For centuries Traditional Health Practitioners (THPs) used their indigenous knowledge (IK) in conserving medicinal plants and environments to maintain sustainability. With the rapid environmental, social, economic and political changes occurring in many areas inhabited by rural people exist the danger that the loss of biodiversity from habitat destruction and unsustainable harvesting practices will result in some species becoming extinct. The main aim of the study was to determine the natural habitat of extinction-prone traditional medicinal plants combining the insight of THPs with an ultimate goal of guiding research for the conservation, propagation and cultivation of traditional medicinal plants. Despite problems, opportunities and challenges expressed and identified by THPs, the analysis of data from interview schedule and personal observations, show that the THPs' practices are shaped by historical processes and local cultural values, social norms and their management strategies that are influenced by a broad range of factors. / Agriculture, Animal Health and Human Ecology / M.A. (Human Ecology)

Xhosa psychiatric nurses stand unique at the interface between Western mental health care and indigenous healing in South Africa. They stem from a cultural history that is embedded within traditional health care discourses and yet are trained and work within a Western psychiatric model. In embodying the intersection between these two paradigms, they are faced with the challenge of making sense of such an amalgamation. These nurses' views are thus valuable in reflecting this intersection and illustrating many of the central concerns that surround it. This study explicates the views of these nurses toward traditional healers and their potential role in mental health care in South Africa. In addition, it illuminates some of the cultural dynamics at work amongst these subjects as they struggle to make sense of their unique cultural position. Using a questionnaire-based methodology, the views of Xhosa psychiatric nurses in a psychiatric hospital in the Eastern Cape, toward traditional healers and their role in mental-health care, were examined. The findings reveal that the vast majority of these nurses believe in traditional cosmology, involve themselves in traditional ritual practices and regularly visit traditional healers as patients. In suggesting ways in which indigenous healing and Western mental health care can work together, 75% of the nurses were in favour of a general referral system between the hospital and traditional healers, most (77%) agreed that certain patients would be better off being treated by both the hospital and traditional healers than they would if they were only being treated by the hospital alone, and 85% of the subjects agreed that patients who are already seeing traditional healers should check if psychiatric medication might help them. These findings indicate that these nurses operate across two healing systems which are at this point not conceptually compatible. This results in deep cultural tension for the nurses. In being entangled in the dialectical tension created in this context, the nurses manage the incongruencies in three general ways: a) Most, in one form or another, incorporate beliefs from both systems into an integrative model, b) some assimilate their cultural belief system into the Western mental health paradigm, throwing off their beliefs in traditional healing, and c) others remain ambivalent in the dialectic between traditional and Western health care discourses. Although this may suggest that these nurses reside within a cultural milieu that is somewhat unhealthy, at another level, in managing and containing the incompatibility between the two systems, these nurses ensure a space for on-going and healthy critique of the underlying assumptions involved in this health care malaise.

Helichrysum longifolium and H. pedunculatum belong to the Astereceae family and are used extensively in folkloric medicine in South Africa to manage stress-related ailments and as dressings for wounds normally encountered in circumcision rites, bruises, cuts and sores. The in vitro antibacterial time-kill studies, the synergistic potentials, the phytochemical screenings and antioxidant potentials as well as the isolation of the bioactive compounds from the extracts of these two plants were carried out in this study. The in vitro antibacterial activities and time kill regimes of crude extracts of H. pedunculatum was assessed. The extracts was active against both Gram positive and Gram negative bacteria tested at a concentration of 10 mg/ml. Minimum Inhibitory Concentration (MIC) values for all the susceptible bacteria ranged between 0.1 – 35 mg/ml. The average log reduction in viable cell count in time kill assay ranged between 0.17 Log10 to 6.37 Log10 cfu/ml after 6 h of interaction, and between 0.14 Log10 and 6.99 Log10 cfu/ml after 12 h interaction in 1 × MIC and 2 × MIC of the extract. The effect of the aqueous extract was only bacteriostatic on both reference and environmental strains and the clinical isolates were outrightly resistant to aqueous extract. This is worrisome and this could be one reason why, there is an incidence of high death rate resulting from circumcision wounds infection even after treating such wounds with H. pedunculatum leaf. In vitro antibacterial time kill studies of extracts of H. longifolium was assessed. All test bacteria were susceptible to the methanol extract, while none was susceptible to the aqueous extract. Two of the test bacteria were susceptible to the ethyl acetate extract, while ten and seven were susceptible to the acetone and chloroform extracts respectively at the test concentration of 5 mg/ml. The minimum inhibitory concentrations (MICs) ranged between 0.1 and 5.0 mg/ml, while minimum bactericidal concentrations (MBCs) ranged between 1.0 and >5 mg/ml for all the extracts. Average log reductions in viable cell counts for all the extracts ranged between 0.1 Log10 and 7.5 Log10 cfu/ml after 12 h interaction at 1 × MIC and 2 × MIC. Most of the extracts were rapidly bactericidal at 2 × MIC achieving a complete elimination of most of the test organisms within 12 h exposure time. The effect of combinations of the crude extracts of H. pedunculatum leaves and eight antibiotics was investigated by means of checkerboard and time-kill methods. In the checkerboard method, synergies of between 45.83-56.81 percent were observed and this is independent of Gram reaction, with combinations in the aqueous extract yielding largely antagonistic interactions (18.75 percent). The time kill assay also detected synergy that is independent of Gram reaction with a ≥ 3Log10 potentiation of the bactericidal activity of the test antibiotics. We conclude that the crude leaf extracts of H. pedunculatum could be potential source of broad spectrum antibiotics resistance modulating compounds. The interactions between crude extracts of H. longifolium in combination with six first-line antibiotics using both the time-kill and the checkerboard methods were carried out. The time-kill method revealed the highest bactericidal activity exemplified by a 6.7 Log10 reduction in cell density against Salmonella sp. when the extract and Penicillin G are combined at ½ × MIC. Synergistic response constituted about 65 percent, while indifference and antagonism constituted about 28.33 percent and 6.67 percent in the time kill assay, respectively. The checkerboard method also revealed that the extracts improved bactericidal effects of the antibiotics. About 61.67 percent of all the interactions were synergistic, while indifference interactions constituted about 26.67 percent and antagonistic interactions was observed in approximately 11.66 percent. The in vitro antioxidant property and phytochemical constituents of the aqueous crude leaf extracts of H. longifolium and H. pedunculatum was investigated. The scavenging activity on superoxide anions, DPPH, H2O2, NO and ABTS; and the reducing power were determined, as well as the flavonoid, proanthocyanidin and phenolic contents of the extracts. The extracts exhibited scavenging activity in all radicals tested due to the presence of relatively high total phenol and flavonoids contents in the extracts. Our findings suggest that H. longifolium and H. pedunculatum are endowed with antioxidant phytochemicals and could serve as a base for future drugs. Bioactivity-guided fractionation of the leaves of H. longifolium and H. pedunculatum yielded two known compounds. From the n-hexane fraction of H. longifolium a compound was isolated (Stigmasterol) and from the ethyl acetate fraction of H. pedunculatum another compound (β-sitosterol) was isolated. The compounds were isolated and identified using various techniques. The antimicrobial, anti-inflammatory, antioxidant, analgesic and anti-pyretic activities of these compounds have been reported in literatures. In general, the experiments and tests conducted in this study appear to have justified the folkloric medicinal uses of H. longifolium and H. pedunculatum for the treatment of stress related ailments and wound infections and make a substantial contribution to the knowledge base of the use of herbal medicine for the treatment of the microbial infections.

Pelargonium sidoides DC. (Geraniaceae) root extracts are used in the Eastern Cape Province of South Africa as a traditional medicine for the treatment of respiratory tract and gastro-intestinal infections. Ethanolic extracts are used globally as herbal treatments for bronchitis, asthma and as an immune system booster. Despite documented exploitation of wild populations by illegal harvesters, this species has not been awarded a protected status. The high level of harvest in the years preceding this study prompted this investigation of the prospects for sustainable root harvest through wild harvest and greenhouse cultivation. A novel method was developed for the purification of umckalin, a bioactive constituent in root extracts, such that the root umckalin concentrations of wild and cultivated plants could be quantified by HPLC. As part of the cultivation experiments, the concentration of umckalin in roots was measured for plants across part of the species’ distribution range in the Eastern Cape Province. This survey revealed that root umckalin concentrations were inversely related to the average annual rainfall of the collection site (r² = 0.94, p = 0.007) and directly related to soil pH (r² = 0.97, p = 0.002). Thus, the possibility of inducing high umckalin concentrations in greenhouse-cultivated plants was investigated by subjecting plants to rapid and prolonged water stress treatments. Two leaf applied hormone treatments (cytokinin and gibberellin) and a root competition treatment with a fast growing annual (Conyza albida) were also investigated based on the potential function of umckalin in P. sidoides plants. These five treatments did not significantly affect root umckalin concentrations compared to well-watered controls. The results of further experiments suggested that umckalin production may have been influenced by the geographical origin and genetics of plants rather than environmental variation. Following wild harvest experiments, the regrowth of replanted shoots from which a standard proportion of the root was harvested showed that water availability affected shoot survival but not root regrowth rate. Regrowth rates were low, questioning the viability of wild harvest. In contrast, greenhouse cultivated plants showed ca. six times greater growth rates, supporting the cultivation of roots to supply future market demand.

The commercialisation of natural resources such as medicinal plants is a strategy that is increasingly being employed by poor people in developing countries such as South Africa, as a means of generating an income. Increasing economic hardship and a lack of employment opportunities in the formal sector of the economy has led to many urban dwellers seeking alternative means of meeting their everyday livelihood needs. Although the contribution of natural resources to subsistence economies is widely recognised, there are few studies that have examined the significance of the trade in medicinal plants to the livelihoods of poor and marginalised people. Thirty informal street traders were interviewed to investigate the role of the medicinal plant trade in sustaining the livelihoods of the traders who operate in the informal sector of the Nelson Mandela Bay Municipality, South Africa. The findings of the research indicate that the sale and collection of medicinal plants is an activity which is exploited by people with limited resources, few skills, little or no education and often without any other source of household income. Middle-aged women from impoverished, single income households dominated the trade. Although income from the trade is modest, it contributed substantially to the total household cash income of the traders. Other benefits of the trade included independence and having a sense of purpose in life, as the traders felt that they were not only helping their families but also the wider community. However, without the income from the trade, many of the traders and their families would be destitute and thus the medicinal plant trade is vital to the wellbeing of these people.

The human immunodeficiency virus (HIV) is one of the most common and dreaded diseases of the 21th century. Today, the disease is still spreading with increasing incidence. “Since the beginning of the epidemic, almost 75 million people have been infected with the HIV virus and about 36 million people have died of HIV. Globally, 35.3 million [32.2–38.8 million] people were living with HIV at the end of 2012” (http://www.who.int/gho/hiv/en/). Several studies have been conducted on herbs under a multitude of ethnobotanical grounds. The use of medicinal plants for the management of HIV has become a common practice especially, in the Eastern Cape Province of South Africa (Wilfred Otang Mbeng, 2013 PhD thesis, UFH). At the beginning of this programme, an ethnomedicinal survey of plants used for the management of HIV infection was carried out in targeted areas of the Province and information on the names of plants, the parts and the methods of preparation were collected. The survey revealed that 18 species representing 12 families were found to be commonly used for the management of HIV, as well as other opportunistic diseases such as tuberculosis, diabetes mellitus, sores, high blood pressure, etc. Carpobrotus edulis was selected for this research because it was the most frequently used in the Province. The foliar micro morphological contents of the plant, its phytochemical and antioxidant activity, in vitro antimicrobial activity, inhibitory effect against HIV-1 protease and reverse transcriptase, mechanisms of action and cytotoxicity were investigated. In terms of the foliar micro morphological contents in plants, an electron microscopy scanning (SEM) was completed. Investigation revealed that both glandular tricomes and calcium oxalate crystals (CaOX) were observed. Consequently, it is hypothesized that the bioactive therapeutic compounds secreted by C. edulis may be produced in the glandular trichomes. An investigation of phytochemical content of the plant extracts (C. edulis) was completed using four solvent extracts (hexane, acetone, ethanol and water). Results of the phytochemical analysis showed that proanthocyanidins (86.9 ± 0.005%) where highest in the aqueous extract with phenolics at 55.7 ± 0.404% in acetone extract, tannin at 48.9 ± 0.28% in ethanol extract, while the hexane extract had the highest levels of flavonoids (0.12 ± 0.05%) and flavonols (0.12 ± 0.05%). Antioxidant studies of the various extracts revealed that aqueous and ethanol extracts were found to be the best solvents for antioxidant activity in C. edulis leaves. GC-MS analysis of the essential oil from C. edulis leaves revealed that the essential oil contained at least 28 compounds. These included, in order of abundance: Oxygenated monoterpenes (36.61%); fatty acids esters (19.25%); oxygenated diterpenes (19.24%); monoterpenes (10.6%); sesquiterpenes (3.58%); and diterpenes (1.43%). Similarly, a GC-MS analysis of the crude hexane, acetone and ethanol extracts from C. edulis leaves identified a total of 59 compounds. Of the 59 compounds, 12 major phyto-metabolites that are active against infectious diseases were identified. To comfirm the potential use of C. edulis to treat infectious disease, antifungal activity of the crude essential oil extract and the four solvent extracts were tested against Candida albicans, Candida krusei, Candida glabrata, Candida rugosa and Cryptococcus neoformans strains. The essential oil extract was found to be the most active against all the fungal strains tested and performed better than the four extracts used various solvents used to extract (hexane, acetone, ethanol and water) the C. edulis leaves were tested for antibacterial and anti HIV-1 reverse transcriptase (RT) activity. The results indicated that both gram-positive and gram-negative isolates were inhibited by the extracts (hexane, acetone and ethanol) but antimicrobial activity was observed for the water extract. The lowest minimum inhibitory concentration values were obtained for the ethanol extract, followed by acetone and hexane extracts. No inhibition of HIV-1 reverse transcriptase was observed for any of the leaf extracts, even up to concentrations of 16 mg/ml. The potential inhibitory activities of the various solvent extracts against HIV-1 protease were evaluated at four different concentrations (16, 1.6, 0.16 and 0.016 mg/ml). Results indicated that the water extract showed almost 100% inhibition of HIV-1 protease activity, with an IC50 of 0.86 mg/ml leaf extract. Other solvent extracts (hexane, acetone and ethanol) however, did not show any inhibition activity above that observed for the DMSO control. The metabolic components in the water extract were subjected to LC-MS/MS analysis, which identified at least 91 compounds present in the water extract. Further studies involving the molecular modelling need to be carried out to confirm the inhibitory potential of these compounds. The cytotoxicity of the water extract of C. edulis leaves was also screened using human Chang liver cells at concentrations ranging bewteen 0.005 mg/ml and 1 mg/ml. Results indicated that the water extracts were not toxic. In conclusion the results from this study support the use of water extracts of C. edulis leaves by traditional healers to treat HIV infections and have identified possible mechanisms of action of the water extracts of C. edulis.

Medicinal plants have been used as traditional medicine in the treatment of numerous human diseases for thousands of years in many parts of the world. In the developing world, especially in rural areas, herbal remedies continue to be a primary source of medicine. Scientifically, medicinal plants have proven to be an abundant source of biologically active compounds, many of which have already been formulated into useful therapeutic substances or have provided a basis for the development of new lead molecules for pharmaceuticals. Antibiotic resistance, undesireable side effects and expences associated with the use of combination therapy in the treatment of Helicobacter pylori infections have generated a considerable interest in the study of medicinal plants as potential sources of new drugs against this organism. The high complexicity of bioactive compounds accumulated in plants coupled with their broad antimicrobial activity may make it difficult for pathogenic organisms, including H. pylori to acquire resistance during treatment. This study therefore evaluates the antimicrobial potential of selected South African medicinal plants employed in the treatment of H. pylori-related infections, and the subsequent isolation of the plant active principles. An ethnobotanical survey of plants used in the treatment of H. pylori-related infections was conducted in the study area. Crude extracts of Combretum molle, Sclerocarya birrea, Garcinia kola, Alepidea amatymbica and 2 Strychnos species were screened against 30 clinical strains of H. pylori and 2 standard control strains (NCTC 11638 and ATCC 43526). In the preliminary stages of this study, ethyl acetate, acetone, ethanol, methanol and water extracts of the plants were tested against H. pylori by agar well diffusion and micro broth dilution methods. The plant crude extracts that exhibited anti-H. pylori activity with a iv percentage susceptibility of 50 percent and above were considered for the rate of kill assays and the most active crude extracts selected for bio-assay guided isolation of the active ingredient. Preliminary fractionation of the crude extract was achieved by thin layer chromatography (TLC) using different solvent combinations; hexane/diethylether (HDE), ethyl acetate/methanol/water (EMW) and chloroform/ethyl acetate/formic acid (CEF) in order to determine the most suitable combination for column chromatography (CC) and subsequent testing by indirect bioautography. The extract was then fractionated in a silica gel column using previously determined solvent combinations as eluent. Active fractions obtained from column chromatography separations were further fractionated and the compounds identified by gas chromatography/mass spectrometry (GC/MS) analysis. All the plants exhibited antimicrobial activity against H. pylori with zone of inhibition diameters ranging from 0 - 38 mm and minimum inhibitory concentration (MIC) values ranging from 0.06 - 5.0 mg/mL. The most active plant extracts were the acetone extract of C. molle with a percentage susceptibility of 87.1 percent, acetone and aqueous extracts of S. birrea (71 percent each) and the ethanolic extracts of G. kola (53.3 percent). Except for the aqueous extract, these extracts also exhibited a strong bactericidal activity against H. pylori at different concentrations. TLC analysis revealed the presence of 9 components in the acetone extract of S. birrea with the EMW solvent system as opposed to 5 and 8 with HDE and CEF respectively. Bioassay-guided isolation led to the identification of 52 compounds from the acetone extract of S. birrea with n-octacosane being the most abundant (41.68 percent). This was followed by pyrrolidine (38.91 percent), terpinen-4-ol (38.3 percent), n-eicosane (24.98 percent), cyclopentane (16.76 percent), n-triacontane (16.28 percent), aromadendrene (13.63 percent) and α-gujunene (8.77 percent). Terpinen-4-ol and pyrrolidine demonstrated strong antimicrobial activity against H. pylori at all concentrations tested. These results may serve as preliminary scientific validation of the ethnomedicinal uses of the above mentioned plants in the treatment of H. pylori-related infections in South Africa. Terpinen-4-ol and pyrrolidine could be considered for further evaluation as therapeutic or prophylactic agents in the treatment of H. pylori-related infections. However, further investigations would be necessary to determine their toxicological properties, in-vivo potencies and mechanism of action against H.pylori

All six plants studied (Senna petersiana, Terminalia sericea, Cassine transvaalensis, Elephantorrhiza burkei, Rauvolfia caffra and Anredera cordifolia) proved to have considerable antibacterial activity. The water extracts of five of the six plants tested, showed activity against Bacillus pumilis, B. subtilis and Staphylococcus aureus respectively. Water extracts from S. petersiana showed a significant antibacterial activity by inhibiting all Gram-positive and two Gram-negative bacteria. A cytotoxicity assay of three plants (S. petersiana, T. sericea and A. cordifolia) on primary vervet monkey kidney ceelsl showed that A. cordifolia was the least cytotoxic extract with an ID50 value of 1.560 mg/ml. Both S. petersian and T. sericea showed an ID50 value of 0.024 mg/ml. Cytotoxicity as determined in this study does not necessarily mean that the active compound which can be isolated from these plants will also be toxic. Antiviral activity of S. petersiana, T. sericea and A. cordifoli crude extracts were investigated against herpes simplex virus type I at the non-toxic concentrations. Both T. sericea and A. cordifoli extracts showed to be non-active against HSV -I, but S. petersiana showed a 20 % reduction in replication of the virus after the sixth day of the experiment. Because of the sensitivity and instability of compounds in the root extract of S. petersiana, it was very difficult to isolate any pure compound. Bioassay-guided fractionation of the seeds of S. petersiana resulted in the isolation luteolin. Its structure was identified and confirmed through spectroscopic methods including IH, BC, UV, HMBC and HMBQ. An antibacterial assay of luteolin isolated from the seeds of S. petersiana showed activity against Baccilus cereus, B. pumilis, Streptococcus aureus and Staphylococcus areus at the concentration of I mg/ml. In the assay to assess the possible antiviral activity of luteolin against herpes simplex type I virus, 50% of the virus was inactivated at the concentration of 250 μg/ml. The results of this study have shown that it is possibl4e that the extracts studied, can provide humankind with valuable agents of potential use in the treatment of herpes and some bacterial species. / Dissertation (MSc ( Plant Physiology))--University of Pretoria, 2006. / Plant Science / unrestricted

Thesis (MSc. (Microbiology)) -- University of Limpopo, 2019 / The emergence of drug resistance to the first line drugs complicates the treatment of tuberculosis (TB), especially in parts of sub-Saharan Africa where accessibility to quality health care is limited. The search for alternative medication has been the centre of research for years due to challenges posed by infectious organisms including drug resistance, lengthy treatment periods and lack of quality health care in developing countries. Stomatostemma monteiroae is used in traditional medicine to treat TB and related symptoms. The aim of this study was to isolate and characterise compounds with antimycobacterial activity from Stomatostemma monteiroae. The plant materials were collected from Ga-Madiga village in Limpopo province of South Africa. Different plant parts namely: leaves, twigs, roots, tuber and tuber-peels were separated, washed, dried and milled to a fine powder. Several solvents (n-hexane, dichloromethane, acetone and methanol) were used to extract the plant material using various extraction methods such as maceration, defatting, and extract enrichment procedure and phytochemical analysis was done using standard chemical tests and thin layer chromatography. The qualitative antioxidant activity was determined by the thin layer chromatography (TLC) based 2,2-diphenyl-1picrylhydrazyl (DPPH) free radical scavenging activity and quantitative antioxidant activity was determined using colorimetric DPPH free radical scavenging and ferric reducing power assay. Antimycobacterial activity of the extracts was assessed using bioautography and micro dilution method tested on Mycobacterium smegmatis (ATCC 1441), Mycobacterium tuberculosis (ATCC 25177) and M. tuberculosis H37Rv (ATCC 27294). The cytotoxic effects of the extracts were evaluated using the 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide (MTT) assay on Vero monkey kidney cells. The compounds with antimycobacterial activity were isolated using bioassay-guided fractionation and purified using preparative thin layer chromatography and thereafter identified using NMR spectroscopy to elucidate the structure. Various phytochemical constituents were detected in different plant parts, with the leaves and twigs possessing more of the phytoconstituents analysed. The TLC profile of S. monteiroae indicated that more compounds are non-polar to intermediate in polarity. The antioxidant activity analysis on TLC plates indicated that all the plant parts have low antioxidant activity, this was also confirmed by xxii quantitative tests. The leaves of S. monteiroae had antimycobacterial activity when analysed using bioautography, while other plant parts had no active bands. The minimum inhibitory concentration values were much higher than the positive control rifampicin and the roots (0.31 mg/mL) followed by the leaves (0.83 mg/mL) had lower inhibitory concentrations when tested against M. smegmatis. The MIC values of extracts against TB causing strains varied greatly, the leaves and the roots had even higher MIC value. Toxicity analysis indicated that all plant parts were non-toxic towards Vero cells (LC50 > 0.02 mg/mL). Bioassay-guided fractionation enabled isolation of one antimycobacterial pure compound from the leaves extracts. The isolated compound was identified using NMR and was found to be a sitosterol derivative 8,9-dehydro-4-methyl-24-vinylobtusifoliol. This compound had a noteworthy activity against M. smegmatis. The present study validates the use of S. monteiroae in the treatment of TB related symptoms traditionally. Further studies are required to analyse the cytotoxic effects of the isolated compound and also testing the antimycobacterial activity of the isolated compound on TB causing pathogens. / National Research Foundation (NRF)

MAAS / Centre for African Studies / See the attached abstract below