Challenges in collecting clinical samples for research from pregnant women of South Asian origin: evidence from a UK study.

Objective: To recruit South Asian pregnant women, living in the UK, into a clinicoepidemiological study for the collection of lifestyle survey data and antenatal blood and to retain the women for the later collection of cord blood and meconium samples from their babies for biochemical analysis. Design: A longitudinal study recruiting pregnant women of South Asian and Caucasian origin living in the UK. Setting: Recruitment of the participants, collection of clinical samples and survey data took place at the 2 sites within a single UK Northern Hospital Trust. Participants: Pregnant women of South Asian origin (study group, n=98) and of Caucasian origin (comparison group, n=38) living in Leeds, UK. Results: Among the participants approached, 81% agreed to take part in the study while a ‘direct approach’ method was followed. The retention rate of the participants was a remarkable 93.4%. The main challenges in recruiting the ethnic minority participants were their cultural and religious conservativeness, language barrier, lack of interest and feeling of extra ‘stress’ in taking part in research. The chief investigator developed an innovative participant retention method, associated with the women’s cultural and religious practices. The method proved useful in retaining the participants for about 5 months and in enabling successful collection of clinical samples from the same mother–baby pairs. The collection of clinical samples and lifestyle data exceeded the calculated sample size required to give the study sufficient power. The numbers of samples obtained were: maternal blood (n=171), cord blood (n=38), meconium (n=176), lifestyle questionnaire data (n=136) and postnatal records (n=136). Conclusions: Recruitment and retention of participants, according to the calculated sample size, ensured sufficient power and success for a clinicoepidemiological study. Results suggest that development of trust and confidence between the participant and the researcher is the key to the success of a clinical and epidemiological study involving ethnic minorities

Importance of Acetylator Phenotype in the Identity of Asian Populations

The Marma, Tripura, and Chakma are tribal populations of South Asian countries such as Bangladesh. The populations are thought to be immigrants who started moving from their original home in the Far East toward the west and south.We randomly selected 80 Marma, 53 Tripura, and 43 Chakma to determine acetylation capacity and acetylator phenotype. The mean acetylation capacities were 63% in the Marma, 65% in the Tripura, and 70% in the Chakma. The acetylator phenotype was bimodally distributed as fast and slow acetylator. The frequencies of fast acetylator were 83% in the Marma, 89% in the Tripura, and 88% in the Chakma. According to acetylation capacity, the tribes are different from the founder nontribal populations of Bangladesh. They identify themselves as having a separate single population origin. The frequency of fast acetylator predicted served as the acetylator status of the Far East Asian population. The segregation of populations by acetylator phenotype on geographic longitude might be appropriate for geonational identification of Asian populations