beta S-haplotypes and alpha-thalassemia along the coastal belt of Kenya.

In this paper, we present data on studies of beta S-haplotypes and alpha-thalassemia gene in subjects from the indigenous population of the Coast Province of Kenya Of the 7SS patients studied, four were homozygous for beta S-haplotype 20 characteristically associated with the severe form of sickle cell anemia found in the Central African Republic and Western Kenya. Two had haplotype 20 combined with haplotype 19 (Benin Type) and one had haplotype 20 combined with a new haplotype (20x). Alpha thalassaemia-2 gene (-3.7kb deletion) was detected in 45.6% of the 57AA subjects studied. An alpha globin gene triplication was detected in one subject whereas eight had gamma globin gene triplication.

Haplotypes and alpha globin gene analyses in sickle cell anaemia patients from Kenya.

Over 60 patients from the Luo and Luhya tribes of Western Kenya, aged 1-23 years, with severe sickle cell anaemia were evaluated through haematological and gene mapping analyses. Nearly all (56 of 58 tested) were homozygous for haplotype 20 (Antonarakis et al, 1984) which is also frequently present in SS patients of the Central African Republic. All patients had a severe haemolytic anaemia with low Hb F levels and low levels of G gamma chains. An alpha-thalassaemia-2 heterozygosity (-alpha/alpha alpha; -3.7 kb deletion) was present in 26 of 53 patients tested; one patient was a homozygote [f(-alpha) = 0.255]. The alpha-thal-2 was type I in all but one subject with this deficiency; the one exception had an alpha-thal-2 heterozygosity, type II. Heterozygosity for the alpha-thal-2 did not affect the clinical condition nor the haematology; Hb F levels were somewhat lower in SS patients with -alpha/alpha alpha than in those with alpha alpha/alpha alpha. A high frequency was observed for the absence of an Xba I restriction site 5' to the zeta globin gene; the frequency of this anomaly [f(Xba I-)] was estimated at 0.39 for the chromosome with two alpha globin genes and at 0.74 for that with the alpha-thal-2 deletion. An Apa I restriction site polymorphism was observed in the IVS-II of the alpha 2 globin gene; 13 alpha 2 genes of 53 normal (alpha alpha/) chromosomes had this restriction site which was absent in the hybrid alpha globin gene of the -alpha/chromosome.

The treatment of kala-azar: a review with comments drawn from experience in Kenya.

Pentavalent antimony (Sbv) compounds have been used in the treatment of kala azar for over 60 years. Their introduction was preceded by the use, for a few years, of SbIII compounds, especially tartar emetic. Although the exact usage of Sbv varies from country to country, with correct use, cure rates of over 90% can, in most countries, be expected. There is little problem with toxicity, though occasional unexplained deaths that do not appear to be directly due to Sbv do occur during treatment. The main second line drugs, pentamidine and amphotericin, are less effective and relatively toxic. Other second line treatments that have been used in resistant kala azar in Kenya include allopurinol, diminazene aceturate, and Sbv liposomes. Splenectomy has been used as a last resort.

Pharmacokinetics of cyclophosphamide in Kenyan Africans.

The pharmacokinetics of cyclophosphamide was studied in 10 Kenyan Africans with Hodgkins lymphoma. The mean +/- s.d. elimination half-life (t1/2) was 7.5 +/- 1.38 h. The mean +/- s.d. volume of the central compartment (V1) was 0.35 +/- 0.12 l/kg and the apparent volume of distribution (V) was 0.64 +/- 0.06 l/kg. The microconstants k21, k12 and k10 were 1.81 +/- 0.84 h-1, 1.90 +/- 1.080 h-1 and 2.05 +/- 0.86 h-1 respectively (mean +/- s.d.).

Impaired glucose tolerance in a hospital population in Jamaica / 11th Congress of the International Diabetes Federation

During the period January to December 1979, 75 g glucose tolerance tests were performed on 311 patients in the Chemical Pathology Department of the University Hospital. There were 14 (4.5 percent) non-pregrant adult patients, not previously diagnosed as diabetic, whose 2-h post-ingestion blood glucose values, using venous whole blood, fell within the range 140-200 mg percent (8-11 mmol/l). On these results they were diagnosed as impaired glucose tolerance (IGT) and no therapy given except for dietary advice. Two years later, during the month of January 1982, they were contacted by postal telegrams to return to the hospital for reassessment. A 75-g glucose load was given to each respondent and a 2-h post-ingestion blood glucose level determined. Eight (57 percent) had normal values of mean blood glucose 115 mg percent (6.4 mmol/l): 4 were female, and 4 male; age range 20-76 yr, mean age 40 yr; body mass index range 19.7-35.1, mean value 29.2 (>26 regarded as obesity). Two (14.3 percent) females remained in the IGT group: mean blood glucose value 173 mg percent (9.6 mmol/l); mean age 32 yr; and mean body mass index 29.7. Four (28.6 percent) were frank diabetics, mean blood glucose 347 mg percent (19.3 mmol/l): 3 males 1 female; age range 20-66 yr, mean age 48 yr; body mass index range 24.1-28.7, mean value 25.7