The symbolic efficacy of medicinal plants: practices, knowledge, and religious beliefs amongst the Nalu healers of Guinea-Bissau

Medical Ethnobotany of the Bissau-Guinean Community of Migrants Living in Northern Italy and Comparison with the Ethnopharmacology of Guinea-Bissau

This study compares the knowledge of medicinal plants of Bissau-Guinean migrants now established in Italy with the ethnopharmacology still present in their country of origin. We also investigated how traditional ethnobotanical knowledge is changing following the phenomenon of migration from Africa to Europe. The ethnobotanical data were collected during 2017-2018, by interviewing 49 informants belonging to 8 ethnic groups, living in 8 provinces of northern Italy. The final inventory of botanical taxa included 81 species belonging to 34 families, with Fabaceae and Malvaceae the most represented, followed by Euphorbiaceae, Apocynaceae, Combretaceae, and Solanaceae. Plant remedies were used to treat 21 ailment categories, such as fever, internal infections, intestinal and respiratory problems, and pains. The traditional ethnobotanical knowledge of Bissau-Guinean migrants in Italy was associated with gender, with women showing the highest knowledge. In addition, a negative relationship was observed between the maintenance of this knowledge and the number of years migrants have spent in Italy. Overall, a loss of knowledge was observed in the less numerous ethnic groups. However, traditional preparations based on plants from the country of origin are in general well preserved to maintain a good state of health. Our work could help in transferring to the next generation the cultural heritage of Bissau-Guinean people permanently moved to European Countries.

Exploring Knowledge about Fang Traditional Medicine: An Informal Health Seeking Behaviour for Medical or Cultural Afflictions in Equatorial Guinea

This study explores a range of informal health-seeking behaviors, including the use of Fang Traditional Medicine (FTM) for medical or cultural afflictions in Equatorial Guinea (EQ), the therapeutic methods used, the health problems handled, the learning process, traditional medicine user profiles and the social images of Fang Traditional Healers (FTHs). Ethnography was employed as a qualitative strategy using emic–etic approaches. Semi-structured interviews were conducted with 45 individuals, including 6 community leaders, 19 tribal elders, 7 healthcare professionals, 11 FTHs and 2 relatives of traditional healers in 5 districts of EQ. FTM offers a cure for malaria and treatments for reproductive health issues, bone fractures and cultural illnesses. Several methods used to learn FTM are based on empirical observation, and without the need for traditional schooling, unlike with Western medical professionals: for example, watching a family member, or the spirits or ancestors, can reveal healing knowledge. Materials from forests, including tree barks and plants, and rituals are used to keep Fang populations healthy; in addition, two rituals known as “osuiñ” and “etoak” (infusions of tree barks with the blood of sacrificed animals) are the most commonly used treatments. In addition, elders and women are the most active consumers of FTM. FTM plays a relevant role in curing medical and cultural afflictions in Fang communities. The informal health-seeking behavior among the Fang community is conditioned by the explanation model of illness.

Developing an Evidence-Based Coexistence Strategy to Promote Human and Wildlife Health in a Biodiverse Agroforest Landscape

Agroforest mosaics represent one of the most extensive human-impacted terrestrial systems worldwide and play an increasingly critical role in wildlife conservation. In such dynamic shared landscapes, coexistence can be compromised if people view wildlife as a source of infectious disease. A cross-disciplinary One Health knowledge base can help to identify evolving proponents and threats to sustainable coexistence and establish long-term project goals. Building on an existing knowledge base of human–wildlife interactions at Cantanhez National Park (NP), Guinea-Bissau, we developed a causal pathway Theory-of-Change approach in response to a newly identified disease threat of leprosy in the Critically Endangered western chimpanzee (Pan troglodytes verus). The goals of our project are to improve knowledge and surveillance of leprosy in humans and wildlife and increase capacity to manage human–wildlife interactions. We describe the core project activities that aim to (1) quantify space use by chimpanzees across Cantanhez NP and determine the distribution of leprosy in chimpanzees; (2) understand the health system and local perceptions of disease; and (3) identify fine-scale risk sites through participatory mapping of resources shared by humans and chimpanzees across target villages. We discuss the development of a biodiversity and health monitoring programme, an evidence-based One Health campaign, and a One Health environmental management plan that incorporates the sharing of space and resources, and the disease implications of human–non-human great ape interactions. We demonstrate the importance of multi-stakeholder engagement, and the development of strategy that fully considers interactions between people, wildlife, and the environment.

Advancing urban ethnopharmacology: a modern concept of sustainability, conservation and cross-cultural adaptations of medicinal plant lore in the urban environment

The discipline 'urban ethnopharmacology' emerged as a collection of traditional knowledge, ancient civilizations, history and folklore being circulated since generations, usage of botanical products, palaeobotany and agronomy. Non-traditional botanical knowledge increases the availability of healthcare and other essential products to the underprivileged masses. Intercultural medicine essentially involves 'practices in healthcare that bridge indigenous medicine and western medicine, where both are considered as complementary'. A unique aspect of urban ethnopharmacology is its pluricultural character. Plant medicine blossomed due to intercultural interactions and has its roots in major anthropological events of the past. Unani medicine was developed by Khalif Harun Al Rashid and Khalif Al Mansur by translating Greek and Sanskrit works. Similarly, Indo-Aryan migration led to the development of Vedic culture, which product is Ayurveda. Greek medicine reached its summit when it travelled to Egypt. In the past few decades, ethnobotanical field studies proliferated, especially in the developed countries to cope with the increasing demands of population expansion. At the same time, sacred groves continued to be an important method of conservation across several cultures even in the urban aspect. Lack of scientific research, validating the efficiency, messy applications, biopiracy and slower results are the main constrains to limit its acceptability. Access to resources and benefit sharing may be considered as a potential solution. Indigenous communities can copyright their traditional formulations and then can collaborate with companies, who have to provide the original inventors with a fair share of the profits since a significant portion of the health economy is generated by herbal medicine. Search string included the terms 'Urban' + 'Ethnopharmacology', which was searched in Google Scholar to retrieve the relevant literature. The present review aims to critically analyse the global concept of urban ethnopharmacology with the inherent plurality of the cross-cultural adaptations of medicinal plant use by urban people across the world.

Cassia sieberiana DC. leaves modulate LPS-induced inflammatory response in THP-1 cells and inhibit eicosanoid-metabolizing enzymes

ETHNOPHARMACOLOGICAL RELEVANCE

According to ethnobotanical surveys, Cassia sieberiana DC. (1825) is a particularly reputed species in African folk Medicine, namely due to the application of its leaves and roots for the treatment of diseases and symptomatology that appear to be related with an inflammatory background. In contrast with the roots of the plant, the leaves remain to be investigated, which prompted us to further detail mechanisms underlying their anti-inflammatory properties, by using in vitro models of disease.

AIM OF THE STUDY

Considering its use in the amelioration and treatment of conditions that frequently underlie an inflammatory response, C. sieberiana leaves extract was prioritized amongst a collection of extracts obtained from plants collected in Guinea-Bissau. As such, this work aims to deliver experimental data on the anti-inflammatory properties of C. sieberiana leaf and to establish possible associations with its chemical composition, thus providing a rationale on its use in folk Medicine.

MATERIALS AND METHODS

The chemical profile of an hydroethanol extract obtained from the leaves of the plant was established by HPLC-DAD-ESI/MSⁿ in order to identify bioactives. The extract and its main compound were tested towards a series of inflammatory mediators, both in enzymatic and cell-based models. The capacity to interfere with the eicosanoid-metabolizing enzymes 5-lipoxygenase (5-LOX), cyclooxygenase-1 (COX-1) and -2 (COX-2) was evaluated in cell-free systems, while the effects in interleukin 6 (IL-6) and tumour necrosis factor-α (TNF-α) levels produced by THP-1 derived macrophages were assessed through ELISA.

RESULTS

HPLC-DAD-ESI/MSⁿ analysis of the extract elucidated a chemical profile qualitatively characterized by a series of anthraquinones, particularly rhein derivatives, and nine flavonols, most of which 3-O-glycosylated. Considering the concentrations of the identified compounds, quercetin was detached as the main component. Effects of the hydroethanol extract obtained from C. sieberiana leaves against key enzymes of the arachidonic acid cascade were recorded, namely a concentration-dependent inhibition against 5-LOX, at concentrations ranging from 16 to 250 μg mL^-1 and a selective inhibitory action upon COX-2 (IC₅₀ = 3.58 μg mL^-1) in comparison with the isoform COX-1 (IC₅₀ = 9.10 μg mL^-1). Impact on inflammatory cytokines was also noted, C. sieberiana leaf extract significantly decreasing IL-6 levels in THP-1 derived macrophages at 250 and 500 μg mL^-1. In contrast, TNF-α levels were found to be increased in the same model. Quercetin appears to partially account for the observed effects, namely due to the significant inhibitory effects on the activity of the arachidonic acid metabolizing enzymes COX-2 and 5-LOX.

CONCLUSIONS

The anti-inflammatory effects herein reported provide a rationale for the use of C. sieberiana leaves in African folk practices, such as in the treatment of arthritis, rheumatism and body aches. Considering the occurrence of flavonoidic and anthraquinonic constituents, as well as the observed anti-inflammatory properties of quercetin, recorded effects must be related with the presence of several bioactives.

Traditional medicinal knowledge of woody species across climatic zones in Benin (West Africa)

ETHNOPHARMACOLOGICAL RELEVANCE

Plant parts are often used by local people to treat their affections. This study addressed the Traditional Medicinal Knowledge of woody species in Benin and the dependence of medicinal use of woody species on climatic zones.

AIM OF THE STUDY

It reports (i) the main diseases categories treated with medicinal use of woody species in Benin and changes across climatic zones by inferring their epidemiological status, and (ii) the woody species involved and their distribution according to climate conditions.

MATERIALS AND METHODS

Ethnobotanical interviews were undertaken using a semi-structured questionnaire. Five hundred and ninety medicinal plant professionals (healers, traders …) were interviewed in the whole country. Frequency of citation and informant consensus factor were calculated to highlight the main human diseases categories and woody species used for their treatment. A principal component analysis was performed to determine the occurrence of diseases categories in different climatic zones.

RESULTS

About 94% of international diseases categories were treated using medicinal woody species in Benin. Nighty-seven ailments in 16 diseases categories were identified. Among them, 5 diseases categories (General and unspecified, Digestive, Skin, Neurological, and Musculoskeletal) were highlighted as important. The Sudano-Guinean zone showed the highest diseases frequencies, whereas the Sudanian zone showed the lowest. The epidemiological status of some phytodistricts was worrisome. In our study, 123 woody species belonging to 93 genera and 35 families were reported, and among them, 16 were the most used as treatments.

CONCLUSIONS

There is a lack of consensus among traditional healers about which woody species to use. Many different species were used to treat a given diseases category. Also, information concerning their organ composition was not available in the literature, for the majority of species. Biological and chemical investigations are thus needed for a better valorization of the most frequently used plants in the future.

Medicinal plants used by 'root doctors', local traditional healers in Bié province, Angola

ETHNOPHARMACOLOGICAL RELEVANCE

This study is one of the first post-civil war efforts to document traditional botanical knowledge in Bié province, central Angola, in a first step to bring more studies on the use of medicinal plant resources in this area so as to bring new insights into Angolan bio-cultural diversity.

AIM OF THE STUDY

Examine the variety of plant species used for medical purposes, as well as characterize their social and cultural values. Also, it is aimed to compare their uses in the studied region with those in Sub-Saharan Africa and report new ethnomedicinal uses.

MATERIALS AND METHODS

We documented traditional medicinal plant knowledge among professional herbalists in two areas in Bié province through participatory observation, semi-structured interviews and transect walks. Ethnobotanical information was quantified based on Use Reports to (1) rate traditional knowledge; and (2) determine most useful taxa.

RESULTS

In total, 10 traditional healers shared information on their knowledge. A total of 87 plant species distributed among 57 genera and 36 botanical families were documented with Fabaceae being the best-represented family with 18 species, followed by Phyllanthaceae (6), Apocynaceae (5), Asteraceae (5), Rubiaceae (5), Lamiaceae (4), and Ochnaceae (3). Most medicinal plants are usually gathered at a distance from human settlements because of the belief in the higher efficacy of 'wild' plants shared by all herbalists. Roots are the most common plant part used (79%), explaining why the consulted herbalists call themselves 'root doctors'.

CONCLUSIONS

The culturally most important medicinal species identified in this study, i.e. Securidaca longepedunculata, Garcinia huillensis, Annona stenophylla, Afzelia quanzensis and Strychnos cocculoides, were previously reported for the same use in neighbouring countries and elsewhere in Africa. Our study also indicates that there are several locally valuable species that have not yet been studied for their medical potential, to name a few: Alvesia rosmarinifolia, Diplorhynchus condylocarpon, Eriosema affine, Paropsia brazzaeana, Rhus squalida, Sclerocroton cornutus or Xylopia tomentosa. Moreover, the ethnomedicinal use of 26 species was reported for the first time to sub-Saharan Africa.

CLASSIFICATION

Ethnopharmacological field studies.

Traditional Use of Banisteriopsis caapi Alone and Its Application in a Context of Drug Addiction Therapy

Takiwasi is a therapeutic community for the treatment of Substance Use Disorders (SUDs) that combines traditional Amazonian medicine (TAM) with modern psychotherapy. One of the plant medicines from TAM used in this protocol is purgahuasca. It is a decoction of the vine Banisteriopsis caapi alone, whose use is traditional among the Awajún and other ethnic groups in Peru. The research began with a field trip to Awajún territory to explore the indigenous use of purgahuasca as an initiation rite. Then, analysis of its application was conducted in the clinical context of Takiwasi. Open-ended and semi-structured interviews with Awajún informants and Takiwasi's therapeutic staff were performed and analyzed following the narrative methodological approach. Further clinical data on the ingestion of purgahuasca by Takiwasi's SUD patients were obtained from the internal repository. These indicate that 359 (92.1%) patients reported having had the so-called mareación (dizziness), 299 (76.7%) experienced physical sensations, and 208 (53.3%) had visions. These effects can be related to the psychoactivity of β-Carbolines alkaloids from B. caapi, a medicinal plant that seems to have potential benefits also for SUD, especially giving a key contribution to the patients' therapeutic process of becoming aware of the personal reasons behind addictive behaviors.

Mental health issues among indigenous communities and the role of traditional medicine

INTRODUCTION

Mental health in indigenous communities is a relevant issue for the World Health Organization (WHO). These communities are supposed to live in a pure, clean and intact environment. Their real condition is far different from the imaginary; they are vulnerable populations living in difficult areas, exposed to pollution, located far from the health services, exposed to several market operations conducted to extract natural resources, facing criminal groups or illegal exploitation of land resources. These factors may have an impact on mental health of indigenous population.

METHODS

We reviewed all papers available on PubMed, EMBASE and The Cochrane Library until December 2018. We focused on those factors affecting the changes from a traditional to a post-modern society and reviewed data available on stress-related issues, mental distress affecting indigenous/aboriginal communities and the role of Traditional Medicine (TM). We reviewed articles from different countries hosting indigenous communities.

RESULTS

The incidence of mental distress and related phenomena (e.g. collective suicide, alcoholism and violence) among indigenous populations is affected by political and socio-economic variables. The mental health of these populations is poorly studied and described even if mental illness indicators are somewhat alarming. TM still seems to have a role in supporting affected people and may reduce deficiencies due to poor access to medical insurance/coverage, psychiatry and psychotherapy. It would be helpful to combine TM and modern medicine in a healthcare model to face indigenous populations' health needs.

CONCLUSION

This review confirms the impact of societal changes, environmental threats and exploitation of natural resources on the mental health of indigenous populations. Global Mental Health needs to deal with the health needs of indigenous populations as well as psychiatry needs to develop new categories to describe psychopathology related to social variance as recently proposed by the Diagnostic and Statistical Manual of Mental Disorders (5th ed.; DSM-5).

Breaking Through Disciplinary Barriers: Human-Wildlife Interactions and Multispecies Ethnography

One of the main challenges when integrating biological and social perspectives in primatology is overcoming interdisciplinary barriers. Unfamiliarity with subject-specific theory and language, distinct disciplinary-bound approaches to research, and academic boundaries aimed at "preserving the integrity" of subject disciplines can hinder developments in interdisciplinary research. With growing interest in how humans and other primates share landscapes, and recognition of the importance of combining biological and social information to do this effectively, the disparate use of terminology is becoming more evident. To tackle this problem, we dissect the meaning of what the biological sciences term studies in "human-wildlife conflict" or more recently "human-wildlife interactions" and compare it to what anthropology terms "multispecies ethnography." In the biological sciences, human-wildlife interactions are the actions resulting from people and wild animals sharing landscapes and resources, with outcomes ranging from being beneficial or harmful to one or both species. In the social sciences, human-nonhuman relationships have been explored on a philosophical, analytical, and empirical level. Building on previous work, we advocate viewing landscapes through an interdisciplinary "multispecies lens" in which humans are observed as one of multiple organisms that interact with other species to shape and create environments. To illustrate these interconnections we use the case study of coexistence between people of the Nalu ethnic group and Critically Endangered western chimpanzees (Pan troglodytes verus) at Cantanhez National Park in Guinea-Bissau, to demonstrate how biological and social research approaches can be complementary and can inform conservation initiatives at the human-primate interface. Finally, we discuss how combining perspectives from ethnoprimatology with those from multispecies ethnography can advance the study of ethnoprimatology to aid productive discourse and enhance future interdisciplinary research.

Herbal medicines use during pregnancy in Sierra Leone: An exploratory cross-sectional study

BACKGROUND

The influence of complementary therapies on maternal health has attracted the attention of policy makers, health professionals and researchers globally especially in developing countries. However, there is lack of evidence on whether Sierra Leonean women use herbal medicine during pregnancy which limit the chance of providing better maternity care.

AIM

This study was conducted to determine the prevalence and pattern of herbal medicines use among pregnant women attending an antenatal clinic at a tertiary maternal hospital in Sierra Leone.

METHODS

A cross-sectional study was conducted among pregnant women (n=134) who were at least 18 years of age and who have had at least one previous pregnancy, using face to face interview. Descriptive statistics, univariate and multivariate logistic regression analysis were used for data analysis.

RESULTS

The response rate was 82.7%. Nearly two-thirds of pregnant women reported using herbal medicine (62.7%). Herbal medicine users were more likely to be Muslim than Christian. Luffa acutangula (L.) Roxb was the most cited herbal medicine used and was mostly indicated for urinary tract infection and pedal oedema. Perceived effectiveness and safety over conventional medicine (70.2%) was key driver for use, and majority did not disclose their use of herbs to their maternal health professional (95.2%).

CONCLUSION

Herbal medicine use among pregnant women in this study was widespread. Maternal health providers should be aware of this relatively common practice and routinely discuss and educate pregnant women on the potential risks and benefits associated with the use of herbs.

Ethnopharmacology and Therapeutic Value of Bridelia micrantha (Hochst.) Baill. in Tropical Africa: A Comprehensive Review

Bridelia micrantha is traditionally used in tropical Africa to treat a wide range of human and animal diseases. The aim of this study was to summarise the research that has been done on the ethnomedicinal uses, phytochemistry and pharmacological properties of B. micrantha so as to understand its importance and potential value in primary healthcare systems. The literature search for information on ethnomedicinal uses and pharmacological activities of B. micrantha was undertaken using databases such as Web of Science, Scopus, Google Scholar, Science Direct, BioMed Central (BMC), PubMed and Springerlink. Other relevant literature sources included books, book chapters, websites, theses, conference papers and other scientific publications. This study showed that B. micrantha is used as herbal medicine in just over half (57.3%) of the countries in tropical Africa where it is indigenous. A total of 54 ethnomedicinal uses of B. micrantha have been recorded with a high degree of consensus on burns, wounds, conjunctivitis, painful eyes, constipation, gastric ulcers, cough, headache, rheumatism, painful joints, dysentery, ethnoveterinary medicine, malaria, sexually transmitted infections, stomach ache, tape worms and diarrhoea. Different plant parts, aqueous and organic extracts exhibited anthelmintic, antimicrobial, anticonvulsant and sedative, antidiabetic, antidiarrhoeal, antinociceptive, antioxidant, antiplasmodial, antischistosomal, hepatoprotective, insecticidal and β-lactamase inhibitory activities.

Treating infants with frigg: linking disease aetiologies, medicinal plant use and care-seeking behaviour in southern Morocco

BACKGROUND

Although most Moroccans rely to some extent on traditional medicine, the practice of frigg to treat paediatric ailments by elderly women traditional healers known as ferraggat, has not yet been documented. We describe the role of these specialist healers, document the medicinal plants they use, and evaluate how and why their practice is changing.

METHODS

Ethnomedicinal and ethnobotanical data were collected using semi-structured interviews and observations of medical encounters. Information was collected from traditional healers, namely ferraggat, patients, herbalists and public health professionals. Patients' and healers' narratives about traditional medicine were analysed and medicinal plant lists were compiled from healers and herbalists. Plants used were collected, vouchered and deposited in herbaria.

RESULTS

Ferragat remain a key health resource to treat infant ailments in the rural High Atlas, because mothers believe only they can treat what are perceived to be illnesses with a supernatural cause. Ferragat possess baraka, or the gift of healing, and treat mainly three folk ailments, taqait, taumist and iqdi, which present symptoms similar to those of ear infections, tonsillitis and gastroenteritis. Seventy plant species were used to treat these ailments, but the emphasis on plants may be a recent substitute for treatments that used primarily wool and blood. This change in materia medica is a shift in the objects of cultural meaningfulness in response to the increasing influence of orthodox Islam and state-sponsored modernisation, including public healthcare and schooling.

CONCLUSIONS

Religious and other sociocultural changes are impacting the ways in which ferraggat practice. Treatments based on no-longer accepted symbolic elements have been readily abandoned and substituted by licit remedies, namely medicinal plants, which play a legitimisation role for the practice of frigg. However, beliefs in supernatural ailment aetiologies, as well as lack or difficult access to biomedical alternatives, still underlie the need for specialist traditional healers.