Moringa commonly used herbal supplements by human immunodeficiency
oleifera lam.leaf (MOL) powder is a product of the Moringa oleifera tree of the
Moringaceae family 1. It is rich in proteins, minerals and
micronutrients 2, antioxidant compounds 3 and
beta-carotene 4. In developing
countries, different parts of the Moringa oleifera plant have been used as
food, fodder, as well as traditional medicine for asthma, anemia, diarrhea,
respiratory disorders, tuberculosis and several other ailments 4. It
is one of the commonly used herbal supplements by human immunodeficiency virus
(HIV) patients receiving antiretroviral therapy (ART) 5. A recent study in Zimbabwe showed that 68% of
patients were consuming MOL powder with 81% of these patients receiving ART 6.
Furthermore, 80% stated that they consumed it to boost their immune system 6.
Another study in Ethiopia revealed that MOL powder was the second most commonly
used supplement with 20.7% of patients having a CD4 count (microliter) of
‘<100 ?l', 36.7% having a CD4 count between '100-350 ?l' and 52.7% having a CD4 count '>350 ?l’ 5. Despite
these widespread utilization, the impact of MOL powder on the immune system has
not been extensively explored yet and thus empirical evidence is very limited.
United Nations Programme on HIV/AIDS (UNAIDS) 2016 report estimated that 36.7
million people were living with HIV globally 7. Sub-Saharan Africa
was home of 25.5 million of these people with 19.4 million residing in Eastern
and Southern Africa 7. 1.6 million were living in Kenya with 1
million accessing ART, representing an overall coverage of 64% 7.
Among these people, concurrent usage of MOL powder with ART is assumed to be
high. This can be demonstrated by the joint Moringa projects that have been
initiated among patients 8. In addition, some HIV care facilities
have started offering it with ART 9 .It is thus imperative to direct
our interests in assessing the effects of MOL powder on the immune system, as
little research has been accomplished in this area.
5 in vivo
studies, 3 conducted in India (2010 – 2012) 10 – 12, and 2 in Uganda
(2015) 13, 14, showed that MOL powder had an immunomodulatory and
proliferation potential in rats. In particular, there was an increment in white
blood cells, lymphocyte and neutrophils count. This could suggest a probable
impact on the human immune system, which is not clearly established. However, a
recent study revealed that MOL powder taken in combination with ART improved
the body mass index, but, contrary to our expectations, there was no
significant change in the lymphocyte count 9. Thus, we propose this
study to investigate the immunological effects of MOL powder on the immune
system of patients receiving ART.
Specific aims for this study are:
To determine whether MOL powder supplementation improves
the immune system of patients receiving ART.
To investigate the incidence of grade three or four
adverse effects resulting from MOL powder co-administration with ART.
We formulate two hypotheses for this study:
MOL powder supplementation increases the CD4 count by
median (X ?l) after every month in patients
There is no incidence of either grade three or four
adverse effects resulting from MOL powder interaction with ART.
Our findings will have a number of fundamental public
health implications, firstly, they will spearhead the implementation of
evidence based policies and practices among health care providers who are
distributing MOL powder to patients. Secondly, they will inform patients on its
safety when taken with ART. And, lastly, they will avert self-care practices in
future among patients who may resolve to abandon the standard treatment regimen