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Background  This paper reports a study undertaken in three remote communities (Mahaboboka, Amboronabo, Mikoboka), located in Sakaraha, Southwestern Madagascar. Not only villages are far away from sanitary infrastructures and doctors but drugs and consulting fees are unaffordable to villagers. They rely essentially on natural resources for health care as for most of rural areas in Madagascar. This paper aims to document medicinal plants used by communities in Sakaraha and to present the most important plant species used in traditional medicine.    Methods  Semi – structured interview was conducted within 214 informants in 34 villages of the study area. Different ailments encountered in the site study were classified in various categories. For data analysis, frequency of citation (Fq), Informant Consensus Factor (Fic), Fidelity Level (FL) and Use Value (UV) were assessed to find agreement among informants about the use of plants as remedies. Mann-Whitney, Kruskall-Wallis and Spearman correlation tests were performed to determine use of medicinal plants following social status of informants.    Results  A total of 235 medicinal plant species belonging to 198 genera and 75 families were inventoried. The richest families in species used for medicinal purposes were: Fabaceae, Apocynaceae, Rubiaceae, Euphorbiaceae, Asteraceae, and Poaceae. Plant species cited by informants were used to treat 76 various ailments classified in 13 categories. Leaves and leafy twigs were the most used plant parts and decoction was the mostly cited way of preparation of these medicinal plants species. In average, local people cited 6.7 ± 6.03 medicinal taxa among them,  Cedrelopsis grevei  is the most cited medicinal plants (Fq. 0.28). With  Cedrelopsis grevei  (UV = 0.48),  Henonia scoparia  (UV = 0.43) are mostly used species.  Leonotis nepetifolia  (FL = 96%) and  Strychnos henningsii  (FL = 92%) are plant species claimed by high percentage of informants to treat the Digestive System Disorder.    Conclusions  This study highlighted that medicinal plants used by people from three communities in the Southwestern Madagascar are diverse. These plants species ensure care to all family members including babies, children, mothers and adult people. Through this study, newly reported medicinal plants were identified for further work.    Electronic supplementary material  The online version of this article (doi:10.1186/s13002-017-0147-x) contains supplementary material, which is available to authorized users.

The most used medicinal plants by communities in Mahaboboka, Amboronabo, Mikoboka, Southwestern Madagascar