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      Ethnopharmacological Study of the Medicinal Plants Used in the Treatment of Sickle Cell Anemia in the West Region of Cameroon

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          Abstract

          Background

          Sickle cell anemia (SCA) or sickle cell disease (SCD) is a genetic disease associated with increased morbidity and mortality in Africa and other developing nations. Therefore, modern and traditional remedies are being introduced for use in the treatment and management of this disease. This is because safe, effective, and inexpensive therapeutic agents are urgently needed for the treatment of this disease in Africa and other developing nations.

          Objective

          The purpose of this study is to identify medicinal plant species commonly used by traditional healers in the treatment of sickle cell patients across some localities in the west region of Cameroon. Material and Methods. The ethnopharmacological survey was carried out in several districts within some localities of the western region of Cameroon. The survey was based on a semistructured questionnaire that was administered to 17 traditional healers and 62 sickle cell patients. It took place between November 2018 and March 2019. Personal information of participants and plant therapy data were gathered. Plants were identified at the National Herbarium of Cameroon. Literature review determined pharmacological effects and phytochemical compounds of the identified plants. Data were generally analysed using Epi Info 7 software for Windows.

          Results

          Twelve medicinal plant species belonging to 10 families are being used in the treatment of sickle cell anemia across the study sites. Euphorbiaceae is the dominant family with three plant species. Bark (39.3%) and seeds (35.7%) are the most used plant parts, which get administered through maceration, decoction, and chewing in water. According to the literature review, the identified plants have pharmacological effects and phytochemical compounds (especially polyphenols and alkaloids) that signify the presence of antioxidant compounds, which may possess an antisickling activity. There is therefore a need to conduct another study to scientifically validate (in vitro) antisickling properties of these plants.

          Conclusion

          This study has revealed promising medicinal plants that are currently applied in the traditional treatment of sickle cell anemia. Although still inconclusive, the association of pharmacological effects and phytochemical compounds with these medicinal plants justifies their use in traditional pharmacopoeia.

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          Most cited references47

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          Effect of hydroxyurea on the frequency of painful crises in sickle cell anemia. Investigators of the Multicenter Study of Hydroxyurea in Sickle Cell Anemia.

          In a previous open-label study of hydroxyurea therapy, the synthesis of fetal hemoglobin increased in most patients with sickle cell anemia, with only mild myelotoxicity. By inhibiting sickling, increased levels of fetal hemoglobin might decrease the frequency of painful crises. In a double-blind, randomized clinical trial, we tested the efficacy of hydroxyurea in reducing the frequency of painful crises in adults with a history of three or more such crises per year. The trial was stopped after a mean follow-up of 21 months. Among 148 men and 151 women studied at 21 clinics, the 152 patients assigned to hydroxyurea treatment had lower annual rates of crises than the 147 patients given placebo (median, 2.5 vs. 4.5 crises per year, P < 0.001). The median times to the first crisis (3.0 vs. 1.5 months, P = 0.01) and the second crisis (8.8 vs. 4.6 months, P < 0.001) were longer with hydroxyurea treatment. Fewer patients assigned to hydroxyurea had chest syndrome (25 vs. 51, P < 0.001), and fewer underwent transfusions (48 vs. 73, P = 0.001). At the end of the study, the doses of hydroxyurea ranged from 0 to 35 mg per kilogram of body weight per day. Treatment with hydroxyurea did not cause any important adverse effects. Hydroxyurea therapy can ameliorate the clinical course of sickle cell anemia in some adults with three or more painful crises per year. Maximal tolerated doses of hydroxyurea may not be necessary to achieve a therapeutic effect. The beneficial effects of hydroxyurea do not become manifest for several months, and its use must be carefully monitored. The long-term safety of hydroxyurea in patients with sickle cell anemia is uncertain.
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            Sickle hemoglobin (HbS) allele and sickle cell disease: a HuGE review.

            Sickle cell disease is caused by a variant of the beta-globin gene called sickle hemoglobin (Hb S). Inherited autosomal recessively, either two copies of Hb S or one copy of Hb S plus another beta-globin variant (such as Hb C) are required for disease expression. Hb S carriers are protected from malaria infection, and this protection probably led to the high frequency of Hb S in individuals of African and Mediterranean ancestry. Despite this advantage, individuals with sickle cell disease exhibit significant morbidity and mortality. Symptoms include chronic anemia, acute chest syndrome, stroke, splenic and renal dysfunction, pain crises, and susceptibility to bacterial infections. Pediatric mortality is primarily due to bacterial infection and stroke. In adults, specific causes of mortality are more varied, but individuals with more symptomatic disease may exhibit early mortality. Disease expression is variable and is modified by several factors, the most influential being genotype. Other factors include beta-globin cluster haplotypes, alpha-globin gene number, and fetal hemoglobin expression. In recent years, newborn screening, better medical care, parent education, and penicillin prophylaxis have successfully reduced morbidity and mortality due to Hb S.
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              Traditional medicinal plant knowledge and use by local healers in Sekoru District, Jimma Zone, Southwestern Ethiopia

              The knowledge and use of medicinal plant species by traditional healers was investigated in Sekoru District, Jimma Zone, Southwestern Ethiopia from December 2005 to November 2006. Traditional healers of the study area were selected randomly and interviewed with the help of translators to gather information on the knowledge and use of medicinal plants used as a remedy for human ailments in the study area. In the current study, it was reported that 27 plant species belonging to 27 genera and 18 families were commonly used to treat various human ailments. Most of these species (85.71%) were wild and harvested mainly for their leaves (64.52%). The most cited ethnomedicinal plant species was Alysicarpus quartinianus A. Rich., whose roots and leaves were reported by traditional healers to be crushed in fresh and applied as a lotion on the lesions of patients of Abiato (Shererit). No significant correlation was observed between the age of traditional healers and the number of species reported and the indigenous knowledge transfer was found to be similar. More than one medicinal plant species were used more frequently than the use of a single species for remedy preparations. Plant parts used for remedy preparations showed significant difference with medicinal plant species abundance in the study area.
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                Author and article information

                Contributors
                Journal
                Evid Based Complement Alternat Med
                Evid Based Complement Alternat Med
                ECAM
                Evidence-based Complementary and Alternative Medicine : eCAM
                Hindawi
                1741-427X
                1741-4288
                2022
                26 April 2022
                26 April 2022
                : 2022
                : 5098428
                Affiliations
                1Research Unit of Biochemistry of Medicinal Plants, Food Sciences and Nutrition, Department of Biochemistry, Faculty of Science, University of Dschang, P. O Box 67, Dschang, Cameroon
                2Laboratory of Biochemistry, Department of Biochemistry and Physiological Sciences, Faculty of Medicine and Biomedical Science, University of Yaounde I, P. O Box 1364, Yaounde, Cameroon
                Author notes

                Academic Editor: Francesco Cardini

                Author information
                https://orcid.org/0000-0003-4830-9966
                https://orcid.org/0000-0003-1602-6494
                https://orcid.org/0000-0002-4837-5819
                Article
                10.1155/2022/5098428
                9064533
                6b2e5c70-143a-49ae-b590-11ccf61bccd3
                Copyright © 2022 Natacha Lena Yembeau et al.

                This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                : 28 October 2021
                : 1 March 2022
                : 30 March 2022
                Categories
                Research Article

                Complementary & Alternative medicine
                Complementary & Alternative medicine

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