Helminthic infestation in children of Kupwara district: a prospective study.

The present study deals with the investigation of the frequency of intestinal helminth parasites in children of Kupwara, Kashmir, India. Three hundred and twelve children in the age group of 4-15 years were examined for different intestinal helminths in three schools located in rural areas. Two hundred and twenty two of 312 (71.15%) tested positive for various intestinal helminths. The various helminth parasites included Ascaris lumbricoides , Trichuris trichiura , Enterobius vermicularis and Taenia saginata . By far, the highest frequency of 69.23% (216/312) was noted for Ascaris lumbricoides followed by Trichuris trichiura 30.76% (96/312), Enterobius vermicularis 7.69% (24/312) and Taenia saginata 7.69% (24/312). Single infection was found in 33.65% (105/312) and mixed infection was seen in 37.5% (117/312) children. This study emphasizes the need for improved environmental conditions, i.e., clean water supplies, enhanced sanitation and chemotherapy of school-age children in rural areas.

C-reactive protein in CNS infection.

Serum and CSF levels of CRP were measured by radial immunoassay in 99 subjects consisting of 20 controls, 34 pyogenic meningitis (PM), 21 tuberculous meningitis (TBM) and 24 viral encephalitis (VE). There was significant difference in the CRP levels (p less than 0.01) depending on the type of disease in both serum and CSF. The initial serum and CSF levels of CRP in patients with TBM was intermediate between those of PM and VE and were found to be significantly (p less than 0.001) low when compared with three days post treatment levels in children with PM. Both serum and CSF-CRP levels were significantly high (p less than 0.001) in patients succumbing to death than those who survived. Measurement of CRP in serum and CSF is a useful parameter in differentiating partially treated PM from TBM.

Circulating immune complexes in tuberculosis--an indicator of activity.

Circulating immune complexes (CIC) were assayed in 100 cases of tuberculosis and 30 age matched control children. The estimation was done by PEG assay before the commencement of antitubercular therapy. CIC were present in only 3.3% of the control children as compared to 68% of children with tuberculosis. The presence of CIC was observed to vary with the type of tuberculosis. The percentage positivity was highest (100%) in children with miliary tuberculosis. Subsequent estimation of CIC done after one and three months of antitubercular therapy showed a marked decrease in the percentage of positive cases (6.1 and zero percent respectively).

Prognostic value of 'C' reactive protein in tuberculosis.

'C' reactive protein (CRP) levels were determined in 100 cases of tuberculosis and 30 age and sex matched children. Serial estimations, one and 3 to 6 months after initiation of therapy was done in 81 and 41 of these patients, respectively. Mean initial levels of CRP in tuberculosis group was 18.52 micrograms/ml while in the control group it was 2.77 micrograms/ml (p less than 0.001). The elevated CRP levels fell significantly to 5.93 micrograms/ml after one month of treatment (p less than 0.001) and by 3 to 6 months of treatment had fallen to normal values. The fall in CRP levels correlated with clinical response. It is concluded that CRP can serve as a sensitive indicator of activity of the disease and the return to normal values of initially elevated CRP levels may indicate a good therapeutic response.