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  1. Elmonem MA, Belanger-Quintana A, Bordugo A, Boruah R, Cortès-Saladelafont E, Endrakanti M, et al.
    Mol Genet Metab, 2020 11;131(3):285-288.
    PMID: 33004274 DOI: 10.1016/j.ymgme.2020.09.004
    Quantitative estimates for the global impact of COVID-19 on the diagnosis and management of patients with inborn errors of metabolism (IEM) are lacking. We collected relevant data from 16 specialized medical centers treating IEM patients in Europe, Asia and Africa. The median decline of reported IEM related services in March 1st-May 31st 2020 compared to the same period in 2019 were as high as 60-80% with a profound impact on patient management and care for this vulnerable patient group. More representative data along with outcome data and guidelines for managing IEM disorders under such extraordinary circumstances are needed.
    Matched MeSH terms: Africa/epidemiology
  2. Seedat M, McClure R, Suffla S, van Niekerk A
    Int J Inj Contr Saf Promot, 2012;19(3):231-41.
    PMID: 22873717 DOI: 10.1080/17457300.2012.705303
    Safe Communities, representing a global activation of the public health logic, may be strengthened through theoretical, methodological and empirical support. In the spirit of this Special Issue that aims to analyse the achievements and challenges inherent to Safe Communities, we offer our contribution in the form of a methodology of a multi-country child safety, peace and health promotion study. The study, situated within an African-centred initiative called Ukuphepha - an isiZulu word meaning demonstrating African safety - is underpinned by four theoretical claims that frame injury and violence prevention as a multi-disciplinary issue to be addressed through a suite of interventions to family and extended social systems. The interventions, sensitive to the priorities of each participating country, have been informed by the literature on effective interventions and the authors' joint experiences of community development. The study is designed as a population-based, multi-level, multi-intervention partly randomised controlled trial, and there are potentially 24 participant communities representing South Africa, Mozambique, Egypt, Zambia, Uganda, Bangladesh, Malaysia and Australia - over three commencement phases. Whereas process evaluation will focus on community engagement, impact evaluation will consider risk and protective factors, and outcome evaluation will examine the overall effectiveness of the interventions. Notwithstanding the many challenges, the study will provide insights into the methodology and mechanisms of ecologically-oriented interventions that locate injury and violence prevention as an activity arising from safety, peace and health promotion.
    Matched MeSH terms: Africa
  3. da Silva Voorham JM
    Ned Tijdschr Geneeskd, 2014;158:A7946.
    PMID: 25227888
    Sylvatic dengue viruses are both evolutionarily and ecologically distinguishable from the human dengue virus (DENV). Sporadic episodes of sylvatic human infections in West Africa and Southeast Asia suggest that sylvatic DENV regularly come into contact with human beings. Following a study on the sylvatic transmission cycle in Malaysia in 2007, researchers announced that a new DENV serotype, DENV-5, had been discovered. Scientists are still sceptical about these new findings, and indicate that more data is necessary to determine whether this 'new' virus really is a different serotype or whether it is a variant of one of the four DENV serotypes already known. The good news is that this new variant has not yet established itself in the human transmission cycle. However, if it really is a new serotype this will have implications for the long-term control of dengue using vaccines currently under development.
    Matched MeSH terms: Africa, Western
  4. Annas S, Zamri-Saad M, Jesse FF, Zunita Z
    Microb Pathog, 2015 Nov;88:94-102.
    PMID: 26298001 DOI: 10.1016/j.micpath.2015.08.009
    Haemorrhagic septicaemia (HS) is an acute, septicaemic disease of cattle and buffalo of Asia and Africa caused by Pasteurella multocida B:2 or E:2. Buffaloes are believed to be more susceptible than cattle. In this study, 9 buffaloes of 8 months old were divided equally into 3 groups (Groups 1, 3, 5). Similarly, 9 cattle of 8 months old were equally divided into 3 groups (Groups 2, 4, 6). Animals of Groups 1 and 2 were inoculated with PBS while Groups 3 and 4 were inoculated subcutaneously with 10(5) cfu/ml of P. multocida B:2. Animals of Groups 5 and 6 were inoculated intranasally with the same inoculum. Both buffaloes and cattle that were inoculated subcutaneously succumbed to the infection at 16 h and 18 h, respectively. Two buffaloes that were inoculated intranasally (Group 5) succumbed at 68 h while the remaining cattle and buffaloes survived the 72-h study period. Endotoxin was detected in the blood of infected cattle (Group 4) and buffaloes (Groups 3 and 5) prior to the detection of P. multocida B:2 in the blood. The endotoxin was detected in the blood of buffaloes of Group 3 and cattle of Group 4 at 0.5 h post-inoculation while buffaloes of Group 5 and cattle of Group 6 at 1.5 h. On the other hand, bacteraemia was detected at 2.5 h in buffaloes of Group 3 and cattle of Group 4 and at 12 h in buffaloes of Group 5 and cattle of Group 6. Affected cattle and buffaloes showed lesions typical of haemorrhagic septicaemia. These included congestion and haemorrhages in the organs of respiratory, gastrointestinal and urinary tracts with evidence of acute inflammatory reactions. The severity of gross and histopathology lesions in cattle and buffalo calves that succumbed to the infection showed insignificant (p > 0.05) difference. However, inoculated buffalo and cattle that survived the infection showed significantly (p < 0.05) less severe gross and histopathological changes than those that succumbed. In general, cattle are more resistant to intranasal infection by P. multocida B:2 than buffaloes.
    Matched MeSH terms: Africa
  5. Furuoka F, Hoque MZ, Jacob RI, Ziegenhain P
    Health Econ Policy Law, 2020 Oct;15(4):458-476.
    PMID: 30968812 DOI: 10.1017/S1744133119000197
    The Sustainable Development Goals set by the United Nations recognize the importance of making progress in the eradication and treatment of sexually transmitted deceases (STD). STD are among the most widespread diseases in the world and have the highest prevalence in Sub-Saharan Africa. The current study explored the associations between the allocation of the development assistance for health (DAH) in 54 African countries and key development indicators - STD incidence, Gross Domestic Product per capita, health expenditure, and life expectancy at birth. It employed descriptive statistical methods, the matrix scatter plot analysis and the Pearson correlation test for this purpose. The findings indicated that there was a considerable increase in the volume of the DAH given to control and prevent STD in Africa over the period of 2002-2011. A statistically significant positive association was detected between the STD incidence and the health aid allocations. At the same time, the imbalance in the distribution of the health aid between the major and minor aid recipients in the continent increased. The study concludes by discussing policy implications that can be drawn from these findings.
    Matched MeSH terms: Africa South of the Sahara
  6. Wang G, Guo Q, Zhou X, Zhang F
    Environ Sci Pollut Res Int, 2023 Jan;30(1):2315-2328.
    PMID: 35930151 DOI: 10.1007/s11356-022-22337-w
    Agricultural carbon emission is an important cause of climate change, and the carbon transfer caused by agricultural trade is a key area related to carbon emissions of all countries. Based on the Eora database, this paper aims to constructs a multi-region input-output database of 185 countries or regions, analyzes a spatial correlation network of embodied net carbon transfer in global agricultural trade by using UCINET, selects multi-dimensional network measurement indicators, and comprehensively studies the global evolution characteristics and functional features of network plate role of embodied carbon transfer in the global agricultural trade. The result shows that the embodied net carbon transfer network of global agricultural trade is densely connected, the spatial correlation spillover effect is significant, and the edge of the network core structure is clear. On the one hand, the top four countries or regions in terms of embodied carbon outflow in agricultural trade are the USA, Australia, Vietnam, and China. On the other hand, the top four countries or regions of embodied carbon inflow are Malaysia, Central Africa, Singapore, and Serbia. From the perspective of outdegree, indegree, proximity centrality, and intermediary centrality, Cambodia, the Netherlands, Vietnam, Ghana, and South Africa, with the high frequency of the shortest path of the globally embodied net carbon transfer network, have a strong influence and linking facility in spatial correlation and have a strong control ability to the spatial correlation of other countries or regions. The embodied carbon emission network of global agricultural trade can be divided into four sectors: main spillover, two-way spillover, broker, and main benefit. The main spillover segment, constituted by the USA, India, Germany, and China, has significant embodied carbon spillover effects on the internal segment and other segments. It is the main embodied carbon spillover sector of embodied net carbon transfer of global agricultural trade. Countries should reasonably allocate the responsibility of carbon reduction according to the trading embodied carbon transfer and made efforts to optimize the export structure of agricultural products.
    Matched MeSH terms: South Africa
  7. Cooper DLM, Lewis SL, Sullivan MJP, Prado PI, Ter Steege H, Barbier N, et al.
    Nature, 2024 Jan;625(7996):728-734.
    PMID: 38200314 DOI: 10.1038/s41586-023-06820-z
    Trees structure the Earth's most biodiverse ecosystem, tropical forests. The vast number of tree species presents a formidable challenge to understanding these forests, including their response to environmental change, as very little is known about most tropical tree species. A focus on the common species may circumvent this challenge. Here we investigate abundance patterns of common tree species using inventory data on 1,003,805 trees with trunk diameters of at least 10 cm across 1,568 locations1-6 in closed-canopy, structurally intact old-growth tropical forests in Africa, Amazonia and Southeast Asia. We estimate that 2.2%, 2.2% and 2.3% of species comprise 50% of the tropical trees in these regions, respectively. Extrapolating across all closed-canopy tropical forests, we estimate that just 1,053 species comprise half of Earth's 800 billion tropical trees with trunk diameters of at least 10 cm. Despite differing biogeographic, climatic and anthropogenic histories7, we find notably consistent patterns of common species and species abundance distributions across the continents. This suggests that fundamental mechanisms of tree community assembly may apply to all tropical forests. Resampling analyses show that the most common species are likely to belong to a manageable list of known species, enabling targeted efforts to understand their ecology. Although they do not detract from the importance of rare species, our results open new opportunities to understand the world's most diverse forests, including modelling their response to environmental change, by focusing on the common species that constitute the majority of their trees.
    Matched MeSH terms: Africa
  8. Sullivan MJ, Talbot J, Lewis SL, Phillips OL, Qie L, Begne SK, et al.
    Sci Rep, 2017 01 17;7:39102.
    PMID: 28094794 DOI: 10.1038/srep39102
    Tropical forests are global centres of biodiversity and carbon storage. Many tropical countries aspire to protect forest to fulfil biodiversity and climate mitigation policy targets, but the conservation strategies needed to achieve these two functions depend critically on the tropical forest tree diversity-carbon storage relationship. Assessing this relationship is challenging due to the scarcity of inventories where carbon stocks in aboveground biomass and species identifications have been simultaneously and robustly quantified. Here, we compile a unique pan-tropical dataset of 360 plots located in structurally intact old-growth closed-canopy forest, surveyed using standardised methods, allowing a multi-scale evaluation of diversity-carbon relationships in tropical forests. Diversity-carbon relationships among all plots at 1 ha scale across the tropics are absent, and within continents are either weak (Asia) or absent (Amazonia, Africa). A weak positive relationship is detectable within 1 ha plots, indicating that diversity effects in tropical forests may be scale dependent. The absence of clear diversity-carbon relationships at scales relevant to conservation planning means that carbon-centred conservation strategies will inevitably miss many high diversity ecosystems. As tropical forests can have any combination of tree diversity and carbon stocks both require explicit consideration when optimising policies to manage tropical carbon and biodiversity.
    Matched MeSH terms: Africa
  9. Mohammed M, Muhammad S, Mohammed FZ, Mustapha S, Sha'aban A, Sani NY, et al.
    J Racial Ethn Health Disparities, 2021 10;8(5):1267-1272.
    PMID: 33051749 DOI: 10.1007/s40615-020-00888-3
    BACKGROUND: The novel coronavirus disease (COVID-19) caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) was first reported in China and later spread rapidly to other parts of the world, including Africa. Africa was projected to be devastated by COVID-19. There is currently limited data regarding regional predictors of mortality among patients with COVID-19. This study aimed to evaluate the independent risk factors associated with mortality among patients with COVID-19 in Africa.

    METHODS: A total of 1028 confirmed cases of COVID-19 from Africa with definite survival outcomes were identified retrospectively from an open-access individual-level worldwide COVID-19 database. The live version of the dataset is available at https://github.com/beoutbreakprepared/nCoV2019 . Multivariable logistic regression was conducted to determine the risk factors that independently predict mortality among patients with COVID-19 in Africa.

    RESULTS: Of the 1028 cases included in study, 432 (42.0%) were females with a median (interquartile range, IQR) age of 50 (24) years. Older age (adjusted odds ratio {aOR} 1.06; [95% confidence intervals {95% CI}, 1.04-1.08]), presence of chronic disease (aOR 9.63; [95% CI, 3.84-24.15]), travel history (aOR 2.44; [95% CI, 1.26-4.72]), as well as locations of Central Africa (aOR 0.14; [95% CI, 0.03-0.72]) and West Africa (aOR 0.12; [95% CI, 0.04-0.32]) were identified as the independent risk factors significantly associated with increased mortality among the patients with COVID-19.

    CONCLUSIONS: The COVID-19 pandemic is evolving gradually in Africa. Among patients with COVID-19 in Africa, older age, presence of chronic disease, travel history, and the locations of Central Africa and West Africa were associated with increased mortality. A regional response should prioritize strategies that will protect these populations. Also, conducting a further in-depth study could provide more insights into additional factors predictive of mortality in COVID-19 patients.

    Matched MeSH terms: Africa/epidemiology
  10. Bhavadharini B, Mohan V, Dehghan M, Rangarajan S, Swaminathan S, Rosengren A, et al.
    Diabetes Care, 2020 11;43(11):2643-2650.
    PMID: 32873587 DOI: 10.2337/dc19-2335
    OBJECTIVE: Previous prospective studies on the association of white rice intake with incident diabetes have shown contradictory results but were conducted in single countries and predominantly in Asia. We report on the association of white rice with risk of diabetes in the multinational Prospective Urban Rural Epidemiology (PURE) study.

    RESEARCH DESIGN AND METHODS: Data on 132,373 individuals aged 35-70 years from 21 countries were analyzed. White rice consumption (cooked) was categorized as <150, ≥150 to <300, ≥300 to <450, and ≥450 g/day, based on one cup of cooked rice = 150 g. The primary outcome was incident diabetes. Hazard ratios (HRs) were calculated using a multivariable Cox frailty model.

    RESULTS: During a mean follow-up period of 9.5 years, 6,129 individuals without baseline diabetes developed incident diabetes. In the overall cohort, higher intake of white rice (≥450 g/day compared with <150 g/day) was associated with increased risk of diabetes (HR 1.20; 95% CI 1.02-1.40; P for trend = 0.003). However, the highest risk was seen in South Asia (HR 1.61; 95% CI 1.13-2.30; P for trend = 0.02), followed by other regions of the world (which included South East Asia, Middle East, South America, North America, Europe, and Africa) (HR 1.41; 95% CI 1.08-1.86; P for trend = 0.01), while in China there was no significant association (HR 1.04; 95% CI 0.77-1.40; P for trend = 0.38).

    CONCLUSIONS: Higher consumption of white rice is associated with an increased risk of incident diabetes with the strongest association being observed in South Asia, while in other regions, a modest, nonsignificant association was seen.

    Matched MeSH terms: Africa/epidemiology
  11. Bekun FV, Adekunle AO, Gbadebo AD, Alhassan A, Akande JO, Yusoff NYM
    Environ Sci Pollut Res Int, 2023 Sep;30(42):96301-96311.
    PMID: 37572252 DOI: 10.1007/s11356-023-28856-4
    The current study examines sustainable electricity consumption for economic growth in a small open and tourist economy. The energy-tourism nexus is evaluated for the relationship between sustainable electricity consumption and the international tourist arrival for the South African economy. The present study leverages on annual frequency data for South Africa from 1995 to 2019 for empirical analysis using the ARDL technique. Accordingly, empirical findings indicate a significant direct connection between the sustainable electricity consumption and the international tourism arrival; the study affirms that tourism-induced energy hypothesis is valid in South Africa. However, from a policy standpoint, alternative energy efficiency mechanisms such as renewable energy systems and emancipation of current energy management capabilities are recommended in South Africa. This is necessary for sustainable eco-friendly tourism that engenders clean energy consumption for the study area. More insights into policy caveats are presented in the concluding section.
    Matched MeSH terms: South Africa
  12. Khan MNA, Yunus RM
    Nutrition, 2023 Apr;108:111947.
    PMID: 36641887 DOI: 10.1016/j.nut.2022.111947
    BACKGROUND: The proper intake of nutrients is essential to the growth and maturation of youngsters. In sub-Saharan Africa, 1 in 7 children dies before age 5 y, and more than a third of these deaths are attributed to malnutrition. The main purpose of this study was to develop a majority voting-based hybrid ensemble (MVBHE) learning model to accelerate the prediction accuracy of malnutrition data of under-five children in sub-Saharan Africa.

    METHODS: This study used available under-five nutritional secondary data from the Demographic and Health Surveys performed in sub-Saharan African countries. The research used bagging, boosting, and voting algorithms, such as random forest, decision tree, eXtreme Gradient Boosting, and k-nearest neighbors machine learning methods, to generate the MVBHE model.

    RESULTS: We evaluated the model performances in contrast to each other using different measures, including accuracy, precision, recall, and the F1 score. The results of the experiment showed that the MVBHE model (96%) was better at predicting malnutrition than the random forest (81%), decision tree (60%), eXtreme Gradient Boosting (79%), and k-nearest neighbors (74%).

    CONCLUSIONS: The random forest algorithm demonstrated the highest prediction accuracy (81%) compared with the decision tree, eXtreme Gradient Boosting, and k-nearest neighbors algorithms. The accuracy was then enhanced to 96% using the MVBHE model. The MVBHE model is recommended by the present study as the best way to predict malnutrition in under-five children.

    Matched MeSH terms: Africa South of the Sahara
  13. Clark CS, Rampal KG, Thuppil V, Roda SM, Succop P, Menrath W, et al.
    Environ Res, 2009 Oct;109(7):930-6.
    PMID: 19656507 DOI: 10.1016/j.envres.2009.07.002
    In 2006 a report on the analysis for lead in 80 new residential paints from four countries in Asia revealed high levels in three of the countries (China, India and Malaysia) and low levels in a fourth country (Singapore) where a lead in paint regulation was enforced. The authors warned of the possible export of lead-painted consumer products to the United States and other countries and the dangers the lead paint represented to children in the countries where it was available for purchase. The need for a worldwide ban on the use of lead in paints was emphasized to prevent an increase in exposure and disease from this very preventable environmental source. Since the earlier paper almost 300 additional new paint samples have been collected from the four initial countries plus 8 additional countries, three from Asia, three from Africa and two from South America. During the intervening time period two million toys and other items imported into the United States were recalled because the lead content exceeded the United States standard. High lead paints were detected in all 12 countries. The average lead concentration by country ranged from 6988 (Singapore) to 31,960ppm (Ecuador). One multinational company sold high lead paint in one country through January 2007 but sold low lead paint later in 2007 indicating that a major change to cease adding lead to their paints had occurred. However, the finding that almost one-third of the samples would meet the new United States standard for new paint of 90ppm, suggests that the technology is already available in at least 11 of the 12 countries to produce low lead enamel paints for domestic use. The need remains urgent to establish effective worldwide controls to prevent the needless poisoning of millions of children from this preventable exposure.
    Matched MeSH terms: Africa
  14. Yokogawa M
    Adv Parasitol, 1969;7:375-87.
    PMID: 4935271
    Matched MeSH terms: Africa
  15. Rozali, A., Zakaria, A., Sherina, M.S., Muhd Amin, M., Mohd Ghazalli, M.T., Muhamad Ello, M.S., et al.
    MyJurnal
    Military personnel who are deployed for peace-keeping missions are exposed to many hazards, including infectious diseases. One of the most common and fatal infectious disease is Malaria. Although well controlled in Malaysia, this deadly disease is still widely endemic in many other countries especially Africa. We would like to report the case of a military personnel who was infected with Malaria during a peace-keeping mission in Sudan and subsequently died after returning home. We hope that by reporting this case in depth, strategic actions can be taken to avoid similar unfortunate events in future.
    Matched MeSH terms: Africa
  16. Park AW, Yaacob HB
    J Nihon Univ Sch Dent, 1991 Dec;33(4):211-43.
    PMID: 1787417
    Belief in a golden age has provided mankind with solace in times of despair and with élan during the expansive periods of history. Dreamers imagine the golden age in the remote past, in paradise lost, free from toil and grief. Optimists put their faith in the future and believe that mankind, Prometheus-like, will master the arts of life through power and knowledge. Thus, the golden age means different things to different men, but the very belief in its existence implies the conviction that perfect health and happiness are birthrights of men. Yet, in reality, complete freedom from disease and from struggle is almost incompatible with the process of living.
    Matched MeSH terms: Africa
  17. Tan CH, Wong KY, Huang LK, Tan KY, Tan NH, Wu WG
    Toxins (Basel), 2022 Dec 07;14(12).
    PMID: 36548757 DOI: 10.3390/toxins14120860
    Naja nivea (Cape Cobra) is endemic to southern Africa. Envenoming by N. nivea is neurotoxic, resulting in fatal paralysis. Its venom composition, however, has not been studied in depth, and specific antivenoms against it remain limited in supply. Applying a protein decomplexation approach, this study unveiled the venom proteome of N. nivea from South Africa. The major components in the venom are cytotoxins/cardiotoxins (~75.6% of total venom proteins) and alpha-neurotoxins (~7.4%), which belong to the three-finger toxin family. Intriguingly, phospholipase A2 (PLA2) was undetected-this is a unique venom phenotype increasingly recognized in the African cobras of the Uraeus subgenus. The work further showed that VINS African Polyvalent Antivenom (VAPAV) exhibited cross-reactivity toward the venom and immunorecognized its toxin fractions. In mice, VAPAV was moderately efficacious in cross-neutralizing the venom lethality with a potency of 0.51 mg/mL (amount of venom completely neutralized per milliliter of antivenom). In the challenge-rescue model, VAPAV prevented death in 75% of experimentally envenomed mice, with slow recovery from neurotoxicity up to 24 h. The finding suggests the potential para-specific utility of VAPAV for N. nivea envenoming, although a higher dose or repeated administration of the antivenom may be required to fully reverse the neurotoxic effect of the venom.
    Matched MeSH terms: South Africa
  18. Riveron JM, Ibrahim SS, Mulamba C, Djouaka R, Irving H, Wondji MJ, et al.
    G3 (Bethesda), 2017 06 07;7(6):1819-1832.
    PMID: 28428243 DOI: 10.1534/g3.117.040147
    Pyrethroid resistance in malaria vector, An. funestus is increasingly reported across Africa, threatening the sustainability of pyrethroid-based control interventions, including long lasting insecticidal nets (LLINs). Managing this problem requires understanding of the molecular basis of the resistance from different regions of the continent, to establish whether it is being driven by a single or independent selective events. Here, using a genome-wide transcription profiling of pyrethroid resistant populations from southern (Malawi), East (Uganda), and West Africa (Benin), we investigated the molecular basis of resistance, revealing strong differences between the different African regions. The duplicated cytochrome P450 genes (CYP6P9a and CYP6P9b) which were highly overexpressed in southern Africa are not the most upregulated in other regions, where other genes are more overexpressed, including GSTe2 in West (Benin) and CYP9K1 in East (Uganda). The lack of directional selection on both CYP6P9a and CYP6P9b in Uganda in contrast to southern Africa further supports the limited role of these genes outside southern Africa. However, other genes such as the P450 CYP9J11 are commonly overexpressed in all countries across Africa. Here, CYP9J11 is functionally characterized and shown to confer resistance to pyrethroids and moderate cross-resistance to carbamates (bendiocarb). The consistent overexpression of GSTe2 in Benin is coupled with a role of allelic variation at this gene as GAL4-UAS transgenic expression in Drosophila flies showed that the resistant 119F allele is highly efficient in conferring both DDT and permethrin resistance than the L119. The heterogeneity in the molecular basis of resistance and cross-resistance to insecticides in An. funestus populations throughout sub-Saharan African should be taken into account in designing resistance management strategies.
    Matched MeSH terms: Africa
  19. Wolfe N
    Sci. Am., 2009 Apr;300(4):76-81.
    PMID: 19363924
    Matched MeSH terms: Africa/epidemiology
  20. Wilson DB, Wilson ME
    Trans R Soc Trop Med Hyg, 1937;30:431-448.
    DOI: 10.1016/S0035-9203(37)90131-7
    1. 1. The results of various studies by other workers on the spleen and parasite rates in Indians, Malays and Bantu are summarized. 2. 2. The results of our own observations on Khonds in India, and on Masai and Bantu in East Africa are also summarized and compared with the foregoing and with one another. 3. 3. It is pointed out that wide differences may be found in the malarial status of communities in the same country and, in the case of the Bantu, of the same race; while close similarities occur in different countries. 4. 4. The results of experimental infections in birds and monkeys are cited and interpreted in terms of the two states of allergy and immunity. The probable significance of these is illustrated by reference to the role of the two states in tuberculosis. 5. 5. It is suggested that the observed contrasts in the spleen and parasite rates in diverse communities may also be explained in terms of immunity and hypersensitivity. 6. 6. It is concluded that the immune status is dependent not on race but on the frequency of infection; and that the most accurate index of endemicity is the frequency of infections in the non-immune, that is the rate in early infancy. 7. 7. While a consideration of the Spleen Rate and Endemic Index may be of value in forming an estimate of endemicity and immunity when similar communities are being compared, these indices may be misleading when the epidemiological surroundings are dissimilar. 8. 8. A consideration of the variation with age in the spleen and parasite rates throws more light on endemicity and immunity and on such variation a rough classification may be made into immune and sub-immune communities. 9. 9. But it is suggested that by far the most sensitive index at present available for field studies is the average parasite count, and its variation with age. c 1937.
    Matched MeSH terms: Africa
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