The health requirements of pygmies is poorly understood because of their continued isolation from the other tribes in Central Africa. This study was undertaken among the Baka pygmies of the Eastern Province of Cameroon to generate basic health data among them. A total of 141 adults (18-45 years) were tested for the hepatitis B surface antigen (HBsAg), antibody to the surface antigen (anti-HBs), antibody to the core antigen (anti-HBc) and antibody to the hepatitis C virus (anti-HCV). All HBsAg-positive sera were tested for the hepatitis B e antigen (HBeAg) and antibody (anti-HBe). The presence of antibodies to the hepatitis D virus was determined in most of the anti-Hbs-positive sera, and some of the HBsAg-positive sera. In addition to these, previous infection with syphilis, measles, HIV 1/2 and HTLV were determined by looking for the specific antibodies. We found HBsAg in 14.2% (20/141), anti-HBs in 93.6% (132/141), anti-HBs in 52.2% (73/140), anti-HCV in 7.9% (11/139, measles antibody in 99.3% (139/140), antibody to Treponema pallidum in 13.4% (18/134), antibody to HTLV-1 in 10.9% (15/138) and antibody to HIV-1 in 0.7% (1/140) of the sera tested.

Cholecystosonography was undertaken in 90 patients with sickle cell disease aged 15 years and over. Gall stones were found in 26 (28.9%) patients. There was no sex difference, but the incidence increased with age from 13.2% at under 20 years to 75% at 30 years and over. The mean serum cholesterol and total and unconjugated bilirubin concentrations were not significantly different between patients with and without gall stones. As most (80.8%) stones were radiolucent they were probably of pigment type, containing little or no calcium, and further investigation into how they are produced is needed. Sickle cell patients with acute abdominal crisis should have gall bladder disease excluded before a diagnosis ofvascular crisis is made.Sickle cell disease is a major health problem in Africa, especially south of the Sahara. In Cameroon, which stretches from latitude 20 to 13°N ofthe equator, the carrier state ranges from 10-25% of the population in the southern parts of the country to 30-40% in the northern parts. 1 2 Anaemia is the commonest complication due to haemolysis of the sickled cells, but the deposition of the resulting excess pigment as a possible predisposing factor to other complications has received little attention.Sickle cell disease was formerly primarily a paediatric problem, but better management has led to more children surviving to adulthood and thus developing other complications of their disease.In view of the increase in the number of patients with sickle cell disease who survive into adulthood in our region and also the increased incidence of gall stones with age,3 we thought that a study of gall stone disease in this highly selected group of patients was indicated. The hiatus in our knowledge of gall stone disease in Cameroonian patients with sickle cell disease, the need to establish its prevalence, and the need to evaluate radiology as a diagnostic tool led us to undertake this study. Cholesterol concentrations were determined using the oxidase method, total bilirubin concentrations using the diazo reaction with diazotised sulphanilic acid in the presence of dimethylsulphoxide, and unconjugated bilirubin concentrations by the diazo reaction without dimethylsulphoxide.After an overnight fast all 90 patients were screened for gall stones using real time cholecystosonography and a 3 5 MHz transducer. The examination was conducted in both the supine and the left lateral decubitus positions. When the need arose it was carried out in an erect position. Multiple tomographic sections, parallel to and perpendicular to the long axis of the gall bladder were obtained. Gall stones were identified as the presence of intravesicular hyperechogenic structures with acoustic shadows, mobile with gravity in a pear shaped gall bladder whose expanded lower end, tapered proximal contour, and relation to the liver fossa could be seen.Patients who were found to have gall stones were further investigated by two anteroposterior plain x ray examinations of the abdomen: one centred on the right hypochondrium a...

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