| Literature DB >> 34149785 |
Adalberto Alves Pereira Filho1, Grasielle C D'Ávila Pessoa1, Lydia F Yamaguchi2, Mariana Alves Stanton2, Artur M Serravite1, Rafael H M Pereira1, Welber S Neves2, Massuo Jorge Kato2.
Abstract
The continuous and indiscriminate use of insecticides has been responsible for the emergence of insecticide resistant vector insect populations, especially in Aedes aegypti. Thus, it is urgent to find natural insecticide compounds with novel mode of action for vector control. The goal of this study was to investigate the larvicidal activity of essential oils (EOs) from Piper species against A. aegypti characterized as resistant and susceptible strains to pyrethroids. The EOs from leaves of 10 Piper species were submitted to the evaluation of larvicidal activity in populations of A. aegypti in agreement with the (World Health Organization, 2005) guidelines. The resistance of the strains characterized by determining the lethal concentrations (LCs) with the insecticide deltamethrin (positive control). The major compounds of the EOs from Piper species was identified by GC-MS. The EOs from Piper aduncum, P. marginatum, P. gaudichaudianum, P. crassinervium, and P. arboreum showed activity of up to 90% lethality at 100 ppm (concentration for screening). The activities of the EOs from these 6 species showed similar LCs in both susceptible strain (Rockefeller) and resistant strains (Pampulha and Venda Nova) to pyrethroids. The major compounds identified in the most active EO were available commercially and included β-Asarone, (E)-Anethole, (E)-β-Caryophyllene, γ-Terpinene, p-Cymene, Limonene, α-Pinene, and β-Pinene. Dillapiole was purified by from EO of P. aduncum. The phenylpropanoids [Dillapiole, (E)-Anethole and β-Asarone] and monoterpenes (γ-Terpinene, p-Cymene, Limonene, α-Pinene, and β-Pinene) showed larvicidal activity with mortality between 90 and 100% and could account for the toxicity of these EOs, but the sesquiterpene (E)-β-Caryophyllene, an abundant component in the EOs of P. hemmendorffii and P. crassinervium, did not show activity on the three populations of A. aegypti larvae at a concentration of 100 ppm. These results indicate that Piper's EOs should be further evaluated as a potential larvicide, against strains resistant to currently used pesticides, and the identification of phenylpropanoids and monoterpenes as the active compounds open the possibility to study their mechanism of action.Entities:
Keywords: Aedes aegypti; Piper; essential oils; insecticide resistance; larvicides; vector control
Year: 2021 PMID: 34149785 PMCID: PMC8213341 DOI: 10.3389/fpls.2021.685864
Source DB: PubMed Journal: Front Plant Sci ISSN: 1664-462X Impact factor: 5.753
Voucher number, sampling site, and yield of essential oil from Piper species.
| K-0057 | Campus–USP | 2.5 | |
| K-0223 | Campus–USP | 1.10 | |
| K-0031 | Serra do Japi | 0.98 | |
| K-0091 | Campus–USP | 1.80 | |
| K-0053 | Campus–USP | 0.74 | |
| K-1086 | Campus–USP | 0.86 | |
| K-0137 | Campus–USP | 0.69 | |
| K-0486 | Campus–USP | 0.70 | |
| K-2325 | Serra do Japi | 0.65 | |
| K-0110 | Serra do Japi | 0.66 |
K (Voucher number Kato-XXXX).
From fresh leaves.
University of São Paulo.
Parque Municipal Serra do Japi, Jundiaí, Brazil.
LC50 and LC95 for the technical grade deltamethrin insecticide (Bayer Brazil, 99.1%) in larvae of Aedes aegypti.
| Rockefeller | 0.16 (0.14–0.189) | 1 | 0.751 (0.55–1.22) | 1 | 3.55 ± 0.45 |
| Venda Nova | 3.65 (3.21–4.08) | 21.94 (18.36–26.23) | 9.905 (8.29–12.80) | 20.51 (14.44–29.12) | 3.79 ± 0.41 |
| Pampulha | 2.94 (2.42–3.47) | 17.67 (14.17–22.02) | 12.590 (9.20–21.13) | 26.07 (16.07–42.28) | 2.60 ± 0.36 |
95% CI, 95% confidence interval; LC.
SRL—susceptibility reference lineage.
Mortality percentage of Aedes aegypti larvae in resistant and susceptible strains to pyrethroids treated with essential oils of Piper species.
| 100.00 | 100.00 | 100.00 | |
| 100.00 | 97.11 | 98.44 | |
| 99.33 | 90.22 | 94.88 | |
| 96.22 | 91.11 | 92.66 | |
| 93.11 | 90.66 | 90.00 | |
| 66.44 | 43.11 | 36.00 | |
| 45.11 | 42.00 | 30.44 | |
| 16.22 | 18.88 | 24.00 | |
| 12.00 | 13.55 | 10.22 | |
| 2.66 | 6.22 | 2.22 | |
Lethal concentrations of essential oil of Piper species against Aedes aegypti larvae resistant and susceptible strains to pyrethroids, during 24 h of exposure.
| Rockefeller | 4.5 ± 0.2 | 23.50 (20.92–26.60) | 45.25 (37.46–62.61) | |
| Venda Nova | 4.2 ± 0.2 | 25.11 (22.92−27.80) | 50.29 (42.37–65.56) | |
| Pampulha | 4.3 ± 0.2 | 26.39 (24.69–28.40) | 52.08 (45.58–62.60) | |
| Rockefeller | 4.3 ± 0.2 | 37.88 (29.58–46.21) | 75.20 (58.19–142.75) | |
| Venda Nova | 5.6 ± 0.3 | 54.01 (49.50–58.95) | 91.41 (79.56–115.2) | |
| Pampulha | 3.9 ± 0.2 | 41.35 (34.57–49.01) | 86.61 (67.51–148.57) | |
| Rockefeller | 4.1 ± 0.2 | 39.91 (34.94–45.11) | 80.85 (66.94–112.42) | |
| Venda Nova | 5.0 ± 0.2 | 41.72 (37.05–46.80) | 87.27 (72.22–120.23) | |
| Pampulha | 4.0 ± 0.2 | 45.77 (43.65–48.05) | 96.06 (87.07–108.70) | |
| Rockefeller | 5.4 ± 0.3 | 51.63 (47.68–55.72) | 89.13 (78.69–108.22) | |
| Venda Nova | 5.6 ± 0.3 | 54.01 (49.50–58.95) | 91.41 (79.56–115.27) | |
| Pampulha | 5.5 ± 0.3 | 56.22 (52.16–60.82) | 96.01 (84.15–118.36) | |
| Rockefeller | 4.9 ± 0.3 | 59.03 (53.36–66.47) | 106.81 (88.43–152.98) | |
| Venda Nova | 5.1 ± 0.3 | 63.55 (58.34–70.79) | 113.21 (95.01–154.04) | |
| Pampulha | 5.1 ± 0.3 | 62.96 (57.94–69.77) | 112.10 (94.58–150.34) |
95% CI, 95% confidence interval; LC50, 50% lethal concentration; LC90, 90% lethal concentration; SD, standard deviation.
Major constituents of the EOs of Piper species.
| Dillapiole (P) | 1632 | 81.01 | |
| Germacrene D (S) | 1484 | 18.58 | |
| δ-Elemene (S) | 1339 | 14.53 | |
| α-Pinene (M) | 932 | 13.95 | |
| β-Pinene (M) | 975 | 12.09 | |
| ( | 1422 | 8.01 | |
| α-Humulene (S) | 1457 | 15.50 | |
| Bicyclogermacrene (S) | 1500 | 13.53 | |
| ( | 1462 | 35.23 | |
| ( | 1286 | 21.67 | |
| Limonene (M) | 1039 | 30.99 | |
| β-Pinene (M) | 975 | 10.08 | |
| ( | 1422 | 9.65 | |
| α-Pinene (M) | 932 | 28.80 | |
| ( | 1566 | 9.2 | |
| 1024 | 8.4 | ||
| α-Pinene (M) | 932 | 61.67 | |
| α-Copaene (S) | 1378 | 6.4 | |
| Limonene (M) | 1039 | 5.3 | |
| α-Pinene (M) | 932 | 16.6 | |
| β-Pinene (M) | 975 | 11.5 | |
| Bicyclogermacrene (S) | 1500 | 10.7 | |
| Bicyclogermacrene (S) | 1500 | 27.47 | |
| ( | 1527 | 21 | |
| β-Myrcene (M) | 992 | 10.7 |
RI, retention index; % rel., relative percentage.
P, Phenylpropanoid; S, Sesquiterpene; M, Monoterpene.
Chemical composition of the essential oils of Piper species.
| α-Pinene | 932 | 932 | 0.2 | 1.0 | 1.5 | 14.0 | – | 0.8 | 3.2 | 28.8 | 61.7 | 16.6 | – |
| Camphene | 947 | 946 | – | – | – | – | – | 0.4 | – | – | 1.7 | 0.1 | 2.2 |
| β-Pinene | 975 | 974 | 0.3 | 0.6 | – | 12.1 | – | 0.7 | 10.1 | 3.0 | 1.4 | 11.5 | – |
| Sulcatone | 989 | 981 | – | – | – | 6.2 | – | – | – | – | – | – | – |
| β-Myrcene | 992 | 988 | – | 1.7 | – | 0.6 | – | – | 0.7 | 5.9 | 0.3 | 1.0 | 10.7 |
| α-Phellandrene | 1,004 | 1,002 | 0.1 | 0.5 | 3.7 | 0.5 | – | – | – | 0.7 | – | 0.2 | 1.4 |
| 2-Carene | 1,010 | 1,008 | 0.1 | 0.7 | – | 1.5 | – | 0.8 | 0.5 | 0.7 | – | 0.2 | 0.1 |
| α-Terpinene | 1,016 | 1,014 | – | 6.8 | – | – | – | – | – | – | – | 4.5 | – |
| 1,024 | 1,020 | 0.1 | 3.0 | 1.5 | 0.5 | – | – | 0.3 | 8.4 | 1.0 | 9.2 | – | |
| Limonene | 1,039 | 1,024 | 0.1 | – | 2.1 | 1.2 | 0.2 | 0.1 | 30.9 | – | 5.3 | 0.8 | 1.9 |
| ( | 1,039 | 1,032 | 1.6 | – | 8.5 | 0.1 | 0.5 | 0.1 | 0.3 | 2.1 | – | 0.1 | 4.6 |
| ( | 1,049 | 1,044 | 3.4 | – | 4.9 | 0.1 | 0.7 | 0.2 | 3.2 | 0.3 | – | 0.3 | – |
| γ-Terpinene | 1,059 | 1,054 | 0.2 | 22.6 | – | 0.1 | – | – | – | – | – | 9.9 | 0.3 |
| α-Terpinolene | 1,088 | 1,086 | 0.4 | 11.5 | – | 0.1 | – | – | 0.1 | – | – | 2.7 | 0.2 |
| 2-Nonanone | 1,092 | 1,087 | – | 3.1 | – | – | – | – | – | – | – | – | – |
| Linalool | 1,100 | 1,095 | – | – | 0.6 | 2.4 | 0.7 | – | – | 2.0 | 1.6 | – | 5.9 |
| ( | 1,117 | 1,114 | – | – | 1.1 | 0.7 | – | – | 0.6 | – | – | 0.3 | – |
| Camphor | 1,144 | 1,141 | – | – | – | – | – | 0.2 | – | – | 1.1 | – | – |
| Terpinen-4-ol | 1,178 | 1,174 | – | – | – | – | – | – | – | – | 0.1 | 0.3 | 1.0 |
| α-Terpineole | 1,191 | 1,186 | – | – | – | 0.6 | 0.4 | – | 0.7 | – | 2.3 | 0.3 | 1.1 |
| Methyl-chavicol | 1,198 | 1,195 | – | – | – | – | – | 0.2 | – | – | – | – | – |
| Oxygenated monoterpene 1 | 1,201 | – | – | – | – | – | 0.1 | – | – | – | – | – | – |
| Oxygenated monoterpene 2 | 1,209 | – | 0.1 | – | – | – | 0.3 | – | – | – | 0.1 | – | – |
| Verbenone | 1,209 | 1,204 | – | – | – | – | – | – | – | – | – | – | – |
| ( | 1,253 | 1,249 | – | – | – | – | – | 6.1 | – | – | – | – | – |
| (+)-Piperitone | 1,255 | 1,249 | 0.7 | – | – | – | – | – | – | – | – | – | – |
| ( | 1,286 | 1,282 | – | – | – | – | – | 21.7 | – | – | – | – | 0.1 |
| Safrole | 1,289 | 1,285 | – | 4.1 | – | – | 1.4 | – | – | – | – | – | – |
| δ-Elemene | 1,339 | 1,335 | 0.1 | 0.5 | 14.5 | 2.1 | 0.6 | – | 0.1 | 1.7 | 1.1 | 0.4 | 1.5 |
| α-Cubebene | 1,352 | 1,345 | – | – | 0.3 | 0.7 | 0.7 | – | 0.3 | – | 0.1 | 0.3 | 1.7 |
| α-Ylanglene | 1,374 | 1,373 | 0.1 | – | – | 1.1 | 0.4 | – | 0.1 | – | – | – | – |
| α-Copaene | 1,378 | 1,374 | 0.2 | – | 1.4 | 2.9 | 2.8 | 1.4 | 4.1 | 0.2 | 6.4 | 2.1 | 0.7 |
| β-Bourbonene | 1,387 | 1,387 | – | 0.5 | 0.3 | 0.5 | 0.1 | 0.2 | – | 2.2 | 0.2 | 0.6 | 2.4 |
| β-Elemene | 1,394 | 1,389 | 0.2 | 0.2 | 1.4 | 1.0 | 1.8 | 0.5 | 0.6 | 3.3 | 0.3 | 4.4 | – |
| ( | 1,404 | 1,408 | – | – | – | – | – | – | 0.5 | – | – | – | – |
| Methyl-eugenol | 1,406 | 1,403 | – | 4.0 | – | – | – | 0.1 | – | – | – | – | – |
| α-Gurjunene | 1,412 | 1,409 | 0.1 | – | – | 0.3 | 0.7 | – | 0.2 | 1.0 | – | 0.1 | 0.2 |
| ( | 1,422 | 1,417 | 0.8 | 0.3 | 8.1 | 8.0 | 4.8 | 2.7 | 9.6 | 0.1 | 0.5 | 7.0 | 2.7 |
| β-Gurjunene | 1,432 | 1,431 | 0.2 | 0.2 | 1.0 | 2.2 | 1.4 | 0.2 | 0.9 | 4.1 | 0.6 | 0.5 | 0.3 |
| α-Guaiene | 1,436 | 1,437 | – | – | 0.4 | 0.2 | 0.8 | – | – | 0.8 | – | – | 0.2 |
| (+)-Aromadendrene | 1,442 | 1,439 | – | – | 0.5 | 1.5 | 4.4 | – | 0.4 | 0.3 | 0.2 | 0.4 | 0.9 |
| α-Himachalene | 1,446 | 1,449 | – | – | – | – | 0.8 | – | – | – | – | – | 0.1 |
| α-Humulene | 1,457 | 1,452 | 0.9 | – | 4.9 | 2.8 | 15.5 | 0.9 | 2.7 | 1.2 | 0.2 | 2.1 | 0.5 |
| Isoosmorhizole | 1,462 | 1,466 | – | – | – | – | – | 15.4 | – | – | – | – | – |
| Croweacin | 1,463 | 1,457 | 1.1 | 10.4 | – | – | – | – | – | – | – | – | – |
| (-)-Alloaromadendrene | 1,464 | 1,458 | – | – | – | 0.4 | – | – | 0.5 | 0.5 | 0.9 | 0.1 | 0.3 |
| Dehydro-aromadendrane | 1,466 | 1,460 | – | – | – | 0.4 | 1.6 | – | – | 1.9 | 0.9 | – | 0.3 |
| γ-Muurolene | 1,480 | 1,479 | – | – | 2.1 | – | 2.8 | 0.1 | 1.3 | 0.8 | 1.3 | 0.5 | 0.2 |
| Germacrene D | 1,484 | 1,481 | 2.7 | 2.1 | 18.6 | – | 4.0 | 0.1 | 2.7 | 2.8 | – | 5.2 | 3.4 |
| β-Selinene | 1,490 | 1,490 | – | – | – | – | 1.2 | 1.1 | 1.0 | – | 0.3 | 0.5 | – |
| α-Selinene | 1,500 | 1,498 | 1.4 | 1.2 | 2.4 | – | – | 0.2 | 1.7 | 2.4 | 0.1 | – | – |
| Bicyclogermacrene | 1,500 | 1,500 | 2.3 | 2.0 | 3.8 | 4.3 | 13.5 | 0.1 | 1.7 | – | – | 10.7 | 27 |
| α-Muurolene | 1,503 | 1,500 | 0.1 | 0.6 | 1.3 | 3.0 | 4.2 | 0.4 | 0.9 | 1.9 | 1.0 | – | 0.5 |
| α-Bulnesene | 1,510 | 1,509 | 0.2 | – | 2.1 | – | – | – | – | 0.4 | – | 0.7 | – |
| ( | 1,512 | 1,517 | – | – | – | – | – | 35.2 | – | – | – | – | – |
| γ-Cadinene | 1,517 | 1,513 | 0.1 | – | – | 5.1 | 5.7 | – | 1.3 | 2.5 | 1.2 | 0.4 | – |
| δ-Cadinene | 1,522 | 1,522 | 1.2 | – | 1.2 | – | – | 1.0 | – | – | – | – | – |
| Myristicin | 1,524 | 1,518 | 1.1 | – | – | – | – | – | – | – | – | – | – |
| ( | 1,527 | 1,533 | – | – | – | 4.3 | 10.1 | – | 7.1 | – | 1.3 | 0.3 | 21 |
| α-Cadinene | 1,537 | 1,537 | – | – | – | – | – | – | – | – | – | – | – |
| Germacrene B | 1,561 | 1,559 | 0.2 | – | 2.1 | 0.4 | 1.2 | – | 0.6 | – | – | 0.1 | – |
| ( | 1,566 | 1,561 | 0.1 | – | 1.0 | 5.2 | 0.6 | – | 0.9 | 9.2 | – | 0.9 | – |
| Palustrol | 1,572 | 1,567 | – | – | – | – | 0.3 | – | 0.3 | – | – | 0.1 | 0.2 |
| γ-Asarone | 1,577 | 1,572 | – | 22.0 | – | – | – | – | – | – | – | – | – |
| Spathulenol | 1,581 | 1,577 | 0.1 | – | 0.3 | 0.2 | 1.9 | – | 0.8 | 2.2 | 0.3 | 0.7 | 3.1 |
| (-)-Caryophyllene oxide | 1,587 | 1,582 | – | – | 0.6 | 0.8 | – | 0.1 | 4.3 | 1.1 | 3.4 | 0.8 | 0.9 |
| Veridiflorol | 1,596 | 1,592 | 0.3 | – | 0.3 | 0.4 | 1.5 | – | 0.3 | 0.7 | 0.5 | 0.6 | 0.9 |
| Guaiol | 1,601 | 1,600 | – | – | – | 5.2 | – | – | – | 1.5 | – | – | 0.9 |
| Humulene epoxide II | 1,613 | 1,608 | – | – | – | – | 1.0 | – | 0.3 | 0.2 | – | – | – |
| β-Asarone | 1,623 | 1,616 | – | – | – | – | – | 0.4 | – | – | 0.3 | – | – |
| Methoxy-4,5-(methylenedioxy)-propiophenone isomer | 1,627 | 1,627 | – | – | – | – | – | 2.3 | – | – | – | – | – |
| Dillapiole | 1,632 | 1,620 | 81.0 | – | 2.2 | 1.7 | – | – | – | – | – | 0.1 | – |
| epi-α-Muurolol | 1,646 | 1,640 | 0.3 | – | 1.5 | 1.1 | 3.2 | – | 1.1 | 1.8 | 0.6 | 0.6 | 0.5 |
| Torreyol | 1,650 | 1,644 | – | – | 0.6 | 3.3 | 2.6 | – | 1.1 | 0.4 | 0.3 | 0.4 | 0.2 |
| α-Cadinol | 1,659 | 1,652 | – | 0.1 | 2.9 | – | 5.3 | – | 1.7 | 3.1 | 0.9 | 1.2 | 0.5 |
| α-Asarona | 1,682 | 1,675 | – | – | – | – | – | 0.9 | – | – | – | – | – |
| Apiole | 1,686 | 1,677 | 0.2 | – | – | – | – | – | – | – | – | – | – |
| 2-Methoxy-4,5-(methylenedioxy)-propiophenone | 1,717 | 1,713 | – | – | – | – | – | 4.7 | – | – | – | – | – |
, Retention Index calculated against C8-C40 n-alkanes on the HP-5 m column;
, Retention index from literature (Adams, ;
Compound identity confirmed with an authentic standard, the remaining compounds were identified by comparing the RI and mass spectra with the Adams and Wiley databases (see text for details).
Compound IR corresponds to those found for Piper marginatum in Andrade et al. (.
Unidentified compounds.
Percentage of dead larvae after 24 h of exposure to major compounds of the studied Piper species at concentration 100 ppm.
| Dillapiole | 100 | 100 | 100 |
| 98.89 | 96.67 | 100 | |
| γ-Asarone | 98.89 | 96.67 | 97.78 |
| ( | 0 | 0 | 0 |
| γ-Terpinene | 94.44 | 93.3 | 100 |
| 91.1 | 92.2 | 90 | |
| Limonene | 100 | 100 | 100 |
| α-Pinene | 90 | 91.1 | 100 |
| β-Pinene | 95.5 | 97.7 | 91.1 |
Evaluation of lethal concentrations of major compounds in Aedes aegypti larvae of resistant and susceptible strains to pyrethroids during 24 h exposure to major compounds of Piper species.
| Dillapiole | Rockfeller | 2.6 ± 0.2 | 15.06 (11.94–18.33) | 46.16 (35.62–68.71) |
| Venda Nova | 2.6 ± 0.2 | 15.75 (12.01–19.74) | 47.96 (35.21–77.11) | |
| Pampulha | 2.6 ± 0.1 | 17.60 (14.24–21.28) | 54.56 (41.77–82.48) | |
| Rockfeller | 4.0 ± 0.3 | 34.41 (25.60–42.10) | 71.03 (54.85–136.85) | |
| Venda Nova | 4.3 ± 0.3 | 38.20 (29.33– 47.26) | 75.39 (57.74–153.58) | |
| Pampulha | 3.9 ± 0.3 | 38.98 (33.57–44.52) | 82.72 (67.24–120.97) | |
| γ-Asarone | Rockfeller | 3.7 ± 0.3 | 32.65 (29.91–35.20) | 71.92 (64.20–83.85) |
| Venda Nova | 3.3 ± 0.1 | 37.85 (34.73–40.96) | 92.52 (79.59–114.69) | |
| Pampulha | 3.3 ± 0.3 | 36.23 (31.02–41.20) | 88.34 (71.06–130.59) | |
| Rockfeller | 2.7 ± 0.2 | 25.29 (21.25–29.30) | 74.77 (59.26–108.25) | |
| γ-Terpinene | Venda Nova | 2.6 ± 0.2 | 24.58 (21.87–27.26) | 76.33 (64.23–96.71) |
| Pampulha | 2.7 ± 0.2 | 25.00 (22.41–27.58) | 72.55 (61.87–89.92) | |
| Rockfeller | 3.6 ± 0.3 | 44.80 (41.23–48.48) | 100.71 (88.53–119.53) | |
| Venda Nova | 3.4 ± 0.3 | 49.25 (45.30–53.52) | 115.51 (99.70–141.21) | |
| Pampulha | 3.5 ± 0.3 | 47.39 (43.60–51.43) | 109.83 (95.47–132.59) | |
| Rockfeller | 3.1 ± 0.2 | 21.86 (18.43–25.33) | 55.02 (45.22–72.76) | |
| Limonene | Venda Nova | 3.2 ± 0.2 | 23.23 (18.76–27.97) | 57.94 (45.53–85.24) |
| Pampulha | 3.0 ± 0.2 | 21.92 (17.01–27.27) | 58.38 (44.19–93.46) | |
| Rockfeller | 4.2 ± 0.2 | 44.17 (37.68–50.50) | 71.92 (74.59–112.61) | |
| α-Pinene | Venda Nova | 4.1 ± 0.2 | 45.17 (37.72–52.43) | 92.52 (76.84–124.16) |
| Pampulha | 3.9 ± 0.2 | 45.70 (39.48–51.80) | 96.49 (82.01–122.45) | |
| β-Pinene | Rockfeller | 2.8 ± 0.1 | 32.97 (26.97–38.92) | 93.11 (75.49–126.12) |
| Venda Nova | 2.8 ± 0.1 | 33.35 (26.31–40.40) | 95.70 (75.13– 138.87) | |
| Pampulha | 2.6 ± 0.1 | 35.13 (26.02–44.53) | 105.59 (78.01–179.01) |
95 % CI, 95% confidence interval; LC.