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Ethnobotanical knowledge of Prunus
africana (Hook. f.) Kalkman
(Rosaceae) by people living in
community forests in North Kivu,
Eastern Democratic Republic of
Congo
Eloge Kambale Muhesi, Jean Lagarde Betti, Ndongo Din, Moïse
Musubao Kapiri, Harmelle Natacha Nana Afiong and Pascal
Billong Fils
Correspondence
Eloge Kambale Muhesi1,2, Jean Lagarde Betti1,3,4, Ndongo Din1, Moïse Musubao Kapiri5,6, Harmelle Natacha Nana Afiong1
and Pascal Billong Fils1
1Laboratory of Biology and Physiology of Plant Organisms, Faculty of Science, University of Douala, PO Box 24 157 Douala,
Cameroon
2Department of Water and Forests, Higher Institute of Agronomic, Veterinary and Forestry Studies of Butembo (ISEAVF), PO
Box 421 Butembo, Democratic Republic of Congo.
3Station for Specialized Research in Botany, National Herbarium of Cameroon, IRAD, PO Box 2123 Yaoundé, Cameroon.
4Department of Wood and Forest Sciences, ISABEE, University of Bertoua, Cameroon.
5Department of Water and Forestry, Faculty of Agricultural Sciences, Catholic University of Butembo (UCG), PO Box. 29
Butembo, Democratic Republic of Congo.
6Department of Environmental Sciences and Management, Campus Arlon Environment, University of Liège, Liège, Belgium.
*Corresponding Author: elogemuhesi@gmail.com
Ethnobotany Research and Applications 26:12 (2023) - http://dx.doi.org/10.32859/era.26.12.1-28
Manuscript received: 15/05/2023 – Revised manuscript received: 15/07/2023 - Published: 24/07/2023
Research
Abstract
Background: Prunus africana (Hook. f) Kalkman (Rosaceae) is a multi-purpose species with important utility value for the
populations that depend on it. Indeed, local populations living in community forests use P. africana. The objective of this
study is to document the different uses of P. africana by local populations in traditional medicine for a better vulgarization
for a sustainable management of the resource.
Methods: Ethnobotanical surveys were conducted in four P. africana distribution areas in North Kivu. Data were collected
on the basis of a survey from 221 informants. Statistical analysis and calculation of ethnobotanical indices were performed
using R 4.1.2 software.
Results: Results of the investigations show that P. africana is by far used in medical practices (96.83%). It is also used as wood
energy (60.18 %), charcoal (40.27 %), in handicrafts (7.24 %), construction (6.79 %), food (2.26 %) and traditional rites (0.45
%). In traditional pharmacopoeia, the characterization of the uses allowed us to identify 23 diseases for which P. africana
extracts are used to treat them. The bark and leaves are the most used organs in the recipes. The decoction (99.5%), the
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macerated (10.41%) and the powders (7.69%) are the galenic or pharmaceutical forms in which the local populations prepare
the remedies. The potions prepared are mainly administered orally (99.5%).
Conclusion: The multiple forms of use of P. africana by the populations of North Kivu, both in medicine and in other categories
of use, constitute a threat to its survival. For a sustainable management, the results of this study reveal that it is possible to
substitute the species P. africana with other plant species with similar potential in order to limit its overexploitation.
Keywords: Prunus africana, community forests, multiple uses, traditional medicine, sustainable management, DR Congo
Background
Medicinal plant use in the world is very old, there is a modern revival in the use of these plants. In all ancient civilizations
and on all continents, there are traces of the use of medicinal plants and their bioactive constituents in the treatment of
various diseases (Islam et al. 2020; Nanjala et al. 2022; Islam et al. 2022). Worldwide, more than 50,000 plant species are
documented for their clinical benefits and pharmacological effects on humans and domestic animals (Sharma et al. 2022).
Studies show that 80% of the world's population uses medicinal plants or their bioactive compounds for the prevention, cure
or treatment of several diseases (Macía et al. 2005; Ajibesin et al. 2012; Chiribagula et al. 2020; Mlilo and Sibanda 2022;
Ugbogu et al. 2022; Delices et al. 2023). In developing countries, the use of herbal medicines as an alternative to modern
medicine is very common (Nath and Puzari 2022). Indeed, the World Health Organization (WHO) reported that between 70-
90% of the population in developing countries used herbal medicines in primary health care (Costa et al. 2023).
In addition, the increase in the use of traditional medicine in both developing (such as DR Congo) and developed countries
can be explained by several factors. The first factor is related to the discovery in plants of secondary metabolites that have
different pharmacological potentials (Delices et al. 2023). The second factor is the low cost of treatment (in terms of
consultation and consumption of medicinal plants) compared to conventional medicine which is based on overpriced
commercial pharmaceuticals (Macía et al. 2005; Kasika et al. 2015; Kasika et al. 2016; Basak et al. 2022; Ginko et al. 2023).
The third factor is the financial capacity of the patients or his family and the difficulties in accessing modern health care
(Amuri et al. 2018; Cakupewa et al. 2022). In this sense, medicinal plants are the most accessible form of health care resource,
especially for populations living in rural areas (Mlilo and Sibanda 2022; Ginko et al. 2023). The fourth factor is related to the
changing needs, diseases, and beliefs of the populations (Ginko et al. 2023) on the one hand, faith in ancestral culture healing
practices on the other (Amuri et al. 2018; Cakupewa et al. 2022). These healing practices of ethnic populations have been
socially recognized at all stages of anthropological, cultural, and environmental evolution (Islam et al. 2022).
Democratic Republic of Congo (DRC) is a reservoir of biodiversity in terms of both flora and fauna. Its flora abounds in
medicinal plants of biopharmaceutical interest and capable of supplying new molecules (Masunda et al. 2019). Given the
country's socio-economic realities, which prevent a large proportion of the population from accessing modern healthcare,
the use of medicinal plants to solve health problems is an alternative (Cakupewa et al. 2022; Iragi et al. 2021). Indeed,
traditional medicine is a highly credible alternative against diseases such as malaria, which is endemic throughout the
Congolese territory (Chiribagula et al. 2020). In the Beni and Lubero territories, traditional medicine is widely used due to
the rising cost of conventional medicines, which are becoming inaccessible to many populations, particularly in rural areas
(Kasika et al. 2015; Kasika et al. 2016).
In these territories, traditional medicine is used to treat over 50 diseases, including malaria, diarrhea, colic, internal
candidiasis, yellow fever, migraine, rheumatism, otitis, abscesses, gastritis, intestinal worms, panariasis, wounds, ulcers,
haemorrhoids, hernias, dysentery, nasal haemorrhage, gastroenteritis, sprains, atherosclerosis, urogenital infections,
furunculosis, ringworm, scabies, coughs, asthma, poison, etc. (Kasika et al. 2016; Ndavaro et al. 2023; Saa-Sita et al. 2022).
Among these medicinal plants is Prunus africana, distributed in the Afromontane forests of North and South Kivu provinces
(Cunningham et al., 2016; Muhesi and Mate, 2018; Muhesi et al. 2023). In 1995, due to its ever-increasing international
demand for bark, it was listed on Appendix II of the Convention on International Trade in Endangered Species of Wild Fauna
and Flora (CITES) (Betti et al. 2003). Furthermore, the importance of P. africana lies in the medicinal virtues of its bark
extracts, which are used in the manufacture of over 19 medicines sold on the European and American markets (Cunningham
et al. 2016; Muhesi et al. 2023). P. africana bark extracts are used medicinally to treat benign prostate adenoma and benign
prostate hyperplasia, which are common in older men (Betti and Ambara 2013; Betti et al. 2014). Demand for Prunus africana
bark and wood from other species worries scientists, given that several authors such as Muhesi and Mate (2018) and
Cunningham et al. (2016) have already reported the lack of natural regeneration and low levels of recruitment under dense
canopies in forests across its range.
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Studies carried out to date in the region have focused, for example, on the natural regeneration of P. africana (Muhesi and
Mate 2018) or its post-barking response under various ecological zones (Muhesi et al. 2023). However, studies on the
ethnobotanical uses of this species among local and indigenous communities in eastern DR Congo are fragmentary. Yet
simple observation shows that indigenous communities living around forests where P. africana specimens are found, and
lacking access to health systems due to their remoteness, use this species to treat various illnesses. In a context characterized
by the need to reconcile the sustainable use of P. africana by these local and indigenous communities with its conservation,
ethnobotanical studies on this species in North Kivu are necessary.
There are several reasons why ethnobotanical studies of endangered species like P. africana are important. First, these
studies could lead to the discovery of effective medicines of health importance. In this sense, ethnobotanical studies have
become increasingly valuable for the development of health care programs (Shil et al. 2014). Second, documenting
indigenous knowledge of medicinal plants can also contribute to the conservation of these species (Mahwasane et al. 2013;
Adil et al. 2022) and the cultural heritage of associated indigenous people for future generations (Mahwasane et al. 2013).
Indeed, the link between ecosystem services, resource ecology, and people is exploited, which is essential for sustainable
resource use (Chen and Sun 2018; Ncube et al. 2022). This importance is further justified as recent research has shown that
increasing demand for medicinal plants is leading to overexploitation of wild populations for commercial purposes, resulting
in habitat degradation and possible extinction of these species (Shopo et al. 2022). Third, with the impacts of urbanization,
industrialization, migration from rural to urban areas, rapid loss of natural habitats, and lifestyle changes, the wealth of
ethnomedicinal plant knowledge in many cultures is gradually decreasing (Pradhan et al. 2022). This decline in traditional
knowledge due to a breakdown in oral transmission between current and future generations needs to be restored (Pradhan
et al. 2022).
Taking into regard the above-mentioned considerations, this article is of particular interest because it will allow to
understand the relationships between the riparian populations of the community forests and the species P. africana in order
to put in the following management and conservation strategies. This study will also help fill gaps in traditional knowledge
about the uses of this species and the sustainability of biocultural links. Indeed, the documentation and prioritization of
ethnomedicinal plants associated with P. africana in the preparation of traditional remedies in this paper will also provide a
baseline for studies on bioactive components and local and national drug discovery programs based on these plants.
This paper has 2 objectives:
1. To identify the different uses of P. africana by people living in community forests in four zones in North Kivu; and
2. To characterize the traditional uses of P. africana in the local pharmacopoeia, considering the plant parts used, the
pharmaceutical forms, the ways of administration and the associations with other plants.
Materials and Methods
Study area
Ethnobotanical investigations were conducted in four forest sites in the province of North Kivu (Lubero, Mangurejipa,
Walikale and Ruwenzori) in the northeast of the Democratic Republic of Congo (Figure 1). Lubero and Mangurejipa sites are
located in Lubero territory in the Bamate Chiefdom and in the Bapère sector, respectively. Walikale site is located in Walikale
territory, specifically in the Wanianga sector, while the Ruwenzori site is located in Beni territory in the Ruwenzori sector.
These four zones have fairly similar agroclimatic characteristics. The climate belongs to the equatorial zone. In the highlands,
there is a decrease in temperature as the altitude increases (Kapiri et al. 2023a). This explains the presence of two climates:
the equatorial climate of altitude in the highlands and the classic equatorial climate in the lowlands (Kapiri et al. 2023b;
Muhesi et al. 2023). Populations in the areas studied are divided into two categories: indigenous communities (Pygmies) and
non-indigenous communities. Indigenous communities are more dependent on forests than others. Cultural diversity
characterizes the population of the study areas. Ethnic groups found in the different zones include the Nande, who
predominate, and the Nyanga, Piri, Kovo, Rega and Pygmy (Mbuti), who are in the minority. In the four study zones, the
majority of people make their living from agriculture, livestock breeding, gold panning, logging and petty trading. As the
areas are heavily landlocked, access to modern healthcare is a problem for most of the population.
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Figure 1. Study sites, North Kivu, eastern Democratic Republic of Congo
Materials and Methods
Sample size
We selected a sample of individuals with knowledge of the species P. africana. Informants were selected randomly and
consisted of interviews with individuals available to participate in the study based on criteria. Given that the plurality of
people to be interviewed always reveals a diversity of viewpoints (Ndavaro et al. 2023) and that the diversification of sources
of ethnobotanical data allows us to consider the societal realities specific to each environment (Sambiéni et al. 2015, Ndavaro
et al. 2023), the sample size (n) was calculated by the normal approximation of the binomial distribution (Padonou et al.
2014; Agbo et al. 2017; Ndavaro et al. 2023):
! "
#
$!"#
$
%
$&'()* +',
-$(((((()*,
With n the sample size, p the proportion of people with the characteristic i.e. the proportion of people who claimed to have
ever used P. africana. Based on a pre-survey, where 82.7% of the 50 people randomly selected in the four zones had already
used P. africana in traditional medicine or in other forms, the value of p is then equal to 0.827 for this investigation. In
Equation 1, the quantity
($!"!
"(
is the value of the normal random variable for a risk α (α=0.05;
($!"!
"" *./0
) and δ is the
expected margin of error of any parameter to be calculated and is set to 5%. By substituting the value of each parameter in
equation 1, a sample consisting of 219 informants was obtained. To simplify matters, this sample was rounded up to 221
informants.
Selection of villages and informants
Two criteria were used to select villages in the four study areas: the presence of a forest with Prunus africana trees and
indicators of Prunus africana use. A pre-survey phase verified these indicators and ensured the medicinal and socio-cultural
importance of the study for the local communities. Thus, ethnobotanical investigations were organized in 9 villages (notably
Rusamambo, Bukumbirwa, Misinga in Walikale, Mwenda, Ibathama, Rughetsi in Ruwenzori, Mbuavinywa in Lubero and
Njiapanda and Mangurejipa in the Bapère sector). Informants were selected using a simple random sampling method, based
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5
primarily on criteria such as age and length of time in the village. However, some informants were chosen for convenience
(traditherapists) as they had sufficient knowledge of the different uses of P. africana.
Data collection and botanical identifications
Ethnobotanical surveys in the four zones were conducted between July 15 and December 13, 2022. Informants were
interviewed using a well-structured questionnaire with four sections. The first section presented the socio-demographic
characteristics of the informant (gender, ethnicity, age, seniority, level of education, profession, origin, marital status, etc.).
In the second section, the different uses of P. africana in their community (medicinal, construction, charcoal, fuelwood,
handicrafts, magico-religious, etc.) were noted. The third section dealt with questions related to the characterization of
medicinal uses only. Here, informants were asked about the plant parts used in the preparation of the recipes, the methods
of preparation, the routes of administration, the materials used in the formulation of the extracts, the units of measurement
used to estimate the dose (posology) and the duration of treatment. In the fourth section, informants were asked to name
five diseases treated by P. africana according to the order of priority of the disease. Combination of plants in the medicinal
recipes was also discussed. Thus, the informants provided information on the vernacular name, the organs used, the modes
of preparation, the forms of administration, the dosage, the duration of treatment and the morphological type of the
associated species. Transposition of the vernacular names into scientific names and the identification of the plants were
carried out with the expertise of a specialized botanist. Families of these species were determined according to the APG
(Angiosperm Phylogeny Group) III classification (Bremer et al. 2009).
Data processing and statistical analysis
Due to the complexity of the questionnaire linked to the different conditionality’s, the survey questionnaire was formalized
in the KoboCollect v1.25 application to limit errors and to allow the prioritization of variables during the analysis. This
application automatically generated a file in Excel format via the online tool KoboToolbox. Statistical analyses were
performed using R 4.1.2 (R Core Team 2021). Descriptive statistics focused on the calculation of proportions between
different modalities of socio-demographic characteristics. These proportions were compared using Pearson's chi-square test
of independence. Comparison of informants' means according to study areas was done using an analysis of variance
(ANOVA). We compared the importance of each species associated with P. africana during the preparation of remedies using
the four indices which are: Use Report (UR) of organs of the species (equation 2), Frequency of Citation (FC) per species
(equation 3), the number of organs solicited per species (NU) (equation 4) and the Relative Importance Index (RI) of the
species (equation 5). Use Report (UR) and Relative Importance Index (RI) were also used to calculate the importance
informants place on Prunus africana in relation to disease treatment (prioritization of diseases based on importance).
Use Report (UR) per species
With this index, the total uses of species organs by all informants (i1 to iN) in each organ category for that species (s) were
calculated. It is a count of the number of informants mentioning each organ used of the species NC and the sum of all organs
in each category (u1 to uNC) (Prance et al. 1987; Tardío and Pardo-De-Santayana 2008):
$1%"
2 2
$1&'
(
#
')'$
(*
%
&)&$
(((((((()3,
Frequency of Citation (FC) per species
It is the sum of informants citing a use of the species (Prance et al. 1987):
45+"
2
$1',,,,,,,,,,
(
#
')'$
((((((((((((()6,
Number of organs used (NU) per species
7$+"
2
(((((((((((((((((((()8,
(*
%
&)&$
NC are the number of organ categories and NUs is the sum of all organ categories for which a species is considered useful
(Prance et al. 1987).
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6
Relative Importance Index (RI)
It calculates the Relative Importance Index (RI) for each species in the database.
19+"145+-./01:17$+-2341
3(((((((((((((((();,
145+-./01(
is the relative frequency of citation of the species over the maximum,
17$+-2341(
is the relative number of solicited
organs of the species over the maximum (Tardío and Pardo-De-Santayana 2008). These indices were implemented in R
software using the ethnobotanyR package (Whitney 2022). Chord diagrams between diseases, P. africana-associated species,
and solicited organs and/or preparation modes were obtained by the circlize package (Gu et al. 2014). A Multiple
Correspondence Analysis (MCA) was performed between, on the one hand, the diseases and the informants' socio-
demographic characteristics and, on the other hand, between the species associated with P. africana and the informants'
socio-demographic characteristics. MCA was performed using the packages FactoMineR (Lê et al. 2008), factoextra
(Kassambara and Mundt 2020) and ggplot2 (Wickham 2016).
Results
Informants' Characteristics
A Total of 221 people were interviewed in all sites, including 55 informants in Lubero, 42 informants in Mangurejipa, 78
informants in Ruwenzori and 46 informants in Walikale. Males were predominantly represented compared to females. The
gender ratio of informants differs between the different study areas (p-value=0.026). Regarding the level of education in the
sample, informants with no education or with a primary level of education are more represented (Table 1). The analyses show
that there is a significant difference in the proportion of the different levels of education according to the study areas (p-
value=0.002)
A majority of the respondents (more than 80% for each study area) were couples. Chi-square test shows that there is no
significant difference between the marital status categories and the study areas. With regard to the activities practiced in the
four study zones, the proportion of farmers and traditional practitioners is much higher than the other professional categories.
Most informants have been living in the areas for a long time (more than 15 years). Large majority of informants were
indigenous (Table 1). The proportion of people who were native to the area (indigenous) and those who had migrated (non-
indigenous) showed a significant difference (p-value =0.022). The most represented ethnic group in the four zones is the
Nande. The average age of informants in all four study zones is high. Indeed, the informants in Lubero ranged in age from 19
to 70 years with an average of 47.51 ± 13.76 years, while in Mangurejipa, the age ranged from 21 to 75 years with an average
of 47.31 ± 14.25 years. Finally, the informants in Ruwenzori ranged in age from 23 to 69 years with an average of 42.33 ±12.47
years, while those in Walikale ranged in age from 22 to 71 years with an average of 43.78 ±13.44 years. Nevertheless, the
analysis of variance shows that the average ages of informants in the areas of interest in this study are similar (p-value=0.0862
> 0.05).
Table 1. Socio-demographic characteristics of informants according to study sites
Variable
Modalities
Lubero
Mangurejipa
Ruwenzori
Walikale
p
Gender
Female (F)
13 (23.6)
15 (35.7)
18 (23.1)
4 (8.7)
0.026
Male (M)
42 (76.4)
27 (64.3)
60 (76.9)
42 (91.3)
Education
level
Agricultural literacy (A. literacy)
2 (3.6)
0 (0.0)
10 (12.8)
0 (0.0)
0.002
Primary (Pri.)
13 (23.6)
16 (38.1)
21 (26.9)
17 (37.0)
No education (No. edu)
11 (20.0)
18 (42.9)
24 (30.8)
12 (26.1)
Secondary (Sec.)
24 (43.6)
8 (19.0)
18 (23.1)
15 (32.6)
High schooling (H. schooling)
5 (9.1)
0 (0.0)
5 (6.4)
2 (4.3)
Civil State
Celibates (Cel.)
5 (9.1)
0 (0.0)
6 (7.7)
1 (2.2)
0.506
Divorced (Div.)
1 (1.8)
0 (0.0)
2 (2.6)
0 (0.0)
Married (Mar.)
44 (80.0)
37 (88.1)
63 (80.8)
39 (84.8)
Widow/Widower (Wid.)
5 (9.1)
5 (11.9)
7 (9.0)
6 (13.0)
Occupation
Farmers (Farm.)
24 (43.6)
20 (47.6)
45 (57.7)
23 (50.0)
0.029
State agents (S.agents)
2 (3.6)
0 (0.0)
0 (0.0)
5 (10.9)
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Breeders (Breed.)
6 (10.9)
1 (2.4)
5 (6.4)
0 (0.0)
Teachers (Teach)
3 (5.5)
1 (2.4)
3 (3.8)
3 (6.5)
Forest operators (F. operators)
3 (5.5)
2 (4.8)
3 (3.8)
0 (0.0)
Doctors & nurses (Doc & Nu)
1 (1.8)
1 (2.4)
0 (0.0)
3 (6.5)
Traditherapists (Tradi)
16 (29.1)
17 (40.5)
22 (28.2)
12 (26.1)
Seniority
1-5 years (1-5)
1 (1.8)
0 (0.0)
16 (20.5)
0 (0.0)
<0.001
11-15 years (11-15)
1 (1.8)
6 (14.3)
6 (7.7)
11 (23.9)
6-10 years (6-10)
1 (1.8)
0 (0.0)
14 (17.9)
4 (8.7)
Over 15 years (> 15)
52 (94.5)
36 (85.7)
42 (53.8)
31 (67.4)
Origin
Migrant (Migr)
7 (12.7)
10 (23.8)
28 (35.9)
10 (21.7)
0.022
Native (Nat)
48 (87.3)
32 (76.2)
50 (64.1)
36 (78.3)
Informant
categories
Old women (Old_w)
5 (9.1)
8 (19.0)
2 (2.6)
1 (2.2)
<0.001
Adult women (Adult_w)
4 (7.3)
3 (7.1)
11 (14.1)
2 (4.3)
Adult man (Adult_m)
22 (40.0)
10 (23.8)
15 (19.2)
17 (37.0)
Young women (Young_w)
2 (3.6)
5 (11.9)
7 (9.0)
2 (4.3)
Young man (Young_m)
8 (14.5)
4 (9.5)
40 (51.3)
12 (26.1)
Old man (Old)
14 (25.5)
12 (28.6)
3 (3.8)
12 (26.1)
Age groups
(years)
[18,25]
5 (9.1)
3 (7.1)
2 (2.6)
2 (4.3)
0.166
[25,35]
7 (12.7)
7 (16.7)
28 (35.9)
13 (28.3)
[35,45]
13 (23.6)
10 (23.8)
20 (25.6)
13 (28.3)
[45,55]
14 (25.5)
12 (28.6)
12 (15.4)
8 (17.4)
[55,65]
12 (21.8)
4 (9.5)
12 (15.4)
6 (13.0)
[65,75]
4 (7.3)
6 (14.3)
4 (5.1)
4 (8.7)
Ethnicity
Kovo
0 (0.0)
0 (0.0)
0 (0.0)
35 (76.1)
<0.001
Mbuti (Pygmies)
0 (0.0)
6 (14.3)
0 (0.0)
0 (0.0)
Nande
52 (94.5)
4 (9.5)
78 (100.0)
3 (6.5)
Nyanga
2 (3.6)
0 (0.0)
0 (0.0)
5 (10.9)
Piri
0 (0.0)
30 (71.4)
0 (0.0)
1 (2.2)
Rega
1 (1.8)
2 (4.8)
0 (0.0)
2 (4.3)
Note: In the "modalities" column in table 1, the names in parentheses represent the variable names that will be on the graphs
of the MCA analysis to avoid overlapping labels.
Uses of Prunus africana, plant parts used, modes of preparation and modes of administration
Uses of Prunus africana are of the medicinal, service, and artistic type. Communities living along the banks of community
forests mainly use Prunus africana for traditional medicine (96.83% of informants). Some communities use this species as a
source of energy: fuelwood and charcoal (Figure 2a). Bark and other organs (leaves) used as remedies for diseases are generally
prepared in the form of decoction (99.5% of informants) (Figure 2b). The potions are administered orally (95.5% of informants)
or by simply chewing the fresh bark or by anal way (purgation). Fresh extracts of Prunus africana bark can also be administered
to the sick by the skin (local application) to treat specific diseases (Figure 2c). Communities use one glass (98.19%) as a unit of
measurement for dosage because it is difficult for these communities to determine the amount of active ingredient in
decoctions or infusions (Figure 2d). Depending on the zone and the ethnicity that determines people's beliefs and perceptions,
Prunus africana-based remedies are prepared in a pan (96.38% of informants) or are only ground on a mortar (66.52% of
informants).
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Figure 2. Prunus africana in traditional medicine: organs used, preparation, and administration methods
Diseases treated by Prunus africana extracts
Extracts from the bark and other organs of Prunus africana are used to treat various diseases. Informants interviewed stated
that they use this species in the treatment of prostate (UR=174), malaria (UR=101), urogenital infections (UR=69), sexual
weakness/impotence (UR=68) and digestive disorders (UR=41) (Table 2). Great importance is given to the prostate (IR=1) when
riparian communities use Prunus africana in traditional medicine (Table 2). Depending on the diseases targeted, the methods
of preparing the organs and the methods of administering the remedies are not always the same. For the majority of diseases,
decocted forms (Figure 3) administered orally are the most commonly used (Figure 4). Through an MCA, we found that there
is a relationship between the diseases treated by P. africana and the socio-demographic characteristics of individuals. For
example, adult and old females solicit potions from this species for diseases such as cancer, amoeba cyst, nocturia, and malaria
while young females mainly struggle with ovarian cyst. In contrast, young men and singles use extracts of P. africana organs
for diseases such as hernia, diarrhea, and typhoid fever. In addition, the use of P. africana associated with herbaceous and
woody species among young and adult males is directly related to sexual problems (male sterility, sexual weakness, prostate)
common in the communities (Figure 5).
Table 2. Diseases identified by Prunus africana and their importance according to the informants
Id
Disease treated
UR
RI
1
Prostate
174
1
2
Malaria
101
0.66
3
Urogenital infections
69
0.59
4
Sexual weakness
68
0.58
5
Lumbago
61
0.56
6
Digestive disorders
41
0.61
7
Nocturia
29
0.35
Ethnobotany Research and Applications
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8
Hernia
23
0.43
9
Muscle pain
14
0.28
10
Ovarian cyst
10
0.27
11
Curvature
8
0.27
12
Asthma
7
0.26
13
Cancers
6
0.26
14
Diarrhea
6
0.26
15
Fatigues
4
0.26
16
Apendiseptonia
1
0.25
17
Amoeba cyst
1
0.12
18
Heart attack
1
0.12
19
Male sterility
1
0.12
20
Rheumatism
1
0.12
21
Threats of abortion
1
0.12
22
Tooth decay
1
0.12
23
Typhoid fever
1
0.12
Figure 3. Links between diseases and organ preparation methods
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Figure 4. Links between diseases and modes of administration of remedies (cures)
Figure 5. MCA showing the influence between disease occurrence, community characteristics, and solicitation of P. africana-
based cures.
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Plants associated with P. africana in the preparation of cures
Informants reported that they combine Prunus africana-based extracts with other herbaceous and woody species to increase
the effectiveness of remedies against the targeted disease(s). Trunk bark, leaves, fruits and roots are the main organs used
for these species (Figure 6). Extracts from these organs of the different species are prepared following the same preparation
methods as P. africana and are administered mainly orally. Other species require their remedies to be administered to sick
people by the anal way (purgation), by the cutaneous way (local application), by the auricular way, by a simple chewing in
the mouth or by a shower bath to be effective (Figure 6 and 7).
However, the species associated with Prunus africana during the preparation of the remedies vary according to the socio-
demographic characteristics of each individual (living zone, ethnicity, gender, education level, marital status, age groups, and
seniority). Multiple correspondence factor analysis (MCA) (Figure 8) shows, for example, that people from the Piri ethnic
group associate P. africana more with native forest species such as Anthochleista grandifolia, Bridelia micrantha, Piper
nigrum, Garcinia kola and Azadiracha indica. In contrast, Pygmies (Mbuti) preferentially use the forest species Zanthoxylum
gilletii and Piptadeniatrum africanum. With the exception of Tabernaemontana johnstonii, the populations of Lubero
territory largely associate P. africana with herbaceous species that grow in the climatic conditions of this zone (Cymbopogon
citratus, Bidens pilosa, Conyza sumatrensis, Ricinus communis, Camellia sinensis, etc.) MCA also shows that adult males
associate more in P. africana potions with aphrodisiac species such as Zingiber officinale (Fig. 8). Chi-square test shows that
species use varies by zone (X2=365.25, df=120, p-value< 0.001), gender (X2=83.14, df=40, p-value< 0.001), seniority in the
locality (X2=317. 05, df=120, p-value< 0.001), level of education (X2=255.87, df=160, p-value< 0.001), marital status
(X2=186.83, df=120, p-value< 0.001) and age group (X2=381.05, df=200, p-value< 0.001) of the respondents. Venn diagram
shows the similarities and dissimilarities between the uses of species associated with Prunus africana according to the areas
surveyed. For example, it can be seen that the populations of Ruwenzori use 17 species that the populations of other zones
(Lubero, Mangurejipa, Walikale) do not use (Figure 9a and Table 3).
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Table 3. Synthesis of ethnobotanical knowledge of local and indigenous communities on Prunus africana in North Kivu: herbaceous and woody species associated with the preparation of cures.
Species name
Local/ Vernacular name
Family
Life form
Parts used
Modes of
preparation
Modes of
administration
Disease treated
UR
FC
NU
RI
Ethnicity
Zones
Aloe vera (L) Burm.f
Ngaka
Xanthorrhoeaceae
Herb
Leaves, Young
shoots
Decoction,
Infusion
Oral way
Digestive
disorders, Hernia,
Malaria
5
4
2
0.28
Nande
Lubero,
Ruwenzori
Anthochleista
grandifolia L.
Mukuvokuvo/Kipoku
Sapotaceae
Tree
Trunk bark
Decoction
Oral way
Prostate,
Digestive
disorders,
Urogenital
infections
5
5
1
0.17
Nande,
Piri
Lubero,
Mangurejipa
Artemisia annua L.
Artemisia
Asteraceae
Herb
Leaves, Young
shoots, Trunk
bark, Whole
plant
Decoction,
Infusion,
Maceration,
Direct use
Oral way,
Mastication
Prostate, Malaria
23
18
4
0.66
Nande,
Kovo, Piri
Lubero,
Mangurejipa,
Ruwenzori,
Walikale
Azadirachta indica
A.Juss.
Neem, Murubaini,
Dira
Meliaceae
Tree
Leaves
Decoction
Oral way
Nocturia
1
1
1
0.13
Nande
Ruwenzori
Bidens pilosa L.
Vukuto
Asteraceae
Herb
Whole Plant
Decoction
Oral way
Sexual weakness
1
1
1
0.13
Nande
Ruwenzori
Bridelia micrantha
(Hochst.) Baill
Mughanza
Phyllanthaceae
Tree
Trunk bark
Decoction
Oral way
Nocturia,
Prostate,
Lumbago,
Curvature,
Urogenital
infections
20
20
1
0.30
Kovo,
Nande,
Nyanga,
Piri
Lubero,
Mangurejipa,
Ruwenzori,
Walikale
Camellia sinensis (L.)
Kuntze
Chai, Thé
Theaceae
Shrub,
Small tree
Leaves
Decoction
Oral way
Prostate
2
2
1
0.14
Nande
Ruwenzori
Canarium
schweinifurthi Engl.
Canarium
Burseraceae
Tree
Exudates
Local
application
Cutaneous way
Digestive
disorders, Hernia,
Malaria
2
2
1
0.14
Kovo,
Nyanga
Walikale
Carica papaya L.
Papaye
Caricaceae
Herb
Leaves, Fruits,
Flowers,
Young shoots
Decoction
Oral way
Malaria, Digestive
disorders,
Lumbago
9
6
4
0.55
Kovo,
Nande
Ruwenzori,
Walikale
Cinchona legderiana
L.
Kingina
Rubiaceae
Tree,
shrub
Leaves, Trunk
bark, Young
shoots, Roots
bark
Decoction
Oral way
Prostate, Malaria,
Lumbago,
Curvature,
Urogenital
infections, Sexual
weakness
31
23
4
0.70
Nande,
Piri, Rega
Lubero,
Mangurejipa,
Ruwenzori,
Walikale
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Coffea sp
Kawa
Rubiaceae
Tree,
shrub
Fruits
Decoction
Oral way
Sexual weakness,
Muscle pain,
Malaria, Prostate,
Hernia
18
18
1
0.28
Nande
Lubero,
Ruwenzori
Cola acuminata
Schott & Endl.
Ngongolio
Malvaceae
Tree
Fruits
Decoction,
Direct use
Oral way,
Mastication
Sexual weakness,
Urogenital
infections
5
5
1
0.17
Kovo,
Nande,
Piri
Lubero,
Mangurejipa,
Walikale
Conyza sumatrensis
(syn. Erigeron
sumatrensis Retz.)
Kavingande
Asteraceae
Herb
Leaves,
Flowers,
Exudates
Decoction,
Oral way
Malaria
3
1
3
0.38
Nande
Lubero,
Ruwenzori
Cymbopogon
citratus (DC.) Stapf
Citronnelle
Poaceae
Herb
Leaves
Decoction
Oral way
Malaria, Fatigues,
Sexual weakness,
Prostate,
Lumbago, Hernia
16
16
1
0.27
Kovo,
Nande
Ruwenzori
Dracaena sp
Mughathi
Asparagaceae
Shrub
Leaves, Trunk
bark, Young
shoots
Decoction,
Direct use
Oral way,
Mastication
Prostate,
Curvature,
Malaria,
Urogenital
infections
22
20
3
0.55
Kovo,
Mbuti,
Nande,
Nyanga,
Piri, Rega
Lubero,
Mangurejipa,
Walikale
Drypetes aubrevillei
Leandri
Mulabe
Putranjivaceae
Tree
Trunk bark,
Fruits,
Exudates
Decoction,
Maceration,
Direct use
Oral way, Anal
way, Shower
bath
Prostate, Sexual
weakness,
Curvature,
Lumbago,
Digestive
disorders,
Urogenital
infections,
Cancers
56
55
3
0.87
Kovo,
Mbuti,
Nande,
Nyanga,
Piri, Rega
Lubero,
Mangurejipa,
Ruwenzori,
Walikale
Eucalyptus globulus
subsp. Maidenii
(F.Muell.) J.B.Kirkp.
Muratusi
Myrtaceae
Tree
Leaves
Decoction
Oral way
Malaria, Muscle
pain
9
9
1
0.33
Kovo,
Nande,
Piri
Lubero,
Mangurejipa,
Ruwenzori,
Walikale
Garcinia kola Heckel
Kadika
Clusiaceae
Tree
Trunk bark
Decoction,
Direct use,
Powder
Oral way,
Mastication,
Shower bath
Prostate, Malaria
2
2
1
0.14
Nande,
Piri
Lubero,
Mangurejipa
Harungana
madagascariensis
Lam. ex Poir.
Musombo
Hypericaceae
Tree
Trunk bark
Decoction,
Maceration
Anal way
Diarrhea,
Digestive
disorders
2
2
1
0.14
Nande
Ruwenzori
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Hibiscus
malvacearum L.
(syn. H. vitifolius L.)
-
Malvaceae
Herb,
Shrub
Leaves
Decoction
Oral way
Male sterility
1
1
1
0.13
Nande
Ruwenzori
Mangifera indica L.
Muhembe
Anacardiaceae
Tree
Leaves, Trunk
bark
Decoction
Oral way
Lumbago
5
3
2
0.27
Nande
Ruwenzori
Markhamia lutea
(Benth.) K.Schum
Musavu/Muchafu
Bignoniaceae
Tree
Trunk bark
Decoction
Oral way
Ovarian cyst
2
2
1
0.14
Nande
Lubero,
Ruwenzori
Mondia withei
(Hook.f.) Skeels
Murondo
Apocynaceae
Perennial
herb,
Woody
climber
Roots, Trunk
bark, Fruits
Decoction,
Direct use
Oral way,
Mastication
Prostate,
Nocturia, Sexual
weakness,
Fatigues
8
8
3
0.44
Kovo,
Nande,
Nyanga
Lubero,
Ruwenzori,
Walikale
Moringa oleifera
Lam.
Muringa
Moringaceae
Tree
Fruits
Decoction
Oral way
Hernia,
Apendiseptonia
2
2
1
0.14
Nande
Ruwenzori
Nicotiana tabacum
L.
Tabac
Solanaceae
Herb
Leaves
Decoction
Oral way
Prostate
2
2
1
0.14
Nande
Ruwenzori
Ocimum
gratissimum L.
Mujaja
Lamiaceae
Herb
Leaves
Decoction
Oral way
Asthma, Malaria,
Diarrhea, Hernia
6
6
1
0.18
Nande
Ruwenzori
Piper guineense
Schum and Thonn
Ketchu
Piperaceae
Herb,
Liane
Roots, Fruits
Decoction,
Direct use,
Powder
Oral way,
Mastication
Prostate,
Digestive
disorders, Sexual
weakness,
Malaria
18
12
2
0.35
Kovo,
Nande
Ruwenzori,
Walikale,
Mangurejipa
Piper nigrum L.
Piperaceae
Perennial
woody
wine
Roots, Fruits
Decoction,
Direct use
Oral way
Lumbago
2
1
2
0.25
Piri
Mangurejipa
Piptadeniastrum
africanum (Hook.f.)
Brenan
Dabema/Mukundusevere
Fabaceae
Tree
Roots, Trunk
bark, Roots
bark
Decoction
Oral way
Nocturia, Tooth
decay, Sexual
weakness
12
9
3
0.45
Kovo,
Nande,
Piri, Rega
Lubero,
Mangurejipa,
Ruwenzori,
Walikale
Psidium guayava L.
Mabela, Mapera
Myrtaceae
Shrub,
Small tree
Leaves
Decoction
Oral way
Prostate
1
1
1
0.13
Nande
Lubero
Rauvolfia vomitoria
L.
Katongwe/Kathongo
Apocynaceae
Shrub,
Small tree
Trunk bark,
Roots bark
Decoction
Oral way
Malaria, Digestive
disorders,
Diarrhea, Hernia,
Lumbago
14
11
2
0.35
Kovo,
Mbuti,
Nande,
Nyanga
Mangurejipa,
Ruwenzori,
Walikale
Ricinus communis L.
Mbono
Euphorbiaceae
Shrub,
Herb
Leaves, Fruits
Decoction,
Direct use
Anal way,
Cutaneous way
Rheumatism,
Lumbago
3
3
2
0.35
Nande
Ruwenzori
Rosmarinus
officinalis L. (syn.
Romarin
Lamiaceae
Shrub
Leaves
Decoction
Oral way
Hernia, Fatigues
1
1
1
0.13
Nande
Ruwenzori
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Salvia rosmarinus
Spenn.)
Sorghum vulgare L.
Mughemba
Poaceae
Shrub
Fruits
Decoction
Oral way
Digestive
disorders, Hernia,
Malaria
5
4
1
0.16
Nande
Ruwenzori
Spathodea
campanulata
P.Beauv
Aro (Kilur)rruu (Kilendu)
Bignoniaceae
Tree
Trunk bark
Decoction
Oral way
Urogenital
infections
1
1
1
0.13
Nande
Ruwenzori
Tabernaemontana
jonhstonii (Stapf)
Pichon
Apocynaceae
Tree
Trunk bark
Decoction
Oral way, Anal
way
Urogenital
infections,
Prostate, Sexual
weakness
4
4
1
0.16
Kovo,
Nande,
Rega
Lubero,
Mangurejipa,
Ruwenzori,
Walikale
Tetradenia riparia
(Hochst.) Codd
Mutuvya
Lamiaceae
Shrub
Leaves
Decoction
Oral way
Typhoid fever,
Heart attack
2
2
1
0.14
Nande
Ruwenzori
Triticum sativum L.
Engano
Poaceae
Herb
Fruits
Decoction
Oral way
Malaria
2
2
1
0.14
Nande
Ruwenzori
Zanthoxylum gilletii
(De Wild.)
P.G.Waterman
Sia/Rwese
Rutaceae
Tree
Leaves, Roots,
Trunk bark
Decoction,
Maceration
Auricular way,
Oral way
Nocturia,
Prostate,
Urogenital
infections,
Lumbago,
Malaria, Sexual
weakness,
Curvature
39
38
3
0.72
Kovo,
Nande,
Piri, Rega,
Nyanga,
Mbuti
Lubero,
Mangurejipa
Zea mays L.
Etsikussa (Maïs)
Poaceae
Herb
Fruits, Flowers
Decoction
Oral way
Prostate
10
10
1
0.34
Kovo,
Nande
Lubero,
Ruwenzori,
Walikale
Zingiber officinale
Roscoe
Tangawisi
Zingiberaceae
Perennial
herb
Roots, Fruits
Decoction,
Direct use
Oral,
Mastication
Prostate,
Lumbago, Sexual
weakness,
Digestive
disorders
6
6
2
0.30
Mbuti,
Nande,
Nyanga,
Piri
Mangurejipa,
Ruwenzori,
Walikale
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Figure 6. Relationship between species associated with P. africana in traditional disease treatment and organs used (Chord
diagramm species-organ used)
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Figure 7. Relationship between species associated with P. africana and methods of administration of drugs (Chord diagramm
species-modes of administration)
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Figure 8. MCA between socio-demographic characteristics of informants and species associated with P. africana during cure
preparation
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Figure 9. Venn diagram: similarities of zones (a) and ethnic groups (b) on species associated with P. africana in traditional
disease treatment
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Diversity of species families associated with P. africana in the treatment of diseases
Analysis of the ethnobotanical data provided by the informant’s shows that the species of the Putranjivaceae family is are
most cited. It is followed by Rubiaceae, Rutaceae, Poaceae, Apocynaceae, Asparagaceae, Asteraceae and Phyllanthaceae
(Figure 10). However, the Poaceae family remains the most diverse in terms of species associated with P. africana during
disease treatment (4 species out of a total of 41 species cited by informants). This is followed by the Apocynaceae,
Asteraceae, and Lamiaceae families, each with 3 different species (Figure 11).
Figure. 10 Families of species used in association with Prunus africana
Figure. 11 Diversity of medicinal species families
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Discussion
Ethnobotanical uses of P. africana
According to our study, people living near community forests in the four study areas use P. africana for a variety of uses. Use
in traditional medicine is the most sought-after, given that local and forest-dwelling communities have no access to the
modern health system. Beyond medicinal use, the results of our study show that the species is used as a source of energy in
households (fuelwood and charcoal), produces building materials for homes (poles, rafters, etc.) and is used in handicrafts
(manufacture of wooden chairs, beds, furniture, mortar, etc.). These results are similar to those obtained in various countries
(DR Congo, Cameroon, Kenya, Uganda, Burundi, South Africa, and West Africa) where climatic conditions are favorable to
the growth of this species (Stewart, 2003). For all these countries except DR Congo and Burundi, Stewart (2003) reports that
P. africana produces firewood, construction wood (truck bodies, beer boats, bridges, cupboards and furniture, roof supports,
window and door frames, cutting blocks, beehive supports, etc.) and is used in handicrafts (mortar and pestle manufacture,
…).
In the same vein, Zocchi et al. (2020) found that the wood of P. africana is highly valued by local people in the manufacture
of beehives. The wood of this species results in a highly valued hive in terms of its durability. In addition to medicinal use
and the production of wood for various purposes, Stewart (2003) reports that some indigenous populations in countries
where this species is found use it in traditional rituals and ceremonies (ceremonial spear handles, wainscoting on sculptures).
P. africana also has agricultural importance in that the young stems (1.5-5 cm in diameter) are also used as stakes for the
cultivation of voluble beans in many populations.
Types of parts used and diseases treated by P. africana extracts
A majority of local populations living in the P. africana range use extracts from the bark and leaves of this species to treat a
wide range of illnesses. This tendency is linked to the fact that ethnobotanical knowledge is passed on from person to person
by word of mouth, and some people restrict themselves to what is known to all (for example, some people believe that only
P. africana bark extracts are effective against disease, as this knowledge was passed on to them by their elders). In general,
Stewart (2003) reports that P. africana extracts are effective in the traditional treatment of over 45 human and 11 animal
diseases based on ethnobotanical studies in Cameroon alone.
For example, in the province of North Kivu where we conducted ethnobotanical surveys, people living in community forests
with specimens of P. africana treat 23 human diseases with extracts from the bark and leaves of this woody species. When
asked what diseases local people target when using P. africana, 174 of 221 informants in the sample cited prostate, or 78.7%.
These local populations attach great importance to the prostate (IR=1). After the prostate, the other most cited diseases
were malaria (101 informants), urogenital diseases (69 informants), sexual weakness and/or impotence in men (68
informants) and digestive disorders (41 informants). These results are similar to those obtained by Kasika et al. (2016).
Indeed, in a study on the use of plant species in traditional medicine among two ethnic groups (Bantu and Pygmies), Kasika
et al. (2016) identified 63 diseases that are treated by plants. The most cited diseases in their study are: malaria (15 species
for treatment), diarrhea (11 species), colic (7 species), internal candidiasis and yellow fever (12 species), migraine (3 species)
and rheumatism (4 species). Four species identified in this study were previously reported by Kasika et al. (2016): Ricinus
communis (15 diseases), Bidens pilosa (13 diseases), Conyza sumatrensis (13 diseases), and Canarium schweinfurthii (12
diseases).
If we compare the diseases identified in this study with those reported by previous research, we can observe a great similarity
with local populations using P. africana in other countries. Indeed, a number of ethnobotanical studies have found that not
only local populations but also the scientific community are attracted to this species because of its effective active ingredients
against benign prostatic hyperplasia and prostate hypertrophy (Abera 2014; Ibrahim et al. 2016; Jared Misonge et al. 2019;
Qureshi et al. 2009; Tugume et al. 2016; Komakech and Kang 2019; Komakech et al. 2020; Komakech et al. 2022), an
increasingly common problem in older men. Beyond the prostate, our ethnobotanical surveys showed that local people also
use P. africana in the treatment of other diseases. Diseases reported are similar to those mentioned in previous research.
Without being exhaustive, P. africana extracts treat the following diseases: malaria (Jiofack et al. 2008; Jiofack et al. 2010;
Ibrahim et al. 2016; Syamasamba et al. 2022), gastralgia (i.e., stomach pain) (Mwaura et al. 2020), digestive disorders, chest
pain, heartburn, madness (Jiofack et al. 2008; Jiofack et al. 2010), cough, flu, chest congestion, abdominal and back pain (low
back pain), analgesic cancer, blood purification, muscle pain, joint pain (Gakuya et al. 2013), ear infections, toothache and
tooth decay (Giday et al. 2009), diarrhea, fever, kidney disease, inflammation, complaints and allergies (Ibrahim et al. 2016),
breast cancer (Jared Misonge et al. 2019), jaundice (Kassa et al. 2020) and fainting (Tugume et al. 2016). Besides these
aforementioned diseases, Gail et al. (2015) report that some populations living in or around forests use the leaves and ground
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powder of P. africana bark as a remedy for HIV as well as HIV-TB co-infection. According to these same authors, traditional
P. africana-based formulations are a source of blood purification, a universal tonic, an antidepressant, and a remedy for TB-
related respiratory conditions such as asthma, bronchitis, influenza, and weight loss (Gail et al. 2015).
Analysis of previous ethnobotanical research results from around the world shows that medicinal plants are never used alone
to treat a given disease. Whether among traditional healers (traditherapists) or among individuals with little knowledge of
traditional medicine, the tendency is always to mix several species to constitute a remedy. We made similar observations
for populations in four study areas in North Kivu where the majority of informants stated that they mix P. africana with other
woody and herbaceous species when preparing remedies. Studies have shown, however, that mixing species in traditional
medicine is a source of many side effects and intoxications. According to Kamau (2021), the main toxic effects resulting from
the mixing of medicinal plants include headache, diarrhea, and stomachache. In interviewing traditional healers, Kamau
(2021) found that the majority mix extracts of P. africana with those of other species in order to increase the effectiveness
of the treatment on the targeted disease(s). In this study, we identified 41 woody and herbaceous species associated with
P. africana in the preparation of potions in the four study areas. Among the top 10 species most cited by informants were:
Drypetes aubrevillei (FC=55), Zanthoxylum gilletii (FC=38), Cinchona legderiana (FC=23), Bridelia micrantha (FC=20),
Dracaena sp. (FC=20), Artemisia annua (FC=18), Coffea spp. (C. arabica and C. canephora) (FC=18), Cymbopogon citratus
(FC=16), Piper guineense (FC=12) and Rauvolfia vomitoria (FC=11). Some species listed in Table 3 had already been
mentioned by Kasika et al. (2014) as likely to treat 10 different diseases among the Nande (the majority in our sample). These
species are: Aloe Vera, Bidens pilosa, Carica papaya, Conyza sumatrensis and Ricinus communis (Kasika et al. 2014).
Effects of informants' socio-demographic characteristics on the use of P. africana and other species
Results of this paper revealed that the use of medicinal plants associated with P. africana in the preparation of cures varied
according to the individual's place of residence, his/her gender, his/her seniority in the locality, his/her level of education,
his/her marital status and his/her age group (p-value< 0.05). Residence's influence on plant use is due to two factors: (i) each
area is characterized by populations with different ancestral practices, customs and even perceptions; (ii) ethnobotanical
knowledge is highly dependent on the species available in each study area, despite the similarities we observed. Considering
gender, we found that men are most often concerned by erectile dysfunction and tend to associate plants with aphrodisiac
properties (Zingiber officinale, Cola acuminata) with P. africana to increase sexual strength, unlike women.
In contrast, the chi-square test of independence showed that ethnic group and occupation did not have a significant influence
on the preference for species used in the traditional treatment of illnesses. This statistical insignificance of belonging to an
ethnic group on the use of species may be linked to the fact that, in our sample, the majority of informants were from the
Nande ethnic group. Thus, the fact that individuals belonging to the same ethnic group share the same culture, practices
and, by extension, lifestyles explains this trend. In addition, each ethnic group transmits ethnobotanical knowledge in its
own way from one generation to the next (oral transmission). Our results are contrary to those obtained by Kasika et al.
(2015), who found that Bantu (Nande) phytotherapy was different from that of the Pygmies (Mbuti). Their study showed
that 97 recipes from 182 plant species were used by the ethnic group versus 78 recipes from 83 species among the pygmies
(Kasika et al. 2015).
In another study, Kasika et al. (2016) showed that Bantus and Pygmies living in the same village in the Beni and Lubero
territories used different plant species as traditional medicines to treat the same illnesses. If we consider seniority in the
village, our results show a difference in the use of species linked to the fact that the most senior know more medicinal species
than the least senior, due to their great experience. Level of education influences species use, because people with a high
level of education (high school, university) have more knowledge of plant virtues acquired at school than people with a low
level of education. People with a low level of education have endogenous knowledge, but in some cases are limited to what
their ancestors, parents, relatives or friends pass on to them orally. With regard to age group and marital status, we believe
that the significant effect on species use is linked to the fact that the diseases and plants used to treat them are different for
young people, adults and the elderly/old ladies, and for married, single, widowed and divorced people. So, for example,
married people of all ages will be more interested in aphrodisiac plants. Similarly, older people will be more interested in
species that treat recurrent diseases of the elderly (rheumatism, for example).
Implications of the study results for P. africana conservation
Results of our study could have implications for the conservation of P. africana in the region if local and indigenous
communities are supported in substituting or reducing the extraction of bark from this species. Indeed, we found that the
leaves are also used by informants to prepare cures, so replacing bark with leaves would reduce the pressure on P. africana
Ethnobotany Research and Applications
23
in the region. In addition, we have shown that local and indigenous communities mix extracts of P. africana with extracts of
other woody and herbaceous species. As these herbaceous and woody species can treat the same diseases as P. africana, it
is possible to reduce the pressure on this species in North Kivu. Furthermore, previous literature shows that certain
herbaceous and woody species can be substituted for P. africana in the treatment of certain diseases. Based on some recent
previous research, we present a non-exhaustive list of species found in forests or agricultural landscapes that could play the
same role as P. africana in traditional medicine, in order to limit pressure on this endangered species in North Kivu.
A recent study shows the species Catharanthus roseus (L.) G. Don to possess anticarcinogenic properties quite similar to
those of P. africana, as several antitumor drugs are already produced there (Omara et al. 2020). Besides Catharanthus roseus,
Zingiber officinale has active principles that are effective in the traditional treatment of influenza, internal parasitosis (Abera
2014) and rheumatism (Jiofack et al. 2008). Another example is that of species of the Coffea genus, which can be substituted
for P. africana in the treatment of diarrhoea (Abera 2014). Another recent study shows that Carica papaya leaf and fruit
extracts are effective against gastritis, malaria, diarrhea (Amsalu and Regassa 2022), cervical cancer, prostate cancer and
breast cancer (Omara et al. 2020). Carica papaya seeds also have antivermifuge properties (Focho et al. 2009). So, as Carica
papaya grows spontaneously or can easily be cultivated, it offers an alternative for reducing pressure on P. africana.
Other woody species of the Bridelia genus, easily found in the community forests of North Kivu, can also be used in place of
P. africana to treat certain diseases. Indeed, leaf extracts from Bridelia spinosa and Bridelia micrantha are effective in the
traditional treatment of diabetes. Extracts from the roots and bark of Rauvolfia vomitoria are used to calm the mentally ill
(Focho et al. 2009), as well as treating typhoid fever, helminths and cardiac pain (Jiofack et al. 2008). In view of the diversity
of diseases that Rauvolfia vomitoria treats, and its availability in forest ecosystems, it also represents an alternative to P.
africana. Jiofack et al. (2008) show that extracts of guava leaves (Psidium guayava L.) cure diarrhoea and wounds. Same
authors report that extracts of maize (Zea mays L.) are an excellent worm extractor and limit bladder problems (nocturia) in
adults (Jiofack et al. 2008). In addition to guava and maize, Jiofack et al. (2008) have also shown that extracts of Spathodea
campanulata (a species also found in community forests and other ecosystems in North Kivu province) have an effect on
hooked eye disease, while the use of castor oil (Ricinis communis) is part of the traditional treatment of infertility in women.
On the basis of the species presented in Table 3 and the diseases they treat, they can easily be substituted for P. africana,
which could enable this species to be conserved on a long-term basis in its areas of distribution in DR Congo. Research into
medicinal species that can be substituted for P. africana to treat diseases must be a priority in the region, as numerous
studies (e.g. Betti and Ambara 2013) have already warned of the overexploitation of P. africana linked to the increase in its
demand for prostate bark since the 1990s.
In this context, the possibility of extinction of P. africana would become high in view of the organs used not only in traditional
but also modern medicine, as well as other uses such as energy wood, handicrafts and construction timber. This extinction
would be further accelerated by the fact that numerous studies have found that the repetitive harvesting of medicinal plants
from their roots, stems or bark has a serious effect on the survival of many species (Abera 2014). Using other organs such as
leaves to prepare recipes in association with other woody or herbaceous species we have identified (Table 3) may contribute
in some small way to the survival of the species in its range in North Kivu province. Debarked or uprooted species have a low
regenerative capacity. This observation was noted for the species P. africana.
Conclusion
This study investigated the ethnobotanical knowledge of P. africana in four areas of distribution in North Kivu. Results show
that this species is used for a wide range of uses, although local people living in community forests mainly exploit its bark
and leaves for traditional medicine. This often-uncontrolled exploitation exposes the species to extinction if sustainable
management strategies are not implemented. However, people do not use this species alone; they combine it with other
herbaceous and woody species to prepare remedies against various diseases. As these herbaceous and woody species have
similar virtues in the treatment of certain diseases, we suggest that local and indigenous communities use them to reduce
the pressure on P. africana. In the meantime, further in-depth research should be carried out with the aim of identifying
new species based on phytochemical analyses that could constitute an alternative or be substituted for P. africana in local
traditional medicine. Indeed, knowledge of these alternative medicinal plants will reduce the pressure on this species and
ensure its conservation for present and future generations. However, the results of our investigations lay the foundations
for further reflection on how to raise community awareness of the fact that other species can be used instead of P. africana
to treat a number of illnesses. Such awareness-raising is essential if we are to achieve sustainable management and use of
P. africana in eastern DR Congo.
Ethnobotany Research and Applications
24
Declarations
Ethical considerations: No informants from either local or indigenous communities were forced to respond without their
free consent. All informants who voluntarily refused to participate in the study were excluded.
Data Availability: Data used in this article are available for any requests from the Editorial Board of Ethnobotany Research
& Applications.
Conflicts of interest: All authors of the article declare that there are no conflicts of interest between them or other authors.
Authors' contributions: EKM: Conceptualization, Methodology, Data collection, validation, writing of the original manuscript,
revision and editing of the manuscript; JLB: Conceptualization, Methodology, revision and editing, validation, supervision;
ND: Conceptualization, Methodology, revision and editing, validation, supervision; MMK: Conceptualization, Methodology,
Data analysis, revision and editing; HNNA: Validation, Revision and editing; PBF: Validation, Revision and editing.
Acknowledgements
We are grateful to the local and indigenous communities of Walikale, Lubero, Ruwenzori and Mangurejipa for voluntarily
providing their ethnobotanical knowledge. We would also like to thank the interviewers for the time and effort they devoted
to collecting data in a context of armed conflict in eastern DR Congo.
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