Medicinal Plants Used by Oromo Community in Kofale District, West-Arsi Zone, Oromia Regional State, Ethiopia

Abstract

Purpose

The purpose of this study was to record the utilization of medicinal plants by the Oromo people in the Kofale District, Oromia Regional State, Ethiopia, to control human and animal health problems.

Methods

Data regarding the use of medicinal plants were collected using ethnobotanical methods from 84 traditional medicine practitioners and 304 general informants sampled employing purposive and systematic random sampling methods, respectively, in the Kofale District. Data were analyzed using different indices, including a preference ranking exercise, informant consensus factor (ICF), fidelity level (FL) and relative popularity level (RPL).

Results

In the district, 106 medicinal plants were claimed to be used for the treatment of 43 human and 18 livestock illnesses, of which 75 (71%) were used to manage human health problems, 23 (21.5%) were used to treat both human and livestock ailments and eight (7.5%) were utilized to treat manage livestock health problems. Most (76.4%) plants were harvested from the wild. Leaves were the most commonly used plant part (55.6%) in remedy preparations. Skin diseases scored the highest ICF value (0.97), followed by gastrointestinal disorders (ICF = 0.95), cancer (ICF = 0.93), and hemorrhoids (ICF = 0.91). Medicinal plants that record the highest fidelity level (FL) (100%) and rank order priority (ROP) (100%) values included Justicia schimperiana, Embelia schimperi, Ekebergia capensis and Datura stramonium, which have been used to treat liver disorders, tapeworm infections, babesiosis, and rabies, respectively. There were significant differences (p<0.05) in the mean numbers of medicinal plants claimed by different social groups: older, illiterate, and traditional medicine practitioners reported higher mean numbers of medicinal plants than younger, literate, and general informants, respectively.

Conclusion

This study indicated the richness of medicinal plant species in Kofale District. Medicinal plants with the highest FL and ROP values and those used to treat disease categories with the highest ICF values should be prioritized in future phytochemical and pharmacological investigations.

Introduction

World Health Organization (WHO) has reported that nearly 60% of people worldwide, and as far as 80% of the population in Africa, directly or indirectly, depend on traditional medicinal plants to solve their healthcare problem.¹ The high reliance on medicinal plants is attributed to a number of claimed reasons that include easy accessibility, cultural acceptability, affordability (cheaper cost), fewer side effects,² and the widespread availability of harmful pathogenic microorganisms that are resistant to existing modern drugs.³ Medicinal plants are valuable sources for the discovery of new therapeutics against different diseases,⁴ which may also have a wider therapeutic window than synthetic drugs, and thus prevent the development of drug resistance. Medicinal plants contain a diverse groups of phytochemical constituents such as flavonoids, triterpenoids, glycosides, saponins, carotenoids, volatile oils, amino acids, steroids, quinines, alkaloids⁵ and coumarins⁶ responsible for multifaceted biological effects.⁷ According to estimates, around 80% of the human population and 90% of the livestock population in Ethiopia rely on traditional medicinal plants for their day-to-day primary healthcare.^8,9 Ethiopia is one of the most ethnically diverse countries in East Africa with the majority of its citizens living in rural areas and thus with limited access to modern healthcare services.¹⁰ Such condition has made the people blessed with rich traditional knowledge and practices on the use of medicinal plants, remedy preparations and administrations as well as illness diagnoses.⁸ Even though the majority of the populations in Ethiopia heavily depend on medicinal plants for their primary healthcare needs, very limited work has so far been done to record and analyze the associated knowledge, and validate the therapeutic values of the claimed plants.^11,12 On the other hand, there is an ongoing rapid population increase, indiscriminate deforestation, overexploitation of natural resources, worldwide climate change, which has contributed to the depletion of useful medicinal plant resources and the associated indigenous knowledge.¹³ As a result, documenting and protecting medicinal plants and the associated knowledge is becoming a greater priority. A number of ethnobotanical studies conducted in different parts of Ethiopia have reported the common uses of medicinal and wild edible plants.^12,14–27 However, only a few ethnobotanical studies have been conducted in the West-Arsi Zone of the Oromia Regional State Ethiopia^28,29 which were conducted in the Negele Arsi and Nansebo districts, and no such study has been conducted in Kofale District. Like most Ethiopian communities, people in Kofale District are expected to practice traditional medicine, mainly associated with the use of medicinal plants to maintain their health, as well as that of their domestic animals. Therefore, this study was carried out to properly document traditional knowledge related to the use of medicinal plants to manage both human and livestock ailments by the people of the Kofale District, West-Arsi Zone, Oromia Regional State, Ethiopia.

Materials and Methods

Description of the Study Area

According to 2007 census conducted by the Population Census Commission (PCC) of Ethiopia, the West-Arsi Zone has a total population of 1,975,295.³⁰ Most inhabitants in the zone belong to the Oromo ethnic group, constituting 88.52% of the total population. The Zone has 12 districts, one of which is Kofale District (Figure 1). Kofale District is geographically located between 6° 50ˈ-7° 9ˈN and 38° 38ˈ-39° 4ˈE, south of the capital Addis Ababa. According to Kofale District Healthcare Office (KDHCO), the district gets a mean annual rainfall of 1300 mm and a temperature of 10–24°C (KDHCO, 2022, unpublished data). The district has a total population of 179,508, of which 90,000 are men and 89,508 are women.³⁰ People in the rural areas of the study district are mainly dependent on crop farming and livestock production for their livelihood. According to the Kofale District Agricultural Office (KDAO), there are 106,325 cattle heads, 112,570 sheep, 91,400 horses, 9784 goats, 9410 donkeys, and 35,901 chickens in the district (KDAO 2022, unpublished data). Based on data collected during a reconnaissance survey, the district has 43 kebeles (sub-districts) located at different distances from the administrative district center (Kofale town). The top-five human health problems in the district are dermatochalasis, gastrointestinal tract infections (diarrhea, typhoid, stomachache, abdominal pain, and internal parasite infestation), cancer, respiratory infections, and sexually transmitted diseases (KDHCO 2022, unpublished data), and the main livestock diseases in the study area include anthrax, black leg, pasteurellosis, dermatochalasis, tick infestations, equine glanders, leech infestation, and rabies (KDAO 2022, unpublished data).

Figure 1.

Map of Kofale District, West-Arsi Zone, Oromia Regional State, Ethiopia.

Selection of Study Sites

A reconnaissance survey was conducted in Kofale District in January and February 2021 to select study kebeles and informants. Health and agricultural professionals in the district played key roles in the identification of herbal medicine practitioners. Of the 43 kebeles in the district, eight (Wege Abosa, Benjo Ashoka, Ilka Bebe, Sayimanna muudi, Chatimanna Jangala, Guchi, Bulchaana, and Garmaama) were purposively selected for the study, taking into consideration the history of use of traditional medicine and availability of practitioners in the area, less exposure of the community to modernization, and agro-ecological representation. Additional information regarding the sampled kebeles and traditional healers was gathered from kebele administration officers, knowledgeable elders, and other local inhabitants.

Study Design, Sample Size Determination and Sampling Techniques

A cross-sectional study design was adopted to conduct the ethnobotanical survey, and sample size was determined based on the total of household heads in the sampled kebeles³⁰ using a standard sample size determination formula given below.³¹

n = N/(1+N(e)²), where n = sample size, N = total number of households in sample villages/kebeles (11,754), e = maximum variability or margin of error 5% (0.05) and 1 = the probability of event occurring

Based on this, the total sample size obtained was 388, of which 84 were locally recognized traditional health practitioners (THP) who were identified using purposive sampling method, and 304 were general informants that were sampled using a systematic random sampling method as described by Martin²⁸ based on the total number of households each kebele (Table 1).

Table 1.

Number of Households and Informants in Each Sampled Kebele

Kebeles	Altitude	Number of Households	Number of Informants	General Informants			Traditional Health Practitioners
				Total	M	F	Total	M	F
Garmaama	1500–2660	2726	88	69	65	4	19	18	1
Benjo Ashoka	1918–1945	1091	35	27	25	2	8	8
Sayimanna Muudi	1938–1961	1148	37	29	26	3	8	8
Chatimanna Jangala	1970–2500	1551	58	47	44	3	11	11
Bulchaana	1989–2196	1298	42	33	31	2	9	9
Wege Abosa	2190–2300	1721	56	43	40	3	13	12	1
Guchi	2200–2786	1262	41	32	36	2	9	8	1
Ilka Bebe	2605–2867	957	31	24	21	3	7	6	1
Total		11,754	388	304	282	22	84	80	4

Ethnobotanical Data Collection

Ethnobotanical data were gathered from February 2022 to March 2023 through individual semi-structured interviews and guided field walks using the methods of Martin³² and Cotton.³³ Data collected from informants during interviews included sociodemographic information, local name of each claimed medicinal plant, part used, condition of plant part used (fresh/dried), additive used (if any), preparation method, ailment treated, route of administration, dosage, side effects, and antidotes used. Additional data regarding habitat, abundance, and existing threats of medicinal plants were also gathered through guided field walks as described in Martin³² and Alexiades.³⁴ Voucher specimens from all mentioned medicinal plants were collected, dried, identified by botanists at ALIPB and the National Herbarium, AAU using published volumes of the Flora of Ethiopian and Eritrea, and deposited for future reference.

Analysis of Data

Data were analyzed using quantitative tools, including preference ranking exercise, informant consensus factor (ICF), fidelity level index (FL), and rank order priority (ROP) value^32,35–37 to identify the most important medicinal plants in the district. Analysis of variance (ANOVA) and t-tests were used to determine the effects of sociodemographic factors on respondents’ knowledge of traditional medicinal plants. Preference ranking exercises³² were conducted on seven medicinal plants with the highest number of informant citations to manage the most commonly reported human gastrointestinal complaints and skin diseases by ten traditional medicine practitioners sampled from those who were already involved in individual interviews. Informant consensus factor was computed to determine culturally important human and livestock ailment categories and, by doing so, identify potentially effective medicinal plant species within the respective disease categories using the formula ICF = (N_ur − N_t)/(Nur − 1), where N_ur is the number of use reports for each disease category and N_t is the number of species used in that category.³⁶ Fidelity level index was computed to reveal the level of agreement among informants in selecting medicinal plants used to manage a specific ailment using the formula, FL = (N_p/N) x100, where N_p is the number of informants who cited or mentioned the use of a medicinal plant against a particular disease and N is the total number of informants who cited that plant for any other medical use.³⁵ However, plants with similar FL values but known to different numbers of informants may vary in their healing potential. Thus, a correlation index known as relative popularity level (RPL) was additionally determined to compute the rank order priority (ROP) value, as given by Ali-Shtayeh et al³⁷ by multiplying the FL value by RPL to differentiate the healing potential of plants with similar FL values.

Results

Socio-Demographic Status of Informants

In this study, 388 informants (84 traditional healers and 304 general informants) were involved, the majority (54.12%) of whom were between 41 and 60 years of age. Regarding educational status, 57.73% of informants were illiterate, and 42.27% were literate. Regarding the gender of the informants, 360 (92.79%) were males and 28 (7.22%) were females (Table 2).

Table 2.

Demographic Categories of Local Respondents

	Socio-Demographic Group	Number of Informants	Percentage
Gender	Male	360	92.79
	Female	28	7.22
Age group	20–40 years old (youngster)	86	22.16
	41–60 years old (middle aged)	210	54.12
	61–89 years old (elder)	92	23.71
Literacy	Illiterate	224	57.73
	Literate	164	42.27
Informant type	Traditional healer	84	21.65
	General informant	304	78.35

Diversity of Medicinal Plants Reported and Their Growth Forms

The study conducted in Kofale District recorded 106 medicinal plant species that belonged to 90 genera and 56 families, which were reported to treat 43 human illnesses and 18 livestock diseases (Table 3). Of these, 75 (71%) were used to manage human health problems, 23 (21.5%) to treat both human and livestock ailments, and eight (7.5%) to treat livestock diseases. The family Asteraceae was represented by nine species, Fabaceae and Solanaceae by seven species each, and Euphorbiaceae and Lamiaceae by five species each. Five families (Amaranthaceae, Myrsinaceae, Cucurbitaceae, Rosaceae, and Myrsinaceae) were represented by three species each and three families (Urticaceae, Meliaceae, and Rubiaceae) were represented by two species each. Each of the remaining families was represented by single species. Regarding the growth forms of medicinal plants, shrubs contributed the most (37.7%), followed by herbs (28.3%), trees (23.5%), herbaceous climbers (5.7%), lianas (3.7%), and epiphytes (0.9%) (Figure 2).

Table 3.

List of Medicinal Plants Used to Treat Human and Livestock Diseases in Kofale District

Species Name	Family Name	Local Name	Habit	Part used	Disease Name Treated	Use	Mode of Preparation	Administration Route	Use citation	Voucher Number	Ailment Managed Elsewhere in Ethiopia
Achyranthes sp.	Amaranthaceae	Qadara	Cl	Wh	Aspiration	Hu/Ls	Crushed with teeth	Nostrils	12	GN-120	Wound infections,38 skin diseases39
Acmella caulirhiza Delile	Asteraceae	Caanga	H	Wh	Headache	Hu	Crushed and squeezed	Nostril	14	GN-52	Cancer-like symptoms,39,40 toothache41
Adiantum sp.	Adiantaceae	Laaftuu	H	L	Wound		Crushed & squeezed	Topical	5	GN-72	Wound treatment42
Agarista salicifolia (Comm.e.x. Lam.) Hook	Ericaceae	Sotra	T	Ba	Bone TB	Hu	Fresh bark is crushed and extract is applied	Dermal	33	GN-59	Abdominal pain24
Albizia gummifera (J.F.Gmel.) C.A.Sm.	Fabaceae	Qarcacee	T	Ba	Aspiration	Hu	Fresh bark is crushed and chewed	Oral	34	GN-16	Anthrax28
Albizia schimperiana Oliv.	Fabaceae	Sisaa	T	L/R	Liver disorder	Hu	Crush leaves and roots and mix them with water	Oral	21	GN-43	Trypanosomiasis,43 helminthic infection,44 microbial infection,45 microbial infection46
					Cough	Ls	Fresh leaf is crushed and pounded	Oral	49
					Hemorrhoids		Decoction	Topical	16
Aloe sp.	Aloaceae	Hargisa	H	La	Hepatitis	Hu	Crushing the latex	Oral	18	GN-127	Wounds and skin complaints, malaria, microbial infections, and complaints of the digestive system,47 malaria48
				L	Hemorrhoids	Hu	Crushing and squeezing	Anal	260
				L	Abdominal pain	Hu	Crushing and squeezing	Oral	80
				La	Dermatphilosisis, hair loss	Hu	Creaming	Topical	78
				L	Blood pressure	Hu	Crushing	Oral	103
				La	Eye ache	LS	Squeezing	Topical	4
Amaranthus dubius Mart ex Thell.	Amaranthaceae	Raafu qinxa	H	L	Anorexia	Hu	Fresh leaves are boiled	Oral	8	GN-33	Diarrhea49
				L	Cancer	H	Crushed & squeezed	Oral	52
				R	HIV-AIDS	H	Crush & mix juice produced with honey	Oral	1
Anethum graveolens L.	Apiaceae	Goomana	H	L	Constipation	Hu/LS	Fresh leaves are crushed and boiled	Oral	23	GN-171	Stomachache50
Apodytes dimidiata E.Mey. ex Arn.	Icacinaceae	Odda badaa	T	Ba	Stomachache	Hu	Decoction	Oral	23	GN-66	Stomachache, cough,28; child diarrheal disease, cholera, general health problem (low weight and compromised immunity of infants24
				Ba	Internal parasite infection	LS	Crushed & mixed with water	Oral	9
Arundinaria alpina K. Schum	Poaceae	Leman	Sh	Sh	Hemorrhoid, diarrhea	Hu	Leaves are pounded and squeezed and mixed with water	Oral	12	GN-48	Neck tumour23
Asparagus africanus Lam.	Asparagaceae	Sariiti	H	L	Breast cancer	Hu	Crush leaves and add honey	Oral	59	GN-2	Malaria,51 erectile dysfunction,52 malaria53
				R	Anthrax	Ls	Crush fresh root and mix it with water	Oral	6
					Blackleg				5
Bersama abyssinica Fresen.	Melianthaceae	Koraqa	Sh	L L L Ba	Intestinal parasite Stomach ache, diarrhea Equine glanders Elephantiasis, itching	Hu Hu Ls Hu	Crush pounded and mix it with water Crush pounded and mix it with water Crush pounded and mix it with water Pounded and boiled	Oral Oral Oral Dermal	90 95 44 115	GN-1	HIV-AIDS,54 diabetics,55,56 diarrhea57
Brucea antidysenterica J.F. Mill	Simaroubaceae	Ciironta	Sh	L	Eczema	Hu	Crush pounded and mix it with water	Oral	69	GN-6	Diarrhea,58 leishmaniasis59
				Sd	Amoeba/diarrhea	Hu	Dry, grind and mix it with water	Oral	53
Caesalpinia decapetala (Roth) Alston		Gorxa	La	L	Dermatophilosis	Hu	Fresh leaves are smashed, pounded and mixed with water	Oral	3	GN-35	Spiritual use,59 Tonsillitis60
Calpurnia aurea (Aiton) Benth	Fabaceae	Ceekata	Sh	L	Tick infestation	Ls	Pounding and squeezing	Dermal	87	GN-143	Malaria,61 snake poisoning,62 livestock external parasites63
				L	Rabies	Hu/Ls	Fresh leaves are crushed and squeezed	Oral	21
				L	Liver disorders	Hu	Dried & ground and mix it with water	Oral	76
Carica papaya L.	Caricaceae	Papaya	Sh	Fr	Anemia	Hu	Crushed & squeezed	Oral	7	GN-174	Malaria,64
Carissa spinarum L.	Apocynaceae	Agamsa	Sh	Ba	Tumour	Hu	Fresh bark is crushed and squeezed	Oral	17	GN-23	Evil eye,65,66 gonorrhea,67 bacterial infection,68 spiritual illness,59 accumulation of fluid in the body69
				R	Cancer	Hu	Root is crushed together with root of Euclea schimperi, pounded and boiled	Oral & dermal	77
				R	Wound	Hu	Fresh bark is crushed and mixed with butter	Topical	22
Casimiroa edulis La Llave	Solanaceae	Koshimi	SH	R	Evil eye	Hu	Pounded & decocted for steam bath	Topical	3	GN-107	Cancer70
Catha edulis (Vahl) Forssk. Ex Endl.	Celastraceae	Caatii	H	L	Stomachache	Hu	Chewed	Oral	4	GN-108	Jaundice,71 stomachache72
Clematis hirsuta Perr. and Guill.	Ranunculaceae	Fiitii	La	L	Bone cancer Wound	Hu Hu	Pounded	Politice	43 32	GN-76	Blackleg,73 respiratory tract problem and cataract74
Clerodendrum myricoides (Hochst.) R. Br. ex Vatke	Verbenaceae	Marachisa	T	Fr	Oedema	Hu	Dried & ground	Oral	18	GN-4	Rheumatism, evil eye71
				L	Wound	Hu/Ls	Fresh leaves are crushed and mixed with water	Dermal	16
Coffee arabica L.	Rubiaceae	Buna	Sh	Fr	Diarrhea	Hu	Dried, ground and mixed with water	Oral	13	GN-178	Diarrhea75
Cordia africana Lam.	Borginaceae	Wodeessa	T	Ba	Cancer	Hu	Crushed while fresh and mixed with water	Oral	13	GN-	Pain, inflammation, microbial and viral infections, and fertility problem76
Croton macrostachyus Hochst. ex Delile	Euphorbiaceae	Makanisa	T	Ba	Tumour	Hu	Bark is dried and ground	Topical	55	GN-25	Malaria, abdominal pain, gonorrhea, wounds, ringworm infestation, hemorrhoids, ascariasis, venereal diseases, cough and rheumatism,77 malaria65
Cynoglossum lanceolatum Forssk.	Borginaceae	Maxxanne	H	Wh	Febrile illnesses	Hu	Crushed & boiled	Oral	2	GN-98	Fever,78 hemorrhoids79
Datura stramonium L.	Solanaceae	Banji	H	Sd	Rabies	Hu	Seeds are roasted, ground and mixed with water	Oral	76	GN-9	Bacterial infection,80 skin infections,81 head fungal infection,82 toothache,41 dermatological diseases61
				Sd	Head ache	Hu	Seeds are roasted	Nostril	13
Discopodium penninervum Hochst.	Solanacae	Maraaro	Sh	L	Pasteurollosis	Ls	Its leaves are crushed with leaves of Kalanchoe petitiana and mixed with water	Oral	7	GN-29	Malaria, hemorrhoids, and anthrax in livestock28
Dodonaea viscosa subsp. angustifolia (L.f.) J.G. West	Sapindaceae	Ittacha	Sh	L	Herpes zoster	Hu	Crushed & squeezed	Dermal	16	GN-15	Malaria,83 diarrhea, ulcer, microbial infection, diabetics, HIV-AIDS54
					Dermatochalasis	Hu	Crushing, pounding and powdering	Dermal	27
					Wound	Hu	Decoction	Body shower	42
Dovalis abyssinica (A.Rich.)Warb.	Flacourtiaceae	Dhangago	Sh	Fr	Jaundice	Hu	Its fruits are mixed with root of Stephania abyssinica, crushed and mixed with water	Oral	22	GN-44	Ascariasis84
Drynaria volkensii Hieron.	Polypodiaceae	Kokoso	Sh	L	Tumour	Hu	Chewed & swallowed	Oral	2	GN-71	Tooth ache41
Echinops angustilobus S. Moore	Asteraceae	Anshokala	H	R	Evil eye	Hu	Dried, and ground	Nostrils	5	GN-153	Bloating28
Ekebergia capensis Sparrm	Miliaceae	Onoonuu	T	Ba	Babesiosis	Ls	Fresh bark is crushed and mixed with water	Oral	73	GN-55	TB,28 weight loss in children, stabbing pain, bovine TB85
Embelia schimperi Vatke	Myrsinaceae	Qaanqu	Sh	Fr	Tapeworm	Hu	Grind the dried fruit by mixing with Hagenia abyssinica dried flower	Oral	197	GN-73	Helminthic infection,86 gastro-intestinal diseases in animals,87 helminthic infection88
Englerina woodfordioides (Schweinf.) M Gilbert	Loranthaceae	Mukure	Epi	Wh	Liver disorders	Hu	Crushed & boiled	Oral	19	GN-36	Earaches71
Ensete ventricosum (Welw.) Cheesman	Musaceae	Worqe	Sh	L	Stomachache	Hu	Leaf petiole is crushed and fermented for weeks	Oral	3	GN-177	Abdominal pain89
Entada abyssinica Steud. Ex A. Rich	Fabaceae	Bobanqa	T	L	Skin diseases	Hu	Crushed, pounded and mixed with water	Dermal	62	GN-86	Convulsion90
Erica sp.	Ericaceae	Sato	Sh	L	Stomachache	LS	Fresh leaf is crushed and mixed with water	Oral	11	GN- 60	Indigestion and bloating24
Erythrina abyssinica Lam. ex DC.	Fabaceae	Woleena	Sh	Sh	Pasteurollosis	Ls	Fresh shoot is crushed and squeezed	Oral	14	GN-5	Snakebites, malaria, sexual transmittable diseases such as syphilis and gonorrhoea, amoebiasis, cough, liver inflammation, stomachache, colic, measles, burns, ulcers and swellings,91 evil eye92
				L	Eye ache	LS	Crushed and squeezed	Topical	33
Eucalyptus camaldulensis Dehnh.	Myrtaceae	Bergamo diima	Sh	Ba	Febrile illness	Hu	Fresh part is crushed and squeezed	Topical	8	GN-169	Bacterial infection93
Eucalyptus globulus Labill.	Myrtaceae	Bargamo adii	T	L	Stomachache	Hu	Crushed & chewed	Oral		GN-162	Stomachache,94 influenza,95 bacterial infection,96 respiratory tract infections,97 malaria57
Euclea schimperi (A.DC) Dandy	Ebenaceae	Mi’eesa	T	RB	Hemorrhoids	Hu	Its root bark and seeds of Solanum anguivi are dried, ground and mixed with butter Dried, pounded and mixed with butter	Topical	15	GN-87	Wound, teeth infections, eye disorders, head ache, pain, spasm98
					Dermatophilosis	Hu	Fresh leaf is crushed and mixed with water	Topical	131
				L	Stomach ache	Hu		Oral	50
Euphorbia schimperiana Scheele	Euphorbiaceae	Guurii	H	Sp St	Gonorrhea Hemorrhoid	Hu HU	Crushed & decocted Crushing & pounding	Dermal Anal	73 95	GN-6	Proliferative activity,99 cancer,39 anthrax in livestock73
Euphorbia tirucalli L.	Euphorbiaceae	Aananoo	Sh	La	Body swelling, gonorrhea	Hu	Crushed and squeezed	Dermal	89	GN-100	Bacterial infection of urinary tract,100 urogenital disease,101 Stomachache28
Ficus sycomorus L.	Moraceae	Qiltu	T	Ba	Diarrhea	Hu	Fresh bark is crushed and squeezed	Oral	19	GN-104	Nausea and vomiting,49 ascariasis102
Galiniera saxifraga (Hochst.) Bridson	Rubiaceae	Koralla	Sh	Ba Ba Ba Ba	Babesiosis Liver disorders Jaundice Stomach ache	LS Hu Hu Hu	Crushed squeezed and mixed with water Fresh leaf is crushed and swallowed Fresh root is chewed and swallowed Decoction	Oral Oral Oral	14 73 31 63	GN-15	Anthrax28
Hagenia abyssinica (Bruce) J.F. Gmel.	Rosaceae	Heexo	T	Fr	Tapeworm	Hu	Crush its dried flower with bark of Croton macrostachyus and fruit of Embelia schimperi	Oral	76	GN-91	Helminthic infections82
Halleria lucida L	Scrophulariaceae	Muka dadhi	T	L	Body swelling	Hu	Decoction	Topical	16	GN-54	Evil eye and kidney problem103
Hypericum quartinianum A.Rich.	Hypericaceae	Garamba	Sh	L	Hepatitis	Hu	Its leaves and that of Junipers procera are crushed together and boiled	Oral	85	GN-	Stomachache for livestock104
Ilex mitis (L.) Radlk	Rubiaceae	Amshiqa	T	Ba	Hemorrhoids	Hu	Fresh bark is crushed and boiled in water	Oral	98	GN-161	Rheumatism71
Juniperus procera Hochst.ex. Endl.	Cuperssaceae	Hidhesa ummama	T	Ba	Diarrhea	Hu	Fresh bark is crushed and squeezed and mixed with water	Oral	35	GN-14	Stomachache105
Justicia schimperiana (Hochst. ex Nees) T. Anderson	Acanthaceae	Dhumuuga	Sh	Sh	Hepatitis	Hu	Fresh shoot is pounded to make juice	Oral	235	GN-7	Diabetes mellitus106
Kalanchoe petitiana A. Rich	Rassulaceae	Hancuura	H	L L L L L	Tonsillitis Bone fracture GIT disorders Pasteurellosis Anthrax	Hu Hu Ls	Crushed while fresh and squeezed Boiled while fresh Fresh leaf is chewed Crushed together with leaf of Disco podium penninervum	Oral Dressing Oral Oral	15 71 13 11 5	GN-18	Evil eye, fractured bones and skin disorders,107 tissue proliferation,39 metacarpal bone fracture in livestock,91,108 anthrax28
Lagneria sp.	Cucurbitaceae	Buqe arba	Sh	St	Hepatitis	Hu	Crushed & sap produced is collected	Oral	87	GN-66	Gonorrhea,16 cancer109
Lippia adoensis Hochst.	Verbenaceae	Sukayi	H	L	Stomachache	HU	Crushed & chewed	Oral	22	GN-37	Severe headache,25 pain,110 harm on body by free radicals,111 fungal infection,112 repelling Anopheles arabiensis and Aedes aegypti,113 bacterial and fungal infection,114 stomach pain71
Maesa Lanceolata Forssk.	Myrsinaceae	Abbayii	T	Ba Ba	Liver disorders Dermatophilosis	Hu Hu/Ls	Its bark is mixed with leaves of Discopodium penninervum and boiled Dried & boiled	Oral Dermal	97 62	GN-142	Mastitis,28 malaria,115 ovicidal and larvicidal activity,116 Snakebites81
Mangifera indica L.	Anacardiaceae	Mango	Sh	Fr	Blood pressure	Hu	Squeezed	Oral	4	GN-110	Harm on body by free radicals117
Maytenus addat (Looes.) Sebsebe	Celastraceae	Kombolcha	Sh	Ba	Diarrhea	Hu	Fresh bark is crushed and mixed with water	Oral	10	GN-53	Parasites infections28
Millettia ferruginea (Hochst.) Bak.	Fabaceae	Dhadhatu	T	Fr	Leech infestation	Ls	Crushed & pounded	Nostril	72	GN-90	‘Mujele’ (infection caused by an insect present in the soil)118
Moringa stenopetala (Bak.f.) Cuf.	Moringaceae	Shifera	Sh	L	Blood pressure	Hu	Crushed, dried and ground	Oral	44	GN-126	Anthrax28
Myrsine melanophlous (L.) R.Br.	Myrsinaceae	Tuula	Sh	L Ba	Child emaciation Stomachache	Hu Hu	Fresh leaf is pounded and boiled Decoction	Oral & body shower Oral	57 69	GN-41	Stomach problem28
Nicotiana tabacum L.	Solanaceae	Tambo	H	R L	Leech infestation Tooth ache	Hu/Ls HU	Chewed & spit into the mouth of the sick animal Dried & powdered	Oral Topical	48 14	GN-176	Leech repulsion78
Nuxia congesta R. Br. ex Fresen.	Loganiaceae	Bixana			Anthrax	Ls	Crushed, squeezed and mixed with water	Oral	11	GN-47	Malaria,119 calf pneumonia,120 anthrax28
Ocimum gratissimum L	Lamiaceae	Cabbicha	H	L	Rheumatism, headache, eye disease, allergic reaction	Hu	Crushed & squeezed	Oral & nostril	31	GN-80	Skin infections121
Oenanthe palustris (Chiov.) Norman	Apiaceae	Goonde	H	L	Bone cancer	Hu/ Ls	Fresh leaves are crushed	Topical	13	GN-42	Tooth ache41
Olinia rochetiana A. Juss.	Oliniaceae	Gunaa	T	L	Bone TB Diarrhea	Hu Hu	Fresh leaf is crushed and macerated with water Fresh leaf is crushed and macerated with water	Dermal Oral	79 133	GN-17	Stabbing pain,73 colds and chest related condition122
Physalis peruviana L.	Solanaceae	Mujulo	H	Wh	Indigestion	Hu	Crushed & boiled in water	Oral	3	GN-111	Medicinal value95
Phytolacca dodecandra L’Her.	Phytolaccaceae	Handoode	H	L L R	Jaundice External parasite, dermatophilosis Rabies	Hu LS Hu/LS	Fresh leaves are crushed and juice diluted in water Fresh leaf is crushed Fresh root is crushed and mixed with water	Oral Dermal Oral	8 64 92	GN-93	Molluscicidal properties,123 used for abortion118
Pittosporum abyssinicum Del.	Pittosporaceae	Aaraa	T	L Ba	Cancer Blackleg	Hu	Fresh leaves are crushed and mixed with water Crushed & mixed with water	Oral Oral	22 6	GN-50	Coughing, Pneumonia, TB, and Abdominal pain,24 cancer,124 intestinal problems, internal parasites, urine problems, diarrhea, swelling of gland, ascariasis, diarrhea, and vomiting125
Podocarpus falcatus (Thunb.) R.B. ex Mirb.	Podocarpaceae	Birbirsa	T	L	Epilepsy Cancer	Hu Hu	Its leaves together with leaves of Carissa spinarum are crushed and boiled Fresh leaves are crushed and boiled in water	Oral Oral	50 17	GN-8	Wound of both human and livestock126
Polycarpon tetraphyllum (L.) L.	Caryophyllaceae	Laalessa	CL	R	Toothache	Hu	Crushed & kept between teeth	Topical	4	GN-172	Lung diseases and menstrual problem71
Prunus africana (Hook.f.) Kalkman	Rosaceae	Sukee	T	L Sh Ba	GIT cancer Stomachache Skin diseases, wound	Hu Hu/Ls	Fresh leaves are boiled in water Crushed & squeezed	Oral Dermal	21 73 76	GN-27	Cancer, respiratory disorders, bad breath, diarrhea, gonorrhea, tuberculosis, and ear problems28
Psidium guajava L.	Myrtaceae	Zeeytuna	Sh	Sd	Hepatitis	Hu	Dried, powdered and mixed with water	Oral	7	GN-175	Damage on body by free radicals and bacterial infection127,128
Ranunculus multifidus Forssk.	Ranunculaceae	Siifa	H	L	Cancer	Hu	Fresh leaf is crushed and mixed with water	Oral	12	GN-51	Oedema129
Rhamnus prinoides L’Hér	Rhamnaceae	Geesho	H	Wh	Stomach ache	Ls	Pounded & mixed with water	Oral	6	GN-170	Tonsillitis71
Rhus tenuinervis Engl.	Anacardiaceae	Kolaassa	Sh	L	Cough	Hu/Ls	Dried, ground and boiled in water	Oral	3	GN-22	Stomach bloating in livestock28
Ricinus communis L.	Euphorbiaceae	Qoboo	Sh	Sd	Infertility	Hu/LS	Seeds are dried, powdered and boiled	Oral	44	GN-92	Erectile dysfunction,52 antimicrobial infection,130 coughing, constipation and swelling and anthrax94
Rosmarinus officinalis L.	Lamiaceae	Wodi fooni	H	L	Diabetes	Hu	Crushed & boiled	Oral	31	GN-99	Bacterial infection,110,131,132
Rubus steudneri Schweinf.	Rosaceae	Gora	La	L	Wound	Hu/LS	Dried & ground	Dermal	5	GN-40	Bacterial infection,87 damage on body by free radicals116
Rumex abyssinica Jacq.	Polygonaceae	Shoshira	Sh	L	Gonorrhea, diarrhea	Hu	Crushed, pounded and boiled	Oral	10	GN-74	Damage on body by free radicals and inflammation,133 diabetes mellitus134
Rumex nepalensis Spreng.	Polygonaceae	Shaabee	H	R	Hemorrhoids	Hu	Dried, ground and mixed with sugar	Oral	78	GN-9	Gastrointestinal infection,74 diarrhoea73
				L	Goiter	Hu	Crushed & mixed with water	Oral	10
					Diarrhea	LS	Fresh leaf crushed and mixed with water	Oral	77
Ruta chalepensis L	Rutaceae	Caarota	H	L	Stomachache, abdominal pain, gastritis	Hu	Crushed and chewed	Oral	6	GN-97	Stomachache28
Rytigynia neglecta (Hiem) Robyns	Rubiaceae	Gaaloo	Sh	R	Pneumonia	Hu	Fresh root is crushed and boiled in water	Oral	13	GN-20	TB135
Saliva nilotica Juss. ex Jacq.	Lamiaceae	Hulageb	H	L	Snakebites	Hu	Crushed, dried and mixed with butter	Dermal	27	GN-173	Skin diseases28
Schefflera abyssinica Hochst. ex A. Rich.) Harms	Araliaceae	Gatame	T	Ba	Tonsillitis	Hu	Inner part of the bark is chewed	Oral	13	GN-151	Anthrax28
Schefflera volkensii (Engl). Harms	Araliaceae	Anshaa	T	L	Anthrax	Ls	Its leaves are crushed with leaves of Hypericum quartinianum and mixed with water	Oral	28	GN-161	Head ache73
Sedum baleensis M. Gilbert	Crassulaceae	Buri	H	R	Eczema	Hu/LS	Fresh leaves are crushed	Dermal	4	GN-68	Eczema71
Senecio myriocephalus Sch. Bip. ex A. Rich.	Asteraceae	Agadena	T	R	Stomachache		Fresh root is crushed, squeezed and mixed with water	Oral	24	GN-163	Evil eye,118 herpes Zoster71
Sida schimperiana Hochst. ex A. Rich	Malvaceae	Kotte jabeesa	H	L	Evil eye	Hu	Leaf is dried and ground	Tie on the neck	12	GN-152	Prenatal abortion,67 microbial infection136
Solanecio gigas (Vatke) C. Jeffrey	Asteraceae	Taruura	Sh	Ba	Babesiosis	Hu/LS	Crushed & mixed with water	Oral	4	GN-172	Bacterial infection137
Solanum adoense Hochst ex. A.Rich.	Solanaceae	Hiddi oromoo	Sh	L	Nose bleed	Hu	Fresh leaves are smashed	Nostril	11	GN-10	Malaria138
Solanum anguivi Lam	Solanaceae	Xoshine	H	L	Blood pressure	Hu	Dried, ground and boiled	Oral	51	GN-65	Trypanosomiasis,139 diabetes and atherosclerosis140
Solanum benderianum Schimp. ex Engl.	Solanaceae	Galimo	T	R	Stomachache	Hu	Root is crushed, dried and boiled	Oral	3	GN-69	Hypertension141
Solanum benderianum Shimper ex Damme	Solanaceae	Galimo	CL	Ba	Stomachache	Hu	Dried, ground and boiled	Oral	3	GN- 69	Calf diarrhea142
Stephania abyssinica (Dillon & A. Rich.) Walp.	Menispermaceae	Kalaala	Cl	L	Jaundice	Hu	Leaf dried, ground and boiled in water	Oral	31	GN-11	Malaria,143 gastrointestinal diseases,144 external cancer91
Syzygium guineense (Willd.) DC.	Myrtaceae	Baddeesa	T	Ba	Kidney infection Diarrhea Tonsillitis	Hu Hu	Fresh leaf is crushed, squeezed and mixed with water Fresh leaf is chewed and ingested	Oral Oral	20 133 13	GN-62	Stomachache, diarrhea,28 hypertension,145 Malaria,100 cancer.146
Teclea nobilis Del.	Rutaceae	Hadhesa	Sh	L	Blackleg	Ls	Leaves are pounded and mixed with water	Oral	10	GN-30	Blackleg89
Toddalia asiatica (L) Lam.	Rutaceae	Gaawo	Sh	Fr	Stomach ache, wound	Hu/ Ls	Fruit is crushed, pounded and mixed with water	Oral	7	GN-28	External body swelling147
Urera hypselodendron (Hochst. ex A. Rich.) Wedd.	Urticaceae	Haliila	CL	Ba	Internal parasite		Leaves are crushed and mixed with water	Oral	66	GN-31	Anthrax17
Urtica simensis Steudel.	Urticaceae	Doobii	H	L	Constipation & gastritis Bloat	Hu Ls	Leaves are washed and boiled in water Leaves are washed and boiled in water	Oral	35 16	GN-95	Damage on body by free radicals,92 stomach ulcer,144 wound,148 malaria149
Verbascum sinaiticum Benth.	Scrophulariaceae	Gurra harree	Sh	L	Hepatitis	Hu	Fresh/dry leaves are crushed and mixed in water	Oral	8	GN-	Hepatitis,150 blood pressure151
Vernonia amygdalina Del.	Asteraceae	Ebicha	Sh	Ba L L L	Bone TB Skin diseases Diarrhea Goiter	Hu Hu Hu/Ls Hu	Fresh root is crushed and mixed with honey Decoction Decoction Fresh leaf is crushed and squeezed	Oral Dermal Oral Oral	7 81 84 15	GN-12	Malaria152
Vernonia auriculifera Hiern	Asteraceae	Reejii	Sh	L	Bloat	Ls	Leaves are crushed and macerated in water	Oral	16	GN-13	Wound,153 bacterial infection,154 pain and inflammation, wound155
Vernonia sp.	Asteraceae	Kalaqicha	Sh	L	Diarrhea	Hu	Crushed & squeezed	Oral	7	GN-70	Mlaria64
				St	Ringworm	Hu	Stem is crushed	Dermal	12
Withania somnifera (L.) Dunal	Solanaceae	Baala ajo	Sh	L/R	Evil eye	Hu	Dried, ground and mixed with water	Oral & nostril	78	GN-84	Trypanosomiasis,156 evil eye,157 enteric bacteria infection83
				L	Diarrhea		Leaf is crushed and squeezed	Oral	65

Abbreviations: T, tree, Sh, shrub, H, herb, Fr, fruit, Sa, sap, La, liana, Cl, climbers, ep, epiphyte, Hu, human, Ls, livestock, Hu/Ls, human and livestock, L, leaf, Ba, bark, R, root, Se, seed, St, stem, Wh, whole plant, Sh, shoot, Lt, latex, L/R, leaf and root, GIT, gastro-intestinal tract, TB, tuberculosis.

Figure 2.

Proportions of medicinal plants growth forms in percent.

Habitat of Medicinal Plants

Most medicinal plants (76.4%) used in traditional medicine in the district were uncultivated that were harvested from forests, riverbanks, grasslands, roadsides, life fences, and school compounds. Some were grown in homestead gardens (15%), and a few were harvested from both wild and homestead gardens (8.6%).

Medicinal Plant Parts Used in Remedy Preparations

The leaves were the most commonly used medicinal plant parts (55.6%) in the preparation of plant-based remedies in the district, followed by the bark (21.6%), root (14.15%), fruit/seed (11.3%), shoot/apex (3.8%), whole parts (2.8%), and sap (2.6%) (Figure 3).

Figure 3.

Proportions in percent of plant parts used for the treatment of human and livestock diseases in Kofale District, Oromia Regional State, Ethiopia.

Conditions of Plant Parts Used and Preparation Methods

The majority (75.8%) of the medicinal plant parts were claimed to be used in their fresh form, whereas some others were used in their dry (14.15%) and dry or fresh (10.65%) forms. The highest proportion (39%) of remedies was prepared by crushing (39%), followed by squeezing (16%), pounding and squeezing (14.5%), decoction (13%), pounding and powdering (9%), pounding and mixing (7.5%), and chewing (1%) (Figure 4).

Figure 4.

Percentages of different methods of remedy preparations.

Administration Routes of Remedies

Oral was the most frequently cited route of remedy administration in the district (61.3%), followed by topical/dermal (26.3%), nasal (4.7%), and ocular (3.8%) routes (Table 4).

Table 4.

Route of plant remedy application

Route of Application	Frequency of Citation	Percentage
Oral	65	61.3
Dermal	27	25.4
Nasal	5	4.7
Ocular	4	3.8
Skin cut	2	1.9
Ears	2	1.9

Dosage of Medicinal Plants and Use of Antidotes

Most frequently, traditional medicine practitioners’ prescriptions were based on patient age, gender, presence or absence of pregnancy and body condition. Different measuring materials, such as waterglass, teacup, coffee cup, teaspoon, bottle cap, handful, and between two fingertips were used to determine the dosage. Traditional medical practitioners employ different antidotes to neutralize possible adverse effects such as vomiting, nausea, diarrhea, headache, and loss of consciousness. Antidotes used mainly included fermented milk, fresh milk, honey, and coffee.

Commonly Reported Human and Livestock Diseases in the District

Of 43 human health problems occurring in Kofale District, dermatophilosis, gastrointestinal disorders, cancer, and hemorrhoids were the most prevalent reported by 35%, 31%, 18%, and 12% of the informants, respectively. Of the total 18 livestock health problems occurring in Kofale District, wound, tick infestation, leech infestation, dermatophilosis, equine glanders, anthrax, blackleg and pasteurellosis were the most reported ones with frequency of citation 26%, 22.4%, 19%, 16%, 11.3%, 7.2% and 3.3%, respectively.

Preference Ranking of Selected Medicinal Plants Used Against Human Gastrointestinal and Skin Diseases in the District

According to preference ranking exercise conducted on seven medicinal plants of the highest informant citations for their uses to treat human gastrointestinal complaints, a health problem of the second highest prevalence in the study district, Olinia rochetiana was the most preferred medicinal plant, followed by Bersama abyssinica and Vernonia amygdalina (Table 5).

Table 5.

Preference ranking of selected medicinal plants used to treat human gastrointestinal complaints in Kofale District

Medicinal Plants Ranked	Informants Labeled A to J										Total Score	Rank
	A	B	C	D	E	F	G	H	I	J
Olinia rochetiana	5	4	7	6	7	5	4	6	7	6	57	1
Bersama abyssinica	4	7	6	5	5	6	6	5	5	6	55	2
Vernonia amygdalina	6	5	6	4	6	5	5	5	6	6	54	3
Euclea schimperi	5	6	5	5	3	4	5	3	7	4	47	4
Rumex nepalensis	4	4	6	7	3	2	6	7	5	2	46	5
Prunus africana	5	3	2	5	4	3	5	4	2	6	39	6
Myrsine melanophloeos	4	3	3	3	6	4	3	2	6	2	36	7

A preference ranking exercise conducted on seven medicinal plants with the highest informant citations for their use in managing skin disorders, a health problem with the highest prevalence in the study district revealed that Euclea schimperi was the most preferred medicinal plant, followed by Maesa lanceolata and Vernonia amygdalina (Table 6).

Table 6.

Preference ranking of selected medicinal plants used to manage skin diseases in Kofale District

Medicinal Plants Ranked	Informants Labeled A to J										Total Score	Rank
	A	B	C	D	E	F	G	H	I	J
Euclea schimperi	7	7	4	4	6	7	5	5	6	7	61	1
Maesa Lanceolata	7	4	7	5	7	6	6	4	6	6	58	2
Vernonia amygdalina	7	7	4	4	5	5	6	7	5	4	57	3
Aloe sp.	7	6	6	5	5	6	5	5	5	4	55	4
Prunus africana	7	6	5	5	6	7	4	4	4	4	52	5
Bersama abyssinica	4	4	3	5	5	5	5	6	6	6	50	6
Phytolacca dodecandra	5	5	3	6	4	5	4	3	6	6	47	7

Medicinal Plants Scoring the Highest Fidelity Level and Rank Order Priority Values

Of the medicinal plants used to manage human ailments in the district, Justicia schimperiana, Embelia schimperi, Olinia rochetiana and Euclea schimperi which have been used to treat liver disorders, tapeworm infections, general gastrointestinal complaints, and dermatological disorders, respectively, scored the highest fidelity level (FL) (100%) and rank order priority (ROP) (>81%) values (Table 7).

Table 7.

Rank order priority values of medicinal plants used to treat human ailments in the Kofale District with fidelity level values of above 80%

Medicinal Plant Spp.	Therapeutic Category	Np	N	FL (%)	RPL	ROP
Justicia schimperiana	Liver disorders	235	235	100.0	1.00	100.0
Embelia schimperi	Tapeworm worm infection	197	197	100.0	1.00	100.0
Olinia rochetiana	General gastrointestinal complaints	133	133	100.0	0.83	83.1
Euclea schimperi	Dermatological diseases	131	131	100.0	0.82	81.9
Aloe sp.	Hemorrhoids	260	320	81.0	1.00	81.0
Phytolacca dodecandra	Rabies	92	98	94.0	0.61	57.6
Withania somnifera	Evil spirit	65	75	87.0	0.47	40.8
Podocarpus falcatus	Epilepsy	50	62	80.6	0.39	31.2
Asparagus africanus	Cancer	44	52	84.6	0.33	27.5

Among the medicinal plants claimed to manage livestock health problems in the study district, Ekebergia capensis (for treatment of babesiosis), Datura stramonium (for treatment of rabies), and Millettia ferruginea (for treatment of leech infestation) had the highest fidelity level (FL) (>97%) and rank order priority (ROP) (97%) values (Table 8).

Table 8.

Rank order priority values of medicinal plants for livestock diseases in the Kofale District

Medicinal Plant Spp.	Therapeutic Category	Np	N	FL (%)	RPL	ROP
Ekebergia capensis	Babesiosis	73	73	100	1.00	100.0
Datura stramonium	Rabies	76	76	100	1.00	100.0
Millettia ferruginea	Leech infestation	72	74	97.2	1.00	97.2
Prunus africana	Wound	102	121	82.6	1.00	82.6
Maesa lanceolata	Dermatophilosis	62	76	82	1.00	82.0
Calpurnia aurea	Tick infestation	87	107	81.3	1.00	81.3
Bersama abyssinica	Equine glanders	44	46	95.6	0.75	72.1
Schefflera volkensii	Anthrax	28	33	85	0.54	46.0
Kalanchoe petitiana	Pasteurellosis	11	13	85	0.21	18.1

Informant Consensus Factor Values

Human and livestock ailments in the study district reported by informants were grouped into 12 major disease categories, and informant consensus factor (ICF) values were calculated. Accordingly, skin-related diseases scored the highest ICF value (0.97), followed by gastrointestinal tract infections (0.95), cancer (0.93), animal bites (0.92), hemorrhoids, and body swelling (0.91). Respiratory tract disorder category had the lowest ICF value (0. 62) (Table 9).

Table 9.

Informant consensus factor values of disease categories in study area

Diseases Category	Specific Ailment Reported	Use Citation (Nur)	Number of Species Used (Nt)	Informant Consensus Factor (ICF)
Skin-related diseases	Eczema, dandruff, lump rashes, skin lesion, ringworm, wound, wart, scabies, tick infestation, epizootic lymphangitis of horse	288	10	0.97
Gastro-intestinal tract infections and parasitic diseases	Abdominal pains, diarrhea, dysentery, typhoid fever, indigestion, stomachache, ulcers, vomiting, nausea, constipation, ascariasis, taeniasis	286	16	0.95
Cancer diseases	Breast cancer, throat cancer, skin cancers, tumor, other cancers	124	9	0.93
Animal bites	Poisoning, rabies, insect bites	76	7	0.92
Hemorrhoid, and body swellings		100	9	0.91
Liver diseases	Hepatitis, diseases of gallbladder, bile duct diseases, jaundice	75	9	0.87
Animal bacterial diseases	Anthrax, blackleg, glanders, Pasteurellosis	92	12	0.87
Endocrine & metabolic diseases	Diabetes, blood pressure, anemia heart diseases, hypertension	31	5	0.86
Musculoskeletal diseases & nervous disorders Arthritis	Bone fracture, rheumatism, epilepsy	28	5	0.85
Spiritual complications		29	7	0.78
Urogenital and reproductive disorders	Erectile dysfunction, syphilis, uterine infections, retained placenta, gonorrhea, abnormal menstrual cycle, infertility, breech position in pregnancy, dystocia labor	34	9	0.75
Respiratory tract-related problem	Asthma, chest pain, cough, pneumonia, tonsillitis.	9	4	0.62

Ways of Acquisition of Traditional Medical Knowledge

Traditional medicinal knowledge in the district was reported to have been acquired in different ways. Among the informants interviewed, 79.8% reported that they acquired knowledge through family lines, while the remaining (20.2%) confirmed that they acquired knowledge through observation (10.8%), mentorship with other traditional medicine practitioners (3.5%), experimentation (3.5%), and friends (2.4%).

Medicinal Plant Knowledge Comparison Between Different Social Groups

Interview data analyses showed that a significantly (p < 0.05) higher mean number of medicinal plants (6.52944 ± 0.1041) was reported by older informants (age > 60 years) compared to youngsters (20–40 years of age) (1.833 ± 0.1931) and those between the ages of 41–60 years (2.69603± 0.18031). Similarly, significantly (p < 0.05) higher mean numbers of medicinal plants were reported by illiterate (5.296 ± 3.0703) and traditional medicine practitioners (8.9058 ± 3.620) as compared with that of literate (3.6234 ± 3.122) and general informants (3.389 ± 1.661) (Table 10), respectively. But, there was no significant difference (p = 0.8789) between the mean numbers of medicinal plants reported by male (4.638 ± 3.252) and female (4.0714 ± 2.355) respondents.

Table 10.

Comparison of medicinal plant knowledge among different groups of informants

Demographic Features	Categories	No.	No. of Plants Reported (Mean ± SD)	P-value
Gender	male	360	4.638 ± 3.252	0.8789
	female	28	4.0714 ± 2.355
Age	20–40	86	1.833 ± 0.1931
	41–60	210	2.69603± 0.18031
	61–86	92	6.52944±0.1041	0.0001
Education	Illiterate	226	5.296 ± 3.0703	0.0001
	Literate	162	3.6234 ± 3.122
Experience	Traditional medicine practitioners	84	8.9058 ± 3.620	0.0001
	General informants	304	3.389 ± 1.661

Threats to Medicinal Plants and Conservation Practices

Agricultural expansion and deforestation are commonly cited threats to medicinal plants as reported by 91% and 80% of the informants, respectively. Other stated threats included drought (8%), timber and firewood production (11%), overexploitation (4%), and exotic species plantations (3%). The preference ranking exercise conducted by the informants also ranked agricultural expansion and deforestation as the major and leading threats (Table 11).

Table 11.

Ranking of commonly reported threats against medicinal plants in the study area

Major Treats	Informants Labelled K1 to K10										Total Score	Rank
	K1	K2	K3	K4	K5	K6	K7	K8	K9	K10
Deforestation	4	5	4	4	4	5	5	3	5	4	43	2
Agricultural expansion	5	5	4	5	5	4	5	5	4	5	47	1
Timber & firewood making	4	3	3	4	5	4	5	3	4	5	40	3
Plantation of exotic species	1	2	2	3	4	2	1	2	3	1	20	5
Over exploitation	2	4	3	3	3	2	2	1	2	2	24	4

Medicinal plant conservation practices in the study area were poor. Only a few informants (13%) reported the cultivation of medicinal plants, including Achyranthes aspera, Asparagus africanus, Ocimum lamiifolium, Rumex nepalensis, Ruta chalepensis, Withania somnifera and Aloe sp. in homestead gardens.

Ranking of Threatened Medicinal Plants

Preference ranking exercise, carried out on six threatened medicinal plants based on the interview results, revealed Hagenia abyssinica as the most threatened medicinal plant, followed by Juniperus procera and Podocarpus falcatus (Table 12).

Table 12.

Ranking of medicinal plants reported as threatened in the study district

Medicinal Plants List	Informants Coded A-J										Total Score	Rank
	A	B	C	D	E	F	G	H	I	J
Hagenia abyssinica	5	4	5	5	4	5	4	5	5	5	47	1
Juniperus procera	5	5	4	4	5	4	3	5	5	5	45	2
Podocarpus falcatus	5	4	5	4	4	5	3	4	4	5	44	3
Asparagus africanus	4	5	5	5	3	4	3	3	5	2	43	4
Withania somnifera	5	5	2	4	4	5	5	3	3	4	40	5
Cordia africana	4	2	4	5	3	4	2	5	4	4	37	6
Croton macrostachyus	3	2	2	1	3	2	1	3	1	1	19	7

Discussion

The findings of this study showed the high dependence of the people in the Kofale District of West-Arsi Zone on traditional herbal medicine in their day-to-day primary healthcare needs, as demonstrated by the high number of medicinal plant species reported by informants. In Kofale District, 106 medicinal plant species have been claimed to be used to manage both human and livestock ailments, which is a higher number than that reported for other districts in the country. Studies by Tolossa et al,²⁰ Ashagre and Molla,¹⁵⁸ Yineger et al,⁷¹ and Gijan and Dalle²⁸ reported the use of 91, 98, 101, and 102 medicinal plants, respectively. The utilization of a relatively high number of medicinal plants in the study district may be linked to people’s restricted access to modern healthcare facilities, cultural acceptability of medicinal plant-based treatments, and better vegetation cover in the area. All medicinal plants reported in the current study were found to have similar or different medicinal uses elsewhere in the country, as shown in Table 3. Of the total claimed medicinal plants, some were claimed to have been used elsewhere in the world for same or similar purpose, which include Asparagus africanus for treatment of tumor and cancer in Cote d’Ivoire,¹⁵⁹ Calpurnia aurea as antidermatophytic in Kenya,¹⁶⁰ Carissa spinarum against wound in India,¹⁶¹ Croton macrostachyus against cancer in India,¹⁶² Euclea schimperi against skin sores and rashes in Namibia,¹⁶³ Ocimum gratissimum as analgesic in Nigeria,¹⁶⁴ Physalis peruviana to treat gastro-intestinal tract disorders in Uganda,¹⁶⁵ Podocarpus falcatus to treat cancer in China,¹⁶⁶ Rumex abyssinicus to relieve stomachache in Africa,¹⁶⁷ Syzygium guineense to treat stomachache in Mali¹⁶⁸ and Verbascum sinaiticum against hepatitis in Egypt.¹⁶⁹

The dominance of the families Asteraceae, Fabaceae, and Solanaceae in contributing high number of medicinal plants in the study district could be due linked to their diversity in species and/or richness in medically active constituents. Fabaceae and Asteraceae are among the dominant families in the Flora of Ethiopia and Eritrea in terms of species richness contributing 486⁵⁰ and 440¹⁷⁰ species, respectively. Studies conducted in other areas of country have also reported a high contribution of Asteraceae,^74,125,171 Fabaceae^14,161–163 and Solanaceae¹⁴ to the medicinal flora.

The majority of claimed medicinal plants was collected from the wild and semi-wild habitats is in accordance with the results of other studies conducted elsewhere in different parts of the country.^{23,38,67,74,81,135} The poor cultivation practice of medicinal plants in the district might be related to their easy accessibility in the wild.

This study also shown that shrubs were the most dominant medicinal flora in the study district, which might be because of their year-round availability, in contrast to trees that were exposed to selective cutting and herbs that blossom seasonally after the rainy season. The dominance of shrubby medicinal plants has been observed in other parts of the country.^20,135,172

Leaves were the dominant plant parts employed in remedy preparations for the treatment of human and livestock ailments in the study district, which could be attributed to their perceived efficacy, accessibility, ease of harvesting, and simplicity of preparation. The common use of leaves in the preparation of remedies has also been reported in studies conducted elsewhere in the country.^{14,20,23,28,125} Harvesting leaves has been reported to have much less damaging effects on the mother plant as compared to other parts such as roots and barks, the gathering of which could seriously affect the existence of individual plants.^24,135

Different techniques were employed in the preparation of remedies in the district, with the crushing method taking the lead, which is in agreement with the results of previous studies conducted elsewhere in the country.^21,27 Moreover, the finding related to the condition of the plants used for preparation indicated that the majority of remedies were made from fresh plant parts, which is in agreement with the results of studies carried out elsewhere in the country.^173,174 Fresh materials retain volatile bioactive compounds, such as essential oils, which may be lost upon drying.

Oral was the most popular route of remedy administration which could be due to the reason that it creates favorable environmental condition for quick physiological reaction of the preparation against the pathogens and by so doing boosts its healing power.²⁰ Oral administration has an additional advantage in that it allows the traditional medicine practitioners to reverse complication that might happen on the clients during treatment using antidotes. Other ethnobotanical studies conducted elsewhere in Ethiopia also reported oral administration as a common route of remedy application.^{12,14,16,20,27,175}

Skin-related and gastrointestinal tract diseases had the highest ICF values, which might imply better consensus among informants in the study district regarding the selection of plants used to manage such diseases.^176,177

Of the medicinal plants employed to treat human health problems, Justicia schimperiana, Embelia schimperi, Olinia rochetiana and Euclea schimperi which were used to treat liver disorders, tapeworm infection, general gastrointestinal complaints, and skin diseases, respectively, scored the highest FL and ROP values, which are measures of therapeutic potential.³⁵ Justicia schimperiana was reported to have shown antioxidant,¹⁷⁸ lousicidal and acaricidal,¹⁷⁹ anticancer¹⁸⁰ and antimalarial¹⁸¹ activities. Crude extracts of Embelia schimperi exhibited anthelmintic¹⁸² and antioxidant properties.¹⁸³ Investigation reported the antibacterial,¹⁸⁴ antidiarrheal¹⁸⁵ and anti-inflammatory¹⁸⁶ activities of Olinia rochetiana. Leaf extracts of Euclea schimperi demonstrated antioxidant and antibacterial activities.¹⁸⁷ Generally, there is a higher consensus among informants in the study district regarding the selection of medicinal plants for the treatment of skin infections and gastrointestinal complaints, as revealed by the highest informant consensus factor (ICF) values scored by the two disease categories, which again is a sign of their better healing potential. Similar medicinal uses of these plants have been widely reported in different parts of the country.^{14,17,25,54,71,86,88,98,188} Among the medicinal plants claimed to manage livestock health problems, Ekebergia capensis and Datura stramonium which are used against babesiosis and rabies, respectively, scored the highest FL and ROP values. Previous studies have also reported the anti-infectious properties.^28,81

Data analysis revealed that older, illiterate, and key informants in the study district reported significantly higher mean numbers of medicinal plants than that reported by the young, literate, and general informants, respectively. The fact that the younger generation had less medicinal plant knowledge compared to the older generation could be due to the reason that the former are more prone to acculturation and modernization and thus are more reluctant to learn and practice traditional medicine. Studies conducted in other areas of the country also reported that older people have better knowledge of medicinal plants than younger people.^21,74,175 The reason that key informants had better knowledge of medicinal plants in the study district compared to general informants is also in agreement with the findings of previous studies conducted elsewhere in the country.^26,189 The fact that literate informants in the district had less knowledge of medicinal plants than illiterate ones could be attributed to the influence of modern education. A study conducted in other areas of the country reported similar results.¹¹⁸

Agricultural expansion and deforestation were identified as major threats to the survival of medicinal plants in the district. Research carried out elsewhere in the country also revealed that agricultural expansion and deforestation are main threats to medicinal plants.^28,60,94,190

Conclusion

The diversity of reported medicinal plants (106 species) employed to manage human and livestock disorders is indicative of plant-related rich knowledge of traditional medicine practices in the Kofale district. Leaves have been reported to be the most commonly utilized plant part in the preparation of remedies for the treatment of various ailments. Skin and gastrointestinal disorders were the major disease categories, with the highest ICF values. Medicinal plants, including Euclea schimperi, Olinia rochetiana, Embelia schimperi, and Justicia schimperiana, were the ones having the highest FL and ROP values for their use in the treatment of skin diseases, general gastrointestinal complaints, tapeworm infections, and liver disorders. Different scientific investigations also revealed the bioactivity of these plants against a number of aetiological agents. Comparative studies conducted on sociodemographic factors in the district revealed that older, illiterate, and key informants had better knowledge of the use of medicinal plants for the treatment of various human and livestock diseases than younger, literate, and general informants, respectively. In future phytochemical and pharmacological investigations, priority needs to be given to medicinal plants that scored the highest FL and ROP values and those plants that were used to treat disease categories with the highest ICF values.

Funding Statement

This study was sponsored by the School of Graduate Studies of Addis Ababa University and the Office of the Vice President for Research and Technology Transfer of Addis Ababa University (grant number TR/003/2021). We confirm that the information is accurate and the grant number is correct.

Data Sharing Statement

Data concerning this study were kept on a desktop computer at the Aklilu Lemma Institute of Pathobiology (ALIPB), Addis Ababa University (AAU). Readers may get access to the data through requests made to ALIPB. Plant voucher specimens were stored at the mini-herbarium of the Endod and Other Medicinal Plants Research Unit (ALIPB, AAU).

Ethical Consideration

The study proposal was evaluated and approved by the Ethical Review Committee of the Aklilu Lemma Institute of Pathobiology at the Addis Ababa University. Permissions were granted by the zone, district, and kebele administrations to conduct the fieldwork. Verbal consent was obtained from the study participants, which was also approved by the Review Committee. We confirm that our study complies with the Declaration of Helsinki.¹⁹¹

Disclosure

The authors report no conflicts of interest in this work.