w ww.e l s e v i e r . c o m / l o c a t e / b j p
Original
Article
Ethnobotanical
study
of
medicinal
flora
utilised
by
traditional
healers
in
the
management
of
sexually
transmitted
infections
in
Sesheke
District,
Western
Province,
Zambia
K.C.
Chinsembu
DepartmentofBiologicalSciences,FacultyofScience,UniversityofNamibia,Windhoek,Namibia
a
r
t
i
c
l
e
i
n
f
o
Articlehistory:
Received30January2015 Accepted27July2015 Availableonline27January2016
Keywords:
Ethnobotany Medicinalplants
Sexuallytransmittedinfections Sesheke
Zambia
a
b
s
t
r
a
c
t
Sincemanyrural-poorLozipeopleofSeshekeDistrict(WesternProvince,Zambia)thatsufferfrom sexuallytransmittedinfectionsdonotusuallyaccesspublichealthfacilities;theyturntotraditional healerswhoadministerremediesextractedfrommedicinalplants.However,themedicinalplantsused forsexuallytransmittedinfectionsanddataontheusageofplantsinSeshekeDistrictinparticularand WesternProvinceingeneralhavenotbeendocumented.Inthisstudy,anethnobotanicalsurveywas con-ductedtodocumenttheindigenousknowledgeofmedicinalplantsthatalleviatesymptomsofsexually transmittedinfectionsinSeshekeDistrict,WesternProvince,Zambia.Usingsemi-structuredinterviews andquestionnaires,ethnobotanicaldatawerecollectedfromtwentytraditionalhealersthatmanage patientspresentingwithsexuallytransmittedinfections.Theresultsshowedthat52plantspeciesin25 familiesand43generawereusedtotreatgonorrhoea,syphilis,chancroid,chlamydia,genitalherpes,and ano-genitalwarts.Sexuallytransmittedinfectionswerefrequentlymanagedusingthefollowingplants:
Terminaliasericea,Strychnoscocculoides,Ximeniacaffra,Cassiaabbreviata,Cassiaoccidentalis,Combretum
hereroense,Combretumimberbe,Dichrostachyscinerea,Bosciaalbitrunca,Momordicabalsaminaand
Pel-tophorumafricanum.Manyoftheseplantshaveputativeantimicrobialactivitieswhichmayjustifytheir
rolesasnaturalremediesforsexuallytransmittedinfections.Furtherstudiesareneededtodetermine thedosages,minimuminhibitoryconcentrations,biologicalactivitiesandtoxicities,andcharacterisethe plants’chemicalcompounds.
©2016SociedadeBrasileiradeFarmacognosia.PublishedbyElsevierEditoraLtda.Allrightsreserved.
Introduction
Upto80%oftheAfricanpopulationusestraditionalmedicine forprimaryhealthcare(WHO,2003).InmanyAfricancountries includingZambia,traditionalhealersadministerplantremediesto patientssufferingfromsexuallytransmittedinfections(STI). Tradi-tionalbeliefs,culturalbarriers,lowsocio-economicstatus,stigma, lackofconfidentiality,andinadequateuser-friendlyfacilitiesare someofthereasonswhythetraditionalhealerisusuallythefirst lineofcareforSTIpatients(Peltzeretal.,2006).
Other factors for seeking traditional medicine involve chal-lengessurroundingpublichealthcarefacilities.Theseincludelong distances to hospitals, long waiting queues, lack of laboratory facilities,drugshortages,andpoorhealthworker attitudes.The reluctancetodisclose informationrelated togenitaliaisfurther
E-mail:kchinsembu@unam.na
reasontoinitiallyseekhelpfromtraditionalhealers( Kamatenesi-Mugishaetal.,2008).Itisthereforenotsurprisingthatamongall thediseasestreatedbyAfricantraditionalhealers,STIareoneof themostfrequentlyencountered(Peltzeretal.,2006).
VermaniandGarg(2002)reviewedmedicinalplantsfortreating STI.VanVuurenandNaidoo(2010),DeWetetal.(2012),Semenya et al.(2013), and De Wet and Ngubane (2014)recorded South AfricanmedicinalflorautilisedinthetreatmentofSTI.VanVuuren (2008)andNaidooetal.(2013)havealsoshownthatAfrican medic-inalplantsusedforthetreatmentofSTIhavegoodantimicrobial activities.NdubaniandHöjer(1999)documentedmedicinalplants usedbytraditionalhealersinthetreatmentofSTIinChiawa, Zam-bia.
In the Lozi language of western Zambia, STI are commonly knownas‘matukuasihule’or‘butukubwasihule’;meaning ‘dis-eases of prostitutes’. Several demographic and socio-economic factorsforcepatientswithSTIinwesternZambia(Barotseland)to usemedicinalplants:lackofformaleducation,unemployment,lack ofhealthinsurance,poverty,lowagesofsexualdebut,andrisky
http://dx.doi.org/10.1016/j.bjp.2015.07.030
sexualbehaviours.Forinstance,meninWesternProvincehadthe highestlevelsofriskysexualintercourseinZambiaat90.3%;about 3.1%ofmenreportedanSTI;6.8%ofwomenand5.3%ofmenhad syphilis(CentralStatisticalOfficeetal.,2009).WomeninWestern ProvincearethemostpromiscuousinZambia,with3.2%having morethantwo2sexualpartnersand28.1%havinghighrisksexual intercourse(CentralStatisticalOfficeetal.,2009).
Datainthe2009ZambiaDemographicHealthSurveyrevealthat about56.7%womenand74.9%ofmenhadnevertestedforHIV. Over15.2%ofadultsaged15–49yearsand7.7%ofyoungpeople aged15–24yearswereHIVpositive(CentralStatisticalOfficeetal., 2009).TheRedCrossreported30%adultHIVprevalenceinSesheke (IntegratedRegionalInformationNetworks,2006).In1992,quite earlyintheAIDSepidemic,sero-prevalencefiguresforHIVwere 16%forblooddonorsand41%forpatientsattendingtheclinicfor STI(VanDerHoek,1992).
Despitethe presenceof curableSTI, over 25.7%of peoplein WesternProvincedonotaccesshealthcareatclinicsbecausedrugs andlaboratoryfacilitiesarenotavailable(CentralStatisticalOffice etal.,2009).Onlyathirdofeligiblepregnantwomenhaveaccess todrugs,and19%hadaurinesampletest.Publichealthservice deliveryinSeshekeisbelowpar,oftencharacterisedbyinadequate staffathealthfacilities, poorhealth workertraining and super-vision, in additionto patientswalkinglong distances toaccess care(Chinyama,2013).Corollary,alackofcommunity participa-tioninpublichealthserviceswasreported(Chinyama,2013).In Sesheke,evenworkersrarelyseekpublichealthservicesrelatedto STIincludingHIV/AIDS(Chilekwa,2014).
Giventheaforementionedfactorsand challengesinWestern Provincein generaland Sesheke District in particular, most of thepeoplethatsufferfromSTIusemedicinalplants.Theuseof medicinal plants in Barotseland including Sesheke is also part ofthemedical pluralismwherebytheintroductionof allopathic medicineshasnotreallydampenedBulozibeliefs inindigenous diagnosisandtherapeuticsystems(Chinsembu,2009).Thispaper isaninauguralreportonmedicinalplantsusedbytraditional heal-ersinthemanagementofSTIinSeshekeDistrict,WesternProvince, Zambia.
Materialsandmethods
Studyarea
ThestudywascarriedoutinvillagesnearLipumpu,Machile, Mwanalisa,Mambova,Mulimambango,SankolongaandMwandiin SeshekeDistrictlocatedinWesternProvince,Zambia. Geographi-callocationsofZambiainAfricaandSeshekeDistrictinZambia areshowninFig.1.Seshekeisasmalltownontheborderwith Namibia.ItisamajortransitpointtothesmallNamibiantownof KatimaMuliloservedbytheTrans-CaprivihighwayfromWalvis BayandWindhoek.Driversonthisrouteareservicedbyabooming commercialsexindustrythatcontributestoSTI.MostofSeshekeis inhabitedbytheLoziethnicgroupwhoserelativesocioeconomic statuscomparespoorlytootherpartsofZambia.
SeshekeDistrictcovers28,500km2 inthesouth-western
cor-nerofWesternProvince,Zambia.Ithasanaveragealtitudeof951 metresabovesealevel(rangeof915–1220m),withinlatitudesof 15◦30′and17◦50′Sandlongitudes23◦00′and25◦30′E(Lwando, 2013).TheDistrictisdividedbytheZambeziRiverintotwoparts, mainlandSeshekefacingZambiaandKatimaMulilofacingNamibia. LocatedinZambia’sagro-ecologicalregionI,Seshekegenerally experienceslow andscatteredrainfallduringmid-Novemberto theendofMarchwithameanof670mmperannum;thehighest averagerainfallof180mmisrecordedinJanuary(Lwando,2013). Althoughtemperaturesarequiteextreme,averagetemperatures rangefrom15to26◦C.Inwinter,nightradiationfromthesand
Fig.1.(A)GeographicalpositionofZambiainAfrica.(B)LocationofSeshekeDistrict inZambia.(C)SeshekeCentral.
givesrisetoverylownighttemperaturessothatlow-lyingareas sufferfromfrigidity(Lwando,2013).InJuly,theminimum tem-peratureis 3.6◦C andfromSeptembertoFebruarytheabsolute
maximumtemperatureisover38◦C.Duringtheremainderofthe
year,temperatureishigh,over31◦C.
TheterraininSeshekeDistrictiswellvegetated,mostlymade upof swamps,floodplains,wetlands,and deciduouswoodlands dominatedbytreessuchastheZambeziteak(Chidumayo,1987). Sesheke has one of the best-conserved populations of Mukusi (Baikiaea) and Pterocarpus forests. The remainder of the Dis-trict is mostly co-dominated by Kalahari woodlandsconsisting ofmembersoftheJulbernardia,Cryptosepalum,Ricinodendronand
Ethnobotanicaldatacollection
Ethnobotanicaldatawerecollectedusingamethodsimilarto thatofChinsembuandHedimbi(2010).Briefly,snowballsampling wasappliedduringethnobotanicalsurveysoftraditionalhealers thatuseplants totreat STI in severalvillages.Key gatekeepers wereusedtoverifythepresenceofandaccesstorespondent tra-ditionalhealersinvariouspartsoftheDistrict.Twentytraditional healerswereeventuallyincludedinthestudythroughatwo-stage samplingdesign.
Beforeconductinginterviews,theaimofthestudywasclearly explainedand traditional healers were askedfor theirconsent. Thenthetraditionalhealerswereindividuallyengagedin semi-structuredinterviewssupplementedwithquestionnaires.During theconversations,dataonrespondentcharacteristicsand informa-tionrelatedtomedicinalusesofplantsforthemanagementofSTI werecaptured.Allinterviewswereconductedinthelocallanguage, siLozi.ResearchassistantsactedassiLozi-Englishtranslators.
Datawerecollectedduringtwostagesconsistingofprimaryand secondarysamplings.Theprimarystageinvolvedanexploratory studyofthreetraditional healersthat manageSTI.Thefocus of theexploratorystudywastogaincriticalinsightsintotheworkof thetraditionalhealers,distilpertinentissues,andgaugewhethera detailedethnobotanicalsurveywouldbefeasible.Traditional heal-erswere askedabout themain symptoms of STI, theirhealing practices,andsourcesofethnomedicinalknowledge.The follow-ingdatainrelationtotheplantswerealsorecorded:siLozinames, planthabits,plantpartsused,theSTIconditionstreatedwiththe plants,andthemodesofpreparationandapplicationoftheplant remediestothepatient.
Thesecondary samplingstage wasa follow-up and detailed descriptive study of seventeen traditional healers who veri-fiedprior ethnobotanicaldataobtainedfromhealersduringthe exploratoryinquiry.Toallowfortriangulationofethnomedicinal use,onlyplantsmentionedbyatleastthreetraditionalhealersin thedescriptivestudy(foreachdiseasecondition)wereeligiblefor documentation(KonéandAtindehou,2008).On-the-spot identi-ficationoffamiliarplantspecies wasdoneinthefield.Voucher specimensforallplantswerecollectedinherbariumplantpresses andtransportedtotheUniversityofNamibiaforidentification, con-firmation,and storage.Botanicalnameswereverifiedusingthe InternationalPlantNameIndex(IPNI).
Dataanalysis
Quantitativeanalysisofethnobotanicaldatawasdoneby cal-culatingthefamiliarityindexFi.TheFi,arelativeindicatorofthe
familiarityofaplantspecies,isdefinedasthefrequencyagiven plantspeciesismentionedasamedicinedividedbythetotal num-beroftraditionalhealersinterviewedinthestudy(Tabutietal., 2004).TheFiwascalculatedasfollows:
Fi=Na Nb×100
whereNaisthenumberofinformantsthatmentionaspeciesasa
medicine,andNbisthetotalnumberofrespondents.
Resultsanddiscussion
Traditionalhealers
Ofallthetwentytraditionalhealersincludedinthestudy,only fourwerefemale.Thisgenderdifferencearisesbecausemale tra-ditionalhealersinthecommunityweremorecomfortabletotalk aboutSTIthanfemaletraditionalhealerswhofacecultural restric-tionswhenitcomestotalkingaboutmattersrelatedtosexand
STI.Theaverageageofthehealerswas52years.About90%ofthe traditionalhealersreceivedtheirmedicinalplantknowledgefrom theirolderfamilymembers,andtheremainderfromspiritualand supernaturalpowerssuchasdreamsandvisions.Onlythree tra-ditionalhealershadanapprenticeundertheirtutelage;therest didnottrainotherpeople.Healers’knowledgeofSTIsymptoms pointedtothepresenceofgonorrhoea,syphilis,chancroid,genital herpes,chlamydia,HIVinfection,andwarts.
Ethnomedicinalflora
Datarelatedtotheplants’scientificnames,siLozinames, fami-lies,vouchernumbers,habits,frequencyindices,parts,STItreated, modesofpreparationandapplicationareinTable1.Overall,the studyrecorded52plantspeciesusedbytraditionalhealersto man-agecommonSTIinSeshekeDistrict,WesternProvince,Zambia.The frequencyindexrevealed11commonlyusedplantswithFivalues
decreasingfrom80to50:Terminaliasericea,Strychnoscocculoides,
Ximenia caffra, Cassia abbreviata, Cassia occidentalis, Combretum hereroense,Combretumimberbe,Dichrostachyscinerea,Boscia albi-trunca,MomordicabalsaminaandPeltophorumafricanum(Table1). The52plantspeciesweredistributedamong25familiesand 43genera.ThefamilyFabaceae(25%)hadthehighestproportion ofplantspeciesusedtomanageSTIinSeshekeDistrict,followed byCombretaceae(10%),Capparaceae(6%),andLoganiaceae(6%). Theotherfamilieswererepresentedby1and2plantspecies.The familiesFabaceaeandCombretaceaehadthehighestdiversityof speciesusedtotreatSTIprobablybecausethesefamiliescontain severalspeciesofplants.InZimbabwe,Maroyi(2011)alsofound thatmostethnomedicinalplantswereintheFabaceaefamily.In theneighbouringtownofKatimaMulilo,Namibia,Chinsembuand Hedimbi(2010)observedthatmajorityofthemedicinalplantsused tomanageHIV/AIDSopportunisticinfectionswereinthe Combre-taceaefamily.
About50%oftheplantsusedtomanageSTIweretrees,31% wereshrubs,and19%wereclimbers.Throughouttheyear,even afterfireoutbreaks,thevegetationinSeshekeismostlytreesand shrubsthusreadilyharvestedbyhealers.Maroyi(2011)alsofound thattreesandshrubswereusuallyutilisedinZimbabwe.Themost plantpartsusedwereroots(39%),followedbystembarkandleaves, bothat27%,respectively.Althoughrootsandbarksarebelieved tocontainmorepotentpharmacologicalcompounds,their indis-criminateharvestingcandestroytheplants.Traditionalhealersand otherpersonsthatharvestrootsandbarksformedicinalpurposes shouldbeeducatedonsustainableharvestingtechniquesandplant conservation.
Across-checkintheliteratureshowedthatapartfromhaving antimicrobialactivity,mostoftheplantsinthisstudywereapplied inthemanagementofSTIinothersettings.Forexample,Ndubani andHöjer(1999)alsodocumentedtheuseofS.cocculoides,X.caffra, andC.abbreviatabynganga(traditionalhealers)inthemanagement ofSTIinChiawa,aruralcommunitysouth-eastofLusaka,Zambia.C. abbreviata,S.cocculoides,X.caffra,andP.africanumarealsousedin themanagementofSTIinZimbabwe(Maroyi,2011).Otherplants usedinthemanagementofSTIinSeshekeDistrictwerealsoutilised inSouthAfrica(DeWetetal.,2012;Naidooetal.,2013).
P.africanumisamulti-usemedicinalplantwithhighamountsof phenolics,alkaloids,saponins,cardiacglycosides,andflavonoids; itisharvestedinZimbabwetoalleviatesyphilis(Maroyi,2011).A reviewofthepharmacologyandphytochemistryofP.africanum
revealedthattheplanthasseveralactivecompoundsthatconfer antibacterial,antifungal,anti-HIV,antioxidant,andanti-helminthic activities(Mazimba,2014).Thesebiologicalactivitiesmayjustify thehealingofpatientssufferingfromSTI.
Table1
EthnobotanicaldataofmedicinalplantsusedtomanageSTIinSeshekeDistrict,WesternProvince,Zambia.
Family
Scientificname,LocalsiLoziname, vouchernumber
Planthabit;part(s)used STItreated;frequencyindex Preparationandadministration
Anacardiaceae
LanneastuhlmanniiEngl.,Musamba, s53
Tree;roots Gonorrhoea,syphilis;25 Crushedfreshrootsaresoakedinwarm water,drinksolution
SclerocaryacaffraSond.,Mulula,s248 Tree;stembark,leaves Gonorrhoea,HIV/AIDS;30 Poundplantmaterials,boilinwater,drink concoction
Asparagaceae
SansevieriakirkiiBaker,Lukushe, s274
Climber;roots MostSTI;20 Boilfreshrootswithwateranddrink
solutionwhiletepid
Bignoniaceae
Kigeliaafricana(Lam.)Benth., Muzungula,s200
Tree;fruit Syphilis;75 Exudateisusedasadressingforwounds;
boilinwater,drinkdecoction
Burseraceae
CommiphoraangolensisEngl., Mubwabwa,s270
Tree;stembark Gonorrhoea,Chlamydia
symptomsinmen;30
Pounddrymaterial,mixwithwater,drink
Capparaceae
BosciaalbitruncaBurch.Gilg& Benedict,Kabombwa-mutemwa,s27
Tree;roots Syphilis,HIV/AIDS;50 Boilinwater,drinkwhilewarm
CapparistomentosaLam.,Chiwezeze, s8
Climber;roots Syphilisrashes,HIV/AIDS;25 Boilrootsboiledinwater,mixedwithtea, anddrunk;drinktepiddecoction; decoctionofrootsisusedasatopicalwash forrashes
CleomegynandraL.,Namanga,s84 Shrub;leaves Chancroid;35 Boil,disinfectwounds Combretaceae
CombretumapiculatumSond., Mukalanga,s56
Shrub;leaves GeneralSTIsyndromes;45 Boilleavesinwater,drinkwarmsolution
CombretumhereroenseSchinz, Mububu,s42
Shrub;leaves Gonorrhoea,Chlamydia
symptomsinmen;60
Crushleaves,suspendinwater,drinkcold infusion
CombretumimberbeWawra, Muzwili,s2
Tree;leaves GeneralSTI;55 Crushleaves,suspendinwater,drink
infusion CombretummossambicenseEngl.,
Silutombolwa,s299
Climber;wholeplant Gonorrhoea,syphilis;35 Cutintosmallpieces,pound,putinwater, drinkcoldinfusion
TerminaliasericeaBurch.exDC., Muhonono,s5
Tree;roots,leaves Gonorrhoea,syphilis;80 Maceratematerialstogether,boilinwater, drinkdecoction
Convolvulaceae
IpomoeaverbascoideaChoisy, Litalala,s219
Climber;roots Gonorrhoea;25 Rootsareboiledandthesolutionisdrank
Cucurbitaceae
MomordicabalsaminaL., Lombwalombwa,s282
Climber;wholeplant Gonorrhoea,syphilis, HIV/AIDS;50
Boil,decoctionistakenwithporridge
Dioscoreaceae
DioscoreahirtifloraBenth., Mantembe,s254
Climber;leaves Syphiliticsores,chancroid;15 Grindfreshleavesandapplytosores
Ebenaceae
DiospyroslycioidesDesf.,Mupichu, s111
Shrub;leaves Gonorrhoea,syphilis;45 Leavesaresoakedincoldwaterfor3days, solutionisdrank
EucleadivinorumHiern,Musokola, s261
Shrub;stems,leaves Syphilis,genitalherpes;35 Boilandwashsyphiliticulcers
Euphorbiaceae
CrotongratissimusBurch.,Mukena, s249
Tree;leaves Syphilis;20 Exudatefromcrushedleavesisappliedto
sores
EuphorbiabenthamiiHiern, Kabomba,s245
Shrub;leaves Gonorrhoea,Chlamydia
symptomsinmen;20
Boilahandfulofleavesinpotofwater. Takeonecupofdecoctionthreetimesaday Fabaceae
AbrusprecatoriusL.,Mupitipiti,s110
Climber;roots Gonorrhoea,Chlamydia,
syphiliticulcers,genital herpes;20
Boiledandtakenorallyasaninfusion; topicalapplicationtowounds
Acaciamellifera(M.Vahl)Benth., Kakumbwe,s148
Shrub;stembark,roots Syphilis;35 Boilinwateranddrinksolution
Acacianilotica(L.)Del.,Mukotokoto, s123
Tree;leaves,roots,stembark Gonorrhoea,Chlamydia symptomsinmen;25
Pound,addwarmwater,anddrink
AfzeliaquanzensisWelw.,Muwande, s204
Tree;stembark,roots GeneralSTI;40 Crushinwater,oral
AlbiziaversicolorWelw.exOliv., Mububa,s195
Tree;stembark Gonorrhoea,Chlamydia
symptomsinmen;15
Dry,boilanddrinksolution
BaikiaeaplurijugaHarms,Mukusi, s163
Tree;stembark Syphilis;30 Decoctionsandinfusionsaretakenorally
BrachystegiaspiciformisBenth., Mutuya,s154
Tree;stembark GeneralSTI;40 Boilinwater,drinksolutionwhiletepid
BurkeaafricanaHook.,Musheshe, s149
Tree;roots,stembark Gonorrhoea,HIV/AIDS;40 Driedplantpartsarepoundedinto powder,boiledinwater,sieved,and filtratedisintroducedintourethra CassiaabbreviataOliv.,Mululwe,
s118
Tree;stembark,roots Gonorrhoea,HIV/AIDS;60 Macerateinwater,drink
Table1(Continued)
Family
Scientificname,LocalsiLoziname, vouchernumber
Planthabit;part(s)used STItreated;frequencyindex Preparationandadministration
Colophospermummopane(Benth.) Leonard,Mupane,s122
Tree;stembark Syphilis;15 Macerate,boilinwater,drinkdecoction;
barkextractisappliedtosores Dichrostachyscinerea(L.)Wight&
Arn.,Muselesele,s179
Shrub;roots,stembark,leaves GeneralSTIsyndromes especiallysyphilis;55
Crushplantmaterials,mixwithwater, drinkfiltrate;leavesaredrunkasatea; chewleavesandapplypastetosyphilis sores;topicalapplicationofdriedbark powdertosoresorskineruptions PeltophorumafricanumSond.,
Munyele,s189
Tree;stembark,roots GeneralSTI;50 Boilcutplantmaterialsinwater.Drink decoction
Lamiaceae
ClerodendrummyricoidesR.Br.& Vatke,Mutume,s108
Shrub;stembark,roots GeneralSTIsyndromes;45 Boilinwater,drinkdecoctioninsmall amountsusingteaspoon
ClerodendrumuncinatumSchinz, Mubwanyo,s151
Shrub;roots Gonorrhoea;30 Crushdryroots,mixinboiledwater,drink
Leguminosae
IndigoferaormocarpoidesBaker, Kungandofu,s39
Shrub;leaves Syphilis;25 Freshleavesareboiledinboiledand
solutionisdrunk
Loganiaceae
StrychnoscocculoidesBaker, Muhuluhulu,s81
Tree;roots Gonorrhoea;75 Crushinwateranddrinksolution
StrychnosinnocuaDel., Muzimbikolo/Muteme,s55
Tree;roots Gonorrhoea,Chlamydia
symptomsinmen;50
Rootdecoctionistakenorally
StrychnospotatorumL.f., Mulombelombe,s85
Tree;roots Syphilis;30 Boiledandtakenorally
Malvaceae
AdansoniadigitataL.,Mubuyu,s6
Tree;stembark,leaves,roots GeneralSTI;45 Boilinwater,drinkdecoction
Meliaceae
Entandrophragmacaudatum (Sprague)Sprague,Mupamena,s43
Tree;roots,fruits Gonorrhoea,genitalwarts;25 Rootsareboiledinwater,solutionis drunk;fruitpeelsareburnt,mixedwith Vaseline,rubbedontogenitalwarts
TrichiliaemeticVahl,Musikili,s91 Tree;stembark,leaves Gonorrhoea,syphilis;20 Soakcrushedbarkandleavesinwater, drinksmallamountsofsolution;boilin water,decoctionisdrunk;powdereddry rootsappliedtowounds
Menispermaceae
CissampelosmucronataA.Rich., ltende,s61
Climber;roots,leaves Syphilis,chancroid;35 Powdereddryrootsaremixedwith Vaselineandappliedtosores;root decoctionisdrunk
Moraceae
FicusnatalensisHochst.,Mutaba,s79
Tree;leaves Genitalwarts;15 Poundleaves,rubintowarts
Olacaceae
XimeniaamericanaL.,Mutente,s46
Tree;stembark Bacterialvaginosis, gonorrhoea;25
Applypowdertovagina;dissolvestem powderinwateranddrink
XimeniacaffraSond.,Mulutulua,s96 Shrub;roots GeneralSTIconditions;75 Cutrootsintoverysmallpieces,mixwith water,boil,anddrinksolution
Plumbaginaceae
PlumbagozeylanicaL.,Sikalutenta,s9
Shrub;leaves GenerallytreatsallSTI symptoms;30
Macerateleavesintopastewhichisapplied tosoresandrashes;crushdriedleaves,mix withwaterorhoneysolutionanddrink Polygalaceae
SecuridacalongepedunculataFresen., Muiinda,s73
Shrub;stembark,roots Syphilis,gonorrhoea;20 Drymaterials,crush,mixwithwater,sieve, drinkfiltrate
Rhamnaceae
HelinusintegrifoliusKuntze, Mulalawa,s18
Climber;roots Gonorrhoea,syphilis,
HIV/AIDS;15
Macerate,soakincoldwater,drink infusion
ZiziphusmucronataWilld.,Mukalu, s25
Tree;stembark Gonorrhoea,syphilis,
Chlamydiasymptomsinmen; 40
Boilinwaterforhalfanhour,drink solution;washurethra;powderisapplied towounds
Solanaceae
SolanumpanduriformeE.Mey, Ntulwantulwa,s64
Shrub;roots HIV/AIDS;24 Cut,macerateinwarmwater,drink
solution
Vitaceae
AmpelocissusobtusataPlanch., Munsansa,s108
Climber;roots Syphiliticrashes,Genital herpes;25
Coldinfusionusedasadressingtoheal wounds
Tonaetal.,1999).S.potatorumhasconsiderableantimicrobial activ-itywhichmayhelpalleviatesymptomsofSTI(Mallikharjunaand Seetharam,2009)anddiarrhoea(Tonaetal.,1999).Mabogo(1990)
alsoreportedtheuseofthefollowingplantsinthetreatmentofSTI
amongtheVendapeopleofSouthAfrica:Adansoniadigitata,Acacia karroo,Aloesp.,andX.caffra(thelargesourplum).
andAfolayan, 2001;Hedimbi andChinsembu, 2012).Nair etal. (2013) found that water extracts of X. caffra leaves had good antibacterialactivity,animportantpropertyinthemanagementof STI.AcommonethnomedicineforSTI,X.caffracontainsthenovel antigonococcalagent,bisnorsesquiterpenevomifoliol,which has 63.1%activityagainstNeisseriagonorrhoeae(Nairetal.,2013).Ina separatestudy,Naidooetal.(2013)reportedthatleafextractsofX. caffrapossessanti-gonnococcalactivity.Albiziaversicolorcontains saponins,lupeol,acacicacid,andlactone;ithadactivityagainstSTI, fungalinfections,andTrichomonasvaginalis(DeWetetal.,2012).
AmpelocissusobtusatawasaremedyforsyphilisinZimbabwe (Maroyi,2011).Baikiaeaplurijugawasaknownremedyforsyphilis inmanypartsofZambia(Theiladeetal.,2001).B.albitruncawas used to treat symptoms of syphilis, gonorrhoea, and HIV/AIDS in Namibiaand South Africa(Chinsembu etal., 2014).Capparis tomentosahadantibacterial,anti-Trichomonasandantifungal prop-erties(BuwaandVanStaden,2006).Combretumapiculatumwasan ethno-remedyforSTIinNamibia,anditgenerallypossesses triter-penes, glycosides, alkaloids, quercetrin, kaempferol, and ellagic acidderivatives(Chinsembuetal.,2011).
TraditionalhealersuseAbrusprecatoriustotreatgonorrhoeain Kenya(Kareruetal.,2008)andIndia(ParekhandChanda,2007).
TrichiliaemeticisaremedyforSTIinSouthAfrica(DeWetetal., 2012).Securidacalongepedunculatahasantibacterialactivityand isacommontreatmentforTrichomonasvaginalisandotherSTIin manycountriesincludingNigeriaandSouthAfrica(Fernandesetal., 2008;Maroyi,2011).
The frequent useT. sericeain this study mirrors reports by
Semenyaetal.(2013)thatplantsinthegenusTerminaliahavemany antimicrobialproperties includinganti-HIV functions.Fyhrquist etal.(2014)describedthathotdecoctionsofT.sericeaareusedin themanagementofgonorrhoea.Terminaliaspeciespossess ellagi-tannins,powerfulchemicalingredientswithantimicrobialefficacy against multi-antibioticresistantN.gonorrhoeae. Naidoo(2014)
cautionedthatthecellularsafetyandefficacyofsometheplants usedinthemanagementofSTIwasnotguaranteed.Morestudies shouldbedonetoascertaintheirbiologicalactivitiesandtoxicities. Experimentsrelatedtoposologyarealsourgentlyneeded.
Conclusion
Thestudydocumentedtheindigenousknowledgeofmedicinal plantsthatalleviatesymptomsofSTIinSeshekeDistrict,Western Province,Zambia.Overall,52plantspeciesfoundin25familiesand 43generawereutilisedinthemanagementofgonorrhoea,syphilis, chancroid,chlamydia,genitalherpes,andano-genitalwarts. Fur-ther studies are needed to determinethe minimum inhibitory concentrations,biologicalactivities,cellularsafety,andtoisolate aswellascharacterisetheplants’activecompounds.
Conflictsofinterest
Theauthordeclaresnoconflictsofinterest.
Acknowledgements
Wethankinstitutionsthatfundedthestudythroughresearch grantstotheauthor:UniversityofNamibiaResearchand Publica-tionsCommittee,JointNamibia-SouthAfricaresearchcollaboration programme,andtheAfricanUnion/NEPADSouthernAfrican Net-workforBiosciences(SANBio)throughtheCouncilforScientificand IndustrialResearch(CSIR),Pretoria,SouthAfrica.Allresearch assis-tantsarethankedfortheirhelpduringdatacollection.Theauthor is highlyindebted toalltraditional healers withoutwhom this researchwouldnothavebeenpossible.Prof.KazhilaC.Chinsembu
istheChairpersonof theSteering CommitteeonScientific Vali-dationofTraditionalMedicinesfortheTreatmentofHIV/AIDSin Namibia.
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