Evidence-Based Complementary and Alternative Medicine

Evidence-Based Complementary and Alternative Medicine / 2018 / Article

Review Article | Open Access

Volume 2018 |Article ID 6274021 | 28 pages | https://doi.org/10.1155/2018/6274021

Plants Used as Anticancer Agents in the Ethiopian Traditional Medical Practices: A Systematic Review

Academic Editor: Chong-Zhi Wang
Received13 Mar 2018
Revised12 Jul 2018
Accepted18 Sep 2018
Published03 Oct 2018

Abstract

Background. This systematic review aimed at examining the use patterns of Ethiopian anticancer traditional medicinal plants (MPs) in view of recommending further validation studies. Methods. The information was retrieved from PubMed according to the PRISMA guideline. The electronic library of Addis Ababa University and relevant church-based religious books were also inspected for additional data. Results. From 34 studies meeting specific inclusion/exclusion criteria, 119 anticancer MP species distributed in 98 genera and 57 families were recorded. Fabaceae (10.92 %) and Euphorbiaceae (10.08 %) were the most widely used families. Plumbago zeylanica (Plumbaginaceae) was the most frequently used anticancer MP species. Shrubs (42.02 %) and herbs (35.29 %) were dominant growth forms. About 89.08 % of the MPs were collected from wild habitats. Leaves (33.73 %) and roots (27.11 %) were the most frequently harvested parts. The most favored routes were dermal (33.33 %) and oral (29.25 %). About 87.07 % preparations were made from fresh plant materials. Breast cancer and skin cancer were treated with 14 % and 10.76 % of anticancer MPs, respectively. Conclusion. The review showed that anticancer MPs are widely used across the regions of Ethiopia. Most of the MPs are not scientifically experimented and yet are at a higher vulnerability to loss mainly by human activities. Calling for conservation measures, we recommend experimental validation of the frequently used anticancer MPs. This augments global anticancer drug researches.

1. Background

1.1. Cancer

Cancer is the name given to a group of diseases comprising a combination of genetic, metabolic, and signaling pathway aberrations [1]. It is usually a fatal disease, which constitutes an enormous burden on society in both economically developed and underdeveloped nations alike [2]. It is the second leading cause of death globally next to cardiovascular diseases; and available estimates by GLOBOCAN (an International Agency for Research on Cancer-IARC) show that about 14.1 million new cancer cases and 8.8 million deaths occurred in 2012 worldwide. Furthermore, by 2012 32.6 million people were living with cancer, within 5 years of diagnosis [3, 4]. Overall, 57 % of new cancer cases, 65 % of the cancer deaths, and 48 % of the 5-year prevalent cancer cases occurred in the less developed regions [3]. According to WHO estimates in 2015, about 200 known types of cancer exist and the most common causes of cancer deaths include cancer of the lung (1.69 million), liver (788, 000), colorectal (774, 000), stomach (754, 000), and breast (571, 000) [4]. The prevalence of cancer is increasing because of the growth and aging of the population, as well as an increasing prevalence of established risk factors such as smoking, overweight, physical inactivity, and changing reproductive patterns associated with urbanization and economic development [3, 5].

In Africa, cancer is alarmingly becoming a critical public health problem, with cancer forms attributed to infectious agents (e.g., cervical cancer, liver cancer, Kaposi sarcoma, and urinary bladder cancer) being the dominant types [6]. According to the IARC, about 715,000 new cancer cases and 542,000 cancer deaths occurred in 2008 in Africa [6, 7]. The numbers are projected to double by 2030 due to the aging and fast growth of the population. The potential of being even higher has been imagined because of the adoption of behaviors and lifestyles associated with economic development [69]. Thus, prostate cancer in men and breast cancer in women have now become the most commonly diagnosed cancers in some parts of Africa [3, 10].

Reports on the prevalence of cancer in Ethiopia are scanty and difficult to verify because oncology services are inadequate and national registry centers do not exist; there are no control and prevention programmes against the disease; diagnosis and treatment services are very limited [1113]. However, the limited reports show that Kaposi sarcoma, liver, prostate, cervical, and breast cancer are the most common cancers [14] in Ethiopia. According to the cancer country profiles of WHO, most prevalent forms among males are colorectal, Kaposi sarcoma, leukemia, lymphomas (non-Hodgkin), and prostate cancers in the order of listing, whereas cancer of the breast, cervix-uteri, ovary, colorectal, and leukemia, in the order given, are topping the list among females [15]. A study at the radiotherapy center of Tikur Anbessa specialized hospital (currently the only one in the country) showed that breast cancer had a high prevalence (27.8 %) [16]. On the scale of mortality leukemia (12.7 %) in males and breast cancer (24.4 %) in females were reported to be the highest in 2014 [15].

1.2. Traditional Medicines and Cancer

Herbal medicine (phytomedicine, phytotherapy, or botanical medicine) is the oldest system of complementary and alternative medicine (CAM) in the world with a history of more than 2,000 years [17]. It is made exclusively from plants and is used by all societies and are common to numerous cultures [18]. There are, however, variations in the preparation and treatment procedures throughout the world [19]. Certain herbal medicines defend the body from malignancy by augmenting detoxification or cleaning the body. Some biological response modifiers derived from herbs are known to hinder the growth of cancer by modifying the activities of hormones and enzymes, while others diminish lethal side effects and complications of chemotherapy and radiotherapy [20].

The use of CAM is common among cancer patients in general and breast cancer patients, in particular [21]. They are perceived by the general public to be safe, cause less complications, and are less likely to cause dependency [19]. Most cancer patients combine herbal remedies with conventional therapy in the hope of boosting the effect of conventional medicine [22]. Nevertheless, cancer patients who use CAM report outcomes including improvement of clinical symptom, quality of life, reduction of chemo/radiotherapy induced side effects, and reduced tumor size [2325]. Supporting conventional cancer treatment, preventing recurrence and eventual prolonging of survival were also reported [26]. In addition to these claims, anticancer agents derived from plants were shown to inhibit angiogenesis, suppress cell proliferation, inhibit or reverse tumor development, and show general antioncogenic effects [27]. A number of phytoconstituents resulting from the herbs were also reported to assist the body’s immune system to combat cancer more efficiently [20].

1.3. Ethiopian Flora and Medicinal Plants

Historical accounts substantiate age-long usage of traditional medicines (TMs) in Ethiopia. For instance, collections of medicoreligious manuscripts of the Axumite kingdom, medical textbooks that have been written in Ge’ez and Arabic languages between mid- and beginning of the century are few among long-standing sources [28, 29]. It is widely reported that over seventy percent of the Ethiopian people depend on TM for their healthcare, where more than 95 % of traditional medicines are sourced from plants [30, 31]. Ethiopia’s location in a tropical area, its huge landmass, and incredible variation in altitude ranging from about 120 meters below sea level to 4,543 meters above sea level have strongly influenced the range of its ecosystem and have contributed to the high diversity and rate of endemism in the flora [3234]. Thus, the flora of Ethiopia has about 6,027 species of vascular plants with 10 % endemism [3538]. According to recent reports, over 1000 species are used as traditional medicinal plants (MPs) of which about 33 species are endemic to Ethiopia [39, 40].

2. The Rationale for the Systematic Review on the Anticancer MPs of Ethiopia

It is evident that the incidence of cancer is on the rise globally. The disparity in cancer survival between high and low economic settings mainly lies on two factors: the stage of its diagnosis and availability and access to treatments [6, 81, 82]. Although surgery is the existing standard curative therapy for most cancer forms, its therapeutic efficacy is compromised as most tumors are often diagnosed at an advanced stage, particularly in the underdeveloped part of the world [83, 84]. Therefore, treatments such as radiotherapy and chemotherapy are next ladder therapies although they achieve only very modest results [85]. The everincreasing occurrence of cancer and the severe side effects and limited efficacy of current cancer chemotherapy based on synthetic drugs shift the attention toward drugs of plant origin [86, 87].

In Ethiopia, environmental degradation, deforestation, intermittent drought, high rate of cultural and habitat loss, and various anthropogenic activities are threatening the MPs. However, recent ethnobotanical studies from different parts of the country have shown that TM is widely practiced in the country. It is also claimed that cancer patients prefer TMs to conventional therapeutic approaches mainly due to its cultural acceptance and ease of access [37, 39, 51, 52, 56, 59, 72, 73, 76, 77, 8899]. The Ethiopian flora largely remained untouched with tremendous potential that could offer a lot in the fight against cancer. Therefore, it is believed that the systematic review of ethnobotanical studies reported from Ethiopia would help identify potential anticancer MPs. This will serve as a basis for initiating rigorous scientific investigations for the chemopreventive and anticancer attributes of the MP species most frequently used across the regions of Ethiopia. Such investigation would contribute to the global anticancer drug discovery effort.

3. Methods

3.1. Literature Search Strategy

Ethnobotanical studies from Ethiopia were systematically reviewed. Information included in this review spans from mid-1970s to 2017, which was the period when valid documentation on the Ethiopian TMs was undertaken. Knowledge of CAM for the treatment of various forms of cancer/malignancies in Ethiopia was retrieved from PubMed database (https://www.ncbi.nlm.nih.gov/pubmed-accessed on 25.09.2017) following “Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA)” guidelines [100]. Electronic repository of the Addis Ababa University (AAU) (http://etd.aau.edu.et) and sources that make references to the TM knowledge of church-based religious teachers (‘DEBTERAS’) were examined as additional sources (Figure 1). In the search process, keywords including, “ethnobiology”, “ethnobotany”, “ethnobotanical” “ethnomedicine”, “ethnomedicinal”, “medicinal plants”, “traditional healer”, “traditional medicine practitioner”, “traditional medicine”, “traditional herbal medicine “herbal medicine”, “food supplements” and “medico-cultural”, all with the term “Ethiopia” were used. After completing identification, screening and checking the eligibility of the literature for the systematic review, only those reporting forms of malignancies/cancer, neoplasms,NEKERSA’, tumor and swelling due toNEKERSA’ were analyzed. Throughout the review paper the term “cancer” or ‘NEKERSA’ or “malignancy” is used to define a condition where cells of neoplastic features divide without control and can invade nearby tissues.

3.2. Inclusion and Exclusion Criteria

Information obtained from the database and other sources were scrutinized based on the following conditions. Published articles and unpublished thesis/dissertation on ethnomedicinal/ethnobotanical surveys reporting MPs used in Ethiopia to treat various forms of malignancies/cancer were included.

Researches reporting (i) CAM used for the treatment of single etiology; (ii) ethnoveterinary research reports; (iii) review articles; (iv) published in languages other than English; (v) lacking clear objectives and methodologies; (vi) abstract only or without full text access; (vii) experimental studies; (viii) articles lacking scientific plant names; (ix) research reports without voucher numbers of the specimens; and (x) ethnobotanical information with no reports of MP use for the treatment of malignancies/cancer and/or any neoplasm were excluded.

3.3. Data Extraction and Review Process

After the retrieval from the electronic databases, the research articles were imported to the ENDNOTE software version X7 (Thomson Reuters, USA) and the duplicates were removed. After the removal of the duplicates, all the imported articles and the additional files were checked against the inclusion/exclusion criteria. Following the confirmation of the eligibility for the systematic review, each document was carefully examined at a time. We extracted the following data from each eligible document: (i) taxonomic diversity (the scientific name of the species and family name), (ii) vernacular/local name of the plant, (iii) habitat of the plant, (iv) the growth form (habit of the MP), (v) parts of the MPs used for the remedy preparation and routes of administration, (vi) the forms of malignancies treated, and (vii) reports on the adverse effect(s); contraindications and antidotes were carefully extracted and analyzed. The citation frequency and mapping of their geospatial distribution were done. Data on the distribution of MPs in the Ethiopian flora region and the altitudinal range the plants grow was generated. Data extraction was carried out twice independently and the data sheet was further checked for methodological conformity and correction of any discordance. Descriptive statistics was used to summarize the findings.

4. Results

4.1. Taxonomic Diversity and Growth form and Distribution of the Anticancer MPs of Ethiopia

One hundred nineteen (119) species of anticancer MPs distributed in 98 genera and 57 families were retrieved from thirty-four (34) reports that fulfilled the inclusion/exclusion criteria (Table 1). Twenty-five (25) families were represented by two or more anticancer MPs, whereas 32 families were represented by a single species each (Appendix). The families Fabaceae (10.92 %) and Euphorbiaceae (10.08 %) were represented by the highest number of anticancer MP species followed by the families Asteraceae and Lamiaceae (5.04 % each). Eight (8) anticancer MP species were found to be widely used in different regions of the country, where the species Plumbago zeylanica (family Plumbaginaceae) being the most frequently used in areas including Jeldesa Cluster (Dire Dawa city administration), Mecha and Ghimbi Districts of Oromia Regional State and Zegie Peninsula, Amhara regional state (Table 2). The life forms of the anticancer MPs are constituted shrubs (42.02 %), herbs (35.29 %), trees (18.49 %), and climber/liana (4.2 %). A total of 89.08 % of the MPs are found in the wild habitats; home gardens make up 9.24 % and the remaining 1.68 % are found, both in the wild and home gardens. About 8.4 % of anticancer MP species are endemic, 86.56 % are indigenous, and 5.04 % are introduced from elsewhere. Bidens macroptera (Sch Bip.) ex Chiov. Mesfin, Erythrina brucei Schweinf., Euphorbia heterochroma Pax., Galium boreo-aethiopicum Puff., Lobelia rhynchopetalum (Hochst.) Hemsl, Millettia ferruginea (Hochst.) Baker, Pittosporum abyssinicum Del., Plectocephalus varians (A. Rich) Jeffrey ex Cufod., Sideroxylon oxyacanthum Baill, and Vernonia leopoldi (Sch. Bip. ex Walp.) Vatke are endemic to Ethiopia [39, 101, 102].


Family (N=57)Genera N ()Species N ()

Fabaceae9 (9.18)13 (10.92)
Euphorbiaceae7 (7.14)12 (10.08)
Asteraceae4 (4.08)6 (5.04)
Lamiaceae5 (5.10)6 (5.04)
Ranunculaceae3 (3.06)5 (4.2)
Cucurbitaceae3 (3.06)3 (2.52)
Rosaceae3 (3.06)3(2.52)
Solanaceae3 (3.06)3(2.52)
Other 49 families61 (62.24)68(57.14)

Total98 (100)119 (100)


Scientific Name [Family]Part(s) of the MP(s) usedTotal reportsAreas/regions the MP(s) are used as anticancer agentReferences

Plumbago zeylanica [Plumbaginaceae]Lf, Rt and Sh5Jeldesa Cluster (Dire Dawa)
Mecha District, Zegie Peninsula, Ghimbi District and across the regions
[4145]
Brucea antidysenterica [Simaroubaceae]Lf, St and Br3Jimma Zone, Bale Zone and
Fiche District
[4648]
Clematis hirsuta var. hirsute [Ranunculaceae]Lf, St and Br3Wondo Genet; Dega Damot and Blue Hora[4951]
Croton macrostachyus [Euphorbiaceae]Lf3Wondo Genet, Hawassa city, and Dalle District[37, 51, 52]
Dodonaea angustirolia [Sapindaceae]Lf3Dalle District (different sites) and Debre Libanos monastery[45, 52, 53]
Dovyalis abyssinica [Flacourtiaceae]Fr, Br and WP3Fiche District, Dalle District and across the regions[45, 54, 55]
Vernonia leopoldi (bitter leaf) [Asteraceae]Lf3Jimma area, Bale Zone, and Zegie Peninsula[44, 47, 48]
Zanthoxylum chalybeum [Rutaceae]Lf and Rt3Hawassa city and Dalle District (different sites) [52, 55, 56]

Note: Parts Used: Lf=Leaf; Rt=Root; Fr=Fruit; Br=Bark; Sh=Shoot; St=Stem.
4.2. Geospatial Distribution of the Anticancer MPs

According to the present systematic review, the eligible studies on anticancer MPs were reported mainly from the Oromia Regional State (37.04 %), Amhara Regional State (33.33 %), and Southern Nations, Nationalities and Peoples Regional (SNNPR) State (18.52 %) (Table 3). The frequency of reports across the regions and distribution in the Ethiopian Flora Region are shown in Figure 2 and Appendix.


Region/city administration of the Federal Democratic Republic of Ethiopia Frequency ()

Oromia Regional State10 (37.04)
Amhara Regional State9 (33.33)
SNNPR State5 (18.52)
Tigray Regional State1 (3.70)
Dire Dawa City Administration1 (3.70)
Afar Regional State1 (3.70)

Total reports27 (100)

4.3. Forms of Malignancies Most Frequently Treated by Traditional MPs

A variety of malignancies or cancer forms were reported to be treated with traditional MPs in Ethiopia. In the higher number of the reports (43.33 %), it was reported as “cancer/ ‘NEKERSA’” nonspecifically. Specific forms of cancer reported include breast cancer (14.0 %) and skin cancer/‘MINSHIRO NEKERSA’ (10.67 %). The remaining list includes bone cancer, brain cancer, cervical cancer, rectal cancer, anal cancer, invasive cancer/KAYSI NEKERSA’, swelling with wound/‘KEMENZINA NEKERSA’, leukemia, and lung cancer among others (Figure 3).

4.4. Parts of the MPs Used for the Remedy Preparation and Routes of Administration

Analysis of the eligible ethnobotanical findings showed that various parts of the anticancer MPs were used for the remedy preparation. The most frequently harvested parts of the anticancer MPs are leaves (33.73 %) and roots (27.11 %). Debarking constituted 10.84 % whereas the whole parts of the MPs were used in as high as 4.22 % of the preparations. The stem and shoots were rarely collected (only 1.81 %, each) for the remedy preparation (Figure 4).

From the various formulations and application procedures reported, the most preferred administration route of the TMs was dermal application (33.33 %) followed by oral (29.25 %). About 4.08 % of the applications recommend both oral and dermal routes of applications and in 26.53 % of the cases, the route of administration has not been specified (Figure 5). About 12.93 % of the preparations were made from dried plant materials whereas 87.07 % were prepared from fresh plant materials and water is the solvent that is mostly used to prepare anticancer TMs. About 4.76 % of preparations included honey as an additive to the remedy. Butter, flour ofTEFF’, spicy stew, and sulfur (locally calledDIGNE’ in Amharic) among others were found to be mixed in about 4.08 % of the remedies. Common methods of dermal application included dressing the swelling with warm plant material, smearing on the wound, rubbing the affected area with the TM, tying the residue on the swelling, and giving a message with the fresh plant material preparation, as in the cases of breast and skin cancer.

4.5. Adverse Effects, Contraindications Implicated, and Antidotes

The present finding revealed that nine eligible studies discussed the existence and management approaches used by the TM practitioners in case the anticancer remedies cause any possible side effect(s). Besides, contraindications were also noted, pregnant women being the most commonly at risk. Out of 119 MP species compiled, eleven (11) species were found to have adverse side effects and/or contraindications. The most commonly implicated species was Phytolacca dodecandra, followed by Croton macrostachyus. Two studies have reported that any MP could result in mild adverse effects especially among the risk groups or in case of overdosing of the remedy. During such circumstances, drinking coffee, local beer and flax, and eating local food like ‘SHIRO’ alleviates the symptoms [41, 69]. The findings are summarized along with the recommended antidote(s) (Table 4).


FamilyMP (s) involvedContraindication (if any)Adverse effect(s); [possible antidote recommended] (if any)Reference

AsteraceaeVernonia Amygdalina,Pregnant womenA headache and diarrhea[50, 57]
CucurbitaceaeZehneria scabra-A headache, vomiting, and diarrhea [Taking shower][50, 57]
EuphorbiaceaeCroton macrostachyusPregnant womenA headache, vomiting, diarrhea, urination; [“TEFF  INJERA and porridge are anecdotes][50, 57]
-Any; [milk whey as an antidote][58]
Pregnant womenNausea, vomiting and diarrhea[59]
FabaceaeCalpurnia aurea-headache[57]
Millettia ferrugineaPregnant womenNausea, vomiting and diarrhea[59]
LobeliaceaeLobelia rhynchopetalum-Vomiting and diarrhea; [“SHIRO WOT” (sauce made of pulse grains) and powder of Linum usitatissimum infusion in water][60]
MenispermaceaeStephania abyssinica-Any; [milk whey as an antidote][58]
PhytolaccaceaePhytolacca dodecandraPregnant womenOverdosage would result in death[53]
Women at a child-bearing ageCould result in sterility in women[46]
-Vomiting and diarrhea; [“SHIRO WOT” (sauce made of pulse grains) and powder of Linum usitatissimum infusion in water][60]
Children and pregnant womenVomiting and diarrhea; [milk and red “TEFF” PORRIDGE][50, 57]
Pregnant womenNausea, vomiting and diarrhea[59]
PolygonaceaeRumex nervosusChildrenVomiting and diarrhea; [red “TEFFPORRIDGE][50, 57]
RanunculaceaeClematis hirsuta var. hirsuta-A headache, Sweating, and diarrhea[50, 57]
RosaceaeHagenia abyssinica-A headache, vomiting, and diarrhea[50, 57]
[“SHIRO WOT” (sauce made of pulse grains) and powder of Linum usitatissimum infusion in water][60]

5. Discussion

These days, there is a higher level of dynamics in sociocultural transformations in Ethiopia. It is evident, however, that the communities by and large retained valuable knowledge of the MPs and their uses with regard to traditional healthcare. In the present investigation, 119 anticancer MPs were documented. This implies a wider usage of CAM among cancer patients in Ethiopia. This could be related to lack of full access to healthcare facilities. In addition, CAM usage is culturally accepted among Ethiopians as an effective cure and safe and is affordable. It is also perceived more efficacious against certain types of diseases including cancer [103105]. However, the rapid population growth has resulted in an alarmingly high demand for agricultural land which in turn seriously threatens forest cover and hence the MPs. This makes designing and implementing of an insightful conservation program mandatory [29, 30, 106].

Consistent with various ethnobotanical studies, shrubs made up a larger proportion of the anticancer MPs (42.02 %) followed by herbs (35.29 %) [31, 44, 97, 107109]. This may be explained by the fact that shrubs are perennial in the arid or subarid environments and may be available for use as MPs [64]. The dominance of certain life forms of MPs in different study areas might be explained by their availability and adaptation in the particular ecological setting and the dynamics involved due to bushy vegetation being left behind when the forest recedes.

Dominant families from which anticancer MPs are prepared were found to be Fabaceae (13 MP species, 10.92 %), Euphorbiaceae (12 MP species, 10.08 %), and Lamiaceae and Asteraceae (six MP species, 5.04 %, each). This could be attributed to the fact that these families are among the most widely distributed ones in the Ethiopian Flora Regions [31, 67, 110]. Since Plumbago zeylanica (Plumbaginaceae) is the anticancer MP species most widely used across the country, it may have a better healing potential over other anticancer MPs. This finding would make it a prime candidate for further in-depth experimental investigations.

The present review also revealed that roots (27.11 %), bark (10.84 %), and the whole part of the MPs (4.22 %) accounted for about 42.17 % usage in TM. This will significantly affect the sustainability of the MPs unlike use of aerial parts, such as leaves [91, 106, 111]. It was revealed that most remedies are prepared from fresh plant materials (87.07 %). This would result in the extensive exploitation of the MPs and in a long run and will compromise the sustainability of the MPs [55, 58, 111].

The finding that a significant proportion of the remedies were given orally (29.25 %) implies that the remedies are safe for systemic applications. However, in the present report over ten MP species used as anticancer agents across the country had contraindications and/or adverse effects calls for cautionary usage. In addition, there are experimental evidences on the toxicity of some anticancer MPs (e.g., Hagenia abyssinica and the species from genus Vernonia) reported in the present study [112114]. This indicates the need for acute and chronic toxicity investigations on the most commonly used traditional anticancer MPs.

The majority of anticancer MPs reported in the present study were from wild habitats (89.08 %). These habitats are vulnerable to demise by anthropogenic activities [57, 115]. As intermittent drought and wide spreading climatic changes are posing additional threats to the anticancer MPs of the country, they are limited to inaccessible areas. Therefore, as d’Avigdor and the coworkers suggested, the community must be encouraged to grow them in and around home gardens and backyard [46].

One of the greatest challenges in ethnomedicinal researches is the issue of access and benefit sharing (ABS) and that of intellectual property rights. WHO states that “agreements on the return of immediate and/or long-term benefits and compensation for the use of MP materials and associated community knowledge must be discussed and concluded” [116]. In the year 1986, there were over 6,000 TM practitioners in the country registered with the Ethiopian Ministry of Health [117]. However, there is no national guideline to address the regulatory situation [118]. The proclamation, which was issued based on the National Drug Policy in 1999 in Article 6, Sub-Article 8 states, “the Drug Administration and Control Authority shall prepare standards of safety, efficacy, and quality of TMs and shall evaluate laboratory and clinical studies in order to ensure that these standards are met”. It states that the authority shall also issue licenses for the use of TMs in the official health services. However, there were no official education and training systems to strengthen the TM practitioners in addition to the lack of regulation to address the issue of property rights and benefit sharing [117].

In Ethiopia, there have been attempts to implement ABS system of the Convention on Biological Diversity (CBD) according to the provisions in the Nagoya Protocol and other international agreements [119121]. The country has acceded to it and developed a code of conduct to administer the ABS regime. However, there are several unmet issues requiring resolution [119, 120].

6. Conclusion

From the present study, it can be concluded that CAM practice is an integral part of the primary healthcare system of Ethiopians, where the traditional anticancer MPs are reported from different corners of the country. The majority of anticancer MPs are found in wild habitats. This shows that most MPs are vulnerable to destructive anthropogenic activities directed against forests and other environmental factors including climate variability. Thus, due attention should be given to conserving these valuable resources in addition to raising awareness of the community on how to use these plants sustainably.

We also call for the proper enforcement of the Nagoya Protocol with all its international recommendations and in accordance with the national setups in order to protect the TM knowledge and associated rights of indigenous communities. This will further not only grant an opportunity to salvage the indigenous knowledge held by the communities, but also help the scientific endeavor in plant-based anticancer and other diseases drug discoveries.

The efficacies of most Ethiopian traditional anticancer treatment claims with the MPs are not validated scientifically. Besides, only a small proportion of the MPs were reported to have side effects and/or contraindications. To avoid such overlooked health risks, we recommend further assessment on the safety of the anticancer MPs. Scientific investigation on the MP’s potential toxicity and anticancer efficacy must also be made. This would possibly provide a lead material to a more thorough anticancer drug development researches.

Appendix

See Table 5.


FamilyScientific name of the plant Vernacular name¥HabitatPU§ARApplication procedureCancer form describedThe study area reported [Reference]Distribution in the flora region (altitudinal range (m)) [Reference]

AcanthaceaeBarleria eranthemoides R. Br. ex C.B. ClarkeBilinjii (Oro)WSbRtOrDried or fresh root powder with water is given orallyTumorFiche District, Oromia [54]EW, AF, TU, GD, GJ, WU, SU, KF, GG, SD, BA, HA (500-1900) [61]
Hygrophila schulli (Hamilt.) MR. & S.M AlmeidaBala noranti (Oro)WHRtNANANEKERSAAcross the regions of Ethiopia [45]EW, TU, GD, GJ, WU, SU, WG, IL, KF, GG, SD (550-2600) [61]
AloaceaeAloe pirottae Berger (aloe) Iret (Amh)WSbLfOrOne tablespoon of pulp (leaf) is mixed with honey and eaten twice a dayCancerSidama Zone, SNNP Region [62]GG, SD, BA, HA (1300-1820) [63]
AmaranthaceaeCelosia polystachia (Forssk.) C.C. Towns.NAWHLfOr, Ns & DeThe leaf of the plant is applied orally, nasally or topicallyBreast cancerYalo District, Zone 4, Afar Region [64]EW, WU, SU, KF, GG, SD, BA, HA, (300-1300) [65]
AmaryllidaceaeScadoxus multiflorus (Martyn) Raf.Dem astefit (Amh)WHRtDeUsed in combination with other herbs and applied topicallyInternal cancerAcross the regions of Ethiopia [45]EW, GD, SU, AR, WG, KF, IL, GG, SD, BA, HA (1000-3000) [63]
AnacardiaceaeLannea sp. Duduna (Age)WTBrDeTied on the affected partKEMENZINA   NEKERSA/ 
swelling with wound
Across the regions of Ethiopia [45]EW, TU, GD, GJ, WU, SU, AR, WG, KF, GG, SD, BA, ?HA (300-2200) [66]
AnthericaceaeAnthericum angustifolium Hochst. ex A.RichWotet Ashir (Age)WHRtDeCreamed on the surfaceMINSHIRO   NEKERSA/ skin cancerAcross the regions of Ethiopia [45]EW, TU, GD, WU (1300-3000) [63]
Chlorophytum tetraphyllum (L.f) Baker Ye-Eregna kolo (Amh)WHFrOrThe fruit is pounded, cold macerated and drunkNEKERSAAcross the regions of Ethiopia [45]EW, TU, GD, GJ, WU, SU, WG, SD, BA (1250-3400) [63]
ApiaceaeFerula communis L. Doge (Amh)
Etse-Tekhino (Ge’ez)
WHRtOrThe root is crushed and drunk with waterLung cancerLibo Kemkem District, Amhara Region [67]EW, TU, GD, GJ,
WU, SU, SD, BA, HA (1400-3250) [68]
RtNANANEKERSAAcross the regions of Ethiopia [45]
Foeniculum vulgare Mill.Ensilal (Amh)HGHRtOrUsed in combination with other herbs and taken orallyLung cancerAcross the regions of Ethiopia [45]EW, TU, GD, GJ, WU, SU, AR, WG, KF, GG, SD, BA, HA (1600-2350) [68]
ApocynaceaeCarissa spinarum L.Agam (Amh)
Otila (Sid)
WSbFrNANACancerDale District, Sidama Zone, SNNP Region [52]AF, EW, TU, GD, GJ, WU, SU, AR, WG,.KF, GG, SD, BA, HA (550-2500) [68]
Vinca major L.NAHGSbWPNAThe whole areal part is usedCancerLoma and Gena bosa Districts Dawro zone, SNNP Region [59]EW, SU (NA) [68]
AsclepiadaceaeHuernia macrocarpa (A.Rich) SprengerYemidir kulkual (Amh)WHLxInThe latex is mixed with ‘SUMANFAR and inserted in to the cancer woundSkin cancerGubalafto District, North Wello Zone, Amhara Region [69]EW, TU, WU (1600-2400) [68]
Kanahia Laniflora (Forssk.) R. Br.Arust /tifirinde (Amh)WSbLf & LxOr & DeFresh leaf juice with latex is given orally or applied topicallyTumorMecha District, West Gojjam Zone, Amhara Region [42]AF, EW, TU, GD, GJ, SU, AR, IL, KF,
GG, SD, BA, HA, (600-2500) [68]
WPDeNANEKERSAAcross the regions of Ethiopia [45]
AsparagaceaeAsparagus africanus Lam.Yeset kest (Amh)
Serati (Kam)
WSbRtOrNABreast pain/NEKERSAKembatta Tembaro (KT) Zone, SNNP Region [58]EW, TU, GD, GJ, WU, SU, AR, WG, KF, GG, SD, BA, HA (700-3800) [63]
AspleniaceaeAsplenium trichomanes L.Etse-Anbessa (Ge’ez)WSbRtOrNANEKERSAAcross the regions of Ethiopia [45]BA, SU and possibly other regions (2900) [70]
AsteraceaeArtemisia absinthium L.Ariti (Amh)HGHLfOrMixed with Tenadam (Ruta chalepensis), and Zingibil (Zingiber officinale) made into an infusion, filtered and drunkCancerFiche District, North Shewa Zone, Oromia Region [46]EW, TU, GD, SU, WG, HA (1700-2440) [71]
Bidens macroptera (Sch Bip.) ex Chiov. Mesfin Adey Abeba (Amh)WHFlOrPowdered flower part is usedBrain cancerLibo Kemkem District, Amhara Region [67]EW, TU, GD, GJ, WU, SU, AR, IL, KF, GG, BA, HA (1750-3600) [71]
Plectocephalus varians (A. Rich) Jeffrey ex Cufod.Este-Yohannes (Amh)WHWPNAWhole fresh plant is squeezed and appliedTumorMecha District, West Gojjam Zone, Amhara Region [42]EW, TU, GD, GJ, SU, AR, WG, KF, GG, SD, BA, HA (1900-3600) [71]
Vernonia amygdalina Del.Grawa (Amh) Hecho (Sid)WSbShOrTender shoots are pounded and the juice squeezed from the pulp is drunkCancer (as chemoprevention)Sidama Zone, SNNP Region [62]EW TU, WU, GD GJ, SU, WG, IL, KF, GG, SD, BA, HA (650-3000) [71]
Vernonia hymenolepis A. Rich.Qilxuu (Oro)WSbLfNANATumorJimma Zone and Bale Zone, Oromia Region [47, 48]GJ, SU, AR, WG, IL, KF, GG, SD, BA, HA (1200-3000) [71]
Vernonia leopoldi (Sch. Bip. ex Walp.) Vatke (bitter leaf)Merara kitel (Amh)WSbLfNANATumorJimma Zone and Bale Zone, Oromia; Zegie Peninsula, Northwestern Ethiopia, Amhara Region [44, 47, 48]TU, GD, GJ, WU, SU, WG, KF, HA, GG (1850-2850) [71]
BalanitaceaeBalanites aegyptiaca (L.) Del.NAWTLfOr, Ns & DeNABreast cancerYalo District, Zone 4, Afar Region [64]EW, TU, WU, SU, AR, HA, IL, GG, SD (700-1800) [66]
Balanites rotundifolia (van Tieghem) BlatterNAWSbLfOR & DeNABreast cancerYalo District, Zone 4, Afar Region [64]AF, GG, SD (300-1500) [66]
BerberidaceaeBerberis holstii Engl. GB Yeset af / Zinkila (Amh)WSbBrDeBark of the root; used in combination with other herbs and applied topicallyFISTULA  NEKERSAAcross the regions of Ethiopia [45]EW, TU, WU, SU (2406-3200) [65]
BoraginaceaeCordia africana Lam.Wanza (Amh)W/HGTBrDeThe bark of Cordia africana with the root of Plumbago zeylanica is powdered, mixed with butter and creamed on the affected part until recoveryTumors
(‘NEKERSE’)
Debark District, North Gondar Zone, Amhara Region [72]EW, TU, GD, GJ, WU, SU, AR, WG, IL, KF, GG, SD, BA, HA (700-2550) [61]
BrNANACancerDale District, Sidama Zone, SNNP Region [52]
Ehretia cymosa Thonn.Mukerba (Amh)W/HGSbBrBark of the root is used in combination with other herbs and applied topicallyFISTULA  NEKERSA’/ 
rectal & anal cancer
Across the regions of Ethiopia [45]EW, TU, GJ, WU, SU, AR, WG, IL, KF, GG, SD, BA, HA (900-2350) [61]
BrassicaceaeBrassica carinata A. Br.Gomen zer (Amh)HGHSdDeThe seed of B. carinata with seed and leaf of Tarenna graveolens (galo – Amh) is crushed, powdered, mixed with honey and creamed on the affected partSkin cancerDebark District, North Gondar Zone, Amhara Region [72] EW, GD, SU, IL, HA (1350-3850) [65]
CapparidaceaeCadaba farinosa Forssk.Qalaanqaal (Som)WSbLfOrNABreast cancerYalo District, Zone 4, Afar Region[64] AF, EW, TU, GD, GJ, WU, SU, AR, WG, IL, KF, GG, SD, BA (sea level to 2000) [65]
CaryophyllaceaeSilene macrosolen A. RichNAWHLfOrNABreast cancerYalo District, Zone 4, Afar Region [64]TU, GD, WU, SU, AR SD BA, HA (1900-3600 ) [65]
CelastraceaeMaytenus senegalensis (Lam.) ExellAtat (Amh)WSbLfDeIt is pasted on the affected areaCancerGondar Zuria District, Amhara Region [73]EW, TU, WU, GD, GJ, WG, SU, HA, AR, BA, IL, KF, GG, SD (380-2440) [66]
CombretaceaeCombretum Collinum Fresen. Abalo (Amh)WTLfDeThe leaves of Combretum Collinum are pounded, powdered and applied on wound or tumorWound and
Tumors (‘NEKERSA)
Debark District, North Gondar Zone, Amhara Region [72]GJ, SU, (Gibe Gorge),WG, IL, KF, GG, SD, BA, HA (450-1950) [74]
CucurbitaceaeLagenaria siceraria (Molina) StandlBasu baaqula (Sid) HG HLfDeThe leaves are crushed,
squeezed, and applied on the wound
‘NEKERSADega Damot District, Amhara Region [50]GD, GJ, TU, SU, AR, IL, KF, GG, BA, HA (300-2800) [74]
RtOrDry root is pounded, powdered and drunk orallyCancerHawassa city, Sidama Zone, SNNP Region [56]
Momordica friesiorum (Harms) C. JeffreyWof tech (Amh)WHRtDeUsed in combination with other herbs and applied topicallyKAYSI  NEKERSA/ 
invasive cancer
Across the regions of Ethiopia [45]SU, AR, GG, BA, HA (1180-2800) [74]
Zehneria scabra (L.F. Sond) Areg resa (Amh)
Etse-Sabek (Ge’ez)
WHLf & RtNANA‘NEKERSAAcross the regions of Ethiopia [45]EW, TU, GD, GJ, WU, SU, AR, WG, IL KF GG, SD, BA, HA (1200-3580) [74]
EuphorbiaceaeAcalypha fruticosa ForsskNAWSbLfOr, Ns & DeCrushed and applied oral, nasal or topicalBreast cancerYalo District, Zone 4, Afar Region [64]EW, WU, SU, GG, SD, HA (435-1800) [74]
Bridelia micrantha (Hochst.) Baill. Yenebir tifir (Amh)WSbRtNANA‘NEKERSAAcross the regions of Ethiopia [45]GD, GJ, SU, AR, WG, IL, KF, GG, SD, BA (1050-2200) [74]
Clutia abyssinica Jaub. and Spach.Fiyele-fej (Amh)
Este-mefrih (Ge’ez)
WHWPDeThe whole part often together with C. richardiana and C. robusta; used topically‘NEKERSAAcross the regions of Ethiopia [45]TU, GD, WU, GJ, SU, AR, KF, SD, BA, HA (1450-2950) [74]
Croton macrostachyus Del.Bisana (Amh)
Masina (Sid)
WSbLfDeDry/fresh leaves are pounded, powdered and put on the affected partWound cancerWondo Genet District, Sidama Zone, SNNP Region [51]
LfInFresh leaves are crushed and inserted into the woundSkin cancerHawassa city, Sidama Zone, SNNP Region [37]EW, TU, GD, GJ, WU, SU, AR, WG, IL, KF, SD BA HA (500-2350) [74]
LfNANACancerDale District, Sidama Zone, SNNP Region [52]
Euphorbia ampliphylla Pax. Qulquale (Amh)WTFlDeThe flower of Euphorbia ampliphylla is pounded, powdered and mixed with honey and creamed on the affected partSkin cancer (‘LEMTSE)Debark District, North Gondar Zone, Amhara Region [72]TU, GD, GJ, WU, SU, IL, KF, SD, HA (1200-2700) [74]
Rt & LxNARoot and latex of Euphorbia abyssinica, together with Euphorbia caandelabrum & Kotschy and Euphorbit oboalifolia ‘NEKERSAAcross the regions of Ethiopia [45]
Euphorbia dalettiensis M Gilbert. Kelekol (Amh)WSbRt & LxNANAInvasive ‘NEKERSAAcross the regions of Ethiopia [45]HA (1200) [74]
Euphorbia lathyris L.Hadaamii (Oro)HGHStDeStem of Euphorbia lathris is chopped and fumigated to ulcerated breast due to cancerBreast ulcerChelya District, West Shewa, Oromia Region [75]SU, HA (c 2000) [74]
Euphorbia platyphyllos L.Anitrfa (Amh)WHLxDeFresh latex is applied on the tumor topicallyTumorMecha District, West Gojjam Zone, Amhara Region [42]GJ, SU, AR (2000-3200) [74]
Euphorbia polyacantha Boiss.Carricho (Sid)WSbLxDeIts latex is squeezed and creamed on the affected areaSkin cancer (tumor)Delanta District, Northwestern Wello, Amhara Region [60]EE, EW, TU, WU, SU, BA, HA (1200-2250) [74]
Euphorbia tirucalli L. Kinchib (Amh) Shuraamo carre (Sid)WTLxDeLatex dropped on the affected partSkin cancerWondo Genet District, Sidama Zone, SNNP Region [51]EW, TU, WU, SU, IL, GG, SD, BA, HA (1300-2000) [74]
NANANAUnidentified swellings/ Neck CancerDebre Libanos monastery, North Shewa Zone, Oromia Region [53]
Phyllanthus ovalifolius Forssk.Sosiye (Amh)WSbRtNANA‘NEKERSAAcross the regions of Ethiopia [45]GD, GJ, WU, WG SU, AR, IL, KF, GG, SD, BA, HA (900-2750) [74]
Ricinus communis L. Gulo (Amh) Qonbo”o (Sid)HGHRtOrFresh root is chewed and swallowedBreast cancerHawassa city, Sidama Zone, SNNP Region [55, 56]TU, GD, WU, SU,
WG, IL, KF, GG, SD, BA, HA (400-
2500) [74]
LxNANA‘NEKERSAAcross the regions of Ethiopia [45]
FabaceaeAcacia oerfota (Forssk.) Schweinf.Seraw (Tig)WSbLfNs & DeCrushed and applied nasally and/or topicallyBreast cancerYalo District, Zone 4, Afar Region [64]AF, EW, TU, WU, SU, BA, HA, SD (100-1600) [66]
Acacia tortilis (Forssk.) Hayne.Seraw (Tig)WTLfNs & De Crushed and applied nasally and/or topicallyBreast cancerYalo District, Zone 4, Afar Region [64]AF, EW, TU, WU, SU, AR, HA, BA (600-1900) [66]
Calpurnia aurea (Alt.) Benth. Digita (Amh)WSbLfOrThe powdered leaf of the plant is mixed with root of Cucumis ficifolius (Yemidir Embuay) is cold macerated and given orallyUnidentified
swellings/ Cancer
Debre Libanos monastery, North Shewa Zone, Oromia Region [53]EW, TU, GD, WU, GJ, WG, SU, AR, BA, HA, KF, GG, SD (1650-3000) [66]
Colutea abyssinica Kunth & BouchéDuaduate (Amh)WSbRt & SdDeUsed in combination with other herbs and applied topicallyCervical and rectal cancerAcross the regions of Ethiopia [45]EW, TU, GD, WU, SU, AR, BA, HA, SD (1600-4000) [66]
Dichrostachys cinerea (L.) Wight et Am.Ader (Amh)WSbRtOrRoot of the plant is crushed and taken orallySkin bleaching (cancer)Yalo District, Zone 4, Afar Region [64]EW, TU, WU, GJ, WG, SU, AR, BA, HA, KF, GG, SD (450-2000) [66]
Erythrina brucei Schweinf.Kuara /Korch (Amh)
Welekko (Sid)
WTBrNANACancerDale District, Sidama Zone, SNNP region [52]WU, WG, GJ, SU, BA, HA, IL, KF, GD, GG, SD (1400-2600) [66]
Indigofera oblongifolia Forsk.NAWSbLfOr & DeLeaf of the plant is used orally and as a body washBreast cancerGubalafto District, North Wello Zone, Amhara Region [69]AF, EW, HA, BA, KF, GG, SD (up to 1200) [66]
Millettia ferruginea (Hochst.) BakerBirbira (Amh)
Hengedicho (Sid)
WTBrOrNA/ The bark is washed, pounded, filtered and given orallyCancerDale District, Sidama Zone, SNNP region [52]WG, SU, HA, BA, IL, KF, SD (1600-
2500) [66]
Senna alexandrina Mill.Mekerbaa (Oro)WSbBrDeThe bark is pounded and creamed on the swellingNEKERSAAcross the regions of Ethiopia [45]AF, EW (0-1400) [66]
Senna italica Mill.NAWHLfOr & DeLeaf of the plant is used orally and as a body washBreast cancerYalo District, Zone 4, Afar Region [64]AF, EW, TU, GD (0-1850) [66]
Senna septemtrionalis (Viv.) Irwin & BarnebyNAWHLfOrThe Leaf is crushed in water and the filtrate is drunkLung cancerGubalafto District, North Wello Zone, Amhara Region [69]SU, AR, HA, IL, KF, SD (1700-2400) [66]
Senna singueana (Del.) LockKey enchet (Amh)
Busha (Age)
WSbLf & BrDeApplied topically‘MINSHIRO  NEKERSAAcross the regions of Ethiopia [45]EW, TU, GD, WU, GJ, SU, SD (1500-2400) [66]
Sesbania sesban L.Merr. Bofefe – AmhWSbRtNANA‘NEKERSAAcross the regions of Ethiopia [45]AF, EW, TU, GD (Sudan border), WU, GJ, WG, SU, AR, HA, IL, KF, GG, SD (300-2000) [66]
FlacourtiaceaeDovyalis abyssinic a (A. Rich.) Warb Koshim (Amh)WSbFrOrSix to ten fruits are eatenCancerFiche District, Oromia [54]
BrOrThe raw bark of Dovyalis abyssinica is chewed and swallowed ‘MUJE /Lymphatic tumorDale District, Sidama Zone, SNNP Region [55]TU, GD, GJ, WU, SU, AR, GG, SD, BA, HA (1700-3000) [65]
WPDeCreamed on the affected part‘NEKERSAAcross the regions of Ethiopia [45]
IridaceaeGladiolus candidus (Rendle), Goldblatt Milas Golgul (Amh) Hanxxaye (Oro)WHRtOr & DeThe root is powdered and applied on the wound, or the powder is mixed with water and drunk‘NEKERSA(cancer)Across the regions of Ethiopia; Dega Damot District, Amhara Region [45, 50]AR, SD, BA, HA (1450-2250) [63]
JuncaceaeJuncus effusus L.Etse felatsut (Amh)WHRtDeUsed in combination with other herbs and applied topicallyKAYSI  NEKERSAAcross the regions of Ethiopia [45]AR, BA (2400-3120) [63]
LamiaceaeAjuga integrifolia Buch.-Ham. ex D. DonEtse-libawit (Ge’ez)
Harma guusaa (Oro)
WHbLfDeApplied on affected breastBreast cancer massageJimma Zone, Oromia Region [47]EW, TU, GD, GJ, WU, SU, KF, SD, BA, HA (1500-3400) [61]
Clerodendrum myricoides (Hochst.) VatkeMisrichi (Amh)
Mardhisiisaa (Oro)
Ma’niisa (Sid)
WHLfOrThe leaf part will be pounded, mixed with honey and drunk; or its root boiled often mixed with the shoot of Zanthoxylum chalybeum Cancer (Leukemia)Dale District, Sidama Zone, SNNP Region [55]TU, GD, WU, SU,
AR, WG, IL, KF, GG, SD, HA (700-
2600) [61]
Leonotis ocymifolia (Burm.f.) IwarssonYe feres zeng (Amh)WSbLfDeChopped leaves are applied to the ulcer for 24 hoursUlcer of the neck (‘NEKERSA)Fiche District, North Shewa Zone, Oromia Region [46]EW, TU, GD, WU, GJ, SU, AR, WG, IL, KF, GG, SD, SA, HA (500-3700) [61]
Leonotis raineriana De FC (Vis.)Ras kimir (Amh)WSbRtNAOften used with Leonotis Africana and an application is not givenMINSHIRO  NEKERSAAcross the regions of Ethiopia [45]EW, TU, GD, WU, GJ, SU, AR, WG, IL, KF, GG, SD, SA, HA (500-3700) [61]
Salvia nilotica Jacq.Hulegeb (Amh)WHRtNANA‘NEKERSAAcross the regions of Ethiopia [45]All Flora region, except AF (1300-3800) [61]
Satureja abyssinica (Benth.) Briq.Este meaza (Amh)WSbLfDeUsed in combination with other herbs and applied topicallyInternal cancerAcross the regions of Ethiopia [45]EW, TU, GD, GJ, WU, SU, AR, KF, GG, SD, BA, HA (900–2700) [61]
LinaceaeLinum usitatissimum L.Telba (Amh)HGHSdOrNABreast pain/NEKERSAKembatta Tembaro (KT) Zone, SNNP Region [58]Throughout the highlands (1600-3800) [65]
LobeliaceaeLobelia giberroa Hemsl.Jibira (Amh)WTLxNANA‘NEKERSAAcross the regions of Ethiopia [45]EW, TU, GD, SU,
WG, IL, KF, GG, SD, HA, BA (1700-2800) [61]
Lobelia rhynchopetalum Hemsl.Etse-kemun (Ge’ez)WTRtDeUsed in combination with other herbs andapplied topicallyMINSHIRO  NEKERSAAcross the regions of Ethiopia [45]GD, GJ, SU, AR, BA, HA (3000-4350) [61]
LoganiaceaeBuddleja polystachya Fresen Anfar (Amh)
WSbLfOrPounded, cold macerated and taken orallyCancerDale District, Sidama Zone, SNNP Region [55]AF, TU, GD, GJ,
WU, SU, AR, WG,
KF, SD, BA, HA (700-3300) [68]
.Bullaancho (Sid)LfNANAMINSHIRO  NEKERSAAcross the regions of Ethiopia [45]
MalvaceaeMalva verticillata L. Lut (Amh)WHLfDeThe leaf is crushed, warmed on fire and tied on the swellingSwelling by ‘NEKERSAAda’a District, East Shewa Zone Oromia Region [31] EW, TU, GD, GJ, WU, SU, AR
WG, KF, SD, BA, HA (l600-4000) [74]
NANANAUnidentified swellings/ Neck CancerDebre Libanos monastery, North Shewa Zone, Oromia Region [53]
Sida schimperiana Hochst. ex. A. Rich.Chefreg (Amh)WSbLf & RtDeThe leaf and root of Sida schimperi is pounded,
powdered and then applied on
affected part
Wound and
Tumors
(NEKERSA)
Debark District, North Gondar Zone, Amhara Region [72]EW, TU, GD, GJ, SU, WG, SD, BA HA (1500-2600) [74]
RtOrThe juice of freshly squeezed root is mixed with honeyBreast cancerNekemte Town, East Wellega, Oromia Region [76]
MeliaceaeEkebergia capensis Sparm Duduna (Amh)
Simboo (Oro) Goddiicho (Sid)
WSbRt & BrNANA‘NEKERSAAcross the regions of Ethiopia [45] TU, WU, GD, GJ,
WG, SU, AR, IL, KF, SD, BA, HA (1680-3000) [66]
FrOrThe fruit of the plant is pounded, filtered and drunkCancerDale District, Sidama Zone, SNNP Region [55]
MelianthaceaeBersama abyssinica Fresen.Azamir (Amh) Xeweerrakko (Sid)WTBrOrThe bark of the plant pounded boiled and a small amount of the preparation is drunkCancerDale District, Sidama Zone, SNNP Region [55]TU, GD, WU, WG,
GJ, SU, IL, KF, AR, HA, BA, SD (1700-2715) [66]
MenispermaceaeStephania abyssinica (Dillon & A. Rich.) Walp. Engochit (Amh)
Etse Eyesus (Ge’ez) Kalaala (Sid)
WHLfDeFresh leaves are rubbed by hand and droplets are applied on the skinSkin cancerWondo Genet District, Sidama Zone, SNNP Region [51]EW, TU, GD, GJ, WU, SU, AR, WG, KF, IL, GG, SD, HA (1450-3400) [65]
MoraceaeDorstenia barnimiana Schwienf. Work Bemeda (Amh)WHRtInSmall opening is made in the affected area and the root is insertedCancerZegie Peninsula, Northwestern Ethiopia, Amhara Region [44]GD, SU, HA, SD, BA, IL, GG (500-2450) [66]
Ficus palmata Forssk.Beles (Amh)WSbLf & RtDeIts root and leaves with bulb of Allium sativium, fruits of Lagenaria siceraria crushed together, backed with powder of teff and then applied on woundsSkin cancer (‘LEMTSE)Minjar-Shenkora District, North Shewa Zone, Amhara Region [77]EW, TU, GD, GJ, WU, SU, HA, AR, KF (1000-2400 ) [66]
BrNANAKAYSI  NEKERSAAcross the regions of Ethiopia [45]
Ficus sur Forssk. Shola (Amh)WTRt, Br & FrNANAKEMENZINA  NEKERSAAcross the regions of Ethiopia [45]EW, TU,WU, GD, GJ, WG, SU, HA, AR, IL, KF, SD (1400-2500) [66]
MyrsinaceaeMyrsine africana L. Quechemo (Amh)WSbFrOrDried fruit with dried leaf of Osyris quadripartita, powdered, mixed with little water is given orallyCancerFiche District, North Shewa Zone, Oromia Region [54]EW, TU, GD, GJ, WU, SU, AR, KF, SD, BA, HA (1900-3800) [68]
Myrsine Melanophloeos
(L.) R. Br.
Morocho (Sid)WTLfOrThe leaf (often mixed with Olea capensis) is pounded, cold macerated and drunkCancer (leukemia)Dale District, Sidama Zone, SNNP Region [55]TU, GD, GJ, SU, AR, WG, GG, BA (2500-3750) [68]
OleaceaeOlea capensis L.f.Seettaame (Sid)WTShOrThe shoot part is boiled, mixed with honey and drunk; Shoot of Zanthoxylum chalybeum and Clerodendrum myricoides are often boiled togetherCancerDale District, Sidama Zone, SNNP Region [55]GD, SU, AR, IL, KF, SD, BA (1350-
3200) [68]
Olea europaea subsp.
Cuspidate (Wall. ex. G. Don) Cif.
Woira (Amh)WTFrNsThe dried fruit and Embelia schimperi fruit powder with water is given nasally before foodTumorMecha District, West Gojjam Zone, Amhara Region [42]AF, EW, TU, GD, WU, SU, KF, GG,
SD, BA, HA, (1250-3000) [68]
PhytolaccaceaePhytolacca dodecandra L 'Herit.Endod (Amh)WSbLf & RtNARoot and leaf of the plant is used by chopping and pounding;Cancer/swelling of glandLoma and Gena bosa Districts Dawro zone, SNNP region [59]EW, TU, BA,GG, GD, WU, GJ, WG, SU, IL, KF, AR, SD, HA (1500-3000 ) [65]
PittosporaceaePittosporum abyssinicum Del.Lola (Amh)
Boncho (Sid)
WSbBrNANACancerDale District, Sidama Zone, SNNP region [52]GD, SU, BA, HA (2300-3200) [66]
PlantaginaceaePlantago lanceolata L.Qorxobi (Oro)WHSdDeDried seeds are crushed, powdered and applied to the cancer woundCancerHawassa city, Sidama Zone, SNNP Region [56]EW, TU,GD, GJ, WU, SU, WG, IL, KF, GG, SD, BA (1200-3200) [61]
PlumbaginaceaePlumbago zeylanica L.Amera (Amh)
Aftuh (Tig)
Mexres (Som)
WHLfOrLeaf of P. zeylanica is squeezed and the juice is taken orallyCancerGhimbi District, West Wollega Zone, Oromia Region [43]
RtDeRoot powder mixed with “digne” (sulfur) is applied/ dressed with root pasteCancerZegie Peninsula, Northwestern Ethiopia, Amhara Region [44]
ShOrFresh shoot boiled with water is given orallyStomach tumorMecha District, West Gojjam Zone, Amhara Region [42]AF, EW, TU, GD
GJ, WU, SU, AR, IL, GG, SD, BA, HA (700-2200) [61]
RtNANAKAYSI  NEKERSAAcross the regions of Ethiopia [45]
RtOr & DeThe root part is boiled and consumed orally and also applied topicallyBone cancerJeldesa Cluster, Dire Dawa city Administration [41]
PodocarpaceaeAfrocarpus falcatus (Thunb.) C.N.PageZigba (Amh)WTLfNANACancerDale District, Sidama Zone, SNNP region [52]TU, GD, GJ, WU, SU, AR, IL, KF, GG, WG, SD, BA, HA (1350-2900) [78]
PolygonaceaeOxygonum sinuatum (Meisn.) DammerKurnchit (Amh)WHWPDeWhole part is creamed on the affected partNEKERSAAcross the regions of Ethiopia [45]EW, TU, GD, GJ,
SU, GG, SD, BA, HA (600-2500) [65]
Rumex abyssinicus Jacq.Mekmeko (Amh)
Este-berhan (Ge’ez)
Shiishoone (Sid)
HGHRtDeThe root is pounded and creamed on the swellingNEKERSAAcross the regions of Ethiopia [45]EW, TU, GD, GJ, SU, AR, WG, KF, IL, GG, SD, BA, HA (1200-3300) [65]
RtOrRoot powder is mixed in spicy stew to increase its power of curing and taken orallyCancerSeharti Samre District, Southern Tigray Region [57]
Rumex nervosus Vahl.Huhot/Embuacho (Amh) Dhangaggoo (Oro)WSbLfDeLeaves are crushed and pasted on the affected areaBreast cancerSeharti Samre District, Southern Tigray Region [57]EW, TU, GD,, GJ, WU, SU, AR, GG, SD, HA (400-3300) [65]
PunicaceaePunica granatum L.Roman (Amh)HGSbFrOrThe fruit is crushed and eatenCancerLibo Kemkem District, Amhara Region [67]EW, SU, KF, and probably elsewhere (1000-2450) [65]
RanunculaceaeClematis bracteata (Roxb.) KurzYeazo Areg (Amh)WClWPDeThe plant is crushed and mixed with butter and appliedCancerBale area, Southeast Ethiopia, Oromia Region [79]GD, GD/GJ, GJ, SU, WG, KF, IL, SD (1350-3300 ) [65]
Clematis hirsuta var. hirsuta./Perr. and Guill. Nech yeazo Areg (Amh)
WClLf, St & BrOrLeafs/stem and bark are mixed with leafs of Plectranthus ingiarius then pounded, filtered and drunkBreast cancerWondo Genet District, Sidama Zone, SNNP Region [51]
LfDeThe leaves are crushed and applied on the swelling as bandageSwelling by NEKERSADega Damot District, Amhara Region [50]EW, TU, GD, GJ, WU, SU, AR, IL, KF, SD, BA, HA (850- 3200) [65]
LfOr & InThe leaves are pounded to make a solution and half of small glass is drunk; certain amount of the solution is applied into the hole of the wound using syringe or other domestic material; the residue is put on the opening of the wound.Bone cancerBlue Hora District, Borana Zone, Oromia Region [49]
Clematis simensis Fresen.Fiide (Sid)WClLfDeThe leaves are crushed, powdered and then creamedCancerLibo Kemkem District, Amhara Region [67]GD, TU, WU, GJ,
SU, AR, WG, KF,
GG, SD, BA, HA
(1500-3350) [65]
LfOrLeaves of the plant will be macerated and drunkCancerDale District, Sidama Zone, SNNP Region [55]
Ranunculus multifidus Forssk. Etse Siol (Amh/Ge’ez)WHLfDeThe leaf is powdered and dressed externallyNEKERSA (Cancer)Debre Libanos monastery, North Shewa Zone, Oromia Region [53]EW, TU, GD, GJ, WU, SU, AR, WG, IL, KF, SD, BA, HA (1200-3800)[65]
Thalictrum rhynchocarpum Dill. & A. Rich.Sire bizu (Amh)WHRtDeUsed in combination with other herbs and applied topically‘KEMENZINA  'NEKERSAAcross the regions of Ethiopia [45]TU, GD, GJ, SU, AR, WG, IL, KF, HA (1600-3050) [65]
RhamnaceaeZiziphus mauritiana Lam.NAWSbLfOrNABreast cancerYalo District, Zone 4, Afar Region [64]IL, GG, SD, SD-BA, HA (400-1600) [66]
Ziziphus spina-christi L. Desf. Geba (Amh/Age) Qurqura (Oro)WTRt & FrNANAMINSHIRO  NEKERSA; TumorsAcross the regions of Ethiopia [45, 80]AF, EW, TU, GD, WU, SU, GG, BA, HA (0-2400) [66]
RosaceaeHagenia abyssinica (Bruce) J.F.Gmel. Kosso (Amh)WTRtDeThe root is pounded and mixed with honey, then creamed on the affected partMINSHIRO  NEKERSAAcross the regions of Ethiopia [45]EW, TU, GD, WU, GJ, WG, SU, AR, BA, HA, KF, SD (2450-3250) [66]
Prunus Africana (Hook. f.) KalkmTikur Enchet (Amh)WTBrOrLiquid extracts from P. Africana bark is pounded, juiced and taken orallyBenign prostatic hyperplasia,
prostate gland hypertrophy
Ghimbi District, West Wollega Zone, Oromia Region [43]GD, GJ, WG, SU, AR, BA, HA, IL, KF, SD (1700-2500) [66]
Rosa abyssinica LindleyKega (Amh)WSbRt & FlNANA‘NEKERSAAcross the regions of Ethiopia [45]EW, TU, GD, WU, GJ, SU, AR, HA, BA (1900-3300) [66]
RubiaceaeRubia cordifolia L.Enchibir (Amh)WHRtDeUsed in combination with other herbs and applied topicallyInternal cancerAcross the regions of Ethiopia [45]EW, TU, GD, GJ, WU, SU, AR, KF, SD, BA, HA, (1000-2850) [68]
RtOrThe root part is crushed in water for 3 days and taken orallyLung cancerGubalafto District, North Wello Zone, Amhara Region [69]
RutaceaeFagaropsis angolensis (Engl.) DaleOloncho (Sid)WSbFrNANACancerDale District, Sidama Zone, SNNP region [52]TU, WU, GD, GJ,
WG, SU, AR, IL, KF, SD, BA, HA (1680-3000) [66]
Zanthoxylum Gadda (Sid/O ro)WTLfOrThe leaves are dried, powdered, cold macerated and drunkBreast cancerHawassa city and Dalle District, Sidama Zone, SNNP Region [52, 55, 56]GG, BA, HA (900-
1550) [66]
chalybeum Engl.RtNANACancer
SantalaceaeOsyris quadripartita Decn. Queret (Amh)WTLfOrDried leaf with dried fruit of Myrsine africana, is powdered, mixed with water and given orallyCancerFiche District, Oromia Region [54]EW, TU, GD, WU,
GJ, WG, SU, KF, GG, AR, HA, BA, SD (1600-2900) [66]
SapindaceaeDodonaea angustirolia L. f. Kitkita (Amh) Ittancha (Sid)WSbLfNANACancerDale District, Sidama Zone, SNNP Region; Across the regions of Ethiopia [45, 52]EW, TU, GD, WU, SU, AR, GJ, WG, KF, GG, SD, BA, HA (500-2900) [66]
NANANAUnidentified swellings/ Neck CancerDebre Libanos monastery, North Shewa Zone, Oromia Region [53]
SapotaceaeSideroxylon oxyacanthum Baill.Bunguude (Sid)WSbLfOrThe leaf part macerated and taken orallyCancerDale District, Sidama Zone, SNNP Region [55]TU, GD, SU,
AR, BA, HA (1250-2800) [68]
ScrophulariaceaeCraterostigma pumilum Hochst.Delashut (Amh)WHLf & FlDeUsed in combination with other herbs and applied topicallyCervical and rectal cancerAcross the regions of Ethiopia [45]GD, EW, SU, HA, BA, WU, GJ, TU (1300-3100) [61]
Rhamphicarpa fistulosa (Hochst.) Benth.Yeset lib (Amh)WHFlOrUsed in combination with other herbs and given orallyLung cancerAcross the regions of Ethiopia [45]GD, GJ, WG, KF (800-1650) [61]
SimaroubaceaeBrucea antidysenterica J.F. Mill. Yedega Abalo (Amh)WSbSt & BrOrDecoction is drunkCancerJimma Zone and Bale Zone, Oromia Region [47, 48]EW, TU, GD, GJ, WG, SU, AR, IL,
KF, SD, BA, HA (1650-2800) [66]
Waginos (Ge’ez)LfDeThe leaves are collected and dried, the powder is then applied to the skinCancerFiche District, North Shewa Zone, Oromia Region [46]
SolanaceaeNicotiana tabacum L.Timbaho (Amh)HGHLfDeThe leaf is pounded and creamed on the swellingNEKERSAAcross the regions of Ethiopia [45]EW, TU,GD, SU, WG, KF, GG, SD, HA (300-2400) [61]
Solanum gigantum Jacq. Tikur Embuay (Amh)
Ziza (Kam)
WSbLfDeNABreast painKembatta Tembaro (KT) Zone, SNNP Region [58]GD, GJ, WG, IL, KF, SD, BA (1100-2300) [61]
Withania somnifera (L.) Dunal in DC.Gizawa (Ama)WSbNANANACancerFiche District, North Shewa Zone, Oromia Region [46]AF, EW, TU,GD, GJ, WU, SU, KF, GG, SD, HA (600-2700) [61]
VitaceaeCyphostemma adenocaule (Steud. ex. A. Rich.) Descoings exWild & DrummondAsserkush (Amh)WClLfDeThe leaf part is warmed up and pasted on the affected areaSwelling by NEKERSAAda’a District, East Shewa Zone Oromia Region; Across the regions of Ethiopia [31, 45]EW, TU, GD, GD-GJ, WU, SU, WG, IL, KF, GG, SD, BA, HA (600-2650) [66]
Cyphostemma cyphopetalum (Fresen.) Descoings ex Wild&Drummond Gindosh (Amh) Kelkalo (Oro)WClRt & FlNANANEKERSAAcross the regions of Ethiopia [45]AF, EW, TU, GD, WU, SU, SU-AR, GJ, WG, GG, SD, BA, HA (250-2800) [66]
ZygophyllaceaeTribulus terrestris L.Ch’amare (Oro)WHFrNANACancerAcross the regions of Ethiopia [80]EW, WU, SU, AR, SD, HA (sea level up to 2300) [65]

Note: PU§= part used (Lf-leaf; Rt=root; Br=bark; Fl; flower; Fr=fruit; Sd=seed; Lx=latex; Sh=shoot; St=stem; WP=whole part); AR=application route (Or=oral; De=dermal; In=insertion; Ns=nasal); = growth forms (T=tree; Sb=shrub; H=herb; Cl=climber/liana); habitat (W=wild; HG=home garden); Key: ¥local names: Ge’ez: Ge’ezinga; Amh: Amharic; Tig: Tigrigna; Oro: Afaan Oromoo; Sid: Sidamu-afoo; Age: Agewugna; Kam: Kambatissa; Som: Somali; NA= not available. Note: vernacular names of malignancies/cancer are written in small caps, Italic, font 10, within single inverted commas throughout the document.
TU: Tigray region above 1000 m contour; AF: Afar region below 1000 m contour to Eritrean border in the east and Harerge border in the south; WU: Welo region above 1000 m contour; GD: Gondar region; WG: Welega region; KF: Kefa region; AR: Arsi region; BA: Bale region; GJ: Gojam region; IL: I1ubabor region; GG: Gamo Gofa region; SD: Sidamo region; HA: Harerge region.

Abbreviations

AAU:Addis Ababa University
ABS:Access and benefit sharing
CAM:Complementary and alternative medicine
IARC:International Agency for Research on Cancer
MP/MPs:Medicinal plant(s)
SNNP:Southern Nations, Nationalities and Peoples
TM/TMs:Traditional medicine(s)
WHO:World Health Organization.

Disclosure

This work did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.

Conflicts of Interest

The authors declare that they have no conflicts of interest.

Authors’ Contributions

Nigatu Tuasha has incepted and designed this systematic review, searched the literature, screened the literature for eligibility against inclusion/exclusion criteria, extracted the data, carried out the analysis of the results, and prepared the draft manuscript. Beyene Petros and Zemede Asfaw independently checked for the methodological conformity, corrected the discordance, provided consistent comments during the analysis and write-up, and rigorously reviewed the manuscript. All authors have read, approved, and agreed on submission of the final manuscript.

Acknowledgments

The authors would like to appreciate Mr. Girma Gudesho, lecturer at Mizan-Tepi University and a Ph.D. candidate at AAU, for kindly generating the map shown in Figure 2 using ArcGIS.

References

  1. J. S. Long and K. M. Ryan, “New frontiers in promoting tumour cell death: Targeting apoptosis, necroptosis and autophagy,” Oncogene, vol. 31, no. 49, pp. 5045–5060, 2012. View at: Publisher Site | Google Scholar
  2. J. Font-Burgada, B. Sun, and M. Karin, “Obesity and Cancer: The Oil that Feeds the Flame,” Cell Metabolism, vol. 23, no. 1, pp. 48–62, 2016. View at: Publisher Site | Google Scholar
  3. L. A. Torre, F. Bray, R. L. Siegel, J. Ferlay, and J. Lortet-Tieulent, “Global cancer statistics, 2012,” CA: A Cancer Journal for Clinicians, vol. 65, no. 2, pp. 87–108, 2015. View at: Publisher Site | Google Scholar
  4. WHO: Fact sheet No. 297: Cancer. http://www.who.int/mediacentre/factsheets/fs297/en/.
  5. WHO, Global Health Risks: Mortality and Burden of Disease Attributable to Selected Major Risks, World Health Organization, 2009.
  6. A. Jemal, F. Bray, D. Forman et al., “Cancer burden in Africa and opportunities for prevention,” Cancer, vol. 118, no. 18, pp. 4372–4384, 2012. View at: Publisher Site | Google Scholar
  7. V. A. McCormack and J. Schüz, “Africa's growing cancer burden: Environmental and occupational contributions,” Cancer Epidemiology, vol. 36, no. 1, pp. 1–7, 2012. View at: Publisher Site | Google Scholar
  8. D. M. Parkin, F. Bray, J. Ferlay, and A. Jemal, “Cancer in Africa 2012,” Cancer Epidemiology, Biomarkers & Prevention, vol. 23, no. 6, pp. 953–966, 2014. View at: Publisher Site | Google Scholar
  9. E. Weiderpass, “Lifestyle and cancer risk,” Journal of Preventive Medicine & Public Health, vol. 43, no. 6, pp. 459–471, 2010. View at: Publisher Site | Google Scholar
  10. J. Ferlay, H. R. Shin, F. Bray, D. Forman, C. Mathers, and D. M. Parkin, “Estimates of worldwide burden of cancer in 2008: GLOBOCAN 2008,” International Journal of Cancer, vol. 127, no. 12, pp. 2893–2917, 2010. View at: Publisher Site | Google Scholar
  11. Y. W. Woldeamanuel, B. Girma, and A. M. Teklu, “Cancer in Ethiopia,” The Lancet Oncology, vol. 14, no. 4, pp. 289-290, 2013. View at: Publisher Site | Google Scholar
  12. T. Hailu, H. Berhe, and D. Hailu, “Awareness of Breast Cancer and Its Early Detection Measures among Female Students, Northern Ethiopia,” International Journal of Public Health Science (IJPHS), vol. 5, no. 3, p. 213, 2016. View at: Publisher Site | Google Scholar
  13. B. Legesse and T. Gedif, “Knowledge on breast cancer and its prevention among women household heads in Northern Ethiopia,” Open Journal of Preventive Medicine, vol. 04, no. 01, pp. 32–40, 2014. View at: Publisher Site | Google Scholar
  14. N. Yarom, E. Gorbatsevich, N. Geva et al., “Colon cancer in immigrants from Ethiopia.,” Journal of Clinical Oncology, vol. 33, no. 3_suppl, pp. 521–521, 2015. View at: Publisher Site | Google Scholar
  15. WHO, Cancer Country Profiles, World Health Organization, 2014.
  16. M. Assefa, Assessment of types and treatment pattern of cancer in TASH Radiotherapy Center: Retrospective study [M.Sc. thesis], Addis Ababa University, Addis Ababa, 2011.
  17. H. Ma, C. L. Carpenter, J. Sullivan-Halley, and L. Bernstein, “The roles of herbal remedies in survival and quality of life among long-term breast cancer survivors - results of a prospective study,” BMC Cancer, vol. 11, article no. 222, 2011. View at: Publisher Site | Google Scholar
  18. WHO, WHO traditional medicine strategy 2014–2023, World Health Organization, Geneva, 2013.
  19. O. Olaku and J. D. White, “Herbal therapy use by cancer patients: a literature review on case reports,” European Journal of Cancer, vol. 47, no. 4, pp. 508–514, 2011. View at: Publisher Site | Google Scholar
  20. D. Sakarkar and V. Deshmukh, “Ethnopharmacological review of traditional medicinal plants for anticancer activity,” International Journal of PharmTech Research, vol. 3, no. 1, pp. 298–308, 2011. View at: Google Scholar
  21. J. Vardy, H. M. Dhillon, S. J. Clarke et al., “Investigation of herb-drug interactions with ginkgo biloba in women receiving hormonal treatment for early breast cancer,” SpringerPlus, vol. 2, no. 1, p. 126, 2013. View at: Publisher Site | Google Scholar
  22. M. A. Richardson, L. C. Mâsse, K. Nanny, and C. Sanders, “Discrepant views of oncologists and cancer patients on complementary/ alternative medicine,” Supportive Care in Cancer, vol. 12, no. 11, pp. 797–804, 2004. View at: Publisher Site | Google Scholar
  23. X. Li, G. Yang, Y. Zhang et al., “Traditional Chinese medicine in cancer care: a review of controlled clinical studies published in Chinese,” PLoS ONE, vol. 8, no. 4, Article ID e60338, 2013. View at: Publisher Site | Google Scholar
  24. A. Molassiotis, P. Fernandez-Ortega, D. Pud et al., “Use of complementary and alternative medicine in cancer patients: a European survey,” Annals of Oncology, vol. 16, no. 4, pp. 655–663, 2005. View at: Publisher Site | Google Scholar
  25. E. Ernst, “The prevalence of complementary/alternative medicine in cancer: a systematic review,” Cancer, vol. 83, no. 4, pp. 777–782, 1998. View at: Publisher Site | Google Scholar
  26. D. . M Malki, Cancer Treatment Strategies, OMICS International, 2014. View at: Publisher Site
  27. D. O. Levitsky and V. M. Dembitsky, “Anti-breast Cancer Agents Derived from Plants,” Natural Products and Bioprospecting, vol. 5, no. 1, pp. 1–16, 2015. View at: Publisher Site | Google Scholar
  28. F. Kibebew, “The Status of Availability of Data of Oral and Written Knowledge and Traditional Health Care in Ethiopia,” in Conservation and Sustainable Use of Medicinal Plants in Ethiopia, pp. 107–119, Institute of Biodiversity Conservation and Research, Addis Ababa, 2001. View at: Google Scholar
  29. A. Debela, D. Abebe, and K. Urga, “An over view of traditional medicine in Ethiopia: perspective and developmental efforts,” Ethiopian Pharmaceutical Association, vol. 72, pp. 45–52, 1999. View at: Google Scholar
  30. L. M. Souza, T. C. Boone, and J. Gabrilove, “Recombinant human granulocyte colony-stimulating factor: effects on normal and leukemic myeloid cells,” Science, vol. 232, no. 4746, pp. 61–65, 1986. View at: Publisher Site | Google Scholar
  31. A. Kefalew, Z. Asfaw, and E. Kelbessa, “Ethnobotany of medicinal plants in Ada'a District, East Shewa Zone of Oromia Regional State, Ethiopia,” Journal of Ethnobiology and Ethnomedicine, vol. 11, article 25, 2015. View at: Publisher Site | Google Scholar
  32. T. Awas, M. Gashaw, and G. Tesfaye, Ecosystems of Ethiopia. in. National Biodiversity Strategy and Action Plan (NBSAP) Project, Ethiopia, Addis Ababa, IBCR, 2003.
  33. IBCR, Convention on Biological Diversity (CBD) Ethiopias 4th Country Report, IBC, Addis Ababa, Ethiopia, 2009.
  34. Hydro Meteorological Bulletin for May, 2016, Addis Ababa, http://www.ethiomet.gov.et/bulletins/bulletins.
  35. T. B. Gebre-Egziabher, “Diversity of Ethiopian flora,” in Plant Genetic resources of Ethiopia, Engels J. M. M., J. G. Hawkes, and M. Worede, Eds., p. 75, Cambridge University Press, Cambridge, 1991. View at: Google Scholar
  36. E. Kelbessa, S. Demissew, and Z. Woldu, “Some threatened endemic plants of Ethiopia,” The status of some plants in parts of tropical Africa, pp. 35–55, 1992. View at: Google Scholar
  37. R. Regassa, “Diversity and conservation status of some economically valued indigenous medicinal plants in Hawassa College of Teacher Education Campus, Southern Ethiopia,” International Journal of Advanced Research, vol. 1, no. 3, pp. 308–328, 2013. View at: Google Scholar
  38. E. Kelbessa and S. Demissew, “Diversity of vascular plant taxa of the flora of Ethiopia and Eritrea,” The Ethiopian Journal of Biological Sciences, vol. 13, pp. 37–45, 2014. View at: Google Scholar
  39. R. Tena, Endemic Medicinal Plants of Ethiopia: Review of the Literature [Ph.D. thesis], Addis Ababa University, 2014.
  40. E. Bekele, Study on actual situation of medicinal plants in Ethiopia, Prepared for Japan Association for International Collaboration of Agriculture and Forestry (JAICAF), Addis Abab.
  41. A. Shimels, K. Atinafu, M. Akalu, and M. Getachew, “Ethnobotanical study of medicinal plants used by agro pastoralist Somali people for the management of human ailments in Jeldesa Cluster, Dire Dawa Administration, Eastern Ethiopia,” Journal of Medicinal Plants Research, vol. 11, no. 9, pp. 171–187, 2017. View at: Publisher Site | Google Scholar
  42. G. Gebeyehu, Z. Asfaw, and A. Enyew, “Ethnobotanical study of traditional medicinal plants and their conservation status in Mecha Woreda, West Gojjam Zone of Ethiopia,” International Journal of Pharmaceuticals and Health care Research, vol. 2, p. 17, 2014. View at: Google Scholar
  43. B. Abera, “Medicinal plants used in traditional medicine by Oromo people, Ghimbi District, Southwest Ethiopia,” Journal of Ethnobiology and Ethnomedicine, vol. 10, no. 1, article 40, 2014. View at: Publisher Site | Google Scholar
  44. T. Teklehaymanot and M. Giday, “Ethnobotanical study of medicinal plants used by people in Zegie Peninsula, Northwestern Ethiopia,” Journal of Ethnobiology and Ethnomedicine, vol. 3, article 12, 2007. View at: Publisher Site | Google Scholar
  45. G. Abate, in Etse Debdabe – Ethiopian traditional medicine (Amharic version), S. Demissew, Ed., Addis Ababa University, Addis Ababa, Ethiopia, 1989.
  46. E. d'Avigdor, H. Wohlmuth, Z. Asfaw, and T. Awas, “The current status of knowledge of herbal medicine and medicinal plants in Fiche, Ethiopia,” Journal of Ethnobiology and Ethnomedicine, vol. 10, no. 1, pp. 38–71, 2014. View at: Publisher Site | Google Scholar
  47. B. Abera, “Medicinal plants used in traditional medicine in Jimma Zone,” Ethiopian Journal of Health Development, vol. 13, no. 2, 2003. View at: Google Scholar
  48. N. T. Wabe, M. A. Mohammed, and N. J. Raju, “An ethnobotanical survey of medicinal plants in the Southeast Ethiopia used in traditional medicine,” Spatula DD, vol. 1, no. 3, pp. 153–158, 2011. View at: Publisher Site | Google Scholar
  49. M. A. Eshete, Ethnobotanical Study of Medicinal Plants in Guji Agro-pastorilists, Bule Hora District of Borana Zone, Oromia Region, Ethiopia [M.Sc. thesis], Addis Ababa University, 2011.
  50. L. Limenih, S. Umer, and M. Wolde-Mariam, “Ethnobotanical Study on Traditional Medicinal Plants in Dega Damot Woreda, Amhara Region, North Ethiopia,” International Journal of Research in Pharmacy and Chemistry, vol. 5, pp. 258–273, 2015. View at: Google Scholar
  51. S. T. Beyene, An Ethnobotanical Study of Medicinal Plants in Wondo Genet Natural Forest and Adjacent Kebeles, Sidama Zone, SNNP Region, Ethiopia [M.Sc. thesis], Addis Ababa University, 2011.
  52. G. Kewessa, T. Abebe, and A. Demessie, “Indigenous knowledge on the use and management of medicinal trees and shrubs in Dale District, Sidama Zone, Southern Ethiopia,” Ethnobotany Research and Applications , vol. 14, pp. 171–182, 2015. View at: Publisher Site | Google Scholar
  53. T. Teklehaymanot, M. Giday, G. Medhin, and Y. Mekonnen, “Knowledge and use of medicinal plants by people around Debre Libanos monastery in Ethiopia,” Journal of Ethnopharmacology, vol. 111, no. 2, pp. 271–283, 2007. View at: Publisher Site | Google Scholar
  54. A. Enyew, Z. Asfaw, E. Kelbessa et al., “Ethnobotanical study of traditional medicinal plants in and around Fiche District,” Current Research Journal of Biological Sciences, vol. 6, no. 4, pp. 154–167, 2014. View at: Google Scholar
  55. N. Tuasha, B. Petros, and Z. Asfaw, “Medicinal plants used by traditional healers to treat malignancies and other human ailments in Dalle District, Sidama Zone, Ethiopia,” Journal of Ethnobiology and Ethnomedicine, vol. 14, no. 1, 2018. View at: Google Scholar
  56. R. Regassa, “Assessment of indigenous knowledge of medicinal plant practice and mode of service delivery in Hawassa city, southern Ethiopia,” Journal of Medicinal Plants Research, vol. 7, no. 9, pp. 517–535, 2013. View at: Google Scholar
  57. S. Araya, B. Abera, and M. Giday, “Study of plants traditionally used in public and animal health management in Seharti Samre District, Southern Tigray, Ethiopia,” Journal of Ethnobiology and Ethnomedicine, vol. 11, no. 1, article no. 22, 2015. View at: Publisher Site | Google Scholar
  58. M. Maryo, S. Nemomissa, and T. Bekele, “An ethnobotanical study of medicinal plants of the Kembatta ethnic group in Enset-based agricultural landscape of Kembatta Tembaro (KT) Zone, Southern Ethiopia,” Asian Journal of Plant Science Research, vol. 5, no. 7, pp. 42–61, 2015. View at: Google Scholar
  59. M. Agize, S. Demissew, and Z. Asfaw, “Ethnobotany of medicinal plants in Loma and Gena bosa districts (woredas) of dawro zone, southern Ethiopia,” Topclass Journal of Herbal Medicine, vol. 2, pp. 194–212, 2013. View at: Google Scholar
  60. M. Meragiaw, Z. Asfaw, and M. Argaw, “The Status of Ethnobotanical Knowledge of Medicinal Plants and the Impacts of Resettlement in Delanta, Northwestern Wello, Northern Ethiopia,” Evidence-Based Complementary and Alternative Medicine, vol. 2016, Article ID 5060247, 24 pages, 2016. View at: Publisher Site | Google Scholar
  61. I. Hedberg, Flora of Ethiopia and Eritrea, vol. 5, Uppsala: The National Herbarium, Addis Ababa, Ethiopia, and Department of Systematic Botany, 2006.
  62. H. T. G. Busse, “Handbook of Sidama Traditional Medicinal Plants,” in A Service Learning Project School of Medicine and Public Health, University of Wisconsin Madison (UW), 2013. View at: Google Scholar
  63. R. Schmid, S. Edwards, S. Demissew, and I. Hedberg, “Flora of Ethiopia and Eritrea,” in Hydrocharitaceae to Arecaceae, vol. 6, Uppsala: The National Herbarium, Addis Ababa, Ethiopia, and Department of Systematic Botany, 1997. View at: Publisher Site | Google Scholar
  64. T. Teklehaymanot, “An ethnobotanical survey of medicinal and edible plants of Yalo Woreda in Afar regional state, Ethiopia,” Journal of Ethnobiology and Ethnomedicine, vol. 13, no. 1, 2017. View at: Google Scholar
  65. S. Edwards, M. Tadesse, S. Demissew, and I. Hedberg, “Flora of Ethiopia and Eritrea,” in Magnoliaceae to Flacourtiaceae., Uppsala, The National Herbarium, vol. 2, Uppsala: The National Herbarium, Addis Ababa, Ethiopia, and Department of Systematic Botany, 2000. View at: Google Scholar
  66. I. Hedberg and S. Edwards, Flora of Ethiopia, volume 3: Pittosporaceae to Araliaceae: The National Herbarium, Uppsala: Addis Ababa, Ethiopia, and Department of Systematic Botany, 1989.
  67. G. Chekole, Z. Asfaw, and E. Kelbessa, “Ethnobotanical study of medicinal plants in the environs of Tara-gedam and Amba remnant forests of Libo Kemkem District, northwest Ethiopia,” Journal of Ethnobiology and Ethnomedicine, vol. 11, no. 1, 2015. View at: Google Scholar
  68. I. Hedberg, S. Edwards, and S. Nemomissa, Flora of Ethiopia and Eritrea. Volume 4, part 1. Apiaceae to Dipsacaceae, Uppsala: The National Herbarium, Addis Ababa, Ethiopia, and Department of Systematic Botany, 2003.
  69. G. Chekole, “Ethnobotanical study of medicinal plants used against human ailments in Gubalafto District, Northern Ethiopia,” Journal of Ethnobiology and Ethnomedicine, vol. 13, no. 1, article 55, 2017. View at: Google Scholar
  70. P. Chaerle and R. Viane, “Additions to the fern flora of Ethiopia,” Willdenowia, vol. 32, no. 1, pp. 55–60, 2002. View at: Publisher Site | Google Scholar
  71. I. Hedberg, I. Friis, and S. Edwards, Flora of Ethiopia and Eritrea. Volume 4, part 2. Asteraceae, Uppsala: The National Herbarium, Addis Ababa, Ethiopia, and Department of Systematic Botany, 2004.
  72. E. Abebe, Ethnobotanical Study on Medicinal Plants Used by Local Communities in Debark Wereda, North Gondar Zone, Amhara Regional State, Ethiopia [M.Sc. thesis], Addis Ababa University, 2011.
  73. Z. Birhanu, “Traditional use of medicinal plants by the ethnic groups of Gondar Zuria district, North-Western Ethiopia,” Journal of Natural Remedies, vol. 13, no. 1, pp. 46–53, 2013. View at: Google Scholar
  74. S. Edwards, M. Tadesse, and I. Hedberg, Flora of Ethiopia and Eritrea, volume 2, part 2: Canellaceae to Euphorbiaceae, Uppsala: The National Herbarium, Addis Ababa, Ethiopia, and Department of Systematic Botany, 1995.
  75. E. Amenu, Use and management of medicinal plants by indigenous people of Ejaji area (chelya woreda) west shoa, Ethiopia: An ethnobotanical approach [M.Sc. thesis], Addis Ababa University, Ethiopia, 2007.
  76. S. Suleman and T. Alemu, “A survey on utilization of ethnomedicinal plants in Nekemte town, East Wellega (Oromia), Ethiopia,” Journal of Herbs, Spices & Medicinal Plants, vol. 18, no. 1, pp. 34–57, 2012. View at: Publisher Site | Google Scholar
  77. G. Alemayehu, Ethnobotanical Study on Medicinal Plants Used by Indigenous Local Communities in Minjar-Shenkora Wereda, North Shewa Zone of Amhara Region, Ethiopia [M.Sc. thesis], Addis Ababa University, 2010.
  78. I. Friis, “Floristic richness and endemism in the flora of Ethiopia and Eritrea,” in Flora of Ethiopia and Eritrea, volume 8 General part and index to volumes 1-7, I. Hedberg, I. Friis, and E. Presson, Eds., The National Herbarium, Addis Ababa, Ethiopia, and Department of Systematic Botany, Uppsala, Sweden, 2009. View at: Publisher Site | Google Scholar
  79. R. W. Bussmann, P. Swartzinsky, A. Worede, and P. Evangelista, “Plant use in Odo-Bulu and Demaro, Bale region, Ethiopia,” Journal of Ethnobiology and Ethnomedicine, vol. 7, article 28, 2011. View at: Publisher Site | Google Scholar
  80. R. Yadav, “Medicinal plants in folk medicine system of Ethiopia,” Journal of Poisonous and Medicinal Plants Research, vol. 1, no. 1, p. 11, 2013. View at: Google Scholar
  81. H. P. Freeman and K. C. Chu, “Determinants of cancer disparities: Barriers to cancer screening, diagnosis, and treatment,” Surgical Oncology Clinics of North America, vol. 14, no. 4, pp. 655–669, 2005. View at: Publisher Site | Google Scholar
  82. A. Jemal, R. Siegel, E. Ward et al., “Cancer statistics, 2008,” CA: A Cancer Journal for Clinicians, vol. 58, no. 2, pp. 71–96, 2008. View at: Publisher Site | Google Scholar
  83. H. J. Wanebo, B. J. Kennedy, J. Chmiel, G. Steele Jr., D. Winchester, and R. Osteen, “Cancer of the stomach. A patient care study by the American college of surgeons,” Annals of Surgery, vol. 218, no. 5, pp. 583–592, 1993. View at: Publisher Site | Google Scholar
  84. M. Sant, C. Allemani, R. Capocaccia et al., “Stage at diagnosis is a key explanation of differences in breast cancer survival across Europe,” International Journal of Cancer, vol. 106, no. 3, pp. 416–422, 2003. View at: Publisher Site | Google Scholar
  85. J. J. G. Marin, R. Al-Abdulla, E. Lozano et al., “Mechanisms of resistance to chemotherapy in gastric cancer,” Anti-Cancer Agents in Medicinal Chemistry, vol. 16, no. 3, pp. 318–334, 2016. View at: Publisher Site | Google Scholar
  86. E. Harlev, E. Nevo, E. Solowey, and A. Bishayee, “Cancer preventive and curative attributes of plants of the Cactaceae family: A review,” Planta Medica, vol. 79, no. 9, pp. 713–722, 2013. View at: Publisher Site | Google Scholar
  87. J. D. McChesney, S. K. Venkataraman, and J. T. Henri, “Plant natural products: Back to the future or into extinction?” Phytochemistry, vol. 68, no. 14, pp. 2015–2022, 2007. View at: Publisher Site | Google Scholar
  88. M. Giday, Z. Asfaw, Z. Woldu, and T. Teklehaymanot, “Medicinal plant knowledge of the Bench ethnic group of Ethiopia: an ethnobotanical investigation,” Journal of Ethnobiology and Ethnomedicine, vol. 5, article 34, 2009. View at: Publisher Site | Google Scholar
  89. F. Senbeta, T. Woldemariam Gole, M. Denich, and E. Kellbessa, “Diversity of useful plants in the coffee forests of Ethiopia,” Ethnobotany Research and Applications , vol. 11, pp. 49–70, 2013. View at: Google Scholar
  90. T. Awas and S. Demissew, “Ethnobotanical study of medicinal plants in Kafficho people, southwestern Ethiopia,” in Proceedings of the 16th International Conference of Ethiopian Studies, pp. 711–726, 2009. View at: Google Scholar
  91. M. Ragunathan and S. M. Abay, “Ethnomedicinal survey of folk drugs used in Bahirdar Zuria district, Northwestern Ethiopia,” Indian Journal of Traditional Knowledge, vol. 8, no. 2, pp. 281–284, 2009. View at: Google Scholar
  92. G. Yirga, M. Teferi, and M. Kasaye, “Survey of medicinal plants used to treat human ailments in Hawzen district, Northern Ethiopia,” International Journal of Biodiversity and Conservation, vol. 3, no. 13, pp. 709–714, 2011. View at: Google Scholar
  93. T. Seta, S. Demissew, and Z. Asfaw, “Home gardens of Wolayta, Southern Ethiopia. An ethnobotanical profile,” Academia Journal of Medicinal Plants, vol. 1, no. 1, pp. 14–30, 2013. View at: Google Scholar
  94. M. A. Seid and S. G. Aydagnehum, “Medicinal plants biodiversity and local Healthcare management system in Chencha District; Gamo Gofa, Ethiopia,” Journal of Pharmacognosy and Phytochemistry, vol. 2, no. 1, pp. 284–293, 2013. View at: Google Scholar
  95. S. Zerabruk and G. Yirga, “Traditional knowledge of medicinal plants in Gindeberet district, Western Ethiopia,” South African Journal of Botany, vol. 78, pp. 165–169, 2012. View at: Publisher Site | Google Scholar
  96. M. Gebrehiwot, An Ethnobotanical Study of Medicinal Plants in Seru Wereda, Arsi Zone of Oromia Region, Ethiopia [M.Sc. thesis], Addis Ababa University, 2010.
  97. H. Yineger and D. Yewhalaw, “Traditional medicinal plant knowledge and use by local healers in Sekoru District, Jimma Zone, Southwestern Ethiopia,” Journal of Ethnobiology and Ethnomedicine, vol. 3, article 24, 2007. View at: Publisher Site | Google Scholar
  98. M. Bekele, Ethnobotanical Study of Medicinal Plants in Gorichei Wereda, Sidama Zone, SNNPR, Ethiopia [M.Sc. thesis], Addis Ababa University, 2014.
  99. S. Asnake, T. Teklehaymanot, A. Hymete, B. Erko, and M. Giday, “Survey of Medicinal Plants Used to Treat Malaria by Sidama People of Boricha District, Sidama Zone, South Region of Ethiopia,” Evidence-Based Complementary and Alternative Medicine, vol. 2016, 2016. View at: Google Scholar
  100. D. Moher, A. Liberati, J. Tetzlaff, and D. G. Altman, “Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement,” PLoS Medicine, vol. 6, no. 7, Article ID e1000097, 2009. View at: Publisher Site | Google Scholar
  101. T. Awas, “Endemic plants of Ethiopia: Preliminary working list to contribute to National plant conservation target,” Institute of Biodiversity Conservation, p. 14, 2016. View at: Google Scholar
  102. E. Dagne, Natural Database for Africa(NDA), CD-ROM Version 2.0, Addis Ababa, Ethiopia, 2011.
  103. A. Belayneh and N. F. Bussa, “Ethnomedicinal plants used to treat human ailments in the prehistoric place of Harla and Dengego valleys, eastern Ethiopia,” Journal of Ethnobiology and Ethnomedicine, vol. 10, article 18, 2014. View at: Publisher Site | Google Scholar
  104. W. Birhan, M. Giday, and T. Teklehaymanot, “The contribution of traditional healers' clinics to public health care system in Addis Ababa, Ethiopia: a cross-sectional study,” Journal of Ethnobiology and Ethnomedicine, vol. 7, article 39, 2011. View at: Publisher Site | Google Scholar
  105. K. Tolossa, E. Debela, S. Athanasiadou, A. Tolera, G. Ganga, and J. G. M. Houdijk, “Ethno-medicinal study of plants used for treatment of human and livestock ailments by traditional healers in South Omo, Southern Ethiopia,” Journal of Ethnobiology and Ethnomedicine, vol. 9, no. 1, article no. 32, 2013. View at: Publisher Site | Google Scholar
  106. A. Teklay, B. Abera, and M. Giday, “An ethnobotanical study of medicinal plants used in Kilte Awulaelo district, Tigray Region of Ethiopia,” Journal of Ethnobiology and Ethnomedicine, vol. 9, no. 1, article 65, 2013. View at: Publisher Site | Google Scholar
  107. E. Lulekal, E. Kelbessa, T. Bekele, and H. Yineger, “An ethnobotanical study of medicinal plants in Mana Angetu District, southeastern Ethiopia,” Journal of Ethnobiology and Ethnomedicine, vol. 4, article 10, 2008. View at: Publisher Site | Google Scholar
  108. F. Mesfin, S. Demissew, and T. Teklehaymanot, “An ethnobotanical study of medicinal plants in Wonago Woreda, SNNPR, Ethiopia,” Journal of Ethnobiology and Ethnomedicine, vol. 5, no. 28, 2009. View at: Publisher Site | Google Scholar
  109. T. H. Bekalo, S. D. Woodmatas, and Z. A. Woldemariam, “An ethnobotanical study of medicinal plants used by local people in the lowlands of Konta Special Woreda, southern nations, nationalities and peoples regional state, Ethiopia,” Journal of Ethnobiology and Ethnomedicine, vol. 5, article 26, 2009. View at: Publisher Site | Google Scholar
  110. M. Giday, Z. Asfaw, and Z. Woldu, “Medicinal plants of the Meinit ethnic group of Ethiopia: an ethnobotanical study,” Journal of Ethnopharmacology, vol. 124, no. 3, pp. 513–521, 2009. View at: Publisher Site | Google Scholar
  111. M. Megersa, Z. Asfaw, E. Kelbessa, A. Beyene, and B. Woldeab, “An ethnobotanical study of medicinal plants in Wayu Tuka District, East Welega Zone of Oromia Regional State, West Ethiopia,” Journal of Ethnobiology and Ethnomedicine, vol. 9, article 68, 2013. View at: Publisher Site | Google Scholar
  112. B. Assefa, G. Glatzel, and C. Buchmann, “Ethnomedicinal uses of Hagenia abyssinica (Bruce) J.F. Gmel. among rural communities of Ethiopia,” Journal of Ethnobiology and Ethnomedicine, vol. 6, article no. 20, 2010. View at: Publisher Site | Google Scholar
  113. S. Kebede, M. Afework, A. Debella, W. Ergete, and E. Makonnen, “Toxicological study of the butanol fractionated root extract of Asparagus africanus Lam., on some blood parameter and histopathology of liver and kidney in mice,” BMC Research Notes, vol. 9, no. 1, article no. 1861, 2016. View at: Publisher Site | Google Scholar
  114. E. B. Izevbigie, J. L. Bryant, and A. Walker, “A novel natural inhibitor of extracellular signal-regulated kinases and human breast cancer cell growth,” Experimental Biology and Medicine, vol. 229, no. 2, pp. 163–169, 2004. View at: Publisher Site | Google Scholar
  115. M. A. Eshete, E. Kelbessa, and G. Dalle, “Ethnobotanical study of medicinal plants in Guji Agro-pastoralists, Blue Hora District of Borana Zone,” Journal of Medicinal Plants Studies, vol. 4, no. 2, pp. 170–184, 2016. View at: Google Scholar
  116. WHO, WHO guidelines on good agricultural and collection practices (GACP) for medicinal plants, Geneva, Switzerland, 2003.
  117. WHO, Legal Status of Traditional Medicine and Complementary/Alternative Medicine: A Worldwide Review, World Health Organization, Switzerland, Geneva, 2001.
  118. M. Bishaw, “Promoting traditional medicine in Ethiopia: a brief historical review of government policy,” Social Science & Medicine, vol. 33, no. 2, pp. 193–200, 1991. View at: Publisher Site | Google Scholar
  119. A. Ashenafi, Current status of ABS implementation in Ethiopia, 2015.
  120. F. M. Birhanu, “Challenges and prospects of implementing the access and benefit sharing regime of the Convention on Biological Diversity in Africa: The case of Ethiopia,” International Environmental Agreements: Politics, Law and Economics, vol. 10, no. 3, pp. 249–266, 2010. View at: Publisher Site | Google Scholar
  121. CBD: The Nagoya Protocol on Access and Benefit-sharing. https://wwwcbdint/abs/. Convention on Biological Diversity. CBD Secretariat.

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