Plant use and perceptions in the context of sexual health among people of Congolese descent in Belgium.

BACKGROUND: The use of medicinal plants is integral to global healthcare systems, with Sub-Saharan Africa maintaining a robust tradition of herbal medicine alongside Western-oriented healthcare. As migrant communities tend to continue traditional herbal practices after migration, documenting this use is vital to develop culturally sensitive healthcare. This study investigates plant usage and perspectives in the context of sexual and reproductive health among the Congolese community in Belgium, particularly in the Matongé quarter of Brussels. Our research questions were: (1) What is the current knowledge of medicinal plants among the Congolese community in Belgium in the context of sexual health, and what are the applications and commonly employed administration methods of these plants? (2) What role does herbal medicine play in the context of sexual health for people of Congolese descent in Belgium and how this is influenced by perceptions of sexuality? and (3) Is there a gender bias in the use of medicinal plants, and if so, can this be related to perceived gender norms? METHODS: We conducted 22 semi-structured interviews with people of Congolese descent currently living in Belgium. Participants were selected using both snowball sampling and purposive sampling. Plant use in the context of sexual health was recorded through freelisting. Data on narratives, ideas, and perceptions of this plant use in the context of sexual health were collected. Interview transcripts were analyzed using thematic analysis. RESULTS: We identified 17 plant species used for sexual health. Three overarching themes emerged from our data. Plants were used with a notable gender bias favoring male sexual potency enhancement. Men used these plants for both remedying potency issues and enhancing sexual prowess. In contrast, knowledge about plants for female sexual health was limited. Gender norms reinforced the importance of male sexual potency, while stigmatizing open discussions of female sexuality. CONCLUSIONS: The use of medicinal plants for sexual health raises health, social, and conservation concerns, underscoring the need for further research in this area. This study contributes to understanding medicinal plant use within the Congolese community in Belgium and highlights the necessity for future research on herbal practices for female sexual health in this context.

Phytochemical Profiling by UPLC-ESI-QTOF-MS of Kalaharia uncinata (Schinz) Moldenke, Widely Used in Traditional Medicine in DR Congo.

Kalaharia uncinata (Schinz) Moldenke, is a tropical erect bushy shrub or subshrub of the Lamiaceae family. It is an endemic plant species of Southern Africa, widely used in the pharmacopoeia against upper respiratory tract infections. A previously conducted ethnobotanical survey revealed that it is believed to contain bioactive substances. However, no relevant phytochemical information was available. This study aimed to perform a phytochemical characterization of K. uncinata and also to discuss the potential bioactivity of the identified phytochemical constituents based on documented data. Ultra-performance liquid chromatography with electrospray ionization quadrupole time-of-flight mass spectrometry (UPLC-ESI-QTOF-MS) was used for profiling and identification of the main phytochemical constituents from leaf extracts (MeOH 90 %, DCM, AcOEt, BuOH, hexane and residue) of K.uncinata. Twenty-four constituents, representing mainly flavonoids (14), followed by phenylethanoid glycosides (7), phenolic acids (2), and an iridoid glycoside (1) were tentatively identified. Most of the identified compounds are documented to have antiviral and anti-inflammatory properties, which could possibly be the rationale behind the use of K. uncinata against upper respiratory tract infections.

Family Physician Perceptions of Climate Change, Migration, Health, and Healthcare in Sub-Saharan Africa: An Exploratory Study.

Although family physicians (FPs) are community-oriented primary care generalists and should be the entry point for the population's interaction with the health system, they are underrepresented in research on the climate change, migration, and health(care) nexus (hereafter referred to as the nexus). Similarly, FPs can provide valuable insights into building capacity through integrating health-determining sectors for climate-resilient and migration-inclusive health systems, especially in Sub-Saharan Africa (SSA). Here, we explore FPs' perceptions on the nexus in SSA and on intersectoral capacity building. Three focus groups conducted during the 2019 WONCA-Africa conference in Uganda were transcribed verbatim and analyzed using an inductive thematic approach. Participants' perceived interactions related to (1) migration and climate change, (2) migration for better health and healthcare, (3) health impacts of climate change and the role of healthcare, and (4) health impacts of migration and the role of healthcare were studied. We coined these complex and reinforcing interactions as continuous feedback loops intertwined with socio-economic, institutional, and demographic context. Participants identified five intersectoral capacity-building opportunities on micro, meso, macro, and supra (international) levels: multi-dimensional and multi-layered governance structures; improving FP training and primary healthcare working conditions; health advocacy in primary healthcare; collaboration between the health sector and civil society; and more responsibilities for high-income countries. This exploratory study presents a unique and novel perspective on the nexus in SSA which contributes to interdisciplinary research agendas and FP policy responses on national, regional, and global levels.

Ethnobotanical characterization of medicinal plants used in Kisantu and Mbanza-Ngungu territories, Kongo-Central Province in DR Congo.

BACKGROUND: The phytotherapeutic knowledge of the Kongo people in the territories of Kisantu and Mbanza-Ngungu in Kongo-Central Province (DR Congo) is rapidly eroding. To document the remaining knowledge, we conducted an ethnobotanical survey on the most important medicinal plant species and diseases treated with them, as well as plants with therapeutic potential. We also checked for the cultural similarity in medicinal plant knowledge between the two territories and how knowledge about Kongo medicinal plants differs between different social groups. METHODS: From June 2017 until February 2018 and from February 2019 until April 2019, we conducted a survey with 188 phytotherapists, selected using the snowball method and surveyed using semi-structured interviews. Voucher specimens were taken for identification. Ethnobotanical data were analyzed using medicinal use value (UVs), informant agreement ratio (IARs), informant consensus factor (ICF), and species therapeutic potential (STP). Rahman's similarity index was used for ethno-cultural comparison of medicinal plant knowledge between the two communities. Medicinal knowledge between different social groups was analyzed using non-parametric tests and Poisson regression. RESULTS: A total of 231 plants (i.e., 227 botanical species, representing 192 genera and 79 families) were reportedly used to treat 103 diseases. Most abundant taxa were reported for the Fabaceae family (including 11.9% of species and 10.9% of genera). Most reported species (45.0%) were from anthropized areas. Leaves (39.4%), herbs (37.1%), decoction (41.7%), and oral ingestion (72%) were the most frequently cited plant part, botanical form, preparation, and administration method, respectively. Four of all inventoried species showed high UVS (> 0.05), whereas eight had an IAR of one. According to ICF, 31 diseases were mentioned. Highest ICF (≥ 0.4) was observed for hemorrhoids (0.44), amoebiasis (0.43), and itchy rash (0.42). Fifty-four plant species were identified as likely possessing an interesting therapeutic potential. Low ethno-cultural similarity in medicinal knowledge (RSI = 16.6%) was found between the two territories. Analysis of the Kongo medicinal plant knowledge showed that the mean number of reported species and diseases vary considerably depending on gender, type, and residence of therapists (P < 0.05). CONCLUSION: Results prove that the Kongo phytopharmacopeia makes use of interesting medicinal plant species that could be further studied for conservation and pharmacological applications.

The Health Risks of Belgian Illicit Indoor Cannabis Plantations.

We assessed the prevalence of potential health hazards to intervention staff and cannabis growers in Belgian indoor cannabis plantations. Surface mold swab samples were taken at 16 Belgian indoor plantations contained mostly Penicillium sp. and Aspergillus sp. However, their precise health impact on intervention staff and illicit growers is unclear as no molds spore concentrations were measured. Atmospheric gas monitoring in the studied cannabis plantations did not reveal dangerous toxic substances. Health symptoms were reported by 60% of 221 surveyed police, but could not be linked to specific plantation characteristics. We conclude that Belgian indoor cannabis plantations pose a potential health threat to growers and intervention staff. AS there are currently no clear safety guidelines for seizure and dismantling of Belgian indoor cannabis plantations, we recommend first responders to follow strict safety rules when entering the growth rooms, which include wearing appropriate personal protective equipment.

Dietary species richness as a measure of food biodiversity and nutritional quality of diets.

Biodiversity is key for human and environmental health. Available dietary and ecological indicators are not designed to assess the intricate relationship between food biodiversity and diet quality. We applied biodiversity indicators to dietary intake data from and assessed associations with diet quality of women and young children. Data from 24-hour diet recalls (55% in the wet season) of n = 6,226 participants (34% women) in rural areas from seven low- and middle-income countries were analyzed. Mean adequacies of vitamin A, vitamin C, folate, calcium, iron, and zinc and diet diversity score (DDS) were used to assess diet quality. Associations of biodiversity indicators with nutrient adequacy were quantified using multilevel models, receiver operating characteristic curves, and test sensitivity and specificity. A total of 234 different species were consumed, of which <30% were consumed in more than one country. Nine species were consumed in all countries and provided, on average, 61% of total energy intake and a significant contribution of micronutrients in the wet season. Compared with Simpson's index of diversity and functional diversity, species richness (SR) showed stronger associations and better diagnostic properties with micronutrient adequacy. For every additional species consumed, dietary nutrient adequacy increased by 0.03 (P < 0.001). Diets with higher nutrient adequacy were mostly obtained when both SR and DDS were maximal. Adding SR to the minimum cutoff for minimum diet diversity improved the ability to detect diets with higher micronutrient adequacy in women but not in children. Dietary SR is recommended as the most appropriate measure of food biodiversity in diets.

The use of pesticides in Belgian illicit indoor cannabis plantations.

Cannabis (Cannabis spp.) use and cultivation continue to increase in many (European) countries. The illicit indoor cannabis plantations that supply Belgian and European cannabis markets create problems and concerns about health and safety of intervention staff, dismantling companies, the direct environment of cannabis plantations and, eventually, of cannabis users. Main risks may come from pesticide residues on plants, cultivation infrastructure and materials; left-over plant growth-promoting substances; mycotoxins from fungal pathogens on harvested plants; and/or high levels of cannabinoids in cannabis plant parts for consumption. In the present research, we report on pesticides found in illicit indoor cannabis plantations in Belgium. EN15662 QuEChERS extraction method and LC-MS/MS analysis were used to identify pesticides in indoor cannabis plantations and thus to evaluate the hazards associated with the use, cultivation and removal of cannabis plants in plantations as well as with dismantling activities in the cultivation rooms. We found pesticides in 64.3% of 72 cannabis plant samples and in 65.2% of 46 carbon filter cloth samples. Overall, 19 pesticides belonging to different chemical classes were identified. We found o-phenylphenol, bifenazate, cypermethrin, imidacloprid, propamocarb, propiconazole and tebuconazole, which is consistent with the commonly reported pesticides from literature. In only a few cases, pesticides found in bottles with a commercial label, were also identified in plant or stagnant water samples collected from the growth rooms where the bottles had been collected. We further revealed that, even though most pesticides have a low volatility, they could be detected from the carbon filters hanging at the ceiling of cultivation rooms. As a result, it is likely that pesticides also prevail in the plantation atmosphere during and after cultivation. The risk of inhaling the latter pesticides increases when plants sprayed with pesticides are intensively manipulated during dismantling activities. We conclude that pesticides represent an underestimated and under-documented health risk for intervention staff. The standard procedure for dismantling illicit indoor cannabis cultivation sites should be improved by including guidelines for appropriate personal protection equipment and dismantling protocols that take into account all possible hazards.

Why is it so difficult to determine the yield of indoor cannabis plantations? A case study from the Netherlands.

Together, the Netherlands and Belgium are the largest indoor cannabis producing countries in Europe. In both countries, legal prosecution procedure of convicted illicit cannabis growers usually includes recovery of the profits gained. However, it is not easy to make a reliable estimation of the latter profits, due to the wide range of factors that determine indoor cannabis yields and eventual selling prices. In the Netherlands, since 2005, a reference model is used that assumes a constant yield (g) per plant for a given indoor cannabis plant density. Later, in 2011, a new model was developed in Belgium for yield estimation of Belgian indoor cannabis plantations that assumes a constant yield per m2 of growth surface, provided that a number of growth conditions are met. Indoor cannabis plantations in the Netherlands and Belgium share similar technical characteristics. As a result, for indoor cannabis plantations in both countries, both aforementioned yield estimation models should yield similar yield estimations. By means of a real-case study from the Netherlands, we show that the reliability of both models is hampered by a number of flaws and unmet preconditions. The Dutch model is based on a regression equation that makes use of ill-defined plant development stages, assumes a linear plant growth, does not discriminate between different plantation size categories and does not include other important yield determining factors (such as fertilization). The Belgian model addresses some of the latter shortcomings, but its applicability is constrained by a number of pre-conditions including plantation size between 50 and 1000 plants; cultivation in individual pots with peat soil; 600W (electrical power) assimilation lamps; constant temperature between 20°C and 30°C; adequate fertilizer application and plants unaffected by pests and diseases. Judiciary in both the Netherlands and Belgium require robust indoor cannabis yield models for adequate legal prosecution of illicit indoor cannabis growth operations. To that aim, the current models should be optimized whereas the validity of their application should be examined case by case.

In vitro antimicrobial activity of plants used in traditional medicine in Gurage and Silti Zones, south central Ethiopia.

BACKGROUND: To overcome the escalating problems associated with infectious diseases and drug resistance, discovery of new antimicrobials is crucial. The present study aimed to carry out in vitro antimicrobial analysis of 15 medicinal plant species selected according to their traditional medicinal uses in Gurage and Silti Zones, south central Ethiopia. METHODS: Ethanol extracts of various plant parts were investigated for their antimicrobial activity against 20 bacterial and one yeast strains. The minimum inhibitory concentration (MIC) was determined by broth microdilution method. RESULTS: Asparagus africanus, Guizotia schimperi, Lippia adoensis var. adoensis and Premna schimperi were active against Candida albicans, Enterococcus faecalis and Staphylococcus aureus at a concentration of 512 µg/ml or lower. Strong antibacterial activity (MIC≥128 µg/ml) was observed for G. schimperi extract against 17 resistant and sensitive Staphylococcus strains, at a concentration comparable to standard antibiotics. Moreover, this extract showed higher antibacterial activity for the test against S. aureus ATCC 33591, ATCC 33592, SA3 and SA5 strains (128-256 µg/ml) than oxacillin (512 µg/ml). CONCLUSIONS: The study revealed in vitro antibacterial activity of plants used in folk medicine in south central Ethiopia. The usefulness of these plants, in particular of G. schimperi, should be confirmed through further phytochemical and toxicity analyses.

Filling in the blanks. An estimation of illicit cannabis growers' profits in Belgium.

BACKGROUND: As a result of increased pressure on cannabis cultivation in The Netherlands, the number of confiscated indoor cannabis plantations in Belgium is rising. Although increases are reported for all plantations sizes, half of the seized plantations contain less than 50 plants. In this study, factors and variables that influence costs and benefits of indoor cannabis cultivation are investigated as well as how these costs and benefits vary between different cannabis grower types. METHODS: Real-situation data of four growers were used to perform financial analyses. Costs included fixed and variable material costs, as well as opportunity costs. Gross revenue per grow cycle was calculated based on most recent forensic findings for illicit Belgian cannabis plantations and was adjusted for the risk of getting caught. Finally, gross revenues and return on costs (ROC) were calculated over 1 year (4 cycles). FINDINGS: Financial analysis shows that in all cases gross revenues as well as ROC are considerable, even after a single growth cycle. Highest profitability was found for large-scale (600 plants, ROC=6.8) and mid-scale plantations (150 plants, ROC=6.0). However, industrial plantations (23,000 plants, ROC=1.4) and micro-scale plantations (5 plants, ROC=2.8) are also highly remunerative. Shift of police focus away from micro-scale growers, least likely to be involved in criminal gangs, to large-scale and industrial scale plantations would influence costs as a result of changing risks of getting caught. However, sensitivity analysis shows that this does not significantly influence the conclusions on profitability of different types of indoor cannabis growers. CONCLUSION: Seizure and confiscation of profits are important elements in the integral and integrated policy approach required for tackling illicit indoor cannabis plantations. The large return of costs evidenced in the present study, underpin the policy relevance of confiscating those illicit profits as part of enforcement.

Yield and turnover of illicit indoor cannabis (Cannabis spp.) plantations in Belgium.

In prosecution, Belgian judiciary currently uses outdated yield figures (28.1g per plant, sold at € 3/g at grower level) for fining illicit indoor cannabis plantations. Using state-of-the-art cultivation techniques, our growth experiments showed that yield is better expressed in g/m(2) cultivated surface area rather than in g per plant, and that yield varies significantly between different cannabis strains. It was found that the lower-bound of the one-sided 95% confidence interval of the yield of an indoor cannabis plantation can be set at 575 g/m(2). Prices and pricing mechanisms were investigated using interviews with respondents selected through snowball sampling. Results reveal that (i) the Belgian cannabis market chain is highly complex; (ii) unit prices are predominantly determined by transaction sizes; but also (iii) a set of product- and socially-related price-fixing mechanisms have an equally important role. At grower level, respondents reported prices for 1 g of dry cannabis buds to range € 3.00-4.25.

Factors determining yield and quality of illicit indoor cannabis (Cannabis spp.) production.

Judiciary currently faces difficulties in adequately estimating the yield of illicit indoor cannabis plantations. The latter data is required in penalization which is based on the profits gained. A full factorial experiment in which two overhead light intensities, two plant densities and four varieties were combined in the indoor cultivation of cannabis (Cannabis spp.) was used to reveal cannabis drug yield and quality under each of the factor combinations. Highest yield was found for the Super Skunk and Big Bud varieties which also exhibited the highest concentrations of Δ(9)-tetrahydrocannabinol (THC). Results show that plant density and light intensity are additive factors whereas the variety factor significantly interacts with both plant density and light intensity factors. Adequate estimations of yield of illicit, indoor cannabis plantations can only be made if upon seizure all factors considered in this study are accounted for.