The legislative and regulatory framework governing herbal medicine use and practice in Kenya: a review

Complementary and alternative medicine is an integral component of primary healthcare in Kenya. This is because the infrastructural health setup in the country is inadequate in catering for all the medical needs of the population. This particularly holds true in the rural areas where many rural folk rely on products of herbal origin to offset their healthcare needs. More often than not these products are an elaborate cacophony of several different substances of biological origin and thus need personnel adept in their preparation. Sadly, due to loopholes in legislation and regulation, quacks have a field day in the practice. Moreover, the process of planting, harvesting, preparation and storage of herbs and related products dictates that a significant number of people will ultimately be involved in the whole process. This is likely to set the stage for manipulation and compromise of the safety, quality and efficacy of these products. This state of affairs appears unabated especially in the context of the current legal and regulatory framework governing herbal medicine use and practice in Kenya. Not only are these laws inadequate, they are shrouded in ambiguity, open to interpretation and the authorities mandated to implement them often end up performing duplicate roles. The aim of this review is to critique the legal and regulatory provisions governing herbal medicine use and practice in Kenya. In conclusion, laws and regulations meant to control herbal medicine use and practice in Kenya are wanting. Clear and definitive legislation on herbal medicine use and practice coupled with effective implementation by mandated institutions will go a long way in inspiring confidence to all stakeholders of herbal medicine.Keywords: Herbal medicine, legislation, regulatory framework, Keny

Prevalence and risk factors associated with Ehrlichia infections in smallholder dairy cattle in Nairobi City County, Kenya

Background and Aim: Ehrlichiosis caused by Ehrlichia ruminantium is a tick-borne disease of great economic importance in cattle production worldwide. Despite its economic impact, limited knowledge is available on its epidemiology in Africa, including Kenya. Suspected cases of E. ruminantium infections have been reported in the recent past to the University of Nairobi's Veterinary Hospital, prompting the need to investigate their possible re-emergence. Therefore, this study was aimed at determining the prevalence of E. ruminantium among smallholder dairy cattle in Nairobi City County and to assess potential risk factors. This knowledge may guide the development of appropriate control strategies of ehrlichiosis, subsequently reducing associated losses. Materials and Methods: A total of 107 smallholder dairy farms from Nairobi City County were recruited for the study. Blood samples were collected from 314 apparently healthy dairy cattle, and Giemsa-stained blood smears were screened under the microscope for Ehrlichia species. A commercial antigen enzyme-linked immunosorbent assay (ELISA) kit was then used to confirm the presence of the infections in serum samples. A pre-tested questionnaire was used to collect data on management practices that may be potential risk factors. A univariate and mixed-effects logistic regression was then used to determine significant risk factors. Results: On microscopy, 79.3% (249/314) of the sampled animals had Ehrlichia-like inclusion bodies in white blood cells, though only 18.6% (95% confidence interval [CI] 14.2-23.0) of these were confirmed to be E. ruminantium on ELISA. A farm-level prevalence of 35.5% (95% CI 27.0-45.3) was reported. Female-headed households (p=0.013), farms in Langata region (p=0.027), cleaning of cowsheds fortnightly (p=0.019), and roofing of cowshed (p=0.022) were factors significantly associated with E. ruminantium infections. Conclusion: There is a relatively high prevalence of E. ruminantium infections in apparently healthy cattle in smallholder dairy farms in this area, warranting control measures. It is critical to improve animal welfare-related factors, such as cowshed cleaning and roofing, as well as the strategic location of farms, especially, since reservoirs may reduce infection levels in the farms, in relation to wildlife. However, since Ehrlichia-like inclusion bodies other than those of E. ruminantium were observed in this study, there is a need to investigate further these factors and the possibility of other Ehrlichia species infecting cattle in the study area

Prevalence of gastrointestinal helminths and management practices for dogs in the Greater Accra region of Ghana

Toxocariosis and ancylostomosis remain the most important parasitic infections affecting companion animals worldwide and pose a risk to animal and human health. Information on these infections in dogs in Ghana is inadequate. A cross sectional study was undertaken to determine the occurrence of gastrointestinal helminths infections and management practices of dogs in the Greater Accra Region (GAR) of Ghana. Faecal samples were obtained from 380 dogs from communities in 11 out of 16 districts in the GAR. Coprological examination of the samples was performed using the modified McMaster technique. Management practices for control of helminths in dogs were assessed through questionnaire interviews of the dog owners. Most dogs (70.7%) were kept for security reasons and were not housed (61.8%). Prevalence of gastrointestinal helminths was 62.6%. Hookworm eggs were found in 178 (46.8%) dogs, Toxocara canis eggs in 22 (5.8%) and mixed infections of hookworms and T. canis in 38 (10.0%). Dipylidium caninum was found in 51 (13.4%) dogs, while Isospora species was in 33 (8.5%) dogs. Most households (68%; 133/194) of the sampled dogs had at least a child below the age of 5 years. Hookworm, T. canis and D. caninum were the zoonotic gastrointestinal helminths prevalent in dogs in the study area. Lack of housing for dogs creates ideal conditions for infection and spread of the zoonotic parasites

Prevalence of Ticks Infesting Dairy Cattle and the Pathogens They Harbour in Smallholder Farms in Peri-Urban Areas of Nairobi, Kenya

This study aimed at determining the tick species infesting dairy cattle in Nairobi, Kenya, and the pathogens they harbour. While ticks are well-known vectors of major bacterial pathogens of both veterinary importance and public health importance, few studies have investigated the range of the tick species and the associated pathogens, especially present in unique dairy production systems, which compromise animal welfare, such as those in peri-urban areas. A cross-sectional study was undertaken involving 314 randomly selected dairy cattle in 109 smallholder farms. Each animal was examined for attached ticks followed by morphological tick identification at the species level. Genomic DNA was extracted from each of the ticks, and 16S rDNA gene was amplified for pathogen identification. Sequencing of the amplicons and subsequent BLASTn analysis, multiple sequence alignment, and phylogenetic reconstruction were performed to confirm the species of the pathogens. Sixty-six (21.0%) of the cattle examined had ticks. A total of 94 adult ticks were found on the cattle, and of these, 63 (67.0%), 18 (19.1%), and 13 (13.8%) were in the genera Rhipicephalus, Amblyomma, and Hyalomma, respectively. Twelve tick species in Rhipicephalus genus and two in Amblyomma and Hyalomma genera were identified. Although Rh. decoloratus was the most prevalent tick (24.5% (23/94)), the emerging Rh. microplus (6.4% (6/94)) was also identified. The DNA of Rickettsia was detected in the ticks, with Rickettsia conorii in H. rufipes and A. variegatum, and Rickettsia aeschlimannii in Rh. microplus and H. rufipes, while Ehrlichia ruminantium and E. canis were in A. variegatum. In conclusion, the study reported a wide range of tick species present in the study area including Rhipicephalus microplus, which is an emerging tick species in parts of Kenya. The ticks harboured DNA of Rickettsia and Ehrlichia, highlighting possible animal and human health concerns. Hence, effective tick control strategies remain paramount to prevent potential diseases associated with the harboured pathogens

Mitigative effects of Moringa oleifera against liver injury induced by artesunate-amodiaquine antimalarial combination in wistar rats

Abstract Background Artesunate-amodiaquine (AS-AQ) is an antimalarial drug. It is associated with improved cure rates, accelerated response to therapy and delayed development of resistance. However, liver damage, neurotoxicity and agranulocytosis have been reported as adverse effects whose origins have been linked to free radicals generated by the drug. According to native materia medica, Moringa oleifera (MO) has wide utility in ethnomedicine. However, there is paucity of information on the hepatoprotective efficacy of this plant. The present study evaluated the mitigative effects of MO leaf extracts against liver injury induced by AS-AQ combination in female Wistar rats. Methods Dry leaf powder of MO was extracted with water and a 20:80 v/v mixture of water and methanol to give aqueous (AQ) and aqueous-methanol (AQ-ME) MO leaf extracts respectively. In vitro hydroxyl free radical scavenging activity of serial dilutions (10–100 μg/ml) of each of the extracts was then evaluated using an assay model where butylated hydroxytoluene (BHT) served as a reference standard. The extract with better free radical scavenging activity was then evaluated for hepatoprotective effects against AS-AQ intoxication in female Wistar rats based on the Acute Toxic Class method (OECD 2000). Serum asparate amino transferase (AST), alanine amino transferase (ALT), total bilirubin and histological examination of rat liver sections were used to evaluate the hepatoprotective activity of the selected MO leaf extract. Siliphos® (standard hepatoprotectant) was used for comparison. Results There was a concentration dependent increase in the hydroxyl free radical scavenging activity of MO leaf extracts and standard (BHT) with values ranging from 46.36–66.36% for the AQ extract, 41.04–60.95% for the AQ-ME extract and 44.93–65.23% for BHT with corresponding IC50 values of 26.84 μg/ml, 51.88 μg/ml and 32.58 μg/ml respectively. A 1000 mg/kg dose of the AQ-ME MO leaf extract significantly (p  0.05). The 1000 mg/kg dose also reduced hepatocyte degeneration in rats treated with four times the clinical dose of AS-AQ. This study suggests that the hepatoprotective activity of the leaves of MO may have some relation to its free radical scavenging properties. These leaves may thus be useful in mitigating free radical initiated disease conditions. Conclusion The aqueous-methanol Moringa oleifera leaf extract exhibits free radical scavenging and hepatoprotective properties. Further investigations on the structural identity of the phytoconstituents and their mechanisms of action should be performed to facilitate the development of a potent medicinal agent