Review ArticleExploring Antimalarial Herbal Plants across Communities inUganda Based on Electronic Data

Denis Okello 1,2,3 and Youngmin Kang 1,3

1Korean Convergence Medicine Major, University of Science and Technology (UST), Daejeon, Republic of Korea2Gombe Secondary School, P. O. Box 192, Butambala, Mpigi, Uganda3Herbal Medicine Research Division, Korea Institute of Oriental Medicine (KIOM), Yuseongdae-ro, Yuseong-gu, Daejeon 34054,Republic of Korea

Correspondence should be addressed to Youngmin Kang; ymkang@kiom.re.kr

Received 5 June 2019; Accepted 14 August 2019; Published 15 September 2019

Guest Editor: Vivitri D. Prasasty

Copyright © 2019 Denis Okello and Youngmin Kang. ,is is an open access article distributed under the Creative CommonsAttribution License, which permits unrestricted use, distribution, and reproduction in anymedium, provided the original work isproperly cited.

Malaria is one of the most rampant diseases today not only in Uganda but also throughout Africa. Hence, it needs very closeattention as it can be severe, causing many deaths, especially due to the rising prevalence of pathogenic resistance to currentantimalarial drugs. ,e majority of the Ugandan population relies on traditional herbal medicines for various health issues. ,us,herein, we review various plant resources used to treat malaria across communities in Uganda so as to provide comprehensive andvaluable ethnobotanical data about these plants. Approximately 182 plant species from 63 different plant families are used formalaria treatment across several communities in Uganda, of which 112 plant species have been investigated for antimalarialactivities and 96% of the plant species showing positive results. Some plants showed very strong antimalarial activities and couldbe investigated further for the identification and validation of potentially therapeutic antimalarial compounds. ,ere is no recordof an investigation of antimalarial activity for approximately 39% of the plant species used for malaria treatment, yet these plantscould be potential sources for potent antimalarial remedies. ,us, the review provides guidance for areas of further research onpotential plant resources that could be sources of compounds with therapeutic properties for the treatment of malaria. Some of theplants were investigated for antimalarial activities, and their efficacy, toxicity, and safety aspects still need to be studied.

1. Introduction

Malaria, a dangerous and life-threatening disease caused byPlasmodium parasites is spread to humans through bites ofinfected female Anopheles mosquitoes [1]. It is one of themost widespread diseases today not only in Uganda but alsothroughout Africa. Hence, careful monitoring of malaria isrequired as the disease can be severe and can cause manydeaths, especially due to the increasing prevalence of re-sistance to current antimalarial drugs. Among the fiveparasitic species that cause malaria to humans, Plasmodiumfalciparum and Plasmodium vivax are the deadliest [2, 3]. P.falciparum and P. vivax being the most prevalent malariaparasites in sub-Saharan Africa and regions of the Americas,respectively, were responsible for about 99.7% and 74.1% of

malaria cases in 2017 [4]. In Southeast Asia, Plasmodiumknowlesi is the most common cause of malaria, accountingfor up to 70% of malaria cases, although it has been known toinfect Old-World monkeys more [5]. Two other species ofPlasmodium, Plasmodium malariae and Plasmodium ovale,generally cause mild fevers. Approximately 216 millionmalaria cases were registered in 2016, with a death toll of upto 445,000 [1]. According to the World Health Organization[6], the incidence of malaria in Uganda, at 47.8%, was thehighest worldwide in 2005. According to Njoroge andBussman [7], malaria is responsible for one to two milliondeaths annually in Africa. Typical symptoms of malariainclude high fever, fatigue, headache, muscle ache, nausea,abdominal discomfort, and profuse sweating. However, inextreme cases and cases of prolonged illness without

HindawiEvidence-Based Complementary and Alternative MedicineVolume 2019, Article ID 3057180, 27 pageshttps://doi.org/10.1155/2019/3057180

treatment, brain tissue injury, pulmonary edema, kidneyfailure, severe anemia, yellow discoloration of the skin, andlow blood sugar may be noted (Figure 1) [1, 2]. In Uganda,malaria is one of the major causes of illness and death [7].Statistically, it accounts for 46% of children’s sicknesses,almost 40% of outpatient visits to hospitals and clinics, 25%of hospital admissions, 14% of inpatient deaths, and ap-proximately 23% of infant mortalities [7].

In different parts of the world, the use of herbs andherbal extracts in the management and treatment of malariais very common since herbs are cheap and readily availablebesides being effective. In fact, the use of herbal medicine fortreatment worldwide is on the rise. Over 80% of theUgandan population relies directly on herbal plants for theirhealth care primarily [8]. A great majority of the populationuses traditional herbal medicines because of their confirmedtherapeutic value [8]. ,e increase in preference for herbalremedies coupled with resistance exhibited by pathogenicstrains, including Plasmodium species, to the modern drugsavailable is the driving force behind researchers’ interest inherbal plants for possible alternatives for more effectiveantimalarial drugs [9, 10].

,is review was aimed at providing comprehensiveethnobotanical information about various plant resourceswith antimalarial properties that are primarily used tomanage and treat malaria across communities in Uganda,based on which further evaluation of these plants such asthose of their efficacy and safety for the treatment of malariamay be based.

2. Methods and Materials

In the review, the data search processes employed byKomakech et al. [11] were modified to gather information onherbal plants for malaria treatment in Uganda from peer-reviewed articles in English published in scientific journalsand other verifiable databases, with a focus on plant speciesand families, plant parts used, antimalarial activities of theextracts from herbal plants, and mechanisms of action ofnovel antimalarial phytochemicals and derivatives. Elec-tronic literature databases such as PubMed, Medline,Scopus, SciFinder, Google Scholar, and Science Direct werecarefully searched for suitable information. ,e followingwords were used as key search terms: (“Herbal medicine inUganda” OR “Herbs in Uganda” OR “Traditional remediesin Uganda” OR “Natural remedies in Uganda” OR “Anti-malarial herbs in Uganda” OR “Anti-malarial plants inUganda” OR “Ugandan herbs” OR “Ugandan ethno-medicine” OR “Ugandan phyto-medicine”), AND (“anti-plasmodial activities” OR “anti-malarial activities” OR“anti-plasmodial effects” OR “anti-malarial effects” OR“malaria treatment” OR “malaria management”) OR(“Malaria in Uganda” AND “prevalence” OR “occurrence”OR “distribution” OR “herbal treatment” OR “herbalremedies” OR “phyto-medicine” OR “phyto remedy” OR“plant parts used for treatment”) OR (Phytochemicals formalaria treatment OR Artemisinins OR Quinine OR Nobleanti-malarial compounds OR Plant derived anti-malarialcompounds AND mechanisms of action OR modes of

action) OR (“Malaria herbal medicine in Uganda” OR“Herbal medicine in Uganda” OR “Herbal malaria remedyin Uganda” OR “Natural malaria medicine in Uganda” OR“Traditional malaria herbal medicine” OR “Malaria herbalrecipe” AND “dosage” OR “dose” OR “dose given” OR“mode of administration” OR “means of traditional ex-traction” OR “traditional extraction” OR “Toxicity” OR“Safety and toxicity” OR “Policy framework” OR “otherethno-pharmacological uses” OR “other ethno-pharma-cological utilizations” OR “other ethno-medicinal uses”).,e information gathered was verified separately for itsreliability; any discrepancies discovered were resolved bydiscussions between the authors. ,ereafter, these datawere summarized and analyzed, and comparisons weremade to draw conclusions.

3. Prevalence of Malaria

Malaria in Uganda is highly endemic because the climate isfavorable for its consistently stable and year-round trans-mission in about 99% of the country, with the country’sentire population being at risk for contraction [12].,emostvulnerable groups of people at great risk for malaria areexpectant mothers and young children under the age of5 years [12]. ,e malarial parasite, P. falciparum, is mostcommonly the cause of malaria throughout Uganda, ac-counting for over 90% of malaria cases. However, Betsonet al. [13] have warned of the potential for the emergence ofinfections due to P. malariae and P. ovale spp. as well, sincethere is much focus on countering P. falciparum infections.In 2016, Larocca et al. [14] indicated that Uganda was one ofthe leading countries in the world with malaria incidencerate as high as 478 cases per 1,000 population per year.Specifically, overall registered death cases caused by malariain children were between 70,000 and 100,000 annually inUganda [14]. Tremendous effort has been made to controlmalaria in Uganda by the government-headed UgandaMalaria Reduction Strategic Plan and Mass Action AgainstMalaria. ,ese efforts have greatly reduced the malariaburden and incidence from 272 cases per 1000 population in2016/17 to 191 cases per 1000 population in 2017/18 [12].Although there has been a general reduction in the incidenceof malaria, studies indicate that malaria prevalence alonglakes, for example, Lake Victoria, and in remote areas of thecountry (villages) as well as areas closer to forests are muchhigher, with over 450 malaria cases per 1000 population(Figure 2) [12, 13, 15]. Communities around lakeshores inUganda have always had high prevalence of malaria amongchildren and especially the young ones despite routinetreatments [12, 16]. ,rough the government initiative tocontrol malaria, the prevalence in some districts remained aslow as 4.3% in 2018 [12]. Malaria control strategies includingindoor residual spraying along with house to house distri-bution of mosquito nets treated with insecticides resulted ina remarkable reduction in malaria burdens in many parts ofthe country [17]. Raouf et al. [18] observed that significantreductions in the levels of malaria in Uganda cannot besustained if the current control measures are terminated.

2 Evidence-Based Complementary and Alternative Medicine

4. Mechanisms of Actions of NovelPhytochemicals in Malaria Treatment

Herbal plants are extremely rich in phytochemicals that arehighly efficacious in the treatment of malaria, such as ses-quiterpenes and sesquiterpene lactones, fluoroquinolones,chalcones, flavanones, phenolics, quinones, coumarins, andalkaloids (Table 1) [35, 36].,e herbal plants that are used asprophylactic measures to prevent malaria as well containsome of these compounds (Table 2). From these groups ofcompounds, active metabolites including quinine andartemisinin have been derived and the most successfulantimalarial drugs to date have been obtained. Artemisininsfrom Artemisia annua a plant belonging to the familyAsteraceae have actually been an integral part of the fightagainst malaria, with artemisinin-based combination ther-apy contributing enormously to modern day treatments[36]. ,ey have been effective against all strains of P. fal-ciparum including multi-drug-resistant ones [36, 37].

,e mechanism of action of artemisinin is widely de-bated but the most accepted theory is that of activation of themolecule by heme, which enables it to produce free radicalsthat then destroy the proteins needed for parasite survival[36]. ,e presence of an uncommon chemical peroxidelinkage bridge in artemisinin, a sesquiterpene lactone, is themost probable reason for its antimalarial effects. Cleavage ofthe peroxide linkage bridge in the presence of iron (II) ions(from heme) forms very reactive free radicals that undergo

rapid rearrangement to form more stable carbon-centeredradicals, which chemically modify the parasite and inhibitvarious processes within the parasite molecules, resulting inits death [36]. Artemisinin acts on primarily the trophozoiteparasitic phase and prevents disease progression. It killscirculating ring-stage parasites, thus increasing the thera-peutic response [37]. Mok et al. [38] suggested that arte-misinin is linked to the upregulation of unfolded proteinresponse pathways, which leads to decreased parasiticgrowth and development. Shandilya et al. [39] suggested thatartemisinin is activated by iron, which then functionallyinhibits PfATP6, a calcium pump, by terminating phos-phorylation, nucleotide binding, and actuator domains,eventually leading to a functional loss of PfATP6 of thePlasmodium parasite and its death. A study by Mbengueet al. [40] indicated that artemisinin strongly inhibitsphosphoinositide-3-kinase (PfPI3K), an enzyme importantin cellular activities including growth, multiplication, dif-ferentiation, and survival in P. falciparum.

Cinchona tree bark, from which quinine was isolated,has been used to treat malaria since 1632 [41]. ,e WorldHealth Organization listed quinine as one of the importantmedicines needed in a health system [42]. It is however onlyused to treat malaria caused by chloroquine-resistant strainof P. falciparum in the absence of artemisinins [43]. Apopular hypothesis about the mechanism of action of qui-nine is based on chloroquine, another quinoline drug whichis closely linked to quinine and has been comprehensively

Dry cough

Profuse sweating

Stomach discomfort

High fever

Enlarged spleen

Kidney failure

Headache

Muscle and back pain Malaria

A

Symptoms

Figure 1: Illustration of some common symptoms of malaria.

Evidence-Based Complementary and Alternative Medicine 3

studied. Quinine inhibits the pathway of biocrystallization ofhemozoin, resulting in the accumulation of the free cytotoxicheme which eventually kills the parasite [44].

Most of the plants used in the treatment of malaria inUganda contain alkaloids greatly implicated in anti-plasmodial activity (Table 3). A number of alkaloids targetapicoplast, an organelle in the Plasmodium parasite, whileothers such as benzylisoquinoline alkaloids in Cissam-pelos mucronata, a plant belonging to the familyMenispermaceae inhibits protein synthesis in the parasite[99].

Flavonoids in a vast number of plants used for malariatreatment in Uganda are common to plants in the familyAsteraceae such as B. longipes, A. conyzoides, and A. africanaalthough other herbal plants from different families in-cluding C. roseus in Apocynaceae and A. zygia and A.nilotica in Mimosaceae also have them as active anti-plasmodial constituents (Table 3). Flavonoids exhibit greatantiplasmodial activity against different strains of themalaria parasite although the mechanism of antimalarialaction is not clear [99]. Some studies suggest that flavonoidsimpede the influx of myoinositol and L-glutamine in

erythrocytes that are infected [99]. Some flavonoids increasethe level of oxidation of erythrocytes and inhibit proteinsynthesis in malaria parasites [99]. Furthermore, flavonoidsare believed to inhibit fatty acid biosynthesis (FAS II) inPlasmodium [102].

Artemisinin resistance in P. falciparum has been re-ported in Vietnam, Cambodia, Muang Lao, and ,ailand. Areport published in 2018 showed over 30 separate cases inSoutheast Asia of artemisinin resistance [36]. In case ofresistance, parasitic clearance is slowed down and game-tocytemia increases, resulting in greater selective pressure onother partner drugs to which resistance increases, therebyposing a great health threat. ,us, it is very important thatthe discovery of other drugs with novel mechanisms ofaction be prioritized by extensive exploration of the hugemedicinal plant resources in Africa, which have been used bylocals for effective malaria treatment yet have never beenscientifically investigated for their antimalarial potential.Amoa Onguene et al. [35] emphasized that it was indeedAfrica’s turn to offer a new antimalarial drug to humanitysince artemisinin was discovered in Asia and quinine inLatin America.

Africa

BoundariesNational

District

Malaria cases per 1000 population

Over 450300–450150–30050–150Under 50

N

Lake Victoria

Lake Kyoga

0 100k

Lake Edward

Lake Albert

Figure 2: Malaria prevalence in Uganda (modified from [12]).

4 Evidence-Based Complementary and Alternative Medicine

Tabl

e1:

Herbs

used

inthetreatm

ento

fmalaria

inUgand

a.

Plantfamily

Scientificname

Localn

ame

Part

used

Growth

form

Mod

eof

preparation

Doseandmod

eof

administratio

nformalaria

Status

ofantim

alarial/

antip

lasm

odiala

ctivity

investigation

Other

ailm

ents

treated

Reference(s)

Acanthaceae

Justicia

betonica

L.Nalon

go/quinine

Leaves/w

hole

plant

Herb

Decoctio

nAbo

ut120mle

very

8ho

ursfora

week

Investigated

Diabetes,yello

wfever,diarrhea

[10,

19]

Justicia

ansellian

a(N

ees)

T.And

erson

Kwiniin

iomuganda

Leaves/tw

igHerb

Decoctio

nOrally

taken,

dose

notspecified

Norecord

[20]

Mon

echm

asubsessileC.B

.Clarke

Erazi

Leaves

Decoctio

nOrally

taken,

dose

notspecified

Norecord

Abd

ominal

pain

[19]

8un

bergia

alataSims

Kasaamusaamu/

ntud

debu

leku

Leaves/w

hole

plant

Clim

ber

Decoctio

nAbo

ut120mle

very

8ho

ursfora

week

Norecord

False

teeth

[8,1

0]

Alliaceae

Allium

cepa

L.Katun

gulu

Bulb

Herb

Norecord

[21]

Aloeaceae

Aloedawei

A.B

erger(w

ild/

cultivated)

Kigagi

Leaves

Herb

Decoctio

nA

glassful

once

adayfor7days

Investigated

Candida

[10]

Aloekedongensis

(wild

)Kigagi

Leaves

Herb

Decoctio

nOrally

taken,

dose

notspecified

Investigated

[19,

22]

Aloevolkensii

(cultiv

ated)

Kigagi

Leaves

Herb

Decoctio

n/infusio

nOrally

taken,

dose

notspecified

Norecord

[19]

AloeferoxMill

Kigagi

Leaves

Herb

Decoctio

nOrally

taken,

dose

notspecified

Investigated

Wou

nds,digestivedisorders,

rheumatic

arthritis

[18,

19]

Aloelateritia

(wild

)Kigagi

Leaves/roo

tHerb

Decoctio

nOrally

taken,

dose

notspecified

Norecord

[19]

Amaranthaceae

Amaran

thus

hybridus

L.Bb

uga

Leaves

Herb

Decoctio

nHalfa

glassevery24

hoursfor

7days

Norecord

[10]

Anacardiaceae

Man

gifera

indica

L.Muyem

begw

akon

aLeaves/bark

Tree

Decoctio

n4and3teaspo

onsafterevery

8ho

ursforadults

andchild

ren,

respectiv

ely,

foraweek

Investigated

Diarrhea,dysentery,

body

pain,

venereal

diseases,cou

gh,syphilis

[10,

23]

Rhus

natalensisBe

rnh.

ExKrauss

Omesheshe

Leaves

Shrub

Decoctio

nOrally

taken,

dose

notspecified

Investigated

[24]

Rhus

vulgarisMeikle

Kakwasok

waso/

tebu

dda

Leaves

Shrub

Decoctio

nHalfa

glasse

very

8ho

ursfor

7days

Norecord

Skin

rush,erectile

dysfun

ction

[10]

Apiaceae

Heterom

orphatrifo

liata

Eckl.&

Zeyh.

Omum

emena

Leaves/roo

tsHerb

Decoctio

nOrally

taken,

dose

notspecified

Norecord

[19]

Centella

asiatica(L.)Urb.

KaboKabakyala/

mbu

tamu

Leaves/w

hole

plant

Herb

Decoctio

n4teaspo

onsthrice

adayfor4days

Investigated

[10]

Apo

cynaceae

Alston

iaboon

eiDeWild

.Mub

ajangalabi

Bark

Tree

Decoctio

nOrally

taken,

dose

notspecified

Investigated

[8]

Carissa

edulis(Forssk.)Vahl

Muyun

za,ekamuriei

Roots

Herb

Decoctio

nOrally

taken,

dose

notspecified

Investigated

Epilepsy,

fever,cough,

syph

ilis,

measle

s,dysentery

[21,

23]

Carissa

spinarum

Lodd

.exA.D

C.

Omuyon

zaRo

ots

Decoctio

nOrally

taken,

dose

notspecified

Investigated

[19]

Catharan

thus

roseus

G.D

onSekagya

Leaves

Herb

Decoctio

nAbo

ut120mle

very

8ho

ursfora

week

Investigated

[10]

Araceae

Culca

siafaleifo

liaEn

gl.

Ntang

awuzi

yomuk

ibira

Roots

Herb

Decoctio

nAbo

ut120mlonceadayfora

week

Norecord

[10]

Aristolochiaceae

Aristolochia

elegan

sMast.

Musujawelaba/

nakasero

Seeds/sap

Vine

Steepedin

water

and

drun

kA

glassful

once

aday

Investigated

Abd

ominal

pain,E

astcoastfever

[8,1

9]

Aristolochia

tomentosa

Sims.

Kankapu

Stem

Clim

ber

Infusio

nOral,do

seno

tspecified

Norecord

Wou

nds,skin

diseases,snake

bites

[23]

Asclepiadaceae

Gom

phocarpu

sphysocarpu

sE.

Mey.

Kafum

boLeaves

Herb

Decoctio

nHalfa

glassdaily

foraweek

Norecord

[10]

Aspho

delaceae

Aloevera

(L.)Bu

rm.f.

Kigagi/a

lovera

Leaves

Herb

Decoctio

n1teaspo

onand1tablespo

on3

times

adayforc

hildrenandadults,

respectiv

ely,

foraweek

Investigated

Stom

achache

[8,2

5]

Evidence-Based Complementary and Alternative Medicine 5

Tabl

e1:

Con

tinued.

Plantfamily

Scientificname

Localn

ame

Part

used

Growth

form

Mod

eof

preparation

Doseandmod

eof

administratio

nformalaria

Status

ofantim

alarial/

antip

lasm

odiala

ctivity

investigation

Other

ailm

ents

treated

Reference(s)

Asteraceae

Ageratum

conyzoides

L.Nam

irem

beWho

leplant/

leaves

Herb

Decoctio

nA

glassful

thrice

adayfor7days

Investigated

Worms,weakn

essin

pregnancy

[8,1

0]

Artem

isiaan

nuaL.

Sweeta

nne

Leaves

Herb

Decoctio

nOral,do

seno

tspecified

Investigated

Fever

[19]

Artem

isiaafra

Jacq.exWilld

Pasile

Leaves

Herb

Infusio

nOral,do

seno

tspecified

Investigated

Fever

[10]

Aspiliaafric

ana(Pers.)

C.D

.Adams

Makayi,ekarwe

Who

leplant/

leaves/roo

tsHerb

Decoctio

n8teaspo

ons3

timesadayfora

week

Investigated

Abd

ominal

aches,measle

s,diarrhea,w

ound

s,indu

ctionof

appetite

[10,

19]

Baccha

roidesadoensis(Sch.B

ip.ex

Walp.)H.R

ob.

Okello

kello

Leaves

Shrub

Decoctio

n

1teaspo

onand1tablespo

on3

times

adayforc

hildrenandadults,

respectiv

ely,fora

week;bath-le

aves

squeezed

andaddedto

bathing

water

Investigated

Flu,

skin

rush,ear

infections

[25,

26]

Bidens

gran

tiiSh

erff

Ehon

gwa

Leaves,fl

ower

Herb

Decoctio

nOral,do

seno

tspecified

Norecord

Pregnancydisorders,prehepatic

jaun

dice

[19]

Bidens

pilosa

L.Sere/la

bika

Who

leplant/

leaves

Herb

Decoctio

n/freshleaf

extract

4teaspo

onsthrice

adayfor4days

Investigated

Diarrhea,wou

nds

[10,

23]

Bothrio

cline

longipes

N.E

.Br.

Ekyogayanja

Leaves

Decoctio

nOral,do

seno

tspecified

Investigated

Fever,ague,p

alud

ism[19,

24]

Conyza

bona

riensis(L.)

Ndasha

Leaves

Decoctio

nOral,do

seno

tspecified

Norecord

Stom

achache,b

odypain,anemia,

respiratoryprob

lems

[19]

Conyza

florib

unda

H.B

.K.

Kafum

beLeaves

Herb

Decoctio

nAbo

ut120mlonceadayfora

week

Norecord

Headache

[10]

Conyza

sumatrensis(Retz.)E.

H.

Walker

Katik

ati

Leaves

Herb

Norecord

Wou

nds,sore

throat,ringw

orms

[21,

27]

Crassocephalum

vitellinu

mKito

nto

Leaves

Herb

Hon

eyaddedto

decoction

2teaspo

onsthrice

adayfor7days

Investigated

[10,

19]

Emiliajavanica

(Burm.F

.)C.B

.Ro

b.Nakate

Who

leplant

Herb

Decoctio

nHalfa

glasson

ceadayforaweek

Norecord

[10]

Guizotia

scabra

Chiov.

Ekiterank

uba

Leaves

Decoctio

nOral,do

seno

tspecified

Investigated

Stom

achache,H

IV/A

IDS

oppo

rtun

istic

infections

[19]

Gynurascan

dens

O.H

offm.

Ekizim

ya-m

uriro

Leaves

Decoctio

nOral,do

seno

tspecified

Norecord

Febrile

conv

ulsio

ns[19]

Melan

therascan

dens

(Schum

ach.

&,

onn.)Ro

berty

Makaayi

Leaves

Herb

Decoctio

nOral,do

seno

tspecified

Investigated

Stom

achache,b

odyod

our,yello

wfever

[8]

PlucheaovalisDC.

Omun

eera

Leaves

Decoctio

nOral,do

seno

tspecified

Norecord

[19]

Microglossa

pyrifolia(Lam

.)O.K

tze

Kafugankand

eWho

leplant/

leaves/roo

tsHerb

Decoctio

nHalfa

glassthrice

adayforaweek

Investigated

Cou

gh,abd

ominal

disorders,chest

pain

[10,

19,2

8]

Schkuh

riapinn

ata(Lam

.)Apu

nait

Leaves

Herb

Infusio

n1teaspo

onand1tablespo

on3

times

adayforc

hildrenandadults,

respectiv

ely,

foraweek

Investigated

Wou

nds,skin

diseases,d

iabetes,

earinfections,w

ound

s[23,

25]

SigesbeckiaorientalisL.

Kyaryaho

Roots

Decoctio

nOral,do

seno

tspecified

Norecord

Wou

nds,stom

achache

[19]

Solanecioman

nii(Hoo

k.f.)

C.

Jeffrey

Omusun

unu

Leaves

Decoctio

nOral,do

seno

tspecified

Investigated

Fever,indigestion

[19]

Sonchu

soleraceusL.

Entahu

tara

Leaves

Decoctio

nOral,do

seno

tspecified

Norecord

Stom

achache,scars,a

nemia,

diarrhea

[8,1

9]

TagetesminutaL.

Kaw

unyira

Who

leplant/

leaves

Herb

Decoctio

nHalfa

glassthrice

adayforaweek

Investigated

Flu,

headache,con

vulsion

s[10]

Tithon

iadiversifo

liaA.G

ray

Kim

yula

Leaves

Herb

Decoctio

nHalfa

glassthrice

adayforaweek

Investigated

Diabetes,abdo

minal

pain

[10,

19,2

5]Verno

niaadoensisSch.

Bip.

exWalp.

Nyakajuma

Leaves/flow

ers

Decoctio

nOral,do

seno

tspecified

Investigated

Diarrhea,dizziness

[19]

Verno

niaam

ygdalin

aDelile

Mululuza/labw

ori

Who

leplant/

roots

Shrub

Decoctio

nHalfa

glass2

times

adayfor5

days

Investigated

Headache,stom

achache,b

urns,

baths

[8,1

0,19,2

0]

Verno

niacinerea(L.)Less.

Kayayana

Bark

Tree

Decoctio

nHalfa

glassthrice

adayforaweek

Investigated

Fever,vomiting

,infl

ammation

[10]

Verno

nialasio

pusO.H

offm.

Kaluluzakasajja

Roots/leaves

Shrub

Freshleaf

extract/r

oot

decoction

2teaspo

onsthrice

adayfor7days

Investigated

Abd

ominal

pain,cou

gh,m

igraine

headache,d

elayed

delivery

[8,1

0,19,2

0]

Bign

oniaceae

Markham

ialutea(Benth.)K.

Schu

m.

Musam

bya/

muzangand

aRo

ots

Tree

Decoctio

nA

glassful

once

adayfor7days

Investigated

Cou

gh,d

iarrhea

[8,1

0,19]

Spathodeacampanu

lata

Buch.

-Harm.exDC.

Kifa

bakazi

Bark

Tree

Decoctio

nHalfa

glass3

times

adayfor5

days

Investigated

Increasedvaginalfl

uid,

skin

infection,

infertility,h

ernia

[8,1

0]

6 Evidence-Based Complementary and Alternative Medicine

Tabl

e1:

Con

tinued.

Plantfamily

Scientificname

Localn

ame

Part

used

Growth

form

Mod

eof

preparation

Doseandmod

eof

administratio

nformalaria

Status

ofantim

alarial/

antip

lasm

odiala

ctivity

investigation

Other

ailm

ents

treated

Reference(s)

Caesalpiniaceae

Cassia

didymobotryaFres.

Muk

yula

Leaves

Shrub

Decoctio

nAbo

ut120mle

very

8ho

ursfora

week

Investigated

[10]

Cham

aecristanigrican

sGreene

Epedurulo

didi

Leaves

Herb

Infusio

nOral,do

seno

tspecified

Norecord

Labo

urindu

ction,

hypertensio

n,retained

placenta

[23]

Erythrophleum

pyrifolia

Omuram

aLeaves/roo

tsInvestigated

[24]

Senn

aspectabilis

(DC.)H.S.Irw

in&

Barneby

Gasiya

Leaves

Tree

Decoctio

nHalfa

glasstwiceadayfor5days

Investigated

[10]

Caesalpinioideae

Cassia

hirsuta

Kasagalansansi

Roots

Herb

Infusio

nInvestigated

Stom

achpains

[23]

Canelliaceae

Warbu

giaugan

densisSprague

Omuk

uzanum

eBa

rk/le

aves

Tree

Decoctio

n/po

wder

swallowed

with

banana

Halfa

glasson

ceadayforaweek

Investigated

Toothache,flu

,skindiseases,

asthma,

stom

achache,b

odyand

musclepain

[10,

20,2

7]

Caricaceae

Caric

apapaya

L.Pa

apalie

ssajja

Leaves

Tree

Decoctio

nHalfa

glasstwiceadayfor3days

Investigated

Snakebite,sterility,

cough,

cancer,

body

pain,ind

uces

labo

ur[10,

19,2

3,25]

Celastraceae

Maytenu

ssenegalensis

Echo

mai

Roots

Tree

Decoctio

nOral,do

seno

tspecified

Investigated

Toothache,skin

diseases,chest

pain,w

ound

,fever

[23]

Cheno

podiaceae

Chenopodium

ambrosioides

L.Kaw

unawun

aLeaves

Investigated

Headache,epilepsy

[21]

Chenopodium

opulifo

lium

Koch&

Ziz

Nam

uvu

Leaves

Norecord

Oralw

ound

s,skin

rush,too

thache

[8,21]

Com

bretaceae

Combretum

molleG.D

onNdagi

Bark

Tree

Decoctio

nHalfa

glasson

ceadayfor3days

Investigated

Cou

gh,

[10,

21]

Crassulaceae

Kalan

choe

densifloraRo

lfeKisa

nasana

Leaves

Herb

Norecord

[21]

Cucurbitaceae

Cucurbita

maxim

aLam.

Kasuu

nsa

Leaves

Herb

Decoctio

nHalfa

glasson

ceadayfor7days

Investigated

Abd

ominal

pain

[10,

25,2

7]

Mom

ordica

foetidaSchu

mach.

Orw

ihura

Leaves

Decoctio

nOral,do

seno

tspecified

Investigated

Vom

iting

,baths,cou

gh,fl

ue,

worms

[19,

26,2

8]

Dracaenaceae

Dracaenasteudn

eriE

ngl.

Kajjolyenjovu

Leaves

Herb

Decoctio

nHalfa

glassthrice

adayforaweek

Norecord

Scars,cough,

syph

ilis,kidn

eyston

es,snake

bites

[8,1

0]

Ebenaceae

Eucle

alatid

eusStaff

Emusi

Roots

Shrub

Decoctio

nOral,do

seno

tspecified

Investigated

Ring

worms,sw

ollenlegs

[23]

Euph

orbiaceae

Alch

orneacordifo

lia(Schum

ach.)

Mull.Arg.

Luzibaziba

Leaves

Herb

Decoctio

nHalfa

glasson

ceadayfor7days

Investigated

Shakingbo

dy[8,1

0]

Bridelia

micrantha

Baill.

Katazam

itiBa

rkTree

Decoctio

nHalfa

glassthrice

adayforaweek

Investigated

[10]

Clutia

abyssin

icaJaub

.&Spach

Omub

aram

aLeaves

Decoctio

nOral,do

seno

tspecified

Investigated

Fever,diarrhea

[19]

Croton

macrostachyus

Olive.

Ook

ota

Roots/bark

Tree

Decoctio

nOral,do

seno

tspecified

Investigated

Tuberculosis,

stom

achache,cou

gh,

fever,asthma

[23]

Fluegeavirosa

(Roxb.

ExWillb.)

Voigt

Lukand

wa/

muk

andu

laLeaves

Shrub

Decoctio

nHalfa

glass3

times

adayfora

week

Investigated

Misc

arriage,chestp

ains,infertility

inwom

en[8,1

0,21,2

3]

Jatropha

curcas

L.Kirow

aLeaves

Shrub

Investigated

Toothdecay,headache,w

eakn

essin

pregnancy

[21]

Macaran

gaschw

einfurthiiPa

xKyeganza

Bark

Tree

Decoctio

nHalfa

glass3tim

esadayfora

5days

Norecord

[10]

Phyllanthu

s(pseud

o)niruriMull.

Arg.

Nakitembe

Leaves

Shrub

Decoctio

nHalfa

glass3tim

esadayfora

7days

Investigated

[10]

Shira

kiopsis

ellip

tica(H

ochst.)

H.–J.Esser

Musasa

Back

Tree

Decoctio

nOral,do

seno

tspecified

Norecord

[20]

Tetrorchidium

didymostemon

(Baill.)Pa

x&

K.H

offm.

Ekiziranfu

Bark

Decoctio

nUsedas

enem

aNorecord

Jaun

dice,m

easle

s,gastrointestinal

disorders,enem

a[8,1

9]

Evidence-Based Complementary and Alternative Medicine 7

Tabl

e1:

Con

tinued.

Plantfamily

Scientificname

Localn

ame

Part

used

Growth

form

Mod

eof

preparation

Doseandmod

eof

administratio

nformalaria

Status

ofantim

alarial/

antip

lasm

odiala

ctivity

investigation

Other

ailm

ents

treated

Reference(s)

Fabaceae

Arachishypogea(N

C)

Ebinyobw

aLeaves

Freshextract

Oral,do

seno

tspecified

Norecord

[19]

Cajanu

scajan(L.)Druse

Entond

aigw

aLeaves

Shrub

Freshextract

100mlo

nceadayforaweek

Investigated

Diarrhea,bo

dypain

[27]

Crotalaria

agatifloraSchw

einf.

Kijjebejebbe

Who

leshoo

tSh

rub

Freshextract

Daily

bath

Norecord

Highbloo

dpressure

[10]

Crotalaria

ochroleuca

G.D

onAlayo

Leaves

Herb

Freshextract

1teaspo

onand1tablespo

on3

times

adayforc

hildrenandadults,

respectiv

ely,

foraweek

Norecord

Stom

achache

[28]

Entada

abyssin

icaSteud.

exA.

Rich.

Mwolola

Leaves

Tree

Decoctio

nInvestigated

Oralw

ound

s,bo

dyweakn

ess,

wou

nds,skin

infections

[8,2

0,26]

Entada

afric

anaGuill.

&Perr.

Mwolola

Bark

Tree

Decoctio

n4and3teaspo

onsafterevery

8ho

ursforadults

andchild

ren,

respectiv

ely,

foraweek

Investigated

[10]

Erythrinaabyssin

icaLam.

Girikiti/la

coro

Bark

Tree

Decoctio

nHalfa

glass3tim

esadayfora

5days

Investigated

Fever,leprosy,

burns,tuberculosis,

toothache,syph

ilis

[10,

23]

Erythrinaexcelsa

Bak.

Bajjang

ala

Bark

Tree

Decoctio

nHalfa

glass3

times

adayfora

week

Norecord

Wou

nds,cand

ida

[10]

Indigofera

arrectaHochst.Ex

A.

Rich

Omusho

roza

Roots/bark

Norecord

Abd

ominal

pain

[19]

Indigofera

congesta

Baker

Nam

asum

iTw

igHerb

Infusio

nOral,do

seno

tspecified

Norecord

[8,2

0]Indigofera

emerginella

Steud.

exA.

Rich

Omun

yazabashum

baLeaves/roo

tsSh

rub

Decoctio

nOral,do

seno

tspecified

Investigated

Cou

gh[19]

MacrotylomaaxillareVerdc.

Akihabu

kuru

Leaves

Norecord

Impo

tence,dizziness

[19]

Pseudarthria

hookeriW

ight

&Arn

Omuk

ongorani/

kikakala

Leaves/w

hole

plant

Herb

Decoctio

nOne

teaspo

onthrice

adayfor

4days

Norecord

Fever

[19,

20,2

5,29]

Rhynchosia

viscosaDC

Omutegansi

Flow

erNorecord

Labo

urindu

ction

[19]

Senn

aabsus(L.)Ro

xb.

Mucuu

laSh

rub

Leaves

Freshextract

Oral,do

seno

tspecified

Norecord

Prolon

gedem

bryo

inuterus

[8]

Senn

adidymobotrya(Fresen.)H

.S.

Irwin

&Ba

rneby

Omugabagaba/

kivumuzi

Herb

Leaves,

twig

Decoctio

nOral,do

seno

tspecified

Investigated

Chang

eof

sexof

child

[8,1

9,20,2

9]

Senn

asia

mea

(Lam

.)H.S.Irw

in&

Barneby

Garcia

Roots

Tree

Freshextract

Acupful

(500

ml)on

ceadayfor

3days

Investigated

Abd

ominal

pain,sorethroat

[25,

27]

Tamarindu

sindica

L.Cwaa/nko

geBa

rkTree

Decoctio

nOral,do

seno

tspecified

Investigated

Con

vulsion

s,fever

[8,21]

Flacou

rtiaceae

Ocoba

spinosaFo

rssk

Ekalepulepu

Roots

Herb

Decoctio

nOral,do

seno

tspecified

Norecord

Syph

ilis,skin

prob

lems,wou

nds,

headache,impo

tence,stom

achache

[23]

Trim

eria

bakeriGilg.

Omwatanshare

Leaves

Shrub

Decoctio

nOral,do

seno

tspecified

Investigated

[24]

Hypericaceae

Harun

gana

madagascarie

nsisLam.

Muk

aabiransiko/

mulirira

Bark

Tree

Decoctio

n2tablespo

onsthricea

dayfor3

days

Investigated

Yello

wfever

[8,1

0]

Labiatae

Hyptis

pectinataPo

ir.

Bong

oloza

Who

leplant

Herb

Decoctio

nOral,do

seno

tspecified

Norecord

[20,

29]

8 Evidence-Based Complementary and Alternative Medicine

Tabl

e1:

Con

tinued.

Plantfamily

Scientificname

Localn

ame

Part

used

Growth

form

Mod

eof

preparation

Doseandmod

eof

administratio

nformalaria

Status

ofantim

alarial/

antip

lasm

odiala

ctivity

investigation

Other

ailm

ents

treated

Reference(s)

Lamiaceae

Aeolanthu

srepens

Oliv.

Ntulagi

Leaves

Herb

Decoctio

nQuarter

aglassthrice

adayfor

3days

Norecord

[10]

Ajuga

remotaBe

nth.

Kitinw

aLeaves

Herb

Decoctio

nHalfa

glasson

ceadayforaweek

Investigated

Stom

achache

[10]

Clerodendrum

myricoidesR.

Br.

Kikon

geLeaves

Shrub

Decoctio

nHalfa

glassdaily

foraweek

Investigated

Syph

ilis,intestinal

prob

lems,

indu

ctionof

labo

ur[10,

28]

Clerodendrum

rotund

ifoliu

mOliv.

Kise

keseke

Roots/leaves

Shrub

Freshleaf

extract/r

oot

decoction

Halfa

glassdaily

fora5days

Investigated

Diabetes

[10]

Hoslund

iaoppositaVahl.

Kam

unye

Leaves

Herb

Decoctio

nHalfa

glass3

timesad

ayfora

week;

bath

Investigated

Ulcers

[8,1

0,25]

Leon

otisnepetifolia

Schimp.

exBe

nth

Kifu

mufum

uWho

leplant

Herb

Decoctio

nA

glassful

thrice

adayfor3days

Investigated

Headache

[10,

21]

Ocimum

basilicum

Emop

imLeaves

Herb

Infusio

nHalfa

glass3

times

adayfora

week

Investigated

Fever,eyecataract

[23,

27]

Ocimum

gratissim

umWilld.

Mujaaja

Leaves

Herb

Decoctio

nHalfa

glass3

times

adayfor5

days

Investigated

Wou

nds,earinfections,chestpain

[10,

21]

Ocimum

lamiifolium

Hochst.

Omwenyi

Leaves

Decoctio

nHalfa

glass3

times

adayfora

week

Investigated

Abd

ominal

pain

[19]

Plectran

thus

barbatus

Ebiririo

mutano

Who

leplant/

leaves,roo

ts/

stem

Herb

Infusio

nOral,do

seno

tspecified

Investigated

Fever,heartdisease,snakebite

[10,

23]

Plectran

thus

caninu

sRo

thKibwanku

lata

Leaves

Herb

Decoctio

n4and2teaspo

onsthrice

adayfor

adults

andchild

ren,

respectiv

ely,

foraweek

Norecord

[10]

Plectran

thus

cf.forskohlii

Ekizera

Leaves

Decoctio

nOral,do

seno

tspecified

Norecord

[19]

Rosm

arinus

officina

lisL.

Rosemary

Leaves

Herb

Decoctio

nHalfa

glasstwiceadayfor5days

Investigated

Chest

pain

[10]

Tetradenia

riparia

(Hochst.)

Cod

dKyewam

ala

Leaves

Herb

Decoctio

nOne

teaspo

ontwiceadayfora

week

Investigated

[10]

Lauranceae

Persea

american

aMill.

Ovakedo

Leaves

Tree

Decoctio

nOral,do

seno

tspecified

Investigated

Fung

alandbacterialinfectio

n,high

bloo

dpressure,intestin

alworms

andparasites

[23]

Loranthaceae

Tapina

nthu

scon

stric

tiflorus

(Eng

l.)Danser

Enzirugaze

Leaves

Herb

Decoctio

nA

glassdaily

for7days

Norecord

[10]

Malvaceae

Hibiscus

suratte

nsisL.

Nantayitwako

musota

Leaves

Shrub

Decoctio

nHalfa

glassthrice

adayfor7days

Norecord

Highbloo

dpressure

[10]

Meliaceae

Azadirachta

indica

A.Juss.

Neem

Leaves

Tree

Decoctio

nAbo

ut120mlo

nceadayfor7

days

Investigated

Dentald

ecay/ache,yello

wfever,

cough,

skin

diseases,d

iabetes,

nausea

[10,

19,2

3,25]

Carapa

gran

diflora

Sprague

Omuk

eete

Leaves/bark

Tree

Decoctio

nHalfa

glasstwiceadayfor7days

Norecord

[10]

Melia

azedarach

Elira

Leaves

Tree

Decoctio

nOral,do

seno

tspecified

Investigated

Fever,skin

disease,itching

wou

nds,

parasitic

worms

[23]

Menisp

ermaceae

Cissam

pelosmucrona

taA.R

ich.

Kavaw

ala

Leaves/w

hole

plant

Herb

Decoctio

nHalfa

glasstwiceadayfor5days

Investigated

[10]

Mim

osaceae

AcaciahockiiDewilld

Ekisim

Roots

Tree

Decoctio

nOral,do

seno

tspecified

Norecord

Diarrhea,syph

ilis,dysentery

[23,

30]

Acacianilotica

Investigated

[31]

Acaciasie

beria

naEtiriri

Roots

Tree

Decoctio

nOral,do

seno

tspecified

Norecord

Dysentery,epilepsy,

cough

[21,

23]

Albizia

coria

riaWelw.

Lugavu

Bark

Tree

Decoctio

n1and3teaspo

onsthrice

adayfor

child

renandadults,respectively,

foraweek.

Investigated

Skin

diseases,d

iarrhea

[10]

Albizia

gran

dibracteataTaub

eNon

goBa

rkTree

Decoctio

nHalfa

glasson

ceadayforaweek

Investigated

Yello

wfever,anem

ia,fun

gal

infections

ofscalp

[8,1

0,32]

Albizia

zygia(D

C.)Macbr.

Mulon

goBa

rkTree

Investigated

[21]

New

toniabu

chan

anii(Baker)G

ilb.

&Perr.

Mpewere

Bark

Tree

Dried,p

owdered,

addedto

boiling

water

Halfa

glasson

ceadayforaweek

Norecord

[10]

Moraceae

Antiaris

toxicaria

Lesch.

Kirun

duBa

rkTree

Decoctio

nHalfa

glasson

ceadayforaweek

Investigated

Weakn

essin

pregnancy,

headache

[8,1

0]Ficusna

talensisHochst

Tree

Investigated

Gon

orrhea

[8,3

3]Ficussaussurean

aDC.

Muw

oBa

rkTree

Decoctio

nHalfa

glassthrice

adayfor7days

Norecord

[10]

Miliciaexcels(W

elw.)C.C

.Berg.

Mivule

Bark

Tree

Decoctio

nHalfa

glassthrice

adayfor7days

Investigated

Burns,freshcuts,skinrush

[8,1

0]

Evidence-Based Complementary and Alternative Medicine 9

Tabl

e1:

Con

tinued.

Plantfamily

Scientificname

Localn

ame

Part

used

Growth

form

Mod

eof

preparation

Doseandmod

eof

administratio

nformalaria

Status

ofantim

alarial/

antip

lasm

odiala

ctivity

investigation

Other

ailm

ents

treated

Reference(s)

Moringaceae

Moringa

oleifera

Lam

Moringa

Leaves/roo

tsTree

Decoctio

n/chew

edraw

Aglassful

thrice

adayfor7days;a

hand

fulo

ffresh

leaves

chew

ed3

times

for4days

Investigated

Jointpains

[21,

25]

Musaceae

Musaparadisia

ca(N

C)

Kabalagala

Leaves

Herb

Decoctio

nOral,do

seno

tspecified

Investigated

Jaun

dice,p

rolong

edem

bryo

inuterus

[19]

Myricaceae

Myricakand

tiana

Engl.(NC)

Omujeeje

Leaves

Decoctio

nOral,do

seno

tspecified

Norecord

Vom

iting

,diarrhea

[19]

Myristicaceae

Pycnan

thus

angolensis(W

elw.)

Warb.

Lunaba

Leaves

Tree

Decoctio

nHalfa

glassaday

Investigated

[10]

Myrsin

aceae

Maesa

lanceolata

Forssk.

Kiwon

dowon

doLeaves

Shrub

Decoctio

nHalfa

glassthrice

adayfor7days

Investigated

Febrile

conv

ulsio

ns[10,

19,2

4]

Myrtaceae

Eucalyptus

gran

disMaiden.

Kalitu

nsi

Leaves

Tree

Decoctio

nHalfa

glassaday

Norecord

Cou

gh[8,1

0]

Psidium

guajavaL.

Mup

eera

Leaves

Tree

Decoctio

nHalfa

glassthrice

adayforaweek

Investigated

Bloo

dydiarrhea,typho

id,w

ound

s,cough

[10,

23]

Syzygium

cordatum

Hochst.

Mugeege

Bark

Tree

Decoctio

nOral,do

seno

tspecified

Investigated

Dry

cough,

skin

rush,w

ound

s[8,1

0,20,2

9]Syzygium

cumini(L.)Skeels

Jambu

laLeaves

Tree

Decoctio

nHalfa

glassthrice

adayforaweek

Investigated

Cou

gh[32]

Syzygium

guineense(W

illd.)DC.

Kalun

ginsanvu

Bark

Tree

Decoctio

nOral,do

seno

tspecified

Investigated

[20]

Papillion

aceae

Butyrospermuu

mparadoxu

mEk

unguri

Roots

Tree

Decoctio

nOral,do

seno

tspecified

Norecord

Labo

urpains,headaches

[23]

Orm

ocarpu

mtrachycarpum

Ederut

Roots

Shrub

Decoctio

nOral,do

seno

tspecified

Norecord

Pneumon

ia,snake

bite

[23]

Passifloraceae

PassifloraedulisSims

Akatund

aLeaves

Herb

Freshextract

Oral,do

seno

tspecified

Norecord

Diarrhea,cough

[19]

Pitto

sporaceae

Pitto

sporum

brachcalya

Not

defin

edNot

defin

edSh

rub

Norecord

[34]

Pitto

sporum

man

niiH

ook.

f.Su

bsp.

ripicola

(J.L

eon)Cuf.

Mub

ajjank

onLeaves

Shrub

Infusio

n/decoction

Halfa

glassadayforaweek

Norecord

[10]

Poaceae

Cymbopogoncitratus

Stapf.

Kisu

biLeaves

Grass

Decoctio

n120mle

very

after8ho

ursfora

week

Investigated

Dentalc

aries,influ

enza,cou

gh,

cancer,ind

igestio

n,fever

[10,

19,2

3]

Digita

riascalarum

Chiov.

Lumbu

guLeaves

Grass

Decoctio

n120mle

very

after8ho

ursfora

week

Norecord

[10]

Imperata

cylin

drical

(L.)Be

auv.

var.africana

(And

erss.)C.E

.Hub

bard

Lusenk

eRo

ots

Grass

Dried,p

owdered,

addedbo

iling

water/

decoction

120mlo

nceadayforaweek

Norecord

Abd

ominal

pain

[10]

ZeamaysL.

Luyang

elwakasoli

Flow

ers/hu

sks

Cereal

grass

Decoctio

n120mle

very

after8ho

ursfora

week

Investigated

Boosts

immun

ity[10]

Polygalaceae

Securid

acalongipedun

culata

Fresen.

Elilo

iRo

ots

Shrub

Decoctio

nOral,do

seno

tspecified

Investigated

Skin

diseases,m

easle

s,cough,

hernia,d

iarrhea

[23]

Maesopsisem

iniiEn

gl.

Musizi

Bark

Tree

Decoctio

nHalfa

glassthrice

adayforaweek

Norecord

[10]

Portulacaceae

Talin

umportulacifo

lium

(Forssk.)

Asch.

exSchw

einf.

Mpo

zia

Leaves

Herb

Oral,do

seno

tspecified

Norecord

[21]

Rosaceae

Prun

usafric

ana(H

ook.

f.)Kalkm

anNtaseesaor

Ngw

abuzito

Bark

Tree

Decoctio

n2and3teaspo

onsthrice

adayfor

child

renandadults,respectively,

foraweek

Investigated

Faintin

g,cancer

[8,1

0]

Rubu

ssteudn

erischweinf.

Nkenene

Leaves

Herb

Decoctio

nHalfa

glasson

ceadayforaweek

Norecord

[10]

Rubiaceae

CoffeacanephoraFroehn

erMwanyi

Leaves

Shrub

Decoctio

nOral,do

seno

tspecified

Norecord

[21]

Hallearubrostip

ulata(K

.Schum

.)J.-F.

Leroy

Muziku

Bark

Tree

Decoctio

nOral,do

seno

tspecified

Investigated

[20]

Pentas

longifloraOliv.

Ishagara

Leaves

Decoctio

nOral,do

seno

tspecified

Investigated

Fever

[19]

Van

gueria

apiculataK.S

chum

.Matugun

daBa

rkSh

rub

Decoctio

n2and3teaspo

onsthrice

adayfor

child

renandadults,respectively,

foraweek

Norecord

[10]

Rutaceae

Citrus

reticulata

Omuq

ugwa

Roots

Tree

Decoctio

nOral,do

seno

tspecified

Investigated

Weigh

tlossind

uctio

n,cancer,skin

diseases

[23]

Citrus

sinensis

Omucun

gwa/

cung

wa

Roots

Tree

Decoctio

nOral,do

seno

tspecified

Investigated

Vom

iting

,cou

gh,d

iabetes

[21,

23,2

5]

Tecle

ano

bilis

Delile

Omuzo

Aerialp

arts

Decoctio

nOral,do

seno

tspecified

Investigated

Body

cleanser

[32]

Todd

alia

asiaticaBa

ill.

Kaw

ule

Roots

Clim

ber

Decoctio

nHalfa

glassthrice

adayforaweek

Investigated

Cou

gh,abd

ominal

pain

[10,

19,2

4]

Zanthoxylum

chalybeum

Engl.

Ntale

yadd

ungu

Roots

Tree

Decoctio

nOral,do

seno

tspecified

Investigated

Body

swellin

gs,stomachache,

cough,

fever,chestp

ain

[10,

23,2

8]

Zanthoxyllu

mleprieuriiGuill.

&Perr.

Mutatem

bwa/

mun

yeny

eBa

rkTree

Decoctio

ndrun

kHalfa

glassthrice

adayforaweek

Norecord

[10]

10 Evidence-Based Complementary and Alternative Medicine

Tabl

e1:

Con

tinued.

Plantfamily

Scientificname

Localn

ame

Part

used

Growth

form

Mod

eof

preparation

Doseandmod

eof

administratio

nformalaria

Status

ofantim

alarial/

antip

lasm

odiala

ctivity

investigation

Other

ailm

ents

treated

Reference(s)

Salicaceae

Trim

eria

gran

difolia

ssp.

trop

ica

(Hochst.)

Warb.

Omwatanshare

Leaves

Decoctio

nOral,do

seno

tspecified

Investigated

[19]

Sapind

aceae

Blighiaun

ijugata

Baker

Nku

zany

ana

Bark

Tree

Decoctio

ndrun

kHalfa

glasstwiceadayforaweek

Investigated

Wou

nds,vomiting

,skindiseases,

fibroids,cervical

cancer

[8,1

0]

Sapo

taceae

Man

ilkaraobovata(Sabine&

G.

Don

)Nku

nya

Bark

Tree

Decoctio

nOral,do

seno

tspecified

Norecord

[20]

Scroph

ulariaceae

Sopu

biaramosa(H

ochst.)

Hochst.

Kakulun

kany

iWho

leplant

Herb

Decoctio

nOral,do

seno

tspecified

Norecord

[20]

Simarou

baceae

Harrison

iaabyssin

icaOlive.

Ekeroi

Roots/leaves

Shrub

Decoctio

nOral,do

seno

tspecified

Investigated

Fever,wou

nds,syph

ilis,snakebite,

abdo

minal

pain

[23]

Solanaceae

Daturastramon

ium

,un

b.Amadud

uLeaves

Herb

Decoctio

ndrun

kHalfa

glassthrice

adayforaweek

Norecord

Ulcers,stom

achache,chestpain

[10]

Physalisperuvian

aL.

Ntuntun

uLeaves

Herb

Decoctio

ndrun

kHalfa

glass3

times

adayfora

week

Norecord

Vom

iting

,febrile

conv

ulsio

ns,

faintin

g[8,1

0,19]

Solanu

mnigrum

L.Nsugga

Leaves

Herb

Decoctio

ndrun

kHalfa

glass3

times

adayfora

week

Investigated

Earinfection,

headache,epilepsy,

STI,diarrhea

[8,1

0]

Tiliaceae

Trum

fetta

rhom

boidea

Jacq.

Musom

bank

oko

Roots

Shrub

Decoctio

ndrun

kHalfa

glasson

ceadayforaweek

Norecord

[10]

Ulm

aceae

Celtisafric

anaL.

Akasis

aLeaves

Tree

Decoctio

ndrun

kHalfa

glassadayforaweek

Investigated

[10]

Umbelliferae

Stegan

otan

iaaraliaceaHoeshst

Ematule

Roots/leaves

Tree

Decoctio

nOral,do

seno

tspecified

Norecord

Measle

s,bo

dysw

ellin

g[23]

Verbenaceae

Lantan

acamara

Kanpang

aLeaves

Shrub

Decoctio

nOral,do

seno

tspecified

Investigated

Wou

nds,measle

s,tuberculosis,

pneumon

ia,snake

bite,chestpain

[23]

Lantan

atrifo

liaL.

Omuh

ukye

Leaves

Decoctio

nOrally

taken,

dose

notspecified

Investigated

Yello

wfever,ring

worms,muscle

pain,p

rolapsed

rectum

[8,1

9]

Zing

iberaceae

Curcum

alongaL.

Binjali

Rhizom

eHerb

Freshextract

30mlthriceadayfor3days

Investigated

[28]

Evidence-Based Complementary and Alternative Medicine 11

5. Herbs and Plant Parts Used to Manage andTreatMalaria across Communities inUganda

About 182 plant species from about 63 different plant familiesare used to treat malaria across several communities in

Uganda (Table 1). Of the 63 plant families, species within thefamily Asteraceae are most widely used in the country to treatmalaria, constituting up to 15% of all plant species used(Figure 3(a)). ,is is followed by species from Fabaceae (9%),Lamiaceae (8%), Euphorbiaceae (6%), and Mimosaceae (4%)

Table 2: Some herbs used in malaria prevention amongst communities in Uganda.

Plant family Plant species Local name Plantform Mode of use to prevent malaria Reference(s)

Cleomaceae Cleome gynandra L. Akeyo Herb Leaves are cooked and eaten as a prophylacticmeasure [25]

Cucurbitaceae Cucurbita maximaDuchesne Acuga Scrambler Leaves cooked and pasted with groundnut then

eaten [25]

Euphorbiaceae Manihot esculenta Crantz Gwana Herb Tuber peelings are dried then burnt in house sothat smoke repels mosquitoes [25]

Fabaceae Crotalaria ochroleuca G.Don Alayo Herb Leaves are cooked and eaten as a prophylactic

measure [25]

Lamiaceae

Ocimum forsskaolii Benth. Yat cola Herb Leaves dried and burnt so that smoke chases awaymosquitoes; bath infusion to repel mosquito [25]

Rosmarinus officinalis L. Rosemary HerbLeaves are cooked and eaten as a prophylacticmeasure; planted around the house to repel

mosquitoes[10]

Malvaceae Gossypium hirsutum L. Pama Shrub Cotton lint is dried and burnt so that smoke keepsaway mosquitoes [25]

Musaceae Musa sp. Labolokwon Shrub Fruit peeling are dried and burnt in the house to

produce smoke that keeps away mosquitoes [25]

Myrtaceae Eucalptus grandis Maiden. Kalitunsi Tree Leave and branches are burnt to repel mosquitoes [25]

Poaceae Cymbopogon citratus Stapf. Kisubi Grass Planted around the house to repel mosquitoes;taken in tea as a prophylactic measure [19, 23]

Solanaceae Solanum americanum Mill. Ocuga Herb Leaves are cooked and eaten as a prophylacticmeasure [25]

15%

8%

9%

6%

3%3%

3%4%

49%

AsteraceaeLamiaceaeFabaceae

EuphorbiaceaeMyrtaceaeAloeaceae

RutaceaeMimosaceaeOthers

(a)

54%

16%

18%

7%

5%

Whole plantOther plant parts

LeavesBarkRoots

(b)

Figure 3: (a) Composition of plant species in each family used to treat malaria. (b) Percentage use of plant parts for treatment of malaria.

12 Evidence-Based Complementary and Alternative Medicine

Tabl

e3:

Antiplasm

odial/a

ntim

alariala

ctivities

ofinvestigated

plants

used

formalaria

treatm

entinUgand

aandtheiractiv

echem

ical

constituents.

Plantfamily

Scientificname

Part

used

Extractin

gsolvent

Means

oftradition

alextractio

nRe

port

onantip

lasm

odial,IC

50(μg/ml)/

antim

alariala

ctivity

(Plasm

odium

strain)

Activechem

ical

constituents

Reference(s)

Acanthaceae

Justicia

betonica

L.Sh

oot

Methano

lHot

water

69.6

(chloroq

uine

sensitive,K

39)

Justeton

in(in

dole(3,2-b)qu

inolinealkaloid

glycoside)

[20]

Water

>100

(chloroq

uine

sensitive,K

39)

Aloeaceae

Aloedawei

A.B

erger(w

ild/

cultivated)

Leaves

Ether

Coldwater;m

ashing

;ho

twater

Extracth

adanti-P.falciparumactiv

ityvalueo

f7.97

(95%

CI:3.56

to17.85)

μg/m

lwith

50%

schizonts

supp

ressionper200WBC

(EC50)

Anthraquino

nes,aloin,

lectins,

[19,

45]

Aloekedongensis

(wild

)Leaves

Methano

lHot

water

87.7(chloroq

uine

sensitive,D

6);67.8(chloroq

uine

resis

tant,W

2)Anthron

e,C-glucosid

eho

mon

ataloin,

anthraqu

inon

es,aloin,lectin

s[19,

46]

AloeferoxMill

Leaves

Dichlorom

ethane

Water

21(chloroq

uine

sensitive,D

10)

Mannans,p

olym

annans,a

nthraquino

nes,aloin,

lectins,anthrones

[19,

31,4

7]

Water

>100

(chloroq

uine

sensitive,D

10)

Anacardiaceae

Man

gifera

indica

L.Leaves

Chloroform:M

ethano

l(1:1)

Hot

water

Inhibitedgrow

thof

P.falciparum

by50.4%

at20

μg/m

lPh

enolics

[48,

49]

Stem

bark

Ethano

l>5

0(chloroq

uine

resis

tant,F

cB1)

Rhus

natalensisBe

rnh.

ExKrauss

Leaves

Ethano

lHot

water

6.6(P.falciparum)

Triterpenoids

[24]

Apiaceae

Centella

asiatica(L.)Urb.

Who

leplant

Water

Water

58.6

(chloroq

uine

sensitive,D

6);n

otdetected

(chloroq

uine

resis

tant,W

2)Ph

enolicsandflavono

ids

[50]

Apo

cynaceae

Alston

iaboon

eiDeWild

.Stem

bark

Water

Hot

water

80.97%

supp

ressiveactiv

ityat

200mg/kg

(P.

berghei)in

combinatio

nwith

othertwolocalherbs.

Alkaloids,triterpenoids

[51]

Carissa

edulis(Forssk.)Vahl

Stem

bark

Dichlorom

ethane

Mashing

;hot

water

33(chloroq

uine

sensitive,D

10)

Lign

an,n

ortrachelogenin

[52]

Carissa

spinarum

Lodd

.exA.D

C.

Root

bark

Methano

lHot

water

14.5

(chloroq

uine

sensitive,D

6)Sapo

nins,sesqu

iterpenes

[53]

Catharan

thus

roseus

G.D

onLeaves

Methano

lHot

water

4.6(chloroq

uine

sensitive,D

6);5

.3(chloroq

uine

resis

tant,W

2)Alkaloids,terpeno

ids,flavono

ids,esqu

iterpenes

[54]

Aristolochiaceae

Aristolochia

elegan

sMast.

Seeds

Methano

lWater

>50(chloroq

uine

sensitive,3

D7);u

ndetectable

(chloroq

uine

resis

tant,W

2)Sesquiterpenoids,d

iterpenoids,m

onoterpeno

ids,

alkaloids

[19,

55]

Aspho

delaceae

Aloevera

(L.)Bu

rm.f.

Leaves

Water

Coldwater;m

ashing

;ho

twater

Antiplasm

odiala

ctivity

interm

sof

EC50

values

0.289to

1.056μg/m

l(chloroqu

inesensitive)

Aloin,anthraquino

nes,aloe-emod

in[56]

Evidence-Based Complementary and Alternative Medicine 13

Tabl

e3:

Con

tinued.

Plantfamily

Scientificname

Part

used

Extractin

gsolvent

Means

oftradition

alextractio

nRe

port

onantip

lasm

odial,IC

50(μg/ml)/

antim

alariala

ctivity

(Plasm

odium

strain)

Activechem

ical

constituents

Reference(s)

Asteraceae

Ageratum

conyzoides

L.Who

leplant

Methano

lHot

water

11.5(chloroq

uine

sensitive,D

6);12.1(chloroq

uine

resis

tant,W

2)Flavon

oids

[54]

Artem

isiaan

nuaL.

Leaves

Water

Hot

water

1.1(chloroq

uine

sensitive,D

10);0.9(chloroq

uine

resis

tant,W

2)

Sesquiterpenes

andsesquiterpenelacton

esinclud

ingartemisinin,

flavono

idssuch

aschrysoplenol-D

,eup

atorin,chyrsop

lenetin

[19,

57]

Artem

isiaafra

Jacq.E

xWilld

Leaves

Methano

lHot

water

9.1(chloroq

uine

sensitive,D

6);3

.9(chloroq

uine

resis

tant,W

2)Acacetin

,genkw

anin,7

-metho

xyacacetin

[54]

Aspiliaafric

ana(Pers.)

C.D

.Adams

Leaves

Ethano

lHot

water

Sign

ificant

chem

osupp

ressiveeffecto

f92.23%

(400

mg/kg)on

P.berghei

Sapo

nins,terpeno

ids,alkaloids,resin

s,tann

ins,

flavono

ids,sterols

[19,

58]

Baccha

roides

adoensis(Sch.B

ip.ex

Walp.)H.R

ob.

Leaves

Petroleum

ether

Hot

water

4.6(chloroq

uine

resis

tant,K

1)Flavon

oids

[26]

Aspiliaafric

anaL.

Leaves

Dichlorom

ethane

Hot

water;m

ashing

8.5(chloroq

uine

sensitive,D

10)

Flavon

oids

includ

ingqu

ercetin

3,3′-dim

ethyl

ether7-0-α-L-rham

nopyrano

syl-(1⟶

6)-β-D

-glucop

yranoseandqu

ercetin

3,3′-dim

ethyle

ther

7-0-β-D-glucopyrano

se

[52]

Bothrio

cline

longipes

N.E

.Br.

Leaves

Chloroform

Hot

water

3.7(P.falciparum)

5-alkylcou

marins,

[19,

24]

Ethano

l50

(P.falciparum)

Crassocephalum

vitellinu

mLeaves

Ethyla

cetate

Hot

water

40.6%

inhibitio

nof

P.falciparum

at10

μg/m

lFlavon

oids

[32]

Guizotia

scabra

Chiov.

Who

leplant

Crude

ethano

lHot

water

49.09%

grow

thinhibitio

nat

100μg/m

l(chloroq

uine

resis

tant,D

d2)

Lacton

es,eud

esmanoline

[59]

Melan

therascan

dens

(Schum

ach.

&,

onn.)Ro

berty

Leaves

Chloroform

Hot

water

68.83%

chem

osupp

ressionactiv

ity(P.b

erghei)

Triterpenoidsapo

nins

[60]

Microglossa

pyrifolia

(Lam

.)O.K

tze

Leaves

Hot

water

<5(bothchloroqu

inesensitive,N

F54and

resis

tant,F

CR3

)E-ph

ytol;6

e-gerany

lgeraniol-1

9-oicacid

[2,2

8]

Schkuh

riapinn

ata(la

m.)

Who

leplant

Water

Hot

water

22.5(chloroq

uine

sensitive,D

6);51.8(chloroq

uine

resis

tant,W

2)Schk

uhrinIandschk

uhrinII

[54]

Methano

l1.3(chloroq

uine

sensitive,D

6);6

.8(chloroq

uine

resis

tant,W

2)

Solanecioman

nii(Hoo

k.f.)

C.Jeffrey

Leaves

Methano

lWater

21.6

(chloroq

uine

sensitive,3

D7);2

6.2

(chloroq

uine

resis

tant,W

2)Ph

ytosterols,

n-alkanesandN-hexacosanol,

[19,

55]

TagetesminutaL.

Leaves

Ethyla

cetate

Water

61.0%

inhibitio

nof

P.falciparum

at10

μg/m

l[32]

Tithon

iadiversifo

liaA.G

ray

Leaves

Methano

lWater

1.2(chloroq

uine

sensitive,3

D7);1

.5(chloroq

uine

resis

tant,W

2)Tagitin

inC,sesqu

iterpenelacton

es[55]

Verno

niaadoensisSch.

Bip.

exWalp.

Leaves

Methano

lHot

water

83.4%

inhibitio

nof

parasitaemia,at6

00mg/kg

(P.

berghei)

Glycocides,glaucolid

es[19,

61]

Verno

niaam

ygdalin

aDelile

Leaves

Methano

l/dichloromethane

Hot

water;coldwater

2.7(chloroq

uine

resis

tant,K

1)Cou

marin,sesqu

iterpenelacton

esinclud

ing

vernolepin,v

erno

lin,v

erno

lide,vernod

alin

and

hydroxyverno

dalin

,steroid

glucosides

[19,

26]

Verno

niacinerea(L.)Less.

Who

leplant

Water

Hot

water

>50(chloroq

uine

sensitive,3

D7);3

7.2

(chloroq

uine

resis

tant,K

1)Sesquiterpenelacton

e[62]

Verno

nialasio

pusO.H

offm.

Leaves

Methano

lMashing

;hot

water

44.3(chloroq

uine

sensitive,D

6);52.4(chloroq

uine

resis

tant,W

2)Sesquiterpenelacton

es,p

olysaccarides

[19,

54]

Bign

oniaceae

Markham

ialutea(Benth.)K.Schum

.Leaves

Ethyla

cetate

Hot

water

71%

inhibitio

nof

P.falciparum

at10

μg/m

lPh

enylprop

anoidglycosides,cycloartane

triterpenoids

[32]

Spathodeacampanu

lata

Buch.-

Harm.exDC.

Stem

bark

Ethyla

cetate

Water

28.9%

inhibitio

nof

P.falciparum

at10

μg/m

lQuino

ne(la

pachol)

[32]

Caesalpiniaceae

Cassia

didymobotryaFres.

Leaves

Methano

lHot

water

23.4

(chloroq

uine

sensitive,D

6);u

ndetectable

(chloroq

uine

resis

tant,W

2)Alkaloids

[54]

Erythrophleum

pyrifolia

Leaves

Ethano

lHot

water

>50(P.falciparum)

[24]

Senn

aspectabilis

(DC.)H.S.Irw

in&

Barneby

Leaves

Ethano

lWater

59.29%

grow

thinhibitio

nat

100mg/kg

body

weigh

tdo

se(P.b

erghei)

Piperidine

alkaloids

[63]

Caesalpinioideae

Cassia

hirsuta

Root

back

Methano

lWater

32.0

(chloroq

uine

sensitive

3D7)

[64]

Canelliaceae

Warbu

giaugan

densisSprague

Stem

back

Methano

lHot

water

6.4(chloroq

uine

sensitive,D

6);6

.9(chloroq

uine

resis

tant,W

2)Sesquiterpenes

e.g.

muzigadiolid

e[27,

54]

Water

12.9(chloroq

uine

sensitive,D

6);15.6(chloroq

uine

resis

tant,W

2)

14 Evidence-Based Complementary and Alternative Medicine

Tabl

e3:

Con

tinued.

Plantfamily

Scientificname

Part

used

Extractin

gsolvent

Means

oftradition

alextractio

nRe

port

onantip

lasm

odial,IC

50(μg/ml)/

antim

alariala

ctivity

(Plasm

odium

strain)

Activechem

ical

constituents

Reference(s)

Caricaceae

Caric

apapaya

L.Leaves

Ethyla

cetate

Hot

water

2.96

(chloroq

uine

sensitive,D

10);3.98

(chloroq

uine

resis

tant,D

D2)

Alkaloids,sapon

ins,tann

ins,glycosides

[65]

Methano

l10.8

(chloroq

uine

sensitive,D

10)

Celastraceae

Maytenu

ssenegalensis

Roots

Hot

water

1.9(chloroq

uine

sensitive,D

6);2

.4(chloroq

uine

resis

tant,W

2)Terpenoids,pentacyclictriterpenes

e.g.pristim

erin

[66]

Cheno

podiaceae

Chenopodium

ambrosioides

L.Leaves

Crude

hydroalcoh

olic

extract

Hot

water

InhibitedtheP.

falciparum

grow

th,exh

ibiting

anIC

50of

25.4μg/m

lSesquiterpenes,m

onoterpenes

[67]

Com

bretaceae

Combretum

molleG.D

onStem

back

Acetone

Water

8.2(chloroq

uine

sensitive

3D7)

Phenolics,pu

nicalagin

[68]

Cucurbitaceae

Cucurbita

maxim

aLam.

Seeds

Crude

ethano

lHot

water

50%

redu

ctionof

parasitaemia

levelsin

P.berghei

infected

miceat

500mg/kg.

Phenols,terpenoids,a

lkaloids,tannins

[69]

Mom

ordica

foetidaSchu

mach.

Shoo

tWater

Hot

water

6.16

(chloroq

uine

sensitive,N

F54);0

.35

(chloroq

uine

resis

tant,F

CR3

)Sapo

nins,a

lkaloid,

cardiacglycosides

[28]

Ebenaceae

Eucle

alatid

eusStaff

Root

back

Hexane

Water

38.2

(chloroq

uine

sensitive,3

D7);3

8.9

(chloroq

uine

resis

tant,D

d2)

Triterpenoids

lupeol,b

etulin,3

β-(5-

hydroxyferuloyl)lup

-20(30)-ene

[23]

Euph

orbiaceae

Alch

orneacordifo

lia(Schum

ach.)

Mull.Arg.

Leaves

Water

Hot

water

4.8(chloroq

uine

resis

tant,K

1)Ph

enolicsinclud

ingellagicacid

[70]

Bridelia

micrantha

Baill.

Stem

bark

Methano

lHot

water

19.4(chloroq

uine

sensitive,D

6);14.2(chloroq

uine

resis

tant,W

2)[50]

Clutia

abyssin

icaJaub

.&Spach

Leaves

Methano

lWater

7.8(chloroq

uine

sensitive,D

6);1

1.3(chloroq

uine

resis

tant,W

2)Diterpenes

[54]

Croton

macrostachyus

Olive.

Leaves

Chloroform

Hot

water

Chemotherapeutic

effecto

f66–82%

inmalaria

mou

semod

elTriterpenoids

includ

inglupeol

[71]

Fluegeavirosa

(Roxb.Ex

Willb.)V

oigt

Leaves

Water/m

ethano

lHot

water

2(chloroq

uine

resis

tant,W

2)Be

rgenin

[72]

Jatropha

curcas

L.Leaves

Ethyla

cetate

Hot

water

5.1(chloroq

uine

sensitive,N

F54);2.4(chloroq

uine

resis

tant,K

1)Alkaloids,sapon

nins,g

lycosid

es,tannins

[73]

Phyllanthu

s(pseud

o)niruriMull.

Arg.

Water

Hot

water

Rang

edfrom

2.9to

4.1(bothchloroqu

inesensitive,

3D7andresis

tant,D

d2)

Cou

marinsinclud

ing1-O-galloyl-6-O

-luteoyl-a

-D-glucose

[74]

Fabaceae

Cajanu

scajan(L.)Druse

Leaves

Crude

ethano

lMashing

29.0

(P.falciparum)

Cajachalcon

e;[75]

Entada

abyssin

icaSteud.

exA.R

ich.

Seeds

Methano

lHot

water

>5(chloroq

uine

resis

tant,K

1)Flavon

oids,terpeno

ids

[26,

32]

Entada

afric

anaGuill.

&Perr.

Leaves

Ethano

lHot

water

26.4

(chloroq

uine

sensitive,H

B3);28.9

(chloroq

uine

resis

tant,F

cM29)

Phenolics

[76]

Erythrinaabyssin

icaLam.

Stem

bark

Ethyla

cetate

Hot

water

83.6%

inhibitio

nof

P.falciparum

at10

μg/m

lChalcon

es(5-preny

lbutein,

homob

utein),

flavano

nesinclud

ing5-deoxyabyssinin

II,

abyssin

inIIIandabyssin

oneIV

[32]

Indigofera

emerginella

Steud.

exA.

Rich

Leaves

Ethano

lHot

water

5.8(P.falciparum)

[24]

Senn

adidymobotrya(Fresen.)H.S

.Irwin

&Ba

rneby

Leaves

Methano

lHot

water

>100

(chloroq

uine

sensitive,K

39)

Quino

nes

[20,

29]

Senn

asia

mea

(Lam

.)H.S

.Irw

in&

Barneby

Leaves

Ethano

lMashing

;hot

water

28.8

(chloroq

uine

sensitive,3

D7);4

8.3

(chloroq

uine

resis

tant,W

2)Ph

enolic

derivativ

e,chrobisia

mon

ea,

anhydrob

arakol

[77]

Tamarindu

sindica

L.Stem

bark

Water

Hot

water

25.1%

chem

osupp

ressiveactiv

ityat

10mg/kg

(P.

berghei)

Sapo

nins

(leaves),tann

ins(fruits)

[78]

Flacou

rtiaceae

Trim

eria

bakeriGilg.

Leaves

Petroleum

ether

Hot

water

3.9(P.falciparum)

Triterpenoids

[24]

Hypericaceae

Harun

gana

madagascarie

nsisLam.

Stem

bark

Water

Hot

water

9.64

(chloroq

uine

resis

tant,K

1)Quino

nesinclud

ingbazouanthron

e,feruginina,

harung

anin,h

arun

gano

la[70]

Evidence-Based Complementary and Alternative Medicine 15

Tabl

e3:

Con

tinued.

Plantfamily

Scientificname

Part

used

Extractin

gsolvent

Means

oftradition

alextractio

nRe

port

onantip

lasm

odial,IC

50(μg/ml)/

antim

alariala

ctivity

(Plasm

odium

strain)

Activechem

ical

constituents

Reference(s)

Lamiaceae

Ajuga

remotaBe

nth.

Who

leplant

Ethano

lHot

water

55(chloroq

uine

sensitive,F

CA/G

HA);57

(chloroq

uine

resis

tant,W

2)Ajugarin-1,

ergosterol-5,8-end

operoxide,8-O-

acetylharpagide,steroids

[79]

Clerodendrum

myricoidesR.

Br.

Root

bark

Methano

lHot

water

4.7(chloroq

uine

sensitive,D

6);8

.3(chloroq

uine

resis

tant,W

2)[50,

80]

Clerodendrum

rotund

ifoliu

mOliv.

Leaves

Methano

lMashing

;hot

water

<5(bothchloroqu

inesensitive,N

F54and

resis

tant,F

CR3

)Sapo

nins,tannins

[28]

Hoslund

iaoppositaVahl.

Leaves

Ethyla

cetate

Hot

water

66.2%

inhibitio

nof

P.falciparum

at10

μg/m

lQuino

nes,sapo

nins,a

bietanediterpenes

(3-O

-benzoylhoslopp

one)

[32]

Leon

otisnepetifolia

Schimp.

exBe

nth

Leaves

Ethyla

cetate

Water

27.0%

inhibitio

nof

P.falciparum

at10

μg/m

l[32]

Ocimum

basilicum

Leaves

Ethano

lHot

water

68.14(chloroq

uine

sensitive,C

Q-s);67.27

(chloroq

uine

resis

tant,C

Q-r)

[50,

80]

Ocimum

gratissim

umWilld.

Leaves/tw

igs

Dichlorom

ethane

Hot

water

8.6(chloroq

uine

resis

tant,W

2)Flavon

oids

[47,

49]

Ocimum

lamiifolium

Hochst.

Leaves

Water

Water

Sign

ificantly

supp

ressed

parasitaemia,2

2.2%

,26.8%

and35.5%

atdo

seof

200,

400and

600mg·kg,respectively(P.b

erghei)

[81]

Plectran

thus

barbatus

Leaves/stem

Dichlorom

ethane

Hot

water

Noactiv

ity[23,

47]

Rosm

arinus

officina

lisL.

Hot

water

Essentialoilatac

oncentratio

n15867ng

/mlhad

noantim

alariala

ctivity

[82]

Tetradenia

riparia

(Hochst.)

Cod

dRo

otHot

water

13.2

(chloroq

uine-sensitive,NF5

4)[83]

Lauranceae

Persea

american

aMill.

Leaves

Ethano

lHot

water

10.15(chloroq

uine

sensitive,3

D7);4

4.94

(chloroq

uine

resis

tant,W

2)Ph

enolics

[84]

Meliaceae

Azadirachta

indica

A.Juss.

Leaves

Hot

water

17.9(chloroq

uine

sensitive,D

6);43.7(chloroq

uine

resis

tant,W

2)Terpenoids,isoprenoids,g

edun

in[49,

66]

Melia

azedarach

Leaves

Methano

lHot

water

55.1(chloroq

uine

sensitive,3

D7);1

9.1

(chloroq

uine

resis

tant,W

2)[85]

Menisp

ermaceae

Cissam

pelosmucrona

taA.R

ich.

Root

bark

Methano

lHot

water

8.8(chloroq

uine

sensitive,D

6);9

.2(chloroq

uine

resis

tant,W

2)Be

nzyliso

quinolinealkaloids

[80]

Mim

osaceae

Acacianilotica

Stem

bark

Methano

lHot

water

Doseof

100mg/kg

b/w

prod

uced

parasitic

(P.

berghei)inhibitio

n77.7%

Tann

ins,flavono

ids,terpenes

[86]

Albizia

coria

riaWelw.

Stem

bark

Methano

lHot

water

15.2(chloroq

uine

sensitive,D

6);16.8(chloroq

uine

resis

tant,W

2)Triterpenoids,lup

eol,lupeno

ne[54]

Albizia

gran

dibracteataTaub

eLeaves

Ethyla

cetate

Hot

water

22.0%

inhibitio

nof

P.falciparum

at10

μg/m

l[32]

Albizia

zygia(D

C.)Macbr.

Stem

bark

Methano

lWater

1.0(chloroq

uine

resis

tant,K

1)Flavon

oids

mainly3′,4′,7

-trihydroxyflavon

e[87]

Moraceae

Antiaris

toxicaria

Lesch.

Stem

bark

Ethyla

cetate

Hot

water

36.4%

inhibitio

nof

P.falciparum

at10

μg/m

l[32]

Ficusna

talensisHochst

Leaves

Hexane

Hot

water

6.7(P.falciparum)

[88]

Miliciaexcels(W

elw.)C.C

.Berg.

Leaves

Ethano

lHot

water

76.7%

chem

osupp

ressiveactiv

ityat

250mg/kg/

day(P.b

erghei)

[89]

Moringaceae

Moringa

oleifera

Lam

Leaves

Methano

lMashing

;hot

water

9.8(chloroq

uine

sensitive,D

6);n

otdetected

(chloroq

uine

resis

tant,W

2)Flavon

ols

[49,

80]

Musaceae

Musaparadisia

ca(N

C)

Leaves

Ethyla

cetate

Hot

water

75(chloroq

uine

sensitive,3

D7);1

00(chloroq

uine

resis

tant,D

d2)

Flavon

oids

[49,

90]

Myristicaceae

Pycnan

thus

angolensis(W

elw.)W

arb.

Leaves

50%

ethano

lHot

water

>1000(chloroq

uine

sensitive,3

D7)

Talaum

idin

[91]

Myrsin

aceae

Maesa

lanceolata

Forssk.

Twig

Dichlorom

ethane:

Methano

l(1:1)

Hot

water

5.9(chloroq

uine

sensitive,D

10)

Lanciaqu

inon

es,2

,5,d

ihydroxy-3-(no

nadec-14-

enyl)-1,4-benzoq

uino

ne[24,

52,5

5]

Myrtaceae

Psidium

guajavaL.

Stem

back

Water

Hot

water

10–20(chloroq

uine

sensitive,D

10)

Phenols,flavono

ids,caroteno

ids,terpenoids

[49,

92]

Syzygium

cordatum

Hochst.

Twig

Dichlorom

ethane:

Methano

l(1:1)

Hot

water

14.7

(chloroq

uine

sensitive,D

10)

[55]

Syzygium

cumini(L.)Skeels

Stem

back

Hot

water

0.25

to27.1(chloroq

uine-resistantstrains)

[93]

Syzygium

guineense(W

illd.)DC.

Leaves

Crude

ethano

lHot

water

49.09%

chem

osupp

ressionat

400mg/kg

(P.

berghei)

[94]

Poaceae

Cymbopogoncitratus

Stapf.

Who

leplant

Hot

water

99.89%

supp

ressionof

parasitaemiaat1600

mg/kg

Flavon

oids

[20,

49,9

5]

ZeamaysL.

Husks

Ethyla

cetate

Hot

water

9.3(chloroq

uine

sensitive,3

D7);3

.7(chloroq

uine

resis

tant,INDO)

Alkaloids,fl

avon

oids

andtriterpenoids

[96]

Polygalaceae

Securid

acalongipedun

culata

Fresen.

Leaves

Dichlorom

ethane

Hot

water

6.9(chloroq

uine

sensitive,D

10)

Sapo

nins,fl

avon

oids,a

lkaloids,steroids

[92]

Rosaceae

Prun

usafric

ana(H

ook.

f.)Kalkm

anStem

bark

Methano

lHot

water

17.3

(chloroq

uine

sensitive,D

6);n

otdetected

(chloroq

uine

resis

tant,W

2)Terpenoids

[54]

16 Evidence-Based Complementary and Alternative Medicine

Tabl

e3:

Con

tinued.

Plantfamily

Scientificname

Part

used

Extractin

gsolvent

Means

oftradition

alextractio

nRe

port

onantip

lasm

odial,IC

50(μg/ml)/

antim

alariala

ctivity

(Plasm

odium

strain)

Activechem

ical

constituents

Reference(s)

Rubiaceae

Hallearubrostip

ulata(K

.Schum

.)J.-

F.Leroy

Root

Ethano

lWater

100μg/m

lextract

had65.54%

grow

thinhibitio

n(chloroq

uine

resis

tant,D

d2)

Alkaloids

[59]

Pentas

longifloraOliv.

Root

Methano

lHot

water

0.99

(chloroq

uine

sensitive,D

6);0.93(chloroq

uine

resis

tant,W

2)

Pyrano

naph

thoq

uino

nes,pentalon

gin(1)and

psycho

rubrin

(2),naph

thalenederivativ

emollugin

(3)

[97]

Rutaceae

Citrus

reticulata

Seeds(isolim

onexic

acid

methyle

ther)

Hot

water

<4.76(bothchloroqu

inesensitive,D

6and

resis

tant,W

2)Limon

in,isolim

onexicacidmethylether,ichangin,

deacetylno

milin,

obacun

one

[98]

Citrus

sinensis

70%

ethano

lHot

water

53.27%

supp

ressionof

parasitaemia

at700mg/kg

Tann

ins,alkaloids,sapo

nins,fl

avon

oids

[20,

24,9

9]Tecle

ano

bilis

Delile

Bark

Ethyla

cetate

Water

54.7%

inhibitio

nof

P.falciparum

at10

μg/m

lQuino

nlinealkaloids

[32]

Todd

alia

asiaticaBa

ill.

Root

bark

Methano

lWater

6.8(chloroq

uine

sensitive,D

6);1

3.9(chloroq

uine

resis

tant,W

2)Fu

roqu

inolines

(nitidine,5

,6-dihydronitid

ine),

coum

arins

[80]

Zanthoxylum

chalybeum

Engl.

Stem

bark

Water

Hot

water

4.3(chloroq

uine

sensitive,N

F54);2

5.1

(chloroq

uine

resis

tant,F

CR3

)Chelerythine,nitid

ine,methylc

anadine

[28]

Salicaceae

Trim

eria

gran

difolia

ssp.

trop

ica

(Hochst.)

Warb.

Leaves

Methano

lHot

water

>50(chloroq

uine

sensitive,3

D7)

[55]

Sapind

aceae

Blighiaun

ijugata

Baker

Leaves

Ethyla

cetate

Hot

water

2.3%

inhibitio

nof

P.falciparum

at10

μg/m

l[32]

Simarou

baceae

Harrison

iaabyssin

icaOlive.

Roots

Hot

water

4.4(chloroq

uine

sensitive,D

6);10.25

(chloroq

uine

resis

tant,W

2)Limon

oids,steroids

[66]

Solanaceae

Solanu

mnigrum

L.Fruit

Methano

lHot

water

10.3

(chloroq

uine

sensitive,3

D7);1

8.7

(chloroq

uine

resis

tant,K

1)Steroidala

lkaloids,fl

avon

oids

[100]

Ulm

aceae

Celtisafric

anaL.

Stem

bark

Ethyla

cetate

Hot

water

37.5%

inhibitio

nof

P.falciparum

at10

μg/m

l[32]

Verbenaceae

Lantan

acamara

Leaves

Dichlorom

ethane

Hot

water

8.7(chloroq

uine

sensitive,3

D7);5

.7(chloroq

uine

resis

tant,W

2)Sesquiterpenes,triterpenes,fl

avon

oids

[30]

Lantan

atrifo

liaL.

Arial

parts

Petroleum

ether

Hot

water

13.2

(P.falciparum)

Steroids,terpeno

ids,alkaloids,sapo

nins

[24]

Ethano

l>5

0(P.falciparum)

Zing

iberaceae

Curcum

alongaL.

Hot

water;m

ashing

5mg/kg

hadasig

nificantly

high

chem

osupp

ressiveactiv

ityof

56.8%

(P.b

erghei)

Polyph

enolic

curcum

in[101]

Evidence-Based Complementary and Alternative Medicine 17

Tabl

e4:

Top17

herbal

plants

used

locally

inUgand

aformalaria

treatm

entw

ithhigh

esta

ntim

alarial/a

ntiplasm

odiala

ctivities

(arrangedalph

abetically).

Plantfamily

Plantspecies

Plantpart

Extractin

gsolvent

Repo

rton

antip

lasm

odial,

IC50

(μg/ml)/antim

alarial

activ

ity(Plasm

odium

strain)

Activechem

ical

constituents

Toxicity/safetyinform

ation

Reference(s)

Asteraceae

Artem

isiaafra

Jacq.E

xWilld

Leaves

Methano

l3.9(chloroq

uine

resis

tant,

W2)

Acacetin

,genkw

anin,7

-metho

xyacacetin

Cytotoxicity

was

observed

inVerocells

[54,

103]

Artem

isiaan

nuaL.

Leaves

Water

0.9(chloroq

uine

resis

tant,

W2);1

.1(chloroq

uine

sensitive,D

10)

Sesquiterpenes

and

sesquiterpenelacton

esinclud

ingartemisinin

Generallysafeandeffectiv

e;nausea

may

occuron

drinking

herbal

extract;

artemisinin,

anactiv

ecompo

undin

theextractis

safeforp

regn

antw

omen

atleastd

uringsecond

and

thirdtrim

esters

[19,

57,1

04]

Aspiliaafric

ana(Pers.)

C.D

.Adams

Leaves

Ethano

lSign

ificant

chem

osupp

ressivee

ffectof92.23%

(400

mg/kg)on

P.berghei

Sapo

nins,terpeno

ids,

alkaloids,resin

s,tann

ins,

flavono

ids,sterols

Nosig

nsof

toxicity

inmice

even

atado

seas

high

as5000

mg/kg

[19,

58]

Jatropha

curcas

L.Leaves

Ethyla

cetate

2.4(chloroq

uine

resis

tant,

K1)

Alkaloids,sapon

nins,

glycosides,tannins

Mod

eratetoxicity

onthrombo

cyte

lineanda

protectiv

eeffecto

ncardiovascular

system

;no

signs

oftoxicity

inmice

follo

wingoral

administratio

nof

5000

mg/

kgbo

dyweigh

t(bw)do

se

[73,

105]

Microglossa

pyrifolia

(Lam

.)O.K

tze

Leaves

Dichlorom

ethane

1.5(chloroq

uine

sensitive,

3D7;

2.4chloroqu

inresis

tant,W

2)

E-ph

ytol;6

e-gerany

lgeraniol-1

9-oicacid

Relativ

elyhigh

cytotoxicity

againstcells

from

the

human

foetal

lung

fibroblastc

ellline

[2,2

8,55]

Schkuh

riapinn

ata

(lam.)

Who

leplant

Methano

l1.3(chloroq

uine

sensitive,

D6)

Schk

uhrinIandschk

uhrin

II

Methano

lextract:low

cytotoxicity

againsth

uman

cells;a

queous

extracts:n

oob

served

toxicity

observed

inmice

[32,

54]

Tithon

iadiversifo

liaA.

Gray

Leaves

Methano

l1.2(chloroq

uine

sensitive,

3D7);1

.5(chloroq

uine

resis

tant,W

2)

Tagitin

inC,sesqu

iterpene

lacton

es

Aerialp

arts

arecytotoxic

againstcells

from

the

human

foetal

lung

fibroblastc

ellline

[55]

Verno

niaam

ygdalin

adelile

Leaves

Methano

l/dichloromethane

2.7(chloroq

uine

resis

tant,

K1)

Cou

marin,sesqu

iterpene

lacton

esinclud

ing

vernolepin,v

erno

lin,

vernolide,vernod

alin

and

hydroxyverno

dalin

,steroid

glucosides

Petroleum

etherextract

show

sstrong

cytotoxicity

[19,

26,3

2]

18 Evidence-Based Complementary and Alternative Medicine

Tabl

e4:

Con

tinued.

Plantfamily

Plantspecies

Plantpart

Extractin

gsolvent

Repo

rton

antip

lasm

odial,

IC50

(μg/ml)/antim

alarial

activ

ity(Plasm

odium

strain)

Activechem

ical

constituents

Toxicity/safetyinform

ation

Reference(s)

Caricaceae

Caric

apapaya

L.Leaves

Ethyla

cetate

2.96

(chloroq

uine

sensitive,

D10);3.98

(chloroq

uine

resis

tant,D

D2)

Alkaloids,sapon

ins,

tann

ins,glycosides

Noseriou

stoxicity

repo

rted,carpaine,an

activ

ecompo

undagainstP

.falciparum

hadhigh

selectivity

andwas

nontoxic

tono

rmal

RBCs

[65,

106]

Celastraceae

Maytenu

ssenegalensis

Roots

1.9(chloroq

uine

sensitive,

D6);2

.4(chloroq

uine

resis

tant,W

2)

Terpenoids,p

entacyclic

triterpenes,e.g.,pristim

erin

Notoxicity

observed

inethano

lextract

[66,

107]

Cucurbitaceae

Mom

ordica

foetida

Schu

mach.

Shoo

tWater

0.35

(chloroq

uine

resis

tant,

FCR3

);6.16

(chloroq

uine

sensitive,N

F54)

Sapo

nins,alkaloid,

phenolic

glycosides

includ

ing5,7,4′-

Trihydroxyflavano

neand

kaem

pferol

Nopron

ounced

toxicity

againsthu

man

hepatocellu

lar(H

epG2)

andhu

man

urinarybladder

carcinom

a(ECV-304,

derivativ

eof

T-24)cells

[26,

28,1

08]

Euph

orbiaceae

Alch

orneacordifo

lia(Schum

ach.)Mull.Arg.

Leaves

Water

4.8(chloroq

uine

resis

tant,

K1)

Phenolicsinclud

ingellagic

acid

Nomortalityin

micein

acutetoxicity

test

[70,

109]

Fluegeavirosa

(Roxb.

ExWillb.)V

oigt

Leaves

Water/m

ethano

l2(chloroq

uine

resis

tant,

W2)

Bergenin

Non

toxic,extracts

expo

sed

tomurinem

acroph

ages

did

nots

low

orinhibitg

rowth

ofcells

[72,

110]

Phyllanthu

s(pseud

o)niruriMull.Arg.

Water

Rang

edfrom

2.9to

4.1

(bothchloroqu

ine

sensitive,3

D7and

resis

tant,D

d2)

Cou

marinsinclud

ing1-O-

gallo

yl-6-O

-luteoyl-a

-D-

glucose

Notoxicity

was

observed;

thus,L

D50

oftheaqueou

sextractis>5

000mg/kg.

b.w.

[74,

111]

Lamiaceae

Clerodendrum

rotund

ifoliu

mOliv.

Leaves

Methano

l0.02

(chloroq

uine

sensitive,

CQS );1

.56(chloroq

uine

resis

tant,C

QR)

Iridoidglycosides

such

asserratosideA,serratosid

eB

andmon

omelittoside,

diterpenoids

includ

ing

uncinatone,clerodin,

and

sugiol

Not

explored

[28,

33]

Mim

osaceae

Albizia

zygia(D

C.)

Macbr.

Stem

bark

Methano

l1.0(chloroq

uine

resis

tant,

K1)

Flavon

oids,m

ainly3′,4′,7

-trihydroxyflavone

,eaqueou

sextractis

relativ

elysafe

onsubacute

expo

sure

[87,

112]

Rubiaceae

Pentas

longifloraOliv.

Root

Methano

l0.99

(chloroq

uine

sensitive,

D6);0

.93(chloroq

uine

resis

tant,W

2)

Pyrano

naph

thoq

uino

nes,

pentalon

gin(1)and

psycho

rubrin

(2),

naph

thalenederivativ

emollugin(3)

Low

cytotoxicity

[97]

Evidence-Based Complementary and Alternative Medicine 19

Tabl

e4:

Con

tinued.

Plantfamily

Plantspecies

Plantpart

Extractin

gsolvent

Repo

rton

antip

lasm

odial,

IC50

(μg/ml)/antim

alarial

activ

ity(Plasm

odium

strain)

Activechem

ical

constituents

Toxicity/safetyinform

ation

Reference(s)

Rutaceae

Citrus

reticulata

Seeds(isolim

onexic

acid

methyle

ther)

<4.76(bothchloroqu

ine

sensitive,D

6andresis

tant,

W2)

Limon

in,isolim

onexic

acid

methyle

ther,ichangin,

deacetylno

milin,ob

acun

one

Dermal

50%

lethal

dose

(LD50)of

undilutedleaf

oil

is>2

g/kg

inrabb

its;seed

extractc

ausesrespiratory

distress

andstrong

spleen

contraction

[34,

113]

20 Evidence-Based Complementary and Alternative Medicine

families, with Myrtaceae, Aloeaceae, and Rutaceae familieseach contributing approximately 3% to the total number ofspecies used for malaria treatment in Uganda (Figure 3(a)).,e remaining families contribute only 49% of the total plantspecies used for malaria treatment (Figure 3(a)).

,e plant parts greatly used to treat malaria are leaves(54.4%) followed by roots (17.4%) and bark (16%); wholeplants and other plant parts are used less commonly(Figure 3(b)). A particular herbal plant is commonly usedsingly though some times in combination with other herbs.,e most common way of use is by boiling the medicinalplant part in water and then drinking the decoction; in-gestion of fresh extracts and powdered forms of the herbs isalso practiced (Table 1).

Different herbal remedies are used in different com-munities in different parts of the country depending on thegeographical distribution of the medicinal plant species, forexample, Warburgia ugandensis is particularly used in theeastern part of Uganda. However, herbal plant species suchas Bidens pilosa L. are spread throughout the country andthus well known for malaria treatment across the country. Ina study conducted by Ssegawa and Kasenene [20], no treespecies in the forests of southern Uganda were more usefulthan Hallea rubrostipulata andWarburgia ugandensis in thetreatment of malaria. ,ese medicinal plants are known bydifferent local names in different parts of the country asUganda has diverse ethnic groups, including the Luo,Baganda, Itesots, and Banyankole/Bakiga.

Among all communities in Uganda, some measures aretaken to control malaria, including draining of stagnantwater, clearing and burning bushes, sleeping under in-secticide-treated mosquito nets, and house spraying withinsecticides.

6. Mode of Preparation and Use of Herbs inTreatment of Malaria in Uganda

,e mode of preparation and use of herbs among differentcommunities vary depending on the nature of the herb andplant parts used for malaria treatment [10]. Most commonly,the herbal medicines are prepared as water extracts in theform of decoction and infusion or as steam baths (Table 1)[19, 23]. ,e herbal plant water extract is made mostly byboiling a handful of the medicinal plant parts such as leavesin a litre of water and then given to the patient to take orally(Table 1) [23]. ,e dose of the extract given is dependent onthe age of the patient and the “strength” of the herbalmedicine although occasionally the weight of the patient[19, 23]. ,e quantity of extract given ranges from 100 to500ml, 100 to 250ml, and 1 to 3 tea or tablespoons foradults, older children, and young children below 5 years ofage, respectively, between 1 and 3 times a day for about aweek or until when patient has recovered [19, 25]. ,eextracts are mostly prepared from single herbal plants orfrom combination of two herbal plants, for example, adecoction of Tamarindus indica and Mangifera indica iscommon [25].

In some cases, the medicinal plant parts are dried thenpulverized to powder and 2–5 tablespoons of the power

added to water and boiled to make a decoction. Somemedicinal plant parts such as bark of M. indica stem androots of V. lasiopus and their powders are boiled for longuntil the water is half the initial amount [25]. ,e herbalplant powder can also be added to cold or hot water andstirred and then drunk as recommended [10].

Medicine for malaria treatment from a herb such as B.pilosa can be made by squeezing a handful of its freshlypicked leaves and drinking 1–3 teaspoons of the extract a day(Table 1) [23]. Occasionally, malaria herbal medicines can beobtained by preparing different plant parts in combination,for example, an infusion can be made from fresh leaves andpounded fresh roots of V. amygdalina [25]. ,is is thentaken orally in a recommended dose. A handful of medicinalplant parts such as leaves can be squeezed and mixed withcold or warm water for bath, for example, leaves of B.adoensis [25]. Some common herbs are also eaten as veg-etables as a prophylactic measure against malaria whileothers are planted in pots around houses or burnt to driveaway mosquitoes (Table 2).

7. Antimalarial Activities and Toxicity of HerbsUsed in Uganda for Malaria Treatment

Some studies have been performed on antiplasmodial/an-timalarial activities of some of the herbal plants used inUganda to treat malaria by using various strains of malarialparasites to confirm effectiveness as malaria treatment[26, 28]. Furthermore, a broad range of phytochemicalsresponsible for biological activities in some of the antima-larial herbs have been isolated and identified [23]. Of the 182plant species used in Uganda for the treatment of malaria,112 plant species (64%) have been investigated for anti-malarial activities, of which 108 plants showed positiveresults and only four plant species did not give positiveresults when tested for antimalarial activities (Table 1). Forabout 70 plant species (39%) that are used among differentcommunities in Uganda for the treatment of malaria, therewas no record of investigation for antimalarial activities(Table 1).

,e antimalarial activity of herbal plants is due to thepresence of a number of metabolically active compounds[23]. ,ese compounds may occur in the form of alkaloids,sesquiterpenes, quinones, triterpenoids, flavonoids, quassi-noids, limonoids, terpenes, chalcones, coumarins, or othermiscellaneous forms [85]. ,e solvent of extraction largelydetermines the concentrations of the active metabolites inthe extract. For example, methanolic extracts of the herbalplants are in general more active in vitro than water extractsprobably due to the presence of higher amounts of moreactive lipophilic compounds (Table 3) [54].

,e levels of activity of the antimalarial plant extractsdepend on the concentration of the active antimalarialsecondary metabolites [54]. For example, gedunin, a veryactive compound against Plasmodium present in leaves of A.indica had an IC50 of 0.02 μg/ml against P. falciparum, but itsconcentration in the plant is in very low and thus moderateactivity of its extract (Table 3) [23, 54].

Evidence-Based Complementary and Alternative Medicine 21

,e synergistic effect of the interaction of the differentactive secondary metabolites is a main contributing factorto the high levels of antiplasmodial activity of some of theherbal plant extracts, for example, in A. afra, none of theisolated flavonoids and sesquiterpenes had a high activity,yet the plant extract had an IC50 of 3.9 μg/ml against P.falciparum suggesting a synergistic effect of the com-pounds in the extract [54]. ,e presence of particularactive compounds in the herbal plant extracts is key inenhancing its antimalarial property. ,e compound 6E-geranylgeraniol-19-oic-acid a diterpene isolated from M.pyrifolia aqueous extract was considered responsible for itsantiplasmodial activity; nitidine isolated from Z. chaly-beum had an IC50 as low as 0.17 μg/ml against P. falci-parum 3D7 [10]; and pristimerin with an IC50 0.5mg/mlagainst P. falciparum was the main active ingredient in M.senegalensis extract, making it have a very high anti-plasmodial activity [54]. ,e presence of a moderateamount of a minimum of two secondary metabolites in theextract could explain the efficacy of the herbal extracts formalaria treatment [10].,e pathogenic strains used may bedifferent for different in vitro studies; thus, resistance ofthe parasite to the active metabolites could cause a vari-ation in the level of antimalarial activity of the extracts[10]. Herbal plants with no antiplasmodial activity suggestthe absence of the metabolically active compounds againstthe Plasmodium parasites in their extracts [23]. Table 4indicates a list of herbal plants used for malaria treatmentin Uganda with high antiplasmodial activities (IC50 < 5 μg/ml in one of its solvent extracts or high percentage in-hibition of plasmodia) that could be potentially in-vestigated further.

Although herbs are generally considered safer when usedfor treatment compared to conventional drugs, some of theherbs used traditionally to treat malaria in Uganda may beefficacious, but there is a need to have them used withcaution as some may be toxic (Table 4). ,ere is a variationin degree of toxicity depending on the sensitivity of animals,tissue or cells used, type of extract, nature of the test sub-stance, dose, and mode of administration [114]. Accordingto Lacroix et al. [32] one third of the herbs for malariatreatment in Uganda they investigated had significantantiplasmodial activity with low toxicity. Some of the plantparts with good antiplasmodial/antimalarial activities withno or low toxicity include leaves of A. annua, leaves of A.africana, S. pinnata whole plant, leaves of C. papaya, andleaves of F. virosa amongst others (Table 4). ,ere arehowever extracts of some plants used for malaria treatmentwith very good activity against Plasmodium but with hightoxicity; such plant extracts include petroleum ether leafextract ofV. amygdalina and dichloromethane leaf extract ofM. pyrifolia (Table 4) [32, 55]. Clerodendrum rotundifoliumis on those plants that have very good antimalarial/anti-plasmodial activities but have not been investigated for theirtoxicity (Table 4) [33].

8. Traditional Health Care Practice and PolicyFramework in Uganda

,e health care system of Uganda consists of the public,private-profit oriented, and private-nonprofit orientedsectors. ,ere is quite a large sector of informal health careincluding traditional medicine practitioners, drug shops,medicine vendors, and complementary and alternativepractitioners. ,e contribution of traditional health prac-titioners to Uganda’s health care system was not valued untillately [115]. ,e negative perspective could be traced back tothe colonial times when culture including use of traditionalmedicine such as herbs for treatment was consideredprimitive and so discouraged [115]. Efforts are now beingmade to promote the use of traditional medicine since thegovernment has realized that traditional health practitionersare key contributors to its primary health care system [115].,e Ministry of Health created a public-private partnershipwith the traditional health practitioners following a rec-ommendation that they be brought into the mainstreamhealth system [115, 116].

A policy on Traditional and Complementary Medicinewas created to regulate traditional medicine practice fo-cusing on research and development while emphasizing thepropagation, protection, and sustainable use of medicinalplant resources [115, 116]. For collaboration between themainstream health care sector and traditional health prac-titioners, the Ministry of Health submitted a bill for thecreation of the National Council of Indigenous and Com-plementaryMedicine Practitioners, a semiautonomous bodythat shall as well protect their intellectual property rights[115, 116].

,e National Drug Authority (NDA) is a body that en-sures quality control of all medical products including herbalmedicines in Uganda under the government statute andpolicy of 1993 [117]. In Uganda, there is no special regulatorymeasure for herbal medicines in that the same laws andpolicies for conventional pharmaceuticals also apply to theherbal medicinal products. A policy was introduced in 2002 tohave herbal medicines registered, but so far, no registration ofany herbal medicine has been made [117].

Herbal medicines though vastly used in Uganda are notsufficiently regulated. A system to license and track tradi-tional health practitioners or their products is still lacking inthe country, and the efforts to have the TCM integrated inthe mainstream health care system is still a long way frombeing realized.

9. Conclusion

Uganda is rich in indigenous plant resources that are used byits people to treat malaria. Communities in different regionsof the country use different herbs within their geographicalrange, though a few common herbs are used by differentcommunities across the country. Many herbs used for

22 Evidence-Based Complementary and Alternative Medicine

malaria treatment among several communities have notbeen investigated for their efficacy, and yet they could bepotential sources for antimalarial remedies including drugs.Few studies have been conducted to document herbs formalaria treatment in the country, especially in the northernregion. Some of the plants investigated for antimalarial/antiplasmodial activities have been found to lack efficacy,toxicity, and safety study aspects. Some plants used in thelocal communities had very strong antimalarial activitiesand could be investigated further for the identification andvalidation of the potential therapeutic antimalarial com-pounds. ,is review is critical in that it clearly highlightsherbal plants documented in Uganda for malaria treatmentbut have never been investigated for their antimalarialpotential, thus providing guidance for further research onpotential natural plant resources that could be sources ofnovel compounds with therapeutic properties for thetreatment of malaria.

Conflicts of Interest

,e authors declare that they have no conflicts of interest.

Authors’ Contributions

Denis Okello carried out the data search and was the maincontributor in writing the manuscript. Youngmin Kangtechnically designed and helped in writing the manuscript.Both authors read and approved the final manuscript.

Acknowledgments

,is study was supported under the framework of In-ternational Cooperation Program (Korea-South AfricaCooperative Research Project for Excavation of CandidateResources of Complementary and Alternative Medicine)managed by National Research Foundation of Korea (grantnos. 2017093655 and KIOM:D17470). Additionally, thisstudy was equally supported by grants from Development ofFoundational Techniques for the Domestic Production ofHerbal Medicines (K18405) and Applicational Developmentof Standardized Herbal Resources (KSN1911420), from theKorea Institute of Oriental Medicine (KIOM), through theMinistry of Science and ICT, Republic of Korea.

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