Prevalence, management and ethnobotanical investigation of hypertension in two Guinean urban districts

ETHNOPHARMACOLOGICAL RELEVANCE

Hypertension is an important public health challenge in low- and middle-income countries, and in many African countries including Guinea medicinal plants are still widely used for its treatment.

MATERIALS AND METHODS

The objective of this study was to determine the prevalence of hypertension in two Guinean urban districts (Pounthioun and Dowsare), to describe its management and to collect information on traditional herbal remedies. A total of 316 participants entered the study, 28.2% (89/316) men and 71.8% (227/316) women. Of these, 181 were from Dowsare (50 men and 131 women) and 135 from Pounthioun (39 men and 96 women). The mean age of subjects was 40.8 ± 14.0 years (range18 - 88years), while the majority of subjects (63.3% or 200/316) were 45-74 years old.

RESULTS

The overall prevalence of hypertension was 44.9% (142/316): 46.4% (84/181) from Dowsare and 43.0% (58/135) from Pounthioun. Ethnobotanical investigations among hypertensive patients led to the collection of 15 plant species, among which Hymenocardia acida leaves and Uapaca togoensis stem bark were the most cited. Phytochemical investigation of these two plant species led to the isolation and identification of isovitexin and isoorientin from H. acida, and betulinic acid and lupeol from U. togoensis.

CONCLUSION

The presence of these constituents in Hymenocardia acida leaves and Uapaca togoensis stem bark may at least in part support their traditional use against hypertension in Guinea.

[Premature delivery: epidemiology, etiologic factors, prevention strategies]

Early delivery is not rare, it is an important cause of perinatal mortality. In this study its rate, was 4.95%. The early and late ages of procreation were particularly interested (7.95%) and 3.90%. The first and last parities were more exposed (7.75%-5.31%). The woman occupation was as an important risk-factor. The incidences increased in the poor and rich women groups (7.34%-3.84%) the early labor risk was reduced when the women had efficient prenatal care; when the women had delivered early, the early labor risk increased. So when the women had delivered a stillborn. The early labor risk factor was more important. Finally the authors founded 83.33% of maternal causes could be controlled by efficient prenatal care. Even this rate was so important in the foetal group causes.

[Maternal morbidity associated with delivery apropos of 124 cases]

In a prospective survey, the authors related 124 cases of maternal traumatic lesions during a child birth. They were apper lesions in 13% of uterine rupture, and lower lesions in 87% cervical vaginal and vulvoperineal ruptures). Adolescent primiparas were the most concerned with an incidence of 9.12% followed by the greater number of multiparas 8.24%. Age, parity, badly or unassisted deliveries were the main factors of risk. For the uterine rupture surgical intervention was preservative in 62% of cases. Suture has been essential in lower lesions. One maternal decease is registered, the foetal forecast is bad (14 foetal decease out of 16) in the uterine rupture. Morbidity was important: 64% in cicatricial perineum, 62% in cicatricial uterine, 37% in hysterectomy. In results, that all the cases of maternal traumatic lesions observed were avoidable. The authors recommended a better pregnancy and delivery care.

[Anemia and pregnancy. Epidemiologic, clinical and prognostic study at the university clinic of the Ignace Deen Hospital, Conakry (Guinee)]

Our intentions were to determine the incidence of the association of anemia and pregnancy, to evaluate maternal and fetal prognosis and to offer some recommendations regarding national health care policies. This prospective study lasting 30 months included all cases of anemia and pregnancy detected by clinical and laboratory examinations. Thus 13,191 women were enrolled in the study but only 1408 cases of anemia and pregnancy (10.67%). Primipara and grand multipara were particularly at risk. Severe forms of anemia and pregnancy were encountered often (51.71%). Maternal and fetal prognoses were very poor. Maternal mortality was 852/100,000, accounting for 65% of the maternal mortality of the department. The stillborn rate was 50 per thousand. This is a serious health problem which needs to be dealt with by a national health education programme.