Coinfection by human immunodeficiency virus, hepatitis B virus and hepatitis C virus in injecting drug users.

Detection of hepatitis B surface antigen (HBsAg), anti hepatitis C virus (HCV) antibody and anti human immunodeficiency virus (HIV) antibody was carried out in serum samples from 250 injecting drug users (IDUs) from a deaddiction centre, Shalom, in Churachanpur district, Manipur during the period of August-October, 2002. One hundred and forty-nine (59.6%) IDUs were positive for HIV antibody, 226 (90.4%) were positive for anti HCV antibody and 27 (10.8%) were positive for HBsAg. There was coinfection of HIV, hepatitis B virus (HBV) and HCV in 15 (6%) of the IDUs. The coinfection of HBV and HCV was found in 12 cases (4.8%) and coinfection of HIV and HCV was found in 131 cases (52.4%). HIV and HCV were the highest among the coinfection of IDUs. The IDUs were in sexually active age group with a risk of infection to their sexual partner.

A comparative study of fluorescent microscopy with Ziehl-Neelsen staining and culture for the diagnosis of pulmonary tuberculosis.

BACKGROUND: For developing countries with a large number of cases and financial constraints, evaluation of rapid and inexpensive diagnostic methods has great importance. The bacilli in the sputum can be detected microscopically by ZN stain and fluorochrome stain. OBJECTIVES: To study the efficacy of fluorescence microscopy in the diagnosis of pulmonary tuberculosis in comparison to Ziehl-Neelsen staining and culture of sputum samples from patients suspected of pulmonary tuberculosis. MATERIALS AND METHODS: 306 sputum samples collected from 102 patients suspected of pulmonary tuberculosis were processed by the Petroff's method, and subjected to Ziehl-Neelsen staining (ZN), fluorescent Auramine-O staining (AO) and culture on modified Lowenstein-Jensen media (gold standard) for detection of Mycobacterium tuberculosis. Positive smears were graded according to Forbes BA et al, and culture isolates were biochemically tested for confirmation of species. RESULTS: Out of 102 patients, 44.1%, 71.6% and 70% were found positive by ZN, AO and culture respectively. AO was found to be superior to ZN on several aspects. The difference in their case detection rates was statistically significant (chi(2) = 24.93, p < 0.001). AO was also able to detect more pauci-bacillary cases than ZN. There was more agreement between culture and fluorescence microscopy (95.1%) than with ZN microscopy (69.6%). The percentage of false negative by AO staining was only 2.78% which was in sharp contrast to that of ZN (40.27%). CONCLUSION: The better case detection rates of AO over ZN were comparable to those found by several studies. Since screening was done under lower power of magnification (400x), fluorescence microscopy has been found to be less time consuming as compared to ZN method (1000x) in the diagnosis of tuberculosis. The tubercle bacilli stood out as bright objects against a dark background in fluorescence microscopy which makes them easily identifiable hence causing less eye-strain. The efficacy of fluorescence microscopy proved to be much higher than conventional light microscopy and comparable to that of culture.

Co-infection by human immuno deficiency virus, hepatitis B and hepatitis C virus in injecting drug users.

Injecting drug users (IDUs) are at risk of parenterally transmitted diseases such as hepatitis B virus (HBV) hepatitis C virus (HCV) and human immunodeficiency virus (HIV) infections. The present study was undertaken to find out the prevalence of HIV infection, HBV infection and HCV infection among IDUs of a deaddiction centre. Serum samples from 250, injecting drug users (IDUs) from a de-addiction centre were screened for HBsAg using immunochromatography, anti HCV antibody by 3rd generation ELISA test and anti HIV antibody by ELISA test and immunochromatographic rapid test during the period August to October 2002. One hundred and forty-nine (59.6%) IDUs were positive for HIV antibody, 226 (90.4%) were positive for anti HCV antibody and 27 (10.8%) were positive for HBsAg. There was co-infection of HIV, HBV and HCV in 15 (6%) of the IDUs. The Co-infection of HBV and HCV were found in 12 cases (4.8%) and Co-infection of HIV and HCV was found in 131 cases (52.4%). The IDUs were in sexually active age group with a risk of infection to their sexual partner. There is high prevalence of HCV and HIV infection and co-infection of both viruses among IDUs. Comprehensive public health interventions targeting this population and their sexual partners must be encouraged. Increase coverage of needle, syringe exchange programme (NSEP) to young and new IDUs is required before they are exposed to blood borne viruses.

Helminthic infestation of the primary school-going children in Manipur.

A total of 1010 stool samples collected from the primary school-going children between the age group of 5 to 10 years from September 1998 to October 2000, were studied to find out the prevalence of intestinal helminths in this paediatric age group and in the urban and rural areas of Manipur. The samples were processed in the Microbiology Department, RIMS, Imphal by wet film, iodine preparation and concentration techniques (formol-ether concentration) to find out the presence of eggs, larvae of the intestinal parasites (helminths). A total of 248 (24.5%) were positive for various helminths. Among the positive cases, 110 (26.3%) were from the urban area (city) and 138 (23.4%) from the rural areas of Manipur. Of the 552 males and 458 females tested, 136 (24.6%) males and 112 (24.5%) females respectively were positive for various helminths. Maximum number of parasitic infection occurred in the age group of 5 to 6 years (27.0%) in both sexes. Among the parasites, Ascaris lumbricoides was the commonest (19.6%) followed by Trichuris trichiura (2.18%), Hymenolepis nana (0.99%), Tapeworm (0.19%), Hookworm (0.09%), Strongyloides stercoralis (0.09%), Enterobius vermicularis (0.09%). Mixed infection of Ascaris lumbricoides with T. trichiura (1.08), T. trichiura with E. vermicularis (0.09%) and T. trichiura with S. stercoralis (0.09) were also encountered. Antihelminthic drugs were prescribed to those who were found positive for the helminths.