Progress toward poliomyelitis eradication--South-East Asia, January 2000-June 2001.
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Since the World Health Assembly resolved in 1988 to eradicate poliomyelitis globally, the estimated number of polio cases worldwide has declined 99%. During 1994, member countries of the South-East Asia Region (SEAR) of the World Health Organization (WHO) began accelerating efforts to eradicate polio. By 2000, wild poliovirus was detected in only four of the 10 countries: Bangladesh, India, Nepal, and Myanmar. This report summarizes polio eradication activities during January 2000-June 2001 in SEAR, where wild poliovirus transmission has declined rapidly and is occurring primarily in northern India. (+info)
Musculoskeletal pain is more generalised among people from ethnic minorities than among white people in Greater Manchester.
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OBJECTIVE: To assess the prevalence of musculoskeletal symptoms among the major ethnic minority populations of Greater Manchester. METHOD: The study group was a community sample of 2117 adults from the Indian, Pakistani, Bangladeshi, and African Caribbean communities. Questionnaires administered by post and by an interviewer were used to assess the presence of any musculoskeletal pain, pain in specific joints, and the level of physical function. Ethnicity was self assigned. The results were compared with those from a recent study in the local white population using the same methodology. RESULTS: Overall response rate was 75% among the south Asian (Indian, Pakistani, and Bangladeshi community and 47% among the African Caribbean community. The profile of musculoskeletal pain among the ethnic minority groups differed from that in the white population. Although musculoskeletal symptoms were slightly more prevalent among people from ethnic minority groups than among the white population, pain in multiple sites was considerably more common among ethnic minorities. CONCLUSIONS: The finding that musculoskeletal pain is more widespread among ethnic minority communities in the UK has not previously been reported. This may reflect social, cultural, and psychological differences. The cause of the differences in the profile of pain and the health needs that follow need further investigation. (+info)
The cost barrier to peritoneal dialysis in the developing world--an Asian perspective.
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Countries in Asia vary significantly in culture and socioeconomic status. Dialysis costs and reimbursement structures are significant factors in decisions about the rates and modalities of renal replacement therapy. From our survey of Asian nephrologists conducted in 2001, a number of observations can be made. In many developing countries, the annual cost of continuous ambulatory peritoneal dialysis (CAPD) is greater than the per-capita gross national income (GNI). The median cost of a 2-L bag of peritoneal dialysis (PD) fluid is around US$5. The absolute cost of PD fluid among countries with significant differences in per-capita GNI actually varies very little. Thus, most renal failure patients can be expected to have problems accessing PD therapy in developing countries in Asia. In countries with unequal reimbursement policies for PD versus hemodialysis, a lack of incentive to prescribe PD also exists. Automated PD is nearly non existent in many developing countries in Asia. Some possible ways to reduce the cost barriers to PD in those countries include individual governments providing more public funding for treating dialysis patients; dialysate-producing companies reducing the cost of their products; physicians using appropriately smaller exchange volumes (3 x 2 L) in some Asian patients with smaller body sizes and with residual renal function; and reducing the complication rate for PD (for example, peritonitis) thereby reducing the costs required for treatment and hospitalization. (+info)
Relation between racial discrimination, social class, and health among ethnic minority groups.
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OBJECTIVES: This study explored associations between racism, social class, and health among ethnic minority people in England and Wales. METHODS: We conducted a series of regression analyses on cross-sectional data from the Fourth National Survey of Ethnic Minorities to explore the relation between different indicators of racism and health and household occupational class. RESULTS: Marked independent associations existed between reported experience of racism and perceptions of Britain as a "racist society," household social class, age, sex, and various mental and physical health indicators. These associations showed reasonable consistency across the different ethnic groups. CONCLUSIONS: The different ways in which racism may manifest itself (as interpersonal violence, institutional discrimination, or socioeconomic disadvantage) all have independent detrimental effects on health, regardless of the health indicator used. (+info)
High-resolution analysis of Y-chromosomal polymorphisms reveals signatures of population movements from Central Asia and West Asia into India.
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Linguistic evidence suggests that West Asia and Central Asia have been the two major geographical sources of genes in the contemporary Indian gene pool. To test the nature and extent of similarities in the gene pools of these regions we have collected DNA samples from four ethnic populations of northern India, and have screened these samples for a set of 18 Y-chromosome polymorphic markers (12 unique event polymorphisms and six short tandem repeats). These data from Indian populations have been analysed in conjunction with published data from several West Asian and Central Asian populations. Our analyses have revealed traces of population movement from Central Asia and West Asia into India. Two haplogrops, HG-3 and HG-9, which are known to have arisen in the Central Asian region, are found in reasonably high frequencies (41.7% and 14.3% respectively) in the study populations. The ages estimated for these two haplogroups are less in the Indian populations than those estimated from data on Middle Eastern populations. A neighbour-joining tree based on Y-haplogroup frequencies shows that the North Indians are genetically placed between the West Asian and Central Asian populations. This is consistent with gene flow from West Asia and Central Asia into India. (+info)
Nutrition, adequacy of dialysis, and clinical outcome in Indo-Asian and White European patients on peritoneal dialysis.
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BACKGROUND: There is a high incidence of end-stage renal disease in Asians originating from the Indian subcontinent living in the UK. Research to date has focused on the cause of renal disease in Indo-Asians, and their outcome on peritoneal dialysis (PD) is less well studied. AIM: To determine whether nutrition, adequacy of dialysis, and outcome of Indo-Asian patients on PD were similar to those of White European patients. DESIGN: Prospective longitudinal observational study over 2 years. METHODS: We enrolled 35 Indo-Asians and 35 White Europeans on peritoneal dialysis, closely matched for age, gender, diabetes and duration of renal replacement therapy. At enrolment (>3 months on PD), demographic data was recorded. From enrolment, and at 6-month intervals, dialysis adequacy, nutritional status, hospitalizations, PD infections, and treatment modality changes were recorded. RESULTS: Dietary protein intake, which was significantly worse in Indo-Asians (particularly vegetarians), declined in all patients over time, along with other measures of nutritional status. Adequacy of dialysis, peritoneal characteristics, and PD infections were similar in Indo-Asian and White patients. Technique failure, and death rate were similar in both groups, but the transplant rate was lower in Indo-Asians. DISCUSSION: Interventions are needed to improve nutritional status in these patients, particularly the Indo-Asian patients. The long-term impact of worse social deprivation and lower transplant rates in Indo-Asians needs to be investigated further. (+info)
The genetic heritage of the earliest settlers persists both in Indian tribal and caste populations.
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Two tribal groups from southern India--the Chenchus and Koyas--were analyzed for variation in mitochondrial DNA (mtDNA), the Y chromosome, and one autosomal locus and were compared with six caste groups from different parts of India, as well as with western and central Asians. In mtDNA phylogenetic analyses, the Chenchus and Koyas coalesce at Indian-specific branches of haplogroups M and N that cover populations of different social rank from all over the subcontinent. Coalescence times suggest early late Pleistocene settlement of southern Asia and suggest that there has not been total replacement of these settlers by later migrations. H, L, and R2 are the major Indian Y-chromosomal haplogroups that occur both in castes and in tribal populations and are rarely found outside the subcontinent. Haplogroup R1a, previously associated with the putative Indo-Aryan invasion, was found at its highest frequency in Punjab but also at a relatively high frequency (26%) in the Chenchu tribe. This finding, together with the higher R1a-associated short tandem repeat diversity in India and Iran compared with Europe and central Asia, suggests that southern and western Asia might be the source of this haplogroup. Haplotype frequencies of the MX1 locus of chromosome 21 distinguish Koyas and Chenchus, along with Indian caste groups, from European and eastern Asian populations. Taken together, these results show that Indian tribal and caste populations derive largely from the same genetic heritage of Pleistocene southern and western Asians and have received limited gene flow from external regions since the Holocene. The phylogeography of the primal mtDNA and Y-chromosome founders suggests that these southern Asian Pleistocene coastal settlers from Africa would have provided the inocula for the subsequent differentiation of the distinctive eastern and western Eurasian gene pools. (+info)
Evolutionary relationships among strains of Mycobacterium tuberculosis with few copies of IS6110.
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Molecular typing of Mycobacterium tuberculosis by using IS6110 shows low discrimination when there are fewer than five copies of the insertion sequence. Using a collection of such isolates from a study of the epidemiology of tuberculosis in London, we have shown a substantial degree of congruence between IS6110 patterns and both spoligotype and PGRS type. This indicates that the IS6110 types mainly represent distinct families of strains rather than arising through the convergent insertion of IS6110 into favored positions. This is supported by identification of the genomic sites of the insertion of IS6110 in these strains. The combined data enable identification of the putative evolutionary relationships of these strains, comprising three lineages broadly associated with patients born in South Asia (India and Pakistan), Africa, and Europe, respectively. These lineages appear to be quite distinct from M. tuberculosis isolates with multiple copies of IS6110. (+info)