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1.
Rev Med Suisse ; 16(709): 1849-1852, 2020 Oct 07.
Artigo em Francês | MEDLINE | ID: mdl-33026726

RESUMO

For safe procedures, the surgeon performing thyroid gland surgeries must know precisely the anatomical relationships of the inferior laryngeal nerve with other cervical structures, in particular the inferior laryngeal artery and its branches. Classic descriptions of these relationships are based almost exclusively on the observation of Caucasian populations. However, this study shows that there are important differences between Caucasian and Sub-Saharian ethnic group, differences that any surgeon having the opportunity to operate in Africa should know to limit the risk of iatrogenic nerve damage and its morbid consequences.


Assuntos
Grupo com Ancestrais do Continente Africano , Artérias/cirurgia , Grupos Étnicos , Nervo Laríngeo Recorrente/cirurgia , Glândula Tireoide/cirurgia , África/etnologia , Grupo com Ancestrais do Continente Europeu , Humanos , Laringe/irrigação sanguínea , Laringe/cirurgia
2.
Epidemiol Prev ; 44(4): 304-307, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32921037

RESUMO

It has been hypothesized that bacille Calmette-Guerin (BCG), the anti-tuberculosis vaccine, can be protective against Covid-19. Using data of performed swabs and RT-PCR results for SARS-CoV-2 in the Reggio Emilia province (Emilia-Romagna Region, Northern Italy) from March 6th to March 26th, 2020, we computed age, gender, and place of birth (Italy or abroad) specific risk of being tested, prevalence of positive tests, and probability of testing positive given that a swab has been taken during the epidemic peak. We report that immigrants resident in Reggio Emilia province, mostly coming from Countries with high BCG vaccination coverage, and Italians had a similar prevalence of infection (odds ratio - OR 0.99; 95%CI 0.82-1.20) and similar probability of being tested (OR 0.93; 95%CI 0.81-1.10). Our data do not support the hypothesis that immigrants from Countries where BCG vaccination is recommended have a lower risk of Covid-19 infection.


Assuntos
Betacoronavirus , Infecções por Coronavirus/epidemiologia , Emigrantes e Imigrantes/estatística & dados numéricos , Pandemias , Pneumonia Viral/epidemiologia , Adulto , África/etnologia , Idoso , Ásia/etnologia , Vacina BCG , Betacoronavirus/isolamento & purificação , Técnicas de Laboratório Clínico , Infecções por Coronavirus/diagnóstico , Infecções por Coronavirus/etnologia , Infecções por Coronavirus/prevenção & controle , Feminino , Humanos , Itália/epidemiologia , Masculino , Pessoa de Meia-Idade , Nasofaringe/virologia , Pandemias/prevenção & controle , Pneumonia Viral/diagnóstico , Pneumonia Viral/etnologia , Pneumonia Viral/prevenção & controle , Polônia/etnologia , Prevalência , Utilização de Procedimentos e Técnicas , Cobertura Vacinal
3.
Zhonghua Liu Xing Bing Xue Za Zhi ; 41(7): 1092-1096, 2020 Jul 10.
Artigo em Chinês | MEDLINE | ID: mdl-32741177

RESUMO

Objective: To analyze the influencing factors of HIV testing behavior among foreigners in Guangzhou, and provide a reference for promoting HIV testing and intervention services in foreigners. Methods: A cross-sectional survey was conducted from November 2019 to January 2020 among 230 eligible foreigners selected in Guangzhou through convenient sampling method in the form of one-to-one questionnaire interview, HIV testing behaviors and related influencing factors were described and analyzed with χ(2) test and multivariate logistic regression model. Results: A total of 230 foreigners were included in the study, in whom 156 were males (67.8%), 217 were from Africa (94.3%), 138 (60.0%) were with education level of university and above, 169 (73.5%) were in business, 47 (20.4%) were students, 132 (57.4%) had cumulative residence >12 months in Guangzhou and 113 (49.1%) had health examination in China in the past 6 months. In these foreigners, the rate of AIDS-related knowledge awareness was 76.0%, the proportion of condom use in the last sex was 39.6%(89/225) and 47.8%(110/230) received HIV tests in the past 3 months. Multivariate logistic regression analysis showed, the influencing factors of HIV testing behavior in the past 3 months included cumulative residence ≤12 months (compared with cumulative residence >12 months, OR=3.12, 95%CI: 1.49-6.56), health examination in China in the past 6 months (compared to those who had not, OR=2.53, 95%CI: 1.17-5.48), awareness of HIV testing and consulting service in Guangzhou (compared with those who had no awareness, OR=3.65, 95%CI: 1.71-7.78). Conclusions: Some foreigners in Guangzhou had relatively low rates of HIV testing and condom use. Those who pay attention to their own health status and know well about HIV testing and consulting services are more likely to receive HIV testing, foreigners in Guangzhou should be encouraged to receive HIV testing. Their self-testing awareness should be improved.


Assuntos
Emigrantes e Imigrantes/psicologia , Infecções por HIV/prevenção & controle , Programas de Rastreamento/psicologia , África/etnologia , China/epidemiologia , Estudos Transversais , Emigrantes e Imigrantes/estatística & dados numéricos , Feminino , Infecções por HIV/epidemiologia , Humanos , Masculino , Fatores Socioeconômicos , Inquéritos e Questionários
5.
Artigo em Inglês | MEDLINE | ID: mdl-32599711

RESUMO

Stress leads to physiologic dysfunction and cardiometabolic disease. Allostatic load score (ALS) measures stress-induced cardiovascular, metabolic, and inflammatory biomarkers. We estimated the odds of high ALS by reason for and age at immigration, duration of American residence, number of children, and socioeconomic status in 193 African immigrants (male: 65%, age 41 ± 10 y (mean ± Standard Deviation (SD)), range 22-65 y). ALS was calculated with High-ALS defined as ALS ≥ 3.0 and Low-ALS defined as ALS < 3.0. Oral glucose tolerance tests (OGTT) were performed, the cardiovascular disease (CVD) risk estimated, and TNF-α, an inflammatory cytokine, measured. Logistic regression was used to estimate odds of High-ALS. In the High- and Low-ALS groups, ALS were 4.0 ± 1.2 vs. 1.3 ± 0.7, diabetes prevalence: 14% vs. 4%, CVD risk: 23% vs. 8%, TNF-α levels: 15 ± 9 vs. 11 ± 6 pg/mL, respectively (all p ≤ 0.01). Immigrants were more likely to be in the High-ALS group if their reason for immigration was work or asylum/refugee (OR 2.18, p = 0.013), their age at immigration was ≥30 y (OR 3.28, p < 0.001), their duration of residence in United States was ≥10 y (OR 3.16, p = 0.001), or their number of children was ≥3 (OR 2.67, p = 0.019). Education, income, health insurance, marital status, and gender did not affect High-ALS odds. Factors adversely influencing allostatic load and cardiometabolic health in African immigrants were age at and reason for immigration, duration of residence in America, and number of children.


Assuntos
Alostase , Emigrantes e Imigrantes , Emigração e Imigração , Refugiados , Estresse Psicológico , Adulto , África/etnologia , Estudos Transversais , Emigrantes e Imigrantes/psicologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Refugiados/psicologia , Estados Unidos
6.
BMC Public Health ; 20(1): 1132, 2020 Jul 20.
Artigo em Inglês | MEDLINE | ID: mdl-32689963

RESUMO

BACKGROUND: Female genital mutilation (FGM) is a deeply-rooted cultural practice mainly undertaken in Africa, the Middle East and Asian countries. Evidence to date suggests that although first-generation migrants to the West are abandoning FGM, the custom continues in some places, albeit in small numbers. This study examined how young people living in FGM affected communities in the United Kingdom (UK), interpreted and explained FGM. METHODS: A community-based participatory research (CBPR) approach was used to recruit and train nine young people aged 15-18 as co-researchers. These comprised eight females and one male from second-generation FGM affected communities, living in Bristol. The co-researchers then undertook focus groups and semi-structured interviews with twenty participants aged 13-15 living in Bristol, Cardiff and Milton Keynes. The qualitative data from the training workshops, interviews and focus groups were collected and analysed using thematic analysis. RESULTS: There were conflicting views among participants. Some perceived FGM as a historical tradition that was of very little, if any, relevance to them. In contrast, others perceived that the more archaic, cultural interpretation of FGM, more commonly shared by older generations, had been supplanted by a new form of FGM, which they believed to be a safe procedure, made so by the availability of highly-trained, qualified doctors and better equipment in the UK. Participants spoke of challenges encountered when attempting to raise the issue of FGM with parents. Nevertheless, they acknowledged that- being born and raised in the UK - enabled them to talk openly and to challenge others. CONCLUSION: Future strategies to address and prevent FGM in the UK will require a public health approach that is holistic, intersectional and empowering. Such measures should be relevant to young people born and raised in the UK who interpret FGM differently to previous first-generation migrant relatives and communities. Tackling FGM requires a shift away from a principal preoccupation with harm reduction and criminalisation towards collaboration and active dialogue with communities, in positive and productive ways that acknowledge and engage issues of identity, race, gender, and generation, enabling people affected by FGM to take control of their health and well-being.


Assuntos
Circuncisão Feminina/psicologia , Emigrantes e Imigrantes , Conhecimentos, Atitudes e Prática em Saúde , Adolescente , África/etnologia , Circuncisão Feminina/etnologia , Pesquisa Participativa Baseada na Comunidade , Feminino , Grupos Focais , Humanos , Masculino , Reino Unido
7.
BMC Public Health ; 20(1): 738, 2020 May 20.
Artigo em Inglês | MEDLINE | ID: mdl-32434483

RESUMO

BACKGROUND: Since 2014, the migrant population residing in Europe has dramatically increased. Migrants' unmet health needs represent a barrier to integration and should be promptly addressed, without stigma, in order to favour resettlement. METHODS: All-cause of admissions in the migrant population at the Infectious Disease Clinic of Policlinico San Martino Hospital in Genoa between 2015 and 2017 were analysed. Patients were classified by duration of residence in Italy according to the Recommendation on Statistics of International Migration, cause of hospitalization, and region of origin. All data were evaluated with SPSS Statistics. RESULTS: Two hundred thirty-five people were admitted, 86 (36.5%) of them residing in Italy for less than 1 year. Except for a significant increase in migrants from Africa, there was no change considering the area of origin, hospitalization reason or by comparing residency in Italy for more or less than 1 year. A considerable number of hospitalizations were related to non-communicable pathologies and latent tuberculosis infection. Residents in Italy for less than 1 year or with active tuberculosis had prolonged hospitalizations, while HIV-infected had shorter hospital stays. CONCLUSIONS: No difference in terms of diagnosis were found between migrants with longer or shorter period of residence in Italy. Adequate outpatient services for the management of communicable diseases could significantly reduce the length of hospitalizations in the migrant population.


Assuntos
Doenças Transmissíveis Importadas/epidemiologia , Emigração e Imigração , Infecções por HIV/epidemiologia , Hospitalização , Migrantes , Tuberculose/epidemiologia , Adolescente , Adulto , África/etnologia , Idoso , Doenças Transmissíveis/epidemiologia , Doenças Transmissíveis/terapia , Doenças Transmissíveis Importadas/terapia , Grupos Étnicos , Europa (Continente) , Feminino , Infecções por HIV/terapia , Hospitalização/estatística & dados numéricos , Hospitalização/tendências , Hospitais/estatística & dados numéricos , Humanos , Itália/epidemiologia , Tempo de Internação , Masculino , Pessoa de Meia-Idade , Prevalência , Tuberculose/terapia , Adulto Jovem
8.
J Int AIDS Soc ; 23(5): e25486, 2020 05.
Artigo em Inglês | MEDLINE | ID: mdl-32437092

RESUMO

INTRODUCTION: Foreign-born persons comprise ~13% of the US population. Immigrants, especially women, often face a complex set of social and structural factors that negatively impact health outcomes including greater risk of HIV infection. We described socio-demographic, clinical and immunological characteristics and AIDs and non-AIDS death among foreign-born women living with HIV (FBWLWH) participating in the US Women's Interagency HIV Study (WIHS) in the US from 1994 to 2016. We hypothesized that FBW will experience higher AIDS-related mortality compared to US-born women (USBW). METHODS: The WIHS is a multicenter prospective observational cohort study of mostly women living with HIV (WLWH). The primary exposure in this analysis, which focused on 3626 WLWH, was self-reported country of birth collapsed into foreign-born and US born. We assessed the association of birthplace with categorized demographic, clinical and immunological characteristics, and AIDS/non-AIDS mortality of WLWH, using chi-squared tests. Proportional hazard models examined the association of birthplace with time from enrolment to AIDS and non-AIDS death. RESULTS: Of the 628 FBW, 13% were born in Africa, 29% in the Caribbean and 49% in Latin America. We observed significant differences by HIV status in socio-demographic, clinical and immunological characteristics and mortality. For both AIDS and non-AIDS caused deaths FBW WLWH had lower rates of death. Adjusting for year of study enrolment and other demographic/clinical characteristics mitigated FBW's statistical survival advantage in AIDS deaths Relative Hazard (RH = 0.91 p = 0.53), but did not substantively change the survival advantage in non-AIDS deaths RH = 0.33, p < 0.0001). CONCLUSION: Foreign-born WLWH exhibited demographic, clinical and immunological characteristics that are significantly different compared with women born in the US or US territory. After adjusting for these characteristics, the FB WLWH had a significantly lower hazard of non-AIDS but not AIDS mortality compared to women born in the US or a US territory. These findings of non-increased mortality can help inform models of care to optimize treatment outcomes among FBWLWH in the United States.


Assuntos
Infecções por HIV/epidemiologia , Adulto , África/etnologia , Região do Caribe/etnologia , Estudos de Coortes , Emigrantes e Imigrantes , Feminino , Infecções por HIV/tratamento farmacológico , Infecções por HIV/etnologia , Humanos , América Latina/etnologia , Modelos de Riscos Proporcionais , Estudos Prospectivos , Fatores de Risco , Estados Unidos
9.
Am J Trop Med Hyg ; 103(1): 480-484, 2020 07.
Artigo em Inglês | MEDLINE | ID: mdl-32342844

RESUMO

The female immigrant population is especially vulnerable to imported diseases. We describe the results of a prospective screening program for imported diseases performed in immigrant female patients. The protocol included tests for HIV, hepatitis B virus (HBV), hepatitis C virus (HCV), Treponema pallidum, Trypanosoma cruzi, Strongyloides stercoralis and Schistosoma spp., intestinal parasites, malaria, and the detection of microfilaremia, according to the patient's origin. Six hundred eleven patients were studied. The most frequent imported diseases were intestinal parasitosis (39.4%), followed by syphilis (14.6%), HIV infection (9%), chronic HCV (5%), and HBV (3.3%). Most of the cases of HIV (78%) and HBV (85%) were diagnosed in patients aged between 16 and 45 years. Hepatitis C virus appeared mostly in patients in the 46- to 65-year range (P = 0.001; odds ratio [OD]: 3.667 [1.741-7.724]) or older than 65 years (P = 0.0001; OR: 26.350 [7.509-92.463]). Syphilis was diagnosed more frequently in patients older than 46 years (P = 0.0001; OR: 4.273 [2.649-6.893]). Multivariate analysis confirmed a greater presence of HCV infection (P = 0.049) and syphilis (P = 0.0001) in patients aged between 46 and 65 years. In 15.4% of patients, screening did not find any pathology. These data show a high prevalence of imported diseases in the female immigrant population, which may have serious consequences in terms of morbimortality and vertical transmission. Our results encourage the establishment of policies of active screening both in women of childbearing age and within the specific pregnancy screening programs.


Assuntos
Doenças Transmissíveis Importadas/diagnóstico , Emigrantes e Imigrantes/estatística & dados numéricos , Mulheres , Adolescente , Adulto , África/etnologia , Idoso , América Central/etnologia , Doença de Chagas/diagnóstico , Doença de Chagas/epidemiologia , Doenças Transmissíveis Importadas/epidemiologia , Feminino , Filariose/diagnóstico , Filariose/epidemiologia , Infecções por HIV/diagnóstico , Infecções por HIV/epidemiologia , Hepatite B Crônica/diagnóstico , Hepatite B Crônica/epidemiologia , Hepatite C Crônica/diagnóstico , Hepatite C Crônica/epidemiologia , Humanos , Transmissão Vertical de Doença Infecciosa , Enteropatias Parasitárias/diagnóstico , Enteropatias Parasitárias/epidemiologia , Malária/diagnóstico , Malária/epidemiologia , Programas de Rastreamento , Pessoa de Meia-Idade , Prevalência , Esquistossomose/diagnóstico , Esquistossomose/epidemiologia , América do Sul/etnologia , Espanha/epidemiologia , Estrongiloidíase/diagnóstico , Estrongiloidíase/epidemiologia , Sífilis/diagnóstico , Sífilis/epidemiologia , Tuberculose/diagnóstico , Tuberculose/epidemiologia , Adulto Jovem
10.
PLoS Med ; 17(3): e1003076, 2020 03.
Artigo em Inglês | MEDLINE | ID: mdl-32231358

RESUMO

BACKGROUND: Information regarding the prevalence of infectious diseases (IDs) in child and adolescent refugees in Europe is scarce. Here, we evaluate a standardized ID screening protocol in a cohort of unaccompanied refugee minors (URMs) in a municipal region of southwest Germany. METHODS AND FINDINGS: From January 2016 to December 2017, we employed a structured questionnaire to screen a cohort of 890 URMs. Collecting sociodemographic information and medical history, we also performed a standardized diagnostics panel, including complete blood count, urine status, microbial stool testing, tuberculosis (TB) screening, and serologies for hepatitis B virus (HBV) and human immunodeficiency virus (HIV). The mean age was 16.2 years; 94.0% were male, and 93.6% originated from an African country. The most common health complaints were dental problems (66.0%). The single most frequent ID was scabies (14.2%). Of the 776 URMs originating from high-prevalence countries, 7.7% and 0.4% tested positive for HBV and HIV, respectively. Nineteen pathogens were detected in a total of 119 stool samples (16.0% positivity), with intestinal schistosomiasis being the most frequent pathogen (6.7%). Blood eosinophilia proved to be a nonspecific criterion for the detection of parasitic infections. Active pulmonary TB was identified in 1.7% of URMs screened. Of note, clinical warning symptoms (fever, cough >2 weeks, and weight loss) were insensitive parameters for the identification of patients with active TB. Study limitations include the possibility of an incomplete eosinophilia workup (as no parasite serologies or malaria diagnostics were performed), as well as the inherent selection bias in our cohort because refugee populations differ across Europe. CONCLUSIONS: Our study found that standardized ID screening in a URM cohort was practicable and helped collection of relevant patient data in a thorough and time-effective manner. However, screening practices need to be ameliorated, especially in relation to testing for parasitic infections. Most importantly, we found that only a minority of infections were able to be detected clinically. This underscores the importance of active surveillance of IDs among refugees.


Assuntos
Doenças Transmissíveis/epidemiologia , Programas de Rastreamento/estatística & dados numéricos , Menores de Idade/estatística & dados numéricos , Refugiados/estatística & dados numéricos , Adolescente , África/etnologia , Doenças Transmissíveis/etiologia , Estudos Transversais , Feminino , Alemanha/epidemiologia , Humanos , Masculino , Prevalência
11.
Nutrients ; 12(3)2020 Mar 22.
Artigo em Inglês | MEDLINE | ID: mdl-32235726

RESUMO

Previous studies have shown that the use of dietary supplements is associated with the prevention of birth defects, negative pregnancy outcomes and cardiovascular diseases. However, there might be some ethnic disparities in supplement usage suggesting that women who could benefit from it are not frequent users. This study aimed to characterise the use of dietary supplement among Black African and Black Caribbean women living in the United Kingdom (UK). Furthermore, it evaluated possible associations between the use of dietary supplements and health and diet awareness. A total of 262 women self-ascribed as Black African and Black Caribbean living in the UK completed a comprehensive questionnaire on socio-demographic factors, diet, use of supplements and cultural factors. The main outcome variable was the regular use of any type of dietary supplement. Use of vitamin D and/or calcium was also explored. A stepwise logistic regression analysis was applied to identify predictors of regular use of dietary supplements. A total of 33.2% of women reported regular use of any dietary supplements and 16.8% reported use of vitamin D and/or calcium. There were no significant ethnic differences in the use of dietary supplements. Reporting use of the back of food packaging label (odds ratio (OR) 2.21; 95% CI 1.07-4.55); a self-rated healthy diet (OR 2.86; 95% CI 1.19-6.91) and having cardiovascular disease (CVD), hypertension and/or high cholesterol (OR 3.81; 95% CI 1.53-9.49) increased the likelihood of using any dietary supplement. However, having poorer awareness decreased the likelihood (OR 0.94; 95% CI 0.88-0.99) of using any dietary supplement. For the use of vitamin D and/or calcium supplements, the main predictor was having CVD, hypertension and/or high cholesterol (OR 4.43; 95% CI 1.90-10.35). The prevalence of dietary supplement use was low among African and Caribbean women. Thus, awareness of potential benefits of some dietary supplements (e.g., vitamin D) among the Black population should be promoted.


Assuntos
Grupo com Ancestrais do Continente Africano/psicologia , Conscientização , Dieta/estatística & dados numéricos , Suplementos Nutricionais/estatística & dados numéricos , Comportamentos Relacionados com a Saúde , África/etnologia , Cálcio , Doenças Cardiovasculares/epidemiologia , Região do Caribe/etnologia , Feminino , Promoção da Saúde , Humanos , Hiperlipidemias/epidemiologia , Hipertensão/epidemiologia , Inquéritos e Questionários , Reino Unido , Vitamina D
12.
BMC Genomics ; 21(1): 289, 2020 Apr 10.
Artigo em Inglês | MEDLINE | ID: mdl-32272904

RESUMO

BACKGROUND: Copy number variation is an important class of genomic variation that has been reported in 75% of the human genome. However, it is underreported in African populations. Copy number variants (CNVs) could have important impacts on disease susceptibility and environmental adaptation. To describe CNVs and their possible impacts in Africans, we sequenced genomes of 232 individuals from three major African ethno-linguistic groups: (1) Niger Congo A from Guinea and Côte d'Ivoire, (2) Niger Congo B from Uganda and the Democratic Republic of Congo and (3) Nilo-Saharans from Uganda. We used GenomeSTRiP and cn.MOPS to identify copy number variant regions (CNVRs). RESULTS: We detected 7608 CNVRs, of which 2172 were only deletions, 2384 were only insertions and 3052 had both. We detected 224 previously un-described CNVRs. The majority of novel CNVRs were present at low frequency and were not shared between populations. We tested for evidence of selection associated with CNVs and also for population structure. Signatures of selection identified previously, using SNPs from the same populations, were overrepresented in CNVRs. When CNVs were tagged with SNP haplotypes to identify SNPs that could predict the presence of CNVs, we identified haplotypes tagging 3096 CNVRs, 372 CNVRs had SNPs with evidence of selection (iHS > 3) and 222 CNVRs had both. This was more than expected (p < 0.0001) and included loci where CNVs have previously been associated with HIV, Rhesus D and preeclampsia. When integrated with 1000 Genomes CNV data, we replicated their observation of population stratification by continent but no clustering by populations within Africa, despite inclusion of Nilo-Saharans and Niger-Congo populations within our dataset. CONCLUSIONS: Novel CNVRs in the current study increase representation of African diversity in the database of genomic variants. Over-representation of CNVRs in SNP signatures of selection and an excess of SNPs that both tag CNVs and are subject to selection show that CNVs may be the actual targets of selection at some loci. However, unlike SNPs, CNVs alone do not resolve African ethno-linguistic groups. Tag haplotypes for CNVs identified may be useful in predicting African CNVs in future studies where only SNP data is available.


Assuntos
Grupo com Ancestrais do Continente Africano/genética , Variações do Número de Cópias de DNA , Genômica/métodos , África/etnologia , Bases de Dados Genéticas , Predisposição Genética para Doença , Genética Populacional , Genoma Humano , Haplótipos , Humanos
14.
Malar J ; 19(1): 59, 2020 Feb 04.
Artigo em Inglês | MEDLINE | ID: mdl-32019571

RESUMO

BACKGROUND: Resistance to anti-malarial drugs hinders malaria elimination. Monitoring the molecular markers of drug resistance helps improve malaria treatment policies. This study aimed to assess the distribution of molecular markers of imported Plasmodium falciparum infections. METHODS: In total, 485 P. falciparum cases imported from Africa, Southeast Asia, and Oceania into Zhejiang province, China, from 2016 to 2018 were investigated. Most were imported from Africa, and only a few cases originated in Asia and Oceania. Blood samples were collected from each patient. Plasmodium falciparum chloroquine resistance transporter (Pfcrt) at residues 72-76 and Kelch13-propeller (k13) were determined by nested PCR and DNA sequence. RESULTS: Wild-type Pfcrt at residues 72-76 was predominant (72.61%), but mutant and mixed alleles were also detected, of which CVIET (22.72%) was the most common. Mutant Pfcrt haplotypes were more frequent in patients from West Africa (26.92%), North Africa (25%), and Central Africa (21.93%). The number of cases of P. falciparum infections was small in Southeast Asia and Oceania, and these cases involved Pfcrt mutant type. For the k13 propeller gene, 26 samples presented 19 different point mutations, including eight nonsynonymous mutations (P441S, D464E, K503E, R561H, A578S, R622I, V650F, N694K). In addition, R561H, one of the validated SNPs in k13, was detected in one patient from Myanmar and one patient from Rwanda. A578S, although common in Africa, was found in only one patient from Cameroon. R622I was detected in one sample from Mozambique and one sample from Somalia. The genetic diversity of k13 was low in most regions of Africa and purifying selection was suggested by Tajima's D test. CONCLUSIONS: The frequency and spatial distributions of Pfcrt and k13 mutations associated with drug resistance were determined. Wild-type Pfcrt was dominant in Africa. Among k13 mutations correlated with delayed parasite clearance, only the R561H mutation was found in one case from Rwanda in Africa. Both Pfcrt and k13 mutations were detected in patients from Southeast Asia and Oceania. These findings provide insights into the molecular epidemiological profile of drug resistance markers in the study region.


Assuntos
Antígenos de Bactérias/genética , Antígenos de Superfície/genética , Malária Falciparum/epidemiologia , Proteínas de Membrana Transportadoras/genética , Plasmodium falciparum/genética , Polimorfismo Genético , Proteínas de Protozoários/genética , Adolescente , Adulto , África/etnologia , Idoso , Criança , China/epidemiologia , Resistência a Medicamentos/genética , Feminino , Variação Genética , Genótipo , Haplótipos , Humanos , Malária Falciparum/etnologia , Masculino , Pessoa de Meia-Idade , Mutação , Mianmar/etnologia , Papua Nova Guiné/etnologia , Filipinas/etnologia , Mutação Puntual , Migrantes , Adulto Jovem
15.
BMC Complement Med Ther ; 20(1): 60, 2020 Feb 18.
Artigo em Inglês | MEDLINE | ID: mdl-32070348

RESUMO

BACKGROUND: Traditional medicine serves as a form of primary health care for more than 80% of African populations. Currently, there is no research documenting if and how African migrant communities engage with their traditional health practices and beliefs after they resettle in Western countries. The aim of this study was to examine African migrant women's experiences and perspectives about traditional and complementary medicine use in relation to their maternal health and wellbeing in Australia. METHODS: We conducted a mixed method study between December 2016 and October 2017. Questionnaires were completed by 319 women and 15 in-depth interviews were conducted among African migrant women residing across the Sydney metropolitan area, Australia. Survey data were analysed using SPSS (version 23) and logistic regression model was used to test associations. Qualitative data were analysed thematically using NVivo 11 software to identify themes and conceptual categories in the participants' responses. The study was informed by Andersen's Socio-behavioural model of health service utilisation. RESULTS: The findings indicated that use of traditional and complementary medicine was high and continued to be well used following African women's resettlement in Australia. The survey found that 232 (72.7%) women use some form of traditional and complementary medicine for maternal health and wellbeing purposes. Most women (179, 77.2%) reported that maintaining their maternal health and wellbeing was the most common reason for use. The interview findings indicated that access to traditional medicine included making requests from relatives and friends who travelled to Africa looking for a similar medicinal plant in Australia and preparing home remedies with advice from family members and healers back in Africa. Age ≥ 35 years (OR, 16.5; 95%CI, 6.58-41.5; p < 0.001), lower education (OR, 24; 95%CI, 8.18-71.1; p < 0.001), parity (OR, 7.3; 95%CI, 1.22-42.81; p = 0.029), and lower income (OR, 2.7; 95%CI, 1.23-5.83; p = 0.013) were strong predictors of traditional medicine use. CONCLUSION: Use of traditional and complementary medicine among African migrant women in Sydney remained high following resettlement in Australia. As noted in Andersen's sociobehavioural model of health service utilisation, specific predisposing and enabling factors including age, education and income were associated with use of traditional and complementary medicine.


Assuntos
Grupo com Ancestrais do Continente Africano/etnologia , Atitude Frente a Saúde/etnologia , Terapias Complementares/estatística & dados numéricos , Saúde Materna/estatística & dados numéricos , Migrantes , Adolescente , Adulto , África/etnologia , Austrália , Feminino , Humanos , Pessoa de Meia-Idade , Inquéritos e Questionários , Adulto Jovem
16.
Int J Infect Dis ; 93: 98-101, 2020 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-32004688

RESUMO

BACKGROUND: Hepatitis B virus (HBV) is a public health threatening virus and is classified into more than eight genotypes and more than forty subgenotypes. OBJECTIVES: To characterize and propose novel strains assigned as A8 and D12. METHODS: Four out of 133 HBV complete genome sequences, isolated from Belgian chronic carriers with African origin were phylogenetically analyzed. RESULTS: Phylogenetic analyses of HBV genotypes A and D strains exhibited separate clusters supported by significant bootstrap values. The two genotype A strains isolated from Congolese patients, and two genotype D strains isolated from Ghanaian carriers clustered separately from the other known subgenotypes A (A1-A6 and quasi-subgenotypes) and subgenotypes D (D1-D11). The mean inter-subgenotypic nucleotide divergence over the full-length genome sequence between the novel strains (A8 and D12) and A1-A7 and D1-D11 subgenotypes was higher than 4%. CONCLUSIONS: Phylogenetic analysis of the full-length HBV genome sequences revealed a novel subgenotype and quasi-subgenotype based on the nucleotide divergence and identification of novel amino acids motifs in different ORFs. We identified two strains of the novel subgenotype A8 and two strains of the novel quasi-subgenotype D12. Notably, the analysis demonstrated that the subgenotype A8 strains are a basal lineage that diverged before the other African subgenotypes A.


Assuntos
Portador Sadio , Vírus da Hepatite B/classificação , Vírus da Hepatite B/genética , Adulto , África/etnologia , Bélgica , Congo/etnologia , Feminino , Genoma Viral , Genótipo , Gana/etnologia , Humanos , Masculino , Filogenia , Análise de Sequência de DNA
17.
Br J Nutr ; 124(5): 481-492, 2020 09 14.
Artigo em Inglês | MEDLINE | ID: mdl-31902380

RESUMO

It is increasingly recognised that the use of BMI cut-off points for diagnosing obesity (OB) and proxy measures for body fatness in a given population needs to take into account the potential impact of ethnicity on the BMI-fat % relationship in order to avoid adiposity status misclassification. This relationship was studied here in 377 Mauritian schoolchildren (200 boys and 177 girls, aged 7-13 years) belonging to the two main ethnic groups: Indian (South Asian descent) and Creole (African/Malagasy descent), with body composition assessed using an isotopic 2H dilution technique as reference. The results indicate that for the same BMI, Indians have more body fat (and less lean mass) than Creoles among both boys and girls: linear regression analysis revealed significantly higher body fat % by 4-5 units (P < 0·001) in Indians than in Creoles across a wide range of BMI (11·6-34·2 kg/m2) and body fat % (5-52 %). By applying Deurenberg's Caucasian-based equation to predict body fat % from WHO-defined BMI thresholds for overweight (OW) and OB, and by recalculating the equivalent BMI values using a Mauritian-specific equation, it is shown that the WHO BMI cut-offs for OB and OW would need to be lowered by 4·6-5·9 units in Indian and 2·0-3·7 units in Creole children in the 7-13-year-old age group. These results have major implications for ethnic-based population research towards improving the early diagnosis of excess adiposity in this multi-ethnic population known to be at high risk for later development of type 2 diabetes and CVD.


Assuntos
Composição Corporal , Índice de Massa Corporal , Grupos Étnicos , Obesidade/diagnóstico , Sobrepeso/diagnóstico , População Urbana , Adolescente , África/etnologia , Criança , Feminino , Humanos , Índia/etnologia , Masculino , Maurício
18.
BMC Public Health ; 20(1): 27, 2020 Jan 08.
Artigo em Inglês | MEDLINE | ID: mdl-31914960

RESUMO

BACKGROUND: Africans immigrants in the United States are the least-studied immigrant group, despite the research and policy efforts to address health disparities within immigrant communities. Although their healthcare experiences and needs are unique, they are often included in the "black" category, along with other phenotypically-similar groups. This process makes utilizing research data to make critical healthcare decisions specifically targeting African immigrants, difficult. The purpose of this Scoping Review was to examine extant information about African immigrant health in the U.S., in order to develop lines of inquiry using the identified knowledge-gaps. METHODS: Literature published in the English language between 1980 and 2016 were reviewed in five stages: (1) identification of the question and (b) relevant studies, (c) screening, (d) data extraction and synthesis, and (e) results. Databases used included EBSCO, ProQuest, PubMed, and Google Scholar (hand-search). The articles were reviewed according to title and abstract, and studies deemed relevant were reviewed as full-text articles. Data was extracted from the selected articles using the inductive approach, which was based on the comprehensive reading and interpretive analysis of the organically emerging themes. Finally, the results from the selected articles were presented in a narrative format. RESULTS: Culture, religion, and spirituality were identified as intertwined key contributors to the healthcare experiences of African immigrants. In addition, lack of culturally-competent healthcare, distrust, and complexity, of the U.S. health system, and the exorbitant cost of care, were identified as major healthcare access barriers. CONCLUSION: Knowledge about African immigrant health in the U.S. is scarce, with available literature mainly focusing on databases, which make it difficult to identify African immigrants. To our knowledge, this is the first Scoping Review pertaining to the healthcare experiences and needs of African immigrants in the U.S.


Assuntos
Atitude Frente a Saúde , Emigrantes e Imigrantes/psicologia , Necessidades e Demandas de Serviços de Saúde , África/etnologia , Emigrantes e Imigrantes/estatística & dados numéricos , Humanos , Estados Unidos
19.
Hist Sci ; 58(1): 51-75, 2020 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-30966814

RESUMO

This essay examines the relationship between slavery and plant knowledge for cultivational activities and medicinal purposes on Isle de France (Mauritius) in the second half of the eighteenth century. It builds on recent scholarship to argue for the significance of slaves in the acquisition of plant material and related knowledge in pharmaceutical, acclimatization, and private gardens on the French colonial island. I highlight the degree to which French colonial officials relied on slaves' ethnobotanical knowledge but neglected to include such information in their published works. Rather than seeking to explore the status of such knowledge within European frameworks of natural history as an endpoint of knowledge production, this essay calls upon us to think about the plant knowledge that slaves possessed for its practical implementations in the local island context. Both female and male slaves' plant-based knowledge enriched - even initiated - practices of cultivation and preparation techniques of plants for nourishment and medicinal uses. Here, cultivational knowledge and skills determined a slave's hierarchical rank. As the case of the slave gardener Rama and his family reveals, plant knowledge sometimes offered slaves opportunities for social mobility and, even though on extremely rare occasions, enabled them to become legally free.


Assuntos
Colonialismo/história , Pessoas Escravizadas/história , Etnobotânica , Jardins/história , Medicina Herbária/história , Plantas Medicinais , África/etnologia , Ásia/etnologia , Escravização/história , Grupos Étnicos/história , Feminino , França , História do Século XVIII , Humanos , Masculino , Maurício
20.
Circ Res ; 126(1): 94-108, 2020 01 03.
Artigo em Inglês | MEDLINE | ID: mdl-31623522

RESUMO

RATIONALE: In black women, triglycerides are paradoxically normal in the presence of insulin resistance. This relationship may be explained by race-related differences in central adiposity and SCD (stearoyl-CoA desaturase)-1 enzyme activity index. OBJECTIVE: In a cross-sectional study, to compare fasting and postprandial triglyceride-rich lipoprotein particle (TRLP) concentrations and size in black compared with white pre- and postmenopausal women and determine the relationship between TRLP subfractions and whole-body insulin sensitivity, hepatic and visceral fat, and SCD-1 levels. METHODS AND RESULTS: In 122 federally employed women without diabetes mellitus, 73 black (58 African American and 15 African immigrant) and 49 white; age, 44±10 (mean±SD) years; body mass index, 30.0±5.6 kg/m2, we measured lipoprotein subfractions using nuclear magnetic resonance. Hepatic fat was measured by proton magnetic resonance spectroscopy, insulin sensitivity index calculated by minimal modeling from a frequently sampled intravenous glucose test, and red blood cell fatty acid profiles were measured by gas chromatography and were used to estimate SCD-1 indices. Hepatic fat, insulin sensitivity index, and SCD-1 were similar in black women and lower than in whites, regardless of menopausal status. Fasting and postprandial large, medium, and small TRLPs, but not very small TRLPs, were lower in black women. Fasting large, medium, and very small TRLPs negatively correlated with insulin sensitivity index and positively correlated with visceral and hepatic fat and SCD-1 activity in both groups. In multivariate models, visceral fat and SCD-1 were associated with total fasting TRLP concentrations (adjR2, 0.39; P=0.001). Black women had smaller postprandial changes in large (P=0.005) and medium TRLPs (P=0.007). CONCLUSIONS: Lower visceral fat and SCD-1 activity may contribute to the paradoxical association of lower fasting and postprandial TRLP subfractions despite insulin resistance in black compared with white pre- and postmenopausal women. Similar concentrations of very small TRLPs are related to insulin resistance and could be important mediators of cardiometabolic disease risk in women. CLINICAL TRIAL REGISTRATION: URL: http://www.clinicaltrials.gov. Unique identifier: NCT01809288.


Assuntos
Adiposidade/etnologia , Grupo com Ancestrais do Continente Africano , Diabetes Mellitus Tipo 2/etnologia , Grupo com Ancestrais do Continente Europeu , Resistência à Insulina/etnologia , Lipoproteínas/sangue , Obesidade/etnologia , Estado Pré-Diabético/etnologia , Estearoil-CoA Dessaturase/fisiologia , Triglicerídeos/sangue , Adulto , África/etnologia , Afro-Americanos , Glicemia/metabolismo , Estudos Transversais , Suscetibilidade a Doenças , Emigrantes e Imigrantes , Ingestão de Energia , Jejum/sangue , Feminino , Humanos , Resistência à Insulina/fisiologia , Gordura Intra-Abdominal/anatomia & histologia , Fígado/anatomia & histologia , Menopausa , Pessoa de Meia-Idade , Período Pós-Prandial , Estearoil-CoA Dessaturase/sangue
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