Hepatitis B vaccination in children infected with Schistosoma mansoni: correlation with ultrasonographic data.

Forty-one schoolchildren with positive stools for Schistosoma mansoni eggs and 39 age- and sex-matched children with negative stools were given 3 doses, 5 micrograms each, of a plasma derived hepatitis B vaccine. Their sera were examined 3 and 9 months after the third dose for hepatitis B surface antibody (anti-HBs). At 9 months after vaccination, both the number of responders and the mean of antibody titers were significantly higher in the control group than in the group infected with S. mansoni (97% vs. 56% and 334.8 +/- 192.9 vs. 67.7 +/- 74.4 mIU/ml). There was a negative correlation between anti-HBs titers and the long diameter of the spleen as well as between the titers and the long diameter of the spleen and the liver span in the mid-clavicular line (right lobe) taken together. There was also a positive correlation between anti-HBs titers and the diameters of the portal vein. There was no correlation between anti-HBs titers and any of the following 3 parameters: liver span in the mid-clavicular line (right lobe) alone, liver span in the middle line (left lobe) alone, and the degree of thickness of the periportal fibrosis. There was also no correlation between anti-HBs titers and egg counts in the stools. An interpretation of these findings was made in the light of the role of phagocytic activity of the liver and spleen as well as of porta-caval shunts in the immune mechanism.

Mother-to-child transmission of hepatitis B virus in a semirural population in Egypt.

A follow-up study for one year was made on 35 babies born to HBsAg positive mothers in a semirural population in Egypt. Five of 21 babies (24%) showed HBsAg in the umbilical cord blood and remained positive throughout the observation period. At 3 months, eight of 37 babies (23%) were HBsAg + ve. At 6 months, 13 of 35 babies (37%) were HBsAg + ve and they were also still found positive at 12 months. None of 30 babies born to HBsAg-ve mothers developed antigenaemia throughout the observation period. Factors which significantly contributed to transmission were maternal educational level, family socio-economic standard, family residence, maternal e/anti-e status, and maternal schistosomal infestation. Factors which did not significantly affect transmission were maternal age, maternal parasitic non-schistosomal infestations, maternal transaminases level, order of the child in the family, and type of child feeding. Of particular note, four of five babies (80%) born to HBsAg + ve mothers who as well had schistosomiasis were HBsAg + ve throughout the observation period.

Knowledge and attitudes towards premarital counselling and examination.

Premarital counselling and examination have begun to play a very important role in the management of many genetic disorders. 600 villager's knowledge and attitudes toward premarital counselling and examination in Menofia Governorate was studied in order to predict the community acceptance and behaviour toward utilization of such service. The result showed a big lack in knowledge even among educated respondents about the term. The main source of information was mass media followed by medical personnel who should participate more in this service. Most respondents, except unmarried males, have a favourable attitude toward either premarital counselling and examination or consanguinous marriage. This may be related to certain social changes in village life such as declining illiteracy, increased economic pressures, increase number of nuclear families and accordingly delay in beginning a family. It was unlikely that non-contraceptive users would resort to induced abortion rather to use contraceptive methods. Educational programs should be directed toward: (a) unmarried males so that their attitude toward premarital counselling and examination can be changed to correct direction, (b) unmarried females to make consanginous marriage more undesirable, and (c) non-contraceptive users to make them more intended to use safe contraceptive methods than induced abortion.

PIP: Premarital counseling and examination have begun to play a very important role in the management of many genetic disorders. 600 villagers knowledge and attitudes toward premarital counseling and examination in Menofia Governorate, Egypt was studied in order to predict the community acceptance and behavior toward utilization of such service. The results showed a big lack of knowledge even among educated respondents about the term. The main source of information was mass media followed by medical personnel who should be more involved in this service. Most respondents, except those unmarried males, have a favorable attitude toward both premarital counseling and examination of consanguineous marriage. This may be related to certain social changes in village life such as declining illiteracy, increased economic pressures, increase in the number of nuclear families, and a subsequent delay in beginning a family. It was unlikely that noncontraceptive users would resort to induced abortion instead of contraceptive methods. Educational programs should target: unmarried males so that their attitude towards premarital counseling and examination can be altered to change direction; unmarried females in order to deter them from consanguineous marriage; and noncontraceptive users to make them choose safe contraceptive methods rather than induced abortion.