Herbal product use in urban slum communities of Freetown, Sierra Leone: Consumption patterns, predictors, and ethnomedicinal applications.

backgroundHerbal products, encompassing medicinal plants and processed formulations, remain central to primary healthcare in informal settlements, where access to conventional medical services is limited. Despite their widespread use in Sierra Leone, contemporary consumption patterns are poorly documented. This study investigated herbal consumption patterns, predictors, and ethnomedicinal applications among adults in urban slum communities of Freetown.

methodsA cross‑sectional quantitative study was conducted between February and December 2024 among 422 participants in Cockle Bay, Kroo Bay, and Susan's Bay. Data were collected using a questionnaire covering socio‑demographic, consumption practices, influencing factors, and perceptions of herbal medicine. Participants were categorized as low, moderate, or high consumers using a consumption scale. Multinomial logistic regression identified predictors of consumption levels, while binary logistic regression examined predictors of herbal product use as sexual stimulants. Odds ratios (OR) with 95% confidence intervals were reported, with statistical significance set at p < 0.05.

resultsAmong the participants, 171 (40.5%) were low-level consumers, while 140 (33.2%) were high-level consumers. Community of residence was the strongest predictor: Kroo Bay residents were less likely to be low (OR = 0.09, p < 0.001) or moderate consumers (OR = 0.47, p = 0.046) compared with Susan's Bay. Young adults aged 18-29 were nearly three times more likely to be moderate consumers than high (OR = 2.79, p = 0.013). Income also showed significance, with those earning SLL 600-2,999 less likely to report moderate consumption (OR = 0.38, p = 0.039). Ethnomedicinal reliance was extensive, with the medicinal plant Cassia sieberiana DC. (Red Gbangba) used for malaria (90%), Cymbopogon citratus (DC.) Stapf (Lemon Grass) for colds (84.6%), and the commercial herbal mixture Coco Samba for sexual stimulation (49.8%). Overall, 314 participants (74.4%) reported using herbal products as sexual stimulants, with men (AOR = 7.53, p < 0.001) and Kroo Bay residents showing the highest likelihood (AOR = 10.05, p < 0.001). Perceptions were largely positive, with 90.0% endorsing nutrient value and 87.4% considering herbal products natural and safe.

conclusionHerbal products play an essential and multidimensional role in the well-being of slum residents in Freetown. Elevated usage rates, significant community-specific influences, and frequent reliance on sexual stimulants underscore the need for culturally grounded regulation, consumer safety education, and integration strategies that reflect local realities.