Fighting Dengue with Tawatawa and Papaya

Dengue viruses, mosquito-borne members of the Flaviviridae family, are the

causative agents of dengue fever. Dengue is the most emerging viral disease of
humans that in recent decades has become a major international public health
concern. It is prevalent in tropical and sub-tropical regions around the world,
predominantly in an urban and semi-urban area. It is estimated that there are
between 50 and 100 million cases of dengue fever and about 500 000 cases of
dengue hemorrhagic fever (DHF) each year which require hospitalization.
Dengue fever is spread through the bite of an infected Aedes aegypti mosquito.
The first symptom of the disease appears in about 5-7 days after the infected
mosquito bites a healthy person. It is possible to become infected by dengue
multiple times because the virus has four different serotypes. Although each
infection confers lifelong immunity to that particular serotype, a subsequent
infection with a different serotype increases the risk of contracting the much
deadlier form known as DHF.

The symptoms of dengue fever include high fever, rash, and severe headache
(dengue triad). Additional symptoms include severe joint and muscular pain
(breakbone fever), nausea, vomiting, and eye pain. Although dengue fever
itself is rarely fatal, it can be an extraordinarily painful and disabling illness
and may become epidemic in a population following the introduction of a new
serotype. Dengue fever is usually a self-limited illness, and only supportive
care is required.

Acetaminophen may be used to treat patients with symptomatic fever. Aspirin,

Brufen nonsteroidal anti-inflammatory drugs (NSAIDs), antibiotics and
corticosteroids should be avoided as these do not help but cause gastritis
and/or bleeding. Patients with known or suspected dengue fever should have
their platelet count and Hematocrit measured daily from the third day of
illness until 1-2 days after defervescence. No vaccine is available for the
prevention of dengue infection. Immunogenic, safe tetravalent vaccines have
been developed and are undergoing clinical trials. The only way to prevent
dengue virus acquisition is to avoid being bitten by a vector mosquito.

As Dengue spreads in epidemic proportions across the country, it’s high time
we take a deeper look at customary or traditional cure in the absence of big
pharma drugs to combat the disease. The folklore herbal medicine against
dengue, Tawatawa tea, and Papaya leaves extract should not be dismissed or
even belittled.

Tawa-tawa (Euphorbia hirta), also known as “gatas-gatas,” is a hairy herb

that grows naturally in open grasslands, backyards, roadsides, and pathways.

A study conducted by University of Santo Tomas (UST) pharmacy students,

published in the Journal of Tropical Medicine, showed that
tawa-tawa contains small amount of phenolic compound sufficient to exert
effect in promoting quality and quantity of platelets,” Based on the results of
their experiment, the researchers concluded that administering
tawa-tawa decoction to animal models help improve their healing
mechanism. Tawa-tawa was able to promote cell production and prevents
platelet destruction. Likewise, the improvement in the cell bleeding time and
clotting time provided evidence that the indigenous plant can preserve and
promote the hemostatic function of platelets.

On the other hand, a study in Pakistan on dengue fever treatment with papaya
(carica) leaves extracts was also published in the Asia Pacific Journal of
Tropical Biomedicine. In the study, a 45 year old feverish (40 oC) truck driver
bitten by an Aedes aegypti mosquito did not respond to a broad spectrum of
antibiotic and anti-malarial drugs. Three to four patients in the hospital who
showed the same symptoms already died. A team of researchers from
Peshawar University that was studying at that time on the chemical properties
of Carica papaya considered the victim for a papaya treatment case study.

In the treatment, plant material was washed with water, cut into pieces and
grounded with a blender. The 25 mL of aqueous extract of papaya leaves was
administered to a patient infected with Dengue fever. The same dose was
given to the patient twice daily i.e. morning and evening for five consecutive
days. The patient’s platelet increased after the papaya treatment, avoided
bleeding complication and survived.

The laboratory analysis of papaya leaves extract showed that it contains two
important biologically active compounds namely: chymopapain and papain
which are widely used for digestive disorders. It showed that papaya-derived
papain, caricain, chymopapain, and glycine endopeptidase can improve acidic
pH conditions and pepsin degradation. Other active compounds of C.
papaya are lipase, or CPL, a hydrolase, which is tightly bonded to the
water-insoluble fraction of crude papain and is thus considered as a “naturally
immobilized” biocatalyst. Said compounds increase platelets and prevent
platelet destruction, thrombocytopenia or bleeding. The different chemical
properties of papaya also show, accordingly, promise as a strong natural
candidate against viral diseases.

Further local studies were also conducted to support the above claims. In 2014,
student-researchers bagged first prize at the Gruppo Medica Award for their
research on the anti-dengue property of papaya (Carica papaya)
and tawa-tawa (Euphorbia hirta) during the 8th Philippine National Health
Research System (PNHRS) Week celebration in Cebu City. The research done
by Pharmacy students at the San Pedro College in Davao City revealed that tea
concoction from tawa-tawa can increase blood platelet counts in rabbits by
194% in just 24 hours. Results on tests done on tea concoctions from papaya
leaves only and a mixture of papaya leaves and tawa-tawa plant also
significantly increased platelet counts in rabbits within 24 hours. Further
laboratory tests on papaya and tawa-tawa revealed that both plants contain
quercetin, a plant pigment known to naturally increase the platelet counts.

Recommending the continuation of the research, especially with the isolation

of quercetin, the students stressed that the study is significant in the effort to
develop a treatment for the management of dengue. They said, “This research
can benefit the society because it will pave the way to the development of a
new drug that is affordable, accessible, and effective against dengue.”

Indeed, despite the absence of mechanism or explanation on how they work,

traditional beliefs and customs have proven their efficacy in addressing
modern maladies.

Sources:
MindaNews
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3614241/
http://pchrd.dost.gov.ph/