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PubMedDate not supplied

Jail fever (epidemic typhus) outbreak in Burundi.

We recently investigated a suspected outbreak of epidemic typhus in a jail in Burundi. We tested sera of nine patients by microimmunofluorescence for antibodies to Rickettsia prowazekii and Rickettsia typhi. We also amplified and sequenced from lice gene portions specific for two R. prowazekii proteins: the gene encoding for citrate synthase and the gene encoding for the rickettsial outer membrane protein. All patients exhibited antibodies specific for R. prowazekii. Specific gene sequences were amplified in two lice from one patient. The patients had typical clinical manifestations, and two died. Molecular techniques provided a convenient and reliable means of examining lice and confirming this outbreak. The jail-associated outbreak predates an extensive ongoing outbreak of louse-borne typhus in central eastern Africa after civil war and in refugee camps in Rwanda, Burundi (1), and Zaire.

Adult↗
PubMed2005

New measles genotype, Uganda.

We report the first genetic characterization of wildtype measles viruses from Uganda. Thirty-six virus isolates from outbreaks in 6 districts were analyzed from 2000 to 2002. Analyses of sequences of the nucleoprotein (N) and hemagglutinin (H) genes showed that the Ugandan isolates were all closely related, and phylogenetic analysis indicated that these viruses were members of a unique group within clade D. Sequences of the Ugandan viruses were not closely related to any of the World Health Organization reference sequences representing the 22 currently recognized genotypes. The minimum nucleotide divergence between the Ugandan viruses and the most closely related reference strain, genotype D2, was 3.1% for the N gene and 2.6% for the H gene. Therefore, Ugandan viruses should be considered a new, proposed genotype (d10). This new sequence information will expand the utility of molecular epidemiologic techniques for describing measles transmission patterns in eastern Africa.

Cell Line↗
PubMed1981

Duffy blood types and vivax malaria in Ethiopia.

We investigated an hypothesis relating the Duffy-negative blood type with insusceptibility to vivax malaria--and previously associated only with people of West African ancestry--in three population samples of eastern African stock. The samples included Nilotic and Hamitic-Semitic residents of a malarious locale in Ethiopia and Hamito-Semites in Addis Ababa where malaria is not endemic. Fresh red blood cells from 191 subjects were tested with Duffy antisera, anti-Fya and anti-Fyb. Duffy-positive rates in the malarious community were 8% for the Nilotes and 70% for the Hamito-Semites; the Hamito-Semites in Addis Ababa were 98% Duffy-positive. The relative prevalences of Plasmodium vivax in the two study groups at risk to malaria were 2.4% for the Nilotes and 27.3% for the Hamito-Semites, producing a ratio similar to the ratio of Duffy-positive in the two samples. We interpret the data as supportive of the Duffy-vivax hypothesis with reference to a part of eastern Africa, and we suggest that the Duffy-negative genotype may represent the original, rather than the mutant, condition in tropial Africa.

Adolescent↗
PubMed1992

Agglutination of Plasmodium falciparum-infected erythrocytes from east and west African isolates by human sera from distant geographic regions.

Plasmodium falciparum-infected erythrocytes (PfE) were collected from acutely infected children in The Gambia and Tanzania and cultured for more than 30 hr until the parasites were mature trophozoites. Sera collected from these countries, other African countries, Asia, and South America were used in the PfE microagglutination test to determine whether PfE from East and West Africa share surface antigens. From the patterns of agglutination reactivity, we identified extensive antigenic diversity in surface antigens, but obtained no evidence for greater differences between isolates from East or West Africa and those within one region. The majority of sera from immune adults from The Gambia, Tanzania, Sudan, Nigeria, or Ghana were pan-agglutinating, and agglutinated all PfE isolates from The Gambia and Tanzania. Some sera from immune adults of Irian Jaya also agglutinated each of the seven African isolates, while others agglutinated many but not all of the isolates, similar to sera from immune adults of Flores, Indonesia. In contrast, sera from nonimmune adults from Colombia agglutinated few of the African isolates. It was remarkable, however, that sera from nonimmune Colombians agglutinated any African isolates. Our results are consistent with the following conclusions: some PfE surface antigen(s) are very diverse; this diversity is a feature of the parasite worldwide; the repertoire of isolate-specific surface antigens, although large, includes antigens that are either identical or antigenically cross-reactive in geographically very distant parasite populations; and African adults have pan-agglutinating antibodies that may contribute to protective immunity. Such pan-agglutinating antibodies could reflect the accumulation of a large repertoire of isolate-specific antibodies. The contribution of antibody against any shared PfE surface antigen to the pan-agglutinating reactivities is unknown and awaits development of the appropriate reagents.

Adolescent↗
PubMed1993

Mycetomas in northern Yemen: identification of causative organisms and epidemiologic considerations.

Fifteen cases of mycetomas from four locations in northern Yemen were studied. On the basis of morphologic characteristics and staining properties of the granules in discharges from the draining sinus tracts (a narrow elongated cavity that extends from a focus of suppuration or other inflammatory softening to a free surface and through which pus discharges) in the affected appendages and in tissue sections, three causative organisms were identified: Streptomyces somaliensis, Actinomadura madurae, and Madurella mycetomatis. Because of the similarity in the climate and the causative organisms, northern Yemen can be considered as being in the same endemic area for mycetomas as eastern Africa.

Actinomycetales↗
PubMed1993

Dracunculiasis eradication: beginning of the end.

Beginning with the International Drinking Water Supply and Sanitation Decade (1981-1990), an increasingly broad coalition of international and bilateral agencies, organizations, private companies, and other institutions have joined forces to eradicate dracunculiasis (Guinea worm disease). From an estimated annual incidence of 10 million persons just before the campaign began, the remaining incidence of cases is now less than two million. More than 23,000 villages are known to be endemic. All 18 countries where the disease is still endemic have completed or begun nationwide searches to identify endemic villages, except Kenya. Dracunculiasis is nearly eradicated in Asia, where Pakistan found only 23 cases in 1992, and India found 1,081 cases. Cameroon and Senegal are close to achieving eradication in Africa, where the two formerly highest endemic countries, Nigeria and Ghana, reduced their combined total of cases from approximately 820,000 in 1989 to less than 240,000 in 1992. Much remains to be done, however, in francophone West Africa and especially in East Africa. The most serious current obstacles to eradicating dracunculiasis by 1995 are the civil war in Sudan, apathy of some national and international health officials, and inadequate funding for the campaign.

Africa, Eastern↗
PubMed1995

Dracunculiasis eradication: March 1994 update.

Substantial progress has been realized in the global campaign to eradicate dracunculiasis by the end of 1995 since a previous review of the subject was published in this journal a year ago. All known endemic countries are now engaged in the eradication effort, and one or more control measures are now in place in 93% of endemic villages. Despite improved surveillance for the disease, the number of reported cases of the disease has been reduced by 41% (to about 221,000), and the number of known endemic villages has been reduced by 28% (to about 16,500) in the past year. Priorities for national eradication programs in 1994 include increasing the use of vector control and intensifying the case containment strategy in endemic villages. It is still possible to achieve the eradication target of December 1995, but greatly intensified efforts this year will be required to do so.

Africa, Central↗
PubMed2004

Severe anemia following uvulectomy in Kenya.

Uvulectomy is a common practice in eastern Africa for treatment of a variety of throat conditions. Traditional healers perform the procedure. I present a case report to illustrate a complication of uvulectomy. This is a report of a child who presented with severe anemia secondary to uvulectomy performed for treatment of chronic cough. This case report is intended to illustrate a procedure not commonly performed by western otolaryngologists and to describe the management of a severe complication. Western physicians are increasingly being tasked in medical situations in which they encounter traditional medical practices outside of their scope of training. The intent of this report is to familiarize western physicians with one such procedure and its potential complications.

Anemia↗
PubMed1999

Severe malnutrition due to subtle neurologic deficits and epilepsy: report of three cases.

In southern and eastern Africa, where approximately eight per cent of households lack access to adequate food, children suffering from chronic infections such as tuberculosis, gastrointestinal parasites and human immunodeficiency virus, often present with severe protein energy malnutrition. Three cases are described of children presenting to Chikankata Salvation Army Hospital who required hospitalization and urgent feeding due to PEM. No underlying aetiology for their life-threatening PEM could initially be identified and they were all observed to gain weight while in the intensive feeding unit. After discharge, each re-presented with recurrent failure-to-thrive and were found to have subtle neurologic deficits and underlying epilepsy. Epilepsy and developmental disabilities should be considered in patients with PEM for whom other aetiologies cannot be identified.

Child Nutrition Disorders↗
PubMed1999

[Transmission and conservation of the amaril virus in nature].

The yellow fever virus is a monkey Flavivirus transmitted by mosquitoes. The transmission cycles and vectors vary from Western to Eastern Africa and in South America. There are two types of endemic areas where the virus is maintained: humid forests and emerging zones and areas where intermediary and urban epidemics occur. On both continents, the virus circulates in forest areas by moving epizooties from one region to another among non immune monkeys. The virus can also be maintained in an enzootic or epidemic zone by vertical transmission from a female to her offspring. This type of transmission was proven experimentally as early as 1903 by Marchoux and Simond for Aedes aegypti, the urban vector of yellow fever, but was observed in nature only in 1995. However, the isolation of the virus in male Ae. furcifer taylori in 1977 in Senegal had already suggested that this kind of transmission took place in nature. The vertical transmission of the yellow fever virus means that it can survive, from one rainy season to the next, in Aedes eggs and thus increases the number of contaminating meals and the proportion of females apt to transmit since they infect at a younger age.

Aedes↗
PubMed2001

Letting the cat out of the bag.

The image of the cheetah sprinting gracefully across the African Serengeti in pursuit of its prey is one that we're all familiar with. Many people perceive the cheetah as an animal flawlessly adapted to its environment-the perfect predator.

Acinonyx↗
PubMed2001

[Co-infections of leishmania/HIV in south Europe].

The Leishmania/HIV co-infection has emerged as a result of the increasing overlap between leishmaniasis (mainly visceral, more rarely cutaneous) and AIDS, which is due to the spread of the AIDS pandemic to rural areas and that of visceral leishmaniasis to suburban areas. Cases of co-infection have so far been reported from 33 countries around the world, most of the cases have been notified in south-western Europe. 1,627 cases have been notified from Spain, France, Italy and Portugal. While Leishmania/HIV co-infection is increasing in eastern Africa, cases of co-infection are expected to diminish in South-western Europe due to the new highly active anti-retroviral therapy (HAART). In 1998, a world wide WHO/UNAIDS surveillance network was established, which now includes 28 member institutions. In south-western Europe, the surveillance system based on 16 institutions is now well established. The systematic use of standardized and recently computerized case-report forms, the central international registry at WHO headquarters, and finally the use of a geographic information system (GIS) for mapping and monitoring co-infections have improved the overall quality of epidemiological data gathering. All member institutions of the network report to WHO on an annual basis. World wide information is analysed and periodically disseminated through international publications. The GIS integrates epidemiological and demographic data sets and allows for the mapping of co-infection cases down to locality level. The system can be used to easily visualise and analyse the spatial distribution of co-infection cases and to permit monitoring of the evolution of the distribution of the cases over time. The risk of co-infected patients, as carriers of Leishmania in the blood, to be a source of infection for the sandfly, has been recently confirmed. Moreover intravenous drug users also transmit the disease through the sharing of needles.

Acquired Immunodeficiency Syndrome↗
PubMedDate not supplied

[Epidemiology of cancer of the cavum].

While rare in most parts of the world, cancer of the nasopharynx is shown to be very common in Southern Chinese whether living in South China or elsewhere, is of intermediate level in a variety of Mongoloid populations such as Malays, Thais, Javanese and Vietnamese and the indigeneous peoples of Borneo, yet uncommon in North China and very rare in Japan. Moderate frequencies are seen in parts of the Maghreb, Malta, the Sudan and possibly East Africa. Occupational risk has not been demonstrated and case-control studies have generally been negative. Studies of migrants, notably Chinese of the US, have shown a diminution of mortality for the second and third generation, yet their risk still remains much higher than for white Americans. There is no convincing evidence of elevated risk among low-risk Caucasian populations living in South East Asia. The above findings, which have been held to indicate a genetic predisposition to an unknown environmental agent, are reviewed in the light of the recent discoveries of a characteristic HL-A profile in the high risk Cantonese. Several investigations of the HL-A profiles of groups of contrasting incidence are suggested as these may be of significance in relation to the postulated causal role of the Epstein-Barr virus for this neoplasm.

Africa, Eastern↗