Search

Two hundred and four (204) consecutive adult asthmatic patients who visited the outpatient clinic of Jima Institute of Medical Sciences from May 1 to August 30, 1989 were prospectively studied. Data on age, sex, ethnic distribution and the associated etiological factors were documented. The age range was from 17-75 (mean 33.4) years and the male to female ratio was 1.4:1. The majority (80%) were not members of the ethnic group indigenous to the area. Of the total, 175 (85%) were not natives of Jima town and its surroundings. One hundred and fifty (85.7%) of the latter developed the disease in Jima. Ninety-six (64%) of the 150 patients contracted the disease in less than 5 years of their stay in the area. Infections, emotional stress, dust, and weather changes were the main precipitating factors. The majority of the attacks occurred from June to October. Allergic rhinitis was present in 88% of the patients and atopic dermatitis in 3%. Forty-one (20%) patients had a family history of asthma. Forty-eight percent of the patients claimed that change of climate relieved their symptoms. Eosinophilia was documented in 51.5% and parasitic infestations were observed in 39% of patients. The study shows that a variety of environmental factors such as pollen dust, fungus and climatic changes play a major role and may account for the high performance of asthma in Jima town. It is recommended that further studies be conducted to find out the causative factors so that appropriate preventive measures can be implemented.

The presence of DQA and DQB alleles conferring protection or susceptibility was assessed in a panel of 39 insulin-dependent diabetes mellitus patients and 39 healthy control subjects from the central highland of Ethiopia. The results were grouped into three entities: a combination of alleles conferring susceptibility, a group conferring protection, and a group without any apparent HLA-DQ or -DR predisposition to insulin-dependent (type 1) diabetes mellitus (IDDM). Statistical analysis revealed that the relative risk of the first group is 64.1. If a similar approach is applied to the data on a study in caucasoid IDDM patients and controls of Kahlil and colleagues, the pattern is fully consistent with the data presented here, with an extraordinarily high relative risk (RR 258.2). It will be of interest to study whether this subdivision is reflected or supported by clinical or etiologic differences of the disease. The predictive value of susceptibility phenotypes appears to be more accurate by the proposed subdivision. Furthermore, in combination with islet-cell antibody analysis, assessment of genotype will permit more accurate identification of prediabetic individuals to be entered in clinical trials.

Thirty Ethiopian malnutrition-related diabetes mellitus (MRDM) patients were HLA typed and their HLA antigen frequencies were compared to those of 31 previously typed insulin-dependent diabetes mellitus (IDDM) patients and to 84 controls from the same ethnic background. In comparison to controls, a striking association between MRDM and HLA-DR3 (X2 = 15.15, p = 0.0001) was observed, whereas the frequency of HLA-DR4 was non-significantly increased (RR = 1.72). The frequency of DR2, DQw1, and DQw6 was decreased among MRDM. In comparison to IDDM that is associated with both DR3 and DR4 in this population, MRDM showed no significant differences in HLA class II antigens frequencies. Therefore, the genetic basis of susceptibility to MRDM and IDMM in Ethiopia is at least partially identical.