Journal of Applied Botany and Food Quality 91, 287 - 295 (2018), DOI:10.5073/JABFQ.2018.091.037 1Technology Transfer Office, Research Administration and Development Department, University of Limpopo, Sovenga, South Africa 2Medicinal Plants and Economic Development (MPED) Research Centre, Department of Botany, University of Fort Hare, Alice, South Africa Ethnobotanical study of plants used medicinally by Bapedi traditional healers to treat sinusitis and related symptoms in the Limpopo province, South Africa Sebua Silas Semenya1, 2*, Alfred Maroyi2 (Submitted: March 17, 2018; Accepted: April 27, 2018) * Corresponding author Summary Traditional uses of plants treating sinusitis are under-studied in Africa and elsewhere. The present study therefore explored ethnobotanical practices of 132 Bapedi traditional healers (THs) pertinent to these diseases in the three districts of Limpopo Province, South Africa. Information was accrued using a semi-structured questionnaire in personal interviews, complemented by field observations. A total of 44 plant species belonging to 43 genera and 29 botanical families, mostly the Fabaceae (n=5 spp.) and Asteraceae (n=4 spp.) were documented as being used by THs for sinusitis and related symptoms. Trees (40.9%), followed by herbs (36.3%) and shrubs (22.7%) occupied the highest floristic composition. Roots (43.1%) and leaves (22.7%) were the most preferred parts from these habits for herbal preparation. The most popular species across the surveyed districts for treating sinusitis and related symptoms were Adansonia digitata, Clerodendrum ternatum, Cryptocarya transvaalensis, Enicostema axillare, Kalanchoe brachyloba, Lasiosiphon caffer, Moringa oleifera, Sclerocarya birrea, Siphonochilus aethiopicus and Stylochaeton natalensis, each scoring the highest fidelity level and use value indexes. Most species used by interviewed THs are recorded in this study for the first time as medicines for these ailments. Key words: Bapedi traditional healers, respiratory tract infections, sinusitis, South Africa, traditional medicine Introduction According to RightDiagnosis (2016), sinusitis is a long-term on- going or recurring inflammation of the air-filled spaces that are located within the bones in and around the nose. This inflammation leads to blockade of the normal sinus drainage pathways, which in turn results in mucus retention, hypoxia, decreased mucociliary clearance and predisposition to bacterial growth (RaDojicic, 2012). Approximately 0.5% of all upper respiratory tract infections worldwide are complicated by this affliction (WoRRall, 2011). Therefore, sinusitis is an important global public health problem. In 2001, this condition represented 13.6 million outpatient visits in the United States of America (spiegel, 2004). It is estimated that 134 million Indian populations are diagnosed with sinusitis annually (sunali and ghaRpuRe, 2012). Its prevalence in seven cities in mainland China ranged from 4.8% to 9.7% in 2015 (Shi et al., 2015). nazRi et al. (2013) reported higher incidence of between 14.8% and 37% in Australia. In Pakistan over 25% of children suffer from sinusitis (sami et al., 2013), and from July 2000 to June 2001, 6.3 million new diagnoses of this ailment were identified in Germany (BacheRt et al., 2003). Little evidence exists suggesting that sinusitis is also one of the most common and significant health care problems in some African coun- tries. For instance, its episode of 11.7% in Nigeria was noted by iseh and makusiDi (2010). mavale-manuel (2007) who conducted an epidemiological study incorporating 27 schools in suburban and semi-rural areas around Maputo, found that the incidence of sinusitis was 23% and 8.8%, respectively. In South Africa, an earlier study by nRiagu (1999) reported the prevalence of 16–27% of this ailment amongst the children residing in KwaZulu-Natal Province. Risk fac- tors of sinusitis such as HIV/AIDS, exposure to pollution, poverty and poor health infrastructures (olusesi and tshipukane, 2011) are prevalent in South Africa, thus suggesting that this disorder might be common and also on the rise across the various geographical areas of the country. Typical symptoms of sinusitis include cough, facial pain, fever, fatigue, halitosis, headache, irritability, nausea and rhinorrhoea (slavin et al., 2005), and its complications encompasses blindness, brain abscess, meningitis, orbital abscess and osteomyelitis, amongst the others (ReuleR et al., 1995). To avoid these complications it is therefore obligatory that sinusitis be treated or managed as earliest as possible. Treatment of sinusitis and related symptoms by traditional doctors of various cultures is mainly based on the prescriptions of herbal medicine. This fact is highlighted by general ethnobotanical stu- dies conducted amongst diverse ethnic groups residing in countries such as India (RameshkumaR and RamakRitinan, 2013), Brazil (agRa et al., 2008), Pakistan (kayani et al., 2015), Vietnam (minh et al., 2014), Yemen (BhuWan et al., 2015). Similar surveys carried amongst African traditional healers (THs) practicing in various countries including Ethiopia (aBeRa, 2014), Cameroon (agBoR and naiDoo, 2014), Nigeria (aWoyemi et al., 2012) and Lesotho (kose et al., 2015) emphasised this. In South Africa same studies was executed amongst cultures such as Zulu (coopoosamy and naiDoo, 2012) and Xhosa (mBeng, 2013), Tswati (manzini, 2005) and Rastafarian (nzue, 2009), and found that THs/people do treat si- nusitis with medicinal plant remedies. However, nothing is known about the medicinal plant remedies used by Bapedi THs residing in the Limpopo Province (South Africa). Overall, despite the glimpse of evidence suggesting that THs do treat sinusitis, there are still no ethnobotanical studies focusing on the documentation of indigenous knowledge pertinent to this condition in South Africa, Africa as a condition and elsewhere. This study was therefore initiated to bridge this gap in knowledge. Materials and methods Study area and population The present study was conducted in the municipalities of Capricorn, Sekhukhune and Waterberg districts of the Limpopo, South Africa (Fig. 1). Five rural settlements from each of these municipalities were selected as a study site. 288 S.S. Semenya, A. Maroyi The local inhabitants of the studied areas, the Bapedi, speak a dialect of Sepedi in the Sotho language group. This culture occupies a large part of Limpopo Province, with an estimated 52.9% of the popula- tion (SOUTHAFRICA.INFO, 2016). Overall, the studied areas are poorly developed by government and very few services are available to the people. The vast majority of the houses are made of locally sourced natural materials (i.e., timber, grass and mud). Most of the villages lack health centres, and as such, people have to pay for ex- pensive and scarce transportation to access the adjacent centre. For most ailments, TH’s services are the only accessible and affordable healing treatments. Ethnobotanical survey and data collection Before the survey commenced, permission to conduct the study was granted from the community leader of each sampled village, and THs who agreed to participate in our survey were requested to sign a consent form. The objective of the study was explained to both local tribal leaders and THs in their native language of Sepedi. Ethnobotanical enquiry and data gathering was carried out from May 2017 to October 2017 through face-to-face interviews guided by a semi-structured questionnaire and direct observation, with 132 THs who were conveniently sampled (i.e., with the help of lo- cal community leaders and THs). This questionnaire was designed to provide information on the Pedi vernacular names of medicinal plants used for sinusitis and related symptoms, used plant part/s, methods of herbal preparation and administration, amongst other data. Generally, interviews were conducted individually with each healer. Field trips for plant collection and observation were conducted in the company of each interviewed THs. Plant species were identified by healers via vernacular name/s, and subsequently researchers col- lected specimen for scientific identification. The plant specimens were collected using standard taxonomical procedures (e.g. taking specimens with flowers and fruits whenever possible). Each plant sample was numbered and deposited at the Larry Leach Herbarium (University of Limpopo) for identification of botanical name by tax- onomist. Voucher specimens of each species were stored in this her- barium for future references. Data analysis Micro Soft Excel and Statistical Package for the Social Sciences (SPSS) Ethnobotanical data gathered from the interview session and field tours with THs were entered in to Microsoft Excel 2000 spread- sheet, and SPSS version 14.0, afterwards analysed using descriptive statistics such as frequencies and percentages. Fidelity level (FL) The uniformity and degree of therapeutic exploitation amongst THs with respect to an individual species against sinusitis and/or related symptoms was determined using FL as described by AL-QURAN (2009), following the formula: NP FL (%) = × 100 N Where Np was the number of THs who claim a use of a plant species to treat sinusitis and/or related symptom, and N was the total number of THs who mentioned the use of species as a medicine to treat any given condition (i.e, sinusitis and/related symptom/s). According to FRieDman et al. (1986), FL index reflects the extent of preference an individual species is given by users in the management of a particular ailment. Fidelity level values show the percentage of THs claiming the use of particular plant species as herbal medicine for sinusitis. Fig. 1: Map of Limpopo Province indicating the studied areas (districts and municipalities). Plants used for sinusitis and related symptoms 289 Therefore, medicinal plants widely used by THs against sinusitis have higher FL values than those that are not widely used. Use value (UV) Use values (UV) are calculated for individual plant to give a quan- titative measure of its relative importance to the informants’ objec- tively. The extent of utilisation of each species used therapeutically by Bapedi THs for sinusitis and related symptoms were determined via UV, following phillips and gentRy (1993) index: U UV = � N From the above formulation, U was the number of citations per spe- cies, where N represented the total number of THs. Generally, plant with broad therapeutic uses or those that are highly accepted as cure of a particular ailment will score a high UV. Results and discussion Diversity of used plant species Forty-four plant species (38 indigenous and 6 exotics) belonging to 43 genera and 29 botanical families were pointed out by 132 inter- viewed Bapedi THs as treatment of sinusitis and related symptoms (Tab. 1). Amongst these families were the Fabaceae, Asteraceae, Euphorbiaceae and Lamiaceae with at least three species used against sinusitis. There is presently no ethnobotanical study focus- ing on traditional treatment of sinusitis which we can compare our finding with. However, members of the Asteraceae, Euphorbiaceae and Lamiaceae were previously reported as conspicuous therapies for respiratory infections in Northern Maputaland, KwaZulu-Natal Province, South Africa (yoRk, 2012), thus suggesting that their phar- macological potential and safety against these infections have been ethnically tested in different areas by different culture and perchance found to be effective, hence they are highly preferred by Bapedi THs. In addition to this conjecture, the supremacy of the aforesaid families in our study might be attributed to THs’ knowledge regarding uses of their members as sinusitis and related conditions medications com- pared to other families. The remaining botanical families encoun- tered in this survey had between two and one species, thus were least presented. Poorly represented as these families were, the high degree and frequency of uses of most of their members by Bapedi THs ap- peared to be worthy of further in-depth investigations with respect to pharmacological activities (Tab. 1). Plant habit Trees (40.9%, n=18), followed by herbaceous species (36.3%, n=16) and shrubs (22.7%, n=10), respectively formed the highest floristic composition of 44 medicinal plants inventoried in the present study. Distinct partialities of the first habit by interviewed THs might be attributed to chronic nature of sinusitis which requires the incessant availability of medications. This speculation is based on the fact that trees are available year round as they are not affected by seasonal changes. Distribution of used plants with in the municipalities and dis- tricts Of all (n=44) the species documented in this study, only 22.7% (n=10), namely Adansonia digitata, Clerodendrum ternatum, Cryptocarya transvaalensis, Enicostema axillare, Kalanchoe brachyloba, Lasiosiphon caffer, Moringa oleifera, Sclerocarya birrea, Siphonochilus aethiopicus and Stylochaeton natalensis were widely used by all THs across the three studied sites, thus suggest- ing that their knowledge as sinusitis and its ailed symptoms cures is common in Bapedi traditional sector. Medical information pertinent to 6.8% (n=3) of species (Nicotiana tabacum, Encephalartos trans- venosus and Lippia javanica) were sparsely distributed amongst THs in certain municipalities within the three surveyed districts (Supplementary file: Tab. 2). Variability in use of these taxa across the studied sites is possibly due to the uneven distribution of knowl- edge among THs regarding their application as sinusitis cure. This supposition might be true especially since the acquisition and devel- opment of knowledge about medicinal plants is a lifelong process and more difficult to learn than other ethnobotanical uses (phillips and gentRy, 1993). Similar sentiment can be said for taxa which were used by THs practicing in certain municipalities located in two of the three studied districts (Acacia senegal, Adenia spinosa, Aloe spp., Artemisia afra, Eucalyptus camaldulensis, Peltophorum africanum, Protea caffra, Schkuhria pinnata, Senna italica, Sorghum bicolor, Vernonia natalensis and Warburgia salutaris), and those used by THs in some municipalities under one of these districts (Acacia tor- tilis, Citrus limon, Clematis brachiata, Euphorbia schinzii, Lantana rugosa, Mentha longifolia, Plumbago zeylanica, Psiadia punctu- lata and Schinus molle). Ethnomedical knowledge of the remain- ing species encompassing Acokanthera rotundata, Cannabis sa- tiva, Carissa bispinosa, Croton gratissimus, Cyperus sexangularis, Erythrina lysistemon, Eucomis pallidiflora, Ptaeroxylon obliquum, Solanum panduriforme and Spirostachys africana were restricted to THs operating in a single municipality within one of the three sur- veyed districts, a finding which indicate that these species are less popular amongst the interviewed THs. However, it is also probable that the limited uses of such taxa might be ascribed to their effective- ness against sinusitis, presently known to few THs who retaliate to share it with colleagues in trepidation of competition. Species utilisation and comparison with ethnobotanical litera- ture Amongst the 44 plant species recorded in this study, vast majority (59%, n=26) were used by THs to exclusively treat sinusitis, 11.3% (n=4) cured this ailment and the following two conditions; fatigue and fever. The remaining plants (31.8%, n=14) was implicated in the treatment of both these disorders. Generally, the above-mentioned findings demonstrate the depth of Bapedi THs’ indigenous knowl- edge on local plants and their application as cure for sinusitis and allied symptoms. Plants used exclusively by THs in this study to treat sinusitis were Aloe spp., A. rotundata, A. senegal, A. tortilis, C. bispi- nosa, C. brachiata, C. gratissimus, C. transvaalensis, C. ternatum, E. axillare, E. lysistemon, E. pallidiflora, E. schinzii, K. brachyloba, L. caffer, S. aethiopicus, S. birrea, L. javanica, N. tabacum, P. af- ricanum, P. caffra, S. africana, S. italica, S. natalensis, S. pandu- riforme and W. salutaris. Not surprisingly, amongst these species, only C. brachiata (RoBeRt, 1990) and W. salutaris (coopoosamy anD naiDoo, 2012), as well as S. aethiopicus (manzini, 2005) were previously reported as being used by other South African cultures, specifically the Zulu and Swazi THs, respectively as treatment of this disease. This came as no surprise due to the fact that currently there is no ethnobotanical study that focused on the medicinal plants used by THs or lay people for sinusitis. However, the fact that there is literature based proof highlighting on the use of above three stated species for this RI by THs of afore-mentioned cultures, suggests that other South African healers do treat the condition, and thus a through exploration and documentation of their related ethnobotani- cal knowledge should be prioritised before it is irretrievably lost to- gether with the holders. Clerodendrum ternatum, C. transvaalensis, E. axillare, K. brachyloba, L. caffer, S. birrea, S. aethiopicus and S. natalensis were used by all interviewed Bapedi THs (n=132) who treated sinusitis in this study, thus indicating that they are pharma- cologically active and principal in the treatment of this condition. 290 S.S. Semenya, A. Maroyi 2 T ab . 1 : M ed ic in al p la n ts u se d b y B ap ed i tr ad it io n al h ea le rs to s in u si ti s an d r el at ed s y m p to m s in th e L im p o p o P ro v in ce , S o u th A fr ic a F re qu en cy o f u se ; N =T H s (1 32 ) B o ta n ic al f am il y Sp ec ie s na m e V er na cu la r na m e H ab it U se d pl an t pa rt s St at e of u se M et ho ds o f h er ba l p re pa ra ti on a nd ad m in is tr at io n A lim en t/ s tr ea te d U M % F L U V A n ac ar d ia ce ae *S ch in us m ol le L . T h o b a/ M o k w ep er e T re e L ea f F re sh B o il ed f o r 5 – 7 m in u te s. S te am i s in h al ed ( n as al ly ) u n d er b la n k et . T h ri ce a d ay F ev er 10 7. 5 10 0 0. 07 A n ac ar d ia ce ae Sc le ro ca ry a bi rr ea ( A .R ic h .) H o ch st . su b sp . ca ff ra ( S o n d .) M o ru la /M o k an o T re e F ru it F re sh Ju ic e is sq u ee ze d (r aw ), d ri ed an d p o u n d ed . P o w d er is p o u re d in th e h o t w at er . S te am is in h al ed ( n as al ly ) u n d er b la n k et . T h ri ce a d ay S in u si ti s 13 2 10 0 10 0 1 A p o cy n ac ea e A co ka nt he ra r ot un da ta ( C o d d ) K u p ic h a M o et h i S h ru b R o o t D ry B o il ed f o r 3 – 6 m in u te s. S te am i s in h al ed ( n as al ly ) u n d er b la n k et . T h ri ce a d ay S in u si ti s 4 3 10 0 0. 03 A p o cy n ac ea e C ar is sa b is pi no sa ( L .) D es f. e x B re n an L ep u tl o /M o th o k o lo /M o ⌃h u k u d u /M o th o lo T re e R o o t D ry P o u n d ed a n d m ix ed w it h d ri ed p o w d er ed r o o t o f E . ly si st em on . T ak en o ra ll y w it h w ar m w at er . T h ri ce a d ay S in u si ti s 1 0. 7 10 0 0. 00 A ra ce ae St yl oc ha et on n at al en si s S ch o tt M o k u n y a/ M o k u ⌃h et e H er b R o o t D ry B o il ed f o r 5 m in u te s. S te am i n h al ed ( n as al ly ) u n d er b la n k et . T h ri ce a d ay S in u si ti s 13 2 10 0 10 0 1 A sp h o d el ac ea e A lo e sp p . T h o g o /M ar o b ad ib o g al e S h ru b L ea f F re sh M ac er at ed i n w ar m w at er f o r 2 4 h rs . D ec o ct io n i s ta k en o ra ll y . T h ri ce a d ay S in u si ti s 5 3. 7 10 0 0. 03 M ix ed w it h d ri ed l ea f o f L. j av an ic a. B o il ed f o r 5 m in u te s. E x tr ac t is t ak en o ra ll y . T h ri ce a d ay S in u si ti s 1 0. 7 50 0. 00 A st er ac ea e A rt em is ia a fr a Ja cq . ex W il ld . v ar . af ra L eg an a/ M o il an ⌃i H er b L ea f F re sh B o il ed f o r 4 – 5 m in u te s. S te am i s in h al ed ( n as al ly ) u n d er b la n k et . T h ri ce a d ay F ev er 1 0. 7 50 0. 00 A st er ac ea e P si ad ia p un ct ul at a (D C .) V at k e L es o tl an e/ M o n o tl et ⌃a n e/ le so d i S h ru b R o o t D ry P o u n d ed a n d t ak en o ra ll y w it h w ar m w at er . T h ri ce a d ay F ev er 10 7. 5 10 0 0. 07 A st er ac ea e *S ch ku hr ia p in na ta ( L am .) K u n tz e ex T h el l. ⇧ at h u m e/ M o ⌃a ⌃a n e/ S er al an e H er b W h o le p la n t F re sh B o il ed f o r 5 m in u te s. S te am i s in h al ed ( n as al ly ) u n d er b la n k et . T h ri ce a d ay F at ig u e 5 3. 7 10 0 0. 03 S in u si ti s 6 4. 5 37 .5 A st er ac ea e V er no ni a na ta le ns is S ch .B ip . e x W al p . M o ⌃u h la H er b L ea f D ry P o u n d ed a n d t ak en o ra ll y w it h w ar m w at er . T h ri ce a d ay F ev er 10 7. 5 62 .5 0. 12 C an el la ce ae W ar bu rg ia s al ut ar is ( G .B er to l. ) C h io v . M o la k a T re e B ar k D ry B o il ed f o r 4 – 1 1 m in u te s. E x tr ac t is t ak en o ra ll y . T h ri ce a d ay S in u si ti s 4 3 10 0 0. 03 3 C an n ab ac ea e *C an na bi s sa tiv a L . v ar . in d ic a (L am .) W eh m er L eb ak e/ P at ⌃e H er b L ea f D ry P o u n d ed a n d t ak en o ra ll y w it h w ar m w at er . T h ri ce a d ay F ev er 1 0. 7 10 0 0. 00 C ra ss u la ce ae K al an ch oe b ra ch yl ob a W el w . ex B ri tt en M o et h i/ M o ⌃i m an ew an ag a/ M o ri t⌃ ik an a S h ru b L ea f F re sh R u b b ed ( ra w ) b et w ee n h an d s an d v ap o u r is i n h al ed (n as al ly ). T h ri ce a d ay S in u si ti s 13 2 10 0 10 0 1 C y p er ac ea e C yp er us s ex an gu la ri s N ee s M o h la h la H er b R o o t D ry P o u n d ed a n d t ak en o ra ll y w it h w ar m w at er . T h ri ce a d ay F ev er 1 0. 7 10 0 0. 00 E u p h o rb ia ce ae C ro to n gr at is si m us B u rc h . v ar . gr at is si m us M o o lo lo g a/ S el o g an e T re e R o o t D ry B o il ed f o r 6 – 1 0 m in u te s. E x tr ac t is t ak en o ra ll y . T h ri ce a d ay O r P o u n d ed a n d t ak en o ra ll y w it h w ar m w at er . T h ri ce a d ay S in u si ti s 5 3. 7 10 0 0. 03 E u p h o rb ia ce ae E up ho rb ia s ch in zi i P ax N g ak a- d ia n y a H er b R o o t D ry B o il ed f o r 5 – 8 m in u te s. S te am i s in h al ed ( n as al ly ) u n d er b la n k et . T h ri ce a d ay S in u si ti s 7 5. 3 10 0 0. 05 E u p h o rb ia ce ae Sp ir os ta ch ys a fr ic an a S o n d . M o re k u ri /M o ta m p o ta T re e R o o t D ry B u rn ed f o r ab o u t 7 – 8 m in u te . S m o k e in h al ed (n as al ly ). T h ri ce a d ay S in u si ti s 2 1. 5 10 0 0. 01 F ab ac ea e A ca ci a se ne ga l ( L .) W il ld . v ar . ro st ra ta B re n an M o k g ar ip e T re e R o o t D ry B o il ed f o r 6 – 1 1 m in u te s. E x tr ac t is t ak en o ra ll y . T h ri ce a d ay S in u si ti s 4 3 10 0 0. 03 F ab ac ea e A ca ci a to rt ili s (F o rs sk .) H ay n e su b sp . h et er ac an th a (B u rc h .) B re n an M o ⌃h w an a T re e R o o t D ry B o il ed f o r 5 m in u te s. S te am i s in h al ed ( n as al ly ) u n d er b la n k et . T h ri ce a d ay S in u si ti s 11 8. 3 10 0 0. 08 F ab ac ea e E ry th ri na ly si st em on H u tc h . S eb al o /M m al e T re e B ar k D ry P o u n d ed a n d m ix ed w it h d ri ed p o w d er ed r o o t o f C . bi sp in os a. T ak en o ra ll y w it h w ar m w at er . T h ri ce a d ay S in u si ti s 1 0. 7 10 0 0. 00 F ab ac ea e P el to ph or um a fr ic an um S o n d . M o se h la T re e B ar k D ry B o il ed fo r 5 – 1 1 m in u te s. E x tr ac ts ta k en o ra ll y . T h ri ce a d ay S in u si ti s 7 5. 3 10 0 0. 05 F ab ac ea e Se nn a ita lic a M il l. s u b sp . ar ac h o id es ( B u rc h .) L o ck M o ro te la d it ⌃h o ⌃i H er b R o o t D ry B o il ed fo r 4 – 8 m in u te s. E x tr ac t is ta k en o ra ll y . T h ri ce a d ay S in u si ti s 5 3. 7 10 0 0. 03 G en ti an ac ea e E ni co st em a ax ill ar e (L am .) A .R ay n al s u b sp . A x il la re M ak g o n o t⌃ o h le /M p h ed u -y a- th ab a H er b W h o le p la n t D ry B o il ed f o r 5 – 1 4 m in u te s. E x tr ac t is t ak en o ra ll y . T h ri ce a d ay O r P o u n d ed a n d t ak en o ra ll y w it h w ar m w at er . T h ri ce a d ay S in u si ti s 13 2 10 0 10 0 1 Ta b. 1 : M ed ic in al p la nt s us ed b y B ap ed i t ra di tio na l h ea le rs t o si nu si tis a nd re la te d sy m pt om s in t he L im po po P ro vi nc e, S ou th A fr ic a Plants used for sinusitis and related symptoms 291 4 H y ac in th ac ea e E uc om is p al lid ifl or a B ak er s u b sp . p o le -e v an si i (N .E .B r. ) R ey n ek e ex J. C .M an n in g M at h u b ad if al a H er b B u lb F re sh B o il ed f o r 5 – 1 0 m in u te s. E x tr ac t is t ak en o ra ll y . T h ri ce a d ay S in u si ti s 1 0. 7 10 0 0. 00 L am ia ce ae C le ro de nd ru m te rn at um S ch in z S eb o k an e H er b W h o le p la n t D ry B o il ed f o r 5 m in u te s. S te am i n h al ed ( n as al ly ) u n d er b la n k et . T h ri ce a d ay S in u si ti s 13 2 10 0 10 0 1 L am ia ce ae M en th a lo ng ifo lia L . M o m in ti H er b W h o le p la n t D ry B o il ed a n d e x tr ac t is t ak en o ra ll y . T h ri ce a d ay F ev er 10 7. 5 10 0 0. 07 B o il ed f o r 5 – 9 m in u te s. E x tr ac t is t ak en o ra ll y . T h ri ce a d ay S in u si ti s 41 L au ra ce ae C ry pt oc ar ya tr an sv aa le ns is B u rt t D av y K g o su p sa T re e B ar k D ry P o u n d ed an d p o u re d in b o il ed w at er . S te am is in h al ed ( n as al ly ) u n d er b la n k et . T h ri ce a d ay S in u si ti s 91 10 0 10 0 1 M al v ac ea e A da ns on ia d ig ita ta M o g o o T re e R o o t D ry B o il ed f o r 6 – 1 0 m in u te s. E x tr ac t is t ak en o ra ll y . T h ri ce a d ay F at ig u e 13 2 10 0 10 0 1 M o ri n g ac ea e *M or in ga o le ife ra s en su E x el l & M en d o n M o ri n g k a T re e L ea f D ry P o u n d ed a n d t ak en o ra ll y w it h w ar m w at er . T h ri ce a d ay F at ig u e 13 2 10 0 10 0 1 S in u si ti s 1 0. 7 9 M y rt ac ea e E uc al yp tu s ca m al du le ns is D eh nh M o p il ik o m o T re e B ar k D ry B o il ed f o r 5 m in u te s. S te am i s in h al ed ( n as al ly ) u n d er b la n k et . T h ri ce a d ay F ev er 10 7. 5 90 .9 0. 08 P o u n d ed a n d t ak en o ra ll y w it h w ar m w at er . T h ri ce a d ay F at ig u e 6 4. 5 10 0 P as si fl o ra ce ae A de ni a sp in os a B u rt t D av y M o n n a- ap ar e/ P is ay ab at ⌃u m i/ M o th em a S h ru b S te m D ry B o il ed fo r 5 m in u te s. S te am is in h al ed (n as al ly ) u n d er b la n k et . T h ri ce a d ay S in u si ti s 10 7. 5 10 0 0. 12 P lu m b ag in ac ea e P lu m ba go z ey la ni ca L . M a⌃ im ab e/ M a⌃ eg o m ab e S h ru b R o o t D ry B o il ed f o r 6 – 1 3 m in u te s. E x tr ac t is t ak en o ra ll y . T h ri ce a d ay F ev er 10 7. 5 10 0 0. 07 P o ac ea e So rg hu m b ic ol or ( L .) M o en ch su b sp . ar u n d in ac eu m ( D es v .) d e W et & H ar la n M ab el e- th o ro H er b S ee d D ry P o u n d ed a n d t ak en o ra ll y w it h M ag eu ® d ri n k o r so ft p o rr id g e. T h ri ce a d ay F at ig u e 18 13 .6 10 0 0. 13 P ro te ac ea e P ro te a ca ffr a M ei sn . su b sp . ca ff ra M o d u m el a T re e R o o t D ry P o u n d ed a n d t ak en o ra ll y w it h w ar m w at er . T h ri ce a d ay S in u si ti s 2 1. 5 10 0 0. 01 P ta er o x y la ce ae P ta er ox yl on o bl iq uu m ( T h u n b .) R ad lk . M o g ab al et sw an a T re e R o o t D ry P o u n d ed a n d t ak en o ra ll y w it h w ar m w at er . T h ri ce a d ay F ev er 4 3 10 0 0. 03 R an u n cu la ce ae C le m at is b ra ch ia ta T h u n b . M o tl em ap o o /M ak g w at ia n e H er b R o o t D ry B u rn ed f o r ab o u t 5 – 6 m in u te s. S m o k e is i n h al ed S in u si ti s 10 7. 5 10 0 0. 07 3 C an n ab ac ea e *C an na bi s sa tiv a L . v ar . in d ic a (L am .) W eh m er L eb ak e/ P at ⌃e H er b L ea f D ry P o u n d ed a n d t ak en o ra ll y w it h w ar m w at er . T h ri ce a d ay F ev er 1 0. 7 10 0 0. 00 C ra ss u la ce ae K al an ch oe b ra ch yl ob a W el w . ex B ri tt en M o et h i/ M o ⌃i m an ew an ag a/ M o ri t⌃ ik an a S h ru b L ea f F re sh R u b b ed ( ra w ) b et w ee n h an d s an d v ap o u r is i n h al ed (n as al ly ). T h ri ce a d ay S in u si ti s 13 2 10 0 10 0 1 C y p er ac ea e C yp er us s ex an gu la ri s N ee s M o h la h la H er b R o o t D ry P o u n d ed a n d t ak en o ra ll y w it h w ar m w at er . T h ri ce a d ay F ev er 1 0. 7 10 0 0. 00 E u p h o rb ia ce ae C ro to n gr at is si m us B u rc h . v ar . gr at is si m us M o o lo lo g a/ S el o g an e T re e R o o t D ry B o il ed f o r 6 – 1 0 m in u te s. E x tr ac t is t ak en o ra ll y . T h ri ce a d ay O r P o u n d ed a n d t ak en o ra ll y w it h w ar m w at er . T h ri ce a d ay S in u si ti s 5 3. 7 10 0 0. 03 E u p h o rb ia ce ae E up ho rb ia s ch in zi i P ax N g ak a- d ia n y a H er b R o o t D ry B o il ed f o r 5 – 8 m in u te s. S te am i s in h al ed ( n as al ly ) u n d er b la n k et . T h ri ce a d ay S in u si ti s 7 5. 3 10 0 0. 05 E u p h o rb ia ce ae Sp ir os ta ch ys a fr ic an a S o n d . M o re k u ri /M o ta m p o ta T re e R o o t D ry B u rn ed f o r ab o u t 7 – 8 m in u te . S m o k e in h al ed (n as al ly ). T h ri ce a d ay S in u si ti s 2 1. 5 10 0 0. 01 F ab ac ea e A ca ci a se ne ga l ( L .) W il ld . v ar . ro st ra ta B re n an M o k g ar ip e T re e R o o t D ry B o il ed f o r 6 – 1 1 m in u te s. E x tr ac t is t ak en o ra ll y . T h ri ce a d ay S in u si ti s 4 3 10 0 0. 03 F ab ac ea e A ca ci a to rt ili s (F o rs sk .) H ay n e su b sp . h et er ac an th a (B u rc h .) B re n an M o ⌃h w an a T re e R o o t D ry B o il ed f o r 5 m in u te s. S te am i s in h al ed ( n as al ly ) u n d er b la n k et . T h ri ce a d ay S in u si ti s 11 8. 3 10 0 0. 08 F ab ac ea e E ry th ri na ly si st em on H u tc h . S eb al o /M m al e T re e B ar k D ry P o u n d ed a n d m ix ed w it h d ri ed p o w d er ed r o o t o f C . bi sp in os a. T ak en o ra ll y w it h w ar m w at er . T h ri ce a d ay S in u si ti s 1 0. 7 10 0 0. 00 F ab ac ea e P el to ph or um a fr ic an um S o n d . M o se h la T re e B ar k D ry B o il ed fo r 5 – 1 1 m in u te s. E x tr ac ts ta k en o ra ll y . T h ri ce a d ay S in u si ti s 7 5. 3 10 0 0. 05 F ab ac ea e Se nn a ita lic a M il l. s u b sp . ar ac h o id es ( B u rc h .) L o ck M o ro te la d it ⌃h o ⌃i H er b R o o t D ry B o il ed fo r 4 – 8 m in u te s. E x tr ac t is ta k en o ra ll y . T h ri ce a d ay S in u si ti s 5 3. 7 10 0 0. 03 G en ti an ac ea e E ni co st em a ax ill ar e (L am .) A .R ay n al s u b sp . A x il la re M ak g o n o t⌃ o h le /M p h ed u -y a- th ab a H er b W h o le p la n t D ry B o il ed f o r 5 – 1 4 m in u te s. E x tr ac t is t ak en o ra ll y . T h ri ce a d ay O r P o u n d ed a n d t ak en o ra ll y w it h w ar m w at er . T h ri ce a d ay S in u si ti s 13 2 10 0 10 0 1 292 S.S. Semenya, A. Maroyi 4 H y ac in th ac ea e E uc om is p al lid ifl or a B ak er s u b sp . p o le -e v an si i (N .E .B r. ) R ey n ek e ex J. C .M an n in g M at h u b ad if al a H er b B u lb F re sh B o il ed f o r 5 – 1 0 m in u te s. E x tr ac t is t ak en o ra ll y . T h ri ce a d ay S in u si ti s 1 0. 7 10 0 0. 00 L am ia ce ae C le ro de nd ru m te rn at um S ch in z S eb o k an e H er b W h o le p la n t D ry B o il ed f o r 5 m in u te s. S te am i n h al ed ( n as al ly ) u n d er b la n k et . T h ri ce a d ay S in u si ti s 13 2 10 0 10 0 1 L am ia ce ae M en th a lo ng ifo lia L . M o m in ti H er b W h o le p la n t D ry B o il ed a n d e x tr ac t is t ak en o ra ll y . T h ri ce a d ay F ev er 10 7. 5 10 0 0. 07 B o il ed f o r 5 – 9 m in u te s. E x tr ac t is t ak en o ra ll y . T h ri ce a d ay S in u si ti s 41 L au ra ce ae C ry pt oc ar ya tr an sv aa le ns is B u rt t D av y K g o su p sa T re e B ar k D ry P o u n d ed an d p o u re d in b o il ed w at er . S te am is in h al ed ( n as al ly ) u n d er b la n k et . T h ri ce a d ay S in u si ti s 91 10 0 10 0 1 M al v ac ea e A da ns on ia d ig ita ta M o g o o T re e R o o t D ry B o il ed f o r 6 – 1 0 m in u te s. E x tr ac t is t ak en o ra ll y . T h ri ce a d ay F at ig u e 13 2 10 0 10 0 1 M o ri n g ac ea e *M or in ga o le ife ra s en su E x el l & M en d o n M o ri n g k a T re e L ea f D ry P o u n d ed a n d t ak en o ra ll y w it h w ar m w at er . T h ri ce a d ay F at ig u e 13 2 10 0 10 0 1 S in u si ti s 1 0. 7 9 M y rt ac ea e E uc al yp tu s ca m al du le ns is D eh nh M o p il ik o m o T re e B ar k D ry B o il ed f o r 5 m in u te s. S te am i s in h al ed ( n as al ly ) u n d er b la n k et . T h ri ce a d ay F ev er 10 7. 5 90 .9 0. 08 P o u n d ed a n d t ak en o ra ll y w it h w ar m w at er . T h ri ce a d ay F at ig u e 6 4. 5 10 0 P as si fl o ra ce ae A de ni a sp in os a B u rt t D av y M o n n a- ap ar e/ P is ay ab at ⌃u m i/ M o th em a S h ru b S te m D ry B o il ed fo r 5 m in u te s. S te am is in h al ed (n as al ly ) u n d er b la n k et . T h ri ce a d ay S in u si ti s 10 7. 5 10 0 0. 12 P lu m b ag in ac ea e P lu m ba go z ey la ni ca L . M a⌃ im ab e/ M a⌃ eg o m ab e S h ru b R o o t D ry B o il ed f o r 6 – 1 3 m in u te s. E x tr ac t is t ak en o ra ll y . T h ri ce a d ay F ev er 10 7. 5 10 0 0. 07 P o ac ea e So rg hu m b ic ol or ( L .) M o en ch su b sp . ar u n d in ac eu m ( D es v .) d e W et & H ar la n M ab el e- th o ro H er b S ee d D ry P o u n d ed a n d t ak en o ra ll y w it h M ag eu ® d ri n k o r so ft p o rr id g e. T h ri ce a d ay F at ig u e 18 13 .6 10 0 0. 13 P ro te ac ea e P ro te a ca ffr a M ei sn . su b sp . ca ff ra M o d u m el a T re e R o o t D ry P o u n d ed a n d t ak en o ra ll y w it h w ar m w at er . T h ri ce a d ay S in u si ti s 2 1. 5 10 0 0. 01 P ta er o x y la ce ae P ta er ox yl on o bl iq uu m ( T h u n b .) R ad lk . M o g ab al et sw an a T re e R o o t D ry P o u n d ed a n d t ak en o ra ll y w it h w ar m w at er . T h ri ce a d ay F ev er 4 3 10 0 0. 03 R an u n cu la ce ae C le m at is b ra ch ia ta T h u n b . M o tl em ap o o /M ak g w at ia n e H er b R o o t D ry B u rn ed f o r ab o u t 5 – 6 m in u te s. S m o k e is i n h al ed S in u si ti s 10 7. 5 10 0 0. 07 5 R an u n cu la ce ae C le m at is b ra ch ia ta T h u n b . M o tl em ap o o /M ak g w at ia n e H er b R o o t D ry B u rn ed f o r ab o u t 5 – 6 m in u te s. S m o k e is i n h al ed (n as al ly ). T h ri ce a d ay S in u si ti s 10 7. 5 10 0 0. 07 R u ta ce ae *C itr us li m on ( L .) B u rm .f . M o sw ir i T re e B ar k D ry P o u n d ed a n d t ak en o ra ll y w it h w ar m w at er . T h ri ce a d ay F ev er 10 7. 5 10 0 0. 07 S o la n ac ea e *N ic ot ia na ta ba cu m L . M o fo la S h ru b L ea f D ry P o u n d ed a n d a p in ch o f a fi n g er i s sn u ff ( n as al ly ). T h ri ce a d ay S in u si ti s 3 2. 2 10 0 0. 02 S o la n ac ea e So la nu m p an du ri fo rm e E .M ey . M o th o la -o -m o se ro lw an e H er b R o o t D ry P o u n d ed a n d t ak en o ra ll y w it h w ar m w at er . T h ri ce a d ay S in u si ti s 4 3 10 0 0. 03 T h y m el ae ac ea La si os ip ho n ca ffe r M ei sn . N k ek o lo g e S h ru b R o o t D ry P o u n d ed an d p o u re d in b o il ed w at er . S te am is in h al ed ( n as al ly ) u n d er b la n k et . T h ri ce a d ay S in u si ti s 13 2 10 0 10 0 1 V er b en ac ea e La nt an a ru go sa T h u n b . B o k o k o ta n e/ m o k o k o ta n e S h ru b L ea f F re sh B o il ed f o r 5 – 1 0 m in u te s. S te am i s in h al ed ( n as al ly ) u n d er b la n k et . T h ri ce a d ay F ev er 10 7. 5 10 0 0. 07 M ix ed w it h f re sh l ea f o f A . a fr a. B o il ed f o r 5 m in u te s. E x tr ac t is t ak en o ra ll y . T h ri ce a d ay S in u si ti s 1 V er b en ac ea e Li pp ia ja va ni ca ( B u rm .f .) S p re n g . M o ⌃u n k w an e/ m o tl ab a- d ip o o S h ru b L ea f F re sh B o il ed fo r 5 – 9 m in u te s. E x tr ac t is ta k en o ra ll y . T h ri ce a d ay S in u si ti s 10 8. 3 10 0 0. 08 Z am ia ce ae E nc ep ha la rt os tr an sv en os us S ta p f & B u rt t D av y M o fa k a T re e R o o t D ry B o il ed f o r 5 m in u te s. E x tr ac t is t ak en o ra ll y . T h ri ce a d ay F at ig u e 81 61 .3 10 0 0. 61 Z in g ib er ac ea e Si ph on oc hi lu s ae th io pi cu s (S ch w ei n f. ) B .L .B u rt t S er o k o lo H er b B u lb F re sh B o il ed f o r 5 – 6 m in u te s. S te am i s in h al ed ( n as al ly ) u n d er b la n k et . T h ri ce a d ay S in u si ti s 13 2 10 0 10 0 1 K ey : E x o ti c p la n t sp ec ie s: a st er is k ( *) , fi d el it y l ev el ; F L , u se m en ti o n ; U M a n d u se v al u e; U V Plants used for sinusitis and related symptoms 293 Therapies for sinusitis and accompanying symptoms As noted earlier species multi-used by Bapedi for sinusitis and perceived symptoms (fatigue and fever) made-up 11.3%. Fatigue was cured with a single species (A. spinosa), and fever with three species namely A. afra, E. camaldulensis and V. natalensis. Traditional uses of A. spinosa as fatigue and sinusitis therapies are recorded in our study for the first time. This might be due to the fact that this species is only localised in selected areas of the Limpopo Province (FoDen and potteR, 2005). Amongst the species used by Bapedi for fever and sinusitis, only their use for the first condition was previously reported in African literature. Our finding regarding use of A. afra as fever medicine concur with that of thRing and Weitz (2005), who worked with the coloureds (mixed-race) people residing in the Bredasdorp/Elim region of the Southern Overberg, Western Cape Province of South Africa. Similar to Bapedi THs, the Shona people of Zimbabwe use E. ca- maldulensis to treat this condition (maRoyi, 2011). Medicinal ap- plication of V. natalensis for fever was previously highlighted by githens (1948) in South Africa. Thus therapeutic claims made on the aforesaid three plant species by Bapedi THs can be taken to be credible, given that they have identical uses elsewhere. Overall uses of these species in the treatment of fever and sinusitis in our study might be attributed to their strong aromatic flavour. This speculation is ascribed to the fact that most of the interviewed THs disclosed that all plant species with aromatic smell has the potential in the treat- ment of respiratory infections, particularly fever and sinusitis. The remaining species recorded in this study were used exclusively for fever (L. rugosa, M. longifolia, P. punctulata, P. zeylanica and S. molle) and fatigue (A. digitata, E. transvenosus, M. oleifera, S. bi- color and S. pinnata) in patients diagnosed with sinusitis. Most of the aforesaid plants used by Bapedi THs to relieve fever are in line with findings of previous studies conducted in South Africa. For instance, Vhavenda THs practicing in Lwamondo area, Limpopo Province also use L. rugosa as fever medicine (mahWasane et al., 2013). Utilisation of M. longifolia by Bapedi THs coincides with findings of van Wyk et al. (1997) who worked with the diverse South African cultures. Comparably to our results, DolD anD cocks (2000), found that Xhosa THs operating in the Grahamstown and Peddie districts of the Eastern Cape Province, South Africa also prescribe S. molle as medicine to relieve fever. The use this species by Bapedi might be at- tributed to its evergreen nature which supplies them with fresh leaves through the year for herbal preparation. No ethnobotanical record of the remaining two fever therapies; P. punctulata and P. zeylanica was found in South Africa. However, both P. punctulata (kokWaRo, 1976) and P. zeylanica (tyagi anD menghani, 2014) are also valued as fever medicines in east Africa, thus emphasising their importance as traditional medicine to heal this condition by interviewed Bapedi THs. In addition, it shows that the species are widely distributed in various geographical areas across Africa. Amongst the medicinal plants documented as being used by Bapedi THs to heal fatigue in patients diagnosed with sinusitis, only A. digi- tata (Wickens, 1979) and M. oleifera (metha et al., 2011) are well supported by literature. The remaining species namely E. transve- nosus, S. bicolor and S. pinnata are recorded for the first time in the present survey as fatigue medicine. Overall, new records of com- monly known medicinal plants for sinusitis and perceived related symptoms in our study are an indication that the indigenous medi- cal knowledge amongst the diverse South African cultures is poorly documented. Fidelity level (FL) and use value (UV) Analysis of all the 44 documented species in this study accord- ing to FL revealed C. ternatum, C. transvaalensis, E. axillare, K. brachyloba, L. caffer, S. birrea, S. aethiopicus and S. natalensis (UM=132 and FL=100; sinusitis for each), A. digitata and M. olei- fera, (UM=132 and FL=100; fatigue, for each), E. transvenosus (UM=81 and FL=100; fatigue) and S. bicolor (UM=18 and FL=100; fatigue) as the most preferred. With exclusion of E. transvenosus and S. bicolor all these taxa scored the highest UVs of 1 against the men- tioned ailments. Plant parts used, mode of preparations, administrations and dosages Anatomical part/s of the plant predominantly used in the present study to prepare herbal remedies included roots (43.1%, n=19), leaves (22.7%, n=10), bark (13.6%, n=6), whole plant (9%, n=4), bulb (4.5%, n=2), fruit, seed and stem (2.2%, n=1, for each), respectively. This finding reflects the extent of utilisation of these plant parts by Bapedi THs, a practice which could partly be attributed to either the effec- tiveness or local availability of such parts throughout the year. These plant parts were processed mainly in their dry (77.2%, n=34) state than when still drench (22.7%, n=10). A total of 50 recipes were prepared by Bapedi THs in this study. Amongst these formulas, mono therapies (92%, n=46) based on pre- parations made from a single plant part were distinctively favoured. Herbal remedies which contained a mixture of plant parts (8%, n=4) harvested from various species was rarely used. The prevalence of mono therapies in this study might be attributed to its ease of prepa- ration and safety, since there are no adverse drug interactions. In ad- dition it might be attributed to its convenience for the patients, thus ensuring adherence in drug preparation. The plant parts combination during herbal preparation was reported by some THs in this study as augmenting the efficacy of medicine, a claim which is well supported by scientific studies (metha et al., 2011; yoRk et al., 2012). The present study revealed that boiling (54%, n=27) and pounding (38%, n=19) was the most frequently employed method preparation for sinusitis and related symptoms treatments. Other techniques such as burning (4%, n=2), maceration, rubbing, pounding and squeezing (2%, n=1, for each) were less frequently utilised in this study. In general, boiling and burning durations of plant parts for medical production in this study varied amongst THs (Tab. 1). However, pre- paration of remedies via the remaining techniques was comparable amongst THs. Harvested plant parts were pounded by all THs with grinding stones. Maceration involved freshly harvested plant parts and the process was done by all THs overnight (24 hrs). Similarly, prescription which was made through rubbing and squeezing only involved fresh plant materials (Tab. 1). Oral (62%, n=31) and nasal (38%, n=19), respectively were the only used means of administering prepared herbal remedies/recipes in the present study. However, nasal was the most flexible route of taking these recipes compared to oral. For instance, THs used it to admin- ister medicines made via all the earlier noted techniques of herbal preparations in this study, while oral was only employed for recipes made via pounding and boiling (Tab. 1). There was no standardized measure on the dose of most herbal remedies documented in this study. Uniformity in dosage strength amongst THs was only observed for oral drugs prepared via boiling; all Bapedi THs prescribed this medicine with a metal (500 ml) thrice a day. The recommended dosages of the remaining medications va- ried amongst THs. For instance, remedies prepared using part/s ob- tained from similar species was prescribed in different doses to treat similar complaints. This might be due to either THs preferences or experience. Conclusions The present study is the first to provide a comprehensive baseline data on the traditional practices associated with therapeutic plants for treatment of sinusitis and related symptoms in South Africa, 294 S.S. Semenya, A. Maroyi thus suggesting that there is still considerable scope for field work to explore and document these practices. Species documented in this study were described for the first time in ethnobotanical literature as treatment of sinusitis and related conditions. Therapeutic claims made by Bapedi THs on some plants are well supported by ethno- botanical literature and therefore, to some extent, corroborate the reliability of ethnobotanical information documented in this study. Acknowledgements Special thanks to the traditional healers in the Capricorn, Sekhukhune and Waterberg districts of the Limpopo Province, South Africa, for sharing their knowledge on plant they use to treat sinusitis. The finan- cial support from the South African National Research Foundation (NRF) is gratefully acknowledged. References aBeRa, B., 2014: Medicinal plants used in traditional medicine by Oromo people, Ghimbi District, Southwest Ethiopia. J. Ethnobiol. Ethnomed. 10, 40. DOI: 10.1186/1746-4269-10-40 agBoR, M.A., naiDoo, S., 2015: Ethnomedicinal plants used by tradi- tional healers to treat oral health problems in Cameroon. Evid. Based Complement Alternat. Med. 2015. DOI: 10.1155/2015/649832 agRa, M.D.F., silva, N.K., Basilio, I.J.L.D., FReitas, P.F.D.F., BaRBosa- Filho, J.M., 2008: Survey of medicinal plants used in the region Northeast of Brazil. Braz. J. Pharmacog. 18, 472-508. DOI: 10.1590/S0102-695X2008000300023 al-QuRan, S., 2009: Ethnopharmacological survey of wild medicinal plants in Showbak, Jordan. J. Ethnopharmacol. 123, 45-50. aWoyemi, O.K., eWa, E.E., aBDulkaRim, I.A., aDuloju, A.R., 2012: Ethnobotanical assessment of herbal plants in South Western Nigeria. Acad. Res. Int. 2, 50-57. BacheRt, C., hoRmann, K., mosges, R., Rasp, G., Riechelmann, H., mulleR, R., 2003: An update on the diagnosis and treatment of sinusitis and nasal polyposis. Allergy. 58, 176-91. BhuWan, K.C., ali, N.A.A., setzeR, W.N., 2015: A survey of chemical com- positions and biological activities of Yemeni aromatic medicinal plants. Med. 2, 67-92. coopoosamy, R.M., naiDoo, K.K., 2012: An ethnobotanical study of me- dicinal plants used by traditional healers in Durban, South Africa. Afr. J. Pharm. Pharmacol. 6, 818-823. DolD, A.P., cocks, M.L., 2000: The medicinal use of some weeds, problem and alien plants in the Grahamstown and Peddie districts of the Eastern Cape, South Africa. S. Afr. J. Sci. 96, 467-473. FoDen, W., potteR, L., 2005: Adenia spinosa Burtt Davy. National Assess- ment: Red List of South African Plants version 2015. Retrieved Feb. 7 2018, from http://redlist.sanbi.org/species.php?species=2712-12. FRieDman, J., yaniva, Z., DaFniB, A., paleWitch, D., 1986: A preliminary classification of the healing potential of medicinal plants, based on a ra- tional analysis of an ethnopharmacological field survey among Bedouins in the Negev Desert, Israel. J. Ethnopharmacol. 16, 275-287. githens, T.S., 1948: Drug Plants of Africa; Africa Handbooks no. 8. University of Pennsylvania Press, Philadelphia. iseh, K.R., makusiDi, M., 2010: Rhinosinusitis: A retrospective analysis of clinical pattern and outcome in north western Nigeria. Ann. Afr. Med. 9, 20-26. kayani, S., ahmaD, M., zaFaR, M., sultana, S., khan, M.P.Z., ashRaF, M.A., hussain, J., yaseen, G., 2015: Ethnobotanical uses of medici- nal plants for respiratory disorders among the inhabitants of Gallies- Abbottabad, Northern Pakistan. J. Ethnopharmacol. DOI: 10.1016/j.jep.2014.08.005 kokWaRo, J.O., 1976: Medicinal Plants of East Africa. East African Pub- lishing Bureau, Nairobi. kose, L.S., moteetee, A., van vuuRen, S., 2015: Ethnobotanical sur- vey of medicinal plants used in the Maseru district of Lesotho. J. Ethnopharmacol. 170, 184-200. DOI: 10.1016/j.jep.2015.04.047 mahWasane, S.T., miDDleton, L., BoaDuo, N., 2013: An ethnobotanical survey of indigenous knowledge on medicinal plants used by the tradi- tional healers of the Lwamondo area, Limpopo Province, South Africa. S. Afr. J. Bot. 88, 69-75. manzini, T.Z., 2005: Production of wild ginger (Siphonochilus aethiopicus) under protection and indigenous knowledge of the plant from traditional healers. M.Sc. dissertation. University of Pretoria, Pretoria. maRoyi, A., 2011: An ethnobotanical survey of medicinal plants used by the people in Nhema communal area, Zimbabwe. J. Ethnopharmacol. 136, 347-354. DOI: 10.1016/j.jep.2011.05.003 mavale-manuel, S., joaQuim, O., macome, C., almeiDa, L., nunes, E., 2007: Asthma and allergies in schoolchildren in Maputo. Allergy. 62, 265-271. mBeng, W.M., 2013: Antifungal evaluation and phytochemical analyses of selected medicinal plants used in the treatment of fungal diseases as- sociated with HIV infection in the Eastern Cape Province, South Africa. University of Fort Hare, Alice. metha, J., shukla, A., BukhaRiya, V., chaRDe, R., 2011: The magic rem- edy of Moringa oliferia: An overview. Int. J. Biomed. Adv. Res. 2, 215- 227. minh, V.V., yen, N.T.K., thoa, P.T.M., 2014: Medicinal plants used by the Hre community in the Bato district of central Vietnam. J. Med. Plants Stud. 2, 64-71. nazRi, M., Bux, S.I., tengku-kamalDen, T.F., ng, T.-H., sun, Z., 2013: Incidental detection of sinus mucosal abnormalities on CT and MRI imaging of the head. Quant. Imaging Med. Surg. 3, 82-88. DOI: 10.3978/j.issn.2223-4292.2013.03.06 nRiagu, J., RoBins, T., gaRy, L., liggans, G., Davila, R., supuWooD, K., haRvey, C., jinaBhai, C.C., naiDoo, R., 1999: Prevalence of asthma and respiratory symptoms in south-central Durban, South Africa. Eur. J. Epidemiol. 15, 747-755. nzue, A.P.M., 2009: Use and conservation status of medicinal plants in the Cape Peninsula, Western Cape Province of South Africa. M.Sc. disserta- tion. University of Stellenbosch, Cape Town. olusesi, A.D., tshipukane, D.N., 2011: Management of allergic rhinitis and chronic rhinosinusitis in developing countries - focus on Africa. In: Akdis, C.A., Hellings, P.W., Agache, I. (eds.), Global atlas of allergic rhi- nitis and chronic rhinosinusitis. The European Academy of Allergy and Clinical Immunology, Zurich, Switzerland. phillips, O.L., gentRy, A.H., 1993: The useful plants of Tambopata, Peru: II additional hypotheses testing in quantitative ethnobotany. Econ. Bot. 47, 33-43. RaDojicic, C., 2012: Sinusitis. Retrieved Feb. 23 2018, from http:// www. clevelandclinicmeded.com. RameshkumaR, S., RamakRitinan, C.M., 2013: Floristic survey of tradi- tional herbal medicinal plants for treatments of various diseases from coastal diversity in Pudhukkottai District, Tamilnadu, India. J. Coast Life Med. 1, 225-232. RIGHTDIAGNOSIS, 2016: Sinusitis: Retrieved 06 February 2018, from Http://www.rightdiagnosis.com/sym/chronic_sinusitis.htm. RoBeRts, M., 1990: Indigenous Healing Plants. Southern Book, Halfway House, South Africa. ReuleR, J.B., lucas, L.M., kumaR, K.L., 1995: Sinusitis - A review for generalists. West. J. Med. 163, 40-48. sami, A.S., scaDDing, G., malik, M., amjaD, M., 2013: Rhinitis, sinu- sitis and ocular disease – 2091. The MSYPQ: Repeatability and applica- bility to rhinitis/rhinosinusitis. World Allergy Organ. J. 6, 169. DOI: 10.1186/1939-4551-6-S1-P169 shi, J., Fu, Q.L., zhang, H., 2015: Epidemiology of chronic rhinosinusitis: results from a cross-sectional survey in seven Chinese cities. Allergy 70, 533-539. DOI: 10.1111/all.12577 slavin, G.R., kalineR, M.A., kenneDy, W.D., viRant, F.S., WalD, E.R., 2005: The diagnosis and management of sinusitis: A practice parameter Plants used for sinusitis and related symptoms 295 update. J. Allergy Clin. Immunol. 116, 13-47. DOI: 10.1016/j.jaci.2005.09.048 SOUTHAFRICA.INFO, 2017: South African Geography. Retrieved Feb. 7, 2018, from Http://www.southafrica.info/about/geography/limpopo.htm#. V-uLO_v6vmQ; 2016. spiegel, J.H., 2004: Sinusitis. Otolaryngol. Clin. North Am. 37, 221-506. sunali, S.K., ghaRpuRe, A.S., 2012: Correlation of increased sinusitis and urban air pollution. Indian J. Sci. Technol. Res. 1, 14-17. thRing, T.S.A., Weitz, F.M., 2005: Medicinal plant use in the Bredasdorp/ Elim region of the Southern Overberg in the Western Cape Province of South Africa. J. Ethnopharmacol. 103, 261-275. DOI:10.1016/j.jep.2005.08.013 tyagi, R., menghani, K., 2014: A review on Plumabgo zeylanica : A com- pelling herb. Int. J. Pharm. Sci. Rev. Res. 5, 119-126. van Wyk, B., ouDshooRn, V., geRicke, N., 1997: Medicinal plants of South Africa. Briza Publications, Pretoria. Wickens, G.E., 1979: The uses of the baobab (Adansonia digitata L.) in Africa. In: Kunkel, G. (ed.), Taxonomic aspects of African economic botany. A.E.T.F.A.T. Las Palmas de Gran Canaria. WoRRall, G., 2011: Acute sinusitis. Can. Fam. Physician. 57, 565-567. yoRk T., 2012: An ethnopharmacological study of plants used for treat- ing respiratory infections in rural Maputaland. Podium presentation, Faculty of Science and Agriculture Annual Post-graduate Symposium. University of Zululand, Oct. 27 2011 yoRk, T., van vuuRen, S.F., De Wet, H., 2012: An antimicrobial evalua- tion of plants used for the treatment of respiratory infections in rural Maputaland, KwaZulu-Natal, South Africa. J. Ethnopharmacol. 31, 118-127. DOI: 10.1016/j.jep.2012.08.038 Address of the corresponding author: E-mail: sebuasemenya@gmail.com/sebua.semenya@ul.ac.za © The Author(s) 2018. This is an Open Access article distributed under the terms of the Creative Commons Attribution Share-Alike License (http://creative- commons.org/licenses/by-sa/4.0/). I Supplementary material Su pp le m en ta ry fi le : T ab . 2: U se o f s pe ci es to tr ea t s in us iti s (S ) an d re la te d sy m pt om s w ith in th e di st ric ts a nd m un ic ip al iti es D is tr ic ts a nd m un ic ip al iti es C ap ri co rn S ek hu kh un e W at er be rg S pe ci es n am e Aganang Blouberg Lepelle-Nkumpi Molemole Polokwane Sum of ailment (FC) Elias Motsoaledi Ephrime Mogale Fetakgomo Makhudumathamaga Tubatse Sum of ailment (FC) Bela-Bela Lephalale Modimolle Mogalakwena Mookgophong Thabazimbi Sum of ailment (FC) Sum of overall ailment treated per species A ca ci a se ne ga l - S :1 - - - 1 - - - - - 0 S :3 - - - - - 3 4 A ca ci a to rt ili s S :1 - - S : 1 0 - 11 - - - - - 0 - - - - - - 0 11 A co ka nt he ra r ot un da ta - - - - - 0 S :4 - - - - 4 - - - - - - 0 4 A da ns on ia d ig ita ta F A : 1 4 F A : 1 5 F A :1 1 F A : 1 3 F A : 1 5 68 F A :1 3 F A :8 F A :6 F A :8 F A :6 41 F A :5 F A :1 - F A :4 F A :8 F A :5 23 13 2 - - - - - 0 - - F A :6 - - 6 - - - - - - 0 6 A de ni a sp in os a S :7 - - S :1 S :2 10 - - - - - 0 - - - - - - 0 10 A lo e sp p. S :1 - S :1 - S :2 4 - - S :1 - - 1 - - - - - - 0 5 - - - - - 0 - - - - - 0 - F E :1 - - - - 1 1 A rt em is ia a fr a - - - - - 0 S :1 ” - - - - 1 - - - - - - 0 1 C an na bi s sa tiv a - - - - - 0 - - - - - 0 - F E :1 - - - - 1 1 C ar is sa b is pi no sa S :1 ” - - - 1 - - - - - 0 - - - - - - 0 1 C itr us li m on - - - - - 0 - - - - - 0 - F E :1 - F E :1 F E :4 F E :4 10 10 C le m at is b ra ch ia ta - - - - - 0 S :3 S :2 S :2 S :1 S :2 10 - - - - - - 0 10 C le ro de nd ru m te rn at um S :1 4 S :1 5 S :1 1 S :1 3 S :1 5 68 S :1 3 S :8 S :6 S :8 S :6 41 S :5 S :1 - S :4 S :8 S :5 23 13 2 C ro to n gr at is si m us - - - - - 0 - - - - - 0 S :5 - - - - - 5 5 C ry pt oc ar ya tr an sv aa le ns is S :1 4 S :1 5 S :1 1 S :1 3 S :1 5 68 S :1 3 S :8 S :6 S :8 S :6 41 S :5 S :1 - S :4 S :8 S :5 23 13 2 C yp er us s ex an gu la ris - - - - - 0 - - - - - 0 - F E :1 - - - - 1 1 - - - - - 0 - - - - - 0 - F E :1 - F E :1 F E :4 F E :4 10 10 E uc al yp tu s ca m al du le ns is - - - - - 0 - S :1 - - - 1 - - - - - - 0 1 E nc ep ha la rt os tr an sv en os us F A :1 4 F A : 1 5 F A : 1 1 F A : 1 3 F A :1 5 68 F A : 2 - F A :3 F A : 2 F A : 1 8 - F A : 2 - F A : 2 F A : 1 - 5 81 E ni co st em a ax ill ar e S :1 4 S :1 5 S :1 1 S :1 3 S :1 5 68 S :1 3 S :8 S :6 S :8 S :6 41 S :5 S :1 - S :4 S :8 S :5 23 13 2 E ry th rin a ly si st em on S :1 ” - - - - 1 - - - - - 0 - - - - - - 0 1 E uc om is p al lid ifl or a - S :1 - - - 1 - - - - - 0 - - - - - - 0 1 E up ho rb ia s ch in zi i - - S : 4 S :1 S :2 7 - - - - - 0 - - - - - - 0 7 K al an ch oe b ra ch yl ob a S :1 4 S :1 5 S :1 1 S :1 3 S : 1 5 68 S :1 3 S :8 S :6 S :8 S :6 41 S : 5 S : 1 - S :5 S :8 S :5 23 13 2 La nt an a ru go sa - - - - - 0 - - - - - 0 - F E :1 - F E :1 F E :4 F E :4 10 10 Li pp ia ja va ni ca S :2 - - - - 2 S :1 ” S :1 - S :3 - 4 S :5 - - - - - 5 11 La si os ip ho n ca ffe r S :1 4 S :1 5 S :1 1 S :1 3 S :1 5 68 S :1 3 S :8 S :6 S :8 S :6 41 S :5 S :1 - S :4 S :8 S :5 23 13 2 M en th a lo ng ifo lia - - - - - 0 - - - - - 0 - F E :1 - F E :1 F E :4 F E :4 10 10 M or in ga o le ife ra F A :1 4 F A :1 5 F A :1 1 F A :1 3 F A :1 5 68 F A :1 3 F A :8 F A :6 F A :8 F A :6 41 F A :5 F A :1 - F A :4 F A :8 F A :5 23 13 2 N ic ot ia na ta ba cu m S :1 - - - - 1 S :1 - - - - 1 - - - - - S :1 1 3 P el to ph or um a fr ic an um S :2 - - - - 2 S :5 - - - - 5 - - - - - - 0 7 P lu m ba go z ey la ni ca - - - - - 0 - - - - - 0 - F E :1 - F E :1 F E :4 F E :4 10 10 P ro te a ca ffr a - - - - - 0 S :1 - - - - 1 - - - S :1 - - 1 2 P si ad ia p un ct ul at a - - - - - 0 - - - - - 0 - F E :1 - F E :1 F E :4 F E :4 10 10 P ta er ox yl on o bl iq uu m - - - - - 0 - - - - - 0 - - - - F E :4 - 4 4 S ch in us m ol le - - - - - 0 - - 0 - - 0 - F E :1 - F E :1 F E :4 F E :4 10 10 S ch ku hr ia p in na ta F A :1 - - - - 1 - - - - - 0 - - - F A :4 - - 4 5 S cl er oc ar ya b irr ea S :1 4 S :1 5 S :1 1 S :1 3 S :1 5 68 S :1 3 S :8 S :6 S :8 S :6 41 S :5 S :1 - S :4 S :8 S :5 23 13 2 S en na it al ic a - - - - - 0 - S :2 S :1 - - 3 S :2 - - - - - 2 5 S ip ho no ch ilu s ae th io pi cu s S :1 4 S :1 5 S :1 1 S :1 3 S :1 5 68 S :1 3 S :8 S :6 S :8 S :6 41 S :5 S :1 - S :4 S :8 S :5 23 13 2 S ol an um p an du rif or m e - - - - - 0 - - - - S :4 4 - - - - - 0 4 S or gh um b ic ol or F A :2 F A :8 - - F A :2 12 - - - F A :6 - 6 - - - - - - 0 18 S pi ro st ac hy s af ric an a - - - - - 0 - S : 2 - - - 2 - - - - - 0 2 S ty lo ch ae to n na ta le ns is S :1 4 S :1 5 S :1 1 S :1 3 S :1 5 68 S :1 3 S :8 S :6 S :8 S :6 41 S :5 S :1 - S :4 S :8 S :5 23 13 2 - - - - - 0 - - - - - 0 - F E :1 - F E :1 F E :4 F E :4 10 10 V er no ni a na ta le ns is - - - - - 0 - - - - S :6 6 - - - - - - 0 6 W ar bu rg ia s al ut ar is S :1 - - - - 1 - - S :3 - - 3 - - - - - - 0 4 K ey : f at ig ue : F A , fe ve r: F E , l ac k of a pp et ite : L A , s in us iti s: S , s or e th ro at : S T. P la in n um er ic in di ca te n um be r of h ea le r/ s w ho u se a s pe ci es to tr ea t a n ai lm en ts w hi ls t n um er ic w ith a q uo ta tio n m ar k in di ca te n um be r of h ea le r/ s w ho u se a s pe ci es in co m bi na tio n to tr ea t a n ai lm en t/s