Journal of Ethnopharmacology 151 (2014) 413–444
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Journal of Ethnopharmacology
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Ethnomedicinal application of native remedies used against diabetes and related complications in Mauritius
Anushka Mootoosamy, M. Fawzi Mahomoodally n
Department of Health Sciences, Faculty of Science, University of Mauritius, Reduit 230, Mauritius article info abstract
Article history: Ethnopharmacological relevance: Notoriously, the tropical island of Mauritius has one of the highest Received 12 August 2013 prevalence of diabetes worldwide and the economic burden associated with it is alarming. The use of Received in revised form native remedies (NRs) is well anchored in the local culture and it continues to be the cornerstone of 27 October 2013 therapy for diabetic patients. However, there is currently a dearth of updated primary data on NRs used Accepted 27 October 2013 by Mauritians against diabetes and diabetes related complications (DRCs). This study was therefore Available online 11 November 2013 designed to record, analyze and document orally transmitted ethnopharmacological knowledge from Keywords: diabetic patients and traditional medicine practitioners (TMPs) in Mauritius concerning NRs commonly Mauritius used against diabetes and DRCs which might open new avenues to initiate novel antidiabetic drugs Diabetes discovery. Diabetes related complications Materials and methods: Data was collected following interviews from diabetic patients (n¼328) and Native remedies TMPs (n¼20). Eleven quantitative indexes, namely informant consensus factor (FIC), fidelity level (FL), Herbal remedies Animal-based remedies use value (UV), relative frequency of citation (RFC), relative importance (RI), cultural importance index (CII), index of agreement on remedies (IAR), cultural agreement index (CAI), quality use value (QUV), quality use agreement value (QUAV) and ethnobotanicity index (EI) were calculated. Statistical analysis such as Pearson correlation and Chi-squared test were performed to determine any association. Results: A total of 111 plant species distributed over 56 families, 30 polyherbal formulations and 16 animal species were documented to be traditionally used against diabetes and DRCs. For the first time 8 endemic plants have been recorded to be used against diabetes and DRCs from Mauritius. The most encountered medicinal plant family was Asteraceae. According to the EI, 16.2% of the native plants in Mauritius were used against diabetes and DRCs. As far as we know, Vangueria madagascariensis, Apium graveolens, Petroselinum crispum and Rubus alceifolius with high RFC values are recorded against diabetes and DRCs for the first time. Sociodemographic characteristics (age, gender, income, religious belief, education and residence) were found to significantly (po0.05) influence the use of NRs. The average FIC for all ailments for plant and animal products were 0.94 and 0.87 respectively. Bryophyllum pinnatum,a native plant to Mauritius scored a high FL value (100%) used against diabetic neuropathy, Allium sativum had the highest RI value (2.00) due to its versatility, Aloe vera had the highest RFC (0.61), the CII (0.640) and the highest CAI value (0.635), Psidium guajava had the highest QUAV (0.961) which indicates its high bioactivity and Allium cepa was reported as the most effective plant species (QUV¼0.965). According to UV, the most important species was Morinda citrifolia (1.21). Panoply of animal products were reported whereby fish (39.7%) was recorded as the most utilised zootherapy and Salmo salar scored the highest FL (100%) for diabetes. Some animal species (n¼14) not previously documented against diabetes and DRCs are reported in the present study. Conclusion: Our present investigation revealed that the use of NRs constitutes the common legacy of Mauritians and despite the penetration of allopathic medicine; NRs continue to play a crucial role in the primary health care system of Mauritius. To this effect, it is of uttermost importance to record this
Abbreviations: AR, animal-based remedy; CAI, cultural agreement index; CII, cultural importance index; DRCs, diabetes related complications; EI, ethnobotanicity index; FIC, informant consensus factor; HR, herbal remedy; IAR, index of agreement on remedies; FL, fidelity level; NR, native remedy; QUAV, quality use agreement value; QUV, quality use value; RFC, relative frequency of citation; RI, relative importance; TMP, traditional medicine practitioner; UV, use value; WHO, World Health Organization; AGE, advanced glycation endproduct n Corresponding author. Tel.: þ230 4037578; fax: þ230 4656928. E-mail addresses: [email protected], [email protected] (M. Fawzi Mahomoodally).
0378-8741/$ - see front matter & 2013 Elsevier Ireland Ltd. All rights reserved. http://dx.doi.org/10.1016/j.jep.2013.10.069 414 A. Mootoosamy, M. Fawzi Mahomoodally / Journal of Ethnopharmacology 151 (2014) 413–444
knowledge before it disappears. In addition, further experimental investigations are required to elucidate the pharmacological properties of the reported medicinal flora and fauna of Mauritius. & 2013 Elsevier Ireland Ltd. All rights reserved.
1. Introduction present in Mauritius (Mauritian Wildlife Federation, (MWF), 2012). Traditional medicine is omnipresent in the Mauritian community Diabetes is one of the world's greatest healthcare challenges whereby Mauritians still use traditional medicine for the treat- currently affecting more than 371 million people globally and ment and/or management of various ailments. In view of the 4.8 million people died due to diabetes in 2012 (International increasing prevalence of diabetes in Mauritius, there is a growing Diabetes Federation, (IDF), 2012). Diabetes prevalence is expected need to develop new approaches towards the management and to rise to 552 million people by 2030 of which more than 90% of prevention of the disease by exploring the potentials offered by diabetic patients will have Type 2 diabetes (International Diabetes NRs. Traditional antidiabetic plants offer great potential for the Federation, (IDF), 2011a). Moreover, 183 million people (50%) with discovery of new antidiabetic agents with the possibility to diabetes are undiagnosed and 80% of people with diabetes live significantly alter the course of diabetic complications where most in low- and middle-income countries (International Diabetes conventional medicines have failed. Federation, (IDF), 2011b). Diabetes prevalence is exacerbating Nonetheless, there is currently a dearth of documentation on worldwide, and Sub-Saharan Africa including Mauritius is no the use of NRs by Mauritians for the management and treatment exception. In 2010, 12.1 million people were estimated to be living of diabetes and DRCs. Therefore, there is a pressing need to record with diabetes in Africa, and this is projected to increase to 23.9 updated primary scientific information on the different NRs used million by 2030 (Motala and Ramaiya, 2010). In Mauritius, the by Mauritians. Moreover, it is very important to document valu- majority of people with diabetes have Type 2 diabetes (Ministry of able traditional knowledge of NRs with therapeutic activity against Health and Quality of Life, (MOH), 2012). According to recent diabetes and DRCs as it is rapidly disappearing after the death of statistics, Mauritius, with a prevalence of 15.5%, no longer features its old secret keepers and also due to the lack of interest shown by among the top ten countries worldwide with the highest pre- the younger generation toward the use and documentation of valence of diabetes (Republic of Mauritius, (ROM), 2013). Never- traditional knowledge. In addition, it is fundamental to conserve theless, with its rapid urbanisation and its prevalent Asian genetic the medicinal flora and fauna of Mauritius for future genera- background, along with today's sedentary lifestyle and obesity tions and to ensure Mauritius's sovereign rights over its genetic epidemic, Mauritius is still at the forefront of this modern scourge. resources and utilisation by first documenting them. Complications associated with diabetes are the major cause of The main endeavour of the present work is to collect, analyze mortality and morbidity in diabetes (Tarak et al., 2011). Prolonged and document primary ethnopharmacological data from diabetic uncontrolled hyperglycemic level entails complications of diabetes patients and TMPs in the tropical island of Mauritius concerning such as renal failure, amputation, cardiovascular diseases and NRs commonly used against diabetes and DRCs. vision loss (Patel et al., 2012). The World Health Organization (WHO) reported that 50% of people with diabetes die of cardio- vascular disease. Furthermore, of the 37 million cases of blindness 2. Materials and methods due to eye diseases worldwide, diabetic retinopathy is responsible for 4.8% of them and 10–20% of people with diabetes die of kidney 2.1. Study area failure (World Health Organisation, (WHO), 2011). In 2010, out of the 12.1 million adults with diabetes in Sub-Saharan Africa 4.51 The island of Mauritius is part of Sub-Saharan Africa and lies in million had eye complications, 2.23 million need dialysis because the southern hemisphere in the middle of the Indian Ocean with of renal failure, 907,500 have cardiovascular disease and 169,400 coordinates 57130′ east and 20120′ south (Map 1).The population have lost a foot because of amputation (Motala and Ramaiya, comprises of Indo-Mauritians, people of mixed European and 2010). In Mauritius, at least 80% of all lower limb amputations are African origin and Sino-Mauritians. Mauritius has an area of attributed to complications due to diabetes and 45% of diabetics 1865 km² and about 43% of the area is allocated to agriculture. suffer from diabetic retinopathy (Ministry of Health and Quality of Mauritius enjoys a mild tropical climate, characterised by a warm Life, (MOH), 2012; Republic of Mauritius, (ROM), 2012a). humid summer between November and April and a cool dry Oral hypoglycemic agents such as sulfonlyureas, biguanides, winter between June and September whereby October and May α-glucosidase inhibitors and thiazolidinediones still continue to are the transition months. Mean mid-day temperature ranges from play a pivotal role in the management of diabetes. However, some 26 1Cto301C during summer days and from 22 1Cto271C during of these antihyperglycemic agents entail a number of serious winter days (Ministry of Finance and Economic Development, adverse effects like hypoglycemic coma and hepatorenal distur- (MOFED), 2011). Mauritius has a rich heritage of indigenous and bances (Mustaffa et al., 2011). Hence, there is a growing interest in endemic plants and possesses 58 families of plant species consist- NRs mostly because of the less frequent side effects associated ing of both indigenous and endemic plants. A total of 711 with them as compared to conventional medicines. Indeed, plants indigenous plant species has been recorded in Mauritius, including have always been an exemplary source of drugs and many 246 endemic plant species (Ministry of Agro Industry and Food antidiabetic drugs, which are actually on the market, have been Security (MOAIFS), 2012). Mauritius is a multiethnic nation which obtained from them, for instance the commonly used hypoglyce- has experienced rapid economic growth since the 1980s, with mic drug, metformin came from the plant Galega officinalis (Grover amplification in disposable income followed by changes in food et al., 2002). consumption and lifestyle patterns similar to the globally observed Mauritius is famous for its cultural diversity and for the pano- trend Mauritius is known to have maintained one of the develop- ply of traditions practiced across the island by various ethnic ing world's most successful democracies. Previously the economy groups. Moreover, the island is renowned for the extraordinary of the country was based on agriculture. However, the economy richness of its flora, which harbours an array of medicinal plant has successfully been diversified into textiles, tourism, banking species. About 315 endemic plant species have been reported to be and business outsourcing. It is classified by the World Bank as an A. Mootoosamy, M. Fawzi Mahomoodally / Journal of Ethnopharmacology 151 (2014) 413–444 415
Map 1. Location map of the island of Mauritius in the Indian Ocean and study area spread over nine districts (Adapted from Mauritius Attractions, 2008). upper middle income country. Twenty-one towns and villages sample was then identified with local botanists and experts. spread over nine districts were visited for the study (Map 1). A local database was constructed whereby plant samples were assigned a collection number for future reference. A personal local 2.2. Data collection repository database has been constructed to store primary data for future data mining and sharing as suggested by Verpoorte (2008). The project was approved by the Department of Health The data obtained during the survey was cross-checked Sciences, Faculty of Science, University of Mauritius, Mauritius. A (local names/ scientific names) according to locally published total of 348 key informants which consisted of 328 diabetic books (Gurib-Fakim and Gueho, 1995; Gurib-Fakim and Brendler, patients and 20 traditional medicine practitioners (TMPs) were 2004). Scientific names of plant species were identified according interviewed during the academic year 2012–2013. Proper data was to the International Plant Name Index (IPNI: http://www.ipni.org). partly collected using the participatory rural appraisal method, as This documentation will fully recognize the contribution of the the key informants also became investigators themselves, partici- local people who have been using the indigenous knowledge, pating in interviews, informal meetings, open and group discus- protection of community biodiversity and intellectual property sions, and overt observations with semi-structured questionnaires. rights, and benefits, if any comes out of the study and prior The content of the semi-structured questionnaire was composed informed consent for publication of the work has been obtained of diverse ethnopharmacological information, including local during the survey. Also informants were assured that this research names of NRs, plant-parts used, ailments, method of preparation is not for commercial purpose, is for documentation and informa- and administration, side effects, and dosage (Kim and Song, 2011). tion dissemination on the traditional knowledge on NRs plants The interview was performed in vernacular and native lan- used for the diabetes and DRCs. guages (‘Bhojpuri’ and ‘Creole’). The questionnaire developed was The medicinal plants and animals used against diabetes and DRCs strictly confidential and non-compulsory and each participant was were identified based on the information obtained from the infor- interviewed alone where appropriate to maintain confidentiality. mants and the reported ailments were classified into nine main Participants were given information on the purpose of the survey categories based on published scientificliteraturefromBodansky and a prior informed consent form was dully signed by the et al. (1982), Ginsberg et al. (2005), Yadav et al. (2008), Riaz (2009) participants before the interview was conducted. During field and according to the Americian Diabetes Association (http://www. visits, when a remedy was mentioned by the participant, where diabetes.org). These were; (I) diabetic angiopathy (atherosclerosis, possible, the participant was encouraged to show a sample of the cardiovascular disease), (II) diabetic nephropathy (renal failure), (III) remedy which was collected and/or photographed. The collected eye diseases (cataracts), (IV) diabetic neuropathy (pain, erectile 416 A. Mootoosamy, M. Fawzi Mahomoodally / Journal of Ethnopharmacology 151 (2014) 413–444 dysfunction, hearing loss), (V) infections and wounds (ulcers, gang- the highest number of properties). AC¼The number of ailment rene, wound healing), (VI) musculoskeletal disorders (gout), (VII) categories treated by a given species divided by the maximum hypertension, (VIII) diabetic dyslipidemia (high level of cholesterol), number of ailment categories treated by the most resourceful and (IX) diabetes (type 1 and type 2 diabetes). species. A value of 2, is the highest possible value for relative importance (RI) indicating the most versatile species with the 2.3. Sample size greatest number of medicinal properties (Oliveira et al., 2010; Kadir et al., 2012a). At the end of year 2012, the population of the island of Culturally important species as medicines was identified by the Mauritius stood at 1,253,000 and the diabetic population repre- cultural importance index (CII). It is an objective index since it sents 15.5% of the whole population (Republic of Mauritius, (ROM), considers diversity of uses along with the consensus of informant 2012b, 2013). Based on the population size, the sample size for the (Mutheeswaran et al., 2011). It was calculated as follows: diabetic population was estimated according to the formula unc in URui proposed by Rashid et al. (2011); n¼(Zα)2 [P (1 P)]/d2—where: Cll ¼ ∑ ∑ u ¼ u ¼ N n¼estimated sample size, Zα at 5% level of significance¼ l i il 1.96, d¼Level of precision and is estimated to be 0.05, P¼the where NC: total number of different illness categories (of each i diabetic population which is 15.5% of the whole population. Hence, species), UR: total number of use reports for each species, N: total the sample size¼(1.96)2 [0.155 (0.845)]/(0.05)2 ¼201 subjects. number of informants. The CII index is the sum of the proportion Following field work, 387 diabetic patients were interviewed and of informants that mention each of the use-categories for a given only 328 diabetic patients were included in the final study. species. The maximum value of the index equals the total number of different use-categories (NC), which would occur if all infor- 2.4. Quantitative indexes mants would mention the use of a species in all use-categories. In this case, the maximum CII value would be 2.00 (Srithi et al., Relative frequency of citation (RFC) was used to show the local 2012). This index was used to estimate the cultural significance of importance of each species (Vitalini et al., 2013). RFC was calcu- each plant species and to verify, in quantitative terms, to what lated as follows: RFC¼FC/N; where, FC: the number of informants extent each plant species is present in the popular culture and in mentioning the use of the species, and N: number of informants the memory of the inhabitants in the study (Leto et al., 2012). participating in the survey. This index theoretically varies from The index of agreement on remedies (IAR) was used to assess 0 to 1. When RFC index is 0, it means that nobody refers to the the importance of individual species in each group (Mutheeswaran plant as useful and when RFC¼1, it means that all informants in et al., 2011). IAR was calculated as follows: IAR¼(nr na)/(nr 1), the survey refer to the plant as useful (Sharma et al., 2012a). where, nr: total number of citations registered for species s, na: The use value (UV) was employed to reflect the relative number of illness categories that are treated with this species. This importance of commonly known species to the informants. UV value ranges between zero (when the number of illness categories was calculated using the formula: UV¼ΣU /N; where, U : the i i equals the number of citations) and one (whereby all the partici- number of uses mentioned by each informant for a given species, pants agree upon the exclusive use of the species for the particular N: the total number of informants. The UV is helpful in determin- illness) (Chellappandian et al., 2012). ing the plants/ animals with the highest use (most frequently Cultural agreement index (CAI) was calculated as follows (Bruschi indicated) in the treatment of an ailment (Hudaib et al., 2008; et al., 2011): CAI¼CII IAR; where, IAR and CII are calculated as Vitalini et al., 2013). Moreover, UV may be useful in determining mentioned above. the use reliability and pharmacological features of the related The quality use value (QUV) was calculated for plant species as plant (Cakilcioglu et al., 2011). follows; QUV¼ΣQUis/ns; where, ΣQUis: sum of the qualities of all For data analysis of the general use of animals and plants, the medicinal uses assigned to species s by informant i; ns: number of informant consensus factor (FIC) was employed to check for participants interviewed for species s. In the present study, homogeneity of the information obtained. All citations were qualities excellent to good was attributed value of 1, fair value of placed into ailment categories for which the plant or animal was 0.5 and bad value of 0.25 according to Thomas et al. (2009). claimed to be used. FIC was calculated as FIC¼(Nur Nt)/(Nur 1); Quality use agreement value (QUAV) was calculated as follows: where, Nur: number of use citations in each category, and Nt: QUAV¼QUV IAR; where, QUR is the Quality use value, IAR is the number of the species used. FIC values will be low (close to index of agreement on remedies and was calculated as mentioned 0 value) if plants/animals are chosen randomly or if informants do above (Thomas et al., 2009). not exchange information about their use and values will be high The ethnobotanicity index (EI) was calculated as follows: EI¼ (close to 1 value) if there is a well-defined selection criterion in the (Nm/Nt) 100; where, Nm is the number of useful medicinal community and/or if information is given between the informants. species reported; Nt is the total flora in the area. This index was The medicinal plants or animals that are presumed to be effec- used to verify the proportion of species considered useful in tive in treating a certain disease will have higher FIC values traditional medicine against diabetes and related complications (Cakilcioglu et al., 2011). by the Mauritian population in relation to the total flora of the The fidelity level (FL) was used to indicate the percentage of study area. EI gives a very clear idea of the importance of the informants claiming the use of a certain animal/plant species for medicinal plant species in a region (Leto et al., 2012). the same medicinal purpose (Jacobo-Salcedo et al., 2011). The FL is calculated as follows: FL (%)¼(Np/N) 100; where, Np: number of informants that claim use of a plant/animal species 2.5. Statistical analysis to treat a particular disease. N: number of informants that use the plant/ animal as medicine to treat any given disease. Pearson correlation was performed to determine if there was The relative importance (RI) of plant species cited by the an association between different demographic characteristics and informants was calculated as follows: RI¼PPþAC; where, PP¼the the treatment used for diabetes and DRCs. Chi-squared (χ2) test number of pharmacological properties (reported specific ailments) was performed to assess the impact of different variables on use of attributed to a species divided by the maximum number of NRs. A p-value of less than 0.05 was considered to be statistically properties attributed to the most resourceful species (species with significant for all analyses. Data obtained was tabulated and A. Mootoosamy, M. Fawzi Mahomoodally / Journal of Ethnopharmacology 151 (2014) 413–444 417
Table 1 3.3. Association between demographic characteristics of diabetic Socio-demographic characteristics of diabetic participants (n¼328) and traditional participants and the use of NRs medicine practitioners (n¼20).
Background characteristics Diabetic Traditional medicine The present study also recorded that the majority of diabetic participants practitioners interviewees were from rural areas (n¼272). Any association frequency (%) frequency (%) between common demographic characteristics of the diabetic participants and the use of NRs was also assessed. Common Age groups 35–44 14 (4.3) 0 (0.0) demographic variables (gender, age, level of education, monthly 45–54 85 (25.9) 5 (25) 55–64 77 (23.5) 8 (40) household income, religious belief and residence) were found to 65–74 62 (18.9) 3 (15) be significantly (po0.05) associated with the use of NRs. However, 75–84 50 (15.2) 2 (10) Over 84 40 (12.2) 2 (10) Gender Male 138 (42.1) 11 (55) Table 2 Female 190 (57.9) 9 (45) Diabetes related complications reported by the Level of No formal education 94 (28.7) 0 (0.0) diabetic participants. education Primary 108 (32.9) 8 (40) a Secondary 110 (33.5) 5 (25) Diabetes related complications Frequency Tertiary 16 (4.9) 7 (35) Religious Hindu 192 (58.5) 7 (35) Hypertension 74 belief Muslim 24 (7.3) 1 (5) High level of cholesterol 48 Chinese 8 (2.4) 6 (30) Pain 45 Christian 98 (29.9) 2 (10) Cataracts 27 Others 6 (1.8) 4 (20) Cardiovascular diseases 21 Occupation Housewife 101 (30.8) 0 (0.0) Gout 17 Retired 134 (40.9) 0 (0.0) Renal failure 9 Government officer 27 (8.2) 0 (0.0) Poor wound healing 8 Non-government 66 (20.1) 0 (0.0) Erectile dysfunction 1 officer a fi Traditional healers 0 (0.0) 11 (55) Number of times the speci c answer was Medicinal herb 0 (0.0) 3 (15) given; answers descending in how frequently it sellers was given (some interviewees reported more than Ayurvedic medicine 0 (0.0) 2 (10) one complication). practitioners 0 (0.0) 2 (10) Naturopath 0 (0.0) 2 (10) Traditional Chinese medicine Practitioners Table 3 TMPs’ knowledge of diabetes.
TMPs’ knowledge of diabetes Frequencya analysed using statistical package SPSS 17.0 and Microsoft Office Clinical symptoms of diabetes Excel 2007. Pharmacological and chemical data of different NRs Frequent urination 20 cited were collected from different data sources namely: Science Increased hunger 19 Frequent thirst 18 Direct, EBSCOhost, PubMed Central, local university dissertations Increased fatigue 15 and books. Weight loss 11 Wounds do not heal quickly 7
Method of diagnosis Question the patients about the 9 3. Results symptoms he/she was experiencing Rely on laboratory report 7 3.1. Demographic characteristics of diabetic participants and Rely on patient confession 4 traditional medicine practitioners Causes of diabetes Consumption of sugary foods and drinks 18 Lack of physical activity 14 The results in Table 1 summarize the main demographic Family history of diabetes 9 variables (gender, age, education level, religious belief and occu- Obesity 5 pation) recorded from the diabetic participants and the traditional Stress 3 medicine practitioners (TMPs). Majority of the TMPs belonged to Liver/pancreas malfunctioning 2 the age group 55–64 years while the majority of the diabetic Complications of diabetes participants are in the age group 45–54 years. Majority of the Hypertension 20 TMPs completed at least primary education and were all full-time Gangrene 19 Cardiovascular disease 19 independent healers with more than 10 years of experience. Poor wound healing 19 Eye problems 18 Renal failure 17 3.2. Traditional knowledge and practice High level of cholesterol 16 Gout 14 Numbness and pain 7 Sixty-five percent of the TMPs interviewd acquired the tradi- Erectile dysfunction 4 tional medical knowledge through apprenticeship, 30% from Urinary tract infections 3 family members and 5% from religious books. Majority (45%) of Hearing loss 3 the TMPs were practicing from residence/home while 20% were a Number of times the specific answer was given. Answers descending in how practicing from clinics/cabinet and 15% were practicing at the frequently it was given (often more than one answer was given by the same market place. informant). 418 A. Mootoosamy, M. Fawzi Mahomoodally / Journal of Ethnopharmacology 151 (2014) 413–444 no significant association (p40.05) emerged between occupation Table 5 and the use of NRs. A positive correlation was found between age Diabetic participants’ attitudes towards the concomitant use of HRs and allopathic and the use of NRs (R¼0.104). However, a negative R value which medicines. indicates an inverse relationship was observed between level of Attitude Yes N (%) No N (%) education and the use of NRs (R¼ 0.340). A negative R value was also found between monthly household income and the use of NRs They work more effectively when taken together 118 (50.9) 114 (49.1) (R¼ 0.213). Moreover, majority (61%) of the diabetic participants Allopathic medicine when taken alone is not good 74 (31.9) 158 (68.1) There is no harm in taking both together 198 (85.3) 34 (14.7) were diagnosed with diabetes since 6–10 years. Among the 328 Herbal medicines can counteract the side effects of 82 (35.3) 150 (64.7) diabetic patients included in the study, 171 participants reported allopathic medicines that they suffer from DRCs. Table 2 illustrates the DRCs reported by the diabetic participants. N: number of participants. As shown in Table 2, hypertension was reported by a large proportion (n¼74) of the participants followed by high level of cholesterol (n¼48). Erectile dysfunction was the least (n¼1) reported DRC. show an inverse relationship between these two variables. The As summarized in Table 3, all the TMPs (n¼20) reported majority of the respondents (43.3%) were found to use water as frequent urination as one of symptom of diabetes. Some TMPs additive and milk was the least (6.1%) commonly used additive. (n¼9) questioned the patients about the symptoms they were Some informants also reported the use of more than one additive. experiencing when they diagnosed for a particular ailment. The Furthermore, the majority (76.2%) of the diabetic interviewees majority (n¼18) of the TMPs reported consumption of sugary responded that there was an improvement in their health condi- foods and drinks as the causes of diabetes and all the informants tion after the use of HRs. When questioned about the use of (n¼20) reported hypertension as one of the complications of polyherbal formulations, the majority (60.4%) of the respondents diabetes. do not use polyherbal formulations against diabetes and DRCs. Furthermore, a large proportion (90.5%) of the diabetic respon- dents did not encounter any side effects following use of HRs. 3.4. Herbal remedies used against diabetes and DRCs Among the 328 diabetic informants, 232 reported that they use HRs along with allopathic medicine. Table 5 illustrates the diabetic ¼ Table 4 illustrates that the majority (n 297) of participants participants’ attitudes towards the concomitant use of HRs and responded that the use of HRs was part of their culture and they allopathic medicines against diabetes and DRCs. have been using it since childhood. The belief that HRs are free As summarized in Table 5, it can be deduced that a high from side effects was also reported as a good reason behind its use. proportion (85.3%) of diabetic participants responded that there The main source of knowledge was family and/or friends with a is no harm in taking HRs with allopathic medicines. However, percentage of 49.4% through oral communication. Physicians were 64.7% responded negatively to the fact that that HRs can counter- the least (5.8%) mentioned source of knowledge. Home garden act the side effects of allopathic medicines. represents the highest (31.1%) source of HRs followed by the wild A total of 111 different medicinal plants were recorded during (26.5%) and the least (19.8%) mentioned source is the herbalist. the survey out of which 108 plants were identified successfully The majority of HRs is prepared using 50.5% leaves, 0.5% of oil and and 3 plants could not be identified. The unidentified plants were pod and 19.1% of fruits as mentioned by respondents. Moreover, recorded under their local names and were not included in the the majority of the herbal preparations (74%) were prepared quantitative analyses. Table 6 summarized the medicinal plants using fresh form of the plant part. Decoction (39.2%) was the and medicinal plants used in mixtures against diabetes and DRCs most commonly employed method of preparation followed by reported by diabetic participants and TMPs. The results of the juice (26.1%). Poultice was the least (1.7%) common method of survey summarized in Table 6, provides the following information preparation. for each plant species: scientific name, botanical family, local/ It was found that the majority (58.8%) of the informants was vernacular name(s), plant parts used, indication, UV, RFC, dosage fi not satis ed with the taste of the HRs and a large proportion and the preparation procedure. Additionally, an endeavour has (62.5%) of the interviewees tends to use additives. The association been made to cite relevant scientific reference(s) on the quoted between satisfaction with the taste of HRs and the use of additives medicinal plants. fi o was signi cant (p 0.01). Moreover, the negative value of the Among the 232 diabetic interviewees who use HRs along with ¼ Pearson Correlation (R 0.545) was recorded which tends to allopathic medicines, 18 of them reported that they experienced herb–drug interactions as summarized in Table 7. Also some key informants reported several side effects following the use of ¼ Table 4 various medicinal plants (Table 8). The majority (n 13) of parti- Assessment of different reasons behind preference to use HRs. cipants responded that they experienced weakness after the concomitant use of Momordica charantia and Metformin against a Reasons for preference Frequency type 2 diabetes while only 1 interviewee reported diarrhoea from
Herbal remedies is part of your culture and you have 297 the concomitant use of Morinda citrifolia and Atorvastatin for the been using it since childhood treatment of high level of cholesterol. Herbal remedies are free from side effects 212 Based on the informant consensus (Table 9), it can be deduced Herbal remedies are easily available 209 that diabetes had the highest agreement among the respondents Herbal remedies are cheaper 194 (FIC¼0.99) followed by hypertension (FIC¼0.98). The least agree- Herbal remedies are more effective than western medicine 127 Belief that some disease cannot be cured using 108 ment between the respondents was observed in infections and western medicine wounds category with FIC value of 0.89. Herbal remedies work faster 96 As shown in Table 10, Rosmarinus officinalis (FL¼100%) has the highest fidelity level for diabetic angiopathy, Cajanus cajan a fi Number of times a speci c answer was given. Answers descending in how ¼ ¼ frequently it was given (often more than one answer was given by the same (FL 100%), Coix lacryma-jobi (FL 100%), Esta laurifolium interviewee). (FL¼100%), Artemisia verlotiorum (FL¼100%) and Hordeum vulgare A. Mootoosamy, M. Fawzi Mahomoodally / Journal of Ethnopharmacology 151 (2014) 413–444 419
Table 6 List of medicinal plants and medicinal plants used as polyherbal formulas with their related information used against diabetes and DRC.
Scientific name Family Local name of Indication Part Method of preparation RFC UV Recorded literature uses of plant plant of the and administration (collection plant number) used
Abelmoschus Malvaceae Lalo Erectile Fr Prepare a juice with 10 fruits and 0.01 0.01 Anti-inflammatory, myocardial esculentus (L.) dysfunction water and drink 1 cup twice per week ischemia protectivea Moench (AM055) Actinidia deliciosa Actinidiaceae Kiwi Hypertension Fr Prepare a juice with the pulp together 18 – (A. Chev.) C.F. with the pulp of Citrus maxima. Drink Liang & A.R. 1 cup thrice per week Ferguson Allium cepa L. Amaryllidaceae Zoiyon/oignon Type 1 B Prepare a decoction with the bulb and 0.33 0.55 Anti-diabeticb (AM008) diabetes drink 1 cup daily for 1 week Type 2 B Prepare a decoction with the bulb and diabetes drink 1 cup daily for 1 week Type 2 B Prepare a juice with the bulb and diabetes add1 teaspoon of honey. Drink 1 cup daily for 3 months High level of B Prepare a decoction with the bulb and cholesterol drink 1 cup daily for 1 week Renal failure B Prepare a decoction with the bulb and drink 1 cup daily for 1 week Hearing loss B Crush and press to obtain the juice and mix 30 g of the juice with 30 g of water. Heat and instill 3–4 drops in the affected ear Erectile B Prepare a juice with the bulb and add dysfunction 1 teaspoon of honey. Drink 1 cup daily for 3 months Cataract B Prepare a decoction with the bulb and add 2 teaspoons of honey. Allow it to cool and use it as an eyebath daily Allium sativum L. Amaryllidaceae L'ail Type 2 B Prepare a decoction with 2-3 bulbs 0.51 0.91 Antitumor, hypolipidemic, (AM010) diabetes and drink 1 cup thrice per week hypocholesterolemic, antiatherosclerotic, antioxidant, immunomodulatoryc Cataract B Prepare a decoction with 2-3 bulbs and drink 1 cup thrice per week. Renal failure B Consume 2-3 raw bulbs daily for 1 week Hypertension B Swallow 2 small bulbs with a cup of water thrice per week Wound B Crush and press to obtain a juice and apply on the wound daily till heal Ulcer B Crush and press to obtain a juice and apply on the ulcer daily till heal Alisma plantago- Alismataceae – High level of – Sold as a polyherbal tea against 0.01 0.01 aquatica subsp. cholesterol cholesterol. Prepare an infusion with orientale (Sam) the teabags which contain Alisma Sam. orientalis (Rhizoma alismatis), Radix angelica sinensis, Herba artemisia capillarie, Hawthorn berry, Rhizoma atracytylodis macrocephalae, Ziziphus jujuba Mill. var. spinosa (bunge) Hu ex H.F. Chow and Chinese tea. Drink 1 cup daily Aloe vera (L.) Xanthorrhoeaceae Aloe vera Type 2 L Gel removed from the leaf pulp and 2 0.61 1.02 Anti-diabeticd, anticancer, Burm.f. diabetes table spoons are eaten daily in the antibacterial, anti-inflammatory, (AM003) morning for 1 week anti-oxidante High level of L Prepare a mixture with 2 tablespoon cholesterol of the gel removed from the leaf pulp, 1 cup of yoghurt and ½ cup of water. Mix all in a juicer and drink 1 cup of the juice obtained twice per week. High level of L Polyherbal formulation containing cholesterol Aloe vera and Phyllanthus emblica. Drink 2 teaspoons in ½ cup of water daily Gangrene L Prepare a footbath with the decoction of the leaf mixed with 1 teaspoon of salt and 1 teaspoon of vinegar. Soak foot for 30-45 min daily for 1 week Verbenaceae Verveine W 0.11 0.11 – 420 A. Mootoosamy, M. Fawzi Mahomoodally / Journal of Ethnopharmacology 151 (2014) 413–444
Table 6 (continued )
Scientific name Family Local name of Indication Part Method of preparation RFC UV Recorded literature uses of plant plant of the and administration (collection plant number) used
Aloysia citriodora Cardiovascular Prepare an infusion with 1 teaspoon Palau (AM065) disease of the plant in 1 cup of hot water. Allow to infuse for 10 min and drink 1 cup thrice per week Ananas comosus Bromeliaceae Anana Renal failure Fr Consume ripe fruit twice per week. 0.06 0.07 Antioxidative, anti-browning, anti- (L.) Merr. inflammatory, anti-plateletf (AM048) Cardiovascular Fr Prepare a juice with the fruit and disease water and drink 1 cup twice per week Gout Fr Prepare a juice with the fruit and water and drink 1 cup twice per week Annona muricata Annonaceae Coronsol Hypertension L Prepare an infusion of the leaves and 0.15 0.15 – L. (AM060) drink 1 cup twice per week nAphloia Aphloiaceae Fandamane Cataract L Prepare an infusion with the leaves 0.28 0.3 – theiformis and wash the eyes with it daily (Vahl) Benn. (AM043) Type 2 L Prepare an infusion of the leaves and diabetes drink 1 cup twice per week Apium graveolens Apiaceae Céleri Type 2 L Prepare a decoction with the leaves 0.38 0.51 – L. (AM035) diabetes and drink1 cup twice per week Hypertension L Prepare a decoction with the leaves and drink1 cup twice per week Gout L Prepare a decoction with the leaves and drink1 cup twice per week Artemisia Asteraceae L'herbe sinois Renal failure L Prepare a decoction of the leaves and 0.04 0.04 – verlotiorum drink 1 cup thrice per week Lamotte. (AM086) Artocarpus altilis Moraceae Fruit a pain Type 2 L Prepare a decoction with the leaves 0.04 0.04 Antioxidant, antibacterial, (Pakinson ex F. diabetes and drink 1cup twice per week antifungal, antidiarrhoeal, A. Zorn) antidiabeticg (AM073) Artocarpus Moraceae Zack Type 2 Fr Prepare a decoction with the young 0.25 0.25 Anti-diabetic d, diarrhoea, feverh heteophyllus diabetes fruits and drink 1 cup daily for 1 Lam. (AM024) week. nAsplenium nidus Aspleniaceae Langue de Hypertension L Prepare an infusion of the leaves and 0.08 0.08 – L. (AM039) boeuf drink 1 cup twice per week Atropa belladonna Solanaceae Belladonne Pain L Prepare an infusion with 4 leaves and 0.01 0.01 – L. mix the infusion with the juice of Morinda citrifolia fruit. Drink 1 cup daily before going to bed for 1 week Avena sativa L. Poaceae Oatmeal Type 2 Gr The grains are soaked in 1 cup of 0.27 0.32 Rheumatism, gout, liver, skin (AM032) diabetes water during the night and drunk in diseasesi the morning on an empty stomach High level of Gr The grains are soaked in 1 cup of cholesterol water during the night and drunk in the morning on an empty stomach. Azadirachta Meliaceae Neem, lila Type 2 L Prepare a decoction of the leaves and 0.39 0.39 Diabetes, hypertension, heart indica A. Juss perche diabetes drink 1cup twice per week disease,cancer, ulcers, skin (AM038) disordersj Type 2 L Crush the leaves and make small balls diabetes with it and allow it to dry in the sun. The following day swallow 2 balls with 1 glass of water twice per week Beta vulgaris L. Amaranthaceae Betrave Cataract R Prepare a juice of the root together 0.02 0.02 – with Daucus carota and drink 1 cup twice per week Gout R Prepare a juice of the root together with Daucus carota and drink 1 cup twice per week Erectile R Prepare a juice of the root together dysfunction with Daucus carota and drink 1 cup twice per week Bidens pilosa L. Asteraceae Lavilbag Type 2 L Prepare a decoction of 3 leaves and 0.42 0.57 Hepatitis, diabetes, anti- (AM062) diabetes drink 1 cup twice per week inflammatory, anti-allergic, antimalarialk Hypertension L Prepare a decoction of 3 leaves and drink 1 cup twice per week Brassica oleracea Brassicaceae Li chou Cardiovascular L Prepare a juice with the leaves and 0.42 0.74 Antioxidantl L. (AM091) disease drink 1 cup daily for 1 week. Type 2 L Prepare a juice with the leaves and diabetes drink 1 cup daily for 1 week. A. Mootoosamy, M. Fawzi Mahomoodally / Journal of Ethnopharmacology 151 (2014) 413–444 421
Table 6 (continued )
Scientific name Family Local name of Indication Part Method of preparation RFC UV Recorded literature uses of plant plant of the and administration (collection plant number) used
Wound L Apply the leaves as a cataplasm on the wound Cataract L Crush and press to obtain a juice and instill 3-4 drops in the eye each 2 h daily till heal Hearing loss L Prepare a juice with the leaves and mix equal amount of the juice with equal amount of the juice of Citrus medica L. fruit. Instill 2 drops in the ears daily before going to bed Bryophyllum Crassulaceae Sulfat Pain in the feet L Prepare a decoction with the leaves 0.03 0.03 Gastric ulcer, rheumatoid arthritis, pinnatum and use it as a footbath hepatoprotective, anti-tumor, (Lam.) Oken. allergic airway diseaseff (AM070) Cajanus cajan (L.) Fabaceae Bravate Renal failure R Prepare a decoction of the roots and 0.03 0.03 Antiperoxidativem Millsp. drink 1 cup twice per week. (AM082) Camellia sinensis Theaceae Thé vert Cataract L Prepare an infusion with the tea bags 0.53 0.81 Hypoglycemic, antihyperglycemic L. Kuntze and wash the eye with it and antidiabetic.n (AM046) Type 2 L Prepare an infusion with the tea bags diabetes and drink 1 cup twice per week Hypertension L Prepare an infusion with the tea bags and drink 1 cup twice per week High level of L Prepare an infusion with the tea bags cholesterol and drink 1 cup twice per week High level of L Prepare an infusion with the teabags cholesterol together with Cinnamomum verum. Drink 1 cup twice per week at night Cardiospermum Sapindaceae Pocpoc Gangrene L Prepare an infusion of the leaves 0.27 0.31 – halicacabum L. together with Senna alexandrina Mill. (AM072) and Senna alata L. Drink 1 cup twice per week. Wound L Crush the leaves and apply on the wound as a poultice Type 2 L Prepare a decoction of the leaves and diabetes drink 1 cup twice per week 0.5 Carica papaya L. Caricaceae Papaya Hypertension Fr Consume ripe fruit half an hour 0.2 0.22 Cancer, allergic disorders (AM051) before breakfast thrice per week High level of Fr Crush and press the raw fruit to immunoadjuvant.o Antioxidant, cholesterol obtain a milky liquid and drink 1 anti-inflammatoryq teaspoon twice per week Cardiovascular Fr Prepare a juice with the fruit together disease with Daucus carota. Drink 1 cup thrice per week Cynara Asteraceae Artichaut Type 2 L Prepare an infusion with 10 g of 0.48 0.65 Antidiabeticz cardunculus L. diabetes leaves in 1 l of water and drink 1 cup (AM042) twice/ thrice per week High level of L Prepare an infusion of the leaves and cholesterol drink 1 cup twice per day for 1 week. High level of L Prepare a juice with the leaves and cholesterol drink 1 cup daily for 1 week Atherosclerosis L Prepare an infusion of the leaves and drink 1 cup twice per day for 1 week Or Prepare a juice with the leaves and drink 1 cup twice per day for 1 week Gout R Prepare a decoction of the roots and drink 1 cup twice per week Cinnamomum Lauraceae Canfe Pain – Formulation contains Mentha 0.01 0.01 – camphora (L.) J. slyvestris, Eucalyptus globulus, Presl. Syzygium aromaticum, Commiphora wightii. Apply paste on painful area daily Cynara Asteraceae Artichaut Type 2 L Prepare an infusion with 10 g of 0.48 0.65 Antidiabeticz cardunculus L. diabetes leaves in 1 l of water and drink 1 cup (AM042) twice/ thrice per week High level of L Prepare an infusion of the leaves and cholesterol drink 1 cup twice per day for 1 week High level of L Prepare a juice with the leaves and cholesterol drink 1 cup daily for 1 week 422 A. Mootoosamy, M. Fawzi Mahomoodally / Journal of Ethnopharmacology 151 (2014) 413–444
Table 6 (continued )
Scientific name Family Local name of Indication Part Method of preparation RFC UV Recorded literature uses of plant plant of the and administration (collection plant number) used
Atherosclerosis L Prepare an infusion of the leaves and drink 1 cup twice per day for 1 week Gout R Or Prepare a juice with the leaves and drink 1 cup twice per day for 1 week Prepare a decoction of the roots and drink 1 cup twice per week Catharanthus Apocynaceae Saponnaire Type 2 L Prepare an infusion with 7 leaves in 2 0.24 0.24 Hodgkin's and non Hodgkins's roseus L. G. Don (blanc) diabetes cups of hot water. Drink 1 cup thrice lymphomas, acute lymphoblastic (AM004) per week leukaemia, anti-hypertensiver Cinnamomum Lauraceae Canfe Pain – Formulation contains Mentha 0.01 0.01 – camphora (L.) J. slyvestris, Eucalyptus globulus, Presl. Syzygium aromaticum, Commiphora wightii. Apply paste on painful area daily Citrus Rutaceae Limon Hypertension Fr Peel and press to obtain the juice and 0.43 0.68 Expectorants aurantiifolia drink 1 cup (Christm.) Swingle (AM031) Hypertension Fr Prepare a juice with the fruit together with 1 clove of Allium sativum,1 teaspoon of honey and 1 cup of water. Drink 1 cup twice per week Gout Fr Peel and press to obtain juice and drink 1 cup twice per week Type 2 Fr Peel and press to obtain juice and diabetes drink 1 cup twice per week Type 2 Fr Peel and prepare a juice with the pulp diabetes and add 1 teaspoon of honey. Drink thrice per week in the morning Renal failure L Prepare an infusion with 4 leaves and drink 1 cup thrice per week Cardiovascular Fr Prepare a juice with the fruit together disease with 1 clove of Allium sativum L., 1 teaspoon of honey and 1 cup of water. Drink 1 cup twice per week Cataract Fr Prepare a juice with the pulp and add 2 teaspoon of honey and use it as an eyebath daily Citrus maxima Rutaceae Pamplemousse Type 2 Fr Prepare a decoction of the peels in 0.47 0.56 – (Burm.) Osbeck diabetes water and drink 1 cup thrice per (AM037) week High level of Fr Prepare a decoction of the peels in cholesterol water and drink 1 cup thrice per week High level of Fr Prepare a juice with the fruit together cholesterol with Daucus carota and 2 cm of Zingiber officinale root. Drink 1 cup once per week Cocos nucifera L. Arecaceae Coco Cataract O Instill 2 drops of oil in the eye twice 0.25 0.34 Diarrhoea, dysentery, diabetest (AM034) per day Type 2 Fr Prepare a decoction with the young diabetes fruits and drink 1 cup thrice per week Renal failure Fr Drink 1 cup of the fruit water four times per week Renal failure R Prepare a decoction of the root and drink 1 cup twice per week Coix lacryma-jobi Poaceae Collier cipaye Renal failure Se Prepare a decoction of the seeds and 0.07 0.07 – L. (AM041) drink 1 cup twice per week Colocasia Araceae Brède songe Gangrene L The leaves are crushed with 1 0.03 0.03 Anti-diabeticu esculenta L. teaspoon of salt and apply on the Schott (AM016) infected skin as a poultice Coriandrum Apiaceae Cotomili Type 2 L Prepare an infusion with the leaves 0.20 0.24 Hypoglycemic and hypolipidemicv sativum L. diabetes and drink 1 cup twice per week (AM009) Crataegus Rosaceae Aubépine Cataract L Prepare an infusion of the leaves and 0.12 0.2 Myocardial protection, laevigata Poir. wash the eye with it hypocholesterolemic action, DC. (AM057) antioxidantw High level of L Prepare an infusion of the leaves and cholesterol drink 1 cup twice per week A. Mootoosamy, M. Fawzi Mahomoodally / Journal of Ethnopharmacology 151 (2014) 413–444 423
Table 6 (continued )
Scientific name Family Local name of Indication Part Method of preparation RFC UV Recorded literature uses of plant plant of the and administration (collection plant number) used
Hypertension Fl Prepare an infusion with 1 teaspoon of flower and drink 2 cups per day twice per week Atherosclerosis Fl Prepare an infusion with 1 teaspoon of flower and drink 2 cups per day twice per week Curcuma longa L. Zingiberaceae Safran Cataract R Peel, crush and press to obtain the 0.1 0.14 Stomach ache, (AM049) juice and instill 2 drops in the eye daily for 1 week Pain R Peel and prepare a decoction of the blood purifier, carminative, root in milk and drink 1 cup before appetizer, tonic, cancer, dermatitis, going to bed AIDS, high cholesterol level, anti- inflammatory, antifungal, antihepatotoxic, antiarthritic activitiesx Cardiovascular R Prepare an infusion of the root and disease drink 1 cup daily for 1 week Cucumis sativus L. Cucurbitaceae Concombre Type 1 Fr Prepare a juice with the fruit and 0.28 0.28 Antidiabetic, hyperlipidemicy (AM089) diabetes water and drink 1 cup on alternative days Type 2 Fr Prepare a juice with the fruit and diabetes water and drink 1 cup on alternative days Cucurbita maxima Cucurbitaceae Giromon Type 2 Fr Prepare a decoction with the peels in 0.2 0.74 – Duchesne diabetes water and drink 1 cup daily for 1 (AM019) week Cataract Fl Crush and press to obtain juice. Apply juice as compress externally on the eyes Renal failure Se Seeds are dried in bright sunlight for 1 day and eaten raw the following day. Seeds should be consumed thrice per week Wound Fr Prepare a juice with the fruit and apply on wound till heal Daucus carota L. Apiaceae Carotte Renal failure R Prepare an infusion with the root 0.01 0.01 – together with the stem of Erythroxylum laurifolium. Drink 1 cup thrice per week *Erythroxylum Erythroxylaceae Bois de ronde Renal failure Ba Prepare a decoction of the bark and 0.08 0.08 – laurifolium drink 1 cup daily for 1 week Lam. (AM061) Eucalyptus Myrtaceae Eucalyptus Type 2 L Prepare an infusion with 2–3 leaves 0.24 0.24 – globulus Labill diabetes and drink 1 cup twice per week (AM058) Eugenia uniflora Myrtaceae Rousaille Type 2 L Prepare a decoction with the leaves a 0.08 0.08 Antioxidant, antibacterial, L. (AM013) diabetes drink 1 cup twice per week. antifungalaa Euphorbia Euphorbiaceae Caca poule High level of Fl Prepare an infusion of the flowers 0.01 0.01 – heterophylla L. cholesterol together with Senna alexandrina, Aphloia theiformis, Erythroxylum laurifolium and Psiloxylon mauritianum. Drink 1 cup daily for 1 week Euphorbia hirta L. Euphorbiaceae Jean robert Type 2 L Prepare a decoction with the leaves 0.19 0.25 Dysentry, eczema, hematuria, (AM029) diabetes and drink 1 cup twice per week hypersensitivity, gastroenteritisbb Cataract L Prepare an infusion with the leaves and use it to clean the eyes. Pain L Prepare a poultice of the leaves by crushing them and apply on the painful area nFaujasiopsis Asteraceae Bois cassant Type 2 L Prepare a decoction of the leaves and 0.23 0.23 – flexuosa (Lam.) diabetes drink 1 cup daily for 1 week C. Jeffrey (AM079) Ficus benjamina L. Moraceae Beljamine Wound L Crush the leaves and apply on the 0.02 0.02 Antitumor, antibacterial, (AM068) wound as poultice antinociceptive, antiviralcc Glechoma Lamiaceae Lierre Type 2 L Prepare a decoction with 7 leaves and 0.12 0.12 – hederacea L. diabetes drink 1 cup twice per day. (AM063) Acanthaceae Lait de vierge Type 2 L Prepare a decoction with 3 leaves and 0.37 0.37 Hypoglycemicdd diabetes drink 2 cups daily for 1 week 424 A. Mootoosamy, M. Fawzi Mahomoodally / Journal of Ethnopharmacology 151 (2014) 413–444
Table 6 (continued )
Scientific name Family Local name of Indication Part Method of preparation RFC UV Recorded literature uses of plant plant of the and administration (collection plant number) used
Graptophyllum pictum (L.) Griff. (AM087) Heliotropium Boraginaceae L'herbe Renal failure R Prepare a decoction of the root and 0.01 0.01 – indicum L. papillon drink 1 cup once per week (AM074) Hibiscus Malvaceae Roselle Type 2 Fr Prepare a juice with 10 fruits. Remove 0.01 0.01 Hypoglycemic, hypolipidemicee sabdariffa L. diabetes the seeds from the fruits and allow it (AM098) to boil in 1 l of water for 10 min. Filter the juice and drink 1 cup twice per week Hordeum vulgare Poaceae Grain de l'orge Renal failure Se Prepare a decoction with the seeds 0.03 0.03 – L. (AM075) and drink 1 cup twice per week Lactuca sativa L. Asteraceae Laitue Type 2 L Prepare a decoction with 3 leaves and 0.08 0.08 – (AM056) diabetes drink 1 cup daily for 1 week Lagenaria Cucurbitaceae Calebasse Type 2 Fr Prepare a decoction of the peels in 0.47 0.74 Antidiabeticd siceraria diabetes water by allowing it to boil for (Molina) Standl 20 min. Drink 1 cup for 3 days (AM018) High level of L Prepare a decoction with the leaves cholesterol and drink 1 cup twice per week Hypertension L Prepare a decoction with the leaves and drink 1 cup twice per week Linum Linaceae. Grain de lin Type 2 Se Soak the seeds in a cup of water at 0.17 0.25 Chemopreventive activity against usitatissimum diabetes night and drink the next morning on various tumors and cardiovascular Linnaeus. an empty stomach. Drink thrice per disordersgg (AM006) week Renal failure Se Soak the seeds in a cup of water at night and drink the next morning on an empty stomach. Drink thrice per week High level of Se Soak the seeds in a cup of water at cholesterol night and drink the next morning on an empty stomach. Drink thrice per week Luffa acutangula Cucurbitaceae Patole Hypertension L Crush and press 3–5 leaves to obtain a 0.14 0.14 – (L.) Roxb. juice and drink twice per week (AM052) Cardiovascular L Prepare a juice with the leaves disease together with Swertia chirayita and honey. Drink 1 cup twice per week Lysimachia Primulaceae – Urinary tract L Prepare a decoction of the leaves and 0.01 0.01 – christiniae infection drink 1 cup daily for 1 week Hance (AM083) Malus domestica Rosaceae Pomme High level of Fr Prepare a juice with 2 cups of apples 0.05 0.05 – Borkh. cholesterol and 2 cups of water and drink 1 cup (AM050) twice per week Magnifera indica Anacardiaceae Mangue Type 2 L Prepare an infusion of the leaves and 0.31 0.31 – L. (AM053) diabetes drink 1 cup twice per week Manihot esculenta Euphorbiaceae Manioc Hypertension L Prepare an infusion of the leaves and 0.09 0.09 Antioxidanthh Crantz drink 1 cup thrice per week. (AM093) Momordica Cucurbitaceae Margose Type 2 L Eat 2–3 leaves twice per week 0.55 0.55 Antidiabeticd charantia L. diabetes (AM002) Type 2 L Extract the liquid by crushing the diabetes leaves and drink 1 teaspoon twice per week Type 2 Fr Extract the liquid by crushing the diabetes fruit and drink 1–2 teaspoon twice per week Type 2 Se Dry the seeds in bright sunlight diabetes during the day and at night allow it to soak in a cup of water and drink the next morning on an empty–stomach Type 2 L Prepare a juice with 3 leaves and add diabetes Piper nigrum. Drink once per week. Type 2 Fr Prepare a juice with the fruit together diabetes with Phaseolus vulgaris L., Malus domestica and Aloe vera. Drink 1 cup once per week A. Mootoosamy, M. Fawzi Mahomoodally / Journal of Ethnopharmacology 151 (2014) 413–444 425
Table 6 (continued )
Scientific name Family Local name of Indication Part Method of preparation RFC UV Recorded literature uses of plant plant of the and administration (collection plant number) used
Type 2 Fr Prepare a juice with the fruit together diabetes with the fruit of Phyllanthus emblica and the fruit of Syzygium cumini. Drink 1 cup twice per week Type 2 Fr Prepare a juice with the fruit together diabetes with Phaseolus vulgaris L. and drink 1 cup twice per week Moringa oleifera Moringaceae Brède Type 2 L Crush and press to obtain juice. Mix 0.37 0.61 Pain, antitumor, anti– Lam. (AM017) mouroungue diabetes with milk and drink 1 cup twice per inflammatoryii week High level of L Crush and press to obtain juice. Mix cholesterol with milk and drink 1 cup twice per week Hypertension R Prepare a decoction with the root and drink 1 cup twice per week Hypertension St Prepare a decoction with the stem and drink 1 cup twice per week Morinda citrifolia Rubiaceae Noni Type 2 Fr The fruit is peeled, crushed and 0.57 1.21 Diabetes, high blood pressure, L. (AM005) diabetes pressed to obtain the juice. Drink 1 inflammation, cancerjj cup thrice per week High level of Fr The fruit is peeled, crushed and cholesterol pressed to obtain the juice. Drink 1 cup thrice per week Hypertension L Prepare an infusion with the leaves and drink 1 cup twice per week Pain L Apply warm oil on the painful area and bind it with the leaves Murraya koenigii Rutaceae Carripoulet Hypertension L Prepare an infusion with 3 leaves and 0.18 0.18 Stomachache, constipation, (L.) Spreng drink 1 cup twice per week diarrhoea, nausea, vomiting, anti– (AM033) tumor, antioxidant, chemo– modulatory, immune–modulatory, antidiabetic, antihypertensive, anti- obesity, lipid lowering.kk Musa acuminata Musaceae Banane Type 2 Fr Ripe fruit eaten half in the morning 0.16 0.18 Antidiabeticd Colla (AM014) diabetes Gout and half in the evening daily Fr Consume 8 fruits: 2 fruits in the morning, 2 fruits at noon, 2 fruits in the afternoon and 2 fruits at night. The fruits are eaten as the main dish thrice per week Nasturtium Brassicaceae Cresson Type 2 L Prepare a juice of the leaves and drink 0.24 0.24 – officinale R.Br diabetes 1 cup daily for 1 week (AM092) Ocimum Lamiaceae Tulsi Type 2 L Crush and press to obtain a juice and 0.6 0.92 Gastro-intestinal disorder, tenuiflorum L. diabetes drink 2 teaspoons twice per week hypertensiond (AM025) Type 2 L Consume raw 2 leaves twice per week diabetes Hypertension L Crush and press to obtain a juice and drink 2 teaspoons twice per week Cataract L Crush 2 leaves and press to obtain a juice and administer 1 drop of the juice in the eye daily Cataract L Crush and press 3–4 leaves to obtain a juice and add 2 teaspoons of honey. Instill 2 drops of the mixture in the eye each night for 5 days Erectile L Prepare a decoction with 3 leaves dysfunction together with 3 leaves of Piper betle and drink 1 cup twice per week Wound L Crush and press the leaves to obtain a juice and mix the juice with the oil of Cocos nucifera that has previously been heated and apply on the wound High level of L Crush and press 3 leaves to obtain a cholesterol juice and add 2 teaspoons of honey and drink twice per week Olea europaea L. Oleaceae Zolive Hypertension L Prepare an infusion of the leaves and 0.38 0.54 Hypotensive, hypoglycemic, (AM081) drink 1 cup daily for 1 week Cardiovascular L Prepare an infusion of the leaves and antiarrhythmic, antioxidant, disease drink 1 cup daily for 1 week antimicrobial, Type 2 L Prepare an infusion of the leaves and thyroid stimulatory, antiviral, anti– diabetes drink 1 cup daily for 1 week HIVll 426 A. Mootoosamy, M. Fawzi Mahomoodally / Journal of Ethnopharmacology 151 (2014) 413–444
Table 6 (continued )
Scientific name Family Local name of Indication Part Method of preparation RFC UV Recorded literature uses of plant plant of the and administration (collection plant number) used
Ophiopogon Asparagaceae – Type 2 – Sold as Chinese anti-diabetic tea. 0.01 0.01 – japonicus diabetes Prepare an infusion with the tea bags (Thunb.) Ker which contains Ophiopogon japonicus Grawl. (Radix ophosiopogonis), fragrant solomons eal rhizome, Chinese yam, Hawthorn berry, Radix pueraeia and white tea. Drink 1 cup daily Orthosiphon Lamiaceae Orthosiphon Type 2 L Prepare a decoction with the leaves 0.13 0.14 – aristatus diabetes and drink 1 cup twice per week (Blume) Miq. (AM007) Gout W Prepare an infusion with 10–15 g of the whole plant in 1 l of water and drink ½ liter per day Hypertension L Prepare an infusion of the leaves together with Senna alata L., Psiloxylon mauritianum and Senna alexandrina Mill. Drink 1 cup twice per week nPandanus sp. Pandanaceae Vacoas Erectile R Prepare a decoction of the roots 0.01 0.01 – dysfunction together with nOlea europaea, Cinnamomum verum and seed of Cola accuminata. Drink 1 cup twice per week Persea americana Lauraceae Avocat Cataract Fr Prepare a juice with 2 cups of 0.14 0.18 Induce lymphocytes MILL. (AM095) yoghurt, ½ the fruit, ½ cup of water proliferationmm and drink 1 cup once per week High level of Fr Prepare a juice with 2 cups of cholesterol yoghurt, ½ the fruit, ½ cup of water and drink 1 cup once per week Petroselinum Apiaceae Persil High level of L Prepare a decoction with the leaves 0.34 0.47 – crispum (Mill.) cholesterol and drink 1 cup twice per week Nyman ex A.W. Hill. (AM036) Type 2 L Prepare a decoction with the leaves diabetes and drink 1 cup twice per week Renal failure L Prepare a decoction with the leaves and drink 1 cup twice per week Hypertension L Prepare a juice with the leaves together with Daucus carota and Apium graveolens L. Drink 1 cup twice per week. High level of L Prepare a soup with the leaves cholesterol together with Apium graveolens L and Allium ampeloprasum var. porrum. Consume twice per week Phaseolus vulgaris Fabaceae Haricot vert Type 2 P Prepare a decoction of the pods and 0.07 0.07 – L. (AM096) diabetes drink 1 cup thrice per day for 1 week Phoenix Arecaceae Tam Type 2 L Prepare a decoction with the leaves 0.2 0.2 Infectious disease, cancer, glycemic dactylifera L. diabetes and drink 1 cup daily for 1 week and lipid control, antioxidant, (AM027) antimutagenic activity.nn Phyllanthus Phyllanthaceae Amla Type 2 Fr Consume raw fruits thrice per week 0.33 0.67 Antidiabeticd emblica L. diabetes (AM026) Type 2 Fr Prepare a juice with 1 cup of fruits diabetes and 1 cup of water and add 1 teaspoon of honey to the juice (optional). Drink 1 cup thrice per week High level of Fr Prepare a juice with 1 cup of fruits cholesterol and 1 cup of water and drink 1 cup thrice per week Type 2 – Polyherbal formulation which diabetes contains Phyllanthus emblica, Terminalia bellirica and Terminalia chebula var. chebula. Drink 1 tablespoon daily Type 2 – Polyherbal formulation which diabetes contains Phyllanthus emblica and Momordica charantia. Drink 10–30 ml of the preparation daily in 100 ml of water A. Mootoosamy, M. Fawzi Mahomoodally / Journal of Ethnopharmacology 151 (2014) 413–444 427
Table 6 (continued )
Scientific name Family Local name of Indication Part Method of preparation RFC UV Recorded literature uses of plant plant of the and administration (collection plant number) used
Phyllanthus niruri Phyllanthaceae Keelaneli Type 2 L Prepare a decoction of the leaves and 0.2 0.2 Antidiabeticoo L. (AM090) diabetes add 1 teaspoon of honey to the decoction (optional). Drink 1 cup twice per week Piper betle L. Piperaceae Betel Type 2 L Dry the leaves in bright sunlight 0.14 0.2 – (AM011) diabetes during the day and at night prepare an infusion and drink 1 cup thrice per week High level of L Dry the leaves in bright sunlight cholesterol during the day and at night prepare an infusion and drink 1 cup thrice per week Plantago afra L. Plantaginaceae – Cardiovascular L Prepare a decoction of the leaves and 0.01 0.01 – (AM084) disease drink 1 cup daily for 1 week Plantago major L. Plantaginaceae Plantain Cataract L Prepare an infusion with the leaves 0.19 0.23 Wound healing, diuretic, (AM028) and use it to clean the eyes antioxidant, antiviralpp Type 2 Fl Prepare a juice with 3–5 flowers and diabetes drink 1 cup thrice per week Prunella vulgaris Lamiaceae – Hypertension – Sold as Chinese anti–hypertensive 0.01 0.01 – L. tea. Prepare an infusion with the tea bags which contains Prunella vulgaris L. (Selfheal spike), Ramulus uncariae cumuncis, Fructus leonuri, Chinese oolomg tea. Drink 1 cup daily Psidium guajava Myrtaceae Goyave Type 2 L Prepare an infusion with 3 leaves and 0.26 0.26 Prevent cardiovascular L. (AM059) diabetes drink 1 cup daily for 1 week Type 2 Fr Consume rip fruit thrice per week complications associated with diabetes diabetes.qq Hypoglycemicrr Type 2 Fr Prepare a juice of the fruit and drink 1 diabetes cup daily for 1 week nPsiloxylon Myrtaceae Bigaignon Type 2 L Prepare a decoction of the leaves and 0.22 0.22 – mauritianum diabetes drink 1 cup twice per day (Bouton ex Hook.f.) Baill. (AM077) Type 2 L Prepare an infusion of the leaves diabetes together with Aphloia theiformis, Erythroxylum laurifolium and Asplenium nidus. Drink 1 cup daily for 1 week Punica granatum Lythraceae Grenade Cardiovascular Fr Prepare a juice with the pulp and 0.16 0.2 Antioxidant, antimutagenicss L. (AM054) disease water and drink 1 cup twice per week High level of Fr Prepare a juice with the pulp and cholesterol water and drink 1 cup twice per week Raphanus sativus Brassicaceae Rave Renal failure R, L Crush and press the root and the 0.01 0.01 Anti-ulcertt L. (AM067) leaves to obtain a juice and drink ½ cup twice per week Ravenala Strelitziaceae Ravenale Type 2 L Prepare a decoction of the leaves and 0.2 0.2 – madagascarien- diabetes drink 1 cup twice per week sis Sonn. (AM047) nRhizophora Rhizophoraceae Manglier Type 2 R Prepare an infusion of the roots and 0.34 0.34 – mucronata diabetes drink 1 cup twice per week Lam. (AM040) Rosa Hybrids Rosaceae Rose blanc Cataract Fl Prepare an infusion with the petals 0.06 0.06 – (AM069) and apply as compress on the eye Rosmarinus Lamiaceae Romarin Cardiovascular L Prepare a decoction with the leaves 0.07 0.07 Hepatoprotectiveuu, antibacterial vv, officinalis L. disease and drink 1 cup thrice per week diuretic ww, antidiabetic, (AM022) antioxidantxx Rubus alceifolius Rosaceae Piquant loulou Type 2 L Prepare a decoction with the leaves 0.25 0.25 – Poir. (AM015) diabetes and drink 1 cup twice per week Saccharum Poaceae Canne Cataract St The syrup obtained from the stem is 0.01 0.01 Immunostimulatory effectsyy officinarum L. used as an eyebath (AM094) Senna alata L. Caesalpiniaceae Quatre Hypertension L Prepare a decoction of the leaves and 0.18 0.18 Anti-allergiczz (Roxb.) épingles drink 1 cup twice per week (AM064) Hypertension L Prepare a decoction of the leaves together with Annona muricata and drink 1 cup twice per week 428 A. Mootoosamy, M. Fawzi Mahomoodally / Journal of Ethnopharmacology 151 (2014) 413–444
Table 6 (continued )
Scientific name Family Local name of Indication Part Method of preparation RFC UV Recorded literature uses of plant plant of the and administration (collection plant number) used
Senna occidentalis Caesalpinaceae Casse–piante Hypertension Se Grill the seeds with 1 teaspoon of 0.05 0.06 Antibacterial, antifungal, Link (AM066) sugar. Then allow it to soak in hot antidiabetic, anti–inflammatory, water for 1 night. Add milk and drink anticancerous, antimutagenic, 1 cup twice per week Gangrene R Prepare a decoction of the roots and hepatoprotective activityp drink 1 cup daily for 1 week Sigesbeckia Asteraceae Herbe de flacq Type 2 L Prepare a decoction of the leaves and 0.36 0.36 Anti-malarialaaa orientalis L. diabetes drink 1 cup twice per week (AM080) Type 2 L Prepare a decoction of the leaves diabetes together with Aphloia theiformis, Faujasiopsis flexuosa, Rubus alceifolius, Ravenala madagascariensis and Rhizophora mucronata. Drink 1 cup twice per week Solanum Solanaceae Pomme Cardiovascular Fr Prepare a juice with 4 fruits and add 1 0.01 0.01 – lycopersicum d'amour disease tablespoon of honey. Filter the juice Lam. (AM100) and drink 1 cup twice per week Solanum Solanaceae Anguive Type 2 Fr Cooked as a dish and eaten twice per 0.04 0.04 – melongena L. diabetes week (AM099)
Solanum Solanaceae Pomme de Pain Tu Crush and press to obtain juice and 0.14 0.27 – tuberosum L. terre apply on the painful area (AM021) Cataract Tu Cut the tuber into slices and place on the eyes daily. Type 2 Tu Prepare a juice with the tuber and diabetes drink ½ cup four times per day for 1 month Sonchus oleraceus Asteraceae Brède lastron Renal failure L Prepare a decoction of the leaves and 0.02 0.02 – (L.) (AM085) drink 1 cup thrice per week Spinacia oleracea Amaranthaceae Epinard High level of L Prepare a juice with a handful of 0.01 0.01 – L. cholesterol Spinacia oleracea L., a handful of Petroselinum crispum, 5 Daucus carota and 2 stalks of Apium graveolens. Drink 1 cup once per week Stevia rebaudiana Asteraceae Stevia Type 2 L Prepare an infusion of the leaves and 0.07 0.07 Antioxidant, anti-diabeticbbb (Bertoni) diabetes drink 1 cup daily for 1 week (AM044) Syzygium cumini Myrtaceae Jamblon Type 2 L Prepare a decoction with the leaves 0.31 0.31 Antidiabetic, antioxidant, anti- L. Skeels diabetes and drink 1 cup daily for 1 week inflammatory, antipyretic, anti- (AM012) allergic, anti-bacterial, gastro- protectiveccc Type 2 Fr Consume 10 ripe fruits thrice per diabetes week Type 2 Fr Prepare a juice with 1 cup of the fruits diabetes and 2 cups of water. Drink 1 cup twice per week Type 2 Se Prepare a decoction with the seeds diabetes and drink 1 cup twice per week Type 2 Fr Formulation contains Syzygium diabetes cumini and Momordica charantia. Drink 5–10 ml of the preparation with ½ glass of water twice per day Type 2 Fr Formulation contains Phyllanthus diabetes emblica, Terminalia chebula, Terminalia bellirica, Syzygium cumini, Picrorhiza kurroa, Swertia chirata, Tinospora cordifolia, Gymena sylvester, Momordica charantia, Curauma longa, Salacia chinesis Linn, Melia azadirachta. Drink 1 tablespoon twice per day Tamarindus Fabaceae Tamarin Hypertension Fr Prepare a juice with the pulp and 0.21 0.22 Laxative, wound healing, indica L. water and drink 1 cup twice per day abdominal pains, diarrhoea, (AM045) for 1 day helminth infections, fever, malaria, aphrodisiac, respiratory problems, dysenteryddd Pain L Prepare a foot bath with a decoction of the leaves mixed with 1 teaspoon of salt A. Mootoosamy, M. Fawzi Mahomoodally / Journal of Ethnopharmacology 151 (2014) 413–444 429
Table 6 (continued )
Scientific name Family Local name of Indication Part Method of preparation RFC UV Recorded literature uses of plant plant of the and administration (collection plant number) used
Taraxacum Asteraceae Pissenlit Type 2 R, L Prepare a decoction with 3–4 leaves 0.23 0.44 Antioxidant, anti-inflammatoryeee officinale Webb diabetes and their roots and drink a cup twice S.L. (AM001) daily for 1 week High level of L Prepare an infusion with 3–5 dried cholesterol leaves and allow infusing for 15 min. Drain to remove the leaves and drink 1 cup thrice daily for 1 week Gout L Prepare an infusion with 3–5 dried leaves and allow infusing for 15 min. Drain to remove the leaves and drink 1 cup thrice daily for 1 week Terminalia Combretaceae Badamier Type 2 L Prepare a decoction with the leaves 0.23 0.23 Anti-cancerfff catappa L. diabetes and drink 1 cup twice per week (AM030) Trigonella Fabaceae Methi Type 2 Se Prepare a decoction with the seeds 0.37 0.47 Anti-diabetic, anti-oxidant, foenum– diabetes and drink 1 cup thrice per week hypocholesterolemic effect, anti- graecum L. cataract activityggg (AM023) High level of Se Soak the seeds in 1 glass of water for cholesterol 1 night and drink the next morning on an empty stomach Erectile Se Prepare a decoction with 1 teaspoon dysfunction of seeds and 2 cup of water. Drink 1 cup on an empty stomach in the morning daily for 1 week Vangueria Rubiaceae Vavangue Type 2 L Prepare a decoction of the leaves and 0.58 0.68 – madagascarien- diabetes drink 1 cup twice per week sis J.F.Gmel. (AM078) Hypertension L Prepare a decoction of the leaves and drink 1 cup twice per week Vitis vinifera L. Vitaceae Raisin Type 2 Se Consume raw seeds daily for 1 week 0.05 0.05 Protect against skin cancer and (AM020) diabetes blood and arterial diseaseshhh Zingiber officinale Zingiberaceae Gingembre High level of R Prepare an infusion with the root and 0.1 0.1 – Roscoe cholesterol drink 1 cup twice per week (AM088) Numbness of R Prepare a paste with the root together the limbs with Allium sativum L. Apply as poultice on the affected area Unidentified – Bacoas Erectile R Prepare a decoction with the root and ––– (AM076) dysfunction drink 1 cup once per week Unidentified – Tirali (blanc) Type 2 L Prepare an infusion with the leaves ––– (AM101) diabetes and drink 2 cups thrice per week Unidentified – Verger canada Pain L Prepare a decoction with 5 leaves and ––– (AM097) drink 1 cup daily for 1 week nEndemic plants of Mauritius. UV: Use value, RFC: relative frequency of citation; plant part used: R, root; L, leaf; Fr, fruit; Se, seeds; W, whole plant; B, bulb; St, stem; Fl, flower; Tu, tuber; Tr, trunk; Gr, grain; O, oil; P, pod; Ba, bark. a Tongjaroenbuangam et al. (2011) b Rachid et al. (2012); c Sharma et al. (2010); d Chintamunnee and Mahomoodally (2012); e Wu et al. (2012a); f Zheng et al. (2010); g Jagtap and Bapat (2010); h Arung et al. (2010); i Zhang et al. (2012); j Shori (2012); k Abdou et al. (2010); l Sikora and Bodziarczyk (2012); m Akinloye and Olaniyi (2011); n Abeywickrama et al. (2011); o Otsuki et al. (2010); p Yadav et al. (2010); q Huang et al. (2011); r Pereira et al. 2010; s Neamsuvan et al. (2012); t Naskar et al. (2011); u Tarak et al. (2011); v Aissaoui et al. (2011); w Dalli et al. (2011); x Singh et al. (2010a); y Das et al. (2012); z Trojan-Rodrigues et al. (2012); aa Victoria et al. (2012); bb Wu et al. (2012b); cc Yarmolinsky et al. (2012); dd Olagbende-Dada et al. (2011); ee Sini et al. (2011); ddCruz et al. (2012); gg Schmidt et al. (2012); hh Yi et al. (2011); ii Cheenpracha et al. (2010); jj Dussossoy et al. (2011); kk Desai et al. (2012); ll Altinyay et al. (2011); mm Gomez-Flores et al. (2008); nn Saafi et al. (2011); oo Okoli et al. (2011); pp Zuhair et al. (2012); qq Soman et al. (2013); rr Ojewole (2005); ss Zahin et al. (2010); tt Devaraj et al. (2011); uu Sotelo-Felix et al. (2002); vv Del Campo et al. (2000); ww Haloui et al. (2000); xx Bakirel et al. (2008); yy Awais and Akhtar (2012); zz Singh et al. (2012b); aaa Stangeland et al. (2011); bbb Sharma et al. (2012b); ccc Renganathan et al. (2011); ddd Havinga et al. (2010); eee Park et al. (2011); fff Yang et al. (2010); ggg Hamza et al. (2012); hhh Lucker et al. (2010); iii Panseeta et al. (2011).
(FL¼100%) had the highest fidelity level for diabetic nephropathy. wounds. Coriandrum sativum (FL¼27.1%) has the lowest fidelity Botrychium pinnatum (Lam.) (FL¼100%) has the highest fidelity level for diabetes and Cynara cardunculus (FL¼6.0%) has the lowest level for diabetic neuropathy, Rubus hybrids (FL¼100%) has the fidelity level for musculoskeletal disorders category. highest fidelity level for eye diseases, Monodelphis domestica Allium sativum possessed the maximum number of pharmaco- (FL¼100%) and Zingiber officinale (FL¼100%) have the highest logical properties and PP value of 1.00(6/6), Ac value of 1.00 (5/5) fidelity level for high level of cholesterol. Murraya koenigii and RI value of 2.00 followed by RI value of 1.63 possessed by (FL¼100%), Asplenium nidus (FL¼100%), Luffa acutangula Allium cepa (Table 11). (FL¼100%, Annona muricata (FL¼100%), Sarracenia alata L. As summarized in Table 12, the highest values of CII were reached (FL¼100%) and Ziziphus mauritiana (FL¼100%) have the highest by Aloe vera (0.640) and Ocimum tenuiflorum (0.598). The lowest value fidelity level for hypertension. Cardiospermum halicacabum of IAR was reached by Crataegus laevigata (IAR¼0.923). The highest (FL¼18.3%) has the highest fidelity level for infections and values of CAI, calculated combining CII and IAR, were reached by Aloe 430 A. Mootoosamy, M. Fawzi Mahomoodally / Journal of Ethnopharmacology 151 (2014) 413–444
Table 7 Herb–drug interactions encountered by the diabetic interviewees.
Scientific name Local name Drug name Ailment Herb–drug interaction encountered No. of citations
Polyherbal.I Triphala Metformin Type 2 diabetes Weakness 2 Momordica charantia Margose Metformin Type 2 diabetes Weakness 13 Lagenaria siceraria Calebasse Metformin Type 2 diabetes Fatigue 3 Citrus aurantiifolia Limon Enapril hypertension Faintness 2 Morinda citrifolia Noni Atorvastatin High level of cholesterol Diarrhoea 1
Polyherbal.I: Phyllanthus emblica, Terminalia bellirica & Terminalia chebula var. chebula (Some interviewees reported more than one herb–drug interaction).
Table 8 Side effects from the use of HRs.
Scientific name Family Local name Ailment Complications/side effects Number of plant of citations
Piper betle Piperaceae Betel Type 2 Higher doses can affect the eyes adversely and lead to blindness. 3 diabetes Erythroxylum Erythroxylaceae Bois de ronde Renal failure Higher doses can lead to gastrointestinal tract toxicity characterized by vomiting 2 laurifolium and diarrhoea Phoenix dactylifera Arecaceae Tam Type 2 Higher doses can affect the eyes adversely. 6 diabetes Coix lacryma-jobi Poaceae Colier cipaye Renal failure Causes gastrointestinal tract problems characterized by vomiting and diarrhea 5 Citrus maxima Rutaceae Pamplemousse Type 2 Higher doses can lead to gastrointestinal tract toxicity characterized by vomiting 3 diabetes and diarrhea Azadirachta indica Meliaceae Neem, lila Type 2 Higher doses can affect the eyes adversely. 4 perche diabetes Trigonella foenum- Fabaceae Methi Type 2 Higher doses can affect the eyes adversely and lead to blindness. Higher doses can 9 graecum diabetes also lead to weakness Murraya koenigii Rutaceae Carripoulet Hypertension Higher doses can affect the eyes adversely and lead to blindness 8 Lagenaria siceraria Cucurbitaceae Calbasse Type 2 Causes gastrointestinal tract problems characterized by diarrhoea and vomiting 2 diabetes Rubus alceifolius Rosaceae Piquant loulou Type 2 Higher doses can affect the eyes adversely and lead to blindness 7 diabetes Momordica Cucurbitaceae Margose Type 2 Higher doses lead to weakness 6 charantia diabetes Aloe vera Xanthorrhoeaceae Aloe vera Type 2 Causes loose motion 9 diabetes Rhizophora Rhizophoraceae Manglier Type 2 Higher doses lead to hypertension 2 mucronata diabetes Atropa belladonna Solanaceae Belladonne Pain Higher doses lead to delirium and increase heart beat 1
Some informants reported more than 1 side effect.
Table 9 Categories of ailments and informant consensus factor for plants.
CA Ailments CB CC FIC
Diabetic angiopathy Atherosclerosis, cardiovascular disease 10 181 0.95 Diabetic nephropathy Renal failure 16 173 0.91 Diabetic neuropathy Pain, erectile dysfunction, hearing loss 9 115 0.93 Eye diseases Cataracts 15 246 0.94 Diabetic dyslipidemia High level of cholesterol 22 651 0.97 Hypertension Hypertension 22 1004 0.98 Infections and wounds Ulcers, gangrene, wound healing 11 89 0.89 Diabetes Type 1 diabetes, Type 2 diabetes 62 4585 0.99 Musculoskeletal disorders Gout 6 54 0.91
CA ¼Disease category. CB¼Number of species for the disease category. CC¼Number of citations for the disease category. FIC¼Informant consensus factor¼(CC CB)/(CC 1) (Phanuel et al., 2010).
vera (CAI¼0.635), followed by Ocimum tenuiflorum (CAI¼0.592) and calculated by combining QUV and IAR was reached by Psidium guajava Vangueria madagascariensis (CAI¼0.575). (QUAV¼0.961) followed by Phyllanthus emblica (QUAV¼0.952). As summarized in Table 13, the highest QUV value was reached by The total flora of the study area was obtained from Republic of Allium cepa (QUV¼ 0.965) followed by Psidium guajava (QUV¼0.961) Mauritius, (ROM) (2011). The flora of Mauritius consists of about and Phyllanthus emblica (QUV¼0.961). The highest value of QUAV, 685 plant species and among them 111 plant species have been A. Mootoosamy, M. Fawzi Mahomoodally / Journal of Ethnopharmacology 151 (2014) 413–444 431
Table 10 Fidelity level values of medicinal plants cited by 10 or more informants for being used against a given ailment category.
Illness category Medicinal plants Npa Nb FL valuec (%)
Diabetic angiopathy Rosmarinus officinalis 23 23 100.0 Cynara cardunculus 31 167 18.6 Punica granatum 36 56 64.3 Aloysia citriodora 39 39 100.0 Olea europaea 17 132 12.9
Diabetic nephropathy Allium cepa 14 116 12.1 Citrus aurantiifolia 10 150 6.7 Cajanus cajan 10 10 100.0 Coix lacryma-jobi 25 25 100.0 Cocos nucifera 13 87 4.9 Erythroxylum laurifolium 26 26 100.0 Hordeum vulgare 11 11 100.0 Artemisia verlotiorum 13 13 100.0
Diabetic neuropathy Morinda citrifolia 13 197 6.6 Solanum tuberosum 23 49 46.9 Euphorbia hirta 15 67 22.4 Tamarindus indica 21 73 28.8 Curcuma longa 19 35 54.3 Bryophyllum pinnatum 12 12 100.0
Eye diseases Rosa Hybrids 22 22 100.0 Brassica oleracea 24 146 16.4 Allium sativum 18 177 10.2 Cucurbita maxima 13 68 19.1 Ocimum tenuiflorum 40 208 19.2 Plantago major 37 66 56.1 Euphorbia hirta 10 67 14.9 Aphloia theiformis 15 96 15.6 Camellia sinensis 14 184 7.6 Cocos nucifera 26 87 29.9
Diabetic dyslipidemia Taraxacum officinale 22 80 27.5 Aloe vera 39 223 17.5 Morinda citrifolia 36 197 18.3 Linum usitatissimum 18 60 30.0 Allium cepa 29 116 25.0 Piper betle 19 50 38.0 Moringa oleifera 43 129 33.3 Lagenaria siceraria 19 165 11.5 Trigonella foenum-graecum 27 129 20.9 Phyllanthus emblica 32 116 27.6 Petroselinum crispum 28 119 23.5 Citrus maxima 42 165 25.5 Cynara cardunculus 29 167 17.4 Malus domestica 18 18 100.0 Carica papaya 23 70 32.9 Punica granatum 20 56 35.7 Avena sativa 42 93 45.2 Camellia sinensis 29 184 15.8 Coriandrum sativum 51 70 72.9 Zingiber officinale 35 35 100.0 Persea americana 44 49 89.8
Hypertension Morinda citrifolia 42 197 21.3 Allium sativum 32 177 18.1 Moringa oleifera 47 129 36.4 Lagenaria siceraria 32 165 19.4 Ocimum tenuiflorum 58 208 27.9 Citrus aurantiifolia 59 150 39.3 Murraya koenigii 62 62 100 Apium graveolens 52 133 39.1 Asplenium nidus 28 28 100 Tamarindus indica 52 73 71.2 Carica papaya 47 70 67.1 Luffa acutangula 50 50 100 Crataegus laevigata 22 40 55 Camellia sinensis 58 184 31.5 Annona muricata 52 52 100 Bidens pilosa 57 146 39 Senna alata 62 62 100 Ziziphus mauritiana 40 40 100 Olea europaea 63 132 47.7 Vangueria madagascariensis 49 201 24.4
Infections and wounds Cardiospermum halicacabum 17 93 18.3 Brassica oleracea 19 146 13 432 A. Mootoosamy, M. Fawzi Mahomoodally / Journal of Ethnopharmacology 151 (2014) 413–444
Table 10 (continued )
Illness category Medicinal plants Npa Nb FL valuec (%)
Diabetes Taraxacum officinale 52 80 65 Solanum melongena 15 15 100 Momordica charantia 192 192 100 Aloe vera 179 223 80.3 Morinda citrifolia 106 197 53.8 Linum usitatissimum 37 60 61.7 Orthosiphon aristatus 39 46 84.8 Allium cepa 68 116 58.6 Allium sativum 109 177 61.6 Coriandrum sativum 19 70 27.1 Piper betle 31 50 62 Catharanthus roseus 82 82 100 Syzygium cumini 107 107 100 Eugenia uniflora 27 27 100 Musa acuminata 45 57 78.9 Rubus alceifolius 86 86 100 Moringa oleifera 39 129 30.2 Lagenaria siceraria 114 165 69.1 Cucurbita maxima 39 68 57.4 Vitis vinifera 17 17 100 Solanum tuberosum 17 49 34.7 Trigonella foenum-graecum 98 129 76 Artocarpus heteophyllus 87 87 100 Ocimum tenuiflorum 110 208 52.9 Phyllanthus emblica 84 116 72.4 Phoenix dactylifera 68 68 100 Plantago major 29 66 43.9 Euphorbia hirta 42 67 62.7 Terminalia catappa 81 81 100 Citrus aurantiifolia 67 150 44.7 Apium graveolens 74 133 55.6 Petroselinum crispum 82 119 68.9 Citrus maxima 123 165 74.5 Azadirachta indica 136 136 100 Rhizophora mucronata 117 117 100 Cynara cardunculus 97 167 58.1 Aphloia theiformis 81 96 84.4 Stevia rebaudiana 23 23 100 Cocos nucifera 48 87 55.2 Ravenala madagascariensis 71 71 100 Magnifera indica 107 107 100 Lactuca sativa 28 28 100 Avena sativa 51 93 54.8 Camellia sinensis 83 184 45.1 Psidium guajava 91 91 100 Bidens pilosa 89 146 61 Glechoma bederaceae 42 42 100 Cardiospermum halicacabum 76 93 81.7 Artocarpus altilis 14 14 100 Psiloxylon mauritianum 75 75 100 Vangueria madagascariensis 152 201 75.6 Faujasiopsis flexuosa 79 79 100 Sigesbeckia orientalis 124 124 100 Cucumis sativus 97 97 100 Eucalyptus globulus 83 83 100 Phyllanthus niruri 69 69 100 Brassica oleracea 94 146 64.4 Nasturtium officinale 85 85 100 Olea europaea 52 132 39.4 Phaseolus vulgaris 26 26 100 Graptophyllum pictum 127 127 100
Musculoskeletal disorders Musa acuminata 12 57 21.1 Citrus aurantiifolia 14 150 9.3 Cynara cardunculus 10 167 6
a Np¼The number of informants who independently indicated the use of a species for the same major ailment. b N¼Total number of informants who mentioned the plant for any major aliment. c Fidelity level (FL)¼(Np/N) 100 (Jacobo-Salcedo et al., 2011). A. Mootoosamy, M. Fawzi Mahomoodally / Journal of Ethnopharmacology 151 (2014) 413–444 433
Table 11 Relative importance values of medicinal plants used against two or more specific ailments and two or more aliments categories treated.
Species aPP bAC RIc
Allium cepa 0.83 0.80 1.63 Allium sativum 1.00 1.00 2.00 Aloe vera 0.50 0.60 1.10 Ananas comosus 0.50 0.60 1.10 Aphloia theiformis 0.33 0.40 0.73 Avena sativa 0.33 0.40 0.73 Bidens pilosa 0.33 0.40 0.73 Brassica oleracea 0.67 0.80 1.47 Camellia sinensis 0.67 0.80 1.47 Cardiospermum halicacabum 0.33 0.40 0.73 Cynara cardunculus 0.67 0.80 1.47 Carica papaya 0.33 0.40 0.73 Citrus aurantiifolia 0.67 0.80 1.47 Citrus maxima 0.33 0.40 0.73 Cocos nucifera 0.50 0.60 1.10 Coriandrum sativum 0.33 0.40 0.73 Crataegus laevigata 0.67 0.80 1.47 Curcuma longa 0.50 0.60 1.10 Cucurbita maxima 0.67 0.80 1.47 Euphorbia hirta 0.50 0.60 1.10 Lagenaria siceraria 0.50 0.60 1.10 Linum usitatissimum 0.50 0.60 1.10 Morinda citrifolia 0.67 0.80 1.47 Moringa oleifera 0.50 0.60 1.10 Musa acuminata 0.33 0.40 0.73 Ocimum tenuiflorum 0.50 0.60 1.10 Olea europaea 0.67 0.60 1.27 Orthosiphon aristatus 0.33 0.40 0.73 Persea americana 0.33 0.40 0.73 Petroselinum crispum 0.50 0.60 1.10 Phyllanthus emblica 0.33 0.40 0.73 Piper betle 0.33 0.40 0.73 Plantago major 0.33 0.40 0.73 Punica granatum 0.33 0.40 0.73 Senna occidentalis 0.33 0.40 0.73 Solanum tuberosum 0.50 0.60 1.10 Tamarindus indica 0.33 0.40 0.73 Taraxacum officinale 0.50 0.60 1.10 Trigonella foenum-graecum 0.50 0.60 1.10 Vangueria madagascariensis 0.33 0.40 0.73
a PP¼The number of pharmacological properties (reported specific ailments) attributed to a species divided by the maximum number of properties attributed to the most resourceful species (species with the highest number of properties). b AC¼The number of ailment categories treated by a given species divided by the maximum number of ailment categories treated by the most resourceful species. c RI¼PPþAC (Kadir et al., 2012a). reported in the current study for their use against diabetes and interviewees (75%) reported that there was an improvement in DRCs. Hence an EI¼(111/685) 100; EI¼16.2% was recorded. their health after using ARs. As depicted in Table 16, it was found that eye diseases (FIC¼ 0.94) and hypertension (FIC¼0.94) had the highest agreement 3.5. Animal-based remedies used against diabetes and DRCs among the informants. Diabetic neuropathy category has the lowest FIC of 0.64. The majority of the participants interviewed (95.1%) were As shown in Table 17 most of the animal species scored a high found not to use animal- based remedies (ARs) on a regular basis FL value of 100%, except Cetoscarus bicolor which scored the lowest as compared to HRs. FL value (30%) for musculoskeletal disorders. Table 14 illustrates that the majority (n¼13) of participants responded that ARs have no side effects. Only a minority (n¼8) of interviewees reported that ARs were efficient. 4. Discussion A total of 16 different animal-based remedies (ARs) were documented during the present study. Table 15 summarized the 4.1. Demographic characteristics ARs used against diabetes and DRCs reported by the key infor- mants. Table 15 provides the following information for each The present study reported a significant relationship between animal species: scientific name, family name, local/ vernacular gender and the use of NRs against diabetes and DRCs. We observed name, part of the animal used, indication, dosage and preparation, that women were the more frequent users of NRs as they are UV and any relevant scientific reference(s). generally more involved in handling minor health issues in the Interestingly, mammals were mentioned 13 times of the total family. Similar observation was reported by Rachid et al. (2012) number of citations for zootherapies. Fish was the most commonly where it was found that women are more common users of HRs used with a citation frequency of 33 (39.8%) compared to the because of their attachment to traditional knowledge. However, a least used species, reptile (22.4%). Moreover, the majority of the recent study showed that acquisition of traditional knowledge was 434 A. Mootoosamy, M. Fawzi Mahomoodally / Journal of Ethnopharmacology 151 (2014) 413–444
Table 12 Cultural importance index, index of agreement on remedies and cultural agreement index of plant species cited by 25 informants or more.
Species 1 2 3 4 5 6 7 8 9 Total CII IAR CAI
Taraxacum officinale ––––0.063 ––0.149 0.017 0.229 0.975 0.224 Momordica charantia –––––––0.552 – 0.552 1.000 0.552 Aloe vera ––––0.112 – 0.014 0.514 – 0.640 0.991 0.635 Morinda citrifolia ––0.037 – 0.103 0.121 – 0.305 – 0.566 0.985 0.557 Linum usitatissimum – 0.014 ––0.052 ––0.106 – 0.172 0.966 0.167 Orthosiphon aristatus –––––––0.112 0.020 0.132 0.978 0.129 Allium cepa – 0.040 – 0.014 0.083 ––0.195 – 0.333 0.974 0.325 Allium sativum – 0.020 – 0.052 – 0.092 0.032 0.313 – 0.509 0.977 0.497 Coriandrum sativum ––––0.147 ––0.055 – 0.201 0.986 0.198 Piper betle ––––0.055 ––0.089 – 0.144 0.980 0.141 Catharanthus roseus –––––––0.236 – 0.236 1.000 0.236 Syzygium cumini –––––––0.307 – 0.307 1.000 0.307 Eugenia uniflora –––––––0.078 – 0.078 1.000 0.078 Musa acuminata –––––––0.129 0.034 0.164 0.982 0.161 Rubus alceifolius –––––––0.247 – 0.247 1.000 0.247 Moringa oleifera ––––0.124 0.135 – 0.112 – 0.371 0.984 0.365 Lagenaria siceraria ––––0.055 0.092 – 0.328 – 0.474 0.988 0.468 Cucurbita maxima – 0.026 – 0.037 ––0.020 0.112 – 0.195 0.955 0.187 Solanum tuberosum ––0.066 0.026 –––0.049 – 0.141 0.958 0.135 Rosmarinus officinalis 0.066 ––––––––0.066 1.000 0.066 Trigonella foenum–graecum –––0.011 0.078 ––0.282 – 0.371 0.984 0.365 Artocarpus heteophyllus –––––––0.250 – 0.250 1.000 0.250 Ocimum tenuiflorum –––0.115 – 0.167 – 0.316 – 0.598 0.990 0.592 Phyllanthus emblica ––––0.092 ––0.241 – 0.333 0.991 0.330 Phoenix dactylifera –––––––0.195 – 0.195 1.000 0.195 Plantago major –––0.106 –––0.083 – 0.189 0.985 0.186 Euphorbia hirta ––0.043 0.029 –––0.121 – 0.193 0.970 0.187 Terminalia catappa –––––––0.233 – 0.233 1.000 0.233 Citrus aurantiifolia – 0.029 –––0.170 – 0.193 0.040 0.431 0.980 0.422 Murraya koenigii –––––0.178 –––0.178 1.000 0.178 Apium graveolens –––––0.149 – 0.213 0.020 0.382 0.984 0.376 Petroselinum crispum – 0.026 ––0.080 ––0.236 – 0.342 0.983 0.336 Citrus maxima ––––0.121 ––0.353 – 0.474 0.994 0.471 Azadirachta indica –––––––0.391 – 0.391 1.000 0.391 Asplenium nidus –––––0.080 –––0.080 1.000 0.080 Rhizophora mucronata –––––––0.336 – 0.336 1.000 0.336 Coix lacryma–jobi – 0.072 –––––––0.072 1.000 0.072 Glechoma bederaceae –––––––0.121 – 0.121 1.000 0.121 Cynara cardunculus 0.089 –––0.083 ––0.279 0.029 0.480 0.982 0.471 Aphloia theiformis –––0.043 – - – 0.233 – 0.276 0.989 0.273 Tamarindus indica ––0.060 ––0.149 –––0.210 0.986 0.207 Cocos nucifera – 0.037 – 0.075 –––0.138 – 0.250 0.977 0.244 Ravenala madagascariensis –––––––0.204 – 0.204 1.000 0.204 Curcuma longa 0.023 – 0.055 0.023 –––––0.101 0.941 0.095 Carica papaya ––––0.067 0.135 –––0.201 0.986 0.198 Luffa acutangula –––––0.144 –––0.144 1.000 0.144 Magnifera indica –––––––0.307 – 0.307 1.000 0.307 Punica granatum 0.103 –––0.057 ––––0.161 0.982 0.158 Lactuca sativa –––- –– – – 0.080 – 0.080 1.000 0.080 Avena sativa ––––0.121 ––0.147 – 0.267 0.989 0.264 Crataegus laevigata 0.026 ––0.009 0.017 0.063 –––0.115 0.923 0.106 Camellia sinensis –––0.040 0.083 0.167 – 0.239 – 0.529 0.984 0.520 Psidium guajava –––––––0.261 – 0.261 1.000 0.261 Annona muricata –––––0.149 –––0.149 1.000 0.149 Erythroxylum laurifolium – 0.075 –––––––0.075 1.000 0.075 Bidens pilosa –––––0.164 – 0.256 – 0.419 0.993 0.417 Senna alata –––––0.178 –––0.178 1.000 0.178 Ziziphus mauritiana –––––0.115 –––0.115 1.000 0.115 Cardiospermum halicacabum ––––––0.049 0.218 – 0.267 0.989 0.264 Aloysia citriodora 0.141 ––––––––0.141 1.000 0.141 Psiloxylon mauritianum –––––––0.216 – 0.216 1.000 0.216 Vangueria madagascariensis –––––0.141 – 0.437 – 0.578 0.995 0.575 Faujasiopsis flexuosa –––––––0.227 – 0.227 1.000 0.227 Sigesbeckia orientalis –––––––0.356 – 0.356 1.000 0.356 Zingiber officinale ––––0.101 ––––0.101 1.000 0.101 Cucumis sativus –––––––0.279 – 0.279 1.000 0.279 Eucalyptus globulus –––––––0.239 – 0.239 1.000 0.239 Phyllanthus niruri –––––––0.198 – 0.198 1.000 0.198 Brassica oleracea 0.026 ––0.069 ––0.055 0.270 – 0.419 0.979 0.411 Nasturtium officinale –––––––0.244 – 0.244 1.000 0.244 Manihot esculenta –––––0.095 –––0.095 1.000 0.095 Olea europaea 0.049 ––––0.181 – 0.149 – 0.379 0.985 0.373 A. Mootoosamy, M. Fawzi Mahomoodally / Journal of Ethnopharmacology 151 (2014) 413–444 435
Table 12 (continued )
Species 1 2 3 4 5 6 7 8 9 Total CII IAR CAI
Persea americana –––0.014 0.126 ––––0.141 0.979 0.138 Phaseolus vulgaris –––––––0.075 – 0.075 1.000 0.075 Graptophyllum pictum –––––––0.365 – 0.365 1.000 0.365
1: Diabetic angiopathy, 2: diabetic nephropathy, 3: diabetic neuropathy, 4: eye diseases, 5: diabetic dyslipidemia, 6: hypertension, 7: infections and wounds, 8: diabetes, 9: musculoskeletal disorders. CII: cultural importance index, IAR: index of agreement on remedies, CAI: cultural agreement index.
Table 13 Quality use value, index of agreement on remedies and quality use agreement value of medicinal plant species cited by 30 or more informants.
Scientific name Family QUV IAR QUAV
Taraxacum officinale Asteraceae 0.888 0.975 0.866 Momordica charantia Cucurbitaceae 0.744 1.000 0.744 Aloe vera Xanthorrhoeaceae 0.743 0.991 0.736 Morinda citrifolia Rubiaceae 0.725 0.985 0.714 Linum usitatissimum Linaceae. 0.900 0.966 0.869 Orthosiphon aristatus Lamiaceae 0.887 0.958 0.850 Allium cepa Amaryllidaceae 0.965 0.974 0.940 Allium sativum Amaryllidaceae 0.807 0.977 0.788 Coriandrum sativum Apiaceae 0.885 0.986 0.873 Piper betle Piperaceae 0.870 0.980 0.853 Catharanthus roseus Apocynaceae 0.870 1.000 0.870 Syzygium cumini Myrtaceae 0.869 1.000 0.869 Musa acuminata Musaceae 0.728 0.982 0.715 Rubus alceifolius Rosaceae 0.773 1.000 0.773 Moringa oleifera Moringaceae 0.893 0.984 0.879 Lagenaria siceraria Cucurbitaceae 0.824 0.988 0.814 Cucurbita maxima Cucurbitaceae 0.808 0.955 0.772 Solanum tuberosum Solanaceae 0.775 0.958 0.742 Trigonella foenum-graecum Fabaceae 0.864 0.984 0.850 Artocarpus heteophyllus Moraceae 0.896 1.000 0.896 Ocimum tenuiflorum Lamiaceae 0.903 0.990 0.894 Phyllanthus emblica Phyllanthaceae 0.961 0.991 0.952 Phoenix dactylifera Arecaceae 0.860 1.000 0.860 Euphorbia hirta Euphorbiaceae 0.708 0.970 0.687 Terminalia catappa Combretaceae 0.833 1.000 0.833 Citrus aurantiifolia Rutaceae 0.813 0.994 0.808 Avena sativa Poaceae 0.790 0.989 0.781 Murraya koenigii Rutaceae 0.903 1.000 0.903 Cocos nucifera Arecaceae 0.867 0.977 0.847 Apium graveolens Apiaceae 0.834 0.984 0.821 Petroselinum crispum Apiaceae 0.865 0.983 0.850 Citrus maxima Rutaceae 0.757 0.994 0.752 Azadirachta indica Meliaceae 0.852 1.000 0.852 Rhizophora mucronata Rhizophoraceae 0.850 1.000 0.850 Cynara cardunculus Asteraceae 0.766 0.982 0.752 Aphloia theiformis Aphloiaceae 0.796 0.989 0.787 Tamarindus indica Fabaceae 0.808 0.986 0.797 Camellia sinensis Theaceae 0.836 0.984 0.823 Ravenala madagascariensis Strelitziaceae 0.802 1.000 0.802 Curcuma longa Zingiberaceae 0.914 0.941 0.860 Carica papaya Caricaceae 0.792 0.986 0.781 Luffa acutangula Cucurbitaceae 0.890 1.000 0.890 Magnifera indica Anacardiaceae 0.911 1.000 0.911 Punica granatum Lythraceae 0.830 0.982 0.815 Crataegus laevigata Rosaceae 0.862 0.923 0.796 Eucalyptus globulus Myrtaceae 0.945 1.000 0.945 Psidium guajava Myrtaceae 0.961 1.000 0.961 Annona muricata Annonaceae 0.826 1.000 0.826 Bidens pilosa Asteraceae 0.869 0.993 0.863 Glechoma hederacea Lamiaceae 0.869 1.000 0.869 Senna alata Caesalpiniaceae 0.879 1.000 0.879 Aloysia citriodora Verbenaceae 0.820 0.981 0.804 Ziziphus mauritiana Rhamnaceae 0.887 1.000 0.887 Cardiospermum halicacabum Sapindaceae 0.887 0.989 0.877 Psiloxylon mauritianum Myrtaceae 0.860 1.000 0.860 Vangueria madagascariensis Rubiaceae 0.815 0.995 0.811 Faujasiopsis flexuosa Asteraceae 0.867 1.000 0.867 Sigesbeckia orientalis Asteraceae 0.895 1.000 0.895 Olea europaea Oleaceae 0.810 0.985 0.798 Zingiber officinale Zingiberaceae 0.800 1.000 0.800 Cucumis sativus Cucurbitaceae 0.819 1.000 0.819 436 A. Mootoosamy, M. Fawzi Mahomoodally / Journal of Ethnopharmacology 151 (2014) 413–444
Table 13 (continued )
Scientific name Family QUV IAR QUAV
Phyllanthus niruri Phyllanthaceae 0.876 1.000 0.876 Brassica oleracea Brassicaceae 0.863 0.979 0.845 Nasturtium officinale Brassicaceae 0.935 1.000 0.935 Manihot esculenta Euphorbiaceae 0.863 1.000 0.863 Graptophyllum pictum Acanthaceae 0.776 1.000 0.776 Persea americana Lauraceae 0.816 0.979 0.799
QUV: Quality use value, IAR: index of agreement on remedies, QUAV: quality use agreement value. The top 10 species according to QUV and QUAV values are underlined in the corresponding columns.
Table 14 Our study also showed that the majority of the diabetic Assessment of different reasons behind the preference to use ARs. participants developed DRCs after 6–10 years after being diag- nosed with diabetes. Jain et al. (2011) reported that hyperglycemia Answers descending in how frequently Frequencya it was given (often more than one answer play a fundamental role in the pathogenesis of DRCs by several was given by the same interviewee) mechanisms; for instance, increased aldose reductase-related polyol pathway flux, increased formation of advanced glycation Animal-based remedies have no side effects 13 end products (AGEs), over expression of AGE receptor, activation of Animal-based remedies are easily available 11 Animal-based remedies are cheaper than allopathic medicines 9 protein kinase C isoform and excessive oxidative stress including Animal-based remedies are efficient 8 superoxide overproduction, glucose autoxidation and protein glycation. a Number of times the specific answer was given. 4.2. TMPs’ knowledge on diabetes and DRCs
The TMPs were found to possess a relatively good knowledge of not always influenced by gender (Bruschi et al., 2011). We also diabetes based on their ability to recognise signs and symptoms observed that the majority of TMPs were males which corrobo- common to diabetes and DRCs. For instance, frequent urination rates with the work of Chellappandian et al. (2012) which and increased hunger were quoted as common means of confirm- documented that traditional medicine is almost a male-exclusive ing diabetes. Moreover, they were well documented on the domain. Moreover, a positive correlation was found between age complications that diabetes entails such as high blood pressure, and the use of NRs. This can be explained by the fact that the elder gangrene and cardiovascular diseases. They identified consump- population is more prone to the use of traditional remedies given tion of sugary foods and drinks and lack of physical activity as their deep knowledge in traditional medicines as opposed to the some of the predisposing factors for diabetes. Regardless of the younger population. Similar finding was reported by Barner et al. cultural differences, our study demonstrated that the TMPs in (2010) where old people were observed to be the most common Mauritius claim to diagnose diabetes the same way as the TMPs in users of traditional medicines. However, a recent study reported Kenya by relying on patient confession and on laboratory report that age does not always have an effect on the use of traditional (Keter and Mutiso, 2012). medicine (Spinks et al., 2013). Place of residence was also found to influence the use of NRs. 4.3. HRs used against diabetes and DRCs Our result showed a significant relationship between place of residence and the use of NRs. This could be due to the fact that HR is an important part of the Mauritian's culture and besides inhabitants of rural areas have less access to health care facilities its cultural significance; they are easily accessible and affordable as and hence have recourse to NRs for the treatment and/or manage- compared to conventional drugs. The perception that HRs are free ment of diabetes and DRCs. This hypothesis is supported by the from side effects are claimed by most participants when ques- work of Cakilcioglu et al. (2011) whereby the majority of the tioned about their preference to use HRs. Many studies have people living in rural areas traditionally use plants for nourish- reported the pharmacological properties of plants used in the ment and medical purposes. In the present study, a negative treatment and management of diabetes and DRCs (Jung et al., correlation was found between the academic background of the 2006; Singh et al., 2010b; Jain et al., 2011; Kavishankar et al., 2011). participants and the use of NRs. People with low academic back- Indeed medicinal plants yield potential therapeutic compounds ground were found to be the more common users of NRs. This can against diabetes and DRCs which corroborate with the high be explained by the fact that highly educated people believe more preference of HRs observed among the participants in the present in the efficacy of allopathic medicine. study. Moreover, transmission of traditional knowledge was high- Income was found to have a significant impact on the use of est among family members and friends. Oral transmission of NRs which can be justified by the cheap cost of HRs and hence are traditional knowledge is the most prevalent means of passing on more affordable to people belonging to low economic background. traditional knowledge. Our result is similar to previous studies Interestingly, Tag et al. (2012) reported that a large portion of which reported that family members were the highest source of underprivileged people still rely on alternative medicines for the knowledge of HRs (Tarak et al., 2011; Tag et al., 2012). Interestingly treatment and management of various ailments. Furthermore, our our result showed that media was the second highest source of study showed a significant relationship between religious belief knowledge of traditional medicine. This can be explained by the and the use of NRs. Our result demonstrated that people belonging fact that people are easily influenced by the media and similar to the Hindu community were the more common users of NRs observation was obtained from the work of Alzweiri et al. (2011) and this can be explained by their deep knowledge in ayurvedic who reported that traditional knowledge of the younger genera- medicine. tion depends on what they hear from the media. A. Mootoosamy, M. Fawzi Mahomoodally / Journal of Ethnopharmacology 151 (2014) 413–444 437
Table 15 Inventory of animal species used against diabetes and DRCs by Mauritians.
Class Vernacular Scientific Parts Indication Prescription UV Reported literature uses name name used
Insecta Bee Mouche di Apis mellifera Honey Cataract A small amount is instilled in the eye daily. 0.03 Eye problems such as blindness and miel inflammations.a Stomach diseases, hemorrhoids, burns, wounds.b Cockroach Cancrela Periplaneta Whole Gangrene Prepare an infusion with 4 cockroaches and 1 handful of 0.02 Asthma.c americana body Petroselinum crispum. Filter in a cloth and drink 1 cup daily.
Mammalia Common Tang Tenrec Whole Renal failure A dish of the body is prepared using Cinnamomum verum, 0.03 – tenrec ecaudatus body Syzygium aromaticum, Murraya koenigii and 1 cup of white wine. The dish is taken once per week. Rat Le rat Rattus rattus Whole Wound The animal is placed in a bottle of coconut oil for 1-2 days 0.01 Reduce pain after conception.d body and the oil is then applied on the wound. Monkey Zako/ Macaca Bones Pain A decoction of the bones is prepared and it is taken twice 0.01 – macaque fascicularis per week.
Chondrichthyes Shark Rekin Sphyrna Fin Renal failure A soup of the fin is prepared and it is taken once per 0.01 Asthma, wounds, rheumatism, marteau mokarran week. inflammation.e
Actinopterygii Old red Vielle rouge Epinephelus Whole Hypertension A dish of the whole body is prepared and it is taken once 0.03 – fasciatus body per week. Parrotfish Cateau Cetoscarus Whole Hypertension A dish of the whole body is prepared and it is taken once 0.03 – bicolor body per week. Gout A dish of the whole body is prepared and it is taken twice per week. Salmon Saumon Salmo salar Whole Type 2 A dish of the whole body is prepared and it is taken once 0.02 Good source of omega-3c body diabetes per week. Eel Anguille Anguilla Skin Pain The skin is peeled and dried in bright sunlight. The dried 0.01 Ear infectionf japonica skin is then placed in a bottle of oil. Massage the painful area daily using this oil. Sea horse Hyppocampe Hippocampus Whole Erectile The whole body is dried in bright sunlight and prepared 0.01 – borboniensis body dysfunction as a soup which is administered once per week.
Gastopoda Snail Courpa Helix aspersa Whole Cataract The whole body is crushed to obtain a white liquid and 2 0.02 Hemorrhoidsb body drops of the liquid is instilled in the eye.
Chilopoda Centipede Centpieds Scutigera Whole Pain Insert the whole body in a bottle of alcohol for 2-3 days. 0.01 – coleoptrata body Massage the painful area daily using this alcohol.
Aves Pigeon Pizon/Pigeon Columba livia Whole Type 2 A soup of the young ones is prepared and it is taken once 0.01 Anemiag body diabetes per week. Duck Canard Anas Eggs Erectile Eggs are boiled and consumed twice per week. 0.01 – Platyrhynchos dysfunction
Reptilia Lizard Lezard Hemidactylus Whole Erectile The whole body is dried in bright sunlight, crushed, 0.01 – frenatus body dysfunction mixed with Chinese herbs and prepared as a tea which s taken once per week.
a Souto et al. (2011). b Lev (2006). c Costa-Neto and Oliveira (2000). d Chakravorty et al. (2011). e Alves and Alves (2011). f Nunkoo and Mahomoodally (2012). g Jacobo-Salcedo et al., 2011.
We recorded a large number of medicinal plants to be tradi- reported during the present investigation, 8 endemic plants tionally used against diabetes and DRCs in Mauritius. Out of 111 species to Mauritius namely, Erythroxylum laurifolium, Faujasiopsis plants reported (distributed over 56 families); Asteraceae was flexuosa, Psiloxylon mauritianum, Asplenium nidus, Aphloia theifor- found to the most represented family with the highest number mis, Olea europaea, Pandanus sp., and Rhizophora mucronata have of species (nine species). Semenya et al. (2012) also reported been documented for the first time, despite their low availability Asteraceae as being the most represented family and Erasto et al. are still used by Mauritians against diabetes and DRCs. This (2005) reported Asteraceae as the most commonly used family in demonstrates that the local population has left no stone unturned the treatment of diabetes. Asteraceae comprises of around 25,000 in exploring the rich biodiversity of the island. species and 1400 genera and the importance of this family can be When questioned about the source of the HRs, participants attributed to its wide range of distribution (Gurib-Fakim, 2006; responded that they obtained the medicinal plants from their Thomas et al., 2009). Based on the primary ethnobotanical data home gardens. In home garden medicinal plants are grown in pots 438 A. Mootoosamy, M. Fawzi Mahomoodally / Journal of Ethnopharmacology 151 (2014) 413–444
Table 16 Categories of ailments and informant consensus factor for zootherapies.
CA Ailments CB CC FIC
Diabetic nephropathy Renal failure 2 12 0.91 Diabetic neuropathy Pain, erectile dysfunction 6 15 0.64 Eye diseases Cataracts 2 17 0.94 Hypertension Hypertension 2 17 0.94 Infections and wounds Gangrene, wound healing 2 10 0.89 Diabetes Type 2 diabetes 2 9 0.88
CA ¼Disease category; CB¼number of species for the disease category; CC¼number of citations for the disease category; FIC¼informant consensus factor¼(CC CB)/ (CC 1) (Phanuel et al., 2010).
Table 17 Fidelity level values of animals used against a given ailment category.
Illness category Animal Npa Nb FL value (%)c
Diabetic nephropathy Tenrec ecaudatus 9 9 100.0 Sphyrna mokarran 3 3 100.0 Diabetic neuropathy Scutigera coleoptrata 5 5 100.0 Macaca fascicularis 2 2 100.0 Anguilla japonica 2 2 100.0 Hemidactylus frenatus 2 2 100.0 Anas platyrhynchos 2 2 100.0 Hippocampus borboniensis 2 2 100.0 Eye diseases Helix aspersa 6 6 100.0 Apis mellifera 11 11 10 0.0 Hypertension Cetoscarus bicolor 7 10 70.0 Epinephelus fasciatus 10 10 100.0 Infections and wounds Rattus rattus 2 2 100.0 Periplaneta americana 8 8 100.0 Diabetes Columba livia 3 3 100.0 Salmo salar 6 6 100.0 Musculoskeletal disorders Cetoscarus bicolor 3 10 30.0
a Np¼The number of informants who independently indicated the use of a species for the same major ailment. b N¼Total number of informants who mentioned the animal for any major aliment. c FL¼(Np/N) 100 (Jacobo-salcedo et al., 2011).
or in small areas surrounding the house. Furthermore, the local healing power is stored in the leaves (Semenya et al., 2012). In an people reported that medicinal plants should not be harvested ethnobotanical survey in Bangladesh, it was reported that leaves after 6 p.m. since the plants sleep at this time. If the medicinal were the preferred part for herbal formulations used in the plant is harvested after 6 p.m. one should place a small amount of management of diabetes (Kadir et al., 2012b). In addition, our uncooked rice near the plant which is used as an offering. result showed that medicinal plants were mostly utilised in fresh Interestingly similar finding was obtained from the work of form. This may be due to the belief that plants used in fresh form Mafimisebi and Oguntade (2010) who reported that the forces contain more bioactive compounds as compared to dried form. which produce the active compounds that make plant potent and However, contrary to the mode of preparation of local people, the efficacious are inactive after 6 p.m. One herbalist mentioned that; herbalists surveyed preferred dried plants and they reported that “….medicinal plants should be harvested when the moon is dark, these should be kept in open air and not in closed container. One since concentration of bioactive compounds is believed to be herbalist narrated that; “….medicinal plants should be used in the highest during that period…” Another herbalist mentioned that; dried form so that the active ingredients in the plants are “….when I used to go to the field to harvest the plants in the early immobilised and the plants should be dried in shade ….” Inter- morning I waited after 6 a.m. in order to harvest the plants. My estingly, our findings corroborates to some extent with that of forefathers used to say that plants should not be collected before Tahraoui et al. (2007), who reported that plant parts are dried in 6 a.m otherwise the plants will suffer. Moreover, plants should be shade and stored in dry places away from direct sunlight for their harvested when they are in bloom since during this period they use during off season. contain more medicinal ingredients….”. The method of preparation employed by the majority of In order to achieve desired response to herbal preparations, participants was decoction. Similar results were obtained in a one should choose the proper part of the plant which contains the study carried out by Gbolade (2009) where HR used against active constituents. In the present study, various parts of the diabetes was mainly prepared as decoction. Juice was the second plants were documented to be used for the herbal preparations, most common method of preparation reported and interestingly with leaves being the most frequently used part. Similar observa- Singh et al. (2012a) reported that the majority of plants are used in tions were obtained from the work of Tarak et al. (2011) which form of juice and are administered orally. From the current study it reported that the majority of the HRs are obtained from leaves was also found that some of the plants cited by the TMPs and the because leaves act as reservoirs for photosynthates which are of diabetic patients used against diabetes are bitter and they believed medicinal value to the human body. Moreover, the wide use of that the bitterness of these plants justify to some extent their leaves to prepare remedies is based on the perception that more therapeutic use against diabetes. In an ethnopharmacological A. Mootoosamy, M. Fawzi Mahomoodally / Journal of Ethnopharmacology 151 (2014) 413–444 439 survey in Congo it was reported that bitter plants are prescribed to Based on the fidelity level (FL), out of the 45 plant species regulate glycemia (Katemo et al., 2012). Some of the bitter plants which scored 100% FL, 5 plant species were found to be endemic to recorded from the present study used against diabetes include: Mauritius. High FL indicates that the plants species are used for Acalypha indica, Catharanthus roseus, Momordica charantia, Phyl- the same medicinal purpose compared to those having a low FL lanthus emblica and Phyllanthus niruri. which are used for multiple ailments. The literature search we We also documented the use of additives to be common in the conducted on the ethnopharmacological use showed that many of preparation of HRs, and water was observed to be the most the plants species with 100% FL were used to treat and/or manage commonly used additive followed by honey and milk. There was ailments in other parts of the world; for instance, the use of a negative correlation between satisfaction with taste of the HRs Momordica charantia against diabetes in Nigeria (Gbolade, 2009). and the use of additives which indicate that as the level of Plants with low FL should not be neglected as failing to mention satisfaction with the taste of the HRs decreases there is an them to the future generation could increase the risk of gradual increased in the value of additives used. It was also recorded that disappearance of the knowledge (Rokaya et al., 2010). Moreover, most participants used additives because the HRs do not possess the high relative importance (RI) value of Allium sativum reported organoleptic properties and the additives were used to mask the might be an indication of its high availability and affordability in taste of the HRs. We also recorded that honey was mostly used in the study area. Furthermore, Allium sativum contains an array of HR with bitter taste in order to make the remedy easier to drink phytochemicals for instance flavonoids, steroids, triterpenes, aliin and hence enhance compliance to the herbal therapy. and allicin which might account for its versatility as it is employed The majority of polyherbal formulations were prepared from against more than one ailment (Kemper, 2000; Olusanmi and several locally available plant species which were easily accessible Amadi, 2010). and affordable. The present documentation has recorded 30 The CII index showed that Aloe vera, Ocimum tenuiflorum and polyherbal formulations used against diabetes and DRCs. Polyher- Morinda citrifolia are the most important species in the study area bal formulations are believed to be more efficacious than single terms of their medicinal uses. Moreover, the high CII values of plant formulations because they contain numerous bioactive these plants indicate their importance to the Mauritian culture molecules which work in a synergistic manner in order to provide and their presence in the memory of the Mauritian population the desired therapeutic effect. Bruschi et al. (2011) reported that because of their medicinal properties. These species have been it is possible that interactions among the different plant species used since the time of our forefathers and the medicinal knowl- present in the mixture involve strengthening of therapeutic edge of these plants has been transmitted from one generation to effects as well as attenuation of toxicity or of adverse effects of the next within the Mauritian population. According to Tardio and some plants present in the mixture. Other studies have also Santayana (2008), the CII is an efficient tool for highlighting those documented the use of polyherbal formulations for the treatment species with a high-agreement for the culture of the study area and management of diabetes and DRCs (Parasuraman et al., 2010; and hence recognise the shared knowledge of these people. Of Viswanathan et al., 2011; Srivastava et al., 2012). those species most cited in the study, the lowest CII value was In this study, eleven quantitative indexes were used to evaluate found in Coix lacryma-jobi which is lesser known by the popula- the main medicinal plants used by the local people. RFC was used to tion for its therapeutic properties. Also, the high IAR values determine the local importance of each plant species. The highest documented for 37 plant species in the current study implies that RFC value scored by Aloe vera which tend to show the importance of all informants agree upon the exclusive use of the medicinal plant this medicinal plant species in Mauritius used against diabetes and species for a particular ailment condition. Moreover, the signifi- DRCs. Nonetheless, plants with low RFC values; for instance Hibiscus cantly high IAR values of easily available plants for instance sabdariffa do not necessarily mean that they are not important Catharanthus roseus recorded in the present study indicate the locally but it could indicate that these plant species are scarce since need to document the traditional knowledge over their usage in most people are not aware of their medicinal properties. According order to prevent the loss of such traditional knowledge. Further- to the UV, the species with the highest UV values were Morinda more, it is important when assessing the cultural importance of citrifolia, Aloe vera and Ocimum tenuiflorum.Thesethreeplant medicinal plants to discover patterns of agreement on plant species are well recognised in Mauritius due to their therapeutic knowledge. Hence CII value and IAR were combined into the CAI properties and are widely used as HRs. The low UV recorded for index. The highest CAI values in the present study were reached by Heliotropium indicum which is used in the treatment of diabetic Aloe vera, Ocimum tenuiflorum L. and Vangueria madagascariensis. nephropathy in the present study indicates that traditional knowl- Therefore we can deduce that the culturally important plant edge about its use is at risk of not being transmitted and that it may species mentioned by the informants in the current study possess be gradually disappearing (Sharma et al., 2012c). high agreement among the informants for the same ailment The high FIC value of diabetes reported in the present study category. indicates the agreement among the informants concerning the plants The perception of efficacy of medicinal plants in the study area appropriate for the treatment and management of this ailment varies significantly, whereby some species were recognised as category. Furthermore, the high FIC value of diabetes in our study more effective for treating diabetes and DRCs than others. Addi- could be due to high prevalence of diabetes in the study area and tionally it was observed that Allium cepa, Phyllanthus emblica and better communication established between informants for treating/ Psidium guajava were reported to be effective by the key infor- managing this condition. Moreover, a high FIC value for a particular mants as shown by QUV value. Moreover, the QUAV which diseasecategorymightindicatetheeffectivenessoftheplantsin represents the cultural significance of medicinal plant species treating this disease category (Cakilcioglu et al., 2011). A high FIC also showed that Psidium guajava and Phyllanthus emblica are the indicates the possibility of containing important active ingredients in culturally most significant medicinal plants in the study area due these plants therefore further phytopharmacological analysis of these to their high QUAV. The advantage of the QUAV is that it takes into plants are required (Kadir et al., 2012a). On the other hand, low FIC consideration (1) the average number of medicinal uses; (2) the value recorded for infections and wounds category may be due to a perceived quality of those medicinal uses reported; and (3) parti- lack of communication among people regarding the treatment of this cipant consensus about those medicinal uses (Thomas et al., 2009). ailment category. In addition, the disease categories were analysed in In addition, according to Thomas et al. (2011) the higher the QUAV order to determine the most important plants species in each score of a species, the higher the chance that the species is category. bioactive in humans. Hence further pharmacological studies are 440 A. Mootoosamy, M. Fawzi Mahomoodally / Journal of Ethnopharmacology 151 (2014) 413–444 required to confirm the bioactivity of Psidium guajava and peptidoglycans, carbohydrates, amino acids and saponins obtained Phyllanthus emblica. from plants possess hypoglycemic activity hence explaining their The EI which is the ratio between the number of plants cited in use against diabetes. The presence of phenolics, tannins, flava- the study and the number of plants constituting the flora of the noids, saponins, glycosides and triterpenoids in Siegesbeckia orien- study area, expressed as a percentage was found to be 16.2%. The talis as reported by Geetha and Gopal (2011) which tend to justify EI gave a very clear idea of the importance of the medicinal species its use as an antidiabetic agent as recorded in the present study. in the study area. When comparing this value with the EI value of Experimental and clinical studies suggest that oxidative stress another ethnobotanical study carried out by Vitalini et al. (2013),it plays a fundamental role in diabetes development and pathogen- was found that the knowledge level of the species considered esis of diabetic complications. Diabetes is typically associated with useful in traditional medicine in Mauritius was higher than that increased generation of free radicals and/or impaired antioxidant found in Val San Giacomo, Italy (6.2%). defense mechanism therefore antioxidant therapy has been Some similarities were reported in comparative studies of cited strongly correlated with decreased risks for DRCs (Maritim et al., plants of our survey to other ethnobotanical surveys in different 2003). The antioxidant properties of some plants identifies in the communities of the world (Kadir et al., 2012a; Katemo et al., 2012; current study: Nasturtium officinale, Citrus maxima, Tamarindus Keter and Mutiso, 2012; Rachid et al., 2012; Semenya et al., 2012; indica, Carica papaya, Senna occidentalis and Cajanus cajan have Trojan-Rodrigues et al., 2012; Tag et al., 2012). Some of the plants been documented experimentally (Yazdanparast et al., 2008; used by the indigenous people of Mauritius have good evidence of Akinloye and Solanke, 2011; Bhutkar and Bhise, 2011; Jamuna effectiveness. The hypoglycemic activity of some plants identified et al., 2011; Vadnere et al., 2011) and this support the utilisation of in this study has been demonstrated experimentally. The antidia- these plants against diabetes and DRCs. betic effect of aqueous extract of Allium cepa was demonstrated on streptozotocin-induced diabetic rats (Ozougwu, 2011). Similarly, 4.4. Religious virtue of some medicinal plants Aloe vera gel extract (Mohamed, 2011), aqueous extract of Artocarpus heterophyllus leaves (Chandrika et al., 2006), leaf and Among the different ethnic groups sampled in the study area twigs extract of Catharanthus roseus (Singh et al., 2001), aqueous we recorded that the Hindu community is the only ethnic group extract of Cynara cardunculus leaf (Heidarian and Soofiniya, 2011), which make use of plant species for religious practices. Acalypha methanolic extract of aerial parts of Lagenaria siceraria (Saha et al., indica, Ocimum tenuiflorum and Piper betle are regarded as holy 2011), aqueous leaf extract of Mangifera indica (Morsi et al., 2010) plants by this community. These sacred plants are found in almost and ethanolic extract of Moringa oleifera leaves (Tende et al., 2011) every household of the Hindu community and are used in religious showed glucose lowering activity in streptozotocin-induced dia- activities as well as for medical practices. The Hindu community betic rats. worship different gods for different purposes and they also wor- On the other hand, n-butanol extract of Apium graveolens seed ship nature with full devotion (Sharma et al., 2012a). For instance (Al-Sa'aidi et al., 2012), Acalypha indica leaf extract (Dholi et al., the holy basil worship is done every morning in every household 2011), chloroform extract of Brassica oleracea (Asadujjaman et al., in order to keep the family members healthy. The holy basil is also 2011), extract of Cocos nucifera (Emojevwe and Jeroh, 2012), used as a medicinal plant against diabetes and related complica- aqueous fruit extract of Morinda citrifolia (Prakash et al., 2010), tions; for example the juice is orally administered twice per week aqueous fruit extract of Phyllanthus emblica (Qureshi et al., 2009), when used against diabetes. ethanolic extract of Syzygium cumini seed (Singh and Gupta, 2007) and ethanolic extract of Trigonella foenum-graecum seed (Renuka 4.5. Side effects and herb–drug interactions et al., 2009) have showed significant hypoglycemic activity in alloxan-induced diabetic rats. Concomitant use of herbs and pharmaceutical drugs was Allium sativum was found to significantly decrease serum reported among a number of informants in the current study. This glucose in diabetic rats and the effect of the extract was more is in line with the result obtained from Picking et al. (2011) who effective than glibenclamide (Eidi et al., 2006). Furthermore, also reported the concomitant use of herbs and pharmaceutical aqueous extract of Bidens pilosa was shown to decrease blood drugs. The majority of the informants reported that there is no glucose levels in mice by stimulating insulin secretion via pan- harm in taking both medicinal plants and pharmaceutical drugs creatic islets (Hsu et al., 2009) and aqueous extract of Camellia when questioned about their attitudes towards the concomitant sinensis was showed to reduce serum glucose in American white use of HRs and allopathic medicines. Nonetheless, from the rats (Sabahelkhier et al., 2012). Administration of ethanolic extract present study thirteen informants reported herb–drug interaction of Rhizophora mucronata to long Evans rats was shown to possess from the concomitant use of Momordica charantia with Metformin hypoglycemic effect (Gaffar et al., 2011). There was a fall in blood against diabetes. Basch et al. (2003a) reported that Momordica glucose level in albino rats after administration of ethanolic charantia is an alternative therapy used for lowering blood glucose extracts of Eucalyptus globulus leaves (Houacine et al., 2012). levels in patients with diabetes and it may have additive effects Alcoholic extract of Momordica charantia was found to lower blood when taken with other glucose-lowering agents such as Metfor- glucose level in alloxan- induced diabetic rabbits (Sărăndan et al., min. Moreover, a number of side effects were reported from the 2010). Oral administration of ethanolic extract of Olea europaea informants from the use of plant species against diabetes and DRC. was shown to decrease blood glucose level in wistar albino rats In the present study four informants reported the harmful effects (Chandak and Shrangare, 2010). Furthermore, studies have of Acalypha indica on the eyes. Interestingly, Katsayal et al. (2008) demonstrated that methanolic extract of Psidium guajava to inhibit reported that large dose consumption of the leaves of Acalypha glucose diffusion in in vitro models (Basha and Kumari, 2012). indica for long term should be avoided as it may cause malfunction Some of the plants have also been studied using human models; of the liver and kidney. Consumption of Trigonella foenum-graecum for instance aqueous extract and alcoholic extract of Coriandrum was found to result in weakness and to affect the eyes adversely sativum was found to possess hypoglycemic activity in type-2 and interestingly Basch et al. (2003b) reported dizziness as one of diabetic patients and similar findings were obtained with Ocimum the side effects of Trigonella foenum-graecum. Moreover, higher tenuiflorum L. (Waheed et al., 2006; Somasundaram et al., 2012). doses of Atropa belladonna were reported to lead to delirium and Prabhakar and Doble (2008) reported that phytochemicals such increase heart beat. In accordance with this result, Rita and as alkaloids, flavonoids, glycosides, glycoplipids, polysaccharides, Animesh (2011) reported the toxic nature of Atropa belladonna A. Mootoosamy, M. Fawzi Mahomoodally / Journal of Ethnopharmacology 151 (2014) 413–444 441 whereby the leaves and berries contain tropane alkaloids Erythroxylum laurifolium and Faujasiopsis flexuosa) have been which include scopolamine and hyoscyamine, causing delirium documented against diabetes and DRCs which despite their and hallucinations in humans. scarcity are still used by the local population. The present study confirms the richness of Mauritius flora due to the availability of 4.6. Zootherapy used against diabetes and related complications an array of medicinal plants effective against diabetes and DRCs. Plants from the Asteraceae family (e.g. Siegesbeckia orientalis and The use of animal species with medicinal properties is a Cynara cardunculus) were the most cited by the informants. common practice worldwide. In China, more than 1500 animals Medicinal plants reported by only a few informants (e.g. Artemisia are used as medicine; in India 15–20% of the Ayurvedic medicine is verlotiorum and Hibiscus sabdariffa) imply that traditional knowl- based on animal-derived substances, whereas in Latin America edge about these plants is highly vulnerable as it may disappear 584 medicinal animal species have been recorded (Alonso-Castro with time together with its holders. We also demonstrated the et al., 2011). However, few literatures are available on the medic- important role of zootherapy in healing practices among the inal fauna in Mauritius. The availability and the lack of side effects Mauritian population with the most prevalent taxa being fish. of ARs are the main reasons to use medicinal fauna in the study Salmo salar was recorded against diabetes which might be attrib- area. This study has recorded 14 animals that have not been uted to the presence of omega-3 in the fish. Further, we reported documented previously for the treatment and/or management of the use of medicinal plants for religious purposes (e.g. Ocimum diabetes and DRC. In the present work, following calculation of FIC tenuiflorum) among the Hindu community revealing that plant values, the reported ailments were grouped into six different species are used for both their therapeutic effects and their ailments categories. Musculoskeletal disorders ailment category religious connotations. With the prominent adverse effects asso- was not included since there was only one animal species cited ciated with conventional hypoglycemic agents and their inability under this category. We found that eye diseases and hypertension to alter the course of diabetic complications, it is undeniably ailments categories had the highest FIC values which indicate necessary to undertake phytochemicals and pharmacological the precise flow of knowledge of the ARs used for treating investigations to explore the therapeutic potentials offered by and/or managing these ailments categories. However in Brazil, NRs. As a conclusive note, the empirical knowledge described in FIC showed that diseases of the circulatory system had the greatest the current study would open new opportunities for the discovery agreement (Oliveira et al., 2010). The majority of the animal of novel antidiabetic drugs based on the active constituents of the species scored 100% fidelity level showing that most animal documented NRs. species in each category were important. In the present study, fish was most commonly used followed by insects and similar findings were obtained from the work of Alves et al. (2007) where Acknowledgments fish was the most commonly used animal species. We documented the use of cockroach for the treatment of gangrene however this The authors are grateful to all participants and herbalists for tends to contradict the work of Costa-Neto and Oliveira (2000) participation in the present survey. We also extend our thanks to where cockroach was used against asthma. Moreover, we also Prof. A. Gurib-Fakim and the local botanist. The authors are also reported the use of honey against cataract and our result is in grateful to the University of Mauritius. agreement with the work of Souto et al. (2011) and Costa-Neto and Oliveira (2000) where honey was used for the treatment of glaucoma and cataracts. Salmon has been found to be commonly References used against diabetes in the study area. Interestingly, salmon has been shown to contain polyunsaturated compound namely Abdou, R., Schelach, K., Dahse, H.M., Sattler, I., Hertweck, C., 2010. Botryorhodines omega-3. Kandasamy et al. (2008) cited that omega-3 is critical A-D, antifungal and cytotoxic depsidones from Botryosphaeria rhodina,an endophyte of the medicinal plant Bidens pilosa. Phytochemistry 71, 110–116. in the structure of cell membranes and the development of the Abeywickrama, K.R.W., Ratnasooriya, W.D., Amarakoon, A.M.T., 2011. Oral hypogly- nervous system and it has been shown to reduce diabetes induced caemic, antihyperglycaemic and antidiabetic activities of Sri Lankan Broken nerve damage. The use of Columba livia recorded in this study is Orange Pekoe Fannings (BOPF) grade black tea (Camellia sinensis L.) in rats. J. Ethnopharmacol. 135, 278–286. also used in popular medicine in other countries. In Mexico, Aissaoui, A., Zizi, S., Israili, Z.H., Lyoussi, B., 2011. Hypoglycemic and hypolipidemic Columba livia is employed to treat infertility and diabetes effects of Coriandrum sativum L. in Meriones shawi rats. J. Ethnopharmacol. 137, (Alonso-Castro et al., 2011), in Brazil, Columba livia meat is used 652–661. Akinloye, O.A., Olaniyi, M.O., 2011. Hepatoprotective effect of Cajanus cajan on against cough (Alves et al., 2009) whereas in India, the fresh blood tissue defense system in D-galactosamine-induced hepatitis in rats. of this bird is employed for paralysis (Mahawar and Jaroli, 2007). Turk. J. Biochem. 36 (3), 237–241. Further studies are required to validate the medicinal claims ARs Akinloye, O.A., Solanke, O.O., 2011. Evaluation of hypolipidemic and potential documented in the present study. antioxidant effects of Pigeon pea (Cajanus cajan mill sp.) leaves in alloxan- induced hyperglycemic rats. J. Med. Plants Res. 5, 2521–2524. Alonso-Castro, A.J., Alvarez, C.C., Maldonado-Miranda, J.J., Jacobo-Salcedo, M.D.R., Quezada-Rivera, D.A., Lorenzo-Marquez, H., Figueroa-Zuniga, L.A., Fernandez- 5. Conclusion Galicia, C., Rios-Reyes, N.A., Rubio, M.A.D.L., Gallegos, V.R., Milan, P.M., 2011. Zootherapeutic practices in Aquismón, San Luis Potosí, México. J. Ethnophar- macol. 138, 233–237. Our present investigation revealed that the use of NRs con- Al-Sa'aidi, J.A.A., Alrodhan, M.N.A., Ismael, A.K., 2012. Antioxidant activity of stitutes the common legacy of all Mauritians and despite the n-butanol extract of celery (Apium graveolens) seed in streptozotocin-induced – penetration of allopathic medicine; NRs continue to play a crucial diabetic male rats. Res. Pharm. Biotechnol. 4, 24 29. Altinyay, C., Güvenç, A., Altun, M.L., 2011. Antioxidant activities of Oleuropein and role in the primary source of healthcare of Mauritians. Our study the aqueous extracts of Olea europaea L. varieties growing in Turkey. recorded for the first time the use of 111 plant species, 30 Turk. J. Pharm. Sci. 8, 23–30. polyherbal formulations and 16 animal remedies used against Alves, R.R.N., Alves, H.N., 2011. The faunal drugstore: animal-based remedies used in traditional medicines in Latin America. J. Ethnobiol. Ethnomed. 7, 9. diabetes and DRCs. Moreover, about 30 medicinal plant species not Alves, R.R.N., Barbosa, J.A.A., Santos, S.L.D.X., Souto, W.M.S., Barboza, R.R.D., 2009. previously documented based on globally published ethnophar- Animal-based remedies as complementary medicines in the semi-arid region of macological surveys have been reported for instance Vangueria Northeastern Brazil. Evidence Based Complement. Altern. Med. 〈http://www. hindawi.com/journals/ecam/2011/179876/〉. madagascariensis, Apium graveolens, Petroselinum crispum and Alves, R.R.N., Rosa, I.L., Santana, G.G., 2007. The role of animal-derived remedies as Rubus alceifolius. Eight endemic plants to Mauritius (e.g., complementary medicine in Brazil. Bioscience 57, 949–955. 442 A. Mootoosamy, M. Fawzi Mahomoodally / Journal of Ethnopharmacology 151 (2014) 413–444
Alzweiri, M., Sarhan, A.A., Mansi, K., Hudaib, M., Aburiai, T., 2011. Ethnopharmaco- Gaffar, M.U., Morshed, M.A., Uddin, A., Roy, S., Hannan, J.M.A., 2011. Study the logical survey of medicinal herbs in Jordan, the Northern Badia. J. Ethnophar- efficacy of Rhizophora mucornata Poir. leaves for diabetes therapy in long evans macol. 137, 27–35. rats. Int. J. Biomol. Biomed. 1, 20–26. Arung, E.T., Yoshikawa, K., Shimizu, K., Kondo, R., 2010. Isoprenoid-substituted Gbolade, A.A., 2009. Inventory of antidiabetic plants in selected districts of Lagos flavonoids from wood of Artocarpus heterophyllus on B16 melanoma cells: State, Nigeria. J. Ethnopharmacol. 121, 135–139. cytotoxicity and structural criteria. Fitoterapia 81, 120–123. Geetha, R., Gopal, G.V., 2011. Phytochemical screening of Siegesbeckia orientalis L., a Asadujjaman, M., Hossain, M.S., Khan, M.R.I., Anisuzzaman, A.S.M., Ahmed, M., medicinal plant of Asteraceae. J. Basic Appl. Biol. 5, 156–164. Islam, A., 2011. Antihyperglycemic and glycogenesis effects of different frac- Ginsberg, H.N., Zhang, Y.L., Hernandez-Ono, A., 2005. Regulation of plasma tions of Brassica oleracea in alloxan-induced diabetic rats. Int. J. Pharm. Sci. triglycerides in insulin resistance and diabetes. Arch. Med. Res. 36, 232–240. Res. 2, 1436–1442. Gomez-Flores, R., Verastegui-Rodriquez, L., Quintanilla-Licea, R., Tamez-Guerra, P., Awais, M.M., Akhtar, M., 2012. Evaluation of some sugarcane (Saccharum offici- Tamez-Guerra, R., Rodriguez-Padilla, C., 2008. In vitro rat lymphocytes prolif- narum L.) extracts for immunostimulatory and growth promoting effects in eration induced by Ocimium basilicum, Persea americana, Plantiago virginica, industrial broiler chickens. Pak. Vet. J. 32, 398–402. and Rosa spp. extracts. J. Med. Plants Res. 2, 005–010. Bakirel, T., Bakirel, U., Keles, O.U., Ülgen, S.G., Yardibi, H., 2008. In vivo assessment of Grover, J.K., Yadav, S., Vats, V., 2002. Medicinal plants of India with anti-diabetic antidiabetic and antioxidant activities of rosemary (Rosmarinus officinalis)in potential. J. Ethnopharmacol. 81, 81–100. alloxan-diabetic rabbits. J. Ethnopharmacol. 116, 64–73. Gurib-Fakim, A., 2006. Medicinal plants: traditions of yesterday and drugs of Barner, J.C., Bohman, T.M., Brown, C.M., Richards, K.M., 2010. Use of complementary tomorrow. Mol. Aspects Med. 27, 1–93. and alternative medicine for treatment among African–Americans: a multi- Gurib-Fakim, A., Brendler, T., 2004. Medicinal and Aromatic Plants of Indian Ocean variate analysis. Res. Social Administrative Pharm. 6, 196–208. Islands. Medpharm Scientific Publishers, Germany. Basch, E., Gabardi, S., Ulbricht, C., 2003a. Bitter melon (Momordica charantia): a Gurib-Fakim, A., Gueho, J., 1995. Plantes médicinales de Maurice. Edition de l’Ocean review of efficacy and safety. Am. J. Health-Syst.Pharm. 60, 356–359. Indien, Mauritius. Basch, E., Ulbricht, C., Kuo, G., Szapary, P., Smith, M., 2003b. Therapeutic applica- Haloui, M., Louedec, L., Michel, J.B., Lyoussi, B., 2000. Experimental diuretic effect of tions of Fenugreek. Altern. Med. Rev. 8, 20–27. Rosmarinus officinalis and Centaurium erythraea. J. Ethnopharmacol. 71, 465–472. Basha, S.K., Kumari, V.S., 2012. In vitro antidiabetic activity of Psidium guajava leaves Hamza, N., Berke, B., Cheze, C., Le Carrec, R., Umar, A., Agil, A.N., Lassalle, R., Jove, J., extracts. Asian Pac. J. Trop. Dis., S98–S100. Gin, H., Moore, N., 2012. Preventive and curative effect of Trigonella foenum- Bhutkar, M.A., Bhise, S.B., 2011. Anti-oxidative effect of Tamarindus indica in graecum L. seeds in C57BL/6 J models of type 2 diabetes induced by high-fat alloxan-induced diabetic rats. Int. J. Res. Pharm. Biom. Sci. 2, 1006–1009. diet. J. Ethnopharmacol. 142, 516–522. Bodansky, H.J., Cudworth, A.G., Whitelocke, R.A.F., Dobree, J.H., 1982. Diabetic Havinga, R.M., Hartl, A., Putscher, J., Prehsler, S., Buchmann, C., Vogl, C.R., 2010. retinopathy and its relation to type of diabetes: review of a retinal clinic Tamarindus indica L. (Fabaceae): patterns of use in traditional African medicine. population. Br. J. Ophthalmol. 66, 496–499. J. Ethnopharmacol. 27, 573–588. Bruschi, P., Morganti, M., Mancini, M., Signorini, M.A., 2011. Traditional healers and Heidarian, E., Soofiniya, Y., 2011. Hypolipidemic and hypoglycemic effects of aerial laypeople: a qualitative and quantitative approach to local knowledge on part of Cynara scolymus in streptozotocin-induced diabetic rats. J. Med. Plants medicinal plants in Muda (Mozambique). J. Ethnopharmacol. 138, 543–563. Res. 5, 2717–2723. Cakilcioglu, U., Khatun, S., Turkoglu, I., Hayta, S., 2011. Ethnopharmacological survey Houacine, C., Elkhawad, A.O., Ayoub, S.M.H., 2012. A comparative study on the anti- of medicinal plants in Maden (Elazig-Turkey). J. Ethnopharmacol. 137, 469–486. diabetic activity of extracts of some Algerian and Sudanese plants. J. Diabetes Chakravorty, J., Rochow, V.B.M., Ghosh, S., 2011. Vertebrates used for medicinal Endocrinol. 3, 57–60. purposes by members of the Nyishi and Galo tribes in Arunachal Pradesh Hsu, Y.J., Lee, T.H., Chang, C.L.T., Huang, Y.T., Yang, W.C., 2009. Anti-hyperglycemic (North-East India). J. Ethnobiol. Ethnomed. 7, 13. effects and mechanism of Bidens pilosa water extract. J. Ethnopharmacol. 122, Chandak, R.R., Shrangare, G., 2010. Evaluation of antidiabetic activity of Olea 379–383. europaea in wistar albino rats. Int. J. Appl. Biol. Pharm. Technol. 1, 952–956. Huang,M.H.,Huang,S.S.,Wang,B.S.,Wu,C.H.,Sheu,M.J.,Hou,W.C.,Lin,S.S.,Huang,G.H., Chandrika, U.G., Wedage, W.S., Wickramasihghe, S.M.D.N., Fernando, W.S., 2006. 2011. Antioxidant and anti-inflammatory properties of Cardiospermum halicacabum Hypoglycaemic action of the flavonoid fraction of Artocarpus heterophyllus leaf. and its reference compounds ex vivo and in vivo.J.Ethnopharmacol.133,743–750. Afr. J. Traditional Complement. Altern. Med. 3, 42–50. Hudaib, M., Mohammad, M., Bustanji, Y., Tayyem, R., Yousef, M., Abuirjeie, M., Cheenpracha, S., Park, E.J., Yoshida, W.Y., Barit, C., Wall, M., Pezzuto, J.M., Chang, L.C., Aburjai, T., 2008. Ethnopharmacological survey of medicinal plants in 2010. Potential anti-inflammatory phenolic glycosides from the medicinal plant Jordan, Mujib Nature Reserve and surrounding area. J. Ethnopharmacol. 120, Moringa oleifera fruits. Bioorg. Med. Chem. 18, 6598–6602. 63–71. Chellappandian, M., Mutheeswaran, S., Pandikumar, P., Duraipandiyan, V., Ignaci- International Diabetes Federation, (IDF), 2011a. IDF Bridges Report 2011.Brussels: muthu, S., 2012. Quantitative ethnobotany of traditional Siddha medical IDF. practitioners from Radhapuram taluk of Tirunelveli District, Tamil Nadu, India. International Diabetes Federation, (IDF), 2011b. The Global Burden. IDF, Brussels. J. Ethnopharmacol. 143, 540–547. International Diabetes Federation, (IDF), 2012. IDF Diabetes Atlas Update. IDF, Chintamunnee, V., Mahomoodally, M.F., 2012. Herbal medicine commonly used Brussels p. 2012. against non-communicable diseases in the tropical island of Mauritius. J. Herbal Jacobo-Salcedo, M.R., Alonso-Castro, A.J., Zarate-Martinez, A., 2011. Folk medicinal Med. 2, 113–125. use of fauna in Mapimi, Durango, México. J. Ethnopharmacol. 133, 902–906. Costa-Neto, E.M., Oliveira, M.V.M., 2000. Cockroach is good for asthma: zoother- Jagtap, U.B., Bapat, V.A., 2010. Artocarpus: a review of its traditional uses, apeutic practices in Northeastern Brazil. Hum. Ecol. Rev. 7, 41–51. phytochemistry and pharmacology. J. Ethnopharmacol. 129, 142–166. Cruz, E.A., Reuter, S., Martin, H., Dehzas, N., Muzitano, M.F., Costa, S.S., Rossi- Jain, A., Sharma, R., Gahalain, N., Chaudary, J., Gupta, K.G., 2011. Herbal plants used Bergmann, B., Buhl, R., Stassen, M., Taube, C., 2012. Kalanchoe pinnata inhibits in diabetic complications: an overview. J. Pharm. Res. 4, 986–988. mast cell activation and prevents allergic airway disease. Phytomedicine 19, Jamuna, K.S., Ramesh, C.K., Srinivasa, T.R., Raghu, K.L., 2011. In vitro antioxidant 115–121. studies in some common fruits. Int. J. Pharm. Pharm. Sci. 3, 60–63. Dalli, E., Colomer, E., Tormos, M.C., Cosin-Sales, J., Milara, J., Esteban, E., Saez, G., 2011. Jung, M., Park, M., Lee, H.C., Kang, Y.H., Kang, S.E., Kim, S.K., 2006. Antidiabetic Crataegus laevigata decreases neutrophil elastase and has hypolipidemic effect: a agents from medicinal plants. Curr. Med. Chem. 13, 1203–1218. randomized, double-blind, placebo-controlled trial. Phytomedicine 18, 769–775. Kadir, M.F., Sayeed, M.S.B., Mia, M.M.K., 2012a. Ethnopharmacological survey of Das, J., Chowdhury, A., Biswas, S.K., Karmakar, U.K., Sharif, R.S., Raihan, S.Z., medicinal plants used by indigenous and tribal people in Rangamati, Bangla- Muhit, M.A., 2012. Cytotoxicity and antifungal activities of ethanolic and desh. J. Ethnopharmacol. 144, 627–637. chloroform extracts of Cucumis sativus Linn (Cucurbitaceae) leaves and stems. Kadir, M.F., Sayeed, M.S.B., Shams, T., Mia, M.M.K., 2012b. Ethnobotanical survey of Res. J. Phytochem. 6, 25–30. medicinal plants used by Bangladeshi traditional health practitioners in the Del Campo, J., Amiot, M.J., Nguyen-The, C., 2000. Antimicrobial effect of rosemary management of diabetes mellitus. J. Ethnopharmacol. 144, 605–611. extracts. J. Food Prot. 63, 1359–1368. Kandasamy, N., Joseph, F., Goenka, N., 2008. The role of omega-3 fatty acids in Desai, S.N., Patel, D.K., Devkar, R.V., Patel, P.V., Ramachandran, A.V., 2012. Hepato- cardiovascular disease, hypertriglyceridaemia and diabetes mellitus. Br. J. protective potential of polyphenol rich extract of Murraya koenigii L.: an in vivo Diabetes Vasc. Dis. 8, 121–126. study. Food Chem. Toxicol. 50, 310–314. Katemo, M., Mpiana, P.T., Mbala, B.M., Mihigo, S.O., Ngbolua, K.N., Tshibangu, D.S.T., Devaraj, V.C., Krishna, B.G., Viswanatha, G.L., Prasad, V.S., Babu, V.S.N., 2011. Koyange, P.R., 2012. Ethnopharmacological survey of plants used against Protective effect of leaves of Raphinus sativus Linn on experimentally induced diabetes in Kisangani city (DR Congo). J. Ethnopharmacol. 144, 39–43. gastric ulcers in rats. Saudi Pharm. J. 19, 171–176. Katsayal, U.A., Nadabo, Y.A., Isiorho, V.J., 2008. Effects of methanol extract of Dholi, S.K., Raparla, R., Mankala, S.K., Nagappan, K., 2011. In vivo antidiabetic evaluation Azadirachta indica leaves on the histology of liver and kidney of Wister rats. of neem leaf extract in alloxan-induced rats. J. Appl. Pharm. Sci. 1, 100–105. Niger. J. Pharm. Sci. 7, 9–14. Dussossoy, E., Brat, P., Bony, E., Boudard, R., Poucheret, P., Mertz, C., Giaimis, J., Kavishankar, G.B., Lakshmidevi, N., Mahadeva Murthy, S., Prakash, H.S., Niranjana, S.R., Michel, A., 2011. Characterization, anti-oxidative and anti-inflammatory effects 2011. Diabetes and medicinal plants—a review. Int. J. Pharm. Biomed. Sci. 2, 65–80. of Costa Rican noni juice (Morinda citrifolia L.). J. Ethnopharmacol. 133, 108–115. Kemper, K.J., 2000. Garlic (Allium sativum). The Center for Holistic Pediatric Eidi, A., Eidi, M., Esmaeili, E., 2006. Antidiabetic effect of garlic (Allium sativum L.) in Education and Research. 1-49. normal and streptozotocin-induced diabetic rats. Phytomedicine 13, 624–629. Keter, L.K., Mutiso, P.C., 2012. Ethnobotanical studies of medicinal plants used by Emojevwe, V., Jeroh, E., 2012. Anti diabetic effects of the Cocos nucifera (coconut) traditional health practitioners in the management of diabetes in Lower husk extract. J. Med. Appl. Biosci. 4, 16–18. Eastern Province, Kenya. J. Ethnopharmacol. 139, 74–80. Erasto, P., Adebola, P.O., Grierson, D.S., Afolayan, A.J., 2005. An ethnobotanical study Kim, H., Song, M.J., 2011. Analysis and recordings of orally transmitted knowledge of plants used for the treatment of diabetes in the Eastern Cape Province, South about medicinal plants in the southern mountainous region of Korea. J. Africa. Afr. J. Biotechnol. 4, 1458–1460. Ethnopharmacol. 134, 676–696. A. Mootoosamy, M. Fawzi Mahomoodally / Journal of Ethnopharmacology 151 (2014) 413–444 443
Leto, C., Tuttolomondo, T., La Belle, S., Licata, M., 2012. Ethnobotanical study in the Pereira, D.M., Ferreres, F., Oliveira, J.M.A., Gaspar, L., Faria, J., Valentao, P., Sotto- Madonie Regional Park (Central Sicily, Italy)-Medicinal use of wild shrub and mayor, M., Andrade, P.B., 2010. Pharmacological effects of Catharanthus roseus herbaceous plant species. J. Ethnopharmacol. 146, 90–112. root alkaloids in acetylcholinesterase inhibition and cholinergic neurotransmis- Lev, E., 2006. Healing with animals in the Levant from the 10th to the 18th century. sion. Phytomedicine 17, 646–652. J. Ethnobiol. Ethnomed. 〈http://www.ethnobiomed.com/content/2/1/11〉. Phanuel, A.S., Nyunja, R.O., Onyango, J.C., 2010. Plant species in the folk medicine of Lucker, J., Martens, S., Lund, S.T., 2010. Characterization of a Vitis vinifera cv. Kit Mikayi Region, Western Kenya. Ethnobot. Leaflets 14, 836–840. Cabernet Sauvignon 3′,5′-O-methyltransferase showing strong preference for Picking, D., Younger, N., Mitchell, S., Delgoda, R., 2011. The prevalence of herbal anthocyanins and glycosylated flavonols. Phytochemistry 71, 1474–1484. medicine home use and concomitant use with pharmaceutical medicines in Mafimisebi, T.E., Oguntade, A.E., 2010. Preparation and use of plant medicines for Jamaica. J. Ethnopharmacol. 137, 305–311. farmers’ health in Southwest Nigeria: socio-cultural, magico-religious and Prabhakar, P.K., Doble, M., 2008. A target based therapeutic approach towards economic aspects. J. Ethnobiol. Ethnomed. 〈http://www.ethnobiomed.com/ diabetes mellitus using medicinal plants. Curr. Diabetes Rev. 4, 291–308. content/6/1/1〉. Prakash, R., Kumar, M., Singh, D.K., Chandra, M., Verma, D., 2010. Antidiabetic effect Mahawar, M.M., Jaroli, D.P., 2007. Traditional knowledge on zootherapeutic uses by of Morinda citrofolia and Coccinia indica in alloxan-induced diabetic rats. Adv. the Saharia tribe of Rajasthan, India. J. Ethnobiol. Ethnomed. 3, 25–30. Biores. 1, 75–77. Maritim, A.C., Sanders, R.A., Watkins III, J.B., 2003. Diabetes, oxidative stress, and Qureshi, S.A., Asad, W., Sultana, V., 2009. The effect of Phyllanthus emblica Linn on antioxidants: a review. J. Biochem. Mol. Toxicol. 17, 24–38. Type-II diabetes, triglycerides and liver-specific enzyme. Pak. J. Nutr. 8, 125–128. Mauritius Attractions, 2008. Mauritius Political (Districts) Map. o〈http://mauritiusat Rachid, A., Rabah, D., Farid, L., Zohra, S.F., Houcine, B., Nacera, B., 2012. Ethnophar- tractions.com/mauritius-districts-map-i-68.html〉4(siteaccessed31June2013). macological survey of medicinal plants used in the traditional treatment of Mauritian Wildlife Federation, (MWF), 2012. Rare Plants. o〈http://www.mauri diabetes mellitus in the North Western and South Western Algeria. J. Med. tian-wildlife.org/application/index.php?tpid=30&tcid=77〉4 (site accessed Plants Res. 6, 2041–2050. 24 July 2013). Rashid, Z.M., Rahman, S.A., Kasim, Z.M., Mustapha, W.A.W., Halip, M.H.M., Arifin, Z., Ministry of Agro Industry and Food Security (MOAIFS), 2012. Forestry-indigenous Rauf, U.F.A., 2011. Nutritional status and physical activities among army and endemic plants. Republic of Mauritius. o〈http://www.gov.mu/portal/site/ trainees in public institutions of higher education in Malaysia. Food Nutr. moa?content_id=e27c8a45abdcb010VgnVCM1000000a04a8c0RCRD〉4 (site Sci. 2, 511–520. accessed date: 26 July 2013). Renganathan, A., Velayutham, M.D.P., Suresh, K.A., Kumpati, P., 2011. Role of Ministry of Finance and Economic Development, (MOFED), 2011. Mauritius in Syzygium cumini seed extract in the chemoprevention of in vivo genomic figures. Republic of Mauritius. o〈http://www.gov.mu/portal/goc/cso/mif11/ damage and oxidative stress. J. Ethnopharmacol. 134, 329–333. mif2011.pdf〉4(site accessed 24 July 2013). Renuka, C., Ramesh, N., Saravanan, K., 2009. Evaluation of the antidiabetic effect of Ministry of health and quality of life, (MOH), 2012. Diabetes in Mauritius. o〈http:// Trigonella foenum-graecum seed powder on alloxan-induced diabetic albino www.gov.mu/portal/sites/diabetes/introduc.htm〉4 (site accessed 24 July 2013). rats. Int. J. PharmTech Res. 1, 1580–1584. Mohamed, E.A.K., 2011. Antidiabetic, antihypercholestermic and antioxidative Republic of Mauritius, (ROM), 2011. Natinonal Parks and Conservation Services. effect of Aloe vera gel extract in alloxan-induced diabetic rats. Aust. J. Basic Ministry of Agro Industry and Food Security. o〈http://www.gov.mu/portal/ Appl. Sci. 5, 1321–1327. site/npcs/menuitem.5dbdbc2b5dcd53090eb4dc46a0208a0c/〉4(site accessed Morsi, R.M.Y., El-Tahan, N.R., El-Hadad, M.A., 2010. Effect of aqueous extract 01 January 2013). Mangifera indica leaves, as functional foods. J. Appl. Sci. Res. 6, 712–721. Republic of Mauritius, (ROM), 2012a. Opening Ceremony of the International Motala, A., Ramaiya, K., 2010. Diabetes: The Hidden Pandemic and its Impact on Conference on Diabetes and Associated Diseases. o〈http://www.gov.mu/ Sub-Saharan Africa. Novo Nordisk. o〈http://www.novonordisk.com/images/ portal/site/pmsite/menuitem.ade81d8b85e53623040d013400b521ca/?conten about_us/changingdiabetes/PDF/Leadership%20forum%20pdfs/Briefing% t_id=93c6c42277ce4210VgnVCM1000000a04a8c0RCRD〉4 (site accessed 03 20Books/Sub-Saharan%20Africa%20BB.pdf〉4 [site accessed 24 July 2013]. February 2013). Mustaffa, F., Indurkar, J., Ali, N.I.M., Hanapi, A., Shah, M., Ismail, S., Mansor, S.M., Republic of Mauritius, (ROM), 2012b. Population and Vital Statistics. ohttp://www.gov. 2011. A review of Malaysian medicinal plants with potential antidiabetic mu/portal/goc/cso/ei987/JANJUNE2012.pdf4(site accessed 02 January 2013). activity. J. Pharm. Res. 4, 4217–4224. Republic of Mauritius, (ROM), 2013. Mauritius no Longer Part of Top 10 Nations Mutheeswaran, S., Pandikumar, P., Chellappandian, M., Ignacimuthu, S., 2011. with High Prevalence of Diabetes.o〈http://www.gov.mu/English/News/Pages/ Documentation and quantitative analysis of the local knowledge on medicinal Mauritius-no-longer-part-of-top-10-nations-with-high-prevalence-of-dia plants among traditional Siddha healers in Virudhunagar district of Tamil Nadu, betes.aspx〉4(site accessed 18 March 2013). India. J. Ethnopharmacol. 137, 523–533. Riaz, S., 2009. Diabetes mellitus. Sci. Res. Essay 4, 367–373. Naskar, S., Mazumder, U.K., Pramanik, G., Gupta, M., Kumar, S.R.B., Bala, A., Islam, A., Rita, P., Animesh, D.K., 2011. An updated overview on Atropa belladonna L. Int. Res. 2011. Evaluation of antihyperglycemic activity of Cocos nucifera Linn. on J. Pharm. 2, 11–17. streptozotocin induced type 2 diabetic rats. J. Ethnopharmacol. 138, 769–773. Rokaya, M.B., Munzbergova, Z., Timsina, B., 2010. Ethnobotanical study of medicinal Neamsuvan, O., Tuwaemaengae, T., Bensulong, F., Asae, A., Mosamae, K., 2012. A plants from the Humla district of western Nepal. J. Ethnopharmacol. 130, survey of folk remedies for gastrointestinal tract diseases from Thailand's three 485–504. southern border provinces. J. Ethnopharmacol. 144, 11–21. Saafi, E.B., Louedi, M., Elfeki, A., Zakhama, A., Najjar, F.M., Hammani, M., Achour, L., 2011. Nunkoo, H.D., Mahomoodally, M.F., 2012. Ethnopharmacological survey of native Protective effect of date palm fruit extract (Phoenix dactylifera L.) on dimethoate remedies commonly used against infectious diseases in the tropical island of induced-oxidative stress in rat liver. Exp. Toxicol. Pathol. 63, 433–441. Mauritius. J. Ethnopharmacol. 143, 548–564. Sabahelkhier, M.K., Sulafa, H.N., Mohammed, N.M., Wesel, A.S., Amani, A.E., Mehad, A.F., Ojewole, J.A., 2005. Hypoglycemic and hypotensive effects of Psidium Guajava Linn. 2012. Effects of aqueous extraction of green tea (Camellia sinensis)onsome (Myrtaceae) leaf aqueous extract. Methods Find. Exp. Clin. Pharmacol. 27, 689–695. biochemical parameters in American white rats. J. Anim. Plant Sci. 13, 1725–1730. Okoli, C.O., Obidike, I.C., Ezike, A.C., Akah, P.A., Salawu, O.A., 2011. Studies on the Saha, P., Sen, K.K., Bala, A., Mazumber, U.K., Haldar, P.K., 2011. Evaluation of anticancer possible mechanisms of antidiabetic activity of extract of aerial parts of activity of Lagenaria siceraria aerial parts. Int. J. Cancer Res. 7, 244–253. Phyllanthus niruri. Pharm. Biol. 49, 248–255. Sărăndan, H., Botau, D., Ianculov, I., Radu, F., Rada, O., Morar, D., Sărăndan, M., Olagbende-Dada, S.O., Ogbonnia, S.O., Coker, A.B., Ukpo, G.E., 2011. Blood glucose Serb,M.,Anghel,A.,2010.ThehypoglicemiceffectofMomordica charantia Linn lowering effect of aqueous extract of Graptophyllum pictum (Linn) Griff. on in normal and alloxan-induced diabetic rabbits. Anim. Sci. Biotechnol. 43, 516–518. alloxan-induced diabetic rats and its acute toxicity in mice. Afr. J. Biotechnol. 10, Semenya, S., Potgieter, M., Erasmus, L., 2012. Ethnobotanical survey of medicinal 1039–1043. plants used by Bapedi healers to treat diabetes mellitus in the Limpopo Oliveira, E.S., Torres, D.F., Brooks, S.E., Alves, R.R.N., 2010. The medicinal animal Province, South Africa. J. Ethnopharmacol. 141, 440–445. markets in the metropolitan region of Natal City, northeastern Brazil. J. Schmidt, T.J., Klaes, M., Sendker, J., 2012. Lignans in seeds of Linum species. Ethnopharmacol. 130, 54–60. Phytochemistry 82, 89–99. Olusanmi, M.J., Amadi, J.E., 2010. Studies on the antimicrobial properties and Sharma, V., Sharma, A., Kansal, L., 2010. The effect of oral administration of Allium phytochemical screening of garlic (Allium sativum) extracts. Ethnobot. Leaflets sativum extracts on lead nitrate induced toxicity in male mice. Food Chem. 14, 537–545. Toxicol. 48, 928–936. Otsuki, N., Dang, N.H., Kumagai, E., Kondo, A., Iwata, S., Morimoto, C., 2010. Aqueous Sharma, U.K., Pegu, S., Hazarika, D., Das, A., 2012a. Medico-religious plants used by extract of Carica papaya leaves exhibits anti-tumor activity and immunomo- the Hajong community of Assam, India. J. Ethnopharmacol. 143, 787–800. dulatory effects. J. Ethnopharmacol. 127, 760–767. Sharma, R., Yadav, R., Manivannan, E., 2012b. Study of effect of Stevia rebaudiana Ozougwu, J.C., 2011. Anti-diabetic effects of Allium cepa (onions) aqueous extracts bertoni on oxidative stress in type-2 diabetic rat models. Biomed. Aging Pathol. on alloxan-induced diabetic Rattus novergicus. J. Med. Plants Res. 5, 1134–1139. 2, 126–131. Panseeta, P., Lomchoey, K., Prabpai, S., Kongsaeree, P., Suksamrarn, A., Ruchirawat, S., Sharma, R., Manhas, R.K., Magotra, R., 2012c. Ethnoveterinary remedies of diseases Suksamrarn, S., 2011. Antiplasmodial and antimycobacterial cyclopeptide alkaloids among milk yielding animals in Kathua, Jammu and Kashmir, India. J. from the root of Ziziphus mauritiana. Phytochemistry 72, 909–915. Ethnopharmacol. 141, 265–272. Parasuraman, S., Kumar, E.P., Kumar, A., Emerson, S.F., 2010. Antihyperlipidemic Shori, A.B., 2012. Changes of hemoglobin content and glucose levels in the blood of effect of Triglize, a polyherbal formulation. Int. J. Pharm. Pharm. Sci. 2, 118–122. Rattus norvegicus by water extracts of Azadirachta indica. Chin. J. Nat. Med. 10, Park, C.M., Park, J.Y., Noh, K.H., Shin, J.H., Song, Y.S., 2011. Taraxacum officinale 0135–0137. Weber extracts inhibit LPS-induced oxidative stress and nitric oxide production Sikora, E., Bodziarczyk, I., 2012. Composition and antioxidant activity of kale via the NF-ĸB modulation in RAW 264.7 cells. J. Ethnopharmacol. 133, 834–842. (Brassica oleracea L. var. acephala) raw and cooked. Acta Sci. Pol. Technol. Patel, D.K., Prasad, S.K., Kumar, R., Hemalatha, S., 2012. An overview of antidiabetic Aliment. 11, 239–248. medicinal plants having insulin mimetic property. Asian Pac. J. Trop. Biomed., Singh, G., Kapoor, I.P.S., Singh, P., Heluani, C.S., Lampasona, M.P., Catalan, C.A.N., 320–330. 2010a. Comparative study of chemical composition and antioxidant activity of 444 A. Mootoosamy, M. Fawzi Mahomoodally / Journal of Ethnopharmacology 151 (2014) 413–444
fresh and dry rhizomes of turmeric (Curcuma longa Linn.). Food Chem. Toxicol. medicinal plant knowledge of the Yuracarés and Trinitarios from Indigenous 48, 1026–1031. Territory and National Park Isiboro-Sécure, Bolivian Amazon. J. Ethnopharma- Singh, A., Singh, K., Saxena, A., 2010b. Hypoglycaemic activity of different extracts of col. 133, 153–163. various plants. Int. J. Res. Ayurveda Pharm. 1, 212–224. Tongjaroenbuangam, W., Ruksee, N., Chantiratikul, P., Pakdeenarong, N., Kongbun- Singh, A.G., Kumar, A., Tewari, D.D., 2012a. An ethnobotanical survey of medicinal tad, W., Govitrapong, P., 2011. Neuroprotective effects of quercetin, rutin and plants used in Terai forest of western Nepal. J. Ethnobiol. Ethnomed. 〈http:// okra (Abelmoschus esculentus Linn.) in dexamethasone-treated mice. Neuro- 〉 www.ethnobiomed.com/content/8/1/19 . chem. Int. 59, 677–685. Singh, B., Nadkarn, J.R., Vishwakarma, R.A., Bharate, S.B., Nivsarkar, M., Anandjiwala, Trojan-Rodrigues, M., Alves, T.L.S., Soares, G.L.G., Ritter, M.R., 2012. Plants used as S., 2012b. The hydroalcoholic extract of Cassia alata (Linn.) leaves and its major antidiabetics in popular medicine in Rio Grande do Sul, southern Brazil. compound rhein exhibits antiallergic activity via mast cell stabilization and J. Ethnopharmacol. 39, 155–163. – lipoxygenase inhibition. J. Ethnopharmacol. 141, 469 473. Vadnere, G.P., Patil, A.V., Jain, S.K., Wagh, S.S., 2011. Investigation on in vitro Singh, N., Gupta, M., 2007. Effects of ethanolic extract of Syzygium cumini (Linn) antioxidant activity of whole plant of Cassia occidentalis Linn. (Caesalpiniaceae). seed powder on pancreatic islets of alloxan-diabetic rats. Indian J. Exp. Biol. 45, Int. J. Pharm.Technol. Res. 3, 1985–1991. 861–867. Verpoorte, R., 2008. Repository for ethnopharmacological survey data? J. Ethno- Singh, S.N., Vats, P., Suri, S., Shyam, R., Kumria, M.M.L., Ranganathan, S., Sridharan, K., pharmacol. 120, 127–128. 2001. Effect of an antidiabetic extract of Catharanthus roseus on enzymic activities Victoria, F.N., Lenardao, E.J., Savegnago, L., Perin, G., Jacob, R.G., Alves, D., Silva, W.P., in streptozotocin induced diabetic rats. J. Ethnopharmacol. 76, 269–277. Motta, A.S., Nascente, P.S., 2012. Essential oil of the leaves of Eugenia uniflora L.: Sini, J.M., Umar, I.A., Inuwa, H.M., 2011. The beneficial effect of extract of Hibiscus – sabdariffa calyces in alloxan-diabetic rats: hypoglycaemic and hypolipidaemic antioxidant and antimicrobial properties. Food Chem. Toxicol. 50, 2668 2674. activities. J. Med. Plants Res. 5, 2182–2186. Viswanathan, V., Kesavan, R., Kavitha, K.V., Kumpatla, S., 2011. A pilot study on the Soman, S., Rajamanickam, C., Rauf, A.A., Indira, M., 2013. Beneficial effects of Psidium effects of a polyherbal formulation cream on diabetic foot ulcers. Indian J. Med. – guajava leaf extract on diabetic myocardium. Exp. Toxicol. Pathol. 65, 91–95. Res. 134, 168 173. Somasundaram, G., Manimekalai, K., Salwe, K.J., Pandiamunian, J., 2012. Evaluation Vitalini, S., Iriti, M., Puricelli, C., Ciuchi, D., Segale, A., Fico, G., 2013. Traditional of the antidiabetic effect of Ocimum sanctum in type 2 diabetic patients. Int. J. knowledge on medicinal and food plants used inVal San Giacomo (Sondrio, Life Sci. Pharm. Res. 2, 75–81. Italy)—an alpine ethnobotanical study. J. Ethnopharmacol. 145, 517–529. Sotelo-Felix, J.I., Martinez-Fong, D., Muriel, P., Santillan, R.L., Castillo, D., Yahuaca, P., Waheed, A., Miana, G.A., Ahmad, S.I., Khan, M.A., 2006. Clinical investigation of 2002. Evaluation of the effectiveness of Rosmarinus officinalis (Lamiaceae) in the hypoglycemic effect of Coriandrum sativum in type-2 (NIDDM) diabetic alleviation of carbon tetrachloride-induced acute hepatotoxicity in the rat. J. patients. Pak. J. Pharmacol. 23, 7–11. Ethnopharmacol. 81, 145–154. World Health Organisation, (WHO), 2011. WHO Media Centre, Diabetes. Geneva. Souto, W.M.S., Mourao, J.S., Barboza, R.R.D., Alves, R.R.N., 2011. Parallels between Wu, X., Yin, S., Zhong, J., Ding, W., Wan, J., Xie, Z., 2012a. Mushroom tyrosinase zootherapeutic practices in ethnoveterinary and human complementary med- inhibitors from Aloe barbadensis Miller. Fitoterapia 83, 1706–1711. icine in northeastern Brazil. J. Ethnopharmacol. 134, 753–767. Wu, Y., Qu, W., Geng, D., Liang, J.Y., Luo, Y.L., 2012b. Phenols and flavonoids from the Spinks, J., Hollingsworth, B., Manderson, L., Lin, V., Canaway, R., 2013. Costs and aerial part of Euphorbia hirta. Chin. J. Nat. Med. 10, 0040–0042. drivers of complementary and alternative medicine (CAM) use in people with Yadav, R., Tiwari, P., Dhanaraj, E., 2008. Risk Factors and Complications of Type type 2 diabetes or cardiovascular disease. Eur. J. Integr. Med. 5, 44–53. 2 Diabetes in Asians. CRIPS. 9 ( 8-12. Srithi, K., Trisonthi, C., Wangpakapattanawong, P., Balslev, H., 2012. Medicinal Yadav, J.P., Arya, V., Yadav, S., Panghal, M., Kumar, S., Dhankhar, S., 2010. Cassia plants used in Hmong women's healthcare in northern Thailand. J. Ethnophar- occidentalis L.: a review on its ethnobotany, phytochemical and pharmacologi- macol. 139, 119–135. cal profile. Fitoterapia 81, 223–230. Srivastava, S., Lal, V.K., Pant, K.K., 2012. Polyherbal formulations based on Indian Yang, S.H., Chen, M.K., Hsieh, Y.S., Yang, J.S., Zavras, A.I., Hsieh, Y.H., Su, S.C., Kao, T.Y., – medicinal plants as antidiabetic phytotherapeutics. Phytopharmacology 2, 1 15. Chen, P.N., Chu, S.C., 2010. Antimetastatic effects of Terminalia catappa L. on oral Stangeland, T., Alele, P.E., Katuura, E., Lye, K.A., 2011. Plants used to treat malaria in cancer via a down-regulation of metastasis-associated proteases. Food Chem. – Nyakayojo sub-county, western Uganda. J. Ethnopharmacol. 137, 154 166. Toxicol. 48, 1052–1058. Tag, H., Kalita, P., Dwivedi, P., Das, A.K., Namsa, N.D., 2012. Herbal medicines used in Yarmolinsky, L., Huleihel, M., Zaccai, M., Shabat, S.B., 2012. Potent antiviral flavone the treatment of diabetes mellitus in Arunachal Himalaya, northeast, India. glycosides from Ficus benjamina leaves. Fitoterapia 83, 362–367. – J. Ethnopharmacol. 141, 786 795. Yazdanparast, R., Bahramikia, S., Ardestani, A., 2008. Nasturtium officinale reduces Tahraoui, A., El-Hilaly, J., Israili, Z.H., Lyoussi, B., 2007. Ethnopharmacological survey oxidative stress and enhances antioxidant capacity in hypercholesterolaemic of plants used in the traditional treatment of hypertension and diabetes in rats. Chemico-Biol. Inter. 172, 176–184. south-eastern Morocco (Errachidia province). J. Ethnopharmacol. 110, 105–117. Yi, B., Hu, L., Mei, W., Zhou, K., Wang, H., Luo, Y., Wei, X., Dai, H., 2011. Antioxidant Tarak, D., Namsa, N.D., Tangjang, S., Arya, S.C., Rajbonshi, B., Samal, P.K., Mandal, M., Phenolic Compounds of Cassava (Manihot esculenta) from Hainan. Molecules 2011. An inventory of the ethnobotanicals used as anti-diabetic by a rural 16, 10157–10167. community of Dhemaji district of Assam, Northeast India. J. Ethnopharmacol. Zahin, M., Aqil, F., Ahmad, I., 2010. Broad spectrum antimutagenic activity of 138, 345–350. Tardio, J., Santayana, M.P., 2008. Cultural importance indices: a comparative antioxidant active fraction of Punica granatum L. peel extracts. Mutation Res. – analysis based on the useful world plants of Southern Cantabria (Northern 703, 99 107. Spain). Econ. Bot. 62, 24–39. Zhang, W.K., Xu, J.K., Zhang, L., Du, G.H., 2012. Flavonoids from the bran of Avena – Tende, J.A., Ezekiel, I., Dikko, A.A.U., Goji, A.D.T., 2011. Effect of ethanolic leaves sativa. Chin. J. Nat. Med. 10, 0110 0114. extract of Moringa oleifera on blood glucose levels of streptozocin-induced Zheng, Z.P., Ma, J., Cheng, K.W., Chao, J., Zhu, Q., Chang, C.C.R., Zhao, M., Lin, Z., diabetics and normoglycemic wistar rats. Br. J. Pharmacol. Toxicol. 2, 1–4. Wang, M., 2010. Sulfur-containing constituents and one 1H-pyrrole-2-car- Thomas, E., Vandebroek, I., Sanca, S., Van Damme, P., 2009. Cultural significance of boxylic acid derivative from pineapple [Ananas comosus (L.) Merr.] fruit. medicinal plant families and species among the Quechua farmers in Apillam- Phytochemistry 71, 2046–2051. pampa, Bolivia. J. Ethnopharmacol. 122, 60–67. Zuhair, M., Ekholma, A., Nyboma, H., Renvert, S., Widen, C., Rumpunen, K., 2012. Thomas, E., Semo, L., Morales, M., Noza, Z., Nunez, H., Cayuba, A., Noza, M., Effects of Plantago major L. leaf extracts on oral epithelial cells in a scratch Humaday, N., Vaya, J., Damme, P.V., 2011. Ethnomedicinal practices and assay. J. Ethnopharmacol. 141, 825–830.