Indigenous Knowledge and Utilisation of Strychnos spinosa Lam. in Sub-Saharan Africa: A Systematic Review of Its Medicinal, Nutritional, and Cultural Significance

Abstract

In sub-Saharan Africa, indigenous knowledge is a vital source of information about the local environment, including the identification and use of various plant species. One plant species that has attracted much attention in the area is Strychnos spinosa Lam., as local communities utilise it for various purposes, such as medicinal, nutritional, and cultural. A systematic search for eligible studies was carried out by exploring different electronic databases, such as JSTOR, ScienceDirect, PubMed, and Google Scholar. The survey yielded 61 eligible studies, highlighting the diverse of uses of S. spinosa. The literature indicates that 37% of African countries have studied S. spinosa, mainly in Southern Africa. Most studies used semi-structured interviews, but over 70% did not analyse the plant’s nutritional and bioactive compounds. The research highlighted six distinct S. spinosa plant parts used for managing different ailments and conditions in Africa. Roots (25%), along with bark and fruits (23%), are primarily used for digestive disorders and fever; this was followed by leaves (20%) and wood (6%). The least utilised plant part was the radix or cortex (3%). These findings emphasise a significant gap in the understanding of S. spinosa’s nutritional and bioactive compounds, emphasising the need for quantitative research on its phytochemical properties and therapeutic applications within African traditional medicine.

1. Introduction

The world is currently confronted with urgent environmental issues, including climate change, deforestation, habitat loss, and biodiversity depletion [1]. It is becoming increasingly clear that indigenous knowledge systems (IKSs) can play a critical role in environmental conservation [2]. These systems contain a wealth of knowledge about local ecosystems, agroecosystems, and sustainable resource management [2,3]. Indigenous people, who have lived in harmony within their natural surroundings for generations, possess invaluable knowledge that can contribute to protecting and preserving the environment [4,5]. However, the older generation is predominantly the custodian of information [3].

Indigenous knowledge (IK) refers to the knowledge, practices, and beliefs accumulated and passed down through generations within specific cultural groups [6]. The use of IK has been a critical aspect of natural resource management, especially in rural communities across Africa, as most developing countries rely on local remedies from traditional medicines for their healthcare needs [7,8,9]. Studies by Bhatta [2], Mpofu, and Miruka [3] have shown that IK is more practiced by the elderly than the young generation. One main factor that influences this is the spread of urbanisation and globalisation [3].

Mpofu and Miruka [3] articulated that young people often lack interest in IKSs because these wisdom, skills, and practices developed by indigenous peoples over generations are frequently overlooked in their activities, such as the school curriculum. Modern school subjects are often valued more highly than IK. As a result, IK is losing ground globally. The potential for finding new solutions to today’s most challenging health and environmental issues is at risk of being lost [10]. IK can complement modern science by providing context-specific insights into local ecosystems and sustainable resource management practices [4]. Unlike conventional scientific methods, which often adopt a universal approach, IK is rooted in long-term observation, adaptive management, and holistic perspectives [5,6]. For example, indigenous practices of crop rotation, water conservation, and forest management have been shown to enhance biodiversity and maintain ecosystem balance [7]. Integrating IK with scientific research enables policymakers and conservationists to develop more effective strategies for addressing climate change and biodiversity loss [8].

Collaborative efforts between indigenous communities and scientists can promote mutual learning and innovation, resulting in hybrid solutions that align with scientific principles and cultural traditions [9]. Furthermore, recognising and integrating IK into environmental governance can bolster community-based conservation initiatives and empower local populations to actively participate in safeguarding their natural heritage. This approach not only improves ecological resilience but also aids in the preservation of cultural heritage and the promotion of social equity [7,9]. In sub-Saharan Africa, IK is an essential repository of information about the local environment, including identifying and using various plant species for medicinal purposes, culinary uses, ecological understanding, and conservation efforts [11].

One such plant species that has garnered significant interest in the African region is Strychnos spinosa Lam. This flowering plant belongs to the family Loganiaceae, within the order Gentianales, commonly known as “monkey orange” or “umKwakwa” [10]. This tree is endemic to Africa [12,13]. In South Africa, it is densely distributed in 44.5% of provinces [13,14]. Strychnos spinosa has acclimatised to drought and low soil fertility [15,16]. Local communities have utilised it for medicinal, nutritional, and cultural purposes [17]. However, the botanical uses of S. spinosa and the factors determining its utilisation within different communities still need to be studied [9,12,14,18].

Studies by Omotayo and Aremu [2], Aremu and Moyo [11] highlighted the excellent potential for S. spinosa to add value to sustainable food systems and health benefits. These studies also highlighted the S. spinosa fruit’s high nutritional content, which includes essential vitamins such as vitamin C, minerals like iron and zinc, and phytochemical compounds with antioxidant qualities. The fruit is drought-tolerant and grows well in soils with low fertility, which makes it a good option for addressing food and nutrition insecurity, especially in the rural and arid areas of sub-Saharan Africa. The potential of S. spinosa to improve diet quality and serve as an economic resource for marginalised communities further reinforces its significance [2].

The studies also highlight the urgent need for sustainable harvesting practices and effective monitoring systems to ensure the long-term existence of S. spinosa. Agricultural expansion, urbanisation, and related habitat destruction are major threats to its natural populations [11]. Furthermore, the absence of formal cultivation practices and reliance on wild harvesting increases the risk of depletion. Establishing guidelines for sustainable use, promoting agroforestry initiatives, and integrating local communities into conservation efforts are critical steps to mitigate these risks [2,11,12].

While S. spinosa is currently classified as “Least Concern” on the IUCN Red List [13], its widespread utilisation by local communities necessitates a reassessment of its conservation status. Ongoing usage patterns and environmental challenges suggest that its long-term availability may be at risk [2]. For instance, studies have documented its application in traditional medicine, where the roots, bark, and fruit are extensively harvested for various ailments. If these practices are not monitored, they could result in localised overexploitation [11,12]. Additionally, research indicating its importance as a renewable food supply and its beneficial bioactive characteristics calls for greater emphasis on its preservation [14].

This study is crucial for biodiversity conservation and sustainable natural resource management [15], an initiative that has already begun worldwide, particularly in regions with higher plant diversity [16,17,18]. It reveals the traditional uses of S. spinosa, providing insights into sustainable harvesting practices. The findings can also benefit environmental policymakers by incorporating IK into conservation and resource management policies. The study aims to address the gap in understanding S. spinosa’s traditional uses in African communities by reviewing existing knowledge, examining the socio-ecological impact of harvesting and use, and screening phytochemicals.

2. Materials and Methods

The Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) 2020 statement founded by Moher, et al. [19] was used to develop this study. A comprehensive electronic search of databases such as Google Scholar, JSTOR, PubMed, ScienceDirect, Scopus, Web of Science, and Wiley was conducted between April 2024 and February 2025. The inclusion criteria encompassed peer-reviewed journal articles and grey literature, such as theses, dissertations, and reports. Peer-reviewed articles were prioritised to ensure the reliability and scientific rigor of the findings. However, grey literature was included to capture valuable IK and ethnobotanical data that may not be widely available in mainstream scientific journals. Grey literature was selected based on its relevance, methodological transparency, and contribution to understanding the traditional uses of S. spinosa. Some of the leading search terms used included “indigenous knowledge”, “socio-ecological impact”, or “traditional ecological knowledge”, and “phytochemical analysis” in conjunction with “Strychnos spinosa”, “monkey orange”, and “umKwakwa”. For this study, inclusion criteria focused on studies explicitly conducted in Africa. The selection process involved three key stages: identification, which included records that met initial search terms; eligibility assessment or screening, which excluded records that were not available in full text and available in non-English; and inclusion (Figure 1).

3. Results and Discussion

3.1. Literature Results

The search through various scientific databases yielded a total of 1924 studies. After removing duplicates, 929 studies were retained. In addition, data from five sources, including theses, dissertations, and books, were obtained from the Thoko Mayekiso Library and Information Centre at the University of Mpumalanga, South Africa. The full texts of the 116 studies were reviewed in detail. About 49 studies were excluded due to no available full text, in foreign languages, and without scientific names. Furthermore, studies focused on different Strychnos species or those that did not examine traditional uses of medicinal plants as their main subjects were also discarded. Ultimately, 61 studies contributed to the inventory presented in this study (Figure 1).

According to Table 1, the studies represented 37% of African countries. More studies were conducted in Southern Africa, with seven conducted in South Africa within KwaZulu Natal Province (four) and Limpopo Province (two). Notwithstanding the studies conducted by Avakoudjo, Hounkpèvi, Idohou, Koné and Assogbadjo [12] andMbhele, et al. [20], which focused explicitly on documenting IK of the uses of S. spinosa, and the study byMadzimure, Nyahangare, Hamudikuwanda, Hove, Belmain, Stevenson and Mvumi [14], which focused on the efficacy of S. spinosa extracts on cattle ticks, the other records were part of broader ethnobotanical surveys by various researchers. Generally, semi-structured interviews or questionnaires were the predominant techniques for gathering data, with only a few having in vitro analysis. The number of participants involved in the interviews was not reported in approximately 20% of the studies.

A comprehensive assessment of nutritional and bioactive compounds found in S. spinosa was not analysed in over 70% of the studies. Authenticating the phytochemical composition of S. spinosa within different African communities is a crucial step towards understanding its pharmacological and nutritional effects [21,22]. A study conducted by Tittikpina, et al. [23] provides some insights into the chemical compounds present in S. spinosa, including alkaloids, terpenes, sterols, flavonoids, saponins, and other bioactive components. By identifying and characterising these phytochemicals, researchers can further investigate the potential therapeutic properties of S. spinosa and assess its efficacy in addressing various health conditions traditionally treated with this plant. The reviewed literature on the phytochemical composition and bioactivity of S. spinosa is limited, with seven studies focusing on the plant’s antimicrobial and antioxidant properties [14,24,25,26,27,28,29]. In-depth research into the phytochemical composition of the products made from parts of the S. spinosa plant could yield significant benefits.

Table 1. An in-depth botanical review of S. spinosa across Sub-Saharan Africa, examining its diverse ecological range, traditional medicinal uses, ethnobotanical significance, and potential for nutritional and pharmacological applications.

Author	Study Title	Location	Participant-Type	Interviewee Number	Methodological Framework	* Nutritional, Phytochemical, and/or Biological Signature
Asase, et al. [30]	Ethnobotanical study of some Ghanaian anti-malarial plants	Wechiau Community Hippopotamus Sanctuary, Ghana	Local community members, herbalists	20	Field interviews, house-to-house interviews, focus group	None
Avakoudjo, Hounkpèvi, Idohou, Koné and Assogbadjo [12]	Local knowledge, uses, and factors determining the use of Strychnos spinosa organs in Benin (West Africa)	Guinean, Sudano-Guinean and Guinean climatic zones, Benin	Farmers, THPs, cattle herdsmen, artisans, and students	733	Semi-structured questionnaires	None
Bero, Ganfon, Jonville, Frederich, Gbaguidi, DeMol, Moudachirou and Quetin-Leclercq [24]	In vitro antiplasmodial activity of plants used in Benin in traditional medicine to treat malaria	South of Benin	N/A	N/A	In vitro testing	B
Bizimana, Tietjen, Zessin, Diallo, Djibril, Melzig and Clausen [25]	Evaluation of medicinal plants from Mali for their in vitro and in vivo trypanocidal activity	Southern part of Mali	N/A	N/A	In vitro testing	B
Bruschi, et al. [31]	Traditional healers and laypeople: A qualitative and quantitative approach to local knowledge on medicinal plants in Muda (Mozambique)	Muda, Mozambique	Local leaders and laypeople THPs, Independent Pentecostal churches “prophets” and lay villagers (7/67)	67	Semi-structured interviews	None
De Wet, et al. [32]	Medicinal plants used for the treatment of various skin disorders by a rural community in northern Maputaland, South Africa	Maputaland, Republic of South Africa	Local community members	87	Structured questionnaires	None
Doka [33]	Ethnobotanical survey of medicinal plants in West Kordofan (Western Sudan)	West Kordofan, Sudan	Local practitioners	31	Semi-structured interviews	None
Karou, et al. [34]	Ethnobotanical study of medicinal plants used in the management of diabetes mellitus and hypertension in the Central Region of Togo	Central Region of Togo	THPs	55	Semi-structured questionnaires	None
Koné and Kamanzi Atindehou [35]	Ethnobotanical inventory of medicinal plants used in traditional veterinary medicine in Northern Côte d’Ivoire (West Africa)	Northern Côte d’Ivoire	Local breeders and traditional practitioners	14	Structured questionnaires	None
Lawal, Bapela, Adebayo, Nkadimeng, Yusuf, Malterud, McGaw and Tshikalange [26]	Anti-inflammatory potential of South African medicinal plants used for the treatment of sexually transmitted infections	Venda region, Limpopo, Republic South Africa	N/A	N/A	In vitro testing	B, P
Lockett, et al. [36]	Energy and micronutrient composition of dietary and medicinal wild plants consumed during drought. Study of rural Fulani, Northeastern Nigeria	Rural Fulani, Northeastern Nigeria	Elderly focus group	Not specified (Four groups of 4–8 participants)	Semi-structured questionnaires; in vitro testing	N
Madzimure, Nyahangare, Hamudikuwanda, Hove, Belmain, Stevenson and Mvumi [14]	Efficacy of Strychnos spinosa (Lam.) and Solanum incanum L. aqueous fruit extracts against cattle ticks	Henderson Research Station (HRS), Zimbabwe	N/A	N/A	In vitro testing	B, P
Magassouba, Diallo, Kouyate, Mara, Mara, Bangoura, Camara, Traore, Diallo, Zaoro, Lamah, Diallo, Camara, Traore, Keita, Camara, Barry, Keita, Oulare, Barry, Donzo, Camara, Tote, Berghe, Totte, Pieters, Vlietinck and Balde [27]	Ethnobotanical survey and antibacterial activity of some plants used in Guinean traditional medicine	Low, Middle, Upper, and Forest ecological zones of Guinea	Traditional practitioners	418	Structured questionnaires; In vitro testing	B, P
Maroyi [37]	An ethnobotanical survey of medicinal plants used by the people in Nhema communal area, Zimbabwe	Nhema communal area, Zimbabwe	Traditional practitioners	9	Participatory Rapid Appraisal approach using open-ended interviews (unstructured)	None
Mbhele, Zharare, Zimudzi and Ntuli [20]	Indigenous knowledge on the uses and morphological variation among Strychnos spinosa Lam. at Oyemeni Area, KwaZulu-Natal, South Africa	Oyemeni Area, KwaZulu-Natal, Republic of South Africa	Knowledgeable local community members	100	Structured questionnaires	None
Molander, Nielsen, Sogaard, Staerk, Ronsted, Diallo, Chifundera, van Staden and Jager [28]	Hyaluronidase, phospholipase A2 and protease inhibitory activity of plants used in traditional treatment of snakebite-induced tissue necrosis in Mali, DR Congo and South Africa	Democratic Republic of Congo, Mali, and Republic of South Africa	N/A	N/A	In vitro testing	B, P
Mhlongo and Van Wyk [38]	Zulu medicinal ethnobotany: new records from the Amandawe area of KwaZulu-Natal, South Africa	Amandawe area of KwaZulu-Natal, Republic of South Africa	Local community members	37	Freelisting; rapid ethnobotanical appraisal	None
Novotna, et al. [39]	Medicinal plants used by ‘root doctors’, local traditional healers in Bié province, Angola	Bié province, Angola	Professional herbalists	10	Participatory observation; semi-structured interviews; transect walks	None
Ruffo [40]	A Survey of medicinal plants in Tabora region [40,41]	Tabora Region, Tanzania	Traditional health practitioners	27	Structured interviews	None
Tchacondo, et al. [42]	Herbal remedies and their adverse effects in Tem tribe traditional medicine in Togo	Tchaoudjo prefecture, Togo	Traditional health practitioners	54	Rapid ethnobotanical appraisal	None
Waterman, Smith, Pontiggia and DerMarderosian [29]	Anthelmintic screening of Sub-Saharan African plants used in traditional medicine	Madagascar and Central African Republic	N/A	N/A	In vitro testing	B, P
Zwane, et al. [43]	Blood purification practices: Some ethnopharmacological insight from a rural community in KwaZulu-Natal, South Africa	Northern Maputaland, Kwazulu-Natal, Republic of South Africa	Knowledgeable local community members	55	Structured questionnaires	None
Derya, et al. [44]	Ethnobotanical survey of medicinal plants in Sissala East municipality of the upper West region, Ghana	Sissala East municipality, Ghana	THPs and knowledgeable local community members	50	Semi-structured questionnaires	None
Mohamadoua, et al. [45]	Ethnopharmacological investigation of plants used in the treatment of breast cancer in Northern Cameroon	Northern Cameroon	Traditional health practitioners	131	Semi-structured questionnaires	None
Magwede, et al. [46]	An inventory of Vhavenḓa useful plants	Venda, Republic of South Africa	Knowledgeable local community members	66	Semi-structured questionnaires	None
Mlilo and Sibanda [47]	An ethnobotanical survey of the medicinal plants used in the treatment of cancer in some parts of Matebeleland, Zimbabwe	Matebeleland, Zimbabwe	Traditional health practitioners, herbalists, apprentices, and family members of traditional health practitioners	25	Open-ended semi-structured interviews	None
Chinsembu, et al. [48]	Ethnomedicinal plants used by traditional healers in the management of HIV/AIDS opportunistic diseases in Lusaka, Zambia	Lusaka, Zambia	Traditional health practitioners	40	Semi-structured interviews	None
Aparicioa, et al. [49]	Ethnobotanical study of medicinal and edible plants used in Nhamacoa area, Manica Province, Mozambique	Nhamacoa area, Manica province, Mozambique	Randomly selected villagers	25	Free listing and semi-structured interviews; random selection	None
Shopoa, et al. [50]	Ethnobotanical study of medicinal plants traditionally used in Gokwe South District, Zimbabwe	Gokwe South District, Zimbabwe	Knowledgeable local community members	46	Semi-structured questionnaire	None
Yaoitcha, et al. [51]	Prioritization of useful medicinal tree species for conservation in Wari-Maro Forest Reserve in Benin: A multivariate analysis approach	Wari-Maro Forest Reserve, Benin	Traditionally most prominent authorities of local households	149	Semi-structured interviews	None
Hilonga, Otieno, Ghorbani, Pereus, Kocyan and de Boer [41]	Trade of wild-harvested medicinal plant species in local markets of Tanzania and its implications for conservation	Arusha, Dodoma, Mbeya, Morogoro, and Mwanza regions, Tanzania	Local herbal vendors	40	Semi-structured interviews	None
Masumbu, et al. [52]	Ethnobotanical survey of medicinal plants claimed by traditional herbal practitioners to manage cancers in Malawi	Mzimba and Nkhata Bay district of northern Malawi	Traditional health practitioners	25	Semi-structured questionnaires and purposive sampling technique	None

* Nutraceutical profile—nutritional (N), phytochemical (P), and/or biological (B) analysis of Strychnos spinosa.

Table 1. An in-depth botanical review of S. spinosa across Sub-Saharan Africa, examining its diverse ecological range, traditional medicinal uses, ethnobotanical significance, and potential for nutritional and pharmacological applications.

Author	Study Title	Location	Participant-Type	Interviewee Number	Methodological Framework	* Nutritional, Phytochemical, and/or Biological Signature
Asase, et al. [30]	Ethnobotanical study of some Ghanaian anti-malarial plants	Wechiau Community Hippopotamus Sanctuary, Ghana	Local community members, herbalists	20	Field interviews, house-to-house interviews, focus group	None
Avakoudjo, Hounkpèvi, Idohou, Koné and Assogbadjo [12]	Local knowledge, uses, and factors determining the use of Strychnos spinosa organs in Benin (West Africa)	Guinean, Sudano-Guinean and Guinean climatic zones, Benin	Farmers, THPs, cattle herdsmen, artisans, and students	733	Semi-structured questionnaires	None
Bero, Ganfon, Jonville, Frederich, Gbaguidi, DeMol, Moudachirou and Quetin-Leclercq [24]	In vitro antiplasmodial activity of plants used in Benin in traditional medicine to treat malaria	South of Benin	N/A	N/A	In vitro testing	B
Bizimana, Tietjen, Zessin, Diallo, Djibril, Melzig and Clausen [25]	Evaluation of medicinal plants from Mali for their in vitro and in vivo trypanocidal activity	Southern part of Mali	N/A	N/A	In vitro testing	B
Bruschi, et al. [31]	Traditional healers and laypeople: A qualitative and quantitative approach to local knowledge on medicinal plants in Muda (Mozambique)	Muda, Mozambique	Local leaders and laypeople THPs, Independent Pentecostal churches “prophets” and lay villagers (7/67)	67	Semi-structured interviews	None
De Wet, et al. [32]	Medicinal plants used for the treatment of various skin disorders by a rural community in northern Maputaland, South Africa	Maputaland, Republic of South Africa	Local community members	87	Structured questionnaires	None
Doka [33]	Ethnobotanical survey of medicinal plants in West Kordofan (Western Sudan)	West Kordofan, Sudan	Local practitioners	31	Semi-structured interviews	None
Karou, et al. [34]	Ethnobotanical study of medicinal plants used in the management of diabetes mellitus and hypertension in the Central Region of Togo	Central Region of Togo	THPs	55	Semi-structured questionnaires	None
Koné and Kamanzi Atindehou [35]	Ethnobotanical inventory of medicinal plants used in traditional veterinary medicine in Northern Côte d’Ivoire (West Africa)	Northern Côte d’Ivoire	Local breeders and traditional practitioners	14	Structured questionnaires	None
Lawal, Bapela, Adebayo, Nkadimeng, Yusuf, Malterud, McGaw and Tshikalange [26]	Anti-inflammatory potential of South African medicinal plants used for the treatment of sexually transmitted infections	Venda region, Limpopo, Republic South Africa	N/A	N/A	In vitro testing	B, P
Lockett, et al. [36]	Energy and micronutrient composition of dietary and medicinal wild plants consumed during drought. Study of rural Fulani, Northeastern Nigeria	Rural Fulani, Northeastern Nigeria	Elderly focus group	Not specified (Four groups of 4–8 participants)	Semi-structured questionnaires; in vitro testing	N
Madzimure, Nyahangare, Hamudikuwanda, Hove, Belmain, Stevenson and Mvumi [14]	Efficacy of Strychnos spinosa (Lam.) and Solanum incanum L. aqueous fruit extracts against cattle ticks	Henderson Research Station (HRS), Zimbabwe	N/A	N/A	In vitro testing	B, P
Magassouba, Diallo, Kouyate, Mara, Mara, Bangoura, Camara, Traore, Diallo, Zaoro, Lamah, Diallo, Camara, Traore, Keita, Camara, Barry, Keita, Oulare, Barry, Donzo, Camara, Tote, Berghe, Totte, Pieters, Vlietinck and Balde [27]	Ethnobotanical survey and antibacterial activity of some plants used in Guinean traditional medicine	Low, Middle, Upper, and Forest ecological zones of Guinea	Traditional practitioners	418	Structured questionnaires; In vitro testing	B, P
Maroyi [37]	An ethnobotanical survey of medicinal plants used by the people in Nhema communal area, Zimbabwe	Nhema communal area, Zimbabwe	Traditional practitioners	9	Participatory Rapid Appraisal approach using open-ended interviews (unstructured)	None
Mbhele, Zharare, Zimudzi and Ntuli [20]	Indigenous knowledge on the uses and morphological variation among Strychnos spinosa Lam. at Oyemeni Area, KwaZulu-Natal, South Africa	Oyemeni Area, KwaZulu-Natal, Republic of South Africa	Knowledgeable local community members	100	Structured questionnaires	None
Molander, Nielsen, Sogaard, Staerk, Ronsted, Diallo, Chifundera, van Staden and Jager [28]	Hyaluronidase, phospholipase A2 and protease inhibitory activity of plants used in traditional treatment of snakebite-induced tissue necrosis in Mali, DR Congo and South Africa	Democratic Republic of Congo, Mali, and Republic of South Africa	N/A	N/A	In vitro testing	B, P
Mhlongo and Van Wyk [38]	Zulu medicinal ethnobotany: new records from the Amandawe area of KwaZulu-Natal, South Africa	Amandawe area of KwaZulu-Natal, Republic of South Africa	Local community members	37	Freelisting; rapid ethnobotanical appraisal	None
Novotna, et al. [39]	Medicinal plants used by ‘root doctors’, local traditional healers in Bié province, Angola	Bié province, Angola	Professional herbalists	10	Participatory observation; semi-structured interviews; transect walks	None
Ruffo [40]	A Survey of medicinal plants in Tabora region [40,41]	Tabora Region, Tanzania	Traditional health practitioners	27	Structured interviews	None
Tchacondo, et al. [42]	Herbal remedies and their adverse effects in Tem tribe traditional medicine in Togo	Tchaoudjo prefecture, Togo	Traditional health practitioners	54	Rapid ethnobotanical appraisal	None
Waterman, Smith, Pontiggia and DerMarderosian [29]	Anthelmintic screening of Sub-Saharan African plants used in traditional medicine	Madagascar and Central African Republic	N/A	N/A	In vitro testing	B, P
Zwane, et al. [43]	Blood purification practices: Some ethnopharmacological insight from a rural community in KwaZulu-Natal, South Africa	Northern Maputaland, Kwazulu-Natal, Republic of South Africa	Knowledgeable local community members	55	Structured questionnaires	None
Derya, et al. [44]	Ethnobotanical survey of medicinal plants in Sissala East municipality of the upper West region, Ghana	Sissala East municipality, Ghana	THPs and knowledgeable local community members	50	Semi-structured questionnaires	None
Mohamadoua, et al. [45]	Ethnopharmacological investigation of plants used in the treatment of breast cancer in Northern Cameroon	Northern Cameroon	Traditional health practitioners	131	Semi-structured questionnaires	None
Magwede, et al. [46]	An inventory of Vhavenḓa useful plants	Venda, Republic of South Africa	Knowledgeable local community members	66	Semi-structured questionnaires	None
Mlilo and Sibanda [47]	An ethnobotanical survey of the medicinal plants used in the treatment of cancer in some parts of Matebeleland, Zimbabwe	Matebeleland, Zimbabwe	Traditional health practitioners, herbalists, apprentices, and family members of traditional health practitioners	25	Open-ended semi-structured interviews	None
Chinsembu, et al. [48]	Ethnomedicinal plants used by traditional healers in the management of HIV/AIDS opportunistic diseases in Lusaka, Zambia	Lusaka, Zambia	Traditional health practitioners	40	Semi-structured interviews	None
Aparicioa, et al. [49]	Ethnobotanical study of medicinal and edible plants used in Nhamacoa area, Manica Province, Mozambique	Nhamacoa area, Manica province, Mozambique	Randomly selected villagers	25	Free listing and semi-structured interviews; random selection	None
Shopoa, et al. [50]	Ethnobotanical study of medicinal plants traditionally used in Gokwe South District, Zimbabwe	Gokwe South District, Zimbabwe	Knowledgeable local community members	46	Semi-structured questionnaire	None
Yaoitcha, et al. [51]	Prioritization of useful medicinal tree species for conservation in Wari-Maro Forest Reserve in Benin: A multivariate analysis approach	Wari-Maro Forest Reserve, Benin	Traditionally most prominent authorities of local households	149	Semi-structured interviews	None
Hilonga, Otieno, Ghorbani, Pereus, Kocyan and de Boer [41]	Trade of wild-harvested medicinal plant species in local markets of Tanzania and its implications for conservation	Arusha, Dodoma, Mbeya, Morogoro, and Mwanza regions, Tanzania	Local herbal vendors	40	Semi-structured interviews	None
Masumbu, et al. [52]	Ethnobotanical survey of medicinal plants claimed by traditional herbal practitioners to manage cancers in Malawi	Mzimba and Nkhata Bay district of northern Malawi	Traditional health practitioners	25	Semi-structured questionnaires and purposive sampling technique	None

* Nutraceutical profile—nutritional (N), phytochemical (P), and/or biological (B) analysis of Strychnos spinosa.

3.2. Plant Part Utilisation of S. spinosa in Africa

This study reports the use of six distinct plant parts of S. spinosa for the treatment of various health conditions in Figure 2. S. spinosa roots, with 25.7% usage, are commonly used for treating digestive disorders and fever, followed by bark (22.9%) and fruit (22.9%). S. spinosa fruit is consumed raw or cooked in East African countries like Tanzania [40,41], where its bark is traditionally used for analgesic properties [40,41]. In South Africa and Zimbabwe, the fruit is valued for its ripeness as a snack or food [14,37,47,50], while the wood is used for tools and firewood production [20,26,28,32,38,43,46]. The plant’s various parts are also used for respiratory and digestive issues.

In the studies of Nigeria, Lockett, Calvert and Grivetti [36] and Ghana, Asase, Oteng-Yeboah, Odamtten and Simmonds [30], Derya, Dzitse and Tom-Dery [44], leaves and roots of a plant are commonly used in herbal preparations to treat ailments like fevers and headaches, with some communities believing it has protective properties [30,36]. In contrast to the Democratic Republic of Congo [28] and Central Africa [29,39,45], where S. spinosa fruit is appreciated more for its nutritional value and is sometimes fermented to enhance the flavour and nutritional profile of the fruit, the leaves and roots are also employed in traditional medicine, particularly in treatments related to women’s health [28,29,39,45].

3.3. Methods of Preparation and Administration

Preparation methods include decoctions, crushed plant parts, infusions, macerations, and calcinations (Figure 3A). Decoction (30%), followed by crushed plant parts (22%), infusions (17%), which involve soaking a part of the plant in hot water for a period ranging from overnight to several hours, macerations (9%), which involve softening plant parts by soaking them in a liquid, and lastly, calcinations (9%) involving heating plant material to high temperatures in the absence of air. Some of the studies (13%) did not specify methods of preparation (Figure 3A). A portion of the studies that reported that the parts of S. spinosa are often crushed, ground, or prepared in powder form, highlight the critical role of dried plant materials in traditional medicine. This method provides benefits such as a longer shelf life and flexibility in usage, which can be especially valuable in resource-limited settings [53,54]. Interestingly, the results are similar to other studies [53,55,56,57] that identified decoction as the predominant preparation method. The ease of making decoctions is a key reason why they are the main method used in traditional healing practices. Numerous indigenous cultures worldwide utilise decoctions to harness the healing properties of different plants. Additionally, decoctions eliminate contaminants and are deemed a safer option than other preparation methods [55].

The distribution of administration methods for S. spinosa, as illustrated in Figure 3B, reveals a strong preference for oral administration, accounting for 59% of the studies. This is followed by topical application (16%). The least documented means of administration was enemas (2%). Some of the studies (23%) did not specify any administration methods. The predominance of oral administration aligns with findings from Yadav, et al. [58], where Strychnos potatorum L.f was found to exhibit significant pharmacological efficacy when administered orally. This predominance of oral administration suggests that S. spinosa may contain bioactive compounds that are effective when ingested. The high incidence of oral usage may stem from the presence of similar bioactive substances readily absorbed through the gastrointestinal tract, potentially aiding in the treatment of various internal disorders [23,59,60]. However, oral administration is influenced by digestive metabolism, first-pass liver effects, and compound solubility, which can impact active compounds’ bioavailability and therapeutic efficacy [20,37]. Beyond oral ingestion, ethnobotanical studies indicate that topical applications, inhalation, and rectal administration are also used for specific treatments. For instance, in South Africa, S. spinosa bark is crushed and applied topically to wounds and skin infections, suggesting transdermal absorption as an alternative route of bioactive compound delivery [41]. Albahri, et al. [61] reported that topical applications of plant extracts demonstrate notable wound-healing properties attributed to their antibacterial and anti-inflammatory effects. In West African communities, steam inhalation from boiled bark extracts is used in traditional respiratory infections and fever treatments, indicating a pulmonary absorption pathway that may enhance rapid systemic effects [2].

3.4. Regional Variations in the Utilisation of S. spinosa

The use of S. spinosa shows significant variations across the various African cultures and regions (

Table 2. Ethnobotanical uses of Strychnos spinosa Lam. and modes of administration in Africa.

Category of Diseases	Ethnobotanical Use	Plant Part	Method of Preparation	Administration	Reference
Gastrointestinal diseases	Stomach aches	Leaves, roots, bark, non-ripe fruit	Calcinated to powder (fruit), decoction (leaves boiled)	Orally	[12,20,39,45,51]
	Diarrhoea (humans and livestock) Constipation	Roots, bark	Powder or decoction (roots)	Orally	[12,37,42]
	Diseases of the digestive tract	Leaves, bark	Decoction	Not specified	[45]
	Vomiting	Roots	Powder	Orally	[42]
	Abdominal pains	Roots	Not specified	Not specified	[37]
Infectious diseases	Malaria	Leaves, twigs	Decoction and infusion (leaves), grind twigs	Orally, topical (twigs ground, mixed with pomade)	[12,30,45,51]
	Venereal diseases (gonorrhoea, syphilis, lymphogranuloma inguinale)	Roots, fruit, root bark	Maceration (roots, fruit), decoction	Orally	[26,27,31,40,42,48,50]
	Bacterial infections	Bark	Calcinated or infusion	Orally	[12]
	Tuberculosis	Not specified	Not specified	Not specified	[45]
	Sleeping sickness (anti-trypanosal activity)	Not specified	Not specified	Not specified	[45]
Pain and inflammation	Haemorrhoids	Root	Crushed	Enema	[39]
	Fever	Root, bark with ripe fruit	Maceration of root and infusion of bark and root	Orally	[12]
	Weariness	Leaves with roots	Infusion	Orally and/or submerged	[12]
	Diabetes	Roots	Calcination	Orally	[34,45]
	Cataract	Bark, fruits, leaves, or roots	Decoction	Topical (on eye)	[50]
	Hernia	Roots	Decoction	Orally	[31,51]
	Cures swelling of feet	Bark with ripe fruit	Decoction	Orally, topical	[12]
	Hypertension	Root, fruit	Infusion	Orally	[12,33,45]
	Ear disease	Leaf, bark, and roots	Not specified	Not specified	[51]
	Prevents paralysis	Bark with ripe fruit	Decoction	Orally, topical	[12]
	Oedema	Bark, fruits, leaves, or roots	Decoction	Orally	[50]
	Foot crevices	Fruit	Pulp	Not specified	[12]
	Cardiovascular	Not specified	Not specified	Not specified	[38]
	Food allergies	Bark, roots	Decoction (bark), powder (roots)	Orally	[20,42]
	Unblocking respiratory deficiencies	Leaves with roots	Maceration	Orally	[12]
Reproductive health	Facilitation of milk production (for mothers and cows)	Fruit	Ripe fruit calcinated and reduced to powder	Orally (sprinkled in porridge)	[12]
	Dysmenorrhea	Root, bark	Infusion of root or bark, decoction of bark	Orally	[12,38,41]
	Prevention of miscarriage	Bark, fruits, leaves, or roots	Decoction	Orally	[50]
	Labour induction	Roots	Maceration	Orally	[31]
	Prevention of sterility	Not specified	Not specified	Not specified	[38]
Trauma and emergencies	Snake bites	Root, bark, fruit, radix/ cortex	Calcination, decoction (bark), un-ripe fruit licked	Orally, topical	[20,28,31,36,44,45]
	Slows venom (anti-venom)	Root	Infusion/calcinated	Orally	[12]
Other uses	Cultural rituals (homestead protection, livestock increase, love charm, blood cleanser)	Fruit, root, bark (mixed with Sapium integerrimuma (Hochst.) J. Leonard.)	Paste (pulp of non-ripe fruit), maceration (root), crushed (bark)	Orally	[12,20,43]
	Growth retardation	Leaves, bark, root	Not specified	Not specified	[51]
	Cattle dermatitis	Leaves with leaves of Crossopteryx febrifuga (G. Don) Benth	Decoction	Orally and topical	[35]
	Fever in oxen	Bark	Calcinated or infusion	Orally	[12]
	Construction/craftwork	Wood	Wood dried	Not specified	[46]
	Firewood	Wood	Wood dried	Not specified	[12,20]
	Solidification of babies	Leaves	Infusion and decoction	Orally and submerged	[12]
	Cattle ticks	Fruit	Ground (pulp and seeds of un-ripe fruit)	Topical	[14]
	Food/drink (fermented maize meal/porridge, jam, alcohol, juice)	Fruit	Pulp from ripe fruit	Orally	[12,20,30,46,49]
	Fodder	Leaves	Picked fresh	Orally	[12]
Skin related conditions	Chronic wounds/sores	Fruit, fruit sap with leaves of S. madagascariensis, bark	Powder	Orally, topical	[32,47,52]

), reflecting the diverse ethnobotanical knowledge systems within sub-Saharan Africa [23]. Although the plant’s medicinal, nutritional, and cultural applications are well documented in the studies reviewed, the methods of preparation, preferred plant parts, and symbolic meanings often vary between regions.

3.4.1. Medicinal Uses of S. spinosa

The medicinal applications of S. spinosa are diverse and widespread across sub-Saharan Africa, with various plant parts being used to treat a wide range of health conditions. According to Figure 4, the most frequently reported use of S. spinosa is in the treatment of gastrointestinal disorders, accounting for approximately 30% of the documented medicinal applications. These include conditions such as diarrhoea (10%), stomach aches (8%), constipation (6%), and vomiting (6%). In South Africa and Zimbabwe, S. spinosa is primarily used to treat digestive disorders such as stomach aches and diarrhoea, with the roots, bark, and leaves being the most used parts [20,32,37,43]. These treatments are widely used across Southern and West Africa, where gastrointestinal issues are prevalent due to poor sanitation and limited healthcare access [12,37].

A significant proportion (20%) of the reported uses of S. spinosa relate to the treatment of infectious diseases, including malaria (7%), bacterial infections (6%), tuberculosis (4%), and venereal diseases (3%) (Figure 4). The leaves, twigs, and bark of S. spinosa are often boiled to create infusions or macerations, which can be consumed orally or applied topically, depending on the ailment [12,26]. Traditional healers in Ghana, Zimbabwe, and Mozambique commonly use S. spinosa to treat these conditions [24,26].

Conditions associated with pain and inflammation represent 18% of the documented medicinal uses of S. spinosa. These uses include fever (7%), haemorrhoids (5%), swelling (4%), and diabetes-related inflammation (2%) (Figure 4). The roots and bark of S. spinosa are often prepared as macerations or infusions; in some cases, calcinations are used to enhance their potency [12,20]. The topical application of S. spinosa extracts is frequently reported for managing pain-related conditions, particularly in rural communities with limited access to conventional pain relievers [27,61].

Approximately 12% of S. spinosa’s medicinal applications are linked to reproductive health issues. The plant is utilised for treating dysmenorrhea (5%), infertility (4%), miscarriage prevention (2%), and labour induction (1%) (Figure 4). The roots and bark are commonly administered orally in decoctions and infusions to regulate menstrual cycles, support fertility, and assist in childbirth [12]. Traditional healers, particularly in West Africa (Benin and Ghana), have used S. spinosa for fertility-related treatments for many years [12,30].

Skin-related conditions account for 10% of reported medicinal uses, including chronic wounds (5%), dermatitis (3%), and foot crevices (2%) (Figure 4). The fruits, bark, and leaves of S. spinosa are commonly crushed into pastes or powders and applied directly to affected areas [32,47]. The use of S. spinosa in dermatological treatments is prominent in South Africa, Zimbabwe, and Mozambique, where it is often integrated into traditional wound-healing practices [12,32].

Respiratory ailments constitute 7% of the reported uses of S. spinosa, with treatments focused on respiratory deficiencies (5%) and cardiovascular issues (2%) (Figure 4). Decoctions and macerations made from leaves and roots are commonly utilised to alleviate symptoms associated with respiratory distress, often administered orally or through steam inhalation [12].

Beyond its medicinal uses, S. spinosa is utilised in various traditional practices (8%), including treatments for snake bites (3%), spiritual rituals (3%), blood purification (1%), and cattle tick management (1%) (Figure 4). The roots, bark, and fruits are employed in diverse cultural and protective rituals, especially in Southern and West Africa, where they are thought to have spiritual and healing properties [12,20,43]. In Central Africa, the plant is more commonly associated with antivenom treatments and wound healing, often prepared by crushing or calcining the roots and bark [28,45]. Traditional healers and local communities have used S. spinosa to manage diarrhoea, dysentery, and stomach ulcers (Table 2), conditions that are prevalent in areas with poor sanitation and limited access to conventional medicine [2]. The plant’s antimicrobial and anti-inflammatory properties may enhance its effectiveness in treating these ailments [24]. Additionally, S. spinosa is commonly utilised in managing fever-related illnesses, which are frequently linked to malaria, typhoid fever, and other febrile infections [14]. Malaria is still a leading cause of mortality in sub-Saharan Africa, and traditional remedies incorporating S. spinosa have been documented for their potential antiplasmodial activity [23].

3.4.2. Preparation Methods of S. spinosa

Preparation methods also vary significantly between regions. In Southern Africa, decoctions and infusions are the predominant methods, which aligns with findings from ethnobotanical studies in KwaZulu-Natal [20,38]. Conversely, West African communities often favour macerations and poultices, particularly for reproductive health treatments [12,30]. In Central African traditions, the calcination of plant parts is frequently utilized for snakebite treatments [28,45].

3.4.3. Cultural Significance of S. spinosa

The cultural significance of S. spinosa extends beyond its medicinal and nutritional applications, playing a vital role in various traditional rituals, ceremonies, and folklore across sub-Saharan Africa [12,30,31]. In several communities, the plant is regarded as a symbol of protection and fertility, with its fruits and bark used in spiritual cleansing and homestead protection rituals [12,20,43]. Among the Zulu communities in South Africa, the plant is believed to possess protective properties and is often used in rituals to ward off evil spirits and promote good fortune [20,38].

In West African traditions, particularly in Benin and Ghana, S. spinosa is incorporated into love charms and fertility rites, where its roots and bark are prepared in decoctions or macerations to aid conception and enhance reproductive health [12,30]. Additionally, some communities in Zimbabwe and Mozambique employ the plant in ancestral ceremonies, using its bark and fruit as offerings to seek blessings from ancestors [14,31].

The plant’s association with healing and purification is prevalent across different regions. For example, in northern Ghana, decoctions made from S. spinosa roots are used in cleansing rituals following periods of illness or misfortune [30]. Similarly, the Shona people of Zimbabwe integrate S. spinosa into rites of passage, symbolising spiritual renewal and communal unity [37].

Despite the widespread use of S. spinosa in cultural practices, there is limited documentation of these rituals in the scientific literature. Future ethnobotanical studies should prioritise recording oral histories and engaging with local communities to preserve this rich cultural heritage [4,7]. Such efforts would enhance the understanding of the plant’s socio-cultural significance and contribute to the broader preservation of IKSs [5].

3.5. Economic Importance of S. spinosa

The fruits of S. spinosa are a vital economic resource for many rural communities [2,11,60]. The plant produces nutrient-rich fruits that can be consumed fresh or processed into various food products, such as jams, juices, and dried fruit snacks, which have growing commercial demand locally and internationally [2]. Research shows that the fruit is sold in markets throughout Southern and East Africa, generating income for small-scale farmers and traders [60]. Furthermore, because of its drought tolerance and capacity to thrive in semi-arid conditions, S. spinosa offers opportunities for sustainable agriculture and food security initiatives [11].

Beyond its nutritional value, S. spinosa has demonstrated potential pharmaceutical applications, with bioactive compounds such as alkaloids, flavonoids, and saponins exhibiting antimicrobial and anti-inflammatory properties [23]. Ethnopharmacological research suggests that fruit, bark, and leaf extracts are therapeutic against bacterial infections, malaria, and gastrointestinal disorders [24,27]. This has led to increased interest from pharmaceutical industries, exploring its potential as a source of novel drug compounds [6].

In addition to formal pharmaceutical research, S. spinosa plays a crucial role in traditional African medicine. Indigenous communities widely use it to treat fevers, digestive ailments, and reproductive health concerns [12]. The commercialisation of traditional remedies derived from S. spinosa could contribute to the growing market for herbal medicines, supporting both economic development and the preservation of IKSs [5].

The species also holds potential for sustainable agriculture and agroforestry. S. spinosa is utilised as fodder for livestock, particularly in arid regions where alternative feed resources are scarce [14]. Additionally, the hardwood is employed in craft production and tool-making, such as general carpentry, implement handles, fighting sticks, hut poles, and carving [23]. Furthermore, the hard shells of dried fruits are repurposed as resonators for musical instruments like the marimba and are carved and sold as souvenirs [23].

3.6. Socio-Ecological Impact and Implications for Conservation

Limited research on the socio-ecological impacts of harvesting and using S. spinosa in African communities, highlighting potential biodiversity and ecosystem changes, requires in-depth analysis [30,41,51]. Future research should focus on assessing the socio-ecological impacts of S. spinosa use, considering factors such as resource sustainability, environmental conservation, and community well-being to inform sustainable management practices. Likewise, expanding on the nutritional and economic potential of S. spinosa, it becomes evident that it holds promise for addressing food-nutrition insecurity and economic prosperity among marginalised rural populations [2]. With its high content of essential nutrients like vitamin C, iron, and zinc, S. spinosa stands out as a valuable resource for enhancing food security and improving health outcomes in developing nations. To fully harness the benefits of S. spinosa, further research on domestication processes, value chain integration, and economic viability is recommended [2]. Collaboration among stakeholders is essential to explore the full potential of this fruit as a sustainable solution to food shortages and malnutrition experienced by rural communities [8].

S. spinosa is currently classified as “Least Concern” on the IUCN Red List due to its widespread distribution across sub-Saharan Africa and the absence of significant population declines reported at a global scale [13]. However, this classification may not fully account for localised threats and regional population pressures associated with widespread harvesting and habitat loss [12]. While the species remains abundant in some regions, increasing demand for its medicinal, nutritional, and cultural uses may pose significant risks to its long-term availability in areas where it is heavily exploited [12,20]. Local communities in Southern Africa, particularly in South Africa, Zimbabwe, and Mozambique, rely extensively on S. spinosa for traditional medicine and food, with roots, bark, and fruit being the most harvested parts [20,32,37]. Overharvesting these plant parts, especially from wild populations, can lead to population decline and affect the species’ natural regeneration capacity [2]. Additionally, the absence of formal cultivation practices and the reliance on wild harvesting further exacerbate the risk of localised depletion [11]. Furthermore, habitat destruction from agricultural expansion, deforestation, and urbanisation indirectly threatens the plant’s natural populations in many regions [11,41].

These pressures highlight the need for a more nuanced approach to assessing the conservation status of S. spinosa, one that considers regional population trends and localised exploitation patterns [12,41,51]. Future conservation efforts should prioritise measures for sustainable conservation, such as establishing sustainable harvesting guidelines in collaboration with local communities [7,9], promoting agroforestry initiatives to encourage the cultivation of S. spinosa [2,11], incorporating IK into community-based conservation programmes [6,7,9], and reassessing the IUCN Red List classification based on regional data and population monitoring [13,41,51]. Collaborative strategies that have been implemented include Community-Based Participatory Research (CBPR), where researchers work directly with indigenous communities to document oral traditions, medicinal practices, and ecological knowledge [7], as well as participatory workshops and co-authorship with local knowledge holders to ensure equitable representation [5]. The establishment of sustainable harvesting and agroforestry initiatives such as partnering with local farmers and conservation groups [51] to promote the sustainable cultivation of S. spinosa instead of relying on wild harvesting.

The current study revealed significant implications for biodiversity conservation and sustainable resource management. The study emphasises the importance of degraded areas as a source of medicinal plants for indigenous communities, indicating the need to prioritise protecting and restoring these ecosystems [30,37]. Furthermore, this study highlights the need to integrate IK into conservation strategies, as the traditional practices and resource utilisation patterns can provide valuable insights for sustainable management [30,41,51]. This calls for developing collaborative approaches that respect and engage with local communities, ensuring the equitable sharing of benefits and the protection of traditional ecological knowledge [9].

4. Research Gap and Limitations

Despite the valuable insights gathered from this systematic review, several limitations affect the completeness and generalisability of the findings. One key limitation is the accessibility and quality of data, particularly in ethnobotanical research. Many relevant studies are published in local or regional journals, government reports, or theses and dissertations, which are not always accessible in mainstream scientific databases. Additionally, language barriers present a challenge, as a significant portion of IK is documented in local dialects and non-English sources, making it difficult to capture a truly comprehensive dataset [12,37]. The quality and methodological rigor of the included studies also vary, with some relying primarily on oral interviews without experimental validation of the reported medicinal or nutritional properties. The absence of quantitative analysis, such as standardised phytochemical screenings, undermines the ability to compare bioactive properties across regions [2].

Furthermore, sample sizes in many ethnobotanical surveys are small, raising concerns about the representativeness and reliability of the data [20]. Thus, future research should address these limitations by expanding the geographic scope, incorporating more diverse sources of IK, and employing innovative methodologies that prioritise community engagement and reciprocity [4,5], such as incorporating multilingual searches or collaborating with native speakers to capture a more comprehensive range of IKSs [5,7]. Further research is needed to explore the biological activity, toxicological properties, and potential applications of S. spinosa, based on the novel use reports and identified knowledge gaps. Collaborative efforts between researchers, local communities, and conservation organisations can contribute to a more comprehensive understanding of this plant species and its role in IKSs, biodiversity conservation, and sustainable resource management [6].

Several studies have documented the traditional uses of S. spinosa within indigenous communities in only two provinces of South Africa [20,32,38,43,46]. This distribution indicates a significant gap in the geographical coverage of S. spinosa research, particularly in underrepresented regions of South Africa and other parts of sub-Saharan Africa [18,19,20]. The previous studies have highlighted the diverse uses of the plant, including medicinal, cultural, and socio-economic purposes [20,32,38,43,46]. However, the existing literature needs a comprehensive and cohesive compilation of the various traditional uses across different communities. There is a need for further research to systematically document and compare the traditional uses of S. spinosa within various indigenous communities to provide a clearer understanding of its significance and cultural value [2,23].

More studies are needed to authenticate the ethnobotanical uses of S. spinosa by assessing its nutritional and bioactive compounds, including its phytochemical composition in Africa [14,24,25,26,27,28,29]. However, the existing literature often needs a community-specific approach to authenticating the phytochemicals within different indigenous communities. Further research should adopt a community-based participatory approach to identify and authenticate the phytochemicals in S. spinosa samples, acknowledging the variations that may exist across different communities and the potential implications for traditional medicinal practices [7].

This study emphasises the critical importance of IK in the conservation and sustainable management of S. spinosa, a plant species of significant cultural and ecological value in Africa [2]. The findings indicate that IK contains invaluable insights into the traditional uses, socio-ecological impacts, and potential phytochemical applications of S. spinosa, highlighting its multifaceted roles in local communities [20].

The comprehensive exploration of current literature underscores the urgent need to document and preserve this knowledge, particularly as it faces threats from modernity and globalisation [4,5]. As communities navigate environmental challenges and shifting socio-economic landscapes, it becomes paramount to empower local populations by recognising and integrating their traditional ecological knowledge. In addition, fostering collaboration between indigenous communities and scientific research can lead to more effective conservation strategies that protect biodiversity and promote cultural heritage [8,9]. This study serves as a call to action for policymakers, researchers, and environmental practitioners to value and incorporate indigenous perspectives into sustainable resource management frameworks [5,23]. Ultimately, efforts to understand and preserve S. spinosa through the lens of IK can enhance environmental resilience and support the rights and well-being of local communities.

5. Conclusions

This systematic review highlights the significant medicinal, nutritional, and cultural uses of S. spinosa across sub-Saharan Africa. The findings underscore the plant’s vital role in traditional medicine, particularly in treating gastrointestinal conditions, fevers, and infectious diseases. Despite its widespread application, a notable gap exists in quantitative research, particularly concerning the plant’s bioactive compounds and pharmacological efficacy. Future research should prioritise underrepresented regions, such as West, Central, and East Africa, to provide a more comprehensive understanding of the plant’s significance. Additionally, interdisciplinary approaches that integrate ethnobotany, pharmacology, and environmental science would enhance the understanding of S. spinosa’s therapeutic potential. Collaborative, community-based participatory research is essential for ethically engaging local communities, respecting IK, and promoting equitable benefit-sharing. By bridging the gap between traditional knowledge and scientific inquiry, S. spinosa could provide innovative solutions for food security, health promotion, and biodiversity conservation. These efforts will not only enhance the scientific understanding of this valuable plant but also support the preservation of IKSs and promote the sustainable management of natural resources.