Traditional Medicine in North East Africa: Research on Traditional Healer Preparations and Herbs

For a long time in the Northeastern part of Africa, most of the population relied on indigenous herbs and had many beliefs and faith in the wisdom of the local traditional healers. It is believed that the ability to diagnose an illness of an herbalist/practitioner is god-gifted and knowledge passed on by their forefathers. Traditional African medicine system involves conventional medical practitioners, midwives, herbalists, and diviners. They use many indigenous herbs or medicinally important plants available locally to cure various ailments. Their indigenous knowledge majorly depends upon the herb's color and special features of the plant like fragrance and animal behavior towards the plant. This chapter describes the role and wisdom of traditional healers or practitioners, various approaches to cure diseases, people's faith in the herbs, important herbs, and their indications. This chapter will also focus on the various dosage forms of herbs and preparation methodologies.

Moringa oleifera (Family Moringaceae), popularly called “drumstick” or “the tree of life” or “the miracle tree, is a vital medicinal plant due to its massive medicinal and non-medicinal applications. Moringa oleifera is native to the subHimalayan parts of Northern India and known to flourish in diverse soil types but grows best in tropical and subtropical regions. The plant is deciduous and grows fast, and has been employed for a long back for its high-quality nutritional, medicinal, and industrial values. For a very long time, people have been eating the leaves, blossoms, fruits, and roots of the Moringa tree as vegetables. For ages, the traditional medical system has employed M. oleifera in a variety of therapeutic purposes. Almost every part of the tree is the source of certain ingredients in traditional herbal medicines. In Africa, people affected with HIV/AIDS, diabetes, and hypertension frequently use this plant as a self-medication. The plant contains a diverse range of phytochemicals such as flavonoids, phenolic acids, steroids, tannins, terpenes, and saponins that are demonstrated to have an excellent plethora of bioactivity. The presence of diverse phytochemicals enables this tree to be a potential drug source to cure various clinical conditions. The main aim of this book chapter is to compile the distribution and botanical characteristics, phytochemical constituents, pharmacological characteristics, and potential therapeutic applications of the Moringa plant.

Ethiopia has a vast array of different types of flora. Most of these plants haven't been studied scientifically. The usage of plants as medicinal agents has long been a family tradition that has been passed down by word of mouth and well-held secrets. Worldwide, the incidence of cancer is rising quickly, even in underdeveloped nations. The majority of anticancer medications are known to be expensive and have undesirable side effects, which is why the current trend in cancer therapy calls for the use of herbal remedies. Most of the medicinal plants (MPs) used for cancer treatment were not deeply investigated from a drug discovery point of view. It is projected that there are 60,960 cases of cancer in Ethiopia each year, with a mortality rate of over 44,000 cases. With 30.2% of cases, breast cancer is the most frequent type of cancer. Cervical (13.4%) and colorectal (5.7%) cancers follow. It is possible to increase trust in the effectiveness of medicinal herbs by looking at how they are used ethnobotanically to identify patterns that are conserved across society. In light of this, drug development efforts may give priority to therapeutic theories originating from the convergent use of MPs. In Africa, a sizable portion of the populace bases their health behaviors on cultural and traditional beliefs. Instead of being overlooked, the potential for safe and successful cancer prevention, screening, and management measures offered by religious communities and traditional medicine, including traditional health practitioners, should be fully utilized. More than 250 ethnobotanical, phytochemical, and in vitro cytotoxicity studies and a few pharmacological studies were reviewed in this chapter.

 Snakebite envenoming is a significant, often overlooked public health challenge globally, particularly in regions with limited access to medical care and antivenoms. Despite affecting millions of people annually and causing permanent injuries, snakebite envenoming remains neglected by health authorities and policymakers worldwide. This neglect is partly attributed to a lack of awareness and attention to the problem. In regions like Africa, where snakebite incidents are prevalent, various venomous snake species contribute to the majority of bites, including the puff adder, Gabon viper, mambas, forest cobra, and black-necked spitting cobra. The complexity of snake venom, comprising various compounds such as polypeptides, proteins, amino acids, organic acids, sugars, lipids, nucleosides, nucleotides, biogenic amines, water, cellular debris, and bacteria ions, poses significant challenges for treatment. Currently, serum antivenom immunotherapy derived from horse or sheep serum is the primary treatment for snake envenomation. However, antivenoms have limitations, including ineffectiveness in neutralizing local tissue damage, adverse reactions, and availability issues. This has led to a growing interest in complementary treatments for snakebites, including the use of medicinal plants. Traditional remedies utilizing plants have been employed in rural areas for managing snakebites, although their scientific basis and effectiveness vary. Pharmacological studies are necessary to comprehend the mechanisms of action of these plants and their potential to provide symptomatic relief or directly neutralize venom. While growing antivenom plants around homes may serve as a preventive measure by repelling snakes, the direct use of medicinal plants as remedies for snakebites through topical or oral administration requires careful consideration and scientific evaluation. The compilation of information on traditional knowledge and practices regarding snakebite management in Africa can contribute to a better understanding of potential treatments and guide further research in this area. Efforts to address snakebite envenoming should include raising awareness among health authorities, policymakers, and communities, improving access to effective antivenom treatments, conducting research on alternative treatments such as medicinal plants, and promoting measures for prevention and education regarding snakebite prevention and management. Collaboration between local communities, healthcare professionals, researchers, and policymakers is crucial in addressing this neglected global health problem.

Diabetes mellitus (DM) stands as a major global health issue characterized by chronic hyperglycemia due to either inadequate insulin production or the body's inability to use insulin effectively. Affecting an estimated 25% of the global population, diabetes leads to severe complications, including damage to vital organs, resulting in disability and premature death. The onset of diabetes is influenced by a mix of genetic and environmental factors, with obesity significantly contributing to insulin resistance and the exacerbation of the disease. The exploration of indigenous African plants in the management of diabetes, particularly those associated with obesity, presents a promising avenue for developing effective, accessible treatments. These plants, steeped in traditional medicinal practices, offer a rich repository of natural remedies with potential antidiabetic properties. There's a growing interest in harnessing the therapeutic potential of these plants, driven by their active compounds that could play a crucial role in glucose metabolism and insulin sensitivity. Scientific investigations into the efficacy of these plants include a range of studies from in-vitro and in-vivo to clinical trials, aiming to evaluate their safety, potential side effects, and overall therapeutic viability. The intersection of traditional knowledge with modern scientific research in this field highlights the importance of developing novel, culturally respectful, and sustainable healthcare solutions. This focus on the antidiabetic activity of African medicinal plants not only underscores the continent's rich biodiversity but also advocates for a shift towards more integrative and sustainable health practices worldwide. By exploring these natural resources, there's potential to significantly impact the global fight against diabetes and obesity, offering hope for more effective management strategies rooted in the natural world.

Traditional herbal treatments have a long history and are highly valued in South Africa. Many North-East African medicinal plants have been found to have a broad range of pharmacological characteristics by using ethnobotanical knowledge as a guide. In this chapter, some successful bioprospecting of phytochemicals formulation & compounds from medicinal plants of North-East African medicinal plantsis highlighted by following the advantages of the medicinal application, status of preclinical & clinical study, and development as a commercial drug. Drugs like Artemisinin, resveratrol, Berberine, Quassin, Cathinone, Colchicine, Glaucine, Ouabain, Salicin, Scopolamine, Silymarin, Vinblastine, Vincristine, Allicin, Capsaicin, Silymarin, Kaempferol, Quercetin, Curcumin, Quinine, THC & CBD has been successfully investigated and developed as drug for various applications with antimalarial, anticancer, cardiotonic, bacillary dysentery, Antitussive, Analgesic, Sedative, Antihepatotoxic activity. Various formulations have been commercialized, like Khat, Aspirin (Acetylsalicylic acid), Quinine, and Quinidine. Recently, proteinbased molecular targets have been developed, which has increased the demand for new chemical diversification in screening. The vast majority of the North East African biodiversity is still uncovered, thus, successful bioprospecting has more potential in the coming days from this North East African region. It requires multidisciplinary, national, and international collaborations in design, synthesis, discovery, and drug development methodologies to investigate these natural resources. More investigation is warranted into the possible chemical variety of traditional medicinal plants and their potential therapeutic utility.

Viburnum opulus L., often called European dogwood shrub, golden rose, or viburnum tree, belongs to the Adoxaceae family and is a species of tall shrub native to Europe, Central Asia, and North Africa. This plant is valued as an ornamental, medicinal, and food plant. It is particularly popular as an ornamental plant but also has health benefits. The fruits of Viburnum opulus L. have a high content of phenolic compounds, including phenolic acids and flavonoids such as chlorogenic acid, catechins, quercetin glycosides, tannins, and anthocyanins. Fruits, juices, flowers, leaves, twigs, and twig extracts of Viburnum opulus L. contain biologically active substances that are known for their antioxidant properties and are used in traditional medicine. The red berries of the European dogwood are not normally consumed directly because of their unpleasant odor and bitter, astringent taste. In traditional folk medicine, however, they are used to treat numerous diseases and disorders such as coughs, colds, ulcers, kidney stones, dysmenorrhea, and high blood pressure, including bleeding, heart disease, neuroses, and diabetes. The plant has been shown to have pharmacological activities such as antioxidant, anti-inflammatory, antimicrobial, antiobesity, antidiabetic, osteogenic, cardioprotective, and cytoprotective effects. In vitro studies have shown that extracts from Viburnum opulus L. can influence cellular glucose and lipid metabolism, stimulate glucose uptake, reduce lipid accumulation, and reduce the secretion of inflammatory cytokines. In conclusion, Viburnum Opulus L. is a testament to the rich botanical heritage of Northeast Africa and a promising avenue for further research and exploration in the field of traditional medicine.

Citrullus colocynths (L.) Schrad is an important cucurbitaceous plant that is widespread in sandy regions of the world. Citrullus colocynth (L.) Schrad. It is widespread in Africa, the Middle East, and South Asia. Citrullus colocynth (L.) Schrad is widely used in African and Asian folk medicine and is known as a fascinating plant for ethnopharmacological purposes. It is used in the treatment of numerous diseases, including dermatological, gynecological, pulmonary infections, inflammation, cardiovascular diseases, asthma, diabetes, joint pain, constipation, jaundice, colds, leprosy, and gastrointestinal diseases. The plant Citrulluscolocynth (L.) Schrad contains active secondary metabolites such as phenols, flavonoids, glycosides, alkaloids, and essential oils that exhibit properties for a wide range of pharmacological activities such as anticancer, antidiabetic, antioxidant, cytotoxic, antimicrobial, antiinflammatory, antilipidemic and insecticidal. However, high doses and prolonged oral administration of Citrulluscolocynth (L.) Schrad has been associated with decreased body weight, increased white blood cell counts, and destruction of the gastric mucosa. Histological changes such as superficial loss of the protective epithelium of the gastric mucosa, atrophy of the gastric mucosal cells, and thickening of the connective tissue of the mucosa were also observed. Citrulluscolocynth (L.) Schrad has numerous pharmacological and physiological functions. It has very useful applications in the treatment of various human ailments. Therefore, the main objective of this comprehensive study is to provide an overview of the findings on the beneficial effects and risks of Citrulluscolocynth (L.) Schrad consumption on human health. 

Salvadora persica L., a member of the Salvadoraceae family, is an evergreen tree standing at 4- 6 measures altitudinous, characterized by a short box, white dinghy, and smooth green leaves. It's generally set up across colorful Asian, African, and Middle Eastern countries. In Ayurveda, Salvadora persica L. has been noted for its remedial eventuality in treating dental conditions. Its fresh leaves are consumable and are employed in traditional drugs to address conditions similar to coughs, asthma, scurvy, rheumatism, hemorrhoids, and other affections. The branches of S. persica, also known as the miswak tree, have been employed for dental cleaning since ancient times, with its operation in oral hygiene being championed by the World Health Organization. The pharmacological parcels of S. Persica L. are well established, flaunting multitudinous significant natural conditioning including antimicrobial, antitumor, hypoglycemic, anti-osteoporosis, anti-inflammatory, analgesic, antiulcer, antioxidant, enzyme inhibitory, anticonvulsant, and dreamy goods. The antimicrobial and antioxidant goods of S. persica can be attributed to various chemicals present in its extracts, analogous as tri-methylamine, salvadorin, chloride, substantial amounts of fluoride, silica, sulfur, mustard, vitamin C, saponins, tannins, cyanogenic glycoside, and benzyl isothiocyanate likewise; disquisition suggests that certain biologically active chemical factors analogous as sodium chloride, potassium chloride, salvadourea, alkaloids, and oleic and linoleic acids combine with saliva, enhancing the sanctification effectiveness and antifungal parcels of Miswak. Phytochemical netting of S. persica leaves, roots, stems, and branches has revealed the presence of secondary metabolites, including sterols terpenes, flavonoids, flavone aglycone, saponins, and tannins.

 In current years, due to awareness regarding numerous health hazards associated with synthetic food additives, consumers are changing their food habits towards food products that contain natural food additives, are less processed, safer and healthier, and have a longer shelf life. Therefore, the food industries are now focusing on finding natural compounds as an alternative to synthetic food additives to fulfill consumer appeal. Due to these natural pursuits, medicinal and aromatic plants have found an increasingly widespread use in making a variety of food products. The rich nutritional content of medicinal and aromatic plants, high antioxidant value, and functional properties such as antimicrobial properties enable these plants to be widely used in the food industry for their natural additive and protective effect. Therefore, the production of medicinal and aromatic plants and products obtained from these plants is constantly increasing throughout the world. Spices are used for flavor, color, aroma, and preservation of food or beverages. Spices are derived from many parts of the plant: bark, buds, flowers, fruits, leaves, rhizomes, roots, seeds, stigmas, and styles or the entire plant tops. It has long been known that a wide range of active chemicals found in spices and condiments have antibacterial, antifungal, and antiviral properties. Spices, herbal tea, food supplements, and food additives are the most common forms of plant products used in the food industry. Thus, the Industrial application of traditional medicinal plants is being increased exponentially to make food products more safe, healthy, therapeutic, and durable.

Adansonia digitata L., which belongs to the mallow family (Malvaceae), has a very wide distribution area and is found in most semi-arid and semi-humid regions of Africa south of the Sahara and in western Madagascar and is widespread in many countries. Adansonia digitata L. is a perennial tree with numerous uses. The various parts of the tree are often used as food and medicine, and the bark fibers are also used. The tree is used as a source of food, shelter, clothing, and medicine, as well as material for hunting and fishing. Traditionally, its various parts are used to treat diseases such as bronchial asthma, dermatitis, sickle cell anemia, diuretic, antidiabetic, diarrhea, dysentery, laxative, hiccups, malaria, and other infections. Adansonia digitata L. is known for its exceptional antioxidant properties due to its extremely high vitamin C content, which is reportedly ten times higher than oranges, and it offers numerous biological benefits, including significant antimicrobial, antiviral, antioxidant, and antiinflammatory properties. Among its components, phytochemical analyses have identified flavonoids, phytosterols, amino acids, fatty acids, vitamins, and minerals. The seeds of Adansonia digitata L. are a rich source of elements such as calcium and iron. In recent years, the commercial importance of the plant has increased as the food and beverage, nutraceutical, pharmaceutical, and cosmetic industries have shown a growing interest in its medicinal use. The demand for the seed oil of Adansonia digitata L. in cosmetic formulations has increased due to its rich fatty acid compounds.

Morocco is a country rich in medicinal plants, many of which have been used for centuries in traditional medicine to treat various ailments, including diabetes. Herbal treatment is often used as an alternative to synthetic drugs because they may be more affordable and accessible. Diabetes is a chronic disease characterized by high blood sugar levels, and it is a major public health concern worldwide. Conventional treatments for diabetes can be expensive. This review aimed to document the traditional use of medicinal plants in the prevention and self-treatment of diabetes in Morocco based on ethnobotanical surveys and experimental studies in vitro and in vivo. In Morocco, 263 botanical species belonging to 76 families have been used to treat diabetes, in which leaves represent the most used part. The most recommended plants are Artemisia herba albaAsso. Citrullus colocynthis(L.) Schrad.Trigonella foenumgraecum L. Marrubium vulgare L. Salvia officinalis L. Ajuga iva L. Nigella sativa L. Nerium oleander L. Olea europaea L. Ammi visnaga Lam. Zizyphus lotus (L.) Lamk. and Lupinus albus L. Many medicinal plants are used in Morocco against diabetes, but few pharmacological studies are carried out to determine the mode of action and the compounds responsible for the hypoglycemic effect.