Mycoplasma pneumoniae infection in Yemen: incidence, presentation and antibiotic susceptibility.

To determine the incidence, clinical presentation and antibiotic susceptibility of Mycoplasma pneumoniae at the main hospitals in Sana'a, we studied 405 patients clinically and radiographically diagnosed with lower respiratory tract infections aged 10-60 years. M. pneumoniae was identified by 3 different methods: culture, antigen detection and IgM serology. Antibiotic susceptibility testing was performed for confirmed isolates by macro-broth dilution technique. There were 125 patients (30.9%) with current infection, mostly among younger age groups, with bronchopneumonia the most common underlying clinical condition. All tested isolates were susceptible to all antibiotics in the in vitro antibiogram, with erythromycin the most active. The results indicate the need for different approaches in the diagnosis of M. pneumoniae infection in Yemen.

Mycoplasma pneumoniae infection in Yemen: incidence, presentation and antibiotic susceptibility

To determine the incidence, clinical presentation and antibiotic susceptibility of Mycoplasma pneumoniae at the main hospitals in Sana'a, we studied 405 patients clinically and radiographically diagnosed with lower respiratory tract infections aged 10-60 years. M. pneumoniae was identified by 3 different methods: culture, antigen detection and IgM serology. Antibiotic susceptibility testing was performed for confirmed isolates by macro-broth dilution technique. There were 125 patients [30.9%] with current infection, mostly among younger age groups, with bronchopneumonia the most common underlying clinical condition. All tested isolates were susceptible to all antibiotics in the in vitro antibiogram, with erythromycin the most active. The results indicate the need for different approaches in the diagnosis of M. pneumoniae infection in Yemen

A study of 235 cases of human brucellosis in Sana'a, Republic of Yemen.

We studied the clinical characteristics of brucellosis among all patients with brucellosis referred to the Central Health Laboratory from the main hospitals in Sana'a during a 2-year period (1992-93) (235 adults and children). A history was taken from each patient and clinical examination, general laboratory tests and brucellosis laboratory tests carried out. The overall clinical picture of brucellosis in this study is very similar to that reported by other workers in this geographical area. Awareness of the presenting features and the realization that brucellosis should be part of the differential diagnosis of febrile patients with enlarged liver, spleen and lymph nodes will lead to an increasing index of suspicion for this disease.

A study of 235 cases of human brucellosis in Sana'a, Republic of Yemen

We studied the clinical characteristics of brucellosis among all patients with brucellosis referred to the Central Health Laboratory from the main hospitals in Sana'a during a 2-year period [1992-93] [235 adults and children]. A history was taken from each patient and clinical examination, general laboratory tests and brucellosis laboratory tests carried out. The overall clinical picture of brucellosis in this study is very similar to that reported by other workers in this geographical area. Awareness of the presenting features and the realization that brucellosis should be part of the differential diagnosis of febrile patients with enlarged liver, spleen and lymph nodes will lead to an increasing index of suspicion for this disease

Risk factors for human brucellosis in Yemen: a case control study.

Brucellosis is known to occur in Yemen but its epidemiology has not been extensively studied. The present investigation examined risk factors for human brucellosis in Yemen using a hospital-based case-control study. A total of 235 consecutive patients with brucellosis attending the Central Health Laboratory in Sana'a, Yemen, were matched in respect of age, sex, and place of residence, rural or urban, with 234 controls selected from individuals attending the Central Health Laboratory for unrelated health problems. Clinical information on patients and controls was supplemented with occupational and socio-economic data obtained by interview of cases and controls using a standard questionnaire. After controlling for confounding factors significant risk factors for infection related to occupation as a farmer (OR 2.5 (95% CI 1.4-4.5, P < 0.0001)), shepherd (OR 7.8 (95% CI 1.0-61, P 0.05)) or microbiologist (OR 24.5 (95% CI 2.9-204, P 0.003)); and drinking fresh milk (OR 2.0 (95% CI 1.3-4.3, P 0.001)) and laban (OR 22.7 (95% CI 1.7-4.2 P < 0.0001)). Taking other milk products and offal were not risk factors. Socio-economic and educational factors were also independent risk factors. Occupational, food and socio-economic risk factors significantly confounded one another. Yemen shares some but not all of the risk factors of neighbouring countries. The interrelation between the various factors is complex and studying any one in isolation may give a false impression of its public health significance. Control through education of the population to minimize exposure to, and contact with, animals and their milk and milk products and to boil milk before drinking it or using it to make buttermilk, would be difficult as these would represent such fundamental changes to established patterns of behaviour of this society. Ideally there would be a campaign to control the infection by animal vaccination but the costs and logistic difficulty would be great. Presently there is a clear need for doctors in Yemen to be made aware of the frequency of this infection, the means available for clinical and laboratory diagnosis and effective treatment, while strategies to control the disease in Yemen are formulated and field tested.

Enzyme-linked immunosorbent assay for brucella antigen detection in human sera.

A sandwich enzyme-linked immunosorbent assay (ELISA) with monoclonal antibody coupled to the solid phase was evaluated for the detection of brucella antigen in serum samples. Under optimum conditions, 100 brucella cells/well or 10(5) fg/ml of lipopolysaccharide (LPS) were detected in spiked specimens. The standardised assay was performed on 1607 sera from random blood donors, 146 patients with brucellosis, 20 persons in high risk groups and 264 sera from patients with diseases other than brucellosis. Sensitivity was 100% compared with positive blood culture, and 44% compared with serological tests for brucella antibodies. Specificity was 99.5% among random blood donors and 99.2% in the patient population. These data showed a strong agreement between ELISA antigen detection and blood culture for the detection of brucella positive blood samples. Moreover, the results indicated that antigen detection by ELISA could be an acceptable alternative to blood culture for the diagnosis of brucellosis.