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Biomedical subjects

J Muttunga

Publications and source records attributed to J Muttunga.

4 recordsLinked to original sources

Is one year follow-up justified in kala-azar post-treatment?

Sixty-five patients, 51 males and 14 females, with clinical and parasitological evidence of visceral leishmaniasis were initially treated as follows: 44.6% were on intravenous sodium stibogluconate (pentostam) 20 mg/kg/d for 30 days, 35.4% was on a combination of pentostam as above and allopurinol 21 mg/kg/d in three divided doses for 30 days while 20% was on pentostam 10 mg/kg thrice/d intravenously for 10 days. All patients were parasitologically negative by the end of their respective treatment regimen. All patients were reviewed at 2 months, 6 months, and 12 months periods in order to evaluate the relapse rates and optimal follow-up period. Thirteen patients (20%) relapsed at 2 months and one patient (1.5%) relapsed at 6 months follow-up periods respectively. There was no relapse between 6 months and 12 months follow-up period. The mean liver and spleen sizes in responders showed a dramatic reduction at 2 months follow-up and thereafter a gradual reduction occurred in the next 10 months. Weight gain continued throughout the year. Apart from platelet count which showed a sustained high level from discharge to 12 months follow-up, the peripheral blood indices stabilized from 2 months follow-up. Relapses were retreated until parasitologically negative twice and then followed up, for a period of 12 months. At follow-up the liver and spleen sizes reduced gradually in the next 12 months.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗

Comparative aetiology of childhood diarrhoea in Kakamega and Kiambu Districts, Kenya.

Two hundred diarrhoea specimens collected during January to February 1988, from rural children aged 0 to 60 months in Kakamega District were examined for bacteria, parasites and rotavirus. The results were compared with a sample of 184 diarrhoea specimens matched for month of collection, taken from data collected in the same manner from children in Kiambu District. The mean ages of children in the 2 samples did not differ significantly. There were significant differences in the prevalence of specific potential pathogens isolated in the 2 areas. Notably, A. lumbricoides and rotavirus were more common in Kakamega, while G. lamblia, Entamoeba histolytica, Trichomonas hominis, Cryptosporidium sp., Hymenolepis nana and EPEC were more common in Kiambu. There was no difference with respect to prevalence of Campylobacter sp. or Blastocystis hominis. Factors which were probably important in determining aetiological differences included climate, water sources, animal contact and crowding. The differences highlight the fact that general predictions about aetiology cannot be made from isolated studies.

Child, Preschool↗

Cereal based oral rehydration solutions.

A total of 257 boys (age range 4-55 months), who had acute diarrhoea with moderate to severe dehydration, were randomly assigned to treatment with either the World Health Organisation/United Nations Childrens Fund (WHO/Unicef) recommended oral rehydration solution or cereal based oral rehydration solution made either of maize, millet, sorghum, or rice. After the initial rehydration was achieved patients were offered traditional weaning foods. Treatment with oral rehydration solution continued until diarrhoea stopped. Accurate intake and output was maintained throughout the study period. Efficacy of the treatment was compared between the different treatment groups in terms of intake of the solution, stool output, duration of diarrhoea after admission, and weight gain after 24, 48, and 72 hours, and after resolution of diarrhoea. Results suggest that all the cereal based solutions were as effective as glucose based standard oral rehydration solution in the treatment of diarrhoea.

Dehydration↗

Mixed infections in childhood diarrhoea: results of a community study in Kiambu District, Kenya.

One thousand four hundred and twenty diarrhoea specimens from 846 children aged 0 to 60 months were collected and analysed for bacteria, parasites and rotavirus over a 16 month period, from June 1985 to September 1986 inclusive. The study was conducted in 4 villages situated in Kiambu District, Kenya. All the specimens were analysed for rotavirus and parasites, including Cryptosporidium. The majority of the specimens were analysed for enteropathogenic Escherichia coli (EPEC), Shigella, Salmonella, Campylobacter and Aeromonas. Only 387 specimens were analysed for enterotoxigenic E. coli (ETEC). However, of this proportion analysed for ETEC, 33% were positive. A total of 344 specimens were negative for any organisms while a further 140 were only positive for parasites which have been implicated as being pathogenic, including Ascaris lumbricoides, Hymenolepis nana, Trichomonas hominis and Blastocysts hominis were considered to be at least potentially pathogenic and capable of causing diarrhoea. An average of only 29.4% of these organisms occurred as single isolates. The remaining infections were mixed, with a maximum of 7 potentially pathogenic organisms occurring together in a single specimen. The associations of certain organisms were significant, notably Campylobacter with Giardia lamblia. Campylobacter with EPEC, EPEC with Ascaris, and G. lamblia with rotavirus. The latter was a negative association.

Community Health Services↗