Journal of Ethnopharmacology 185 (2016) 347–360 Contents lists available at ScienceDirect Journal of Ethnopharmacology journal homepage: www.elsevier.com/locate/jep Ethnomedicinal survey of medicinal plants used in the management of sickle cell disorder in Southern Nigeria O.O. Amujoyegbe a,n, M. Idu a, J.M. Agbedahunsi b, J.O. Erhabor a a Department of Plant Biology and Biotechnology, Faculty of Life Sciences, University of Benin, Benin City, Nigeria b Drug Research and Production Unit, Faculty of Pharmacy, Obafemi Awolowo University, Ile-Ife, Nigeria article info abstract Article history: Ethnopharmacological relevance: The present study entails the medicinal plant species used to manage Received 25 September 2015 sickle cell disorder in Southern States of Nigeria. Received in revised form Materials and methods: The ethnomedicinal information was gathered through multistage approach 16 March 2016 from three geopolitical zones of Southern Nigeria, which were purposively selected. Semi-structured Accepted 16 March 2016 questionnaires were administered on 500 respondents in 125 locations. The ethnomedicinal data col- Available online 21 March 2016 lected were analyzed using quantitative value indices such as fidelity level (percentage) and use value. Keywords: The information got was cross checked using literature search and other related materials. Ethnomedicine Result: Five hundred respondents comprising 53.12% females and 46.88% males were observed. It was Euphorbiaceae noted that 26.70% were illiterate while 73.30% had formal education. Seventy-nine percent is traditional Fabaceae healers, 27% herb traders and the other 4% are those who have awareness of sickle cell disease . One Fidelity value fi Medicinal plants hundred and seventy ve plant species belonging to 70 families, of which Fabaceae made up 26.76% and Nigeria Euphorbiaceae 16.90% forming the highest occurrence. It was observed that leaves were the most Sickle cell disorder common plant part used (69.10%) followed by root (15%) and stem bark (14%) in the preparation for sickle Use value cell management. Majority (48.57%) of these plants were harvested from wild with 38.86% being trees. Citrus aurantifolia and Newbouldia laevis had highest use values of 0.69 and 0.64 respectively. Plants with the least use value (0.001) include Abrus canescens, Acacia xanthophloea, Aerva lanata and Axonopus compressus. The result of fidelity level values of the plant species for the management of Sickle Cell Disorder (SCD) revealed that Citrus aurantifolia had the highest value of 70.2% while Angraecum distichum and Axonopus compressus had the lowest Fidelity Level value of 0.18%. Conclusion: The study revealed that people in the studied areas were well grounded in the medicinal plants used to manage sickle cell disease. This study reported for the first time 102 plant species having anti-sickling potentials with Fabaceae and Euphorbiaceae as the most dominant plant families. Many of the claimed plants were harvested from the wild showing threat thus providing needs for conservation of plants. The documented plants had high use value and fidelity level that provided quantitative and qualitative ethnomedicinal evaluation within and across the plant families. These give room for further scientific investigations in pharmacological profiles. & 2016 Elsevier Ireland Ltd. All rights reserved. 1. Introduction deoxygenated Hbs. This abnormality characterized by painful episodes, chronic anemia, enlarged spleen, serious frequent in- Sickle cell disorder (SCD) or sickle cell anemia is an autosomal fections and damage to vital organs (Balgir, 2006). The sickled red recessive genetic blood disorder with over-dominance character- blood cells have small oxygen contact that increased blood visc- ized by red blood cells with abnormal, rigid, sickle shaped. This is osity and impede normal circulation in small blood vessels re- one disease afflicting the population living in Africa, South sulting in ischemia and infarction (Carl and Ashwood, 1996). As a America and Asia. It occurs in other ethnic groups including result, micro-vascular occlusion arises which may lead to serious, sometimes fatal crises (Mehanna, 2001). Over 50 million people Mediterranean and Middle Eastern descent (WHO, 2007). Sickling were affected throughout the world (Diop et al., 2000; Gulbism of red blood cells occur because of the polymerization of et al., 2005). African continent remains the most affected by this disease with the highest prevalence in its West and Central parts. n Corresponding author. In Nigeria, the number of occurrence is believed to be up to four E-mail address: [email protected] (O.O. Amujoyegbe). million and at least 12 million people suffer from sickle cell disease http://dx.doi.org/10.1016/j.jep.2016.03.042 0378-8741/& 2016 Elsevier Ireland Ltd. All rights reserved. 348 O.O. Amujoyegbe et al. / Journal of Ethnopharmacology 185 (2016) 347–360 worldwide (Ibrahim et al., 2007). Treatment of SCD required that and Ohiri, 1999). Traditional healers and local folks have knowl- one focus on ways of inhibiting sickle cell haemoglobin poly- edge of the indigenous and healing properties of various herbs merization and prevention or repair of red cell dehydration. SCD common to their locality. These herbs may not be documented and treatment also requires interrupting the interaction of sickle cells could be lost in near future. The need to gather knowledge from with the endothelium (Brugnara et al., 1993; Charache et al., 1995; various geographical areas and collate information necessary for Kinney et al., 1999; Claster and Vichinsky, 2003; Vadolas et al., database of medicinal plants used to manage SCD in those areas is 2004). Hydroxyurea is a known inhibitor of sickle cell poly- the aim of this paper. merization and various drugs containing it has an ability to in- crease fetal hemoglobin concentration (Mcgoron et al., 2000; Sauntharajah et al., 2009). 2. Materials and methods Veeramuthu (2006) noted that more than 80% of the world population relies on traditional medicine for their primary health 2.1. Description of the study area care. The World Health Organisation (WHO, 2002) estimated 90% of the population of developing countries relied on medicinal The survey was carried out within the forest agro-ecological plants to help meet their primary health care needs. In developing region of southern part of Nigeria (Fig. 1). The basic occupation of countries, medicinal plants used to treat sickle cell crises asso- the people in the study areas are more of agrarian. The selected ciated morbidities among the less privileged classes of the society. state includes- Osun, Oyo, Ondo in Southwestern Nigeria, Edo in Treatment and management of diseases such as HIV/AIDS, malaria, South South zone of Nigeria, and Enugu State in Southeastern diabetes, sickle-cell anemia and mental disorders involve the use Nigeria. The agro-ecology areas experiences eight months (March– of medicinal plants (Elujoba et al., 2005). Medicinal plant extracts October) of bimodal rainfall and five months (November–March) were found to have ability to prevent the erythrocytes from de- of dry season each year with irregularity in the rainfall distribu- forming and losing its integrity. Adejumo et al. (2010) reported the tion. Vegetation in the study area is rainforest with patches of in vitro antisickling activities of crude methanol extracts and guinea savanna in Ondo state. The survey covered nine months aqueous fractions of roots of Plumbago zeylanica and Uvaria cha- (July 2014–March 2015). mae. Result of the antisickling assay of root of P. zeylanica and U. chamae showed the abilities to inhibit sickling under hypoxia 2.2. Ethnomedicinal data collection condition. Terminalia catappa could be effective antisickling agents that inhibit induced hemolysis of human erythrocytes (Mgbemene Multistage sampling procedure was used to select respondents Fig. 1. Location map of the study area consisting of South West, South East and South South regions of Nigeria (West Africa). O.O. Amujoyegbe et al. / Journal of Ethnopharmacology 185 (2016) 347–360 349 for the study with five states selected from the southern Nigeria. Table 1 At the second stage, five local government areas, demarcated with Demographic features of respondents on the plants used in the management of five communities for their ethnobotanical involvement in sickle sickle cell disease.Source: Field Survey 2014. cell management were selected. Lastly, 20 notable individuals Demographic features Frequency Percentage (%) from the list generated from each of the selected communities were randomly selected, adding up to 100 per state and 500 re- Gender spondents from all the states. Structured questionnaire was used Male 265 53.00 Female 235 47.00 to get bio-demographic data, knowledge of SCD such as their level Total 500 100 of understanding. Other information gotten were their involve- ment to manage the disorder, different methods, plant used, Age source (s) of medicinal plants used, plant parts and their 20–30 30 6.00 preparations. 31–40 45 9.00 41–50 60 12.00 2.3. Plant collection and identification 51–60 205 41.00 61–70 110 22.00 Above 70 50 10.0 Preliminary identification and collection of plant species was done in the field after which samples were taken for further identification and authentication at the Obafemi Awolowo Uni- Level of Education Primary 0 0 versity and University of Benin Herbaria. The photo voucher spe- Secondary 302 60.23 cimen numbers were obtained for the plants. The plant samples Tertiary 64 13.07 were arranged chronologically based on their families; use value Illiterate 134 26.70 and fidelity level (percentage). Occupation 2.4. Verification of claims of antisickling plants used in Southern Traditional healers 345 69.03 Nigeria Herb sellers 134 26.71 Others 21 4.26 Level of understanding Current study investigated whether claimed ethnomedicinal Respondents with SCD knowledge 420 84 plants used for SCD had any literature record in Nigeria or other Respondents without SCD knowledge 80 16 parts of the World, as information obtained was crosschecked using literature search and other related materials.