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Herbal Medicine and Parasitic Diseases

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ISSN: 0258-3216 Vol. 4, No. 1, 2011

R E V I E W A RT I C L E PUJ
Herbal Medicine and Parasitic Diseases
Samia E. Etewa1, Sherif M. Abaza2

Parasitology Department, Faculty of Medicine, Zagazig1 and Suez Canal2 Universities, Ismailia, Egypt

Received: August, 2010 Accepted: October, 2010

INTRODUCTION
Herbal medicine (also known as traditional, folk The emergence of parasites resistant to current
and alternative medicine) comprises medical chemotherapies highlights the importance
knowledge systems that developed over generations of plant essential oils as novel anti-parasitic
within various societies before the era of modern agents; e.g., in schistosomiasis(5), malaria(6) and
medicine. WHO defines traditional medicine as the visceral leishmaniasis(7). Some plant oils have
health practices, approaches, knowledge and beliefs immunomodulatory effects that could modify host-
incorporating plant, spiritual therapies and manual parasite immunobiology and the lipid solubility of
techniques, applied singularly or in combination plant oils might offer alternative, transcutaneous
to treat, diagnose and prevent illnesses or maintain delivery routes(8). In addition, the safety and use
well-being(1). Ancient Egyptian medicine, 1000 of plant essential oils in drug resistant cases are
Before Christ (BC), was known to use garlic, considered the most advantages. However, lack of
opium, castor oil, coriander, mint and other herbs proper understanding of plant and drug interactions
for medicinal purposes and Indian medicine used have led to adverse reactions that are sometimes life
turmeric (Curcumin) possibly as early as 1900 threatening or lethal(9). Furthermore, adulteration
BC(2). N. sativa seeds have been used as a traditional
or counterfeit herbs can also be a health hazard, as
medicine for the treatment of a variety of sicknesses
WHO confirmed that inappropriate use of traditional
including parasitic diseases(3). The scope of herbal
medicines or practices can have negative or dangerous
medicine sometimes extended to include fungal and
bee products, as well as minerals, shells and certain effects(1).
animal parts(4). It is estimated that 20,000 species of The present review is an analysis to through light on
higher plants are used medicinally throughout the different herbs with their active compunds that could
world. In some Asian and African countries, up to be used as drug targets in parasitic diseases. It also
80% of the population rely on traditional medicine discusses some herbs with repellent activity and
for their primary health care needs(1). molluscicidal effects.

Keywords: Herbal Medicine, Parasitic Diseases, Treatment, Repellents, Molluscicides.

Corresponding author: Sherif M. Abaza, smabaza@hotmail.com

Examples of Known Herbs with Antiparasitic Effects

Allium cepa; Onion (Al-Basal) experimentally infected with T. spiralis and increases the
Two sets of compounds make up the majority of onion's production of antibodies generated during life cycle of the
known active constituents: Sulphur compounds such as parasite(13). Recently, effectiveness of A. Cepa extract in
allicin and allyl propyl disulphide and flavonoids such as eyelids inflammation caused by Demodex folliculorum
quercetin. Allicin exhibits its antimicrobial action mainly was tested with promising results(14). Onion reportedly
by immediate and total inhibition of RNA, DNA and exerted different physiological changes in snails of
protein synthesis(10). B. alexandrina leading to decrease in glucose and glycogen
In a study conducted in 2004, all tested strains of which are the snail energy fuel and inhibited the phenol
Leishmania (major, donovani and mexicana) were found to oxidase enzyme which led to disturbance in egg-shell
be sensitive in vitro to the onion juice in the promastigote formation(15). Some adverse effects have been reported
stage(11). Aqueous onion extract is similar to metronidazole where higher intakes may worsen existing heartburn and
in inhibiting both multiplication and motility of T. there are also isolated reports of allergy manifesting as
vaginalis(12). A. cepa oil has an antihelminthic effect in rats skin rash and red, itchy eyes(16).
Personal non-commercial use only. PUJ copyright © 2011. All rights reserved PUJ; 2011, 4(1): 3-14
Herbal Medicine and Parasites

Allium sativum; Garlic (Al-Tom) that were not treated with garlic, versus those treated
The active constituents of garlic exceed 200 chemicals. with garlic. The effect of methanol garlic extract
It contains sulphur compounds (allicin, alliin and in a concentration of 3.90 mg/ml, on the growth of
agoene), volatile oils, enzymes (allinase, peroxidase Acanthamoeba castellanii and its cytotoxicity on
and miracynase), carbohydrates (sucrose and glucose), corneal cells was studied in vitro. These findings
minerals (selenium), amino acids such as cysteine, indicated its amoebicidal, as well as cysticidal effects
glutamine, isoleucine and methionine, bioflavonoids on trophozoites and cysts, with no cytotoxicity to
such as quercetin and cyanidin, Allistatin I and Allistatin corneal cells(28). In addition, aqueous garlic extract
II and vitamins A, B1, B2, C, E and niacin(17). The main proved similar to metronidazole in inhibiting both
antimicrobial effect of allicin is due to its chemical multiplication and motility of T. vaginalis(13).
reaction with thiol groups of various enzymes e.g.
alcohol dehydrogenase and DNA polymerase which Antihelminthic effects: Aqueous garlic extract, with
affect the essential metabolism of cysteine proteinase its potent free radical scavenging and antioxidant
activity involved in the virulence of parasites(18). properties, seemed to be a highly promising agent in
Garlic appears to be safe during pregnancy and breast- protecting hepatic tissue against oxidative damage due
feeding. Some sensitive people may experience to S. mansoni infection(29). Garlic efficacy was highest in
heartburn and flatulence(19). the group treated with garlic before and after bilharzial
Antiprotozoal effects: Several studies were conducted infection and resulted in various ultrastructural
to investigate the efficacy of garlic in giardiasis. There alterations in the surviving adult worm’s tegument(30).
were reports of complete relief of clinical symptoms Results of a study conducted in 2008 showed that
within 36 hours(20), loss of flagellar movement and chloroform garlic extract exerted the highest effect
motility with trophozoites swelling leading to decreased on the viability of hydatid cyst protoscoleces in vitro,
ability to adhere to host cells(21), inhibition of Giardia’s in comparison with garlic aqueous extract and hydro-
cysteine proteases activity and excretory/secretory alcoholic garlic extract(31).
products resulting in reduction of GIT symptoms(22). The Garlic as repellent and its acaricidal effect:
therapeutic effect of allicin was evaluated against C. The repellent effect of garlic oil was evaluated against
cayetanensis and the results showed that Tomex (10 mg/ female Phlebotomus bite. A dose dependent anti-feeding
Kg/day of garlic extract) caused significant reduction
effect, which was 100% effective at 1% concentration,
in oocyst shedding and improvement of intestinal
was obtained(32). Topical application of 10% garlic juice
pathological changes (100% in immunocompetent and
by spraying, effectively decreased Northern fowl mite
80% in immunosuppressed mice)(23).
(NFM, Ornithonyssus sylviarum) infestation in laying
The circumsporozoite protein (CSP), which is the hens. Humans could be bitten by these mites and suffer
major surface protein of Plasmodia sporozoites, is irritation and allergic reactions(33).
proteolytically processed by a parasite-derived cysteine
protease and this event is temporally associated with Garlic as molluscicide: The effect of the plant-derived
sporozoite invasion of host cells. At low concentrations, molluscicides Annona squamosa and Lawsonia inermis
allicin inhibited CSP processing and prevented combined with A. sativum on the reproduction of the
sporozoite invasion of host cells in vitro. In vivo, snail Lymnaea was studied. A significant reduction in
mice injected with allicin had decreased Plasmodia the fecundity, hatchability and survival of young snails
infections compared to controls. Allicin was also was observed(34).
tested on erythrocytic stages where a 4-day regimen
of allicin administered either orally or intravenously Artemisia (Al-Sheeh)
significantly increased the survival of infected mice There are about 300 species in the Artemisia genus.
by 10 days(24). Two of them, sweet annie (Artemisia annua) and
In mice infected with L. mexicana, intraperitoneal wormwood (Artemisia absinthium), are of medical
injection of garlic extract or its protein fraction importance in treatment of some parasitic diseases.
augmented parasite engulfment and destruction of The active constituents in the first one are artesunate,
intracellular amastigotes by macrophages. Modulation of dihydroartemisinin, artemether and arteether, while the
the immune response through macrophages activations second contains aromatic oils (thujone and isothujone)
was postulated as a mechanism of action of garlic(25). and strong bitter agents (absinthin and anabsinthin).
Another explanation claimed that garlic extract reduced Adverse effects associated with artemether treatment
macrophage infection through induction of nitric oxide were abdominal pain, anorexia, nausea, vomiting,
(NO) production in vitro. Therefore, it may act on both diarrhoea and CNS involvement (headache and
T cells and macrophages to stimulate IFN-γ production dizziness)(35). Longer-term use of wormwood (over 4
and NO synthesis for parasite killing(26). weeks) can cause nausea, vomiting, insomnia, restlessness,
In a study conducted in 2007, Eimeria stiedae induced vertigo, tremors and seizures(36). In addition, it is not
marked hepatic histopathological alterations in rabbits recommended during pregnancy and breast-feeding(37).

4
 Etewa and Abaza

Artemisinin (ART) derivatives: Mass drug killing than mature worms which probably participates
administration schemes in malaria control should in the mechanism of anti-schistosomal action of
ideally use more than one drug, preferably combinations ART(49). The efficacy and safety of artemether was
including a rapid-acting schizonticidal drug, such studied in sheep infected with Fasciola spp. A single
as ART, as well as primaquine that can kill sexual intramuscular dose of artemether significantly reduced
and liver stages to prevent transmission. This could both egg and worm burdens. There were no adverse
be considered as an alternative strategy for malaria events, however, two abortions were observed 7 days
control, and in combination with other anti-malarial post treatment(50). Recently, a study was carried out to
measures may provide a tool for malaria elimination and determine the morphological changes to F. hepatica
eradication(38). ART combination therapy is the first-line after in vivo treatment with artemether and the results
treatment for uncomplicated P. falciparum malaria in showed increased disruption of the tegumental system,
most malaria-endemic countries(39). All ART compounds with isolated patches of surface blebbing and reduced
induce very rapid reduction of parasitaemia, starting production of secretory bodies by the tegumental cells(51).
almost immediately after administration. The proposed Wormwood: A. absinthium extracts were found to be
mechanism of action involves cleavage of endoperoxide effective against the enteral (adult) and parenteral (larva)
bridges by iron producing free radicals which damage phases of trichinellosis(52). In addition, oil extracts were
biological macromolecules causing oxidative stress in tested in the laboratory against host-seeking nymphs of
parasitized cells(40). Pure artemisinin has a low solubility Ixodes ricinus Linnaeus (Acari: Ixodidae). The results
in water, oil and therefore it could be administered showed 62-70% repellent ability and hence could be
orally, rectally and intramuscularly. Intramuscular used in control of arthropods of medical, veterinary or
artesunate is easier to administer but is associated with agricultural importance(53).
hypoglycaemia(41). Unfortunately, oral administration is
often not possible in patients with severe malaria, due Commiphora molmol; Myrrh (Al-Mor)
to extreme vomiting; hence the development of several All the three main constituents of myrrh; resin, gum and
semi-synthetic ART derivatives(42). volatile oil are important in myrrh's activity as herbal
medicine(54). The mechanism of the anti-schistosomal
Artemisinin also showed anti-leishmanial activity for
action of myrrh on S. mansoni is not fully understood.
both promastigotes and amastigotes and was accompanied
However, it has been attributed to permanent muscle
by a high safety index. The leishmanicidal activity of
paralysis of the worms leading to their shift to the
artemisinin was mediated via apoptosis as evidenced
liver where destruction takes place(55). Meanwhile,
by externalization of phosphatidylserine, loss of
results of studies published on the efficacy of myrrh
mitochondrial membrane potential and cell-cycle arrest.
in the treatment of S. mansoni-infected mice are
These data indicated promising anti-leishmanial activity
greatly conflicting. Several experimental and clinical
mediated by programmed cell death(43).
studies reported significant parasite reductions and
Moreover, several ART derivatives were shown to be marked ultrastructural changes after treatment of S.
effective against T. gondii in vitro(44) as well as in vivo mansoni-infected mice with Mirazid®(56,57) or under field
in a murine model of reactivated toxoplasmosis(45). conditions(58). However, other studies negated myrrh
The mechanism of action is uncertain. However, it efficacy in the treatment of schistosomiasis in either
was suggested that they may inhibit sarcoplasmic- experimental(59), or clinical studies(60).
endoplasmic reticulum (ATPase), thus disrupting
calcium homeostasis by increasing the periodicity of There is also such debate over the efficacy of Mirazid®
calcium oscillations and inducing recurrent, strong for the treatment of fascioliasis. Complete cure rate
calcium spikes(44). In addition, these new ART derivatives was achieved in experimentally infected rabbits with
have the ability to inhibit multiple steps of T. gondii oral dose of 20 mg/day for 6 consecutive days(61).
lytic cycle; they effectively inhibited T. gondii growth, On the contrary, results obtained for experimentally
tachyzoite replication, attachment to and invasion of infected sheep treated with Mirazid® appeared similar
host cells(46). to those for untreated infected animals(62). On the other
hand, Mirazid® was reported to be effective against
The ART derivatives were shown to possess a broad
D. dendriticum(63), H. heterophyes(64) and H. nana(65).
spectrum of activities against several helminthic
Regarding its antiprotozoal efficacy, Mirazid® was
infections. Combination between artemether and
effective against cryptosporidiosis(66) and trichomoniasis
praziquantel showed highest efficacies against juvenile
in metronidazole-resistant infected females(67).
and adult worms of S. haematobium(47). Scanning and
transmission microscopic observations indicated that Myrrh proved to have insecticidal activity against
artemether induces extensive damage to juveniles and mosquito larvae of Culex pipiens and Aedes caspius(68).
adults of different Schistosoma spp.(48). In addition, In addition, the molluscicidal activity of myrrh was
significant progress has been made with artemether use evaluated in several studies on B. alexandrina, B.
for chemoprophylaxis in schistosomiasis, as immature truncatus and L. cailliaudi and the results revealed
stages of S. mansoni are more prone to oxidative significant lethal and ovicidal effects(69,70).

5
Herbal Medicine and Parasites

Curcuma longa; Turmeric (Al-Korkom or Curcumin) its protection against hepatotoxicity(83), its antioxidant
As turmeric is a very cheap, easily available, effective role(84) and stimulation of immune system(85). The results
and acceptable mode of treatment in developing of the studies conducted in 2007 proved that its aqueous
countries, with no toxic or adverse reaction, it was used extract could be useful in the treatment of B. hominis(86)
as paste for the treatment of scabies, with 97% cure rate and as an anti-malarial drug(3). In the following year, its
within 3-15 days of treatment(71). The active inhibitory effect against T. vaginalis was investigated
constituent known as curcumin showed a wide in vitro and the results showed remarkable inhibition of
range of therapeutic actions. When used in the trophozoites growth and motility(87).
recommended amounts, turmeric is generally safe.
The antioxidant and anti-schistosomal activities of N.
Some herbal books recommend not taking high
sativa oil was studied in control and S. mansoni-infected
amounts of turmeric during pregnancy as it may cause
mice. Remarkable reduction in worms, tissue eggs and
uterine contractions and patients with gallstones or
alteration in oogram pattern were recorded in all the
bile passages obstruction are advised to consult their
healthcare practitioner before using turmeric(72). treated groups. The data pointed to the importance
of these seeds as a promising agent to complement
Curcumin had a significant effect on the progression schistosomiasis specific treatment(29). Its antiparasitic
of experimental cerebral malaria. Survival of treated effect was studied also in H. nana-infected mice, where
mice was significantly increased and development of it was found to reduce the infection starting from 2nd
cerebral malaria was either delayed or prevented(73).
day of the treatment(85). Moreover, its prophylactic
Possessing antiprotozoal effects, turmeric as well
treatment prior to T. spiralis infection was effective
proved to (1) show cytotoxicity against T. brucei(74),
against both adult worms and muscle larval count in
(2) have leishmanicidal activity in vitro(75), (3) inhibit
infected rats(14).
G. lamblia trophozoite growth and adhesion, by more
than 50%, in dose and time dependent manner(76) Zingiber officinale; Ginger (Ganzabil)
and (4) be an attenuating agent against T. gondii The main constituents of ginger are the gingerols,
tachyzoites in the peritoneal fluid of mice(77). shogaols, zingerone and paradol(88). The anti-amoebic
Studies were designed to evaluate the schistosomicidal effect of a crude drug formulation against E. histolytica
activity of curcumin in vivo as well as immuno- was studied in comparison to metronidazole. Results
modulation of granulomatous inflammation in acute showed that the product had a minimal inhibitory
schistosomiasis mansoni. It was found that praziquantel concentration of 1000 mg/ml as compared with 10 mg/
was more effective in lowering worm burden while ml for metronidazole(89). In vitro, a concentration of
curcumin was more potent in reducing egg count(78). 200 mg of ginger extract killed almost all Schistosoma
The mechanism by which curcumin might function as worms within 24 hrs(90). The anti-helminthic activity
a schistosomicidal agent is unclear and needs further of ginger was reported also in sheep naturally
investigation. In another study, curcumin was effective infected with mixed species of GIT nematodes e.g. T.
in reducing both male and female worms and tissue-egg colubriformis, Strongyloides papillosus and Trichuris
burdens, hepatic granuloma volume and liver collagen ovis(91). Another study conducted in 2006 showed
content. In addition, curcumin treatment modulates that there was significant reduction in intestinal adult
cellular and humoral immune responses of infected worms and muscle larval count in mice infected with
mice(79). On the other hand, curcumin is effective T. Spiralis(92). In addition, there was microfilaricidal
in the treatment of many inflammatory diseases. Its activity of aqueous extracts of ginger when administered
efficacy on reducing the histopathological changes to dogs infected with D. immitis filarids(93).
of opisthorchiasis in hamsters was evaluated. Results
Ginger essential oils proved to have repellent results
showed reduced inflammatory cells aggregation
against host-seeking chiggers (scrub typhus) of
surrounding the hepatic bile ducts, leading to reduced
Leptotrombidium imphalum(94) and ovicidal and repellent
risk factors of cholangiocarcinoma development(80).
effects against different mosquitoes as Anopheles
For molluscicidal activity, turmeric was evaluated
stephensi, Aedes aegypti and Culex quinquefasciatus(95).
against B. alexandrina and the results showed that its
In addition, its petroleum ether extract has larvicidal
30 ppm extract stopped snail egg laying and caused
activity against A. aegypti and C. Quinquefasciatus(96).
deformity of all embryonic stages(81).
As a molluscicidal agent, gingerol and shogaol exhibited
Nigella sativa; Nigella (Black Seed or Habbat potent effects on Biomphalaria glabrata, indicating
Al-Barakah) their ability to interrupt Schistosoma transmission(97).
Nigella oil contains saponin, nigellidine and nigellone Results of in vivo exposure of Lymnaea acuminata to
and its seeds contain thymoquinone, monoterpenes gingerol proved its effect on snail neurotransmission
such as p-cymene and α-pinene(82). Several mechanisms mechanisms, either separately or through a complex
were described for the activity of black seeds such as interaction between the different neurotransmitters(98).

6
 Etewa and Abaza

Berberis vulgaris, Berberis Aristata; Barberry malaria treatment for more than 350 years in Africa
The active constituent in barberry is berberine which and remains the first-line anti-malarial drug for the
is an alkaloid having antibacterial, anti-amoebic, anti- treatment of complicated malaria in Europe and Africa.
fungal, anti-helminthic and leishmanicidal properties. Its Children with uncomplicated malaria are generally
reported main side effect was interference with normal treated with oral medication, except those unable to take
liver function in infants. Strong standardized extracts oral drugs(113). It has substantial disadvantages mainly
may cause stomach upset and should be used for no its poor tolerability, the long treatment course and the
more than two weeks continuously. Other symptoms of unpleasant bitter taste of its tablets(114). Therefore, it
excessive berberine intake include lethargy, nose bleed, is no longer recommended by the WHO as first line
skin and eye irritation and kidney irritation(71). treatment for malaria and should be used only when
Berberine is a useful drug for the treatment of visceral as artemesinins are not available(115). Treatment of S.
well as cutaneous leishmaniasis. In L. donovani infection, mansoni-infected female mice with daily intraperitoneal
it inhibited in vitro multiplication of amastigotes injections of quinine and quinidine caused significant
in macrophage culture and their transformation to decrease in worm burden and egg production. Their
promastigotes in cell free culture(99), while 1% berberine schistosomicidal effects are due to their capacity
sulphate inoculated intra-lesionally was found to be to interfere with hemozoin formation which is the
highly effective against cutaneous leishmaniasis in main heme detoxification pathway in S. mansoni(116).
domestic dogs(100). In addition, crude extract formulation In addition, quinine and chloroquine are considered
including berberine had a maximum cure rate of 73% potential drugs against L. loa infection(117).
at a dose of 800 mg/kg/day in hepatic amoebiasis(101). Triticum vulgare, Triticum aestivum; Wheat germ
The results of a study conducted in patients with (Ganin Habit Al-Kamh)
chloroquine-resistant malaria indicated that berberine Lectin (wheat germ agglutinin) is the active constituent,
was more effective in clearing the parasite than both however, it is a concentrated source of vitamin E, folic
tetracycline and cotrimoxazole and that the combination acid, phosphorus, thiamin, zinc and magnesium, as
of pyrimethamine and berberine gave the best results for well as essential fatty acids and fatty alcohols(71). In a
chloroquine resistant malaria(102). Moreover, berberine clinical trial, wheat germ helped in quick resolution of
sulphate was comparable to metronidazole as regards symptoms in Giardia-infected patients. It did not kill
potency on the growth of T. vaginalis in vitro(103). the parasites, but prevented their growth, replication
and attachment(118). In addition, the effectiveness of
Azadirachta indica, Melia Azadirachta; Neem wheat germ as a useful dietary supplement administered
The major active constituents in neem are fatty to E. histolytica-infected patients was reported, both
acids and terpenoids such as azadirachtin, which in acute and chronic stages of infection(119). When its
is considered to possess anti-microbial and insect therapeutic effect was experimentally evaluated in
repellent effects, among many other actions(104). immunosuppressed mice infected with Cryptosporidium
Neem seed oil is problematic and should be kept oocysts, it showed significant reduction of excreted
out of reach of children(105). In this form, it is mainly oocysts on day 7 post-infection(120). It was also shown to
used in control of vector borne parasitic diseases. have remarkable inhibitory effect on multiplication and
The larvicidal and emergence inhibitory activities motility of T. Vaginalis(87).
of neem were tested successfully against the vectors
of malaria, filariasis and dengue fever(106). Besides, Cinnamomum zeylanicum; Cinnamon (Al-Kerfa)
water-free neem seed extract shampoo was effective Various terpenoids (eugenol and cinnamaldehyde)
against S. scabiei-infesting dogs in Egypt(107). As an are believed to account for cinnamon's medicinal
acaricidal agent, neem extracts showed high level of effects(121). Some people develop bronchial constriction
efficacy (80%) for adult ticks after 5 hours of or skin rash after exposure to cinnamon and chronic
treatment(108). As a pediculicide, its extract shampoo use of the concentrated oil may cause mouth
proved to be highly effective against all stages of head inflammation. Cinnamon is not recommended for
lice, with no side effects(109). The significant repellent use by pregnant women(71). Cinnamon essential oil
activities of neem against Phlebotomus papatasi(110) and had potent insecticidal and ovicidal activities against
Ixodes ricinus(111) nymphs were reported. human head louse, P. humanus capitis(122), acaricidal
activity against adult Dermanyssus gallinae(123) and
Cinchona officinalis; Cinchona (Al-Quina tree) strong larvicidal activity against 4th instar Aedes
The medicinally active constituents of cinchona are aegypti larvae(124). Recently, its inhibitory action against
a variety of alkaloids as quinine and quinidine. Oral other mosquito species as Aedes albopictus, Culex
quinine has marked side effects, including tinnitus, quinquefasciatus and Armigeres subalbatus larvae was
dizziness and nausea(112). Quinine has been used as reported(125).

7
Herbal Medicine and Parasites

Melaleuca alternifolia; Tea Tree: Pimpinella anisum; Anise (Al-Yanson): The active
Oil of tea tree containing terpenoids such as terpinen-4- constituents in anise, particularly the terpenoid anethole,
ol and cineole has the ability to kill resistant fungus and are in its volatile oil(141). Its uses for medication in
bacteria(126). The reported side effects included burning parasitic diseases are due to its insecticidal and repellent
and allergic reactions(127). Its oil was reported to have effects. The acaricidal activity of anise seed oil against
similar repellent effects, as clove oil used against scrub house dust mites Dermatophagoides farinae and
typhus(94). Tea tree oil (5%) showed similar effects as D. pteronyssinus was about 8.4 and 6.7 times more
those of benzyl benzoate, lindane and ivermectin against toxic than benzyl benzoate, respectively(142). Besides
all stages of S. scabiei(128). Acaricidal and pediculocidal its acaricidal activity, it was highly effective as both
activity against house dust mites and lice was evaluated larvicidal and ovicidal against different mosquito spp.
using three essential oils: Tea tree, lavender and lemon As Anopheles, Aedes and Culex(95). Moreover, its spray
and the results revealed that tea tree oil was the most preparation had significant cure rates against head louse
effective(129). Moreover, improvement of symptoms and infestations(143).
dramatic resolution of ocular irritation and conjunctival Punica granatum; Pomegranate (Al-Roman): Ellagic
inflammation were reported in patients with Demodex acid is likely to be the main constituent responsible for
blepharitis who were treated with 50% tea tree oil the antiparasitic effect of pomegranate(144). It acts through
shampoo for a minimum of 6 weeks(130). stimulation of the cell-mediated and humoral components
Cucurbita pepo, Cucurbita maxima; Pumpkin of the immune system(145). The in vitro studies conducted
(Karh El-Asal, or Al-Yakten): in 2009 proved that ellagic acid may contribute as a
Pumpkin seeds contain several active constituents: promising anti-malarial drug(146), it had the ability to
Essential fatty acids, amino acids, phytosterols (e.g. inhibit the growth of P. falciparum asexual blood stages in
β-sitosterol), minerals, vitamins and curcurbitin which vitro(147). In addition, a natural plant extract purified from
shows anti-parasitic activity(131). Oral administration pomegranate was effective against T. vaginalis in vitro(67).
of crude ethanolic extracts from C. maxima reduced Ricinus communis; Castor Oil Plant (El-Khirwa):
by 50% the levels of parasitaemia in Plasmodium Ricinoleic acid is the main component of castor oil,
berghei-infected mice(132). In heterophyiasis, a combined and it constitutes approximately 90% of its fatty acid
extract of areca nut and pumpkin seeds gave an excellent content(148). Leaves of castor oil plant are toxic to sand
result than when either extract was given alone(133). flies and offer protection against their bites and decrease
In addition, it gave effective results against canine the risk of leishmaniasis(149). The methanol extract of castor
tapeworms(134). Its leaf extract with different solvents oil exhibited acaricidal and insecticidal activities against
showed larvicidal, ovicidal and repellent activities Haemaphysalis bispinosa and Hippobosca maculata(158).
against Culex quinquefasciatus(135).
Rosmarinus officinalis; Rosemary (Ekleel Al-Gabal):
The active constituents include volatile oil (eucalyptol
Less Commonly Used Herbal Medicine with
Antiparasitic Effects or cineole) as a potent antibacterial agent, rosmarinic
acid with antioxidant activity and carnosol as anti-cancer
Cuminum cyminum; Cumin (Al-Kammoun):
formation in animal studies. Internal intake of its oil
Cuminaldehyde, cymene and terpenoids are the major
should be avoided during pregnancy because it may cause
constituents of volatile oils of cumin(136). It is usually
abortion(151). Rosemary oil produced decreased oviposition,
used in traditional medicine as a stimulant, a carminative
had high larvicidal activity against all larval stages of A.
and an astringent(137). Significant larvicidal activity
aegypti and proved to be a promising agent in mosquito
(100% mortality) of essential oils derived from cumin
control programs(152)
against early 4th stage larvae of Aedes aegypti and Culex
pipiens was reported(138). Salix alba; Willow (Al-Sefsaf): The main active constituent
is glycoside salicin which has anti-inflammatory and pain-
Eugenia caryophyllata; Syzygium aromaticum
relieving actions. As with aspirin, some people may
Clove (Al-Kornfel): The main constituents of the
experience stomach upset from taking willow(153). During
clove essential oil are phenylpropanoids such as
the American Civil War, the unreliable supply and high cost
carvacrol, thymol, eugenol and cinnamaldehyde(139).
of quinine forced the Confederate Army to use alternative
Under field conditions, Gel B (20% clove oil) provided
treatments for malaria which were made from indigenous
significant repellent effects against Aedes aegypti,
plants such as dogwood, willow and tulip tree. The quinine
Culex quinquefasciatus and Mansonia uniformis. These
substitutes were generally considered useful but not as
promising results raised the possibility for its use by
effective as quinine(154).
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repellent effects against host-seeking chiggers (scrub constituents are the volatile oils, including phenols, thymol
typhus) of Leptotrombidium imphalum(94). and carvacol. Thyme oil should be reserved for topical

8
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