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Abstract

Background: Fever is a very common complaint in children, about 20% of childhood fevers have no apparent cause and the risk is greatest among infants and children younger than 36 months. Physical examination and patient history do not always identify the cause. Moringa oleifera is a desert tree found in the Middle East to India and it could provide health benefits to humans by protection against oxidative stress. It also showed an antipyretic effect compared to paracetamol in an experimental animal. Objective: This study aimed to investigate the antipyretic effect of Moringa oleifera in a case of toddler presented with pyrexia. Subjects: An 18-month-old girl was feverish for four days with loss of appetite. There were no symptoms of upper or lowers respiratory infection or otitis media or gastrointestinal disease. Results: The temperature returned to normal after an hour of sweating when the girl drank 40 ml of warm water extract of five grams of Moringa leaves boiled for twenty minutes. Conclusions: Moringa oleifera can be a safe and natural alternative to other well-known antipyretics for treating toddlers having fever who could not tolerate certain antipyretic medications due to some its side effects and to avoid the unnecessary use of antipyretics that in case it is not efficient alone it will be combined with other medications such as antibiotics.
The Canadian Journal of Clinical Nutrition, Volume 6, Issue 2, June 2018
ISSN 1927-8942 (Print Edition), ISSN 1927-8950 (Online Edition)
The Canadian Journal of Clinical Nutrition is published by Global Science Heritage, (http://www.globalscienceheritage.org)
Registered publisher by the Library and Archives/Government of Canada, (www.collectionscanada.gc.ca)
Page57
Research Article
Effect of Moringa oleifera Water Extract on Pyrexia: A Case Study
Walaa MR El-Meidany1*, Dalia I. Tayel1, Ahmed A. El-Nawawy2
1Nutrition Department, High Institute of Public Health, Alexandria University, Egypt
2Department of Pediatrics, Faculty of Medicine, Alexandria University, Egypt
*Corresponding Author Email Address: mamdouh_loly@yahoo.com
ABSTRACT
Background: Fever is a very common complaint in children, about 20% of childhood
fevers have no apparent cause and the risk is greatest among infants and children younger
than 36 months. Physical examination and patient history do not always identify the
cause. Moringa oleifera is a desert tree found in the Middle East to India and it could
provide health benefits to humans by protection against oxidative stress. It also showed
an antipyretic effect compared to paracetamol in an experimental animal. Objective: This
study aimed to investigate the antipyretic effect of Moringa oleifera in a case of toddler
presented with pyrexia. Subjects: An 18-month-old girl was feverish for four days with
loss of appetite. There were no symptoms of upper or lowers respiratory infection or
otitis media or gastrointestinal disease. Results: The temperature returned to normal after
an hour of sweating when the girl drank 40 ml of warm water extract of five grams of
Moringa leaves boiled for twenty minutes. Conclusions: Moringa oleifera can be a safe
and natural alternative to other well-known antipyretics for treating toddlers having fever
who could not tolerate certain antipyretic medications due to some its side effects and to
avoid the unnecessary use of antipyretics that in case it is not efficient alone it will be
combined with other medications such as antibiotics.
Keywords: Moringa oleifera, Antipyretic, Fever, Toddler
Citation: El-Meidany WMR, Tayel DI, El-Nawawy AA. Effect of Moringa oleifera
Water Extract on Pyrexia: A Case Study. Canad J Clin Nutr 2018; 6 (2): 57-61.
DOI: http://dx.doi.org/10.14206/canad.j.clin.nutr.2018.02.05
Page 57-61
The Canadian Journal of Clinical Nutrition, Volume 6, Issue 2, June 2018
ISSN 1927-8942 (Print Edition), ISSN 1927-8950 (Online Edition)
The Canadian Journal of Clinical Nutrition is published by Global Science Heritage, (http://www.globalscienceheritage.org)
Registered publisher by the Library and Archives/Government of Canada, (www.collectionscanada.gc.ca)
Page58
INTRODUCTION
Moringa oleifera has been known as an effective remedy for more than 300 diseases,
because of its phytochemicals and antioxidants content (1, 2). It is a desert tree found in
the Middle East to India and recorded in a total of 154 species cultivated in Siwa Oasis.
The antioxidant potential of Moringa leaves extract is attributed to its phenolic content as
well as flavonoids. Thus, the free radical scavenging ability of Moringa could provide
health benefits to humans by protection against oxidative stress (3, 4).
The World Health Organization recommended that feeding moderately malnourished
children green leafy vegetables containing iron and provitamin A is a valuable ingredient
in their diet and recommended further assessment of moringa leaves value for children
with moderate malnutrition (5). In May 2017, a study concluded that regular consumption
of Moringa oleifera leaves by schoolchildren might help to improve certain micro-
nutrient deficiencies such as iron deficiency anemia, vitamin A , and folic acid
deficiencies as well (6). Fever is a very common complaint in children and it is a
condition characterized by rising in the core temperature above 38ºC rectally. In most of
the cases fever is due to self-limited viral infections and requires symptomatic treatment
only (7).
About 20% of childhood fevers have no apparent cause and a significant number of these
patients may have a serious bacterial infection, the risk is greatest among infants and
children younger than 36 months making proper diagnosis and management important.
Physical examination and patient history do not always identify patients with occult
bacteremia or serious bacterial infection (7, 8). Moringa oleifera has an antipyretic effect
and it showed a dose-dependent antipyretic activity compared to paracetamol in rats.
Several studies have proved the important role of Moringa oleifera in preventing the
progression of many diseases (4, 9-11). To the best of our knowledge, previously
reported scientific data regarding the use of Moringa oleifera as an antipyretic on
children under two years old is almost none.
The Canadian Journal of Clinical Nutrition, Volume 6, Issue 2, June 2018
ISSN 1927-8942 (Print Edition), ISSN 1927-8950 (Online Edition)
The Canadian Journal of Clinical Nutrition is published by Global Science Heritage, (http://www.globalscienceheritage.org)
Registered publisher by the Library and Archives/Government of Canada, (www.collectionscanada.gc.ca)
Page59
CASE PRESENTATION
An 18-month-old girl weighed 11.5 kg and her height was 81 cm, had a fever for four
days with no symptoms of upper respiratory infection such as congested nasal mucosa or
lower respiratory infection such as coughing or expectorating or gastrointestinal disease
such as diarrhea, constipation or colic. The temperature was recorded twice daily by
placing the digital thermometer (Beurer) under the armpit directly on the skin after
turning the device on and then cross the child's arm over the chest and wait five minutes
until I hear the beep then record it. The study protocol was approved by the ethical
committee at the High Institute of Public Health, Alexandria University, Egypt.
RESULTS
The fever was fluctuating from 37.7 to 38.3°C auxiliary temperature in the first three
days and was responsive to 4 ml of antipyretic (acetaminophen 160 ml/5ml) every six to
eight hours. On the fourth day the temperature rose to 39°C and needed antipyretic in
every four hours. No clinical signs of tonsillitis or otitis media or chest infection was
noted after full inspection (palpation, percussion, and auscultation of the body and
extremities). She was given 2.5 ml of antipyretic (ibuprofen 100 mg/5 ml) once and
applied cold fomentation but she couldn't tolerate the drug and vomited it out few
seconds after the intake.
The ibuprofen dose with then replaced with 40 ml of warm water extract of Moringa
leaves cultivated in Siwa Oasis in Egypt after boiling 5 gm in a water for 20 minutes.
After one hour of sweating the fever returned from 38.9°C to normal, and in the morning
she was active as usual, thirsty, and regained her appetite.
DISCUSSION
Children might have as many as 4-6 febrile illnesses during the first 24 months of life and
most of these febrile episodes have no clear source of infection (12). Sweating that
follows fever reduction means that the tissues at the site of infection are healing. That is,
if the fever is infectious in origin, the causative organisms are decreasing in number or
function, so this explains the regain of appetite and improvement of the case presented in
this study (13).
The Canadian Journal of Clinical Nutrition, Volume 6, Issue 2, June 2018
ISSN 1927-8942 (Print Edition), ISSN 1927-8950 (Online Edition)
The Canadian Journal of Clinical Nutrition is published by Global Science Heritage, (http://www.globalscienceheritage.org)
Registered publisher by the Library and Archives/Government of Canada, (www.collectionscanada.gc.ca)
Page60
Boiling Moringa leaves for twenty minutes has been supported by many studies as
boiling increased the availability of antioxidant content. Fifteen minutes boiling at 100
°C resulted in a significant increase in xanthophyll content than that in fresh leaves. This
might be the powerful weapon against infection with pathogenic microorganisms (14,
15). The aqueous extract of Moringa leaves was proved to inhibit pathogenic
microorganisms for representing a good alternative to the use of a traditional
antimicrobial in therapy (4, 10). The adverse effects of Moringa consumption on human
health has not been reported so far. A study conducted with the intake of whole leaf
powder of Moringa at up to a single dose of fifty grams or using eight grams per day dose
for more than one month (16).
CONCLUSION
Moringa oleifera can be a safe and natural alternative to other well-known antipyretics
for treating young children having an asymptomatic fever.
AUTHORS CONTRIBUTION
Manuscript preparation were undertaken and approved by all authors.
ACKNOWLEDGEMENTS
I would like to express my thanks hardly to every person who helped me to do this work
and made it possible for their collaboration.
CONFLICTS OF INTEREST
The authors declare no conflict of interest.
REFERNCES
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3. El-Saied A, El-Ghamry G, Khafagi M ,Powell O, Bedair R. Floristic diversity and
vegetation analysis of Siwa Oasis: An ancient agro-ecosystem in Egypt’s Western
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The Canadian Journal of Clinical Nutrition, Volume 6, Issue 2, June 2018
ISSN 1927-8942 (Print Edition), ISSN 1927-8950 (Online Edition)
The Canadian Journal of Clinical Nutrition is published by Global Science Heritage, (http://www.globalscienceheritage.org)
Registered publisher by the Library and Archives/Government of Canada, (www.collectionscanada.gc.ca)
Page61
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