Assessment of Knowledge, Attitudes, and Practices of Traditional Healers toward Dosage Forms and Routes of Administration: A Cross-Sectional Study in Ethiopia

Methods

A cross-sectional study design was conducted on 70 traditional healers from June 1, 2022 to July 25, 2022. The data were collected through structured questionnaires. The data were checked for completeness and consistency and then entered into SPSS version 25.0 for analysis. The results were presented with frequencies and percentages. The association between sociodemographic factors and traditional healers' knowledge of dosage forms and route of administration was determined using the Pearson's chi-squares test. A statistically significant difference was declared if the p value was 0.05 or lower.

Results

Most (58.1%) traditional healers had information on dosage forms, especially about solid, semisolid, and liquid dosage forms. In addition, 33 (53.2%) traditional healers had information about rectal, nasal, and oral route of administration. All traditional healers had practiced different dosage forms and route of administration both individually and in combination earlier to date. More than half of the participants agreed on the need for different dosage forms and route of administration. This study result also showed that most (72.6%) traditional healers had gaps in sharing experiences and information with other healers and health professionals.

Conclusions

The current study revealed that solid, semisolid, and liquid were the most frequently formulated dosage forms with oral, rectal, and nasal route of administration by traditional healers. The practice of checking the status of the formulations was poor. Traditional healers had a good attitude towards the need for different dosage forms and route of administration. The stakeholders should provide continuous training and exchange of experiences between traditional healers and healthcare professionals to improve the knowledge of traditional healers for appropriate use of dosage forms and route of administration.

Ethnobotanical Study of Medicinal Plants Used to Treat Human and Livestock Ailments in Hulet Eju Enese Woreda, East Gojjam Zone of Amhara Region, Ethiopia

Indigenous people of a given community have their own local specific knowledge on plant use, management, and conservation. The objective of this study was to document medicinal plants used to treat human and livestock ailments in Hulet Eju Enese Woreda. The data were collected using semistructured interviews, focus group discussions, and field observations with local people. A total of 100 informants over the age of 20 years were selected to collect information on medicinal plant use. Descriptive statistics (percentage and frequency), Jaccard's similarity index, independent sample t-test and analysis of variance, informant consensus factor, fidelity level, preference ranking, and direct matrix ranking were computed. A total of 80 medicinal plant species belonging to 75 genera and 52 families were documented. In terms of species diversity, Solanaceae stood first with 5 species followed by Euphorbiaceae and Malvaceae with 4 species each. Out of eighty medicinal plants, 53 species were used to treat only human ailments, 8 species were used to treat only livestock ailments, and the remaining 19 species were used for treating both human and livestock ailments. From the total medicinal plant species, shrub constitutes the largest number with 42.5% species. The most frequently used plant parts were leaves, accounting for 28.9%. The major routes of administration were oral accounts, 81 (57%), followed by dermal, 45 (31.7%), nasal, 6 (4.2%), and others, 10 (7%). In the disease category with the highest informant consensus factor (0.83) value was sudden sickness. There was highest preference (49) for Phytolacca dodecandra to treat rabies. Cordia africana was shown to be the top multipurpose species. This study revealed that the study area was rich in medicinal plants. Agricultural expansion, charcoal making, and firewood collection were considered major threats to medicinal plants. Therefore, awareness creation to the youth and training to the healers play a pivotal role to prevent the loss of indigenous knowledge.

Medicinal Plants Used to Manage Human and Livestock Ailments in Raya Kobo District of Amhara Regional State, Ethiopia

Plant-based traditional medicine is practiced in Raya Kobo district, Amhara Regional State, Northeastern Ethiopia, to manage different human and livestock ailments. However, the formal ethnobotanical survey that documented such knowledge is lacking. Therefore, the aim of this study was to document the traditional knowledge on the use of medicinal plants to manage human and livestock ailments in the district. The study was conducted from January to July 2017 in five purposefully selected kebeles of the district. Ethnobotanical data were collected mainly using semistructured interviews conducted with 150 informants. In the five kebeles, 30 informants (15 males and 15 females) were selected using the stratified random sampling method from a list of traditional practitioners and knowledgeable individuals. Data were analyzed by employing descriptive and inferential statistical methods. The study documented a total of 91 medicinal plant species (distributed in 51 families) used in managing 38 human and 12 livestock ailments. Out of the total recorded plants species, 74 and 17 were used in managing human and livestock ailments, respectively. Leaves were the most frequently used plant parts in the preparation of remedies, accounting for 53.1% of the total preparations. The three most common methods of remedy preparation were grinding/pounding (23.5%), crushing (19.8%), and boiling (14.5%). Preference ranking conducted by selected informants on eight medicinal plants used in treating human febrile illness locally called “mich” revealed that Ocimum urticifolium is the most preferred medicinal plant—an indication of its high potency against the disease, and therefore needs to be prioritized for future scientific investigation. The result of this study demonstrated the rich traditional knowledge and practices in the district on the use of medicinal plants in treating various human and livestock ailments. Deforestation and drought were reported to be the major factors in the district threatening the medicinal plants and the associated knowledge. Thus, concerted efforts have to be made to conserve this important heritage using every possible means.

The use of medicinal plants by pregnant women in Africa: A systematic review

ETHNOPHARMACOLOGICAL RELEVANCE

Medicinal plant (MP) use during pregnancy is common in Africa and may have profound effects on both the mother and the developing foetus. A lack of overview complicates monitoring and regulating the use of MPs during pregnancy.

AIM OF THE STUDY

This systematic review analyses prevalence of use of MPs during pregnancy, regional distribution, types and prevalence, MP properties, potential health risks, and consensus of MPs use, and suggests relevant measures to mitigate negative effects on pregnancy.

MATERIALS AND METHODS

A search was undertaken using a range of scientific databases (Medline, Embase, African Journals OnLine, Google Scholar and Biological Abstracts), non-governmental organisations, various African universities and regulatory websites for original published and unpublished studies that assess and indicate the prevalence of use of MPs during pregnancy in Africa. Additional articles were located by exploring pertinent bibliographies, and contacting experts.

RESULTS

A total of 3659 MP-use studies were found, but only 303 articles received full-text assessment for eligibility and finally only 50 scientific papers were eligible for the systematic review. The prevalence of MP use by pregnant women varied widely from 2% to 100%. Twenty-eight studies (56%) specified one or more plant species used as MP during pregnancy. The major reasons for MP use were relief of nausea and vomiting during pregnancy (NVP), stimulation of labour, and facilitation of childbirth. The most commonly cited MP species were Zingiber officinale Roscoe, Allium sativum L. and Cucurbita pepo L. and these were used for relief of NVP, motion sickness and as a nutritional supplement. Route of administration was most commonly oral, and few adverse effects were reported.

CONCLUSIONS

The use of MPs among pregnant women in Africa is prevalent, and the most commonly used plant species are not known to have harmful foetal effects during pregnancy. However, many of the MP species are poorly studied and teratogenic effects cannot be ruled out. Collaboration between healthcare providers and traditional practitioners to inform about the safe use of MPs may promote safer pregnancies and better health for mothers and infants.

Toxicological investigation of acute and chronic treatment with Gnidia stenophylla Gilg root extract on some blood parameters and histopathology of spleen, liver and kidney in mice

Background

In southeast Ethiopia, people locally use the roots of Gnidia stenophylla Gilg (Thymelaeaceae) to cure malaria and other diseases with no literature evidence substantiating its safety. The aim of this study was, therefore, to investigate the safety of the aqueous root extract of G. stenophylla after acute (single dose) and repeated sub chronic oral administration in mice.

Results

A single oral administration of the extract at 500, 1000, 2000 and 4000 mg/kg body weight did not induce any behavioral change and mortality in both sexes. The oral LD₅₀ of the extract was found to be above 6000 mg/kg body weight in mice. Chronic treatment with the extract for 13 weeks did not induce any sign of illness and/or death and had no adverse effect on the body weight. Dose-related elevations of erythrocytes, hematocrit, hemoglobin, platelets and neutrophils differential and significant decrease in the number of lymphocyte were observed. Liver sections of mice treated with 800 mg/kg body weight, revealed mild inflammations around the portal triads and central veins; whereas the spleen and kidneys appeared normal with no detectable gross morphological and histopathological alteration at both doses.

Conclusions

The results of this study revealed that aqueous root extract of G. stenophylla Gilg at antimalarial dose is safe even when taken for a longer period. At a higher dose, the extract may have a potential to increase some hematological indices but may induce mild hepatotoxicity as a side effect.

Electronic supplementary material

The online version of this article (10.1186/s13104-017-2964-3) contains supplementary material, which is available to authorized users.

Health seeking behavior and use of medicinal plants among the Hamer ethnic group, South Omo zone, southwestern Ethiopia

BACKGROUND

Health seeking behavior of people around the globe is affected by different socio-cultural and economic factors. In Ethiopia, people living in rural areas in particular, are noted for their use of medicinal plants as a major component of their health care option. This study was conducted to document ethnopharmacological information of the Hamer semi-pastoralists ethnic group in southwestern Ethiopia.

METHODS

A cross-sectional study was carried out whereby information on demographic characteristics, prevalence of perceived illnesses, factors associated with preference of health care seeking options, medicinal plants used and hoarded as well as some healers' socio-economic characteristics were collected using two sets of semi-structured questionnaires - one for household (HH) heads and the other for traditional healers supplemented by focus group discussions (FGDs). Households were selected using a cluster sampling followed by systematic sampling techniques; whereas healers and FGD participants were purposively selected with the assistance of local leaders and elders from the community.

RESULTS

The study revealed that the use of traditional medicine among the Hamer ethnic group is very high. Females preferred traditional medicine more than males. The main reasons for this preference include effectiveness, low cost and ease of availability. Malaria (gebeze) was the most frequently occurring illness in the area identified by all FGD participants. A total of 60 different medicinal plants were reported [34 by HH respondents, 14 by traditional healers and 12 by both]. Fifty-one medicinal plants were fully identified, 3 at generic level and 6 have not yet been identified.

CONCLUSION

It can be concluded that traditional medical practices, particularly herbal aspect, is widely used by the Hamer ethnic group, although health seeking behavior of the community is affected by different socio-economic and cultural factors.

Ethnobotanical study of medicinal plants in the environs of Tara-gedam and Amba remnant forests of Libo Kemkem District, northwest Ethiopia

BACKGROUND

Remnant forests found in areas that have long been converted to agricultural landscapes are refuges of wild useful plants; and societies inhabiting them are custodians of rich indigenous botanical knowledge. This study was undertaken to document the medicinal plants used by the people living in and around Tara-gedam and Amba remnant forests, northwestern Ethiopia, together with the associated ethnomedicinal knowledge.

METHODS

Data were collected from 105 informants through semi-structured interviews, guided field walk, market survey; and analyzed using standard ethnobotanical analytical tools including ranking and comparison.

RESULTS

A total of 163 medicinal plant species in 145 genera and 67 families were recorded among which Zehneria scabra drew the highest community consensus. Seventy-one percent of the medicinal plants were those used for treating human ailments only, 21% for both human and livestock and 8% for livestock only. Asteraceae, with 14 species, had the highest number of medicinal plant species. The medicinal plants mainly (79.1%) belong to the shrub and herb categories and most of them were sourced from the wild habitats. Leaves and fresh plant materials were more frequently used for medicine preparation than other parts. Protected government and church forests as well as tree propagation in nurseries followed by planting them and local practices constitute the major forest conservation efforts that indirectly protect the medicinal plants in the area. Elders and healers knew more about the medicinal plants, their distribution, the local ethnomedicinal practices and knowledge transfer patterns. Though important for the local healthcare system and with potentials for modern drug discovery, both the plants and the knowledge pool are under threat.

CONCLUSION

The diversity of medicinal plants and the associated indigenous knowledge of Tara-gedam and its environs are of a considerable value to the local community and beyond. There is, therefore, a need for conservation of the vegetation and the medicinal plants along with preservation of the wealth of the indigenous knowledge.

An ethnobotanical study of medicinal plants used in sacred groves of Kumaon Himalaya, Uttarakhand, India

ETHNOPHARMACOLOGICAL RELEVANCE

International organizations recognize the importance of sacred groves and place them into the context of sustainable development and also emphasize to conserve biodiversity through protection of sacred groves and sties. The significance of medicinal plants from Himalayan region is well known to the world. Therefore, present study was conducted in identified sacred groves of Kumaon Himalaya to investigate and document the utilization of medicinal plants by various local communities and tribal people.

MATERIALS AND METHODS

The study was conducted during 2008-2011 in four seasons of the year. Information was collected from 70 locals from different sacred groves by using free listing interviews with randomly selected informants and semi-structured questionnaires; plant specimens were collected, identified and deposited at the CSIR-NBRI herbarium (LWG), Lucknow, India.

RESULTS

Seven sacred groves viz., Dhwaj, Haat Kali, Hokra, Malay Nath, Nakuleshwar, Narayan Swami Ashram and Patal Bhuvneshwar were identified from the Pithoragarh district of Kumaon Himalaya. 89 medicinal plants belonging to 52 families and 77 genera of which, 2 are lichens, 4 are pteridophytes, 3 are gymnosperms and remaining 80 plant species are angiosperms. 6 plant species are reported with new therapeutic uses for the first time in this paper. Highest informant׳s consensus factor value was found in liver disorder (0.55) and least by body pains (0.23). 55 ethnomedicinal plants are showing 100% fidelity level against various diseases.

CONCLUSION

Sacred groves in Kumaon region of Indian Himalaya are rich sources and best repository of ethno-medicinally important plants with many rare, endangered and threatened species. It is an excellent example of unique traditional way of in situ conservation of different plant species.

The contribution of traditional healers' clinics to public health care system in Addis Ababa, Ethiopia: a cross-sectional study

BACKGROUND

Ethiopian people have been using traditional medicine since time immemorial with 80% of its population dependent on traditional medicines. However, the documentation of traditional healers' clinics contribution to modern public health system in cosmopolitan cities is scanty. Studies conducted so far are limited and focused on the perceptions and practices of modern and traditional health practitioners about traditional medicine. Thus, a cross sectional study was conducted from February to May 2010 to assess the contribution of traditional healers' clinics to public health care system in Addis Ababa.

MATERIALS AND METHODS

Ten traditional healers who were willing to participate in the study and 306 patients who were visiting these traditional healers' clinics were interviewed using two types of semi-structured questionnaires. Data were summarized using percentages, tables and bar chart.

RESULTS

The diseases mostly treated by traditional healers were wound, inflammation, herpes zoster, hemorrhoids, fracture, paralysis, back-pain, liver diseases, cancer and eczema. This study showed that traditional healers' clinics considerably contribute to public health care in Addis Ababa. Fifty two percent of patients reported that traditional healers' clinics were their first choice when they faced health problems. The reasons for visiting these clinics were 175 (57.2%) efficacy, 109 (35.6%) dissatisfaction with modern medicine, 10 (3.3%) dissatisfaction with modern medicine and efficacy, 6 (2.0%) cost and 6 (2.0%) dissatisfaction and cost. Females (55.2%), young age (20-40 years, 65.0%), never married (56.9%), orthodox (73.9%), Amhara (52.3%), educational status above grade 12 (34.6%) and government employees (29.4%) were frequent visitors. Healers reported that there was no form of cooperation with modern health professionals. The reasons were lack of motivation to collaborate and communicate with modern health service workers. Family based apprenticeship was the sources of knowledge for majority of the healers.

CONCLUSIONS

The study conducted showed that for the majority of patients interviewed traditional healers' clinics were one of the options to solve their health problems that indicated the considerable contribution of these clinics to the public health care system in Addis Ababa. Nevertheless, in this study the contribution of traditional healers' clinics to the public health system would have been better shown if individuals who are not users of the traditional healers' clinics were included in the interview. However, the study might be useful as a base line data for future evaluation of the significance of traditional healers' clinics for public health system and the services rendered in these clinics.

An ethnobotanical survey of medicinal plants in the Eastern Himalayan zone of Arunachal Pradesh, India

AIM OF THE STUDY

The medicinal plants are integral source of easily available remedy used in rural healthcare system. This study was conducted among three major ethnic groups namely the Nocte, the Nyishi and the Adi in the Eastern Himalayan region of Arunachal Pradesh to evaluate their comparative knowledge on medicinal plants.

MATERIALS AND METHODS

The three remote districts of Arunachal Pradesh namely the Tirap, the Dibang Valley and the Papum Pare were surveyed through interviewing of randomly selected 237 participants using semi-structured questionnaire and regular field visits to selected districts.

RESULTS

We recorded the traditional use of 74 medicinal plants species belonging to 41 taxonomic plant families used for treating a total of 25 different diseases/ailments. The informant consensus factor (ICF) values demonstrated that local people tend to agree more with each other in terms of the plants used to treat malaria (0.71), jaundice (0.62), urological problems (0.56), dermatological disorders (0.45), pain (0.30), and respiratory disorder (0.33), and while the general health (0.15) and gastro-intestinal disorders category (0.28) were found low ICF values.

CONCLUSION

Of the total 74 species recorded, the highest number of medicinal plants (36 species) was reported from the Adi of Lower Dibang Valley followed by the Nocte of the Tirap (25 species) and the Nyishi ethnic groups of Papum Pare districts (13 species). In the present study, we found that the men, elder people and illiterate ones had better knowledge on medicinal plants as compared to women, younger and literate people. Findings of this documentation study can be used as an ethnopharmacological basis for selecting plants for future phytochemical and pharmaceutical studies.

Ethnomedicinal study of plants used by Sheko ethnic group of Ethiopia

AIM OF THE STUDY

This study was conducted to document and evaluate knowledge on medicinal plant use by Sheko ethnic group in Southwest Ethiopia.

MATERIALS AND METHODS

Interviews and ranking exercises were the main methods employed to collect the ethnobotanical data. Fidelity level (FL) values were calculated for claimed Sheko medicinal plants to estimate their healing potentials.

RESULTS

Seventy-one Sheko medicinal plants were reported, the majority of which were used to treat skin and gastro-intestinal ailments. Ocimum lamiifolium, Phytolacca dodecandra, Amaranthus dubius and Amaranthus graecizans were the medicinal plants assigned with the highest FL values, a possible indication of their better healing potential. The majority of Sheko medicinal plants were found to be herbs, and leaf was the most preferred plant part in remedy preparations. The study indicated that men, older people and illiterate ones had better knowledge of medicinal plants use as compared to women, younger people and literate ones, respectively.

CONCLUSIONS

The study showed that the Sheko people have rich knowledge of medicinal plant use. This knowledge is however, currently threatened mainly due to acculturation. Awareness should thus be created among Sheko community by concerned bodies regarding the usefulness of their medical practice. The efficacy and safety of the claimed medicinal plants need to be evaluated before recommending them for a wider use with priority given to those with high fidelity level values.

Medicinal plant knowledge of the Bench ethnic group of Ethiopia: an ethnobotanical investigation

BACKGROUND

Plants have traditionally been used as a source of medicine in Ethiopia since early times for the control of various ailments afflicting humans and their domestic animals. However, little work has been made in the past to properly document and promote the knowledge. Today medicinal plants and the associated knowledge in the country are threatened due to deforestation, environmental degradation and acculturation. Urgent ethnobotanical studies and subsequent conservation measures are, therefore, required to salvage these resources from further loss. The purpose of the present study was to record and analyse traditional medicinal plant knowledge of the Bench ethnic group in Southwest Ethiopia.

METHODS

Semi-structured interviews were conducted with Bench informants selected during transect walks made to houses as well as those identified as knowledgeable by local administrators and elders to gather data regarding local names of medicinal plants used, parts harvested, ailments treated, remedy preparation methods, administration routes, dosage and side effects. The same method was also employed to gather information on marketability, habitat and abundance of the reported medicinal plants. Purposive sampling method was used in the selection of study sites within the study district. Fidelity Level (FL) value was calculated for each claimed medicinal plant to estimate its healing potential.

RESULTS

The study revealed 35 Bench medicinal plants: 32 used against human ailments and three to treat both human and livestock ailments. The majority of Bench medicinal plants were herbs and leaf was the most frequently used part in the preparation of remedies. Significantly higher average number of medicinal plants was claimed by men, older people and illiterate ones as compared to women, younger people and literate ones, respectively. The majority of the medicinal plants used in the study area were uncultivated ones.

CONCLUSION

The study revealed acculturation as the major threat to the continuation of the traditional medical practice in the study area. Awareness should, therefore, be created among the Bench community, especially the young ones, by concerned organizations and individuals regarding the usefulness of the practice.

Medicinal plants of the Meinit ethnic group of Ethiopia: an ethnobotanical study

ETHNOPHARMACOLOGICAL RELEVANCE

The majority of the Ethiopian people, including the Meinit ethnic group, are highly dependent on medicinal plants for their day-to-day public healthcare and veterinary needs. The existence of medicinal plants and the associated knowledge is, however, currently being threatened mainly due to deforestation, environmental degradation and acculturation. Thus, there is an urgent need to document and analyse the knowledge.

AIM OF STUDY

The aim of this study was to record and analyse local knowledge of the Meinit people of Ethiopia on the use of plants to treat or cure diseases of humans and domestic animals.

MATERIALS AND METHODS

Ethnobotanical data were gathered through series of individual interviews conducted with selected informants representing different social groups within the Meinit Community. Fidelity Level (FL) values were calculated to estimate the healing potentials of claimed medicinal plants.

RESULTS

The study revealed 51 medicinal plants, most of which were herbs. Root was the most frequently used part in remedy preparation. The majority of medicinal plants were not cultivated. Significantly higher numbers of medicinal plants were cited by men than women, by older people than younger ones and by illiterate people than literate ones. Rumex nepalensis Spreng., Leucas deflexa Hook.f. and Embelia schimperi Vatke were the medicinal plants that scored the highest FL values.

CONCLUSIONS

Acculturation of the young generation has been found to be the major treat to the continuation of traditional medical knowledge and practice in the study area. Efforts should, therefore, be made to incorporate traditional medicine in school curricula so that younger people could appreciate its usefulness. Priority for further Pharmaco-chemical investigation should be given to plants that scored highest FL values, as such values could indicate better efficacy.