https://orcid.org/0009-0001-5064-9444
Figures
Abstract
Background
The coexistence of traditional healing practices deeply rooted in cultural and historical contexts and the evolving landscape of modern healthcare approaches in West African societies creates a dynamic interplay between tradition and modernity in healthcare. This study aims to comprehensively map the landscape of traditional medicine use for health in West Africa.
Methods
A scoping review was conducted following the Joanna Briggs Institute (JBI) methodology and reported according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews (PRISMA-ScR) guidelines. Research questions focused on the links between traditional medicine practices and health in West Africa. The systematic literature search covered PubMed, Web of Science, and CINAHL from database inception to September 2023. A descriptive analysis was conducted highlighting the years of publication, countries of publication, study designs of plant families and plant parts used for making traditional medicines, and the diseases the traditional remedies are for.
Results
The search identified 3484 records, with 46 articles meeting the inclusion criteria. Publications spanned from 1979 to 2023, with no observed trend in the number of publications over successive decades. Nigeria had the highest number of publications (54.3%), followed by Ghana (19.6%). The studies employed various designs, including clinical trials, ethnobotanical, ethnopharmacological, and experimental designs. Plant families frequently studied included Combretaceae, Euphorbiaceae, and Rubiaceae. Traditional remedies address various health issues, highlighting their versatility, from general symptoms to specific diseases.
Conclusion
This scoping review offers an extensive overview of traditional healing practices in West Africa. The studies highlighted in this review stress the necessity for culturally sensitive healthcare interventions. The widespread use of traditional medicine and the variety of practices underscore the importance of encouraging collaboration between traditional healers and modern healthcare professionals. This review also identifies knowledge gaps and areas needing further research, setting the stage for future exploration into West Africa’s intricate healthcare landscape.
Citation: D’Almeida SA, Gbomor SE, Osaio-Kamara B, Olagunju MT, Abodunrin OR, Foláyan MO (2024) A scoping review of the use of traditional medicine for the management of ailments in West Africa. PLoS ONE 19(7): e0306594. https://doi.org/10.1371/journal.pone.0306594
Editor: Timothy Omara, BOKU: Universitat fur Bodenkultur Wien, AUSTRIA
Received: January 19, 2024; Accepted: June 9, 2024; Published: July 8, 2024
Copyright: © 2024 D’Almeida et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
Data Availability: All relevant data are within the manuscript and its Supporting Information files.
Funding: The author(s) received no specific funding for this work.
Competing interests: The authors have declared that no competing interests exist.
Introduction
The dynamic interplay between tradition and modernity in healthcare practices remains a complex and intriguing facet of West African societies [1]. This interplay reflects the ongoing negotiation between longstanding traditional healing methods deeply rooted in cultural and historical contexts and the evolving landscape of modern healthcare approaches [2]. In West Africa, traditional healing practices often involve indigenous knowledge, rituals, and the use of natural remedies passed down through generations [3]. These practices coexist with, and at times, intersect with, modern medical interventions, technologies, and pharmaceuticals, thereby reflecting the adaptability and resilience of West African societies in navigating the complexities of health and well-being [4].
Patients often engage with traditional and modern healthcare systems, sometimes concurrently or sequentially, depending on their health needs, personal beliefs, and accessibility [5]. This health-seeking behaviors is a common practice across Africa, creating a nuanced healthcare ecosystem in the region [6]. This underscores the importance of acknowledging diverse healthcare practices and fostering collaborative efforts between practitioners, including fostering collaborations between traditional healers and modern healthcare professionals [7,8].
As global interest in alternative and complementary medicine grows [9], understanding the prevalence and scope of traditional healing practices in West Africa becomes paramount for fostering culturally sensitive and effective healthcare interventions. Therefore, gathering and synthesizing information is essential to provide a comprehensive overview of traditional healing practices in West Africa. One way of doing this is to identify key themes, patterns, and trends in the literature related to traditional healing practices, thereby allowing for a nuanced understanding of the prevalence and variations of these practices across different regions, communities, and culture contexts in West Africa. By systematically reviewing the existing literature, gaps in knowledge and areas where further research is needed can be identified, and future studies designed.
This scoping review aimed to explore the landscape of traditional medicine use for health in West Africa, a region known for its diverse ethnicities, languages, and cultures and a rich tapestry of indigenous healing practices [10]. The review systematically outlines the various modalities employed in traditional medicine and discusses the implications of these findings for public health in West Africa.
Methods
The study design was guided by the Joanna Briggs Institute (JBI) scoping review methodology [11]. The study was reported following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews guidelines (PRISMA-ScR) [12,13].
Identifying research question
The review was guided by the research question: What is the extent and nature of English-language publications on utilizing traditional medicine for treating various ailments in West Africa?
Identifying relevant studies
A systematic literature search was conducted in PubMed, Web of Science, and the Cumulative Index of Nursing and Allied Health Literature (CINAHL) using the terms shown in S1 File. The search was conducted from the inception of the database till September 2023. A search of the references of the publications included in the scoping review was also carried out.
Study selection
Publications identified through the search strategy were downloaded into Endnote and imported into Rayyan. After that, duplicate publications were removed. Three researchers (ORA, MTO, MOF) independently screened the titles and abstracts of the downloaded articles using pre-defined inclusion and exclusion criteria. Studies were included if there was an agreement among the three researchers who performed the screening. Disparities were settled by consensus. In addition, the three researchers completed the full-text review (ORA, MTO, MOF). Uncertainty regarding whether publications met the inclusion criteria was resolved via consensus among the three researchers.
Inclusion criteria
Peer-reviewed journal articles that covered traditional medicine and health focusing on West Africa. Studies included were published in the English Language, addressed preventive and curative aspects of traditional medicine, and explored herbal and traditional remedies. Studies reporting outcomes related to the impact of traditional medicine on preventive and curative health were included. There was no restriction on study design or date of publication.
Exclusion criteria
Animal studies were excluded. Also excluded were studies on non-African populations. In addition, unpublished theses and dissertations, letters to the editor, commentaries on studies, scoping, systematic and narrative reviews, and studies whose full lengths could not be accessed were excluded. Also, studies with insufficient results suitable for analysis were excluded.
Data charting process
A data-charting form was developed to extract relevant variables. The charted variables were the literature characteristics (authors, year of publication, country where study was conducted), study aim, study design, form of traditional medicines used, diseases managed, and the outcomes of the studies.
Data analysis
The results of the scoping review were reported according to the PRISMA-ScR checklist. A deductive analysis was conducted using the framework developed for the data extraction. Details generated from the analysis were the years of publication, the country in West Africa where studies were conducted, forms of traditional medicines used, diseases (and diseases pathogenic organisms) investigated, plants (and plant extracts) investigated, and forms and routes of administration of the traditional medicines for the management of diseases.
A descriptive analysis was conducted highlighting the years of publication, countries of publication, study designs, plant families and plant parts used for making traditional medicines, forms in which the traditional remedies are produced, family of plants used for the traditional remedy, and the diseases the traditional remedies are made to prevent or cure. A compilation o of the names of the plant families studied was compiled. The findings were presented in tables.
Results
The search identified 3484 records, which were downloaded into Endnote and imported into Rayyan. After de-duplication, 3395 records remained. After reviewing titles, abstracts, and screening, 226 articles were eligible for full-text screening. On screening the full articles, 13 articles were excluded either because full articles were not available, the focus of the study was not Africa, or the study was not related to health, leaving 46 articles [14–59]. Three articles were also identified through peer review [60–62], making up to 49 articles for this review. Fig 1 shows the flow diagram of the publication screening process.
As shown in Table 1, the publication period for the 49 manuscripts spanned from 1979 to 2023. The distribution across time revealed four (8.2%) were published between 1979 and 1990 [31–33,35], 20 (40.8%) were published between 1991 and 2000 [14–19,20–23,25,38,41–43,46,49,51,57,59], 13 (26.5%) were from 2001 to 2010 [26,36,37,40,44,47,48,50,52–56], seven (14.3%) papers from 2011 to 2020 [27–30,39,58,62], and five (10.2%) papers from 2021 to 2023 [24,34,45,59,61].
Of the 17 West African countries, only nine have publications on traditional medicines. These countries include Nigeria, which accounts for 25 (51.0%) of the publications [14,16–18,20–26,30,31,33–36,38,41–43,48,49,53,56], Ghana accounting for nine (18.4%) of the publications [27–29,39,40,45,50,52,54], Mali [15,37,47,57] and Togo [19,46,51,59] accounting for four (8.2%) publications each, Benin accounting for three (6.1%) publication [51,60,62], Cote d’Ivoire accounting for two (4.1%) publications [44,55], and Sierra Leone [32], Guinea Bissau [58] and Gabon [61], each having one (2.0%) publication. A publication was produced by Togo and Benin [51].
The studies encompassed various types of study design ranging from experimental studies conducted in laboratories to determine the bioactivities of identified traditional remedies [14,17–19,21–23,25,26,28–31,33–35,38,40–43,44,46,49,51–54,56,57,59]; to ethnobotanical studies which are studies focus on the traditional knowledge, practices, and uses of plants by local communities [15,16,20,24,27,32,36,45,58–62]; ethnopharmacological investigations which are the investigation of traditional knowledge related to the medicinal uses of plants, animals, and other natural substances within specific cultural or ethnic groups [37,39,47,55]; and clinical trials which are systematic investigations conducted on human participants to evaluate the safety, efficacy, and effects of medical treatments, interventions, or therapies [48,50].
Table 2 highlights the characteristics of the 14 ethnobotanical and ethnopharmacological surveys included in the scoping review. The studies were conducted in Nigeria (n = 4), Ghana (n = 3), Mali (n = 2), Benin (N = 2), Gabon (N = 1), Sierra Leone (n = 1) and Guinea-Bissau (N = 1).
A hundred and twenty-three plant families were identified for use as medicinal plants. The Suplemental File 2 provides a compendium of these plant. The most cited plant family was Euphorbiaceae [16,24,27,32,39,45,58,60– 62].
The part of the plants used for medicinal purposes range from the aerial part of plants [58] to barks [15,16,24,27,37,39,45,47,58,60–62], bulbs [60], branches [32,58,60], climbers [39], flowers [39,58], fruits [15,24,27,39,45,47,60,62], gum [15], juice [60], leaves [15,16,24,27,32,36,37,45,47,48,58,60–62], liana [61,62], male plant-inflorescences [16], nuts [60], pods [16,37], rhizome [15,16,39,60,61], roots [15,27,47,24,32,36,37,39,45,58,60–62], sap [39,58,60,61,62], seeds [15,16,24,36,39,45,58,60], stems [15,16,24,32,39,58,60–62], thorns [15], tubers [39,60], twigs [16,36,37,60], and whole plants [15,27,39,45,58,61,62].
Fig 2 shows that leaves and roots are the most used for medicinal purposes, followed by barks and stems. Other parts, such as fruits, seeds, and whole plants, also contribute to many plant-based remedies.
The prepared remedies could be applied topically applied [15,36,39,60,61], inhaled [16], taken orally [60,61], used as scarification [60], or intranasally applied [15,39]. It can be prepared as a decoction [15,16,27,32,36,37,39,47,60,62], powder [15,37,39,47,62], poultice [15,32,39,61], oil [39], juice [15,32,36,39,61], macerated [15,39,47,60–62] or taken as food [24,58,60], soup [36,39], tea [39] or taken as raw fruit [39]. The remedies could also be used for bathing [36], as an enema [15], for infusion [16,27,32,47,61], as a fumigant [15], or for gargling [15,32,37], triturate [60,61] and shampoo [15].
As shown in Fig 3, the forms in which the remedies are prepared are decoction [N = 10], macerated [N = 6], power [N = 5], juice [N = 5], poultice [N = 4], taking as food [N = 3], soup [N = 2], tea [N = 1], oil [N = 1], and taken as raw fruits [N = 1]. Forms in which the remedies are administered are gargling, triturate, bathing, enema, fumigant, and shampoo. These remedies can be administered topically, inhaled, orally, intranasally, or using scarification.
The remedies were used to manage general symptoms such as aches and pains [15,24,32,37,47,58], diarrhea [15,24,32,37], odema, wounds, and burns [15,24,32,37,47,58], dizziness [15,24], convulsion [24,27,32], jaundice [15,27,37,47], bites and sting [24,27,37,58,60,61].
The remedies are also applicable to specific diseases like malaria/fever [15,24,27,32,37,47,58], measles [24,32,36], diabetes [24,27,58], candidiasis [62], sexually transmitted diseases [24,32,37,58], yellow fever [24,32,37], leprosy cholera [24,37], sinusitis [15], cancer [24,39] tuberculosis [24], and schistosomiasis [32,45,47].
Organ disorders managed are anemia and blood disorders [24,27,32,58], bone fracture [24], cold, cough and respiratory diseases [15,24,32,37,58], diseases of the eyes [15,24,32,47,58], diseases of the kidney [37,58], diseases of the liver [24,47,58], the gastrointestinal problem [15,24,27,32,37,47,58], skin problems [15,24,27,32,37,47,58], haemorrhoid [15,27,32,47,58], mental and neurological disorders [16,24,58], neuromuscular problems [15,24,27,47,58], gynaecological problems [24,27,32,37,47,58], and cardiovascular problems [24,27,32,47].
Other non-specific disorders are child health problems [27,32,47,58], oral health problems [15,24,27,32,37], and hernia [27,58]. The remedies are also used as anthelmintic [15,24,37], antiseptic [15], diuretic [27], for the management of poisoning [32,58], baldness [27], dropsy [37], foot rot [27], and to prevent frequent urination when drunk [32].
Table 3 highlights the characteristics of the scoping review’s 36 experimental studies and clinical trials. These studies were conducted in Nigeria (n = 22), Ghana (n = 7), Togo (n = 4), Cote d’Ivoire (n = 2), Republic of Benin (n = 1), Mali (n = 1). A single study was conducted in Togo and the Republic of Benin [51].
The effect of medicinal plants was explored against the following group of diseases and disorders: sickle cell [14], gastrointestinal disorders including diarrhea and dysentery [17,23,31,34,54], respiratory disorders like cough [23,34,43,54,56], malaria/fever [19,22,28,29,40,41,50,55–57], dental infection [30,33,35], skin infections [20,23,31,44,54,55] and wound infections [21,43,53]. Other disorders managed were eye infection [31,56], infertility [31], leprosy [41,43], ulcers [43], meningitis/encephalitis [34], smallpox [43], urinary tract infection [44,56], sore throat [23], gonorrheal [23], schistosomiasis [45] and rhematic pain specifically [41,54,56]. Some studies explored specific antifungal [18,20,42,48,49,51], antibacterial [18,20–23,25,26,30,35,42,46,49,52,53,59] and antiviral [34,46,59] effects of plant extracts.
Sixty plant families were studied (See S3 File for the compendium). The most common plant family studied were Euphorbiaceae [18,21,29,38,40,41,42,44,45,47,50,55], Rubiaceae [19,20,26,30,35,40,44,46,55,57,59] and Combretaceae [14,23,30,35,44,51,55]. The 12 studies on Euphorbiacea were conducted in Nigeria [18,21,38,41,42,48], Ghana [29,40,45,50], and Cote D’Ivoire [44,55]. The plant family studied in the most diverse country was the Rubiaceae studied in Togo [19,46,59], Nigeria [20,26,30,35], Ghana [40], Cote D-Ivoire [44,55], and Mali [57]. Combretaceae was studied in Nigeria [14,23,30,35], Cote D’Ivoire [44,55], Togo [51], and the Republic of Benin [51].
Plant families reported in studies conducted in Nigeria include Lamiaceae [17], Euphorbiacea [18,21,38,41,41,48], Rubiaceae [20,26,30,35], Mahogany [20], Combretaceae [14,23,30,35], Daisy [25,35], Annonaceae [34], Sapotaceae [30,35], Fabaceae [30,35], Piperaceae [30], Rutaceae [30,33,35], Anacardiaceae [35], Aspergillaceae [49], Leguminosea [53], Costaceae [56], Rutaceae [35] and Madder [35].
Plant families reported in studies conducted in Ghana include Euphorbiacea [29,40,45,50], Daisy [52], Apocynaceae [28,40], Annonaceae [29,35], Moringaceae [29], Anacardiaceae [29], Zingiberaceae [54], Amaranthaceae [40] Asclepiadaceae [40], Asteraceae [40], Bombacaceae [40], Mimosaceae [40], Rubiaceae [40], Mallows [50], Solanaceae [45,50], Legumes [50], Olacaceae [45], Acanthaceae [45], Zingiberaceae [45], Leguminoceae [45], Rhizophoraceae [45], Rutaceae [45], and Loranthaceae [45].
Plant families reported in studies conducted in Togo include Rubiaceae [19,46], Combretaceae [51], Malvacae [46,59], Astraceae [46,59], Commelinaceae [46,59], Bombacaceae [46,59], Davalliaceae [46,59], Moraceae [46,59], Rutaceae [46,59], Simarubaceae [46,59], Sapindaceae [46,59], Apocynaceae [59], Bignoniaceae [59], Orchidaceae [59], Rubiaceae [59], Verbenaceae [59].
Plant families reported in studies conducted in Cote d’Ivoire include Combretaceae [44,55], Annonnaceae [44,55], and Lythraceae [55]. Agavaceae [44], Amaranthaceae [44], Anacardiaceae [44], Apocynaceae [44,55], Araliaceae [44], Asparagaceae [44], Bignoniaceae [44], Caesalpinaceae [44], Celastraceae [44], Chrysobalanaceae [44], Cochlospermaceae [44], Convolvulaceae [44], Cyperaceae [44], Euphorbiaceae [44,55], Fabaceae [44], Hymenocardiaceae [44], Hyppocrateaceae [44], Loganiaceae [44], Malvaceae [44], Meliaceae [44,55], Mimosaceae [44], Moraceae [44], Olacaceae [44], Opiliaceae [44,55], Polygalaceae [44], Rubiaceae [44,55], Sterculiaceae [44], Verbenaceae [44,55], Vitaceae [44], Combretaceae [55], Papilionaceae [55], Passifloraceae [55], Sapindaceae [55], and Zingiberaceae [55].
The plant family reported in Benin was Combretacea [51]. The plant family studied in Mali was Rubiaceae [57].
Discussion
This scoping review maps herbal remedies used for medicinal purposes in humans in West Africa. The findings indicate that the study of traditional medicines has continued and increased over time, thereby underscoring the enduring relevance of traditional medicine research, with contributions consistently observed over the years. There has also been an extensive exploration of medicinal plants across West African countries, including their use for managing various diseases and disorders. The geographic distribution of these studies emphasizes the regional relevance of traditional medicine in addressing diverse health challenges. However, the number of countries in West Africa publishing experimentations on traditional remedies, especially clinical trials and ethnobotanical and ethnopharmacological surveys of plants used for traditional medicine, is low, with research skewed towards Nigeria and Ghana.
One of the strengths of this study lies in its thorough examination of research about traditional medicine used in managing diseases in West Africa—a continent widely recognized for its considerable reliance on traditional healthcare practices for the well-being of its population [63]. However, the study had some limitations. First is the inclusion of only publications available and accessible in English, and second is the search limit to three databases employed. These may have inadvertently excluded some research publications on traditional medicines used in West Africa since researchers in the sub-region also publish in French and other languages. Despite this limitation, the present study provides valuable insights into the subject matter.
First, diverse study designs have been employed to investigate traditional medicine in the region. The studies were majorly experimental in design, focusing on laboratory-based investigation of identified traditional remedies. In addition, a few clinical trials, representing systematic investigations on human participants, were conducted to evaluate the safety and efficacy of some traditional medical treatments. There is, however, the need for a lot more experimental and clinical trial studies that can facilitate the translation of the traditional medicines found to have therapeutic effects into commercial products, as the validation of indigenous drugs is relevant to modern societies at large and helps to sustain local health care practices [64].
Furthermore, ethnobotanical and ethnopharmacological studies provided insights into plants’ traditional knowledge, practices, and uses, contributing valuable cultural context to the exploration. In addition, the ethnobotanical and ethnopharmacological surveys provide a deeper understanding of the traditional knowledge embedded in local communities. The surveys conducted in West Africa spotlighted a diverse array of plant families, plant parts, and preparation methods utilized in traditional remedies. Despite this wealth of knowledge, there remains untapped potential for further exploration using research methods tailored to the practice of traditional medicines [65].
These insights can be enhanced through dedicated studies focusing on specific diseases and their traditional medical remedies, as undertaken by those publications on schistosomiasis [45], cancer [39], sickle cell [14], malaria [22,29,40,50], snake bites [60,61], candidiasis [62], and Herpes simplex virus [46]. Conducting disease-centric studies has the potential to aid the sub-region in developing therapeutic measures for disease entities categorized as neglected tropical diseases [66], which are of interest to the sub-region and currently receive limited global attention and funding. Such disease-specific studies on herbal remedies are growing. These include reviews on herbal therapies for diarrhoea in sub-Saharan Africa [67] and the global use of traditional medicines for cancer [68]. These disease-specific studies generate evidence for evaluating the efficacy and safety of these herbal remedies, which is crucial for integrating traditional medicine into mainstream healthcare systems to help inform medical decision-making based on empirical data. Further studies are needed to compare the disease-specific herbal therapies used between regions and their efficacy and safety profile.
The current study highlights the diverse therapeutic applications of identified traditional remedies, encompassing the management of symptomatic conditions and the targeted treatment of specific diseases. However, the efficacies of these therapies remain inadequately studied, with only two identified clinical trials [48,50]. To address this gap, countries should actively promote research on traditional medicines by formulating policies and guidelines and funding such endeavors. Developing policies and guidelines that facilitate the seamless integration of traditional medicines into mainstream healthcare can be crucial in encouraging and supporting clinical trials in this field.
Nigeria [69,70] and Ghana [71] are at the forefront of these regional integration efforts. These pioneering initiatives aim to bridge the gap between traditional and modern medical practices and foster a more comprehensive approach to healthcare that embraces the rich heritage of traditional healing methods. The progress made by these nations in the number of publications on traditional medicines reflects a dedicated commitment to exploring the potential benefits of traditional medicine within the broader healthcare framework. As these integration efforts unfold, they promise to expand therapeutic options for patients, foster collaborative healthcare practices, and preserve the invaluable traditional knowledge passed down through generations. There are also ongoing efforts in Sierra Leone, led by the World Health Organisation, to regulate the practice of traditional medicines in the country. The observed regional disparity in the countries contributing information on using plants for traditional medicines emphasizes the need for broader engagement and collaboration to enrich the diversity of perspectives and practices captured in research.
Frequently referenced plant families in medicinal studies in West Africa include Euphorbiaceae, Rubiaceae, Combretaceae, Meliaceae, and Euphorbiaceae, has gained global recognition for their effectiveness in treating gastrointestinal disorders, respiratory complaints, skin problems, and inflammation and injuries [72]. Within the Rubiaceae family, plant species predominantly found in warmer climates are indicated for treating diverse conditions such as malaria, hepatitis, eczema, edema, cough, hypertension, diabetes, and sexual dysfunction. Biological screenings of plants used by traditional healers have demonstrated various beneficial activities, including anti-malarial, antimicrobial, antihypertensive, antidiabetic, antioxidant, and anti-inflammatory properties [73].
Combretaceae species find extensive use in traditional medicine to address inflammation, infections, diabetes, malaria, bleeding, diarrhea, and digestive disorders and are employed as diuretics [74]. In the Meliaceae family, while various species are utilized for purposes such as vegetable oil, soap-making, and insecticides, Trichilia emetica, a plant native to Africa, holds significance in traditional medicine for treating a range of ailments such as abdominal pains, dermatitis, hemorrhoids, jaundice, and chest pain [75].
As indicated in the current study, the medicinal properties of plants can originate from various plant components such as leaves, roots, bark, fruits, seeds, and flowers. Each plant part may harbor distinct active ingredients, contributing to its therapeutic effects. We found that leaves and roots are the region’s most used parts for medicinal purposes. Leaves, often rich in bioactive compounds, are frequently utilized for their therapeutic properties in various remedies and are prepared in various forms ranging from decoctions to poultices. Roots are also valued for their medicinal properties and are often prepared as decoctions or infusions to extract their active ingredients. The range of plant parts used for medicinal purposes and the forms used in the current study reflect the diverse traditional knowledge and practices embedded in local communities across West Africa.
This scoping review, however, highlights the need for broader regional engagement and collaboration on traditional medicines’ use to capture diverse perspectives and practices in West Africa, such as conducting more experimental and clinical trial studies to validate Indigenous medicine’s use and facilitate their translation into commercial products. This validation is crucial for local healthcare practices, improving access to medical care for populations in the sub-region and scaling up possible management of diseases of concern to the sub-region.
Furthermore, although the current study reports on the landscape of herbal remedies employed for medicinal purposes in West Africa, the findings underscore the need for broader engagement and collaboration to expand the range of studies and countries engaged with trade-medicinal research, given its importance for complimentary healthcare delivery in the region, and the need to address neglected tropical diseases prevalent in the sub-region. Such collaborations will also enrich the diversity of perspectives and practices captured in research and facilitate the commercialization of validated products.
In conclusion, this scoping review mapping the modalities employed in traditional medicine research reveals a rich tapestry of temporal, geographical, and methodological diversity. The findings underscore the enduring relevance of traditional medicine across West Africa and emphasize the need for continued research to harness its full potential for healthcare. The study also highlights the need for further reviews of publications on traditional medicines written in other languages in the region to develop a rich compendium of the opportunities to harness the potential healthcare opportunities traditional medicines offer in the sub-region.
Supporting information
S1 Checklist. Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR) checklist.
https://doi.org/10.1371/journal.pone.0306594.s001
(DOCX)
S1 File. Search strategy for the CINAHL, web of science and pubmed.
https://doi.org/10.1371/journal.pone.0306594.s002
(DOCX)
S2 File. A compendium of plant families used for medicinal purposes in West Africa.
https://doi.org/10.1371/journal.pone.0306594.s003
(DOCX)
S3 File. Compendium of plant families used for experimentation.
https://doi.org/10.1371/journal.pone.0306594.s004
(DOCX)
References
- 1. Abdullahi AA. Trends and challenges of traditional medicine in Africa. Afr J Tradit Complement Altern Med. 2011;8(5 Suppl):115–23. pmid:22754064
- 2. Feierman S. Struggles for Control: The Social Roots of Health and Healing in Modern Africa. African Studies Review. 1985; 28(2/3): 73–147. pmid:11616461
- 3. Ezekwesili-Ofili JO, Okaka ANC. Herbal Medicines in African Traditional Medicine. 2019:
- 4. Sato A. Revealing the popularity of traditional medicine in light of multiple recourses and outcome measurements from a user’s perspective in Ghana, Health Policy and Planning. 2012; 27(8): 625–637. pmid:22345671
- 5.
Putsch RW III, Joyce M. Dealing with Patients from Other Cultures. In: Walker HK, Hall WD, Hurst JW (editors). Clinical Methods: The History, Physical, and Laboratory Examinations (3rd edition). Boston: Butterworths; 1990.
- 6.
World Health Organisation. Traditional medicine has a long history of contributing to conventional medicine and continues to hold promise.10 August 2023. Available at: https://www.who.int/news-room/feature-stories/detail/traditional-medicine-has-a-long-history-of-contributing-to-conventional-medicine-and-continues-to-hold-promise. Accessed: 18 November 2023.
- 7. Krah E, de Kruijf J, Ragno L. Integrating Traditional Healers into the Health Care System: Challenges and Opportunities in Rural Northern Ghana. J Community Health. 2018 Feb;43(1):157–163. pmid:28681282
- 8. Kayombo EJ, Uiso FC, Mbwambo ZH, Mahunnah RL, Moshi MJ, Mgonda YH. Experience of initiating collaboration of traditional healers in managing HIV and AIDS in Tanzania. J Ethnobiol Ethnomed. 2007 Jan 26;3:6. pmid:17257409
- 9. Frass M, Strassl RP, Friehs H, Müllner M, Kundi M, Kaye AD. Use and acceptance of complementary and alternative medicine among the general population and medical personnel: a systematic review. Ochsner J. 2012 Spring;12(1):45–56. pmid:22438782
- 10.
Bulia F. African Herbal Remedies: Traditional Healing Plants and Their Modern Uses. [online] polish distributor of raw materials. 2023. Available at: https://naturalpoland.com/en/artykuly/produkty-z-afryki/african-herbal-remedies-traditional-healing-plants-and-their-modern-uses/ [Accessed 22 Dec. 2023].
- 11. Peters MDJ, Marnie C, Tricco AC, Pollock D, Munn Z, Alexander L, McInerney P, Godfrey CM, Khalil H. Updated Methodological Guidance for the Conduct of Scoping Reviews. JBI Evidence Synthesis 2020; 18 (10): 2119–2126. pmid:33038124
- 12. Tricco AC, Lillie E, Zarin W, O’Brien KK, Colquhoun H, Levac D, et al. PRISMA Extension for Scoping Reviews (PRISMA-ScR): Checklist and Explanation. Ann Intern Med. 2018 Oct 2;169(7):467–473. pmid:30178033
- 13.
Prismastatement.org. https://www.prismastatement.org/Extensions/ScopingReviews?AspxAutoDetectCookieSupport=1. (accessed: 30 September 2023).
- 14. Mgbemene CN, Ohiri FC. Anti-sickling Potential of Terminalia catappa Leaf Extract. Pharmaceutical Biology. 1999; 37(2): 152–154.
- 15. Diallo D, Hveem B, Mahmoud ME, Berge G, Paulsen BS, Maiga AA. An Ethnobotanical Survey of Herbal Drugs of Gourma District, Mali. Pharmaceutical Biology. 1999; 37(1): 80–91.
- 16. Nwosu MO. Herbs for mental disorders. Fitoterapia. 1999; 70(1): 58–63.
- 17. Ilori ME, Sheteolu AO, Omonigbehin EA, Adeneye AA. Antidiarrhoeal activities of Ocimum gratissimum (Lamiaceae). PubMed. 1996; 14(4): 283–285. pmid:9203793
- 18. Alade PI, Irobi ON. Antimicrobial activities of crude leaf extracts of Acalypha wilkesiana. Journal of Ethnopharmacology. 1993; 39(3): 171–174. pmid:8258974
- 19. Koumaglo K, Gbeassor M, Nikabu O, de Souza C, Werner W. Effects of Three Compounds Extracted fromMorinda lucidaonPlasmodium falciparum. Planta Medica. 1992; 58(06): 533–534. pmid:1484892
- 20. Irobi ON, Daramola SO. Antifungal activities of crude extracts of Mitracarpus villosus (Rubiaceae). Journal of Ethnopharmacology. 1993; 40(2): 137–140. pmid:8133654
- 21. Irobi ON, Banso A. Effects of crude leaf extracts of Acalypha torta against some anaerobic bacteria. Journal of Ethnopharmacology. 1994; 43(1): 63–65. pmid:7967651
- 22. Udeinya IJ. Anti-malarial activity of Nigerian neem leaves. Transactions of the Royal Society of Tropical Medicine and Hygiene. 1993; 87(4): 471. pmid:8249085
- 23. Olukoya DK, Idika N, Odugbemi T. Antibacterial activity of some medicinal plants from Nigeria. Journal of Ethnopharmacology. 1993; 39(1): 69–72. pmid:8331963
- 24. Olowo SF, Omotayo AO, Lawal IO, Ndhlovu PT, Aremu AO. Ethnobotanical use-pattern for indigenous fruits and vegetables among selected communities in Ondo State, Nigeria. South African Journal of Botany. 2022; 145: 501–511.
- 25. Irobi ON. Activities of Chromolaena odorata (Compositae) leaf extract against Pseudomonas aeruginosa and Streptococcus faecalis. Journal of Ethnopharmacology. 1992; 37(1): 81–83. pmid:1453706
- 26. Adomi PO. Screening of the leaves of three Nigerian medicinal plants for antibacterial activity. 2008; 7(15).
- 27. Boadu AA, Asase A. Documentation of Herbal Medicines Used for the Treatment and Management of Human Diseases by Some Communities in Southern Ghana. Evidence-Based Complementary and Alternative Medicine. 2017: 1–12. pmid:28684965
- 28. Amoah LE, Kakaney C, Kwansa-Bentum B, Kusi KA. Activity of Herbal Medicines on Plasmodium falciparum Gametocytes: Implications for Malaria Transmission in Ghana. PLOS ONE. 2015; 10(11): e0142587. pmid:26562778
- 29. Cudjoe E, Donu D, Okonu R, Amponsah JA, Amoah LA. The In Vitro Antiplasmodial Activities of Aqueous Extracts of Selected Ghanaian Herbal Plants. Journal of Parasitology Research. 2020; 1–8. pmid:32518693
- 30. David OM, Famurewa O, Olawale AK. In vitro assessment of aqueous and ethanolic extracts of some Nigerian chewing sticks on bacteria associated with dental infections. African Journal of Microbiology Research. 2010; 4(19): 1949–1953.
- 31. Healy MA, Aslam M, Bamgboye OA. Traditional medicine and lead-containing preparations in Nigeria. Public Health. 1984; 98(1): 26–32. pmid:6709817
- 32. Macfoy CA, Sama AM. Medicinal plants in pujehun district of Sierra Leone. Journal of Ethnopharmacology. 1983; 8(2): 215–223. pmid:6645571
- 33. Odebiyi O, Sofowora E. Antimicrobial Alkaloids from a Nigerian Chewing Stick (Fagara zanthoxyloides). Planta Medica. 1979; 36(07): 204–207. pmid:482432
- 34. Ogbole OO, Akinleye TE, Segun PA, Faleye TC, Adeniji AJ. In vitro antiviral activity of twenty-seven medicinal plant extracts from Southwest Nigeria against three serotypes of echoviruses. Virology Journal. 2018;15(1). pmid:30021589
- 35. Rotimi VO, Mosadomi HA. The effect of crude extracts of nine African chewing sticks on oral anaerobes. Journal of Medical Microbiology. 1987; 23(1): 55–60. pmid:3820271
- 36. Sonibare MA, Moody JO, Adesanya EO. Use of medicinal plants for the treatment of measles in Nigeria. 2009; 122(2): 268–272. pmid:19168120
- 37. Grønhaug TE, Glæserud S, Skogsrud M, Ballo N, Bah S, Diallo D, Paulsen B S. Ethnopharmacological survey of six medicinal plants from Mali, West-Africa. Journal of Ethnobiology and Ethnomedicine. 2008; 4(1). pmid:19111068
- 38. Adesina SK, Idowu O, Ogundaini AO, Oladimeji H, Olugbade TA, Onawunmi GO, et al. Antimicrobial constituents of the leaves ofAcalypha wilkesiana and Acalypha hispida. Phytotherapy Research. 2000; 14(5): 371–374.
- 39. Agyare C, Spiegler V, Asase A, Scholz M, Hempel G, Hensel A. An ethnopharmacological survey of medicinal plants traditionally used for cancer treatment in the Ashanti region, Ghana. Journal of Ethnopharmacology. 2018; 212: 137–152. pmid:29066406
- 40. Köhler I, Jenett-Siems K, Kraft C, Siems K, Abbiw D, Bienzle U, et al. Herbal Remedies Traditionally Used Against Malaria in Ghana: Bioassay-Guided Fractionation of Microglossa pyrifolia (Asteraceae). Zeitschrift Für Naturforschung C. 2002; 57(11–12): 1022–1027. pmid:12562088
- 41. Ajali U. Antibacterial activity of Alchornea cordifolia stem bark. Fitoterapia. 2000; 71(4): 436–438. pmid:10925019
- 42. Aiyelaagbe OO, Adesogan EK, Ekundayo O, Adeniyi BA. The antimicrobial activity of roots ofJatropha podagrica (Hook). Phytotherapy Research. 2000; 14(1): 60–62. pmid:10641053
- 43. Akinpelu D. A., & Obuotor E. M. (2000). Antibacterial activity of Piliostigma thonningii stem bark. Fitoterapia, 71(4), 442–443. pmid:10925021
- 44. Koné WM, Atindehou KK, Terreaux C, Hostettmann KURT, Traore D, Dosso M. Traditional medicine in North Côte-d’Ivoire: screening of 50 medicinal plants for antibacterial activity. Journal of ethnopharmacology. 2004; 93(1): 43–49.
- 45. Asante-Kwatia E, Gyimah L, Forkuo AD, Anyan WK, Gbemu MA, Armah FA, et al. Ethnobotanical Survey and Cercaricidal Activity Screening of Medicinal Plants Used for Schistosomiasis Treatment in Atwima-Nwabiagya District, Ashanti Region, Ghana. Journal of Parasitology Research 2023: 1–15. pmid:37520159
- 46. Hudson JB, Anani K, Lee MK, de Souza C, Arnason JT, Gbeassor M. Further Investigations on the Antiviral Activities of Medicinal Plants of Togo. Pharmaceutical Biology. 2000; 38(1): 46–50. pmid:21214439
- 47. Togola A, Diallo D, Dembélé S, Barsett H, Paulsen BS. Ethnopharmacological survey of different uses of seven medicinal plants from Mali, (West Africa) in the regions Doila, Kolokani and Siby. Journal of Ethnobiology and Ethnomedicine. 2005; 1(1). pmid:16270940
- 48. Oyelami OA, Onayemi O, Oladimeji FA, Ogundaini AO, Olugbade TA, Onawunmi GO. Clinical evaluation ofAcalypha ointment in the treatment of superficial fungal skin diseases. Phytotherapy Research. 2003; 17(5): 555–557. pmid:12748998
- 49. Irobi ON, Gbodi TA, Moo-Young M, Anderson WA. Antibiotic Activity of Aspergillus quadrilineatus Extracts Isolated From a Nigerian Cereal. Pharmaceutical Biology. 2000; 38(1): 57–60. pmid:21214441
- 50. Ankrah N.-A, Nyarko AK, Addo PGA, Ofosuhene M, Dzokoto C, Marley E, et al. Evaluation of efficacy and safety of a herbal medicine used for the treatment of malaria. Phytotherapy Research.2003; 17(6): 697–701. pmid:12820245
- 51. Baba-Moussa F, Akpagana K, Bouchet P. Antifungal activities of seven West African Combretaceae used in traditional medicine. Journal of Ethnopharmacology.1999; 66(3): 335–338. pmid:10473181
- 52. Fleischer TC, Ameade EPK, Sawer IK. Antimicrobial activity of the leaves and flowering tops of Acanthospermum hispidum. Fitoterapia. 2003; 74(1–2): 130–132. pmid:12628407
- 53. Ebi GC, Ofoefule SI. Antimicrobial activity of Pterocarpus osun stems. Fitoterapia. 2000; 71(4): 433–435. pmid:10925018
- 54. Konning GH, Agyare C, Ennison B. Antimicrobial activity of some medicinal plants from Ghana. Fitoterapia. 2004; 75(1): 65–67. pmid:14693222
- 55. Okpekon T, Yolou S, Gleye C, Roblot F, Loiseau P, Bories C, et al. Antiparasitic activities of medicinal plants used in Ivory Coast. Journal of Ethnopharmacology. 2004; 90(1): 91–97. pmid:14698515
- 56. Taiwo AO, Bolanle AA. The leaf essential oil of Costus afer Ker-Grawl from Nigeria. Flavour and Fragrance Journal. 2003; 18(4): 309–311.
- 57. Traore-Keita F, Gasquet M, Di Giorgio C, Ollivier E, Delmas F, Keita A, et al. Anti-malarial activity of four plants used in traditional medicine in Mali. Phytotherapy Research. 2000; 14(1): 45–47. pmid:10641048
- 58. Catarino L, Havik PJ, Romeiras MM. Medicinal plants of Guinea-Bissau: Therapeutic applications, ethnic diversity and knowledge transfer. Journal of Ethnopharmacology. 2016; 183: 71–94. pmid:26923540
- 59. Anani K, Hudson JB, de Souza C, Akpagana K, Tower GHN, Arnason JT, et al. Investigation of Medicinal Plants of Togo for Antiviral and Antimicrobial Activities, Pharmaceutical Biology. 2000; 38:1, 40–45, pmid:21214438
- 60. Dossou AJ, Fandohan AB, Djossa AB, Assogbadjo AE. Diversity and knowledge of plants used in the treatment of snake bite envenomation in Benin. Ethnobotany Research and Applications. 2021; 21: 1–20.
- 61. Mengome LE, Mewono L, Mboma R, Engohang-Ndong J, Angone SA. Ethnobotanical survey and phytochemical screening of anti-snakebite plants used in Bissok District of Gabon. Biodiversitas Journal of Biological Diversity. 2021; 22(8):
- 62. Fanou BA, Klotoe JR, Fah L, Dougnon V, Koudokpon CH, Toko G, et al. Ethnobotanical survey on plants used in the treatment of candidiasis in traditional markets of southern Benin. BMC Complementary Medicine and Therapies/ 2020; 20: 1–18. pmid:32957970
- 63. James PB, Wardle J, Steel A, Adams J. Traditional, complementary and alternative medicine use in Sub-Saharan Africa: a systematic review. BMJ Global Health. 2018; 3(5): 1–18. pmid:30483405
- 64. Leonti M, Casu L. Traditional medicines and globalization: current and future perspectives in ethnopharmacology. Front Pharmacol. 2013;4:92. pmid:23898296
- 65. Liu JP, Chen KJ; guideline development team. Methodology guideline for clinical studies investigating traditional Chinese medicine and integrative medicine: executive summary. Complement Ther Med. 2015;23(5):751–6. pmid:26615617
- 66.
World Health Organisation. Neglected Tropical Diseases. 9 January 2024. Available at: https://www.who.int/news-room/questions-and-answers/item/neglected-tropical-diseases. Accessed: 7 May 2024.
- 67. Plaatjie MTA, Onyiche TE, Ramatla T, et al. A scoping review on efficacy and safety of medicinal plants used for the treatment of diarrhea in sub-Saharan Africa. Trop Med Health. 2024; 52: 6. pmid:38173018
- 68. Imtiaz I, Schloss J, Bugarcic A. Traditional and contemporary herbal medicines in management of cancer: A scoping review. J Ayurveda Integr Med. 2024;15(1):100904. pmid:38395014
- 69.
Federal Ministry of Health. Traditional Medicine Policy for Nigeria. 2007.
- 70.
Osuide GE. Chapter 21—Regulation of herbal medicines in Nigeria: the role of the National Agency for Food and Drug Administration and Control (NAFDAC). Maurice M Iwu, Jacqueline C Wootton (Eds). Advances in Phytomedicine, Elsevier. 2002: 249–258. https://doi.org/10.1016/S1572-557X(02)80030-7
- 71.
World Health Organisation. Traditional healers broaden health care in Ghana. 12 December 2019. Available at: https://www.afro.who.int/photo-story/traditional-healers-broaden-health-care-ghana. Accessed 22 December 2023.
- 72. Ernst M, Grace OM, Saslis-Lagoudakis CH, Nilsson N, Simonsen HT, Rønsted N. Global medicinal uses of Euphorbia L. (Euphorbiaceae). J Ethnopharmacol. 2015; 176: 90–101. pmid:26485050
- 73. Karou SD, Tchacondo T, Ilboudo DP, Simpore J. Sub-Saharan Rubiaceae: a review of their traditional uses, phytochemistry and biological activities. Pak J Biol Sci. 2011;14(3):149–69. pmid:21870639
- 74. de Morais Lima GR, de Sales IR, Caldas Filho MR, de Jesus NZ, de Sousa Falcão H, Barbosa-Filho JM, et al. Bioactivities of the genus Combretum (Combretaceae): a review. Molecules. 2012 Aug 2;17(8):9142–206. pmid:22858840
- 75. Komane BM, Olivier EI, Viljoen AM. Trichilia emetica (Meliaceae)–A review of traditional uses, biological activities and phytochemistry. Phytochemistry Letters. 2011; 4(1): 1–9.