Response of Black African patients with hepatitis C virus genotype 4 to treatment with peg-interferon and ribavirin.

AIM: To compare responses to therapy of Black African (BA) and non-Black African (non- BA) patients with hepatitis C virus genotype 4 (HCV-4) residing in Belgium. METHODS: In this retrospective multicenter study, 473 patients with HCV-4 were selected from databases at 7 Belgian centers; 209 treatment-naive patients (154 BA) had received treatment with peg-interferon (peg-IFN) plus ribavirin (RBV) and were included in the study. RESULTS: There was a greater percentage of female patients in the BA group than in the non- BA group; BA patients were also older, had a greater body mass index, and more frequently had abnormal glucose metabolism. The route of contamination was more frequently unknown in BA than in non-BA patients and BA patients had more HCV-4 subtypes. There were no differences in other demographic factors between the groups. Sustained viral response (SVR) and complete early viral response rates were significantly lower and relapse rates significantly higher in BA than in non-BA patients. There were no differences between groups in rates of dose modification or in drug tolerance. CONCLUSION: In our cohort, treatment-naive BA patients with HCV-4 who were treated with peg-IFN and ribavirin had a much lower SVR rate than treatment-naive non-BA patients with HCV-4 who were treated with peg-IFN and ribavirin, and a higher relapse rate, possibly related to a weaker response to interferon-based therapy. Treatment may need to be adapted in this population.

A biocultural approach to breastfeeding interactions in Central Africa.

Anthropologists have long recognized that breastfeeding involves much more than feeding; it entails intimate social interactions between infants or children and their mothers. However, breastfeeding has predominantly been studied with respect to structural features (frequency, timing) as well as nutritional and health aspects of infant feeding. Thus, in this study we complement previous anthropological studies by examining social interactions that occur during breastfeeding among the Aka and Bofi foragers and Ngandu and Bofi farmers at various ages (three to four months, nine to ten months, toddlers). Further, we use an integrated biocultural perspective to explore how patterns of breastfeeding and social interactions can be shaped by economic constraints, cultural values, and children's development. Overall, our findings illustrate how biological and cultural factors interact and provide useful explanations of variations in breastfeeding structure and social interactions more so than either perspective alone.

The deleterious effects of physical inactivity on elements of insulin resistance and metabolic syndrome in Central Africans at high cardiovascular risk.

AIM: We aimed to describe the physical activity and to investigate the association between classical hypertension, obesity, diabetes, and new inflammation, IDF-defined metabolic syndrome, insulin resistance CV risk factors. DESIGN: This was a cross-sectional study based on interviews and physical and biochemistry measurements among Central African patients. MEASUREMENTS: Waist circumference (WC), blood pressure, weight and height to calculate body mass index (BMI), fasting glucose, CRP, ERS, uric acid, cholesterol (C), LDL-C, HDL-C, triglycerides, elements of homeostatic model assessment (HOMA) including insulin, HOMA index, QUICKI, insulin sensitivity (%S), beta-cell function (%ß) and insulin resistance (IR). FINDINGS: Of the 60 patients included, 30 (50%) were physically inactive versus 30 (50%) active. In pooled analyses, in men and in women, there was significant and positive correlation between WC and seating/laying down position (WC=92.41+1.49 seating time in hours, R(2)=0.11; P<0.0001). The mean value of CRP and ERS were higher and those of all indices of HOMA were lower in inactive patients. The discriminant function for physical activity was Z (score=barycentre)=-7.36+1.013 HOMA index where -1.4 was the barycentre for active and +1.4 for inactive. HOMA index >2.42 was the optimal cut-off value to detect physically inactive patients: sensitivity=93.3%, specificity=100%, area under ROC=0.991±0.01 95%=0.975-1.0; P<0.0001. CONCLUSION: The association between low-grade inflammation markers, insulin resistance and physical inactivity favours the hypothesis that a low-grade inflammatory status and enhanced insulin, sensitivity may constitute a part of the CV benefits from physical activity.

Chronic disease and its risk factors among refugees and asylees in Massachusetts, 2001-2005.

INTRODUCTION: Better understanding of the health problems of refugees and people who are granted political asylum (asylees) in the United States may facilitate successful resettlement. We examined the prevalence of risk factors for and diagnoses of chronic disease among these groups in Massachusetts. METHODS: We retrospectively analyzed health screening data from 4,239 adult refugees and asylees who arrived in Massachusetts from January 1, 2001, through December 31, 2005. We determined prevalence of obesity/overweight, hypertension, coronary artery disease (CAD), diabetes, and anemia. Analyses included multivariate logistic regression to determine associations between CAD and diabetes with region of origin. RESULTS: Almost half of our sample (46.8%) was obese/overweight, and 22.6% had hypertension. CAD, diabetes, and anemia were documented in 3.7%, 3.1%, and 12.8%, respectively. People from the Europe and Central Asia region were more likely than those from other regions to have CAD (odds ratio, 5.55; 95% confidence interval, 2.95-10.47). CONCLUSION: The prevalence of obesity/overweight and hypertension was high among refugees and asylees, but the prevalence of documented CAD and diabetes was low. We noted significant regional variations in prevalence of risk factors and chronic diseases. Future populations resettling in the United States should be linked to more resources to address their long-term health care needs and to receive culturally appropriate counseling on risk reduction.

Child slaves and freemen at the Spiritan Mission in Soyo, 1880-1885.

Catholic missionaries in late nineteenth- and early twentieth-century Africa more commonly than Protestants purchased slaves to build their mission stations. This article provides a micro-historical analysis of the redemption of child slaves by the Holy Ghost Fathers in Soyo, West Central Africa, in the years immediately preceding the colonial partition of Africa. It argues that the Spiritan missionaries liberated slaves for instrumental rather than humanitarian reasons. As local freemen were difficult to control, the mission depended for its growth on the import of slave children. Furthermore, since the missionaries operated on the same markets and paid the same prices for slaves as regular buyers, their purchasing practices showed a strong resemblance with ordinary slave trading.

Paradox of precision: bright tobacco as technology of transfer, 1880-1937.

This article compares two episodes of technology transfer in the 1890s: the movement of bright tobacco production technology to south-central Africa with the spread of the crop to eastern North Carolina and South Carolina. It finds similarities in the people who introduced the crop, but significant differences in the methods used to produce it. This is troubling because the type is defined by the cultivation and especially the curing techniques used to produce it; it is also often described in the historical literature as "Virginia tobacco," even when grown elsewhere. the technological differences are the product of different environments, which include not only the climate but also many elements of the technological system beyond immediate human control: the availability and organization of labor, differences in market structures and marketing institutions, and the government incentives provided to buyers. Therefore, this essay takes as its subject the paradox inherent in the official classification of tobacco types regulated by the USDA and argues that varietal types represent a form of market regulation disguised as botanical taxonomy.

Aggressive periodontitis among young Israeli army personnel.

BACKGROUND: The aim of this study was to assess the prevalence of aggressive periodontitis among young Israeli army recruits and to evaluate its association with smoking habits and ethnic origin. METHODS: The study population consisted of 642 young army recruits (562 men [87.5%] and 80 women [12.5%]), aged 18 to 30 years (average: 19.6 +/- 1.6 years), who arrived at a military dental clinic for dental examinations between January and December 2004. Subjects filled out a questionnaire regarding their ethnic origin and family periodontal history, followed by radiographs and a clinical periodontal examination of four first molars and eight incisors. RESULTS: Aggressive periodontitis was found in 5.9% of the subjects (4.3% localized and 1.6% generalized). At least one site with a probing depth > or =5 mm was found in 20.1% of the subjects. A radiographic distance between crestal bone height and the cemento-enamel junction >3 mm was found in 43 (6.7%) subjects. Current smokers (39.9%) (P = 0.03) and subjects of North African origin (P <0.0001) correlated with a high prevalence of aggressive periodontitis. CONCLUSION: A relatively high prevalence of aggressive periodontitis was found in young Israeli army recruits, which was particularly associated with smoking and ethnic origin.

African hair growth parameters.

BACKGROUND: Hair growth parameters have been studied mostly in caucasian hair, whereas few data on African hair have been reported in the literature. OBJECTIVES: To evaluate hair growth characteristics of African volunteers born in Africa. METHODS: Thirty-eight young adults (19 women, 19 men, mean +/- SD age 27 +/- 10 years), native of central and western Africa, took part in the study. Phototrichograms were performed in order to record three parameters of hair growth: hair density, telogen percentage and rate of growth. For each volunteer, three regions of the scalp, namely vertex, temporal and occipital areas, were assessed. RESULTS: Hair density varied from 90 to 290 hairs cm(-2), with higher counts on the vertex. No significant difference between men and women was recorded. Telogen percentage showed wide variations, from 2 to 46%, with higher levels on the temporal area and in men. The rate of growth fluctuated from 150 to 363 microm day(-1) with no difference related either to gender or to scalp region. These data were compared with those previously obtained in caucasian volunteers of comparable age, and showed significant differences between the two ethnic groups in all three parameters studied. Hair density in African volunteers was lower than that in caucasians (mean +/- SD 190 +/- 40 and 227 +/- 55 hairs cm(-2), respectively). African hair grew at a much slower rate than caucasian hair (mean +/- SD 256 +/- 44 vs. 396 +/- 55 microm day(-1)), and telogen counts were frequently higher in African hair (mean +/- SD 18 +/- 9% vs. 14 +/- 11%). CONCLUSIONS: This study demonstrated significant differences between African and caucasian hair growth parameters, which might suggest a trend towards increased hair loss in Africans, even though it contrasts with a lower and slower incidence of the development of alopecia in Africans.

A study on ten short tandem repeat systems: African immigrant and Spanish population data.

This work presents the results obtained from a genetic-population study for the D1S1656 system in the population of Southwest Spain (Huelva, Cádiz and Sevilla), Spaniards of Caucasian origin from North Africa (Ceuta), as well as in the black Central West African and Moroccan immigrant populations in Spain. The results of a study of the autochtonous population of the Canary Islands (n=138), and immigrant Central West African populations in Spain (n=132), obtained for nine short tandem repeat (STR) loci (D3S1358, VWA, FGA, D8S1179, D21S11, D18S51, D5S818, D13S317, D7S820), as well as the amelogenin locus, all contained in Profiler Plus (Perkin-Elmer) PCR amplification kits, are also presented. Except for the FGA and VWA data on immigrant Central West African populations in Spain, no deviations from the Hardy-Weinberg equilibrium were detected.

Extent of heterogeneity in mitochondrial DNA of sub-Saharan African populations.

Variation in the mitochondrial DNA (mtDNA) control region as detected by sequence-specific oligonucleotide (SSO) probes is described for 381 individuals from nine sub-Saharan African populations. Population diversity estimates for SSO types ranged from 0.23 to 0.97, while 102 SSO types were detected, none of these types was shared by more than four populations. Eighteen types occurred in > or = 10% of individuals in some populations; of these, 11 were population-specific. One type occurred in 15% of the total sample, but was shared among only three populations. African SSO types were characterized by high frequencies of blank variants, indicating that there was additional variation present at the nucleotide sequence level in regions where SSO probes hybridize. Analyses of molecular variance (AMOVA) incorporating genetic distances between SSO types showed that 30% of the total variation was due to differences among populations, indicating that there is statistically significant heterogeneity (p < 0.001). An AMOVA on mtDNA control region nucleotide sequence data from 12 populations showed that including all additional variation present at the sequence level increased the variance due to population subdivision to 34% (p < 0.001). Overall, when considering both the low diversity within some populations and high heterogeneity among populations, SSO typing of mtDNA may not be a desirable forensic DNA typing method for continental African populations. Further mtDNA sampling of African-derived populations of North America should be carried out to determine how much of the continental African mtDNA variation is of forensic significance. However, the existence of extensive mtDNA control region nucleotide sequence variation in African populations means that control region sequencing is still appropriate in forensic cases requiring mtDNA analysis.

[Female circumcision opposed in Haninge]. / Kvinnlig könsstympning motarbetas i Haninge.

PIP: Less radical forms of female circumcision are called infibulation and Pharaonic circumcision. It is estimated that 113 million women in the world are exposed to female circumcision of one form or another. In Sweden about 16,000 women originate from countries where female circumcision is practiced. 60% of them are from Somalia or Ethiopia, and 11,000 of these women are of reproductive age. About 5000 girls are under 18 years of age and are at risk of female circumcision if it has not already taken place. Sweden has ratified a UN convention on the right of children, and since 1982 there has been a law in force that prohibits female circumcision. A great number of African refugees have been settling in Jordbro, in the county of Haninge, south of Stockholm, since 1992. 35 central African families live there, one-third of them from Somalia. The mother and child health care agency has confronted several problems related to female circumcision: infibulated women do not get traditional gynecological examinations, families demand that women get infibulated after delivery, and some families have asked for circumcision of their newborn daughters. The agency organized African family group sessions, held for a month during evenings, in which all families were invited to discuss topics related to the improvement of women's and children's health and the fight against female circumcision. At each family group meeting 10-15 adults participated. Several sessions dealt with children's diseases, reproductive physiology, and the role of female circumcision in religion and tradition. Most women were illiterate and this was their first encounter with the Swedish health system whereby they were informed about the functioning of the human body. African traditions are deeply rooted. In Gambia female circumcision is practiced by 50-60% of people, although in milder forms. Since 1993, when the group discussions started, not a single case of circumcision was reported in pre-school-age girls.^ieng