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      Ethnobotany, ethnopharmacology, and phytochemistry of traditional medicinal plants used in the management of symptoms of tuberculosis in East Africa: a systematic review

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          Abstract

          Objective

          Many studies on the treatment of tuberculosis (TB) using herbal medicines have been undertaken in recent decades in East Africa. The details, however, are highly fragmented. The purpose of this study was to provide a comprehensive overview of the reported medicinal plants used to manage TB symptoms, and to analyze scientific reports on their effectiveness and safety.

          Method

          A comprehensive literature search was performed in the major electronic databases regarding medicinal plants used in the management of TB in East Africa. A total of 44 reports were retrieved, and data were collected on various aspects of the medicinal plants such as botanical name, family, local names, part(s) used, method of preparation, efficacy, toxicity, and phytochemistry. The data were summarized into percentages and frequencies which were presented as tables and graphs.

          Results

          A total of 195 species of plants belonging to 68 families and 144 genera were identified. Most encountered species were from Fabaceae (42.6%), Lamiaceae (19.1%), Asteraceae (16.2%), and Euphorbiaceae (14.7%) families. Only 36 medicinal plants (18.5%) have been screened for antimycobacterial activity. Out of these, 31 (86.1%) were reported to be bioactive with minimum inhibitory concentrations ranging from 47 to 12,500 μg/ml. Most tested plant extracts were found to have acceptable acute toxicity profiles with cytotoxic concentrations on normal mammalian cells greater than 200 μg/ml. The most commonly reported phytochemicals were flavonoids, terpenoids, alkaloids, saponins, cardiac glycosides, and phenols. Only Tetradenia riparia, Warburgia ugandensis, and Zanthoxylum leprieurii have further undergone isolation and characterization of the pure bioactive compounds.

          Conclusion

          East Africa has a rich diversity of medicinal plants that have been reported to be effective in the management of symptoms of TB. More validation studies are required to promote the discovery of antimycobacterial drugs and to provide evidence for standardization of herbal medicine use.

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          Most cited references95

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          Methods for in vitro evaluating antimicrobial activity: A review

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            Ethnobotanical survey of medicinal plant species used by communities around Mabira Central Forest Reserve, Uganda

            Background An ethnobotanical study of medicinal plants was carried out in 14 villages adjacent to Mabira Central Forest Reserve (CFR) in Central Uganda between August 2013 and March 2014. Methods Information was obtained through interviews using semi- structured questionnaires. Field excursions with traditional healers and herbal medicine collectors were carried out. Descriptive statistics were used to present the data. Fidelity ratios and Informant consensus agreements were calculated. Results A total of 190 plant species in 61 families and 152 genera were reported in the treatment of various health conditions. Family Fabaceae was dominant representing 14 % of the plant species documented. Vernonia amygdalina was the preferred species for treating malaria. Leaves (68 %) were the most frequently used parts in preparing herbal remedies. Decoctions (29 %) and oral route (53 %) of administration were commonly used method of herbal medicine preparation and administration respectively. Fifty-eight health conditions grouped in 25 categories were treated using medicinal plants. Informant consensus agreement was highest for blood system disorders (0.9) that included anaemia, hypertension and blood cleansing indicating homogeneity of informant’s knowledge about remedies used. Vernonia amygdalina and Erythrina abyssinica had 100 % fidelity level for treatment of malaria and vomiting respectively. Conclusion The diversity of medicinal plant species used and the associated indigenous knowledge are of great value to the local community and their conservation and preservation is paramount. The therapeutic uses of the documented plants provides basic data for further research focused on pharmacological studies and conservation of the most important species.
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              Exploring the potential of endophytes from medicinal plants as sources of antimycobacterial compounds

              Natural product drug discovery has regained interest due to low production costs, structural diversity, and multiple uses of active compounds to treat various diseases. Attention has been directed towards medicinal plants as these plants have been traditionally used for generations to treat symptoms of numerous diseases. It is established that plants harbour microorganisms, collectively known as endophytes. Exploring the as-yet untapped natural products from the endophytes increases the chances of finding novel compounds. The concept of natural products targeting microbial pathogens has been applied to isolate novel antimycobacterial compounds, and the rapid development of drug-resistant Mycobacterium tuberculosis has significantly increased the need for new treatments against this pathogen. It remains important to continuously screen for novel compounds from natural sources, particularly from rarely encountered microorganisms, such as the endophytes. This review focuses on bioprospecting for polyketides and small peptides exhibiting antituberculosis activity, although current treatments against tuberculosis are described. It is established that natural products from these structure classes are often biosynthesised by microorganisms. Therefore it is hypothesised that some bioactive polyketides and peptides originally isolated from plants are in fact produced by their endophytes. This is of interest for further endophyte natural product investigations.
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                Author and article information

                Contributors
                sobakiro@gmail.com
                Journal
                Trop Med Health
                Trop Med Health
                Tropical Medicine and Health
                BioMed Central (London )
                1348-8945
                1349-4147
                14 August 2020
                14 August 2020
                2020
                : 48
                : 68
                Affiliations
                [1 ]GRID grid.448602.c, ISNI 0000 0004 0367 1045, Department of Pharmacology and Therapeutics, Faculty of Health Sciences, , Busitema University, ; P.O. Box 1460, Mbale, Uganda
                [2 ]GRID grid.79730.3a, ISNI 0000 0001 0495 4256, Department of Chemistry and Biochemistry, School of Sciences and Aerospace Studies, , Moi University, ; P.O. Box 3900-30100, Eldoret, Kenya
                [3 ]GRID grid.79730.3a, ISNI 0000 0001 0495 4256, Africa Centre of Excellence II in Phytochemicals, Textiles and Renewable Energy (ACE II PTRE), , Moi University, ; P.O. Box 3900-30100, Eldoret, Kenya
                [4 ]GRID grid.442475.4, ISNI 0000 0000 9025 6237, Department of Pure and Applied Chemistry, Faculty of Science, , Masinde-Muliro University of Science and Technology, ; P.O. Box 190-50100, Kakamega, Kenya
                [5 ]GRID grid.33058.3d, ISNI 0000 0001 0155 5938, Centre of Traditional Medicine and Drug Research, , Kenya Medical Research Institute, ; P.O. Box 54840-00200, Nairobi, Kenya
                [6 ]Department of Quality Control and Quality Assurance, Product Development Directory, AgroWays Uganda Limited, Plot 34-60, Kyabazinga Way, P.O. Box 1924, Jinja, Uganda
                [7 ]GRID grid.11194.3c, ISNI 0000 0004 0620 0548, Department of Pharmacology and Therapeutics, School of Biomedical Sciences, , Makerere University College of Health Sciences, ; P.O. Box 7062, Kampala, Uganda
                Author information
                https://orcid.org/0000-0001-9258-2519
                https://orcid.org/0000-0002-1742-4470
                https://orcid.org/0000-0002-9550-4417
                https://orcid.org/0000-0002-0175-1055
                Article
                256
                10.1186/s41182-020-00256-1
                7427981
                32818019
                0ce83819-d64c-4c63-a6b8-ca133d06c164
                © The Author(s) 2020

                Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/.

                History
                : 27 April 2020
                : 4 August 2020
                Categories
                Review
                Custom metadata
                © The Author(s) 2020

                Medicine
                antimycobacterial,antitubercular,medicinal plants,herbal medicine,phytochemicals,mycobacterium tuberculosis

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