EXPLORING SOME ANTIMALARIAL PLANTS SOLD IN THE MARKET IN LIBREVILLE GABON

EXPLORING SOME ANTIMALARIAL PLANTS SOLD IN THE MARKET IN LIBREVILLE GABON

M. M. Boukandou *, S. R. R. R. Aworet, L. Mewono and S. Aboughe-Angone

Institut de Pharmacopée et de Médecine Traditionnelle (IPHAMETRA) /Centre National de la Recherche Scientifique et Technologique (CENAREST). BP: 5011, Libreville, Gabon.

ABSTRACT: The increasing microorganism resistance to common antimicrobial drugs constitutes a major public health issue worldwide and particularly in Gabon. The objective of this study was to conduct an ethnobotanical survey among merchants of Peyrie market in Libreville (Gabon) to identify plants or a combination of plants used to treat malaria in traditional medicine. Information was collected by interviewing merchants of the market using a structured questionnaire. Plant samples were identified and authenticated at National Herbarium at the Institute of Pharmacopeia and Traditional Medicine in Libreville, Gabon. A literature review of the collected species was done. Twenty-nine (29) plants were identified, and some of them are often used in combination. Decoction, maceration, and herbal teas were the different methods of preparation. Barks, leaves, and fruits were the most plant parts used. Overall, some of these plants have already been investigated for their antimalarial properties, such as Momordica foetida (Cucurbitaceae) and Enantia chlorantha (Annonaceae). The data also highlighted several chemical compounds in the plants which can be responsible for the antiplasmodial activity described, such as kaempferol, berberine, eugenol, and ascarisin. No study assessing the antimalarial effects of 13 plants like A. klaineana, D. benthamianus or M. monandra was found so far. Also, no data regarding the potential antiplasmodial activity of Amphimas ferrugineus, Amphimas klaineanus, Poga oleosa, and Desmodium salicifolium were available, as well as any information about the chemical compounds present in these species. This study has validated the use of some plants in the treatment of malaria in Gabon.

Keywords: Antimalarial, Ethnobotanical survey, Libreville, Peyrie Market, Plants, Traditional medicine

INTRODUCTION: The increasing micro-organism resistance to common antimicrobial drugs constitutes a major public health problem worldwide as it impacts negatively both socio-economic and healthcare systems ^{1, 2}.

Globalization, massive use, and malpractices seem to play a role in the occurrence and the spread of drug-resistant microbial strains ³. The concern raises a critical point in areas where healthcare systems are basics and where governments are unarmed against this threat. Besides, in these regions, highly pathogenic microorganisms such as HIV, Mycobacterium tuberculosis, enteropathogens viruses, and Plasmodium falciparum ⁴ are responsible for high morbidity and mortality rates and contribute to the massive economic burden due to their associated disabilities.

In this review, the potential of Gabonese medicinal plants to be a reliable and sustainable source of antiplasmodial molecules is particularly addressed. Why P. falciparum causing malaria? Malaria is, according to the World Health Organization (WHO), one of the deadliest diseases that accounted in 2017 for about 435 000 deaths, with an estimated 219 million cases mainly in Sub-Saharan and Southeast Asian regions ⁵. Pregnant women, infants, children under five years of age, patients with HIV/AIDS, but also non-immune migrants, mobile population, and travelers are at considerably higher risk of contracting malaria, and developing severe disease, than others ⁵. Children are at the highest risk for severe disease and death between six months and five years of age: During this period, children are more vulnerable as they have lost maternal immunity and they haven't yet developed specific immunity to infection.

In the past 15 years, the number of malaria cases has tremendously declined ⁶. This relative success is the consequence of: the conjugated efforts of governments and populations, the wide use of artemisinin-based combination therapy (ACT) and insecticide-treated bed nets. Unfortunately, reports of ACT-drug-resistant strains are increasing worldwide. Hence, a malaria vaccine would have been an important contribution to effective malaria control ^{7, 8, 9}. Yet, for this concern, several candidate malaria vaccines are being set up and are progressing through clinical trials while many more are in pre-clinical development ¹⁰. As an example, the malaria vaccine candidate RTS,S/AS01 has shown moderate efficacy ^11, but the further investigation needs to be undertaken to allow his utilization. Therefore, in the absence of a formally marketed vaccine, special efforts must be done to better control the deleterious effects of malaria in an integrated approach including (i) vector control, (ii) vaccine development, and (iii) search for new molecules active against the parasite.

In Gabon, a holoendemic country with a perineal P. falciparum transmission, P. falciparum malaria is the leading cause of hospitalization, especially in children ¹². As in most African countries, the Gabonese population uses both conventional and plant-based traditional medicine against malaria. In many countries, a large number of medicinal plants are used to treat malaria and showed great antimalarial potential ^{13, 14, 15}. Thus, many studies related to Gabonese antimalarial plants have been led by Gabonese researchers ^{16, 17, 18}. These investigations must be extended to the systematic evaluation of the antiplasmodial activity of the plants widely used to treat malaria and the identification of the active compounds. At the end of the day, these investigations might validate their utilization by the population and help to manufacture improved traditional treatment.

This study aimed to carry out an ethnobotanical survey with merchants of Peyrie market in Libreville on plants used by Gabonese people to treat malaria.

MATERIALS AND METHODS:

Study Area: Among the several sites where medicinal plants are sold in Libreville (capital), Peyrie Market is one of the biggest markets where a large variety of medicinal plants can be found Fig. 1.

FIG. 1: MAP OF GABON INDICATING WHERE ETHNOBOTANICAL SURVEY TOOK PLACE

This study was conducted with twenty-three (23) merchants who provided information about the plants used to treat malaria such as the part(s) of the plant (leaves, bark, roots, etc.), mode of preparation (maceration, infusion, decoction, etc.) as well as the dosage then, the samples were collected.

Questionnaire Administration: Ethnobotanical data were collected following semi-structured interviews and field observation. The questionnaire was used to interview the traders about their knowledge of the plants used in the treatment of malaria. The questionnaire recorded the date of the interview, name, surname of the merchants, age, sex, and ethnic group. Indications on the vernacular plant name, part(s) used, dosage, duration of the treatment, preparation, administration modes, and other therapeutic uses were also asked.

After the above-mentioned data were collected, plant materials were purchased, identified, and authenticated at the National Herbarium at the Institute of Pharmacopeia and Traditional Medicine in Libreville Gabon. After authentication, a literature review was undertaken to gather knowledge about the selected plants.

Literature Review: Data regarding the plant species cited by the vendors were then gathered using Google Scholar and Scopus. The information needed was the antimalarial activity, antiplasmodial activity, chemical compounds, geographical location, and the traditional uses in other countries. Recent manuscripts describing the in-vitro or in-vivo study design for antimalarial assessment as well as those reporting on the phytochemical assessment of the studied plants were retained for the study. Abstracts, old manuscripts and manuscripts with a study design not well detailed were excluded from the study.

RESULTS AND DISCUSSION: The twenty-third traders were divided into 22 females and one (1) male aged between 30 and 55 years old. The Ipunu was the most represented language, followed by the Fang. The interviewed had globally a basic primary or secondary level education. Religion was not determined. In Gabon, medicinal plant merchants are mostly women who have the knowledge of plant usage inherited from their parents.

The mode of preparation and the administration route of traditional antimalarial treatment were recorded. The reported preparation modes were mostly maceration and decoction, while the administration modes were oral, bathing, and enema Table 1. The major symptoms reported were fever, cold, dizziness, headaches, and to lesser extent, diarrhea. The ethnobotanical survey of medicinal plants used to treat malaria and sold in the market yielded a total of 29 species distributed into 20 families Table 1. The Fabaceae family was the most represented with 8 species, followed by the Apocynaceae with 4 species.

TABLE 1: ETHNOBOTANICAL INVESTIGATION OF ANTIMALARIAL MEDICINAL PLANTS

Plants cited by different vendors were not recorded twice. Further, the origin of plant specimen and their national geographic distribution was determined. Several species are also found in other regions of Gabon, namely: Mouila (1°52′ 00″S, 11°03′18″ E), Tchibanga (2°55′ 59′′S, 10° 58′59′′ E) in the southern region; Lambarené (0°42′ 05″S, 10°14′04″ E) in the center, Oyem (1°37′00′′N,11° 35′00′′ E) in the North and Makokou (0°34′ 00′′N,12° 52′00′′ E) in the northeastern region.

In this study, some plants such as Momordica foetida, Ocimum gratissimum, Chenopodium ambrosioides, Aucoum eaklaineana, Macaranga monandra, and Scyphocephalium ochocoa were told to be used alone; while othersareoften used in combination such as Distemonanthus benthamianu/Alstonia congensis; Distemonanthus benthamianus/Enantia chlorantha; Cymbopogon citratus/ Ocimum basilicum/Citrus limon. Also, the survey revealed that fresh material, mainly leaves and barks is used. However, other parts of the plants (oil, roots, inflorescence) can be used for the treatment of other ailments.

Simultaneously, a literature review aiming at identifying published research on the recorded plants was done. The literature investigation revealed that out of 29 plants, 16 (Momordica foetida, Ocimum gratissimum, Chenopodium ambrosioides, Alstonia congensis, Enantia chlorantha, Cymbopogon citratus, Ocimum basilicum, and Citrus limon) have been previously assessed for antiplasmodial effect (in-vivo or in-vitro) and have displayed interesting antimalarial activities Table 2. For the remaining plants (A. klaineana, D. benthamianus, M. monandra, S. ochocoa, A. ferrugineus, A. klaineanus, H. madagascariensis, P. oleosa, L. vulgare, A. giganteum, D. salicifolium, S. zenkeri and D. gossweileri), the antimalarial activity is still to be determined. Additionally, many of the compounds present in some of the cited plants have been elucidated except for Amphimas ferrugineus, Amphimas klaineanus, Poga oleosa and Desmodium salicifolium where no data regarding any phytochemical screening was found so far.

TABLE 2: ANTIMALARIAL ACTIVITIES AND ISOLATED COMPOUNDS OF THESE MEDICINAL PLANTS

Nowadays, malaria is still a major global health concern that kills primarily pregnant women and children, especially in developing countries. Although several medications are available for prevention and treatment, many reports on death from malaria are done every year, mainly due to drug resistance. Medicinal plants remain the key source to fight malaria as some antimalarial drugs are plant derivatives such as quinine, chloroquine (Cinchona spp), and Artemisinin (Artemisia annua) ⁵⁷. In this regard, the plants mentioned in the ethnobotanical survey were subjected to a literature review, and it was found that many of them have shown antimalarial and antiplasmodial activity against several strains of parasites responsible for causing malaria. Indeed, in-vitro and in-vivo studies demonstrated that several plants such as Sarcocephalus latifolius, Picralima nitida, Carica papaya, and Tetrapleura tetraptera cited in this study can be used as potential treatment for malaria caused by Plasmodium falciparum and P. Vivax ^{15, 17, 53}. Besides, Froelich ¹⁹ demonstrated thatM. foetidahas an antimalarial activity on the multi-resistant clone Dd2 of P. falciparum. And according to Shekinset al. (2014) ²⁷, C. citratus possesses a good antimalarial property and can be used for prophylactic and chemotherapeutic purposes, while the essential oil displays an antimalarial potential ⁵⁸.

Amongst the species that were cited to treat malaria in Gabon folk medicine, 17 plant species have displayed in-vitro antiplasmodial and/or in-vivo antimalarial effects Table 2. Additionally, active compounds were isolated from some of these plants, such as kaempferol, berberine, eugenol, or linalool. Moreover, studies indicated that plant extracts from Momordica foetida, Drypetes gossweileri, Sarcocephalus latifolius, Carica papaya, Tetrapleura tetraptera, Cylicodiscus gabunensis, and Distemonanthus benthamianus contained sugar and derivatives such as D-fructose, β-D-glucopyranose, and α-methyl mannopyranoside ^{19, 47, 55} which might contribute to the antimalarial activity displayed. Flavonoids were also detected in the studied plants, and compounds such as quercetin and derivatives were successfully isolated from Momordica foetida, Aframomum giganteum, Distemonanthus benthamianus and Citrus limon. Monoterpenes were identified in Chenopodium ambrosioides, Sarcocephalus latifolius, and Aucoumeak laineana extracts. Juma and collaborators ⁵⁹ demonstrated that sesquiterpene lactones present in the ethanol extract of O. basilicum have antimalarial activities against chloroquine-resistant (CQ-r) and CQ-sensitive (CQ-s) strains of Plasmodium falciparum. C. ambrosioides phytochemical composition shows the presence of a monoterpene named ascaridole (also known as ascarisin; 1,4-epidioxy-p-menth-2-ene) which is a potent inhibitor of P. falciparum development

Overall, the present study highlighted the plants previously studied for anti-malaria properties, thus, validating their use in traditional medicine to treat malaria as claimed by the Gabonese vendors. However, no study related to the potential antimalarial activity has been done yet regarding Distemonanthus benthamianus, Aucoumeak laineana, Scorodophloeus zenkeri, Aframomum giganteum, Leucanthemum vulgare, Harunganama dagascariensis, Macaranga monandra, Drypetes gossweileri, and Scyphocephalium ochocoa, which arealso used in traditional medicine to treat malaria. As such, these plants should be the subject of scientific studies to confirm their antimalarial activities. On the other hand, no information was available in the literature regarding the phytochemical composition and the potential activity against malaria of Desmodium salicifolium, Poga oleosa, Amphimas ferrugineus, and Amphimas klaineanus which were also mentioned as good for treating malaria in Gabon. Thus, investigation of the potential antimalarial activity along with the identification of compounds responsible for the activity must be done to validate the use of these plants.

The investigation of the geographical distribution of the plants revealed that these species can be found in the sub-regions (Cameroon, Congo, and Equatorial Guinea) and also in other countries such as Ivory Coast and Nigeria. Besides, many of these plants are distributed through the whole country such as Carica papaya, Naucleadi derrichii, Picralima nitida or Scyphocephalium ochocoa except for Drypetes gossweileri, Chenopodium ambrosioides, Momordica foetida and Ocimum basilicum which are found only in 3, 2 and 1 regions (Estuaire, Woleu Ntem, OgoouéIvindo or Moyen Ogooué) respectively. The preparation and the administration modes used for malaria treatment were found to be the same in West and Central Africa and different other countries like Ivory Coast, Uganda, Nigeria, and Mexico ^{60, 61, 62}. These findings support the fact that, regardless of the region, numerous plants are commonly used to treat the same ailments.  The increasing number of studies reporting antimalarial resistance on the one hand, and the low number of available efficacious drugs, on the other hand, call for an urgent search for new antimalarial molecules. But, the fact that at least 15 years are needed for a molecule to complete the 3 phases of clinical research appears to be a major concern to the modern use of medicinal plants. However, it is possible to overcome this situation. Firstly, the development of improved traditional medicine derived from traditional healers’ remedies (which are already consumed by the population and which show efficacy and safety) should be preferred to the conventional approach of drug development; secondly, studies must be conducted to evaluate potential synergistic or antagonistic relation between pharmaceutical drugs and medicinal preparations; thirdly, training must be given to traditional healers to improve their comprehension of posology and toxicity.  These together may help to better use of plant-based antimalarial preparations by both Traditional African Medicine and modern medicine.

CONCLUSION: Malaria remains a major public health problem in endemic countries, particularly in sub-Saharan countries with tropical and subtropical climates. Some of the plants in this study are also found in other countries (Cameroon, Mexico, Congo, and Equatorial Guinea) and are used for approximately the same diseases and ailments. This shows that the use of medicinal plants in traditional medicine worldwide is frequently the same.

Plants such as M. foetida, O. gratissimum, C. ambrosioides, A. congensis, E. chlorantha, C. citratus, O. basilicum, and C. limon have been previously investigated as having anti-malarial potential, hence confirming their use in traditional medicine. Further investigations are needed to allow the development of improved traditional medicines (ITM) as described by the traditional healers in order to mimic as much as possible the way the herbal remedy is indigenously used.

The advantages of ITM are that they are not time and resources consuming; moreover they will allow low-income populations to afford cheap and efficient treatments.

It is true that many studies have been done in this direction, but the results obtained with medicinal plants worldwide and the data presented in this study show that the use of medicinal plants is of great importance in managing diseases such as malaria.

AUTHORS' CONTRIBUTIONS: SAA, LM, RRRAS, and MBM performed the experimental studies and drafted the manuscript. SAA and LM played roles in the writing and editing of the manuscript.

ACKNOWLEDGEMENT: Our thanks go to all the participants of the ethnobotanical surveys including technicians of the National Herbarium of Gabon and the various merchants for their frank collaboration.

CONFLICTS OF INTEREST: The authors declare no conflict of interests.

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    How to cite this article:

    Boukandou MMM, Aworet SRRR, Mewono L and Aboughe-Angone S: Exploring some antimalarial plants sold in the market in libreville gabon. Int J Pharm Sci & Res 2021; 12(11): 5848-59. doi: 10.13040/IJPSR.0975-8232.12(11).5848-59.

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