BACKGROUND AND OBJECTIVES: Chlamydia trachomatis can be directly transmitted by sexual or perinatal contact and indirectly transmitted by flies or fomites. Whether distinct epidemiologic forces among human populations or biologic characteristics of the organism are responsible for the different routes of transmission is uncertain. STUDY DESIGN: To determine if ophthalmia neonatorum and trachoma are linked epidemiologically, 38 infants with ophthalmia and 277 children with trachoma were studied for evidence of C. trachomatis infection using culture, antigen and DNA detection tests. The study was performed in a trachoma endemic area of central Kenya. RESULTS: Of infants with ophthalmia neonatorum, 8% to 9% had microbiologic evidence of ocular C. trachomatis infection. Of the children with trachoma, 31% had evidence of chlamydial infection. Ninety-two percent of the 59 identified strains causing trachoma belonged to the classic trachoma serovars (A, B, Ba and C). Neither of the two chlamydial strains recovered from infants with ophthalmia was a trachoma serovar. Mothers rarely (3%) had cervical C. trachomatis infection. CONCLUSION: This study does not support a major role for perinatally transmitted C. trachomatis infection in trachoma epidemiology.

Adolescent↗

PubMedDate not supplied

A Canadian isolate of hepatitis D (delta) virus.

Hepatitis D (delta) virus (HDV) is an infectious agent that propagates in hepatocytes only in the presence of hepatitis B virus, causing fulminant or chronic hepatitis with liver cirrhosis. HDV is a 36 nm particle that includes a circular RNA genome of 1.7 kilobases with an extensive internal complementary that allows it to fold into a rod-like structure. The relationships among genotypes, sequence variability, geographical distribution and disease severity of HDV remain unknown. Consequently, in the present study, the complete nucleotide sequence of an HDV isolated from a Canadian patient was determined. The viral RNA from serum was amplified using reverse transcription coupled to polymerase chain reaction amplification. The resulting complementary DNA was cloned and sequenced. Sequence analysis revealed that this new isolate contained 1672 nucleotides corresponding to genotype 1, which has a worldwide distribution. Sequencing of four independent clones revealed 17 substitutions, corresponding to an overall sequence variability of 1%. Surprisingly, seven mutations were found in the 48-nucleotide region located between the two highly conserved self-catalytic motifs. This is the first demonstration that many substitutions are identified in this region of HDV, and prompts the present authors to define it as a hypervariable region.

Base Sequence↗

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Access to health services in Ireland for people with Multiple Sclerosis and Motor Neurone Disease.

We conducted a telephone questionnaire to determine the utilisation of hospital and community based services by patients with Motor Neurone Disease and Multiple Sclerosis in Ireland. 94 MND and 188 MS patients participated in the study. MND patients were more likely to have free medical care than MS patients, despite legislation favouring the converse. Severely disabled MND patients were more successful at accessing free community-based services than were severely disabled MS patients. Private medical insurance conferred no advantage when obtaining services or purchasing equipment. Many patients were unaware of the specific roles of the various clinical professionals. There are significant deficiencies in patients' ability to access multidisciplinary services. Voluntary organisations often bridge the gap in service provision. An investment in services for people with chronic neurological disability is urgently required.

Community Health Services↗

PubMedDate not supplied

[Upper digestive system endoscopy in Gabon. Contribution of 2 years' experience].

Reporting on 805 endoscopies of upper digestive tract performed in a rural area of Gaboon during a period of 28 months, the authors describe the indications and the results by analysing comparatively their findings with some other African ones. Their experience is deeply in favour of performing much more often fibreoptic endoscopy, even if the percentage of investigations revealing no anomaly is high, because its indisputable medical and economical interest.

Adolescent↗

PubMedDate not supplied

[Three successive cases of salmonella meningitis in Gabon].

In a two months period Salmonella ajiobo and S. typhimurium (twice) were isolated from cloudy cerebrospinal fluids (CSF) of children less than one year old. No other cases of Salmonella meningitis occurred in a 2 year survey of meningitis in Franceville, a semi-rural community in southeastern Gabon. One case was fatal and the case with S. ajiobo needed a prolonged course since the CSF was not sterilized even after 6 days of therapy.

Female↗