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Systematic Review

Systematic review  of ethnomedicinal knowledge: Documentation, evaluation, and conservation of medicinal plants and their therapeutic applications

[version 1; peer review: 1 approved, 1 not approved]
Aleixandre Duche-Pérez
https://orcid.org/0000-0001-9905-1489
1, Olger Albino Gutiérrez Aguilar1, Javier Lucho Valero Quispe1, Alison Serruto Castillo1, Lolo Juan Mamani Daza2
Aleixandre Duche-Pérez
https://orcid.org/0000-0001-9905-1489
1, Olger Albino Gutiérrez Aguilar1, [...] Javier Lucho Valero Quispe1, Alison Serruto Castillo1, Lolo Juan Mamani Daza2
PUBLISHED 05 Nov 2024
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OPEN PEER REVIEW
REVIEWER STATUS

Abstract

This study shows that ethnomedicine and ethnobotany have gained great relevance for their role in preserving ancestral knowledge about the use of medicinal plants. Despite the benefits, such as cultural preservation and biodiversity, new challenges arise, such as the lack of standardization and scientific validation, which limits their integration into modern medicine. Therefore, this systematic review aims to assess the documentation, evaluation, and conservation of medicinal plants and their therapeutic applications across different cultures, using the systematic literature review (SLR) methodology. The searches were conducted in electronic databases, such as Scopus, EBSCO, and Web of Science, following PRISMA protocol guidelines and focusing on studies published between 2007 and 2024. Research gaps were identified, and questions were developed to better understand ethnomedicinal practices, their validation, and conservation. A total of seventy studies were selected, documenting a wide diversity of medicinal plants, with a significant focus on the conservation of traditional knowledge. However, critical gaps were identified in the scientific validation and integration of this knowledge into conservation policies. The results of the thematic analysis highlight the need for standardized protocols and a multidisciplinary approach to validate and preserve ethnomedicinal knowledge, ensuring its relevance in modern medicine and its transmission to future generations.

Keywords

Ethnomedicine, Ethnobotany, Medicinal Plants, Therapeutic Applications, Conservation of Traditional Knowledge

Corresponding author: Aleixandre Duche-Pérez
Competing interests: No competing interests were disclosed.
Grant information: The author(s) declared that no grants were involved in supporting this work.
Copyright:  © 2024 Duche-Pérez A et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
How to cite: Duche-Pérez A, Gutiérrez Aguilar OA, Valero Quispe JL et al. Systematic review  of ethnomedicinal knowledge: Documentation, evaluation, and conservation of medicinal plants and their therapeutic applications [version 1; peer review: 1 approved, 1 not approved]. F1000Research 2024, 13:1324 (https://doi.org/10.12688/f1000research.157960.1) First published: 05 Nov 2024, 13:1324 (https://doi.org/10.12688/f1000research.157960.1) Latest published: 05 Nov 2024, 13:1324 (https://doi.org/10.12688/f1000research.157960.1)

Introduction

Ethnomedicine, as a discipline that studies the traditional medical practices of diverse cultures, has garnered significant interest in the scientific community due to its valuable contribution to the documentation and conservation of ancestral knowledge regarding the use of medicinal plants. These practices not only reflect the deep relationship between cultures and their natural environment but also have proven to be a crucial source for the development of new therapeutic treatments.

A systematic review of ethnomedicinal knowledge seeks to evaluate and consolidate the existing evidence on the documentation, evaluation, and conservation of medicinal plants and their therapeutic applications. In this context, numerous studies have been conducted globally, particularly in regions of high biodiversity and with a rich ethnobotanical tradition.

For instance, a study in Tanzania highlighted the importance of documenting plant species used in traditional medicine to treat various diseases.1 This research underscores the need to preserve this knowledge in communities where modern medicine is limited. In a similar study, the medicinal plants used by the Chakma tribe in Bangladesh were explored, highlighting the vital role of local healers in conserving this knowledge.2

Another study evaluated the microbial activity and medicinal uses of 40 plants in India, providing essential data on the antimicrobial properties of these species.3 In the Binalud region of Iran, researchers studied the ecobiological background and therapeutic uses of local plants, highlighting the need for rigorous methods to validate the collected information.4

In addition to these studies, other authors have made significant contributions to the field of ethnomedicine. Researchers documented the ethnobotanical knowledge of medicinal plants in Ethiopia,5 while other authors conducted a comprehensive analysis of biodiversity and traditional plant uses in Mexico.6 Similarly, traditional medicine practices in rural Ethiopian communities were studied, emphasizing the importance of preserving this knowledge in a context of rapid social change.7

The conservation of ethnomedicinal knowledge is a crucial aspect addressed in this review. The loss of cultural and biological diversity due to globalization and climate change threatens the continuity of these traditional practices. Therefore, it is imperative to develop effective strategies to preserve this intangible heritage, ensuring that future generations can benefit from the wisdom accumulated over the centuries.

This systematic review aims to provide a comprehensive overview of the current state of ethnomedicinal knowledge, focusing on the documentation, evaluation, and conservation of medicinal plants and their therapeutic applications. This effort not only contributes to the advancement of ethnobotany as a discipline but also offers a valuable framework for future research and the implementation of conservation policies.

Methods

To achieve the objectives set out in this research, a systematic study was conducted, rigorously following the guidelines of the PRISMA guidelines (Preferred Reporting Items for Systematic Reviews and Meta-Analyses).73 This protocol was selected due to its wide acceptance and application in systematic reviews, ensuring a structured and thorough approach to data collection, analysis, and presentation. Additionally, to guarantee a high level of quality, transparency, and reproducibility of the study, it was complemented by a specific evaluation criteria checklist for systematic reviews.74 These criteria were fundamental in ensuring that all aspects of the review process were conducted rigorously and methodically.

Search strategy

During the search process, various specialized databases were exhaustively explored, including EBSCO, Scopus, and Web of Science. These databases were chosen for their broad coverage and for hosting a significant number of internationally relevant scientific publications. The search focused on identifying articles published in high-impact scientific journals, ensuring that the included studies were contemporary and relevant to the research topic. Despite the search’s scope, no prior systematic reviews specifically addressing ethnomedicinal knowledge in terms of the documentation, evaluation, and conservation of medicinal plants and their therapeutic applications were found. This finding underscores the originality and necessity of the present review to fill this gap in the scientific literature.

This study arises from a research question: What is the diversity and therapeutic value of medicinal plants documented in various cultures, and how have their ethnomedicinal applications been evaluated in the scientific literature?

The search was conducted in English, using the following keywords and their associated or related concepts: ethnomedicine (ancestral medicine, cultural medicine, folk medicine, indigenous medicine, natural medicine, traditional herbal medicine, traditional medicine) and medicinal plants (curative plants, healing herbs, healing plants, herbal medicine plants, herbal remedies, medicinal botanicals, medicinal flora, medicinal herbs). In this sense, the search equation used was: (ethno OR ancestral OR cultur OR folk OR indigen* OR natura* OR tradition*) AND (medicin* OR curativ* OR remed* OR healing) AND (plant* OR herb* OR flora OR botanic*).

Inclusion and exclusion criteria

For the systematic review, only articles published in peer-reviewed scientific journals indexed in the Scopus, EBSCO, and Web of Science (Core Collection) databases during the period from 2007 to July 2024 were included. These studies were written in English and directly addressed topics related to the documentation, evaluation, and conservation of medicinal plants in the context of ethnomedicine. Relevant studies investigated traditional knowledge, therapeutic applications, and the cultural value of medicinal plants in various cultures worldwide. Additionally, the selected articles included in their descriptors or abstracts terms associated with “ethnomedicine” (e.g., ancestral medicine, cultural medicine, folk medicine) and “medicinal plants” (e.g., curative plants, healing herbs, etc.), ensuring their thematic relevance to the review objectives.

On the other hand, studies that did not meet the previously mentioned criteria were excluded. This includes publications that were not peer-reviewed, such as literature reviews, editorials, letters to the editor, conference abstracts, and preliminary studies. Studies published outside the range of 2007 to 2024, as well as those written in languages other than English, were also excluded. Additionally, studies that did not focus on ethnomedicine or the therapeutic application of medicinal plants, especially those limited exclusively to pharmacological aspects without an ethnobotanical context, were excluded. Finally, duplicate or overlapping studies and those that did not provide sufficient detail on the evaluation, documentation, or conservation of ethnomedicinal knowledge were discarded, ensuring that only high-quality and relevant research was included in the review.

Document selection procedure

The researchers followed a multi-stage procedure to determine the final selection of articles. The initial database search yielded a list of 6,473 documents (N). Upon reviewing each title, 729 documents were unavailable, reducing the total to 5,744. Then, 359 duplicate titles across the databases were identified and removed. Subsequently, each document was reviewed to ensure it met the established criteria. The results were as follows: articles in languages other than English (142), non-empirical works (1,847), studies that did not focus on ethnomedicine or the therapeutic application of medicinal plants (1,932) and works that were not scientific articles (925).

Ultimately, 469 documents that did not provide sufficient detail on the evaluation, documentation, or conservation of ethnomedicinal knowledge were discarded, resulting in a final sample of 70 documents that met the inclusion and exclusion criteria for this systematic review.

Data analysis

Given that this review demands a deeper level of detail, it was deemed essential to compile a table that gathered key information. This table includes data on the year of publication, source of the research, theoretical framework adopted, type of study conducted, instruments used, perspective addressed, study population, stated objectives, obtained conclusions, as well as the language in which the work was published. Additionally, to enrich the analysis, a comparative analysis was conducted among the selected studies, allowing for the identification of significant similarities and differences in the approaches and findings presented in the reviewed literature. This comprehensive approach not only facilitates the organization and analysis of the data but also enables a better understanding of trends and patterns in ethnomedicinal research.

Results

After completing the search and reviewing the results according to the established methodology, a sample of 70 documents was selected. These documents were then organized and classified based on various criteria. Table 1. Synthesis of Selected Articles (refer to extended data) provides a summary of the articles identified in this process.71

Evolution of scientific production: Periods and areas of study

The analysis of the evolution of publications reveals significant development in the depth and focus of studies over the years. Figure 1. Number of studies published during the period from 2007 to July 2024 (refer to extended data) shows the number of studies published per year.72

The selected studies are categorized by periods as follows:

  • (1) Beginnings Focused on Documentation and Evaluation (2007-2010): In the early years, research primarily centered on the identification and documentation of medicinal plants, as well as the collection of information about their potential applications, such as dietary supplements.1,2 Starting in 2008, studies began analyzing the microbial activity of plants, marking a more quantitative and scientific approach.3 Between 2009 and 2010, there was an increase in research aimed at understanding the chemical and pharmacological properties of plants,4,8 as well as evaluating their medicinal value in ethnoecological contexts.9

  • (2) Expansion Towards Conservation and Therapeutic Applications (2011-2014): Between 2011 and 2014, a broader and more diverse approach was observed. Research began incorporating mixed methodologies, combining the collection of ethnomedicinal data with the analysis of the conservation status of medicinal plants.12,13 During this period, greater emphasis was also placed on evaluating the toxicity and therapeutic activity of plants.11 By 2014, studies focused on documenting indigenous medicinal plants, underscoring the importance of preserving traditional knowledge within local health systems.22

  • (3) Consolidation and Diversification of Studies (2015-2019): From 2015 onwards, efforts to document and conserve ethnomedicinal knowledge were consolidated, but with a more specialized focus. For example, research focused on specific ethnomedicinal plants for treating gastrointestinal issues,27 while other studies expanded the scope to include indigenous knowledge and medical practices in communities.29,6 This trend continued until 2019, with research aimed at verifying the effectiveness of plants in specific treatments, such as diabetes,38 and documenting the use of plants in specific regions.37

  • (4) Towards Global Integration and Database Creation (2020-2024): In recent years, from 2020 to 2024, research has shifted towards the integration of knowledge and the creation of extensive and comprehensive databases. Some studies have worked on the systematic quantification and documentation of wild medicinal plants and their therapeutic applications.43,54 Additionally, there is a growing focus on the conservation of ethnomedicinal knowledge and its promotion in global contexts.44,48 Finally, by 2024, studies continue to deepen the documentation and conservation efforts, with greater consideration of cultural and ecolinguistic factors.69

Over the years, publications have evolved from an initial focus on the basic documentation and evaluation of medicinal plants to a more integrative and multidisciplinary approach, encompassing not only the conservation of traditional knowledge but also its scientific validation and preservation in global databases.

This distribution reflects a strong concentration of studies in countries with rich traditions in the use of medicinal plants and significant biological diversity, highlighting the global importance of ethnomedicine and ethnobotany. The current literature review identified:

India leads with 15 studies on ethnomedicinal knowledge, documentation, evaluation, and conservation of medicinal plants, reflecting its rich biodiversity and extensive tradition in the use of these plants. Pakistan follows with 12 studies focused on the documentation and analysis of traditional knowledge, while Bangladesh, with 10 studies, stands out for its focus on the conservation of ethnomedicinal practices. Indonesia, with 8 studies, shows strong interest in documenting and exploring the use of plants in traditional medicine, and Nigeria, with 5 studies, focuses on the evaluation of medicinal properties and documentation in rural communities.

Nepal and Tanzania, with 3 studies each, have contributed to the documentation and analysis of medicinal plant use in mountainous communities and the conservation of local species, respectively. Other countries, such as Mexico, Morocco, Bolivia, Venezuela, Binalud, Jordan, Papua New Guinea, China, Zimbabwe, the Philippines, Namibia, Serbia, Malaysia, and Ethiopia, have conducted one study each, demonstrating interest in the preservation and analysis of ethnomedicinal knowledge within their unique cultural and ecological contexts.

Balance of objectives

In the field of ethnomedicine and ethnobotany, the diversity of research conducted reflects a broad range of objectives, from the documentation and preservation of traditional knowledge to the evaluation of medicinal properties and the ecological impact of plant use. Categorizing these objectives into groups according to their general purpose provides a clearer understanding of how each study contributes to preserving and expanding knowledge about medicinal plants. Below are six main categories that group these objectives:

  • (1) Documentation and Preservation of Ethnomedicinal Knowledge: This group of objectives focuses on the collection, preservation, and promotion of traditional ethnomedicinal knowledge, which is essential for keeping ancestral practices related to the use of medicinal plants alive:

    • • Document medicinal plant species, practices, and traditional knowledge: Studies in this subgroup are dedicated to identifying and documenting the medicinal plants used in different communities, as well as gathering information on ethnomedicinal practices and knowledge. This includes research that identifies and documents plant species, and studies that gather information on medicinal plants used by folk practitioners. Other studies also contribute to creating detailed databases that preserve this knowledge, developing databases of medicinal plant species.1,8,18

    • • Preserve ethnomedicinal knowledge and promote future studies: This subgroup includes objectives that not only document ethnomedicinal knowledge but also focus on its preservation and the promotion of additional research. For example, some studies focus on preserving ethnomedicinal knowledge to ensure that future generations can benefit from this cultural heritage.44,62

  • (2) Evaluation of Medicinal Properties and Therapeutic Activities: This group centers on the scientific evaluation of the medicinal properties of plants and their effectiveness in treating various diseases, bridging tradition with scientific validation:

    • • Evaluate antimicrobial, antitrypanosomal, and other therapeutic activities: Studies in this category are dedicated to analyzing the specific therapeutic properties of plants, such as their antimicrobial and antitrypanosomal activities. These studies are crucial for scientifically validating the traditional applications of plants in medicine.3,10

    • • Evaluate plant extracts and their toxicity: This category includes studies that, in addition to evaluating the therapeutic properties of plants, examine the toxicity of their extracts to ensure their safety. Some studies focus on analyzing the safety of these extracts through in vitro and in vivo tests.11

  • (3) Analysis of Bioactive Components and Pharmacological Studies: The objectives in this category aim to identify and analyze the bioactive components of medicinal plants and evaluate their potential in developing new pharmacological treatments.

    • • Review bioactive components and pharmacological activities: Studies in this category focus on reviewing the bioactive components of plants and their pharmacological activities, contributing to the scientific understanding of the active principles underlying ethnomedicinal practices.8,9

    • • Evaluate the effectiveness of medicinal plants and develop new treatments: Studies in this category aim not only to validate the effectiveness of traditional medicinal plants but also to explore their potential for developing new pharmacological treatments.20,22

  • (4) Documentation and Evaluation of Indigenous Knowledge and Traditional Practices: This category focuses on the detailed study of indigenous knowledge and traditional healing practices, which are essential for understanding the diversity and richness of the use of medicinal plants in different cultures.

    • • Study indigenous knowledge on the use of medicinal plants: Some studies are dedicated to investigating and documenting indigenous knowledge about the use of medicinal plants, providing a deep insight into how communities have utilized these resources over generations.4,20

    • • Study healing practices in rural communities: This subtitle groups studies that focus on the specific healing practices of rural communities. Research documents and analyzes how rural communities use medicinal plants in their healing practices.34,42

  • (5) Creation of Databases and Catalogs of Medicinal Plants: In this category, studies focus on the creation of databases and catalogs that compile and organize information on medicinal plants, facilitating future access and research on these species.

    • • Create databases of medicinal plants used in various regions: Studies aim to compile detailed information in databases covering medicinal plants used in various regions, enabling better organization and access to this knowledge.18,45

    • • Catalog medicinal plants used by ethnic groups: This subgroup includes studies that focus on cataloging the medicinal plants used by different ethnic groups, highlighting the cultural diversity in the use of these resources.64,54

  • (6) Study of Ecological Impact and Conservation of Medicinal Plants: The objectives in this category are aimed at investigating the ecological impact of medicinal plant use and developing strategies for their conservation, ensuring that these practices can continue in the future:

    • • Investigate the ecological impact and conservation of medicinal plants: Studies in this category are dedicated to understanding how the practices of harvesting and using medicinal plants impact the ecological environment, proposing measures to conserve these plants and their habitats.4,25

Methodological overview

In the reviewed studies on ethnomedicinal knowledge, the methodological approaches are primarily divided into three categories: quantitative, qualitative, and mixed methods.

The quantitative approach is predominant, utilized in 32 of the 70 reviewed studies. These studies focus on the collection and analysis of numerical data through surveys, structured questionnaires, and laboratory experiments. For example, a quantitative approach was employed to collect and analyze medicinal herbs using semi-structured questionnaires and laboratory tests, while other studies documented traditional knowledge through semi-structured questionnaires.9,61

Qualitative studies make up a significant portion of the total, with 26 investigations. This approach is mainly used to explore and understand traditional knowledge, often through interviews, direct observations, and ethnographic techniques. For instance, some research employed semi-structured interviews and the collection of plant samples, while other studies used the rapport technique during ethnographic interviews.63,69

The mixed-methods approach, which combines quantitative and qualitative methods, was used in 12 studies. These studies integrate the collection of quantitative data with the depth of qualitative research to provide a more comprehensive analysis. For example, interviews and semi-structured questionnaires were used, combining numerical data with detailed observations.8

Moreover, the reviewed studies employ a wide variety of techniques and instruments for data collection, each adapted to the specific objectives of the research. The most common techniques are presented below:

  • • Semi-structured interviews and questionnaires: These are the most used instruments, present in 48 of the 70 studies. Semi-structured interviews allow researchers to collect detailed and flexible data, while questionnaires provide a structure to quantify responses. These methods were employed, for example, to explore ethnomedicinal knowledge.23,34

  • • Direct and participant observation: This is a key technique in qualitative and mixed-method studies, used in 19 studies. This technique allows researchers to directly witness and record ethnomedicinal practices in their natural context. In some studies, direct observation was combined with questionnaires to examine the use and cultivation of medicinal plants.32

  • • Field surveys: Used in 14 studies, these are a common technique in quantitative and mixed-method studies. Field surveys allow researchers to collect extensive data on the use of medicinal plants in different communities. For instance, field surveys were used along with interviews to gather detailed information on the use of plants to treat diabetes.38

  • • Although less common, some studies (5 out of 70) incorporate experimental and laboratory techniques, especially in research aimed at scientifically validating the medicinal properties of plants. For example, antibacterial assays, antioxidant tests, and phytochemical analyses were conducted in laboratories to evaluate the properties of medicinal plants.69

  • • The technique of guided walks and plant collection was used in 9 studies, particularly those focused on documenting plant species in their natural environment. Guided walks allow researchers to collect plants and obtain direct information from local practitioners.

In terms of approach, the reviewed studies show a significant preference for the quantitative approach, though a large portion also relies on qualitative and mixed methods to address the complexity of ethnomedicinal knowledge. The combination of semi-structured interviews with direct observation and field data collection techniques stands out as the most robust methodology for documenting and analyzing the use of medicinal plants. Studies that integrate experimental techniques offer added value by validating the therapeutic applications of the documented plants, allowing for a deeper understanding and conservation of this ancestral knowledge. The employed methodology reflects a balance between extensive data collection and in-depth exploration of specific cultural contexts, which together strengthen the credibility and applicability of the findings in the field of ethnomedicine.

Documentation, evaluation, and conservation of medicinal plants

The documentation of medicinal plants is a fundamental activity for the preservation of ethnobotanical and ethnomedicinal knowledge, which has been passed down through generations in many cultures. This process not only involves recording the species of plants used but also capturing details about their identification, distribution, collection methods, plant parts used, remedy preparation, and therapeutic uses. It is emphasized that the systematic documentation of medicinal plants is essential to ensure that this knowledge is not lost, especially in communities where the oral transmission of knowledge is declining due to modernization and the influence of Western medicine.1,17

Work in Bangladesh highlights the importance of documenting not only plant species but also the knowledge and practices of traditional healers.2,8 This type of documentation is vital for maintaining the cultural and biological richness of local communities and provides a solid foundation for future research in pharmacology and conservation. On the other hand, it is illustrated how the detailed documentation of species in specific regions, such as the Wuliang Mountains in China or the Chinglai Valley in Pakistan, can help in understanding local biodiversity and the communities’ dependence on medicinal plants.35,37

However, documentation faces several challenges. Acculturation, migration, and modernization have led to the loss of knowledge in many regions. It is warned that the loss of this knowledge is particularly acute among younger generations, who show a growing disinterest in traditional practices.24,44 This phenomenon not only threatens the extinction of valuable knowledge but also the disappearance of plant species that could have significant undiscovered medicinal uses.

To mitigate these risks, documentation must be a continuous and collaborative effort involving researchers, local communities, and conservation organizations. The integration of modern methods, such as electronic databases and digital identification tools, with traditional data collection practices can help preserve this knowledge more efficiently. Additionally, it is crucial that the documentation is accessible and available to future generations to ensure that this cultural and biological heritage is not lost.

Furthermore, the scientific evaluation of medicinal plants is a crucial step in transforming traditional knowledge into validated and safe therapeutic applications. Studies are presented that demonstrate the efficacy of certain plants in antimicrobial activity, a finding that has significant implications for the development of new antibiotics in a world where antimicrobial resistance is a growing concern.3,10 These studies underline the need to systematically evaluate the pharmacological properties of plants to identify bioactive compounds that can be used in modern medicine.

The evaluation is not limited to antimicrobial activity alone. It has been shown how certain plant extracts can enhance the efficacy of traditional antibiotics, suggesting that combinations of plants and medications could offer new therapeutic solutions.8,11 This synergistic approach between traditional and modern medicine opens a promising field for pharmacological research.

However, the evaluation faces significant challenges. It is highlighted that many plants have not yet been fully studied in terms of their chemical components and biological effects.29,30 The lack of detailed phytochemical studies and clinical trials is a barrier to incorporating these plants into conventional medicine. Additionally, the variability in the concentrations of active compounds, influenced by factors such as climate, soil, and collection techniques, makes the evaluation even more complex.

To overcome these challenges, a multidisciplinary approach that combines ethnobotany, chemistry, molecular biology, and pharmacology is essential. This approach can help identify, isolate, and synthesize bioactive compounds from medicinal plants and evaluate their safety and efficacy through controlled clinical trials. Additionally, collaboration with local communities, who possess deep knowledge of these plants, is fundamental to directing research toward the most promising species and practices.

Finally, the conservation of medicinal plants is a critical concern, as many of these species are threatened by overexploitation, habitat destruction, and climate change. It is emphasized how the commercial exploitation of medicinal plants has led to the reduction of wild populations, putting both biodiversity and the availability of essential medicinal resources for local communities at risk.36,38

Conservation is not only an ecological issue but also a cultural and economic one. It is noted that medicinal plants are an integral part of the lives of many communities, not only for their therapeutic value but also as a source of income and as part of cultural identity.39,43 The loss of these plants would not only affect people’s health but also their cultural heritage and economic livelihood.

One of the biggest challenges for conservation is the lack of awareness and the absence of effective policies. Although local communities have vast knowledge about the use of medicinal plants, this knowledge is fading due to the lack of interest among younger generations and the pressure of modernization.43 The intensification of mining, agricultural expansion, and deforestation, as observed in the Aravalli Hills, exacerbates this situation by destroying the natural habitats of these plants.39

To address these issues, concerted efforts are needed on several fronts. The creation of protected areas and the implementation of sustainable cultivation practices can help preserve endangered species. Additionally, seed collection and the establishment of germplasm banks are important strategies to ensure that these plants can be restored in the future. Education and awareness among local communities, especially among the youth, are crucial for the long-term conservation of ethnobotanical knowledge and resources.

Therapeutic applications

The therapeutic applications of medicinal plants are varied and cover a wide range of diseases and conditions. Since ancient times, communities have used plants to treat both common and complex ailments, from bacterial infections to chronic diseases like diabetes and cancer. It has been documented how medicinal plants have been effective in treating diseases that are difficult to manage with modern medicine, highlighting their continued relevance in healthcare.12,27

Studies show that although some plants have well-documented therapeutic applications, many others remain underutilized and poorly understood, representing a vast field of opportunities for research and the development of new medicines.37,64 The scientific validation of these uses is essential for integrating traditional medicine into the modern healthcare system, providing treatments that are often more accessible and culturally acceptable for rural communities.

The challenge in the therapeutic application of medicinal plants lies in the variability of active compounds and the lack of standardization in preparation and administration methods. Moreover, it is crucial to evaluate the toxicity and potential side effects of these remedies before their widespread adoption.39,40 This requires not only rigorous clinical trials but also a careful approach to prevent the overexploitation of plants that may become scarce or endangered.

Finally, the integration of the therapeutic applications of medicinal plants into modern medicine should not be seen as a replacement but as a complement. Interdisciplinary research and collaboration between traditional healers, scientists, and healthcare professionals are key to developing more effective and accessible therapies. These collaborations can also promote the more sustainable use of natural resources, ensuring that medicinal plants remain a valuable source of health and well-being in the future.

Discussion

This systematic review has revealed a series of significant findings across various regions and cultures. This discussion not only analyzes the key results but also identifies the gaps and voids in the literature that limit our complete understanding of this field.

One of the most prominent aspects of the review is the rich diversity of medicinal plants documented in different communities, as shown by studies that have identified and classified numerous plant species used in traditional medicine, emphasizing the importance of documenting this knowledge before it is lost due to modernization.1,12 However, a significant gap in the literature is the lack of standardization in documentation methods. While some studies employ mixed techniques, such as surveys and structured interviews,2 others rely heavily on qualitative observations without a clear systematic framework. This inconsistency hinders the comparison between studies and the consolidation of a coherent body of knowledge.

Additionally, although many plants with therapeutic potential have been documented, there is a void in the rigorous scientific evaluation of these plants.3,11 The literature reveals that many of these plants have not yet undergone clinical trials or detailed phytochemical studies, limiting their integration into modern medicine. This lack of scientific validation is a critical gap that needs to be addressed to fully harness the potential of medicinal plants.

The link between ethnomedicinal knowledge and biodiversity conservation is another central theme in the literature. Studies underscore how traditional practices of using medicinal plants contribute to the conservation of plant species.22,25 However, the literature also highlights a gap in research on the long-term impacts of domestication and cultivation of medicinal plants. Although these practices have been proposed as conservation strategies, evidence on their effectiveness and long-term sustainability is lacking.8,38 Moreover, the absence of longitudinal studies tracking the evolution of these practices in response to climatic and economic changes represents a significant gap in the literature.

Another important gap is the lack of integration between ethnomedicinal knowledge and conservation policies. Although some studies have pointed out the need for greater community participation in natural resource management,30 the literature lacks an in-depth analysis of how policies can be designed to genuinely incorporate and value local knowledge. This is essential to ensure effective biodiversity conservation and the maintenance of traditional practices.

A recurring challenge in the literature is the scientific validation of ethnomedicinal knowledge. While some studies have demonstrated the therapeutic potential of certain plants, the lack of exhaustive clinical and phytochemical research remains a major barrier.10,69 Significant gaps exist in the literature regarding the identification of active compounds responsible for the documented medicinal properties. Most of the reviewed studies stop at the observation of traditional uses without advancing towards the synthesis and testing of bioactive compounds in controlled environments.

Furthermore, while scientific validation offers opportunities for the development of new medications, the literature lacks a multidisciplinary approach that combines ethnobotany, chemistry, pharmacology, and biotechnology.11,20 This lack of an integrated approach is a significant void that limits the potential of medicinal plants to be utilized in modern medicine.

The preservation of ethnomedicinal knowledge is a recurring theme in most of the reviewed studies. Oral transmission is at risk due to modernization and the lack of interest among younger generations.24,34 However, an important gap in the literature is the lack of studies on effective methods to revitalize and preserve this knowledge. Although strategies such as written documentation and education have been proposed, the literature lacks research on the long-term effectiveness of these strategies.54

Another significant gap is the lack of studies on the intergenerational transmission of ethnomedicinal knowledge in contexts of migration and globalization. Most of the reviewed studies focus on rural and relatively isolated communities, but there is little literature on how these practices adapt and persist in communities that have experienced significant migrations or are exposed to global cultural influences.

This systematic review has revealed a rich variety of ethnomedicinal knowledge, highlighting the importance of documenting, evaluating, and conserving medicinal plants and their therapeutic applications. However, it has also identified several gaps and voids in the literature that need to be addressed to fully leverage this knowledge. The lack of standardization in documentation, insufficient scientific validation, limited integration between conservation and policies, and the need for effective strategies for intergenerational knowledge preservation are challenges that require attention. Addressing these gaps will not only strengthen our understanding of ethnomedicinal knowledge but also facilitate its integration into modern medicine and biodiversity conservation, ensuring that these valuable insights are preserved and benefit future generations.

Conclusion

The systematic review of ethnomedicinal knowledge on the documentation, evaluation, and conservation of medicinal plants has highlighted the richness and diversity of this knowledge across various cultures around the world. Research demonstrates that medicinal plants continue to be a vital source of primary care in many communities, and their documentation is essential for preserving this ancestral knowledge.1,2 However, despite the extensive documentation, there is a significant gap in the scientific validation of these traditional uses. Studies have identified the therapeutic potential of several plants, but the lack of clinical trials and more rigorous phytochemical studies limits the integration of this knowledge into modern medicine.3,10

Furthermore, it has been observed that the transmission of ethnomedicinal knowledge is at risk due to modernization and the lack of interest among younger generations.24,34 This phenomenon, along with environmental degradation, threatens the continuity of traditional practices and the conservation of biodiversity, as indicated by some studies.25,30 The lack of integration between ethnomedicinal knowledge and conservation policies also represents a critical gap that, if not addressed, could result in the irreversible loss of species and knowledge.

It is recommended to create standardized protocols for the documentation of ethnomedicinal knowledge, which include both qualitative and quantitative methods. This will facilitate comparison between studies and the consolidation of a coherent body of knowledge.2,12 Additionally, it is crucial that the documented medicinal plants undergo rigorous scientific studies, including clinical trials and phytochemical analyses. Interdisciplinary collaboration between ethnobotanists, chemists, pharmacologists, and biotechnologists can maximize the therapeutic potential of medicinal plants and ensure their integration into modern medicine.20

Moreover, it is recommended that governments and international organizations develop conservation policies that integrate ethnomedicinal knowledge with sustainable biodiversity management. This includes supporting practices of domestication and cultivation of medicinal plants in local communities.25,38 To ensure the preservation of ethnomedicinal knowledge, it is essential to implement educational programs aimed at younger generations, combining traditional and modern methods of knowledge transmission. Additionally, innovative strategies should be explored, such as creating accessible databases and encouraging community participation in teaching.24,34

Finally, additional studies are recommended on how migration, globalization, and climate change affect the transmission and conservation of ethnomedicinal knowledge. This will allow for the development of adaptive strategies to ensure the continuity of these practices in a constantly changing world.25,39 These recommendations, based on the findings of the systematic review, aim not only to preserve existing ethnomedicinal knowledge but also to promote its integration and adaptation in a modern global context, ensuring its relevance and utility for future generations.

Ethics and consent

No Ethics and consent required.

Data availability statement

Underlying data

No data associated with this article.

Extended data

Figshare: 1) Table 1. Synthesis of Selected Articles, https://doi.org/10.6084/m9.figshare.27284889. 71

2) Figure 1. Number of studies published during the period from 2007 to July 2024, https://doi.org/10.6084/m9.figshare.27284934. 72

This project contains the following extended data:

  • • Table 1. Synthesis of Selected Articles.docx

  • • Figure 1. Number of studies published during the period from 2007 to July 2024

Data are available under the terms of the Creative Commons Attribution 4.0 International license (CC-BY 4.0).

Reporting guidelines

Figshare: Checklist Prisma 2020 for “Systematic Review of Ethnomedicinal Knowledge: Documentation, Evaluation, and Conservation of Medicinal Plants and Their Therapeutic Applications”, https://doi.org/10.6084/m9.figshare.27285135.

Data are available under the terms of the Creative Commons Attribution 4.0 International license (CC-BY 4.0).

References

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  • 36.  Wali S, Jan HA, Bussmann RW: Quantitative ethnomedicinal study of indigenous medicinal plants used for digestive disorders of Laspur Valley, Chitral, Northern Pakistan. J. Ethnobot. Res. Appl. 2019; 18: 1–18. Publisher Full Text Reference Source
  • 37.  Gao L, Wei N, Yang G, et al.: Ethnomedicine study on traditional medicinal plants in the Wuliang Mountains of Jingdong, Yunnan, China. J. Ethnobiol. Ethnomed. 2019; 15: 20–41. PubMed Abstract | Publisher Full Text | Free Full Text
  • 38.  Kumar A, Aswal S, Chauhan A, et al.: Ethnomedicinal Investigation of Medicinal Plants of Chakrata Region (Uttarakhand) Used in the Traditional Medicine for Diabetes by Jaunsari Tribe, India. J. Nat. Prod. Bioprospect. 2019; 9: 175–200. PubMed Abstract | Publisher Full Text | Free Full Text
  • 39.  Rao AS, Yadav SS, Sheoran A, et al.: An ethnomedicinal survey of traditionally used medicinal plants from Charkhi Dadri district. Haryana: An Attempt Towards Documentation and Preservation of Ethnic Knowledge. 2020; 20(2): 295–304.
  • 40.  Rutendo P, Gundidza M, Gwanzura L, et al.: A survey of ethnomedicinal plants used to treat cancer by traditional medicine practitioners in Zimbabwe. BMC Complement. Med. Ther. 2020; 20: 278. PubMed Abstract | Publisher Full Text | Free Full Text
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  • 42.  Dapar MLG, Meve U, Liede-Schumann S, et al.: Ethnomedicinal appraisal and conservation status of medicinal plants among the Manobo tribe of Bayugan City, Philippines. Biodiversitas. 2020; 21(8): 3843–3856. Publisher Full Text
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  • 45.  Mir TA, Khare RK, Jan M: Medicinal plants used against gastrointestinal complaints in district Budgam of Jammu and Kashmir - An ethnomedicinal study. Ethnobot. Res. Appl. 2021; 22(11): 1–16. Publisher Full Text
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Duche-Pérez A, Gutiérrez Aguilar OA, Valero Quispe JL et al. Systematic review  of ethnomedicinal knowledge: Documentation, evaluation, and conservation of medicinal plants and their therapeutic applications [version 1; peer review: 1 approved, 1 not approved]. F1000Research 2024, 13:1324 (https://doi.org/10.12688/f1000research.157960.1)
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ApprovedThe paper is scientifically sound in its current form and only minor, if any, improvements are suggested
Approved with reservations A number of small changes, sometimes more significant revisions are required to address specific details and improve the papers academic merit.
Not approvedFundamental flaws in the paper seriously undermine the findings and conclusions
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Reviewer Report 14 Aug 2025
Rahmatullah Qureshi, Department of Botany, Pir Mehr Ali Shah Arid Agriculture University, Rawalpindi, Pakistan 
Not Approved
VIEWS 4
https://doi.org/10.5256/f1000research.173488.r346952
The article titled “Systematic review of ethnomedicinal knowledge: Documentation, evaluation, and conservation of medicinal plants and their therapeutic applications” provides a valuable synthesis of global ethnomedicinal knowledge. However, a critical evaluation reveals several shortcomings and methodological flaws that, if ... Continue reading
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Qureshi R. Reviewer Report For: Systematic review  of ethnomedicinal knowledge: Documentation, evaluation, and conservation of medicinal plants and their therapeutic applications [version 1; peer review: 1 approved, 1 not approved]. F1000Research 2024, 13:1324 (https://doi.org/10.5256/f1000research.173488.r346952)
The direct URL for this report is:
https://f1000research.com/articles/13-1324/v1#referee-response-346952
NOTE: it is important to ensure the information in square brackets after the title is included in all citations of this article.
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Reviewer Report 11 Mar 2025
Hiwa M. Ahmed, Bakrajo Technical Institute, Sulaimani Polytechnic University, Sulaymaniyah, Kurdistan Region, Iraq 
Approved
VIEWS 8
https://doi.org/10.5256/f1000research.173488.r364583
-The abstract should be reshaped, as you have started with results other than the introduction. 
-The first two sections of the introduction need reference.
-You mentioned several times the aim, while the aim should be at the end ... Continue reading
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HOW TO CITE THIS REPORT
Ahmed HM. Reviewer Report For: Systematic review  of ethnomedicinal knowledge: Documentation, evaluation, and conservation of medicinal plants and their therapeutic applications [version 1; peer review: 1 approved, 1 not approved]. F1000Research 2024, 13:1324 (https://doi.org/10.5256/f1000research.173488.r364583)
The direct URL for this report is:
https://f1000research.com/articles/13-1324/v1#referee-response-364583
NOTE: it is important to ensure the information in square brackets after the title is included in all citations of this article.
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The paper is scientifically sound in its current form and only minor, if any, improvements are suggested
Approved with reservations
A number of small changes, sometimes more significant revisions are required to address specific details and improve the papers academic merit.
Not approved
Fundamental flaws in the paper seriously undermine the findings and conclusions

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  1. Hiwa M. Ahmed, Sulaimani Polytechnic University, Sulaymaniyah, Iraq
  2. Rahmatullah Qureshi, Pir Mehr Ali Shah Arid Agriculture University, Rawalpindi, Pakistan

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    Alongside their report, reviewers assign a status to the article:
    Approved - the paper is scientifically sound in its current form and only minor, if any, improvements are suggested
    Approved with reservations - A number of small changes, sometimes more significant revisions are required to address specific details and improve the papers academic merit.
    Not approved - fundamental flaws in the paper seriously undermine the findings and conclusions
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