Qualitative Microbiological Risk Assessment of Moringa oleifera Leaf Powder To Be Used To Treat Undernutrition in Infants and Children in Cambodia and India: A Review.

This qualitative risk assessment (QRA) was conducted to estimate the microbiological risk associated with the consumption of Moringa oleifera leaf powder (MLP) by infants and children ages 6 to 23 months to prevent or treat undernutrition in Siem Reap, Cambodia, and Madhya Pradesh, India. This QRA follows the Codex Alimentarius Commission principles and guidelines for risk assessment and takes into account all known microbial hazards that are associated with MLP. A comprehensive literature search was carried out for foodborne pathogens isolated from MLP and other dried foods of similar consistency, such as dried herbs and spices and flour. From this literature search, the following pathogens were identified and considered for this microbiological QRA: Bacillus cereus, Escherichia coli, Campylobacter spp., Clostridium perfringens, Cronobacter spp., Listeria monocytogenes, Salmonella spp., and Staphylococcus aureus. Results suggest that when cereal slurry (porridge) fortified with MLP is boiled (a rolling boil for 5 min) prior to consumption, the food safety risk to undernourished infants and children of B. cereus, C. perfringens type A, Cronobacter, enterohemorrhagic E. coli, L. monocytogenes, Salmonella spp., and S. aureus is low to moderate, with only a moderate to serious risk posed by C. perfringens type C. However, when the fortified porridge is not boiled before consumption, the food safety risk is increased for all of the evaluated pathogens. Overall, the QRA suggests that MLP presents a risk to undernourished infants and children. However, this risk can be mitigated when the powder is stored under the appropriate conditions to ensure there is no ingress of moisture and then processed in a hygienic manner to reduce contamination and/or cross-contamination by following hazard analysis critical control point or similar procedures (even in a home setting) including a heat treatment, i.e., boiling, to further reduce microbial hazards.