Dengue cannot be cured or prevented with homeopathic treatment Eupatorium Perfoliatum

Like every year, the cases for mosquito-borne diseases such as Dengue, have spiked in different parts of India after the end of the summer season. This year the epidemic has lasted much longer than the previous years, while a 16-year-old girl died from dengue on the 10th of November 2019 at the Delhi hospital.

In Delhi, 75 cases of dengue, 21 of chikungunya, and 131 cases of malaria have been reported until the end of August 2019. In 2017 and 2018 in Delhi, 4726 dengue cases with 10 deaths and 2798 dengue cases with 4 deaths were reported respectively. In Telangana, a severely affected state, this year alone over 4500 dengue cases have been reported with the highest outbreak in August and September. The death count due to dengue in Telangana has been estimated of above 50 which includes minors.

Dengue is a viral disease that spreads through mosquitoes with no known cures but treatable symptomatically using evidence-based medications. Previously, Alt News Science conducted a sci-Check on the evidence available for papaya, and its leaf extracts drug ‘Caripill’ for the treatment of dengue. No evidence was found to suggest that papaya or ‘Caripill’ can be effective in treating dengue or raising the platelet count.

The newly developed vaccine Dengvaxia and TAK-003 are undergoing large systematic trials for safety and efficacy before it can be available worldwide as a robust form of preventative or treatment measure.

Subsequently, many forms of alternative treatments in India have emerged that claim to cure and/or prevent Dengue. Other than using papaya, one of the most common claims include using homeopathy for dengue.

Claim:

Eupatorium Perfoliatum (EP), a Homeopathic preparation is preventative and curative for high risk as well as dengue infected populations.

Along with the viral WhatsApp forwards, YouTube videos and other social media content that has been consistently making this claim, the National Health Portal (NHP), has listed Eupatorium Perfoliatum as the most commonly indicated for Dengue. EP along with 12 other homeopathic medications has been indicated as a preventative as well as a curative treatment for Dengue.

The NHP is an official portal designed, developed and hosted by the Centre for Health Informatics (CHI), set up at the National Institute of Health and Family Welfare (NIHFW), by the Ministry of Health and Family Welfare (MoHFW), Government of India.

Alt News found multiple mainstream media reports of Eupatorium Perfoliatum being given to patients by Government organisations. (1, 2, 3, 4)

Fact Check:

Study 1: Non scientific study design with lack of appropriate controls

Marino R. Homeopathy and Collective Health: The Case of Dengue Epidemics. Int J High Dilution Res 2008;7:179-85

In Brazil, a single dose of Eupatorium Perfoliatum was administered preventatively between January- May 2001 to 40% of the population in the most affected neighbourhood. Results from this study showed 81% reduction in dengue incidences between May-December 2001 from that neighbourhood as compared to other non-treated neighborhood. The other treated areas showed a reduction of 58%, 39%, 37% and 10% in dengue incidences during that period.

However, the study did not show the prevalence or reduction of dengue incidence in the treated areas from the previous years when no treatment was administered. A comparison of reduction in dengue can only be made if the incidences from the same area is compared with and without EP dosage. Thus, due to lack of comparative controls, it cannot be determined that EP indeed have an impact on dengue reduction.

Study 2: Conference paper, not a peer-reviewed paper, and lack of data

The double blind controlled trial quoted from Novaes (2015) is a conference proceeding, not a peer review paper, repeatedly cited as conclusive proof of efficacy by many sources, but neither the data is cited nor the published paper is available for viewership.

Study 3: Falsified and misrepresented data from 25 patients

In Pakistan, a combination of homeopathic remedies including Eupatorium Perfoliatum was given to 25 dengue patients (Hassan et al 2003). Their full blood count (FBC) including platelet count (PLT), white blood cell count (WBC) and hematocrit level (HCT) were recorded instead of the change in viral load and was compared with the non-treated group. However, the comparison was conducted at the end of the 6-day dengue infection period.

Their study quoted that, in the homeopathic treated group platelet count increased from (95.60 ± 0.04) x 10³ to (311 ± 0.13) x 10³/μL, while the standard maintenance therapy (control) increased platelet count from (73.44 ± 0.04) x 10³ to (239.00 ± 0.04) x 10³/μL.

It was claimed, in this study as well as in other reviews of this study, that the relative change from approximately 95,000 (day 0) to 311,000 (day 6) per μL in the homeopathy treated group was larger than the relative change in the control group, i.e. 73,000 (day 0) to 239,000 (day 6) per μL.

Alt News Science calculated the % change in platelets between the two groups. If the baseline platelets at day 0 for both groups is treated as 100%,

Day 6 Homeopathy = (311,000 x 100)/95,000= 327%

Day 6 Control = (239,000 x 100)/72,000= 332%

Thus, there were no significant differences in platelet increase between the homeopathy treated group and the group with standard treatment, as the platelet count increased from day 0 to day 6.

Hence, Hassan et al’s conclusion of homeopathy combination treatment group being more effective is a falsification and misrepresentation of results. Subsequently, this research study is not a proof of efficacy for EP or the combination of homeopathic remedies for dengue.

Study 4: Lack of evidence for efficacy

In Honduras, a double-blind, placebo-controlled randomized trial of a homeopathic combination medication, including EP, for 60 dengue patients was carried out in municipal health clinics by Jacobs et al 2007.

As per their own conclusion from Jacobs at et 2007, the results showed no difference in outcomes between homeopathy treated group vs. the placebo group, including the number of days of fever and pain as well as analgesic use and complication rate. The study did not evaluate blood count or viral load as a parameter for homeopathic treatment efficacy.

Review studies:

A review paper published by Raj Manchanda in 2015, The Editor in Chief, Central Council for Research in Homoeopathy (CCRH), India listed the global studies, reviewed above, to conclude Eupatorium Perfoliatum (EP) efficacy for dengue.

Another review paper from the Regional Research Institute for Homoeopathy, India by Bawaskar & Shinde (2019) listed the same studies and detailed the results but did not analyse or “peer-review” the data to validate its authenticity.

Conclusion:

The data paper published in Pakistan is a serious breach in research conduct for which the paper should not have allowed to be published or cited several times. Additionally, that Pakistani paper was cited without criticism of misrepresentation by the editor in chief of CCRH, India (Manchandana, 2015) and in another review paper from India by Bawaskar & Shinde (2019).

The limited number of studies, largely concluding efficacy in review papers, lack of empirical data as well as falsification of data presented no evidence for Eupatorium Perfoliatum (EP), or EP with a combination of other homeopathic drugs to be effective in treating or preventing dengue.

The majority of criticism towards evidence-based scientists conducting research to test homeopathy efficacy is dismissed by the homeopaths. Here, we used homeopathy research studies to reveal lack of efficacy, misrepresented and falsified data.

This does not counter that homeopathy itself is based on principles not acknowledged by evidence-based medicine. Our previous article on homeopathy as an ineffective treatment method demonstrates its lack of scientific evidence. This informed opinion about homeopathy is shared by major public health institutions across the western world.

References:

Claim:

The National Health Portal: National Health Portal

Fact check:

Review papers:

1. Manchanda RK. Dengue epidemic: What can we offer?. Indian J Res Homoeopathy 2015;9:137-40Available from: Indian Journal of Research in Homeopathy
2. Bawaskar RS, Shinde VH. A Review of Homoeopathic Research in the Prevention and Treatment of Dengue Fever. Homœopathic Links. 2019 Mar;32(01):010-7.Available from: https://www.thieme-connect.com/products/ejournals/html/10.1055/s-0039-1687897#JR1920069-19

Data papers:

1. Marino R. Homeopathy and Collective Health: The Case of Dengue Epidemics. Int J High Dilution Res 2008;7:179-85Available from: International Journal of High Dilution
2. Novaes AR. Homeopathic Intervention In Users Treatment Network Public Advised With Dengue In Victory, Brazil. Proceedings of 70th Congress of Liga Medicorum Homoeopathica Internationalis 2015. Liga Medicorum Homoeopathica Internationalis.
3. Saeed-ul-Hassan S, Tariq I, Khalid A, Karim S. Comparative clinical study on the effectiveness of homeopathic combination remedy with standard maintenance therapy for dengue fever. Tropical Journal of Pharmaceutical Research. 2013;12(5):767-70.Available from: Tropical Journal of Pharmaceutical Research
4. Jacobs J, Fernandez EA, Merizalde B, Avila-Montes GA, Crothers D. The use of homeopathic combination remedy for dengue fever symptoms: a pilot RCT in Honduras. Homeopathy. 2007 Jan;96(01):22-6.Available from: Thieme