Research ArticleDocumentation of Herbal Medicines Used forthe Treatment and Management of Human Diseases bySome Communities in Southern Ghana

Augustine A Boadu and Alex Asase

Department of Plant and Environmental Biology University of Ghana PO Box LG 55 Legon Ghana

Correspondence should be addressed to Alex Asase alexasasegmailcom

Received 19 January 2017 Revised 31 March 2017 Accepted 3 May 2017 Published 8 June 2017

Academic Editor Andrea Pieroni

Copyright copy 2017 Augustine A Boadu and Alex Asase This is an open access article distributed under the Creative CommonsAttribution License which permits unrestricted use distribution and reproduction in any medium provided the original work isproperly cited

Traditional medicine is an important component of the health care system of most developing countries However indigenousknowledge about herbal medicines of many Ghanaian cultures has not yet been investigated The aim of the present study was todocument herbal medicines used by traditional healers to treat and manage human diseases and ailments by some communitiesliving in Ghana The study was conducted in eight communities in southern Ghana Data were collected from 45 healers usingethnobotanical questionnaire and voucher specimens were collected A total of 52 species of plants belonging to 28 plant familieswere reportedly used for treatment andmanagement of 42 diseases and ailments Medicinal plants were commonly harvested fromthe wild and degraded lowland areas in the morning from loamy soil Herbal medicines were prepared in the form of decoctions(67) and infusions (33) Oral administration of the herbals was most (77) common route of administration whereas theleast used routes were nasal (1) and rectal (2) The results of the study show that herbal medicines are used for treatment andmanagement of both common and specialized human diseases and that factors of place and time are considered important duringharvesting of plants for treatments

1 Introduction

According to the World Health Organization (WHO) about80of developing countries depend on traditionalmedicinesfor their primary health care needs [1] In Ghana traditionalmedicine particularly herbal medicines is an importantcomponent of the health care system of the people [2]The utilization of herbal medicines and associated medicinalplants in Ghana has been documented by many authors [eg[3ndash5]] although there are still many indigenous cultures andcommunities inGhana that possess a great store of traditionalknowledge about herbal medicines for treatment of varioushuman ailments which are yet to be documented The useof herbal medicine in Ghana is widespread but highlydiverse due to floristic and cultural diversity and traditionalmedicine has huge impacts on the local economy andbiodiversity conservation The rich history of use of herbalmedicines and innovative utilization of plants as sources of

medicines in Ghana and broadly within Africa has beenpassed down through generations largely as oral tradition[6] and as such it is important that this knowledge bedocumented The WHO has a keen interest in documentingthe use of medicinal plants by indigenous people fromdifferent parts of the world [7]

Documentation of indigenous knowledge about utiliza-tion of medicinal plants is important for a plethora ofreasons Firstly it ensures that indigenous culture heritageis preserved from being lost for the use of both present andfuture generations [8] Studies have indicated that indigenousknowledge about herbal medicines is continuously being lostthrough factors such as acculturation and biodiversity lossesFor example a comparative study of contemporary plant usesin Ghana shows that themateria medica of the Fanti Ga andAshanti has changed considerably over time [6] Secondlythrough further research such as phytochemical biochem-ical pharmacological and clinical studies information on

HindawiEvidence-Based Complementary and Alternative MedicineVolume 2017 Article ID 3043061 12 pageshttpsdoiorg10115520173043061

2 Evidence-Based Complementary and Alternative Medicine

indigenous herbal medicines can lead to discovery of newbioactive agents for treatment of ailments Despite the recentinterest in molecular modelling combinatorial chemistryand other synthetic chemistry techniques by pharmaceuticalcompanies and funding organizations natural products andparticularly medicinal plants remain an important sourceof new drugs new drug leads and new chemical entities(NCEs) [9 10] Thirdly biodiversity conservation can beenhanced when information about plants that are harvestedand utilized in the management of ailments within particularareas are available [3] For biodiversity conservation it isalso important to know what quantities of plant materials areharvested not only for home consumption but also for tradeCommercial trade often stimulates extensive wild-collectionwhich often has negative effects on medicinal plant pop-ulation sizes and recovery after harvesting On the otherhand the trade and marketing of herbal medicine createsemployment for thousands of people for example in Ghana[11] For these reasons the harvest should be documented andsustainable so this can continue to be a profitable resource forfuture generations [12]

The aim of this study was to investigate herbal medicinescommonly used for the treatment andmanagement of humandiseases and ailments by some communities living in south-ern Ghana To the best of our knowledge no specific previousethnobotanical report on use of herbal medicines as yet existsfor the studied communities Here we investigated aspectsof the diversity and harvesting of medicinal plants as well asthe modes of preparation and routes of administration of theherbal medicines It is hoped that this baseline data will inaddition to preservation of indigenous knowledge generateinterest for studies regarding the harvesting patterns bioac-tivity and safety of the medicinal plants being used Specifi-cally our study addressed the following questions (1) Whatare the most important species and families of plants beingused (2) Which plant parts are most frequently used(3) Which diseases are commonly treated with the herbalmedicines (4) What is the percentage of plants that areused for treatment and management of a single diseaseversus multiple diseases (5) Which factors of place andtime are considered important during harvesting of plantsfor treatments (6) What are the most common methodsof preparation and routes of administration of the herbalmedicines We hypothesize that healers are consulted forherbal medicines for the treatment and management of onlyspecialized human diseasesailmentsWe further hypothesizethat factors of place and time are considered importantduring harvesting of individual plants for treatments andmanagement of human diseases by traditional healers

2 Materials and Methods

21 Study Area The present study was conducted in 8 com-munities located within Akuapim-North Municipality andLower Manya-Krobo Municipality in southern Ghana (Fig-ure 1) Selection of the studied communities was basedon preliminary surveys by the first author which showedthat traditional healers in the communities possess rich butundocumented traditional knowledge about use of herbal

medicines The selection of the communities was also basedon the perceived willingness of healers in the communities tocooperate with the objectives of our study

The Akuapim-North Municipality covers a land area ofca 450 km2 and is located on longitude 6∘11015840N and latitude0∘501015840W and at altitude 408m above sea level The major veg-etation type is semidecidous forest and the area is mountain-ous consisting of the Togo-Atakora hills There are two rain-ing seasonsmdasha major rainfall between May and August andtheminor rainfall inOctober Average annual rainfall is about1250ndash1270mm and mean daily temperatures range between25 and 30∘C (httpwwwstatsghanagovgh) The natives arethe Akuapim people although other ethnic groups are com-mon in the area Christianity is the predominant religion inthe area

LowerManya-KroboMunicipality is located between lat-itudes 6∘051015840N and 6∘301015840N and longitudes 0∘81015840W and 0∘201015840Wwith an altitude of 4575m above sea level The vegetationis semidecidous forest with patches of savanna woodlandand dispersed secondary forestsThemunicipality lies withinthe semiequatorial climate belt with mean annual rainfallbetween 9000 and 11500mm Temperatures are usually highranging between 26 and 35∘C Topography is relatively flatwith isolated hills (httpwwwstatsghanagovgh)The nativepeople of the area are Krobo but there are people from otherethnic groups such as Ewes Akans and HausasThemajorityof people are Christians with fewMuslims and Traditionalists(httpwwwstatsghanagovgh)

22 Selection of Healers and Data Collection The presentstudy was conducted following the guidelines of the Codeof Ethics of the International Society of Ethnobiology [13]A total of 80 healers from the study area were initiallyapproached through peer recommendations The purposeof the study including research objectives methods of datacollection and intention to publish data were thoroughlyexplained to each individual healer that was approached Sub-sequently detailed interviews for purposes of data collectionwere carried out with only healers that agreed to participatein the study and have signed an individual written priorinformed consent Data were collected from 45 traditionalhealers (Table 1) through interviews using semistructuredquestionnaire with predetermined open-ended and directquestions [14]The interviews were based on the plants beingused diseases and ailments treatedmodes of preparation andadministration of the herbal remedies and factors of time andplace that they consider as importantwhen harvestingmedic-inal plants Healers were interviewed individually and theinterviews were mostly conducted in their homes and placeswhere they collected plants for treatments

23 Specimen Collection and Plant Identification Plant spec-imens were collected with the healers interviewed in placeswhere they normally collected plant materials for usepressed and processed following standard ethnobotanicalpractices [15] Plant identification was achieved by matchinglocal names with those in standard literature [16] follow-ing the work of [17] as well as by comparison of the

Evidence-Based Complementary and Alternative Medicine 3

Nifa

KodjonyaMenekpo

Kubi

Obom

Atua

Tutu

Lakpa

Yensi

Konko

Akuseakuse

Kpong

Akuni

Mamfe

Sappor

Oborpa

Asifaw

Sokode

Yogaga

Ama-hi

Tinkon

Adenya

Adowso

Abonse

Nyensi

Abiriw

Lartey

Saforo

Mampon

Gyakiti

Asenema

Asamang

Kotogye

Nkyenoa

Kwamoso

Odumase

Apirede

Adukrom

Okorase

Yonurase

Ayermaso

Agyemang Akpekope

Sanfoano

Otwetire

Agomanya

Bueyonye

Bepowasi

AsesiesoAwukugua

Akropong

Achichiso Akuni no1

Kurutiase

Obosomase

Oborpa jct

Okrakwadwo

Paterwonya

Boeriakura

Amanokurom

New mangoase

Piengua yokwenor

Amanfrom akwapim

11000 0 110005500(Meters)

RiversRoads

Lower Manya-Krobo DistrictAkuapem North Municipality

Dawu

Study Communities

Towns

5∘54

㰀0㰀㰀N

6∘0㰀0㰀㰀N

6∘6㰀0㰀㰀N

6∘12

㰀0㰀㰀N

6∘18

㰀0㰀㰀N

5∘54

㰀0㰀㰀N

6∘0㰀0㰀㰀N

6∘6㰀0㰀㰀N

6∘12

㰀0㰀㰀N

6∘18

㰀0㰀㰀N

0∘18

㰀0㰀㰀W 0

∘12

㰀0㰀㰀W 0

∘6㰀0㰀㰀W 0

∘0㰀0㰀㰀

0∘6㰀0㰀㰀E 0

∘12

㰀0㰀㰀E0

∘24

㰀0㰀㰀W

0∘24

㰀0㰀㰀W 0

∘18

㰀0㰀㰀W 0

∘12

㰀0㰀㰀W 0

∘6㰀0㰀㰀W 0

∘0㰀0㰀㰀

0∘6㰀0㰀㰀E 0

∘12

㰀0㰀㰀E

STUDY AREA

N

Bewiase

Figure 1 Map of study area showing communities where study was conducted

voucher specimens collectedwith those in theGhanaHerbar-ium at Department of Plant and Environmental BiologyUniversity of Ghana Classification and names of plantswere authenticated using The Plant List (2013) database(httpwwwtheplantlistorg)

3 Results and Discussion

31 Composition of Herbal Medicines In total 52 speciesof plants belonging to 28 plant families were documented(Table 2) Of the 28 families of plants members of theFabaceae Euphorbiaceae Asteraceae and Sapindaceae werethe most commonly used ones (12 in each case) in theherbal medicines (Figure 2(a)) The use of members ofthe above families in herbal medicines is widely known inGhana [3] It is widely known that members of the familiescontain secondary metabolites such as tannins phenolicsand alkaloids that are responsible for their bioactivity

Trees formed the majority (37) of the plants being used(Figure 2(b)) Two of the species of plants reported being

used namely Pteridium aquilinum (L) Kuhn and Pteridiumesculentum (Forst) Nakai were ferns whereas the rest of theplants were vascular plants There is very little informationon the use of ferns in the Ghanaian traditional pharmacopeia[see eg [3 4]] Speciesmost commonly reported being usedwere Aloe vera L and Paullinia pinnata L with a percentagefrequency of citation 7 each out of a total of 92 citationsAbout 54 of the species reported being used were cited onlyonce by the healers during the period of the current study

Leaves formed 57 of the herbal medicines documentedOther plant parts used were fruits barks and whole plants(Figure 2(c)) Leaves are commonly used in herbal medicinesbecause they represent the site ofmost photosynthetic activityin plants and they also contain very high concentrationsof secondary metabolites The benefit of a high proportionof leaves being used is also that the threat posed to thepopulations of the plant community is minimal comparedto harvesting of roots and barks The use of a combinationof various plants parts formed 18 of the herbal medicinesand this use is well documented in the literature Since the

4 Evidence-Based Complementary and Alternative Medicine

Table 1 Biodata on traditional healers interviewed

Categories Variables Number ofhealers

Percentage ofhealers

Sex Female 13 289Male 32 711

Religion Christians 37 822Traditionalist 8 178

Formaleducation

None 6 133Basic 30 667

Secondary 9 200

Age-groups

40ndash49 11 24450ndash59 10 22260ndash69 10 22270ndash79 9 20080ndash89 4 89ge90 1 22

Years of practice

10ndash19 2 4420ndash29 11 24430ndash39 11 24440ndash49 15 33350ndash59 5 111ge60 1 22

composition of secondary metabolites differs in plant organs[18] the use of different organs of the same plant in the herbalmedicines might be to ensure extraction of the differentbioactive agents

32 Common Human Diseases and Ailments Herbal medici-nes were reportedly used for treatment and management of42 diseases and ailments Two ormore herbal medicines werereportedly used for treatment and management of 17 thediseases andailments and the herbals were most commonlyused for treatment and management of stroke fevers anddiabetes (Figure 3) The herbal medicines were used fortreatment and management of both common ailments (egcuts foot root) as well as the more specialized diseases suchas stroke diabetes cancer and stomach ulcer Some of thediseases such as stroke malaria and HIVAIDS are amongthe top 10 causes of deaths in Ghana (httpswwwcdcgovglobalhealthcountriesghana) Knowledge of frequentlyreported diseases andailments can be an indication of healthcare issues in a region and it should be of great importance tohealth care organizations and government

About 43 of the species of plants were reportedly usedin treatment of a single disease whereas the rest of theplants (57) were involved in treatment of more than onediseaseailment Medicinal plants are commonly used in themanagement of different ailments because they contain avariety of bioactive agents such as alkaloids and terpenoids[18 19] It is possible to isolate the bioactive agents orcompounds from extracts made from plants for detailedpharmacological and clinical investigations to be madeNevertheless in some cases isolation of bioactive agents has

been unsuccessful even though the extracts are active In thelatter case characterization of the active extract could enablestructure-related activity studies leading to possible synthesisof a more potent drug to be developed

33 Harvesting of Plant Materials Almost all the healers(98) interviewed harvested plant materials from lowlandareas (Table 3) About half of the healers harvested plantmaterials from forest-mosaic vegetation type while 7 of thehealers considered vegetation type unimportant when har-vesting plants About 93 of the healers considered the habi-tat of individual plants as important during harvesting Of thehealers who considered habitat as important 44 harvestedplants from the wild and 36 harvested from degraded areasand few (13) of them harvested plants from their homegardens The values of degradedsecondary habitats [20] andhome gardens [21 22] as sources of medicinal plants havebeen discussed by authors Secondary forests are gainingmore importance for medicinal plant collection as old-growth forests are becoming scarce and overexploited [2324] Our result is similar to that of [25] which indicated thathealers favoured primary forest and wild habitats in termsof medicinal plant collection According to [26] if a plantgrows readily in the wild and produces a good yield of activeconstituents or takes several years to mature then collectionfrom the wild is most practicable On the other hand ifplants that are harvested fromwild vegetation are rare or haveendemic status overharvesting can be a particularly seriousthreat [27] About 76 of the healers harvested plants fromloamy soils and 18 from sandy soil None of the healers har-vested plants from clayey soils while about 6 of the healerdid not consider soil type when harvesting plants Healersdid not explain why they avoided clayey soil and we did notfind any scientific evidence that clayey soil plants do not pro-duce pharmacologically active secondary metabolites Soilphysiochemical properties particularly nutrient levels affectgrowth and development of plants The levels of secondarymetabolites in plant tissues vary with resource availability[28] and plant nutrient balance in soil is thought to influenceproduction of secondary compounds at the level of metabolicregulation in plants [29] Topography of an area affectsrainfall soil type and amount of light reaching a plant andtherefore indirectly also affects plant growth and develop-ment In this study about 91of the healers harvestmedicinalplants in areas of flat topography while about 9 of thehealers harvested plants from areas of gentle slope

The time of harvesting medicinal plants was investigatedwith respect to time of day (24 hr duration) and season (dryversuswet season) of the year About 57of healers harvestedplants in themorning followed by 289who collected plantsanytime of the day and then 44 that collected plants in theafternoon None of the healers collected plantmaterials in thenight and about 9 considered time of the day unimportantwhen harvesting plant materials for herbal preparationsPlantsmaterials were harvested in themorning because of theimportance of healthcare to healers as they collected plantsfirst thing in the day About 28 of the healers harvestedplants anytime of the day which might suggest that healersalso collected plants as when they are needed According to

Evidence-Based Complementary and Alternative Medicine 5

Table2Specieso

fplantsreportedlybeingused

byhealersa

rrangedaccordingto

theirfam

ilies

with

inform

ationon

theirh

abitsailm

entstre

atedplant

partsu

sedmetho

dsof

preparation

androuteo

fadm

inistratio

nof

thep

lants

Families

Scientificn

ames

(vou

cher

specim

en)

Localn

ames

(Aku

apem

Krobo

)Frequencyof

citatio

n(

)Habitof

plant

Dise

ases

andailm

ents

Plantp

arts

Metho

dsof

preparation

Routeo

fadministratio

n

Acanthaceae

Ruelliabrevifolia

(Poh

l)C

Ezcurra

(A029)

Mokotso

(Krobo

)11

Herb

Halito

sisLeaf

Infusio

nNasal

Aloaceae

Aloe

vera

L(A

001)

Aloe

65

Herb

Diabetes

Diabetes

Typh

oidfever

Baldness

Leaf

Leaf

Leaf

Leaf

Decoctio

nDecoctio

nInfusio

nDecoctio

n

Oral

Oral

Oral

Topical

Amaranthaceae

Alternanthera

pungensK

unth

(A028)

Nkassenkasee(

Aku

apem

)11

Herb

Stom

achulcer

Who

leplant

Infusio

nRe

ctal

Ann

onaceae

Polya

lthialongifolia

(Son

n)Th

waites

(K001)

Tsogaga(

Krob

o)22

Tree

Fever

Leaf

Decoctio

nOral

Apocyn

aceae

Alsto

niabooneiDe

Wild

(A026)

Nyamedua

(Aku

apem

)11

Tree

Sexu

aldisorders

Root

andbark

Infusio

nTo

pical

Rauvolfia

vomito

riaWennb

erg(A

025)

Unk

nown

11Tree

Oste

oarthritis

Leafandbark

Infusio

nRe

ctal

Ascle

piadaceae

Calotro

pisgigantea

(L)WTA

iton

Unk

nown

11Sh

rub

Heartbu

rns

Leaf

Decoctio

nOral

Asteraceae

Chromolaena

odorata

(L)R

MK

ing

(K003)

Acheam

pong

(Aku

apem

Krobo

)32

Shrub

Typh

oidfever

Stop

bleeding

Typh

oidfever

Leaf

Leaf

Leaf

Decoctio

nDecoctio

nInfusio

n

Oral

Oral

Oral

Laun

aeataraxacifolia

(Wild

)Amin

exC

Jeffrey

(K002)

Unk

nown

32

Herb

Bloo

dpressure

Diuretic

Bloo

dpressure

Leaf

Leaf

Leaf

Infusio

nDecoctio

nInfusio

n

Oral

Oral

Oral

Vernoniaam

ygdalin

aDelile(A

023)

Awun

yun(A

kuapem

)32

Shrub

Malaria

Who

leplant

Infusio

nOral

Vernoniaconferta

Benth(K

010)

Owud

ifukete(A

kuapem

)22

Shrub

Diabetes

Root

andbark

Decoctio

nOral

Bign

oniaceae

Kigelia

afric

ana

(Lam

)Be

nth(K

004)

Nfuten(A

kuapem

)11

Tree

Piles

Bark

Infusio

nOral

Spathodea

campanu

lata

PBe

auv

(K005)

Aku

akua

nisuo(A

kuapem

)11

Tree

Stroke

Leaf

Decoctio

nOral

6 Evidence-Based Complementary and Alternative Medicine

Table2Con

tinued

Families

Scientificn

ames

(vou

cher

specim

en)

Localn

ames

(Aku

apem

Krobo

)Frequencyof

citatio

n(

)Habitof

plant

Dise

ases

andailm

ents

Plantp

arts

Metho

dsof

preparation

Routeo

fadministratio

n

Bombacaceae

Bombax

buonopozenseP

Beauv(A

002)

Nyank

uduroAkonk

odies

(Aku

apem

)Tree

Stroke

Diabetes

Leaf

Leaf

Decoctio

nInfusio

nOral

OralT

opical

Boraginaceae

Heliotropium

indicum

L(K

007)

Akomfemtik

oro

(Aku

apem

)22

Herb

Con

vulsion

Leaf

Infusio

nOral

Capp

aridaceae

Euadeniaem

inensL

(K

008)

Dinsik

uro(A

kuapem

)11

Herb

Lowsperm

coun

tRo

otandbark

Decoctio

nOral

Chrysobalanaceae

Maranthesrobu

sta(O

liv)Prance

(K00

9)Afambere

(Aku

apem

)11

Tree

Rheumatism

Leafandseed

Decoctio

nOralT

opical

Com

bretaceae

Term

inaliasuperba

Englamp

Diels(A

021)

Ofram

(Aku

apem

)11

Tree

Con

vulsion

Root

andbark

Decoctio

nOralT

opical

Cucurbita

ceae

Mom

ordica

charantia

L(K

020)

Nyenye(Kr

obo)

22

Clim

ber

Snakeb

iteDiabetes

Who

leplant

Who

leplant

Infusio

nDecoctio

nOral

Oral

Cyperaceae

CyperusesculentusL

(A

020)

WintoW

intin

o(K

robo

)11

Herb

Typh

oidfever

Who

leplant

Decoctio

nOral

Dennstaedtia

ceae

Pteridium

aquilin

um(L)Ku

hn(A

012)

Unk

nown

11Herb

Fever

Leaf

Decoctio

nOral

Pteridium

esculen

tum

(Forst)N

akai(A

018)

Meyaabea(

Aku

apem

)11

Herb

Menstr

uald

isorders

Leaf

Decoctio

nOral

Euph

orbiaceae

Brideliafer

ruginea

Benth(K

014)

Unk

nown

11Tree

Diarrho

eaRo

otDecoctio

nOral

Discoglyprem

nacaloneura(Pax)P

rain

(A017)

Unk

nown

22

Tree

Stroke

Femaleinfertility

Leafandroot

Leafandroot

Decoctio

nDecoctio

nOral

OralR

ectal

Drypetesa

ubrevillei

Leandri(K0

17)

Duameko(A

kuapem

)11

Shrub

Stroke

Root

Decoctio

nOralT

opical

Drypetesfl

oribun

daHutch(K0

16)

Katirika(

Aku

apem

)11

Shrub

Misc

arria

geRo

otandbark

Decoctio

nOral

Jatro

phacurcas

L(A

014)

Unk

nown

11Sh

rub

Hernia

Leaf

Infusio

nOral

Jatro

phagossy

pifolia

L(A

015)

Unk

nown

11Sh

rub

Highfever

Leafandfruit

Decoctio

nOral

Macaranga

barteri

MullArg(K0

15)

Opam

(Aku

apem

)11

Shrub

Foot

rot

Bark

Decoctio

nOral

Uapaca

guineensis

MullArg(A016)

Agyahere(Aku

apem

)11

Tree

Stroke

Rootbarkand

leaf

Decoctio

nTo

pical

Evidence-Based Complementary and Alternative Medicine 7

Table2Con

tinued

Families

Scientificn

ames

(vou

cher

specim

en)

Localn

ames

(Aku

apem

Krobo

)Frequencyof

citatio

n(

)Habitof

plant

Dise

ases

andailm

ents

Plantp

arts

Metho

dsof

preparation

Routeo

fadministratio

n

Fabaceae

Acaciasenegalen

sis(H

outt)R

oberty

(K022)

Unk

nown

11Tree

Highfever

Leaf

Decoctio

nOral

Albiziafer

ruginea

(GuillampPerr)B

(K021)

Awiemtosamina

(Aku

apem

)11

Tree

Diarrho

eaRo

otDecoctio

nOral

Baphianitid

aLo

dd

(A005)

Odw

aen

11Sh

rub

Retarded

grow

thLeaf

Infusio

nTo

pical

Berliniasp(A013)

Unk

nown

22

Tree

Rheumatism

Fever

Root

andbark

Bark

Infusio

nDecoctio

nTo

pical

Oral

CassiaalataL

(K0

23)

Kobatso(K

robo

)33

Shrub

Purgative

Menstr

uald

isorders

Fertilityprob

lems

Leaf

Leaf

Leaf

Decoctio

nDecoctio

nDecoctio

n

Oral

Oral

Oral

Copaifera

salikound

aHeckel(A030)

Otedu

a(Aku

apem

)22

Tree

Highfever

Piles

Bark

Root

andbark

Decoctio

nDecoctio

nTo

pical

OralR

ectal

Lamiaceae

Ocim

umgratissim

umSeem

(A011)

Nun

num

(Aku

apem

)22

Herb

Bloatin

gLeaf

Infusio

nOralT

opical

Malvaceae

Gossypium

hirsutum

L(K

024)

Asaw

adua

(Aku

apem

)22

Herb

Oste

oarthritis

Infertility

Leaf

Leaf

Infusio

nInfusio

nOral

Oral

Meliaceae

Azadira

chta

indica

A

Juss(A

008)

Nim

tso(K

robo

)54

Tree

Fever

Fever

Malaria

Leaf

Leaf

Leaf

Decoctio

nDecoctio

nDecoctio

n

Oral

Oral

Oral

Khayasenegalen

sisA

Juss(K0

08)

Mahogany

(Aku

apem

Krobo

)33

Tree

Infertility

Maleinfertility

Bark

Leaf

Decoctio

nDecoctio

nOral

Oral

Menisp

ermaceae

Sphenocentriu

mjollyanum

Pierre

(K026)

Kram

aoti(A

kuapem

)11

Herb

Diabetes

Who

leplant

Decoctio

nOral

Moringaceae

Moringa

oleiferaLam

(A007)

Moringa

33

Tree

Bloo

dtonic

Pruritu

sJaun

dice

Leaf

Leaf

Leaf

Decoctio

nDecoctio

nDecoctio

n

Oral

Oral

Oral

Myrtaceae

Psidium

guajavaL

(K028)

Agu

ava(

Aku

apem

Krobo

)22

Shrub

Diarrho

eaRo

otDecoctio

nOral

8 Evidence-Based Complementary and Alternative Medicine

Table2Con

tinued

Families

Scientificn

ames

(vou

cher

specim

en)

Localn

ames

(Aku

apem

Krobo

)Frequencyof

citatio

n(

)Habitof

plant

Dise

ases

andailm

ents

Plantp

arts

Metho

dsof

preparation

Routeo

fadministratio

n

Rutaceae

Citru

ssinensis

Pers

(K030)

Ank

a(Aku

apem

)Kp

eta

(Krobo

)11

Tree

Con

stipation

Leafandfruit

Infusio

nOral

Zanthoxylum

leprie

uriiGuillamp

Perr(K0

29)

Okanto(A

kuapem

)Oyaa

(Krobo

)22

Shrub

Sexu

alweakn

ess

Stroke

Leaf

Root

Decoctio

nDecoctio

nOral

OralT

opical

Sapind

aceae

Lecaniodisc

uscupanioidesP

lanch

(K031)

Unk

nown

11Sh

rub

Stom

achulcer

Leaf

Decoctio

nOral

Paullin

iapinn

ataL

(A002)

Tuatin

(Twi)Detsemam

u(K

robo

)65

Herb

Misc

arria

geStom

achulcer

Stroke

HIV

AID

SBo

nefracture

Leaf

Leaf

Leaf

Leaf

Leaf

Decoctio

nInfusio

nDecoctio

nDecoctio

nInfusio

n

Oral

Oral

Oral

Oral

OralR

ectal

Sapo

taceae

Aningeria

altissim

a(A

Chev)

Aubrev

(K033)

Asanfena

(Twi)

22

Shrub

Stop

sbleeding

Leafandbark

Decoctio

nOral

Malacanthaalnifolia

Pierre

(K032)

Unk

nown

22

Shrub

Misc

arria

geLeaf

Decoctio

nOral

Solanaceae

Physalisangulata

L(K

034)

Totoa(

Krob

o)11

Herb

Cancer

Who

leplant

Infusio

nOralT

opical

Solanu

mmelo

ngena

L(A

003)

Unk

nown

33

Shrub

Anaem

iaFruit

Infusio

nOral

Evidence-Based Complementary and Alternative Medicine 9

Families

0

2

4

6

8

10

12

Num

ber o

f her

bals

spec

ies

Apoc

ynac

eae

Alo

acea

e

Am

aran

thac

eae

Bign

onia

ceae

Capp

arad

acea

e

Euph

orbi

acea

e

Chry

soba

lana

ceae

Den

nsta

edtia

ceae

Bom

baca

ceae

Bora

gina

ceae

Com

bret

acea

e

Lam

iace

ae

Cucu

rbita

ceae

Sapo

tace

ae

Mal

vace

aeAc

anth

acea

e

Ruta

ceae

Men

isper

mac

eae

Meli

acea

eA

stera

ceae

Sola

nace

ae

Cype

race

ae

Ann

onac

eae

Myr

tace

aeSa

pind

acea

e

Mor

inga

ceae

Faba

ceae

Herbal remediesSpecies of plants

(a)

Herbal remediesSpecies of plants

0

5

10

15

20

25

30

35

Num

ber o

f her

bals

spec

ies

Herbs Shrubs ClimbersTreesHabit of plants

(b)

Leaf57Others

18

Whole plant9

Root6

Bark6

Fruit4

(combinationsof variousplant parts)

(c)

Figure 2 Composition of herbal remedies used in terms of (a) plant families (b) habit of plants and (c) percentage of plant parts

the healers they collected plants any time of the day becausethey sometimes needed to treat emergency cases There isscientific evidence to support the fact that yield of some plantchemical constituents differs within a time span of 24 hoursdue to the interconversions of compounds [19] Accordingto [30] time of the day should be given important consid-eration when collecting medicinal plants in order to obtainoptimum yield of desired products For season of the yearmore than half of the healers (67) harvested plants duringboth dry and wet seasons followed by 200 who collectedin only the wet season and about 7 collected in only dryseason About 7 of the healers did not consider season ofthe year as an important factor during harvesting of plant

materials although the availability of certain plant parts couldbe directly related to season of the year

34 Methods of Preparation and Administration of HerbalMedicines Theharvested plantmaterials were used in prepa-ration of 81 herbalmedicinesmainly in the formof decoctions(67) and infusions (33) Although it is documented that avariety of methods have been used for preparation of herbalmedicines themethods of decoctions and infusions have beenthe widely reported [eg [18]] However differences existin the preparations of decoctions and infusions both withinhealers and from place to place In the study area diversityexisted among healers in the amount of menstruum (mainly

10 Evidence-Based Complementary and Alternative Medicine

Diseases andailments treated

Oste

oart

hriti

s

Hig

h bl

ood

pres

sure

Stop

s ble

edin

g

Pile

s

Dia

bete

s

Mal

aria

Typh

oid

feve

r

Con

vulsi

on

Men

strua

l diso

rder

s

Rheu

mat

ism

Feve

rsSt

roke

Dia

rrho

ea

Misc

arria

ges

Hig

h fe

ver

Stom

ach

ulce

r

Ana

emia

0

1

2

3

4

5

6

7

8N

umbe

r of h

erba

l med

icin

es

Figure 3 Human diseases commonly treated andmanaged withherbal medicines

water) length of time of boiling and how long the decoctionswere kept Infusions were made by adding waterlocal gin(akpeteshie) to the pulverized plant materials although theamount of solvent added and duration of use of infusionsdiffered Generally there were no standards in the methodsof preparation of the herbal medicines by even the samehealer and this lack of standardization is amajor disadvantageof traditional medicine [26 31] It also means that herbalmedicines made by the same healer could vary in potencywhich has implications in their use for treatment of patients

The routes of administration of the remedies reportedin this study were oral rectal topical and nasal (Table 1)However the most common route of administration was oral(77) followed by a combination of oral and topical routes(10) whereas the least used routes were nasal (1) and rectal(2)The fact that oral route of administration of the herbalswas most common was not a surprise as this has been previ-ously reported [18 32] However a recent study in [33] foundfrequent use of herbal enemas (rectal) in Western Africantraditional medicine The route of administration of herbalmedicines could be related to bioactive agents in the extractsof the plants [32] For example herbal medicines whosebioactive agents are alkaloids are easily assimilated whenadministered orally while terpenoids especially essential oilsare best administered through dermal andnasal routes Bothdecoctions and infusions were mostly administered orally45 and 17 respectively Only infusions were administeredvia the rectal and nasal routes

4 Conclusions

In this paper we have documented the current state ofknowledge and use of herbal medicines for treatment andmanagement of human diseases among some communitiesliving in southern Ghana This documentation contributes

Table 3 Information on considerations on factors of place andtime during harvesting of medicinal plants by healers in somecommunities in southern Ghana

Placetime Factorsvariables Number ofhealers

Percentage ofhealers

ElevationLowland 44 978Highland 1 22

Unimportant 0 0

Habitat

Wild 20 444Home garden 6 133Degraded area 16 356Unimportant 3 67

Seasonality

Wet season 9 200Dry season 3 67

Both 30 667Unimportant 3 67

Soil type

Loam soil 34 756Sandy soil 8 177Clay soil 0 0

Unimportant 3 67

Time of day

Morning 26 578Eveningnight 0 0Afternoon 2 44Anytime 13 289

Unimportant 4 89

Topography

Steep slope 0 0Gentle slope 4 88Flat land 41 911

Unimportant 0 0

Vegetationtype

Forest 17 378Savanna 2 44

Forest-savannamosaic 23 511

Unimportant 3 66

primary data to the wealth of data stored on the indigenousknowledge on medicinal plants from Ghana The findingsfrom the study suggest that healers are consulted for herbalmedicines for the treatment and management of both com-mon and specialized diseases and ailments The extent towhich the people living in the area consult the healers isunknown but it is important to understanding this in orderto determine the proper role of herbal medicine in the healthcare system of the people It is also essential to scientificallyevaluate the specific uses of the medicinal plants reportedin the current study using plant materials from the areathrough pharmacological toxicological and clinical studiesin order to ensure the safety of the people consuming themedicines and for possible drug development The results ofthe study have also confirmed that factors of time and placeare given considerations during harvesting of plant materialsby healers Further studies on the methods and quantities ofplant materials that are harvested for treatment will improve

Evidence-Based Complementary and Alternative Medicine 11

our understanding on the impacts of harvesting of medicinalplants on biodiversity conservation in the area

Conflicts of Interest

The authors declare that there are no conflicts of interestregarding this manuscript

Authorsrsquo Contributions

Augustine A Boadu conducted field work and identificationof plants Alex Asase conceived idea designed study andwrote manuscript Both authors read and approved the finalmanuscript

Acknowledgments

The authors are grateful to the chiefs and herbalists living inthe study area for providing information and permission topublish the findings of this study Thanks are due to the staffof the Ghana Herbarium for assistance in the identificationof the plantsThe authors also thank the Department of Plantand Environmental Biology at theUniversity of Ghana for theapproval to conduct the study

References

[1] J B Calixto ldquoTwenty-five years of research on medicinal plantsin Latin America a personal viewrdquo Journal of Ethnopharmacol-ogy vol 100 no 1-2 pp 131ndash134 2005

[2] A Hensel E Kisseih M Lechtenberg F Petereit C Agyareand A Asase ldquoFrom ethnopharmacological field study to phy-tochemistry and preclinical research the example of Ghanaianmedicinal plants for improved wound healingrdquo in Ethnophar-macology M Heinrich and A K Jager Eds pp 179ndash197 JohnWiley amp Sons Ltd Chichester UK 1st edition 2015

[3] R N Mshana D K Abbiw I Addae-Mensah et al TraditionalMedicine and Pharmacopoeia Contribution to the Revision ofEthnobotanical and Floristic Studies in Ghana Science andTechnology Press CSIR 2001

[4] D K Abbiw Useful Plants of Ghana Intermediate TechnologyPublication Royal Botanic Gardens LondonKew UK 1990

[5] PORSPI Ghana Herbal Pharmacopoeia Policy Research andStrategic Planning Institute Council for Scientific and Indus-trial Research CSIR Ghana 1992

[6] J Soelberg A Asase G Akwetey and A K Jager ldquoHistoricalversus contemporary medicinal plant uses in Ghanardquo Journal ofEthnopharmacology vol 160 pp 109ndash132 2015

[7] J Buragohain ldquoEthnomedicinal plants used by the ethnic com-munities of Tinsukia district of Assam Indiardquo Research inScience and Technology vol 3 pp 31ndash42 2011

[8] S T Mahwasane L Middleton and N Boaduo ldquoAn ethnob-otanical survey of indigenous knowledge on medicinal plantsused by the traditional healers of the Lwamondo area Limpopoprovince SouthAfricardquo South African Journal of Botany vol 88pp 69ndash75 2013

[9] D J Newman G M Cragg and K M Snader ldquoNatural pro-ducts as sources of new drugs over the period 1981ndash2002rdquoJournal of Natural Products vol 66 no 7 pp 1022ndash1037 2003

[10] M S Butler ldquoThe role of natural product chemistry in drugdiscoveryrdquo Journal of Natural Products vol 67 no 12 pp 2141ndash2153 2004

[11] T van Andel B Myren and S Van Onselen ldquoGhanarsquos herbalmarketrdquo Journal of Ethnopharmacology vol 140 no 2 pp 368ndash378 2012

[12] T R van Andel S Croft E E van Loon D Quiroz A MTowns andNRaes ldquoPrioritizingWestAfricanmedicinal plantsfor conservation and sustainable extraction studies based onmarket surveys and species distribution modelsrdquo BiologicalConservation vol 181 pp 173ndash181 2015

[13] ISE International Society of Ethnobiology Code of Ethics 2016httpwwwethnobiologynetethicsphp

[14] S Ragosta I Harris N Gyakari E Otoo and A AsaseldquoPartcipatory ethnomedicinal cancer research with Fante-Akanherbalists in rural Ghanardquo Ethnobiology Letters vol 6 no 1 pp66ndash79 2015

[15] G Martin EthnobotanymdashA Manual of Methods EarthsacnPublishers Limited London UK 1995

[16] W Hawthorne and N Gyakari Photoguide for the Trees ofGhana Oxford Forestry Institute 2006

[17] A Asase and G Oppong-Mensah ldquoTraditional antimalarialphytotherapy remedies in herbal markets in southern GhanardquoJournal of Ethnopharmacology vol 126 no 3 pp 492ndash499 2009

[18] K Busia Fundamentals of HerbalMedicine vol 1 amp 2 LightningSource UK Ltd Milton Keynes UK 2016

[19] W C Evans Trease and Evans Pharmacognosy WR SaundersLondon UK 16th edition 2009

[20] A M Towns S Ruysschaert E van Vliet and T van AndelldquoEvidence in support of the role of disturbance vegetation forwomenrsquos health and childcare in Western Africardquo Journal ofEthnobiology and Ethnomedicine vol 10 no 1 p 42 2014

[21] A Agelet M A Bonet and J Valles ldquoHomegardens and theirrole as a main source of medicinal plants in mountain regionsof Catalonia (Iberian Peninsula)rdquo Economic Botany vol 54 no3 pp 295ndash309 2000

[22] C High and C M Shackleton ldquoThe comparative value of wildand domestic plants in home gardens of a South African ruralvillagerdquo Agroforestry Systems vol 48 no 2 pp 141ndash156 2000

[23] J Salick A Mejia and T Anderson ldquoNon-timber forestproducts integrated with natural forest management Rio SanJuan Nicaraguardquo Ecological Applications vol 5 no 4 pp 878ndash895 1995

[24] R L Chazdon and F G Coe ldquoEthnobotany of woody speciesin second-growth old-growth and selectively logged forests ofnortheastern Costa Ricardquo Conservation Biology vol 13 no 6pp 1312ndash1322 1999

[25] R M Kunwar L Mahat R P Acharya and R W Buss-mann ldquoMedicinal plants traditional medicine markets andmanagement in far-west Nepalrdquo Journal of Ethnobiology andEthnomedicine vol 9 no 1 article no 24 2013

[26] A Sofowora Medicinal Plants and Traditional Medicine inAfrica Spectrum Books Ibadan Nigeria 3rd edition 2008

[27] A P Dold and M L Cocks ldquoThe trade in medicinal plants inthe Eastern Cape Province South Africardquo South African Journalof Science vol 98 no 11-12 pp 589ndash597 2002

[28] P D Coley J P Bryant and F S Chapin III ldquoResourceavailability and plant antiherbivore defenserdquo Science vol 230no 4728 pp 895ndash899 1985

[29] D A Herms andW JMattson ldquoThe dilemma of plants to growor defendrdquo Quarterly Review of Biology vol 67 no 3 pp 283ndash335 1992

6 Evidence-Based Complementary and Alternative Medicine

Table2Con

tinued

Families

Scientificn

ames

(vou

cher

specim

en)

Localn

ames

(Aku

apem

Krobo

)Frequencyof

citatio

n(

)Habitof

plant

Dise

ases

andailm

ents

Plantp

arts

Metho

dsof

preparation

Routeo

fadministratio

n

Bombacaceae

Bombax

buonopozenseP

Beauv(A

002)

Nyank

uduroAkonk

odies

(Aku

apem

)Tree

Stroke

Diabetes

Leaf

Leaf

Decoctio

nInfusio

nOral

OralT

opical

Boraginaceae

Heliotropium

indicum

L(K

007)

Akomfemtik

oro

(Aku

apem

)22

Herb

Con

vulsion

Leaf

Infusio

nOral

Capp

aridaceae

Euadeniaem

inensL

(K

008)

Dinsik

uro(A

kuapem

)11

Herb

Lowsperm

coun

tRo

otandbark

Decoctio

nOral

Chrysobalanaceae

Maranthesrobu

sta(O

liv)Prance

(K00

9)Afambere

(Aku

apem

)11

Tree

Rheumatism

Leafandseed

Decoctio

nOralT

opical

Com

bretaceae

Term

inaliasuperba

Englamp

Diels(A

021)

Ofram

(Aku

apem

)11

Tree

Con

vulsion

Root

andbark

Decoctio

nOralT

opical

Cucurbita

ceae

Mom

ordica

charantia

L(K

020)

Nyenye(Kr

obo)

22

Clim

ber

Snakeb

iteDiabetes

Who

leplant

Who

leplant

Infusio

nDecoctio

nOral

Oral

Cyperaceae

CyperusesculentusL

(A

020)

WintoW

intin

o(K

robo

)11

Herb

Typh

oidfever

Who

leplant

Decoctio

nOral

Dennstaedtia

ceae

Pteridium

aquilin

um(L)Ku

hn(A

012)

Unk

nown

11Herb

Fever

Leaf

Decoctio

nOral

Pteridium

esculen

tum

(Forst)N

akai(A

018)

Meyaabea(

Aku

apem

)11

Herb

Menstr

uald

isorders

Leaf

Decoctio

nOral

Euph

orbiaceae

Brideliafer

ruginea

Benth(K

014)

Unk

nown

11Tree

Diarrho

eaRo

otDecoctio

nOral

Discoglyprem

nacaloneura(Pax)P

rain

(A017)

Unk

nown

22

Tree

Stroke

Femaleinfertility

Leafandroot

Leafandroot

Decoctio

nDecoctio

nOral

OralR

ectal

Drypetesa

ubrevillei

Leandri(K0

17)

Duameko(A

kuapem

)11

Shrub

Stroke

Root

Decoctio

nOralT

opical

Drypetesfl

oribun

daHutch(K0

16)

Katirika(

Aku

apem

)11

Shrub

Misc

arria

geRo

otandbark

Decoctio

nOral

Jatro

phacurcas

L(A

014)

Unk

nown

11Sh

rub

Hernia

Leaf

Infusio

nOral

Jatro

phagossy

pifolia

L(A

015)

Unk

nown

11Sh

rub

Highfever

Leafandfruit

Decoctio

nOral

Macaranga

barteri

MullArg(K0

15)

Opam

(Aku

apem

)11

Shrub

Foot

rot

Bark

Decoctio

nOral

Uapaca

guineensis

MullArg(A016)

Agyahere(Aku

apem

)11

Tree

Stroke

Rootbarkand

leaf

Decoctio

nTo

pical

Evidence-Based Complementary and Alternative Medicine 7

Table2Con

tinued

Families

Scientificn

ames

(vou

cher

specim

en)

Localn

ames

(Aku

apem

Krobo

)Frequencyof

citatio

n(

)Habitof

plant

Dise

ases

andailm

ents

Plantp

arts

Metho

dsof

preparation

Routeo

fadministratio

n

Fabaceae

Acaciasenegalen

sis(H

outt)R

oberty

(K022)

Unk

nown

11Tree

Highfever

Leaf

Decoctio

nOral

Albiziafer

ruginea

(GuillampPerr)B

(K021)

Awiemtosamina

(Aku

apem

)11

Tree

Diarrho

eaRo

otDecoctio

nOral

Baphianitid

aLo

dd

(A005)

Odw

aen

11Sh

rub

Retarded

grow

thLeaf

Infusio

nTo

pical

Berliniasp(A013)

Unk

nown

22

Tree

Rheumatism

Fever

Root

andbark

Bark

Infusio

nDecoctio

nTo

pical

Oral

CassiaalataL

(K0

23)

Kobatso(K

robo

)33

Shrub

Purgative

Menstr

uald

isorders

Fertilityprob

lems

Leaf

Leaf

Leaf

Decoctio

nDecoctio

nDecoctio

n

Oral

Oral

Oral

Copaifera

salikound

aHeckel(A030)

Otedu

a(Aku

apem

)22

Tree

Highfever

Piles

Bark

Root

andbark

Decoctio

nDecoctio

nTo

pical

OralR

ectal

Lamiaceae

Ocim

umgratissim

umSeem

(A011)

Nun

num

(Aku

apem

)22

Herb

Bloatin

gLeaf

Infusio

nOralT

opical

Malvaceae

Gossypium

hirsutum

L(K

024)

Asaw

adua

(Aku

apem

)22

Herb

Oste

oarthritis

Infertility

Leaf

Leaf

Infusio

nInfusio

nOral

Oral

Meliaceae

Azadira

chta

indica

A

Juss(A

008)

Nim

tso(K

robo

)54

Tree

Fever

Fever

Malaria

Leaf

Leaf

Leaf

Decoctio

nDecoctio

nDecoctio

n

Oral

Oral

Oral

Khayasenegalen

sisA

Juss(K0

08)

Mahogany

(Aku

apem

Krobo

)33

Tree

Infertility

Maleinfertility

Bark

Leaf

Decoctio

nDecoctio

nOral

Oral

Menisp

ermaceae

Sphenocentriu

mjollyanum

Pierre

(K026)

Kram

aoti(A

kuapem

)11

Herb

Diabetes

Who

leplant

Decoctio

nOral

Moringaceae

Moringa

oleiferaLam

(A007)

Moringa

33

Tree

Bloo

dtonic

Pruritu

sJaun

dice

Leaf

Leaf

Leaf

Decoctio

nDecoctio

nDecoctio

n

Oral

Oral

Oral

Myrtaceae

Psidium

guajavaL

(K028)

Agu

ava(

Aku

apem

Krobo

)22

Shrub

Diarrho

eaRo

otDecoctio

nOral

8 Evidence-Based Complementary and Alternative Medicine

Table2Con

tinued

Families

Scientificn

ames

(vou

cher

specim

en)

Localn

ames

(Aku

apem

Krobo

)Frequencyof

citatio

n(

)Habitof

plant

Dise

ases

andailm

ents

Plantp

arts

Metho

dsof

preparation

Routeo

fadministratio

n

Rutaceae

Citru

ssinensis

Pers

(K030)

Ank

a(Aku

apem

)Kp

eta

(Krobo

)11

Tree

Con

stipation

Leafandfruit

Infusio

nOral

Zanthoxylum

leprie

uriiGuillamp

Perr(K0

29)

Okanto(A

kuapem

)Oyaa

(Krobo

)22

Shrub

Sexu

alweakn

ess

Stroke

Leaf

Root

Decoctio

nDecoctio

nOral

OralT

opical

Sapind

aceae

Lecaniodisc

uscupanioidesP

lanch

(K031)

Unk

nown

11Sh

rub

Stom

achulcer

Leaf

Decoctio

nOral

Paullin

iapinn

ataL

(A002)

Tuatin

(Twi)Detsemam

u(K

robo

)65

Herb

Misc

arria

geStom

achulcer

Stroke

HIV

AID

SBo

nefracture

Leaf

Leaf

Leaf

Leaf

Leaf

Decoctio

nInfusio

nDecoctio

nDecoctio

nInfusio

n

Oral

Oral

Oral

Oral

OralR

ectal

Sapo

taceae

Aningeria

altissim

a(A

Chev)

Aubrev

(K033)

Asanfena

(Twi)

22

Shrub

Stop

sbleeding

Leafandbark

Decoctio

nOral

Malacanthaalnifolia

Pierre

(K032)

Unk

nown

22

Shrub

Misc

arria

geLeaf

Decoctio

nOral

Solanaceae

Physalisangulata

L(K

034)

Totoa(

Krob

o)11

Herb

Cancer

Who

leplant

Infusio

nOralT

opical

Solanu

mmelo

ngena

L(A

003)

Unk

nown

33

Shrub

Anaem

iaFruit

Infusio

nOral

Evidence-Based Complementary and Alternative Medicine 9

Families

0

2

4

6

8

10

12

Num

ber o

f her

bals

spec

ies

Apoc

ynac

eae

Alo

acea

e

Am

aran

thac

eae

Bign

onia

ceae

Capp

arad

acea

e

Euph

orbi

acea

e

Chry

soba

lana

ceae

Den

nsta

edtia

ceae

Bom

baca

ceae

Bora

gina

ceae

Com

bret

acea

e

Lam

iace

ae

Cucu

rbita

ceae

Sapo

tace

ae

Mal

vace

aeAc

anth

acea

e

Ruta

ceae

Men

isper

mac

eae

Meli

acea

eA

stera

ceae

Sola

nace

ae

Cype

race

ae

Ann

onac

eae

Myr

tace

aeSa

pind

acea

e

Mor

inga

ceae

Faba

ceae

Herbal remediesSpecies of plants

(a)

Herbal remediesSpecies of plants

0

5

10

15

20

25

30

35

Num

ber o

f her

bals

spec

ies

Herbs Shrubs ClimbersTreesHabit of plants

(b)

Leaf57Others

18

Whole plant9

Root6

Bark6

Fruit4

(combinationsof variousplant parts)

(c)

Figure 2 Composition of herbal remedies used in terms of (a) plant families (b) habit of plants and (c) percentage of plant parts

the healers they collected plants any time of the day becausethey sometimes needed to treat emergency cases There isscientific evidence to support the fact that yield of some plantchemical constituents differs within a time span of 24 hoursdue to the interconversions of compounds [19] Accordingto [30] time of the day should be given important consid-eration when collecting medicinal plants in order to obtainoptimum yield of desired products For season of the yearmore than half of the healers (67) harvested plants duringboth dry and wet seasons followed by 200 who collectedin only the wet season and about 7 collected in only dryseason About 7 of the healers did not consider season ofthe year as an important factor during harvesting of plant

materials although the availability of certain plant parts couldbe directly related to season of the year

34 Methods of Preparation and Administration of HerbalMedicines Theharvested plantmaterials were used in prepa-ration of 81 herbalmedicinesmainly in the formof decoctions(67) and infusions (33) Although it is documented that avariety of methods have been used for preparation of herbalmedicines themethods of decoctions and infusions have beenthe widely reported [eg [18]] However differences existin the preparations of decoctions and infusions both withinhealers and from place to place In the study area diversityexisted among healers in the amount of menstruum (mainly

10 Evidence-Based Complementary and Alternative Medicine

Diseases andailments treated

Oste

oart

hriti

s

Hig

h bl

ood

pres

sure

Stop

s ble

edin

g

Pile

s

Dia

bete

s

Mal

aria

Typh

oid

feve

r

Con

vulsi

on

Men

strua

l diso

rder

s

Rheu

mat

ism

Feve

rsSt

roke

Dia

rrho

ea

Misc

arria

ges

Hig

h fe

ver

Stom

ach

ulce

r

Ana

emia

0

1

2

3

4

5

6

7

8N

umbe

r of h

erba

l med

icin

es

Figure 3 Human diseases commonly treated andmanaged withherbal medicines

water) length of time of boiling and how long the decoctionswere kept Infusions were made by adding waterlocal gin(akpeteshie) to the pulverized plant materials although theamount of solvent added and duration of use of infusionsdiffered Generally there were no standards in the methodsof preparation of the herbal medicines by even the samehealer and this lack of standardization is amajor disadvantageof traditional medicine [26 31] It also means that herbalmedicines made by the same healer could vary in potencywhich has implications in their use for treatment of patients

The routes of administration of the remedies reportedin this study were oral rectal topical and nasal (Table 1)However the most common route of administration was oral(77) followed by a combination of oral and topical routes(10) whereas the least used routes were nasal (1) and rectal(2)The fact that oral route of administration of the herbalswas most common was not a surprise as this has been previ-ously reported [18 32] However a recent study in [33] foundfrequent use of herbal enemas (rectal) in Western Africantraditional medicine The route of administration of herbalmedicines could be related to bioactive agents in the extractsof the plants [32] For example herbal medicines whosebioactive agents are alkaloids are easily assimilated whenadministered orally while terpenoids especially essential oilsare best administered through dermal andnasal routes Bothdecoctions and infusions were mostly administered orally45 and 17 respectively Only infusions were administeredvia the rectal and nasal routes

4 Conclusions

In this paper we have documented the current state ofknowledge and use of herbal medicines for treatment andmanagement of human diseases among some communitiesliving in southern Ghana This documentation contributes

Table 3 Information on considerations on factors of place andtime during harvesting of medicinal plants by healers in somecommunities in southern Ghana

Placetime Factorsvariables Number ofhealers

Percentage ofhealers

ElevationLowland 44 978Highland 1 22

Unimportant 0 0

Habitat

Wild 20 444Home garden 6 133Degraded area 16 356Unimportant 3 67

Seasonality

Wet season 9 200Dry season 3 67

Both 30 667Unimportant 3 67

Soil type

Loam soil 34 756Sandy soil 8 177Clay soil 0 0

Unimportant 3 67

Time of day

Morning 26 578Eveningnight 0 0Afternoon 2 44Anytime 13 289

Unimportant 4 89

Topography

Steep slope 0 0Gentle slope 4 88Flat land 41 911

Unimportant 0 0

Vegetationtype

Forest 17 378Savanna 2 44

Forest-savannamosaic 23 511

Unimportant 3 66

primary data to the wealth of data stored on the indigenousknowledge on medicinal plants from Ghana The findingsfrom the study suggest that healers are consulted for herbalmedicines for the treatment and management of both com-mon and specialized diseases and ailments The extent towhich the people living in the area consult the healers isunknown but it is important to understanding this in orderto determine the proper role of herbal medicine in the healthcare system of the people It is also essential to scientificallyevaluate the specific uses of the medicinal plants reportedin the current study using plant materials from the areathrough pharmacological toxicological and clinical studiesin order to ensure the safety of the people consuming themedicines and for possible drug development The results ofthe study have also confirmed that factors of time and placeare given considerations during harvesting of plant materialsby healers Further studies on the methods and quantities ofplant materials that are harvested for treatment will improve

Evidence-Based Complementary and Alternative Medicine 11

our understanding on the impacts of harvesting of medicinalplants on biodiversity conservation in the area

Conflicts of Interest

The authors declare that there are no conflicts of interestregarding this manuscript

Authorsrsquo Contributions

Augustine A Boadu conducted field work and identificationof plants Alex Asase conceived idea designed study andwrote manuscript Both authors read and approved the finalmanuscript

Acknowledgments

The authors are grateful to the chiefs and herbalists living inthe study area for providing information and permission topublish the findings of this study Thanks are due to the staffof the Ghana Herbarium for assistance in the identificationof the plantsThe authors also thank the Department of Plantand Environmental Biology at theUniversity of Ghana for theapproval to conduct the study

References

[1] J B Calixto ldquoTwenty-five years of research on medicinal plantsin Latin America a personal viewrdquo Journal of Ethnopharmacol-ogy vol 100 no 1-2 pp 131ndash134 2005

[2] A Hensel E Kisseih M Lechtenberg F Petereit C Agyareand A Asase ldquoFrom ethnopharmacological field study to phy-tochemistry and preclinical research the example of Ghanaianmedicinal plants for improved wound healingrdquo in Ethnophar-macology M Heinrich and A K Jager Eds pp 179ndash197 JohnWiley amp Sons Ltd Chichester UK 1st edition 2015

[3] R N Mshana D K Abbiw I Addae-Mensah et al TraditionalMedicine and Pharmacopoeia Contribution to the Revision ofEthnobotanical and Floristic Studies in Ghana Science andTechnology Press CSIR 2001

[4] D K Abbiw Useful Plants of Ghana Intermediate TechnologyPublication Royal Botanic Gardens LondonKew UK 1990

[5] PORSPI Ghana Herbal Pharmacopoeia Policy Research andStrategic Planning Institute Council for Scientific and Indus-trial Research CSIR Ghana 1992

[6] J Soelberg A Asase G Akwetey and A K Jager ldquoHistoricalversus contemporary medicinal plant uses in Ghanardquo Journal ofEthnopharmacology vol 160 pp 109ndash132 2015

[7] J Buragohain ldquoEthnomedicinal plants used by the ethnic com-munities of Tinsukia district of Assam Indiardquo Research inScience and Technology vol 3 pp 31ndash42 2011

[8] S T Mahwasane L Middleton and N Boaduo ldquoAn ethnob-otanical survey of indigenous knowledge on medicinal plantsused by the traditional healers of the Lwamondo area Limpopoprovince SouthAfricardquo South African Journal of Botany vol 88pp 69ndash75 2013

[9] D J Newman G M Cragg and K M Snader ldquoNatural pro-ducts as sources of new drugs over the period 1981ndash2002rdquoJournal of Natural Products vol 66 no 7 pp 1022ndash1037 2003

[10] M S Butler ldquoThe role of natural product chemistry in drugdiscoveryrdquo Journal of Natural Products vol 67 no 12 pp 2141ndash2153 2004

[11] T van Andel B Myren and S Van Onselen ldquoGhanarsquos herbalmarketrdquo Journal of Ethnopharmacology vol 140 no 2 pp 368ndash378 2012

[12] T R van Andel S Croft E E van Loon D Quiroz A MTowns andNRaes ldquoPrioritizingWestAfricanmedicinal plantsfor conservation and sustainable extraction studies based onmarket surveys and species distribution modelsrdquo BiologicalConservation vol 181 pp 173ndash181 2015

[13] ISE International Society of Ethnobiology Code of Ethics 2016httpwwwethnobiologynetethicsphp

[14] S Ragosta I Harris N Gyakari E Otoo and A AsaseldquoPartcipatory ethnomedicinal cancer research with Fante-Akanherbalists in rural Ghanardquo Ethnobiology Letters vol 6 no 1 pp66ndash79 2015

[15] G Martin EthnobotanymdashA Manual of Methods EarthsacnPublishers Limited London UK 1995

[16] W Hawthorne and N Gyakari Photoguide for the Trees ofGhana Oxford Forestry Institute 2006

[17] A Asase and G Oppong-Mensah ldquoTraditional antimalarialphytotherapy remedies in herbal markets in southern GhanardquoJournal of Ethnopharmacology vol 126 no 3 pp 492ndash499 2009

[18] K Busia Fundamentals of HerbalMedicine vol 1 amp 2 LightningSource UK Ltd Milton Keynes UK 2016

[19] W C Evans Trease and Evans Pharmacognosy WR SaundersLondon UK 16th edition 2009

[20] A M Towns S Ruysschaert E van Vliet and T van AndelldquoEvidence in support of the role of disturbance vegetation forwomenrsquos health and childcare in Western Africardquo Journal ofEthnobiology and Ethnomedicine vol 10 no 1 p 42 2014

[21] A Agelet M A Bonet and J Valles ldquoHomegardens and theirrole as a main source of medicinal plants in mountain regionsof Catalonia (Iberian Peninsula)rdquo Economic Botany vol 54 no3 pp 295ndash309 2000

[22] C High and C M Shackleton ldquoThe comparative value of wildand domestic plants in home gardens of a South African ruralvillagerdquo Agroforestry Systems vol 48 no 2 pp 141ndash156 2000

[23] J Salick A Mejia and T Anderson ldquoNon-timber forestproducts integrated with natural forest management Rio SanJuan Nicaraguardquo Ecological Applications vol 5 no 4 pp 878ndash895 1995

[24] R L Chazdon and F G Coe ldquoEthnobotany of woody speciesin second-growth old-growth and selectively logged forests ofnortheastern Costa Ricardquo Conservation Biology vol 13 no 6pp 1312ndash1322 1999

[25] R M Kunwar L Mahat R P Acharya and R W Buss-mann ldquoMedicinal plants traditional medicine markets andmanagement in far-west Nepalrdquo Journal of Ethnobiology andEthnomedicine vol 9 no 1 article no 24 2013

[26] A Sofowora Medicinal Plants and Traditional Medicine inAfrica Spectrum Books Ibadan Nigeria 3rd edition 2008

[27] A P Dold and M L Cocks ldquoThe trade in medicinal plants inthe Eastern Cape Province South Africardquo South African Journalof Science vol 98 no 11-12 pp 589ndash597 2002

[28] P D Coley J P Bryant and F S Chapin III ldquoResourceavailability and plant antiherbivore defenserdquo Science vol 230no 4728 pp 895ndash899 1985

[29] D A Herms andW JMattson ldquoThe dilemma of plants to growor defendrdquo Quarterly Review of Biology vol 67 no 3 pp 283ndash335 1992

Evidence-Based Complementary and Alternative Medicine 7

Table2Con

tinued

Families

Scientificn

ames

(vou

cher

specim

en)

Localn

ames

(Aku

apem

Krobo

)Frequencyof

citatio

n(

)Habitof

plant

Dise

ases

andailm

ents

Plantp

arts

Metho

dsof

preparation

Routeo

fadministratio

n

Fabaceae

Acaciasenegalen

sis(H

outt)R

oberty

(K022)

Unk

nown

11Tree

Highfever

Leaf

Decoctio

nOral

Albiziafer

ruginea

(GuillampPerr)B

(K021)

Awiemtosamina

(Aku

apem

)11

Tree

Diarrho

eaRo

otDecoctio

nOral

Baphianitid

aLo

dd

(A005)

Odw

aen

11Sh

rub

Retarded

grow

thLeaf

Infusio

nTo

pical

Berliniasp(A013)

Unk

nown

22

Tree

Rheumatism

Fever

Root

andbark

Bark

Infusio

nDecoctio

nTo

pical

Oral

CassiaalataL

(K0

23)

Kobatso(K

robo

)33

Shrub

Purgative

Menstr

uald

isorders

Fertilityprob

lems

Leaf

Leaf

Leaf

Decoctio

nDecoctio

nDecoctio

n

Oral

Oral

Oral

Copaifera

salikound

aHeckel(A030)

Otedu

a(Aku

apem

)22

Tree

Highfever

Piles

Bark

Root

andbark

Decoctio

nDecoctio

nTo

pical

OralR

ectal

Lamiaceae

Ocim

umgratissim

umSeem

(A011)

Nun

num

(Aku

apem

)22

Herb

Bloatin

gLeaf

Infusio

nOralT

opical

Malvaceae

Gossypium

hirsutum

L(K

024)

Asaw

adua

(Aku

apem

)22

Herb

Oste

oarthritis

Infertility

Leaf

Leaf

Infusio

nInfusio

nOral

Oral

Meliaceae

Azadira

chta

indica

A

Juss(A

008)

Nim

tso(K

robo

)54

Tree

Fever

Fever

Malaria

Leaf

Leaf

Leaf

Decoctio

nDecoctio

nDecoctio

n

Oral

Oral

Oral

Khayasenegalen

sisA

Juss(K0

08)

Mahogany

(Aku

apem

Krobo

)33

Tree

Infertility

Maleinfertility

Bark

Leaf

Decoctio

nDecoctio

nOral

Oral

Menisp

ermaceae

Sphenocentriu

mjollyanum

Pierre

(K026)

Kram

aoti(A

kuapem

)11

Herb

Diabetes

Who

leplant

Decoctio

nOral

Moringaceae

Moringa

oleiferaLam

(A007)

Moringa

33

Tree

Bloo

dtonic

Pruritu

sJaun

dice

Leaf

Leaf

Leaf

Decoctio

nDecoctio

nDecoctio

n

Oral

Oral

Oral

Myrtaceae

Psidium

guajavaL

(K028)

Agu

ava(

Aku

apem

Krobo

)22

Shrub

Diarrho

eaRo

otDecoctio

nOral

8 Evidence-Based Complementary and Alternative Medicine

Table2Con

tinued

Families

Scientificn

ames

(vou

cher

specim

en)

Localn

ames

(Aku

apem

Krobo

)Frequencyof

citatio

n(

)Habitof

plant

Dise

ases

andailm

ents

Plantp

arts

Metho

dsof

preparation

Routeo

fadministratio

n

Rutaceae

Citru

ssinensis

Pers

(K030)

Ank

a(Aku

apem

)Kp

eta

(Krobo

)11

Tree

Con

stipation

Leafandfruit

Infusio

nOral

Zanthoxylum

leprie

uriiGuillamp

Perr(K0

29)

Okanto(A

kuapem

)Oyaa

(Krobo

)22

Shrub

Sexu

alweakn

ess

Stroke

Leaf

Root

Decoctio

nDecoctio

nOral

OralT

opical

Sapind

aceae

Lecaniodisc

uscupanioidesP

lanch

(K031)

Unk

nown

11Sh

rub

Stom

achulcer

Leaf

Decoctio

nOral

Paullin

iapinn

ataL

(A002)

Tuatin

(Twi)Detsemam

u(K

robo

)65

Herb

Misc

arria

geStom

achulcer

Stroke

HIV

AID

SBo

nefracture

Leaf

Leaf

Leaf

Leaf

Leaf

Decoctio

nInfusio

nDecoctio

nDecoctio

nInfusio

n

Oral

Oral

Oral

Oral

OralR

ectal

Sapo

taceae

Aningeria

altissim

a(A

Chev)

Aubrev

(K033)

Asanfena

(Twi)

22

Shrub

Stop

sbleeding

Leafandbark

Decoctio

nOral

Malacanthaalnifolia

Pierre

(K032)

Unk

nown

22

Shrub

Misc

arria

geLeaf

Decoctio

nOral

Solanaceae

Physalisangulata

L(K

034)

Totoa(

Krob

o)11

Herb

Cancer

Who

leplant

Infusio

nOralT

opical

Solanu

mmelo

ngena

L(A

003)

Unk

nown

33

Shrub

Anaem

iaFruit

Infusio

nOral

Evidence-Based Complementary and Alternative Medicine 9

Families

0

2

4

6

8

10

12

Num

ber o

f her

bals

spec

ies

Apoc

ynac

eae

Alo

acea

e

Am

aran

thac

eae

Bign

onia

ceae

Capp

arad

acea

e

Euph

orbi

acea

e

Chry

soba

lana

ceae

Den

nsta

edtia

ceae

Bom

baca

ceae

Bora

gina

ceae

Com

bret

acea

e

Lam

iace

ae

Cucu

rbita

ceae

Sapo

tace

ae

Mal

vace

aeAc

anth

acea

e

Ruta

ceae

Men

isper

mac

eae

Meli

acea

eA

stera

ceae

Sola

nace

ae

Cype

race

ae

Ann

onac

eae

Myr

tace

aeSa

pind

acea

e

Mor

inga

ceae

Faba

ceae

Herbal remediesSpecies of plants

(a)

Herbal remediesSpecies of plants

0

5

10

15

20

25

30

35

Num

ber o

f her

bals

spec

ies

Herbs Shrubs ClimbersTreesHabit of plants

(b)

Leaf57Others

18

Whole plant9

Root6

Bark6

Fruit4

(combinationsof variousplant parts)

(c)

Figure 2 Composition of herbal remedies used in terms of (a) plant families (b) habit of plants and (c) percentage of plant parts

the healers they collected plants any time of the day becausethey sometimes needed to treat emergency cases There isscientific evidence to support the fact that yield of some plantchemical constituents differs within a time span of 24 hoursdue to the interconversions of compounds [19] Accordingto [30] time of the day should be given important consid-eration when collecting medicinal plants in order to obtainoptimum yield of desired products For season of the yearmore than half of the healers (67) harvested plants duringboth dry and wet seasons followed by 200 who collectedin only the wet season and about 7 collected in only dryseason About 7 of the healers did not consider season ofthe year as an important factor during harvesting of plant

materials although the availability of certain plant parts couldbe directly related to season of the year

34 Methods of Preparation and Administration of HerbalMedicines Theharvested plantmaterials were used in prepa-ration of 81 herbalmedicinesmainly in the formof decoctions(67) and infusions (33) Although it is documented that avariety of methods have been used for preparation of herbalmedicines themethods of decoctions and infusions have beenthe widely reported [eg [18]] However differences existin the preparations of decoctions and infusions both withinhealers and from place to place In the study area diversityexisted among healers in the amount of menstruum (mainly

10 Evidence-Based Complementary and Alternative Medicine

Diseases andailments treated

Oste

oart

hriti

s

Hig

h bl

ood

pres

sure

Stop

s ble

edin

g

Pile

s

Dia

bete

s

Mal

aria

Typh

oid

feve

r

Con

vulsi

on

Men

strua

l diso

rder

s

Rheu

mat

ism

Feve

rsSt

roke

Dia

rrho

ea

Misc

arria

ges

Hig

h fe

ver

Stom

ach

ulce

r

Ana

emia

0

1

2

3

4

5

6

7

8N

umbe

r of h

erba

l med

icin

es

Figure 3 Human diseases commonly treated andmanaged withherbal medicines

water) length of time of boiling and how long the decoctionswere kept Infusions were made by adding waterlocal gin(akpeteshie) to the pulverized plant materials although theamount of solvent added and duration of use of infusionsdiffered Generally there were no standards in the methodsof preparation of the herbal medicines by even the samehealer and this lack of standardization is amajor disadvantageof traditional medicine [26 31] It also means that herbalmedicines made by the same healer could vary in potencywhich has implications in their use for treatment of patients

The routes of administration of the remedies reportedin this study were oral rectal topical and nasal (Table 1)However the most common route of administration was oral(77) followed by a combination of oral and topical routes(10) whereas the least used routes were nasal (1) and rectal(2)The fact that oral route of administration of the herbalswas most common was not a surprise as this has been previ-ously reported [18 32] However a recent study in [33] foundfrequent use of herbal enemas (rectal) in Western Africantraditional medicine The route of administration of herbalmedicines could be related to bioactive agents in the extractsof the plants [32] For example herbal medicines whosebioactive agents are alkaloids are easily assimilated whenadministered orally while terpenoids especially essential oilsare best administered through dermal andnasal routes Bothdecoctions and infusions were mostly administered orally45 and 17 respectively Only infusions were administeredvia the rectal and nasal routes

4 Conclusions

In this paper we have documented the current state ofknowledge and use of herbal medicines for treatment andmanagement of human diseases among some communitiesliving in southern Ghana This documentation contributes

Table 3 Information on considerations on factors of place andtime during harvesting of medicinal plants by healers in somecommunities in southern Ghana

Placetime Factorsvariables Number ofhealers

Percentage ofhealers

ElevationLowland 44 978Highland 1 22

Unimportant 0 0

Habitat

Wild 20 444Home garden 6 133Degraded area 16 356Unimportant 3 67

Seasonality

Wet season 9 200Dry season 3 67

Both 30 667Unimportant 3 67

Soil type

Loam soil 34 756Sandy soil 8 177Clay soil 0 0

Unimportant 3 67

Time of day

Morning 26 578Eveningnight 0 0Afternoon 2 44Anytime 13 289

Unimportant 4 89

Topography

Steep slope 0 0Gentle slope 4 88Flat land 41 911

Unimportant 0 0

Vegetationtype

Forest 17 378Savanna 2 44

Forest-savannamosaic 23 511

Unimportant 3 66

primary data to the wealth of data stored on the indigenousknowledge on medicinal plants from Ghana The findingsfrom the study suggest that healers are consulted for herbalmedicines for the treatment and management of both com-mon and specialized diseases and ailments The extent towhich the people living in the area consult the healers isunknown but it is important to understanding this in orderto determine the proper role of herbal medicine in the healthcare system of the people It is also essential to scientificallyevaluate the specific uses of the medicinal plants reportedin the current study using plant materials from the areathrough pharmacological toxicological and clinical studiesin order to ensure the safety of the people consuming themedicines and for possible drug development The results ofthe study have also confirmed that factors of time and placeare given considerations during harvesting of plant materialsby healers Further studies on the methods and quantities ofplant materials that are harvested for treatment will improve

Evidence-Based Complementary and Alternative Medicine 11

our understanding on the impacts of harvesting of medicinalplants on biodiversity conservation in the area

Conflicts of Interest

The authors declare that there are no conflicts of interestregarding this manuscript

Authorsrsquo Contributions

Augustine A Boadu conducted field work and identificationof plants Alex Asase conceived idea designed study andwrote manuscript Both authors read and approved the finalmanuscript

Acknowledgments

The authors are grateful to the chiefs and herbalists living inthe study area for providing information and permission topublish the findings of this study Thanks are due to the staffof the Ghana Herbarium for assistance in the identificationof the plantsThe authors also thank the Department of Plantand Environmental Biology at theUniversity of Ghana for theapproval to conduct the study

References

[1] J B Calixto ldquoTwenty-five years of research on medicinal plantsin Latin America a personal viewrdquo Journal of Ethnopharmacol-ogy vol 100 no 1-2 pp 131ndash134 2005

[2] A Hensel E Kisseih M Lechtenberg F Petereit C Agyareand A Asase ldquoFrom ethnopharmacological field study to phy-tochemistry and preclinical research the example of Ghanaianmedicinal plants for improved wound healingrdquo in Ethnophar-macology M Heinrich and A K Jager Eds pp 179ndash197 JohnWiley amp Sons Ltd Chichester UK 1st edition 2015

[3] R N Mshana D K Abbiw I Addae-Mensah et al TraditionalMedicine and Pharmacopoeia Contribution to the Revision ofEthnobotanical and Floristic Studies in Ghana Science andTechnology Press CSIR 2001

[4] D K Abbiw Useful Plants of Ghana Intermediate TechnologyPublication Royal Botanic Gardens LondonKew UK 1990

[5] PORSPI Ghana Herbal Pharmacopoeia Policy Research andStrategic Planning Institute Council for Scientific and Indus-trial Research CSIR Ghana 1992

[6] J Soelberg A Asase G Akwetey and A K Jager ldquoHistoricalversus contemporary medicinal plant uses in Ghanardquo Journal ofEthnopharmacology vol 160 pp 109ndash132 2015

[7] J Buragohain ldquoEthnomedicinal plants used by the ethnic com-munities of Tinsukia district of Assam Indiardquo Research inScience and Technology vol 3 pp 31ndash42 2011

[8] S T Mahwasane L Middleton and N Boaduo ldquoAn ethnob-otanical survey of indigenous knowledge on medicinal plantsused by the traditional healers of the Lwamondo area Limpopoprovince SouthAfricardquo South African Journal of Botany vol 88pp 69ndash75 2013

[9] D J Newman G M Cragg and K M Snader ldquoNatural pro-ducts as sources of new drugs over the period 1981ndash2002rdquoJournal of Natural Products vol 66 no 7 pp 1022ndash1037 2003

[10] M S Butler ldquoThe role of natural product chemistry in drugdiscoveryrdquo Journal of Natural Products vol 67 no 12 pp 2141ndash2153 2004

[11] T van Andel B Myren and S Van Onselen ldquoGhanarsquos herbalmarketrdquo Journal of Ethnopharmacology vol 140 no 2 pp 368ndash378 2012

[12] T R van Andel S Croft E E van Loon D Quiroz A MTowns andNRaes ldquoPrioritizingWestAfricanmedicinal plantsfor conservation and sustainable extraction studies based onmarket surveys and species distribution modelsrdquo BiologicalConservation vol 181 pp 173ndash181 2015

[13] ISE International Society of Ethnobiology Code of Ethics 2016httpwwwethnobiologynetethicsphp

[14] S Ragosta I Harris N Gyakari E Otoo and A AsaseldquoPartcipatory ethnomedicinal cancer research with Fante-Akanherbalists in rural Ghanardquo Ethnobiology Letters vol 6 no 1 pp66ndash79 2015

[15] G Martin EthnobotanymdashA Manual of Methods EarthsacnPublishers Limited London UK 1995

[16] W Hawthorne and N Gyakari Photoguide for the Trees ofGhana Oxford Forestry Institute 2006

[17] A Asase and G Oppong-Mensah ldquoTraditional antimalarialphytotherapy remedies in herbal markets in southern GhanardquoJournal of Ethnopharmacology vol 126 no 3 pp 492ndash499 2009

[18] K Busia Fundamentals of HerbalMedicine vol 1 amp 2 LightningSource UK Ltd Milton Keynes UK 2016

[19] W C Evans Trease and Evans Pharmacognosy WR SaundersLondon UK 16th edition 2009

[20] A M Towns S Ruysschaert E van Vliet and T van AndelldquoEvidence in support of the role of disturbance vegetation forwomenrsquos health and childcare in Western Africardquo Journal ofEthnobiology and Ethnomedicine vol 10 no 1 p 42 2014

[21] A Agelet M A Bonet and J Valles ldquoHomegardens and theirrole as a main source of medicinal plants in mountain regionsof Catalonia (Iberian Peninsula)rdquo Economic Botany vol 54 no3 pp 295ndash309 2000

[22] C High and C M Shackleton ldquoThe comparative value of wildand domestic plants in home gardens of a South African ruralvillagerdquo Agroforestry Systems vol 48 no 2 pp 141ndash156 2000

[23] J Salick A Mejia and T Anderson ldquoNon-timber forestproducts integrated with natural forest management Rio SanJuan Nicaraguardquo Ecological Applications vol 5 no 4 pp 878ndash895 1995

[24] R L Chazdon and F G Coe ldquoEthnobotany of woody speciesin second-growth old-growth and selectively logged forests ofnortheastern Costa Ricardquo Conservation Biology vol 13 no 6pp 1312ndash1322 1999

[25] R M Kunwar L Mahat R P Acharya and R W Buss-mann ldquoMedicinal plants traditional medicine markets andmanagement in far-west Nepalrdquo Journal of Ethnobiology andEthnomedicine vol 9 no 1 article no 24 2013

[26] A Sofowora Medicinal Plants and Traditional Medicine inAfrica Spectrum Books Ibadan Nigeria 3rd edition 2008

[27] A P Dold and M L Cocks ldquoThe trade in medicinal plants inthe Eastern Cape Province South Africardquo South African Journalof Science vol 98 no 11-12 pp 589ndash597 2002

[28] P D Coley J P Bryant and F S Chapin III ldquoResourceavailability and plant antiherbivore defenserdquo Science vol 230no 4728 pp 895ndash899 1985

[29] D A Herms andW JMattson ldquoThe dilemma of plants to growor defendrdquo Quarterly Review of Biology vol 67 no 3 pp 283ndash335 1992

8 Evidence-Based Complementary and Alternative Medicine

Table2Con

tinued

Families

Scientificn

ames

(vou

cher

specim

en)

Localn

ames

(Aku

apem

Krobo

)Frequencyof

citatio

n(

)Habitof

plant

Dise

ases

andailm

ents

Plantp

arts

Metho

dsof

preparation

Routeo

fadministratio

n

Rutaceae

Citru

ssinensis

Pers

(K030)

Ank

a(Aku

apem

)Kp

eta

(Krobo

)11

Tree

Con

stipation

Leafandfruit

Infusio

nOral

Zanthoxylum

leprie

uriiGuillamp

Perr(K0

29)

Okanto(A

kuapem

)Oyaa

(Krobo

)22

Shrub

Sexu

alweakn

ess

Stroke

Leaf

Root

Decoctio

nDecoctio

nOral

OralT

opical

Sapind

aceae

Lecaniodisc

uscupanioidesP

lanch

(K031)

Unk

nown

11Sh

rub

Stom

achulcer

Leaf

Decoctio

nOral

Paullin

iapinn

ataL

(A002)

Tuatin

(Twi)Detsemam

u(K

robo

)65

Herb

Misc

arria

geStom

achulcer

Stroke

HIV

AID

SBo

nefracture

Leaf

Leaf

Leaf

Leaf

Leaf

Decoctio

nInfusio

nDecoctio

nDecoctio

nInfusio

n

Oral

Oral

Oral

Oral

OralR

ectal

Sapo

taceae

Aningeria

altissim

a(A

Chev)

Aubrev

(K033)

Asanfena

(Twi)

22

Shrub

Stop

sbleeding

Leafandbark

Decoctio

nOral

Malacanthaalnifolia

Pierre

(K032)

Unk

nown

22

Shrub

Misc

arria

geLeaf

Decoctio

nOral

Solanaceae

Physalisangulata

L(K

034)

Totoa(

Krob

o)11

Herb

Cancer

Who

leplant

Infusio

nOralT

opical

Solanu

mmelo

ngena

L(A

003)

Unk

nown

33

Shrub

Anaem

iaFruit

Infusio

nOral

Evidence-Based Complementary and Alternative Medicine 9

Families

0

2

4

6

8

10

12

Num

ber o

f her

bals

spec

ies

Apoc

ynac

eae

Alo

acea

e

Am

aran

thac

eae

Bign

onia

ceae

Capp

arad

acea

e

Euph

orbi

acea

e

Chry

soba

lana

ceae

Den

nsta

edtia

ceae

Bom

baca

ceae

Bora

gina

ceae

Com

bret

acea

e

Lam

iace

ae

Cucu

rbita

ceae

Sapo

tace

ae

Mal

vace

aeAc

anth

acea

e

Ruta

ceae

Men

isper

mac

eae

Meli

acea

eA

stera

ceae

Sola

nace

ae

Cype

race

ae

Ann

onac

eae

Myr

tace

aeSa

pind

acea

e

Mor

inga

ceae

Faba

ceae

Herbal remediesSpecies of plants

(a)

Herbal remediesSpecies of plants

0

5

10

15

20

25

30

35

Num

ber o

f her

bals

spec

ies

Herbs Shrubs ClimbersTreesHabit of plants

(b)

Leaf57Others

18

Whole plant9

Root6

Bark6

Fruit4

(combinationsof variousplant parts)

(c)

Figure 2 Composition of herbal remedies used in terms of (a) plant families (b) habit of plants and (c) percentage of plant parts

the healers they collected plants any time of the day becausethey sometimes needed to treat emergency cases There isscientific evidence to support the fact that yield of some plantchemical constituents differs within a time span of 24 hoursdue to the interconversions of compounds [19] Accordingto [30] time of the day should be given important consid-eration when collecting medicinal plants in order to obtainoptimum yield of desired products For season of the yearmore than half of the healers (67) harvested plants duringboth dry and wet seasons followed by 200 who collectedin only the wet season and about 7 collected in only dryseason About 7 of the healers did not consider season ofthe year as an important factor during harvesting of plant

materials although the availability of certain plant parts couldbe directly related to season of the year

34 Methods of Preparation and Administration of HerbalMedicines Theharvested plantmaterials were used in prepa-ration of 81 herbalmedicinesmainly in the formof decoctions(67) and infusions (33) Although it is documented that avariety of methods have been used for preparation of herbalmedicines themethods of decoctions and infusions have beenthe widely reported [eg [18]] However differences existin the preparations of decoctions and infusions both withinhealers and from place to place In the study area diversityexisted among healers in the amount of menstruum (mainly

10 Evidence-Based Complementary and Alternative Medicine

Diseases andailments treated

Oste

oart

hriti

s

Hig

h bl

ood

pres

sure

Stop

s ble

edin

g

Pile

s

Dia

bete

s

Mal

aria

Typh

oid

feve

r

Con

vulsi

on

Men

strua

l diso

rder

s

Rheu

mat

ism

Feve

rsSt

roke

Dia

rrho

ea

Misc

arria

ges

Hig

h fe

ver

Stom

ach

ulce

r

Ana

emia

0

1

2

3

4

5

6

7

8N

umbe

r of h

erba

l med

icin

es

Figure 3 Human diseases commonly treated andmanaged withherbal medicines

water) length of time of boiling and how long the decoctionswere kept Infusions were made by adding waterlocal gin(akpeteshie) to the pulverized plant materials although theamount of solvent added and duration of use of infusionsdiffered Generally there were no standards in the methodsof preparation of the herbal medicines by even the samehealer and this lack of standardization is amajor disadvantageof traditional medicine [26 31] It also means that herbalmedicines made by the same healer could vary in potencywhich has implications in their use for treatment of patients

The routes of administration of the remedies reportedin this study were oral rectal topical and nasal (Table 1)However the most common route of administration was oral(77) followed by a combination of oral and topical routes(10) whereas the least used routes were nasal (1) and rectal(2)The fact that oral route of administration of the herbalswas most common was not a surprise as this has been previ-ously reported [18 32] However a recent study in [33] foundfrequent use of herbal enemas (rectal) in Western Africantraditional medicine The route of administration of herbalmedicines could be related to bioactive agents in the extractsof the plants [32] For example herbal medicines whosebioactive agents are alkaloids are easily assimilated whenadministered orally while terpenoids especially essential oilsare best administered through dermal andnasal routes Bothdecoctions and infusions were mostly administered orally45 and 17 respectively Only infusions were administeredvia the rectal and nasal routes

4 Conclusions

In this paper we have documented the current state ofknowledge and use of herbal medicines for treatment andmanagement of human diseases among some communitiesliving in southern Ghana This documentation contributes

Table 3 Information on considerations on factors of place andtime during harvesting of medicinal plants by healers in somecommunities in southern Ghana

Placetime Factorsvariables Number ofhealers

Percentage ofhealers

ElevationLowland 44 978Highland 1 22

Unimportant 0 0

Habitat

Wild 20 444Home garden 6 133Degraded area 16 356Unimportant 3 67

Seasonality

Wet season 9 200Dry season 3 67

Both 30 667Unimportant 3 67

Soil type

Loam soil 34 756Sandy soil 8 177Clay soil 0 0

Unimportant 3 67

Time of day

Morning 26 578Eveningnight 0 0Afternoon 2 44Anytime 13 289

Unimportant 4 89

Topography

Steep slope 0 0Gentle slope 4 88Flat land 41 911

Unimportant 0 0

Vegetationtype

Forest 17 378Savanna 2 44

Forest-savannamosaic 23 511

Unimportant 3 66

primary data to the wealth of data stored on the indigenousknowledge on medicinal plants from Ghana The findingsfrom the study suggest that healers are consulted for herbalmedicines for the treatment and management of both com-mon and specialized diseases and ailments The extent towhich the people living in the area consult the healers isunknown but it is important to understanding this in orderto determine the proper role of herbal medicine in the healthcare system of the people It is also essential to scientificallyevaluate the specific uses of the medicinal plants reportedin the current study using plant materials from the areathrough pharmacological toxicological and clinical studiesin order to ensure the safety of the people consuming themedicines and for possible drug development The results ofthe study have also confirmed that factors of time and placeare given considerations during harvesting of plant materialsby healers Further studies on the methods and quantities ofplant materials that are harvested for treatment will improve

Evidence-Based Complementary and Alternative Medicine 11

our understanding on the impacts of harvesting of medicinalplants on biodiversity conservation in the area

Conflicts of Interest

The authors declare that there are no conflicts of interestregarding this manuscript

Authorsrsquo Contributions

Augustine A Boadu conducted field work and identificationof plants Alex Asase conceived idea designed study andwrote manuscript Both authors read and approved the finalmanuscript

Acknowledgments

The authors are grateful to the chiefs and herbalists living inthe study area for providing information and permission topublish the findings of this study Thanks are due to the staffof the Ghana Herbarium for assistance in the identificationof the plantsThe authors also thank the Department of Plantand Environmental Biology at theUniversity of Ghana for theapproval to conduct the study

References

[1] J B Calixto ldquoTwenty-five years of research on medicinal plantsin Latin America a personal viewrdquo Journal of Ethnopharmacol-ogy vol 100 no 1-2 pp 131ndash134 2005

[2] A Hensel E Kisseih M Lechtenberg F Petereit C Agyareand A Asase ldquoFrom ethnopharmacological field study to phy-tochemistry and preclinical research the example of Ghanaianmedicinal plants for improved wound healingrdquo in Ethnophar-macology M Heinrich and A K Jager Eds pp 179ndash197 JohnWiley amp Sons Ltd Chichester UK 1st edition 2015

[3] R N Mshana D K Abbiw I Addae-Mensah et al TraditionalMedicine and Pharmacopoeia Contribution to the Revision ofEthnobotanical and Floristic Studies in Ghana Science andTechnology Press CSIR 2001

[4] D K Abbiw Useful Plants of Ghana Intermediate TechnologyPublication Royal Botanic Gardens LondonKew UK 1990

[5] PORSPI Ghana Herbal Pharmacopoeia Policy Research andStrategic Planning Institute Council for Scientific and Indus-trial Research CSIR Ghana 1992

[6] J Soelberg A Asase G Akwetey and A K Jager ldquoHistoricalversus contemporary medicinal plant uses in Ghanardquo Journal ofEthnopharmacology vol 160 pp 109ndash132 2015

[7] J Buragohain ldquoEthnomedicinal plants used by the ethnic com-munities of Tinsukia district of Assam Indiardquo Research inScience and Technology vol 3 pp 31ndash42 2011

[8] S T Mahwasane L Middleton and N Boaduo ldquoAn ethnob-otanical survey of indigenous knowledge on medicinal plantsused by the traditional healers of the Lwamondo area Limpopoprovince SouthAfricardquo South African Journal of Botany vol 88pp 69ndash75 2013

[9] D J Newman G M Cragg and K M Snader ldquoNatural pro-ducts as sources of new drugs over the period 1981ndash2002rdquoJournal of Natural Products vol 66 no 7 pp 1022ndash1037 2003

[10] M S Butler ldquoThe role of natural product chemistry in drugdiscoveryrdquo Journal of Natural Products vol 67 no 12 pp 2141ndash2153 2004

[11] T van Andel B Myren and S Van Onselen ldquoGhanarsquos herbalmarketrdquo Journal of Ethnopharmacology vol 140 no 2 pp 368ndash378 2012

[12] T R van Andel S Croft E E van Loon D Quiroz A MTowns andNRaes ldquoPrioritizingWestAfricanmedicinal plantsfor conservation and sustainable extraction studies based onmarket surveys and species distribution modelsrdquo BiologicalConservation vol 181 pp 173ndash181 2015

[13] ISE International Society of Ethnobiology Code of Ethics 2016httpwwwethnobiologynetethicsphp

[14] S Ragosta I Harris N Gyakari E Otoo and A AsaseldquoPartcipatory ethnomedicinal cancer research with Fante-Akanherbalists in rural Ghanardquo Ethnobiology Letters vol 6 no 1 pp66ndash79 2015

[15] G Martin EthnobotanymdashA Manual of Methods EarthsacnPublishers Limited London UK 1995

[16] W Hawthorne and N Gyakari Photoguide for the Trees ofGhana Oxford Forestry Institute 2006

[17] A Asase and G Oppong-Mensah ldquoTraditional antimalarialphytotherapy remedies in herbal markets in southern GhanardquoJournal of Ethnopharmacology vol 126 no 3 pp 492ndash499 2009

[18] K Busia Fundamentals of HerbalMedicine vol 1 amp 2 LightningSource UK Ltd Milton Keynes UK 2016

[19] W C Evans Trease and Evans Pharmacognosy WR SaundersLondon UK 16th edition 2009

[20] A M Towns S Ruysschaert E van Vliet and T van AndelldquoEvidence in support of the role of disturbance vegetation forwomenrsquos health and childcare in Western Africardquo Journal ofEthnobiology and Ethnomedicine vol 10 no 1 p 42 2014

[21] A Agelet M A Bonet and J Valles ldquoHomegardens and theirrole as a main source of medicinal plants in mountain regionsof Catalonia (Iberian Peninsula)rdquo Economic Botany vol 54 no3 pp 295ndash309 2000

[22] C High and C M Shackleton ldquoThe comparative value of wildand domestic plants in home gardens of a South African ruralvillagerdquo Agroforestry Systems vol 48 no 2 pp 141ndash156 2000

[23] J Salick A Mejia and T Anderson ldquoNon-timber forestproducts integrated with natural forest management Rio SanJuan Nicaraguardquo Ecological Applications vol 5 no 4 pp 878ndash895 1995

[24] R L Chazdon and F G Coe ldquoEthnobotany of woody speciesin second-growth old-growth and selectively logged forests ofnortheastern Costa Ricardquo Conservation Biology vol 13 no 6pp 1312ndash1322 1999

[25] R M Kunwar L Mahat R P Acharya and R W Buss-mann ldquoMedicinal plants traditional medicine markets andmanagement in far-west Nepalrdquo Journal of Ethnobiology andEthnomedicine vol 9 no 1 article no 24 2013

[26] A Sofowora Medicinal Plants and Traditional Medicine inAfrica Spectrum Books Ibadan Nigeria 3rd edition 2008

[27] A P Dold and M L Cocks ldquoThe trade in medicinal plants inthe Eastern Cape Province South Africardquo South African Journalof Science vol 98 no 11-12 pp 589ndash597 2002

[28] P D Coley J P Bryant and F S Chapin III ldquoResourceavailability and plant antiherbivore defenserdquo Science vol 230no 4728 pp 895ndash899 1985

[29] D A Herms andW JMattson ldquoThe dilemma of plants to growor defendrdquo Quarterly Review of Biology vol 67 no 3 pp 283ndash335 1992

Evidence-Based Complementary and Alternative Medicine 9

Families

0

2

4

6

8

10

12

Num

ber o

f her

bals

spec

ies

Apoc

ynac

eae

Alo

acea

e

Am

aran

thac

eae

Bign

onia

ceae

Capp

arad

acea

e

Euph

orbi

acea

e

Chry

soba

lana

ceae

Den

nsta

edtia

ceae

Bom

baca

ceae

Bora

gina

ceae

Com

bret

acea

e

Lam

iace

ae

Cucu

rbita

ceae

Sapo

tace

ae

Mal

vace

aeAc

anth

acea

e

Ruta

ceae

Men

isper

mac

eae

Meli

acea

eA

stera

ceae

Sola

nace

ae

Cype

race

ae

Ann

onac

eae

Myr

tace

aeSa

pind

acea

e

Mor

inga

ceae

Faba

ceae

Herbal remediesSpecies of plants

(a)

Herbal remediesSpecies of plants

0

5

10

15

20

25

30

35

Num

ber o

f her

bals

spec

ies

Herbs Shrubs ClimbersTreesHabit of plants

(b)

Leaf57Others

18

Whole plant9

Root6

Bark6

Fruit4

(combinationsof variousplant parts)

(c)

Figure 2 Composition of herbal remedies used in terms of (a) plant families (b) habit of plants and (c) percentage of plant parts

the healers they collected plants any time of the day becausethey sometimes needed to treat emergency cases There isscientific evidence to support the fact that yield of some plantchemical constituents differs within a time span of 24 hoursdue to the interconversions of compounds [19] Accordingto [30] time of the day should be given important consid-eration when collecting medicinal plants in order to obtainoptimum yield of desired products For season of the yearmore than half of the healers (67) harvested plants duringboth dry and wet seasons followed by 200 who collectedin only the wet season and about 7 collected in only dryseason About 7 of the healers did not consider season ofthe year as an important factor during harvesting of plant

materials although the availability of certain plant parts couldbe directly related to season of the year

34 Methods of Preparation and Administration of HerbalMedicines Theharvested plantmaterials were used in prepa-ration of 81 herbalmedicinesmainly in the formof decoctions(67) and infusions (33) Although it is documented that avariety of methods have been used for preparation of herbalmedicines themethods of decoctions and infusions have beenthe widely reported [eg [18]] However differences existin the preparations of decoctions and infusions both withinhealers and from place to place In the study area diversityexisted among healers in the amount of menstruum (mainly

10 Evidence-Based Complementary and Alternative Medicine

Diseases andailments treated

Oste

oart

hriti

s

Hig

h bl

ood

pres

sure

Stop

s ble

edin

g

Pile

s

Dia

bete

s

Mal

aria

Typh

oid

feve

r

Con

vulsi

on

Men

strua

l diso

rder

s

Rheu

mat

ism

Feve

rsSt

roke

Dia

rrho

ea

Misc

arria

ges

Hig

h fe

ver

Stom

ach

ulce

r

Ana

emia

0

1

2

3

4

5

6

7

8N

umbe

r of h

erba

l med

icin

es

Figure 3 Human diseases commonly treated andmanaged withherbal medicines

water) length of time of boiling and how long the decoctionswere kept Infusions were made by adding waterlocal gin(akpeteshie) to the pulverized plant materials although theamount of solvent added and duration of use of infusionsdiffered Generally there were no standards in the methodsof preparation of the herbal medicines by even the samehealer and this lack of standardization is amajor disadvantageof traditional medicine [26 31] It also means that herbalmedicines made by the same healer could vary in potencywhich has implications in their use for treatment of patients

The routes of administration of the remedies reportedin this study were oral rectal topical and nasal (Table 1)However the most common route of administration was oral(77) followed by a combination of oral and topical routes(10) whereas the least used routes were nasal (1) and rectal(2)The fact that oral route of administration of the herbalswas most common was not a surprise as this has been previ-ously reported [18 32] However a recent study in [33] foundfrequent use of herbal enemas (rectal) in Western Africantraditional medicine The route of administration of herbalmedicines could be related to bioactive agents in the extractsof the plants [32] For example herbal medicines whosebioactive agents are alkaloids are easily assimilated whenadministered orally while terpenoids especially essential oilsare best administered through dermal andnasal routes Bothdecoctions and infusions were mostly administered orally45 and 17 respectively Only infusions were administeredvia the rectal and nasal routes

4 Conclusions

In this paper we have documented the current state ofknowledge and use of herbal medicines for treatment andmanagement of human diseases among some communitiesliving in southern Ghana This documentation contributes

Table 3 Information on considerations on factors of place andtime during harvesting of medicinal plants by healers in somecommunities in southern Ghana

Placetime Factorsvariables Number ofhealers

Percentage ofhealers

ElevationLowland 44 978Highland 1 22

Unimportant 0 0

Habitat

Wild 20 444Home garden 6 133Degraded area 16 356Unimportant 3 67

Seasonality

Wet season 9 200Dry season 3 67

Both 30 667Unimportant 3 67

Soil type

Loam soil 34 756Sandy soil 8 177Clay soil 0 0

Unimportant 3 67

Time of day

Morning 26 578Eveningnight 0 0Afternoon 2 44Anytime 13 289

Unimportant 4 89

Topography

Steep slope 0 0Gentle slope 4 88Flat land 41 911

Unimportant 0 0

Vegetationtype

Forest 17 378Savanna 2 44

Forest-savannamosaic 23 511

Unimportant 3 66

primary data to the wealth of data stored on the indigenousknowledge on medicinal plants from Ghana The findingsfrom the study suggest that healers are consulted for herbalmedicines for the treatment and management of both com-mon and specialized diseases and ailments The extent towhich the people living in the area consult the healers isunknown but it is important to understanding this in orderto determine the proper role of herbal medicine in the healthcare system of the people It is also essential to scientificallyevaluate the specific uses of the medicinal plants reportedin the current study using plant materials from the areathrough pharmacological toxicological and clinical studiesin order to ensure the safety of the people consuming themedicines and for possible drug development The results ofthe study have also confirmed that factors of time and placeare given considerations during harvesting of plant materialsby healers Further studies on the methods and quantities ofplant materials that are harvested for treatment will improve

Evidence-Based Complementary and Alternative Medicine 11

our understanding on the impacts of harvesting of medicinalplants on biodiversity conservation in the area

Conflicts of Interest

The authors declare that there are no conflicts of interestregarding this manuscript

Authorsrsquo Contributions

Augustine A Boadu conducted field work and identificationof plants Alex Asase conceived idea designed study andwrote manuscript Both authors read and approved the finalmanuscript

Acknowledgments

The authors are grateful to the chiefs and herbalists living inthe study area for providing information and permission topublish the findings of this study Thanks are due to the staffof the Ghana Herbarium for assistance in the identificationof the plantsThe authors also thank the Department of Plantand Environmental Biology at theUniversity of Ghana for theapproval to conduct the study

References

[1] J B Calixto ldquoTwenty-five years of research on medicinal plantsin Latin America a personal viewrdquo Journal of Ethnopharmacol-ogy vol 100 no 1-2 pp 131ndash134 2005

[2] A Hensel E Kisseih M Lechtenberg F Petereit C Agyareand A Asase ldquoFrom ethnopharmacological field study to phy-tochemistry and preclinical research the example of Ghanaianmedicinal plants for improved wound healingrdquo in Ethnophar-macology M Heinrich and A K Jager Eds pp 179ndash197 JohnWiley amp Sons Ltd Chichester UK 1st edition 2015

[3] R N Mshana D K Abbiw I Addae-Mensah et al TraditionalMedicine and Pharmacopoeia Contribution to the Revision ofEthnobotanical and Floristic Studies in Ghana Science andTechnology Press CSIR 2001

[4] D K Abbiw Useful Plants of Ghana Intermediate TechnologyPublication Royal Botanic Gardens LondonKew UK 1990

[5] PORSPI Ghana Herbal Pharmacopoeia Policy Research andStrategic Planning Institute Council for Scientific and Indus-trial Research CSIR Ghana 1992

[6] J Soelberg A Asase G Akwetey and A K Jager ldquoHistoricalversus contemporary medicinal plant uses in Ghanardquo Journal ofEthnopharmacology vol 160 pp 109ndash132 2015

[7] J Buragohain ldquoEthnomedicinal plants used by the ethnic com-munities of Tinsukia district of Assam Indiardquo Research inScience and Technology vol 3 pp 31ndash42 2011

[8] S T Mahwasane L Middleton and N Boaduo ldquoAn ethnob-otanical survey of indigenous knowledge on medicinal plantsused by the traditional healers of the Lwamondo area Limpopoprovince SouthAfricardquo South African Journal of Botany vol 88pp 69ndash75 2013

[9] D J Newman G M Cragg and K M Snader ldquoNatural pro-ducts as sources of new drugs over the period 1981ndash2002rdquoJournal of Natural Products vol 66 no 7 pp 1022ndash1037 2003

[10] M S Butler ldquoThe role of natural product chemistry in drugdiscoveryrdquo Journal of Natural Products vol 67 no 12 pp 2141ndash2153 2004

[11] T van Andel B Myren and S Van Onselen ldquoGhanarsquos herbalmarketrdquo Journal of Ethnopharmacology vol 140 no 2 pp 368ndash378 2012

[12] T R van Andel S Croft E E van Loon D Quiroz A MTowns andNRaes ldquoPrioritizingWestAfricanmedicinal plantsfor conservation and sustainable extraction studies based onmarket surveys and species distribution modelsrdquo BiologicalConservation vol 181 pp 173ndash181 2015

[13] ISE International Society of Ethnobiology Code of Ethics 2016httpwwwethnobiologynetethicsphp

[14] S Ragosta I Harris N Gyakari E Otoo and A AsaseldquoPartcipatory ethnomedicinal cancer research with Fante-Akanherbalists in rural Ghanardquo Ethnobiology Letters vol 6 no 1 pp66ndash79 2015

[15] G Martin EthnobotanymdashA Manual of Methods EarthsacnPublishers Limited London UK 1995

[16] W Hawthorne and N Gyakari Photoguide for the Trees ofGhana Oxford Forestry Institute 2006

[17] A Asase and G Oppong-Mensah ldquoTraditional antimalarialphytotherapy remedies in herbal markets in southern GhanardquoJournal of Ethnopharmacology vol 126 no 3 pp 492ndash499 2009

[18] K Busia Fundamentals of HerbalMedicine vol 1 amp 2 LightningSource UK Ltd Milton Keynes UK 2016

[19] W C Evans Trease and Evans Pharmacognosy WR SaundersLondon UK 16th edition 2009

[20] A M Towns S Ruysschaert E van Vliet and T van AndelldquoEvidence in support of the role of disturbance vegetation forwomenrsquos health and childcare in Western Africardquo Journal ofEthnobiology and Ethnomedicine vol 10 no 1 p 42 2014

[21] A Agelet M A Bonet and J Valles ldquoHomegardens and theirrole as a main source of medicinal plants in mountain regionsof Catalonia (Iberian Peninsula)rdquo Economic Botany vol 54 no3 pp 295ndash309 2000

[22] C High and C M Shackleton ldquoThe comparative value of wildand domestic plants in home gardens of a South African ruralvillagerdquo Agroforestry Systems vol 48 no 2 pp 141ndash156 2000

[23] J Salick A Mejia and T Anderson ldquoNon-timber forestproducts integrated with natural forest management Rio SanJuan Nicaraguardquo Ecological Applications vol 5 no 4 pp 878ndash895 1995

[24] R L Chazdon and F G Coe ldquoEthnobotany of woody speciesin second-growth old-growth and selectively logged forests ofnortheastern Costa Ricardquo Conservation Biology vol 13 no 6pp 1312ndash1322 1999

[25] R M Kunwar L Mahat R P Acharya and R W Buss-mann ldquoMedicinal plants traditional medicine markets andmanagement in far-west Nepalrdquo Journal of Ethnobiology andEthnomedicine vol 9 no 1 article no 24 2013

[26] A Sofowora Medicinal Plants and Traditional Medicine inAfrica Spectrum Books Ibadan Nigeria 3rd edition 2008

[27] A P Dold and M L Cocks ldquoThe trade in medicinal plants inthe Eastern Cape Province South Africardquo South African Journalof Science vol 98 no 11-12 pp 589ndash597 2002

[28] P D Coley J P Bryant and F S Chapin III ldquoResourceavailability and plant antiherbivore defenserdquo Science vol 230no 4728 pp 895ndash899 1985

[29] D A Herms andW JMattson ldquoThe dilemma of plants to growor defendrdquo Quarterly Review of Biology vol 67 no 3 pp 283ndash335 1992

10 Evidence-Based Complementary and Alternative Medicine

Diseases andailments treated

Oste

oart

hriti

s

Hig

h bl

ood

pres

sure

Stop

s ble

edin

g

Pile

s

Dia

bete

s

Mal

aria

Typh

oid

feve

r

Con

vulsi

on

Men

strua

l diso

rder

s

Rheu

mat

ism

Feve

rsSt

roke

Dia

rrho

ea

Misc

arria

ges

Hig

h fe

ver

Stom

ach

ulce

r

Ana

emia

0

1

2

3

4

5

6

7

8N

umbe

r of h

erba

l med

icin

es

Figure 3 Human diseases commonly treated andmanaged withherbal medicines

water) length of time of boiling and how long the decoctionswere kept Infusions were made by adding waterlocal gin(akpeteshie) to the pulverized plant materials although theamount of solvent added and duration of use of infusionsdiffered Generally there were no standards in the methodsof preparation of the herbal medicines by even the samehealer and this lack of standardization is amajor disadvantageof traditional medicine [26 31] It also means that herbalmedicines made by the same healer could vary in potencywhich has implications in their use for treatment of patients

The routes of administration of the remedies reportedin this study were oral rectal topical and nasal (Table 1)However the most common route of administration was oral(77) followed by a combination of oral and topical routes(10) whereas the least used routes were nasal (1) and rectal(2)The fact that oral route of administration of the herbalswas most common was not a surprise as this has been previ-ously reported [18 32] However a recent study in [33] foundfrequent use of herbal enemas (rectal) in Western Africantraditional medicine The route of administration of herbalmedicines could be related to bioactive agents in the extractsof the plants [32] For example herbal medicines whosebioactive agents are alkaloids are easily assimilated whenadministered orally while terpenoids especially essential oilsare best administered through dermal andnasal routes Bothdecoctions and infusions were mostly administered orally45 and 17 respectively Only infusions were administeredvia the rectal and nasal routes

4 Conclusions

In this paper we have documented the current state ofknowledge and use of herbal medicines for treatment andmanagement of human diseases among some communitiesliving in southern Ghana This documentation contributes

Table 3 Information on considerations on factors of place andtime during harvesting of medicinal plants by healers in somecommunities in southern Ghana

Placetime Factorsvariables Number ofhealers

Percentage ofhealers

ElevationLowland 44 978Highland 1 22

Unimportant 0 0

Habitat

Wild 20 444Home garden 6 133Degraded area 16 356Unimportant 3 67

Seasonality

Wet season 9 200Dry season 3 67

Both 30 667Unimportant 3 67

Soil type

Loam soil 34 756Sandy soil 8 177Clay soil 0 0

Unimportant 3 67

Time of day

Morning 26 578Eveningnight 0 0Afternoon 2 44Anytime 13 289

Unimportant 4 89

Topography

Steep slope 0 0Gentle slope 4 88Flat land 41 911

Unimportant 0 0

Vegetationtype

Forest 17 378Savanna 2 44

Forest-savannamosaic 23 511

Unimportant 3 66

primary data to the wealth of data stored on the indigenousknowledge on medicinal plants from Ghana The findingsfrom the study suggest that healers are consulted for herbalmedicines for the treatment and management of both com-mon and specialized diseases and ailments The extent towhich the people living in the area consult the healers isunknown but it is important to understanding this in orderto determine the proper role of herbal medicine in the healthcare system of the people It is also essential to scientificallyevaluate the specific uses of the medicinal plants reportedin the current study using plant materials from the areathrough pharmacological toxicological and clinical studiesin order to ensure the safety of the people consuming themedicines and for possible drug development The results ofthe study have also confirmed that factors of time and placeare given considerations during harvesting of plant materialsby healers Further studies on the methods and quantities ofplant materials that are harvested for treatment will improve

Evidence-Based Complementary and Alternative Medicine 11

our understanding on the impacts of harvesting of medicinalplants on biodiversity conservation in the area

Conflicts of Interest

The authors declare that there are no conflicts of interestregarding this manuscript

Authorsrsquo Contributions

Augustine A Boadu conducted field work and identificationof plants Alex Asase conceived idea designed study andwrote manuscript Both authors read and approved the finalmanuscript

Acknowledgments

The authors are grateful to the chiefs and herbalists living inthe study area for providing information and permission topublish the findings of this study Thanks are due to the staffof the Ghana Herbarium for assistance in the identificationof the plantsThe authors also thank the Department of Plantand Environmental Biology at theUniversity of Ghana for theapproval to conduct the study

References

[1] J B Calixto ldquoTwenty-five years of research on medicinal plantsin Latin America a personal viewrdquo Journal of Ethnopharmacol-ogy vol 100 no 1-2 pp 131ndash134 2005

[2] A Hensel E Kisseih M Lechtenberg F Petereit C Agyareand A Asase ldquoFrom ethnopharmacological field study to phy-tochemistry and preclinical research the example of Ghanaianmedicinal plants for improved wound healingrdquo in Ethnophar-macology M Heinrich and A K Jager Eds pp 179ndash197 JohnWiley amp Sons Ltd Chichester UK 1st edition 2015

[3] R N Mshana D K Abbiw I Addae-Mensah et al TraditionalMedicine and Pharmacopoeia Contribution to the Revision ofEthnobotanical and Floristic Studies in Ghana Science andTechnology Press CSIR 2001

[4] D K Abbiw Useful Plants of Ghana Intermediate TechnologyPublication Royal Botanic Gardens LondonKew UK 1990

[5] PORSPI Ghana Herbal Pharmacopoeia Policy Research andStrategic Planning Institute Council for Scientific and Indus-trial Research CSIR Ghana 1992

[6] J Soelberg A Asase G Akwetey and A K Jager ldquoHistoricalversus contemporary medicinal plant uses in Ghanardquo Journal ofEthnopharmacology vol 160 pp 109ndash132 2015

[7] J Buragohain ldquoEthnomedicinal plants used by the ethnic com-munities of Tinsukia district of Assam Indiardquo Research inScience and Technology vol 3 pp 31ndash42 2011

[8] S T Mahwasane L Middleton and N Boaduo ldquoAn ethnob-otanical survey of indigenous knowledge on medicinal plantsused by the traditional healers of the Lwamondo area Limpopoprovince SouthAfricardquo South African Journal of Botany vol 88pp 69ndash75 2013

[9] D J Newman G M Cragg and K M Snader ldquoNatural pro-ducts as sources of new drugs over the period 1981ndash2002rdquoJournal of Natural Products vol 66 no 7 pp 1022ndash1037 2003

[10] M S Butler ldquoThe role of natural product chemistry in drugdiscoveryrdquo Journal of Natural Products vol 67 no 12 pp 2141ndash2153 2004

[11] T van Andel B Myren and S Van Onselen ldquoGhanarsquos herbalmarketrdquo Journal of Ethnopharmacology vol 140 no 2 pp 368ndash378 2012

[12] T R van Andel S Croft E E van Loon D Quiroz A MTowns andNRaes ldquoPrioritizingWestAfricanmedicinal plantsfor conservation and sustainable extraction studies based onmarket surveys and species distribution modelsrdquo BiologicalConservation vol 181 pp 173ndash181 2015

[13] ISE International Society of Ethnobiology Code of Ethics 2016httpwwwethnobiologynetethicsphp

[14] S Ragosta I Harris N Gyakari E Otoo and A AsaseldquoPartcipatory ethnomedicinal cancer research with Fante-Akanherbalists in rural Ghanardquo Ethnobiology Letters vol 6 no 1 pp66ndash79 2015

[15] G Martin EthnobotanymdashA Manual of Methods EarthsacnPublishers Limited London UK 1995

[16] W Hawthorne and N Gyakari Photoguide for the Trees ofGhana Oxford Forestry Institute 2006

[17] A Asase and G Oppong-Mensah ldquoTraditional antimalarialphytotherapy remedies in herbal markets in southern GhanardquoJournal of Ethnopharmacology vol 126 no 3 pp 492ndash499 2009

[18] K Busia Fundamentals of HerbalMedicine vol 1 amp 2 LightningSource UK Ltd Milton Keynes UK 2016

[19] W C Evans Trease and Evans Pharmacognosy WR SaundersLondon UK 16th edition 2009

[20] A M Towns S Ruysschaert E van Vliet and T van AndelldquoEvidence in support of the role of disturbance vegetation forwomenrsquos health and childcare in Western Africardquo Journal ofEthnobiology and Ethnomedicine vol 10 no 1 p 42 2014

[21] A Agelet M A Bonet and J Valles ldquoHomegardens and theirrole as a main source of medicinal plants in mountain regionsof Catalonia (Iberian Peninsula)rdquo Economic Botany vol 54 no3 pp 295ndash309 2000

[22] C High and C M Shackleton ldquoThe comparative value of wildand domestic plants in home gardens of a South African ruralvillagerdquo Agroforestry Systems vol 48 no 2 pp 141ndash156 2000

[23] J Salick A Mejia and T Anderson ldquoNon-timber forestproducts integrated with natural forest management Rio SanJuan Nicaraguardquo Ecological Applications vol 5 no 4 pp 878ndash895 1995

[24] R L Chazdon and F G Coe ldquoEthnobotany of woody speciesin second-growth old-growth and selectively logged forests ofnortheastern Costa Ricardquo Conservation Biology vol 13 no 6pp 1312ndash1322 1999

[25] R M Kunwar L Mahat R P Acharya and R W Buss-mann ldquoMedicinal plants traditional medicine markets andmanagement in far-west Nepalrdquo Journal of Ethnobiology andEthnomedicine vol 9 no 1 article no 24 2013

[26] A Sofowora Medicinal Plants and Traditional Medicine inAfrica Spectrum Books Ibadan Nigeria 3rd edition 2008

[27] A P Dold and M L Cocks ldquoThe trade in medicinal plants inthe Eastern Cape Province South Africardquo South African Journalof Science vol 98 no 11-12 pp 589ndash597 2002

[28] P D Coley J P Bryant and F S Chapin III ldquoResourceavailability and plant antiherbivore defenserdquo Science vol 230no 4728 pp 895ndash899 1985

[29] D A Herms andW JMattson ldquoThe dilemma of plants to growor defendrdquo Quarterly Review of Biology vol 67 no 3 pp 283ndash335 1992

Evidence-Based Complementary and Alternative Medicine 11

our understanding on the impacts of harvesting of medicinalplants on biodiversity conservation in the area

Conflicts of Interest

The authors declare that there are no conflicts of interestregarding this manuscript

Authorsrsquo Contributions

Augustine A Boadu conducted field work and identificationof plants Alex Asase conceived idea designed study andwrote manuscript Both authors read and approved the finalmanuscript

Acknowledgments

The authors are grateful to the chiefs and herbalists living inthe study area for providing information and permission topublish the findings of this study Thanks are due to the staffof the Ghana Herbarium for assistance in the identificationof the plantsThe authors also thank the Department of Plantand Environmental Biology at theUniversity of Ghana for theapproval to conduct the study

References

[1] J B Calixto ldquoTwenty-five years of research on medicinal plantsin Latin America a personal viewrdquo Journal of Ethnopharmacol-ogy vol 100 no 1-2 pp 131ndash134 2005

[2] A Hensel E Kisseih M Lechtenberg F Petereit C Agyareand A Asase ldquoFrom ethnopharmacological field study to phy-tochemistry and preclinical research the example of Ghanaianmedicinal plants for improved wound healingrdquo in Ethnophar-macology M Heinrich and A K Jager Eds pp 179ndash197 JohnWiley amp Sons Ltd Chichester UK 1st edition 2015

[3] R N Mshana D K Abbiw I Addae-Mensah et al TraditionalMedicine and Pharmacopoeia Contribution to the Revision ofEthnobotanical and Floristic Studies in Ghana Science andTechnology Press CSIR 2001

[4] D K Abbiw Useful Plants of Ghana Intermediate TechnologyPublication Royal Botanic Gardens LondonKew UK 1990

[5] PORSPI Ghana Herbal Pharmacopoeia Policy Research andStrategic Planning Institute Council for Scientific and Indus-trial Research CSIR Ghana 1992

[6] J Soelberg A Asase G Akwetey and A K Jager ldquoHistoricalversus contemporary medicinal plant uses in Ghanardquo Journal ofEthnopharmacology vol 160 pp 109ndash132 2015

[7] J Buragohain ldquoEthnomedicinal plants used by the ethnic com-munities of Tinsukia district of Assam Indiardquo Research inScience and Technology vol 3 pp 31ndash42 2011

[8] S T Mahwasane L Middleton and N Boaduo ldquoAn ethnob-otanical survey of indigenous knowledge on medicinal plantsused by the traditional healers of the Lwamondo area Limpopoprovince SouthAfricardquo South African Journal of Botany vol 88pp 69ndash75 2013

[9] D J Newman G M Cragg and K M Snader ldquoNatural pro-ducts as sources of new drugs over the period 1981ndash2002rdquoJournal of Natural Products vol 66 no 7 pp 1022ndash1037 2003

[10] M S Butler ldquoThe role of natural product chemistry in drugdiscoveryrdquo Journal of Natural Products vol 67 no 12 pp 2141ndash2153 2004

[11] T van Andel B Myren and S Van Onselen ldquoGhanarsquos herbalmarketrdquo Journal of Ethnopharmacology vol 140 no 2 pp 368ndash378 2012

[12] T R van Andel S Croft E E van Loon D Quiroz A MTowns andNRaes ldquoPrioritizingWestAfricanmedicinal plantsfor conservation and sustainable extraction studies based onmarket surveys and species distribution modelsrdquo BiologicalConservation vol 181 pp 173ndash181 2015

[13] ISE International Society of Ethnobiology Code of Ethics 2016httpwwwethnobiologynetethicsphp

[14] S Ragosta I Harris N Gyakari E Otoo and A AsaseldquoPartcipatory ethnomedicinal cancer research with Fante-Akanherbalists in rural Ghanardquo Ethnobiology Letters vol 6 no 1 pp66ndash79 2015

[15] G Martin EthnobotanymdashA Manual of Methods EarthsacnPublishers Limited London UK 1995

[16] W Hawthorne and N Gyakari Photoguide for the Trees ofGhana Oxford Forestry Institute 2006

[17] A Asase and G Oppong-Mensah ldquoTraditional antimalarialphytotherapy remedies in herbal markets in southern GhanardquoJournal of Ethnopharmacology vol 126 no 3 pp 492ndash499 2009

[18] K Busia Fundamentals of HerbalMedicine vol 1 amp 2 LightningSource UK Ltd Milton Keynes UK 2016

[19] W C Evans Trease and Evans Pharmacognosy WR SaundersLondon UK 16th edition 2009

[20] A M Towns S Ruysschaert E van Vliet and T van AndelldquoEvidence in support of the role of disturbance vegetation forwomenrsquos health and childcare in Western Africardquo Journal ofEthnobiology and Ethnomedicine vol 10 no 1 p 42 2014

[21] A Agelet M A Bonet and J Valles ldquoHomegardens and theirrole as a main source of medicinal plants in mountain regionsof Catalonia (Iberian Peninsula)rdquo Economic Botany vol 54 no3 pp 295ndash309 2000

[22] C High and C M Shackleton ldquoThe comparative value of wildand domestic plants in home gardens of a South African ruralvillagerdquo Agroforestry Systems vol 48 no 2 pp 141ndash156 2000

[23] J Salick A Mejia and T Anderson ldquoNon-timber forestproducts integrated with natural forest management Rio SanJuan Nicaraguardquo Ecological Applications vol 5 no 4 pp 878ndash895 1995

[24] R L Chazdon and F G Coe ldquoEthnobotany of woody speciesin second-growth old-growth and selectively logged forests ofnortheastern Costa Ricardquo Conservation Biology vol 13 no 6pp 1312ndash1322 1999

[25] R M Kunwar L Mahat R P Acharya and R W Buss-mann ldquoMedicinal plants traditional medicine markets andmanagement in far-west Nepalrdquo Journal of Ethnobiology andEthnomedicine vol 9 no 1 article no 24 2013

[26] A Sofowora Medicinal Plants and Traditional Medicine inAfrica Spectrum Books Ibadan Nigeria 3rd edition 2008

[27] A P Dold and M L Cocks ldquoThe trade in medicinal plants inthe Eastern Cape Province South Africardquo South African Journalof Science vol 98 no 11-12 pp 589ndash597 2002

[28] P D Coley J P Bryant and F S Chapin III ldquoResourceavailability and plant antiherbivore defenserdquo Science vol 230no 4728 pp 895ndash899 1985

[29] D A Herms andW JMattson ldquoThe dilemma of plants to growor defendrdquo Quarterly Review of Biology vol 67 no 3 pp 283ndash335 1992

12 Evidence-Based Complementary and Alternative Medicine

[30] P N Okolie and B N Obasi ldquoDiurnal variation of cyanogenicglucosides thiocyanate and rhodanese in cassavardquo Phytochem-istry vol 33 no 4 pp 775ndash778 1993

[31] E Evans-Anfom Traditional Medicine in Ghana PracticeProblems and Prospects Ghana Academy of Arts and Sciences1986

[32] A Gurib-Fakim ldquoMedicinal plants traditions of yesterday anddrugs of tomorrowrdquo Molecular Aspects of Medicine vol 27 no1 pp 253ndash255 2006

[33] T van Andel S van Onselen B Myren A Towns and DQuiroz ldquoThe medicine from behind The frequent use ofenemas in western African traditional medicinerdquo Journal ofEthnopharmacology vol 174 pp 637ndash643 2015

Submit your manuscripts athttpswwwhindawicom

Stem CellsInternational

Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014

Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014

MEDIATORSINFLAMMATION

of

Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014

Behavioural Neurology

EndocrinologyInternational Journal of

Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014

Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014

Disease Markers

Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014

BioMed Research International

OncologyJournal of

Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014

Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014

Oxidative Medicine and Cellular Longevity

Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014

PPAR Research

The Scientific World JournalHindawi Publishing Corporation httpwwwhindawicom Volume 2014

Immunology ResearchHindawi Publishing Corporationhttpwwwhindawicom Volume 2014

Journal of

ObesityJournal of

Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014

Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014

Computational and Mathematical Methods in Medicine

OphthalmologyJournal of

Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014

Diabetes ResearchJournal of

Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014

Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014

Research and TreatmentAIDS

Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014

Gastroenterology Research and Practice

Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014

Parkinsonrsquos Disease

Evidence-Based Complementary and Alternative Medicine

Volume 2014Hindawi Publishing Corporationhttpwwwhindawicom

Submit your manuscripts athttpswwwhindawicom

Stem CellsInternational

Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014

Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014

MEDIATORSINFLAMMATION

of

Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014

Behavioural Neurology

EndocrinologyInternational Journal of

Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014

Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014

Disease Markers

Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014

BioMed Research International

OncologyJournal of

Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014

Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014

Oxidative Medicine and Cellular Longevity

Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014

PPAR Research

The Scientific World JournalHindawi Publishing Corporation httpwwwhindawicom Volume 2014

Immunology ResearchHindawi Publishing Corporationhttpwwwhindawicom Volume 2014

Journal of

ObesityJournal of

Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014

Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014

Computational and Mathematical Methods in Medicine

OphthalmologyJournal of

Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014

Diabetes ResearchJournal of

Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014

Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014

Research and TreatmentAIDS

Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014

Gastroenterology Research and Practice

Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014

Parkinsonrsquos Disease

Evidence-Based Complementary and Alternative Medicine

Volume 2014Hindawi Publishing Corporationhttpwwwhindawicom