Seahorses Hippocampus spp. are commercially and culturally important to many communities. Although seahorses are widely used in traditional medicine, as curios and as aquarium fishes in Southeast Asia, documentation on the current nature and extent of culturally motivated seahorse uses in Malaysia is lacking. To examine how ethnicity and other socio-demographic drivers shape traditional medicinal use and underlying cultural beliefs involving seahorses, we administered a questionnaire-based survey during March 2021–April 2022 to members of the general public and fishers in Malaysia. Approximately one-fifth (21.0%) of respondents reported consuming seahorses (34.4% of these used seahorses for medicinal purposes, 55.2% for other non-medicinal uses and 10.4% for both types). Consumers of seahorses were from all ethnic groups except for Indigenous groups. In the general public group, medicinal use was more common amongst the Chinese respondents, whereas in the fisher group, other uses were more common amongst the Malay respondents. Amongst the threats facing seahorses, which include overfishing, habitat destruction, bycatch and ocean plastic pollution, only bycatch was perceived as a major threat by most of the general public and fisher respondents. The relatively low prevalence of reported seahorse use amongst Malaysians is an encouraging finding from a conservation perspective. However, the high proportion of non-medicinal uses indicates the need to focus on such other uses to ensure the sustainability of seahorse use in Malaysia.

This paper examines the significance of divination in traditional African medicine, highlighting its impact on patient trust, perception and health outcomes. Through critical reflections, this paper interrogates the power dynamics, epistemological assumptions and ontological commitments underlying traditional medical practices, exposing the complex interplay between divination, health and wellness. By exploring the intersection of traditional medicine and modern healthcare in Africa, this research aims to deepen our understanding of divination’s role in promoting holistic well-being. This reflection concludes by suggesting ways to integrate traditional medicine into modern healthcare practices, emphasizing the importance of recognizing and respecting indigenous beliefs and practices. Ultimately, this research contributes to the growing body of literature on traditional medicine and its potential to enhance healthcare delivery in Africa.

Nearly 80% of the world’s population trusts traditional medicine and plant-based drug compounds to improve health, and more than 50% of women who participated in a study have used herbal remedies during pregnancy. Bocconia frutescens L. is a plant native to tropical America, where infusion of its leaves has been widely used for the treatment of several gastrointestinal disorders. We have already shown that orogastric consumption of B. frutescens L. during the organogenesis period at concentrations equivalent to human consumption produces teratogenic effects in rats, but effects on progeny development have not yet been studied. In this study, we aimed to investigate the possible association between the consumption of B. frutescens L. at a dose equivalent to that consumed by humans and the neurological development of rat progeny. Pregnant Wistar rats were administered lyophilized B. frutescens L. extract at 300 mg/kg/day or vehicle via the orogastric route during the organogenesis period (gestation days 7–13). The physical development and sensory and motor maturation of their offspring during lactation were analyzed with a battery of reflex and physical tests. B. frutescens L. produced a significant delay in physical development and sensorimotor maturation, compared to the control group. Proton nuclear magnetic resonance spectroscopy analysis showed signals for both flavonoids and alkaloids in the B. frutescens L. extract. We conclude that the delay in physical and neurological development could be interpreted as alterations in the maturation of some neuronal circuitries induced by B. frutescens L.

Exploring traditional healing practices in the Arab world unveils a diverse range of methods deeply rooted in ancient beliefs. Traditional healing practices encompass natural remedies, spiritual rituals and physical treatments. These historical practices persist today, reflecting their enduring relevance in Arab culture and their influence on healthcare approaches. Factors such as accessibility to traditional healing services, a lack of affordable medical treatment, cultural familiarity and a strong belief in the efficacy of traditional healing methods in treating mental problems contribute to their continued use. However, potential challenges arise when an exclusive reliance on traditional methods might hinder access to critical medical interventions. Thus, the need for further documentation and research into these deeply ingrained healing traditions is emphasised. Some research has focused on integrating these traditional approaches with the modern medical system, recognising their combined value in healthcare. This balanced approach holds the potential to bridge the gap between culturally informed traditional practices and contemporary medical treatments.

Edible clays are consumed by diverse groups of people, especially of African descent, living in Africa and abroad, in a behavior known as geophagy. The clays are used topically as an emollient and drying agent and internally to control diarrhea. Scientific information concerning the chemical constituents and toxicity of edible clays is scarce. The aims of the present study, therefore, were to ascertain the chemical composition of white edible clays (WEC) and gray edible clays (GEC); to determine their toxicity profiles using analytical chemical methods; to test the acute and sub-acute toxicity of edible clays in their natural form as consumed; and to compare the raw and processed clays, and also to compare the latter to a proprietary drug known as ‘Mist kaolin’ (Moko®) which contains some clay along with other chemicals. Atomic absorption spectroscopy (AAS) and gas chromatography/mass spectrometry (GC/MS) were used to determine the elements present. White female Wistar mice and rats were used for the acute and sub-acute toxicity analyses, respectively. The results from AAS showed the presence of heavy metals and metalloids in both GEC and WEC, and the GC/MS revealed the presence of contaminants such as indomethacin and ethyl benzene, but quantities were below human toxicity levels. Doses of 100–500 mg/kg of either clay type could be harmful to the digestive system, but all of the tests revealed that edible clay is not toxic to humans unless very large amounts (500–1000 mg/kg of body weight) are consumed.

This paper interrogates the depoliticising effects of a seemingly neutral regulatory drive at the heart of the World Health Organization (WHO)'s promotion of traditional medicine. Emerging at WHO in the late 1960s against a political backdrop of decolonisation and pan-Africanism, traditional medicine has continued to be promoted in subsequent decades, culminating in the latest global Traditional Medicine Strategy (2014 to 2023). Yet WHO's promotion and acceptance of traditional medicine have also become increasingly conditional upon its standardisation and regulation – something that appears fundamentally at odds with traditional medicine's heterogeneity. Drawing on insights from critical law and science and technology studies, we suggest that such a process at WHO has done more than simply disqualify the toxic and the dangerous. Rather, it has implicitly and explicitly marginalised and excluded those aspects of traditional medicine that deviate from scientific, biomedical ways of seeing, knowing and organising.

South-East Asian refugees have lived in the United States of America for nearly four decades, with early refugee immigrants experiencing ageing and later life within the refugee context. As refugees age, health concerns of this older population grow, highlighting the need for ongoing assessment of refugee health and health-seeking behaviours. This study builds on previous literature that assessed the health and health-seeking patterns of South-East Asian refugees in the early years following resettlement, exploring how health and health-seeking is understood among older refugees 40 years after immigration. This paper includes a subset of 37 older refugees from a larger, community-based participatory, mixed-methods intergenerational study of Cambodian and Laotian refugee families conducted over four years (quantitative N = 433; qualitative N = 183). Thematic analysis of 34 semi-structured interviews with these older refugees in coastal Alabama revealed trends in health and health-seeking practices. Older refugees reported high rates of diabetes and hypertension within their generational cohort, and indicated a shift in health-seeking behaviours, whereby Western biomedicine is sought first for such chronic concerns, followed by traditional medicines for mild ailments such as headaches or colds. Older refugees underscored barriers of language, finances and transportation as limiting access to Western health care. Implications for engaging in community health practices and incorporating services to specifically meet the needs of the ageing refugee population are discussed.

Praziquantel (PZQ) remains the only drug of choice for the treatment of schistosomiasis, caused by parasitic flatworms. The widespread use of PZQ in schistosomiasis endemic areas for about four decades raises concerns about the emergence of resistance of Schistosoma spp. to PZQ under drug selection pressure. This reinforces the urgency in finding alternative therapeutic options that could replace or complement PZQ. We explored the potential of medicinal plants commonly used by indigenes in Kenya for the treatment of various ailments including malaria, pneumonia, and diarrhoea for their antischistosomal properties. Employing the Soxhlet extraction method with different solvents, seven medicinal plants Artemisia annua, Ajuga remota, Bredilia micranta, Cordia africana, Physalis peruviana, Prunus africana and Senna didymobotrya were extracted. Qualitative phytochemical screening was performed to determine the presence of various phytochemicals in the plant extracts. Extracts were tested against Schistosoma mansoni newly transformed schistosomula (NTS) and adult worms and the schistosomicidal activity was determined by using the adenosine triphosphate quantitation assay. Phytochemical analysis of the extracts showed different classes of compounds such as alkaloids, tannins, terpenes, etc., in plant extracts active against S. mansoni worms. Seven extracts out of 22 resulted in <20% viability against NTS in 24 h at 100 μg/ml. Five of the extracts with inhibitory activity against NTS showed >69.7% and ≥72.4% reduction in viability against adult worms after exposure for 24 and 48 h, respectively. This study provides encouraging preliminary evidence that extracts of Kenyan medicinal plants deserve further study as potential alternative therapeutics that may form the basis for the development of the new treatments for schistosomiasis.

The double burden of communicable and noncommunicable diseases is a major threat to the Indian public health system. AYUSH, an acronym for Ayurveda, Yoga and Naturopathy, Unani, Siddha, Sowa-Rigpa, and Homeopathy, represents the Indian system of medicine recognized by the Government of India. Mainstreaming of AYUSH is one of the key strategies of the Indian government for tackling increasing disease burden through initiatives such as AYUSH wellness centers, telemedicine, and quality control measures for medications in the AYUSH system of medicine. Such investment of resources in health systems may require economic evaluations. However, such evaluations are lacking in the AYUSH system, except for a few in homeopathy and yoga. In the absence of evidence from economic evaluations, researchers and decision makers are guided mostly by clinical efficacy while formulating healthcare strategies. In view of the increasing use of AYUSH across the country, economic evaluations of the AYUSH system are the need of the hour to aid healthcare decision making.

Traditional and complementary medicines are increasingly considered possible options for prevention and symptomatic treatment of the novel coronavirus, COVID-19. With renewed attention on these therapies from researchers and policy makers alike, the well-documented challenges of evaluating their safety and efficacy are once again of global concern. Between 2005 and 2018, the World Health Organization conducted a series of surveys, in which 88 percent of responding member states confirmed that their biggest challenge in traditional medicine was the need for technical guidance on research and evaluation. As a first step in pursuing this need, our commentary summarizes thirteen international and regional guidance documents by three broad categories on evaluating safety, efficacy, and product quality for market-based approval and distribution of these treatments. We highlight the paucity of updated international recommendations on these subjects and identify gaps that could inform the current evidence base. All available guidance note the need for evidence surrounding the efficacy of these treatments and practices but are also quick to caution against methodological difficulties in the conduct of such evaluations. Evidence suggests that improved evaluation methods on efficacy and effectiveness are crucial toward expanding future research into establishing the cost-effectiveness of these therapies, in the context of shifting acceptance, interest, and integration of traditional medicines into health systems, and as another step toward Universal Health Coverage.

We investigated the range of people involved in killing tigers Panthera tigris in the Bangladesh Sundarbans, their motives and methods, and their links to the commercial trade. Using snowball sampling we conducted 141 qualitative interviews with local people. We identified five categories (village residents, poachers, shikaris, trappers and pirates), each with different motives, methods and networks. Village residents kill tigers predominantly for safety, whereas others kill in the forest professionally or opportunistically. Poachers kill tigers for money, but for others the motives are more complex. The motives of local hunters are multifaceted, encompassing excitement, profit, and esteem and status arising from providing tiger parts for local medicine. Pirates kill tigers for profit and safety but also as a protection service to the community. The emerging international trade in tiger bones, introduced to the area by non-local Bangladeshi traders, provides opportunities to sell tiger parts in the commercial trade and is a motive for tiger killing across all groups.

Diurnal raptors have declined significantly in western Africa since the 1960s. To evaluate the impact of traditional medicine and bushmeat trade on raptors, we examined carcasses offered at markets at 67 sites (1–80 stands per site) in 12 countries in western Africa during 1990–2013. Black kite Milvus migrans and hooded vulture Necrosyrtes monachus together accounted for 41% of 2,646 carcasses comprising 52 species. Twenty-seven percent of carcasses were of species categorized as Near Threatened, Vulnerable or Endangered on the IUCN Red List. Common species were traded more frequently than rarer species, as were species with frequent scavenging behaviour (vs non-scavenging), generalist or savannah habitat use (vs forest), and an Afrotropical (vs Palearctic) breeding range. Large Afrotropical vultures were recorded in the highest absolute and relative numbers in Nigeria, whereas in Central Africa, palm-nut vultures Gypohierax angolensis were the most abundant vulture species. Estimates based on data extrapolation indicated that within West Africa 73% of carcasses were traded in Nigeria, 21% in Benin and 5% elsewhere. Offtake per annum in West Africa was estimated to be 975–1,462 hooded vultures, 356–534 palm-nut vultures, 188–282 Rüppell's griffons Gyps rueppellii, 154–231 African white-backed vultures Gyps africanus, 143–214 lappet-faced vultures Torgos tracheliotos, and 40–60 crowned eagles Stephanoaetus coronatus. This represents a sizeable proportion of regional populations, suggesting that trade is likely to be contributing significantly to declines. Stronger commitment is needed, especially by governments in Nigeria and Benin, to halt the trade in threatened raptors and prevent their extirpation.

The orange-bellied Himalayan squirrel Dremomys lokriah is used for medicinal purposes by the Apatani community in north-east India. The monetary value of the species has increased 40-fold since 1986. Hunting is perceived to be the primary cause of the decline of D. lokriah but this is now being curtailed through a unique social restriction system (Dapo) under the administration of the traditional village council (Builyang). Here we report on the socio-ecological values of D. lokriah and the traditional hunting system, and conservation initiatives implemented by the Apatani community to conserve the species. This initiative is an opportunity for government agencies and conservationists to merge a traditional knowledge system with modern conservation methods and strengthen participatory conservation management.

Seahorses and their syngnathid relatives have provided a focus for efforts to ensure sustainable use of marine resources, with new international trade controls (CITES Appendix II) implemented in May 2004. We demonstrate how a study of international trade can be used to assess relative levels of threat and set domestic research and conservation priorities. Australia has remarkably high syngnathid biodiversity with at least 14 seahorse species, two endemic sea dragon species, and 90 species of pipefishes and pipehorses found in its territorial waters. Our objectives were to quantify species, trade routes, volumes, values and temporal trends in syngnathid trade to and from Australia. We found that Australia is probably the major global supplier of dried pipehorses Solegnathus spp.. These fishes, including at least one endemic species, are sourced from trawl bycatch and comprise Australia's largest syngnathid export, by both volume and value. Research is urgently needed to evaluate the impacts and sustainability of trawling on pipehorse populations. Australia is also the sole supplier of two sea dragon species, Phycodurus eques and Phyllopteryx taeniolatus, for the live aquarium trade. Although lucrative, the number of wild-caught individuals involved in this trade was relatively low and probably of low conservation risk relative to habitat loss. Exports of seahorses and other pipefish species, and imports of all syngnathid species, are minor on a global scale, although the burgeoning aquaculture industry for seahorses requires careful evaluation for its potential impacts on wild populations.

Sea moths (family Pegasidae) are little-studied benthic fish, found throughout the Indo-Pacific. Two species of sea moths, Pegasus volitans and Eurypegasus draconis, are caught incidentally in illegal trawl gear in the Philippines and sold into the dried fish trade. Approximately 130,000–620,000 P. volitans and 130,000 E. draconis were landed off north-western Bohol alone in 1996. An additional 43,000–62,000 sea moths (predominantly P. volitans) were caught live for the aquarium trade. Catch per unit effort for P. volitans was double that of E. draconis, probably because of its occurrence in shallower waters where fishing effort was concentrated. Sea moths may be unsuited for heavy exploitation as they occur at low densities. Moreover, a female-biased catch could lower the effective population size, given the reported monogamy amongst sea moths. No population data were available for a complete conservation assessment, although divers surveyed did report declines in their abundance.

Zingiber kelabitianum from Sarawak, Borneo is described. This new species belongs to section Zingiber, having radical, erect inflorescences. It is related to Z. pachysiphon B.L. Burtt & R.M. Sm. in the large size of the plant and the robust, cylindrical inflorescences with deflexed bracts. It differs in the dense, yellow-brown indumentum of the leaf sheath and ligules, the bright red bracts, the longer bracteole and the free, well-developed lateral lobes of the labellum. The traditional uses of the plant by the indigenous people, the Kelabits, are described.

The Mayan people of Mexico have a radically different concept of illness than that of western countries. In the absence of any formal psychiatric service in their area, the people continue to rely on the interventions of the traditional healers, which include the use of herbal medicines, prayers and magico-religious rituals. A case history of a Mayan patient with a chronic psychotic illness is described, which illustrates the gulf in concepts of mental illness that exists between Western and folk cultures. These cultural differences may have a profound impact on the application of modern psychiatric interventions in developing countries.