ABSTRACT
OBJECTIVE: To evaluate human immunodeficiency virus (HIV) serology, dietary iron and serum concentrations of markers of T-helper type (Th) 1 and Th-2 immune pathways in the setting of tuberculosis (TB). METHODS: A total of 49 patients with pulmonary TB in rural Zimbabwe, 32 of whom were HIV-positive, were evaluated at presentation and over 10 weeks of anti-tuberculosis treatment. RESULTS: Interleukin (IL) 12 and neopterin, Th-1 markers, were both elevated at presentation in 92% of the subjects. In contrast, only 23% had elevation of the Th-2 marker, IL-4. Neopterin and IL-6 concentrations decreased over 10 weeks of treatment (P Subject(s)
HIV Seropositivity/complications
, Th1 Cells/immunology
, Th2 Cells/immunology
, Tuberculosis, Pulmonary/immunology
, Adult
, Antitubercular Agents/therapeutic use
, Cytokines/immunology
, Female
, Humans
, Iron, Dietary/adverse effects
, Male
, Middle Aged
, Nitrates/metabolism
, Nitrites/metabolism
, Risk Factors
, Tuberculosis, Pulmonary/drug therapy
, Tuberculosis, Pulmonary/etiology
, Young Adult
, Zimbabwe
ABSTRACT
To determine whether increased dietary iron could be a risk factor for active tuberculosis, dietary iron history and human immunodeficiency virus (HIV) status were studied in 98 patients with pulmonary tuberculosis and in 98 control subjects from rural Zimbabwe. Exposure to high levels of dietary iron in the form of traditional beer is associated with increased iron stores in rural Africans. HIV seropositivity was associated with a 17.3-fold increase in the estimated odds of developing active tuberculosis (95% confidence interval [95% CI], 7.4-40.6; P<.001), and increased dietary iron was associated with a 3.5-fold increase (95% CI, 1.4-8.9; P=.009). Among patients treated for tuberculosis, HIV seropositivity was associated with a 3.8-fold increase in the estimated hazard ratio of death (95% CI, 1.0-13.8; P=.046), and increased dietary iron was associated with a 1.3-fold increase (95% CI, 0.4-6.4; P=.2). These findings are consistent with the hypothesis that elevated dietary iron may increase the risk of active pulmonary tuberculosis.
Subject(s)
Iron, Dietary/adverse effects , Tuberculosis, Pulmonary/etiology , Adult , Antitubercular Agents/administration & dosage , Antitubercular Agents/therapeutic use , Beer/adverse effects , Comorbidity , Female , HIV Seropositivity/complications , HIV Seropositivity/epidemiology , Humans , Male , Odds Ratio , Risk Factors , Rural Population , Tuberculosis, Pulmonary/drug therapy , Tuberculosis, Pulmonary/epidemiology , Zimbabwe/epidemiologyABSTRACT
A review of 262 histologically verified spinal cord tumours in Black Zimbabweans who were operated on in Harare Central and Parirenyatwa Hospitals, Harare, Zimbabwe during the period 1st January 1972 to 31st December 1991 is presented. Fifty one pc of the neoplasms were found in the thoracic region, 53.4 pc were found extradurally, and of these the majority were metastatic (52 pc) and malignant tumours (85 pc). Most (96 pc) intradural-extramedullary tumours were benign with Schwannomas as the largest group (54 pc). Malignant astrocytomas presented as 71.4 pc of all intramedullary tumours. Metastatic tumours represented 28.6 pc of all spinal cord tumours. The most common sites of metastasis were from liver, thyroid and prostate.
