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Table 1 Summary of included studies

From: Carica papaya extract in dengue: a systematic review and meta-analysis

Study Methods Participants Interventions Outcomes Adverse events
Assir et al. [15], 2011 Randomized single blind placebo controlled study Patients > 14 years with DF or DHF with platelet < 50 × 109(19 intervention, 20 control) CP leaf extract syrup 5 ml twice a day for four days Mean platelet count increments after 2–4 days were not statistically significant between the two groups. Mean platelet increment between day 5(4 days after intervention) and baseline was 106 ± 69.16 in the intervention group and 82.3 ± 37.28 in the control group, and not statistically significant. No significant adverse effects with CP
Yunita et al. [16], 2012 Randomized open-label controlled study Patients 15–55 years with suspected DF (40 in each arm) CP leaf extract capsule 1100 mg three times a day Platelet counts rise more rapid in the intervention group (p < 0.05). Haematocrit changes not significant. Period of hospitalization shortened with treatment. Intervention group 3.48 ± 0.6 days, Control group 5.38 ± 0.67 days (p < 0.05). Not reported
Subenthiran et al. [17], 2013 Randomized open label controlled study Patients 18–60 years with DF or DHF with platelet < 100 × 109(145 in each arm) Fresh juice from 50 g of CP leaves daily for three days Mean difference in platelet count at 8 h and after 40 h: intervention group − 16.764 (− 24.566, − 8.964), p < 0.001, control group − 7.703 (− 14.055, 1.351) (p = 0.018). Not reported
Abhishek et al. [18], 2015 Randomized open label controlled study Patients 18–60 years with DF or DHF I, II with platelet count 30 – 100 × 109 (30 in each arm) CP leaf extract tablets 1100 mg three times a day for five days Mean platelet count after five days: intervention group 110.71 + 30.57, control group 75.63 + 22.49. Mean difference in platelet count from day 1 to day 5: 39.89 + 38.50 in the intervention group, 0.71 + 24.76 in the control group, p = 0003. Not reported
Gowda et al. [19], 2015 Randomized, open label controlled study Patients 18–60 years with DF or DHF I, II with platelet count 30-100 × 109 (14 intervention group, 16 control group) CP leaf extract tablets 1100 mg three times a day for five days Mean platelet count on day 5: intervention group 104.71 ± 30.57, control group 66.63 ± 22.49. Mean difference in platelet count from day 1 to day 5: intervention group 39.92 ± 38.51, control group 00.69 ± 24.75, p = 0003. Not reported
Gadhwal et al. [20], 2016 Randomized controlled study Patients > 16 years with DF and platelet count < 150 × 109 (200 in each group) CP leaf extract capsule 500 mg once daily for five days Mean platelet count was higher in the intervention group from 3rd to 5th day. Average hospitalization period: intervention group 3.65 ± 0.97 days, control group 5.42 ± 0.98, p < 0.01. Platelet transfusion requirements: intervention group 55/200, control group 93/200. No side effects reported with CP
Kasture et al. [21], 2016 Randomized double blind placebo controlled study Patients 18–60 years with DF or DHF I, II with platelet count 30-100 × 109 (150 each group) CP leaf extract tablets 1100 mg three times a day for five days Median platelet count on day three: intervention group 88.89, control group 55.63; on day four 102.57 and 64.58; on day five 155.88 and 70.52, respectively. White cell count also increased in the intervention group. No difference in haematocrit. Nausea, vomiting
Adarsh et al. [22], 2017 Randomized double blind placebo controlled study Adult patients with DF (50 each) CP leaf extract capsules 500 mg three times a day for five days Average platelet count was higher in the intervention group on day 3, 4 and 5 (p < 0.01). Platelet transfusion requirements: intervention group 28%, control group 46% (p < 0.01). White cell count increased in the intervention group. Haematocrit did not show significant difference. Duration of hospitalization: intervention group 3.45 ± 0.98, control group 6.42 ± 0.98 (p < 0.01). Nausea, vomiting
Srikanth et al. [23], 2019 Randomized open label controlled study Paediatric patients (1–12 years) with DF or DHF grades I or II with platelet count 30-100 × 109 (145 intervention, 140 control) CP leaf extract syrup 275 mg three times a day (1–5 years age) or 550 mg three times a day (>  5 years) Increase in platelet count on day 03, 04 and 05 were statistically significant (p < 0.05). Increase in red cell count was statistically significant on day 05 and white cell count statistically significant on day 3, 4 and 5. Nausea in two patients
  1. CP Carica papaya, DF dengue fever, DHF dengue haemorrhagic fever