Open Access

Ethnopharmacologic survey of medicinal plants used to treat human diseases by traditional medical practitioners in Dega Damot district, Amhara, Northwestern Ethiopia

BMC Research Notes201710:157

https://doi.org/10.1186/s13104-017-2482-3

Received: 22 December 2015

Accepted: 5 April 2017

Published: 18 April 2017

Abstract

Background

One of the services that plants provide for human beings is their wider medicinal application. Although it is not fully assessed, the practice and wider use of traditional medicine is frequent in Ethiopia. Studies conducted previously are confined to the perceptions of modern and traditional health practitioners about traditional medicine. A total of 45 informants were selected purposefully from the study area. For collecting the data, semi-structured interviewees, observation and field walks were employed from August 10 to September 30/2014. To summarize the information, descriptive statistical methods were applied.

Results

Sixty species of medicinal plants distributed in 42 families were collected and identified applied locally for the treatment of 55 human disorders. The most commonly treated ones were evil eye, malaria, wound, peptic ulcer disease and rabies. According to this study, leaves were the commonly used plant parts (36.5%) and 39% of the preparations were decoctions. Oral route, 43 (44%) was the commonly used route of application whereas most (54.8%) remedies were administered only once. Fourteen percent of preparations caused vomiting in addition most (40.4%) of the formulations was contraindicated for pregnant patients. Only seventeen percent of the formulations possessed drug food interactions. Most preparations were stored within clothes, 31 (29.8%). There exists a high (ICF = 0.8) evenness of plant use among healers for treating respiratory problems. Alliumsativum (FI = 0.75) for evil eye, Phytolacca dodecandra (FI = 0.8) for rabies and Croton macrostachyus (FI = 0.78) for treating malaria were medicinal plants with highest fidelity levels showing consistency of knowledge on species best treating power. This study also documented that drought, overgrazing and firewood collection are major threats.

Conclusion

Dega Damot district is loaded in its medicinal plant diversity and indigenous knowledge though plants are highly affected by drought, overgrazing and firewood collection. Therefore awareness activities must be created among the district’s population by concerned governmental and nongovernmental organizations about the value of medicinal plants and conservation of these plants. The healing potential and associated adverse issues of the claimed medicinal plants should be assessed before proposing for a broader utilization.

Keywords

Medicinal plants Traditional medical practitioner Ethnopharmaclogy

Background

According to world health organization, traditional medicine (TM) is the sum total of the knowledge, skills and practices based on the theories, beliefs and experiences indigenous to different cultures and nations. It is used in the maintenance of health, prevention, diagnosis, or treatment of disorders [1, 2]. Under TM, health practices, remedies, approaches, and beliefs incorporating plant, animal and mineral products, spiritual therapies are all included [3]. Traditional medicine is popular in the developing world and its use is rapidly spreading in the developed nations. In China, traditional herbal preparations account for 30–50% of the total drug consumption. In Ghana, Mali, Nigeria and Zambia, the first choice for 60% of children with high fever resulting from malaria is the use of herbal medicines. In Ethiopia up to 80% of the population uses TM due to the cultural acceptability of healers and local pharmacopeias, the relatively low cost of TM and difficult access to modern health facilities [4].

In Ethiopia, TM plays both preventive and curative roles. Vegetables are the abundant sources of traditional remedies. Various parts of plants like leaves, flowers, seeds, bark, sap and roots are used. Honey, butter, and sheep fat are TM sources from animals. In Ethiopia, traditional medical practitioners put much emphasis on the supernatural force as a source of wisdom for healing various illnesses. Even though practitioners practically deal with tangible problems like bone setting, simple traditional surgery, historical evidence shows that there were many prayers for the prevention and cure of various ailments [1, 58]. Despite its continued use over many countries, its popularity and extensive use, TM has not been officially recognized in most countries. As a result, training and research in this area have not been conducted intensively on the various aspects of TM. The safety and efficacy of data on TM are not sufficient to meet the criteria required to support its worldwide use [4, 5, 9, 10].

In Dega Damot district about 90% of the population relies on traditional health products (unpublished data from the district) for primary health care aspects. There have been no studies conducted in the study area on the use and practice of TM. For policies regarding TM ultimately geared towards integration of TM into the national health service to be formed and implemented, results of this study will be able to protect the interest of those making use of this health care option.

Methods

Description of the study district

This study involved traditional medical practitioners residing in Dega Damot district, Northwestern Ethiopia. It shares borders with the districts of Bibugn in the north, Dembecha in the east, Kuarit and Hulet eju enesie in the west and Jabitehnan in the South (Fig. 1). The district’s administrative town, Feres Bet, is located at about 400 km north western of the capital, Addis Ababa. According to 2013 data, the population of the district is about 170, 575. The district is administratively divided into 32 kebeles and Amharic which belongs to the Semitic language family is the language of the population. In Ethiopia, Kebele is the smallest administrative unit. In the district, barley, maize, potato and wheat are the main crops cultivated, off which, potato is exported to neighboring towns of the Amhara region like Burie, Bahirdar and Gondar.
Fig. 1

Map of the Dega Damot district (the officials who gave permission to use the respective maps were: personnel of Dega Damot district communication office, west Gojjam zonal communication office and Amhara regional state communication beau rue)

According to 2004–2013 rainfall data, the District has a high rainfall distribution between July and August and a smaller rainfall between January and May. The mean monthly rainfall and mean annual rainfall of the District are 60.24 and 708.54 mm, respectively (National Metrological Service Agency, Bahirdar Branch Office, unpublished data). According to data from the health personnel of the district, the top ten diseases in 2014 are malaria, diarrhea, helmenthiasis, pneumonia, acute upper respiratory diseases, dyspepsia, typhoid, eye infection, urinary tract infection and skin infection respectively.

Selection of study subjects

Data were collected from the traditional medical practitioners (TMPs) who were purposively chosen with the help of community leaders and local authorities. The informants selected were the most knowledgeable ones as recommended by community leaders and local authorities who involved in the selection process. The ages of the TMPs ranged between 22 and 80 years. A total of 45 (40 male and 5 female) TMPs were included in this study from August 10 to September 30/2014.

Data collection techniques

Semi-structured interviews, observation and field walks were used to collect the research data. To collect information about local names of plants used, their threats, part(s) used, preparations methods, routes of remedy administration and diseases treated, individual interviews were conducted (Additional file 1). Interviews were carried out in Amharic, language that is spoken by the practitioners. For claimed plant, specimen was collected, and identified and voucher was reserved at University of Gondar. Field observations were performed to document habitat of each medicinal plant. As this study has been conducted on wild plants, permission was mandatory to perform the survey. Hence, Dega Damot district agricultural office was informed and asked permission to conduct the study and collect the medicinal plants. The study was also ethically approved by the Graduate Program Evaluation Committee of the College of medicine and health sciences, University of Gondar. Prior to the initiation of the data collection, the objective of the survey was clarified to the TMPs, verbal consent was obtained from them. Letter of collaboration was sent to district officials of the study area and biology department at University of Gondar.

Data analysis

Descriptive statistic procedures like percentage and frequency distribution were applied for analyzing and summarizing the data. To check the level of homogeneity among information provided by traditional practitioners, the informants’ consensus factor, ICF [11] was computed
$$[{\text{ICF}} = {\text{Nur}} - {\text{Nt}}/({\text{Nur}} - 1)]$$
where, Nur = number of use reports from informants for a particular plant-use category; Nt = number of taxa or species that are used for that plant use category for all informants. ICF Values vary between 0 and 1, where ‘1’ represents the highest level of consensus. The fidelity level (FL), which shows for the percentage of informants claiming the use of a certain plant species for the same major purpose, was calculated for the commonly reported disorders as:
$${\text{FL}}\;(\% ) = ({\text{Np}}/{\text{N}}) \times 100$$
where: Np = number of traditional practitioners that claim a use of a plant to treat a certain disease; N = number of informants that use the plants as a remedy to treat an ailment [12].

Results

Socio-demographic data of the informants

Totally, 45 TMPs out of which 40 (88.8%) and 5 (11.2%) males and females, respectively, were involved in this study and 55.6% were illiterate. Most of them were married (86.7%) and 37.8% were older than 56 years. Thirty-one (68.9%) were farmers and all TMPs were Ethiopian orthodox tewahido Christian followers.

Forty percent of healers indicated that they acquired their healing wisdom from their family, whereas 26.6% assumed it as a gift from God. Other sources of wisdom are religious Institutions (22.2%) and preceding sickness and corresponding use (11.2%). About 67% of the practitioners had practiced their healing activities for more than 25 years.

Diseases treated and medicinal Plants used

About 55 human diseases are treated by TMPs of the district. The most commonly treated ones being evil eye, malaria, wound; peptic ulcer disease and rabies (Table 1).This study revealed that about 60 plant species find applications by the TMPs of the district. Those plants were identified and distributed in 42 families. Families, Gramineae and Solanaceae each accounts 4 (9.5%) medicinal plants followed by Fabaceae and Leguminosae, 3 (7%) each. Most of the plants collected and identified from the study area were trees (40%), followed by herbs (30%) and shrubs (25%) and (Fig. 2).
Table 1

Medicinal plants used to treat human diseases

Scientific name

Family name

Voucher no.

Amharic name

Habit

Part used

Used for

Preparation, dose and application

Acacia Senegal (L.) Wild.

Leguminosae

MW-053

Grar

Tree

Resin

Stabbing pain

Powder of resin taken mixed with molten butter

Agrostis semiverticillata (Forssk.) Christm.

Gramineae

MW-049

Serdo

Grass

Leaf

Tinea decalvans

Fresh pulverized leaf is applied once daily

Albizia gummifera (J.F.Gmel) C.A.Sm

Leguminosae

MW-039

Sesa

Tree

Bark

Rectal prolapsed

About 80 ml of Powder of bark mixed with little water (decoction) taken once daily

Allium sativum L.

Alliaceae

MW-001

Nech Shinkurt

Bulb

Seed

Evil eye

Crushing the seed with seeds of Lepidium sativum L. and Ruta chalepensis L. and inhale it

Fruit

Common cold

Inhale the smell of the fruit

Fruit

Malaria

Crushing the fruit and boil it, finally drink it with much amount of milk for 1 day

Seed

Dry cough

Crushing the seed and drink with adulterated butter

Aloe pulcherrima Gilbert & Sebsebe

Aloaceae

MW-002

Eret

Tree

Latex

Wound

Applying the latex to the wound for 2 days

Artemisia afra Jack. ex Wild.

Asteraceae

MW-003

Chikugn

Shrub

Leaf

Common cold

Inhaling the smell of the leaf

Leaf

Urine retention

Powder of leaf taken once mixed with mead

Leaf

Haematuria

Milk decoction of leaf taken once

Avena sativa L.

Poaceae

MW-004

Ankerdad

Grass

Seed

Wound

Drying the seed then crushing, then apply on the wound till the wound cures

Bersama abyssinica Fresen.

Melianthaceae

MW-005

Azamira

Tree

Leaf

Ascariasis

Crushing the leaf and drink it

Brucea antidysenterica J. F. Mill.

Simaroubaceae

MW-006

Abalo

Tree

Root

Evil eye

Crushing its root with the roots of Pterolobium stellatum (Forssk.) Brenan, Carissa spinarum L. and Clausena anisata (Wild) Benth. and inhale it

Seed

Cutaneous leshmaniasis

Crushing the seed and apply on the infected area

Leaf

Leprosy

Handful of fresh leaf grounded to make a paste and to it add small quantity of honey or butter and it is applied externally until cure

Capsicum annuum L.

Solanaceae

MW-007

Berbere

Shrub

Leaf

Anthrax

Crushing the leaf with leaves of Vernonia amygdalina Del. and eat it on empty stomach once

Leaf

Infertility

Small quantities of fruit chewed and swallowed once

Carissa spinarum L.

Apocynaceae

MW-008

Agam

Shrub

Root

Evil eye

Crushing the root with the fruit of garlic and the fruit of Ruta chalepensis L., finally inhale it

Root

Snake bite

Crushing the root and bandage on the site of bite for 1 day

Citrus aurantifolia.

Rutaceae

MW-036

Lomi

Tree

Leaf

Hypertension

Crushing the leaf and drying it, finally drinking it as tea

Clausena anisata (Wild) Benth.

Rutaceae

MW-059

Limch

Tree

Stem

Bone dislocation

Stem powder boiled with butter applied daily

Whole plant

Mental illness/exorcism

The juice of whole plant is employed for bathing

Clematis simensis Fresen.

Ranunculaceae

MW-009

Azo Hareg

Climber

Leaf

Hemorrhoids

Drying the leaf then crushing it and mixing with butter finally apply to area once

Leaf

Skin cancer

Crushing the leaf and apply it to the area of infection

Leaf

Eczema

Drying the leaf, crushing it and then mixing it with benzene and wood charcoal

Cordial africana Lam.

Boraginaceae

MW-058

Wanza

Tree

Leaf

Nightmare

Powder of the semi-parasite worn as amulet against startling dreams

Coriandrum sativum L.

Umbelliferae

MW-052

Dinblal

Herb

Seed

Menorhagia

Handful of seeds from each pounded with onions and taken once mixed with milk of black cow

Croton macrostachyus Del.

Euphorbiaceae

MW-035

Bisana

Tree

Leaf

Malaria

Crushing leaf and drink with either Guizotia abyssinica (L.F.) Cass. or milk

Root

Tuberculosis

Root powder taken pasted with honey or taken dissolved with mead

Cussonia ostinii Chiov.

Araliaceae

MW-048

Getem

Tree

Bark

Syphilis

An inside part of the bark is pounded into powder which is then taken once mixed with a glass of local beer

Cynoglossum coeruleum Hochst. A. Rich. DC.

Boraginaceae

MW-010

Shingug

Shrub

Leaf

Acute febrile illness

Crushing the leaf with fresh water

Datura stramonium L.

Solanaceae

MW-054

Astenagir

Shrub

Headache

Unspecified part of the plant pounded mixed with ink and placed under the skin of the head

Leaf

Mumps

Fresh leaf is tied on to the site of the problem

Dovyalis abyssinica (A. Rich.) Warb.

Flacoutiaceae

MW-011

Koshim

Tree

Seed

Decayed teeth

Brushing the decayed teeth with the yellow seed of the plant

Echinops kebericho Mesfin

Asteraceae

MW-012

Kebericho

Shrub

Stem

Evil eye

Drying, crushing and adding the seed on fire to smell

Stem

Tape worm

Drying and crushing then drink by mixing with Capsicum annuum L. and salt

Stem

Common cold

Burning the root and inhale it

Stem

Acute febrile illness

Burning the root on fire and fumigate

Embelia schimperi Vatke

Myrsinaceae

MW-013

Enkoko

Shrub

Seed

Anthrax

Crushing the seed with the seeds of Guizotia abyssinica (L.F.) Cass. and eat with honey

Seed

Tape worm

Crushing the seed and drink with alcohol

Englerina woodfordioides (Schweinf.) M. Gilbert

Loranthaceae

MW-014

Teketsila

Shrub

Leaf

Cutaneous leshmaniasis

Crushing the leaf and apply it topically

Eragrostis tef (Zucc.)Trotter

Gramineae

MW-045

Nech teff

Herb

Seed

Diarrhea

Porridge of the floor eaten three times daily

Erytbrina brucei Schweinf.

Fabaceae

MW-015

Korch

Tree

Leaf

Wound

Crushing its leaf with the leaves of Solanum incanum L. and Phytolacca dodecandra L’Hérit, finally apply it to the wound once for 3 days

Eucalyptus globulus Labill.

Myrtaceae

MW-016

Nech Bahirzaf

Tree

Leaf

Common cold

Burning the leaf on fire and inhale it

Euphorbia abyssinica J.F.Gmel.

Euphorbiaceae

MW-034

Kulkual

Tree

Latex

Jaundice

Mixing the latex with teff powder and putting it in fire till it becomes semidry

Root

Rabies

Crushing the root and mixing with powder of wheat or teff, finally drying it on fire

Leaf

Cutaneous leshmaniasis

Crushing the leaf and mixing it with butter

Latex

Skin cancer

Applying the latex to the affected area

Root

Malaria

Crushing the root and drink with milk

Ficus vasta Forssk.

Moraceae

MW-038

Shola

Tree

Bark

Epilepsy

Fumigate the patient once daily with the smoke of the powder of bark

Root

Frequent miscarriage

Root and leaf powder taken once mixed with milk

Grewia ferruginea Hochst. ex A. Rich.

Tiliaceae

MW-017

Lenquata

Shrub

Bark

Hair fungus

Washing hair with the latex of the bark

Guizotia abyssinica (L.F.)

Cass.

Compositae

MW-040

Nug

Herb

Fruit

Rabies

A cup of oil is given in morning in empty stomach for 3 days

Seed

Dry cough

A cup of seed powder decoction is given orally in the morning and evening for a week

Seed

Retained placenta

Boil the oil of the seed together with onions and egg and allow the steam to get into the vagina cavity

Hagenia abyssinica (Brace.) J. F. Gmel.

Rosaceae

MW-018

Koso

Tree

Leaf

Tape worm

Crushing the fresh leaves and mix with water and drink it once

Hordeum vulgare

Gramineae a

MW-033

Gebs

Grass

Seed

Peptic ulcer disease

Drying the seed on fire and eat

Hypericum revolutum (Forssk.) Vahl

Guttiferae

MW-056

Amja

Shrub

Fruit

Earache

Fruit juice applied as ear drops

Juniperus procera Hochst.

Cupressaceae

MW-057

Tsid

Tree

Resin

Congestive heart failure

Powder of fried resin taken orally mixed with water

Justicia schimperiana (Hochst.ex Nees) T. Anders.

Acanthaceae

MW-019

Simeza

Tree

Leaf

Anthrax

Crushing the leaf and mix with fresh water drink it once on empty stomach

Kalanchoe petitiana A.Rich.

Crassulaceae

MW-020

Andahula

Herb

Stem

Hemorrhoids

Putting the stem on fire till it becomes hot then putting it on the area of infection

Leaf

Abdominal cramp

Crushing the leaf and eat it

Root

Sexual dysfunction

Milk decoction of the fresh pulverized roots and leaves

Lathyrus sativus L.

Leguminosae

MW-044

Guaya

Herb

Seed

Constipation

Seeds eaten cooked at least once daily to overcome evacuation problem

Lepidium sativum L.

Cruciferae

MW-050

Feto

Herb

Seed

Wound

Powder of seed mixed with latex of Euphorbia abyssinica and bandaged once daily every other day

Linum usitatissimum L.

Linaceae

MW-021

Telba

Shrub

Seed

Anthrax

Crushing the seed with the seeds of Lepidium sativum L. or Guizotia abyssinica (L.F.) Cass. Then eating with honey on empty stomach

Seed

Peptic ulcer disease

Boil the seed with water and after cooling drink it

Seed

Pain during delivery

Putting the seed in water till it becomes semisolid and drink it

Lupinus albus L.

Fabaceae

MW-041

Gibto

Herb

Seed

Hypertension

Small quantity of seed and fruit is grounded with water, filtered. The resultant juice is given orally in the morning for 1 month

Myrica salicifolia Hochst. ex A.Rich

Myricaceae

MW-060

Shinet

Tree

Root

Headache

Butter paste of the root powder placed in the nostril

Olinia rochetiana A. Juss.

Oliniaceae

MW-023

Chife

Tree

Leaf

Teeth ache

Chewing the leaf within the mouth for about a minute and spit it

Root

Goiter

Powder of root and leaf mixed with latex of euphorbia abyssinica and bandaged on the goiter once every other day

Osyris quadripartite Decn.

Santalaceae

MW-042

Keret

Tree

Leaf

Jaundice

A handful of fresh leaf is grinded and cup of this juice given orally for 15 days

Phytolacca dodecandra L’Hérit

Phytolaccacee

MW-024

Mekan Endod

Climber

Leaf

Anthrax

Crushing the leaf with fresh water and drink one glass of it once

Leaf

Scabies

Crushing the leaf and washing the area of infection with the crushed leaf

Bark

Jaundice

Powder of bark taken once mixed with diluted local beer

Root

Rabies

Crushing the root and drink with honey

Rhamnus prinoides L’Herit

Rhamnaceae

MW-026

Gesho

Shrub

Leaf

Wound

Crushing the leaf and apply it to the wound till the wound cures

Leaf

Epitaxis

Leaf powder taken mixed with once own urine

Ricinus communis L.

Euphorbiaceae

MW-047

Chakma

Shrub

Leaf

Appendicitis

Fresh pulverized leaf infused in water solution of safflower powder and one glass taken only once

Rumex nepalensis Spreng.

Polygonaceae

MW-027

Yewusha Milas

Herb

Leaf

Acute febrile illness

Crushing leaf with fresh water and wash with it

Rumex nervosus Vahl

Polygonaceae

MW-028

Ambacho

Shrub

Leaf

Wound

Crushing the leaf and mixing with benzene, then boil it, finally washing the wound with it

Ruta chalepensis L.

Rutaceae

MW-029

Tiladam

Shrub

Seed

Evil eye

Crushing the seed with the seeds of garlic and apply it on the nostril

Leaf

Epitaxis

Fresh pulverized leaves are placed in the nostril

Root

Headache

Powder of root and garlic mixed with water

Root

Recurrent seasonal illness

Decoction of fresh pulverized root applied externally

Skebergia capensis Sparrm.

Meliaceae

MW-046

Lol

Tree

Bark

Malaria

Infusion of fresh pulverized bark

Snowdenia polystachya (Fresen.)Pilg.

Graminaceae

MW-051

Muja

Herb

Whole plant

Menorhagia

Juice or infusion of whole plant taken once

Solanum incanum L.

Solanaceae

MW-055

Embuay

Climber

Seed

Attention deficient disorder

Powder of seed given in small amount through the nose to help a child to be a fast learner and intelligent

Syzygium guineense (Wild.) Dc.

Myrtaceae

MW-043

Dokma

Tree

Root and leaf

Syphilis

A decoction is made from each one teaspoon of root and leaf powder and a cup of this decoction is given orally three times a day for 7 days

Trigonella foenum-graecu

Fabaceae

MW-037

Absh

Herb

Seed

Peptic ulcer disease

Putting in water, drying it, crushing and the eating by mixing with water and sugar

Seed

Dry cough

Crushing the seed and boil with milk

Seed

Weight loss

Putting in water, drying it, crushing and the eating by mixing with water and sugar

Descopodium penninervum Hochst.

Solanaceae

MW-022

Aluma

Tree

Seed

Wound

Crush the dried seed and apply the powder to the affected area for 3 days

Urtica simensis

Urticaceae

MW-025

Sama

Herb

Leaf

Peptic ulcer disease

Boil the semi-crushed leaf and eat it for 2 or 3 days

Root

Malaria

The root will be crushed and dried the mixed with fresh water, drink one glass of it and drink much amount of milk

Vernonia amygdalina Del.

Asteraceae

MW-030

Girawa

Tree

Leaf

Bladder distention

Crushing the leaf with water and drink about one glass once

Zehneria scabra (Linn. f.) Sond.

Cucurbitaceae

MW-031

Haregresa

Climber

Leaf

Diarrhea

Crushing the leaf and mix with some fresh water, finally drink one cup of it

Leaf

Acute febrile illness

Boil the leaf in water till it evaporates and then fumigate with it

Leaf and root

Sexual dysfunction

Bathe in the infusion of leaf and root for 7 days

Root, bark and leaf

Gout

Decoction of root, bark and leaf and excrement of hyena employed for bathing

Zingiber officinale Roscoe.

Zingiberaceae

MW-032

Zingibl

Bulb

Root

Bladder distention

Crushing the root with fresh water and drink about one glass once

Root

Abdominal cramp

Crushing the root and mixing with some water then drink the filtrate

Fig. 2

Frequency distribution of growth form of medicinal plants

Plant parts used

According to this survey, the commonly used plant part was leaf (36.5%), followed by seed (21.2%) (Fig. 3).
Fig. 3

Frequency distribution of plant parts used to prepare remedies

Method of preparation, routes of administration and dose

Traditional medical practitioners used simpler techniques like crushing and powdering with the help of easily available materials like water, honey and milk for preparation of remedies to treat various human ailments as shown in Table 1. This survey also documented that most of the remedies were given orally, (44%). Topical (26.5%), nasal (25.5%), rectal (2%), vaginal (1%) and subcutaneous (1%) routes are also used. This study showed that TMPs in the district were not aware of the exact dose of remedies to be administered. They easily determined the dose depending on mainly age. The doses of 24 preparations were not determined. Healers expressed doses as a glass of, half a cup of or a teaspoon full of.

Dosage forms and frequency of administration

The documented 60 species of medicinal plants were reported to be formulated in various forms. Majority of dosage forms were decoctions 35 (38.9%) followed by liquid preparations 18 (20%) as shown in Fig. 4. Most of the preparations were given only once (Fig. 5).
Fig. 4

Frequency distribution of dosage forms of plant remedies

Fig. 5

Distribution of frequency of administration of plant remedies

Solvents and additives

Forty-three percent of the formulations did not require any additive or solvent. Of the formulations that involve the use of solvents, water accounted 25 (42.4%) followed by milk 8 (13.6). Different additives like butter, honey, sugar and others were also incorporated (Table 2).
Table 2

Solvents and additives used

Solvents and additives

Number (%) of formulations

Water

25 (42.4)

Alcohol

5 (8.5)

Milk

8 (13.6)

Benzene

2 (3.4)

Honey

4 (6.8)

Salt

1 (1.7)

Sugar

4 (6.8)

Charcoal

1 (1.7)

Butter

5 (8.5)

Ink

1 (1.7)

Urine

1 (1.7)

Teff

2 (3.4)

Contraindications and side effects

According to TMPs of the area, 42 (40.4%) of the formulations were contraindicated for pregnant patients. No contraindication was indicated for 35 (33.6% of the formulations (Table 3). Twelve (11.5%) of the preparations were free from any side effect (Table 4).
Table 3

Distribution of contraindication to remedies

Category

Frequency

% Age

Contraindicated to

 Children

19

18.3

 Pregnant women

42

40.4

 Elderly

8

7.7

No contraindication

35

33.6

Table 4

Frequency distribution of side effects of remedies

Category

Frequency

% Age

Those with known side effects

 Nausea

15

14.4

 Vomiting

15

14.4

 Diarrhea

8

7.7

 Loss of consciousness

8

7.7

 Local pain

12

11.5

 Headache

6

5.8

 Nasal stiffness

10

9.6

 PUD

4

3.8

 Constipation

3

2.9

 Abdominal cramp

9

8.7

Free from any side effect

12

11.5

Drug food interactions

According to this study, only 17% of the formulations possessed drug food interactions, of which 12 (66.7%) were exhibited by preparations for gastrointestinal problems. Synergistic reactions were observed in poly herbal preparations like in the case of remedies for evil eye.

Storage

Asked on how they store plant remedies, healers responded that they don’t normally store plant preparations; rather they collect fresh material and formulate remedies. For those medicinal plants which are not easily available and which are seasonal, they collect and store in papers, horns or and with in bottles. Only three percent of the total preparations were stored in cool and dry places (Fig. 6).
Fig. 6

Frequency of storage of remedies

Informant’s consensus

Depending on the data obtained, seven use-categories (Table 5) were set in which 127 use reports were documented. As depicted below, informant consensus factor values and the mean ICF are close to 1. There is high uniformity in plant consumption for respiratory diseases.
Table 5

Informants’ consensus score

Use category

Species (#) (nt)

Use-reports (Ur)

ICF (nur − nt/nur − 1)

Gastrointestinal problems

7

15

0.57

Central nervous system disorders

9

18

0.53

Respiratory problems

2

6

0.8

Urinary tract problems

7

15

0.57

Skin problems

8

13

0.42

Cardiovascular disorders

13

28

0.55

Other organ problems

14

32

0.58

Mean ICF

0.57

Fidelity level

In the survey, the FL values were analyzed for seven plants in treating three medical conditions (Table 6). Croton macrostachyus (FL = 0.78) is reported by high number of informants (36%) in treating malaria. Allium sativum (FL = 0.75) is more preferable than Echinops kebericho (FL = 0.64) in treating evil eye.
Table 6

FI for plant species used to treat evil eye, malaria and rabies

Ailments

Percentage of informants

Species

Np

N

FI (Np/N)

Evil eye

30

Allium sativum

6

8

0.75

34

Echinops kebericho

7

11

0.64

Rabies

9

Guizotia abyssinica

4

5

0.8

34

Phytolacca dodecandra

8

9

0.89

Malaria

19

Urtica simensis

10

15

0.67

36

Croton macrostachyus

7

9

0.78

5

Euphorbia abyssinica

5

12

0.42

Np number of TMPs who used the medicinal plant for the same purpose, N number of TMPs who used the medicinal plant for various purposes

Threats to medicinal plants

As shown in Table 7 below, drought, overgrazing and firewood collection are the major threats of medicinal plants. Practitioners leveled drought as the most serious threat.
Table 7

Threats to medicinal plants

Threats to medicinal plants

% of TMPs

Drought

55.6

Overgrazing

22.2

Firewood collection

15.6

Agricultural expansion

4.4

Soil erosion

2.2

Discussion

This study revealed that about 60 plant species find applications by the TMPs of the woreda. Those plants were identified and distributed in 42 families. Families, Graminae and Solanaceae each accounts 4 (9.5%) medicinal plants followed by Fabaceae and Leguminosae, 3 (7%). But Fabaceae was the dominant family according to the conducted in Hawasa [13], Wayu Tuka District of Oromiya region [14] and Benshangul-Gumuz [15]. In addition a study done in Spain [16], Korea [17] and Loma and Gena Bosa Districts [18] showed that Asteraceae has the highest number of medicinal plants. Caesalpiniaceae was the family with higher number of plants according to the study in Nigeria [19].

The ailments reported to be handled by the TMPs of the district are those disorders most prevalent in the district. According to the result of this study, the majority of plants were reported to treat wound followed by malaria, evil eye and anthrax. However, a study done in Hawasa [13] showed that stomach ache is the disease treated by large number of medicinal plants. In addition a study done in Sheko ethinic group of Ethiopia [8] showed that skin and gastrointestinal problems were the commonly treated diseases. According to a study in Lebanon [20], most medicinal plants were used to treat gastrointestinal disorders, kidney and urinary diseases as well as blood and cardiovascular diseases. Diarrhea was the commonly treated disease in Benshangul-Gumuz [15].This discrepancy may be the result of the difference in the climatic, ethnic, and hygienic conditions the areas. The current study is also unlike the one done in Israel [21]. Mental illnesses were commonly treated according to the study in Kenya [22].

The most commonly used plant part was leaf in this study area which is in agreement with other studies. [8, 13, 15, 18, 19, 21, 2326]. Considerable threat to the mother plant radiates to the various parts of the plant. However, root was the commonly used plant part according to a study done in Benshangul-Gumuz [15]. Medicinal plants were formulated in various forms using various solvents and additives. They were formulated as decoctions, liquid preparations and pastes. This is supported by a study done in Korea [17], Israel [21], Gondar zuria woreda [24] and Hawasa [13]. However, in a study done in Chencha [18] and Tewledere districts [27], the majority of remedies were formulated as concoctions. Practitioners prepare remedies in such a simple manner without further processing which may be due to lack of education and processing instruments. TMPs of the current study area used butter, charcoal, sugar, milk and salt as additives to increase the efficacy and potency of the remedies. The rationale behind the use of honey and sugar is just to make the formulation palatable. This is supported by a study done in Israel [17] and Hawasa [13].

This study showed that there was no harmony in measurement or unit used among practitioners. Most informants stated measuring units like cup, spoon, bottle and handful which lack accuracy. This problem was also observed in studies done elsewhere which may be due to lack of education [13, 14, 19, 28].

This study revealed that higher sizes of preparations were given orally which agrees with results of other studies [1113, 15, 17, 2225, 2729]. Practitioners prefer simple routes like topical and oral due to their inability to administer remedies in other routes like intravenous. Oral administration allows relatively fast physiological action of remedies on pathogens and enhance its efficacy. However, studies conducted in Sheko ethnic group in Southwest Ethiopia [8] revealed that most preparations were prescribed for administration to the cutaneous route. According to the result of the current study, most formulations were given only once. This may be due to the fact that most practitioners do not know the actual dose to be given and fear the risk that comes at the end of the treatment due to over dose and continuous administration.

One-third of the medicinal plants recorded were trees. However, other research works indicate the abundant use of herbs [8, 22, 24, 25, 27, 30]. The availability of most woody plants in the area might have enforced the local inhabitants to rely on tress.

Most of the formulations were contraindicated for pregnant patients. This is due to the healers’ belief that it may harm the fetus. No contraindication is indicated for one-third of the formulations. Most preparations taken orally cause nausea, vomiting and abdominal cramp whereas, some of the preparations are free from any side effect which may be due to the lack of follow up of patients by healers once they gave remedies and due to illiteracy of the patients.

This study revealed that, only some of the formulations possessed drug food and drug–drug interactions, this may be because most practitioners are illiterate, they do not know about the interaction of their remedies with modern medicines. In addition practitioners do not follow the progress of their patients, hence have little information on drug food interaction. Synergistic reactions were observed in poly herbal preparations like in the case of remedies for evil eye.

According to this study, practitioners do not normally store remedies which is in contrast to the study done in Addis Ababa [28]. For those medicinal plants which are not easily available and which are seasonal, practitioners collect and store in papers, horns and with in bottles. Only three percent of the total preparations are stored in cool and dry places. This may be due to the lack of modern education about drug storage and other health related issues.

A total of 127 URs from 60 species of plants were recorded which were assigned to seven use categories. Analysis of ICF shows that there exists a high evenness of plant consumption among the population which is in harmony with the study in Chencha [18]. The low ICF for skin problems may because of a multifaceted preparation of plants required to treat disease. Majority of plant species have a number of medicinal values, which result in higher variety of use reports.

Croton macrostachyus (FL = 0.78) is reported by high number of informants (36%), hence more preferable than Euphorbia abyssinica (0.42) and Urtica simensis (0.67) in treating malaria. However, despite Allium sativum (FL = 0.75) is reported by less figures of informants (30%), than Echinops kebericho (FL = 0.64) which is mentionedd by relatively higher percentage of practitioners (34%), it seems that Allium sativum is more preferable than Echinops kebericho in treating evil eye. But a study done in Sheko [8] indicated that Ocimum lamiifolium, Phytolacca dodecandra, Amaranthus dubius and Amaranthus graecizans were the medicinal plants assigned with the highest FL values. This discrepancy may be the result of the differences in the type of diseases dominating the areas, and the level of availability of the medicinal plants.

According to the results of this study, drought is the most serious threat to medicinal plants followed by overgrazing. This is in conformity with the survey conducted in Gemad district [25] and Kilte Awulalo [27], but according to a study done in Loma and Gena Bosa [26], agricultural expansion was the major threat followed by timber and other demands. This is probably due to the increasing number of population. However, study done in Hawasa city [13] indicated urbanization as the most serious threat for medicinal plants.

Conclusion

Dega Damot district is loaded in its medicinal plant diversity and indigenous knowledge though plants are highly affected by drought, overgrazing and firewood collection. Therefore awareness activities must be created among the district’s population by concerned governmental and nongovernmental organizations about the value of medicinal plants and conservation of these plants. The healing potential and associated adverse issues of the claimed medicinal plants should be assessed before proposing for a broader utilization.

Abbreviations

HIV: 

human immunodeficiency virus

ICF: 

informant’s consensus factor

PUD: 

peptic ulcer disease

TM: 

traditional medicine

TMPs: 

traditional medical practitioners

UR: 

use-report

Declarations

Authors’ contributions

All of the authors had magnificent contribution in the design of the study, data collection and analysis and preparation of the manuscript. MW and TA played a pivotal role in writing the proposal and designing the study. MW was instrumental during the data collection, analysis and manuscript preparation. GD involved in the discussion as well as manuscript preparation of this paper. All authors read and approved the final manuscript.

Acknowledgements

We are indebted to the people of Dega Damot district for their unreserved collaboration and hospitality. We have appreciated the Dega Damot district offices of Rural Agricultural Development, Health, Administration and Plan and Finance for their provision of information during data collection. We thank university of Gondar and Debre Markos University for their support to conduct our study and biology department, university of Gondar for the provision of some facilities during identification of plants. Our gratitude also goes to Mr. Abyu Eniyew, a botanist at University of Gondar, who identified the plants. The role of the west Gojjam zone communication office and Amhara region communication beaurue was also instrumental.

Competing interests

The authors declare that they have no competing interests.

Availability of data and materials

Data and materials will be available on request at any time.

Ethical approval and consent to participate

The study was ethically approved by the Graduate Program Evaluation Committee of the College of medicine and health sciences, University of Gondar. Prior to the initiation of the data collection, the objective of the survey was clarified to the TMPs, verbal consent was obtained from them. Letter of collaboration was sent to district officials of the study area and biology department at University of Gondar.

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Authors’ Affiliations

(1)
Pharmacy Department, Debre Markos University
(2)
School of Pharmacy, Addis Ababa University
(3)
Public Health Department, Debre Markos University

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