Use of prednisolone in the treatment of HIV-positive tuberculosis patients.

Corticosteroids are beneficial in the treatment of some forms of tuberculosis, but their role in TB affecting HIV-positive patients is not clear. During a cohort study of tuberculosis patients in Lusaka, Zambia, prednisolone was prescribed for specific indications. Six of 47 (13 per cent) of patients who received prednisolone early in treatment developed herpes zoster, compared with 2 of 118 (2 per cent) of those who did not.

Intestinal parasites in Zambian patients with AIDS.

Previous studies have found a high prevalence of Isospora belli and Cryptosporidium parvum infections in African acquired immune deficiency syndrome (AIDS) patients with chronic diarrhoea. We aimed to determine the prevalence of gastrointestinal parasite in AIDS patients in hospital, not only those with diarrhoea, and to compare them with the general community. Clinically diagnosed AIDS patients in a Zambian teaching hospital were interviewed and examined, and stool specimens were studied for parasite infection.

IgM serum antibodies to phenolic glycolipid-I and clinical leprosy: two years' observation in a community with hyperendemic leprosy.

A village population with hyperendemic leprosy in Papua New Guinea was repeatedly examined for clinical leprosy and for serum IgM antibodies to phenolic glycolipid-I (APGL-I) over 2 years between 1984 and 1986. In 1984, serum APGL-I was elevated in 15% of the subjects without clinical leprosy, and the prevalence of seropositivity was not significantly different in subjects from households with or without leprosy. In 1986, the prevalence of elevated serum APGL-I in leprosy-free subjects had risen to 23%.

BCG vaccination in leprosy: final results of the trial in Karimui, Papua New Guinea, 1963-79.

The efficacy of BCG vaccine in preventing the clinical manifestations of leprosy in a tuberculosis-free area of Papua New Guinea is reported. Between 1963 and 1966 a total of 5356 subjects, randomized to receive BCG or saline inoculations, were examined for leprosy before the vaccination and surveillance was continued until 1979. BCG afforded 48% protection against clinical leprosy, being most effective against borderline tuberculoid leprosy and in children vaccinated when under 15 years old.

The epidemiology of leprosy in a high prevalence village in Papua New Guinea.

In a village of about 1000 people in Papua New Guinea the prevalence of clinical leprosy was 8.6% compared to about 3% in surrounding villages. This exceptionally high prevalence could not be explained by recent introduction of the disease or by social factors.

Use of phenolic glycolipid 1 for serodiagnosis of leprosy in a high prevalence village in Papua New Guinea.

This study reports on the usefulness of an IgM phenolic glycolipid 1 (PGL-1) ELISA for serodiagnosis of leprosy in the first year of a prospective longitudinal community survey in a high (8.8%) prevalence village in Papua New Guinea. The IgM PGL-1 ELISA had limited value as a screening method for detection of new cases.

Portal vein thrombosis in adults.

Idiopathic thrombotic occlusion of the extrahepatic portal vein is one of the commonest causes of portal hypertension in adult Blacks. The condition occurs more frequently in men and may be accompanied by evidence of minor functional impairment of the liver. Associated pancytopenia is quantitatively related to the degree of splenomegaly.

Hepatitis B surface antigenaemia in Kenyans with chronic liver disease.

Fifty Kenyan patients with chronic liver disease or hepatocellular carcinoma were tested for hepatitis B surface antigenaemia by radioimmunoassay. The hepatitis B surface antigen was detected in 77% of the patients with chronic persistent or chronic aggressive hepatitis, or cirrhosis confirmed by liver biopsy, compared with 15% in a control group. All six patients with hepatocellular carcinoma had detectable hepatitis B surface antigen or antibody.

Dysfibrinogenaemia and primary hepato-cellular carcinoma.

The mechanisms of blood coagulation and fibrinolysis have been evaluated in 28 black adult Africans with primary hepato-cellular carcinoma (HCC). A characteristic pattern of abnormalities has been defined. Dysfibrinogenaemia appears to be a useful biological marker for the disease.

The significance of hepatitis B antigenaemia in symptom-free blood donors in Kenya.

One-hundred and eight blood donors found to have hepatitis B antigenaemia have been examined for evidence of liver disease. In five the liver was enlarged, and in six apparently normal donors there was histological evidence of disease. One or more tests of liver function were abnormal in an additional fifty-three donors without definite evidence of disease.

Hepatitis Bs antigen and liver cancer: A population based study in Kenya.

Peers and Linsell (1973) demonstrated a significant association between the incidence of primary liver cancer and ingested aflatoxin in a study in the Muranga district of Kenya. A study of hepatitis B antigen in the same district showed no significant differences between the low altitude area, with a relatively high incidence of primary liver cancer, and the high altitude area with a lower incidence of the tumour. Current evidence is more in favour of aflatoxin playing an important role in the aetiology of primary liver cancer but hepatitis B antigen may play an ancillary role.