A Study on Incidence of Dengue and Efficacy of Caripill a Papaya Extract in Mild and Moderate Cases in a Tertiary Care Hospital

Abstract

Dengue is a mosquito borne viral infection with major complication thrombocytopenia. According to WHO, high incidence of dengue over 6.5 million cases with more than 7300 dengue related deaths were reported in 2023. This study aimed to assess the incidence of dengue and effect of Caripill, a papaya leaf extract in augmented clinical outcomes in moderately affected dengue patients in a tertiary care center. A prospective observational study conducted from May 2023 to april 2024 in Durgabai Deshmukh Hospital & Research Center, Vidyanagar Hyderabad. A total of seventy-five Patients enrolled were treated with Caripill and followed up daily for 5 days with monitoring platelet and other hematological parameters. Total subjects were evaluated for efficacy and safety. All the subjects significantly increased their platelet count from 80,800 on Day 1 to 116,093 on Day 5; (P = 0.0001) and improved hemoglobin levels, RBC levels, and systolic blood pressure. Symptoms were typical of dengue with fever, myalgia, and dyspnea being most prevalent. Caripill significantly increased the platelet count and selective hematologic improvements that could make it an adjunct therapy for dengue.

Keywords

Introduction

Diagnostic Tests and Length of Hospital stay:

Effect of Carica Papaya (Caripill)  On Platelet Values in Dengue Patients:

Table no. 4 shows the effect of Caripill on platelet counts in patients with dengue , recorded from baseline, Day 1, until Day 5. A progressive increase in mean platelet count was seen in the patients from Day 1 to Day 5, with significant daily increases. Each day demonstrated statistically significant improvement in platelet count (P = 0.0001) when compared to Day 1; thus, the study opens the possibility that Caripill may be effective in augmenting platelet counts in the mild to moderate form of dengue cases.

Table 4 : Effect of Carica Papaya (Caripill)  On Platelet Values in Dengue Patients

DISCUSSION

This study examined the prevalence of dengue and the clinical effects of Caripill, an extract from papaya leaves, in patients with dengue fever. The incidence of dengue was calculated and found to be 6.818 cases per 1,000 individuals. This fairly high incidence calls for the proper preventive measure and therapeutic intervention for the control of dengue cases in the same health care settings, especially in the peak outbreak periods. The demographic data reflects a balanced distribution among both sexes, while 55% are males with an area of concentration mostly within the ages 21-40 years. Most of the patients, 74.7%, came from an urban background-most likely in the areas with the highest population density, where most dengue transmission has been recorded. This also results in increased exposure to sites of the vector's breeding.¹¹

Clinical presentations of the patients included manifestations typical for the common disease; all showed fever as the most universal symptom. Other common symptoms were myalgia (64%), dyspnea (64%), headache (58.7%), and arthralgia (53.3%). Thus, these symptoms reflect typical dengue symptomatology and demonstrate the wide spectrum of clinical presentation of dengue, which complicates early diagnosis and management. The distribution of BMI was suggestive of a significant proportion of overweight or obese patients that could plausibly affect the immune response and disease progression and may be associated with BMI that affects the severity of disease, although more work is to be done to establish such claims. Social habits such as smoking and alcohol consumption were reported in patients, and 24% were noted to be smokers and 14.7% alcohol consumers, but whether such impacts dengue outcomes cannot be ascertained.¹²

Diagnostic evaluation confirmed the diagnosis of dengue and clinical evaluation. Serological examination revealed 37.3% Ns1 positivity, 38.7% IgM positivity, and 24% IgG positivity; this varied range of the stages of immune response in the study group. The ultrasound findings like hepatomegaly and splenomegaly were present in a very few patients, which was indicative of mild to moderate organ involvement seen in most dengue cases in this population.^13,14 This treatment produced remarkable alterations in the physiological parameters and blood values. Improvement in the count of platelets within the five-day course of treatment was remarkable; the mean counts improved from 80,800 on Day 1 to 116,093 on Day 5 (P = 0.0001); such change makes Caripill a potential agent in supporting platelet recovery, a pivotal concept in dengue management. Other vital changes were noted in systolic blood pressure, from 116 to 109.64; P = 0.003, hemoglobin from 13.06 to 13.71; P = 0.02, and RBC count from 4.07 to 4.4; P = 0.0001, all of which indicate that Caripill has a positive impact on the hematological values of dengue patients. Other parameters, pulse rate, and levels of SGPT/SGOT showed nonsignificant changes, meaning that Caripill's effect is more specific toward the support of platelet as well as RBC rather than affecting general systemic markers.^15,16,17

This study has shown the incidence and clinical profile of dengue in a tertiary care setting while demonstrating the promising role of Caripill in enhancing platelet recovery and improving select hematological parameters in dengue patients. These results indicate that an adjunctive role of Caripill may be of use in the treatment of dengue fever, which will be evaluated further in large trials through long-term patient outcomes. The high incidence rate of this disease emphasizes the necessity of continuing public health efforts in controlling dengue transmission, especially in urban areas where the vulnerability may be higher.¹⁸

CONCLUSION

The study established an incidence rate of 6.818 dengue cases per 1,000 persons in a tertiary care hospital for a period of five months, thereby reiterating the threat posed by dengue infection that persists. Clinical presentation is supportive of the classical presentation of dengue and diverse demographic profiles, and Caripill treatment has been very effective, especially regarding platelet counts. Five-day evidence of significant improvement of both platelet counts and vital hematological parameters underscores an important role of Caripill in the treatment and management of mild to moderate dengue cases. Such outcomes of the study indicate the application of Caripill could be useful as adjunct treatment in dengue although large-scale studies should be undertaken so that its efficacy may prove and treatment modalities in dengue should further be expanded.

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