1. INTRODUCTION:

Tuberculosis (TB) arises from Mycobacterium tuberculosis (MTB) and poses a worldwide health concern, particularly due to the rising prevalence of multidrug-resistant (MDR) MTB variants. The rapid spread of the disease is largely driven by population movement. Additionally, co-infection with the human immunodeficiency virus (HIV) presents a significant health and scientific hindrance due to its high mortality rate¹. Garlic, scientifically known as Allium sativum, has a wide geographic distribution and has been cultivated in many regions around the world for its culinary and medicinal uses. It originated in central Asia and has a long history of cultivation in Great Britain, various parts of Europe, the Middle East, and North Africa. It's also grown in New Zealand, Australia, and North America. Garlic's Allium sativum variety is indeed widely cultivated for culinary purposes due to its distinctive flavour².

India possesses a rich heritage of traditional medicine, encompassing various elements such as Ayurveda, Siddha, and Unani, which have thrived in the country for centuries. The potential synergy of Ayurveda and other Indian medical systems with modern scientific approaches holds promise for advancements in healthcare⁴.

In ancient times, medicinal plants have been employed as traditional remedies, spices, and constituents of food, contributing to human health care. Garlic (Allium sativum L.) is a member of the Amaryllidaceae family, a fragrant herbaceous plant, that is globally consumed as both a food item and a traditional treatment for diverse ailments. Garlic has been ascribed to a multitude of biological characteristics, encompassing its traditional use in roles such as preventing cancer, providing antioxidants, managing diabetes, protecting the kidneys, preventing atherosclerosis, fighting bacterial and fungal infections, and lowering blood pressure⁵.

Figure 1: Schematic representation of the effect of Allicin in the treatment of different diseases with the mechanism involved ³.

When treatment is not fully administered, there is a risk of disease reactivation, frequently linked to drug-resistant forms of the condition ^6-7.

Tuberculosis, a highly contagious illness affecting approximately one-third of the global population, including around 40 per cent of individuals in India, has become a significant concern. Mycobacterium tuberculosis, the causative agent, has developed resistance to both primary and secondary medications ⁸. The existing treatment regimen for tuberculosis is lengthy, prompting the need to enhance it by shortening the duration or allowing more spaced-out intermittent treatment. Current drugs also pose challenges due to adverse effects like liver toxicity, sometimes leading to premature treatment cessation. The emergence of multi-drug resistant (MDR) and extensively drug-resistant (XDR-TB) strains underscores the urgency to discover new effective drug compounds. TB is caused by mycobacteria, notoriously resilient to antibiotics due to their protective cell wall. Around one-third of the global population carries latent TB, with a 10 per cent chance of progression to active TB ⁹. In 2011, TB caused 1.4 million deaths and affected 8.7 million individuals, leaving a tragic toll on orphaned children due to parental TB-related deaths in preceding years ¹⁰.

Table 1: Selected ethnomedicinal plants with traditional knowledge of usTB-allied or TB-allied symptoms among the Indian population validated scientifically with diverse activity ¹¹.

Plant name	Allium sativum L
Common name	Sukandak (S) Rasun (B/H), Garlic (E)
Family	Amaryllidaceae
Plant used	Underground bulb
Traditional uses/activities	For more than 5,000 years, it was utilized in India and afterwards in China for culinary purposes, as a spice, and in traditional medicine, followed by its adoption in ancient Greek and Roman cultures. bulb daily with lukewarm milk after breakfast to prevent TB.
Bioactive compound	Allicin
Activity and mode of action	Antibacterial: Shows effectiveness against a broad spectrum of gram-negative and gram-positive bacteria, containing multidrug-resistant variants.

Given the societal and financial burdens of MDR-TB transmission, it's important to establish the clinical effectiveness of Allium sativum. Current reviews indicate that clinical trials have been limited in number, small in scale, and lacking proper controls. However, exploiting the standardized and time-tested use of garlic as medicine could bring significant benefits to TB containment. Scientific evidence from well-designed clinical trials can validate the use of Allium sativum, making it more accessible to those affected by MDR-TB through the public health system. Its utilization could contribute to effective MDR-TB management due to its affordability and absence of harmful effects. This could lead to substantial reductions in healthcare costs and better equip governments to address the pandemic's challenges.

Description:

Garlic, a perennial plant, features delicate leaves and a compound bulb comprising numerous small bulb-lets or cloves, ranging from 10 to 50. These cloves are enveloped by a thin, white or pinkish sheath, accompanied by short, embedded roots. The cloves exhibit an asymmetrical shape, except for those positioned near the centre. Garlic plants can reach heights of up to 1.2 meters (4 feet) and produce hermaphrodite flowers, yielding both seeds and bulb-lets ¹².

1. Anti-Microbial Properties:

Garlic possesses elements that can hinder bacterial growth or trigger apoptosis, without harming the infected organism. In the battle against these microorganisms, garlic is supposed to be as potent as broad-spectrum antibiotics ¹³.

Garlic's effectiveness, coupled with fewer side effects compared to commercial antibiotics, suggests its potential as an antibiotic substitute. Recent findings highlight garlic's antibacterial qualities against a broad range of gram-negative bacteria like

1. Aeromonas hydrophila

2. Pseudomonas aeruginosa

as well as gram-positive bacteria including

1. Bacillus cereus

2. Streptococcus mutants

3. Staphylococcus epidermidis

4. Methicillin-resistant Staphylococcus aureus¹⁴.

Extracts from garlic exhibit a wide range of antibacterial effects, targeting both gram-negative and gram-positive microorganisms¹⁵.

The effectiveness of extracts and oil in fighting bacteria was measured using the zone of inhibition technique. Garlic extracts containing allicin and ajoene displayed notable antimycobacterial effects in comparison to standard medications. Garlic oil exhibited strong antibacterial properties, especially against methicillin-resistant Staphylococcus aureus ¹⁶.

The antibacterial properties of garlic extracts stem from various bioactive elements within them.

These components disrupt bacterial cell membranes, leading to the death of bacterial cells ¹⁷.

2.1 Anti-Microbial Activity:

Garlic possesses a wide range of abilities to fight against bacteria and fungi ^18-20

Mycobacteria constitute a group of acid-fast bacilli within the Mycobacteriaceae family, encompassing organisms responsible for tuberculosis and various other well-known, as well as rarer, diseases. Tuberculosis, commonly referred to as TB or tubercle bacillus, and historically known as phthisis, phthisis pulmonalis, or consumption, is a frequently lethal infectious ailment brought about by different strains of mycobacteria, primarily Mycobacterium tuberculosis (M.tb.). TB is a prevalent and deadly infectious disease that typically affects the lungs but can also afflict other body parts.

Since the 1960s, society has consistently overlooked the control of tuberculosis due to inadequate management and unfocused national tuberculosis control programs. This neglect has led to an increase in mortality rates and relapse cases related to TB. According to the World Health Organization (WHO), approximately one-third of the world's population is infected with Mycobacterium tuberculosis. Globally, 8 million people are diagnosed with tuberculosis, with 2.9 million deaths occurring in developing countries, primarily among individuals aged 15-59 years.

Tuberculosis claims the lives of over three million individuals annually worldwide, accounting for about 25% of preventable adult deaths in developing regions. Without immediate intervention, it's projected that as many as 70 million people could succumb to TB over the next two decades. In 1993, WHO made an unprecedented declaration, classifying tuberculosis as a global emergency ²¹.

· The antibacterial effects of two unique garlic varieties, namely "Rosato" and "Caposele," found in Italy's Campania region, were studied.

· It was revealed that garlic oil is the primary antibacterial component responsible for breaking down the structure and metabolic processes of bacterial cells ²².

· The ethanolic extract of garlic demonstrated its highest activity against B. subtilis. In China, a proprietary garlic derivative called Allitridi has effectively treated systemic bacterial infections, including Helicobacter pylori. Another study revealed that garlic extract significantly inhibits Sal. enteritidis, while Staph. aureus displayed lower sensitivity to it ²³.

3. Bioactive Compound of Garlic:

Garlic has different types of active substances, including compounds like organosulfur, saponins, phenolic compounds, and polysaccharides^24-27. The key active parts of garlic are organosulfur compounds, like allicin, DAS, DADS, and alliin^28-31. These organosulfur compounds are more easily digested in raw garlic than in cooked garlic ³². The main elements contributing to that taste are non-volatile amino acids rich in sulfur (thiosulfinates), with alliin or S-allyl-cysteine sulfoxide (ACSO) being the primary precursors of garlic flavour ³³. Throughout history, garlic has been recognized for its ability to eliminate mycobacterial strains, with its active component, allicin, exhibiting antimicrobial properties against diverse microorganisms. In this study, we've demonstrated that allicin not only decreased the bacterial load in the lungs of mice infected with Mycobacterium tuberculosis (M. tb) but also induced strong anti-tubercular immunity²⁴.

Table 2: List and structures of some sulphur-containing compounds isolated from Allium Sativum ³⁴.

Compounds	Molecular formula	Structure
Alliin	C₆H₁₁NO₃S
Allicin	C₉H₁₄OS₃
E-Ajoene	C₉H₁₄OS₃
2-Vinyl-1-4H-1,3-dithiin	C₆H₈S₂
Diallyl sulfide (DAS)	C₆H₁₀S
Diallyl disulfide (DADS)	C₆H₁₀S₂
Diallyl trisulfide (DATS)	C₆H₁₀S₃
Allyl methyl sulfide (AMS)	C₆H₈S

3.1 ALLICIN:

Allicin, also referred to as diallylthiosulfinate, is a sulfur-based compound found in garlic (Allium sativum).

This volatile and oxygenated substance gives garlic its distinctive aroma.

Allicin plays a role as an antipathogenic agent by interacting with sulfur-containing proteins and enzymes in various microorganisms. Additionally, it can influence crucial genes responsible for the virulence of these microorganisms ³⁵.

Figure 2: Structure of Allicin

In this study, garlic oil is employed due to its well-established antibacterial properties that have been recognized for many years. When garlic cloves are chopped or crushed, they release a compound called alliin, which interacts with the enzyme allinase, producing allicin—a potent antibacterial substance. According to Castleman, allicin demonstrates efficacy in eradicating both fungi and bacteria³⁶.

Due to its remarkable capability to eliminate harmful substances, allicin is often regarded as a remarkable compound. Its volatile nature is particularly beneficial in combatting lung infections. Allicin boosts the antimicrobial effectiveness of macrophages in the presence of Mycobacterium tuberculosis infection. The findings of this research reveal that allicin has a dual impact on Mycobacterium tuberculosis (M. tb). It not only prevents the bacteria from entering cells by blocking surface receptors but also eradicates the bacteria through its antimycobacterial actions. The study's authors have observed that allicin not only serves as a bacteria killer but also acts as an immunomodulator, prompting a defensive immune response in the host. This response helps safeguard the host by reducing the negative effects and immune suppression that can result from traditional antibiotic treatments. ³⁷.

As outlined in this study, allicin doesn't just eliminate drug-sensitive strains of M.tb, but it's also remarkably successful against drug-resistant strains in both laboratory settings and mouse models. This result is quite encouraging, especially considering the limited options available for treating drug-resistant M.tb. For instance, bedaquiline (SIRTUROTM) took nearly 40 years to gain approval for treating MDR-TB ³⁸. The possibility of allicin effectively eliminating drug-resistant M. tb strains is a hopeful development, especially in regions with significant TB issues where garlic is accessible and affordable. Additionally, allicin and its variations have shown the ability to hinder the creation of bacterial biofilm which is a key factor in antibiotic resistance, by controlling quorum sensing ³⁹. Over time, allicin has gained significant attention as one of the most extensively studied natural bioactive compounds. Its wide availability and notable inhibitory effects on various infectious agents, beyond bacteria, have contributed to its popularity. This compound has been explored for its antimicrobial, anti-inflammatory, anti-cancer, anti-viral, and antiparasitic properties. It also exhibits potent immunomodulatory qualities, making it a versatile tool against infections and diseases.

Furthermore, research has shown that allicin operates in multiple effective ways both in controlled lab environments (in vitro) and in living organisms (in vivo) to provide defence against the dangerous pathogen M.tb. Given that tuberculosis (TB) primarily affects underdeveloped and developing countries, where resources are limited, the current treatment involves lengthy courses of multiple antibiotics. This therapy often leads to severe toxicity in patients. Additionally, due to the extended treatment duration and low treatment adherence, which is common in certain populations, we are witnessing the emergence of strong drug resistance in M.tb, resulting In strains that are resistant to multiple drugs (MDR) and extremely resistant to drugs (XDR). More recently, cases of totally drug-resistant (TDR) strains have also been identified in some populations⁴⁰.

One reason could be that allicin treatment increases the susceptibility of microorganisms, making them more responsive to antibiotics or antifungals. This combined approach enhances the effectiveness of these treatments, rather than using them individually. Consequently, using allicin alongside traditional antimicrobial drugs in a combination therapy might lead to shorter treatment durations, potentially curbing the emergence of drug-resistant strains. Allicin's antibacterial strength is comparable to certain common antibiotics like penicillin, tetracycline, and kanamycin^41-43.

Unlike widely used antibiotics that target specific pathogens or have a narrow scope, allicin has a broader inhibitory impact. It can affect a wide range of microorganisms, including both gram-positive and gram-negative bacteria, yeasts, fungi, parasites, and even viruses⁴⁴.

In addition to TB, which is the primary focus of this conversation, garlic has demonstrated its effectiveness against various other infectious agents. A brief exploration of the impact of garlic and its derivative allicin on different infectious diseases could enhance the significance of this commentary. This discussion would provide us with a deeper understanding of its potential as a strong candidate for drug use or as part of combination therapies in the future. Allicin's remarkable efficacy has also been observed in preventing different types of infections, such as viral, fungal⁴⁵, and parasitic⁴⁶, infections.

4. Involvement of Traditional Healers:

Another significant advantage of utilizing garlic extract in developing nations is that individuals affected by diseases can rely on their traditional healers (TH), who offer informal care services within the community's support network. According to the South African Department of Health, traditional health practitioners are a vital part of the comprehensive care provided, often approaching health promotion and disease management holistically. Research conducted in urban areas of Kwazulu Natal revealed that patients often sought consultations with TH due to a shared cultural background⁴⁷. Investigating the potential for collaboration, a study found that 84% of 100 TB patients surveyed would consider having a TH as their treatment supervisor, while 92% of TH were willing to take on this role, indicating the potential for interaction with formal TB caregivers⁴⁸. Integrating TH into existing community-based TB DOTS programs demonstrated their effective contribution to TB plan performance, as shown in a pilot initiative in a Kwazulu Natal district⁴⁹.

In Malawi, some interviewed TH displayed knowledge about TB, suggesting the importance of involving TH in the national TB control program⁵⁰. There is extensive literature exploring the possibilities of cooperation between traditional healers and conventional health services. It's noted that a majority of people in Africa seek guidance from TH before or alongside conventional health services^51-52. Given their relevance in local societies and their integration as well as high regard within communities for medical concerns, TH could potentially play a significant role in TB control programs. Such an approach could be both affordable and effective simultaneously.

CONCLUSION:

Tuberculosis (TB) is highly contagious and easily spreads, particularly in impoverished and overcrowded environments. Given the growing prevalence of drug-resistant strains, the use of garlic extract remains a potent antimicrobial agent. Allicin, the primary compound found in garlic, exhibits a robust antimicrobial effect and triggers various immune responses that aid in eliminating different forms of drug-sensitive and drug-resistant M.tb. Analyzing allicin's molecular impact on diverse illnesses reveals its immunomodulatory and anti-inflammatory properties. However, high doses of allicin can lead to gastric discomfort.

This article highlights the efficacy of garlic extract against clinical isolates of multi-drug-resistant M. tuberculosis. Incorporating garlic as a natural supplement alongside standard anti-tuberculosis treatment is recommended. Substituting conventional medications with plant extracts like garlic could play a vital role in reducing drug resistance and cutting down healthcare costs.

REFERENCES:

1. The potential role of garlic (Allium sativum) against the multi-drug resistant tuberculosis pandemic: a review

2. Chemical Datasets, Antioxidant, Free Radicals Scavenger activities estimate in Aqueous Garlic (Allium sativum) extract, Research Journal of Pharmacy and Technology

3. https://doi.org/10.33696/immunology.2.039

4. Rohan R. Vakhariya, Swati Talokar, Archana R. Dhole, S.K. Mohite, C.S. Magdum, Comparative Standardization Study of Two Marketed Shatavari Churna Formulation. Asian Journal of Pharmaceutical Analysis. 2016; 6 (1): 1-6.

5. Chemical Constituents and Pharmacological Activities of Garlic (Allium sativum L.) : A Review

6. Cohen KA, et al. Evolution of extensively drug-resistant tuberculosis over four decades: whole genome sequencing and dating analysis of Mycobacterium tubercu by losis isolates from KwaZulu-Natal. PLoS Med. 2015; 12(9):e1001880. doi: 10.1371/journal.pmed.1001880.

7. Velayati AA, et al. The emergence of new forms of totally drug-resistant tuberculosis bacilli: super extensively drug-resistant tuberculosis or totally drug-resistant strains in Iran. Chest. 2009; 136(2): 420–425. doi: 10.1378/chest.08-2427.

8. Anti-mycobacterial activity of garlic (Allium sativum) against multi-drug resistant and reference strain of Mycobacterium tuberculosis

9. Gupta VK, Shukla C, Bisht GR, Saikia D, Kumar S, Thakur RL. Detection of anti-tuberculosis activity in some folklore plants by radiometric BACTEC assay. Lett Appl Microbiol. 2004; 52: 33– 40.

10. Garlic Inhibits Tuberculosis Bacteria (possibly by Jamming Bacteria Twitter Feed)

11. Bhattacharya (1976); Thomson and Ali (2003); Hosseini and Hosseinzadeh (2015)

12. Singh R., Singh K. Garlic: a spice with wide medicinal actions. Journal of Pharmacognosy and Phytochemistry. 2019; 8(1): 1349–1355.

13. Jang HJ, Lee HJ, Yoon DK, Ji DS, Kim JH, Lee CH. Antioxidant and antimicrobial activities of fresh garlic and aged garlic by-products extracted with different solvents. Food Sci Biotechnol. 2018; 27: 219–25. doi:10.007/s10068-017-0246-4

14. Medicinal and therapeutic properties of garlic, garlic essential oil, and garlic-based snack food: An dated review

15. Garlic extracts have a broad antibacterial spectrum that includes gram-negative and gram positive microorganisms

16. Antimycobacterial and Antibacterial Activity of Allium sativum Bulbs

17. Choo S, Chin VK, Wong EH, Madhavan P, Tay ST, Yong PVC, et al. Antimicrobial properties of allicin used alone or in combination with other medications. Folia Microbiol. 2020; 65: 451–65. doi: 10.1007/s12223-020-00786-5

18. Guo, Y.J. Experimental study on the optimization of extraction process of garlic oil and its antibacterial effects. Afr. J. Tradit. Complement. Altern. Med. 2014; 11: 411–414.

19. Liu, Q.; Meng, X.; Li, Y.; Zhao, C.N.; Tang, G.Y.; Li, S.; Gan, R.Y.; Li, H.B. Natural products for the prevention and management of Helicobacter pylori infection. Compr. Rev. Food Sci. F. 2018; 17: 937–952.

20. Liu, Q.; Meng, X.; Li, Y.; Zhao, C.N.; Tang, G.Y.; Li, H.B. Antibacterial and antifungal activities of spices. Int. J. Mol. Sci. 2017; 18: 1283.

21. Chemistry of Fluoroquinones in The Management of Tuberculosis (TB): An Overview, Sourabh D Jain, Arun Kumar Gupta, Asian Journal of Pharmaceutical Research

22. Fratianni, F.; Riccardi, R.; Spigno, P.; Ombra, M.N.; Cozzolino, A.; Tremonte, P.; Coppola, R.; Nazzaro, F. Biochemical characterization and antimicrobial and antifungal activity of two endemic varieties of garlic (Allium sativum L.) of the campania region, southern Italy. J. Med. Food. 2016, 19: 686–691.

23. https://rjptonline.org/AbstractView.aspx?PID=2017-10-11-77.

24. Diretto, G.; Rubio-Moraga, A.; Argandona, J.; Castillo, P.; Gomez-Gomez, L.; Ahrazem, O. Tissue-specific accumulation of sulfur compounds and saponins in different parts of garlic cloves from purple and white ecotypes. Molecules. 2017; 22: 1359.

25. Szychowski, K.A.; Rybczynska-Tkaczyk, K.; Gawel-Beben, K.; Swieca, M.; Karas, M.; Jakubczyk, A.; Matysiak, M.; Binduga, U.E.; Gminski, J. Characterization of active compounds of different garlic (Allium sativum L.) cultivars. Pol. J. Food Nutr. Sci. 2018; 68:73–81.

26. Bradley, J.M.; Organ, C.L.; Lefer, D.J. Garlic-derived organic polysulfides and myocardial protection. J. Nutr. 2016; 146: 403S–409S.

27. Wang, Y.C.; Guan, M.; Zhao, X.; Li, X.L. Effects of garlic polysaccharide on alcoholic liver fibrosis and intestinal microflora in mice. Pharm. Biol. 2018; 56: 325–332.

28. Yoo, D.Y.; Kim, W.; Nam, S.M.; Yoo, M.; Lee, S.; Yoon, Y.S.; Won, M.H.; Hwang, I.K.; Choi, J.H. Neuroprotective effects of Z-ajoene, an organosulfur compound derived from oil-macerated garlic, in the gerbil hippocampal CA1 region after transient forebrain ischemia. Food Chem. Toxicol. 2014; 72: 1–7.

29. Kodera, Y.; Ushijima, M.; Amano, H.; Suzuki, J.; Matsutomo, T. Chemical and biological properties of S-1-propenyl-l-cysteine in aged garlic extract. Molecules. 2017; 22: 570.

30. Yoo, M.; Lee, S.; Kim, S.; Hwang, J.B.; Choe, J.; Shin, D. Composition of organosulfur compounds from cooland warm-type garlic (Allium sativum L.) in Korea. Food Sci. Biotechnol. 2014; 23:337–344.

31. Mansingh, D.P.; Dalpati, N.; Sali, V.K.; Vasanthi, A.H.R. Alliin the precursor of allicin in garlic extract mitigates proliferation of gastric adenocarcinoma cells by modulating apoptosis. Pharmacogn. Mag. 2018; 14: S84–S91.

32. Torres-Palazzolo, C.; Ramirez, D.; Locatelli, D.; Manucha, W.; Castro, C.; Camargo, A. Bioaccessibility and permeability of bioactive compounds in raw and cooked garlic. J. Food Compos. Anal. 2018; 70” 49–53.

33. Block, Naganathan, Putman, and Zhao, 1993; Horníčková, Kubec, Cejpek, Velíšek, Ovesná, and Stavelíková, 2010.

34. Chemical Constituents and Pharmacological Activities of Garlic (Allium sativum L.): A Review

35. Reiter J, Levina N, Van der Linden M, Gruhlke M, Martin C, Slusarenko AJ. Diallylthiosulfinate (Allicin), a volatile antimicrobial from garlic (Allium sativum), kills human lung pathogenic bacteria, including MDR strains, as a vapor. Molecules. 2017; 22(10): 1711.

36. Formulation and Evaluation of Antifungal Soap of Garlic Oil, Rutuja R. Shah, Rohan R. Vakhariya, Asian Journal of Pharmaceutical Research

37. Dwivedi VP, Bhattacharya D, Singh M, Bhaskar A, Kumar S, Fatima S, et al. Allicin enhances antimicrobial activity of macrophages during Mycobacterium tuberculosis infection. Journal of Ethnopharmacology. 2019; 243: 11163.

38. Deoghare S. Bedaquiline: a new drug approved for treatment of multidrug-resistant tuberculosis. Indian Journal of Pharmacology. 2013; 45(5): 536.

39. Li WR, Ma YK, Shi QS, Xie XB, Sun TL, Peng H, et al. Diallyl disulfide from garlic oil inhibits Pseudomonas aeruginosa virulence factors by inactivating key quorum sensing genes. Applied Microbiology and Biotechnology. 2018; 102(17): 7555-64.

40. Fatima S, Kumari A, Das G, Dwivedi VP. Tuberculosis vaccine: A journey from BCG to present. Life Sciences. 2020: 117594

41. Majewski M. Allium sativum: facts and myths regarding human health. Roczniki Państwowego Zakładu Higieny. 2014; 65(1).

42. Curtis H, Noll U, Störmann J, Slusarenko AJ. Broadspectrum activity of the volatile phytoanticipin allicin in extracts of garlic (Allium sativum L.) against plant pathogenic bacteria, fungi and Oomycetes. Physiological and Molecular Plant Pathology. 2004; 65(2): 79-89.

43. Fujisawa H, Watanabe K, Suma K, Origuchi K, Matsufuji H, Seki T, Ariga T. Antibacterial potential of garlic-derived allicin and its cancellation by sulfhydryl compounds. Bioscience, Biotechnology, and Biochemistry. 2009; 73(9): 1948-55.

44. Marchese A, Barbieri R, Sanches-Silva A, Daglia M, Nabavi SF, Jafari NJ, Izadi M, Ajami M, Nabavi SM. Antifungal and antibacterial activities of allicin: A review. Trends in Food Science and Technology. 2016; 52: 49- 56

45. Borlinghaus J, Albrecht F, Gruhlke MC, Nwachukwu ID, Slusarenko AJ. Allicin: chemistry and biological properties. Molecules. 2014; 19(8): 12591-618.

46. Vathsala PG, Murthy PK. Immunomodulatory and antiparasitic effects of garlic–arteether combination via nitric oxide pathway in Plasmodium berghei-infected mice. Journal of Parasitic Diseases. 2020; 44(1): 49- 61.

47. Peltzer K, Mngqundaniso N. Patients. Consulting traditional health practioners in the context of HIV/AIDS in urban areas in Kwazulu-Natal, South Africa. Afr J Tradit Complement Altern Med. 2008; 5(4): 370-9.

48. Willkinson D, Gcabashe L, Lurie M. Traditional healers as tuberculosis treatment supervisors: precedent and potential. Int J Tuberc Lung Dis. 1999; 3(9): 838-42.

49. Colvin M, Gumede L, Grimwadw K, Maher D, Willkinson D. Contribution of traditional healers to a rural tuberculosis control programme in Hlabisa, South Africa. Int J Tuberc Lung Dis. 2003; 7(9 Suppl. 1): 86-91.

50. Brouwer JA, Boeree MJ, Kager P, Varkevisser CM, Harries AD. Traditional healers and pulmonary tuberculosis in Malawi. Int J Tuberc Lung Dis 1998; 2(3): 231-4.

51. UNAIDS. Collaboration with traditional healers in HIV/ AIDS prevention and care in sub-Saharan Africa. A literature review. Geneva: UNAIDS; 2000.

52. UNAIDS. Ancient remedies, new disease: involving traditional healers in increasing access to AIDS care and prevention in East Africa. Geneva: UNAIDS; 2002.

Received on 11.09.2023 Modified on 29.11.2023

Research J. Science and Tech. 2024; 16(1):97-103.

DOI: 10.52711/2349-2988.2024.00015