Title: Documentation and Phytochemical Screening of Most Commonly used Nutri-Medicinal Plants by Pregnant Women in Kyeizooba, Bushenyi District, Western Uganda.
Address for Correspondence: Kiconco Catherine, Department of EthnoBiology,
Faculty of Agriculture, Environmental Sciences and Technology (then Applied Sciences), Bishop Stuart University, Mbarara, Uganda, Tel: +256772934766; E-mail: ckiconco61@gmail.com
Copyright: © 2020 Catherine K, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
Received 13 December 2019; Accepted 06 January 2020; Published 13 January 2020.
Abstract
Nutri-medicinal plants are widely used as a remedy for some ailments among pregnant women worldwide. There are different medicinal plants used by pregnant women in Uganda depending on the culture and knowledge of these medicinal plants. A cross-sectional study was carried out on 135 women in Kyeizooba sub-county Bushenyi District from September 2016 to March 2017.
Medicinal plants used by pregnant women were identified and documented, and hytochemical screening of the frequently used Nutri-medicinal plants was done and their effects were studied comparing with the available literature. Fidelity levels, Informant consensus factor, and use values were used to obtain the most frequently used medicinal plants.
Lamiaceae and Asteraceae families presented the highest number of medicinal plants used by pregnant women. The phytochemicals analyzed in the herbs were saponins, alkaloids, flavonoids, reducing compounds, phenols, and steroids which were found to exist in some Nutri-medicinal plants with varying intensities. Herbal medicines contain important phytochemicals which if standardized and the dosages prescribed could present therapeutic advantages to the users.
Keywords: Pregnancy • Traditional birth attendants • Nutri-medicinal plants • Phytochemicals.
Introduction
The use of medicinal plants for treatment of ailments continues to increase though interventions to improve health care have been put in place. WHO reports 80% usage of herbal medicines worldwide [1] with higher percentages reported in developing countries. The prevalence of use is equally traced in developed countries where health care facilities are in place and up to date for example in the USA [2].
In Africa, the prevalence of use of herbal medicine was estimated at 80% [3]. A large population of pregnant women uses herbal medicines for ailments like gastro intestinal disorders, nausea and vomiting, inducing labor and infections. Herbal medicines are extracts of naturally occurring plants which may be taken in its crude or in processed form without any form of prescription or dosage, exclusively made from plants and is administered in different forms of solution, boiled or powdery form. In developed countries like China, herbal medicines are taken as decoctions or as granules. The extracts are of defined parts of the plants which include floral parts, areal parts or the whole plant. Preparation of these herbs usually is by steaming, roasting, boiling or extracting their juice by squeezing or by pounding [4,5].
The most commonly used herbs in Europe, America, and Australia were ginger (Zingiber officinale Roscoe, cranberry (Vaccinium macrocarpon Aiton), valerian (Valeriana officinalis Linn), Echinace (Echnacea angustifolia L.), chamomile (Matricaria chamomilla L. and raspberry (Rubus idaeus L.) for treatment of nausea, vomiting and colds among pregnant women [6]. In USA, Zingiber officinale (ginger) was the most commonly used in the treatment of nausea and vomiting in the first trimester [7].
The most commonly used herbs in Iran are Ammi visnaga for Nausea and Vomiting and gastrointestinal problems, and heartburn, Saatar (Oreganum syriaca L.) for nausea and vomiting, pepper mint (Mentha piperita L.) for gastrointestinal problems, chamomile (Matricaria chamomilla L.) for relaxation and liquorice (Glycyrrhiza glaba Linn) for common colds [8]. In a clinical trial, ginger was found to treat prenatal nausea and vomiting [9].
A randomized controlled trials which were conducted about the efficacy of ginger showed a significant improvement in the severity of both nausea and vomiting of pregnancy among the experimental group compared to those that were taking a placebo [10,11]. Gingerols and 6-shagoal a polyphenolic component was found to inhibit the action of neurotransmitter acetylcholine and increase gastric motility which greatly reduces nausea, vomiting and abdominal pain [12].
Fischer Rasmussen found it particularly effective for hyperemesis gravidarum a condition characterized by severe nausea, vomiting, and weight loss and electrolyte disturbance common in about 3% of the pregnant women when compared to placebo.
Some herbal medicines like Zingiber officinale were used for morning sickness and short term use of Echinacea Angustifolia for colds and flu in pregnant women [2].
Different cultures use different herbal medicines as remedies for particular illnesses during pregnancy mostly during the third trimester [13]. In Kenya, about 20% of pregnant women used herbal medicine alongside western medicine for ailments like indigestion, respiratory tract infections and boosting immunity [14,15] states four major Nutri-medicinal herbs used by pregnant women in his study carried out in Egypt.
These include Garlic (Allium sativum L.), ginger (Zingiber officinale), green tea (Camellia sinensis L.) and peppermint (Mentha piperita L). Garlic (Allium sativum L) was used as an antibacterial and antifungal remedy, and was an ideal nutrient to consume particularly during pregnancy to raise immunity of the expecting mother. Green tea (Camellia sinensis L.) contributed to regulation of blood sugar, cholesterol, and blood pressure levels, helps speed up the body’s metabolic rate and provided a natural source of energy. Peppermint (Mentha piperita L) had been used to treat gastrointestinal (GI) disorders, common cold and respiratory conditions, muscle pain, headache, and neuralgia during pregnancy.
Fenugreek (Trigonella foenum-graecum L.) seeds contain oxytocin which stimulates uterine contractions and fastens labor process thus is helpful in inducing childbirth, however could lead to miscarriages if not well prescribed [15]. Ginger is well known remedy for gestational sickness particularly morning sickness and nausea [12].
In Uganda, Seventy-five medicinal plant species and one fungal species mainly toadstool mushrooms in the family Tricholomataceae were recorded as being used to induce labor during child birth in western Uganda [5]. The main reasons for the use of these herbal medicines are for treatment of syphilis, inducing labor, increasing appetite, and treatment of stomach pains and prevention of ante-partum hemorrhage. Some of the herbal medicines were reported to treat bacterial and fungal infections during pregnancy.
Steam distillation of fresh leaves of O. gratissimum showed that eugenol (54%) was the most abundant essential oil which was found to have an antibacterial activity. In vitro experiments showed that eugenol had an effect on Cryptococcus neorformans. Plectrunthus argentatus also called Coleus forskolhii contained an active ingredient of forskolin which was found to stimulate enzymes and was also found to treat abdominal pains and upper respiratory tract disorders [16]. A study by Asiimwe and Savina [4] indicated that most plant species possess radical scavenging properties due to the presence of compounds like saponins, tannins, alkaloids. These compounds boost immunity and fight fungal infections like Candinda albicans. In Kyeizooba, medicinal plants are commonly used during pregnancy even with the presence of health centre III where antenatal care services are provided.
The most commonly used medicinal plants were E. tomentosa, C. vitellinum, O. gratissimum, Z. officinale and S. princeae. The synergistic use of E. tomentosa and C. vitellinum is high among the women in this area. Most women took medicinal herbs to treat gastro intestinal disorders, vomiting, nausea and obstructed labor and the most common route of administration was oral. Use of herbal medicines however could be useful in treating some conditions.
Valuable information about medicinal plants for women’s reproductive health needs to be documented so that these plants of therapeutic advantage could be conserved [17,18]. The increase in the use of herbal medicines among pregnant women, therefore requires in-depth scientific studies about their safety and efficacy so that they can be integrated into health care systems [18].
There is need for more studies about the efficacy, proper dosages and concentrations to be used if these herbal medicines were to be effectively used in treatment of pregnancy related ailments. Thus this research thus documented the medicinal plants used by pregnant women in Kyeizooba Sub County and to identified the phytochemical content in the nutri-medicinal plants which are commonly used by pregnant women and this could be a basis for programmed health education.
Methods
Research design
A cross sectional study was conducted in Kyeizooba Sub county, Igara East constituency, Bushenyi District where 135 women participated in the study. Both qualitative and quantitative methods of data collection were used with both structured and unstructured questions.
Participants were elderly women and the traditional birth attendants who were presumed to be knowledgeable about the medicinal plants used. Purposive and snow ball sampling was used to select respondents in the area. Information about nutri-medicinal plants used, plant parts used, methods of preparation and administration of the herbal medicines were mentioned by the respondents who were mainly the pregnant women.
Medicinal plants were collected, identified and documented by the researcher. Chemical analysis of selected herbs was done and the effects of the phytochemicals present were studied using the available literature. The study was conducted between September 2016 and March 2017.
Data collection methods and instruments
In depth interviews were used for data collection about medicinal plants used, plant parts used and the method of preparation.
Field visits were also carried out to identify the local names of the medicinal plants. They were asked to mention the type of herbs administered during pregnancy, the ailments the herbs were treating, how they were administered, methods of preparation and conservation status.
Collection of medicinal plants and treatment
The herbs mentioned were collected and identified during the field visits. Plant samples were collected just before noon and before the flowering stage since the nutrient concentration was considered maximum in this period.
The samples were collected from plants just before the flowering stage. The family names and scientific names were determined by use of a herbarium and the International Plant Names Index [19].
The women were asked about the uses of each of the herbs that were mentioned.
The herbs that had many uses as determined by calculating their fidelity levels and informant consensus factor [4], were selected for chemical analysis. Experimental investigation was done at Mbarara University pharmaceutical laboratory where the phytochemistry of the selected herbs was analyzed. The selected herbs were collected and dried under roof at room temperature, ground to obtain powder and extracted by hot maceration method.
The liquid extracts were dried under room temperature to obtain the samples which were used in phytochemical screening. Qualitative chemical tests were done on herbs to identify presence of saponins, alkaloids, flavonoids, tannins, phenols, steroids, and reducing compounds.
Phytochemical screening methods
Saponins: The froth formation test: To 2 cm3 of each extract, 2 cm3 of distilled water were added and the mixture shaken. This test was for identification of the saponins. Froth that lasted for 15 minutes indicated the presence of saponins [20].
Alkaloids: They were tested by using Dragenndorrff’s reagent. To 2 cm3 of each extract, 2-3 cm3 of the reagent was added. Formation of an orange-red precipitate indicated the presence of alkaloids [20,21].
Flavonoids: To 2 cm3 of each extract, equal volume of sodium hydroxide was added. Formation of a yellow precipitate or solution indicated the presence of flavonoids [20].
Tannins and the phenols: To 2 cm3 of each extract, 2 cm3 of 5% Iron III chloride was added. A deep blue or black precipitate indicated presence of tannins and phenols [20].
Steroids: To 2 cm3 of each extract 2 cm3 of acetic anhydride solution was added and then heated in a water bath for about 5 minutes and cooled. A few drops of concentrated sulphuric acid was added. Presence of steroids were indicated by a blue precipitate [20,21].
Reducing sugars: Reducing sugars were tested by addition of 2-3 cm3 of Benedict’s solution to 2 cm3 of the herbal extract and then heated in water [22].
Levels of intensity of the phytochemical were determined by the intensity of the color changes and how fast these colors were forming. The phytochemical components were then studied and compared with the available literature to obtain their health impacts on pregnant women and the fetus
Data analysis and presentation
Most commonly used herbs were obtained by calculating the informant consensus factor (FIC), fidelity levels (FL) and use-value. The category of medicinal plants that presented greater importance were obtained by calculating their informant consensus factor [23,24]… Continue reading: Download a full text PDF file