Acute respiratory infections (ARIs) are one of the leading causes of morbidity and mortality worldwide, affecting individuals across all age groups but disproportionately impacting young children, the elderly, and those in low-income settings[1]. These infections, which primarily affect the respiratory tract, range from mild upper respiratory conditions like the common cold to severe lower respiratory diseases such as pneumonia and bronchitis[2]. According to the World Health Organization (WHO), ARIs are responsible for approximately 4 million deaths annually, with pneumonia ranking as the single largest infectious cause of death in children under five years old, accounting for 15% of all deaths in this age group[3]. The burden of ARIs is particularly high in developing countries due to factors such as poor sanitation, malnutrition, limited access to healthcare, and overcrowded living conditions, which facilitate the rapid spread of pathogens[4]. Furthermore, the rise of antimicrobial resistance has compounded the challenge of managing ARIs, as the overuse and misuse of antibiotics reduce the efficacy of treatments[5]. In the context of public health, ARIs represent a significant challenge due to their economic impact, which includes healthcare costs, lost productivity, and the strain on healthcare systems during outbreaks [6-8].

In the Philippines, acute respiratory infections (ARIs) pose a significant public health burden, particularly in rural and underserved communities where access to healthcare and preventive measures is limited. ARIs, including pneumonia and bronchitis, rank among the top causes of morbidity and mortality in the country, with children under five and the elderly being the most vulnerable groups [9-11]. According to the Department of Health (DOH), pneumonia is consistently one of the leading causes of death among Filipino children, contributing to the high child mortality rate. Rural areas and underserved communities face heightened challenges due to a combination of socioeconomic factors, such as poverty, inadequate healthcare infrastructure, poor sanitation, and malnutrition, which exacerbate susceptibility to infections and hinder timely treatment [12,13]. Environmental factors further compound the burden of ARIs in these areas[14]. Many rural households rely on biomass fuels for cooking and heating, leading to indoor air pollution, a recognized risk factor for respiratory infections [15-17]. Additionally, limited access to clean water and proper hygiene facilities increases the risk of transmission of respiratory pathogens[18]. Seasonal patterns, such as increased rainfall and typhoons, can also lead to overcrowded evacuation centers, creating environments conducive to the spread of ARIs [19]. Healthcare accessibility is a critical issue in these communities. Many rural areas have insufficient healthcare workers, limited supplies of medicines, and under-resourced health facilities, making it difficult to manage ARI cases effectively [20]. The financial burden of seeking medical care or traveling to urban centers for treatment often discourages early intervention, resulting in more severe cases and higher mortality rates [21, 22].

The reliance on medicinal plants is deeply embedded in the cultural and healthcare practices of many communities [23], particularly in resource-limited areas where access to conventional medicine is often constrained. Across generations, traditional knowledge of medicinal plants has been preserved and passed down [24], forming a cornerstone of primary healthcare for millions of people worldwide. In rural and underserved communities, including those in the Philippines, medicinal plants serve as an accessible and affordable alternative to pharmaceuticals, addressing a range of health conditions, including respiratory infections [25]. For communities with limited healthcare infrastructure, medicinal plants provide a practical solution to the barriers of cost and accessibility associated with modern medicine [26, 27]. Culturally, the use of medicinal plants is often integrated with traditional healing practices and local beliefs, fostering a sense of trust and acceptance among community members. Healers and non-healers believe that combining medicinal plants can produce synergistic effects [28]. These practices not only address physical health needs but also contribute to the preservation of cultural heritage and biodiversity[29]. Moreover, the use of medicinal plants aligns with sustainable healthcare practices by promoting the use of renewable natural resources [30]. In many cases, these plants have demonstrated therapeutic efficacy for treating ARIs through their antimicrobial, anti-inflammatory, and immune-boosting properties, making them a valuable resource for complementing or substituting conventional treatments [31-33].

Despite recent scientific advancement and globalization, the system of traditional medicine and alternative medicine is considered a primary healthcare modality in resource-constrained healthcare settings. However, the gradual fading of traditional knowledge among younger generations may hinder the preservation of cultural heritage and valuable insights into medicinal plants. Thus, this study aims to document and evaluate the traditional medicinal plants used in treating acute respiratory infections among the local people of Linamon, Lanao, Del Norte, Philippines.

Study Area 

Linamon is a municipality located in Northern Mindanao, Philippines, and known as the gateway to Lanao Del Norte. Located within the grid coordinates 8º 09’ 00” to 8º 10’ 30” north latitude and 124º 07” 30” to 124º 10’ 30”. Elevation at these coordinates is estimated at 32.0 meters or 105.1 feet above sea level. It has eight (8) Barangays, five (5) coastal Barangays viz., Poblacion, Mago-ong, Samburon, Larapan, and Napo, and the three (3) interior Barangays are: Bosque, Purakan, and Robocon. 

Data Collection

Prior to conducting the interviews, approval letters were secured from the municipal mayor and the respective barangay captains. A purposive sampling method was employed in this study to gather specific data. Preliminary data was collected from municipal health centers, and acute respiratory infections (ARI), being the most reported case over the past five years.

The sampling area comprises eight barangays viz; Poblacion, Mago-ong, Samburon, Larapan, Napo, Bosque, Purakan, and Robocon. The study also took 20 respondents from every barangay, a total of 160 respondents participated in the study. Elders are purposely selected as respondents (ages 30-80) since they know a lot about the study and were interviewed individually using a semi-structured questionnaire. The plant species used in the treatment, the type of ARI treated by a plant, the part of the plant used, and the mode of preparation and application were asked during the survey. A possible source of the infections was also asked if there were any. The personal backgrounds of the respondents were also recorded, like their name, gender, age, and civil status.

Identification of medicinal plants utilized by the local people

Plant species mentioned by the local people were photo-documented. The plant species that are not common were collected in the field to aid in the identification. Identification of plant species was referred to Madulid[34], Merrill[35], and the Co’s Digital Flora[36] aid in the identification of the plant species and verified by the Botanist faculty from the Department of Biological Sciences, Mindanao State University-Iligan Institute of Technology. After plant identifications, the herbarium specimens were done for comparison and verification of each plant and arranged alphabetically with their exact nomenclature, family name, botanical name, common name, habit, used parts, medicinal uses, and other uses. Then, the preserved herbarium specimens were donated to the Botany Museum at MSU-IIT.

Data Analysis

Relative Frequency Citation (RFC)

Data that was gathered was analyzed using the Relative Frequency of Citation (RFC). The importance of each plant was calculated based on the RFC[37].

Assessment of the Conservation Status and Endemicity

IUCN: International Union for Conservation of Nature and the data from Merrill’s (1923–1926) Philippine Digital Botanical Literature Index[38] and the DENR Administrative Order of 2017 [39] were used. 

Demographic Profile of the Respondents

A total of 160 respondents from Linamon, Lanao Del Norte, Philippines, participated in the study through Key Informant Interviews (KII) and semi-structured questionnaires. As shown in Table 1, the majority of the respondents were female (85.00%), while males accounted for only 15.00%. This finding reflects the role of women, particularly housewives, in preserving knowledge of medicinal plants. Women are often the primary caregivers in their families and rely on medicinal plants for healthcare, especially in areas where access to modern medicine is limited [40, 41]. The highest percentage of respondents belonged to the 51–60 age group. This suggests that older individuals continue to hold significant knowledge of medicinal plants, passed down verbally from generation to generation[42]. However, there is a growing concern that this knowledge could be lost as fewer young people engage in these traditional practices [43]. Documenting the knowledge of medicinal plants is, therefore, essential to ensure that they are not forgotten over time.

Table 1. Demographic Profile of the Respondents in Linamon, Lanao Del Norte, Philippines

Table 2 shows the plant family, scientific name, and relative frequency citation (RFC) values of medicinal plants used in treating acute respiratory infections among the local people in Linamon. The Coleus amboinicus, Carica papaya, Citrus macrocarpa, Zingiber officinale, and Blumea balsamifera are the top five medicinal plant species with the highest Relative Frequency Citation (RFC). 

The Coleus amboinicus belongs to the Lamiaceae family and is well-known for its aromatic leaves and has significant potential for clinical applications due to its diverse array of bioactive phytochemicals and pharmacological activities, including antitumor, antibacterial, antifungal, anti-inflammatory, antioxidant, and antidiabetic effects [44, 45]. In this study, several respondents mentioned that the fresh leaves of “Kalabo” are boiled to prepare an herbal tea or decoction, which is consumed to relieve flu-like symptoms. They also use this plant as a natural steam inhalation remedy as its aromatic properties help clear nasal passages and reduce congestion. Some also mentioned that the crushed leaves are applied externally on the chest to provide relief from respiratory discomfort.

Carica papaya has been traditionally used in managing various ailments, including antibacterial, antipyretic, insecticidal, and antimicrobial effects, and is a potential nutraceutical agent for treating various diseases [46, 47]. Its medicinal properties are attributed to the bioactive compounds present in its leaves, fruits, and other parts of the plant [48]. It is rich in Vitamin C, beta-carotene, and other antioxidants, which help boost the immune system [49]. During the interviews, the respondents shared that they consumed raw green papaya fruit (unripe) as a remedy for tonsillitis and pharyngitis. Additionally, they mentioned that the flowers of the male papaya plant were pounded to extract sap, which was then consumed as a treatment for influenza. 

Table 2. List of Medicinal plant species and their Relative Frequency Citation (RFC) values.

The diversity of plants remains essential for human beings, providing numerous modern and traditional remedies for the healthcare system [50, 51]. Table 3 shows the list of medicinal plant species used by the locals in Linamon, Lanao Del Norte to treat acute respiratory infections along with their botanical name, local names, family, parts used, mode of preparation and administration, relative frequency citation value (RFC), endemicity and conservation status of the medicinal plant species are given below. A total of 59 species were recorded belonging to 36 botanical families. Lamiaceae (7) are families with the highest number of species followed by Euphorbiaceae (5), Rutaceae (4), Asteraceae/Compositae (3), Anonaceae (2), Asteraceae (2), Cyperaceae (2), Gramineae (2), Amaryllidaceae/Liliaceae (2), Piperaceae (2), Poaceae/Gramineae (2), Zingiberaceae (2) other botanical families have only one (1) species). 

Lamiaceae holds the top position among the families used as medicinal plants, especially in treating acute respiratory infections. It comprises about 236 genera and 6,900 to 7,200 species; many species are cultivated for their fragrant leaves and attractive flowers, and it is particularly important to humans for herb plants, especially in medicinal properties [52]. Various secondary metabolites have been reported to be present in the members of this family, especially sesquiterpene lactones, in addition to volatile oils and terpenoids [53]. Perhaps these secondary metabolite profiles, together with a large number of species, are primarily responsible for the relevance of this family in traditional medicine. According to Firdaus et al. [54], the leaves of this plant have been traditionally used for coughs, colds, asthma, and bronchitis.

Moreover, the high representation of other families, such as Euphorbiaceae, Rutaceae, and Zingiberaceae, suggests the availability and diversity of medicinal plant options for ARI treatment. Families like Zingiberaceae are widely recognized for their bioactive compounds, such as gingerols and shogaols, which contribute to their use in managing inflammation and respiratory infections [55, 56]. Similarly, members of Rutaceae are often rich in essential oils and flavonoids that are known for their antiviral and antimicrobial properties, which can directly support respiratory health [57, 58]. Traditional remedies are a cornerstone of respiratory ailment management in Linamon, Lanao Del Norte, forming a vital part of the region’s primary healthcare system. Influenza viruses, as the leading cause of respiratory infections, pose significant health risks, particularly to vulnerable populations such as the elderly, infants, and those with chronic illnesses [59]. This situation underscores the critical reliance on traditional remedies in the absence of accessible modern healthcare, such as vaccines and antiviral treatments.

An ethnobotanical survey revealed that neonates and young children are especially vulnerable to influenza due to immature immune systems and behaviors that promote germ transmission, such as face-touching and close physical interactions [60, 61]. This reliance on traditional remedies highlights the need for deeper understanding and preservation of these practices to ensure continued healthcare support. 

Leaves are the most commonly utilized plant parts in traditional medicine due to their high concentration of medicinal compounds, sustainability, and ease of collection [62]. Their widespread use reflects their practicality and effectiveness in treating respiratory ailments [63]. Fruits are the second most used, valued for their nutritional and therapeutic benefits, such as boosting immunity and alleviating symptoms of acute respiratory infections (ARI) [64]. Roots, while effective due to their bioactive compounds, present sustainability challenges as their harvest disrupts plant growth and reproduction [65]. This calls for careful resource management to balance therapeutic benefits with ecological preservation.

Other plant parts, including flowers and rhizomes, are used for specific purposes. Flowers offer aromatic and anti-inflammatory properties, while rhizomes like ginger provide antimicrobial and soothing effects on the respiratory system [66, 67]. These diverse applications underscore the extensive knowledge of local communities and the importance of sustainable harvesting to ensure long-term availability.

Decoctions are the most common preparation method due to their simplicity, cost-effectiveness, and efficacy, reflecting the adaptability of traditional medicine to meet community needs [62]. However, many ethnobotanical studies fail to document detailed preparation methods and the reasoning behind plant selection, limiting the reproducibility and scientific understanding of these remedies [68]. Factors such as locality, harvest time, and plant growth stage significantly influence the levels of active compounds, highlighting the need for comprehensive documentation.

The preference for herbs, shrubs, and trees in traditional medicine reflects their abundance, accessibility, and resilience to environmental factors. This selection is shaped by socio-cultural beliefs, ecological conditions, and traditional practices, illustrating the interconnectedness of local ecosystems and healthcare [51, 69].

In remote areas of Linamon, the availability of medicinal plants is critical for addressing health issues, especially where healthcare facilities are scarce. Common species are more frequently used, while rare species face threats from overexploitation and habitat loss. Sustainable cultivation and harvesting practices are essential to prevent shortages and ensure the continued availability of these resources [70, 71].

Table 3. List of Medicinal Plants Mentioned by the Respondents in Linamon, Lanao Del Norte, Philippines in treating Acute Respiratory Infections.

Cultivating medicinal plants empowers communities by providing a reliable and accessible healthcare resource. For families in remote locations, this approach offers a practical solution to healthcare challenges while preserving biodiversity and traditional knowledge. By adopting sustainable practices, the balance between resource utilization and conservation can be maintained, securing the future of traditional remedies in primary healthcare systems.

Endemicity and Conservation Status

Table 4 shows the endemicity and conservation status of medicinal plants used against respiratory infections in Linamon, 59 plant species were evaluated through IUCN Red list [38] categories and DAO [39]. Regarding endemicity, 32 plant species were not endemic to the Philippines, while 27 were native. For conservation status based on the IUCN, one species was classified as endangered, 23 as least concern, five as data deficient, and 30 plant species had no recorded data. However, based on DAO (2017), no conservation data was available for any of the recorded plant species.

Table 4. Endemicity and Conservation Status of Medicinal Plant Species in Linamon, Lanao Del Norte, Philippines 

In essence, inhabitants from Linamon determined and made use of 59 medicinal plant species, belonging to 36 families for acute respiratory infections. Lamiaceae (7) are the families with the highest number of species followed by Euphorbiaceae (5), Rutaceae (4), Asteraceae/Compositae (3), Anonaceae (2), Asteraceae (2), Cyperaceae (2), Poaceae/Gramineae (2), Amaryllidaceae/Liliaceae (2), Piperaceae (2), Poaceae/Gramineae (2), Zingiberaceae (2) other botanical families have only one (1) species. Among the parts, leaves have been maximally used in decoction form and administered orally for the treatment of respiratory infections. RFC values “Kalabo” as a common species in treating acute respiratory infections. Flu from influenza virus is a common ARI mentioned by the respondents, especially in neonatal and young children. The study revealed that the people of Linamon are still inclined toward the use of medicinal plant species as an alternative medicine, especially those families living in interior Barangays and kilometers away from hospitals or health centers. According to some locals, older generations from 51-60 still have this knowledge, and the transmission of this to the next generation through verbal communication is important. This preliminary result on the importance of plants in the field of medicine could be a way to conserve local knowledge as well as the conservation of biodiversity. Furthermore, this study could also lead to the production of a new pharmaceutical product. 

The authors declare that they have no conflict of interest

No funding sources

The study was approved by the Mindanao State University – Iligan Institute of Technology, Iligan City, 9200 Philippines

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