Amid an integrated approach in patient care, environmental (fogging) and biological control on mosquito reproduction, there is still no sign of the disease abating.
In a letter headlined “National research on dengue” (The Star, Aug 12), the writer, Dr Manimalar Selvi Naicker, stressed the need for in-depth clinical research on dengue which is currently lacking.
Information from existing research on dengue was the basis of the 2015 Adult Dengue Clinical Practice Guidelines drawn up by the Health Ministry in collaboration with the Academy of Medicine Malaysia. However, as Dr Naicker pointed out, there are still some gaps that need to be filled with regards to possible treatment options.
There are currently several natural therapies that are being researched to treat dengue. Two of the most researched are the papaya leaf extract and tongkat ali extract. The papaya leaf extract has been found to increase platelet counts (which typically reduce during a dengue viral attack), reduce viral loads and hasten recovery.
In a study conducted at the Tropical Infectious Disease Research and Education Centre at Universiti Malaya, a propriety tongkat ali extract (Physta) developed by Malaysian researchers was found to inhibit the replication of new virus progenies. This could potentially reduce the intensity of the infection (published in Tropical Biomedicine, 2019).
The same tongkat ali extract has also been found to increase platelet production and is an effective immunomodulator, as observed in another clinical study conducted at Orthomedico Inc Japan (published in Phytotherapy Research, 2016), which is key to faster recovery from the disease.
While there are testimonials of faster recovery from dengue with tongkat ali ingestion, there are no clinical studies to ensure and document the therapeutic dose and rate of recovery to suggest it as a potential treatment or adjuvant therapy. It is also important to use an extract that has been standardised for consistent quality and safety.
Approval to conduct clinical studies is either met with extreme caution or cynicism, impeding progress to develop the product to the next level. Funding for the studies is lacking as well.
Unless medical practitioners, who are the first point of contact for treatment, understand enough of these natural therapies that could act as adjuvant therapy to current treatment methods, they would be unwilling to prescribe or recommend them to their patients. Hence, a concerted effort to invest in research and innovation to treat dengue, especially in clinical research, could help to fill in the gaps and provide the necessary information and education to medical practitioners.
This will eventually contribute to the improvement of the 2015 Adult Dengue Clinical Practice Guidelines, making it effective in reducing the spike in dengue cases.
DR ANNIE GEORGE
Biotropics Malaysia Berhad
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