Tawa-Tawa versus dengue

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Sunday, February 16, 2014

THREE weeks ago, I was catapulted from my deep sleep when I heard my phone ringing. It was already 10 o'clock at night and I was so tired since I had been busy for the past two days. But it was my sister Jean talking and she seemed to be crying. "What's the problem?" I inquired.

"Ashley has dengue fever," Jean explained. "The doctor said her blood platelet has gone down dramatically. I went panic so we decided to bring her to a hospital in Digos City, just in case something will go wrong with her."

Before I left for Davao City to attend a five-day live-in seminar, I learned that five-year-old Ashley had an off-and-on fever. Her parents brought her to a hospital in our small town because they thought it was just an ordinary fever.


But it wasn't; it was dengue fever. Recalling an assignment I did for Reader's Digest a couple of years back, I wrote: "Symptoms vary according to the age and health of the patient. Generally, the sickness starts with a high temperature, rash, agonizing headache, and muscle and joint pain. Nausea, vomiting and loss of appetite are common, and a rash usually appears three or four days after the fever starts. The worst symptoms can last up to 10 days, and complete recovery can take a month."

But the deadly form of the infection, called dengue hemorrhagic fever (DHF), is another story. In this variant, cells release chemicals that trigger leakage of plasma from blood vessels.

Dr. Lulu Bravo, a professor at the University of the Philippines College of Medicine, told me this bit of information as what would happen when DHF attacks: "Fluids accumulate in body cavities, causing profound shock. Death often results from bleeding in the brain, intestines or other organs."

"After a dengue patient has gone into shock, it's usually a matter of time before multi-organ failure occurs and death becomes inevitable," pointed out Professor Zulkifli Ismail, a pediatrician at the Hospital Universiti Kebangsaan Malaysia in Kuala Lumpur.

The following day, I immediately went to the hospital where my niece was confined. There, I saw her weak and not wanting to eat. I talked with my sister for a few minutes when I saw some herbs near the drinking water. "What's that?" I asked.

"That's tawa-tawa," she replied. "My friends told me that it can help dengue patients get well."

Here's what she did. First, she took 5-6 full whole tawa-tawa plants. She cut off the roots and set aside. She washed the remaining stalks thoroughly. She boiled the tawa-tawa stalks slowly in a pot of water for one minute. She cooled the tawa-tawa water. It became my niece's drinking water for the next two days. Ashley drank the 1.5 glasses of tawa-tawa water every hour.

Four days later, my niece was dismissed from the hospital. Ashley went back home and started playing with her brother and cousins. She was back to her normal self; as if nothing happened to her.

Was it because of tawa-tawa?

Recently, the Philippine Council for Health Research and Development (PCHRD) -- a line agency of the Department of Science and Technology -- published the result of a study conducted by students of the University of Santo Tomas Faculty of Pharmacy on tawa-tawa.

The objective of the study -- "Investigation of the anti-thrombocytopenic property of Euphorbia hirta Linn ("tawa-tawa") decoction in rat models" -- was to verify the effects of tawa-tawa decoction or tea to a DHF patient showing a symptom of thrombocytopenia (low platelet count due to excessive bleeding).

"In the study, the students used chloramphenicol, ethanol, and heparin to induce thrombocytopenia on rat models, mimicking dengue hemorrhagic fever. They administered tawa-tawa decoction to the sample groups and collected blood samples to check for platelet count, bleeding time (duration of bleeding), and blood clotting times in several stages of the experiment," the PCHRD article read.

"Results showed that platelet count increased to 47 percent depending on the drug used to induce thrombocytopenia. Bleeding time was reduced up to 62 percent while blood clotting time decreased to 58 percent compared to the control group."

In the study, the students pointed out the presence of phenolic compounds in tawa-tawa, which they suspect to be the active ingredients that increased the platelet counts of the laboratory mice.

Neglected in the past, tawa-tawa is now gaining local recognition because of its medicinal properties. "The discovery of tawa-tawa's active ingredient will lead to the development of treatments for dengue and tuberculosis," DOST said in a statement.

"Tawa-tawa does not fight dengue virus," wiki.answers.com clarifies. "Instead, it promotes the development of blood platelets and softens the effects of dengue virus. Tawa-tawa has natural enzymes within that stabilize the membranes of the blood vessels, preventing internal bleeding."

Aside from dengue fever and its complications, tawa-tawa has other medicinal uses, according to Arlene May G. Corpus, a therapeutic dietitian at the Manila Adventist Medical Center.

Some studies have shown that the ethanol extracts in tawa-tawa inhibits the growth of test isolates, except Salmonelle typi. The antibacterial effect was attributed to the presence of alkaloids, tannins, and flavanoids that have been found to have noncytotoxic and antibacterial properties.

"Tawa-tawa has an antimicrobial action and has been shown to be effective against amoeba and fungal infections," Corpus wrote in an article, which appeared in Health and Home.

Other studies showed that the extract of tawa-tawa leaves and stems inhibits the activity of angiotensin-converting enzyme, a vasoconstrictive activity that functions physiologically in controlling arterial pressure.

In another study, tawa-tawa's leaf extracts were found to have antihypertensive action as they increase urine output and electrolytes in rats.

"Despite tawa-tawa's medicinal benefits, it must be taken under a physician's guidance," Corpus reminded. "While there are no known interactions with other drugs, it is advisable that tawa-tawa should not be used in large doses as it may cause gastrointestinal irritation, nausea, and vomiting. Excessive and prolonged intake of tawa-tawa may interfere with iron absorption."

Published in the Sun.Star Davao newspaper on February 17, 2014.


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