Sex and age differences in Mycobacterium tuberculosis infection in Brazil.

Globally, the prevalence of tuberculosis (TB) disease is higher in males. This study examined the effect of sex and age on Mycobacterium tuberculosis (Mtb) infection. Demographic and exposure data were collected on household contacts of sputum smear-positive pulmonary TB patients in Brazil. Contacts with tuberculin skin test induration ⩾10 mm at baseline or 12 weeks were considered Mtb infected. The study enrolled 917 household contacts from 160 households; 508 (55.4%) were female, median age was 21.0 years (range 0.30-87.0) and 609 (66.4%) had Mtb infection. The proportion infected increased with age from 63.3% in girls <5 years to 75.4% in women ⩾40 years and from 44.9% in boys <5 years to 73.6% in men ⩾40 years. Multivariable modelling showed the odds of infection increased between age 5 and 14 years among female contacts (OR 1.5 per 5-year age increase; 95% CI 1.1-2.2; P = 0.02) and between ages 0-4 and 15-39 years among male contacts (OR 2.7, 95% CI 0.83-8.9 and 1.1, 95% CI 0.99-1.3 per 5-year age increase; P = 0.10, 0.07, respectively). The study suggests that the age at which Mtb infection increases most is different in females compared with males. Studies are needed to explore whether these findings are due to differences in host susceptibility, exposure outside the household or other factors.

Assessing risks of releasing exotic biological control agents of arthropod pests.

More than 5000 introductions of about 2000 species of exotic arthropod agents for control of arthropod pests in 196 countries or islands during the past 120 years rarely have resulted in negative environmental effects. Yet, risks of environmental effects caused by releases of exotics are of growing concern. Twenty countries have implemented regulations for release of biological control agents. Soon, the International Standard for Phytosanitary Measures (ISPM3) will become the standard for all biological control introductions worldwide, but this standard does not provide methods by which to assess environmental risks. This review summarizes documented nontarget effects and discusses the development and application of comprehensive and quick-scan environmental risk assessment methods.

[Neonatal blood group incompatibility due to anti-M antibodies]. / Neonataal bloedgroepantagonisme door anti-M-antistoffen.

Neonatal blood group antagonism due to anti-M antibodies is extremely rare. The case is reported of a neonate with moderately severe haemolytic anaemia due to anti-M which required two blood transfusions. Although anti-M antibodies are as a rule regarded as clinically irrelevant, and although they react almost exclusively at lower temperatures, they may in exceptional cases be demonstrated at 37 degrees C, as in the patient described; they may then cause haemolysis. Most strikingly, the direct Coombs test in this patient was negative; this phenomenon has been described before. In unexplained haemolytic anaemia of a newborn, even in the presence of a negative direct Coombs test, the possibility of blood group antagonism should be considered.

A new, low-incidence red cell antigen (HOFM), associated with depressed C antigen.

A case of mild hemolytic disease of the newborn is presented which was caused by an antibody to a hitherto unknown antigen of low incidence. This antigen, now designated as HOFM (ISBT number 700050) was detected in 6 relatives, and in all of them, it was associated with an unusually weakened expression of C antigen. The serological data indicate that HOFM may be part of the Rh system, but the genetic data, although supportive of this interpretation, are inconclusive.