Effectiveness of Soursop (Annona muricataI) Extract Nanoparticles in Pantyliners on Vaginal Discharge in Childbearing-age women

  • Elyasari Elyasari Department of Midwifery, Faculty of Midwifery, Poltekkes Kemenkes Kendari, Kendari, Indonesia
  • Arsulfa Arsulfa Department of Midwifery, Faculty of Midwifery, Poltekkes Kemenkes Kendari, Kendari, Indonesia
  • Heyrani Heyrani Department of Midwifery, Faculty of Midwifery, Poltekkes Kemenkes Kendari, Kendari, Indonesia
  • Sitti Mukarramah Department of Midwifery, Faculty of Midwifery, Poltekkes Kemenkes Makassar, Makassar, Indonesia
  • Melania Asi Department of Midwifery, Faculty of Midwifery, Poltekkes Kemenkes Kendari, Kendari, Indonesia
Keywords: Women, Childbearing Age, Vaginal Discharge, Soursop Leaves (Annona muricata), Pantyliners

Abstract

Introduction: The treatment of vaginal discharge is pharmacological, such as cyclovir, podoflin 25%, and antiseptic solution for vaginal rinsing, and non-pharmacological, such as Annona muricata decoction. The aim of this study was to analyze the effectiveness of using pantyliners with Annona muricata extract nanoparticles against vaginal discharge in North Konawe Regency.

Methods: This study used a two-group pre-posttest approach and a quasi-experimental design to compare the efficacy of regular pantyliners and pantyliner nanoparticles over a seven-day period. This study surveyed 124 childbearing women aged 15-49 in the North Konawe Regency who experienced vaginal discharge. Participants were those who could read and write, experienced moderate and severe discharge, and participated in ? 2 activities. This study used questionnaires to assess childbearing women's characteristics, knowledge of vaginal discharge, personal hygiene, observation sheets, and standard operating procedures. Wilcoxon, Mann-Whitney, and independent T tests were used.

Results: The analysis revealed a significant difference in the level of vaginal discharge between the intervention and control groups (P = 0.000). However, changes in vaginal discharge differed between the intervention and control groups. The elimination of vaginal discharge was better in the group treated with Annona muricata extract panty than that in the control group.

Conclusion: Annona muricata extract panty effectively reduced vaginal discharge in both the intervention and control groups. However, pantyliners containing Annona muricata extract may be more effective than regular panties.

References

Prasad D, Parween S, Kumari K, Singh N. Prevalence, Etiology, and Associated Symptoms of Vaginal Discharge During Pregnancy in Women Seen in a Tertiary Care Hospital in Bihar. Cureus. 2021;13(1):1–11. https://doi.org/10.7759/cureus.12700

Farida S, Sahlan M, Rohmatin E, Adawiyah R. The beneficial effect of Indonesian propolis wax from Tetragonula sp. as a therapy in limited vaginal candidiasis patients. Saudi J Biol Sci. 2020;27(1):142–6. https://doi.org/10.1016/j.sjbs.2019.06.010

Juniar AD, Simamora AY, Manalu CNP, Cathryne J, Ningsih MTAS. The relationship between level of knowledge and vaginal discharge prevention behavior for nursing student. Rev Bras Enferm. 2023;76(suppl 2):1–8. https://doi.org/10.1590/0034-7167-2022-0602

Mulqie L, Darusman F, Ary Lantika U, Sunendiari S. Training Programs on the Uses and Benefits of Herbal Feminine Hygiene. KnE Life Sciences. 2022;1(12):1–12. https://doi.org/10.18502/kls.v7i5.12502

Santos IL, Rodrigues AM da C, Amante ER, Silva LHM da. Soursop (Annona muricata) Properties and Perspectives for Integral Valorization. Foods. 2023;12(7):1–20. https://doi.org/10.3390/foods12071448

Olude OM, Omoregie FO. Antioxidant potential of ethanol extract of Annona muricata leaves and its inhibitory effect on lipid peroxidation in 1,2-dimethylhydrazine induced colon carcinogenesis. Bio-Research. 2023;21(3):2079–90. https://doi.org/10.4314/br.v21i3.2

Gavamukulya Y, Maina EN, El-Shemy HA, Meroka AM, Kangogo GK, Magoma G, et al. Annona muricata silver nanoparticles exhibit strong anticancer activities against cervical and prostate adenocarcinomas through regulation of CASP9 and the CXCL1/CXCR2 genes axis. Tumor Biology. 2021;43(1):37–55. https://doi.org/10.3233/TUB-200058

Pieme CA, Kumar SG, Dongmo MS, Moukette BM, Boyoum FF, Ngogang JY, et al. Antiproliferative activity and induction of apoptosis by Annona muricata (Annonaceae) extract on human cancer cells. BMC Complement Altern Med. 2014;14(1):1–10. https://doi.org/10.1186/1472-6882-14-516

Usunomena U. Protective effects of Annona muricata ethanolic leaf extract against Dimethylnitrosamine (DMN)-Induced Hepatotoxicity. IOSR J Pharm Biol Sci. 2014;9(4):01–6. https://doi.org/10.9790/3008-09420106

Adelina R, Oktoberia IS, Intan PR. Annona muricata’s Leaves Ethanolic Extract Enhance p53 Expression in Rat Hepatic Cells Induced by Dimethylbenz(a)Anthracene (DMBA). Indonesian Journal of Cancer Chemoprevention. 2013;4(1):483–7. https://doi.org/10.14499/indonesianjcanchemoprev4iss1pp483-487

Astuti Y, Priambodo WJ, Rahmah, Septiyana DA. Overview of wound assay methods extract ethanol leaves soursop (annona muricata) on widr colon cancer cells. Bali Medical Journal. 2021;10(3):1385–9. https://doi.org/10.15562/bmj.v10i3.2979

Selvanathan V, Aminuzzaman M, Tan LX, Win YF, Guan Cheah ES, Heng MH, et al. Synthesis, characterization, and preliminary in vitro antibacterial evaluation of ZnO nanoparticles derived from soursop (Annona muricata L.) leaf extract as a green reducing agent. Journal of Materials Research and Technology. 2022;20(9):2931–41. https://doi.org/10.1016/j.jmrt.2022.08.028

Abd Karim Nzab, Mohd Yusoff Hb, Ul Haq Bhat I, Yusoff F, Asari A, Mohd. Izham Nzb. Green Synthesis And Characterisation Of Magnesium Oxide Nanoparticles Using Annona Muricata Leaves Extract. Universiti Malaysia Terengganu Journal of Undergraduate Research. 2022;4(1):117–30. https://doi.org/10.46754/umtjur.v4i1.265

Hadisaputri YE, Habibah U, Abdullah FF, Halimah E, Mutakin M, Megantara S, et al. Antiproliferation Activity and Apoptotic Mechanism of Soursop (Annona muricata L.) Leaves Extract and Fractions on MCF7 Breast Cancer Cells. Breast Cancer: Targets and Therapy. 2021;13(7):447–57. https://doi.org/10.2147/BCTT.S317682

Permatasanti A, Hidayat W. Potential of Indonesian Herbal as an Anti-Cancer Therapy: A Systemic Review of in vitro Studies. Cancer Manag Res. 2023;15(8):837–50. https://doi.org/10.2147/CMAR.S414457

Ilankoon MPS, Goonewardena CSE, Fernandopulle RC, Perera PPR. Women’s Knowledge and Experience of Abnormal Vaginal Discharge Living in Estates in Colombo District, Sri Lanka. International Journal of Women’s Health and Reproduction Sciences. 2017;5(2):90–6. https://doi.org/10.15296/ijwhr.2017.17

McClellan J. Clinical Relevance Versus Statistical Significance. J Am Acad Child Adolesc Psychiatry. 2017 Dec;56(12):1008–9. https://doi.org/10.1016/j.jaac.2017.09.431

Freidlin B, Korn EL. Methods for Accommodating Nonproportional Hazards in Clinical Trials: Ready for the Primary Analysis? Journal of Clinical Oncology. 2019;37(35):3455–9. https://doi.org/10.1200/JCO.19.01681

Scott IA. Statistical and clinical significance. Medical Journal of Australia. 2017;207(5):187–9. https://doi.org/10.5694/mja16.01148

Abdel-Rahman T, Hussein A-S, Beshir S, Hamed AR, Ali E, El-Tanany SS. Antimicrobial Activity of Terpenoids Extracted from Annona muricata Seeds and its Endophytic Aspergillus niger Strain SH3 Either Singly or in Combination. Open Access Maced J Med Sci. 2019;7(19):3127–31. https://doi.org/10.3889/oamjms.2019.793

Mutakin M, Fauziati R, Fadhilah FN, Zuhrotun A, Amalia R, Hadisaputri YE. Pharmacological Activities of Soursop (Annona muricata Lin.). Molecules. 2022;27(4):1201–12. https://doi.org/10.3390/molecules27041201

Campos LM, Silva TP, de Oliveira Lemos AS, Mendonça Diniz IO, Palazzi C, Novaes da Rocha V, et al. Antibiofilm potential of Annona muricata L. ethanolic extract against multi-drug resistant Candida albicans. J Ethnopharmacol. 2023;315(10):116682–95. https://doi.org/10.1016/j.jep.2023.116682

Campos LM, de Oliveira Lemos AS, de Lima Paula P, da Rocha VN, de Freitas Araújo MG, Tavares GD, et al. Exploring the antifungal potential of Annona muricata leaf extract-loaded hydrogel in treating vulvovaginal candidiasis. Colloids Surf B Biointerfaces. 2024;238(6):113919–29. https://doi.org/10.1016/j.colsurfb.2024.113919

Handayani SI, Sari MIP, Sardjana MS, Kusmardi K, Nurbaya S, Rosmalena R, et al. Ameliorative Effects of Annona muricata Leaf Ethanol Extract on Renal Morphology of Alloxan-Induced Mice. Applied Sciences. 2022;12(18):9141–53. https://doi.org/10.3390/app12189141

Abdallah RH, Al-Saleem MSM, Abdel-Mageed WM, Al-Attar A-SR, Shehata YM, Abdel-Fattah DM, et al. LCMS/MS Phytochemical Profiling, Molecular, Pathological, and Immune-Histochemical Studies on the Anticancer Properties of Annona muricata. Molecules. 2023;28(15):1–18. https://doi.org/10.3390/molecules28155744

Pineda-Ramírez N, Calzada F, Alquisiras-Burgos I, Medina-Campos ON, Pedraza-Chaverri J, Ortiz-Plata A, et al. Antioxidant Properties and Protective Effects of Some Species of the Annonaceae, Lamiaceae, and Geraniaceae Families against Neuronal Damage Induced by Excitotoxicity and Cerebral Ischemia. Antioxidants. 2020;9(3):1–19. https://doi.org/10.3390/antiox9030253

Zeweil MM, Khafaga AF, Mahmoud SF, Wasef L, Saleh H, Elrehim AttaaMA, et al. Annona Muricata L. extract restores renal function, oxidative stress, immunohistochemical structure, and gene expression of TNF-?, IL-?1, and CYP2E1 in the kidney of DMBA-intoxicated rats. Front Pharmacol. 2024;15(2):1–16. https://doi.org/10.3389/fphar.2024.1348145

Suganda Y, Gusmadewi, Rahmatul Ulya, Mekar Zenni Radhia. The Effect of Infusing Soursop Leaves (Annona muricata L.) on Vaginal Discharge in Women of Childbearing Age: A Randomized Clinical Trial at the Lolo Community Health Center, Kerinci Regency, Jambi, Indonesia. Sriwijaya Journal of Obstetrics and Gynecology. 2024;2(2):82–91. https://doi.org/10.59345/sjog.v2i2.146

Fatmawati Z, Rustanti E. The Effectiveness of Crocatum Piper and Annona Muricata L Leaves Toward Leukorrhea in Hormonal Contraception Acceptors in the Working Area of Regional Public Service Agencies of Public Health Center in Tembelang. In: Proceedings of the 2nd Borobudur International Symposium on Humanities and Social Sciences, BIS-HSS 2020, 18 November 2020, Magelang, Central Java, Indonesia. EAI; 2021. p. 1–12. https://doi.org/10.4108/eai.18-11-2020.2311737

Pacheco-Quito E-M, Ruiz-Caro R, Rubio J, Tamayo A, Veiga M-D. Carrageenan-Based Acyclovir Mucoadhesive Vaginal Tablets for Prevention of Genital Herpes. Mar Drugs. 2020;18(5):249–68. https://doi.org/10.3390/md18050249

Schwameis R, Ganhoer-Schimboeck J, Hadjari VL, Hefler L, Bergmeister B, Küssel T, et al. TRICIN: A Phase II Trial on the Efficacy of Topical TRIchloroacetic Acid in Patients with Cervical Intraepithelial Neoplasia. Cancers (Basel). 2022;14(23):5991–5611. https://doi.org/10.3390/cancers14235991

Obiero J, Rulisa S, Ogongo P, Wiysonge CS. Nifuratel-Nystatin combination for the treatment of mixed infections of bacterial vaginosis, vulvovaginal candidiasis, and trichomonal vaginitis. Cochrane Database of Systematic Reviews. 2018;4(1):1–20. https://doi.org/10.1002/14651858.CD013012

Hsin YK, Thangarajoo T, Choudhury H, Pandey M, Meng LW, Gorain B. Stimuli-Responsive in situ Spray Gel of Miconazole Nitrate for Vaginal Candidiasis. J Pharm Sci. 2023;112(2):562–72. https://doi.org/10.1016/j.xphs.2022.09.002

Mirzaeei S, Zangeneh M, Veisi F, Parsa S, Hematti M. Chlorhexidine, clotrimazole, metronidazole and combination therapy in the treatment of vaginal infections. J Med Life. 2021;14(2):250–6. https://doi.org/10.25122/jml-2019-0160

Sheppard C. Treatment of vulvovaginitis. Aust Prescr. 2020;43(6):195–7. https://doi.org/10.18773/austprescr.2020.055

Haas DM, Morgan S, Contreras K, Kimball S. Vaginal preparation with antiseptic solution before cesarean section for preventing postoperative infections. Cochrane Database of Systematic Reviews. 2020;2020(4):1–68. https://doi.org/10.1002/14651858.CD007892.pub7

Kumwenda P, Cottier F, Hendry AC, Kneafsey D, Keevan B, Gallagher H, et al. Estrogen promotes innate immune evasion of Candida albicans through inactivation of the alternative complement system. Cell Rep. 2022;38(1):110183–200. https://doi.org/10.1016/j.celrep.2021.110183

Stanton A, Mowbray C, Lanz M, Brown K, Hilton P, Tyson-Capper A, et al. Topical Estrogen Treatment Augments the Vaginal Response to Escherichia coli Flagellin. Sci Rep. 2020;10(1):8473–88. https://doi.org/10.1038/s41598-020-64291-y

Romeo M, D’Urso F, Ciccarese G, Di Gaudio F, Broccolo F. Exploring Oral and Vaginal Probiotic Solutions for Women’s Health from Puberty to Menopause: A Narrative Review. Microorganisms. 2024;12(8):1614–22. https://doi.org/10.3390/microorganisms12081614

Mei Z, Li D. The role of probiotics in vaginal health. Front Cell Infect Microbiol. 2022;12(7):1–12. https://doi.org/10.3389/fcimb.2022.963868

Liu P, Lu Y, Li R, Chen X. Use of probiotic lactobacilli in the treatment of vaginal infections: In vitro and in vivo investigations. Front Cell Infect Microbiol. 2023;13(4):1–17. https://doi.org/10.3389/fcimb.2023.1153894

Edet UO, Nwaokorie FO, Mbim EN, Asanga EE, Agbor YO, Okoroiwu HU, et al. Evaluation of Annona muricata extract against Staphylococcus aureus isolate and in-silico activity of bioactive compounds against Capsular protein (Cap5O). BMC Complement Med Ther. 2022;22(1):192–204. https://doi.org/10.1186/s12906-022-03672-4

Afzaal M, Saeed F, Asghar A, Shah YA, Ikram A, Ateeq H, et al. Nutritional and Therapeutic Potential of Soursop. J Food Qual. 2022;2022(8):1–9. https://doi.org/10.1155/2022/8828358

Meza-Gutiérrez NN, Magallón-Servín P, Balois-Morales R, Pérez-Ramírez IF, López-Guzmán GG, Berumen-Varela G, et al. Growth Promoting Activity of Annona muricata L. Leaf Extracts on Lactobacillus casei. Plants. 2022;11(5):581–93. https://doi.org/10.3390/plants11050581

Abdul Wahab SM, Jantan I, Haque MdA, Arshad L. Exploring the Leaves of Annona muricata L. as a Source of Potential Anti-inflammatory and Anticancer Agents. Front Pharmacol. 2018;9(6):1–20. https://doi.org/10.3389/fphar.2018.00661

Arnaud K, Nicodème C, Durand D-N, Martial N, Basile S, Haziz S, et al. Antioxidant, Anti-Inflammatory Efficacy and HPLC Analysis of <i>Annona muricata</i> Leaves Extracts from Republic of Benin. Am J Plant Sci. 2020;11(06):803–18. https://doi.org/10.4236/ajps.2020.116057

Balderrama-Carmona AP, Silva-Beltrán NP, Gálvez-Ruiz J-C, Ruíz-Cruz S, Chaidez-Quiroz C, Morán-Palacio EF. Antiviral, Antioxidant, and Antihemolytic Effect of Annona muricata L. Leaves Extracts. Plants. 2020;9(12):1650–66. https://doi.org/10.3390/plants9121650

Othman L, Sleiman A, Abdel-Massih RM. Antimicrobial Activity of Polyphenols and Alkaloids in Middle Eastern Plants. Front Microbiol. 2019;10(5):1–14. https://doi.org/10.3389/fmicb.2019.00911

Pai BM. Anti-microbial Efficacy of Soursop Leaf Extract ( Annona muricata ) on Oral Pathogens: An In-vitro Study. Journal Of Clinical And Diagnostic Research. 2016;10(11):1–4. https://doi.org/10.7860/JCDR/2016/18329.8762

Lekjing S, Venkatachalam K, Charoenphun N, Noonim P. Effect of Different Drying Methods on the Phytochemical and Antioxidant Properties of Soursop Leaves at Two Stages of Maturity. ACS Omega. 2024;2024(9):40095–109. https://doi.org/10.1021/acsomega.4c06071

Abdul-Hammed M, Olaide IA, Adegoke HM, Olajide M, Osilade OJ, Afolabi TI, et al. Antifungal Activities of Phytochemicals from Annona muricate (Sour Sop): Molecular Docking and Chemoinformatics Approach. Majalah Obat Tradisional. 2022;27(3):218–30. https://doi.org/10.22146/mot.77380

Nayak A, Hegde K. A Comprehensive Review on the Miracle Nature of Annona muricata Linn. Rajiv Gandhi University of Health Sciences Journal of Pharmaceutical Sciences. 2021;11(1):1–8. https://doi.org/10.26463/rjps.11_1_6

Putri DN, Widyarti S, Jatmiko YD. Increasing antioxidant activity of soursop (Annona muricata L.) and noni (Morinda citrifolia L.) leaves fermented by Lactobacillus plantarum BP102. Berkala Penelitian Hayati. 2022;27(2):73–7. https://doi.org/10.23869/bphjbr.27.2.20223

Adegoke Caleb Oladele, Adeleke Adekola Olumayowa, Ogunbanwo Samuel Temitope. Phytochemical and antimicrobial activity of ethnomedicinal leaf extract of selected plants in Nigeria. World Journal of Advanced Research and Reviews. 2020;7(1):253–62. https://doi.org/10.30574/wjarr.2020.7.1.0256

Published
2026-07-01
How to Cite
Elyasari Elyasari, Arsulfa, A., Heyrani Heyrani, Sitti Mukarramah, & Melania Asi. (2026). Effectiveness of Soursop (Annona muricataI) Extract Nanoparticles in Pantyliners on Vaginal Discharge in Childbearing-age women. Journal of Public Health and Pharmacy, 6(2), 228-240. https://doi.org/10.56338/jphp.v6i2.6318
Section
Articles