Review Article

Plants used for the management of paediatric ailments in Zimbabwe: A narrative review

Alfred Maroyi

Received: 25 May 2024; Accepted: 15 July 2024; Published: 14 Aug. 2024

Copyright: © 2024. The Author Licensee: AOSIS.
This is an Open Access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Background: Children are susceptible to various types of infections and diseases because of their low and weakened immune system. In various communities throughout the world, medicinal plants have historically been used to treat and manage paediatric diseases and ailments.

Aim: The current study was aimed at identifying and analysing medicinal plants used traditionally to treat and manage paediatric diseases in Zimbabwe.

Setting: This review provides an overview of medicinal plants used to manage paediatric ailments in Zimbabwe.

Method: Ethnobotanical information on medicinal plants used to treat and manage paediatric diseases in Zimbabwe was obtained using online databases such as Scopus, JSTOR, PubMed, Google Scholar and Science Direct.

Results: A total of 178 taxa belonging to 64 families have been documented as traditional medicines for paediatric diseases and ailments in Zimbabwe. Cryptolepis oblongifolia, Asparagus spp., Dichrostachys cinerea, Fadogia ancylantha, Inula glomerata, Lannea edulis and Strychnos spinosa are the most popular medicinal plants with four to five use reports each. Medicinal plants are used to treat and manage 41 childhood medical conditions in Zimbabwe.

Conclusion: Baseline data provided in this study can be used for future ethnopharmacological research focusing on chemical, pharmacological and toxicological evaluations of the documented species.

Contribution: This study contributes to the existing literature about medicinal plants used to treat and manage paediatric diseases, and such data can be used to develop new health-promoting products for children and also pharmaceutical products that can be used to reduce child or infant mortality rate.

Keywords: indigenous pharmacopeia; medicinal plants; paediatric diseases; traditional medicine; tropical Africa; Zimbabwe.

Introduction

Children are susceptible to various types of infections and diseases because of their low and weakened immune system. Research showed that many diseases such as eye infections, gastro-intestinal problems, dental anomalies, respiratory infections, liver and kidney disorders and urinary problems are common in children throughout the world (Shaheen et al. 2017). While child mortality is decreasing globally by at least 50% (Wright, Power & Shivak 2022), mortality burden is still a major challenge in developing countries in sub-Saharan Africa and South Asia (Patton et al. 2016). In developing countries, non-fatal outcomes and disabilities because of long-term consequences of congenital conditions, malnutrition, complications of infections, injury and non-communicable diseases are common (Wright et al. 2022). Moreover, children’s diseases present a notable health concern as child mortality is regarded as an important measure of a population’s health status (Mbunge et al. 2024). In 2019, about 5.2 million children died before reaching the age of 5 years in sub-Saharan Africa and south Asia (Sharrow et al. 2022). The major causes of these deaths are preterm birth complications, intrapartum-related events, lower respiratory infections, diarrhoea, malaria, injury, meningitis, measles and congenital abnormalities (Perin et al. 2022). Zimbabwe is one of the countries still facing a high child or infant mortality rate with 54 deaths per 1000 live births recorded in 2020 (Mbunge et al. 2024), which is higher than the United Nations 2030 Sustainable Development Goal target of 12 deaths per 1000 live births (Raina et al. 2023). Despite concerted global efforts to enhance children’s health care through conventional medicines, the influence of traditional health practices persists in many countries in sub-Saharan Africa, including Zimbabwe (James et al. 2023; Ngere et al. 2022). Although the use of medicinal plants against children’s diseases in Zimbabwe dates back to the onset of human civilisation through human–plant interactions, this traditional knowledge is often neglected or not given priority. However, in developing countries, the use of medicinal plants to treat and manage children diseases is regarded as an important alternative. Traditional and complementary medicine is within the reach of millions of people who are unable to access modern health care facilities that are expensive and inaccessible (Hailu et al. 2020; Kasilo et al. 2019; Khalid & Ahmed 2023; Liheluka et al. 2023; Mokhesi & Modjadji 2022; Tugume & Nyakoojo 2019). Therefore, this review explores the indigenous knowledge of plants used for paediatric diseases in Zimbabwe to establish the knowledge gaps and areas for further research.

Methods

Ethnobotanical information on medicinal plants used to treat and manage paediatric diseases in Zimbabwe was obtained using online databases such as Scopus, JSTOR, PubMed, Google Scholar and Science Direct, and these data are summarised in Table 1. Additional information on medicinal plants used to treat and manage paediatric diseases in Zimbabwe was also obtained by a systematic search of various resources that are not covered by electronic databases, and these included journal papers, books, dissertations, book chapters, theses and other scientific articles obtained from the university library. All published studies related to the use of plants for managing paediatric diseases in Zimbabwe were included in this narrative review (Table 1). The ethnobotanical surveys listed in Table 1 were conducted in all floristic regions of the country. Zimbabwe is divided into five floristic divisions, that is, the central region, eastern, northern, southern and western region (Pope & Pope 1998). The relevant literature covered the period 1959–2022, that is, more than 60 years, a very long period to capture all the relevant work on the subject.

Review findings

The list of plant species used as sources of traditional medicines against paediatric diseases in Zimbabwe is presented in Table 2. A total of 178 taxa are listed. These taxa are distributed among 64 families and 149 genera. Sixteen (9.0%) of these taxa are exotic to Zimbabwe (Table 1). These species include Agave americana L., Asparagus asiaticus L., Bidens biternata (Lour.) Merr. & Sherff, B. pilosa L., Carica papaya L., Citrus limon (L.) Osbeck, Dysphania ambrosioides (L.) Mosyakin & Clemants, Jatropha curcas L., Lantana camara L., Melia azedarach L., Mentha spicata L., Moringa oleifera Lam., Musa spp., Ricinus communis L., Zea mays L. and Zingiber officinale Roscoe. These exotic species are now an important component of the indigenous or traditional pharmacopoeia in Zimbabwe (Maroyi 2018). Similarly, these exotic species are also included in the official indigenous or traditional pharmacopoeias in South Africa with species such as A. americana, B. biternata, B. pilosa, C. papaya, C. limon, J. curcas, L. camara, M. azedarach, M. spicata, M. oleifera, R. communis and Z. officinale traded in informal herbal medicine markets or shops as sources of traditional medicines (Williams et al. 2021). Moreover, exotic species such as C. papaya, C. limon, M. spicata, R. communis, Z. mays and Z. officinale are well-known sources of traditional medicines, and these species are included in the book entitled ‘Medicinal plants of the world’ written by Van Wyk and Wink (2015), emphasising their therapeutic uses, phytochemistry and pharmacological properties.

Twenty species, namely, Acalypha petiolaris Hochst., Ansellia africana Lindl., Asparagus spp., C. sericeum G. Don, Convolvulus sagittatus Thunb., Cryptolepis oblongifolia (Meisn.) Schltr., Dichrostachys cinerea (L.) Wight & Arn., Fadogia ancylantha Schweinf., Ficus sur Forssk., Flacourtia indica (Burm.f.) Merr., Grewia flavescens Juss., Gymnosporia senegalensis (Lam.) Loes., Hoslundia opposita Vahl, Inula glomerata Oliv. & Hiern, Lannea edulis (Sond.) Engl., Lippia javanica (Burm.f.) Spreng., Ormocarpum trichocarpum (Taub.) Engl., Senna singueana (Delile) Lock, Solanum campylacanthum Hochst. ex A. ich., Strychnos spinosa Lam. and Turraea nilotica Kotschy & Peyr. have the highest number of medicinal uses against paediatric diseases in Zimbabwe (Figure 1). Species documented in at least three independent ethnobotanical surveys include Euclea divinorum Hiern, L. edulis, Pterocarpus angolensis DC., S. campylacanthum and Ziziphus mucronata Willd. (Table 2; Figure 1). Notably, this study also identified medicinal plants that had been previously documented by Van Wyk (2015, 2017) who categorised such species as commercially important in sub-Saharan Africa as the species are regularly traded on local, national and international markets as medicinal plants, dietary supplements or functional foods. Such species include Adansonia digitata L., Carissa spinarum L., D. cinerea, Dicoma anomala L., D. ambrosioides, Heteromorpha arborescens (Spreng.) Cham. & Schltdl., Hibiscus sabdariffa L., Kigelia africana (Lam.) Benth., L. javanica, Mondia whitei (Hook.f.) Skeels, Phytolacca dodecandra L’Hér., Senna italica Mill., S. campylacanthum, Syzygium cordatum Hochst. ex Krauss, Terminalia sericea Burch. ex DC., Ximenia americana L. and Z. mucronata (Table 2). Such similarities in terms of species uses and values highlight the importance of recording indigenous and local knowledge about medicinal plants from different cultures and geographical regions. The insights that can be generated from such ethnomedicinal applications and cross-cultural comparisons offer promising avenues for further ethnopharmacological exploration.

FIGURE 1: Popular medicinal plants used against paediatric diseases with 3–5 use reports.

About three quarters (71.0%) of the taxa listed in Table 2 are from 17 families (Figure 2), namely, Fabaceae, Asteraceae, Rubiaceae, Lamiaceae, Malvaceae, Asparagaceae, Apocynaceae, Euphorbiaceae, Convolvulaceae, Poaceae, Acanthaceae, Vitaceae, Araliaceae, Anacardiaceae, Combretaceae, Moraceae and Solanaceae. The rest of the families is represented by one to three taxa each (Table 2). These research findings highlight the dominance of medicinal plants belonging to Fabaceae and Asteraceae families and therefore, corroborating earlier findings that indicated that the majority of medicinal plants used to treat and manage paediatric diseases in South Africa (Ndhlovu et al. 2023) and Uganda (Nalumansi, Kamatenesi-Mugisha and Godwin 2014) belong to Fabaceae and Asteraceae families. Apart from being large families characterised by more than 19 000 species each (Christenhusz & Byng 2016), families Fabaceae and Asteraceae are the most widespread taxa worldwide (Koekemoer, Steyn & Bester 2014) and have diverse ethnopharmacological applications (Garcia-Oliveira et al. 2021; Panda et al. 2019; Rolnik & Olas 2021; Van Wyk 2019). The genera with the highest number of taxa are Acalypha, Asparagus, Cyphostemma, Ficus, Leucas, Senna and Solanum, with three species each (Table 2). These genera are represented by two species each: Bidens, Combretum, Cussonia, Dracaena, Eriosperma, Gardenia, Grewia, Hypostes, Ormocarpum, Ozoroa, Rhynchosia, Senecio and Senegalia (Table 2).

FIGURE 2: Frequency of major plant families, genera and species used to manage and treat paediatric diseases in Zimbabwe.

Growth habit and parts used

Herbs (32.0%), shrubs (30.0%) and trees (24.0%) are the primary sources of medicinal plants used to treat and manage paediatric diseases in Zimbabwe (Figure 3A). The plant parts used to prepare these traditional medicines include calyses, cobs, rhizomes, stems, wood, bulbs, fibres, seeds, whole plants, fruits, bark, leaves and roots (Figure 3B). Roots are the main plant parts used to prepare the remedies used to treat and manage paediatric diseases (Figure 3B). Similarly, Ndhlovu et al. (2023) reported the predominance of the roots and rhizomes (40.0%), leaves (23.0%) and whole plants (20.0%) in the preparation of remedies against childhood diseases in the North West Province of South Africa. Traditional healers and other users of traditional medicines believe that underground plant parts such as roots, bulbs, rhizomes, corms and tubers contain higher concentration of active ingredients or phytochemical compounds (Barata et al. 2016; Chebii, Muthee & Kiemo 2023; Flores & Flores 1997) and therefore, likely to be more effective than the aerial plant parts such as branches, twigs, flowers, leaves, seeds and fruits. Research by Asigbaase et al. (2023) showed that harvesting pressure on medicinal plants is determined by the frequency of harvesting, quantity and plant parts being harvested, method of harvesting, plant species being harvested and its population size.

FIGURE 3: Characteristics of medicinal plants used against paediatric diseases in Zimbabwe. (a) Growth habit represented in pie diagram and (b) Plant parts used represented in a bar chart.

Disease categories

This study showed that medicinal plants are used to treat and manage 41 childhood medical conditions in Zimbabwe (Table 2). Maximum use is for depressed fontanelle (74 use reports), followed by abdominal pains (22 use reports), diarrhoea (19 use reports), fattening infants (17 use reports) and inflammation of umbilical cord (14 use reports) (Table 3). Results of this study corroborate previous findings by Towns, Eyi and Van Andel (2014), which revealed that fontanelle is a common paediatric ailment managed through the use of traditional medicines in tropical Africa. Literature search showed that traditional medicines are widely used against depressed fontanelle in Benin (Towns et al. 2014), Botswana (Teichler 1971), Gabon (Towns et al. 2014), Ghana (Ani-Amponsah et al. 2023) and South Africa (Khoza et al. 2023; Mashile, Tshisikhawe & Masevhe 2019). Similarly, Chandra and Wanda (2017) argued that traditional medicine is effective in managing diarrhoea in children in Indonesia. The general role and value of medicinal plants in childhood well-being is highlighted through utilisation of various plants in the management of malnutrition, kwashiorkor, growth of infants, wasting and prevention of illnesses (see Tables 2 and 3). Therefore, local communities in Zimbabwe have developed knowledge and skills necessary to exploit medicinal plants collected from the surrounding environment to treat and manage paediatric ailments and diseases.

Conclusion

The current study explored medicinal plants that are used to treat and manage paediatric diseases and ailments in Zimbabwe. The study also explored the traditional knowledge associated with utilisation of medicinal plants to manage such diseases in children. This study revealed that children are prone to several ailments, and there is need for systematic documentation of medicinal plants used for the treatment and management of paediatric diseases. Results of this study, therefore, provide baseline data that can be used for future ethnopharmacological research focusing on chemical, pharmacological and toxicological evaluations of the documented species.

Acknowledgements

The author declares that they have no financial or personal relationship(s) that may have inappropriately influenced him in writing this article.

A.M. declares that they are the sole author of this review article.

This article followed all ethical standards for research without direct contact with human or animal subjects.

This research received no specific grant from any funding agency in the public, commercial or not-for-profit sectors.

Data sharing is not applicable to this article as no new data were created or analysed in this study.

The views and opinions expressed in this article are those of the author and are the product of professional research. It does not necessarily reflect the official policy or position of any affiliated institution, funder, agency or that of the publisher. The author is responsible for this article’s results, findings and content.

References