Fighting Dengue with Tawa-tawa 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.

Tawa-tawa plant used in folkloric medicine in the Philippines against Dengue.

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. 



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