journal of · pdf filejournal of ethnopharmacology 138 (2011) 415 ... were interviewed and...

Tl

MCa

b

c

d

a

ARR1AA

KEEAS

1

oa(w

nT

dCT

(

0d

Journal of Ethnopharmacology 138 (2011) 415– 431

Contents lists available at SciVerse ScienceDirect

Journal of Ethnopharmacology

journa l h o me page: www.elsev ier .com/ locate / je thpharm

raditional phytotherapy remedies used in Southern Rwanda for the treatment ofiver diseases

arie-Jeanne Mukazayirea,b, Védaste Minanib, Christopher K. Ruffob, Elias Bizuruc,aroline Stévignya, Pierre Dueza,d,∗

Université Libre de Bruxelles (ULB), Laboratory of Pharmacognosy, Bromatology and Human Nutrition, CP 205-9, B-1050 Brussels, BelgiumInstitute of Research in Science and Technology (I.R.S.T.), Phytomedecine and Life Sciences Research Programme, P.O. Box 227, Butare, RwandaNational University of Rwanda, Department of Biology, P.O. Box 117, Butare, RwandaUniversité de Mons (UMONS), Department of Therapeutic Chemistry and Pharmacognosy, Bât. Mendeleiev, Av. Maistriau, 7000 Mons, Belgium

r t i c l e i n f o

rticle history:eceived 30 April 2011eceived in revised form0 September 2011ccepted 16 September 2011vailable online 22 September 2011

eywords:thnopharmacologythnomedicinenti-hepatitis plantsouthern Rwanda

a b s t r a c t

Ethnopharmacological relevance: Liver diseases represent a major health problem due to their complica-tions and limited treatment possibilities. In Rwanda, given low accessibility to modern treatments, mostpeople still rely on traditional medicinal plants. The symptomatology of many hepatic troubles (icterus)is evident for traditional healers who have a high probability of selecting efficient herbal medicines.Objectives: To document medicines used in the treatment of “hepatitis” in Southern Rwanda with theknowledge, attitudes and practices related to liver disorder recognition, control and treatment.Materials and methods: 56 traditional health practitioners, each a legal representative of an official associ-ation, were interviewed and participated in plant collection for the preparation of botanically identifiedherbarium specimens.Results: 68 multi-component and 65 single-component herbal recipes were identified for the treatment ofliver diseases with a total of 86 different herbs from 34 families identified. The most represented were theAsteraceae and the Lamiaceae. Crassocephalum vitellinum, Hypoestes triflora and Erythrina abyssinica werethe most widely used plants. The principle of polymedication for complex (i.e. multifactorial) diseases(“Ifumbi” in Rwanda), is a constant in every traditional practice. It is striking that the Rwandese therapy
of liver diseases proposes so many single-herb preparations (49% of all herbal preparations). Some ofthe recorded plants or other species from the same genus have previously been documented for liverprotection using various in vivo and in vitro models.Conclusion: Herbal remedies for hepatitis are widely used and highly diverse in Southern Rwanda; furtherchemical, pharmacological and toxicological studies are clearly required to rationally develop the most important remedies.
. Introduction

The predominant liver pathologies in a given country dependn the lifestyle and economic conditions. Acute and chronic hep-
titis, liver cirrhosis (LC) and primary hepatocellular carcinomaHCC) have become one of the major public health problems world-ide and are very common in Africa, especially in Sub-Saharan
Abbreviations: CCl4, carbon tetrachloride; HCC, primary hepatocellular carci-oma; IRST, Institute of Research in Science and Technology; LC, liver cirrhosis;HPs, traditional health practitioners; WHO, World Health Organization.∗ Corresponding author at: Laboratoire de Pharmacognosie, de Bromatologie ete Nutrition humaine, Institut de Pharmacie, Université Libre de Bruxelles (ULB),ampus de la Plaine – CP205/9, Bd du Triomphe, B-1050 Bruxelles, Belgium.el.: +32 26505172; fax: +32 26505430.

E-mail addresses: [email protected] (M.-J. Mukazayire), [email protected]. Duez).

378-8741/$ – see front matter © 2011 Elsevier Ireland Ltd. All rights reserved.oi:10.1016/j.jep.2011.09.025

© 2011 Elsevier Ireland Ltd. All rights reserved.

Africa (Mets et al., 1993; Dasnoy et al., 1997; Thomas et al.,2011). In Rwanda, estimates from the University Hospital of Butareindicate that viral hepatitis and its complications, cirrhosis andhepatic carcinoma, represent 80% of all liver pathologies, the ninthmost common cause of morbidity (Musemakweli, 1999). Modernmedicine is still quite limited in hepatic diseases prevention ortreatment, apart from vaccines and interferon �-2b, used againstsome viral infections; the only drugs available are cholagogues,choleretics, and drugs for cholesterolic lithiasis, N-acetyl-cysteineand flavo-lignanes obtained from Silybum marianum (Evans, 2002).This limitation of therapeutic options gives considerable interestto the search for active compounds from plants traditionally usedagainst liver diseases (Mukazayire et al., 2010; Jaeschke et al., 2011).

Plants are an integral part of life in many indigenous communi-ties, and Africa is no exception (Sidigia et al., 1995; Heinrich et al.,2009). Plant biodiversity plays major specific roles in the culturalevolution of local human societies (Mugabe and Clark, 1998) with

dx.doi.org/10.1016/j.jep.2011.09.025

http://www.sciencedirect.com/science/journal/03788741

http://www.elsevier.com/locate/jethpharm

mailto:[email protected]

mailto:[email protected]

dx.doi.org/10.1016/j.jep.2011.09.025

4 thnopharmacology 138 (2011) 415– 431

pprt2fpTaMpnanaae

mplrrNtcatt(pa

hocumueAuct

dpp

arptw

2

2

2STgwr

ers were contacted and 56 of them, dispersed throughout the studyarea (7 per district), were interviewed on a voluntary basis. Therewere 25 women and 31 men and the distribution of ages is shownin Fig. 2. Interviews and plant collection for the preparation of

16 M.-J. Mukazayire et al. / Journal of E

lants being important for their ethnomedical uses amongst otherurposes. In Africa, as in many tropical countries, about 80% of theural population still depends on traditional herbal remedies due tohe limited availability and affordability of pharmaceuticals (WHO,002; Mueller and Mechler, 2005; Zirihi et al., 2005). The reasonsor acceptability and use of traditional medicine by indigenousopulations of developing countries have been well documented.hese include the accessibility to herbal medicines at consider-bly reduced costs compared to imported medicines (Mueller andechler, 2005) and a considerable trust in traditional healers cou-

led to pride in local community knowledge (Mathur, 2003). Theumber of plant users is very important and does not depend on sex,ge and socio-cultural level (Jouad et al., 2001). The use of indige-ous plants in Africa plays an important role in the treatment of

variety of disorders and is reflected by intense ethnobotanicalnd pharmacological studies (Hedberg and Hedberg, 1982; Chhabrat al., 1987; Ramathal and Ngassapa, 2001; Cos et al., 2002a,b).

Although it is a challenge for medicinal plants to meet theodern criteria of quality control, efficacy and safety applied for

harmaceuticals (Wagner, 1997), the phytochemical, pharmaco-ogical and toxicological profiles of the extracts should be a basicequirement for the production of improved phytodrugs. This rep-esents a huge and costly input for laboratory and clinical work.evertheless, the World Health Organization (WHO) recognizes

hat the centuries-old use of certain plants as therapeutic resourcesould be taken into account as a good indication of their activitynd possible harmlessness (WHO, 1993). The WHO considers phy-otherapy in its health programs and suggests basic procedures forhe validation of drugs from plant origin in developing countriesVulto and Smet, 1998; Rates, 2001). The research on medicinallant extracts used in folk medicine also represents an invaluablepproach for the development of new drugs (Rates, 2001).

Of the many diseases traditionally treated with medicinal plants,epatitis ranks amongst one of the most severe. In contrast to manyther pathologies, the symptomatology of a number of hepaticonditions (icterus) is evident. Traditional healers can easily eval-ate the response to treatments and thus select efficient herbaledicines (Pandikumara et al., 2011). There is thus a widespread

se of traditional herbal remedies for the management of liver dis-ases (Thabrew and Hughes, 1996; Stickel and Schuppan, 2007).

scientific understanding of these plants however remains largelynexplored (WHO, 2002; Negi et al., 2008). Hence there is a need toollect ethnobotanical information on anti-hepatitis plants in ordero further evaluate their activity and safety as remedies.

The extent to which plant remedies are still used in the tra-itional treatment of hepatitis and the concepts underlying thereparation of remedies specifically used for hepatitis patients areoorly documented.

The present study was aimed at obtaining specific informationbout the plants and plant parts that are used as antihepatitisemedies in Southern Rwanda, how the plants are collected androcessed to make remedies, and how the remedies are adminis-ered, and to whom. In order to collect this information, interviewsere conducted with traditional health practitioners.

. Materials and methods

.1. Study area and methodology

Two surveys were carried out, for a period of 10 days in June004 and 20 days in March 2008, in eight districts located in theouthern Province of Rwanda (Kinyarwanda: Intara y’Amajyepfo).
he Southern Province encompasses the former provinces of Gikon-oro, Gitarama, and Butare and is divided into eight districts,ith Nyanza as the capital (Fig. 1). The two surveys were car-
ied out with the same methodology and each concerned four of

Fig. 1. Map of Rwanda highlighting the Southern Province where field work wascarried out. Districts: 1. Gisagara, 2. Huye, 3. Kamonyi, 4. Muhanga, 5. Nyamagabe,6. Nyanza, 7. Nyaruguru, 8. Ruhango (Steverwanda, 2010).

the eight districts (Nyanza, Ruhango, Muhanga and Kamonyi in2004; Nyaruguru, Nyamagabe, Gisagara and Huye in 2008). Thesame number of informants were interviewed in each district. Thestudy community lives near the Nyungwe forest and it has beenestablished, in other parts of Africa, that such communities pos-sess authentic information on the utilization of natural resources(Terashima, 2001; Kakudidi, 2004a,b). The national language ofthe country was used. In some cases, monetary incentives weregiven to compensate for time taken. In Rwanda, many traditionalhealers are working in associations organized by the Ministry ofHealth and the Institute of Research in Science and Technology(IRST). Through the legal representatives of associations, local heal-

Fig. 2. Demographics of interviewed traditional healers.

M.-J. Mukazayire et al. / Journal of Ethnop

Fig. 3. Relationships between recipes and medicinal plants. Recipes are represented as cifrequency of citation of a medicinal plant. The colors of diamonds correspond to the botafruit; FL, flower; L, leaves; R, root; S, seed; STB, stem bark; WP, whole plant) (Shannon et

harmacology 138 (2011) 415– 431 417

rcles, medicinal plants as diamonds; the size of the diamond is proportional to thenical family of the plant. In brackets, the part of the plant used (AP, aerial parts; F,al., 2003).

4 thnopharmacology 138 (2011) 415– 431

hbdtcIdeapi

2

HwnoiocdvhmpWdwwt

2

ctlcdiiaaRahPRf(2

2

a(2r

Table 1Symptoms used to diagnose liver diseases according to the respondents (n = 56).

Symptoms Number of respondents

Yellow eyes 56Yellow urine 56Abdominal pain in the right side 34Weakness 31Increased “volume of stomach” 25Desire of vomiting 23Pain in the knee 20

Rumex usambarensis and Plectranthus barbatus (diarrhea).Diagnosed “hepatitis” patients were mainly out-patients (96%

of THPs). In the few instances of admission, the herbal clinicor residence of the practitioners served as the admission port.

Table 2Causes of liver diseases according to the respondents (n = 56).

Causes Number of respondents

Virus 42Alcohols 42Fat and toxin in food 39Bad nutrition 37


erbarium specimens were done on alternate days. The interviews,ased on a prepared series of questions, were in the form of groupiscussions, in groups of three to four practitioners, except for theraditional healers who preferred confidentiality. Each group dis-ussion (7 per district) was centred on only one healer at a time.nformation was sought concerning their knowledge about liveriseases, local names of plants used in the treatment of the dis-ase, plant parts, methods of preparation, dosage, duration of usend any special condition/information about the drug. Medicinallants reported in this paper are those mentioned by at least five

nformants.

.2. Questionnaire

The study followed principles laid out in the Declaration ofelsinki (World Medical Association, 2008). The questionnairesere divided into three sections: (i) personal information such asame, age, sex, civil status, studies level, location and nationalityf the traditional practitioner; (ii) traditional medicine practice,ncluding information on specialty, duration of practice, originf the therapeutic knowledge, diagnosis method, appreciation ofause and symptoms of liver diseases, side effects, interdicts andietary recommendations; and (iii) recommended recipes, herbernacular names, plant part and processing, area of harvesting,erb combinations, additional non-plant ingredients, preparationethods, administration route and dosage of remedies, additional

ractices and other treatment methods used for liver diseases.eights of plants used for preparing the recipes were estimated as

escribed by Chifundera (2001). In all instances, informed consentas obtained from the respondents to divulge information and,hen consent was refused, no question whatsoever was forced on

he individual.

.3. Collection of herbal samples and plant identification

Interviewed traditional health practitioners participated in theollection and identification of botanical specimens, visually iden-ifying the plants claimed to be useful in managing the variousiver diseases. Voucher specimens were collected in duplicate andarefully dried, using standard taxonomic/ethnobotanical proce-ures, particularly recording important features for identification

n the Herbarium, including the vernacular names. Each specimenncluded vital parts such as leaves, stems, flowers and fruits ifvailable and was deposited in the National Herbarium of Rwandat the Institute of Research in Science and Technology (Butare,wanda). For small herbaceous plants, whole specimens were usu-lly collected. Collected plant materials were identified at the sameerbarium, using relevant taxonomic literature and the Africanlant Database, comparing with voucher specimens (Flore duwanda, vols. I; II; III) (Troupin, 1985; CJB, 2011). The orders and

amilies of flowering plants were classified on the basis of APGAngiosperm Phylogeny Group) III 2009 system (Elspeth et al.,009).

.4. Graphing of data

The relationships between recipes and herbs was graphed
s an interaction network using the software Cytoscape 2.8.0http://cytoscape.org), with the layout organic (Shannon et al.,003). The Cytoscape file corresponding to Fig. 3 is available onequest from the senior author.
Yellow fingers 17Waste with bad odor 11Blood vomiting 6

3. Results and discussion

3.1. Treatment practices of traditional health practitioners (THPs)

Eighty percent of the respondents claimed to have treated hep-atitis for up to 10–20 years, having acquired the knowledge mainlythrough training and/or parental inheritance. Fourteen percentof respondents indicated that they gained knowledge of reme-dies for liver diseases from neighbours or co-workers and 6%acquired knowledge from their own talent. Ninety-eight percentof the respondents claimed to use only herbs while others usednon-plants materials like honey, mainly as a support for herbsadministration. THPs based their diagnostic on symptoms, prin-cipally yellow eyes (100% of THPs), yellow urine (100% of THPs),abdominal pain in the right side (61% of THPs), weakness (55% ofTHPs) and “increased volume of stomach” (45% of THPs); patientsfrom local hospitals occasionally come to THPs with laboratorytest results that are claimed to contribute to diagnosis (16% ofTHPs) (Table 1). The THPs principally considered viral infectionsand alcohol drinking (75% of THPs) followed by fat and “food toxins”(70% of THPs) consumption as the principal causes of liver diseases(Table 2). Details of herbs and recipes used by the THP in multi-component preparations are presented in Table 3 and Fig. 3. Manyherbs are used in single-herb recipes that are presented in Table 4.

All respondents claimed to have successfully treated non-complicated hepatitis on a weekly (39% of THPs) or monthly (23%of THPs) basis. Only verbal instructions (97% of THPs) accompaniedthe use of herbal remedies and no ceremonial nor magic practiceswere reported. The duration of treatment was usually between twoand four weeks (25% of THPs) without known serious side effectsfor 82% of THPs. Eighteen percent of the respondents were aware ofside effects which occur in overdosage cases. The following herbswere quoted as having side effects – Cissampelos mucronata, Clutiaabyssinica, Lysimachia ruhmeriana, Mitragyna rubrostipulata, Clema-tis hirsuta and Crotalaria sp. (abortion; danger for children; THPssensibly reduced dosages for pregnant women and children); Rubusrigidus (vomiting); Lantana triflolia (abdominal disorder and pain);

Eating avocadoes in excess 28Entamoeba histolytica 25Smoking 20Poison 9

http://cytoscape.org/

M.-J. Mukazayire et al. / Journal of Ethnopharmacology 138 (2011) 415– 431 419

Table 3Multi-herbal recipes reported by respondents.

Recipe number Botanical name of plants (vernacular in Kinyarwanda)Family (part used,a voucher specimen number)

Preparationb (decoction, maceration,juice, infusion are made in water,except where a solvent is mentioned)

Mode of administration

1 Erythrina abyssinica Lam. ex DC.c (Umuko) Fabaceae (STB,AP2652)

Decoct 1/2 kg of crushed stem barks ofErythrina abyssinica and mix up 1 g ofthe mixture of the three other leaves(1:1:1) in 1 L. Filter and add a smallquantity of honey.

A small cup 3 times a day with 8 hinterval for one week

Hygrophilia auricurata (Schum) Heine (Gangabukari)Acanthaceae (L, RA28)Cissampelos mucronata A. Rich.c (Ishikashiki)Menispermaceae (WP, TG14420)Acacia hockii De Wild (Umugenge) Fabaceae (FL or R,GT2692)

2 Erythrina abyssinica Lam. ex DC.c (Umuko) Fabaceae (STB,AP2652)

Decoct 500 g of Erythrina abyssinicabark and mix with 300 mg each of 3other plants grounded in a mortar, in1 L.

Half a cup 3 times a day with 8 hinterval for 10 or 12 days

Bidens pilosa L.c (Inyabarasanya) Asteraceae (WP, RA47)Chenopodium ugandae (Aellen) Aellenc (Umugombe)Chenopodiaceae (L, TG5893)Draceana steudneri Engl. (Igihondohondo) Liliaceae (L,GT16028)

3 Bidens pilosa L.c (Inyabarasanya) Asteraceae (WP, RA47) Grind 1/2 kg of Erythrina abyssinicastem bark in a mortar and mix up with1 spoon of each other plant. Macerateand filter.

A small cup 3 times per day for 3 daysCoffea arabica L.c (Ikawa) Rubiaceae (L, VM79)Guizotia scabra (Vis.) Chiov.c (Igishikashike) Asteraceae (L,TG10482)Crassocephalum vitellinum (Benth.) S. Moorec (Isununu)Asteraceae (L, RJ20568)Chenopodium ugandae (Aellen) Aellenc (Umugombe)Chenopodiaceae (L, TG5893)Erythrina abyssinica Lam. ex DC.c (Umuko) Fabaceae (STB,AP2652)

4 Hypoestes triflora (Forssk.) Roem. & Schult.c (Magaru)Acanthaceae (L, TG14820)

Macerate 350 g of fresh leaves ofHypoestes triflora in 1 L and mix up withone spoon of the juice squeezed fromeach of the three other plants. Filter.

Half a glass 3 times a day for 7 days

Mangifera indica L. (Umwembe) Anacardiaceae (L,TG16136)Persea americana Mill. (Avoka) Lauraceae (L, TG946)Lantana trifolia L.c (Umuhengeri) Verbenaceae (L, RJ2035)

5 Faurea saligna Harv. (Umutiti) Proteaceae (L, GB912) Crush a handful of each plant in amortar and macerate in 1 L of water.Filter and boil.

2 cups 2 times a day within 12 h for1 weekDodonaea viscosa Jacq. (Umunyuragisaka, Umusasa)

Sapindaceae (L, GB648)6 Carica papaya L. (Ipapayi) Caricaceae (L, VM64) Macerate a handful of each plant

crushed in a mortar and in 1 L of water.Filter and boil.

One small cup 3 times a day within 8 hof interval during 12 daysHypoestes triflora (Forssk.) Roem. & Schult.c (Magaru)

Acanthaceae (L, TG14820)Erythrina abyssinica Lam. ex DC.c (Umuko) Fabaceae (STB,AP2652)Chenopodium ugandae (Aellen) Aellenc (Umugombe)Chenopodiaceae (L, TG5893)


Crush a handful of each plant in amortar and macerate in 1 L of water.Filter and boil. In some cases (notmentioned) the recipe can besimplified to only Hypoestes triflora,Leucas martinicensis and Chenopodiumugandae.

A small cup 3 times a day

Leucas martinicensis (Jacq.) R.Br.c (Akanyamapfundo)Lamiaceae (L, MG5239)Silybum marianum (L.) Gaertn. (Igihwarara) Asteraceae (S,L, R, Fr, VM99)Desmodium repandum (Vahl) DC. (Ituza, Umuvumo)Fabaceae (L, TG15365)Draceana steudneri Engl. (Igihondohondo) Liliaceae (L,GT16028)Chenopodium ugandae (Aellen) Aellenc (Umugombe)Chenopodiaceae (L, TG5893)Erythrina abyssinica Lam. ex DC.c (Umuko) Fabaceae (STB,AP2652)

8 Bidens pilosa L.c (Inyabarasanya) Asteraceae (WP, RA47) Grind Erythrina abyssinica bark in amortar, mix with other herbs anddecoct in 1 L of water. Filter.

A small cup 3 times a day for 7 daysMelanthera scandens (Schumach. & Thonn.) Roberty(Icyumwa) Asteraceae (L, VD10894)Erythrina abyssinica Lam. ex DC.c (Umuko) Fabaceae (STB,AP2652)Guizotia scabra (Vis.) Chiov.c (Igishikashike) Asteraceae (L,TG10482)

9 Musa acumunata Colla (Igitoki cy’ikakama) Musaceae(Mucilage, VM58)

Mix a handful of each plant and decoctin 1 L of water. Filter.

2 bottles of 1 L over 4 to 5 days

Erythrina abyssinica Lam. ex DC.c (Umuko) Fabaceae (STB,AP2652)Vernonia lasiopus O. Hoffm. (Ivumavumo) Asteraceae (L,RA42)Leonotis nepetifolia (L.) R.Br.c (Igicumucumu) Lamiaceae (L,RJ20349)Bidens pilosa L.c (Inyabarasanya) Asteraceae (WP, RA47)Persea americana Mill. (Avoka) Lauraceae (L, TG946)Indigofera arrecta Hochst. ex A.Rich.c (Umusororo)Fabaceae (L, RM242)

420 M.-J. Mukazayire et al. / Journal of Ethnopharmacology 138 (2011) 415– 431

Table 3 (Continued)




10 Crassocephalum vitellinum (Benth.) S. Moorec (Isununu)Asteraceae (L, RJ20568)

Mix up 250 g of Indigofera arrecta, 250 gof Hypoestes triflora + 100 g each of allother plants. Decoct in 1 L of water.Indigofera arrecta and Hypoestes trifloraare essential in the preparation.

1 glass 2 times a day for 7 days

Carica papaya L. (Ipapayi) Caricaceae (L, VM64)Hypoestes triflora (Forssk.) Roem. & Schult.c (Magaru)Acanthaceae (L, TG14820)Desmodium repandum (Vahl) DC. (Ituza, Umuvumo)Fabaceae (L, TG15365)Ocimum lamiifolium Hochst. ex Benth. (Umusura)Lamiaceae (L, TG16239)Erythrina abyssinica Lam. ex DC.c (Umuko) Fabaceae (L,AP2652)Indigofera arrecta Hochst. ex A.Rich.c (Umusororo)Fabaceae (L, RM242)

11 Lantana trifolia L.c (Umuhengeri) Verbenaceae (L, RJ2035) Mix up a handful of each plant withErythrina abyssinica stem bark crushedin mortar and decoct in 1 L of water.Filter.

Half a cup 3 times per day for 1 weekOcimum lamiifolium Hochst. ex Benth. (Umusura)Lamiaceae (L, TG16239)Markhamia lutea (Benth.) K.Schum. (Umusave)Bignoniaceae (L, GT5968)Erythrina abyssinica Lam. ex DC.c (Umuko) Fabaceae (STB,AP2652)Persea americana Mill. (Avoka) Lauraceae (L, TG946)

12 Sorghum bicolor (L.) Moench (Amasaka) Poaceae (S, RB112) Mix up a handful of each plant in 3 L ofwater and put at boiling point. Filter.

A small cup of tea 3 times a day for1 weekHypoestes triflora (Forssk.) Roem. & Schult.c (Magaru)

Acanthaceae (L, TG14820)Rubus rigidus Sm. (Imikeri) Rosaceae (L, GT336)Indigofera arrecta Hochst. ex A.Rich.c (Umusororo)Fabaceae (L, RM242)Leucas martinicensis (Jacq.) R.Br.c (Akanyamapfundo)Lamiaceae (L, MG5239)Crassocephalum vitellinum (Benth.) S. Moorec (Isununu)Asteraceae (L, RJ20568)Berkheya spekeana Oliv. (Ikigwarara) Asteraceae (L, MM64)Erythrina abyssinica Lam. ex DC.c (Umuko) Fabaceae (STB,AP2652)

13 Vernonia lasiopus O.Hoffm. (Ivumo, Ivumavumo)Asteraceae (L, RA42)

Mix a handful of each plant, decoct in2 L of water and filter.

2 glasses a day during 6 days or 2 cupsper day for 3 days

Indigofera arrecta Hochst. ex A.Rich. (Umusororo) Fabaceae(L, RM242)Lantana trifolia L.c (Umuhengeri) Verbenaceae (L, RJ2035)Hypoestes triflora (Forssk.) Roem. & Schult.c (Magaru)Acanthaceae (L, TG14820)Crassocephalum vitellinum (Benth.) S. Moorec (Isununu)Asteraceae (L, RJ20568)Guizotia scabra (Vis.) Chiov.c (Igishikashike) Asteraceae (L,TG10482)Melanthera scandens (Schumach. & Thonn.) Robertyc

(Icyumwa) Asteraceae (L, VD10894)Chenopodium ugandae (Aellen) Aellenc Umugombe)Chenopodiaceae (L, TG5893)Dodonaea viscosa Jacq. (Umunyuragisaka, Umusasa)Sapindaceae (L, GB648)

14 Mangifera indica L. (Umwembe) Anacardiaceae (L,TG16136)

Grind 500 g of Erythrina bark in amortar and mix up with 100 g of eachother plant. Macerate in 2 L of waterand filter.

3 cups a day for 3 days

Leonotis nepetifolia (L.) R.Br.c (Igicumucumu) Lamiaceae (L,RJ20349)Guizotia scabra (Vis.) Chiov.c (Igishikashike) Asteraceae (L,TG10482)Draceana steudneri Engl. (Igihondohondo) Liliaceae (L,GT16028)Chenopodium ugandae (Aellen) Aellenc (Umugombe)Chenopodiaceae (L, TG5893)Crassocephalum vitellinum (Benth.) S. Moorec (Isununu)Asteraceae (L, RJ20568)Erythrina abyssinica Lam. ex DC.c (Umuko) Fabaceae (STB,AP2652)

15 Desmodium repandum (Vahl) DC. (Ituza, Umuvumo) (L,TG15365)

Crush a handful of each plant, add 1 Lof water and decoct with 500 g ofErythrina abyssinica stem bark. Filter.

Half a cup 3 times a day for 1 week

Indigofera arrecta Hochst. ex A.Rich.c (Umusororo)Fabaceae (L, RM242)Berkheya spekeana Oliv. (Ikigwarara) Asteraceae (L, MM64)Leucas martinicensis (Jacq.) R.Br.c (Akanyamapfundo)Lamiaceae (L, MG5239)Chenopodium ugandae (Aellen) Aellenc (Umugombe)Chenopodiaceae (L, TG5893)


Table 3 (Continued)




Crassocephalum vitellinum (Benth.) S. Moorec (Isununu)Asteraceae (L, RJ20568)Erythrina abyssinica Lam. ex DC.c (Umuko) Fabaceae (STB,AP2652)

16 Berkheya spekeana Oliv. (Ikigwarara) Asteraceae (L, MM64) Grind a handful of each plant in 1 L ofwater, boil and filter.

One small cup every 8 h for 1 weekLeucas martinicensis (Jacq.) R.Br.c (Akanyamapfundo)Lamiaceae (L, MG5239)Chenopodium ugandae (Aellen) Aellenc Umugombe)Chenopodiaceae (L, TG5893)Desmodium repandum (Vahl) DC. (Ituza, Umuvumo)Fabaceae (L, TG15365)Indigofera arrecta Hochst. ex A.Rich. (Umusororo) Fabaceae(L, RM242)

17 Markhamia lutea (Benth.) K.Schum. (Umusave)Bignoniaceae (L, GT5968)

Grind 500 g of Erythrina abyssinica barkin a mortar and mix up with 100 g ofeach other plant. Macerate in 1 L andfilter.

1 glass 2 times a day for 7 days

Rubus rigidus Sm. (Imikeri) Rosaceae (L, GT336)Draceana steudneri Engl. (Igihondohondo) Liliaceae (L,GT16028)Guizotia scabra (Vis.) Chiov.c (Igishikashike) Asteraceae (L,TG10482)Indigofera arrecta Hochst. ex A.Rich. (Umusororo) Fabaceae(L, RM242)Erythrina abyssinica Lam. ex DC.c (Umuko) Fabaceae (STB,AP2652)

18 Leonotis nepetifolia (L.) R.Br.c (Igicumucumu) Lamiaceae (L,RJ20349)

Mix a handful of each plant in 1 L ofwater, boil and filter.

2 glasses a day for 3 days

Dodonaea viscosa Jacq. (Umunyuragisaka, Umusasa)Sapindaceae (L, GB648)Hypoestes triflora (Forssk.) Roem. & Schult.c (Magaru)Acanthaceae (L, TG14820)Guizotia scabra (Vis.) Chiov.c (Igishikashike) Asteraceae (L,TG10482)Chenopodium ugandae (Aellen) Aellen. (Umugombe)Chenopodiaceae (L, TG5893)

19 Melanthera scandens (Schumach. & Thonn.) Robertyc

(Icyumwa) Asteraceae (L)Crush 350 g of each plant in 2 L ofwater and one glass of banana wine,heat until boiling point and filter.

2 bottles over 4 days

Draceana steudneri ENGL. (Igihondohondo) Liliaceae (L,GT16028)Hypoestes triflora (Forssk.) Roem. & Schult.c (Magaru)Acanthaceae (L, TG14820)Crassocephalum vitellinum (Benth.) S. Moorec (Isununu)Asteraceae (L, R J20568)

20 Rubus rigidus Sm. (Imikeri) Rosaceae (L, GT336) Grind 500 g of Erythrina abyssinica barkin a mortar and mix up with one spoonof the juice from all other plants. Boilin 1 L of water and filter.

1 cup 3 times a day for 1 weekCoffea arabica L.c (Ikawa) Rubiaceae (L, VM79)Erythrina abyssinica Lam. ex DC.c (Umuko) Fabaceae (STB,AP2652)Persea americana Mill. (Avoka) Lauraceae (L, TG946)Bidens pilosa L. (Inyabarasanya) Asteraceae (WP, RA47)Indigofera arrecta Hochst. ex A.Rich. (Umusororo) Fabaceae(L, RM242)Leonotis nepetifolia (L.) R.Br.c (Igicumucumu) Lamiaceae (L,RJ20349)Chenopodium ugandae (Aellen) Aellen. (Umugombe)Chenopodiaceae (L, TG5893)

21 Acanthus pubescens (Thomson ex Oliv.) Engl. (Igitovu)Acanthaceae (L, NP8)

Triturate a handful of each plant in 1 Lof water and 1 glass of banana wine.

1 glass a day

Leucas martinicensis (Jacq.) R.Br. (Akanyamapfundo)Lamiaceae (AP, MG5239)Vernonia amygdalina Delile (Umubilizi) Asteraceae (L,RM508)Vernonia kirungae R.E.Fr.c (Igiheriheri) Asteraceae (L,RJ15502)Vernonia lasiopus O.Hoffm.c (Ivumavumo) Asteraceae (L,RA42)

22 Dracaena steudneri Engl.c (Igihondohondo) Liliaceae (STB,GT16028)

Crush a handful of each plant and boilin 3 L of water.

1 bottle a day for 12 days

Monechma subsessilis (Oliv.) C.B.Clarkc (Umubazi)Acanthaceae (R, BD206)Ludwigia abyssinica A.Rich.c (Umuzigangore) Onagraceae(R, MR23)Aspilia africana (Pers.) C.D.Adamsc (Icyumwa, Kizimyamuliro) Asteraceae (L, MJ12)Chenopodium ugandae (Aellen) Aellen. (Umugombe)Chenopodiaceae (L, TG5893)


Table 3 (Continued)

Recipe number Botanical name of plants (vernacular in Kinyarwanda) Family (partused,a voucher specimen number)



23 Ranunculus multifidus Forssk. (Kazingashya) Ranunculaceae (L,MM24)

Macerate a handful of fresh leaves with1 L of water.

1 tea spoon 3 times daily

Crotalaria mesopontica Taub. (Umuyogera, Akayogera) Fabaceae (L,GM5895)

24 Allium cepa L. (Igitunguru gitukura) Liliaceae (Bulb, VM65) Decoct a handful of each plant with 3 Lof water.

1 glass a dayHypoestes triflora (Forssk.) Roem. & Schult.c (Magaru) Acanthaceae(L, TG14820)Erythrina abyssinica Lam. ex DC.c (Umuko) Fabaceae (STB, AP 2652)Helichrysum odoratissimum (L.) Sweet (Manayeze) Asteraceae (L,GM5890)Crassocephalum vitellinum (Benth.) S. Moorec (Isununu) Asteraceae(L, RJ20568)

25 Dracaena steudneri Engl.c (Igihondohondo) Liliaceae (L, GT16028) Crush a handful of each plant with 1 Lof water and one glass of banana wineand decoct.

Half a glass 3 times dailyVernonia amygdalina Delilec (Umubilizi) Asteraceae (L, RM508)Microglossa pyrifolia (Lam.) Kuntzec (Umuhe) Asteraceae (L, AP3287)Hypoestes triflora (Forssk.) Roem. & Schult.c (Magaru) Acanthaceae(L, TG14820)Bidens pilosa L.c (Inyabarasanya) Asteraceae (WP, RA47)Crassocephalum vitellinum (Benth.) S. Moorec (Isununu) Asteraceae(L, RJ20568)Ludwigia abyssinica A. Rich.c (Umuzigangore) Onagraceae (L, MR23)

26 Myrica kandtiana Engl. (Morella kandtiana (Engl.) Verdc. & Polhill)(Isubyo) Myricaceae (L, RB380)

Crush a handful of each plant anddecoct with 1 L of water.

2 glasses a day

Bidens pilosa L.c (Inyabarasanya) Asteraceae (WP, RA47)Crassocephalum vitellinum (Benth.) S. Moorec (Isununu) Asteraceae(L, RJ20568)Leucas martinicensis (Jacq.) R.Br.c (Akanyamapfundo) Lamiaceae (AP,MG5239)Hypoestes triflora (Forssk.) Roem. & Schult.c (Magaru) Acanthaceae(L, TG14820)Erythrina abyssinica Lam. ex DC.c (Umuko) Fabaceae (STB, AP2652)

27 Leucas martinicensis (Jacq.) R.Br.c (Akanyamapfundo) Lamiaceae (AP,MG5239)


1 glass a day

Vernonia lasiopus O.Hoffm.c (Ivumavumo) Asteraceae (L, RA42)Guizotia scabra (Vis.) Chiov.c (Igishikashike) Asteraceae (L, TG10482)Hygrophila auriculata (Schumach.) Heinec (Gangabukari)Acanthaceae (L, RA28)Indigofera arrecta Hochst. ex A.Rich. (Umusororo) Fabaceae (L,RM242)Vernonia amygdalina Delilec (Umubilizi) Asteraceae (L, RM508)

28 Vernonia amygdalina Delilec (Umubilizi) Asteraceae (L, RM508) Crush a handful of each plant anddecoct with 1 L of water.

1 bottle a dayVernonia lasiopus O.Hoffm.c (Ivumavumo) Asteraceae (L, RA42)Hygrophila auriculata (Schumach.) Heine (Gangabukari) Acanthaceae(L, RA28)Markhamia lutea (Benth.) K.Schum. (Umusave) Bignoniaceae (L,GT5968)Rubus rigitus Smith (Imikeri) Rosaceae (L, GT336)

29 Clematis hirsuta Guill. & Perr. (Umunkamba) Ranunculaceae (L,TG1340)


1 coffee cup twice daily

Vernonia fontinalis S.Moore (Umubimbafuro) Asteraceae (L, MM59)Vernonia lasiopus O.Hoffm.c (Ivumavumo) Asteraceae (L, RA42)Leucas martinicensis (Jacq.) R.Br.c (Akanyamapfundo) Lamiaceae (AP,MG5239)Indigofera arrecta Hochst. ex A.Rich.c (Umusororo) Fabaceae (L,RM242)Lantana trifloria L. (Umuhengeri) Verbenaceae (L, RJ2035)Hygrophila auriculata (Schumach.) Heine (Gangabukari) Acanthaceae(L, RA28)Bidens pilosa L.c (Inyabarasanya) Asteraceae (WP, RA47)Solanum nigrum L. (Urusogo) Solanaceae (L, MM29)

30 Crassocephalum vitellinum (Benth.) S. Moorec (Isununu) Asteraceae(L, RJ20568)


Half a glass 3 times daily

Leucas martinicensis (Jacq.) R.Br.c (Akanyamapfundo) Lamiaceae (AP,MG5239)Hypoestes triflora (Forssk.) Roem. & Schult.c (Magaru) Acanthaceae(L, TG14820)Microglossa pyrifolia (Lam.) Kuntzec (Umuhe) Asteraceae (L, AP3287)Vernonia amygdalina Delilec (Umubilizi) Asteraceae (L, RM508)

31 Vernonia lasiopus O. Hoffm.c (Ivumavumo) Asteraceae (L, RA42) Crush a handful of each plant anddecoct with 1 L of water.

1 coffee cup 3 times dailyLeucas martinicensis (Jacq.) R.Br.c (Akanyamapfundo) Lamiaceae (AP,MG5239)Crassocephalum vitellinum (Benth.) S. Moorec (Isununu) Asteraceae(L, RJ20568)Bidens pilosa L.c (Inyabarasanya) Asteraceae (WP, RA47)


Table 3 (Continued)

Recipe number Botanical name of plants (vernacular in Kinyarwanda) Family (partused,a voucher specimen number)



32 Acanthus pubescens (Thomson ex Oliv.) Engl.c (Igitovu)Acanthaceae (L, NP8)


1 coffee cup 3 times daily

Crassocephalum vitellinum (Benth.) S. Moorec (Isununu) Asteraceae(L, R J20568)Erythrina abyssinica Lam. ex DC.c (Umuko) Fabaceae (Fl, AP2652)Helichrysum odoratissimum (L.) Sweet (Manayeze) Asteraceae (L,GM5890)Hypoestes triflora (Forssk.) Roem. & Schult.c (Magaru) Acanthaceae(L, TG14820)

33 Rubus rigidus Smith (Imikeri) Rosaceae (L, GT336) Crush a handful of each plant anddecoct with 1 L of water.

1 glass twice dailyHypoestes triflora (Forssk.) Roem. & Schult.c (Magaru) Acanthaceae(L, TG14820)Markhamia lutea (Benth.) K.Schum. (Umusave) Bignoniaceae (L,GT5968)Guizotia scabrac (Vis) Chiov (Igishikashike) Asteraceae (L, TG10482)Aloe myriacantha (Haw.) Schult. & Schult. f. (Igikakarubamba)Liliaceae (Aloaceae) (L, GT6773)

34 Ocimum lamiifolium Hochst ex Benth (Umusura) Lamiaceae (L,TG16239)


1 glass 3 times daily

Microglossa pyrifolia (Lam.) Kuntzec (Umuhe) Asteraceae (L,AP3287)Leucas martinicensis (Jacq.) R.Br.c (Akanyamapfundo) Lamiaceae(AP, MG5239)Crassocephalum vitellinum (Benth.) S. Moorec (Isununu) Asteraceae(L, RJ20568)

35 Dracaena steudneric Engl. (Igihondohondo) Liliaceae (L, GT16028) Crush a handful of each plant anddecoct with 1 L of water.

1 bottle a dayBerkheya spekeana Oliv (Ikigwarara) Asteraceae (L, MM64)Ocimum gratissimum L. (Umwenya) Lamiaceae (L, BD231)Coffea arabicac L. (Ikawa) Rubiaceae (L, VM79)Lantana trifloria L. (Umuhengeri) Verbenaceae (L, RJ2035)Markhamia lutea (Benth.) K. Schum (Umusave) Bignoniaceae (L,GT5968)

36 Hygrophila auriculata (Schumach.) Heine (Gangabukari)Acanthaceae (L, RA28)


1 glass twice daily

Leucas martinicensis (Jacq.) R.Br.c (Akanyamapfundo) Lamiaceae(AP, MG5239)Myrica kandtiana Engl. (Morella kandtiana (Engl.) Verdc. & Polhill)(Isubyo) Myricaceae (L, RB380)Coffea arabica L.c (Ikawa) Rubiaceae (L, VM79)

37 Clematis hirsutac L. (Umunkamba) Ranunculaceae (L) Crush a handful of each plant anddecoct with 1 L of water.

1 coffee cup twice dailyVernonia fontinalis S. Moore (Umubimbafuro) Astaraceae (L)Coffea arabica L.c (Ikawa) Rubiaceae (L, VM79)Ludwigia abyssinica A. Rich.c (Umuzigangore) Onagraceae (L, MR23)Ocimum gratissimum L. (Umwenya) Lamiaceae (L, BD231)

38 Ocimum gratissimum L. (Umwenya) Lamiaceae (L) Crush a handful of each plant anddecoct with 1 L of water.

1 coffee cup twice dailyVernonia lasiopus O. Hoffmc (Ivumavumo) Asteraceae (L, RA42)Dodonaea viscosa Jack (Umunyuragisaka, Umusasa) Sapindaceae (L)Hypoestes triflora (Forssk.) Roem. & Schult.c (Magaru) Acanthaceae(L, TG14820)

39 Erythrina abyssinica Lam. ex DC.c (Umuko) Fabaceae (FL, AP2652) Crush a handful of each plant anddecoct with 1 L of water.

1 bottle a dayHypoestes triflora (Forssk.) Roem. & Schult.c (Magaru) Acanthaceae(L, TG14820)Guizotia scabra (Vis) Chiovc (Igishikashike) Asteraceae (L, TG10482)Markhamia lutea (Benth.) K. Schum (Umusave) Bignoniaceae (L,GT5968)Crassocephalum vitellinum (Benth.) S. Moorec (Isununu) Asteraceae(L, RJ20568)Microglossa pyrifolia (Lam.) Kuntzec (Umuhe) Asteraceae (L,AP3287)Ocimum lamiifolium Hochst ex Benth (Umusura) Lamiaceae (AP,TG16239)Vernonia lasiopus O.Hoffm.c (Ivumavumo) Asteraceae (L, RA42)Bidens pilosa L.c (Inyabarasanya) Asteraceae (L, RA47)Dracaena steudneri Engl.c (Igihondohondo) Liliaceae (L, GT16028)Aloe myriacantha (Haw.) Schult. & Schult.f. (Igikakarubamba)Liliaceae (Aloaceae) (L, GT6773)

40 Vernonia lasiopus O.Hoffm.c (Ivumavumo) Asteraceae (L, RA42) Crush a handful of each plant anddecoct with 1 L of water.

Half a bottle twice dailyHygrophila auriculata (Schumach.) Heinec (Gangabukari)Acanthaceae (L, RA28)Bidens pilosa L.c (Inyabarasanya) Asteraceae (WP, RA47)Crassocephalum vitellinum (Benth.) S. Moorec (Isununu) Asteraceae(L, RJ20568)


Table 3 (Continued)






1 glass twice daily

Erythrina abyssinica Lam. ex DC.c (Umuko) Fabaceae (FL,AP2652)Vernonia lasiopus O.Hoffm.c (Ivumavumo) Asteraceae (L,RA42)Guizotia scabra (Vis) Chiovc (Igishikashike) Asteraceae (L,TG10482)Lantana trifolia L.c (Umuhengeri) Verbenaceae (L, RJ2035)

42 Guizotia scabrac (Vis) Chiov (Igishikashike) Asteraceae (L,TG10482)

Crush a handful of each plant andmacerate with 1 L of water.

1 glass twice daily

Erythrina abyssinica Lam. ex DC.c (Umuko) Fabaceae (FL,AP2652)Markhamia lutea (Benth.) K.Schum (Umusave)Bignoniaceae (FL, GT5968)


Grind a handful of each plant in amortar, add to 250 ml of cold waterand filter.

1 glass twice daily

Clerodendron myricoïdes R.Brc (Umukuzanyana)Verbenaceae (L, TG1328)Maesa lanceolata var golungensis Hiern (Umuhanga)Myrsinaceae (L, DG7529)

44 Erythrina abyssinica Lam. ex DC.c (Umuko) Fabaceae (FL,AP2652)

Decoct Dodonaea viscosa (2 spoons ofleaves powder) and a handful of eachplant in 2 L of water and filter.

1 glass twice daily

Guizotia scabra (Vis) Chiovc (Igishikashike) Asteraceae (L,TG10482)Hypoestes triflora (Forssk.) Roem. & Schult.c (Magaru)Acanthaceae (L, TG14820)Ludwigia abyssinica A. Rich.c (Umuzigangore) Onagraceae(L, MR23)Anisopappus africanus (Hook.f.) Oliv. & Hiern(Umuretezaho) Asteraceae (L, MR2092)Markhamia lutea (Benth.) K. Schum (Umusave)Bignoniaceae (FL, GT5968)Dodonaea viscosa Jack (Umunyuragisaka, Umusasa)Sapindaceae (L, GB648)

45 Maesa lanceolata var golungensis Hiern (Umuhanga)Myrsinaceae (L, DG7529)

Decoct a handful of each plant with 1 Lof water and add to 1 glass of bananawine.

1 glass twice daily

Hypoestes triflora (Forssk.) Roem. & Schult.c (Magaru)Acanthaceae (L, TG14820)Mytragyna rubrostipulata (K. Schum.) Havil (Hallearubrostipulata (K. Schum.) Leroy) (Umuzibaziba) Rubiaceae(L, TG1437)Vernonia amygdalina Delilec (Umubilizi) Asteraceae (L,RM508)Vernonia lasiopus O. Hoffm.c (Ivumavumo) Asteraceae (L,RA42)Crassocephalum vitellinum (Benth.) S. Moorec (Isununu)Asteraceae (L, RJ 20568)Guizotia scabra (Vis) Chiovc (Igishikashike) Asteraceae (L,TG10482)Erythrina abyssinica Lam. ex DC.c (Umuko) Fabaceae (STB,AP2652)


Grind a handful of each plant in amortar, add to 1 L of cold water andfilter.

1 glass twice daily

Erythrina abyssinica Lam. ex DC.c (Umuko) Fabaceae (FL,AP2652)Crassocephalum vitellinum (Benth.) S. Moorec (Isununu)Asteraceae (L, RJ20568)Coffea arabica L.c (Ikawa) Rubiaceae (L, VM79)


Grind a handful of each plant in amortar, boil in 1 L of cold water.

1 glass of one bottle a day with a totalof 12 days or 12 bottles

Monechma subsessilis (Oliv.) C.B.Clarkc (Umubazi)Acanthaceae (R, BD206)Ludwigia abyssinica A. Rich.c (Umuzigangore) Onagraceae(R, MR23)Aspilia africana (Pers.) C.D.Adamsc (Icyumwa, Kizimyamuliro) Asteraceae (L, MJ12)Chenopodium ugandae2 (Aellen.) Aellen.c (Umugombe)Chenopodiaceae (L, TG5893)

48 Vernonia amygdalina Delilec (Umubilizi) Asteraceae (L,RM508)

Grind a handful of each plant in amortar, add to 1 glass of banana wineand filter.

3 glasses daily with a total of 30 days

Ocimum gratissimum L. (Umwenya) Lamiaceae (L, BD231)


Table 3 (Continued)





Boil a handful of each plant with 1 L ofwater, filter, add 1 glass of bananawine.

One glass 3 times daily with a total of 6days or 6 bottles

Lantana trifolia L.c (Umuhengeri) Verbenaceae (L, RJ2035)Guizotia scabra (Vis) Chiovc (Igishikashike) Asteraceae (L,TG10482)Ocimum lamiifolium Hochst ex Benth (Umusura) Lamiaceae(L, TG16239)Vernonia crudia Klatt (Umukurazo) Asteraceae (L, MM37)

50 Vernonia lasiopus O. Hoffm.c (Ivumavumo) Asteraceae (L,RA42)

Decoct the mixture of plants (1:1:1, 1/2kg total) with 2 L of water.

2× half a bottle per day with a total of12 days or 12 bottles

Bidens pilosa L.c (Inyabarasanya) Asteraceae (L, RA47)Acanthus pubescens Thomson ex Oliv) Englc (Igitovu)Acanthaceae (L, NP8)

51 Crassocephalum vitellinum (Benth.) S. Moorec (Isununu)Asteraceae (AP, RJ20568)

Boil 150 g of each plant in 5 bottles ofwater, filter, add 1 glass of bananawine.

3 glasses per day with a total of 10–15bottles

Bidens pilosa L.c (Inyabarasanya) Asteraceae (AP, RA47)52 Vernonia amygdalina Delilec (Umubilizi) Asteraceae (L,

RM508)Decoct a handful of each plant in 3 L ofwater, filter, add 1 glass of bananawine.

2 glasses a day for 8 days

Clematis hirsutac Guill. & Perr. (Umunkamba)Ranunculaceae (L, TG1340)Lantana triflolia L. (Umuhengeri) Verbenaceae (L, RJ2035)Clutia abyssinica Jaub. et Spach.c (Umutarishonga)Euphorbiaceae (L, TG6234)Rumex abyssinicus Jacqc (Umufumbageshi) Polygonaceae(L, BG1408)Pavetta ternifolia (Oliv.) Hiern.c (Umumenamabuye)Rubiaceae (L, RA44)Leucas martinicens (Jacq) R.Br. (Akanyamapfundo)Lamiaceae (L, MG5239)Microglossa pyrifolia (Lam.) Kuntzec (Umuhe) Asteraceae(L, AP3287)Rumex usambarensis (Engl) Danmer (Umufumbageshi)Polygonaceae (L, MG5867)Geniosporum rotundifolium Briqc (Umusekerasuka)Lamiaceae (AP, RJ20401)Clerodendron myricoïdes R.Brc (Umukuzanyana)Verbenaceae (L, TG1328)Vernonia lasiopus O. Hoffm.c (Ivumavumo) Asteraceae (L,RA42)Mytragyna rubrostipulata (K. Schum.) Havil (Hallearubrostipulata (K. Schum.) Leroy) (Umuzibaziba) Rubiaceae(L, TG1437)Erythrina abyssinica Lam. ex DC.c (Umuko) Fabaceae (STB,AP2652)Ludwigia abyssinica A. Rich.c (Umuzigangore) Onagraceae(L, MR23)

53 Guizotia scabrac (Vis) Chiov (Igishikashike) Asteraceae (L,TG10482)

Crush a handful of each plant andmacerate in 1 L of water.

1 glass a day for 7 days

Rumex abyssinicus Jacqc (Igifumba) Polygonaceae (L,BG1408)Crassocephalum vitellinum (Benth.) S. Moorec (Isununu)Asteraceae (L, RJ20568)Erythrina abyssinicac Lam. ex DC. (Umuko) Fabaceae (L,AP2652)

54 Grewia platyclada K. Schum. (Umurokombe) Tiliaceae (L,TG316)

Express the juice from a handful ofeach plant and add to 1 L of water.

2 soup spoons a day

Ranunculus stagnalis Hochst ex A. Rich (Kazingashya)Ranunculaceae (L, VD917).

55 Musa acuminata Collac (Igitoki cy’ikakama) Musaceae(Mucilage, VM58)

Mix one bunch of Musa acuminatamucilage in 1 bottle of water, add 500 gof the mixture of crushed plants, add to3 bottles of banana wine, filter andevaporate to about 3 L.

3 tea spoons 3 times daily

Crassocephalum vitellinum (Benth.) S. Moorec (Isununu)Asteraceae (L, RJ20568)Plantago palmata Hookc (Imbatabata) Plantaginaceae (L,PK2365)Rumex usambalensis (Engl) Danmerc (Umufumbageshi)Polygonaceae (L, MG5867)

56 Melanthera scandens (Schum. et Thonn.) Robertyc

(Icyumwa) Asteraceae (L, VD10894)Crush a handful of each plant anddecoct with 1 L of water.

Half a glass 2 times daily for 7 days. Fat,alcohol and salt are prohibited duringtreatment and the patient must haveabsolute rest

Erythrina abyssinica Lam. ex DC.c (Umuko) Fabaceae (STB,AP2652)Crassocephalum vitellinum (Benth.) S. Moorec (Isununu)Asteraceae (L, RJ20568)Gynura scandens O. Hoffm (Ikizimyamuliro) Asteraceae (L,TG12658)


Table 3 (Continued)




57 Clematis hirsuta Guill. & Perr.c (Umunkamba)Ranunculaceae (L, TG1340)


1 glass per day with a total of 1.5 to 3 L

Thalyctrum rynchocarpum Dillon ex A. Richc (Ubugomboro)Ranunculaceae (L, TG1416)Erythrina abyssinica Lam. ex DC.c (Umuko) Fabaceae (FL,AP2652)Vernonia amygdalina Delilec (Umubilizi) Asteraceae (L,RM508)Leonotis nepetifolia (L.) R.Br (Igicumucumu) Lamiaceae (L,RJ20349)Ocimum urticifolium ROTHc (Umwenya) Lamiaceae (L,MM21)



1 glass a day

Triumfeta cordifolia A. Rich. (Umushyigura) Tiliaceae (L,NG11)Embelia schimperii Vatkec (Umukaragata) Myrcinaceae (L,CA2215)Lysmachia ruhmeriana Vatkec (Umuyobora) Primulaceae (L,RJ2381)

59 Erythrina abyssinica Lam. ex DC.c (Umuko) Fabaceae (FL,AP2652)


2 soup spoons a day with a total of onebottle

Allophyllus africanus P. Beauv.c (Urutete, Umutwetwe)Sapindaceae (L, BG547)Lantana triflolia L. (Umuhengeri) Verbenaceae (L, RJ2035)


Mix and decoct a handful of each plantwith 1 L of water.

1/2 glass twice a day

Desmodium repandum (Vahl) DC (Ituza, Umuvumo)Fabaceae (L, TG15365)Hygrophila spiciformis Lindauc (Gangabukari) Acanthaceae(L, MJ800)

61 Vernonia thompsoniana Oliver et Hiernc (Urukurazo)Asteraceae (L, BJ1325)


1 glass a day

Lantana trifolia L.c (Umuhengeri) Verbenaceae (L, RJ2035)Vernonia hochstetteric Sch. Bip. ex Walp (Uruhombo)Asteraceae (L, MG5966)Vernonia lasiopus O. Hoffm.c (Ivumavumo) Asteraceae (L,RA42)Sorghum bicolor (L) Moench (Amasaka) Poaceae (S, RB112)


Mix and decoct a handful of each plantwith 1 L of water + 1 glass of bananawine.

Half a glass twice a day for 7 days

Vernonia lasiopus O. Hoffm.c (Ivumavumo) Asteraceae (L,RA42)Vernonia kirungae R.E. Friesc (Igiheriheri) Asteraceae (L,TG15502)Leucas martinicensis (Jacq.) R.Br.c (Akanyamapfundo)Lamiaceae (L, MG5239)Acanthus pubescens Thomson ex Oliv) Engl (Igitovu)Acanthaceae (L, NP8)

63 Guizotia scabra (Vis) Chiovc (Igishikashike) Asteraceae (L orFL, T.G. 10482)


Half a glass twice a day with a total of1.5 L

Urtica massaica Mildbr.c (Igisura) Urticaceae (R or L, BP297)64 Rumex usambalensis (Engl) Danmerc (Umufumbageshi)

Polygonaceae (L, MG5867)Squeeze the juice of fresh leaves (1handful for each plant) and mix with1 L of water.

Half a bottle a day with a total of 30days

Centella asiatica Urbanc (Gutwikumwe) Apiaceae (WP,DP1032)Clutia abyssinica Jaub. et Spach.c (Umutarishonga)Euphorbiaceae (L, TG6234)Digitaria abyssinica (Hochst ex A. Rich) Stapfc (Urwiri)Poaceae (WP, TG14598)Triumfetta cordifolia A. Rich.c (Umushyigura) Tiliaceae (L,NG11)

65 Mytragyna rubrostipulata (K. Schum.) Havilc (Hallearubrostipulata (K. Schum.) Leroy) (Umuzibaziba) Rubiaceae(L, TG1437)

Mix and decoct the fresh crushedleaves with 1 L of water and 1 glass ofbanana wine.

1 glass a day

Erythrina abyssinica Lam. ex DC.c (Umuko) Fabaceae (L,AP2652)

66 Conyza sumatransis (Retz) E.K. Walkerc (Bambuba)Asteraceae (L, MR1418)

Squeeze the juice of fresh leaves (1handful for each plant).

1 spoon twice a day until the end ofjaundice

Plectranthus barbatus Andrewsc (Igicunshu) Lamiaceae (L,TG7212)

67 Ocimum lamiifolium Hochst ex Benth (Umusura) Lamiaceae(L, TG16239)

Mix and decoct a handful of each plantwith 1 L of water.

Half a glass twice a day until the end ofjaundice

Vernonia lasiopus O. Hoffm.c (Ivumavumo) Asteraceae (L,RA42)


Table 3 (Continued)




68 Vernonia crudia Klatt (Umukurazo) Asteraceae (L, MM16) Mix and decoct the fresh crushedleaves with 1 L of water and 1 glass ofbanana wine.

3 glasses a day with a total of 12 daysor 12 bottlesLantana triflora L. (Umuhengeri) Verbenaceae (L, RJ2035)

Guizotia scabra (Vis) Chiovc (Igishikashike) Asteraceae (L,TG10482)Ocimum lamiifolium Hochst ex Benth (Umusura) Lamiaceae(L, TG16239)Vernonia amygdalina Delilec (Umubilizi) Asteraceae (L,RM508)

a Part of the plant used (AP, aerial parts; F, fruit; FL, flower; L, leaves; R, root; S, seed; STB, stem bark; WP, whole plant).b Weights of plants used for preparing the recipes can be estimated from Chifundera (2001) as follows: a handful (20–35 g of fine powder or 50 g of coarse plant material);

one pinch (3–5 g of fine powder); a handful of crushed fresh whole herbaceous plant or leaves (130–150 g); one local bottle (720 ml); one glass (200–250 ml). One cupcorresponds to about half a glass.

c Indicates herbs previously reported for liver disorders treatment in Northern and Western Rwanda (Van Puyvelde et al., 1977; Van Puyvelde, 1988; Mungarurire, 1990;Rwangabo, 1993; Nahayo et al., 2010).

Table 4Mono-herbal recipes reported by respondents.

Botanical name of plants (vernacular in Kinyarwanda)Family (part used,a voucher specimen number)

Preparation b (decoction, maceration, juice, infusion aremade in water, except where a solvent is mentioned)


Acacia hockii De Wild (Umugenge) Fabaceae (R,GT2692)

One spoon of powder mixed with one cup of black tea. One cup a day for one week

Acanthus pubescens (Thomson ex Oliv) Englc (Igitovu)Acanthaceae (L, NP8)

Crush 3 handfuls of fresh leaves and mix up with bananawine. Filter.

One and half glass twice a day for one week

Albizia adianthifolia (Schumach) W.F.Wright(Umusange) Mimosaceae (L, MV53)

Crush a handful of leaves and mix up with one bottle ofwater. Boil and filter.

One bottle a day for two weeks

Allophyllus africanus P. Beauv. (Urutete, Umutwetwe)Sapindaceae (L, BG547)

Crush a handful of fresh leaves and macerate with 1 L ofwater. Filter.

One and half glass a day for one week

Aspilia africana (Pers.) C.D.Adamsc (Icyumwa,kizimyamuliro) Asteraceae (L, MJ12)

Crush 5 g of fresh leaves. Boil with 2 L of water. Filter. One bottle a day for 12 days

Aspilia kotschyi (Schultz Bip ex Hochst) Oliverc

(Umuretezaho) Asteraceae (L, GB761)Decoct a handful of fresh leaves in 3 L of water. Filter. One glass 3 times a day for one week

Bidens pilosa L.c (Inyabarasanya) Asteraceae (L or WP,RA47)

50 g of dry leaves powder are boiled with 2 L of water.Filter.

Half a bottle twice a day for 12 days

Bothriocline longipes (Oliv. & Hiern) N.E.Br. (Uruhehe)Asteraceae (AP, GB760)

Crush 50 g of fresh leaves. Boil with 1 L of banana wine andfilter.

One glass twice a day for one week

Carduus nyassanus (S.Moore) (Mugabudasumbikwa,Ikigwarara) Asteraceae (L or R, EK1127)

The juice squeezed out from the crushed leaves or roots. 1 spoon twice a day for one week

Centella asiatica (L.) Urbanc (Gutwikumwe) Apiaceae(WP, DP1032)

Crush 350 g fresh aerial parts or whole Plant. Boil with 1 Lof water and filter.

1 glass a day for one week

Chenopodium ugandae (Aellen) Aellenc (Umugombe)Chenopodiaceae (L, TG5893)

Crush 250 g of leaves and boil with 1 bottle of water. Filter. One bottle a day for 12 days

Cissampelos mucronata A. Rich.c (Ishikashiki)Menispermaceae (L, TG14420)

Decoct a handful of leaves with 1 L of water. Add to oneglass of banana wine. Filter.

One glass 3 times a day for 12 days

Clematis hirsuta L.c (Umunkamba) Ranunculaceae (L,TG11340)

Crush 150 g of dry leaves and boil with 1 L of banana wine.Filter.

One glass twice a day for 8 days

Clerodendron myricoïdes R. Brc (Umukuzanyana)Verbenaceae (L, TG13288)

Crushed 350 g of dry leaves and boil with 1 L of bananawine. Filter.


Clutia abyssinica Jaub. et Spach. Var. pedicellarisc

(Umutarishonga) Euphorbiaceae (L, TG6234)Decoct a handful of leaves with 1 L of banana wine. Filter. One glass a day for one week

Conyza sumatransis (Retz) E.K.c (Bambuba, Wambuba)Asteraceae (L, MR1418)

The juice squeezed out from the crushed leaves. One spoon twice a day until the end of thesymptom “icterus”

Crassocephalum vitellinum (Benth.) S. Moorec (Isununu)Asteraceae (L or ST, RJ20568)

Crush a handful of leaves and stem. Boil in 2 L of water andadd one glass of banana wine. Filter.

Half of glass twice a day for 12 days

Desmodium repandum (Vahl) DC (Ituza, Umuvumo)Fabaceae (L, TG15365)

Crush a handful of fresh leaves. Boil with 2 L of water andfilter.

One glass a day for one week

Digitaria abyssinica (Hochst ex A. Rich) Stapfc (Urwiri)Poaceae (WP, TG14598)

Crush a handful of fresh leaves. Boil with 1 L of water andfilter.

Half a bottle a day for 30 days

Dracaena steudneric Engl. (Igihondohondo) Liliaceae (Lor STB, GT16028)

Crush a handful of leaves and boil with three bottles ofwater. Filter.

One bottle a day for 12 days

Embelia schimperii Vatke Christiaensenc

(Umukaragata) Myrsinaceae (WP, AR2215)Crush a handful of fresh leaves and macerate with 1 L ofwater.

One glass 3 times a day for one month

Erythrina abyssinica Lam. ex DC.c (Umuko) Fabaceae (Lor STB, AP2652)

Crush a handful of the fresh Stem bark and macerate with1 L of water.

Half a glass a day for one week

Guizotia scabra (Vis) Chiovc (Igishikashike, Icyumya)Asteraceae (L, TG10482)

Decoct 5 g of fresh leaves with 1 L of water. Filter. One glass a day for 4 days.

Gynura scandens O. Hoffm (Ikizimyamuliro) Asteraceae(L, TG12658)

Crush 5 g of fresh leaves and boil with 2 L of water. Filter. One and half glass twice a day for one week

Helichrysum odoratissimum (L) Less (Manayeze)Asteraceae (L, GM5890)

The juice squeezed out from the crushed leaves. One spoon twice a day for one week

Helinus mystacinus (Ait.) E. Mey. (Umubimbamfuro)Rhamnaceae (L, GT3662)

Crush a handful of fresh leaves and boil with 250 ml ofwater. Filter.

One spoon twice a day

Hygrophila auriculata (Schumach.) Heinec

(Gangabukari) Acanthaceae (L or R, RA28)Decoct a handful of fresh leaves or roots with 1 L of waterand filter.

One spoon twice a day with 8 h interval forone week


Table 4 (Continued)




Hygrophila spiciformis Lindauc (Gangabukari)Acantaceae (L, MJ800)

Decoct a handful of fresh leaves with 1 L of water and filter. One glass a day for one week

Hypoestes triflora (Forssk.) Roem. & Schult.c (Magaru)Acanthaceae (L, TG14820)

Crush a handful of fresh leaves and boil with 1 L of water.Filter.


Ipomea wightii (Wallich) Choisy (Umuryanyoni)Convolvulaceae (L, RM2263)

Crush a handful of fresh leaves and macerate with 1 L ofwater. Filter.

One glass a day for 2 days

Lantana trifolia L.c (Umuhengeri) Verbenaceae (L,RJ20335)

Crush a handful of fresh leaves and macerate with 2 bottlesof water. Filter.

One and half glass a day for one week

Leonotis nepetifolia (R.Br) Aitonc (Igicumucumu)Lamiaceae (L, RJ20349)

Decoct a handful of fresh leaves with 2 bottles of water andfilter


Leucas martinicensis (Jacq.) R.Br.c (Akanyamapfundo)Lamiaceae (L, MG5239)

Decoct a handful of fresh leaves with 1 L of banana wineand filter.

One and half glass 2 times a day for oneweek

Ludwigia abyssinica A. Rich.c (Umuzigangore)Onagraceae (R, R23)

Decoct a handful of the fresh leaves with one bottle ofwater and filter.

One bottle a day for 12 days

Maesa lanceolata var golungensis Hiern (Umuhanga)Myrsinaceae (L, WG7529)

The juice squeezed out from the crushed leaves. One half glass a day for one week

Melanthera scandens (Schum. et Thonn.) Robertyc

(Icyumwa) Asteraceae (L, VDVP10894)Decoct 2 handfuls of fresh leaves with 2 L of water andfilter.

One and half glass twice a day for one week

Microglossa pyrifolia (Lam.) Kuntzec (Umuhe)Asteraceae (L, AP3287)

Crush 350 g of fresh leaves and macerate with 2 L of water.Filter.


Mitragyna rubrostipulatac (Hallea rubrostipulata)(K.Schumann) Havl (Umuzibaziba), Rubiaceae (L,TG14379)

Decoct a handful of fresh leaves with 2 L of water and 1 L ofbanana wine


Musa acuminata Collac (Igitoki cy’ikakama) Musaceae(Mucilage, MV58)

Decoct one bunch of Musa acuminata mucilage with onebottle of water. Add 1 L of banana wine and filter.

3 spoons 3 times a day

Ocimum gratissimum L. (Umwenya) Lamiaceae (L,B231)

Crush 50 g of fresh leaves. Boil with 1 L of water and filter. One glass a day for one week

Ocimum lamiifolium L. (Umusura) Lamiaceae (L,TG16239)

Decoct a handful of fresh leaves with 250 ml of water andone glass of banana wine.

One glass twice a day

Ocimum urticifolium Rothc (Umwenya) Lamiaceae (L,BD231)

Decoct 50 g of crushed fresh leaves with 1 L of water andfilter.


Oxygonum sinuatum (Hochst. & Steud. ex Meisn.)Dammer (Ubuhandanzovu), Polygonaceae (WP,RJ20635)

Macerate 50 g of whole plant powder with 1 L of water.Filter.


Pavetta ternifolia (Oliv.) Hiern (Umumenamabuye)Rubiaceae (L, RA44)

Crush 150 g of dry leaves and boil with 1 L of banana wine.Filter.


Plantago palmatac Hook (Imbatabata) Plantaginaceae(L, PK2365)

Crush 50 g of leaves. Mix up with 1 L of water and 1 glass ofbanana wine.


Plectranthus barbatusc Andrews (Igicunshu) Lamiaceae(L, T7212)

The juice squeezed out from a handful of crushed leaves. One spoon twice a day until the end of thesymptom “icterus”

Pycnostachys sp. (Umutsinduka) Lamiaceae (L,AFX1592)

The juice squeezed out from a handful of crushed leaves.Add 1 bottle of water and 1 glass of banana wine.

One and half glass twice a day for a week

Ranunculus stagnalis Hochst ex A. Rich, (Kazingashya)Ranunculaceae (L, VDV9107)

The juice squeezed out from the crushed leaves. One tea spoon twice a day for a week

Rhoicissus tridentate (L.f.) Wild et Drumond (Umumara)Vitaceae (L, BP2735)

Crush and decoct 2 handfuls of fresh or dry leaves with 3bottles of water. Filter.

One and half glass a day for a week

Rumex abyssinicus Jacq,c (Igifumba, Umufumba)Polygonaceae (L, MG5867)

The juice of 50 g of crushed leaves is mixed up with oneglass of banana wine.

3 spoons 3 times a day for a week

Rumex usambalensis (Engl) Danmerc (Umufumbageshi)Polygonaceae (L, BG1408)

Crush and decoct a handful of fresh leaves with 1 L ofwater and one glass of banana wine.

Half bottle a day with a total of 4 liters

Solanum nigrum L.(Urusogo) Solanaceae (L, MM29) Crush and decoct 50 g of fresh leaves with 1 L of water.Filter and add one cup of honey.

Half glass twice a day for a week

Solenostemon platostomoides (Robyns & Lebrun)Troupin (Umusura) Lamiaceae (L, GJ31)

Crush and decoct a handful leaves with 1 L of water. Filter. One glass twice a day for 12 days

Sorghum bicolor (L) Moench (Amasaka, Isaka) Poaceae(Fr, RB 112)

Crush and macerate 50 g of fruits with 1 L of water. Filter. One glass a day for a week

Thalyctrum rynchocarpum Dillon ex A. Richc

(Ubugomboro, Uruhungangeli, Akanyaruhima)Ranunculaceae (L, TG14616)

The juice squeezed out from crushed fresh leaves is addedto a cup of banana wine and 1 L of cold water.

One glass a day for a week. Fat, alcohol andsalt are prohibited during the treatment

Triumfetta cordifolia A. Rich.c (Umushyigura) Tiliaceae(L, NG11)

Crush and macerate a handful of fresh leaves with onebottle of water. Filter.

One half glass 3 times a day for a week

Urtica massaica Mildbr.c (Umusurasura, Igisura)Urticaceae (L or R, BP2997)

Crush and macerate 50 g of fresh leaves in 2 bottles ofwater.

One glass a day for 4 days

Vernonia amygdalina Delilec (Umubilizi) Asteraceae (L,RM508)

Crush and Decoct a handful of fresh leaves with 2 L waterand filter.


Vernonia crudia Klatt (Umukurazo) Asteraceae (L,MM16)

Decoct a handful of leaves with 1 L of water and one glassof banana wine. Filter.

One glass 3 times a day for 12 days

Vernonia fontinalis Moore (Umubimbafuro) Asteraceae(L, MM59)

Decoct a handful of fresh leaves with1 L of water. Filter. One glass 3 times a day for one week

Vernonia hochstetteri Sch. Bip. ex Walpc (Uruhombo)Asteraceae (L, MG5966)

Crush and Macerate a handful of fresh leaves with 1 L ofwater.


Vernonia kirungae R.E. Friesc (Igiheriheri) Asteraceae (L,TG15502)

Decoct a handful of crushed fresh leaves with 1 L of waterand 500 ml of banana wine.

One glass and half twice a day for one week

Vernonia lasiopus O. Hoffm.c (Ivumavumo) Asteraceae(L, RA42)

Macerate a handful of fresh or dry crushed leaves with 1bottle of water. Filter.



Table 4 (Continued)




Vernonia pogosperma Klattc (Umubimbafuro)Asteraceae (L, RJ20360)

Crush a handful of fresh leaves and mix up with 1 L ofwater.


Vernonia thompsoniana Oliver et Hiernc (Urukurazo)Asteraceae (L, BG1325)

Macerate a handful of crushed fresh leaves with one bottleof water.

One glass a day for a week

a Part of the plant used (AP, aerial parts; F, fruit; FL, flower; L, leaves; R, root; S, seed; STB, stem bark; WP, whole plant).b Weights of plants used for preparing the recipes can be estimated from Chifundera (2001) as follows: a handful (20–35 g of fine powder or 50 g of coarse plant material);

one pinch (3–5 g of fine powder); a handful of crushed fresh whole herbaceous plant or leaves (130–150 g); one local bottle (720 ml); one glass (200–250 ml). One cupc

d WeR

Ftotcwtmr

3

omdmt

3

rfacs(aKaiit“ep

tcsi1N4s

ivine

orresponds to about 1/2 glass.c Indicates herbs previously reported for liver disorders treatment in Northern an

wangabo, 1993; Nahayo et al., 2010).

urthermore, 96% of the traditional health practitioners claimedo have treated referral cases usually from orthodox hospitals (49%f THPs) and from other herbal clinics. Only a few of the practi-ioners (20%) have referred cases to other centres. This seems toorroborate their claim of having successfully treated the diseaseith herbal remedies. Apart from herbal therapy, traditional prac-

itioners also recommended their patients take appropriate dietaryeasures such as fat (65% of THPs) and alcohol (25% of THPs)

estricted diets.

.2. Dosage forms and routes of administration

Dosage forms include liquid preparations (decoctions, infusionsr macerates), juices obtained by steaming or crushing the plantaterial followed by squeezing and solid preparations, including

ry powdered materials. All the preparations were taken orally. Inost cases, the use of a given drug preparation was continued up

o at least three days after symptomatic relief was achieved.

.3. Herbal recipes for the therapy of liver diseases

Sixty-five single-herb preparations (Fig. 2) and 68 herbalecipes, mostly containing over two components, were reportedor use in the treatment of liver diseases (Table 3, Fig. 3), giving

total of 86 different herbs. These plants belong to 34 botani-al families, the most represented families being Asteraceae (23pecies), Lamiaceae (9 species), Fabaceae (5 species), Acanthaceae5 species) and Ranunculaceae (4 species). Previous studies havelso reported many mono-component recipes (Haddad et al., 2003;areru et al., 2007) and the advantage of combining several herbs, ifny, has never been investigated. The principle of polymedications a constant in every traditional practice and relies on a generaldea that “complex drugs are needed to treat complex (i.e. multifac-orial) diseases”, a principle known in Rwanda under the name ofIfumbi”. It is striking to note that the Rwandese therapy of liver dis-ases proposes so many single-herb preparations (49% of all herbalreparations).

General ethnobotanical investigations, previously carried out inhe areas of Western and Northern Rwanda and directed towardsollecting recipes, without emphasis on particular types of diseases,howed that the Asteraceae and Lamiaceae were the botanical fam-lies mostly used in these regions. These studies (Van Puyvelde et al.,977; Van Puyvelde, 1988; Mungarurire, 1990; Rwangabo, 1993;ahayo et al., 2010;) enumerated 76 plants used in liver diseases,9 of which were also mentioned in the present Southern Rwandaurvey.

Using various in vivo and in vitro models, some of the plants usedn Rwanda, or other species from the same genus, have been pre-
iously investigated against an hepatotoxicity induced (i) by CCl4n rats and/or mice (Hypoestes triflora, Acanthus ilicifolius, Solanumigrum, Leucas hirta, Indigofera sp., Myrica rubra) (Van Puyveldet al., 1989; Babu et al., 2001; Singh et al., 2001; Manjunatha
stern Rwanda (Van Puyvelde et al., 1977; Van Puyvelde, 1988; Mungarurire, 1990;

et al., 2005; Shahjahan et al., 2005; Singh et al., 2006; Lin et al.,2008; Mukherjee et al., 2009; Xu et al., 2009); (ii) by CCl4 and d-galactosamine in rats (Ocimum gratissimum and Ocimum basilicum)(Lin et al., 1995); (iii) by CCl4 and acetaminophen in rats and/ormice (Vernonia amygdalina, Carica papaya, Bidens pilosa) (Babalolaet al., 2001; Rajkapoor et al., 2003; Iwalokun et al., 2006; Yuan et al.,2008); (iv) by acetaminophen and thioacetamide in rats (Hygrophilaauriculata) (Singh and Handa, 1995; Shanmugasundaram andVenkataraman, 2006); (v) by CCl4, acetaminophen, ethanol, d-galactosamine, iron and Amanita phalloides in rats and mice(Silybum marianum) (Chih et al., 1996; Pradhan and Girish, 2006);and (vi) by CCl4 and acetaminophen in guinea pigs and rats (Ocimumlamiifolium, Crassocephalum vitellinum, Guizotia scabra and Vernonialasiopus) (Mukazayire et al., 2010). An antihepatitis C activity hasalso been demonstrated for Embelia schimperi that acts on the HCV-Protease (Hussein et al., 2000). For all the other plants cited in thepresent survey, practically no information is available on eventualeffects on liver diseases. The efficiency and safety of these plantsstill require scientific assessment to rationalize their use. Whenadvocating herbal therapy for alternative management of diseases,the potential toxicity of proposed herbs should always be a concern(Jouad et al., 2001). For example, on an in vitro rat precision-cutliver slices model, three of the herbs frequently cited here (Guizo-tia scabra, Microglossa pyrifolia and Vernonia lasiopus) were foundhepatotoxic (Mukazayire et al., 2010), warranting further safetyinvestigation. The eventual use of these three herbs in traditionalmedicine should be quite cautious and ideally be accompanied bymonitoring of the patient hepatic function.

4. Conclusion

To the best of our knowledge, ethnobotanical surveys of medic-inal plants in Southern Rwanda for the treatment of hepatitis havenot yet been published. The present inventory therefore repre-sents a contribution of the natural flora of Southern Rwanda toa global approach in controlling hepatitis. This survey has clearlyidentified 86 herbs used in traditional remedies and, accordingto the respondents, Crassocephalum vitellinum, Hypoestes trifloraand Erythrina abyssinica were the most widely used plants. Pre-vious surveys made in different regions (Northern and WesternRwanda) had reported 49 of these herbs but with different associ-ation of plants and varied modes of preparation, suggesting spreadbut also very local traditional knowledge. The following endemicplants commonly used as antihepatitis in Southern Rwanda areoriginal to the present study and have never been cited before:Vernonia hochstetteri, Vernonia fontinalis, Desmodium repandum,Solenostemon platostomoides, Geniosporum rotundifolium, Thalyc-trum rynchocarpum, Ranunculus stagnalis and Grewia platyclada
(Table 3).
This research has shown that, in Southern Rwanda, liver dis-eases are still frequently treated by means of herbal remedies.Many indigenous plants still not known are used and deserve to

4 thnop

b(hpadepst

tdb

D

A

(BhnmgpmDM

R

B

B

C

C

C

C

C

C

CD

E

E

H

H


e studied. On the basis of our data, it is possible to discern thati) Southern Rwandese traditional health practitioners possess auge knowledge of medicinal plants, already confirmed by somerevious experimental studies; (ii) herbal remedies for hepatitisre widely used in this region; (iii) Southern Rwanda shows a highiversity of herbal medicines which have a clear potential, both sci-ntific and commercial, to be further explored from the chemical,harmacological and toxicological points of view. The goal of suchubsequent studies will be phytomedicines with efficacy and safetyhat could be promoted for efficient use in primary health care.

In conclusion, conservation of the ecosystem, rational produc-ion of interesting phytomedicines and preservation of bio-culturalata remain extremely important, certainly for scientific reasonsut also to promote the standard of life for local inhabitants.

eclaration of interests

The authors report no declarations of interest.

cknowledgements

This work was funded by the Coopération Technique BelgeCTB) and partly supported by the Foundation David and Alice Vanuuren. Both aids are gratefully acknowledged. The study could notave been completed without the cooperation of local authorities,otably the Mayors of the Rwanda Southern Province, and of ourany interlocutors whose help has been invaluable. We are very

rateful to all the people who provided information on medicinallants in the eight districts and to Mrs Lelia & Dr Frank Fore-an for their contribution to this work. We thank Prof. Wei Ding,epartment of Biochemistry and Molecular Biology, China Capitaledical University, for pointing us to recipe data graphing.

eferences

abu, B., Shylesh, B., Padikkala, J., 2001. Antioxidant and hepatoprotective effect ofAcanthus ilicifolius. Fitoterapia 72, 272–277.

abalola, O., Anetor, J., et al., 2001. Amelioration of carbon tetrachloride-inducedhepatotoxicity by terpenoid extract from leaves of Vernonia amydgalina. AfricanJournal of Medicine & Medical Sciences 30, 91–93.

hifundera, K., 2001. Contribution to the inventory of medicinal plants from theBushi area, South Kivu Province, Democratic Republic of Congo. Fitoterapia 72,351–368.

hih, H.-W., Lin, C.-C., Tang, K.-S., 1996. The hepatoprotective effects of Taiwan folkmedicine Ham-hong-chho in rats. The American Journal of Chinese Medicine 24,231–240.

hhabra, S.C., Mahunnah, R.L.A., Mshiu, E.N., 1987. Plants used in traditionalmedicine in Eastern Tanzania. I. Pteridophytes and angiosperms (Acanthaceae– Canellaceae). Journal of Ethnopharmacology 21, 253–277.

JB, 2011. African Plant Database – Conservatoire et Jardin botaniques ville deGenève (CJB). South African SANBI.

os, P., Hermans, N., De Bruyne, T., Apers, S., Sindambiwe, J.B., Vanden, B.D., Pieters,L., Vlietinck, A.J., 2002a. Further evaluation of Rwandan medicinal plant extractsfor their antimicrobial and antiviral activities. Journal of Ethnopharmacology 79,155–163.

os, P., Hermans, N., De Bruyne, T., Apers, S., Sindambiwe, J.B., Witvrouw, M., DeClercq, E., Vanden Berghe, D., Pieters, L., Vlietinck, A.J., 2002b. Antiviral activityof Rwandan medicinal plants against human immunodeficiency virus type-1(HIV-1). Phytomedicine 9, 62–68.

ytoscape, 2011. http://cytoscape.org, consulted on 19th July.asnoy, J., Colebunders, R., Ngilimana, P.T., 1997. Hepatitis cirrhosis and biliary dis-

eases. In: Janssens, P.G. (Ed.), Health in Central Africa Since 1885: Past PresentFuture. King Baudoin Foundation, Brussels, pp. 925–973.

lspeth, H., James, R., Peter, F., Mark, W.C., David, J.H., 2009. The Linear AngiospermPhylogeny Group (LAPG) III: a linear sequence of the families in APG III. BotanicalJournal of the Linnean Society 161, 128–131.

vans, W.C., 2002. An overview of drugs with antihepatotoxic and oral hypo-glycaemic activities. In: Evans, W.C. (Ed.), Trease Evans Pharmacognosy. W.B.Saunders, Edinburgh, pp. 414–420.

addad, P.S., Depot, M., Settaf, A., Chabli, A., Cherrah, Y., 2003. Comparative study on
the medicinal plants most recommended by traditional practitioners in Moroccoand Canada. Journal of Herbs, Spices and Medicinal Plants 10, 25–45.
edberg, I., Hedberg, O., 1982. Inventory of plants used in traditional medicinein Tanzania. I. Plants of the families Acanthaceae to Cucurbitaceae. Journal ofEthnopharmacology 6, 29–60.

harmacology 138 (2011) 415– 431

Heinrich, M., Edwards, S., Moerman, D., Leonti, M., 2009. Ethnopharmacological fieldstudies: a critical assessment of their conceptual basis and methods. Journal ofEthnopharmacology 124, 1–17.

Hussein, G., Miyashiro, H., Nakamura, N., Hattori, M., Kakiuchi, N., Shimotohno, K.,2000. Inhibitory effects of Sudanese medicinal plant extracts on hepatitis C virus(HCV) protease. Phytotherapy Research 14, 510–516.

Iwalokun, B.A., Efedede, B.U., Alabi-Sofunde, J.A., Oduala, T., Magbagbeola, O.A.,Akinwande, A.I., 2006. Hepatoprotective and antioxidant activities of Vernoniaamygdalina on acetaminophen-induced hepatic damage in mice. Journal ofMedicinal Food 9, 524–530.

Jaeschke, H., McGill, M.R., Williams, C.D., Ramachandran, A., 2011. Current issueswith acetaminophen hepatotoxicity. A clinically relevant model to test the effi-cacy of natural products. Life Sciences 88, 737–745.

Jouad, H., Haloui, M., Rhiouani, H., El Hilaly, J., Eddouks, M., 2001. Ethnobotanicalsurvey of medicinal plants used for the treatment of diabetes, cardiac and renaldiseases in the North centre region of Morocco (Fez–Boulemane). Journal ofEthnopharmacology 77, 175–182.

Kakudidi, E.K, 2004a. Cultural and social uses of plants from and around KibaleNational Park, Western Uganda. African Journal of Ecology 42, 114–118.

Kakudidi, E.K., 2004b. Folk plant classification by communities around KibaleNational Park, Western Uganda. African Journal of Ecology 42, 57–63.

Kareru, P.G., Kenji, G.M., Gachanja, A.N., Keriko, J.M., Mungai, G., 2007. Traditionalmedicines among the Embu and Mbeere peoples of Kenya. African Journal ofTraditional Complementary and Alternative Medicine 4, 75–86.

Lin, C., Lin, J., Chang, C., 1995. Evaluation of hepatoprotective effect of “Chhit-Chan-Than” from Taiwan. International Journal of Pharmacognosy 33, 139–143.

Lin, H.-M., Tseng, H.-C., Wang, C.-J., Lin, J.-J., Lo, C.-W., Chou, F.-P., 2008. Hepatopro-tective effects of Solanum nigrum Linn extract against CCl4-induced oxidativedamage in rats. Chemico-Biological Interactions 171, 283–293.

Manjunatha, B., Vidya, S., Dhiman, P., 2005. Hepatoprotective activity of Leucas hirtaagainst CCl4-induced hepatic damage in rats. Indian Journal of ExperimentalBiology 43, 722–727.

Mathur, A., 2003. Who Owns Traditional Knowledge? Indian Council for Researchon International Economic Relations, New Delhi, India.

Mets, T., Smitz, J., Ngendahayo, P., Sabbe, L., Bigilimana, I., Ngirabatware, B., 1993.Hepatitis C virus infection in African patients with liver cirrhosis or primary hep-atocellular carcinoma. Scandinavian Journal of Gastroenterology 28, 331–334.

Mueller, M., Mechler, E., 2005. Medicinal Plants in Tropical Countries – TraditionalUse – Experience – Facts. Georg Thieme Verlag, Stuttgart, Germany.

Mugabe, J., Clark, N., 1998. Managing Biodiversity: The National Systems of Conser-vation and Innovation in Africa. Acts Press, Nairobi.

Mukazayire, M.J., Allaeys, V., Buc Calderone, P., Stevigny, C., Bigendako, M.J., Duez,P., 2010. Evaluation of the hepatotoxic and hepatoprotective effect of Rwandeseherbal drugs on in vivo (guinea pigs barbiturate-induced sleeping time) andin vitro (rat precision-cutliverslices PCLS) models. Experimental and ToxicologicPathology 62, 289–299.

Mukherjee, P.K., Sahoo, A.K., Narayanan, N., Kumar, N.S., Ponnusankar, S., 2009. Leadfinding from medicinal plants with hepatoprotective potentials. Expert OpinionDrug Discovery 4, 545–576.

Mungarurire, J., 1990. A phytochemical investigation of five medicinal plants of theCompositae family from Rwanda. Thesis, University of Nairobi, Nairobi, Kenya.

Musemakweli, A., 1999. Séminaire sur les plantes medicinales et la pharmacopéetraditionnelle. In: Compte-Rendu des Travaux. IRST, Butare.

Nahayo, A., Bigendako, M.-J., Fawcett, K., Yansheng, G., 2010. Ethnobotanic studyaround Volcanoes National Park, Rwanda. New York Science Journal 3, 37–49.

Negi, A.S., Kumar, J.K., Shanker, K., Gupta, M.M., Khanuja, S.P.S., 2008. Recentadvances in plant hepatoprotectives: a chemical and biological profile of someimportant leads. Medicinal Research Reviews 28, 746–772.

Pandikumara, P., Chellappandiana, M., Mutheeswarana, S., Ignacimuthu, S., 2011.Consensus of local knowledge on medicinal plants among traditional healers inMayiladumparai block of Theni District, Tamil Nadu, India. Journal of Ethnophar-macology 134, 354–362.

Pradhan, S.C., Girish, C., 2006. Hepatoprotective herbal drug, silymarin from exper-imental pharmacology to clinical medicine. Indian Journal of Medical Research124, 491–504.

Rajkapoor, B., Jayakar, B., Murugesh, N., 2003. Effect of dried fruits of Carica papayaLinn. on hepatotoxicity. Biological & Pharmaceutical Bulletin 25, 1645–1646.

Ramathal, D.C., Ngassapa, O.D., 2001. Medicinal plants used by Rwandese traditionalhealers in refugee camps in Tanzania. Pharmaceutical Biology 39, 132–137.

Rates, S.M.K., 2001. Plants as source of drugs. Toxicon 39, 603–613.Rwangabo, P.C., 1993. La médecine traditionnelle au Rwanda. Karthala et ACCT, Paris.Shahjahan, M., Vani, G., Shyamala Devi, C., 2005. Protective effect of Indigofera

oblongifolia in CCl4-induced hepatotoxicity. Journal of Medicinal Food 8,261–265.

Shanmugasundaram, P., Venkataraman, S., 2006. Hepatoprotective and antioxidanteffects of Hygrophila auriculata (K. Schum) Heine Acanthaceae root extract. Jour-nal of Ethnopharmacology 104, 124–128.

Shannon, P., Markiel, A., Ozier, O., Baliga, N., Wang, J., Ramage, D., Amin, N.,Schwikowski, B., Ideker, T., 2003. Cytoscape: a software environment for inte-grated models of biomolecular interaction networks. Genome Research 13,2498–2504.

Sidigia, I., Nyaigotti-Chacha, C., Kanunah, M.P., 1995. Traditional Medicine in Africa.East African Educational Publishers, Nairobi.

Singh, A., Handa, S.S., 1995. Hepatoprotective activity of Apium graveolens andHygrophila auriculata against paracetamol and thioacetamide intoxication inrats. Journal of Ethnopharmacology 49, 119–126.

http://cytoscape.org/

thnop

S

S

SS

T

T

T

T

V

V

M.-J. Mukazayire et al. / Journal of E

ingh, B., Saxena, A., Chandan, B., Bhardwaj, V., Gupta, V.N., Suri, O.P.,Handa, S.S., 2001. Hepatoprotective activity of indigtone – a bioac-tive fraction from Indigofera tinctoria Linn. Phytotherapy Research 15,294–297.

ingh, B., Chandan, B.K., Sharma, N., Bhardwaj, V., Satti, N.K., Gupta, V.N., Gupta, B.D.,Suri, K.A., Suri, O.P., 2006. Isolation, structure elucidation and in vivo hepatopro-tective potential of trans-tetracos-15-enoic acid from Indigofera tinctoria Linn.Phytotherapy Research 20, 831–839.

teverwanda, 2010. Southern Province, Rwanda. Wikipedia, the Free Encyclopedia.tickel, F., Schuppan, D., 2007. Herbal medicine in the treatment of liver diseases.

Digestive and Liver Diseases 39, 293–304.erashima, H., 2001. The relationships among plants, animals, and man in the African

tropical rain forest. Africa Study Monographs Supplement 27, 43–60.habrew, M.I., Hughes, R.D., 1996. Phytogenic agents in the therapy of liver disease.

Phytotherapy Research 10, 461–467.homas, D., Leoutsakas, D., Zabransky, T., Kumar, M., 2011. Hepatitis C in HIV-

infected individuals: cure and control, right now. Journal of the InternationalAIDS Society 14, 1–8.

roupin, G., 1985. Flore du Rwanda, spermatophytes. In: ACCT (Ed.), Musée Royal del’Afrique centrale. ACCT, Paris.

an Puyvelde, L., 1988. Contribution to the study of Rwandese medicinal plants.Thesis, Rijksuniversiteit te Leiden, Gent, Belgium, pp. 104–121.

an Puyvelde, L., Kayonga, A., Brioen, P., Costa, J., Ndimubakunzi, A., De Kimpe, N.,Schamp, N., 1989. The hepatoprotective principle of Hypoestes triflora leaves.Journal of Ethnopharmacology 26, 121–127.

harmacology 138 (2011) 415– 431 431

Van Puyvelde, L., Ngaboyisonga, M., Mukarugambwa, P.C.S., Kayonga, A., Barab-wiliza, 1977. Enquêtes ethnobotaniques sur la médicine traditionnellerwandaise, Tome I, Préfecture de Kibuye. U.N.R. (Université Nationale duRwanda), Butare.

Vulto, A.G., Smet, P.A.G.M., 1998. In: Dukes, M.M.G. (Ed.), Meyler’s Side Effects ofDrugs. Elsevier, Amsterdam.

Wagner, H.,1997. Guidelines for quality control of phytomedicines. In:World Congress on Medicinal and Aromatic Plants for Human Welfare.ICMPA/ISHS/SAIPOA, Mendoza, p. 4.

WHO, 1993. Research Guidelines for Evaluating the Safety and Efficacy of HerbalMedicines. World Health Organization Regional Office for the Western Pacific,Manila.

WHO, 2002. Traditional Medicine: Planning for Cost-Effective Traditional HealthServices in the New Century – A Discussion Paper. Centre for Health Develop-ment.

World Medical Association, 2008. Declaration of Helsinki, http://www.wma.net/en/30publications/10policies/b3/, consulted on 25th July 2011.

Yuan, L., Chen, F., Ling, L., Dou, P., Bo, H., Zhong, M., Xia, L., 2008. Protective effects oftotal flavonoids of Bidens pilosa L. (TFB) on animal liver injury and liver fibrosis.Journal of Ethnopharmacology 116, 539–546.

Xu, L., Gao, J., Wang, Y., Yu, W., Zhao, X., Yang, X., Zhong, Z., Qian, Z., 2009. Myrica rubraextracts protect the liver from CCl4-induced damage. eCAM Advance 17, 1–9.

Zirihi, G.N, Mambu, L., Guédé-Guina, F., Bodo, B., Grellier, P., 2005. In vitro antiplas-modial activity and cytotoxicity of 33 West African plants used for treatment ofmalaria. Journal of Ethnopharmacology 98, 281–285.

http://www.wma.net/en/30publications/10policies/b3/

http://www.wma.net/en/30publications/10policies/b3/

journal of · pdf filejournal of ethnopharmacology 138 (2011) 415 ... were interviewed and...

Documents