Ahiabor Wisdom K, Darkwah Samuel, Donkor Eric S
Department of Medical Microbiology, University of Ghana Medical School, Korle Bu, Accra, Ghana.
Environ Health Insights. 2024 Oct 30;18:11786302241293345. doi: 10.1177/11786302241293345. eCollection 2024.
Herbal medicine has been a cornerstone of healthcare for centuries, with an estimated 80% of the world's population relying on it. In Africa, herbal medicine is the backbone of rural healthcare, serving 80% to 90% of the population. Despite its widespread use, the safety of herbal medicine raises a significant concern considering the lack of regulation and testing, particularly in Africa. Microbial contamination is a primary safety risk threatening consumer health. In this systematic review, we aimed to synthesise evidence on microbial contamination in herbal medicines across Africa, provide a clear understanding of the problem, and inform effective public health interventions regarding microbial contamination of herbal medicines in Africa.
The systematic review was conducted in accordance with the PRISMA guidelines. A literature search was conducted across PubMed, Web of Science, Science Direct, Scopus, and Google Scholar using appropriate search terms. Eligible studies were selected based on predetermined criteria, and data were extracted and analysed.
The review included fifty eligible studies in Africa, with a combined sample size of 1996, of which 1791 showed microbial contamination. Bacterial contaminants were reported in 98% of studies, with (62%) being the most reported bacteria, followed by (57%), and spp. (55%). Fungal contaminants were reported in 70% of studies, with spp. (40%) being the most reported, followed by spp. (27%) and spp. (26%). Parasitic contaminants were reported in 2% of the studies reviewed. A total of 70 bacterial species, 37 fungal species, and 6 parasite species were identified in this review.
Herbal medicines in Africa pose significant health threats to consumers due to the high prevalence of diverse microbial contaminants and clinically significant pathogens. This emphasises the need for stricter regulations and quality control measures in the production, sale and use of herbal medicines.
几个世纪以来，草药一直是医疗保健的基石，据估计全球80%的人口依赖草药。在非洲，草药是农村医疗保健的支柱，为80%至90%的人口提供服务。尽管草药使用广泛，但考虑到缺乏监管和检测，尤其是在非洲，草药的安全性引发了重大关注。微生物污染是威胁消费者健康的主要安全风险。在本系统评价中，我们旨在综合非洲草药微生物污染的证据，清晰了解这一问题，并为非洲草药微生物污染的有效公共卫生干预提供参考。
本系统评价按照PRISMA指南进行。使用适当的检索词在PubMed、科学网、科学Direct、Scopus和谷歌学术上进行文献检索。根据预先确定的标准选择符合条件的研究，并提取和分析数据。
该评价纳入了非洲的50项符合条件的研究，合并样本量为1996，其中1791显示存在微生物污染。98%的研究报告了细菌污染物，其中（62%）是报告最多的细菌，其次是（57%）和 spp.（55%）。70%的研究报告了真菌污染物，其中 spp.（40%）是报告最多的，其次是 spp.（27%）和 spp.（26%）。在所审查的研究中，2%报告了寄生虫污染物。本评价共鉴定出70种细菌、37种真菌和6种寄生虫。
由于多种微生物污染物和具有临床意义的病原体的高流行率，非洲的草药对消费者构成了重大健康威胁。这强调了在草药生产、销售和使用中需要更严格的法规和质量控制措施。
