ABSTRACT
To determine the incidence of chronic nephritis after poststreptococcal acute glomerulonephritis in Trinidad, 760 patients (41 adult) were examined two to six years after recovery from the illness, 344 being studied twice (four and six years). Only 1.8 per cent had persistent urine abnormalities on their last follow-up examination, and another 8.0 per cent had abnormalities that were transient or occurred only after the patient had assumed the lordotic position. In 1.4 per cent hypertension was present, whereas only one had azotemia. Both persistent urine abnormalities and hypertension increased in prevalence with age at onset of prior poststreptococcal glomerulonephritis but did not vary between sexes, races or epidemic versus endemic forms. Half the urine abnormalities present four years after recovery were absent two years later. Thus, poststreptococcal acute glomerulonephritis appears to have a low incidence of chronicity in Trinidad, with continuing resolution for more than four years.
Subject(s)
Glomerulonephritis/etiology , Streptococcal Infections/complications , Acute Disease , Adolescent , Adult , Child , Child, Preschool , Chronic Disease , Disease Outbreaks/epidemiology , Female , Follow-Up Studies , Glomerulonephritis/epidemiology , Hematuria/complications , Humans , Hypertension/complications , Male , Prognosis , Proteinuria/complications , Streptococcal Infections/epidemiology , Time Factors , Trinidad and TobagoSubject(s)
Diphtheria/epidemiology , School Health Services , Skin Diseases, Infectious/epidemiology , Child , Corynebacterium diphtheriae/isolation & purification , Diphtheria/complications , Diphtheria/immunology , Diphtheria Antitoxin/analysis , Glomerulonephritis/epidemiology , Glomerulonephritis/etiology , Humans , Immunity, Active , Skin Diseases, Infectious/immunology , Skin Diseases, Infectious/microbiology , Streptococcal Infections/complications , Streptococcal Infections/epidemiology , Trinidad and TobagoSubject(s)
Glomerulonephritis/complications , Rheumatic Fever/complications , Antibodies , Antistreptolysin/analysis , Glomerulonephritis/immunology , Humans , Hyaluronoglucosaminidase/antagonists & inhibitors , Immunoglobulins/analysis , Rheumatic Fever/immunology , Skin Diseases/complications , Skin Diseases/immunology , Streptococcus/isolation & purification , Trinidad and TobagoABSTRACT
The relation of seven different M types of streptococci to acute glomerulonephritis associated with skin lesions in South Trinidad has been studied by means of type-specific antibody assays as well as by isolation and identification of the strains. The data indicate that, one after another, five of these strains have prevailed among patients with acute glomerulonephritis during the past five years. At least three of the strains (M-types 55, 49, 57, and/or 60) were associated with epidemic increases in nephritis cases. The appearance of five consecutively predominant types of nephritogenic streptococci during a relatively short period of time is in contrast to the continuing prevalence of M-type 12 strains among nephritogenic streptococci primarily associated with respiratory infections in temperate zones. These observations suggest that the skin sores commonly found on children in tropical Trinidad, provide a particularly suitable environment for development of nephritogenic types. It remains to be seen whether these types will recur or whether new types will continue to emerge in Trinidad.
