bluuebunny/crossref_metadata_2025_split huggingface dataset:
Hepatitis B virus infection in Thai children
Authors: Kozik Christine A. , Vaughn David W. , Snitbhan Rapin , Innis Bruce L. 
Published: March 2003

Summary We studied hepatitis B virus (HBV) transmission among 7416 Thai children from 148 schools in Kamphaeng Phet province, a rural part of northern Thailand. Their age ranged from 2 to 16 years (median 9 years). Between May 1991 and June 1992, 61 of 2593 (2.4%) in the cohort of susceptible children acquired anti‐HBc immunoglobulin. Forty‐seven of the 148 schools had children who acquired anti‐HBc. School seroconversion rates to anti‐HBc varied from 0% to 23%. There was no correlation between percent of carriers in schools and percent of anti‐HBc acquisition. Of the 61 children who acquired anti‐HBc, eight (13%) became HBsAg carriers but only two were symptomatic, for a clinical to subclinical infection ration of 1 : 30. One of the two symptomatic children became an HBsAg carrier. Three (38%) of the eight who were persistently antigenemic developed antibody to hepatitis B virus e antigen. Males were 2.5 times (95% CI 1.4–4.3) more likely to acquire anti‐HBc than females. Risk factors for acquisition of HBc in Thailand over a 9‐month period were examined in a subset of 2412 susceptible children and later in a case‐control study of 22 children who acquired anti‐HBc and 59 age and sex‐matched controls. Risks for acquiring anti‐HBc were male gender and a history of bleeding gums. In comparing this study to an earlier pilot study among 9848 children from the same area in Thailand, the yearly antibody acquisition rate to anti‐HBc among Thai children dropped from 5.7% in 1989 to 2.4% in 1992. A random sample of children in the pilot study showed that 16% were HBsAg positive and 27% had anti‐HBc at the beginning of the study. 34% had markers for either anti‐HBc or HBsAg. 12% were repeatedly positive for HBsAg a year later.
Antibiotic medication and bacterial resistance to antibiotics: a survey of children in a Vietnamese community
Authors: Larsson Mattias , Kronvall Göran , Thi Kim Chuc Nguyen , Karlsson Inga , Lager Fredrik , Duc Hanh Hoang , Tomson Göran , Falkenberg Torkel 
Published: March 2003

Summary objective  To investigate antibiotic use and antibiotic susceptibility of respiratory tract pathogens in children aged 1–5 years in Bavi, Vietnam. method  Nasopharynx and throat specimens were collected from 200 children from randomly selected households in a demographically defined population. Respiratory isolates were tested for antibiotic susceptibility according to the standard disk diffusion method. A questionnaire survey of carers elicited information on type of antibiotic used, duration of treatment, where the antibiotics had been purchased, type of treatment information retained by carers and episodes of illness preceding the study. results  82% of the children had at least one symptom of acute respiratory tract infection (ARI) in the 4 weeks prior to the study, and of these 91% were treated with antibiotics. The most commonly used antibiotics were ampicillin (74%), penicillin (12%), amoxicillin (11%), erythromycin (5%), tetracycline (4%) and streptomycin (2%). Ampicillin was used for 3.3 days on average (SD:1.8) and penicillin for 2.6 days (SD:0.7). When deciding which antibiotic to use, 67% of the carers consulted the pharmacy seller, 11% decided themselves and 22% followed the doctor's prescription. The carrier rate of Streptococcus pneumoniae, Haemophilus influenzae and Moraxella catarrhalis was 50%, 39% and 17%, respectively. Isolates from 145 children were susceptibility tested, and 74% were found to carry resistant pathogens. Of the tested isolates, 90% of S. pneumoniae, 68% of H. influenzae and 74% of M. catarrhalis were resistant to at least one antibiotic. The mean number of antibiotics (susceptible strains excluded) to which resistance was found was 2.0 (SD:1.2), 2.5 (SD:1.8) and 2.1 (SD:0.9), respectively. S. pneumoniae and H. influenzae showed high resistance to tetracycline (88% and 32%, respectively), trimethoprim/sulphonamide (32% and 44%), and chloramphenicol (25% and 24%). 23% of S. pneumoniae were erythromycin‐resistant and 18% of H. influenzae isolates were resistant to ampicillin. There was a significant difference in ampicillin and penicillin resistance between the group of children previously treated with beta lactam antibiotics and the group of children who did not receive antibiotics. conclusion  As reported by the carers, children in Bavi are treated with antibiotics frequently. Most antibiotics were obtained without consulting a doctor. High levels of antibiotic resistance and high prevalence of multidrug‐resistant strains were found among respiratory pathogens. The existence of a large reservoir of resistance genes among children in low‐income countries represents a threat to the success of antibiotic therapy throughout the world. Multi‐faceted programmes to improve rational use of antibiotics in Vietnam are urgently needed.
Utility of history, examination and laboratory tests in screening those returning to Europe from the tropics for parasitic infection
Authors: Whitty Christopher J. M. , Carroll Bernadette , Armstrong Margaret , Dow Carol , Snashall David , Marshall Thomas , Chiodini Peter L. 
Published: March 2003

Summary objectives  To examine the utility of the different elements of screening expatriates and travellers returned from the tropics for parasitic disease (exposure history, symptoms, examination and laboratory tests).methods  In phase 1 (conducted prospectively 1990–91), 1029 asymptomatic returnees had a detailed questionnaire and interview on risk‐behaviour, physical examination and laboratory tests. In phase 2 (1997–98), 510 consecutive patients referred for routine screening (276 symptomatic and 234 asymptomatic) were screened with laboratory tests.results  Exposure history did not correlate reliably with parasite burden. In phase 1 physical examination revealed 387 abnormalities, only three of which indicated parasitic disease. Schistosomal serology was positive in 11% (CI 9–13) of these asymptomatic cases including patients with light or no reported freshwater exposure. Stool microscopy was positive in 19% (CI 16–22) of cases not correlated with reported eating habits, and eosinophilia was present in 8% (CI 6–10). In phase 2 reported symptoms did not correlate with parasitic disease. Schistosomiasis was present in 15% (CI 13–24) of asymptomatic and 18% (CI 13–22) of symptomatic individuals (OR 1.2 P = 0.46); stool microscopy was positive in 14% of both symptomatic and asymptomatic patients, and eosinophilia in 9% of symptomatic and 6% of asymptomatic individuals.conclusion  Potentially serious asymptomatic infection is common in travellers. Detailed exposure history, symptom history and physical examination added little to detecting cases. Stool microscopy, schistosomal serology and eosinophil count all had good yield. Filarial serology had low yield in patients without eosinophilia.
Using evidence to change antimalarial drug policy in Kenya
Authors: Shretta R. , Omumbo J. , Rapuoda B. , Snow R. W. 
Published: March 2003

Summary Chloroquine resistance was first detected in Kenya in 1978 and escalated during the 1980s. Chloroquine remained the treatment of choice for uncomplicated malaria infections until revised guidelines were launched in 1998 despite a plethora of scientific evidence on failure. This review analyses the range and quality of the evidence base that was used to change the drug policy in Kenya from chloroquine to SP and examines the process of consensus building and decision making. Our review illustrates the difficulties in translating sensitivity data with gross geographical, temporal and methodological variations into national treatment policy. The process was complicated by limited options, unknown adverse effects of replacement therapies, cost, as well as limited guidance on factors pertinent to changing the drug policy for malaria. Although > 50% of the studies showed parasitological failures by 1995, there was a general lack of consensus on the principles for assessing drug failures, the inclusion criteria for the study subjects and the relative benefits of parasitological and clinical assessments. A change in international recommendations for assessment of drug efficacy in 1996 from parasitological to clinical response further perplexed the decisions. There is an urgent need for international standards and evidence‐based guidelines to provide a framework to assist the process by which decision‐makers in malaria‐endemic countries can make rational choices for antimalarial drug policy change.
Efficacy of praziquantel against Schistosoma mansoni with particular consideration for intensity of infection
Authors: Utzinger Jürg , N'goran Eliézer K. , N'dri Amani , Lengeler Christian , Tanner Marcel 
Published: March 2003

Summary Chemotherapy with praziquantel is the cornerstone of schistosomiasis control. In view of recent concern about tolerance or resistance to praziquantel, monitoring its efficacy in different epidemiological settings is required. We report a study among 253 schoolchildren in an area highly endemic for Schistosoma mansoni in western Côte d'Ivoire. After examining four consecutive stool specimens from each child, the first praziquantel treatment at 60 mg/kg divided into two doses was administered. Four weeks later, stool specimens were again screened over 4 consecutive days and revealed a cure rate of 71.6% and an egg reduction rate of 79.9%. There was a significant association between cure rate and intensity of infection prior to treatment with highest cure rates observed in light infections (P < 0.01). Praziquantel, at a single dose of 40 mg/kg, was again administered 35 days after the first treatment. The overall cure and egg reduction rates increased considerably. The association between cure rate and intensity of infection prior to the second treatment was significant but less pronounced. Twenty‐two children remained S. mansoni positive after the two chemotherapy campaigns, and interestingly, many of these were only identified after repeated stool examinations. We argue that pre‐patent infections may account for some of these ‘treatment failures’. However, further studies in other endemic settings are needed, with parasitological diagnoses having a high sensitivity.
Educational attainment and HIV‐1 infection in developing countries: a systematic review
Authors: Hargreaves James R. , Glynn Judith R. 
Published: March 2003

OBJECTIVES  To assess whether educational status is associated with HIV‐1 infection in developing countries by conducting a systematic review of published literature. METHODS  Articles were identified through electronic databases and hand searching key journals. Studies containing appropriately analysed individual level data on the association between educational attainment and HIV‐1 status in general population groups were included. RESULTS  Twenty‐seven articles with appropriately analysed results from general population groups in developing countries were identified, providing information on only six countries. Large studies in four areas in Africa showed an increased risk of HIV‐1 infection among the more educated, whilst among 21‐year‐old Thai army conscripts, longer duration of schooling was strongly protective against HIV infection. The association between education and schooling in Africa was stronger in rural areas and in older cohorts, but was similar in men and women. Serial prevalence studies showed little change in the association between schooling and HIV over time in Tanzania, but greater decreases in HIV prevalence among the more educated in Uganda, Zambia and Thailand. CONCLUSIONS  In Africa, higher educational attainment is often associated with a greater risk of HIV infection. However, the pattern of new HIV infections may be changing towards a greater burden among less educated groups. In Thailand those with more schooling remain at lower risk of HIV infection.
The effect of six rounds of single dose mass treatment with diethylcarbamazine or ivermectin on Wuchereria bancrofti infection and its implications for lymphatic filariasis elimination
Authors: Ramaiah K. D. , Vanamail P. , Pani S. P. , Yuvaraj J. , Das P. K. 
Published: March 2003

SummaryAnnual mass treatment with single‐dose diethylcarbamazine (DEC) or ivermectin (IVM) in combination with albendazole (ALB) for 4–6 years is the principal tool of lymphatic filariasis (LF) elimination strategy. This placebo‐controlled study examined the potential of six rounds of mass treatment with DEC or IVM to eliminate Wuchereria bancrofti infection in humans in rural areas in south India. Apercentage of 54–75 of the eligible population (≥15 kg body weight) received treatment during different rounds of treatment – 27.4% in the DEC arm and 30.7% in the IVM arm received all six treatments, 4.8% and 5.6% received none, and the remainder received one to five treatments. After six cycles of treatment, the microfilaria (Mf) prevalence in treated communities dropped by 86% in the DEC arm (P < 0.01) (n = 5 villages) and by 72% in the IVM arm (P < 0.01) (n = 5 villages), compared with 37% in the placebo arm (P < 0.05) (n = 5 villages). The geometric mean intensity of Mf fell by 91% (t = 8.11, P < 0.05), 84% (t = 6.91, P < 0.05) and 46% (t = 2.98, P < 0.05) in the DEC, IVM and placebo arms, respectively. The proportion of high‐count Mf (>50 Mf per 60 mm3 of blood) carriers was reduced by 94% (P < 0.01) in the DEC arm and by 90% (P < 0.01) in the IVM arm. Among those who received all six treatments, 1.4% in the DEC arm and 2.4% in the IVM arm remained positive for Mf. Two of five villages in the DEC arm and one of five in the IVM arm showed zero Mf prevalence, but continued to have low levels of transmission of infection. The results also indicate that DEC is as effective as or slightly better than IVM against microfilaraemia. Results from this and other recent operational studies proved that single‐dose treatment with antifilarials is very effective at community level, feasible, logistically easier and cheap and hence a highly appropriate strategy to control or eliminate LF. Higher treatment coverage than that observed in this study and a few more than six cycles of treatment and more effective treatment tools/strategies may be necessary to reduce microfilaraemia to zero level in all communities, which may lead to elimination of LF.
Recognition of pallor associated with severe anaemia by primary caregivers in western Kenya
Authors: Desai M. R. , Phillips‐Howard P. A. , Terlouw D. J. , Wannemuehler K. A. , Odhacha A. , Kariuki S. K. , Nahlen B. L. , Ter Kuile F. O. 
Published: March 2003

Summaryobjectives  To explore which pallor signs and symptoms of severe anaemia could be recognized by primary caregivers following minimal instructions.methods  Data from three community‐based cross‐sectional surveys were used. Test characteristics to predict haemoglobin (Hb) concentrations < 5 and < 7 g/dl were compared for different combinations of pallor signs (eyelid, tongue, palmar and nailbed) and symptoms.results  Pallor signs and haemoglobin levels were available for 3782 children under 5 years of age from 2609 households. Comparisons of the sensitivity and specificity at a range of haemoglobin cut‐offs showed that Hb < 5 g/dl was associated with the greatest combined sensitivity and specificity for pallor at any anatomical site (sensitivity = 75.6%, specificity = 63.0%, Youden index = 38.6). Higher or lower haemoglobin cut‐offs resulted in more children being misclassified. Similar results were obtained for all individual pallor sites. Combining a history of soil eating with pallor at any site improved the sensitivity (87.8%) to detect Hb < 5 g/dl with a smaller reduction in specificity (53.3%; Youden index 41.1). Other combinations including respiratory signs or poor feeding resulted in lower accuracy.conclusion  Primary caregivers can recognize severe anaemia (Hb < 5 g/dl) in their children, but only with moderate accuracy. Soil eating should be considered as an additional indicator of severe anaemia. The effect of training caretakers to improve recognition of severe anaemia and care‐seeking behaviour at the household level should be assessed in prospective community‐based studies.
Therapeutic efficacy of chloroquine plus sulphadoxine/ pyrimethamine compared with monotherapy with either chloroquine or sulphadoxine/pyrimethamine in uncomplicated Plasmodium falciparum malaria in Laos
Authors: Schwöbel Babett , Jordan Sabine , Vanisaveth Viengsay , Phetsouvanh Rattanaxay , Christophel Eva‐Maria , Phompida Samlane , Von Sonnenburg Frank , Jelinek Tomas 
Published: March 2003

SummaryIn a southern border province of Lao PDR, we compared the efficacy of antimalarial drug combinations in patients aged ≥1 year with uncomplicated Plasmodium falciparum malaria: monotherapy with either mefloquine (MQ), chloroquine (CQ), or sulphadoxine/pyrimethamine (SP) vs. the combination of both CQ and SP. Follow‐up time was 14 days. Of 265 P. falciparum positive patients, 119 were enrolled in the drug trial. Significantly more patients treated with CQ than with SP developed early or late treatment failure [44.8%vs. 17.9%, relative risk (RR) = 2.51, 95% CI 1.03–6.12]. In the SP group, 82.1% were sensitive and 17.9% were treatment failures. The combination treatment CQ plus SP resulted in 83.3% sensitivity and 16.7% treatment failures. Combination treatment has no advantage over monotherapy with SP (RR = 1.01, 95% CI 0.8–1.3). All patients who received MQ for treatment (total dose 25 mg/kg) were cured within the 14 days of follow‐up. The findings of this study suggest that use of CQ as first‐line treatment of uncomplicated malaria in the Lao PDR has to be reconsidered. The combination of both CQ and SP has been discussed as a cost‐effective alternative treatment, but in our patient population achieved no better results than single therapy with SP.
Hybridoma cell agglutination as a novel test to detect circulating antigen of Schistosoma japonicum
Authors: Li Yong‐long , Liu Wenqi , Ruppel Andreas 
Published: March 2003

SummaryWe developed a serodiagnostic test which is based on the agglutination of hybridoma cells. In the presence of specific antigen, agglutination of the fixed and stained cells occurs and can be visualized in analogy to traditional erythrocyte agglutination. The procedures were developed with a murine cell line producing a monoclonal antibody against a schistosome gut protein and sera of patients and mice infected with Schistosoma japonicum. This test is capable of detecting circulating antigen during pre‐patency in mice infected with 50 cercariae. Its sensitivity was high with acute schistosomiasis japonica (97%, n = 32) and moderate with chronic cases (75%, n = 57). No positive reactions were obtained with healthy persons (n = 78) or patients infected with other parasites (Chlonorchis sinensis, n = 20; Paragonimus westermani, n = 20; Plasmodium vivax, n = 10) or suffering from lupus erythomatodus (n = 5) or mononucleosis (n = 10).
Evaluation of the clinical efficacy of marbofloxacin (Zeniquin) tablets for the treatment of canine pyoderma: an open clinical trial
Authors: Paradis Manon , Abbey L. , Baker B. , Coyne M. , Hannigan M. , Joffe D. , Pukay B. , Trettien A. , Waisglass S. , Wellington J. 
Published: March 2003

AbstractThe efficacy and field safety of marbofloxacin (Zeniquin) for the treatment of superficial and deep bacterial pyoderma were evaluated. Seventy‐two dogs were treated with 2.75 mg kg−1of marbofloxacin orally once daily for 21 or 28 days. Sixty‐two dogs (86%) had superficial pyoderma and 10 (14%) had deep pyoderma. A history of prior pyoderma was reported in 39/72 dogs. Pretreatment aerobic bacteriologic cultures of skin lesions were performed in 47 cases and the predominant pathogen isolated wasStaphylococcus intermedius. Treatment was successful in 62/72 (86.1%) dogs, improvement was noted in 6/72 (8.3%) dogs and treatment failed in 4/72 (5.6%) dogs. Adverse effects associated with treatment included listlessness, anorexia, vomiting, soft stool, flatulence and polydipsia; these adverse effects were seen in only 6/81 dogs. Marbofloxacin was safe and effective for the treatment of superficial and deep pyoderma in dogs at the dosage used in this study.
Influence of straw management, nitrogen fertilization and dosage rates on the dissipation of five sulfonylureas in soil
Authors: Menne H J , Berger B M 
Published: March 2003

The dissipation behaviour of metsulfuron‐methyl, tribenuron‐methyl, thifensulfuron‐methyl, triasulfuron and amidosulfuron were studied in soil following post‐emergence spring applications to cereal crops. Incorporation or removal of straw and different fertilizer applications had no influence on the disappearance time (DT50) of the herbicides. However, in laboratory trials dissipation of metsulfuron‐methyl, triasulfuron and amidosulfuron at higher application rates was accelerated after incorporation of straw into the soil. The addition of straw decreases soil pH thereby causing faster hydrolysis of the compounds. Addition of nitrogen fertilizer increased the half‐lives (t1/2) of the herbicides. Combination of both straw and N fertilizer, however, had no effect. Neither straw nor N influenced the degradation of tribenuron‐methyl and thifensulfuron‐methyl.The DT50of all herbicides investigated varied from 6 to 17 days in the field trials. Except for amidosulfuron, herbicides could not be detected 38–68 days after application. In the laboratory, t1/2values were higher than those in the field at 75 days (amidosulfuron), 63 days (metsulfuron‐methyl), 35 days (triasulfuron) and 13 days (tribenuron‐methyl). Only the t1/2of thifensulfuron‐methyl was at 29 h faster under laboratory conditions. T1/2values of all herbicides were influenced by their initial concentration. The t1/2values of amidosulfuron and tribenuron‐methyl at 1 mg a.i. kg−1soil were 2–2.5 times higher than at the recommended field application rate of 42 μg a.i. kg−1 soil.
A questionnaire study of road pavers’ and roofers’ work‐related skin symptoms and bitumen exposure
Authors: Riala Riitta , Heikkilä Pirjo , Kanerva Lasse 
Published: March 2003

BackgroundSkin contact with the components in asphalt and bitumen can lead to irritant and allergic contact dermatitis, but few data are available in the dermatologic literature on the skin symptoms caused by work with bitumen. In addition, working methods have changed markedly during recent decades. MethodsA questionnaire was delivered to 50 roofers and 101 road pavers. The questionnaire dealt with skin symptoms, symptoms caused by solvent products, the use of personal protection, smoking, eating habits, work conditions, changing and cleaning of overalls, etc. ResultsForty‐eight per cent of the road pavers and 58% of the roofers responded to the questionnaire. Relatively high percentages of work‐induced skin irritation were reported by both the roofers (44%) and the road pavers (31%); 22% of the road pavers had dermatitis often or sometimes compared with 15% of the roofers. The hands, arms, face, and lower extremities were the most common sites affected. In addition to bitumen products, the road pavers considered amine adhesion‐improving agents for paving and naphtha and solvents used in machine repairs, to be the main causes of their skin symptoms. The skin problems of the roofers were caused by man‐made mineral fibers, cutback bitumen, and hot bitumen burns. ConclusionsRoofers endure greater exposure to chemicals than road pavers. Certain components, e.g. polycyclic aromatic hydrocarbons in bitumen, can be absorbed through the skin. Skin exposure should be lowered by keeping the tools, working clothes, shoes, and gloves clean. Overalls and gloves are recommended to be changed at least once a week. Water laundering is not sufficient in dissolving bitumen from overalls and underwear. Cleaning the skin with solvents or naphtha is not recommended, as they are skin irritants.