Friday, April 17, 2015

SAYE: An Antimalarial Phytomedicine from Burkina Faso

SAYE: An Antimalarial Phytomedicine from Burkina Faso

Burkina Faso (formerly called the Republic of Upper Volta) is a landlocked country in West Africa around 274,200 square kilometres (105,900 sq mi) in size. It is surrounded by six countries: Mali to the north; Niger to the east; Benin to the southeast; Togo and Ghana to the south; and Ivory Coast to the southwest. Its capital is Ouagadougou.

Like many other African countries, Burkina Faso faces malaria as one of the biggest human killer disease. The humane laws in Burkina Faso officially recognizes traditional medicine as part of the health system (Loi No 23/94/ADP). The national policy on traditional medicine aims to integrate traditional medical practices and medicinal products derived from the traditional pharmacopoeia into the national health care system in order to improve access to medicines for the whole population.

SAYE sounds like CHAI, thats North-Indian word for TEA

Using this life-promoting law, Dr. Z├ęphirin Dakuyo promotes/sells mixture named SAYE, which literally means “jaundice” in the local Dioula language. SAYE is manufactured by mixing the three dried and coarsely chopped ingredients in the proportions given in Table. It is sold in a box of 175 g of the chopped, dried plant parts. Patients are instructed to mix 3 tablespoons of the dried plant material in two glasses of water, boil the mixture for 5 minutes, filter it, and drink it. Adults should drink one large glass three times a day, and children age 7 years and older are advised to drink half a glass three times a day for 5 days.

Component Amount per box (g) Amount per batch (kg)
C. planchonii Hook. f. ex Planch. (Bixaceae) rhizome 115 230
Cassia alata L. (Caesalpiniaceae) leaves 25 50
Phyllanthus amarus Schumach. (Euphorbiaceae) whole plant 35 70

Dr. Z├ęphirin Dakuyo was the first pharmacist to be posted in Banfora Hospital in Southwest Burkina Faso, in 1983. At the time, chloroquine was the first-line treatment for malaria, but it has since been abandoned because of high levels of drug resistance. He soon received feedback from patients that they did not like chloroquine but preferred to treat themselves with herbal medicines, in particular the roots of N'Dribala (Cochlospermum planchonii). However, they did not have time to collect this medicinal plant themselves, so Dr. Dakuyo, with support from the hospital staff, started to harvest and package it for the patients. The medicine was sold at the hospital to patients with malaria and was also provided to community health workers to supply to patients.

Dr. Dakuyo received feedback from patients that SAYE was even more effective than N'Dribala for treating malaria, and patients started buying it for this condition. In 1986, Dr. Dakuyo also developed capsules of powdered SAYE because he found that many patients did not have time to boil the herbs every day.

In 1993, Dr. Dakuyo left the hospital to start his own pharmacy; he also set up a small factory for producing the herbal medicine. As demand increased and he began producing other herbal products, the size of the factory gradually increased. In 2001 it was registered as a company, Phytofla. In 2005, SAYE and N'Dribala both received an official license from the Ministry of Health for the treatment of uncomplicated malaria. Annual sales now stand at 60,000 boxes of SAYE and 25,000 boxes of N'Dribala. Although Artemisinin-based Combination Therapies (ACTs) are widely available in Burkina Faso, they are expensive and are believed to have some adverse effects. Therefore, many adult patients still prefer to use SAYE, sometimes in combination with a modern medicine and sometimes alone.

Article citation: Dakuyo, Z.; et. al. SAYE: The Story of an Antimalarial Phytomedicine from Burkina Faso. The Journal of Alternative and Complementary Medicine 2015, 21(4), 187-195.

Herbal medicine is Ayurveda