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S Bennett

Publications and source records attributed to S Bennett.

At least 163 records · Page 9Linked to original sources

Adjustments to the Mantel-Haenszel test for data from stratified multistage surveys.

The usual form of the Mantel-Haenszel test statistic assumes independent observations. This is inappropriate for data from a stratified multistage survey. Two alternative adjustments to the test statistic are developed to deal with this: (a) a modification of the effective sample size for each row of each table, using the design effects, extending a method proposed by Donald and Donner for familial aggregation studies; (b) a Taylor series approximation to the variance of the square root of the numerator of the Mantel-Haenszel statistic. Both methods are evaluated by application to both simulated and real data. The two methods perform equally well, and offer a considerable improvement over the unadjusted test statistic when observations from the same cluster are highly correlated. A simplified adjustment is also considered, as is the need for correction to the variance of the odds ratio estimator.

Chi-Square Distribution↗

MHC and malaria: the relationship between HLA class II alleles and immune responses to Plasmodium falciparum.

In mice, immune responses to subunits of defined malaria antigens are regulated by genes mapping within the MHC and it has been suggested that such genetic restriction will be a major obstacle in the development of a human malaria vaccine. The relationship between class II human leukocyte antigen (HLA) genes and immune recognition of three candidate antigens for a vaccine against Plasmodium falciparum malaria has been investigated in a human population living in a malaria endemic area of West Africa. The study population was shown to be extremely heterogeneous for HLA class II alleles and marked differences in allelic frequency were detected between members of different ethnic groups. One class II DQA-DQB combination (serological specificity DQw2) was particularly common among members of the Fula ethnic group. This haplotype was significantly associated with higher than average levels of antibody to a peptide epitope, (EENV)6, of the malaria antigen Pf155/RESA. There was little evidence of association between HLA class II genotype and cellular proliferative or interferon gamma responses to the antigens tested. Overall, the number of significant associations between immune responses and specific HLA class II haplotypes was greater than would be expected by chance but less than would be expected if class II-dependent genetic restriction were a major factor governing human immune responses to malaria antigens. Thus, although some qualitative variation in the immune response to vaccine antigens may occur in ethnically different target populations, widespread HLA-associated nonresponsiveness to a multivalent subunit malaria vaccine is unlikely.

Adolescent↗

Naturally acquired cellular and humoral immune responses to the major merozoite surface antigen (PfMSP1) of Plasmodium falciparum are associated with reduced malaria morbidity.

We have investigated the pattern of acquired immune responses to the major surface protein of Plasmodium falciparum merozoites (gp 190, PfMSP1) in a malaria endemic population in West Africa. A prospective longitudinal study in 3- to 8-year-old children was conducted to examine the relationship between naturally acquired immune responses to PfMSP1 and subsequent susceptibility to malaria infection and clinical disease. A population cross-sectional survey was performed to investigate changes in immune response with age. The prevalence and concentration of antibodies to all regions of the molecule increased with age with the highest prevalence of antibodies being detected against regions of the molecule which are highly conserved between parasite isolates. In vitro lympho-proliferation and interferon-gamma production in response to recombinant proteins representing polymorphic regions of the molecule also increased with age. Interestingly, proliferative responses to some regions of the molecule, including some highly conserved sequences, were highest in young children and decreased markedly with increasing age. Significant associations were observed between antibody and lymphoproliferative responses to proteins from the C terminus of the molecule and resistance to episodes of fever associated with high parasitaemia in partially immune children. In addition, high concentrations of antibodies to a conserved region close to the N terminus of PfMSP1 were also significantly associated with protection.

Africa, Western↗

Shyness and education: the relationship between shyness, social class and personality variables in adolescents.

The study considers the relationship between shyness, some related personality variables and socio-economic status. Adolescent shyness levels are examined using two self-report questionnaires which cover the spectrum of inherent, emotional and situational shyness. These findings were correlated with individual levels of anxiety, neuroticism and also with socio-economic status. The educational implications of these results are discussed and the problem of the definition of shyness is addressed. The sample comprised 650 adolescents in the age range 11-18 years, drawn at random from two secondary schools, the number of boys being 300 and the number of girls 350. The results indicate that high levels of both situational and inherent shyness are related significantly to high levels of anxiety and neuroticism. Inherent shyness and situational shyness correlate only moderately with one another. Low levels of situational and inherent shyness are related positively and significantly to high levels of self-esteem and extraversion. Similar patterns of relationships occur for the other variables considered. The stability coefficients of correlations for each type of shyness were high after an interval of six months. Furthermore, shyness is related significantly to the socio-economic class of adolescents: a relatively higher percentage of shyness occurs among adolescents of lower socio-economic class.

Achievement↗

Reproducibility of measurements of blood pressure in a tropical environment.

The reproducibility of measurements of the blood pressure of 65 adult male Gambians was investigated to assess the role that replication of measurements may have in epidemiological studies in a tropical environment. Observations were made at approximately seven week intervals over a period of 15 months and measurements were repeated three times on each occasion a subject was seen. The magnitude of the variation of an individual subject's BP between occasions, and between readings on the same occasion, was comparable with those which have been observed in studies in developed countries in temperate climates. The variation between occasions was greater than that between readings on the same occasion. There was a significant fall in systolic pressure between the first and third occasions, and a more gradual fall in diastolic pressure. The observations suggest that an individual subject's BP level would be better characterized by making a second reading on another occasion than by making three or more readings on the same occasion. These results have implications for the design of epidemiological studies and for the diagnosis of hypertension in the tropics.

Adult↗

An investigation of some risk factors for severe leptospirosis on Barbados.

Between November 1979 and the end of December 1986 (7.17 years), 248 cases of leptospirosis were confirmed among hospital patients on Barbados (mean 35 per year; range 25-57). Considering the 235 who were greater than or equal to 15 years of age, the annual incidence of leptospirosis was 19.2/100,000 population (14.0 for all age groups). There were 173 males and 62 females, and for cases aged 15-34 leptospirosis was 9.6 times more common in men than women. Among men, incidence increased fairly steadily with age, and an even steadier increase was apparent in women up to age 64, with some decline in later years. The incidence of disease was much higher among agricultural than other workers and the non-employed. Highest case numbers were recorded in the parishes of St Michael (65 or 28%) and Christ Church (36 or 15%), though the incidence was lowest in these two parishes (13.1/100,000 and 17.4/100,000, respectively). The highest incidence rates were in St Andrew and St Joseph (50.2 and 36.1/100,000, respectively). The incidence in areas with rainfall greater than or equal to 1600 mm (32.6/100,000) was nearly twice that in areas with rainfall less than 1600 mm (17.3/100,000). There is a clear link between cases of severe disease and recent rainfall. Using 134 patients greater than or equal to 15 years of age with fever due to other illnesses as controls, a higher proportion of cases than controls came from rural areas. The risk of contracting leptospirosis was increased for all categories of manual workers relative to the group at lowest risk (non-manual indoor workers). Sugar-cane workers were five times more likely to contract leptospirosis than were non-manual indoor workers, while those whose families minded livestock were 2.5 times more likely, and those with rodents in their garden/yard were 1.8 times more likely to do so. Other risk factors examined did not show significant associations with the disease. Despite increasing mechanization and the use of more protective clothing, agricultural workers are still at high risk from leptospirosis. The annual range of cases is likely to stay much as it is in the foreseeable future.

Adolescent↗

Common west African HLA antigens are associated with protection from severe malaria.

A large case-control study of malaria in West African children shows that a human leucocyte class I antigen (HLA-Bw53) and an HLA class II haplotype (DRB1*1302-DQB1*0501), common in West Africans but rare in other racial groups, are independently associated with protection from severe malaria. In this population they account for as great a reduction in disease incidence as the sickle-cell haemoglobin variant. These data support the hypothesis that the extraordinary polymorphism of major histocompatibility complex genes has evolved primarily through natural selection by infectious pathogens.

Animals↗

Immune response to soluble exoantigens of Plasmodium falciparum may contribute to both pathogenesis and protection in clinical malaria: evidence from a longitudinal, prospective study of semi-immune African children.

Some soluble exoantigens of Plasmodium have lipopolysaccharide (LPS)-like properties and are believed to contribute to the pathogenesis of acute malaria. We have studied cellular and humoral immune responses to several purified exoantigens of Plasmodium falciparum in a cohort of children and compared these responses with their subsequent susceptibility to malaria infection and clinical disease. We found no evidence that either lymphoproliferative or interferon-gamma (IFN-gamma) responses to these antigens were associated with protective immunity. On the contrary, children whose cells produced IFN-gamma after in vitro activation with one of the soluble antigens (Ag7) were more likely to experience clinical manifestations of malaria infection (fever and malaise) than were children whose cells did not produce IFN-gamma. It is possible that exoantigen-induced IFN-gamma may exacerbate the LPS-like effects of these antigens. However, serum antibodies to another antigen (Ag2) were more prevalent in children with asymptomatic infections or low parasitemia than in children with fever and higher parasitemia (confirmed clinical malaria), suggesting that these antibodies may contribute to the development of protective immunity.

Animals↗

Absence of epidemicity of severe leptospirosis in Barbados.

The possibility of micro-epidemics of severe leptospirosis occurring on the island of Barbados was investigated by examining the space-time clustering of the disease in 212 laboratory-confirmed cases admitted to Queen Elizabeth Hospital, Bridgetown, over a 7-year period. A series of 109 patients with symptoms compatible with leptospirosis but shown to be otherwise by laboratory examination were also examined for comparison. No significant space-time clustering was found among the leptospirosis cases, indicating no evidence for micro-epidemics. By comparison, statistically significant clustering was apparent among the smaller non-leptospirosis series. Possible explanations for the absence of observed micro-epidemics of leptospirosis are discussed.

Barbados↗