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Amid a worsening global health crisis, researchers are turning to an unlikely hero: Neem (Azadirachta indica), a plant that has been used for centuries to treat various ailments, including typhoid fever, which is a major global health concern, especially in developing countries where antibiotic-resistant S. Typhi strains are on the rise.
The emergence of these resistant strains has necessitated the exploration of new treatment options.
Neem has demonstrated potential in treating this disease, and this review provides an overview of the scientific evidence supporting its efficacy, highlighting its bioactive compounds, antimicrobial properties, and potential benefits over conventional antibiotics.
Typhoid fever is a bacterial infection caused by Salmonella Typhi, typically spread through contaminated food and water.
If left untreated, it can lead to serious complications.
Symptoms typically appear within six to 30 days after infection and include fever, headache, abdominal pain, diarrhoea and vomiting.
is usually made using blood or stool cultures. It is typically treated with antibiotics, such as ciprofloxacin and azithromycin.
However, the widespread use of these antibiotics has led to the emergence of resistant S. Typhi strains, complicating treatment, according to the World Health Organisation (WHO).
In several countries, including Ghana, antibiotic-resistant S. Typhi strains have been reported showing alarming rates of resistance, with 73.3 per cent of S. Typhi isolates resistant to ciprofloxacin and 62.5 per cent resistant to azithromycin (Amoako et al., 2019; Owusu-Ofori et al., 2018).
Neem contains several bioactive compounds that have shown promise in combating typhoid fever.
These compounds work through various mechanisms to inhibit the growth of S. Typhi, reduce inflammation and modulate the immune response.
Azadirachtin inhibits bacterial growth and reduces virulence by targeting specific biochemical pathways.
Studies have shown that azadirachtin inhibits the growth of S. Typhi with a minimum inhibitory concentration (MIC) of 12.5 μg/mL (Singh et al., 2018).
Nimbin possesses anti-inflammatory and immunomodulatory effects, reducing inflammation and improving immune response in mice infected with S. Typhi (Kumar et al., 2017).
Nimbidin exhibits antibacterial and anti-inflammatory effects, inhibiting bacterial growth with an MIC of 6.25 μg/mL (Rao et al., 2019).
Gedunin inhibits bacterial growth and reduces inflammation, with an MIC of 25 μg/mL (Rao et al., 2019). Quercetin possesses antioxidant and anti-inflammatory effects, reducing oxidative stress and inflammation in mice infected with S. Typhi (Kumar et al., 2018).
Neem seeds and leaves are utilised in treating typhoid fever. Its preparation is extracted using methanol or ethanol solvents. The resulting extract is administered orally, typically as a decoction or infusion.
Dosage and preparation methods vary depending on traditional medicine or cultural practices.
Although Neem is safe and effective in treating typhoid fever, potential risks and side effects should be considered as it has been found to cause gastrointestinal upset and allergic reactions in some individuals.
Additionally, Neem may interact with certain medications, such as blood thinners and diabetes medications.
The emergence of antibiotic-resistant Salmonella Typhi strains necessitates alternative treatments for typhoid fever.
Neem (Azadirachta indica) has shown promise due to its bioactive compounds, which inhibit S. Typhi growth and reduce virulence.
However, Neem treatment is not without risks and side effects.
Its unique properties make it a promising treatment option for typhoid, and further research is warranted to fully explore its therapeutic potential and optimise clinical use.
Therefore, using Neem decoction or infusion may be considered for typhoid treatment after failure of antibiotic treatment, potentially leading to a total cure.
The writer is a Doctor of Naturopathic Medicine (N.D. Candidate),
Medical Journalist, & Medical Laboratory Technologist.
E-mail: kofiappiah803@gmail.com
