The Effect of Carica Papaya Leaf Extract on Increasing Platelet Count Among Dengue Fever Patients: A Meta-Analysis

Objective: Hemorrhagic fever is a very serious complication of dengue, which remains a major public health concern in the Philippines. On average, there are 170, 503 symptomatic dengue infections and 750 deaths reported in 4 years, with an incidence of around 180 dengue episodes per 100, 000, and a case fatality rate of approximately 0.44%, owing mostly to bleeding secondary to thrombocytopenia, with reported mortalities occurring among individuals less than 20 years of age. In most rural areas in the country, a health care institution is often inaccessible and most patients cannot afford the high cost of hospitalization and transfusion. In a local study of the knowledge, attitude, and practices on dengue, herbal medicines including “tawa-tawa” and papaya are often used as an alternative supportive treatment due to easy availability and low cost. Animal studies also support a potential therapeutic effect. The objective of this review is to assess the effects of C. papaya leaf extract as an adjunct treatment among patients with dengue hemorrhagic fever using a systematically searched and synthesized meta-analysis. Materials and Methods: Six randomized clinical trials with a total of 988 subjects involving the efficacy of C. papaya leaf extract in increasing platelet count in dengue patients were searched through PubMed, Google Scholar, Scopus, and Science Direct and selected after assessing the eligibility and validity of the articles through a standard criterion. Mean difference of platelet counts from days 1 to 5 were pooled together and analyzed by Review Manager (RevMan) software 5.3. Results: Pooled estimates revealed significant increase in platelet count at Day 3 (MD=12.18; CI 10.28-14.08), Day 4 (MD=31.30; CI 27.77-34.83), and Day 5 (MD=13.23; CI 9.90-16.55). Random effects model at Day 5 also showed significant increase in platelet count. Likewise, a subgroup analyses of studies based on route of administration, frequency, and dosage were performed and showed significant increase in platelet count. Conclusion: Based on this meta-analysis, supplementation with C. papaya leaf extract in patients with dengue shows a beneficial effect in increasing platelet count.

Kaynakça

[1]Singhi, S., Kissoon, N., & Bansal, A. Dengue and dengue hemorrhagic fever: Management issues in an intensive care unit, J. Pediatrics. 2007; 83(2): 22-35.

[2]Guzman, M. G., Halstead, S. B., Artsob H., et al. Dengue: a continuing global threat, Nat Rev Microbiol. 2010; 8: 7-16.

[3]Department of Health, Epidemiology Bureau, Public Health Surveillance Division.

[4]Frances, E. E., Yara, A. H., Francisco, M. L., et al. Economic cost and burden of dengue in the Philippines, Am J Trop Med Hyg. 2015; 92(2): 360-366.

[5]Idrees, S., & Ashfaq, U. A. A brief review on dengue molecular virology, diagnosis, treatment and prevalence in Pakistan, Genet Vaccines Ther. 2012; 10: 6.

[6]Yboa, B. C., & Labrague, L. J. Dengue knowledge and preventive practices among rural residents in Samar Province, Philippines. Am J Public Health. 2013; 1(2): 47-52.

[7]Okeniyi, J. A., Ogunlesi, T. A., Oyelami, O. A., et al. Effectiveness of dried Carica papaya seeds against human intestinal parasitosis: a pilot study. J Med Food. 2007; 10: 194–196.

[8]Karishna, K. L., Paridhavi, M., & Patel, J. A. Review on nutritional, medicinal and pharmacological properties of papaya. Nat Prod Radiance. 2008; 7: 364–373.

[9]Ranasinghe, P. R., Ranasinghe, P. A., Kaushalya, W. P., et al. In vitro erythrocyte membrane stabilization properties of Carica papaya leaf extracts. Phcog Res 2012; 4: 196-202.

[10]Sarala, N. & Paknikar, S. S. Papaya extract to treat dengue: a novel therapeutic option? Ann Med Health Sci Res. 2014; 4(3): 320-324.

[11]Charan, J., Saxena, D., Goyal, J. P., et al. Efficacy and safety of Carica papaya leaf extract in the dengue: A systematic review and meta-analysis. Int J Appl Basic Med Res. 2016; 6(4): 249–254.

Kaynak Göster

  • ISSN: 2147-9488
  • Yayın Aralığı: Yılda 4 Sayı
  • Başlangıç: 2012

797 675

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