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Antibacterial and Antifungal Activities of Ethiopian Medicinal Plants: a Systematic Review Antibacterial and antifungal activities of Ethiopian medicinal plants: a systematic review Article (Published Version) Nigussie, Dereje, Davey, Gail, Beyenee, Takele Beyene, Brewster, Malcolm, Legesse, Belete Adefris, Fekadu, Abebaw and Makonnen, Eyasu (2021) Antibacterial and antifungal activities of Ethiopian medicinal plants: a systematic review. Frontiers in Pharmacology, 12. a633921 1-17. ISSN 1663-9812 This version is available from Sussex Research Online: http://sro.sussex.ac.uk/id/eprint/99210/ This document is made available in accordance with publisher policies and may differ from the published version or from the version of record. If you wish to cite this item you are advised to consult the publisher’s version. Please see the URL above for details on accessing the published version. Copyright and reuse: Sussex Research Online is a digital repository of the research output of the University. Copyright and all moral rights to the version of the paper presented here belong to the individual author(s) and/or other copyright owners. To the extent reasonable and practicable, the material made available in SRO has been checked for eligibility before being made available. Copies of full text items generally can be reproduced, displayed or performed and given to third parties in any format or medium for personal research or study, educational, or not-for-profit purposes without prior permission or charge, provided that the authors, title and full bibliographic details are credited, a hyperlink and/or URL is given for the original metadata page and the content is not changed in any way. http://sro.sussex.ac.uk SYSTEMATIC REVIEW published: 01 June 2021 doi: 10.3389/fphar.2021.633921 Antibacterial and Antifungal Activities of Ethiopian Medicinal Plants: A Systematic Review Dereje Nigussie 1,2*, Gail Davey 2,3, Takele Beyene Tufa 4, Malcolm Brewster 5, Belete Adefris Legesse 1, Abebaw Fekadu 1,2 and Eyasu Makonnen 1,6 1Centre for Innovative Drug Development and Therapeutic Trials for Africa (CDT-Africa), College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia, 2Centre for Global Health Research, Brighton and Sussex Medical School, University of Sussex, Brighton, United Kingdom, 3School of Public Health, Addis Ababa University, Addis Ababa, Ethiopia, 4Department of Biomedical Sciences, College of Veterinary Medicine and Agriculture, Addis Ababa University, Addis Ababa, Ethiopia, 5Rye Medical Centre, Rye, United Kingdom, 6Department of Pharmacology and Clinical Pharmacy, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia Background: Podoconiosis and lymphatic filariasis are the most common causes of lower limb lymphoedema in the tropics. Many sufferers experience frequent painful episodes of acute bacterial infection. Plant based traditional medicines are used to treat infections in Edited by: Alessandra Durazzo, many countries and are culturally established in Ethiopia. Ethiopian medicinal plants found Council for Agricultural Research and to have antibacterial and antifungal activities were reviewed with the aim of increasing Economics, Italy information about the treatment of wound infections in patients with lymphoedema. Reviewed by: Vivekananda Mandal, Methods: This study collates data from published articles on medicinal plants with Guru Ghasidas Vishwavidyalaya, India antibacterial and antifungal activities in Ethiopia. A systematic search of Scopus, Wondimeneh Shiferaw, Debre Berhan University, Ethiopia EMBASE, PUBMED/MEDLINE and Google Scholar was undertaken. The Preferred *Correspondence: Reporting Items for Systematic Reviews and Meta-analysis (PRISMA) guidelines were Dereje Nigussie followed. The protocol was registered on PROSPERO with registration number [email protected] CRD42019127471. All controlled studies of in vitro antibacterial and antifungal Specialty section: activities were considered. All articles containing the descriptors published until June This article was submitted to 28, 2019 were included. The outcome was measured as percent inhibition of microbial Ethnopharmacology, growth. For quality assessment of individual in vitro studies, OECD guidelines and the a section of the journal Frontiers in Pharmacology WHO-Good Laboratory Practice (GLP) handbook were used. Received: 26 November 2020 Results: Seventy-nine studies met the inclusion criteria. A total of 150 plant species and Accepted: 14 May 2021 Published: 01 June 2021 three compounds had been tested against 42 species of bacteria, while 43 plant species Citation: had been tested against 22 species of fungus. Nigussie D, Davey G, Tufa TB, Brewster M, Legesse BA, Fekadu A Conclusion: Materials derived from several Ethiopian medicinal plants have been shown and Makonnen E (2021) Antibacterial to have promising activity against a variety of bacteria and fungi. Those derived from and Antifungal Activities of Ethiopian Medicinal Plants: Azadiractha indica A. Juss. and Lawsonia inerms L. are the most extensively studied A Systematic Review. against a wide range of gram-negative and positive bacteria, and fungal species. Front. Pharmacol. 12:633921. doi: 10.3389/fphar.2021.633921 Keywords: systematic literature review, antifungal, antibacterial, Ethiopia, medicinal plants Frontiers in Pharmacology | www.frontiersin.org 1 June 2021 | Volume 12 | Article 633921 Nigussie et al. Antimicrobial Medicinal Plants - Systematic Review INTRODUCTION medico-religious manuscripts, and traditional pharmacopeia (Jima and Megersa, 2018). The antimicrobial activities of these Lymphoedema is a chronic illness that has a major physical and traditional medicinal plants are based on their secondary psychological effect on patients and lowers the quality of patient metabolites such as alkaloids, terpenoids, flavonoids, tannins life substantially. Neglected tropical diseases (NTDs) such as and glycosides (Sisay et al., 2019). podoconiosis, lymphatic filariasis, and leprosy are the most Many in vitro antibacterial and antifungal studies have been common causes of lower limb lymphoedema in the tropics. conducted on the safety and efficacy of Ethiopian medicinal Suffering can be aggravated by frequent painful episodes of plants used to treat bacterial and fungal infections. However, acute bacterial limb infection known as “acute attacks” data on the efficacy and safety of these medicinal plants in the (Ndzeshang et al., 2020). Cellulitis and erysipelas are typical management of wound infection have not yet been wound complications, with the majority of infections caused summarized. This systematic review draws together up-to- by group A, C, or G streptococci and Staphylococcus aureus date information on Ethiopian medicinal plants used as species (Al-Niaimi and Cox, 2009). However, Aeromonas antibacterial and antifungal agents that might potentially be hydrophila/caviae, Acinetobacter lwoffii, Escherichia coli, used for the management of wound infections in Klebsiella pneumoniae, Pseudomonas aeruginosa, Shewanella lymphoedema. algae, Staphylococcus aureus, Streptococcus pyogenes, The aim of this systematic literature review was to evaluate Streptococcus dysgalactiae, Staphylococcus haemolyticus, Ethiopian medicinal plants found to have antibacterial and Streptococcus agalactiae and Staphylococcus simulans have antifungal properties in vitro studies. recently been found to be involved in colonising wounds of In the context of this review, terms are defined as follows: lymphoedematous limbs in patients from Ethiopia (Nigussie et al., 2020b). “Ethiopian medicinal plants” refer to plants that are found in Lymphoedema caused by the aforementioned NTDs is Ethiopia and have been utilized traditionally for medicinal progressive if not treated. In the early stages oedema can be purposes by societies in Ethiopia and elsewhere. reversed overnight, but with disease progression there can be “In vitro anti-infective activity tests” involve direct culture of serious impairment and loss of independence. Patients are the microorganisms in media and application of plant extracts excluded from society because of their incapacitating and to the media to evaluate their activity. stigmatized impairments which cause significant economic “Anti-infective agents” refer to agents (medicinal plant effects, intergenerational poverty, and alienation from society. extracts, fractions, and/or compounds) that act against In Ethiopia, an estimate of 5.6 and 34.9 million peoples are at risk infective agents (bacteria, fungi and others) either by of lymphatic filariasis and podoconiosis respectively (Caprioli inhibiting the agent’s growth or by killing it. et al., 2020). There are 1.5 million cases of podoconiosis across 345 districts of Ethiopia, and the country has the highest prevalence of podoconiosis in the world (Deribe et al., 2020). MATERIALS AND METHODS The use of medicinal plants has a long history in the treatment of a range of diseases, including infectious diseases, and these days To ensure inclusion of relevant information, the study was hundreds of thousands of plant species have been tested for their undertaken based on the guideline of Preferred Reporting medicinal properties (Górniak et al., 2019). However, the Items for Systematic Reviews and Meta-analysis (PRISMA) phytochemical and pharmacological activities of many more (Lulekal et al., 2014)(Figure 1). The protocol for this review plants remain to be studied. Plant-derived substances are was registered on PROSPERO, with registration number tolerated and accepted by patients and seem a reliable source CRD42019127471
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