Preliminary clinical evaluation of the antiparasite effect of Stevia rebaudiana Bertoni (ka`a he ê) in adults and children
DOI:
https://doi.org/10.18004/Keywords:
Stevia rebaudiana Bertoni, Intestinal parasitic disease, Children, Adult, Protozoan, HelmintsAbstract
Intestinal parasitic diseases are mainly observed among children and immunocompromized adults. The current treatments are usually effective, but the occurrence of resistance demands the search for new drugs. The main objective of the present study was to evaluate the effectiveness of Stevia rebaudiana Bertoni as an antiparasitic agent. For this purpose a randomized, single blind clinical assay was performed, including 22 adults and 134 children (6-18 years of age), all of them with intestinal parasites, either protozoans and/or helmints. The treatments consisted in pharmaceutical commercial preparations of S. rebaudiana leaves (SRB) or mebendazole-tinidazole (MBZ-TNZ). At baseline evaluation of the 134 children involved, 113 (99,3%) revealed the presence of protozoans, and 28 (20,8%) helmints, mostly as coinfections. S. rebaudiana reduced the frequency of protozoan infection in children (74,5%) when compared to the conventional treatment with MBZ-TNZ (40,7%) (p<0,001). SRB also reduced the frequency of infection by helmints by 70,6%, similarly as MBZTNZ (p>0,05). There were not reported adverse effects among treated children. SRB and MBZ-TNZ treatments showed similar efficacy in adults reducing infections of protozoans and helmints, but the number of adverse events reported for the MBZ-TNZ treatment was significantly more frequent than SRB (p<0,02). These results encourage us to continue the evaluation of SRB as a potential antiparasitic agent.
References
1. Ferreira MU; Silva Foronda A; Shumaker TTS: Nematódeos Intestinales en fundamentos
Biologicos de Parasitologia Humana. Manole. Año 2003. p 89 – 113.
2. Harhay MO, Horton J, Olliaro PL. Epidemiology and control of human gastrointestinal parasites in children Expert Rev Anti Infect Ther. 2010; 8(2): 219–234.
3. Kappagoda S, Singh U, Blackburn BG., Antiparasitic therapy Mayo Clin Proc. 2011; 86(6): 561– 583.
4. Lalle M Giardiasis in the post genomic era: treatment, drug resistance and novel therapeutic perspectives. Infect Disord Drug Targets. 2010;10(4):283-94.
5. Albonico M, Bickle Q, Ramsan M, Montresor A, Savioli L, Taylor M. Efficacy of mebendazole
and levamisole alone or in combination against intestinal nematode infections after repeated
targeted mebendazole treatment in Zanzibar. Bull World Health Organ. 2003;81(5):343-52.
6. Achucarro C, Echague G, Sosa L, Ferro E, Sckell C, Ferreira M, Pistilli N, Alborno RM. Actividad antihelmíntica de la Stevia rebaudiana Bertoni (SRB) Ka´a Héê: Primera etapa del proyecto de investigación con lombrices terrestres. Anales FCM – UNA. 2009;.42: 19-26.
7. Nuñez C, Bilbao N, Ramirez A, Sosa L, Vazquez S, Cabañas F, Sanabria R. Prevalence of
intestinal parasitosis in children from Escobar, Paraguay. Annuals Reports IICS.1991;15:44 –
51.
8. Nuñez C, Calabró MA, Monzón MI, Amarilla R, Cabañas F. Prevalence of intestinal parasitosis in children from a rural town in Paraguay. Annuals Reports IICS. 1991; 16:19 – 62.
9. Jure D; Muñoz M; Canese J; Canese A. “Prevalencia de parásitos intestinales en niños escolares de Paraguay”. Rev. Paraguay microbiología; 23 (1) Dic. 2003: 52 – 57 (Estudio 1998 – 2002)
10. Hulley SB; Cummings SR. Apéndice 13. B En: Diseño de la Investigación Clínica. Barcelona.
Doyma; 1993. p 232 – 233
11. Ritchie LS. An ether sedimentation technique for routine stool examinations. Bull US Army Med Dept. 1948; 8:326.
12. Brusick DJ. A critical review of the genetic toxicity of steviol and steviol glycosides. Food Chem. Tóxicol. 2008; 46:83 – 91
13. Rossignol JF, Kabil SM, Said M, Samir H, Younis AM. Effect of nitazoxanide in persistent
diarrhea and enteritis associated with Blastocystis hominis. Clin Gastroenterol Hepatol.
2005;3(10):987-91
14. Ibarrola D, Degen R, editores. Catálogo ilustrado de 80 especies medicinales del Paraguay. Facultad de Ciencias Químicas, UNA – Agencia de Cooperación Internacional del Japón, Asunción, 2011.83-84.
15. López de Guimaraes D, Neyra Llanos RS, Romero Acevedo JH. Ascaridiasis: comparación de la eficacia terapéutica entre paico y albendazol en niños de Huaraz. Rev. Gastroenterol. Perú 2001; 21: 8.
16. Athanasiadou S, Githiori J, Kyriazakis I. Medical plants for helminth parasite control: facts and fiction. Animal 2007; 1 (9), 1392 – 1400
17. Dwivedi A, Dwivedi S, Sitoke AK, Patel R, Jhade D. Anthelmintic activity of a polyherbal
preparation - Ethnobotanical Leaflets 2009, 13: 259-62
18. Salazar W, Cárdenas J, Núñez M, Fernández I, Villegas L, Pacheco L, Untiveros G - Estudio
fitoquímico y de la actividad antihelmíntica de los extractos de Euphorbia huanchahana y
Baccharis salicifolia. - Rev. Soc. Quím. Perú 2007 v.73 n.3 Lima jul./set. 150 – 157
19. Kozan E; Kupeli E; Yesilada E: Evaluation of some plants used in Turkish folk medicine against parasitic infections for their in vivo anthelminthic activity. J Ethnopharmacol. 2006; 108: 211 – 216.
20. Kujer RS, Singh V, Ram M, Yadava HN, Singh KK, Kumari S, Roy BK. Abntidiabetic activity and phytochemical screening of crude extract of Stevia rebaudiana in alloxan-induced diabeteic rats.Pharmacognosy res. 2010; 2(4): 258-263.
21. Jeppesen PB, Gregersen S, Poulsen CR, Hermansen K, Stevioside acts directly on pancreatic beta cells to secrete insulin: Actions independent of cyclic adenosine monophosphate and adenosine triphosphate sensitive potassium ion channel activity. Metab. 2000;49:208-214.
22. Shiozaki K, Fuji A, Nakano T, Yamaguchi T, Sato M. Inhibitory effects of hot water extract of
Stevia stem on the contractile response of the smooth muscle of the guinea pig ileum. Biosci
Biotechnol Biochem. 2006; 70(2): 489 – 494.

