Herbal Medicine-Associated Acute Kidney Injury Among Obstetric Patients in Africa: A Scoping Review Protocol
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Objectives: This scoping review aims to map the existing evidence on herbal medicine-associated Acute Kidney Injury (AKI) among obstetric patients in Africa, with a specific focus on the clinical presentation, management strategies, and clinical outcomes reported in the literature. Introduction: Acute Kidney Injury is a significant contributor to maternal morbidity and mortality across settings. In sub-Saharan Africa, it is frequently community-acquired and linked to infectious diseases, obstetric complications, and the ingestion of nephrotoxic substances. Notably, herbal medicine use remains widespread in African obstetric care, driven by cultural beliefs, perceived safety of natural remedies, and limited access to formal healthcare, particularly for managing pregnancy-related complications and inducing labor. However, the lack of standardization in the preparation, dosage, and regulation of these remedies poses a considerable threat to renal health, with several plant-based agents already linked to nephrotoxicity and adverse maternal-fetal outcomes, including stillbirth and neonatal mortality. Despite these risks, existing evidence remains fragmented across isolated case reports or broader AKI literature that does not specifically isolate the herbal-obstetric relationship. A scoping review is therefore needed to consolidate this evidence and identify existing knowledge gaps. Methods: This review will follow the JBI methodology for scoping reviews and be reported according to PRISMA-ScR guidelines. A comprehensive search of PubMed, CINAHL, AJOL, EMBASE, Web of Science, Scopus, and relevant grey literature sources will be conducted for studies published between January 2000 and June 2026. Eligible sources will include primary studies, descriptive studies, secondary evidence, and grey literature involving obstetric patients in Africa with herbal medicine-associated AKI. Screening will be conducted independently by two reviewers in two phases (title/abstract and full-text), with disagreements resolved by a third reviewer. Data will be charted using a standardized extraction form and synthesized descriptively, with results presented through tables, maps, and narrative summary. Ethics: As this review draws on existing published literature, formal ethical approval is not required.
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