A preliminary survey of malnutrition and helminthiasis among school-children in one mountain and one lowland ujamaa village in Northern Tanzania

The nutritional status, parasite prevalence and immediate skin hypersensitivity to Ascaris and Schistosoma antigens were determined for 185 schoolchildren living in two ujamaa villages in Northern Tanzania.In the lowland village of Kwamsisi the parasite ova found were Schistosoma haematobium (53·8%), Ascaris (26·0%) and hookworm (24·7%). 57·5% of the children examined were regarded as malnourished, being less than 80% of their expected weight for age.In the mountain village of Ubiri the parasite prevalence rates were 15·2% for Schistosoma haematobium, 1·6% for S. Mansoni, 65·2% Ascaris and 24·1% hookworm. Malnutrition was found in 81·9% of the boys and in 41·2% of the girls. This sex difference is considered to be due to the physiological effects of living in a hilly environment.Correlation between malnutrition and multiple infections of Ascaris, hookworm and Schistosoma gave a chi-square value of 5·972 (p = 0·02). All other statistical comparisons between parasite prevalence and nutritional status were insignificant.Immediate skin hypersensitivity tests proved unreliable with 23·3% false negatives (negative skin test with parasite ova found). The serum IgE levels were extremely high with a mean of 3174 units per ml suggesting that the immune mechanisms were not retarded by undernutrition.     

Comparative study of biological characteristics of the causal agents of zoonotic and anthroponotic cutaneous leishmaniasis in the USSR

A comparative study was made of the virulence of Leishmania tropica major and L. tropica minor, the causal agents of the zoonotic and anthroponotic forms of cutaneous leishmaniasis, from the USSR and their antigenic characteristics were compared with those of other Leishmania species (L. donovani, L. adleri, and promastigotes from Turkmenian reptiles). The virulence of strains of L. t. major was slightly higher than that of strains of L. t. minor. However, the difference in virulence gradually levelled out in successive multiple passages of the strains in hamsters. A comparative serological study of L. t. major and L. t. minor revealed clear antigenic differences between them. The differences between L. t. major, L. t. minor and L. donovani were shown to be equal in degree.     

Treatment of hydatid cysts (Echinococcus granulosus) by Cetrimide (R)

Cetrimide (^R) has been efficiently assessed against hydatid protoscolices as a scolicidal adjunct to hydatid surgery. It was tested in four concentrations (0·05, 0·1, 0·5 and 1%) against the protoscolices of hydatid cysts in sheep and cattle and in 0·1% concentration against the protoscolices of hydatid cysts in humans. For each concentration, three incubations of one, five and 10 min exposure were tested in vitro and in vivo on sheep and cattle cysts, and two successive incubations each of five min exposure on human cysts. All experiments resulted in rapid mortality of the protoscolices, as judged by their loss of motility, readiness to take vital stains and inability to develop into secondary hydatid cysts when inoculated into albino mice. The low toxicity of Cetrimide (^R), its rapid action against the protoscolices, its scolicidal effect at a low concentration, and its low degree of absorption by the host tissues make it the most promising drug in hydatid surgery, displaying no side effects on the host.     

Hepatitis-B virus infection in children and adults in Northern Nigeria: a preliminary survey

Hepatitis-B surface antigen (HBsAg) and its corresponding antibody (anti-HBs) have been detected by radio-immunoassay in children and adults and in adult expatriates in Zaria, Northern Nigeria. The exposure rate to hepatitis-B virus (frequency of HBsAg and anti-Hbs) was found to vary from 59% in children under five years to 72·5% in adults over 30 years of age, while the frequency of HBsAg alone was 40% and 10% respectively. The anti-HBs prevalence rates rose progressively with age and reached a peak at 62·5% in adults. Five of 32 adult expatriates (15·6%) were positive for anti-HBs. The factors contributing to the high exposure rate in the indigenous population in this region require further study to enable judicious use to be made of preventive measures.     

Jejunal absorption rates of glucose and glycine in post-infective tropical malabsorption

In a prospective study jejunal absorption rates of glucose (from a 200 mmol 1^?1 solution) and glycine (from a 100 mmol 1^?1 solution) were measured, using a perfusion technique, in nine patients with clinical evidence of post-infective tropical malabsorption (TM group) and in 10 others with trivial symptoms who had also visited the tropics (control group); all were of northern European origin. Seven and one in the two groups, respectively, had Giardia lamblia infections. Mean glucose absorption rate was significantly impaired by TM (P < 0·01); mean rate for glycine was also depressed but not significantly. Presence of G. lamblia did not affect the severity of malabsorption although numbers studied were small.     

Effect of specific and non-specific prior sensitization on the outcome of amoebic infection

Guinea-pigs were sensitized with monoaxenic amoebic antigen (Group I), bacterial associate antigen (Group II) and axenic amoebic antigen (Group III). All animals in Group I, 95% in Group II and 70% in group III, developed caecal lesions on intra-caecal inoculation of Entamoeba histolytica trophozoites; 92·8% of control (unsensistized) animals developed lesions in their caeca. Lesions were more severe in sensitized animals than in controls. Hepatic abscesses were found in 7·6% of group I, 11·1% of group II and 7·1% of group III. No animal from the untreated but infected group developed hepatic abscess. It thus appears that specific (amoebic) and non-specific (bacterial) prior sensitization may render the host more susceptible to hepatic amoebic infection.     

Application of the indirect fluorescent antibody test in serodiagnosis of cutaneous leishmaniasis in experimentally infected mice and naturally infected Rhombomys opimus

The indirect fluorescent antibody test (IFAT) was used to detect leishmanial antibodies in experimentally inoculated mice with promastigote forms of Leishmania major, L. tropica and L. donovani infantum and in naturally infected Rhombomys opimus captured from the area endemic for cutaneous leishmaniasis in Esfahan, Iran. In the mice inoculated with L. major, the leishmanial lesion appeared at the site of inoculation and the leishmanial antibody level was much higher than in mice inoculated with other strains of Leishmania and in which no lesion was observed up to the 22nd week after inoculation. In R. opimus, the microscopical examination of the two smears prepared from the ears of each gerbil (one by the ordinary and the other by the sand-paper method) showed about 41% to be parasitologically positive. However, in IFAT about 84% were serologically positive. There was a good correlation between the percentage of thickened ears and leishmanial antibody titres in the gerbils.This investigation indicated that IFAT is a suitable serological technique for finding the reservoir hosts of leishmaniasis and determining leishmanial infection among rodents.     

Duodenal ulceration in sickle cell anaemia

Duodenal ulceration was found to affect 30·5% of 72 male patients aged over 25 years, with sickle cell anaemia in Jamaica. As a group, these patients did not manifest the high gastric acid secretory rates which are generally associated with duodenal ulceration. There was a positive association with irreversibly sickled cells which are known to relate to vessel obstruction and tissue infarction. It is suggested that primary mucosal damage (presumably ischaemic in nature) may contribute to the development of duodenal ulcers in this condition.     

Nasal carrier rates and antibiotic resistance of Staphylococcus aureus isolates from hospital and non-hospital populations,Addis Ababa

Surgical staff of five different hospitals and university biology students were screened for nasal carriage of Staphylococcus aureus: 32·4% of the surgical staff and 21·6% of the students were carriers. The rate for the hospital staff was significantly higher (χ² = 9·2, P<0·01). The carrier rates among the surgical staff varied between 59·1% for surgeons and 22·7% for other surgical staff.195 S. aureus strains were isolated: 109 from surgical staff and 86 from students. All were tested for their resistance to antibiotics. Resistance to penicillin was 86·2% and 74·4%, respectively, for hospital and non-hospital isolates. Resistance to erythromycin, gentamicin, kanamycin or co-trimoxazole was not detected among the non-hospital isolates. All isolates were sensitive to vancomycin, cephalothin and clindamycin. Over 96% and 88% of hospital and non-hospital isolates, respectively, were resistant to at least one antibiotic. About 45% of the hospital isolates and 2·3% of the non-hospital isolates showed multiple resistance.The rate of multiple resistance among the hospital staff isolates was considered high and indicative of still higher rates among clinical isolates. Further studies are suggested in order to take appropriate measures against bacterial resistance to antibiotics.     

Unusual axonemal doublet arrangements in the flagellum of Leishmania amastigotes

Studies on the fine structure of Leishmania mexicana, L. enriettii and L. tropica major have revealed several unusual arrangements of microtubules in the flagellar axoneme. The anterior end of the flagellum in these three species was found to contain disarranged axonemal doublets (d) in the absence of the two central singlets (s). Leishmania amastigotes do not use their flagellum as do promastigotes for propulsion, and persistence of the usual 9d and 2s microtubular arrangement may not be necessary.     

环孢素A联合小剂量激素治疗特发性膜性肾病31例临床分析

目的特发性膜性肾病(IMN)是肾病综合征的主要病理类型之一,因其对激素不敏感而易于成为难治性肾病综合征,本文通过观察环孢素A+小剂量激素治疗IMN的临床疗效,探讨其治疗。方法观察31例经肾活检证实诊断的IMN患者对环孢素A(CsA)+小剂量激素的治疗反应。治疗方法为环孢素A2～3mg·kg-1·d-1(CsA血药浓度120～150mg/L)8周,继以1～2mg·kg-1·d-1(CsA血药浓度80～100mg/L)维持12～24个月;泼尼松给予0.25mg·kg-1·d-1开始,8周后每2周逐渐减量至0.125mg·kg-1·d-1维持。观察尿蛋白排出量、血浆蛋白和症状体征。结果完全缓解率52%,部分缓解率35%,未缓解13%,有效率达87%。结论环孢素A联合小剂量激素治疗IMN疗效肯定。     

Faecal carriage of Pseudomonas aeruginosa in newborn infants

Carriage rates of Pseudomonas aeruginosa were studied using Solari medium and 1 g of faeces. The incidence in infants delivered at home was 6·0 per cent and 56·6 per cent in infants in hospital nursery. The carriage rate in healthy adults averaged 17·1 per cent and showed seasonal variations, high in summer and low in winter months. In 25 infants and two mothers the mean count of Ps. aeruginosa was 10³/g faeces.     

A fourth study of case-finding methods for pulmonary tuberculosis in Kenya

This investigation is the fourth of a series of case-finding studies in Kenya. It explored in a new area (the Baragwi location of Kirinyaga), five methods of case-finding involving the examination of the sputum by smear and culture of symptomatic tuberculosis suspects in the community identified (i) by interrogation of the Elders, (ii) by interrogation of household heads, (iii) by tracing all patients registered during the previous 10 years in the District Tuberculosis Register, (iv) by the examination of all their close contacts and (v) from outpatients attending peripheral health units.The initial interrogation of the Elders yielded 123 suspects with bacteriological results, of whom seven were culture-positive, including four smear-positive. A second interrogation three to six months later produced a further 66 suspects and four more culture-positive cases (all smear-negative). The examination of a second sputum specimen after three to six months from all the suspects from both interrogations produced a further culture-positive smear-negative case.A single interrogation of household heads in a house-to-house survey yielded 867 suspects and 15 culture-positive cases, including eight smear-positive.Of 862 suspects with no history of tuberculosis, 778 (90%) claimed they had attended a medical facility for their respiratory symptoms during the previous year, the most recent visit being within the previous month in 24%. All except 1% of the total had attended on more than one occasion, the average number of attendances being 5·3. 83% said they had attended the peripheral health units and 37% had attended the Central District Hospital, yet 65% of the suspects had had neither a chest radiograph nor their sputum examined bacteriologically.Of the 114 cases of tuberculosis registered in the District Tuberculosis Register during the previous 10 years, nine were currently culture-positive, seven being smear-positive. The examination of a second sputum specimen from 105 yielded one more culture-positive case.Of 577 household contacts of the registered cases, seven were culture-positive, three being smear-positive. The examination of a second sputum specimen from 568 yielded two more culture-positive cases.During a full year, only 45 suspects were registered among out-patients attending seven health units serving the area (population 27,500), of whom four were smear-positive. This indicates a failure of the staff to take appropriate actions.     

伊来西胺单药治疗儿童癫痫部分性发作的临床疗效及安全性的研究

目的:评价伊来西胺(Ilepcimide)单药治疗儿童癫痫部分性发作的临床疗效及依从性。方法:收集2011年3～9月吉林大学第一医院小儿神经内科门诊癫痫部分性发作的患儿,2～5岁年幼组27例,5～15岁的年长组39例。所有患儿的伊来西胺初始计量均为5 mg·kg-1·d-1,如发作未被控制则每周加量<5 mg·kg-1·d-1,目标剂量为10 mg·kg-1·d-1,最大剂量<300 mg/d。观察期为6月,进行自身对照开放性研究,观察各组的维持期累计疗效,并进行安全性评估。结果:服药3个月后,年幼组的有效率、控制率分别为62.96%、40.74%,年长组的分别为64.10%、41.03%。服药6个月后,年幼组的有效率、控制率分别为77.78%、48.15%;年长组的分别为79.49%、51.28%。66例患儿在服药前及服药后第4周、3和6月时分别查血常规、尿常规、肝功能、肾功能、血液电解质及心电图,各项指标均未见异常改变。15.15%(10/66例)的患儿出现不良反应,主要表现为胃部不适、食欲差或恶心、疲倦、头晕、嗜睡的症状。结论:伊来西胺作为一种新型中药类抗癫痫药物对儿童癫痫部分性发作疗效良好,安全范围大,不良反应少,患者耐受性好,尤其适用伴有其他系统疾病的患者。     

Long-term efficacy of single-dose oral treatment in schistosomiasis haematobium

A two-year follow-up was conducted in children who had been the subjects of a six-month double-blind trial in the single-dose treatment of Schistosoma haematobium infection. The trial had assessed therapeutic efficacy of three oral preparations—praziquantel 40 mg/kg, metrifonate 10 mg/kg, and the “combination” (concurrent niridazole 25 mg/kg and metrifonate 10 mg/kg administration).Reduction in urinary egg excretion remained high up to follow-up at two years, based on a comparison of pre- and post-treatment geometric mean counts—praziquantel 96·9% (n = 96 at six months, 51 at two years); the ‘combination’ 93·9% (n = 97 at six months, 48 at two years); and metrifonate 90·3% (n = 92 at six months, 49 at two years). The differences in percentage reduction were not significant (p>0·1). However, a significantly greater reduction in egg ouput was produced by praziquantel (81·7%) and the ‘combination’ (82·5%) than by metrifonate (54·2%), on comparing pre- and post-treatment arithmetic mean counts (p<0·01).A significantly smaller percentage of subjects were excreting ≥125 ova/10 ml urine two years after treatment with praziquantel (10·3%), compared to treatment with the ‘combination’ (25·7%) and metrifonate (35·8%) (p<0·01). The cure rate was significantly higher in the praziquantel group (47·4%) compared to the ‘combination’ (24·7%) and metrifonate (17·4%) groups, for the six to 24-month follow-up period (p<0·001).The pattern and level of transmission had contributed to the long-term efficacy recorded in this study.     

African sleeping sickness: new evidence that mature tsetse flies (Glossina morsitans) can become potent vectors

Starved mature male tsetse flies (21 to 25 days old) are capable of developing salivary gland (SG) infections of Trypanosoma brucei rhodesiense at rates nearly comparable to teneral males < 24 hours old when given an infective meal containing parasites, horse red cells and culture medium. Although the over-all SG infection rate for mature males starved for three, four or five days before infection was about half that for teneral males < 48 hours old (8 · 0% v. 15 · 6%), males starved for four days developed infection rates (12 · 3%) that were comparable to those of teneral flies < 24 hours old (11 · 8%). It is suggested that the acquisition of infection by mature flies should be considered when evaluating factors contributing either to maintenance of endemic infections or perhaps even epidemic infections of human sleeping sickness.     

Prevalence and incidence of onchocerciasis as baseline data for evaluation of vector control in San Vicente Pacaya,Guatemala

The aim of this study was to estimate the incidence rate of onchocerciasis as measured by skin biopsy during field surveys carried out in San Vicente Pacaya, Guatemala from 1977 through 1979.The age standardized prevalence rates for males and females were 44·6% and 19·9%, respectively, in 1979. There were annual incidence rates of 0·08 and 0·04 for males and females, respectively. The incidence rates seem to increase with age. Since the effect of false negatives will be greater in females than in males, these rates should be interpreted cautiously.Extremely high reversion rates (proportion of negatives in a later examination among positives at the first examination by skin biopsy) were observed; these figures might be explained mainly by false negatives due to the skin biopsy. However, it is suspected that some of the apparent reversion rates may also have been influenced by other factors e.g., sex difference.     

10. Effect of insecticide-treated bed nets on the dynamics of multiple Plasmodium falciparum infections

The rates of acquisition and loss of individual genotypes belonging to the FC27 family of the Plasmodium falciparum merozoite surface protein 2 (msp2) gene were studied in 120 children aged 5 months to 2·5 years, in a randomized controlled trial of insecticide-treated bed nets (ITNs) in Kiberege village, Tanzania. Analysis of longitudinal changes in positivity for individual alleles in samples collected at intervals of one month indicated that the average duration of infections, allowing for undetected parasite genotypes, was 73 d in those aged <18 months and 160 d in children aged ≥18 months, consistent with a shift from acute to chronic infection with age. Overall, 51% of genotypes infecting the host were estimated to be detected by polymerase chain reaction-restriction fragment length polymorphism analysis in any one sample of 0·5 μL of packed peripheral blood cells. In children less than 18 months old this sensitivity was 61% (SE = 6%) compared with 41% (SE = 6%) in older children. Conversely, the rate of appearance of new parasite genotypes was higher in children <18 months of age than in older children, but this partly reflected the difference in sensitivity. The overall incidence of new infections was estimated to be reduced by 17% in ITN users. There was no statistically significant difference between users and non-users in observed infection multiplicity, sensitivity, recovery rate, or estimated infection rates for individual alleles. This suggests that, in areas of high P. falciparum endemicity, ITNs have little effect on the establishment of chronic malaria infection.     

Cryopreservation of viable Giardia intestinalis trophozoites

A technique is described for the cryopreservation of Giardia intestinalis trophozoites. The most satisfactory results were obtained when organisms were preserved with either 7·5 or 10% dimethyl sulphoxide (Me₂SO) and cooled using a liquid nitrogen controlled freezer. Under these conditions more than 70% of organisms were motile after thawing. Lower recovery rates were obtained using glycerol as the cryopreservant or when samples were placed directly into a ?70 °C refrigerator to cool. Cultures were successfully re-established from material cooled under controlled conditions using either 7·5% Me₂SO or glycerol as the cryopreservant. However, the former had an initial generation time of 12·0 hours compared to 24·5 hours for the latter.     

Bancroftian filariasis in coastal north Trinidad,West Indies: intensity of transmission by Culex quinquefasciatus

The intensity of transmission of Wuchereria bancrofti was measured in a coastal community in north Trinidad where 15% of the residents were microfilaraemic. The only significant vector, Culex quinquefasciatus, was studied in detail to determine seasonal abundance, longevity, infection and infectivity rates. Only 2·1% of the indoor biting population and 7·0% of the indoor resting population were infected. The daily mortality rate of the vector increased with age from 27% at four days to 44 to 47% at 12 days and is considered to be an important factor contributing to the low infectivity rate (0·1%). The mean number of C. quinquefasciatus bites received by a resident of the village during the year of observation was estimated to be 17,948 of which 14 were from mosquitoes harbouring infective larvae of W. Bancrofti. The results from similar studies elsewhere are outlined, but the need for standardization of procedures is emphasized before more reliable comparisons can be made.