ABSTRACT
The purpose of this study was to determine if Mycobacterium leprae is an opportunistic pathogen in immunosuppressed subjects with HIV infection. Ninety six leprosy patients at Infectious Diseases Hospital (IDH), Nairobi were screened for, HIV-1 antibody between January 1991 and June 1992. The patients included 15 who were diagnosed during the study period and 81 who were previously diagnosed and were on anti-leprosy treatment. Blood was screened for HIV antibody by first ELISA and double positive samples were confirmed by a second ELISA. The HIV seronegative patients were re-tested serologically every 3 months. Smears from skin slits were used to determine bacterial index and the patients were classified according to criteria described by Ridley and Jopling. The patients were re-assessed clinically monthly. The mean age of the patients was 40 years and ranged from 13 to 78 years. Forty seven percent had paucibacillary and 53% had multibacillary leprosy. The HIV seroprevalence was 8% in previously diagnosed patients and zero in the newly diagnosed patients. There were no changes in clinical spectrum in HIV seropositive patients during follow up period; neither reversal reactions nor erythema nodosum leprosum were observed. The study suggests that M. leprae may not be an opportunistic pathogen in immunosuppressed subjects with HIV infection.
Subject(s)
AIDS-Related Opportunistic Infections/epidemiology , HIV Seroprevalence , HIV-1 , Leprosy/epidemiology , AIDS-Related Opportunistic Infections/microbiology , Adolescent , Adult , Aged , Enzyme-Linked Immunosorbent Assay , Female , Follow-Up Studies , Humans , Kenya/epidemiology , Leprosy/microbiology , Male , Mass Screening , Middle Aged , Urban HealthABSTRACT
Clinical findings in 54 consecutive negroid children with atopic dermatitis (AD) are presented. The age range was 0.25 to 10.25 years. Male:Female ratio was 1.2:1. Time of onset range between 1 week and 8 years with onset before the age of 1 year in 81.1%. Facial and flexural involvement were observed in 81.5% and 70.4% of patients respectively. The latter was more common after the age of two years. Keratosis pilaris, repeated skin infections and ichthyosis were observed in 72, 45, and 40 per cent of the children. Allergic conjunctivitis was present in 11.8%. The findings suggest that the clinical presentation of AD in Negroid children is similar to that in white children.
Subject(s)
Black People , Dermatitis, Atopic/diagnosis , Age Factors , Case-Control Studies , Child , Child, Preschool , Dermatitis, Atopic/epidemiology , Dermatitis, Atopic/etiology , Female , Humans , Incidence , Infant , Infant, Newborn , Male , Risk FactorsABSTRACT
There is little published literature on the effects of skin contactants during early infancy on eventual development of atopic dermatitis (AD). The purpose of this study was to determine whether or not a relationship exists between the use of skin care products in early infancy and the subsequent development of AD. We studied a group of 54 Kenyan children with AD and 63 age and sex matched controls. Emollients had been used to lubricate the skin during early infancy in a similar proportion of children in both groups (odds ratio = 0.33; 95% CI = 0.14, 0.80). Similarly, no association was found between the use of toilet soaps or laundry detergents in early infancy and development of AD. These findings suggest that baby soaps and vaseline petroleum jelly can safely be used in the skin care of AD susceptible individuals.
Subject(s)
Dermatitis, Atopic/chemically induced , Detergents/adverse effects , Emollients/adverse effects , Soaps/adverse effects , Breast Feeding , Case-Control Studies , Child , Child, Preschool , Humans , Infant , LaunderingABSTRACT
41 patients out of 804 registered lepromatous (LL) and borderline lepromatous (BL) patients were studied for possible dapsone resistance by series of biopsy specimens, skin smears and clinical examination. These patients were drawn from a pool of 4384 registered leprosy patients in the west Kenya Leprosy Control Project area. Six out of fourty one cases (14.6%) were confirmed as dapsone resistant by series of biopsy specimens taken when patients were on supervised dapsone therapy; 11 patients (26.8%) were suspected to be resistant and 24 patients (58.6%) responded well to dapsone therapy. All the confirmed cases were lepromatous leprosy cases. We therefore found that there is dapsone resistance here with a maximal prevalence rate of 7 per 1000 in all lepromatous cases and 14.6% in clinically suspicious cases.
Subject(s)
Dapsone/therapeutic use , Leprosy/drug therapy , Drug Resistance, Microbial , Humans , KenyaSubject(s)
Leprosy/epidemiology , Adolescent , Adult , Child , Cross-Sectional Studies , Female , Humans , Kenya , MaleABSTRACT
The efficacy of a single 2.5-g dose of thiamphenicol against infection with penicillinase-producing strains of Neisseria gonorrhoeae (PPNG) or non-penicillinase-producing strains (non-PPNG) was studied in a two-phase clinical trial in Nairobi. The first phase included men who had had a urethral discharge for less than seven days, were infected with either PPNG or non-PPNG, and had not received previous treatment. The second phase included men with PPNG infections that had not responded to treatment with penicillin. The overall cure rate (determined by follow-up examinations and cultures three and ten days after treatment) was 90.6% in the first phase of the study and 92.1% in the second phase. A second 2.5-g dose of thiamphenicol was administered to four of the six patients in the second phase whose cultures yielded gonococci after the initial dose; the infections of all four patients were cured. The results of disk diffusion tests of gonococcal isolates did not correlate well with the outcome of treatment.
