[Scalds in children caused by water from toppled electrical kettles. Mechanisms, costs and preventive measures]. / Skoldninger hos børn forårsaget af vand fra vaeltede elektriske kogekar. Ulykkesmekanisme, omkostninger og forebyggende indsats.

Since 1988 a new type of burns in children has been recorded at the Burns Centre at Hvidovre Hospital in Copenhagen, being scalds caused by water from toppled electrical kettles (el-kettles). The children with el-kettle scalds were younger and their injuries more severe than those of children whose scalds had other causes. During the six year period 1988 to 1993, a total of 29 children (0-3 years) have been admitted with scalds caused by el-kettles, 15 children alone in 1993. The costs for treatment have been more than 3 million Danish kroner, 1.8 million DKK alone in 1993. From 1993 preventive measures were taken to reduce the number of this type of scalds. Since the number of households with el-kettles in Denmark is on the increase, an increasing number of toddlers with severe scalds could be anticipated. However, a fall in the number of children admitted was registered in 1994 (four children) and 1995 (six children).

[Treponemal infection among children in Ramotswa, Botswana. A serological study]. / Treponemal infektion blandt børn i Ramotswa, Botswana. Et serologisk studie.

In Botswana in southern Africa, an area with a high prevalence of syphilis, non-venereal treponematoses used to be prevalent. In the present study sera from 136 children (0-18 years) were analysed to evaluate whether infection with non-venereal treponematoses during childhood could explain the high prevalence of treponemal seropositivity found in adults. In the age group 0-14 years, seropositivity was demonstrated in one (1%) of 87 children, compared to 10 (20%) of 49 children in the age group 15-18 years, a statistically significantly higher prevalence. All cases of seropositivity were due to active infection. The local laboratory in Botswana failed to diagnose four (36%) of the 11 cases of active syphilis when the VDRL-test alone was used. We conclude that no serological indication of non-venereal treponematoses were found in the examined children, and that syphilis was the cause of the high prevalence of treponemal infection among the sexually active adults in Botswana. It is recommended that both the VDRL-test and the TPHA-test are used in screening for syphilis in Botswana. Sexually transmitted disease-campaigns directed at the youth in Botswana should have high priorities.

Burn injuries caused by fireworks: effect of prophylaxis.

During the New Year 1991-92, a total of 17 patients with burns caused by fireworks (an unprecedentedly high number) were admitted to the two Danish burns units. They were all males and all had carried the causative firework in their clothes; 88 per cent were minors, and 87 per cent of these had bought their fireworks themselves in ordinary shops. Fireworks described as 'whistles' were responsible in 88 per cent of the cases. Appeals to the authorities resulted in a change of the legislation in November 1992, allowing only whistles equipped with safety fuses. Altogether 25 tons of unauthorized fireworks were confiscated and destroyed before January 1993. Campaigns were conducted at all schools and in the media in November and December 1992 and 1993, giving information about the dangers of carrying fireworks close to the body. During the New Year 1992-93, only four children were admitted with firework burns; the number of patients was significantly lower than in the preceding New Year, as was also the extent of their burn injuries. Furthermore, the patients were all younger than the age group targeted by the school campaign. The following New Year 1993-94, only three children were admitted with minor burns caused by fireworks, confirming the effect of the prophylactic actions. We conclude that the prophylactic actions were effective enough to reduce the number and severity of burn injuries caused by fireworks.

[HIV infection, syphilis and genital diseases in Maun, Botswana]. / HIV-infektion, syphilis og genitale laesioner i Maun, Botswana.

The prevalence of HIV-infection was studied in a district hospital in Botswana, in southern Africa. Sera from 466 patients were analysed. The sexually transmitted diseases (STD) group consisted of 175 women and 178 men, who consulted the STD-clinic for complaints which could be attributed to STD or infertility and the antenatal clinic (ANC) group consisted of 113 pregnant women, who attended routine ANC. Sera were analysed with HIV-ELISA, and 3% were positive. All sera were negative in Western blot and were considered false-positive in HIV-ELISA. In the STD group, 42% of the women and 39% of the men, were seropositive for syphilis, while 41% were positive in the ANC group. The figures for clinically demonstrated genital lesions were 33%, 60% and 13%, respectively. It is concluded that HIV-infection is a new disease in Botswana, and that the prevalence is still low in the rural population examined in the present survey.

Enzyme-linked immunosorbent assays for detection of immunoglobulin M to nontreponemal and treponemal antigens for the diagnosis of congenital syphilis.

Sera from newborn infants born of mothers with a high risk of syphilis were examined for immunoglobulin M (IgM) antibodies in two different enzyme-linked immunosorbent assays (ELISAs), using either purified flagella from Treponema phagedenis biotype Reiter or the Venereal Disease Research Laboratory (VDRL) antigen as the antigen. All sera were also examined by the fluorescent treponemal antibody absorption (FTA-ABS) test for IgM. Three different groups of patients were studied. Group 1 consisted of 84 women and their newborn infants from a high-risk population for syphilis. Congenital syphilis was diagnosed in one child who had an IgM-positive cord blood specimen in both the ELISA and the FTA-ABS test. Group 2 consisted of 10 mothers and their newborn children. All mothers had positive syphilis-screening tests, and all children had signs of congenital syphilis. All but one child had positive IgM tests. Group 3 consisted of 15 mothers and their newborn children. These mothers had been treated for syphilis late in pregnancy, and all had a positive screening test at delivery. Two of the children had positive IgM tests, probably caused by reactivity after late intrauterine treatment of congenital syphilis. The specificities of the IgM tests were high when evaluated with sera from newborn children without signs of congenital syphilis. Even though IgM rheumatoid factor was found in all of the children tested with definite congenital syphilis, the rheumatoid factor did not cause false-positive results in either the VDRL ELISA or the flagellum ELISA. No significant IgG-IgM competition was noticed in the ELISAs. This study also confirmed that IgA antibodies do not cross the placenta; most newborn children with congenital syphilis were positive in the VDRL ELISA for IgA. Both the VDRL ELISA and the flagellum ELISA are very useful in the diagnosis of congenital syphilis and may be substitute for the FTA-ABS test. The VDRL ELISA for IgM will be especially useful in developing countries with a high incidence of congenital syphilis.