Antimicrobial evaluation of plants used for the treatment of diarrhoea in a rural community in northern Maputaland, KwaZulu-Natal, South Africa

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Abstract

Background

Zulu people living in the rural area of Maputaland (KwaZulu-Natal, South Africa) rely heavily on medicinal plants for the treatment of diarrhoea. Abundant availability of medicinal plants in the study area offers low cost health care, but scientific validation is needed in order to lend credibility to the traditional use against many ailments including diarrhoeal infections. With this in mind a study was designed to test the in vitro antimicrobial efficacy of 23 plant species which are used for the treatment of diarrhoea in rural Maputaland. Four 1:1 plant combinations were also evaluated to determine their interactive effects against seven diarrhoea-related bacterial pathogens.

Methods

Minimum inhibitory concentration (MIC) assays were undertaken on dichloromethane-methanol (CH ₂Cl ₂: MeOH) and aqueous crude extracts. The following micro-organisms were selected for this study and were tested based on their association with stomach ailments and diarrhoea; Bacillus cereus (ATCC 11778), Enterococcus faecalis (ATCC 29212), Escherichia coli (ATCC 8739), Proteus vulgaris (ATCC 33420), Salmonella typhimurium (ATCC 14028), Shigella flexneri (ATCC 25875) and Staphylococcus aureus (ATCC 12600). The fractional inhibitory concentration index (ΣFIC) was determined for plants traditionally used in combination.

Results

Shigella flexneri proved to be the most susceptible pathogen, where the organic extract of Terminalia sericea showed the most prominent noteworthy antibacterial activity (mean MIC value of 0.04 mg/mL). The aqueous extracts generally showed poorer antimicrobial activity with some exceptions i.e. Acacia burkei, Brachylaena transvaalensis against B. cereus and B. transvaalensis against S. flexneri. In the combination studies, synergy was predominant with mean (across all pathogens) ΣFIC values of 0.30 for Acanthospermum glabratum with Krauseola mosambicina; ΣFIC values of 0.46 for A. glabratum with Psidium guajava; ΣFIC values of 0.39 for B. transvaalensis with P. guajava and ΣFIC values of 0.88 (additive) for the combination of B. transvaalensis with Sclerocarya birrea.

Conclusion

This study provided some insight into the bacterial in vitro efficacies of plants traditionally used to treat diarrhoea by the people of Northern Maputaland. Very little connection was observed between frequency of use and efficacy. Plant combinations demonstrated favourable efficacy with mostly synergistic effects noted, lending some credibility to their use in combination.

Related collections

Most cited references 30

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Agar diffusion techniques are used widely to assay plant extracts for antimicrobial activity, but there are problems associated with this technique. A micro-dilution technique was developed using 96-well microplates and tetrazolium salts to indicate bacterial growth. p-Iodonitrotetrazolium violet [0.2 mg/ml] gave better results than tetrazolium red or thiazolyl blue. The method is quick, worked well with Staphylococcus aureus, Enterococcus faecalis, Pseudomonas aeruginosa, and Escherichia coli and with non-aqueous extracts from many different plants. The method gave reproducible results; required only 10-25 microliters of extract to determine minimal inhibitory concentrations, distinguished between microcidal and microstatic effects, and provided a permanent record of the results. Using S. aureus, and a Combretum molle extract, the technique was 32 times more sensitive than agar diffusion techniques and was not sensitive to culture age of the test organism up to 24 hours. The S. aureus culture could be stored up to 10 days in a cold room with little effect on the assay results. This method was useful in screening plants for antimicrobial activity and for the bioassay-guided isolation of antimicrobial compounds from plants. MIC values determined for sulfisoxazole, norfloxacin, gentamicin, and nitrofuratoin were similar to values indicated in the literature but values obtained with trimethroprim and ampicillin were higher with some bacteria.

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In the present paper, we analyze the past, present and future of medicinal plants, both as potential antimicrobial crude drugs as well as a source for natural compounds that act as new anti-infection agents. In the past few decades, the search for new anti-infection agents has occupied many research groups in the field of ethnopharmacology. When we reviewed the number of articles published on the antimicrobial activity of medicinal plants in PubMed during the period between 1966 and 1994, we found 115; however, in the following decade between 1995 and 2004, this number more than doubled to 307. In the studies themselves one finds a wide range of criteria. Many focus on determining the antimicrobial activity of plant extracts found in folk medicine, essential oils or isolated compounds such as alkaloids, flavonoids, sesquiterpene lactones, diterpenes, triterpenes or naphtoquinones, among others. Some of these compounds were isolated or obtained by bio-guided isolation after previously detecting antimicrobial activity on the part of the plant. A second block of studies focuses on the natural flora of a specific region or country; the third relevant group of papers is made up of specific studies of the activity of a plant or principle against a concrete pathological microorganism. Some general considerations must be established for the study of the antimicrobial activity of plant extracts, essential oils and the compounds isolated from them. Of utmost relevance is the definition of common parameters, such as plant material, techniques employed, growth medium and microorganisms tested.

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Psidium guajava: a review of its traditional uses, phytochemistry and pharmacology.

R T Solis, Rosa Martha Pérez Gutiérrez, Jonathan Mitchell (2008)

Psidium guajava, is an important food crop and medicinal plant in tropical and subtropical countries is widely used like food and in folk medicine around of the world. This aims a comprehensive of the chemical constituents, pharmacological, and clinical uses. Different pharmacological experiments in a number of in vitro and in vivo models have been carried out. Also have been identified the medicinally important phyto-constituents. A number of metabolites in good yield and some have been shown to possess useful biological activities belonging mainly to phenolic, flavonoid, carotenoid, terpenoid and triterpene. Extracts and metabolites of this plant, particularly those from leaves and fruits possess useful pharmacological activities. A survey of the literature shows P. guajava is mainly known for its antispasmodic and antimicrobial properties in the treatment of diarrhoea and dysentery. Has also been used extensively as a hypoglycaemic agent. Many pharmacological studies have demonstrated the ability of this plant to exhibit antioxidant, hepatoprotection, anti-allergy, antimicrobial, antigenotoxic, antiplasmodial, cytotoxic, antispasmodic, cardioactive, anticough, antidiabetic, antiinflamatory and antinociceptive activities, supporting its traditional uses. Suggest a wide range of clinical applications for the treatment of infantile rotaviral enteritis, diarrhoea and diabetes.

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Author and article information

Contributors

Sandy F van Vuuren: Sandy.Vanvuuren@wits.ac.za

Mduduzi N Nkwanyana: NkwanyanaM@unizulu.ac.za

Helene de Wet: DeWetH@unizulu.ac.za

Journal

Journal ID (nlm-ta): BMC Complement Altern Med

Journal ID (iso-abbrev): BMC Complement Altern Med

Title: BMC Complementary and Alternative Medicine

Publisher: BioMed Central (London )

ISSN (Electronic): 1472-6882

Publication date (Electronic): 10 March 2015

Publication date PMC-release: 10 March 2015

Publication date Collection: 2015

Volume: 15

Electronic Location Identifier: 53

Affiliations

[ ]Department of Pharmacy and Pharmacology, Faculty of Health Sciences, University of Witwatersrand, 7 York Road, Parktown, 2193 South Africa

[ ]Department of Botany, University of Zululand, Private Bag 1001, KwaDlangezwa, 3886 South Africa

Article

Publisher ID: 570

DOI: 10.1186/s12906-015-0570-2

PMC ID: 4364486

PubMed ID: 25881066

SO-VID: 8e3d5042-af00-4bd6-8856-158a3535c081

License:

This is an Open Access article distributed under the terms of the Creative Commons Attribution License ( http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly credited. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.