1969
DOI: 10.1016/0035-9203(69)90120-5
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Epidemiology of viral hepatitis in Accra, Ghana

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1971
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Cited by 11 publications
(10 citation statements)
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“…This may account for an underestimate of G6PD deficiency in Hb AS and Hb SS indi viduals in the present study as well as in previous reports [28], While it has been proposed by Lewis and Iiathorn [16] that G6PD deficiency modifies the clinical sever ity of sickle cell anemia by causing an im proved fitness, this has not been demon strated [11,13]. On the contrary, it is pro posed that the increased fitness of Gd A -/H b AS individuals is accorded by the in creased G6PD enzyme levels in G6PD-deficient males in the presence of Hb S. It has been established that viral hepatitis, and perhaps other infectious agents, including influenza A virus, may induce hemolytic anemias with a more severe clinical course of hepatitis in individuals deficient in G6PD than in G6PD-normal individuals, leading to a high rate of acute hepatic coma, pro longed hyperbilirubinemia, massive intra vascular hemolysis, and death [5,12,21,22,26,27], Hepatic disease was more se vere in both G6PD-deficient males and fe males than in G6PD-normal individuals, and the highest rates of viral hepatitis were in the age group of 15-44 years [21,22]. Viral hepatitis is common in Africa, the preva lence of hepatitis B surface antigen in the general population being from 1 to 6°/o [29]; yet viral hepatitis may be only one of sev eral or many factors (including falciparum malaria) producing oxidative stress which may select against G6PD deficiency.…”
Section: Discussionmentioning
confidence: 99%
“…This may account for an underestimate of G6PD deficiency in Hb AS and Hb SS indi viduals in the present study as well as in previous reports [28], While it has been proposed by Lewis and Iiathorn [16] that G6PD deficiency modifies the clinical sever ity of sickle cell anemia by causing an im proved fitness, this has not been demon strated [11,13]. On the contrary, it is pro posed that the increased fitness of Gd A -/H b AS individuals is accorded by the in creased G6PD enzyme levels in G6PD-deficient males in the presence of Hb S. It has been established that viral hepatitis, and perhaps other infectious agents, including influenza A virus, may induce hemolytic anemias with a more severe clinical course of hepatitis in individuals deficient in G6PD than in G6PD-normal individuals, leading to a high rate of acute hepatic coma, pro longed hyperbilirubinemia, massive intra vascular hemolysis, and death [5,12,21,22,26,27], Hepatic disease was more se vere in both G6PD-deficient males and fe males than in G6PD-normal individuals, and the highest rates of viral hepatitis were in the age group of 15-44 years [21,22]. Viral hepatitis is common in Africa, the preva lence of hepatitis B surface antigen in the general population being from 1 to 6°/o [29]; yet viral hepatitis may be only one of sev eral or many factors (including falciparum malaria) producing oxidative stress which may select against G6PD deficiency.…”
Section: Discussionmentioning
confidence: 99%
“…The average figure for all surveys in Ghana is 17% (table II). In Ghana, a higher than expected incidence of G -6-PD deficiency has been reported in neonatal jaundice [5], infectious hepatitis [8,9], in ty phoid fever [10J and in sickle cell disease [11]. These findings arc sum marized in table III.…”
mentioning
confidence: 63%
“…The report of a higher than expected incidence of G -6-PD deficiency in sickle cell trait [11] must be regarded with suspicion because most of the A A individuals were normal volunteers while many of the A S individ uals had infectious hepatitis [8], However, in Saudi Arabia such a corre lation has been proven [13]. The assessment of an association between sickle cell anaemia and G-6-PD deficiency is more complicated.…”
mentioning
confidence: 99%
“…In West African cities morbidity and mortality rates from viral hepatitis are particularly high among young adults (Mabayoje, 1962;Ogunlesi, 1962;Payet et al, 1962;Morrow et al, 1968). The increase of hepatitis in Accra since the second world war has accompanied the development of shanty towns with poor sanitation, accommodating the large number of young men looking for work, and where the spread of infection is attributed to gross faecal pollution (Morrow et al, 1969).…”
Section: Introductionmentioning
confidence: 99%
“…Liver biopsies from these patients show a distinctive histological pattern of a "glandular" transformation of liver cells around bile canaliculi, a high frequency of cholestasis, and a paucity of acidophilic bodies (Morrow et al, 1968(Morrow et al, , 1969.…”
Section: Introductionmentioning
confidence: 99%