Journal of Ethnopharmacology 138 (2011) 415–431 Contents lists available at SciVerse ScienceDirect Journal of Ethnopharmacology journa l h o me page: www.elsevier.com/locate/jethpharm Traditional phytotherapy remedies used in Southern Rwanda for the treatment of liver diseases Marie-Jeanne Mukazayire a,b , Védaste Minani b , Christopher K. Ruffo b , Elias Bizuru c , Caroline Stévigny a , Pierre Duez a,d,* a Université Libre de Bruxelles (ULB), Laboratory of Pharmacognosy, Bromatology and Human Nutrition, CP 205-9, B-1050 Brussels, Belgium b Institute of Research in Science and Technology (I.R.S.T.), Phytomedecine and Life Sciences Research Programme, P.O. Box 227, Butare, Rwanda c National University of Rwanda, Department of Biology, P.O. Box 117, Butare, Rwanda d Université de Mons (UMONS), Department of Therapeutic Chemistry and Pharmacognosy, Bât. Mendeleiev, Av. Maistriau, 7000 Mons, Belgium a r t i c l e i n f o Article history: Received 30 April 2011 Received in revised form 10 September 2011 Accepted 16 September 2011 Available online 22 September 2011 Keywords: Ethnopharmacology Ethnomedicine Anti-hepatitis plants Southern Rwanda a b s t r a c t Ethnopharmacological relevance: Liver diseases represent a major health problem due to their complica- tions and limited treatment possibilities. In Rwanda, given low accessibility to modern treatments, most people still rely on traditional medicinal plants. The symptomatology of many hepatic troubles (icterus) is evident for traditional healers who have a high probability of selecting efficient herbal medicines. Objectives: To document medicines used in the treatment of “hepatitis” in Southern Rwanda with the knowledge, attitudes and practices related to liver disorder recognition, control and treatment. Materials and methods: 56 traditional health practitioners, each a legal representative of an official associ- ation, were interviewed and participated in plant collection for the preparation of botanically identified herbarium specimens. Results: 68 multi-component and 65 single-component herbal recipes were identified for the treatment of liver diseases with a total of 86 different herbs from 34 families identified. The most represented were the Asteraceae and the Lamiaceae. Crassocephalum vitellinum, Hypoestes triflora and Erythrina abyssinica were the most widely used plants. The principle of polymedication for complex (i.e. multifactorial) diseases (“Ifumbi” in Rwanda), is a constant in every traditional practice. It is striking that the Rwandese therapy of liver diseases proposes so many single-herb preparations (49% of all herbal preparations). Some of the recorded plants or other species from the same genus have previously been documented for liver protection using various in vivo and in vitro models. Conclusion: Herbal remedies for hepatitis are widely used and highly diverse in Southern Rwanda; further chemical, pharmacological and toxicological studies are clearly required to rationally develop the most important remedies. © 2011 Elsevier Ireland Ltd. All rights reserved. 1. Introduction The predominant liver pathologies in a given country depend on the lifestyle and economic conditions. Acute and chronic hep- atitis, liver cirrhosis (LC) and primary hepatocellular carcinoma (HCC) have become one of the major public health problems world- wide and are very common in Africa, especially in Sub-Saharan Abbreviations: CCl4, carbon tetrachloride; HCC, primary hepatocellular carci- noma; IRST, Institute of Research in Science and Technology; LC, liver cirrhosis; THPs, traditional health practitioners; WHO, World Health Organization. * Corresponding author at: Laboratoire de Pharmacognosie, de Bromatologie et de Nutrition humaine, Institut de Pharmacie, Université Libre de Bruxelles (ULB), Campus de la Plaine – CP205/9, Bd du Triomphe, B-1050 Bruxelles, Belgium. Tel.: +32 26505172; fax: +32 26505430. E-mail addresses: mmukazay@ulb.ac.be (M.-J. Mukazayire), pduez@ulb.ac.be (P. Duez). Africa (Mets et al., 1993; Dasnoy et al., 1997; Thomas et al., 2011). In Rwanda, estimates from the University Hospital of Butare indicate that viral hepatitis and its complications, cirrhosis and hepatic carcinoma, represent 80% of all liver pathologies, the ninth most common cause of morbidity (Musemakweli, 1999). Modern medicine is still quite limited in hepatic diseases prevention or treatment, apart from vaccines and interferon -2b, used against some viral infections; the only drugs available are cholagogues, choleretics, and drugs for cholesterolic lithiasis, N-acetyl-cysteine and flavo-lignanes obtained from Silybum marianum (Evans, 2002). This limitation of therapeutic options gives considerable interest to the search for active compounds from plants traditionally used against liver diseases (Mukazayire et al., 2010; Jaeschke et al., 2011). Plants are an integral part of life in many indigenous communi- ties, and Africa is no exception (Sidigia et al., 1995; Heinrich et al., 2009). Plant biodiversity plays major specific roles in the cultural evolution of local human societies (Mugabe and Clark, 1998) with 0378-8741/$ – see front matter © 2011 Elsevier Ireland Ltd. All rights reserved. doi:10.1016/j.jep.2011.09.025