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1.
C A Wanke D Cohan T Thummakul S Jongwuitiwes M L Grayson S M Hammer M Hanvanich 《The American journal of tropical medicine and hygiene》1999,60(5):871-874
Diarrheal disease and its associated morbidities occur frequently in patients infected with human immunodeficiency virus (HIV) and may be associated with a decreased quality of life. We studied the spectrum of symptoms, measures of nutritional status, and the enteric pathogens associated with diarrheal disease in a group of 24 patients infected with HIV in Bangkok, Thailand compared with a group of 19 patients infected with HIV without diarrhea cared for at the same clinic. Patients with diarrhea appeared to have more advanced disease by CD4 cell counts and complained more frequently of symptoms such as anorexia, gas, and bloating than patients without diarrhea. Patients with diarrhea had a tendency toward a lower nutritional status, as measured by body mass index and mid arm circumference. Stool culture and examination revealed that enteric pathogens including Salmonella species and Cryptosporidium parvum sporidia were recovered at equal frequencies in patients with and without diarrhea (27% of the patients with diarrhea and 25% of the patients without diarrhea). Microsporidia was identified in one patient with diarrhea. It was not possible to identify a pathogen in 73% of the patients with diarrhea and 75% of the patients without diarrhea, suggesting that additional agents or factors may be responsible for the diarrheal symptoms in the patients with diarrhea. More extensive studies to identify potentially treatable pathogens in HIV-infected patients with diarrhea in Thailand are warranted and further attempts to better define the syndrome of pathogen-negative diarrheal disease in patients infected with HIV might result in the development of more targeted interventions in these patients. 相似文献
2.
Human immunodeficiency virus-related lymphocytic alveolitis 总被引:9,自引:0,他引:9
We observed 276 HIV-infected patients to determine the frequency, degree, and clinical presentation of the lymphocytic alveolitis in different stages of HIV disease, and also to identify the lymphocyte subsets involved. In 154 patients with proved lung infections or tumors (group A), bronchoalveolar lavage fluid showed lymphocytosis in 78 percent of cases. In 122 subjects (31 AIDS and 91 HIV-infected non-AIDS patients) without evidence of lung tumor or infection (group B), lymphocytic alveolitis was seen in 72 percent of cases. In 61 of 88 (69 percent) group B lymphocytic patients, we observed respiratory symptoms or diffuse interstitial opacities; however, we also observed such alveolitis in 27 of 46 (59 percent) group B patients free of respiratory symptoms and abnormality of chest x-ray film. This alveolitis was seen not only in AIDS or ARC patients but also at earlier stages of HIV infection. T-lymphocyte analysis showed a large majority (40 to 93 percent) of CD8 positive lymphocytes in the 37 patients tested. A dual fluorescence analysis revealed, in 18 subjects, that those cells were phenotypically cytotoxic (CD8 + D44 +). These findings suggest that, regardless of HIV-infection stages and of opportunistic lung infections, a CD8-positive T-lymphocyte alveolitis may be present in HIV-infected patients and could be responsible for cough, dyspnea, interstitial pneumonitis, and abnormalities of pulmonary function tests. 相似文献
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Tornee S Kaewkungwal J Fungladda W Silachamroon U Akarasewi P Sunakorn P 《The Southeast Asian journal of tropical medicine and public health》2004,35(2):375-383
A cross-sectional study was conducted to determine the prevalence of tuberculosis infection and risk factors for tuberculosis infection among household contacts aged less than 15 years in Bangkok, Thailand, between August 2002 and September 2003. During the study period, 342 index cases with sputum smear positive pulmonary tuberculosis patients were recruited into the study and their 500 household contacts aged under 15 years were identified. The prevalence of tuberculosis infection among household contacts was found to be 47.80% (95%CI = 43.41-52.19). In multivariate analysis, a generalized estimating equation (GEE) was used to determine the risk factors for tuberculosis infection among household contacts. The results indicated that the risk of tuberculosis infection was significantly associated with close contact (adjusted OR = 3.31, 95%CI = 1.46-7.45), exposure to female index case (adjusted OR = 2.75, 95%CI = 1.25-6.08), exposure to mother with tuberculosis (adjusted OR = 3.82, 95%CI = 1.44-10.14), exposure to father with tuberculosis (adjusted OR = 2.55, 95%CI = 1.19-5.46), exposure to index case with cavitation on chest radiograph (adjusted OR = 4.43, 95%CI = 2.43-8.05), exposure to index case with 3+ sputum smear grade (adjusted OR = 3.85, 95%CI = 1.92-7.70), and living in crowded household (adjusted OR = 2.63, 95%CI = 1.18-5.85). The distribution of tuberculosis infection and risk factors among contact cases are significant for health care staff in strengthening and implementing tuberculosis control programs in Thailand. 相似文献
5.
Changsap B Nithikathkul C Boontan P Wannapinyosheep S Vongvanich N Poister C 《The Southeast Asian journal of tropical medicine and public health》2002,33(Z3):72-75
A study of enterobiasis and its correlation with various factors that could potentially influence the rate of infection was conducted among 3,621 primary school children (five to ten years old), drawn from sixteen schools in Bang Khun Thian District, Bangkok. Diagnosis was by the transparent tape swab technique, which was used to recover Enterobius vermicularis eggs from the perianal region. The transparent tape swabs were then placed on slides for examination by light microscopy. The average rate of infection for the group was 21.57%. No statistically significant differences were found between the male and female children. The younger children had a higher rate of infection. Subjects from schools located in industrial and metropolitan areas showed slightly higher rates of infection than those from agricultural areas. Data from the questionnaires in the study indicated that factors such as parental socio-economic status (occupational, income and education) and the children's personal hygiene contributed to the varying rates of infection. 相似文献
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Injection drug users have been overlooked in the Thai government's response to HIV/AIDS, but not in its war on drugs. They experience constant police harassment and ineffective services, and face stigma and discrimination in society and in the health-care setting. Paisan Suwannawong, of the Thai Drug Users' Network, was scheduled to speak at the Opening Ceremonies of the XV International AIDS Conference in Bangkok on 11 July 2004. But he was placed last on a very long agenda that included Thai Prime Minister Thaksin Shinawatra, United Nations Secretary-General Kofi Annan, and Miss Universe. By the time he spoke, all the dignitaries and almost all the delegates had left the hall. In this edited version of his address, Paisan provides a personal testimonial about what it is like to be a drug user living with HIV/AIDS in Thailand, outlines the problems with the government's response, and describes other obstacles to delivering treatment and other services to drug users. 相似文献
7.
K Okanurak D Kitayaporn W Wanarangsikul C Koompong 《The international journal of tuberculosis and lung disease》2007,11(7):762-768
SETTING: All health care centres under the Department of Health, Bangkok Metropolitan Administration. OBJECTIVES: To investigate patterns of drug administration for tuberculosis (TB) patients and to determine whether these patterns affect treatment success rates. DESIGN: In a prospective cohort study conducted during May 2004 to November 2005, newly diagnosed TB patients aged >/=15 years were enrolled after giving informed consent. The cohort was followed until treatment outcome. Structured questionnaires were used to interview patients three times: at the first visit, at the end of the intensive phase and at treatment completion. Data were also collected from treatment cards. RESULTS: Five patterns of drug administration were used in the health centres: centre-based directly observed treatment (DOT), family-based DOT, self-administered treatment (SAT), centre-based DOT + SAT and centre- + family-based DOT. The pattern of drug administration had a significant impact on treatment success (P < 0.001). Using unconditional binary multiple logistic regression controlling for confounding factors, centre- + family-based DOT had the highest success rates compared with centre-based DOT (OR 20.9, 95%CI 5.0-88.3). CONCLUSION: The pattern of drug administration impacted on treatment success. Centre- + family-based DOT, family-based DOT and centre-based DOT + SAT achieved higher rates of treatment success than the World Health Organization target. Centre-based DOT had the lowest success. 相似文献
8.
Cryptosporidiosis in Siriraj Hospital, Bangkok, Thailand 总被引:2,自引:0,他引:2
V Thamlikitkul M Tepmongkol C Lamon S Sripochang W Rungnapawate T Suvajeejarun 《The Southeast Asian journal of tropical medicine and public health》1987,18(2):229-232
During January to July 1986, 1,500 fecal specimens from out and in-patients attending Siriraj Hospital, Bangkok were examined for Cryptosporidium oocysts by modified acid fast technique. Eight were found to be positive. The prevalence of cryptosporidiosis was 3.7% in children with acute diarrhoea. Medical records of the patients showed that the main clinical presentation was acute diarrhoea with fever for one to 7 days duration. Stool examinations and cultures revealed no white blood cells or parasites or other enteropathogenic bacteria. All recovered within two weeks. The study suggest that Cryptosporidium is a relatively common nonviral cause of acute diarrhoea in young children and routine laboratory study to detect Cryptosporidium may be justified. 相似文献
9.
Chokephaibulkit K Wanachiwanawin D Tosasuk K Pavitpok J Vanprapar N Chearskul S 《The Southeast Asian journal of tropical medicine and public health》2001,32(4):770-775
A prospective observational study was conducted to determine the prevalence and the clinical impact of intestinal parasitic infections in diarrheal illness among HIV-infected and HIV-uninfected children hospitalized with diarrhea in Bangkok, Thailand. Stool samples were examined for intestinal parasites using a simple smear method, a formalin-ether concentration method, a modified acid-fast stain and a modified trichrome stain. Intestinal parasites (IP) were identified in the stool specimens of 27 of 82 (33%) HIV-infected and 12 of 80 (15%) HIV-uninfected children (p=0.01). Microsporidia and Cryptosporidium were the most common IP found. Eighty-two percent of HIV-infected and 97% of HIV-uninfected groups presented with acute diarrhea and 76% of each group had watery diarrhea. Pneumonia was the most common concurrent illness, found in 22%. Clinical findings were unable to differentiate children infected with IP. Sixty-three percent of HIV-infected and 83% of HIV-uninfected children who had IP made a satisfactory recovery without specific anti-parasitic therapy. However, 9 children (7 HIV-infected and 2 HIV-uninfected) with persistent diarrhea who also had cryptosporidiosis and/or microsporidiosis did not respond to azithromycin and/or albendazole respectively. HIV-infected children with cryptosporidiosis were older and had more advanced HIV infection than those with microsporidiosis. Routine stool examination for IP should be considered due to the absence of clinical markers. The lack of effective therapy for the major IP found underscores the importance of preventive measures. 相似文献
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Schwartz DA Sungkarat S Shaffer N Laosakkitiboran J Supapol W Charoenpanich P Chuangsuwanich T Mastro TD 《The Journal of infectious diseases》2000,182(6):1652-1657
The effects of human immunodeficiency virus (HIV) type 1 on the placenta and the role of the placenta in mother-to-child HIV-1 transmission are not well understood. Placentas from 78 HIV-infected and 158 HIV-uninfected women were examined as part of a prospective perinatal HIV transmission study in Bangkok. HIV-infected women were more likely than HIV-uninfected women to have chorioamnionitis (odds ratio [OR], 2.1; P=.03), placental membrane inflammation (PMI; OR, 2. 7; P=.02), and deciduitis (OR, 2.3; P=.03) and less likely to have villitis (OR, 0.3; P=.02). However, among HIV-infected women, fewer women who transmitted infection to their child had chorioamnionitis (relative risk [RR], 0.2; P=.03), funisitis (RR, 0.4; P=.1), or PMI (RR undefined; P=.03). These findings suggest that, in this population, HIV-infected women are at increased risk for placental membrane inflammatory lesions, but that placental inflammatory lesions are not associated with increased perinatal HIV transmission. 相似文献
12.
Walaiporn Tonpitak Chulabha Sornklien Mongkol Chawanit Suvarin Pavasutthipaisit Vanaporn Wuthiekanun Viriya Hantrakun Premjit Amornchai Janjira Thaipadungpanit Nicholas P. J. Day Samuel Yingst Sharon J. Peacock Direk Limmathurotsakul 《The American journal of tropical medicine and hygiene》2014,91(2):287-290
Bangkok, Thailand, is a city considered to be at low risk for melioidosis. We describe 10 goats that died of melioidosis in Bangkok. Half of them were born and reared in the city. Multilocus sequence typing ruled out an outbreak. This finding challenges the assumption that melioidosis is rarely acquired in central Thailand.Melioidosis, an often fatal infectious disease for humans and animals, is caused by the Gram-negative bacillus and biothreat select agent Burkholderia pseudomallei.1 This organism is present in soil and water in melioidosis-endemic regions of the world, including much of Asia, northern Australia, regions of South America, some countries in Africa, and various Pacific and Indian Ocean islands.1 Most infections in humans and animals occur after skin inoculation, inhalation, or ingestion of the organism from the environment. A wide range of animal species are susceptible to melioidosis, including sheep, goats, swine, horses, cats, dogs, and non-human primates.2We recently described the first report of culture-confirmed melioidosis in animals in Thailand, in which goats were the most frequently affected species.3 The regions where animal melioidosis were reported mapped to those areas where melioidosis is endemic in humans, including northeastern, eastern, southern, and western Thailand. To our knowledge, animal melioidosis has not been reported from central Thailand, and melioidosis is not considered to be endemic in humans in this area.1,4 Here, we describe 10 goats that died of melioidosis in Bangkok in central Thailand.Study animals underwent necropsy as part of a routine service at the Veterinary Diagnostic Center, Mahanakorn University of Technology, Nong Chok District, Bangkok, Thailand. Organs with gross pathologic lesions were cultured on bovine blood agar and MacConkey agar. Presumptive B. pseudomallei colonies were confirmed by using conventional biochemical tests, multiplex polymerase chain reaction,5 and latex agglutination tests.6 A total of 72 goats and 367 other animals were necropsied during 2006–2012. Ten goats (14%) had at least one specimen that was culture positive for B. pseudomallei, and all other animals were culture negative for this species.The ten goats were from six different farms (range = 1–4 goats/farm) located in two districts in Bangkok (Nong Chok and Khlong Sam Wa). The median age of affected goats was three years (range = 2–4 years), and nine (90%) were female. Common symptoms before death were pneumonia (n = 9), weakness (n = 4), anorexia (n = 2), neurologic symptoms (n = 2), and mastitis (n = 2). All cases had more than one organ involved, and multiple abscesses in the lung, liver, and spleen were common (Case no. Year Farm Age, years Sex Origin Presenting symptoms Organs with gross pathology showing abscesses† Organs with gross pathologic changes showing other abnormalities Sequence type determined by MLST‡ 1 2006 A 2 F Born and raised in farm A Lethargy, weakness, nasal discharge, dyspnea, and bloody mucoid diarrhea Lung, liver, spleen Aorta, adrenal gland, pleura, nasal cavity, mandibular LN* 70 2 2006 B 3 F Unknown history Anorexia, chronic pneumonia, nasal discharge, abdominal distension Mandibular LN, prefemoral LN, spleen − 70 3 2006 B 3 F Unknown history Anorexia, chronic pneumonia, nasal discharge Lung, kidney, spleen − 70 4 2008 C 4 F Bought from other farms High fever, anorexia, mastitis, hemiparesis, pneumonia Mammary gland (milk), retropharyngeal LN, pleural cavity, spleen, brain − 188 5 2010 D 3 F Born and raised on farm D Weakness, lethargy, pneumonia Lung, liver, spleen, omentum, kidney, mandibular LN − 169 6 2010 D 3 F Born and raised in farm D Weakness, mastitis, pneumonia, neurologic signs Mammary gland (milk), spleen − 169 7 2010 D 3 F Born and raised in farm D Weakness, bloated, constipation Lung, spleen, kidney Endocardial hemorrhage, abomasitis, pitting scar in liver 46 8 2010 D 3 F Born and raised on farm D Cough, hyperpnea Lung, spleen, kidney Hydropericardium, petechial hemorrhage of small intestine, multifocal necrosis of liver 169 9 2011 E 3 F Bought from other farms Chronic pneumonia, mastitis Lung, liver, spleen, kidney − 168 10 2012 F 3 M Bought from other farms Chronic pneumonia Lung, liver, kidney Myocardial and endocardial hemorrhage, congestion of pancreas and small intestine 1089