Comparison of PCR method with the culture method for identification of gonococci from endocervical swabs.

Gonococcal infection remains still a major cause of morbidity among sexually active individuals. Diagnosis of the infection in a female case is more difficult than that in a male. This was a prospective study among 269 female commercial sex workers (CSWs) to screen them for gonococcal infection, comparing the rapid method of identification of gonococci by polymerase chain reaction (PCR) with the selective culture method. A total of 92 (34.2%) CSWs were identified positive for Neisseria gonorrhoeae by combination of the two methods. The PCR method identified 87 of the specimens to harbour cppB gene of N. gonorrhoeae, whereas culture method identified 83 specimens showing colonies of gonococci. Taking into consideration of the total positive cases (92), the PCR method showed a sensitivity of 94.57%, whereas sensitivity of culture method was 90.22%. The selective culture method appears to be the most applicable in the identification of gonococci from clinical specimens, particularly in the less resourceful countries like Bangladesh.

Primary drug resistance pattern of mycobacterium tuberculosis in Dhaka, Bangladesh.

One thousand two hundred and eighty one clinically suspected untreated patients with pulmonary tuberculosis were studied from an urban tuberculosis clinic in Dhaka. Majority of the 1281 patients (77.6%) were from the age group of 14 to 44 years. Sputum, 106 (8.3%) were found positive for mycobacteria (both by Ziehl-Neelsen smear staining and culture to consider those as confirmed cases of mycobacterial infection. Out of these 106 cases, 101 (95.3%) were identified as M. tuberculosis and the rest 5 (4.7%) as Non-tuberculous Mycobacteria (NTM). Among the 101 M. tuberculosis strains, 30 (29.7%) were resistant to at least one drug; 16 (15.8%); to isoniazid, 11 (10.9%) to rifampicin, 07 (6.9%) to streptomycin, 03 (2.9%) to ethambutol and 04 (3.9%) to pyrazinamide. Multi-drug resistant tuberculosis (MDR-TB) was found in 5 (4.95%) cases. 5 (4.95%) cases were resistant to two drugs and 3 (2.97%) cases to three drugs. Ciprofloxacin was tested against 30 strains of M. tuberculosis; 2 (6.67%) of which were resistant. This is the first report of ciprofloxacin resistant Mycobacterium tuberculosis from Bangladesh. All the 5 strains of NTM tested for said 5 anti-tuberculous drugs, were found resistant to more than one.

Sero-epidemiological study of hepatitis B virus infection in a village.

A cross-sectional study was conducted in a randomly selected village of Rangpur district from June '94 to May '95. Serum from 1000 human subjects irrespective of age and sex were screened for hepatitis B surface antigen (HBsAg). Among the respondents 661 were male and 339 female. The overall seroprevalence of HBsAg was 6.4%. It was 6.66% in male and 5.89% in female. Age, sex, religion, income, occupation, education and marital status did not show any relationship with HBsAg status. Among 64 sero-positive cases, 16 (25%) had no history of exposure to known risk factors and 48 (75%) had one or more exposure to known risk factors (p < 0.05). This study did not depict the national scenario. Well designed studies with more sensitive serological methods are recommended to get the epidemiological information of hepatitis B virus (HBV) infection in our community.

Prevalence of typhoid fever among patients attending Saddam general hospital in Kirkuk

A retrospective study was carried out in Saddam general hospital at Kirkuk city for the period of January to September 1996 to investigate the prevalence of typhoid fever disease. A total of 136 patients were recognized as typhoid fever. Forty two were males while 94 were females. The age group of 20-29 years was the most frequent group [25%] and over 90% of cases were urban in residence while 38.2% of patients were housewives. The relation of some clinical symptoms and laboratory diagnosis with occurrence of disease was also studied

Hepatitis B virus markers among the prostitutes of Dhaka.

The objective of this study was to estimate the prevalence of hepatitis B virus (HBV) carrier states among prostitutes in Dhaka. Enzyme linked immunosorbent assay (ELISA) was used to detect HBV markers in a group of 164 prostitutes. Serological evidence of current or past HBV infection was present in 129(78.7%) prostitutes. HBsAg was detected in 16(9.7%) of whom 7(43.7%) were positive for e-antigen and e-antibody was present in another 7 (43.7%). Anti-HBs was detected in 94 (57.3%) of the specimens while anti-HBc in 108(73%) of HBsAg negative sera. Prevalence of HBV markers was 87% and 52.6% in VDRL reactive and non reactive sera respectively. The study indicates that the prevalence of HBV infection is high among the prostitutes in Dhaka city. Infection with Treponema pallidum is associated with increased risk of infection with HBV.

Development and evaluation of co-agglutination test to detect rotavirus antigens in stools of patients with diarrhoea.

Rotavirus is the most common cause of acute diarrhoea in infants and children in both the developed and developing countries including Bangladesh. Information about rotavirus diarrhoea in Bangladesh is insufficient primarily due to the lack of diagnostic facilities due to the high cost of reagents and equipment and lack of skilled personnel. A simple, suitable and less costly technique of co-agglutination test using protein-A secreting staphylococci was developed and evaluated against a commercially available ELISA kit to detect rotavirus antigen in stools of patients with diarrhoea. Staphylococcus cowan strain 1 was grown and coated with rabbit antisera raised against RV5 and SA11 rotavirus strains. The antibody-coated staphylococci were agglutinated specifically by rotavirus present in faecal samples within one or two minutes. A total of 1332 stool specimens were tested by co-agglutination and ELISA, of which 210 (15.77%) were positive by ELISA and 276 (20.72%) by co-agglutination test. Compared to ELISA, sensitivity of co-agglutination test was 76.19%, specificity 89.66% and predictive values of a positive and a negative test were 57.97% and 95.26% respectively. The results indicate that the co-agglutination test is a simple and suitable technique for rapid screening of rotavirus infection which could be adopted in clinical practice.

Prevalence of hepatitis B surface antigen (HBsAg) among prostitutes at Dhaka.

One hundred prostitutes were studied with an aim to acquire more insight on the role of sexual transmission of HBsAg and to detect carrier state among them. All subjects were interviewed and their serum samples were tested for HBsAg by reverse passive haemagglutination method (RPHA). Eleven (11%) of the prostitutes were found to be positive for HBsAg. Their mean age was 19.3 +/- 4.9 years. The mean duration in the profession was 2.5 +/- 1.6 years. Mean number of clients for each woman per 24 hours was 10.7 +/- 1.2. Most of the prostitutes (84%) were lacking knowledge about spread and contact of the disease.