Assessment of glucose-6-phosphate dehydrogenase activity using CareStart G6PD rapid diagnostic test and associated genetic variants in Plasmodium vivax malaria endemic setting in Mauritania.

BACKGROUND: Primaquine is recommended by the World Health Organization (WHO) for radical treatment of Plasmodium vivax malaria. This drug is known to provoke acute hemolytic anemia in individuals with glucose-6-phosphate dehydrogenase (G6PD) deficiency. Due to lack of data on G6PD deficiency, the use of primaquine has been limited in Africa. In the present study, G6PD deficiency was investigated in blood donors of various ethnic groups living in Nouakchott, a P. vivax endemic area in Mauritania. METHODOLOGY/PRINCIPAL FINDINGS: Venous blood samples from 443 healthy blood donors recruited at the National Transfusion Center in Nouakchott were screened for G6PD activity using the CareStart G6PD deficiency rapid diagnostic test. G6PD allelic variants were investigated using DiaPlexC G6PD genotyping kit that detects African (A-) and Mediterranean (B-) variants. Overall, 50 of 443 (11.3%) individuals (49 [11.8%] men and 1 [3.7%] woman) were phenotypically deficient. Amongst men, Black Africans had the highest prevalence of G6PD deficiency (15 of 100 [15%]) and White Moors the lowest (10 of 168, [5.9%]). The most commonly observed G6PD allelic variants among 44 tested G6PD-deficient men were the African variant A- (202A/376G) in 14 (31.8%), the Mediterranean variant B- (563T) in 13 (29.5%), and the Betica-Selma A- (376G/968C) allelic variant in 6 (13.6%). The Santamaria A- variant (376G/542T) and A variant (376G) were observed in only one and two individuals, respectively. None of the expected variants was observed in 8 (18.2%) of the tested phenotypically G6PD-deficient men. CONCLUSION: This is the first published data on G6PD deficiency in Mauritanians. The prevalence of phenotypic G6PD deficiency was relatively high (11.3%). It was mostly associated with either African or Mediterranean variants, in agreement with diverse Arab and Black African origins of the Mauritanian population.

Frequencies and ethnic distribution of ABO and Rh(D) blood groups in Mauritania: results of first nationwide study.

There is no data available on the ABO/Rh(D) frequencies in the Mauritanian population. We retrospectively analysed records of a 5-year database that contained ABO/Rh phenotype and ethnic origin of 10 116 volunteers giving blood at the national blood transfusion centre to derive the frequencies of ABO/Rh(D) groups in the Mauritanian population. The two race categories in the country and their sub-ethnic groups: the Moors (whites and black) and the black Africans (Pulhars, Soninkes and Wolof) were included in this study. Globally, group O had the highest frequency (49.10%) followed by A (28.28%), B (18.56%) and AB (4.05%). This order more common in North African populations was found in four of the five ethnic groups composing our population. Allele frequencies were, respectively, 70.20%, 17.74% and 12.04% giving the same order of O > A > B. We observed no significant variation in these frequencies between the different ethnic groups. Rhesus study showed that with a percentage of 94.23% Rh(D) positive is by far the most prevalent, while Rh(D) negative is present only in 5.77% of the total population. This frequency distribution supports the mixed-race composition of the Mauritanian population.

Clinical issues in caring for former chattel slaves.

Over the centuries, slavery has become embedded into the social fabric of Mauritania with generations of abid and bizan (Mauritanian slaves and slave masters, respectively) born and raised knowing nothing but the institution of chattel slavery. Abid fleeing their station in Mauritania come to the USA with unique psychological needs that will affect all of their interactions with the medical community. This paper aims to assist health professionals and others concerned with the welfare of former chattel slaves in competently serving this vulnerable population. Discussion includes an overview of Mauritanian chattel slavery, deduced sequelae of chattel slavery, preliminary recommendations for mental health and medical treatment protocols, and suggestions for future research. A confidential Institutional Review Board (IRB)-approved case report will be used to illustrate these objectives.

West African immigrant families from Mauritania and Senegal in Cincinnati: a cultural primer on children's health.

Similar to many cities in the US, the Greater Cincinnati area has recently had an increase in immigrants from other countries. In particular, there is a small but growing population of West African immigrants especially from Senegal and Mauritania. In order to better understand children's health of West African families in the Cincinnati area, in-depth, in-home narrative interviews were conducted with ten West African immigrant parents from Senegal and Mauritania. Four salient themes about cultural information related to children's health were derived from the qualitative analysis: (1) health care practice and expectations including barriers; (2) cultural values and identity; (3) health beliefs and traditions/customs; and (4) quality of life. It is essential that health care providers understand the nuances of working with West African immigrants including cultural differences, strengths, challenges and perceptions in order to provide these individuals with the most effective health care services.

[Schistosoma haematobium among immigrants consulting in municipal free clinics in Paris in 2003]. / La schistosomose urinaire chez des migrants ayant consulté dans des centres médico-sociaux de Paris en 2003.

The "Consultations de Diagnostic et d'Orientation" (CDO) are free medical consultations for precarious populations, proposed by the Health Department of Paris. More than two-thirds of the CDO patients come from Sub-Saharan Africa. Schistosoma haematobium (SH) is one of the most frequent infectious diseases detected within CDO. More than a thousand people have consulted for the first time in CDO in 2003 in one of the municipal free Clinics which proposes this service. Parasitologic test of urine has been performed among 220 patients and found 24 positive results: viable eggs of SH (10.8%). All 24 patients are male, most of them are under 35 years-old and come from the region of the Senegal River that lies in the junction of Mali, Senegal and Mauritania. We want to remind physicians in non-tropical setting to think of SH when they see a patient originating from Africa. To ask him if he presents haematuria and if not, to prescribe a parasitologic test of urine. If all patients from endemic regions had undergone this screening in 2003, we would have detected about 20 more cases of SH. If treated early enough, it could avoid severe uronephrological complications, which are rare but represent a high health care cost (bladder tumor, renal failure).

[Urogenital bilharziasis: imaging diagnosis]. / Bilharziose urogénitale: diagnostic par imagerie.

Urogenital bilharziasis is a well-known disease that seldom is encountered in western countries. Therefore, bilharziasis usually only is considered after tuberculosis, the main differential diagnosis, has been excluded. Using this case, we will discuss the value of different imaging techniques (especially that of CT combined with transrectal US) for diagnosing bilharziasis and review specific criteria to more easily distinguish both pathologies.

[Delivery in France of patients born in Black Africa]. / L'accouchement en France des patientes nées en Afrique Noire.

171 cases of African women who delivered at the Maternity Hospital in Le Havre were analyzed. A few specific points are worth mentioning. During the pregnancy, serology is often positive for treponema, and many women are not immunized against toxoplasmosis and rubella (German measles), and anemia is so frequent that its prevention must be systematic. The pelvis may seem narrowed transversally at the upper strait. However, delivery is usually easy with a high rate of episiotomies and perineal tears, representing the obstetrical cost of the ritual excision procedure. It is not necessary to perform caesarean sections more often in African than in other women, more especially as caesarean section is poorly tolerated and exposes the patient to the risk of rupture of the uterus when they deliver again in their own country. The newborn is rather small, more in weight than size or cranial circumference, without the possibility of incriminating only the ethnic factor. Perinatal morbidity and mortality do not appear to be higher than in the general population.

Geographical and ethnical distribution of HBs antigen subtypes in Mauritania.

A survey conducted in sera from 515 black and 499 white individuals living in 8 villages of Mauritania showed an HBs Ag prevalence of 15.7%. Two main subtypes, ayw2 (34.7%) and ayw4 (63%), were found in this country which is a junction area between North and West Africa and where 2 ethnic groups are living close one to the other but with very rare cross-breeding. ayw2 was more prevalent in the driest part of the country (North) and ayw4 in the South. Analysis of the subtype distribution in each village indicates that there is no relationship between HBs Ag subtype and ethnic groups, but there is a correlation between HBs Ag subtype and the geographical location of the villages.