Popular use of medicinal plants in the municipality of Tefé, Amazonas, Brazil.

Medicinal plants are natural products used since ancient times, and the knowledge regarding their properties and use is transferred from one generation to the next. Many people continue to consume this natural product, which has made this means of treatment relevant in the eyes of researchers. The search for this learning using the collection of information as a source is increasingly growing, thus allowing to study their properties, their therapeutic powers, and active principles. For this reason, this work aimed to collect, analyze and record information about the level of knowledge of the population about pre-established medicinal plants, their origin, the form of use and the pharmacological effects of these species cultivated in the municipality of Tefé-Amazonas, Brazil. The collection of information took place through an interview, which contained questions regarding the plants: pobre-velho ( Costus spicatus ), escada de jabuti ( Bauhinia rutilans ), mucuracaá ( Petiveira alliacea ), sucuuba ( Himatantuhs sucuuba ) and panquelé ( Piper amapens ). The data collected had satisfactory results where it was observed that a large part of the population knows and makes use of the plants mentioned and often the same plant is used for different pathologies. Another relevant point is that some plants are known with different names, and many people did not recognize them by the names mentioned, which made the answers of the interviews inaccurate at times, however, did not compromise the results. Therefore, the knowledge of the population has great relevance for the enrichment of knowledge about natural products, where many scholars are able to discover and develop products that are essential for curing, treating or preventing diseases that are often referred to as irremediable.


Introduction
The use of plants for medicinal application has been carried out since the beginning when primitive man depended on nature's resources for his survival and healing, so they were one of the main means for these ends (Weyrich, et al., 2017;Almeida, 2011). Medicinal plants are so called because they have active principles that help in the therapeutic process of curing diseases. They can be found both in nature and on small family farms. Knowledge about the use of these plants is always passed from generation to generation. However, it is necessary to know about the therapeutic principles due to these organisms, since many can be harmful to health, depending on their origin, method of preparation, and lack of knowledge of their pharmacological actions (Silveira & Bassan, 2021;Shirabayashi et al., 2021).
Among the areas of study, there is ethnobotany, which analyzes the subsisting relationship between man and plants in a dynamic way, through the uses of medicinal plants given by the ancient population that did not have access to drugs (Monteiro & Brandelli, 2017). Another area responsible for studying the use of medicinal plants is ethnopharmacology which, contrary to what many people believe, does not refer to popular superstitions, but the knowledge acquired by the population through traditional knowledge. In addition, this has a great contribution to the discovery of new phytochemical compounds with pharmacological properties, providing relevant aspects about the precaution in the use of medicines extracted from nature (Elisabetsky, 2003;Pio et al., 2018).
The Amazon is the largest biodiversity database on the planet. Consequently, it is where the great mass of medicinal plants is located, sheltering a vast amount of indigenous peoples and traditional populations that acquired over time knowledge about how to live in different environments and how to make use of each plant (Carvalho, 2019). The extraction of forest resources is a very common activity in the municipalities of Amazonas, including the municipality of Tefé, which contains about 59,250 inhabitants (IBGE, 2021). In this city, family farming is the most used economic activity, in addition to fishing and hunting (Gomes, 2018). Even with the advancement of the health system, there is still a lot of difficulty in receiving good care in hospital units, due to the lack of trained professionals, materials, structures, and the difficulty of moving from neighboring communities to the Basic Health Unit (UBS) or hospital. In addition, most of the population of Tefé has a low income, which makes it impossible to buy medicines in drugstores/pharmacies (Queiroz, 2019).
For these reasons, the population seeks other means of obtaining treatment for their illnesses, such as, for example, medicinal plants that are part of the culture of many family members, where they exchange pharmacological medicines for teas, bottles, syrups, and baths made with these plants, which stimulates the study of the relationship between the population and nature (SEDECTI & SECTI, 2021). With this concept in mind, this work aimed to collect, analyze, and record information about the population's level of knowledge about the plants studied: origin, use, and the pharmacological effects of these species cultivated in the municipality of Tefé -Amazonas, Brazil.

Study area
The opinion poll was carried out in the municipality of Tefé, which is located in the physiographic region of Solimões-Tefé. This is one of the most central municipalities in the state of Amazonas (Figure 1), with the headquarters (Tefé) located on the right bank, in the mouth/east direction, of Lake Tefé (Sousa, 1989). Due to its location close to the confluence of the Japurá and Juruá rivers with the Solimões river and being a little distant from the Jutaí river, Tefé is characterized as a supply depot in river arteries, having great importance for the distribution of products and the circulation of people (Santos, 2012;Sousa, 1989). Research, Society and Development, v. 11, n. 16, e336111636745, 2022 (CC BY 4.0) | ISSN 2525-3409 | DOI: http://dx.doi.org/10.33448/rsd-v11i16.36745 4 Tefé has a territorial area of 23,692.223 km 2 and, according to the Brazilian Institute of Geography and Statistics (IBGE, 2021), the population present in the last census carried out in 2010 was 61,453 people. However, it is estimated that in the 2021 was approximately 59,250 inhabitants.
The city monopolizes important public services that serve the inhabitants of the city, the rural population, and neighboring municipalities. The economic income of the urban population is through commerce, where retail and wholesale stores, bank agencies, hotels, and supermarkets are present. In the primary sector, the main income comes from agriculture, followed by livestock, fishing, and plant extraction (IDSM, 2022;Gomes, 2018).
The city has two public hospitals and health posts in several neighborhoods. According to the IBGE, there are 26 municipal health establishments and five private ones. It also has universities: Amazonas State University (UEA) and Federal Institute of Education of Amazonas (IFAM), in addition to private universities. The capital of Amazonas, Manaus, is 521 km away from Tefé, where both can be accessed by flights, boats, and speedboats. These types of transport, including canoeing, are also used by the population and neighboring communities of the municipality of Tefé to access other cities and municipalities (IDSM, 2022).

Data Collection and Analysis
The work began in March 2021 in the city of Tefé-AM with the choice of medicinal plants that would be used to carry out the research through works reported in the literature. The selected plants were: pobre-velho (Costus spicatus), escada de jabuti (Bauhinia rutilans), mucuracaá (Petiveira alliacea), sucuuba (Himatantuhs sucuuba), and panquelé (Piper amapens).
In the second stage, the questionnaire for opinion research was produced, containing objective and essay questions regarding the selected medicinal plants (Table 1). The research took place voluntarily, the elements were people aged between 22 and 66 years old, all of whom were residents of the city of Tefé. The questionnaire was applied by the scholarship students and they were carried out in public places, such as the municipal fair of Tefé, streets, and the Regional Hospital of Tefé Carlos Braga for the employees and in some residences that were selected by the interviewers. After the conclusion of the interview, all the data collected were stored and transferred to an electronic spreadsheet, to later carry out the production of graphs and analysis of the results. The resource used to transfer the data to the spreadsheet was Google Forms.

Respondentes Profiles
The age range of the interview participants was 22 to 66 years (the approximate age of the oldest participant according to the questionnaire). Of the 200 participants interviewed, 61% were women and 39% had a mean age of 37.94 years for men and 35.43 years for women (Table 2). Most of the respondents belong to the female gender. It is inferred that this result is due to the fact that the interview was carried out in public places such as the municipal fair of Tefé, where the interviews were concentrated, and which are usually frequented by women. Generally, those who carry out the sales and purchases of products are women since the husbands are responsible for collecting products for sale. The fact that there were a greater number of women at the fair corroborates the data from IDSM (2013), where during their interview with 55 fair traders, 58% were female, in addition, Scalco et al. (2012) in their research carried out in two fairs, found that most of the visitors to these places are women.
The level of education was not used as a criterion for classifying people to answer this research, as it is about traditional knowledge that is transmitted through orality from generation to generation. According to Pires et al. (2014), the use of medicinal plants is similar between illiterates and those with a high level of education, that is, even though many people do not have education through schools, they can obtain knowledge regarding the use of medicinal plants. Tuler (2011) shows that people who have a low level of education have deeper knowledge regarding the use of medicinal plants because they are restricted from using these means for the treatment and cure of diseases due to a lack of access to specific medicines.

Identification, diseases, and use of medicinal plants
According   During the interview, they were asked about its usefulness and 43% said that it is used to cure diseases, 28.5% for medicinal use in the treatment of infections and inflammation, and 28.5% to treat other types of diseases (Figure 4). In the work carried out by Silva et al. (2022) the participants of their interview reported that medicinal plants are used for the treatment of diseases such as stomach pains, flu, and general inflammation, with 13.1, 12.8, and 10.3%, respectively.
Research, Society andDevelopment, v. 11, n. 16, e336111636745, 2022 (CC BY 4.0) | ISSN 2525-3409 | DOI: http://dx.doi.org/10.33448/rsd-v11i16.36745  Regarding the diseases for which each plant is used, we made a table containing: scientific name, popular name, part used by the population, preparation method, and its main uses (Table 3). The method of preparation for the application of the plants is essential to obtain the desired effect and, for this reason, the interviewees were asked how they used them and the result was that 49% use them in the form of tea, and tea bath, 15.5% tea, bath and infusion in bottle, 14.5% use only as tea, 13% reported that they do not use the plants mentioned, and 8% use it only as a tea bath ( Figure 5). Corroborating these results, Vásquez et al. (2014) observed that 62.2% of their respondents used medicinal plants in teas. In the research by Queiroz (2019), the most cited form of preparation was also tea, obtaining a total of 86 citations, followed by infusion in bottle with 34 and macerated with 20 citations. In the work by Silva et al. (2022), respondents reported that the most used method for the preparation of medicines with medicinal plants is in the form of tea (61.1%), followed by tea bath (8.5%), syrup (6%), submerged in water (5.1%), and juice (4.8%).

Himatanthus sucuuba
Sucuuba Stem bark Tea, bath tea Bath for women, stomach ache, and urine pain.

Leaves
Tea Stomach ache, colic, fever, and constipation. Because these plants are quite common in the municipality of Tefé, when we asked what other names the population knew these plants by, 70% reported knowing them only by the names mentioned, 19% knew the panquelé as elixir parigórico, but other names were also mentioned: matricá, óleo-elétrico, pimenta-de-macaco, and ventre-livre. 11% differed only with mucuracaá names: erva de alho, erva de guiné, and erva pipi ( Figure 6). Most of the respondents knew the panquelé only as elixir parigórico, making it difficult to answer the other questions in the questionnaire, but after detecting this, at the time of the interview, both names were used to identify the plant by the population. Pinto (2008) reiterates that one of the great difficulties to expand the knowledge about medicinal plants is their popular name, since many are different from one place to another, for this reason, to have reliability when collecting data and information. The scientific name can be used, however, these are not known by society. When asked about the efficiency of medicinal plants, 55.5% of the participants think that they are better than pharmaceutical remedies, 28.5% reported that they are great for use in the treatment of diseases and 16% were divided in the opinions that are good to use and have less side effect than pharmaceutical drugs and are important for the use of people who do not have access to pharmacy drugs (Figure 7). In the work developed by Silva et al., (2019), among 70 participants, 45 reported that they consider medicinal plants to be more effective than pharmacy remedies, 6 said they are no longer effective, 15 did not know how to respond and 4 do not use them. It was found in the obtained data that there is always a comparison between natural and synthetic products. Generally, this comparison occurs due to the experience that the person has with the plant, with the effects that it presents or because it is a natural product and, consequently, is considered less aggressive. Regarding the question about which medicinal plants the participants used: 18% answered that they did not use them, 18% used boldo, mangarataia (ginger), and malvarisco; 15% boldo, corama, and mastruz; 15% used corama, mint, mastruz, and mangarataia; 13.5% boldo, mucuracaá, panquelé and corama; 12% capim santo (lemongrass), erva-cidreira (lemon balm), mutuquinha, pobre-velho, barbatimão, alfavaca, and crajiru; and 8.5% mastruz, jambú, and corama ( Figure 8). As we can see, one of the plants most cited by the population is boldo, this result is similar to the research by Silva et. al. (2019), where 65.7% of respondents cited this medicinal plant as the most used in the region of Abacatal, Ananindeua (PA), other plants that were also mentioned were the paregórigo/panquelé elixir (17.1%), alfavaca (18.6%), mucuracaá (18.6%), and capim santo (20%). Brasileiro et al. (2008) in their work carried out in Governador Valadares -Minas Gerais, Brazil, observed that boldo was the second most used plant and erva cidreira the first one. Mint and cana-de-macaco/pobre-velho were also presented as the most used medicinal plants. When asked if they had plants with medicinal properties in their homes, 36.5% of respondents reported that they did not, while 63.5% said they had (Figure 9). This fact was also confirmed by Silva et al. (2022), where 47% of the residents of Santa Tereza, a neighborhood in the city of Tefé, did not cultivate. Similarly, Pedrollo et al. (2016) in a study carried out in communities on the Jauaperi river, between the states of Amazonas and Roraima, reported that 63% of respondents did not cultivate medicinal plants. This fact is justified by the fact that the Amazonian culture is quite extractive, in which instead of cultivating, the population obtains the products through nature. Among the people who cultivated, 17.5% cultivated mucuracaá, boldo, and corama, 12.5% mangarataia, mucuracaá, corama and quebra-pedra, 6% pobre-velho, mangarataia, and boldo. The others were divided in the cultivation of arruda (rue), capim santo, erva cidreira, malvarisco, sara-tudo, algodão roxo, panquelé and mint (Figure 9). It is worth noting that the plants that are normally cultivated by the population are the most used also because of the ease of access to them.
As previously described 63.5% of respondents cultivate some medicinal plant in their homes (Figure 9), a fact also confirmed by de Marçal et al. (2003), in Goioerê, a municipality located in the interior of Paraná (southern Brazil), where 66% cultivated certain species of medicinal plant in their backyards. In the municipality of Porto Alegre -Rio Grande do Sul (also southern Brazil), 86.2% of the population of the Ponta Grossa neighborhood reported that they planted medicinal plants (Vendruscolo & Mentz, 2006). In an interview carried out by Cassino (2010) in floodplain communities of the Solimões-Amazonas River -Brazil, 70.5% of the medicinal species mentioned by the participants were cultivated in the region.  Regarding the replacement of synthetic drugs by plants with medicinal properties, most respondents said they did ( Figure 11). People who use medicinal plants believe that they are less aggressive to the body and that they do not have adverse reactions. However, this information may be wrong, as several plants that do not have a study on their toxic profile, which can cause damage to health. These reactions are related to the chemical constitution and can cause intoxications and allergies (Silveira et al., 2008).

Conclusions
Medicinal plants are very present in the lives of residents of the municipality of Tefé-Amazonas, Brazil. Most of them use these plants as medicine and believe in their therapeutic powers to cure, treat, and prevent diseases, and, even with the improvement of health in the community and the ease of acquiring pharmacological medicines, many residents choose to use the products as the first option for the cure of their illnesses.
It is important to report that a great knowledge of the population on medicinal plants was presented even in the groups under 40 years of age, which is inferred in the process of passing of knowledge from the old generation to the current one.
Therefore, there is a great contribution so that this understanding of the use, method, not fall into oblivion, through it, new studies may emerge to disseminate and prove the beneficial effects of these plants.
Thus, the knowledge of the population has a great contribution to the enrichment of knowledge about natural products, where many researcher are able to discover and create products that are essential for curing, treating, or preventing diseases that are often referred to as irremediable. Another important factor for the continuation of studies on medicinal plants is that many can treat a disease. However, they can cause intoxications or some undesirable reactions, since there is no complete knowledge about the ethnopharmacological and phytochemical properties of many plants used by the population.