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Herbal Medicine and Parasitic Diseases

Vol. 4, No. 1, 2011
ISSN: 0258-3216
Personal non-commercial use only. PUJ copyright © 2011. All rights reserved PUJ; 2011, 4(1): 3-14
Herbal Medicine and Parasitic Diseases
Samia E. Etewa1, Sherif M. Abaza2
Parasitology Department, Faculty of Medicine, Zagazig1 and Suez Canal2 Universities, Ismailia, Egypt
Received: August, 2010 Accepted: October, 2010
Examples of Known Herbs with Antiparasitic Effects
Allium cepa; Onion (Al-Basal)
Two sets of compounds make up the majority of onion's
known active constituents: Sulphur compounds such as
allicin and allyl propyl disulphide and avonoids such as
quercetin. Allicin exhibits its antimicrobial action mainly
by immediate and total inhibition of RNA, DNA and
protein synthesis
In a study conducted in 2004, all tested strains of
Leishmania (major, donovani and mexicana) were found to
be sensitive in vitro to the onion juice in the promastigote
. Aqueous onion extract is similar to metronidazole
in inhibiting both multiplication and motility of T.
. A. cepa oil has an antihelminthic effect in rats
experimentally infected with T. spiralis and increases the
production of antibodies generated during life cycle of the
. Recently, effectiveness of A. Cepa extract in
eyelids inammation caused by Demodex folliculorum
was tested with promising results
. Onion reportedly
exerted different physiological changes in snails of
B. alexandrina leading to decrease in glucose and glycogen
which are the snail energy fuel and inhibited the phenol
oxidase enzyme which led to
disturbance in egg-shell
. Some adverse effects have been reported
where higher intakes may worsen existing heartburn and
there are also isolated reports of allergy manifesting as
skin rash and red, itchy eyes
Herbal medicine (also known as traditional, folk
and alternative medicine) comprises medical
knowledge systems that developed over generations
within various societies before the era of modern
medicine. WHO denes traditional medicine as the
health practices, approaches, knowledge and beliefs
incorporating plant, spiritual therapies and manual
techniques, applied singularly or in combination
to treat, diagnose and prevent illnesses or maintain
well-being(1). Ancient Egyptian medicine, 1000
Before Christ (BC), was known to use garlic,
opium, castor oil, coriander, mint and other herbs
for medicinal purposes and Indian medicine used
turmeric (Curcumin) possibly as early as 1900
BC(2). N. sativa seeds have been used as a traditional
medicine for the treatment of a variety of sicknesses
including parasitic diseases(3). The scope of herbal
medicine sometimes extended to include fungal and
bee products, as well as minerals, shells and certain
animal parts(4). It is estimated that 20,000 species of
higher plants are used medicinally throughout the
world. In some Asian and African countries, up to
80% of the population rely on traditional medicine
for their primary health care needs(1).
The emergence of parasites resistant to current
chemotherapies highlights the importance
of plant essential oils as novel anti-parasitic
agents; e.g., in schistosomiasis(5), malaria(6) and
visceral leishmaniasis(7). Some plant oils have
immunomodulatory effects that could modify host-
parasite immunobiology and the lipid solubility of
plant oils might offer alternative, transcutaneous
delivery routes(8). In addition, the safety and use
of plant essential oils in drug resistant cases are
considered the most advantages. However, lack of
proper understanding of plant and drug interactions
have led to adverse reactions that are sometimes life
threatening or lethal(9). Furthermore, adulteration
or counterfeit herbs can also be a health hazard, as
WHO conrmed that inappropriate use of traditional
medicines or practices can have negative or dangerous
The present review is an analysis to through light on
different herbs with their active compunds that could
be used as drug targets in parasitic diseases. It also
discusses some herbs with
repellent activity and
molluscicidal effects.
Corresponding author: Sherif M. Abaza,
Keywords: Herbal Medicine, Parasitic Diseases, Treatment, Repellents, Molluscicides.
Herbal Medicine and Parasites
Allium sativum; Garlic (Al-Tom)
The active constituents of garlic exceed 200 chemicals.
It contains sulphur compounds (allicin, alliin and
agoene), volatile oils, enzymes (allinase, peroxidase
and miracynase), carbohydrates (sucrose and glucose),
minerals (selenium), amino acids such as cysteine,
glutamine, isoleucine and methionine, bioavonoids
such as quercetin and cyanidin, Allistatin I and Allistatin
II and vitamins A, B1, B2, C, E and niacin
. The main
antimicrobial effect of allicin is due to its chemical
reaction with thiol groups of various enzymes e.g.
alcohol dehydrogenase and DNA polymerase which
affect the essential metabolism of cysteine proteinase
activity involved in the virulence of parasites
Garlic appears to be safe during pregnancy and breast-
feeding. Some sensitive people may experience
heartburn and atulence
Antiprotozoal effects: Several studies were conducted
to investigate the efcacy of garlic in giardiasis. There
were reports of complete relief of clinical symptoms
within 36 hours
, loss of agellar movement and
motility with trophozoites swelling leading to decreased
ability to adhere to host cells
, inhibition of Giardia’s
cysteine proteases activity and excretory/secretory
products resulting in reduction of GIT symptoms
. The
therapeutic effect of allicin was evaluated against C.
cayetanensis and the results showed that Tomex (10 mg/
Kg/day of garlic extract) caused signicant reduction
in oocyst shedding and improvement of intestinal
pathological changes (100% in immunocompetent and
80% in immunosuppressed mice)
The circumsporozoite protein (CSP), which is the
major surface protein of Plasmodia sporozoites, is
proteolytically processed by a parasite-derived cysteine
protease and this event is temporally associated with
sporozoite invasion of host cells. At low concentrations,
allicin inhibited CSP processing and prevented
sporozoite invasion of host cells in vitro. In vivo,
mice injected with allicin had decreased Plasmodia
infections compared to
controls. Allicin was also
tested on erythrocytic
stages where a
4-day regimen
of allicin administered
either orally or intravenously
signicantly increased the survival of infected mice
by 10 days
In mice infected with L. mexicana, intraperitoneal
injection of garlic extract or its protein fraction
augmented parasite engulfment and destruction of
intracellular amastigotes by macrophages. Modulation of
the immune response through macrophages activations
was postulated as a mechanism of action of garlic
Another explanation claimed that garlic extract reduced
macrophage infection through induction of nitric oxide
(NO) production in vitro. Therefore, it may act on both
T cells and macrophages to stimulate IFN-γ production
and NO synthesis for parasite killing
In a study conducted in 2007, Eimeria stiedae induced
marked hepatic histopathological alterations in rabbits
that were not treated with garlic, versus those treated
with garlic. The effect of methanol garlic extract
in a concentration of 3.90 mg/ml, on the growth of
Acanthamoeba castellanii and its cytotoxicity on
cells was studied in vitro. These ndings
indicated its amoebicidal, as well as cysticidal effects
on trophozoites and cysts, with no cytotoxicity to
corneal cells
. In addition, aqueous garlic extract
proved similar to metronidazole in inhibiting both
multiplication and motility of T. vaginalis
Antihelminthic effects: Aqueous garlic extract, with
its potent free radical scavenging and antioxidant
properties, seemed to be a highly promising agent in
protecting hepatic tissue against oxidative damage due
to S. mansoni infection
. Garlic efcacy was highest in
the group treated with garlic before and after bilharzial
infection and resulted in various ultrastructural
alterations in the surviving adult worm’s tegument
Results of a study conducted in 2008 showed that
chloroform garlic extract exerted the highest effect
on the viability of hydatid cyst protoscoleces in vitro,
in comparison with garlic aqueous extract and hydro-
alcoholic garlic extract
Garlic as repellent and its acaricidal effect:
The repellent effect of garlic oil was evaluated against
female Phlebotomus bite. A dose dependent anti-feeding
effect, which was 100% effective at 1% concentration,
was obtained
. Topical application of 10% garlic juice
by spraying, effectively decreased Northern fowl mite
(NFM, Ornithonyssus sylviarum) infestation in laying
hens. Humans could be bitten by these mites
and suffer
irritation and allergic reactions
Garlic as molluscicide: The effect of the plant-derived
molluscicides Annona squamosa and Lawsonia inermis
combined with A. sativum on the
reproduction of the
snail Lymnaea was studied. A signicant reduction in
the fecundity, hatchability and survival of young snails
was observed
Artemisia (Al-Sheeh)
There are about 300 species in the Artemisia genus.
Two of them, sweet annie (Artemisia annua) and
wormwood (Artemisia absinthium), are of medical
importance in treatment of some parasitic diseases.
The active constituents in the rst one are artesunate,
dihydroartemisinin, artemether and arteether, while the
second contains aromatic oils (thujone and isothujone)
and strong bitter agents (absinthin and anabsinthin).
Adverse effects associated with artemether treatment
were abdominal pain, anorexia, nausea, vomiting,
diarrhoea and CNS involvement (headache and
. Longer-term use of wormwood (over 4
weeks) can cause nausea, vomiting, insomnia, restlessness,
vertigo, tremors and seizures
. In addition, it is not
recommended during pregnancy and breast-feeding
Etewa and Abaza
Artemisinin (ART) derivatives: Mass drug
administration schemes in malaria control should
ideally use more than one drug, preferably combinations
including a rapid-acting schizonticidal drug, such
as ART, as well as primaquine that can kill sexual
and liver stages to prevent transmission. This could
be considered as an alternative strategy for malaria
control, and in
combination with other anti-malarial
measures may provide a tool for malaria elimination and
. ART combination therapy is the rst-line
treatment for uncomplicated P. falciparum malaria in
most malaria-endemic countries
. All ART compounds
induce very rapid reduction of parasitaemia, starting
almost immediately after administration. The proposed
mechanism of action involves cleavage of endoperoxide
bridges by iron producing free radicals which damage
biological macromolecules causing oxidative stress in
parasitized cells
. Pure artemisinin has a low solubility
in water, oil and therefore it could be administered
orally, rectally and intramuscularly. Intramuscular
artesunate is easier to administer but is associated with
. Unfortunately, oral administration is
often not possible in patients
with severe malaria, due
to extreme vomiting; hence the development of several
semi-synthetic ART derivatives
Artemisinin also showed anti-leishmanial activity for
both promastigotes and amastigotes and was accompanied
by a high safety index. The leishmanicidal activity of
artemisinin was mediated
via apoptosis as evidenced
by externalization of
phosphatidylserine, loss of
mitochondrial membrane potential and cell-cycle arrest.
These data indicated promising anti-leishmanial activity
mediated by programmed cell death
Moreover, several ART derivatives were shown to be
effective against T. gondii in vitro
as well as in vivo
in a murine model of reactivated toxoplasmosis
The mechanism of action is uncertain. However, it
was suggested that they may inhibit sarcoplasmic-
endoplasmic reticulum (ATPase), thus disrupting
calcium homeostasis by increasing the periodicity of
calcium oscillations and inducing recurrent, strong
calcium spikes
. In addition, these new ART derivatives
have the ability to inhibit multiple steps of T. gondii
lytic cycle; they effectively inhibited T. gondii growth,
tachyzoite replication, attachment to and invasion of
host cells
The ART derivatives were shown to possess a broad
spectrum of activities against several helminthic
infections. Combination between artemether and
praziquantel showed highest efcacies against juvenile
and adult worms of S. haematobium
. Scanning and
transmission microscopic observations indicated that
artemether induces extensive damage to juveniles and
adults of different Schistosoma spp.
. In addition,
signicant progress has been made with artemether use
for chemoprophylaxis in schistosomiasis, as immature
stages of S. mansoni are more prone to oxidative
killing than mature worms which probably participates
in the mechanism of anti-schistosomal action of
. The efcacy and safety of artemether was
studied in sheep infected with Fasciola spp. A single
intramuscular dose of artemether signicantly reduced
both egg and worm burdens. There were no adverse
events, however, two abortions were observed 7 days
post treatment(50). Recently, a study was carried out to
determine the morphological changes to F. hepatica
after in vivo treatment with artemether and the results
showed increased disruption of the tegumental system,
with isolated patches of surface blebbing and reduced
production of secretory bodies by the tegumental cells
Wormwood: A. absinthium extracts were found to be
effective against the enteral (adult) and parenteral (larva)
phases of trichinellosis
. In addition, oil extracts were
tested in the laboratory against host-seeking nymphs of
Ixodes ricinus Linnaeus (Acari: Ixodidae). The results
showed 62-70% repellent ability and hence could be
used in control of arthropods of medical, veterinary or
agricultural importance
Commiphora molmol; Myrrh (Al-Mor)
All the three main constituents of myrrh; resin,
gum and
volatile oil are important in myrrh's
activity as herbal
. The mechanism of the anti-schistosomal
action of myrrh on S. mansoni is not fully understood.
However, it has been attributed to permanent muscle
paralysis of the worms leading to their shift to the
liver where destruction takes place
. Meanwhile,
results of studies published on the efcacy of myrrh
in the treatment of S. mansoni-infected mice are
greatly conicting. Several experimental and clinical
studies reported signicant parasite reductions and
marked ultrastructural changes after treatment of S.
mansoni-infected mice with Mirazid
or under eld
. However, other studies negated myrrh
efcacy in the treatment of schistosomiasis in either
, or clinical studies
There is also such debate over the efcacy of Mirazid
for the treatment of fascioliasis. Complete cure rate
was achieved in experimentally infected rabbits with
oral dose of 20 mg/day for 6 consecutive days
On the contrary, results obtained for experimentally
infected sheep treated with Mirazid
appeared similar
to those for untreated infected animals
. On the other
hand, Mirazid
was reported to be effective against
D. dendriticum
, H. heterophyes
and H. nana
Regarding its antiprotozoal efcacy, Mirazid
effective against cryptosporidiosis
and trichomoniasis
in metronidazole-resistant infected females
Myrrh proved to have insecticidal activity against
mosquito larvae of Culex pipiens and Aedes caspius
In addition, the molluscicidal activity of myrrh was
evaluated in several studies on B. alexandrina, B.
truncatus and L. cailliaudi and the results revealed
signicant lethal and ovicidal effects
Herbal Medicine and Parasites
Curcuma longa; Turmeric (Al-Korkom or Curcumin)
As turmeric is a very cheap, easily available, effective
and acceptable mode of treatment
in developing
countries, with no toxic or adverse reaction, it was used
as paste for the treatment of scabies, with 97% cure rate
within 3-15 days of treatment
. The active
constituent known as curcumin showed a wide
range of therapeutic actions. When used in the
recommended amounts, turmeric is generally safe.
Some herbal books recommend not taking high
amounts of turmeric during pregnancy as it may cause
uterine contractions and patients with gallstones or
bile passages obstruction are advised to consult their
healthcare practitioner before using turmeric
Curcumin had a signicant effect on the progression
of experimental cerebral malaria. Survival of treated
mice was signicantly increased and development of
cerebral malaria was either delayed or prevented
Possessing antiprotozoal effects, turmeric as well
proved to (1) show cytotoxicity against T. brucei
(2) have leishmanicidal activity in vitro
, (3) inhibit
G. lamblia trophozoite growth and adhesion, by more
than 50%, in dose and time dependent manner
and (4) be an attenuating agent against T. gondii
tachyzoites in the peritoneal uid of mice
Studies were designed to evaluate the schistosomicidal
activity of curcumin in vivo as well as immuno-
modulation of granulomatous inammation in acute
schistosomiasis mansoni. It was found that praziquantel
was more effective in lowering worm burden while
curcumin was more potent in reducing egg count
The mechanism by which curcumin might function as
a schistosomicidal agent is unclear and needs further
investigation. In another study, curcumin was effective
in reducing both male and female worms and tissue-egg
burdens, hepatic granuloma volume and liver collagen
content. In addition, curcumin treatment modulates
cellular and humoral immune responses of infected
. On the other hand, curcumin is effective
in the treatment of many inammatory diseases. Its
efcacy on reducing the histopathological changes
of opisthorchiasis in hamsters was evaluated. Results
showed reduced inammatory cells aggregation
surrounding the hepatic
bile ducts, leading to reduced
risk factors of cholangiocarcinoma development
For molluscicidal activity, turmeric was evaluated
against B. alexandrina and the results showed that its
30 ppm extract stopped snail egg laying and caused
deformity of all embryonic stages
Nigella sativa; Nigella (Black Seed or Habbat
Nigella oil contains saponin, nigellidine and
and its seeds contain thymoquinone, monoterpenes
such as p-cymene and α-pinene
. Several mechanisms
were described for the activity of black seeds such as
its protection against hepatotoxicity
, its antioxidant
and stimulation of immune system
. The results
of the studies conducted in 2007 proved that its aqueous
extract could be useful in the treatment of B. hominis
and as an anti-malarial drug
. In the following year, its
inhibitory effect against T. vaginalis was investigated
in vitro and the results showed remarkable inhibition of
trophozoites growth and motility
The antioxidant and anti-schistosomal activities of N.
sativa oil was studied in control and S. mansoni-infected
mice. Remarkable reduction in worms, tissue eggs and
alteration in oogram pattern were recorded in all the
treated groups. The data pointed to the importance
of these seeds as a promising agent to complement
schistosomiasis specic treatment
. Its antiparasitic
effect was studied also in H. nana-infected mice, where
it was found to reduce the infection starting from 2
day of the treatment
. Moreover, its prophylactic
treatment prior to T. spiralis infection was effective
against both adult worms and muscle larval count in
infected rats
Zingiber ofcinale; Ginger (Ganzabil)
The main constituents of ginger are the gingerols,
shogaols, zingerone and paradol
. The anti-amoebic
effect of a crude drug formulation against E. histolytica
was studied in comparison to metronidazole. Results
showed that the product had a minimal inhibitory
concentration of 1000 mg/ml as compared with 10 mg/
ml for metronidazole
. In vitro, a concentration of
200 mg of ginger extract killed almost all Schistosoma
worms within 24 hrs
. The anti-helminthic activity
of ginger was reported also in sheep naturally
infected with mixed species of GIT nematodes e.g. T.
colubriformis, Strongyloides papillosus and Trichuris
. Another study conducted in 2006 showed
that there was signicant reduction in intestinal adult
and muscle larval count in mice infected with
. In addition, there was microlaricidal
activity of aqueous extracts of ginger when administered
to dogs infected with D. immitis larids(93).
Ginger essential oils proved to have repellent results
against host-seeking chiggers (scrub typhus) of
Leptotrombidium imphalum(94) and ovicidal and repellent
effects against different mosquitoes as Anopheles
stephensi, Aedes aegypti and Culex quinquefasciatus(95).
In addition, its petroleum ether extract has larvicidal
activity against A. aegypti and C. Quinquefasciatus(96).
As a molluscicidal agent, gingerol and shogaol exhibited
potent effects on Biomphalaria glabrata, indicating
their ability to interrupt Schistosoma transmission(97).
Results of in vivo exposure of Lymnaea acuminata to
proved its effect on snail neurotransmission
mechanisms, either separately or through a complex
between the different neurotransmitters
Etewa and Abaza
Berberis vulgaris, Berberis Aristata; Barberry
The active constituent in barberry is berberine which
is an alkaloid having antibacterial, anti-amoebic, anti-
fungal, anti-helminthic and leishmanicidal properties. Its
reported main side effect was interference with normal
liver function in infants. Strong standardized extracts
may cause stomach upset and should be used for no
more than two weeks continuously. Other symptoms of
excessive berberine intake include lethargy, nose bleed,
skin and eye irritation and kidney irritation
Berberine is a useful drug for the treatment of visceral as
well as cutaneous leishmaniasis. In L. donovani infection,
it inhibited in vitro multiplication of amastigotes
in macrophage culture and their transformation to
promastigotes in cell free culture
, while 1% berberine
sulphate inoculated intra-lesionally was found to be
highly effective against cutaneous leishmaniasis in
domestic dogs
. In addition, crude extract formulation
including berberine had a maximum cure rate of 73%
at a dose of 800 mg/kg/day in hepatic amoebiasis
The results of a study conducted in patients with
chloroquine-resistant malaria indicated that berberine
was more effective in clearing the parasite than both
tetracycline and cotrimoxazole and that the combination
of pyrimethamine and berberine gave the best results for
chloroquine resistant malaria
. Moreover, berberine
sulphate was comparable to metronidazole as regards
potency on the growth of
T. vaginalis in vitro
Azadirachta indica, Melia Azadirachta; Neem
The major active constituents in neem are fatty
acids and terpenoids such as azadirachtin, which
is considered to possess anti-microbial and insect
repellent effects, among many other actions
Neem seed oil is problematic and should be kept
out of reach of children
. In this form, it is mainly
used in control of vector borne parasitic diseases.
The larvicidal and emergence inhibitory activities
of neem were tested successfully against the vectors
of malaria, lariasis and dengue fever
. Besides,
water-free neem seed extract shampoo was effective
against S. scabiei-infesting dogs in Egypt
. As an
acaricidal agent, neem extracts showed high level of
efcacy (80%) for adult ticks after 5 hours of
. As a pediculicide, its extract shampoo
proved to be highly effective against all stages of head
lice, with no side effects
. The signicant repellent
activities of neem against Phlebotomus papatasi
Ixodes ricinus
nymphs were reported.
Cinchona ofcinalis; Cinchona (Al-Quina tree)
The medicinally active constituents of cinchona are
a variety of alkaloids as quinine and quinidine.
quinine has marked side effects, including tinnitus,
dizziness and nausea
. Quinine has been used as
malaria treatment for more than 350 years in Africa
and remains the rst-line anti-malarial drug for the
treatment of complicated malaria in Europe and Africa.
Children with uncomplicated malaria are generally
treated with oral medication, except those unable to take
oral drugs
. It has substantial disadvantages mainly
its poor tolerability, the long treatment course and the
bitter taste of its tablets
. Therefore, it
is no longer recommended by the WHO as rst line
treatment for malaria and should be used only when
artemesinins are not available
. Treatment of S.
mansoni-infected female mice with daily intraperitoneal
injections of quinine and quinidine caused signicant
decrease in worm burden and egg production. Their
schistosomicidal effects
are due to their capacity
to interfere with hemozoin formation which is the
main heme detoxication pathway in S. mansoni
In addition, quinine and chloroquine are considered
potential drugs against L. loa infection
Triticum vulgare, Triticum aestivum; Wheat germ
(Ganin Habit Al-Kamh)
Lectin (wheat germ agglutinin) is the active constituent,
however, it is a concentrated source of vitamin E, folic
acid, phosphorus, thiamin, zinc and magnesium, as
well as essential fatty acids and fatty alcohols
. In a
clinical trial, wheat germ helped in quick resolution of
symptoms in Giardia-infected patients. It did not kill
the parasites, but prevented their growth, replication
and attachment
. In addition, the effectiveness of
wheat germ as a useful dietary supplement administered
to E. histolytica-infected patients was reported, both
in acute and chronic stages of infection
. When its
therapeutic effect was experimentally evaluated in
immunosuppressed mice infected with Cryptosporidium
oocysts, it
showed signicant reduction of excreted
oocysts on day 7 post-infection
. It was also shown to
have remarkable inhibitory effect on multiplication and
motility of T. Vaginalis
Cinnamomum zeylanicum; Cinnamon (Al-Kerfa)
Various terpenoids (eugenol and cinnamaldehyde)
are believed to account for cinnamon's medicinal
. Some people develop bronchial constriction
or skin rash after exposure to cinnamon and chronic
use of the concentrated oil may cause mouth
inammation. Cinnamon is not recommended for
use by pregnant women
. Cinnamon essential oil
had potent insecticidal and ovicidal activities against
human head louse, P. humanus capitis
, acaricidal
activity against adult Dermanyssus gallinae
strong larvicidal activity against 4
instar Aedes
aegypti larvae
. Recently, its inhibitory action against
other mosquito species as Aedes albopictus, Culex
quinquefasciatus and Armigeres subalbatus larvae was
Herbal Medicine and Parasites
Melaleuca alternifolia; Tea Tree:
Oil of tea tree containing terpenoids such as terpinen-4-
ol and cineole has the ability to kill resistant fungus and
. The reported side effects included burning
and allergic reactions
. Its oil was reported to have
similar repellent effects, as clove oil used against scrub
. Tea tree oil (5%) showed
similar effects as
those of benzyl benzoate, lindane and ivermectin against
all stages of S. scabiei
. Acaricidal and pediculocidal
activity against house dust mites and lice was evaluated
using three essential oils: Tea tree, lavender and lemon
and the results revealed that tea tree oil was the most
. Moreover, improvement of symptoms and
dramatic resolution of ocular irritation
and conjunctival
inammation were reported in patients with Demodex
blepharitis who were treated with 50% tea tree oil
shampoo for a minimum of 6 weeks
Cucurbita pepo, Cucurbita maxima; Pumpkin
(Karh El-Asal, or Al-Yakten):
Pumpkin seeds contain several active constituents:
Essential fatty acids, amino
acids, phytosterols (e.g.
β-sitosterol), minerals, vitamins and curcurbitin which
shows anti-parasitic activity
. Oral administration
of crude ethanolic extracts from C. maxima reduced
by 50% the levels of parasitaemia in Plasmodium
berghei-infected mice
. In heterophyiasis, a combined
extract of areca nut and pumpkin seeds gave an excellent
result than when either extract was given alone
In addition, it gave effective results against canine
. Its leaf extract with different solvents
showed larvicidal, ovicidal and repellent activities
against Culex quinquefasciatus
Less Commonly Used Herbal Medicine with
Antiparasitic Effects
Cuminum cyminum; Cumin (Al-Kammoun):
Cuminaldehyde, cymene and terpenoids are the major
constituents of volatile oils of cumin
. It is usually
used in traditional medicine as a stimulant, a carminative
and an astringent
. Signicant larvicidal activity
(100% mortality) of essential oils derived from cumin
against early 4
stage larvae of Aedes aegypti and Culex
pipiens was reported
Eugenia caryophyllata; Syzygium aromaticum
Clove (Al-Kornfel): The main constituents of the
clove essential oil are phenylpropanoids such as
carvacrol, thymol, eugenol and cinnamaldehyde
Under eld conditions, Gel B (20% clove oil) provided
signicant repellent effects against Aedes aegypti,
Culex quinquefasciatus and Mansonia uniformis. These
promising results raised the possibility for its use by
low-income rural communities against various mosquito
. Moreover, essential oils of clove showed
repellent effects against host-seeking chiggers (scrub
typhus) of Leptotrombidium imphalum
Pimpinella anisum; Anise (Al-Yanson): The active
constituents in anise, particularly the terpenoid anethole,
are in its volatile oil
. Its uses for medication in
parasitic diseases are due to its insecticidal and repellent
effects. The acaricidal activity of anise seed oil against
house dust mites Dermatophagoides farinae and
D. pteronyssinus was about 8.4 and 6.7 times more
toxic than benzyl benzoate, respectively
. Besides
its acaricidal activity, it was highly effective as both
larvicidal and ovicidal against different mosquito spp.
As Anopheles, Aedes and Culex
. Moreover, its spray
preparation had
signicant cure rates against head louse
Punica granatum; Pomegranate (Al-Roman): Ellagic
acid is likely to be the main constituent responsible for
the antiparasitic effect of pomegranate
. It acts through
stimulation of the cell-mediated and humoral components
of the immune system
. The in vitro studies conducted
in 2009 proved that ellagic acid may contribute as a
promising anti-malarial drug
, it had the ability to
inhibit the growth of P. falciparum asexual blood stages in
. In addition, a natural plant extract puried from
pomegranate was effective against T. vaginalis in vitro
Ricinus communis; Castor Oil Plant (El-Khirwa):
Ricinoleic acid is the main component of castor oil,
and it constitutes approximately 90% of its fatty acid
. Leaves of castor oil plant are toxic to sand
ies and offer protection against their bites and decrease
the risk of leishmaniasis
. The methanol extract of castor
oil exhibited acaricidal and insecticidal activities against
Haemaphysalis bispinosa and Hippobosca maculata
Rosmarinus ofcinalis; Rosemary (Ekleel Al-Gabal):
The active constituents include volatile oil (eucalyptol
or cineole) as a potent antibacterial agent, rosmarinic
acid with antioxidant activity and carnosol as anti-cancer
formation in animal studies. Internal intake of its oil
should be avoided during pregnancy because it may cause
. Rosemary oil produced decreased oviposition,
had high larvicidal activity against all larval stages of A.
aegypti and proved to be a promising agent in mosquito
control programs
Salix alba; Willow (Al-Sefsaf): The main active constituent
is glycoside salicin which has anti-inammatory and pain-
relieving actions. As with aspirin, some people may
experience stomach upset from taking willow
. During
the American Civil War, the unreliable supply and high cost
of quinine forced the Confederate Army to use alternative
treatments for malaria which were made from indigenous
plants such as dogwood, willow and tulip tree. The quinine
substitutes were generally considered useful but not as
effective as quinine
Thymus vulgaris; Thyme (Al-Zaatar): The primary
constituents are the volatile oils, including phenols, thymol
and carvacol. Thyme oil should be reserved for topical
Etewa and Abaza
use, as internally it may lead to dizziness, vomiting and
breathing difculties
. So, its hydroalcoholic extract
was signicantly effective in reduction of ulcer size in
cutaneous leishmaniasis
. Its volatile oil was effective
against Lucilia sericata 3
stage larvae
and Pediculus
Herbal Medicine with Limited Molluscicidal Effects
Ambrosia maritima (Damsissa): In a eld trial in Egypt,
the possible use of single annual application of damsissa
plant, in snail control program for schistosomiasis
transmission season in Lower Egypt, was suggested
Longer prepatent period and remarkable decrease in
cercarial production was also recorded in snails treated
with the sublethal concentrations of this molluscicide
In addition, it has lethal effects on Lymnaea snails
Azolla pinnata: Molluscicidal activity of A. pinnata
was reported against B. alexandrina snails. Its ethanol
extract, at 6600 ppm for three hours
exposure, killed
100% and 19.4% of S. mansoni miracidia and cercariae,
Euphorbia spp. (Sabbaar): The physiological and lethal
effects of the latex components of E. splendens(162)and
E. milii(163), on Biomphalaria spp. were reported. It was
found that unltered crude latex extract is a more potent
molluscicide than ltered latex(162) and milin (the active
component) is likely to be responsible for alteration of
normal physiological functions and lethality of snails(163).
Acknowledgment: The authors would like to thank Prof.
Dr. Raefa Darwish and Prof. Dr. Soad Nada, Parasitology
Department, Faculty of Medicine, Zagazig University,
for revising the review article and Eman Magdy for
references collection.
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... Various herbs are used as natural antiparasitic agents such as Allium cepa (onion), Garlic, Artemisia, Commiphora molmol, Zingiber officinale, Nigella sativa, Berberis vulgaris, Neem (Azadirachta indica), Cinchona officinalis, Triticum spp., Cinnamomum spp., Melaleuca alternifolia, Pimpinella anisum, Punica granatum, Cucurbita pepo, Rosmarinus officinalis, Cuminum cyminum, Thymus vulgaris and Curcuma longa (Etewa and Abaza 2011;Attia et al. 2017). ...
... It could be stated that; the curcumin oils have immunomodulatory effects that modify the hostparasite immunobiology (Anthony et al. 2005). Potent essential oils could be used as effective pesticides in treatment of ecto-parasites instead of chemical drugs that develop resistance to them (Etewa and Abaza 2011). ...
Stomach horse bots (Gasterophilus intestinalis larvae; Diptera: Oestridae) are obligatory parasites inhabit the stomach of domestic Equidae. Colonization of Gasterophilus intestinalis larvae cause funnel-shaped stomach ulcers, sub-serosal abscess, and peritonitis. In the current research work, 3rd instar larvae of G. intestinalis were exposed to different concentrations (5, 10, 20, 40, 80 and 100 ppm) of curcumin from turmeric plant root (Curcuma longa). Survival of insect larvae, their morphological characterization, growth regulation, enzymatic assay and comet assay were assessed. Curcumin exhibited time and concentration dependent insecticidal effect on survival of 3rd instar larvae of G. intestinalis (bot flies). The aqueous extract of curcumin was highly toxic to G. intestinalis larvae with LC50 value of 16.92 ppm after 24 h. The mean comet tail length (µm) and tail moment (µm) at the highest curcumin concentration of 100 ppm were 16.03 ± 0.15 and 3.03 ± 0.09 µm, whereas DNA damage percent was 14.77 ± 0.12%. Further, remarkable inhibition of Glutathione S-transferases (GST) and Acetylcholinesterase (AChE) enzymatic activity were detected. Aqueous extract of curcumin exhibited potent lethal effects to the 3rd instar larvae of G. intestinalis, therefore, it could be used as an active and harmless natural insecticidal to control bot flies’ larvae in donkeys.
... Natural compounds and biological control methods have been searched for their anthelmintic effects (Arun et al., 2016). Medicinal plants and herbs are among the promising sources of effective and safe natural antiparasitic compounds Etewa and Abaza, 2011). ...
Ethnopharmacological relevance Jasminum grandiflorum L. is a medicinal plant widely used in the traditional system of Medicine as an anthelmintic in ringworm infections, for treating ulcers, stomatitis, skin diseases, and wounds. Aim of the study The emergence of resistance by different parasites to currently used chemicals has been reported. There are increasing needs for more effective and safer parasiticides. Therefore, the current study was designed to investigate the methanolic extract of the aerial parts of J. grandiflorum subsp. Floribundum (JGTE) to confirm its traditional uses as anthelmintic through a bioassay-guided fractionation and isolation of the active components with anthelmintic activity. Materials and methods The JGTE was partitioned into dichloromethane (DCM-F) and n-butanol (BuOH-F) fractions. The JGTE, fractions, and the isolated compounds were tested in vitro for their anthelmintic activity using two nematodes; one larval stage of cestode and one arthropod. Four major compounds were isolated from the most active fraction (BuOH-F) including two flavonoids and two secoirridoid glycosides, identified as kaempferol-3-O-neohesperoside (1), rutin (2), oleuropein (3), and ligstroside (4). Results Among the isolated compounds from most active fraction (BuOH-F), rutin (2) displayed the highest anthelmintic activity in a dose-dependent activity with IC50 of 41.04 μg/mL against against H. muscae adult worm, followed by ligstroside (4) with IC50 of 50.56 μg/mL. Conclusions These findings could advocate the traditional use of J. grandiflorum L. and provide further insight into the anthelmintic activity of flavonoids.
... The presence of these side effects in the present chemotherapy highlights the importance of plant origin drug as a novel antiparasitic herbal agent. (Etewa and Abaza 2011) and phytotherapy can be an alternative treatment for the control of that parasite (Hosseinzadeh et al. 2016). ...
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Hymenolepiasis is a common parasitic infection of children and considered an opportunistic disease with a life-threatening effect among immunocompromised patients through cysticercoid dissemination. Mirazid (Commiphora molmol) is new phytotherapy for hymenolepiasis. So, the present study aimed to evaluate the effects of Mirazid treatment comparing to Praziquantel (PZQ) (standard treatment) among immunocompetent and immunocompromised infected albino mice through biochemical and histopathological parameters. A total of 60 clean male albino mice (immunocompetent group) were divided into equal five groups which were infected and treated with Mirazid beside PZQ. Another 72 infected immunocompromised animals were divided into equal six groups and were also treated with Mirazid and PZQ. Liver and kidney functions were estimated as well as histopathological examination of intestine and liver. Levels of AST in the serum of infected mice treated with Mirazid or PZQ recorded a highly significant increase compared to the normal control group. The percentage of increase was 83.30% and 36.60% respectively. While the infected group recorded a non-significant decrease in AST level and the percentage of decrease was-7.4%. Immunocompetent groups showed a positive significant correlation with the control Mirazid or control PZQ groups recorded an increase in liver function enzymes (AST, Bilirubin, and GGT) (P \ 0.001) comparing to the normal control group. In conclusion, Mirazid showed higher cure rates than PZQ, 95.45%, and 74.54% on the 15th and the 21st days, it reached 100% respectively associated with good improvement of histopathological changes in intestine and liver.
... Some of medically important plant species rather gave an effect against schistosomiasis (Kamel et al, 2011). As novel antiparasitic agents, the emergence of parasitic resistance to current chemotherapies highlights the importance of plant essential oils (Etewa and Abaza, 2011). Massoud et al. (2013) reported that Mirazid (Commiphora molmol) is considered as a good clinical improvement with negligible side effects and has side degree of prevalence and spreading not only in Egypt, but worldwide. ...
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Generally, the parasitological markers showed that Neem (Azadirachta indica) and Mirazid (Commiphora molmol, MZ) were effective in reducing worms and eggs of Schistosoma man-soni. This study aimed to detect the histopathological improvement accompanied with using Neem and Mirazid to treat schistosomiasis. A total of 120 Swiss Albino mice were categorized into 10 groups: 5 groups infected with S. mansoni and either treated with only Neem (400 mg/kg), only MZ (500mg/kg), a combination of Neem and MZ, praziquantel (PZQ, 200 mg/kg) or not treated. Other 5 control groups were not infected but acquired the same treated doses as the above groups. The study was done in Department of Zoology, Faculty of Science, Al-Azhar University, Cairo, Egypt. Hematoxylin eosin and Masson's trichrome stain stained sections were used to examine the histopathological changes in the intestine and liver of mice. The results showed marked decrease of liver fibrosis in groups of mice treated with neem and/or MZ. This was ensured by a significant diminution in number and diameters of granulo-mas, reduction in their fibrotic content accompanied with a reduction in total area of infection as compared to infected mice.
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Leishmaniasis is a complex disease, with visceral and cutaneous manifestations, and is caused by over 15 different species of the protozoan parasite genus Leishmania. There are significant differences in the sensitivity of these species both to the standard drugs, for example, pentavalent antimonials and miltefosine, and those on clinical trial, for example, paromomycin. Over 60% of patients with visceral leishmaniasis in Bihar State, India, do not respond to treatment with pentavalent antimonials. This is now considered to be due to acquired resistance. Although this class of drugs has been used for over 60 years for leishmaniasis treatment, it is only in the past 2 years that the mechanisms of action and resistance have been identified, related to drug metabolism, thiol metabolism, and drug efflux. With the introduction of new therapies, including miltefosine in 2002 and paromomycin in 2005-2006, it is essential that there be a strategy to prevent the emergence of resistance to new drugs; combination therapy, monitoring of therapy, and improved diagnostics could play an essential role in this strategy.
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Due to increasing problems of the resistance associated with praziquantel, the drug of choice for treatment of schistosomiasis, alternative therapies are being sought. Scientific interest in the healing power of garlic has resulted in thousands of published papers on the ability of garlic to maintain good health. The current study was designed to evaluate the prophylactic and therapeutic values of garlic treatment against Schistosoma mansoni. Albino mice were infected with S. mansoni cercariae and were classified into: (a) treated with garlic before infection (prophylactic group), (b) treated with garlic after infection (therapeutic group), (c) treated with garlic before and after infection; (d) infected non-treated (control) group. Seven weeks post-infection, all mice were necropsied, and their livers and ilea were obtained for parasitological assessments. Schistosomes recovered from all groups were processed for ultrastructural investigations. Garlic treatment significantly evoked a reduction in the egg and worm burden. Garlic also resulted in various ultrastructural alterations in the tegument of the surviving worms including tubercular disruption, oedema, blebbing, ulcers, and vacuolization of other tegumental structures. Our findings suggest that garlic is a convenient prophylactic and a promising therapeutic agent for schistosomiasis mansoni infection.
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Nigella sativa (black seed) seeds have been used as a traditional medicine for the treatment of a variety of sicknesses including parasitic diseases. Intraperitoneal and oral administrations of ethanol, chloroform and aqueous seed extracts (50, 100, 200 and 400 µL kg¯ 1) of N. sativa, were screened in the 4-day suppressive assays for their anti-malarial properties against Plasmodium berghei in mice. Both intraperitoneal and oral treatments of the seeds extracts showed suppression activities in all groups of mice with the highest values were noted by the 100 and 200 µL kg¯ 1 doses of the ethanol extract and by the 100 µL kg¯ 1 dose of the chloroform extract which significantly (p <0.05) decreased the parasitaemias and increased the survival times of the infected mice. On the other hand, the aqueous extract showed a dose-dependent suppression activity by which the 200 and 400 µL kg¯ 1 extracts doses showed significant degrees of suppression activities in the infected mice. The results of this study confirm the usage of this plant in the Middle East folk medicine as parasitic remedy and open a new opportunity to further investigate the potentials of new plant-based anti-malarials in the future. However, the active responsible principles are yet to be identified, which need further studies to elucidate the anti-malarial mechanism of their action.
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Background-Previous studies have demonstrated the relaxant, anticholinergic (functional antagonism) and antihistaminic effects of Nigella sativa on guinea pig tracheal chains. Mechanisms responsible for the relaxant effect of this plant on tracheal chains were examined in this study. Methods- The calcium-antagonistic effects of three increment concentrations of the aqueous extracts of Nigella sativa and the calcium channel blocker diltiazem in comparison with saline were tested by measuring the cumulative concentration response curves of CaCl2-induced contractions of isolated guinea pig tracheal chains in the presence of calcium-free Krebs-Henseleit solution and 60 mM of KCl under each experimental condition (n = 7). Results-A rightward shift in the CaCl2 response curves was obtained in the presence of two different concentrations of diltiazem (1 and 5 µM) and the aqueous extract compared to the saline control curves. The effective concentration of CaCl2 causing 50% of maximum response (EC50) in the presence of two concentrations of aqueous extract and diltiazem was significantly higher than that of saline (p < 0.05 to p < 0.02). However, the maximum response to CaCl2 obtained in the presence of the final concentrations of aqueous extract and diltiazem was lower than of saline (p < 0.05 and p < 0.005 for aqueous extract and diltiazem, respectively). Conclusion-The results suggest a calcium antagonistic effect of N. sativa in isolated tracheal chains of guinea pigs. Keywordscalcium antagonistic effectguinea pigNigella sativatrachea
Schistosomiasis is a debilitating, and sometimes deadly, parasitic infection that afflicts hundreds of millions of people in developing countries. Great efforts have been devoted to develop a safe and an effective schistosomicidal agent. Myrrh is an oleo-gum-resin obtained from the stem of Commiphora molmol. An alcohol extract of this plant followed by steam distillation produced resin and volatile oil. We report here the results of efficacy, toxicity and side effects of a special formulation of myrrh, mirazid. Oral adminstration of this combination resulted in a significant reduction in the of worm burden of mice. It also induced separation of male-female coupled worms. Moreover, it shifted female worms from their normal habitat to the liver. Coincident with the shift of the female worms to the liver, a progressive reduction in the number of immature eggs laid in the wall of the small intestine was proved. This effect was accompained by an increase in the percentage of the mature stage from 14.9 ± 1.7 in control animals to 93 ± 7.5 and 93.4 ± 8.2 in animal treated with mirazid formulation at doses 250 and 500 mg/kg, respectively.
Histopathological changes in juvenile Schistosoma haematobium, caused by artemether administered to the infected hamsters, were studied. Hamsters were infected with S. haematobium cercariae, and after 28 days, a single dose of artemether (300 mg/kg) was administered intragastrically. After 24 h, 72 h and 7 days, groups of two hamsters were sacrificed, and livers were removed, fixed and processed routinely, and examined by light microscopy. After 24 h, 93% of the schistosomulae examined showed degeneration, which included swelling of the tegument, adherence of inflammatory cells to the damaged tegument, collapsed and damaged intestine, and infiltration of inflammatory cells, predominantly lymphocytes. After 72 h, the intensity of damage increased, including severe swelling of the tegument, loss of definition in the internal structures, collapse of intestine accompanied by release of pigment particles to the parenchymal tissues, and emergence of dead schistosomulae. Seven days after treatment, the number of dead schistosomulae increased, and most of them developed to an early- or late stage of dead worm granuloma. Meanwhile, 12% of the schistosomulae showed a normal appearance, which suggested that those schistosomulae that had survived the treatment were recovered to normal. The results demonstrated that artemether effectively acts against the juvenile stages of S. haematobium and confirms earlier results with S. japonicum and S. mansoni.