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The Guinea-Bissau Twin Registry Update: A Platform for Studying Twin Mortality and Metabolic Disease

  • Morten Bjerregaard-Andersen (a1) (a2) (a3) (a4), Gabriel Marciano Gomes (a1), Ditte Egegaard Hennild (a1) (a3) (a5), Dorte Møller Jensen (a6) (a7), Kaare Christensen (a8), Morten Sodemann (a1) (a5), Henning Beck-Nielsen (a3) (a6) and Peter Aaby (a1) (a2)...

Abstract

Sub-Saharan Africa has the highest natural twinning rate in the world. Unfortunately, due to lack of adequate care during pregnancy, labor and postnatally, twin mortality in Sub-Saharan Africa also remains very high. Thus, it has been estimated that one in five twins dies during the childhood years. In spite of this, surprisingly few twin studies have been conducted in the region, making additional epidemiological data much needed. In 2009, we established one of the first twin registries in Sub-Saharan Africa at the Bandim Health Project in Guinea-Bissau. The registry had two main objectives. First, we wanted to describe the twinning rate and mortality patterns among newborn twins, including mortality risk factors and hospitalization patterns. Such studies can help the local clinicians improve twin health by identifying the most vulnerable children. Second, and in light of the rapidly increasing diabetes rates in Africa, we wanted to use the registry to particularly focus on metabolic disorders. Twins are often born with low birth weight, which according to the ‘thrifty phenotype hypothesis’ could predispose them to metabolic disorders later in life. Yet, no such ‘fetal programming’ data have previously been available from African twins despite the fact that nutritional patterns and influences from other factors (e.g., infections) could be markedly different here compared to high-income settings. In this article, we summarize the findings and current status of the Guinea-Bissau twin registry.

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Corresponding author

Author for correspondence: Morten Bjerregaard-Andersen, Email: mban@dadlnet.dk

References

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Aaby, P., & Molbak, K. (1990). Siblings of opposite sex as a risk factor for child mortality. British Medical Journal, 301, 143145.
Aaby, P., Jensen, H., Rodrigues, A., Garly, M. L., Benn, C. S., Lisse, I. M., & Simondon, F. (2004). Divergent female-male mortality ratios associated with different routine vaccinations among female-male twin pairs. International Journal of Epidemiology, 33, 367373.
Akinboro, A., Azeez, M. A., & Bakare, A. A. (2008). Frequency of twinning in southwest Nigeria. Indian Journal of Human Genetics, 14, 4147.
Biai, S., Rodrigues, A., Gomes, M., Ribeiro, I., Sodemann, M., Alves, F., & Aaby, P. (2007). Reduced in-hospital mortality after improved management of children under 5 years admitted to hospital with malaria: Randomised trial. British Medical Journal, 335, 862862.
Bjerregaard-Andersen, M., Biering-Sorensen, S., Gomes, G. M., Bidonga, A., Jensen, D. M., Rodrigues, A., … Sodemann, M. (2014). Infant twin mortality and hospitalisations after the perinatal period — A prospective cohort study from Guinea-Bissau. Tropical Medicine & International Health, 19, 14771487.
Bjerregaard-Andersen, M., Gomes, M. A., Joaquim, L. C., Rodrigues, A., Jensen, D. M., Christensen, K., … Sodemann, M. (2013a). Establishing a twin registry in Guinea-Bissau. Twin Research and Human Genetics, 16, 179184.
Bjerregaard-Andersen, M., Hansen, L., da Silva, L. I., Joaquim, L. C., Hennild, D. E., Christiansen, L., … Beck-Nielsen, H. (2013b). Risk of metabolic syndrome and diabetes among young twins and singletons in Guinea-Bissau. Diabetes Care, 36, 35493556.
Bjerregaard-Andersen, M., Lund, N., Jepsen, F. S., Camala, L., Gomes, M. A., Christensen, K., … Sodemann, M. (2012). A prospective study of twinning and perinatal mortality in urban Guinea-Bissau. BMC Pregnancy Childbirth, 12, 140.
Bjerregaard-Andersen, M., Lund, N., Pinstrup Joergensen, A. S., Starup Jepsen, F., Werner Unger, H., Mane, M., … Stabell Benn, C. (2018). Stillbirths in urban Guinea-Bissau: A hospital- and community-based study. PLoS One, 13, e0197680.
Carvalho, ACC., Naforna, N., & Santos, G. (2018). A Prevalência da Diabetes Mellitus e Obesidade na População Adulta da Guiné-Bissau: Um Estudo Piloto. Revista Portuguesa de Endocrinologia, Diabetes e Metabolismo, 13, 26.
Christensen, K., & Bjerregaard-Andersen, M. (2017). Twin-singleton early-life survival in sub-Saharan Africa. Lancet Global Health, 5, e636e637.
Frost, M., Petersen, I., Brixen, K., Beck-Nielsen, H., Holst, J. J., Christiansen, L., … Christensen, K. (2012). Adult glucose metabolism in extremely birthweight-discordant monozygotic twins. Diabetologia, 55, 32043212.
Groot, M. C., & Buchmann, E. J. (2003). Where there is no ultrasound: Delay and failure of antenatal diagnosis of twin pregnancy. Tropical Doctor, 33, 57.
Hales, C. N., & Barker, D. J. (2001). The thrifty phenotype hypothesis. British Medical Bulletin, 60, 520.
Hennild, D. E., Bjerregaard-Andersen, M., Joaquim, L. C., Christensen, K., Sodemann, M., Beck-Nielsen, H., & Jensen, D. M. (2016). Prevalence of impaired glucose tolerance and other types of dysglycaemia among young twins and singletons in Guinea-Bissau. BMC Endocrine Disorders, 16, 46.
Hur, Y. M., Kim, J. W., Chung, K. W., Shin, J. S., Jeong, H. U., & Auta, E. (2013). The Nigerian twin and sibling registry. Twin Research and Human Genetics, 16, 282284.
International Diabetes Federation. (2017). IDF diabetes atlas. https://www.idf.org/
Justesen, A., & Kunst, A. (2000). Postneonatal and child mortality among twins in Southern and Eastern Africa. International Journal of Epidemiology, 29, 678683.
Kuhn, L., Kasonde, P., Sinkala, M., Kankasa, C., Semrau, K., Scott, N., … Thea, D. M. (2005). Does severity of HIV disease in HIV-infected mothers affect mortality and morbidity among their uninfected infants? Clinical Infectious Diseases, 41, 16541661.
Miyahara, R., Jasseh, M., Mackenzie, G. A., Bottomley, C., Hossain, M. J., Greenwood, B. M., … Roca, A. (2016). The large contribution of twins to neonatal and post-neonatal mortality in The Gambia, a 5-year prospective study. BMC Pediatrics, 16, 39.
Monden, C. W. S., & Smits, J. (2017). Mortality among twins and singletons in sub-Saharan Africa between 1995 and 2014: A pooled analysis of data from 90 Demographic and Health Surveys in 30 countries. Lancet Global Health, 5, e673e679.
Pastakia, S. D., Pekny, C. R., Manyara, S. M., & Fischer, L. (2017). Diabetes in sub-Saharan Africa — From policy to practice to progress: Targeting the existing gaps for future care for diabetes. Diabetes, Metabolic Syndrome and Obesity, 10, 247263.
Petersen, I., Nielsen, M. M., Beck-Nielsen, H., & Christensen, K. (2011). No evidence of a higher 10 year period prevalence of diabetes among 77,885 twins compared with 215,264 singletons from the Danish birth cohorts 1910–1989. Diabetologia, 54, 20162024.
Pinstrup Joergensen, A. S., Bjerregaard-Andersen, M., Biering-Sorensen, S., Byberg, S., Camala, L., Martins, C., … Stabell Benn, C. (2018). Admission and mortality at the main neonatal intensive care unit in Guinea-Bissau. Transactions of the Royal Society of Tropical Medicine and Hygiene, 112, 335341.
Pison, G. (1992). Twins in Sub-Saharan Africa: Frequency, social status and mortality. In van de Walle, E., Pison, G., & Sala-Diakanda, M. (Eds.), Mortality and society in Africa (pp. 253278). Oxford, UK: Clarendon Press.
Poulsen, P., & Vaag, A. (2006). The intrauterine environment as reflected by birth size and twin and zygosity status influences insulin action and intracellular glucose metabolism in an age- or time-dependent manner. Diabetes, 55, 18191825.
Poulsen, P., Grunnet, L. G., Pilgaard, K., Storgaard, H., Alibegovic, A., Sonne, M. P., … Vaag, A. (2009). Increased risk of type 2 diabetes in elderly twins. Diabetes, 58, 13501355.
Tomar, A. S., Tallapragada, D. S., Nongmaithem, S. S., Shrestha, S., Yajnik, C. S., & Chandak, G. R. (2015). Intrauterine programming of diabetes and adiposity. Current Obesity Reports, 4, 418428.
Vaag, A., & Poulsen, P. (2007). Twins in metabolic and diabetes research: What do they tell us? Current Opinion in Clinical Nutrition and Metabolic Care, 10, 591596.

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