In vitro and in vivo Activity of Mist Amen Fevermix and Edhec Malacure, Polyherbal Antimalarial Products on Field Isolates of Plasmodium falciparum and Plasmodium berghei

BackgroundMalaria is a life-threatening infectious disease, which pose a public health challenge. Currently, reports of parasites resistance to artemisinin-based combination therapies is widespread. This has renewed calls for new antimalarial medications including  herbal products for the treatment of malaria. This study was undertaken to scientifically assess the antiplasmodial potentials of Mist Amen Fevermix and Edhec Malacure, two polyherbal antimalarial products used for the management of uncomplicated malaria, and establish their phytochemical constituents.MethodsQualitative phytochemical screening based on standard analytical methods. The antiplasmodial activity was assessed in vitro by using Plasmodium falciparum. The SYBR® Green assay was used to measure parasite growth inhibition. In vivo activity was assessed with Plasmodium berghei parasites using the Rane’s curative method with artesunate as positive control.ResultsThe phytochemical screening of the products revealed the presence of alkaloids, flavonoids, tannin, steroid and saponin. In the in vitro studies, the IC50 values for Edhec Malacure was 70.89 ng/mL and 112.5ng/mL for Mist Amen Fevrmix. Artesunate exhibited an IC50 value of 1.571ng/mL. Edhec Malacure suppressed parasitemia by 76.17% (at 4.25mg/kg-1) and Mist Amen Fevermix by 69.03% (at 1.56 mg/kg-1) in vivo.  ConclusionMist Amen Fevrmix and Edhec Malacure Mixture demonstrated antiplasmodial activity and may be useful alternative antimalarial agents.Â

Integrating biomedical and herbal medicine in Ghana:experiences from the Kumasi South Hospital: a qualitative study

BACKGROUND: Over the past decade there has been growing interest in the use of herbal medicine both in developed and developing countries. Given the high proportion of patients using herbal medicine in Ghana, some health facilities have initiated implementation of herbal medicine as a component of their healthcare delivery. However, the extent to which herbal medicine has been integrated in Ghanaian health facilities, how integration is implemented and perceived by different stakeholders has not been documented. The study sought to explore these critical issues at the Kumasi South Hospital (KSH) and outline the challenges and motivations of the integration process. METHODS: Qualitative phenomenological exploratory study design involving fieldwork observations, focus group discussion, in-depth interviews and key informants’ interviews was employed to collect data. RESULTS: Policies and protocols outlining the definition, process and goals of integration were lacking, with respondents sharing different views about the purpose and value of integration of herbal medicine within public health facilities. Key informants were supportive of the initiative. Whilst biomedical health workers perceived the system to be parallel than integrated, health personnel providing herbal medicine perceived the system as integrated. Most patients were not aware of the herbal clinic in the hospital but those who had utilized services of the herbal clinic viewed the clinic as part of the hospital. CONCLUSIONS: The lack of a regulatory policy and protocol for the integration seemed to have led to the different perception of the integration. Policy and protocol to guide the integration are key recommendations

Treatment of Malaria Infection and Drug Resistance

Malaria is a public health challenge that requires prompt treatment for those infected to make a full recovery. Treatment of malaria infection is to be started as soon as a diagnosis is confirmed. Antimalarial medications are administered to prevent and also to treat malaria. The type of medication used and the duration of therapy is dependent on the type of malaria-causing plasmodium species, the severity of the symptoms, geographical area where malaria infection occurred and the medication used to prevent malaria and whether there is pregnancy. Treatment of malaria from public health perspective is to reduce transmission of the infection to others, by reducing the infectious reservoir and to prevent the emergence and spread of resistance to antimalarial medicines. Medications used in the treatment of malaria infection come from the following five groups of chemical compounds: quinolines and aryl amino alcohols, antifolate, artemisinin derivatives, hydroxynaphthoquinones and antibacterial agents. The treatment of malaria is not initiated until the diagnosis has been established through laboratory testing. Artemisinin-based Combination Therapy (ACTs) has been used for the treatment of uncomplicated malaria. ACTs are also to enhance treatment and protect against the development of drug resistance. IV artesunate is used in the treatment of severe malaria, regardless of infecting species

Clinical Evaluation of the Effectiveness and Safety of Mist Amen Fevermix, a Ghanaian Bi-Herbal Product, Used in the Management of Uncomplicated Malaria

Medicinal plants and products have been used all over the world throughout the history of mankind. Over time in some countries, they have been integrated into the public healthcare system but in the case of Ghana, integration is at the pilot stage. However, questions related to the effectiveness and safety of these medicinal plants and products have been raise and become the bone of contention between orthodox and traditional medicine practitioners. Malaria is a public health problem and continues to be a major cause of morbidity and mortality in most tropical and subtropical countries. The influx of fake medicines and drug counterfeiting have led to malaria parasites becoming resistant to allopathic medicines and have led to an urgent need for new effective antimalarials from medicinal plants.  This research was to determine the effectiveness and safety of Mist Amen Fevermix which is a decoction of the stem bark of Morinda lucida and Parinari robusta at the Tafo Government Hospital, Kumasi after Committee on Human Research, Publication and Ethics approval.Clinically established malaria in male and female patients aged, 15-60 years were treated with Mist Amen Fevermix, at the specified dose of 45 mls (0.45 g) three times daily for six days. Parasitaemia clearance was 82.35% within the first three days in clients who responded positively to treatment. There was a statistically significant difference between the mean levels of malaria parasite load recorded at the first visit and those recorded at the second visit, t (34) =12.20, p=.000. Similarly, there was statistically significant difference between the malaria parasite load recorded on the second visit and that of the third visit, t (24) = 2.50, p=.022. This shows a significant effectiveness of Mist Amen Fevermix in the treatment of malaria. Kidney and liver function tests were within normal range at the end of the study as well as full blood count.The main findings of the study are that Mist Amen Fevermix produced by Amen Scientific Herbal Hospital, Kumasi is an effective and safe finished herbal antimalarial product when used as specified by the manufacturer. Keywords: Malaria; effectiveness; herbal; integrated; antimalarial: parasitaemia

In vivo toxicity, anti-hyperlipidaemic, antioxidant and anti-atherogenic activities of ‘LIPO A’ A traditional herbal product in rodents

Hyperlipidemia accounts for about 17 million deaths worldwide each year. High cost and side effects have limited the use of conventional anti-lipidaemic agents in some cases, majority of whom resort to traditional medicine. The current research focused on validating the safety and efficacy of a herbal product, ‘LIPO A’ used in the management of hyperlipidaemia. Induction of hyperlipidaemia was achieved by oral administration of 3 mL of cholesterol in coconut oil for 4 weeks in male Sprague Dawley rats with water available as 40 % sucrose. Subsequently, the animals were treated with 100, 200 and 400 mg/kg of the product ‘LIPO A’ for 4 additional weeks with atorvastatin as reference drug (at 2 mg/kg body weight). Blood samples were taken for serum biochemistry and atherogenic ratios were then calculated. 2,2-Diphenyl-1-Picrylhydrazyl (DPPH) scavenging assay, total antioxidant capacity, physicochemical and phytochemical analysis were also carried out using standard methods. Treatment resulted in a dose-dependent reduction in total cholesterol with maximum reduction of 46.01 % at 400 mg/kg compared to atorvastatin with 49.30 %. There were significant changes in the low-density lipoprotein cholesterol and high-density lipoprotein cholesterol (LDL-c/HDL-c) and Total Cholesterol (TC/HDL-c) ratios which measures the atherogenic and coronary risk indices respectively. Acute and subacute toxicity studies did not reveal any signs of toxicity. High Performance Liquid Chromatography (HPLC) fingerprint revealed six well resolved peaks with two prominent compounds with retention times 24.88 and 23.95 min, which could serve as quality control markers for the product. The herbal product showed considerable antihyperlipidemic and antioxidant actions in rodent models and lend credence to its use in traditional medicine for hyperlipidaemia