[Analysis of different clinical criteria in malaria patients in Papua New Gwinea]. / Analiza wybranych elementów badania przedmiotowego i podmiotowego u chorych na zimnice w Papua Nowa Gwinea.

To assess the validity of different clinical criteria in malaria patients, a small study including 92 children presented with fever or history of fever were examined in a highly endemic area of Papua New Gwinea. In 21 children parasitaemia was confirmed by microscopy examination of thick and thin smear stained with Giemsa method (9 cases of Plasmodium falciparum, 8 cases of Plasmodium vivax and 4 cases of mixed invasion Plasmodium falciparum and Plasmodium vivax). Only 4 from different 39 criteria analyzed in children with history of fever or hot skin showed significant association with parasitaemia (conscious disturbances, severe wasting, enlarged spleen and diarrhoea), however none of the criteria presented high sensitivity and could serve as good predictors for parasitaemia accept two (first and second one). These findings help to realize the importance of laboratory examination in diagnosis of malaria and explain difficulties in confirming or exclusion of malaria where microscopy is not available.

Clinical and parasitological appraisal of patients with imported malaria.

The study group comprised 118 patients suspected of malaria who underwent an examination following their return to Poland from the tropical countries. Evaluation of the admitted patients was based on epidemiological, clinical and parasitological criteria. The obtained data allowed to confirm acute malaria in 20 patients (16.9%) and malaria in the past, in 32 patients (27.1%). In the remaining 65 patients (55.1%) we excluded malaria. Malaria caused by P. vivax was confirmed in 5 patients, by P. falciparum in 9 patients. A mixed invasion was diagnosed in 6 patients including: P. falciparum and P. vivax in 3 cases; P. vivax, P. ovale and P. malariae in 2 cases; P. falciparum, P. vivax and P. ovale in 1 patient. We noted no relationship between the severity of the clinical course and IFA results. It was found an atypical clinical course of malaria and diagnostic difficulties in patients who used chemosuppression for malaria prophylaxis.

[Toxoplasmosis in families. I. Detection of T. gondii invasion and serological appraisal]. / Toksoplazmoza srodowisk rodzinnych. I Wykrywanie inwazji i ocena serologiczna.

Toxoplasmosis was studied in 102 families, in which index-cases manifested the fully symptomatic course of the acquired lymphnodular toxoplasmosis, confirmed by presence of IgM and IgG class antibodies (ELISA, Vidas, BioMerieux). The index-cases (group A) provided a rational index of the acquired invasion or its late sequele in other families members. The studies were performed in 388 persons, originating from Wielkopolska region, including 102 patients of a group A and 286 of families members of group B (167 children and 221 adults). In group A patients (including 49 children and 53 adults) immunoserological studies detected IgM class antibodies in 68.7% of cases and IgG class antibodies in 94.1% patients. In 286 family members (group B), presence of IgM class antibodies was found in 12.2% and IgG class antibodies was found in 55.2% studied persons; clinical pathology was noted in 46 patients (16.3%) including 3 pregnant women. The obtained results point to the need of complex evaluation of family environments based on analysis of serological tests (including estimation of IgM and IgG class antibodies) and accompanied by clinical analysis of studied children and adults.

[Toxoplasmosis in families. II. Clinical analysis]. / Toksoplazmoza srodowisk rodzinnych. II. Analiza kliniczna.

Clinical and serological analysis was conducted on 102 families including index-cases of lymphonodular toxoplasmosis (102 patients-group A) and 286 family members (group B). The studies included a total of 388 persons (167 children and 221 adults), originating mainly from Wielkopolska region (West Poland). The lymphonodular form of toxoplasmosis represented the dominating pattern among adult cases but among children the clinical pathology pattern was variable: in 14 out of 49 children (group A) lymphadenopathy was not dominating sign and clinically signs and symptoms of central nervous system or organ of vision involvement prevailed; in 6 cases clinical pattern pointed to congenital toxoplasmosis and in 8 cases it indicated sequele of acquired toxoplasmosis. In group B, among 35 children with lymphadenopathy, 7 presented also neurological signs/symptoms, in 5 children the pattern suggested acquired neurotoxoplasmosis in 2 cases congenital form of toxoplasmosis. In 11 adults of the group, lymphonodular form of the disease was diagnosed. In both groups (A and B), the pattern lymphonodular toxoplasmosis was detected also in 5 pregnant women (1.3% of studied persons and 2.7% of all adults). Four of the pregnant women manifested active stage of the disease, confirmed by the presence of IgM class antibodies. Thus, among 286 family members clinical pathology was demonstrated in 46 patients (16.1%) and in 35 patients (12.2%) activity of the disease presented indications for a specialistic therapy.