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[Seroepidemiological investigations in domestic ruminants from Egypt, Somalia and Jordan for the demonstration of complement fixing antibodies against Rickettsia and Chlamydia (author's transl)].

1450 random serum samples of domestic ruminants from Egypt, Somalia and Jordan were investigated for complement fixing antibodies against Rickettsia and Chlamydia. Between 1.5 and 3.4% of the samples from the animals investigated had antibodies against the RMSF-group of Rickettsia, with exception of the sera from Somalian cattle and sheep from Jordan. Antibodies against Rickettsia of the Typhus-group were found in 4 cattle and 1 goat from Jordan and 2 sheep from Egypt; by agglutination test with type-specific antigen they were identified as antibodies against R. typhi. Using 2 different antigens, antibodies against Coxiella burnetii were found in every population tested. The prevalence was 2.0 to 12.2%, with the exception of cattle in Somalia, where only 1 positive serum (0.2%) was found. 27% of the serum samples from Jordan and 22% from Egypt but none of the 802 samples from Somalia had antibodies against Chlamydia. The results are discussed under an epidemiological point of view.

Animals

[Mycetoma in Somalia - results of a survey done from 1959 to 1964].

The Pasteur Institute studied 103 mycetoma patients in Somalia between 1959 and 1964. Grains were seen in 94 of them and this, added to cultural features, allowed the diagnosis of 60 pathogens as follows: 44 Madurella mycetomi, 1 Leptosphaeria senegalensis, 7 Pyrenochaeta romeroi (or Madurella grisea), 3 Allescheria boydii, 1 Fusarium sp., 3 Neotestudina (Zopfia) rosatii, and 1 unidentified; 34 were actinomycetes: 24 Streptomyces somaliensis, 4 Actinomadura madurae, 3 A. pelletieri and 3 Nocardia spp. The patients delayed too long in consulting their doctors and health education is vital if amputations are to be avoided. The geographical distribution is related to climate and fungal species. In central Somalia the association of M. mycetomi and S. somaliensis, organisms characteristic of desert conditions, was found; white grain mycetomata and those caused by Nocardia spp. occurred in more humid areas. The study revealed 2 new fungi. One, obtained in culture was called Neotestudina (Zopfia) rosatii. The 3 patients affected, lived in Mudugh (2 in El Bur). The other fungus was not identified. It also was recovered from El Bur and one with similar microscopic characters has been seen in Chad and also in "territoire français des Afars et des Issas". Both fungi are desert species.

Acremonium

Histoplasmosis diffusion in Somalia: study of skin-test and serological survey.

Histoplasmin skin-test was applied to 1014 patients in two different parts of Somalia: in Mogadishu, an arid area, and in Jilib, a southern village on the banks of the Juba river. Among these patients only three gave areas of induration greater than 5 mm in diameter; all reactors were from Jilib. Results of a serological survey (latex-agglutination test) of histoplasmosis antibodies among 203 Somalian patients from three villages in river valleys are compared with the results of 171 inhabitants of the town of Mogadishu. Indirect agglutination antibody titers greater than or equal to 20 were found in 21.6% of the Mogadishu population as compared to 52.2% found in the river villages. In 96.2% of our cases in which the two tests were contemporarily used, the skin-test was completely negative despite high titres of positivity in the serological test. The results indicate the existence of founts of histoplasmosis infection in Somalia, particularly in humid areas bordering the rivers rather than in the surrounding arid semi-desert area characteristic of most of the country.

Female

Alpha-1-antitrypsin phenotypes in a group of newborn infants in Somalia.

Pi phenotype determinations were performed on umbilical cord serum specimens of 347 infants born in Mogadishu (Somalia) hospitals. Phenotyping was performed by isoelectric focusing on polyacrylamide gel slabs. Sera containing alpha1AT in types other than MM were also studied by crossed antigen-antibody immunoelectrophoresis on agar. The most frequently occuring Pi allele proved to be PiM. With respect to the other African populations studied so far, there was a high prevalence of the PiS and PiZ alleles. In particular, three individuals were found with the ZZ phenotype, which had not yet been observed in Africa.

Fetal Blood

Resistance to antibiotics of Shigella strains isolated in Somalia.

The resistance to antibiotics of 240 Shigella strains isolated in Somalia from 1973 to 1976 was studied. Many strains, particularly those of Shigella dysenteriae type 1, were found to be resistant to more than one drug. In view of their resistance to ampicillin, chloramphenicol, streptomycin, tetracycline, and sulfonamides, it is suggested that polymyxin B or M sulfate - which have proved to be effective in vivo - should be used for the treatment of clinically typical cases of bacillary dysentery.

Anti-Bacterial Agents

Bovine brucellosis in the southern regions of the Somali Democratic Republic.

For the first time a survey of the prevalence of bovine brucellosis in three regions of the Democratic Republic of Somalia has been carried out. Blood sera were tested by the SAT and CFT and milk samples by the MRT. An average prevalence rate of 9.5 per cent (SAT) and 12.0 per cent (MRT) was found. There was considerable differences between regions and the reasons for this are discussed.

Agglutination Tests

Smallpox eradication: progress and problems.

In 1958, the Eleventh World Health Assembly, on the proposal of the USSR, approved a resolution for world-wide smallpox eradication. In that year alone the disease occurred in 59 countries, and in addition many other areas experienced imported cases. When the intensified eradication programme began in 1967, there were 33 countries with endemic smallpox and two more countries subsequently became endemic. These 33 countries had a population of over 1,200,000,000 and were located in four of the six WHO regions. The most important endemic area was in Asia, but the disease was also endemic in South America and in Africa, south of the Sahara. The intensified campaign quickly narrowed the endemic area. In April 1971, the last case was reported from Brazil, the stronghold of the disease in the Western Hemisphere. By 1973, with the exception of those in the Horn of Africa, smallpox transmission was interrupted in all African countries. The last case in Asia occurred in Bangladesh where variola major made its last stand. The last known case of smallpox in the world was reported from Somalia on 27 October 1977. If no more cases are discovered it will be possible, in two years from that date, to certify that smallpox has been eradicated from all areas of the world, and Member States of the World Health Organization will be able to celebrate an unprecedented victory for preventive medicine. The complete eradication of smallpox is not only the liberation of the world from one of its most dangerous diseases, but also provides an example of what can be achieved when countries throughout the world join together with a common aim.

Africa

Leprosy and hepatitis B virus markers: incidence of HBsAg and HBeAg in Somalian patients.

Serum samples from 222 Somalian patients, 135 with the lepromatous form of leprosy and 87 with the tuberculoid form of the disease, were examined for the presence of the surface antigen (HBsAg), the "e" antigen (HBeAg), and their corresponding antibodies (anti-HBs and anti-e). HBsAg was present in 24.4% of the LL cases and in 11.5% of the TT patients while anti-HBs was found respectively in 46.6% and 58.6%. The e-antigen was not found in any case of leprosy; anti-e was detected in 8.1% of the LL patients and in 3.5% of the TT cases. The rate of HBV seropositivity (HBsAg plus anti-HBs) was the same in the LL patients (71.1%) and in the TT patients (70.1%) and that could reflect the conditions of life in their closed community. The analysis of results obtained in Somalia has shown the presence of a difference in the distribution of HBsAg among leprosy patients, with an increased antigenemia in the lepromatous form which was statistically significant (p less than 0.05). No differences, however, were found between the leprosy patients and healthy controls. These observations seem to indicate that patients with lepromatous leprosy do not have an increased susceptibility to infection by hepatitis B virus.

Adolescent

Certification of smallpox eradication.

The world's last known case of smallpox resulting from human-to-human transmission in an endemic focus occurred in Somalia in October 1977, and there remains the task of documenting the global eradication of the disease and establishing the safety of vaccination. Those countries as yet uncertified have been grouped into four categories according to the procedures recommended for their certification. An important criterion for deciding the type of procedure is how recently smallpox was endemic in a particular country. This paper is concerned with those countries in which the disease has been nonendemic for some years but which have not yet received certification of eradication. One such country is Burma, which was certified free of smallpox in 1977, some 8 years after its last reported case but 2 years after the last case in Bangladesh, with which it shares a long frontier. The procedures used in Burma and the lessons that were learnt therefrom are described.

Adolescent

[Diffusion of hepatitis B surface antigens in subjects with bladder schistosomiasis].

The problem of the relationship between the surface B antigen and the parasitosis characterized by active penetration of the larvae through the skin has not yet been resolved. Conflicting results have been reported lately on this problem even though it is currently believed that HBsAg is found more often among patients infected by parasites than among healthy subjects. Serum samples from 67 Somalian patients infected by S. haematobium were tested for the presence of the surface B antigen by ELISA method. The HBsAg was found in 19.4 per cent of these patients, while among controls (90 cases) the frequency of HBsAg was of 10 per cent. A comparative analysis of the results obtained with various methods in Somalia shows that the frequency of HBsAg among subjects with urinary schistosomiasis is of 25.9 per cent with indirect haemoagglutination (IHA), of 19.4 per cent with ELISA method and of 14.8 per cent with radioimmunoassay (RIA). These observations seem to indicate that the problem of an increased frequency of HBsAg among patients with urinary schistosomiasis needs further investigation.

Adolescent

[Relations between hepatitis B surface antigen and parasitic diseases: observations in patients with ancylostomiasis and schistosomiasis].

Hepatitis B antigen carriage was studied in Somalia in 155 patients with ancylostomiasis, with urinary schistosomiasis and with leprosy (lepromatosus and tuberculoid type and leprosy with schistosomiasis). The results have showed a significantly (p less than 0,001) higher frequency of HBsAg among the patients with ancylostomiasis (33,33%) and with urinary schistosomiasis (25,92%) than either the leprosy patients (9,67% in the L type and 6,89% in the T type) or the controls (11,11%); in the leprosy patients with schistosomiasis the frequency was 40,0%. The role of some penetrating skin parasites in the epidemiology of hepatitis B was discussed.

Ancylostomiasis

The surface antigen (HBsAg) and the e-antigen (HBeAg) in Somalian patients with acute viral hepatitis.

Serum samples from 55 Somalian patients with acute viral hepatitis were examined for the presence of the surface antigen (HBsAG) and the e-antigen (HBeAg) and the corresponding antibodies (anti-HBs and anti-e). No e-antigen was detected in patients with viral hepatitis or in controls (47 cases); anti-e was found in 23.6% of hepatitis cases, all of whom were HBsAg carriers, and in 10% of the controls. The HBsAg was found in 60% of cases with hepatitis and 34% of controls; the anti-HBs was detected in 18% of the patients with hepatitis, all except one of whom were negative for HBsAg; in the one exception the HBsAg and anti-HBs were present simultaneously; the anti-HBs was found in 44.6% of controls. The frequency of serological evidence of hepatitis B infection (HBV) based on the presence of antigen/antibody HBs was 78.2% among patients with acute viral hepatitis; only 30% of these patients showed evidence of anti-e antibody.

Acute Disease