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Effectiveness of Dried Carica papaya Seeds Against Human Intestinal Parasitosis: A Pilot Study

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Abstract

The tropical fruit Carica papaya and its seeds have proven antihelminthic and anti-amoebic activities. To determine the effectiveness of air-dried C. papaya seeds on human intestinal parasitosis, 60 asymptomatic Nigerian children with stool microscopic evidence of intestinal parasites received immediate doses (20 mL) of either an elixir composed with air-dried C. papaya seeds and honey (CPH) or honey alone (placebo) in two randomized treatment groups. Repeat stool microscopic examinations were conducted 7 days postintervention for intestinal parasites. Significantly more subjects given CPH elixir than those given honey had their stools cleared of parasites [23 of 30 (76.7%) vs. five of 30 (16.7%); z = 4.40, P = .0000109]. There were no harmful effects. The stool clearance rate for the various types of parasites encountered was between 71.4% and 100% following CPH elixir treatment compared with 0-15.4% with honey. Thus, air-dried C. papaya seeds are efficacious in treating human intestinal parasites and without significant side effects. Their consumption offers a cheap, natural, harmless, readily available monotherapy and preventive strategy against intestinal parasitosis, especially in tropical communities. Further and large-scale intervention studies to compare C. papaya with standard antiparasitic preparation are desirous.
JOURNAL OF MEDICINAL FOOD
J Med Food 10 (1) 2007, 194–196
© Mary Ann Liebert, Inc. and Korean Society of Food Science and Nutrition
DOI: 10.1089/jmf.2005.065
Short Communication
Effectiveness of Dried Carica papaya Seeds Against Human Intestinal Parasitosis:
A Pilot Study
John A.O. Okeniyi,
1
Tinuade A. Ogunlesi,
2
Oyeku A. Oyelami,
1
and Lateef A. Adeyemi
3
1
Department of Paediatrics and Child Health, College of Health Sciences, Obafemi Awolowo University,
Ile-Ife; and Departments of
2
Paediatrics and
3
Microbiology and Parasitology, Wesley Guild Hospital,
Ilesa, Nigeria
ABSTRACT The tropical fruit Carica papaya and its seeds have proven antihelminthic and anti-amoebic activities. To de-
termine the effectiveness of air-dried C. papaya seeds on human intestinal parasitosis, 60 asymptomatic Nigerian children
with stool microscopic evidence of intestinal parasites received immediate doses (20 mL) of either an elixir composed with
air-dried C. papaya seeds and honey (CPH) or honey alone (placebo) in two randomized treatment groups. Repeat stool mi-
croscopic examinations were conducted 7 days postintervention for intestinal parasites. Significantly more subjects given CPH
elixir than those given honey had their stools cleared of parasites [23 of 30 (76.7%) vs. five of 30 (16.7%); z 4.40, P
.0000109]. There were no harmful effects. The stool clearance rate for the various types of parasites encountered was between
71.4% and 100% following CPH elixir treatment compared with 0–15.4% with honey. Thus, air-dried C. papaya seeds are
efficacious in treating human intestinal parasites and without significant side effects. Their consumption offers a cheap, nat-
ural, harmless, readily available monotherapy and preventive strategy against intestinal parasitosis, especially in tropical com-
munities. Further and large-scale intervention studies to compare C. papaya with standard antiparasitic preparation are de-
sirous.
KEY WORDS:
amoebiasis
ascariasis
giardiasis
helminths
honey
ova
parasites
pawpaw
stool
194
INTRODUCTION
H
UMAN INTESTINAL PARASITOSIS
constitutes a significant
global health problem with enormous financial impli-
cations.
1
Unfortunately, for reasons mainly attributable to
poor hygiene,
2
the burden is more in the tropics and sub-
tropics where, particularly among children,
3,4
parasites
cause noteworthy morbidity such as anemia, diarrhea and
dysentery, malnutrition, apathy, and underdevelopment as
well as severe acute abdominal and surgical conditions.
2
As most patients particularly from the tropics and partic-
ularly from Africa are from low socioeconomic groups who
can ill-afford imported and expensive medicines,
5
the need
for affordable and readily available local alternatives can-
not be overemphasized. Carica papaya, a fruit plant also
called papaya, papaw, pawpaw, mamao, or tree melon, is
found in virtually every tropical and subtropical country.
6
C. papaya contains proven antihelminthic
7
chemical agents
such as benzyl isothiocyanate and papain
8,9
and has other
antiparasitic properties.
10,11
In folk medicine, C. papaya
seeds have been used to treat helminthiasis.
12
Thus, we eval-
uated the antiparasitic effects of dried C. papaya seeds. It is
hoped that the information obtained will provide guidance
for further research that may ultimately assist in the formu-
lation of necessary preventive and treatment strategies
against intestinal parasitosis, particularly in tropical com-
munities.
MATERIALS AND METHODS
Between November 1, 2003 and January 30, 2004, in the
Children’s Welfare Clinic of the Wesley Guild Hospital,
Ilesa, Nigeria, consecutive children 2–6 years old with nor-
mal weight and height for age and no health complaints were
screened with light microscopic examination of wet prepa-
rations of freshly passed stools to confirm the presence of
intestinal parasites, their cysts, trophozoites, larvae, or ova.
Manuscript received 17 October 2005. Revision accepted 10 January 2006.
Address reprint requests to Dr. John A.O. Okeniyi at his present address: Department of
Paediatrics and Child Health, Wesley Guild Hospital, Ilesa. P.M.B. 5011, Ilesa, Osun
State, Nigeria, E-mail: akinyemiokes2@yahoo.com
Following informed parental consents, a total of 60 children
with seven different species of intestinal parasites were re-
cruited into this study.
C. papaya seeds and natural honey were harvested from
an apiary of one of the investigators (O.A.O). The seeds
were air-dried and then machine-blended. An elixir of the
air-dried C. papaya seeds and honey (CPH) was prepared
by mixing 500 g of the blend with honey to make a total
preparation volume of 1,000 mL, i.e., 0.2 g of dried C. pa-
paya seeds/mL. Each subject received immediately received
an oral dose of either 20 mL (equivalent to 4 g of dried,
blended C. papaya seeds) of the CPH elixir or honey alone
in two randomized treatment groups. Thus, honey served not
only as the means of administration of the C. papaya seeds
but also as the placebo/control. All the subjects were ad-
vised to abstain from honey and C. papaya during the study
period. The children then had repeat stool microscopic ex-
amination 7 days later conducted by the same laboratory sci-
entist (L.A.A), who was blinded to each subject’s treatment.
Histories of gastrointestinal symptoms and other possible
side effects were further documented. Data were analyzed
using with the computer program for epidemiologists (PEPI)
version 3.01.
13
Means and standard deviations were com-
pared using Student’s t test and proportions by the z-scores
at 95% confidence interval (CI). Values of P .05 were
considered statistically significant.
RESULTS
Sixty children (41 boys and 19 girls) between 3 and 6
years of age (mean, 4.6 1.1 years) with stool microscopic
evidence of intestinal parasites were recruited, with 30
(50.0%) each treated with CPH elixir or honey. Table 1 de-
tails the types of intestinal parasites and the comparison of
stool clearance in both treatment groups. The most preva-
lent intestinal parasites were Ascaris lumbricoides, Enta-
moeba histolytica, Necator americanus, and Strongyloides
stercoralis, found in 26 (43.3%), 14 (23.3%), nine (15.0%),
and eight (13.3%) of the 60 children, respectively. Only two
(3.3%) children (one in each treatment group) had Taenia
saginata. Fifty-one (85.0%) of the children had single par-
asites only, while nine (15.0%) had polyparasitism; in ad-
dition to A. lumbricoides, six (10.0%) had E. histolytica, and
the remaining three (5.0%) had N. americanus. Among the
children with multiple parasites, five received CPH elixir,
and four had honey treatment.
CPH elixir demonstrated a high stool clearance efficacy
against A. lumbricoides (84.6%) and S. stercoralis (100%)
with statistically significant differences compared with
honey. Although CPH demonstrated 100% efficacy against
Trichuris trichuria, Giardia lamblia, and T. saginata, com-
pared with honey, the efficacy in each instance did not reach
the accepted level of statistical significance. Also, despite a
high stool clearance rate for E. histolytica (71.4%) and N.
americanus (80.0%), these were not statistically significant
relative to honey. Overall, the stools of 23 of 30 (76.67%)
subjects given the CPH elixir compared with five of 30
(16.67%) given honey alone were cleared of parasites (stan-
dard error 0.1029; 95% CI 0.3649; 0.8351, z 4.40;
P .0000109).
There were no significant adverse effects, though two of
30 (6.7%) children given the CPH elixir had transient com-
plaints on the day the treatments were given. One had nau-
sea, while the other had an episode of loose stools. None of
the children who received honey alone had complaints. The
difference in the proportion of children with complaints in
either treatment group was not statistically significant (stan-
dard error 0.0456; 95% CI 0.0559, 0.1893; z 0.72;
P .472).
DISCUSSION
Our high stool parasite clearance rates of between 71.4%
and 100% are an affirmation of the effectiveness of C. pa-
paya seeds against intestinal parasites.
7,12
A. lumbricoides,
the most prevalent intestinal helminth (a nematode), was ef-
fectively cleared. Probably because of the limited sample
population, our findings lacked statistical significance de-
spite demonstrable and absolute parasite clearance of cer-
tain other helminths, including a cestode, T. saginata. Our
IN VIVO ANTIPARASITIC EFFICACY OF PAPAYA SEED 195
T
ABLE
1. T
YPES OF
I
NTESTINAL
P
ARASITES AND THE
C
OMPARISON OF
S
TOOL
C
LEARANCE WITH
CPH
AND
H
ONEY
T
REATMENT
Clearance Statistical values
Parasite (number of children CPH elixir Honey-alone z
with parasite) group group score 95% CI P
A. lumbricoides (n 26)
b
11/13 (84.6%)
a
2/13 (15.4%) 3.14 0.3376, 1.0464 .002
E. histolytica (n 14 5/7 (71.4%) 1/7 (14.3%) 1.62 0.0047, 1.1373 .106
N. americanus (n 9)
b
4/5 (80.0%) 1/4 (25.0%) 0.98 0.2255, 1.3255 .330
S. stercoralis (n 8) 4/4 (100%) 0/4 (0%) 2.12 0.0075, 1.2500 .034
T. trichuria (n 6) 3/3 (100%) 0/3 (0%) 1.63 0.6667, 1.3333 .102
G. lamblia (n 4) 2/2 (100%) 1/2 (50.0%) 0.00 0.6930, 1.6930 1.000
T. saginata (n 2) 1/1 (100%) 0/1 (0%) 0.00 0.0000, 2.0000 1.000
a
Number (%) of children with stools cleared on parasite/total number of children with the same parasite.
b
Some children had multiple parasites.
observation of over 70% effectiveness against E. histolytica
was also watered-down by the lack of statistical significance
compared with the honey placebo. Papaya had previously
been documented as having anti-amoebic properties.
10
Ezeoke
14
had earlier reported a case of hypersensitiv-
ity reaction to papaya. However, it was gratifying to note
the absence of untoward effects in both treatment groups.
This was indeed our expectation ab initio considering the
facts that C. papaya and its seeds are edible
6
and widely
consumed by both humans and animals in the tropics,
though the seeds are less favored because of less palata-
bility. This was why we opted to use honey, a natural
sweetener, as vehicle for our elixir. The transient nausea
and loose stools observed among two of our subjects may
be unrelated to our elixir in view of the fact that all our
subjects had intestinal parasitosis, which may present with
these features.
1,2,4
The mechanisms of action of C. papaya are not fully elu-
cidated,
7
though it clearly has antihelminthic activity
8,9
and
other immunomodulatory activities.
15
Though intestinal par-
asite clearance by honey, our placebo in this study, was un-
expected, it is still noteworthy. Could there be a possible
antihelminthic property to honey? Our observations are at
best inconclusive in view of the low clearance rate. This
finding may be a spurious occurrence or possibly a demon-
stration of minimal antihelminthic properties to honey. Also,
could the honey have had synergistic or inhibitory effects
on the therapeutic properties of the C. papaya seeds? Fur-
ther large-scale human studies are required to provide a con-
clusive clarification.
It is conceivable that C. papaya, which thrives effort-
lessly,
6
can be much more readily available and affordable
still if commercial and subsistence farming of the papaya
plant was encouraged in tropical communities. Also, future
studies may revolutionize preventive or therapeutic care
against intestinal parasites by determining the minimal
amounts of C. papaya seeds or its active ingredients required
to be consumed. There is that old English adage that “an ap-
ple a day keeps the doctor away.” Could a papaya a day also
do the same? Especially judging from its luxuriant growth
in the tropics and its richness in -carotene, the main pre-
cursor of vitamin A,
6,12
a vitamin reputed to be a magic bul-
let in childhood survival.
16
We conclude that C. papaya
seeds could be beneficial in the treatment and plausibly pre-
vention of intestinal parasites, more so being readily avail-
able, harmless, and cheap. We therefore recommend their
consumption for not only for their nutritive but their medi-
cinal value.
ACKNOWLEDGMENTS
We wish to thank our numerous subjects and their par-
ents for their cooperation.
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Carica papaya is a fruit known for its great economic values in tropical Africa due to its diverse industrial, medicinal and nutritional benefits. In this study, oil was extracted from dried powdered C. papaya seeds using n-hexane as extraction solvent. The physiochemical characterization of C. papaya seed oil extract was investigated using AOAC standard procedures. Acute toxicity test was carried out to determine the toxicity of the oil. Rats were randomly divided into four groups with five rats per group. Groups B, C and D were given 200, 400 and 800 mg/kg body weight of the seed oil thrice in a week for 28 days while group A rats were not administered with the oil. The results obtained from the physical properties of the Carica papaya seed oil include: oil yield (30.31±2.38%), colour (golden yellow), specific gravity (0.9162±0.012), refractive index (1.468±0.22), viscosity (22.45±2.00 mms-1), melting point (42.30±3.0°C), smoke point (212.13±9.0°C) and flash point (274.74±12°C). The chemical properties indicate the presence of acid value (2.848±0.28%), free fatty acids (1.29±0.16%), saponification value (mg KOH/g) (192.06±1.62), iodine value (70.78±1.69 gI2/100 g) and peroxide value (5.079±0.079 meq/kg). The fatty acid profile of the seed oil shows that it contains: oleic acid (73.36±1.07%), palmitic acid (14.36±0.96%), stearic acid (5.09±0.5%) and linoleic acid (4.56±0.20%). The total composition of unsaturated and saturated fatty acids in the seed oil was 79.52 and 20.48%, respectively. The oil exhibited viable potentials for biodiesel feedstock based on the results of the physicochemical parameters. The biochemical parameters show that the oil is hematotoxic and it causes significant (P<0.05) increase in total cholesterol, triglyceride and low density lipoprotein-cholesterol values. The high density lipoprotein-cholesterol and catalase did not show any significant (P>0.05) difference among all groups. The oil has slight effect on the kidney and the heart architecture.
... [28]. The antimicrobial, antifungal and antihelmintic activities of the seed and latex of the plant have been extensively reported [29,30]. With regard to the effect of extracts against cercariae, the exposure of S. mansoni cercariae to the methanol extract of Carica papaya showed an increase in the mortality rate of cercariae when compared to other extracts. ...
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Schistosomias is a prevalent parasitic disease in tropical and sub-tropical areas, which comes in the second place in terms of socioeconomic and public health burden. Around 600 million people in 74 countries are infected yearly, predominantly in the developing world. The aim of this work was to assess the efficiency of three extracts from Carica papaya (methanol, ethanol and butanol extracts) for their molluscicidal and anti-schistosomal activities. The LC50 of methanol, ethanol and butanol extracts of Carica papaya against B. alexandrinea were 180, 499.3 and 509.1 mg/L while the respective LC90 values were 220.3, 700.6, 769.6 mg/L respectively. The effect of these extracts on Biomphalaria alexandrina snails and larval stages of Schistosma mansoni, for miracidia the LC50 of methanol, ethanol and butanol extracts of Carica papaya against miracidia were 3.4, 15.4 and 8.1 mg/L, respectively, while the respective LC90 values were 8.4, 38.2, 11.2 mg/L, and for cercariae the LC50 of methanol, ethanol and butanol extracts of Carica papaya were 2, 20 and 4 mg/L, while the respective LC90 values were 13.5, 80.5, 18.5 mg/L respectively was evaluated, in addition to flowcytometric analysis of CD4, CD25, FOXP3 and TGF-β levels during S. mansoni infection in mice. The in-vivo results showed that the three extracts have variable potential against snails and miracidia and cercariae of S. mansoni. The mortality rate in B. alexandrina snails for methanol, ethanol and butanol extracts of Carcia papay were 86%, 45% and 64%, respectively. While it was 83%, 35% and 66%, respectively in miracidia and 92%, 40% and 70%, respectively in cercariae. The results indicated that methanol extract from Carica papaya recorded higher activity against snails, miracidia and cercariae. The levels of CD4, CD25, FOXP3 regulatory T (Treg) cells were decreased significantly (p<0.001) in infected mice compared to healthy controls. However, there was a significant (p<0.001) increase in levels of TGF-β. A significant increase in the levels of CD4, CD25, and FOXP3 Treg in Carica papaya treated group compared to infected control group, with a significant (p<0.001) decrease in TGF-β level than infected group. In conclusion, methanol extract was more effective at concentration of LC50 180 and LC90 220.3 than ethanol and butanol extracts of Carica papaya therefore controlling B. alexandrina snails by methanol extract is a promising way as it is an eco-friendly strategy in rural areas of developing countries, where schistosomiasis is endemic. Moreover, the increased immune defense mechanism in treated group with the same extracts is a promising target for new immune modulatory strategies against schistosomiasis.
... In addition to their alkaloid effect, benzyl isothiocyanate (BITC) could explain the parasiticidal properties of the seeds of C. papaya [ 104 , 105 ]. In another study, Okeniyi [106] stated a notable clearance of intestinal worms ( p = 0.0 0 0 01) in the fecal sample of Nigerian children when C. papaya seeds were mixed with honey when administered to the children compared to the control (honey alone). Although C. papaya seeds were successful in expelling the worms, it resulted in side effects such as nausea and loose stools without such experience when the control was used. ...
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Papaya (Carica papaya L.), one of the extensively studied plants, belongs to the family Caricaceae. Papaya is commonly known for its nutritional and medicinal value worldwide. Many parts of papaya plant such as roots, leaves, peels, fruits, and seeds have nutritional and therapeutic significance. The aim of this review is to consolidate the evidence-based information on papaya's functional activities, accumulated from online databases (Scopus, Dimensions, Google Scholar, ScienceDirect, and Web of Science) up to December 2020. A considerable literature is available detailing biomedical uses of different papaya plant parts which made papaya a treasured nutraceutical plant. Papaya plant possesses the valuable phytochemicals such as phytosterols, tocopherols, flavonoids, alkaloids, and carotenoids. These compounds with interesting nutraceutical properties play key roles in ameliorating and treating some medical conditions such as inflammation, hyperglycemia, fertility-related complications, hypertension and possess anticarcinogenic activities. However, further studies are warranted to validate the dosage, mode of action, and safety profile of papaya seeds, peels, and leaves when used as medicine.
... Pandy et al. (2007) observed that spilanthes plant had larvicidal activity against Anopheles and thus its use is effective in control of malaria disease. Okeniyi et al. (2007) investigated that carica papaya seeds were effective against parasites of intestine. The folk medicine practionners narrated that papaya latex may be used to cure dyspepsia and also applied to scalds and cure of external burns. ...
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