Comparing local perspectives on women's health with statistics on maternal mortality: an ethnobotanical study in Bénin and Gabon

Soil seed bank dynamics of two invasive alien plants in Nigeria: implications for ecosystem restoration

The assessment of seed banks could provide useful hints towards ensuring restoration planning and invasive species management. In this study, the impacts of two invaders such as Hyptis suaveolens and Urena lobata on the soil seed banks were investigated. We also assessed the seed characteristics of the invaders at the invaded sites. This was achieved using 10 sites each for H. suaveolens- and U. lobata-invaded habitats and -non-invaded habitats making a total of 30 sites. We collected 200 soil samples from each habitat type. A seedling emergence method was used to determine the seed bank recruitment of both invasive plants. The diversity indices of the above-ground vegetation of sites invaded by the two plants were significantly lower than those of the non-invaded sites. Only two plant species emerged from the seed banks of H. suaveolens and five plants from those of U. lobata when compared with non-invaded sites where 53 species emerged. A larger portion of the seeds was located in the soil's lower layer at all the sites invaded by H. suaveolens while those of U. lobata and non-invaded sites were found in the upper layers and there are significant associations between the habitats. The lower soil layers of the two species have the highest percentage of viable seeds. These results help us to understand more about the invasiveness of both species as related to their impacts on the seed banks and native vegetation. It also indicates that the native species that emerged from the invaded seed banks could be used for the restoration of the invaded habitats.

Food Taboos and Cultural Beliefs Influence Food Choice and Dietary Preferences among Pregnant Women in the Eastern Cape, South Africa

A well-nourished and healthy population is a central tenet of sustainable development. In South Africa, cultural beliefs and food taboos followed by some pregnant women influence their food consumption, which impacts the health of mothers and children during pregnancy and immediately afterwards. We documented food taboos and beliefs amongst pregnant isiXhosa women from five communities in the Kat River Valley, South Africa. A mixed-methods approach was used, which was comprised of questionnaire interviews with 224 women and nine focus group discussions with 94 participants. Overall, 37% of the women reported one or more food practices shaped by local cultural taboos or beliefs. The most commonly avoided foods were meat products, fish, potatoes, fruits, beans, eggs, butternut and pumpkin, which are rich in essential micronutrients, protein and carbohydrates. Most foods were avoided for reasons associated with pregnancy outcome, labour and to avoid an undesirable body form for the baby. Some pregnant women consumed herbal decoctions for strengthening pregnancy, facilitating labour and overall health of both themselves and the foetus. Most learnt of the taboos and practices from their own mother or grandmother, but there was also knowledge transmission in social groups. Some pregnant women in the study may be considered nutritionally vulnerable due to the likelihood of decreased intake of nutrient-rich foods resulting from cultural beliefs and food taboos against some nutritious foods. Encouraging such women to adopt a healthy diet with more protein-rich foods, vegetables and fruits would significantly improve maternal nutrition and children's nutrition. Adhering to culturally appropriate nutrition education may be an important care practice for many pregnant women in the Kat River Valley.

'We are always desperate and will try anything to conceive': The convoluted and dynamic process of health seeking among women with infertility in the West Coast Region of The Gambia

Introduction

In many Sub-Saharan African countries, women with infertility search relentlessly for treatment. Guided by the Partners for Applied Social Sciences model for health seeking behaviour and access to care research, this study aims to understand the health seeking behaviour of women with infertility in the West Coast region of The Gambia and the influence of aetiological beliefs on health seeking paths.

Methodology

A qualitative approach was used to generate both primary and secondary data for thematic analysis. The data collection methods included in-depth interviews (36), observations (18), informal conversations (42), group discussion (7) and made use of pile-sorting exercises. Sources of secondary data included government and non-governmental reports and media outputs.

Results

The health seeking approaches of women living in both rural and urban areas were extremely complex and dynamic, with women reporting that they looked for biomedical treatment as well as seeking indigenous treatment provided by local healers, sacred places and kanyaleng groups. While treatment choice was related to the perceived aetiology of infertility, it was also strongly influenced by the perceived effectiveness of the treatment available and the duration of the fertility problems. Other relevant factors were the affordability, accessibility and availability of treatment and respondents’ family and social networks, whereby access to the biomedical health sector was strongly influenced by people’s socio-economic background.

Conclusion

On the basis of this analysis and our wider research in the area, we see a need for health authorities to further invest in providing information and counselling on issues related to infertility prevention and treatment. The availability of locally applicable guidelines for the management of infertility for both men and women at all levels of the health system would facilitate such work. In addition, the public sphere should provide more space for alternative forms of social identity for both men and women.

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.

Medicinal foods and beverages among Maasai agro-pastoralists in northern Tanzania

ETHNOPHARMACOLOGICAL RELEVANCE

Pastoralist Maasai populations of east Africa use several different wild plants as dietary and medicinal additives in beverages (soups and teas), yet little is known about how the plants used and the rationales for use compare and contrast across different Maasai beverages, including how gender specific dietary and health concerns structure patterns of intake.

AIM OF THE STUDY

We investigated three Maasai beverages: almajani (tea or herbal infusion); motorí (traditional soup); and okiti (psychoactive herbal tea). In order to build knowledge about the cultural functions of these Maasai food-medicines and their incidence of use we also investigated use rationales and self-reported frequencies of use. We conclude by examining gender differences and the possible pharmacological antimicrobial activity of the most frequently used plants.

MATERIALS AND METHODS

Research was conducted in 2015, with a population of semi-nomadic agropastoralist Maasai residing in northern Tanzania. Data were collected using key informant interviews, plant collections, n = 32 structured surveys, and n = 40 freelist interviews followed by a literature review to determine the known antimicrobial activity of the most used plants.

RESULTS

We identified 20 plants that Maasai add to soup, 11 in tea, and 11 in the psychoactive tea, for a total of 24 herbal additives. Seven plant species were used in all three Maasai beverages, and these clustered with 10 common ailments. Based on self-reports, women use the beverages less frequently and in smaller amounts than men. There were also several gender differences in the plants that Maasai add to motorí and their associated use rationales.

CONCLUSIONS

There are several intersections concerning the plant species used and their associated rationales for use in almajani, motori, and okiti. Moving outward, Maasai beverages and their additives increasingly involve gender specific concerns. Female use of food-medicines, relative to men, is structured by concerns over pregnancy, birth, and lactation. The frequent consumption of herbal additives, many of which contain antimicrobial compounds, potentially helps modulate infections, but could have other unintentional effects as well.

Traditional uses, phytochemistry and pharmacological properties of African Nauclea species: A review

ETHNOPHARMACOALOGICAL RELEVANCE

The genus Nauclea in Africa comprises seven species. Among them, N. latifolia, N. diderrichii and N. pobeguinii are widely used by the local population in traditional remedies. Preparation from various parts of plants (e.g. roots, bark, leaves) are indicated by traditional healers for a wide range of diseases including malaria, pain, digestive ailments or metabolic diseases.

MATERIALS AND METHODS

A literature search was conducted on African species of the genus Nauclea using scientific databases such as Google Scholar, Pubmed or SciFinder. Every document of ethnopharmacological, phytochemical or pharmacological relevance and written in English or French were analyzed.

RESULTS AND DISCUSSION

The Nauclea genus is used as ethnomedicine all along sub-Saharan Africa. Several local populations consider Nauclea species as a major source of remedies for malaria. In this regard, two improved traditional medicines are currently under development using extracts from N. latifolia and N. pobeguinii. Concerning the chemical composition of the Nauclea genus, indoloquinolizidines alkaloids could be considered as the major class of compounds as they are reported in every analyzed Nauclea species, with numerous structures identified. Based on traditional indications a considerable amount of pharmacological studies were conducted to ensure activity and attempt to link them to the presence of particular compounds in plant extracts.

CONCLUSION

Many experimental studies using plant extracts of the African species of the genus Nauclea validate traditional indications (e.g. malaria and pain). However, bioactive compounds are rarely identified and therefore, there is a clear need for further evaluations as well as for toxicity experiments. The sustainability of these plants, especially of N. diderrichii, a threatened species, should be kept in mind to adapt local uses and preparation modes of traditional remedies.

Why ritual plant use has ethnopharmacological relevance

ETHNOPHARMACOLOGICAL RELEVANCE

Although ritual plant use is now recognised both for its socio-cultural importance and for its contribution to nature conservation, its potential pharmacological effects remain overlooked.

AIM OF THE STUDY

Our objective was to see whether ritual plant use could have ethnopharmacological relevance through practices that involve direct physical contact with the human body. We hypothesise that ritual practices reflect traditional knowledge on biological activities of plant species, even if plants are used in a symbolic way.

MATERIALS AND METHODS

Data were collected in collaboration with traditional healers and ritual plant vendors and harvesters in Benin (West Africa) and Gabon (Central Africa). Both ritual and medicinal uses of plants were recorded. Voucher specimens were collected and identified. We documented different administration routes of ritual plants and selected those whose uses involved direct contact with the human body. Based on our quantitative market surveys and field inventories, we identified 24 commercially or otherwise culturally important species and compared their ritual uses with proven biological activity from the literature.

RESULTS

We recorded 573 plant species with 667 ritual uses, of which ca. 75% (442 species and 499 uses) implied direct contact with the human body. The most common route of administration for ritual treatments was baths, followed by oral ingestion and skin rubbing. One third (186 species) of all ritual plants doubled as medicine for physical ailments. In contrast to previous research that explained the effectiveness of ritual plant use to be a matter of belief, our results hint at the potential medicinal properties of these plants. Ritual treatment of madness caused by evil spirits by the consumption of Rauvolfia vomitoria roots, for example, may be based on the species' proven anticonvulsant properties.

DISCUSSION AND CONCLUSION

We discuss some of the possible implications of ritual plant use for public health and conclude by suggesting that ritual plant uses that do not involve contact with the human body may also be vehicles for the transmission of traditional medicinal knowledge.

Wild plants, pregnancy, and the food-medicine continuum in the southern regions of Ghana and Benin

ETHNOPHARMACOLOGICAL RELEVANCE

In West Africa, women utilize wild plant species to maintain and enhance their health throughout the duration of pregnancy. These plants are a culturally resilient and financially accessible form of nourishment for pregnant women in the region, many of whom are malnourished, yet studies that identify both the nutritional and medicinal properties of these plants are limited.

AIM OF THE STUDY

The objective of this study was to analyze women's knowledge of plants consumed in pregnancy in the southern regions of Ghana and Benin from a food-medicine continuum perspective.

MATERIALS AND METHODS

We gathered data in two fieldwork periods in West Africa (Ghana 2010 and Benin 2011) through herbal market surveys and 56 questionnaires with women and then conducted a literature review on known properties of the plants.

RESULTS

Ghanaian women reported consuming wild greens such as iron-rich Nephrolepis biserrata and tree barks such as protein-rich Ricinodendron heudelotii in a soup based on the African oil palm fruit (Elaeis guineensis), a source of fatty acids. In Benin, participants frequently reported ingesting plants during pregnancy in the form of herbal teas. Commonly cited species included Securidaca longipedunculata, Dichapetalum madagascariense, and Schwenckia americana. Several of the plants demonstrated antioxidant, anti-malarial and anti-inflammatory activity in pharmacological studies, yet the majority has incomplete nutritional and pharmacological profiles. In total, informants cited 105 species that were consumed during pregnancy. Although Ghanaian and Beninese women mentioned different species and different forms of consumption, in both countries women cited "strengthening" as the most common motivation to consume wild plants during pregnancy. Strengthening is a concept that resonates within the food-medicine continuum, bridging the local diet and herbal pharmacopoeia of women's plant use during pregnancy.

CONCLUSIONS

Ethnobotanical studies of this nature highlight the multidimensional use of plants and can improve health and nutritional programs in the region.

"The medicine from behind": The frequent use of enemas in western African traditional medicine

ETHNOPHARMACOLOGICAL RELEVANCE

Purgative enemas form an integral part of African traditional medicine. Besides possible benefits, serious health risks of rectal herbal therapy have been described in literature. To design appropriate health education programs, it is essential to understand traditional herbal practices and local perceptions of health and illness. Little is known about the herbal ingredients of enemas in Sub-Saharan Africa and consumers' personal reasons to use them.

AIM OF THE STUDY

To analyze the importance of enema use with regard to plant species used and illnesses treated in West and Central Africa, to understand the local health beliefs that underlie frequent enema use and to evaluate which recipes and practices could be beneficial or harmful.

MATERIALS AND METHODS

We extracted data from 266 ethnobotanical questionnaires on medicinal (in particular women's health and childcare) and ritual plant use in Ghana, Benin and Gabon. Plants mentioned during interviews were vouchered and identified in herbaria. Health issues treated by means of enemas were ranked according to the number of plant species used for a specific illness. We compared our results with findings of medical research on benefits and risks of enema use in Sub-Saharan Africa.

RESULTS

We recorded ca. 213 different plant species used in hundreds of recipes for rectal insertions, mostly in Ghana and Gabon. Stomachache, abdominal pain, female infertility and birth facilitation were treated with the highest number of plants species. Cleansing the intestines of young children to promote their health by getting rid of 'dirt', instead of treating constipation, was an important cultural practice that required the rectal application of herbal medicine, as well as other cultural bound health issues like stimulating children to walk at an early age. Tradition, the bitter taste of herbal medicine and the rapid effect of enemas were frequently mentioned reasons for enema use.

DISCUSSION AND CONCLUSIONS

Literature indicates that although enemas can help to improve the hygienic conditions of a household with young infants, frequent enema use can pose serious risks like direct toxicity caused by harmful ingredients, mechanical injury and infections. In Africa, enemas containing herbal medicine are common methods of administering herbal medicine for a variety of diseases, rather than just medicinal treatments for constipation as previously thought. Health professionals should be aware of the extent of, and motivation behind enema use to develop culturally appropriate education programs, especially targeted at vulnerable groups such as elderly people, parents of young infants and pregnant women.

Local plant names reveal that enslaved Africans recognized substantial parts of the New World flora

How did the forced migration of nearly 11 million enslaved Africans to the Americas influence their knowledge of plants? Vernacular plant names give insight into the process of species recognition, acquisition of new knowledge, and replacement of African species with American ones. This study traces the origin of 2,350 Afro-Surinamese (Sranantongo and Maroon) plant names to those plant names used by local Amerindians, Europeans, and related groups in West and Central Africa. We compared vernacular names from herbarium collections, literature, and recent ethnobotanical fieldwork in Suriname, Ghana, Benin, and Gabon. A strong correspondence in sound, structure, and meaning among Afro-Surinamese vernaculars and their equivalents in other languages for botanically related taxa was considered as evidence for a shared origin. Although 65% of the Afro-Surinamese plant names contained European lexical items, enslaved Africans have recognized a substantial part of the neotropical flora. Twenty percent of the Sranantongo and 43% of the Maroon plant names strongly resemble names currently used in diverse African languages for related taxa, represent translations of African ones, or directly refer to an Old World origin. The acquisition of new ethnobotanical knowledge is captured in vernaculars derived from Amerindian languages and the invention of new names for neotropical plants from African lexical terms. Plant names that combine African, Amerindian, and European words reflect a creolization process that merged ethnobotanical skills from diverse geographical and cultural sources into new Afro-American knowledge systems. Our study confirms the role of Africans as significant agents of environmental knowledge in the New World.

Medicinal plants used for menstrual disorders in Latin America, the Caribbean, sub-Saharan Africa, South and Southeast Asia and their uterine properties: a review

ETHNOPHARMACOLOGICAL RELEVANCE

Menstrual disorders are generally not perceived as major health concerns by global health organizations, despite being disruptive to women׳s daily activities, particularly when access to sanitary facilities or analgesics is limited. Improving menstrual health requires access to safe and effective medication, but many women in Latin America, Africa or Asia prefer traditional medicine above modern remedies (such as contraceptives), as they can cause physical symptoms associated with fertility loss. Many medicinal plants are used for menstrual disorders, but few have been examined for their pharmacological activities related to traditional uses. Plants that have a smooth muscle-relaxant effect could ease menstrual cramps, but there are indications that dysmenorrhea in low-income countries is commonly treated with emmenagogues. This review aims to assess the most salient plants used to treat menstrual morbidity in Latin America and the Caribbean, sub-Saharan Africa, South and Southeast Asia, their uterine properties and adverse effects. To test whether plants used for painful menstruation could have uterine contracting properties, we recorded whether these species were also used to ease birth, induce menstruation, abortion or expel the afterbirth, as these suggest spasmogenic activities.

MATERIALS AND METHODS

We reviewed the literature documenting traditional plant use in the study area for dysmenorrhea, regulating or inducing menstruation, uterine cleansing, uterine fibroids, expelling the placenta and lochia and for easing childbirth. Thirty genera (59 species) used in at least two continents or frequently throughout one continent, where shortlisted from the 90 most salient plant species emerging from our literature review. Using Medline, we searched for pharmacological properties and/or mechanisms of action relevant to their traditional uses of the shortlisted species. We searched VigiBase™, the WHO global individual case safety report database, on reported adverse drug reactions associated with these species.

RESULTS

More than 2000 plant species are used for menstrual disorders in the study area. The most salient uses are to treat painful menstruation, induce or regulate menses, and induce abortion. Around half (29) of the 59 most salient species have been tested for their pharmacological effects, of which 48% act as uterine spasmolytics and 31% as uterine spasmogenics. Several frequently used species contain toxic constituents, which may put women and their unborn children at serious risk. VigiBase(TM) listed adverse drug reactions for 18 of these species, but few reports came from the study area.

CONCLUSIONS

Research into the risks and benefits of medicinal plants for menstrual complaints should be given a higher priority in reproductive health programs that respect traditional knowledge and practices. Increased data collection is needed on adverse drug reactions among women using herbal medicines for reproductive health, especially in countries with limited reproductive health facilities.

Volume, value and floristic diversity of Gabon׳s medicinal plant markets

ETHNOPHARMACOLOGICAL RELEVANCE

African medicinal plant markets offer insight into commercially important species, salient health concerns in the region, and possible conservation priorities. Still, little quantitative data is available on the trade in herbal medicine in Central Africa. The aim of this study was to identify the species, volume, and value of medicinal plant products sold on the major domestic markets in Gabon, Central Africa.

MATERIALS AND METHODS

We surveyed 21 herbal market stalls across 14 of the major herbal medicine markets in Gabon, collected vouchers of medicinal plants and documented uses, vernacular names, prices, weight, vendor information and weekly sales. From these quantitative data, we extrapolated volumes and values for the entire herbal medicine market.

RESULTS

We encountered 263 medicinal plant products corresponding with at least 217 species. Thirteen species were encountered on one-third of the surveyed stalls and 18 species made up almost 50% of the total volume of products available daily, including the fruits of Tetrapleura tetraptera and seeds of Monodora myristica. Although bark comprised the majority of the floristic diversity (22%) and the highest percentage of daily stock (30%), the resin of IUCN red-listed species Aucoumea klaineana represented 20% of the estimated daily volume of the entire herbal market. Plants sold at the market were mainly used for ritual purposes (32%), followed by women׳s health (13%), and childcare (10%). The presence of migrant herbal vendors selling imported species, especially from Benin, was a prominent feature of the Gabonese markets.

CONCLUSION

An estimated volume of 27 t of medicinal plant products worth US$ 1.5 million is sold annually on the main Gabonese markets. Aucoumea klaineana and Garcinia kola are highlighted as frequently sold species with conservation priorities. The herbal market in Gabon is slightly higher in species diversity but lower in volume and value than recently surveyed sub-Saharan African markets.

Traditional medicine and childcare in Western Africa: mothers' knowledge, folk illnesses, and patterns of healthcare-seeking behavior

Background

In spite of the strong role of traditional medicine in childcare in the pluralistic healthcare system in Western Africa, little information is known on mothers’ domestic plant knowledge. Identifying local perspectives and treatments of children’s illnesses, including folk illnesses, is essential to having a comprehensive understanding of how mothers make healthcare treatment decisions. We aimed to identify which infant illnesses Beninese and Gabonese mothers knew to treat with medicinal plants and for which illnesses they sought biomedical care or traditional healers.

Methods

We conducted 81 questionnaires with mothers in Bénin and Gabon and made 800 botanical specimens of cited medicinal plants. We calculated the number of species cited per illness and the proportion of participants knowledgeable on at least one herbal remedy per illness. Using qualitative data, we described folk illnesses in each country and summarized responses on preferences for each of the three healthcare options.

Results

Participants from both countries were most knowledgeable on plants to treat respiratory illnesses, malaria, diarrhea, and intestinal ailments. Mothers also frequently mentioned the use of plants to encourage children to walk early, monitor the closure of fontanels, and apply herbal enemas. Major folk illnesses were atita and ka in Bénin and la rate and fesses rouges in Gabon. Traditional healers were reported to have specialized knowledge of cultural bound illnesses. Malaria was frequently cited as an illness for which mothers would directly seek biomedical treatment.

Conclusion

Mothers largely saw the three systems as complementary, seamlessly switching between different healing options until a remedy was found. Folk illnesses were found to give insight into local treatments and may reveal important neglected diseases. Due to high reported levels of knowledge on treating top statistical causes of infant mortality and folk illnesses, mothers’ medicinal plant knowledge should be included in the analysis of healthcare-seeking behavior for childcare.