Chapter I

INTRODUCTION

Background of the study

From time immemorial *, mankind has been in search for plant, animal and other

materials that could be used to take care of the pains, deformities, ailments and diseases that

affect some of the unfortunate members of our society. The history of medicine can be link

with the remote past. Although modern medicine, or allopathy †, has been accepted by a

large portion of the population of the world, only in recent years has there been a new look

at natural remedies, home remedies, and simple ways of using plant materials which are so

easily available in one’s own backyard or in the neighborhood. The use of medicative plants

for the cure of various diseases is extremely wide unfold in several parts of the world

including Nigeria among the agricultural population who cannot afford modern medicines

which most often is beyond their reach. This practice involves the use of various

plants/plant parts in different part of the world to cure human diseases and infections.

A disease caused by a Mycobacterium, specifically a Pulmonary Tuberculosis, is a

common disease nowadays. Young or adults, men or women, and even children are not

exempted for this disease. Especially those who have vices, specifically smoking, are very

prone to tuberculosis, and even people with no vices but have a weak immune system.

*
Immemorial - Originating in the distant past; very old.
Oxford University Press, accessed November 10, 2019, https://www.lexico.com/en/definition/immemorial.

†
Allopathy - The treatment of disease by conventional means, i.e. with drugs having effects opposite to the
symptoms.
Oxford University Press, accessed November 10, 2019, https://www.lexico.com/en/definition/allopathy.
 Tuberculosis (TB) is a disease caused by bacteria called Mycobacterium tuberculosis.

The bacteria usually attack the lungs, but they can also damage other parts of the body. TB

spreads through the air when a person with TB of the lungs or throat coughs, sneezes, or talks.

You are more likely to get TB if you have a weak immune system (U.S. National Library of

Medicine, 2019). There are two types of TB conditions: latent TB infection and TB disease. TB

bacteria can live in the body without making you sick. This is called latent TB infection. In most

people who breathe in TB bacteria and become infected, the body is able to fight the bacteria to

stop them from growing. People with latent TB infection do not feel sick, do not have any

symptoms, and cannot spread TB bacteria to others. If TB bacteria become active in the body

and multiply, the person will go from having latent TB infection to being sick with TB disease.

For this reason, people with latent TB infection are often prescribed treatment to prevent them

from developing TB disease (Centers for Disease Control and Prevention, 2019).

Mycobacterium tuberculosis is a species of pathogenic bacteria in the

family Mycobacteriaceae‡ and the causative agent of tuberculosis. First discovered in 1882

by Robert Koch, M. tuberculosis has an unusual, waxy coating on its cell surface primarily due

to the presence of mycolic acid. This coating makes the cells impervious to Gram staining, and

as a result, M. tuberculosis can appear either Gram-negative or Gram-positive. Acid-fast stains

such as Ziehl-Neelsen, or fluorescent stains such as auramine are used instead to identify M.

tuberculosis with a microscope. The physiology of M. tuberculosis is highly aerobic and requires

high levels of oxygen. Primarily a pathogen of the mammalian respiratory system, it infects the

lungs (Wikipedia, The Free Encyclopedia, 2019).

‡
Mycobacteriaceae - are Gram-positive, strictly aerobic, non-motile, acid-fast rod-shaped bacteria with fastidious
growth requirements.
“Mycobacteriaceae,” Elsevier, accessed November 10, 2019, https://www.sciencedirect.com/topics/agricultural-
and-biological-sciences/mycobacteriaceae.
 In 2018, there were an estimated 10 (9.0—11.1) million new (incident) TB cases

worldwide, of which 5.7 million were men, 3.2 million were women and 1.1 million were

children. People living with HIV accounted for 9% of the total. Eight countries accounted for

66% of the new cases: India, China, Indonesia, the Philippines, Pakistan, Nigeria, Bangladesh,

and South Africa. In 2018, 1.5 (1.4—1.6) million people died from TB, including 251 000 (223

000—281 000) people with HIV. Globally, the TB mortality rate fell by 42% between 2000 and

2018. The severity of national epidemics varies widely among countries. In 2018, there were

fewer than 10 new cases per 100 000 populations in most high-income countries, 150 - 400 in

most of the 30 high TB burden countries, and above 500 in a few countries including

Mozambique, the Philippines and South Africa (World Health Organization, 2019).

Abelmoschus is a genus of about fifteen species of flowering plants in the mallow family,

Malvaceae, native to tropical Africa, Asia and northern Australia. It was formerly included

within Hibiscus, but is now classified as a distinct genus (Wikipedia, The Free Encyclopedia,

2019).

Regular intake of okra can give a boost to your immunity. The high vitamin C content

helps the white blood cells function properly and develop immunity against infectious agents,

reducing episodes of the common cold and protecting your body from harmful free radicals

(scribd, 2017). The healthy fiber in okra feeds much-needed good bacteria in our intestines,

which builds our immunity against viruses and infection (Lifehack, 2019). From the point of

view of traditional medical science, it is understandable that, okra is a cooling and cleansing

food, affecting gastrointestinal tract and respiratory system. It reduces fire (fever, inflammation,

ulcer and sore) in digestive tract, mouth, throat and lung, thus it helps to prevent and reduce the

risk of cancers in these organs (Natural Remedies Center, 2019).

 Allium cepa, commonly known as onion, is a worldwide culinary and therapeutic spice

belonging to the family Liliaceae. Onion is an essential ingredient in many African sauces and is

mostly produced locally, with Egypt being the first producer in the continent. Onion is a source

of various biologically active compounds, such as phenolic acids, thiosulfinates, and flavonoids.

The plant has a variety of pharmacological activities including anticancer, antidiabetic,

antimicrobial, cardiovascular, antioxidant effects, etc., justifying its possible use in the treatment

of various human ailments (Victor Kuete, 2017).

Allium cepa (onion)., contains various constituents like quercetin, fructose, quercetin-3-

glucoside, isorhamnetin-4-glucoside, xylose, galactose, glucose, mannose, organosulfur

compounds, allylsulfides, flavonoids, flavenols, S-alk(en)yl cysteine sulfoxides, cycloalliin,

selenium, thiosulfinates, and sulfur and seleno compounds that have proved to have protective

role in tuberculosis. Allium cepa (onion) possesses antibiotic activity against both Gram-positive

and Gram-negative bacteria and can be used to prevent tuberculosis most effectively (Mehta, S.

et al., 2015, 1–2).

Our government has already developed a cure or a medicine for tuberculosis and it is

even free in any public hospitals. However, it has a strict management of taking t he

medicine for this disease because if stopped, it will cause complications and treatment will

have to start again from the beginning. In addition, drinking alcohol while on tuberculosis

treatment should be avoided. Alcohol can increase drug side effects and toxicity, because

both can affect the liver (Better Health Channel, 2018), which will cause trouble to people

who are alcoholic.

As a concerned citizen of our country, the proponents are also trying to make an

alternative solution to prevent this particular disease and any other sub-infections and
complications while having a treatment. The proponents want to prove that the synergy of an

unripen fruit of Okra (Abelmoschus esculentus Linn.) and a bulb of Onion (Allium cepa Linn.)

can be used as an alternative anti-tuberculosis remedy for Pulmonary Mycobacterium

Tuberculosis. It is a natural approach to Pulmonary Tuberculosis (PTB) treatment, it serve as a

natural remedy for this disease because it is not processed too highly and will not cause any other

side effects, which will avoid complications and any other sub-infections.

Through the cooperation of the government and these Okra and Onion used as an

alternative remedy for Pulmonary Tuberculosis, there is a possibility of an effective and non-

producing-other-infection treatment.

This study entitled “Anti-tuberculosis Activity of the Synergy of an Unripen Fruit of

Okra (Abelmoschus esculentus Linn.) and a Bulb of Onion (Allium cepa Linn.) Against

Pulmonary Mycobacterium Tuberculosis: A Natural Remedy for Tuberculosis” will answer the

following objectives generally:

To develop an alternative anti-tuberculosis remedy using the unripen fruit of Okra

(Abelmoschus esculentus Linn.) and the bulb of Onion (Allium cepa Linn.).

Specifically it aims to answer the following:

(1) Which among the Okra (Abelmoschus esculentus Linn.) and Onion (Allium cepa

Linn.) is the most specific natural remedy for tuberculosis; (2) What is the effect of the

combination of Okra (Abelmoschus esculentus Linn.) and Onion (Allium cepa Linn.) in treating

diseased lung to eliminate bacteria such as Mycobacterium Tuberculosis and; (3) How long will

it take to treat a Pulmonary Tuberculosis with the use of the unripen fruit of Okra (Abelmoschus

esculentus Linn.) and the bulb of Onion (Allium cepa Linn.)?

 The synergy of an unripen fruit of Okra (Abelmoschus esculentus Linn.) and the bulb of

Onion (Allium cepa Linn.) does not have any significant difference to the existing anti-

tuberculosis tablets in treating Pulmonary Tuberculosis.

The rationale of the study is to avoid complications and other sub-infections to reduce the

estimated value of the people who are suffering with tuberculosis. And on the other side, the

study aims to develop an alternative anti-tuberculosis remedy that does not require a strict

management of treatment. Hence, this will benefit the people who are low in memory that

always forgets and those who are highly alcoholic person.

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