Ethnobotanical knowledge on native Brazilian medicinal plants traditionally used as anthelmintic agents – A review

Intestinal helminthiasis is a neglected disease and one of the most common infections in humans, mostly affecting vulnerable individuals living in poor sanitary conditions and rural areas in developing countries (Agyare et al., 2014; Bibi et al., 2016; Gonçalves et al., 2016). According to the World Health Organization (WHO), more than 1.5 billion people are infected with soil-transmitted helminths (STH), corresponding to 24% of the worldwide population (World Health Organization, 2022), and share symptoms such as diarrhea, abdominal pain, nutritional disorders, and fatigue. Notably, intestinal helminthiasis can cause cognitive and developmental dysfunctions in children under the age of 5 years (Curico et al., 2022; Poague et al., 2021; World Health Organization, 2006). Although the mortality rate is low, in severe cases infection can induce serious complications such as rectal prolapse, intestinal obstruction, severe anemia and inflammation, leading to a decline in educational levels and affecting economic productivity (Agyare et al., 2014; Bóia et al., 2006; Romero–Benavides et al., 2017).

Globally, STH infections are primarily caused by Ascaris lumbricoides, Trichuris trichiura, and hookworms (Ancylostoma duodenale, A. ceylanicum, and Necator americanus) (World Health Organization, 2022). Estimates from Brazil show that 15.6% of the population are infected with A. lumbricoides, 10.1% with T. trichiura, and 2.5% with hookworms (Humphries et al., 2012; Scholte et al., 2013). Moreover, cases of intestinal helminthiasis have been reported throughout the country, although they are not homogeneously distributed (Celestino et al., 2021).

Although the Ministry of Health of Brazil supported the administration of broad-spectrum anthelmintic drugs (albendazole and mebendazole), poor sanitation and limited access to adequate water supply and healthcare services have led to a great vulnerability for STH re-infections (Celestino et al., 2021; de Oliveira et al., 2020). Moreover, harmful adverse effects such as hepatotoxicity, loss of appetite, nausea, dizziness, and headache have been reported for currently available synthetic anthelmintic drugs, as well as drug resistance for some gastrointestinal parasites that affect humans and almost all species of domestic animals (Humphries et al., 2012; Lalthanpuii and Lalchhandama, 2020), which has generated interest in new alternative deworming treatments. The development of resistance to anthelmintic drugs is also considered a major problem for the control of STH infections, threatening the sustainability of mass helminth control programs, mainly in developing world populations (Gilleard, 2013).

The use of traditional plant remedies for treating STH infections by different communities is very common (Agyare et al., 2014; Ataba et al., 2020; Bussmann et al., 2016) and several bioactive compounds have been identified as anthelmintic agents (Romero–Benavides et al., 2017). Flavonoids (Lasisi and Kareem, 2011), tannins (Aggarwal et al., 2016; Ahmed et al., 2020; Guo et al., 2017), alkaloids (Castagna et al., 2020; Kaiaty et al., 2021) and terpenes (Okombe Embeya et al., 2014; Monzote et al., 2009) have demonstrated antiparasitic activities, which could be of interest in the development of novel drugs. Brazil has an enormous biodiversity, and several ethnobotanical studies have established that the use of plants for the treatment of intestinal worms is the only alternative available for most populations (de Andrade et al., 2018; Batista et al., 2019; Santos–Lima et al., 2016). However, documentation of traditionally used herbal medicines to manage human helminthiasis in Brazil has not yet been conducted. In this context, the objectives of this study were to compile the anthelmintic plants traditionally used in Brazil mentioned in books of folk medicine literature from various regions in the country, the main plant parts and methods of preparation used, and to review the biological validation of the most reported species.

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