Wednesday, April 01, 2009

BACK TO THE SOMALI MATTER

A few months back, we were talking about the perceived rise in diagnosed ASD among the families of Somali immigrants living in the Minneapolis area (see here, here, and here). Well, it seems those parents just might not be crazy after all. Of course, the powers that be are not yet willing to acknowledge that point.

As the Associated Press reported:
The Health Department studied Minneapolis public school autism programs for the three years starting with the 2005 school year. Researchers found the percentage of Somali children in the programs was two to seven times higher than non-Somali children.

“What that doesn't prove is that more Somali children have autism,” Health Commissioner Sanne Magnan said Tuesday. “That is the question that is still on the table.”
. . .
. . . the report said that one of the big questions is whether children might be misclassified when evaluators aren’t familiar with the child’s language, culture and behaviors that might be routine among some racial or ethnic groups.
Here’s a little clue for the Minnesota Health Department. If the parents have been confronted with something they never (or at least rarely) saw in children in their native land, and it’s now occurring at an alarming rate after they moved here, something is going on.

The New York Times quoted a CDC official, who seems to indicate that the agency is willing to take its usual head-in-the-sand approach:
The study was done in consultation with the federal Centers for Disease Control and Prevention. Coleen Boyle, director of the agency’s division of birth defects and developmental disabilities, called the study well done but preliminary, adding, “It highlights the importance of ongoing monitoring.”

There are no plans yet to study autism in Somalis elsewhere or to do genetic studies, Dr. Boyle said.

Why is no thought given to a study that might actually tell us something: an examination about what might be different between these families’ lives in Somalia and their lives here in the US. Is it because such a study might actually tell us something?

2 Comments:

Blogger María Luján said...

Hi Wade
There are several avenues of research and lots lots of literature on the topics- some of that Mark Blaxill mentioned in his post
a) the vitamin D metabolism consideration and its implicancies in the adverse reactions to xenobiotics in general-(over)vaccination, antibiotics, chemicals in general- from air,water and food and other known differences in african inmigrants (vitamin A, iron deficiency and vitamin D deficiency
Arch Dis Child. 2007 Dec;92(12):1088-93. .
High prevalence of asymptomatic vitamin D and iron deficiency in East African immigrant children and adolescents living in a temperate climate.McGillivray G, Skull SA, Davie G, Kofoed SE, Frydenberg A, Rice J, Cooke R, Carapetis JR.
Murdoch Children's Research Institute, Melbourne, Australia.

OBJECTIVES: Vitamin D deficiency (VDD) is common in immigrant children with increased skin pigmentation living in higher latitudes. We assessed the pattern of and risk factors for VDD in immigrant East African children living in Melbourne (latitude 37 degrees 49' South). STUDY DESIGN: A prospective survey of 232 East African children attending a clinic in Melbourne. Data were collected by questionnaire, medical assessment and laboratory tests. RESULTS: Low 25-hydroxyvitamin D (25-OHD) levels (<50 nmol/l) occurred in 87% of children, and VDD (25-OHD <25 nmol/l) in 44%. Risk factors included age <5 years, female gender, increased time in Australia, decreased daylight exposure and winter/spring season. Anaemia (20%), vitamin A deficiency (20%) and iron deficiency (19%) were also identified. CONCLUSIONS: Asymptomatic VDD is common in East African immigrant children residing at a temperate latitude. Risk factors for VDD limit endogenous vitamin D production. Screening of immigrant children with increased skin pigmentation for VDD, anaemia, iron and vitamin A deficiency is appropriate. VDD in adolescent females identifies an increased risk of future infants with VDD.
Br J Gen Pract. 2007 Jul;57(540):577-9.

Br J Gen Pract. 2007 Oct;57(543):836-7.
Vitamin D deficiency in multicultural primary care: a case series of 299 patients.Mytton J, Frater AP, Oakley G, Murphy E, Barber MJ, Jahfar S.
University of The West of England, Bristol. Julie.
An increase in diagnoses of vitamin D deficiency prompted a review of cases from four general practices. Of the 299 cases identified, the predominant patient group comprised adult Somali females presenting with symptoms of chronic musculoskeletal pain. Women of childbearing age were particularly at risk. Known at-risk groups were not receiving supplementation. Significant clinical need appears not to be met in this population group and consideration of vitamin D deficiency during consultations is warranted.
http://www.pubmedcentral.nih.gov/articlerender.fcgi?tool=pubmed&pubmedid=17727752
and
CONCLUSIONS: Vitamin D insufficiency, as reflected by low 25(OH)D serum concentrations, was a universal finding in this group of women, suggesting the need for widespread education and intervention in this and other immigrant groups at northern latitudes.
from
J Womens Health (Larchmt). 2007 Mar;16(2):206-13.
Prevalence of vitamin D insufficiency and clinical associations among veiled East African women in Washington State.Reed SD, Laya MB, Melville J, Ismail SY, Mitchell CM, Ackerman DR.
The deficiency of vitamin D in pregnancy may cause seizures in the newborn- reported.
The Calcium and vitamin D3 status in inmigrants-mainly from Africa has been found to be low in high percentages of this population- not only in USA but Also in Australia and in Sweden.
b) the genetic predisposition to autoimmune or inflammatory conditions in Somali population by gender-
and the diagnosis of ASD in children- with all the different subgroups including Aspergers.

Probably this is particularly interesting to me, because my son demonstrated to be a severe Vitamin D3 deficient...

4/1/09, 7:21 PM  
Blogger Wade Rankin said...

María,

Thanks so much for the comment, which underscores that a direction for reasonable inquiry is not a matter of shooting in the dark.

4/1/09, 7:45 PM  

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