Pregnancy Outcome of ART-experienced and ART-naïve HIV-infected Mothers at the University of Port Harcourt Teaching Hospital, Port Harcourt, Nigeria

Background:Untreated maternal Human Immunodeficiency Virus (HIV) infection is associated with adverse pregnancy outcome including preterm birth, low birth weight, and mother-to-child transmission of the virus. This study aimed to compare the pregnancy outcome between HIV infected mothers who received ART in pregnancy and those who were ART-naïve. Methods:A cross-sectional study of HIV-infected mothers who brought their infants for follow up between November 2007 and May 2017 at the University of Port Harcourt Teaching Hospital, Port Harcourt, Nigeria.Relevant information obtained include: time of diagnosis, antiretroviral therapy (ART) regimen and when it was commenced, gestational age at delivery and birthweight of child, mode of delivery, infant feeding option and ARV prophylaxis. Infection status of the infant was determined by DNA PCR at 6weeks of age. Based on when ART was commenced, mothers were grouped into three [(HAART experienced (HE) if ART was started before pregnancy, HAART in pregnancy (HIP) and HAART naive (NH) if no HAART was taken in pregnancy].Main outcome measures were rates of prematurity, low birth weight, mean birth weight, birth defects and mother-to-child transmission Result:A total of 1,640 HIV-exposed infants were seen (716(43.6%) in HE, 360(22.0%) in HIPand 564(34.4%) in NH groups). There were 825(50.3%) males and 815(49.7%) females. Zidovudine/Lamivudine and Nevirapine/Efavirenz was the most frequently used combined ART in 724 (67.3%) mothers. The mean birthweight was 3.12±0.38Kg; range 1.2 –5.7Kg (3.11±0.58Kg in HE; 3.13±0.53Kg in HIP; 3.18±0.74Kg in NH) Table 3. A hundred and eighty (11.0%) babies were preterm [76(42.2%) in HE; 26(14.4%) in HIP; 78(43.3%) in NH](p=0.007), while 159(9.7%) were LBW [74(46.5%) in HE; 22(13.8%) in HIP; 63(39.6%) in NH](p=0.03). Fourteen (0.9%) babies had birth defects [5(35.7%) in HE; 9(64.3%) in HIP] (p=0.01). The commonest birth defects were neural tube defect 7(50%) and congenital heart defect 4(28.8%). Overall transmission rate was 21.4% [8% in the HE, 4.5% in HIP and 87.5% in NH groups] (p=0.001). The mean birth weights of uninfected babies were higher than their infected counterparts but was not significant (p>0.05).Conclusion:The benefits of early HAART in reducing mother-to-child transmissionmust be weighed against the risks of lower birthweight and potential teratogenic effects of drug exposure on the foetus

Malaria Preventive Practices among Under-five Children in Rivers State, Nigeria

Background:Malaria is a life threatening protozoan infection and children under 5 years are one of the most vulnerable group. Good malaria preventive practices among these group is key to reducing malaria burden and its associated mortality Objective:The aim of the study was to assess malaria preventive practices among under-five children in Rivers State, Nigeria. Materials and Methods:This was a cross sectional study carried out in public and private health facilities in Rivers state. Ethical approval for the study was obtained from the Research and Ethics committee of the University of Port Harcourt Teaching Hospital, while an informed written consent was obtained from the parents or caregivers of the participants. Stratified sampling method was used to select the health facilities and the subjects for the study. A pretested interviewer administered questionnaire was used to harvest relevant information on socio demographic characteristics of the subjects and informants and malaria preventive practices. Obtaineddata was analysed using SPSS version 22 and results are presented in prose and tables. Results:A total of 1138 children participated in the study constituting of 613 (53.9%) male and 525(46.1%) female giving a male: female ratio of 1.2:1. Mean age of participants was 1.74±1.08 years. Mothers, accounted for majority 1012 (88.9%) of the informants. Most of the informants had tertiary degree; 605 (53.4%) and 697 (61.8%) among mothers and fathers respectively. Among the occupations of fathers, public servants, civil servants and the self-employed were more represented, constituting 242 (21.4%), 200 (17.7%) and 149 (13.2%) respectively. Traders/business women, the self-employed and civil servants were most represented among the occupations of mothers in the study and these accounted for 444 (39.7%), 181 (16.2%) and 137 (12.3%) respectively. Malaria preventive practices included use of Insecticide-treated bed nets (ITNs), Indoor spraying of insecticide (modified IRS), use of antimalarial drugs, clearing of bushes/ disposal of containers where mosquitoes breed and use of mosquito repellent creams which constituted 605 (53.2%), 483 (42.4%), 133 (11.7%), 4 (0.4%) and 2 (0.2%) respectively; there were 512 (45.0%) children who slept under ITNs the previous night. Also, 970 (85.2%) had window nets installed in their homes. Protective window nets was also in place in the homes of 970 (85.2%) of the study participants. Among families that practiced use of ITNs, 110 (61.8%) were from the middle social class and 62 (34.8%) were from the upper social class, while 316 (52.2%) and 276 (45.6%) were from the upper and middle social class respectively among those that practised Indoor spraying of insecticide (IRS). Conclusion:Use of ITNs, modified IRS and use of anti malarials were the common malaria preventive practices among under-fives in Rivers state and these methods were more practiced among the middle and upper social class. Education on the integrated approach to malaria prevention which advocates the use of several malaria prevention methods in a holistic manner should be intensified

Amblyopia in Black Children: as seen in University of Port Harcourt Teaching Hospital, Nigeria.

Background: Amblyopia is a common cause of visual impairment in children with uncorrected refractive errors, so screening and treatment should be carried out as early as possible to prevent permanent visual loss. Objective: To determine the prevalence of amblyopia among individuals less than 18years with refractive errors presenting to the Ophthalmology clinic of the University of Port Harcourt Teaching Hospital (UPTH). Methods: Children with refractive errors presenting at UPTH over a period of 2 years were studied. Their bio-data and relevant medical and ocular history were obtained. Their visual acuity was measured and standard ophthalmic examination was done for the anterior segment with a pen torch and slit lamp bio-microscope. The posterior segment was examined with Welch Allen direct ophthalmoscope. All the children in the study were refracted using the appropriate techniques. Result: A total of 306 children with refractive errors were studied, out of which 110 (36%) were males and 196 (64%) were females. Of these children, 204 (66.7%) had astigmatism, 68 (22.2%) had Myopia, 23(7.5%) had hypermetropia and 11(3.6%) had inconclusive refraction. Two hundred and seventy eight (90.8%) of these children with refractive errors had optimal correction by refraction while 17(5.6%) had developed amblyopia. All the children who had amblyopia were between 13 and 18years; five (29.5%) were males while twelve (70.5%) were females which is statistically significant (p=0.00001). Conclusion: The prevalence of amblyopia among children with refractive error is high and therefore early screening and intervention is important to prevent permanent visual loss.

Molecular serovar characterization of Leptospira isolates from animals and water in Colombia / Caracterización molecular de serovariedades de Leptospira spp. aisladas de muestras de animales y agua en Colombia

Introduction: Leptospirosis is a bacterial disease transmitted directly or indirectly from animals to humans that may result in severe hemorrhagic, hepatic/renal and pulmonary disease. There are 20 known Leptospira species and hundreds of serovars, some of which belong to different species. It is essential to identify pathogenic Leptospira serovars and their potential reservoirs to prepare adequate control strategies. Objective: To characterize the Leptospira serovars isolated from rodents, dogs, pigs and water samples in Colombia. Materials and methods: Leptospira organisms were isolated and cultured, and pathogenic strains were identified using a polymerase chain-reaction (PCR). Leptospira DNA and Salmonella Braenderup H9812 (molecular weight standard) DNA were cleaved using NotI and subjected to pulsed-field gel electrophoresis (PFGE). The PFGE patterns were analyzed based on bacterial strain-typing criteria and Dice coefficients (DCs) between these isolates and over 200 Leptospira organisms isolated from other parts of the world. Results: All of the isolates were pathogenic strains, and five were genetically characterized. The P275 (84% DC) and P282 (95% DC) pig isolates were related to the Leptospira interrogans Pomona serovar; the I15 (DC: 100%) rat isolate was identical to the Leptospira interrogans Icterohameorrhagiae or Copenhageni serovars, while the C67 (64% DC) dog and A42 (60% DC) water isolates were not related (< 73.7% DC) to any of the 200 reference serovars; the closest serovars were the Leptospira noguchii Nicaragua and Orleans serovars, respectively. Conclusion: This was the first molecular characterization of Colombian Leptospira spp isolates; these isolates will be used to develop a Colombian diagnostic panel.

Introducción. La leptospirosis es una infección bacteriana transmitida directa o indirectamente de animales a humanos, la cual puede resultar en una enfermedad hemorrágica grave, hepática o renal y pulmonar. Hay 20 especies de Leptospira conocidas y cientos de serovariedades, algunas de las cuales pertenecen a diferentes especies. Es esencial identificar las serovariedades patógenas y sus reservorios potenciales para enfocar estrategias de control. Objetivo. Caracterizar las serovariedades de Leptospira aisladas de muestras de roedores, perros, cerdos y agua en Colombia. Materiales y métodos. Las cepas de leptospiras aisladas fueron identificadas como patógenas usando la reacción en cadena de la polimerasa (PRC). Sus ADN y el ADN de Salmonella Braenderup H9812 (marcador de peso molecular) fueron cortados con NotI y corridos en electroforesis de campo pulsado. Los patrones de la ECP se analizaron con base en los criterios de tipificación para cepas bacterianas y el coeficiente de Dice, cuando se compararon con 200 cepas aisladas en otras partes del mundo. Los perfiles de ADN con un coeficiente de Dice entre 73,7 % y 100 % se consideraron pertenecientes a la misma especie. Resultados. Todos los aislamientos fueron cepas patógenas y cinco se caracterizaron genéticamente. El aislamiento P275 (coeficiente de Dice: 84 %) y el P282 (coeficiente de Dice: 95 %) de cerdos, se relacionaron con Leptospira interrogans de serovariedad Pomona; el aislamiento de rata (I15) fue indistinguible de Leptospira interrogans de serovariedades Icterohaemorrhagiae o Copenhageni (coeficiente de Dice: 100 %), mientras que los aislamientos de perro (C67) y agua (A42) no se relacionaron (coeficiente de Dice <73,7 %) con ninguna de las 200 cepas de referencia; las más cercanas fueron Leptospira noguchii de serovariedades Nicaragua (coeficiente de Dice: 63 %) y Orleans (coeficiente de Dice: 60 %). Conclusiones. Esta fue la primera caracterización molecular de serotipos de aislamientos colombianos, los cuales serían los primeros miembros de un panel diagnóstico colombiano.

Pathogenicity of Metarhizium anisopliae (Metch) Sorok and Beauveria bassiana (Bals) Vuill to adult Phlebotomus duboscqi (Neveu-Lemaire) in the laboratory.

Background & objectives: Biological control of sandflies using entomopathogenic fungi is a possible alternative to the expensive synthetic chemical control. It is potentially sustainable, less hazardous, and relatively inexpensive and merits further investigations. The objective of this study was to identify the most pathogenic fungal isolate(s) to sandflies in the laboratory. Methods: Isolates of entomopathogenic fungi Metarhizium anisopliae and Beauveria bassiana were screened for their pathogenicity against Phlebotomus duboscqi. Adult flies were contaminated using the technique described by Migiro et al (2010). Briefly, flies were exposed to 0.1 g of dry conidia evenly spread on a cotton velvet cloth covering the inner side of a cylindrical plastic tube (95 mm long × 48 mm diam). In all 25 sandflies were transferred into the cylindrical tube and allowed to walk on the velvet for one minute, after which they were transferred from the velvet into the cages in Perplex. Insects in the control treatments were exposed to fungusfree velvet cloth before being transferred into similar cages. The treatments were maintained at 25 ± 2°C, 60–70% RH and 12L: 12D photoperiod. The experiment was replicated 5 times. The most pathogenic isolates were selected for further studies. Results: A total of 19 isolates were screened against adult sandflies in the laboratory. Mortality in the controls was approximately 16.8 ± 1.7 %. All the isolates were found to be pathogenic to P. duboscqi. Mortality ranged between 76.8 and 100% on all the fungal isolates tested. The lethal time taken to 50% (LT50) and 90% (LT90) mortality ranged from 3.0–7.8 days and from 5.3–16.2 days, respectively. The virulent isolates, causing mortalities of 97.5–100%, were selected for further studies. Interpretation & conclusion: The high susceptibility of sandflies to entomopathogenic fungi suggests that fungi are potential alternatives to chemical control methods. We conclude that application of entomopathogenic fungi could result in acute mortalities of sandflies and reduction of parasite transmission and subsequently, reduction of leishmaniasis risk. This method of biological control has great potential as a new strategy for leishmaniasis control.

Mesotelioma peritoneal maligno / Malignant peritoneal mesothelioma

El mesotelioma peritoneal es una patología rara que se presenta con síntomas inespecíficos, por lo que su diagnóstico es dificultoso. Reportamos el caso de un hombre de 58 años con diabetes mellitus tipo 2, hipertensión arterial y tabaquismo; sin antecedente de exposición a asbestos. El paciente refirió que un mes antes del ingreso inició una enfermedad insidiosa y progresiva, caracterizada por aumento progresivo del volumen abdominal y sensación de llenura; tres semanas después se agregaron dificultad respiratoria y anorexia. El paciente estaba en regular estado general; no presentaba: estigmas hepáticos, edema o adenomegalias. El examen de tórax y cardiovascular fue normal. El abdomen distendido por ascitis, no doloroso, hígado y bazo no evaluables. Exámenes auxiliares: Hb 11,9 gr, Leucocitos 6840, Ab 1 por ciento, Linfocitos 10 por ciento, Plaquetas 620,000, TP 12ô, TTP 34ô, glucosa 158, urea 41, creatinina 1,2, proteínas totales: 6,1, albúmina 2,6. Perfil hepático, examen de orina y electrolitos normales. DHL 316, Colesterol 155 mg/ dl, Triglicéridos 210 mg/dl. Marcadores virales B y C negativos. Marcadores tumorales Ca 19.9, CEA, AFP y PSA negativos. Hemocultivo negativo, B2 microglobulina 2,2 mg/l (0.83-1.15). Los estudios del líquido ascítico fueron: ADA: 20,3 U/l, gradiente de albumina (GASLA) < 1.1; citoquímico: 2237 cel/mm3, PMN 6 por ciento, Linfocitos 90 por ciento, células mesoteliales 4 por ciento, proteinas 4,6, albúmina 2,34, glucosa 44 y DHL 1918; gram y cultivo negativos; BAAR y cultivo BK negativos; PAP: presencia de células mesoteliales con cambios de tipo reactivo; block cell: negativo para células tumorales. Ecografía abdominal: peritoneo engrosado y abundante ascitis. TEM tóraco-abdominal: ascitis, engrosamiento difuso del peritoneo y epiplón...

The peritoneal mesothelioma is a rare pathology with unspecific symptoms reason to be a difficult diagnosis. We report a case of a 58 year old man with diabetes mellitus type 2, arterial hypertension and smoking; without precedent of asbestos exposure. The patient presented a one month history characterized by progressive increase of the abdominal volume and sensation of fullness; three weeks later they added breathlessness and hyporexia. The patient was in regular general condition; he was not presenting hepatic stigmas, edema or adenomegalies. The examination of thorax and cardiovascular it was normal. The abdomen distended by ascites, not painful, liver and spleen not examined.Laboratory: Hemoglobin 11,9 gr/dl, WBC 6840/mm3 Bands 1 percent, lymphocytes 10 percent, platelets 620000/mm3, PT 12 seconds, PTT 34 seconds, glucose 158 mg/dl, BUN 20,5 mg/ dl, creatinine 1,2 mg/dl, proteins 6,1 gr/dl, albumin 2,6 gr/dl. LDH 316 U/l, â2microglobulin 2,2 mg/l (0.83-1.15 mg/l). HBV and HCV negative. Ca 19.9, CEA, AFP and PSA negative.Hemocultive negative. Ascitic fluid: ADA 20,3 U/l, serum-ascitic albumin gradient (SAAG) <1,1. Leukocytes 2237 cells/mm3, PMN 6 percent, lymphocytes 90 percent, mesothelial cells 4 percent, proteins 4,6 gr/dl, albumin 2,34 gr/dl, glucose 44 mg/dl, LDH 1918 U/l. Gram and cultive: negatives. BAAR and cultive: negative . Cytology: mesothelial cells with changes of type reagent, Block cell for tumour cells: negative. Abdominal US: increased peritoneum and abundant ascitic fluid. Thoracic-abdominal CT: left side pleural effusion, severe ascites with thick epyplon...

A phenomenon useful for the detection of Salmonella implementing a device from citrus extracts

The effect of lemon slices, as well as ascorbic and citric acid impregnated paper discs, on the growth of ten non-typhoidal Salmonella, six <I>Citrobacter freundii</I> and four <I>Proteus mirabilis</I> species on Desoxycholate Hydrogen Sulfide Lactose (DHL) agar were examined in comparison to controls without fruit slices or paper discs applied. After 24 h incubation, thick black rings were observed around fruit slices and impregnated discs growing on non-typhoidal <I>Salmonella</I> serovars and not around the other species. We named this the “MY Phenomenon”. We propose that the phenomenon can be used as a rapid, simple and inexpensive screening test that distinguishes non-typhoidal <I>Salmonella</I> species from other enterobacteriaceae in stool samples.

Quinine-induced arrhythmia in a patient with severe malaria.

It was reported that there was a case of severe malaria patient with jaundice who presented with arrhythmia (premature ventricular contraction) while getting quinine infusion was reported. A man, 25 years old, was admitted to hospital with high fever, chill, vomiting, jaundice. The patient was fully conscious, blood pressure 120/80 mmHg, pulse rate 100 x/minute, regular. On admission, laboratory examination showed Plasmodium falciparum (++++), total bilirubin 8.25 mg/dL, conjugated bilirubin 4.36 mg/dL, unconjugated bilirubin 3.89 mg/dL, potassium 3.52 meq/L Patient was diagnosed as severe malaria with jaundice and got quinine infusion in dextrose 5% 500 mg/8 hour. On the second day the patient had vomitus, diarrhea, tinnitus, loss of hearing. After 30 hours of quinine infusion the patient felt palpitation and electrocardiography (ECG) recording showed premature ventricular contraction (PVC) > 5 x/minute, trigemini, constant type--sinoatrial block, positive U wave. He was treated with lidocaine 50 mg intravenously followed by infusion 1500 mg in dextrose 5%/24 hour and potassium aspartate tablet. Quinine infusion was discontinued and changed with sulfate quinine tablets. Three hours later the patient felt better, the frequency of PVC reduced to 4 - 5 x/minute and on the third day ECG was normal, potassium level was 3.34 meq/L. He was discharged on 7th day in good condition. Quinine, like quinidine, is a chincona alkaloid that has anti-arrhythmic property, although it also pro-arrhythmic that can cause various arrhythmias, including severe arrhythmia such as multiple PVC. Administration of parenteral quinine must be done carefully and with good observation because of its pro-arrhythmic effect, especially in older patients who have heart diseases or patients with electrolyte disorder (hypokalemia) which frequently occurs due to vomiting and or diarrhea in malaria cases.

Epidemiology of Helicobacter pylori infection in Barbados

The epidemiology of Helicobacter pylori infection in Barbadian patients and controls was studied. H. pylori was isolated from biopsies from 50/100 (50 percent) adult patients undergoing endoscopy for investigation of upper gastrointestinal tract symptoms. Urease was detected in biopsies from 54 patients and gastritis was detected by histology in 71 patients. Serology was performed using a commercial ELISA method. Using an IgG concentration of 10 U/ml as a threshold, antibodies were detected in 78 percent of 100 patients undergoing endoscopy, 72 percent of 230 blood donors and 22 percent of 50 children. The mean antibody concentration was significantly higher in patients (92 U/ml) than in blood donors (49 U/ml) or in children (9.5 U/ml). Culture-positive patients (120 U/ml) had higher IgG concentration than culture-negative patients (64 U/ml). Using isolation of H. pylori or a positive biopsy urease test as a measure of true prevalence of infection, the sensitivity of serology was 96 percent, the specificity 42 percent positive predictive value 67 percent and negative predictive value 90 percent. Seroprevalence increased with age, to a peak of more than 90 percent in blood donors aged 50 - 59 years and in patients aged over 60 years. The epidemiology of H. pylori in Barbados is similar to that in developed countries, where few children was infected, but resembles other developing countries in the high seroprevalence observed in middle-aged adults.

Estructura y ultraestructura del pancreas endocrino de ratones transgenicos diabeticos / Structure and ultrastructure of the endocrine pancreas in diabetic transgenic mice

El objetivo del trabajo fue corroborar los cambios estructurales y determinar las alteraciones ultraesctructurales ocurridas en el páncreas endocrino de ratones con un síndrome inducido de diabetes mellitus insulinodependiente (DMID). Para ello se utilizaron ratones transgénicos (OVE 27) que sobreexpresan el gen de calmodulina en las células beta del páncreas endocrino; en estos animales, el aumento de calmodulina disminuye los niveles de calcio citosólico de las células beta, produciendo alteraciones morfológicas y funcionales que desencadenan una DMID de curso severo. Para nuestro estudio se obtuvieron y procesaron porciones del páncreas (cola) de 4 ratones transgénicos machos diabéticos de 5 semanas de edad (glucemia: 376 + 2 mg/del) y de 4 controles no transgénicos de la misma cepa, sexo y edad (glucemia: 113 + 13 mg/dl). El estudio inmunohistoqu­mico con microscop­a de luz confirmó que los ratones transgénicos presentan una disminución del número y tama o de los islotes con distorsión de su arquitectura, sin respuesta inflamatoria asociada. Los estudios ultraestructurales demostraron diversos grados de da o en las células Beta, tales como la presencia de interdigitaciones de membrana y alteraciones de sus organelas y de sus gránulos de secreción. Estos hallazgos coinciden con el deterioro cuantitativo y funcional de las células beta y la conservación de las problaciones celulares no-beta de los islotes. Estos cambios ultraestructurales en las células beta del páncreas del modelo experimental estudiado, sumados a las alteraciones inmunohistoquímicas previamente descriptas, contribuyen a explicar la manifestación de la diabetes.

Genital tract infections in sexually active women in Barbados

Ninety-eight women attending three different clinics were prospectively studied for the presence of genital tract infections, including Chlamydia trachomatis. Of these 98 women, 35 were presenting to a polyclinic with symptoms of genital tract infection, 55 were attending an antenatal clinic for their first visit, and 8 referred to a colposcopy clinic because of an abnormal Papanicolaou smear were included. Gonorrhoea was detected in one patient, syphilis in two, and Trichomonas vaginalis in six. Candida albicans and Chlamydia trachomatis were each detected in 18 patients, while the most common condition was bacterial vaginosis, detected in 35 patients. The prevalence of these infections was lowest in patients referred for colposcopy and highest in the women attending the antenatal clinic, Chlamydia trachomatis was the most common sexually-transmitted pathogen detected in this population. These data emphasise the need for an aggressive approach to the diagnosis and treatment of chlamydial infection in females

Antibiotic sensitivity of neisseria gonorrhoeae isolates in Barbados; longitudinal surveillance 1990-1994

The antimicrobial susceptibility of 775 isolates of Neisseria gonorrhoeae, recovered in Barbados over a five-year period, was studied by disc diffusion. Sensitivity to penicillin declined from 56 percent in 1990 to 38 percent in 1994. The prevalence of ß-lactamase production rose from 30 percent to 50 percent during this period and sensitivity to tetracycline declined from 96 percent to 46 percent, while co-trimoxazole and spectinomycin sensitivities varied. Ceftriaxone, norfloxacin and erythromycin were the only compounds tested to which sensitivity remained uniform. The results confirm the current recommendations by several agencies that ceftriaxone or an oral fluoroquinolone should be considered the drug of choice for the empirical treatment of gonorrhoea

Aetiology of vaginal infections in pregnant and non-pregnant women in Barbados

The aetiology of vaginal discharge was studied in 175 Barbadian women. Pregnant women accounted for 52 percent (91) of the population studied. Candida albicans was detected in 45 percent of the women, bacterial vaginosis in 28 percent and Trichomonas vaginalis in 8.6 percent. Bacterial vaginosis was more common in non-pregnant women (33 percent vs 23 per cent) whereas C. albicans was more common in pregnant women. Mixed infections were found in 10 women and an aetiological agent was detected in 75 percent of the women studied. These data emphasize the need for laboratory investigation of vaginal discharge since each of these infections can be treated effectively with specific agents

Seroepidemiology of chlamydial infection among a sexually-active population in Barbados

During a two-year period, sera from 1179 patients with urogenital tract symptoms and from 256 controls were tested for IgG and IgA antibodies to Chlamydia trachomatis, using a commercially prepared indirect immunoperoxidase assay. Of the patient sera, 1051 (89//) were from female patients and 128 (11//) were from males. Specimens were received from patients attending private practitioners (424), government polyclinics (348), the Queen Elizabeth Hospital (206), the Barbados Family Planning Association (117) and various other source (84). Nine hundred and fifty-nine of specimens (81//) from all patients had IgG titres of 64 or greater, and 441 (37//) had IgA titres of 16 or greater. A lower proportion of male patients (43//) than female patients (61//) had IgG titres of 128 or greater. Among 76 control females attending the antenatal clinic, IgG were detected in 76//and IgA in 16//, while among 75 adult blood donors, IgG was detected in 70//and IgA in 39//. A group comprising 97 asymptomatic children aged 9 months to 13 years, and 8 adolescents aged 14 - 18 years was also studied. IgG antibodies (titre ñ 64) were detected in 13.4//of children and in 50//of the adolescents. IgA antibodies were detected in only 1//of children and adolscents. Antibodies were not detected in children under the age of 5 years. The detection of antibodies by indirect immunoperoxidase assay in such a high proportion of the population suggests that this method is of little value for diagnosis of infection with Chlamydia trachomatis