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.

Chloroquine sensitivity of Plasmodium falciparum in Ethiopia. I. Results of an in vivo test.

The in vivo response of Plasmodium falciparum to the WHO single test dose (10 mg/kg body weight) of chloroquine base was examined in Ethiopia at four localities where malaria was meso- or hyperendemic. Parasitemias cleared by the 3rd day after chloroquine administration in all of the 150 test subjects. No recrudescences were detected during the 6-day or 11-day follow-up periods. The value of the in vivo test was severely limited by the inability to quarantine subjects and follow them for the 28-day period recommended by the World Health Organization.

Chloroquine sensitivity of Plasmodium falciparum in Ethiopia. II. Results of an in vitro test.

Field trials were performed in two areas of Ethiopia with the Rieckmann in vitro test for chloroquine sensitivity of Plasmodium falciparum. Blood cultures from 82 test subjects showed growth of trophozoites to the schizont stage in control vials. Growth in test vials occurred in 21 cultures incubated with chloroquine at concentrations of 0.5 nanomoles or more per ml of blood. In vitro results confirm previous results obtained with an in vivo test.

Susceptibility to vivax malaria in Ethiopia.

Plasmodium vivax prevalence rates for Nilotic and Hamitic-Semitic residents of an Ethiopian town were compared. Over a ten-year period, 8,316 blood films from Nilotes were examined and 59 P. vivax infections (0.7%) were diagnosed. In 1,630 films from Hamito-Semites, 75 probable P. vivax infections (4.6%) were found. The problem of morphological differentiation between P. vivax and P. ovale was evaded by combining the two diagnoses. P. vivax/ovale infection rates for Hamitic-Semitic subjects were higher than for Nilotic subjects in all age groups. It was concluded that the two populations are inately different in susceptibility to patient infection with vivax malaria.

Epidemiology of Plasmodium malariae infection in Gambela, Ethiopia.

Malaria incidence and prevalence surveys were performed from December, 1967 to February, 1969 among the indigenous Nilotic inhabitants of Gambela, a small administrative centre in the western lowlands of Ethiopia. Entomological data suggested that malaria transmission was seasonal and this was consistent with monthly P. falciparum parasite rates. Monthly P. malariae parasite rates, however, were consistent with an hypothesis of homogeneity. The age-specific incidence of quartan malaria among 26 children zero to 11 years old at the start of study was examined at 28 day intervals over a 15-month period. The resulting data suggested that parasite acquisition was a slow process and an annual P. malariae incidence of 0.17 was derived. This statistic was supported by studies performed five years later: The incidence of P. malariae among 102 infants followed from birth up to 48 months of age was 0.16-0.20. An attempt was then made to account for the prevalence of P. malariae in terms of the entomological conditions observed in Gambela. Macdonald's formula for the sporozoite rate was used to derive hypothetical relative proportions of P. falciparum and P. malariae among the observed sporozoite-positive mosquito populations. About 4% of the sporozoite challenges were estimated to be of P. malariae. An hypothetical annual entomological P. malariae inoculation rate was then made by multiplying the number of observed sporozoite inoculations per person (approximately 10/year) by the proportion of them estimated to be of P. malariae. The annual P. malariae sporozoite challenge was thus estimated at 0.4 per person, in good agreement with the annual incidence estimates from parasite rates in children.

Effects of extreme obliquity variations on the habitability of exoplanets.

We explore the impact of obliquity variations on planetary habitability in hypothetical systems with high mutual inclination. We show that large-amplitude, high-frequency obliquity oscillations on Earth-like exoplanets can suppress the ice-albedo feedback, increasing the outer edge of the habitable zone. We restricted our exploration to hypothetical systems consisting of a solar-mass star, an Earth-mass planet at 1 AU, and 1 or 2 larger planets. We verified that these systems are stable for 10(8) years with N-body simulations and calculated the obliquity variations induced by the orbital evolution of the Earth-mass planet and a torque from the host star. We ran a simplified energy balance model on the terrestrial planet to assess surface temperature and ice coverage on the planet's surface, and we calculated differences in the outer edge of the habitable zone for planets with rapid obliquity variations. For each hypothetical system, we calculated the outer edge of habitability for two conditions: (1) the full evolution of the planetary spin and orbit and (2) the eccentricity and obliquity fixed at their average values. We recovered previous results that higher values of fixed obliquity and eccentricity expand the habitable zone, but we also found that obliquity oscillations further expand habitable orbits in all cases. Terrestrial planets near the outer edge of the habitable zone may be more likely to support life in systems that induce rapid obliquity oscillations as opposed to fixed-spin planets. Such planets may be the easiest to directly characterize with space-borne telescopes.

Effects of antibiotic treatment of nonlactating dairy cows on antibiotic resistance patterns of bovine mastitis pathogens.

Antibiotic resistance patterns of the major groups of bovine mastitis pathogens (Streptococcus agalactiae, other streptococci, Staphylococcus aureus, and Staphylococcus epidermidis) were examined by determining the minimum inhibitory concentration (MIC) of 13 different antibiotics against bacterial isolates from dairy cattle. The bacterial strains were obtained from milk samples from each cow in 21 New York state dairy herd surveys. In 12 herd surveys (high antibiotic-use group), all 365 cows received antibiotic infusions into the udder at the cessation of each lactation cycle. The 324 animals in the other nine herd surveys (low antibiotic-use group) did not routinely receive antibiotics during the nonlactation period. The MICs from the two groups were compared by calculating for each bacterial group the average MIC, the antibiotic concentration necessary to inhibit 90% of the isolates, and the antibiotic concentration necessary to inhibit 50% of the isolates. Increased resistance to all 13 antibiotics was observed with Streptococcus agalactiae isolates from the high antibiotic use herds. However, there was relatively little difference between the two groups in the resistance patterns of the other bacterial species examined. The most important finding of the study was the identification of a multiple beta-lactam resistance phenotype in Streptococcus agalactiae.

Population adjustment of the definition of the vaginal birth after cesarean rate.

OBJECTIVE: The vaginal birth after cesarean delivery rate is calculated with a denominator equal to the number of all women who give birth after a previous cesarean delivery, including those who are not candidates for a trial of labor. We evaluated the impact of adjustment for noncandidates for a trial of labor on vaginal birth after cesarean delivery rates. STUDY DESIGN: All women with a previous cesarean delivery who were delivered during 1998 were classified as either candidates or noncandidates for a trial of labor. An adjusted vaginal birth after cesarean delivery rate was calculated by eliminating noncandidates for a trial of labor from the denominator. The percentage of noncandidates for a trial of labor, the vaginal birth after cesarean delivery rate, and the adjusted vaginal birth after cesarean delivery rate were compared among 3 clinical services. RESULTS: The maternal-fetal medicine service had a significantly higher percentage of noncandidates for a trial of labor than did either the low-risk resident clinic or the low-risk private service. The maternal-fetal medicine service had a significantly lower vaginal birth after cesarean delivery rate than did the private service, but this difference was no longer present after application of an adjusted vaginal birth after cesarean delivery definition. CONCLUSION: For accurate comparison of vaginal birth after cesarean delivery rates among providers it is essential to account for patient risk status in the vaginal birth after cesarean delivery definition through the elimination of noncandidates for a trial of labor.