Evidence-Based Management of Sickle Cell Disease: Ethnobotanical Survey and Laboratory Validation of Traditional Herbal Recipes

Our study explored the scientific rationale behind the traditional use of medicinal plants as a foundation for evidence-based strategies for the management of sickle cell disease (SCD) in developing countries. Firstly, we conducted a survey among people living at Kisangani city in DR Congo to identify the plants used alone or in combination for the SCD management considering the following criteria: used parts, preparation methods, administration routes and common combinations with other substances. This step allowed to select the most used plants which were harvested from two different soil types and prepared according to local practices. Secondly, different preparations were tested at laboratory focusing on the antioxidant and anti-inflammatory biological activities which are mainly observed with people suffering from SCD. Out of 384 surveyed people, 201 reported the use of 45 medicinal plants whereas the additives comprised sugar, caramel, ash and lemon juice. Alchornea cordifolia Müll. Arg and Hibiscus tiliaceus L. were selected for laboratory analyses. Their leaves were collected from both dry and marshy soils and prepared following local methods with additive. A. cordifolia showed significantly higher antioxidant (p = 0.001) and anti-inflammatory activity (p = 0.01) than H. tiliaceus. Soil type influenced activity in H. tiliaceus, favoring marshy soil. However, sugar and caramel significantly reduced bioactivity, ash and lemon juice enhanced antioxidant effects without significantly altering anti-inflammatory properties.