[Diseases arising from contact with animals in an urban tropical milieu].
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Marquesas Islands, within the French Polynesian territory, are situated in the south hemisphere, near the Equator. They are volcanic islands, with a humid and hot climate, and high hygrometry . These islands are relatively isolated. Our sera were collected at the occasion of a blood test campaign: in Taiohae , 104 people, and Atuona , 149 people; they were between 17 and 57 years old. The results show that 45 people have antibodies against L. biflexa Patoc (17,8%). Among them, 24 have antibodies against icterohaemorrhagiae (9,5%). This is the evidence of the presence of leptospires in these islands.
Electrocardiographic changes defined as probable or suspect ischaemic heart disease and coded according to the Minnesota coding system, were found in 14 (10.3 percent) of 136 Funafutians surveyed. Of these abnormal electrocardiograms, nine were classified as "probable" ischaemia and five as "suspect" ischaemia. There was a higher prevalence of electrocardiographic ischaemia in the female population compared with the male population of Funafuti. This is consistent with the greater degree of obesity and higher prevalence of diabetes previously reported in females in this population.
The prevalence of hypertension and the change in blood pressure with age were investigated in a Polynesian population (Tuvalu), and in a Micronesian population (Nauru) in the South Pacific region. Hypertension was present in 27.2 percent of the Nauruans and 11.1 percent of the Tuvaluans. Both population groups also showed a rise in mean blood pressure with increasing age--a phenomenon apparently absent in traditional-living populations of the world but present in western societies.
Primary liver cancer (PLC) data from 30 selected cancer registries covering 37 populations in 18 countries were used to compare incidence rates in two periods (2-5 yr long) between 1956 and 1972. The median distance between central years of the two periods was about 8 years. Over this interval, all-ages incidence rates, standardized to world population, showed a statistically significant increase in 17 (45.9%) of the populations for males and in 10 (27.0%) for females. Corresponding figures for the 0- to 44-year age group were 4 (10.8%) for males and 7 (18.9%) for females. One statistically significant decrease was observed among the remaining populations. Over the whole set of 37 populations the median percent yearly increase was +3.7 for males and +6.7 for females (all ages) and +1.3 for males and +8.3 for females (ages 0-44 yr). The increase in PLC was most clearly identifiable in the populations of Kracow, Poland; Alberta, Canada; and Bombay, India; and in the Jewish population of Israel. Correlations between levels and/or changes of some variables (per capita income and calorie and alcohol consumption) and changes in PLC rates provided no consistent pattern of results. Changes in PLC mortality rates showed only a weak correlation with changes in PLC incidence rates, indicating the inadequacy of mortality data to describe PLC trends. Data on PLC incidence trends, as available from routine source, appeared insufficient to determine the role of diagnosis-registration changes in the observed increase and to exclude the contribution of etiologic factors.
Possible myocardial infarction defines a group of cases who describe severe ischaemic-type chest pain, who survive at least 24 hours, but have no clear electrocardiographic or enzymatic evidence of acute myocardial infarction. The descriptive epidemiology of this condition is described for a group of such cases in Auckland, New Zealand. The sex ratio is 1.75 and the crude incidence about 0.0012 per year. There was evidence that Polynesian females are particularly prone to this condition compared to Polynesian males. Alcohol consumption was relatively high as was the frequency of cigarette smoking. Fifty-two percent had a history of hypertension. Twenty-four percent had a normal electrocardiography. Death during the first 30 days was uncommon.
Tokelauans show an increased prevalence and incidence of diabetes mellitus after migration to the modern industrial society of New Zealand (NZ). In females the prevalence rose from 6.1 percent before migration to 10.8 percent afterwards, while in males a nonsignificant rise from 2.3 percent to 4.4 percent was observed. Migrants who had been in New Zealand for longer periods had higher incidence than other migrants. Time since arrival in New Zealand was a significant predictor of diabetes, but time spent in an intermediate environment, Samona, on the way to New Zealand was not. Increase in body weight and adiposity occurred in the migrants. Adiposity was associated with an increased risk of diabetes, but nonspecific weight increase was not. Diabetic females had experienced 15 percent more births than nondiabetic females. Changed energy balance related to diet and work patterns may be related to the increased incidence of diabetes in migrants, in a population predisposed by high serum uric acid concentrations, obesity and high fertility.
A follow-up at five months of 269 Polynesian infants born at Hutt Hospital over a nine month period showed an incidence of lower respiratory symptoms of 42 percent. Nineteen percent of the infants had recurrent or prolonged symptoms. These infants more frequently had a family history of asthma or bronchitis in first degree relatives, had a greater incidence of damp housing and were often of lower socio-economic status. There was a lower rate of breast feeding in the symptomatic groups suggesting that breast milk has a role in preventing the syndrome of recurrent respiratory illness in Polynesian infants.
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The prevalence of abnormal glucose tolerance in the Polynesian population of Funafuti, Tuvalu (formerly the Ellice Islands) is much higher in females than males. However, the women are more obese than the men. Adjusting for obesity reduced the relative risk of abnormal glucose tolerance between males and females but the differences remained statistically significant. It is concluded that differences in the extent of obesity in the male and female population of Tuvalu explain part (but not all) of the differences in prevalence of impaired glucose tolerance in Funafutians.
An epidemiologic survey of 133 adult Polynesians of Manihiki Atoll, Cook Island group, revealed a high prevalence of diabetes mellitus (males 8.0 percent, females 10.3 percent) and impaired glucose tolerance (males 8.0 percent, females 31.0 percent). Those with abnormal glucose tolerance were older, more obese, and engaged in less physical activity than normals. The females had a higher prevalence of both diabetes and impaired glucose tolerance than the males. Although Manihiki is geographically isolated, the islanders have a good income from copra and pearl shell. The change from a traditional to a modern way of life in a population with an increase susceptibility to diabetes is the probable cause of the high prevalence of abnormal glucose tolerance. The change in living patterns is a consequence of change from a subsistence existence to involvement in the cash economy.
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Prompted by the marked regional differences in the incidence of acute nephritis in childhood, a comparative clinical study is reported. The features of the disease in a high incidence area, Tauranga, are contrasted with those in a low incidence area, Christchurch. The relative infrequency of the disease in Christchurch has been confirmed. The clinical features and the severity of the disease showed a similar pattern in the two centres. Serological evidence of recent streptococcal infection occurred in the majority of patients from both areas. Prior skin infection was more frequently reported from Tauranga and the significance of this is discussed.
A Schick survey of 689 children was carried out in the Wellington health district during winter 1981. Only 25 (3.6 percent) were found to be non-immune. Although this appears to indicate a high level of herd immunity in school children, the results must be interpreted with caution. Because cases of diphtheria are still occurring in New Zealand, it is argued that unless efforts are made to raise the level of infant immunisation, this country cannot be considered free from the threat of an increase in clinical diphtheria, particularly among non-Europeans.
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The screening of different ethnic groups who live in the same natural system have enabled the authors to study interaction between genetic and environmental factors as a part of etiology of diabetes mellitus. In New Caledonian country areas, the prevalences of glucose tolerance abnormality (GTA) and diabetes mellitus (DM) have been higher with people of polynesian descent than with Melanesians. GTA 7.6 p. ct. versus 5.1 p. ct. DM 6.5 p. ct. versus 2.2 p. ct. The prevalence of these combined diseases have been 14 p. ct. with the Polynesians and 7.2 p. ct. with Melanesians. These two ethnic groups have shown mean ages and obesity rates similar enough to lead the authors to deny these two factors a major part in the difference between the ethnic prevalences of DM. Besides, the mean plasmatic glycemia two hours after a dose of glucose and the relative risk of DM and GTA according to age and obesity rate have shown that the slight differences between these groups are not involved in the different prevalences of DM. This inter-ethnic difference may be due to genetic factors. However, some environment linked factors besides obesity (such as diet and daily life activity) may share a major part in this difference.