Sickle cell disease: Ethnopharmacological survey in the eastern part of Madagascar

Abstract

Sickle cell disease (SCD) is one of the most devastating inherited haemoglobinopathy that affects mostly children. Its prevalence can reach up to 13 % in the south-eastern part of Madagascar. For socio-cultural and economic reasons, the majority of patients use plants to manage the symptoms of this genetic disease. This work aims to inventory these plants and collect all information on their use, their therapeutic effects, and their eventual side effects in order to compile a database. These plants will be the subject of future chemical, pharmacological and toxicological investigations in the laboratory. Semi-directive interviews were led among 208 respondents from January 2018 to January 2020 in the eastern part of Madagascar. After obtaining the informed consent of the interviewees, collected data on the used medicinal plants were analyzed for various ethnomedicinal parameters including frequency of citation (FC), use value (UV), relative frequency of citation (RFC), fidelity level (FL), family use value (FUV) and informant consensus factor (ICF) related to the SCD management and the other mentioned diseases. Among the 208 respondents, 30.29 % were male; 73.39 % received formal education; 53.37 % were farmers, 8.17 % were traditional healers and 6.73 % were herbal sellers. Most of them (94.23 %) have a good knowledge of SCD and 91.83 % of them use herbal medicine to manage SCD. They recommended 123 plant species belonging to 111 genera and 62 families. Asteraceae (14.50 %) was the most cited family however Blechnaceae was the most valued family (FUV = 0.356). The majority of the cited species (70.73 %) were wild plants. Herbs (42.28 %) were the most used plant life form and the most used common parts were leaves (44.68 %). They usually prepare tea by infusion of plant material (71.83 %). Ficus polita was the most important species with the highest FC (10.93 %), UV (0.393), RFC (75.92 %) and FL (94.94 %). ICF of SCD and its symptoms value was 0.50 showing the homogeneity, and the consensus among the informants in the use of medicinal plants for managing this disease. Some species (08) have been reported for their anti-sickling properties and some of the other species have been reported for their pharmacological properties related to SCD symptoms management. These results confirmed the importance of investigating the use of plant species to manage SCD and its symptoms in the eastern part of Madagascar, suggesting the fundamental role of ethnomedicinal studies for the sustainable use of plant species for future scientific investigations on phyto-drugs for SCD management.