Traditional phytotherapy remedies used in Southern Rwanda for the treatment of liver diseases.

ETHNOPHARMACOLOGICAL RELEVANCE Liver diseases represent a major health problem due to their complications and limited treatment possibilities. In Rwanda, given low accessibility to modern treatments, most people still rely on traditional medicinal plants. The symptomatology of many hepatic troubles (icterus) is evident for traditional healers who have a high probability of selecting efficient herbal medicines. OBJECTIVES To document medicines used in the treatment of "hepatitis" in Southern Rwanda with the knowledge, attitudes and practices related to liver disorder recognition, control and treatment. MATERIALS AND METHODS 56 traditional health practitioners, each a legal representative of an official association, were interviewed and participated in plant collection for the preparation of botanically identified herbarium specimens. RESULTS 68 multi-component and 65 single-component herbal recipes were identified for the treatment of liver diseases with a total of 86 different herbs from 34 families identified. The most represented were the Asteraceae and the Lamiaceae. Crassocephalum vitellinum, Hypoestes triflora and Erythrina abyssinica were the most widely used plants. The principle of polymedication for complex (i.e. multifactorial) diseases ("Ifumbi" in Rwanda), is a constant in every traditional practice. It is striking that the Rwandese therapy of liver diseases proposes so many single-herb preparations (49% of all herbal preparations). Some of the recorded plants or other species from the same genus have previously been documented for liver protection using various in vivo and in vitro models. CONCLUSION Herbal remedies for hepatitis are widely used and highly diverse in Southern Rwanda; further chemical, pharmacological and toxicological studies are clearly required to rationally develop the most important remedies.