Swiss Tropical and Public Health Institute (Swiss TPH), Socinstr. 53, 4051, Basel, Switzerland; University of Basel, Petersplatz 1, 4001, Basel, Switzerland; Nacional Center of Scientific Investigation (CNIC), Luanda, Angola.
Centro de Estudos e Investigação Científica de Botânica, Universidade Agostinho Neto, Luanda, Angola.
J Ethnopharmacol. 2020 Jun 28;256:112382. doi: 10.1016/j.jep.2019.112382. Epub 2019 Nov 16.
This study reports for the first time on the use of folk medicine to treat sleeping sickness and its symptoms in four endemic provinces in northern Angola. By interviewing both traditional practitioners and confirmed patients, it highlights reasons to recourse to folk medicine, the plant species used for this affection as well as arises awareness about the use of particular plants showing potential risks.
The aims of this explorative study were three-fold. Firstly, it informed on access to, and use of plant-based medicine as first-choice treatment by infected persons. Secondly, it aimed at collecting comprehensive data from patients and traditional healers on herbal remedies in order to identify plant species used in the management of the disease. Thirdly, it served as contribution for primary indication of potential risk of use associated with the studied plants and their preparation.
The study was conducted in 4 endemic provinces of Angola, namely Bengo, Zaire, Kwanza Norte and Uíge. We explored the use of herbal remedies by conducting structured and semi-structured interviews within two distinct study populations. The first group comprises 30 patients who had been diagnosed for trypanosomiasis and treated by the reference treatment. The second group included 9 traditional practitioners who had already treated sleeping sickness. The plants that were cited during the interviews were collected during field walks under supervision of a traditional healer, then authenticated and deposited at the National Herbarium in Luanda.
Of the 30 included patients, 12 (40%) had turned to folk medicine in the management of trypanosomiasis and related symptoms. 7 medicinal plants were reported by this group. Considering the key motivation to consult a traditional practitioner, two main factors accounted for half of the cases: "past experience with folk medicine" and "family habit". Out of 9 traditional practitioners' interviewees, 26 medicinal plants were cited. Roots and leaves were the most used plant parts, and decoction was the common mode of preparation. Evidence for antitrypanosomal activity in the scientific literature was found for 56% (17 of 30) of the identified plant species. The most cited plant was Crossopteryx febrifuga (UR = 6). Some of the cited plants, as for example Aristolochia gigantea, raised concern about potential toxicity.
With 40% of infected persons having turned first to folk medicine before consulting a medical doctor, this explorative study points out that plant-based medicines play an important role in local dynamics of health care. It highlights the need for primary assessment of potential risk of use related to the herbal recipes, and for reporting it to the concerned population. This first ethnobotanical study on trypanosomiasis in endemic provinces of Angola provides information on 30 plants, of which some had been identified as promising for further pharmacological research. Our results provide a first step towards the validation and valorization of Angolan herbal remedies for sleeping sickness.
本研究首次报道了在安哥拉北部四个流行省份使用民间医学治疗昏睡病及其症状。通过采访传统从业者和确诊患者，本研究强调了人们求助于民间医学的原因、用于治疗这种疾病的植物种类，并提高了对使用具有潜在风险的特定植物的认识。
本探索性研究的目的有三。首先，它提供了感染者首选植物药治疗的获取途径和使用情况。其次，它旨在从患者和传统治疗师那里收集关于草药治疗的综合数据，以确定用于治疗该疾病的植物种类。第三，它为研究植物及其制剂的潜在使用风险提供了初步依据。
该研究在安哥拉的四个流行省份进行，分别是本哥省、扎伊尔省、北宽扎省和威热省。我们通过在两个不同的研究人群中进行结构化和半结构化访谈，探索了草药疗法的使用情况。第一组包括 30 名已被诊断患有锥虫病并接受参照治疗的患者。第二组包括 9 名已治疗过昏睡病的传统从业者。访谈中提到的植物是在传统治疗师的监督下进行实地考察时收集的，然后在罗安达的国家植物标本馆进行鉴定和存放。
在 30 名纳入的患者中，有 12 名（40%）在治疗锥虫病和相关症状时转向了民间医学。该组报告了 7 种药用植物。考虑到咨询传统从业者的主要动机，有两个主要因素占了一半的病例：“过去使用民间医学的经验”和“家庭习惯”。在 9 名传统从业者的受访者中，共提到了 26 种药用植物。根和叶是最常用的植物部位，汤剂是常用的制备方法。在科学文献中发现了 56%（30 种中的 17 种）鉴定植物物种的抗锥虫活性证据。最常被引用的植物是 Crossopteryx febrifuga（UR=6）。一些被引用的植物，如 Aristolochia gigantea，引起了人们对潜在毒性的关注。
40%的感染者在咨询医生之前首先求助于民间医学，这一探索性研究表明，植物药在当地医疗保健动态中发挥了重要作用。它强调了需要对与草药配方相关的潜在使用风险进行初步评估，并向有关人群报告。这是安哥拉昏睡病流行省份进行的第一项民族植物学研究，提供了 30 种植物的信息，其中一些被确定为进一步药理学研究的有前途的候选植物。我们的研究结果为验证和利用安哥拉昏睡病草药疗法提供了一个起点。
