A study of the quality of ginseng containing products in Nairobi, Kenya
The use and acceptance of nutritional and herbal supplements is popular in Kenya as is the case in other developing countries. Ginseng containing products, for example, are herbal formulations that are available as hard and soft gelatin capsules, dried roots, tinctures and tea or beverage additives. These products are used based on the specific indications for which they are promoted such as, adaptogenic effects, antioxidant, antidiabetic, anti-hypotensive, immune stimulatory and anti-cancer effects. Despite advances made in understanding medicinal and toxic properties of many herbs, the consumer today, is confronted with several unproven claims concerning the quality, efficacy and safety of herbal preparations including ginseng containing products. The main objective of this study therefore, was to evaluate the quality of ginseng containing products and their use through retail outlets in Nairobi County, Kenya. Forty commercial products labeled as coiitaining ginseng were obtained through a structured systematic random sampling technique from 76 retail outlets in Nairobi, Kenya. Seventy six store attendants (one from each" store) were assessed for their knowledge about properties of ginseng based on their Imderstanding of schedule or classification of ginseng containing products, conditions for ~hich they are prescribed and side effects. The mean knowledge score, of the attendants, on ginseng products was 3.2 (± 1.8 SD) ranging between 0 and 8. Approximately one-third of the attendants (32.9%) had adequate knowledge on ginseng products. The highest level of education attained was not significantly associated. with knowledge on ginseng products (P=O.823). However, the type of professional training was significantly-associated with knowledge on ginseng products (P<O.OO1). An attendant with a Bachelor of Pharmacy degree (Pharmacist) was 3.11 times more likely to have adequate knowledge on ginseng products compared to an attendant with Diploma in Pharmaceutical Technology (Pharmaceutical Technologist). The likelihood was equally high among attendants trained in other unspecified professions (3.22-folds). A trained nutritionist attendant was 16.92 times more likely to have adequate knowledge on ginseng products compared to an attendant who is a pharmaceutical technologist. Out of 40 ginseng products 41.5% were 80 - 100 % compliant to all labeling requirements with 4.9% being fully compliant, 36.6% being 80 - <100 % compliant, 39% being between 60 - <80% and 19.5% being <60% compliant. All the products (100%) were compliant to microbial load requirements. Mean Total Aerobic Microbial Count (AV.TAMC) was 6.5 (± 6.0 SO) ranging between 0 and 29x 101 while Mean Total Combined Yeast and Mould Count (AV.TYMC) was 2.3 (± 3.1 SO) ranging between 0 and 10;):,(i._1..~'. Mean Total Viable Aerobic Microbial Count (TVAMC) was 8.9 (± 7.1 SO) ranging between 0 and 29 x 10'. However 22.0% of the samples did not meet pharmacopoeia requirements for absence of high-risk microbes (Salmonella species and Escherichia coli). Of the 40 samples, 90 % (36) samples were analyzed for presence of ginseng, using a Shimadzu Cs-9000 densitometer. Thirty (83.3%) of them tested positive for either RbI or Rg1 groups of ginsenoside(s). From this study, it is recommended that herbal or nutritional supplements containing ginseng should be subjected to guided registration requirements and pharmacovigilance programs. Special emphasis should be put on microbial contamination, especially microbial identification, to avoid high risk micro~bes. Fu.rthermore, assay for ginsenosides should be carried out to establish levels of compliance to active ingredients. It is also recommended that attendants selling these products should have basic training in herbal and nutritional supplements and the pharmacy curriculum for Bachelor of Pharmacy degree and Diploma in Pharmaceutical Technology should be reviewed in order to empower the graduates to offer proper services in complementary medicines.