Serologic classification of acute viral hepatitis at San Lazaro Hospital, Manila, Philippines.

Sixty-four out of 189 jaundiced patients at San Lazaro Hospital were defined as acute viral hepatitis cases. Of this number, 22 (34.4%) were positive for hepatitis A markers while 26 (40.6%) were positive for hepatitis B markers. Hepatitis D infection accounted for 1.6%, while non-A, non-B hepatitis accounted for 21.9%.

Symptoms associated with diarrhoeal illness at San Lazaro Hospital, Manila in 1983 and 1984.

The clinical features associated with various agents of diarrhoeal disease were studied using 2,836 patients admitted to San Lazaro Hospital, Manila. Three general patient groups were considered including single pathogen isolations, "multiple pathogen" isolations, and "no pathogen" isolations. In general, symptoms of diarrhoeal illness were found to be non-specific. However, Shigella flexneri. Vibrio parahemolyticus, and rotavirus were significantly associated with a number of prominent symptoms and could sometimes be predictably diagnosed on clinical grounds, especially when age of the patient was considered. Clinical diagnosis cannot be considered an adequate substitute for laboratory methods; other enteric pathogens can sometimes present with the same symptoms. When appropriate laboratory testing is unavailable, as is often the case in developing countries, symptomatologic diagnosis may be of limited value for the organisms mentioned.

Comparison of washed and unwashed specimens in the Plasmodium falciparum in vitro microculture drug assay.

The dose response of Plasmodium falciparum isolates in the standard in vitro assay for drug resistance was compared using blood specimens which were centrifuged and washed before cultivation. Washing of the cultures increased the success of cultivation by greater than 100%. Eight cultures which grew using both methods gave similar results in the determination of resistance or sensitivity. The ED50 as determined by probit analysis, was approximately 50% higher in parasites which had been washed before cultivation.

In vitro drug response of Plasmodium falciparum in the Philippines: increased resistance to amodiaquine.

A long term study was carried out at San Lazaro Hospital, Manila, Philippines, monitoring the in vitro response of Plasmodium falciparum to chloroquine, amodiaquine, mefloquine, and quinine. The in vitro effective dose giving 50% inhibition of schizogony was: 0.68 X 10(-6) M/liter blood for chloroquine; 0.18 X 10(-6) for amodiaquine; 0.2 X 10(-6) for mefloquine; and 1.12 X 10(-6) for quinine. The percent of isolates determined to be resistant in vitro was 85.2% for chloroquine, and 1.2% for both mefloquine and quinine. These figures were relatively unchanged over the course of 3 years studied. The in vitro resistance rate to amodiaquine increased from 5.1% in 1982 to 22.2% in 1984.

Cryptosporidiosis in Philippine children.

Cryptosporidiosis, a newly recognized parasitosis of humans is being identified with increased frequency in immunocompromised and more recently in immunocompetent persons with gastroenteritis and or diarrhea. It has been found in the Philippines for the first time in children seen at the San Lazaro Hospital in Manila. A total of 735 stool specimens from adults and children with diarrhea were examined by the Ziehl-Neelson and Kinyoun acid-fast methods and 2.9% of the children 6 to 20 months of age were found passing Cryptosporidium oocysts. This parasitic infection should be considered in the differential diagnosis of cases of diarrhea in both immunodeficient and immunocompetent persons.

Comparative study of three blood culture systems for isolation of enteric fever Salmonella.

Eight hundred blood cultures were tested in parallel in three conventional systems: tryptic soy broth containing 0.05% sodium polyanethosulfonate (TSB-SPS), whole blood in bile (BILE-BLOOD), and blood clots in bile (BILE-CLOT). Sixty-eight cultures were Salmonella typhi positive and 29 were positive for S. paratyphi A in at least one of the systems. Analysis of the isolation rates of the 97 Salmonella-positive specimens showed that BILE-BLOOD was significantly more sensitive (p less than 0.05) than either TSB-SPS or BILE-CLOTS, and that the latter two were not significantly different. The time required for positive results was shortest in BLOOD-BILE which was significantly quicker than BILE-CLOTs (p less than 0.05), but not TSB-SPS (p greater than 0.05). Possible explanations for the observed, superior performance of the BILE-BLOOD system are discussed and recommendations for efficient recovery of enteric fever salmonellae from blood are presented.

HLA antigens and malaria at San Lazaro Hospital Manila, Philippines.

Human leucocyte antigens (HLA) were used as genetic markers in an attempt to determine possible host genetic susceptibility or resistance to malarial infections. HLA-A and B typing on lymphocytes from 68 confirmed P. falciparum and 77 P. vivax cases was compared with that found in 66 control subjects with no known history of malaria. A significant deviation was observed in the distribution of HLA-B27. This phenotype was absent in the P. falciparum group although found present in the P. vivax group (10%) and the control group (11%). Also, the combination of A9(w24) and B5 was significantly higher among the P. falciparum group than that found in the P. vivax and control groups. These findings require confirmation but do suggest the possibility of genetic susceptibility and that extensive genetic studies might be worth investigating.