A study funded by the Government of Uganda through Makerere University Research and Innovation Fund (Mak-RIF) in the College of Agricultural and Environmental Sciences (CAES) has found that prolonged use of herbal medicines affects body organs.

Researchers recommend that traditional medicines should not be used for more than 14 days therefore the need to regulate and strengthening quality assurance along the value chain to reduce risks associated with the use of herbal medicines has been emphasized.

This was revealed during the virtual research dissemination meeting about the project titled, “Development of   Safe and Efficacious Anti-Malarial drug from Traditional Medicine on 16th June 2021.

DESAT is an interdisciplinary and multi-institutional research project led by Prof. John Steven Tabuti an ethnobotanist from Makerere University’s Department of Environmental Management in the College of Agricultural and Environmental Sciences.

The project is being managed by a team of University Scientists including Dr. Alice Nabatanzi from the College of Natural Sciences (CoNAS), Cissy Nambejja, Senior Research Officer, Ministry of Health, Natural Chemotherapeutics Research institute, Prof.  Paul Waako, Vice Chancellor Busitema University and Micheal R Mutyaba, Manager Traditional and Complementary Medicine, National Drug Authority.

Presenting the project results, Prof. Tabuti said the project undertook research in Tororo district and gathered data to determine the commonly used plant material for the treatment  of malaria  and the safety profiles of three selected  species namely Vernomia amygdalina, Warbugia ugandensis and Abrus precatorius for the safety assay.

“We found through this study that the three species that we investigated were reasonably safe to use in a period of 14 days. Beyond 14 days, we have observed some negative impacts on the organs of the animals,” he noted.

One of the effects was on the kidney, blood clot and ulcers in the stomach as well as death of some cells in the liver. This suggests that these traditional herbs are not safe.

The plant which causes liver damage is called Vernomia which people are advised not to take you can take as you please, but, you have to be conscious.” The PI cautioned.

Prof. Tabuti reported that people with chronic diseases are taking these concoctions for a long time and they present signs and symptoms only to go to the hospital and are told their liver is beyond control.

He noted that malaria is still a leading cause of illness and death worldwide with 92% of the cases occurring in Africa. The management is complicated by the fact that access to medicines is limited in some places with a possibility of treatment resistance.

“There is thus a need to develop new locally efficacious medicines from local materials and this requires that we determine which materials are used, confirm that they are efficacious and are safe to use,” he noted.

The survey and field work he said, was conducted in Tororo district using the questionnaire where 151 respondents were selected for interviews, asked to name species they use and how they are prepared and administered.

Plant species

There 47 plant species used by people to treat malaria in Tororo and 9 were mentioned by majority respondents and were considered the most culturally efficient and safe.

These include  Vernomia amygdalina Del commonly called Muluswa, Chamaecrista nigricans (Vahl) Greene (Achwa ), Aloe sp (Atworo ), Warbugia ugandensis  (Atiko), Abrus precatorius (Osito), Kedrostis foetidissima  (Nyamikesi), Senna accidentalis L ( Yekeyeke,), Azadirachta indica( Arobaine) and Mangifera indica L. ( Mayembe).

Process of establishing the dangers of the plants

Dr. Alice Nabatanzi noted that to determine the acute toxicity of the malaria treating plants, 30 Wister albino mice   were randomly divided into 10 groups with three in each group and one mouse in each group given the extract, water and test solvent respectively.

Each mouse was starved for 24 hours prior to treatment with a single dose of dissolved extract of 500 mg/kg.

The mice were given food 30 minutes after the dosage, weighed and checked for signs of toxicity daily for 7 days and a Lethal Dose computed and clinical signs noted.

To the sub-acute toxicity of the malaria treating plants, Dr. Nabantanzi said, a procedure similar to acute toxicology was conducted and the mice were treated twice a week for 4 weeks, each weighed and checked for signs of toxicity daily for 28 days.

“The kidney, liver, heart and stomach issues were examined. Acute toxicity and histopathology assays were conducted in the Pharmacology laboratory of the College of Veterinary Medicine, Animal Resources and Biosecurity (CoVAB) and the Biochemical parameters were conducted at the Uganda Cancer Institute.

The clinical observations after acute toxicity showed that the plants are not toxic. However, the extracts had mild to severe effects on the stomach and liver.    

What herbal medicines

Dr. Patience from the National Drug Authority defined herbal medicine product as a finished, labelled herbal medicine product that contains active ingredients. It also be defined as underground parts of plant materials, or a combination whether in a crude state or as plant portions which may contain conventional excipients in addition to active ingredients and may also contain tradition, natural organic or non-organic ingredients which are not of plant origin.

This medicines may take the form of crude drugs such as solutions, teas, powders and other herbal formulations.

If correctly applied they can contribute to preventing diseases, maintaining wellness in addition to complementing  convention care for chronic and acute health conditions.

He said patients commonly use herbal products alone or concomitantly with conventional medicines and that the general public considers them to be safe and relevant source of health care.

This emphasizes the need for regulation and strengthening quality assurance along the value chain to reduce risks associated with their use.                     

The Vice Chancellor Busitema University Prof. Paul Waako noted that Traditional medicines are widely used and no doubt they will continue to be used.

He however, observed that the biggest challenge is evidence of safety and efficacy therefore the need for scientists to carry out research and advice which traditional plant species are safe

He hailed the research team for the inter-disciplinarily and working with tirelessly to come up with their findings.

Citing the  Uganda coffee scenario of exporting coffee beans, Prof. Waako challenged  people who are working on natural products not to fall in that trap.

He implored researchers and universities to mobilize more resources and invest in the infrastructure required to develop herbal medicines into final compounds to protect the intellectual property.