Ethnomedical knowledge of plants used in alternative medicine to treat hemorrhoidal diseases in Lubumbashi, Haut-Katanga province, Southern Democratic Republic of Congo

Abstract

Background: A variety of medicinal plants are used in traditional medicine in Lubumbashi for the management of hemorrhoidal diseases. However, no investigation has been conducted to gather the knowledge required for this type of management in the region. The present study was conducted to inventory the plants used in Lubumbashi to treat hemorrhoidal diseases and to relate their ethnomedical characteristics.

Methods: This study was conducted between March 2022 and February 2023 by interviews using semi-structured questionnaire with households (n = 1520), herbalists (n = 25), and traditional healers: THs (n = 59).

Results: The 1,604 respondents (sex ratio M/F = 0.9; mean age: 56 ± 3 years; experience: 12 ± 3 years) provided information on 100 taxa, 84 of which are used against internal hemorrhoids, Phyllanthus amarus being the most cited (Citation Index, CI: 0.76). Most of them are trees (38%) or shrubs (32%), belonging to 90 genera and 45 families dominated by the Fabaceae (10%) and Asteraceae (9%). They are indicated in 76 other pathologies, dominated by gastrointestinal disorders (GID), wounds and sexually transmitted infections (CI > 0.57). From these 100 taxa, 117 anti-hemorrhoidal formulations were derived, 11 of which combined more than one plant. In all these recipes, the leaf is the most commonly used part (> 60%) and the liniment (> 45%) is the most popular form of application. For the first time, this study reports 14 taxa as plants used in the treatment of hemorrhoids. Among these taxa, Ficus stuhlmannii, Ficus laurifolia, and Ocimum centraliafricanum are listed as medicinal plants for the first time. Khaya nyasica, and Syzygium cordatum, each with 11 uses, have the highest traditional medicinal value.

Conclusion: The findings of this study indicate that a significant number of medicinal plants are used in traditional medicine in Lubumbashi for the treatment of hemorrhoidal diseases. Some of these plants are endemic to the biodiversity area, while others are shared with other cultures and regions. A series of pharmacological studies is currently underway with the objective of validating the anti-hemorrhoidal properties of these plants and in order to identify phytochemical compounds responsible of this activity.

Keywords: Ficus stuhlmannii; Khaya nyasica; Phyllanthus amarus; Hemorrhoids; Lubumbashi; Traditional healers.

Fig.1

Lubumbashi’s city in Haut-Katanga province, Democratic Republic of Congo

Fig. 2

Morphological types (n = 100)

Fig. 3

Geographical type. Legend: TA(Tropical Africa); NEA(North-East Africa); CA (Central Africa); SA(Southern Africa); MA(Madagascar); EA(East Africa); NA(North Africa); WE(West Africa)

Fig. 4

Plant naming languages. Seventeen families have more than two taxa each. The Fabaceae (10 species), Asteraceae (9 plant species), Lamiaceae (7 species), Phyllanthaceae (6 species), Anacardiaceae (5 species), Euphorbiaceae (4 species), Malvaceae (4 species) and Sapindaceae (4 species) families are the eight most important, collectively accounting for 49% of all plants cited (Fig. 5)

Fig. 5

Family with taxa n ≥ 2. The most frequently cited taxa are Phyllanthus amarus Schumach. & Thonn. (Phyllanthaceae), Terminalia mollis MA Lawson (Combretaceae), and Mesosphaerum suaveolens (L.) Kuntze (Lamiaceae). These taxa were claimed by over 1123 resource persons (CI ≥ 0.728) in total, with each species being cited individually (Table 2)

Fig. 6

Parts of plants used to treat hemorrhoids. The most prevalent method of preparing herbal remedies is decoction (51%) in mono-herbal recipes and pounding (44%) in polyherbal recipes (Fig. 7). Topical administration of herbal remedies is employed in five forms, with liniment (CI: 0.49–0.38) and sitz bath (CI: 0.30–0.25) representing over 50% of anti-hemorrhoidal recipes (Fig. 8)

Fig. 7

Mode of anti-hemorrhoidal recipe’s preparation

Fig. 8

Form of uses of recipe

Fig. 9

Distribution of plants inventoried across the 3 categories of people surveyed. The five pathologies for which the resource persons in this study have the most taxa, in addition to hemorrhoids, are GID (31 taxa), diabetes (15 taxa), sexually transmitted infections (STI; 14 taxa), malaria (13 taxa), and wounds (11 taxa) (Table 5)