PubMed Health⌕ Search

Biomedical subjects

A J Smits

Publications and source records attributed to A J Smits.

30 records · Page 2Linked to original sources
PubMed1984

Overcrowding and intensive exposure as determinants of measles mortality.

Data from a 1979 measles epidemic in an urban district of Guinea- Bissau indicate that state of nutrition is not a major determinant of outcome of infection. However, overcrowding increases the risk of early infection and the severity of disease. In instances in which several children have measles simultaneously, the case fatality rate is significantly higher than for isolated cases. This tendency is apparently a result of intensity of exposure; within the same house, secondary cases have a much higher age-specific case fatality rate than index cases. It is suggested that the association between intensive exposure and severity of infection may be due to increase rates of intercurrent infection and/or a greater dose of infection. Since it is not only the malnourished children who die of measles, vaccination may have a greater importance for survival patterns than has previously been assumed.

Age Factors↗
PubMed1983

Measles mortality, state of nutrition, and family structure: a community study from Guinea-Bissau.

In an urban area of Guinea-Bissau where the general state of nutrition seemed fairly good, the case fatality rate for measles among children less than three years of age who were examined clinically during an epidemic was 25.0%. Nutritional indicators (weight-for-age, height-for-age, and weight-for-height ratios) measured a few months before the epidemic were about equal both for the group of 60 children who subsequently died of measles and for the general child population. Because no community study has demonstrated that the nutritional state influences the outcome of measles, the assumed importance of the state of nutrition for measles fatality rates is questioned. Children in monogamous households had a lower risk of dying of measles. It is suggested that measles may be more severe in polygamous families because several children can have the disease simultaneously.

Adolescent↗
PubMedDate not supplied

Risk factors in subacute sclerosing panencephalitis: age- and sex-dependent host reactions or intensive exposure?

The central epidemiologic features of subacute sclerosing panencephalitis (SSPE)--young age of measles attack and overrepresentation or males--are usually explained as resulting from age- and sex-dependent host reactions. In this report, an alternative hypothesis is offered: intensive exposure, presumably due to the dose of infection, is a risk factor in the pathogenesis of SSPE. A hypothetical model of the influence of age and sex on the transmission of measles is suggested. According to this model, girls are exposed to measles more easily outside the home. Furthermore, small children are most likely to be exposed to measles at home. Consistent with this model is the fact that all studies indicate that female SSPE patients contract measles at a younger age than do male patients. Reports in the epidemiologic literature suggest that several characteristics of SSPE may result not from host reactions per se but from the distribution of intensive exposure to measles.

Adolescent↗
PubMedDate not supplied

Cross-sex transmission of infection and increased mortality due to measles.

In an urban and a rural area of Guinea-Bissau, the incidence of and mortality due to measles were followed over four years. Significantly higher case-fatality ratios among secondary cases occurred when infection was transmitted across sexes than within the same sex. The case-fatality ratio was highest for girls infected by boys and lowest for girls infected by girls. Published reports of cases of fatal measles indicate a similar tendency. Apparently, no general background factor or difference in social interaction between children can explain this variation in severity of infection. It is therefore hypothesized that cross-sex transmission of measles virus produces infections of greater severity. These observations may suggest that measles virus incorporates host-specific cellular characteristics that interfere with the immune responses of persons infected by a member of the opposite sex.

Adolescent↗