bluuebunny/crossref_metadata_2025 huggingface dataset:
The epidemiology of a recent focus of mixed Schistosoma haematobium and Schistosoma mansoni infections around the ‘Lac de Guiers’ in the Senegal River Basin, Senegal
Authors: De Clercq D. , Vercruysse J. , Picquet M. , Shaw D. J. , Diop M. , Ly A. , Gryseels B.
Published: March 2003

Summary A village with mixed Schistosoma mansoni and S. haematobium infections (probably in a early endemic phase) was identified around the Lac de Guiers in the Senegal River Basin. In documenting the epidemiology of both schistosomes, we focused on prevalence and intensity of infection, transmission patterns and the impact of treatment. S. mansoni prevalences (near 100%) and egg counts (overall geometric mean eggs per gram of faeces (epg) of 589 were high in all age groups, with 35% of individuals excreting > 1000 epg, and showing a slow decline in egg output only after the age of 30 years. The overall prevalence (28%) and egg counts (2% > 50 eggs/10 ml) of S. haematobium were low, with mean counts of 6.3 eggs/10 ml. Maximal mean S. mansoni egg counts were found in 5–9 year‐old boys and in 15–19 year‐old girls; S. haematobium maximal counts in 1–4 year‐old boys and in girls aged 5–9. Extremely high Biomphalaria pfeifferi infection ratios were recorded over the whole year. Following a single treatment, re‐infection was rapid with prevalences and mean egg counts of both Schistosoma species reaching pretreatment levels within 7 months.
The Simulium damnosum complex in western Uganda and its role as a vector of Onchocerca volvulus
Authors: Krüger A. , Nurmi V. , Yocha J. , Kipp W. , Rubaale T. , Garms R.
Published: March 2003

Summary The status of onchocerciasis vectors in the former Ruwenzori focus in western Uganda was re‐examined some 15 years after control measures against Simulium damnosum s.l. were suspended. The four cytoforms S. kilibanum, ‘Sebwe’, ‘Nkusi’ and S. pandanophilum were found. While the nonanthropophilic ‘Sebwe’ was still widely distributed in rivers north, east and south of the Ruwenzori, the only anthropophilic species and vector, S. kilibanum, had disappeared from most of its former habitats and was now restricted to two limited foci, where high biting densities were encountered. It was still a vector south of the Ruwenzori (Kasese focus), where 15.4% of the parous flies were infected with larval stages of Onchocerca volvulus and 34 infective larvae were found in the heads of 1000 parous flies. In the second focus along the Mahoma and Nsonge rivers, a chromosomally highly polymorphic population of S. kilibanum had replaced the former vector S. neavei, but does not act as a vector. Only 2.3% of the parous females were infected and just 1 infective larva was found in the heads of 1000 parous flies.
Prospective validation of a standardized questionnaire for estimating childhood mortality and morbidity due to pneumonia and diarrhoea
Authors: Coldham C. , Ross D. , Quigley M. , Segura Z. , Chandramohan D.
Published: March 2003

Summary This paper reports the validation of a ‘best‐judgement’ standardised questionnaire using guidelines and algorithms developed by an expert working group conducted in Nicaragua between 1995 and 1997. Prospective hospital data, including standardised medical recording of selected signs and symptoms, laboratory and radiographic test results and physician diagnoses were collected for children < 5 years admitted with any serious life‐threatening condition in 3 study hospitals. The mothers or caregivers of the children were later traced and interviewed using the ‘best‐judgement’ questionnaire. Interviews were completed 1–22 months after admission to hospital for 1115 children (400 who died during the stay in hospital and 715 who were discharged alive). The cause of death or admission to hospital was determined by an expert algorithm applied to hospital data. A similar procedure was used to derive the cause using the answers to questions from interviews. Hospital causes were compared with interview causes and sensitivity and specificity calculated, together with the estimated cause‐specific fraction for diarrhoea and pneumonia. Multiple diagnoses were allowed; 378 children in the sample (104 deaths, 274 survivors) had a reference diagnosis of diarrhoeal illness, and 506 (168 deaths, 338 survivors) a reference diagnosis of pneumonia. When results for deaths and survivors in all age groups were combined, the expert algorithms had sensitivity between 86% and 88% and specificity between 81% and 83% for any diarrhoeal illness; and sensitivity between 74% and 87% and specificity between 37% and 72% for pneumonia. Algorithms tested in previous validation studies were also applied to data obtained in this study, and the results are compared. Despite less than perfect sensitivity and specificity, reasonably accurate estimates of the cause‐specific mortality and morbidity fractions for diarrhoea were obtained, although the accuracy of estimates in other settings using the same instrument will depend on the true cause‐specific fraction in those settings. The algorithms tested for pneumonia did not produce accurate estimates of the cause‐specific fraction, and are not recommended for use in community settings.
Acceptance and use of communal filtration units in guinea worm eradication
Authors: Aikhomu S. E. , Brieger W. R. , Kale O. O.
Published: March 2003

SummaryThe use of cloth to filter drinking water for guinea worm prevention is a long‐standing control strategy and part of a mixed approach that includes the provision of wells, chemical treatment of ponds and protection of water supplies. As the goal of eradication nears, filters are a useful component of the quick response needed to implement case containment at village level. Various designs of filters have been used. Individual hand‐sewn filters (HSFs) using monofilament nylon cloth have played a central role in village‐based control to date. Problems such as the need to continually reinforce correct habitual filtering behaviour have led to the design and testing of communal filtration units (CFUs) made from metal oil drums with filter cloth inserted in the top and spigots at the bottom. Approximately one year after the introduction of CFUs in the South‐western Zone of Nigeria, village surveys were conducted to determine opinions about the two types of filters and reported use. Percentage use was calculated by dividing the number of times water was filtered in the week preceding the survey by the number of times water was collected in that week. Those respondents with access to CFUs filtered an average of 91.9% of the time compared to 75.7% of those with HSFs. Using the village as level of analysis since it was the main level of intervention, the average percent of times villagers in CFU villages filtered was 91.1% compared to 77.8% in HSF villages. Although CFUs were more expensive in the short run, their greater acceptance by villagers is a factor to recommend their wider implementation to speed up elimination of guinea worm from Nigeria.
Markers of inflammation in children with severe malarial anaemia
Authors: Biemba Godfrey , Gordeuk Victor R. , Thuma Philip , Weiss Günter
Published: March 2003

Summary OBJECTIVE   To investigate if severe malarial anaemia is associated with a specific immune response pattern, we determined serum levels of neopterin (a marker of activation of macrophages by interferon‐γ) and of the anti‐inflammatory cytokines, interleukins 4 and 10.

METHODS   Zambian children < 6 years of age presenting to a rural hospital with cerebral malaria were studied. Twenty‐one children with admission haemoglobin concentrations ≤ 5 g/dl were classified as having severe anaemia and 40 with haemoglobin concentrations ≥ 7 g/dl served as a control group.

RESULTS   Logistic regression modelling indicated that a 10‐fold rise in serum neopterin concentrations was associated with a 50‐fold increase in the estimated odds of having severe anaemia (P = 0.015), while a 10‐fold rise in serum interleukin 4 concentrations was associated with a 10‐fold decrease in the estimated odds of having severe anaemia (P = 0.023). Increasing serum interleukin 10 concentrations, measured in less than half of the subjects, were associated with a nonsignificant reduction in the odds of having severe anaemia (P = 0.095).

CONCLUSION   Development of severe malarial anaemia may be directly associated with serum neopterin concentrations and inversely correlated with serum interleukin 4 levels.
Coping strategies of health personnel during economic crisis: A case study from Cameroon
Authors: Israr Syed Muhammad , Razum Oliver , Ndiforchu Victor , Martiny Patrick
Published: March 2003

Summary OBJECTIVES   Severe economic crisis compelled many governments in Sub‐Saharan Africa to adopt structural adjustment programmes. This was accompanied by price increases and cuts in the salaries of civil servants. We explored how health personnel in one province of Cameroon coped with this situation, and what the perceived effects on service quality were.

METHODS   Key informant and focus group interviews with government and mission (church) health personnel; interviews with service users to validate the findings.

RESULTS   Government health personnel had experienced larger cuts in salaries than their mission counterparts; they no longer received allowances and incentives still available to mission personnel and appeared more demotivated. Most government and mission personnel reported legal after‐hours income raising activities. Government personnel frequently reported additional ‘survival strategies’ such as parallel selling of drugs, requesting extra charges for services, and running private practices during work hours. There was a high level of self criticism among government personnel indicating a dissonance between their attitude and practices. They considered these practices negative and harmful for service users.

CONCLUSION   Remedial action is urgent. Options include reinstating allowances for good performance and ensuring regular supervision without blaming individual health workers for problems caused by the state of the health system.
AIDS caused by HIV1 and HIV2 infection: are there clinical differences? Results of AIDS surveillance 1986–97 at Fann Hospital in Dakar, Senegal
Authors: Ndour Marguerite , Salif Sow Papa , Coll‐Seck Awa Marie , Badiane Salif , Tidiane Ndour Cheik , Diakhaté Ndella , Diop Bernard , Faye Mame , Soumaré Masserigne , Diouf Georges , Colebunders Robert
Published: March 2003

Summary objective  To compare the clinical manifestations observed in AIDS patients infected with HIV2 and HIV1 infection.

methods  The medical records of AIDS patients hospitalized between January 1986 and July 1997 at the Department of Infectious Diseases of Fann Hospital, Dakar, were reviewed.

results  599 hospitalizations (76%) were HIV1 seropositive patients, 137 (17%) were HIV2 seropositive patients and 54 (7%) were patients serologically dually reactive to HIV1 and HIV2. There was no significant difference in medium CD4 lymphocyte count between patients with HIV1 and HIV2 infection. Chronic diarrhoea and diarrhoea caused by bacterial infections were more frequently observed in HIV2‐infected individuals. Oral candidiasis and chronic fever were more often noted in patients with HIV1 infection. Bacterial and cryptococcal meningitis was only observed among patients with HIV1 infection.

conclusions  Certain clinical differences were observed comparing AIDS patients with HIV1 and those with HIV2 infection. As there is no clear physiopathological explanation for these differences, additional studies with larger numbers of AIDS patients are needed to determine whether these differences are real.
Case report: paraphimosis due to erotic dancing
Authors: Ramdass M. J. , Naraynsingh V. , Kuruvilla T. , Maharaj D.
Published: March 2003

Summary Paraphimosis usually develops when a tight foreskin is retracted over the glans penis for a prolonged period. Many esoteric aetiologies have been implicated in the development of paraphimosis including piercing the foreskin, Plasmodium falciparum infection, application of celadine juice to the foreskin, chancroid, pessaries and the implantation of pearls. We report the first two cases of paraphimosis developing during wining, an erotic dance native to Trinidad & Tobago.
Diagnosing visceral leishmaniasis with the recombinant K39 strip test: experience from the Sudan
Authors: Zijlstra E. E. , Nur Y. , Desjeux P. , Khalil E. A. G. , El‐Hassan A. M. , Groen J.
Published: March 2003

We compared a strip test employing recombinant K39 (rK39) antigen and protein A/colloidal gold as read‐out agents with the rK39 ELISA for IgM and IgG antibodies and the direct agglutination test (DAT) using 55 sera from patients with parasitologically confirmed visceral leishmaniasis (VL). The rK39 strip test was positive in 37/55 (67%), the DAT in 50/55 (91%) at ≥ 1 : 1600 cut‐off value and in 47/55 (85%) at ≥ 1 : 6400 cut‐off value. The rK39‐ELISA gave positive IgG results for all sera; those who had a positive strip test had significantly higher IgG levels than those with a negative strip test (31.1 (SD=3.6) and 17.7 U/ml (SD=9.8), respectively, P < 0.0001). A total of 31/55 (56%) sera showed a positive IgM result; of these 27 (49%) had a positive strip test. We tested 115 apparently cured VL patients with the strip test during follow‐up; 68 were also tested with DAT. In the strip test, 25–43% of patients had a positive result at time points 3, 6, 9 and 12 months after treatment; for DAT (cut‐off ≥ 1 : 1600) these results were 67–83%. In neither test did a significant decrease in positivity rates occur over time (P=0.37 for the strip test, P=0.17 for the DAT). No correlation (P=0.33) was found between a positive strip test and a positive DAT result (cut‐off ≥ 1 : 1600), indicating that the strip test and DAT are complementary rather than interchangeable. Of 61 endemic controls two (3%) had a positive strip test result; both had a positive leishmanin skin test. The rK39 strip test has the ideal format for use in the field, but its sensitivity is limited; like DAT, but to a lesser extent, it remains positive after treatment.
Acute respiratory infections in rural Bangladesh: cultural understandings, practices and the role of mothers and community health volunteers
Authors: Rashid Sabina Faiz , Hadi Abdullah , Afsana Kaosar , Begum Shameem Ara
Published: March 2003

Qualitative data collected from 63 older and younger mothers revealed that almost all recognized pneumonia and all described mild and severe signs and symptoms to explain incidences of pneumonia. Respiratory illnesses were attributed to humoral imbalances, supernatural causes and ‘negligent’ mothers. Home care practices involved drinking specially prepared juices, massaging the child with oil and avoiding ‘cooling’ foods. Traditional and allopathic care was sought depending on the perceived severity of the illness. The role of the family was important in decision‐making. Rural mothers were relieved and satisfied to be able to quickly access low‐cost medicines from Bangladesh Rural Advancement Committee (BRAC) health volunteers, who clearly influence health care practices. In‐depth interviews and focus group discussions with 23 health volunteers showed that 22 were able to correctly identify breathing rates and their association with pneumonia. All had knowledge of acute respiratory infections (ARI) and were able to list a range of signs and symptoms. Some health volunteers complained of operational constraints with monitoring and technical equipment. Nevertheless, the programme has strong links with grassroots volunteers and community people, making it a successful intervention.
Community perceptions of a mass administration of an antimalarial drug combination in The Gambia
Authors: De Martin Sarah , Von Seidlein Lorenz , Deen Jacqueline L. , Pinder Margaret , Walraven Gijs , Greenwood Brian
Published: March 2003

To test the hypothesis that widespread treatment with artemisinin derivatives can reduce malaria transmission, a mass drug administration (MDA) campaign was undertaken in an area of The Gambia in 1999. Coverage of 85% of the target population was achieved, but the intervention did not reduce overall malaria transmission. We studied the perceptions, knowledge and attitudes of the community to the MDA campaign. A validated questionnaire was administered to randomly selected MDA participants (n=90) and MDA refusers (n=71). Individuals who believed in the importance of the MDA (adjusted OR 58.3%; 95% CI 17.4–195.8) and those who were aware that a high level of participation was needed for the MDA to be successful (adjusted OR 28.1; 95% CI 10.3–75.9) were more likely to participate. Understanding that the purpose of the MDA was to reduce malaria (adjusted OR 13.9; 95% CI 5.5–35.1) and knowledge of the fact that malaria is transmitted by mosquitoes and of the clinical signs of malaria (adjusted OR 3.4; 95% CI 3.1–9.0) were associated with participation. Individuals who discussed the MDA with other villagers (adjusted OR 5.5; 95% CI 2.2–13.5) and those who attended the sensitization meeting (adjusted OR 2.6; 95% CI 1.1–6.0) were also more likely to participate. Women were significantly more likely to participate in the MDA than men (adjusted OR 3.1; 95% CI 1.5–6.2). Individuals who refused to participate were unlikely to plan participation in future MDAs. One of the most difficult challenges in the implementation of a malaria control strategy such as an MDA is to convince villagers to participate and to make them aware that a high level of participation by the community is needed for success. We found that our sensitization meetings could be improved by giving more information on how the MDA works and finding means to generate small group discussions after the meeting.
Improving adherence to malaria treatment for children: the use of pre‐packed chloroquine tablets vs. chloroquine syrup
Authors: Ansah E. K. , Gyapong J. O. , Agyepong I. A. , Evans D. B.
Published: March 2003

Malaria is a major cause of morbidity and mortality among children under five in sub‐Saharan Africa. Prompt diagnosis and adequate treatment of acute clinical episodes are essential to reduce morbidity and prevent complications and mortality. In many countries, chloroquine syrup is the mainstay of malaria treatment for children under five. Not only is syrup more expensive than tablets, adherence to the prescribed dose at home is a problem because mothers use wrongly sized measuring devices or have difficulty with the instructions. We investigated the impact of introducing pre‐packed tablets for children on adherence to treatment and compared the total cost of the tablets with that of syrup. Children aged 0–5 years diagnosed with malaria at the clinic over a 6‐week period received either pre‐packed tablets or syrup by random assignment. The principal caregivers were interviewed at home on day 4 after attending the clinic. Of the 155 caregivers given pre‐packed tablets, 91% (n=141) adhered to the recommended dosage, while only 42% (n=61) of 144 who were provided syrup did. Only 20% of caregivers who received syrup used an accurate 5 ml measure. The cost of treatment with tablets was about one‐quarter that of syrup and 62% (n=96) of caregivers preferred tablets. Pre‐packed chloroquine tablets are a viable alternative to syrup.
Pattern and associated factors of the neurolathyrism epidemic in Ethiopia
Authors: Getahun Haileyesus , Lambein Fernand , Vanhoorne Michel , Van der Stuyft Patrick
Published: March 2003

OBJECTIVES To describe the neurolathyrism epidemic in Ethiopia and to identify associated household factors.

METHODS We interviewed 589 randomly selected heads of household in Debre Sina district of Ethiopia, the area afflicted by the recent neurolathyrism epidemic. Disease information was obtained for 2987 family members.

RESULTS Neurolathyrism patients were detected in 56 (9.5%) households (prevalence rate 2.38%). The mean number of affected family members per household was 1.27 (SD 0.65, range 1–3). Most (77.5%) patients developed the disability during the epidemic (1995–1999). The median age at onset of paralysis was 11 years with a range of 41 (range 3–44). Younger people were more affected during the epidemic than during the non‐epidemic period (P=0.01). The presence of a neurolathyrism patient in the family was associated with illiteracy [adjusted OR (95% CI)=2.23 (1.07–5.10)] of the head of household, with owning a grass pea farm [adjusted OR (95% CI)=2.01 (1.04–3.88)] and with the exclusive cooking of grass pea foods using handmade traditional clay pots [adjusted OR (95% CI=2.06 (1.08–3.90)].

CONCLUSION Males aged 10–14 years were most affected by neurolathyrism. Increased household risk was associated with illiteracy of the head of the household and exclusive cooking of grass pea foods with handmade traditional clay pots.
Deliberate self‐poisoning in Oman
Authors: Zaidan Ziad A. J. , Burke David T. , Dorvlo Atsu S. S. , Al‐Naamani Aziz , Al‐Suleimani Abdullah , Al‐Hussaini Ala'Adin , Al‐Sharbati Marwan M. , Al‐Adawi Samir
Published: March 2003

OBJECTIVE  To describe the demographics, precipitating factors, substances and methods used for deliberate self‐harm in Oman.

METHODS  Data were extracted from the Accident and Emergency (A & E) records of patients treated at the A & E units in Muscat from 1993 to 1998. Data were obtained form the history, and clinical findings resulting form deliberate self‐harm.

RESULTS  During the 5‐year study period, 123 persons presented to various hospitals in the Muscat area with injuries that resulted form deliberate self‐harm. Most of these cases were women, students and unemployed. There was a high incidence of family, marital and psychiatric or social problems. The methods of self‐harm were most often analgesics (such as paracetamol) and non‐pharmaceutical chemicals.

CONCLUSIONS  The rate of self‐injurious behaviour is low in Oman, compared with other countries, including other Islamic countries. The data illustrate a rising rate and a tendency to ingest toxic doses of analgesics or non‐pharmaceutical chemicals.
Genetic characterization of Trypanosoma brucei gambiense and clinical evolution of human African trypanosomiasis in Côte d'Ivoire
Authors: Jamonneau V. , Garcia A. , Ravel S. , Cuny G. , Oury B. , Solano P. , N'Guessan P. , N'Dri L. , Sanon R. , Frézil J. L. , Truc P.
Published: March 2003

Human African trypanosomiasis is a parasitic infection caused by protozoa belonging to Trypanosoma brucei subspecies. The clinical evolution of this disease is complex and might be because of the parasite itself, as genetic diversity has been observed in T. brucei ssp. We investigated the relationship between the genetic diversity of trypanosomes and the diversity of clinical patterns in Côte d'Ivoire. We studied clinical sleeping sickness cases, and genetically analysed the trypanosomes isolated from these patients. An important genetic monomorphism among stocks isolated in Côte d'Ivoire was observed by using various markers: isoenzymes electrophoresis, random amplified polymorphism DNA and PCR of microsatellite sequences. At the same time, the diversity of clinical patterns and evolutions was confirmed by clinical analysis. The existence of an individual susceptibility to disease (human trypanotolerance) should be taken into account even if our genetic conclusions might be distorted because the isolation success rates were particularly poor. In fact, we observed that the isolation success rate varied significantly depending both on the focus of origin (P=0.0002) and on the ethnic group (P=0.0317) of the patient. Further investigations are required in order to study a possible selective impact of the use of the kit for in vitro isolation of trypanosomes as an isolation technique.
Contraception and induced abortion in rural Ghana
Authors: Geelhoed D. W. , Nayembil D. , Asare K. , Van Leeuwen J. H. Schagen , Van Roosmalen J.
Published: March 2003

This article describes the results of a community‐based survey on birth control in a rural district in western Ghana. Structured interviews with 2179 women and men aged 15–49 years were used to study the prevalence of contraceptive methods and induced abortion. In addition, the influence of induced abortion on reported fertility in relation to residence and education was analysed. The results show that 59.8% had used a contraceptive method at some time in life, while use of induced abortion was reported by 22.6% of respondents. Prevalence of ever‐use of any method to avoid childbirth, contraception and/or induced abortion was 67.1%. Urban residence and higher education were associated with more induced abortions and higher use of contraceptive methods. Differences in use of induced abortion were partly responsible for the education and residence‐related changes in fertility. Induced abortion needs to be considered when discussing methods in use to avoid childbirth in developing countries.
Renal dysfunction in falciparum– malaria is detected more often when assessed by serum concentration of cystatin C instead of creatinine
Authors: Günther A. , Burchard G. D. , Slevogt H. , Abel W. , Grobusch M. P.
Published: March 2003

objectives  To estimate the frequency of renal dysfunction in falciparum malaria by serum concentration of cystatin C, a new sensitive indicator of the glomerular filtration rate (GFR).

methods  Retrospective study of stored sera and patient files. Assessment of renal function by serum concentration of creatinine and cystatin C and comparison of the results from both indicators of GFR.

results  A total of 108 adult patients with falciparum malaria were included in the study. Concentration of creatinine and cystatin C correlated well (r = 0.706; P < 0.001). Elevated cystatin C was more frequent than elevated creatinine (54.6%vs. 20.4%; P < 0.001). Patients older than 50 years developed renal dysfunction more often (P < 0.05) than younger ones. Results from cystatin C and creatinine were concordant in 63 (58.3%) and contradictory in 45 (41.6%) cases. Four (3.7%) patients had elevated creatinine but normal cystatin C levels, hence 63 patients (58.3%) showed elevation of at least one indicator of GFR. The frequency of elevated cystatin C and elevated creatinine was unrelated to body weight, gender or bilirubin level.

conclusions  The prevalence of impaired renal function in patients with falciparum malaria seems to have been underestimated in the past. Using a sensitive marker, 55% of the patients have a reduced GFR.
Increasing transparency in partnerships for health – introducing the Green Light Committee
Authors: Gupta Rajesh , Cegielski J. Peter , Espinal Marcos A. , Henkens Myriam , Kim Jim Y. , Lambregts‐van Weezenbeek Catherina S. B. , Lee Jong‐Wook , Raviglione Mario C. , Suarez Pedro G. , Varaine Francis
Published: March 2003

Public–private partnerships have become central to efforts to combat infectious diseases. The characteristics of specific partnerships, their governance structures, and their ability to effectively address the issues for which they are developed are being clarified as experience is gained. In an attempt to promote access to and rational use of second‐line anti‐tuberculosis (TB) drugs for the treatment of multidrug‐resistant TB, a unique partnership known as the Green Light Committee (GLC) was established by the World Health Organization. This partnership relies on five categories of actors to achieve its goal: academic institutions, civil society organizations, bilateral donors, governments of resource‐limited countries, and a specialized United Nations agency. While the for‐profit private sector is involved in terms of supplying concessionally priced drugs it is excluded from decision‐making. The effectiveness of the partnership emerges from its review process, flexibility to modify its modus operandi to overcome obstacles, independence from the commercial sector, and its ability to link access, rational use, technical assistance, and policy development. The GLC mechanism may be useful in the development of other partnerships needed in the rational allocation of resources and tools for combating additional infectious diseases.
Treatment seeking behaviour and costs due to acute and chronic forms of lymphatic filariasis in urban areas in south India
Authors: Nanda B. , Krishnamoorthy K.
Published: March 2003

Previous estimates on the economic burden of lymphatic filariasis (LF) in India and elsewhere were primarily based on studies in rural areas. We investigated the treatment costs due to acute and chronic forms of LF in urban areas, where nearly one‐third of the affected people live. Almost 98% of the patients with acute episodes of adenolymphangitis (ADL) underwent treatment and 49% of chronic patients also received treatment. The average treatment cost per ADL episode (n = 108) was Rs 22.21 ± 53.84 (US$ 0.46 ± 1.12). The overall (n = 200) treatment costs incurred by a chronic patient per visit were Rs 16.71 ± 62.36 (US$ 0.35 ± 1.30); for those who paid (n = 98) they were Rs 34.10 ± 85.90 (US$ 0.71 ± 1.79). These costs are considerably higher than in rural areas. Government health centres and private practitioners were important sources of treatment. Treatments received from private practitioners were considerably more expensive than those from government health facilities. The cost of medicine accounted for 44% and 50% of the total expenditure on treatment for acute and chronic disease patients, respectively. The medical personnel from these treatment sources need to be trained on the new morbidity management methods, which are likely to be more effective than the current methods of treatment.
Stomatitis, pharyngitis and tonsillitis caused byMalassezia pachydermatisin a dog
Authors: Pinter  , Noble
Published: March 2003

A case of oropharyngitis caused byMalassezia pachydermatisin a 3‐year‐old male Cocker Spaniel is reported. Recurrent episodes of pharyngitis were treated with antibacterial antibiotics; when a final treatment after tooth extraction was unsuccessful, the dog was admitted to the clinic at the Department of Microbiology and Infectious Diseases at the Veterinary Faculty, University of Zagreb. Bacteriological culture of enlarged tonsils revealed a mixed culture ofStreptococcussp.,Staphylococcussp. andPasteurellasp. During antibacterial treatment with amoxicillin plus clavulanic acid and metronidazole, lesions appeared in the oral cavity and mycological examination of the lesions and enlarged tonsils revealed a pure culture ofM.pachydermatis. The patient was treated with ketoconazole, 10 mg kg−1twice daily for 7 days when the lesions resolved.M. pachydermatisstrains from the mouth and from various sites on the dog’s body had identical protein patterns and DNA profiles which differed from strains from other animals.
German Shepherd dog pyoderma: a prospective study of 23 cases
Authors: Denerolle  , Bourdoiseau  , Magnol  , Ulpat  , Chabanne
Published: March 2003

Twenty‐three German Shepherd dogs affected with recurrent deep pyoderma (GSP) were studied prospectively. After selection according to inclusive and exclusive criteria, parameters of humoral and cell‐mediated immunity were examined. Radial immunodiffusion showed high levels of IgG and low levels of IgA. Peripheral blood lymphocytes were analysed by flow cytometry. The CD8 subpopulation was abnormally elevated, while the CD4 cell subpopulation was decreased. German Shepherd pyoderma is thus associated with immunological factors.
Topical 0.1% tacrolimus for the treatment of discoid lupus erythematosus and pemphigus erythematosus in dogs
Authors: Griffies J. D. , Mendelsohn C. L. , Rosenkrantz W. S. , Muse R. , Boord M. J. , Griffin C. E.
Published: March 2003

Skin lesions of discoid lupus erythematosus (DLE) and pemphigus erythematosus (PE) are often localized to the nasal planum, dorsal muzzle and less commonly, pinnae, periocular skin and lips. The objective of this study was to explore the use of 0.1% tacrolimus as a topical therapy in the management of localized DLE and PE lesions in dogs. Ten cases of DLE and two cases of PE in various breeds were included. Degree of erythema, crust, ulceration or erosion, depigmentation and scarring were evaluated at the start of the trial and after 2, 4 and 8 weeks of therapy. Complete blood count, serum chemistry and whole blood tacrolimus concentrations (Abbot IMx Microparticle Immunoassay; Abbot IMx, Chicago, IL, USA) were performed at each evaluation. Ten cases of DLE and two cases of PE were treated using the lotion either as a sole therapy (both DLE) or as an adjunctive treatment (eight DLE and two PE). Five of the cases evaluated had an excellent response (three DLE and two PE), five a partial response (all DLE), and two dogs (both DLE) showed no appreciable difference after receiving topical tacrolimus therapy. Concurrent medications were discontinued in eight of the ten dogs that improved. No adverse effects in clinical or laboratory parameters were noted throughout the study. However, measurement of tacrolimus concentrations by the MEIA assay was of little benefit due to false‐positive measurements. Results of this study indicate that topical 0.1% tacrolimus may be a safe and effective adjunctive therapy for DLE and PE, with fewer systemic and topical adverse effects than current treatment modalities.
Native maize field weed communities in south‐central Mexico
Authors: VIBRANS
Published: March 2003

Maize (Zea mays L.) field weeds of an important agricultural region of south‐central Mexico were analysed for their phytogeographical composition, using data from a floristic list (317 species) and the cover values of 378 Braun–Blanquet relevés. Exotic species played a small role (16% of species, 13% of weed vegetation cover). The fields were dominated by species distributed between Mexico and Central America (14/47%) and those New World species with a wide distribution on the American continent, including temperate areas (10/20%). Other area types (Mexican endemics, species of warmer America, species with northern affiliations and species of Old World origin) may contribute numerous species, but these are not as competitive. The data show that native anthropogenic weed communities have evolved in Mesoamerica.
Changes in germinability, dormancy and viability of Amaranthus retroflexus as affected by depth and duration of burial
Authors: Omami  , Haigh  , Medd  , Nicol
Published: March 2003

Changes in dormancy and viability of Amaranthus retroflexus seeds were examined after placement in pots that were buried in the field. Seeds were placed in woven nylon envelopes on the soil surface or buried at depths of 2.5, 5 or 10 cm. After 1, 3, 6, 9 and 12 months seeds were exhumed and their germinability was tested to assess changes in dormancy and viability. Depletion of seed stocks placed on the soil surface was partly because of in situ germination that did not exceed 21% and did not vary significantly over the 12‐month study period. Less germination of buried seeds occurred in situ, and seeds that did not germinate appeared to acquire dormancy. Exhumed seeds germinated readily; germinability was linearly related to the depth of burial, with those retrieved from the surface germinating least. Cyclical changes in germinability occurred during the 12‐month burial period, but this influence was identical for seeds buried at all depths. Germinability was greatest after periods with the lowest mean monthly temperatures and least during the hottest periods. The stimulation of remaining ungerminated seeds exhumed at each period, by the addition of ethephon to the germination medium, provided further evidence of a seasonal acquisition of dormancy, and it was concluded that other unknown factors besides cyclical changes in seasonal temperature were responsible. Irrespective of placement, all seeds lost viability at an exponential rate over time. However, the decline was most rapid for those placed on the surface, whereas the loss in viability became less with increased depth of burial. Possible explanations for this adaptation of enhanced survival when buried are discussed.
Aspects of the growth and development of Cyperus rotundus under arable crop canopies: implications for integrated control
Authors: Rambakudzibga
Published: March 2003

Cyperus rotundus L. is one of the most difficult weeds to control worldwide. In Zimbabwe, it is an important weed in arable areas with high crop production potential. The effect of maize, cotton and groundnut canopies on the suppression of C. rotundus was investigated under field conditions over two growing seasons. Similarly, C. rotundus growth and development under a constant maize population planted in isometric and rectangular stands were also studied over one growing season. The capacity of C. rotundus to spread in the short term and its regenerative capacity were curtailed under maize compared with groundnut and cotton canopies. The same was also true under isometric maize stands compared with rectangular maize stands. Significant interactions between crop canopy and time of sampling for C. rotundus shoot counts, leaf area, rhizome length, tuber counts and tuber dry weight suggest the effectiveness of the maize canopy in suppressing the spread and regenerative capacity of C. rotundus early in the season. The implications of these results for the integrated control of C. rotundus are discussed.
Classification of Italian Xanthium strumarium complex based on biological traits, electrophoretic analysis and response to maize interference
Authors: Baldoni  , Viggiani  , Bonetti  , Dinelli  , Catizone
Published: March 2003

Xanthium strumarium complex was studied taking plant seeds from 16 diverse locations in Italy. Plant morphophysiological traits were noted and electrophoretical analysis of seed reserve proteins was carried out from individual plants grown at the same site, in the presence and absence of competition from maize. Significant correlations between diverse plant phenological traits, the geographical origin of the seeds and the seed protein electrophoretic patterns were found. A high correlation between seed reserve proteins and the genetic structure of this weed was also detected. Maize competition increased Xanthium stem growth and decreased bur production and number of branches. Xanthium plant populations could be classified according to the morphological characters evaluated in three groups closely related to their geographical original area and latitude (northern, central and southern Italy), each showing precise morphological traits of Xanthium italicum, X. strumarium and X. orientale respectively. Electrophoresis supported the classification of these three morphological groups.
A review of new PCR‐based genetic markers and their utility to weed ecology
Authors: O’Hanlon  , Peakall  , Briese
Published: March 2003

Several recent molecular developments provide new genetic tools for addressing difficult problems in weed ecology. In this review, we describe some of the techniques and the DNA markers they generate [including amplified fragment length polymorphisms (AFLPs), simple sequence repeats (SSRs) or microsatellites, and intron‐polymerase chain reaction (intron‐PCR)], contrast their relative advantages and disadvantages, and discuss how they might be used in weed research. As these new markers generally reveal higher levels of variation than other techniques, they promise to improve our understanding of breeding systems, assist in determining the origin(s) of invaders, help to resolve taxonomic boundaries and relationships between closely related taxa and enable the identification of phenotypic linked markers. In addition, compared with other techniques, some of these markers may be more cost‐effective, less technically demanding and more reliable. Regardless of the marker adopted, all genetic studies will benefit from careful consideration of experimental design and the formulation of testable hypotheses with practical outcomes.
Evaluation of variability in Striga aspera, Striga hermonthica and their hybrids using morphological characters and random amplified polymorphic DNA markers
Authors: Aigbokhan  , Berner  , Musselman  , Mignouna
Published: March 2003

Striga aspera and Striga hermonthica are recognized as separate species, but their close morphological similarity causes difficulty in distinguishing between them in areas where they coexist in Africa. In this study, crosses between the species were made using randomly selected morphologically typical parental plants collected from different locations in Nigeria. Genetic analysis of both species and their reciprocal F1 hybrids were determined using cluster analysis of DNA profiles derived from genetic polymorphism (RAPD)‐polymerase chain reaction (PCR) markers. Principal component and hierarchical cluster analyses were used to separate parental and hybrid populations based on 13 morphological characteristics. Morphological data from wild samples of both species were compared with the hand‐pollinated parental, F1 and F2 hybrids, and back‐crosses. Results showed that S. aspera and S. hermonthica were genetically and morphologically distinct. Morphological and genetic analyses revealed two major clusters: a S. aspera cluster and a S. hermonthica cluster. Genetically, the F1 hybrids showed closer affinity to their maternal parents, while morphologically, the F1 hybrids formed distinct clusters intermediate to the parents. Most F2 plants and back‐crosses were morphologically similar to S. hermonthica. Comparative morphological analysis of wild and hand‐pollinated populations showed some samples from the wild clustered with the hybrids, suggesting that hybrids may exist in nature.
Effects of maternal light environment on germination and morphological characteristics of Sicyos deppei seeds
Authors: Orozco‐Segovia A , Brechú‐Franco A E , Zambrano‐Polanco L , Osuna‐Fernández R , Laguna‐Hernández G , Sánchez‐Coronado M E
Published: March 2003

The effect was studied of sunlight and far‐red (FR) light during seed development, on seed quality and germination of Sicyos deppei G. Don. Seeds exposed to FR during development were lighter in colour and their weight, size and water content were significantly lower. Less than 10% of non‐scarified freshly harvested seeds germinated. Scarified, freshly harvested seeds developed under sunlight had a partially negative photoblastic response; both red (R) and FR light inhibited germination. The highest and fastest germination occurred in darkness, probably due to the effect of the high photon flux densities on the phytochrome during seed development. Scarified seeds ripened under FR light, germinated well in FR light and in darkness, but R light inhibited germination. After 6 months of storage, the permeability of S. deppei seeds increased, the partially negative photoblastic response was lost and germination of scarified seeds increased. Specifically, in seeds developed under FR, germination in darkness was faster than for the other light treatments, but slow in darkness for seeds developed under sunlight. The physiological and morphological heteroblastic responses in S. deppei probably extend its seed germination and seedling recruitment periods.
AA line
Authors: Ahn MD Sung Ku , Kim MD Soo Jung , Choi MD Eung Ho , Lee MD Seung Hun , Lee MD Sungnack
Published: March 2003

BackgroundThe transverse skin line of the upper part of the forearm is a common, easily recognized condition; however, this line has not been defined clearly and does not correspond to other previously reported skin lines. Our purpose was to assess the nature and associated conditions of this skin line, and characterize the histopathologic features.

MethodsWe examined 1343 healthy Korean people. The persons showing this skin line were evaluated by history and physical examination. Skin biopsy was performed on 10 persons showing this line: on one side at both the lesion and contralateral, non‐lesion sites.

ResultsA total of 480 persons (36.4%) showed this line. The incidence was significantly higher in the female group and in the group between 10 and 19 years of age. Histopathologic examination showed subtle edema, separation and fragmentation of collagen bundles, and vasodilation at the transverse skin line.

ConclusionsWe conclude that this skin line represents a newly defined skin line, and propose the term AA line.
Leishmaniasis recidiva cutis in New World cutaneous leishmaniasis
Authors: Oliveira‐Neto Manoel Paes , Mattos Marise , da Silva Celeste , de Souza Freitas , Fernandes Octavio , Pirmez Claude
Published: March 2003

Background Leishmaniasis recidiva cutis (LRC) is rare in New World leishmaniasis. Only seven cases have been reported so far.

Materials and methods Four cases are reported here. Parasite diagnosis was performed by classical methods of touch preparations, histopathologic sections, and cultures. In addition, the detection of parasite DNA by the polymerase chain reaction (PCR) was performed in all cases.

Results Parasites were detected by at least one of the classical methods in all primary lesions; however, only the PCR was positive in the recidivant lesions.

Discussion LRC cases most likely represent a reactivation of an initial infection, probably due to the persistence of parasites in scarred tissue. Although lupoid leishmaniasis (LL) has been used as a synonym of LRC, a clear difference between LRC and LL can be defined as LL is the initial clinical presentation while LRC is a recurrent lesion.

Conclusions The results indicate that it is not appropriate to use these two denominations as synonyms. The designation of LRC should be maintained in order to define recidives occurring at the border of an old scar of cutaneous leishmaniasis, avoiding the confusion with the lupoid form of the disease.
Correspondence
Authors: Goihman‐Yahr Mauricio
Published: March 2003

Pyoderma gangrenosum: unusual complication following mammoplasty reduction

A 27‐year‐old woman, with unremarkable previous medical history, underwent a bilateral mammoplasty reduction. Four days afterwards, the surgical wound developed ulcers with pustulous, undermined borders. The patient's general status worsened and high fever (40 °C) developed. Local pain was absent. Initial diagnosis was wound infection, even though bacteriologic cultures were negative, and therapy consisted of oral antibiotics together with surgical debridement. Ten days after the mammoplasty, the ulcers had increased dramatically in size affecting most of the lower half of the breasts. The areolas were spared, and the lesions were strikingly symmetrical ( Fig. 1). The ulcers had a necrotic, hemorrhagic base with fibrin deposition, and pustulous borders. Perilesional edema and inflammation were noted. The patient did not reveal clinical manifestations of inflammatory bowel disease or other illnesses in addition to the skin lesions. At this time, the patient was sent to our department and a diagnosis of pyoderma gangrenosum (PG) was considered. The advancing edge of one ulcer was biopsied and, although histopathologic examination was unspecific, it was consistent with PG. Routine laboratory tests revealed a moderate leukocytosis (14,000/μL, 65% neutrophils), and an acute phase reaction with thrombocytosis (727,000/μL), elevated erythrocyte sedimentation rate (ESR) (84 mm/h), and increased levels of α‐1 and α‐2 globulins. Bacteriologic cultures were negative. Rheumatoid factor and antinuclear antibodies were also negative. Therapy was started with the local application of gauze impregnated with gentamicine ointment, and oral cyclosporine (5 mg/kg/day) and methylprednisolone (0.5 mg/kg/day). Twenty four hours after the onset of therapy, the fever had disappeared. In the first month, the perilesional edema and pustulation resolved, central areas of re‐epithelization were noted, and previously abnormal laboratory tests returned to normal limits. At the end of the second month, the ulcers had completely healed, with residual scarring (
Fig. 2).

PG ulceration involving most of the lower half of both breasts. Note the sparing of areolas

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Residual scarring after resolution of the ulcers

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