Journal Pre-proof
Indigenous traditional knowledge of medicinal plants used by herbalists in treating
opportunistic infections among people living with HIV/AIDS in Uganda
G. Anywar, E. Kakudidi, R. Byamukama, J. Mukonzo, A. Shubert, H. Oryem-Origa
PII:
S0378-8741(19)31646-0
DOI:
https://doi.org/10.1016/j.jep.2019.112205
Reference:
JEP 112205
To appear in:
Journal of Ethnopharmacology
Received Date: 25 April 2019
Revised Date:
28 August 2019
Accepted Date: 28 August 2019
Please cite this article as: Anywar, G., Kakudidi, E., Byamukama, R., Mukonzo, J., Shubert, A.,
Oryem-Origa, H., Indigenous traditional knowledge of medicinal plants used by herbalists in treating
opportunistic infections among people living with HIV/AIDS in Uganda, Journal of Ethnopharmacology
(2019), doi: https://doi.org/10.1016/j.jep.2019.112205.
This is a PDF file of an article that has undergone enhancements after acceptance, such as the addition
of a cover page and metadata, and formatting for readability, but it is not yet the definitive version of
record. This version will undergo additional copyediting, typesetting and review before it is published
in its final form, but we are providing this version to give early visibility of the article. Please note that,
during the production process, errors may be discovered which could affect the content, and all legal
disclaimers that apply to the journal pertain.
© 2019 Published by Elsevier B.V.
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
33
34
35
36
37
38
39
40
41
42
43
Ethnopharmacological relevance: Currently, more than two thirds of the world’s 36.9
million people living with HIV/AIDS reside in Sub-Saharan Africa. Opportunistic infections
(OI) associated with HIV are the single most important cause of mortality and morbidity
among HIV/AIDS patients in poor countries. There is widespread use of medicinal plants
species to manage the HIV infection and it’s associated OI in Uganda, even by patients
already on antiretroviral drugs (ARV). However, much of this information remains
undocumented and unverified. Aim of study: The aim of this study was to systematically and
comprehensively document the traditional indigenous knowledge and practices associated
with the management of HIV/AIDS infections by herbalists in Uganda. Methods:
Ethnobotanical data was collected using semi-structured interviews and questionnaires.
Ninety traditional medicine practitioners (TMP) or herbalists were interviewed in Arua,
Dokolo, Mbale, Bushenyi, Iganga, Rakai, Luwero and Kaabong districts to gather
information on the plant species used. Data were analysed and presented using descriptive
statistics and the Informant Consensus Factor. Results: We documented 236 medicinal plant
species from 70 families and 201 genera. Acacia was the most widely represented genus with
five species. The most frequently used medicinal plant species for treating various OI were
Erythrina abyssinica (45), Warbugia ugandensis (43), Zanthoxylum chalybeum (38), Acacia
hockii (37), Mangifera indica (36), Aloe vera (35), Albizia coriaria (34), Azadirachta indica
(32), Psorospermum febrifugum (27) Vernonia amygdalina (22) and Gymnosporia
senegalensis (21). Some of the plant species were used for treating all the OI mentioned.
There is a high degree of consensus among the TMP on which plant species they use for the
different OI, even though they are geographically separated. Herbalists contribute to the
widespread practice of simultaneously using herbal medicines and ARV. Some TMP are also
engaged in dangerous practices like injecting patients with herbs and encouraging
simultaneous use of herbs and ARV. Although the TMP relied on biomedical laboratory
diagnoses for confirming the patients’ HIV sero status, they were familiar with the signs and
symptoms of HIV/AIDS. Conclusion: There is wide spread use of a rich diversity medicinal
plants species and practices by TMP to manage OI in HIV/AIDS patients in Uganda.
44
45
Key words: Medicinal plants; herbalists; opportunistic infections; HIV/AIDS; indigenous;
traditional knowledge; Uganda.
Indigenous traditional knowledge of medicinal plants used by herbalists in treating
opportunistic infections among people living with HIV/AIDS in Uganda
Anywar G*1, 4, Kakudidi E1, Byamukama R2, Mukonzo J3, Shubert, A4, Oryem-Origa H1,
1
Department of Plant Sciences, Microbiology & Biotechnology, College of Natural Sciences,
Makerere University, P.O.Box 7062, Kampala, Uganda
2
Department of Chemistry, College of Natural Sciences, Makerere University, P.O.Box 7062,
Kampala, Uganda
3
Department of Pharmacology & Therapeutics, College of Health Sciences, Makerere University,
P.O.Box 7062, Kampala, Uganda
4
Fraunhofer Institute for Cell Therapy & Immunology (IZI), Perlickstraße 104103, Leipzig, Germany
Corresponding author: godwinanywar@gmail.com / ganywar@cartafrica.org /ganywar@cns.mak.ac.ug
Abstract
46
47
1
48
1.0 Introduction
49
There are about 36.9 million people living with HIV/AIDS (PLHIV) globally, with more than
50
two thirds living in sub-Saharan Africa (SSA), and about 19 million in east and southern
51
Africa alone (UNAIDS, 2018a). Although there has been substantial progress in the fight
52
against HIV/AIDS epidemic in Uganda since it was first reported in 1982 (Mugerwa et al.,
53
1996), there is concern that the prevalence rate, which had dropped from 18.5% in 1995 to
54
6.3% in 2010 has stagnated at 7.4% (MoH, 2010). Currently, there are about 1.3 million
55
PLHIV in Uganda (UNAIDS, 2018a).
56
57
Highly active antiretroviral therapy (HAART) or Antiretroviral therapy (ART) is the most
58
effective clinical intervention for reducing mortality in the HIV infection (Mermin et al.,
59
2008; De Clercq, 2009). However, it can only control the HIV infection among individuals
60
who are on life-treatment and withdrawal of medication leads to re-emergence of the disease
61
(Mukhtar et al., 2008). In spite of the efforts to increase availability of ART, most of those
62
who require it either cannot afford it or do not have access to it (Larsson et al., 2007;
63
UNAIDS, 2018a). In Uganda, only about 67% of the HIV infected adults are on ART, despite
64
the introduction of the WHO test and treatment guidelines in 2015 (UNAIDS, 2018a). Thus
65
HIV/AIDS is not well managed with prescribed medications in resource-poor areas (Holmes,
66
2017).
67
68
Opportunistic infections (OI) and cancers such as Hodgkin’s disease characterise AIDS
69
(Bedoya et al., 2002; Gea-Banacloche, 2006) and are relatively frequent complications,
70
especially at more advanced stages of immunosuppression. Opportunistic infections are the
71
single most important cause of mortality and morbidity in PLHIV in poor countries (Holmes
72
et al., 2003; Mermin et al., 2008). The OI lower the quality of life of PLHIV; hasten the
73
progression to fully blown AIDS and lower patients’ response to ART (Moore & Chaisson,
74
1996). In Uganda, the Northern and Eastern regions have the highest burden of OI both
75
before and after HAART (Rubaihayo et al., 2016). Therefore continued efforts are needed to
76
develop effective strategies for preventing OI particularly in very advanced HIV infection
77
(Moore & Chaisson, 1996).
78
79
Several governments and international organisations have tried to impose total dependence
80
on conventional medicine in combating the HIV/AIDS epidemic. This is done at the expense
81
of traditional medicines and systems of healing which are often depicted as backward,
2
82
ineffective and superstitious (Holmes, 2017), despite their popularity and widespread use
83
especially in PLHIV (Ahmad, 2005; Mills et al., 2005a, 2005b; Haile et al., 2017). In Uganda
84
for instance, more than 90% of the rural population rely on traditional herbal remedies to
85
meet their daily health care needs (Kamatenesi-Mugisha and Oryem-Origa, 2007).
86
87
Even though previous efforts to find a cure or vaccine for HIV/AIDS have not been
88
successful (Mukhtar et al., 2008), the ethnobotanical or ethnopharmacological approach still
89
remains one of the most effective ways in selecting medicinal plants for screening for
90
therapeutic activity (Svetaz et al., 2010; Bagla et al., 2012). Therefore, this study aimed to
91
document the medicinal plant species used by traditional medicine practitioners (TMP) or
92
herbalists in the treatment of PLHIV in Uganda.
93
94
1.0 Methods
95
2.1 Study area
96
This study was conducted in Uganda in the districts of Arua in the Northwest, Dokolo in the
97
North, Mbale and Iganga in the East, Bushenyi in the West, Rakai in the South, Luwero in
98
the central and Kaabong in the North East (Figure 1).
99
Figure 1: Map of Uganda showing study sites
100
2.2 Ethical considerations
101
Ethical approval for this study was obtained from the Higher Degrees Research and Ethics
102
Committee of the School of Biomedical Sciences, College of Health Sciences, Makerere
103
University, and the Uganda National Council of Science and Technology (UNCST) No. HS
104
2233. Written Prior Informed Consent (PIC) was also obtained from the TMP before
105
interviewing them.
106
107
2.3 Study design
108
An ethnobotanical study was conducted on 90 TMP across the country, between March and
109
September 2017. Different local languages were spoken in the selected districts surveyed.
110
Only TMP who had experience of at least five years and were members of local herbalists
111
associations in their districts were selected for the study. This was done to minimise chances
112
of dealing with quacks. Semi-structured interviews were conducted using questionnaires to
113
gather information such as the causes and symptoms of HIV/AIDS, the medicinal plant
114
species used, how they are prepared and where they are harvested. Field guides and
115
interpreters were used to help in locating the TMP and offering translation services.
3
116
2.4 Collection of plant specimens
117
Field excursions with the TMP were conducted to collect voucher specimens of the plant
118
species following standard procedures described in Martin (1995). The plant specimens were
119
deposited at the Makerere University Herbarium for identification and classified according to
120
the Kew database at http://www.theplantlist.org accessed on 4thJanuary-March, 2018 at 18:09
121
EAT. The plant families were checked against the Angiosperm Phylogeny Group IV.
122
123
2.5 Data analysis
124
Ethnobotanical data obtained were analysed and presented using descriptive statistics such as
125
percentage frequencies and the Informant Consensus Factor (FIC) (Trotter and Logan, 1986).
126
The FIC that is an indicator of the level of agreement on use of medicinal plant species on
127
particular ailments was calculated using the formula:
FIC =
Nur − Nt
Nur − 1
128
Where, Nur = number of use reports from informants for a particular plant use category and
129
Nt = number of taxa or species that are used for that use category for all informants. FIC
130
values range between 0 and 1, where 1 indicates the highest level of informant consensus
131
(Trotter and Logan, 1986).
132
133
3.0 Results
134
3.1 Socio-Demographic characteristics of the TMP
135
The mean age of the TMP was 51.1 and their ages ranged from 24-90 years. Over one third
136
(34.4%) of the TMP had attained primary level education, 30.3% had no formal schooling at
137
all, and 5.5% had tertiary level education, including a university graduate. Most TMP were
138
Christian (74.5%), including a priest. The rest were Moslems (24.4%) and animists (1.1%). A
139
majority of TMP were male (66.7%) and subsistence farmers (73.3 %). The rest were full-
140
time herbalists (3.3%), traditional birth attendants (3.3%) and business people (7.8%). Most
141
of the TMP (67.0%) acquired their knowledge from their parents and grand parents only. The
142
rest of the TMP obtained their knowledge from various sources such as through spiritual
143
calling, friends, fellow herbalists, seminars and workshops and other relatives.
144
145
3.2 Medicinal plant species documented
146
We documented 236 medicinal plant species from 70 families and 201 genera (Table 1).
147
Although most of the plant species documented were used to treat the various opportunistic
148
infections mentioned, some were also used for improving the immunity of patients. Most
4
149
plants (46.7%) were harvested from the wild while the rest were grown in home gardens
150
(39.3%) and purchased from local markets (14.0%). The plant species predominantly used
151
were herbs (41.9%), trees (28.6%) and shrubs (19.7%). One parasitic plant, Hyndora
152
abyssinica was also used. Nearly half (45.9%) of the plant parts used were leaves. The bark
153
(18.1%) and roots (17.3%) are also commonly used, whereas other parts such as bulbs,
154
rhizomes, peels and twigs were infrequently used. The families with most species were
155
Fabaceae (30), Asteraceae (24) and Lamiaceae (11).
156
157
The most important medicinal plant species by frequency of mention were Warbugia
158
ugandensis (43), Erythrina abyssinica (38), Acacia hockii (37), Aloe vera (35), Mangifera
159
indica (30), Zanthoxylum chalybeum (29), Psorospermum febrifugum (27), Azadirachta
160
indica (25), Albizia coriaria (24), Gymnosporia senegalensis (21) and Vernonia amygdalina
161
(19). Some medicinal plants such as A. hockii, E. abyssinica, S. longipedunculata and Z.
162
chalybeum, were used in treating all or most of the OI.
163
164
3.3 Methods of preparation, routes of administration and treatment of OI
165
The herbal medicines were mainly prepared as decoctions (63.4%) and as teas or infusions
166
(11.8%). The other methods of preparation such as tinctures, ash and clay tablets were not
167
frequently used. During preparation, adjuncts such as petroleum jelly (9.5%), clay (1.7%),
168
honey (1.2%) and milk (0.9%) were added to the preparations for various reasons. For
169
instance, wet clay was mixed with crushed herbs and moulded into various shapes and sizes
170
and administered as clay tablets. The clay was used as a preservative and binding agent. Milk
171
and honey were used to improve taste and for perceived therapeutic benefits in cough and
172
sore throats. Most herbs were administered orally (81.6%), then topically (15.0%) as herbal
173
ointments made with petroleum jelly. The other methods included inhalation, herbal or steam
174
baths and eardrops. The most unusual route of administration was through intramuscular
175
injections by one TMP.
176
177
Most TMPs reported that HIV was spread through unprotected sex with infected people
178
(43.7%), sharing sharp objects and contact with body fluids at 19.0% each. A majority (77%)
179
of the TMP used both laboratory tests for confirmatory diagnosis of patients and experience.
180
The TMP relied on signs and symptoms such as herpes zoster and wasting. The TMP from Ik
181
community in Kaabong district did not use laboratory services because they were not readily
182
available in the remote difficult to reach area. Counselling was an important part of the
183
services by TMP.
5
184
A great majority of the TMP (86.7%) noted that patients disclosed their sero status to them.
185
The main reasons patients sought the services of TMP were severe side effects from the ARV
186
like nausea, weakness, and recrudescence or failure of some OI to resolve. Depending on the
187
condition the patients presented, TMP would either advise their patients to discontinue ARV
188
treatment and use herbs only or to combine both ARV and herbs and later discontinue the
189
ARV once they improved.
190
191
192
3.4 Informant Consensus Factor (FIC and OI by TMP
193
International Classification of Primary Care (Bentsen, 1986). (Table 2). Only four conditions
194
had FIC values lower than 0.7 i.e. low sexual drive, heart diseases, pain and paralysis and
195
inappetence, and were not included in table 2. The rest had higher FIC values ranging from
196
0.79-0.95. Most (19.1%) of the medicinal plants species were used to treat Gastrointestinal
197
(GIT) diseases such as diarrhoea, dysentery, stomach aches and ulcers. Skin diseases such as
198
rashes, lesions, sores, boils, ringworms and other mycoses followed at 16.4%, then
199
respiratory tract infections such as cough and pulmonary tuberculosis at 8.5%. Opportunistic
200
infections like Herpes zoster, swollen lymph nodes (lymphadenopathy), persistent cough,
201
wasting and oral thrush were considered typical and characteristic of HIV/AIDS infection by
202
most TMP.
203
204
4.0 Discussion
For the FIC analysis, the OI were grouped into 21 broad categories by the TMP and the
205
206
207
4.1 Efficacy of medicinal plants
208
treated by the herbalists are discussed with supporting scientific evidence.
209
4.1.1. Infections
210
Gastrointestinal infections such as chronic diarrhoea are one of the most frequently occurring
211
and devastating complications of HIV infection. People in developing countries are the worst
212
affected with cases as high as 100% previously reported (Colebunders, 1987). Chronic
213
diarrhoea greatly reduces quality of life, results in significant morbidity and mortality and
214
higher costs to health care delivery (Lubeck et al., 1993). In addition, bacterial and fungal
215
infections which are commonly manifested as skin and buccal cavity infections are often the
216
first sign of HIV infection and subsequent conversion to AIDS (Nnoruka, 2005). Over 90%
217
of PLHIV are diagnosed with a skin disease at some point as the disease progresses (Coldiron
218
et al., 1989; Mosam et al., 2004). Candida infections greatly vary but oral candidiasis remains
The efficacies of medicinal plants that were highly cited (>15) vis-à-vis the common OI
6
219
the commonest OI in immunocompromised persons, occurring in up to 95% of PLHIV
220
(Dupont et al., 1992; Wadhwa et al., 2007).
221
frequently. About 33.3% of all PLHIV globally are co-infected with TB and 70% of these are
222
in SSA (UNAIDS, 2018b). HIV is thus the leading risk factor for development of TB and TB
223
is the leading cause of death in PLHIV (WHO, 2018).
Respiratory tract infections also occur
224
225
W. ugandensis, G. senegalensis, E. abyssinica, A. indica, Psidium guajava, Z. chalybeum, M.
226
indica and A. coriaria were the most highly cited medicinal plant species for the various
227
infections. W. ugandensis and Z. chalybeum have in vitro antibacterial and antifungal
228
activities against several species of bacteria and fungi (Olila et al., 2001; Mwitari et al.,
229
2013). G. senegalensis has antimycobacterial and antinflammatory properties (Makgatho et
230
al., 2018). Extracts from E. abyssinica have antimycobacterial activities (Bunalema et al.,
231
2011), whereas extracts from M. indica, P. guajava and A. coriaria all have antibacterial
232
activity (Bbosa et al., 2007; Biswas et al., 2013; Nalubega et al., 2011).
233
234
4.1.2 Malaria
235
Malaria is an important cause of disease in people infected with HIV wherever the two
236
infections coexist (Alemu et al., 2013). The plasmodium parasite weakens the ability of the
237
immune system to trigger an efficient immune response. This might explain why patients
238
with malaria are susceptible to a wide range of other infections (Millington et al., 2006).
239
People from malaria-endemic areas that are considered semi-immune to malaria can also
240
develop clinical malaria when infected with HIV (Alemu et al., 2013). HIV and malaria
241
infections interact with and confound each other. HIV infection can increase the risk and
242
severity of malaria infection and the increased parasite burden might facilitate higher rates of
243
malaria transmission. Malaria infection offers a conducive microenvironment for the spread
244
and quick replication of HIV virus among CD4+ cells by strongly activating them and up-
245
regulating proinflammatory cytokines (WHO, 2004). Malaria is thus a risk factor of
246
concurrent HIV infection at the population level (Cuadros et al., 2011).
247
248
Vernonia amygdalina and Aloe vera were the most highly cited medicinal plants for treating
249
malaria. V. amygdalina extracts also have antimalarial activity in vivo in mice infected with
250
chloroquine resistant and sensitive Plasmodium berghei strains (Iwalokun, 2008). V.
251
amygdalina is moderately clinically effective in the treatment of malaria in adult patients
252
(Challand & Willcox 2009). The extracts of A. vera showed good antiplasmodial activity
7
253
against Chloroquine sensitive strain of P. falciparum (MRC-2) in vivo (Kumar et al., 2017).
254
255
4.1.3 Viral infections
256
Herpes zoster or varicella zoster virus is an acutely painful condition in immunocompromised
257
patients that can occur at all stages of the HIV infection (Stewart et al., 1995). Herpes zoster
258
is frequently looked at as an early indicator of HIV and is reported to be a clinical predictor
259
of HIV infection (Colebunders et al., 1988; Tyndall et al., 1995). Although herpes zoster was
260
a frequently cited condition by the TMP, the only plant species highly cited for treating it was
261
Psorospermum febrifugum. P. febrifugum has antiviral properties (Epifano et al., 2013) and
262
antimicrobial compounds such as febrifuquinone and adamabianthrone (Tsaffack et al.,
263
2009). In a clinical trial to evaluate the effectiveness of herbal treatments used by TMP for
264
treating herpes zoster in PLHIV in Uganda, Homsy et al. (1999) showed that herpes zoster-
265
associated pain resolved substantially and significantly faster among patients receiving
266
treatment from TMP, in comparison to western treatment with the standard drug Acyclovir.
267
In addition, fewer patients on herbal medicines experienced superinfections and keloid
268
formation.
269
270
Various markers of improved overall health such as increased CD4+ counts and decrease in
271
viral load in PLHIV who are using herbal medicines have been verified in clinical tests
272
(Tshibangu et al. 2004). Acacia, the most widely represented genus with five species is not
273
only popular in managing OI in HIV in Uganda but also in other African countries such as
274
Zambia, (Chinsembu, 2016), Tanzania (Kisangau et al., 2011; Maregesi et al., 2010) and
275
Namibia (Chinsembu and Hedimbi, 2010). The widespread use of Acacia species is
276
supported by scientific evidence of its anti-HIV activity. Nutan et al. (2013) for instance
277
demonstrated the ability of A. catechu to suppress of HIV-1 infection in vitro. A.
278
auriculiformis (Mandal et al., 2005) and A. mellifera (Kanyara and Njagi, 2005) also have
279
proven in vitro anti-HIV activity. Other species from our study with proven anti-HIV activity
280
are: Bridelia micrantha and Combretum molle (Bessong et al., 2005), Ximenia americana
281
(Asres et al., 2001) and Maytenus senegalensis, Prunus africana and Rhus natalensis
282
(Kanyara and Njagi, 2005). Punica granatum (Lansky & Newman, 2007) and Moringa
283
oleifera (Nfambi et al., 2015) have significant immonomodulatory activities in vivo
284
285
4.2 Conservation status medicinal plant species used
286
Some of the plant species documented are listed as threatened under the Nationally
8
287
Threatened Species for Uganda, (2016). Afrocarpus usambarensis is listed as endangered:
288
Milicia excelsa as near threatened and Lovoa trichilioides, Afzelia africana, Vitellaria
289
paradoxa and Prunus africana as vulnerable in the wild. However, plant species that have
290
not been red-listed may be at an even greater risk because they have either not been
291
scientifically evaluated or are data deficient. Holmes, (2017) has reported that numerous
292
African tree species commonly used for medicine are either endangered or vulnerable.
293
Since roots are generally popular and widely used in traditional medicine (Mugisha et al.,
294
2014; Lamorde et al., 2015; Chinsembu, 2016), their use puts plants at a higher risk of loss
295
due to the destructive nature of harvesting. The TMP also expressed concern over the scarcity
296
of some herbs especially in Iganga district, where the establishment and expansion of
297
commercial sugarcane plantations have led to the large-scale destruction of natural
298
vegetation. However, TMPs in Luwero, Dokolo, Mbale and Bushenyi have also established
299
medicinal plant gardens to grow some of the important and scarce medicinal plant species.
300
301
302
303
4.3 Preparation and administration of traditional medicine
Several preparations were made by combining various herbs in order to: (i) harness the
304
healing properties of different plant species through synergy, (ii) tackle the multiple OI in
305
HIV/AIDS with the different properties of each herb and (iii) lessen the preparation time and
306
dosage burden and (iv) lower the possible side effects of some herbs such as Albizia spp.
307
which contain toxic compounds such as 4′-Methoxypyridoxine (Botha and Penrith, 2008).
308
The judicious and careful use of some plant species by the TMP demonstrates their
309
awareness of plant toxicity and how to mitigate it. Interestingly, one TMP injected his
310
patients with herbs without any formal medical training. Injections can potentially harm
311
patients because they introduce risks of sciatic nerve injection injury and secondary infection
312
through the reuse of syringes or needles that is common in resource poor settings (Kim and
313
Park, 2014; WHO, 2010).
314
315
Some TMP referred their patients to colleagues but in Iganga, some also referred patients to
316
modern health facilities for testing and management. This has been attributed to collaborative
317
efforts between allopathic doctors and TMP, established by some Non-governmental
318
organisations. Davids et al. (2014) have also reported the existence of elaborate referral
319
networks by TMP treating PLHIV in South Africa.
320
321
322
9
323
4.4 Informant consensus factor (FIC) and opportunistic infections categories
324
The FIC values were generally high for most OI, indicating agreement on the medicinal plant
325
species used despite the large species and cultural diversity and spatial distribution of the
326
TMP. This confirms the cultural significance of the used plant species (Heinrich et al., 1998),
327
and indicates that a large proportion of TMP use relatively few taxa or that information was
328
exchanged between informants (Heinrich et al., 1998; Canales et al. 2005).
329
330
4.5 Causes diagnosis and treatment of OI in PLHIV
331
The TMP have a hybrid knowledge system of traditional and western concepts of HIV/AIDS.
332
Davids et al. (2014) made similar findings in South Africa. The ability of TMPs to recognise
333
important signs and symptoms of HIV/AIDS has been reported in many studies across Africa
334
(Lamorde et al., 2010; Kisangau et al., 2011; Tchouya et al., 2015; Chinsembu et al., 2015;
335
Nyamukuru et al. 2017). Because HIV presents with multiple OI, the services of traditional
336
healers are usually focused on treating such infections. Medicinal plant species are widely
337
used in ameliorating the side effects of ARV (Langlois-Klassen-Klassen et al., 2008;
338
Tchouya et al., 2015). The TMP also use herbs to boost energy levels, improve immunity and
339
appetite and general wellbeing of their patients.
340
341
Lamorde et al. (2010) argued that the use of traditional medicines in HIV/AIDS does not
342
appear to be well developed because HIV/AIDS is a relatively new disease. Other infectious
343
diseases have symptoms similar to those in HIV-related illnesses, which have been
344
commonly treated with herbal medicine irrespective of the underlying medical condition.
345
This justifies the widespread use of herbal medicine in SSA (Homsy et al., 1999; Bodeker,
346
2003).
347
348
349
350
4.6 Concurrent use of herbal medicines and ARV and potential herb-drug interactions
There are several reports confirming that TMP promote the simultaneous use of herbal
351
remedies and ARV by PLHIV. This has been attributed to the chronic nature of the disease,
352
the complexities of treatment modalities and the difficulty in adhering to treatment regimens
353
(Langlois-Klassen et al., 2007; Nagata et al., 2011; Haile et al., 2017). However, herbs
354
potentially interact with HIV drug metabolising enzymes in the body causing herb-drug
355
interactions that could diminish the medication effects of drugs or lead to drug toxicity (Mills
356
et al., 2005c). However, most interactions might have a negligible clinical significance,
357
although some may pose a serious public health threat (Izzo, 2012). One of the widely used
10
358
herbs in this study, Allium sativum as garlic supplements lowers the plasma concentrations of
359
the ARV saquinavir (Piscitelli et al., 2000).
360
361
Additionally, PLHIV rarely disclose their use of herbal medicines to health care providers
362
due to the negative perceptions about herbal medicines and reprimands from them. However,
363
Lubinga et al. (2011) reported that widespread concomitant use of herbal medicines and ART
364
had no association to poor ART adherence in western Uganda. The concomitant use of herbs
365
with ARV can be explained by the fact that TMP are prominent and respected members of
366
society where they are recognised as competent to provide health care. The TMP can
367
therefore influence health-seeking behaviour of patients (UNAIDS, 2002; Liverpool et al.,
368
2004; Dickinson, 2009). In fact, traditional healers provide healthcare to a substantial
369
proportion of PLHIV in high HIV burden countries in SSA (Kisangau et al., 2011; Wanyama
370
et al., 2017) and also constitute a significant proportion of health care providers. The TMP
371
can therefore support the general wellbeing of PLHIV and thereby enhance ARV treatment
372
outcomes (Holmes, 2017).
373
374
However, consulting a TMP because of HIV has been shown to be an independent risk factor
375
for incomplete ART adherence (Wanyama et al. 2017) and causes delays presentation of
376
symptomatic HIV in seropositive persons to a medical clinic by up to several months (Audet
377
et al. 2014). This has negative consequences because the early start of ARV treatment is
378
associated with reduction in risk for most OI and HIV disease in low and middle-income
379
countries (Low et al., 2016).
380
381
Conclusion
382
Herbalists in Uganda use a rich diversity of medicinal plant species to treat opportunistic
383
infections. There is a high degree of consensus among the TMP on which plant species they
384
use for the different opportunistic infections. The TMP contribute to the widespread practice
385
of concurrently using herbal medicines and ARV by encouraging their patients to use herbs
386
concurrently with ARV. The plant species used need to be investigated for therapeutic
387
benefits and safety.
388
Acknowledgement
389
"This research was supported by the Consortium for Advanced Research Training in Africa
390
(CARTA). CARTA is jointly led by the African Population and Health Research Centre and
391
the University of the Witwatersrand and funded by the Carnegie Corporation of New York
11
392
(Grant No--B 8606.R02), Sida (Grant No: 54100029), the DELTAS Africa Initiative (Grant
393
No: 107768/Z/15/Z). The DELTAS Africa Initiative is an independent funding scheme of the
394
African Academy of Sciences (AAS)’s Alliance for Accelerating Excellence in Science in
395
Africa (AESA) and supported by the New Partnership for Africa’s Development Planning
396
and Coordinating Agency (NEPAD Agency) with funding from the Wellcome Trust (UK)
397
(Grant No: 107768/Z/15/Z) and the UK government, " The statements made and views
398
expressed are solely the responsibility of the fellow. We also acknowledge and thank the
399
research assistants Kasozi Dauda, Kibuuka Sserwano Moses, Kizito Medi, Onenarach Walter
400
& Opio Henry, for their dedicated work. We are also grateful to the TMP who gave their
401
consent to take part in this study and to share their knowledge with us.
402
Conflict of interest
403
The authors declare no conflict of interest
404
405
References
406
407
408
409
410
411
412
413
414
415
416
417
418
419
420
421
422
423
424
425
426
427
428
429
430
431
432
433
434
435
Ahmad, K., 2005. Herbal treatment for HIV/AIDS not recommended. The Lancet Infectious
diseases. 5(9): 537.doi: 10.1016/S1473-3099 (05) 70205-X
Alemu, A., Shiferaw, Y., Addis, Z., Mathewos, B., Birhan, W., 2013. Effect of malaria on
HIV/AIDS transmission and progression. Parasites & Vectors. 6:18.
Asres, K., Bucar, F., Kartnig, T., Witvrouw, M., Pannecouque, C., De Clercq, E., 2001.
Antiviral activity against human immunodeficiency virus type 1 (HIV-1) and type 2
(HIV-2) of ethnobotanically selected Ethiopian medicinal plants. Phytotherapy
Research.
15(1):
62-9.doi:
10.1002/1099-1573(200102)
15:1<62:AIDPTR956>3.0.CO;2-X
Audet, C.M., Blevins, M., Rosenberg, C., Farnsworth, S., Salato, J., Fernandez, J., Vermund,
S.H., 2014. Symptomatic HIV-positive persons in rural Mozambique who first consult
a traditional healer have delays in HIV testing: A cross-sectional study. Journal of
acquired immune deficiency syndromes (1999). 66(4): e80-6. doi:
10.1097/qai.0000000000000194
Bbosa, G. S., Kyegombe, D. B., Ogwal-Okeng, J., Bukenya-Ziraba, R., Odyek, O., & Waako,
P., 2007. Antibacterial activity of Mangifera indica (L.). African Journal of Ecology,
45(s1), 13-16. doi: 10.1111/j.1365-2028.2007.00731.x
Bedoya, L.M., Palomino, S.S., Abad, M.J., Bermejo, P., Alcami, J., 2002. Screening of
selected plant extracts for in vitro inhibitory activity on Human Immunodeficiency
Virus. Phytotherapy Research. 16(6): 550-4. doi: 10.1002/ptr.992
Bentsen, B. G. 1986. International Classification of Primary Care. Scandinavian Journal of
Primary Health Care, 4(1), 43-50. doi: 10.3109/02813438609013970
Bessong, P.O., Obi, C.L., Andréola, M.L., Rojas, L.B., Pouysegu, L., Igumbor, E, Meyer, S.,
Quideau, Litvak, S., 2005. Evaluation of selected South African medicinal plants for
inhibitory properties against human immunodeficiency virus type 1 reverse
transcriptase and integrase. J Ethnopharmacol. 99. doi: 10.1016/j.jep.2005.01.056
Biswas, B., Rogers, K., McLaughlin, F., Daniels, D., & Yadav, A., 2013. Antimicrobial
Activities of Leaf Extracts of Guava (Psidium guajava L.) on Two Gram-Negative
and Gram-Positive Bacteria. International Journal of Microbiology, 2013, 7. doi:
10.1155/2013/746165
12
436
437
438
439
440
441
442
443
444
445
446
447
448
449
450
451
452
453
454
455
456
457
458
459
460
461
462
463
464
465
466
467
468
469
470
471
472
473
474
475
476
477
478
479
480
481
482
483
484
Bodeker, G., 2003. Traditional medicine, in: Cook, G., Zumla, A., (Eds.), Manson’s Tropical
Disease. 21st ed. London: W.B. Saunders, 33–48.
Botha, C.J., Penrith, M.L., 2008. Poisonous plants of veterinary and human importance in
southern Africa. J Ethnopharmacol. 119 (3), 549–558.https://doi.org/10.
1016/j.jep.2008.07.022
Bunalema, L., Kirimuhuzya, C., Tabuti, J. R., Waako, P., Magadula, J. J., Otieno, N., Orodho
J.A., Okemo, P., 2011. The efficacy of the crude root bark extracts of Erythrina
abyssinica on rifampicin resistant Mycobacterium tuberculosis. Afr Health Sci, 11(4),
587-593.
Canales, M., Hernandez, T., Caballero, J., Romo, de Vivar A., Avila, G., Duran, A., Lira, R.,
2005. Informant consensus factor and antibacterial activity of the medicinal plants
used by the people of San Rafael Coxcatlan, Puebla, Mexico. J Ethnopharmacol.
97(3): 429-39.doi: 10.1016/j.jep.2004.11.013
Challand, S., & Willcox, M., 2009. A critical trial of the traditional medicine V. amygdalina
in the treatment of uncomplicated malaria. J Altern Complement Med, 15. doi:
10.1089/acm.2009.0098
Chinsembu, K.C., 2016. Ethnobotanical Study of Plants Used in the Management of
HIV/AIDS-Related Diseases in Livingstone, Southern Province, Zambia. EvidenceBased Complementary and Alternative Medicine. 2016:14.
Chinsembu, K.C., Hedimbi, M., 2010. An ethnobotanical survey of plants used to manage
HIV/AIDS opportunistic infections in Katima Mulilo, Caprivi region, Namibia. J
Ethnobiol Ethnomed. 6:25
Coldiron, B.M., Bergstresser, P.R., 1989. Prevalence and clinical spectrum of skin disease in
patients infected with human immunodeficiency virus. Archives of dermatology.
125(3): 357-61.
Colebunders, R., Francis, H., Mann, J.M., Bila, K.M., Izaley, L., Kimputu, L., Behets, F.,
Van der Groen, G., Quinn, T.C., Curran, J.W., 1987. Persistent diarrhea, strongly
associated with HIV infection in Kinshasa, Zaire. The American journal of
gastroenterology. 82(9): 859-64.
Colebunders, R, Mann, J.M., Francis, H., Bila, K., Izaley, L., Ilwaya, M, Kakonde, N.,
Quinn, T.C., Curran, J.W., Piot, P., 1988. Herpes zoster in African patients: a clinical
predictor of human immunodeficiency virus infection. The Journal of infectious
diseases. 157(2): 314-8.
Cuadros, D.F., Branscum, A.J., Crowley, P.H., 2011. HIV-malaria co-infection: effects of
malaria on the prevalence of HIV in East sub-Saharan Africa. International journal of
epidemiology. 40(4): 931-9. doi: 10.1093/ije/dyq256
Davids, D., Blouws, T., Aboyade, O., Gibson, D., De, Jong, J.T., Van’t Klooster, C., Gail, H.,
2014. Traditional health practitioners’ perceptions, herbal treatment and management
of HIV and related opportunistic infections. Journal of Ethnobiology and
Ethnomedicine. 10(1): 77. doi: 10.1186/1746-4269-10-77
De Clercq E., 2009. Anti-HIV drugs: 25 compounds approved within 25 years after the
discovery of HIV. International Journal of Antimicrobial Agents. 33 (4): 307-20.doi:
http://dx.doi.org/10.1016/j.ijantimicag.2008.10.010
Dickinson, D., 2008. Traditional healers, HIV/AIDS and company programmes in South
Africa. African journal of AIDS research: AJAR. 7(3): 281-91.
Dupont, B., Graybill, J.R., Armstrong, D., Laroche, R., Touze, J.E, Wheat, L.J., 1992. Fungal
infections in AIDS patients. Journal of medical and veterinary mycology. 30 Suppl
1:19-28.
Epifano, F., Fiorito, S., & Genovese, S., 2013. Phytochemistry and pharmacognosy of the
13
485
486
487
488
489
490
491
492
493
494
495
496
497
498
499
500
501
502
503
504
505
506
507
508
509
510
511
512
513
514
515
516
517
518
519
520
521
522
523
524
525
526
527
528
529
530
531
532
533
534
genus Psorospermum. Phytochemistry Reviews, 12(4), 673-684. doi:
10.1007/s11101-013-9274-8
Gea-Banacloche, J.C., 2006. Immunomodulation. In Principles of molecular medicine
Eds.Marschall S. R, Patterson C. Humana Press. DOI10.1007/978-1-59259-963-9.
Haile, K.T., Ayele, A.A., Mekuria, A.B., Demeke, C.A., Gebresillassie, B.M., Erku, D.A.,
2017. Traditional herbal medicine use among people living with HIV/AIDS in
Gondar, Ethiopia: Do their health care providers know? Complementary Therapies in
Medicine. 35:14-9.doi: https://doi.org/10.1016/j.ctim.2017.08.019
Heinrich, M., Ankil, A., Frei, B., Weimann, C., Sticher, O., 1998. Medicinal plants in
Mexico; Healers, Consensus and Cultural importance. Soc Sci Med. 47. doi:
10.1016/s0277-9536(98)00181-6
Holmes, B., Losina, E., Walensky, R., Yazdanpanah, Y., Freedberg, K., 2003. Review of
human immunodeficiency virus type 1-related opportunistic infections in Sub-Saharan
Africa. Clin Infect Dis. 36:652–62.
Holmes, T., 2017. Shifts in African Traditional Herbal medicine (THM): Relevance for
HIV/AIDS, as Foremost Among New Diseases, and Impacts of Stigma and Culture
Change: A Review/ Africa: Moving the Boundaries. Proceedings of the 39th African
Studies Association of Australasia and the Pacific (AFSAAP) Annual Conference, 5-7
December 2016, The University of Western Australia.
Homsy, J., Katabira, E., Kabatesi, D., Mubiru, F., Kwamya, L., Tusaba, L., Kasolo, C.,
Mwebe, D., Ssentamu, L., Okello, M., King, R., 1999. Evaluating herbal medicine for
the management of Herpes zoster in human immunodeficiency virus-infected patients
in Kampala, Uganda. Journal of alternative and complementary medicine (New York,
NY). 5(6): 553-65.
Iwalokun, B. A. (2008). Enhanced antimalarial effects of chloroquine by aqueous Vernonia
amygdalina leaf extract in mice infected with chloroquine resistant and sensitive
Plasmodium berghei strains. Afr Health Sci, 8(1), 25-35.
Izzo, A.A., 2012. Interactions between Herbs and Conventional Drugs: Overview of the
Clinical Data. Medical Principles and Practice. 21(5): 404-28.
Kamatenesi-Mugisha, M., Oryem-Origa, H., 2007. Medicinal Plants used to induce labour
during childbirth in Western Uganda. J Ethnopharmacol. 109.doi:
10.1016/j.jep.2006.06.011
Kanyara, J.N., Njagi, E.N.M., 2005. Anti-HIV-1 activities in extracts from some medicinal
plants as assessed in an in vitro biochemical HIV-1 reverse transcriptase assay.
Phytotherapy Research. 19(4): 287-90. doi: 10.1002/ptr.1536
Kim, H.J., Park, S.H., 2014. Sciatic nerve injection injury. Journal of International Medical
Research. 42(4): 887-97.
Kisangau, D.P., Herrmann, T.M., Lyaru, H., Hosea, K., Joseph, C., Mbwambo, Z., Masimba,
P., 2011. Traditional Knowledge, Use Practices and Conservation of Medicinal Plants
for HIV/AIDS Care in Rural Tanzania. 9:15. doi: 10.17348/era.9.0.43-57
Kumar, S., Yadav, M., Yadav, A., Rohilla, P., & Yadav, J. P., 2017. Antiplasmodial potential
and quantification of aloin and aloe-emodin in Aloe vera collected from different
climatic regions of India. 17(1), 369. doi: 10.1186/s12906-017-1883-0
Langlois-Klassen, D., Kipp, W., Jhangri, G.S., Rubaale, T., 2007. Use of Traditional Herbal
Medicine by AIDS Patients in Kabarole District, Western Uganda. The American
Journal of Tropical Medicine and Hygiene. 77(4): 757-63.
Langlois-Klassen, D., Kipp, W., Rubaale, T., 2008. Who’s talking? Communication between
health providers and HIV-infected adults related to herbal medicine for AIDS
treatment
in
western
Uganda.
Soc
Sci
Med.
67.
doi:
http://dx.doi.org/10.1016/j.socscimed.2008.02.027
14
535
536
537
538
539
540
541
542
543
544
545
546
547
548
549
550
551
552
553
554
555
556
557
558
559
560
561
562
563
564
565
566
567
568
569
570
571
572
573
574
575
576
577
578
579
580
581
582
583
584
Lamorde, M., Tabuti, J.R.S., Obua, C., Kukunda-Byobona, C., Lanyero, H., ByakikaKibwika, P., Bbosa, G.S., Lubega, A., Ogwal-Okeng, J., Ryan, M., Waako P.J.,
Merry, C., 2010. Medicinal plants used by traditional medicine practitioners for the
treatment of HIV/AIDS and related conditions in Uganda. J Ethnopharmacol. 130(1):
43-53.doi: http://dx.doi.org/10.1016/j.jep.2010.04.004
Lansky, E.P., Newman, R.A., 2007. Punica granatum (pomegranate) and its potential for
prevention and treatment of inflammation and cancer. J Ethnopharmacol. 109(2), 177206. doi: 10.1016/j.jep.2006.09.006
Larsson, E.C., Okong, P., Thorson, A., Ekström, A.M., 2007. Antiretroviral treatment of HIV
in Uganda: a comparison of three different delivery models in a single hospital.
Transactions of the Royal Society of Tropical Medicine and Hygiene. 101(9), 885892.doi:http://dx.doi.org/10.1016/j.trstmh.2007.04.024http://dx.doi.org/10.1016/j.vacc
ine.2010.07.021
Liverpool, J., Alexander, R., Johnson, M., Ebba, E.K., Francis, S., Liverpool, C., 2004.
Western medicine and traditional healers: partners in the fight against HIV/AIDS. J
Natl Med Assoc. 96.
Low, A., Gavriilidis, G., Larke, N., Marie-Renee B-Lajoie, BL., Drouin O, Stover J, Muhe
L., Easterbrook P., 2016. Incidence of Opportunistic Infections and the Impact of
Antiretroviral Therapy Among HIV-Infected Adults in Low- and Middle-Income
Countries: A Systematic Review and Meta-analysis. Clin Infect Dis. 62(12): 1595603. doi: 10.1093/cid/ciw125
Lubeck, D.P., Bennett, C.L., Mazonson, P.D., Fifer, S.K., Fries, J.F., 1993. Quality of life
and health service use among HIV-infected patients with chronic diarrhoea. Journal of
acquired immune deficiency syndromes. 6(5): 478-84.
Lubinga, S.J., Kintu, A., Atuhaire, J., Asiimwe, S., 2012. Concomitant herbal medicine and
Antiretroviral Therapy (ART) use among HIV patients in Western Uganda: a crosssectional analysis of magnitude and patterns of use, associated factors and impact on
ART adherence. AIDS Care. 24(11): 1375-83. doi: 10.1080/09540121.2011.648600
Makgatho, M.E., Nxumalo, W., & Raphoko, L.A., 2018. Anti-mycobacterial, -oxidative, proliferative and -inflammatory activities of dichloromethane leaf extracts of
Gymnosporia senegalensis (Lam.) Loes. South African Journal of Botany, 114, 217222. doi: https://doi.org/10.1016/j.sajb.2017.11.002
Mandal, P., Babu, S.P.S., Mandal, N.C., 2005. Antimicrobial activity of saponins from
Acacia auriculiformis. Fitoterapia. 76(5): 462-465.
Maregesi, S.M., Pieters, L., Ngassapa, O.D., Apers, S., Vingerhoets, R., Cos, P., Berghe,
D.A.V., Vlietinck, A.J. 2008. Screening of some Tanzanian medicinal plants from
Bunda district for antibacterial, antifungal and antiviral activities. Journal of
Ethnopharmacology. 119(1): 58-66.doi: http://dx.doi.org/10.1016/j.jep.2008.05.033
Martin, G.J., 1995. Ethnobotany: A Methods Manual. Chapman & Hall, London.
Mermin, J., Were, W., Ekwaru, J.P., Moore, D., Downing, R., Behumbiize, P., Lule, J.R.,
Coutinho, A., Tappero, J., Bunnell, R., 2008. Mortality in HIV-infected Ugandan
adults receiving antiretroviral treatment and survival of their HIV-uninfected children:
a prospective cohort study. Lancet. 1; (371) 752-59.doi: 10.1016/S0140-6736 (08)
60345-1.
Millington, O.R., Di Lorenzo, C., Phillips, R.S., Garside, P., Brewer, J.M., 2006. Suppression
of adaptive immunity to heterologous antigens during Plasmodium infection through
hemozoin-induced failure of dendritic cell function. Journal of Biology. 5(2): 5.
Mills, E., Cooper, C., Seely, D., Kanfer, I., 2005a. African herbal medicines in the treatment
of HIV: Hypoxis and Sutherlandia. An overview of evidence and pharmacology. Nutr
J. 4. doi: 10.1186/1475-2891-4-19
15
585
586
587
588
589
590
591
592
593
594
595
596
597
598
599
600
601
602
603
604
605
606
607
608
609
610
611
612
613
614
615
616
617
618
619
620
621
622
623
624
625
626
627
628
629
630
631
632
633
634
Mills, E.J., Foster, B.C., van Heeswijk, R.P., Wilson, K.E.P., Kosuge, K., Kanfer, I., 2005c.
Impact of African herbal medicines on antiretroviral metabolism. Aids. 19.
Mills, E., Montori, V., Perri, D., Phillips, E., Koren, G., 2005b. Natural health product-HIV
drug interactions: a systematic review. Int JSTD AIDS. 16. doi:
10.1258/0956462053420103
Ministry of Health (MoH) Uganda, 2010.The Status of the HIV/AIDS Epidemic in Uganda.
The HIV/AIDS Epidemiological Surveillance Report STD/AIDS Control Programme
Mosam, A., Irusen, E.M., Kagoro, H., Aboobaker, J., Dlova, N., 2004. The impact of human
immunodeficiency virus/acquired immunodeficiency syndrome (HIV/AIDS) on skin
disease in KwaZulu-Natal, South Africa. International journal of dermatology. 43(10):
782-3. doi: 10.1111/j.1365-4632.2004.02187.x
Moore, R.D., Chaisson, R.E., 1996. Natural history of opportunistic disease in an HIVinfected urban clinical cohort. Annals of internal medicine. 124(7): 633-42.
Mugerwa, R.D., Marum, L.H., Serwadda, D., 1996. Human immunodeficiency Mugerwa RD,
Marum LH, Serwadda D. Human immunodeficiency virus and AIDS in Uganda. East
African medical journal. 73(1): 20-6.
Mugisha, M.K., Asiimwe, S., Namutebi, A., Borg-Karlson, A-K., Kakudidi, E.K., 2014.
Ethnobotanical study of indigenous knowledge on medicinal and nutritious plants
used to manage opportunistic infections associated with HIV/AIDS in western
Uganda.
J
Ethnopharmacol
155(1):
194-202.
doi:
https://doi.org/10.1016/j.jep.2014.05.012
Mukhtar, M., Arshad, M., Ahmad, M., Pomerantz, R.J., Wigdahl, B., 2008. Parveen, Z.,
Antiviral potentials of medicinal plants. Virus Research. 131(2): 111-20. doi:
http://dx.doi.org/10.1016/j.virusres.2007.09.008
Mwitari, P. G., Ayeka, P. A., Ondicho, J., Matu, E. N., & Bii, C. C. (2013). Antimicrobial
activity and probable mechanisms of action of medicinal plants of Kenya: Withania
somnifera, Warbugia ugandensis, Prunus africana and Plectrunthus barbatus. PLOS
ONE, 8(6), e65619. doi: 10.1371/journal.pone.0065619
Namuddu, B., Kalyango, J.N., Karamagi, C., Mudiope, P., Sumba, S., Kalende, H.,
Wobudeya, E., Kigozi, B.K., Waako, P., 2011. Prevalence and factors associated with
traditional herbal medicine use among patients on highly active antiretroviral therapy
in Uganda. BMC Public Health. 11(1): 1-9.
Nalubega, R., Kabasa, J. D., Olila, D., & Kateregga, J. 2011. Antibacterial activity and
phytochemical screening of eleven plants used as poultry ethnomedicines in southern
Uganda. Agric J, 6(6), 303-309.
Nationally Threatened Species for Uganda. National Red List for Uganda for the following
Taxa: Mammals, Birds, Reptiles, Amphibians, Butterflies, Dragonflies and Vascular
Plants,
2016.
http://www.nationalredlist.org/files/2016/03/National-Redlist-forUganda.pdf (accessed 2 February 2019).
Nfambi, J., Bbosa, G.S., Sembajwe, L.F., Gakunga, J., Kasolo, J.N., 2015.
Immunomodulatory activity of methanolic leaf extract of Moringa oleifera in Wistar
albino rats. J Basic Clin Physiol Pharmacol, 26(6), 603-611. doi: 10.1515/jbcpp-20140104
Nnoruka, E.N., 2005. Skin diseases in southeast Nigeria: a current perspective. International
journal of dermatology. 44(1): 29-33. doi: 10.1111/j.1365-4632.2004.02485.x
Nutan, M.M, Dezzutti, C.S. Kulshreshtha, S., Rawat, A.K.S. Srivastava, S.K., Malhotra, S.
Verma, A. Ranga, U., Gupta, S. K., 2013. Extracts from Acacia catechu suppress
HIV-1 replication by inhibiting the activities of the viral protease and Tat. Virology
Journal. 10(1): 1-17. doi: 10.1186/1743-422X-10-309
Nyamukuru, A., Tabuti, J.R.S., Lamorde, M., Kato, B., Sekagya, Y., Aduma, P.R., 2017.
16
635
636
637
638
639
640
641
642
643
644
645
646
647
648
649
650
651
652
653
654
655
656
657
658
659
660
661
662
663
664
665
666
667
668
669
670
671
672
673
674
675
676
677
678
679
680
681
682
683
684
Medicinal plants and traditional treatment practices used in the management of
HIV/AIDS clients in Mpigi District, Uganda. Journal of Herbal Medicine. 7:51-8. doi:
https://doi.org/10.1016/j.hermed.2016.10.001
Olila, D., Olwa-Odyek, Opuda-Asibo, J. (2001). Antibacterial and antifungal activities of extracts of Zanthoxylum chalybeum and Warburgia ugandensis, Ugandan medicinal
plants. African Journal of Health Sciences 1 (2), 66–72.
Piscitelli, S.C., Burstein, A.H., Welden, N., Gallicano, K.D., Falloon, J., 2002. The effect of
garlic supplements on the pharmacokinetics of saquinavir. Clin Infect Dis. 34(2): 234238.
Rubaihayo, J., Tumwesigye, N.M., Konde-Lule, J., Wamani, H., Nakku-Joloba, E.,
Makumbi, F., 2016. Frequency and distribution patterns of opportunistic infections
associated with HIV/AIDS in Uganda. BMC research notes. 9(1): 501. doi:
10.1186/s13104-016-2317-7
Stewart, J.A., Reef, S.E., Pellett, P.E., Corey, L., Whitley, R.J., 1995. Herpesvirus infections
in persons infected with human immunodeficiency virus. Clin Infect Dis. 21 Suppl
1:S114-20.
Svetaz, L., Zuljan, F., Derita, M., Petenatti, E., Tamayo, G., Cáceres, A., Cechinel, V., Filho,
A., Giménez, R., Pinzón, S. Zacchino, A., Gupta, M., 2010. Value of the
ethnomedical information for the discovery of plants with antifungal properties. A
survey among seven Latin American countries. J Ethnopharmacol. 127(1): 13758.doi: http://dx.doi.org/10.1016/j.jep.2009.09.034
Tchouya, G.R., Souza, A., Tchouankeu, J.C., Yala, J.F., Boukandou, M, Foundikou, H.,
Obiang, G.D., Boyom, F.F., Mabika, R.M., Menkem, E.Z., Ndinteh, D.T., Lebibi, J.,
2015. Ethnopharmacological surveys and pharmacological studies of plants used in
traditional medicine in the treatment of HIV/AIDS opportunistic diseases in Gabon. J
Ethnopharmacol. 162:306-16.doi: 10.1016/j.jep.2014.12.052
Trotter, R.T., Logan, M.H., 1986. Informant Consensus: A new approach for identifying
potentially effective medicinal plants. In plants used in indigenous medicine:
Biocultural approaches Etkin N, editor. Redgrave Publications. 91-112
Tsaffack, M., Nguemeving, J. R., Kuete, V., Ndejouong Tchize Ble, S., Mkounga, P., Penlap
Beng, V., Hultin P.G., Tsamo, E., Nkengfack, A.E., 2009. Two new antimicrobial
dimeric compounds: febrifuquinone, a vismione-anthraquinone coupled pigment and
adamabianthrone, from two Psorospermum species. Chem Pharm Bull (Tokyo),
57(10), 1113-1118.
Tshibangu, K.C., Worku, Z.B., de Jongh, M.A., van Wyk, A.E., Mokwena, S.O., Peranovic,
V., 2004. Assessment of effectiveness of traditional herbal medicine in managing
HIV/AIDS patients in South Africa. East African medical journal. 81(10): 499-504.
Tyndall, M.W., Nasio, J., Agoki, E., Malisa, W., Ronald, A.R., Ndinya-Achola, JO.,
Plummer, F.A., 1995. Herpes zoster as the initial presentation of human
immunodeficiency virus type 1 infection in Kenya. Clin Infect Dis. 21(4): 1035-7.
UNAIDS, 2002. Ancient Remedies, New Disease: Involving traditional healers in increasing
access to AIDS care and prevention in East Africa. United Nations Programme On
HIV/AIDS, Geneva, Switzerland. http://data.unaids.org/publications/irc-pub02/jc761ancientremedies_en.pdf (accessed 22 October 2018).
UNAIDS. 2018a. HIV and AIDS estimates. Global factsheets 2018 http://aidsinfo.unaids.org
UNAIDS. 2018b. ‘Ending tuberculosis and AIDS: a joint response in the era of the
Sustainable
Development
Goals
country
submissions’
https://www.unaids.org/sites/default/files/media_asset/20180625_UNAIDS_PCB42_
CRP3_Thematic_TBHIV-Country-Submissions_EN.pdf Accessed on 31/Aug/2019
13:02 EAT
17
685
686
687
688
689
690
691
692
693
694
695
696
697
698
Wadhwa, A., Kaur, R., Agarwal, S.K., Jain, S., Bhalla, P., 2007. AIDS-related opportunistic
mycoses seen in a tertiary care hospital in North India. J Med Microbiol. 56(Pt 8):
1101-6. doi: 10.1099/jmm.0.46893-0
Wanyama, J.N., Tsui, S., Kwok, C., Wanyenze, R.K., Denison, J.A., Koole, O., van Praag,
E., Castelnuovo, B., Wabwire-Mangen, F., Kwesigabo, G.P., Colebunders, R. 2017.
Persons living with HIV infection on antiretroviral therapy also consulting traditional
healers: a study in three African countries. International Journal of STD & AIDS.
28(10): 1018-27. doi: 10.1177/0956462416685890
WHO, 2004. Malaria and HIV interactions and their implications for Public Health Policy.
Geneva, Switzerland: WHO.
WHO, 2010. World Health Organisation best practices for injections and related procedures
toolkit. Geneva, Switzerland
WHO, 2018 ‘HIV-Associated Tuberculosis: factsheet’ https://www.who.int/tb/areas-ofwork/tb-hiv/tbhiv_factsheet.pdf?ua=1 Accessed on 31/Aug/2019 13:014 EAT
18
1
Table 2: Informant consensus factor (FIC) for the different categories of OI treated by TMPs
Ailment
No of species (Nt)
No of citations (Nur) FIC
1. Gastrointestinal Tract diseases
90
534
0.83
2. Skin diseases
77
423
0.82
3. Respiratory tract infections
59
479
0.88
4. Malaria & persistent fevers
49
302
0.84
5. Fatigue
39
307
0.88
6. Sexually Transmitted Infections (STI)
24
233
0.90
7. Mental illness
18
133
0.87
8. Anaemia
13
171
0.93
9. Herpes zoster
13
57
0.79
10. Blood tonic/ cleanser
11
111
0.91
11. Infections (Ear, nose & others)
8
25
0.71
12. Oral diseases
8
49
0.85
13. Cancer
8
68
0.90
14. Lymphadenopathy
5
31
0.87
15. Kidney & liver disease
4
45
0.93
16. Wasting
3
38
0.95
2
1
Table 1 Medicinal plants used to manage HIV/AIDS and its related opportunistic infections by traditional medicine practitioners in Uganda
Family, Scientific, Name (Voucher No.)
Acanthaceae
1. Acanthus pubescens (Oliv.) Engl. (AG422)
2. Asystasia mysorensis (Roth) T. Anderson (AG434)
3. Dicliptera laxata C.B.Clarke (AG 455)
4. Justicia betonica L. (AG 438)
5. Justicia ladanoides Lam. (AG460)
6. Thunbergia alata Bojer ex Sims (AG442)
Amaranthaceae
7. Amaranthus dubius Mart. ex Thell. (AG361)
8. Amaranthus sp (AG 362)
Local names
Hb
Condition(s) treated
PU
F
MoP
Matovu [Lug], Muswata [Lus]
Tembabagole [Lug]
Ffuula [Lus, Gis], Nyarwefora [Ru]
Nalongo [Lug], Chloroquine* [Lan]
Ekwirigwiny [Lgb]
Wankuura [Ru]
Sh
H
H
H
H
Cl
Syphilis, tonsillitis
Herpes zoster & fever
Anaemia
Fever & malaria
Cough
Diarrhoea & abdominal pain
R
L
L
R, L
L
3
2
10
8
1
1
D
D
D/In
D
D
D
Doodo [Lug]
Amaranth*
H
H
Inappetence
Inappetence, cough, fatigue, nausea & flu
L
Sd
1
2
D
D/Po
9. Aerva lanata (L.) Juss. (AG369)
Mwenza [Ru]
H
10. Chenopodium opulifolium Schrad.
Mwetango [Lus & Gis]
H
Kikwansi [Ru]
Mujumbajumba [Ru]
H
H
Wounds
Headache
Ear infection
Persistent fevers
Skin infections
Stomach ache
L
L
L
L
L
L
4
1
1
1
2
1
In
B
In
D
O
D
Mukontambaale [Lus], Kibumbu [Gis]
T
Fever
B
4
D
Muyembe [Lug & Gis], Mahembe [Lan],
Mengu [Lgb]
T
B/R/L
30
D/O
T
Sh
Cough, TB, fatigue, anaemia, diarrhoea, abdominal aches,
vomiting, body/skin infections
Dysentery
Wounds
Diarrhoea, dysentery, fever, cough, chest pain, wounds
B, L
B
B/L/R
1
1
9
D/Injection
D
Tea/ D
Mugaali [Lug], Ilipaku [Lgb]
Kitafeeri [Lug]
T
T
Diarrhoea & respiratory infections
Cancer
B, L
R/L/Fr
4
2
D
D
Mweyihaho [Ru]
H
Cough
L
1
D /Chew
Skin infections, lesions
Malaria, fevers
Fatigue
Condition(s) treated
Diarrhoea, fatigue, syphilis
L
B
R
PU
R/L/B
2
2
1
Fi
6
O
D
Chew
MoP
D/ In
ex W.D.J.Koch & Ziz (AG 446)
11. Cyathula uncinulata (Schrad.) Schinz (AG481)
12. Dysphania procera (Hochst. ex
Moq.) Mosyakin & Clemants. (AG490)
Anacardiaceae
13. Lannea barteri (Oliv.) Engl. (AG 377)
14. Mangifera indica L. (AG401)
15. Pseudospondias microcarpa (A.Rich.) (AG 626)
16. Searsia pyroides (Burch.) Moffett (AG 381)
Annonaceae
17. Annona senegalensis Pers. (AG489)
18. Anona Muricata L. (AG512)
Apiaceae
19. Agrocharis incognita (C.Norman)
Heywood & Jury (AG529)
20. Centella asiatica (L.) Urb. (AG388)
21. Alstonia boonei De Wild. (AG390)
22. Daucus carota L. (AG473)
Family, Scientific, Name (Voucher No.)
23. Steganotaenia araliaceae Hochst. (AG464)
Muziru [Lus]
Kakwansokwanso [Lug],Bilkibil [Lgb]
Musheshe/Mukanja [Ru], Kakunso [Lus]
Kutukumwe [Ru]
Mubajjangalabi [Lun]
Karoti*
Local names
Buco [Lgb], Elwilwi [Lan]
H
T
H
Hb
T
1
Apocynaceae
24. Carrisa spinarum L. Syn. C. edulis (Forssk.) Vahl
25. Cynanchum viminale (L.) (AG514)
26. Cryptolepis sanguinolenta (Lindl.) Schltr. (AG480)
27. Mondia whytei (Hook.f.) Skeels. (AG373)
28. Pachycarpus lineolatus (Decne.) Bullock (AG479)
29. Plumeria rubra L. (AG513)
Aristolochiaceae
30. Aristolochia littoralis Parodi (AG491)
Asparagaceae
31. Asparagus africanus Lam. (AG463)
32. Dracaena steudneri Engl. (AG385)
Empakulo
Alacku/Alakalak [Lgb]
Kafulu [Lug & Lus]
Mulondo [Lug & Lus], Orono [Lan]
Loupe [Ik]
Musikamoli [Lug], Musikamori [Ru]
Sh
Cl
H
Cl
H
T
Joint & body aches & pain
Stomach ache
Skin infections
Fatigue, anaemia, inappetence, diarrhoea
Stomach ache
Herpes zoster
R
Ap
R
R
R
Sp
1
1
4
3
3
8
D
Roast+ Sl
D
In/Chew
Musujja awalaba [Ru] Nakasero [Lug],
Pilopilo [Lgb]
H
Skin allergy/infections, fever
Fr/L/Sd
4
D/Swallow
seeds/In
Minimini [Lgb]
Kajjolyenjovu [Lug & Lus] Mugorora [Ru]
H
T
Syphilis, gonorrhoea, cough
All symptoms
TB & cough
Skin rashes
R
B, R, L
B, L
8
8
4
2
H
H
H
H
H
H
H
H
H
Scr
H
H
H
H
Scr
H
H
H
H
H
H
Sh
Persistent fevers, hiccough
Cancer, cough, indigestion, cleanser, malaria/fever
Fevers & malaria
STI, skin infections, cough, stomach ache, malaria
Malaria, fevers, diarrhoea, stomach aches, ulcers
Cleansing, anaemia
Infections, diarrhoea,
Diarrhoea & dysentery
All HIV symptoms, poisoning,, diarrhoea, headache
Skin infections
Infection e.g. cough, sinuses, blood cleanser
Stomach ache
Skin rash
Diarrhoea & skin infections
Fever
Ulcers, STI, wounds
Vomiting
Fatigue, stomach ache
Diarrhoea, dysentery, stomach aches, itchy skin
Diarrhoea, vomiting, malaria
Fever
Fever/Malaria
Diarrhoea, stomach disorders, cough,
L
L
L
L
L, Fl
R, Ap
L
L
L, B, R
L, St
R&L
R
L
2
3
2
3
11
2
2
1
7
1
1
1
1
1
1
3
1
1
4
1
1
19
3
D
D/Snf/Cl
D/Lick P
O
D
D
In + Rock Sl
D
D
D
D
D
D
D/Sq
D+ B
D
D
O
D
D/B
D
D
B/D/Sq
D
Tn
D/B
D/In
D
Astaraceae
33. Ageratum conyzoides (L.) L. (AG498)
Mubuza [Lug]
34. Artemisia annua L. (AG392)
Artemesia*
35. Aspilia africana (Pers.) C. D. Adams (AG505)
Makaayi [Lug]
36. Aspilia mossambicensis (Oliv.) Wild (AG497)
Operek [Ik]
37. Baccharoides lasiopus (O.Hoffm.) H.Rob. (AG493)
Obu/Icro [Lgb]
38. Bidens pilosa L. (AG508)
Bukaala [Lus], Ononot [Lan]
39. Berkheya spekeana Oliv. (AG510)
Briyo [Lgb]
40. Conyza attenuata DC. (AG494)
Kibimbakika [Ru]
Kafugankande [Lug], Muhe [Ru],Yagyag [Lgb]
41. Conyza pyrrhopappa Sch.Bip. ex A.Rich. (AG397)
42. Crassocephalum vitellinum (Benth.) S. Moore (AG502) Ntarahondo [Ru]
43. Echinacea angustifolia DC. (AG419)
Echinacea*
44. Echinops amplexicaulis Oliv. (AG450)
Ekwang [Lan]
45. Erigeron floribundus (Kunth) Sch.Bip. (AG495)
Wambera [Ru], Adittong [Lan], Nazaca[Lgb]
46. Gutenbergia cordifolia Benth. ex Oliv. (AG504)
Nyakwenga [Ik]
47. Gynura scandens O.Hoffm. (AG511)
Kizimyamuriro [Ru]
48. Lactuca inermis Forssk. (AG501)
Ebirica [Lgb]
49. Laggera alata Nanth. (AG524)
50. Senecio hadiensis Forssk (AG451)
Mugina/mubiri [Lug]
51. Solanecio mannii (Hook.f.) C.Jeffrey (AG521)
Mugango [Lug, Ru]
52. Schkuhria pinnata (Lam.) Kuntze ex Thell. (AG516)
Quinine*
53. Sonchus oleraceus (L.) L (AG530)
Kizimya murro [Ru]
54. Vernonia amygdalina Delile (AG405)
Mululuza [Lug, Lus], Lubirizi [Lus]
2
L
L
L
L
L
Ap
L
R, L
R, B
Apply sap
55. Vernonia auriculifera Hiern (AG477)
Ekikuuma [Gis]
Local names
Ruherere [Ru]
Sh
H
Sh
Syphilis, fatigue
Condition(s) treated
Diarrhoea
L
PU
L
4
Fi
1
D
MoP
D
Mussa [Lug & Lus], Mufungedha/Mwisa
[Lus] Mwisya [Ru], Ibologo [Lug]
Lusambya [Lus], Lusoola [Gis], Sambya
[Lug]
Kinyarisa [Ru]
Kifabakazi [Lug, Lus], Shitsubi [Gis]
T
B, R
L
R, L
1
7
15
D
D + Hy
D
T
T
Wasting & inappetence
Cough
Fatigue, anaemia, liver disease, inappetence, stomach
ache, headache & skin rash
Malaria & fevers
Cough, chest pain & GIT ulcers
B
B
1
9
D
D
Emeku [Lug]
T
Fevers, convulsions, headaches
L
8
Muwafu [Lug] Mubafu [Lus & Ru]
T
Female organ system, diarrhoea, fatigue, inappetence
B
10
D
D
D
Egaboyakubuku [Lug]
Sh
Skin infections
1
D
Abasi/Muya [Lug], Balwegiira [Lus],
Balwejiira /Abasi [Gis] Abac [Lan]
T
Stomach ache, sore throat, ulcers, fatigue, fever, blood
infections cough/TB/asthma, diarrhoea, allergies, syphilis,
skin lesions/rash
L, B, R
43
D/O/Tea/In
Sh
66. Boscia salicifolia Oliv. (AG478)
Mukolokombi [Lug], Mukorokombi[Ru],
Ogadaman [Lan]
Ror [Ik]
Cleanser
Diarrhoea, pain
Headaches, blackout
R
R
R
3
1
1
D/Po
D
D
Cannabaceae
67. Cannabis sativa L. (AG410)
Njagga [Lug] Enjaaye/ Njaga [Ru]
H
Cough/TB
Cancer, pain, blood, cleanser/ asthma, diarrhoea
L
L
1
3
Paapali [Lug & Lus], Mupaapali [Lus],
Apapalo [Lan], Paipai [Lgb]
T
Vomiting
Skin infections, ulcers, anaemia, cough, fatigue
Sh
Sh
71. Garcinia buchananii Baker (AG515)
72. Symphonia globulifera L.f. (AG455)
Embaluka [Ru]
Lusaikye [Lug], Muwaiswa [Lus & Gis],
Okuto eterka [Lan]
Musaali [Lus]
Musaali [Lug]
Combretaceae
73. Combretum molle R.Br. ex G.Don (AG499)
Family, Scientific, Name (Voucher No.)
Endagi [Lug], Khirahi [Gis], Ngulara [Ik]
Local names
Family, Scientific, Name (Voucher No.)
56. Vernonia campanea S. Moore (AG522)
Bignoniaceae
57. Kigelia africana (Lam.) Benth. (AG401)
58. Markhamia lutea (Benth.) K.Schum. (AG367)
59. Steriospermamum kanthium Cham. (AG394)
60. Spathodea campanulata P.Beauv. (AG455)
Boraginaceae
61. Ehretia cymosa Thonn. (AG492)
Burseraceae
62. Canarium schweinfurtii Engl. (AG500)
Cactaceae
63. Cactus spp (AG506)
Canellaceae
64. Warburgia ugandensis Sprague (AG383)
Capparaceae
65. Capparis tomentosa Lam. (AG397)
Caricaceae
68. Carica papaya L. (AG378)
Celastraceae
69. Cassine aethiopica Thunb. (AG374)
70. Gymnosporia senegalensis (Lam.) Loes. (AG462)
3
T
Sh
Tea/D/Milk
D
B
L/R/S/Fr
3
6
Inappetence, syphilis, sexual dysfunction
Fatigue, ulcers, headache, cough, skin infections, STI
B
R, B, L
4
21
D
D
D
D
D/O/ B
T
T
Vomiting
Cough & mental illness
B
R
1
2
Tea
D
T
H
Syphilis, cough
Condition(s) treated
B
PU
3
Fi
D
MoP
74. Terminalia schimperiana Hochs t. ex Delile (AG448)
Commelinaceae
75. Commelina zambesica C. B. Clarke. (AG503)
76. Tradescantia zebrina var. zebrine (AG496)
Convolvulaceae
77. Ipomoea batatas (L.) Lam. (AG517)
78. Ipomoea hildebrandtii Vatke (AG527)
Costaceae
79. Costus lucanusianus J.Braun & K.Schum. (AG480)
Crassulaceae
80. Bryophyllum pinnatum (Lam.) Oken (AG520)
81. Kalanchoe densiflora Rolfe (AG427)
Cucurbitaceae
82. Cucurbita maxima Duchesne (AG406)
83. Kedrostis foetidissima (Jacq.) Cogn. (AG531)
84. Luffa cylindrica (L.) M.Roem. (AG553)
85. Momordica foetida Schumach. (AG518)
Dioscoreaceae
86. Dioscorea bulbifera L. (AG519)
87. Dioscorea dumetorum (Kunth) Pax (AG556)
Ebenaceae
88. Euclea divinorum Hiern (AG532)
89. Diospyros mespiliformis Hochst. ex A. C. (AG526)
Euphorbiaceae
90. Acalypha vallicaulis Müll.Arg (AG533)
91. Croton macrostachyus Hochst. ex Delile (AG540)
92. Euphorbia prostrata Aiton (AG534)
93. Euphorbia hirta
94. Jatropha curcas L. (AG429)
95. Manihot esculenta Crantz (AG426)
96. Ricinus communis L. (AG535)
97. Tragia benthamii Bake (AG550)
Family, Scientific, Name (Voucher No.)
Fabaceae
98. Abrus precatorius L. (AG487)
Kadri [Lgb]
T
Ulcers, skin lesions &infections
L
3
Etobi aroni [Lgb]
Etiiza enkye [Ru]
H
H
Diarrhoea & skin infections
Diarrhoea
L
Ap
2
1
Mbooli [Gis], Bitakuri [Ru]
Bingirebityo [Ru]
H
H
Skin rash, Herpes zoster
Ulcers & bed sores
L
L
2
1
Kisombi [Lug]
H
Headaches & mental illness
Fl
1
In
Kiyondo [Gis], Ereka [Ru]
Kkiyondo Ekyeru
H
H
Malaria, diarrhoea
Abdominal pain
Fevers, malaria, cough, fatigue, ulcers
Anaemia
L
L
L, B
L
2
2
9
1
D
Heat/Sq
D
Pound/Sq
Nsujju [Lug]
Zziizi [Lus, Gis]
Kyangwe [Lug]
Bombo [Lug], Bomo [Lan]
Scr
Cl
Cl
Cl
Fatigue
Inappetence
Skin infections
Fever & cough
Diarrhoea, malaria
Fr
L
L
L
Sht
2
6
1
4
2
Eat/D
Po + Hy
O
D
In
Kamahunyu [Gis]
Itiyo [Lgb]
Cl
H
Body cleanser
Jaundice, fever, malaria
Blb
Blb
2
1
Eat
D
Emuc [Lan]
Okum [Lan]
Sh
Skin rashes & infections
Skin rashes & diarrhoea
L
Sht, L
1
1
O
O
Ofaka [Lgb]
Murangara [Ru]
Kasandusandu (omunene) [Lus]
Kasandosando [Lus]
Kiroowa [Lug]
Muwogo [Lug]
Mukakaala [Lus]
Kashogashoga/ Mwerangoro [Ru]
Kamyu [Lug]
Local names
H
T
H
H
T
Sh
H
H
H
Jaundice, fever, dysentery, skin infections
Constipation, diarrhoea, cough & STI
Diarrhoea &ulcers
Diarrhoea
Fatigue
Fatigue
Headache
Skin infections, cardiac arrhythmias
Skin rashes
Condition(s) treated
Sh
L
Ap
L
Sd
L
L
L
R
PU
3
2
1
2
2
1
1
2
1
Fi
D
D
In/Tea
D
In
D
Sq
D/B
O
MoP
Lusiiti [Lug, Lus, Gis]
H
Oral sores
L
2
Pound/Sq
4
D
D
D
D
D/Hy/Sg/Sl/Pw
D
99. Acacia hockii De Wild. (AG428)
100. Acacia amythethophylla A.Rich. (AG406)
101. Acacia polyacantha subsp.campylacantha (A.Rich.)
Akaasana [Lug], Okuto atino [Lan]
Omuwologoma [Lug]
Kibere [Lug], Morigo [Lgb]
Sh
Sh
Sh
102. Acacia seyal (L.) Willd. (AG570)
Naibeere [Lus]
Sh
103. Acacia senegal (L.) Willd. (AG566)
Katasubwa [Lus]
Sh
104. Afzelia africana Pers. (AG471)
105. Albizia coriaria Oliv (AG366)
Eiya [Lgb]
Omugavu [Lug], Musiita [Lus]
Kiluku [Ik]
T
T
Diarrhoea
All symptoms, anaemia, blood, cleanser, cough
Diarrhoea
Fatigue, gonorrhoea, skin infections
L
B
R
R
3
37
3
2
D
D
D/Snf/Cl
D
Fever, blood tonic
Skin infections
GIT disorders, diarrhoea, fatigue
Diarrhoea, fevers, abdominal infections
Cough
Malaria, pain, vomiting, stomach aches, aphrodisiac
Cancer, heart disease, allergy, nausea, headaches &
mental illness, diarrhoea, cough, TB, anaemia
Fatigue, stomach & skin lesions
Skin rash
L/B/Fr
B, R
B, L
R
L
B
B
5
2
1
7
1
2
24
D
O/D
D
D
D
D
D/O
B, L
10
7
D/O
D
Skin rash, diarrhoea
Diarrhoea, pain
Inappetence
Diarrhoea & dysentery
Ringworms, candida & fungal infections
B
1
1
2
2
1
D
D /O
Cook
D/In
D
B, R
L
B, R
26
D/O
38
D
B, L
10
D/O
L
1
D
Brena (AG486)
106. Albizia macrophylla (A. Rich.) Walp. var. ugandensis
T
Bak.f. (AG558)
107. Albizia zygia (DC.) J.F.Macbr. (AG554)
108. Bauhinia thonningii Schum. (AG571)
109. Cajanus cajan (L.) Millsp. (AG565)
T
T
H
110. Chamaecrista absus (L.) H.S.Irwin & Barneby
Ackla [Lgb]
Ogali [Lan]
Nkolimbo [Lug/ Lus]/, Mpinamuti [Lug],
Ntondiigwaaa [Ru]
Mucuula [Lug]
(AG567)
111. Chamaecrista nigricans (Vahl) Greene (AG424)
Ayebi [Lan]
H
112. Erythrina abyssinica DC. (AG418)
Jjirikiti [Lug], Murinzi/Kiko [Ru], Oluo
[Lgb], Muyirikiti [Lus]
T
113. Entada abyssinica A.Rich (AG387)
Mwolola [Lug, Lus]
Musambamadi [Lus, Gis]
Ekibundabunzi [Ru]
T
Sh
All OI, stomach ache, ulcers, fatigue, fevers, cough,
syphilis, diarrhoea, dysentery, skin infections
All OI, fatigue, mental illness, anaemia, chest pain, skin,
infections/lesions, ulcers, cancer, stomach aches,
diarrhoea, STI, fevers,
Syphilis, blood tonic, fever, chest pain, abdominal pain,
fatigue, anaemia ulcers, skin ulcers/ lesions
Diarrhoea
Akangi [Lan]
Kiihabukuru [Ru]
Mukuna*
Mpewere [Lug]
Aremu [Lan]
Muvuvumira [Lus], Guberubenu [Gis],
Mugabagaba [Ru]
Bwalula [Lug]
T
H
H
T
Scr
T
Epilepsy /convulsions
Diarrhoea, ulcers
Mental illness, aphrodisiac
Allergies, syphilis & other STI’s
Diarrhoea & dysentery
Skin rashes & general OIs
R
R
Sd
B
L
L
1
1
1
2
1
6
D
D
Tea
D
In
D/O
H
Stomach ache & diarrhoea
L
1
D
114. Kotschya aeschynomenoides (Bak.) De Wild. &
115.
116.
117.
118.
119.
120.
121.
Devign. (AG359)
Leucaena leucocephala (Lam.) de Wit (AG575)
Macrotyloma axillare (E.Mey.) Verdc. (AG571)
Mucuna pruirens (L.) DC. (AG409)
Piptadeniastrum africanum (Hook.f.) Brenan (AG579)
Rhynchosia goetzii Harms (AG573)
Senna didymobotrya (Fresen.) H.S.Irwin & Barneby
(AG436)
Senna obtusifolia (L.) H.S.Irwin & Barneby (AG580)
5
Sh
L
L
L
122.
123.
124.
125.
126.
127.
Senna singueana (Delile) Lock (AG589)
Senna spectabilis (DC.) H.S.Irwin & Barneby (AG586)
Sesbania macrantha E.Phillips & Hutch. (AG581)
Tamarindus indica L. (AG403)
Tephrosia vogelii Hook.f. (AG590)
Tylosema fassoglensis (Schweinf.) Torre & Hillc.
Lokeru [Ik]
Mucuula
Cilcill [Lgb]
Nkooge [Lug], Eti [Lgb]
T
T
H
T
Sh
Cl
Kiyugeyuge [Lus]
(AG414)
Lamiaceae
128. Achyrospermum carvalhoi Gürke (AG544)
129. Ajuga integrifolia Buch. -Ham. (AG541)
130. Basilicum polystachyon (L.) Moench (AG549)
131. Clerodendrum umbellatum Poir. (AG523)
132. Hoslundia opposita Vahl (AG413)
133. Ocimum lamiifolium ex Benth. (AG537)
134. Ocimum basilicum L. (AG534)
135. Ocimum gratissimum L (AG560)
136. Plectranthus lactiflorus (Vatke) Angew (AG536)
137. Tetradenia riparia (Hochst.) Codd. (AG561)
138. Vitex fischeri Gürke (AG437)
Lauraceae
139. Persea americana Mill. (AG421)
Lythraceae
140. Punica granatum L. (AG423)
Malvaceae
141. Hibiscus fuscus Garcke (AG582)
142. Hibiscus sabdarifa L. (AG587)
143. Grewia mollis Juss. (AG583)
144. Melochia corchorifolia L. (AG425)
145. Sida sp.
Meliaceae
146. Azadirachta indica A.Juss. (AG598)
147. Carapa grandiflora Sprangue (AG591)
148. Ekebergia capensis Sparrm. (AG435)
149. Lovoa trichilioides Harms (AG593)
Kitiinwa [Ru]
Ekitiinwa [Ru]
Kachumita [Ru]
Acer [Lan]
Kamunye [Lug], Nfoodo [Lus], Sitimwe [Ru]
Enkoma nyangwe [Ru]
Kakubansiri [Lug, Lus]
Mujaaja [Lus]
Marwagahibaare [Ru]
Kyewamala [Lug], Muravunga [Ru]
Mubengeya/ Nfulubwa/ Ffulubwa [Lug]
Cough, diarrhoea
STI skin lesions, diarrhoea, stomach aches
Diarrhoea, liver disease & cough
Skin infections
GIT disorders, fatigue, diarrhoea,
Fever, convulsions, wasting
L
L
B
B, L, Fr
L
B, R
Fl
1
2
4
2
8
2
D
D + Sg
D
D
Sq/O
D /+ Milk
D
H
H
H
Sh
H
H
H
H
H
Sh
Sh
Herpes zoster, skin infection & rashes
Malaria
Cough
Stomach ache
Stomach ulcers, skin infections, anaemia, fatigue
Hiccough
Pain killer, inappetence
Itchy skin
Skin rashes
Oral thrush, skin infections & lesions
Cancer, herpes zoster, skin infections/rashes, TB
R
L
L
R
L
Ap
Ap, L
L
L
L
L
3
1
1
2
9
1
2
1
1
2
1
O
D
O & B/ D
In
D
D
Tea/In
D
In & B
Gargle
D
Ovakedo [Lug, Ru, Lgb]
Vadeko [Lus]
T
Ulcers, cough, anaemia, fatigue
Blood tonic & respiratory infectious
Skin infections
Herpes zoster
L, Sd, B
L, Fr
L
L
9
2
3
1
D
D + food
O
Tn
Mukoma mawananga [Lus]
Sh
Wounds, diarrhoea, general, infections
B
2
D
Lusaala [Lug]
Kirekedde [Lug]
Eku [Lgb]
Akeeyo [Ru]
Mumbane Ru]
H
H
Sh
Sh
H
TB & cough
Anaemia, paralysis, abdominal pain, dizziness, UTI
Diarrhoea, stomach ache, wounds
Skin lesions, infections
Skin rash
L
L, Sd
L
Ap
L
1
1
1
1
1
Lick ash
In
D
Poultice
Mac
Neem*
T
R, L, B
25
D
Mario [Lgb]
T
T
T
Liver, kidney, disease, cough, fever diarrhoea, STI,
abdominal pain, swelling & vomiting
Skin rash & sores
Infections
Blood cleanser, fever, diarrhoea, skin infections, malaria
Skin lesions, cancer, infections, diarrhoea
Oil
L
R
B, Sd,L
1
9
2
1
O
D
Pound/D
O
Musonko [Lug]
6
Family, Scientific, Name (Voucher No.)
Melianthaceae
150. Bersama abyssinica Fresen. (AG594)
Menispermaceae
151. Cissampelos mucronata A. Rich. (AG599)
152. Chasmanthera dependens Hochst. (AG596)
Moraceae
153. Ficus natalensis Hochst. (AG600)
154. Ficus platyphylla Delile (AG595)
155. Ficus saussureana DC. (AG610)
156. Milicia excelsa (Welw.) C.C.Berg (AG431)
Moringaceae
157. Moringa oleifera Lam. (AG408)
Musaceae
158. Musa sp (AG465)
Myricaceae
159. Morella kandtiana (Engl.) Verdc. & Polhill (AG601)
Myrtaceae
160. Callistemon citrinus (Curtis) Skeels (AG606)
161. Eucalyptus grandis W.Hill (AG609)
162. Psidium guajava L. (AG419)
163. Syzygium cumini (L.) Skeels (AG603)
Olacaceae
164. Ximenia americana L (AG605)
Onagraceae
165. Ludwigia abyssinica A.Rich. (AG608)
Oxalidaceae
166. Oxalis latifolia Kunth (AG607)
Passifloraceae
167. Barteria nigritana Hook.f. (AG611)
168. Passiflora edulis Sims (AG365)
Pedaliaceae
169. Sesamum calycinum Welw. (AG619)
Peraceae
170. Clutia abyssinica Jaub. & Spach (AG612)
Family, Scientific, Name (Voucher No.)
Local names
Hb
Condition(s) treated
PU
Fi
MoP
Lepengo [Lan]
Sh
Diarrhoea, stomach ache, malaria, STI
L
1
D
Mony [Lan]
Akeng [Lan]
Cl
H
Stomach ache
Haemorrhoids
R
ST, R
1
1
In
O
Mutuba [Lug]
Mutuba [Lug]
Muwo [Lug]
Muvule [Lug, Lus, Lan]
T
T
T
T
Diarrhoea, dysentery, vomiting
Malaria
UTI’s, syphilis & skin rash
Asthma, cough, skin lesions, pain, fatigue.
B
Sd
B
B, L
2
1
2
2
D
D
D
D/Tea
Molinga*
T
Fatigue, inappetence, cough, malaria
4
Sauce/Tea
Kitooke [Lug], Kisubi [Lus]
H
Herpes zoster & ulcers
Diarrhoea
Pl
Sp
1
1
O / De
Lick Sap
Nkikimbo [Lug]
Sh
Diarrhoea, cough, flu, allergies
R
5
T
T
T
T
Cough
Fatigue, Gonorrhoea
Oral sores, Cough
Cough, TB, epilepsy, skin rushes
Diarrhoea, dysentery & stomach aches, Skin rash
13
2
6
15
13
D
D
D
D
D
D
D
Icuki [Lgb]
Sh
Skin infections, diarrhoea, malaria, ulcers, fever, STI
Fr
3
D
Crocojafo [Lgb]
H
Malaria, wounds, skin infections
L
2
D
Kajampuni [Gis]
H
Diarrhoea Vomiting
L, St
3
D/Sq
Abwolo mono [Lan]
Katunda [Lus, Ru]
T
Cl
Fever, diarrhoea, headache
Fatigue
Diarrhoea
L
R, Fr
L
1
4
1
D
D
D
Lutungotungo [Lus]
H
Inappetence, fatigue
L
1
D
Mubarama [Ru]
Local names
Sh
Hb
Diarrhoea, inappetence
Condition(s) treated
L
PU
3
Fi
In/Tea
MoP
Mwambalabutonya [Lug, Lus]
Bottle brush*
Kalituusi [Lug]
Mupeera [Lug, Ru], Ipeera [Ru], Gova [Lug]
Jjambula [Lug, Gis]
7
L, R, Sd
L
R
L
L/R/B/Fr
L, B Sht,
Phyllanthaceae
171. Bridelia micrantha (Hochst.) Baill (AG452)
172. Flueggea virosa (Roxb. ex Willd.) Royle (AG430)
173. Hymenocardia acida Tul. (AG411)
174. Phyllanthus ovalifolus Forssk. (AG376)
175. Phyllanthus nummulariifolius Poir. (AG420)
Phytolaccaceae
176. Phytolacca dodecandra L'Hér. (AG614)
Poaceae
177. Cymbopogon citratus (DC.) Stapf (AG615)
178. Digitaria abyssinica (A.Ric.) Stapf (AG620)
179. Eleusine coracana (L.) Gaertn.
180. Sorghum bicolor (L.) Moench
181. Sporobolus pyramidalis Beauv.
Katazamiti [Lug], Ijio (Obua/cuajo [Lgb]
Lukandwa [Lug, Lus]
Nabbaluka/Mbaluka [Lug, Lus]
Mutulika [Lug]
Musheshe [Ru]
T
Sh
T
Sh
Sh
Pain, cough & chest pain
Most OI, stomach disorders
Skin rashes, fatigue,
All symptoms esp. mental illness & aches, cough
Itchy skin, skin infections, rashes, lesions
L, B
Tw, R
B
L
L
8
5
5
2
1
D
D
O/D
D/Snf/Cl
O
Muhoko [Ru]
H
Herpes zoster
L, Fl
4
B
Kisubi [Lug]
Lumbugu [Lus]
Rumbugu [Gis]
H
H
L
R
L
Sd
Sd
L
1
2
3
6
2
1
D
D
Poultice
Po
On/B
D
Muwemba [Lug]
Arua [Lgb]
H
H
H
Blood cleanser
Fatigue, stomach disorders
Herpes zoster
Diarrhoea
Skin infections & lesions
Boils, swellings, skin infections
Musenene [Lus]
T
Dizziness, headaches
L
1
B
Bwanda [Lus]
H
Skin rashes
Ap
1
Pw + oil
Muhanga [Ru]
T
Skin infections
Sd
2
O
Luklolukl [Lgb]
Cl
Skin infections & lesions
L
1
D
Kayongo [Lug]
H
Chest pain & respiratory infections
Fr
1
D
Mufumbi egyesha [Ru]
Mukondwe [Lug], Mukondwa [Lus]
H
T
L
R
R, L
B
Sd
2
1
6
2
1
D + Po/ Tea
L
3
D
B
L
L
Fr
PU
2
1
1
3
Fi
D
O
Tea
Eat
MoP
Podocarpaceae
182. Afrocarpus usambarensis (Pilg.) C.N.Page (AG444)
Portulacaceae
183. Portulaca quadrifida L. (AG630)
Primulaceae
184. Maesa lanceolata Forssk. (AG621)
Podostemaceae
185. Zehneria scabra (L.) (AG418)
Pteridaceae
186. Pityrogramma calomelanos (L.) Link (AG443)
Polygalaceae
187. Rumex usambarensis (Dammer) Dammer (AG368)
188. Securida longipedunculata Fresen. (AG363)
189. Plumbago zeylanica L. (AG633)
Ranunculaceae
190. Clematis hirsuta Guill. & Perr. (AG625)
Rhamnaceae
191. Maesopsis eminii Engl. (AG416)
192. Gouania longispicata Engl. (AG467)
193. Ziziphus abyssinica Hochst. ex A.Rich. (AG470)
Family, Scientific, Name (Voucher No.)
Akatekere [Lus]
H
Sore throat, allergies
All symptoms
Fatigue, joints & chest pain, cough, ulcers & oral sores
Diarrhoea, skin rash
Persistent fevers
Sisi [Ik]
Cl
Joint aces, respiratory infections
Musizi [Lug]
Omufurra [Ru]
Lawic Omoko [Lan]
Laki [Lgb]
Local names
T
Malaria, fevers, stomach aches
Scr Swelling in groin, boils
Ulcers, Malaria, stomach aches
Sh Diarrhoea, stomach aches, chest pain & infection
Hb Condition(s) treated
8
D+Milk
D+Hy/Sg/Sl/Com
Cook/G. nut
Rosaceae
194. Prunus africana (Hook.f.) Kalkman (AG 440)
Rubiaceae
195. Afrocanthium lactescens (Hiern) Lantz (AG628)
196. Craterispermum schweinfurthii Hiern (AG442)
197. Gardenia ternifolia Schumach. & Thonn.
Subsp.jovis-tonantis (Welw.) Verdc. (AG453)
198. Fleroya rubrostipulata (K.Schum) Y.F.Deng
(AG404)
199. Keetia gueinzii (Sond.) Bridson (AG469)
200. Pavetta crassipes K.Schum (AG631)
201. Rubia cordifolia L. (AG454)
202. Sarcocephalus latifolius (Sm.) E.A.Bruce (AG415)
Rutaceae
203. Citropsis articulata (Willd. ex Spreng.) Swingle &
M.Kellerm (AG439)
204. Citrus limon (L.) Osbeck (AG447)
205. Citrus sinensis (L.) Osbeck (AG466)
206. Harrisonia abyssinica Oliv. (AG432)
207. Zanthoxylum chalybeum Engl. (AG632)
Ngwabuzito [Lug], Ntaseesa [Lus],
Sirumandu [Gis]
T
Prostate cancer, epilepsy, heart diseases, diarrhoea, cough,
chest pain
B, L
6
D/Tea
Ogu [Lgb]
Musekera/Omuseka [Lug]
Kalemanjovu [Lug]
Cl
T
Sh
Skin lesions, infections, headaches
Ulcers & oral Sores
TB, fatigue, fever
L
B
B, L
1
2
3
D
Tea
D/Snf/Cl/Lick
Muziko [Ru]
T
Munuure [Ru]
Anyango [Lan]
Mutaamataamu [Lus], Obele [Lgb]
Cl
Sh
Cl
Sh
Abdominal pains
TB & respiratory infections
Kidney disease
Inappetence, fatigue
Cough & chest pain, diarrhoea, ulcers
Inappetence, abdominal pain, swelling, vomiting, STI
B
B, L
L
L
L, Ap
R
3
1
1
1
5
3
Mubolo [Lug]
Sh
Diarrhoea, fatigue, inappetence
B
3
D
Sh Stomach aches
Sh Diarrhoea, cough
Sh STI, stomach ache/ulcers, diarrhoea, inappetence, sores
Skin rash
Headaches & mental illness
T
All symptoms
Skin rash
Headaches & mental illness
Fr
R/B/Fr
R, L
Ap
R, B
B/R/L
Ap
R, B
2
1
1
2
7
29
2
7
D
D
D/In
O
Snf/Tea
D
O
Sniff/Tea
Buzibira [Lgb]
Cl
Diarrhoea & dysentery
St
1
D
Nkalati [Lug]
Yet ngok kede [Lan]
Komero [Lgb]
T
T
T
Mental illness
Abdominal pain, swelling & vomiting
Stomach aches, skin infections
R, B
R
R, Sd
2
1
2
D
D
D
Kamulali [Lug]
Nyaanya [Lug, Gis]
Katuntunu [Lug]
Losuk [Ik]
Katunkuma [Lug]
Ocokcok adongo [Lan], Etulatula [Lus]
Ocokcok atino [Lan]
H
H
H
H
Sh
Sh
H
Herpes zoster,
Herpes zoster
Syphilis
Fatigue, diarrhoea
Inappetence
Skin rashes, lesions, itching, boils
Skin rashes, lesions, itching, boils
Fr
Fr, L
L
1
3
1
Fr
R
R
1
2
1
O
Po
D
D
Stm
O
D
Niimu [Lug], Ndima [Lgb]
Omuchungwa [Lus], Chungwa [Lan]
Akere [Lgb]
Entale ya Ddungu [Lug], Ddungu lya ntale
[Lus], Rukuts [Ik], Outiku [Lugb]
D/Tea
Lick P
Mac
D/Po
D/Lick P
Cook/D
Sapindaceae
208. Cardiospermum halicacabum L. (AG629)
Sapotaceae
209. Chrysophyllum albidum G.Don (AG 445)
210. Pouteria adolfi-friedericii (Engl.) A.Meeuse (AG 455)
211. Vitellaria paradoxa C.F.Gaertn. (AG627)
Solanaceae
212. Capsicum annuum L. (AG412)
213. Lycopersicon esculentum Mill. (AG461)
214. Physalis minima L (AG468)
215. Withania somnifera (L.) Dunal (AG453)
216. Solanum anguivi Lam. (AG635)
217. Solanum dasyphyllum Schumach. & Thonn. (AG484)
218. Solanum incanum L. (AG433)
9
Family, Scientific, Name (Voucher No.)
Talinaceae
219. Talinum portulacifolium (Forssk.) Asch. ex Schweinf
Local names
Hb
Ijuki [Lgb]
H
Condition(s) treated
Stomach aches, diarrhoea
PU
Ap
Fi
1
MoP
D
(AG474)
Theaceae
223. Camellia sinensis (L.) Kuntze (AG472)
Majaani [Gis]
Verbenaceae
Kayukiyuki [Lug & Lus] Musekerannyi [Lus]
224. Lantana trifolia L. (AG375)
225. Lantana camara L. (AG485)
Kapanga [Gis]
226. Verbena officinalis L. (AG634)
Mugoshoora [Ru]
227. Cyphostemma adenocaule (Steud. ex A.Rich.) Desc.
Kabombo akatono [Lug]
ex Wild & R.B.Drumm. (AG637)
228. Cyphostemma cyphopetalum (Fresen.) Desc. Ex. Wild Lobere [Lgb]
&R. B. Drumm (AG640)
229. Cissus rotundifolia Vahl (AG476)
Nkamyo [Lgb]
Xanthorrhoeaceae
230. Aloe vera (L.) Burm.f. (AG398)
Kigagi [Lug], Kikaaka [Lus, Gis], Rukaka
[Gis], Tikorotot [Ik], Tebakore [Lan]
231. Aloe dawei A.Berger (AG380)
232. Aloe sp. (AG441)
Kigagi [Lug], Rukaka [Ru]
Zingiberaceae
233. Curcuma longa L. (AG383)
Ocaoayom [Lan]
234. Zingiber officinale Roscoe (AG449)
Ntangawuzi [Lug], Tangawizi [Lan]
Zygophyllaceae
235. Balanites wilsoniana Dawe & Sprague (AG400)
Naggwalimu [Lug]
T
Fatigue
L
2
D
H
H
H
H
All symptoms: Cleanser, cough, ear infections
Stomach ache, cough
Vomiting/skin infections
Fever, skin infections
L, Fl
L
Ap
L
4
2
1
1
D/In
D/ Sl
In/B
D/B
Cl
TB
R
1
Pw
H
Diarrhoea & vomiting
L
1
Stm
H
H
H
Fever/malaria, wasting, UTI
Skin infections
Fever, skin infections
Fever/malaria
L
L
L
L
35
26
1
1
D
O
D
D
H
H
Hernia, chest pain
Cough & TB
Rh
Rh
1
2
In
Tn
T
All symptoms
Herpes zoster
Fatigue, aphrodisiac
Rh
L
R
2
1
2
D
O/B
D
Musongola [Lug]
Sh
Key: Languages spoken: Lgb=Lugbara, Lan=Langi, Gis=Lugissu, Lus=Lusoga, Ru=Runyankore, Lug=Luganda, Ik=Ik/Karimojong,* = No local name. Western name
adopted. Parts Used: PU=Part used, Ap =All-aerial parts Pl=Peel, L- leaves, Sh- Shrub, Tw-Twigs, F=Fruit, Fr=Fronds, Blb= Bulb, Rh=Rhizome, Sc=Scandent, Sht=Shoot,
Hb=Habit, H=Herb, Cl=Climber, Rt=Root, T-Tree, FM=Frequency of Mention, MoP= Method of Preparation, D=Decoction, In=Infusion, B=Bath, Tn=Tincture,
Po=Porridge, O=Ointment, Stm=Steam, Sq=Squeeze out juice, Pw=Lick powder, Po=Porridge, G.nut=Ground nut paste, Com=Compress, STI=syphilis & gonorrhoea, Hy=
Honey, Sl = Salt, Sg= Sugar, Cl=Clay, Mac= Maceration, Snf=Snuff
236. Unidentified
10
Figure 1: Map of Uganda showing study sites
1