South African medicinal plants traditionally used to treat gonorrhoea: A comprehensive review

• Only 44 % of the identified plant species have undergone pharmacological evaluation against Neisseria gonorrhoeae . • Antigonococcal constituents have been isolated from Ximenia caffra, Aloe ferox , and Helichrysum caespititium . • Most documented species have undergone extensive in vitro cytotoxicity studies reporting no apparent cytotoxicity. • In vivo toxicity studies need to be conducted for clinical safety assessment of the plant species. Gonorrhoea is the second most common sexually transmitted infection (STI) and a major health issue in South Africa. This review provides a detailed list of South African medicinal plants used to treat gonorrhoea. The study followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Researchers used databases like Google Scholar, Scopus, ScienceDirect, and Web of Science. Search terms included “medicinal” plants, “traditional use,” “gonorrhoea,” “venereal diseases,” “sexually transmitted infections,” and “South Africa.” Plant species were verified through the South African National Biodiversity Institute (SANBI) and the New Plants of Southern Africa (NEWPOSA) online databases. A total of 28 plant species from 21 families were identified in South Africa for treating gonorrhoea. The Fabaceae and Maliaceae families, with three plant species each, were the most commonly used for this purpose. However, only 44 % of these species have undergone pharmacological testing against Neisseria gonorrhoeae. The remaining 56 % have not been evaluated for gonococcal activity. Although some phytoconstituents have been isolated, few antigonococcal compounds have been documented. Cytotoxicity tests have mostly been conducted in vitro , with limited evidence from in vivo studies. In vivo evaluations are essential for accurately determining the clinical safety of crude extracts and isolated compounds. Future research should focus on validating the antigonococcal properties of South African medicinal plants, isolating phytoconstituents, and conducting in vivo safety assessments.