A retrospective study of the pattern of sexually transmitted diseases during a ten-year period.

BACKGROUND: Proper knowledge of the patterns of sexually transmitted diseases (STDs) in different geographical regions is necessary for evolving proper strategies for control of these diseases. AIMS: To study the pattern of STDs and to analyze the changes during a ten-year period from 1990 among patients attending Medical College Hospital, Kottayam. METHODS: Case records of 686 patients with STDs who attended the outpatient wing of the Department of Dermatology and Venereology were studied. RESULTS: There were 504 males and 182 females in the total of 686 patients. Marital contact alone was reported by 123 (67.6%) female patients. Genital ulcer diseases (GUDs) accounted for the maximum number of STDs, with 504 cases (73.5%), followed by condyloma acuminatum (17.5%) and gonorrhea (10.1%). Forty-three patients had multiple infections. The total number of patients during the first year of study was 129, while it was 41 during the last year. Bacterial STDs showed a striking reduction in numbers. The decline was less marked in the case of viral STDs. CONCLUSION: The majority of patients had genital ulcer diseases. Spouses were the most common source of infection for female patients. There was a marked decline in the number of patients with various STDs during the ten-year period. The decline was more evident in the bacterial STDs resulting in an apparent increase of the viral STDs towards the end of the period of study.

The role of infectious agents in the aetiology and pathogenesis of childhood nephrotic syndrome in Africa.

Childhood nephrotic syndrome is common in Africa where infectious agents are prevalent. This paper reviews the possible aetiological role of infectious agents in childhood nephrotic syndrome in Africa. There is a strong association, possibly causal, between childhood nephrotic syndrome on the one hand and Plasmodium malariae, Schistosoma mansoni and hepatitis B antigens on the other. Beta-haemolytic streptococci are less strongly associated with nephrotic syndrome, and a few other organisms are suspect. The many ubiquitous infectious agents and the prevalence of multiple infections make it difficult to define the role of any single infectious agent or to determine the interaction between the various agents. Control or eradication of infectious diseases should lower the incidence of childhood nephrotic syndrome in Africa.

Primary hepatocellular carcinoma in intertropical Africa: relationship between age and hepatitis B virus etiology.

Clinical observations of patients with primary hepatocellular carcinoma (PHC) at Le Dantec Hospital, Dakar, Senegal, were studied to determine a correlation with hepatitis B virus (HBV) infection. Of the 103 patients with PHC, 80 had an active HBV infection (HBsAg and/or anti-HBc); 23 showed signs of previous HBV infection (anti-HBs and anti-HBc). The two groups were similar in the detection of alpha-fetoprotein (approximately 60%) and in the major clinical findings: hepatomegaly, 76.25% and 86.96%, respectively; and ascites, 57.50% and 47.83%, respectively. Jaundice, however, was three times more frequent (P < 0.01) in the group of patients with signs of active HBV replication. Distribution of HBV markers as a function of age at onset of PHC revealed that the presence of HBsAg was primarily confined to the sera of the younger patients (< 50 yr old). When compared with leprosy patients and blood donors, the younger PHC patients differed in the frequency of detection of HBsAg and anti-HBs. The older people (> 50 yr old) in the three groups (PHC patients, leprosy patients, and blood donors) had identical HBV markers.

[The hepatitis A and B virus markers (anti-HAV, HBsAg, HBsAb, HBeAg, HBeAb) in leprous patients (author's transl)]. / Marcatori sierici dell'infezione da virus dell'epatite "A" (anti-HAV) e "B" (HBsAg-HBsAb, HBeAg-HBeAb) nei lebbrosi.

The hepatitis A and B virus markers (anti-HAV, HBsAg, HBsAb, HBeAg, HBeAb) were studied in the serum of 25 patients at the leprosy hospital of Messina. Anti-HAV were detected, by RIA in 100% of the patients; by the same method HBsAg was found in 12% and HBsAb in 48% of the cases. In no patient HBeAg was detected by immunodiffusion; on the contrary, HBsAb was found in 4% of the cases. No significant difference between lepromatous and tuberculoid leprosy was found.

[The hepatitis B virus markers, in leprous patients (author's transl)]. / Les marqueurs du virus de l'hépatite B chez les lépreux.

The hepatitis B virus markers were studied on 553 leprous sera and 100 controls sera. HBs Ag detected by RIA were present on 25,4% of leprous and 12% of controls; the anti-HBs by RIA were revealed in 44,1% of patients out 38% of controls. The leprous was not carrying this markers were HBe Ag or anti-HBe or anti-HBc positive. By this vertical study it appears that 2,4% of the cases presented recent or acute hepatitis; 23% were chronic carriers; 41,7% had been in times past infected but were cured and the third remaining had been infected but coat markers were absent, it is more than likely that is an old infected group. The study revealed no significant difference in hepatitis chronic forms frequency between lepromatous and tuberculoïd patients.

[The "e" antigen (HBeAg) in leprosy]. / L'antigene "e" (HBeAg) nella lebbra.

Sixty-six sera from leprosy patients, 42 with lepromatous leprosy (l.l.) and 24 with tuberculoid leprosy (t.l.) were examinated for the presence of e-antigen and e-antibody by immunodiffusion. The test for e-antigen was negative in all leprosy patients; e-antibodies were found in only three patients (4.5%) with l.l., all carriers of hepatitis B antigen. The HBsAg test was positive in 23.8% of the l.l. cases and in 12.5% of the t.l. cases; the anti-HBs was present in 38.1% of the l.l. cases and in 41.6% of the t.l. cases. The results suggest the possibility that the leprosy patients positive for the surface B antigen represent a very low risk and can be considered as chronic asymptomatic carriers of HBsAg.

Hepatitis B antigen in a leprosy hospital.

A survey of hospital patients with lepromatous and with tuberculoid leprosy showed 5% of the former and 6.3% of the latter to be carriers of hepatitis B antigen. These findings contradict the hypothesis of a genetically determined predisposition; opportunity for infection appears rather to be the determining factor. It was also found that (1) the number of carriers was higher among patients staying longer in hospital; (2) titres of antigen in patients with lepromatous leprosy were higher than in those with tuberculoid leprosy or in controls; and (3) antigen titres measured twice at an interval of 4 months indicated that the carrying of hepatitis B antigen in patients with leprosy is stable and persistent.

Hepatitis B antigen in a leprosy hospital

A survey of hospital patients with lepromatous and with tuberculoid leprosy showed 5% of the former and 6.3% of the latter to be carries of hepatitis B antigen. These findings contradict the hypothesis of a genetically detrmined predisposition; opportunity for infection appears rather to be the determining factor. It was also found that 1. the number of carries was higher among patients stayng longer in hospital; 2. titres of antigen in patients with lepromatous leprosy were higher than in those with tuberculoid leprosy or in controls; and 3. antigen titres measured twice at an interval of 4 months indicated that the carryng of hepatitis B antigen in patients with leprosy is satble and persistent.

Australia antigen and antibody in British patients with leprosy.

Seventy-five sera collected from leprosy patients in England were tested for Australia antigen and antibody. Australia antigen was detected in only two patients with lepromatous leprosy and in one patient with borderline pure leprosy. Antibody to Australia antigen was found in one patient with lepromatous leprosy. These findings differ from previous reports and it is suggested that the frequency of Australia antigen in lepromatous leprosy is a function of the incidence of this antigen in the general population rather than increased genetic susceptibility to chronic infection.