Genetic load in an isolated tribal population of south India

Summary The Kota of Nilgiri Hills, Tamilnadu, are an isolated tribal population and occupy the lowest stratum in the local social hierarchy. They have developed an economic symbiotic relationship with other tribes of the Nilgiri Hills (e.g., Toda, Kurumba, Badaga), but have almost no social relationship with other communities, such as the Hindu and Muslim, communities, etc. The total population of the Kota is about 1200. Consanguineous marriages are highly favoured in this group.This paper presents data on prenatal, infant and adolescent mortality in relation to the degree of inbreeding. No perceptible difference has been found in mortality figures between consanguineous and non-consanguineous marriages. This may be due to the long history of inbreeding among the Kota. No case of visible congenital malformation has been noticed.The estimates of genetic load as revealed by inbreeding data indicate that genetic load in the Kota is low (perhaps about 1 lethal equivalent per gamete); it is also low in comparison with that in other Indian populations.     

Under-diagnosis and under-ascertainment of cases may be the reasons for low childhood cancer incidence in rural India

Cancer statistics from India revealed that childhood cancer incidence is lesser in rural than urban India. This might be due to under-diagnosis or under-ascertainment of cases or could even be true. With registries able to explicitly measure and appropriately streamline the ascertainment of cases to comply with acceptable standards, it is under-diagnosis that is variable and highly influenced by development of or accessibility to specialized centres in or around the registry area. This is reflected implicitly by marked variation in incidence between different populations in India: weighted age standardized rates of all childhood cancers together was the highest (108 per million) in metropolitan areas, followed by other urban (86) and rural (53) areas in that order. A childhood cancer registry focusing on pertinent data collection and specific epidemiological studies is desirable to explain the variations in incidence and outcome of childhood cancers in India.     

Selection intensities in menopausal and permanent contraceptor women of a rural population in India

Changing fertility and mortality patterns due to socioeconomic forces have a profound effect on natural selection in human populations. The opportunity for selection was estimated in the rural population of Visakhapatnam District, Andra Pradesh, India, in 1979. A total of 1570 women were interviewed, 1544 among them had ever been pregnant. Data were analyzed to compute fertility and mortality components of the population. The index of total selection was found to be low. Selection in relation to birth control reveals that opportunity for selection is lower among women who completed their fertility by family planning methods than in women who completed their fertility by attaining menopause. Further, the results showed that differential fertility and mortality make equal contributions to the total measure of selection in both groups, whereas in developed countries like the US the mortality component contributes only a small fraction to the total index, due to improved health conditions.     

Selection intensities in menopausal and permanent contraceptor women of a rural population in India

Abstract

The opportunity for selection was estimated in the rural population of Visakhapat‐nam District, Andhra Pradesh, India. The index of total selection was found to be low. Selection in relation to birth control reveals that opportunity for selection is lower among the women who completed their fertility by family planning methods than in women who completed their fertility by attaining menopause. Further, the results showed that differential fertility and mortality make equal contributions to the total measure of selection in both groups.     

High prevalence of diabetes in an urban population in south India.

An urban population in a township in south India was screened for diabetes with an oral glucose tolerance test, every fifth person aged 20 and over registered at the local iron ore company''s hospital being screened. Of 678 people (346 men and 332 women) who were tested, 34 (5%; 20 men and 14 women) had diabetes and 14 (2%; 8 men and 7 women) had impaired glucose tolerance. Thirteen subjects were already known to be diabetic. Diabetes was present in 21% (37/179) of people aged over 40. The peak prevalence (41%; 7/17) was in the group aged 55-64. A family history of diabetes was present in 16 of the 34 subjects with diabetes and nine of the 15 with impaired glucose tolerance. Diabetes was significantly related to obesity in women but not in men (57% (8/14) v 5% (1/20)). The plasma glucose concentration two hours after glucose loading was correlated to body mass index, age, and income in both sexes. The prevalence of diabetes was significantly higher in subjects whose income was above the mean. When the overall prevalence of diabetes was adjusted to the age distribution of the Indians living in Southall, London, and in Fiji it increased to 10% and 9%, respectively. The prevalence of diabetes is high among urban Indians and is comparable with the high prevalence seen in migrant Indian populations.     

Birth rights and rituals in rural south India: care seeking in the intrapartum period

Maternal morbidity and mortality are high in the Indian context, but the majority of maternal deaths could be avoided by prompt and effective access to intrapartum care (WHO, 1999). Understanding the care seeking responses to intrapartum morbidities is crucial if maternal health is to be effectively improved, and maternal mortality reduced. This paper presents the results of a prospective study of 388 women followed through delivery and traditional postpartum in rural Karnataka in southern India. In this setting, few women use the existing health facilities and most deliveries occur at home. The analysis uses quantitative data, collected via questionnaires administered to women both during pregnancy and immediately after delivery. By virtue of its prospective design, the study gives a unique insight into intentions for intrapartum care during pregnancy as well as events following morbidities during labour. Routine care in the intrapartum period, both within institutions and at home, and impediments to appropriate care are also examined. The study was designed to collect information about health seeking decisions made by women and their families as pregnancies unfolded, rather than trying to capture women's experience from a retrospective instrument. The data set is therefore a rich source of quantitative information, which incorporates details of event sequences and health service utilization not previously collected in a Safe Motherhood study. Additional qualitative information was also available from concurrent in-depth interviews with pregnant women, their families, health care providers and other key informants in the area. The level of unplanned institutional care seeking during the intrapartum period within the study area was very high, increasing from 11% planning deliveries at a facility to an eventual 35% actually delivering in hospitals. In addition there was a significant move away from planned deliveries with the auxiliary nurse midwive (ANM), to births with a lay attendant or dai. The proportion of women who planned for an ANM to assist was 49%, as compared with the actual occurrence, which was less than half of this proportion. Perceived quality of care was found to be an important factor in health seeking behaviour, as was wealth, caste, education and experience of previous problems in pregnancy. Actual care given by a range of practitioners was found to contain both beneficial and undesirable elements. As a response to serious morbidities experienced within the study period, many women were able to seek care although sometimes after a long delay. Those women who experienced inadequate progression of labour pains were most likely to proceed unexpectedly to a hospital delivery.     

The incidence and histo-pathological characteristics of colorectal cancer in a population based cancer registry in Zimbabwe

BackgroundData on colorectal cancer (CRC) in sub-Saharan Africa is mainly based on hospital series which suggest low incidence and frequent early onset cancers. This study characterises colorectal cancer in a population-based cancer registry in Zimbabwe.MethodsCases of CRC recorded by the Zimbabwe National Cancer Registry between 2003 and 2012 were analysed. Demographic and pathological characteristics were compared according to ethnicity and age. Trends in age standardised incidence rates (ASR) were determined.ResultsThere were 886 and 216 cases of CRC among black Africans and Caucasians respectively, and 26% of the black Africans were younger than 40 years. Signet ring cell carcinomas were more common among black Africans compared to Caucasians (4% vs 1%, p = 0.027). ASR increased by 1.9%/year and 3.9%/year among black African males and females respectively.ConclusionCRC incidence is rising among black Africans and has unique demographic and pathological characteristics.     

AB0 blood groups and smallpox in a rural population of West Bengal and Bihar (India)

The problem was reexamined whether there is a relationship between the AB0 blood groups and incidence, severity and outcome of smallpox. In persons suffering from smallpox, and living in rural areas of West Bengal and Bihar, India, severity and outcome of the disease were registered, and the AB0 blood groups were determined. Healthy siblings were used as controls for incidence. Four series were available:

1. 1.
   200 suffering patients and 200 controls examined during summer 1965 in the Burdwan district. West Bengal.     
   
   

Socioeconomic position and incidence of colorectal cancer in the Swedish population

BackgroundThe association between socioeconomic position and incidence of colorectal cancer is inconsistent and differs by global region. We aimed to clarify this association in the Swedish population.MethodsWe conducted a population-based open cohort study using data from Swedish national registers. We included all individuals, aged ≥30 years, residing in Sweden between 1993 and 2010. Socioeconomic position was indicated by (1) highest educational level (five groups), and (2) disposable income (quintiles). We used Poisson regression to estimate incidence rate ratios (IRR) and 95% confidence intervals (95% CI) of colon and rectal cancer, and colon and rectal dysplasia.ResultsIn total, 97,827,817 person-years were accumulated and 82,686 cases of colorectal cancer were diagnosed. Compared to men with ‘higher secondary’ education, the adjusted IRRs (95% CI) of rectal cancer in men with ‘primary or less’, ‘lower secondary’, ‘lower university’ or ‘higher university’ education were: 1.06 (1.00, 1.11), 1.05 (0.99, 1.10), 0.96 (0.89, 1.03), and 0.92 (0.86, 0.98), respectively. In women, the corresponding figures were: 1.04 (0.95, 1.14), 1.03 (0.94, 1.13), 0.92 (0.82, 1.02) and 0.92 (0.82, 1.02). Disposable income was not associated with rectal cancer incidence. Adjusted IRRs of colon cancer did not differ between levels of education or disposable income overall or for specific colon sub-sites. Neither education nor disposable income was consistently associated with incidence of colon or rectal dysplasia.ConclusionsPrevention strategies for colon cancer should be applicable to individuals regardless of their socioeconomic position. However, factors conferred by education, e.g., health awareness, may be important for approaches aiming to reduce inequalities in incidence of rectal cancer. Further evaluation of cancer prevention and health promotion strategies among less educated groups is warranted.     

Maternal and fetal nutrition in south India.

The relation between the nutrition of the mother and that of her baby was assessed in a south Indian community where malnutrition is common and women do not smoke. Unselected mothers and their infants of over 37 weeks'' gestation were studied in two groups: those who paid for their care (150) and a poorer group who did not (172). There were significnat differences between the paying and non-paying groups in maternal triceps skinfold thickness, infant weight, and infant length. Overall there was a significant positive correlation between maternal triceps thickness and infant weight, length, and triceps and subscapular skinfold thickness. The correlation with the infant head circumference was less significant. These findings are further evidence that the nutrition of the mother has an important effect on the nutrition of her baby and that malnutrition is an important reason why Indian babies are lighter than European ones.     

The rising incidence and mortality of prostate cancer in Belgrade population

The purpose of this study was to analyze the epidemiological situation of prostate cancer in Belgrade population. Morbidity data were obtained from the Institute of Public Health of Serbia for the period 1999-2005. Mortality data for the period 1990-2006, were derived from the Statistical Office of Republic of Serbia. Average standardized incidence and mortality rates for the prostate cancer were 33.57 and 11.86 respectively. Standardized incidence rates of prostate cancer steadily increased from 29.34 per 100,000 in 1999 to 36.86 per 100,000 in 2005. In the observed period, the mortality rates significantly increased in the age groups 50-59 (y = 2.77+0.42x, p = 0.015), 70-79 (y = 61.92+10.70x, p = 0.000) and 80+ (y = 183.08+19.99x, p = 0.000). The average annual percentage of changes (AAPC) was the highest (7.2%) for the 70-79 age group, the lowest (0.1%) for the youngest group (< or = 50), and 5% for the total. The increase of prostate cancer incidence and mortality during the observed period in Belgrade population indicate urgent need for Serbian health professionals to adopt existing evidence-based cancer control and preventive measures. A national policy including prostate specific antigen (PSA) screening should be considered.     

Genetic epidemiological study of blood pressure in a sedentary rural agricultural population of West Bengal, India

To study the genetic epidemiology of blood pressure (BP), data on 78 families were collected from a sedentary agricultural population of eastern India. The general levels of both systolic (SBP) and diastolic (DBP) blood pressures are found to be low (mean SBP = 106.41 mm Hg; mean DBP = 63.94 mm Hg). Trends of blood pressures with age are similar to those reported earlier (e.g., in the Framingham study). Environmental variables--e.g., occupation and tobacco use--do not have any direct significant effect on blood pressure variability in this population. Path analysis of family data shows a highly significant familial aggregation and yields a genetic heritability (maximum) estimate of 0.3 for both SBP and DBP. Sib-sib and mother-child correlation estimates are, respectively, 0.3 and 0.25. Father-child correlation estimates are 0.13 for SBP and near zero for DBP. A pseudopolygenic model yields the best fit to the data on SBP, while for DBP a proper resolution of various models considered could not be obtained.     

Frequency of HLA antibodies in south India

Sera from 4088 pregnant women (649 antenatal bleeding and 3439 post-partum bleeding) living in Madurai, were collected and screened for anti-HLA. A, B and DR antibodies. 696 of them were screened for anti-HLA DR antibodies. Ten per cent (65/649) of antenatal sera and 13 4% of post-partum sera (463/3439) were positive for HLA A and B antibodies: nonetheless the percentage of monospecific sera were almost the same in both. Screening for HLA DR antibodies were carried out using platelet absorption in test tray technique: seventy three of 696 (10.5%) were positive. The incidence of anti-HLA A, B antibodies correlates to the allelic frequencies in the population. Thus in India, collection and screening post-partum haemorrhage is the simplest and cost effective method of acquiring polyclonal sera for routine laboratory and diagnostic use.     

Educational status,coronary heart disease,and coronary risk factor prevalence in a rural population of India.

OBJECTIVE--To define the association between educational level and prevalence of coronary heart disease and coronary risk factors in India. DESIGN--Total community cross sectional survey with a doctor administered questionnaire, physical examination, and electrocardiography. SETTING--A cluster of three villages in rural Rajasthan, western India. SUBJECTS--3148 residents aged over 20 (1982 men, 1166 women) divided into various groups according to years of formal schooling. RESULTS--Illiteracy and low educational levels were associated with less prestigious occupations (agricultural and farm labouring) and inferior housing. There was an inverse correlation of educational level with age (rank correlation: mean -0.45, women -0.49). The prevalence of coronary heart disease (diagnosed by electrocardiography) was significantly higher among uneducated and less educated people and showed an inverse relation with education in both sexes. Among uneducated and less educated people there was a higher prevalence of the coronary risk factors smoking and hypertension. Educational level showed a significant inverse correlation with systolic and diastolic blood pressure. Logistic regression analysis with adjustment for age showed that educational level had an inverse relation with prevalence of electrocardiographically diagnosed coronary heart disease (odds ratio: men 0.82, women 0.53), hypertension (men 0.88, women 0.56), and smoking (men 0.73, women 0.65) but not with hypercholesterolaemia and obesity. The inverse relation of coronary heart disease with educational level abated after adjustment for smoking, physical activity, body mass index, and blood pressure (odds ratio: men 0.98, women 0.78). CONCLUSION--Uneducated and less educated people in rural India have a higher prevalence of coronary heart disease and of the coronary risk factors smoking and hypertension.     

Edentulousness and associated risk factors in a south Brazilian elderly population

Aim: To examine the relationship between edentulousness and the socioeconomic and behavioural variables collected in a cross‐sectional study of an elderly population. Methods: The study was conducted on 277 elderly (60 years or older) in the municipality of Biguaçu, Southern Brazil. The oral examinations and questionnaires were conducted by two calibrated dentists. The criteria used followed the WHO and FDI standards. Results: Prevalence of edentulousness reached 48.4%. A significant association was found in bivariate analysis for gender, satisfaction with appearance, time since last dental visit, the type of dental service sought in the last 5 years, educational level of the elderly and their children, and age of the elderly. In the multivariate analysis, gender, time since last dental visit and level of education of the elderly were significantly associated with edentulousness. Conclusions: Female sex and low educational level were the main risk factors for edentulousness in this population. Although various Brazilian studies suggest a decline in edentulousness in the country, methodologically robust research into edentulousness in Brazil is still limited, demanding further studies into this highly prevalent yet preventable health problem amongst the elderly.