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

Abstract

In traditional medicine, laboratory tests are essential tools used to evaluate practices in healthcare that use natural products, particularly when there are few established treatments such as in the case of chronic diseases like sickle cell disease (SCD). SCD is a genetic hemoglobin disorder associated with hemolysis, oxidative stress, inflammation, and vaso-occlusive complications. This study aims to document medicinal plants used in the management of SCD and the traditional practices associated with their use, in order to assess their added value in relation to biological activities relevant to SCD. First, this study carried out an ethnobotanical survey at Kisangani, with 384 participants. A total of 201 respondents, 58% of whom were women, identified 45 medicinal plant species from 30 families. They reported the use of sugar, caramel, ash, and lemon juice as additives in traditional remedies. Based on several criteria, <i>Alchornea cordifolia</i> Müll. Arg. and <i>Hibiscus tiliaceus</i> L. were selected for laboratory evaluation. Their leaves were collected from arid and marshy soils and prepared according to the respondents' descriptions for antioxidant and anti-inflammatory assessments. <i>A. cordifolia</i> showed significantly higher activities than <i>H. tiliaceus</i> regarding antioxidant (<i>p</i> = 0.001) and anti-inflammatory (<i>p</i> = 0.01) properties. Soil type was observed to influence the bioactivity of <i>H. tiliaceus</i>, with better performance in marshy soil samples. Sugar and caramel were found to reduce antioxidant activity, whereas ash and lemon juice preserved it without markedly altering anti-inflammatory effects. These findings are promising for supporting local knowledge about these two plant species.