bluuebunny/crossref_metadata_2025_split huggingface dataset:
Workshop Report on the Genotyping of Blood Cell Alloantigens
Authors: Kroll H. , Carl B. , Santoso S. , Bux J. , Bein G. 
Published: March 2003

The immunization against alloantigens present on platelets, granulocytes and red blood cells (RBCs) is responsible for various clinical syndromes. Since the molecular basis of these antigens has become clear during the last decade, genotyping is nowadays used in several laboratories. However, many DNA‐based techniques still have to be evaluated. We therefore organized a workshop on the genotyping of the most relevant alloantigens on platelets and granulocytes as well as on selected RBC alleles.DNA was isolated from peripheral blood lymphocytes or from B‐lymphoblastoid cell lines (B‐LCL). We distributed samples for the identification of platelet (n = 7), granulocyte (n = 6) and RBC (n = 4) polymorphisms, respectively. There were 33 institutions in Germany, Austria and Switzerland, which participated in at least one part of the workshop.Twenty‐four laboratories reported results on HPA‐1, and 23 laboratories on HPA‐2, ‐3, and ‐5 typing. In addition, five laboratories typed for HPA‐4 and ‐6. The HNA‐1a/b (NA1/NA2) alleles were identified by eight laboratories, one of which also typed for HNA‐1c (SH). The most frequent genes of the ABO (A1, B, O) and Rh (D, C, c, E, e) systems were typed by 12 participating laboratories, and an additional four laboratories restricted their RBC typing to the RHD gene. The typing technique mainly used for all three cell lineages was the polymerase chain reaction with sequence‐specific primers. Other techniques were restriction fragment length analysis, oligonucleotide ligation assay, enzyme‐linked mini‐sequence assay or direct sequence analysis. The following typing errors were observed: HPA: 15/1442 (1·0%), HNA: 4/108 (3·7%), ABO: 5/96 (5·2%) RH 1/320 (0·3%).Our workshop demonstrated the existence of a number of reliable techniques for the genotyping of blood cell alloantigens and a high standard in the participating laboratories. In addition, we could show the usefulness of B‐LCL as a source of reference DNA. However, the 5·2% rate of mistyping in the ABO system demonstrated that further efforts are needed to improve the precision of the genotyping techniques. Future workshops will have to challenge methods and participants with rare variants of RBC genes to guarantee reliable genotyping, e.g. in prenatal diagnosis of fetomaternal incompatibility.
Hydrops foetalis caused by anti‐Mur in first pregnancy – a case report
Authors: Wu K. H. , Chang J. G. , Lin M. , Shih M. C. , Lin H. C. , Lee C. C. , Peng C. T. , Tsai C. H. 
Published: March 2003

Summary Anti‐‘Mia’ is the most common alloantibody of potential clinical significance in the Taiwanese population. The Mi.III phenotype is rare among Caucasians but has a high incidence in various Oriental populations. We describe a nulliparous woman with no history of transfusions, who had hydrops foetalis at 28 weeks gestation. Foetal haemoglobin was 4·4 g dL−1, and a positive direct antiglobulin test was positive in the foetal blood. Intrauterine intravascular transfusion was given, and the baby was discharged healthy.Anti‐‘Mia’ was identified in the maternal serum, the cord blood serum and the eluate from red cells of the cord blood. Anti‐‘Mia’ in the maternal serum was confirmed to be anti‐Mur. The polymerase chain reaction‐restriction fragment length polymorphism method confirmed that both the baby and her father had the Mi.III gene. Therefore, our report documents that anti‐Mur has the potential to cause hydrops foetalis.
Willingness to pay for community‐based ivermectin distribution: A study of three onchocerciasis‐endemic communities in Nigeria
Authors: Onwujekwe O. E. , Shu E. N. , Nwagbo D. , Akpala C. O. , Okonkwo P. O. 
Published: March 2003

Summary Objective To determine the willingness to pay (WTP) for local ivermectin distribution in a community financing framework. Method Contingent valuation in three communities in Nigeria, using randomly selected household heads. WTP was elicited using a bidding game, and for collecting information on the households' socio‐economic status, level of knowledge, priority ranking and perception of risk of contracting the disease, structured questionnaires were used. Ordinary least squares (OLS) multiple regression analysis was used to analyse factors associated with WTP. Results Between 92.1% and 93.3% of respondents were willing to pay amounts ranging from 5 Naira (US$ 0.06) to 100 Naira (US$ 1.25) (median: 20 Naira, US$ 0.25) in the three communities, more than three times the modelled unit direct cost of distributing ivermectin by the communities themselves. Occupation of the respondent, marital status, average monthly expenditure on health care, manifestations of onchocerciasis, the type of savings scheme embarked on by the respondent, age‐group, level of education and type of property were statistically significant (P < 0.05) variables affecting WTP. Conclusion This study shows that there is WTP for local ivermectin distribution in the three study communities, and that it should be assessed before instituting community‐directed treatment with ivermectin.
Increased prevalence of malaria in HIV‐infected pregnant women and its implications for malaria control
Authors: Verhoeff Francine H. , Brabin Bernard J. , Hart C. Anthony , Chimsuku Lyson , Kazembe Peter , Broadhead Robin L. 
Published: March 2003

Summary objectives  To examine in pregnant women the relationship between HIV infection and malaria prevalence and to determine, in relation to HIV infection, the effectiveness of sulphadoxine‐pyrimethamine in clearing P. falciparum infection. method  Descriptive cross‐sectional analysis of P. falciparum prevalence in pregnant women at first antenatal visit and of women at delivery who had received two sulphadoxine‐pyrimethamine treatments for malaria. HIV status was assessed in 621 women who attended for antenatal care and for delivery at two rural hospitals in southern Malawi in 1993–94. Information was collected on maternal age, parity and gestational age. Prevalence of P. falciparum was measured at first antenatal visit and delivery. Women were given two routine treatment doses of sulphadoxine‐pyrimethamine (SP), at first antenatal visit and between 28 and 34 weeks gestation, conforming to Malawi government policy on antimalarial control during pregnancy. results  Prevalence of HIV infection was 25.6% and all infections were HIV type‐1. In primigravidae malaria prevalence at recruitment was 56.3% in HIV‐infected and 36.5% in HIV‐uninfected women (P= 0.04). The corresponding figures for multigravidae were 23.8% and 11.0%, respectively (P < 0.01). HIV‐infected primigravidae had increased malaria prevalence at all gestational ages. Peak parasite prevalence occurred earlier in gestation in HIV‐infected primigravidae (16–19 weeks if HIV‐infected; 20–23 weeks if HIV‐uninfected). The relative risk for parasitaemia in HIV‐infected compared to HIV‐uninfected women was significantly increased in three of five parity groups, including the two highest ones (parity >3), indicating parity‐specific immunity to malaria was impaired. Malaria prevalence at delivery remained high in HIV‐infected women despite prior routine treatment with sulphadoxine‐pyrimethamine in pregnancy. There was no significant difference in parasite prevalence at delivery between women who did or did not use sulphadoxine‐pyrimethamine. conclusions  HIV infection is associated with a significant increase in malaria prevalence in pregnant women of all parities with the effect apparent from early in gestation. Two treatment doses of sulphadoxine‐pyrimethamine were inadequate to clear parasitaemia in many women by the time of delivery and this occurred independently of HIV status and despite high sensitivity to SP in this area. There is a need to undertake longitudinal studies to determine the incidence of P. falciparum infection in HIV‐infected and uninfected pregnant women and to re‐assess the frequency and timing of sulphadoxine‐pyrimethamine treatment doses in these women. Late pregnancy re‐infections with P. falciparum probably explain the high parasite prevalence at delivery following sulphadoxine‐pyrimethamine treatment at 28–34 weeks gestation.
Lung function, blood gases, pH and serum electrolytes of small‐scale miners exposed to chrome ore dust on the Great Dyke in Zimbabwe
Authors: Osim E. E. , Tandayi M. , Chinyanga H. M. , Matarira H. T. , Mudambo K. K. , Musabayane C. T. 
Published: March 2003

Summary We measured and compared lung function indices and some blood parameters (gases, electrolytes, glucose, pH, red cell indices) of 54 male small‐scale miners (SSM) chronically exposed to chrome ore dust to those of 50 nonmining control subjects (NMC) and 46 large‐scale chrome miners (LSM) who had taken internationally recommended precautionary measures (secondary control). The respirable dust level in the SSM environment (6.0 ± 0.5 mg/m3) was significantly higher (P < 0.001) than in the NMC and LSM environments (0.3 ± 0.1 mg/m3 and 0.5 ± 0.3 mg/m3, respectively). There were no significant differences in neither dust levels nor lung function status between NMC and LSM environments. The values of FVC, FEV1, PEFR and FEV1% of the SSM were 3.5 ± 0.09 l, 2.61 ± 0.09 l, 6.07 ± 0.36 l/second and 76.19 ± 2.36%, respectively. These values were significantly lower than those of NMC (P < 0.01, respectively). However, the blood parameters of the SSM and NMC were not significantly different. The results are indicative of both restrictive and obstructive ventilatory defects in the SSM which may be attributed exposure to chrome ore dust in the environment. Associated risk factors appear to be advancing age, prolonged exposure to chrome ore dust and acid base disturbance.
Maternal responses to childhood fevers: a comparison of rural and urban residents in coastal Kenya
Authors: Molyneux C. S. , Mung'ala‐Odera V. , Harpham T. , Snow R. W. 
Published: March 2003

Summary Urbanization is an important demographic phenomenon in sub‐Saharan Africa, and rural‐urban migration remains a major contributor to urban growth. In a context of sustained economic recession, these demographic processes have been associated with a rise in urban poverty and ill health. Developments in health service provision need to reflect new needs arising from demographic and disease ecology change. In malaria‐endemic coastal Kenya, we compared lifelong rural (n = 248) and urban resident (n = 284) Mijikenda mothers' responses to childhood fevers. Despite marked differences between the rural and urban study areas in demographic structure and physical access to biomedical services, rural and urban mothers' treatment‐seeking patterns were similar: most mothers sought only biomedical treatment (88%). Shop‐bought medicines were used first or only in 69% of the rural and urban fevers that were treated, and government or private clinics were contacted in 49%. A higher proportion of urban informal vendors stocked prescription‐only drugs, and urban mothers more likely to contact a private than a government facility. We conclude that improving self‐treatment has enormous potential to reduce morbidity and mortality in low‐income urban areas, as has frequently been argued for rural areas. However, because of the underlying socio‐economic, cultural and structural differences between rural and urban areas, rural approaches to tackle this may have to be modified in urban environments.
The epidemiology of human hookworm infections in the southern region of Mali
Authors: Behnke J. M. , De Clercq D. , Sacko M. , Gilbert F. S. , Ouattara D. B. , Vercruysse J. 
Published: March 2003

Summary Two surveys of hookworm (Necator americanus) infections, conducted three years apart (December 1994 and January 1998) in a village in the Sikasso region of Mali, revealed that overall prevalence of infection was 68.7% and 53%, respectively. In both years there was a highly significant difference between the sexes in the prevalence and abundance of infection, with male subjects carrying heavier infections than females. Both prevalence and abundance of infection increased with age, although in 1998 there was a strong interaction between sex and age, arising from the declining egg counts among 16–20‐year‐old females and the continuing increase among males, reinforced by the subsequent reduction among the older males (≥ 61 years) and concomitant increase among females. After controlling for the effects of age, sex and their interaction, a highly significant positive relationship was detected between faecal egg counts of individuals who were examined in both 1994 and 1998 (n = 134), indicating predisposition to infection. This relationship remained significant in each of 4 age classes spanning 7–79 years. The members of some family compounds were shown to carry heavier infections than expected whilst others were less infected, suggesting compound‐related clustering of hookworm infections. The use of footwear increased with age but there was no significant relationship between the extent of use of footwear and the abundance of hookworm infection. Eyesight deteriorated with age and impaired vision was particularly prominent among the older sectors of the community, a legacy from the time when onchocerciasis was widely prevalent in the region. Although men with partially damaged eyes carried lower infections than expected for their age, no overall significant relationship was found between quality of vision and hookworm infections. These results are discussed in relation to hookworm epidemiology in general and in Mali in particular.
The impact of weekly iron supplementation on the iron status and growth of adolescent girls in Tanzania
Authors: Beasley N. M. R. , Tomkins A. M. , Hall A. , Lorri W. , Kihamia C. M. , Bundy D. A. P. 
Published: March 2003

Summary We evaluated the effect of weekly doses of 400 mg of ferrous sulphate for 4 months on the iron status of adolescent girls in a controlled trial in Tanga, Tanzania. Supplementation led to a significantly greater increase in serum ferritin compared with the control group (+ 15.6 μg/l vs. 8.6 μg/l) (P= 0.002) but there was no significant difference in change in haemoglobin. Children given iron showed a significantly greater weight gain than controls (+ 2.4 kg vs. + 1.4 kg) (P= 0.03). Weekly iron supplementation may be an effective means of increasing iron stores and growth in children vulnerable to iron deficiency.
Field evaluation of the ICT Malaria P.f/P.v immunochromatographic test for diagnosis of Plasmodium falciparum and P.vivax infection in forest villages of Chhindwara, central India
Authors: Singh Neeru , Saxena Ajay , Valecha Neena 
Published: March 2003

Summary A rapid new immunochromatographic test (ICT malaria P.f/P.v) for diagnosis of Plasmodium falciparum and P.vivax was evaluated against thick blood smears in forest villages of Chhindwara, Madhya Pradesh, where both Plasmodium falciparum and P.vivax are prevalent. 344 symptomatic patients (Gond ethnic tribe) in five villages were screened by field staff of the Malaria Research Centre in October 1999. For P.falciparum, the ICT was 97.5% sensitive and 88% specific, with a positive predictive value (PPV) of 87.6% and a negative predictive value (NPV) of 97.6%. For P.vivax the sensitivity was only 72%, the specificity 99%, with a PPV of 92% and an NPV of 96%. Although a negative test result was inadequate to exclude parasitaemia ≤ 300/μl for P.falciparum and ≤ 1500/μl for P.vivax, the test is potentially useful in remote areas.
Non‐invasive management of Ascaris lumbricoides biliary tract migration: a prospective study in 69 patients from Ecuador
Authors: González Abad Horacio , Regalado Victor Crespo , Van den Ende Jef 
Published: March 2003

Summary Ascariasis is one of the most common helminthic diseases. Its most feared complication is migration into the biliary tree. Some authors recommend immediate duodenoscopy in all cases of biliary migration, with sphincterotomy for the extraction of the parasites, and a surgical extraction in case of intrahepatic ascariasis. We followed prospectively 69 patients with ultrasonographical evidence of migration. Initial treatment consisted of intravenous analgesics and antispasmodics, and albendazol 800 mg by mouth. Only patients with persisting symptoms or with high amylasaemia underwent duodenoscopy, with extraction in case of a visible worm. Surgery was limited to cases with persistent or progressive complications. In 97% of our cases the worms disappeared with noninvasive therapy alone. A duodenoscopy was done in 30 (42%) cases; in 10 (14.4%) a worm was found in the ampula of Vater and extracted without sphincterotomy. In none of the 6 cases with A. lumbricoides in the intrahepatic biliary tree did the parasite persist. Only one patient required surgical intervention. Treatment of A. lumbricoides migration to the biliary tract should be principally medical. Duodenoscopy with extraction of a visible worm should be limited to cases with persisting pain and/or hyperamylasaemia. Invasive methods like sphincterotomy and surgery should be restricted to patients who do not respond to conservative treatment.
Tract microflora in Saudi patients with cholelithiasis
Authors: Al Harbi M. , Osoba A. O. , Mowallad A. , Al‐Ahmadi K. 
Published: March 2003

OBJECTIVES To identify the microflora in the gallbladder of patients undergoing laparoscopic cholecystectomy for gallstones, and the antibiotic susceptibility pattern of the isolates, as well as the usefulness of Gram staining of bile at the time of operation. METHODS Bile samples were obtained from 112 patients undergoing elective laparoscopic cholecystectomy for gallstones and inoculated directly into aerobic and anaerobic blood culture bottles in the operating theatre. Samples were also collected in sterile universal containers for Gram staining of a centrifuged deposit. Isolates were identified and their in‐vitro susceptibilities determined by Kirby Bauer technique. RESULTS Of 112 bile samples examined, 28 (25%) were culture positive, four of which contained more than one organism. The most common organisms isolated were Escherichia coli 9 (28.1%), Enterococcus faecalis 5 (15.6%) and Pseudomonas aeruginosa 3 (9.4%). In one sample we found Aeromonas hydrophilia and Enterobacter cloacae. No anaerobes were detected but Candida albicans was isolated in one case. In 19 bile samples (67.8%) organisms were identified on Gram stain. Positive bile cultures were found statistically significant (P < 0.05) in patients over the age of 50 (13/32), in patients who developed post‐operative fever (6/12) and patients who developed leucocytosis (5/6). CONCLUSION Age over 50 years was the only significant pre‐operative factor associated with positive bile cultures (P < 0.05). In view of the microflora of the gallbladder and the susceptibility pattern of our isolates we would suggest that antibiotic prophylaxis recommended for laparoscopic cholecystectomy for gallstones needs to be reviewed and the role of bacteribilia in the surgical management of cholelithiasis requires further study.
Diarrhoea and effects of different water sources, sanitation and hygiene behaviour in East Africa
Authors: Tumwine James K. , Thompson John , Katua‐Katua Munguti , Mujwajuzi Mark , Johnstone Nick , Wood Elizabeth , Porras Ina 
Published: March 2003

SummaryApart from Drawers of Water (DOW I) published in 1972, there have been only a handful of publishedstudies on domestic water use and environmental health in East Africa, based on direct observations or other reliable research methods. The objective of this study was to carry out a repeat analysis of domestic water use and environmental health in East Africa based on DOW I. The study was conducted in the same sites as DOW I. Field assistants spent at least 1 day in each household observing and conducting semi‐structured interviews. They measured the amount of water collected, recorded the amount of water used in the home, and noted household socio‐demographic characteristics, prevalence of diarrhoea, state and use of latrines, sources of water and conditions of use. We surveyed 1015 households in 33 sites in Uganda, Tanzania and Kenya in 1997. From 1967 to 1997, the prevalence of diarrhoea, in the week preceding the survey, increased from 6% to 18% in Kenya and from 16% to 21% in Uganda; it declined slightly in Tanzania (11–8%). Determinants of diarrhoea morbidity included poor hygiene (unsafe disposal of faeces and wastewater), education level of household head, obtaining water from surface sources or wells and per capita water used for cleaning. Hygiene practices are an important complement to improved water and sanitation in reducing diarrhoea morbidity.
A community randomized controlled trial to investigate impact of improved STD management and behavioural interventions on HIV incidence in rural Masaka, Uganda: trial design, methods and baseline findings
Authors: Kamali Anatoli , Kinsman John , Nalweyiso Norah , Mitchell Kirstin , Kanyesigye Edward , Kengeya‐Kayondo Jane F. , Carpenter Lucy M. , Nunn Andrew , Whitworth James A. G. 
Published: March 2003

Summaryobjective  To describe study design, methods and baseline findings of a behavioural intervention alone and in combination with improved management of sexually transmitted diseases (STDs) aimed at reducing HIV incidence and other STDs.design  A three‐arm community randomized controlled trial (RCT) of 18 rural communities (approximately 96 000 adults) in SW Uganda. A standardized behavioural intervention was implemented in 12 communities (arms A and B) through community‐based education, meetings and information leaflets. Six of these communities in addition received improved STD management through government and private health units (arm B). Arm C communities received routine government health services. Impact assessment was through three questionnaire and serological surveys of 750–1000 adults in each community at 18–24‐month intervals. The primary outcome measure was HIV incidence and secondary measures were syphilis and herpes simplex virus type 2 incidence, prevalence of Neisseria gonorrhoea and Chlamydia trachomatis and sexual behaviour changes.results  Approximately 15 000 adults (72% of eligible population) were enrolled at baseline. HIV baseline prevalence rates were 9–10% in all arms and demographic and behavioural characteristics and STD prevalence were also similar. In intervention communities, there were 391 995 attendance at 81 502 activities (6.1 per target adult), 164 063 leaflets distributed (2.6 per person) and 1 586 270 condoms (16.5 condoms per adult). In the STD communities a total of 12 239 STD cases (65% women) were seen over a 5‐year period (7.7 per 100 adults/year).conclusion  This is the first community RCT of its type with a behavioural component. There is fair baseline comparability between study arms and process data suggest that interventions were adequately implemented.