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Research Article

Application of Herbal Carica Papaya on Guineaworm Lesions: Responses to Health Questionnaire on this Local Practice at AI-Ezza

I.G. Ameh
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A cross-sectional examination of the inhabitants of rural AI-Ezza in Ado local government area of Benue State shows a guineaworm disease prevalence rate of 39.4% (n = 241). An evaluation of traditional method of guineaworm disease treatment among those affected shows that 62 (65.3%) out of 95 of patients applied decoction made from root, stem and leave extract of pawpaw (Carica papaya) on guineaworm lesions. Statistical analysis however showed no association (CX<1) between the application of herb and expulsion of worms or relief from guineaworm pain. The frequency and the popularity of this practice among patients who use it nonetheless underscore the galenical value of Carica papaya, that may be exploited for guineaworm disease treatment.

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  How to cite this article:

I.G. Ameh , 2005. Application of Herbal Carica Papaya on Guineaworm Lesions: Responses to Health Questionnaire on this Local Practice at AI-Ezza. Journal of Entomology, 2: 109-111.

DOI: 10.3923/je.2005.109.111



Guineaworm disease is endemic in many rural communities of Benue state[1-4]. Affected persons suffer painful and disabling affliction, especially during epidermic outbreaks when the disease impose chronic illnesses, widespread human misery and extensive socioeconomic adversity in endemic communities[5-7]. Some of the guineaworm disease presenting symptoms which exert serious burden of morbidity on patients include complications such as tetanus, gangrene, fatal blood poisoning, pericarditis, visual impairment, pregnancy complications, urinary obstruction, painful emergent worm blisters, urticaria, ulceration, abscesses, acute arthritis, paralysis and asthma among others[6-10]. Victims of these symptoms often seek orthodox as well as traditional herbal remedy in endemic villages[5,11-13]. Indeed the use of herbs to treat guineaworm disease is common practice among West African endemic country households[5,11,13]. This report analyses responses to health questionnaire on the traditional use of Carica papaya extracts to treat guineaworm disease in study village. This investigation is relevant because no drug or herb has yet been conclusively tested as an effective guineaworm expellant[6,12]. Moreover, higher plants such as Carica papaya are important sources of drug development[14,15].


Survey: In the study carried out between February and April of 2004, 241 randomly selected individuals were physically examined, in a cross-sectional survey, for symptoms of guineaworm disease at AI-Ezza in Ado local government area, of Benue State, Nigeria. Emergent worm was taken as any skin lesion, from which adult guinea worm visibly emerged or from which guineaworm was microscopically identified from cold water washing of the lesion[6,12]. An unstructured questionnaire was administered in a follow-up ethnographic study, to determine traditional symptom management practices and the efficacy of the use of Carica papaya to relief guineaworm pain or extrude emergent worm.

Statistical method: The statistical Cross-product or odds ratio (CX) was used to test whether or not herbal application was associated with guineaworm extrusion and/or pain relief. The assumption is that these events were dependent and so associated (CX>1) or independent and not associated (CX = 1 or CX<1). The ratio was presented on a 2 x 2 contingency table equivalent to the statement as follows:

Image for - Application of Herbal Carica Papaya on Guineaworm Lesions: Responses to Health Questionnaire on this Local Practice at AI-Ezza


Disease prevalence: The results showed (Table 1) that 95 (39.4%) of those examined (n = 241) had guineaworm disease. Proportion of cases among females (44.0%) was higher than among males (35.6%) while those of 11-20 years had higher percentages (53.1%) than any of the age brackets considered (Table 1). All patients complained of guineaworm disease pains while 62 (65.3%) of patients had emergent worm.

Table 1: Distribution of guineaworm disease in study village
Image for - Application of Herbal Carica Papaya on Guineaworm Lesions: Responses to Health Questionnaire on this Local Practice at AI-Ezza

Table 2: Proportion of herb users in relation to guineaworm extrusion
Image for - Application of Herbal Carica Papaya on Guineaworm Lesions: Responses to Health Questionnaire on this Local Practice at AI-Ezza
Image for - Application of Herbal Carica Papaya on Guineaworm Lesions: Responses to Health Questionnaire on this Local Practice at AI-Ezza

Table 3: Proportion of herb users in relation to pain relief
Image for - Application of Herbal Carica Papaya on Guineaworm Lesions: Responses to Health Questionnaire on this Local Practice at AI-Ezza
Image for - Application of Herbal Carica Papaya on Guineaworm Lesions: Responses to Health Questionnaire on this Local Practice at AI-Ezza

Decoctions: Sixty-two (65.3%) of patients applied root, stem and leave extracts of pawpaw (Carica papaya) on guineaworm lesions. The decoctions were prepared and applied as follows:

Root extract: Scrappings of dug-out pawpaw root was sun-dried sparingly, mashed and slightly heated in a few drops of water and mixed with powdered pepper. This was locally applied on guineaworm lesions such as emergent worm bubo, sore, ulcer or arthritis at no specific dosage.

Leave extract: Leaves of pawpaw often mixed with leaves of cow pea (Vigna unguiculata) were slightly sun-dried, crushed in woody mortar and mixed with pepper in a few drops of water. This decoction was squeezed and rubbed with the fingers onto guineaworm lesions including bubo, emergent worm, arthritic swelling and others, to expel worm and relief pain.

Stem extract: Preparation and application of stem extract is similar to the root extract. Depending on individual patient, the papaya decoctions was further mixed with cow-dung, red palm oil or additional extracts from mango, orange, guava and other tree plants.

Effect of decoction: Guineaworm disease response to herbal application was statistically measured and the result shows as follows:

Worm extrusion: The statistical analysis (Table 2) shows no association (CX<1) between the application of papaya decoction and worm extrusion. This is because the probability (Table 2) of this occurring is less than one (0.34<1). However, 15 (15.8%) of the 62 patients who applied this decoction agreed that papaya actually effected the expulsion of their worms or quickened the process while 47 (49.5%) of them maintained that this was improbable (Table 2).

Pain relief: The result also shows (Table 3) that there was no association (CX<1) between the topical use of papaya decoction and pain relief from guineaworm illness. The chance for this to occur is less than one (0.5<1) as shown (Table 3). However, 28 (29.5%) of the 62 patients who treat guineaworm with papaya confirmed the soothing effect of the herb, although a higher number or 34 (35.8%) of them did not get relief.

However, it was curious that 47 (49.5%) of patients whose worms failed to extrude (Table 2) and the 34 (35.8%) patients who had no pain relief (Table 3) from papaya application continued to use the decoction despite their awareness of apparent ineffectiveness of the process. Respondents claimed that the reason for this was because papaya decoction was more widely used and more readily available, at no cost, than orthodox therapy which was expensive, unavailable in remote villages and not trusted to cure patients who apparently suffer repeated exposure to the disease.


Morbidity data as recorded for study village is characteristic of endemic guineaworm disease in West Africa rural communities[7,8,13]. In particular, the incidence of chronic guineaworm pains and crippling emergent worm compares with the disease in other endemic villages of Nigeria[1,9,13]. This investigation also indicates that the use of papaya extract to treat guineaworm disease is wide-spread in study village. It is therefore probable that the autochthonous use of galenicals, in this case, papaya is a feature of many guineaworm endemic communities of West Africa[4,5,8,11,13]. However, since statistical measurement of result shows that it is not probable (CX<1) that papaya decoctions expelled worm or relieved guineaworm pains in study village, then it is possible that galenicals are used as readily available substitute where orthodox treatment is unaffordable, limited, unavailable or unreliable[5,11,12]. It appears also that patients are compelled to use galenicals mostly in desperate need of relief from chronic and crippling guineaworm pains when orthodox treatment could not be used for reasons stated. The choice of papaya as an anti-guineaworm galenical in these communities probably derives from its tested biological activities as anti-microbial and an anti-parasitic vermifuge[15-17]. It has been shown as well that papin and xylitol are important active medicinal constituent or drug product of papaya[14,17,18]. This study suggests a possible guineaworm expulsion and pain relief property of papaya as admitted by an insignificant but observable proportion of patients who use the plant as a galenical.


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