Traditional herbal medicines for malaria

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Abstract
Traditional medicines have been used to treat malaria for thousands of years and are the source of the two main groups (artemisinin and quinine derivatives) of modern antimalarial drugs. With the problems of increasing levels of drug resistance and difficulties in poor areas of being able to afford and access effective antimalarial drugs, traditional medicines could be an important and sustainable source of treatment. The Research Initiative on Traditional Antimalarial Methods (RITAM) was founded in 1999 with the aim of furthering research on traditional medicines for malaria.1 The initiative now has in excess of 200 members from over 30 countries. It has conducted systematic literature reviews and prepared guidelines aiming to standardise and improve the quality of ethnobotanical, pharmacological, and clinical studies on herbal antimalarials and on plant based methods of insect repellence and vector control. We review some of this work and outline what can be learnt from the developing countries on the management and control of malaria. We carried out searches of relevant articles published up to 2004 through Medline, Embase, CAB, Sociofile, and the central clinical trials database of the Cochrane Library, using the terms “traditional medicine” and “malaria”, “malaria-therapy”, “knowledge,-attitudes,-practice”, “self-medication”, and “drug-utilisation”. We also searched the references of identified articles and handsearched journals on ethnobotany, herbal medicines, and tropical medicine, such as the Journal of Ethnopharmacology, Fitoterapia, Transactions of the Royal Society of Tropical Medicine and Hygiene, Tropical Medicine , and International Health . Authors were contacted for unpublished papers. #### Summary points Over 1200 plant species from 160 families are used to treat malaria and fever On average, a fifth of patients use traditional herbal remedies for malaria in endemic countries Larger, more rigorous randomised controlled trials are needed with long term follow up So far only a few studies have reported on side effects from …