Safety and efficacy of herbal medicines for the management of sickle cell disease in Africa: a systematic review and meta-analysis

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dc.contributor.authorAwor, Silvia
dc.contributor.authorBongomin, Felix
dc.contributor.authorKaggwa, Mark Mohan
dc.contributor.authorPebalo, Pebolo Francis
dc.contributor.authorKivumbi, Ronald Muganga
dc.contributor.authorMalinga, Geoffrey Maxwell
dc.contributor.authorOngwech, Acaye
dc.contributor.authorNnamuyomba, Proscovia
dc.contributor.authorOryema, Christine
dc.contributor.authorAbola, Benard
dc.contributor.authorEpila, Jackie
dc.contributor.authorMusoke, David
dc.date.accessioned2025-08-27T13:38:56Z
dc.date.available2025-08-27T13:38:56Z
dc.date.issued2024-12-16
dc.descriptionSilvia Awor drafted the research protocol, registered it in Prospero, did data extraction and screening processes and drafted the manuscript. Ronald Kivumbi and Benard Abola participated in data screening, did the meta-analysis and reviewed the manuscript. Felix Bongomin provided expert advice on the subject, did data screening and analysis and reviewed the manuscript. Mark Mohan Kaggwa did data extraction and reviewed the manuscript. Francis Pebolo Pebalo proofread and reviewed the manuscript. David Musoke, Geoffrey Maxwell Malinga, Proscovia Nnamuyomba, Jackie Epila, Acaye Ongwech and Christine Oryema guided the protocol writing and reviewed the manuscript. All authors have read and agreed to the final manuscript.
dc.description.abstractThis systematic review and meta-analysis evaluated the safety and efficacy of herbal remedies used to manage sickle cell disease (SCD) in Africa. Before the advent of western medicine, people depended on herbal medicines for treating different illnesses. Using herbal medicines to sickle cell disease (SCD) is still common in Africa. However, data on the safety and efficacy of any of these remedies are limited. We searched PubMed, Embase, Google Scholar and Web of Science from inception to 11thJanuary 2024 using the keywords "herbal medicine" and "sickle cell" and the name of each of the countries in Africa without language restrictions. We included cross-sectional studies that reported the safety or efficacy of herbal medicine for managing sickle cell disease. Two reviewers assessed all included studies for suitability for inclusion in this review. All included articles were assessed using ROBINS-1, a tool for assessing the risk of bias in non-randomized studies of interventions. We used the randomeffect model to pool the efficacy and safety profiles of the herbal medicines using RStudio version 4.2.2. Overall, we included five studies involving 1,489 individuals with SCD. Of these, 789 (53.0%) used herbal remedies like Aloe barbadensis (Aloe vera), Zingiber officinale (ginger), Cymbopogon citratus (lemongrass), Forever Living products, Golden Neo-Life Diamite International (GNLD) diet supplements and ginseng products. About 22.9% (181 out of 789) of the participants who used herbal remedies reported side effects, while 38.5% (304 out of 789) reported improving their symptoms. There was a high risk of publication bias in the articles included in this review. The pooled adverse effects of the herbal medicines for SCD treatment were 48% lower (Odds ratio: 0.52, 95% confidence interval (CI): 0.26 - 1.05, I²= 82%, p<0.01) while the pooled efficacy of herbal remedies for treating SCD was nearly 100% higher (odds ratio= 2.07, 95% confidence interval 0.99 - 4.32, I²= 78%, p<0.01) among the users than controls. However, these findings were not statistically significant. Our findings indicate no significant difference in the safety and efficacy of herbal medicines among people with SCD who used or did not use herbal remedies. However, the sample sizes of the primary studies were small. Thus, more extensive controlled studies with better-defined endpoints are required to inform the use of herbal medicines in managing SCD in Africa.
dc.identifier.citationSilvia Awor et al. Safety and efficacy of herbal medicines for the management of sickle cell disease in Africa: a systematic review and meta-analysis. PAMJ-One Health. 2024;15(22)
dc.identifier.issn2707-2800
dc.identifier.urihttps://www.one-health.panafrican-med-journal.com/content/article/15/22/full
dc.identifier.urihttp://hdl.handle.net/20.500.14270/602
dc.language.isoen
dc.publisherPAMJ One Health
dc.subject: Herbal remedies
dc.subjecttreatment
dc.subjectsickle cell disease
dc.subjectsafety
dc.subjectefficacy
dc.subjectAfrica
dc.subjectsystematic review
dc.titleSafety and efficacy of herbal medicines for the management of sickle cell disease in Africa: a systematic review and meta-analysis
dc.typeArticle

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