Attitudes and use of medicinal plants during pregnancy among women at health care centers in three regions of Mali, West-Africa.

BACKGROUND: Although, medicinal plants have been important for women's health historically, the knowledge about such use during pregnancy in developing countries is limited. This is the first quantitative, ethnobotanical study on Malian women's use of and attitudes towards the use of medicinal plants during pregnancy. The aim of the study was to describe Malian women's use of medicinal plants during pregnancy according to indications and to evaluate the potentially safety of such use. The overall aim was to preserve valuable information about medicinal plants for women's reproductive health for the future. METHODS: Data was collected through structured interviews of 209 pregnant women or mothers in three health care centers in Mali. The women were interviewed about their uses of medicinal plants during pregnancy and their attitudes to such use. Nine specific medicinal plants commonly used in Mali and treatment of eleven common ailments in pregnancy were specifically queried about. RESULTS: In total, 79.9 % had used medicinal plants during pregnancy. Only 17 women (8.5 %) had received a recommendation from a traditional practitioner (TP). The most commonly used medicinal plants were Lippia chevalieri (55.5 %), Combretum micranthum (39.7 %), Parkia biglobosa (12.0 %) and Vepris heterophylla (8.1 %). The most common reasons for use were for well-being (37.7 %), symptoms of malaria (37.1 %) and "increased salt-elimination" (to reduce edema) (19.2 %). For treatment of symptoms of malaria and urinary tract infections during pregnancy, the women's choices of medicinal plants agreed with those previously reported from interviews with TPs. Almost 30 % believed that medicinal plants had no adverse effects for the mother. CONCLUSION: This study showed an extensive use and knowledge of medicinal plants during pregnancy in three regions in Mali. However, exclusive use of medicinal plants as treatment of malaria and urinary tract infections during pregnancy may pose a health risk for the mother and her unborn child. A wider collaboration with TPs, with local communities and conventional health workers of the health care centers, on the safe use of medicinal plants, is important to promote safer pregnancies and better health care for pregnant women and their unborn infants in Mali.

Traditional medicine practitioners' knowledge and views on treatment of pregnant women in three regions of Mali.

BACKGROUND: Despite the widespread use of medicinal plants in Mali, knowledge about how traditional practitioners (TPs) treat pregnant and lactating women is lacking. AIM OF THE STUDY: The aim of this study was to investigate how traditional practitioners in Mali treat common diseases and ailments during pregnancy. METHODS: Data was collected through structured interviews of traditional practitioners in one urban (Bamako) and two rural areas (Siby and Dioila) in Mali. The TPs were interviewed about how they treat common diseases and ailments during pregnancy. They were also asked to name harmful plants in pregnancy and plants that could affect breast milk production. In addition, we asked about nine specific medicinal plants commonly used in Mali; Opilia amentacea (syn. Opilia celtidifolia), Ximenia americana, Cola cordifolia, Combretum glutinosum, Parkia biglobosa, Trichilia emetica, Combretum micranthum, Lippia chevalieri and Vepris heterophylla. RESULTS: A total of 72 traditional practitioners (64% women, age: 34 to 90 years) were interviewed during an eight week period October 2011 to December 2011. They treated between 1 and 30 pregnant women with medicinal plants per months. We found a relatively high consensus for treatment of pregnant women with common diseases and ailments like nausea and dermatitis. The highest informer consensus was found for the treatment of malaria during pregnancy. TPs generally recommended pregnant women to avoid medicinal plants with bitter tastes like stem and root bark of Khaya senegalensis and Opilia amentacea (syn. Opilia celtidifolia). TPs distinguished between oral (potentially unsafe) and dermal use (safe) of Opilia amentacea (syn. Opilia celtidifolia). Cola cordifolia was used to facilitate labor. CONCLUSION: Experience and knowledge about treatment of pregnant women with medicinal plants was broad among the traditional practitioners in the three investigated regions in Mali. Collaborating with traditional practitioners on the safe use of medicinal plants in pregnancy may promote safer pregnancies and better health for mothers and their unborn infants in Mali.

A comparison of bioactive aqueous extracts and polysaccharide fractions from roots of wild and cultivated Cochlospermum tinctorium A. Rich.

In Malian traditional medicine the roots of Cochlospermum tinctorium are used in the treatment of gastric ulcer, but extending harvesting is causing a growing concern of a dramatic reduction in the wild plant population. In the present study cultivation of C. tinctorium is evaluated, and structural components and bioactive properties of crude water extracts and isolated polysaccharide fractions from roots of wild and cultivated C. tinctorium are compared. The crude water extracts were shown to contain starch, pectin- and inulin-type polysaccharides, in addition to phenolic substances and protein, while the isolated acidic polysaccharide fractions contained mainly monosaccharides typical for pectins. The monosaccharide compositions of the polysaccharide fractions from roots of wild versus cultivated plants were comparable, albeit the yields in the cultivated roots were lower. Furthermore, the crude extracts and isolated polysaccharide fractions from wild and cultivated roots exhibited similar complement fixating activities, but were not able to activate macrophages. The crude extracts from cultivated roots were also shown to be moderate radical scavengers. The present study has shown that roots of cultivated C. tinctorium contain the same types of bioactive polysaccharides as the wild roots. However, in order to utilize roots of cultivated C. tinctorium in traditional medicine the cultivation method should be improved.

Ethnopharmacological survey of six medicinal plants from Mali, West-Africa.

An ethnopharmacological survey was carried out to collect information about the use of six medicinal plants in the regions around Siby and Dioila, Mali. The plants investigated were Biopyhtum petersianum, Cola cordifolia, Combretum molle, Opilia celtidifolia, Parkia biglobosa and Ximenia americana. More than 60 medical indications were reported for the use of these plants in traditional medicine. The most frequently reported ailments were malaria (25.6%), different types of pain (14.0%) and dermatitis (7.4%). The main forms for preparation were decoction (58.1%) and powdered plant material (28.4%). The most frequent used plant parts were leaves (37.7%) and stem bark (18.6%). The healers' consensus for the main indications is fairly high for the four plants B. petersianum, C. cordifolia, C. molle and O. celtidifolia, and this supports the traditional use of these plants. However for P. biglobosa and X. americana the healers' consensus is less consistent and it is more difficult to draw conclusions about the most important traditional use of these two plants.