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Polynesian origins and affinities: globin gene variants in eastern Polynesia.

Analysis of copy number variants of the duplicated alpha-, zeta-, and gamma-globin genes in eastern Polynesians revealed a high frequency of both triplicated-zeta-gene chromosomes and a specific alpha thalassemia deletion. This deletion and a novel restriction-enzyme-site polymorphism associated with a zeta zeta zeta chromosome are found only in Melanesians and Polynesians. Analysis of alpha-globin restriction-enzyme haplotypes indicated further similarities to Melanesians but suggested an additional non-Melanesian genetic component in eastern Polynesia. Several globin gene alleles showed evidence of marked frequency fluctuations due to genetic drift.

Alleles↗

Seroepidemiological study on 724 household contacts of leprosy patients in French Polynesia using disaccharide-octyl-BSA as antigen.

A seroepidemiological surveillance of a contact population was started in 1984 in French Polynesia. The ELISA test was used to measure IgM anti-ND-O-BSA in the sera. Specific antibody levels were higher in healthy Polynesians than in normal individuals living in a nonendemic country. The positive threshold of the reaction was fixed according to this background activity in healthy Polynesians. Under these conditions, 100% of the multibacillary patients were detected as seropositive as compared to 5% of the paucibacillary group. In the population of 724 household contacts tested and observed for 2 years: 93 (12.8%) were seropositive, with 8 (1.1%) showing activity equivalent to multibacillary patients (1 of these 8 individuals developed a lepromatous form of leprosy); 631 (87%) were seronegative and 3 developed a paucibacillary form of the disease (2 BT, 1 I) without any antibody increase. Among those four contacts who developed leprosy, three were related to a multibacillary index case. These data suggest that this test may be useful for the prediction of multibacillary leprosy. A long-term surveillance of this high-risk population will be able to evaluate the diagnostic and prognostic value of the serological assay.

Antibodies, Bacterial↗

[Filarian elephantiasis in French Polynesia (Wuchereria bancrofti var. pacifica). Health study on 274 subjects. I Epidemiological and Clinical aspects].

Twenty-five years after the fight started against Wuchereria bancrofti var. pacifica in French Polynesia and which was based upon mass chimiotherapy by diethylcarbamazine (Banocide), a survey realized in 1975 and 1976 among 274 patients with elephantiasis allows us to give precise details of the local clinical and epidemiological aspects. Since 1950 the number of clinical cases varies along with the parasitological incidence, but with a certain delay which is explained by the late and irreversible elephantiasis characteristics. The overall prevalence is actually low. However the occurrence of new cases, although very rare, is still possible. Among sick patients the lymphangitic crisis frequency whose aspect lead to evoke a bacterial participation, is low. Women are less frequently and less severely involved than men. Localisations are essentially restricted to the lower limbs. Several limbs are involved in approximately 50 0/0 of the cases. The scrotum involvement is rare, the one of the breast is found only once. Among men we can notice a 33 0/0 incidence of associated hydroceles. A past history of chyluria is not rare.

Adult↗

[Filarian elephantiasis in French Polynesia (Wuchereria bancrofti var. pacifica). II. Biological aspects].

Realized in French Polynesia among 274 patients with elephantiasis, this survey studied the microfilaremia, the eosinophily, the immunoglobulin titers and the antifilarian antibodies (done by passive hemagglutination) for Wuchereria bancrofti var. pacifica. Patients with elephantiasis seldom have circulating microfilariae in their blood. Hypereosinophily is frequent but rarely high. It is similar to the one patients with microfilaremia. There is a trend towards neutropenia during lymphangitic crisis that occur on an elephantiasis limb. The IgE titer is clearly increased, the IgG one is lesser elevated. The mean values are identical to those encoutered among microfilariae asymptomatic cariers. On the other hand the serodiagnosis is more frequently positive among elephantiasic patients.

Adult↗

[Dental caries and its prevention in French Polynesia].

For some years, a global program for prevention of dental caries is carried on in french Polynesia. Polynesian populations were, more than a century ago, almost totally free of dental caries. This disorder suddenly appeared and reached, in a couple of decennia, a frequency and an intensity rarely observed in other countries. Ten years ago, with support of WHO, the Public health department of the territory organized a dental hygiene service for school children; positive results can already be observed.

Dental Caries↗

[Epidemiological aspects and diagnosis of 60 cases of leptospiroses in French Polynesia].

60 cases of leptospiroses were diagnosed in Polynesia by blood culture and immunological test. Fever and pains are prevailing signs. Among 3 patients, presence of leptospires is revealed on the 43th, 54th and 90th days. The following serogroups are found: Icterohaemorrhagiae 69.7%, Canicola 13%, Pomona 4%, Australis 2%. 85% of the patients come from Tahiti and 15% from "Sousle-Vent" Islands and Tuamotou. Walking bare foot on wet ground in areas where numerous rodents are found is a source of contamination. The procedure of blood cultures plays a prominent part.

Adult↗

[Inventory of the parasites of domestic animals in French Polynesia. 1st list].

After a parasitological survey in French Polynesia a first list of parasites of domestic animals has been drawn up. 42 helminthes and 23 protozoan parasites have been found in seven species of domestic animals. The pathogenicity and economic importance is discussed. The parasitic fauna is rather poor in spite of favourable environmental conditions for the evolution of parasites; therefore veterinary services must increase their surveillance to avoid any introduction of new parasite.

Animals↗

[Dengue outbreak by virus type 4 in French Polynesia. I. General epidemiology - clinical specific aspects (author's transl)].

Authors describe an extensive outbreak of dengue 4 virus which is observed for the first time out of its Asian original focus. The whole archipelagos of French Polynesia have been contaminated in a space of four months. Usual form of the disease is typical with lightness of the symptoms. This outbreak has been implicated in the death of a child by shock; and two cases of reversible encephalitis have been certainly caused by this virus. The neurotropism is the main characteristic of dengue virus type 4.

Adult↗

[Dengue outbreak by virus type 4 in French Polynesia. II. Preliminary biological observations on epidemiology and physiopathology of the disease (author's transl)].

Authors report some accurate epidemiologic and physiopathologic data about dengue 4. Thanks to virus intrathoracic inoculation in Toxorhynchites amboinensis (Doleshall, 1857), 202 viral strains have been isolated from 633 sera samples. The incidence of the disease has decreased very early after immunization of the whole population and resulted in an eradication of dengue type 1 virus which was endemic in French Polynesia since 1976. Only one type of dengue virus seems to be tolerated in French Polynesian ecosystem in the same time. There is no crossing protection with dengue 1. Clinically, the picture has been the same in both new and previously infected by dengue 1 patients. Duration of viremia during the secondary dengue fever is not shorter than in the primary one. The hemagglutination inhibiting antibodies do not protect patients, but do not result in immune-complexes pathology.

Antibodies, Viral↗

[Hemorrhagic dengue with shock in children in French Polynesia].

The dengue fever is an intertropical arbovirus, well known in French Polynesia where the first cases of dengue haemorrhagic fever appeared at the end of 1989. The authors report their experience in the paediatrics ward of the Centre Hospitalier Territorial (CHT) of Papeete, where, from 1990 to 1992, 310 cases of dengue fever have been registered with 79 cases of dengue shock syndrome (25.5%) and 12 deaths (4%). Then, following an epidemiologic summary and a description of how the clinical picture evolves in children, they insist on the fact that the pathophysiology of dengue fever is unknown, and there is no predictive factor; even if, in this study, the young age seems to be factor of severity. Therefore, an epidemiologic survey, and a very close monitoring of each case are necessary, in order to start an aggressive symptomatic treatment as soon as possible. The antivector's fight is still the only prevention against this arbovirosis.

Child↗

Low predictive value of PGL-I serology for the early diagnosis of leprosy in family contacts: results of a 10-year prospective field study in French Polynesia.

In 1983, a cohort study to follow up the family contacts of leprosy cases was implemented in French Polynesia to assess the usefulness and applicability of phenolic glycolipid-I (PGL-I) serology in a leprosy control program. A total of 1201 contacts (666 females, 535 males) have been included in the study. The IgM anti-PGL-I seroprevalence determined on the initial sera was 17%. It was significantly higher among females than males (20% vs 15%, p = 0.02). From 1983 to 1992, 4 out of 204 (2%) anti-PGL-I seropositive contacts developed the disease (1 indeterminate, 1 BT, 1 BL, 1 LL) compared with 10 out of 997 (1%) seronegative contacts (4 indeterminate, 3 BT, 1 BB, 2 TT). Of these 10 patients, only 3 (2 indeterminate, 1 BT) converted to seropositivity when leprosy was diagnosed. The risk of developing leprosy was not significantly higher among seropositive than among seronegative groups (2% vs 1%, p = 0.2). A PGL-I circulating antigen test performed on 216 selected sera at entry into the trial showed a higher antigen prevalence when the antibody level was higher. PGL-I antigen was detectable in 5 of 12 patients tested prior to diagnosis (1 LL, 1 BL, 3 indeterminate). The median time to externalize the disease was not significantly different among antibody-positive and -negative contacts (17 vs 25 months, p = 0.3). The relative risk of developing leprosy for contact individuals was 30.8 times that of noncontacts, and 15% of the total new cases detected between 1983 and 1992 emerged from the study population.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗

[Presence of gregarine (Protozoa sporozoa) parasite of black-lipped pearl oysters Pinctada margaritifera (L.,1758) (Mollusca bivalvia) in French Polynesia].

High death rates have been recorded in populations of Pinctada margaritifera (natural or reared stocks) in atolls in the Tuamotu Archipelago (French Polynesia). An histological study of the oysters from the concerned areas revealed the occurrence of a protist of which ultrastructural features correspond to those of Gregarinea. It is still premature to establish a link between the presence of the Gregarine and recent deaths of pearl oysters.

Animals↗

Periodicity of Wuchereria bancrofti var. pacifica filariasis in French Polynesia.

In 1992, a study on microfilaremia periodicity was carried out on 12 Wuchereria bancrofti carriers in the Marquesas islands. Blood samples were collected simultaneously every 4 hours during a 48 hour period by finger-prick and venipuncture for determination of microfilaremia by both blood film and membrane filtration technique methods, and for determination of antigenemia. The membrane filtration results showed no significant nycthemeral variations between the microfilaria densities at hours 16:00, 20:00, 24:00, 04:00, 08:00 and 12:00. Conversely, the blood film method showed a significant difference between the microfilaria densities: the microfilaremia was higher during the day (12:00-20:00 hours) than during the night (24:00-08:00 hours). As for antigenemia, using Og 4 C3 monoclonal antibody, there was no significant fluctuation during 48 hours. These results confirm that W. bancrofti var. pacifica is subperiodic and diurnal in French Polynesia. In particular, they substantiate the validity of examining venous blood by the membrane filtration technique as the judgment criterion of choice in therapeutic trials and of examining capillary blood during peak hours by the blood film method for evaluating the endemic level in a population.

Adult↗

Tuberculosis in leprosy patients detected between 1902 and 1991 in French Polynesia.

From 1902 onward, notification and follow up of leprosy patients has been systematic in French Polynesia. Since 1960, a tuberculosis control program and a register has also been implemented. From 1902 to 1959, 673 cases of leprosy were detected [346 multibacillary (MB), 138 paucibacillary (PB), and 179 unclassified due to the loss of medical files by the time of classification which was done during the 1980s]. Of these 673 cases, 89 (13.2%) died from tuberculosis, giving a mean annual death rate of tuberculosis in leprosy patients of 232 per 100,000. Mortality from tuberculosis in leprosy patients detected between 1901 and 1930 was 20.7%, and decreased to 8.04% in patients detected from 1931 to 1959. In total, it was estimated that 26.4% of the leprosy cases had developed tuberculosis. From 1960 to 1991, 350 new cases of leprosy were detected (141 MB, 209 PB). Of them, 12 (3.4%) developed tuberculosis (7 before detection of leprosy, 5 after detection of leprosy). The dramatic decrease of the proportion of leprosy patients who developed tuberculosis between the periods 1902-1959 (26.4%) and 1960-1991 (3.4%) might be related to the important decline of the tuberculosis situation since 1960. From 1902 to 1959, mortality from tuberculosis occurred significantly more frequently in MB patients (13%) than in PB patients [4%, relative risk (RR) = 3.21, p = 0.003]. From 1960 to 1991, the incidence of tuberculosis seemed more frequent in MB patients (RR = 2.96, p = 0.07) whatever the sequence of detection of the two diseases. Our study suggests that lepromatous patients could share factors of susceptibility to mycobacterial diseases with patients developing tuberculosis.

Adult↗

Parasites of coral reef fish recruits, Epinephelus merra (Serranidae), in French Polynesia.

Honeycomb grouper recruits Epinephelus merra (Serranidae) from 2 recruitment events on Moorea Island, French Polynesia, were examined for internal parasites. Trypanorhynch blastocysts (Eucestoda: Trypanorhyncha) and encysted phyllobothriid metacestodes (Eucestoda: Phyllobothriidae) were found in recruits from both events. Fish from the second event were examined later as juveniles and were found to harbor apparently melanized parasites. Neither parasite was found in adults. Evidence suggests these patterns are not due to differential mortality among recruits but to the elimination of parasites by host immune responses. The data also suggest that pelagic fish larvae may represent a dispersal mechanism for parasites if transfer occurs before the death of the parasite.

Animals↗

No evidence for linkage between leprosy susceptibility and the human natural resistance-associated macrophage protein 1 (NRAMP1) gene in French Polynesia.

In order to determine whether a human homolog (NRAMP1) to a murine candidate gene for resistance to mycobacteria influences susceptibility to human disease, we analyzed data from seven multicase leprosy families (84 individuals) from French Polynesia for linkage markers within the NRAMP1 gene and leprosy per se. Individual family members were typed at nine polymorphic loci within NRAMP1. In addition, three physically linked, polymorphic microsatellite markers-D2S104, D2S173 and D2S1471-were also typed. Linkage analyses were done using affected sibpair and LOD score methods employing different modes of inheritance with full and reduced penetrance. The results of this study strongly suggest that NRAMP1 is not linked to leprosy susceptibility in the French Polynesian families tested.

Alleles↗

[About Dick...or the lack of family structure in Polynesia].

Using the case of Dick, an inmate treated in the Psychiatric Ward of the Penitentiary of Nuutania in Tahiti, the author describes the difficulty and even impossibility of formation of traditional family units in Polynesia. The characteristic features are lack of communication, the role of the unspoken and isolation. Old taboos no longer provide controls in crisis situations. Basic landmarks allowing symbolization of the law have disappeared and people now turn to an outside source, metropolitan law which nevertheless remains "alien". This ultimate consensus is the last vestige of Polynesian culture. The different parties appear to be satisfied by this arrangement, the last bastion before the appearance of a totally unstructured society in which the underlying violence is no longer held in check by sacred beliefs.

Adoption↗

Subadult health and disease in prehistoric Tonga, Polynesia.

This article focuses on the differential diagnosis of pathologic lesions recorded on the limbs and crania of 17 subadults from two pre-European burial mounds in Tonga, western Polynesia. All affected subadults were between the ages of 6 months and 3 years at death. The lesions described consist primarily of subperiosteal new bone deposition on the limbs and endocranial surface. However, the presence of cribra orbitalia in a number of individuals indicates concurrent iron-deficiency anaemia. A differential diagnosis of haematogenous osteomyelitis, congenital syphilis, yaws, scurvy, hypervitaminosis A, trauma, Caffey's disease, and iron-deficiency anaemia is discussed. It was concluded that the most likely cause for the lesions observed is a synergistic relation between infection (weanling diarrhoea, yaws) and metabolic disease (scurvy and possibly hypervitaminosis A). Trauma is not ruled out as contributing to the development of some pathologic lesions. It is concluded that, in the Pacific Islands at least, multiple causes for skeletal pathology in subadults should be considered rather than a single aetiology.

Adolescent↗