Showing papers in "Tropical and geographical medicine in 1975"

Effect of the Aswan High Dam on prevalence of schistosomiasis in Egypt.

Abstract: An increase in the prevalence of schistomiasis in Egypt, as a result of the Aswan High Dam, has for long time been predicted because of reclamation of land and conversion of annual flooding (basin irrigation) into perennial irrigation in Upper Egypt. Two aspects, neglected in the predictions, have been investigated in the present study, and these are: the ecological changes, relevant to the transmission of the disease, in the Nile itself, and those in irrigation canals and drains in areas which had been under perennial irrigation before the constriction of the dam. The findings indicate that the Nile, at least in the Delta, has become a favorite habitat for breeding of the snail hosts of both urinary and intestinal schistosomiasis, a center for human activities and evidently for transmission, and that irrigation canals and drains now harbor throughout the year undisturbed and stable populations of these snail hosts. This has resulted from the elimination in these canals, of the so-called 'winter closure', because it is no more needed. Before the dam the closure was enforced for about 40 days, during which the canals were closed and dried up, and the silt deposited on their beds during the Nile flood dredged out together with the snails and aquatic weeds.

Traditional medical practitioners among the Bambara of Mali and their role in the modern health care delivery system.

Abstract: The Bambara of Mali, who are sedentary agriculturists, number about two million and are the most important ethnic group in the country. They are gradually being Islamized, but retain many animist beliefs. Their traditional medical care system possesses a heterogenous group of practitioners who have either an animist or an Islamic culture reference. The traditional medical care system of the Bambara was studied and an evaluation of the quality of its practitioners made on the basis of a survey conducted in 128 villages over an eight-year period. During the study, patients, traditional practitioners and modern health workers were interviewed and their attitudes towards one another recorded and analyzed. Certain categories of traditional practitioners have a definite constructive role to play in a modern health care delivery system. Others, however, have had a long history and high incidence of charlatanism. Legitimatization of these categories and their incorporation into the modern health care system is not recommended.

Re-establishment of cutaneous leishmaniasis after cessation of anti-malaria spraying.

Abstract: Decrease or interruption of transmission of cutaneous leishmaniasis as a result of spraying of human dwellings with residual insecticides has been reported by several investigators. In this report the behaviour of the disease after cessation of spraying in the villages of Isfahan is studied. In 16 villages sprayed with DDT from 1966 through 1969, the incidence decreased from 8.2 per 1000 in 1965 to 0,7 per 1000 in 1969 but in 1970, the first year after cessation of spraying, the incidence increased to 15 per 1000, a 20-fold increase. The control villages did not show these changes, still having the incidence figure of more than 9 per 1000 per year. The study shows that insecticide spraying is not the fianl answer in the control of leishmaniasis.

The traditional basis of neuropsychiatric practice among the Yorubas of Nigeria.

Abstract: The Nigerian, because of gross shortage of 'western-trained' health personnel, not infrequently resorts to traditional native medicine and the native herbalists. The training of these native doctors is an arduous one and lasts on the average of 8-10 years. The core of their practice is handed-down tradition learned by rote and memorised. Pharmacotherapeutics are based in part on observations tested through the ages, and not uncommonly on the cause and effect phenomena. They are excellent psychotherapists, and maintain good relationship with their patients. Neurology as practised among the Yoruba native doctors recognises several classical neurological diseases including epilepsy, cerebrovascular accidents, fever and headache, migraine and the tropical ataxic neuropathy. Several often compound prescriptions are available, but the scientific basis of most of the prescriptions is for the moment unknown to them or to modern medicine. It seems that further research into some aspects of traditional native medicine may yield some fruitful results.

Scabies and other skin diseases in pre-school children in Ujamaa villages in Tanzania.

Abstract: A survey of skin diseases was carried out in pre-school children in five Ujamaa villages in Rufiji district and 532 children (5.3% of the total population) were screened. The results showed that scabies was the commonest skin problem affecting 31% of the children. Primary pyoderma and fungal infections were relatively less common and accounted for 7.0 and 2.4% respectively. Staphylococcus aureus, Group A beta haemolytic streptococci and Corynebacterium diphteriae were the commonest pathogeneic bacteria isolated from both infected scabies and primary pyoderma. Tinea capitis was similarly the commonest fungal infection and Microsporium audouinii was the main pathogen. The high prevalence of scabies was attributed to poor hygiene, overcrowding with intimate personal contact. The low prevalence of pyoderma was due to the fact that we did not include secondarily infected scabies and eczema amongst the cases of pyoderma.

Intestinal helminths in dogs and cats on the Antillian Islands Aruba, Curaçao and Bonaire.

Abstract: An investigation into the prevalence, identity and size of population of intestinal helminths in dogs and cats was carried out in the Dutch Antillian Islands, Curacao, Bonaire and Aruba during April and May 1974 Ninety-one dogs and 83 cats were examined In all, 4,824 helminths were isolated and identified The following species were isolated from dogs: Dipylidium caninum (most frequent), Ancylostoma caninum (frequent in Curacao), Toxocara, Taenia hydatigena and Ancylostoma braziliense Species isolated from cats: Dipylidium caninum (most frequent) Ancylostoma tubaeforme (frequent in Curacao), Oncicola canis, Taenia taeniaformis, Spirometra (mansonoides), Platynosomum (fastosum), Toxocara, Trichuris and Thelazia The man-infecting hookworm species Ancylostoma ceylanicum was not found at all and A braziliense was only found in dogs in Aruba in light infections Remarkable differences in the prevalence of parasitic infections were demonstrated between Curacao and the two other islands Aruba and Bonaire, especially regarding the frequency and worm burden of the hookworms It was suspected that this was due to the recent increase in the number of dogs in Curacao

Salmonella weltevreden: a sero-type of increasing public health importance in India.

Abstract: Infection due to Salmonalla weltevreden in man in India was quite uncommon until 1970, constituting less than 4% of total human salmonellosis. The incidence of infection increase considerably since that year and in 1972 this serotype constituted 29.1% of total human and 22.4% of both human and and animal salmonellosis. This serotype ranks second among 47 and 83 Salmonella serotypes isolated from sewage and other water sources during 1958-1973. The public health importance of this serotypes is discussed.

The 1974 epidemic of Chikungunya fever in children in Ibadan.

Abstract: During an epidemic of Chikunguya fever in Ibadan 16 strains of Chikungunya virus were recovered from children reporting sick with fever at the University College Hospital and Oluyoro Catholic Hospital Outpatient Clinic. Twelve strains were obtained from children within the 1-4 year age group, two from 5-10 year group and one each from less than one-year age group, and 10-15 year age group. A retrospective survey for neutralising antibodies to Chikungunya shows a significantly higher proportion of children were positive for Chikungunya N antibodies just after the 1969 epidemic than in 1974 just before the epidemic, with resultant pooling of Chikungunya seronegative children who are susceptible to infection.

Heptatic and rectal pathology in Schistosoma intercalatum infection.

Abstract: Forty nine needle biopsies and 16 rectal biopsies taken from patients infected with S. intercalatum at the Ndoungue hospital (Department of Mungo, Cameroon) were studied. The histopathological changes were compared with the characteristic liver changes in S. mansoni infections. The pathological findings and clinical data were correlated in order to evaluate the extent of the liver changes in isolated S. intercalatum infections and in S. intercalatum infections assoicated with a concomitant disease. Outside the portal triangle eggs were less frequently found in S. intercalatum infection than in S. mansoni infection. This may be explained by the greater dimensions of S. intercalatum eggs. S. intercalatum granulomata, observed only in the portal triangle, had smaller dimensions than S. mansoni granulomata. S. intercalatum infection did not cause liver-cell destruction. Parenchymal lesions, when present, were always due to other causes (concomitant diseases). The liver cells sometimes showed aspecific changes such as pleomorphism of cells or nuclei or doubling of nuclei as a reaction to the toxic effect of schistosomal metabolites or to egg secretions or the inflammatory process around eggs. These changes were not associated with any impairment of liver function. No profound vascular changes such as are found in S. mansoni hepatosplenic schistosomiasis could be demonstrated; this explains the clinically noted absence of portal hypertension. Pigment formation was extensive in S. intercalatum infection; probably more pigment was present in the liver than in S. mansoni infection. In all patients the Kupffer cells were hypertrophied. The cause of the differences in the liver lesions of S. intercalatum and S. MANSONI INFECTION IN MAN MIGHT BE A LOWER IMMUNE RESPonse to S. intercalatum egg antigens.

Millipede burns in man.

Abstract: A review is made of the clinical features and treatment of the lesions caused by the secretions of millipedes. The toxicology of these secretions is discussed. The geographical distribution is reviewed. The species identified as inflicting injury to man are enumerated. Lesions of soft parts of the skin can be moderately severe. Eye injuries may be serious and must receive effective treatment rapidly to prevent residual damage.

Mortality and morbidity pattern in measles in Tanga District, Tanzania.

Abstract: Two hundred and fifty children, suffering from measles were studied for morbidity and mortality in Tanga District Hospital in Tanzania. The highest incidence of measles was in the second half of the first year of childhood (40%). Mortality was directly related to the nutritional status and associated complications. Medical care at the health centre level by medical auxiliaries during the acute phase and the problem of poor weight gain on follow-up are discussed.

Dietary intakes and food taboos of lactating women in a South Indian community.

Abstract: The diets of women, studied at regular intervals in the first year of lactation, showed that food taboos adversely affected the daily intake of energy, protein and some nutrients in the first month. Despite the poor intakes, the women breastfed their babies successfully and the weight gained by the babies in the early months was satisfactory. Breast feeding continued until the next pregnancy. Most women believed lactation prevented conception.

An epidemiologic and serologic study of arboviruses in Lake Rudolf basin.

Abstract: An epidemiologic and serologic study of arboviruses was done in 1972 in the basin of Lake Rudolf. The main object of this study was to demarcate the southern limit of the yellow fever epidemic which occurred from 1959 to 1962 in Southern Sudan and Ethiopia. Other purposes were to contribute to the inventory of arboviruses and their distribution in this region. The ethnic groups were studied: the Nyangatom and the Dassanetch in Ethiopia and the Turkana in northern Kenya. The results of tests on sera of the Nyangatom and the Dassanetch are practically identical: a high percentage of positive tests for group B. The Turkana on the other hand show a low percentage of positives. This is attributed to differences in the climatic characteristics of the two regions. The serological results suggest the presence of West Nile virus in the geographical areas inhabited by the three ethnic groups. The presence of Wesselsbron and probably Uganda S virus is suspected. Circulation of these viruses could be explained by the presence of Culex univittatus and other mosquitoes. As for yellow fever, the results suggest that the virus did not reach the areas studied, probably because of absence of efficient vectors.

Clinical observations of scrub typhus on Penghu (the Pescadores Islands).

Abstract: Between May and September 1973, 68 cases of scrub typhus in Chinese military personnel on the Pescadores Islands were studied. The common symptoms and signs were fever, chills, headache, eschar, myalgia, and lymph node enlargement. Most eschars were located in the axilla, waist, groin and genitals, and neck. These lesions were painless and not noticed by the patients themselves. Regional lymph node enlargement at the site of eschar drainage was common. Relative bradycardia with fever was observed in 40%, a skin rash in 35% of the patients. Leucopenia was noted more frequently in the febrile than in the convalescent stage, but more than half of the patients had a normal count. Lymphocytosis was prominent, especially during the convalescent period. An acceleration of ESR was noted. Instead of depression of the erythroid series in the marrow which was reported previously, 47% of examined patients were found to have erythroid hyperplasia. Two patients showed marked hypocellularity of the marrow in the acute febrile stage; later on became normocellular. Albuminuria was present in 15 and BUN increased in 12 patients. Elevation of serum bilirubin and SGOT was also noted. Biologic false positive VDRL tests were observed in nine patients. In 30 tests elevation of Proteus OX-K titres between 1:160 and 1:640 was noted. A geometric mean OX-K titre rise in the patients is presented; the mean titre reached a peak in the third week of illness, and then fell off. Most of the patients were treated with tetracycline 500 mg every six hours for about nine days. The fever usually subsided within 36 hours. Complications or mortality were not encountered.

Cow's urine poisoning in Nigeria. Experimental observations in mice.

Abstract: The method of preparation and administration of "cow's urine" and the signs and symptoms of cow's urine poisoning have been described. Experimental investigations were carried out in mice to assess the toxicity ot this concoction. Effect of the preparation was compared with that of pure nicotine. The effect of each component used in preparing the concoction was also tested. Results of the experiments show that both "cow's urine" and nicotine cause excitement in low doses and cause convulsion and/or death in higher doses. Both also depress respiration. The role of "cow's urine" toxicity following administration to patients with convulsion and the possible aetiology of the neurological sequelae of "cow's urine" poisoning are discussed.

Arbovirus studies in two towns in western state of Nigeria.

Abstract: Three hundred and fifty-one persons were tested for HI antibody to arbovirus Groups A, B and Ingwavuma viruses in Ilesha and Oshogbo, two towns in western Nigeria. Chikungunya accouted for most Group A infections (39%). Antibodies to Group B virus were distributed as follows: Dengue 22%, Yellow Fever 25%, West Nile 28% and Wesselsbron 30%. Few sera 5% were positive to Ingwavuma. No virus was isolated from 188 blood specimens processed for virus isolation.

A local outbreak of paralytic rabies in Surinam children.

Abstract: A rapidly fatal encephalomyelitis, which was in most cases characterized by ascending paralysis, developed in seven children of the age of 3 to 10 years in a bushnegro village in the interior of Surinam. Rabies virus was recovered from the central nervous system of three autopsied children. Although the source of infection has not been detected, there is an indication that, at least in some cases, the disease has been transmitted by rat-bite rather than by vampire bats. During the same period a few cases of minor febrile illness occurred in the same community. Since virological and serological evidence of a wide-spread distribution of Coxsackie A virus type 4 was obtained, the latter illness may presumably be attributed to this virus.

Isolation and identification of leptospira hardjo from cattle in Argentina.

Abstract: A serological evaluation was done on the prevalence of bovine leptospirosis in Argentina. In 1,857 serum samples obtained from the major cattle raising areas of the country, 59.1 percent showed leptospiral agglutinins in the microscopic-agglutination test. The most frequent leptospiral antigens showing antibody reactions were the hebdomadis group serotypes, of which 45.8 per cent of the sera reacted to Leptospira hardjo with titres ranging from 1:100 to 1:25,600. Six Leptospira isolations were made from 161 bovine kidneys collected at local abattoirs. Their isolation and subsequent identification as serotype L. hardjo is described. This study reports on L. hardjo in cattle of Argentina for the first time and confirms the need for improved cultural methodology for its isolation.

Prevalence of diabetes mellitus among the ethnic groups in Singapore.

Abstract: During a routine medical examination of 5280 government employees (2736 males, 2544 females; age range 17 to 66 years; 3386 Chinese, 1252 Malays, 508 Indians and 134 other ethnic groups) diabetes was found in 31 (0.59%). The prevalence was higher in males (0.95%) than in females (0.20%). The highest prevalence was in the age-group 50 to 59 years (5.4%); at ages 30 to 66 years, the overall prevalence was 2.18%. The prevalence of diabetes is higher in Indians (2.76%) than in Chinese (0.30%) and Malays (0.48%); the difference is statistically significant, as it also is in the age-group 30 to 66 years (Indians 6.36%, Malays 1.39%, Chinese 0.9%). Of the 31 cases, only four were previously known and only nine were overwieght. The possible reasons for the higher prevalence of diabetes in Indians are discussed.

Radiological patterns of pulmonary tuberculosis in Nigeria.

Abstract: Two hundred and sixteen patients with pulmonary tuberculosis were reviewed. Childhood and adult patterns of tuberculosis as noted in other countries were recognised. However, some children were seen with an adult pattern most probably due to a reinfection. There were also adults with the childhood pattern most probably due to a failure in the localisation of the primary intra-pulmonary parenchymal lesions with subsequent haematogenous spread. The prognosis in children with the adult pattern, and in adults with the childhood pattern was poor. The lesions (noted in this study) were severe and widespread, and with a high incidence of complications such as adenopathy and exudative lesions. The high incidence of associated diseases such as measles and malnutrition would account for the severity of tuberculosis and the high percentage of negative tuberculin tests in these patients. No lobes were exempted from involvement. But the upper lobes especially the right were the most affected. Negative tuberculosis tests make repeated sputa examinations imperative in the diagnosis of tuberculosis in this environment. The high predominance of male patients among those with miliary tuberculosis in our study remains unexplained. The genotype distribution amongst our patients shows no statistical difference between them and that of the population.

The nutritional status of children ages 0-5 years in Nkhotakota, Malawi.

Abstract: A nutritional status survey of children aged 0-5 years was carried out in a lake shore district in Malawi. Anthropometric and clinical studies indicated a high overall prevalence (14%) of Protein-Calorie Malnutrition (PCM), particularly among the 1- to 1 1/2-year-olds. Few signs of vitamin deficiencies were seen but iron deficient anaemia was common at all ages, 68% being below the acceptable haemoglobin level. Sixty percent of children had malaria parasitaemia and 25% conjunctivitis. Under-five mortality was estimated to lie between 31 and 44%. Muslim children had a higher mortality and prevalence of PCM and fewer of their fathers had been to school. It is suspected that many cases of undernutrition go unrecognized because of uniform stunting occurs and ages are not known. It is recommended therefore that medical units use a local calendar, similar to that evolved for the survey, in order to estimate ages more accurately.

A new focus of onchoceriasis in the Sudan.

Abstract: A new focus of onchocerciasis is reported from Upper Atbara River area in the Sudan. This river is a known seasonal breeding place of Simulium damnosum. The area was sparsely populated in the past but now, following agricultural development, is inhibited mainly by immigrants from Northern Nigeria and Chad. Clinically the common features are skin changes of the legs, thighs buttocks, arms and trunk. Other features are corneal opacities and small often deeply placed subcutaneous nodules. Choroido-retinal degeneration, genital elephantiasis and hydrocoele, commonly associated with onchocerciasis in other parts of the Sudan, are absent.

Serological study of amebiasis and toxoplasmosis in the Lindu Valley, Central Sulawesi, Indonesia.

Abstract: Results of a serology survey in April 1972 for Entamoeba histolytica and Toxoplasma gondii antibodies among 484 inhabitants of the isolated Lake Lindu Valley of Central Sulawesi (Celebes) are presented. Indirect hemagglutination antibody titers for amebiasis were found in over 10% of the population, although only 3.7% demonstrated significant titers of 1:128 or greater. There appeared to be no relationship between antibody titers and the age and sex of individuals tested, and the frequency distribution of antibody titers indicates a low prevalence of invasive amebiasis in the population. Indirect hemagglutination antibody titers for Toxoplasma gondii equal to or greater than 1:32 were found in 27.1% of the total population, and it appeared that the prevalence of titers increased with age in both sexes. More families with cats had Toxoplasma gondii antibody titers than families without cats.

Cerebrovascular disease in Uganda.

Abstract: Cerebrovascular disease in Uganda is probably as common as in developed countries. However, the aetiology is very different. Predisposing factors such as hypertension and systemic embolization from an intracardiac source are common, whereas atherosclerotic vascular disease is not. The relative frequency of these factors and the incidence of the various types of cerebrovascular accident differ in the present autopsy series from two previously published clinical series from Africa. The reasons for this are discussed. Luetic vascular disease, a common aetiological factor in earlier series, is now rare.

Serological evidence for syphilis in different population groups in Rwanda.

Abstract: The prevalence of serological syphilis, based on qualitative VDRL slide test was studied in different population groups in Rwanda. A positive VDRL was found in 0.7% of female students of a social school, in 2.2% of male and female premarital consultants, in 3.2% of prenatal consultants, in 6.5% of soldiers, and in 27.9% of prostitutes. As the first groups were not exposed to venereal disease, VDRL reactivity due to biological false positive reaction or to yaws antecedents is estimated at 0.5 to 2%. Accordingly, VDRL reactivity due to syphilis is estimated at 1 to 2% in prenatal consultants, 5 to 6% in soldiers and 25 to 26% in prostitutes. It is concluded that syphilis is not yet an important public health problem except in certain promiscuous population groups in towns, as soldiers, migrant workers and prostitutes.

Maternal mortality in Western Nigeria.

Abstract: Data on maternal deaths were collected from a randomly selected sample of medical institutions in the Western State of Nigeria for the years 1972 and 1973. An overall maternal mortality rate of 3.8/1000 total births were recorded for 1972 and 1973 respectively. The major causes of maternal mortality were haemorrhage, obstructed labour, eclampsia, anaemia of pregnancy and infection.

Pulmonary embolism in Africans.

Abstract: The clinical and autopsy records of 54 cases of pulmanary embolism seen at the Lagos University Teaching Hospital over the period 1966-1972 are analysed. The incidence of pulmonary embolism during this period was 0.1 per cent of all patients admitted, and there was a 78 per cent mortality. The primary medical condition associated with pulmonary embolism is heart disease. Sex has little influence on the liability to pulmonary embolism. Age has a pronounced influence, the incidence increases steadily after the age of 40. Medical cases are more liable than surgical cases to suffer from pulmonary embolism in each age group. The view is expressed that pulmonary embolism is not rare in Africans. Our results support the opinion that the possession of the haemoglobin S predisposes although the final veridct must await the result of a larger prospective study.