Browsing by Author "Kafeero, Hussein. M."

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    Antibiotic‑resistance in medically important bacteria isolated from commercial herbal medicines in Africa from 2000 to 2021: a systematic review and meta‑analysis
    (Antimicrobial Resistance & Infection Control, 2022) Walusansa, Abdul; Asiimwe, Savina; Nakavuma, Jesca. L.; Ssenku, Jamilu. E.; Katuura, Esther; Kafeero, Hussein. M.; Aruhomukama, Dickson; Nabatanzi, Alice; Anywar, Godwin; Tugume, Arthur K.; Kakudidi, Esezah K.
    Antimicrobial resistance is swiftly increasing all over the world. In Africa, it manifests more in pathogenic bacteria in form of antibiotic resistance (ABR). On this continent, bacterial contamination of commonly used herbal medicine (HM) is on the increase, but information about antimicrobial resistance in these contaminants is limited due to fragmented studies. Here, we analyzed research that characterized ABR in pathogenic bacteria isolated from HM in Africa since 2000; to generate a comprehensive understanding of the drug-resistant bacterial contamination burden in this region. Methods: The study was conducted according to standards of the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA). We searched for articles from 12 databases. These were: PubMed, Science Direct, Scifinder scholar, Google scholar, HerbMed, Medline, EMBASE, Cochrane Library, International Pharmaceutical Abstracts, Commonwealth Agricultural Bureau Abstracts, African Journal Online, and Biological Abstracts. Prevalence and ABR traits of bacterial isolates, Cochran’s Q test, and the I2 statistic for heterogeneity were evaluated using MedCalcs software. A random-effects model was used to determine the pooled prevalence of ABR traits. The potential sources of heterogeneity were examined through sensitivity analysis, subgroup analysis, and meta-regression at a 95% level of significance. Findings: Eighteen studies met our inclusion criteria. The pooled prevalence of bacterial resistance to at least one conventional drug was 86.51% (95% CI = 61.247–99.357%). The studies were highly heterogeneous (I2 = 99.17%; p < 0.0001), with no evidence of publication bias. The most prevalent multidrug-resistant species was Escherichia coli (24.0%). The most highly resisted drug was Ceftazidime with a pooled prevalence of 95.10% (95% CI = 78.51–99.87%), while the drug-class was 3rd generation cephalosporins; 91.64% (95% CI = 78.64–96.73%). None of the eligible studies tested isolates for Carbapenem resistance. Extended Spectrum β-lactamase genes were detected in 89 (37.2%) isolates, mostly Salmonella spp., Proteus vulgaris, and K. pneumonia. Resistance plasmids were found in 6 (5.8%) isolates; the heaviest plasmid weighed 23,130 Kilobases, and Proteus vulgaris harbored the majority (n = 5; 83.3%). Conclusions: Herbal medicines in Africa harbor bacterial contaminants which are highly resistant to conventional medicines. This points to a potential treatment failure when these contaminants are involved in diseases causation. More research on this subject is recommended, to fill the evidence gaps and support the formation of collaborative quality control mechanisms for the herbal medicine industry in Africa.
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    Global evidence on the potential of some Ugandan herbal medicines to mitigate antibiotic resistance: a systematic review and meta-analysis from 1996 to 2021
    (Research Square, 2022) Walusansa, Abdul; Ssenku, Jamilu. E.; Tugume, Arthur. K.; Asiimwe, Savina; Kafeero, Hussein. M.; Aruhomukama, Dickson; Nakavuma, Jesca. L.; Kakudidi, Esezah K.
    Diarrheal and respiratory ailments are major causes of global deaths, and are mostly escalated by antibiotic-resistant bacteria (ARB), warranting novel therapies against ARB. In Uganda, plants like C. pyrrhopappa, E. abyssinica, C. limon, M. foetida, C. flexuosus, and C. citrinus are often used to treat diarrhea and/or cough. Some of these are reported to demonstrate antibacterial properties in some countries, but the evidence is limited due to fragmented studies. We evaluated global antibacterial research on these plants, to derive practical insights, able to stimulate new thinking and inform drug development. Methods Electronic articles on antibacterial effects of the named plants (with a special focus on efficacy against ARB), were identified from 14 electronic databases. The eligible articles were examined using Standard Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA). Sensitive ARB to the plant-extracts, Cochran’s Q test, and heterogeneity were evaluated with MedCalcs software, using a random-effects model. Sources of heterogeneity were examined through sensitivity analysis, subgroup analysis, and meta-regression (p < 0.05). Publication bias was assessed using Begg’s test and funnel plot asymmetry. Results Sixty-one articles met the inclusion criteria. Of these, 20 assessed the plants against 237 ARB invitro. C. flexuosus had the greatest efficacy (89.8%), while C. pyrrhopappa had the least (0.0%). Efficacy differences between C. flexuosus (the most efficacious species), and the rest of the plants were not significant except for M. foetida and C. pyrrhopappa (χ2, p < 0.05). The multidrug-resistant strains (resistant to at least three drug-classes), with 100% sensitivity to plant extracts included A. baumannii, S. aureus, and P. aeruginosa. Heterogeneity was high (I2 = 86.85%), with no evidence of publication bias, hence suggesting robust results. Conclusion Some herbal medicines in Uganda have vast potential to avert the global antibacterial resistance menace. Their efficacy against globally circulating bacteria that are resistant to vital drugs, such as carbapenems, shows possible treatment success if these species are used in drug development. More research is desired, especially on the potential efficacy of these plants against the world’s leading strains of resistant bacteria like K. pneumoniae and E. coli. Also, in-vivo studies are recommended due to their importance in drug discovery.