Hasil untuk "Arctic medicine. Tropical medicine"

Pelin Durukan Azman, Serkan Yildirim, Emin Sengul et al.

Objective: To investigate the protective effects of naringin on doxorubicin (DOX)-induced liver injury. Methods: A total of 50 male rats were allocated into five groups: the control group, the DOX group, the DOX groups treated with 50 mg/kg and 100 mg/kg of naringin by gastric lavage for 10 days, as well as the group treated with 100 mg/kg of naringin alone. Liver and serum samples were collected for biochemical, histopathological, and molecular analyses, including liver enzyme activity, oxidative stress markers, inflammation, apoptosis-related proteins, and DNA damage indicators. Results: Naringin attenuated DOX-induced elevation in liver enzyme activity and inflammation markers while enhancing antioxidant activities. Naringin also activated the Nrf2-HO-1 signaling pathway, with the most pronounced effect in the high-dose naringin group. In addition, naringin modulated apoptotic signaling by downregulating the expression of PI3K-AKT and BAX, and upregulating Bcl-2, as well as reduced the level of 8-OHdG. Histopathological evaluation showed that DOX-induced structural liver alterations, such as cellular degeneration and necrosis, were notably attenuated by naringin treatment. Conclusions: Naringin treatment exerts protective effects against DOX-induced liver injury through its antioxidative, anti-inflammatory, and anti-apoptotic effects.

Lina M. Castaño-Jaramillo, Olga Rodríguez, Natalia Vélez-Tirado

Introducción. La deficiencia predominantemente de anticuerpos es el grupo de errores inmunólogicos innatos más frecuente, sin embargo, hay poca información sobre el estado nutricional de los pacientes afectados. Objetivo. Caracterizar el estado nutricional de pacientes colombianos con deficiencias predominantemente de anticuerpos. Materiales y métodos. Se analizaron las historias clínicas de los pacientes con deficiencias predominantemente de anticuerpos en un hospital pediátrico de Bogotá. Resultados. Se analizaron 55 historias clínicas. Los diagnósticos más frecuentes fueron la deficiencia específica de anticuerpos de polisacáridos, la deficiencia selectiva de inmunoglobulina A, la inmunodeficiencia común variable y la agammaglobulinemia. Más del 70 % de los pacientes tenía infecciones sinopulmonares. La infección más frecuente fue la neumonía, seguida de la otitis media aguda y la sinusitis. El 45 % de los menores de cinco años tenía un peso adecuado para la talla, el 18 % tenía riesgo de desnutrición y el 18 % presentaba desnutrición aguda moderada; el 4,5 % sufría de obesidad, el 4,5 % tenía sobrepeso y el 9 % presentaba riesgo de sobrepeso. En los mayores de cinco años, el 54 % tenía un índice de masa corporal adecuado, el 22,5 % tenía sobrepeso, el 9,6 % tenía riesgo de delgadez y el 9,6 % presentaba delgadez. Se encontró que el riesgo de talla baja y la talla baja fueron más frecuentes que la talla normal, y que los pacientes evaluados presentaron porcentajes de talla baja por encima de los reportados a nivel nacional. Conclusiones. Debido a la epidemia de obesidad infantil, va a ser más frecuente encontrar sobrepeso u obesidad en niños mayores de cinco años, por lo que se considera que la talla baja puede ser un signo de alarma más sensible en pacientes con deficiencias predominantemente de anticuerpos.

Maíra Sant Anna Genaro de Brito, Micheli Said de Marchi, Matheus Yung Perin et al.

ABSTRACT Introduction: Chikungunya chronic joint disease causes debilitating arthralgia, significantly impacting the quality of life of affected individuals. Methods: In this study, patients underwent clinical follow-ups, joint biopsies, and pre-biopsy and 24 months post-biopsy serum dosage of cytokines. Results: All participants were female and had pain in 12 joints on average, with 41.17% exhibiting moderate disease activity. Histopathological analysis revealed collagen deposition. Indirect immunofluorescence detected the CHIKV glycoprotein E1 antigen, and an increase in cytokines. Conclusions: Persistent inflammation and ineffective antiviral immune responses leading to antigen persistence may contribute to chronic CHIKV arthritis.

Gabriel Naylor-Leyland, Simon M Collin, Francis Gatluak et al.

<h4>Background</h4>Visceral Leishmaniasis (VL) is endemic in South Sudan, manifesting periodically in major outbreaks. Provision of treatment during endemic periods and as an emergency response is impeded by instability and conflict. Médecins Sans Frontières (MSF) has provided health care in South Sudan since the late 1980's, including treatment for 67,000 VL patients. In recent years, MSF monitoring data have indicated increasing numbers of VL relapse cases. A retrospective analysis of these data was performed in order to provide insight into the possible causes of this increase.<h4>Methodology/principal findings</h4>Programme monitoring data from the MSF hospital in Lankien, Jonglei State, South Sudan, for the period 2001-2018 were analysed to detect trends in VL relapse as a proportion of all VL cases presenting to MSF treatment centres. Routinely collected patient-level data from relapse and primary VL cases treated at all MSF sites in South Sudan over the same period were analysed to describe patient characteristics and treatments received. VL relapse as a proportion of all VL cases increased by 6.5% per annum (95% CI 0.3% to 13.0%, p = 0.04), from 5.2% during 2001-2003 to 14.4% during 2016-2018. Primary VL and VL relapse patients had similar age, sex and anthropometric characteristics, the latter indicating high indices of undernutrition which were relatively constant over time. Clinical factors (Hb, spleen size, and VL severity score) also did not vary substantially over time. SSG/PM was the main treatment regimen from 2001-2018, used in 68.7% of primary and 70.9% of relapse VL cases; AmBisome was introduced in 2013, received by 22.5% of primary VL and 32.6% of VL relapse cases from 2013-2018.<h4>Conclusion</h4>Increasing incidence of VL relapse in South Sudan does not appear to be explained by changes in patient characteristics or other factors. Our data are concerning and may indicate an emergence of treatment-resistant parasite strains, decreasing the effectiveness of treatment regimens. This warrants further investigation as a causal factor. New chemical entities that will enable safe and highly effective short-course oral treatments for VL are urgently needed.

H. Van

Amomum Roxb. includes the aromatic and medicinal plants native to tropical and subtropical Asia belonging to the family Zingiberaceae. Members of Amomum genus have been used for a long time in traditional medicine for the treatment of throat trouble, congestion of lungs, inflammation of eyelids, and digestive disorders, etc. Amomum essential oils have been studied for their chemical profiles in which limonene, allo-aromadendrene, 1,8-cineole, camphor, farnesyl acetate, α-pinene, β-pinene, caryophyllene, camphene, D-camphor, santolina triene, methyl chavicol, bornyl acetate, β-elemene, δ-3-carene, etc. were the major compounds. Furthermore, the oils extracted from Amomum plants have been reported to possess antimicrobial, antioxidant, insecticidal, larvicidal, cytotoxic, anti-scabies, and anti-inflammatory activities. This review focuses on the chemical constituents and biological activities of the essential oils isolated from the different plant parts of Amomum plants. The objective of the present review is to highlight therapeutic potentials and provide evidence for future medicinal applications of these species of genus Amomum.

C. Caillet, Serena Vickers, Stephen C. Zambrzycki et al.

1 Lao-Oxford-Mahosot Hospital-Wellcome Trust Research Unit, Microbiology Laboratory, Mahosot Hospital, Vientiane, Lao PDR, 2 Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford, Oxford, United Kingdom, 3 Infectious Diseases Data Observatory (IDDO)/World Wide Antimalarial Resistance Network (WWARN), University of Oxford, Oxford, United Kingdom, 4 Mahidol Oxford Tropical Medicine Research Unit (MORU), Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand, 5 School of Chemistry and Biochemistry, Georgia Institute of Technology, Atlanta, Georgia, United States of America

A. Dondorp, A. Papali, M. Schultz

Arjen M. Dondorp,* Alfred C. Papali, and Marcus J. Schultz for the COVID-LMIC Task Force and the Mahidol-Oxford Research Unit (MORU) Mahidol–Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand; Nuffield Department of Medicine, University of Oxford, Oxford, UnitedKingdom; Department of IntensiveCare, AmsterdamUniversityMedical Centers, Amsterdam, The Netherlands; Division of Pulmonary and Critical Care Medicine, Atrium Health, Charlotte, North Carolina

Andrew Marvin Kanyike, Ronald Olum, Jonathan Kajjimu et al.

Abstract Background COVID-19 is still a major global threat for which vaccination remains the ultimate solution. Uganda reported 40,751 cases and 335 deaths as of 9 April 2021 and started its vaccination program among priority groups like health workers, teachers, those with chronic diseases among others in early March 2021. Unanimous uptake of the COVID-19 vaccine is required to subsequently avert its spread; therefore, we assessed COVID-19 vaccine acceptability, hesitancy, and associated factors among medical students in Uganda. Methods This study employed an online descriptive cross-sectional survey among medical students across 10 medical schools in Uganda. A structured questionnaire via Google Form was conveniently sent to eligible participants via WhatsApp. Each medical school had a coordinator who consistently shared the data tool in the WhatsApp groups. Chi-square or Fisher’s exact test, and logistic regression were used to assess the association between vaccine acceptability with demographics, COVID-19 risk perception, and vaccine hesitancy. Results We surveyed 600 medical students, 377 (62.8%) were male. COVID-19 vaccine acceptability was 37.3% and vaccine hesitancy 30.7%. Factors associated with vaccine acceptability were being male (adjusted odds ratio (aOR) = 1.9, 95% CI 1.3–2.9, p=0.001) and being single (aOR= 2.1, 95% CI 1.1–3.9, p=0.022). Very high (aOR= 3.5, 95% CI 1.7–6.9, p<0.001) or moderate (aOR =2.2, 95% CI 1.2–4.1, p=0.008) perceived risk of getting COVID-19 in the future, receiving any vaccine in the past 5 years (aOR= 1.6, 95% CI 1.1–2.5, p=0.017), and COVID-19 vaccine hesitancy (aOR 0.6, 95% CI 0.4–0.9, p=0.036). Conclusions This study revealed low levels of acceptance towards the COVID-19 vaccine among medical students, low self-perceived risks of COVID-19, and many had relied on social media that provided them with negative information. This poses an evident risk on the battle towards COVID-19 in the future especially when these future health professions are expected to be influencing decisions of the general public towards the same.

P. Hotez, C. Booker

1 Texas Children’s Hospital Center for Vaccine Development, Department of Pediatrics and Molecular Virology & Microbiology, National School of Tropical Medicine, Baylor College of Medicine, Houston, Texas, United States of America, 2 Hagler Institute for Advanced Study at Texas A&M University, College Station, Texas, United States of America, 3 Department of Biology, Baylor University, Waco, Texas, United States of America, 4 James A Baker III Institute of Public Policy, Rice University, Houston, Texas, United States of America, 5 United States Senator for the State of New Jersey, Washington DC, United States of America

P. Hotez, M. Bottazzi, N. Strub-Wourgaft et al.

1 Global Chagas Disease Coalition, Barcelona, Spain, 2 Texas Children’s Hospital Center for Vaccine Development, National School of Tropical Medicine, Baylor College of Medicine, Houston, Texas, United States of America, 3 Department of Biology, Baylor University, Waco, Texas, United States of America, 4 Hagler Institute for Advanced Studies at Texas A&M University, College Station, Texas, United States of America, 5 Scowcroft Institute of International Studies, Bush School of Government and Public Service, Texas A&M University, College Station, Texas, United States of America, 6 James A Baker III Institute of Public Policy, Rice University, Houston, Texas, United States, 7 Drugs for Neglected Diseases Initiative (DNDi), Geneva, Switzerland, 8 Fundación Ciencias y Estudios Aplicados para el Desarrollo y Salud Medio Ambiente (CEADES), Cochabamba, Bolivia, 9 Barcelona Institute for Global Health (ISGlobal), Hospital Clı́nic, University of Barcelona, Barcelona, Spain, 10 Fundación Mundo Sano, Madrid, Spain

B. G. Dhoubhadel, G. Raya, D. Shrestha et al.

Background The nutritional status of children may deteriorate after natural disasters such as earthquakes. A 7.8 Richter scale earthquake struck Nepal in 2015 that affected 1.1 million children. Children whose homes were destroyed and had to live in temporary shelters were at risk of malnutrition. With the support of Nagasaki University School of Tropical Medicine and Global Health (TMGH) and Siddhi Memorial Hospital (SMH), we conducted a nutritional survey of under-5 children living in temporary shelters in Bhaktapur Municipality in 2015 immediately after the earthquake and a follow-up survey in 2017. Results We found 591 under-5 children living in 22 temporary shelters in 2015. A total of 285 children were followed up and re-assessed in 2017. In a paired analysis ( n = 285), the prevalence of underweight children increased from 10.9% in 2015 to 14.0% in 2017 ( P < 0.001), stunting increased from 26.7 to 31.9% ( P = 0.07), and wasting decreased from 4.2 to 2.5% ( P = 0.19). Conclusions Children who lived in temporary shelters after the 2015 Nepal earthquake might be at increased risk of a deterioration in nutritional status.

P. Hotez, J. Huete-Pérez, M. Bottazzi

1 Texas Children’s Center for Vaccine Development, Departments of Pediatrics and Molecular Virology & Microbiology, National School of Tropical Medicine, Baylor College of Medicine, Houston, Texas, United States of America, 2 Department of Biology, Baylor University, Waco, Texas, United States of America, 3 Hagler Institute for Advanced Study at Texas A&M University, College Station, Texas, United States of America, 4 James A Baker III Institute for Public Policy, Rice University, Houston, Texas, United States of America, 5 Scowcroft Institute of International Affairs, Bush School of Government and Public Service, College Station, Texas, United States of America, 6 Molecular Biology Center, University of Central America, Managua, Nicaragua

Shipra Shah, J. Bhat

The World Health Organization recently raised concerns about antimicrobial resistance and lack of novel antibiotics in the health sector. The success rate of drug discovery is higher when chemical constituents are sourced from natural products and when drug candidates are based on the indigenous knowledge of local communities. Tropical rainforests are an important source of medicinal plants for traditional healthcare systems. The pharmaceutical industry also recognizes the potential of rainforests in novel drug development. However, habitat degradation and loss of traditional knowledge are endangering the healing powers of nature. The islands of Fiji have a rich cultural history of traditional medicine and a number of medicinal plants are sourced from the country's rainforest ecosystems. While deforestation and forest degradation are decimating unique rainforest biodiversity and reducing access to medicinal plants in the wild, inter-generational erosion of ethnobotanical knowledge is attributed to acculturation, rural-urban migration and their effects on the transmission of oral traditions from one generation to another. Under these conditions, plants may disappear before their therapeutic value is formally identified. This review summarizes the importance of traditional medicinal knowledge and the potential for drug discovery from the tropical rainforest ecosystems of Fiji. However, there are several challenges that need to be addressed to realize the true potential of ethnopharmacology in this country.

A. Omokhua, M. Abdalla, J. van Staden et al.

BackgroundTithonia diversifolia and T. rotundifolia belong to the Asteraceae family and are native to Mexico and Central America. These plants have become invasive in parts of tropical Africa and Asia where they have become an ecological, agricultural and economic burden. Tithonia diversifolia is exploited by locals in its native and most parts of its invasive range as a source of medicines; however, T. rotundifolia is only used for medicinal purposes in one country in the native range (Venezuela) and none in the invasive range. Although T. diversifolia has been studied for different biological activities, little or no attention has been given to T. rotundifolia. This study compared the antimicrobial activity, phytochemistry, identification of bioactive compound(s) and toxicity levels of different leaf extracts and fractions of T. diversifolia and T. rotundifolia.MethodsAntimicrobial activity was evaluated against seven pathogenic bacteria, four non-pathogenic Mycobacterium species and three fungal species using serial microdilution assays. Phytochemical contents were determined through standard methods of analysis. UPLC/MS was used to analyse the fractions to identify possible bioactive compounds that may be responsible for bioactivity, while toxicity tests were carried out using the colorimetric MTT assay and the Ames test.ResultsBoth species had a range of antimicrobial activity against bacterial, mycobacterial and fungal species. However, T. rotundifolia displayed better activity against most of the strains tested with minimum inhibitory concentration values ranging between 0.01 and 0.07 mg/ml. Both species were rich in phenolics, flavonoids and tannins. Tagitinin A was identified as the main compound present in both species, and this compound may be responsible for the antimicrobial activity displayed. Toxicity tests showed that T. diversifolia was cytotoxic at concentrations used in this study, while T. rotundifolia was not. Both species did not show any mutagenic/genotoxic effects.ConclusionThe above results suggest that both species may be further developed as a source of antimicrobials for the treatment of infections caused by opportunistic pathogens. They may also serve as alternatives to highly exploited plant species with the same medicinal properties. However, T. diversifolia should be used with caution as it may be toxic.

Richard Selby, Charles Wamboga, Olema Erphas et al.

In 1994, combined active and passive screening reported 1469 cases from the historic Gambian Human African Trypanosomiasis (gHAT) foci of West Nile, Uganda. Since 2011 systematic active screening has stopped and there has been reliance on passive screening. During 2014, passive screening alone detected just nine cases. In the same year a tsetse control intervention was expanded to cover the main gHAT foci in West Nile to curtail transmission of gHAT contributing to the elimination of gHAT as a public health problem in the area. It is known that sole reliance on passive screening is slow to detect cases and can underestimate the actual true number. We therefore undertook an active screening programme designed to test the efficacy of these interventions against gHAT transmission and clarify disease status. Screening was conducted in 28 randomly selected villages throughout the study area, aiming to sample all residents. Whole blood from 10,963 participants was analysed using CATT and 97 CATT suspects (0.9%) were evaluated with microscopy and trypanolysis. No confirmed cases were found providing evidence that the gHAT prevention programmes in West Nile have been effective. Results confirm gHAT prevalence in the study area of West Nile is below the elimination threshold (1 new case / 10,000 population), making elimination on course across this study area if status is maintained. The findings of this study can be used to guide future HAT and tsetse management in other gHAT foci, where reduced caseloads necessitate a shift from active to passive screening.

A. Blum, M. Majid, P. Hotez

1 Department of Surgery, Baylor College of Medicine, Houston, Texas, United States of America, 2 Center for Health and Biosciences, James A Baker III Institute of Public Policy, Rice University, Houston, Texas, United States of America, 3 Texas Children’s Center for Vaccine Development, Departments of Pediatrics and Molecular Virology and Microbiology, National School of Tropical Medicine, Baylor College of Medicine, Houston, Texas, United States of America, 4 Center for Medical Ethics, and Health Policy, Baylor College of Medicine, Houston, Texas, United States of America, 5 Department of Biology, Baylor University, Waco, Texas, United States of America, 6 Scowcroft Institute of International Affairs, Bush School of Government and Public Policy, Texas A&M University, College Station, Texas, United States of America

Renia Coghlan, Peter Stephens, Bernice Mwale et al.

Abstract Background The steady supply of quality, affordable medicines is a pillar of a functioning health system. In addition to the public sector, the private, mission and not-for-profit sectors often serve a large part of the population in Africa. However, while there is generally systematic recording of public sector supply of medicines, detailed, systematic and reliable national market data including these non-public sectors are not commonly available in most countries in Africa. Understanding the total market is a missing part of the access puzzle: without this information, policy makers and health practitioners are not able to fully measure the impact of interventions, measure access to effective products, or fully evaluate the rational use of medicines. This article reports on a unique innovation which provides routine, national-level data on the total pharmaceuticals market, through a system which can be replicated elsewhere. It demonstrates how national-level market data contribute to the evidence base for policies on access to essential medicines, using the Zambian anti-malarial medicines market as a case study. Methods A new, routine national database on pharmaceutical market size and structure was established through a multi-partner collaboration. Information was extracted from import authorizations and allows for information on local manufacture. Data included value and volume of products as well as pack details, manufacturer and importer. The system was continually updated: data for this analysis were extracted for 6 years: 2009–2014 inclusive. Data were analysed using Microsoft Excel and validated against other sources including donor procurement data. Analysis included public and private sector markets. The policy relevance was demonstrated through analysis of four aspects of national policies on access and rational use of malaria medicines: (i) volume of product relative to disease burden; (ii) distribution by sector relative to treatment-seeking; (iii) consistency of products with respect to national policy guidelines; (iv) market concentration as a proxy for security of supply. Results The system developed provides the first accurate, systematic data on the breakdown of a national pharmaceutical market in an African context. The total value of the anti-malarials market in Zambia, including all sectors, was USD 5.5–6 million. This included 22 different molecules or combinations, produced by 56 different manufacturers, with 142 different permutations of molecule/manufacturer/strength. Such data provide a complementary mechanism to confirm key trends in malaria treatment and control in Zambia: (i) sufficient supply relative to disease burden, (ii) value and volume of the private/non-profit sector; 29%–2% of market value and 17%–2% of market volume (from 2009 to 2014), (iii) dominance of the 3 molecules recommended in the national treatment guidelines; and (iv) an evidence-base for national discussions on medicines quality, security of supply and rationale use. The system extracts information on all medicines and therefore could be used to analyse other therapeutic classes. Data have been used for several policy purposes, notably by ZAMRA to monitor the quality of products in Zambia, monitoring implementation of WHO Resolutions on artemisinin monotherapy as well as monitoring trends in product choice across sectors. Conclusion Routine data are important for researchers and policy makers alike. This study shows how medicines data can be systematically gathered at national level—comprising range, volume and value in the public, private and not-for-profit sectors—to monitor more detailed trends in the market and allows triangulation of supply-side data against other sources. This systematic approach can contribute significantly to support access to medicines, monitor treatment and public health policies and create healthy markets. It can be used to monitor changes between therapeutic areas, for example the impact of improved malaria treatment on the use of antibiotics in the context of anti-microbial resistance monitoring. As data contain commercially confidential information, appropriate safeguards should be put in place to balance public health and commercial interests.

Petra Dickmann, Andrew Kitua, Franklin Apfel et al.

International activities to respond to the Ebola crisis in West Africa were mainly developed and focussed around the biomedical paradigm of Western health systems. This approach was often insensitive to societal perception, attitude, and behavioural determinants and clashed with community-based health traditions, narratives, and roles, e.g., of community health workers. In this peer-led capacity-building initiative, these deficiencies were identified and analysed. Innovative, more locally focussed, community-based solutions were articulated. The new approaches described put local people at the centre of all preparedness, response, and recovery strategies. This paradigm shift reframed the role of communities from victims to active managers of their response and reacknowledged the strength of community-based One Health. We conclude that strategies should aim at empowering, not just engaging, communities. Communities can improve short-term crisis management and build longer-term resilience and capacities that are much needed in the current global health climate.The Ebola outbreak in West Africa, 2014-2016, was unprecedented in scale, extent, and duration. The international community was slow to step up its assistance in this global public health emergency and then faltered when its infection control management approaches clashed with West African realities [1]. Outbreak response evaluations have identified the need to better integrate social science intelligence [2], better collaborate with communities [3,4], more effectively draw on the strength of community health workers [5], and critically question the paradigm of Western health systems, which focus on imposing 'evidence-based' solutions that lack external validity in affected communities; i.e., they too often recommend actions that are inconsistent with, ignore, or violate traditional behaviours [6]. While there appears to be a consensus now on what needs to be done, how to achieve these goals remains a challenge.

F. Barbosa, E. Barnett, P. Gautret et al.

R. Sood, R. Raut, Poornima Tyagi et al.

Background Dengue, a mosquito-borne viral disease, poses a significant global public health risk. In tropical countries such as India where periodic dengue outbreaks can be correlated to the high prevalence of the mosquito vector, circulation of all four dengue viruses (DENVs) and the high population density, a drug for dengue is being increasingly recognized as an unmet public health need. Methodology/Principal findings Using the knowledge of traditional Indian medicine, Ayurveda, we developed a systematic bioassay-guided screening approach to explore the indigenous herbal bio-resource to identify plants with pan-DENV inhibitory activity. Our results show that the alcoholic extract of Cissampelos pariera Linn (Cipa extract) was a potent inhibitor of all four DENVs in cell-based assays, assessed in terms of viral NS1 antigen secretion using ELISA, as well as viral replication, based on plaque assays. Virus yield reduction assays showed that Cipa extract could decrease viral titers by an order of magnitude. The extract conferred statistically significant protection against DENV infection using the AG129 mouse model. A preliminary evaluation of the clinical relevance of Cipa extract showed that it had no adverse effects on platelet counts and RBC viability. In addition to inherent antipyretic activity in Wistar rats, it possessed the ability to down-regulate the production of TNF-α, a cytokine implicated in severe dengue disease. Importantly, it showed no evidence of toxicity in Wistar rats, when administered at doses as high as 2g/Kg body weight for up to 1 week. Conclusions/Significance Our findings above, taken in the context of the human safety of Cipa, based on its use in Indian traditional medicine, warrant further work to explore Cipa as a source for the development of an inexpensive herbal formulation for dengue therapy. This may be of practical relevance to a dengue-endemic resource-poor country such as India.