Therapeutic uses of Mimusops zeyheri Sond., by the Vhavenda Traditional Health Practitioners in the Vhembe Biosphere Reserve, South Africa

INTRODUCTION

Genus Mimusops is known to belong to diverse genera of flowering plants [1]. Hamdy et al. [1] approximated the number of species distributed within this genus to reach 47. Therefore, only four species among these 47 members of this genus are considered indigenous in Southern African countries [2]. This includes Mimusops caffra E.Mey. ex A.DC., Mimusops obovata Nees ex Sond., Mimusops zeyheri Sond., and Mimusops obtusifolia Lam., [1]. In South Africa, M. caffra is spread alongside the coastal belt in the KwaZulu Natal and the Eastern Cape region [3], with M. obovata widespread across the eastern escarpment of the Limpopo and Mpumalanga provinces through the Kingdom of Eswatini to KwaZulu Natal and stretch towards the Eastern Cape Province [4], while the distribution of M. obtusifolia is considered uncertain in South Africa; however, some scholars argued that its distributional range stretches across the northern provinces [5]. The distributional range of M. zeyheri is also considered widespread in South Africa, stretching across the northern provinces of Limpopo, Mpumalanga, Gauteng, North-West, and KwaZulu Natal [4]. This plant species is known to have adapted to different habitats, including the Tzaneen Sour Bushveld, Sekhukhune Mountain Bushveld, Limpopo Sweet Bushveld Soutpansberg Mountain Bushveld, Waterberg Mountain Bushveld, Makhado Sweet Bushveld [4], but not the least. Different tribal ethnic groups in the northern provinces of South Africa called M. zeyheri using distinct vernacular names, which differ from one group to another [4]). As an example, the Afrikaaner vernacular name for M. zeyheri is Transvaalmelkhout, whereas its Venda name is Mumbubulu, and therefore, in the Ndebele language, it is called Umbumbulu [4,6]6]. Therefore, these vernacular names translate to M. zeyheri’s distributional range and diverse utilizations in various parts of South Africa. Ramarumo and Maroyi [7] stated that vernacular names for a particular species provide information about its uses and distributional range. Furthermore, it is a mutual understanding that most indigenous local communities do not give names to plants they do not utilize [7].

Due to that, it is, therefore, arguable that those tribes utilize M. zeyheri for varied purposes and visa-versa. Scientific evidence suggests that indigenous people from different tribes differ in their knowledge about the utilizations of similar or diverse plant species [8–11]. For example, the study by Mabogo [12] reported that the Vhavenda tribe of South Africa utilizes the Opuntia ficus-indica (L.) Mill. ‘s root to remedy toothache. In contrast, Mbambala et al. [13] asserted that the same tribe utilizes the root of a similar species for treating mouth sores and wounds, while Maema et al. [14] accentuate that the Bapedi tribe utilizes the same root to remedy sexually transmitted ailments such as Syphilis and Gonorrhoea. Due to this, and since M. zeyheri is widespread across various tribal regions in the northern provinces of South Africa, there is no doubt that local people across those tribal communities utilize it for varied purposes. The search for alternative medicines has swiftly increased nationwide and worldwide [15]. This was due to an increase in market value and share of medicinal plants [16], an increasing number of pandemics [17], and the growing number of patients who are rapidly consulting traditional healthcare systems nationwide [18]. According to Mander et al. [19], 27 million people countrywide consult traditional health practitioners for their daily immediate healthcare.

However, there are still inadequate numbers of ethnobotanical studies that report on certain medicinal plants, including the utilization of M. zeyheri for both medicinal and fruit purposes [20–23], whereas, it contributes to local traditional primary healthcare, but remains not definitively studied [24]. This justifies the utmost need to investigate further ethnomedicinal knowledge associated with M. zeyheri by the Vhavenda traditional health practitioners in the Vhembe Biosphere Reserve of the Limpopo Province, South Africa. The study by Ahad et al. [25] emphasizes that approximately half of the traditional medicines worldwide, particularly those possessing the potential to remedy most challenging ailments, have not yet been comprehensively studied. Within the same context, this study aimed to explore therapeutic uses, preparatory techniques, and administration of M. zeyheri by the Vhavenda traditional health practitioners in the Vhembe Biosphere Reserve, Limpopo Province, South Africa. It is worth noting that no previous studies have evaluated detailed therapeutic usage, preparatory techniques, and administration of M. zeyheri by the Vhavenda traditional health practitioners. The recent study sought to preserve local indigenous medicinal knowledge associated with M. zeyheri in the Vhembe region. This study contributes to addressing some issues linked to South Africa’s Version 2030 National Development Plan, African Union Priorities incorporated within Agenda 2063, and the United Nations Sustainable Development Goals, particularly the aspects concerning the improvement of life on land and primary health care system [26–29].

MATERIALS AND METHODS

Ethnomedicinal data gathering

Semi-structured questionnaires were used in an interview with two first traditional health practitioners discovered through arbitrary informants section to elicit information regarding the ethnomedicinal uses, preparatory techniques, and administration process in the Vhembe Biosphere Reserve [40–41]. An exponential non-discriminative snowball sampling method was then applied to systematically discover an additional 19 traditional health practitioners to take part in the current study. Furthermore, a total number of 21 traditional health practitioners participated in the recent study. The unwillingness of suggested practitioners in the region influenced the small sample size of participants in the recent study. It is worth indicating that 69 suggested traditional health practitioners were visited at their homesteads between June and July 2023; however, only 21 agreed to participate in the recent study. The selected sample size of 21 participants was informed by the number of suggested people who gave the informed consent. This was justified by Crouch and McKenzie [42]; Guest et al. [43], Latham [44], and Atyosi et al. [41], who suggested that saturations mostly occurred when less than 12 participants were homogenously selected; however, heterogenous sample, participants should be at least more than 12. The first two arbitrarily selected traditional health practitioners were purposefully interviewed about the medicinal usage of M. zeyheri, and therefore, afterward, requested to suggest any of their colleagues and let them know that the researchers were interested in interviewing them about the medicinal uses of the targeted species. Following the receipt of informed consent, homestead visits were made to traditional health practitioners to enlighten the study’s objective, show them the photographs of the targeted species, and then interview them individually in their native Tshivenda language. It should be mentioned that every traditional health practitioner contacted was requested to refer or suggest one or more of their colleagues with similar medicinal expertise until no one was suggested. Then, the suggested practitioners were visited either at their homestead or workspace. This was to grant the flow of information and afford traditional health practitioners their required privacy while sharing their inherited medicinal expertise. Scientific evidence suggests that traditional health practitioners, particularly of the Vhembe Biosphere Reserve, are reserved when sharing their medicinal knowledge and wisdom with other practitioners [40,45,46]46]. It should also be stated that all the traditional health practitioners interviewed gave their verbal informed consent. Equivalent questions were administered to all traditional health practitioners interviewed to validate the authenticity of acquired medicinal information. The same validation techniques were also used in the studies by Atyosi et al. [41] and Bazzicalupo et al. [46]. The following questions were administered to all participants: (a) Do you use M. zeyheri for medicinal purposes?; (b) If yes, kindly specify its medicinal uses, preparatory techniques, and dosage administration?; (c) How do you describe yourself in terms of gender?; (d) How old age are you?; (e) Tell us about your educational background. When did you start practicing as a traditional health practitioner, and how did you gain such knowledge?

Figure 1. Vicinity map of the study areas. [Click here to view]

RESULTS

Figure 2 classifies traditional health practitioners’ socio-demographic details. A total of 21 traditional health practitioners from varying demographic backgrounds participated in the recent study, including those from different age groups, educational levels, genders, and marital statuses. Among the participants, females constituted 57.9%, while male respondents constituted 42.1%. A total of 57.1% of all the traditional health practitioners who participated were married, whereas 33.3% of them were widowed, and only 9.5% of them were divorced. Their age categories are varied, with the most participants aged between 69> <86 years old (47.6%), tailed by those aged 52> <69 years old (33.3%), and the least were those aged between 86> years old (19.1%). More than 80% of all the traditional health practitioners who took part in this study have at least acquired formal education, either primary (47.6%), secondary (28.6%), or tertiary (4.8%).

Moreover, 52.4% of them claimed that most of their medicinal plant knowledge originated as dreams while sleeping or visions (while awake). In comparison, others (28.6%) claimed that the knowledge they possessed was their family knowledge passed from one generation to another through the word of months, and therefore, 19.1% indicated that they received training to become traditional health practitioners.

According to the traditional health practitioners who had undergone traditional healing initiations, most of their medicinal knowledge originates through ancestral visits, dreams, and visions (personal communication with the traditional health practitioners). All the traditional health practitioners who participated in the recent study have more than 15 years of experience in traditional herbal medicines. More than 52% possessed herbal medicinal healing experience ranging between 20 > <25 years, followed by those with greater than 25 years of experience, and the least 14.3% possessed 15> < 20 years of practicing experience.

Table 1 illustrates the therapeutic uses, preparational methods, and administration modes of M. zeyheri by the Vhavenda traditional health practitioners of the Vhembe Biosphere Reserve, Limpopo province, South Africa. This study demonstrates that practitioners across the studied sites utilize M. zeyheri to remedy multiple ailments. A total of six categorized ailments were remedied using M. zeyheri. This includes external wounds, throat wounds, ulcers, womb cleaning to improve fertility, Enhancing weight loss, and the combinations of associated ailments such as Erectile dysfunctionality, Bilhazia, and Gonorrhea. However, the study findings revealed that traditional health practitioners of the region, for instance, in more than 80% of their preparation of M. zeyheri for medicinal purposes, they combined it with other medicinal plants. For instance, when prepared for remedying either external (RFC = 1; FL = 100%) or throat (RFC = 0.8; FL = 80%) wounds, it is mixed with grounded stem barks of Zanthoxylu davy, while prepared for womb cleaning (RFC = 1; FL = 100%) and weight loss (RFC = 0.9; FL = 90%) was mixed with Warbugia salutari and Moringa olifera.

Figure 2. Traditional health practitioner’s socio-demographic information. [Click here to view]

Table 1. Therapeutic uses, preparation method, and administration of M. zeyheri Sond., (Keys: n, number of traditional health practitioners participated; and Frequency; RFC; and FL (%), fedelity level of percentage). [Click here to view]

Furthermore, when prepared for assorted ailments such as Erectile dysfunction, Bilhazia, and Gonorrhea (RFC = 0.7; FL = 70%), it is combined with multiple medicinal plants, including the root barks of Elephantorrhiza elephantina, Securidaca longependunculata, Albizia versicolor, and Annona senegalensis. The findings of the recent study show some commonality among the participated traditional health practitioners concerning medicinal uses, preparations, and administration of M. zeyheri, particularly for remedying ailments including external wounds, ulcers, and womb cleaning for improving fertility, both with RFC value of 1 and the fidelity level of percentage 100.

DISCUSSION

The number of respondents who participated in this study is aligned with the population demography of different genders in the Vhembe region [47]. Unequal participation of correspondents was also recorded by several ethnobotanical studies across the Vhembe Biosphere Reserve [48–50]. Furthermore, Scherrer et al. [51] stated that women express more interest in practicing traditional herbal healing than their male counterparts. The data collection methods influenced the varied age categories of respondents. However, such funding corroborates the widely accepted scientific notion stating that indigenous herbal medicinal knowledge is primarily rooted amongst older people [52–55]. The educational status of respondents within the study areas concurs with the results of the 2022 census in the region, as illustrated on the Statistics South Africa website [56].

The fact that traditional health practitioners stated that most of the knowledge originated through ancestral visits, dreams, and visions differs from the findings reported by Ramarumo et al. [57], who articulated that most indigenous healing knowledge is family-based, transmitted by parents or relatives to their children. According to African cultural beliefs, ancestors are departed family members or relatives [58]. Therefore, it is within this context that, although the findings of this study regarding the origin of participants healing knowledge differs from those of previous studies, it is still arguable that such difference is too slim or there is no difference at all since ancestors are also known as the departed relatives family members [58]. The experiences of practitioners demonstrate the wealth of traditional therapeutic knowledge and expertise associated with the use of M. zeyheri for remedying multiple ailments that they have accumulated over these years.

The use of M. zeyheri in combination with other medicinal plants was not unusual in traditional African healthcare systems, mainly in the Vhembe region, since previous studies observed comparable findings [59–60]. This was an ancient cultural practice by Vhavenda traditional health practitioners to increase the efficacy of prepared herbal medications. Such findings concur with those from various studies in the equivalent region [57,61,62]. According to Wang et al. [63], the therapeutic results obtained from combinations of multiple herbal medicinal plants are more efficient. This demonstrates richness in diagnostic and ethnopharmacological knowledge amongst the Vhavenda traditional health practitioners. Jimenez-Fernandez et al. [64] reported that most traditional health practitioners from similar tribes had the same medicinal knowledge about specific plant species and used similar methodological techniques to prepare and remedy multiple ailments. In addition, traditional health practitioners of the region were revealed to be remedying or treating multiple ailments similarly because they share similar medicinal knowledge. Therefore, the research method utilized in this study allows participants only to suggest their counterparts with whom they shared similar knowledge, and therefore, comparable findings were reported by Mashile et al. [65].

CONCLUSION

The recent study reported on therapeutic uses of M. zeyheri by the Vhaven?a traditional health practitioners in the Vhembe Biosphere Reserve. No study has previously specified ethnomedicinal usage or documented preparatory techniques and administration modes associated with M. zeyheri by the VhaVenda traditional health practitioners. Indeed, the VhaVenda practitioners utilize M. zeyheri for multiple medicinal benefits. The results of this study cemented the value of traditional healthcare systems in providing immediate healthcare to rural and marginalized communities across the region and countrywide. The recent study contributed to the record of medicinal plants used for remedying distinctive ailments by the VhaVenda traditional health practitioners in the Vhembe Biosphere Reserve and nationwide. Even though the research technique used in this study validates the medicinal utilizations of the target plant species, it is worth recommending that the assessment of active biological compounds and pharmacological properties of M. zeyheri could enhance plant-derived drugs. The documentation of the ethnomedicinal uses of M. zeyheri is essential for sustaining the immediate traditional healthcare systems and preserving regional ancient cultural heritage. In this regard, it is arguable that the recent study contributes to the knowledge bodies encompassing social-ecological systems, ethnobotany, ethnomedicine, anthropology, and sustainability studies.

ACKNOWLEDGMENT

The authors thanked all the participated practitioners. This study was partially financed by the Water Research Commission of South Africa (Grant no. C2023/2024-01331) and the South African National Research Foundation (NRF Grant no. PSTD2204295307) in partnership with the University of Mpumalanga’s Directorate of Research and Innovations.

AUTHOR CONTRIBUTIONS

All authors contributed substantially to conception and design, while NPL, MM, and LJR conducted fieldwork, data analysis, and interpretation. NPL, drafted the article, while SNM, WOM, and LJR, supervised and revised it critically for important intellectual content. All the authors agreed to submit to the current journal; gave final approval of the version to be published; and agree to be accountable for all aspects of the work. All the authors are eligible to be authors as per the International Committee of Medical Journal Editors (ICMJE) requirements/guidelines.

CONFLICTS OF INTEREST

The authors report no financial or any other conflicts of interest in this work.

ETHICAL APPROVALS

Ethical approval details are given in 'Material and Methods section'.

DATA AVAILABILITY

All data generated and analyzed are included in this research article.

PUBLISHER’S NOTE

All claims expressed in this article are solely those of the authors and do not necessarily represent those of the publisher, the editors and the reviewers. This journal remains neutral with regard to jurisdictional claims in published institutional affiliation.

USE OF ARTIFICIAL INTELLIGENCE (AI)-ASSISTED TECHNOLOGY

The authors declares that they have not used artificial intelligence (AI)-tools for writing and editing of the manuscript, and no images were manipulated using AI.

REFERENCES

1. Hamdy R, El-Hadidy A, Abd El-Mohsen G. Taxonomic revision of the cultivated species of Mimusops (Sapotaceae) in Egypt, with new records. J Horticul Sci. 2022;17(2):505–19. CrossRef

2. Dube ZP, Mashela PW, Mathabatha RV. Mediterranean fruit fly on Mimusops zeyheri indigenous to South Africa: a threat to the horticulture industry. Pest Manag Sci. 2016;72(8):1517–20. CrossRef

3. von Staden L. Mimusops caffra E.Mey. ex A.DC. National Assessment: red list of South African Plants version 2020.1. Pretoria, South Africa, 2017a [cited 2023 Jul 23]. Available from: http://redlist.sanbi.org/species.php?species=3381-1

4. von Staden L. Mimusops zeyheri Sond. National Assessment: Red List of South African Plants version 2020.1. 2017b [cited 2023 Jul 23]. Available from: http://redlist.sanbi.org/species.php?species=3381-6.

5. Kamundi DA, von Staden L. Mimusops obtusifolia Lam. National Assessment: Red List of South African Plants version 2020.1. 2018. [cited 2023 Jul 23]. Available from: http://redlist.sanbi.org/species.php?species=3381-7.

6. Magwede K, Van Wyk BE, Van Wyk AE. An inventory of Vhaven?a useful plants. S Afr J Bot. 2009;122:57–89. CrossRef

7. Ramarumo LJ, Maroyi A. An inventory of useful threatened plant species in Vhembe biosphere reserve, Limpopo Province, South Africa. Biodiversitas 2020;21(5):2146–58. CrossRef

8. Gouwakinnou GN, Lykke AM, Assogbadjo AE, Sinsin B. Local knowledge, pattern and diversity of use of Sclerocarya birrea. J Ethnobiol Ethnomed. 2011;7(1):1–9. CrossRef

9. Smith YCE, Maseko MS, Sosibo M, Dlamini PV, Gumede ST, Ngcobo SP, el al. Indigenous knowledge of South African bird and rangeland ecology is effective for informing conservation science. J Environ Manag. 2021;284:112041. CrossRef

10. Seile BP, Bareetseng S, Koitsiwe MT, Aremu AO. Indigenous knowledge on the uses, sustainability and conservation of African ginger (Siphonochilus aethiopicus) among two communities in Mpumalanga province, South Africa. Diversity. 2022;14(3):192. CrossRef

11. Ndhlovu PT, Asong JA, Omotayo AO, Otang-Mbeng W, Aremu AO. Ethnobotanical survey of medicinal plants used by indigenous knowledge holders to manage healthcare needs in children. PLoS One. 2023;18(3):e0282113. CrossRef

12. Mabogo DEN. The ethnobotany of the Vhavenda. Thesis, Master of Science, Faculty of Science, Pretoria, South Africa: University of Pretoria; 1990.

13. Mbambala SG, Tshisikhawe MP, Masevhe NA. Invasive alien plants used in the treatment of HIV/AIDS-related symptoms by traditional healers of Vhembe municipality, Limpopo Province, South Africa. Afr J Tradit Compl Alt Med. 2017;14(5):80–8. CrossRef

14. Maema LP, Potgieter MJ, Samie A. Ethnobotanical survey of invasive alien plant species used in the treatment of sexually transmitted infections in Waterberg District, South Africa. S Afr J Bot. 2019;122:391–400. CrossRef

15. Hu Z, Venketsamy R. Traditional Chinese medicine to improve rural health in South Africa: a case study for Gauteng. Health S Afr Gesondheid. 2022;27:1–8. CrossRef

16. Van Niekerk J. Traditional healers formalised?. S Afr Med J. 2012;102:105–6. CrossRef

17. Malapela RG, Thupayagale-Tshweneagae G, Baratedi WM. Use of home remedies for the treatment and prevention of coronavirus disease: an integrative review. Health Sci Rep. 2023;6(1):e900. CrossRef

18. Mothibe ME, Sibanda M. African traditional medicine: South African perspective. In: Mordeniz C, editor. Traditional and Complementary Medicine. London, UK: Intechopen; 2019 [cited 2023 Oct 19] pp.1–27. Available from: https://books.google.co.za/books?hl=en&lr=&id=Zpj8DwAAQBAJ& oi=fnd&pg=PA31&dq=Mothibe+ME,+Sibanda+M.+African +traditional+medicine: +South+African+ perspective.+Intechopen.+ Traditional+and+Complementary+Medicine.+2019%3 B+pp.1%E2%80%9327.&ots=Op0oFZMTcl&sig=BEv51RptWa Ri9ju8W6xe4qRM22I&redir_esc=y#v=onepage&q&f=false.

19. Mander M, Ntuli L, Diederichs N, Mavundla K. Economics of the traditional medicine trade Mazid in South Africa care delivery. S Afr Health Rev. 2007 [cited 2023 Oct 19];2007(1):189–96. Available from: https://hdl.handle.net/10520/EJC35482

20. Constant NL, Tshisikhawe MP. Hierarchies of knowledge: ethnobotanical knowledge, practices and beliefs of the Vhavenda in South Africa for biodiversity conservation. J Ethnobiol Ethnomed. 2018;14:1–28. CrossRef

21. Mogale MMP, Raimondo DC, VanWyk BE. The ethnobotany of Central Sekhukhuneland, South Africa. S Afr J Bot. 2019;122:90–119. CrossRef

22. Semenya SS, Maroyi A. Ethnobotanical survey of plants used by Bapedi traditional healers to treat tuberculosis and its opportunistic infections in the Limpopo Province, South Africa. S Afr J Bot. 2019;122:401–21. CrossRef

23. Shai KN, Ncama K, Ndhlovu PT, Struwig M, Aremu AO. An exploratory study on the diverse uses and benefits of locally-sourced fruit species in three villages of Mpumalanga Province, South Africa. Foods. 2020;9(11):1581. CrossRef

24. Omotayo AO, Ijatuyi EJ, Ogunniyi AI, Aremu AO. Exploring the resource value of transvaal red milk wood (Mimusops zeyheri) for food security and sustainability: an appraisal of existing evidence. Plants. 2020;9(11):1486. CrossRef

25. Ahad B, Shahri W, Rasool H, Reshi ZA, Rasool S, Hussain T. Medicinal plants and herbal drugs: an overview. In: Aftab T, Hakeem KR, editors. Medicinal and Aromatic Plants: Healthcare and Industrial Applications. Berlin, Germany: Springer Nature; 2021 [cited 2023 Aug 17];1–40. Available from: https://doi.org/10.1007/978-3-030-58975-2_1

26. Isike C, Ogunnubi O. South Africa’s foreign policy aspirations and the National Development Plan (NDP 2030): the role of soft power. J Cont Afr Stud. 2017;35(3):284–302. CrossRef

27. Nwebo OE. The African Union Agenda 2063 and the imperative of democratic governance. Law Dev Rev. 2018;11(2):259–76. CrossRef

28. Gowreesunkar V. African Union (AU) Agenda 2063 and tourism development in Africa: contribution, contradiction and implications. Int J Tourism Cities. 2019;5(2):288–300. CrossRef

29. Chen L, Debono D, Hemsley B. A bite closer: using 3D food printing to achieve Sustainable Development Goals 2, 3, 9 and 17. Int J Speech-Lang Pathol. 2023;25(1):58–61. CrossRef

30. Mpandeli S. Managing climate risks using seasonal climate forecast information in Vhembe District in Limpopo Province, South Africa. J Sustain Dev. 2014;7(5):68. CrossRef

31. Odhiambo BDO, Kataka MO, Mashudu M. The use of remote sensing to map landslide-prone areas in Makhado Municipality of Limpopo Province, South Africa. 2019 [cited 2023 Jul 23]. Available from: https://www.preventionweb.net/publications/view/65868

32. Ruwanza S, Thondhlana G. People’s perceptions and uses of invasive plant Psidium guajava in Vhembe Biosphere Reserve, Limpopo Province of South Africa. Eco People. 2022;18(1):64–75. CrossRef

33. Hahn N. Refinement of the soutpansberg geomorphic Province, Limpopo, South Africa. Trans Royal Soc S Afr. 2011;66(1):32–40. CrossRef

34. Malaza NM. Basin analysis of the Soutpansberg and Tuli coalfields, Limpopo province of South Africa. Thesis, Doctor of Philosophy, Faculty of Science and Agriculture, Alice, South Africa: University of Fort Hare; 2014.

35. Kori E, Onyango Odhiambo BD, Chikoore H. A geomorphodiversity map of the Soutpansberg Range, South Africa. Land Anal 2019;38:13–24. CrossRef

36. Hahn N. Endemic flora of the Soutpansberg, Blouberg and Makgabeng. S Afr J Bot. 2017;113:324–36. CrossRef

37. Mucina L, Rutherford MC. The Vegetation of South Africa, Lesotho and Swaziland, Strelitzia 19. Pretoria, South Africa: South African National Biodiversity Institute; 2006.

38. Luseba D, Tshisikhawe MP. Medicinal plants used in the treatment of livestock diseases in Vhembe region, Limpopo Province, South Africa. J Med Plants Res. 2013;7:593–601.

39. Mostert TH, Bredenkamp GJ, Klopper HL, Verwey C, Mostert RE, Hahn N. Major vegetation types of the Soutpansberg conservancy and the Blouberg nature reserve, South Africa. Koedoe. 2008 [cited 2023 Oct 19];50:32–48. Available from: https://hdl.handle.net/10520/EJC139700

40. Ramarumo LJ, Maroyi A, Tshisikhawe MP. Asparagus sekukuniensis (Oberm.) Fellingham & NL Mey.: A threatened medicinal plant species used by Vhavenda in the Soutpansberg Region, Vhembe Biosphere Reserve, Limpopo province, South Africa. J Appl Pharm Sci. 2019a;9(6):080–5. CrossRef

41. Atyosi Z, Ramarumo LJ, Maroyi A. Alien plants in the Eastern Cape province in South Africa: Perceptions of their contributions to livelihoods of local communities. Sustain. 2019;11(18):5043. CrossRef

42. Crouch M, McKenzie H. The logic of small samples in interview-based qualitative research. Soc Sci Info. 2006;45:483–99. CrossRef

43. Guest G, Bunce A, Johnson L. How many interviews are enough? azn experiment with data saturation and variability. Field Methods. 2006;18(1):59–82. CrossRef

44. Latham JR. A framework for leading the transformation to performance excellence part I: CEO perspectives on forces, facilitators, and strategic leadership systems. Qual Manag J. 2013;20(2):12–33. CrossRef

45. Peu MD, Mulaudzi FM, Rikhotso SR, Ngunyulu RN, Rasweswe MM. Reflections on accessing indigenous research settings: encounters with traditional health practitioners and leaders in Vhembe district, South Africa. Cult Psychol. 2021;27(2):227–42. CrossRef

46. Ndou-Mammbona AA. The effects of traditional healing on HIV and AIDS management: an ethnographic study. S Afr Fam Pract. 2022;64(1):5559. CrossRef

47. Vhembe District Municipality. Profile and Analysis of District Development Model. 2020 [cited 2023 Oct 17]. Available from: https://www.cogta.gov.za/ddm/wp-content/uploads/2020/11/vhembe-october-2020.pdf.

48. Setshego MV, Aremu AO, Mooki O, Otang-Mbeng W. Natural resources used as folk cosmeceuticals among rural communities in Vhembe district municipality, Limpopo province, South Africa. BMC Compl Med Therap. 2020;20:1–16. CrossRef

49. Mudau TE, Olowoyo JO, Amoo SO. Ethnobotanical assessment of medicinal plants used traditionally for treating diabetes in Vhembe district, Limpopo Province, South Africa. S Afr J Bot. 2022;146:304–24. CrossRef

50. Amoo SO, Mudau TE, Olowoyo JO. In vitro α-glucosidase inhibitory activity of medicinal plants used traditionally for treating diabetes in Vhembe District, South Africa. J Herb Pharmacol. 2022;11(4):513–21. CrossRef

51. Scherrer MM, Zerbe S, Petelka J, Säumel I. Understanding old herbal secrets: the renaissance of traditional medicinal plants beyond the twenty classic species?. Front Pharmacol. 2023;14:1141044. CrossRef

52. Mokganya MG, Tshisikhawe MP. Medicinal uses of selected wild edible vegetables consumed by Vhavenda of the Vhembe District Municipality, South Africa. S Afr J Bot. 2019;122:184–8. CrossRef

53. Ssenku JE, Okurut SA, Namuli A, Kudamba A, Tugume P, Matovu P, et al. Medicinal plant use, conservation, and the associated traditional knowledge in rural communities in Eastern Uganda. Tropic Med Health. 2022;50(1):39. CrossRef

54. Liu F, Peng J, Feng Y, Ma Y, Ren Y, Sun P, et al. An ethnobotanical study on the medicinal herb practices of the gelao ethnic minority in North Guizhou, China: an exploration of traditional knowledge. Front Pharmacol. 2023;14:1217599. CrossRef

55. Rashid S, Pathan NA, Ahmad Jan H, Majeed LR, Nisar B. Study of Perceptional Attitude of Resource Limited Uri Populace of District Baramullah Toward Traditional Medicinal Usage in the Kashmir Himalayas. J Herbs Spices Med Plants. 2023;29(2):115–33. CrossRef

56. Census. Vhembe District Population. 2022 [cited 2023 Oct 17]. Available from https://census.statssa.gov.za/#/province/9/2

57. Ramarumo LJ, Maroyi A, Tshisikhawe MP. Warburgia salutaris (G. Bertol.) Chiov.: An endangered therapeutic plant used by the Vhavenda ethnic group in the Soutpansberg, Vhembe Biosphere Reserve, Limpopo province, South Africa. Res J Pharm Tech. 2019b;12(12):5893–8. CrossRef

58. Nwokoha PA. Rites and rituals for the dead: bases for good moral behaviour in Ezzaland, Nigeria. J Rel Human Relations. 2020;12(1):67–85.

59. Masevhe NA, McGaw LJ, Eloff JN. The traditional use of plants to manage candidiasis and related infections in Venda, South Africa. J Ethnopharmacol. 2015;168:364–72. CrossRef

60. Ramovha LI, van Wyk AE. Ethnoveterinary practices of the Vhavenda, South Africa, in the treatment of redwater (mali) in cattle. Indilinga Afr J Indig Knowl Syst. 2016;15(3):314–27. CrossRef

61. Chitura T, Muvhali PT, Shai K, Mushonga B, Kandiwa E. Use of medicinal plants by livestock farmers in a local municipaity in Vhembe district, South Africa. Appl Acol Environ Res. 2018;16(5):6589–605. CrossRef

62. Mhlanga S, Matshidze PE, Cebekhulu E, Kugara SL, Makoni T. Exploring the utilisation of indigenous knowledge by medicinal plant vendors as a livelihood strategy: a case study of Thohoyandou, Vhembe District, South Africa. Afr J Rel Phil Cult. 2021;2(2):59. CrossRef

63. Wang J, Rao C, Goh M, Xiao X. Risk assessment of coronary heart disease based on cloud-random forest. Art Int Rev. 2023;56(1):203–32. CrossRef

64. Jimenez-Fernandez R, Rodriguez Vázquez R, Marín-Morales D, Herraiz-Soria E, Losa-Iglesias ME, Becerro-de-Bengoa-Vallejo R, et al. Exploring knowledge about fang traditional medicine: an informal health seeking behaviour for medical or cultural afflictions in equatorial Guinea. Healthcare. 2023;11:808. CrossRef

65. Mashile SP, Tshisikhawe MP, Masevhe NA. Medicinal plants used in the treatment of maternal health-related problems by the Mapulana of Ehlanzeni District, Mpumalanga province, South Africa. J Appl Pharm Sci. 2019;9(12):021–9. CrossRef