32,33]
Balanitaceae B. aegyptiaca (L.) Delile Whooping cough, wound healing, leucoderma, skin diseases Leaves Ethanol – S.t. 6.5   mg/mL – [34]
Bignoniaceae K. africana (Lam.) Benth Dysentery, sores, stomach ailments, wounds, rheumatism, skin care, cosmetic Bark Ethyl acetate B.s. 10   μg/mL (MIC) E.c.78   μg/mL, K.p. 78   μg/mL (MIC) – [35–37]
Bark Dichloromethane – E.c.78   μg/mL, K.p. 78   μg/mL (MIC) –
Bombacaceae A. digitata L. Diarrhea, dysentery, wound healing, venereal diseases; malaria, tuberculosis, toothache, anemia, fever, influenza Stem bark Water/ethanol S.a.mr 78   μg/mL (MIC) – – [38]
Stem bark Dichloromethane S.a.mr 156   μg/mL (MIC) – –
Stem bark Methanol S.a.mr 78   μg/mL (MIC) – –
Burseraceae B. sacra Flueck Wound healing, skin diseases, urinary tract infections, gynecological disorders, anti-inflammatory agent Seeds Essential oils S.a. 4   mg/mL, B.c. 2   mg/mL (MIC) E.c. 4   mg/mL, P.v. 3   mg/mL (MIC) – [11]
C. myrrha Engl. Trauma, arthritis, fractures, diseases caused by blood stagnation, wounds, worms, sepsis, cough, snakebite, infections in mouth, teeth, and eyes Leaves Ethanol S.a. 0.4   mg/mL (MIC) E.c. 0.18   mg/mL (MIC) – [39–41]
Canellaceae W. salutaris (G. Bertol.) Chiov. Fever, malaria, cold, influenza, venereal diseases, abdominal pain, toothache, constipation, cancer, ulcers, headache, cough, chest infections Bark Methanol B.s., S.a., S.e. 0.78, 0.38, 0.15   mm, respectively (ZI) at 10   μL of crude plant extract – – [27,42,43]
Bark Water S.a., S.e. 1.34, 0.25   mm, respectively (ZI) at 10   μL of crude plant extract B.s. 0.36   mm (ZI) at 10   μL of crude plant extract –
Clusiaceae H. madagascariensis Lam. ex Poir As an abortifacient and antiseptic for treating anemia, asthma, tuberculosis, fever, angina, diarrhea, dysentery, STDs, malaria, parasitic skin diseases, wounds Leaves Water B.s. 1.9   mg/mL (MIC) E.c. 1.9   mg/mL (MIC) Harunmadagascarin D (B.m. 10   mm ZI at 5   μg/µL) and astilbin (M.l, S.e. 25, 50   μg MIC, respectively) [44–48]
Ethyl acetate M.l., M.s., S.h., S.x. 50, 250, 100, 25   μg/mL, respectively (MIC) – –
Ethanol S.a. 94   μg/mL (IC100) – –
Stem bark Ethanol S.a., E.f. 94, 188   μg/mL, respectively (IC100) – –
Acetone E.f., S.a. 0.31, 0.62   mg/mL, respectively (MIC) E.c., P.a. 0.62, 0.31   mg/mL, respectively (MIC) –
Water E.f., S.a. 2.5   mg/mL each (MIC) E.c., P.a. 2.5   mg/mL each (MIC) –
Hexane E.f, S.a. 1.25, 0.62   mg/mL, respectively (MIC) E.c., P.a. 1.25, 2.5   mg/mL, respectively (MIC) –
Dichloromethane E.f, S.a. 0.15   mg/mL each (MIC) E.c., P.a. 0.83, 0.31   mg/mL, respectively (MIC) –
Chloroform E.f, S.a. 0.15   mg/mL each (MIC) E.c., P.a. 0.62, 0.15   mg/mL, respectively (MIC) –
Ethyl acetate E.f, S.a. 0.15, 0.31   mg/mL, respectively (MIC) E.c., P.a. 0.62, 0.31   mg/mL, respectively (MIC) –
Methanol E.f, S.a. 0.31   mg/mL each (MIC) E.c., P.a. 0.62, 0.31   mg/mL, respectively (MIC) –
Combretaceae C. micranthum G. Don. Wound healing, sores, cough, bronchritis, malaria, fever, smallpox, chicken pox, measles Leaves Acetone S.a. 400   μg/mL (MIC) – – [49]
T. sericea Burch. ex DC. Tuberculosis, diarrhea, wounds, infections, inflammation, STDs, diabetes, gonorrhea, menorrhagia, bilharzia Roots Ethyl acetate S.a. 1.5   mg/mL (MIC), B.s. 0.3   mg/mL (MIC) E.c. 1.5   mg/mL (MIC), K.p. 0.7   mg/mL (MIC) Anolignan B (IC50 3.8   μg/mL against B.s.) [50–52]
Euphorbiaceae A. madagascariense Lam. Dysentery, fever, diabetes, boils, muscle pain Leaves Water S.a. 4.0   mg/mL (MIC) E.c., P.a., S.t. 8.0   mg/mL each (MIC) – [53,54]
E. hirta Linn. Galactagogue, venereal discharges, dysentery, diarrhea, asthma, bronchitis, hay fever, cough, cold Leaves Ethanol S.a. 2.2   mg/mL (MIC) E.c., P.a. 5.9, 7.4   mg/mL, respectively (MIC) Diterpenes, triterpenes, afzelin, quercitrin, myricitrin [55]
Fabaceae A. senegal (L.) Willd. Roots: constipation, diarrhea, stomach disorders, gonorrhea; bark, leaves, and gum: cold, cough, dysentery, sore throat, typhoid, urinary tract infection Bark Methanol S.a. 8.0   mm (ZI) at 100   mg/mL P.a., P.v., S.t., S.d. 8.0, 10.0, 8.0, 8.0   mm, respectively (ZI) at 100   mg/mL Arabic acid [56]
Bark Methanol K.p. 8.0   mm (ZI) at 100   mg/mL P.a., P.v., S.t., S.d. 8.0, 10.0, 8.0, 8.0   mm, respectively (ZI) at 100   mg/mL –
Aspalathus linearis (Brum.f) R. Dahlgr. Herbal (rooibos) tea for neutraceutical, health, and beauty products; relief of vomiting, nausea, stomach cramps, heartburn, dermatological problems Leaves, stems Water S.a. 57% growth inhibition at 2   mg/mL, B.c, L.m. S.m. 45%, 55%, and 48% growth decrease, respectively, at 2   mg/mL E.c. 69% growth inhibition at 5   mg/mL – [57–59]
Ethanol – E.c. 60% growth inibition at 10   mg/mL –
C. cajan (L.) Millsp. Treatment or relief of cough, bronchitis, fever, hepatitis, diabetes, measles, urinary infections, dysentery, menstrual disorders, inflammation, pain, ulcers Leaves Methanol B.c. 39   μg/mL (MIC) S.t., P.a. 2.5   mg/mL each (MIC), S.s. 5   μg/mL (MIC) – [60–62]
Ethanol B.s., S.a., S.e. 2.5   mg/mL each (MIC), 10.0   mg/mL (MBC) – Cajanuslactone (S.a. 31   μg/mL MIC; B.s., S.e. 125   μg/mL each MIC), cajaninstilbene acid (S.e. 13   μg/mL MIC; B.s., S.a. 25   μg/mL each MIC)
Water – E.c., S.t. 0.125   mg/mL each (MIC) –
Petroleum ether S.a. 0.125   mg/mL (MIC) S.t. 62.5   μg/mL (MIC) –
Seeds Methanol B.c. 625   μg/mL (MIC) K.p., P.a., S.t. 5   mg/mL each (MIC)
Cyclopia genistoides (L.) R. Br. Herbal (honeybush) tea for neutraceutical, health, and beauty products; as a restorative and expectorant in chronic catarrh and pulmonary tuberculosis; relief of nausea, heartburn Leaves, stems Ethanol – E.c. 80% growth inhibition at 10   mg/mL – [58,59]
Cyclopia subternata Vog. Herbal (honeybush) tea for neutraceutical, health, and beauty products Leaves, stems Ethanol – E.c. 85% growth inhibition at 10   mg/mL – [58,59]
S. frutescens R. Br. Dysentery, diarrhea, wounds, infections, pustules, influenza, chicken pox, fever Leaves Acetone S.a. 10.0   mg/mL (MIC) E.c. 1.25   mg/mL, P.a. 1.25   mg/mL, E.f. 1.25   mg/mL (MIC) – [63–65]
Flacourtiaceae A. theiformis Benn. Dysentery, fever, gastrointenstinal infections, ulcers, jaundice, stomach pains, skin infections Leaves Methanol S.a. 500   μg/mL S.e. 500   μg/mL – [66]
Geraniaceae Pelargonium sidoides DC. Gonorrhea, diarrhea, dysentery Roots Hexane M.a. 64   mg/mL (MIC) – Coumarins, umckalin, gallic acid, flavonoids (quercetin) [36,67,68]
Hypoxidaceae H. hemerocallidea Fisch. & Avé-Lall. Bladder disorders, dizziness, insanity, tonic, prostate hyperplasia Leaves/corms Water S.a. 0.39   mg/mL (MIC) K.p. 0.25   μg/mL (MIC) – [26,69,70]
Malvaceae Hibiscus sabdariffa L. Calyx: aphrodisiac; leaves: diuretic, diaphoretic, cholagogic, cough, childbirth, wounds, boils, mouthwash, toothache Calyces 80% Methanol S.a., M.l. 0.3   mg/mL each (MIC) P.a., E.c. 1.3   mg/mL each (MIC) Mucilage polysaccharides, pectin; ascorbic, citric, malic, tartaric acids [71,72]
Meliaceae Trichilia emetica Vahl. Hepatic diseases, purgative, antiepileptic, antipyretic, antimalarial, intestinal worms, jaundice, skin diseases Leaves Acetone S.a. 0.60   mg/mL (MIC) E.c. 0.40   mg/mL, P.a. 0.40   mg/mL, E.f. 0.26   mg/mL (MIC) Limonoids, trichilins [73,74]
Moringaceae Moringa oleifera Lam. Malaria, wound healing Seeds Methanol – S.t. 76.5% at 2.5% concentration, E.c. 36.8% at 2.5% concentration (disc diffusion) – [75,76]
Pedaliaceae H. procumbens (Burch.) DC. ex Meisn. Allergies, analgesia, arteriosclerosis, boils, skin injuries, ulcers, sores, childbirth, dysmenorrhea, edema, fever, gastrointestinal disorders, headache, migraine, malaria, myalgia, neuralgia, tendonitis, urinary tract infections Tubers 50% Ethanol S.a., M.l. 10, 100   μg/mL, respectively (MIC) E.c., M.m., B.s., P.m. 100, 100, 100, 20   μg/mL, respectively (MIC) Iridoid glycosides, harpagoside, pagoside, cinnamic acid, caffeic acid, procumbide, procumboside, flavonoids, fatty acids, harpagoquinone, stigmasterol, sitosterol (compounds not tested for antibacterial properties) [77]
Rosaceae P. africana (Hook.f.) Kalkm. For treating chest pain, diarrhea, fever, genitourinary complaints, allergies, inflammation, kidney diseases, malaria, stomachache Bark Ethanol B.s., S.a. 3.12, 1.56   mg/mL, respectively (MIC) K.p. 2.9   mg/mL (MIC) – [78–80]
Bark Water B.s., S.a. 2.9   mg/mL each (MIC) – –
Leaves Ethanol B.s., S.a. 1.56, 2.9   mg/mL, respectively (MIC) – –
Stem bark Methanol S.a., E.h., S.p. 0.073, 0.625, 0.3   mg/mL, respectively (MIC) P.a. 0.3125   mg/mL (MIC) –
Rubiaceae N. latifolia Sm. Malaria, sterility, female fertility, stomachache, urinary retention, hernia, leprosy, diarrhea, dysentery Leaves, stem bark Methanol S.a. 64   μg/mL, B.c. 128   μg/mL (MIC) E.c. 32   μg/mL (MIC), P.a. 64   μg/mL (MIC), S.f. 32   μg/mL (MIC), S.t., cr 32   μg/mL (MIC) – [81,82]
Rutaceae A. betulina (P. J. Bergius) Pillans. Urinary tract infections, stomach ailments, cough Aerial parts Methanol:dichloromethane (1:1) B.c. 4.0   mg/mL, S.a. 4.0   mg/mL (MIC) K.p. 4.0   mg/mL (MIC) – [83]
Leaves Ethanol E.c.>1.0   mg/mL (MIC) – [84]
Leaves, flowers (essential oils) Steam distilled S.a. 5.8   mm, E.h. 4   mm (ZI) at 10   μL of undiluted extract E.c. 6   mm, P.a. 4   mm (ZI) at 10   μL of undiluted extract – [85]
T. asiatica Lam. Diaphoretic, stomachic, antipyretic, antimalarial, lung diseases, rheumatism, snakebite Leaves Ethyl acetate S.a. 0.039   mg/mL, S.e. 0.078   mg/mL, B.s. 0.156   mg/mL (MIC) E.f. 2.5   mg/mL (MIC) Flindersine (MIC 31.25   μg/mL against B.s.) [19,86]
Sterculiaceae G. kola Heckel Antihepatotoxic drug extract, bronchitis, diarrhea, throat infections, aphrodisiac, cough Leaves Ethanol S.a. 13   mm (ZI) at 0.1   mL of crude extract E.c. 12   mm, P.a. 13   mm (ZI) at 0.1   mL of crude extract – [87]
Xanthorrhoeaceae A. ferox Mill. As a laxative, emetic, relief of arthritis, sinusitis, conjunctivitis, and opthalmia, skin and wound healing, treatment of infection-related ailments including sexually transmitted infections Leaves Methanol – N.g. 0.5   mg/mL (MIC) Aloe emodin (B.c., E.c. 62.5   μg/mL each (MIC); B.s., S.a. 125   μg/mL each (MIC); S.e., S.s. 250   μg/mL each (MIC)), chrysophanol (S.e., E.c., B.s. 31.25, 125, 250   μg/mL, respectively, (MIC)), aloin A (B.c., B.s., S.a. 62.5   μg/mL each (MIC); E.c., S.e. 125   μg/mL each (MIC); S.s. 250   μg/mL (MIC)) [88–91]
Zingiberaceae Aframomum melegueta (Roscoe) K. Schum. Wound healing, skin rushes, mouth sores, boils, fractures, stomachache, cough remedy, measles, yellow fever Seeds Methanol (3% w/v) S.a. 11.8   mm, B.s. 15.2   mm (ZI) E.c.15.4 mm P.a. 5.7   mm (ZI) – [92,93]
n-Hexane (10   mg/mL) S.a. 11.5   mm (ZI) E.c. 30   mm, P.a. 23   mm (ZI) – [17]
Methanol (10   mg/mL) P.a. 25   mm (ZI) –
S. aethiopicus (Schweinf.) B.L. Burtt Treatment or relief of cold, cough, influenza, sore throat, pain, asthma, dysmenorrhea, hysteria Leaves Ethyl acetate B.c., B.s., S.a. 3.0, 1.56, 1.56   mg/mL, respectively (MIC) E.c., K.p. 3.13, 6.25   mg/mL, respectively (MIC) – [94,95]
Ethanol B.s., S.a. 3.13, 1.56   mg/mL, respectively (MIC) E.c., K.p. 3.13   mg/mL each (MIC) –
Roots Ethyl acetate B.s., S.a. 0.78, 1.56   mg/mL, respectively (MIC) E.c., K.p. 6.25, 12.5   mg/mL, respectively (MIC) –
Ethanol B.s., S.a. 1.56, 0.78   mg/mL, respectively (MIC) E.c., K.p. 6.25   mg/mL each (MIC) –
Rhizomes Ethyl acetate B.c., B.s., M.k., S.a. 3, 1.56, 4, 1.56   mg/mL, respectively (MIC) E.c., K.p. 6.25   mg/mL each (MIC) –
Ethanol B.s., S.a. 1.56   mg/mL each (MIC) E.c., K.p. 3.13, 6.25   mg/mL, respectively (MIC) –
Acetone B.c., B.s., M.k., S.a., S.e. 4, 3, 3, 3, 2   mg/mL, respectively (MIC) E.c., P.v. 3, 4   mg/mL, respectively (MIC) –
Roots Ethyl acetate B.s., S.a. 0.78, 1.56   mg/mL, respectively (MIC) E.c., K.p. 6.25, 12.5   mg/mL, respectively (MIC) –
Ethanol B.s., S.a. 1.56, 0.78   mg/mL, respectively (MIC) E.c., K.p. 6.25   mg/mL (MIC) –

B.c., Bacillus cereus; B.m., Bacillus megaterium; B.s., Bacillus subtilis; C.j., Campylobacter jejuni; C.d., Citrobacter diversus; E.f., Enterococcus faecalis; E.h., Enterococcus hirae; E.c., Escherichia coli; E.p., Escherichia paracoli; K.p., Klebsiella pneumoniae; L.m., Listeria monocytogenes; M.k., Micrococcus kristinae; M.l., Micrococcus loteus; M.r., Micrococcus roseus; M.s., Micrococcus sedentarius; M.k., Mocuria kristinae; M.m., Morganella morganii; M.a., Mycobacterium aurum; M.b., Mycobacterium bovis; M.f., Mycobacterium fortuitum; M.s., Mycobacterium smegmatis; M.t., Mycobacterium tuberculosis; N.g., Neisseria gonorrhoeae; O.u., Oligella ureolytica; P.g., Porphyromonas gingivalis; P.n., Porphyromonas nigrescens; P.m., Proteus mirabilis; P.v., Proteus vulgaris; P.a., Pseudomonas aeruginosa; P.m., Pseudomonas maltophilia; S.e., Salmonella enteritidis; S.tp., Salmonella typhi; S.t., Salmonella typhimurium; S.h., Schistosoma haematobium; S.f., Shigella flexnerii; S.d., Shigella dysenteriae; S.s., Shigella sonnei; S.a., Staphylococcus aureus; S.a.mr, Staphylococcus aureus methicillin resistant; S.e., Staphylococcus epidermidis; S.h., Staphylococcus haemolyticus; S.t.cr., Salmonella typhi - Chloramphenicol resistant; S.s., Staphylococcus saprophytious; S.x., Staphylococcus xylosus; S.g., Streptococcus gordonii; S.m., Streptococcus mutans; S.p., Streptococcus pyogenes; MBC, minimum bactericidal concentration; MIC, minimum inhibitory concentration; STDs, sexually transmitted diseases; ZI, zone of inhibition; (–), no data.

Figure 16.2. Some of the widely used medicinal plants used for bacterial, fungal, and viral infections throughout Africa: (A) B. frutescens, (B) W. salutaris, (C) H. hemerocallidea (African potato), (D) P. sidoides, (E) A. ferox.

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