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Electrocardiographic abnormalities and associated factors in Chinese living in Beijing and in Mauritius. The Mauritius Non-Communicable Disease Study Group.

OBJECTIVE: To compare the prevalence of electrocardiographic abnormalities and to evaluate the association between these abnormalities and the levels of coronary heart disease among Chinese living in different environments. DESIGN: Cross sectional surveys. SETTING: Beijing, China, and the island of Mauritius. SUBJECTS: Random samples of people aged 35-64 years in Beijing (621 men, 642 women) in 1984 and in Mauritius among Chinese (137 men, 130 women) and non-Chinese (1265 men, 1432 women) in 1987. MAIN OUTCOME MEASURES: Prevalence of electrocardiographic abnormalities suggesting coronary heart disease and of associated risk factors. RESULTS: Prevalence of electrocardiographic abnormalities suggesting coronary heart disease was significantly lower in Beijing (4.0%) than in Mauritian Chinese (24.3%) and Mauritian non-Chinese (24.5%). Mean serum concentrations of total and non-high density lipoprotein cholesterol were lower in Beijing Chinese than in Mauritian Chinese, but smoking and hypertension were slightly more prevalent. Overall, men with electrocardiographic abnormalities had higher risk factor levels than those with a normal electrocardiogram regardless of ethnic origin. CONCLUSIONS: The prevalence of coronary heart disease and associated risk factors was different among Chinese living in two different environments: in Beijing in the People's Republic of China and in Mauritius. Chinese, who traditionally have a very low frequency of coronary heart disease, are by no means protected against coronary heart disease and other non-communicable diseases. Therefore, primary prevention of coronary heart disease is a major challenge for preventive medicine in China, as well as in many other developing countries.

Adult↗

Changes in population cholesterol concentrations and other cardiovascular risk factor levels after five years of the non-communicable disease intervention programme in Mauritius. Mauritius Non-communicable Disease Study Group.

OBJECTIVE: To study changes in the prevalence of risk factors for cardiovascular disease after a five year population-wide intervention programme promoting a healthy lifestyle in a developing country. DESIGN: Cross sectional cluster surveys in 1987 and 1992. Methodology included a two hour 75 g oral glucose tolerance test, measurement of body mass index, waist:hip ratio, basal lipid concentrations, and blood pressure; and a lifestyle questionnaire. SETTING: Mauritius, in the Indian Ocean. SUBJECTS: All adults aged 25-74 years residing in geographically defined clusters. MAIN OUTCOME MEASURES: Age standardised prevalence of categorical disease and risk factor conditions and mean levels and frequency distributions of continuous variables. RESULTS: Response rates were 86.2% (5080/5892) in 1987 and 89.5% (5162/5770) in 1992. Significant decreases were found in the prevalence of hypertension (15.0% to 12.1% in men and 12.4% to 10.9% in women); cigarette smoking (58.2% to 47.2% and 6.9% to 3.7% respectively); and heavy alcohol consumption (38.2% to 14.4% and 2.6% to 0.6% respectively). Moderate leisure physical activity increased from 16.9% to 22.1% in men and from 1.3% to 2.7% in women. Mean population serum total cholesterol concentration fell appreciably from 5.5 mmol/l to 4.7 mmol/l (P < 0.001). The prevalence of overweight or obesity increased, and the rates of glucose intolerance changed little. The population frequency distributions of blood pressure, serum lipid concentration, and a composite risk factor score shifted advantageously. CONCLUSIONS: Lifestyle intervention projects can be implemented and have positive effects in developing countries. A pronounced improvement in the population lipid profile in Mauritius was probably related to a change in the saturated fat content of a widely used cooking oil.

Adult↗

Is there a relationship between leptin and insulin sensitivity independent of obesity? A population-based study in the Indian Ocean nation of Mauritius. Mauritius NCD Study Group.

OBJECTIVE: It has been shown previously in smaller studies that fasting serum leptin and insulin concentrations are highly correlated, and insulin sensitive men have lower leptin levels than insulin resistant men matched for fat mass. We have examined the association between insulin resistance (assessed by fasting insulin) and leptin after controlling for overall and central adiposity in a population-based cohort. DESIGN: Leptin levels were compared across insulin resistance quartiles within three categories of obesity (tertiles of body mass index (BMI)). Partial correlation coefficents and multiple linear regression models were used to assess the relationship between leptin and fasting insulin after adjusting for BMI and waist to hip ratio (WHR) or waist circumference. SUBJECTS: Subjects were normoglycemic participants of a 1987 non-communicable diseases survey conducted in the multiethnic population of Mauritius. 1227 men and 1310 women of Asian Indian, Creole and Chinese ethnicity had normal glucose tolerance and fasting serum leptin measurements. RESULTS: Mean serum leptin concentration increased across quartiles of fasting insulin in each BMI group and gender, after controlling for BMI, WHR and age. Furthermore, fasting insulin was a significant determinant of serum leptin concentration, independent of BMI and WHR, in both men and women. Similar results were found if waist circumference replaced BMI and WHR in the model. CONCLUSION: These results suggest that insulin resistance/concentration may contribute to the relatively wide variation in leptin levels seen at similar levels of body mass or alternatively, leptin may play a role in the etiology of insulin resistance. Further studies will be important to determine whether the hyperleptinemia/insulin resistance relationship has a role in the natural history of obesity, Type 2 diabetes mellitus and the other metabolic abnormalities associated with insulin resistance.

Adult↗

Do leptin levels predict weight gain?--A 5-year follow-up study in Mauritius. Mauritius Non-communicable Disease Study Group.

OBJECTIVE: To investigate whether relative baseline leptin levels predict long-term changes in adiposity and/or its distribution. RESEARCH METHODS AND PROCEDURES: In a longitudinal study of 2888 nondiabetic Mauritians aged 25 years to 74 years who participated in population-based surveys in 1987 and 1992, changes in body mass index (BMI), waist/hip ratio (WHR), and waist circumference were compared between "hyperleptinemic," "normoleptinemic," and "hypoleptinemic" groups. "Relative leptin levels" were calculated as standardized residuals from the regression of log10 leptin on baseline BMI to provide a leptin measure independent of BMI. Analyses were performed within each sex. A linear regression model was used to assess the effect of standardized residuals on changes in BMI, WHR, and waist circumference, independent of baseline BMI, age, fasting insulin, and ethnicity. RESULTS: After adjusting for age and baseline BMI by analysis of covariance, there was no difference in changes in BMI, WHR, or waist circumference between men with low, normal, or high relative leptin levels. Among women, there was a significant difference in deltaWHR across leptin groups, such that the largest increase occurred in the "normal" leptin group. For both men and women, the linear regression models explained approximately 10% of variation in dependent variables, and the only significant independent variables were age, BMI, and being of Chinese origin, compared with Indian origin. DISCUSSION: These findings do not support a role for leptin concentration in predicting weight gain or changes in fat distribution in adults over a 5-year period.

Blood Glucose↗

"MAURITIUS": tumour dose in patients with advanced carcinoma.

Radioimaging of various human tumours by means of somatostatin analogues and vasoactive intestinal peptide has been introduced into clinical practice in recent years. The finding that human tumours express various subtypes of somatostatin receptors has led to the development and characterization of a novel peptide tracer, termed MAURITIUS. MAURITIUS identifies a broad range of somatostatin receptors with high binding affinity, and somatostatin receptor 1 with low binding affinity. In order to evaluate patients for tumour radiotherapy with 90Y-MAURITIUS, tumour dose calculation is performed with 111In-MAURITIUS [111In-DOTA-lanreotide]. Treatment is initiated in patients presenting a tumour uptake of > or = 10 Gy/GBq (i.e., standard dose for 1 treatment cycle with 90Y-MAURITIUS). In 25 patients with advanced cancer refractory to conventional antineoplastic treatment 111In-MAURITIUS (approximately 150 MBq; 10 nmol/patient), scintigraphy and dosimetry was performed. Dosimetry data were calculated based on scintigraphic results as well as urine, faeces and blood data. In all patients, at least one tumour site was visualized during the initial few minutes of application. Additional tumour sites not seen on conventional imaging (computerized tomography, magnetic resonance imaging bone scan) could be detected in 6 patients with carcinoids, one patient with prostate cancer and one patient with lymphoma. Liver metastases were visualized in all patients with gastrointestinal cancers, while the primary tumour was not detected in 2 patients with pancreatic, and in 1 patient with rectal, cancer. The calculated radiation dose for tumours and/or metastases ranged between 3-60 Gy/GBq for 90Y-MAURITIUS. MAURITIUS is a universal receptor ligand for a large variety of different human tumours, and is suitable for treatment when labelled with 90Y.

Dose-Response Relationship, Radiation↗

Hepatitis C and arboviral antibodies in the island populations of Mauritius and Rodrigues.

A serological survey for antibodies to hepatitis C virus (HCV), dengue viruses (DEN), West Nile virus (WN), and sindbis virus (SIN) was carried out in sera of selected groups of the population of the Islands of Mauritius (n = 449) and Rodrigues (n = 115), Indian Ocean. 8.3% of 564 sera were positive for anti-HCV. In Mauritius, 2.1% of sera of healthy individuals were found with anti-HCV. The highest prevalence was found in sexually transmitted disease (STD) patients and prison inmates with 46.2% and 43.8%, respectively. None of the sera from blood donors sampled from Rodrigues Island had anti-HCV. Antibodies to arboviruses were detected in sera of individuals from both islands. Anti-DEN IgG was detected in 3.8% of sera from Mauritius and 0.9% from Rodrigues. Anti-WN IgG was detected in 2.2% of sera from Mauritius and 0.9% from Rodrigues. All sera from Rodrigues were without anti-SIN IgG, 1.1% of those from Mauritius were positive. This suggests that arboviruses occur on these islands.

Adult↗

Variation among strains of Xanthomonas campestris pv. vasculorum from Mauritius and other countries based on fatty acid analysis.

Fatty acid profiling was used to study variation amongst strains of Xanthomonas campestris pv. vasculorum (Xcv). They could be divided into five groups using cellular fatty acid profiles. Group A strains represent a new and little known taxon and all came from plants of broom bamboo (Thysanolaena maxima) from Mauritius. Group B strains included the Xcv pathotype reference strain and were from palms, broom bamboo and sugarcane from Mauritius, Reunion and Australia. Group C contained southern African and Malagasy strains from sugarcane and maize, together with X. campestris pv. holcicola strain. No Mascarene strains fell into this group. Group D strains isolated from sugarcane, maize and royal palm (Roystonea regia) were from Mauritius and Reunion, the earliest known strains coming from Réunion. These groups represented in the Mascarene Islands possibly belong to three different Xanthomonas species. A further Group E comprised one Xcv strain (NCPPB 182) from Puerto Rico, one X. vasicola pv. holcicola strain plus 6 other unclassified Xanthomonas strains causing red stripe disease symptoms in sugarcane. Three of these groups occur on Mauritius and two occur on Réunion. Group B strains originally caused serious problems in noble canes. As resistant interspecific hybrids were introduced, group D strains appeared in Mauritius possibly being introduced from Reunion but having similar host ranges within the Gramineae and Palmae. The findings that 3 of these groups (A, B, D) can cause gumming disease in a grass species (T. maxima) and that 2 of them (B, D) also cause gumming disease in sugar cane (Gramineae) and palms (Palmae) is unusual.

Fatty Acids↗

Decreasing prevalence of cigarette smoking in the middle income country of Mauritius: questionnaire survey.

OBJECTIVES: To describe changes in the prevalence of cigarette smoking in the middle income country of Mauritius from 1987 to 1998, and to relate these changes to legislative and health promotion efforts over the same period. DESIGN: Questionnaire survey. SETTING: Mauritius, an island in the Indian Ocean with a population of about 1.2 million (about 70% south Asian, 2% Chinese, and 28% Creole). PARTICIPANTS: Data were obtained from 5072 participants in 1987, 6573 in 1992, and 6281 in 1998. MAIN OUTCOME MEASURES: Prevalence of current smoking in 1987, 1992, and 1998, sales of cigarettes in Mauritius, and information on activities for control of tobacco. RESULTS: Self reported cigarette smoking has been decreasing in Mauritius since 1987, with the largest decrease between 1987 and 1992. From 1987 to 1998 smoking prevalence decreased by 23% in men and 61% in women. Smoking decreased across all age and ethnic groups and across different levels of income and education. Sales of cigarettes also decreased in line with smoking prevalence. CONCLUSIONS: The introduction of cigarette taxes, a limited health promotion programme, and the absence of massive promotional campaigns by the sole tobacco company on Mauritius have led to a striking and continued decrease in smoking prevalence and cigarette consumption on the island.

Adult↗

Mauritius type black rats with peculiar karyotypes derived from Robertsonian fission of small metacentrics.

All seventeen black rats collected from Mauritius Island were characterized by having many extra small acrocentric autosomes. Their basic karyotype was of Oceanian type, because of the presence of the large metacentric M1 and M2 pairs, but chromosome numbers in 13 specimens among them were 42, those of 3 specimens 43, and those of the remaining one specimen 44. Although the Oceanian type rat had 2 small acrocentric autosomes (pair no. 13), 16 Mauritius rats had 10 small acrocentrics, and the remaining one had 8 small acrocentrics. Comparative karyotype analysis between Oceanian and Mauritius type rats showed that the extra small acrocentrics found in Mauritius rats were due to Robertsonian fission of small metacentric pairs no. 14 and 18 of the original Oceanian type rat. Only one rat with 8 small acrocentrics showed the heteromorphic pair no. 18 consisting of one metacentric and two acrocentrics. The large metacentric M1 chromosome in 13 of 17 rats examined showed homologous pair, but two of them were heteromorphic by involving one metacentric M1 and two acrocentrics. In the remaining two rats M1 chromosome was not observed, but acrocentric pairs no. 4 and 7 were included. These acrocentrics were also suggested to be originated from Robertsonian fission of the large metacentric M1 chromosome. Robertsonian fission seemed to be one of the important mechanism found in karyotype evolution.

Animals↗

Prevalence of infections and use of antibiotics among hospitalized patients in Mauritius. A nationwide survey for the planning of a national infection control programme.

As part of a programme for improving hospital infection control in Mauritius a nationwide survey, including a prevalence study, was carried out in order to identify characteristics of the hospitals, the population, and the infections. Community-acquired infections were three times more prevalent than nosocomial infections: 15.0% and 4.9%, respectively. Surgical wound infection was by far the most common nosocomial infection, with a prevalence rate of 8.2 per 100 operations, followed by urinary tract infection with a low rate of 0.8 per 100 admissions. The survey showed that these hospitals in Mauritius housed mainly a young population (mean of 36.8 years for females and 39.4 years for males) with few risk factors for acquiring nosocomial infection. Although diabetes mellitus is prevalent in Mauritius the diagnosis of diabetes was not associated with nosocomial infection. The spectrum of operations offered was limited, and Caesarean section was the most prevalent operation. The amount and types of antibiotics used in hospitalized patients were recorded. More than one third of the patients received antibiotic treatment at the time of the survey, which is comparable to figures reported from large teaching hospitals in Western Europe. The information gathered from the survey, the interviews and the inspection were used to establish priorities for a collaborative programme for improved infection control. It included the draft of a set of custom-made guidelines, which were eventually studied by staff members from hospitals in Mauritius during a training period in Denmark. We believe that a prevalence survey is useful for initiating infection control programmes in hospitals in developing countries.

Adult↗

Fall in total cholesterol concentration over five years in association with changes in fatty acid composition of cooking oil in Mauritius: cross sectional survey.

OBJECTIVE: To determine the extent to which reducing the saturated fatty acid composition of a ubiquitously used cooking oil influenced changes in cholesterol concentration in the population during a five year intervention programme in Mauritius. DESIGN: Cross sectional surveys in 1987 and 1992 determined mean total cholesterol concentrations in the population. A random sample of respondents in the 1992 survey completed a nutrition questionnaire that included questions on diet in the previous 24 hours. SETTING: Mauritius. INTERVENTION: In 1987 the government of Mauritius changed the composition of the commonly used cooking oil from being mostly palm oil (high in saturated fatty acids) to being wholly soya bean oil (high in unsaturated fatty acids). SUBJECTS: 5080 and 5162 subjects in 1987 and 1992 cross sectional surveys. 2059 subjects aged 30-64 years were randomly selected from the respondents of the 1992 survey to take part in the nutrition survey. MAIN OUTCOME MEASURES: Fatty acid composition of phospholipids in pooled serum samples from men and women from the two surveys; measured and predicted change in serum cholesterol concentration. RESULTS: From 1987 to 1992 total cholesterol concentrations fell significantly by 0.79 mmol/l (P < 0.001) in men and 0.82 mmol/l (P < 0.001) in women. The estimated intake of saturated fatty acids decreased by 3.5% of energy intake in men and by 3.6% in women, and the intake of polyunsaturated fatty acids increased by 5.5% and 5.6% of energy intake, respectively. These changes were reflected in changes in the fatty acid composition of serum phospholipids, and according to Keys' formula these changes explained much of the decrease in serum cholesterol concentrations (predicted decrease of 0.38 mmol/l in men and by 0.40 mmol/l in women). CONCLUSION: Dietary changes that entailed a reduction in the saturated fat content of a ubiquitous cooking oil explained most of the observed decrease in serum cholesterol concentration over five years in the population of Mauritius.

Adult↗

Fluoride and sugar intake among adults and youth in Mauritius: preliminary results.

The potential use of different vehicles for delivering fluoride to prevent dental caries has been discussed recently in Mauritius. Water fluoridation was found not to be feasible, and extending the fluoride tablet program would not be easy. Thus, sugar fluoridation as one possibility was considered. For these purposes, the average fluoride and sugar intake was estimated in Mauritius. The results are based on two studies--a Survey on Diet, Health and Lifestyle of Youth in Mauritius (1990) and the Mauritius Diet and Health Survey. Information was collected by trained interviewers using food-frequency and 24-hour-recall questionnaires. The daily total sugar intake, manufactured and natural, was found to be 62 g per day in young people and 50 g per day in adults. In the younger groups, daily frequencies of raw sugar, sweets, and biscuit (cookie) consumption were 1.5, 0.2, and 0.2 times a day, respectively. For adults, the mean daily frequency of consuming sugar-containing foods was 2.6 (SD = 1.3). The daily sucrose intake was rather high, representing about 10% of the daily energy intake. The fluoride levels of foods were calculated by use of Finnish and other available fluoride tables. The mean fluoride intakes per day were 0.64, 0.72, and 0.62 mg per day for 8-17-year-, 18-24-year-, and 30-64-year-old groups, respectively. The median fluoride intake for the oldest group was 0.62 mg/day. The estimated fluoride intake from food did not correspond with the proposed level for the prevention of caries (Murray, 1986) except for the 18-24-year-olds, where it might have been just above the lower recommended limit. However, further data based on analysis of the fluoride contents of Mauritian food samples, especially of whole daily diet, are needed.

Adolescent↗

Physical inactivity and glucose intolerance in the multiethnic island of Mauritius.

The island nation of Mauritius, located in the southwest Indian Ocean, has a high prevalence of non-insulin-dependent diabetes mellitus (NIDDM) among all of its ethnic groups (Hindu and Muslim Indians, African-origin Creoles, and Chinese). These high rates of NIDDM among groups of varying genetic background provide strong support for the importance of environmental components in the etiology of the disease. Research in Mauritius using a simple activity scale has suggested that physical inactivity may be one of these components. The current investigation further examined the association between glucose tolerance and physical activity in middle-aged nondiabetic residents of Mauritius using a more extensive physical activity questionnaire (the Modifiable Activity Questionnaire). Excluding individuals with NIDDM, a statistically significant (P < 0.05) inverse relationship between physical activity and 2-h post-load glucose concentration was found for both males (rho = -0.14) and females (rho = -0.11). Stratifying by ethnic group, similar inverse correlations were observed in Hindu, Creole, and Chinese males, and in Hindu females (P < 0.05), as well as weaker relationships in Muslim males and Creole females (P < 0.10). Total physical activity remained an independent predictor of 2-h post-load glucose concentration after controlling for body mass index, waist-hip ratio, age, and family history of NIDDM. These data are supportive of a potentially important role of physical activity in the prevention of NIDDM in middle-aged inhabitants of Mauritius.

Adult↗

[Entomological surveillance in Mauritius].

The entomological surveillance is an essential link in the fight against malaria in Mauritius. Because of the large number of malaria-infected travellers in Mauritius and the presence of the vector Anopheles arabiensis, the risk of local transmission is very real. The medical entomology division together with the malaria control unit and the health appointees exert a rigorous entomological surveillance of malaria. Field agents make entomological investigations of pilot villages and around the harbor and airport, where there have been cases of malaria, in addition to a few randomly chosen regions. All of the inhabited regions are accessible because of a good highway infrastructure, which enables a complete coverage for the entomological prospectives. Entomological controls are also conducted in the airplanes and the ships. All of the captured mosquitos and the harvested larva are transferred to a laboratory for identification, dissection or sensibility tests, etc. The larva of A. arabiensis have not yet developed resistance to Temephos and the adults are still sensitive to DDT. Thus, the larval habitats are treated with Temephos and DDT is sprayed in the residences where there have been native cases of malaria. The entomology division studies the ecology and the evolution of the larval habitats, as well as the impact of the anti-larval fight on the anophelene density. In addition to the chemical fight, a biological control is being tried with larva-eating fish such as Lebistes and Tilapia. In general, the anophelene density in Mauritius is low, but after the big summer rains, especially during a period of cyclones, there is a considerable increase of larval habitats and consequently a higher number of A. arabiensis. Therefore during this season, it is necessary to make an even more rigorous entomological surveillance. A. arabiensis has a strong exophile tendency even if it is endophage and exophage. This mosquito is zoophile, mostly towards cattle, and the zooprophylaxis must have a significant role in the regions with herds of cattle such as the western part of the island. However, the favorite larval habitat of A. arabiensis seems to be water on the flat roofs of solid houses. Therefore, the availability of such larval habitats across the country facilitates the vector-human contact. On the other islands forming part of the state of Mauritius, such as Rodriguez and Agaléga, there are no anopheles and therefore no risk of transmission of malaria. There still are entomological investigations on these islands periodically to assure that there is no accidental introduction of anopheles mosquitos.

Animals↗

[The development of public health education: the Mauritius experience].

A public course has been initiated in 1990 in Mauritius for covering the national growing needs of public health specialists. This training course was organized jointly by the Ministry of Health, the University of Bordeaux II and the French Cooperation. After 3 sessions dedicated specifically to the Mauritian physicians, the course has been re-designed for the needs of the other countries of the region. A feasibility study performed in 1994 in the countries of the Indian ocean region showed that during the past decade, the district level had become the focus point to integrate the health programs. This process has progressively transferred a wider and stronger part of the responsibilities from the central level to the district level and the survey showed that most of the health district managers were physicians that did not have the proper background for carrying such responsibilities. According to these results, a course curriculum was created by the Mauritian Ministry of Health and the University of Bordeaux II and submitted to various organisms supporting health program development in the region. This proposal was strongly supported by several agencies (the french Cooperation, Unicef, WHO, World Bank...) who agreed to sponsor candidates for that training course. The first session was organized in 1995, a second one in 1996. This training course is targeted to the medical doctors who are in charge of the management of health services at the district level. It is divided in two parts: A six-weeks intensive training course performed in Mauritius that include formal teaching and practical exercises in small groups for a total of 210 hours. The curriculum is mainly targeted on the various aspects of management as the management of health information (biostatistics epidemiology and computing), the management of human resources, financial resources and material resources. In addition to these main topics, there is an introduction to pedagogy, communication skills and applied research methodology. Following this six-weeks, training the students come back to work in their country and have 8 months to perform a thesis supervised by a local public health specialist. The subject of the thesis has to be closely related with one of the topic taught and should provide an obvious improvement for the public health situation in the district where this physician is acting. In 1995, 22 candidates attend to the course (13 from Madagascar, 4 from Mauritius, 3 from Comoros, 1 from Angola, 1 from Equatorial Guinea and 1 from Tchad), 19 had successively completed all the modules and got the diploma of public health delivered by the University of Bordeaux II. This diploma has been recognized as an equivalent to a master in public health in Mauritius. The evaluation of the courses-performed by the students, the teachers and the financial agencies gave a very positive results although the workload was considered as too important for a six-weeks training course. The recommendations of the 1995 session were included in the 1996 programs which is still on going for 23 candidates. The 97 session will probably extend the number of students up to 40, divided in 4 subgroups for practical exercises. In parallel to the course, a quarterly bulletin will be created and sent to the present and past candidates of this course in order to support a continuous medical education training program targeted to the district physicians.

Communication↗

Hb F-Mauritius [A gamma 23 (B5) Ala deleted]: evidence for an identical hotspot for deletions in the various beta-like genes.

Hemoglobin (Hb) F-Mauritius, a new A gamma chain variant, was identified from a dried blood spot collected from a heelprick during neonatal screening for the main hemoglobinopathies. This hemoglobin is the first gamma chain variant having a one residue deletion: it concerns alanine at position gamma 23. Hb F-Mauritius is therefore the counterpart of Hb Freiburg, an unstable variant of the beta chain in which the valine residue that occupies position beta 23 is deleted. The structural modification of Hb F-Mauritius was characterized by miniaturized protein chemistry methods, including sequence determination by mass spectrometry measurements. Hb Freiburg was used as a control in several experimental procedures. The hypothesis that a similar mechanism for deletion has occurred in Hb F-Mauritius and in Hb Freiburg is supported by the high percentage of homology observed between the beta and gamma globin genes. In addition, the first exon of the beta-globin has been recognized as a hotspot for deletion: several beta-thalassemic mutations, or abnormal Hbs, with deletions of short nucleotide sequences map in this region.

Alanine↗

The inequalities of morbidity and mortality in Mauritius--its ethnic [correction of ethic] and geographic dimension.

This overview of the changing patterns of morbidity and mortality on the one hand and ethnicity and geographic variables on the other is an attempt to understand the changes which are taking place in the economic and social geography of Mauritius. Recently in the economic literature, there has been constant reference to the changes taking place in Mauritius. This article explores the changing patterns of morbidity and mortality based on official censuses, reports and studies. It further seeks to relate these to the geography of Mauritius.

Adult↗

Microbial and nutrient pollution of coastal bathing waters in Mauritius.

The coastal pollution problem in Mauritius is exacerbated by the hydrogeology of the volcanic substratum. Bacterial contamination of bathing waters and nutrients, water temperature, salinity, and dissolved oxygen (DO) were monitored at three different spatial and temporal scales along the coastline of Mauritius during 1997-1998. Standard techniques for water sample collection and analysis set by the American Public Health Association [APHA. Standard methods for the examination of water and wastewater. 19th ed. Washington, DC: APHA, 1995.] were used at: (a) 16 sites around the island over a period of 7 months; (b) 12 stations along a recreational beach over an 18-month period; and (c) at an underground freshwater seepage point over 1 day. Total coliform (TC), faecal coliform (FC), and faecal streptococci (FS) contamination reported during all surveys varied randomly (e.g., with maximum densities in the ranges of 346-2020 TC, 130-2000 FC, and 180-1040 FS at one site) and at times exceeded the established EEC and Environment Protection Agency (EPA) standards for bathing water (e.g., in >90% of samples) to qualify for beach closure. Computed FC:FS ratios were used to pinpoint human faecal matter as the main source of contamination. Nitrate, phosphate, and silicate concentrations in seepage water were high (3600-9485, 38-105, and 9950-24,775 microg l(-1), respectively) and a cause for concern when compared with levels (5-845, 5-72, and 35-6570 microg l(-1), respectively) in cleaner lagoon water samples. Statistical analysis showed significant correlations (for TC and NO3: r=.75, P<.02; for TC and PO4: r=.779, P<.02; for TC and SiO4: r=.731, P<.05; for FC and NO3: r=.773, P<.02; for FC and SiO4: r=.727, P<.05; for FS and SiO4: r=.801 P<.01) between microbial densities and nutrients recorded, confirming the pathogen-contaminated water to be highly eutrophic. There is an urgency for Mauritius to properly address the issue of sewage treatment and wastewater discharge to safeguard its coastal environment, public health, and tourism expansion.

Enterobacteriaceae↗