IGA antiphospholipid antibodies in HLTV-1-associated tropical spastic paraparesis

A retrovirus human T cell lymphotropic virus type I (HTLV-I), is an essential but not a sufficient aetiological factor for tropical spastic paraparesis (TSP). Because some TSP patients have biological false positive tests for trepomemal infections (BFP-STS), we used EISA to study BFP-STS and anticardiolipin antibodies in 42 Jamaican TSP patients. The data indicate that in TSP anticardiolipin antibodies accur in about 26 percent of patients, are associated with biological false positive treponemal serology, are relatively restricted to the IgA isotype and may be induced by HTLV-I or other non-treponemal infections. (Au)

Effects of life conditions on the health of a negro slave community in Suriname: with reference to similar aspects in local pre-Columbian Amerindians

Describes a physical, anthropological, paleo-pathological study on the remains of Negro slaves from plantation "Waterloo" in Suriname (1793/1796-1861). Its aim was to reveal the living and health conditions of a plantation community. It comprised of a survey of the burial site, the excavation and inspection of 57 graves, and the laboratory analysis of the skeletal remains of 38 individuals. Main topics were the burial practice, demography, pathological changes and anomalities of bones. The results seem to correspond with archive data. A high incidence of treponematosis (56 per cent) was probably due to a surplus of males and to unstable matrimonial relationships. Both the calculated stature and Harris lines reflected a poor and fluctuating health and nutritional status during growth. Compared to a locally buried pre-Columbian Amerindian population (ca. 900 A.D.) the slaves seemed to have a better life expectancy and dental status. The Amerindians seemed less susceptible to infectious diseases and anaemia

Prevalence of reactive serological tests for syphilis in the Jamaican population

Serological tests for syphilis (STS) were performed on sera from 15,876 members of the general adult population, 3,039 pregnant women and 1,029 children, in order to assess the prevalence and value of reactive STS in Jamaicans; 2.7 percent of sera from the general adult population, 4.7 percent from pregnant women and 2.2 percent from children were reactive in the Venereal Disease Research Laboratory (VDRL) test. Reactive Flourescent Treponemal Absorption (FTA-ABS) tests occurred in significantly higher frequency in pregnant women (4 percent ) than in the general population (2.2 percent; p<0.001). The prevalence of reactive STS in children did not differ significantly from that of the general adult population. The predictive value of a reactive VDRL test in pregnant women (85 percent) was higher than that of the general population (79 percent). These results suggest that inadequate screening with the inexpensive VDRL test would enable the early detection and treatment of syphilis, and could prevent increasing incidence of congenital syphilis in Jamaica (AU)

A historical study of human T lymphotropic virus type I transmission in Barbados

A 1972 historic sera collection from two health districts in Barbados, British West Indies, was evaluated for risk factors and epidemiologic patterns of HTLV-I (human T cell leukemia virus type I) during a time prior to the first report of its discovery in 1980. HTLV-I seroprevalence is 4.2 percent (43 of 1,012) and is consistent with current estimates in endemic areas in the Caribbean. Age dependent rise (P<.01) and higher seroprevalence rates for females (P<.01) are indistinguishable from the pattern in contemporary Caribbean and Japanese populations. HTLV-I seropositivity was 4 times higher in women (P<.003) and 2.6 times higher in men (P=.32) with treponemal antibodies, supporting a role for sexual transmission. Children who were positive in a household were more likely to have a seropositive mother than a seropositive father. This pattern is consistent with transmission of the virus from mother to child. Our results document that rates of infection and modes of transmission of HTLV-I are persistent. (AU)

Treponemal serological tests in Jamaican school children, 1976

Sera from 899 children aged 6-14 years attending schools in rural St. Andrew and St. Mary in Jamaica were examined by the VDRL test and, if reactive or weakly reactive, by the FTA-ABS test. Fourteen sera were weakly reactive and, of these, 5 were positive in the FTA-ABS test. The cause of these reactive tests was not determined. The proportion of children in St. Mary who were weakly reactive in the VDRL test was 0.1 percent compared to 27.6 percent weakly reactive and reactive children in 1963, 13 years earlier, which suggests that yaws transmission has become rare in St. Mary and, by inference, probably elsewhere in Jamaica. The mistaken diagnosis of syphilis by sero-reactivity which was, in fact, due to yaws contracted in childhood used to be a major problem. With the disappearance of childhood yaws, the value of reactive treponemal tests as evidence of syphilitic infection should be of increasing significance (AU)

Prognosis of idiopathic cardiomegaly in Jamaica with reference to the coronary arteries and other factors

Clinical and epidemiological features of idiopathic cardiomegaly in Jamaica are reviewed, and the high community prevalence of the disorder is shown. The frequency occurrence of sudden or unexpected death in patients whose earlier electrocardiograms had shown repeated ventricular ectopic beats has been noted. Common electrocardiographic findings included a high rate of abnormalities usually regarded as indicative of coronary artery disease: cardiac arrhythmias, particularly multiple ventricular extrasystoles; and high voltage complexes characteristic of left ventricular hypertrophy. The differences and similarities between idiopathic cardiomegaly and coronary heart disease are shown. A possible role for intramuscular lignocaine in the control of the chronic ventricular ectopic rhythms is demonstrated. There is a statistically significant association between idiopathic cardiomegaly and positive serological tests for treponemal infection. The hearts are invariably hypertrophied at necropsy. In some hearts the smaller intramuscular coronary arteries show occlusive changes. Their possible nature and significance are discussed.(AU)

Serological tests for treponemal disease in adults in two Jamaican communities

VDRL and RPCF tests were carried out on representative samples of about 500 subjects aged 35-64 living in a rural area of Jamaica where yaws was once common, and in about the same number of subjects in a suburban community where yaws transmission very rarely occurred; some people had, however, spent their childhood in rural areas. The proportion of reactors was high; 40 per cent. by the VDRL and 50 per cent. by the RPCF tests were reactive in the rural area; 34 per cent. by the VDRL and 38 per cent. by the RPCF were reactive in the suburban community. The reactivity of those who were born and brought up in the suburban community was lower (16 and 24 per cent. by the VDRL and RPCF tests respectively) than that of those who had spent their childhood in rural areas before migrating to the city. These differences are attributed to the prevalence of yaws infection acquired in childhood in rural areas; although the disease had been cured, sero-reactivity persisted. The rapidly changing pattern of treponemal infection and the difficulties involved in interpreting serological tests in Jamaica are briefly discussed.(Summary)

Treponemal serological tests in Jamaican school children

Yaws, although occurring in parts of Jamaica, is much rarer than in the past. Sera from children, 7-15 years old, attending primary school in areas in which the incidence of yaws differs, were examined by VDRL and RPCF tests. The proportion reactive at the schools ranged from 1.6 percent to 27.6 percent and 4.0 percent to 34.1 percent respectively. Clinical yaws was seen in only one of the sero-reactors; most of the positive tests were in children with either latent or cured yaws. It is suggested that the RPCF, which showed a higher proportion of reactors than the VDRL test, measures antibodies against yaws different from those measured by the VDRL test in these circumstances. The immediate and long-term problems of sero-reactivity in a country where both yaws and syphilis are present are discssed (Summary)

The use of the reiter protein complement fixation test in the diagnosis of syphilis in Jamaica

Blood from 2,232 persons were tested with the treponemal and non-treponemal antigens over a two-year period in the Serology laboratory of the Department of Microbiology, University of the West Indies. Like other tests in the diagnosis of syphilis the Reiter Protein Complement Fixation test although highly sensitive and specific, has its limitations, and this should be recognised. The sensitivity and specificity of the results are discussed. The high rate of radioactivity in patients with treponemal infection and the low positive rate in the non-syphilitic illustrates its value. The Reiter Protein Complement Fixation test is useful as an aid in the diagnosis of syphilis and yaws (AU)

Myocardial disease in a rural population in Jamaica

This survey has revealed an unexpectedly high prevalence of angina pectoris and of electrocardiographic abnormalities usually interpreted as due to myocardial ischaemia or focal myocardial damage. The rarity of myocardial infarction caused by coronary artery occlusion in Jamaicans, as well as the lack of any clear relationship between myocardial damage and age, the association with high serum globulin levels, and the apparently increased prevalence in those with haemoglobinopathies suggest that its etiology is different from that of ischaemic heart disease due to atheroma of the coronary arteries. This study has raised a number of questions of which the most important concern the pathogenesis of the condition and its importance in terms of prognosis; it forms the base line for longitudinal investigation that may resolve some of the outstanding questions (AU)

Survey of cases examined for aortic dilatation, hypertension and syphilis

1,447 persons - 792 females, 655 males - were studied in the age group 35-65 years. 327 females and 343 males were serologically positive. It is felt that with increasing age treponemal infection appears to be a factor in the production of aortic dilation (AU)

Dilatation and unfolding of the aorta in a Jamaican population

In an analysis of 2085 70 mm. chest X-rays of subjects aged 35-64 from a rural population in Jamaica, 79 of the 1090 women (8.4 percent) showed some degree of aortic dilatation. The clinical examination of these people and age and sex balanced control groups drawn by random methods from the same population revealed three main findings. (1) Arterial pressure levels were consistently higher in the affected, than in the controls. (2) The conditions was associated with aortic regurgitation in 20 percent of men and 7 percent of women. (3) Both aortic dilatation and arterial pressure in these subjects were apparently unrelated to their present serological status. Positive serological reactions were found in about 25 percent of affected and controls. The possible role of syphillis and/or yaws in association with hypertension in producing aortic dilatation is discussed. A relationship between aortic dilatation, often gross, and hypertension has been demonstrated and this combination appears to have a high prevalence in West Indian negroes. Whatever the role of treponemal infection it is apparently not the most important single factor in the production of either the aortic dilatation, the associate hypertension, or the resulting aortic regurgitation. The significance of uncomplicated aortic dilatation, in terms of morbidity and mortality, remains to be determined by follow-up studies of these groups (Summary)

The relation of the treponematoses to idiopathic neuropathies in Jamaica

An approach is made to the aetiology of an idiopathic paraplegic syndrome in Jamaica. The main features comprise upper motor neurone paresis and sensory loss of posterior column type, with optic atrophy, nerve deafness and selective peripheral nerve lesions in a minority. Symptoms arise most commonly in the fourth decade, and show little change after the first few months. Serology is negative in the CSF in all cases and in the blood of the majority. Nevertheless some evidence of past treponemal infection can be found in over 50 percent. Abnormality of the CSF, including a positive colloidal gold reaction, is found in one third of cases; and special study of this group shows that treponemal infection has occurred in 80 percent and also that the history of illness is significantly shorter than in the remainder. Comparison of the two groups suggests that they may be progressive stages of the same syndrome. Autopsy studies reveal meningovascular and degenerative processes which are not typical of syphilis. Analysis of the geography of the condition reveals a concentration in certain inland rural areas - less than 20 percent occurring in inhabitants of Kingston. The detailed distribution closely follows that of yaws 20 years ago. The evidence is discussed that this syndrome - and perhaps some cases of frank spinal arachnoiditis - may be late manifestations of treponemal infection, whether veneral or otherwise, due to a strain variant acting as a poor stimulus to standard tests, but producing atypical meningovascular disease (Summary)