This article is part of the supplement: Natural products for the control of malaria

Open Access Reviews

Do ethnobotanical and laboratory data predict clinical safety and efficacy of anti-malarial plants?

Merlin Willcox12*, Françoise Benoit-Vical134, Dennis Fowler1, Geneviève Bourdy56, Gemma Burford17, Sergio Giani8, Rocky Graziose9, Peter Houghton10, Milijaona Randrianarivelojosia11 and Philippe Rasoanaivo12

Author Affiliations

1 Research Initiative on Traditional Antimalarial Methods (RITAM), 66 Lye Valley, Oxford OX3 7ER, UK

2 Department of Primary Health Care, University of Oxford, Old Road Campus, Roosevelt Drive, Oxford OX3 7LF, UK

3 CNRS; LCC (Laboratoire de Chimie de Coordination) UPR8241; 205, route de Narbonne, F-31077 Toulouse, France and Université de Toulouse III ; UPS, LCC; 118, route de Narbonne, F-31077 Toulouse, France

4 Service de Parasitologie-Mycologie, Centre Hospitalier Universitaire de Toulouse, TSA 50032, 31059 Toulouse cedex 9, France et Faculté de Médecine de Rangueil, Université de Toulouse III, UPS, 31059 Toulouse, France

5 Université de Toulouse, UPS; UMR152 (Laboratoire de Pharmacochimie des Substances Naturelles et Pharmacophores Redox), F-31062 Toulouse, Cedex 9, France

6 Institut de Recherche pour le Développement, UMR152, F-31062 Toulouse cedex 9, France

7 Aang Serian Community College, PO Box 19, Monduli, Arusha, Tanzania

8 Aidemet ONG, Bamako, Mali

9 Rutgers University, NJ, USA

10 Dept of Pharmacy, King’s College London, Franklin-Wilkins Building, 150 Stamford Street, LONDON SE1 8WA, UK

11 Unité de Recherche sur le Paludisme, Institut Pasteur de Madagascar, Antananarivo, Madagascar

12 Laboratoire de Biothérapeutique, Institut Malgache de Recherches Appliquées, BP 3833, 101-Antananarivo, Madagascar

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Malaria Journal 2011, 10(Suppl 1):S7  doi:10.1186/1475-2875-10-S1-S7

Published: 15 March 2011

Abstract

Background

Over 1200 plant species are reported in ethnobotanical studies for the treatment of malaria and fevers, so it is important to prioritize plants for further development of anti-malarials.

Methods

The “RITAM score” was designed to combine information from systematic literature searches of published ethnobotanical studies and laboratory pharmacological studies of efficacy and safety, in order to prioritize plants for further research. It was evaluated by correlating it with the results of clinical trials.

Results and discussion

The laboratory efficacy score correlated with clinical parasite clearance (rs=0.7). The ethnobotanical component correlated weakly with clinical symptom clearance but not with parasite clearance. The safety component was difficult to validate as all plants entering clinical trials were generally considered safe, so there was no clinical data on toxic plants.

Conclusion

The RITAM score (especially the efficacy and safety components) can be used as part of the selection process for prioritising plants for further research as anti-malarial drug candidates. The validation in this study was limited by the very small number of available clinical studies, and the heterogeneity of patients included.