Study of hepatoma from all provincial hospitals in Kenya

Hepatocellular carcinoma is common in Kenya occurring at an earlier age than in Europe. It is the third commonest solid tumour among males at the Kenyatta National Hospital. Hepatitis B virus seems to be playing a very important role in the causation of HCC. A study done at the KNH in 1985 showed that hepatitis B surface antigen (HBsAg) was positive in 85of HCC patients. Some of these cases had integrated HBV-DNA in the liver; whereas others had free HBV-DNA. We undertook to screen patients with possible HCC clinically and ultrasonographically in all teh provincial hospitals in Kenya and taat KHN. These patients had blodded samples taken for HBV markers; hepatitis C virus (HCV)) antibodies and allllphafetopreotein (AFP). A few of teh patients had histological confirmation of the HCC. A total of 137 cases of HCC were screened; with a mean age of 45.7 years (range 7-86 years). The prevalence of HBsAg in HCC was found to be 39.4 per cent and the prevalence of anti-HCV Ab was found to be 2.9 per cent. AFP was positive in 51.8 per cent of HCC cases with 38 per cent of cases having levels greater than 200 ng/ml. Most of the HCC cases were diffuse (48 per cent) or multiple (32.7 per cent) and only solitary in 9.2 per cent of the cases. Even the solitary tumours were large with an average size of 41.3 pmm. HBV plays an important role in the causation of HCC in our setup whereas HCV does not seem to be as important. AFP is an important indicator of HCC and combined with ultrasound; it can be used for early diagnosis of HCC in high risk groups; that is; HBsAg positive individuals

Hemorrhagic Fevers : Few Clues after 25 Years

There is a high prevalence of Ebola antibodies found in the Kenya population; related to geographical area and season; although the clinical disease was never found and the virus was not isolated. A field study was carried out in 7 hospitals in western Kenya; 1986 -1987 (including surveillance studies in suspect areas); to intensify collection and transport of samples; testing facilities; patient observation with record keeping and follow-up. This study involved 1109 admitted patients with fever and/or bleeding; 155 contacts of haemorrahagic fever antibody (Hfab) patients; and 916 people in suspect areas. Respectively 160;44 and 80 persons were found Hfab positive mainly to Ebola; using an indirect immunofluorescent assay. From 676 viral cultures no virus was isolated. A relationship between antibody titres and ecological factors; social habitat; age; sex or season was not found. The non-specificity of IF testing was demonstrated by: 1) the disagreement between the results of two reference laboratories; 2) the unpredictability of the titre conversation course; and 3) by proving a significant cross-reactivity with Borrelia burgdorferii antibodies; Plasmodium falcparum antibodies and Salmonella typhi antibodies. Renewed testing in 1995 of 90 positive sera (with low titres) showed 19 sera to be positive by Elisa (2 in Zaire; 1 in Sudan; 9 in Reston and 7 in Cote d'Ivoire) from which 4 were confirmed by IFI 2 in Reston and 2 in Cote d'Ivoire. These findings are more proof that non-human virulent strains of Filoviridae; especially Ebola virus; are around in Kenya

Prevalence of Hepatocellular Carcinoma; liver Cirrhosis and HBV Carriers in Liver Disease Patients Reffered to Clinical Research Centre; Kemri

The prevalence of HBsAg positivity; liver cirrhosis (LC) and hepatocellular carcinoma (HCC) is studied in 139 patients at the Clinical Research Centre of KEMRI. The prevalences were found to be 15.1; 9.3and 10respectively. 14of the HBsAg positives were also E antigen positive. The positivity of HBsAg in HCC was 42.9only 15.4in LC and 57.1HCC had AFP compared to only 15.4in LC. It is suggested that the findings support an association of Hepatitis B virus with LC and HCC