Biomedical subjects
P D Marsden
Publications and source records attributed to P D Marsden.
Control of the transmission of Chagas' disease in Mambai, Goias, Brazil (1980-1988).
The results of entomologic surveillance conducted after Chagas' disease control in Mambai, Goias, Brazil are reported for the years 1985-1988, including a summary of results from 1980 to 1988. A progressive decrease in the incidence of Triatoma infestans in houses reached zero in 1988. The threat of secondary vector colonization and the continued need for vigilance are discussed.
The effect of plastering in a house persistently infested with Triatoma infestans (Klug) 1934.
The replastering of a house in Mambai-Goias, Brazil, as a measure to wall-in Triatoma infestans, is briefly described. Unfortunately, because the houseowner would not cooperate the roof tiles were not improved and eventually T. infestans reappeared at this site. A brief discussion follows of some aspects of house improvement in the vigilance phase of a Chagas Disease Control Programme. T. infestans appeared in the house described 51 and 258 days after the replastering.
AIDS: it came for the carnival.
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Letter from Brasilia. Yellow fever.
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Fertile flukes and mediating molluscs.
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Histological analysis and the pathogenesis of mucocutaneous leishmaniasis.
A series of over 400 well-documented biopsies of mucocutaneous leishmaniasis was evaluated to elucidate the histological processes associated with the elimination of parasites, and their correlation with the course of the disease. Non-specific inflammation was the most frequent and least effective response; its onset might be delayed, and in this event particularly the incidence of metastasis from skin to mucosa was high. Lysis of parasite-laden macrophages appeared to be the basic mechanism of parasite reduction, even when it was not overt. When it was acute the onset was usually rapid, and though it resulted in much tissue destruction the prognosis was generally better and mucosal metastasis rare. Lysis and non-specific inflammation both led to the formation of a post-necrotic type of granuloma, but reversion of the process was almost as common as progression. Ultimately a tuberculoid granuloma evolved and proceeded to resolution. In about 5 per cent of cases, macrophage activation appeared to bring about early resolution; neither reversion nor mucosal metastasis was seen.
Mucosal leishmaniasis in Brazil.
The clinical diagnosis and laboratory identification of Leishmania braziliensis braziliensis, a parasitic disease affecting the upper aerodigestive tract, is difficult. A retrospective computer-assisted analysis of patient records was done after examination of 58 patients with mucosal leishmaniasis in an endemic area of L. braziliensis braziliensis in Bahia, Brazil during January 1987. Biopsies of clinically active and clinically inactive mucosal patients were examined for parasites using routine hematoxylin and eosin histopathology and a new technique for rapid detection of Leishmania amastigotes using a genus-specific indirect immunofluorescent assay. No amastigotes were found in specimens from seven patients with clinically inactive mucosal disease using immunofluorescent monoclonal assay techniques, whereas specimens from seven out of 14 patients with clinically active mucosal disease were positive. These results suggest that the immunofluorescent antibody technique is markedly superior in identifying the intracellular amastigote in tissue sections of mucosal biopsies when compared to histopathology techniques or with other standard tests done in rural areas of Brazil. Various clinical and laboratory test data of the entire group of patients were examined and the efficacy of treatment evaluated. The median interval of time noted between cutaneous and mucosal disease was 4.5 years. Relapse was noted in 31% of patients treated with a low dose of meglumine antimoniate (10 mg per kg of body weight). Patients treated with a high dose of meglumine antimoniate (20 mg per kg of body weight) had a relapse rate of 27.3%. A chi-square statistical analysis revealed no significant difference (chi 2 = 0.049) between the two groups. Patients were considered cured if mucosal granulations were clinically absent after 4.6 years.
Predominance of Leishmania braziliensis braziliensis in the regions of Três Braços and Corte de Pedra, Bahia, Brazil.
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Epidemiological vigilance with community participation in the control of the vectors of Chagas' disease in Goias, Central Brazil.
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