Systematic Review on Plant-Based Therapies for the Management of Sickle Cell Anaemia.

BACKGROUND: Sickle cell anaemia (SCA) is a hereditary haemoglobin disorder that continues to pose a significant public health burden worldwide. This systematic review aimed to synthesise evidence on plant-derived therapies investigated for their antisickling, antioxidant and membrane-stabilising effects in the management of SCA. METHODS: A systematic search of PubMed, Scopus and Web of Science was performed according to PRISMA 2020 guidelines to identify studies (2010-2025) evaluating plant-based interventions for SCA. RESULTS: Thirty-four studies published between 2010 and 2025 were included, with the majority (58.8%) published between 2018 and 2025, while 20.6% were published between 2010 and 2012. Most studies originated from Africa (58.8%), particularly Nigeria and the Democratic Republic of the Congo, followed by Asia (26.5%). Carica papaya was the most frequently investigated medicinal plant (21.2%), and leaves were the most commonly used plant part (39%). Strong antisickling activity was reported in 41.2% of studies, while 26.5% demonstrated inhibition of haemoglobin S (HbS) polymerisation and 17.6% reported membrane-stabilising or antihaemolytic effects. Antioxidant activity accounted for 45.5% of all oxidative assessments. Overall, inhibition of HbS polymerisation was the most frequently reported mechanism of action, identified in 60.6% of the included studies. CONCLUSION: The evidence demonstrates that plant-derived extracts and phytochemicals possess significant antisickling, antioxidant and membrane-protective activity, supporting their potential as adjunct therapies for SCA. Nonetheless, standardisation of experimental protocols, toxicological evaluation and clinical trials are essential to advance towards clinical application.