Pregnancy rates among female participants in phase I and phase IIA AIDS vaccine clinical trials in Kenya.

BACKGROUND: Female participants in AIDS candidate vaccine clinical trials must agree to use effective contraception to be enrolled into the studies, and for a specified period after vaccination, since the candidate vaccines' effects on the embryo or foetus are unknown. OBJECTIVES: To review data on female participants' pregnancy rates from phase I and IIA AIDS vaccine clinical trials conducted at the Kenya AIDS Vaccine Initiative (KAVI) and to discuss the challenges of contraception among female participants. DESIGN: Descriptive observational retrospective study. SETTING: KAVI clinical trial site, Kenyatta National Hospital and University of Nairobi, Kenya. SUBJECTS: Thirty nine female participants were enrolled into these trials. They received family planning counselling and were offered a choice of different contraceptive methods, as per the protocols. All contraception methods chosen by the participants were offered at the study site at no cost to the participant. RESULTS: Four women conceived during the study period when pregnancies were to be avoided. All four had opted for sexual abstinence as a contraceptive method, but reported having been coerced by their partners to have unprotected sexual intercourse. CONCLUSION: Abstinence is clearly not a reliable contraceptive option for women in developing-country settings. Effective female-controlled contraceptives, administered at the clinical trial site, may empower female participants to better control their fertility, leading to more complete clinical trial data.

Isolation of Toxoplasma gondii from goats with history of reproductive disorders and the prevalence of Toxoplasma and chlamydial antibodies.

The prevalence of antibodies to Toxoplasma gondii and Chlamydia psittaci was assessed in goats with a history of abortion, stillbirth and neonatal mortality. Antibodies were detected in 540 (30%) and 57 (3.2%) goats out of 1799 tested by indirect haemagglutination and complement fixation tests, respectively. Toxoplasma gondii was isolated for the first time in Botswana from 22 out of 81 sets (27.2%) of foetal tissues, maternal and foetal cotyledons and uterine tissues of goats which had previously aborted or given birth to stillborn or weak kids that died within two days of birth. These results implicate T. gondii and C. psittaci, but especially the former, to be associated with caprine reproductive problems and require appropriate control measures.

A severe case of contagious ecthyma in Tswana goats.

The first severe case of caprine contagious ecthyma (parapox) in Tswana goats is described from Botswana. Affected animals were indigenous adult Tswana goats. The case involved a flock of 12 goats of which 4 (33.3%) were very severely affected but none died. The lesions were confined to the head and included swollen lips, swollen submandibular lymph nodes, gingivitis, glossitis, ulceration on lip and gum mucosae and scab formation on ulcerated areas. No lesions were found on other parts of the body. This case was clinically indistinguishable from bluetongue.

Risk factors associated with the occurrence of bovine tuberculosis in cattle in the Southern Highlands of Tanzania.

A study was conducted in the Southern Highlands of Tanzania to determine the prevalence of bovine tuberculosis and the risk factors associated with the occurrence of the disease in cattle of different categories and in different climatic zones. The overall prevalence of the disease was 13.2%, and 51% of the herds tested contained reactor cattle. Assessment of risk factors was based on comparisons of the reactivity of the cattle in the single comparative intradermal tuberculin test (SCITT). Older cattle were more affected by the disease than yearlings and calves (p<0.0001). There were significant differences between male and female cattle (p<0.05) and between cattle with exotic blood compared to indigenous Short Horn Zebu (SHZ) cattle (p<0.05). The castrated bulls, often used for draught power, were more frequently (p<0.01) affected than the entire bulls, mainly used for breeding. Reactivity to tuberculin did not appear to be influenced by the reproductive status of the animal. The reactivity to tuberculin of pregnant cattle was not significantly different from that of the rest of the cows (p>0.05). However, significantly more (14.6%) lactating cattle reacted in the SCITT than did non-lactating cows (12.0%) (p<0.05). There was a highly significant difference (p<0.001) between reactivity in the SCITT among cattle grazing in the hot and dry lower lands (14.0%) and that in those grazing in the cool and wet highlands (8.7%).

Selenium-vitamin E responsive myopathy in farmed ostriches (Struthio camelus) in Botswana.

Four adult ostriches developed sudden onset paresis and were unable to stand up when disturbed. After treatment with selenium and vitamin E, one of the birds could stand and move normally. The others died and post mortem examination revealed pale patches in the thigh muscles. Histopathological examination showed degeneration of skeletal muscles as seen in nutritional myopathy. Serum selenium and vitamin E levels were low whereas aspartate aminotransferase and creatine kinase levels were very high. All remaining birds on the farm were given multimineral and vitamin E supplement and no more cases were seen.

Continuing presence of rinderpest virus as a threat in East Africa, 1983-1985.

The re-emergence of rinderpest virus in East Africa in 1979 caused widespread outbreaks of disease and subclinical infection throughout the region until mid-1983. Subsequent massive emergency vaccination campaigns have been successful in eliminating clinical rinderpest from Tanzania and preventing its spread southwards. Unfortunately the virus is still endemic in north-eastern Uganda and has recently caused epidemic outbreaks with high mortality in cattle in that country. In Kenya, buffaloes (Syncerus caffer) in and around the Masai Mara game reserve have developed antibodies to rinderpest virus as recently as late 1984. Although there have been no outbreaks of clinical disease in Tanzania or Kenya from April 1983 to the end of 1985 this serological evidence plus the increasing incidence of clinical outbreaks in Uganda indicate that rinderpest virus still threatens East Africa. The substantial aid which has been provided to the region for rinderpest control must be maintained.

Re-emergence of rinderpest as a threat in East Africa since 1979.

Following the success of the JP15 scheme and subsequent annual vaccination campaigns, East Africa was virtually free of rinderpest after the mid 1960s and the disease was considered beaten. However, economic difficulties have recently reduced the expensively maintained vaccine cover and the disease has reappeared throughout much of the region. In 1979 rinderpest was diagnosed in cattle in north eastern Uganda and caused considerable losses until finally brought under control in 1981. No field outbreaks of the disease in cattle have been seen in Kenya but there is serological evidence that the virus has recently infected unvaccinated sheep and goats and wild ungulates in that country. In 1982 rinderpest was confirmed in the laboratory as the cause of death of large numbers of buffaloes in northern Tanzania and implicated as the cause of a rinderpest-like disease of cattle which is reported to be still active in that area. Substantial aid is essential for further control and research if the virus is not again to become endemic in the region.