Ethnobotanical study of traditional antivenom treatments in Burkina Faso
PMCID: PMC12281730
PMID: 40691653
Abstract
Background Snakebite envenomation constitutes a major public health challenge in Burkina Faso, particularly within rural communities. Limited access to formal healthcare services, coupled with the high cost of antivenom treatment, has led to widespread reliance on traditional health practitioners (THPs). This study was therefore undertaken to generate empirical data on the role of THPs in the management of snakebite envenomation, with a focus on the medicinal plants employed, methods of remedy preparation, and routes of administration. Method A preliminary survey was conducted to identify traditional health practitioners THPs involved in snakebite envenomation management within the study regions. The preliminary survey involved 799 individuals selected through convenience sampling in local markets. Ethnobotanical data were subsequently gathered from the identified practitioners via semi-structured interviews. The collected data were entered and analysed via an Excel spreadsheet. In addition to the sociodemographic characteristics of THPs, the relative frequency of citation (RFC) were also determined. Results The results revealed that 90% of the THPs were male and that 76.67% illiterate. Over half of the THPs had more than two decades of experience. Diagnosis was mainly based on symptoms, with 60% relying on bite site examination. Most treatments involved plant-based powders (73.33%), typically applied subcutaneously through incisions. Roots were the most commonly used plant part in antivenom preparations (29%), while dried and calcined materials were the predominant form of medicinal plant preparation in the region. The study identified 29 plant species across 18 botanical families. Annona senegalensis Pers., Nauclea latifolia Sm., and Vitellaria paradoxa C.F. Gaertn had the highest relative frequency of citation (RFC), each at 10%. Encouragingly, 63.33% of THPs had participated in training or awareness sessions with health centres. Additionally, 46.66% referred patients to hospitals when traditional treatments were insufficient. Conclusion These results highlight the therapeutic potential of local medicinal plants in the treatment of snakebite envenomation and support the need for strengthened collaboration between traditional and biomedical healthcare systems.
Full Text
Burkina Faso, a landlocked country in West Africa, is characterised by a hot, arid climate and dense tropical vegetation, particularly in its eastern and southern zones [1]. This ecological setting supports a high diversity of venomous snake species, with members of the Viperidae family being the most prevalent [2]. The population is predominantly rural and youthful, with widespread engagement in farming and livestock rearing. These activities frequently bring individuals into contact with grasslands, forested areas, and snake habitats, thereby contributing to a high annual incidence of snakebite cases. Between 2010 and 2020, an estimated 213,683 snakebite cases were recorded [3]. This corresponds to an annual incidence exceeding 20,000 cases, with a case fatality rate of approximately 3% [4].
Snakebite envenomation is recognized as a serious medical emergency [5]. It typically presents with local symptoms such as erythema, oedema, and intense pain at the bite site, usually within the first hour. Systemic manifestations may involve emetic episodes, visual disturbances, paraesthesia of the extremities, and diaphoresis [6]. The limbs and hands are the most commonly affected areas. Psychological reactions commonly observed among envenomated patients include acute anxiety, which is often associated with tachycardia and presyncope [5]. The severity and specificity of clinical manifestations depend largely on the species of snake involved, the quantity of venom injected, and the individual physiological response to envenomation [7].
The treatment of snakebite envenomation typically involves symptomatic management using anti-inflammatory, analgesic, and anticoagulant and sedative therapies [8]. The administration of antivenom serum significantly improves survival outcomes [9]. However, antivenom production is complex and resource-intensive. It requires the preparation of venom mixtures for immunization, the generation of hyperimmune plasma, and the purification of immunoglobulins [10]. In many low-resource settings, fragile infrastructure and high production costs, limit the availability and accessibility of antivenom [11]. As a result, many affected individuals, particularly in rural areas, rely on traditional herbal remedies [12]. These treatments are more accessible, can be used against multiple snake species, and do not require cold storage [13].
Scientific investigations have identified a range of phytochemicals exhibiting antivenom activity. Plant-derived extracts have thereby shown efficacy in counteracting the inflammatory, haemorrhagic, myotoxic, and neurotoxic effects induced by snake venom. In certain cases, these extracts are also employed prophylactically to mitigate the risk of complications [14–17].
This research constitutes a prospective ethnobotanical study conducted within the Eastern, Centre-Southern, and South-Western health regions of Burkina Faso (Fig. 1).
The Eastern Region is the largest administrative area in Burkina Faso, covering 46,694 km2. The Centre-South region occupies 11,457 km2, whereas the South‒West region spans 16,318 km2. These regions comprise five, two, and three provinces, respectively [18].
In terms of population, the Eastern region had an estimated 1,941,505 inhabitants in 2019. The Centre-South region recorded 788,341 inhabitants, and the South‒West region was home to approximately 874,030 people during the same year [19].
In the Eastern Region, fieldwork was conducted in the localities of Nadiagou, Oumpougdeni, Diapaga, Gayéri, and Kossougoudou. In the Centre-South Region, data collection took place in Kombissiri, Batinga, Nobili, and Pô. In the South-West Region, surveys were carried out in Loto, Diébougou, Gaoua, and Kampti (Fig. 1). These three regions were purposively selected to capture potential inter-regional variations in traditional practices related to the management of snakebite envenomation. Moreover, the Eastern, Centre-Southern, and South-Western health regions report thousands of snakebite incidents annually. Between 2010 and 2020, a total of 35,214 cases of snakebite envenomation were recorded by health services in these regions [3], representing an average of over 3000 cases per year.
On the basis of the recorded data the relative frequency of citations (RFC) for each plant species were calculated by dividing the number of informants who mentioned a particular species (FC) by the total number of informants surveyed (N) [20]: RFC = FC/N.
The percentage distribution of the respondents is presented in Fig. 2.
Table 1 presents the distribution of survey participants from each of the three regions, categorised according to their views on the traditional management of ophidian envenomation and the perceived effectiveness of the remedies.
The sociodemographic characteristics of the THPs surveyed in this study are summarised in Table 2.
The various diagnostic methods employed by THPs to identify snakebite envenomation are summarised in Table 3.
Table 4 presents the clinical manifestations reported by snakebite victims to the THPs surveyed.
The characteristics related to the physical form, preparation method, administration route, proposed mechanism of action, and treatment cost of the recipes recommended by THPs for the management of snakebite envenomation are summarised in Table 5.
Table 6 provides an overview of the mechanisms of collaboration between the surveyed THPs and conventional healthcare personnel in the management of snakebite victims.
Table 7 presents the plant species employed by the THPs in the studied regions for the preparation of antivenom remedies.
Roots were the most commonly used plant part in antivenom preparations (29%), followed by leaves (27%), bark (24%), stems (16%), and other parts (4%) (Fig. 3a). The predominant form of medicinal plant preparation in the region involved dried and calcined material (55.6%) (Fig. 3b), whereas fresh plant material was used in only a limited number of cases (13.5%) (Fig. 3b). The dried but uncalcined plant parts accounted for 28.9% of the initial processing of the plant material (Fig. 3b).
Table 8 presents the relative frequency with which each plant species was mentioned by traditional health practitioners in relation to the preparation of antivenom recipes.
Snakebite envenomation is common in Burkina Faso, as it is in many tropical countries, and constitutes a major medical emergency. In traditional societies, snakebites are not always perceived as accidental encounters between a person and a snake but rather as the result of a curse or malevolent spell cast by an adversary [21]. This belief system may partly explain the widespread reliance on traditional remedies among rural populations. Moreover, the prohibitive cost of healthcare, particularly for communities living in precarious socioeconomic conditions, further encourages the use of traditional medicine [4].
Data analysis revealed the high level of community recognition enjoyed by these practitioners. Indeed, more than 60% of respondents in each region reported knowing at least one THP and stated that they had either personally experienced or witnessed the efficacy of their treatments. These observations are consistent with those of Bamogo et al. (2021), who documented the crucial role of traditional knowledge and phytotherapy in West African healthcare systems [22].
A majority (90%) of the THPs surveyed were male, with over half reporting more than twenty years of experience treating snakebite cases and were illiterate. Similar demographic characteristics have been observed in other studies conducted in Burkina Faso and across the West African subregion. For example, Bamogo et al. (2023) reported that 95% of THPs in the western part of Burkina Faso were male, with 76.1% being illiterate and 70.1% being over the age of 50. Similarly, in Benin, 97.4% of the THPs surveyed were male, with those over 50 years of age constituting 51.3% [21]. This male dominance may be attributed to sociocultural norms that limit female participation in traditional healing, except for gender-specific and paediatric ailments such as malaria, haemorrhoids, infertility, and menstrual disorders [21]. The high proportion of experienced THPs may also reflect the selection criteria, which prioritised those with strong reputations within their communities.
In terms of diagnostic practice, 60% of THPs rely on observing the bite site for signs such as puncture marks, haemorrhage, fang impressions, or specific odours, whereas 26.7% of THPs are based on assessments of clinical signs. Typically, traditional West African medicine does not involve systematic diagnosis combining patient-reported symptoms with laboratory or imaging techniques [23]. Instead, diagnosis is based on symptomatic observation and empirical knowledge. This aligns with the findings of this study, where more than 85% of the THPs used physical and symptomatic criteria. The most commonly reported clinical signs included haematological symptoms (e.g., haemorrhage, haemoptysis, and pallor), followed by inflammatory signs (pain, oedema, necrosis). These manifestations are consistent with viperine syndrome, which encompasses local inflammation, hypotension, and hemorrhagic symptoms. Severe envenomation may even lead to ischaemic or haemorrhagic stroke [24]. These findings are consistent with Roman’s inventory of venomous snakes in Burkina Faso, which reported a predominance of the Viperidae family, notably Causus maculatus and Echis ocellatus, as the main species responsible for envenomation [25]. In contrast, cobraic syndrome typically begins with paresthesia, fasciculations, muscarinic symptoms, ptosis, and cranial nerve involvement, followed by ascending areflexic paralysis and, ultimately, respiratory failure [26].
With respect to the therapeutic scope of the remedies, 60% were reported to be effective against all snake species, whereas 40% were specific to viperine envenomation. This specificity likely reflects the high prevalence of Viperidae species in the studied regions. As venom composition and clinical manifestations are species dependent [27], such practitioner beliefs may derive from empirical familiarity with local envenomation patterns.
For the preparation methods, remedies were mainly in powdered form, primarily plant based. This contrasts with findings from Côte d’Ivoire, where Tra Bi Boli et al. (2024) reported that pastes prepared from freshly ground leaves or whole plants were more commonly used [28]. Roots were the most frequently used plant parts, followed by leaves and bark. These findings differ from those of Yosef S. et al. (2025), who reported that leaves are the most commonly used parts in Ethiopia for treating human ailments [29]. Roots and leaves are known to retain a wide range of bioactive secondary metabolites long after harvesting, which may account for their frequent use in traditional medicinal preparations [30]. The predominance of root use observed in the present study, although slight, raises environmental concerns, as root harvesting threatens the survival of individual plants [31–33] and, consequently, the preservation of the species in the region. In most studies reported in the literature, leaves are the most commonly used plant parts [34–37], which offers the advantage of allowing regeneration of the plants after collection [38]. Moreover, their study indicated that fresh plant material was predominantly used (67%) [39], whereas in the present study, dried material was predominant. An intriguing aspect of this study was that more than half of remedies were dried and calcined. In fact, most ethnobotanical survey findings reported the predominant use of fresh plant material in traditional medicine [40–43]. This raises questions regarding their mechanism of action. Do they act through residual active compounds, the adsorption of venom, or their properties being altered by calcination? Some authors have investigated the impact of calcination on the bioactivity and phytochemical profile of plant materials. For example, Zhukovets and Özcan (2020) reported reduced antioxidant activity in calcined Zingiber officinale Roscoe extracts compared with their raw forms [44]. Conversely, Xue et al. (2022) reported that carbonisation decreased gingerol levels but increased shogaol and gingerone concentrations [45].
Topical application was the predominant route of administration. Powders are often applied directly to incisions at the bite site, a practice also reported by Bamogo et al. (2023) in Burkina Faso’s Hauts-Bassins and Southwest regions [30]. However, this method is discouraged because of the risks of hemorrhage and infection [46]. Furthermore, given the acute nature of snakebite envenomation, the effectiveness of dermal application is questionable because of variability in the dermal absorption of active compounds.
With respect to pharmacological claims, 46.7% of the THPs believed that their remedies both neutralised the venom and alleviated its effects. In clinical toxicology, snakebite management typically involves symptomatic treatment and specific antivenom therapy [46]. Unlike biomedical treatment, which combines multiple drugs (anti-inflammatories, antibiotics, haemostatics, etc.) with antivenom [47], traditional treatments tend to be monotherapeutic.
With respect to the plant species used, 29 species from 18 botanical families were recorded, reflecting considerable phytochemical diversity and potential for antivenom drug development. Numerous reviews have reported the use of plants in snakebite treatment: Giovannini and Howes (2017) listed 208 species in Central America; Dharmadasa et al. (2016) documented 341 species from 32 families in Sri Lanka; Okot et al. (2020) reported 60 species from 28 families in Uganda; and Dossou et al. (2021) identified 109 species from 51 families in Benin [21, 48–50]. In this study, the Rubiaceae family was the most represented, followed by the Euphorbiaceae, Annonaceae, Apocynaceae, Poaceae, and Sapotaceae families. Several of these species are also used in Mali [51], Nigeria [52], and Kenya [53]. Annona senegalensis Pers., Nauclea latifolia Sm., and Vitellaria paradoxa C.F. Gaertn. Were cited in all three studied regions and had the highest relative citation frequencies (10% each). Similarly, Bamogo et al. (2023) reported Annona senegalensis Pers. as highly cited (14.5%), although Securidaca longipedunculata Fresen. was the most frequently mentioned. Phytochemical screening of Annona senegalensis Pers. extracts revealed the presence of tannins, flavonoids, saponins, alkaloids, glycosides, steroids, essential oils, anthocyanins, triterpenes, and coumarins [54]. These compounds may confer various biological activities, such as anti-inflammatory, analgesic, antibiotic, and hemostatic effects, which could contribute to the treatment of snakebite envenomation [55].
Sections
"[{\"pmc\": \"PMC12281730\", \"pmid\": \"40691653\", \"reference_ids\": [\"CR1\", \"CR2\", \"CR3\", \"CR4\"], \"section\": \"Background\", \"text\": \"Burkina Faso, a landlocked country in West Africa, is characterised by a hot, arid climate and dense tropical vegetation, particularly in its eastern and southern zones [1]. This ecological setting supports a high diversity of venomous snake species, with members of the Viperidae family being the most prevalent [2]. The population is predominantly rural and youthful, with widespread engagement in farming and livestock rearing. These activities frequently bring individuals into contact with grasslands, forested areas, and snake habitats, thereby contributing to a high annual incidence of snakebite cases. Between 2010 and 2020, an estimated 213,683 snakebite cases were recorded [3]. This corresponds to an annual incidence exceeding 20,000 cases, with a case fatality rate of approximately 3% [4].\"}, {\"pmc\": \"PMC12281730\", \"pmid\": \"40691653\", \"reference_ids\": [\"CR5\", \"CR6\", \"CR5\", \"CR7\"], \"section\": \"Background\", \"text\": \"Snakebite envenomation is recognized as a serious medical emergency [5]. It typically presents with local symptoms such as erythema, oedema, and intense pain at the bite site, usually within the first hour. Systemic manifestations may involve emetic episodes, visual disturbances, paraesthesia of the extremities, and diaphoresis [6]. The limbs and hands are the most commonly affected areas. Psychological reactions commonly observed among envenomated patients include acute anxiety, which is often associated with tachycardia and presyncope [5]. The severity and specificity of clinical manifestations depend largely on the species of snake involved, the quantity of venom injected, and the individual physiological response to envenomation [7].\"}, {\"pmc\": \"PMC12281730\", \"pmid\": \"40691653\", \"reference_ids\": [\"CR8\", \"CR9\", \"CR10\", \"CR11\", \"CR12\", \"CR13\"], \"section\": \"Background\", \"text\": \"The treatment of snakebite envenomation typically involves symptomatic management using anti-inflammatory, analgesic, and anticoagulant and sedative therapies [8]. The administration of antivenom serum significantly improves survival outcomes [9]. However, antivenom production is complex and resource-intensive. It requires the preparation of venom mixtures for immunization, the generation of hyperimmune plasma, and the purification of immunoglobulins [10]. In many low-resource settings, fragile infrastructure and high production costs, limit the availability and accessibility of antivenom [11]. As a result, many affected individuals, particularly in rural areas, rely on traditional herbal remedies [12]. These treatments are more accessible, can be used against multiple snake species, and do not require cold storage [13].\"}, {\"pmc\": \"PMC12281730\", \"pmid\": \"40691653\", \"reference_ids\": [\"CR14\", \"CR17\"], \"section\": \"Background\", \"text\": \"Scientific investigations have identified a range of phytochemicals exhibiting antivenom activity. Plant-derived extracts have thereby shown efficacy in counteracting the inflammatory, haemorrhagic, myotoxic, and neurotoxic effects induced by snake venom. In certain cases, these extracts are also employed prophylactically to mitigate the risk of complications [14\\u201317].\"}, {\"pmc\": \"PMC12281730\", \"pmid\": \"40691653\", \"reference_ids\": [\"Fig1\"], \"section\": \"Description of the study area\", \"text\": \"This research constitutes a prospective ethnobotanical study conducted within the Eastern, Centre-Southern, and South-Western health regions of Burkina Faso (Fig.\\u00a01).\"}, {\"pmc\": \"PMC12281730\", \"pmid\": \"40691653\", \"reference_ids\": [\"CR18\"], \"section\": \"Description of the study area\", \"text\": \"The Eastern Region is the largest administrative area in Burkina Faso, covering 46,694 km2. The Centre-South region occupies 11,457 km2, whereas the South\\u2012West region spans 16,318 km2. These regions comprise five, two, and three provinces, respectively [18].\"}, {\"pmc\": \"PMC12281730\", \"pmid\": \"40691653\", \"reference_ids\": [\"CR19\"], \"section\": \"Description of the study area\", \"text\": \"In terms of population, the Eastern region had an estimated 1,941,505 inhabitants in 2019. The Centre-South region recorded 788,341 inhabitants, and the South\\u2012West region was home to approximately 874,030 people during the same year [19].\"}, {\"pmc\": \"PMC12281730\", \"pmid\": \"40691653\", \"reference_ids\": [\"Fig1\", \"CR3\"], \"section\": \"Description of the study area\", \"text\": \"In the Eastern Region, fieldwork was conducted in the localities of Nadiagou, Oumpougdeni, Diapaga, Gay\\u00e9ri, and Kossougoudou. In the Centre-South Region, data collection took place in Kombissiri, Batinga, Nobili, and P\\u00f4. In the South-West Region, surveys were carried out in Loto, Di\\u00e9bougou, Gaoua, and Kampti (Fig.\\u00a01). These three regions were purposively selected to capture potential inter-regional variations in traditional practices related to the management of snakebite envenomation. Moreover, the Eastern, Centre-Southern, and South-Western health regions report thousands of snakebite incidents annually. Between 2010 and 2020, a total of 35,214 cases of snakebite envenomation were recorded by health services in these regions [3], representing an average of over 3000 cases per year.\"}, {\"pmc\": \"PMC12281730\", \"pmid\": \"40691653\", \"reference_ids\": [\"CR20\"], \"section\": \"Data analysis\", \"text\": \"On the basis of the recorded data the relative frequency of citations (RFC) for each plant species were calculated by dividing the number of informants who mentioned a particular species (FC) by the total number of informants surveyed (N) [20]: RFC\\u2009=\\u2009FC/N.\"}, {\"pmc\": \"PMC12281730\", \"pmid\": \"40691653\", \"reference_ids\": [\"Fig2\"], \"section\": \"Traditional health practitioners selection\", \"text\": \"The percentage distribution of the respondents is presented in Fig.\\u00a02.\"}, {\"pmc\": \"PMC12281730\", \"pmid\": \"40691653\", \"reference_ids\": [\"Tab1\"], \"section\": \"Perceptions of the efficacy of traditional health remedies\", \"text\": \"Table 1 presents the distribution of survey participants from each of the three regions, categorised according to their views on the traditional management of ophidian envenomation and the perceived effectiveness of the remedies.\\n\"}, {\"pmc\": \"PMC12281730\", \"pmid\": \"40691653\", \"reference_ids\": [\"Tab2\"], \"section\": \"Sociodemographic profile of the THPs\", \"text\": \"The sociodemographic characteristics of the THPs surveyed in this study are summarised in Table\\u00a02.\\n\"}, {\"pmc\": \"PMC12281730\", \"pmid\": \"40691653\", \"reference_ids\": [\"Tab3\"], \"section\": \"Diagnosis of snakebite envenomation THPs\", \"text\": \"The various diagnostic methods employed by THPs to identify snakebite envenomation are summarised in Table\\u00a03.\\n\"}, {\"pmc\": \"PMC12281730\", \"pmid\": \"40691653\", \"reference_ids\": [\"Tab4\"], \"section\": \"Clinical manifestations reported by THPs\", \"text\": \"Table 4 presents the clinical manifestations reported by snakebite victims to the THPs surveyed.\\n\"}, {\"pmc\": \"PMC12281730\", \"pmid\": \"40691653\", \"reference_ids\": [\"Tab5\"], \"section\": \"Characteristics of antivenom recipes\", \"text\": \"The characteristics related to the physical form, preparation method, administration route, proposed mechanism of action, and treatment cost of the recipes recommended by THPs for the management of snakebite envenomation are summarised in Table\\u00a05.\\n\"}, {\"pmc\": \"PMC12281730\", \"pmid\": \"40691653\", \"reference_ids\": [\"Tab6\"], \"section\": \"Collaboration between THPs and conventional healthcare services\", \"text\": \"Table 6 provides an overview of the mechanisms of collaboration between the surveyed THPs and conventional healthcare personnel in the management of snakebite victims.\\n\"}, {\"pmc\": \"PMC12281730\", \"pmid\": \"40691653\", \"reference_ids\": [\"Tab7\"], \"section\": \"Medicinal plant diversity\", \"text\": \"Table 7 presents the plant species employed by the THPs in the studied regions for the preparation of antivenom remedies.\\n\"}, {\"pmc\": \"PMC12281730\", \"pmid\": \"40691653\", \"reference_ids\": [\"Fig3\", \"Fig3\", \"Fig3\", \"Fig3\"], \"section\": \"Plant part used and initial processing of plant material\", \"text\": \"Roots were the most commonly used plant part in antivenom preparations (29%), followed by leaves (27%), bark (24%), stems (16%), and other parts (4%) (Fig.\\u00a03a). The predominant form of medicinal plant preparation in the region involved dried and calcined material (55.6%) (Fig.\\u00a03b), whereas fresh plant material was used in only a limited number of cases (13.5%) (Fig.\\u00a03b). The dried but uncalcined plant parts accounted for 28.9% of the initial processing of the plant material (Fig.\\u00a03b).\"}, {\"pmc\": \"PMC12281730\", \"pmid\": \"40691653\", \"reference_ids\": [\"Tab8\"], \"section\": \"Frequence of citations (FC) and relative frequency of plant citations (RFC)\", \"text\": \"Table 8 presents the relative frequency with which each plant species was mentioned by traditional health practitioners in relation to the preparation of antivenom recipes.\\n\"}, {\"pmc\": \"PMC12281730\", \"pmid\": \"40691653\", \"reference_ids\": [\"CR21\", \"CR4\"], \"section\": \"Discussion\", \"text\": \"Snakebite envenomation is common in Burkina Faso, as it is in many tropical countries, and constitutes a major medical emergency. In traditional societies, snakebites are not always perceived as accidental encounters between a person and a snake but rather as the result of a curse or malevolent spell cast by an adversary [21]. This belief system may partly explain the widespread reliance on traditional remedies among rural populations. Moreover, the prohibitive cost of healthcare, particularly for communities living in precarious socioeconomic conditions, further encourages the use of traditional medicine [4].\"}, {\"pmc\": \"PMC12281730\", \"pmid\": \"40691653\", \"reference_ids\": [\"CR22\"], \"section\": \"Discussion\", \"text\": \"Data analysis revealed the high level of community recognition enjoyed by these practitioners. Indeed, more than 60% of respondents in each region reported knowing at least one THP and stated that they had either personally experienced or witnessed the efficacy of their treatments. These observations are consistent with those of Bamogo et al. (2021), who documented the crucial role of traditional knowledge and phytotherapy in West African healthcare systems [22].\"}, {\"pmc\": \"PMC12281730\", \"pmid\": \"40691653\", \"reference_ids\": [\"CR21\", \"CR21\"], \"section\": \"Discussion\", \"text\": \"A majority (90%) of the THPs surveyed were male, with over half reporting more than twenty years of experience treating snakebite cases and were illiterate. Similar demographic characteristics have been observed in other studies conducted in Burkina Faso and across the West African subregion. For example, Bamogo et al. (2023) reported that 95% of THPs in the western part of Burkina Faso were male, with 76.1% being illiterate and 70.1% being over the age of 50. Similarly, in Benin, 97.4% of the THPs surveyed were male, with those over 50\\u00a0years of age constituting 51.3% [21]. This male dominance may be attributed to sociocultural norms that limit female participation in traditional healing, except for gender-specific and paediatric ailments such as malaria, haemorrhoids, infertility, and menstrual disorders [21]. The high proportion of experienced THPs may also reflect the selection criteria, which prioritised those with strong reputations within their communities.\"}, {\"pmc\": \"PMC12281730\", \"pmid\": \"40691653\", \"reference_ids\": [\"CR23\", \"CR24\", \"CR25\", \"CR26\"], \"section\": \"Discussion\", \"text\": \"In terms of diagnostic practice, 60% of THPs rely on observing the bite site for signs such as puncture marks, haemorrhage, fang impressions, or specific odours, whereas 26.7% of THPs are based on assessments of clinical signs. Typically, traditional West African medicine does not involve systematic diagnosis combining patient-reported symptoms with laboratory or imaging techniques [23]. Instead, diagnosis is based on symptomatic observation and empirical knowledge. This aligns with the findings of this study, where more than 85% of the THPs used physical and symptomatic criteria. The most commonly reported clinical signs included haematological symptoms (e.g., haemorrhage, haemoptysis, and pallor), followed by inflammatory signs (pain, oedema, necrosis). These manifestations are consistent with viperine syndrome, which encompasses local inflammation, hypotension, and hemorrhagic symptoms. Severe envenomation may even lead to ischaemic or haemorrhagic stroke [24]. These findings are consistent with Roman\\u2019s inventory of venomous snakes in Burkina Faso, which reported a predominance of the Viperidae family, notably Causus maculatus and Echis ocellatus, as the main species responsible for envenomation [25]. In contrast, cobraic syndrome typically begins with paresthesia, fasciculations, muscarinic symptoms, ptosis, and cranial nerve involvement, followed by ascending areflexic paralysis and, ultimately, respiratory failure [26].\"}, {\"pmc\": \"PMC12281730\", \"pmid\": \"40691653\", \"reference_ids\": [\"CR27\"], \"section\": \"Discussion\", \"text\": \"With respect to the therapeutic scope of the remedies, 60% were reported to be effective against all snake species, whereas 40% were specific to viperine envenomation. This specificity likely reflects the high prevalence of Viperidae species in the studied\\u00a0regions. As venom composition and clinical manifestations are species dependent [27], such practitioner beliefs may derive from empirical familiarity with local envenomation patterns.\"}, {\"pmc\": \"PMC12281730\", \"pmid\": \"40691653\", \"reference_ids\": [\"CR28\", \"CR29\", \"CR30\", \"CR31\", \"CR33\", \"CR34\", \"CR37\", \"CR38\", \"CR39\", \"CR40\", \"CR43\", \"CR44\", \"CR45\"], \"section\": \"Discussion\", \"text\": \"For the preparation methods, remedies were mainly in powdered form, primarily plant based. This contrasts with findings from C\\u00f4te d\\u2019Ivoire, where Tra Bi Boli et al. (2024) reported that pastes prepared from freshly ground leaves or whole plants were more commonly used [28]. Roots were the most frequently used plant parts, followed by leaves and bark. These findings differ from those of Yosef S. et al. (2025), who reported that leaves are the most commonly used parts in Ethiopia for treating human ailments [29]. Roots and leaves are known to retain a wide range of bioactive secondary metabolites long after harvesting, which may account for their frequent use in traditional medicinal preparations [30]. The predominance of root use observed in the present study, although slight, raises environmental concerns, as root harvesting threatens the survival of individual plants [31\\u201333] and, consequently, the preservation of the species in the region. In most studies reported in the literature, leaves are the most commonly used plant parts [34\\u201337], which offers the advantage of allowing regeneration of the plants after collection [38]. Moreover, their study indicated that fresh plant material was predominantly used (67%) [39], whereas in the present study, dried material was predominant. An intriguing aspect of this study was that more than half of remedies were dried and calcined. In fact, most ethnobotanical survey findings reported the predominant use of fresh plant material in traditional medicine [40\\u201343]. This raises questions regarding their mechanism of action. Do they act through residual active compounds, the adsorption of venom, or their properties being altered by calcination? Some authors have investigated the impact of calcination on the bioactivity and phytochemical profile of plant materials. For example, Zhukovets and \\u00d6zcan (2020) reported reduced antioxidant activity in calcined Zingiber officinale Roscoe\\u00a0extracts compared with their raw forms [44]. Conversely, Xue et al. (2022) reported that carbonisation decreased gingerol levels but increased shogaol and gingerone concentrations [45].\"}, {\"pmc\": \"PMC12281730\", \"pmid\": \"40691653\", \"reference_ids\": [\"CR30\", \"CR46\"], \"section\": \"Discussion\", \"text\": \"Topical application was the predominant route of administration. Powders are often applied directly to incisions at the bite site, a practice also reported by Bamogo et al. (2023) in Burkina Faso\\u2019s Hauts-Bassins and Southwest regions [30]. However, this method is discouraged because of the risks of hemorrhage and infection [46]. Furthermore, given the acute nature of snakebite envenomation, the effectiveness of dermal application is questionable because of variability in the dermal absorption of active compounds.\"}, {\"pmc\": \"PMC12281730\", \"pmid\": \"40691653\", \"reference_ids\": [\"CR46\", \"CR47\"], \"section\": \"Discussion\", \"text\": \"With respect to pharmacological claims, 46.7% of the THPs believed that their remedies both neutralised the venom and alleviated its effects. In clinical toxicology, snakebite management typically involves symptomatic treatment and specific antivenom therapy [46]. Unlike biomedical treatment, which combines multiple drugs (anti-inflammatories, antibiotics, haemostatics, etc.) with antivenom [47], traditional treatments tend to be monotherapeutic.\"}, {\"pmc\": \"PMC12281730\", \"pmid\": \"40691653\", \"reference_ids\": [\"CR21\", \"CR48\", \"CR50\", \"CR51\", \"CR52\", \"CR53\", \"CR54\", \"CR55\"], \"section\": \"Discussion\", \"text\": \"With respect to the plant species used, 29 species from 18 botanical families were recorded, reflecting considerable phytochemical diversity and potential for antivenom drug development. Numerous reviews have reported the use of plants in snakebite treatment: Giovannini and Howes (2017) listed 208 species in Central America; Dharmadasa et al. (2016) documented 341 species from 32 families in Sri Lanka; Okot et al. (2020) reported 60 species from 28 families in Uganda; and Dossou et al. (2021) identified 109 species from 51 families in Benin [21, 48\\u201350]. In this study, the Rubiaceae family was the most represented, followed by the Euphorbiaceae, Annonaceae, Apocynaceae, Poaceae, and Sapotaceae families. Several of these species are also used in Mali [51], Nigeria [52], and Kenya [53]. Annona senegalensis Pers., Nauclea latifolia Sm., and Vitellaria paradoxa C.F. Gaertn. Were cited in all three studied regions and had the highest relative citation frequencies (10% each). Similarly, Bamogo et al. (2023) reported Annona senegalensis Pers.\\u00a0as highly cited (14.5%), although Securidaca longipedunculata Fresen. was the most frequently mentioned. Phytochemical screening of Annona senegalensis Pers.\\u00a0extracts revealed the presence of tannins, flavonoids, saponins, alkaloids, glycosides, steroids, essential oils, anthocyanins, triterpenes, and coumarins [54]. These compounds may confer various biological activities, such as anti-inflammatory, analgesic, antibiotic, and hemostatic effects, which could contribute to the treatment of snakebite envenomation [55].\"}]"
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