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[Genetic structure of Tujia as revealed by Y chromosomes].

Tujia people call themselves "Bizika", which means aboriginal. Genetic study of Tujia is virtually absent. To characterize the genetic structure of Tujia,the distribution of 14 Y haplogroups was studied in Tujia populations sampled from Enshi, Hubei (31 males) and Jishou, Hunan (68 males). A total of eight haplogroups were observed in the Enshi and Jishou populations. The haplogroup frequencies of Tujia were compared with the frequencies of other related ethnic groups, including Northern Han, Southern Han, Tibetan-Burman speaking populations,Daic and Hmong-Mien. The principal component (PC) analysis was conducted and the PCs were plotted to explore the historical migrations. In addition, partial correlation analysis was performed to study the relationship between the first three PCs and the haplogroups. The PC2 revealed a cluster of Tujia groups including Longshan,Yongshun, and Enshi with Lahu, suggesting possible interaction between Tujia and the Di-Qiang groups. However,a similarity between Han and Tujia populations, though differentiated, were also observed. We postulated, by incorporating the results of archaeological and historical evidences, that the Ba people, the ancestors of the Tujia,might be related with Di-Qiang groups and inhabited the Tujia area initially before a substantial interaction with Han and other ethnic groups.

Asian People↗

The new face of refugee resettlement in Wisconsin: what it means for physicians and policy makers.

BACKGROUND: Historically, Wisconsin has received refugees from 3 large geographic areas: Southeast Asia, the Former Soviet Union, and the former Republic of Yugoslavia. However, recent trends demonstrate a dramatic increase in the number of countries from which current refugees originate. Further, state migration patterns show that most counties in Wisconsin have sizable per capita refugee populations and can expect more. OBJECTIVE: This paper describes past and current refugee resettlement trends and their ramifications on health care delivery, health policy, and social development in Wisconsin. METHODS: Statistical data on national, regional, and state refugee resettlement trends was obtained from the US Department of Health and Human Services' Office of Refugee Resettlement and the Wisconsin Department of Workforce Development. Additional data was obtained from Milwaukee-based refugee service agencies. Further, discussions were held with health officials in Barron County and around the Midwest. FINDINGS: Beginning in the 1980s, with the influx of Laotian Hmong refugees, and continuing through the late 1990s with the end of the Balkan Wars, Wisconsin has provided safe refuge for thousands of refugees. Over the last 5 years the diversity of refugees being resettled in Wisconsin has accelerated to include an array of countries. This phenomenon has led to an increase in the range of health behaviors and health needs characteristic of these populations. The new face of refugee immigration has profound implications on Wisconsin's health landscape, not only in terms of clinical disease, but also in health policy, planning, and social development.

Asia, Southeastern↗

Obstetric care of a Southeast Asian refugee population in a midwestern community.

The obstetric records of 430 Hmong and other Southeast Asian refugee women were retrospectively reviewed from January 1, 1977 to July 1, 1988. All patients gave birth in two hospitals in a midwestern community, La Crosse, Wisconsin. Lack of medical care for early pregnancy complications, late onset of obstetric care, anemia, and high rates of parasites and hepatitis occurred frequently in pregnancy. Admission in advanced labor, a low operative delivery rate (6%), and a higher prematurity rate characterized intrapartum care. Birthweight data revealed statistically significantly smaller infants after 38 weeks' gestation. Postpartum febrile morbidity and neonatal complications were rare. Cultural differences and their effects on obstetric care are discussed.

Abortion, Spontaneous↗

Cardiovascular disease risk factors in an Indochinese population.

One hundred seventeen Indochinese adults were screened for heart disease risk factors at a San Diego community health facility during December 1986. Two levels of excess risk, moderate-high and high, were categorically defined for blood pressure, total cholesterol, cigarette smoking, and obesity. Overall, 61% were at moderate-high or high risk in at least one category, and 34% were at high risk by these criteria. Systolic blood pressure, diastolic blood pressure, and total cholesterol were positively correlated to age, and ethnicity was a significant covariate for cholesterol, body mass index, and cigarette smoking. The Hmong, compared with other Indochinese, had a significantly lower mean cholesterol level, which remained after adjusting for age and body mass. High rates of cigarette smoking were found among Vietnamese men and young Indochinese men. If confirmed, the high prevalence of heart disease risk factors in Indochinese refugees and immigrants suggests that cardiovascular health education programs are appropriate in Indochinese communities.

Adolescent↗

The use of chemical weapons. Conducting an investigation using survey epidemiology.

The use of chemical weapons in conflict represents a breach of international law as well as a grave violation of human rights. Investigating allegations of their use often is difficult. A basic tool is the survey interview. Experience has shown that a rigorous epidemiologic approach should be taken. A primary emphasis should be designing the study so that consistency of responses can be analyzed to judge the validity of the testimony. Only when the testimony can withstand this scrutiny is it possible to surmise the possible identity of agents employed. Securing samples of the putative agent is of obvious importance. Two recent investigations are discussed herein, one conducted by US Army medical researchers on allegations of chemical weapons use against the Hmong in Laos and another mounted by us on allegations of poison-gas attack against the Iraqi Kurds.

Chemical Warfare Agents↗

Comparative seroepidemiology of HTLV-I and HTLV-III in the French West Indies and some African countries.

The prevalence of antibodies detected by ELISA against human T-lymphotropic viruses, type I (HTLV-I) and type III (HTLV-III-LAV), is described in a comparative serosurvey in the French West Indies and African countries. The data confirm that the Caribbean basin is endemic for HTLV-I. In this region, HTLV-I antibody prevalence varied from 3.4% to 5.2% among blood donors and increased with age to reach a value of 33% among elderly people from the Dominica Island. In French Guyana, a South American country bordering the Caribbean sea, differences in antibody distribution across three ethnic groups (black Bonis, Indian Wayanas, and Hmongs from Asia) provide clues for investigation of the mode of HTLV-I transmission. Africa appears to be an endemic continent for HTLV-I and HTLV-III. For both viruses, the antibody prevalence exhibited an increasing gradient from northern to equatorial through Sudanic areas. These preliminary data by showing that Africa represents an endemic reservoir of HTLVs and, possibly, of other human retroviruses should stimulate further investigations on the natural history and the geographical origin of these viruses.

Adolescent↗

Analysis for Fusarium toxins in various samples implicated in biological warfare in Southeast Asia.

Samples of leaves, water, cereal grains, soil, and yellow powder as well as blood, urine, and body tissues from chemical warfare victims were analyzed for Fusarium toxins by using gas chromatography and mass spectrometry. The leaves, water, and yellow powder samples contained various combinations of T-2 toxin, diacetoxyscirpenol, deoxynivalenol, nivalenol, and zearalenone in concentrations ranging from trace (1.0 ppb) amounts to 143 ppm. These trichothecenes do not occur naturally on the substrates described and were correlated with the so-called "yellow rain" chemical attacks against Hmong people in Southeast Asia. Analysis of leaves, soil, water, and cereals collected in areas adjacent to but apart from the area where chemical attacks had been staged did not contain any Fusarium toxins. Moreover, T-2 and HT-2 toxins were found in human blood, urine, and body tissues (heart, esophagus, kidney, lung, and large intestine) of alleged victims. In addition, diacetoxyscirpenol was found in the kidney of one person who had died.

Adult↗

[Pathology of migrants: paragonimiasis (or pulmonary distomatosis)].

Three cases diagnosed and treated in Hmong Laotian refugees in Thailand are presented; one can expect to see more cases in western countries with the influx of south east Asian refugees. The symptoms are the ones of a chronic pulmonary tuberculosis. The origin of the patients must lead to a suspicion (mainly Laotian Hill tribes). Direct microscopic examination of th sputum reveals easily the eggs of the parasite. Radiologic signs are not specific. The Niclofolan (Bayer) is the ultimate progress in the treatment at a single dose of 2 mg per kilo body weight, its efficiency is much superior to the classic treatments (Emetin, Chloroquin, Bithionol), except in some pleural forms.

Adult↗

Risk factors for maternal HTLV-I infection in French Guiana: high HTLV-I prevalence in the Noir Marron population.

The aim of this study was to compare rates of human T-cell lymphotropic virus type I (HTLV-I) seroprevalence in pregnant women belonging to different ethnic groups in French Guiana and to determine the risk factors associated with HTLV-I seropositivity. All 1,873 deliveries between 1 July 1991 and 30 June 1993 in the only gynecologic and obstetric unit at Saint Laurent du Maroni were enrolled. Serologic status could be established for 1,727 women, with 75 (4.3%) being HTLV-I seropositive. The HTLV-I seroprevalence rate differed significantly between ethnic groups: 5.7% for Noir-Marron (70/1,302), 6.3% for Haitian (3/50), and 0% for Creole (126), Amerindians (166), and Hmong (64). In Noir-Marron pregnant women, HTLV-I seropositivity was associated with a maternal age of > 35 years [odds ratio (OR), 3.3; 95% confidence interval (CI), 1.4-7.6], prior miscarriage (OR, 1.7; CI, 1-2.8), prior cesarean section (OR, 2.1; CI, 1.1-4.0), a parity > 4 (OR, 4.0; CI, 1.8-8.8), a gravidity > 6 (OR, 4.2; CI, 2.0-7.2), and a negative Rhesus factor (OR, 2.2; CI, 1.1-4.5). Two separate stepwise logistic regressions were done because gravidity and parity were highly correlated. HTLV-I seropositivity remained associated with a gravidity > 6 (OR, 3.9; CI, 2.1-7.4) and a negative Rhesus factor (OR, 2.6; CI, 1.2-5.3) for the first model and with a parity > 4 (OR, 4.1; CI, 1.9-9.0) and a negative Rhesus factor (OR, 2.5; CI, 1.2-5.1) for the second model.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗

Tuberculosis among Tibetan immigrants from India and Nepal in Minnesota, 1992-1995.

OBJECTIVE: To study screening outcomes among a group of Tibetan immigrants at high risk for developing active tuberculosis (TB) after arrival in Minnesota. DESIGN: Retrospective cohort study. PARTICIPANTS: A total of 191 Tibetan immigrants undergoing medical screening. MAIN OUTCOME MEASURES: Occurrence and treatment outcomes of active TB. SETTING: A health maintenance organization and a public TB clinic in Minneapolis, Minn. RESULTS: Positive (induration, > or =10 mm) tuberculin skin test results were documented in 98% of Tibetans, compared with 44% of Vietnamese, 10% of Hmong, and 51% of Russian refugees in Minnesota (P<.001 for each group). Sixteen active cases (8.4%) were confirmed by isolation of Mycobacterium tuberculosis; however, 5 (31%) were culture-negative on initial screening in Minnesota. Seven cases (44%) were diagnosed during initial screening efforts, and 9 cases (56%) were diagnosed a mean of 19 months (range, 10-27 months) after their initial medical evaluation. Of these 9 cases, 6 (38% of all Tibetan cases) had isolates resistant to 1 or more antituberculous drugs, and 3 (19% of all Tibetan cases) were multidrug resistant (MDR TB). All 3 MDR TB cases were culture-negative on initial screening; these cases constituted 75% of the MDR TB isolates in Minnesota in 1994. The presence of MDR TB was associated with a known history of active TB in Asia (P<.02). Any abnormality on chest radiograph noted either during the Immigration and Naturalization Service screening evaluation in India (relative risk [RR], 5.2; P=.006) or on arrival in Minnesota (RR, 6.8; P=.005) was associated with an increased risk of subsequent active TB. CONCLUSIONS: Tuberculosis infection is nearly universal among Tibetans settling in Minnesota. A single screening evaluation failed to detect the majority of TB cases among Tibetans. Even in the face of negative M tuberculosis cultures, persons with a history of active TB require particularly close follow-up.

Adult↗

Twenty-seven base pair deletion in erythrocyte band 3 protein gene responsible for Southeast Asian ovalocytosis is not common among Southeast Asians.

Screening for a 27-bp deletion in the band 3 protein gene that causes Southeast Asian/Melanesian ovalocytosis (SAO) was carried out using the PCR method among 15 Southeast Asian populations of Thailand (Akha, Hmong, Isaan, Red Karen, White Karen, Black Lahu, Lisu, Manni, Shan, and central Thais) and Indonesia (Bugis, Dayak, Javanese, Madurian, and Toraja). Individuals with the 27-bp deletion were identified only in the Bugis of southern Sulawesi, the Dayak of southern Borneo, and Javanese of central Java. The gene frequency of the 27-bp deletion in the general population was rather low: 0.012 and 0.013 in the Dayak and the Bugis, respectively. This restricted ethnic and geographic distribution of the 27-bp deletion suggests (1) local differentiation in the prevalence of this deletion in a given ethnic group and (2) the presence of molecular heterogeneity of SAO.

Anion Exchange Protein 1, Erythrocyte↗