Malaria still constitutes a major public health menace, especially in tropical and subtropical countries. Close to half a million people mainly children in Africa, die every year from the disease. With the rising resistance to frontline drugs (artemisinin-based combinations), there is a need to accelerate the discovery and development of newer anti-malarial drugs. A systematic review was conducted to identify the African medicinal plants with significant antiplasmodial and/or anti-malarial activity, toxicity, as wells as assessing the variation in their activity between study designs (in vitro and in vivo). Key health-related databases including Google Scholar, PubMed, PubMed Central, and Science Direct were searched for relevant literature on the antiplasmodial and anti-malarial activities of African medicinal plants. In total, 200 research articles were identified, a majority of which were studies conducted in Nigeria. The selected research articles constituted 722 independent experiments evaluating 502 plant species. Of the 722 studies, 81.9%, 12.4%, and 5.5% were in vitro, in vivo, and combined in vitro and in vivo, respectively. The most frequently investigated plant species were Azadirachta indica, Zanthoxylum chalybeum, Picrilima nitida, and Nauclea latifolia meanwhile Fabaceae, Euphorbiaceae, Annonaceae, Rubiaceae, Rutaceae, Meliaceae, and Lamiaceae were the most frequently investigated plant families. Overall, 248 (34.3%), 241 (33.4%), and 233 (32.3%) of the studies reported very good, good, and moderate activity, respectively. Alchornea cordifolia, Flueggea virosa, Cryptolepis sanguinolenta, Zanthoxylum chalybeum, and Maytenus senegalensis gave consistently very good activity across the different studies. In all, only 31 (4.3%) of studies involved pure compounds and these had significantly (p = 0.044) higher antiplasmodial activity relative to crude extracts. Out of the 198 plant species tested for toxicity, 52 (26.3%) demonstrated some degree of toxicity, with toxicity most frequently reported with Azadirachta indica and Vernonia amygdalina. These species were equally the most frequently inactive plants reported. The leaves were the most frequently reported toxic part of plants used. Furthermore, toxicity was observed to decrease with increasing antiplasmodial activity. Although there are many indigenous plants with considerable antiplasmodial and anti-malarial activity, the progress in the development of new anti-malarial drugs from African medicinal plants is still slothful, with only one clinical trial with Cochlospermum planchonii (Bixaceae) conducted to date. There is, therefore, the need to scale up anti-malarial drug discovery in the African region.

中文翻译：

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非洲药用植物的抗疟原虫、抗疟活性和毒性：文献系统综述

疟疾仍然构成主要的公共卫生威胁，特别是在热带和亚热带国家。每年有近五十万人死于这种疾病，其中主要是非洲儿童。随着对一线药物（基于青蒿素的组合）的耐药性不断上升，需要加速新型抗疟疾药物的发现和开发。进行了系统评价，以确定具有显着抗疟原虫和/或抗疟疾活性、毒性的非洲药用植物，并评估了研究设计（体外和体内）之间活性的差异。检索了包括 Google Scholar、PubMed、PubMed Central 和 Science Direct 在内的主要健康相关数据库，查找有关非洲药用植物抗疟原虫和抗疟疾活性的相关文献。总共确定了 200 篇研究文章，其中大部分是在尼日利亚进行的研究。所选研究文章由 722 个独立实验组成，评估了 502 个植物物种。在 722 项研究中，体外研究、体内研究以及体外和体内结合研究分别占 81.9%、12.4% 和 5.5%。最常被研究的植物种类是印楝、花椒、苦皮和大叶木，同时豆科、大戟科、番荔枝科、茜草科、芸香科、楝科和唇形科是最常被研究的植物科。总体而言，有 248 项 (34.3%)、241 项 (33.4%) 和 233 项 (32.3%) 的研究分别报告了非常好、良好和中等的活动。Alchornea cordifolia、Flueggea virosa、Cryptolepis sanguinolenta、Zanthoxylum chalybeum 和 Maytenus senegalensis 在不同的研究中始终表现出非常好的活性。总的来说，只有 31 项研究 (4.3%) 涉及纯化合物，并且相对于粗提取物，这些研究具有显着 (p = 0.044) 更高的抗疟原虫活性。在进行毒性测试的 198 种植物中，有 52 种（26.3%）表现出一定程度的毒性，其中最常报道的毒性是印楝和斑鸠菊。这些物种同样是报道中最常见的不活跃植物。叶子是最常报道的植物有毒部分。此外，观察到毒性随着抗疟原虫活性的增加而降低。尽管许多本土植物具有相当大的抗疟原虫和抗疟疾活性，但利用非洲药用植物开发新的抗疟疾药物的进展仍然缓慢，迄今为止仅进行了一项针对 Cochlospermum planchonii（红木科）的临床试验。因此，有必要扩大非洲地区抗疟疾药物的发现。