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 ±â€¯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.

Ethnomedical and ethnobotanical investigations on the response capacities of Guinean traditional health practioners in the management of outbreaks of infectious diseases: The case of the Ebola virus epidemic.

ETHNOPHARMACOLOGICAL RELEVANCE: The recent outbreak of Ebola virus infections has mostly remained confined to the West African countries Guinea-Conakry, Sierra-Leone and Liberia. Due to intense national and international mobilizations, a significant reduction in Ebola virus transmission has been recorded. While international efforts focus on new vaccines, medicines and diagnostics, no coherent national or international approach exists to integrate the potential of the traditional health practitioners (THPs) in the management of infectious diseases epidemics. Nevertheless, the first contact of most of the Ebola infected patients is with the THPs since the symptoms are similar to those of common traditionally treated diseases or symptoms such as malaria, hemorrhagic syndrome, typhoid or other gastrointestinal diseases, fever and vomiting. MATERIALS AND METHODS: In an ethnomedical survey conducted in the 4 main Guinean regions contacts were established with a total of 113 THPs. The socio-demographic characteristics, the professional status and the traditional perception of Ebola Virus Disease (EVD) were recorded. RESULTS: The traditional treatment of the main symptoms was based on 47 vegetal recipes which were focused on the treatment of diarrhea (22 recipes), fever (22 recipes), vomiting (2 recipes), external antiseptic (2 recipes), hemorrhagic syndrome (2 recipes), convulsion and dysentery (one recipe each). An ethnobotanical survey led to the collection of 54 plant species from which 44 identified belonging to 26 families. The most represented families were Euphorbiaceae, Caesalpiniaceae and Rubiaceae. Literature data on the twelve most cited plant species tends to corroborate their traditional use and to highlight their pharmacological potential. CONCLUSIONS: It is worth to document all available knowledge on the traditional management of EVD-like symptoms in order to evaluate systematically the anti-Ebola potential of Guinean plant species.

Ethnobotanical survey on medicinal plants used by Guinean traditional healers in the treatment of malaria.

ETHNOPHARMACOLOGICAL RELEVANCE: The objective of the present study was to collect and document information on herbal remedies traditionally used for the treatment of malaria in Guinea. MATERIALS AND METHODS: The survey was carried out from May 2008 to September 2010 and targeted traditional medical practitioners and herbalists. The questionnaire and oral interviews were based on the standardized model which was prepared by the "Centre de Recherche et de Valorisation des Plantes Médicinales (CRVPM) - Dubréka". RESULTS AND DISCUSSION: A total of 258 people (141 males and 117 females) from which 150 traditional healers and 108 herbalists were interviewed. The age of informants ranged from 28 to 82 years old. 57% (149/258) of the interviewees were more than 50 years old. The respondents had good knowledge of the symptoms of malaria, and a fairly good understanding of the causes. One hundred thirteen plant species were recorded, out of which 109 were identified. They belonged to 84 genera and 46 families. The most frequently cited plants were Vismia guineensis, Parkia biglobosa, Nauclea latifolia, Harungana madagascariensis, Terminalia macroptera, Crossopteryx febrifuga, Terminalia albida, Annona senegalensis, and Nauclea pobeguinii. The leaves were most frequently used (80/113 species), followed by stem bark (38/113 species) and roots (4/113 species). The remedies were mostly prepared by decoction (111 species), followed by maceration (seven species). Only one species was prepared by infusion. CONCLUSION: The present study showed that traditional healers in Guinea have a consistent knowledge of antimalarial plants. Further research should be carried out to compare the anti-malarial activity of the different species, and to check if their use against malaria can be scientifically validated.

Ethnobotanical survey and antibacterial activity of some plants used in Guinean traditional medicine.

A total of 418 healers have been interviewed in Guinea, a coastal country of West Africa, ranging between 7 degrees 30 and 12 degrees 30 of northern latitude and 8 degrees and 15 degrees of western longitude. Plant species used by the local inhabitants to treat infectious diseases were identified using ethnobotanical, ethnographic and taxonomic methods. During these investigations, 218 plants were registered, of which the following were the most frequently used: Erythrina senegalensis, Bridelia ferruginea, Crossopteryx febrifuga, Ximenia americana, Annona senegalensis, Cochlospermum tinctorium, Cochlospermum planchonii, Lantana camara, Costus afer, Psidium guajava, Terminalia glaucescens, Uapaca somon and Swartzia madagascariensis. Most plants, and especially the leaves, were essentially used as a decoction. In order to assess antibacterial activity, 190 recipes were prepared and biologically tested, among which six showed activity (minimal inhibitory concentration<125 microg/ml) against Bacillus cereus, Mycobacterium fortuitum, Staphylococcus aureus, or Candida albicans, i.e., Entada africana, Chlorophora regia, Erythrina senegalensis, Harrisonia abyssinica, Uvaria tomentosa, and a mixture of six plants consisting of Swartzia madagascariensis, Isoberlinia doka, Annona senegalensis, Gardenia ternifolia, Terminalia glaucescens and Erythrina senegalensis.

[Four year management of HIV serology at the National Center of Blood Transfusion in Conakry]. / Bilan de 4 ans de sérologie VIH au Centre national de transfusion sanguine de Conakry.

From January 1997 to December 2000, 21145 blood donations have been collected and tested for anti-HIV antibodies by the National Center of Blood Transfusion of Conakry (NCBT). 347 were positive, confirmed by Western Blot (312 HIV-1, 20 HIV-2 and 15 HIV1-2). HIV seroprevalence in tested blood donations showed a slow decrease by year: 1.87% in 1997 to 1.79% in 2000. The distribution according to donation type was 1% for volunteer donors and 2% for family donors. Seropositivity HIV rates according to sex indicate that the female donors are more infected than male donors. Among 347 seropositive, 83% were more than 20 years old. The seroprevalence is higher in soldier blood donors 3.72% (53/1422) than in student donors 0.55% (43/7712). The number of seropositive results found during these 4 years is not really representative of the HIV spreading infection in Guinean population, but their distribution according to sex and age is very close to the distribution of the AIDS cases in Guinea.

[Prevalence of hypertension in Guinean rural areas]. / Prévalence de l'hypertension artérielle en milieu rural guinéen.

OBJECTIVE: To determine the prevalence and awareness of HTA in Guinean rural populations with respect to age and gender. DESIGN AND SETTING: Cross-sectional survey in rural Guinea: Köpèrè-Döfili (400 inhabitants) and Töbölön (900 inhabitants). PARTICIPANTS: 188 subjects (81 in Köpèrè-Döfili and 107 in Töbölön), 15 years and older were visited in their homes between November 2000 and April 2001. METHODS: The blood pressures were measured with an electronic tensiometer "Philips HF305". Awareness of HTA and risk factors were determined by interviews. HTA was defined as mean SBP/DBP = 140/90 mmHg. RESULTS: Overall, 69% (56/81) in Köpèrè-Döfili and 27% (29/107) in Töbölön were hypertensive. Among these, only 2 (Köpèrè) and 6 patients (Töbölön) were aware of their condition. HTA was strongly gender dependent in Köpèrè where 98% (44/45) of the males were concerned. In Köpèrè-Döfili, the combined systolo-diastolic hypertension (SDH) was predominant (80%; 45/56) and was associated to the male gender (80%; 36/45). In the hypertensive population of Töbölön, the isolated PAD (DH) was mainly associated with the female group (47%, 8/17). The grade III HTA (PAS/PAD > or = 180/110 mmHg) concerned both gender (41%, 18/44 for males; 42%, 5/12 for females) in Köpèrè-Döfili and mainly the female group in Töbölön (29%, 5/17). Smoking was the most frequently associated risk factor in the studied population of Köpèrè-Döfili (70%) and Töbölön (45%). The smokers were predominantly female in Köpèrè-Döfili (89%, 32/36) or male in Töbölön (51%, 24/47). Among the smokers, the hypertensive individuals were 96% (24/25) of the males and 38% (12/32) of the females in Köpèrè, 29% (7/24) of the males and 38% (9/24) of the females in Töbölön. CONCLUSION: Hypertension is highly prevalent in two Guinean rural localities where less than 5% of the studied population were aware of their conditions, suggesting the nationwide demand for preventing and controlling HTA in Guinea.

Cycloabyssinone, a new cycloterpene from Harrisonia abyssinica.

A new cycloterpene, 4beta,14-dimethyl-9,19-cyclo-5alpha,9beta-ergost-24(28)-en-3-one (cycloabyssinone) (1), and a known terpene, 3-friedelanone, were isolated from stem bark of Harrisonia abyssinica and identified by spectroscopic methods.

Steroids from Harrisonia abyssinica.

In addition to the known sterols and ketosteroids beta-sitosterol (24 alpha-ethylcholest-5-en-3 beta-ol), stigmasterol (24 alpha-ethylcholesta-5,22-dien-3 beta-ol), campesterol (24 alpha-methylcholest-5-en-3 beta-ol), beta-sitostenone (stigmast-4-en-3-one, 24 alpha-ethylcholest-4-en-3-one), stigmastenone (stigmasta-4,22-dien-3-one, 24 alpha-ethylcholesta-4,22-dien-3-one), campestenone (24 alpha-methylcholest-4-en-3-one), and stigmasta-3,5-dien-7-one (24 alpha-ethylcholesta-3,5-dien-7-one), the new steroids stigmasta-3,5,22-trien-7-one (24 alpha-ethylcholesta-3,5,22-trien-7-one), and campesta-3,5-dien-7-one (24 alpha-methylcholesta-3,5-dien-7-one) were isolated from the stem bark of Harrisonia abyssinica and identified by NMR and mass spectrometry.

[Malignant tropical malaria in native Africans living in a large city]. / Zlokachestvennaia tropicheskaia maliariia u korennykh afrikantsev, zhitelei krupnogo goroda.

The clinical and laboratory features of severe Plasmodium falciparum-induced malaria were analyzed in 91 adult patients living a large African city. Within a week, 52 patients developed the disease from the manifestations of overall intoxication to the complete picture of severe malaria accompanied by coma. Fifty eight patients were found to be residents of Conakry and 54 of them left the city 2 months before the malaria attack. Eighty one patients had experienced malaria, including 38 patients had 1-2 attacks in the past year. The patients were parenterally treated with quinine in a dose of 750-850 mg of the active ingredient for 24 hours during 4.1 +/- 1.7 days at hospital. In 17 of 34 patients, parasitemia disappeared from single to 5-10 parasites and more in the field of thick drop field, in the other 17 patients it decreased from 5-10 to single parasites at recovery. Twenty four comatose patients died at days 3-8 of hospital stay, most of them had symptoms of oligoanuria. The high cost of hospitalization and specific drugs were the reasons for late referral to hospital and for the use of low daily and course doses of quinine. The necessity of reviewing the principal trends of a national malaria control programme.

[The importance of fluid perfusion for the outcome of the disease in malarial coma due to Plasmodium falciparum in adult Africans]. / Znachenie perfuzii zhidkosti dlia iskhoda bolezni pri maliariinoi kome, vyzvannoi Plasmodium falciparum, u vzroslykh afrikantsev.

Malaria coma induced by P.falciparum was diagnosed in 51 of 390 adult African patients who had been admitted to the therapeutical unit of the Donk Central Hospital and were receiving parenteral quinine at day 1 of the onset of coma. Examining some clinical and laboratory manifestations of malaria coma indicated that fatal outcome was significantly recorded among the patients with severe concomitant anemia and among the patients who had not or had received inadequate liquid parenterally on the first day of coma. The occurrence of acute renal failure in 4 patients with malaria coma resulted in 3 deaths. No great impact on the prognosis of malaria "hyperparasitemia", the severity of fever, the values of blood pressure was found. Whether it is advisable to use the parameters characterizing the opportuneness and scope of health care delivered to patients with severe malaria is discussed.

Triterpenoid saponins from Maesa lanceolata.

Six new homologous triterpenoid saponins were isolated from the methanol extract of the leaves of Maesa lanceolata and characterized as 3 beta-O-[alpha-L-rhamnopyranosyl(1 --> 2)-beta-D-galactopyranosyl (1 --> 3)]-[beta-D-galactopyranosyl(1 --> 2)]-beta-D-glucuronopyranosides alpha-diol, 22 alpha-angeloyloxy-16 alpha-butanoyloxy-13 beta,28-oxydoolean-21 beta,28 alpha-diol, 16 alpha,22 alpha-diangeloyloxy-13 beta,28-oxydoolean-21 beta,-28 alpha-diol, 22 alpha-angeloyloxy-13 beta,28-oxydo-16 alpha-(2-methyl-butanoyloxy)-olean-21 beta,28 alpha-diol, 21 beta-acetoxy-22 alpha-angeloyloxy-13 beta,28-oxydo-16 alpha-propanoyloxyolean-28 alpha-ol, 21 beta-acetoxy-22 alpha-angeloyloxy-16 alpha-butanoyloxy-13 beta,28-oxydoolean-28 alpha-01. The structures were established on the basis of chemical and spectral evidence.

Biological investigations on Harrisonia abyssinica.

Extracts of the bark and the root of Harrisonia abyssinica exhibited in vitro antiviral, antifungal, antibacterial and molluscicidal activities. Bioassay-guided fractionation resulted in the isolation of the active compounds.

Schistosomicidal effects of Pavetta owariensis and Harrisonia abyssinica in mice infected with Schistosoma mansoni.

The schistosomicidal properties of ethanol and acetone extracts of Pavetta owariensis and an ethanol extract of Harrisonia abyssinica were assessed in mice infected with Schistosoma mansoni. Spleen weight, number of adult worms and eggs and size of liver granulomas were the main parameters studied. All P. owariensis extracts containing proanthocyanins were shown to cause a reduction in size of periovular granuloma formation in the liver. This effect was most pronounced with ethanol extracts of both "white bark" and "red bark" varieties of the plant. Acetone extracts of P. owariensis "red bark" variety, containing the highest concentration of proanthocyanins, caused a marked reduction of egg numbers in the liver and intestine whereas the ethanol extract of H. abyssinica proved to be inactive.

In vivo activity of an extract of Pavetta owariensis bark on experimental Schistosoma mansoni infection in mice.

Mice were experimentally infected with Schistosoma mansoni. Comparisons were carried out of total body weight, weight of liver, spleen and left lung, number of adult worms and eggs, and size of liver granulomas between an untreated group and a group treated only with an alcoholic extract of Pavetta owariensis. In the treated group, liver granulomas were smaller for both the acute and chronic infections, indicating a modulation of the granulomatous reaction. A reduction of worm burden, especially of male worms was observed after treatment of chronically infected mice with the same extract.