Acute glomerulonephritis in Guyana

A retrospective study on 154 children with acute glomerulonephritis seen at the Georgetown Hospital, Guyana during the period 1976 - 1979 has been reported. Forty-eight per cent of cases were aged 5 - 10 years, and the condition occurred equally in males and females. There were 60 percent East Indians. The commonest presenting symptom was swelling of the face or feet. Over one-third of cases developed hypertension, and 41 percent had raised blood urea nitrogen levels. Evidence of preceding pyogenic skin infection was found in 68 percent of cases and scabies infestation in 11 percent. There were no deaths, and the prognosis in those followed for over 3 years has been excellent. Since pyogenic skin infection seems to be a predisposing factor to the development of acute glomerulonephritis in Guyana, the implications for public health measures are discussed. (AU)

Acute glomerulonephritis in Guyana - abstract

Although it is well known that acute glomerulonephritis occurs quite commonly in Trinidad, and to a much lesser extent in Jamaica, there has surprisingly been a paucity of information concerning the prevalence of acute glomerulonephritis in other parts of the Caribbean. To help correct that deficiency, this paper describes a study of 154 children seen with acute glomerulonephritis over the last four years at the Georgetown Hospital. Their ages ranged from 1 year 9 months to 14 years with the greatest percentage of cases (48 percent) occurring in the 5 - 10 years age group. The sex incidence was approximately equal. Nearly 60 percent of the children were East Indians, and 65 percent of the cases admitted came from the rural areas. The commonest presenting feature was swelling of the face and or feet. Over a third of the children developed hypertension and 62 of148 children in whom the blood urea nitrogen was estimated had a raised level. There was evidence of skin infection, either past or present, in 68 percent of the children, and of those with skin infections 16 percent were noted to have scabies. There were no deaths and the prognosis in those followed for over a year has been excellent. As skin infections seem to be the predisposing factor leading to acute glomerulonephritis the implications for public health measures are discussed (AU)

Rheumatic fever and rheumatic heart disease in children in Guyana

The pattern of rheumatic fever and rheumatic heart disease observed in children at the Georgetown Hospital, Guyana, over the past 10 years has been analyzed. Ninety patients up to age 13 years were diagnosed as having rheumatic fever or rheumatic heart disease. There was equal sex distribution, and the greatest number of cases occurred in the age group 6 - 10 years. There was no racial difference of the disease in the two major ethnic groups (East Indians and Negroes). Of the 90 cases, 54, 60 percent gave a history of rheumatic fever. Erythema marginatum and subcutaneous nodules were not seen. Four patients presented with chorea one of whom subsequently developed mitral stenosis. Seventy-five patients now have established valve lesions, the commonest being mitral incompetence. There were only 6 cases with pure mitral stenosis. The majority of the patients with established valvular heart disease runs a comparatively benign course in Guyana (AU)

Bacteriuria, prematurity, and the hypertensive disorders of pregnancy

The occurrance of prematurity and the hypertensive disorders of pregnancy in bacteriuric and in non-bacteriuric women has been compared. In all age and parity groups the occurrance of prematurity and the hypertensive disorders of pregnancy was higher in bacteriurics than in non-bacteriurics. Prevalence rates for the emergence of the hypertensive disorders of pregnancy rose particularly rapidly with increasing age parity in bacteriuric subjects. The predictive value of bacteriuria as an index of subsequent clinical pyelonephritis has been confirmed. The possible implications of these observations are discussed. It is suggested that some of the perinatal mortality and morbidity associated with hypertension and prematurity may be preventable. (Summary)