Populations Of African Origin Research Articles

Objectively measured moderate-to-vigorous physical activity does not attenuate prospective weight gain among African-origin adults spanning the epidemiological transition.

Traditional obesity-related public health messaging often includes physical activity (PA) recommendations. However, at the population level, the data are conflicting, especially when comparing different self-reported vs measured techniques across different settings and populations. We measured the association between moderate-to-vigorous intensity PA (MVPA) and prospective weight change across five African-origin populations and the extent to which MVPA attenuated weight change over time. At baseline, 2,500 adults (median age: 37y) were recruited into the Modelling the Epidemiologic Transition Study (METS), from Ghana, South Africa, Jamaica, Seychelles, and US. 2000 participants were followed up 8 years later, with 851 participants having complete 7-day accelerometry to measure MVPA at both time points. Generalised estimating equations were used to explore the longitudinal association between weight and MVPA adjusted for several confounders. The obesity prevalence at baseline was 27.5% which increased to 38.0% at follow-up. Baseline MVPA varied from 7 (IQR: 4, 16) min/day in US women to 52 (IQR: 36, 78) min/day in South African men, and similarly at follow-up ranged from 8 min/day to 41 min/day among the same participant groups. While overall, engaging in higher MVPA levels was associated with a lower body weight, such that every additional 30 min of MVPA equalled a 600g lower body weight (p = 0.04), the interaction between time and MVPA was not statistically significant (p = 0.18). Therefore, regardless of the amount of MVPA at any time point, body weight increased over time. Despite the association between MVPA and weight, our results suggest that objectively measured longitudinal MVPA was not associated with the change in 8-year weight in African-origin adults. Our research confirms that while PA is a critical determinant of cardiovascular health, it alone may not be enough to stem the rising obesity burden.

The utility of physical activity questionnaires among African origin populations; lost in translation?

Background: Physical activity (PA) is an important preventive factor of non-communicable diseases (NCDs), particularly cardiovascular disease, yet progress towards reducing physical inactivity in populations is slow. Population-levels of PA are most often estimated using self-report questionnaires in population surveys, such as the Global PA Questionnaire (GPAQ), which may not accurately reflect objectively measured PA, such as accelerometers. The aim of the current study was to compare self-report vs objectively measured PA across 5 African-origin populations. Methods: Approximately 2,000 African-origin men and women (35-55 yrs) were enrolled in a prospective cohort study to explore the relationship between lifestyle and cardiometabolic health. Participants were from Ghana, South Africa (SA), Jamaica, Seychelles, and the United States (US). Data collection included objective PA (accelerometer) and self-reported PA (GPAQ). WHO defines "sufficiently active" as performing >150 minutes of moderate intensity PA per week, or >600 MET*min/week (metabolic equivalent of task in minutes/week). Logistic regression was used to determine the proportion of participants that were physically active by accelerometry, among those who were found as sufficiently active based on GPAQ. Results: 1,161 participants had complete self-reported PA and accelerometery data. Overall, 23.5% were classified as sufficiently active by both PA measures, while 38.2% of those classified as sufficiently active based on self-reported PA did not meet the criteria using objective monitoring (sensitivity of GPAQ: 74%, specificity: 44%). Among participants who were classified as sufficiently active according to the questionnaire (n=717), participants from Ghana (OR=3.2, p<0.01), SA (OR=5.3, p<0.01), Jamaica (OR=2.3, p=0.01), and Seychelles (OR=1.9, p=0.03) were more likely to be similarly classified as sufficiently active based on accelerometry, compared to those from the US, and men (OR=2.9, p<0.01) more likely than women. Finally, obese participants had 0.4 times lower adjusted odds to be similarly classified as sufficiently active using objective measures compared to non-obese participants (p<0.01). Conclusion: Our findings further underscore difficulties in interpreting self-reported PA, which may furthermore vary across different settings and socio-economic settings. Given the importance of PA interventions for reducing the NCD burden, future research should explore tailored approaches to better understand self-report PA accuracy and to better assess the dose-response between PA and cardiometabolic risk.

The relationship between leptin-to-adiponectin ratio and HOMA-IR and metabolic syndrome in five African-origin populations.

This cross-sectional study aims to assess the associations between serum leptin, adiponectin, leptin-to-adiponectin ratio (L/A ratio), and metabolic syndrome (MS) and HOMA-IR in five African-origin populations: Ghana, South Africa, Jamaica, Seychelles, and US. Clinical measures included serum glucose, insulin, adipokines, blood pressure and anthropometric measures. MS was determined using the Harmonized criteria. The final sample included 2087 adults. After adjusting for age, sex, and fat mass, L/A ratio, unlike HOMA-IR, was significantly associated with MS across all sites (p < 0.001). Within sites, L/A ratio was only associated with MS and HOMA-IR in the US (p < 0.001) and South Africa (p < 0.01), respectively. Leptin was associated with MS in South Africa only (p < 0.05) but was significantly associated with HOMA-IR across all five sites and within the US (p < 0.05). Similarly, adiponectin was associated with HOMA-IR in South Africa (p < 0.05) and with MS across all five sites (p < 0.001) and within each site separately, except Ghana. Our study suggests that individuals of the African diaspora in different geographical locations may differ in the determinants of MS. Future studies should investigate the determinants for the disparate relationships between MS, IS and adipokines across different African-origin populations.

Toxic Metals Impact Gut Microbiota and Metabolic Risk in Five African-Origin Populations.

Exposure to toxic metals impacts obesity and type 2 diabetes (T2DM) risk. Yet, the underlying mechanisms remain largely unknown. Gut microbiota has been strongly associated with progression of cardiometabolic risk. To determine whether high metal exposures and gut dysbiosis interact to promote metabolic dysregulation and cardiometabolic risk, we assessed relationships between these factors. We analyzed cross-sectional associations between arsenic, lead, mercury, cadmium, and cardiometabolic health markers in 178 randomly selected African-origin adults (52% female, 51% obese, mean age=43.0±6.4 years) from Ghana, South Africa, Seychelles, Jamaica, and USA. Metal levels were dichotomized to high or low at the median level of each metal. We analyzed associations between gut microbiome taxa, metal levels, clinical measures (BMI, fasting blood glucose, and blood pressure) and diagnoses (hypertension, obesity, and diabetes status). High vs. low lead and arsenic exposures had a significant effect on beta diversity (p <0.05). 71 taxa were associated with high lead levels: 30 with elevated BMI, 22 with T2DM, and 23 with elevated fasting blood glucose (p<0.05). 115 taxa were associated with high arsenic levels: 32 with elevated BMI, 33 with T2DM, and 26 with elevated blood glucose (p<0.05). Of the taxa associated with high lead and arsenic exposure and either elevated BMI or fasting blood glucose, porphyrin metabolism was the most enriched metabolic pathway. These data collectively provide the first findings in a human study that the gut microbiome may drive the association between lead and arsenic exposure and obesity and T2DM risk.

Silhouette showcards confirm altered obesity-associated body image perception in international cohort study of African-origin populations

ObjectivesGiven the increasing prevalence of obesity and need for effective interventions, there is a growing interest in understanding how an individual’s body image can inform obesity prevention and management. This...

Genetic contribution of breast cancer genes in women of black African origin.

Breast cancer (BC) is an increasing public health issue worldwide. BC incidence and mortality rates are rising in transitioning countries in Africa, with the most rapid increase occurring in Sub-Saharan Africa (SSA). Female BC represents 25.8% of all cancer diagnosis in SSA. Early age at onset, high grade and triple negative tumors are hallmarks of BC in this region, associated with germline pathogenic variants in susceptibility genes. While several genes have been associated with genetic predisposition (BRCA1, BRCA2, PALB2, TP53, PTEN, CDH1, STK11, ATM, CHEK2, NBN, BARD1, BRIP1, RAD50, RAD51C, RAD51D, … ), most studies have reported contribution of BRCA1 and BRCA2 pathogenic variants. Genetic contribution of BRCA genes has been estimated at 27% in Caucasian women. Available data from population of African origin are scarce and have mainly focused on pathogenic variants of BRCA1 and BRCA2. Reports from main studies on large sample size highlighted that BRCA1 still the major gene associated with BC in SSA. In addition, BRCA2, PALB2, and P53, are also on the top major genes with high penetrance, associated with BC. Mutation spectrum of BC genes in black African women seems to be different from Caucasian with increasing number of founder mutations identified. We hypothesis that the genetic contribution of known BC genes may be different between women of black African origin compared to Caucasians. In this review we explore the genetic contribution of known breast cancer genes in women of African origin, and discuss perspectives for prevention and patients care strategies in the era of precision medicine.

Real World Experience of Ibrutinib in an Ethnically Diverse Canadian Community Hospital

Chronic Lymphocytic Leukemia (CLL) is an indolent lymphoproliferative disorder commonly managed in community centers. Ibrutinib revolutionized the management of patients with CLL (2). Ibrutinib was initially considered an easy to administer, well tolerated oral medication with excellent efficacy. It was the first clinically available Bruton's Tyrosine Kinase (BTK) inhibitor widely used to treat CLL (3). Recently there have been concerns about cardiovascular toxicities leading to the use of alternative BTK inhibitors (5). Where alternative BTK inhibitors are available these toxicity concerns have led to a decline in the use of ibrutinib to treat CLL. The population served is ethnically diverse consisting of 52% South East Asian with a significant population of African origin. We suspected that the concerns regarding Ibrutinib toxicity were not seen in our patient population prompting a retrospective review of our experience. Ibrutinib therapy A total of 106 CLL patients treated with Ibrutinib were identified from which data was extracted. The mean age was 63.4 years. Patients with CLL treated with Ibrutinib from 2014 to 2021 were identified using OPIS and Meditech and data was extracted manually. Table 1 60% of patient received their initial drug funding through compassionate access, 2% via private insurance and the remaining 38% through the provincial health system. The majority of patients who received funding through compassionate access were eventually transitioned to the provincial health system for drug funding. Toxicity and outcomes Table 2 81% of treated patients never required a dose adjustment of Ibrutinib. The majority of dose reductions were of a temporary nature. We were unable to obtain accurate response data in our retrospective review. 82 of the 106 patients continue on ibrutinib therapy. It is presumed that these patients continue to benefit from therapy without disease progression although response data details were poorly recorded in the medical record. Conclusions There is a lack of data of community real world experience with Ibrutinib particularly in the Canadian setting. Community centers generally are lacking in information technology required to do retrospective audits. Our data shows that ibrutinib therapy for CLL is a reasonable and effective option with good tolerability in a patient population with high cardiovascular risk. The data is limited by the retrospective data collection. The efficacy of therapy is likely comparable to that of the published literature. These data suggest that the tolerability of Ibrutinib therapy seems better than that of the published literature (1) with a low incidence of atrial fibrillation, dose adjustments and low drug discontinuation rate. Of note Richter's transformation was also uncommon in our patient population. This is particularly of interest as our study did capture patients in the early days of ibrutinib therapy when there were concerns that Richter's transformation was more common than seen today. Many of the patients who were treated with ibrutinib would not have received the drug today because of cardiovascular concerns (4). At that time, it was the only available oral targeted agent for the treatment of chronic lymphocytic leukemia. Other agents such as Venetoclax, Acalabrutinib, Zanubrutinib and novel combinations were unavailable at that time or were not funded. These lack of options likely contribute to the persistence of Ibrutinib therapy in our patients. These data suggest that ibrutinib can be used in a high cardiovascular risk population with good efficacy and tolerability. 1.Alloucjery, M., Tomowiak, C., Lombard, T., &amp; et al. (2021). Safety Profile of Ibrutinib: An Analysis of the WHO Pharmacovigilance Database. Front Pharmacology, 12:769315. 2.Byrd, J. C., Brown, J. R., O'Brien, S., &amp; et al. (2014). Ibrutinib versus ofatumumab in previously treated chronic lymphoid leukemia. NEJM, 371(3):213-223. 3.Byrd, J. C., Furman, R. R., &amp; Coutre, S. S. (2013). Targeting BTK with ibrutinib in relapsed chronic lymphocytic leukemia. NEJM, 369(1):32-42. 4.Lovell, A. R., Jammal, N., &amp; Bose, P. (2022). Selecting the optimal BTK inhibitor therapy in CLL: rationale and practical considerations. Therapueltic Advances in Hematology, 13:1177/20406207221116577. 5.Salem, J. E., Manouchehri, A., &amp; Bretagne, M. (2019). Targeting BTK with ibrutinib in relapsed chronic lymphocytic leukemia. J Am Coll Cardiol, 74:1667-1678.

Introduction: African International Migration to the West: Insights from Canada, Australia and Nigeria

Introduction: African International Migration to the West: Insights from Canada, Australia and Nigeria

Crown tissue proportions and enamel thickness distribution in early Pleistocene Homo antecessor maxillary premolars (Atapuerca, Spain)

AbstractObjectivesBoth morphometric and proteomic studies have revealed the close relationship of Homo antecessor with Neanderthals and H. sapiens. Considering this relationship, we aim to characterize the Early Pleistocene Atapuerca‐Gran Dolina (TD6) maxillary premolars to test if their pattern of enamel thickness is shared with Neanderthals or H. sapiens.Materials and MethodsWe employed microcomputed tomography to estimate 2D and 3D tissue proportions in seven H. antecessor maxillary premolars, belonging to two individuals: H1 and H3, and compared them to a sample of extinct and extant Homo populations of African, Asian and European origin (n = 52).ResultsOur results reveal a different pattern of enamel thickness between the Atapuerca‐Gran Dolina two individuals. While TD6‐H1 possesses thin‐enameled crowns, with a clear affinity with Neanderthals, TD6‐H3 exhibits the thick pattern, a trait shared with the majority of fossil hominins and H. sapiens.DiscussionThis work provides new data on upper premolar enamel thickness in H. antecessor. By documenting both a thin and a thick pattern of enamel thickness in the TD6 sample, we warn about the taxonomic utility of this feature in the characterization of isolated remains. We suggest that the thin enamel condition would have emerged during the Early Pleistocene and it became the most frequent and typical condition in Neanderthals. Possible causes for the pattern observed in TD6 include sexual dimorphism or presence of two populations in the sample; however, population variability is the most plausible explanation with a character expression intermediate between those of Neanderthals and other members of the genus Homo. This interpretation is compatible with the phylogenetic position of H. antecessor close to the ancestor of Neanderthals and H. sapiens.

Frequency and characterization of RHD and RHCE variants in the Noir Marron population from French Guiana.

The RH system is one of the most polymorphic blood group systems due to the proximity and opposite orientation of RHD and RHCE genes. Numerous alleles are described and can affect Rh protein expression. This complexity is especially evident in populations of African origin. We performed RHD and RHCE genotyping of the Noir Marron population in French Guiana. This population belongs to the Maroon community who are direct descendants of African slaves, who escaped from Dutch plantations, in the current day Suriname, during the 17th century. They represent an original ethnic group with highly blended culture. A total of 89 DNA samples were collected from four different ethnic groups of the Noir Marron population of French Guiana. RHD and RHCE genotyping was performed using DNA microarray and/or sequencing. Significant allelic diversity was shown, with 45% of individuals presenting an RHD gene variant (most common: RHD*DAU, RHD*DIVa, and RHD*DIIIa allele) and 9.4% with a partial D phenotype. Likewise, 85% presenting an RHCE gene variant and 9% a partial RH2 antigen. One original allele was identified in two D+ Noir Marron individuals: a hybrid RHD*DIIIa-CE(9)-D allele, encoding probably a partial D antigen and associated with an RHCE*ce(48C,733G,1006T) allele. The African diversity of RHD and RHCE genes is found in this population with preserved genetic but mixed cultural backgrounds. These data allow us to describe the characteristics of the RH system antigen and highlights a significant number of partial antigens with a risk of alloimmunization.

Precision Medicine and Sickle Cell Disease.

Sickle cell disease (SCD) is characterized by variable clinical outcomes, with some patients suffering life-threatening complications during childhood, and others living relatively symptom-free into old age. Because of this variability, there is an important potential role for precision medicine, in which particular different treatments are selected for different groups of patients. However, the application of precision medicine in SCD is limited by difficulties in identifying different prognostic groups and the small number of available treatments. The main genetic determinant of outcomes in SCD is the underlying β-globin genotype, with sickle cell anemia (HbSS) and hemoglobin SC disease (HbSC) forming the 2 major forms of the disease in most populations of African origin. Although there are clear differences in clinical outcomes between these conditions, treatments approaches are very similar, with little evidence on how to treat HbSC in particular. Other genomic information, such as the co-inheritance of α-thalassemia, or high fetal hemoglobin (HbF) levels, is of some prognostic value but insufficient to determine treatments. Precision medicine is further limited by the fact that the 2 main drugs used in SCD, penicillin and hydroxyurea, are currently recommended for all patients. Newer treatments, such as crizanlizumab and voxelotor, raise the possibility that groups will emerge who respond best to particular drugs or combinations. Perhaps the best current example of precision medicine in SCD is the selective use of blood transfusions as primary stroke prevention in children with evidence of cerebral vasculopathy. More precise treatments may emerge as we understand more about the pathology of SCD, including problems with erythropoiesis.

Postexercise hypotension in African and Asian populations: a systematic review and meta-analysis of randomized controlled trials

Abstract Funding Acknowledgements Type of funding sources: None. Background Worldwide, raised blood pressure (BP) or hypertension (HT) is the global leading risk factor for the development of cardiovascular diseases and all-cause mortality, with the highest prevalence found in Asian and African-origin populations. Post-exercise hypotension (PEH) defined as a sustained reduction in BP after a single bout of exercise is an important physiological phenomenon in BP management which can last up to 24 hours. However, little is known about the hypotensive effect of a single bout of exercise in non-Caucasian populations. Objectives To systematically summarize the acute effects of a single bout of aerobic exercise on blood pressure in a population of African or Asian origin. Methods We searched the MEDLINE database identifying randomized controlled trials investigating the effect of a single bout of aerobic exercise on BP in African or Asian populations with optimal BP, high normal BP or HT published in a peer reviewed journal up to August 2021. A subsequent meta-analysis was performed using random effect models fitted to estimate effect sizes. Results We identified 10 aerobic exercise trials of individuals of Asian origin (n= 156; mean age: 27.05 years: 72% male; baseline SBP/DBP: 114.93 [99,142] / 67.34 [61,74] mmHg) and 11 aerobic exercise trials involving individuals of African origin (n=112; mean age: 41.37 years; 62% male; baseline SBP/DBP: 125.77 [106.6,140.2] / 79.72 [69.9, 84.3] mmHg). Non-significant moderate reductions in office SBP and DBP at 30 minutes postexercise (-2.25 [-6.38, 1.88] mmHg, p = 0.28 / -1.02 [-2.51, 0.47] mmHg, p = 0.18) and 60 minutes postexercise (-2.80 [-7.90, 2.28], p = 0.27 / -1.95, [-5.66, 1.75], p = 0.3) were observed compared to control group. No statistically significant differences were found between ethnic groups (p &amp;gt; 0.05). Ambulatory BP was reported only in the African groups. No effect was found on 24h-SBP post-exercise, but 24h-DBP was statistically signficantly reduced (-1.89 [-3.47, -0.31] mmHg, p &amp;lt; 0.01) after a bout of aerobic exercise. Conclusions A single bout of aerobic exercise did not significantly reduce BP immediately in the African and Asian group. In the African group a small though statistically significant lower 24h-DBP was observed. Unfortunately, no data was found on the 24h-BP response in Asians. The low number of studies in both ethnic groups and lack of data on isometric and resistance exercise in African and Asian populations warrant more research to improve quality of evidence.

Serum potassium concentration and its association with hypertension among Ghanaian migrants and non-migrants: The RODAM study

Background and aimsLow serum potassium concentration is associated with hypertension, but whether the same association can be found in African origin populations, is unknown. We assessed serum potassium concentration, and its association with hypertension among Ghanaians living in different geographical locations. MethodsBaseline data of 962 rural, 1420 urban, and 2947 migrant Ghanaians from the Research on Obesity and Diabetes among African Migrants study were analysed. Mean serum potassium concentration was compared between the groups, and the association between serum potassium and hypertension was assessed using multivariate regression analyses. ResultsMean serum potassium concentration was higher in rural Ghana (4.28, 95% confidence interval 4.25–4.32 mmol/L) than in Ghanaians living in Amsterdam (3.90, 3.88–3.92 mmol/L) and London (4.11, 4.07–4.14 mmol/L), but lower than in Ghanaians living in urban Ghana (4.38, 4.34–4.42 mmol/L) and Berlin (4.57, 4.51–4.62 mmol/L) in both sexes. In the age-adjusted analyses, serum potassium was associated with hypertension in urban- (odds ratio 0.44, 0.23–0.82), London- (0.34, 0.17–0.64) and Amsterdam-Ghanaian males (0.41, 0.20–0.86), and in rural- (0.49, 0.28–0.84), London- (0.29, 0.17–0.49) and Amsterdam-Ghanaian females (0.33, 0.17–0.64). However, after adjustment for demographic, lifestyle, and health factors, serum potassium was associated with hypertension in Amsterdam-Ghanaian males only (0.12, 0.02–0.59). ConclusionsThis study shows differences in mean serum potassium among Ghanaian populations living in different locations in Europe and Ghana, and different associations with hypertension between sites. Further research should focus on elucidating the mechanism underlying potassium handling and blood pressure regulation in African populations, in order to mitigate the burden of hypertension among these populations.

Consumption of Monounsaturated Fatty Acids Is Associated with Improved Cardiometabolic Outcomes in Four African-Origin Populations Spanning the Epidemiologic Transition.

Long-chain omega-3 PUFAs, specifically eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA), are of increasing interest because of their favorable effect on cardiometabolic risk. This study explores the association between omega 6 and 3 fatty acids intake and cardiometabolic risk in four African-origin populations spanning the epidemiological transition. Data are obtained from a cohort of 2500 adults aged 25–45 enrolled in the Modeling the Epidemiologic Transition Study (METS), from the US, Ghana, Jamaica, and the Seychelles. Dietary intake was measured using two 24 h recalls from the Nutrient Data System for Research (NDSR). The prevalence of cardiometabolic risk was analyzed by comparing the lowest and highest quartile of omega-3 (EPA+ DHA) consumption and by comparing participants who consumed a ratio of arachidonic acid (AA)/EPA + DHA and >4:1. Data were analyzed using multiple variable logistic regression adjusted for age, gender, activity, calorie intake, alcohol intake, and smoking status. The lowest quartile of EPA + DHA intake is associated with cardiometabolic risk 2.16 (1.45, 3.2), inflammation 1.59 (1.17, 2.16), and obesity 2.06 (1.50, 2.82). Additionally, consuming an AA/EPA + DHA ratio of >4:1 is also associated with cardiometabolic risk 1.80 (1.24, 2.60), inflammation 1.47 (1.06, 2.03), and obesity 1.72 (1.25, 2.39). Our findings corroborate previous research supporting a beneficial role for monounsaturated fatty acids in reducing cardiometabolic risk.

Geographic patterns of genetic diversity and fertility restoration ability of Asian and African origin pearl millet populations

A set of 45 diverse Asian and African origin/bred populations of pearl millet were investigated multi-locationally for morphological traits including grain yield and assessed for their fertility restoration ability on three cytoplasmic male sterility (CMS) systems in two contrasting seasons. Significant genetic variation was found for all the yield linked traits. Multivariate analysis for grain yield and its component traits grouped these populations into five clusters. Most of the Asian origin populations grouped into single cluster (Cluster III) and separated from the rest of the African origin populations indicating the presence of correspondence between clustering pattern and geographical origin of the populations. Clusters dominated with Asian populations (As-As) had linkages with early flowering, short plant height, more number of tillers, small and thin panicles, small seeded and low grain yield compared to the clusters dominated by African populations (Af-Af) or African origin and Asian bred (Af-As) populations. Genetically related populations having common parentage were found grouped in same clusters. Fertility restoration/maintainer frequency of 45 populations on three diverse CMS systems revealed that overall fertility restoration frequency was highest for A1 (86%) followed by A4 (37%) and for A5 (7%) CMS system. Five populations were identified as potential sources for developing maintainer lines for all three CMS systems and eight populations were identified specifically for A4 and A5 CMS systems. A set of 11 and four populations were identified for restorer line development exclusively for A1 and A5 CMS system, respectively. Six populations were identified for the development of dual restorers for both A1 and A4 CMS system.

Epidemiological Data from the Algerian Multiple Myeloma Registry (AMMR) over 2 Years (June 2014-June 2016): Report of the Algerian Multiple Myeloma Study Group (GETMA)

Introduction: Multiple myeloma (MM) is the second hematological malignancy in Western countries with varying incidence across countries and ethnicities. In France, the incidence rate in 2012 is 4.2 in men and 2.0 in women, in USA it is 5.6 but in the population of African origin it is 11.1. In Maghreb, the incidence is 1,1 in Algeria and Morocco and 1.4 in Tunisia in 2004. Although epidemiological transition has taken place in our country, the results of epidemiological data on cancers in general and hematological malignancies in particular are remarkably different from those described in the Western literature.Aims : Two epidemiological approaches were carried out in Algeria, the first covering a period of 12 years (1995-2005) and the second of 2006-2012, the incidence of MM was the same of 1.1 and 1.01 respectively. These were retrospective studies with the limitations of this type of study, hence the need to create a register that would collect the data in a prospective and real-time manner. This register, known as AMMR (Algerian Multiple Myeloma Registry) belongs to the SAHTS (Algerian Society of Hematology), was created in 2014 after obtaining the approval of the Ministry of Health. The objectives of this register are:- Obtain reliable epidemiological data- Describe the profile of Algerian patients (pts)- To have an analysis of the diagnostic approaches in all the hematology departments- And measure diagnostic and prognostic difficulties.The AMMR is a prospective, observational, multicenter study.Materials and methods: With the support of a contracted clinical research company, we developed a 19 pages case report form (CRF) which registered all newly pts with MM, plasmocytomas. The main registered variables at diagnosis are patient demographics, disease characteristics, complications, biology, imaging, diagnosis, prognosis and only one item on treatment. All hematology services (17) participated in the study with the help of 23 investigators to inform the CRF. The diagnostic criteria used are those of the IMWG 2003, the prognosis is evaluated according to the classification of Salmon and Durie and the International Staging System.Results: Thus, 1010 pts are collected during these 2 years, 505 men and 505 women. The median age is 63 years (29-100 years), 53% are under 65 years, 13% under 50 years and 18% more than 75 years old. The age-standardized incidence rate (world population WHO 2000-2025) of MM for the year 2015 is 1.71 / 105 inhabitants (1.75 for men and 1.68 for women). In this series: 975 pts (96.53%) are secreting MM and 20 non-secretory MM(1.98%), 4 plasmocytoma (0.40%) and 2 plasma cell leukemias (0.20%). According to the geographical distribution, 62% of the patients are in the middle of Algeria, 19% of the western region and 19% of the eastern region. Among the risk factors for the occurrence of MM, a MGUS is found in 16 pts, a professional activity at risk in 96 pts of which 57 workers of the earth. The clinical feature at diagnosis is dominated by bone syndrome since 92% have bone symptoms, pain in 80.4% of cases and pathological fractures for 96 pts (12%). Neurological signs related to medullary compression are described in 89 pts, anemia is the second complication (56% of the pts). Biological characteristics, the immunological type are IgG type in 50.67% of cases, IgA in 26.36%, light chains in 21.64% of the secreeting MM. All the pts are classified according to the classification of Salmon and Durie, 82% are stages III and 13% of the stages II, among them 24% are classified B. The ISS classification is used in 72% of the pts, with 16.21% stage I, 18.56% stage II and 36.92% stage III. Flow cytometry is performed only in 45 pts (4.5%) and cytogenetics in only one patient.Comments and conclusion: This study shows that the number of pts with MM is important in our country: more than 1000 in 2 years, whereas the previous data did not exceed 350 pts/year. The median age is 63 years, with 53% under 65 years candidates for therapeutic intensification. On the other hand the incidence is 1.71 higher than the two previous studies; this is explained by the rigor of the prospective studies but not by an increase of the frequency. The data collected still show pts diagnosed later (82% stage III) with complications. We deplore the lack of genetics study for our pts. The AMMR is the first hematological malignancy registry in Algeria, is a reliable data bank, which will allow us to claim more diagnostic, pronostic assessment and care for our pts. DisclosuresNo relevant conflicts of interest to declare.

Heterotic pools in African and Asian origin populations of pearl millet [Pennisetum glaucum (L.) R. Br.

Forty-five African or Asian origin pearl millet populations bred either in Africa or Asia were investigated to generate information on heterotic pools. They were clustered into seven groups (G1 to G7) when genotyped, using 29 highly polymorphic SSRs. Fourteen parental populations representing these seven marker-based groups were crossed in diallel mating design to generate 91 population hybrids. The hybrids evaluated at three locations in India showed mean panmictic mid-parent heterosis (PMPH) and better-parent heterosis (PBPH) for grain yield ranging from − 21.7 to 62.08% and − 32.51 to 42.99%, respectively. Higher grain yield and heterosis were observed in G2 × G6 (2462 kg ha−1, 43.2%) and G2 × G5 (2455 kg ha−1, 42.8%) marker group crosses compared to the most popular Indian open-pollinated variety (OPV) ICTP 8203. Two heterotic groups, Pearl millet Population Heterotic Pool-1 (PMPHP-1) comprising G2 populations and Pearl millet Population Heterotic Pool-2 (PMPHP-2) comprising G5 and G6 populations, were identified based on hybrid performance, heterosis and combining ability among marker group crosses. Population hybrids from two heterotic groups, PMPHP-1 × PMPHP-2 demonstrated PMPH of 14.75% and PBPH of 6.8%. Populations of PMPHP-1 had linkages with either African or Asian origin populations, whereas PMPHP-2 composed of populations originating in Africa and later bred for Asian environments. Results indicated that parental populations from the two opposite heterotic groups can be used as base populations to derive superior inbred lines to develop high yielding hybrids/cultivars.

Colorectal cancer demographics in Barbados.

Barbados is an island in the Eastern Caribbean that is reported to have the 8th highest incidence of colorectal cancer (CRC) worldwide. However, these figures are based only on estimates, and there is little available epidemiological data collected from Barbadians with CRC. The present study sought to collect epidemiologic data from patients in Barbados diagnosed with CRC. This information is considered important to shape national public health policies. For this purpose, hospital admission registers at all tertiary care facilities in Barbados were retrospectively audited over a four-year period from January 1, 2014 to December 31, 2018 to identify patients who underwent operative treatment for CRC. The following data were extracted: Age, sex, ethnicity, the location of the primary tumour and tumour stage. Descriptive statistical analyses were generated using SPSS version 21.0. The results revealed that there were 97 patients with CRC at a mean age of 64.9 years (SD ±12.2) and a male preponderance (1.3:1). The majority (93.8%) were from the African diaspora. Only 18.5% of diagnoses were made at (opportunistic) screening. Consequently, two thirds of the patients had advanced-stage disease at diagnosis. The disease staging of the patients was as follows: Stage 0 (1%), stage I (10.3%), stage II (23.7%), stage III (38.1%) and stage IV (26.8%). Right-sided primary tumours were most common (44.3%), followed by left-sided (41.2%) and rectal lesions (14.4%). Women were significantly more likely to have right-sided lesions (55 vs. 45%) and males were more likely to have rectal lesions (77 vs. 23%). On the whole, the present study highlights the need to implement a national screening programme in this high-risk population of African origin with a predominantly right-sided distribution of CRC primary tumours. This is reinforced by the fact that 10% of patients will be diagnosed before the age of 50 years with more aggressive disease.

HYPERTENSION AWARENESS, TREATMENT AND CONTROL AMONG MINORITY ETHNIC POPULATIONS IN EUROPE: A SYSTEMATIC REVIEW AND META-ANALYSIS

Objective: Ethnic minority populations in Europe are disproportionally affected by hypertension-related complications. Early detection, adequate treatment and control of hypertension can help to prevent these complications. We conducted a systematic review and meta-analysis to quantify levels of hypertension awareness, treatment and control among minority ethnic populations residing in Europe compared to the host European population. Design and method: MEDLINE, EMBASE and Web of Science were systematically searched for population-based studies reporting levels of hypertension awareness, treatment or control in minority ethnic populations in Europe. Using Review Manager, pooled odds ratios (OR) with corresponding 95% confidence intervals (CI) were calculated, stratified by ethnic group. Results: 3532 records were screened of which sixteen were included in the analysis, comparing data of 26,800 subjects from five minority ethnic groups with 57,000 subjects from the European host population. African origin populations were more likely to be aware (OR 1.26, 95% CI 1.02–1.56) and treated (OR 1.49, 1.18–1.88) for hypertension, but less likely to have their blood pressure (BP) controlled (OR 0.56, 0.40–0.78), compared to the European host population. Compared to the host population, South Asian (SA) origin populations were more likely to be aware (OR 1.15, 1.02–1.30) of their hypertension status, but there were no differences in treatment and control rates. In Turkish and Moroccan origin populations, hypertension awareness rates were lower (Turkish OR 0.81, 0.65–1.00; Moroccan OR 0.46, 0.62–1.00), as were treatment levels in Moroccan population (OR 0.77, 0.60–0.97), and a trend towards lower BP control rates compared to the European populations. Hypertension awareness and control rates did not differ between Chinese origin populations and the European host population (no data on treatment available). Conclusions: Levels of hypertension awareness, treatment and control differ between ethnic groups in Europe. Effort should be made to improve hypertension control in African origin populations and awareness, treatment and control in Turkish and Moroccan populations, aiming to reduce ethnic inequalities in hypertension-related complications.

Implementing Hypertension Management Interventions in Immigrant Communities in the U.S.: a Narrative Review of Recent Developments and Suggestions for Programmatic Efforts.

Purpose of ReviewTo outline intervention efforts focused on reducing hypertension disparities in immigrant communities in the U.S. and to identify areas in the design, implementation, and evaluation of these interventions that warrant further exploration guided by an implementation science framework.Recent FindingsStudies examined (n = 11) included immigrant populations of African, Hispanic, and Asian origin. Men were underrepresented in most studies. Culturally tailored group-based educational sessions in religious or community spaces were common. Intervention agents included research assistants, registered nurses, community health workers, and faith-based organization volunteers. Community stakeholders were engaged in most studies, although most commonly for recruitment efforts. Surveys/interviews were used for intervention evaluation, and documentation of intervention activities and trainings was used to assess fidelity.SummaryIdentified pathways for further intervention innovation included gender or migration-status–based targeting, diversifying intervention agents, enhancing mixed-method process evaluations, and tailoring to emerging needs during the COVID-19 pandemic.