Journal of Ethnopharmacology xxx (xxxx) xxxx
Contents lists available at ScienceDirect
Journal of Ethnopharmacology
journal homepage: www.elsevier.com/locate/jethpharm
Ethnomedicinal survey and mutagenic studies of plants used in Accra
metropolis, Ghana
Emelia Oppong Bekoea,∗, Christian Agyareb, Yaw Duah Boakyeb, Benedict Mbeah Baidenc,
Alex Asased, Joseph Sarkodiea, Henry Netteye, Francis Adub, Priscilla Boatema Otua,
Benjamin Agyarkwaa, Patrick Amoatengf, Isaac Asiedu-Gyekyef, Alexander Nyarkof
a Department of Pharmacognosy and Herbal Medicine, School of Pharmacy, University of Ghana, P.O Box LG 43, Legon, Accra, Ghana
bDepartment of Pharmaceutics, Faculty of Pharmacy and Pharmaceutical Sciences, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
c Department of Statistics and Actuarial Science, University of Ghana, P.O. Box LG 115, University of Ghana, Legon, Accra, Ghana
dDepartment of Plant and Environmental Science, University of Ghana, P.O. Box LG55, University of Ghana, Legon, Accra, Ghana
e Department of Pharmaceutics and Microbiology, University of Ghana, P.O Box LG 43, Legon, Accra, Ghana
fDepartment of Pharmacology and Toxicology, University of Ghana, P.O Box LG 43, Legon, Accra, Ghana
A R T I C L E I N F O A B S T R A C T
Keywords: Ethnopharmacological relevance: Majority of people living in Ghana and many other developing countries rely on
Ethnomedicinal survey traditional medicinal plants for their primary healthcare. These plants are used either alone or in combination to
Herbal medicines manage a wide range of ailments. However, most of these plants have not been investigated for their mutagenic
Medicinal plants effects.
Herbalists Aim of the study: This study, therefore aimed at evaluating the mutagenic activity of the most frequently used
Herbal dealers
Mutagenicity medicinal plants amongst Ghanaians living within the Accra metropolis, Ghana.
Materials and methods: Validated questionnaires were administered to 53 herbalists and herbal medicines dealers
in the Makola, Madina and Nima communities. Plants that were identified as being frequently used were in-
vestigated for their mutagenicity using the Ames test.
Results: A total of 110 medicinal plants belonging to 53 families were identified as most frequently used plants in
the study sites. These are used to treat various ailments including gastric ulcer, fever, malaria, male impotence,
diabetes, typhoid, high blood pressure and candidiasis. Thirteen samples (52%) showed moderate to high mu-
tagenicity in the TA 100 bacterial strain before and after metabolism with rat liver enzyme.
Conclusions: The study showed that over half of the frequently used medicinal plants showed moderate to high
mutagenicity before and after metabolism at the concentration of a 100 μg/mL. This may have implications for
the safety of those who use them to manage diseases. These findings will suggest the need for an in-depth study
of the mutagenic potentials of plants commonly used by indigenous people and more especially for those ex-
hibiting high mutagenicity in this study.
1. Introduction effects, safer, cheaper, more effective and more readily available com-
pared to orthodox medicines (Agyare et al., 2009; Calixto, 2000;
In Ghana, it is estimated that 951 tons of crude plant medicines are Firenzuoli and Gori, 2007; Kamboj, 2000; Kaur et al., 2013). These
sold annually on the domestic market (van Andel et al., 2012). About advantages have accounted for the increased patronization of herbal
70% of the population rely on herbal medicines for their primary medicinal plants in most developing countries including Ghana
healthcare (Yarney et al., 2013). It is generally believed that these (Calixto, 2000). With the increased usage have come important safety
herbal medicines have the advantages of being natural, with less side concerns. For example, the consistent increase in cancer cases in Ghana
Abbreviations: FIC, The informant consensus factor; BP, base pair; PM, point mutation; FSM, frame shift mutations
∗ Corresponding author.
E-mail addresses: eoppongbekoe@ug.edu.gh (E. Oppong Bekoe), chrisagyare@yahoo.com (C. Agyare), yawduahb@gmail.com (Y.D. Boakye),
mbeahbaiden@gmail.com (B.M. Baiden), alexasase@gmail.com (A. Asase), joseph_sarkodie@yahoo.com (J. Sarkodie), hnettey@msn.com (H. Nettey),
franceadu@yahoo.com (F. Adu), pboatemoatu98@yahoo.com (P.B. Otu), benjaminagyarkwa@yahoo.co.uk (B. Agyarkwa), patamo@yahoo.com (P. Amoateng),
asiedugyekye@yahoo.com (I. Asiedu-Gyekye), akn115@yahoo.com (A. Nyarko).
https://doi.org/10.1016/j.jep.2019.112309
Received 28 November 2018; Received in revised form 22 July 2019; Accepted 13 October 2019
0378-8741/ © 2019 Published by Elsevier B.V.
Please cite this article as: Emelia Oppong Bekoe, et al., Journal of Ethnopharmacology, https://doi.org/10.1016/j.jep.2019.112309
E. Oppong Bekoe, et al. Journal of Ethnopharmacology xxx (xxxx) xxxx
Fig. 1. A. Age distribution of herbalists and herbal dealers B. Level of education of herbalists and herbal dealers C. Duration of practice of herbalists and herbal
dealers.
has led to the advancement of various theories with regards to the 2. Materials and methods
causes. Among the possible causes discussed are commonly consumed
substances which may include herbal medications. This notion is not 2.1. Study area
farfetched, since some herbal plants and even finished and packaged
herbal medicinal products have been proven to contain mutagenic Three areas, Makola, Madina and Nima within the Greater Accra
compounds (Abdullah et al., 2017; Hoang et al., 2013b; Vanherweghem region of Ghana were selected for the study. These study areas were
et al., 1993). To screen for mutagenicity, the Ames test is very com- selected because of the high patronage of herbal plant materials and
monly employed because it enables the screening of many chemicals, herbal products together with the high numbers of herbalists and
rapidly and inexpensively. Those that are found to be mutagenic are medicinal plant dealers within the metropolis. In addition, medicinal
then further tested in animal studies to assess their ability to cause plant materials are readily available in open markets in these areas and
cancer (Rodriguez et al., 2012). It is important to note that most of the can be easily obtained in bulk quantities for the preparation of herbal
traditionally used medicinal plants have never been the subject of ex- products.
haustive toxicological investigations. In Ghana, only a small percentage Makola is located in the centre of the city of Accra within the Accra
of traditionally used medicinal plant materials have been thoroughly Metropolis, 5.55602° N, −0.1969° W. In 2010, the Accra Metropolis
investigated scientifically for their acclaimed benefits and side effects had a population of 1,848,614 which consisted of 887,673 males and
(Dar et al., 2017). Based on their traditional uses, they are often as- 960,941 females (GSS, 2012).
sumed to be safe; however reports have shown that a number of plants Madina is located in the La Nkwantanang Madina-Municipality in
which are used as food ingredients or in traditional medicine may have the northern part of the Greater Accra Region, 5.6833° N, 0.1667° W. It
in vitro mutagenicity (Ames et al., 1975; Cardoso et al., 2006; Ghazali covers a total land surface area of 70.887 square kilometres and is 84%
et al., 2011; McCann and Ames, 1976) and 90% of the mutagens are urban. The population of La Nkwantanang-Madina Municipality is
carcinogens capable of inducing cells to undergo abnormal growth and 111,926 and is the twelfth most populous human settlement in Ghana.
genetic defects (Ames et al., 1975; McCann and Ames, 1976). Females constitute 51.5% and males 48.5% of the population (GSS,
Though sale and use of herbal medicines have increased massively, 2012).
there is still limited information on the identity of the herbs sold as Nima in the East Ayawaso constituency, is situated approximately
dried barks, roots, stems and leaves. In addition, there is often a dearth 8 Km north of Accra Central. It shares boundaries with the Ring Road
of information on the herbalists, those who deal in the trade of med- (south), Kanda Highway (east), Accra Girls Secondary School (north)
icinal plants, their knowledge base and qualifications.The immense and the Odaw drain (west). The coordinates are 5.5820° N, 0.1984° W
traditional knowledge on herbs is rapidly being lost due to urbanization (Owusu et al., 2008). Nima has immense problems with settlement
and modernization, hence there is an urgent need to scientifically because spatial planning was never implemented in this locality. The
document these plants. The objectives of this study were therefore to population of Nima was estimated at 69, 044 (Owusu et al., 2008).
initially scientifically document some of the most commonly sold or
used traditional herbal materials amongst Ghanaians living within the 2.2. Participant selection and data collection
Accra metropolis and to conduct in vitro mutagenic investigations on
extracts prepared from these plants. As there were no official statistical data available on the numbers of
2
E. Oppong Bekoe, et al. Journal of Ethnopharmacology xxx (xxxx) xxxx
Table 1
Medicinal plant identified within the study sites. The local names of the plants were cross referenced in published literature (1. Burkill, 1985; 2. Burkill, 1994; 3.
Burkill, 1995; 4. Burkill, 1997; 5. Burkill, 2000; 6. Ghana Herbal Pharmacopoeia., 2007; 7. Mshana, 2000). The most frequently used medicinal plants as mentioned
by the 53 herbalists are indicated with asterisks (*) in the Table. * - indicates plants mentioned ˂5 times, **- plants mentioned 5 to 10 times; *** - indicates plants
mentioned 11 to 20 times; **** - indicates plants mentioned 21 or more times. NB:nur represents the number of individual use reports for a specific remedy.
Family name Scientific name Local name Plant part Voucher Indications (nur) Preparation (nur) Frequency of
citation by
Herbalists
Acanthaceae Asystasia gangetica (L.) T. Mmemme dua (Burkill, Leaves PSM51/5/ Anaemia (1) Herbal bath (1) 1
Anderson* 1985) 16 Spiritual protection (1)
Amaryllidiaceae Crinum jagus J. Thomps. Sukooko (Burkill, 1985) Leaves PSM52/5/ Haemorrhoids (1) Decoction (6) 6
** 16 Asthma (3)
Rhinitis (2)
Coughs (2)
Allium sativum L.* Garlic tso (Burkill, 1985; Root PSM92/5/ Constipation (2) Decoction (4) 4
STEPRI and CSIR, 2007) 16 Oedema or inflammation
(1)
Spiritual protection (2)
Anacardiaceae Lannea kerstingii Engl. & Dundu (Mshana, 2000) Root PSM53/5/ Impotence (1) Decoction (1) 1
K. Krause* 16
Mangifera indica L.* Mango (Mshana, 2000) Stem bark PSM54/5/ Fever (2) Decoction (4) 4
16 Malaria (2)
Root Fever (1)
Malaria (1)
Annonaceae Enantia polycarpa (DC.) Dua sika koduben (Burkill, Stem bark PSM38/5/ Malaria (4) Decoction (6) 6
Engl. and Diels ** 1985) 16 Typhoid (4)
Jaundice (1)
Monodora myristica Wedieba (Burkill, 1985) Seed PSM43/5/ Ulcer (1) Decoction (1) 1
(Gaertn) Dunal* 16 Vaginal disorders (1)
Pachypodanthium staudlii Dua wisa (Mshana, 2000) Bark PSM63/5/ Fever (1) Aqueous infusion 1
(Engl. & Diels) 16 (1)
Uvaria chamae Anweda (Mshana, 2000) Root PSM64/5/ Asthma (1) Decoction (9) 9
P. Beauv. ** 16 Cough (1)
Anaemia (4)
Gastric ulcer (3)
Skin rashes (3)
Xylopia aethiopica (Dunal) Hwentia (Mshana, 2000; Fruit PSM50/5/ Gastric ulcer (3) Decoction (5) 5
A. Rich. ** STEPRI and CSIR, 2007) 16 Candidiasis (2)
Apocynaceae Alstonia boonei Onyame dua (Burkill, Stem bark PSM/5/16 Measles (9) Decoction (22) 22
De Wild **** 1985; STEPRI and CSIR, Measle (2)
2007) Gastric ulcer (6)
Pains (4)
Anaemia (2)
Landolphia owariensis Aman (Burkill, 1985) Leaves PSM130/ Haemorrhoids (1) Decoction (1) 1
P. Beauv* 5/16
Mondia whitei (Hook. f.) Asaase huam (Mshana, Root PSM131/ Typhoid (1) Decoction (1) 1
Skeels* 2000) 5/16 Fever (1)
Jaundice (1)
Pricralima nitida Abere (Burkill, 1985) Root PSM134/ Diabetes (2) Decoction (4) 4
Durand & Hook* 5/16 Hepatitis (1)
High blood pressure (1)
Stem bark Malaria (1)
Gastrointestinal disorders
(1)
Strophanthus gratus (Wall. Omaatwaa (Mshana, 2000; Leaves PSM133/ Body pains (2) Decoction (9) 9
& Hook) Baill. ** STEPRI and CSIR, 2007) 5/16 Headache (3)
Stomach ache (1)
Blood detoxifier (1)
Haemorrhoids (2)
Bad breath (1)
Rauvolfia vomitoria Afzel* Kakapenpen (Mshana, Stem and PSM140/ Pains in the bone (1) Decoction (3) 3
2000; STEPRI and CSIR, bark 5/16 Anaemia (1)
2007) Sleeping disorders (1)
Stomach ache (1)
Leptadenia hastata (Pers.) Yaadiya (Burkill, 1985) Leaves PSM58/5/ Diabetes (2) Decoction (2) 2
Decne* 16 High blood pressure (1)
Araceae Colocasia esculenta (L.) Kooko aduro (Mshana, Root PSM55/5/ Eye disorders (3) Decoction (5) 5
Schott * 2000) 16 Haemorrhoids (3)
Cyrtosperma senegalensis Okuo (Burkill, 1985) Stem bark PSM56/5/ Wait and joint pains (2) Decoction (2) 2
(Schott) Engl.* 16 Erectile dysfunction (1)
Haemorrhoids (1)
Araliaceae Cussonia arborea Hochst Saman doro (Burkill, Bark PSM57/5/ Threatened abortion (1) Decoction (1) 1
ex A. Rich* 1985) 16
(continued on next page)
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E. Oppong Bekoe, et al. Journal of Ethnopharmacology xxx (xxxx) xxxx
Table 1 (continued)
Family name Scientific name Local name Plant part Voucher Indications (nur) Preparation (nur) Frequency of
citation by
Herbalists
Asteraceae Ageratum conyzoides L.* Guakuro (Mshana, 2000; Whole PSM60/5/ Oedema (1) Decoction (1) 1
STEPRI and CSIR, 2007) plant 16 Spiritual protection (1) Poultice (1)
Inhalant (1)
Triplotaxis stellulifera Twentwaan (Mshana, Root PSM65/5/ Haemorrhoids (5) Decoction (5) 5
(Benth.) Hutch.* 2000) 16 Cough (1)
Inflammotion (1)
Bignoniaceae Newbouldia laevis (P. Sasanemansa (Burkill, Stem bark PSM66/5/ Low sperm count (1) Decoction (1) 1
Beauv.) Seem.* 1985) 16
Spathodea campanulata Kwekwemunsuo (Mshana, Stem PSM48/5/ Gastric ulcer (2) Decoction (1) 2
P.Beauv* 2000) 16 Wounds (2) Enema (1)
Bixaceae Bixa orellana L.* A'jama leaves (Burkill, Leaves PSM13/5/ Gastric ulcer (1) Decoction (1) 1
1985) 16
Bombacaceae Bombax buonopozense AkƆkƆndea (Burkill, 1985) Bark PSM61/5/ Haemorrhoids (1) Decoction (1) 1
P.Beauv * 16
Ceiba pentandra (L.) Onyina (Mshana, 2000) Stem bark PSM62/5/ Excessive bleeding (1) Decoction (1) 1
Gaertn* 16
Boragonaceae Heliotropium ovalifolium Saanikasan (Burkill, 1985) Root PSM42/5/ Male vitality (1) Decoction (4) 4
Forssk.* 16 Jaundice (1)
Anaemia (1)
Malaria (3)
Leaves Typhoid (2)
Capparaceae Boscia senegalensis Lam.* Anza (Mshana, 2000) Stem PSM68/5/ Impotence (4) Decoction (3) 4
16 Aphrodisiac (4) Infusion (1)
Euadenia eminens Hook. Dinsikoro (Mshana, 2000) Bark PSM69/5/ Waist pains (2) Decoction (2) 2
f.* 16 Male vitality (2)
Impotence (1)
Caricaceae Carica papaya L.* Borofere ahaban (Mshana, Leaves PSM2/5/ Fever (3) Decoction (3) 3
2000; STEPRI and CSIR, 16 Malaria (3) Jaundice (3)
2007)
Clusiaceae Garcinia kola Heckel* Bitter kola (Burkill, 1985) Seed PSM71/5/ Sore throat (1) Cough (1) Chewed (1) 1
16 Appetite stimulant (1)
Combretaceae Combretum molle Wiyandamor (Burkill, Root PSM22/5/ Gastric ulcer (3) Decoction (3) 3
R. Br. Ex G.Don* 1985) 16
Terminalia ivorensis A. Emire (Burkill, 1985) Root PSM70/5/ Menstrual pains (2) Decoction (2) 2
Chev.* 16 Gastric ulcer (2)
Terminalia avicennioides Emle/kumada (Burkill, Stem bark PSM23/5/ Constipation (1) Enema (2) 2
Guill. and Perr.* 1985) 16 Ulcers (2)
Crassulaceae Kalanchoe integra GbƆ (Burkill, 1985) Leaves PSM72/5/ Catarrh (1) Heated to soften 1
(Medik.) Kuntze* 16 Nasal decongestion (1) and squeezed.
Asthma (1) Extract is inhaled
(1)
Cucurbiataceae Lageniana siceraria Kula (Burkill, 1985) Root PSM74/5/ Swollen legs (1) Poultice (1) 1
(Molina.) Standl* 16 Sexual disorders (1)
Luffa cylindrica (L.) Kpekplebeshi (Burkill, Leaves PSM73/5/ High blood pressure (6) Decoction (19) 19
M.Roem *** 1985) 16 Diabetes (6)
Abdominal pains (4)
Genetourinary disorders
(1)
Momordica charantia L. Nyanya (Mshana, 2000; Leaves PSM75/5/ Malaria fever (13) Decoction (15) 15
*** STEPRI and CSIR, 2007) 16 Typhoid (6)
Gastric ulcer (2)
Skin rashes (1)
Jaundice (1)
Cyperaceae Cyperus articulatus (L.)* Kagyiigyi (Burkill, 1985) Roots and PSM79/5/ Cough (1) Asthma (1) Decoction 1
aeriel 16 Pulverized material
parts is inhaled (1)
Euphorbiaceae Alchornea cordifolia Agyamaa (Burkill, 1994; Stem PSM77/5/ Gastric ulcer (3) Decoction (8) 8
(Schum. & Thonn.) Mull. STEPRI and CSIR, 2007) 16 Vaginal candidiasis (4)
Arg ** Sexually transmitted
diseases (2)
Diabetes (1)
Euphorbia hirta (L.)* Awobaguwakyi, animakoa Leaves PSM40/5/ Fever (4) Decoction (4) 4
(Mshana, 2000; STEPRI 16 Malaria (4)
and CSIR, 2007) Gastric ulcer (1)
Jaundice (2)
Typhoid (1)
Gentianaceae Anthocleista nobilis WudifoƆkete (Burkill, Root PSM95/5/ Impotence (1) Urinary Decoction (4) 4
G.Don* 1994) 16 incontinence (1)
Constipation (2)
Infertility (1)
Graminaceae Bambusa vulgaris Pampuro ahaban (Burkill, Leaves PSM4/5/ Malaria (1) Decoction (1) 1
(Schrad.) * 1994) 16
(continued on next page)
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E. Oppong Bekoe, et al. Journal of Ethnopharmacology xxx (xxxx) xxxx
Table 1 (continued)
Family name Scientific name Local name Plant part Voucher Indications (nur) Preparation (nur) Frequency of
citation by
Herbalists
Humiriaceae Sacoglottis gabonensis Ɔfana (Burkill, 1994) Leaves PSM76/5/ Candidiasis (2) Decoction (2) 2
(Baill) Urb.* 16 Sexually transmitted
diseases (1)
Lamiaceae Ocimum basilicum L.* AkokƆbesa (Mshana, Leaves PSM44/5/ Gastric ulcer (1) Poultice (1) 1
2000) 16 Rheumatism (1)
High blood pressure (1)
Ocimum gratissum L. ** Nunum (Mshana, 2000; Leaves PSM12/5/ Enhances child growth (1) Decoction (9) 9
STEPRI and CSIR, 2007) 16 Gastric ulcer (4)
Diarrhoea (4)
High blood pressure (2)
Premna quadrifolia Obotso (Burkill, 1995) Stem bark PSM127/ Low immunity in children Decoction (2) 2
Schum. and Thonn.* 5/16 (1)
Threatened abortion (1)
Vitex grandifolia Gurke* Samanibir (Burkill, 1995) Roots PSM128/ Stroke (1) Aqueous infusion 1
5/16 (1)
Lauraceae Afzelia africana Pers.* Palga (Burkill, 1995) Root PSM80/5/ Bone and joint pains (1) Decoction (1) 1
16 Poultice (1)
Fabaceae- Cassia sieberiana DC.* Ekwo (Burkill, 1995) Bark PSM36/5/ Gastric ulcer (1) Decoction (1) 1
Caesalpinioides 16
Chamaecrista absus (L.) Kolitso (Burkill, 1995) Root PSM81/5/ Haemorrhoids (1) Decoction (1) 1
H.S.Irwin & Barneby* 16 Laxative (1)
Fever (1)
Crudia gabonensis Harms.* Dua mako (Burkill, 1995) Stem PSM25/5/ Body pains (3) Gastric Decoction (3) 3
16 ulcer (2)
Aphrodisiac (1)
Erythrophleum ivorense Apostrodum (Burkill, Stem bark PSM82/5/ Headache (1) Aqueous extract 1
A.Chev.* 1995) 16 applied as nasal
drops (1)
Griffonia simplicifolia Kanya/Gaal (Burkill, Root PSM83/5/ Mental diseases (1) Decoction (1) 1
(DC.) Baill.* 1995) 16
Bauhinia thonningii Otokotaka (Burkill, 1994) Stem bark PSM84/5/ Anaemia (1) Decoction (1) 1
Schum.* 16
Senna alata (L.) Roxb.* Osempe (Burkill, 1995) Leaves PSM85/5/ Diabetes (1) Decoction (1) 1
16
Tamarindus indica L.* Samia (Burkill, 1995) Leaves PSM86/5/ Bloated stomach (1) Aqueous infusion 1
16 (1)
Dichrostachs cinerea (L). Dundun (Burkill, 1995) Root PSM91/5/ Anaemia (1) Decoction (1) 1
Wight & Arn.* 16
Entada africana Guill. & Sre ase (Burkill, 1995) Stem bark PSM90/5/ Gastric ulcer (3) Decoction (10) 10
Perr. ** 16 Candidiasis (3)
Ooedema/inflammation
(1)
Asthmatic cough (3)
Irregular menstruation (2)
Parkia biglobosa (Jacq.) G. Dawadawa/dorowa Leaves PSM10/5/ Malaria (2) Decoction (11) 11
Don *** (Burkill, 1995) 16 High blood pressure (6)
Diabetes (2)
Coughs (2)
Senna sophera L. (Roxb.)* Senna (Burkill, 1995) Leaves PSM885/ High blood cholesterol (2) Decoction (2) 2
16 Constipation (1)
Tetrapleura tetraptera Prekese (Mshana, 2000) Fruit PSM87/5/ Diabetes (4) Decoction (7) 7
(Schum & Thonn.) Taub. 16 Hypertension (4)
** Asthma (2)
Fabaceae- Faboideae Dioclea reflexa (Hook. f.) Atᶓ (Burkill, 1995) Seed PSM97/5/ Breasts cysts in children Seed is used to 1
C. Wright* 16 (1) massage (1)
Tephrosia linearis (Willd.) Birana (Burkill, 1995) Leaves PSM98/5/ Gastric ulcer (1) Decoction (1) 1
Pers.* 16 Typhoid (1) Vaginal
candidiasis (1)
Liliaceae Aloe vera (L.) Burm. f.* Aloe vera (Burkill, 1995) Leaves PSM93/5/ Cancer (1) Decoction (1) 1
16 Diabetes (1)
Sansevieria liberica Gér. & Ogbolo (Burkill, 1995) Root PSM94/5/ Low sperm count (1) Decoction (1) 1
Labr.* 16
Gossypium barbadense (L.) Asaawa ahaban (Burkill, Leaves PSM99/5/ Candidiasis (2) Decoction (2) 2
Gérôme & Labroy * 1995) 16
Malvaceae Azadirachta indica A. Juss. Dongo yaro (Burkill, 1995) Root PSM100/ Malaria (5) Fever (5) Decoction (7) 7
** 5/16 Jaundice (2)
Carapa procera DC.* Kwakuobise (Burkill, Root PSM101/ Low libido (1) Sexual Alcoholic infusion 1
1995) 5/16 dysfunction (1) (1)
Theobroma cacao L.* Cocoa ahaban (Mshana, Leaves PSM1/5/ High blood pressure (1) Decoction (1) 1
2000) 16
(continued on next page)
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E. Oppong Bekoe, et al. Journal of Ethnopharmacology xxx (xxxx) xxxx
Table 1 (continued)
Family name Scientific name Local name Plant part Voucher Indications (nur) Preparation (nur) Frequency of
citation by
Herbalists
Meliaceae Guarea cedrata (A.Chev.) Kwaboro Bark PSM102/ Waist pains (1) Decoction to be 1
Pellegr.* 5/16 used as enema (1)
Khaya ivorensis A. Chev.* Odupon (Mshana, 2000) Bark PSM103/ Anaemia (1) Headache Decoction (1) 1
5/16 (1)
Khaya anthotheca (Welw.) Kwabonhoro (Burkill, Stem PSM104/ Waist pains (2) Aqueous extract 2
DC.* 1997) 5/16 Fever (1) used as enema (2)
Khaya senegalensis (Desv.) Mahogany (Burkill, 1997; Stem bark PSM105/ Anaemia (8) Malaria (17) Decoction (38) 38
A. Juss **** STEPRI and CSIR, 2007) 5/16 Jaundice (11)
Skin diseases (8)
Wounds (4)
Pseudocedrela kotschyi Tuna (Burkill, 1997) Root PSM6/5/ Gastric ulcer (2) Decoction (4) 4
(Schweinf.) Harms.* 16 Impotence (2)
Fibroid (1)
Hernia (1)
Trichilia monadelpha Otanaduro (Burkill, 1997; Stem bark PSM27/5/ Bloody dysentry (2) Decoction (2) 2
(Thonn.) J. J. de Wilde STEPRI and CSIR, 2007) 16 Skin infections (1)
Sphenocentrum jollyanum Ɔkraman kote (Burkill, Roots PSM106/ Erectile dysfunction (10) Decoction (20) 20
Pierre *** 1997) 5/16 Waist pains (7)
Lethargy (5)
Moringa oleifera Lam. **** Bagaruwa (Burkill, 1997) Stem PSM11/5/ Stomach ache (7) Decoction (36) 36
16 Gastric ulcer (15)
Candidiasis (11)
Anaemia (4)
Diabetes (3)
Diarrhoea (2)
Loss of appetite (2)
Pycnanthus angolensis Otiee (Burkill, 1997) Stem bark PSM137/ Impotence (1) Decoction (2) 2
(Welw.) Warb.* 5/16 Threatened abortion (1)
Menispermaceae Eugenia caryophyllata Pepre (Burkill, 1997) Fruit PSM28/5/ Ulcer (1) Chewed (1) 2
(Thunb.)* 16 Pains (1) Aqueous infusion
(2)
Moringaceae Psidium guajava L.* Guava (Burkill, 1997) Leaves PSM107/ Stomach upset (1) Decoction (1) 1
5/16
Myristaceae Ampelocissus multistriata Nimos (Burkill, 1997) Root PSM108/ Malaria () fever, typhoid Decoction (1) 1
(Baker) Planch.* 5/16
Myrtaceae Ximenia americana (L.)* Gbonyo aadon (Burkill, Stem bark PSM29/5/ Gastric ulcer (1) Decoction (1) 1
1997) 16
Zanthoxylum gilletii (De Okuo (Burkill, 1997) Root PSM111/ Impotence (1) Low Decoction (1) 1
Wild.) P.G.Waterman* 5/16 Vitality (2)
Olacaceae Strombosia pustulata Te (Burkill, 1997) Fruit PSM109/ Asthma (1) Burnt to ashes (1) 1
Oliv.* 5/16
Borassus aethiopum Mart. NagƆ (Burkill, 1997) Root PSM35/5/ Fever (4) Decoction (6) 6
** 16 Ulcer (2)
Elaeis guineensis Jacq.* Mmᶓ (Burkill, 1997) Leaves PSM112/ Eye Inflammation (1) Herbal bath (1) 2
5/16 Spiritual protection (1) Poultice (1)
Ochnaceae Adenia rumicifolia Engl. & Ansurogya (Mshana, Root PSM113/ Sexual dysfunction (1) Alcoholic infusion 1
Harms.* 2000) 5/16 Low vitality (1) (1)
Palmae Phyllanthus fraternus Goyonbaaya (Mshana, Leaves PSM78/5/ Malaria (5) Decoction (8) 8
G.L.Webster ** 2000) 16 Fever (4)
Jaundice (1)
High blood presseure (2)
Haemorrhoids (2)
Typhoid (3)
Diabetes (3)
Bridelia ferruginea Benth. Flatso (Mshana, 2000) Stem PSM13/5/ Malaria (1) Decoction (8) 8
** 16 Gastric ulcer (7)
Leaves Gastric Ulcer (2)
Typhoid (1)
Fever (1)
Passifloraceae Polygala arenaria Willd* Shaanikasani (Burkill, Leaves PSM30/5/ Malaria (1) Decoction (2) 2
1997) 16 Fever (1) Jaundice (1)
Anaemia (1)
Pedaliaceae Sesamum radiatum Ninka (Burkill, 1997) Stem PSM110/ Boils (1) Decoction (2) 1
Schumach. & Thonn.* bark/root 5/16 Oedema/Inflammation of
the legs (1)
Phyllanthaceae Securidaca KyiritoƆ (Burkill, 1997) Root PSM114/ Stroke (1) Poultice (5) 5
longipedunculata Fresen ** 5/16 Waist pains (2)
Coughs (2)
Asthma (1)
Craterispermum caudatum Duadᶓ (Burkill, 1997) Root PSM115/ Sexual (1) Acoholic infusion 1
Hutch.* 5/16 Dysfunction (1) (1)
(continued on next page)
6
E. Oppong Bekoe, et al. Journal of Ethnopharmacology xxx (xxxx) xxxx
Table 1 (continued)
Family name Scientific name Local name Plant part Voucher Indications (nur) Preparation (nur) Frequency of
citation by
Herbalists
Polygalaceae Mitragyna inermis (Willd.) Tsinatso (Mshana, 2000) Stem bark PSM118/ Infertility (2) Decoction (3) 3
Kuntze* 5/16 Miscarriages (3)
Morinda germinata DC.* Sukam (Burkill, 1997) Roots PSM117/ Fever (1) Malaria (1) Decoction (1) 1
5/16
Rubiaceae Morinda lucida Benth. ** KpƆti (Mshana, 2000) Stem bark PSM116/ Malaria (3) Decoction (3) 3
5/16 Typhoid (3)
Nauclea latifolia (Sm.) Tafashia (Burkill, 1997; Stem and PSM16/5/ Fever (16) Malaria (10) Aqueous infusion 25
**** STEPRI and CSIR, 2007) bark 16 Typhoid (10) Prolonged (6)
menstruation (1) Decoction (21)
Jaundice (2)
Clausena anisata (Willd.) Samanyobi (Burkill, 1997) Leaves PSM121/ Inflammation (3) Decoction (6) 6
Hook. f. ex Benth. ** 5/16 Rheumatism (2)
Fever (1) Mental
disorders (1)
Oedema (2)
Rutaceae Citrus aurantiifolia Lemon grass (Burkill, Root PSM120/ Fever (2) Decoction (6) 6
(Christm.) Swingle ** 1997; STEPRI and CSIR, 5/16 Malaria (2)
2007) Typhoid (2)
Zanthoxylum Haasto (Mshana, 2000) Root PSM122/ Bone fracture (2) Decoction (28) 28
zanthoxyloides (Lam.) 5/16 Oedema (10)
Zepern. & Timler **** Menstrual disorders (4)
Gastric ulcer (6)
Malaria (1) Sickle Cell (1)
Impotence (2) Pain (3)
Rheumatism (5)
Inflammation (5)
Sapindaceae Blighia sapida Ankyen (Burkill, 2000) Root PSM123/ Waist pains (1) Decoction (1) 1
K.D.Koenig* 5/16 Cough (1) Poultice (1)
Bone fracture (1)
Oedema (1)
Inflammation (1)
Paullinia pinnata L. **** Twentin (Burkill, 2000) Root/ PSM31/5/ Impotence (11) Decoction (24) 24
leaves 16 Arthritis (5)
Cough (3)
Bone fracture (5)
Chest pains (2)
Gastric ulcer (5)
Sapotaceae Vitellaria paradoxa G.F. Nkudua/mankade Root PSM124/ Hypertension (2) Decoction (4) 4
Gaertn* (Mshana, 2000) 5/16 Diabetes (2)
Malaria (1) Typhoid (1)
Fever (1)
Verbenaceae Lantana camara L.* Ananse dokono (Burkill, Dry leaves PSM126/ Memory loss (1) Decoction (1) 1
2000) 5/16
Vitaceae Cissus quadrangularis Kotokolitso (Burkill, 2000) Roots PSM32/5/ Gastric Ulcer (1) Chewed (1) 1
Linn.* 16 Body pains (1)
Zingiberaceae Aframomum melegueta K. Fom wisa (Burkill, 2000; Fruit PSM129/ Bone fracture (1) Poultice (5) 5
Schum. ** STEPRI and CSIR, 2007) 5/16 Cough (3)
Pains (2)
Zygophyllaceae Balanites aegyptiaca (L.) Kabowoo (Mshana, 2000; Root PSM59/5/ Hernia (1) Decoction (1) 1
Delile.* STEPRI and CSIR, 2007) 16
registered herbalists and herbalist shops a convenient sample size was number IRB 00001276.
used. Fifty-three (53) herbalists and herbal medicines dealers above the
age of 18 who were willing to participate in this study were inter- 2.3. Evaluation of data
viewed. Questionnaires were designed, validated and administered by
translators in the local languages (Ga, Hausa and Twi). The ques- Descriptive statistics in SPSS (Statistical Package for Social Sciences)
tionnaire consisted of questions to document the biodata of the parti- version 21, IBM Corporation and Microsoft Excel software, Microsoft
cipants, and information on the medicinal plants they commonly sell, corporation, CA, USA were used to analyse the ethnobotanical data.
the ailments for which the plants are used to manage, the part of the
plant used, how to prepare the plant material for use, how to identify 2.4. Collection and identification of plant materials
the plant species, how the plant materials are obtained, the adverse
effects as well as the contraindications of the plants and the challenges The plant materials mentioned in the survey were bought from the
and problems faced when handling the herbal medicinal plants. herbal dealers to serve as specimen to aid in identification. Information
on the plant materials (vernacular or common names, plant part, pre-
Ethical approval paration methods and the disease(s) they are used to treat were re-
corded. According to the method used by van Andel et al. (2012), the
Ethical clearance for the study was obtained from the Institutional medicinal plant materials were identified by confirming their local
Review Board of the Noguchi Memorial Institute for Medical Research names in documented literature and by also comparing the samples to
(NMIMR–IRB), University of Ghana, Legon, Accra, Ghana with approval photoguides. The latter method was similar to the method previously
7
E. Oppong Bekoe, et al. Journal of Ethnopharmacology xxx (xxxx) xxxx
Table 2 S9 (rat liver enzyme) added to the reaction mixture. The S9 fraction is
Informant consensus factor (FIC) for disease conditions with use reports (Nur) rich in metabolic enzymes and is frequently used in assays to determine
above five. the effect of metabolic activation of drugs and other xenobiotics. Mu-
Disease Number of Taxa Number of Use Fic (Nur-Nt)/ tagenicity was detected either as an increase in the number of histidine
(Nt) Reports (Nur) (Nur-1) revertants with reference to scores provided in the test kit to determine
whether the mutation was significant or not. If a reverse mutation oc-
Typhoid 15 39 0.63 curred, the bacteria in the colony have the ability to synthesize histi-
Waist Pains 6 15 0.64
Malaria 22 82 0.74 dine and will continue to grow, turning the colour in the well from
Jaundice 11 26 0.60 purple to yellow. The number of positive wells scored in the 96 well
High Blood Pressure 7 18 0.65 plates determined the significance of mutation in the fluctuation test
Impotence 9 24 0.65 (Gilbert, 1980). The statistical table provided in the kit was used to
Gastric ulcer 24 77 0.70
Fever 20 64 0.70 compare the natural background rate of reverse mutation to the rate of
Diabetes 11 27 0.62 reverse mutation within a sample assay. Based on these samples, p
Cough 11 20 0.47 values of 0.001 were classified as highly mutagenic, p values of 0.01
Anaemia 11 33 0.69 moderately mutagenic and p values of 0.05 weakly mutagenic. Muta-
Haemorrhoids 9 17 0.50 tion in the TA 100 strain is indicative of a base pair (BP) or point
Asthma 7 10 0.33
Candidiasis 7 25 0.75 mutation (PM) while that in TA 98 is indicative of a frame shift mu-
Constipation 4 6 0.40 tation (FSM).
Oedema 7 17 0.63
3. Results
used by (Asase and Oppong-Mensah, 2009). The identity of the plants 3.1. Socio-demographics of participants
were further verified by comparing their organoleptic properties to
information published in literature. The identification was done by a A total of 53 participants were recruited from the Nima, Madina and
taxonomist in the person of Alex Asase, Department of Plant and En- Makola communities. These were all females. Thirty-eight percent
vironmental Science, University of Ghana, Accra, Ghana. The official (38%) of the participants were from Makola, 41% from Nima and 21%
plant names were confirmed at http://www.theplantlist.org. Voucher from Madina. About 65% from the Madina and Makola communities
specimens have been kept at the Departmental Herbarium, Department however indicated Nima market as their main source of plant materials.
of Pharmacognosy and Herbal Medicine, School of Pharmacy, Uni-
versity of Ghana, Accra, Ghana. 3.1.1. Age groupings and marital status
The age of the participants ranged from 18 to 90 years. Out of the 53
2.5. Preparation and extraction of plant materials participants, nineteen (36%) were between the ages of 18 and 30 years.
Seventeen (32%) of participants were between ages 31 and 45 years.
Twenty five (25) of the most frequently used plant materials were Twelve (22%) were between 46 to 60 years. Three participants (6%)
obtained. One sample bought from each of the study sites were com- were 61–75 years while two (4%) were between the ages of 76 and 90
bined, pulverized and extracted by decoction. Briefly, 50 g of pulverized years. As many as sixty-eight (68%) percent of the participants fell
material was boiled in 500mL of double distilled water for 20min. The within the 18–45 years range (Fig. 1A). Sixty percent (60%) of all the
decoction was centrifuged at 6000 RPM for 10min. The clear super- female participants were married whereas the other 40% were single.
natant was collected and concentrated under vacuum at 40 °C and
lyophilized to obtain dried crude extracts. The extracts were stored at 3.1.2. Level of education
−20 °C until used for further studies. A vast majority (90%) of the herbal dealers had some level of
education, which were both formal (86%) and non-formal (4%).
2.6. Mutagenicity assay of selected plants Twenty four percent, 50% and 12% had formal education up to pri-
mary, middle and secondary school levels, respectively. Four percent
The Ames test was used to determine the mutagenic potential of the had non-formal education while 10% were illiterates (Fig. 1B).
25 most frequently mentioned plants in this study. The Muta-
ChromoPlate TM two strain kit (manufactured by Environmenttal Bio- 3.1.3. Training on herbal medicines and type of practice
Detection Products Inc, Ontario, Canada) which works on the principle Most (96%) of the traders had undergone non-formal education on
of the Ames test was employed (Ames, 1975). The experiments were the use of herbs from a relative (grand parent or parent). Only two
carried out in accordance with the protocol provided by the manu- participants (4%) had a formal education on the use of herbal medi-
facturer Environmenttal Bio-Detection Products Inc., Ontario, Canada. cines. When asked whether they will group themselves as herbal
The bacterial strains (TA100 and TA98) were grown overnight for practitioners, traditional healers, fetish priests or divine healers, all the
14 h at 37 °C in 10mL nutrient medium. A 2.5 mL of the reaction mix- participants said they were herbal practitioners however they used both
ture consisting of 1% 0.4M MgCl2, 1% 1.65M KCl, 0.5% glucose-6- plant and animal products for the treatment of physical ailments and
phosphate disodium and 4% 0.1M NADP, 50% 0.2M phosphate buffer ailments believed to have ‘spiritual’ origins'.
and 39.5% sterile distilled water were placed in 50mL Falcon tubes. To
separate tubes containing the reaction mixture, 100 μL of each plant 3.1.4. Duration of practice
extract or positive control (nitrofluorene for TA98 and sodium azide for Majority of the participants (84%) had a working experience of over
TA100, respectively) were added. Five microliters of the bacteria were five years and quite a number (24%) had worked as herbal practitioners
added to each tube, except for the blank tube, vortexed for 15 s, poured for over 40 years (Fig. 1C). The practice was the main source of income
into the sterile reagents boats and 200 μL dispensed into each well of a for most of the herbalists and herbal dealers (88%) (Fig. 1C) while 12%
sterile 96-well plates. The plates were incubated at 37 °C for 5 days. All had additional sources of income.
the wells were purple coloured and each well was considered a colony.
For the determination of the mutagenic activity, a 100 μg/mL con- 3.2. Plant samples
centration of the extract was assayed. To determine whether the ex-
tracts acted as pro-mutagens, the experiments were repeated with 4% A total of 110 herbal medicinal plants were identified for the
8
E. Oppong Bekoe, et al. Journal of Ethnopharmacology xxx (xxxx) xxxx
Table 3
Muta-ChromoPlate™ Assay report of 100 μg/mL samples after 5 days of incubation.
Test strain TA 100 TA 98
Plant Samples P value Results P value Results Interpretation
1. Nauclea latifolia Sample 0.001 Highly mutagenic – Non-mutagenic BPs or PM before and after metabolism
Sample + S9 0.001 Highly mutagenic – Non-mutagenic
2. Phyllanthus fraternus Sample 0.05 Weakly mutagenic – Non-mutagenic BPs or PM before and after metabolism
Sample + S9 0.001 Highly mutagenic – Non-mutagenic
3. Parkia biglobosa Sample 0.05 Weakly mutagenic – Non-mutagenic BPs or PM before and after metabolism
Sample + S9 0.001 Highly mutagenic – Non-mutagenic
4. Citrus aurantifolia Sample – Non-mutagenic – Non-mutagenic Non-mutagenic
Sample + S9 – Non-mutagenic – Non-mutagenic
5. Bridelia ferruginea Sample 0.001 Highly mutagenic – Non-mutagenic BPs or PM before and after metabolism
Sample + S9 0.001 Highly mutagenic – Non-mutagenic
6. Alstonia boonei Sample – Non-mutagenic – Non-mutagenic Non-mutagenic
Sample + S9 – Non-mutagenic – Non-mutagenic
7. Clausena anisata Sample 0.001 Highly mutagenic – Non-mutagenic BPs or PM before and after metabolism
Sample + S9 0.001 Highly mutagenic – Non-mutagenic
8. Luffa cylindrica Sample 0.001 Highly mutagenic – Non-mutagenic BPs or PM before and after metabolism
Sample + S9 0.001 Highly mutagenic – Non-mutagenic
9. Alchornea cordifolia Sample 0.01 Moderately mutagenic – Non-mutagenic BPs or PM before and after metabolism
Sample + S9 0.001 Highly mutagenic – Non-mutagenic
10. Crinum jagus Sample – Non-mutagenic – Non-mutagenic Non-mutagenic
Sample + S9 – Non-mutagenic – Non-mutagenic
11. Azadirachta indica Sample 0.001 Highly mutagenic 0.01 Moderately mutagenic BPs or PM and FSM before and after metabolism
Sample + S9 0.01 Moderately mutagenic 0.001 Highly mutagenic
12. Paullinia pinnata Sample 0.001 Highly mutagenic – Non-mutagenic BPs or PM before and after metabolism
Sample + S9 0.001 Highly mutagenic – Non-mutagenic
13. Zanthoxylum zanthoxyloides Sample 0.001 Highly mutagenic – Non-mutagenic BPs or PM before and after metabolism
Sample + S9 0.001 Highly mutagenic – Non-mutagenic
14. Enantia polycarpa Sample – Non-mutagenic – Non-mutagenic Non-mutagenic
Sample + S9 – Non-mutagenic – Non-mutagenic
15. Momordica charantia Sample – Non-mutagenic – Non-mutagenic Non-mutagenic
Sample + S9 – Non-mutagenic – Non-mutagenic
16. Borassus aethiopium Sample – Non-mutagenic – Non-mutagenic Non-mutagenic
Sample + S9 0.05 Weakly mutagenic – Non-mutagenic
17. Ocimum gratissimum Sample – Non-mutagenic – Non-mutagenic BPs or PM before metabolism
Sample + S9 – Non-mutagenic – Non-mutagenic
18. Sphenocentrum jollyanum Sample – Non-mutagenic – Non-mutagenic BPs or PM after metabolism
Sample + S9 0.05 Weakly mutagenic – Non-mutagenic
19. Moringa oleifera Sample – Non-mutagenic – Non-mutagenic Non-mutagenic
Sample + S9 – Non-mutagenic – Non-mutagenic
20. Khaya senegalensis Sample – Non-mutagenic – Non-mutagenic Non-mutagenic
Sample + S9 – Non-mutagenic – Non-mutagenic
21 Strophanthus gratus Sample – Non-mutagenic – Non-mutagenic Non-mutagenic
Sample + S9 – Non-mutagenic – Non-mutagenic
22. Uvaria chamae Sample 0.001 Highly mutagenic – Non-mutagenic BPs or PM before and after metabolism
Sample + S9 0.001 Highly mutagenic – Non-mutagenic
23. Sarcocephalus latifolius Sample 0.05 Weakly mutagenic – Non-mutagenic BPs or PM before and after metabolism
Sample + S9 0.001 Highly mutagenic – Non-mutagenic
24. Tetrapleura tetraptera Sample – Non-mutagenic – Non-mutagenic Non-mutagenic
Sample + S9 – Non-mutagenic – Non-mutagenic
25. Entada africana Sample – Non-mutagenic – Non-mutagenic Non-mutagenic
Sample + S9 – Non-mutagenic – Non-mutagenic
Positive Controls Sodium azide 0.001 Highly mutagenic – – BPs or PM mutation before and after metabolism
Sodium azide + S9 0.001 Highly mutagenic – –
2-Nitroflourene – – 0.001 Highly mutagenic FSM mutation before and after metabolism.
2-Nitroflourene + S9 – – 0.001 Highly mutagenic
treatment and managements of various human diseases. Of these, mentioned were malaria (24 plants), fever (24 plants), high blood
Khaya senegalensis, Moringa oleifera, Zanthoxylum zanthoxyloides, pressure, haemorrhoids, gastric ulcer, diarrhoea, coughs, various in-
Paullinia pinnata and Alstonia boonei were the five most commonly flammatory conditions (pains occurring in the bones, waist, legs etc.),
mentioned plant materials as being sold on these herbal markets anaemia, diabetes, typhoid, jaundice, candidiasis and sexual dysfunc-
(Table 1). The plant families having the largest number of plants were tion.
the Fabaceae, Apocynaceae and Meliaceae.
3.2.1. Plant parts used 3.2.3. Adverse effects and contra-indications
It was observed that roots (36%), leaves (30%) and stem bark (26%) Fifty participants (96%) indicated that their plants had no side ef-
were the parts of the plants that were highly used for their medicinal fects, however, 4% stated that some of the herbal plants may cause
properties. The parts that were least sold were the seeds, whole plants frequent urination, loose stools, nausea or vomiting but they were
and fruits. however unspecific about the plants. Most of the participants also in-
dicated that some of their products are not allowed to be used by
pregnant women or children.
3.2.2. Diseases treated
The disease conditions frequently treated/managed with the plants
9
E. Oppong Bekoe, et al. Journal of Ethnopharmacology xxx (xxxx) xxxx
3.2.4. Identification and sources of plant materials 2009; Calixto, 2000; Firenzuoli and Gori, 2007; Kamboj, 2000; Kaur
The participants identified the plant materials by their organoleptic et al., 2013). However, reports indicate that some herbs could have
properties including colour, texture, smell and taste. They indicated severe adverse effects including mutagenic properties (Abdullah et al.,
that they obtained their plant materials from within the Greater Accra 2017; Hoang et al., 2013a; Vanherweghem et al., 1993).
Region and other regions within Ghana, including the Ashanti, In this study, we observed that the herbal dealers were mostly fe-
Northern, Central and Eastern regions. The West African neighboring males. Fassil (2005) as well as Gedif and Hahn (2003) have reported
country of Benin was also cited as a source for many medicinal plants. that women have a significant role in traditional health care delivery in
their capacity as mothers, primary healthcare givers and also the cul-
3.2.5. Challenges associated with herbal medicines sale and use tivators of home gardens. Our findings that 68% of the herbalists and
Thirty-five participants (66% of the herbalists and herbal dealers) herbal dealers were between the ages of 18–45 years suggests that more
indicated that they encountered difficulties in obtaining the raw plant young people may be entering into the herbal medicine's trade as an
materials, and more so especially within the dry season (from occupation. This is in agreement with the findings of d’Avigdor et al.
November to April). However, 34% of the participants did not face any (2014). This is however in contrast to findings made in earlier studies
challenges or difficulties in obtaining or collecting the plant materials. which showed that most African youth are losing interest in traditional
medicine practice (Giday et al., 2009, 2010). About 84% of the parti-
3.2.6. Perceptions about herbal medicines cipants had a working experience of more than five (5) years, which
The participants’ perceptions of herbal medicines were grouped indicates that most of these participants started this trade very early in
under seven themes which are (i) herbal medicines are natural with no life. Studies have shown that the use of herbs by people in the treatment
additives, (ii) herbal medicines are more efficacious than orthodox of diseases, especially in Africa, is embedded in the culture of the so-
medicines, (iii) herbal medicines have no side effects, (iv) herbal ciety, hence the youth pick up this knowledge via observation and
medicines have curative properties, (v) herbal medicines have slower practice at an early age (Abdullahi, 2011).
onset of actions compared to orthodox medicines, (vi) herbal medicines Several other ethno-survey reports have brought to the fore the low
are cheaper compared to orthodox medicines and (vii) herbal medicines level of education among herbal practitioners and the need to improve
are inferior to orthodox medicines. Out of the 53 participants, 27% their education (Amoah et al., 2014; Issa and Basheti, 2017). Financial
believed that herbal medicines have curative properties, 26% believed constraints were the reasons given for their inability to further their
that herbal medicines are better than orthodox medicine in terms of education. This could be the reason for which 96% of the traders had
efficacy, 18% believed that herbal medicine have no side effects, 16% undergone informal education from a relative, namely a grand parent
believed that herbal medicines are natural, 6% believed that herbal or parent. It is a well known fact that the use of complementary and
medicines have a slower onset of action compared to orthodox medi- alternative medicines is predominant among the lower income class
cines, another 6% believed that herbal medicines are cheaper and 1% because of affordability and availability (Amoah et al., 2014; Issa and
believed that herbal medicines are inferior to orthodox medicines. Basheti, 2017). In Africa, including Ghana, knowledge on herbal med-
icines is known to be passed on verbally via the family line or acquired
3.2.7. Informant consensus factor (FIC) through personal experience, hence there is no proper documentation
The informant consensus factor (FIC) which ranged from 0.00 to which could feed into the formal education system (Boadu and Asase,
1.00 was calculated to prioritize the plants documented in this ethno- 2017; Soelberg et al., 2015). This could explain why majority (50%) of
botanical study. The FIC is a descriptive statistic that could be useful in the participants had middle school education while none had a tertiary
prioritizing medicinal plants for further scientific validation. High FIC education. Education may also affect the proper diagnosis, choice of
values are obtained when one or a few plant species are reported to be plants and their administration. This raises concern over adverse ef-
used by a high proportion of informants to treat a particular ailment, fects, herb-drug interactions, and quality and safety profiles of these
whereas low FIC values indicate that informants disagree over which drugs (Issa and Basheti, 2017). Hence, there is a need for formal
plant to use (Mussarat et al., 2014). It was discovered that plants used training on herbal medicines and also streamlining of legal and reg-
in the treatment of gastric ulcer, fever, candidiasis and malaria had the ulatory issues pertaining to the sale and use. The herbal trade was the
highest FIC values of 0.7, 0.7, 0.75 and 0.74, respectively. Plants used in main source of income for most of the herbal dealers (88%). This may
the treatment of impotence, diabetes, high blood pressure, jaundice, be due to the fact that in recent years the use of herbal medicine
waist pains, anaemia, oedema, haemorrhoids and oedema had mod- amongst Ghanaians is burgeoning (Aziato and Antwi, 2016; Gyasi et al.,
erate FIC values, while those used in the treatment of cough, constipa- 2015). The proliferation of media houses in the country is believed to
tion and asthma had the least FIC values (Table 2). have helped in the promotion of herbal products (Aziato and Antwi,
2016; Gyasi et al., 2015).
3.3. Mutagenic activity Out of the 110 herbal medicinal plants identified as being com-
monly used for the managements of various human diseases (Table 1),
Eleven samples (44%) were non-mutagenicity in either bacterial the plant families containing the highest number of plant species were
strains (TA 100 and TA 98) while one sample (4%) was positive in both Fabaceae, Apocynaceae and Meliaceae. Such plants have been docu-
strains. Thirteen samples (52%) showed moderate to high mutagenicity mented to be widely used in the neighbouring country of Burkina Faso
in the TA 100 strain before and after metabolism. Mutation in the TA as well (Zizka et al., 2015).
100 strain is indicative of a base pair (BPs) or point mutation (PM) Khaya senegalensis, Moringa oleifera, Zanthoxylum zanthoxyloides,
while that in TA 98 is indicated of a frame shift mutation (FSM) Paullinia pinnata, Nauclea latifolia and Alstonia boonei which were the
(Table 3). most commonly used, were mainly prepared as aqueous decoctions,
aqueous infusions, aqueous extracts and alcoholic infusions to be taken
4. Discussion orally. The decoction of local plants has long been shown to be a pre-
ferred mode of preparation (Daswani et al., 2011). In this study, it was
Plant medicines play a vital role in the treatment and management observed that the roots (36%) and leaves (30%) had the highest fre-
of communicable and non-communicable diseases especially in devel- quency of use, followed by the stem bark (26%), other parts such as
oping countries where traditional healthcare systems are widely ac- fruits and seeds were least used, accounting for 8%. This is similar to
cepted. Currently, the use of herbal medicines globally has increased the findings of Wambugu et al. (2011) in which roots, stem bark and
due to the belief that they are cheaper, more efficacious, with mild side leaves were the main plant parts used. These plant materials were
effects, low toxicity and hence usually said to be safe (Agyare et al., mainly used to treat malaria, high blood pressure, fever, haemorrhoids,
10
E. Oppong Bekoe, et al. Journal of Ethnopharmacology xxx (xxxx) xxxx
gastric ulcer, diarrhoea, coughs, various inflammatory conditions, and interpretation. BA was co-responsible for field studies, data entry,
anaemia, diabetes, typhoid, jaundice, candidiasis and sexual disorders, analysis and interpretation. PA contributed to field studies and manu-
most of which are of common occurrences in Ghana (Adams et al., script editing. IAG was involved in protocol development of this study.
2004). AN was involved in protocol development. All authors read, approved
The fact that a vast majority of participants (96%) stated that they and reviewed the manuscript.
knew no side effects or adverse reactions that resulted from the intake
of these herbs could support the widespread notion that medicinal Declaration of competing interest
plants are believed to be relatively safe with little or no toxicity when
compared to conventional medicine. However, many medicinal plants The authors declare no conflict of interest in the publication of this
have been reported to possess significant side effects (Ekor, 2014; Ekor manuscript.
et al., 2010; Ernst, 2002). Hence, there should be measures put in place
to educate herbal practitioners, that not all herbal-based products are Acknowledgement
safe and that there is the need for safety assessment.
The informant consensus factor showed that plants used in the The authors are grateful to Clement Sasu, Akosua Okraku, Degraft
treatment of gastric ulcer, fever, candidiasis and malaria were highly Adjei and Mary Twumasi for conducting the fieldwork during this
consistent and can be further investigated and developed into good survey as well as the herbalists and herbal dealers in the Makola, Nima
therapeutic agents. and Nima areas for their cooperation.
Testing for mutagenicity is important in assessing the safety of
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Funding 3043061.
Boadu, A.A., Asase, A., 2017. Documentation of herbal medicines used for the treatment
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University of Ghana Research Fund from the Office of Research 2017/3043061.
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Author's contribution Burkill, H.M., 1994. second ed. The Useful Plants of West Tropical Africa, vol. 2 RoyalBotanic Gardens, Kew.
Burkill, H.M., 1995. second ed. The Useful Plants of West Tropical Africa, vol. 3 Royal
EOB conceptualised the study and was co-responsible for data col- Botanic gardens, Kew.
lection and analysis, drafting and approval of this manuscript. CA was Burkill, H.M., 1997. second ed. The Useful Plants of West Tropical Africa, vol. 4 RoyalBotanic Gardens, Kew.
responsible for the project design (ethno survey and mutagenic in- Burkill, H.M., 2000. second ed. The Useful Plants of West Tropical Africa, vol. 5 Royal
vestigations) and editing of the manuscript. YDB was responsible for Botanic Gardens Kew.
data analysis and drafting of the manuscript. BMB was responsible for Calixto, J.B., 2000. Efficacy, safety, quality control, marketing and regulatory guidelines
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studies of the samples. JAS was co-responsible for field studies. HN was Cardoso, C.R.P., de Syllos Cólus, I.M., Bernardi, C.C., Sannomiya, M., Vilegas, W.,
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drafting. PBO was co-responsible for field studies, data entry, analysis Dar, R.A., Shahnawaz, M., Qazi, P.H., 2017. General overview of medicinal plants: a
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