Detection by immunoblot assay of antibodies to Taenia solium cysticerci in sera from residents of rural communities and from epileptic patients in Bali, Indonesia.

Several studies from Bali have indicated the presence of Taenia solium. Relatively little has been reported, however, implicating human exposure to this parasite on Bali based upon the prevalence of anti-T. solium antibodies in asymptomatic and epileptic individuals. This study was conducted to determine by immunoblot assay and ELISA the frequency of anti-cysticercus antibodies in two groups of Balinese. Among 746 residents of four ecologic zones, 94 (13%) were positive by immunoblot. Of 74 epileptic patients from throughout the island, 10 (14%) were positive by immunoblot and 8 (11%) by ELISA; however, only 4 (22%) of the 18 sera positive in either test were positive in both assays. The previously defined high specificity and sensitivity of immunoblot indicates that T. solium cysticercosis is well established in Bali and that a significant amount of epilepsy may be due to neurocysticercosis.

The development of new foci of echinococcosis in northern Israel: prevalence in domestic animals.

In a survey carried out in 1991-1992 in the town of Yirka in Northern Israel, 49 dogs were examined for Echinococcus granulosus infection and abattoir data, based on organs condemned for the presence of parasites, was collected. The presence of E. granulosus by arecoline test was demonstrated in 7 (14.2%) of the dogs examined, but not parasites were found in the intestines of five stray dogs shot in the area. A survey of sheep slaughtered in the local abattoir during a one-month period revealed Echinococcus cysts in 10% of the 255 animals examined. No Echinococcus parasites were detected in 21 dogs examined 3 months after the initiation of praziquantel treatment. Echinococcosis seems to be a very serious public health problem in Israel and a control programme needs to be given a high priority.

Clinical and epidemiologic studies of Chagas' disease in rural communities of Oaxaca, Mexico, and an eight-year followup: II. Chila.

A seroepidemiologic survey conducted in 1971 in the rural Pacific coastal community of Chila in the Mexican state of Oaxaca showed an unusually high prevalence of antibody against the Chagas' disease agent Trypanosoma cruzi. Further studies were undertaken in 1973 and 1981 to (1) determine the pathologic impact of T. cruzi infection in humans, (2) investigate the natural history of the disease, (3) confirm that serologically positive persons were parasitologically positive, and (4) evaluate whether T. cruzi transmission continued into the next decade. This article reports results derived from those studies.

PIP: In 1971, health workers drew blood samples from 238 people living in the rural Pacific coastal village of Chile in Oaxaca State, Mexico to determine seroprevalence of antibodies against Trypanosoma cruzi--the parasite responsible for Chagas' disease. Seroprevalence was 5% in 16 year old children, but increased from 41% to 62% to a peak of 78% for 16-19, 20-29, and 30-39 year olds respectively then fell to 68% for 40-49 year olds only to climb again to 75% in 50-59 year olds and fell again to 47% for =or 60 year olds. Overall seroprevalence for adults was 67%. By 1981, adult seroprevalence had fallen to 33% and childhood prevalence to 0.7%. The very low levels of T. cruzi antibodies in children corresponded with insecticide (DDT) spraying for malaria control and with the disappearance of triatomine bugs from Chile. Medical histories revealed that seropositive individuals were more likely to exhibit acute signs and symptoms of initial bite lesions (Romana's sign), furuncle like skin lesions (Chagoma), and facial or body edema (p.05). They also tended to suffer from chronic fatigue and difficult breathing while lying down (p.05). 1973 electrocardiogram (ECG) results showed that seropositive individuals were significantly more likely to have complete right bundle branch block (p.005) and premature ventricular contractions (p.05) than seronegative individuals. There were no seroconversions among 57 people examined with ECGs between 1971-1983. Even though more seropositives (21%) experienced a progression of ECG abnormalities (3% rate/year) than seronegatives (7%), the difference was not significant. Despite reductions in seroprevalence and in triatomine bug population, serologic surveillance and monitoring to detect repopulation of houses by the bugs should be maintained.

Low Toxoplasma antibody prevalence in serologic surveys of humans in southern Mexico.

Antibody prevalence to Toxoplasma gondii among residents of a Pacific coastal region of Oaxaca State, Mexico is among low rates reported worldwide. From 60 small, rural communities, 3229 persons from ages 6 months to over 70 years provided blood specimens that were stored on filter papers. 124 (3.8%) of the eluates were seropositive (positive titer greater than 1:256) in the indirect hemagglutination test, and 43 (1.3%) had titers greater than 1:1024. Seropositive rates increased by age group and females were positive twice as often as males. There was no difference in rates for persons who lived at sea level, compared to those who lived between 600 and 1800 meters. In two small communities in which the number of persons tested were a large percentage of the total population, seropositive rates were 1.0 and 1.9%, respectively. The probable explanation for these low rates is the near absence of cats and paucity of meat in the diet. By contrast, sera tested from 479 persons living about 150 km to the east in the coastal, urban towns of Tehuantepec of Salina Cruz showed positive reactions among 122 (125.5%), and 71 (14.8%) had titers less than 1:1024. These people had a higher standard of living, more meat in their diet, and a few cats.

Intestinal helminthic and protozoal infections and urinary schistosomiasis in Egyptian children.

To extend information on the current distribution and frequency of parasitic infections in Egypt, one stool and one urine specimen from 2945 children, aged 6 to 12 years old were examined. The children were from 10 schools, one in Cairo, 2 in Giza Governorate, and 7 in the Nile delata. Frequency rates for S. mansoni by school were 0.3% in Cairo, 8-15% in Giza, and 3-79% in the delta; for S. haematobium, rates were 3% in Cairo, 25-71% in Giza, and 0-33% in the delta. Rates for strongyloidiasis, trichuriasis, and trichostrongliasis were low in each location never exceeding 1%. Frequency rates for ascariasis were 3-31%, ancylostomiasis 3-8%, enterobiasis 2-22%, hymenolepiasis 4-20%, amebiasis 13-52%, and giardiasis 5-25%. F. hepatica infections (0.01%) were found in Sobtas, and an 8% H. heterophyes infection rate was found in Mataryia.

Occupational exposure to hepatitis B virus in hospital personnel in Cairo, Egypt.

To identify hospital occupational categories at potential risk of hepatitis B virus infection, a serologic survey was conducted for hepatitis B surface antigen (HBsAg) and antibody (anti-HBs) by enzyme-linked immunosorbent assay in 765 employees at 4 hospitals in Cairo, Egypt. Overall, 3% HBsAg and 28% anti-HBs seromarkers. Combined HBsAg and anti-HBs frequencies by occupational group were: nonprofessional staff (60%), dentists (32%), graduate nurses (33%), physicians (29%), and student nurses (26%). The main risk factors for hepatitis B infection were frequency of exposure to patients' blood (for physicians, p less than 0.001) and to patients with jaundice (for dentists, p less than 0.01), and years of exposure to patients, as reflected by duration of occupation (for physicians, p less than 0.001) and by age of health care worker. Seropositivity by sex was greater for males (p less than 0.01). Physician specialties with highest risk of infection (29 to 53%) were surgery, infectious diseases, obstetrics-gynecology, and emergency medicine.

The etiology of acute hepatitis in adults in Egypt.

The causes of acute hepatitis were prospectively studied in 141 patients admitted to Embaba Fever Hospital, Cairo, Egypt in 1983. Serologic diagnosis showed: hepatitis A (0.7%), hepatitis B (46.8%), dual infections with A and B (1.4%), acute hepatitis in HBsAg carriers (14.2%), drug induced hepatitis (5.7%), and hepatitis non-A non-B (NANB) (31.2%). Among hepatitis B patients tested for the following seromarkers, 40% had HBeAg, 8% anti-delta antibody, and 6 simultaneous presence of HBsAg and anti-HBs; in convalescence, a 9% HBsAg carrier rate was found. Clinical, epidemiological, and biochemical findings did not distinguish one cause of hepatitis from another. For 32% of NANB patients parenteral injection was a likely source of infection.

The etiology of acute hepatitis in hospitalized children in Cairo Egypt.

Seromarkers for hepatitis A, B and D were used to determine the cause of acute hepatitis in 94 children (age 2 to 14 years) prospectively studied when they were admitted to Embaba Fever Hospital in Cairo, Egypt, between January and April 1983. The diagnoses were: hepatitis A (4%), hepatitis B (33%), acute hepatitis in HBsAg carriers (10%), dual infections with A and B (2%), and hepatitis non-A, non-B (NANB) (50%). Past hepatitis A was diagnosed in 96%. Among acute hepatitis B infections, 17% (5 of 29 tested) had anti-delta antibody; of HBsAg positive persons, 15% (6 of 40) were HBeAg positive. Two patients had simultaneous presence of HBsAg and antiHBs. For differential diagnosis, clinical, epidemiological, and biochemical findings were evaluated but did not distinguish hepatitis B from NANB hepatitis. Males predominated for HBV infections. No risk factors were found for 58% of HBV and 70% of NANB infections; of the remaining patients, 42% percent of HBV and 30% of NANB infections were associated with injections or surgery but none with transfusion or known contact with hepatitis cases.

Estudios clínicos y epidemiológicos de la enfermedad de Chagas en Oaxaca, México, y un estudio complementario de siete años: 1. Cerro del Aire / Clinical and epidemiological studies of Chagas' disease in Oaxaca, México, and a 7-year follow-up: Cerro del Aire

Las encuestas serológicas realizadas en 1971 en el estado de Oaxaca, México, revelaron niveles desusadamente altos de anticuerpos a Trypanosoma cruzi, agente de la enfermedad de Chagas, en ciertas comunidades. En Cerro del Aire resultaron positivas 76% de las 248 personas mayores de 20 años sometidas a pruebas serológicas. Sin embargo, solo 2% de los menores de 10 años dieron resultados seropositivos y la ausencia del vector indicó que la infección no se había transmitido en esa comunidad por un período de cerca de 10 años. En 1973 y 1980 se emprendieron nuevos estudios con fines de: 1) determinar los efectos patológicos de la infección en el hombre; 2) investigar la historia natural de la enfermedad; 3) comprobar que las personas con reacciones serológicas positivas eran parasitológicamente positivas, y 4) comparar los métodos de aislamiento de T. cruzi. De los 237 habitantes de Cerro del Aire (124 eran menores de 16 años) que se sometieron a las pruebas de hemaglutinación indirecta, aglutinación directa y fijación del complemento en 1980, 35% fueron seropositivos. Los exámenes clínicos y electrocardiográficos mostraron diferencias significativas entre 111 personas seropositivas y 65 seronegativas. Los sujetos seropositivos que proporcionaron sus historiales clínicos notificaron lesiones tipo chagoma o Romaña con más frecuencia que los seronegativos (p<0,02). Las diferencias también fueron significativas respecto de los dolores precordiales (p<0,05) y palpitaciones (p<0,02). Los electrocardiogramas revelaron uno o más tipos de anormalidades en 46% de los sujetos seropositivos, pero solo en 22% de los seronegativos (p<0,005). El bloqueo de rama derecha se presentó en 12% de los seropositivos y en 2% de los seronegativos (p<0,02), y las extrasístoles ventriculares en 6% de seropositivos y en ninguno de los seronegativos (p<0,05)...

Estudios clínicos y epidemiológicos de la enfermedad de Chagas en Oaxaca, México, y un estudio complementario de siete años: 1. Cerro del Aire / Clinical and epidemiologic studies of Chagas' disease in rural communities in Oaxaca state, Mexico, and a seven year follow-up: 1. Cerro del Aire

Las encuestas serológicas realizadas en 1971 en el estado de Oaxaca, México, revelaron niveles desusadamente altos de anticuerpos a Trypanosoma cruzi, agente de la enfermedad de Chagas, en ciertas comunidades. En Cerro del Aire resultaron positivas 76 por ciento de las 248 personas mayores de 20 años sometidas a pruebas serológicas. Sin embargo, solo 2 por ciento de los menores de 10 años dieron resultados seropositivos y la ausencia del vector indicó que la infección no se había transmitido en esa comunidad por un período de cerca de 10 años. En 1973 y 1980 se emprendieron nuevos estudios con fines de: 1) determinar los efectos patológicos de la infección en el hombre; 2) investigar la historia natural de la enfermedad; 3) comprobar que las personas con reacciones serológicas positivas eran parasitológicamente positivas, y 4) comparar los métodos de aislamiento de T. cruzi

De los 237 habitantes de Cerro del Aire (124 eran menores de 16 años) que se sometieron a la prueba de hemaglutinación directa y fijación del complemento en 1980, 35 por ciento fueron seropositivos. Los exámenes clínicos y electrocardiográficos mostraron diferencias significativas entre 111 personas seropositivas y 65 seronegativas... (AU)

Serum concentration of 1,25-dihydroxyvitamin D in the human: diurnal variation.

The serum concentrations of many hormones exhibit regular circadian rhythms. To determine if the serum concentration of 1,25-dihydroxyvitamin D [1,25-(OH)2D], undergoes periodic changes during the day, we measured the serum concentration of 1,25-(OH)2D every 30 min for 28 h in five normal men. Serum concentrations and urinary excretion rates of calcium (Ca) and inorganic phosphate (Pi) also were measured. The results indicate that the serum concentration of 1,25-(OH)2D does not undergo any large fluctuations during the day, but, rather, is maintained within approximately 20% of its overall 24-h mean. In two of five men, part of the observed daily variation could be attributed to a low amplitude (less than or equal to 10%) circadian rhythm, with the mean acrophase occurring at 1645 h. The previously reported circadian rhythms in serum concentration and urinary excretion rates of Ca and Pi were confirmed. Although the rhythmic changes in serum 1,25-(OH)2D in two subjects were not correlated with the diurnal changes in the serum concentrations of Ca or Pi, a significant negative correlation (r = 0.61; P less than 0.001) was found between the circulating concentrations of Ca and Pi.

Use of a nomogram to quantitate plasma dilutions for serological testing following blood collection in capillary tubes.

A technique for the processing and quantitation of small volumes of plasma collected in heparinized capillary tubes is presented using a nomogram that determines the final amount of diluent needed for variable volumes of plasma.