South African Ethnic Groups Research Articles

Initial Presentation of SLE among the Different South African Ethnic Groups

Background: Systemic lupus erythematosus (SLE) is a chronic, immune-mediated, inflammatory multi-organ disease. It is characterized by a variety of clinical features including abnormalities of the joints, skin, kidneys, lungs, heart, blood and brain. In addition to gender, genetic, environmental, hormonal and chemical factors appear to play a role in disease activity. Previous studies in South Africa have shown an increasing trend of new diagnoses of SLE patients, with increasing target organ damage but there is an obvious distinction between different organs in terms of incidence. The primary aim of this study was to identify the major initial presentation of SLE patients among the three main South African ethnic groups: Black, Mixed ethnicity, and White. Material and Methods: This was a retrospective descriptive and analytic study in which patients with SLE were compared among the three ethnic groups in South Africa. Data was obtained from patient’s records contained in the Enterprise Content Management System (ECM) and medical records. Results: A total of 198 patients were seen in the Rheumatology Division with SLE between March 1993 and November 1999. The study showed that the most affected group was the mixed ethnicity population (81.4%), followed by the black African group (11.6%), then the white group (7%). Arthritis was the most frequent disorders among the three-different ethnic groups. However, there appear to be some differences in the autoantibody profile.
 Conclusion:This study focused on the initial presenting symptoms. A long-term cohort on the development of the disease may yield further results on possible ethnic differences, and continued research into susceptibility loci and phenotypic associations in enriched multi-ethnic cohorts and looking for the causes of death among the three ethnic groups and related to the first presentation is suggested.

Impact of ethnicity and neighborhood deprivation on preterm birth: How does urban living play a role?

ObjectiveWomen of Black and other non-Western ethnicity and women who live in deprived neighborhoods are at increased risk for preterm birth (PTB). These women may live clustered in certain urban areas. If ethnicity reflects a biological rather than a socioeconomic risk factor, women should have a PTB risk independent of the urban area where they live. In this study we explored the association between urban living and the risk of PTB, combined with knowledge on ethnicity and neighborhood deprivation in these specific urban areas in the Netherlands. Study designNational cohort study of 935,381 women (2014–2019) with a singleton pregnancy resulting in live birth between 24.0 and 42.6 weeks. Antepartum death and severe congenital anomalies were excluded. We performed logistic regression analysis and analyzed the impact of living in one of the four main urban areas on PTB. We adjusted for maternal age, parity and fetal gender. We tested for interaction between ethnicity, neighborhood deprivation index (NDI) and urban living. ResultsMean PTB rate among singleton pregnancies in The Netherlands is 5.1%. There was a strong ethnic difference in PTB risk, with the highest prevalence among South Asian women (7.9%) and African women (6.6%). In the most deprived neighborhoods the PTB risk was 5.7%. We found a significant interaction between ethnicity and urban living, and between NDI and urban living. South Asian and African women living in urban areas had the greatest risk of PTB, between 7.0% and 8.8%. ConclusionEthnicity remains a fixed biological risk for PTB that cannot be fully explained by socioeconomic status or neighborhood deprivation. Independent of ethnicity and neighborhood deprivation, urban living has a great influence on the risk of preterm birth. Future studies and policies should focus on population-based interventions in those urban areas where South Asian and African ethnic groups live and where the preterm birth risk is the highest.

Phytochemical Profile, Safety and Efficacy of a Herbal Mixture Used for Contraception by Traditional Health Practitioners in Ngaka Modiri Molema District Municipality, South Africa.

The use of medicinal plants for contraception remains a common practice among South African ethnic groups. The present study assessed the phytochemical profile, cytotoxicity, acute oral toxicity and efficacy of a herbal mixture used for contraception by the Batswana of South Africa. An aqueous extract was prepared from equal quantities (in terms of weight) of Bulbine frutescens (roots), Helichrysum caespititium (leaves) and Teucrium trifidum (leaves) based on a recipe used by traditional health practitioners. The phytochemical profiles of the freeze-dried herbal mixture were analyzed using gas chromatography–mass spectrometry (GC-MS). In addition, cytotoxicity was determined using an MTT assay on Vero cells and in vivo contraceptive efficacy was evaluated using seven Sprague Dawley rats per control and treatment groups. The control group received distilled water while test groups received 5, 50 and 300 mg/kg of the herbal mixture, which was administered orally once a day for three consecutive days. Subsequently, female rats were paired 1:1 with males for 3 days. Their weights were measured weekly and incidence of pregnancy was recorded. The GC-MS chromatogram revealed the presence of 12 identified and 9 unidentified compounds. In terms of safety, the herbal mixture had an IC50 value of 755.2 μg/mL and 2000 mg/kg, which was the highest tested dose that caused no mortality or morbidity in the rats. A contraceptive efficacy of 14.5% was exerted with 50 mg/kg herbal mixture extract while other doses had no effects given that all the rats were pregnant. Based on a chi-square test (p < 0.05), there was no correlation between the tested herbal mixture doses and contraception, nor on the weight of the rats. Overall, the herbal mixture extract was found to be safe but had limited contraceptive efficacy at the tested doses. In future studies, exploring increased dose range, solvent extract types and hormonal analysis will be pertinent.

Inter-ethnic relations among black students at a South African higher education institution

This study explored the inter-ethnic relations and experiences of students at a higher education institution, using an exploratory case study approach. Purposive sampling was used to select students belonging to black South African ethnic groups. Semi-structured interviews were used to collect data from three participants; interpretative phenomenological analysis was used for analysis. The themes extracted were ethnic identity: identity confusion vs. certainty; personal experiences of inter-ethnic relations; and majority and minority ethnic groups’ experiences. Identity salience was found to not particularly be integral to the cultivation of inter-ethnic relations. Moreover, participants’ inter-ethnic experiences were varied; some were positive, and others, negative. Relations between majority and minority ethnic groups are seemingly supported by existing literature, as majority ethnic group members typically initiated negative interactions, more so than did minority ethnic groups. Future studies should interrogate inter-ethnic dynamics on a broader scale, and explore ethnic bullying and its impact on inter-ethnic relations.

The Relationship Between Environmental Exposure and Genetic Architecture of the 2q33 Locus With Esophageal Cancer in South Africa.

Esophageal squamous cell carcinoma (ESCC) has a high prevalence in several countries in Africa and Asia. Previous genome-wide association studies (GWAS) in Chinese populations have identified several ESCC susceptibility loci, including variants on chromosome 2q33 and 6p21, but the contribution of these loci to risk in African populations is unknown. In this study we tested the association of 10 genetic variants at these two risk loci on susceptibility to ESCC in two South African ethnic groups. Variants at 2q33 (rs3769823, rs10931936, rs13016963, rs7578456, rs2244438) and 6p21 (rs911178, rs3763338, rs2844695, rs17533090, rs1536501) were genotyped in a set of Black Xhosa (463 cases and 480 controls) and Mixed Ancestry (269 cases and 288 controls) individuals. Genotyping was performed using TaqMan allelic discrimination assays. The Pearson’s chi-squared test was used to compare the allele frequency between cases and controls. Gene-environment interactions with tobacco smoking and alcohol consumption were investigated in a case-control analysis. A logistic regression analysis was further performed to elucidate the independent effect of each association signal on the risk of ESCC. The 2q33 variants rs10931936, rs7578456, and rs2244438 were marginally associated with higher risk of ESCC in the Mixed Ancestry population (ORs = 1.39–1.58, p ≤ 0.035), of which rs7578456 and rs2244438 remained significant after multiple correction (p < 0.005). The associations with rs7578456 and rs2244438 were also observed across strata of tobacco smoking (ORs = 1.47–2.75, p ≤ 0.035) and alcohol consumption (ORs = 1.45–2.06, p ≤ 0.085) status. However, only the association with rs2244438, which lies within an exon of TRAK2, remained significant after adjustment for the other variants in the region. Interestingly, none of the variants tested were significantly associated with ESCC in the Black South African population. These finding implicate TRAK2 as a casual gene for ESCC risk in the Mixed Ancestry population of South Africa and confirm prior evidence of population-specific differences in the genetic contribution to ESCC, which may reflect differences in genetic architecture and environmental exposure across ethnic groups.

Evaluating the Psychometric Properties of a Measure of Ethnic Identity Among Black South African Youth

ABSTRACT The authors examined the dimensionality and psychometric properties of the Multigroup Ethnic Identity Measure (MEIM) among Black South African adolescents (ages = 13–14; 52% female) representing several ethnic groups (Ndebele, Pedi, Sotho, Swati, Tsonga, Tswana, Venda, Xhosa, Zulu) and evaluated the measure for differential item functioning primarily among four ethnic groups (Sotho, Tswana, Xhosa, and Zulu). Results indicated that a two-dimensional model best represented the data, reflecting ethnic search/clarity and ethnic affirmations. Subsequently, we evaluated the equivalence of the MEIM among the four South African ethnic groups and a sample of African American adolescents (Mage = 15.57 years; SD = 1.22; 51% female). Further analyses revealed that configural and metric models were excellent across the four South African ethnic groups and the African American group. However, scalar invariance (i.e., intercept) was not found; the item intercepts were different for the South African ethnic groups and African Americans. Findings are discussed with consideration for conducting research on ethnic identity among youth in South Africa.

Population analysis of African Y-STR profiles with UniQ TYPER™ Y-10 genotyping system

The Y-STR prototype UniQ Typer™ Y-10 was tested in 957 males from 8 South African ethnic groups. The overall DC=0.909, and DC=1 in three groups implies an important capacity to resolve the male component(s) of sexual assault evidence. This prototype offers an invaluable feature in a country with the highest rape incidents in the world. In addition, the kit shows potential for genealogical and population studies.

Comparison of Footprint Ridge Density between Two South African Ethnic Groups

Comparison of Footprint Ridge Density between Two South African Ethnic Groups

BRCA1, BRCA2 and PALB2 mutations and CHEK2 c.1100delC in different South African ethnic groups diagnosed with premenopausal and/or triple negative breast cancer.

BackgroundCurrent knowledge of the aetiology of hereditary breast cancer in the four main South African population groups (black, coloured, Indian and white) is limited. Risk assessments in the black, coloured and Indian population groups are challenging because of restricted information regarding the underlying genetic contributions to inherited breast cancer in these populations. We focused this study on premenopausal patients (diagnosed with breast cancer before the age of 50; n = 78) and triple negative breast cancer (TNBC) patients (n = 30) from the four South African ethnic groups. The aim of this study was to determine the frequency and spectrum of germline mutations in BRCA1, BRCA2 and PALB2 and to evaluate the presence of the CHEK2 c.1100delC allele in these patients.MethodsIn total, 108 South African breast cancer patients underwent mutation screening using a Next-Generation Sequencing (NGS) approach in combination with Multiplex Ligation-dependent Probe Amplification (MLPA) to detect large rearrangements in BRCA1 and BRCA2.ResultsIn 13 (12 %) patients a deleterious mutation in BRCA1/2 was detected, three of which were novel mutations in black patients. None of the study participants was found to have an unequivocal pathogenic mutation in PALB2. Two (white) patients tested positive for the CHEK2 c.1100delC mutation, however, one of these also carried a deleterious BRCA2 mutation. Additionally, six variants of unknown clinical significance were identified (4 in BRCA2, 2 in PALB2), all in black patients. Within the group of TNBC patients, a higher mutation frequency was obtained (23.3 %; 7/30) than in the group of patients diagnosed before the age of 50 (7.7 %; 6/78).ConclusionThis study highlights the importance of evaluating germline mutations in major breast cancer genes in all of the South African population groups. This NGS study shows that mutation analysis is warranted in South African patients with triple negative and/or in premenopausal breast cancer.Electronic supplementary materialThe online version of this article (doi:10.1186/s12885-015-1913-6) contains supplementary material, which is available to authorized users.

Analysis of Prostate Cancer Susceptibility Variants in South African Men: Replicating Associations on Chromosomes 8q24 and 10q11.

Genome-wide association studies (GWAS) have implicated single nucleotide polymorphisms (SNPs) on chromosomes 2p15, 6q25, 7p15.2, 7q21, 8q24, 10q11, 10q26, 11q13, 17q12, 17q24, 19q13, and Xp11, with prostate cancer (PCa) susceptibility and/or tumour aggressiveness, in populations of African, European, and Asian ancestry. The objective of this study was to confirm these associations in South African Mixed Ancestry and White men. We evaluated 17 prioritised GWAS SNPs in South African cases (331 Mixed Ancestry and 155 White) and controls (178 Mixed Ancestry and 145 White). The replicated SNP associations for the different South African ethnic groups were rs7008482 (8q24) (p = 2.45 × 10−5), rs6983267 (8q24) (p = 4.48 × 10−7), and rs10993994 (10q11) (p = 1.40 × 10−3) in Mixed Ancestry men and rs10993994 (p = 1.56 × 10−9) in White men. No significant associations were observed for the analyses stratified by disease aggressiveness in the individual and the combined population group analysis. The present study demonstrates that a number of known PCa susceptibility variants may contribute to disease susceptibility in South African men. Larger genetic investigations extended to other South African population groups are warranted to confirm the role of these and other SNPs in disease susceptibility.

Identity in Descriptions of Others Across Ethnic Groups in South Africa

We examined the structure of identity implied in descriptions of others in four South African ethnic groups (Black, Coloured, Indian, and White). We tested the validity of an identity model with attributes, relational orientation, situational aspects, ideology, and valence as constituent dimensions of other-identity, and social distance as a moderator of constituent dimensions. Data were collected from 1,160 participants who provided descriptions of individuals they knew (parents, friends, grandparents, neighbors, and teachers) in semistructured interviews. Results confirmed that relational orientation provides a better conceptual framework of other-identity than individualism–collectivism: Personal orientation (individualism) and collective membership orientation (collectivism) are situated at the endpoints of the relational orientation dimension, with implicit and explicit relational orientation placed in between. We found that ethnic differences are most salient in implicit and explicit relational orientation categories in White and Black South Africans, respectively. We found that the identity of distal individuals was described in less abstract and more norm-regulated terms than the identity of proximal individuals. We concluded that all dimensions of the model are relevant for other-identity.

Genetic testing for Duchenne/Becker muscular dystrophy in Johannesburg, South Africa

Genetic testing for Duchenne/Becker muscular dystrophy (DMD/BMD) mutations initially involved multiplex polymerase chain reaction (mPCR), which targeted two mutation hotspots in the gene and detected deletions in affected males. A newer technology, multiplex ligation-dependent probe amplification (MLPA), was introduced for diagnostic testing in 2007. To evaluate MLPA relative to mPCR as a technique for DMD/BMD diagnostic testing and to establish whether the mutation profile in affected individuals differs between different South African ethnic groups. METHODS; From January 2000 - May 2007, genetic diagnostic testing for DMD/BMD was undertaken in 128 male patients using mPCR. From May 2007 onwards, MLPA replaced this technique and 261 males were investigated. MLPA is a kit-based technology available from MRC-Holland.Results. Of the 128 and 261 probands tested using mPCR and MLPA, respectively, 31% and 34% were found to carry a deletion mutation. Further, MLPA could detect duplication mutations (11.5%), complex rearrangements (1.5%) and small mutations (1.5%). In black patients, deletion mutations were found to cluster in the 3' region of the gene. No population-specific pathogenic mutations were found. The mutation detection rate for mPCR and MLPA is similar for deletion mutations, but MLPA proved to be a better diagnostic approach as it could detect other types of mutations as well, including duplications, complex rearrangements and small mutations. MLPA could also diagnose mutation status in at-risk female relatives, which is not possible with mPCR.

Comparison of osteometric femoral bone dimensions among the South Africans of different ethnic groups and South African whites

The main objective of this paper was to use femoral data to determine whether the different South African ethnic groups should be considered as a homogenous population, as has been assumed in previous studies. Furthermore regression equations for each ethnic group were constructed. Three standard femoral variables were used; bone length (BL), maximum head diameter (HD) and bicondylar width (BCB). The eight South African ethnic groups (Zulu, Tswana, Swazi, Sotho, Xhosa, Shan, Venda and Ndebele) were considered as the independent variable. They were also compared with femora from South Africans of European Descent (SAED). In total 230 male femora were obtained from the Dart’s Collection at Wits University, South Africa. There were not any significant differences in bone length between the eight South African ethnic groups. However, bone length for SAED was significantly longer than for six of the ethnic groups, all except Zulu and Ndebele. Similarly all of the ethnic groups were significantly smaller than SAED for head diameter and bicondylar width. The Zulu and Ndebele femora were significantly larger than the other six African ethnic groups for HD and BCB. Regression equations were derived for the maximum length of femur from the maximum head diameter for all the groups separately. Femora from SAED were significantly larger than for six of the eight African ethnic groups that were considered. However, the data from the Zulu and Ndebele femora suggest that they constitute a separate ethnic grouping. Thus we conclude that these eight South African ethnic groups cannot be considered as a homogenous population and that the Zulu and Ndebele groups should be considered as a distinct population.

A comparative study of central corneal thickness (CCT) and intraocular pressure (IOP) in University of KwaZulu-Natal students of Black and Indian ethnicity*

Thisstudy compared central corneal thickness (CCT) and intraocular pressure (IOP) of Black and Indian students from the University of Kwa-Zulu-Natal. Two hundred (100 Black and 100 Indi-an) participants of both genders aged 18-25 years (mean and standard deviation; 20.1±1.6 years) participated in this study. CCT and IOP were measured for the right eye of each participant using a Tono-Pachymeter (NT530P) and a Goldmann applanation tonometer (GAT) respectively. Data was analyzed with descriptive, t-test and Pearson’s cor-relation statistics. In the total sample (N = 200), the mean CCT value was 519.5 ± 38.6 μm and CCT was higher in the Indians (526.5 ± 37.2 µm) than in the Blacks (512.4 ± 38.9 µm) (p = 0.01). Also, it was higher in the females (522.3 µm) than in males (516.7 µm), but the difference was insignificant (p = 0.07). The mean CCT was higher in the Indian males (520.1 µm) than in the Black males (513.2 µm), but the difference was insignificant (p=0.39). However, it was significantly higher in the Indian females (533 µm) than in the Black females (511.6 µm) (p = 0.003). In the total sample, the mean IOP was 14.6 mmHg and IOP was greater in Indiansthan Blacks (mean = 15.3 ± 2.9 mmHg and 13.8 ± 2.6 mmHg respectively) (p = 0.01). Also, the mean IOP (N = 200) value was slightly higher in the females (14.7 mmHg) than in males (14.5 mmHg) (p = 0.51). The mean IOP was higher in the Indian males (15.0 mmHg) than in the Black males (14.0 mmHg) (p = 0.07) and the mean IOP value was higher in the Indian females (15.7 mmHg) than in the Black females (13.6 mmHg) (p &lt; 0.001). The higher mean IOP value in the Indian than Black participants was attributed to the higher mean CCT values. A positive, but inconsistent association between CCT and IOP was found in this study, the coefficient in the total sample (r = 0.382, p = 0.000), in the Blacks (r = 0.196, p = 0.05) and in Indians (r = 0.498, p = 0.000). A national population study comparing CCT and IOP in the various South African ethnic groups is recommended. Cognizance of these differences should be taken in the diagnoses of glaucoma in these ethnic groups. (S Afr Optom 2012 71(4) 171-177)

The supratrochlear foramen of the humerus in a south african dry bone sample

The supratrochlear foramen (STF) of the humerus is the aperture that forms when the septum separating the coronoid and olecranon fossa is perforated. There are no known studies in the literature on the STF among various South African ethnic groups. The presence and shapes of the STF were established by visual observation from a sample of 538 skeletonized individuals with paired humeri (1,076) and of equal numbers between the sexes. Measurements of the transverse (TD) and vertical (VD) distance of the STF were obtained using extended jaw calipers. An osteometric board was used to measure the epicondylar breadth (EB). Sliding calipers were used to measure the distance of the medial epicondyle to medial aspect of the STF (MB) and that of the lateral epicondyle to lateral border of the STF (LB). The prevalence of STF in the South African population was 32.5% and predominantly on the left with the highest incidence among the Sotho population (41%) and the lowest incidence in Whites (16%). Females (19.5%) had a higher frequency of the STF compared with males (13%). The STF occurred in oval (136), round (77), triangular (9), and irregular (34) shapes. The average EB in this study was 56.1 mm, whereas the average MB and LB were 25.4 mm and 26.3 mm, respectively. The average TD was 6.3 mm and average VD was 4.3 mm. These findings may be of clinical significance to surgeons and osteologists and may have anthropological or forensic importance.

Why do some South African ethnic groups have very high HIV rates and others not?

The differences in HIV prevalence between South Africa's racial/ethnic groups (19.9%, 3.2%, and 0.5% among 15–49-year-old blacks, coloureds and whites, respectively) are as big as those between the countries with the highest and lowest levels of HIV prevalence worldwide. These large racial/ethnic differences are largely determined by different sexual network structures. In networks among black South Africans, sexual partnerships are more likely to be arranged concurrently – a configuration that leads to exponential increases in the spread of HIV. An examination of the historical origins of polygamy (where it is normative for partnerships to be arranged concurrently) and monogamy (serial or lifetime) reveals that it is the practice of universal monogamy in stratified societies which is the outlier. The ideology and practice of universal monogamy originated in Europe as the result of several factors, most prominently conflicts between the Christian Church and the nobility. After its imposition in Europe, the European colonial project would see this ideology disseminated around the world. Under the influence of liberalism it would mutate into a secular and unacknowledged value-programme of monogamy as a universal norm. This value-programme and practice of monogamy (mostly serial) is still the norm for white South Africans; thus, this sexual behaviour ‘spandrel’ (by-product of other historical processes) is a large contributor to the lower levels of HIV prevalence among whites. In pre-colonial African societies, polygyny was normative, and the Christian value-programme of monogamy never achieved the hegemonic status it did in Europe and other areas of conquest. Married black African men who converted to Christianity were no less likely to have additional sexual partners, but only more likely to conceal them. The ongoing secrecy about having concurrent partners has contributed to the connectedness of sexual networks among black Africans at large and in this manner has contributed to the rapid spread of HIV.

An evaluation of a psychosocial stress and coping model in the police work context

Orientation: Stress is a social reality which does not exist in isolation, but in many social situations, especially work-related environments. Police officers in particular suffer from highly negative stress related outcomes.Research purpose: The purpose of the study was to determine how Moos's hypothesised stress and coping model (1994) fitted a sample of police officers.Motivation for the study: The study was an attempt to understand police officers' unique needs and how the frequency and/or intensity of perceived stress could be reduced so that they would be able to cope more effectively with stress.Research design, approach and method: A non-experimental survey design, following the quantitative tradition, was used in pursuit of the research objectives. A random sample of 505 participants was extracted from a population of serving male and female police officers reflecting the typical South African ethnic groups. Structural equation modelling (SEM) was used to establish the adequacy of between the hypothesised Moos model and the sample.Main findings: The hypothesised theoretical framework was disproved. A respecified model and inter-correlations confirm that some officers experience burnout, while, paradoxically, others continue to be unaffected because of the buffering effect of social support, personality factors and other resilience factors not revealed in this study.Practical/managerial implications: The study calls on police management for awareness of the negative health consequences of prolonged stressors. Simultaneously, employee assistance programmes could be directed to problem-solving strategies, perceived self-efficacy and learned resourcefulness to improve control over prolonged negative stress consequences among members.Contribution/value-add: This research provides a theoretical framework to understand, describe and assess individual well-being in the police work context.

The relationship between receptivity to media models of smoking and nicotine dependence among South African adolescents

The purpose of this study is to determine the association of receptivity to media models of smoking and nicotine dependence among South African adolescents from four ethnic groups. A stratified random sample of 731 adolescents aged 12–17 years (mean = 14.55, SD = 1.68) was drawn from Johannesburg, South Africa. A structured questionnaire was administered to the participants in their homes by trained interviewers. Receptivity to media models of smoking was assessed with a three-item Likert scale. The dependent variable, nicotine dependence, was assessed with the Fagerström Test for Nicotine Dependence (FTND). Regression analyses showed a positive relationship between media receptivity and nicotine dependence, with control on demographic variables and hours of TV watched by the adolescent. This relationship was found to be strongest among White adolescents and weakest among Black adolescents. Though equally receptive to media models of smoking, Black adolescents have lower FTND scores than their peers from other South African ethnic groups. This may be related to the low prevalence of images in South Africa depicting Black people smoking cigarettes. Cultural norms against smoking among Black adolescents may also serve as a protective factor.

The prevalence of the platelet glycoprotein IIIa Pl A1/A2 polymorphism in three South African ethnic groups and its effect on platelet function

Introduction In South Africa coronary artery disease (CAD) is less common in African than Indian or white subjects. Although the association between CAD and metabolic factors have been well documented, the role of genetic factors is as yet poorly understood. Specific polymorphisms in the platelet membrane glycoprotein (GP) IIIa gene Pl A1/A2, have been implicated in the development of CAD. Methods The prevalence of platelet GPIIIa (Pl A1/A2) polymorphisms and their effect on platelet function was determined in 313 Indian, 267 white and 227 African subjects with and without a history of CAD. Results In subjects without a history of CAD the frequency of the unfavourable Pl A2 allele was 8.0%, 14.8% and 8.7% in the Indian, white and African populations respectively, with the frequency being significantly higher (p < 0.05) in the white than both other groups. The frequency of the Pl A2 allele was higher in subjects with (23.0%) than without (10.0%; p < 0.0001) a history of CAD. Aggregation studies showed that platelets carrying the Pl A2 allele were hypersensitive to the platelet aggregating agonists ADP and collagen and produced a higher amount of TXA 2 when stimulated with low concentrations of both these agonists. Conclusions The positive association observed between the platelet GPIIIa Pl A1/A2 polymorphism and platelet function suggests that the GPIIIa Pl A2 allele may be a genetic factor that contributes to the risk of sudden death from myocardial infarction in the absence of known risk factors but it does not explain ethnic differences in the prevalence of CAD.

The challenge of diversity: The national curriculum statement and foreign languages

In this paper I will demonstrate that the South African vision of multiculturalism as it is expressed in the National Curriculum Statement is limited and that it is not preparing young South Africans for the twenty-first century. I will argue that to achieve a broader multiculturalism, the educational system needs to further foreign languages actively. Twelve years ago, education was faced with the challenge of designing a curriculum which affirmed the diversity of South African cultures, religions, ethnic and racial groups while unifying people within this diversity. Policy was thus underpinned very firmly by the principles of multiculturalism. However, South African multiculturalism is inward-looking, it does not prepare learners for the realities of a nation composed not only of a heterogeneous population of South Africans but which also comprises a growing number of non-South Africans. South African multiculturalism must be broadened to go beyond local cultural diversity to include world cultures. Education must open learners to the Other: to South Africans of different cultural groups, as well as people of other nationalities. I will argue that this discovery of the Other and of Otherness can best be made through the learning of foreign languages.