Microbiological Profile of Some Ghanaian Herbal Preparations—Safety Issues and Implications for the Health Professions

Joseph A. Ampofo, Anthonia Andoh, Wilhermina Tetteh, Mohammed Bello

Microbiology Section, Environmental Biology and Health Division, Water Research Institute, Accra, Ghana.

DOI: 10.4236/ojmm.2012.23018                

Abstract

Thirty-one herbal preparations produced and sold on the Ghanaian market were randomly purchased from sales outlets and analyzed for their microbiological quality by testing for the presence of total coliform bacteria, faecal coliform bac- teria, and total heterotrophic bacteria count. Also tested for was detection of pathogenic bacteria such as the Salmonella spp. and Clostridium spp. Opportunistic bacterial pathogens (Aeromonas spp., Enterococcus spp. and Pseudomonas spp.) and mould were also tested for. The herbal preparations tested came from different processing companies and in- cluded those labeled as suitable for treating arthritis, asthma, anaemia, diabetes mellitus, epilepsy, cough, hypertension, dysmenorrhoea, malaria, urine retention and loss of appetite. Aliquots of the various herbal products were cultured on various selective media. Eight (8) of the products showed the presence of all microorganism analyzed for including the pathogenic ones and are recommended not be used. Five (5) of the products did not have any microorganism present. Eleven (11) products showed the presence of only total heterotrophic bacteria and the values ranged from 1 to 94 cfu per ml. These two groups of total of sixteen (16) products can be used without any microbiological risk. Another three (3) products showed presence of only total heterotrophic bacteria but the values ranged from 118 to 1648 cfu per ml. Majority of the herbal preparations showed the presence of pathogenic bacteria. These three products may pose danger to the user can be used with caution. None of the herbal products recorded the presence of Enterococcus spp.

Keywords

Herbal Preparations; Bacterial Pathogens; Opportunistic Pathogens; Mould

Conflicts of Interest

The authors declare no conflicts of interest.

References

[1]	A. A. Izzo and E. Ernst, “Interactions between Herbal Medicines and Prescribed Drugs: An Updated Systematic Review,” Drugs, Vol. 69, No. 13, 2009, pp. 1777-1798. HUdoi:10.2165/11317010-000000000-00000U
[2]	N. R. Farnsworth, O. Akerele, A. S. Bingel, D. D. Soejart and Z. G. Guo, “Medicinal Plants in Therapy,” Bulletion of the World Health Organization, Vol. 63, No. 6, 1985, pp. 965-981.
[3]	E. Manheimer, S. Wieland, E. Kimbrough, K. Cheng and B. M. Berman, “Evidence from the Cochrane Collaboration for traditional Chinese Medicine Therapies,” The Journal of Alternative and Complementary Medicine, Vol. 15, No. 9, 2009, pp. 1001-1014. HUdoi:10.1089/acm.2008.0414U
[4]	C. Gratus, S. Wilson, S. M. Greenfield, S. L. Damery, S. A. Warmington, R. Grieve, N. M. Steven and P. Routledge, “The Use of Herbal Medicines by People with Cancer: A Qualitative Study,” BMC Complementary and Alternative Medicine, Vol. 9, No. 14, 2009, p. 14.
[5]	L. L. Dos Santos-Neto, M. A. de Vilhena Toledo, P. Medeiros-Souza and G. A. de Souza, “The Use of Herbal Medicine in Alzheimer’s Disease—A Systematic Review,” Evidence-Based Complementary and Alternative Medicine, Vol. 3, No. 4, 2006, pp. 441-445. HUdoi:10.1093/ecam/nel071UH.
[6]	A. Furnharm, “Why Do People Choose and Use Complementary Therapies?” In: E. Ernst, Ed., Complementary Medicine an Objective Appraisal, Butterworth-Heinemann, Oxford, 1996, p. 170.
[7]	E. Ernst and A. White, “The BBC Survey of Complementary Medicine Use in the UK,” Complementary Therapies in Medicine, Vol. 8, No. 2000, pp. 32-36.
[8]	D. M. Eisenberg, R. B. Davis and S. L. Ettner, “Trends in Alternative Medicine Use in the United States, 19901997—Results of a Follow-Up National Survey,” Journal of the American Medical Directors Association, Vol. 280, No. 18, 1998, pp. 1569-1575. HUdoi:10.1001/jama.280.18.1569U
[9]	World Health Organization, “Traditional Medicine,” 2007. http://www.who.int/mediacentre/factsheets/fs134/en/
[10]	WHO, “The WHO Traditional Medicine Programme: Policy and Implementation,” International Traditional Medicine Newsletter, Vol. 1, 1985, pp.1-5.
[11]	O. A. Olajide, S. O. Awe, J. M. Makinde, A. I. Ekhelar, A. Olushola and O. T. Okpako, “Studies on the Anti-Inflammatory, Anti-Pyretic and Analgesic Properties of Alstonia Boonei Stem Bark,” Journal of Ethnopharmacology, Vol. 71, No. 1-2, 2000, pp. 179-186. HUdoi:10.1016/S0378-8741(99)00200-7U
[12]	D. M. Eisenberg, R. C. Kessler, C. Foster, F. E. Norlock, D. R. Calkins and T. L. Delbanco, “Unconventional Medicine in the United States: Prevalence, Costs, and Patterns of Use,” The New England Journal of Medicine, Vol. 328, No. 4, 1993, pp. 246-252. HUdoi:10.1056/NEJM199301283280406U
[13]	J. Barnes, “Quality, Efficacy and Safety of Complementary Medicines: Fashions, Facts and the Future. Part 1. Regulation and Quality,” British Journal of Clinical Pharmacology, Vol. 55 No. 3, 2003, pp. 226-233. HUdoi:10.1046/j.1365-2125.2003.01810.xU
[14]	P. Gardiner, R. Graham, A. T. Legedza, A. C. Ahn, D. M. Eisenberg, and R. S. Phillips, “Factors Associated with Herbal Therapy Use by Adults in the United States,” Alternative Therapies in Health and Medicine, Vol. 13, No. 2, 2007, pp. 22-29.
[15]	S. S. Hasan, S. I. Ahmed, N. I. Bukhari and W. C. Loon, “Use of Complementary and Alternative Medicine among Patients with Chronic Diseases at Outpatient Clinics,” Complementary Therapies in Clinical Practice, Vol. 15, No. 3, 2009, pp. 152-157. HUdoi:10.1016/j.ctcp.2009.02.003U
[16]	K. Kraft, “Complementary/Alternative Medicine in the Context of Prevention of Disease and Maintenance of Health,” Preventive Medicine, Vol. 49, No. 2-3, 2009, pp. 88-92. HUdoi:10.1016/j.ypmed.2009.05.003U
[17]	A. A. Modi, E. C. Wright and L. B. Seeff, “Complementary and Alternative Medicine (CAM) for the Treatment of Chronic Hepatitis B and C: A Review,” Antiviral Therapy, Vol. 12, No. 3, 2007, pp. 285-295.
[18]	E. Mendes, M. T. Herdeiro and F. Pimentel, “The Use of Herbal Medicine Therapies by Cancer Patients,” Acta Médica Portuguesa, Vol. 23, No. 5, 2010, pp. 901-908.
[19]	M. Oktem, D. Eroglu, H. B. Karahan, N. Taskintuna, E. Kuscu and H. B. Zeyneloglu, “Black Cohosh and Fluoxetine in the Treatment of Postmenopausal Symptoms: A Prospective, Randomized Trial,” Advances in Therapy, Vol. 24, No. 2, 2007, pp. 448-461. HUdoi:10.1007/BF02849914U
[20]	A. Q. Pham, H. Kourlas and D. Q. Pham, “Cinnamon Supplementation in Patients with Type 2 Diabetes Mellitus,” Pharmacotherapy, Vol. 27, No. 4, 2007, pp. 595-599. HUdoi:10.1592/phco.27.4.595U
[21]	M. Shimazaki and J. L. Martin, “Do Herbal Agents Have a Place in the Treatment of Sleep Problems in Long-Term Care?” Journal of the American Medical Directors Association, Vol. 8, No. 4, 2007, pp. 248-252. HUdoi:10.1016/j.jamda.2006.11.001U
[22]	S. Shrestha, H. C. Freake, M. M. McGrane, J. S. Volek and M. L. Fernandez, “A Combination of Psyllium and Plant Sterols Alters Lipoprotein Metabolism in Hypercholesterolemic Subjects by Modifying the Intravascular Processing of Lipoproteins and Increasing LDL Uptake,” The Journal of Nutrition, Vol. 137, No. 5, 2007, pp. 1165-1170.
[23]	H. A. Tindle, R. B. Davis, R. S. Phillips and D. M. Eisenberg, “Trends in Use of Complementary and Alternative Medicine by US Adults: 1997-2002,” Alternative Therapies in Health and Medicine, Vol. 11, No. 1, 2005, pp. 42-49.
[24]	N. W. Crawford, D. R. Cincotta, A. Lim and C. V. Powell, “A Cross-Sectional Survey of Complementary and alternative Medicine Use by Children and Adolescents Attending the University Hospital of Wales,” BMC Complementary and Alternative Medicine, Vol. 6, No. 1, 2006, p. 16.
[25]	S. Joos, B. Musselmann, A. Miksch, T. Rosemann and J. Szecsenyi, “The Role of Complementary and Alternative Medicine (CAM) in Germany—A Focus Group Study of GPs,” BMC Health Services Research, Vol. 8, No. 7-8, 2008, p. 127. HUdoi:10.1186/1472-6963-8-127U
[26]	S. Hori, I. Mihaylov, J. C. Vasconcelos and M. McCoubrie, “Patterns of Complementary and Alternative Medicine Use amongst Outpatients in Tokyo, Japan,” BMC Complementary and Alternative Medicine, Vol. 8, No. 1, 2008, p. 14. HUdoi:10.1186/1472-6882-8-14U
[27]	B. M. Berman, B. K. Singh and L. Lao, “Physicians’ Attitudes towards Complementary or Alternative Medicine: A Regional Survey,” The Journal of the American Board of Family Practice, Vol. 8, No. 5, 1995, pp. 361-363.
[28]	J. A. Astin, A. Marie and K. R. Pelletier, “A Review of the Incorporation of Complementary and Alternative Medicine by Mainstream Physicians,” Archives of Internal Medicine, Vol. 158, No. 21, 1998, pp. 2303-2310. HUdoi:10.1001/archinte.158.21.2303U
[29]	B. M. Berman, B. B. Singh, S. M. Hartnoll, et al., “Pri mary Care Physicians and Complementary Alternative Medicine: Training, Attitudes, and Practice Patterns,” The Journal of the American Board of Family Practice, Vol. 11, No. 4, 1998, pp. 272-281.
[30]	R. D. Crock, D. Jarjoura and A. Polen, “Confronting the Communication Gap between Conventional and Alternative Medicine: A Survey of Physicians’ Attitudes,” Alternative Therapies in Health and Medicine, Vol. 5, No. 2, 1999, pp. 61-66.
[31]	M. M. Tabi, M. Powell and D. Hodnicki, “Use of Traditional Healers and Modern Medicine in Ghana,” International Nursing Review, Vol. 53, No. 1, 2006, pp. 52-58. HUdoi:10.1111/j.1466-7657.2006.00444.xU
[32]	C. Abel and K. Busia, “An Exploratory Ethnobotanical Study of the Practice of Herbal Medicine by the Akan Peoples of Ghana,” Alternative Medicine Review, Vol. 10, No. 2, 2005, pp. 112-122.
[33]	A. Sali and L. Vitetta, “Integrative Medicine in Gynaecological Cancers,” Australian Family Physician, Vol. 36, No. 3, 2007, pp. 135-136.
[34]	A. A. Sittie, “Quality Assessment. In A Manual of Harmonized Procedures for Assessing the Safety, Efficacy and Quality of Plant Medicines in Ghana,” Yamens Press Ltd., Accra, 2005.
[35]	S. C. Lenore, E. G. Arnold and D. E. Andrew, “Standard Methods for the Examination of Water and Wastewater,” American Public Health Association, Washington DC, 1998.
[36]	C. O. Amira and N. U. Okubadejo, “Frequency of Complementary and Alternative Medicine Utilization in Hypertensive Patients Attending an Urban Tertiary Care Centre in Nigeria,” BMC Complementary and Alternative Medicine, Vol. 7, No. 1, 2007, p. 30. HUdoi:10.1186/1472-6882-7-30U
[37]	P. E. Osamor and B. E. Owumi, “Complementary and Alternative Medicine in the Management Of Hypertension in an Urban Nigerian Community,” BMC Complementary and Alternative Medicine, Vol. 10, No. 1, 2010, pp. 36. HUdoi:10.1186/1472-6882-10-36U
[38]	T. O. Fakeye, A. R. Rasaq and I. E. Musa, “Attitude and Use of Herbal Medicines among Pregnant Women in Nigeria,” BMC Complementary and Alternative Medicine, Vol. 9, No. 1, 2009, pp. 53-60. doi:10.1186/1472-6882-9-53U
[39]	R. S. Solecki, “Shanidar IV, a Neanderthal Flower Burial of Northern Iraq,” Science, Vol. 90, No. 4217, 1975, pp. 880-881.
[40]	D. Bensky, A. Gamble and T. J. Kaptchuk, “Chinese Herbal Medicine: Materia Medica,” Revised Edition, Eastland Press Inc., Seattle, 1993.
[41]	N. R. Farnsworth, O. Akerele, A. S. Bingel, D. D. Soejart and Z. G. Guo, “Medicinal Plants in Therapy,” Bulletion of the World Health Organization, Vol. 63, No. 6, 1985, pp. 965-981.
[42]	R. Arvigo and M. J. Balick, “Rainforest Remedies: 100 Healing Herbs of Belize,” Lotus Press, Twin Lakes, 1993.