Data management in schistosomiasis control programmes.

Adequate data recording, processing, analysis and evaluation are all components of data management within schistosomiasis control programmes oriented towards reduction of morbidity. Without data management, the response to operational questions will remain subjective and vague. Different types of data related to the population and the environment are reviewed.

Multicentre clinical trials of benzimidazolecarbamates in human echinococcosis.

Studies coordinated by the World Health Organization were conducted in seven clinical centres on the chemotherapy of human echinococcosis with mebendazole, albendazole, and flubendazole. The first phase of these ended with the following conclusions.Treatment of 85 patients with mebendazole for cystic (Echinococcus granulosus) echinococcosis was successful in 8 patients and partially successful in 4 others.

Effect of praziquantel on hematuria and proteinuria in urinary schistosomiasis.

In five settlements on Lake Volta, Ghana, 230 persons infected with S. haematobium were treated with either 30 or 40 mg/kg of praziquantel. Both treatment regimes gave similar overall cure rates (60%) and reduction in geometric mean egg counts (92%) at a six-month follow-up.

The phosphonomethyl analogue of 3-phosphoglycerate is a potent competitive inhibitor of phosphoglycerate mutases.

The phosphonomethyl analogue of 3-phosphoglycerate (2-hydroxy-4-phosphonobutanoate) is a potent competitive inhibitor of cofactor-dependent phosphoglycerate mutase from yeast and of cofactor-independent phosphoglycerate mutase from wheat germ. For the yeast enzyme Ki is 1.3 mM (Km for substrate is 0.

Treatment with praziquantel of schoolchildren with concurrent Schistosoma mansoni and S. haematobium infections in Gezira, Sudan.

A field trial was conducted in Sudan to evaluate the acceptability and efficacy of praziquantel given to schoolchildren aged 7-11 years who were all infected with both Schistosoma mansoni and S. haematobium. Two dosage regimes were compared, a single dose of 40 mg/kg bodyweight, and a divided dose 2 X 20 mg/kg given 4-6 h apart.

Dose-finding trial using Oltipraz to treat schoolchildren infected with Schistosoma mansoni in Gezira, Sudan.

A field trial has been carried out in Sudan to determine the optimum dosage regimen for the use of Oltipraz in the treatment of Schistosoma mansoni in schoolchildren. A total of 294 children were treated in six groups to test 15 mg/kg, 20 mg/kg, and 25 mg/kg, using a single oral dose and a divided dose taken some 6 h apart. The children were interviewed before and then 24 h after treatment to determine the prevalence of drug-induced side-effects.

The use of the operating microscope in ethmoid surgery.

The operating microscope opens a new world of precision in intranasal sinus surgery by providing binocular vision with excellent illumination. With a self-retaining speculum for better visualization, the surgeon is seated and both hands are free, allowing for better control. Removal of disease is more thorough, complications are reduced, and the need for repeat procedures is diminished.

Indirect screening for Schistosoma haematobium infection: a comparative study in Ghana and Zambia.

Four indirect approaches, based on inquiry into a past history of haematuria, visual inspection for blood in the urine specimens, and the use of reagent strips to detect haematuria and proteinuria, were evaluated to identify persons with Schistosoma haematobium infection. These approaches were applied individually and in three different screening sequences on two populations in Ghana and Zambia in order to identify infected children and adults for subsequent treatment in both areas. Detection of haematuria using reagent strips was the single approach with the highest sensitivity and specificity.

Evaluation of reagent strips in urine tests for detection of Schistosoma haematobium infection: a comparative study in Ghana and Zambia.

The presence of haematuria and proteinuria, detected by reagent strips, was compared with Schistosoma haematobium egg counts in the urines of human subjects from two epidemiologically distinct areas in Ghana and Zambia. In children and adults in both areas, the individual or combined semiquantitative levels of proteinuria and haematuria were related directly to increasing urinary egg counts. In both areas the presence of blood in the urine was highly specific (greater than 85%) and sensitive, being positive in 97% of urine specimens with more than 64 eggs per 5-ml sample of urine.

The mechanism of pyrophosphorolysis of RNA by RNA polymerase. Endowment of RNA polymerase with artificial exonuclease activity.

DNA-directed RNA polymerase from Escherichia coli can break down RNA by catalysing the reverse of the reaction: NTP + (RNA)n = (RNA)n+1 + PPi where n indicates the number of nucleotide residues in the RNA molecule, to yield nucleoside triphosphates. This reaction requires the ternary complex of the polymerase with template DNA and the RNA that it has synthesized. It is now shown that methylenebis(arsonic acid) [CH2(AsO3H2)2], arsonomethylphosphonic acid (H2O3As-CH2-PO3H2) and arsonoacetic acid (H2O3As-CH2-CO2H) can replace pyrophosphate in this reaction.

The arsonomethyl analogue of adenosine 5'-phosphate. An uncoupler of adenylate kinase.

Adenosine was converted into the arsonomethyl analogue of AMP. The reactions used provide a general route for converting an alcohol, R-CH2-OH, into the arsonomethyl analogue, R-CH2-CH2-AsO3H2, of its phosphate, R-CH2-O-PO3H2. The analogue of AMP proves to be a substrate for rabbit adenylate kinase, which shows a limiting velocity with it of 1/17 that with AMP, a Michaelis constant raised 70-fold to about 10 mM, and hence a specificity constant lowered about 1200-fold.

The interrater reliability of DSM III in children.

A total of 195 admissions to a child psychiatric inpatient unit were diagnosed independently by two to four clinicians on the basis of case presentations at the first ward-round after admission. The DSM III as a whole and the major categories were of high or acceptable reliability, though a few were clearly unreliable. The results are generally consistent with other studies.

The arsonomethyl analogue of 3-phosphoglycerate.

4-Arsono-2-hydroxybutanoic acid, the analogue of 3-phosphoglycerate in which -CH2-AsO3H2 replaces -O-PO3H2, was synthesized. It proved to be a substrate for phosphoglycerate kinase. Its Michaelis constant was only slightly higher than that of the natural substrate, but its catalytic constant was about 1300 times smaller.

A field trial using praziquantel (BiltricideR) to treat Schistosoma mansoni and Schistosoma haematobium infection in Gezira, Sudan.

A field trial was conducted in the Gezira, Sudan, to evaluate the acceptability and efficacy of praziquantel, a new schistosomicide. In one Arab village 350 patients with Schistosoma mansoni were randomly assigned to two treatment groups and given 1 X 40 mg kg-1 (Group A) or 2 X 20 mg kg-1 given four to six hours apart (Group B). In two small settlements (camps) 2 km distant from the Arab village 38 patients with S.

Relation between intensity of Schistosoma haematobium infection and clinical haematuria and proteinuria.

In an endemic area on Lake Volta, Ghana, urinary blood and protein levels as determined by chemical reagent strips in persons infected with Schistosoma haematobium, particularly in children aged between 5 and 14, correlated positively with urinary egg counts. Geometric mean S haematobium egg counts were 10 or more times higher in urine specimens with at least 10 mg/dl of protein and detectable haematuria than in those without detectable blood or protein. Chemical reagent strips were both specific and sensitive for detection of urinary blood associated with S haematobium infection.

Microscopic sinus surgery, transnasal ethmoidectomy and sphenoidectomy.

Intranasal ethmoid surgery has traditionally been a "blind procedure" using monocular vision, the delicate control of instruments being less than optimal. The addition of the operating microscope with a special self-retraining retractor speculum is presented in a series of 87 patients over 7 years, 49 of these having had transethmo-sphenoidectomy. Evaluation, anatomy, technique and results are discussed.

The adverse consequences of heavy Trichuris infection.

Sixty-seven children with heavy Trichuris trichiura infection (Group A) were compared to 73 control children of similar socio-economic status but with light or no T. trichiura (Group B), for nutritional status, rates of concomitant bacterial and protozoal, and symptoms and clinical signs associated with heavy T. trichiura infection.