Phedra foliata L., commonly known as "Ephedra", is a medicinal plant that belongs to the Ephedraceae family. It is native to North Africa and Southwest Asia [1] and has been traditionally used in various regions for the treatment of chronic asthma and associated respiratory problems. The genus Ephedra is an important source of the alkaloid ephedrine, which has been widely used in the production of pharmaceutical drugs [2].

The El-Bayadh region of Algeria is known for its diverse plant life, including the presence of Ephedra foliata. This region is characterized by a Mediterranean climate with cold winters and hot summers, providing a suitable environment for the growth of this medicinal plant. Ethnobotanical studies in the region have revealed the traditional uses of Ephedra foliata by local communities, as well as its potential for sustainable harvest and cultivation. [3] Arbuscular mycorrhizal fungi have been found to play a significant role in modulating the drought tolerance of Ephedra foliata, which can be crucial for its survival and growth in the region's arid environment [4].

The genus Atriplex, which includes species such as Atriplex halimus, Atriplex canescens, and Atriplex nummularia, is also found in the arid zones of Algeria and has been recognized for its potential to combat desertification while providing feed for livestock. [5] Furthermore, studies on the leaf morphological and epidermal traits of other plant species, such as Pistacia lentiscus, have contributed to a better understanding of the adaptive strategies developed by these plants in habitats with extreme conditions, as depicted in Figure 1, including altitude and aridity. [6] These findings can provide valuable insights for the sustainable management and potential integration of such species into reforestation programs and efforts to combat desertification in the region.

The present study aims to investigate the ethnobotanical importance of Ephedra foliata-L for the population of El-bayadh. Specifically, this research seeks to identify the traditional medicinal uses of the plant and the ailments it is believed to alleviate.

Figure 1: illustrates the morphological appearance of Ephedra foliata L.

Study area

The Wilaya of El Bayadh is located in Algeria and covers an area of 71,697 km². The region is dominated by three mounts of the Djebel Amour in the Saharan Atlas chain. Soils in the area are often shallow and contain low levels of organic matter, which makes it difficult to repair the damage caused in these environments. The main types of soils present in the region are classified as isohumic steppe soils and sierozem. The semi-arid to arid bioclimate in the region ranges from cool to cold, with a relatively low average annual rainfall. The high temperatures and low rainfall are major causes of degradation and deterioration of the steppe, making it a very sensitive zone to desertification. The region's vulnerability to natural and human-induced changes poses significant challenges for its preservation and sustainable management. Efforts are needed to develop effective strategies to mitigate the negative impact of climate change and anthropogenic activities on the region's ecosystems.

Methodology

An ethnobotanical survey was carried out in the El-Bayadh province to identify traditional medicinal uses of Ephedra foliata L. and its curative potential. The survey was conducted using a pre-established questionnaire, which included questions about the informant's profile, choice between modern and traditional medicine, nature and pharmaceutical techniques of preparation of the plant drug used, and types of diseases treated by the studied plant. The questionnaire was filled out by 150 people, and the data collected was subjected to bibliographic research to identify Ephedra foliata and its medicinal and toxic effects. The results were presented in percentages and numbers and graphical representations were created using Excel software. The study aimed to gather valuable information on the studied species, ready to be exploited scientifically, and to ensure high objectivity of the data obtained from the survey. The random sampling ensured a better representativeness of the region and a sufficiently rich information base. The survey was conducted during March and April 2022, and the respondents' age range, whose educational levels varied, ranged from 20 to over 80 years old.

1. Frequency of plant use by gender

We would like to remind that the survey was conducted on a population of 150 people in the city of El-Bayadh, and the population is divided by gender, with 90 females 60% and 60 males 40%.The data collected from the survey according to gender shows that women use Ephedra foliata much more frequently as a treatment for certain illnesses compared to men. In fact, 60% of the women surveyed use Ephedra foliata for its therapeutic benefits, while only 40% of the male population use it. This dominance can be explained by women using this plant for other purposes besides therapy, or by their responsibilities as mothers, where they provide the first aid, especially for their children. (Figure 2)

Figure 2: Distribution of users according to sex

1. Frequency of plant use by age group

Our survey was conducted on a population ranging from 20 to 80 years old, and the use of Ephedra foliata by the population of El-Bayadh is widespread among all age groups, with a predominance among people aged 50 to 80 years old with 62.66%. However, for the age group of 30 to 50 years old, there is a rate of 27.33%. However, for people aged 20 to 30 years old, the youngest group, the use of Ephedra foliata is only 10% and does not represent a significant therapeutic interest (Figure 3).

The results obtained show that older people have more knowledge of medicinal plants compared to other age groups. In fact, the knowledge of the properties and uses of medicinal plants is generally acquired through long accumulated experience and transmitted from one generation to another. The results obtained show that people belonging to the age group of 50 to 80 years old have more knowledge of medicinal plants compared to other age groups. The accumulated experience with age is the main source of information at the local level regarding the use of plants in traditional medicine. This notable difference is probably due to the fact that older people are more familiar with traditional medicine and the use of Ephedra foliata due to the result of the El Bayadh province. In addition, the health status of older people is more sensitive to chronic diseases such as diabetes. This result confirms the results of other studies conducted at the national level.

Figure 3: Distribution of the population studied according to age groups

However, we also noticed a loss of information on the use of our plant in the age group of 20 to 30 years old, which can be explained by the distrust of some people, especially young people, who tend to no longer believe in this traditional medicine.

1. Frequency of plant use by marital status

The percentages of informants who use medicinal plants according to their marital status (Figure 4), with the highest being found among married people with a higher percentage of 66%. In fact, the use of the plant as a medicine allows them to avoid and minimize the material burdens imposed by doctors and pharmacists, while the rate is 34% for singles. We can conclude that medicinal plants are much more commonly used by married people than by singles for several reasons. Family experiences demonstrate in some cases the ineffectiveness of modern medicine in treating everyday pathologies, the side effects of certain treatments.

Figure 4: Distribution of results Use of the plant according to family situation

1. Use of the plant according to the level of education

The majority of the surveyed population is illiterate, accounting for 40% of the sample (Figure 5). This relatively high percentage is directly correlated with the level of education of the population surveyed. However, individuals with primary school education exhibit a significant utilization rate of medicinal plants at 33.33%. In contrast, individuals with a university education utilize medicinal plants very little, with a utilization rate of 26.66%. This group of individuals believes that these plants only provide an improvement in health status, and there are some who believe that medicinal plants can cause side effects, toxicity, and even worsen the illness, particularly in cases of oral administration. These findings also suggest that knowledge of medicinal plants is increasing among younger generations and is no longer limited to the elderly. This confirms that the transmission of this knowledge is not in danger.

Figure 5: Distribution of the population studied according to academic level

1. The Plant

E.1. Distribution based on plant use

The population in the region predominantly uses Ephedra foliata as a medicinal plant, with a percentage of 56%, followed by its use as a food plant, with a percentage of 40.66%, and rarely as a toxic plant, with a percentage of 03.33% (Figure 6).

E.2. State of the plant

Our survey on Ephedra foliata revealed that people use it mostly in its dry form (80.66%), while 19.33% of the surveyed population use it in its fresh state (Figure 7)

E.3. Parts used

The plant parts used are ranked in decreasing order of importance: stems (90.66%), leaves (07.33%), and the whole plant (02%). (Figure 8).

The high frequency of stem use can be explained by the ease and speed of harvest, as well as their availability in markets. The use of leaves can be attributed to their easy availability at herbalists and their ease of storage.

The survey also revealed that the majority of the population use the dried aerial part (mostly stems) because it contains active flavonoids and alkaloids, primarily ephedrine, pseudoephedrine, and nor-ephedrine known for their therapeutic properties

Figure 6: use of the plant

Figure 7: The state of use of the plant

Figure 8: the used part of the plant

E.4. Mode of preparation

To facilitate the administration of the active principle, several modes of preparation are employed, including decoction, infusion, poultice, and powder. Decoction, maceration, and infusion are the three most commonly used modes of preparation (Figure 9) , with rates of 39.33%, 24%, and 23.33%, respectively. These three modes of preparation are most commonly used, indicating that the local population prefers the decoction method, finding it suitable for warming the body and disinfecting the plant. Moreover, decoction enables the collection of the most active principles and mitigates or nullifies the toxic effect of certain recipes, as most medicinal plants are used in the form of tea, and temperature influences the property of active molecules (ephedrine) [7].

The survey results also indicate that 05.33% of the surveyed population use the plant in the form of a poultice, and 08% of the population use it in the form of a powder.

Figure 9: Method of preparing the plant

E.5. Dosages used

It was observed that 91.98% of the surveyed population use medicinal plants with imprecise dosages, of which 4.66% use a pinch, 38.66% use a spoon, and 48.66% use a handful. The dosage remains arbitrary, which can lead to harmful effects on health, as it is often said that "the dose makes the poison". In contrast, 8.02% of the population use medicinal plants with precise dosages (Figure 10).

Figure 10: Different doses used

E.6. Origin of information on traditional medicinal practices of the plant

Of the surveyed population, 66.66% relied on the experiences of others, such as their grandmothers, to use medicinal plants as remedies for specific illnesses (Figure 11). This reflects the relative transmission of traditional practices from one generation to the next. 14% of the population relied on herbalists and pharmacists, while 19.33% relied on themselves, either by consulting books on traditional Arab medicine, following TV programs, or based on their own experience due to the abundance of medicinal plants in their environment.

Elderly individuals also constitute an interesting source of information by transmitting their experiences and knowledge regarding the use of medicinal plants in general, and Ephedra foliata-L in particular. However, the opinion of medical personnel (such as doctors, pharmacists, and nurses) on dispensing adequate and safe advice regarding the use of Ephedra foliate L has been almost negligible.

Figure 11: Origin of information

E.7. Different diseases treated by Ephedra foliata

This survey (Figure 12) has enabled us to identify a number of diseases treated by Ephedra foliata. The results obtained show that this plant is involved in the treatment of cancer 13.33%, abortions 8.66%, and is frequently used to treat diabetes 6.66%. It is also used for cough and blood pressure 4.66%, gastric ulcer 4%, influenza 4%, intestinal gas 3.33%, obesity 2%, and renal and cardiac insufficiency1.33%. The ethnobotanical study carried out during this investigation indicates that the frequency of Alanda (Ephedra foliate L) use as a medicinal plant in the El Bayadh region is closely related to the profile of the surveyed individuals. Young people, compared to the elderly, generally do not know the scientific name or the usefulness of the plant. Women and men have a shared medicinal knowledge, with a slight advantage going to women.

The ethnobotanical survey revealed a multitude of results on the use of the plant, the parts used, and the diseases treated. Illiterates predominate with a rate of 40%. Foliage and stems are the most commonly used parts, occupying first place with a percentage of 97.99%. Women were found to hold traditional phytotherapeutic knowledge more often, with a percentage of 60%.

The moderately high percentage of knowledge of Alanda by these young adults shows their interest in this plant. These results also indicate that knowledge of medicinal plants is increasing among the new generations and is no longer limited to the elderly, confirming that the transmission of this knowledge is not in danger.

Cancer is the predominant disease treated by Ephedra foliata 13.33%, followed by abortions 8.66%, which confirms the plant's effectiveness in treating this disease. In third place is diabetes 6.66%, followed by cough and blood pressure 4.66%, gastric ulcer 4%, influenza 4%, intestinal gas 3.33%, obesity 2%, and renal and cardiac insufficiency 1.33%.

Ephedrine is capable of stimulating uterine contractions and can trigger an abortion. These results are consistent with those of a study conducted in Morocco [8], Ephedrine prevents the spread of cancer cells in the body and has a hypoglycemic action, justifying the use of the plant against cancer and diabetes. The immunomodulatory effect of this plant is proven, which may justify its use against asthma and cough, and against influenza (fever, nasal decongestion). This plant stimulates metabolic processes in the body, increasing fat burning [9], Through the use of doses and knowledge of methods of use with the state of the plant according to each disease.

Furthermore, these results, although preliminary, have allowed us to establish a source of information that contributes to a deeper understanding of the traditional use of Alanda on one hand and, on the other hand, to constitute a database for the valorization of the plant in order to discover new active principles usable in pharmacology.

Figure 12: Diseases treated by the plant

Traditional medicine is based on the use of medicinal plants and represents a valuable source of knowledge. In the region of El-Bayadh, an ethnobotanical survey was conducted to document the traditional use of Ephedra foliata by the local population for therapeutic purposes.

Results indicate that all parts of the plant are used for medicinal purposes, with usage frequency varying among different demographic groups. Female users were found to be more prevalent than males 60% vs. 40%. Ephedra foliata was used to treat various ailments such as abortion 8.66%, cancer 13.33%, diabetes 6.66%, cough 4.66%, and gastric ulcers 4%.

Despite its effectiveness, the plant was associated with several side effects including insomnia, anxiety, dizziness, headache, hypertension, and hypoglycemia. The over-harvesting of the plant has resulted in its significant decline in the study area.

This study highlights the importance of Ephedra foliata as a medicinal plant and calls for urgent conservation efforts by responsible authorities to prevent its extinction.

In summary, this ethnobotanical survey in El-Bayadh region provides valuable information about the traditional use of Ephedra foliata and its potential therapeutic benefits. However, the indiscriminate harvesting of the plant and associated side effects suggest the need for conservation strategies and further investigation of its safety and efficacy.

1. González-Juárez, Daphne E., et al. “A Review of the Ephedra genus: Distribution, Ecology, Ethnobotany, Phytochemistry and Pharmacological Properties.” Molecules, vol. 25, no. 14, July 2020, p. 3283, doi:3390/molecules25143283.
2. Al-Arjani, Al-Bandari Fahad, et al. “Arbuscular mycorrhizal fungi modulates dynamics tolerance expression to mitigate drought stress in Ephedra foliata ” Saudi Journal of Biological Sciences, vol. 27, no. 1, Oct. 2019, pp. 380–94, doi:10.1016/j.sjbs.2019.10.008.
3. Shinwari, Zabta Khan, and Syed Shahinshah Gilani. “Sustainable harvest of medicinal plants at Bulashbar Nullah, Astore (Northern Pakistan).” Journal of Ethnopharmacology, vol. 84, no. 2–3, Feb. 2003, pp. 289–98, doi:1016/s0378-8741(02)00333-1.
4. Bouzid, Aman, and Benabdeli Kheloufi. “Contribution to the Assessment of Green Biomass of Atriplex halimus Plantation in Arid Western Algeria (Region of Naama).” InTech eBooks, 2015, doi:10.5772/61505.
5. Doghbage, Abdelghafour, et al. “Leaf Morphological and Epidermal Traits Variability along an Environmental Gradients in Ten Natural Populations of Pistacia lentiscus.” Life, vol. 13, no. 7, July 2023, p. 1617, doi:3390/life13071617.
6. Abubakar, AbdullahiR, and Mainul Haque. “Preparation of medicinal plants: Basic extraction and fractionation procedures for experimental purposes.” Journal of Pharmacy and Bioallied Sciences, vol. 12, no. 1, Jan. 2020, p. 1, doi:4103/jpbs.jpbs_175_19.
7. Ducros, Laurent, et al. “Increasing Maternal Blood Pressure with Ephedrine Increases Uterine Artery Blood Flow Velocity during Uterine Contraction.” Anesthesiology, vol. 96, no. 3, Mar. 2002, pp. 612–16, doi:1097/00000542-200203000-00017.
8. Gandhi, G., Leão, G., Da Silva Calisto, V., Vasconcelos, A., Almeida, M., Quintans, J., Barreto, E., Narain, N., Júnior, L., & Gurgel, R. Modulation of interleukin expression by medicinal plants and their secondary metabolites: A systematic review on anti-asthmatic and immunopharmacological mechanisms.” Phytomedicine, vol. 70, Apr. 2020, p. 153229, doi:10.1016/j.phymed.2020.153229.