Indian Journal of Traditional Knowledge

Vol. 17(1), January 2018, pp. 34-42

Ethnobiological study of traditional medicine practices for the treatment of

chronic leg ulcer in South eastern Nigeria
Felix I Nwafor1*, Michel K Tchimene2, Peculiar F Onyekere1, Nkechinyere O Nweze3 & Celestina I Orabueze4
1
Department of Pharmacognosy and Environmental Medicines, University of Nigeria, Nsukka, 410 001, Enugu State, Nigeria;
2
International Centre for Ethnomedicine and Drug Development (Inter CEDD), Nsukka, 410 002, Enugu State, Nigeria;
3
Department of Plant Science and Biotechnology, University of Nigeria, Nsukka, 410 001, Enugu State, Nigeria;
4
Departments of Pharmacognosy, University of Lagos, PMB 12003, Surulere, Lagos, Nigeria
E-mails: felix.nwafor@unn.edu.ng, felixnucifera@gmail.com, mtchimene@yahoo.fr, peculiar.onyekere@unn.edu.ng,
nkechinyere.nweze@unn.edu.ng, ifeoma_orabueze@yahoo.com
Received 15 May 2017, revised 2 August 2017

A comprehensive survey was carried out to document plants and non-plant materials used in traditional medicine
practices for the treatment of chronic leg ulceration in 13 randomly selected Local Government Areas in Anambra and
Enugu States of South east Nigeria. Semi-structured questionnaires as well as informal interviews were administered on 92
respondents, including specialist herbalists, local herb sellers, hunters and other groups of people rich in traditional medicine
knowledge. Photography and short interviews were conducted on some of the patients met in some popular herbal clinics to
obtain their perspectives of the disease. All interviewed respondents gave descriptions that fitted exactly into the general
diagnosis of leg ulcer but with different methods of preparation and modes of administration of the herbal recipes. Thirty six
(36) recipes prepared from 78 plants and 14 non-plant materials were documented as described by the respondents. The 78
plants spread across 41 families. Herbal products were administered orally and by topical application. This study can form a
basis through which pharmaceutical industries can screen these plant species and possibly come out with useful medicines
for treatment of chronic leg ulceration and other related forms of skin ulcer.

Keywords: Ethnobiological survey, Traditional medicine practice, Leg ulcer, South eastern Nigeria
IPC Int. Cl.8: A61K 36/00, A01D 20/48, A61B 17/22, A61G 1/056

Plants have proven themselves as dependable
resources in treatment of diseases in humans. Every
traditional and cultural society has its own medical
system, most of which depends on the plants around
them. Some of these are ethnic and relatively
undeveloped while others are more sophisticated and
are being used in tandem with modern medical
systems. The challenge for plants as medicine is that
the elders who are knowledgeable in this art are
growing old and dying, and plants are being lost to
urbanization and deforestation1. Ethnobiological
studies are carried out by botanists, pharmacists,
medical scientists and other related scholars in order
to gather information from the indigenous people on
how they use bioresources for medicine. It also
provides the rationale for identification, scientific
investigation and potential utilization of medicinal
plants and animals, as well as preservation of their
traditional knowledge for improved healthcare
delivery2. Documentation of indigenous knowledge
—————
*Corresponding author
through ethno-botanical information is very important
for the conservation of biodiversity and biological
resources3.
A leg ulcer is a wound with tissue loss on the lower
leg, including the foot, with full thickness depth and
size and a slow healing tendency4,5. It is most common
in adults, affecting 3-5 % in the population over 65 yrs
of age, having a similar impact on people’s quality of
life as diabetes and arthritis4. Venous insufficiency (45
– 60 %), arterial occlusion (10 – 20 %), diabetes (15 –
25 %), infection, vasculitis, sickle cell disease and
physical or chemical injuries are all possible causes of
chronic leg ulceration6. The pathogenesis of chronic
ulcers is complex. Mechanical obstruction by dense
sickled red blood cells, venous incompetence, bacterial
infections, abnormal autonomic control with excessive
vasoconstriction (when in the dependent position), in
situ thrombosis, anemia with decrease in oxygen
carrying capacity, and decreased nitric oxide
bioavailability leading to impaired endothelial function
have all been proposed as potential contributing
factors7.
 NWAFOR et al.: TRADITIONAL MEDICINE PRACTICES FOR THE TREATMENT OF CHRONIC LEG ULCER IN NIGERIA
Early symptoms include spontaneous inflammation
and pain at the affected area followed by sore on the
skin that usually takes long time to heal8. Leg ulcer
often becomes chronic, causing pain, social
discomfort, and great economic loss and can
subsequently lead to amputation and death. The
treatment of leg ulcer follows accurate identification
of its aetiology. External compression through
compression stockings, stretch bandages, rigid paste
systems, is the major principle of managing venous
ulceration. Other principles are debridement and
cleansing of necrotic tissues, management of pain,
taking care of underlying pathogenic factors and
healing of wound4,5,8.
Plant based preparations have been generally used
in traditional treatment of skin ulcers and wound
healing. These include Carica papaya9,10, Cynodon
dactylon11,12, Chromolaena odorata13, Persea
americana14, Momordica charantia15 and Newbouldia
laevis16. In traditional usage, the leaves are usually
ground into a paste and applied topically on affected
places to heal wounds17.
The Igbo ethnic group inhabits the South east
Nigeria. The Igbos are distributed into five
administrative States - Abia, Anambra, Ebonyi,
Enugu and Imo. Varieties of culture, dialects and
etiquette exist across the Igbo people18. They are one
of the largest groups in Africa with population of
about 12 million and have the highest population
densities in West Africa19. Over the years, leg ulcer
has become increasingly common in South-eastern
Nigeria, especially in the rural areas where the disease
has been widely perceived as spiritually-inclined,
causing paranoia among the indigenous people. Like
in many other cultures, medicinal plants are widely
used by the local people of South east Nigeria to
manage chronic leg ulcer and other related diseases.
However, for many of the plants in use, their methods
of preparation and efficacy have not been
documented. Consequently, this study was aimed at
documenting the indigenous knowledge of these
plants and the way they are used, so as to create the
awareness for further pharmacological investigations
for potential source of active bioactive wound healing
drugs.
Methodology
Study area
This survey was conducted in Anambra and Enugu
States of South east Nigeria (Fig. 1). Twenty-five
towns in 12 local Government areas (LGAs) were
35
randomly selected for the study based on pre-
information on their high prevalence of chronic leg
ulcer as well as traditional beliefs and competence in
traditional medicine practices. The LGAs were
Anambra State: Aguata (6°01'0''N 7°05'0''E),
Anambra East (6°16'0''N 6°49'0''E), Awka South
(6°10'N 7°04'E), Anyamelum (6°33'13''N 6°59'13''E),
Dunukofia (6°13'22''N 6°56'13''E), Idemmili North
(6°07'42''N 6°56'0''E), Njikoka (6°11'3''N 6°58'35''E)
and Nnewi North (6°01'10''N 6°55'2''E); Enugu State:
Igbo Etiti (6°40'N 7°22'E), Igboeze North (6°59'N
7°27'E), Igbeze South (6°55'N 7°24'E), Nsukka
(6°51'24''N 7°23'45''E) and Udenu (6°55'N 7°31'E).
The people belong to the Igbo ethnic group and they
speak diverse dialects of Igbo language. Their major
sources of livelihood include farming, trading and
fishery. The vegetation extends from rainforest (in
Anambra State) to derived savanna (in Enugu State).
The wet season extends from March to
October/November, the dry season is from November
to March and the annual rainfall ranges from 1,845 –
2000 mm. Annual temperature is between 25 oC and
27 oC18,19.
Prior informed consent
The purpose of the study was explained to the
respondents and their prior informed consent obtained
while those who refused to give their consent were
dropped from the study.
Data collection
Data collection was done between March 2014 and
April 2015. Individual interview through semi-
Fig. 1 — Map of South east Nigeria (arrows show the study areas–
Anambra and Enugu States) Source: https://en.wikipedia.org/wiki/
Igboland)
36 INDIAN J TRADIT KNOWLE, VOL. 17, NO. 1, JANUARY 2018
structured questionnaires was the main method of data
collection. Ninety two (92) informants, 20 yrs old and
above, including professional herbalists, herb sellers
and other knowledgeable respondents were selected for
the study. The interview was conducted in their local
dialects and their responses were recorded in English
language. Information recorded were demographic
profile, local name and diagnosis of the ailment, plants
(their local names and parts) and non-plant materials
used, method of preparation, mode of administration,
etc. Short trips were taken with the informants to the
wild for collection of the plant specimens.
Plant identification and authentication
Preliminary identification and photography were
done by a botanist and afterwards they were
compared with the voucher specimens at the
herbarium of the International Centre for
Ethnomedicine and Drug Development (Inter CEDD),
Nsukka using taxonomic keys of Flora of West
Tropical Africa20.
Data analysis
Excel spread sheet was used to make simple
calculations and statistical analysis to determine the
citation frequencies of the bioresources.
Results
From the total of 92 informants 74 were males
while 18 were females. The demographic profile
shows that respondents from 61 yrs old and above
gave the most information about the local treatment of
the disease while the least information was obtained
from respondents of 30 yrs old and below (Table 1).
All interviewed respondents who claimed to treat leg
ulcer gave descriptions that fitted exactly into the
general diagnosis of leg ulcer but with different
methods of preparation and modes of administration
of the herbal recipes. Their diagnostic symptoms
include inflammation, redness of the affected area,
pain and wound that takes long time to heal. A total of
78 plants and 14 non-plant materials were
encountered in the study. The family Fabaceae had
the highest citations (9) followed by Apocynaceae (6),
and Euphorbiaceae and Asteraceae which had 5 each.
The three most cited plants were Ageratum
conyzoides L. (2.7 %), Acanthus montanus (Nees)
T. Anders. (2.5 %), Aspilia africana and Emilia
sonchifolia (2.3 % each). The least cited were
Terminalia superb Engl. & Diels (0.3 %) and
Tacazzea apiculata Oliv. (0.1 %) (Table 2). The
plants belonged to different growth habits–trees
(42 %), shrubs (17 %), herbs (28 %) and climbers (13
%) (Fig. 2). Different plant parts were used in
preparing the recipes, with the leaf being the most
useful part with 31% applications followed by the
root (19%), aerial parts and stem bark with 17% and
1% citations respectively (Fig. 3). Non-herbal
materials encountered include honey, salt, aluminum
sulphate, anthill, human saliva, human urine, animal
parts (head of cobra and scorpion) and some already
processed products from plants (palm oil, palm kernel
oil, local spice and camwood extract).
Thirty-six (36) most commonly prepared recipes
from the plants and non-plant materials were
documented as described by the respondents. The
methods of preparation include decoction, infusion and
poultice and the products were administered either
orally or by topical application. Single plant recipes
were Leea guinenesis (cold water infusion from leaves
are used to wash the affected area at the initial stage of
infection and to remove old dressings), Ageratum
conyzoides (leaf infusions used in wound dressing and
helps in removing necrotic tissues), Erythrina
senegalensis (infusion from stem bark used in wound
dressing), Raphia hookeri (burnt fibres from the stem,
ground and mixed with human saliva and local spice is
applied topically on the inflamed areas), Dioscorea
bulbifera (poultice from the aerial bulbils is applied
topically on affected areas), Byrsocarpus coccineus
(roots are chewed continually to relieve pain and
facilitate wound healing) and Emilia praetermissa (leaf
infusions used in wound dressing and helps in
removing necrotic tissues). Separately prepared
decoctions from Azadirachta indica leaves and Vitex
simplicifolia leaves and stem bark are individually
administered orally, in 200 mL doses, twice daily until
full recovery. Decoctions from Cajanus cajan aerial
parts, Pavetta sp leaves, Spondias mombin leaves and
little common salt are used individually in cleaning the
wound before dressing. Latex from Calotropis procera
is applied topically on affected areas.
Table 1 — Some demographic characteristics of the respondents
Number of Respondents Sex
Age
(Years) Females Males
10 20-30 - 10
12 31-40 4 8
26 41-50 7 19
16 51 – 60 7 9
28 61 and above - 28
Total: 92 18 74
 NWAFOR et al.: TRADITIONAL MEDICINE PRACTICES FOR THE TREATMENT OF CHRONIC LEG ULCER IN NIGERIA 37

Table 2Data obtained from the ethnobiology survey of the medicinal plants used in treatment of chronic leg ulcer in the study area  (Contd).

Family Botanical name Local name Part(s) used Habit Citations Voucher
(%) Number
Acanthaceae Acanthus montanus (Nees) Agamebu Leaf Herb 2.5 INT/035
T. Anders.
Agavaceae Aloe barbadensis Mill. Aloe vera Juice Herb 2.1 INT/1612
Amaryllidaceae Crinum jagus (Thomps.) Dandy Yabasi muo Bulb Herb 2.2 INT/852
Anacardiaceae Lannea welwitschi (Hiern) Engl. Aji agu Stem bark Tree 2.0 INT/1622
Spondias mombin L. Isikara Leaf Tree 2.3 INT/057
Annonaceae Annona senegalensis Pers. Uvuru ocha Aerial parts/roots Shrub 1.9 INT/064
Uvaria chamae P. Beauv. Mmimi ohia Aerial parts Shrub 2.0 INT/001
Xylopia aethiopica (Dunal) A. Rich Uda Fruits Tree 0.8 INT/205
Apocyanaceae Calotropis procera (Ait.) R. Br. Unknown Latex Shrub 0.8 INT/1613
Alstonia boonei De Wild. Egbu Stem bark Tree 0.8 INT/024
Catharanthus roseus (L.) G. Don Unknown Leaves Herb 1.1 INT/1616
Holarrhena floribunda (G. Don) Dur. & - Roots Tree 1.2 INT/049
Schinz
Landolphia dulcis (R. Br. Ex Sabine) Akwari Aerial part Climber 1.6 INT/067
Pichon
Rauvolfia vomitoria Afzel. Akanta Aerial part Tree 1.2 INT/002
Araceae Anchomanes difformis (Blume) Engl. Oje/ede muo Tuber Herb 2.0 INT/1578
Arecaceae Raphia hookeri Mann & Wendl. Akiriko ngwo Fibre Tree 1.5 INT/1626
Asteraceae Ageratum conyzoides L. Isi agadi nwaanyi Aerial part Herb 2.7 INT/073
Aspilia africana (Pers) C.D. Adams Aramjila Leaves Herb 2.3 INT/206
Chromolaena odorata (L.) R. M., King Okome Leaves Herb 2.2 INT/026
& H. Rob.
Emilia sonchifolia (L.) DC. Nti oke Aerial part Herb 2.3 INT/305
Vernonia amygdalina Del. Onugbu Leaves Shrub 1.7 INT/041
Bignoniaceae Kigelia Africana (Lam.) Benth. Uturubenyi Stem bark Tree 2.2 INT/069
Newbouldia laevis (P. Beauv.) Seem. Ogirisi Root bark Tree 2.2 INT/033
Spathodea campanulata P. Beauv. Imi ewu Stem bark Tree 2.0 INT/006
Capparidaceae Ritchiea capparoides (Andr.) Britten Aka ato Root Climber 0.7 INT/803
Combretaceae Anogeissus leiocarpa (DC.) Guill. & Perr. - Stem bark, leaves Tree 0.9 INT/1630
Combretum racemosum - Leaves Climber 1.4 INT/804
Terminalia superba Engl. & Diels Edo Roots Tree 0.3 INT/203
Commelinaceae Palisota hirsuta (Thunb.) K. Schum. Ikpere ukwu mmuo Whole plant Herb 0.9 INT/1624
Connaraceae Byrsocarpus coccineus Schum. & Thonn.Nri abusi Root Shrub 1.1 INT/021
Cucurbitaceae Momordica charantia L. Nsi udene Aerial part Climber 1.1 INT/108
Dioscoreaceae Dioscorea bulbifera L. Adu Aerial bulbils Climber 1.2 INT/1580
Ebenaceae Diospyros preussii Gurke Akpuru-ike Leaves Tree 0.4 INT/1618
Ephorbiaceae Ricinodendron heudelotti (Baill.) Pierre Okwe Stem bark, root Tree 1.1 INT/1627
ex Pax
Bridelia ferruginea Benth. Ede Leaves Tree 1.6 INT/076
Hymenocardia acida Tul. Ago-ozalla Leaves Tree 1.5 INT/1621
Jatropha curcas L. Leaves Shrub 1.8 INT/404
Phyllanthus discoideus (Baill.) Müll. Arg. Isi mkpi Roots Tree 0.6 INT/1579
(Contd.)
38 INDIAN J TRADIT KNOWLE, VOL. 17, NO. 1, JANUARY 2018

Table 2Data obtained from the ethnobiology survey of the medicinal plants used in treatment of chronic leg ulcer in the study area  (Contd).

Family Botanical name Local name Part(s) used Habit Citations Voucher
(%) Number
Fabaceae Albizia adianthifolia (Schum.) W.Wight Ngwu Root bark Tree 1.4 INT/1610
Cajanus cajan (L.) Millsp. Fio-fio/Agbugbu Aerial part Herb 2.1 INT/827
Cassia siamea Lam. - Leaves Tree 1.6 INT/089
Cassia sieberiana DC. - Stem bark Tree 1.5 INT/1615
Desmodium velutinum (Willd) DC. Ike-agwuani Aerial parts Shrub 1.1 INT/097
Detarium microcarpum Guill. & Perr. Ofo Stem bark Tree 0.8 INT/007
Dichrostachys cinerea (L.) Wight & Arn. Ami-ogwu Roots Tree 1.0 INT/048
Senna alata (L.) Roxb. Edema Leaf Shrub 1.6 INT/900
Tetrapleura tetraptera (Schum. & Isha-isha Fruits Tree 0.9 INT/085
Thonn.) Taub.
Hypericaceae Harungana madagascariensis Lam. ex Poir.Oturu Stem bark, roots Shrub 1.4 INT/061
Lamiaceae Ocimum gratissimum L. Nchu anwu Leaves Herb 1.0 INT/863
Lauraceae Cassytha filiformis L. Ogbanaigorigo Aerial part Climber 2.2 INT/065
Lecythidaceae Napoleona imperialis P. Beauv. Mkpodu Root Shrub 1.3 INT/077
Malvaceae Hibiscus surattensis L. Agboghoakabi Leaf Climber 0.6 INT/1620
Sida linifolia Juss. Ire agwo Leaf Herb 1.5 INT/1628
Meliaceae Azadirachta indica A. Juss. Dogonyaro Leaves Tree 1.3 INT/966
Menispermaceae Tinospora cordifolia (Willd.) Miers Udo akpu enyi Stem Climber 0.8 INT/1632
Moringaceae Moringa oleifera Lam. Moringa Root Tree 2.0 INT/025
Nyctaginiaceae Boerhavia diffusa L. - Leaves Herb 1.1 INT/018
Ochnaceae Lophira lanceolata Van Tiegh. Ex Keay Okopi Root Shrub 1.0 INT/005
Periplocaceae Tacazzea apiculata Oliv. - Fruits Climber 0.1 INT/1629
Polygalaceae Securidaca longepeduncalata Fres. Uga-agu, ezeogwu roots Tree 1.7 INT/1600
Proteaceae Protea madiensis Oliv. Okwo-okwo Roots Shrub 0.5 INT/010
Rubiaceae Fadogia cienkowskii Schweinf. Ogwu agu Aerial part Herb 0.6 INT/1607
Morinda lucida Benth. Ogere Leaf, root Tree 1.0 INT/011
Oldenlandia corymbosa L. - Whole plant Herb 0.8 INT/970
Pavetta sp L. - Leaf Shrub 0.4 INT/1625
Rutaceae Citrus aurantifolia L. Oloma nkirisi Fruit juice Tree 1.0 INT/1617
Sapindaceae Paullinia pinnata L. Ashaka-moo Roots Climber 1.0 INT/303
Simaroubaceae Hannoa klaineana Pierre & Engl. - Stem bark Tree 0.5 INT/1619
Solanaceae Capsicum annuum L. Ose Fruits Herb 0.6 INT/1614
Sterculiaceae Cola accuminata (P.Beauv.) Oji Root bark Tree 1.1 INT/075
Schott & Endl.
Verbenaceae Vitex doniana Sweet Mbe-mbe Stem bark Tree 1.1 INT/207
Vitex simplicifola Oliv - Stem bark Tree 0.7 INT/868
Vitaceae Leea guineensis G. Don Odudu nwata Leaf Shrub 1.4 INT/1623
Zingiberaceae Aframomum melegueta K Schum. Ose oji Seeds Herb 1.0 INT/862
Allium sativum L. Yabasi hausa Bulb Herb 1.5 INT/1611
Costus lucanusianus J. Braun & K. Okpete mmuo Stem Herb 0.8 INT/019
Schum.
Thaumatococus daniellii (Benn.), Benth. Uma Leaves Herb 0.6 INT/1631
Zingiber officinale Rosc. Ginger Rhizomes Herb 1.0 INT/1633
 NWAFOR et al.: TRADITIONAL MEDICINE PRACTICES FOR THE TREATMENT OF CHRONIC LEG ULCER IN NIGERIA 39

Equal amounts of Hannoa klaineana stem bark and Whatever the critics of the use of plants for
Rauvolfia vormitoria leaves and suitable quantity of medicinal purposes think or say, the agreement
Tetrapleura tetraptera fruits are boiled with water. between the traditional medicine practitioners in the
Two hundred milliliters of the decoction is taken use of the same plants, for the treatment of the same
orally twice daily until recovery. Poultices made from disease, proves that they actually possess the claimed
Anchomanes difformis tuber and Crinum jagus bulbs, biological activities. Ageratum conyzoides was cited
as well as those made from leaves of Acanthus 63 times (2.7 %), Acanthus montanus (2.5 %), while
montanus and Sida linifolia, are applied topically on Aspilia africana and Emilia sonchifolia had 2.3 %
the affected area to treat inflammation. Decoction citation each. Literature search also showed that
made from known quantities of Vitex doniana stem Uvaria chamae and Spondias mombin cited in this
bark, Uvaria chamae and Xylopia aethiopica is taken research (in South eastern Nigeria) are also used for
orally, in 200 mL doses, twice daily until full wound treatment in other parts of Nigeria21. The
recovery. A heavy concoction comprising roots of leaves were the most cited plant part from this study
Newbouldia laevis and Albizia adianthifolia, cloves of and the most common method of preparation and
Allium sativum, seeds of Aframomum melegueta, mode of administration were poultice and by topical
anthill, scorpion and head of cobra is prepared amidst application respectively. This agrees with Ayyanar &
some incantations and topically applied on the Ignacimuthu17 who mentioned that in traditional
affected areas for both physical and spiritual healing. medicine practice of wound healing, the leaves of the
Juicy extract from leaves of Aloe babardense is mixed medicinal plants are usually ground into a paste and
with equal volumes of honey and palm kernel oil and applied topically on affected areas.
applied topically on wound surfaces to promote The treatment of leg ulcer follows accurate
healing. Powdered substance from burnt R. hookeri identification of its aetiology and before this can be
fibre is mixed with palm kernel oil and camwood successful there must be provision for management of
extract and used as cream after wound healing to
remove scars. Some cases of chronic leg ulceration
encountered during the survey have shown in Fig. 4.
Discussion
The potential and promise of plants in the treatment
of diseases are no longer in doubt. The efficacy and
safety of plants in the treatment of human disease have
been proven by both traditional and orthodox systems of
medicine as well as in vitro and in vivo pharmacological
evaluations in reputable laboratories. Their utilization in
wound treatment is no exception. The present study
showed that traditional healthcare system in South
eastern Nigeria is predominantly practiced by the male Fig. 2 — Percentage growth habits of the documented plants
gender. This includes herb selling, consultation,
diagnoses and dispensing of herbal preparation to the
patients. More often they have a permanent consulting
clinic or place. This agrees with the report of Ajibesin13
and Hermans et al.1 who claimed that herbal practice in
some cultural settings is gender sensitive. The tradition
knowledge of medicinal plants and their use are often
reserved for the male folks in order to retain such in the
family lineage2. It was also observed from the present
study that most of the traditional knowledge is reserved
in the older class, from 61 yrs old and above thus, there
is a concern for frequent investigation and
documentation in a view to conserve this knowledge
from extinction3. Fig. 3 — Percentage plant parts used as reported from the study
40 INDIAN J TRADIT KNOWLE, VOL. 17, NO. 1, JANUARY 2018

Fig. 4 — Cases of chronic leg ulceration encountered during the survey (Photographs taken by the authors themselves) A= Early stage of
inflammation; B= Early stage of ulceration; C= Later stage of ulceration; D= Leg ulceration in a sickle cell patient; E= Early stages of
wound healing; F= Later stage of wound healing

pain and inflammation, taking care of underlying
pathogenic factors and healing of wound4,5. Literature
review of existing laboratory results backs up most of
the plants reported in this study. C. papaya and J. curcas
exhibited analgesic and anti-inflammatory activities in
rats10. Methanolic leaf extract of A. indica was reported
to signifcantly (p < 0.05) promote wound healing
activity in both excision and incision wound models in
rats22, and application of Aloe vera to an open wound
induced significant wound contraction and accelerated
wound healing23.
Other laboratory evaluations on the wound healing
properties of some of the cited plants in this research
include the following: Cynodon dactylon11,12,
Prosopis africana24, Napoleona imperialis25, Aspilia
africana26, Ageratum conyzoides27, Catharanthus
roseus28,29, Calotropis procera30,31, Carica papaya32,
Ocimum gratissimum33,34, Aloe vera35-37, Crinum
jagus38, Moringa oleifera39 and Kigelia africana40.
Furthermore, having earlier mentioned that diabetics
constitutes 15–25 % of causes of leg ulcer6, it is
interesting to note that some of the plants reported in
this study have also been proven to possess strong
anti-diabetic properties. They include Acanthus
montanus41,42, Aloe vera43,44, Alstonia boonei45,46,
Ocimum grattissimum47 and Allium sativum48.
Conclusion
The management of chronic leg ulcers in South
eastern Nigeria is in line with the practice in other
parts of the country and the world as a whole. The
knowledge base of the practice though not acquired
through any formal training (as other traditional
medicine systems) has some scientific and practical
proofs. Therefore, the results from this study could
form a basis through which pharmaceutical industries
can screen these plant species and possibly come out
with useful medicines for treatment of chronic leg
ulceration and other related forms of skin ulcer.
Acknowledgment
The authors wish to acknowledge the informants
who provided valuable information and shared the
traditional knowledge documented in this research.
Special thanks to Chief Dr. Nweke Ifeorah, a
specialist in the treatment leg ulcers and the founder
of Edikata-Ekwue Herbal Clinic, Abagana, Anambra
State for the great assistance rendered during this
study. We also thank the patients who gave their
 NWAFOR et al.: TRADITIONAL MEDICINE PRACTICES FOR THE TREATMENT OF CHRONIC LEG ULCER IN NIGERIA
consents and granted interview sessions with the
researchers.
Conflicts of interest
The authors have not declared any conflicts of
interest.
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