Supportive care and herbal interventions in dengue fever: A critical appraisal of hydration, nutrition, and plant-based therapies

Dengue fever is a significant mosquito-borne viral disease in tropical and subtropical areas that causes a significant burden to public health systems and the affected communities. There is no definite antiviral treatment that can be used routinely in clinical practice, though there is growing interest in natural management, especially in endemic countries where home-based care, traditional medicine, and plant-derived adjuncts are widely used. The objective of this review is to critically evaluate evidence for natural and supportive management strategies in dengue fever, including oral hydration, nutritional support, rest, non-pharmacological symptom relief, and selected herbal interventions. A focused narrative review of clinical, preclinical, systematic-review, and guideline-based literature was conducted. Evidence supports oral hydration as the most established supportive measure in uncomplicated dengue, while nutritional support and rest may aid recovery. Carica papaya leaf extract may improve platelet counts, but this has not consistently translated into better clinical outcomes such as reduced bleeding, shock, hospitalization, or mortality. Evidence for other ethnomedicinal plants remains limited and largely preclinical. Overall, natural approaches may be useful only as adjuncts to standard supportive care and should not replace clinical monitoring or timely referral. Further well-designed trials are needed to clarify efficacy, safety, dosing, and standardization.