Environmental Heavy Metal Contamination from Electronic Waste (E-Waste) Recycling Activities Worldwide: A Systematic Review from 2005 to 2017.

The recycling of electronic waste (e-waste) contaminates ecosystems with metals, though a compilation of data from across sites worldwide is lacking, without which evidence-based comparisons and conclusions cannot be realized. As such, here, a systematic review of the literature was conducted to identify peer-reviewed studies concerning e-waste sites (published between 2005 and 2017) that reported on the concentration of heavy metals (Cd, Hg, As, Pb and Cr) in soil, water and sediment. From 3063 papers identified, 59 studies from 11 countries meeting predefined criteria were included. Reported metal concentrations were summarized, and a narrative synthesis was performed. This review summarized 8286 measurements of the aforementioned metals in soils (5836), water (1347) and sediment (1103). More than 70% of the studies were conducted in Asia. In nearly all cases, the average metal concentrations in a particular medium from a given site were above guideline values; suggesting soils, water and sediment at, or near, e-waste recycling sites are contaminated. Across all media, concentrations of Pb were generally highest, followed by Cr, As, Cd and Hg. The synthesized information demonstrates that e-waste sites worldwide are contaminated with metals, that geographic data gaps exist, that the quality of most studies can be improved and that action is needed to help reduce such levels to protect human health and the environment.

Comparison of motorcycle taxi driver's respiratory health using an air quality standard for carbon monoxide in ambient air: a pilot survey in Benin.

INTRODUCTION: Ambient air quality standards are not designed to protect people occupationally exposed to outdoor air pollution on a routine basis. This study aimed to assess the effect of exceeding the US ambient air quality standard for carbon monoxide (CO) on motorcycle taxi drivers respiratory health. METHODS: A cross-sectional study of 85 current motorcycle taxi drivers with at least 5 years of job tenure in Cotonou (Benin) was conducted. Personal CO was measured with a portable CO data logger for 8 hours per day during working hours. A questionnaire on respiratory symptoms was administered to participants and spirometry was performed. Participants were divided into two groups, those with exposure to CO >9 ppm and ≤9 ppm, according to the US Environmental Protection Agency (EPA) National Ambient Air Quality Standard which is an 8-hour average of 9ppm. 8 and 10 ppm were also used an exposure limit. Analysis was done using these two groups. RESULTS: Socio-demographic characteristics were well balanced between the two study groups. The drivers with a CO exposure of more than 9ppm had non-significantly more respiratory symptoms (OR=1.67; 95%CI:0.26,10.74), lower FVC and FEV1 compared to the less exposed group but they have a significant lower PEF (-10%, p=0.02). When we used an exposure limit of 8 or 10 ppm the results were not statistically different. CONCLUSION: Drivers with a CO exposure >9 ppm tend to have more respiratory problems. More research is needed to reinforce this result in order to improve air quality standards to protect workers occupationally exposed to outdoor air pollution.

Health Risks Associated with Occupational Exposure to Ambient Air Pollution in Commercial Drivers: A Systematic Review.

Ambient air pollution is a major global health problem and commercial drivers are particularly exposed to it. As no systematic assessment of the health risks associated with occupational exposure to ambient air pollution in this population had yet been carried out, we conducted a systematic review using a protocol-driven strategy. Papers published from inception to April 20, 2018 in MEDLINE, EMBASE, CINAHL, African journals online, the Cochrane library, ISRCTN WHO ICTRP, and the Web of Science and Scopus databases were screened for inclusion by two independent reviewers. Original articles with at least an available abstract in English or French were included. The initial search retrieved 1454 published articles of which 20 articles were included. Three studies reported a significant difference in white blood cells (106/L) among commercial motorcyclists compared to rural inhabitants (5.041 ± 1.209 vs. 5.900 ± 1.213, p = 0.001), an increased risk of lung cancer (RR = 1.6, 95%CI 1.5⁻1.8) in bus drivers and an increased standardized mortality ratio (SMR) in bus drivers from Hodgkin's lymphoma (SMR 2.17, 95%CI 1.19⁻3.87) compared to white-collar workers. Other studies also found that drivers had more oxidative DNA damage and chromosome breaks. Four papers failed to demonstrate that the drivers were more exposed to air pollution than the controls. Three other studies also reported no significant difference in lung function parameters and respiratory symptoms. The genetic polymorphisms of detoxifying enzymes were also not homogeneously distributed compared to the controls. There is some evidence that occupational exposure to ambient air pollution among commercial drivers is associated with adverse health outcomes, but the existing literature is limited, with few studies on small sample size, methodological weaknesses, and contradictory findings-thus, further research is recommended.

[Occupational risk factors and perceptions of air pollution by motorcycle taxi drivers in Cotonou, Benin]. / Facteurs de risque professionnel et perceptions de la pollution de l'air chez les taxis motoristes à Cotonou, Bénin.

INTRODUCTION: Motorcycle taxis occupy a major place in urban transport. Motorcycle taxi drivers are exposed to occupational risk factors (ORF) including air pollution. The objective of this study was to evaluate these ORF among motorcycle taxi drivers and their perceptions of air pollution. METHODS: This mixed study was conducted on motorcycle taxi drivers in Cotonou. The qualitative study was based on focus groups concerning 16 items from the Participatory Occupational Risk Screening Guide (DEPARIS) until saturation and after triangulation of data. The quantitative study consisted of administering a questionnaire addressing socioeconomic and demographic characteristics, cardiopulmonary diseases, and perception of air -pollution risk factors among 397 Cotonou motorcycle taxi drivers. RESULTS: Drivers perceived poor road conditions, effort and handling, and lack of social security as unsatisfactory ORF. Their mean age was 40.95 ± 8.75 years and 45.84% had primary -education. They had been working as motorcycle taxi drivers for an average of 134.95 ± 101.53 months with an average income of FCFA 3138 ± 1238. These occupational factors were significantly associated with cardiopulmonary disorders, observed in 63.2% of drivers. Less than 1/3 of drivers felt that air pollution affected their personal health. CONCLUSION: Motorcycle taxi drivers have a poor perception of ORF and the severity of exposure to air pollution in this occupation. There is a need to take action to promote the health of this population.

Prévalence des accidents d'exposition au sang et facteurs associés chez les professionnels de santé à l'hôpital de zone de Menontin, Bénin

Introduction: Les accidents d'exposition au sang (AES) constituent une réelle préoccupation pour les professionnels de santé à cause de la gravité des affections qu'ils engendrent. La présente étude a été menée pour évaluer la fréquence des accidents d'exposition au sang (AES) au sein du personnel de l'hôpital de zone de Mènontin et les facteurs qui lui sont associés. Méthode d'étude : Enquête descriptive transversale et analytique incluant 90 agents de santé. Le recueil des données a été fait sur la base d'un questionnaire anonyme et de deux grilles d'observation. Le questionnaire a été remis à chaque agent de santé volontaire après explication des objectifs de l'étude. Une visite de tous les services a été réalisée pour compléter les grilles d'observation. Résultats : L'âge moyen de notre échantillonnage est de 37 ans ± 10. Les femmes ont représentées dans 70% de notre échantillonnage et le sexe ratio est de 0,42.Les infirmiers (32,2%), les techniciens de laboratoire (25,56%) et les aidessoignants (16,7%) étaient les classes professionnelles plus représentées. La fréquence des AES chez les professionnels de santé à l'hôpital de zone de Mènontin est de 40%. Les types d'AES les plus fréquents sont les piqures (44,4%), les projections sur muqueuse (25%) et les coupures (16,7%).le sang a été impliqué dans 86,11% des cas. Les mécanismes de survenue des AES répertoriés étaient essentiellement le recapuchonnage (66,7%) et l'élimination de déchets (25%). L'absence de formation sur les AES et de port de gants influence significativement la survenue des AES. Les AES n'ont pas été déclarés dans 66,7% des cas. Les mesures de prévention et de prise en charge des AES sont inexistantes au sein de l'hôpital de zone de Mènontin. Conclusion : Des séances de sensibilisation du personnel sur les risques liés aux AES s'imposent en vue de leur prévention

Allergies respiratoires professionnelles liées à l'exposition à la poussière de farine de blé: cas de 05 boulangeries de la ville de Porto-novo

Objectif : Prévenir les allergies respiratoires professionnelles chez les travailleurs exposés à la poussière de farine de blé dans les boulangeries de la ville de Porto-Novo. Méthode : Il s'est agi d'une étude transversale descriptive conduite d'Octobre à Décembre 2014 dans 5 boulangeries de la ville de Porto-Novo. A travers un échantillonnage à deux degrés, nous avons sélectionné d'une part de façon aléatoire 5 boulangeries des 32 de la ville et d'autre part de façon exhaustive recruter 51 travailleurs des 5 boulangeries. Il a été procédé à un examen physique (auscultation pulmonaire et examen oto-rhinolaryngologique) systématique de tous les travailleurs interviewés. Analyse des données : Les données ont été enregistrées et analysées avec le logiciel EPI info version 3.5.3. Les résultats obtenus ont été compilés dans des tableaux de fréquence simple. Résultats : La grande majorité des travailleurs sont de sexe masculin (90,2%). La plupart des travailleurs ont un âge compris dans la tranche de 31 et 50 ans (47,1%) et une ancienneté comprise entre 1 à 9 ans (47,2%). Les travailleurs sont concentrés au niveau des postes de : façonnage (68,7%), pétrissage (49,1%) et enfournage (39,2%). Les procédés et pratiques générateurs d'importantes poussières selon les travailleurs sont : le fleurage (88%), la vidange des sacs à farine dans le pétrin (80%), l'usage du balai pour le nettoyage (41,2%) et le pétrissage (19,6).. Les symptômes respiratoires dont se plaignent souvent les travailleurs sont : éternuement (82,4%), rhume/écoulement nasal (58,8%), toux (37%) et bronchorrhée (27,5%). Ces symptômes apparaissent chez les travailleurs le plus souvent après un délai d'exposition compris entre 1 et 9 ans et plus de la moitié des cas (57,1%) dans la tranche d'âge de 31-50ans. 2/3 des cas d'asthme sont survenus chez les travailleurs dans cette fourchette d'âge. Conclusion : La farine est désormais reconnue comme étant le premier allergène professionnel. Il s'avère important d'adopter une démarche de prévention adéquate du risque qu'elle constitue afin de garantir la santé et la sécurité aux travailleurs

[Capacity of response of the health system to the expectations of populations in zones exposed to results-based financing in Benin in 2015]. / Capacité de réponse du système de santé aux attentes des populations dans les zones exposées au financement basé sur les résultats au Bénin en 2015.

Introduction: The increased use of results-based financing (RBF) services was the basis for this study designed to evaluate the contribution of RBF to the capacity of response of the health system to the population's expectations. Methods: This study, conducted in six Benin health zones randomly selected in two strata exposed to RBF (FBR_PRPSS and FBR_PASS) and one zone not exposed to RBF (Non_FBR), examined the seven dimensions of reactivity. A score, followed by weighting of their attributes, was used to calculate the index of reactivity (IR). Results: Sixty-seven health care units and 653 people were observed and interviewed. The FBR_PRPSS and FBR_PASS strata, managed by the new provisions of RBF, displayed good performances for the "rapidity of management" (70% and 80%) and "quality of the health care environment" dimensions, with a more marked improvement for the PRPSS model, which provides greater resources. Poor access to social welfare networks in the three strata led to renouncing of health care. The capacity of response to expectations was moderate and similar in the Non_FBR (IR = 0.53), FBR_PASS (IR = 0.62) and FBR_PRPSS (IR = 0.61) strata (p > 0.05). Conclusion: The FBR_PRPSS and FBR_PASS models have a non-significant effect on the capacity of response. Their success probably depends on the health system context, the combination of targeted interventions, such as universal health insurance, but also the importance and the use of the new resources that they provide.

Exhaled carbon monoxide: a non-invasive biomarker of short-term exposure to outdoor air pollution.

BACKGROUND: In urban settings of Africa with rapidly increasing population, traffic-related air pollution is a major contributor to outdoor air pollution (OAP). Although OAP has been identified as a leading cause of global morbidity and mortality, there is however, lack of a simple biomarker to assess levels of exposure to OAP in resource-poor settings. This study evaluated the role of exhaled carbon monoxide (exhCO) as a potential biomarker of exposure to ambient carbon monoxide (ambCO) from OAP. METHODS: This was a descriptive study conducted among male commercial motorcycle riders in Cotonou - the economic capital of Benin. The participants' AmbCO was measured using a portable carbon monoxide (CO) data logger for 8 h during the period of their shift. ExhCO was measured just before and immediately after their shift (8-h) Participants were asked not to cook or to smoke during the day of the measurements. Linear regression analysis was used to assess the association between ambCO and exhCO for the last 2, 4 and 6 h of their shift. RESULTS: Of 170 participants who completed the study, their mean ± SD age was 42.2 ± 8.4 years, and their mean ± SD daily income was 7.3 ± 2.7$. Also, 95% of the participants' used solid fuels for cooking and only 2% had ever smoked. Average exhCO increased by 5.1 ppm at the end of the shift (p = 0.004). Post-shift exhCO was significantly associated to ambCO, this association was strongest for the last 2 h of OAP exposure before exhCO measurement (ß = 0.34, p < 0.001). CONCLUSION: ExhCO level was associated with recent exposure to ambCO from OAP with measurable increase after 8 h of exposure. These findings suggest that ExhCO may be a potential biomarker of short-term exposure to OAP.

[Researches' Institutional Framework in Three Sub-Saharan African Countries]. / Chapitre 4. Encadrement institutionnel de la recherche dans trois pays d?Afrique subsaharienne.

This paper presents the overview of the legal and institutional frameworks of research with human beings in sub-Saharan Africa, in particular in Benin, Cameroon and Nigeria. Concerning the methodology, a literature review focused on the regulations of institutional frameworks was done. Then, 28 semi-structured interviews were conducted with members of ethics committees to assess their composition and their mode of operation. Finally, we describe the existing courses in research ethics included in programs of first, second and third cycles in major universities from concerned countries.Concerning structures, all countries have normative and functional ethics committees concerned with the basics of ethics in health research. However, these ethics committees face several challenges including the lack of funding, deficiencies in the training of their members and the application of the ethical evaluation to qualitative and mixed researches.

[Quality of the information system and of the effectiveness of public health interventions in the areas in Benin experiencing performance-based financing approach in 2014]. / Qualité du système d'information et de suivi des interventions en santé dans les zones exposées au financement basé sur les résultats en 2014 au Bénin.

INTRODUCTION: Performance-based financing (PBF) approach is a public health intervention, whose effects on the pillars of this system are often not measured, especially with regard to the information system and to the effectiveness of public health interventions. METHODS: Our cross-sectional study was conducted in Benin in 67 health units randomly drawn from two PBF_HSS (Health Systems Strengthening) health zones and two PBF_NHSSP (Health Sector Support Program) areas, all experiencing PBF, and from two areas where the PBF had not been implemented. It allowed to evaluate the quality of the information and the effectiveness of public health interventions. The quality index and the performance scores of the system components were used to compare the strata covered by the PBF and the noncovered strata. RESULTS: The quality of the information system and of the effectiveness of public health interventions was average in the three strata, with a higher quality index in the PBF_HSS (77%) and PBF_NHSSP (74%) strata than in the Non_PBF (67%) strata. Health system quality distribution was more favorable in the strata covered by PBF. The components achieving a good performance were "demographic information", "results and essential analyzes" and "statistic support archiving". However, the essential components of the PBF and of the information system were "supervision" and "reporting" that continued to have an average QI two years after the beginning of the intervention. CONCLUSION: The average quality of the information system and of the effectiveness of public health interventions could be improved by respecting the instructions of the PBF, especially when the quality of this system becomes a priority for the PBF.

Biomonitoring of 29 trace elements in whole blood from inhabitants of Cotonou (Benin) by ICP-MS.

This study aimed to investigate the blood concentration of 29 trace elements, metals or metalloids, in a healthy population of Cotonou not directly exposed to metals in order to propose reference values. Blood samples from 70 blood donors were collected in K2 EDTA tubes for trace elements during September 2015 and a questionnaire was used to assess lifestyle exposure. Blood metal concentrations were determined by inductively coupled plasma mass spectrometry (ICP-MS) equipped with a quadrupole-based reaction cell. Among the selected blood donors 51.4% were aged from 18 to 36 years and 49.6% from 37 to 65 years. Among the 29 elements analyzed As, Pb, Mn, Pd, Sb, Co, Se, Sr showed blood concentrations higher than the reference values found in the literature for non-exposed healthy European populations and their geometric means were respectively 5.81; 47.39; 19.71; 1.91; 7.50; 0.66; 163.01; 30.53µg/L. This study provides the first reference value (5th-95th percentiles) for each element in Cotonou, which enables us to carry out further investigations on environmental and occupational exposure.

Cotton Dust Exposure and Respiratory Disorders among Textile Workers at a Textile Company in the Southern Part of Benin.

The textile industry sector occupies a prominent place in the economy of Benin. It exposes workers to several occupational risks, including exposure to cotton dust. To assess the effect of exposure to cotton dust on the health of workers, this study was initiated and conducted in a Beninese cotton industry company. The objective of the study was to evaluate the respiratory disorders among the textile workers exposed to cotton dust and the cross-sectional study involved 656 subjects exposed to cotton dust and 113 non-exposed subjects. The methods used are mainly based on a survey using a questionnaire of organic dust designed by the International Commission of Occupational Health (ICOH); and on the measures of lung function parameters (FEV1 and FVC). The main results of the different analyzes revealed that subjects exposed to cotton dust have more respiratory symptoms than unexposed subjects (36.9% vs. 21.2%). The prevalence of chronic cough, expectorations, dyspnoea, asthma and chronic bronchitis are 16.8%, 9.8%, 17.3%, 2.6%, and 5.9% respectively among the exposed versus 2.6%, 0.8%, 16.8%, 0% and 0.8% among the unexposed subjects. The prevalence of byssinosis is 44.01%.The prevalence of symptoms is dependent on the sector of activity and the age of the subject. These results should encourage medical interventions and technical prevention especially since the textile industry occupies an important place in the Benin's economy.

Occupational and Environmental Health Risks Associated with Informal Sector Activities-Selected Case Studies from West Africa.

Most in the Economic Community of West African States region are employed in the informal sector. While the informal sector plays a significant role in the region's economy, policymakers and the scientific community have long neglected it. To better understand informal-sector work conditions, the goal here is to bring together researchers to exchange findings and catalyze dialogue. The article showcases research studies on several economic systems, namely agriculture, resource extraction, transportation, and trade/commerce. Site-specific cases are provided concerning occupational health risks within artisanal and small-scale gold mining, aggregate mining, gasoline trade, farming and pesticide applications, and electronic waste recycling. These cases emphasize the vastness of the informal sector and that the majority of work activities across the region remain poorly documented, and thus no data or knowledge is available to help improve conditions and formulate policies and programs to promote and ensure decent work conditions.

A cross-sectional study with an improved methodology to assess occupational air pollution exposure and respiratory health in motorcycle taxi driving.

INTRODUCTION: Motorcycle taxi driving is common in many African cities. This study tested whether this occupation is associated with more respiratory disorders in a context of widespread urban air pollution with an improved methodology. METHODS: In a cross sectional study we compared 85 male motorcycle taxi drivers in the capital city of the Republic of Benin (Cotonou) with an age and neighborhood matched control group. All participants carried a portable carbon monoxide data logger for 8 hours per day to assess exposure to air pollution. Respiratory symptoms were obtained using a standardized questionnaire and pulmonary function was assessed by spirometry. RESULTS: The two groups did not differ significantly (p>0.10) in their age, height, educational level, and exposures to smoke from biomass fuels and tobacco products. The taxi drivers were exposed to higher mean (SD) levels of carbon monoxide (7.6±4.9ppmvs. 5.4±3.8ppm p=0.001). They reported more phlegm and tended to have slightly lower levels of lung function, although these differences were not statistically significant. CONCLUSION: In this cross sectional study of young motorcycle taxi drivers with substantial exposure to urban traffic and a matched control group, we found no evidence for respiratory impairment. A follow-up of such study population with other pollution exposure surrogate and other clinical endpoint may provide a more robust conclusion regarding the exposure response in this professional group.

BTEX air concentrations and self-reported common health problems in gasoline sellers from Cotonou, Benin.

To examine the relation between BTEX exposure levels and common self-reported health problems in 140 gasoline sellers in Cotonou, Benin, a questionnaire documenting their socioeconomic status and their health problems was used, whereas 18 of them went through semi-directed qualitative individual interviews and 17 had air samples taken on their workplace for BTEX analysis. Median concentrations for BTEX were significantly lower on official (range of medians: 54-207 µg/m³, n = 9) vs unofficial (148-1449 µg/m³, n = 8) gasoline-selling sites (p < 0.05). Self-reported health problems were less frequently reported in sellers from unofficial vs official selling sites (p < 0.05), because, as suggested by the semi-directed interviews, of their fear of losing their important, but illegal, source of income. Concluding, this study has combined quantitative and qualitative methodological approaches to account for the complex socioeconomic and environmental conditions of the investigated sellers, leading to their, in some cases, preoccupying BTEX exposure.

An assessment of malaria diagnostic capacity and quality in Ghana and the Republic of Benin.

BACKGROUND: In malaria-endemic countries, the absence of parasitological confirmation of malaria infection potentially results in overtreatment of non-malaria febrile illness with antimalarial drugs; this may lead to healthcare workers (HCW) missing other treatable illness or wastage of resources. This paper presents results from nationally representative assessments of malaria diagnostic accuracy, quality and capacity in Ghana and the Republic of Benin. METHODS: Cross-sectional surveys were conducted in December 2012 among a representative sample of health facilities (n=30 per country), using a modified service provision assessment, followed by HCW observations and interviews. To analyze the data we used χ(2) statistics and logistic regression. RESULTS: Malaria microscopy and rapid diagnostic test interpretation was accurate most of the time in both countries. Drugs were generally prescribed in line with positive malaria test results (Ghana: 85.4%, 95% CI: 72.2-98.7; Benin: 83.6%, 95% CI: 68.7-98.4), although some patients with negative malaria test results still received treatment (Ghana: 30.1%, 95% CI: 11.1-49.0; Benin: 37.8%, 95% CI: 22.6-53.0). CONCLUSIONS: Diagnostics for malaria are often performed adequately and accurately in Ghana and Benin, although diagnostic coverage within facilities remains incomplete and some individuals who test negative for malaria receive antimalarial drugs.

High serum organochlorine pesticide concentrations in diabetics of a cotton producing area of the Benin Republic (West Africa).

The Borgou region of northern Benin is a major cotton producing area and consistently uses higher amounts of pesticides than other areas of the country. Organochlorine pesticides (OCPs), poorly handled, have been widely used and are still illegally present. We therefore hypothesized that serum OCP levels would be high in Borgou. As part of a case-control study on diabetes status and pesticide exposure, we measured the distribution of serum concentrations of 14 OCPs by gas chromatography with mass spectrometry. A sample of 118 diabetic subjects was selected using a four-stage cluster sampling with 54.2% of men and 45.8% of women; 43% lived in urban areas, 14.4% were obese and 39.8% had high economic status. The four detected OCPs were p,p'-DDT, p,p'-DDE, ß-HCH and trans-nonachlor with respective geometric means (geometric standard deviation) of 497.1 (4.5), 20.6 (7.9), 2.9 (3.4), and 2.0 (2.3) ng/g of total serum lipids. OCP levels were significantly higher in obese, wealthier and more educated subjects and in those living in urban areas as compared to the other groups, particularly for p,p'-DDE, p,p'-DDT and ß-HCH. Levels of DDT and DDE were higher than reported in other countries where DDT is no longer permitted. The low DDT/DDE ratio of 0.05 suggests past human exposure through food contamination. There is thus a need to reinforce governmental regulations for a more responsible use of pesticides in the country, in order to reduce health risks associated with persistent organic pollutants.

Growing burden of diabetes in sub-saharan Africa: contribution of pesticides ?

The diabetes burden is growing in Sub-Saharan Africa (SSA). The low overall access to health care has been documented to contribute to the high diabetes-related mortality. Due to economic, demographic, epidemiological and nutrition transitions in SSA, the growing prevalence of diabetes appears to be related to obesogenic lifestyles and the intergenerational impact of malnutrition in women of childbearing age. Both overnutrition and undernutrition have been associated with the development of diabetes and other chronic diseases. Africans are also suspected of being genetically predisposed to diabetes. According to existing data in developed countries, exposure to pesticides, particularly organochlorines and metabolites, is associated with a higher risk of developing type 2 diabetes and its comorbidities. In African countries, pesticide exposure levels often appear much higher than in developed countries. Furthermore, undernutrition, which is still highly prevalent in SSA, could increase susceptibility to the adverse effects of organic pollutants. Therefore, the growing and inadequate use of pesticides may well represent an additional risk factor for diabetes in SSA. Additionally, high exposure to pesticides in African infants in utero and during the perinatal period may increase the intergenerational risk of developing diabetes in SSA.

Association of IL-4 and IL-10 maternal haplotypes with immune responses to P. falciparum in mothers and newborns.

BACKGROUND: Particular cytokine gene polymorphisms are involved in the regulation of the antibody production. The consequences of already described IL-4, IL-10 and IL-13 gene polymorphisms on biological parameters and antibody levels were investigated among 576 mothers at delivery and their newborns in the context of P. falciparum placental malaria infection. METHODS: The study took place in the semi-rural area of Tori-Bossito, in south-west Benin, where malaria is meso-endemic. Six biallelic polymorphisms were determined by quantitative PCR using TaqMan® Pre-Designed SNP Genotyping Assays, in IL-4 (rs2243250, rs2070874), IL-10 (rs1800896, rs1800871, rs1800872) and IL-13 (rs1800925) genes. Antibody responses directed to P. falciparum MSP-1, MSP-2, MSP-3, GLURP-R0, GLURP-R2 and AMA-1 recombinant proteins were determined by ELISA. RESULTS: The maternal IL-4(-590)*T/IL-4(+33)*T haplotype (one or two copies) was associated with favorable maternal condition at delivery (high haemoglobin levels, absence of placental parasites) and one of its component, the IL-4(-590)TT genotype, was related to low IgG levels to MSP-1, MSP-2/3D7 and MSP-2/FC27. Inversely, the maternal IL-10(-1082)AA was positively associated with P. falciparum placenta infection at delivery. As a consequence, the IL-10(-819)*T allele (in CT and TT genotypes) as well as the IL-10(-1082)*A/IL-10(-819)*T/IL-10(-592)*A haplotype (one or two copies) in which it is included, were related to an increased risk for anaemia in newborns. The maternal IL-10(-1082)AA genotype was related to high IgG levels to MSP-2/3D7 and AMA-1 in mothers and newborns, respectively. The IL-13 gene polymorphism was only involved in the newborn's antibody response to AMA-1. CONCLUSION: These data revealed that IL-4 and IL-10 maternal gene polymorphisms are likely to play a role in the regulation of biological parameters in pregnant women at delivery (anaemia, P. falciparum placenta infection) and in newborns (anaemia). Moreover, IL-4, IL-10 and IL-13 maternal gene polymorphisms were related to IgG responses to MSP-1, MSP-2/3D7 and MSP-2/FC27 in mothers as well as to AMA-1 in newborns.

Insulin resistance status and four-year changes in other cardiometabolic risk factors in West-African adults: the Benin study.

BACKGROUND: The association of insulin resistance (IR) with other cardiometabolic risk (CMR) factors in sub-Saharan Africans is poorly documented. This study examined the links between IR and the evolution of blood pressure (BP), glycaemia, serum lipids and abdominal obesity in the population of Benin. DESIGN: Population-based longitudinal study. METHODS: This study initially included 541 apparently healthy Beninese adults (50% women) aged 25-60 years who were randomly selected in a large city, a small town and a rural area. After a baseline survey, our subjects were followed up after 2 years, and again at 4 years. IR based on homeostasis model assessment (HOMA), blood glucose, BP, waist circumference (WC), triglycerides, total cholesterol and HDL-cholesterol were measured. Complete data at the end of the follow-up periods was available for 416 subjects. RESULTS: IR was more prevalent in women than in men (33.2% versus 17.8%) and it was generally associated with more adverse values of CMR factors, excepting BP. In controlling for baseline age, sex, WC, diet, lifestyle variables and WC changes; the relative risk (RR) of hyperglycemia over 4 years was as least 3-fold in IR subjects, compared to normal subjects. The RR of abdominal obesity was 5.3 (1.04-26.93) in IR women, compared to non-IR. The association of IR with the evolution of dyslipidemia was inconsistent, but IR tended to exacerbate low HDL-cholesterol. CONCLUSION: Over 4 years, IR exacerbated hyperglycemia in both men and women, and abdominal obesity in women, but IR did not affect blood pressure. Further research on the link found between IR and dyslipidemia, particularly low HDL-C, is needed in sub-Saharan Africa.