Ethnobotanical review of antidiarrhoeal medicinal plants used in the KwaZulu-Natal Province, South Africa

Introduction Diarrhoea remains a major public health challenge in sub-Saharan Africa, particularly among children under five. In the KwaZulu-Natal Province, South Africa, traditional medicine is widely used to treat diarrhoeal diseases. Although several plants are used in the province to treat diarrhoea, no comprehensive review synthesising the available literature has been published to date. Therefore, this study aimed to undertake a systematic review of the ethnobotanical knowledge on medicinal plants used traditionally to manage diarrhoea in the KwaZulu-Natal Province. Methods The preferred reporting items for systematic reviews and meta-analyses guidelines were followed. Relevant English-language studies published up to January 2023 were retrieved from PubMed, ScienceDirect, Web of Science, Scopus, and Google Scholar. Theses and dissertations were accessed from the University of Johannesburg repository. Results From 65 eligible studies, 67 medicinal plants from 33 families were recorded. Asteraceae and Fabaceae were the most represented families (13.43% each). Trees dominated growth forms (42.11%), while leaves (24.78%) and bark (23.89%) were the most used plant parts. Decoctions (76.12%) and infusions (20.89%) were the primary preparation methods, with oral and enema routes as the main administration modes. Conclusions This review provides the first province-specific ethnobotanical synthesis of antidiarrhoeal medicinal plants in KwaZulu-Natal. The findings offer a foundation for pharmacological validation, inform conservation efforts, and support the integration of traditional knowledge into evidence-based healthcare strategies.