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[Evaluation of the health status of nomadic and semi-nomadic populations of the Gourma-Mali: epidemiologic approach. II. Overall results and conclusions].

The authors report the main clues of morbidity, infant mortality, fecundity as well as the main endemic affections detected in the nomadic and seminomadic populations in Gourma that they have noticed during a descriptive epidemiological investigation. The worse clues of general morbidity come from children and among the ethnic groups studied from those of the Tamachèques and the Maures. Malaria, brucellosis, treponematosis (bejel) have a high rate of frequency. The few cases of tuberculosis detected incidentally encourage to search for the real effect of this affection. Urinary schistosomiasis is present in Gossi where durable ponds exist. Intestinal helminthiasis, tineas, and hemoglobinopathies seem not to be problems of public health in the area. Pterygiums and conjunctivitis are frequent while trachoma is absent in Gourma.

Adolescent↗

[Evaluation of the health status of nomadic and semi-nomadic populations of the Gourma-Mali: epidemiologic approach. I. Introduction, material and methods].

The authors set out the methodology and the practical way used in transverse epidemiological investigation with a descriptive aim which was made in natural area: Gourma-Mali. This part of the Sahel, hard to reach, is placed deep in the bend of the Niger river. The population is estimated at 100.000. The weather, ecological and human conditions have been unsettled by the drought. Sometimes, it was difficult to collect the data among the nomadic and seminomadic populations (Tamachèques, Peuls, Maures, Bellahs, Sonraïs). This investigation shows well the practical problems that this kind of study sets out in difficult bioclimatological and ethnological conditions.

Blood↗

Molecular characterization of a retrotransposon in Drosophila melanogaster, nomad, and its relationship to other retrovirus-like mobile elements.

The nomad element was identified as a retrovirus-like transposon in Drosophila melanogaster. DNA sequence analysis showed that the nomad element contains three long ORFs that are similar to the gag, pol and env genes of retrovirus- and the copia-like elements of D. melanogaster. The nomad element terminates with 519-bp terminal repeats, each of which contains eukaryotic consensus transcription initiation and termination signals. nomad elements are located at approximately 10-15 sites within the euchromatic arms of the genome and at the chromocenter, as shown by in situ hybridization. The host DNA sequence TANA was found to be duplicated on each side of the nomad element and appears to be a preferential target site for insertion of nomad elements. Analysis of the zinc finger motif in the pol gene product of retrotransposons known to have target site preference suggests involvement of the integrase subunit in target site selection for those retrotransposons that display insert site specificity. A comparison of the predicted amino acid sequence of the pol-like genes of several known retrotransposons was made and the phylogenetic relationship between nomad and other retrovirus-like mobile elements was determined. It was clear from this conceptual protein analysis and from analysis of their structural characteristics that retrotransposons of the gypsy class can be generally classified as members of one of two distinct groups. The phylogenetic relationships of these groups are also discussed.

Amino Acid Sequence↗

Epidemiology and control of parasites in nomadic situations.

Nomadism is a highly specialised mode of life that enables humans to exploit resources that are widely distributed over space and time. The isolation and remoteness of many nomad populations have limited studies on the macroepidemiology of parasitic infection in nomad populations. From the available information, the influence of a number of factors on the prevalence and transmission of parasitic infections in nomads is discussed. Environmental conditions, especially relative humidity and temperature, profoundly influence parasitic diseases. Human behaviour varies with cultural factors and influences exposure to disease. Periodic movements of nomads may either remove them and their animals from contaminated environments or may bring then into contact, often seasonally, with infections. There may be a strong ecological interdependence between diet and infection and disease in nomadic groups. Finally, the influence of drought can be profound in that seasonal or prolonged drought promotes concentration of populations in small areas or their sedenterisation, often with an increase in parasite transmission. Relevant information that needs to be acquired to develop appropriate practical and cost-effective health and veterinary care and control programmes for nomadic populations and their livestock is outlined.

Africa South of the Sahara↗

Where health care has no access: the nomadic populations of sub-Saharan Africa.

Nomadic and seminomadic pastoralists make optimal use of scarce water and pasture in the arid regions south of the Sahara desert, spreading from Mauretania in the west to Somalia in East Africa. We attempted to summarize the fragmentary evidence from the literature on the health status of these populations and to assess the best ways to provide them with modern health care. Infant mortality is higher among nomadic than among neighbouring settled populations, but childhood malnutrition is less frequent. Nomads often avoid exposure to infectious agents by moving away from epidemics such as measles. Trachoma is highly prevalent due to flies attracted by cattle. The high prevalence of tuberculosis is ascribed to the presence of cattle, crowded sleeping quarters and lack of health care; treatment compliance is generally poor. Guinea worm disease is common due to unsafe water sources. Helminth infections are relatively rare as people leave their waste behind when they move. Malaria is usually epidemic, leading to high mortality. Sexually transmitted diseases spread easily due to lack of treatment. Leishmaniasis and onchocerciasis are encountered; brucellosis occurs but most often goes undetected. Drought forces nomads to concentrate near water sources or even into relief camps, with often disastrous consequences for their health. Existing health care systems are in the hands of settled populations and rarely have access to nomads due to cultural, political and economic obstacles. A primary health care system based on nomadic community health workers is outlined and an example of a successful tuberculosis control project is described. Nomadic populations are open to modern health care on the condition that this is not an instrument to control them but something they can control themselves.

Adult↗

[An innovative approach combining human and animal vaccination campaigns in nomadic settings of Chad: experiences and costs].

The purpose of this report is to describe a network of public health care workers, veterinarians and nomadic pastoralists that was set up in Chad to increase vaccination coverage to nomadic children and women who had rarely been vaccinated before. The objectives of the project were to provide human vaccination in conjunction with existing veterinary services, to evaluate the feasibility and limitations of such campaigns, to determine what other services could be provided concurrently, and to estimate the savings for public health care cases in comparison with carrying out vaccination separately. In a series of 12 vaccination campaigns in the Chari-Baguirmi and Kanem districts, more than 2100 children, 2100 women and 52000 cattle were fully immunized. These results confirmed the feasibility of joint campaigns in nomadic settings and provided important experience for improving organization. Information-Education-Communication (IEC) campaigns adapted to the realities of the pastoral setting were an important factor in mobilizing nomadic pastoralists for attendance at vaccination clinics. The savings in logistics costs (i.e., personnel, transportation and cold chain costs excluding vaccine costs) was 15% in Gredaya where 3 out of 6 campaigns were carried out together with veterinarians and 4% in Chaddra/Am Dobak where only 1 out of 6 campaigns was carried out in conjunction with veterinarians. The cost per fully immunized child (FIC) was considerably higher in Chaddra/Am Dobak than Gredaya (EUR 29.2 vs. EUR 11.5). The joint vaccination campaign approach is innovative, appreciated by nomadic pastoralists and less expensive than separate vaccination. By using the mobility of veterinarians in remote zones far from health care facilities, vaccination can be provided to nomadic children and women in countries with limited resources.

Adolescent↗

Comparative vital statistics along the pastoral nomadism-sedentarism continuum.

"This paper attempts to gather and present as much information as possible on crude birth and death rates and natural increase rates for various pastoral nomadic societies in different African and Middle Eastern countries. The information is arranged by a subdivision into nomads, seminomads, and sedentarized nomads. A summarization of this information suggests a possible pattern by which birth rates rise, death rates fall (but may rise in certain circumstances), and natural increase rates rise along the nomadism-sedentarism continuum. Such a possible pattern has several policy implications for governments assessing the needs of a nomadic society undergoing a process of change in its socio-ecological relationships."

Africa↗

Growth of nomadic and settled Turkana infants of northwest Kenya.

Turkana tribespeople reside in a semi-arid savanna ecosystem in northwest Kenya. For over a decade, Ngisonyoka Turkana nomads have been studied within a multidisciplinary framework that embraces ecology, anthropology, and human population biology. Original research objectives of the South Turkana Ecosystem Project were to study nomads longitudinally and within the context of the dry savanna ecosystem. These objectives have been expanded to incorporate settled Turkana who were nomads in the recent past, but who, for a variety of reasons, have taken up a life of sedentary cultivation. The research described here focused on comparisons of growth patterns of nomadic and settled infants from birth to 24 months of age. Infants were measured (recumbent length, weight, head circumference, arm and calf circumference, and selected skinfolds) in 1989 and 1990. Settled infants were slightly longer, but nomadic infants were heavier and fatter. Head circumferences were the same. Some variation was observed by season and year of measurement (from comparative surveys). Both groups showed pronounced weight faltering after 6 months of age when compared with U.S. NCHS reference values. Head circumference faltering was moderate and recumbent length faltering was only slight after 12 months of age. Comparisons of Turkana infant growth in the two populations can contribute indirectly to a better understanding of infant nutritional status, probable morbidity, and other factors, some of which may be linked to female reproduction.

Anthropometry↗

Morbidity and nutrition patterns of three nomadic pastoralist communities of Chad.

As a part of an interdisciplinary research and action programme, morbidity and nutritional patterns were assessed in three nomadic communities: Fulani and Arab cattle breeders and Arab camel breeders, of two prefectures in Chad. The predominant morbidity pattern of Chadian nomadic pastoralists (representing approximately 10% of the total population of the country) had not been documented so far. A total of 1092 women, men and children was examined by a physician and interviewed during two surveys in the dry season and one in the wet season (1999--2000). Participants with no complaint were rare. Pulmonary disorders (e.g. bronchitis) were most often diagnosed for children under 5 years of age. Of the adult participants, 4.6% were suspected of tuberculosis. Febrile diarrhoea occurred more often during the wet season when access to clean drinking water was precarious. Malaria was only rarely clinically diagnosed among Arabs during the dry season, whereas Fulani, who stayed in the vicinity of Lake Chad, were also affected during this period. A 24-h dietary recall showed that less Arab women than men consumed milk during the dry season (66% versus 92%). Malnutrition was only documented for 3 out of 328 children (0--14 years). Arab women in childbearing age had a higher proportion of children not surviving when compared to Fulani women (0.2 versus 0.07). This study identified several implications for reseach and interventions in nomadic settings. Innovative and integrated health services for nomads can possibly be extended to many settings as nomadic pastoralists have in common a similar way of life driven by the needs of their animals.

Adolescent↗

Mutations in the nomad retroelement are modifiers of position-effect variegation in Drosophila melanogaster.

The E(var) 63AP mutation of Drosophila melanogaster was isolated in a genetic screen for P-element induced enhancers of wm4 variegation. Remobilization of the P-element in E(var)63AP resulted in a loss of its ability to enhance position-effect variegation (PEV) of wm4, indicating that the P-element in this mutant resulted in the E(var) phenotype. An allele of E(var)63AP, Su(var)63ALTR was isolated following mobilization of the P-element. Su(var)63ALTR was demonstrated to suppress PEV associated with the variegating rearrangements wm4 and bwVDe2. The P-element insert in E(var)63AP was located in the cytogenetic region 63A by in-situ hybridization and was shown to be inserted into the 3'LTR of a copy of the nomad retroelement. Two additional P-element containing lines were identified that also contained P-inserts into copies of the nomad element and were Su(var)s. The level of nomad transcription in the E(var)63AP and Su(var)63ALTR mutations was shown to correlate with their effect on PEV, suggesting that the nomad element may be directly involved in the regulation of chromatin structure. Several models to explain the effect of mutations in the nomad element on PEV and retroelement expression are presented.

Animals↗

MtDNA of Fulani nomads and their genetic relationships to neighboring sedentary populations.

Despite the large size of the contemporary nomadic Fulani population (roughly 13 million people), the genetic diversity and degree of differentiation of Fulanis compared to other sub-Saharan populations remain unknown. We sampled four Fulani nomad populations (n = 186) in three countries of sub-Saharan Africa (Chad, Cameroon, and Burkina Faso) and analyzed sequences of the first hypervariable segment of the mitochondrial DNA. Most of the haplotypes belong to haplogroups of West African origin, such as L1b, L3b, L3d, L2b, L2c, and L2d (79.6% in total), which are all well represented in each of the four geographically separated samples. The haplogroups of Western Eurasian origin, such as J1b, U5, H, and V, were also detected but in rather low frequencies (8.1% in total). As in African hunter-gatherers (Pygmies and Khoisan) and some populations from central Tunisia (Kesra and Zriba), three of the Fulani nomad samples do not reveal significant negative values of Fu's selective neutrality test. The multidimensional scaling of FST genetic distances of related sub-Saharan populations and the analysis of molecular variance (AMOVA) show clear and close relationships between all pairs of the four Fulani nomad samples, irrespective of their geographic origin. The only group of nomadic Fulani that manifests some similarities with geographically related agricultural populations (from Guinea-Bissau and Nigeria) comes from Tcheboua in northern Cameroon.

Africa South of the Sahara↗

[Indentification of institutional factors affecting the well-being of sedentary and nomadic populations living in the Waza-Logone flood plain along the border between Cameroon and Chad].

This article describes an ongoing research project designed to compile a database to promote pastoral development in the lowlands along the Logone and Chari Rivers in Cameroon. A number of sedentary and nomadic populations depend on these flood plains south of Lake Chad for their livelihood. However the natural resources of the area undergo sharp seasonal variations and sometimes become the property of sedentary groups. As a result nomadic communities experience difficulty not only in gaining access to grazing lands and water but also to quality health care (hospital centers, effective medication). The purpose of this study was to define institutional requirements necessary to ensure access to health care resources for both nomadic and sedentary groups. The main problem for the nomadic population is that, unlike the now defunct pre-colonial structures, today's institutions are not compatible with the subsistence strategies of rural populations. These findings suggest that new institutional frameworks for natural resource management could indirectly improve the health status of nomadic pastoralist.

Cameroon↗

Prevalence of Mansonella perstans infections among the nomadic Fulanis of northern Nigeria.

The study was undertaken to investigate the prevalence and clinical manifestations of Mansonella perstans infection in the nomadic Fulanis of northern Nigeria. Physical examination of 755 consenting nomads for clinical manifestations of M. perstans infection was carried out between June 1996-September 2000. This was followed by parasitological examination of blood samples collected by finger prick method to identify microfilariae (mf). Data collected was stratified by locality, age and sex, and analyzed using the Chi-square test. Overall, 66 (8.7 %) of 755 nomads were infected. Infection was higher in men (9.7 %) than in women (6.5 %) (p<0.05) and occurred in all age groups with highest prevalence in persons in the 4th (14.1 %) and 5th (17.1 %) decades of life. Fifty-six (81.8 %) of the 66 nomads with mf had clinical manifestations with periodic dizziness (18.2 %), body itching (15.2 %) was the most prevalent while back pain (7.6 %) was the least. The findings show that mansonelliasis is an important health problem in nomads. This underscores the need to establish a well-articulated Filariasis Control Programme for this group whose major health problems are rooted in their occupation and amplified by several contingencies of the environment.

Adolescent↗

[Epidemiology of arterial hypertension and various characteristics of mineral metabolism among nomadic stock breeders in Tuva].

To reveal cardiovascular abnormalities, a screening was made in Tuva, which covered 1481 nomadic stock breeders, 1041 settled natives and 1081 migrants. The incidence of arterial hypertension (AH) was 33.5% among the nomadic stock breeders and 17.2% among the settled Tuva habitants and migrants. No impact of obesity and dyslipoproteinemia on the incidence of AH was found in the nomadic stock breeders. There was a direct correlation between the incidence of AH and alcoholization and an inverse correlation between its incidence and smoking in nomadic stock breeders aged 50-59 years. The hairs from the nomadic stock breeders exhibited elevated levels of aluminium, chromium, manganese, iron, and vanadium, which is not attributable to higher levels of these compounds in the meat of domestic animals.

Adult↗

Pregnancy loss in Nomadic and settled women in Turkana, Kenya: a prospective study.

There have been few investigations of intrauterine mortality in non-Western populations that have used techniques capable of detecting early pregnancy loss. We report here the initial results of a prospective study of fetal loss among the Turkana of northwest Kenya. Over 300 nomadic and settled women provided early morning urine samples for 3 consecutive days. Chorionic gonadotropin (hCG), a marker for pregnancy, and markers of ovarian cyclicity (LH, PdG) were determined with solid-phase enzyme immunoassays. Pregnancy was detected in 11% of nomadic women and in 22% of sedentary women of reproductive age. Follow-up surveys revealed that 45% of all pregnancies among settled women were lost; nearly 70% of pregnancies detected in the first trimester were lost. In contrast, none of the nomadic women experienced fetal loss. Because of the small sample sizes, these results must be interpreted cautiously. Nevertheless, even a conservative estimate of the fetal loss rate among the settled women is high compared with Western experience. Anthropometric data suggest that nutritional stress may contribute to the difference between the two populations. There is also some indication that risk of fetal loss in the settled population is associated with parity. The high rate of loss among the settled women along with the difference between the nomadic and settled samples supports the contentions that there may be substantial variation among populations in intrauterine mortality and that the contribution of fetal loss to fertility differences among populations may be more important than has been suspected.

Adolescent↗

Malaria control using permethrin applied to tents of nomadic Afghan refugees in northern Pakistan.

Malaria control among nomadic populations has, in the past, posed serious logistic difficulties. Presented in this article are the results of a pilot study in which permethrin was sprayed on the tents of over 26000 nomadic Afghan refugees in an area of Pakistan where seasonal malaria outbreaks occur. In this area Anopheles culicifacies and A. stephensi are the malaria vectors. Population surveys in the year of the study, before and at the end of the transmission season, showed that the increase in the Plasmodium falciparum prevalence among the Afghan nomads was on average significantly less (increase from 6.4% to 15.3%) than that among the resident Pakistani population (from 3.2% to 45.6%). Surveys at the end of the transmission season among primary schoolchildren the year before and the year of the permethrin trial showed that the P. falciparum prevalence among nomadic children decreased significantly (from 46.9% to 16.3%), whereas an increase was observed among the local Pakistani children. The results show that spraying tents with permethrin was a safe and culturally acceptable intervention for the Afghan refugees and that the findings warrant further investigation.

Adolescent↗

Hypertension prevalence and age-related changes of blood-pressure in semi-nomadic and urban Oromos of Ethiopia.

We evaluated the prevalence of hypertension and the age-related behaviour of systolic blood pressure (SBP) and diastolic blood pressure (DBP) in a wide sample of male and female Ethiopian Oromos living in rural or pre-industrial urbanized settings. Blood pressure (BP) was measured in the sitting position after 5 min rest in 5277 Oromos. In the group, 4928 were semi-nomadic shepherds, while 349 came from a town of 60,000 inhabitants where they were involved in low-technology jobs. The first subgroup was composed of 2482 men and 2446 women. All subjects were divided into 3 age groups: 15-44, 45-64, and > or = 65 years. Body weight (BW) and the Quetelet index (QI) were matched to BP levels using Pearson's method. In semi-nomadic men, SBP was 121.4 +/- 8.4 mmHg versus 132.4 +/- 10.4 mmHg in urban men (p < 0.001). In women, SBP was 120.5 +/- 7.9 mmHg versus 128.1 +/- 10.1 mmHg (p < 0.001). The prevalence of hypertension was 0.40% in the semi-nomadic and 3.15% in the urban population. In the latter, significant increases in BW and QI were found, which were significantly correlated to both SBP and DBP. In semi-nomadic men, a 5.33% increase in SBP and a 5.22% in DBP was found between age groups 1 and 2 (p < 0.001 in both). In urban men the increase was 4.77% and 3.41% respectively (p < 0.001). In both male populations no difference in SBP and DBP was observed between age groups 2 and 3.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗

NOMAD: a versatile strategy for in vitro DNA manipulation applied to promoter analysis and vector design.

Molecular analysis of complex modular structures, such as promoter regions or multi-domain proteins, often requires the creation of families of experimental DNA constructs having altered composition, order, or spacing of individual modules. Generally, creation of every individual construct of such a family uses a specific combination of restriction sites. However, convenient sites are not always available and the alternatives, such as chemical resynthesis of the experimental constructs or engineering of different restriction sites onto the ends of DNA fragments, are costly and time consuming. A general cloning strategy (nucleic acid ordered assembly with directionality, NOMAD; WWW resource locator http:@Lmb1.bios.uic.edu/NOMAD/NOMAD.htm l) is proposed that overcomes these limitations. Use of NOMAD ensures that the production of experimental constructs is no longer the rate-limiting step in applications that require combinatorial rearrangement of DNA fragments. NOMAD manipulates DNA fragments in the form of "modules" having a standardized cohesive end structure. Specially designed "assembly vectors" allow for sequential and directional insertion of any number of modules in an arbitrary predetermined order, using the ability of type IIS restriction enzymes to cut DNA outside of their recognition sequences. Studies of regulatory regions in DNA, such as promoters, replication origins, and RNA processing signals, construction of chimeric proteins, and creation of new cloning vehicles, are among the applications that will benefit from using NOMAD.

Base Sequence↗