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Nutri-medicinal plants used in the management of HIV/AIDS opportunistic infections in western Uganda: documentation, phytochemistry and bioactivity evaluation
KTH, School of Chemical Science and Engineering (CHE), Chemistry, Organic Chemistry. (Chemical ecology group)
2015 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

As a result of the AIDS epidemic, many people are immunocompromised and opportunistic infections are common. Medicinal plants constitute one of the fundaments of HIV treatment and are commonly used in management of HIV–related ailments, and also to counteract the side effects of antiretroviral therapy. This study documents and evaluates nutri-medicinal plants traditionally used in the management of opportunistic infections associated with HIV/AIDS in western Uganda. A six-stage process of documentation, evaluation and analysis of results was conducted: (1) ethnobotanical studies leading to identification and documentation of medicinal and nutritional plants most frequently used in the treatment of opportunistic infections of HIV/AIDS  (2) Collection of plant samples and preparation of the extracts of each of the selected plants needed for bioactivity evaluation; (3) Phytochemical analysis of crude plant extracts (qualitative and GC/MS analysis); (4) pharmacological evaluation of the crude plant extracts (antimicrobial, antioxidant and mineral nutrient evaluation); (5) safety evaluation of the active extracts using animal models, and (6) Statistical analysis of the results.

The study recorded 324 plant species distributed in 75 families, with potential to treat ailments associated with immuno-compromised people living with HIV/AIDS in western Uganda. The study revealed that folk medicine is still widely practiced. Fidelity level values indicated the most preferred plant species for particular ailments. The high consensus values indicated that there was high agreement in the use of plants for various ailments. The selected preferred plant species were subjected to chemical screening to ascertain their pharmacological activities and they could be prioritized for conservation. The study allows for identifying high value medicinal plants indicating high potential for economic development.

Phytochemical screening of the aqueous and ethanol extracts of selected twenty plant species revealed the presence of tannins, saponins, flavonoids, anthocyanins, coumarins and steroid glycosides. Some of the major chemical compounds identified by gas chromatography mass spectrometry of the essential oils include α- phellandrene, linalool, carvacrol, geraniol, β-eudesmene, β-cubebene, α-caryophyllene, 1-8 cineole and caryophyllene oxide. The essential oils of Plectranthus amboinicus, Erlangea tomentosa, Plunchea ovalis and Crassocephalum vitellinum were highly active against Candida albicans and Cryptococcus neoformans. One of the essential oil fractions of Crassocephalum vitellinum (1.56 mg/ml) was highly active against Cryptococcus neoformans. Antioxidant activities of the plant species were also tested. The antioxidant activity of Pseudarthria hookeri (43.68%) and the ferric reducing power of Symphytum officinale (10.48 Mm/L) were the highest values. The ability of the plant extracts to scavenge free radicals may partly justify the traditional use of these plants to boost immunity in HIV/AIDS patients. Mineral nutrient analysis revealed high amounts of iron in Plectranthus amboinicus (5.8 mg/kg dry weight), zinc in Pseudarthria hookeri (6.9 mg/kg dry weight) and selenium in Plunchea ovalis (1.14 mg/kg dry weight). These elements are essential in maintenance of the immune system. Hematological analysis of the aqueous extract of Plectranthus amboinicus showed that the plant has immunostimulating properties by increasing the number of lymphocytes in the test animals. Further ethnopharmacological studies are needed for the documented plants particularly the most active ones.

 

 

Place, publisher, year, edition, pages
Stockholm: KTH Royal Institute of Technology, 2015. , 71 p.
Series
TRITA-CHE-Report, ISSN 1654-1081 ; 2015:34
Keyword [en]
Ethnobotanical study, Medicinal plants, HIV, AIDS, opportunistic infections, bacteria, fungi, GC-MS, phytochemistry, SPME, antioxidant, histopathology, biochemistry, hematology, western Uganda.
National Category
Natural Sciences
Research subject
Chemistry
Identifiers
URN: urn:nbn:se:kth:diva-173635ISBN: 978-91-7595-649-7 (print)OAI: oai:DiVA.org:kth-173635DiVA: diva2:854066
Public defence
2015-10-07, F3, Lindstedtsvägen 26, KTH, Stockholm, 13:00 (English)
Opponent
Supervisors
Projects
Sida Phase III Bilateral program 2010-2015
Funder
Swedish Institute, Sida Phase III Bilateral program 2010-2015
Note

QC 20150916

Available from: 2015-09-16 Created: 2015-09-15 Last updated: 2015-09-16Bibliographically approved
List of papers
1. Ethnobotanical study of nutri-medicinal plants used for the management of HIV/AIDS opportunistic ailments among the local communities of western Uganda
Open this publication in new window or tab >>Ethnobotanical study of nutri-medicinal plants used for the management of HIV/AIDS opportunistic ailments among the local communities of western Uganda
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2013 (English)In: Journal of Ethnopharmacology, ISSN 0378-8741, E-ISSN 1872-7573, Vol. 150, no 2, 639-648 p.Article in journal (Refereed) Published
Abstract [en]

Ethnopharmacological relevance: Herbal remedies are a source of therapeutics for nearly 80% of the population in Uganda. Poor health facilities and limited access to antiretroviral drugs have perpetuated and increased the use of traditional medicine especially in rural areas for the treatment of opportunistic ailments of HIV/AIDS. To document the traditional uses of nutri-medicinal plants in the management of immunocompromised ailments associated with HIV/AIDS. To document the parts and growth forms of plants used, methods of preparation and administration of the herbal remedies. Materials and methods: The study was conducted in Mbarara and Isingiro districts of western Uganda between December 2010 and May 2011. Ethnobotanical information was collected from 64 respondents who were sampled based on recommendations of local elders and administrators. Ethnobotanical data on the use of nutri-medicinal plants for traditional treatment of HIV/AIDS opportunistic ailments were collected by employing semi-structured interviews with selected respondents, house hold visits and field observations as described by (Martin, 1995a). The respondents were mainly traditional medical practitioners who treat patients who are already receiving antiretroviral drugs. Fidelity levels of plant species and informant consensus factor were determined to show the percentage of informants claiming the use of certain plant species for the same major purpose and to analyse people's knowledge of plant use. Results: The study revealed 81 plant species most of which were herbs (49%). Leaves (71%) were the most frequently used parts in remedy preparations which were mainly administered orally (85%). The majority of plants (54%) were harvested from wild populations. Hibiscus sabdariffa L, Plumeria obtusa L, and Abutilon guineense (Shumach.) Baker. F and Exell were the nutri-medicinal plants that scored the highest Fidelity level values. The informant's consensus about usages of plants ranged from 0.75 to 0.80. Plants that are presumed to be effective in treating a certain disease have higher informant consensus factor (ICF) values. Family Asteraceae accounted for 18% of the total species recorded. Thirteen species (16%) of the plants are edible and provide nutritional support. Conclusion: The study recorded plant species with potential to treat ailments associated with immunocompromised people living with HIV/AIDS in western Uganda. Such studies can help stimulate confidence in traditional medicine and enhance appreciation of herbal medicine among the people and to appreciate the value of the plant resources and therefore enhance conservation efforts of the plant species. The high consensus means the majority of informants agree on the use of plant species and this reflects the intercultural relevance and the agreement in the use of the nutri-medicinal plants to the people. We recommend the documented plants for further Ethnopharmacological studies.

Keyword
Ethnobotanical study, Nutri-medicinal plants, HIV/AIDS, Immunocompromised, Uganda
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:kth:diva-139204 (URN)10.1016/j.jep.2013.09.017 (DOI)000327567900028 ()2-s2.0-84887427142 (Scopus ID)
Funder
Sida - Swedish International Development Cooperation Agency
Note

QC 20140113

Available from: 2014-01-13 Created: 2014-01-08 Last updated: 2017-12-06Bibliographically approved
2. Documentation and consensus of indigenous knowledge on medicinal plants used by the local communities of western Uganda
Open this publication in new window or tab >>Documentation and consensus of indigenous knowledge on medicinal plants used by the local communities of western Uganda
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2014 (English)In: Journal of Natural Product and Plant Resource, ISSN 2231-3184, Vol. 4, no 1, 34-42 p.Article in journal (Refereed) Published
Abstract [en]

An ethnobotanical study was conducted to document the uses of medicinal plants among the local communities of western Uganda. The aim of the study was to identify and document plant species used for treatment of various ailments in the study areas, identify the commonly used plants, parts used, preparation and administration of herbal drugs. To find out the level of consensus or agreement between informants regarding the uses of plants for particular disease categories. Information on the plants was gathered between December 2010 and May 2011 from 124 informants using semi-structured interviews and discussions. For analysis of general use of plants, factor informant consensus (Fic) was used. The reported plants were collected and identified. The study revealed 231plant species belonging to 72 families and 164 genera. These plants were used to treat various diseases and ailments grouped under 14 ailment categories, with the highest number of species (127) being used for gastrointestinal disorders followed by reproductive health disorders (75). The factor informant consensus highlighted low agreement in the use of plants. The highest Fic (0.61) was scored for the digestive problems, such as intestinal worms, stomachache and constipation. Aloe vera was used for malaria with the highest frequency of mention (26 mentions). Herbs (55%) were the main source of medicine followed by shrubs (18%). Leaves (65%) and roots (19%) were the main plant parts used in remedy preparation while decoction was the major form of preparation. Family Asteraceae accounted for 16% of the total species recorded. The majority of plants (53%) were harvested from wild habitats. The most important species according to their fidelity are Senna occidentalis (L.) Link for deworming, Aloe vera L. for malaria, Maytenus senegalensis (Lam) Exell for syphilis and Senecio hadiensis Forssk for miscarriages.The low consensus means the majority of informants do not agree or exchange information on the use of plant species and this may require bioactivity screening to justify the use for the reported ailments. The documented information regarding therapeutic uses provides basic data for further studies focused on pharmacological studies and conservation of the most important species.

Keyword
Documentation, indigenous knowledge, medicinal pla nts, consensus, Uganda
National Category
Other Chemistry Topics
Identifiers
urn:nbn:se:kth:diva-173636 (URN)
Note

QC 20150916

Available from: 2015-09-16 Created: 2015-09-16 Last updated: 2015-09-16Bibliographically approved
3. Ethnobotanical study of indigenous knowledge on medicinal and nutritious plants used to manage opportunistic infections associated with HIV/AIDS in western Uganda
Open this publication in new window or tab >>Ethnobotanical study of indigenous knowledge on medicinal and nutritious plants used to manage opportunistic infections associated with HIV/AIDS in western Uganda
Show others...
2014 (English)In: Journal of Ethnopharmacology, ISSN 0378-8741, E-ISSN 1872-7573, Vol. 155, no 1, 194-202 p.Article in journal (Refereed) Published
Abstract [en]

Ethnopharmacological relevance: Traditional medicine plays an important role in the daily lives of the people of Uganda to treat a wide range of health problems. Our study presents results of an ethnobotanical inventory conducted to identify and document medicinal and nutritional plants used in the management of opportunistic infections associated with human immunodeficiency virus / acquired immunodeficiency syndrome (HIV/AIDS), the plant parts used, preparation and administration methods of herbal remedies. Materials and methods: We performed semi-structured interviews with 79 respondents (women 78%, men 22%), who included specialists in medicinal plants (such as traditional birth attendants and herbalists) and non specialists with general knowledge of plant use. Respondents answered a semi-structured questionnaire regarding their knowledge of plants and general treatment practices including management of HIV/AIDS opportunistic infections. The reported plants were collected and identified. Data were analyzed using factor informant consensus and fidelity level to determine homogeneity of informants' knowledge on medicinal and nutritional plants suitable for different ailment categories and the most preferred plant species used to treat each ailment category in the study areas. Results: The study revealed 148 plant species belonging to 54 families, most of which were herbs (50.7%). Leaves (61.6%) were the most frequently used parts in remedy preparations which were mainly administered orally (72%). The majority of plants (62%) were harvested from wild habitats. The most important species according to fidelity values are Hibiscus sabdariffa L for anaemia, Mangifera indica L for cough, Zehneria scabra (L F.) Sond. for skin infections, Rhus natalensis Bernh.ex.Krauss for diarrhoea and Tarenna pavettoides (Harv.) Sim for appetite boosting. The factor informant consensus highlighted the agreement in the use of plants and showed that the respiratory infections category had the greatest agreement (0.60). Family Asteraceae accounted for 15% of the total species recorded. Sixty plant species (40%) of the plants provide nutritional support. Conclusion: The study revealed that folk medicine is still widely practised. Fidelity level values indicate that these plants are the most preferred Species for particular ailments. The high consensus value (0.6) indicated that there was high agreement in the use of plants for respiratory ailments among others. These preferred plant species could be prioritized for conservation and subjected to chemical screening to ascertain their pharmacological activities.

Keyword
Ethnobotanical study, Nutri-medicinal plants, HIV/AIDS, Opportunistic infections, Uganda
National Category
Other Chemistry Topics
Identifiers
urn:nbn:se:kth:diva-151341 (URN)10.1016/j.jep.2014.05.012 (DOI)000340854000018 ()2-s2.0-84904974622 (Scopus ID)
Funder
Sida - Swedish International Development Cooperation Agency
Note

QC 20140919

Available from: 2014-09-19 Created: 2014-09-18 Last updated: 2017-12-05Bibliographically approved
4. Chemical composition and Toxicological evaluation of the aqueous leaf extracts of Plectranthus amboinicus Lour: Spreng
Open this publication in new window or tab >>Chemical composition and Toxicological evaluation of the aqueous leaf extracts of Plectranthus amboinicus Lour: Spreng
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2014 (English)In: International Journal of Pharmaceutical Science Invention, ISSN 2319-6718, Vol. 3, no 2, 19-27 p.Article in journal (Refereed) Published
National Category
Other Chemistry Topics
Identifiers
urn:nbn:se:kth:diva-173637 (URN)
Note

QC 20150916

Available from: 2015-09-16 Created: 2015-09-16 Last updated: 2015-09-16Bibliographically approved
5. Chemical composition and antimicrobial evaluation of the essential oil and fractions obtained from Plectranthus amboinicus(Lour.): Spreng traditionally used in the management of HIV/AIDS opportunistic infections
Open this publication in new window or tab >>Chemical composition and antimicrobial evaluation of the essential oil and fractions obtained from Plectranthus amboinicus(Lour.): Spreng traditionally used in the management of HIV/AIDS opportunistic infections
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(English)Manuscript (preprint) (Other academic)
National Category
Other Chemistry Topics
Identifiers
urn:nbn:se:kth:diva-173638 (URN)
Note

QS 2015

Available from: 2015-09-16 Created: 2015-09-16 Last updated: 2015-09-16Bibliographically approved
6. Phytochemical screening, antioxidant activities and mineral composition of nutri-medicinal plants used in the management of opportunistic ailments in HIV/AIDS patients
Open this publication in new window or tab >>Phytochemical screening, antioxidant activities and mineral composition of nutri-medicinal plants used in the management of opportunistic ailments in HIV/AIDS patients
(English)Manuscript (preprint) (Other academic)
National Category
Other Chemistry Topics
Identifiers
urn:nbn:se:kth:diva-173639 (URN)
Note

QS 2015

Available from: 2015-09-16 Created: 2015-09-16 Last updated: 2015-09-16Bibliographically approved

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