Prevalence of onchocercal skin disease and infection among workers of coffee plantation farms in Teppi,southwestern Ethiopia

In June 1996, a study on the economic impacts of onchocercal skin disease was initiated in southwestern Ethiopia. We made parasitological and clinicoepidemiological investigations among 1619 workers of a coffee plantation firm in Teppi, south-western Ethiopia. Sixty percent of the workers were included in the study. The prevalence of onchocercal skin disease (OSD) was 85.3%. Severe OSD (SOSD) was found in 17.3% of the study subjects. This was 1/5 of all OSD cases. The overall nodule carrier rate was 44.2%, which differed significantly by age classes from a rate of 12.3% to 73.0%. This rate varied by sex, 51.7% in males and 22.6% in females. Microfilarial carrier rate (MFCR) was 77.6%. This rate did not vary neither with severity of disease nor with presence or absence of pruritus or onchodermatitis. Mean microfilarial count was determined to be 38.1 per mg of skin snip or 44.4 per mg of infected skin snips. The geometric mean of microfilarial load per infected skin was 23.8. The community microfilarial load (CMFL) was estimated to be 14.0 per mg skin snip. The study showed that SOSD is prevalent in Teppi and affects a substantial number of the working population. An intervention program is called for.     

Schistosome infection among river rafters on Omo River, Ethiopia

BACKGROUND: Adventure trips to Africa have become more frequent, and rafting on some of the great rivers has become almost commonplace. We describe three rafting trips on the Omo River in Ethiopia, after which most of the participants were diagnosed with schistosomiasis. METHODS: After index cases from the three groups came to medical attention, active surveillance detected outbreaks of illness in a group of American travelers (n = 18 ) in 1993 and in two groups of Israeli travelers in 1997 (n = 26). RESULTS: Of 44 travelers, 37 were screened and 28 (76%) were infected, all with Schistosoma mansoni. Among the infected patients, 16 of 28 (57%) were symptomatic, the most frequent manifestation being fever, which occurred in 14 of 25 (56%); cough occurred in 6 of 18 (33%). Diagnosis was based on FAST-enzyme-linked immunosorbent assay, with confirmation by immunoblot. Other rafting trips on the Omo River sponsored by the same tour companies did not result in symptomatic infection. Investigation of the rafting itineraries suggested the route may have been altered from the usual for these three groups, exposing them to a part of the river that is wider, slower moving, and more densely populated. CONCLUSIONS: Schistosomiasis should be considered in febrile patients following rafting trips in schistosome-endemic areas. As asymptomatic schistosomiasis in travelers is also common (43% in this series), all travelers exposed to freshwater in endemic areas should be encouraged to undergo serologic screening.     

Leishmaniasis in the middle course of the Ethiopian Rift Valley: II. Entomological observations

As part of an epidemiological investigation of visceral leishmaniasis, entomological surveys were conducted in Ziway-Langano, Dimtu-Bilate and Wadjifo-Mirab Abaya areas located in the middle course of the Ethiopian Rift Valley between November 1994 and June 1996. A total of 4518 sand flies (Diptera: Psychodidae) were collected from the study areas using CDC light traps and oiled plastic sheets which were identified to nine species of Phlebotomus and 14 species of Sergentomyia. Most of the Phlebotomus species were from Ziway-Langano area and they included P. martini and P. orientalis, which are the principal vectors of visceral leishmaniasis in Ethiopia. Among 339 females of nine Phlebotomus species dissected, natural infections with flagellates were detected in 11 specimens (two P. duboscqi and nine P. rodhami) from Ziway-Langano area, but were different from mammalian Leishmania species by their position in the insect gut, morphology and behaviour in cultures. However, the reasons for the low level of leishmanin skin-test positivity in this portion of the Rift Valley are not immediately clear in view of the rich sand fly fauna and the presence of potential vectors.     

Leishmaniasis in the middle course of the Ethiopian Rift Valley: I. Clinical and leishmanin skin test surveys

A clinico-epidemiological study of cutaneous leishmaniasis (CL) and visceral leishmaniasis (VL) was undertaken involving 1,809 residents of ten representative villages from Zeway-Langano, Wajifo-Mirab-Abaya and Blate-Dimtu areas in the middle course of the Ethiopian Rift Valley from November 1994 to June 1996. Community prevalence of positive leishmanin skin test (LST) was very low ranging from 5% in Olge village to 0% in Kello-Langano area. Sera collected from 57 clinical VL suspects originating from the different villages tested negative for anti-leishmanial antibodies. The rate of splenomegaly ranged from 5% in Kello-Langano area to as high as 80% in Korga village. Furthermore, the frequency and size of splenomegaly was related to the reported past and recent history of attack(s) of malaria. The low community prevalence of LST suggests minimal transmission of leishmania infections in spite of the knowledge of the presence of the sandfly vectors of CL and VL in the area. However, with increasing villagization and agricultural development activities, the potential risk for the establishment of VL and/or CL as endemic diseases can not be excluded.     

Interactions among primaquine, malaria infection and other antimalarials in Thai subjects.

1. The pharmacokinetics of rac-primaquine (45 mg base) and its principal plasma metabolite, carboxyprimaquine have been investigated in healthy Thai adults prior to and following a single oral dose of mefloquine (10 mg kg-1). 2. Primaquine was rapidly absorbed, attaining peak plasma concentrations (median and range) of 167 (113-532) micrograms l-1 in 2 (1-4) h. Thereafter, concentrations declined rapidly with an apparent terminal half-life of 6.1 (1.7-16.1) h and an oral clearance (CLpo) of 33.1 (17.6-49.3) l h-1. Administration of mefloquine had no effect on the values of any of these parameters at the 5% level of significance [Cmax 229 (114-503) micrograms l-1; tmax 3 (2-4) h; t1/2,z 3.9 (1.7-13.5) h; CLpo 34.0 (21.7-49.0) l h-1]. 3. The carboxylic acid metabolite of primaquine achieved maximum concentrations (median and range) of 890 (553-3634) micrograms l-1 at 6 (3-16) h. Thereafter, plasma concentrations of carboxyprimaquine declined to 346 (99-918) micrograms l-1 at 24 h. AUC (0,24 h) was 12737 (6837-27388) micrograms l-1 h. Administration of mefloquine had no effect on the plasma concentrations of this metabolite [Cmax 1035 (174-3015) micrograms l-1; tmax 8 (2-24) h; AUC(0,24) 13471 (2132-17863) micrograms l-1 h]. 4. The effect of falciparum malaria and treatment with quinine (10 mg salt kg-1 p.o.) on the pharmacokinetics of primaquine (45 mg base p.o.) has been investigated in adult Thai patients during and after infection with falciparum malaria.(ABSTRACT TRUNCATED AT 250 WORDS)     

Sleeping sickness and tsetse awareness: a sociological study among the Tambo and Lambya of the northern Luangwa Valley, Zambia.

Data on awareness of tsetse flies and knowledge of trypanosomiasis were collected in May, 1988, in the Luangwa Valley of Isoka District in the Northern Province of Zambia. One thousand and nine hundred adult males and females were interviewed. There was a high level of fly awareness among all the respondents, regardless of duration of residence and age groups. Malaria was considered as the most serious illness in the community, and hence overshadowed the impact of trypanosomiasis in the community. Disease awareness gravity cannot be attributed to individual's socio-economic levels.     

Decline in prevalence of HIV-1 infection and syphilis among young women attending antenatal care clinics in Addis Ababa, Ethiopia: results from sentinel surveillance, 1995-2001

From 1995 to 2001, five rounds of sentinel surveillance were carried out for young women attending antenatal care clinics at four health centers in Addis Ababa, the capital city of Ethiopia, to monitor trends in the prevalence of HIV infection and syphilis. Serum samples were tested for antibodies to HIV (enzyme-linked immunosorbent assay and Western blotting) and antibodies to Treponema pallidum (T. pallidum hemagglutination assay and rapid plasma reagin test). Prevalence ratios for an increase in one calendar year were estimated using log-binomial models. Between 1995 and 2001, the prevalence of HIV infection among young women (age range, 15-24 years) attending antenatal care clinics in inner city health centers declined from 24.2% to 15.1% (prevalence ratio for an increase in one calendar year, 0.91; 95% confidence interval, 0.87-0.95). No change was observed for older age groups or in outer city health centers. The decline in the prevalence of active syphilis (T. pallidum hemagglutination assay and rapid plasma reagin testing positive for antibodies to T. pallidum) was more pronounced among and also restricted to the young age groups (age range, 15-24 years) in the inner city (from 7.6% in 1995 to 1.3% in 2001; prevalence ratio, 0.69; 95% confidence interval, 0.59-0.80). The declining trends in the prevalence of HIV infection and syphilis among young women attending antenatal care clinics in the inner city are encouraging, but these findings require confirmation in future years and for other population groups.     

The morphology of O. volvulus microfilaria in the northwestern onchocerciasis endemic foci, Ethiopia.

Microfilariae obtained by corneoscleral biopsy machines from persons in the Humera area along the Sudan boarder in Northwestern Ethiopia were stained using hematoxylin. Morphological measurements were made using a microscope fitted with micrometer and camera, as well as map curvimeter. The mean size of microfilariae was 189 microns by 5.8 microns. The percentage of nucleifree cephalic space as percent of total body length was 3.4 and is close to reports in the literature. The measurement of the distance of the anterior end nerve ring as a percent of the total body length (22.1%) is also close to measurements obtained elsewhere. Although the microfilaria encountered in this study are of the short variety, morphological measurements and the absence of sheath suggests that the microfilaria observed belong to O. volvulus.     

Select mortality and cancer incidence among residents in various U.S. communities that received asbestos-contaminated vermiculite ore from Libby, Montana

In response to the significantly elevated asbestosis mortality rates found in Libby, Montana, in 2000, this analysis evaluated whether other communities throughout the United States that received asbestos-contaminated vermiculite ore from Libby experienced similar excess rates of asbestos-related diseases. Standardized mortality ratios were calculated using state death certificates, and standardized incidence ratios were calculated using cancer registry records for populations living near facilities that processed or received Libby vermiculite. This analysis focused primarily on diseases that are directly associated with asbestos exposure (e.g., asbestosis; cancer of the peritoneum, retroperitoneum, and pleura, including mesothelioma; and mesothelioma). Lung cancer and cancers of the digestive system, also associated with asbestos exposure, were not included in the analysis because they have additional risk factors for which exposure information was not available. Data from 70 unique sites in 23 states were evaluated. No statistically significant excesses of asbestosis mortality similar to those in Libby were noted; however, 11 sites (plus a state with 6 pooled sites that were counted as 1 site) had excess rates of mesothelioma and cancer of the peritoneum, retroperitoneum, and pleura. Further investigation should be conducted at these sites with excess rates of mesothelioma and cancer of the peritoneum, retroperitoneum, and pleura by participating state health departments to determine whether exposure to Libby vermiculite might have been a contributing factor.     

Revised analyses of the National Morbidity, Mortality, and Air Pollution Study: mortality among residents of 90 cities

This article presents findings from updated analyses of data from 90 U.S. cities assembled for the National Morbidity, Mortality, and Air Pollution Study (NMMAPS). The data were analyzed with a generalized additive model (GAM) using the gamfunction in S-Plus (with default convergence criteria previously used and with more stringent criteria) and with a generalized linear model (GLM) with natural cubic splines. With the original method, the estimated effect of PM(10) (particulate matter 10 microm in mass median aerodynamic diameter) on total mortality from nonexternal causes was a 0.41% increase per 10-microg/m(3) increase in PM(10); with the more stringent criteria, the estimate was 0.27%; and with GLM, the effect was 0.21%. The effect of PM(10) on respiratory and cardiovascular mortality combined was greater, but the pattern across models was similar. The findings of the updated analysis with regard to spatial heterogeneity across the 90 cities were unchanged from the original analyses.     

Assessing the psychometric properties of smoking-related attitudes,self-efficacy,and intention among a diverse population of middle school students

Large-scale surveys frequently assess smoking-related attitudes, self-efficacy and intention to understand differences in smoking behavior. However, a critical assumption is that measures of these determinants should be equivalent across different subgroups of a target population. The current study examined the factorial invariance of measures of smoking-related attitudes, self-efficacy, and intention with a large sample (N = 13,733) of middle school students from 25 schools in Texas. We examined five levels of factorial invariance using a sequential process, in which increasingly constrained models assess the equivalence of a measure across subgroups. Strong factorial invariance provided a good fit for the model across all of the subgroups: race/ethnicity (CFI = .93), gender (CFI = .96), age (CFI = .95), and grade level (CFI = .95). Invariance results provide strong empirical support for the validity of smoking-related attitudes, self-efficacy, and intention measures across race/ethnicity, gender, age, and grade level for middle school students.     

Impact of the "Rand report" on alcoholics, treatment personnel and Boston residents.

Interviews with patients and staff at six alcoholism treatment centers, respondents in a random telephone sample, and a sample of homeless men considereded to need alcoholism treatment revealed little change in treatment program goals, no increase in patients seeking treatment, and few changes in drinking attributable to the "Rand report."     

Determinants of inorganic arsenic methylation capability among residents of the Lanyang Basin,Taiwan: arsenic and selenium exposure and alcohol consumption

The objective of this study was to assess individual variation in inorganic arsenic methylation capability and the association between selenium levels in urine and blood, and inorganic arsenic methylation capability among residents of the Lanyang Basin who drank groundwater and were exposed to high concentrations of inorganic arsenic. According to the arsenic concentration of their drinking water, they were equally and randomly classified into four groups of 252 persons. It turned out that the higher the concentration of arsenic in well water was and thus the cumulative arsenic exposure, the higher the total inorganic arsenic metabolites in urine (total As(i)) and the overall inorganic and organic arsenic in urine (overall As(i+o)) were. The percentage of inorganic arsenic significantly decreased and the DMA percentage significantly increased as the concentration of urinary selenium and serum alpha-tocopherol increased. It appeared that urinary selenium levels increased the metabolism by methylation of arsenic, a finding that requires further investigation.     

贵州地区吸毒人群HIV、梅毒、HBV、HCV、肺结核感染现状调查

目的:了解贵州地区吸毒人群HIV、梅毒、HBV、HCV和肺结核的感染现状和流行趋势,为制定传染病防控策略提供依据。方法:对贵州省内8个戒毒所实地调查,收集2016-2017年吸毒人群传染病监测报表,对报表数据进行整理,采用WPS Office、SPSS 22. 0分析。结果:监测贵州地区吸毒人员18 106人,HIV、梅毒、HBV、HCV的感染率分别为0. 19%、4. 14%、4. 34%、23. 36%;肺结核患病率0. 34%。结论:吸毒人员的梅毒感染水平稍高,HIV、HBV、HCV、肺结核处在低水平流行阶段,控制总体良好。应继续重视开展健康专题宣传并加强防控工作,避免传染病从吸毒人群向一般人群播散和流行,以减轻社会和医疗负担。