The incidence of hemoglobinopathies (Hb C and Hb S) is relatively high in West Africa. In order to calculate the gene frequency of these hemoglobinopathies, 6619 students from 23 local schools in Ouagadougou, Burkina Faso, West Africa, and 2582 individuals living in five villages near Ouagadougou, all situated in Savanna, were studied. As expected, the gene frequency in the city schools was 0.111 for the betaC gene and 0.051 for the betaS gene; in the five villages it was 0.122 for the betaC gene and 0.047 for the betaS gene. This data is somewhat different from that published in a previous study by Labie et al. [2] in the humid Savanna region, that showed a higher prevalence of betaC (0.14) than betaS (0.03), and is in contrast to data from the arid Sahel region that showed a higher prevalence of betaS (0.1) compared to betaC (0.05). The higher rate of betaS and lower rate of betaC in students in Ouagadougou, and in the individuals living in the five villages near Ouagadougou, suggest the possible influence of migratory fluxes of the betaS gene from the country region of Sahel. The dramatic increase in the prevalence of Hb SS patients, not reported in the study of Labie et al., [2] may be the result of reduced mortality due to environmental change. In addition, the improved health conditions of Hb SC and the increased life expectancy of Hb SS, may also have facilitated the increase of the betaS gene and the focus on secondary prevention for the control of correlated diseases.

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The incidence of hemoglobinopathies (Hb C and Hb S) is relatively high in West Africa. In order to characterize the clinical phenotypes of these hemoglobinopathies 10,166 subjects were studied for suspected hemoglobinopathies at the Laboratory of the Centre Medical Saint Camille (CMSC), Ouagadougou, Burkina Faso. A high rate of Hb SC (6.49%) and Hb SS (1.93%) individuals were detected at the CMSC as a consequence of a selective process, whereby patients with anemia or symptoms of vascular occlusive crisis underwent blood tests. The higher frequency of Hb SC may be explained by the fact that this condition is less severe than the SS status, and it requires frequent clinical and laboratory review. On the other hand, the frequency of Hb CC is very low because it does not interfere with their health status. Moreover, the high percentage of Hb S (12.29%) and Hb C (19.28%) trait individuals may be explained by the fact that, in general, all Hb SS and Hb SC patients followed at the CMSC have parents, siblings and other relatives who could have been referred by the center to receive blood tests. The dramatic increase over the past few years in the prevalence of Hb SS [who were absent in the 1984 study of Labie et al. [5]] and of Hb SC, may be attributed to its reduced lethality due to social and health changes. In conclusion, secondary prevention for the control of concurrent and associated diseases is essential in Hb SS and Hb SC patients for improving health and life expectancy.

Background: The administration of hydrating solutions and early refeeding improve recovery for infants and children with diarrhea.Objective: The aim of this study was to assess the efficacy of a low-osmolarity (30 mEq/L Na ϩ ) solution administered after the standard, high-osmolarity (90 mEq/L Na ϩ ) solution via a nasogastric tube (NGT) and followed by early refeeding to achieve more rapid body weight recovery in infants and children with acute diarrhea.Methods: Infants and children aged Ͻ5 years with acute diarrhea and dehydration (body weight loss of Ն10%) observed from January to August 2001 at Saint Camille Medical Center, Ouagadougou, Burkina Faso, were enrolled. Patients were randomized to 1 of 3 treatment protocols. Patients in group A received, via NGT, rehydration with a high-osmolarity solution for 3 hours, followed by a low-osmolarity solution for at least 3 additional hours. Patients in group B were given only a low-osmolarity solution via NGT. In group C, rehydration was carried out using a high-osmolarity solution via NGT.Results: Four thousand consecutively treated infants and children (2010 boys, 1990 mean [SD] age, 3.5 [2.7] years) were enrolled. After the first 6 hours of infusion, 90% of the patients who had received the combined rehydration (group A) showed significant body weight recovery, versus 80% and 79% of the patients in groups B and C, respectively. Stool output significantly decreased for group A compared with groups B and C (114 vs 125 and 120 g/kg, respectively). Only 7% of the patients in group A required prolonged rehydration (Ͼ6 hours) with the low-osmolarity solution, versus 10% and 12% in groups B and C, respectively. A total of 3% of patients treated with combined rehydration required hospitalization, compared with 10% and 9% in groups B and C, respectively. At the end of infusion, 25% of the patients rehydrated only with a lowosmolarity solution showed poor body weight recovery and appeared lethargic, 189CURRENT THERAPEUTIC RESEARCH versus 10% in group A and 15% in group C. Patients who were rehydrated with a high-osmolarity solution showed symptoms of hypernatremia (serum Na ϩ concentration Ͼ140 mEq/L). At the end of rehydration (Ն6 hours), all patients recovered their previous body weight, partially or totally, and refeeding was begun. Rehydration and diet were continued at home, or in neighboring areas for those living far away. Conclusions:In this study population, the administration of a high-osmolarity solution followed by a low-osmolarity solution and early refeeding was effective in the treatment of acute diarrhea and was well tolerated. (Curr Ther Res Clin Exp. 2003;64:189-202)

Objective: To study the incidence of hemoglobinopathies (Hb C and Hb S) we have examined 15,367 students, aged 11.4 +/-4.64 years (median 11; range 1-26), living in Burkina Faso (12,019 were students of 23 public schools of Ouagadougou and 3348 students of 7 public schools situated in six villages about 12-35 Km from Ouagadougou).Results: In all schools, we found a prevalence of females (54.2%) over males (45.8%) with a high incidence of Hb AC (19.16%), over Hb AS (8.35%). As expected, the gene frequency of B C in the schools of Ouagadougou was 0.112 +/-0.015 and of B S 0.049 +/-0.012, and this was similar in village schools (0.128 +/-0.010 and 0.049 +/-0.09 respectively), irrespective of town latitude. In all groups studied, 13 S and 13 C gene frequencies were age dependent since the advantage of HbS carriers in a malarial region is prevalently expressed in the first years of life. In fact, 13 C gene frequency increases, and 13 S decreases with age. The Mossi, living mainly in Ouagadougou, show a gene frequency which is similar to the Bissa ethnic groups, where the 13 C gene frequencies (0.116 and 0.118) are higher than the 13 S (0.049 and 0.044 respectively). On the contrary in the Peuhl ethhic group 13 C and 13 S gene frequencies (0.049 and 0.049) are the same, while in the Yorouba ethnic group immigrated from Nigeria 13 S gene frequency is higher (0,117) than the 13 C (0.068), showing that different genr frequencies are found in different ethnic groups. Conclusion: The difference in 13 S and 13 C genes frequencies (0.049 and 0.116) found in comparison with a previously performed study (Labie et al, 1984) in the same region (0.03 for the B S gene and 0.14 for the 13 C gene)~ may be due to migration flow of 13 S genes from the near Sahel region or to changes in life expectancy of children with 13 C and i~ S phenotypes. Moreover, the high percentage of SC (1,06%) and SS (0.188%) individuals detected with the present screening, compared with the lower percentages found by Labie et al in 1984, suggest that a modified environment can play an important role in reducing the morbility and lethality of 13 S genotype. HoweVer, even today the number of students affected by HbSC and lib SS attending the schools remains low. Stricter controls of correlated diseases are necessary to guarantee healthier life conditions. Anthropological consideration on prevalence fitness of B C and B S genotypes in Burkins Faso (a survey in the public schools) is a reprint of the publication published in the last issue