Contribution to the phytotherapy against scorpion sting envenomation in the Naama region (Algeria)/Contribucion a la fitoterapia para el tratamiento de picadura por escorpion en la provincia de Naama (Argelia).
For centuries, man has always treated himself by plants, empirically, guided by tradition or customs. Most of the great doctors of the past have been herbalists (Goeb, 1999). Medicinal plants have been used since antiquity to alleviate and cure human diseases and still remain a source of medical care in developing countries in the absence of a modern medical system (Tabuti & al, 2003). Among these diseases, scorpion stings are a major public health problem in the Naama region, as they are the leading cause of intoxication according to studies.
Medicinal plants have therapeutic properties due to the presence of hundreds or even thousands of natural bioactive compounds called secondary metabolites. The latter are subsequently accumulated in different organs, and sometimes in specialized cells, of the plant (Boudjouref, 2011). The use of medicinal plants by man in Naama region, as in all the southern part of Algeria, has been practiced for centuries and continues to be so. The study of the therapeutic effect of certain local plant species on envenomation scorpion is the objective of this investigation.
Envenomation vectors:Androctonus australis L. and Buthus occitanus A.
Scorpions are old insects that appeared on Earth in the primary era, four hundred million years ago (approx.). The fossils of these first specimens show a very similar morphology to that of the present scorpions (Vachon, 1952). They are terrestrial arthropods that resist all the environment aggressive factors (Soulaymani & al, 1999). Nearly 1500 species of scorpions are described throughout the world, only a few of which are dangerous to man. Among these two are endemic from Algeria and are responsible of a high morbidity and mortality: Androctonus australis is a large brown scorpion that can reach up to 10cm, some parts of which are darker (the tongs and the last rings of the tail), its tail is thick. It is the most dangerous species; its venom is powerful and contains 6 toxins. Buthus occitanus is a medium sized scorpion (4 to 7cm), of clear tint, the claws and the legs are brighter and its tail is slender. Its range is wide and its dangerousness is variable.
Scorpions live in groups (Vachon, 1952). They are found in various habitats: under stones, rocks, bark of trees and old buildings. They seek dark corners where they dig burrows (Ismail, 2003; Isbister & al, 2003). They are nocturnal, of fearful nature, not very aggressive and lucifuge (Goyffon & El Ayeb, 2002). Active in the spring and summer, they enter into hibernation early in the fall (Sadine, 2005). Androctonus australis, opportunistic species, omnipresent in all biotopes, is the only species that lives close to man.
Scorpion Envenomation in Algeria
Scorpion envenomation is the result of the sting of a person by a scorpion (Sadine, 2005). Scorpion bites are a major public health problem in many countries (Isbister & al, 2003, Isbister & Bawaskar, 2014). Scorpion bites are a major public health problem in many countries, particularly those in North Africa, Saharan Africa, India, the Near and Middle East, Mexico and South America. The world annual number, in 2008, of scorpion stings was estimated at 1.2 million with 3250 deaths (0.27%). In Algeria, scorpion envenomation (S.E.) was recognized in the mid-1980 as a public health problem. Because of the morbidity and mortality it causes and the financial burden it imposes (Benhabyles, 1990; Laid, 1998). The population at risk of scorpion envenomation has steadily increased, particularly during the last decade (estimated at 71.9% in 2010, compared to 29.6% in 1997). 26 wilaya's (Territorial province) (54.5%) reported 35,497 cases of scorpion in 1997 (N.I.S.P. (National Institute of Public Health), 1997). In 2010, they are 38 wilaya's to have declared 49,574 sting cases (N.I.S.P., 2010). On the national territory, 28 species and 14 genera of scorpions, classified under 3 families: Buthidae, Chactidae (Euscorpiidae) and Scorpionidae were recorded (Dupre, 2011).
Scorpion Envenomation in Naama region
The wilaya of Naama is inserted between the Tellian Atlas in the North and the Saharan Atlas in the South (Figure 2). It covers a 29825 [km.sup.2] area where three homogeneous geographical zones emerge:
A steppe zone constituted by a vast plain and occupying 74% of the territory of the province.
A mountainous area located in the southwestern region reaching 2000 m asl of altitude and representing the 12% of the total area.
A pre-Saharan zone covering the 14% of the total area of the province.
This region has experienced a high number of scorpion stings mainly due to edaphic and climatic conditions. The latter are characterized by 9 hot and dry months. In 2015, 1485 victims of scorpion smears were recorded across all municipalities in the wilaya according to the Direction of Health and Population of Naama (D.H.P. Naama). Figure 1 shows the number of stitches and deaths from 2005 to 2015 per commune (Akin County).
The spatial concentration of scorpion bites for the year 2015 (Figure 2) is mainly found in Ain Sefra, Mecheria and Ain Ben Khelil. It is an important spatial indicator that correlates with environmental conditions (old buildings in particular); scorpions live around the rocky and sandy regions, under stones or in burrows. The scorpion passes the day hidden under rocks or in tunnels it digs in the sand.
Materials and methods
The ethnobotanical study was carried out between December 2015 and February 2016 through a survey at three sites: Mecheria, Ain Sefra, and Naama; using 50 questionnaires.
Interviews were conducted through open -ended questions, to the local population and herbalists, separately and in the vernacular language. Thus, the profile of each respondent includes age, educational level, family situation, and know-how in relation to the treatment, of scorpion stings, by plants.
The studied parameters are on the plants and their parts used as well as the method of preparation. In order to assess informants on the use of plants against scorpion stings, an Informant Consensus Factor (ICF) was calculated according to the following formula:
ICF = [Na/Nt]
Where Na is the number of informants citing a species and Nt the total number of informants (Cotton, 1996).
The results of our ethnobotanical survey are presented according to the parameters studied (age, level of study, plants used, part of the plant used, and the preparation way).
Age. The informant age range varies from 20 to over 80 years. The higher percentage, 42%, represents people age between 40 and 60, who have more knowledge and frequently use medicinal plants. However, for the age group of 20 to 40 years, a rate of 34% is observed, and for people aged between 60 and 80 years, the use of medicinal plants (24%) is not of great therapeutic interest.
Level of study. The intellectual levels of plant users are different, it should be noted that 34% of users of herbal medicine are illiterate. Nevertheless, people with a secondary and/or university level have a significant percentage, of 28% and 20% respectively, of medicinal plants use. For those at primary level, medicinal plants are only used by 10% (Figure 4).
The plants used. The six main local plant species that we have found and which can act against scorpion envenomations are: Hammada scoparia with a percentage of 74%; Artemisia herba-alba with 8%; Cotula cinerea and Citrullus colocynthis at 6%, Artemisia arborescens with 4% and Nicotiana tabacum with 2%; belonging to four botanical families (Table 1).
Informant Consensus Factor (ICF). It varies between 0-1, the calculation of the consensus values of the species revealed weak indices for all the species except for the case of Hammada scoparia for which this index is greater than 0.5 (Table 2).
Hammada scoparia (Pomel) is a Saharan-Mediterranean species. It reaches an ICF of 0.74 because it is cited by the majority of the respondents. It is a shrub with very small stalks, which blacken in drying, with short floral ears, brightly colored winged fruits often pink or red. Hammada scoparia develops in, from the Upper Arid to the Lower Saharan bioclimatic ranges, with variants with mild, cool winters; on loamy brown soil; usually on the degraded steppe of white wormwood. It is very common on Regs (Rocky areas in the Saharan regions) with gypsum soils.
Useful Parts. The plant parts used are ranked in order of importance: leafy stems (60%) followed by leaves (22%), fruits and seeds (6%), flowers (4%) and the whole plant represented by 2% (Figure 4).
Mode of preparation. Hammada scoparia powder is the most used method of preparation associated with butter at a rate of 50%. Other preparations are used: namely the poultice (26%), the natural form (14%) and the decoction (10%) (Figure 5).
The use of plants and the products derived from them are increasing as a result of family extension and transmission from generation to generation. The obtained results showed phytotherapy is practiced by the population whatever the age group or the level of study. Surveys of the local population and herbalists showed the therapeutic effect of species such as Hammada scoparia, Artemisia herba-alba, Cotula cinerea, Citrullus colocynthis, Artemisia arborescens and Nicotiana tabacum, advocated against scorpion stings. There are research focused in some of those plants (Laraba-Djebari & Kabrine, 2014), although the last five revealed low consensus values (close to 0).
Hammada scoparia, with an estimated utilization rate of 74% and an ICF 0.74, shows the great interest in the treatment of scorpion envenomation. A teaspoon of Hammada scoparia powder, combined with a tablespoon of pure ovine butter, low heated, is given to the patient immediately after the sting. This treatment is the most used; because 50% of the interviewees are convinced that this mode allows collecting the most active ingredients. In the same context, Larribaud (1952) reports a practice of making a wound around the bite and burning on it a few twigs of Hammada scoparia. Reynier (1954) observed that parts of Hammada scoparia boiled for a long time, until the water turns on a blackish tint, resulted in a lotion with an emetic action. It has also been proved that the aqueous Hammada scoparia extract has an anti-cancer activity and a larvicidal effect which is also traditionally used for scorpion bites (Maiza & al., 1993; Bellakhdar, 1997; Ben Salah & al, 2002).
Ethnobotanical surveys carried out in the Naama region allowed to gather practical information on the therapeutic use of anti-scorpion plants species. Among these, Hammada scoparia has the highest ICF value much higher than the rest of studied plants. The aerial part of the plant (stem and leaf) is used in the form of vegetal powder combined with pure sheep butter. In perspective, the traditional pharmacopeia should be embodied in experimental approaches in order to provide scientific evidence on the therapeutic efficacy attributed to these plants in traditional medicine.
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Hafidha Bouchent (1,3) ; Kheloufi Benabdeli (2) & Abdelkrim Benaradj (3)
Received 9 November 2016 / Accepted 27 April 2017
(1) Department of Agronomy, Faculty of Sciences, Nature and Life and Universe, Abou Bekr Belkaid University. Tlemcen, Algeria. E-mail: email@example.com
(2) Department of Biology, Laboratory of Geo-Environment and Development Spaces, Faculty of Natural Sciences and Life, University Stambouli Mustapha. Mascara, Algeria.
(3) Department of Biology, Institute of Science and Technology, University Center Salhi Ahmed. Naama, Algeria.
Caption: Figure 1. Number of bites and deaths from 2005 to 2015 in the wilaya of Naama (Anon., 2015).
Caption: Figure 2. Distribution of scorpion stitches per commune in the wilaya of Naama.
Caption: Figure 4. Percentages of plants parts used in the medicinal species analyzed.
Caption: Figure 5. Percentage of preparation modes used by population (see text for explanations).
Table 1. Botanical characteristics and percentage of use (%) of anti-venomous plant species. Species Family Biological Type Hammada scoparia (Pomel.) Iljin Amaranthaceae Chamaephyte Artemisia herba alba Asso Asteraceae Chamaephyte Cotula cinerea Del. Asteraceae Therophytes Citrullus colocynthis (L.) Schrad. Cucurbitaceae Therophyte Artemisia arborescens L. Asteraceae Chamaephyte Nicotiana tabacum L. Solanaceae Therophyte Species Common name Hammada scoparia (Pomel.) Iljin Saligne a balai Artemisia herba alba Asso Armoise blanche Cotula cinerea Del. Armoise cendre Citrullus colocynthis (L.) Schrad. Coloquinte Artemisia arborescens L. Armoise arborescente Nicotiana tabacum L. Tabac Species Vernacular name (%) Hammada scoparia (Pomel.) Iljin Remth 74% Artemisia herba alba Asso Chih 8% Cotula cinerea Del. Guertoufa 6% Citrullus colocynthis (L.) Schrad. Hedaj 6% Artemisia arborescens L. Chhiba 4% Nicotiana tabacum L. Tabagha 2% Table 2. ICF index values on the studied species. Species ICF Hammada scoparia (Pomel) Iljin 0.74 Artemisia herba alba Asso 0.08 Cotula cinerea Del. 0.06 Citrullus colocynthis (L.) Schrad. 0.06 U.S. Total Artemisia arborescens L. 0.04 Nicotiana tabacum L. 0.02 Figure 3. Distribution of medicinal plant users by age (a) and level of study (b). (a) [61-80] 24% [20-40] 34% [41-60] 42% (b) University 20% Illiterate 34% Primary 18% Secondary 28% Note: Table made from pie chart.
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|Author:||Bouchent, Hafidha; Benabdeli, Kheloufi; Benaradj, Abdelkrim|
|Article Type:||Clinical report|
|Date:||Jan 1, 2017|
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