Complementary alternative medicine use among patients with dengue fever in the hospital setting: a cross-sectional study in Malaysia

Complementary and alternative medicine (CAM) is a group of various medical and healthcare systems, products, practices, approaches, knowledge and beliefs, which are not universally considered as a part of conventional Western medicine for maintaining well-being [1, 2]. The National Center for Complementary and Integrative Health classified CAM into five subdivisions: biological-based therapies, alternative medical systems, energy therapies, manipulative and body-based systems, and mind-body interventions [1, 3].

A patient who desires to maintain and improve their physical, psychological and social well-being will tend to use CAM [4]. With the rising trend of dengue fever (DF) cases from 1999 to 2007 [5] and high incidence rates of dengue in Malaysia in 2011 [6], more patients will look up to CAM as an alternative form of treatment. Furthermore, a fool proof antiviral treatment for DF currently does not exist [7] and the development of safe tetravalent dengue vaccine is still undergoing clinical trials [8–10]. Therefore, the treatment is only supportive and symptomatic in nature. In addition, DF also carries the risk of developing into dengue haemorrhagic fever where the mortality rate is up to 44 % [11]. Living with these circumstances, patients began to realise that they need to take action to manage their condition by taking CAM [4].

For decades, several studies have shown the positive effect of CAM for DF treatment. Especially the fresh papaya leaf extracts [12, 13], bitter melon (Momordica charantia), green chirayta (Andrographis paniculata) [14], boneset (Eupatorium perfoliatum) [15]. Double-boiled frog with bitter gourd soup and the whole crab soup are the famous dishes used as CAM for treating DF among Chinese ethnics in Malaysia [16].

Although the scientists and the various governments are developing the effective prevention and control measures, including antiviral drugs and vaccines, CAM could provide good antiviral results as compared to their synthetic analogues [17, 18]. There is a necessity to rethink over medical education, increase the understanding of the concept of medicine and integrating CAM therapies in mainstream health care services [19]. However, the usage of CAM for DF treatment through safe and effective technologies are strongly recommended. Thus, this study aims to determine the prevalence, types, reasons, expenditure, and resources of CAM use among patient with DF.