Medicinal plants used for childhood diarrhoea in Sub-Saharan Africa: A systematic review of ethnobotanical and pharmacological validation with conservation considerations

Childhood diarrhoea remains a major health challenge in Sub-Saharan Africa (SSA), where medicinal plants continue to play a vital role in disease management, particularly in rural communities with limited access to modern healthcare. Literature was systematically searched from Google Scholar, Elsevier, PubMed, and EBSCOhost in accordance with PRISMA guidelines. A total of 95 medicinal plants distributed across 46 families, and six countries, were identified, with Fabaceae (14 species) being the most represented family. Trees constituted the predominant growth form (77%), and leaves (49%) and roots (40%) were the most frequently used plant parts. Decoction (41%) and maceration (40%) were the primary preparation methods, while oral administration (60%) was the common route of delivery. Importantly, only six countries (13%) of the SSA region have documented ethnobotanical data on childhood diarrhoea. Antimicrobial assays were the most commonly investigated bioactivities (76%), and 84% of the species had bioactive compounds reported. Isolated phytochemicals, including kaempferol, gallic acid, and catechin, have demonstrated antidiarrhoeal potential through anti-inflammatory, antioxidant, antimicrobial, and smooth muscle relaxation mechanisms. Several plants were also used to treat respiratory (55%) and other gastrointestinal ailments (47%). Conservation assessment revealed that most species (69%) were of least concern, data deficient (22%), and either vulnerable, near threatened, or critically endangered (5%). This systematic review provides a focused synthesis of medicinal plants used specifically for childhood diarrhoea in SSA, addressing a gap in previous reviews that have largely focused on diarrhoea in general or community perceptions and practices. The findings highlight the need to recognise paediatric traditional healthcare in ethnopharmacological research and to prioritise the safety, efficacy, conservation, and potential drug discovery of medicinal plants used for children, with implications for paediatric public health.