RESUMEN
In 2008, Ethiopia implemented tuberculosis (TB) treatment registers that included columns for recording human immunodeficiency virus (HIV) test results (integrated registers) to replace the previous system of separate TB and HIV registers (pre-integration registers). We compared the proportion of children with documented HIV rapid test results at eight hospitals before and after adopting the integrated registers. HIV status was more consistently documented in the integrated registers; however, HIV status for infants aged <18 months could not be assessed, as the registers did not capture results from polymerase chain reaction-based testing. Recording procedures should be revised to document age-appropriate HIV diagnostic results and ensure referral for appropriate care.
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Infecciones por VIH/epidemiología , Vigilancia de la Población/métodos , Sistema de Registros/estadística & datos numéricos , Tuberculosis/epidemiología , Adolescente , Factores de Edad , Niño , Preescolar , Etiopía/epidemiología , Femenino , Infecciones por VIH/diagnóstico , Humanos , Lactante , Masculino , Reacción en Cadena de la Polimerasa , Derivación y ConsultaRESUMEN
Intensified tuberculosis case finding (ICF) is used in people living with the human immunodeficiency virus (PLHIV) to reduce the burden of tuberculosis (TB). We conducted a retrospective study in 300 PLHIV attending an HIV care clinic in Ethiopia to assess ICF performance during a 12-month period. Between 80% and 95% of patients were screened for TB at enrolment and at each 3-month follow-up visit. Thirty-four (11%) patients were diagnosed with TB, of whom 27 (79%) were identified in the first 6 months. This study assessed serial ICF in routine settings, showing that TB screening had its largest diagnostic yield in the first 6 months.
Asunto(s)
Infecciones por VIH/epidemiología , Tamizaje Masivo/métodos , Tuberculosis/diagnóstico , Adulto , Instituciones de Atención Ambulatoria , Estudios Transversales , Etiopía/epidemiología , Femenino , Estudios de Seguimiento , Infecciones por VIH/complicaciones , Humanos , Masculino , Estudios RetrospectivosRESUMEN
BACKGROUND: Neurological soft signs (NSS) have been reported to be more prevalent in patients with schizophrenia compared to other psychiatric and non-psychiatric controls. However, this issue in bipolar I disorder seems to be understudied. AIMS: The aims of the study were to examine the extent to which NSS are associated with bipolar I disorder cases compared to healthy controls, to assess the possible relationship between NSS and clinical dimensions of the disorder, and to explore the association of sociodemographic characteristics with the occurrence of NSS in cases with this disorder. METHODS: Predominantly treatment naïve cases of bipolar I disorder from rural communities were assessed for NSS using the Neurological Evaluation Scale (NES). RESULTS: This study showed that patients with bipolar I disorder performed significantly worse on two NES items from the sensory integration subscale, on one item from motor coordination and on four items from the 'others' subscale, the highest difference in performance being in items under the sequencing of complex motor acts subscale. Clinical dimensions and sociodemographic characteristics appeared to have no relationship with NES total score. CONCLUSIONS: Bipolar I disorder patients seem to have more neurological dysfunction compared to healthy controls particularly in the area of sequencing of complex motor acts. In addition, the finding suggests that NSS in bipolar I disorder are stable neurological abnormalities established at its onset or may be essential characteristic features of the disorder representing stable disease process that existed long before its onset.
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Trastorno Bipolar/diagnóstico , Trastorno Bipolar/fisiopatología , Encéfalo/fisiopatología , Adolescente , Adulto , Trastorno Bipolar/epidemiología , Estudios Transversales , Etiopía/epidemiología , Femenino , Humanos , Masculino , Persona de Mediana Edad , Esquizofrenia/epidemiología , Índice de Severidad de la EnfermedadRESUMEN
OBJECTIVE: To study the clinical and radiological prevalence of skeletal fluorosis among the retired employees of Wonji-Shoa sugar estate. DESIGN: Retrospective and cross-sectional study. SETTING: Wonji-Shoa sugar estate, an agro-industrial estate located in the Ethiopian Rift Valley. SUBJECTS: Two hundred and sixty three employees of the estate who retired between 1995 and 1996. MAIN OUTCOME MEASURES: Clinical evidence of impaired squatting, neck and lumbar mobility, kyphosis, and X-ray evidence of fluorosis. RESULTS: Skeletal fluorosis was more evident among the males (p<0.05), and the prevalence was higher among the factory and the agricultural workers than among the administrative workers (p<0.05). Clinical prevalence was 20% versus the radiological prevalence of 70.3%, indicating that many cases were asymptomatic. Impaired neck and lumbar mobility and impaired squatting significantly agreed with the radiological diagnosis (p<0.05) while kyphosis was not. CONCLUSION: Further clinical and epidemiological studies are suggested and strengthening of the existing defluoridation programmes within the area is recommended.
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Enfermedades de los Trabajadores Agrícolas/epidemiología , Enfermedades Óseas/epidemiología , Intoxicación por Flúor/epidemiología , Jubilación/estadística & datos numéricos , Enfermedades de los Trabajadores Agrícolas/clasificación , Enfermedades de los Trabajadores Agrícolas/diagnóstico por imagen , Enfermedades Óseas/clasificación , Enfermedades Óseas/diagnóstico por imagen , Comorbilidad , Estudios Transversales , Etiopía/epidemiología , Femenino , Intoxicación por Flúor/clasificación , Intoxicación por Flúor/diagnóstico por imagen , Humanos , Masculino , Persona de Mediana Edad , Exposición Profesional/estadística & datos numéricos , Prevalencia , Radiografía , Estudios Retrospectivos , Distribución por Sexo , EdulcorantesRESUMEN
Several studies have reported neurological soft signs (NSS) to be common in individuals with schizophrenia. The majority of these studies are based on clinical samples exposed to neuroleptic treatment. The present study reports on 200 treatment-naïve and community-identified cases of schizophrenia and 78 healthy individuals from the same area, evaluated using the Neurological Evaluation Scale (NES). The median NES score was 5.0 for cases of schizophrenia and 1.5 for healthy subjects. The impairment rate of NSS in cases with schizophrenia was 65.0% against 50.0% in healthy subjects, and the difference was statistically significant (chi2 = 5.30; df = 1; P < 0.021). NSS abnormality is as common in treatment-naïve cases as reported in many studies in those on neuroleptic medication. There was no significant relation between the NSS impairment and duration of illness, remission status, positive symptoms, negative symptoms and disorganized symptoms.
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Encéfalo/fisiopatología , Población Rural/estadística & datos numéricos , Esquizofrenia/fisiopatología , Adolescente , Adulto , Estudios Transversales , Etiopía , Femenino , Humanos , Masculino , Persona de Mediana Edad , Pruebas Neuropsicológicas , Oportunidad Relativa , Psicología del Esquizofrénico , Factores SocioeconómicosRESUMEN
Leprosy is a unique infectious disease with a prolonged incubation period and a predilection for skin and nerves. The involvement of nerves by the primary infection as well as the immunologically mediated reversal reactions result in impairment of nerve function and severe disabilities. The introduction of the World Health Organization Multi Drug Therapy over the last two decades has produced dramatic changes in the management and control programmes of leprosy. A recent important contribution to the understanding of leprosy pathogenesis has been the elucidation of the molecular basis for the entry of Mycobacterium leprae into the Schwann cell and the peripheral nerve. Leprosy still remains the commonest cause of peripheral neuropathy in developing countries.
Asunto(s)
Lepra/diagnóstico , Humanos , Lepra/tratamiento farmacológicoRESUMEN
BACKGROUND: The recognised clinical spectrum of disease associated with HIV infection is rapidly expanding and now includes a variety of rheumatological manifestations. MATERIAL AND METHODS: In this review of the literature of the last 15 years, we present the most common rheumatic manifestations described in association with HIV infection. RESULTS: Manifestations include a wide array of articular syndromes and autoimmune manifestations such as Reiter's syndrome, psoriatic arthritis, HIV associated arthritis and septic arthritis. Autoimmune diseases associated with HIV infection include a Sjögren-like syndrome, myopathies and systemic vasculitis. INTERPRETATION: Rheumatological manifestations of HIV infection may present earlier than clinical signs of the infection itself. Steroid and cytostatic treatment of rheumatic diseases may worsen the HIV disease.
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Infecciones Oportunistas Relacionadas con el SIDA/inmunología , Artritis Infecciosa/inmunología , Infecciones por VIH/inmunología , Enfermedades Reumáticas/inmunología , Infecciones Oportunistas Relacionadas con el SIDA/diagnóstico , Artritis Infecciosa/diagnóstico , Artritis Infecciosa/virología , Artritis Psoriásica/diagnóstico , Artritis Psoriásica/inmunología , Artritis Psoriásica/virología , Artritis Reumatoide/diagnóstico , Artritis Reumatoide/inmunología , Artritis Reumatoide/virología , Enfermedades Autoinmunes , Enfermedades del Tejido Conjuntivo/diagnóstico , Enfermedades del Tejido Conjuntivo/inmunología , Enfermedades del Tejido Conjuntivo/virología , Infecciones por VIH/diagnóstico , Humanos , Enfermedades Reumáticas/diagnóstico , Enfermedades Reumáticas/virologíaRESUMEN
We report the results of a seroepidemiological study on the prevalence of cysticercosis in Bénin. Cluster sampling at 3 levels was performed in the 6 départements (Atacora, Borgou, Zou, Mono, Atlantique and Oueme) and 2625 serum samples, from 1329 adult females and 1296 adult males, were collected. Antibodies against Taenia solium cysticerci were first searched for by enzyme-linked immunosorbent assay and the 41 seropositive samples were then examined by enzyme-linked electroimmunotransfer blot assay (EITB). Thirty-five samples gave positive results in the EITB. The overall seroprevalence of cysticercosis was therefore 1.3% (95% confidence interval [95% CI] 0.9-1.9). The seroprevalence was 1.9% in males (95% CI 1.2-2.7) and 0.8% (95% CI 0.4-1.5) in females (P < 0.05). A progressive increase in seroprevalence with increasing age was found. The highest seroprevalences were observed in Atacora and Atlantique, 2 non-Muslim départements (3.3% and 3.0%, respectively). This study demonstrated the public health importance of cysticercosis in Bénin.
Asunto(s)
Cisticercosis/epidemiología , Taenia/aislamiento & purificación , Adolescente , Adulto , Animales , Benin/epidemiología , Ensayo de Inmunoadsorción Enzimática , Estudios Epidemiológicos , Femenino , Humanos , Immunoblotting/métodos , Masculino , Persona de Mediana Edad , Parasitología/métodosRESUMEN
The central nervous system (CNS) is often affected by HIV-1 infection. Over 40% of AIDS cases present with neurological symptoms and CNS lesion are detected by anatomical and pathological studies in 80 to 90% of AIDS cases. There may be infections and tumors secondary to the immunodeficiency and pathologies may occur directly due to the neurotropism of the virus. Neurological problems associated with HIV-infection include encephalopathies, myelopathies, neuropathies and myopathies. HIV-1-induced encephalopathy may develop at any stages of HIV-1 infection and affects all risk groups equally. Its frequency worldwide is between 4 and 65% among individuals seropositive for HIV-1. The frequencies reported differ between studies due to differences in sampling methods, geographical factors, diagnostic criteria and investigative methods used. The pathogenesis of HIV-1-associated encephalopathy is not understood, but there are several hypotheses. The involvement of HIV-1 infected macrophages and microglial cells has been demonstrated. Indirect mechanisms such as release of lymphokines (tumor necrosis factor-TNF alpha- and interleukin-1) and neurotoxicity of the HIV envelope protein, gp 120, have also been suggested. This disorder is known as HIV-1-associated cognitive and motor syndrome. It presents clinically as a form of sub-cortical dementia with cognitive problems, motor deficits and behavioral disorders depending on the type and stage of HIV infection. The diagnosis can only be made after all other infections and tumors common in HIV-1 patients have been ruled out by appropriate investigations such as cerebrospinal fluid analysis, cerebral scan and magnetic resonance imaging. Electrophysiological studies, such as evoked responses and electroencephalograms, are particularly useful in its diagnosis. Anatomical examination shows diffuse paleness of the white matter, multi-nucleated giant cells and microglial nodes. Neuropsychological studies could be of value in diagnosis and in assessing the response to anti-retroviral treatment. There is currently no specific therapy for HIV-1-associated cognitive and motor syndrome. The use of new nucleoside analogue drugs in combination with existing drugs may provide new approaches to managing these patients.