Ethnobotanical study of medicinal plants used to treat human and livestock ailments in Addi Arkay district, northwest Ethiopia

Abstract

Background

Ethiopia harbors a wealth of plant biodiversity, diverse ecological zones, rich cultural heritage, and long-standing traditional knowledge and medical practices. Despite documentation of this knowledge in few regions, information remains limited for the Addi Arkay district of northwestern Ethiopia. Therefore, this study aimed to document the indigenous and local knowledge on the use of human and livestock medicinal plants.

Methodology

Ethnobotanical data were collected between October and December 2024 through semi-structured interviews, guided field observations, focus group discussions, and ranking exercises conducted with 385 informants. Stratified sampling, random, and purposive sampling techniques were employed. A mixed-methods approach (both qualitative and quantitative) was used for data analysis. Quantitative analyses included preference ranking, Direct Matrix Ranking (DMR), Informant Consensus Factor (ICF), fidelity level (FL), Jaccard Similarity Index (JSI), and Rahman’s Similarity Index (RSI). T tests and one-way ANOVA were employed to compare mean levels of indigenous and local knowledge across different socio-demographic and socio-economic factors.

Results

This study documented 112 medicinal plant species (105 genera, 58 families, including four endemic and one nearly endemic) were used for human and livestock remedies in the Addi Arkay district, northwestern Ethiopia. Fabaceae was the dominant family (7.14%). The majority of plant species (75.89%) were used to treat human ailments, while a smaller proportion (5.36%) were used for livestock, and 18.75%) were used for both human and livestock ailments. The most frequently used plant parts were leaves (34.6%) followed by roots (27.9%), and grinding was the most common method of preparation (30.4%). The preference ranking exercise revealed Opuntia ficus-indica as the top choice for treating human hemorrhoids and Phytolacca dodecandra as the preferred treatment for rabies in livestock. DMR revealed Cordia africana, Olea europaea subsp. cuspidata, and Terminalia leiocarpa as the most threatened multipurpose medicinal plants. Informant Consensus Factor values ranged from 0.63 to 0.93. Fidelity level analysis revealed that Phytolacca dodecandra was most effective against rabies, followed by Rubia cordifolia for cough and Plumbago zeylanica for swelling. Agricultural expansion posed the most significant threat, followed by overgrazing and fuel (charcoal and fuel wood). The highest levels of indigenous and local medicinal plant knowledge were predominantly transmitted orally through family lines, with paternal contributions often playing a significant role. Compared to other studies conducted in Ethiopia, the Jaccard Similarity Index (JSI%) for human medicinal plants ranged in value from 6.9% to 68.92% and for veterinary plants from 10.91% to 27.91%, whereas the Rahman’s Similarity Index (RSI) ranged from 0.98% to 15.63%. Ten novel medicinal plant uses, not previously documented in Ethiopia or elsewhere, were identified.

Conclusion

This pioneering study in Addi Arkay district, northwestern Ethiopia, documented 112 medicinal plants for the treatment of human and livestock ailments, revealing the significant array of plant resources utilized for local primary healthcare services. However, threats from agricultural expansion, overgrazing, and fuel (charcoal and fuel wood) use necessitate in situ and ex situ conservation actions. Implementing sustainable harvesting practices and community-based conservation initiatives is recommended to protect the rich medicinal plants wealth of the district for continual use across generations besides ensuring preservation of valuable ethnomedicinal knowledge.

Background

Ethiopia is a renowned center for ethnomedicinal research, owing to its exceptional plant biodiversity, diverse ecological zones, rich cultural heritage, and deep-rooted traditional knowledge and ancient medical practices [1, 2]. As one of the twelve Vavilov Centers of Origin, Ethiopia’s flora encompasses 6,027 higher plant species, of which 647 (10.74%) are endemic [1, 3]. From this wealth of plant genetic resources, approximately 800 species are actively employed within the traditional healthcare system to treat nearly 300 distinct physical and mental health disorders [4]. This reliance on traditional medicine is substantial, with an estimated 80% of the Ethiopian human population and 90% of livestock depending on it, and 95% of traditional medical preparations derived from plant sources [5, 6]. However, the transmission of this invaluable knowledge, primarily through oral tradition, is increasingly threatened [7]. Globalization, modern education, and acculturation, coupled with persistent stereotypes of herbalists (often labeled with terms like “wizard,” “magician,” “tenquay,” and “debetera”), contribute to the erosion of traditional practices [2, 8, 9]. Moreover, a range of anthropogenic factors, including habitat destruction, urbanization, agricultural expansion, deforestation, firewood collection, and broader environmental degradation, significantly impacts both the availability of medicinal plants and the transmission of associated knowledge, particularly in culturally rich regions of Ethiopia [10, 11].

Ethiopia’s modern healthcare services and institutions are often inadequate, inaccessible, and unaffordable for a large segment of the population [12]. Limited health centers, coupled with shortages of medicines and healthcare personnel, disproportionately impact low-income communities and rural populations, often compelling them to seek healthcare from traditional practitioners [12, 13]. This is particularly evident in areas like Addi Arkay district, where reliance on plant-based traditional medicine is high. Community trust in the efficacy of traditional remedies and the relative affordability of these plant-based treatments further contribute to their widespread use [14]. The Addi Arkay district, a dryland region characterized by Combretum-Terminalia vegetation [15], is home to the Waldeba Monastery, one of the most sacred sites in Ethiopia. Similar to other lowland regions of the country, this area is often subject to misconceptions, labeled as a “waterless area” and perceived as “resource-poor and challenging for development [16].” As a result, Addi Arkay has been marginalized and neglected in terms of research and management interventions. However, with appropriate management strategies, the area has the potential to serve as a vital resource for herbal medicine, climate change adaptation and mitigation, as well as a buffer against erosion and desertification.

Therefore, given the unique cultural and ecological context of Addi Arkay and the urgent need to document and preserve its traditional medicinal plant knowledge, this study aimed to: (i) document the medicinal plants with the associated indigenous and local knowledge employed by local communities to treat human and livestock ailments; (ii) analyze the influence of socio-demographic and socio-economic factors on traditional medicinal knowledge; and (iii) assess the major threats challenging these vital plant resources.

Materials and methods

Description of the study area

The study was conducted in the Addi Arkay district, situated within the North Gondar Zone of the Amhara Region in northwestern Ethiopia, approximately 837 km northwest from the capital city, Addis Ababa. The Addi Arkay district spans an area of 1,720 km², with elevations ranging from 858.195 to 4411.78 m above sea level (m.a.s.l) and found between 12°50′0"and 13°30′0"N latitude and 37°40′0"—38°20′0"E longitude (Fig. 1). The topographical features of the district were analyzed using Digital Elevation Models (DEMs) obtained from the United States Geological Survey (USGS). The results indicated that the district is predominantly characterized by flat terrain, which constitutes 73% of the total area. In contrast, hilly terrain makes up 5.4% of the landscape, mountainous regions account for 7.2%, and valleys represent 14.4%.

Fig. 1

Map of Ethiopia showing Amhara region and the study district

The district exhibits a uni-modal rainfall pattern (Fig. 2), with a mean annual rainfall of 1,777 mm. The wet season spans from May to October, while the dry season lasts from November to April. The mean annual temperature was 22.8 °C, with minimum and maximum temperatures of 11.9 °C and 37.4 °C, respectively (Amhara Meteorological Service Center, 2024). Following Ethiopia’s traditional agroecological zone classification [17], the district comprises 67.46% Kolla (lowland, 500–1500 m.a.s.l.), 23.43% Woyina Dega (midland, 1500–2500 m.a.s.l.), 7.42% Dega (highland, 2500–3200 m.a.s.l.), and 1.99% Wurch (highland and alpine, > 3500 m.a.s.l.).

Fig. 2

Climate diagram for Addi Arkay town (Amhara Meteorological Service, 2024)

Demographic characteristics of the Addi Arkay district were ascertained from data provided by the North Gondar Zone Plan Commission (2025) projected population size of the Census (CSA, 2007). The total population of the district in 2024 was 125,908, comprising 63,865 men and 62,043 women. A predominantly rural population (103,756) was observed, with a smaller urban population of 22,151. Religious affiliation was primarily Ethiopian Orthodox Christianity (89.5%) and Muslims accounting 10.5%. The district’s ethnic composition was predominantly Amhara (97.63%) and Tigre (2.1%), with other ethnic groups constituting a small proportion (0.27%) of the population. Linguistic data indicated Amharic as the primary language (98.02%), followed by Tigrinya (1.8%), with other languages spoken by the remaining 0.18% of the population.

According to Addi Arkay District Agriculture Office (2024), food insecurity was a significant challenge in the Addi Arkay district, with 18 of its 22 Kebeles reliant on food aid. The district’s diverse agricultural system includes the cultivation of cereals (Eragrostis teff, Hordeum vulgare, Zea mays, Sorghum bicolor, Eleusine corocana, and Triticum aestivum), legumes (Phaseolus vulgaris, Pisum sativum, Cicer arietinum, Glycine max, Lens culinaris, and Lathyrus sativus), oil crops (Guizotia abyssinica, Linum usitatissimum, Helianthus annuus, and Sesamum indicum), fiber crop (Gossypium herbaceum). Mixed crop-livestock farming represents the predominant agricultural practice (80.8%), followed by exclusive crop cultivation (17%) and exclusive livestock rearing (2.2%).

Sampling and data collection methods

Reconnaissance survey and site selection

This research was conducted with ethical approval obtained from the University of Gondar, College of Natural and Computational Science, Department of Biology (clearance number 419/2024). Subsequent to acquiring permission from the Addi Arkay District Administration Office, a reconnaissance survey was undertaken within the district from July 5 th to July 30 th, 2024. Based on the insights gained during the reconnaissance survey and in consultation with district leaders and local community elders, eight Kebeles were selected through stratified random sampling. The selected sample Kebeles represented 36.36% of the total 22 Kebeles in the Addi Arkay district. The selection process considered the presence of traditional healers/herbalists and agroecological variations within the district. These criteria were strategically chosen to ensure representative samples across the district’s diverse ecological and sociocultural contexts, ensuring a comprehensive investigation of indigenous and local knowledge related to traditional medicine.

Sample size determination and informant selection

The sample size was determined using Cochran’s formula: n = N/1 + N (e²), as cited by [18], where n is the sample size, N is the total number of households in the district, and e is the margin of error (0.05)² at a 95% confidence level. The sample size for each Kebele was subsequently calculated based on the proportion of households in that Kebele relative to the total number of households across the selected Kebeles. Thus, informants from each kebele = (number of households in one kebele/total number of households in all kebeles) x total sample size. A total of 385 informants participated in the study, comprising of 355 general informants and 30 key informants, with a gender distribution of 229 men and 156 women (see additional file 1). General informants were selected through stratified random sampling technique, while key informants were chosen via purposive sampling technique based on the recommendations from local leaders and the community [1].

Data collection and voucher specimen identification

Ethnobotanical data were collected following established protocols [19,20,21,22,23] using semi-structured interviews, focus group discussions, and guided field walks. Semi-structured interviews were central to data collection, providing a flexible framework for in-depth exploration of specific topics while allowing informants to share personal experiences and nuanced understandings of traditional healing practices in a conversational setting. Interviews were conducted with a diverse range of informants for detailed qualitative data on various aspects of medicinal plants, including the local plant names, parts used, treated ailments, dosage, additives, preparation/administration methods, perceived efficacy, and threats, as well as qualitative data for ranking exercises. The interviews were primarily conducted in Amharic language, common language of the study area. Subsequently, all the documented data were translated into English.

Focus group discussions (FGDs) complemented the individual interviews by providing a platform for collective knowledge sharing and community dialog. This method encouraged the sharing of ideas and experiences related to medicinal plant use, revealing both community consensus and diverse viewpoints on specific medicinal plants and their applications. FGDs also served to verify and expand upon data collected during the interviews, adding depth to the subsequent analysis. A total of 12 informants (6 men and 6 women) participated in the FGDs. To encourage open communication and address potential gender-specific perspectives, such as communication styles, emotional expression, shyness, and fear of judgment, FGDs were segregated by gender, with separate sessions held for men and women participants [24]. These sessions were conducted at a convenient location within the community, facilitated by the researcher, and meticulously documented through detailed note-taking for subsequent analysis. To ensure the validity and reliability of ethnobotanical data, a triangulation technique was employed, incorporating multiple data collection methods and diverse informant perspectives to cross-validate findings, mitigate bias, and enhance the robustness of the study’s conclusions.

Fieldwork, including guided walks with informants, was conducted from October to December 2024, providing a crucial experiential dimension to the study. Field equipment included a GPS, plant press, data sheets, secateurs, camera, and hand lens. Researchers accompanied informants into the field to directly observe medicinal plants in their natural habitats and collect voucher specimens. During these walks, informants shared their intimate knowledge of plant identification, local names, growth patterns, ecological preferences, morphology of plants assisted for identification, and traditional harvesting practices. During the guided field walk exercise, each specimen was collected numbered, pressed, and dried. Identification was performed using the Flora of Ethiopia and Eritrea [25,26,27,28,29,30,31], with support from experts at the University of Gondar and Ethiopian Biodiversity Institute. Finally, the pressed specimens were deposited at the University of Gondar mini Herbarium. The recent scientific name updates for a plant species were verified using the world flora online [32] and Plants of the World Online (https://powo.science.kew.org/). Additionally, the endemic plants and conservation status of the identified species were cross-referenced and validated against the comprehensive works of [33,34,35,36,37] and the IUCN Red List of Threatened Species online database (https://www.iucnredlist.org/), which provides authoritative information on the endemic flora and conservation status of plants.

Data analysis

This study employed a mixed-methods approach using both qualitative and quantitative data [19, 20]. Quantitative ethnobotanical data, managed in Microsoft Excel 2010, were analyzed using Informant Consensus Factor (ICF), Preference Ranking, Direct Matrix Ranking, Index of Fidelity (FL), Jaccard’s Similarity Index (JSI), and Rahman’s Similarity Index (RSI). Results were presented in tables. Data regarding growth form, parts used, preparation, and administration methods were also analyzed and were presented in graphs and tables. T tests and one-way ANOVA (SPSS v.25) were employed to compare traditional medicinal plant knowledge across various socio-demographic and socio-economic factors. Specifically, a two-tailed independent samples t test was utilized to discern differences between two categorical parameters, while one-way ANOVA assessed variances among three or more categorical variables. To further elucidate specific group differences within variables featuring more than two categorical levels, post hoc analyses, including Tukey’s Honest Significant Difference (HSD) and Least Significant Difference (LSD) tests, were conducted. Qualitative data provided narrative context and insights for the discussion.

Preference ranking

Preference ranking, following [19], was used to identify the five most important medicinal plants for treating human hemorrhoids and the five most important plants for treating rabies in livestock. Ten randomly selected informants ranked the pre-selected plants based on personal preference and perceived community importance, assigning a value of 5 to the most preferred and 1 to the least. Total scores for each plant were summed to determine the overall ranking.

Direct Matrix Ranking (DMR)

DMR, following [19, 20], was used to identify multipurpose medicinal plants under the greatest pressure and their respective threats. Fifteen key informants evaluated ten multipurpose medicinal plants across seven use categories (agriculture tools, building, medicine, fodder, food, fuel and furniture). Informants assigned use values (5 = best, 4 = very good, 3 = good, 2 = less used, 1 = least used, 0 = not used). Subsequently, average use values were calculated for each species, which were then ranked accordingly.

Informant Consensus Factor

Reported human and livestock ailments were categorized according to World Health Organization’s International Classification of Diseases 11 th Revision (ICD-11) [38] with some modifications. The Informant Consensus Factor (ICF) was calculated for each disease category to assess informant agreement and determine the most important diseases categories and potentially effective medicinal plants in the respective disease category [39]. The ICF ranges from 0 to 1, where higher values reflect greater consensus among informants regarding the use of specific medicinal plants for treating particular ailments. An ICF value of 0 indicates no agreement, suggesting that informants have diverse opinions or knowledge about the medicinal properties of plants for a given disease [40]. Conversely, values closer to 1 imply a strong consensus, highlighting the importance of certain plants within traditional medicine for both human and livestock health. The formula used was:

$${\text{ICF}} = \frac{{{\text{nur}} - {\text{nt}}}}{{{\text{nur}} - 1}}$$

where nur = number of use citation in each category and nt = number of species used [19].

Index of fidelity FL

Index of fidelity (FL) was used to determine relative healing potential of medicinal plants using the formula:

$${\text{FL}} = \frac{{{\text{IP}}}}{{{\text{IU}}}} \times { 1}00$$

where IP = the number of informants who independently cited the importance of a species for treating a particular disease, and IU = the total number of informants who reported the plant for any given diseases [41].

Jaccard’s Similarity Index

Jaccard’s Similarity Index (JSI%) was employed to assess the similarity of human and veterinary medicinal plants utilized in this study compared to previous research in Ethiopia. When utilizing the Jaccard index to compare plant use, plant species that were used in both human and livestock remedies were counted in both the human medicinal plant dataset and the livestock medicinal plant dataset separately. This was done to ensure that the full usage of the plant was accounted for in the similarity index calculations. The calculation for Jaccard’s Similarity Index was following [42, 43].

$${\text{JSI}}\left( {\text{\% }} \right) = (\frac{c}{a + b - c}) \, \times { 1}00$$

where a = no species only in current study, b = no species only in previous study, and c = no of common species in current study and previous studies.

Rahman’s Similarity Index (RSI)

Rahman’s Similarity Index (RSI%) serves as a crucial metric for assessing the cultural similarities of indigenous knowledge across diverse communities and areas [44]. RSI facilitates a deeper understanding of how communities interact with their natural environment and the cultural significance they attach to these plants. The RSI in percent is calculated using the formula:

$${\text{RSI}}\left( {\text{\% }} \right) = \frac{{{\text{Nd}}}}{{{\text{Na}} + {\text{Nb}} + {\text{Nc}} - {\text{Nd}}}}{ } \times 100$$

where “Na” is the number of unique species in area A, “Nb” is the number of species unique in area B, “Nc” is the number of common species in both areas A and B, and “Nd” is the number of common species used for similar ailments in both areas A and B. Additionally, “Nc” and “Nd” must be greater than or equal to zero, which allows for a meaningful comparison of shared knowledge regarding plant uses for medicinal purposes.

Results

Socio‑demographic and socio-economic characteristics of the informants

This study investigated the influence of socio-demographic and socio-economic factors on medicinal plant knowledge within the Addi Arkay district. Results indicated significant variations in knowledge scores across demographic groups (Table 1). Key informants (n = 30), possessing specialized knowledge, demonstrated a substantially higher mean score (20.93 ± 5.25) compared to general informants (n = 355) (9.06 ± 5.04, p = 0.000). Gender also played a significant role, with men exhibiting greater knowledge (11.45 ± 6.56) than women (7.84 ± 4.16, p = 0.000). Age correlated positively with knowledge, with individuals aged 60 and above scoring significantly higher (15.55 ± 5.46) than younger age groups (20–39 years: 6.82 ± 4.54; 40–59 years: 9.78 ± 4.72, p = 0.000). Interestingly, illiterate individuals demonstrated greater knowledge (10.80 ± 6.03) than literate individuals (5.47 ± 2.84, p = 0.000), with a further decline in knowledge observed among those with higher education levels (e.g., > 12 years: 3.33 ± 0.71, p = 0.000). Marital status also influenced knowledge scores, with married individuals exhibiting higher scores (10.66 ± 5.99) compared to other marital statuses (p = 0.002). Ethnicity and religion also demonstrated significant associations with medicinal plant knowledge (Amhara: 10.27 ± 6.00; Tigray: 5.00 ± 1.85; Agew: 4.20 ± 0.84, p = 0.000; Orthodox: 10.36 ± 6.01; Muslim: 5.29 ± 2.68, p = 0.000).

Table 1 Medicinal plant knowledge of the informants in Addi Arkay district (n = 385)

Socio-economic factors also significantly impacted medicinal plant knowledge. Occupation influenced knowledge retention, with ascetics (11.05 ± 5.92) and farmers (10.35 ± 6.03) exhibiting substantially higher mean knowledge scores compared to multiple occupations (8.00 ± 3.23), merchants (5.82 ± 1.78), and formally employed individuals (3.65 ± 0.70). Access to transportation showed a negative correlation with knowledge, with individuals lacking transport access scoring higher (11.61 ± 6.08) than those with transport access (5.67 ± 2.58, p = 0.000). Income level also correlated inversely with knowledge, with poor individuals (10.96 ± 6.455) exhibiting greater knowledge than rich individuals (5.85 ± 2.541, p = 0.000). Finally, distance from town exhibited a positive correlation with medicinal plant knowledge, as individuals residing more than 8 km away recorded significantly higher scores (10.96 ± 6.25) compared to those living within 3 km (4.97 ± 1.94, p = 0.000).

Diversity of medicinal plants for human and livestock ailments

A floristic survey of human and livestock medicinal plants in the Addi Arkay district recorded 112 species distributed across 105 genera and 58 families (Table 2). This comprehensive inventory showed the region’s significant ethnomedicinal potential. The Fabaceae family was the most represented, comprising 8 species (7.14%) of the total, followed by Lamiaceae and Solanaceae, each contributing 6 species (8.04%) of the total. Four medicinal plant species endemic to Ethiopia namely: Echinops kebericho (NT), Kalanchoe petitiana (LC), Millettia ferruginea (LC), Urtica simensis (LC), and one nearly endemic medicinal plant, Thymus schimperi (NE), were documented within the study area. The analysis of therapeutic applications revealed a strong focus on human health, with 85 species (75.89%) utilized to address distinct human ailments, while a smaller proportion of species, 6 (5.36%), was employed for livestock ailments, and 21 species (18.75%) served both human and livestock health needs (Table 2).

Table 2 List of medicinal plant used to treat human and livestock ailments in Addi Arkay district, Northwestern Ethiopia

The habitat analysis demonstrated a strong reliance on natural forests as a source of medicinal plants, with 81 species (72.32%) collected from these areas followed by relatively smaller contributions from home gardens (16 species, 14.29%) and arable land (15 species, 13.39%) The distribution of medicinal plant species across various growth forms revealed that shrubs were the most prevalent, accounting for 42 species (37.50%), followed by herbs (41, 36.61%), trees (19, 16.96%), and climbers (10, 8.93%) (Fig. 3).

Fig. 3

Growth form and habitat of human and livestock medicinal plants in Addi Arkay district

Plant parts, preparation, and additives used for remedies

The findings from the interviews revealed significant insights into the utilization of plant parts in traditional medicinal practices. Notably, leaves emerged as the predominant component, constituting 34.6% of the reported medicinal plants (Fig. 4). This was closely followed by roots, which accounted for 27.9%, while fruits represented a smaller fraction at 10% (Fig. 4).

Fig. 4

Plant parts for remedy preparation of human and livestock ailments in the Addi Arkay district (other = flower, root & leaves, seed & leaves)

In terms of preparation methods, grinding was the most frequently employed technique, utilized in 30.4% of cases, followed by squeezing at 14.2% and crushing at 10.4% (Fig. 5). Fresh plant material was predominantly used in remedy preparation (71.31%), followed by dried plant parts (59%) (Table 2). A variety of additives, including honeys, dairy products, and seed oils, were incorporated to mitigate toxicity or enhance flavor. Water was the most commonly used additive, followed by honey, tea, salt, and butter.

Fig. 5

Method of preparation to treat human and livestock ailments in Addi Arkay district (others include inhaling, pounding, heating, massaging, chopping, and catch hold)

Dosage and route of administration for remedies

Regarding dosage and measurement, practitioners employed various tools such as glass containers, bottle gourds, cups, and teaspoons to ascertain appropriate dosages. Dosage considerations were depend on various factors such as age (children, adults, and the elderly), pregnancy, and breast lactation, body weight, and physiological characteristics. The analysis of routes of administration for traditional remedies in the study area revealed that oral administration was the predominant method, accounting for 54.2% of all instances, followed by topical (27.5%) and nasal administration (7.9%) (Fig. 6).

Fig. 6

Route of administration to treat human and livestock ailments in Addi Arkay district (other = fumigate the house, tie around the bone)

Ranking indices of most important human and livestock medicinal plants

Preference ranking

The preference ranking exercise involving five medicinal plants and ten key informants for treating human hemorrhoids indicated that Opuntia ficus-indica was the most favored, followed by Cucumis ficifolius and Euphorbia tirucalli (Table 3). In addition, a similar ranking for medicinal plants used in the treatment of rabies in livestock identified Phytolacca dodecandra as the top choice, followed by Verbascum sinaiticum and Cissus petiolata (Table 4).

Table 3 Preference ranking of commonly used human medicinal plants used to treat hemorrhoid

Table 4 Preference ranking of commonly used livestock medicinal plants used to treat rabies

Direct Matrix Ranking (DMR)

The DMR exercise revealed that Cordia africana was identified as the most threatened species, followed by Olea europaea subsp. cuspidata and Terminalia leiocarpa. These multipurpose medicinal plants were currently being utilized more for furniture, building, and fuel rather than for food, fodder, or agricultural tools (Table 5).

Table 5 Mean value of Direct Matrix Ranking for multipurpose plant species in Addi Arkay district

Informant Consensus Factor (ICF)

This study categorized traditional remedies and their corresponding human and livestock diseases into 12 categories (Table 6). The ICF values ranged from 0.63 to 0.93 (Table 6). The highest ICF value (0.93) was associated with diseases and symptoms of the nervous system (febrile illness, headache, migraine, snake bite, spider poison), with 294 use citations and 20 plant species. This was followed by injury, poisoning, and certain other consequences of external causes (bone luxation, eczema, fire burn, ingestive toxicity, laceration, luxation, wound, swelling, and tumor) having the second highest ICF value (0.92). Diseases of the genitourinary system (dysuria/shintemat, kidney stone) had the lowest ICF value (0.63), with 9 use citations and 4 plant species.

Table 6 Informant Consensus Factor (ICF) for human and livestock ailments Addi Arkay district

Fidelity level (FL)

The fidelity level (FL) demonstrated the relative healing potential of individual medicinal plants used for treating human or livestock ailments in the study area. Phytolacca dodecandra was identified as the most effective against rabies, followed by Rubia cordifolia for cough and Plumbago zeylanica for swelling (megerem) (Table 7).

Table 7 Fidelity level (FL > 80%) of some commonly used human and livestock medicinal plant

Pharmacological values of some selected plants

The pharmacological values of selected medicinal plants have garnered significant attention within the realm of traditional medicine, particularly due to their diverse therapeutic applications. Based on fidelity levels, the four top-ranked medicinal species identified in this study were Phytolacca dodecandra, Rubia cordifolia, Plumbago zeylanica, and Ocimum lamiifolium. These species exhibited important medicinal properties that can be utilized for a wide range of human and livestock ailments.

Phytolacca dodecandra demonstrated substantial pharmacological potential and has been widely employed in traditional medicine for various human and livestock ailments. It is proved particularly effective in treating livestock rabies, where a common preparation involves soaking fresh leaves in water and administering a small quarter cup of the infusion orally to puppies before they are infected. In cases of human hepatitis, the juice extracted from freshly squeezed leaves is consumed orally. For human anthrax, the fresh root is ground, and half a spoon of the extracted juice is ingested. Additionally, for human scabies, a mixture of ground fruit and Rhamnus prinoides is prepared with butter for topical application, followed by heat treatment. Other applications include chewing fresh root for human meningitis, preparing a paste of crushed leaves for wound treatment, and for kidney disease, where dried leaf powder is mixed with honey and dissolved in boiled water for consumption until recovery.

Rubia cordifolia exhibited notable pharmacological properties for a variety of human ailments. For migraines, the fresh or dried root is ground and taken with tea orally. Similar preparations are recommended for treating coughs, eye diseases, and stomachaches. In instances of human nasal bleeding, the fresh or dried root is ground, mixed with butter, and carefully inserted through the nasal passage. Furthermore, for ear parasites, the dried root is ground into a fine powder, mixed with butter, and warmed in the sun before being applied in the ear.

Plumbago zeylanica emerged as a potential remedy for both human and livestock ailments. A traditional preparation for humans involves soaking the fresh root in water within a new Lagenaria siceraria gourd, followed by oral consumption of the resulting fluid. This plant also served as a treatment for swelling in both humans and livestock when the fresh root is soaked in alcohol and the fluid is ingested.

Ocimum lamiifolium was identified as a widely used remedy for various ailments affecting both humans and livestock. For the common cold, fresh leaves are squeezed and mixed with tea or boiled for a steam bath. The same preparation method applies for treating febrile illnesses and hypertension. In cases of ear parasites, a mixture of ground fresh leaves with those of Cucumis ficifolius and Zehneria scabra is prepared, and a few drops are administered auricular. For livestock suffering from febrile illnesses, a mixture of leaf extracts from Ocimum lamiifolium and Croton macrostachyus is prepared for oral administration.

Jaccard’s Similarity Index

A cross-cultural comparative analysis of indigenous knowledge regarding human and veterinary medicinal plants was performed using Jaccard’s Similarity Index (JSI%). These analyses incorporated data from the present study and 22 previously published works on Ethiopia sourced from Scopus and Web of Science databases. The results indicated a wide variation in knowledge share ranging from 6.9% to 68.92% in human medicinal plants and 10.91% to 27.91% in veterinary plants (Table 8).

Table 8 Jaccard’s Similarity Index ethnobotanical comparison of human and veterinary plants between the study districts and other study areas

Rahman’s Similarity Index

This study used the Rahman’s Similarity Index (RSI) to compare ethnobotanical findings from the Addi Arkay district with 20 previously published in indexed and peer-reviewed journals across Ethiopia. The RSI values ranged from 0.98 to 15.63%, indicating varying degrees of cultural similarity in plant use between the Addi Arkay district and the other studied regions (Table 9). The highest RSI of 15.63% was observed in the Hulet Eju Enese district (RSI = 15.63%), closely followed by the Sedie Muja (RSI = 13.67%) and Habru (RSI = 13.22%) districts of the Amhara region (Table 9).

Table 9 RSI comparing the current study (Addi Arkay) with prior research reports

Threats and conservation practice for medicinal plants

The major threats for medicinal plants claimed in focus group discussion were agricultural land expansion, overgrazing, house construction, timber production, fuel (charcoal and fuel wood), drought, agrochemicals (herbicides and pesticides), and drought (Table 10). A ranking exercise involving ten key informants and seven major threats was conducted to evaluate the relative severity of the identified threats to medicinal plants. The results showed that agricultural expansion was considered the primary threat, followed by overgrazing and fuel (charcoal and fuel wood) (Table 10). Despite these significant threats, conservation efforts in the Addi Arkay district remain limited. Current practices were terracing, cultivating medicinal plants in home gardens and arable land, fallow land, and community participation in reforestation campaigns.

Table 10 Ranking exercise of threats to medicinal plants

Source and transfer of indigenous and local medicinal plant knowledge

The findings from the focus group discussion indicated that the highest levels of indigenous and local medicinal plant knowledge were predominantly passed down through family lines, with significant contributions from paternal, followed by maternal, and brother (Fig. 7). Additionally, religious institutions, particularly the Ethiopian Orthodox Church, played a role in this knowledge transfer. This knowledge was primarily conveyed orally from generation to generation, with little written documentation found in religious books. In the study area, a significant challenge was that elderly traditional healers kept their medicinal plant knowledge secret. They believed that sharing this information would reduce its healing potential and minimize their income.

Fig. 7

Sources and methods of transfer for indigenous and local medicinal plant knowledge

Novel ethnobotanical findings

The ethnobotanical study conducted in the Addi Arkay district revealed several novel findings regarding the utilization of medicinal plants, thereby contributing to the growing body of ethnomedicinal knowledge in Ethiopia. Tragia brevipes was identified for its application in brain enlightenment. Leonotis nepetifolia was noted for its efficacy in treating anthrax. Otostegia integrifolia was utilized to address Rh factor complications during pregnancy as maternal health management. Laggera crispate was claimed for managing minor injuries and hemorrhagic conditions as first-aid practices within local communities. In addition, Capparis tomentosa and Juniperus procera were both found effective for alleviating toothaches. Terminalia leiocarpa was associated with treating eye diseases for ophthalmic applications. Remarkably, Croton macrostachyus was used in cases of finger amputation (lufe). Euphorbia tirucalli was employed to treat hemorrhoids. Furthermore, Ricinus communis was reported as a remedy for ear parasites, particularly moth infestations within the auditory canal.

Discussion

Socio-economic and socio-demographic factors

The observed influence of socio-demographic and socio-economic factors on indigenous and local medicinal plants knowledge among informants underscores the dynamic nature of traditional knowledge retention and transmission in Addi Arkay district. Consequently, effective conservation strategies must explicitly consider these factors to safeguarding the knowledge for feature generation. The higher knowledge scores among men compared to women reflected traditional gender roles, where men often engage more in resource gathering and community healthcare, spiritual rules prohibiting women from learning church education, which is the primary source of traditional knowledge, and cultural taboos influencing women not to travel far from their homes as similarly reported in the studies of [50, 68, 99,100,101,102,103]. However, contrasting results emerged from a study conducted in the Fiche region, where women were found to play a significant role in herbal medicine practices, often being the primary caregivers and sellers of medicinal herbs in local markets [104]. Key informants cited a significantly higher number of medicinal plants compared to general informants, similar to the findings reported in other studies [54, 56, 68]. This trend reflects their extensive, full-time experience in utilizing these plants for various treatments. The positive correlation between age and knowledge underscored the role of cumulative experience and cultural transmission among older individuals, consistent with findings that traditional knowledge is more deeply rooted in elder generations [40, 56, 61, 101, 102]. The lower medicinal knowledge among younger individuals suggests a potential decline in the transfer of knowledge between generations [52].

In the study area, illiterate (unable to read and write) individuals exhibited greater knowledge than their literate (able to read and write) counterparts, and even as education level increased, indigenous and local knowledge decreased, aligning with the findings of previous research [40, 49, 54, 56, 99]. This trend can be attributed to the disconnection between formal education systems and indigenous and local knowledge practices. Formal education in Ethiopia has historically prioritized modern scientific methodologies, often neglecting traditional cultural knowledge cultivated over generations [105]. Cultural background, religious affiliations, and marital status categories in the study area had substantial impact on the retention of traditional wisdom on medicinal plants aligned with reports of [106,107,108]. Married informants reported a greater number of medicinal plant species compared to single, divorced, and widowed individuals, suggesting that marital status facilitates access to shared knowledge within families and communities aligned with [55].

Socio-economic factors significantly impacted medicinal plant knowledge in this study, with occupation and wealth status playing pivotal roles aligned with previous studies [46, 49, 109]. Ascetics (Monk/nun), farmers, and poorer individuals demonstrated greater reliance on medicinal plants due to their proximity to natural resources, efficacy, wider cultural acceptability, and limited access to modern healthcare. The inverse relationship between access to transportation or urban centers and knowledge emphasizes the critical role of geographic isolation in preserving traditional practices. Individuals residing in remote areas tend to maintain stronger ties to indigenous and local knowledge systems, as they face limited access to modern medical facilities [49, 110]. In contrast, those with better access to transportation often gravitate toward modern healthcare solutions, which can lead to a decline in the utilization of traditional practices [111, 112].

Diversity of medicinal plants

This study revealed a comprehensive exploration of the ethnobotanical practices in Ethiopia, revealing a total of 112 medicinal plant species utilized for the treatment of humans and livestock ailments. The identification of such a diverse array of medicinal flora underscored the rich cultural heritage and traditional knowledge surrounding plant-based remedies in the region. Furthermore, the documentation of Tragia brevipes, Leonotis nepetifolia, Otostegia integrifolia, Laggera crispata, Capparis tomentosa, Juniperus procera, Terminalia leiocarpa, Croton macrostachyus, Euphorbia tirucalli, and Ricinus communis, with previously unreported therapeutic applications in both Ethiopia and globally, signified a substantial contribution to ethnomedicinal knowledge. This novel documentation not only expanded the existing pharmacopeia but also highlighted the potential for bioprospecting and the discovery of new therapeutic compounds. Compared to other ethnobotanical studies in various districts of Ethiopia, such as Damot Woyde with 57 species [10], Aleta-Chuko with 91 [60], Raya Alamata with 47 species [113], Cheha with 58 species [114], Basona Werana with 76 species [57], Gera with 63 species [80], Seharti Samre with 90 species [47], Sedie Muja with 89 species [5], Ensaro with 44 species [49], Kobo with 91 species [58], and Diguna Fango with 50 species [53], this figure exceeded by the number of species documented. However, the species count in Addi Arkay was lower than that of Mana Angetu with 230 species [69], Ganta Afeshum with 173 species [55], Adwa with 127 species [54], Ada’a with 131 species [50], Habru with 134 species [1], Sekela with 121 species [107], and Dibatie with 170 species [115].

The dominance of Fabaceae, Lamiaceae, and Solanaceae families in the study area aligns with findings in other regions of Ethiopia. For example, Fabaceae was the most represented family in Hawassa Zuria district [61], Raya Alamata district [113] and Dibatie district [115], indicating a widespread reliance on this family for medicinal resources. Similarly, research in Adwa district, northern Ethiopia, identified Fabaceae and Solanaceae as the most important families [54]. These similarities suggest a common ethnomedicinal knowledge base across different ethnic groups and geographical areas in Ethiopia. The dominance of the Fabaceae family among the identified medicinal plants can be attributed to the evolutionary adaptations, nitrogen fixation, and successful dispersion of this plant family within the local environment [116].

The Addi Arkay study emphasized the reliance on natural forests (collected from wild) as a primary source of medicinal plants, with 81 species (72.32%) collected from these areas. This finding had significant implications for conservation efforts, as it suggested that the sustainable management of forest ecosystems was crucial for preserving both biodiversity and access to vital medicinal resources. The relatively smaller contributions from home gardens (16 species, 14.29%) and arable land (15 species, 13.39%) indicate a potential for integrating medicinal plant cultivation into agricultural systems and home gardens, which could alleviate pressure on wild populations and enhance community access to these resources. This was consistent with other studies in Ethiopia, which have also reported that a significant proportion of medicinal plants are harvested from the wild. For instance, in Mana Angetu [69] 90.4% of species, Kilte [45] 74%, Ganta Afeshum [55] 67.1%, Enemay [6] 55.43%, Raya Alamata [113] 53.19%, Dibatie [115]79.41%, Yeki [102] 56.86%, Sekela [107] (70%), were collected from wild or natural vegetation. This implied the importance of forest conservation for preserving access to vital medicinal resources. But continuous destruction of the natural forests of Ethiopia results directly in the loss of unaccounted plant and animal species [117]. In contrast to this study, the Cheha district [114] reported that 65.52% of medicinal plants were obtained from home gardens. This was attributed to the availability of ex situ conservation sites and the community’s greater awareness of the importance of ex situ conservation for the long-term sustainability of medicinal plants.

Regarding the growth form of medicinal plants, the study found that the local people of the Addi Arkay district utilized shrubs and herbs in nearly equal proportions followed by trees and climbers. This observation aligns with previous ethnobotanical findings [50, 118]. These patterns may be due to vegetation types and local preferences for specific plant growth forms in traditional medicine, including the accessibility and ease of harvesting herbs and shrubs.

Plant parts and preparation methods used for remedies

The most frequently used plants part in this study were leaves followed by roots, fruits, stem bark, and seeds. These statistics underscore the importance of foliar and subterranean plant parts in traditional remedies, suggesting a potential preference for these components due to their perceived efficacy or availability. The result was aligned with other ethnobotanical studies in various parts of Ethiopia [10, 45, 46, 54, 55, 57, 61, 102, 107, 113, 114] and elsewhere [119,120,121]. The predominant use of leaves for remedy preparation can be due to the presence and rapid absorption of high concentrations of bioactive compounds, accessibility for sustainable harvesting, and ease of processing into various forms, and cultural beliefs often emphasize the effectiveness of leaf-based remedies. However, roots were predominantly used in a few other studies [40, 69, 122], due to the storage of stable medicinal properties, persistence in the ground, specific therapeutic actions, cultural significance, and sometimes, greater accessibility compared to other plant parts [2, 63]. In additionally, less use of some roots may be due to toxic compounds in roots compared with other parts, requiring careful preparation and knowledge for safe use [123, 124]. Harvesting roots is also more destructive to the plant than harvesting leaves or fruits, potentially harming plant populations if not done sustainably [125].

Grinding was the most frequently used preparation technique, followed by squeezing and crushing, consistent with the findings of previous studies [58, 61] and crushing, which was predominant in many other studies [6, 40, 45, 49, 54, 60, 115], and pounding in [102, 113]. The predominant use of grinding over crushing in the study area for remedy preparation was due to its ability to produce a finer, more uniform particle size, which enhances the extraction of bioactive compounds, improves bioavailability, and ensures consistent dosing in the final remedy. The preference for fresh plants in traditional remedies may be attributed to the belief that bioactive compounds are most potent in their fresh state and may degrade during drying, a notion supported by observations in several studies [45, 54, 55, 57, 60]. Contrarily, the use of dry forms of remedial plants is often associated with lower efficacy because the drying process can lead to the evaporation and deterioration of bioactive components [78]. Furthermore, high drying temperatures can cause thermal degradation of sensitive compounds, significantly reducing their antioxidant properties and altering their chemical composition, which may affect their therapeutic potential [126].

Additives, dosage, and route of administration for remedies

In the study area, various additives, including honey, dairy products (such as milk, yogurt, and butter), and seed oils, are incorporated into remedies to mitigate toxicity or enhance flavor. This practice illustrates the intricate knowledge surrounding the preparation of traditional remedies, where the role of additives extends beyond mere taste. This practice is consistent with findings in the Kilte Awulaelo district [45], Raya Alamata district [113], Gubalafto district [78], Hamar district [127], and Muja district [5], where water and various additives (honey, sugar, butter, salt, coffee, tea, milk) were reported to be used to either reduce poisoning or improve flavor. Local communities employ various tools for measuring doses of remedies, such as glass containers, bottle gourds, cups, and teaspoons. However, many remedies lack precise traditional dosage guidelines, potentially leading to dose-dependent adverse effects. This adaptability in dosage was reflected in an inherent understanding within traditional medicine systems of the importance of tailoring treatments to individual needs, emphasizing the role of traditional knowledge in guiding therapeutic practices. This observation aligns with similar findings reported in other studies, where dosage is often determined using non-standardized measures like cups, spoons, drops, and fingers [45], spoons, coffee cups, and tea glasses [57], or handfuls, cups, and spoons [24].

The results of this study revealed that oral administration is the predominant method, followed by topical administration and nasal administration. This distribution indicated a strong cultural preference for oral intake, likely attributable to its practicality and effectiveness in achieving systemic effects. The significant use of topical applications suggested an awareness of the need for localized treatments. The less frequent use of nasal administration likely reflected the sensitivity of the nasal mucosa, as some individuals may experience discomfort with this route. The current findings align with previous studies of Ethiopian [46, 55, 57, 60, 69] and elsewhere [128,129,130]. The reason for the dominance of oral application of remedies may be due to its ease of use, cultural acceptance, and familiarity to users; perceived safety due to its non-invasive nature (avoiding painful skin penetration and entry into body cavities, thereby minimizing infection risks); and effective absorption in the gastrointestinal tract [2, 131].

Ranking of remedies for human and livestock ailments

Preference ranking

The higher preference ranking of Opuntia ficus-indica, followed by Cucumis ficifolius and Euphorbia tirucalli, in the treatment of human hemorrhoids warrants further investigation, encompassing phytochemical analysis, pharmacological investigation, and conservation measures. Ethnobotanical research has corroborated the use of these plants for various ailments. Opuntia ficus-indica has been documented for treating coughs [1], anthrax [45], uterine fibroids [132], and as a larvicide against malaria vectors [133]. Cucumis ficifolius has a broader range of reported applications, including the treatment of anthrax, snake and scorpion bites, black spider bites, wounds/sores, jaundice/hepatitis, tonsillitis, toothache, abdominal pain, and vomiting [45]. Euphorbia tirucalli has been cited for wound treatment [1], hemorrhoids, and snake bite [56].

In addition, a similar ranking for medicinal plants used in the treatment of rabies in livestock identified Phytolacca dodecandra as the top choice, followed by Verbascum sinaiticum and Cissus petiolata. These findings align with documented traditional uses: Phytolacca dodecandra for rabies, jaundice, eye infections, anthrax, and ectoparasites [54]; Verbascum sinaiticum for febrile diseases and wounds [1], snake bites [6, 53], Anthrax [46], burns, tonsillitis, the"evil eye,"toothache, hemorrhoids, external wounds, and anthrax [45]; and Cissus petiolata for snake bites [54]. The convergence of high preference ranking with documented ethnomedicinal uses strengthens the rationale for rigorous scientific investigation of these promising plant species.

Direct Matrix Ranking (DMR)

DMR revealed Cordia africana as the most threatened species, followed by Olea europaea subsp. cuspidata and Terminalia leiocarpa. This ranking suggests a concerning trend of overexploitation of these multipurpose medicinal plants, primarily for furniture, building materials, and fuel. This shift away from sustainable use is likely driven by increasing demand for timber and fuel wood, reflecting broader socio-economic pressures on natural resources [45]. Similar studies have documented the overexploitation of medicinal plants due to their diverse applications, resulting in habitat degradation and species decline. Specifically, Cordia africana is threatened primarily due to its use in construction and furniture [57]; Olea europaea subsp. cuspidata is a multipurpose species mainly exploited for charcoal production, construction, and food [54]; and Terminalia leiocarpa is threatened by its use in medicine, livestock forage, and as a food source [68]. Further research is needed to explore alternative livelihood options and promote sustainable harvesting practices to mitigate the threats to these valuable plant species and preserve their medicinal and ecological value.

Informant Consensus Factor

The study reported Informant Consensus Factor (ICF) values, ranging from 0.63 to 0.93, suggesting a notable consensus among informants regarding the therapeutic uses and efficacy of specific medicinal plant species. The highest ICF value of 0.93, observed for diseases related to the nervous system (febrile illness, headache, migraine, snake bite, spider poison), is consistent with findings from other studies [110]. Such high ICF values often indicate a strong community agreement on the effectiveness of particular plants for treating common ailments [68]. In contrast, other researches have reported varying ICF values across different ailment categories [49, 50, 56, 57]. These discrepancies may reflect differences in regional disease prevalence, cultural knowledge, and the availability of specific plant species [134, 135]. Despite these variations, the use of ICF remains a valuable tool in ethnobotanical research for identifying reliable and culturally significant medicinal plants, thus guiding further pharmacological investigations and conservation efforts [5, 134].

Fidelity level (FL)

Fidelity level (FL) analysis, used to assess the perceived healing potential of medicinal plants for specific ailments, identified Phytolacca dodecandra as the most effective species against rabies, followed by Rubia cordifolia for cough, and Plumbago zeylanica for swelling (megerem). The identification of Phytolacca dodecandra as highly effective against rabies is particularly significant, considering the disease’s severity and the limited access to conventional treatments in the study area. Similarly, the recognition of Rubia cordifolia for cough aligns with its traditional use in various medicinal systems for respiratory ailments. These findings are consistent with previous reports from Ethiopia documenting the use of Phytolacca dodecandra for rabies [6, 49, 127] and also for gonorrhea and anthrax [52]; Plumbago zeylanica for wounds [79]; and Rubia cordifolia for wounds, cough, and cataracts, as evidenced by a high number of informant citations [50].

Threats and conservation practice for medicinal plants

Four endemic and one nearly endemic medicinal plants classified within IUCN Red List categories have been documented. These species, previously reported at various threat levels, include Echinops kebericho (Near Threatened/NT), and Millettia ferruginea (Least Concern/LC) (https://www.iucnredlist.org), Kalanchoe petitiana (Least Concern/LC) [136], Thymus schimperi (Near Threatened/NT) [137], and Urtica simensis (Least Concern/LC) [136,137,138].

Results indicated that agricultural expansion, overgrazing, fuel (charcoal and fuel wood), house construction, timber production, agrochemicals (herbicides and pesticides), and drought were the major threats of medicinal plants. Agricultural expansion was driven by the confluence of rapid population growth, inherently low land productivity, and infertile soils. Consequently, the escalating demand for land in the study area is a direct result of the need to compensate for these constraints. Despite these efforts, the local people continues to struggle with food insecurity, resulting in a concerning dependence on external food aid. This aligns with other studies in Ethiopia that identify agricultural expansion as a major threat to medicinal plant sustainability [6, 46, 47, 54, 68, 102]. Other documented threats include habitat destruction, overharvesting, pollution, secrecy, stereotype, derogatory attitudes, oral knowledge transfer, lack of awareness, urbanization, herbicide use, fires, drought, informal export, settlement expansion, land degradation, and the introduction of alien species. The excessive use of agrochemicals, particularly herbicides and pesticides, in the Addi Arkay district affects medicinal plants directly and indirectly. Directly, these chemicals harm the medicinal plants themselves [139]. Indirectly, they disrupt the populations of pollinating agents, such as insects, which are crucial for the reproduction of many flowering medicinal plant species [140]. This disruption can lead to reduced seed sets, decreased genetic diversity, and ultimately, a decline in medicinal plant populations.

Despite the significant threats facing medicinal plants in the Addi Arkay district, conservation efforts remain limited and insufficient to reverse the ongoing decline. While initiatives such as terracing, cultivating medicinal plants in home gardens, fallow land management, and community participation in reforestation campaigns exist, they do not adequately address the scale of the problem. This observation aligns with findings from other regions in Ethiopia where similar conservation strategies have been implemented but have struggled to achieve substantial impact [46, 54, 68, 69].

Pharmacological values of some selected plants

The pharmacological values of Phytolacca dodecandra, Rubia cordifolia, Plumbago zeylanica, and Ocimum lamiifolium were extensively studied, revealing their therapeutic potential and richness in bioactive compounds through various in vitro and in vivo investigations. These plants demonstrate a strong cultural consensus regarding their efficacy, which is supported by their extensive use in treating a diverse range of ailments. Phytolacca dodecandra has demonstrated promising molluscicidal activity against schistosomiasis vectors in vitro, highlighting its potential in combating parasitic diseases [141, 142]. Plumbago zeylanica contains plumbagin, a naphthoquinone with significant antibacterial, antifungal, antiulcer, antioxidant, and anticancer activities that result from its principal chemical components, which are concentrated in the roots, leaves, and stems of plants [143,144,145]. In vivo and in vitro studies have confirmed its efficacy in reducing tumor growth and its antiproliferative properties against various cancers, including breast, lung, pancreatic, melanoma, prostate, and leukemia [146].

In Ethiopia, the leaf of Ocimum lamiifolium is traditionally used for the treatment of stomach disorders, headaches, abdominal pains, diarrhea, and fever [147, 148]; cough [98]; pain and malaise [149]; colds, eye infections, and measles [150]; and mosquito repellent [151]. The essential oil of O. lamiifolium contains bioactive compounds such as alkaloids, sterols, carbohydrates, glycosides, tannins, flavonoids, bornyl acetate, p-cymene, camphene, a-pinene, and sabinene used for its antimicrobial, anti-inflammatory, and antipyretic properties supported by in vitro studies [147, 152]. Similarly, Rubia cordifolia has been extensively studied due to the presence of anthraquinones and other phytochemicals for its anti-inflammatory and anticancer properties [153, 154], treatment of abnormal uterine bleeding, internal and external hemorrhage, bronchitis, rheumatism, stones in the kidney, bladder, and gall, dysentery, burns, ulcers, bone fractures, skin diseases, and disorder of spleen [153].

Jaccard’s Similarity Index

A comparative analyses using Jaccard’s Similarity Index between the current study and previous studies in Ethiopia revealed a wider similarity range (6.9% to 68.92%) for medicinal plants used in human healthcare. The highest Jaccard Similarity Index (JSI) was observed between the current study and Adwa (JSI = 68.92%) [54], whereas the lowest similarity was recorded for Yalo (JSI = 6.9%) [48]. This variability may be attributed to the extensive cultural emphasis, historical documentation, and widespread use of medicinal plants for treating human ailments across different regions of Ethiopia [99, 155]. Similar trends were observed in previous studies from Pakistan, which reported a Jaccard’s Similarity Index (JSI) range of 11.11% to 51.85% [156]. This further underscored the diversity in medicinal plant applications and highlighted the variability in ethnobotanical knowledge across different geographical and cultural contexts.

The Jaccard’s Similarity Index cross-cultural comparison of veterinary medicinal plant use in this and previous studies in Ethiopia revealed a narrow similarity range (10.91% to 27.91%). The highest similarity was observed with Toaba (JSI = 27.91%) [97] and the lowest with Ganta Afeshum (JSI = 0.83%) [55]. Similar narrow ranges of Jaccard’s Similarity Index were noted globally, including 10% to 35% in Central Benin [157], 1.92% to 13.07% among the Zemmour and Zayane tribes in the Middle Atlas of Morocco [158], and 0.37% to 12.25% in Punjab, Pakistan [159]. The relatively lower similarity range in veterinary plant use indicates more localized and specialized knowledge, which is often geographically restricted, tailored to meet the health needs of livestock within specific ecological and cultural contexts [160]. This lower JSI percentage for veterinary plants in Ethiopia and globally may also reflect the under-documentation of ethnoveterinary practices, influenced by ecological and cultural factors that shape the use of medicinal plants for livestock health [161]. These findings underscore the need for further research and documentation of ethnoveterinary knowledge, especially in regions where livestock are vital for livelihoods and food security. Integrating ethnoveterinary practices into broader ethnobotanical frameworks could enhance the preservation and sustainable use of medicinal plants for both human and livestock health while contributing to the conservation of traditional knowledge systems.

Rahman’s Similarity Index

The RSI analysis revealed notable patterns in traditional medicinal plant knowledge across various districts in Ethiopia. The highest RSI observed in the Hulet Eju Enese district [52], closely followed by the Sedie Muja [5] and Habru [1] districts of the Amhara region. Comparatively high similarity was also noted in the Ganta Afeshum [55] and Adwa [54] districts of the Tigray region. In contrast, the Tulo district [51] of the Oromia region and the Yalo district [48] of the Afar region exhibited lower similarity indices. These findings suggest that geographical proximity and cultural exchange significantly influence the homogeneity of ethnomedicinal knowledge. The high similarity among the Hulet Eju Enese, Sedie Muja, and Habru districts, all located within the Amhara region, supports the notion that shared cultural practices and environmental conditions foster a common understanding and utilization of similar medicinal plants. Similarly, the relatively high RSI values in the Tigray region’s Ganta Afeshum and Adwa districts indicate a regional coherence in traditional medicine practices, potentially due to similar vegetation and historical interactions transboundary movements of community members.

The lower RSI values observed in the Tulo district of the Oromia region and, particularly, the Yalo district of the Afar region may reflect distinct cultural traditions, ecological differences, or limited knowledge exchange among the cultural groups. The Afar region, characterized by its arid environment and pastoralist lifestyle, likely possesses a unique set of medicinal plant resources and traditional practices that differ significantly from the more agrarian-based societies of Amhara and Tigray.

Source and transfer of indigenous and local medicinal plant knowledge

The findings of this study revealed that familial transmission of indigenous and local medicinal plant knowledge, primarily through paternal, maternal, and sibling lines, was consistent with recent studies in Ethiopia, such as those in Gozamin district [79], Raya Alamata district [113], and Ensaro district [162], where oral inheritance within families was the dominant mode of knowledge transfer, often accompanied by cultural ceremonies and secrecy. Similarly, studies in other regions of Ethiopia, like Sedie Muja District, confirmed that traditional healers pass down knowledge orally and selectively to trusted individuals, emphasizing secrecy due to misconceptions about the efficacy of shared remedies [5]. Contrastingly, while religious institutions like the Ethiopian Orthodox Church discreetly contribute to knowledge preservation through ancient manuscripts in Ethiopia, such roles are less prominent in global contexts where formal documentation is more common [163]. Elderly traditional healers face several challenges in sharing their knowledge of medicinal plants [164]. A key issue is the secrecy they maintain, driven by fears that revealing their knowledge would diminish its healing power and reduce their income. This aligns with findings in Botswana and South Africa, where traditional healers often withhold information due to concerns about exploitation, lack of intellectual property protection, and societal stigma [165].

Novel ethnobotanical findings

This study identified 112 medicinal plant species used to treat 84 distinct diseases, revealing ten species with previously undocumented medicinal use in Ethiopia and globally. Similarly, a novel study was reported in Quara district [68], local communities around Simien Mountains National Park [73], and Bensa district [103]. A particularly striking novel finding in this study was the use of Tragia brevipes. The plant remedy was prepared for cognitive enhancement (“brain enlightenment”) by cutting the root into seven pieces and ingesting them with white honey. Previous reports disclose its use for stomachaches [1], abortion and “evil eye” [5], dactylitis, impotency, and retained placenta [78]. Similarly, Otostegia integrifolia was found to be used to manage Rh factor incompatibility (“shotelay”) during pregnancy, where the root is tied around the mother’s waist until delivery. Previous research has documented its use for ascariasis, abdominal pain, livestock infestations (lice and fleas) [45], “evil spirit” [6], stomachache [62], as an insecticide [54], and for nasal bleeding, stomachache, and diarrhea [52].

A novel application of Leonotis nepetifolia was recorded for treating anthrax, specifically by chewing the root and swallowing the extracted liquid. The other uses with existing literature describe its use for eye aches [54], influenza, chest conditions, insect stings, and snake bites [166], as well as a broader range of conditions including bronchial asthma, diarrhea, fever, influenza, malaria, cough, womb prolapse, epilepsy, burns, skin ailments, and rheumatism [167]. Laggera crispata was newly observed being used to manage minor injuries and hemorrhagic conditions by applying the squeezed leaf extract to stop bleeding. Prior studies have reported its use for anthrax [6], bloat [56], jaundice, inflammation, leukemia, removing phlegm, bronchitis, and bacterial diseases [64].

This study also reported novel uses of Capparis tomentosa and Juniperus procera for alleviating toothaches, suggesting their potential in dental care. Capparis tomentosa is prepared by chewing the root with Zingiber officinale and holding it against the teeth, while Juniperus procera resin is ground with Rosa hybrida fruit, Euphorbia abyssinica latex, Myrica salicifolia root, and Lobelia rhyncopetalum root to create a paste applied to the teeth. Previous reports have documented additional uses for Capparis tomentosa, including treatment for"evil spirit"[6], epidemic, and asthma [59], “evil spirit,” and “evil eyes” [1], and Juniperus procera for hemorrhoids, menstrual irregularities, emaciation in children, skin diseases [56], wounds [52], uterus problems [46], and fire burns [1].

Finally, this study identified novel applications for three additional species: Terminalia leiocarpa for eye diseases (using squeezed leaf extract); Croton macrostachyus for finger amputation (grinding the leaf and mix with butter and applying as a cream); and Euphorbia tirucalli for hemorrhoids (using the extracted latex). Additional use information on the previous reports of Terminalia leiocarpa mentioned for its use for a wide range of conditions, including African trypanosomiasis, animal diarrhea, asthma, cancer, cough, diabetes, dysentery, erectile dysfunction, fever, giardiasis, helminthiases, meningitis, menstrual disorders, monkey pox, oral infections, poliomyelitis, sickle cell anemia, snake bites, toothache, urinary schistosomiasis, and yellow fever [168]. Croton macrostachyus has been previously reported for jaundice, Tinea capitis, malaria, abdominal pain [45], “evil eye,” asthma [6], ringworm [46], swelling [53], atopic eczema, liver problem, stomachache, gonorrhea, malaria, chronic skin diseases, scabies, wound, minor bleeding, and febrile disease [1].

Conclusions

The documentation of 112 medicinal plants including four endemic and one nearly endemic species for human and livestock remedies in the Addi Arkay district of northwestern Ethiopia revealed the significant array of plant uses as the primary healthcare services. The reliance of wild-sourced plants emphasizes the community’s connection to their natural habitats and highlights the importance of conservation efforts to these areas. The predominance of harvesting leaves and roots, combined with grinding as the primary method for preparing remedies, indicated the higher medicinal values of these parts. In addition, the widespread use of oral administration and the incorporation of additives to enhance efficacy and reduce toxicity reflected the locals’ depth of ethnobotanical knowledge and practices. These findings underscored the importance of further exploration and preservation of indigenous knowledge related to medicinal plant use of the study area.

Fidelity level (FL) analyses identified Opuntia ficus-indica as the most preferred treatment for human hemorrhoids and Phytolacca dodecandra as the primary remedy for rabies in livestock. This showed widespread use and reliance of local the community for healthcare on these species, suggesting promising avenues for further pharmacological investigation. The Direct Matrix Ranking (DMR) identified Cordia africana, Olea europaea subsp. cuspidata, and Terminalia leiocarpa as the most threatened multipurpose medicinal plants, highlighting the urgent need for conservation priority to these species. The Jaccard Similarity Index (JSI%) and Rahman’s Similarity Index (RSI) revealed varying degrees of overlap in medicinal plant knowledge compared to other studies in Ethiopian. The lowest values indicate unique and localized ethnobotanical knowledge, reflecting the distinct cultural practices and medicinal plant diversity of the study area, while the highest values suggest shared knowledge and common plant use across regions. The relatively lower similarity in veterinary plant use reflects more localized and specialized knowledge, often confined to specific communities, where ethnoveterinary practices are tailored to address the health needs of livestock in particular ecological and cultural contexts. Agricultural expansion, overgrazing, and the use of fuel were the primary threats to medicinal plants in the study area. These factors have led to habitat degradation and valuable medicinal plant loss, underscoring the need for more coordinated in situ and ex situ conservation initiatives aimed at protecting these vital resources.

In addition, the research revealed that socio-demographic (healing experience, gender, age, education status, education level, marital status, ethnic background, and religion) and socio-economic factors (occupation, transport access, income level, and distance from town) significantly influence indigenous knowledge regarding medicinal plant use in the Addi Arkay district. Understanding these factors is crucial for conservation and effectively integrating traditional knowledge with conventional scientific approaches. Furthermore, the transmission of indigenous and local knowledge about medicinal plants is largely familial and oral, which poses challenges for its preservation. The tendency for secrecy among traditional healers can inhibit the sharing of valuable knowledge, risking the loss of critical information about medicinal plant uses and practices. To address these issues, it is essential to promote community engagement in conservation efforts and establish platforms for knowledge sharing that respect traditional practices while encouraging collaboration.

Limitations of this study

This study is limited to document medicinal plants with the associated indigenous knowledge for treating human and livestock ailments in the Addi Arkay district that did not include further phytochemical analyses of the most preferred and frequently cited medicinal plants. Future studies should focus on antimicrobial assays, phytochemical, and pharmacological validations, as well as in vitro and in vivo investigations.