ABSTRACT
The recurrent nature of yeast infections and the subsequent use of antifungal medicines for treatment, pose a potential threat to women’s health and safety worldwide, which could also give rise to antifungal resistance. The aim of this study is to evaluate the antimicrobial efficacy of garlic and tumeric against multi-drug resistance of Candida albicans, associated with Vulvovaginal infection. Results of the anti-microbial susceptibility test by disc diffusion method revealed that ethanolic extract of both herbal products, was generally more effective in inhibiting the growth of Candida albicans. As observed from the results, garlic was 1.3 times, more effective than turmeric, at a concentration of 400mg/ml. In addition, each of the concentrations of ethanolic extract of garlic was more effective than the corresponding concentrations of tumeric extract.
The antimicrobial activity of the garlic extract displayed more effective result against Candida albicans. The minimum inhibitory concentration test was carried out using concentrations of 200mg/ml of each extract and the MIC was observed at concentration of 6.1 and 7.1 of the garlic for both ethanol and aqueous extract and for the tumeric it was observed at concentration of 4.1 and 5.1 for both ethanolic and aqueous extract. In addition, natural products such as garlic and tumeric promise a great alternation in the future as a compliment to antifungal drug in the treatment of vulvovaginal candidiasis. The reason is because garlic contains allicin, which is one of the active principles that homogenate a variety of antimicrobial activities. Allicin inhibits the growth of fungal and bacterial activities.
CONTENTS
Title page
Page
TABLE OF
Certification
i
Declaration
ii
Acknowledgements
iii
Table of Content
iv
ABSTRACT
v
CHAPTER ONE
Background of study
1
Statement of research problem
2
Justification
3
Aim and Objectives
4
CHAPTER TWO
Literature review
5
CHAPTER THREE
Experimental procedure
31
Collection of samples
32
Apparatus and Reagents
33
Juice extraction
34
Preparation of inoculums and sub culturing of microbes
35
Screening and accessing for antimicrobial activity
36
Disc diffusion susceptibility test
36
Minimum inhibitory concentration
36
CHAPTER FOUR
Result
37
Biochemical identification of Candida albican
38
Antifungal susceptibility test
39
Minimum inhibitory concentration
40
CHAPTER FIVE
Discussion
41
Antifungal efficacy
42
Conclusion and Recommendation
43
REFERENCES
APPENDIX I
44
APPENDIX II
44
CHAPTER
ONE
INTRODUCTION
- Background of study
The recurrent nature of yeast infections and the subsequent use of antifungal medicines for treatment, pose a potential threat to women’s health and safety worldwide, which could also give rise to antifungal resistance (Pfaller, 2014). Statistically opportunistic pathogen like Candida species are the main causative agent of about 50-70% causes morbidity and mortality worldwide and thus a serious threat to health public. Candidiasis is a fungal infection caused by yeast called Candida. Candidiasis can also be caused by other species not just Candida albicans. Candida albicans is opportunistic yeast that naturally inhibits the throat, mouth, digestive tract and genitourinary tract of humans. In its yeast state, Candida albicans lives in harmonious balance with other intestinal flora but if the balance of the intestinal flora is disrupted, it multiplies and convert into its parasitic fungal form, an overgrowth can lead to Candidiasis (Lisa, 2010).
The pathogen Candida albicans can be found in the oral tract in up to 80% of healthy humans.
Candida species are now recognized as causing disease with the high frequency and are of the most prevalent sources of nosocomial infection (Veryduyn et al, 1990).
The apparent explosion in fungal infection may be explained by the increasing numbers of people with impaired immune systems and those suffering from diabetics, cystic fibrosis and leukemia. (Pfaller, 1994).
Garlic has long been used to treat infections around the world; Research supports its antimicrobial activity against bacteria, parasites, viruses and fungi. Garlic was found to be a good alternative to an antifungal drug (Fluconazole) in the treatment of vaginal yeast infections. They kill yeast and reduces it symptoms of vaginal redness, cheesy discharge and rashes. Garlic enhances the sensitivity of yeast to other antifungal drugs (Hammani and Elmay, 2021).
Traditional medicine uses turmeric primarily as an anti-inflammatory agent and also as an antimicrobial against several different types of infections. Tumeric impacts curry with its bright yellow color and pungent taste and because this spice is found in most
kitchens, it is one of the common home remedies for yeast infections. (Hammani and Elmay, 2021)
Candiasis can be manifested as vaginal yeast infection, oral candidiasis (Called thrush), and/or the more serious condition. Research has clearly shown that garlic and turmeric have antimicrobial activity, inhibiting both the growth and function of Candida albicans (Adetumbi et al, 1986). It is interesting to note that when garlic compounds were studied, it was the ajoene fraction that had the strongest activity against Candida. This suggests that when shopping for garlic and turmeric supplement, it is best standardized for its ajoene and not just the typical allicin content.
Garlic and turmeric have an effect on Candida by compromising the structure and integrity of the outer surface of the yeast cell, oxidizing certain essential proteins. This causes inactivation of the yeast enzymes and subsequent microbial growth inhibition.
The treatment regimes used to manage candida infection vary and depend on the anatomical location of the infection foci, the immune status of the patients and the associated risk factors. However, Echinocandis, extended spectrum azoles and amphotericin B are generally the drugs of choice. Fluconazole is considered the first- line drug for patients with candidemia or suspected invasive candidiasis (Jose A Hidalgo 2014).
Opportunistic pathogens, like Candida species, are a major cause of morbidity and mortality worldwide and thus a serious threat to public health (Pfaller et.al, 2014; Mathaiou et al., 2015; paper et al., 2016). Further, Candida species can cause oral Candidiasis, Cutaneous Candidiasis etc. (Wachtler et al.2012). Candidemia is the most frequent hospital infection accounting for up to 15% of bloodstream infection and candida species is the main causative agent in 50-70% of systemic fungal infections. (Cornely et al.,2012); Lionakis and Netea,2013; Barchiesi et al.,2016)
The pathogenesis of Candida species is poorly understood and the rate of infection is increasing rapidly. Furthermore, a steady increment in resistance to traditional antifungal
has resulted in the need to control; Candidal infections through early diagnosis and alternative prevention of Candidiasis.
Within the limited antifungal armamentarium, the azole antifungal are the most frequent class used to treat Candida infection.Azole antifungal such as fluconazole are often preferred treatment I many Candida infections are they are inexpensive, exhibit limited toxicity and are available for oral administration Azole. However, the presence of intrinsic and developed resistance against azole antifungals has been extensively documented among several Candida species (David Vallenet,2017). The advent of original and reemergence of classical fungal diseases have occurred as a consequence of the development of the antifungal resistance. It is thus imperative that new and satisfactory therapy for fungal diseases be developed alternative to present day drugs. Natural products from and traditional medicines provide new promises in the modern clinic (Ankri S, Mirelman D 1999).
These natural products developed alternative drugs that are more efficient and tolerant than the antifungal drugs. The reasons are as follows:
Garlic may work synergistically with antifungal drugs. Allicin enhances the activity and decreases drug resistance of several antifungal drugs including amphotericin B and fluconazole (Hammani and Elmay 2021). Furthermore, garlic enhances the sensitivity of yeast to other antifungals drugs.
Tumeric contains curcumin which possesses antifungal activity. This bright yellow compound kills Candida by increasing oxidative stress leading to early cell death of the yeast to hyphae form, a major virulence factor of Candida, in addition, curcumin has synergetic effect when taken with antifungal drugs (Fulconazole) to improve their efficacy and reduce drug resistance (Hammani and Elmay 2020).
STATEMENT PROBLEM
Garlic contain allicin which possess a compound called ajoene, Garlic has long been used to treat infections around the world. Research supports its antimicrobial activities
against bacteria, viruses, parasites and fungi. Garlic was found to be a good alternative to antifungal drug in the treatment of Vulvovaginal infection (David Vallenet, 2017).
Tumeric on the other hand contains curcumin which possesses antifungal activity. The bright yellow compound kills Candida albicans by increasing oxidative stress leading to early cell death of the yeast.it also prevents the transition from yeast to hyphae form, a major virulence factor of the Candida albicans (Hammani and Elmay,2021).
Many women suffer from chronic recurrent yeast infection often antifungal drugs that provide temporary relief but the infection soon returns. Antifungal drugs are often effective, but might lead to serious adverse effects that some individuals prefer not to use them, furthermore drug resistance is on the increase and as a result, antifungal drugs are not always effective. Individuals thus often seek natural or home remedies for treatment of yeast infections, either as a stand-alone treatment complement to antifungal drugs (Harrison and Brawled, 2018).
Unavailability or lack of access to health care facilities due to low income or poverty, especially in the rural area, (David Vallenet,2017) has led to self- medication through the use of natural plants/herbs such as garlic and tumeric. The research base on testing the effectiveness and creating alternative using garlic and tumeric to generate a solution to the problem and also serve as first aid treatment specifically to less privileged.
JUSTIFICATION
The threat of antifungal resistance and the many side effects of taking synthetic chemotherapeutic agents necessitate the urgent need for the discovery of natural herbal alternatives. This is especially critical for people with low income in rural and urban areas and without access to standard health care facilities
Traditionally, garlic and turmeric has been used to treat urinary tract infection caused by Candida albicans. Garlic (Allium sativum) has been traditionally used for the treatment of diseases since ancient times. A wide range of microorganisms including bacteria, fungi, protozoa and viruses are known to be sensitive to garlic and turmeric preparations. Allicin and other sulphur compounds are thought to be major antimicrobial
factors in garlic and turmeric, because they contain oil and water-soluble organosulfur compounds (Pertanika, 2015).
The efficacy of garlic and turmeric against VVC has been investigated elsewhere but to the best of our knowledge, there has been no exact published data available on isolates obtained from Barau Dikko hospital, Kaduna.
AIM
- To analyze the inhibitory potential of garlic and turmeric in the treatment of Candida albicans associated with Vulvovaginal candidiasis.
OBJECTIVES
- Analyze the inhibitory potentials of both aqueous and ethanolic extract of garlic and turmeric on Candida albicans
- To establish the Minimum Inhibitory Concentration (MIC) of extracts of Garlic and Turmeric.
- To characterize the isolates of Candida albicans.
