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Origin지 Article Ethnobotanical survey and threats to medicinal traditionally used for the management of human diseases in Nyeri County, Kenya

Loice Njeri Kamau1,,* Peter Mathiu Mbaabu1, James Mucunu Mbaria2, Peter Karuri Gathumbi3, Stephen Gitahi Kiama1

‘Department of Veterinary Anatomy and Physiology, University of Nairobi, P.O Box 30197-00100, Nairobi, Kenya; Department of Public Health, Pharmacology and Toxicology, University of Nairobi, P.O Box 30197- 00100, Nairobi, Kenya; "Department of Veterinary Pathology, Microbiology and Parasitology, University ofNairobi, PO. Box 29053-00625 Nairobi, Kenya

ABSTRACT In Kenya, traditional knowledge on herbal medicine has remained a mainstream source of maintaining wellbeing for generations in many communities. However, the knowledge has been eroded in the course of time due to sociocultural dynamics virtually advanced by Christianity and formal education especially in the Kikuyu community. The study documented current ethnobotanical knowledge and threat to the traditional knowledge on medicinal plants among the Kikuyu community. A survey was carried out in Mathira, Tetu, Kieni, Othaya, Mukurweini, and Nyeri Town constituencies. Thirty practicing herbalists were purposively sampled; 5 per constituency. Data was obtained through semi - structured questionnaires and analyzed both qualitatively and quantitatively. A total of 80 ailments treated using 111 medicinal species distributed within 98 genera and 56 families were documented. Prevalent communicable diseases treated using herbal medicine included; gonorrhea (17.5%), malaria (15%), respiratory infections (12%), colds (10%) and amoebiasis (10%). Non-communicable diseases were; joint pains (11.1%), ulcers/hyperacidity (8.7%), high blood pressure (8.7%), intestinal worms (11.1%) and arthritis/gout (10%). Frequently harvested plant materials were; roots, barks and leaves. The study concluded that, traditional medicine practitioners in Nyeri County possessed wide knowledge of herbal medicine but this knowledge was on the verge of disappearing as it was largely a preserve of the aged generation. The study recommended massive campaign about the benefits of using herbal medicine in the study area. Further pharmacological studies are recommended on the mentioned plant species aimed at establishing their efficacy and safety as well as standardization as potential drugs.

Keywords traditional medicine, Kikuyu comunity, Nyeri County, Kenya

INTRODUCTION a mission in Nyeri in 1910. The mission established a primary school in 1924 which is today’s Nyeri High School and, several Traditional knowledge on herbal medicine has remained a other schools. Consolata hospital was established in the same mainstream source of maintaining wellbeing for generations in place in 1937 (Njoroge, 1999). To date, Nyeri County enjoys many communities (Kamboj, 2000). However, while many one of the highest literacy levels in Kenya (Kenya National communities in Africa are custodian of sophisticated plant Bureau of Statistics, 2013). The spread of Christianity and knowledge (Barrow, 1996), adoption of western culture has introduction of formal education brought about unprecedented caused rapid erosion of indigenous knowledge (Fratkin, 1996). changes (Sindiga et al., 1995). It came with a cost especially on The Kikuyu community which largely occupies central Kenya the loss of traditions which the missionaries considered had most of its culture eroded by western influence as a result barbaric. Missionaries were disdainful of African traditional of Christianity, colonialism and formal education (Sindiga et al., beliefs, attitudes and practices. They were guided by “counter 1995). During the colonial period, Nyeri County witnessed cultural” model of Christian-culture interaction based on the unprecedented early missionary establishment notably, assumption that Christianity and indigenous practices were Tumutumu Mission in 1908. This was followed by diametrically opposed and the latter would have to give the establishment of a hospital, school and a church by the Scottish way (Bevans, 1992). Particularly, use of traditional medicine Mission. The mission was a spring board and focal point of faced a major setback due to alleged association with witchcraft Christianity and education establishment in other parts of Nyeri and perceived potent of western medication. Consequently, use region (Presbyterian Church of East Africa, 2011). Similarly, of traditional medicine among other cultural practices was the Catholic missions particularly, Consolata fathers established condemned and prohibited among converts (Muraya, 2013). The effort of missionaries was boosted by colonial government *Correspondence: Loice Njeri Kamau which introduced the "Witchcraft Act" of 1925” outlawing E-mail: [email protected] traditional medicine in Kenya (Sleap, 2011). Moreover, Received March 22, 2016; Accepted May 18, 2016; Published establishment of hospitals alongside schools provided an August 31, 2016 alternative source of healthcare provision (Njoroge, 1999). doi: http://dx.doi.org/10.5667/tang.2016.0007 From the foregoing, the Kikuyu culture within which © 2016 by Association of Humanitas Medicine knowledge on traditional medicine is engrained was rendered This is an open access article under the CC BY-NC license. (http://creativecommons.org/licenses/by-nc/3.0/) amorphous. Nonetheless, the post-independence era witnessed TANG / www.e-tang.org 2016 / Volume 6 / Issue 3 / e21 1 Medicinal plants used in Nyeri County

Kikuyu community from Nyeri County grapple with high Study design and data collection prevalence of non-communicable diseases The study was a cross sectional survey, 30 practicing traditional (http://integratepc. org/ho spitals/kenya-only/) that defied medicine practitioners (TMPs) that willingly consented to conventional treatment approaches (Lucado et al., 2011). participate were purposively sampled (5 per constituency), Further, high incidences of ailments which were resistant to through the guidance of officers from Ministry of Culture and antibiotics (Laxminarayan and Heymann (2012) continued to Social Services. The criteria for selecting the target population challenge allopathic mode of treatment. This may have driven were guided by Cohen et al. (2000). According to the authors, a the community to seek alternative treatment methods, notably, sample of 30 respondents is the minimum sample size that can several herbal clinics were opened especially in urban centers reveal the full range or nearly full range of potentially in Nyeri, an indication that traditional medicine was gaining important opinions when seeking qualitative data as well as in acceptance in Central Kenya. However, future ethno working out statistical analysis in quantitative data. Inclusion therapeutic studies of traditional medicine used by the Kikuyu criteria were based on those TMPs that were born and practiced community from Nyeri County relied on the preservation and in the study area. Data collection involved interviews, protection from extinction, of traditional medicinal knowledge administration of pilot tested semi-structured questionnaire to engrained in the pre-colonial Kikuyu cultural heritage. World the TMPs, and transect walk. Interviews were conducted in the Health Assembly (1987) expressed the need for member native language (Kikuyu) and translated to English by a team countries to develop programmes for conserving cultural of trained research assistants. The respondents were assured of medicinal knowledge (Eloff, 1998). This endeavor could only confidentiality and that, any information volunteered would be be achieved through detailed documentation of ethnobotanical used for research purpose. Information collected from the knowledge of different communities. Njoroge and Bussmann TMPs included; demographic information, traditional (2006) and Bussmann and Njoroge (2007), documented herbal knowledge on herbal medicine (harvesting, processing, dosage, medicine for skin and, eye, ear and throat (ENT) around Mt. preparation, route of administration and toxicity) and Kenya and commonly sold herbs around urban centers in challenges in herbal medicine practice. central region of Kenya. Despite the reported rise in use of herbal health services in Kenya, little published data was Sample collection and identification available on traditional knowledge on herbal medicine used in Medicinal plants used to treat diseases that were mentioned by Nyeri County. The purpose of the current survey was to the TMPs during the interview were collected by a team of investigate and document comprehensively, traditional researchers from the University of Nairobi, research assistants medicinal plants used in the treatment and management of and TMPs. The plants were identified by a botanist and ailments in Nyeri County. voucher specimens were deposited at the University of Nairobi Herbarium. Information about; habit, habitat, plant part harvested and scientific name was recorded. MATERIALS AND METHODS Data an지 ysis Study area and ethnographic background Both qualitative and quantitative data were collected during the Nyeri County occurs in Central Kenya and it borders; Laikipia study. Qualitative responses were organized into themes while County to the North, Nyandarua to the West, Murang’a to the others were presented verbatim. Quantitative data from South, Kirinyaga to the East, and Meru to the North East (Fig. demographic information as well as quantified qualitative data 1). It is located between latitude 0.4167° S, 36.9500° E. At the were presented as proportions, percentages, pie charts and bar time of the study, it had a population of 693,558 (Male - 49%, graphs as well as analyzed using SPSS Version 20. The Female - 51%) occupying an area of about 3,337 km2. It is relevance of medicinal plant species among traditional divided into six constituencies; Tetu, Othaya, Kieni, Mukurwe- medicine practitioners was calculated using the formulae; UVs ini, Mathira and Nyeri town. The temperature ranges from an (total Use Value of the species for all informants) = (EUVis) / average annual minimum of 12°C to a maximum of 27°C and (ni); UVis is the Use Value of the species for a single informant receives rainfall amounts from 550 mm to 1,500 mm per and nis is the number of interviews by the informant (Hoffman, annum. The long rains starts on March and ends on May while 2007; Phillips and Gentry, 1993). the short rains sets in from October to December. Nyeri County leads nationally with a forest cover of 38.5% as compared to a national cover of 6.99%. The major geographical landscapes of RESULTS the County are Mount Kenya (5,199 m) and the Aberdare ranges (3,999 m) to the east and west, respectively; both are Majority of the Traditional Medicine Practitioners (TMPs) were densely forested with rich plant species diversity. Agricultural over 57 years (87%) and were of Christian faith (89%). Seventy activities are a source of livelihood and the most predominant seven percent (77%) had formal education out of which 55.6% economic activities include; tea and coffee which are grown for had undergone professional training and worked in the formal exports, large scale horticultural flower farming, greenhouse sector; however, 20% had since retired. Sixty seven percent farming by small scale vegetable farmers and dairy farming. (67%) combined herbal practice with other income generating The most predominant tribe is the Kikuyu community; others activities such as; business, farming, masonry and formal included the Kamba, Luo, Meru, Embu, Somali, and Borana. employment, the other 33% of the practitioners earned their Most of the people living in Nyeri County are of Christian faith. living from herbalism. The TMPs had long standing experience; Nyeri County has one level 5 hospital, three level 4, 18 level 3 89% had practiced for over 20 years, the other 11% between 6­ and 75 level two health facilities. It has three mission and three 10 years. They mainly practiced from their homes (78%); the private hospitals, one hospice, one nursing home and 228 other 22% had established a clinic at either Karatina, Mweiga private clinics which are spread across the County. The and Nyeri town. Additionally, they had acquired their skills in doctor/population ratio is about 1:6459 and a nurse/population herbal medicine through inheritance from parents and long­ ratio is 1:143. standing experience. Notably, there was no evidence of apprenticeship or organized structures of passing down

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Fig. 1. Map of Africa showing the location of Kenya and Nyeri County. Fig. 2. Commonly used plant parts of the medicinal plants. knowledge which they possessed. However, 67% had acquired were treated as one, like arthritis and gout and, ulcers and additional information from books, media and internet. Fifty hyperacidity (Table 1). For the TMPs to achieve a wholesome six percent (56%) had no formal training on herbal medicine effect they used a holistic treatment approach which included while 44% had attended a government and World Bank several herbs like; blood purifiers, appetizers, digestives and sponsored seminar. The attendees displayed a deep mastery of revitalizers and, nutritional vegetables such as stinging nettle appropriate herbal medicine practices during plant harvesting, and Macdonald’s eye. They combined 4-5 herbs in the preparation, storage, and dosage administration. They were treatment of one disease; some acknowledged using a cocktail aware of the group of patients that should be referred to of up to 20 herbs, thus the saying '“gutifi muti wa m仓mwe", medical practitioners for specialized treatment based on, age, which means “plant species never grow in isolation". sex and magnitude of sickness. Additionally, they learned The plants occurred in diverse habitats, 23.8% of the herbs management skills which included record keeping and financial were harvested either from the; bush, crop farms, compound or management. Besides uplifting their confidence and self­ boundary. The highest proportion of species growth form was esteem in the profession, the seminar had driven out fear trees (36%) followed by shrubs (32%), herbs (24%), liana (7%) among them. Eighty percent (80%) had registered as members and fungi (1%). Regularly harvested plant parts were the roots of the Nyeri Herbalists Association (NYETIPA) under the (34.1%), leaves (25%), bark (20%) and whole plant (9%) (Fig. Ministry of Culture and Social Services. A total of 80 ailments 2). In order to conserve medicinal plants, the TMPs obtained treated by TMPs were recorded, common communicable the bark by cutting longitudinal strips or a third of the roots per (infectious) diseases included; colds (53.3%), (50%), gonorrhea plant; others had developed botanical gardens in their farms (40%), respiratory infections (33.3%), intestinal worms where they grew trees like Prunus africana and Azadirachta (33.3%), and amoebiasis (10.0%) while non-communicable indica. diseases were; high blood pressure (43%), arthritis/gout (40%), Plant materials were washed and dried before grinding and wounds (40%), joint pain (33.3%), malaria ulcers/hyperacidity stored in water proof containers. Plant medicine was prepared (33.3%), stomachache (33.3%), male sexual dysfunction by boiling (80%), as an infusion (15%), inhalant or through (33.3%) and constipation/indigestion (33.3%). Some diseases dermal or nasal application (5%). Frequently used ■ Frequency of responses measurement unit was a glass/cup (equivalent to 250 ml) of herbal decoction or infusion taken twice or thrice daily, children took half the adult dose. Preparation was done by the TMP and therefore cases of over dosage were rarely reported, but when they did, the effects included; constipation/indigestion and vomiting which were treated by administering a laxative and anti-vomiting herb respectively. Notably, TMPs did not treat infants, pregnant women, very old people and emergency cases but referred them to hospital for specialized treatment. Plant toxicity was reportedly rare, however, 11% of TMPs acknowledged that, some herbs like; A^^o~na cherimola. Warbugia ugandensis, Aloe spp. and Senna didymobotrya caused toxic effects such as diarrhea, mild headache, stomachache and general body weakness . In particular, Neoboutonia macrocalyx caused kidney problems, Caesalpina volkensii and Acacia nilotica (L. Willd) reportedly caused blood thinning effect while Rhamnus prinoides and Prunus af"icana demonstrated diuretic effect. The TMPs neutralized plant toxicity by adding milk, fats, and bone soup and, by Fig. 3. Most common poisonous plant species among the Kikuyu combining with other plants such as, Rhamnus prinoides, community, Nyeri County. Periploca linearifolia, Carissa edulis, Rotheca myricoides,

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Fig. 4. Plant families with high proportion of medicinal plant species used in Nyeri County. prunus africana, Acasia nilotica or Tremma orientalis DISCUSSION depending on the plant type. Also, % a glass of Achyranthes aspera leaves and Ficus natalensis (roots or bark) was added to Majority of the herbalist were old, an indication that the the root preparation of Euclea divinorum, Senna didymobotrya practice was not being passed on to the young generation. This and Cyathula polycephala leaves, to counteract their laxative is similar to what was reported in other studies in Kenya effect. (Muthee et al., 2011; Wambugu et al., 2011). Most herbalists Notably, high level of knowledge in plants that are toxic to were of Christian faith; similar observation was made by both man and animals was observed among the TMPs. Plant(s) Muthee et al. (2011) in Loitoktok District. High level of that were not eaten by goats or those that produced a milky sap education among the TMPs was attributed to early introduction were considered to be poisonous to humans or animals. At least of education and Christianity by the missionaries (Sindiga et al., each TMP mentioned 3-5 toxic plants, this finding explained 1995). Lack of laid down structures to pass down knowledge why plant toxicity due to adulteration was reportedly rare; a contradicted Kamenju (2013), report which showed that, total of 12 plants were identified and documented (Fig. 3). Kikuyu traditional herbalists undertook the practice as a The TMPs displayed an in-depth knowledge on herbal profession and a means of livelihood and, they routinely passed medicine used to manage diseases in the Kikuyu community; the knowledge to the young generation. Besides uplifting their majority (67%) mentioned over 20 medicinal plants without confidence and self-esteem in the profession, information reference to their records. However, there was no significant acquired from organized seminar had driven out fear among relationship between level of education (p = 0.070) or age (p = those that had it instilled in them during the colonial period 0.889) and traditional knowledge of herbal medicine. A total of (Sindiga et al., 1995). Additionally, high rate of registration 111 medicinal plant species distributed within 98 genera and 56 with herbalists5 association was observed in other parts of families were documented (Table 1). Plant families with high Kenya, as reported by Muthee et al. (2011) among the Maasai numbers of medicinal plants were; Asteraceae (9.5%), herbalists which were practicing in Loitoktok District. (7.2%), Labiatae (6.3%), Solanaceae (5.4%) and As observed in the present study, respiratory infections and Caesalpinaceae (4.5%) (Fig. 4). Plants that showed a high arthritis have been cited in Tana River County (Kaluwa et al., “User Value” among the TMPs included; Prunus africana, 2014). Similarly, a study carried out by Bussman et al. (2006) Rotheca myricoides, Kigelia africana, Warbugia ugandensis, cited a high prevalence of sexually transmitted diseases, megalocarpus and Cordia abyssinica (Table 1). The malaria, gastro-intestinal disorders, parasitic ailments and TMPs from drier parts of the County in particular Kieni sub­ wounds among the Maasai of Sekenani. Use of polyherbals in county, possessed more information on traditional herbal the treatment of diseases is in agreement with Kamenju (2013) medicine and relied more on knowledge inherited from their view that, Kikuyu traditional herbalists5 treatment approach parents. aims at addressing the root cause of the disease. High usage of Despite their deep knowledge in traditional medicine, the shrub and herbs as reported in this study was in agreement with practice faced several challenges, 70% of the TMPs The present study revealed increased use of roots, similarly, acknowledged that, there was a general belief among members a high prevalence in harvesting of roots and bark was reported of the community that taking herbal medicine causes resistance among the Ilkisonko Maasai community (Kimondo et al., 2015). to modern drugs. Failure to complete prescribed dose was also But in a study carried out in India by Kumar and Bharati (2014), reported, especially when a large quantity of herb decoction it was observed that, leaves (33 instances) were the most was administered mainly because the patient presumed that it frequently used plant part. Although root harvesting threatens was an overdose. Other challenges included poor payment for plants species, conservation measures undertaken by the TMP services rendered by the TMPs and very high expectation from in the present study area were significant towards protection of the patients for immediate healing. the ecosystem. Measurement of the plant medicine using a cup /glass was also observed by Muthee et al. (2011). TMPs in the

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Table 1. Plants traditionally used in the management of human diseases in Kenya Plant Family Botanical name Therapeutic uses Kikuyu Ppua Preparation Growth Habitat Ncsb Use and Voucher name forms Value number (UVs) Acanthaceae Thunbergia alata Tonsils, Kanyanja Leaves Decoction Vine Bu 2 0.06 Bojer ex Sims hemorrhagia and /Herb LNM14/103 postpartum bleeding Acanthaceae Justicia Pain Numa Leaves decoction Herb Bu, Cp 1 0.03 diclipteroides Lindau LNM14/76 Aloaceae Aloe kedongensis Clear pimples, Mugwanugu Leaves Sap Herb Cp, Bu 3 0.1 Reynolds acne LNM14/84 Aloaceae Aloe lateritia Muscle Kiiruma Leaves Sap Herb Cp, Bm, 1 0.03 Engl. LNM14/32 inflammation or Bu elephantiasis Amaranthaceae Achyranthes Wounds (blood Mutegenye Leaf Use sap or Shrub Bu 1 0.03 aspera L. coagulation) / /Kamutegen pound to LNM14/117 used to clean ye obtain the wounds juice Anacardiaceae Rhus natalensis STDs, fibroids Muthigiu Stems Infusion Tree Bu, Cp, 2 0.06 Bernh. and colds Roots ex Kraus Leaves LNM14/96 Bark Annonaceae Annona Cancer Mutomoko Bark Decoction Tree Cf 1 0.03 cherimola Mill. LNM14/53

Apocynaceae Carissa edulis STD polio Mukawa Leaves Decoction Shrub Bu, Cp 8 0.27 (Forssk.)Vahl arthritis/gouts, Bark LNM14/24 energizer, stomach ache, malaria, coughing / cold, Male sexual stimulant Araliaceae Cussonia holostii Wounds, high Muroha Bark Decoction Tree Bu, Cf； 6 0.2 Engl. blood pressure, Cp, Bm LNM14/45 irregular menstrual cycle, uterine cleansing, fibroids, Asclepiadaceae Mondia whitei Appetizer, Muhukura Roots Decoction Liana Bu, Cf, 6 0.2 (Hook f.) Skeels stomach Bark added to soup Cp, LNM14/44 problems, deworming, hyperacidity/ulcer s, male sexual stimulant, kidney cleansing, malaria. Asclepiadaceae Periploca Colds and STDs Mwemba- Roots Sap Liana Bu, Bm 2 0.06 linearifolia Dill. iguru & A. Rich. LNM14/06 Sonchus Constipation, Muthunga Roots Decoction Herb Cf 3 0.1 Asteraceae oleraceus L. stimulate Leaves LNM14/02 digestive system, cancer Asteraceae Tagetes minuta L. Wounds, toothe Mubangi Root Crushed, Herb Cf 5 0.17 LNM14/48 ache, insect bite Stem Chew Leaves Asteraceae Bidens pilosa L. Conjunctivitis, Muhehenje Root decoction Herb Cf 5 0.17 LNM14/49 malaria, kidney /Mucheege cleansing Asteraceae Vernonia Stomach ailments, Muthakwa Roots Decoction, Shrub Bu, Cf, 5 0.17 auriculifera insect repellant, Leaves whole leaves Cp, LNM14/40 intestinal worms, dysentery Asteraceae Galinsonga Measles, tonsils, Mung’ei Whole Chew leaves Herb Cf 4 0.13 parviflora Cav. colds, asthma plant Decoction LNM14/08

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Asteraceae Launaea cornuta Constipation and Muthunga Roots Decoction Herb Cf 3 0.1 (Hochst. ex Oliv. cancer Leaves & Hiern) C. Jeffrey LNM14/03 Asteraceae Vernonia Malaria, Muchatha Roots decoction Shrub Bu 3 0.1 lasiopus deworming, male O.Hoffm. stimulant, restore LNM14/23 periods in women Asteraceae Psiadia Male sexual Mubai or Roots Decoction Shrub Bu, Cf； 5 0.06 punctulata (DC.) stimulant muenda Oliv. & Hiern ngueko LNM14/90 Asteraceae Bersama Epilepsy and male Murumandu Leaves Chew Tree Bu, Cp 2 0.06 abyssinica sexual stimulant Root Decoction Fresen. LNM14/95 Asteraceae Aspilia pluriseta Diarrhea Muuti Roots Decoction Herb Bu 1 0.03 Schweinf. ex Engl. LNM14/110

Asteraceae Vernonia Stomach Kagutu Leaf decoction 1 0.03 brachycalyx O. evacuation Hoffm. LNM14/111 Asteraceae Spilanthes Toothache Gatharia ita Flower Chew Herb Bu 1 0.03 mauritiana s (A.Rich. ex Pers.) Roots DC. LNM14/30 Bignoniaceae Kigelia africana Gonorrhea, Muratina Leaves Decoction Tree Bu, Cf, 15 0.5 (Lam.) Benth. sphyllis, drugs / Bark Cp, Bm LNM14/33 bhang addiction, Fruit jaundice, madness, cataract, blood cleanser, high blood pressure, hydrocephalus, measles, hemorrhagia and postpartum bleeding______Bignoniaceae Markhamia lutea Toothe ache Muu Bark Chew Tree BM, Bu, 1 0.03 (Benth.) K. (mouth wash Cp, Cf Schum. before bed) LNM14/120 Boraginaceae Cordia africana Joints, typhoid, Muringa Bark Decoction Tree Bu, Cf, 12 0.4 Lam. high blood Cp, Bm LNM14/123 pressure, antitumor, chest infection, and cardiac stimulant.

Boraginaceae Ehretia cymosa Wounds and male Murembu Bark Decoction Tree Bu, Cf, 2 0.06 Thonn. sexual stimulant. Sap Cp, LNM14/94 Burseraceae Commiphora Clean teeth, snake Mukungugu Bark Decoction Tree Cf, Cp, 3 0.1 eminii Engl. bite Stem LNM14/74 Root Caesalpinaceae Senna Intestinal worms, Mwinu / Leaves Decoction Shrub Cp, Bu 9 0.3 didymobotrya antifungal, burns, Muinu (Fresen.) Irwin & bleeding gums, Barneby tooth ache, LNM14/39 typhoid, amoebiasis and stomache evacuation. Caesalpiniacea Caesalpinia Headache / Muchuthi Seeds crush to form Liana Bu, Cf, 6 0.2 e volkensii Harms migraine (Njuthi)/ Roots a paste Cp, LNM14/43 energizer, malaria, mubuthi joints Caesalpiniacea Senna Gonorrhea, Muchingiri Root Decoction shrub Bu 3 0.1 e septemtrionalis syphilis, intestinal

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(Viv.) H. Irwin & worms Barneby LNM14/70 Caesalpiniacea Caesalpinia Clean teeth Mubaage Stem Stem cutting Shrub Bu 1 0.03 e decapetala (Roth) Alston LNM14/112 Arthritis / gouts, Muthiga Bark Decoction Tree Bu, Cf； 14 0.47 ugandensis tooth ache, Root Cp, Bm Sprague stomach Leaves LNM14/34 7 problems, malaria, respiratory diseases e.g. colds, asthma, chest pain, AIDs, cancer, anthrax Capparaceae Maerua triphylla Headache and Mukuri- Root Decoction Shrub Bu 3 0.1 LNM14/81 migraine undu Capparaceae Capparis Arthritis, Muri umwe Bark Decoction or Tree Bu 1 0.03 tomentosa Lam. inflammation / cover the LNM14/71 elephantiasis, inflamed joint pain tissue with bark for 15 minutes). Caricaceae Carica papaya L. Skin fungal Mubabae Unripe Juice Tree Cf 1 0.03 LNM14/46 infection fruit

Celastraceae Hippocratea Sexual stimulant Mung'aang' Bark Decoction Liana Bu 2 0.06 africana Loes. ex in men, drying of a Roots Engl. LNM14/93 wounds and STDs Celastraceae Maytenus Diarrhea Muthuthi Roots Decoction Tree Bu 2 0.06 heterophylla (Eckl. & Zeyh.) LNM14/104 Celastraceae Elaeodendron Wounds Mutanga Roots Grinded Tree Bu 1 0.03 buchananii Loes. LNM14/116 Chenopodiacea Chenopodium Gonorrhea Muiganjo Bark Decoction Herb Bu, Cp 1 0.03 e opulifolium Root Schrad. ex W.D.J. Koch & Ziz LNM14/109 Crassulaceae Kalanchoe Tooth ache Mahuitia / Leaves Heat over the Shrub Bu 1 0.03 marmorata Baker Mukondori fire and place or K. densiflora on the Rolfe. LNM14/31 inflamed or swollen muscle Cucurbitaceae Coccinia Syphilis Kagerema Leaves Decoction Vine Bu 1 0.03 trilobata (Cogn.) C. Jeffrey LNM14/108 Dracaenaceae Dracaena High blood Ithare Bark Decoction Tree Bu, Cp 2 0.06 steudneri pressure Root Schweinf. ex Engl. LNM14/11 Ebenaceae Euclea divinorum Diarrhea, typhoid Mukinyai Root Infusion Tree Bu, Cf, 3 0.1 Hiern and Decoction Cp, LNM14/73 stroke Euphorbiaceae Croton Influenza, Mukinduri Bark Decoction Tree Bu, Cf, 12 0.4 megalocarpus pneumonia, Leaves Cp, Bm Del. wounds, family LNM14/35 planning amoeba / protozoa, typhoid, over-bleeding during menstruation cycle and birth

Euphorbiaceae Neoboutonia Coughing / cold, Mutundu Bark Decoction Tree Bu, Cf, 9 0.3 macrocalyx Pax chest, wounds, Roots Cp, Bm LNM14/38 family planning,

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high blood pressure, cardiac problem / hypertrophy, cholesterol, chicken pox Euphorbiaceae Synedenium AIDs, warts and Watha Leaves Decoctionor Shrub Bu, Bm 3 0.1 compactum N. E. joints Milky sap, Br. Ash from the LNM14/77 bark Euphorbiaceae Ricinus Gouts and family Mwariki Root Root Shrub Cf 2 0.06 communis L. planning /Mbariki Seeds decoction LNM14/98 3 drops of oil Euphorbiaceae Tragia brevipes Male sexual Njegeni Roots Roots sap Herb Bu, 2 0.06 Pax. LNM14/100 stimulant and applied on parturition penis Decoction

Euphorbiaceae Bridelia Gastrointestinal Mukoigo Bark Decoction Tree Bu 2 0.06 micrantha worms (Hochst.) Baill. LNM14/106

Euphorbiaceae Acalypha Wounds MUng'aria Roots Sap Shrub Bu 1 0.03 Volkensii Pax LNM14/115 Euphorbiceae Euphorbia Respiratory Kariaria Roots Decoction Shrub Bu, Cp, 2 0.06 gossypina (Pax) diseases, leukemia Stem Bm LNM14/86 and energizer Leaves Flacourtiaceae Trimeria Arthritis / gouts, Muhindahin Roots Decoction Shrub Bu, Cp 4 0.13 grandifolia hyperacidity / di (Hochst.) Warb. ulcers, joints LNM14/56 Flacourtiaceae Dovyalis Gonorrhea Mukambura Bark Decoction Shrub Bu, Cf； 4 0.13 abyssinica A. syphilis, Leaves Cp, Rich LNM14/58 constipation / Roots indigestion, fibroids Gramineae Digitaria Gonorrhea, Thangari Root Decoction Herb Cf, Cp, 2 0.06 scalarum Chiov. candidiasis Bu LNM14/102 Gramineae Saccharum Fibroids Kigwa Stem Juice Herb Cf 1 0.03 officinarum L. Gramineae Pennisetum Kidney cleansing Witima Roots Decoction Herb Cp, Bu, 1 0.03 clandestinum Hochst. ex Chiov. LNM14/78 Guttiferae Hypericum AIDs Muthathum Leaves Decoction Tree Bu 1 0.03 revolutum Vahl. wa LNM14/40 Hydnoraceae Hydnora High blood Muthigira Roots Decoction Herb Bu, Cf, 4 0.13 abyssinica pressure, diarrhea, Rhizo Cp, Schweinf. expel after birth, me LNM14/17 hemorrhagia and postpartum bleeding Hypericaceae Harungana Malaria and Muitathua Roots Decoction Shrub Bu, 2 0.06 madagascariensis stimulate growth Lam. ex Poir. of mammary LNM14/92 glands Hypocreaceae Engleromyces Colds and Kieha kia Whole Decoction Fungi Bu, Bm 2 0.06 goetzei P.Henn. pneumonia murangi plant LNM14/87 Labiatae Ajuga remota. Colds, malaria Wanjiru wa Leaves Decoction Herb Bu, Cp 7 0.23 Benth AIDs tooth ache, kieni Roots LNM14/42 high blood pressure amoeba / protozoa Labiatae Leonotis Goiter, intestinal Muchii Leaves Decoction Shrub Bu 4 0.13 nepetifolia (L.) R. worms, Br. LNM14/63 conjunctivitis, irregular menstrual cycle Labiatae Plectranthus Stomach problem, Maiguya Leaves Decoction Shrub Bu, Cf, 3 0.1

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barbatus tooth ache, Cp, Bm Andrews constipation forskohlii LNM14/67 Labiatae Ocimum Respiratory Makuri Leaves Decoction Shrub Bu, Cf； 3 0.1 kilimandscharicu diseases Cp, m Guaerke insect repellant LNM14/68 Labiatae Ocimum Headache / Mukandu Bark Decoction, Shrub Bu 3 0.1 gratissimum L. migraine, Leaves Infusion LNM14/80 Gonorrhea, colds Labiatae Fuerstia africana Gonorrhea Gathiriga Leaves Decoction Herb Bu 1 0.03 T.C.E.Fr. LNM14/105 Lauraceae Persea Bleeding gums, Mukorobia Seed Seed Tree Cp 4 0.13 Americana diarrhea, high Leaves (infusion, Cf Mill. LNM14/19 blood pressure, Fruit Leaf diuretic, typhoid peels decoction Peel decoction Liliaceae Aloe secundiflora Pneumonia, Thukurui Leaves 3 drops per Herb Bu, Cp 10 0.33 Engl. constipation, glass LNM14/36 malaria, fibroids, AIDs, wounds (apply sap) Loganiaceae Strychnos Arthritis / gouts, Muteta Root decoction Shrub BuCf, 6 0.2 henningsii Gilg back or joint pain, Bark CpBm LNM14/47 pain / fatigue, malaria, respiratory diseases Malvaceae Sida tenuicarpa Gonorrhea, Kahinga Roots Decoction Shrub Bu, Cf, 4 0.13 Vollesen diarrhea and Cp, LNM14/57 toothache. Malvaceae Pavonia urens Hyperacidity and Machuna Leaves Decoction Shrub Bu, Cp, 2 0.06 Cav. tooth ache LNM14/89 Malvaceae Hibiscus fuscus Stomach Mugere Roots Decoction Shrub Bu 1 Garcke evacuation due to food poisoning / afflatoxins Meliaceae Ekebergia Pneumonia, Mununga Bark Decoction Tree Bu, Cf, 3 0.1 capensis Sparrm. induce aggressive Leaves LNM14/75 actions, colds and coughing Meliaceae Melia volkensii Malaria Mwarubaini Bark Decoction Tree Bu, Cp, 1 0.03 Gurke LNM14/59 Leaves Mimosaceae Mimosa pudica Asthma Mukua- Root decoction Herb Cf, Cp, 1 0.03 L. LNM14/113 tuhu / Bu Mwikuithia

Moraceae Ficus thonningii Intestinal worms, Mugumo Bark decoction Tree Cf 4 0.13 Blume colds, dysentery Leaves LNM14/55 Moraceae Ficus lutea Vahl Skin fungal Mumbu Leaves Milky sap Tree Bu 1 0.03 LNM14/83 infection

Moringaceae Moringa oleifera Arthritis / gouts, Moringa Seeds Chew seed, Tree Cf, Cp 4 0.13 Lam. loss of memory, Leaves Leaf LNM 14/28 prostate cancer, decoction high blood pressure Musaceae Musa sapientum Gonorrhea Ngoro ya Inflore Decoction Tree Cf 1 0.03 L. LNM14/107 irigu scence (flower ) Myricaceae Myrica salicifolia AIDs Muthongoya Bark decoction Shrub Bu 1 0.03 Boj. ex Baker Roots LNM14/99 Myrsinaceae Myrsine Intestinal worms, Mugaita Fruits Decoction Shrub Bu, 4 0.13 africanum L. Cancer Bark LNM14/26

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Myrtaceae Eucalyptus Asthma, Mubao wa Bark Decoction, Tree BuCpBM 3 0.1 globilus Labil. pneumonia, cold, white Leaves Infusion LNM14/82 sinuses, epilepsy, high blood pressure (bark) Myrtaceae Callistemon Tooth ache Bottle brush Leaves Boil Tree Cp 1 0.03 viminalis (Gaertn.) G.Don ex Loudon LNM14/119 Oleaceae Olea africana L. Intestinal worms, Mutero / Stem Decoction Tree Bu, Cf； 6 0.2 LNM14/27 high blood Mutamaiyo Root Cp, Bm pressure, amoeba / Bark protozoa, joints

Oleaceae Olea hochstetteri Gonorrhea, Mucharage Bark Decoction Tree Bu 3 0.1 Bak. syphilis, Stem LNM14/69 colds, intestinal worms

Oleaceae Schrebera alata Tooth ache Muga nyoni Bark Chew Tree Bu, Cp 1 0.03 (Hochst.) Welw. Twig LNM14/41 Papilionaceae Erythrina Gonorrhea, Muhuti Roots Decoction Tree Bu, Cf, 3 0.1 abyssinia DC sphyllis, arthritis / Bark Cp, LNM14/72 gouts Phytolacaceae Phytolacca Hyperacidity, Muhoko Leaves Powder Liana Bu, 2 0.06 dodecandra L jigger repellant Decocotion Her. LNM14/91 Polygonaceae Oxinum sinuatum STDs, candidiasis Cong’e Roots Decoction Herb Cf, Cp 4 0.13 LNM14/52 Polygonaceae Rumex Pneumonia Muguagua Stem Crushed/chew Herb Bu, Cf 1 0.03 abyssinicus Jacq. /Mugagatiu LNM14/114 Ranunculaceae Clematis hirsuta Colds, kidney Mugaya- Leaves Inhale Shrub Bu 3 0.1 Guill. & Perr. cleanser ng’undu Roots crushed LNM14/10 leaves or roots Rhamnaceae Rhamnus Arthritis / gouts, Mukaraking Leaves Decoction Shrub Bu, Cp 7 0.23 prinoides L. appetizer, a Roots He’rit constipation / Bark LNM14/18 digestive system, hyperacidity / ulcers, high blood pressure, male sexual stimulant, anthrax Rhamnaceae Rhamnus staddo Kidney cleansing, Ngukura Roots Decoction Shrub Bu 2 0.06 A. Rich malaria added to soup LNM14/101 Rosaceae Prunus africana Animal protein Muiri Bark Decoction Tree Bu 17 0.57 (Hook .F.) allergy, STD, Leaves Cf Kalkm. arthritis / gouts, Cp LNM14/20 blood purifier / Bm cleanse, appetizer, prostate, arthritis, stomach 10 problems, constipation, malaria hyperacidity / ulcers, fibroids, joints, renew memory Rubiaceae Galium aparine STDs and kidney Gakaraku Leaves Decoction Herb Cf, Bu 2 0.06 L. cleansing LNM14/85 Rubiaceae Vangueria Stimulate Mubiru Roots Decoction Tree Bu 1 0.03 madagascariensis digestion J. F. Gmel. LNM14/61 Rutaceae Zanthoxylum Toothache and Muheheti Bark, Decoction, Tree Bu, Cf, 9 0.3 usambarense cleaning teeth, Stem Chew Cp, Bm

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(Engl.) malaria, chest LNM14/37 11 problems: colds, coughing, asthma Rutaceae Toddalia asiatica Colds, respiratory Mururue Leaves Decoction Tree Bu, Cf； 4 0.13 (L.) Lam. diseases, e.g. cold, Cp, Bm LNM14/60 asthma or chest pain, tooth ache Rutaceae Clausena anisata Toothe ache Mutathi Leaf Decoction Tree Bu 1 0.03 Hook.f., De Wild. (mouth wash Root & Staner before bed) LNM14/121 Solanaceae Solanum Whooping cough, Mutura Roots Decoction Shrub Bu, Cf, 5 0.17 aculeastrum wounds and male (mugandura Fruits Cp, Bm Dunal sexual stimulant anake) LNM14/51 (Ndura/fuit) Solanaceae Solanum incanum Anti-vomiting, Mutongu Roots Decoction Shrub Bu, Cf, 4 0.13 L. stomach Cp, LNM14/62 11 problems, hyperacidity, dyspepsia Solanaceae Solanum nigrum Nausea, high Managu Leaves Decoction Herb Cf 3 0.1 L. blood pressure, LNM14/29 arthritis/gouts Solanaceae Withania Hyperacidity/ulce Murumbae Flower Decoction Shrub Bu, Cf, 2 0.06 somnifera (L.) rs s Cp, Dunal LNM14/97 Solanaceae Physalis Hyperacidity Munathi Whole Decoction Herb Bu 1 0.03 peruviana L. plant LNM14/65 Sterculiaceae Dombeya Stops bleeding Mukeu Leaves Sap Shrub Bu 1 0.03 burgessiae Gerr. (clotting effect) Stem ex Harv. LNM14/118 Ulmaceae Trema orientalis Asthma Muhethu Roots Decoction Tree Bu 1 0.03 (L.) Blume. LNM14/64 Urticaceae Urtica masaica Arthritis / gouts, Hatha Roots, Decoction Herb Cf, Bu 3 0.1 Mildbr. high blood /Thabai Leaves LNM14/12 pressure, sexual stimulant, joint pain, Verbenaceae Rotheca Kidney cleansing, Munjuga- Roots Decoction Shrub Bu, Cf, 15 0.5 myricoides gonorrhea, iria (Boil) Cp, Bm (Hochst.) Vatke syphilis, STD, LNM14/09 headache / migraine, pneumonia, prostate cancer, constipation / indigestion, malaria, hyperacidity / ulcers, amoeba, typhoid, joints, brucellosis Verbenaceae Lantana camara Headache / Karendi / Leaves Crush sniff Shrub Bu 3 0.1 L. migraine, athletes Mukigi decoction Cf, Cp LNM14/66 foot, sun burn Bm Vitaceae Rhoicissus Remove after Ndurutua Roots Decoction Liana Bu 1 0.03 11 tridentata birth (L.f.) Wild & Drummond LNM14/54 Bu-bush, Cf- Crop field, Cp-Compound and Bm-Boundary marker Ppua- Part of plant used, Ncsb- Number of citation present study did not treat some groups of patients, the findings depth knowledge on herbal medicine; similar findings were contradicted the perception and attitude by pregnant women in reported from Samburu County and Sekenani valley in Maasai Nigeria who believed that, herbal medicine was safe (Fakeye et Mara (Bussman, et al., 2006; Nanyingi et al., 2008). In the al. (2009) however, it was in agreement with the report by present study, family Asteraceae had the highest citations of Muthee et al. (2011). medicinal plants, this finding concurred with that of Malik et al. The present study revealed that, the TMPs possessed in- (2015) in a study carried out in Northern Punjab. As indicated

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Table 2. Cross-reference of most cited medicinal plants using existing literature Botanical name and Ncsb Therapeutic uses Chemical constituents plant family Prunus africana 17 It has antimicrobial activity (Mwitari et al., 2013) It contains tannins, saponins, flavonoids, terpenoids, (Hook .F.) (Rosaceae) against Salmonella typhi, Proteus vulgaris, Serratia glycosides, alkaloids and phenols (Mutuku et al., marscecens, Escherichia coli and Bacillus cereus 2014) (Mutuku et al., 2014). Kigelia africana (Lam.) 15 It has antiplasmodial (Zofou et al., 2012) and It contains glycosides, phenolics, alkaloids, flavonoid Benth. (Bignoniaceae) hepatoprotective activity (Olaleye and Rocha, 2008). and cardiac glycosides (Abdulkadir et al., 2015) Rotheca myricoides 15 It has antiplasmodial activity (Muthaura et al., 2015) It contains alkaloids, terpernoids and flavonoids (Hochst.) Vatke (Jeruto et al., 2010) (Verbenaceae) 14 It has antimicrobial (Mwitari et al., 2013) and It contains alkaloids, terpenoids, flavonoids and Sprague (Canellaceae) antiplasmodial activity against Plasmodium knowlesi terpenes (Were et al., 2015). and Plasmodium berghei (Were et al., 2010). Cordia africana Lam. 12 It has antibacterial activity against Bacillus subtilis and It contains coumarins, saponins, sterols, flavonoids (Boraginaceae) Staphylococcus aureus and, antifungal activity against and triterpenes (Emtinan et al., 2015). Apergillus niger and Candida albicans (Emtinan et al., 2015). 12 It contains alkaloids, glycosides, saponins, steroids, Del. flavones and catecholics (Waiganjo et al., 2013) (Euphorbiaceae) Aloe secundiflora Engl. 10 It contains aloenin which has antiviral (Waihenya et It contains anthrones (aloenin, isobarbaloin, aloenin B (Liliaceae) al., 2005) and nematicidal activity against Ascaridia and barbaloin), chromones and phenylpyrones galli ( Kaingu et al., 2013) (Rebecca et al., 2003). Senna didymobotrya 9 It has antimicrobial activity against Streptococcus It contains steroids, saponins, flavonoids, tannins, (Fresen.) Irwin & pyogenes, Escherichia coli and Proteus vulgaris phenols, steroids, cardiac glycosides (Ngule et al., Barneby (Ngule et al., 2013). 2013), terpenoids, anthraquinones, tannins and (Caesalpinaceae) alkaloids (Nyamwamu et al., 2015). Neoboutonia 9 It has antiplasmodial activity (Fabrice et al., 2009). It contains cycloartane triterpenes and phenanthrene macrocalyx Pax (Namukobe et al., Namukobe), steroids and (Euphorbiaceae) diterpenoids (Kirira et al., 2007). Zanthoxylum 9 It has anti-inflammatory, antibacterial (Matu and van It contains alkaloids (Atsushi et al., 1995). usambarense (Engl.) Staden, 2003) and antiplasmodial activity against (Rutaceae) Plasmodium knowlesi and Plasmodium berghei (Were et al., 2010). Carissa edulis 8 It has anti-inflammatory, diuretics, hypotensive It contains saponins, cardiac glycosides and terpenoids (Forssk.)Vahl (Hanan and Wafaa, 2012) and antibacterial activity (Ngulde et al., 2013). (Apocynaceae) against Salmonella typhi, Shigella dysenteriae and Streptococcus pyogenes (Ngulde et al., 2013). Ncsb - Number of citations in the present study, Njoroge (2012) had reported Prunus information about treatment various ailments affecting its africana and Strychnos henningsii as frequently used herbs in community; despite lack of clientele. The documented plants Central Kenya. TMPs from drier parts of Nyeri County had medicinal potential; the most cited herbal medicines demonstrated deeper knowledge in medicinal plants and contained common phytochemical compounds such as; reported increased use of herbal medicine by the TMPs. Over terpenoids, flavonoids and saponins and demonstrated reliance on medicinal plants was reported in other drier regions pharmacological activities such as antimalarial, antibacterial like Samburu and Tana River Counties which had fewer and antifungal activities. Therefore the study recommended medical facilities (Nanyingi et al., 2008, Kaluwa et al., 2014). massive campaign about the benefits of herbal medicine in The most cited medicinal plants demonstrated various order to promote their use. Further research on efficacy and pharmacological activities as well as phytochemicals (Table 2). safety of the documented herbs was encouraged with the aim of Major challenges facing demand for the services from developing drugs that can be used to treat and manage various TMPs in Nyeri County was attributed to poor perception diseases. towards herbal medicine. A study carried out in Thika and Nairobi by Njoroge (2012), showed that, “part of the local populations still holds TMPs with suspicion, erroneously ACKNOWLEDGEMENTS perceiving them as “witchdoctors”. In a study carried out in The author(s) acknowledge funding from “Carnegie Murang’a, 20 % of patients didn’t believe that herbal medicine Cooperation”， through “Regional Initiative in Science work while 16% said they didn’t like it (Mwangi and Gitonga, Education - African Natural Product Network (RISE - 2014). This was in contradiction with the upward trend in the AFFNET)”. They also acknowledge technical support from Mr. use of traditional herbal medicines observed in other parts of Mutiso in the identification of plant specimen and Nyeri Kenya (Mboya, 2003). herbalists for willingly sharing in-depth traditional knowledge on plant medicine.

CONCLUSION CONFLICT OF INTEREST The study concluded that; the current cohort of traditional medicine practitioners from Nyeri County possess vast The authors declares that there is no conflict of interest

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