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Background: Rapid modernization in the East Sepik (ES) Province of Papua New Guinea (PNG) is resulting in a decrease in individuals knowledgeable in medicinal plant use. Here we report a synthesis and comparison of traditional medicinal plant use from four ethnically distinct locations in the ES Province and furthermore compare them to two other previous reports of traditional plant use from different provinces of PNG. Methods: This manuscript is based on an annotated combination of four Traditional Medicines (TM) survey reports generated by University of Papua New Guinea (UPNG) trainees. The surveys utilized a questionnaire titled "Information sheet on traditional herbal preparations and medicinal plants of PNG", administered in the context of the TM survey project which is supported by WHO, US NIH and PNG governmental health care initiatives and funding. Regional and transregional comparison of medicinal plant utilization was facilitated by using existing plant databases: the UPNG TM Database and the PNG Plant Database (PNG Plants) using Bayesian statistical analysis. Results: Medicinal plant use between four distinct dialect study areas in the ES Province of PNG showed that only a small fraction of plants had shared use in each area, however usually utilizing different plant parts, being prepared differently and to treat different medical conditions. Several instances of previously unreported medicinal plants could be located. Medicinally under- and over-utilized plants were found both in the regional reports and in a transregional analysis, thus showing that these medicinal utilization frequencies differ between provinces. Conclusions: Documentation of consistent plant use argues for efficacy and is particularly important since established and effective herbal medicinal interventions are sorely needed in the rural areas of PNG, and unfortunately clinical validation for the same is often lacking. Despite the existence of a large corpus of medical annotation of plants for PNG, previously unknown medical uses of plants can be uncovered. Furthermore, comparisons of medicinal plant utilization is possible if databases are reformatted for consistencies that allow comparisons. A concerted effort in building easily comparable databases could dramatically facilitate ethnopharmacological analysis of the existing plant diversity. [ABSTRACT FROM AUTHOR]