Herbal cures for malaria show promise in treating resistant strains
Guardian. Lagos, Nigeria. 23.4.09
As Nigeria celebrates the World Malaria Day on Saturday April 25, 2009, researchers may have developed herbal cocktails that can take care of resistant strains. CHUKWUMA MUANYA reports.
IN recent times, the malaria parasite has developed resistance against most malaria drugs including the popular Artemisinin-based Combination Therapy (ACT) - from the Artemisia annua plant. This has made effective treatment of the disease that affects over 500 million people and kills more than two million each year elusive.
Naturopaths blame the situation on the isolation of active ingredients from the anti-malarial plant instead of the use of the whole plant. They say the malaria parasite, Plasmodium species, also developed resistance against chloroquine because the active ingredient was isolated from Cinchona bark.
However, Nigerian researchers have developed herbal cures for malaria that can take care of resistant strains. They have produced potent anti-malaria cocktails from local plants.
A typical cocktail developed by a plant taxonomist at the University of Nigeria Nsukka (UNN) and Ebonyi State University, Professor Jonathan Okafor, consists of Morinda lucida, Nauclea latifolia, Cymbopogon citratus, Carica papaya leaves, Moringa oleifera, Mangifera indica, Garcinia kola, and Psidium guajava.
74 years old Okafor, told The Guardian that he has successfully used the concoction for the last 25 years to treat malaria. "I have been developing this combination for over 25 years now. I hope to produce it in commercial quantities. I call it 'malaria destroyer'.
"To prepare it you get the leaves of Morinda lucida. It is commonly called local cinchona, and Eze ogwu in Ibo. It should consist half of the whole concoction. Mix with leaves of Nauclea latifolia (ubulu inu in Ibo), Cymbopogon citratus (lemon grass), male Carica papaya leaves (pawpaw), Moringa oleifera leaves because of its high nutritional content and immune boosting properties, Mangifera indica leaves and bark (Mango), which boosts red blood cells, Garcinia kola (bitter cola) and Psidium guajava (guava) in equal quantities," he said.
Morinda lucida belongs to the plant family Rubiaceae. It is commonly called Brimstone tree. It is oruwo or erewo in Yoruba, eze-ogu or njisi Igbo.
Nauclea latifolia also is of the plant family Rubiaceae. It is called egbesi in Yoruba, uburu inu or mbitinu in Igbo, marga in Hausa.
Cymbopogon citratus belongs to the plant family Graminae. To the French it is citronelle; Potuguese, citronela. But in Nigeria the Edos call it eti, Efik ikon eti, Hausa tsauri, Ibibio myoyaka makara, Igbo (Owerri) achara ehi and Yoruba kooko oba.
Moringa oleifera is commonly known as the ben oil tree, the horseradish tree, or the drumstick tree. It belongs to the plant family Moringaceae.
In Nigeria, it is called ewe ile, ewe igbale, or idagbo monoye (the tree which grows crazily) in Yoruba, gawara, habiwal hausa, konamarade, or rini maka in Fulani, bagaruwar maka, bagaruwar masar, barambo, koraukin zaila, shipka hali, shuka halinka, rimin nacara, rimin turawa, zogall, or zogalla-gandi in Hausa and odudu oyibo, okochi egbu, okwe olu, okwe oyibo, okughara ite, uhe, ikwe beke in Ibo.
Mango is botanically called Mangifera indica and belongs to the plant family Anacardiaceae. Mango is mangoro (the fruit), mangorohi (the tree) in Fula-Fulfulde, Idoma, umangohi, Igala, mangolo, Igbo, mangulo and Yoruba, mangoro or oro oyinbo.
Commonly called bitter kola, false kola, male kola, Garcinia kola belongs to the plant family Guttiferae. In Nigeria, it is oje in Bokyi, edun in Edo, efrie in Ejagham-Ekin, cida goro in Hausa, efiat in Ibibio, aku-ilu (bitter palm kernel) or ugolo in Igbo, akaan in Ijo-Izon, okain in Itsekiri and orogbo in Yoruba.
Director of Pax Herbal Clinics, Rev. Fr. Anselm Adodo, in his book "Nature Power For malaria" writes: "Squeeze four yellow pawpaw leaves and 30 leaves of bitter-leaf plant all together in eight bottles of water and a glassful taken thrice daily for 20 days.
"The second formula is squeeze the leaves of Goat weed (Ageratum conyzoides) in water. It is called akwukwo nea, osi n'aka or ahenhea in Igbo, imi-eshu in Yoruba, eb-ghedore in Edo, ikpamaku in Urhobo and otiti in Efik. Make it as concentrated as possible. Take one glassful thrice daily for five days. This preparation is excellence for intestinal ulcer.
"Thirdly, bring an equal amount of lemon grass leaves, orange peels and leaves of Brimstone tree (Morinda lucida), boil in a medium-sized pot for 40 minutes. Take one glass thrice daily for seven days.
"Boil stool wood (Alstonia boneei) and allow it to stand for 24 hours. Stool wood in Igbo is egbu, Yoruba- ahun or awun, Esan- ojegbuhkun. Drink half glass thrice daily for seven days.
"...The root of Nauclea latifolia soaked in corn water for three days and taken one glass thrice daily before meal would clear the fever in yellow fever."
Researchers have conducted phytochemical screening and antioxidant activities of some selected medicinal plants used for malaria therapy in southwestern Nigeria.
The study was published in Tropical Journal of Pharmaceutical Research by Ayoola, G.A., Coker, H.A.B., Adesegun, S.A., Adepoju-Bello, A.A., Obaweya, K., Ezennia, E.C. and Atangbayila, T.O.
Oxidative stress has been shown to play an important role in the development of anaemia in malaria. Indeed, increase in total antioxidant status has been shown to be important in recovery from malaria.
The antioxidant activities of four medicinal plants traditionally used in the treatment of malaria in southwestern Nigeria were determined.
The ethanolic extracts of the leaves of Carica papaya (Caricaceae), stem bark of Magnifera indica (Anacardiaceae), leaves of Psidium guajava (Myrtaceae) and the leaves of Vernonia amygdalina (Compositae), were used in the present study. The plant parts commonly used in the locality in malaria therapy were employed in this study. The plants were screened for the presence of phytochemicals and, their effect on 2,2-Diphenyl-1-picryl-hydrazyl radical (DPPH) was used to determine their free radical scavenging activity.
Phytochemical screening of the plants showed the presence of flavonoids, terpenoids, saponins, tannins and reducing sugars. Mangifera indica did not contain cardiac glycosides and alkaloids while, Psidium guajava also showed the absence of alkaloids and anthraquinones. Anthraquinones was similarly absent from V. amygdalina. Concentrations of the plant extracts required for 50 per cent inhibition of DPPH radical scavenging effect (IC50) were recorded as 0.04 mg/ml, 0.313 mg/ml, 0.58 mg/ml, 2.30 mg/ml and 0.054 mg/ml for P. guajava, M. indica, C. papaya, V. amygdalina and Vitamin C, respectively.
All the plants showed potent inhibition of DPPH radical scavenging activity, P. guajava being the most potent. The free radical scavenging (antioxidant) activities of these plants probably contribute to the effectiveness of the above plants in malaria therapy.
S.O. Awe and J.M. Makinde- have also evaluated the antimalarial activity of fractions obtained from Morinda lucida, a local medicinal plant commonly used against fever.
The researchers in a report published in Pharmaceutical Biology screened the plant samples against Plasmodium berghei berghei in mice.
According to the study titled "Effect of Petroleum Ether Fractions of Morinda lucida on Plasmodium berghei berghei in Mice", the fractions demonstrated schizontocidal activity against early infection. The fractions showed less activity when evaluated for repository effect, while some of the fractions of the samples proved active against established infections.
A Pharmacist, Consultant in Traditional/Alternative Medicine and President Prometra Ghana, Dr. Togbera Dabra in a paper titled "Traditional Healers' Approach to Malaria Treatment" said First Aid / Supportive treatment options include Cold bath or Sponging to reduce the temperature, Neem (Dogonyaro) leaves steam inhalation and bath and Eucalyptus leaves steam inhalation and bath.
For herbal remedies treatment options for malaria, Dabra recommends: "Pawpaw leaves, Neem leaves/Bitter leaves, boiled together in water and cooled. 30mls taken three times daily for seven days and Cryptolepis sanguinolenta roots boiled in water, cooled and sieved. 30mls to be taken twice daily for seven days."
He said that fruit juices, vegetable juice, pepper soups with spices and Moringa powder have been found to be beneficial in treatment and management of malaria and other fevers.
Researchers have also evaluated the antimalarial activity of Morinda lucida leaf extract, using a rabbit in vitro model.
According to the study published in Indian Journal of Pharmacology, the petroleum either extract and fractions of the leaf samples of Morinda lucida were evaluated for antimalarial effects against Plasmodium falciparum using the rabbit in vitro technique.
The sera collected from rabbits administered with the extract, fractions, chloroquine (standard) and normal saline. These were used to evaluate their activity in inhibiting growth of the parasites in vitro.
They wrote: "The petroleum either extract, chloroquine and fractions A and C at the employed doses inhibited the P. falciparum growth. Petroleum ether extract and some fractions of M. lucida inhibited the maturation of drug sensitive strain of P. falciparum in-vitro."
French researchers have confirmed the anti-malaria activities of Nauclea latifolia.
Benoit-Vical F, Valentin A, Cournac V, P�lissier Y, Malli� M, Bastide JM at the Laboratoire d'Immunologie et Parasitologie, Facult� de Pharmacie, Montpellier, France, tested aqueous extracts from Nauclea latifolia, a plant commonly used in Ivory Coast by traditional healers for the treatment of malaria, were tested on two strains of Plasmodium faliparum: FcB1-Colombia (chloroquine-resistant) and a Nigerian strain (chloroquine-sensitive).
According to the study published in Journal of Ethnopharmacology, the extracts were obtained from stems and roots of the plant in two forms, infusion and decoction, both methods used by most traditional healers.
The study is titled "In vitro antiplasmodial activity of stem and root extracts of Nauclea latifolia."
The researchers write: "The in vitro activity of N. latifolia extracts on P. falciparum was assessed both visually and by a radioactive method. The visual analysis allowed determination of the time of extract action on the erythrocytic cycle, as well as the parasitic stage of most inhibitory effect.
"Similar results were obtained applying fresh, frozen or lyophilized extracts. The IC50 values determined were within the range already reported for other antimalarial plants such as Azadirachta indica (Neem tree) or Artemisia annua. Aqueous extracts of N. latifolia inhibited P. falciparum (FcB1 strain) mainly at the end of the erythrocytic cycle (32nd to 48th hour)."
According to a study published in African Journal of Pharmacy and Pharmacology, Nauclea latifolia could also be used to lower blood pressure.
The study titled "Preliminary studies of blood pressure lowering effect of
Nauclea latifolia in rats" was conducted by Z. A. M. Nworgu and B. A. Ayinde of the Department of Pharmacology and Toxicology Faculty of Pharmacy, University of Benin, D. N. Onwukaeme and A. J. Afolayan of the Department of Pharmacognosy, Faculty of Pharmacy, University of Benin and F. C Ameachina of the Department of Botany, Faculty of Science, University of Fort Hare.
Phytochemical screening indicates that the roots of Nauclea latifolia showed the presence of sugars, saponins and flavonoids. The phytochemical screening also showed that there were no alkaloids, tannins, or cardiac glycoside.
Researchers have demonstrated the in vivo antimalarial activity of essential oils from Cymbopogon citratus and Ocimum gratissimum (scent leaf) on mice infected with Plasmodium berghei.
Tchoumbougnang F. of the Department of Biochemistry, Faculty of Science, University of Douala, Douala, Cameroun, Amvam Zollo P. H. of the Department of Chemistry, Faculty of Science, Addis Ababa University, Addis Ababa, Ethiopia and Dagne E. and Mekonnen Y. of the Department of Biology, Faculty of Science, Addis Ababa University, Ethiopia analysed the essential oils obtained by hydrodistillation from fresh leaves of Cymbopogon citratus and Ocimum gratissimum growing in Cameroon by GC and GC/MS.
According to the study published in Planta medica, the main constituents of the oil of Ocimum gratissimum were -terpinene (21.9 per cent), -phellandrene (21.1 per cent), limonene (11.4 per cent) and thymol (11.2 per cent), while the oil of Cymbopogon citratus contained geranial (32.8 per cent), neral (29.0 per cent), myrcene (16.2 per cent) and -pinene (10.5 per cent).
The researchers write: "The effects of these oils on the growth of Plasmodium berghei were investigated. Both oils showed significant antimalarial activities in the four-day suppressive in vivo test in mice. At concentrations of 200, 300 and 500 mg/kg of mouse per day, the essential oil of C C. citratus produced the highest activity with the respective percentages of suppression of parasitaemia: 62.1 per cent, 81.7 per cent and 86.6 per cent.
"The corresponding values for the oil of O. gratissimum at the same concentrations were 55.0 per cent, 75.2 per cent and 77.8 per cent, respectively. Chloroquine (10 mg/kg of mouse, positive control) had a suppressive activity of 100 per cent."
Nigerian researchers have compared the efficacy of crude aqueous extract of Mangiferea indica, Carica papaya and sulphadoxine pyrimethamine on mice infested with malaria parasite in vivo.
Uhegbu, F. O., Elekwa, I., and Ukoha, C. of the Department of Biochemistry, Faculty of Biological and Physical Sciences, Abia State University, Uturu, investigated the comparative efficacy of sulfadoxine-pyrimethamine (Maloxine) and leaf extracts of Mangifera indica (mango) and Carica papaya (paw-paw) in Plasmodium berghei-infected mice.
According to the study published in Global Journal of Pure and Applied Sciences, Maloxine had the highest efficacy, reducing the parasite count from an average count of 9.4�0.04 to 1.4�0.05 after six days of treatment. The paw-paw leaf extract reduced the malaria parasite count from an average of 9.2�0.06 to 2.6�0.06; while the mango leaf extract showed an average reduction from 9.8�0.01 to 3.2�0.03 after six days of treatment.
However, a combination of the two leaf extracts (1:1) exhibited a higher antimalaria efficacy than the separate leaf extracts, reducing the parasite count from 9.4�0.031 to 2.0�0.15. The public health implications of these findings are discussed.
Until now, various laboratory researches have confirmed that Moringa is a natural energy booster, strengthens the immune system, has antibiotic properties, cures headaches, migraines, asthma, and ulcers, reduces arthritic pains and inflammations and restricted tumour growths. Nutritionists say, the Moringa plant has more iron than "Kontonmire" and contains seven times the Vitamin C in oranges, four times the calcium in milk, four times the Vitamin A in carrots, two times the protein in milk and three times the potassium in banana.
In the field of medicine, it has been found out that Moringa can help to prevent common killer diseases like hypertension and diabetes and has become the poor man's prophylaxis against malaria and some common ailments.
Moringa can also detoxify the body given its ability to purify water by attaching itself to impurities and harmful bacteria and allowing them to be expelled as a waste.
There is a growing global interest in the use of Moringa to address malnutrition because it is readily available and inexpensive. In Africa, it has become popular as a locally produced nutritional supplement for individuals infected with the Human Immuno-deficiency Virus (HIV)/Acquired Immune Deficiency Syndrome (AIDS) virus. Nursing mothers have shown to produce far more milk and malnourished children gained more weight after the leaves were added to their diets.
Indeed, local researchers have made huge progress on herbal cures for malaria. One of such herbs used to treat malaria that efforts are currently on to study its safety limits is Enatia chlorantha, a herb that bears different local names in Nigeria. The stem bark of this plant also known as African yellow wood among the Yoruba speaking community is called Iyani or Awopa while in Benin it is called Evenbavbogo.
In Nigeria, the bark extract are used widely to treat malaria fever, high body temperature, wounds, kick start labour in pregnant women and as a naturally occurring antibiotics.
The plant is also used traditionally to treat jaundice, tuberculosis and leprous spots and many researchers including Dr. E. A Agbaje from the Department of Pharmacology, College of Medicine, University of Lagos in the West African Journal of Pharmacology and Drug Research, have even confirmed that its aqueous extract is effective in the treatment of conditions like ulcer.
Nigerian researchers have shown that the fruit extract of Tetrapleura tetraptera possesses significant anti-malarial, analgesic and anticonvulsant activities.
Tetrapleura tetraptera belongs to the family Fabaceae (formerly Leguminosae:Mimosoideae). To the French it is esehese a grandes feuilles. In Nigeria it is ebuk in Bokyi; esegheseghe (rattling), ighimiakhie or ikhememi in Edo, edeminang (four backs) in Efik, manto in Ejagham, ekpankpan or ekuk in Ejagham-Etung, ighirehimi in Esan, dawo in Hausa, uyayak in Ibibio, ashobo, ashosho, oshogisha (Arochukwu), ora-ora (Awka), osshosha (Bende), osakirisa (Owerri) in Igbo, apapa in Ijo-izon, idisain in izon, yurem in Nkem, arida, arizan, ayida or ikoho in Nupe, sekok-mpap in Nyanga, mangongon in Yamba, imiminje in Yekhee and aidan (Ife) or aridan (meaning cast no spell) in Yoruba.
The fruit extract of Tetrapleura tetraptera has been shown to possess antiplasmodial (active against malaria parasite) activity, which may have contributed to the immune status of the Nigerians against malaria in addition to its nutritive value.
Researchers at the Pharmacology and Toxicology Department, Faculty of Pharmacy, University of Uyo have confirmed the antimalaria activity of ethanolic extract of Tetrapleura tetraptera fruit. The researchers include Okokon J. E., Udokpoh A. E., Antia B.S.
The in vivo (inside a living environment) antiplasmodial activity of the ethanol fruit extract of Tetrapleura tetraptera was evaluated in Plasmodium berghei (one of the many species of malaria parasites that infect mammals other than humans) infected mice.
Tetrapleura tetraptera (300-900 mg/kg day) exhibited significant blood schizonticidal activity both in four-day early infection test and in established infection with a considerable mean survival time comparable to that of the standard drug, chloroquine, five mg/kg day.
According to a study titled "Formulation of an effective mosquito-repellent topical product from lemon grass oil", published recently by the Department of Pharmaceutics, Obafemi Awolowo University, Ile-Ife, extracts of lemon grass cannot only bring relief in malaria fever, but can repel mosquitoes.
The team of researchers: Oyedele A.O, Gbolade A.A, Sosan M.B, Adewoyin F.B, Soyelu O.L and Orafidiya O.O evaluated ointment and cream formulations of lemon grass oil in different classes of base and the oil in liquid paraffin solution for mosquito repelling property in a topical application.
Mosquito repelling property was tested by determining the bite-deterrence of product samples applied on an experimental bird's skin against a two-day starved culture of Aedes aegyptica mosquitoes. The one per cent v/v solution and 15 per cent v/w cream and ointment preparations of the oil exhibited not more than 50 per cent repelling lasting two to three hours, which may be attributed to citral, a major oil constituent. According to the authors, this activity was comparable to that of a commercial mosquito repellent.
A study by Gordian C. Obute of the Department of Plant Science and Biotechnology, University of Port Harcourt has unveiled some 35 medicinal plants scattered in 23 plant families, with reported medicinal importance to the people of Southeastern Nigeria.
The study indicates that drinking or bathing with leaf decoction or infusion of Neem or Dogoyaro is a remedy for chicken pox and small pox, boiling leaves with lemon grass treats malaria, used as a vermifuge, remedy for ulcers and wounds.
According to the study, unripe fruit of papaya or pawpaw, when mixed with garlic and fermented for three days is used as a diuretic. Chewing a handful of seeds of pawpaw, in the morning and evening and add decoction of unripe papaw with unripe pineapple, lime, 10cm long sugar cane piece, six bags of Lipton tea in four litres of water has anti-malarial effects.
The study also indicated that boiling of Mango leaves in water and drinking the resultant solution is a cure for malaria, bark is soaked for 24 hours and the water extract is used, along with bathing with this three times a day, to treat typhoid fever.
The stem of Broom weed (udo or nsi inyinya in Ibo is used to treat malaria. It is also called Sida acuta (Malvaceae).