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1.
West Indian med. j ; 50(Suppl 5): 12, Nov. 2001.
Artigo em Inglês | MedCarib | ID: med-210

RESUMO

OBJECTIVE: To determine the seroprevalence of the hepatitis B carrier state in Jamaican children. METHODS: Serum specimens from 525 randomly-selected students attending one of 6 basic/pre-schools in the Kingston and St.Andrew region were tested at the MIcrobiology Laboratory of the University Hospital of the West Indies for hepatitis B surface antigen and hepatitis B antibodies. A second specimen was sent from each patient to a private laboratory where the tests were repeated and cross-checked against the results obtained from the UHWI laboratory. Demographic data concerning patients age and sex, maternal age and socio-economic status obtained from a parent interview were recorded on a pre-coded questionnare. The age of the students ranged from 3 years to 6 years with a mean age of 4 years. The male to female ratio was 2:3. Eighty percent of the mothers were under thirty-five years of age. RESULTS: The carrier state was identified in 12 percent of students. Six percent of the study sample had a reactive test for antibodies to hepatitis B surface antigen. CONCLUSION: The high prevalence of hepatitis B carrier state in children under 6 years of age supports infection acquired perinatally from infected mothers. This seroprevalence rate would classify Jamaica as an area of high endemicity and further support the urgent need for a national hepatitis B screening. (AU)


Assuntos
Criança , Pré-Escolar , Feminino , Humanos , Masculino , Adulto , Pessoa de Meia-Idade , Antígenos de Superfície da Hepatite B/sangue , Antígenos da Hepatite B/sangue , Portador Sadio/sangue , Jamaica , Estudos Transversais , Estudos Soroepidemiológicos , Amostragem
2.
J Nat Cancer Inst ; 90(8): 617-22, Apr. 15, 1998.
Artigo em Inglês | MedCarib | ID: med-1754

RESUMO

BACKGROUND: Human T-cell lymphotropic virus type I (HTLV-I) is linked to adult T-cell luekemia/lymphoma (ATL) and HTLV-I associated myelopathy (HAM; also known as tropical spastic paraparesis [TSP]), a chronic neurodegenerative disorder. Worldwide, several million HTLV-I carriers are at risk for disease, with an estimated lifetime cumulative risk of 1 percent-5 percent. However, the determinants of disease progression are relatively unknown. We studied human leukocyte antigens (HLA class II) that have been implicated in the pathogenesis of HTLV-I related diseases. METHODS: We analyzed HLA class II alleles among asymptomatic HTLV-I carriers (n = 45), patients with ATL (n = 49) or HAM/TSP (n = 54), and HTLV-I seronegative control subjects (n = 51). All participants were of African descent and were enrolled in epidemiologic studies conducted at the University of the West Indies, Kingston, Jamaica. We used standard microlymphocytotoxicity assays for HLA antigen serotyping and polymerase chain reaction-based methods to examine HLA class II DRB1 and DQB1 alleles. RESULTS: Two antigens determined by serotyping DR15 and DQ1, occurred at significantly increased frequency among HTLV-I carriers compared with seronegative control subjects (42 percent versus 22 percent for DR15 [odds ratio [OR] = 2.7; 95 percent confidence interval [CI] - 1.0-7.2] and 78 percent versus 53 percent for DQ1 [OR = 3.1; 95 percent CI= 1.2-8.5]). Asymptomatic carriers were shown to have and HLA class II allele distribution similar to that of patients with ATL, and the frequencies of the alleles DRB1*1501, DRB1*1101, and DQB1*0602 were significantly increased among patients with ATL compared with patients with HAM/TSP. CONCLUSIONS: These data suggest that host genetic background is an important factor in determining weather HTLV-I carriers develop either ATL or HAM/TSP.(AU)


Assuntos
Humanos , Portador Sadio/virologia , Genes MHC da Classe II/genética , Leucemia-Linfoma de Células T do Adulto/genética , /genética , Alelos , Razão de Chances
3.
Viral Immunol ; 7(3): 113-20, 1994.
Artigo em Inglês | MedCarib | ID: med-2050

RESUMO

The immunoglobulin (Ig) isotypes of antibodies to specific proteins of the human T cell lymphotropic virus type I (HTLV-I) were determined by Western blot analysis of serial specimens from six individuals who experienced HTLV-I seroconversion following blood transfusion; five remained asymptomatic carriers, while one developed HTLV-I associated myelopathy/tropical spastic paraparesis (HAM/TSP) 32 weeks posttransfusion. Analysis of Ig isotypes demonstrated that while IgM was the most frequent early response to gag (p19, p24) and env (r21e) proteins within the first 3 months following transfusion, IgG and IgA responses could also be detected within this period. HTLV-I-specific antibody responses plateaued in all Ig isotypes, including IgM, wtihin the next 4- to 6-months period following transfusion and pesisted through the entire study period (> 4 years). Comparison of antibody profiles in Ig isotypes and IgG1 and IgG3 subclass among asymptomatic carriers and one individual who developed HAM/TSP demonstrated no evidence of isotypic prominence or IgG subclass restriction in either group. These results indicate the appearance of HTLV-I-specific IgM that persists even after the primary infection and suggest that such responses does not appear to provide an early marker of seroconversion. Further, we found no evidence of isotypic prominence or restriction of the antibody response in recipients who remained asymptomatic compared to one who developed HAM/TS.(AU)


Assuntos
Adulto , Humanos , Transfusão de Sangue/efeitos adversos , Anticorpos Anti-HTLV-I/biossíntese , Vírus Linfotrópico T Tipo 1 Humano/imunologia , Infecções por HTLV-I/transmissão , Western Blotting , Estudos Prospectivos , Portador Sadio/sangue , Portador Sadio/imunologia , Estudos de Coortes , Anticorpos Antideltaretrovirus/imunologia , Infecções por HTLV-I/sangue , Infecções por HTLV-I/epidemiologia , Infecções por HTLV-I/imunologia , Imunoglobulina M/biossíntese , Imunoglobulina M/imunologia , Isotipos de Imunoglobulinas/imunologia , Jamaica/epidemiologia , Paraparesia Espástica Tropical/sangue , Paraparesia Espástica Tropical/imunologia , Paraparesia Espástica Tropical/transmissão
4.
J Trop Med Hyg ; 94(6): 411-5, Dec. 1991.
Artigo em Inglês | MedCarib | ID: med-15935

RESUMO

A subsample (1.6 percent; n = 13,260) of a healthy Jamaican population of food-handlers, studied by Murphy et al. (1991), who were serologically positive (n = 99) or negative (n = 113) for HTLV-I was investigated for intestinal parasitic infection using coprological methods. Helminth infection included Ascaris lumbricoides (2.8 percent), Trichuris trichiura (7.1 percent) and hookworms (6.1 percent). Entamoeba coli was found in 21.8 percent of samples, while E. hartmanni, Giardia lamblia, Endolimax nana, Iodamoeba butschlii and Chilomastrix mesnili each occurred in less than 10 percent of responders. T. trichiura displayed a higher prevalence (10.6 vs 3 percent (chi 2 = 4.623;p = 0.03) in the HTLV-I negative group. G. lamblia was detected more frequently among HTLV-I carriers compared to controls (9.1 and 3.5 percent respectively), but the association was not statistically significant (chi 2 = 2.825;p = 0.09). Infection with intestinal parasites is likely to occur independent of HTLV-I status: however, possible HTLV-I-induced immunosuppression may lead to higher intensity infections of certain organisms thus facilitating easier detection using parasitological methods. The immunomodulatory potential of HTLV-I infection in the aetiology of non-malignant diseases requires further investigation. (AU)


Assuntos
Humanos , Masculino , Feminino , Portador Sadio , Anticorpos Anti-HTLV-I/sangue , Infecções por HTLV-I/complicações , Enteropatias Parasitárias/complicações , Infecções por Nematoides/complicações , Infecções por Protozoários/complicações , Análise de Variância , Estudos de Casos e Controles , Distribuição de Qui-Quadrado , Enteropatias Parasitárias/epidemiologia , Jamaica/epidemiologia , Infecções por Nematoides/epidemiologia , Prevalência , Infecções por Protozoários/epidemiologia
5.
Br Med J ; 301(6743): 95-6, July 14, 1990.
Artigo em Inglês | MedCarib | ID: med-12563

RESUMO

Infection with human T cell leukaemia/lymphoma virus type I has often been reported in British adults originating from the Caribbean islands, though few data exists on the prevalence of the virus in unselected populations in the United Kingdom. In recent studies in North London fewer than 0.02 percent of blood donors were found to be positive for the virus (JAJ Barbara, personal communication). We assessed the prevalence of antibody to human T cell leukaemia/lymphoma virus type I in women attending an antenatal clinic in an area of London with an ethnically heterogenous population and investigated whether seropositivity was confined to groups known to be of risk of carrying the virus. (AU)


Assuntos
Humanos , Gravidez , Feminino , Complicações Infecciosas na Gravidez/epidemiologia , Infecções por HTLV-I/epidemiologia , Fatores Etários , Afro-Americanos , Portador Sadio , Anticorpos Anti-HTLV-I/análise , Infecções por HTLV-I/etnologia , Infecções por HTLV-I/imunologia , África/etnologia , Londres/epidemiologia , Complicações Infecciosas na Gravidez/etnologia , Complicações Infecciosas na Gravidez/imunologia , Cuidado Pré-Natal , Prevalência , Índias Ocidentais
6.
BMJ ; 300(3): 300-4, Feb. 3, 1990.
Artigo em Inglês | MedCarib | ID: med-14849

RESUMO

OBJECTIVE -- To compare the prevalence of antibody to and proviral DNA of the retrovirus HTLV-I in relatives of 11 British patients with tropical spastic paraparesis who migrated from Jamaica before they developed symptoms, and to examine factors possibly related to transmission of HTLV-I. DESIGN -- Migrant family study. Antibody state was determined by several methods and confirmed by western blotting; the polymerase chain reaction was used to detect proviral DNA. SETTING -- Britain and Jamaica. SUBJECTS -- All available first degree relatives: those born and still resident in Jamaica (group 1); those born in Jamaica who migrated to Britian (group 2); and index patients' children who were born and resident in Britian (group 3). All had been breast fed and none had had blood transfusions. RESULTS -- Of the 66 living relatives, 60 were traced. Seroprevalence among those born in Jamaica (irrespective of current residence) was 22 percent (10/46; 95 percent confidence limits 9 to 34 percent) compared with zero among British born offspring (0/14) and was higher in group 2 at 33 percent (7/21; 12 to 55 percent) than in group 1 at greatest mean age.) Proviral DNA was not detected in any subject negative for HTLV-I antibody, making prolonged viral incubation in those negative for the antibody unlikely. CONCLUSION -- In this sample factors related to place of birth and early residence were more important in transmission of HTLV-I than naternal or age effects. In areas with a low to moderate prevalence policies of preventing mothers who are carriers of the virus from breast feeding would be premature (AU)


Assuntos
Humanos , Pessoa de Meia-Idade , Masculino , Feminino , Infecções por Deltaretrovirus/epidemiologia , Paraparesia Espástica Tropical/epidemiologia , Sequência de Bases , Portador Sadio , Estudo Comparativo , DNA Viral/análise , Reino Unido/epidemiologia , Anticorpos Anti-HTLV-I/análise , Infecções por HTLV-I/genética , Jamaica/epidemiologia , Dados de Sequência Molecular , Paraparesia Espástica Tropical/transmissão , Linhagem , Reação em Cadeia da Polimerase , Prevalência , Fatores de Tempo
8.
J Trop Med Hyg ; 91(4): 173-80, Aug. 1988.
Artigo em Inglês | MedCarib | ID: med-12513

RESUMO

A total of 206 community-acquired and 73 nosocomial infections in 50 malnourished Jamaican children were studied prospectively. Predominantly community-acquired infections in the 50 children, included gastroenteritis (68 percent), otitis media (60 percent), rhinopharyngitis (60 percent), oral candidiasis (46 percent), skin infections (40 percent), pneumonia (28 percent), bacteraemia (24 percent) and bacteriuria (18 percent). The most frequent nosocomial infections were rhinopharyngitis (34 percent), lower respiratory tract infections (24 percent) and septicaemia (18 percent). In those infections where an aetiological agent was identified, Giardia lamblia was the commonest enteric pathogen, Staphylococcus epidermidis, the most frequent blood culture isolate and Klebsiella sp. were recovered from the majority of urines. The lack of clinical signs and symptoms and atypical clinical presentation in some infected malnourished children were attributed to impairment of the acute inflammatory response. Diagnosis of infection in these children required a high index of suspicion and a comprehensive screening system. Nasal throat and axial swabs taken on admission revealed significant colonization with coliforms and pneumococcus; however, these swabs were not useful as indicators of potentially infective organisms. Four of the fifty children died and two of these deaths were attributed to infection. (AU)


Assuntos
Humanos , Lactente , Masculino , Feminino , Infecção Hospitalar/complicações , Transtornos da Nutrição do Lactente/complicações , Infecções Bacterianas/complicações , Infecções Bacterianas/epidemiologia , Infecções Bacterianas/mortalidade , Portador Sadio/microbiologia , Infecção Hospitalar/epidemiologia , Infecção Hospitalar/mortalidade , Gastroenteropatias/complicações , Gastroenteropatias/epidemiologia , Gastroenteropatias/microbiologia , Gastroenteropatias/parasitologia , Transtornos da Nutrição do Lactente/mortalidade , Jamaica , Estudos Prospectivos , Infecções Respiratórias/complicações , Infecções Respiratórias/epidemiologia , Infecções Respiratórias/microbiologia , Sepse/complicações , Sepse/epidemiologia , Sepse/microbiologia , Viroses/complicações , Viroses/epidemiologia , Viroses/mortalidade
9.
Int J Cancer ; 38(1): 41-5, July 1986.
Artigo em Inglês | MedCarib | ID: med-13285

RESUMO

Six healthy relatives of 3 adult T-cell leukemia lymphoma (ATLL) patients and 6 members of a Caribbean family immigrant to the UK have been investigated for the presence of HTLV-I and expression of interleukin 2(IL-2) receptors. Serum antibodies to HTLV-I were detected in all but 4 samples. Four to 10 percent of circulating cells from 3/4 seropositive donors studied displayed IL-2 receptors (anti-Tac+) and were shown to be convoluted lymphocytes by light microscopy morphology and immunoelectromicroscopy. After 5 to 28 days in culture, cells from 4 seropositive donors reacted with monoclonal antibodies (MAbs) against the HTLV-I core proteins, p19 and p24, and released retrovirus particles. Simmilar experiments with blood from 3 seronegative donors from the same families and 4 normal controls proved negative. Our findings indicate that seropositive individuals harbour the virus in a population of T-lymphocytes which may then acquire receptors for IL-2. These individuals are at risk of developing ATLL. (AU)


Assuntos
Humanos , Portador Sadio/microbiologia , Leucemia/microbiologia , Infecções por Retroviridae/microbiologia , Anticorpos Antivirais/análise , Portador Sadio/sangue , Células Cultivadas , Reino Unido , Deltaretrovirus/imunologia , Técnicas Imunoenzimáticas , Leucemia/sangue , Linfócitos/imunologia , Linfócitos/ultraestrutura , Receptores de Antígenos de Linfócitos T/imunologia , Receptores Imunológicos/imunologia , Proteínas do Core Viral/análise , Vírion/ultraestrutura , Índias Ocidentais/etnologia
10.
West Indian med. j ; 32(1): 38-43, Mar. 1983.
Artigo em Inglês | MedCarib | ID: med-11447

RESUMO

In an effort to find and eliminate sources of infection in the operating theatres of the University of Benin Teaching Hospital, Nigeria, 28 air samples by the settle plate technique, 20 samples from various surfaces, 20 samples from sterilised equipment and 5 from antiseptic solutions kept in the theatre were investigated bacteriologically. Thirty nasal swabs were cultured for pathogenic organisms, one from each of the 30 theatre personnel comprising 8 surgeons, 8 students, 4 anaesthetists, 6 nurses and 4 orderlies. The bacteria-containing particles in the theatre air ranged from 4.2 to 113.2/m3. The figures were significantly more when operations were prolonged and students were present during the operations. A high bacterial count was noticed during the start of operations which could be related to movement of theatre staff, particularly orderlies during initial cleaning and arranging of the theatre. Staphylococcus pyogenes was consistently observed in theatre air, in nasal swabs of 30 percent of the staff, and in some floor samples. Only one of the 28 individuals operated on developed sepsis; this was caused by Staphylococcus progenes probably derived from nasal colonisation of a theatre orderly. Treatment of nasal carriers by Hibitane cream, prevention of entry of unwanted persons, preponement of cleaning exercise, and tightening of other aseptic measures have reduced the aerial bacterial count of the operating theatres (AU)


Assuntos
Humanos , Infecções Bacterianas/microbiologia , Infecção Hospitalar/microbiologia , Salas Cirúrgicas , Microbiologia do Ar , Portador Sadio/microbiologia , Hospitais de Ensino , Complicações Pós-Operatórias , Infecções Estafilocócicas/microbiologia
11.
Trans R Soc Trop Med Hyg ; 72(6): 588-91, 1978.
Artigo em Inglês | MedCarib | ID: med-12678

RESUMO

Enteropathogenic Escherichoa coli (EPEC) is frequently found in asymptomatic carriers. When checked over a period of two and a half months at fortnightly intervals, nine out of 20 children at a child centre in Jamaica showed EPEC of three different serotypes in faecal smears. Four stool specimens were found to be positive in another 45 children, controlled routinely on admission to a district hospital in Jamaica. None of either group had diarrhoea at the time of collection. These results confirm that serotypes should not be equated with pathogenicity. Also, current methods of detecting enterotoxin are too time-comsuming and impractical for non-specialized laboratories. The place of antibiotics in EPEC diarrhoea is criticized. Initial control measures should centre on fluid and electrolyte replacement irrespective of the aetiology of the diarrhoea (AU)


Assuntos
Humanos , Lactente , Pré-Escolar , Criança , Infecções por Escherichia coli/complicações , Infecções por Escherichia coli/epidemiologia , Infecções por Escherichia coli/transmissão , Portador Sadio/epidemiologia , Diarreia/tratamento farmacológico , Diarreia/etiologia , Fezes/microbiologia , Antibacterianos/uso terapêutico , Jamaica
12.
J Trop Med Hyg ; 69(5): 117-9, May 1966.
Artigo em Inglês | MedCarib | ID: med-12238

RESUMO

A case report of an apparently successful cure by ampicillin of the typhoid carrier state in a nurse aged 40 years despite the presence of gallstones is presented. No secondary cases of typhoid fever are known to have arisen from contact with her after she became aware that she was a typhoid carrier. The patient chose to be treated with ampicillin rather than by cholecystectomy. (Summary)


Assuntos
Adulto , Feminino , Humanos , Ampicilina/uso terapêutico , Portador Sadio , Febre Tifoide/tratamento farmacológico
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