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Modifiable and Non-modifiable Factors Associated with Low Awareness of Hypertension Treatment in Indonesia: A Cross-Sectional Population-Based National Survey. Glob Heart 2022; 17:56. [PMID: 36051316 PMCID: PMC9389957 DOI: 10.5334/gh.1143] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2022] [Accepted: 07/26/2022] [Indexed: 11/24/2022] Open
Abstract
Introduction: Low awareness about hypertension treatment is recognized as a significant cause of treatment failure. Therefore, identifying its underlying factors is essential for developing effective intervention strategies. This study aims to identify the modifiable and non-modifiable factors associated with low awareness about hypertension treatment. Method: This national, cross-sectional, population-based survey used publicly available data from the Indonesian Family Life Survey (IFLS-5) for 2014 among respondents with hypertension aged ≥15 years. Depression and insomnia, as modifiable factors, were assessed using the Centre for Epidemiologic Studies—Depression (CES-D) and the Patient-Recorded Outcomes Measurement Information System (PROMIS) questionnaire, respectively. Non-modifiable factors, such as sociodemographic information, were obtained from self-reported data. Logistic regression analysis was used to assess the association between these factors and low awareness about hypertension treatment. Odds ratios (ORs) with 95% confidence intervals (CIs) were reported. Result: The study recruited 7,920 respondents, the majority of whom were female (53.8%) and aged <60 years (71.1%). The prevalence of low awareness of hypertension treatment was 87.1% (51.8% in women and 48.2% in men). Being an elderly (OR: 1.60, 95%CI 1.36–1.88), being irregularly blood pressure control (OR: 4.40, 95% CI 3.78–5.13), having depressive symptoms (OR: 1.35, 95% CI 1.12–1.62), having insomnia (OR: 1.31, 95% CI 1.11–1.53), and having low satisfaction with health care (OR: 1.28, 95% CI 1.08–1.51) were associated with low awareness of hypertension treatment. Surprisingly, respondents with strong religiosity (OR: 1.62; 95% CI 1.25–2.09) were more likely to display low awareness of hypertension treatment. Conclusion: The main factors associated with low awareness of hypertension treatment are modifiable. Thus, health care professionals should integrate more patient-specific factors when designing tailored interventions.
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Houël E, Ginouves M, Azas N, Bourreau E, Eparvier V, Hutter S, Knittel-Obrecht A, Jahn-Oyac A, Prévot G, Villa P, Vonthron-Sénécheau C, Odonne G. Treating leishmaniasis in Amazonia, part 2: Multi-target evaluation of widely used plants to understand medicinal practices. JOURNAL OF ETHNOPHARMACOLOGY 2022; 289:115054. [PMID: 35131338 DOI: 10.1016/j.jep.2022.115054] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/12/2021] [Revised: 01/18/2022] [Accepted: 01/26/2022] [Indexed: 05/27/2023]
Abstract
ETHNOPHARMACOLOGICAL RELEVANCE Leishmaniasis are widely distributed among tropical and subtropical countries, and remains a crucial health issue in Amazonia. Indigenous groups across Amazonia have developed abundant knowledge about medicinal plants related to this pathology. AIM OF THE STUDY We intent to explore the weight of different pharmacological activities driving taxa selection for medicinal use in Amazonian communities. Our hypothesis is that specific activity against Leishmania parasites is only one factor along other (anti-inflammatory, wound healing, immunomodulating, antimicrobial) activities. MATERIALS AND METHODS The twelve most widespread plant species used against leishmaniasis in Amazonia, according to their cultural and biogeographical importance determined through a wide bibliographical survey (475 use reports), were selected for this study. Plant extracts were prepared to mimic their traditional preparations. Antiparasitic activity was evaluated against promastigotes of reference and clinical New-World strains of Leishmania (L. guyanensis, L. braziliensis and L. amazonensis) and L. amazonensis intracellular amastigotes. We concurrently assessed the extracts immunomodulatory properties on PHA-stimulated human PBMCs and RAW264.7 cells, and on L. guyanensis antigens-stimulated PBMCs obtained from Leishmania-infected patients, as well as antifungal activity and wound healing properties (human keratinocyte migration assay) of the selected extracts. The cytotoxicity of the extracts against various cell lines (HFF1, THP-1, HepG2, PBMCs, RAW264.7 and HaCaT cells) was also considered. The biological activity pattern of the extracts was represented through PCA analysis, and a correlation matrix was calculated. RESULTS Spondias mombin L. bark and Anacardium occidentale L. stem and leaves extracts displayed high anti-promatigotes activity, with IC50 ≤ 32 μg/mL against L. guyanensis promastigotes for S. mombin and IC50 of 67 and 47 μg/mL against L. braziliensis and L. guyanensis promastigotes, respectively, for A. occidentale. In addition to the antiparasitic effect, antifungal activity measured against C. albicans and T. rubrum (MIC in the 16-64 μg/mL range) was observed. However, in the case of Leishmania amastigotes, the most active species were Bixa orellana L. (seeds), Chelonantus alatus (Aubl.) Pulle (leaves), Jacaranda copaia (Aubl.) D. Don. (leaves) and Plantago major L. (leaves) with IC50 < 20 μg/mL and infection rates of 14-25% compared to the control. Concerning immunomodulatory activity, P. major and B. orellana were highlighted as the most potent species for the wider range of cytokines in all tested conditions despite overall contrasting results depending on the model. Most of the species led to moderate to low cytotoxic extracts except for C. alatus, which exhibited strong cytotoxic activity in almost all models. None of the tested extracts displayed wound healing properties. CONCLUSIONS We highlighted pharmacologically active extracts either on the parasite or on associated pathophysiological aspects, thus supporting the hypothesis that antiparasitic activities are not the only biological factor useful for antileishmanial evaluation. This result should however be supplemented by in vivo studies, and attracts once again the attention on the importance of the choice of biological models for an ethnophamacologically consistent study. Moreover, plant cultural importance, ecological status and availability were discussed in relation with biological results, thus contributing to link ethnobotany, medical anthropology and biology.
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Affiliation(s)
- Emeline Houël
- CNRS, UMR EcoFoG, AgroParisTech, Cirad, INRAE, Université des Antilles, Université de Guyane, 97300, Cayenne, France.
| | - Marine Ginouves
- TBIP, Université de Guyane, 97300, Cayenne, French Guiana; Université de Lille, CNRS, Inserm, CHU Lille, Institut Pasteur de Lille, U1019-UMR9017-CIIL Center for Infection and Immunity of Lille, 59000, Lille, France
| | - Nadine Azas
- Aix Marseille Univ, IHU Méditerranée Infection, UMR VITROME, Tropical Eukaryotic Pathogens, 19-21 Boulevard Jean Moulin, 13005, Marseille, France
| | - Eliane Bourreau
- Institut Pasteur de la Guyane, 23 Avenue Pasteur, BP6010, 97306, Cayenne Cedex, French Guiana
| | - Véronique Eparvier
- CNRS - Institut de Chimie des Substances Naturelles, Université Paris-Saclay, 1 Avenue de la Terrasse, 91198, Gif-sur-Yvette Cedex, France
| | - Sébastien Hutter
- Aix Marseille Univ, IHU Méditerranée Infection, UMR VITROME, Tropical Eukaryotic Pathogens, 19-21 Boulevard Jean Moulin, 13005, Marseille, France
| | - Adeline Knittel-Obrecht
- Plate-forme de Chimie Biologique Intégrative de Strasbourg UAR 3286 CNRS-Université de Strasbourg, Institut du Médicament de Strasbourg, ESBS Pôle API, Bld Sébastien Brant, 67412, Illkirch Cedex, France
| | - Arnaud Jahn-Oyac
- CNRS, UMR EcoFoG, AgroParisTech, Cirad, INRAE, Université des Antilles, Université de Guyane, 97300, Cayenne, France
| | - Ghislaine Prévot
- TBIP, Université de Guyane, 97300, Cayenne, French Guiana; Université de Lille, CNRS, Inserm, CHU Lille, Institut Pasteur de Lille, U1019-UMR9017-CIIL Center for Infection and Immunity of Lille, 59000, Lille, France
| | - Pascal Villa
- Plate-forme de Chimie Biologique Intégrative de Strasbourg UAR 3286 CNRS-Université de Strasbourg, Institut du Médicament de Strasbourg, ESBS Pôle API, Bld Sébastien Brant, 67412, Illkirch Cedex, France
| | - Catherine Vonthron-Sénécheau
- Laboratoire d'Innovation Thérapeutique UMR 7200 CNRS - Université de Strasbourg, Institut du Médicament de Strasbourg, Faculté de Pharmacie, 74 route du Rhin, 67401, Illkirch cedex, France
| | - Guillaume Odonne
- Laboratoire Ecologie, évolution, interactions des systèmes amazoniens (LEEISA), CNRS, Université de Guyane, IFREMER, 97300, Cayenne, French Guiana
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