Plants traditionally used in treating malaria, typhoid fever and piles in the Wa Municipality and Wa East (Funsi) District of the Upper West Region of Ghana.
Plants have been used for various purposes since prehistoric times [6,8,5]. Indian Ayurveda medicine used herbs as early as 1900 BC describing about 700 medicinal plants . Herbal medicine was also important from early days in Europe. Dioscorides who became popular with natural remedies about 60 AD described over 600 plants and plant extracts . Sir William Osler (1849-1919) a physician, born in Ontario, Canada described morphine as "God's own Medicine" .
In Ghana, the knowledge about medicinal plant uses has been passed on mainly through folklore. Recently, however, a few have been documented in many emerging publications including Ghana herbal Pharmacoepoeia and Floristic Studies of Ghana [11,9]. However, many more plants needs to be documented for immediate research and use and for posterity, even more so when plant use varies highly from place to place. In a situation where it has become a common knowledge that majority of the Ghanaian population estimated at 65% live in rural areas and are highly dependent on traditional herbal medicine, documentation as a prelude to research and standardization of the medicinal plant s in use for various ailments is a necessity to safeguard their rational and safe use. The World Health Organization estimates that there are between 300 and 500 million new cases of malaria worldwide, every year, mostly in Africa, Asia, South Pacific Islands and South America, which causes, at least, 3 million deaths. The main drugs developed for malaria and used up to now were discovered based on traditional use and ethno medical data. Therefore new efforts to search for novel drugs for treating malaria are very important in countries like Ghana, where many endemic areas still exist [12,2]. In 2000, it was estimated that over 2.16 million episodes of typhoid occurred worldwide, resulting in 216,000 deaths . This study therefore aimed at obtaining and identifying plants traditionally used in the treatment of malaria, typhoid fever and piles in the Wa municipality and Wa East District of Ghana with the hope that potential sources of treatments can be unearthed from medicinal plants. Malaria, typhoid fever and piles are the most prevalent diseases in these areas.
Materials and methods
Area of Study:
The area of study is Wa Municipality and Wa East (Funsi) Districts of the Uppr West Region. The Upper West Region of Ghana is located in the north-western corner of the country and is bordered by Burkina Faso to the north and La Cote D'Ivoire to the west. The capital and largest town is Wa. Other major towns include Nandom, Daffiema, Jirapa, Kaleo, Nadowli, Lawra, Tumu and Funsi. The major ethnic groups are the Dagaba, Sisaala and Wala. The Dagaba live in the western part of the district, the Sisaala live in the eastern areas, and the Wala live in South-western part of the district. The Sisaala and Dagaba are mostly Christians and animist, while most Wala are Muslims. Waali, the language of the Wala, and Dagaare, the language of the Dagaaba are mutually intelligible.
The major economic activity of the region is agriculture. Crops grown include corn, millet, groundnuts, okro, and rice. Mainly Sheep, goats, fowls and guinea fowls are raised for meat and eggs. The region has two main seasons-the wet season which is short covering May to September and the dry season extending roughly from October to May. The vegetation is Guinea savannah. Using the 2000 population census figures, Wa Town ship has a population of 576,583. About 7 out of every 10 males can be said to be literate but only about 4 out of every 10 females are literates (Ghana population census, 200).
Semi-random sampling (Burns, 2000) was employed. Each of the healers using various plants was met by chance in the selected area. Fifty one traditional healers were interviewed. All 51 healers were visited within from July 10th to July 24th 2010. Upon arrival at the house of each of the traditional healer, introductions were done and the purpose of the visit stated. After each interview, the healer was thanked and a packet of sugar given out to him/her as a sign of appreciation. Each traditional healer was made to answer a set of questions. Since most of the traditional healers were not formally educated, the questions had to be translated into the local dialect. The answers provided were used to complete the questionnaire. Wherever necessary, collected specimens were coded in the field for identification later.
The plants collected were identified by their vernacular names and their scientific equivalent found and documented.
Analysis of data:
The data collected were analyzed using Microsoft Exel.
Results and analysis:
The information obtained through the interview was grouped into two broad areas: a) Botanical source and part of the plant used in treatments and b) all other related information. The names of plants appearing in the survey are summarized in table1. In table 2, the methods of preparing the medicines from the plants have been summarized.
Disease frequency of occurrence and treatment:
Table three summarizes the frequency of malaria treatment by healers. Twenty-six healers claimed to treat between six to fifteen cases of malaria a week. Eleven healers claim to treat sixteen to twenty-five cases of malaria a week. These values are high and it could therefore be said that malaria is predominant in the area. The time used to treat malaria, typhoid fever and piles are also summarized in tables 4, 5 and 6. Of the fifty-one healers interviewed, forty-six of them treat typhoid fever. Five did not handle the disease at all (Table 7).
Thirty-eight of the fifty-one healers interviewed claimed to treat piles (Table 8).
This study was conducted to collect and identify plants traditionally used to treat malaria, typhoid and piles in the Funsi District and Wa Municipality.
The anus is surrounded by many blood vessels including the very weak '2,7,9 haemorrhoidal veins' If these become dilated and swollen, they project into the anal canal or out of the back passage to form visible swellings. The traditional healers interviewed generally described piles as a haemorrhoidal growth in the anus which is usually characterized by severe pain during defecation. Feces of patient normally contain mucous and blood. This description fits allopathic concept of piles very well however, the healers notion that piles may also affect the eyes of the patient causing them to itch is questionable.
Malaria was described by healers as a disease that causes fever, headache, loss of appetite, malaise sometimes accompanied by vomiting and dizziness. However these symptoms described by the healers are not peculiar to malaria alone since many other disease states such as typhoid may present with similar symptoms. Typhoid itself was diagnosed by symptoms such as fever, malaise, headache, vomiting, diarrhea and constipation. Though the symptoms given by healers tallies with allopathic descriptions, the healers need to refer patients to laboratory for confirmation diagnosis.
The study has provided information about the species of plants used in the treatment of malaria, typhoid fever and piles in the Wa and Funsi districts.
The species used in the treatment of malaria represents 37.3% of the total species reported whilst that of typhoid fever represents 32.2% and that of piles, 30.5% of the total species reported.
[FIGURE 1 OMITTED]
Most of the species used to treat malaria in the two areas are known to be anti-malarial plants and thus corroborate data from among other sources including Abbiw  and Mshana et al , but the study has also identified and documented the anti-malarial use probably for the first in Ghana of three species namely Haematostaphisbarteri, Monathotaxissp and Strychnosinnocua. Also for the first time, the use of Khayasenegalensis, Haemastostaphisbarteri, Mitragynainermis, Monanthotaxissp, Eucalyptus camaldulensis, Cochlospermumtinctorium and Acanthospermushispidum for the treatment of typhoid fever was recorded. First time usage of Piptoporusbetulinusand Vignea subterranean for management of piles was also recorded. Interestingly, there was some overlap in the species used in the treatment of malaria and typhoid fever. This could be either because some healers probably did not know the difference between malaria and typhoid fever and so treated the two diseases as the same illness or it could be just that the species used had both anti-malaria and anti-typhoid fever properties.
Thirty-three percent of the healers claim they se one week to treat typhoid. This information is particularly important since the condition is treated in a minimum of 10-14 days with conventional treatment methods. The data provided could thus provide more effective and easier methods of treating the condition. Generally the healers use at least three days to treat malaria and a maximum of a week (7 days) to treat the condition despite the differences in recipe. This data is therefore a prelude for standardization of preparations for wider use.
The frequency of treatment of the diseases (malaria, typhoid fever and piles) and the ability of herbalists encountered in the course of the study, in giving at least one herbal prescription for the diseases show the prevalence of the diseases in the area and how they have been tackled over time. Therefore these findings suggest that medicinal plants for the therapy of these conditions in the two districts are potential sources for the development of new drugs from indigenous plants from these two areas.
Twenty-two species from nineteen families have been identified for the treatment of malaria in the Wa Municipality and Wa East (Funsi) District Upper West Region of Ghana. Twenty-one species from ten families have been identified for the treatment of typhoid fever and eighteen species from fifteen families have been identified for management of piles in the two districts.
Cochlospermumtinctorium, Khayasenegalensis, Haemastostaphisbarteri, Mitragynainermis and Acanthospermushispidum have been identified as being used to treat both malaria and typhoid fever by some healers in the two districts. The study has also identified and documented the anti-malarial use, probably, for the first in Ghana of three species namely Haematostaphisbarteri, Monathotaxissp and Strychnosinnocuaand. Also for the first time, the use of Khayasenegalensis, Haemastostaphisbarteri, Mitragynainermis, Monanthotaxissp, Eucalyptus camaldulensis, Cochlospermumtinctorium and Acanthospermushispidum for the treatment of typhoid fever was recorded. First time usage of Piptoporusbetulinus and Vigneasubterranean for the treatment of piles was also recorded.
The authors would like to acknowledge the technical staff of Pharmacognosy department, all herbalists interviewed in the study area, the ranger, Mr. Bahass who offered to guide the tour and to the forestry department (Wa, Ghana) who helped with the identification.
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[9.] Mshana, R.N., D.K. Abbiw, I. Addae-Mensah, E. Adjanouhoun, M.R.A. Ahyi, J.A. Ekpere, E.G. Enow-Rock, Z.O. Gbile, G.K. Noamesi, M.A. Odei, A. Odunlami, A.A. Oteng-Yeboah, K. Sarpong, A. Sofowora, Tackie, 2001. Traditional Medicine and Pharmacopoeia; Contribution to the Revision of Ethno botanical and Floristic Studies in Ghana. Science and Technology Press, CSIR, pp: 920.
[10.] Ochiai, R.L., C.J. Acosta, M.C. Danovaro-Holliday, B. Dong, S.K. Bhattacharya, M.D. Agtini, A.B. Zulfiqar, D.G Canh,. M. Ali, S. Seonghye, J. Wain, P. Anne-Laure, J. Farrar, R. Abu-Elyazeed, T. Pang, C.M. Galindo, S. Lorenz von and J.D. Clemens, 2011. A study of typhoid fever in five Asian countries: disease burden and implications for controls. Bulletin of the World Health Organization, 89(7): 469-544.
[11.] Policy Research and Strategic Planning Institute, Council for Scientific and Industrial Research, CSIR, Ghana, 1992. Ghana Herbal Pharmacopoeia, pp: 295.
[12.] Symth, J.D., 1994. Animal Parasitology, 3rd edition. Cambridge University Press, pp: 549.
(1) Sam, G.H., (2) Mensah, M.L.K., (3) Annan, Kofi and (4) Sena Zahree
(1,2,3) Department of Herbal Medicine, College of Health Sciences, Kwame Nkrumah University of Science and Technology (KNUST), Kumasi, Ghana.
(4) Department of Pharmacognosy, College of Health Sciences, Kwame Nkrumah University of Science and Technology (KNUST), Kumasi, Ghana.
Sam, G.H., Mensah, M.L.K., Annan, Kofi and Sena Zahree; Plants Traditionally Used in Treating Malaria, Typhoid Fever and Piles in the Wa Municipality and Wa East (Funsi) District of the Upper West Region of Ghana
Sam, G.H., Department of Herbal Medicine, College of Health Sciences, Kwame Nkrumah University of Science and Technology (KNUST), Kumasi, Ghana.
Table 1: Plantscited in the study area. Vernacular name (1, 2) (Waale-Sissali) Scientific name 1. Naahoonyeko[??]biri Paulina pinnata 2. Gbalenbili Cochlospermumtinctorium 3. Kogo Khayasenegalensis 4. Sunsugree Aradirachtaindica 5. Dondoleeyeelee Mitragynainermis 6. Nansaalesunsugree Cassia sieberiana 7. Guava Psidiumgnavaja 8. Bedawsaalong Sidaacuta 9. Nyegimaalee Hoslundiaopposita 10. Bogovaare Acanthospermushispidum 11. Magengeri Carica papaya 12. Vape[??]laa Strychnosinnocua 13. Puhae Tamarindusindica 14. Kambasagha Lippiaadoensis 15. Kyuuna Combretumghasalense 16. Kpela Pseudocedrelakotschyi 17. Gbentori Lanneaacida 18. Haarielel Alchorneacordifolia 19. Gimberi Haematostaphisbarteri 20. Myanbeine Monanthotaxissp 21. Lumbumiihuu Citrus aurantifolia 22. Simbiri Vigneasubterranea 23. Bawye[??]lee Phyllanthusdiscoideus 24. Mongo Mangiferaindica 25. Bilenbi Plumbagozeylanica 26. Shiwaaka Veroniaamygdalina 27. Jumburi Kigeliaafricana 28. Misi Xylopiaaethiopica 29. Nyegimaalee Hoslundiaopposita 30. Satutulee Monadoramyristica 31. Bedawsaalong Sidaacuta 32. Duosingbuo Piptoporusbetulinus 33. Kogo Khayasenegalensis 34. Moose sunsugree Dialiumguineense 35. Kooka bark Harunganamadagascariensis 36. Kwagiri Corchorusolitorius 37. Maakyehaa Blighiasapida 38. Guongae Nauclealatifolia 39. kpakpaga Emilia sonchifolia 40. Shiwaaka Veroniaamygdalina 41. Kogo Khayasenegalensis 42. Gimberi Haemastostaphisbarteri 43. Dondoliyelee Mitragynainermis 44. Myanbeine Monanthotaxissp 45. Baabili Eucalyptus camaldulensis 46. Odubrafo(Twi) Mareyam icrantha 47. Gyama (Twi) Alchorneacordifolia 48. Gbalenbile Cochlospermumtinctorium 49. Bogovaare Acanthospermushispidum 50. Kongo[??] 51. Pootei (Twi) 52. Logone[??]he 53. Kponkpolo 54. Gronongtikpa (Gonja) 55. Baabean 56. Simago[??] 57. Logone[??]he 58. Lawkperi 59 Konbarisaaka(Gonja) Vernacular name (1, 2) (Waale-Sissali) Family 1. Naahoonyeko[??]biri Sapindaceae 2. Gbalenbili Bixaceae 3. Kogo Meliaceae 4. Sunsugree Meliaceae 5. Dondoleeyeelee Rubiaceae 6. Nansaalesunsugree Leguminosae 7. Guava Myrtaceae 8. Bedawsaalong Malvaceae 9. Nyegimaalee Labiatae 10. Bogovaare Compositae 11. Magengeri Caricaceae 12. Vape[??]laa Logoniaceae 13. Puhae Caesalpinadeae 14. Kambasagha Verbenaceae 15. Kyuuna Combretaceae 16. Kpela Meliaceae 17. Gbentori Anacardiaceae 18. Haarielel Euphorbiaceae 19. Gimberi Anacardiaceae 20. Myanbeine Annonaceae 21. Lumbumiihuu Rutaceae 22. Simbiri Fabaceae 23. Bawye[??]lee Euphorbiaceae 24. Mongo Anacardiaceae 25. Bilenbi Plumbaginaceae 26. Shiwaaka Asteraceae 27. Jumburi Bignoniaceae 28. Misi Annonaceae 29. Nyegimaalee Lamiaceae 30. Satutulee Annonaceae 31. Bedawsaalong Malvaceae 32. Duosingbuo Fomitopsidaceae 33. Kogo Meliaceae 34. Moose sunsugree Leguminosae 35. Kooka bark Hypericaceae 36. Kwagiri Tiliaceae 37. Maakyehaa Sapindaceae 38. Guongae Rubiacaea 39. kpakpaga Asteraceae 40. Shiwaaka Asteraceae 41. Kogo Meliaceae 42. Gimberi Anacardiaceae 43. Dondoliyelee Rubiaceae 44. Myanbeine Annonaceae 45. Baabili Myrtaceae 46. Odubrafo(Twi) Euphorbiaceae 47. Gyama (Twi) Euphorbiaceae 48. Gbalenbile Bixaceae 49. Bogovaare Compositae/ Asteraceae 50. Kongo[??] 51. Pootei (Twi) 52. Logone[??]he 53. Kponkpolo 54. Gronongtikpa (Gonja) 55. Baabean 56. Simago[??] 57. Logone[??]he 58. Lawkperi 59 Konbarisaaka(Gonja) Vernacular name (1, 2) (Waale-Sissali) Use/S 1. Naahoonyeko[??]biri Malaria 2. Gbalenbili Malaria 3. Kogo Malaria 4. Sunsugree Malaria 5. Dondoleeyeelee Malaria 6. Nansaalesunsugree Malaria 7. Guava Malaria 8. Bedawsaalong Malaria 9. Nyegimaalee Malaria 10. Bogovaare Malaria 11. Magengeri Malaria 12. Vape[??]laa Malaria 13. Puhae Malaria 14. Kambasagha Malaria 15. Kyuuna Malaria 16. Kpela Malaria 17. Gbentori Malaria 18. Haarielel Malaria 19. Gimberi Malaria 20. Myanbeine Malaria 21. Lumbumiihuu Malaria 22. Simbiri Piles 23. Bawye[??]lee Piles 24. Mongo Piles 25. Bilenbi Piles 26. Shiwaaka Piles 27. Jumburi Piles 28. Misi Piles 29. Nyegimaalee Piles 30. Satutulee Piles 31. Bedawsaalong Piles 32. Duosingbuo Piles 33. Kogo Piles 34. Moose sunsugree Piles 35. Kooka bark Piles 36. Kwagiri Piles 37. Maakyehaa Piles 38. Guongae Piles 39. kpakpaga Typhoid fever 40. Shiwaaka Typhoid fever 41. Kogo Typhoid fever 42. Gimberi Typhoid fever 43. Dondoliyelee Typhoid fever 44. Myanbeine Typhoid fever 45. Baabili Typhoid fever 46. Odubrafo(Twi) Typhoid fever 47. Gyama (Twi) Typhoid fever 48. Gbalenbile Typhoid fever 49. Bogovaare Typhoid fever 50. Kongo[??] Typhoid fever 51. Pootei (Twi) Typhoid fever 52. Logone[??]he Typhoid fever 53. Kponkpolo Malaria 54. Gronongtikpa (Gonja) Typhoid fever 55. Baabean Typhoid fever 56. Simago[??] Typhoid fever 57. Logone[??]he Typhoid fever 58. Lawkperi Typhoid fever 59 Konbarisaaka(Gonja) Piles Table summary: Plant species for Malaria, 22; typhoid, 19; piles, 18 (1) Unless otherwise stated, the vernacular names are Waale- Sissali. (2) Plants numbered 50 to 59 have not been identified by their scientific names. Table 2: Plants and methods of preparation for use in the study area. Plant Species Local Name Indication (Waale-Sissali) Paulina pinnata Naahoonyekobiri Malaria: Cochlospermumtinctorium Gbalenbili Malaria Khayasenegalensis Kogo Malaria Aradirachtaindica Sunsugree Malaria Mitragynainermis Dondoleeyeelee Malaria Psidiumguavaja Guava Malaria Sidaacuta Bedawsaalong Malaria Hoslundia opposite Nyegimaalee Malaria Cassia sieberiana Nansaalesunsugree Malaria Acanthosperm ushispidum Bogovaare Malaria Citrus aurantifolia Lumbimiihuu Malaria Carica papaya Magengeri Malaria Strychnosinnocua Vapelaa Malaria Tamarindusindica Puhae Malaria Lippiaadoensis kambasagha Malaria Com bretumghasalense Kyuuna Malaria Lanneaacida Gbentori Malaria Alchorneacordifolia Haarielel Malaria Haematostaphisbarteri Gimberi Malaria Monanthotaxissp Myanbeine Malaria Vigneasubterranea Simbiri Piles Phyllanthusdiscoideus Bawyelee Piles Mangiferaindica Mongo Piles Plum bagozeylanica Bilenbi Piles Kigeliaafricana Jumburi Piles Xylopiaaethiopica Misi Piles Hoslundiaopposita Nyegimaalee Piles Monadoramyristica Satutulee Piles Veroniaamygdalina Shiwaaka Piles Sidaacuta Bedawsaalong Piles Piptoporusbetulinus Duosingbuo Piles Khayasenegalensis Kogo Piles Khayasenegalensis Kogo Piles Dialiumguineense Moose sunsugree Piles Harunganamatdagascariens is Kooka bark Piles Corchorusolitorius Kwagiri Piles Blighiasapida Maakyehaa Piles Emilia sonchifolia Kpakpaga Typhoid fever Veroniaamygdalina Shiwaaka Typhoid fever Khayasenegalensis Kogo Typhoid fever Mitragynainermis Dondoliyelee Typhoid fever Chorchorusolitorus Kwagiri Typhoid fever Monanthotaxissp Myanbeine Typhoid fever Mareyamicrantha Odubrafo Typhoid fever Alchorneacordifolia Gyama Typhoid fever Acanthosperm ushispidum Bogovaare Typhoid fever Cochlospermumtinctorium Gbalenbili Typhoid fever Plant Species Method of Preparation Paulina pinnata Boil leaves and drink three times daily Cochlospermumtinctorium Boil chopped roots and drink Khayasenegalensis Boil stem bark and drink Aradirachtaindica Boil leaves, drink and use for steam bath Mitragynainermis Boil leaves and twigs and drink 3 times daily Psidiumguavaja Boil leaves and drink decoction Sidaacuta Drink leave decoction 3 times daily Hoslundia opposite Boil leaves and drink 3 times a day Cassia sieberiana Boil chopped roots and drink. Boil leaves and use as steam bath Acanthosperm ushispidum Boil leaves and drink and also use as steam bath Citrus aurantifolia Boil leaves and/or fruit juice and drink. (May add sugar) Carica papaya Boil leaves with leaves of Azadirachtaindica and drink Strychnosinnocua Drink leave decoction Tamarindusindica Boil leaves and stem bark and drink decoction 3 times daily Lippiaadoensis Boil leaves and drink twice daily (May add sugar) Com bretumghasalense Boil leaves and drink decoction Lanneaacida Boil leaves with leaves of Mangiferaindica. Drink and use as steam bath for three days Alchorneacordifolia Boil leaves and drink decoction Haematostaphisbarteri Boil leaves with leaves of Psendocedrelakotschyi Drink twice daily Monanthotaxissp Boil leaves and twigs and drink 3 times daily Vigneasubterranea Char leaves and mix with Shea butter and apply to the area Phyllanthusdiscoideus Burn leaves and let smoke pass over area. Char leaves, mix with shea butter and apply to affected area Mangiferaindica Burn stem bark and let smoke pass over affected area. Boil leaves with Xylopiaaethiopica fruit and drink. Plum bagozeylanica Boil leaves and use as enema Kigeliaafricana Burn leaves and fruits and let smoke pass over area. Apply charred leaves and fruit with shea butter and apply Xylopiaaethiopica Grind fruit and mix with Shea butter and apply to area. make fruit decoction and drink Hoslundiaopposita Boil leaves,add fruit juice of Citrus aurantifoliaand drink Monadoramyristica Char leaves, mix with shea butter and apply to affected area. Boil leaves and drink 2 times a day Veroniaamygdalina Grind leaves and boil in water with Tamarindus. Strain and drink infusion. May add sugar. Sidaacuta Grind charred leaves and mix with shea butter and apply to affected area Piptoporusbetulinus Grind and mix with shea butter and apply to affected area Khayasenegalensis Boil stem bark and leaves and drink and use as enema Khayasenegalensis Grind stem bark, boil sieve and drink 3 times daily Dialiumguineense Grind charred leaves, mix with Shea butter and apply area. Boil leaves and drink 2 times daily Harunganamatdagascariens is Burn stem bark and let smoke pass over area. Grind bark boil and sieve and drink Corchorusolitorius Boil leaves and drink 3 times daily Blighiasapida Boil leaves and stem bark and drink. Char stem bark and grind and mix with Shea butter and apply to area Emilia sonchifolia Boil chopped leaves and drink 3 times a day Veroniaamygdalina Boil chopped leaves with Tamarindus and drink Khayasenegalensis Boil stem bark and leaves and drink Mitragynainermis Boil leaves and twigs with leaves of neem tree and drink. May add sugar. Chorchorusolitorus Boil leaves and drink Monanthotaxissp Boil leaves and drink 3 times daily. Use as steam bath. Mareyamicrantha Boil leaves with leaves of Veroniaamygdalina and drink Alchorneacordifolia Boil leaves and drink Acanthosperm ushispidum Grind leaves with hot pepper, sieve and drink Cochlospermumtinctorium Boil chopped roots and drink Table 3: Frequency of malaria treatment. Number of Cases of Number of Healers Malaria Seen in A Week 1-5 5 6-15 26 16-25 11 [greater than or equal to] 26 5 Table 4: Duration of time used to treat malaria. Number of Days Used Number of Healers To Treat Malaria 0-3 23 4-7 24 [greater than or equal to] 8 0 Table 5: Duration of time used to treat typhoid fever. Period Used in Treating Number of Healers Typhoid Fever (Weeks) 0-1 15 1-2 22 2-3 5 3-4 2 [greater than or equal to] 4 1 Table 6: Duration of time used to treat piles. Period Used In Treating Number of Healers Piles (Weeks) 0-1 11 1-2 14 2-3 10 3-4 2 [greater than or equal to] 4 1 Table 7: Frequency of typhoid fever treatment. Number of Healers Number of Cases of Typhoid Fever Seen In A Week 19 0-5 20 6-15 4 16-25 3 [greater than or equal to] 25 Table 8: Frequency of treating piles Number of Cases of Number of Healers Seen In A Week 0-5 cases 16 6-15 cases 22