Comparison of GenoType MTBC with RFLP-PCR and multiplex PCR to identify Mycobacterium tuberculosis complex species.

The aims of the work presented here were to evaluate a commercial system based on DNA hybridization technology on nitrocellulose strips (GenoType MTBC; Hain Diagnostika, Nehren, Germany) for identifying Mycobacterium tuberculosis complex isolates to the species level and to compare the results with those obtained using the RFLP-PCR and multiplex PCR molecular techniques, biochemical tests and susceptibility testing. The commercial system correctly identified 102 of 103 (99.03%) strains studied, indicating it is capable of discriminating among the tuberculosis complex species.

The use of macroarrays for the identification of MDR Mycobacterium tuberculosis.

The emergence of Mycobacterium tuberculosis (Mtb), resistant to both isoniazid (INH) and rifampicin (RIF) (MDR-TB), is an increasing threat to tuberculosis control programs. Susceptibility testing of Mtb complex isolates by phenotypic methods requires a minimum of 14 days from a primary specimen. This can be reduced significantly if molecular analysis is used. Low density oligonucleotide arrays (macroarrays) have been used successfully for the detection of RIF resistance in Mtb. We describe the use of macroarray technology to identify Mtb complex isolates resistant to INH and/or RIF. The macroarray MDR-Mtb screen has been designed to detect mutations in the RIF resistance determining region (RRDR) of Mtb rpoB and loci in katG and mabA-inhA associated with INH resistance. A panel of Mtb isolates containing 38 different RRDR genotypes, 4 different genotypes within codon 315 of katG and 2 genotypes at mabA-inhA was used to validate the macroarray. The wild type (WT) genotype was correctly identified at all three loci. Of the 37 mutant rpoB genotypes, 36 were correctly detected; the single mutant not detected contained a 9 base insertion. All mutations within katG and mabA-inhA were correctly identified. We conclude that this low cost, rapid system can usefully detect the mutations associated with the vast majority of MDR-Mtb.

[Social development and infant mortality, 1977-1986, Cuba. A regional analysis]. / Desarrollo social y mortalidad infantil, 1977-1986, Cuba. Un analisis regional.

In Cuba, the infant mortality rate (IMR) dropped by 65% between 1970 and 1986. The 1986 IMR - 13.6% - has put the country in the lead in Latin American mother and child health care. However, the behavior of the IMR is not homogeneous throughout the country. This paper seeks to identify by multiple regression techniques, those sociodemographic or health care factors which have determined the decline in the IMR and those variables which best explain the inter-regional differences in this indicator. Sociodemographic factors fundamentally explain the evolution of the IMR in Cuba; on the other hand, although in the first instance the proportion of live births of low weight and the crude birth rate explain the inter-regional differences in IMR levels every year, it can be seen that other socioeconomic variables really lie behind these differences.

[Seasonal variations in infant mortality in Cuba]. / Variaciones estacionales de la mortalidad infantil en Cuba.

Mortality risk in the first year of life is different according to climatological characteristics of the season's year. In this paper two periods are taken (1965-1971 and 1979-1985) with the purpose of analyzing seasonal variations in infant mortality and to determine seasonal differences between both periods and in each of them. This study may identify the existence of seasonality and the presence of overmortality in summer months. This seasonality is not similar in both periods because of the decrease in infant mortality rate and the changes in the cause of death structure. Author gives element to planning from a more realistic view evolution during the year of infant mortality rate in the country.

[Estimation of infant mortality in the early ages in the western provinces of Cuba]. / Estimacion de la mortalidad infantil y en edades tempranas en las provincias occidentales de Cuba

PIP: Infant and child mortality in the western provinces of Cuba is analyzed using methods developed by Brass and adapted by Trussell. Consideration is given to regional differences and to differences between rural and urban areas. (summary in ENG, FRE)^ieng