Several studies have documented the use of herbal medicine in specific health subpopulations and various locations and settings [15, 16, 18, 20]. The use of herbal medicine by the general population has been reported in Nigeria, Jordan, and Malaysia [6, 11, 13]. However, there is limited information available on the prevalence of herbal medicine usage in the general population within Sudan.

This study examined the prevalence of herbal medicine usage among Sudanese adults in a residential district in Omdurman city, Khartoum. A high prevalence of 85.9% was observed in our study. This is close to a similar rate observed in another study from Jordan [13], but is considered a higher rate compared to findings presented in other studies from Nigeria, and Malaysia [6, 13]. This can be attributed to the cultural and traditional acceptability of herbal remedies and the availability of diverse herbal resources. Sudan’s geographical location and climate provide a rich environment for a diverse range of medicinal plants and herbs, making them easily accessible to the population.

The study identified the most commonly used Sudanese herbal remedies, including peppermint, acacia nilotica, hibiscus, ginger, and fenugreek. This highlights that these herbal remedies hold cultural significance and are perceived as effective in managing various health conditions within the Sudanese population. Further research and exploration of these herbal remedies can provide valuable insights into their safety, efficacy, and potential integration into mainstream healthcare practices.

A significant proportion of the participants (56.7%) reported using herbal medicines, primarily when sick. The most common method of using herbal remedies was preparing them in the form of tea, which aligns with traditional practices in the region. Herbal remedies were found to be commonly used for treating coughs and colds, gastrointestinal disturbances, and joint pains, in contrast to a study in Nigeria where they were frequently used for treating malaria and reducing blood sugar levels. Another study done in Morocco showed that they were more frequently used for gastrointestinal disorders, which aligns with our findings [15]. This suggests that herbal medicines are perceived as effective remedies for these medical conditions among the participants. Further research is needed to explore the specific mechanisms and potential benefits of these herbal remedies for the mentioned conditions. Understanding the active compounds, pharmacological properties, and potential interactions with conventional treatments can provide valuable insights into their effectiveness and safety. Clinical trials and rigorous scientific studies are necessary to evaluate their efficacy and establish evidence-based guidelines for the use of these herbal remedies in the management of these medical conditions.

The main sources for obtaining herbal remedies were herbal product stores and supermarkets. This finding highlights the accessibility and availability of herbal medicines through commercial channels. Additional studies are need to ensure the quality and safety of herbal products obtained from these sources. The main sources of information on how to obtain herbal remedies were families, neighbors, and the internet which is consistent with the findings of some previous studies [12, 15]. This highlights the influence of social networks and the growing role of online platforms in shaping the use of herbal medicines in the Sudanese population.

This study revealed a statistically significant association between the participants’ gender and the use of herbal medicine, with a p-value of 0.004, indicating that women were more likely to use these remedies than men, which is consistent with the findings of various previous studies [14, 21,22,23]. This could be due to multiple factors. One possible explanation is that women often play a central role in family healthcare and are more likely to seek alternative remedies for themselves and their families. Women may also have specific health concerns or conditions for which they find herbal remedies more suitable or effective. This discrepancy may also be due to the differences in how females and males perceive and define herbal medicines, which can contribute to variations in how these remedies are recognized and valued. These gender-based variations can help explain the differences observed in the use of herbal medicine. Attitudes towards overall health can also contribute to explain this gender difference [14]. However, further research is needed to explore the specific reasons behind the gender disparity in herbal medicine usage.

The participants’ beliefs about herbal medicines were found to be significantly associated with their actual usage. The belief that herbal medicines are safer and more effective in treating various diseases appeared to influence the decision to use herbal remedies, with p-values of 0.006 and 0.027, respectively. These beliefs reflect the perception of herbal medicines as a natural and holistic approach to healthcare, aligning with traditional Sudanese healing practices. It could also be explained by the historical context of herbal medicines in Islamic culture, which established a strong acceptance of these products among users, enhancing their credibility and popularity [12]. The perception of herbal medicine’s safety was the only independent predictor of their use (p-value = 0.038, OR = 9.65). This finding suggests that the participants’ beliefs about the safety of herbal remedies played a crucial role in determining whether they chose to use these products, even after accounting for other potential factors. This highlights the importance of addressing concerns about the safety of herbal products and promoting their credibility as a means of encouraging their uptake among the study population. Strategies to enhance the perceived safety of herbal medicines, such as increased regulation, quality control, and public education, may be particularly effective in driving their usage in the Sudanese context, where traditional healing practices remain deeply embedded in the cultural fabric.

This study has several limitations that warrant acknowledgement. While the study aimed to have a robust sample size, the minimal sample size required for the analysis was ultimately not achieved. The use of a general prevalence of 50% for herbal medicine usage among Sudanese adults, rather than relying on prevalence data from other studies, may have also introduced some uncertainty or bias in the estimation of the true prevalence within the target population. To address these limitations, future research would benefit from conducting a comprehensive systematic review or meta-analysis of studies on herbal medicine usage in the Sudanese context. This could provide more reliable and context-specific prevalence data to inform the design and analysis of subsequent studies with an adequately powered sample size. The study was conducted in only one residential district in Omdurman city, Khartoum. Therefore, the findings may not be representative of the entire population or other residential districts and rural areas. Generalizing the results to a broader population or different geographic localities should be done with caution. In order to ensure that the findings are applicable to a wider population, future research should cover multiple districts and diverse areas.

The study was done during the COVID-19 pandemic period; therefore, due to health restrictions, a paper-and-pencil questionnaire was adopted instead of one-to-one direct interviews with the participants. Using a paper-and-pencil questionnaire as the data collection method in this study has two limitations: the potential for missing data due to skipped or omitted questions and the possibility of inaccurate responses influenced by social desirability bias, memory recall limitations, or question misunderstanding. These limitations may have affected the completeness, accuracy, and generalizability of the data. To mitigate these limitations, future research should explore strategies to minimize missing data, consider alternative data collection methods, and enhance participants’ understanding of the questionnaire. In addition, although the content validity of the adapted questionnaire was established through the review and feedback from university professors, the reliability and construct validity of the instrument were not formally tested in this study. Future research should consider evaluating the psychometric properties of the adapted questionnaire to further strengthen the validity and reliability of the measurement tool.

This study focused on the use of herbal medicines for a limited number of medical conditions, such as coughs and colds, gastrointestinal disturbances, and joint pains. Other medical conditions were not evaluated, which may limit the generalizability of the findings to a broader range of health conditions. It is possible that herbal medicines may be used differently or have varying efficacy for other medical conditions not assessed in this study. Therefore, further research is needed to explore the use of herbal medicines for a wider spectrum of health conditions to provide a more comprehensive understanding of their potential benefits and limitations.

Another limitation of the study is the lack of a clear link between the use of specific herbal remedies for treatment of specific medical conditions. This absence of specificity hinders accurate conclusions regarding the effectiveness and appropriateness of herbal remedies for specific conditions. Consequently, the study’s findings may have limited practical implications for healthcare providers and individuals seeking evidence-based guidance on herbal medicine usage. Future research should aim to establish clearer connections between specific herbal remedies and their corresponding medical indications to enhance understanding of their therapeutic potential. In addition to this, the study did not evaluate the effect of concurrent use of conventional medicine with herbal medicines, which may have influenced the participants’ perceptions of effectiveness, safety, outcomes, and satisfaction levels. Another limitation is that the data collected in the study provide a snapshot of the participants’ experiences with herbal medicines at a specific point in time. It is unable to capture any changes or developments in their experiences over time.