Abstract: An ethnobotanical study of plants used for the treatment of diarrhoea in the Eastern Cape Province, South Africa was carried out, using a questionnaire which was administered to herbalists, traditional healers and rural dwellers. Information collected revealed the names of plants used for the treatment of diarrhoea, the parts used and the methods of preparation. This survey indicated a total of 17 plant species from 14 families used in the Province. Elephantorrhiza elephantina, Hermannia incana, Pelargonium reniforme, Alepidea amatymbica and Bulbine latifolia were the most frequently mentioned and highly recommended plants for the treatment of diarrhoea by both the traditional healers and rural dwellers. Roots, bark and leaves are the common parts of plants used, while decoctions and infusions are the main methods of preparation.
INTRODUCTION
Diarrhoea is one of the leading causes of morbidity and mortality in developing countries. It is most commonly caused by gastrointestinal infections and kills around 4.6 million people, including 2.5 million children, every year (Thapar and Sanderson, 2004). Diarrhoea is the passage of watery stools, usually at least three times in a 24 h period. The main cause of death from diarrhoea is dehydration, which results from the loss of electrolytes in diarrhoeal stools. Cholera and dysentery are severe, sometimes life threatening forms of diarrhoea (Thapar and Sanderson, 2004). The use of clean potable water is an important preventive measure against the disease. In South Africa, with its mix of developed and developing regions, 9.7 million people do not have access to adequate water supply and 16 million lack proper sanitation services (Kahinda et al., 2007). It is estimated that about 1.5 million cases of diarrhoea in children under the age of 5 are reported annually (DWAF, 2001) and about 43,000 South Africans die every year from diarrhoeal disease while the annual public and private direct health care cost incurred due to diarrhoea alone is $ 4.3 million (Pegram et al., 1998).
Medicinal plants have proven to be an abundant source of biologically active compounds. About 80% of people in developing countries use traditional medicines for their health care (Kim, 2005), including the treatment of diarrhoea. Continuous usage of traditional medicine by a large proportion of the population in developing countries is largely due to the high cost of Western medications and healthcare. It is therefore important to identify and evaluate the safety and efficacy of available natural medications as alternatives to currently used anti-diarrhoeal drugs. Plant extracts are known to have antispasmodic effects, delay gastrointestinal transit, suppress gut motility, stimulate water adsorption or reduce electrolyte secretion (Palombo, 2006). All these activities may explain the benefits of using certain plants in the treatment of diarrhoeal disease. The use of herbal drugs in the treatment of various infections is a common practice in South Africa. An estimated three million people in South Africa are currently using indigenous, traditional plant medicine for primary health care purposes (Van Wyk and Gericke, 2000), hence a range of medicinal plants with antimicrobial properties has been widely used by the traditional healers in the Eastern Cape. The people of this province have a long history of traditional medicine usage for the treatment of various infections, diseases and ailments (Van Wyk et al., 1997). The present study reports the local and scientific names of the plants used for the treatment of diarrhoea in this province as well as the parts of the plants used and the various methods of preparation and administration.
Similar ethnobotanical studies have been reported in another part of South Africa (Lin et al., 2002; Mathabe et al., 2006) and some other part of the world (Mukherjee et al., 1998; Rahman et al., 2003).
MATERIALS AND METHODS
Information for this study was collected in June 2007 through scientifically guided questionnaires, interviews and general conversations from the herbalists and rural dwellers in the Eastern Cape Province. The study area falls within the latitudes 30 °00`-34 °15`S and longitudes 22 °45`- 30 °15`E. It is bounded by the sea in the East and the drier Karroo (semi-desert vegetation) in the West. The elevation ranges from sea-level to approximately 2200 m in the North and the vegetation is veld type 7, known as the Eastern Cape thorn veld (Masika and Afolayan, 2003). This area consists of many villages which are generally classified as rural and poor.
During this survey some of the plants implicated in the treatment of diarrhoea were obtained directly from the healers and herbalists, while others were collected during walk through the forest accompanied by traditional healers and rural dwellers. The plants were initially identified by their vernacular names through consultations with the local people. The information collected included local names, the parts of the plant used, methods of preparation and the experience of healers. Voucher specimens were prepared and deposited in the herbarium of the Department of Botany, University of Fort Hare.
Additional information on the identification of the plants and their uses in other communities was collected and new findings established by consulting Roberts (1990), Van Wyk et al. (1997) and Van Wyk and Gericke (2000).
RESULTS AND DISCUSSION
This study revealed 17 plant species belonging to 14 families that were frequently used for the treatment of diarrhoea by the people of the Eastern Cape Province, South Africa (Table 1). Members of the family Fabaceae were the most commonly used plants, followed by Anacardiaceae (two species) while the remaining families all had one species each for the treatment of diarrhoea. Different parts of plants were used by the local traditional healers. Among the different parts, roots were most frequently used, followed by the bark, leaves and bulbs. The observed methods of preparation involved the use of only a single plant part but more than one method of preparation. Decoctions and infusions were the main methods of preparation. The data also showed that majority of the remedies were taken orally. The dosage depended on the age of the patient and was administered orally until the patient was healed.
| Table 1: | Medicinal plants used for the treatment of diarrhoea in the Eastern Cape Province , South Africa |
Of these plants, five were frequently mentioned and highly recommended by both the traditional healers and rural dwellers. These are Elephantorrhiza elephantina, Hermannia incana, Pelargonium reniforme, Alepidea amatymbica and Bulbine latifolia. Most of these plants were also used for coughs, colds, fever and wound treatment. Elephantorrhiza elephantina has also been reported to be used for diarrhoeal treatment in Limpopo province, South Africa and has shown appreciable antimicrobial activity (Mathabe et al., 2006). Bulbine latifolia is popular among the traditional healers. The roots are used to treat diarrhoea and a number of other ailments (Van Wyk et al., 1997). Hermannia incana is used by the local people as an emetic and the leaf sap extracted in cold water, is used to treat stomach-ache and diarrhoea, having purgative and diaphoretic effects. Decoctions of the whole plant are taken to soothe coughs. However, no other studies relating to the chemical composition of this species have earlier been reported. Pelargonium reniforme is indigenous to South Africa and abundant in the Eastern Cape Province. The extracts of P. reniforme have modest antibacterial activity (Kayser and Kolodziej, 1997). Alepidea amatymbica is described as a popular remedy for colds, coughs and chest complaints as well as for asthma, influenza, diarrhoea, abdominal cramps, sore throats and rheumatism (Van Wyk et al., 1997). Antidiarrhoeal and antidysenteric properties of medicinal plants were found to be due to the presence of tannins, alkaloids, saponins, flavonoids, steroids and terpenoids (Palombo, 2006).
The results of the present study provide enough evidence that medicinal plants still play an important role in the primary health care system of the people of this province. During this survey, it was observed that most of these people questioned use medicinal plants regularly to treat many ailments, including diarrhoea. Study is in progress on the ethnopharmacological, phytochemical and pharmacological aspects of some of these plants.
ACKNOWLEDGMENTS
This research was supported by the National Research Foundation (Grant No U1D T147) of South Africa.