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Caries prevalence in 12-year-old schoolchildren in New Caledonia.

This study reports on the most recent epidemiological survey undertaken in New Caledonia, a French dependency in the South Pacific. Three hundred and twenty-five 12-year-old children were selected from schools using the World Health Organization pathfinder sampling methodology. The results showed a DMFT of 4.09. This places New Caledonia in the 'moderate' category on the World Health Organization scale of caries severity for 12-year-old children. Two oral health risk groups were identified: Melanesian and Wallisian children. Different approaches to promoting oral health in New Caledonia, taking into account local socio-cultural traditions, are proposed.

Child↗

Chemoprophylaxis of leprosy with a single dose of 25 mg per kg rifampin in the southern Marquesas; results after four years.

In January-February 1988, a program of chemoprophylaxis for leprosy, using a single 25 mg/kg dose of rifampin, was conducted among 2786 (98.7%) inhabitants of the Southern Marquesas and 3144 South Marquesan "emigrants" and their families. Among the treated population, during the 4 years which followed the implementation of the program, two leprosy patients were detected, one of whom can be considered as a failure of chemoprophylaxis because she was not known by the leprosy control unit. During the same period (1988-1991), a decrease in detection rates for leprosy in the entire French Polynesian population has been observed, an event which makes the interpretation of these findings very difficult. Nevertheless, according to presently available data, the effectiveness of chemoprophylaxis with a single dose of 25 mg/kg rifampin is estimated to be about 40% to 50%. When considering not only the results of the present study but also the financial and logistic constraints raised by such a program, one is led to the conclusion that chemoprophylaxis, even with a single dose of rifampin, is not likely to become an effective component of leprosy control programs.

Adolescent↗

Epidemiology, development and treatment of end-stage renal failure in type 2 (non-insulin-dependent) diabetes mellitus. The case of mainland France and of overseas French territories.

The prevalence of diabetes mellitus among patients treated for end-stage renal failure by dialysis in France was studied in two stages (UREMIDIAB Study). The first stage consisted of a questionnaire which was mailed to all dialysis centres in mainland France. The response rate was 80.8%, resulting in a study population of 12,903 patients. Of these patients 884 were declared diabetic (6.9%). Later 295 of them were interviewed by seven specially-trained physicians who checked the medical records together with the nephrologist in charge. Plasma C-peptide was measured in almost all of the patients. Effectively, 1.4% were found to have Type 1 diabetes and 5.5%, Type 2. Diabetic nephropathy was found to be the only primary renal diagnosis among 93.9% of Type 1 diabetic patients and 36.8% of Type 2. Of the latter 51.6% had a non-diabetic cause of renal failure. In the second stage a survey was later conducted in 13 of 14 dialysis centres located in the remote overseas French territories. Among 934 patients 1.04% were Type 1 diabetic and 19.67% Type 2 (22.9% altogether). Type 2 diabetic patients treated overseas were essentially non-Caucasians (92.6%). The sex ratio was 0.54 in the overseas territories vs 1.4 in the mainland. We conclude that the prevalence of diabetes among people on dialysis is low in mainland France. But there are striking differences in the prevalence of Type 2 diabetes among dialysis patients in mainland France and its overseas territories. These differences are not related to access to dialysis facilities.

Adult↗

The polarized light microscopy and ultrastructure of Polynesian pigmented tooth enamel.

Transmitted and polarized light microscopy of unerupted and erupted teeth affected by a pigmented anomaly found in two geographically isolated Polynesian populations, the New Zealand Maori and the French Polynesian Marquesas Islander, showed similar histological characteristics. Mounted in water, the pigmented areas were positively birefringent and covered with a thin negatively birefringent surface layer 200-250 microns thick. Cervical areas were negatively birefringent. Transmission electron microscopy of argon-ion-beam thinned specimens of affected enamel revealed large voids, disruption in the packing of crystals and spacing at prism boundaries. In the surface layer of enamel from erupted and unerupted teeth, the intra- and interprismatic spaces were occluded by fine crystals or amorphous material. A well-defined prism structure and close crystal packing were found in cervical enamel. The ultrastructure of these pigmented enamels was similar to and consistent with a hypomaturation type of amelogenesis imperfecta.

Birefringence↗

Some epidemiological and scanning electron microscopic features of crazing of the dental enamel of Polynesians.

The prevalence of enamel crazing was determined from the maxillary incisors and canines of 1,109 Tongan residents aged 5-20 years, 1,417 Cook Island residents aged 6-20 years, 520 French Polynesian residents aged 10-15 years, and 92 New Zealand-born and -resident Polynesians aged 11-18 years. Crazing occurred in 22 percent of Tongans, 7 percent of Cook Islanders, but not in French Polynesians or New Zealand-born Polynesians. Cracks become clinically apparent at about 8 years of age; were more common in males than females; and became more common with increasing age. The central incisors were the most commonly affected of the maxillary anterior teeth. Cross-sections of teeth with crazing viewed by light and scanning electron microscopy appeared similar to other stained cracks. The indications are that crazing is a post-eruptive change caused by trauma from local environmental factors resulting in stress fractures. The significance of crazing on enamel structure and strength is unknown, but it is probably minor without long-term disadvantages. The prevalence of crazing may prove useful in anthropology as an indicator of the use of teeth as tools and in assessing the "modernisation" of a population.

Adolescent↗

Association of D2 dopamine receptor and alcohol dehydrogenase 2 genes with Polynesian alcoholics.

Alleles of the D2 dopamine receptor (DRD2) and the alcohol dehydrogenase 2 (ADH2) genes were determined in 69 French Polynesian alcoholic patients and 57 controls matched for racial origin. Three racial groups were studied: pure Polynesians (PP), Polynesians mixed with Caucasian (PCA) ancestry and Polynesians mixed with Chinese (PCH) ancestry. DRD2 A1 allele frequencies in the alcoholics compared to their controls in these groups were: PP,.26 vs.32 (P =. 69); PCA,.44 vs.35 (P =.46); PCH,.40 vs 0.39 (P =.88). ADH2 1 allele frequencies in alcoholics compared to their controls groups were: PP, .56 vs.62 (P =.66); PCA,.75 vs.56 (P =.09); PCH,.78 vs.32 (P =.009). In the PCA group, the combination of the DRD2 A1 genotypes and the ADH2 1 homozygotes was strongly associated with alcoholism (P =. 0027). This preliminary study shows the importance of ascertaining racial ancestry in molecular genetic association studies. Moreover, it suggests that a combination of genes are involved in susceptibility to the development of alcoholism.

Adult↗