**Abstract**

Human papilloma virus (HPV) is associated with 99% cause of cervical cancer with 20.2 million women at risk of having it in South Africa. Vaccine is the major way to prevent HPV infection. However, the vaccination program is not within easy reach for all that need it. Plants are an important source of medicines for African people, some herbal medicines are widely used for many ailments such as malaria, respiratory problems, pains, infection, and inflammation. There is limited information regarding the efficacy of medicinal plant use as there lack human studies, and no proper dosing measures are available. This study evaluated the global perspective of people over using medicinal plant products/plant-derived bio-therapeutics in the management of HPV infection. A survey method (Survey Monkey) distributed through social media was used for 3 months. 117 people participated and data realized from the study indicated their approval and readiness to use medicinal plant products.

**Keywords:** human papillomavirus, infection, cervical cancer, medicinal plants, efficacy

### **1. Introduction**

In South Africa and other Sub-Sahara countries, cervical cancer (CC) is the most prevalent type of cancer disease suffered by women, with 20.2 million women at risk and 12.983 cases diagnosed annually [1]. Management of CC requires access to health care systems. Due to the stage of progression, the affected persons by this disease would require surgery, radiotherapy, and chemotherapy in order to increase their chances of survival. However, if CC is left unmanaged death may result [2].

In Low Middle-Income Countries (LMICs), the unaffordability of therapeutic resources and negligence of palliative care are among the factors hampering the fight against CC. Most women often consult health care providers at an advanced stage of cervical cancer due to financial hardship. The partial resources available for treatment are not adequate to provide effective surgical, radiotherapy, and chemotherapeutic services [2].

#### *Medicinal Plants*

Studies [3, 4] have shown that among HIV positive women, there is consistent higher incidence of human papilloma virus (HPV) infection (the major cause of CC), persistent HPV infection with high-risk types, multiple types of HPV, and cervical cancer precursors (CIN or SIL). An estimate as high as 20–40% has been made for the prevalence of CIN in HIV-positive women. Many studies have shown that HIV-positive women are more likely to have persistent HPV infections than HIVnegative women [3]. South Africa is among countries in the world with a very high HIV prevalence. Zhang et al. [3] in their study recorded nearly half (41/83, 43%) of HIV-infected women co-infected with carcinogenic HPV genotypes [3]. Similarly, Temmerman et al. [4] reported a five-fold increased risk of high-grade SIL among 513 HIV-positive women in a family planning clinic in Kenya. Other reports from the region show that women with HIV develop cervical cancer at an earlier age than women who are HIV-negative [4]. Statistically, cervical cancer in South Africa is at a prevalence of 22.8 and 27 per 100,000 women when compared with the global average of 15.8. A total of 5743 new cases are encountered annually with an approximately 3000 mortalities. About 99% of these mortalities are associated with HPV, HPV strains 16 and 18 being responsible for 70% of the cases [1, 5].

Currently, in most of these sub-Sahara African countries, a vaccination program is either ongoing [1] or not yet incorporated into the eradication/screening policy [6, 7]. In South Africa, there is a vaccination of Cervarix®, which is provided for protection against HPV-16 and HPV-18 strains [1]. However, this vaccination program is either expensive, not efficient, or not within easy reach for all that need it. Furthermore, not much effort has been observed in HPV eradication and cervical cancer status in spite of the vaccination efforts in all the locations where it is operating.

Traditional medicines or herbal medicines have always been recorded as an important component of the health care system of the African people [8]. Medicinal plants/extracts involved in this practice are becoming a worldwide topic, drawing an impact on world health. They are still being administered by traditional practitioners in some parts of the health care system, especially in the rural areas of developing countries [9, 10] for the treatment of various illnesses, including viral infection, cancer, osteoarthritis, asthma, heart disease, tuberculosis, swollen ankles, bone fracture, malaria, convulsion, piles, hypertension, typhoid fever, diabetes, and anemia [8, 11, 12]. Additionally, extracted compounds of medicinal plants are being employed as inputs in toxicology, phytochemicals, pharmaceuticals, and other chemical industries [8, 13]. Furthermore, [14] has shown that medicinal plants are a source of bioactive agents employed in the preparation of synthetic medicine, therefore, function in the discovery of drugs like antiviral, antidiabetic, anticancer, antifungal, antiasthma, antibacterial, anti-HIV, and antimalarial [14]. This study evaluates how people see the use of native floral-derived products and bio-therapeutics in the management of HPV infection.

### **2. Materials and methods**

#### **2.1 Study design**

A mixed-method, including both qualitative and quantitative methods, was used by means of an electronic survey setup (Survey monkey) conducted between December 2020 and March 2021 to assess people's notions about the use of medicinal plant extract or bio-therapeutics in the treatment/management of HPV infection. A total of 117 participants took part in the online survey monkey questionnaire.

*The Use of Native Flora/Herbal Products in Human Papilloma Virus (HPV) Infection… DOI: http://dx.doi.org/10.5772/intechopen.104742*

#### **2.2 Data collection**

Data collection was predominantly close-ended questions and a few open-ended questions were compiled in the form of an electronic survey/questionnaire on the Survey monkey Google platform. A link to the survey was disseminated via social media platforms along with an information leaflet. Participants accessed the survey and participated voluntarily and anonymously. Implied consent was assumed by the act of participating in the survey.
