Ethnopharmacological study of plants used in the treatment of prostate cancer and benign prostatic hyperplasia in togo: the value of annona muricata (soursop)

Background: Prostate cancer and benign prostatic hyperplasia (BPH) are common reasons for consultation in Togo, where prostate cancer is still diagnosed at an advanced stage. Leaves of Annona muricata L. (soursop) are among the most frequently cited traditional remedies for these conditions, yet their local uses have never been systematically documented. Objective: To document the knowledge, practices and perceptions of traditional medicine stakeholders regarding A. muricata in the management of prostatic disorders. Methods: A cross-sectional ethnopharmacological survey was conducted from 31 December 2025 to 25 January 2026 among 84 respondents (53 medicinal plant sellers, 18 traditional healers, 8 patients or former patients, 3 caregivers and 2 others) in Greater Lomé (Golfe and Agoè-Nyivé prefectures), using a semi-structured questionnaire digitised in KoboToolbox. Analysis combined descriptive statistics, ethnobotanical indices (relative frequency of citation, fidelity level), χ², Fisher’s exact, Mann-Whitney and Kruskal-Wallis tests, Spearman correlation and logistic regression. Results: Soursop was known to 83 respondents (98.8%), mainly for its leaves (98.8%); knowledge was mostly inherited within the family (66.3%). The most frequently suggested indications were hypertension (78.0%), diabetes (75.6%), infections (65.9%) and prostatic disorders (62.2%; fidelity level = 62.2%). Thirty-nine of 79 respondents (49.4%) had already used or recommended the leaves for the prostate, particularly traditional healers (88.2%). The main preparation was an aqueous decoction or infusion (84.6%) taken orally, twice daily (82.8%) with honey (96.8%). Perceived efficacy was high (median 8/10; ≥ 7 in 78.9%), but 89.5% of respondents reported at least one adverse effect, mainly nausea (71.1%). Cost (60.5%) and lack of trust (63.2%) were the main barriers to biomedical care. Reported use differed markedly by survey area, an effect inseparable from the interviewer. Conclusion: A. muricata leaves hold an established place in the urban pharmacopoeia of Greater Lomé for prostatic disorders, with poorly standardised practices, modest gastrointestinal tolerability and frequent mixed care-seeking. These findings call for botanical authentication, chemical characterisation of traditional preparations, toxicity studies and structured collaboration between traditional healers and urology services.