Background Patients with lymphoedema are at high risk of getting bacterial and fungal wound infections leading to acute inflammatory episodes associated with cellulitis and erysipelas. In Ethiopia, wound infections are traditionally treated with medicinal plants. Methods Agar well diffusion and colorimetric microdilution methods were used to determine the antibacterial activity of methanol extracts of the three medicinal plants against Staphylococcus aureus, Streptococcus pyogenes, Escherichia coli, Klebsiella pneumoniae, Pseudomonas aeruginosa, Shewanella alage, methicillin-resistant S. aureus ATCC®43300TM, Staphylococcus aureus ATCC25923, Escherichia coli ATCC25922, Klebsiella pneumoniae ATCC700603, and Pseudomonas aeruginosa ATCC37853. Results The methanol extract of L. inermis leaves showed high activity against all tested bacterial species, which was comparable to the standard drugs. Similarly, the extracts of A. indica showed activity against all tested species though at higher concentrations, and higher activity was recorded against Streptococcus pyogenes isolates at all concentrations. However, the extract of A. aspera showed the lowest activity against all tested species except Streptococcus pyogenes isolates. The lowest minimum inhibitory concentration (MIC) was recorded with the extract of L. inermis against E. coli isolate and S. aureus ATCC 25923. Conclusion Methanol extracts of L. inermis, A. indica, and A. aspera leaves exhibited antimicrobial activity against selected bacterial isolates involved in wound infections, of which the methanol extracts of L. inermis exhibited the highest activity. The results of the present study support the traditional use of plants against microbial infections, which could potentially be exploited for the treatment of wound infections associated with lymphoedema.

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Background: Podoconiosis and lymphatic filariasis are the most common causes of lower limb lymphoedema in the tropics. Many sufferers experience frequent painful episodes of acute bacterial infection. Plant based traditional medicines are used to treat infections in many countries and are culturally established in Ethiopia. Ethiopian medicinal plants found to have antibacterial and antifungal activities were reviewed with the aim of increasing information about the treatment of wound infections in patients with lymphoedema.Methods: This study collates data from published articles on medicinal plants with antibacterial and antifungal activities in Ethiopia. A systematic search of Scopus, EMBASE, PUBMED/MEDLINE and Google Scholar was undertaken. The Preferred Reporting Items for Systematic Reviews and Meta-analysis (PRISMA) guidelines were followed. The protocol was registered on PROSPERO with registration number CRD42019127471. All controlled studies of in vitro antibacterial and antifungal activities were considered. All articles containing the descriptors published until June 28, 2019 were included. The outcome was measured as percent inhibition of microbial growth. For quality assessment of individual in vitro studies, OECD guidelines and the WHO-Good Laboratory Practice (GLP) handbook were used.Results: Seventy-nine studies met the inclusion criteria. A total of 150 plant species and three compounds had been tested against 42 species of bacteria, while 43 plant species had been tested against 22 species of fungus.Conclusion: Materials derived from several Ethiopian medicinal plants have been shown to have promising activity against a variety of bacteria and fungi. Those derived from Azadiractha indica A. Juss. and Lawsonia inerms L. are the most extensively studied against a wide range of gram-negative and positive bacteria, and fungal species.

Background Lymphoedema is caused by dysfunction of the lymphatic system resulting in accumulation of high-protein content fluid in the interstitial space. To date, the bacteria associated with wound infections of patients with lower limb lymphoedema in Ethiopia have not been studied. This study identified pathogenic bacteria involved in wound infection and assessed antimicrobial susceptibility patterns in patients with lymphoedema in Ethiopia. Methods Swab samples were collected from the wounds of patients with lymphoedema and cultured using standard microbiological techniques. Micro-organisms were identified by colony morphology followed by identification and antimicrobial susceptibility testing using the automated VITEK 2 COMPACT Microbial Detection System. Results Swabs were collected from 103 patients and 84 were culture positive: 44 (52.4%) culture-positive samples showed polymicrobial growth and 40 (47.6%) grew single bacterial isolates. In total, 134 isolates were obtained, of which 26 gram-negative and 12 gram-positive bacterial species were identified. A total of 28/63 (44.4%) gram-negative isolates and 3/57 (5.3%) gram-positive isolates were multiple drug resistant. There was no resistance to ciprofloxacin, moxifloxacin or gentamycin among gram-negative or gram-positive bacteria. Conclusion In this study, many infections were polymicrobial and showed multiple drug resistance. Fluoroquinolones and gentamycin, however, seemed to be effective against bacterial wound infection in this setting.

Regardless of the intervention for peripheral nerve repair, slow rates of axonal regeneration often result in poor clinical outcomes. Thus, using new materials such as biologically inspired, biocompatible, organic rosette nanotubes (RNTs) could provide a tailorable scaffold to modulate neurite extension and attachment for improved nerve repair. RNTs are obtained through the spontaneous self-assembly of a synthetic DNA base analogue featuring the hydrogen bond triads of both guanine and cytosine, the G∧C base. Here, we investigated the potential of RNTs functionalized with lysine and Arg-Gly-Asp-Ser-Lys (RGDSK) peptide to support neural growth. We hypothesized that (a) due to their dimensions, the RNTs would support neuron attachment, and (b) their conjugation to the integrin-binding peptide RGDSK would further enhance neurite outgrowth compared to unfunctionalized RNT. Neurite extension was examined on a variety of RNT structures, including RNT with a lysine side chain (K1), a mixture of the K1 and a free RGDS peptide, RNT alone, an RGDSK-functionalized RNT, in addition to poly-d-lysine and laminin controls. Both whole dorsal root ganglion (DRG) and single dissociated DRG neurons were seeded onto RNT-coated substrates containing various ratios of peptides. Analysis of neuron morphometrics showed that RNT blends support DRG neuron attachment and neurite extension, with RGDS presentation increasing neurite outgrowth from whole DRG by up to 47% over a 7-day period compared to K1 alone (p < 0.013). In addition, while RNTs increased the sprouting of primary neurites extending from dissociated DRG neurons, the total neurite outgrowth per neuron remained the same. These results show that functionalized biomimetic RNTs provide a support for neurite growth and extension and have the ability to modulate neuronal morphology. These results also pave the way for the design of injectable RNT-based nanomaterials that support guided neural regeneration following traumatic injury.

Background:Traditionally Aloe trigonantha leaf is used for the treatment of different diseases. However, there were no in vivo studies which prove its claimed use for wound healing and anti-inflammatory activity. Therefore, the present study aimed at evaluating the in vivo wound healing and anti-inflammatory effects of the leaf gel of the plant in rats. Methods: The leaf gel powder of the Aloe trigonantha was prepared after the gel gets lyophilized. It was evaluated for wound healing activity topically by incorporating it in a simple ointment base at a concentration of 5% (w/w) and 10% (w/w). Excision and incision models were used for wound healing activity in rats. For the excision wound model, wound contraction and period of epithelialization were evaluated, while wound tensile strength was evaluated using an incision wound model. A Xylene-induced ear edema model and cotton pellet-induced granuloma model were used for anti-inflammatory study. The leaf gel powder of Aloe trigonantha was given orally at a dose of 100, 200, and 400 mg/kg in both models of anti-inflammatory studies. An anti-inflammatory effect was measured by reduction of ear edema weight and reduction of wet exudate and dry granuloma weight in both of xyleneinduced ear edema and cotton pellet-induced granuloma models, respectively. Results: Treatment of wounds with ointment containing 5% and 10% (w/w) of the gel exhibited a significantly increased wound contraction rate, shorter epithelialization time, and higher skin breaking strength (p<0.05) compared to controls. Aloe trigonantha leaf gel powder also produced dose-dependent significant reductions (p<0.05) of inflammation compared to control in both models. Conclusion: Data obtained from this study collectively indicated that Aloe trigonantha is a potential wound-healing and anti-inflammatory agent in rat models of wound and inflammation which provides evidence for the traditional claim.

ObjectivesMedicinal plants are used globally as alternative medicines in the management of a range of disease conditions and are widely accepted across differing societies. Ethiopia hosts a large number of plant species (>7000 higher plant species), of which around 12% are thought to be endemic, making it a rich source of plant extracts potentially useful for human health. The aim of this review is to evaluate Ethiopian medicinal plants for their anti-inflammatory, wound healing, antifungal or antibacterial activities.Methods and analysisThe guidance of the Preferred Reporting Items for Systematic Review and Meta-analysis Protocols (PRISMA-P) statement will be used. This review will consider all controlled studies of anti-inflammatory and wound healing properties (both in vivo and in vitro) and in vitro anti-infective properties of medicinal plants found in Ethiopia. Data sources will be EMBASE, PubMed/Medline, Scopus and Google Scholar. Guidance documents on good in vitro methods and checklists for reporting in vitro studies will be used for quality assessment of in vitro studies. The risk of bias tool for animal intervention studies (the SYRCLE RoB tool) will be used to assess the validity of studies. The main outcomes will be percent inhibition of inflammation, time of epithelisation and tissue tensile strength in wounds and microbial growth inhibition.Ethics and disseminationThe findings of this systematic review will be disseminated by publishing in a peer-reviewed journal and via conference presentations. Ethical clearance was obtained from the Brighton and Sussex Medical School, Research Governance & Ethics Committee (RGEC) and Addis Ababa University, College of Health Science, Institutional Review Board.PROSPERO registration numberThis systematic literature review has been registered with PROSPERO (registration number CRD42019127471).