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Seroepidemiology of viral and toxoplasmal infections during pregnancy among Arab women of child-bearing age in Kuwait.

Five hundred and seventy three of 606 (94.6%), 583 of 604 (96.5%) and 575 of 595 (96.6%) women were found to have antibody to rubella virus, cytomegalovirus and herpes simplex virus, respectively. The Geometric Mean Titre (GMT) of haemagglutination-inhibition antibody to rubella virus was 60.97, while the GMT of complement-fixation antibody to cytomegalovirus and herpes simplex virus were 28.49 and 25.01, respectively. Furthermore, 301 of 517 (58.2%) women were also found to possess antibody to toxoplasma (GMT = 10.12) as detected by the passive-haemagglutination test. No significant differences in antibody prevalence or GMT could be found among the various nationalities studied except among Bedouins who showed a significantly higher rate and GMT of antibody to rubella virus and for the Mediterranean Arabs who showed significantly higher rate of immunity to and GMT of toxoplasma antibody when compared to other nationalities. Finally, no significant differences in antibody prevalence or GMT could be found among the various age groups.

Adolescent↗

Kuwait nutritional survey: comparison of the nutritional status of Kuwaiti children aged 6-9 years with the NCHS/CDC reference population.

A national cross-sectional survey of the heights and weights of Kuwaiti primary school children aged 6-9 years was conducted on a stratified multistage sample of 5132 subjects from two socio-economic districts. The collected data were used to compare the nutritional status of Kuwaiti children with their American counterparts using the NCHS/CDC reference population. The basic indices used for comparison were height for age and weight for height, each considered in terms of centiles and SD scores and cross-classified using SD scores. The results indicated that although Kuwaiti children in the studied age groups are shorter than American children severe short stature is relatively infrequent as 48.3% fell below the 30th centile of the reference population. Conversely, Kuwaiti children are relatively heavier than American children as 61.1% fell above the 50th centile of the reference population.

Body Height↗

The changing pattern of antibiotic susceptibilities of Bacteroides fragilis in Kuwait.

The susceptibility of 340 distinct strains of Bacteroides fragilis isolated during 1981 to 1988, to eight antimicrobial agents was determined. These included isolates from infected hospitalized patients (127), infected out-patients (89), faecal isolates from uninfected patients hospitalized for greater than 10 days (48) and from normal subjects in the community (76). All strains were susceptible to metronidazole with a MIC of 1 mg/l. The least effective antibiotics were ampicillin, fusidic acid, erythromycin and tetracycline. There was no significant difference in antibiotic sensitivities between strains causing community-acquired and those causing hospital-acquired infections. However faecal isolates from hospitalized patients were significantly more resistant to ampicillin (P less than 0.05), cefoxitin (P less than 0.005) and clindamycin (P = 0.001) than community faecal isolates. During the study period there was a rise in resistance to clindamycin (P less than 0.005), cefoxitin, erythromycin and fusidic acid (P less than 0.001) and tetracycline (P less than 0.05). Antimicrobial resistance of B. fragilis is rising and long periods of hospitalization seem to play an important role in its development.

Anti-Bacterial Agents↗

Helicobacter pylori-associated gastritis in Kuwait: endoscopy-based study in symptomatic and asymptomatic children.

Information is limited concerning the prevalence of Helicobacter pylori infection in asymptomatic children. Since January 1989, we have endoscoped 60 children for recurrent abdominal pain or for obtaining small-intestinal biopsy (their ages were a mean of 6.6 (range 9 months-13 years); there were 37 boys and 23 girls. Antral biopsies were obtained from all subjects and these were studied for the presence of gastritis and stained for H. pylori using modified Gram's stain. All biopsies were cultured for H. pylori. Children endoscoped for small-intestinal biopsy (n = 18) were used for comparison. Of the 42 children who had abdominal pain, 24 showed histological gastritis and 13 had H. pylori on microscopy (31% H. pylori-associated gastritis). In the compared group, five showed histological gastritis, and all had H. pylori on microscopy (27.7%). Culture was positive in 15; sensitivity was 85.7%. Six children, three pairs of siblings, had H. pylori gastritis supporting environmental etiology. Two had coinfection with intestinal giardiasis. Seven children were treated with daily oral amoxycillin (50 mg/kg) and tinidazole (20 mg/kg) for 6 weeks. In 3 (42.3%) H. pylori colonization cleared with healing of gastritis and resolution of symptoms. These results indicate that H. pylori gastritis is equally prevalent in symptomatic and asymptomatic children (31 and 27.7%, respectively; p > 0.05) in our population. It seems that the combination of oral amoxycillin and tinidazole is a poor choice in the treatment of H. pylori-associated gastritis in Kuwaiti children.

Abdominal Pain↗

Microbial etiology of acute gastroenteritis in hospitalized children in Kuwait.

During a period of 15 months 621 hospitalized children with acute gastroenteritis and 152 control children were investigated for etiologic agents of the disease. Putative enteropathogens were identified in 86% of the patients and 10% of the controls. Common viral agents associated with gastroenteritis among children included rotaviruses (45%) and enteric adenoviruses (4%). Bacterial pathogens infecting children were Salmonella serotypes (24%), enterotoxigenic Escherichia coli (9%), Campylobacter jejuni (7%), enteropathogenic E. coli (7%), Shigella (4%) and enterotoxigenic Aeromonas sp. (1%). The highest incidence of infections was observed in the 3- to 25-month age group. Mixed infections were observed in 12% of the patients. Viral gastroenteritis was clinically mild and of short duration. Upper respiratory tract infections, vomiting and watery stools were common features. In contrast bacterial gastroenteritis was more severe; stools were frequently bloody and abdominal pain, cramps, shock, convulsions and milk intolerance were predominant clinical features. Comparative analysis revealed differential features of bacterial and viral gastroenteritis which should help clinicians to make a tentative diagnosis and to start treatment early.

Acute Disease↗

Molecular characterization of strains of Human herpesvirus 8 from Japan, Argentina and Kuwait.

Current genotyping systems for Human herpesvirus 8 (HHV-8) are based on the highly variable gene encoding the K1 glycoprotein. Most strains collected worldwide cluster into two subtypes (I/A and II/C). Sequenced African strains have belonged to subtypes I/A and IV/B. Members of all three of these subtypes can have either the M or P allele at the right-hand side (RHS) of the genome. Strains obtained predominantly from aboriginal or relatively isolated populations have formed clades that branch at a distance from subtypes I/A and II/C, all being of the RHS P allele. The characterization is reported here of 16 Japanese, two Kuwaiti and five Argentine HHV-8 strains obtained from human immunodeficiency virus-infected and non-infected patients with Kaposi's sarcoma (KS), primary effusion lymphoma, multicentric Castleman's disease or renal transplants. K1 sequences of five Japanese, one Kuwaiti and two Argentine strains were identified as subtype I/A and eight Japanese, one Kuwaiti and three Argentine strains were subtype II/C. Three strains from elderly classic KS patients originally from Hokkaido, a northern Japanese island, were relatively closely related to strains of subtypes III/D and E. Consistent with previous observations, both the M and P alleles were identified at the RHS of subgroup I/A and II/C genomes; only the P allele was detected among the three Hokkaido strains. Distances among the Hokkaido strains were similar to the distance between subtypes I/A and II/C, suggesting that the Hokkaido strains may represent two distinct subtypes and that, as more strains are analysed, the currently recognized III/D subgroups will probably emerge as independent subtypes.

AIDS-Related Opportunistic Infections↗