title: Treatment of oral thrush in HIV/AIDS patients with lemon juice and lemon grass (Cymbopogon citratus) and gentian violet.
abstract: OBJECTIVE
  The purpose of the study was to investigate the safety and efficacy of lemon juice and lemon grass (Cymbopogon citratus) in the treatment of oral thrush in HIV/AIDS patients when compared with the control group using gentian violet aqueous solution 0.5%. Oral thrush is a frequent complication of HIV infection. In the Moretele Hospice, due to financial constraints, the treatment routinely given to patients with oral thrush is either lemon juice directly into the mouth or a lemon grass infusion made from lemon grass (Cymbopogon citratus) grown and dried at the hospice. These two remedies have been found to be very efficacious therefore are used extensively. Gentian violet, the first line medication for oral thrush in South Africa, is not preferred by the primary health clinic patients due to the visible purple stain which leads them to being stigmatized as HIV-positive. Cymbopogon citratus and Citrus limon have known antifungal properties.
  
  
  METHODS
  The study design was a randomised controlled trial. Ninety patients were randomly assigned to one of three groups: gentian violet, lemon juice or lemon grass. Inclusion criteria included being HIV-positive with a diagnosis of oral thrush. The study period was 11 days and patients were followed up every second day. International ethical principles were adhered to during the study.
  
  
  RESULTS
  Of the 90 patients, 83 completed the study. In the intention-to-treat analysis, none of the p-values were significant therefore the null hypothesis could not be rejected. In the analysis of the participants who actually completed the trial, the lemon juice showed better results than the gentian violet aqueous solution 0.5% in the treatment of oral thrush in an HIV-positive population (p<0.02). The null hypothesis in terms of the lemon grass and gentian violet could also be rejected on the basis of the Chi-square test and the likelihood ratio test (p<0.05).
  
  
  CONCLUSIONS
  Though the patient population was small, the use of lemon juice and lemon grass for the treatment of oral candidiasis in an HIV population was validated by the randomised controlled trial.
authors.affiliation: Adelaide Tambo School of Nursing Science, Tshwane University of Technology, Staatsartillerie Road, Pretoria-West, Pretoria 0001, Gauteng, South Africa. wrightscd@tut.ac.za
authors.forename: S C
authors.initials: SC
authors.lastname: Wright
authors.forename: J E
authors.initials: JE
authors.lastname: Maree
authors.forename: M
authors.initials: M
authors.lastname: Sibanyoni
mesh_terms: D017088:AIDS-Related Opportunistic Infections / Q000188:drug therapy*; D000891:Anti-Infective Agents, Local / Q000627:therapeutic use*; D000935:Antifungal Agents / Q000627:therapeutic use*; D002180:Candidiasis, Oral / Q000188:drug therapy*; D002957:Citrus / Q000009:adverse effects; D031743:Cymbopogon; D005260:Female; D005840:Gentian Violet / Q000009:adverse effects / Q000627:therapeutic use*; D015658:HIV Infections / Q000150:complications / Q000188:drug therapy; D006801:Humans; D008297:Male; D009055:Mouth / Q000382:microbiology; D008517:Phytotherapy / Q000009:adverse effects; D018515:Plant Leaves; D028321:Plant Preparations / Q000009:adverse effects / Q000627:therapeutic use; D013019:South Africa; D016896:Treatment Outcome
chemical_list: D000891:Anti-Infective Agents, Local; D000935:Antifungal Agents; D028321:Plant Preparations; D005840:Gentian Violet