ABSTRACT
This chapter looks into the importance of phytomedicines in the holistic management of sickle cell disease (SCD), especially in Sub-Saharan Africa (SSA), where they are most widely formulated and extensively used by a vulnerable population of affected persons with SCD. The chapter fills a gap in literature, providing a background of phytomedicine use in SCD, scientific evaluation of the practice, its current usage, and potential for future use, outlining the successes and challenges with the use of these medications. It provides a brief on the history of herbal medicine use, the different types of plants used as medicines, the phytochemicals or active ingredients of these, and their multiple mechanisms of action (including epigenetics) culminating in an anti-sickling effect. It highlights the benefits of use in clinical practice and limited information available on its adverse effects. The chapter concludes by reviewing the prototype phytomedicine Niprisan, an anti-sickling agent discovered as a collaboration between traditional and orthodox medical practitioners in Nigeria, as well as Ciklavit and Pfaffia paniculata. It evaluates available scientifically analyzed information to their beneficial use in SCD. It further highlights the limited scientific research into these drugs, and the need for further collaboration between different types of medical practitioners to harness the wide potentials of phytomedicines in the holistic management of SCD in SSA. As well as the successes obtained with Niprisan and other home-grown anti-sickling agents in the holistic management of SCD, the chapter evaluates the challenges to their use, particularly the limited research into the drugs, and concerns about their safety and toxicity profiles, as well as inadequate licensing and regulation of their use in general. It emphasizes the importance of these anti-sickling agents in managing SCD in SSA, where partnerships between traditional and orthodox medical practice would be beneficial.
