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The use of antimalarial plants as traditional treatment in Papua Island, Indonesia.

ABSTRACT: The residents of the Eastern part of Indonesia, specifically, Papua and West Papua provinces, are dependent on traditional medicines with the use of plants, which includes treating malaria. However, there are limited information on the diversity of medicinal plants in Papua Island. Hence, the Indonesian Ministry of Health put together a database of all the natural plant-based raw materials in Indonesia, to address part of the issues encountered as a result of the limited information on the diversity of plants. Based on this background, the aim of the research was to analyze the information on medicinal plants used by the traditional healers in Papua Island based on the results of research on medicinal plants and Jamu (RISTOJA), especially in treating malaria. Data were obtained through ethnomedicine research conducted in 2012 and 2017 involving 54 ethnicities in Papua. Based on the results, 72 species of medicinal plants from 67 genera and 40 families were used traditionally in treating malaria on Papua Island. The most common medicinal plants used as traditional antimalarial concoction are Alstonia scholaris (L.) R. Br., Carica papaya L., Andrographis paniculata (Burm. f.) Nees, and Physalis minima L. Similar to other ethnobotany research, the leaves were the most used plant parts in preparing the various traditional concoctions.

SUBMITTER: Budiarti M

PROVIDER: S-EPMC7736719 | biostudies-literature | 2020 Dec

REPOSITORIES: biostudies-literature

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The use of antimalarial plants as traditional treatment in Papua Island, Indonesia.

Budiarti Mery M Maruzy Anshary A Mujahid Rohmat R Sari Aniska Novita AN Jokopriyambodo Wahyu W Widayat Tri T Wahyono Slamet S

Heliyon 20201214 12

The residents of the Eastern part of Indonesia, specifically, Papua and West Papua provinces, are dependent on traditional medicines with the use of plants, which includes treating malaria. However, there are limited information on the diversity of medicinal plants in Papua Island. Hence, the Indonesian Ministry of Health put together a database of all the natural plant-based raw materials in Indonesia, to address part of the issues encountered as a result of the limited information on the diver ...[more]

PMID: 33344788

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Project description:BackgroundPapua Province, Indonesia is experiencing an on-going epidemic of Human Immunodeficiency Virus (HIV) infection, with an estimated 9-fold greater prevalence than the overall national rate. This study reviewed the treatment outcomes of an HIV-infected cohort on Antiretroviral Therapy (ART) and the predictors in terms of immunological recovery and virological response.MethodsART-naïve individuals in a workplace HIV program in southern Papua were retrospectively analyzed. Patients were assessed at 6, 12 and 36 months after ART initiation for treatment outcomes, and risk factors for virological suppression (viral load (VL) <1,000 copies/ml), poor immune response (CD4 <200 cells/mm3) and immunological failure (CD4 <100 cells/ mm3) after at least 6 months on ART, using a longitudinal Generalized Estimating Equations multivariate model.ResultsAssessment of 105 patients were included in the final analysis with a median age of 34 years, 88% male, median baseline CD4 236 cells/ mm3, and VL 179,000 copies/ml. There were 74, 73, and 39 patients at 6, 12, and 36 months follow-up, respectively, with 5 deaths over the entire period. For the three observation periods, 68, 80, and 75% of patents achieved virological suppression, poor immune responders decreased from 15, 16 to 10%, whilst 15, 16, 10% met the immunological failure criteria, respectively. Using multivariate analysis, the independent predictor for viral suppression at 12 and 36 months was ≥1 log decrease in VL at 6 months (OR 19.25, p<0.001). Higher baseline CD4 was significantly correlated with better immunological outcomes, and lower likelihood of experiencing immunological failure (p <0.001).ConclusionVirological response at six months after beginning ART is the strongest predictor of viral suppression at 12 and 36 months, and may help in identifying patients needing additional adherence therapy support. Higher baseline CD4 positively affects the immunological outcomes of patients. The findings indicate HIV control programs should prioritize the availability of VL testing and begin ART regardless of CD4 counts in infected patients.

Project description:BackgroundMaternal Mortality Ratio (MMR) in Indonesia is still high, 305, compared to 240 deaths per 100,000 in South East Asian Region. The use of Traditional Birth Attendance (TBA) as a cascade for maternal health and delivery, suspected to be the pocket of the MMR problem. The study aimed to assess the influence of traditional practices on maternal health services in Indonesia.MethodsWe used two data sets of national surveys for this secondary data analysis. The samples included 14,798 mothers whose final delivery was between January 2005 and August 2010. The dependent variables were utilization of maternal healthcare, including receiving antenatal care (ANC≥4), attended by skilled birth attendance (SBA), and having a facility-based delivery (FBD). The independent variables were the use of traditional practices, type of family structure, and TBA density. We run a Multivariate logistic regression for the analysis by controlling all the covariates.ResultsTraditional practices and high TBA density have significantly inhibited the mother's access to maternal health services. Mothers who completed antenatal care were 15.6% lost the cascade of facility-based delivery. The higher the TBA population, the lower cascade of the use of Maternal Health Services irrespective of the economic quintile. Mothers in villages with a high TBA density had significantly lower odds (AOR = 0.30; CI = 0.24-0.38; p<0.01) than mothers in towns with low TBA density. Moreover, mothers who lived in an extended family had positively significantly higher odds (AOR = 1.33, CI = 1.17-1.52; p<0.01) of using maternal health services.DiscussionNot all mothers who have received proper antenatal delivered the baby in health care facilities or preferred a traditional birth attendance instead. Traditional practices influenced the ideal utilization of maternal health care. Maternal health care utilization can be improved by community empowerment through the maternal health policy to easier mothers get delivery in a health care facility.

Project description:New diagnoses of tuberculosis (TB) present important opportunities to detect and treat HIV. Rates of HIV and TB in Indonesia's easternmost Papua Province exceed national figures, but data on co-infection rates and outcomes are lacking. We aimed to measure TB-HIV co-infection rates, examine longitudinal trends, compare management with World Health Organisation (WHO) recommendations, and document progress and outcome.Adults with newly-diagnosed smear-positive pulmonary TB managed at the Timika TB clinic, Papua Province, were offered voluntary counselling and testing for HIV in accordance with Indonesian National Guidelines, using a point-of-care antibody test. Positive tests were confirmed with 2 further rapid tests. Study participants were assessed using clinical, bacteriological, functional and radiological measures and followed up for 6 months.Of 162 participants, HIV status was determined in 138 (85.2%), of whom 18 (13.0%) were HIV+. Indigenous Papuans were significantly more likely to be HIV+ than Non-Papuans (Odds Ratio [OR] 4.42, 95% confidence interval [CI] 1.38-14.23). HIV prevalence among people with TB was significantly higher than during a 2003-4 survey at the same TB clinic, and substantially higher than the Indonesian national estimate of 3%. Compared with HIV- study participants, those with TB-HIV co-infection had significantly lower exercise tolerance (median difference in 6-minute walk test: 25 m, p = 0.04), haemoglobin (mean difference: 1.3 g/dL, p = 0.002), and likelihood of cavitary disease (OR 0.35, 95% CI 0.12-1.01), and increased occurrence of pleural effusion (OR 3.60, 95% CI 1.70-7.58), higher rates of hospitalisation or death (OR 11.80, 95% CI 1.82-76.43), but no difference in the likelihood of successful 6-month treatment outcome. Adherence to WHO guidelines was limited by the absence of integration of TB and HIV services, specifically, with no on-site ART prescriber available. Only six people had CD4+ T-cell counts recorded, 11 were prescribed co-trimoxazole and 4 received ART before, during or after TB treatment, despite ART being indicated in 14 according to 2006 WHO guidelines.TB-HIV co-infection in southern Papua, Indonesia, is a serious emerging problem especially among the Indigenous population, and has risen rapidly in the last 5 years. Major efforts are required to incorporate new WHO recommendations on TB-HIV management into national guidelines, and support their implementation in community settings.

Dataset Information

The use of antimalarial plants as traditional treatment in Papua Island, Indonesia.

Publications

The use of antimalarial plants as traditional treatment in Papua Island, Indonesia.

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