Use of herbal formulations for the treatment of circumcision wounds in Eastern and Southern Africa

Medicinal plants used to treat and manage circumcision wounds have remained an integral part of traditional practice in Eastern and Southern Africa. This study reviews the traditional usage of medicinal plants to treat and manage circumcision wounds in Eastern and Southern Africa. Drawing on data from Kenya, Namibia, South Africa and Tanzania, information was collected from different sources including books, theses and electronic scientific search engines such as Scopus, Science Direct, PubMed, SciFinder and Google Scholar. A literature search was also undertaken focusing on medicinal plants used against circumcision wounds that demonstrated antibacterial and anti-inflammatory activities in in vitro studies. Twenty-eight medicinal plants from 15 families are recorded as traditional therapies for circumcision wounds following an extensive literature search. These species used to treat and manage circumcision wounds, and as dressing after circumcision to prevent serious inflammation are mainly (64.3%) members of Amaryllidaceae, Asparagaceae, Asteraceae, Euphorbiaceae and Fabaceae families. Three quarters (75.0%) of these species including Acalypha ornata, Achyranthes aspera, Asparagus africanus, Boophone disticha, Brunsvigia grandiflora, Burkea africana, Colophospermum mopane, Datura stramonium, Dichrostachys cinerea, Helichrysum appendiculatum, H. foetidum, H. longifolium, H. nudifolium, H. pedunculatum, Lippia javanica, Maesa lanceolata, Ptaeroxylon obliquum, Ricinus communis, Searsia natalensis, Triumfetta rhomboidea and Vachellia nilotica have shown antibacterial and anti-inflammatory effects in a set of in vitro models. Further studies are needed such as isolation of phytochemical compounds, in vivo activities, clinical and toxicological studies.