1. Introduction: The Persistent Challenge of Typhoid Fever in Nigeria
Typhoid fever remains a significant public health burden in Nigeria, particularly in low-income regions where inadequate sanitation and limited access to clean water contribute to widespread morbidity and mortality. The disease, caused by the bacterium Salmonella enterica serovar Typhi, is transmitted through contaminated food and water, and its prevalence in Nigeria is compounded by poor waste management practices and antibiotic overuse.
The challenge of managing typhoid fever has been exacerbated by the emergence of multidrug-resistant strains of S. Typhi, leading to treatment failures and prolonged illness. This resistance, combined with the high cost of conventional healthcare—with some patients spending over ₦212,000 on hospital treatment —has driven a significant proportion of the population toward traditional and complementary approaches.
In Nigeria, where up to 80% of people in developing African countries rely on herbal medicine as their primary healthcare source, the use of medicinal plants for typhoid management reflects both cultural heritage and practical necessity. Traditional healers, often inheriting knowledge from their forefathers, play a crucial role in healthcare delivery, particularly in rural communities where access to modern healthcare remains limited.
2. Prevalence and Patterns of Herbal Medicine Use
2.1 Extent of Usage
The reliance on herbal remedies for typhoid fever is widespread across Nigeria, driven by multiple factors:
| Factor | Finding |
| Cost of conventional care | Hospital bills for typhoid can exceed ₦200,000, forcing families to seek cheaper alternatives |
| Accessibility | Rural residents rely more on herbal remedies due to family traditions and availability |
| Perceived efficacy | Many believe herbal treatments are effective and may have fewer side effects |
| Economic pressures | Following the withdrawal of pharmaceutical giants and rising drug prices, traditional medicine usage surged to 81.6% |
A cross-sectional survey in Nsukka involving 400 respondents found that rural residents relied more on herbal remedies due to accessibility, affordability, and family traditions, while urban respondents, despite higher education levels, also used herbal extracts and often alternated them with prescription drugs . Residence, occupation, and age were significant predictors of knowledge and use (P < 0.05), whereas education was not.
2.2 Traditional Healer Demographics
An ethnobotanical survey in North Eastern Nigeria revealed important patterns among traditional healers:
| Characteristic | Finding |
| Age range | 18–90 years |
| Gender | 85% male, 15% female |
| Education | 49% SSCE holders, 9% degree holders |
| Knowledge source | 77% inherited from forefathers, 15% from brother/friend, 8% self-experience |
| Practitioner type | 37% traditional healers (highest), 7% elders (lowest) |
3. Nigerian Herbal Remedies for Typhoid Fever: Scientific Evidence
3.1 Systematic Review: A Comprehensive Overview
A systematic review published in 2024 provided the most comprehensive documentation of medicinal plants used for typhoid fever in Nigeria . The review, which analyzed 122 studies covering 75% of Nigeria’s states, revealed:
Key Findings :
| Parameter | Finding |
| Total plant species | 232 species from 66 families |
| Most prevalent family | Fabaceae |
| Most frequently used plants | Mangifera indica, Carica papaya, Azadirachta indica |
| Most used plant part | Leaves (47.9%) |
| Preferred preparation method | Decoction (38.7%) |
| Species with anti-Salmonella activity | 81 species (34.9% of documented species) |
The systematic review highlighted that Cajanus cajan, Euphorbia hirta, and Phyllanthus niruri showed promising activity with MIC values ≤ 0.5 mg/ml, suggesting their potential for novel anti-salmonella drugs of natural origin.
3.2 Plants with Scientifically Validated Anti-Salmonella Activity
3.2.1 Hibiscus sabdariffa (Zobo)
A study evaluating five medicinal plants against Salmonella Typhi found that Hibiscus sabdariffa demonstrated potent antimicrobial activity.
Key Findings :
| Parameter | Result |
| Inhibition zone diameter | 29.00 mm (concentrated extract) |
| Minimum Inhibitory Concentration (MIC) | 4.27 mg/mL |
| Minimum Bactericidal Concentration (MBC) | 68.25 mg/mL |
| Phytochemicals detected | Saponins, cardiac glycosides, terpenoids, steroids, flavonoids, phenolics, tannins |
The study concluded that H. sabdariffa exhibited consistent low MICs against Salmonella, suggesting its potential for antibiotic production.
3.2.2 Calotropis procera (Sodom Apple)
Calotropis procera, traditionally used for medicinal purposes in Nigeria, was evaluated for its antimicrobial efficacy against Salmonella typhi in a study conducted in Yola, Adamawa State.
Key Findings :
| Parameter | Result |
| Chloroform extract MIC | 25 mg/mL against S. typhi |
| Chloroform extract inhibition zone | 23.50±0.38 mm against S. aureus |
| Phytochemicals detected | Tannins, saponins, alkaloids, phenolics, flavonoids, reducing sugars |
| Minimum Bactericidal Concentration | 100 mg/mL for S. typhi |
The study concluded that the root extracts of C. procera exhibited promising antimicrobial effects against S. typhi, indicating its potential as a rich source of bioactive compounds and a viable alternative to antibiotics for treating infectious diseases.
3.2.3 Heteropogon contortus
A study evaluating medicinal plants against Salmonella found that Heteropogon contortus exhibited significant antimicrobial activity:
| Parameter | Result |
| Inhibition zone diameter | 25.05 mm (concentrated extract) |
| Minimum Inhibitory Concentration | 4.69 mg/mL |
| Minimum Bactericidal Concentration | 75.00 mg/mL |
3.2.4 Zingiber officinale and Xylopia aethiopica Combination
A 2025 study investigated the bactericidal effect of a mixture of Zingiber officinale (ginger) and Xylopia aethiopica (African pepper) extracts against Salmonella enterica serovar Typhi .
Key Findings :
| Parameter | Result |
| Phytochemicals detected | Cardiac glycosides, steroids, alkaloids, tannins, flavonoids, phenolics, saponins |
| Predominant compounds | Alkaloids and flavonoids |
| Effect | The mixture was able to reduce the number of resistant Salmonella significantly |
The study concluded that the combination of Zingiber officinale and Xylopia aethiopica extracts could therefore be used in the management of this bacterial infection.
3.3 Most Frequently Used Plants Across Nigeria
A review compiling medicinal plants used for treating typhoid fever across the six geopolitical zones of Nigeria identified 166 plant species from 66 families. The ten plants most widely used across the country were:
| Plant Name | Common Name | Family |
| Mangifera indica L | Mango | Anacardiaceae |
| Carica papaya L | Pawpaw | Caricaceae |
| Cymbopogon citratus (DC.) Stapf | Lemongrass | Poaceae |
| Psidium guajava L. | Guava | Myrtaceae |
| Citrus aurantifolia Christm | Lime | Rutaceae |
| Ananas comosus (L.) Merr | Pineapple | Bromeliaceae |
| Ocimum gratissimum L. | Scent leaf | Lamiaceae |
| Vernonia amygdalina (Wild) Darke | Bitter leaf | Asteraceae |
| Alstonia boonei De Wild. | African cheesewood | Apocynaceae |
| Azadirachta indica A. Juss | Neem | Meliaceae |
The review noted that all parts of plants are reported to be relevant in treating typhoid fever, with leaves mostly used alone or in combination with other plant parts .
3.4 Traditional Formulations and Recipes
An ethno-medicinal survey in North East Nigeria documented specific recipes used for typhoid fever treatment:
| Recipe Components | Plant Part | Preparation/Dosage |
| Guiera senegalensis | Leaf | Grind dried leaf, sieve; one teaspoon mixed with 25 cl pap. 1 cup twice daily for five days |
| Cassia siamea + Gossypium hirsutum | Leaves | Boiled together; taken twice daily; patient also bathes with it for four days |
| Aloe vera + Allium sativa | Leaf + bulb | Aqueous concoction; 20 cl cup thrice daily for one week |
| Khaya senegalensis | Leaves | Ground into powder; small amount (tip of finger nail) inhaled for three days |
| Hibiscus sabdariffa | Calyces | Pounded and infused in cold water; one cupful twice daily for six days |
| Tamarindus indica + Vernonia amygdalina | Fruits + leaves | Boiled together; half cup thrice daily for four days |
Traditional healers reportedly used more than one plant species in the preparation of typhoid fever herbs, with combined plants being the most dominant.
4. Mechanisms of Action: How Nigerian Herbs Work
4.1 Direct Antimicrobial Effects
| Plant | Target Pathogen | MIC/MBC | Mechanism |
| Hibiscus sabdariffa | S. Typhi | MIC: 4.27 mg/mL, MBC: 68.25 mg/mL | Disruption of cell wall/membrane |
| Calotropis procera | S. Typhi | MIC: 25 mg/mL, MBC: 100 mg/mL | Bioactive compounds (alkaloids, tannins, flavonoids) |
| Heteropogon contortus | S. Typhi | MIC: 4.69 mg/mL, MBC: 75.00 mg/mL | Phytochemical-mediated inhibition |
4.2 Phytochemical Composition
Phytochemical screening of Nigerian antityphoid plants has identified several bioactive compounds responsible for antimicrobial activity :
| Phytochemical Class | Antimicrobial Activity |
| Alkaloids | Interfere with DNA replication and protein synthesis |
| Flavonoids | Disrupt cell wall synthesis, inhibit enzymes |
| Tannins | Inhibit bacterial growth by precipitating proteins |
| Saponins | Increase cell membrane permeability |
| Phenolics | Disrupt electron transport chains |
4.3 Immune Support
Many Nigerian herbs used for typhoid also possess immunomodulatory properties. The widespread perception among patients that herbs “boost immunity” supports continued usage.
5. Holistic and Complementary Therapies
5.1 Traditional Preparation and Administration Methods
Common Preparation Methods:
| Method | Description | Prevalence |
| Decoction | Boiling plant material in water | 38.7% |
| Infusion | Steeping in cold or hot water | Commonly used |
| Concoction | Mixing multiple plant preparations | Dominant method |
| Powdered formulations | Ground plant material taken with pap or honey | Common in North East |
Plant Parts Used :
| Plant Part | Usage |
| Leaves | Most frequently used (47.9%) |
| Bark | Second most used (18.8%) |
| Fruit | Third most used (11.5%) |
| Roots | Used for some formulations |
Administration Routes:
| Route | Description |
| Oral | Most common; decoctions, infusions, powders with pap or honey |
| Inhalation | Inhaling steam from boiled preparations |
| Topical bathing | Bathing with herbal mixtures |
5.2 Steam Inhalation Therapy
Traditional healers in Oyo State described a specific treatment method where patients would sit covered in several layers of cloth while inhaling steam from boiling herbal leaves for hours, followed by bathing with the mixture for several days. Healers reported that “within five days, a patient could fully recover”.
5.3 Dietary Support
Dietary practices that support typhoid management include:
- Hydration: Oral rehydration through herbal teas and soups
- Nutrient support: Vitamin C-rich fruits (lemon, pawpaw) support immune function
- Traditional foods: Pap (fermented cereal porridge) used as vehicle for powdered herbs
5.4 Spiritual and Psychological Support
The holistic nature of traditional medicine often includes spiritual elements. Traditional healers in the North East reported that their knowledge was inherited from forefathers and that their drugs are considered “safe, efficient and had no side effects except from vomiting”.
6. Safety Considerations and Clinical Implications
6.1 Key Safety Concerns
| Concern | Implication |
| Lack of standardisation | Dosage varies from one healer to another despite using same plants |
| Limited scientific validation | Only 34.9% of documented plants have confirmed anti-Salmonella activity |
| Potential toxicity | Some plants may be hepatotoxic or nephrotoxic at high doses |
| Concurrent use issues | Patients may alternate herbs with prescription drugs without informing healthcare providers |
| Species loss | Deforestation threatens availability of key medicinal plants, forcing use of substitutes |
6.2 Dosage and Duration
The ethno-medicinal survey in North East Nigeria revealed significant variation in dosing despite the use of similar plants:
| Parameter | Range |
| Dosage volume | 20 cl to 35 cl |
| Frequency | Twice to thrice daily |
| Duration | 3 to 7 days |
Traditional healers claimed that “the plants used in preparing and subsequent administration for the treatment of typhoid fever were safe, efficient and had no side effects except from vomiting”.
6.3 Conservation Concerns
Deforestation threatens medicinal plant availability:
| Impact | Consequence |
| Loss of primary forests | 96% of Nigeria’s original forests lost |
| Critically endangered species | 18 medicinal plant species classified as critically endangered |
| Threatened species | 146 species classified as threatened |
| Plant scarcity | Healers must travel farther or use substitutes, reducing efficacy |
Traditional healers interviewed in Oyo State reported that “those remedies worked fast. Within five days, a patient could fully recover. But with the alternatives we use now, it takes a week or more”.
6.4 Recommendations for Safe Use
For Patients and Families:
- Seek laboratory diagnosis (Widal test, blood culture) before treatment
- Disclose all herbal medicine use to healthcare providers
- Do not delay seeking medical care for severe symptoms (prolonged fever, confusion, intestinal bleeding)
- Use products from reputable sources, preferably with NAFDAC registration
- Monitor for adverse effects and seek help if symptoms worsen
- Complete full treatment course, whether herbal or conventional
For Healthcare Providers:
- Ask about herbal medicine use during consultations
- Provide evidence-based guidance on complementary therapies
- Monitor for potential drug interactions with antibiotics
- Document CAM use in patient records
For Researchers:
- Conduct high-quality clinical trials on promising plants (C. cajan, E. hirta, P. niruri have MIC ≤ 0.5 mg/ml)
- Evaluate safety profiles for chronic use
- Study drug interactions with antibiotics
For Policymakers:
- Strengthen NAFDAC regulation of herbal products
- Fund research on antityphoid plants
- Support conservation of medicinal plant species
- Promote health education on safe CAM use
7. Research Gaps and Future Directions
7.1 Key Research Needs
| Area | Priority |
| Controlled clinical trials | Most evidence from in vitro studies; human efficacy data needed |
| Standardised dosing protocols | Defined dosing for herbal formulations |
| Drug interaction studies | Interactions with antibiotics (ciprofloxacin, ceftriaxone) |
| Pharmacokinetic studies | Absorption, distribution, metabolism, elimination |
| Long-term safety studies | Chronic use effects on liver, kidney |
| Conservation studies | Sustainable harvesting and cultivation of threatened species |
7.2 Opportunities
| Opportunity | Description |
| Novel drug development | Plants with MIC ≤ 0.5 mg/ml (C. cajan, E. hirta, P. niruri) warrant further investigation |
| Standardised formulations | Moving from traditional decoctions to pharmaceutical-grade products |
| Integration strategies | Combining evidence-based herbal therapies with conventional care |
| Conservation programs | Cultivation of threatened species |
| Traditional knowledge preservation | Documenting indigenous knowledge before it is lost |
8. Conclusion
Typhoid fever remains a significant health challenge in Nigeria, driven by inadequate sanitation, multidrug-resistant S. Typhi, and limited healthcare access. Against this backdrop, traditional medicine offers a rich repository of plant-based remedies that are accessible, affordable, and culturally accepted.
The scientific literature reveals substantial diversity in Nigerian antityphoid flora:
- 232 plant species from 66 families documented in a systematic review
- 166 plant species from 66 families documented across Nigeria’s six geopolitical zones
- 52 plant species from 37 families documented in Kaduna State alone
Scientific validation of these plants has progressed considerably:
- Hibiscus sabdariffa demonstrated potent antimicrobial activity against S. Typhi with inhibition zones of 29.00 mm and MIC of 4.27 mg/mL
- Calotropis procera showed MIC of 25 mg/mL against S. Typhi
- Zingiber officinale and Xylopia aethiopica combinations significantly reduced resistant Salmonella
- Cajanus cajan, Euphorbia hirta,and Phyllanthus niruri show MIC values ≤ 0.5 mg/ml, suggesting potential for novel drug development
However, challenges remain:
- Only 34.9% of documented plants have confirmed anti-Salmonella activity
- Dosage variation and lack of standardisation persist
- Deforestation threatens the availability of key medicinal plants
- Loss of traditional knowledge as older healers pass on without documentation
The path forward requires:
- Acknowledging and respecting traditional knowledge while subjecting it to scientific scrutiny
- Strengthening regulatory oversight of herbal products through NAFDAC
- Promoting open communication between patients and healthcare providers
- Investing in clinical research on safety, efficacy, and mechanisms of action
- Supporting conservation of medicinal plant species threatened by deforestation
- Preserving and documenting indigenous knowledge before it is lost
As Nigeria continues to face the burden of typhoid fever and antibiotic resistance, the careful integration of evidence-based traditional medicine into the healthcare system offers promising strategies for improving access to effective, affordable, and culturally appropriate treatment.
9. References
- Medicinal plants used in the treatment of Typhoid fever in Nigeria: A Systematic Review. Journal of Herbal Medicine. 2024.
- Shitu AS, Salisu ZN, Johnson AA. Evaluation of Phytochemical Constituents and Antimicrobial Activity of Calotropis procera Root Extract against some Pathogenic Microorganisms in Yola, Adamawa State, Nigeria. UMYU Journal of Microbiology Research. 2024;9(3):194-200.
- Family traditions, accessibility and cost shape the continued reliance on Cajanus cajan and Azadirachta indica for malaria and typhoid despite prescription medicines in urban and rural Nsukka, Nigeria. BMC Complementary Medicine and Therapies. 2026.
- Bello AA, Gani AM, Sawa FBJ, et al. Ethno-botanical survey of plant species used for treatment of typhoid fever and demography of traditional medicine practitioners in North Eastern Nigeria. Bayero Journal of Pure and Applied Sciences. 2024;15(1).
- Evaluation of Phytochemical Constituents and Antimicrobial Activity of Calotropis procera Root Extract against some Pathogenic Microorganisms. OUCI. 2024.
- Bello AA, Usman AM. Ethno-medicinal Survey of Plants Used for the Treatment of Typhoid Fever in North East, Nigeria. DUJOPAS. 2022;8(3b):79-86.
- Typhoid fever and medicinal plants review: A case study in Nigeria. KIU Journal of Health Sciences. 2026.
- Dunoma A, Abubakar T, Umar MB, Abba HM, Mu’azu F. Ethnobotanical Survey of Medicinal Plant in Kaduna North and South Local Government Areas, Kaduna State, Nigeria. Science World Journal. 2025;20(4):1740.
- Evaluation of antimicrobial properties of five medicinal plants used against bacterial infections in Jalingo, Nigeria. African Journal of Clinical and Experimental Microbiology. 2024;25(2).
- Dunoma A, et al. Ethnobotanical Survey of Medicinal Plant in Kaduna North and South Local Government Areas. Science World Journal. 2025.
- Nwodo NC. Bactericidal Effect of the Mixture of Zingiber Officinale and Xylopia Athiopica Extract Against Salmonella Enterica Serovar Typhi. Chukwuemeka Odumegwu Ojukwu University. 2025.
- Amid Deforestation Scourge, Vanishing Herbal Plants Pose Health Crisis in Southwestern Nigeria. Pulitzer Center. 2024.