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Ethnobotanical Survey of Flora Used in Maasai Food
System and Traditional Medicine against Gout-
related and Other Human Ailments in Monduli,
Arusha, Tanzania
Richard Paul Clement ( clementr@nm-aist.ac.tz )
Mkwawa University College of Education https://orcid.org/0000-0002-4800-0558
Jofrey Raymond
Nelson Mandela African Institute of Science and Technology School of Life Sciences and Bio-
Engineering
Musa N Chacha
Nelson Mandela African Institute of Science and Technology School of Life Sciences and Bio-
Engineering
Research
Keywords: Ethnobotany, Flora, Food, Gout, Maasai, Traditional medicine, Monduli
DOI: https://doi.org/10.21203/rs.3.rs-838942/v1
License: This work is licensed under a Creative Commons Attribution 4.0 International License.
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1
Ethnobotanical survey of flora used in Maasai food system and traditional medicine
against gout-related and other human ailments in Monduli, Arusha, Tanzania
Richard P Clement1, 2*, Jofrey Raymond1, Musa N Chacha1
1School of Life Sciences and Bioengineering, The Nelson Mandela African Institution of Science
and Technology, P. O. Box 447, Arusha, Tanzania
2Mkwawa University College of Education, A constituent College of the University of Dar es
Salaam, P. O. Box 2513, Iringa, Tanzania
*Correspondence: clementr@nm-aist.ac.tz; richardclement28@gmail.com
1st Co-author: musa.chacha@nm-aist.ac.tz
2nd Co-author: jofrey.raymond@nm-aist.ac.tz
2
Abstract
Background: Flora used by Maasai practitioners (MSPs) in traditional medicine (TM) and food
system (FS) were investigated in Monduli District, Arusha, Tanzania. The objective of this study
was to document the knowledge on flora used by MSPs in their FS and TM against gout-related
and other ailments.
Methods: Ethnobotanical knowledge held by 21 MSPs was investigated following standard
approaches. Guided field walk, free listing, rigorous individual-interviews and local market
surveys were employed to obtain information. Use value (UV) index, relative frequency of citation
(RFC), specific RFC (RFCs), fidelity level (FL) and informant consensus factors (ICF) matrices
were involved to determine the knowledge on flora used in Maasai FS and TM against gout-related
and other ailments.
Results: A total of 101 plant species in 83 genera and 47 families, used in Maasai FS and TM were
recorded. Food, food processing or storage, and medicinal plant (MPs) flora accounted 29, 32 and
80 species respectively. MPs treated more than 38 ailments. A high proportion of plants recovered,
was trees 45.19%; while 88.79% were retrieved from the wild habitat. Roots were mostly used
part (30.73%); preparations were made from fresh or dry material and 44-species involved
decoction in meat broth or stock. The frequently route of delivery was oral, 85.19%. About 37.5%
of the MPs were used to treat joints’ pain or inflammation (ICF = 0.52) whereas, mostly used was
Rapanea melanophloeos (FL = 1.00; RFCs = 0.29) followed by Withania somnifera (FL = 0.5;
RFCs = 0.24). Withania somnifera frequently used against other gout-related ailments. Vangueria
infausta and Olea europaea subsp. Africana uses in FS ranked the highest.
Conclusion: The study area is very rich in flora biodiversity, and the flora is an integral part of the
indigenous foods’ and health care systems. The flora is exposed to various destructive
anthropogenic activities; thus, integrated conservation measures are required. The rich
ethnobotanical knowledge held by MSPs, requires an in-depth study and documentation.
Investigations of flora used in the FS, and TM, with high FL, and RFCs could contribute to future
nutraceuticals and drug discovery against gout and other ailments.
Keywords: Ethnobotany, Flora, Food, Gout, Maasai, Traditional medicine, Monduli
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Background
Flora used in indigenous food systems (FS) or traditional medicine (TM) play a significant role in
promoting individual health and well-being particularly in the disadvantaged communities across
the word [1–3]. For instance, globally, floral species used in folk medicine account 35,000 – 70,000
species [1]. Besides, 60-80% of the developing countries rely on the medicinal flora while 30-49%
of the population in developed countries such as China, Germany, Australia, USA and France, is
extensively using medicinal flora [1]. In addition, some floral species are known to provide both
nutritional and medicinal benefits while some are used in processing foods in the indigenous food
systems [2–5]. Still, 25% of the contemporary allopathic drugs are derived directly from flora or
synthetic analogies of different compounds isolated from medicinal flora [1]. Dependency of flora
resources on such benefits is attributed by existing poverty, cultural conservatism and perceived
efficacy, safety, easy accessibility and lower cost of the flora [6].
Tanzania, one of the mega-biodiversity rich country and sixth topmost known biodiversity
hotspots, is not left behind from such benefits of flora biodiversity [6–11]. The country is endowed
with widespread diversity of species with at least 14,500 known and confirmed species [9]
whereas, flora accounts 12, 667 species, and 1122 species of it are endemic while more than 375
of the species are more threatened [6,9]. Despite the threats and endemism on some Tanzanian
floral species, still the flora biodiversity supports large population living in both rural and urban
area for their health and well-being [7,8,10,11]. An estimate of more than 60% (45 million people)
of the Tanzanian population in both rural and urban areas, depends mainly on flora-based
traditional medicines as a vital components of their primary health care and as a means of
generating income [6,12]. In addition, about 69.1% (35 million) of the Tanzania population live in
rural area and 80% of them depend on the flora resources for such needs [6]. Moreover, some
flora species are used as food sources or added in food to provide dietary and or medicinal role in
the indigenous peoples’ food systems [2,4,5].
Traditional knowledge on flora biodiversity up to the current time is still held by many rural
communities and is varying among them depending on their cultural reflections [1]. The cultural
reflection can change individual view point about the environment and also guide interactions
between human being and resources in the ecosystem [1,4]. Consequently, the traditional
knowledge is varying from one culture to the other regardless being in the same ecosystem and
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thus the varying benefits of their traditional knowledge [1]. This also suggest that community with
strong uphold of their culture are likely to have broader traditional knowledge which is reflected
in their characteristic cultural values such as those of Maasai [4,5].
Maasai among other ethnic groups existing in Tanzania, have managed to keep many of their
traditional life styles which support their livelihood [3,6]. Maasai nomadic life has allowed them
to have an access of various biological resources, which has a significant contribution to their
enormous ethnobotanical or traditional knowledge on their landscape [6]. Traditionally Maasai are
pastoralists keeping cattle, sheep and goats, and sometimes donkeys which are used as a source of
income and wealthy symbols [6]. In addition, Maasai depends on animals for foods such as blood,
milk, meat and honey, though in recent days they consume other food sources like banana, beans,
maize, potatoes, rice, and others [4–6].
Maasai along with other cultural practices have long known for their use of flora in their food
system and traditional medicine which is deep-rooted in their life [3–6]. Maasai utilize flora in
their food system and traditional medicine when they are health and during sickness condition [4–
6]. Such dependency on flora in the food system and traditional medicine is attributed by the
enormous knowledge they possess on nature as well as by their life in isolated areas where modern
health care is inaccessible and unavailable [5,6]. Maasai are trained on the value of flora in their
food system and traditional medicine since their childhood. In their age set system during ‘orpul’
festival of meat eating and healing, young boys and ‘Morans’, in addition to other skills and
experiences, are thoroughly trained on flora used in the food system and traditional medicine [4–
6]. On the other hand Maasai girls gain such knowledge from their mothers and grandmothers as
they spend a lot of time with them [4–6]. Such training prepares ‘Morans’ or girls before and after
entering elders group, (allowed to get married) capable of taking family responsibilities including,
to ensure primary health care is provided at the household level through the use of flora in their
food systems and traditional medicine [5,6].
Use of flora in indigenous food system and traditional medicine by Maasai has been linked with
the low prevalence of some diseases including metabolic diseases such as gout in their
communities [3,13]. Gout has been reported to be uncommon in Maasai community predominantly
to those who uphold their traditional life styles in food system and tradition medicine [3]. Gout
risks factors include consumption of food with high purine contents, drinking sweetened drinks,
5
alcohol particularly bear, genetic predisposition, health conditions such as diabetes, obesity, blood
pressure, cancer, hyperlipidemia, kidney disease and some digestive system disorders [14–19] In
contrast Maasai community regularly consume food sources such as meat from goat, cattle, and
lamb with high purine content and fat yet gout is uncommon in their society especially those
embracing their culture of using flora in their food system and traditional medicine [3]. In this
respect flora used in Maasai food systems and traditional medicine have potential nutritional
benefits and medicinal role in management of various human ailments including health conditions
related to gout and its risk factors.
However, Maasai traditional knowledge on flora used in their food system and traditional medicine
is less researched and documented. Still such knowledge is threatened to be lost by the changes
toward a more western lifestyles, poor relation between young and old generation, urbanization,
and over exploitation of the resources [1,6,20,21]
Therefore, this study aimed at conducting ethnobotanical survey to recover and document the
traditional knowledge on flora used in Maasai food system and traditional medicine which manage
various human ailments including gout related health conditions, in Maasai community of Monduli
district, Arusha, Tanzania.
Methods
Description of the study area
The study was mainly conducted in Monduli District and some part of Arusha rural (see figure 1).
Monduli district is one of seven districts located in the northeastern part of Tanzania in Arusha
region. District has an area of 6,419 sq. Km of which land area covers 6290.62 sq. Km and water
covers 128.38 sq. Km; whereas, grazing land covers 3,983.855 sq. Km, arable land covers
1,055.475 sq. Km and forest covers 374.965 sq. Km. Monduli district is bordered to the north by
Longido District, to the east by Arusha rural district, to the south by Manyara region and to the
west by Ngorongoro and Karatu district. Monduli Districts is situated between latitudes 3.00” to
4.50’ South of the Equator and Longitudes 36.50’ to 36.45’ East of Greenwich Meridian. The
district has 20 Wards and 62 villages. In this study ethnobotanical survey was conducted in seven
villages. These villages included Lemiyoni, Makuyuni juu and Zaburi in Makuyuni ward;
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Lossimingori in Lepurko ward; Mlimani in Monduli; and Imbibia and Engalaon villages in
Mwandeti ward found in Arusha rural close to Monduli forest reserve (see figure 1).
The district comprises of three climatic zones: highlands, flat and rolling plains, and rift valley
zones. The zones are further categorized into two major agro-ecological zone: Highlands zone with
average altitude of 2000 m and low land zone (flat and rolling plains) with altitude ranging from
600 m to 1200 m above sea level. Monduli district is one of driest district in Tanzania and has a
warm climate in low altitude areas and cool climate in high altitude areas. District temperature is
ranging between 20 °C to 35 °C while rainfall is ranging from less than 500 mm in low lands to
900 mm at high elevations. Soil characteristics of the district is classified based on the potential of
land-use, into shallow soils with depth less than 40-50 cm, dee soils and deep freely soil drainage
soil with depth more than 40-50 cm. The dominant soils are deep, freely drained clays with a
moderate natural fertility status and occupy about 32% of the district.
Major Ethnic group in the district is Wamaasai constitutes about 40% of the entire population and
their main activities is livestock keeping. The second ethnic group is Waarusha constitutes about
20% of the entire population and their main activities are livestock keeping and farming. The rest
who are not indigenous of Monduli district constitutes 40% and their main activities are farming,
trading and civil servants.
The population size of the district is 158,929 people out of 1,694,310 people of Arusha region as
per National census of 2012 [22]. Sex distribution of the district population showed that males are
75,615 and females are 83,314 in number and the sex ratio was 91. Average house hold size is 4.7
in the district. Monduli has one hospital, one health Centre, and 22 dispensaries. Furthermore, the
study area has open markets were trading of various services and goods such as foods and
traditional medicine are being conducted (figure 1)
7
Figure 1 Location of open markets and participants’ (MSPs) residence, selected as study site in
Monduli District, Arusha Region, Tanzania
Reconnaissance survey and informant selection
Ethnobotanical survey started on June 2020 and end up after two months in August 2020 while
collection of voucher specimens went up to April, 2021. Two (2) to three (3) days before the
interview started, local administrator or village leaders were consulted and the theme of the
research was introduced to them, where it served as the basis for their recommendation on the
participants to be included in the study. Their recommendations were guided by the set criteria
used to include or exclude the participants in the study. This study aimed at determining and
documenting flora used in Maasai food system and traditional medicinal with emphasis to those
used in management or making gout uncommon in Maasai community; therefore, Maasai
respondents with much experience and knowledge on flora used in food system and traditional
medicine as well as those with experience on gout disease, were required. Elders or marriage
people with strong uphold of their culture in Maasai community are expected to hold enough
8
knowledge and practices on flora used in food system and traditional medicine through their
traditional training in ‘orpul’ festival as well as past experiences from their ancestors, and they
have obligation to ensures primary health care is provided at family level. Participants were also
included based on the age where the lowest age for a male participant was not below 30 years as
it qualifies for being elder/married with enough ethnobotanical knowledge and experience as well
as it was the age for risk of getting gout, and its experience. Female were included bases on married
experience and or age at menopause which qualifies for enough ethnobotanical knowledge and
experiences as well as age at risk of acquiring gout and its experiences. Twenty-one (21) MSPs
(15 males and 6 females) were identified from total of seven (7) villages and their backgrounds
were recorded (Table 1). The villages from which respondents were recruited are Mlimani,
Lossimingori, Makuyuni juu, Zaburi and Lemiyoni found in Monduli district as well as Imbibia
and Engalaoni found in Arusha rural district close to Monduli forest reserve as explained early.
Three respondents (MSPs) were local midwifes, two traditional healers, and the rest were normal
elders in the community and all of them mostly working with flora used in FS and TM. Their ages
ranged from 30 to 97 years (mean = 66.90: SD = 17.98). The knowledge held by respondents was
recorded based on their preferences. Most frequently mentioned human ailments of public health
importance around the area were also investigated with respect to the symptoms of the diseases as
confirmed by their indigenous knowledge. Ailments of public health importance are diseases or
conditions that are threat to public health and those can be identifiable on an individual or at a
community level.
9
Table 1: Demographic data of the MSPs in FS and TM in Monduli District, Arusha Region, 2021.
Demographic data
(N=21) Frequency (%)
Gender
Male 15 (71)
Female 6 (29)
Education status
Non-formal 11 (52)
Basic reading and writing skills only (adult education) 3 (14)
Elementary school (STD I - IV/VII) 7 (33)
Ethnicity
Maasai 21 (100)
Occupation of MSPs
Agro-pastoralist (
AGP
) 18 (86)
Agro-zerograzing (
AGZ
) 3 (14)
Traditional Healer (
TH
) 2 (10)
Traditional Midwife (
TM
W
) 3 (14)
Years of Experience (range) AGP AGZ TH TMW
< 10 years (least experience was 8 years) 1 (5) 0 0 0
10 - 20 years 4 (19) 0 0 0
More than 20 years 13 (62) 3 (14) 2 (10) 3 (14)
Ethnobotanical data collection
Rigorous individual interviews and extended discussions with the MSPs, guided field walk, free
listing and market survey were the main data collection methods used in this study. Bennett’s
Golden Rules for ethnobotanical fieldwork were followed to ensure effective interaction with
MSPs. Standard pre-prepared questionnaires were used to record the information given by MSPs
about the local name of the MP, the part (s) used, preparation methods, disease (s) treated, the
route of delivery, possible side effects and antidotes used. Plant growth habitat, habit, conservation
status, potential threats, and management prospects of the reported MPs were also included in the
study interview guide. The checklist used was translated into the local language (Maasai), and the
10
responses of the MSPs in the data collection tool. All interviews and discussion were conducted
in Maasai or Swahili by the principal investigator with the assistance of a translator of Maasai
language to Swahili or English and vice versa. Each MSPs was visited and interviewed two or
three times to ensure consistency of the information provided. The local market survey was carried
out at four open marketplaces (Ngaramtoni, Monduli, Makuyuni and Meserani) found in the study
area (see figure 1). In the market survey name of the plant, part used and the purpose it was sold
were recorded.
Plant specimen collection and identification
Following the records of ethnobotanical information, voucher specimens of the flora were
collected from the wild (W), home garden (HG) and farms (FM) under the guidance of MSPs from
June through August 2020 and end up in April, 2021. GPS was used to record data on geographical
coordinates and altitude. The specimens were numbered and the Maasai name of the species were
recorded, pressed, and properly dried in the field. Appropriate documentation was made with
photographic pictures of the area and the mature individual plant at the site of collection. The
identification of specimens was carried out using Flora of Tropical East Africa [23] by an
assistance of the botanist and his team members at the National herbarium of Tanzania. Specimens
with labels were finally deposited at the National Herbarium (TPRI) in Tanzania.
Data Analysis
Data analysis was carried out using both the classical ethnobotanical systematic investigation and
a numerical quantitative approach in order to evaluate the importance of the mentioned plant
species in the investigated area. The quantitative study was carried out by calculating the following
ethnobotanical indices:
Use categories. Plants used in the study area were classified into categories by adopting the
method developed by cook [24]. Plants were broadly classified into different use categories which
included: medicinal, food, food processing or storage, and other uses based on the use reports in
the study area. Each time a plant was mentioned as “used” was considered as one “use report”. If
one informant used a plant to treat more than one disease or for more than one use in the category
it was considered as a single use report [24]
11
Use value (UV) index. The index is a quantitative measure which facilitates evaluation of the
relative importance of each species known locally based on its relative use among informants [24–
26]:
UV = ∑𝑈i
N
where Uirepresents the number of use reports cited by each informant for a given species and N
denotes the total number of informants. However, the use value does not distinguish between
single or multiple use purpose of a plant species. Use values are high when there are many use
reports for a plant species, signify that the species is important, and approach zero (0) when there
are few reports related to its uses.
Informant consensus factor (ICF). This measure was used to test the homogeneity of knowledge
among informants [24,27]:
ICF = 𝑁ur −𝑁s
𝑁ur − 1
where Nur denotes the number of use reports for a particular use category and Ns denotes the number
of species or taxa used for a particular use category by all informants. Informant consensus factor
(ICF) values are low, close to zero (0) if plants are chosen randomly or if there is no exchange of
information about their use among informants or there is disagreement among the informants
which may be due to having different experiences and keeping information with strict secrecy
[24,27]. Informant consensus factor (ICF) approach to one (1) when there is well-defined selection
criterion in the community and/or if there is information exchange between informants or when
there is only one or few species reported by the majority of informants [24,27].
Fidelity level (FL). This measure provide the ratio of informants who independently reported their
use of a species for the same major purpose to the total number of informants who mentioned the
species for any use [27]:
FL (%) = 𝑁𝑝
𝑁× 100
12
Where Npis the number of informants that claim the use of a plant species for a particular purpose
(e.g., treating a particular disease), and N is the total number of informants that use the plant species
for any use such as treating a particular disease [27].
Relative frequency of citation (RFC). The index of relative frequency of citation (RFC) was
determined by employing the following formula:
RFC = FC
N
where FC is the number of informants reporting use of a particular species and N is the total
number of informants [25].
Specific Relative Frequency of Citation (RFCs). This study ought to determine and compare
relative importance of plant species used for the same specific purpose in the study area; therefore,
the RFCs was computed by employing the following formula:
RFC𝑆= FL × RFC = 𝑁𝑝
𝑁×FC
N
𝐍𝐨𝐭𝐞: 𝑁= FC
Most reliable flora used in FS and TM considered to be effective for the common human illness
or health condition or role performed were identified based on the agreement among the MSPs
using the free list data that show degree of consensus among them.
Results
Flora reported by MSPs in indigenous FS and TM
Results provide the following information for each species: botanical family, scientific name,
vernacular name, habitat, habit, part used, route of administration, use value, relative frequency of
citation, preparation and application, and illness/disease condition treated or role performed (Table
2). This study documented one hundred and one (101) plant species distributed in 47 families and
83 genera in the study area (Table 2). Twenty-two (22) families were represented by two (2) or
more flora species, whereas twenty-five (25) families were represented by only single species each
(Table 2). The most represented family were Euphorbiaceae and Fabaceae with 8 species each;
13
followed by Solanaceae (6 species); Boraginaceae, Rhamnaceae, Rutaceae and Verbenaceae (5
species each); Anacardiaceae, (4 species); and the remaining families each represented by at most
three (3) species (Table 2). Most of the ethnobotanical species constituted trees (T) which
accounted 45.19 % (47 species), followed by shrubs (Sb) 24.04% (25 species) (Fig. 1). Most of
the species (88.79%) were sourced from the wild environment, followed by home gardens (HG)
7.48% (Fig. 2).
Figure 1 Species distributions (a) and percentages (b) on habit of flora used in the study area
14
Figure 2 Habitat percentages of flora used in the study area
The species recorded in this study have different uses; whereas, medicinal uses accounted for
53.69% (80 species) at ICF of 0.71, followed by food processing or storage accounted for 21.48%
(32 species) at ICF of 0.82, food source accounted for 19.46% (29 species) at ICF of 0.79, and
other additional uses such as glue, soap, axe handle, veterinary and ritual purpose, accounted for
5.37% (8 species) at ICF of 0.56 (Fig. 3 and Table 2). Most of the species used, theirs plants parts
have more than one uses which were varying from plant to plant (Table 2).
The most commonly used plants for food sources included Vangueria infausta (FL = 1.00; RFC =
81%); followed by Ximenia caffra and Dovyalis abyssinica each with (FL = 1.00; RFC = 52%)
and in all cases fruits were used. Furthermore, it was found that 58.62 % (17 species) of the plants
used as food sources were also used for medicinal purpose (Table 2). Some of which shared
common parts for food and medicinal uses while for others, their parts were different for the uses
(Table 2). Ximenia caffra apart from being a food source plant, it barks and roots are used as a
medicine for treating various health conditions including joints’ pain (Table 2).
Furthermore, food processing or storage in this study, included cleaning and preventing
contamination, stirring, preservation, providing taste, appetite, odor, flavor, color or viscosity of
15
the food, dissolving fats or coagulate animal blood, holding cooked food, grinding food staffs and
storing food (Table 2). In this study it was found that the most commonly used plant for food
processing or storage was Lagenaria siceraria (storing liquid food) with FL of 1.00 and RFC =
100%; followed by Olea europaea subsp. Africana which is used for fumigating storage container
(calabash), preservation, providing odor and taste of liquid foods (FL = 1.00; RFC = 100). In
addition: Lippia javanica (FL = 1.00; RFC = 0.57); Grewia bicolor (FL = 0.75; RFC = 57%);
Ficus thonningii (FL = 1.00; RFC = 52%); and Clausena anisata (FL = 0.80; RFC = 48%) were
also frequently used for their roles (Table 2). Moreover, it was found that 56. 25% (18 species) of
the plants used for food processing or storage materials were also used for medicinal purpose
(Table 2). Thirteen (13) of these plants shared common parts for medicinal and food processing
uses while the remaining species their parts were different for the uses (Table 2). Among these
plants the following species namely, Acacia nilotica,Combretum zeyheri, Cordia sp, Croton
dichogamus, Cyphostemma subciliatum, Ocimum gratissimum, Piper capense, and Ximenia caffra
shared the common parts for food processing and treatment of various health conditions including
joints’ pain and inflammation, ‘OSUPETAI’ and ‘OLGILA’ (Table 2).
Still, this study recorded some plants with highest use value. Withania somnifera (L.) Dunal
(Olesayet) had the highest UV of 2.67 followed by Lagenaria siceraria (Molina) Standl
(Oltulet/engotii) with UV of 2.48, and Olea europaea subsp. Africana (Mill.) P. S. Green
(Oloirien) with UV of 1.95 (Table 2). Use value of the remaining plants are detailed in table 2.
16
Figure 3 Species distributions (a) and uses percentages (b) on categories of uses for flora in the
study area
Degree of MSPs’ agreement on flora used in the study area
Selection of flora used in FS and TM by the MSPs depends profoundly on their prior gaining of
knowledge from well-organized training in meat eating festival ‘orpul’, elders, parents or cross
communication with other MSPs in the community. Furthermore, MSPs apprehended that
historical narratives or experiences were taken into account in choosing the best or the most
effective flora in their FS and TM to avoid the plants that are reported to have serious side effects
or consequence to human life.
This study showed that some plants such as Olea europaea subsp. Africana and Lagenaria
siceraria were used by all (RFC = 100%) of the MSPs for food processing (preservation and
flavoring agent) and storage purpose respectively, followed by Vangueria infausta used by 81%
of the MSPs as the most commonly used food source (Table 2). In addition, evading plants with
side effects or negative consequences to human life was evident in the choice of Albizia
anthelmintica (Emukutan). Existence of two species of Emukutan was reported. One Emukutan
(‘Orong’ujinia’ in Maasai / ‘Fisi’ in Swahili) which has spots on the back and its backs is brittle,
17
kills human instantly when eaten and always is fenced with thorns as a sign of killing history. The
other normal Emukutan (Albizia anthelmintica) with smooth (no spots) and non-brittle back which
can be made into a rope, is used for medicinal purpose as reported in this study. Furthermore, both
Albizia anthelmintica and Embelia schimperi (Olchani onyokie) with FL of 0.36 and 0.90
respectively, have history or experience of inducing abortion in pregnant women while Embelia
schimperi with FL of 0.90 can further induce excess menstrual flow and causes infertility in
women; thus, care is taken in using the MPs by considering pregnancy and menstrual cycle or
menopause status in women to avoid the side effects.
Computation of ICF values has shown varying degree of agreement among informants on illness
treated, health conditions induced or roles performed by the flora used in the study area. Two (2)
floral species inducing ‘abortion or excess menstrual flow’ (Table 2) had the highest ICF of 0.90
followed by those (6 species) used to treat intestinal worms or parasites (Table 2) with ICF of
0.773 (Table 3). The remaining illness or health conditions are detailed in Table 2 and Table 3.
Moreover, reports of other use categories showed that some flora (4 species) used for food
preservation, taste and flavor (Table 2) had the highest ICF of 0.93 (Table 3) followed by those (2
species) used to stop thirst with ICF of 0.833 (Table 2 and Table 3) and those (32 species) used
for food processing or storage purpose (Table 2) had ICF of 0.815 (Table 3). In addition, some
flora (29 species) used as a source of food had ICF of 0.791 (Table 2 and Table 3). Likewise, some
flora (8 species) used for other additional uses such as veterinary, gluing materials and canning
stick had ICF of 0.563 (Table 2 & Table 3).
Diseases treated and Treatment approaches managed by MPs of the study area
This study recorded more than 38 different human illness or health conditions (Table2 & Table 3)
treated or induced by MPs used in the study (Table 2). The most prevalent diseases or health
conditions managed by the MPs was intestinal worms or parasite (ICF = 0.77); followed by
increasing confidence or angriness (‘MORI’) and increasing libido, energy or strength each with
(ICF = 0.71); inducing vomiting (ICF = 0.69); and constipation or stomach gas, cough and food
digestion each with ICF of 0.67 (Table 3). Besides, health conditions that are accounted for higher
number of species used in their management included ‘OSUPETAI’/ ‘OLGILA’ treated by 33
species (41.3%) of the MPs with ICF of 0.58; followed by diuresis (cleanse kidney) induced by 32
18
species (40.0%) of MPs with ICF of 0.63; joints’ pain and or inflammation treatment by 30 species
(37.5%) of MPs with ICF 0.52 (Table 2 & Table 3).
On the other hand, the study recorded three (3) main approaches for treating the most common
diseases. These included diuresis or frequent urination, which more often results into a white urine,
an indicator for cleansing kidney as per respondents, the second was diarrhea while the third was
vomiting. Diarrhea was induced by 13 species with ICF of 0.57 while vomiting was induced by 5
species with ICF of 0.69.
The most frequently used MP in inducing diarrhea was Albizia anthelmintica (FL = 0.91; RFCs =
0.48). This was followed by Croton megalocarpus (FL = 1.00; RFCs = 0.19), and Rapanea
melanophloeos (FL = 0.5; RFCs = 0.14). Albizia anthelmintica was used in treatment of stomach
worms, malaria or fever, ‘OSUPETAI’, detoxify swallowed poison and increasing body heat
(Table 2). Croton megalocarpus was used in treatment of stomach worms, ‘OSUPETAI’, joints
and back pain (Table 2). Rapanea melanophloeos used for worms, ‘OSUPETAI’, gonorrhea, boil,
pain and swelling on ankles or knee, and wounds treatments (Table 2).
Moreover, the most frequently used MP in inducing vomiting was Albizia anthelmintica (FL =
0.54; RFCs = 0.29), followed by Rumex usambarensis with (FL = 0.80; RFCs = 0.19). Rumex
usambarensis is used to detoxify food poisoning or swallowed poison, treat ‘OSUPETAI’, stomach
ulcers, infertility and clean uterus (Table 2).
Furthermore, this study showed that some of the disease conditions are understood, defined and
explained in a unique way by MSPs in their indigenous health care system. This indigenous health
care system of the study area is apparent from the local vocabularies applied to the diseases or
health conditions described by the respondents. For instance, ‘OSUPETAI’ with RFC of 95.2% is
the health conditions characterized by the following symptoms with their FL (%) value in the
bracket: swelling on a skin with an opening and discharging pus, boil (10%); swelling and or pain
on legs (15%), ankles (10%) knee (30%) tooth gum (5%), and nipples (5%); pain on waist (30%),
joints (10%), muscles (5%), back (35%); body tiredness or weakness (25%); gonorrhea, obstructed
urination associated with pain and discharge of blood and pus from the urinary tracts, as well as
waist pain (47.6%); edema, a swollen part when pressed retain dimples or pits (20%); sudden and
severe pain and warmth on ankle, finger and knee joint especially during the night (5%); reduced
19
libido (10%); pain and coldness feeling on bones (10%); tonsillitis (5%); and headache on one side
of the head in cold weather (5%).
‘OSUPETAI’ is reported to be caused by the following with their FL value in the bracket: sexual
intercourse (55%) between a man and a woman which results in mixing blood between them;
whereas, a condition for infection could be a virgin woman, a prostitute non-pregnant woman with
a sperm deposit in her womb, or a woman in her menstrual cycle or a male infected with
‘OSUPETAI’. In addition, it is also caused by urine of small worms (‘Minyoo ya safura’ in Swahili)
in the body (10%); drinking of soda or eating roast food or lack of physical exercise (10%); eating
food without taking herbs (15%) or eating food without cleaning the body through diarrhea or
frequent urination (10%).
‘OSUPETAI’ is classified by the MSPs based on the part of the body affected or the effect of the
disease. The following are the categories of ‘OSUPETAI’ with their FL values in the bracket:
‘OSUPETAI’ of the bones, ‘loloik’ in Maasai (30%); muscles ‘OSUPETAI’ (15%); joints’
‘OSUPETAI’ (15%); and urinary tract or gonorrhea ‘OSUPETAI’ (45%).
Equally, other health conditions included ‘OLGILA’ with RFC of 38.1%. It is reported to be
characterized by the following symptoms with their FL in the bracket: body weakness and pain on
joints such as knee, fingers as well as pain of the back and waist (38.1%). The disease is caused
by the following: modern way of roasting meat which involve the use of salt and direct fire
resulting into smoke and ashes on the meat (4.8%); lack of exercise or eating without working,
just sleeping (4.8%); and coldness weather (4.8%). In addition, ‘ENAPORSESENI’ is the health
condition which in Swahili is referred to as ‘ngiri’ while in English is hernia, is characterized by
stomach grumbling or pain on umbilical cord. Besides, ‘OROROBI’ is another health condition
characterized by flue, cough and fever. Other common medicinal function or illness are detailed
in the Table 2 and Table 3.
Parts of the flora used by MSPs
In this study it was found that various parts of the plants separately or in combination were used
to treat particular illnesses or to perform specific roles (Table 2) as described by MSPs. Roots were
the most commonly used part accounted for 55 species with 30.73% of uses and 213 use reports,
20
followed by fruits accounted for 35 species with 19.55% of uses and 171 use reports (Fig. 4). Other
parts are detailed in figure 4 and Table 2.
Figure 4 Species distributions (a), number of use reports (b) and usage percentages on parts of
flora used in the study area
Preparation and routes of delivery of flora used in Maasai FS and TMs
Preparation of the flora used in Maasai FS and TMs was reported to involve decoction, infusion,
squeezing, oozing, smoke or ashes, chewing and swallowing, beating on a body part particularly
on the skin. The decoctions were used alone or mixed with other materials (medium) or mixed
with other herbal decoctions. Materials (medium) mixed with the herbal decoctions included meat
broth or stock, milk, melted tallow, clarified butter, blood, castor oil, honey and other plant parts
such as Aloe sp roots. The decoction of the flora particularly MPs, when mixed with meat broth or
stock, it is often in mixtures with other herbal decoction though a decoction for a single herb could
be mixed alone with the meat broth or stock and drunk to realize its specific medicinal purpose.
The decoction of the mixture of MPs when used alone or added into the medium such as meat
broth or stock and honey was used to realize multiple medicinal roles, each performed by a specific
components’ MP. In addition, some herbal decoction was mixed with medium like meat broth or
21
stock and milk to realize some roles such as dissolving fats, add taste, flavor, increasing viscosity
of the mixture (Table 2). On the other hand, medium used in infusion preparation included coco-
cola soda, table salt solution, fat, margarine, honey, sugar solution, meat broth or stock, milk,
porridge, melted tallow or clarified butter, hot water or tea (Table 2). Mixing of herbal medicine
with medium as explained above was reported to have advantages in balancing the strength or
reducing side effects that mighty associate with the herbs, facilitating its diffusion into the body
and increasing its efficacy in treating a disease or realizing targeted effect on the health condition.
However, some of the herbs were used alone or in decoction without mixing with other medium
especially when the herb is considered safe for such use condition.
The most common preparation was decoction in meat broth or stock accounted for 44 species
(55%) of MPs followed by herbal decoction alone accounted for 24 species (30%) of MPs.
Chewing and swallowing accounted for 35 species; whereas, 29 species (82.9%) of the plant used
as food sources of which 17 species (58.6%) of them had both medicinal and food uses. The
remaining preparations are detailed in (Fig. 5 & Table 2). The most common route of delivery for
the preparations was oral accounted for 92 species (85.19%), followed by nasal 8 species (7.41%
each) see (Fig. 6). Some of species were found to be used, through more than one route of delivery
(Table 2).
Dosage of the therapy was administered by MSPs based on sex, age, fitness status, health history,
duration of the sickness, presence or absence of pregnancy and other related factors. For instance,
Albizia anthelmintica and Embelia schimperi preparations were reported to cause abortion in
pregnant women; thus, pregnant women should avoid their uses. In addition, Embelia schimperi
preparations were reported to induce excess menstrual flow; thus, women before menopause
should not use the medicine. Furthermore, in case of overdose or excess diarrhea induced by
Albizia anthelmintica preparation, porridge and fresh milk mixture were drunk to stop diarrhea
and restore the lost energy. The reported dosage measurements included drops, palm, tea spoon,
table spoon, ‘Molel’ (¼ L), ‘Neing’asha or Laiser’ (½ L), ‘Leseri or Tumberi’ (1 L) and any locally
accessible measuring material. The amount of MP drunk, chewed and swallowed, eaten, applied
externally and the duration of the therapy application were varying among the MSPs.
22
Figure 5 Species distributions on mode of preparations or application of flora used in FS and TM
by MSPs in the study area
Figure 6 Species distributions (a) and usage percentages (b) on route of delivery of flora used in
FS and TM by MSPs in the study area
23
Table 2
Description on the habitat, habit, part used, route of administration, use value, relative frequency of citation, mode of pre
paration
and human illness treated or role performed by flora used by MSPs in Monduli Districts, Arusha, 2021
24
Table 2
Description on the habitat, habit, part used, route of administration, use value, relative frequency of citation, mode of pre
paration
and human illness treated or role performed by flora used by MSPs in Monduli Districts, Arusha, 2021 (continued)
25
Table 2
Description on the habitat, habit, part used, route of administration, use value, relative frequency of citation, mode of pre
paration
and human illness treated or role performed by flora used by MSPs in Monduli Districts, Arusha, 2021 (continued)
26
Table 2
Description on the habitat, habit, part used, route of administration, use value, relative frequency of citation, mode of pre
paration
and human illness treated or role performed by flora used by MSPs in Monduli Districts, Arusha, 2021 (continued)
27
Table 2
Description on the habitat, habit, part used, route of administration, use value, relative frequency of citation, mode of pre
paration
and human illness treated or role performed by flora used by MSPs in Monduli Districts, Arusha, 2021 (continued)
28
Table 2
Description on the habitat, habit, part used, route of administration, use value, relative frequency of citation, mode of pre
paration
and human illness treated or role performed by flora used by MSPs in Monduli Districts, Arusha, 2021 (continued)
29
Table 2
Description on the habitat, habit, part used, route of administration, use value, relative frequency of citation, mode of pre
paration
and human illness treated or role performed by flora used by MSPs in Monduli Districts, Arusha, 2021 (continued)
30
Table 2
Description on the habitat, habit, part used, route of administration, use value, relative frequency of citation, mode of pre
paration
and human illness treated or role performed by flora used by MSPs in Monduli Districts, Arusha, 2021 (continued)
31
Table 2
Description on the habitat, habit, part used, route of administration, use value, relative frequency of citation, mode of pre
paration
and human illness treated or role performed by flora used by MSPs in Monduli Districts, Arusha, 2021 (continued)
32
Table 2
Description on the habitat, habit, part used, route of administration, use value, relative frequency of citation, mode of pre
paration
and human illness treated or role performed by flora used by MSPs in Monduli Districts, Arusha, 2021 (continued)
33
Table 2
Description on the habitat, habit, part used, route of administration, use value, relative frequency of citation, mode of pre
paration
and human illness treated or role performed by flora used by MSPs in Monduli Districts, Arusha, 2021 (continued)
34
Table 2
Description on the habitat, habit, part used, route of administration, use value, relative frequency of citation, mode of pre
paration
and human illness treated or role performed by flora used by MSPs in Monduli Districts, Arusha, 2021 (continued)
35
Table 2
Description on the habitat, habit, part used, route of administration, use value, relative frequency of citation, mode of pre
paration
and human illness treated or role performed by flora used by MSPs in Monduli Districts, Arusha, 2021 (continued)
36
Table 2
Description on the habitat, habit, part used, route of administration, use value, relative frequency of citation, mode of pre
paration
and human illness treated or role performed by flora used by MSPs in Monduli Districts, Arusha, 2021 (continued)
37
Table 2
Description on the habitat, habit, part used, route of administration, use value, relative frequency of citation, mode of pre
paration
and human illness treated or role performed by flora used by MSPs in Monduli Districts, Arusha, 2021 (continued)
38
Table 2
Description on the habitat, habit, part used, route of administration, use value, relative frequency of citation, mode of pre
paration
and human illness treated or role performed by flora used by MSPs in Monduli Districts, Arusha, 2021 (continued)
39
d, route of administration, use value, relative frequency of citation, mode of pre
paration
ra
used by MSPs in Monduli Districts, Arusha, 2021 (continued)
40
Table 3 Results of informants’ consensus factor (ICF) for the illness treated or role performed by
flora used in FS and TM by MSPs in Monduli District, Arusha
41
Table 3 Results of informants’ consensus factor (ICF) for the illness treated or role performed by
flora used in FS and TM by MSPs in Monduli District, Arusha (continued)
Abbreviation: Sp, species; URPT, use reports; ICF, informants’ consensus factor
MPs Used in Management of Health Conditions Associated with Gout
This section presents findings of health conditions associated with gout as reported by respondents
as well as it was pointed out early in the background of this study. MPs used in the management
of the health conditions are also presented in this section. The health conditions included
‘OSUPETAI’, inducing diuresis, joints’ pain and inflammation, pressure, diabetes and digestive
system disorders. Some of these health conditions were linked with gout condition by some MSPs.
In this section, where necessary, MPs are presented in figures by their vernacular names and
collections numbers which can be used to refers their scientific names in Tables 2.
42
Thirty (30) species of MPs were reported to be used by MSPs in management of joints’ pain and
or inflammation at ICF of 0.52 (Table 2, Table 3 & Fig. 7). This health condition was linked to
gout by some respondents, only 2 (9.52%) of the them who claim to know gout. The respondents
reported that gout symptoms included pain and inflammation on joints such as knee, in step, fingers
and ankles especially when stretching the joints, as well as difficult in walking and standing upright
easily. The respondents further reported that gout is caused by age (getting older above 60-years),
eating roast meat every day (particularly of goat) without taking any herbal medicine, adding salt
to the meat and roasting it on metal wires. These symptoms were managed by the MPs as detailed
in this section.
The most frequently used MPs in management of joints’ pain was Rapanea melanophloeos
(Iloodwa / Engodwai) with RFCs = 0.29 and FL of 1.00; followed by Embelia schimperi (Olchani
onyokie) and Withania somnifera (Olesayet) each having RFCs of 0.24 and FL of 0.50; Combretum
zeyheri (Ormaroroi-oibor) with RFCs of 0.19 and FL of 0.80; and Commicarpus plumbagineus
(Orng’eriandus), Croton megalocarpus (Ormarbait) and Harrisonia abyssinica (Endundulu) with
RFCs value of 0.14 each and FL of 1.00, 0.75, 0.38 respectively (Fig. 7).
Figure 7 Fidelity level, FL (a) and specific relative frequency of citation, RFCs (b) of MPs used
in management of joints’ pain by MSPs
43
Furthermore, this study found that 26.7% (8 species) of the MPs used in management of joints’
pain were also used in the management of joints’ inflammation. The species had ICF of 0.50 in
management of joints’ inflammation. The most commonly used MPs in management of joints’
inflammation was Withania somnifera (Olesayet) with RFCs and FL of 0.24 and 0.50 respectively.
This was followed by Caesalpinia decapetala (Ormashinga), Commicarpus plumbagineus
(orng’eriandus) and Embelia schimperi (Olchani onyokie) with RFCs of 0.10 each and FL of 0.67,
0.67, and 0.20 respectively. The other MPs used in management of joints’ inflammation were
Acacia sp. (Osiyamalei), Cyphostemma subciliatum (Olorondo), Harrisonia abyssinica
(Endundulu) and Rhamnus staddo (Engokola), and with RFCs value of 0.05 each, and FL value of
1.0, 0.5, 0.13, and 0.11 respectively (Fig. 8). These MPs used in management of joints’
inflammation were also used in joints’ pain management (Table 2).
Figure 8 Fidelity level, FL (a) and specific relative frequency of citation, RFCs (b) of MPs used
in management of joints’ inflammation by MSPs.
Moreover, 33 MPs were reported to be used in management of ‘OSUPETAI’ or ‘OLGILA’ with
ICF of 0.58 (Table 3). The most commonly used MPs in treatment of ‘OSUPETAI’ or ‘OLGILA’
was Withania somnifera (Olesayet) with RFCs and FL values of 0.43 and 0.9 respectively;
44
followed by Aloe sp Mast (Osukuroi), a common ingredient in ‘opururua’ (Table 2) with RFCs
and FL value of 0.29 and 1.00 respectively.
On the other hand, 66.7% (22 species) of the MPs, used in the management of ‘OSUPETAI’ or
‘OLGILA’ were also found to be used in the management joints’ pain and or inflammation. These
species had ICF of 0.63 in management of ‘OSUPETAI’ or ‘OLGILA’. In this case the most
frequently used MPs in management of ‘OSUPETAI’ or ‘OLGILA’ was Withania somnifera
(Olesayet) with RFCs and FL values of 0.43 and 0.9 respectively; followed by Rapanea
melanophloeos (Iloodwa), Rhamnus Prinoides (Orkonyil), and Harrisonia abyssinica
(Endundulu) with RFCs of 0.24 each, and FL value of 0.83, 0.63, and 0.63 respectively (Fig. 9);
Lepidotrichilia volkensii (Engilelekuru) and Embelia schimperi (Olchani onyokie) with RFCs of
0.19 each, and FL value of 1.00 and 0.40 respectively; and Combretum zeyheri (Ormaroroi-oibor)
with RFCs and FL value of 0.14 and 0.60 respectively (Fig. 9). The remaining MPs used in the
management of ‘OSUPETAI’ or ‘OLGILA’ are detailed in (Table 2 & Fig. 9).
Figure 9 Fidelity level, FL (a) and specific relative frequency of citation, RFCs (b) of MPs used
in management of ‘OSUPETAI’ by MSPs.
45
Equally, 32 MPs (Table 2) were found to be used by MSPs in inducing diuresis (cleanse kidney)
with ICF of 0.63 (Table 3) while 59.4% (19 species) of the MPs were also used in treatment of
joints’ pain and or inflammation. The most commonly used MPs in inducing diuresis was Withania
somnifera (Olesayet) with RFCs and FL value of 0.43 and 0.90 respectively. This was followed
by Rhamnus Prinoides (Orkonyil) with RFCs and FL value of 0.33 and 0.88 respectively; Iloodua
and Rhamnus staddo (Engokola) with RFCs of 0.24 each and FL value of 0.83 and 0.56
respectively; Chenopodium schraderianum (Olekukunu) and Piper capense (Olerubat) with RFCs
of 0.19 each and FL value of 1.00 and 0.80 respectively; Helinus mystacinus (Olesupeni) and
Acacia nilotica (Orkiloriti) with RFCs of 0.14 each and FL value of 0.43 each (Fig. 10). These
MPs were also used in treatment of joints’ pain and or inflammation. Besides, other MPs
commonly used in inducing diuresis but not reported in treating joints’ pain and or inflammation
included Vepris simplicifolia (RFCs = 0.24; FL = 0.63), followed by Carissa spinarum (RFCs =
0.19; FL = 0.67), and Scutia myrtina (RFCs = 0.14; FL = 0.50). The remaining MPs that induce
diuresis are detailed in (Table 2 and Fig. 10).
Figure 10 Fidelity level, FL (a) and specific relative frequency of citation, RFCs (b) of MPs used
to induce diuresis (cleansing kidney) by MSPs
46
Besides, this study recorded three (3) MPs used in treatment of blood pressure and diabetes. These
plants included Asparagus setaceus, Tragia ukambensis and Hydnora abyssinica with ICF of zero
(0) in treatment of the disease conditions. The MPs were used in combination to treat pressure and
diabetes (Table 2)
In addition, other MPs were used in treatment of constipation or stomach gas and food digestion
disorders. Three (3) species of MPs were used in treatment of constipation and stomach gas or
bloating at ICF of 0.67; whereas, the most frequently used MPs, was Physalis peruviana (FL =
1.00; RFCs = 0.14) followed by, Ocimum gratissimum (FL = 0.75; RFCs = 0.14) see (Table 2 and
Table 3). On the other hand, food digestion was facilitated by five (5) species (Table 2) with ICF
of 0.67 (Table 3); whereas, Acacia nilotica (FL = 1.00; RFCs = 0.33) was the most frequently used
MP.
Market value of the flora used in Maasai FS and TMs
Market survey was conducted in the selected common open markets which included, Makuyuni,
Monduli, Meserani, and Ngaramtoni to assess the market value of the flora cited in the interviews
conducted at the respondents’ residence (figure 1). The findings showed that the majority (66.7%)
of flora observed in the open markets were cited during the interviews and collected from the field
around the respondents’ residence area. The remaining (33.3%) of the observed flora were cited
in the interviews done at the respondents’ residence but their sample and voucher specimens were
not collected for identification due to the reasons that were out of rich of this study. Flora observed
in the open markets their parts were sold for medicinal purposes. Most of the medicinal purposes
to which each floral part was sold, it was the same as that reported in the interviews done at the
respondents’ residence, except Acacia nilotica was reported to additionally be used for cleaning
blood (Table 2 & Table 4). This survey also showed that some MPs used in management of joints’
pain and inflammation occupy space in the market and are one of the commodities with value in
the open markets (Table 4).
47
Table 4 Description on parts used, purpose of selling for the floral parts sold at Ngaramtoni,
Makuyuni, Meserani and Monduli open markets in the study area.
48
Table 4 Description on parts used, purpose of selling for the floral parts sold at Ngaramtoni,
Makuyuni, Meserani and Monduli open markets in the study area (continued)
Discussion
Flora used in indigenous food systems (FS) or traditional medicine (TM) have been playing an
important role in promoting individual health and well-being particularly in the disadvantaged
communities across the word [1,2]. Such flora is vital and often undervalued part of health care,
and their application in indigenous FS or TM is evident in almost every country in the world
[1,2,4,5]. The demand for its services is currently increasing mainly in form of alternative
nutraceuticals or medicine. It is the main source of healthcare, and sometimes the only source of
care, due to its closeness to the ordinary rural communities and its accessibility and affordability
in view of the rising of healthcare costs [1,2,4,5]. The use of such flora has been linked to some of
49
the diseases for instance gout, being uncommon in certain communities like Maasai with strong
uphold of cultural values in their FS and TM, though, they are exposed to similar risk factors like
other communities with no such values where the disease is common. Tanzanians particularly
Maasai to a large extent depend on flora used in indigenous FS and TM for their primary health
care due to limited access to functional modern healthcare facilities, affordability, cultural
acceptability of traditional medicine practices and practitioners, perceived efficacy against certain
types of diseases, and the belief that such flora has low side effects [2,4,5,27]. As a result of
improved access to contemporary medicine, poor relation between young and old generation,
environmental degradation such as overgrazing, over exploitation of natural resources, and
urbanization, both traditional knowledge and flora that have been used in indigenous FS and TM,
for millennium are highly threatened [1].
Despite of such threats contributed mainly by the anthropogenic activities, there are still many
flora in different part of Tanzania [7,8,10,11]. The findings of the current study conducted in
Monduli District and some part of Arusha rural, have recovered a total of 101 flora with various
uses. It was found that medicinal uses accounted for 53.69% (80 species). This was followed by
food processing and storage, 21.48% (32 species); food sources 19.46% (29 species); and other
uses such as glue, soap, veterinary and ritual purpose, 5.37% (8 species). Furthermore, it was
observed that some of the flora particularly MPs with the most common uses and some with low
or no availability in some places of the study area, were found to be sold in opens markets. This
observation justifies the traditional healthcare and economic importance of the MPs. The findings
of this study suggest that the study area has large biodiversity of flora that are main source of
medicine, food, food processing and storage materials and other uses, as well as it plays its role in
income generation. Therefore, protection and sustainable use of such biodiversity is inevitable.
Furthermore, it was found that trees accounted for a higher proportion of the flora used in the study
area. This observation was also made in Maasai of Southern Kaijiado District, Kenya [28]. This
could be attributed to the common cultural reflections and pattern of growth forms in Maasai
communities.
This study also revealed that families Euphorbiaceae and Fabaceae (8 species each); followed by
Solanaceae (6 species); Boraginaceae, Rhamnaceae, Rutaceae and Verbenaceae (5 species each);
Anacardiaceae (4 species) comprise a greater number of flora species. These are among the
50
topmost families comprising flora used mainly as MPs in different parts of the country, and their
higher proportion in the flora of Tanzania substantiates this report, implying documentation of
wide distribution and higher number of species of these families throughout the country [7,8,11].
Still, it was found that mostly widely used part of the flora used in the Maasai FS and TM was root
accounting for 55 species with 30.73% of uses and 213 use reports. The study by Ngowi et al
reported similar findings with medicinal plants of Kondoa [8]. Possible explanation for this
observation is that Maasai people like Rangi people through their long experiences have been able
to ascertain that roots were the most effective plant part. The observation is scientifically supported
by Ngowi et al., reporting that alkaloid composition of Strychos species in South America was two
folds higher in roots and barks relative to the amount found in leaves [8]. It can therefore be
concluded that roots play an important role especially in the indigenous healthcare systems for
management of various health conditions. Though, exploitation of the roots and barks poses more
threats to the flora than the use of other parts [27].
Moreover, it was found that more of the flora were used in the Maasai TM as MPs than other use
categories as indicated by the high proportion of species, 80 out of 101 species recorded in this
study. This suggest that the flora of the study area play a significant role in management of various
health conditions as detailed in table 2. Out of these MPs some were used to manage symptoms
and related health conditions of gout, a disease claimed to be uncommon in Maasai community
embracing their cultural values in FS and TM.
Treatment of joints’ pain and inflammation was among the medicinal function achieved by the
MPs used by MSPs. The joints’ pain and inflammation are among the important symptoms of gout
in addition to the deposition of monosodium urate in the affected joints, which often is determined
clinically [29,30].
It was revealed that, 37.5% (30 species) of the MPs were used in management of joints’ pain and
or inflammation while 10.0% of the MPs were used in management of both joints’ pain and
inflammation. On one hand, the most frequently used MPs in the management of joints pain was
Rapanea melanophloeos, followed by Embelia schimperi and Withania somnifera, Combretum
zeyheri, Commicarpus plumbagineus, Croton megalocarpus and Harrisonia abyssinica. On the
other hand, the most frequently used MPs in management of joints’ inflammation was Withania
somnifera, followed by Caesalpinia decapetala and Commicarpus plumbagineus, Embelia
51
schimperi, Acacia sp. (Osiyamalei), Cyphostemma subciliatum, Harrisonia abyssinica and
Rhamnus staddo. These species were also used in management of joints’ pain. This finding
suggests that the most common MP in treating both joints’ pain and inflammation is Withania
somnifera.
The use of MPs in management of joints’ pain and inflammation in the current study is supported
by findings of some other ethnomedicinal studies. Pappea capensis and Rhamnus prinoides were
reported to be used traditionally in the treatment of arthritis or gout [28,31]. Moreover, Acacia
nilotica was reported to treat painful joints while Rhamnus staddo treat joints pain, inflammation,
gout, and clean kidney [32,33]. Also, Commicarpus plumbagineus is used in treatment of arthritis
[34].
Still, findings of some pharmacological studies support the traditional use of the MPs in treatment
of joints’ pain and inflammation. Withania somnifera is the well-known important medicinal plant
in Indian system of medicine for treating many ailments since time immemorial [35,36]. This
concur with its highest use value (UV = 2.67) recorded in this study. Moreover, pre-clinical studies
of Withania somnifera has shown anti-inflammatory, anti-diabetic, anti-microbial, anti-stress, anti-
tumor, cardioprotective, neuroprotective properties as well as ability to reduce reactive oxygen
species, modulate mitochondrial function, regulate apoptosis, reduce inflammation and enhance
endothelial function [35,36]. Moreover, Caesalpinia decapetala, Rhamnus prinoides and
Harrisonia abyssinica are reported to have antioxidant or anti-inflammatory activities [37–41].
Species with antioxidant or free radical scavenging, anti-inflammatory and xanthine inhibitory
activity are known to be the best choice of bioactive agents in treatment of gout [15,30,42,43].
Furthermore, phenolic compounds are known to have anti-hyperuricemia or anti-inflammatory
activities [40,43]. Thus, the use of such MPs by Maasai while they are health or sick in their FS
and TM, could support the claim that gout is not common in the Maasai community. Such species
used in management of joints pain and inflammation have potential contribution in the discovery
of drugs against gout.
Furthermore, this study revealed that some MPs were used to treat illness or manage health
conditions that are uniquely defined by the MSPs as well as some related to or share some
symptoms and causes of gout. These illness or health conditions included ‘OSUPETAI’ or
‘OLGILA’, blood pressure, diabetes, diuretic process, and digestive system disorders.
52
‘OSUPETAI’ and ‘OLGILA’ are sometimes interchangeably used by MSPs to refers the same
health condition. ‘OSUPETAI’ which is sometimes referred to as ‘TAMBAZI’ in Swahili by most
of MSPs, was identified by symptoms and causes described by the respondents; however, the
symptoms and causes of the health condition are supported by clinical literature and findings.
Reported symptoms of ‘OSUPETAI’ included pain and inflammation of joints like ankle, finger
and knee, and sometimes sudden and severe pain and warmth inflammation on the joints that
occurred at specific time (particularly at night). All of these symptoms are the clinical
representation of gout [18]. Furthermore, a swelling of the skin occurring on an area such as nipple
or leg and that develop an opening and accumulation of pus was another reported symptom and
claimed to represent boil which in Swahili was termed as ‘JIPU’ and clinically is known to be
caused by Staphylococcus aureus infection [44].
Still, obstructed urination associated with pain and discharge of blood and pus from the penile or
vagina were also reported as symptoms of ‘OSUPETAI’ as well as claimed to signify gonorrhea,
a clinical illness represented by the symptoms [45,46]. However, other infections such as
chlamydia and Trichomonas may share the same symptoms of gonorrhea [47,48]. Moreover, a
swelling when pressed retains dimples or pits was reported as another symptom of the disease
which also is a clinical representation of edema [49–51]. In addition, other symptoms of
‘OSUPETAI’ included pain on muscles, waist and back, which clinically may be caused by muscle
and ligament strain, bulging or ruptured disks, arthritis or osteoporosis [52,53].
Likewise, reduced libido was one of the reported symptom of ‘OSUPETAI’ and clinically has
different interplaying causes that involves internal cognitive processes, neurophysiological
mechanisms and affective [54–58]. Similarly, body weakness and fatigue are claimed symptoms
of the health condition. Clinical causes of body weakness could be infectious, inflammatory,
endocrine, genetic, metabolic, neurologic, rheumatologic, electrolyte-induced, or drug-induced
[59]. While fatigue could due to physiological states, medical conditions, psychiatric disorders or
medical prescriptions [60,61]
Equally pain and coldness feeling to the bones in cold weather were reported symptoms of
‘OSUPETAI’ and clinically are explained by some theories which have not yet pinpoint the actual
cause of the situation: one theory explaining that inactiveness due to cold weather lower blood
circulation to organs and bones hence pain and weakness to the joints; and the other theory
53
explaining that barometric pressure changes in cold weather may have an effect to the tendons,
muscles, scar tissue or exposed nerves of the bone, that results into bones and joints pain especially
to those people with arthritis [62,63]
Tonsillitis was another reported manifestation of the health condition; whereas, common virus or
bacteria are the clinical causes of the illness [64–66]. Swelling of the tooth gum was also
recognized as a symptom of ‘OSUPETAI’; whereas, the underlying causes include poor dental
hygiene and periodontal infections particularly with [67,68]. Lastly, but not least one-sided
headache in cold weather was reported as the symptom of ‘OSUPETAI’ and it is a clinical sign of
migraine where its pathogenesis is suggested to represent vascular phenomenon or a neurovascular
disturbance, relating to changes in brain and genes [69–71]
Furthermore, MSPs reported causes or risk factors of ‘OSUPETAI’; whereby, the most common
risk factor was sexual intercourse between infected partners who could either be a virgin woman,
a woman in her menstrual cycle, a prostitute men or women. This risk factor coincides with the
reported symptoms particularly those of gonorrhea or sexually transmitted disease gonorrhea [45–
48]
Small worms in Swahili referred to as ‘Minyoo ya Safura’ was also reported as the cause of the
‘OSUPETAI’ represented by edema. Though, the worms clinically known to causes anemia
‘Safura’ include, Necator americanus and Ancylostoma duodenale and in severe case could result
into heart failure and widespread tissue swelling [72–75]. Nevertheless, other worms
predominantly Wuchereria bancrofti and to some extent Brugia malayi and Brugia timori are
clinically known to cause lymphedema in filariasis with no or less effect on hemoglobin content
and anemia, contrary to the reported ones in anemia ‘Safurra’ case[76,77]. Consequently, the
reported edema as one of ‘OSUPETAI’ symptom may be linked to the reported and clinical worms
associated with anemia and lymphedema.
Moreover, drinking of sweetened drinks such as soda or eating roast food such as meat or lack of
exercise were other reported causes of ‘OSUPETAI’ and clinically they represent some risk factors
of gout disease [18]. Besides, eating food without taking herbal medicine or cleaning the body
through diarrhea or frequent urination were reported causes of ‘OSUPETAI’ and this claim agrees
with orpul festival of meat eating and healing by MSPs with one of the intentions being disease
prevention and treatment [6].
54
In view of the reported and clinical symptoms, causes and risk factors of ‘OSUPETAI’ it is clear
that the health condition or the term represents collection of illness affecting human with different
causes including infectious pathogens and non-infectious agents which locally cannot be
determined with certainty rather their symptoms are linked to their risk factors. This fact also
supports the claim by one of the respondents saying ‘OSUPETAI’ is a collection of diseases’; thus,
it was classified into bone (‘loloik’ in Maasai), muscles, joints, and urinary tract/gonorrhea
‘OSUPETAI’ depending on the part of the body affected. In addition, ‘OSUPETAI’ share common
risks factors and symptoms of gout among other illnesses related to the reported health condition.
Additionally, ‘OLGILA’ was another health condition reported by MSPs and has different
symptoms representing the disease. Body weakness and pain on joints such as knee, fingers as well
as pain of the back and waist were the most common symptoms of the health condition. As
discussed early, the pain on joints are among the clinical signs of arthritis or gout [18]. Still, the
pain on the back are the symptoms of the condition and have the same clinical etiologies as that
described in ‘OSUPETAI’ [52,53]. Moreover, body weakness as the symptom of ‘OLGILA’, has
the same clinical causes as described in the ‘OSUPETAI’ condition [59].
Furthermore, MSPs reported different causes of ‘OLGILA’. Modern way of roasting meat which
involve the use of salt and direct fire resulting into smoke and ashes on the meat was one of the
reported causes. This is partly and clinically known to cause gout from the purine content of the
meat and probably the added salt as the purine metabolism result into monosodium urate
formation, a condition for the development of gout which is characterized by pain and
inflammation of the joints [18] which also, they fairly represent the reported symptoms of
‘OLGILA’. Moreover, lack of exercise or eating without working were other causes of the disease
condition and clinically may result into body weakness and obese respectively. Obesity is the risk
factor for many diseases including gout, diabetes and pressure [18]. Coldness weather was also the
reported cause of ‘OLGILA’ as in ‘OSUPETAI’ condition with the same clinical justifications
[62,63].
Therefore, in accord to the reported causes, risks factors, symptoms of ‘OLGILA’ and their clinical
justifications it is clear that the disease shares some common risk factors, causes and symptoms of
gout that are the subset of causes, risk factors and symptoms of ‘OSUPETAI’. However, in
assessing the risk factors and causes of ‘OLGILA’ they seem to closely relate to gout, despite other
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diseases may bear the same risks factors and causes as discussed early. Furthermore, the sharing
of common causes, risk factors and symptoms between ‘OSUPETAI’ and ‘OLGILA’ justifies their
interchangeable use by some MSPs to refers the same health condition. Thus, the MPs used in
management of ‘OSUPETAI’ could sometimes be used to manage ‘OLGILA’ as well as gout
particularly for the shared causes and symptoms.
In this study it was found that the most commonly used MP in the management of ‘OSUPETAI’
or ‘OLGILA’ was Withania somnifera, followed by Rapanea melanophloeos, Rhamnus Prinoides
and Harrisonia abyssinica, Lepidotrichilia volkensii, Embelia schimperi, and Combretum zeyheri.
About, 66.7% (22 species) of the MPs used in management of ‘OSUPETAI’ or ‘OLGILA’, were
also used in management of joints’ pain and inflammation (gout symptoms); whereas, most
respondents agreed on the use at ICF of 0.632. Furthermore, most of the MPs used in management
of ‘OSUPETAI’ or ‘OLGILA’, their different parts were combined to make preparations such as
‘Opururua’ or a mixture of herbal decoctions and meat broth or stock (Table 2 & fig 5) for
prevention and treatment of the health condition as described in Table 2. This practice can be
justified by the fact that ‘OSUPETAI’ is the collection of diseases or illness as discussed early;
thus, it may require different herbs with different role to realize effective prevention or treatment
of the health condition. The practice of combining herbs is reported to be very common in ‘orpul’
festival of meat eating and healing; though, in some cases few plants can be combined or used
alone in the treatment of specific illness with characteristics symptoms. For instance, one
respondent combined Eucalyptus saligna and Ocimum gratissimum in preparing the decoction
mixture to treat joints (finger & knee) pain, claimed to occur during the night and reported as early
signs of ‘OSUPETAI’. Another respondent used Combretum zeyheri alone when he had experience
of joints pain which was claimed to be caused by eating roast meet for long time without taking
herbs.
Still, use of the MPs in management of ‘OSUPETAI’ or ‘OLGILA’ with its characteristics causes,
risk factors and symptoms is supported by findings of other studies. Withania somnifera with its
broad spectrum biological activities [35,36] could be responsible in management of symptoms and
the underlying causes of ‘OSUPETAI’ or ‘OLGILA’. In addition, Rapanea melanophloeos and
Embelia schimperi are reported to have activity against parasitic worms or microbes [78–80], the
possible underlying causes of ‘OSUPETAI’ or ‘OLGILA’.
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This study further recorded MPs used in management of other illnesses or health conditions
associated with gout. Pressure and diabetes were among illness treated by the MPs, and are
clinically known to be the risks factors for the development of gout [18]. Each of the diseases was
treated by a combined therapy from Asparagus setaceus, Tragia ukambensis and Hydnora
abyssinica. However, the homogeneity of the knowledge were lacking as ICF on the use of the
species in treatment of each disease was zero (0), this may be due to randomly choice of the species
or no exchange of information about the use of the MPs on each disease or disagreement among
the informants attributed by different experiences and keeping the information with strict secrecy
[24,27]. Despite lacking of homogeneity on the use of the MPs in treating pressure and diabetes,
these species have potential contribution for discovery of pressure and diabetes drugs as well as
reducing the co-morbidities or the risk factors from the disease associated with gout.
Moreover, some MPs were used to induce diuresis or frequent urination which clinically is known
to have effect on the gout health condition. Diuretics are known for helping the body to get rid of
salt and water by stimulating a kidney to release sodium into the urine hence more water is pulled
from blood into the urine and thus frequent urination [81]. Diuretics are commonly used to treat
heart failure and other conditions such as liver or kidney disorders that cause fluid retention or
edema in the body [82].
Conventional diuretics have been used for the management of the health conditions. Such diuretics
are reported to have side effects including, upset of bloodstream salt balance, commonly resulting
into low blood level of potassium, sodium, and magnesium and high level of calcium; stomach
upset; dizziness on standing; and worsening diabetes and gout conditions [82,83]. Yet, the effect
of diuretics on the occurrence of gout may depends on the condition for which the diuretics are
given rather than ensuing from the drugs themselves [84]. In addition, renal handling of urate
depends on the type of diuretic used, those with uricosuric properties may also help treatment of
gout or the weaker may have low risks while the stronger may have higher risks on the occurrence
of gout [84].
Conversely, natural diuretics particularly veggies and fruits are high in water and potassium (and
some in magnesium and calcium) which help to offset the constriction of blood vessels that makes
one feel bloated in case of excess sodium [85,86]. Furthermore, natural diuretics have been used
57
in treatment of swelling and rheumatism as well as some have properties of reducing uric acid in
the body[87].
In this study 40% (32 species) of MPs were found to be used as diuretic agents and the respondents
agreed on the use at ICF of 0.627. From these diuretic plants, 59.4% (19 species) of them were
used both as diuretic agents and for the treatment of joints pains and inflammation. Amongst
species the most commonly used diuretic agent was Withania somnifera, followed by Rhamnus
Prinoides, Rapanea melanophloeos, Rhamnus staddo, Chenopodium schraderianum, Piper
capense, Helinus mystacinus and Acacia nilotica. The observation that some MPs were used as
diuretic agents and in treatment of joints’ pain and inflammation could be supported by the fact
that diuretics have the capacity of removing edema or fluid retained in the body as well as some
have uricosuric properties which remove uric acid from the body[87]. Moreover, irrespective of
the use of the MPs as diuretic agents, no side effects associated with diuresis were reported in this
study as compared to those possessed by the conventional diuretics. This observation could be
supported by the fact that most natural diuretics as discussed early are known to contain high
amount of water, potassium and sometimes calcium and magnesium which have the capacity of
offsetting the effect of excess sodium [85,86]. In addition, mixture of herbal decoction and meat
broth or stock, and decoction of MPs were the most commonly used preparations. This could also
have significant contribution in prevention of dehydration and other related side effects as both of
the preparations have plenty of water and possibly the necessary minerals. The use of these diuretic
agents in the current study is supported by the study showing that Withania somnifera in Ayurveda
healthcare system of India is known as a prominent herbal Rasayana with diuretic property [36].
So, MPs with diuretic properties that are also used in management of joints’ pain and inflammation
are potential sources for discovery of diuretic and uricosuric drugs that could be used in
management of gout and other related health conditions. In addition, the use of diuretic agents
along with plenty of fluid and minerals could be the best approach in management of gout and
other related health conditions.
Still, this study recorded some MPs used in management of food digestion, constipation, stomach
gas or bloating, the conditions related to digestion system. Digestion system has an important role
on the gout health conditions and some of its disorders are the risk factors for the disease [88].
Studies have shown that extensive degradation of a substantial amount of uric acid occurs in human
58
with carbon dioxide and ammonia being principal uricolytic products [88]. Intestine, a digestive
organ known for its contribution in elimination of one-third of uric acid formed daily in a person
[88]. The elimination of uric acid in the gut is through uricolysis supported by intestinal bacteria
which degrades uricolysis products particularly carbon dioxide; whereas, the formed products are
excreted through feces [88]. It is therefore logical to ascertain that any factor that affect the normal
function of digestion system including breakdown and excretion of uric acid it has contribution in
the development of gout.
Constipation, a less than three (3) number of bowl movement per week [89] it is a clear indication
of lower defecation rate hence the slow excretion rate of uric acid. Constipation is one of the
symptoms of gastrointestinal disorders that has various etiologies including mechanical,
metabolic, neuropathies and myopathies causes that may affects coordination of bowl motility,
mucosal transport or defecation reflexes [89–91]. Some causes of constipation include colonic
malignancy or sensorimotor dysfunction, bowl or pelvic cancers, cancer therapy and uremia [91].
In addition to the causes, risks factors such as female sex, older age, sedentary life style, low fiber
diet, malnutrition, polypharmacy and low social economic status may result into constipation [89]
Moreover, indigestion, a group of symptoms ranging from pain or discomfort to postprandial
fullness, early satiation, burping, abdominal bloating, gurgling sounds, or even nausea and
vomiting, is another condition affecting digestive system. Indigestion is known to be caused by
intra-abdominal, dietary and lifestyle factors that are categorized into physiological, biological,
psychological and environmental mechanisms [92]. Furthermore, indigestion relates to other
health conditions that are known to have influence on gout conditions.
Hyperchlorhydria, a high stomach acid, is a common symptom known to be associated with
indigestion as well as other health conditions such as gastritis, peptic ulcer disease, renal failure
and some cancers [14,16,17]. Hyperchlorhydria symptoms include abdominal pain, heartburn,
nausea, vomiting of sour liquid, gas and bloating, belching, flatulence, and constipation.
Furthermore, some of the health conditions are known as the factors for occurrence of
hyperchlorhydria and some are results of the health conditions. Studies have shown that gastrin, a
larger precursor for various biologically active peptides, has an important role in meal-stimulated
gastric acid secretion, epithelia cell proliferation of gastrointestinal tract and sometime its products
can serve as autocrine growth factor for colorectal cancers development [93]. Overexpression of
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gastrin due to gastrin secreting tumor (Zollinger-Ellison syndrome) or the presence of some
bacterial infection such as Helicobacter pylori results into hyperchlorhydria and consequently
peptic ulcers and thickening of gastro-intestinal mucosa [16,93].
Furthermore, hyperchlorhydria is found to be one of marked conditions in gout patients. The
condition has been associated with delayed starch digestion and flatulence, followed by
enlargement of the liver, a condition if not relieved is succeed with characteristic arthritic attacks
[94]. The liver is found to be the source of glycocin which is suggested to be responsible in
production of uric acid through its conjunction with urea in the kidney where excretion of uric acid
occurs hence its disorder may result into gout [94]. Still, some other disorders of the liver
particularly glycogen storage disease type Ia is also known to results into gout [19]. Defective
enzyme involved in the this liver disorder does not only affect the liver it may also cause damage
to the kidney an important organ for excretion of uric acid and other wastes [95]. In addition,
glycogen storage disease type Ia is also known to be the main cause of gout in premenopausal
patients [19,96].
In view of the disorders of digestive system it is clear that the symptoms or health conditions
particularly constipation, stomach gas or bloating reported in this study, are the indication of the
digestive system disorders of which some are associated or are the risk factors for gout condition.
Thus, MPs used in management of the symptoms play an important role in the health of the
digestive system and may have potential effects on the digestive disorders underlying causes or its
consequences related the gout condition.
In the current study, three (3) species of MPs were used in management of constipation, stomach
gas or bloating whereby the respondents agreed on the uses at ICF of 0.667. The most commonly
used MP to treats the conditions was Physalis peruviana, followed by Ocimum gratissimum.
Furthermore, five (5) species of MPs were used in facilitating food digestion or preventing
indigestion at ICF of 0.667; whereas, the most commonly used MP was Acacia nilotica.
The use of these MPs in management of digestive system disorders as well as their potential effects
on gout condition in this study is supported by findings of other studies. Physalis peruviana is
known to have antioxidant activity and inhibitory effect on xanthine oxidase activities. It is a
widely used herb for treating various health conditions including cancer, hepatitis and rheumatism.
Furthermore, Ocimum gratissimum is also known for its antioxidant, anti-inflammatory, anti-
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diarrheal activity as well as relaxant effect on gastro intestinal tract [97–99]. Moreover, it is used
against gastrointestinal helminths, diarrhea or stomach upset and bacterial infections among other
health conditions [97]. In addition, it is used against rheumatism and has hypoglycemia activity
that is important in the management of gout as well [97,98]. Still, Acacia nilotica possesses
antioxidant, anticancer, anti-diabetic activities and is traditionally used for nutritive purpose,
against diarrhea, cancer, induration of liver and spleen and digestive problems [100,101]. Hence,
the use of the MPs in management of the digestive system disorders has positive impact to health
of the digestive system as well as its conditions associated with gout.
Apart from the flora used in the Maasai TM in management of various ailments including gout
symptoms and its associated health conditions as discussed early, the current study recorded some
flora used in the Maasai FS. Most flora involved in the Maasai FS were used for food sources,
food processing or storage purpose. However, some of them had also medicinal values as detailed
in Table 2.
The most commonly used food source plant recorded in this study was Vangueria infausta and the
study by Maroyi, support its use as the food source as well as a medicine for treating various health
conditions including gastrointestinal disorders, parasitic worms and abdominal pains [102]. Such
nutraceutical properties of Vangueria infausta play its role in health of digestive system;
consequently, may have potential effect on gout condition. Besides, the most commonly used
plants for food processing or storage purpose in this study was Olea europaea subsp. Africana
which was used for food preservation, taste and flavor of a liquid food while Lagenaria siceraria
was used for storage purpose of the liquid food. Olea europaea subsp. Africana is known for its
antihypertensive, hypoglycemic, antioxidant and antibacterial activities [103]. Furthermore,
Lagenaria siceraria fruit has been used traditionally as antidiabetic remedy as well as it has a
capacity of enhancing stability of stored herbal concoction in its dry fruit [104,105]; though, its
effect on food is not well known. Subsequently, such food source plants and those used in food
processing and storage purpose in this study may have potential contribution in the management
of gout and other health conditions in addition to their reported uses.
61
Conclusion
The current study gathered the knowledge held by MSPs in their indigenous FS and TM, along
with assessing the ethnobotanical knowledge available in the public domain particularly on open
markets. The study area in Monduli district, Arusha has diverse flora (101 species) used mainly
for medicinal purpose, 53.69% (80 species) in treating or managing various human ailments or
health conditions; food processing and storage, 21.48% (32 species); food sources, 19.46% (29
species); and other uses, 5.37% (8 species). This study has shown that the MSPs of the area have
rich knowledge on their FS and TM; whereas, the flora is an integral part mainly in the primary
healthcare and indigenous food system as well as income generation in the Maasai community.
Due to limited access of modern healthcare services, cultural conservatism, and economic
insufficiency to meet the prices of available modern healthcare services, flora, mostly MPs are the
most reliable source of healthcare services which more often is provided at household level in the
community.
MPs of the area were used to treat more than 38 ailments, and some induce diuresis, diarrhea, and
vomiting as the approaches involved in the treatments. Some MPs were used to manage health
conditions associated with gout, which included: joints pain and inflammation, pressure, diabetes,
‘OSUPETAI’, digestive system disorders, and diuresis. In addition, some were used in the
indigenous FS with their medicinal values against the ailments including health conditions
associated with gout.
Most (88.79%) of the flora are found in the wild habitat where anthropogenic activities are
evolving and thus are exposed to demolition. Consequently, this calls for establishment of
sustainable integrated natural resources management system on the area as soon as possible.
Indigenous stewardship of the natural resources, including flora used in the indigenous FS and TM
needs documentation and improvement by government and non-government environmental
restoration programs to preserve the flora of the area. Additional plant use categories including,
firewood, construction, bee forage, ornamental, fodder, shade, etc. requires documentation so as
to augment the preservation of the vital natural resources.
This study recommends an in-depth laboratory investigation of the frequently cited MPs with high
FL, RFCs used in management of the ailments including joints pain and inflammation, diuresis,
and digestive system disorders. This would have potential contribution to the current global drug
62
discoveries for the management of gout condition and other reported health conditions. Also,
further study of the Maasai food system is required to ascertain its influence on gout and other
reported health conditions.
Abbreviations
FL: Fidelity level; FS: Food system; ICF: Informant consensus factor; MP/MPs: Medicinal
plant(s); MSP/MSPs: Maasai practitioner(s); RFC: Relative frequency of citation; RFCs: Specific
relative frequency of citation; TM/TMs: Traditional medicine(s); UV: Use value
Acknowledgements
We extend our deepest gratitude to the community of Monduli district, Arusha particularly the one
living in Engalaoni, Imbibia, Lossimingori, Lemiyoni, Makuyuni juu, Mlimani and Zaburi
villages, as well as MSPs who participated consciously in the present study. The local authorities
are exceedingly cherished for the extrovert support given to us during the fieldwork in the study
area. We thankfully concede the staff of the National Herbarium (TPRI) for assisting us in
herbarium work. Special gratefulness goes to Gabriel S Laizer (Field botanist) and his team
members, Dr. Neduvoto Piniel Mollel (Head of Division, National Herbarium, TPRI), John Elia
Ntandu (TPRI researcher), and Diana Mbaruku (TPRI herbarium data base Logger) for their
unreserved assistance during the identification and validation of the specimens. Also, special
thanks go to Tanzania Forest Service (TFS) of Monduli District, Arusha for their great support and
permission to include some of the areas under their Authority in this Study.
Funding
The Tanzania Ministry of Education Science and Technology (MoEST) has covered cost of the
current study.
Availability of data and materials
Data generated or analyzed during this study are included in this article
63
Authors’ contribution
RPC developed the study design and protocols, collected the data, carried out the statistical
analysis, and prepared the draft manuscript. MNC and JR were involved in the design and protocol
development, provided consistent comments during the analysis and write-up of the manuscript,
and rigorously reviewed it. All authors have read, approved and agreed on the submission of the
final manuscript.
Authors’ information
Richard Paul Clement – M.Sc. (Marine Sciences); Assistant Lecturer in Chemistry Department at
Mkwawa University College of Education, a Constituent College of the University of Dar es
Salaam, Tanzania and a PhD candidate in the School of Life Science specialized on Health and
Biomedical Sciences at The Nelson Mandela African Institution of Science and Technology, and
currently working on the validation of anti-hyperuricemia traditional MPs of Tanzania.
Musa N Chacha – MPhil & PhD in Natural Products Chemistry; Senior Lecturer at The Nelson
Mandela African Institution of Science and Technology, Arusha, Tanzania and working on
development of antimicrobial, anticancer and insecticidal agents from medicinal plants, marine
invertebrates and microorganisms.
Jofrey Raymond – PhD in Life Science (Food and Nutritional Sciences); Lecturer at The Nelson
Mandela African Institution of Science and Technology, Arusha, Tanzania and working on Food
systems for nutrition, Nutrition-sensitive agriculture, Microbiome-nutrition, Personalized
nutrition, Nutritious product formulation and development, Formulation methods for product
stability, Novel technologies in food and nutrition, Linear and goal programming in nutrition, Food
economics, Business models in food and nutrition.
Ethical approval and consent to participate
This study was conducted following a thoroughly review of the study protocols by scholars in the
ethnobotanical field of the study from different research works. Moreover, official permission
support letter was provided by Nelson Mandela African Institution of Science and Technology
(NM-AIST) administration. The study participants were informed about the benefits of taking part
64
in the present study. To get their consent, a briefly discussion was made with the MSPs and the
aim of the study was explained so that they would be clear about the purpose of documenting the
flora and their knowledge on the same for academic use with no commercialization being involved.
It was also made clear that the usual benefits they get by accessing and using resources will not be
affected by giving full information about the flora to the investigator. Verbal consent was obtained
from the study participants before beginning the study. Costs of travel and time spent were
compensated with modest payments.
Consent for publication
Not applicable
Competing interests
The authors declare that they have no competing interests.
Authors details
1School of Life Sciences and Bio-engineering, The Nelson Mandela African Institution of Science
and Technology, P. O. Box 447, Arusha, Tanzania.
2Mkwawa University College of Education, a Constituent College of the University of Dar es
Salaam, P. O. Box 2513, Iringa, Tanzania.
References
1. Amjad MS, Zahoor U, Bussmann RW, Altaf M. Ethnobotanical survey of the medicinal
flora of Harighal , Azad Jammu & Kashmir , Pakistan. J Ethnobiol Ethnomed.
2020;16(65):1–28.
2. Kuhnlein H V. Food system sustainability for health and well-being of Indigenous Peoples.
Public Health Nutr. 2014;18(13):2415–24.
3. Kimondo JW. An Evaluation of Antioxidant and Anti-inflammatory Effects of Natural
Foods and Medicinal Plants of the Ilkisonko Maasai Community, Kenya. University of
Nairobi; 2020.
4. Kaj Århem. Maasai Food Symbolism. Antropos. 1989;84(1):1–23.
5. Oiye S, Oniang’o R, Simel JO, Johns T. The Maasai food system and food and nutrition
security. In: Indigenous Peoples’ food systems. McGill University Library; 2006. p. 231–
65
49.
6. Makule E. Ethnopharmacological survey and phytochemical investigation of Maasai
traditional medicinal plants from north-eastern Tanzania Dissertation. University of
Regensburg; 2015.
7. Amri E, Kisangau DP. Ethnomedicinal study of plants used in villages around Kimboza
forest reserve in Morogoro, Tanzania. J Ethnobiol Ethnomed [Internet]. 2012;8(1):1–9.
Available from: http://www.ethnobiomed.com/content/8/1/1
8. Ngowi NJ. Ethnobotanical Study of Medicinal Plants in Kondoa Eroded Area of Central
Tanzania. Int J Sci Basic Appl Res [Internet]. 2015;21(1):223–33. Available from:
http://gssrr.org/index.php?journal=JournalOfBasicAndApplied
9. URT (United Republic of Tanzania). Fifth National Report on the Implementation of the
Convention on Biological Diversity. Division of Environment, Vice President’s Office. Dar
es Salaam; 2014.
10. Pereus D, Otieno JN, Ghorbani A, Kocyan A, Hilonga S, de Boer HJ. Diversity of Hypoxis
species used in ethnomedicine in Tanzania. South African J Bot [Internet].
2019;122(March):336–41. Available from: https://doi.org/10.1016/j.sajb.2018.03.004
11. Moshi MJ, Otieno DF, Weisheit A. Ethnomedicine of the Kagera Region, north western
Tanzania. Part 3: Plants used in traditional medicine in Kikuku village, Muleba District. J
Ethnobiol Ethnomed. 2012;8:1–5.
12. Nahashon M. Conservation of Wild-harvested Medicinal Plant Species in Tanzania.
Examensarbete i Hållbar Utveckl [Internet]. 2013;50. Available from: http://www.diva-
portal.org/smash/get/diva2:615493/FULLTEXT01.pdf
13. Christensen DL, Boit MK, Mwaniki DL, Kilonzo B, Tetens I, Kiplamai FK.
Cardiorespiratory Fitness and Physical Activity in Luo , Kamba , and Maasai of Rural
Kenya. Am J ofHuman Biol. 2012;1–7.
14. Cheney WF. Hyperchlorhydria. Cal State J Med. 1911;9(2):48–51.
15. Liu X, Chen R, Shang Y, Jiao B, Huang C. Lithospermic acid as a novel xanthine oxidase
inhibitor has anti-inflammatory and hypouricemic effects in rats. Chem Biol Interact.
2008;176(2–3):137–42.
16. Alter DN. Clinical chemistry of the gastrointestinal disorders. In: Contemporary Practice in
Clinical Chemistry [Internet]. Elsevier Inc.; 2020. p. 561–72. Available from:
http://dx.doi.org/10.1016/B978-0-12-815499-1.00032-6
17. Friesen SR, Tomita T. Pseudo-Zollinger-Ellison Syndrome: Hypergastrinemia,
Hyperchlorhydria without Tumor pseudo-Zollinger-Ellison. Ann Surg. 1981;194(4):481–
91.
18. Vizcaíno Luna Y, Bermúdez Marrero WM, Bermúdez Marrero WA, Egües Mesa JL,
Cárdenas Domínguez T, Prendes García E. Gout Arthritis. Ten years of follow up. Rev Cuba
Reumatol. 2019;21(3):1–14.
66
19. Zhang B, Zeng X. Tophaceous gout in a female premenopausal patient with an unexpected
diagnosis of glycogen storage disease type Ia : a case report and literature review. Clin
Rheumatol [Internet]. 2016; Available from: http://dx.doi.org/10.1007/s10067-016-3290-1
20. Pergola T. “ Changes in Using and Conserving Medicinal Plants in Maasai Villages in
Monduli District , Tanzania .” Arusha; 2001.
21. Kaswamila A. Human-wildlife conflicts in monduli District, Tanzania. Int J Biodivers Sci
Manag. 2009;5(4):199–207.
22. URT (United Republic of Tanzania). 2012 Population and Housing Census. National
Bureau of Statistics (NBS) and Office of Chief Government Statistician (OCGS). Dar es
Salaam and Zanzibar; 2014.
23. FTEA [Flora of Tropical East Africa] 1952-2012. Flora of Tropical East Africa. In: Royal
Botanic Garden, Kew. 2012.
24. Issa TO, Mohamed YS, Yagi S, Ahmed RH, Najeeb TM, Makhawi AM, et al.
Ethnobotanical investigation on medicinal plants in Algoz area (South Kordofan), Sudan. J
Ethnobiol Ethnomed. 2018;14(1):1–22.
25. Amjad MS, Qaeem M, Ahmad I, Khan SU, Chaudhari SK, Malik NZ, et al. Descriptive
study of plant resources in the context of the ethnomedicinal relevance of indigenous flora :
A case study from Toli Peer National Park , Azad Jammu and Kashmir ,. PLoS One. 2017;1–
31.
26. Jin B, Liu Y, Xie J, Luo B, Long C. Ethnobotanical survey of plant species for herbal tea in
a Yao autonomous county (Jianghua, China): Results of a 2-year study of traditional
medicinal markets on the Dragon Boat Festival. J Ethnobiol Ethnomed. 2018;14(1).
27. Tuasha N, Petros B, Asfaw Z. Medicinal plants used by traditional healers to treat
malignancies and other human ailments in Dalle District, Sidama Zone, Ethiopia. J
Ethnobiol Ethnomed. 2018;14(1):1–21.
28. Kiringe JW. A Survey of Traditional Health Remedies Used by the Maasai of Southern
Kaijiado District , Kenya. Ethnobot Res Appl. 2006;4:61–73.
29. Bruderer S, Bodmer M, Jick SS, Meier CR. Use of Diuretics and Risk of Incident Gout.
Arthritis Rheumatol. 2014;66(1):185–96.
30. So AK, Martinon F. Inflammation in gout: Mechanisms and therapeutic targets. Nat Rev
Rheumatol [Internet]. 2017;13(11):639–47. Available from:
http://dx.doi.org/10.1038/nrrheum.2017.155
31. Kamau LN. Study of Extent of Use, Efficacy and Acute Toxic Effects of Selected
Antidiabetic Plants in Nyeri and Narok Counties, Kenya. University of Nairobi; 2018.
32. Innocent E, Augustino S, Kisinza W. Plants Used to Control Mosquitoes and Treat
Mosquito Related Diseases in Maasai-land of Longido District, Tanzania. European J Med
Plants. 2016;12(2):1–12.
33. Kamau LN, Mbaabu PM, Mbaria JM, Gathumbi PK, Kiama SG. Ethnobotanical survey and
67
threats to medicinal plants traditionally used for the management of human diseases in Nyeri
County, Kenya. Tang [Humanitas Med. 2016;6(3):1–15.
34. Seifu T, Asres K, Gebre-Mariam T. Ethnobotanical and ethnopharmaceutical studies on
medicinal plants of Chifra District, Afar Region, North Eastern Ethiopia. Ethiop Pharm J.
2006;24(1).
35. Gupta G, Rana A. Withania somnifera (Ashwagandha): A Review. Pharmacogn Rev.
2007;1(1):129–36.
36. Dar NJ, Hamid A, Ahmad M. Pharmacologic overview of Withania somnifera, the Indian
Ginseng. Cell Mol Life Sci. 2015;72(23):4445–60.
37. Gallego MG, Gordon MH, Segovia F, Almajano Pablos MP. Gelatine-based antioxidant
packaging containing Caesalpinia decapetala and tara as a coating for ground beef patties.
Antioxidants. 2016;5(2).
38. Pawar CR, Surana SJ. Antioxidant properties of the methanol extract of the wood and
pericarp of Caesalpinia decapetala. J Young Pharm [Internet]. 2010;2(1):45–9. Available
from: http://dx.doi.org/10.4103/0975-1483.62212
39. Bhadoriya U, Sharma P, Solanki SS. In Vitro Free Radical Scavenging Activity of Gallic
Acid Isolated From Caesalpinia Decapetala Wood. Asian Pacific J Trop Dis [Internet].
2012;2(SUPPL2):S833–6. Available from: http://dx.doi.org/10.1016/S2222-
1808(12)60274-6
40. Chen GL, Mutie FM, Xu YB, Saleri FD, Hu GW, Guo MQ. Antioxidant, anti-inflammatory
activities and polyphenol profile of rhamnus prinoides. Pharmaceuticals. 2020;13(4):1–12.
41. Madivoli ES, Maina EG, Kairigo PK, Murigi MK, Ogilo JK, Nyangau JO, et al. In vitro
antioxidant and antimicrobial activity of Prunus africana (Hook. f.) Kalkman (bark extracts)
and Harrisonia abyssinica Oliv. extracts (bark extracts): A comparative study. J Med Plants
Econ Dev. 2018;2(1):1–9.
42. Das DK, Engelman RM, Clement R, Otani H, Prasad MR, Rao PS. Role of xanthine oxidase
inhibitor as free radical scavenger: A novel mechanism of action of allopurinol and
oxypurinol in myocardial salvage. Biochem Biophys Res Commun. 1987;148(1):314–9.
43. Tung Y-T, Chang S-T. Inhibition of Xanthine Oxidase by Acacia confusa Extracts and Their
Phytochemicals. J Agric Food Chem. 2010;781–6.
44. Ismael TK. Antimicrobial activity of Loranthus europaeus L . and Lawsonia inermis L .
extracts against clinical Methicillin-resistant Staphylococcus aureus isolated from boil
infections. Tikrit J Pure Sci. 2018;23(6):24–30.
45. Kirkcaldy RD, Harvey A, Papp JR, Rio C del, Soge OO, Holmes KK, et al. Antimicrobial
Susceptibility Surveillance — The Gonococcal Isolate Surveillance Project , 27 Sites ,
United States , 2014. 2016. (Surveillance Summaries; vol. 65).
46. Reekie J, Donovan B, Guy R, Hocking JS, Kaldor JM, Mak D, et al. Risk of Ectopic
Pregnancy and Tubal Infertility Following Gonorrhea and Chlamydia Infections. Clin Infect
Dis. 2019;69(9):1621–3.
68
47. Brunham RC, Rey-ladino J. Immunology of Chlamydia Infection: Implications for a
Chlamydia Trachomatis Vaccine. Nat Rev | Immunol. 2005;5:149–61.
48. Alary M, Laga M, Vuylsteke B, Nzila N, Piot P. Signs and symptoms of prevalent and
incident cases of gonorrhea and genital chlamydial infection among female prostitutes in
Kinshasa, Zaire. Clin Infect Dis. 1996;22(3):477–84.
49. Trayes KP, Studdiford JS, Pickle S, Tully AS. Edema: Diagnosis and Management. Am
Fam Physician. 2013;88(2):102–10.
50. Nicolaides AN. From Symptoms To Leg Edema: Efficacy Of Daflon 500 mg. Angiology.
2003;54(1):33–44.
51. Ramelet AA. Daflon 500 mg: Symptoms and edema - Clinical update. Angiology.
2005;56(SUPPL. 1):25–32.
52. Borenstein DG, Calin A. Fast Facts : Low Back Pain [Internet]. 2nd edn. Oxford: Health
Press Limited; 2012. 1–143 p. Available from: www.fastfacts.com
53. Shiri R, Solovieva S, Husgafvel-pursiainen K, Telama R, Yang X, Viikari J, et al. The role
of obesity and physical activity in non-specific and radiating low back pain_ The Young
Finns study. Semin Arthritis Rheum [Internet]. 2013;42(6):640–50. Available from:
http://dx.doi.org/10.1016/j.semarthrit.2012.09.002
54. Basson R. Testosterone therapy for reduced libido in women. Ther Adv Endocrinol Metab.
2010;1(4):155–64.
55. Corona G, Rastrelli G, Ricca V, Jannini EA. Risk Factors Associated with Primary and
Secondary Reduced Libido in Male Patients with Sexual Dysfunction. J Sex Med.
2013;1074–89.
56. Cumming GP, Currie HD, Moncur R, Lee AJ. Web-based survey on the effect of
menopause on women ’ s libido in a computer-literate population. Menopause Int.
2009;15(1):8–12.
57. Dissanayake D, Wijesinghe P, Ratnasooriya W, Wimalasena S. Effects of zinc
supplementation on sexual behavior of male rats. J Hum Reprod Sc. 2009;2(2):57–61.
58. Malavige LS, Jayaratne SD, Kathriarachchi ST, Sivayogan S, Fernando DJ, Levy JC.
Erectile Dysfunction Among Men with Diabetes is Strongly Associated with Premature
Ejaculation and Reduced Libido. J Sex Med. 2008;5:2125–34.
59. Saguil A. Evaluation of the patient with muscle weakness. Am Fam Physician.
2005;71(7):1327–36.
60. Noakes TD. Fatigue is a brain-derived emotion that regulates the exercise behavior to ensure
the protection of whole body homeostasis. Front Physiol. 2012;3(82):1–13.
61. Torres-harding S, Jason LA. 1 What Is Fatigue ? History and Epidemiology. 1994;
62. Timmermans EJ, Schaap LA, Herbolsheimer F, Dennison EM, Maggi S, Pedersen NL, et
al. The Influence of Weather Conditions on Joint Pain in Older People with Osteoarthritis :
Results from the European Project on OSteoArthritis. J Rheumatol. 2015;42(10):1–8.
69
63. Lee M, Ohde S, Urayama KY, Takahashi O, Fukui T. Weather and Health Symptoms. Int J
Environ Res Public Heal. 2018;15(1670):1–15.
64. Bakar MA, Mckimm J, Haque SZ, Haque M. Chronic tonsillitis and biofilms : a brief
overview of treatment modalities. J Inflamm Res. 2018;329–37.
65. Jensen A, Bank S, Hansen TM, Kristensen LH, Prag J. Fusobacterium necrophorum
tonsillitis: An important cause of tonsillitis in adolescents and young adults. Clin Microbiol
Infect [Internet]. 2014; Available from: http://dx.doi.org/10.1016/j.cmi.2014.09.020
66. Loganathan A, Arumainathan UD, Raman R. Comparative study of bacteriology in
recurrent tonsillitis among children and adults. Singapore Med J. 2006;47(4):271–5.
67. Ghali MJA, Mukhaimer MN, Yousef MKA, Naser SSA. Expert System for Problems of
Teeth and Gums. Int J Eng Inf Syst. 2017;1(4):198–206.
68. Johnstone L, Spence D, Koziol-mcclain J. Oral Hygiene Care in the Pediatric Intensive Care
Unit : Practice Recommendations. Pediatr Nurs. 2010;36(2):85–96.
69. Marmura MJ. Triggers , Protectors , and Predictors in Episodic Migraine [Internet].
Department of Neurology Faculty Papers. 2018. (170; vol. Paper 170). Available from:
https://jdc.jefferson.edu/neurologyfp/170
70. Grosberg BM, Solomon S, Lipton RB. Nummular Headache. Curr Pain Headache Rep.
2007;11:310–312.
71. Mattsson P. Headache caused by drinking cold water is common and related to active
migraine. Cephalalgia. 2001;21:230–5.
72. Daveson AJ, Jones DM, Gaze S, Mcsorley H, Clouston A, Cooke S, et al. Effect of
Hookworm Infection on Wheat Challenge in Celiac Disease – A Randomised Double-
Blinded Placebo Controlled Trial. PLoS One. 2011;6(3):1–9.
73. Stoltzfus RJ, Dreyfuss ML, Chwaya HM. Hookworm Control as a Strategy to Prevent Iron
Deficiency. Nutr Rev. 1997;55(6):223–32.
74. Hyun HJ, Kim EM, Park SY, Jung JO, Chai JY, Hong ST. A case of severe anemia by
Necator americanus infection in Korea. J Korean Med Sci. 2010;25(12):1802–4.
75. Loukas A, Hotez PJ, Diemert D, Yazdanbakhsh M, McCarthy JS, Correa-Oliveira R, et al.
Hookworm infection. N Engl J Med. 2004;351(8):799–807.
76. Taylor MJ, Hoerauf A, Bockarie M. Lymphatic filariasis and onchocerciasis. Lancet.
2010;376(9747):1175–85.
77. Sultana F, Juliana FM, Islam MJ, Asaduzzaman M. Impact of Lymphatic Filariasis ( LF )
on Hemoglobin Content and Anemia : A Cross-Sectional Based Study. J Heal Med Nurs.
2017;44:30–2.
78. Amenya HZ, Gathumbi PK, Mbaria JM, Thaiyah AG, Thoithi GN. Sub-acute toxicity of
the chloroformic extract of Rapanea melanophloeos (L.) Mez in rats. J Ethnopharmacol
[Internet]. 2014;154(3):593–9. Available from: http://dx.doi.org/10.1016/j.jep.2014.04.001
70
79. Mehrbod P, Abdalla MA, Fotouhi F, Heidarzadeh M, Aro AO, Eloff JN, et al.
Immunomodulatory properties of quercetin-3-O-α-L-rhamnopyranoside from Rapanea
melanophloeos against influenza a virus. BMC Complement Altern Med. 2018;18(1):1–10.
80. Ndontsa BL, Dongmo FLM, Tala MF, Wabo HK, Zeng GZ, Tan NH, et al. A new cytotoxic
alkenylresorcinol from embelia schimperi. Rec Nat Prod. 2014;8(1):37–40.
81. Zafar O. Diuretic Activities of Aqueous Methanolic Extracts of Watermelon and Bottle
Gourd Seeds In Albino Rats. The Islamia University of Bahawalpur; 2015.
82. Oh SW, Han SY. Loop Diuretics in Clinical Practice. Electrolyte Blood Press. 2015;13:17–
21.
83. Better O s., Busch A, Dorup J, Endou H, Greger R, Guder WG, et al. Diuretics: Handbook
of Experimental Pharmacology Volume 117. Greger RF, Knauf H, Mutschler E, editors.
Hong Kong: Springer-Verlag Berlin Heidelberg; 1995. 1–517 p.
84. Pascual E, Perdiguero M. Gout, diuretics and the kidney. Ann Rheum Dis. 2006;65:981–3.
85. Shi Y, An S, Wan Y, Liu Q. The intake of potassium-rich food by the potassium-requiring
heart disease patients and potential mechanism. Eur J Prev Cardiol. 2019;26(7):NP1–2.
86. Hedaoo SA, Bodhankar MM. Advantages of Natural Diuretics Over Synthetic. World J
Pharm Pharm Sci. 2019;8(3):310–27.
87. Sharma N, Singh NR, Varsakiya J. Management of Vatarkta (Gout) in Ayurveda : Review.
World J Pharm Res. 2019;8(6):1319–29.
88. Sorensen B. Role of the Intestinal Tract in the Elimination of Uric Acid. Arthritis Rheum.
1965;8(5).
89. Bahna H, Alame AM. Evaluation of Constipation. Clin Colon Rectal Surg 2012. 2012;25:5–
11.
90. Portenoy RK. Constipation in the Cancer Patient : Causes and Management. Med Clin
North Am [Internet]. 1987;71(2):303–11. Available from: http://dx.doi.org/10.1016/S0025-
7125(16)30872-0
91. Dinning PG, Smith TK, Scott SM. Pathophysiology of colonic causes of chronic
constipation. Neurogastroenterol Motil. 2009;21(2):20–30.
92. Derakhshan AR, Yousefi M, Dehghan S, Zargaran A, Khodadoost M. Digestion process
and causes of indigestion based on Avicenna’s view and modern medicine. Tradit Med Res.
2019;(March).
93. Shulkes A, Baldwin GS. Gastrin [Internet]. Second Edi. Handbook of Biologically Active
Peptides. Elsevier Inc.; 2013. 1219–1226 p. Available from:
http://dx.doi.org/10.1016/B978-0-12-385095-9.00165-2
94. Stockton CG. Gastro-intestinal and Hepatic Relations of Gout [Internet]. 1897 p. 222–3.
Available from: http://jama.jamanetwork.com/
95. Reitsma-Bierens WCC. Renal complications in glycogen storage disease type I. Eur J
71
Pediatr. 1993;152(1):60–2.
96. Sever S, Weinstein DA, Wolfsdorf JI, Gedik R, Schaefer EJ. Glycogen storage disease type
Ia : Linkage of glucose , glycogen , lactic acid , triglyceride , and uric acid metabolism. J
Clin Lipidol. 2012;6:596–600.
97. Akinmoladun AC, Ibukun E, Obuotor EM, Farombi O. Phytochemical constituent and
antioxidant activity of extract from the leaves of Ocimum gratissimum. Sci Res Essays.
2007;2(5):163–6.
98. Aguiyi JC, Obi CI, Gang SS, Igweh AC. Hypoglycaemic activity of Ocimum gratissimum
in rats. Fitoterapia. 2000;71(4):444–6.
99. Prabhu KS, Lobo R, Shirwaikar AA, Shirwaikar A. Ocimum gratissimum: A Review of its
Chemical, Pharmacological and Ethnomedicinal Properties. Open Complement Med J.
2009;1(1):1–15.
100. Ali A, Akhtar N, Khan BA, Khan MS, Rasul A. Acacia nilotica : A plant of multipurpose
medicinal uses. J Med Plants Res. 2012;6(9).
101. Charles NN, Bonareri NL. An inventory of some medicinal plants used by abagusii
traditional healers of South West Kenya. J Med Plant Stud [Internet]. 2020;8(3):127–35.
Available from: www.plantsjournal.com
102. Maroyi A. Nutraceutical and ethnopharmacological properties of vangueria infausta subsp.
infausta. Molecules. 2018;23(5).
103. Msomi NZ, Simelane MBC. Olea europaea subsp. africana (Oleaceae). Act Ingredients
from Aromat Med Plants. 2017;
104. Oseni LA, Iddrisu A-M. An evaluation of relative stabilities of selected local herbal
concoctions stored in Calabash fruit pods and clay pot containers. J Chem Pharm Res.
2012;4(1):409–15.
105. Juee LYM, Naqishbandi AM. Calabash (Lagenaria siceraria) potency to ameliorate
hyperglycemia and oxidative stress in diabetes. J Funct Foods [Internet].
2020;66(January):103821. Available from: https://doi.org/10.1016/j.jff.2020.103821
