Volume 151, Issue 1, 10 January 2014, Pages 413–444
Ethnomedicinal application of native remedies used against diabetes and related complications in Mauritius
Abstract
Ethnopharmacological relevance
Notoriously,
the tropical island of Mauritius has one of the highest prevalence of
diabetes worldwide and the economic burden associated with it is
alarming. The use of native remedies (NRs) is well anchored in the local
culture and it continues to be the cornerstone of therapy for diabetic
patients. However, there is currently a dearth of updated primary data
on NRs used by Mauritians against diabetes and diabetes related
complications (DRCs). This study was therefore designed to record,
analyze and document orally transmitted ethnopharmacological knowledge
from diabetic patients and traditional medicine practitioners (TMPs) in
Mauritius concerning NRs commonly used against diabetes and DRCs which
might open new avenues to initiate novel antidiabetic drugs discovery.
Materials and methods
Data was collected following interviews from diabetic patients (n=328) and TMPs (n=20).
Eleven quantitative indexes, namely informant consensus factor (FIC),
fidelity level (FL), use value (UV), relative frequency of citation
(RFC), relative importance (RI), cultural importance index (CII), index
of agreement on remedies (IAR), cultural agreement index (CAI), quality
use value (QUV), quality use agreement value (QUAV) and ethnobotanicity
index (EI) were calculated. Statistical analysis such as Pearson
correlation and Chi-squared test were performed to determine any
association.
Results
A total of
111 plant species distributed over 56 families, 30 polyherbal
formulations and 16 animal species were documented to be traditionally
used against diabetes and DRCs. For the first time 8 endemic plants have
been recorded to be used against diabetes and DRCs from Mauritius. The
most encountered medicinal plant family was Asteraceae. According to the
EI, 16.2% of the native plants in Mauritius were used against diabetes
and DRCs. As far as we know, Vangueria madagascariensis, Apium graveolens, Petroselinum crispum and Rubus alceifolius
with high RFC values are recorded against diabetes and DRCs for the
first time. Sociodemographic characteristics (age, gender, income,
religious belief, education and residence) were found to significantly (p<0.05)
influence the use of NRs. The average FIC for all ailments for plant
and animal products were 0.94 and 0.87 respectively. Bryophyllum pinnatum, a native plant to Mauritius scored a high FL value (100%) used against diabetic neuropathy, Allium sativum had the highest RI value (2.00) due to its versatility, Aloe vera had the highest RFC (0.61), the CII (0.640) and the highest CAI value (0.635), Psidium guajava had the highest QUAV (0.961) which indicates its high bioactivity and Allium cepa was reported as the most effective plant species (QUV=0.965). According to UV, the most important species was Morinda citrifolia (1.21). Panoply of animal products were reported whereby fish (39.7%) was recorded as the most utilised zootherapy and Salmo salar scored the highest FL (100%) for diabetes. Some animal species (n=14) not previously documented against diabetes and DRCs are reported in the present study.
Conclusion
Our
present investigation revealed that the use of NRs constitutes the
common legacy of Mauritians and despite the penetration of allopathic
medicine; NRs continue to play a crucial role in the primary health care
system of Mauritius. To this effect, it is of uttermost importance to
record this knowledge before it disappears. In addition, further
experimental investigations are required to elucidate the
pharmacological properties of the reported medicinal flora and fauna of
Mauritius.
Graphical abstract
Abbreviations
- AR, animal-based remedy;
- CAI, cultural agreement index;
- CII, cultural importance index;
- DRCs, diabetes related complications;
- EI, ethnobotanicity index;
- FIC, informant consensus factor;
- HR, herbal remedy;
- IAR, index of agreement on remedies;
- FL, fidelity level;
- NR, native remedy;
- QUAV, quality use agreement value;
- QUV, quality use value;
- RFC, relative frequency of citation;
- RI, relative importance;
- TMP, traditional medicine practitioner;
- UV, use value;
- WHO, World Health Organization;
- AGE, advanced glycation endproduct
Keywords
- Mauritius;
- Diabetes;
- Diabetes related complications;
- Native remedies;
- Herbal remedies;
- Animal-based remedies
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