Study of brucellosis in a pastoral community and evaluation of the usefulness of clinical signs and symptoms in differentiating it from other flu-like diseases.

A study of differentials causing flu-like symptoms (malaria, typhoid, streptococcal infections and rheumatoid arthritis) in 488 patients from a pastoralist area is presented. The potential usefulness of clinical signs, symptoms and diagnostic tests in ruling-in or ruling-out these diseases was investigated in the District hospital and three outlying health dispensaries. For each patient a detailed clinical history plus diagnostic test for brucellosis, typhoid, streptococcal infections and rheumatoid arthritis, and for some patients malaria were conducted. Incidence levels of these diseases were estimated using laboratory test results; brucellosis, 13%, typhoid, 40%: streptococcal infections, 6% malaria, 9%: and rheumatoid arthritis, 10%. Brucellosis could not be differentiated clinically from the other flu-like diseases but rheumatoid arthritis could.

Study of Brucellosis in a Pastoral Community and Evaluation of the Usefulness of Clinical Signs and Symptoms in Differentiating it from other Flu-Like Diseases

A study of differentials causing flu-like symptoms (malaria; typhoid; streptococcal infections and rheumatoid arthritis) in 488 patients from a pastoralist area is presented. The potential usefulness of clinical signs; symptoms and diagnostic tests in ruling-in or ruling-out these diseases was investigated in the District hospital and three outlying health dispensaries. For each patient a detailed clinical history plus diagnostic test for brucellosis; typhoid; streptococcal infections and rheumatoid arthritis; and for some patients malaria were conducted. Incidence levels of these diseases were estimated using laboratory test results; brucellosis; 13; typhoid; 40: streptococcal infections; 6malaria; 9: and rheumatoid arthritis; 10. Brucellosis could not be differentiated clinically from the other flu-like diseases but rheumatoid arthritis could

Some gastro-intestinal parasites of zoonotic (public health) importance commonly observed in old world non-human primates in Kenya.

A study was undertaken to categorise some gastro-intestinal (GIT) parasites commonly observed in Kenyan non-human primates (NHPs) on the basis of their health implications for humans. Six species of locally available non-human primates, namely olive baboons (Papio cyanocephalus anubis), Vervet monkey (Cercopithecus aethiops), Sykes monkey (Cercopithecus mitis), Black and white colobus (Colobus abyssinicus), Debrazzas monkey (Cercopithecus neglectus) and Grey and Black mangabeys (Cercocebus torquatus and Cercocebus albigena) which were imported from Zaire (Democratic Republic of Congo) were sampled. Simple laboratory methods involving microscopic examination of stained faecal smears were used. Wet faecal smears stained with iodine and unstained controls were used for conventional parasites while acid fast staining was employed to detect Cryptosporidium oocysts. Both helminths and protozoan parasites were detected in varying rates in all primate species. Trichuris sp. was the most frequent helminth followed by Strongyloides fulleborni, Strongyles sp. and Schistosoma mansoni in that order. Entamoeba coli was the most common protozoan followed, respectively, by Balantidiun coli and Entamoeba histolytica. All primate species examined were infected with all the parasites listed except the black and white colobus. Cryptosporidium was found in both clinically normal and diarrhoeic baboons and vervets. Most taxa of parasites observed could prejudice human welfare directly through infection and causation of illness and indirectly through increased cost of livestock production and decreased availability of animal proteins. The potential of some of the agents to cause opportunistic infections in immuno-compromised persons was suggested as a likely threat to man's well-being. This would warrant such person's exemption from high risk operations at primate and other animal facilities in developing countries. Further, specific studies are needed to provide data on the epidemiology, socio-economic impact and pathogenicity of the primate parasites to other species of animals and man.

Helminth and protozoan gastrointestinal tract parasites in captive and wild-trapped African non-human primates.

The objective of this study was to investigate the gastro-intestinal (GIT) parasites commonly occurring in captive and wild-trapped (WT) non-human primates (baboons, vervets and Sykes) in Kenya and compare their prevalence. Three hundred and fifteen faecal samples were subjected to a battery of diagnostic tests, namely, direct smear, modified formal ether sedimentation, Kato thick smear, Harada-Mori techniques for parasite detection and culture to facilitate nematode larvae identification. Of these, 203 (64.4%) harboured helminths and 54 (17.1%) had protozoa. The helminth parasites comprised Strongyloides fulleborni 141 (44.8%), Trichuris trichuira 200 (63.5,%), Oesophagostomum sp. 48 (15.2%), Trichostrongylus sp. 73 (23.2%), Enterobius vermicularis 44 (14.0%), Schistosoma mansoni 4/92 (4.3%) and Streptopharagus sp. 68 (21.6%). Protozoan parasites consisted of Entamoeba coli 204 (64.8%), Balantidium coli 127 (40.3%) and Entamoeba histolytica 78 (24.8%). Both WT and colony-borne (CB) primates had similar species of parasites, but higher prevalences of protozoan infection were observed in CB baboons while helminth infections were relatively more common in WT primates. Some of the parasites observed in this study are reported to be zoonotic in various parasitological literatures. Chemoprophylaxis and other managerial practices were believed to be responsible for the lower worm prevalence in CB primates. Similar intervention against protozoa and other agents will not only improve primate health, but also increase safety to animal handlers and colony workers.

The presence of Cryptosporidium oocysts in stools of clinically diarrhoeic and normal nonhuman primates in Kenya.

A total of 114 nonhuman primates comprising 51 vervet monkeys (Cercopithecus aethiops) and 63 olive baboons (Papio anubis) were examined for Cryptosporidium oocysts using the modified Kinyoun's acid-fast staining technique. About 51.7% (59/114) of all the specimens examined, representing 78.4% (40/51) of the vervet monkeys and 30.1% (19/63) of the olive baboons were positive. Bright red, refractile Cryptosporidium oocysts were observed in the stained faecal smears against a blue background. Up to 4/6 (66.7%) of the diarrhoeic vervets and 2/3 (66.7%) baboons, respectively, were positive while the rest were negative. To the best of our knowledge, this report is the first on cryptosporidiosis in old world nonhuman primates in Kenya and probably the first report of the infection in olive baboons. Given the high frequency of oocysts in diarrhoeal specimens, the parasite may have been associated with clinical diarrhoea in the sampled animals. Cryptosporidium, which has been reported in humans in Kenya, is also suspected to occur in livestock. Its isolation from clinically ill, normal colony-borne and newly caught feral nonhuman primates has significant implications for both public health and animal agriculture in Kenya.

Criteria for better detection of brucellosis in the Narok District of Kenya.

Monthly disease summary sheets from 1986-1992 of 60 dispensaries, clinics and hospitals in Narok district, Kenya were reviewed for the occurrence of brucellosis and other diseases with "flu-like symptoms". Diseases with these symptoms accounted for about 52% of the 1,037,875 cases reported for the time period. These were classified as malaria (79.3%), rheumatism (7.1%), PUO (2.4%), and brucellosis (0.8%). Brucellosis was diagnosed by a positive Rose Bengal (RB) test routinely conducted in seven out of the 60 health units. In these units, 55% of flu-like cases were classified as malaria and 21.2% as brucellosis. Individual case records of patients at four dispensaries using the RB test during 1991-92 were assessed for specific predictor symptoms. For 625 RB tested patients, a positive test result was associated with joint pain, headache, and the combinations of joint pain with headache and lameness with headache. A logistic regression model correctly predicted the RB test result in 62.3% of the time. For the 465 patients examined by the blood smear examination, identification of malaria parasites was associated with, headache, joint pain and combinations of emesis with pale mucous membranes. This regression model correctly predicted positive results 67.2% of the time. Both models indicate that selected clinical predictors represented significantly increased odds of being positive to the respective tests. However, for both diseases, clinical signs alone appear insufficient for reliable diagnosis and differentiation probably due to resemblance in symptomatology between these two and other diseases.