Abstract
Acute gastroenteritis (AGE) is the highest cause of mortality worldwide in children under the age of 5 years, with the highest mortalities occurring in low-to-middle income countries. Treatment can involve use of unregulated herbal medication and antibiotics. A cross sectional study was carried out to investigate the use of antibiotics and traditional herbal medications in the management of AGE among Yòrùbá-speaking communities in Kwara State, Nigeria. Our findings suggest habitual use of antibiotics (54.6%) and herbal medication (42.5%) in the management of AGE with high levels of self-prescription of antibiotics (21.7%) and herbal medications (36.2%) within the community. Ethanolic extracts of selected herbal plants reported (i.e. Aristolochia ringens, Azadirachta indica, Chromolaena odorata, Etanda Africana, Ficus capensis, Ficus vogelii, Mangifera indica, Momordica charantia, Ocimum gratisimum, Senna alata, Sorghum bicolor and Vernonia amygdalina) were investigated for antibacterial properties, using bacteria known to be causative agents of AGE. Our findings showed that, with exception of Ficus vogelii, which enhanced bacterial growth, the plant extracts reported all showed some antibacterial activity. We further discuss our findings within a regulatory context, with the aim to guide the use of traditional and herbal medication in low-to medium income countries (LMICs) and reduce the potential risks associated with the development of antimicrobial resistance.
Highlights
F. capensis, M. indica, S. alata and V. amygdalina resulted in low Minimal Inhibitory Concentrations (MIC) and IC50 values across all bacterial species tested; M. charantia resulted in low MIC and IC50 values across all bacteria except E. coli, while other plants extracts showed moderate to high MICs and IC50 across bacterial species tested (Table 4)
As a low-to medium income countries (LMICs), Nigeria is reported to have a high level of drugs prescription per encounter [37], most of which occur via primary healthcare settings [38]
This study found that 3 in 4 cases of Acute gastroenteritis (AGE) were managed with the use of antimicrobials with 1 in 2 cases managed with the use of antibiotics
Summary
African herbal medicines are prepared as alcohol infusions or tea brewed from part(s) of plants [8], with therapeutic benefits on infectious and non-infectious diseases derived from vast deposits of bioactive compounds with potent antimicrobial activities [9]. In Sub-Saharan Africa, the unregulated use of herbal medicines together with antibiotic use [12] may contribute to the high mortalities of AGE and contribute to increased antimicrobial-resistance [16, 17]. A descriptive cross-sectional survey was carried out to investigate local practices in the management of AGE in Kwara state, Nigeria, which include the use of antibiotics and traditional herbal medications. The study further investigated antibacterial properties of selected plants reported, to assess the potential impact of such practices
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