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Serotyping and RAPD profiles of Salmonella enterica isolates from Mauritius.

AIMS: The genus Salmonella is a common agent of gastroenteritis in Mauritius, generating more cases of the disease during summer than during winter. The aims of this study were to assess the genetic diversity of isolates of Salmonella enterica by RAPD fingerprinting, and to establish the relationship between human and chicken isolates. METHODS: Twenty-six isolates were obtained from hospital laboratories and commercial poultry producers locally. RESULTS: The RAPD profiles, biochemical and serological analyses showed that two of the chicken isolates were mistakenly identified as Salmonella. The genetic diversity of the remaining 24 isolates (five chicken and 19 human), confirmed as Salmonella, was analysed using four arbitrary primers, OPA-10, OPR-03, OPI-06 and OPJ-09, chosen from an initial set of 10 decamers. Seventy RAPD markers were generated in four individual DNA profiles. SIGNIFICANCE AND IMPACT OF THE STUDY: Cluster analysis (UPGMA) performed using the NTSYS-pc V 1.8 computer software, confirmed that some strains of Salmonella isolated from chicken were genetically similar to those isolated from humans. Furthermore, a 1 kbp band amplified using primer OPA-10 was specific for the Salmonella genus as it was not amplified in any of the control bacteria.

Animals↗

Dietary Westernisation: conceptualisation and measurement in Mauritius.

OBJECTIVES: The aims of the study were to provide information that will contribute to conceptualising what is called "dietary Westernisation", and to provide an example of measuring it on an individual level. DESIGN: Food consumption frequency and demographic data on adults in Mauritius were examined in 1988, 1992 and 1998. In 1992, a 24-hour recall was also included. The cross-sectional samples consisted of 1115 (age 25-74 years) Mauritians in 1987/88, 1917 (age 30-74 years) in 1992 and 2239 (age 20-74 years) in 1998. Principal components analysis was carried out on daily consumption frequencies of 10 indicator foods (white rice, white bakery bread, pulses, processed meat, poultry, fresh/frozen fish, butter, margarine, whole milk and skimmed/low-fat milk). Correlations between dietary patterns and selected food consumption frequencies were examined in each survey year. RESULTS: Four dietary patterns were identified as being related to dietary Westernisation. The Traditional dietary pattern was characterised by higher consumption frequencies of Indian breads, salted/smoked fish and sugar-sweetened tea. The Western dietary pattern was characterised by higher consumption frequencies of cakes/pastries, meat and many Western fast foods like burgers, but, surprisingly, also by brown bread, breakfast cereals and salad. The Bread/butter dietary pattern predominantly described more frequent consumption of bread compared with rice. The Margarine/milk dietary pattern was inconsistently related with staple foods. Younger, educated and wealthier Mauritians appeared to adopt Western dietary patterns earlier. CONCLUSIONS: This study suggests that relatively few indicator foods are needed for measuring dietary Westernisation. Dietary Westernisation in a non-Western country may also include shifts towards voluntary consumption of healthier foods.

Adult↗

Hepatitis A in Mauritius: an apparent transition from endemic to epidemic transmission patterns.

Between January 1984 and December 1985 a large outbreak of viral hepatitis occurred in the island nation of Mauritius (population 986,000). No hepatitis epidemics had occurred there since the 1930s. The outbreak involved 2428 reported cases; however, reporting levels were thought to be extremely low. All of the island's nine geographical districts were affected, but cases were concentrated in five districts mostly in the central and northern parts of the island. The highest attack rate occurred in children aged five to nine; persons above age 14 were almost unaffected. The male:female ratio of cases was 1.1:1. Evidence to support hepatitis A virus (HAV) as the infecting agent included; (1) clinical illness was compatible with hepatitis A; (2) the age profile of cases was typical for community-wide hepatitis A outbreaks; (3) the rate of positive tests for hepatitis B surface antigen in suspected hepatitis patients did not increase during the outbreak; and (4) nine of nine clinically ill children tested were serum-positive for IgM anti-hepatitis A virus antibody. Transmission was probably by the person-to-person route; no common source was implicated. The outbreak appears to represent a transition from a 40-year pattern of endemic HAV transmission on the island to an epidemic pattern.

Adolescent↗

Multiple logistic regression modelling substantiates multifactor contributions associated with sick building syndrome in residential interiors in Mauritius.

This paper presents a mathematical model that depicts the relationship between the possibility of occurrence of common health problems and factors leading to Sick Building Syndrome symptoms in domestic interiors in Mauritius. The prevalence of upper respiratory symptoms (dry eyes, runny nose), central nervous system symptoms (headache, nervousness), and musculoskeletal symptoms (pain/stiffness in shoulders/neck) were found to be elevated when responses were statistically regressed to type of building and age of respondents. The model presented here will be useful in helping to identify and quantify the relative role of factors that contribute to Sick Building Syndrome. Thus it may be possible to evaluate the effectiveness of current building operation practices and to prioritise allocations of resources for reduction of risk associated with Indoor Environmental Air Quality.

Adult↗

A survey on home generated medical waste in Mauritius.

This study was carried out to evaluate home-generated medical waste in Mauritius. A questionnaire survey was undertaken among a random sample population in 250 houses in the nine districts of the island. Results of this study showed an overwhelmingly large proportion of medical waste arising from the domestic environment joins the common municipal solid waste stream and ends in landfills. This improper disposal process poses a serious health hazard to the general public, waste haulers and landfill personnel. It is therefore recommended that a national policy on medical waste management be urgently implemented, proper training of waste haulers be offered and education campaign be carried out to sensitize the general public on safe disposal of medical waste.

Data Collection↗

Assessing the contribution of age-sex differentials in causes of death due to infectious and parasitic diseases to the trends in age-sex differentials in life expectancy in Mauritius.

This study applies two methodologies to Mauritian life tables and cause-of-death data: (1) the decomposition of sex differentials in life expectancy using Arriaga's approach and (2) the estimation of the effect of marginal reduction in deaths from infectious and parasitic diseases on life expectancy using Keyfitz's methodology on cause-specific entropy and that of Nanjo. The findings in this paper support earlier findings about the importance of the period 1969-1976 in the mortality transition in Mauritius, a period in which sex differentials in life expectancies reached a peak level. The results suggest that the driving force behind those sex differentials in life expectancy was the sex differential in mortality in infectious and parasitic diseases, first among the young (ages below 10 years) and second among the older population (ages above 50 years). If the decline in mortality due to infectious and parasitic diseases was differentially greater in the older ages compared to the younger ages, that difference would have gone a long way toward reducing the magnitude of the historic peak sex differential in life expectancy achieved in 1976.

Adolescent↗

The relation of physical activity to cardiovascular disease risk factors in Mauritians. Mauritius Noncommunicable Disease Study Group.

The authors investigated the relation between physical activity and cardiovascular disease risk factors in a random sample of 4,658 Asian Indian, Creole, and Chinese adults aged 25-74 years from the island nation of Mauritius. Subjects known to have diabetes were excluded from analyses. Subjects were divided into "active" and "inactive" groups on the basis of a combined leisure and occupational physical activity score determined at interview (April 1987). Two-hour plasma glucose concentration and fasting and 2-hour serum insulin concentrations were significantly lower and high density lipoprotein (HDL) cholesterol was significantly higher in active subjects of both sexes. Plasma uric acid and fasting triglyceride levels were also lower among active subjects, but significantly so only in females. Systolic and diastolic blood pressure levels, body mass index (weight (kg)/height (m)2), and waist:hip ratio varied little between the two activity groups. In multiple linear regression analyses, physical activity made an independent negative contribution to the models for 2-hour glucose and insulin in both males and females, as well as for fasting insulin in males. When glucose and insulin were not included, physical activity also made an independent contribution to the models for plasma triglycerides (inversely) in females and HDL cholesterol and HDL cholesterol as a proportion of total cholesterol (positively) in males. The authors have demonstrated improved cardiovascular disease profiles associated with physical activity in Mauritians. The data suggest that much of the effect is modulated via an effect on insulin-glucose metabolism. Promotion of exercise should become an important strategy in the prevention of cardiovascular disease and glucose intolerance in this population.

Adult↗

Slavery, smallpox, and revolution: 1792 in Ile de France (Mauritius).

In 1792 a slave-ship arrived on the french Indian Ocean island of Ile de France (Mauritius) from South India, bringing with it smallpox. As the epidemic spread, a heated debate ensued over the practice of inoculation. The island was in the throes of revolutionary politics and the community of French colonists were acutely aware of their new rights as 'citizens'. In the course of the smallpox epidemic, many of the political tenisons of the period came to focus on the question of inoculation, and were played out on the bodies of slaves. Whilst some citizens asserted their right, as property owners, to inoculate their slaves, others, equally vehemently, objected to the practice and asserted their right to protect their slaves from infection. Eighteenth-century colonial medicine was largely geared to keeping the bodies of slaves and workers productive and useful, but formal medicine never had a monopoly. Slaves on Ile de France brought with them a rich array of medical beliefs and practices from Africa, India, and Madagascar. We have little direct historical evidence for these, but we do know that many slaves came from areas in which forces of smallpox inoculation were known and practised.

Colonialism↗

Low resting heart rate at age 3 years predisposes to aggression at age 11 years: evidence from the Mauritius Child Health Project.

OBJECTIVE: Previous studies indicate that low resting heart rate is probably the best-replicated biological correlate of childhood antisocial and aggressive behavior. Nevertheless, there have been few longitudinal tests of this relationship, little control over potential confounds and mediators, and no test of its cross-cultural generalizability. This study tests the hypothesis that low resting heart rate at age 3 years predicts aggression at age 11 years. METHOD: Resting heart rate at age 3 years was assessed in 1,795 male and female children from Mauritius. Aggressive and nonaggressive forms of antisocial behavior were assessed at age 11 years using the Child Behavior Checklist. RESULTS: Aggressive children had lower heart rates than nonaggressive children (p < .001). Conversely, those with low heart rates were more aggressive than those with high heart rates (p < .003). There were no interactions with gender or ethnicity. Evidence was found for specificity of low heart rate to aggressive forms of antisocial behavior. Group differences in heart rate were not attributable to 11 biological, psychological, and psychiatric mediators and confounds. CONCLUSIONS: It is concluded that low resting heart rate, a partly heritable trait reflecting fearlessness and stimulation-seeking, is an important, diagnostically specific, well-replicated, early biological marker for later aggressive behavior.

Aggression↗

Prevalence and medical care of hypertension in four ethnic groups in the newly-industrialized nation of Mauritius.

Prevalence of hypertension was investigated in Mauritius in 2362 men and 2712 women among Hindu and Muslim Indian, Creole and Chinese ethnic groups aged 25-74 years. The age-standardized prevalence of hypertension varied from 9.4% to 17.3% in men and from 9.5% to 16.9% in women among the four ethnic groups and increased with age. The population mean values of systolic/diastolic blood pressure were 126/79 mmHg in men and 124/75 mmHg in women. The proportion of hypertensive persons aware of their condition was 50.5% in men and 66.6% in women. The proportion of treated and adequately controlled hypertensive patients was only 21.7% in men and 29.3% in women. Creoles had the highest mean value of systolic and diastolic blood pressure and the highest prevalence of hypertension whilst Muslim Asian Indians had the lowest values both in men and women. Further studies are needed to define the determinants of hypertension in the multi-ethnic Mauritian population. Diagnosis and treatment of hypertension need to be improved, especially in men and the Creole ethnic group.

Adult↗

Insulin and blood pressure levels are not independently related in Mauritians of Asian Indian, Creole or Chinese origin. The Mauritius Non-communicable Disease Study Group.

OBJECTIVES: There is conflicting evidence of a link between circulating insulin concentrations and blood pressure. The aim of this study, therefore, was to investigate this relationship in a representative population sample of different ethnic groups. DESIGN: A cross-sectional study was performed, using a random cluster sample of 5080 adults aged 25-74 years from the Indian Ocean island of Mauritius. METHODS: Glucose tolerance was assessed with a 75-g oral glucose tolerance test. Hypertension and glucose tolerance were classified using World Health Organization criteria. Subjects known to have diabetes before the survey were excluded from these analyses, leaving 3104 Asian Indian, 1256 African-origin Creole and 384 Chinese subjects eligible for this study. RESULTS: There were statistically significant linear correlations between fasting and 2-h insulin and mean blood pressure in all sex-ethnic subgroups, except for Chinese men. However, after controlling for age and the body mass index, partial correlations were much reduced and remained significant only for fasting insulin in Indian men (r = 0.07, P < 0.01) and women (r = 0.09, P < 0.001) and 2-h insulin in Chinese women (r = 0.15, P < 0.05). After controlling for age and body mass index, mean fasting and 2-h insulin concentrations were not significantly different between hypertensive and normotensive subjects in any of 36 possible subgroups defined by ethnic group, gender or glucose tolerance (normal, impaired glucose tolerance or newly diagnosed diabetes). In both men and women with normal glucose tolerance (ethnic groups combined) there was no evidence of increasing systolic or diastolic blood pressure across quartiles of either fasting or 2-h serum insulin within any quartile of the body mass index. By contrast, at any given level of serum insulin there was a clear association between an increasing body mass index and increasing blood pressure, suggesting strongly that insulin is not the final pathway by which obesity influences blood pressure. CONCLUSIONS: This study of three ethnic groups does not support the hypothesis that the circulating insulin concentration is an independent determinant of blood pressure in populations.

Adult↗

The house dust mite Dermatophagoides pteronyssinus is the most important allergen on the island of Mauritius.

To determine the relative importance of mites as a cause of allergic sensitivity and asthma on the western Indian Ocean island of Mauritius, we measured specific IgE antibodies to common inhalant allergens in sera from Mauritians claiming to have allergic symptoms and we examined house dust samples for evidence of mites and their allergens. Seventy-two of the 110 sera tested (65%) contained detectable IgE antibody to at least one mite, mould or pollen allergenic extract. By far the most prevalent was antibody to one or both of the common house dust mites, Dermatophagoides pteronyssinus and Dermatophagoides farinae, being present in 67 (61%) of the 110 sera. Allergy to pollens, including the locally prevalent Bermuda grass and sugar cane, was infrequent. Antibody to a limited number of moulds was detected in 22% of the sera tested. Of 81 subjects whose clinical history was known, 60 were asthmatic, and 75% of these asthmatic individuals had IgE antibody to mites. In contrast, only 35% of the subjects with rhinitis without asthma were sensitive to mites. Different mite species, including D. pteronyssinus but not D. farinae, were identified microscopically in samples of local house dust. Mite antigen Der p I but not antigen Der f I was detected with specific monoclonal antibodies in extracts of these dust samples. On the bases of this serological and environmental survey, we conclude that our data support the hypothesis that the house dust mite D. pteronyssinus is the principal cause of allergic sensitivity and asthma in that tropical environment.

Adolescent↗

Is hyperinsulinaemia a central characteristic of a chronic cardiovascular risk factor clustering syndrome? Mixed findings in Asian Indian, Creole and Chinese Mauritians. Mauritius Noncommunicable Disease Study Group.

The aim of the study was to investigate whether the constellation of cardiovascular disease risk factors, described as Insulin Resistance Syndrome, exists in the multi-ethnic population of Mauritius, and to assess whether hyperinsulinaemia is the key feature of this syndrome. A sample of 5080 Mauritian subjects (aged 25-74 years) was examined in a noncommunicable diseases survey in 1987. Survey procedure included an oral glucose tolerance test, and anthropometric, blood pressure, plasma lipids and serum insulin measurements. Abnormal glucose tolerance (diabetes and impaired glucose tolerance), general obesity, upper-body obesity, hypertension, low HDL-cholesterol, and hypertriglyceridaemia were defined as risk factor conditions. Mean values for a series of risk factor variables were compared between reference subjects (no risk factors) and those with a risk factor condition (either one condition only, or in combination with one or more others). Prevalence estimates for each risk factor condition in combination with three or more other conditions were three to four times greater than expected by chance, and levels of risk factors for subjects with more than one risk factor condition were further away from the reference levels than for those with just one condition. Fasting and 2-h serum insulin levels were elevated for each condition when in combination with others, or to a lesser extent when isolated. However, this was not the case for isolated hypertension where insulin levels were not elevated. When adjusted for age, sex, and body mass index, insulin levels were only significantly elevated in subjects with upper-body obesity if in association with general obesity.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗

Maternal exposure to influenza and cold in pregnancy and electrodermal activity in offspring: the Mauritius Study.

Data are in conflict concerning whether a mother's exposure to influenza in pregnancy gives rise to an increased probability that her offspring will develop schizophrenia. In Northern Hemisphere studies, exposure to influenza and cold tend to be confounded. The present study, carried out in Mauritius, examines the effect of maternal exposure to the virus and separately to cold on aspects of electrodermal activity that have been shown in other studies to be related to schizophrenia. The findings are that maternal exposure to influenza in the second and third trimesters gives rise to children who at the age of 3 years show electrodermal hyperresponsivity, whereas exposure to cold in the same periods gives rise to children who tend to be hyporesponsive. In both instances, exposure tends to produce lower levels of tonic activity than in those not exposed to the virus or to cold.

Child, Preschool↗

Simian immunodeficiency virus SIVmac239 infection of major histocompatibility complex-identical cynomolgus macaques from Mauritius.

Nonhuman primates are widely used to study correlates of protective immunity in AIDS research. Successful cellular immune responses have been difficult to identify because heterogeneity within macaque major histocompatibility complex (MHC) genes results in quantitative and qualitative differences in immune responses. Here we use microsatellite analysis to show that simian immunodeficiency virus (SIV)-susceptible cynomolgus macaques (Macaca fascicularis) from the Indian Ocean island of Mauritius have extremely simple MHC genetics, with six common haplotypes accounting for two-thirds of the MHC haplotypes in feral animals. Remarkably, 39% of Mauritian cynomolgus macaques carry at least one complete copy of the most frequent MHC haplotype, and 8% of these animals are homozygous. In stark contrast, entire MHC haplotypes are rarely conserved in unrelated Indian rhesus macaques. After intrarectal infection with highly pathogenic SIVmac239 virus, a pair of MHC-identical Mauritian cynomolgus macaques mounted concordant cellular immune responses comparable to those previously reported for a pair of monozygotic twins infected with the same strain of human immunodeficiency virus. Our identification of relatively abundant SIV-susceptible, MHC-identical macaques will facilitate research into protective cellular immunity.

Animals↗

Early detection and prevention of mental illness: the Mauritius project. A preliminary report.

The experimental manipulation method is in general not feasible in studies of the etiology of severe mental illness, whereas this method can be used in studies pertaining to primary prevention, because possible preventive methods would most likely be of a protective or beneficial nature. Preventive experimentation requires early detection of those individuals who will eventually become seriously mentally deviant. A study of children at a high genetic risk for schizophrenia is described. This study suggested certain autonomic nervous system variables as predictors of later serious mental breakdown. In a WHO-sponsored project in Mauritius the authors used these results for the selection of a group of children at risk for mental illness. 1,800 3-year-old Mauritian children were studied socially, psychologically, pediatrically and psychophysiologically between 1972 and 1973. 100 of these children were selected for experimental preventive intervention during their daily presence in two modern kindergartens. Members of this group were characterized by either abnormally fast autonomic recovery or autonomic nonresponding, or normal autonomic responding. A matched group of another 100 children served as a community control. The paper presents preliminary results from the screening of the 1,800 children.

Age Factors↗

Early colonial health developments in Mauritius.

The historical development of Mauritius and in particular the early developments in health care are crucial to an understanding of the contemporary health system. The introduction of major epidemic diseases through the movements of French soldiers to and from India and the immigration of indentured laborers from India account for the high mortality and morbidity rates in the 18th and 19th centuries and later. The colonial economy created and fortified the dependence on a single cash crop and on imported food. It also contributed toward the impoverization of large sections of the Mauritian population. The colonial era is also responsible for initiating a three tier system of health care.

Delivery of Health Care↗

Impaired fasting glucose or impaired glucose tolerance. What best predicts future diabetes in Mauritius?

OBJECTIVE: To determine if impaired fasting glucose (IFG; fasting plasma glucose level 6.1-6.9 mmol/l) can predict future type 2 diabetes as accurately as does impaired glucose tolerance (IGT; 2-h plasma glucose level 7.8-11.0 mmol/l). RESEARCH DESIGN AND METHODS: A longitudinal population-based study was performed with surveys in 1987 and 1992 on the island of Mauritius, assessing diabetes status by the oral glucose tolerance test. A total of 3,717 subjects took part in both surveys. Of these subjects, 3,229 were not diabetic in 1987 and formed the basis of this study. RESULTS: At baseline, there were 607 subjects with IGT and 266 subjects with IFG. There were 297 subjects who developed diabetes by 1992. For predicting progression to type 2 diabetes, the sensitivity, specificity, and positive predictive values were 26, 94, and 29% for IFG and 50, 84, and 24% for IGT, respectively. Only 26% of subjects that progressed to type 2 diabetes were predicted by their IFG values, but a further 35% could be identified by also considering IGT. The sensitivities were 24% for IFG and 37% for IGT in men and 26% for IFG and 66% for IGT in women, respectively. CONCLUSIONS: These data demonstrate the higher sensitivity of IGT over IFG for predicting progression to type 2 diabetes. Screening by the criteria for IFG alone would identify fewer people who subsequently progress to type 2 diabetes than would the oral glucose tolerance test.

Adult↗