Effectiveness of Azadirachta indica (neem tree) on prevention and treatment of clinical human malaria: A systematic review

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Erasto Vitus Mbugi
Alfred Said Sife
Mboni Ruzegea
Grace Emmanuel Peter Msoffe
Bestina Daniel
Edward Kabyemela
Bruno Sunguya
Edda Tandi Lwoga


Introduction: Neem tree parts such as leaves, stem barks, and roots are known to have some medicinal values in both humans and animals. However, the evidence is scattered and vary with populations and regions. This systematic review sought to explore the effectiveness of neem as a therapeutic and prophylactic agent against malaria.

Methodology: The systematic review examined the effectiveness of neem using the pre-registered review protocol and followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) checklist. The Population Intervention Comparator Outcome (PICO) question was: “What is the effectiveness of neem (Azadirachta indica) when used as a therapeutic and prophylactic agent for malaria infection?” It included all cross-sectional survey studies, qualitative studies, case-control studies, randomised controlled trials, quasi-experimental studies, and cohort studies with or without comparison groups. Studies that had both children and adult patients who were diagnosed with malaria were included in the survey. Malaria patients using traditional medications other than neem as well as those who did not use neem were excluded from this study. The search for articles, screening, and synthesis were conducted using the Rayyan software.

Results: Out of the total 1089 articles retrieved, only 3 fitted the inclusion criteria, 1 article could not be retrieved. A narrative synthesis was therefore done on 2 final research articles that were retrievable. The pooled evidence shows that Azadirachta indica is effective against malaria. The medicinal effects are more on symptoms and curbing development to clinical disease than ant parasitic effects.

Conclusion: Neem is potential traditional medicine for malaria symptoms’ treatment, but evidence on ant parasitic effects is still not conclusive. The study recommends further primary studies to enhance the power of results to further recommend this plant for the prevention of or treatment of malaria symptoms.

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