Susceptibility Pattern of Different Parts of Moringa oleifera against Some Pathogenic Fungi, Isolated from Sputum Samples of HIV Positive Individuals Co-Infected with Pulmonary Tuberculosis

Abstract

Background: Opportunistic fungal infection in HIV positive individualshas a high risk of morbidity and mortality as it could be a pointer to systemic infection. Moringa oleifera is one of the 14 species of the family Moringaceae with traditional effectiveness in anti–helminthic, analgesic, anti-ulcerative, anti-microbial, etc. Aim: This study was designed to determine the susceptibility pattern of different parts of Moringa oleifera against some pathogenic fungi using dried Morringa oleifera seed, bark, pod, and leaf extracts/fractions as agents. Materials and Methods: A total of 132 subjects (62 males and 70 females) attending outpatient clinics (OPD) at Nnamdi Azikiwe University Teaching Hospital Nnewi, and Holy Rossary Hospital Emekuku Owerri, Nigeria were recruited for this study. The HIV status of the test subjects was confirmed using immuno-chromatographic technique and their sputum screened for Tuberculosis (TB) using Ziehl Nelsen staining technique. The sputum samples were also cultured on Sabouaurd dextrose agar with and without chloramphenicol incubated at 25oC with examination of growth every 3 days for two weeks. Identification of isolates was done using Gram staining methods, chromogenic media and slide culture.700g, 220g, 500g, and 250g each of the different parts of the pulverized Moringa oleifera (seeds, barks, pods, and leaves) were weighed and exctracted using Soxhlet extractor and methanol as solvent. Results: The prevalence of fungi isolates from test subjects shows that Candida albicans has the highest frequency of 25(26.6%), with the least prevalent being Aspergillus flavus and Phialemonium curvatum at 2(2.1%) respectively. There was also a positive significant correlation between TB and fungi infection in HIV-sero positive subjects (P<0.05).The invitro antifungal activity of these Moringa oleifera extracts/fractions against the test isolates showed no antifungal activity except for ethyl acetate fraction which demonstrated the most prominent activity against A. fumigatus with zones of inhibition of 3-10mm diameter with the least activity against C. krusei with zones of inhibition of 3-6mm diameter. However, the antifungal activities of fluconazole which served as a control in the antifungal susceptibility against the test isolates were more effective than the extract/fractions against the test isolates with a minimum inhibition concentration (MIC) of 50-200mg/ml against 25-100mg/ml for ethylacetate fraction. Conclusion: The comparable antifungi effect of ethylacetate fraction of M. oleifera leaf with that of fluconazole, suggests that ethylacetate fraction of M. oleifera leaf could aid the treatment of pathogenic fungi due to its potential applications in Pharmaceutical industry, thereby ameliorating the morbidity and mortality rate of HIV positive co-infected TB subjects.