title: Medicinal plants used to treat the most frequent diseases encountered in Ambalabe rural community, Eastern Madagascar.
abstract: BACKGROUND
  Traditional medicine remains the only health care available in many rural areas in Madagascar like the rural community of Ambalabe, located in a very remote area in the eastern part of the country. With limited access to modern medicine, the local population uses medicinal plants to treat most diseases. In this study, we aimed to inventory medicinal plants used by local people and how those relate to the treatment of the most frequent diseases encountered in Ambalabe.
  
  
  METHODS
  We interviewed participants in order to identify the most frequent diseases in the region and the medicinal plants used to treat them. The local physician was asked about the most frequent diseases, and ethnobotanical surveys to record medicinal plants and their uses, using semi-structured interviews and free listing, were conducted among 193 informants in local villages, of which 54 % were men and 46 % were women, ageing from 16 to 86 years. The local names, the uses of each plant species and the way they are prepared and administered were recorded and accompanied by herbarium specimens for identification. We also interviewed four traditional healers to elicit more details on the preparation and the use of plants.
  
  
  RESULTS
  Our research allowed us to identify six most frequent diseases, namely diarrhea, malaria, stomach-ache, cough, bilharzia and dysentery. Among 209 plant species identified as having medicinal use, 83 species belonging to 49 families and 77 genera were used to treat these diseases. Our analyses highlighted the 11 commonly used species for their treatment, and also 16 species with a high fidelity level (FL ≥ 75 %) for each ailment. Diarrhea is one of the diseases with high number of species recorded.
  
  
  CONCLUSIONS
  This study highlighted the closed relationship between people in Ambalabe and plant species, especially when faced with frequent diseases. However, most of the species used were collected in the surroundings of the villages. Few species were from Vohibe forest in which a management system on the use of plant species was already established. Therefore, a sustainable use management should be considered for wild species from which medicinal plants are highly abundant.
authors.affiliation: Missouri Botanical Garden, Madagascar Research and Conservation Program, BP 3391, Antananarivo, 101, Madagascar. nivo.rakotoarivelo@mobot-mg.org.|Department of Plant Biology and Ecology, University of Antananarivo, BP 906, Antananarivo, 101, Madagascar. nivo.rakotoarivelo@mobot-mg.org.
authors.forename: Nivo H
authors.initials: NH
authors.lastname: Rakotoarivelo
authors.affiliation: Missouri Botanical Garden, Madagascar Research and Conservation Program, BP 3391, Antananarivo, 101, Madagascar. fortunat.rakotoarivony@mobot-mg.org.
authors.forename: Fortunat
authors.initials: F
authors.lastname: Rakotoarivony
authors.affiliation: Department of Plant Biology and Ecology, University of Antananarivo, BP 906, Antananarivo, 101, Madagascar. arovonjy@yahoo.fr.
authors.forename: Aro Vonjy
authors.initials: AV
authors.lastname: Ramarosandratana
authors.affiliation: Department of Plant Biology and Ecology, University of Antananarivo, BP 906, Antananarivo, 101, Madagascar. vololoniaina.jeannoda@gmail.com.
authors.forename: Vololoniaina H
authors.initials: VH
authors.lastname: Jeannoda
authors.affiliation: Department of Anthropology, Washington University, St. Louis, MO, 63130, USA. akuhlman@wustl.edu.
authors.forename: Alyse R
authors.initials: AR
authors.lastname: Kuhlman
authors.affiliation: William L. Brown Center, Missouri Botanical Garden, P.O. Box 299, St. Louis, MO, 63166-0299, USA. armand.randrianasolo@mobot.org.
authors.forename: Armand
authors.initials: A
authors.lastname: Randrianasolo
authors.affiliation: William L. Brown Center, Missouri Botanical Garden, P.O. Box 299, St. Louis, MO, 63166-0299, USA. rainer.bussmann@mobot.org.
authors.forename: Rainer W
authors.initials: RW
authors.lastname: Bussmann
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003967:Diarrhea / Q000628:therapy; D019448:Ethnobotany; D005260:Female; D006801:Humans; D008270:Madagascar; D008297:Male; D008519:Medicine, Traditional; D008875:Middle Aged; D008517:Phytotherapy; D010946:Plants, Medicinal / Q000145:classification*; D012424:Rural Population; D055815:Young Adult