Asian Families Research Articles

Birt-Hogg-Dub\xe9 syndrome in two Chinese families with mutations in the FLCN gene

BackgroundBirt-Hogg-Dubé syndrome is an autosomal dominant hereditary condition caused by mutations in the folliculin-encoding gene FLCN (NM_144997). It is associated with skin lesions such as fibrofolliculoma, acrochordon and trichodiscoma; pulmonary lesions including spontaneous pneumothorax and pulmonary cysts and renal cancer.MethodsGenomic DNA was extracted from peripheral venous blood samples of the propositi and their family members. Genetic analysis was performed by whole exome sequencing and Sanger sequencing aiming at corresponding exons in FLCN gene to explore the genetic mutations of these two families.ResultsIn this study, we performed genetic analysis by whole exome sequencing and Sanger sequencing aiming at corresponding exons in FLCN gene to explore the genetic mutations in two Chinese families. Patients from family 1 mostly suffered from pneumothorax and pulmonary cysts, several of whom also mentioned skin lesions or kidney lesions. While in family 2, only thoracic lesions were found in the patients, without any other clinical manifestations. Two FLCN mutations have been identified: One is an insertion mutation (c.1579_1580insA/p.R527Xfs on exon 14) previously reported in three Asian families (one mainland family and two Taiwanese families); while the other is a firstly reviewed mutation in Asian population (c.649C > T / p.Gln217X on exon 7) that ever been detected in a French family.ConclusionsOverall, The detection of these two mutations expands the spectrum of FLCN mutations and will provide insight into genetic diagnosis and counseling of Birt-Hogg-Dubé syndrome.

EXPLORATORY STUDY ON RELATIONSHIPS BETWEEN FAMILY FUNCTIONING, DEMOGRAPHICS AND INDIVIDUAL WELL-BEING IN EAST ASIA

This exploratory study examined the relationship between family functioning and individual’s well-being across seven East Asian cities. 3,834 participants recruited through convenience sampling completed a family survey. Descriptive statistics, t-tests, ANOVAs, and hierarchical regression analyses were performed. Results showed that, among the survey respondents, overall 31.1% of families were diagnosed as dysfunctional, 11.3% were scored as low functioning, and 50.7% were classified as high functioning. In various cities, 21.2% to 40.6% of the families were diagnosed as dysfunctional, 6.5% to 16.6% were scored as low functioning, and 33.2% to 68% were classified as high functioning. Income per head and divorce predicted low family functioning. After controlling demographic variables, family functioning significantly predicted subjective happiness (ΔR2 = .17), depression (ΔR2 = .11), mental health (ΔR2 = .05) and physical health (ΔR2 = .02). More cross-cultural studies on Asian families were recommended for improving our understanding of family dynamics and functioning of Eastern families.

Health-Assistive Smart Homes for Aging in Place: Leading the Way for Integration of the Asian Immigrant Minority Voice.

Caring for America’s aging population is a complex humanitarian issue. The number of older adults is expected to increase to 98.5 million by 2060 with a 295% growth in foreign-born older adults, including Asian immigrants. Most older adults will have one or more chronic conditions and 95% of healthcare costs will be attributed to caring for these conditions. Among Asian Americans, common chronic conditions include respiratory disease, cancer, cardiovascular disease, and pain. The National Institutes of Health, Institute on Aging, and National Science Foundation call for innovative technologies to be developed by multidisciplinary teams to address these concerns. Asian community leaders at Asian Health & Service Center and community members in Oregon identified the use of health-assistive technologies as a priority for potentially reducing stress and improving quality of life for both older adults and their caregivers. The purpose of this article is to introduce nurses and healthcare workers, advocating for the interests of Asian/Pacific Island community members, to the innovative health-assistive smart home. The health-assistive smart home uses artificial intelligence to identify and predict health events. Inclusion of minority persons’ data in the development of artificial intelligence has been generally overlooked. This may result in continued health inequities and is incompatible with the goals of global health. Integration of minority voices while exploring the efficacious use of the health-assistive smart home is of significant value to minority populations. Asian immigrant older adults engaging in smart home research and development will enhance the cultural and technical safety of future devices. Asian families may be particularly interested in smart homes for extending independence because they place an emphasis on collective culture and family-based care. Community engagement of stakeholders and steadfast leadership are needed so that future technologies used in healthcare delivery are both technically and culturally sound. A community-engaged research approach promotes community empowerment that is responsive to community identified priorities and is a good fit for studying adoption of smart home monitoring for health-assistance.

Gambling and family: A two-way relationship.

Background and aimsFamilies play an important role in the evolution of gambling and are also adversely affected by the disordered gambling of any one of their members. The aims of this study were to explore both the role families play in gambling initiation, maintenance, and help-seeking, and the harm caused to families by the gambling behavior using a qualitative approach.MethodsRegular older adult gamblers were included in the study. In-depth interviews were conducted with 25 older adults to gain an understanding of gambling from their perspective. Older adult gamblers described their lived experience of gambling ranging from initiation to harm and attempts to cut down or limit gambling. Data were analyzed using thematic network analysis.ResultsThe mean age of the 25 participants was 66.2 years. The majority were male (n = 18), of Chinese ethnicity (n = 16), had secondary education (n = 9), were married (n = 20), and currently employed (n = 15). Four organizing themes related to the role of families in initiation and maintenance of gambling, harm caused to family members, and their role in help-seeking were identified.Discussion and conclusionsThe study emphasizes the role of Asian families in both initiation and maintenance of gambling. Hence, families must be involved in prevention and outreach programs. Family members must be educated, so that they can encourage help-seeking to ensure early treatment and recovery. There is a need for interventional studies for reducing stress and improving coping among family members.

A novel Family Dignity Intervention (FDI) for enhancing and informing holistic palliative care in Asia: study protocol for a randomized controlled trial

BackgroundThe lack of a holistic approach to palliative care can lead to a fractured sense of dignity at the end of life, resulting in depression, hopelessness, feelings of being a burden to others, and the loss of the will to live among terminally ill patients. Building on the clinical foundation of Dignity Therapy, together with the empirical understanding of dignity-related concerns of Asian families facing terminal illness, a novel Family Dignity Intervention (FDI) has been developed for Asian palliative care. FDI comprises a recorded interview with a patient and their primary family caregiver, which is transcribed, edited into a legacy document, and returned to the dyads for sharing with the rest of the patient’s family. The aims of this study are to assess the feasibility, acceptability and potential effectiveness of FDI in reducing psychosocial, emotional, spiritual, and psychophysiological distress in community-dwelling and in-patient, Asian, older terminally ill patients and their families living in Singapore.Methods/designAn open-label randomized controlled trial. One hundred and twenty-six patient-family dyads are randomly allocated to one of two groups: (1) an intervention group (FDI offered in addition to standard psychological care) and (2) a control group (standard psychological care). Both quantitative and qualitative outcomes are assessed in face-to-face interviews at baseline, 3 days and 2 weeks after intervention, as well as during an exit interview with family caregivers at 2 months post bereavement. Primary outcome measures include sense of dignity for patients and psychological distress for caregivers. Secondary outcomes include meaning in life, quality of life, spirituality, hopefulness, perceived support, and psychophysiological wellbeing, as well as bereavement outcomes for caregivers. Qualitative data are analyzed using the Framework method.DiscussionTo date, there is no available palliative care intervention for dignity enhancement in Asia. This first-of-its-kind study develops and tests an evidence-based, family driven, psycho-socio-spiritual intervention for enhancing dignity and wellbeing among Asian patients and families facing mortality. It addresses a critical gap in the provision of holistic palliative care. The expected outcomes will contribute to advancements in both theories and practices of palliative care for Singapore and its neighboring regions while serving to inform similar developments in other Asian communities.Trial registrationClinicalTrials.gov, ID: NCT03200730. Registered on 26 June 2017.

Systematic review of infant and young child complementary feeding practices in South Asian families: the India perspective.

Suboptimal nutrition among children remains a problem among South Asian (SA) families. Appropriate complementary feeding (CF) practices can greatly reduce this risk. Thus, we undertook a systematic review of studies assessing CF (timing, dietary diversity, meal frequency and influencing factors) in children aged <2 years in India. Searches between January 2000 and June 2016 in MEDLINE, EMBASE, Global Health, Web of Science, OVID Maternity & Infant Care, CINAHL, Cochrane Library, BanglaJOL, POPLINE and WHO Global Health Library. Eligibility criteria: primary research on CF practices in SA children aged 0-2 years and/or their families. Search terms: 'children', 'feeding' and 'Asians' and derivatives. Two researchers undertook study selection, data extraction and quality appraisal (EPPI-Centre Weight of Evidence). From 45 712 abstracts screened, sixty-four cross-sectional, seven cohort, one qualitative and one case-control studies were included. Despite adopting the WHO Infant and Young Child Feeding guidelines, suboptimal CF practices were found in all studies. In twenty-nine of fifty-nine studies, CF was introduced between 6 and 9 months, with eight studies finding minimum dietary diversity was achieved in 6-33 %, and ten of seventeen studies noting minimum meal frequency in only 25-50 % of the study populations. Influencing factors included cultural influences, poor knowledge on appropriate CF practices and parental educational status. This is the first systematic review to evaluate CF practices in SA in India. Campaigns to change health and nutrition behaviour and revision of nationwide child health nutrition programmes are needed to meet the substantial unmet needs of these children.

Chinese, Vietnamese, and Asian Indian Parents' Perspectives About Well-Child Visits: A Qualitative Analysis

ObjectivesWell-child visits are a critical component of pediatric health care; however, disparities in attendance and quality of care exist for Asian children. Limited research has explored Asian immigrant parents' perspectives about their well-child visit experience. MethodsQualitative interviews were conducted with Chinese, Vietnamese, and Asian Indian immigrant parents. Participants were recruited from community-based organizations in the Boston area. Interviews focused on parents' perceptions about well-child visits, including individual attitudes, social and cultural factors affecting their opinions, perceived behavioral control, and improving visits for Asian immigrant families. Data were coded and analyzed using thematic analysis. ResultsFifty-one parents participated. Although participants reported attending well-child visits, they thought language barriers and unfamiliarity with US preventive health care may limit attendance for other Asian immigrant families. Some reported high-quality visits, while others described them as “too simple,” recollecting health care experiences from their countries of origin where more tests were completed. Participants described seeking advice about their children's preventive care from elder family members. Many expressed the importance of culturally concordant health care providers and culturally sensitive care, while others thought that culture was less relevant. Differences emerged among the 3 subgroups around culturally concordant care and traditional medicine. ConclusionsQuerying parents about their past health care experiences and providing information about well-child visits may be useful when caring for immigrant families. Social influences on children's health outside of the parent–provider–child triad may also be important. Further work should explore how to deliver culturally sensitive care that considers not only a family's language preferences but also their unique cultural identity.

Systematic review of infant and young child complementary feeding practices in South Asian families: the Pakistan perspective.

Suboptimal nutrition among children remains a problem among South Asian (SA) families. Appropriate complementary feeding (CF) practices can greatly reduce this risk. Thus, we undertook a systematic review of studies assessing CF (timing, dietary diversity, meal frequency and influencing factors) in children aged <2 years in Pakistan. Searches between January 2000 and June 2016 in MEDLINE, EMBASE, Global Health, Web of Science, OVID Maternity & Infant Care, CINAHL, Cochrane Library, BanglaJOL, POPLINE and WHO Global Health Library. Eligibility criteria: primary research on CF practices in SA children aged 0-2 years and/or their families. Search terms: 'children', 'feeding' and 'Asians' with their derivatives. Two researchers undertook study selection, data extraction and quality appraisal (EPPI-Centre Weight of Evidence). From 45 712 results, seventeen studies were included. Despite adopting the WHO Infant and Young Child Feeding guidelines, suboptimal CF was found in all studies. Nine of fifteen studies assessing timing recorded CF introduced between 6 and 9 months. Five of nine observed dietary diversity across four of seven food groups; and two of four, minimum meal frequency in over 50 % of participants. Influencing factors included lack of CF knowledge, low maternal education, socio-economic status and cultural beliefs. This is the first systematic review to evaluate CF practices in Pakistan. Campaigns to change health and nutrition behaviour are needed to meet the substantial unmet needs of these children.

Vietnamese Refugee Elderly Women and Their Experiences of Social Support: A Multiple Case Study.

This study sought to address the gaps in the literature on Asian American gerontology with a multiply marginalized group in terms of gender, immigration status, and context. Guided by a multiple case study approach, we sought to explore how social support was experienced by four Vietnamese elderly refugee women residing in different living arrangements (i.e., alone, with spouse, with adult children, or in a multigenerational household). Within-case analyses were conducted to yield descriptive information about each individual. Additionally, three overarching themes emerged across each of the living arrangements: (1) Burden of care-taking, (2) Distinguishing family from nonfamily help, and (3) Ambivalence toward government-sponsored services. Our findings provide a contextualized understanding of social support to explain the inconsistencies that have been found in the literature on Asian American gerontology and family support. The benefits of living alone are described, along with the potential risks of coresidency.

South Asian families report perceived stigma attached to asthma diagnosis

South Asian families report perceived stigma attached to asthma diagnosis

The Linguistic and Ethnic Transformation of the Church in Quebec since the Mid-1960s

Research Article| October 01 2017 The Linguistic and Ethnic Transformation of the Church in Quebec since the Mid-1960s Roy A. Prete; Roy A. Prete ROY A. PRETE is an emeritus professor of history at the Royal Military College of Canada, Kingston, Ontario, where he taught modern European and Canadian history and published on World War I. He has also edited three books on Latter-day Saint studies and a forthcoming history of the Church in Canada. Search for other works by this author on: This Site Google G. Eric Jarvis; G. Eric Jarvis GEORGE ERIC JARVIS is an associate professor of psychiatry at McGill University. He publishes and presents at international conferences on topics of culture and mental health and the history of psychiatry. His current research evaluates the effect of culture, language, and religion on the diagnosis and treatment of mental disorders. Search for other works by this author on: This Site Google Jonathan A. Jarvis Jonathan A. Jarvis JONATHAN A. JARVIS is an assistant professor of sociology at Brigham Young University. In his research, he examines how globalization shapes the educational strategies of Asian families in their home countries and abroad and how international variations in family background and structure affect educational outcomes. Search for other works by this author on: This Site Google Journal of Mormon History (2017) 43 (4): 155–184. https://doi.org/10.5406/jmormhist.43.4.0155 Cite Icon Cite Share Icon Share Facebook Twitter LinkedIn MailTo Permissions Search Site Citation Roy A. Prete, G. Eric Jarvis, Jonathan A. Jarvis; The Linguistic and Ethnic Transformation of the Church in Quebec since the Mid-1960s. Journal of Mormon History 1 October 2017; 43 (4): 155–184. doi: https://doi.org/10.5406/jmormhist.43.4.0155 Download citation file: Zotero Reference Manager EasyBib Bookends Mendeley Papers EndNote RefWorks BibTex toolbar search Search Dropdown Menu toolbar search search input Search input auto suggest filter your search All Scholarly Publishing CollectiveUniversity of Illinois PressJournal of Mormon History Search Advanced Search The text of this article is only available as a PDF. Copyright 2017 by the Board of Trustees of the University of Illinois2017 Article PDF first page preview Close Modal You do not currently have access to this content.

A qualitative study to identify parents\u2019 perceptions of and barriers to asthma management in children from South Asian and White British families

BackgroundOver one million children receive treatment for asthma in the UK. South Asian children experience excess morbidity and higher rates of hospitalization than the White population. This study aimed to explore perceptions and experiences of asthma and asthma management in British South Asian and White British families, to identify barriers to optimal management and to inform culturally appropriate interventions to improve management.MethodsA qualitative methodology, using semi-structured interviews was adopted. Members of 30 families from six major South Asian ethnic-religious groups were purposively sampled (n = 49). For comparison, 17 White British parents were interviewed. Topics included understandings of asthma; day-to-day management; interactions with health care providers and the perceived quality of healthcare services. Data were analyzed using interpretive thematic analysis, facilitated by NVivo. Similarities and differences between South Asian and White families were analysed across key themes.ResultsMany of the problems facing families of a child with asthma were common to South Asian and White British families. Both had limited understanding of asthma causes and triggers and expressed confusion about the use of medications. Both groups reported delays in receiving a clear diagnosis and many experienced what was perceived as uncoordinated care and inconsistent advice from health professionals. No family had received an asthma plan. South Asian families had more difficulty in recognising severity of symptoms and those with limited English faced additional barriers to receiving adequate information and advice about management due to poor communication support systems. South Asian parents reported higher levels of involvement of wider family and higher levels of stigma. Attendance at the emergency department was related to previous experience, difficulties in accessing primary care, lack of knowledge of alternatives and difficulties in assessing severity.ConclusionsBarriers to optimal asthma management exist at the individual family, community and healthcare systems levels. Culturally sensitive, holistic and collaboratively designed interventions are needed. Improved communication support for families with lower proficiency in English is required. Healthcare professionals need to ensure that families receive an asthma plan and make greater efforts to check families’ understandings of asthma triggers, use of medications, assessment of asthma severity and accessing help.

P248 Next generation sequencing reveals a novel hla-a*24 allele associated with hla-dqb1*06:10 in asians

Aim Next Generation Sequencing (NGS) for HLA typing improves not only the resolution of typing results but also aids in the discovery of novel alleles. Here we present a novel HLA-A∗24 allele associated with HLA-DQB1∗06:10, which was found in an Asian family and an unrelated donor. Methods Genomic DNA samples isolated from a patient, family members and potential unrelated donors were tested by reverse sequence specific oligonucleotide probes (rSSOP), sequence based typing (SBT) and NGS technology. In NGS typing, genomic DNA was amplified using the Illumina TruSight HLA v2 Sequencing Panel kit. After normalization, fragmentation/tagmentation and dual-indexing procedures, the amplicons were pooled onto the MiSeq sequencer to facilitate cluster generation and sequencing by synthesis on the flow cell. The generated data was then analyzed with Illumina TruSight HLA Assign software. Results A patient being evaluated for a potential hematopoietic stem cell transplant (HSCT) was typed by Sanger sequencing and found to be homozygous at HLA-A, B, C and DRB1. By Luminex LabType, the patient was heterozygous at DQA1, DQB1 and DPB1. However, subsequent NGS typing revealed heterozygousity for HLA-A, with an expected A∗24:02:01 and a novel A∗24 with a mutation in exon 6 which resulted in an amino acid change from lysine to glutamic acid. The same mutation was also found in one of his children and one of four unrelated donors. The patient, child and unrelated donor who had the HLA-A∗24:NEW allele all self-identified as Asian. In all three cases, the HLA-A∗24:NEW allele was associated with HLA-DQB1∗06:10; this association is found only in Asians at low frequency. Conclusions This HLA-A∗24:NEW allele may be associated with DQB1∗06:10 in Asians. Implementing NGS technology in clinical practice will not only allow us to choose the best donor from many potentially matched donors but also will fill in gaps in HLA databases to improve our typing.

Return of the Missing Daughters.

The article focuses on the changes in the culture of Asian families that favor most their sons compared to their daughters. It offers overview of the history of how families in rural societies of China, South Korea, and India value more male children and neglect their daughters, who were often aborted, killed at birth or die through neglect. However, gender equality has started to take hold as cultures grant more economic value to women.

Evaluation of a carers' information programme culturally adapted for South Asian families.

The Alzheimer's Society has culturally adapted an Information Programme for South Asian families (IPSAF) who support an individual living with dementia. The objectives of this evaluation were to establish whether IPSAF had an immediate and medium-term impact on those who attended and how it impacted on the wider family and the person with dementia. An inclusive, pluralistic approach was adopted. Seven focus groups were conducted with 42 participants, and 37 participated in a pre-post knowledge quiz. Seven family interviews were conducted with 17 participants, and 3 families were followed up after 6months. Thematic analysis was conducted on the data. The IPSAF was found to improve participants' knowledge of dementia leading to increased understanding of the person with dementia. Participants became more aware of available services and accessed services to make use of practical support. IPSAF was reported to have an impact for people living with dementia, with carers' newfound understanding resulting in some changes in care practice that promoted empowerment and independence for people living with dementia. There was also some evidence to suggest that IPSAF had an impact on the wider family, with participants sharing information about dementia with family members who had not attended the programme. Families were continuing to make changes to improve the lives of people living with dementia 6months later, suggesting IPSAF had a sustained impact. This culturally adapted programme was found to have a significant impact on carers, the person with dementia, and the wider family.

Healthy Living Behaviors Among Chinese–American Preschool-Aged Children: Results of a Parent Survey

Associations between diet, physical activity, parenting, and acculturation among Chinese-American children are understudied. Parents/caregivers of children attending child-care programs in Boston Chinatown completed a self-administered survey on demographics, child's diet, physical activities, anthropometrics, and parenting practices. Associations were evaluated in multivariable regression analysis, stratified by survey language preference, a proxy for acculturation. Responding Asian families = 132; 86.4% were immigrants; 75.8% completed the Chinese-version survey. Children (mean ± SD: 4.9 ± 1.1 years) did not eat vegetables (31.8%), or play actively outside (45.4%) daily, 64.8% watched television/screens daily; 32.6% were overweight/obese (based on parent report). Parenting practices associated with obesity were apparent. Although healthy-living behavioral outcomes were less prevalent among less acculturated parents; multivariable adjustment attenuated the observed significant differences. Findings suggest opportunities for improvement in study children's diet and healthy-living behaviors, and underscore the need for further research on acculturation, and parenting styles in this population.

Re-visioning evidence: Reflections on the recent controversy around gender selective abortion in the UK

ABSTRACTReports in the British media over the last 4 years have highlighted the schisms and contestations that have accompanied the reports of gender selective abortions amongst British Asian families. The position that sex-selection may be within the terms of the 1967 Abortion Act has particularly sparked controversy amongst abortion campaigners and politicians but equally among medical practitioners and the British Pregnancy Advisory Service who have hitherto tended to stay clear of such debates. In what ways has the controversy around gender-based abortion led to new framings of the entitlement to service provision and new ways of thinking about evidence in the context of reproductive rights? We reflect on these issues drawing on critiques of what constitutes best evidence, contested notions of reproductive rights and reproductive governance, comparative work in India and China as well as our involvement with different groups of campaigners including British South Asian NGOs. The aim of the paper is to situate the medical and legal provision of abortion services in Britain within current discursive practices around gender equality, ethnicity, reproductive autonomy, probable and plausible evidence, and policies of health reform.

Family Aggregation and Heritability of ESRD in Taiwan: A Population-Based Study

Aggregation of end-stage renal disease (ESRD) has been observed in families of European origin, as well as those of African origin. However, it is not well documented if this disease aggregates in Asian families. Furthermore, the contribution of genetic factors and shared environmental factors to family aggregation remains unclear. Population-based cross-sectional cohort study. All 23,422,955 individuals registered in the Taiwan National Health Insurance Research Database in 2013. Among these, 47.45%, 57.45%, 47.29%, and 1.51% had a known parent, child, sibling, or twin, respectively. We identified 87,849 patients who had a diagnosis of ESRD. Family history of ESRD. ESRD and heritability defined as the proportion of phenotypic variance attributable to genetic factors. Having an affected first-degree relative with ESRD was associated with an adjusted relative risk of 2.46 (95% CI, 2.32-2.62). Relative risks were 96.38 (95% CI, 48.3-192.34) for twins of patients with ESRD, 2.15 (95% CI, 2.02-2.29) for parents, 2.78 (95% CI, 2.53-3.05) for offspring, 4.96 (95% CI, 4.19-5.88) for siblings, and 1.66 (95% CI, 1.54-1.78) for spouses without genetic similarities. Heritability in this study was 31.1% to 11.4% for shared environmental factors and 57.5% for nonshared environmental factors. This was a registry database study and we did not have detailed information about clinical findings or the definite causes of ESRD. This whole population-based family study in Asia confirmed, in a Taiwanese population, that a family history of ESRD is a strong risk factor for this disease. Moderate heritability was noted and environmental factors were related to disease. Family history of ESRD is an important piece of clinical information.

South Asian women elders and everyday lives of ‘care in the community’ in Britain: the neoliberal turn in social care and the myth of the family

ABSTRACTThis article focuses upon the myth of the South Asian family as a self-fulfilling unit in which a construction of ‘looking after their own’ in the diaspora is perpetuated which intrinsically assumes how care and caring are organised at home. The Care in the Community agenda in Britain, which comes out of the contemporary neoliberal paradigm of austerity in which social welfare services have been dramatically cut and reformulated, utilises this imagined myth of the South Asian family in its judgements of the needs of South Asian women elders. Based on fieldwork at a South Asian women’s centre in Britain, the article highlights how women’s senses of self and selflessness relate to and reflect the neoliberal decline of welfare in which ‘looking after their own’ presents an ideal for policies which are rescinding delivery of services and entitlements. We highlight how South Asian women elders are absorbing the burdens of this social care paradigm shift while also bearing the strains of generational shifts around the culture of the family and expectations of women’s roles as they move through the life course as carers and as those being cared for.

Predominance of Central Asian and European families among Mycobacterium tuberculosis isolates in Kashmir Valley, India

BackgroundAs there are no data available regarding the strains of Mycobacterium tuberculosis circulating in Kashmir Valley, India, the current study aimed at describing the genetic diversity of M. tuberculosis strains in this region, by spoligotyping and 12-locus-based MIRU-VNTR typing (Mycobacterial Interspersed Repetitive Unit-Variable Number Tandem Repeat). MethodsSputa from 207 smear positive cases with newly diagnosed pulmonary tuberculosis were subjected to culture for M. tuberculosis. Eighty-five isolates confirmed as M. tuberculosis were subjected to drug susceptibility testing and molecular typing by spoligotyping and MIRU-VNTRs. ResultsDrug susceptibility results of 72 isolates revealed 76.3% as fully sensitive while 5.5% as multidrug resistant (MDR). Spoligotyping of 85 isolates detected 42 spoligotypes with 50 isolates (58.8%) clustered into seven spoligotypes. SIT26/CAS1_Del was the major spoligotype (23, 27%) followed by SIT127/H4 (12, 14.1%); CAS lineage (37.6%) was predominant, followed by Haarlem (25.8%) and ill-defined T clade (23.5%). MIRU-VNTR analysis displayed 82 MIRU patterns from 85 strains, including 3 small clusters and 79 unique. MIRU 26 was found to be the most discriminatory locus. ConclusionsKashmir Valley has CAS as the predominant lineage of M. tuberculosis similar to the rest of the Indian sub-continent, while it is peculiar in having Euro American lineages such as Haarlem and ill-defined T clade.