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Biomedical subjects

D C Mabey

Publications and source records attributed to D C Mabey.

70 records · Page 4Linked to original sources
PubMed1986

The detection of Chlamydia trachomatis by direct immunofluorescence in conjunctival smears from patients with trachoma and patients with ophthalmia neonatorum using a conjugated monoclonal antibody.

Duplicate specimens were taken with cotton-wool swabs from the upper tarsal conjunctiva of 63 patients living in Gambian villages in which trachoma is endemic and from 34 infants with ophthalmia neonatorum (ON) attending an outpatient clinic in The Gambia. The detection of Chlamydia trachomatis by direct immunofluorescence (IF) using a conjugated monoclonal antibody to its principal outer membrane protein was compared with isolation in cycloheximide-treated McCoy cells. For trachoma, the sensitivity and specificity of the immunofluorescent technique were 62% and 100% respectively if ten elementary bodies (EBs) was taken as the minimum requirement for positivity by IF. If all cases with one or more EB were considered positive, the sensitivity was 81% and the specificity 85%. For ON the sensitivity and specificity were 100% and 95% respectively, regardless of which criterion was used. In view of its simplicity and easy applicability to field conditions it seems likely that direct IF using monoclonal antibodies may be a useful technique for the detection of C. trachomatis in the conjunctival epithelium of patients with trachoma.

Adolescent↗
PubMed1986

The etiology of lobar pneumonia in the Gambia.

Sixty-four patients who had been admitted to hospital in the Gambia with acute lobar pneumonia were investigated. Lung aspiration proved to be the most effective method of establishing a bacterial etiology, and Streptococcus pneumoniae was the pathogen isolated most frequently from patients irrespective of age. Among children, Haemophilus influenzae, either singly or in combination with another bacterial agent, was an important cause of pneumonia. Of 13 isolates of H. influenzae two were of serotype a, while four others were non-capsulated. All isolates of S. pneumoniae and H. influenzae were sensitive to penicillin.

Gambia↗
PubMed1984

Leishmaniasis in The Gambia. 3. Is its incidence increasing?

During 1982 a further case of visceral leishmaniasis and six cases of cutaneous leishmaniasis were seen at the Medical Research Council Laboratories in The Gambia, suggesting that the incidence of this infection in The Gambia is increasing.

Adolescent↗
PubMed1984

Sexually transmitted diseases among randomly selected attenders at an antenatal clinic in The Gambia.

One hundred randomly selected women attending a free government antenatal clinic in the town of Bakau, The Gambia, were examined. Vaginal swabs were taken for microscopical examination for Trichomonas vaginalis and for culture on Sabouraud's medium. Cervical swabs were taken for culture of Neisseria gonorrhoeae and Chlamydia trachomatis and, in 50 cases, Herpesvirus hominis; in addition, urethral swabs were taken for culture of N gonorrhoeae. Serum samples were tested for antibodies to Treponema pallidum by the Venereal Diseases Research Laboratory (VDRL) test and T pallidum haemagglutination assay (TPHA), and to C trachomatis and H hominis by microimmunofluorescence. The prevalence of infection with Candida albicans was found to be 35%, T vaginalis 32%, C trachomatis 6.9%, N gonorrhoeae 6.7%, T pallidum 1%, and H hominis 0%. IgG antibodies at a titre of at least 1/16 to C trachomatis serotypes D-K were found in 29.4%, and to serotypes A-C in a further 10.6%. IgG antibodies at a titre of at least 1/16 to H hominis type I were found in 94%, and to type II in 53%, although a proportion of the latter probably represent cross reacting antibodies to type I.

Adolescent↗
PubMed1982

Genital and neonatal chlamydial infection in a trachoma endemic area.

85 consecutive male patients with urethritis attending the Medical Research Council outpatient department in Fajara, The Gambia, were investigated for Chlamydia trachomatis infection by intraurethral swab and culture on cycloheximide-treated McCoy cells. 7 specimens were contaminated, but C. trachomatis was isolated from 12 of the remaining 78 (15.4%)--from 8 of 59 patients with gonorrhoea (13.6%) and 4 of 19 with non-gonococcal urethritis (21%). C. trachomatis was also isolated from cervical swabs from 6 of 33 female contacts of men with urethritis (18.2%), 3 of 22 women with gynaecological symptoms (13.6%), and 6 of 87 randomly selected antenatal women (6.9%). Eye swabs were taken from 37 infants with ophthalmia neonatorum; C. trachomatis was isolated from 13 (35.1%).

Adult↗
PubMed1981

Paralytic poliomyelitis in The Gambia: lameness in urban children.

A study on lameness among urban Gambian children was carried out to document the prevalence of sequelae of paralytic poliomyelitis. Of a total of 178 lame children 119 (67%) were suffering from the sequelae of polio. Thirty-one per cent were unable to walk without a mechanical aid. Amongst schoolchildren the overall prevalence was 4 X 7 per 1000 with 5 X 6 per 1000 primary schoolchildren and 2 X 7 per 1000 secondary schoolchildren affected. A history of an injection less than a week before the onset of paralysis was given in 52%.

Adolescent↗
PubMedDate not supplied

Further studies on the treatment of African histoplasmosis with ketoconazole.

Five patients with African histoplasmosis were treated with ketoconazole. Three of these were children with disseminated disease and 2 were adults with localized cutaneous disease. Both patients with cutaneous disease responded to treatment, although one was lost to follow-up. Of the 3 children with disseminated disease, one was apparently cured, one responded well but subsequently relapsed, and one failed to respond in spite of having blood levels of ketoconazole within the therapeutic range. Further studies are needed to determine the optimum dosage and duration of treatment with ketoconazole for this condition.

Administration, Oral↗
PubMedDate not supplied

Presentation and outcome of 1107 cases of schistosomiasis from Africa diagnosed in a non-endemic country.

Schistosomiasis is found in a significant proportion of returning travellers and immigrants to Britain. This study is a retrospective review of 1107 consecutive cases of schistosomiasis from Africa diagnosed by microscopy or serology presenting to the Hospital for Tropical Diseases, London, UK. 50.4% of cases were asymptomatic. The most common symptom which resolved on treatment was tiredness. Serology was positive in 951 (86%), and ova seen in 45%. Urine dipstick testing was positive for blood in 21% and protein in 15%, with eosinophilia in 44%. In this population urine dipstick, full blood count and serology were all insufficient screening tools used alone. Among patients with full follow-up data 3 months or more after treatment with praziquantel, definite treatment failure occured in 4 of 271 (1.5%), restricting the analysis to those with ova seen at diagnosis. There was no significant difference in treatment failure between 1 and 3 days of treatment. Antibody level was the same or higher than at treatment in 55% of cases seen after about 3 months and 38% after 1 year, confirming it is probably of limited clinical use in detecting treatment failure.

Adult↗
PubMedDate not supplied

Chlamydial infections.

Chlamydiae are among the most successful bacterial pathogens, and there are few branches of medicine on which chlamydial infection and its sequelae do not impinge. Chlamydia trachomatis is responsible for many million cases of blindness, pelvic inflammatory disease, urethritis, epididymitis, infertility and ectopic pregnancy annually; it also causes lymphogranuloma venereum, reactive arthritis, ophthalmia neonatorum and infantile pneumonia. C. pneumoniae is among the most common causes of community-acquired pneumonia, and recent evidence suggests that it may play a part in the pathogenesis of coronary heart disease. C. psittaci is a highly prevalent zoonotic infection with a wide host range. It is of great economic importance, and causes sporadic but sometimes devastating disease in humans. Most chlamydial infections are subclinical, but even if the initial illness is mild there may be serious long-term sequelae. It is therefore important to identify and treat chlamydial infections in their early stages, but diagnosis usually depends on laboratory tests. Recent trials have shown that single doses of the long-acting macrolide azithromycin are effective in the treatment of genital and ocular C. trachomatis infection, but longer courses of antimicrobials remain the mainstay of treatment for C. pneumoniae and C. psittaci infections.

Chlamydia Infections↗