Good News Medical Centre/HVM Laboratory Survey 1999 - 2002 by Ann McColm
Medicinal plants used by Tsimihety ethnic people group to treat illness in Mandritsara district, North Madagascar.
One hundred and forty plants have been listed during the past three years. Of these, 10 are considered toxic; either from overdose or are poisonous. Tsimihety vernacular name followed by scientifc name, if known.
Note: Identification not confirmed by recognised botanical organisation yet.
1. marigozy - Momordica charantia Cucurbitaceace; known as bitter melon, balsam pear. (ref: Rakotondraparany, Pierre @ Parc de Tsimbazaza Antananarivo)
2. mangidy - unknown (sample sent to Kew Gardens, UK for indentification.)
3. mafaibody - Cassia senna/augustifola/alata Leguminosae (ref: Boiteau, P)
4. mafaimamy - unknown
5. lambohenjana - Desmodium lasiocarpum Decayi
6. andrambafohy - Cabucala cryptohelia Apocyanaceae (ref: Boiteau, Pierre et Allorge-Boiteau, Lucile) NB: Many plants of Apocynaceae are poisonous.
7. mavohiaka - Senecio species, Composees (ref: Ravi-Maitso Descheemaeker, A)
8. vendramalamogno - unknown
9. fankataviakoho - Lantana camara (ref: Novy 1988) toxic if ingested, toxic to animals. ref: "Where there is no Vet" - Brian Forbes
10. romba - Ocimum gratissimum Scrophulariacees (ref: Quansah 1988) NB: Most plants of Scrophulariacees are poisonous, contain cardiac glycosides.
Patients requiring blood transfusions at our hospital during the past three years were investigated. Research concentrated on 3 conditions:
1. Gastro-intestinal bleeding.
2. Pregnant women with anaemia and jaundice.
3. Malnourished children with diarrhoea and severe anaemia from malaria.
1. Gastro-intestinal bleeding.
During October - December for the past 3 years, an average of 20 patients aged 20-40 years, mostly women, were admitted each year with severe anaemia from gastro-intestinal bleeding. Further studies indicated they had bilharzia and/or bacillary dysentry and consuming excess marigozy and mangidy herbal infusions caused bleeding which is probably due to diminished platelet count and clotting factors.
Marigozy contains a saponin, alkaloid momordicin and has anti-diabetic and tumor-inhibiting properties. Much research has been documented. ref: CAB Abstracts lists 34 studies - alkaloid momordicin.
Momordica charantia (bitter gourd) trypsin inhibitor-II prolonged the prothrombin time of human plasma. Inhibits Factor X by Factor VIIa-tissue factor complex or factor IXa. ref: J.Biochem. 116, 1013-1018 (1994)
Hepatitis B surface antigen test Negative in all but two patients with gastro-intestinal bleeding. one female, 24 yrs & one male 30 yrs with GI bleeding. 2 females 7 yrs & 31 yrs with hepatitis; (4 Pos in 30 HbsAg tests)
Cirrhosis caused by alcohol and dietary toxins - alkaloid toxins in bush teas is a cause of veno-occlusive disease. ref: District Laboratory Practice in Tropical Countries Monica Cheesborough 1998 THT
Herbal infusions containing pyrrolizidine alkaloids are known to cause veno-occlusive disease of the liver which leads to portal hypertension and oesphageal varices. ref: Principles of Medicine in Africa. 2nd ed. 1984.
A common cause of hepatic outflow tract obstruction is occlusion of the small intrahepatic venules. In nearly all locations where veno-occlusive disease occurs, it has been associated with ingestion of pyrrolidizine alkaloids, plant derived compounds found in herbal teas as well as in contaminated grain. ref: Strickland Hunter's Tropical Medicine 8th ed. 2000
Heliotropium, Crotolaria and Senecio species are important aetiologically.
There are toxic and non-toxic/edible species of Crotolaria. C. spectabilis contains monocrotaline and spectabiline, both toxic alkaloids. One of the symptoms of poisoning is bleeding stomach. ref: "Plants poisonous to People in Florida and other warm areas." Univ of Miami Florida 1995.
C. retusa contains monocrotaline causes Kimberley horse disease. ref:
2. Pregnant women with anaemia and jaundice.
Pregnant women often drink infusions of mavohiaka to prevent yellow eyes but it seems to cause jaundice or liver disorders. Vendramalamogno is also drunk by pregnant women with swollen feet and after delivery to hasten removal of the placenta. Several women have had ascites after delivery.
Senecio species (ragwort) cause hepatic necrosis and sporadic sudden deaths in a herd of 200 cattle over a period of 10 weeks.
ref: CAB Abstract Pyrrolizidine alkaloidosis in cattle due to Senecio species in Nerang QLD Australia. Veterinary record 1991, 129: 9, 198-199; 10
3. Malnourished children with malaria/diarrhoea.
Mafaibody and mafaimamy infusions are regularly given to children starting at one month until 2 years of age, even if they are not sick. Plasma appearance is not normal, often white and opaque as usually seen in renal disorders.
Herbal Monographs Publication states that Cassia species, commonly known as Senna - the medicinal parts are the leaves. Effects: Senna has a laxative effect due to sennosides and their active metabolite in the colon, rheinanthrone. Long term use leads to losses of electrolytes, in particular potassium ions and as a result of this to hyperaldosteronism, albuminuria, hematuria, inhibition of intestinal motility, muscle weakness, enhancement of the effect of cardio-active steroids and an influence over the effects of antiarryhthmics.
NB: Pediatric use - Not to be used by children under 12 years of age.
Cassia occidentalis known as coffee senna contains the alkaloid chrysaronin, toxalbumin and anthraquinone derivatives. Ingestion can cause severe purging and can be toxic. Whereas this may produce great discomfort and pain in an adult, the result in a child can be death.
Ref: "Some Plants are Poisonous"Sally Wilson (1997) Reed Victoria, Australia.
Acknowledgements:
Special thanks to Mme. Marline, my Malagasy coworker for the past 7 years. Without her help, I would not have obtained all the information regarding herbal usage.
I am grateful to my parents, David and Bernice McColm for sending information re Momordica charantia from Bailey's Queensland Flora Volume 2, 1901 and Merck's index regarding saponins which motivated me to research the cause/s of gastro-intestinal bleeding.
I am also indebted to Ms. Deborah Bushell Richmond, NSW; Mrs. Lyndal Dial, Haematology Dept, Queensland Medical Laboratory, Brisbane; Mr Lloyd Dunlop, Queensland Primary Industries at Goondiwindi QLD and Mr Don Robertson, a consultant chemist for their valuable assistance. Without them, I would not have be able to research these conditions in this remote area of Madagascar, so far from libraries and affordable access to Internet, WWW connections.
Next challenge:
There is a high incidence of Burkitt's Lymphoma in this district which needs to be investigated. Any researchers interested??
Ann McColm
15 October 2002.
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