Vol. 15(1), pp. 1-21, January, 2021 DOI: 10.5897/JMPR2020.7036 Article Number: C3B7BAD65784 ISSN 1996-0875 Copyright © 2021 Author(s) retain the copyright of this article Journal of Medicinal Research http://www.academicjournals.org/JMPR

Full Length Research Paper

Ethnomedical survey of plants used for the management of HIV and AIDS-related conditions in Mbulu District, Tanzania

Alphonce Ignace Marealle1,2*, Mainen Moshi2, Ester Innocent2, Michael Qwarse3 and Kerstin Andrae-Marobela4

1Department of Clinical Pharmacy and Pharmacology, School of Pharmacy, Muhimbili University of Health and Allied Sciences, P. O. Box 65013, Dar es Salaam, Tanzania. 2Department of Biological and Pre-clinical Studies, Institute of Traditional Medicine, Muhimbili University of Health and Allied Sciences, P. O. Box 65001, Dar es Salaam, Tanzania. 3Department of Natural Products Development and Formulations, Institute of Traditional Medicine, Muhimbili University of Health and Allied Sciences, P. O. Box 65001, Dar es Salaam, Tanzania. 4Department of Biological Sciences, University of Botswana, Private Bag UB 00704, Garborone, Botswana.

Received 9 September, 2020; Accepted 8 December, 2020

The aim of this Study was to document medicinal plants used in the management of HIV and AIDS- related conditions in Mbulu District. An ethnomedical survey was conducted using a semi-structured questionnaire. The main HIV and AIDS-related conditions considered during this study were; cough, frequent fevers, diarrhea, weight loss, oral thrush, genital warts, candidiasis, abscesses, skin rashes, shingles and venereal diseases. Literature survey was also carried out to compile supplementary data on ethnomedical used and pharmacological activities of the respective plants. Thirty seven species from 23 families were reported. The plant families with the highest number of documented species were Acanthaceae, Caesalpiniaceae, Compositae and Verbanaceae with three species each. Literature information on the 37 reported plant species showed that, 23 plants could be linked to supporting data on ethnomedical uses, 23 were related to biological activity and 12 had been reported to display varying activities against HIV-1. Sixteen identified medicinal plants recorded new ethnomedical uses related to HIV and AIDS-related conditions, while 8 and 16% of the plant species did not have any previously reported ethnomedical uses or pharmacological activities, respectively.

Key words: Medicinal plants, indigenous knowledge, HIV and AIDS-related conditions.

INTRODUCTION

Due to advances in the development of highly active antiretroviral therapy (HAART), HIV/AIDS has become a

*Corresponding author. E-mail: [email protected].

Author(s) agree that this article remain permanently open access under the terms of the Creative Commons Attribution License 4.0 International License 2 J. Med. Plants Res.

manageable chronic condition. However, HIV infection is data on ethnomedical used and pharmacological activities still a disease of public health concern which in 2018 of respective plants. accounted for 770 000 deaths globally (WHO, 2018). Among reported worldwide HIV cases, more than 70% MATERIALS AND METHODS are from Sub Saharan Africa. In Tanzania, the prevalence of HIV is about 5.1% and in 2017 it was estimated that Study area 1.5 million people were living with HIV, 65 000 new infections were reported and a total of 32 000 AIDS- Mbulu District is one amongst the six districts in Manyara Region, related deaths occurred (NBS, 2017; WHO, 2018). northeastern Tanzania (Figure 1), with an estimated population of The prevalence of HIV in Tanzania by regions ranges 320 279, according to the latest Tanzania National Census of 2012 (NBS, 2013). The district is bordered to the north by the Arusha from 0% in some areas of Unguja and Pemba to 11.4% in region and lake Eyasi, to the east by the Babati rural district, to the Njombe region (NBS, 2017). Manyara Region is currently south by the Hanang district, and to the west by the Singida region. among regions with low prevalence of HIV in Tanzania People of different ethnicities inhabit this district, particularly Iraqw‟ mainland. However, in 2002, Manyara Region was (also called the Wambulu) one of the earliest agro-pastoralists who among the two regions with the highest prevalence of migrated south from the region of Ethiopia to Tanzania. The other indigenous ethnic groups are the Hadzabe, living in Yaeda chini HIV based on prevalence estimated among blood donors and the Datooga people. Local inhabitants engage mainly in (Tanzania, 2002). At that time, the highest prevalence agriculture, livestock keeping, farming activities and hunting. There was noted in Kagera (18.6%), followed closely by are plantations of onions and wheat in many places of Manyara Manyara (17.5%) and Iringa (14.1%) regions. In the same region which attract many business people from across the country year, the prevalence among females by region was and from neighboring countries. Seasonal open markets for highest in Manyara (19.8%), followed by Dar es Salaam livestock and the presence of the Haydom Lutheran hospital, which provides specialized medical care are among factors that attract (18.9%) and Iringa (18.4%) (Tanzania, 2002). However, people from other parts of the region and the country to visit the currently the prevalence of HIV in Manyara Region is district. significantly lower than the national HIV prevalence with the most recent prevalence of 1.5 % as per 2011-2012 HIV impact survey and 2.3% as per 2016-2017 HIV Study design impact survey (NBS, 2017; Tanzania, 2011). This was a qualitative ethnomedical survey conducted in May 2019. The World Health Organization (WHO) estimates that This study design was selected as it offers opportunity for a about three quarter of the population in some African homogeneous exploration, raise more issues through broad and countries still relies on medicinal plants for their primary open-ended inquiry (Choy, 2014). The study employed a purposive health care (WHO, 2008). The great biodiversity in sub- sampling method in which selection of respondents only included Sahara Africa has provided the indigenous people with a THPs recognized by Health authorities in the office of Mbulu District Medical Officer (DMO). This was important to reduce the likelihood range of plants that are used for traditional medicinal of interacting with fake or inexperienced THPs. Acknowledging the purposes. Mbulu District in Manyara Region is inhabited contribution of THPs in health care provision in Tanzania, the by people of different tribes, particularly Iraqw‟, Ministry responsible for health is currently advocating registration of Datooga and Hadzabe with reported use of herbal THPs through the offices of DMOs all over the country. The medicines for treatment and management of their health legitimacy of a THP is checked well before he/she is registered challenges (Patel and Mwamhanga, 2014; Qwarse et al., through the involvement of witnesses like neighbors, village and ward officials where the THP resides or has been practicing. During 2018). The Hadzabe are hunter-gatherers who live in the the conduct of this study, the coordinator from the office of the DMO eastern rift valley in Northern Tanzania and for most of responsible for the registration of THPs was engaged to locate the the time they have relied on natural resources (Marlowe, THPs, and kindly offered translation services when it was required. 2002). This remote area with poor infrastructure has not been extensively reached for the inventory of medicinal Data collection plants. The rural community is almost totally dependent on traditional medicine for their health care needs. It is The study employed face-to-face interviews to document therefore, reasonable to speculate that the use of ethnomedical information about plants used for management of alternative health seeking and coping strategies in Mbulu, selected disease conditions mainly HIV and AIDS-related including the use of herbal therapies, may have conditions using a semi-structured questionnaire. A narrative of symptoms helped in listing plants used by the THPs to treat contributed to the progressive reduction of HIV/AIDS HIV/AIDS-related conditions. The first sections of the questionnaire prevalence. sought to gather demographic information about the THPs, and the Despite the huge biodiversity and the history of use of conditions that the THPs are confident of treating/managing. The medicinal plants in Manyara Region, to the best of our other sections aimed at documenting plants that are used to knowledge, no study has documented plants used for the manage conditions/symptoms of HIV and AIDS-related diseases management of HIV and AIDS-related conditions. including; tuberculosis, Herpes zoster infection (commonly known as “mkanda wa jeshi” in Kiswahili and characterized by a pruritic Therefore, the purpose of this study was to identify rash around the chest or stomach), persistent cough, cough medicinal plants used for the management of HIV and associated with chest pain, skin rashes, frequent fevers, chronic AIDS-related conditions and to compile supplementary diarrhea, chronic wounds, genital warts and wasting. Marealle et al. 3

Other conditions/symptoms probed were oral candidiasis/oral handling matters related to THPs. The average age of the thrush, which the THPs recognize as “Utando wa mdomoni” in THPs interviewed was 61.3 ranging from 45 to 75 years. Kiswahili language and vaginal candidiasis. Other information The average training time and experience of the study solicited by the questionnaire included the common/local names of the plants, parts used, methods of preparation, dosage, frequency participants was 12.2 and 22.5 years respectively. Four and duration of treatment and side effects. The study also of the six THPs reported to have gained their knowledge considered and documented plants used for treatment of pneumonia of traditional medicines from their parents and the (presented in Kiswahili language by the THPs as “Kichomi”). remaining two reported to have learned from their fellow Collection of voucher specimen of the listed plant species was THPs and other people with previous knowledge on done with the THPs and a botanist, Mr Selemani Haji, of the Department of Botany, University of Dar es Salaam to avoid traditional medicines. Four of the THPs had an misidentification. The voucher specimens are kept in the Herbaria apprentice under them. The average number of patients of the Institute of Traditional Medicine, Muhimbili University of attended by these THPs per month was 101 ranging from Health and Allied Sciences (MUHAS) and Department of Botany, 4 to 360 patients. Five THPs reported to be attending University of Dar es Salaam in Tanzania. patients coming from all over Tanzania. Details are summarized in Table 1.

Literature survey to support medicinal plant uses General conditions treated by THPs Literature information on the collected medicinal plant species was compiled using different search engines including Google Scholar, Pubmed/Medline, Research Gate and Hinari. The plant‟s name was THPs are diverse in their professional skills and are used in combination with different keywords such as, ethnomedical, sometimes specialized. In order to gain an insight in the ethnopharmacology, ethnobotany, HIV, AIDS, antimicrobial, overall expertise all THPs participating in this study were antibacterial, antifungal, anti-HIV, tuberculosis, Herpes zoster, oral asked to mention disease conditions which they generally candidiasis, sexually transmitted infections, cough, skin rashes, treat. All six interviewed THPs reported to be able to treat fevers, diarrhea, wounds, warts, oral thrush, weight loss, vaginal at least one type of cancer. The majority stated also candidiasis etc. In this review, only articles written in English language were considered. The review covered the ethnobotanical being capable of treating other conditions including and ethnopharmacological literature from 1989 to 2019. gonorrhea 5(83%), typhoid fever 5(83%) and syphilis 4 (67%).

Data analysis HIV and AIDS-related conditions encountered by Data were entered into Excel spreadsheet and summarized using THPs descriptive statistics. The descriptive statistics were applied to identify the number and percentage of species, genera and families Most of the interviewed THPs were aware of the common of medicinal plants. They were also applied to identify the percentage distribution of plant parts used and diseases treated by symptoms of HIV related conditions including tuberculosis the identified medicinal plants. The graphs were plotted by and candidiasis. The THPs reported that they often GraphPad prism software version 8. encounter several common symptoms of HIV/AIDS- related conditions including persistent cough (50%), cough and chest pain (66.7%), frequent fevers (66.7%), Ethical approval and consent to participate diarrhea (66.7%), skin rashes (66.7%), oral thrush (66.7%), genital warts (66.7%) and vaginal candidiasis This study was awarded Ethical clearance by the MUHAS (83.3%). However, patients complaining of weight loss institutional review board (Ethical clearance No. 2018-04- 04/AEC/Vol. XII/87; Dated, 4th April 2018). Permission to conduct were rarely attended by these THPs (16.7%). the study in Mbulu District was sought from all government authorities from the district to village level. All THPs gave prior informed consent before they were interviewed. Medicinal plant species documented

This study documented 37 plant species used in Mbulu RESULTS for the management of a variety of human disease conditions, majority of which (81%) were for management Socio-demographic characteristics of the THPs of HIV and AIDS-related conditions (Figure 1). The plants represent 23 families and the families with the highest The study interviewed six THPs from Mbulu District. Four number of species documented were Acanthaceae, of them were males and two were females. Six different Caesalpinaceae, Compositae and Verbenaceae with 3 wards of Mbulu District were visited for the survey species each (Figure 2). including Gidhim, Labay, Endamilay, Masqaroda, Yaeda Out of the 37 reported plant species, 23 (62%) had chini and Haydom. The wards were chosen purposively related cited ethnomedical uses, 23 (62%) had based on the availability of THPs recognized by the scientifically proven related cited biological activity and 12 coordinators from the office of DMO responsible for (32%) had been reported to have varying activities 4 J. Med. Plants Res.

Table 1. Characteristics of the interviewed THPs.

Place of Estimated number Marital Education Knowledge Training Duration of Training THPs Gender Age Ward birth of patients served Patients from Type of patients status level gained from time practice others (District) per month No formal 1 F 60 Married Gidhim Mbulu Mother 5 10 Yes 20 All over Tanzania Children and adults education No formal 2 M 45 Married Labai Karatu THP 2 15 No 12 All over Tanzania Children and adults education Primary 3 F 69 Married Endamila Babati Mother 20 30 Yes 150 All over Tanzania Children and adults education Primary Father and 4 M 75 Married Maskaruda Mbulu 6 21 Yes 4 All over Tanzania Children and adults education others Yaeda No formal 5 M 60 Married Mbulu Father 20 40 No 60 Manyara region Children and adults chini education Primary Several 6 M 59 Married Haydom Babati 20 19 Yes 360 All over Tanzania Children and adults education people

against HIV-1 (Table 2), while 8 and 16% species were roots (58.1%) whereby 37.2% use root barks chalybeum Engl was indicated for six conditions, did not have any previously reported ethnomedical and 20.9% reported to use whole roots. The other Ozoroa insignis Delile and Croton scheffleri Pax uses or pharmacological activities, respectively. plant part used is stem bark (23.3%) followed by were indicated for eight conditions, Ximenia About 44% of the plant species recorded new leaves (11.6%) (Figure 3). The main method of americana L, Ximenia caffra Sond. and Zanha ethnomedicinal uses related to HIV and AIDS- preparation used by the THPs was decoction africana (Radlk) Exell were indicated for ten related conditions. Some of these plants include (52%), followed by dry powder (38.1%) (Figure conditions and Ensete ventricosum (Welw.) Conyza pyrrhopappa Sch. Bip. ex A.Rich for 4).The methods of drug administration were oral Cheesman was indicated for twelve conditions. persistent cough, Croton megalocarpus Hutch for application (81.1%) and topical application, mainly candidiasis, Croton cheffleri Pax for cough and used for wounds and other skin infections STIs, Embelia schimperi Vatke for HIV and STIs, (19.9%). DISCUSSION Ensete ventricosum (Welw.) Cheesman for genital warts, candidiasis, tuberculosis and STIs, The study reports 37 plant species which are used Hymenodictyon floribundum (Hochst. & Steud.) Disease conditions treated by the plants in the management of various conditions related B.I.Rob for vaginal candidiasis, Justia subsessilis to HIV/AIDS, of which 12 (32%) are previously Oliv for STIs, Balanites aegyptica (L.) Delile for More than 20 different disease conditions are reported to have anti-HIV activity, including chronic wounds, Ozoroa insignis Delile for treated with the documented 37 plant species, Balanites aegyptica (L.) Delile, Barleria gonorrhea and Teclea simpliformis Thonn for including gonorrhea (35%), syphilis (35%), cough eranthemoides R.Br. ex C.B.Clarke, Cassia diarrhea. (30%), chronic wounds (30%) and oral candidiasis abbreviata subsp. beareana (Holmes) Brenan, Erythrina abyssinica Lippia javanica (24%), (Figure 5). Fifty nine percent (59%) of the DC, L, Plant part used, dosage forms and routes of reported plant species were indicated for more Pappea capensis Eckl & Zeyh, Plectranthus administration than one conditions; Elaeodendron buchananii barbatus Andrews, Plumbago zeylanica L, (Engl) Verdc and Embelia schimperi Vatke were Terminalia sericea Burch. ex DC, Warburgia The most frequently used plant parts by the THPs indicated for five conditions, Zanthoxylum ugandensis Sprague, Ximenia Americana L and Marealle et al. 5

Figure 1. Map showing the location of Mbulu District in Manyara Region, Tanzania. The map was originally generated using ArcGIS software version 10.7.1 (https://www.esri.uconn.edu/software/arcgis-student/).

Ximenia caffra Sond (Chothani and Vaghasiya, 2011; C. abbreviata and Plumbago zeylanica L. were among 10 Kapewangolo et al., 2013; Leteane et al., 2012; Maregesi plants ethnobotanically identified in Botswana and tested et al., 2010; Maroyi, 2014; Mohammed et al., 2012; by our collaborators for anti-HIV activity in recent years. Mujovo et al., 2008; Mulaudzi et al., 2011; Rukunga et al., Both plants were among 3 plants with the highest ability 2002; Tshikalange et al., 2008). The majority of the plants to inhibit HIV-1c (MJ4) replication as measured by p-24 with reported anti-HIV activity were not collected from antigen Elisa kit (Leteane et al., 2012). Their study Tanzania. Barleria eranthemoides whose methanolic revealed that C. abbreviata subsp. beareana (Holmes) extract exhibited anti-HIV activity (IC50 value 2.1 μg/ml) Brenan inhibited HIV-1c in a concentration dependent was collected from Bunda district in Tanzania, not too far manner but the activity of P. zeylanica L. was linked to its away from the Manyara Region (Maregesi et al., 2010; tannin content. They also tested another plant Cassia Maregesi et al., 2007). Barleria eranthemoides recorded sieberiana which is in the same as C. abbreviata the highest anti-HIV activity of the 50 plant extracts subsp. beareana (Holmes) Brenan and had the highest obtained from 39 different plant species collected from ability to inhibit HIV-1c replication among the 10 tested Bunda district, Tanzania and tested for anti-HIV-1 activity plants in a concentration dependent manner. During the (Maregesi et al., 2010). survey in Manyara other plants from the Cassia genus 6 J. Med. Plants Res.

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Figure 2. Percentage distribution of families of the collected plants (N=37).

were also reported and collected which include Cassia had similar cited ethnomedical uses elsewhere and 62% didymobotrya and Cassia singueana. C. didymobotrya have similar proven biological activities. All interviewed has been reported to have no anti-HIV activity as it failed THPs in Mbulu reported to have ability to treat cancer to protect the MT-4 cells from HIV cytopathy measured and majority reported to be able to treat STIs (STIs), by MTT (Cos et al., 2002). However, there are no reports typhoid fever and brucellosis, diseases which are on anti-HIV activity of the other plant Cassia singueana. relevant in their area. Therefore, the results are indicative In Mbulu, Tanzania, C. abbreviata is mixed with several of how strong the THPs in Mbulu district are managing other plants for treatment of diarrhea and some of these infections and cancers. This is supported by the big plants have been proven scientifically to have varying number of patients these THPs are receiving and antimicrobial activities including anti-HIV-1 activity. These attending per month. Some other reported plant species plants include Elaeodendron buchananii, Ozoroa insignis, have not been screened for anti-HIV activity but some Ximenia americana and . Ximenia species from the same genus have been tested and americana has been reported to have ability to inhibit found to have anti-HIV activity. A good example is HIV-1 replication (Maroyi, 2014). Therefore, there is a Vernonia glabra, used in Mbulu for management of STIs need to test the individual plants and combinations to see and is confirmed to have weak antimalarial and if the combinations will have improved antimicrobial antimicrobial activity (Frank, 2012; Kitonde et al., 2012; and/or anti-HIV activity. Ramadhani et al., 2015) but has no reports on anti-HIV High percentage of the reported plant species (62%) activity. However, Vernonia amygdalina and Vernonia Marealle et al. 7

Table 2. Plants used for management of selected conditions in Mbulu district, Manyara region.

Scientific name (voucher Vernacular Part Method of Previous reported Family name Uses Pharmacological activities specimen number) name (tribe) used preparation and use ethnomedical use Leaves decoction is drunk or applied topically for fungal infections and also used against typhoid, wounds, and Ahhweri/ snakebites (Tanzania) Aloaceae Dry powder mixed with (Hamza et al., 2006; Mbunde Toxic to brine shrimps Aloe lateritia Engl. (AIM-07) Awurmo Persistent cough Roots porridge or tea et al., 2017). Leaves are (Moshi et al., 2007). (Iraqw’) used for treatment of liver diseases, wounds, pneumonia and constipation (Rwanda) (Alphonse et al., 2010).

Anti-HIV/antiviral, antimicrobial, anticancer, wound-healing and anthelmintic properties Stem bark decoction is used (Chothani and Vaghasiya, in Tanzania for Cough and Decoction. One table 2011; Hussein et al., 1999; Chronic wounds chest infections (Maregesi et Balanites aegyptiaca (L.) Delile Putluputlu spoonful is taken three Kabbashi, 2015; Runyoro et Balanitaceae (Cancer), chronic Roots al., 2007). In Uganda roots (AIM-25) (Hadzabe) times a day for three al., 2006). An oral abdominal ulcers and leaves decoction is days. administration of the drunk for yellow fever aqueous extract for the (Tugume et al., 2016). treatment of HIV patients has shown good results (Chothani and Vaghasiya, 2011).

In Tanzania root decoction or infusion of leaves is drunk for treatment of dysentery and it is very potent for several Decoction. One tea Methanol extract exhibited Barleria eranthemoides R.Br. ex Palangate infectious diseases Acanthaceae Fever (malaria) Roots cup is taken twice a anti-HIV activity (Maregesi C.B.Clarke. (AIM-27) (Hadzabe) (Maregesi et al., 2007). In day for two days. et al., 2010). Ethiopia, it is used for wound healing and cancer (Bitew et al., 2019; Tuasha et al., 2018).

Decoction. One tea Ngwilla Frequent fevers, Blepharis affinis Lindau. (AIM-37) Acanthaceae Roots cup is taken twice a No reports No reports (Hadzabe) epilepsy day until recovered. 8 J. Med. Plants Res.

Table 2. Contd.

Dry powder is taken with water for Used in Zimbabwe for STIs treatment of frequent (Kambizi and Afolayan, fevers. Mixed with 2001), in Mozambique for Ozoroa insignis Anti-HIV activity (Leteane et eye infection, stomach ache, Delile. Ximenia al., 2012). It is reported to Cassia abbreviata Frequent fevers, diarrhea, and malaria Quarerei darma Root bark, Americana L. exhibit antimicrobial, subsp. beareana (Holmes) Caesalpinaceae all types of (Ribeiro et al., 2010). Used in (Iraqw’) stem bark /Ximenia caffra antimalarial and anthelmintic Brenan. (AIM-33) diarrhea Botswana for general Sond., Elaeodendron activity (I, 2013; Shai et al., cleansing, abdominal pain, buchananii (Engl) 2013) womb problems, menstrual Verdc. and Zanha pains, and STIs (Leteane et africana (Radlk) al., 2012). Exell. for treatment of diarrhea.

In Kenya leaves and roots are used for treatment of cancer, skin diseases, malaria, gonorrhea, ring It exhibited moderate worms, emetic, excess bile cytotoxicity (Kamuhabwa et To induce vomiting and as a purgative (Jeruto et al., 2000) but had no anti- Cassia didymobotrya Fresen Qarerei aya Caesalpinaceae before initiation of Leaves, roots Decoction al., 2008). In Rwanda it is HIV activity (Cos et al., (AIM-21) (Iraqw’) any treatment used against ascariasis, and 2002). It also exhibited neuropsychopathy (Cos et antimicrobial activity (Singh al., 2002). In Tanzania it is et al., 2010). used for treatment of anemia, as laxative and antihelmintic (Kamuhabwa et al., 2000).

Decoction. One cup In Zimbabwe it is used for It is reported to have toxicity Gitalashayi Tape worm, Cassia singueana Del (AIM-23) Caesalpinaceae Roots is taken once per treatment of STIs (Kambizi against brine shrimps LC50 (Hadzabe) Diabetes mellitus day for one day and Afolayan, 2001). of 11 µg/ml (Adoum, 2016).

Management of HIV/AIDS (Uganda) (Lamorde et al., No protection against HIV 2010). Treatment of induced cytopathy (Cos et pneumonia and stomach al., 2002). Cytotoxic Clerodendrum myricoides ache (Kenya) (Radol et al., (Kamuhabwa et al., 2000) Tloqomo STIs, chronic Dry powder applied (Hochst.) R.Br. ex Vatke. (AIM- Verbenaceae Roots 2016). Constipation, but low cytotoxicity in plant (Iraqw’) wounds (cancer) topically 01) hepatitis, syphilis (Rwanda) from Rwanda (Cos et al., (Cos et al., 2002). Analgesic, 2002). Strong activity management of fever, against Plasmodium berghei treatment of infections (Deressa et al., 2010). (Kamuhabwa et al., 2000). Marealle et al. 9

Table 2. Contd.

A decoction of the Treatment of infections roots and infusion of including STIs (Guinea) the leaves are used (Magassouba et al., 2010). for treatment of Mixed with other plants in fevers. The infusion Conyza pyrrhopappa Sch.Bip. ex Persistent cough, treatment of sores in infants Compositae Ankwey (Iraqw’) Leaves, roots of the leaves with No reports A.Rich. (AIM-04) frequent fevers (Tanzania) (Ramathal and Zanthoxylum Ngassapa, 2008). Used for chalebeum Engl. treatment of diarrhea leaves or roots is (Ethiopia) (Woldeab et al., used for treatment of 2018). persistent cough.

In Uganda it is used for Dry powder infusion Crassocephalum picridifolium (DC.) management of weakness in Compositae Amabei (Iraqw’) Boils Roots is drunk for treatment No reports S.Moore. (AIM-34) pregnancy (Tugume et al., of boils 2016)

It is used in Uganda for treatment of wounds (Njoroge and Bussmann, 2007). In Sexually Kenya the bark decoction is transmitted Dry powder mixed used for management of Antibacterial activity (Kariuki Croton megalocarpus Hutch Euphorbiaceae Ailoi (Iraqw’) infections, vaginal Stem bark with porridge or tea wounds and whooping cough et al., 2014). candidiasis, (Peter et al., 2015). It is also brucellosis used for syphilis, anthrax and snakebites (Kariuki et al., 2014).

Dry powder mixed with porridge or tea Gonorrhea, for treatment of syphilis, typhoid, Girgirimo/ tonsillitis, mumps Used in Tanzania for brucella, mumps, High toxicity against brine Croton scheffleri Pax. (AIM-11) Euphorbiaceae Girgirimo Daat Roots and cough. treatment of fungal infections tonsillitis, cough, shrimps (Moshi et al., 2007). (Iraqw’) Decoction used for (Hamza et al., 2006). urinary tract treatment of infections gonorrhea, syphilis, boils.

Fungal infections White sap from the Dregea macrantha Klotzsch. (AIM- Asclepidaceae Tsamu (Iraqw’) with Tinea Aerial parts fresh leaves and No reports No reports 24) versicolor stem applied locally 10 J. Med. Plants Res.

Table 2. Contd.

Dry powder can be applied topically for treatment of oral It is used in Kenya for Antibacterial and antifungal All types of thrush, genital warts, treatment of microbial activities (Odak et al., 2018). Elaeodendron buchananii (Engl) diarrhea, oral thrush, Roots bark, vaginal candidiasis. It infections (Odak et al., Celastraceae Gharmo (Iraqw’) Contains cytotoxic the Verdc (AIM-13) genital warts, vaginal stem bark can be mixed with 2018).Decoction used as compound elabunin (Kubo candidiasis, syphilis Ozoroa insignis aphrodisiac (Moshi et al., and Fukuhara, 1990). Delile and taken 2010). orally for treatment of genital warts.

Used in Tanzania to treat Dry powder mixed chronic cough, and Helmintic infestation, with porridge and tea. tuberculosis (Thabeet et al., Anti- Staphylococcal, anti- Embelia schimperi Vatke. (AIM- Sexually transmitted Fruits, stem Mixed with Cassia 2017) and tapeworm helmintic activity (Bogh et al., Myrsinaceae Qaytla (Iraqw’) 30) infections, HIV, bark singueana Del. for infestation (46). In Ethiopia it 1996; Debebe et al., 2015; typhoid treatment of tape is used for treatment of Rondevaldova et al., 2015). worm infestation leprosy, ascariasis and taeniasis (Giday et al., 2009).

Cough, tuberculosis, typhoid, brucellosis, Ndizi pori skin rashes, oral (Swahili) thrush, vaginal In Ethiopia the roots are used Dry powder drunk Antimicrobial and anti- Ensete ventricosum (Welw.) candidiasis, wound, for management of abdominal Musaceae Arwor do Seeds with water or applied nematodal activity (Tesfaye Cheesman (AIM-36) cancer, genital pain and diarrhea (Mesfin et netlangw/ Arwir locally and Girma, 2017). do netlangw warts, diabetes al., 2009). (Iragw) mellitus, sexually transmitted infections

In Tanzania the stem bark and root decoction is used in dysentery and jaundice(Maregesi et al., 2007). In Uganda it is used in It contains Anti-HIV-1 Erythrina abyssinica DC. (AIM- Leguminosae Sexually transmitted Dry powder applied the management of HIV/AIDS- Qanqari (Iraqw’) Seeds alkaloids (Mohammed et al., 09) (Pap) infections locally related conditions (Lamorde et 2012) al., 2010; Nyamukuru et al., 2017). In Rwanda it is used to treat dysentery (Maikere- Faniyo et al., 1989) . In Zimbabwe it is used in the Marealle et al. 11

Table 2. Contd.

treatment of STIs (Kambizi and Afolayan, 2001). In Ethiopia it is used for tonsillitis . (Kebebew and Mohamed, 2017).

In Ethiopia it is used for treatment of eye infections Hymenodictyon floribundum Dry powder applied (Kebebew and Mohamed, Genital warts, (Hochst. & Steud.) B.L.Rob. (AIM- Leaves/Stem locally and decoction 2017; Temam and Dillo, Rubiaceae Tsere (Iraqw’) vaginal candidiasis, No reports 02) bark drunk for treatment of 2016), while in Angola the cancers diarrhea barks are used to treat febrile conditions (Fernandes et al., 2015).

It is used in Burundi for Sexually treatment of diarrheal transmitted One tea cup of diseases, leaves or aerial Tonganayi infections including decoction is taken parts used for treatment of Antimicrobial activity Justicia subsessilis Oliv. (AIM-35) Acanthaceae Roots (Iraqw’) gonorrhea. It is before meal once a Skin mycosis, varicella, and (Ngezahayo et al., 2017). also used to day for 3 days dysentery (Ngezahayo et al., manage anuria 2015; Ngezahayo et al., 2017).

Inhibition of HIV-1 reverse transcriptase enzyme by (E)- 2(3)-tagetenone epoxide and It is used in South Africa for piperitenone which are treatment of cough, bronchitis, compounds from this chest pain, asthma (South plant(Mujovo et al., 2008). Africa) (Gail et al., 2015). Antibacterial activity against Used as herbal tea, E. coli and S. aureus Lippia javanica L. (AIM-26) Verbenaceae Not provided Pneumonia Roots Decoction respiratory problems, GI (Manenzhe et al., 2004). The problems, fever, malaria, oil is also active against insect repellant, wound, Plasmodium falciparum in injuries, pain, skin infections micromolar concentrations (Maroyi, 2017). (Manenzhe et al., 2004). Activity against Entamoeba histolytica (Samie et al., 2009).

Antimicrobial activity against In Philippines it is used in the Nyctaginaceae Wounds, ear Decoction applied gram positive and gram Mirabilis jalapa L. (AIM-32) Not provided Seeds management of infections locally negative bacteria, Aspergillus dermatological diseases niger, Fusarium solani, 12 J. Med. Plants Res.

Table 2. Contd.

(Tantiado, 2012). It is used Fusarium oxysporium and as antidiarrheal, carminative,. Fusarium granularium (Hajji detoxifier, digestive stimulant, et al., 2010; Singh et al., diuretic, purgative, tonic, 2010; Zachariah et al., vermifuge. It is also used in 2011). Antiviral effect on the wound healing and skin infectivity of potato virus problems (Zachariah et al., (Vivanco, 1999). 2011)

Dry root bark powder is mixed with Terminalia sericea Burch. ex DC.stem bark for treatment of persistent cough. Dry powder is In Tanzania it is used in the Very toxic to brine shrimps applied on genital Cough, diarrhea, management of skin rashes, and cytotoxic to human warts. Root barks genital warts, Tuberculosis, Herpes hepatocelullar carcinoma, mixed with Ximenia Ozoroa insignis Delile (AIM- vaginal Root, stem simplex, Herpes zoster, human mammary Anacardiaceae Makri (Iraqw’) caffra Sond. or 14) candidiasis, bark Cryptococcal menengitis, adenocarcinoma and human Ximenia Americana cancer, boils, Oral candidiasis, bilharzia hepatocellular carcinoma L. roots, Zanha gonorrhea, syphilis (Kisangau et al., 2007; Moshi cells (Moshi et al., 2009; Africana (Radlk) et al., 2009). Rea, 2003) . Exell. roots and Elaeodendron buchananii (Engl) Verdc. stem bark/roots for treatment of diarrhea including dysentery

Inhibition of HIV-1 reverse transcriptase and antimicrobial activities (Mulaudzi et al., 2011). Used in the management of Broad spectrum of activity diarrhea in South Africa against Bacillus subtilis, Pappea capensis Eckl & Zeyh. Chronic wounds Dry powder applied (Semenya and Maroyi, Getaquabay Roots Staphylococcus aureus, (AIM-06) (Cancer) locally 2012). Venereal diseases, Escherichia coli and painful eyes, aphrodisiac Candida albicans (Pendota (Mulaudzi et al., 2011). et al., 2017). Little or no cytotoxicity against Vero monkey kidney cells (Pendota et al., 2017). Marealle et al. 13

Table 2. Contd.

Used as anthelmintic, antiseptic, antivenin and also used for management of Fungal infections White sap from the amenorrhea, diarrhea, Antifungal, antibacterial, and Pergularia daemia (Forssk.) Chiov. Tsamu Asclepidaceae with Tinea Aerial parts fresh leaves and stem asthma, whooping cough, anticancer (Karthishwaran (AIM-29) (Iraqw’) vescolor applied locally wounds, bronchitis, a