RESUMO
Scrub typhus is common among patients with acute fever in rural areas of Thailand. The authors prospectively recruited patients with acute fever from provincial Thai army hospitals. Dot-ELISA test for scrub typhus was done in hospitals and then compared with standard immunofluorescent assay for diagnosis of scrub typhus. Among 178 patients, scrub typhus was diagnosed by immunofluorescent assay in 10 patients (5.61%). The incidence was high in the northeastern and northern regions. Dot-ELISA gave positive results in 4 of 115 patients, while immunofluorescent assay gave positive results in 6 patients (sensitivity = 66.7%). No false positive results of Dot-ELISA were found among 109 patients (specificity = 100%). All patients gave negative results for murine typhus and Thai tick typhus using immunofluorescent assay. Regarding this present study, Dot-ELISA for scrub typhus has a good sensitivity and specificity and can be used in rural hospitals. This test could be useful for diagnosis of scrub typhus in hospitals where immunofluorescent assay is not available.
Assuntos
Febre/etiologia , Orientia tsutsugamushi/imunologia , Infecções por Rickettsia/epidemiologia , Tifo por Ácaros/diagnóstico , Doença Aguda , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Anticorpos Antibacterianos/sangue , Antígenos de Bactérias/imunologia , Ensaio de Imunoadsorção Enzimática , Feminino , Febre/epidemiologia , Imunofluorescência , Hospitais Militares , Humanos , Incidência , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos , Infecções por Rickettsia/complicações , População Rural , Tifo por Ácaros/complicações , Tifo por Ácaros/epidemiologia , Sensibilidade e Especificidade , Tailândia/epidemiologia , Adulto JovemAssuntos
Infecções por HIV/complicações , Doenças do Sistema Nervoso Periférico/complicações , Doenças do Sistema Nervoso Periférico/epidemiologia , Adulto , Fármacos Anti-HIV/uso terapêutico , Contagem de Linfócito CD4 , Estudos Transversais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Doenças do Sistema Nervoso Periférico/tratamento farmacológico , RNA Viral/sangue , Tailândia/epidemiologiaRESUMO
HIV Associated Dementia (HAD) is a complication of HIV infection in developed countries and is still poorly defined in resource-limited settings. In this study we investigated the expression of the monocyte phenotype CD14CD16HLADR and the inflammatory profiles in monocytes supernatants by surface-enhanced laser desorption/ionization-time of flight (SELDI-TOF) mass spectrometry in a cohort of HAD and non-HAD Thai volunteers prior to the initiation of ARV. The CD14CD16HLADR phenotype was significantly increased in monocytes from HAD and non-HAD versus negative controls, but there was no difference in phenotype and in the secretion protein profiles between the two seropositive groups. In addition, monocytes supernatants from HAD and non-HAD did not induced apoptosis or cell death in brain aggregate culture. In conclusion it appears that HAD in Thai individuals has a different immunological profile then in North America cohorts.
Assuntos
Complexo AIDS Demência/patologia , Antígenos CD4/metabolismo , Infecções por HIV/patologia , HIV-1 , Monócitos/metabolismo , Complexo AIDS Demência/metabolismo , Adulto , Contagem de Linfócito CD4 , Linfócitos T CD4-Positivos/patologia , Estudos de Coortes , Ensaio de Imunoadsorção Enzimática/métodos , Feminino , Infecções por HIV/metabolismo , Humanos , Técnicas In Vitro , Masculino , Espectrometria de Massas por Ionização e Dessorção a Laser Assistida por Matriz , Estatísticas não Paramétricas , Tailândia/epidemiologia , Carga ViralRESUMO
High HIV-1 DNA (HIV DNA) levels in peripheral blood mononuclear cells (PBMC) correlate with HIV-1-associated dementia (HAD) in patients on highly active antiretroviral therapy (HAART). If this relationship also exists among HAART-naïve patients, then HIV DNA may be implicated in the pathogenesis of HAD. In this study, we evaluated the relationship between HIV DNA and cognition in subjects naïve to HAART in a neuro AIDS cohort in Bangkok, Thailand. Subjects with and without HAD were recruited and matched for age, gender, education, and CD4 cell count. PBMC and cellular subsets were analyzed for HIV DNA using real-time PCR. The median log(10) HIV DNA copies per 10(6) PBMC for subjects with HAD (n=15) was 4.27, which was higher than that found in subjects without dementia (ND; n=15), 2.28, p<0.001. This finding was unchanged in a multivariate model adjusting for plasma HIV-1 RNA levels. From a small subset of individuals, in which adequate number of cells were available, more HIV DNA was in monocytes/macrophages from those with HAD compared to those with ND. These results are consistent with a previous report among HAART-experienced subjects, thus further implicating HIV DNA in the pathogenesis of HAD.
Assuntos
Complexo AIDS Demência/etiologia , DNA Viral/sangue , HIV-1/genética , Complexo AIDS Demência/imunologia , Complexo AIDS Demência/virologia , Adulto , Terapia Antirretroviral de Alta Atividade , Contagem de Linfócito CD4 , Cognição , Feminino , Humanos , Leucócitos Mononucleares/virologia , Receptores de Lipopolissacarídeos/análise , Masculino , Receptores de IgG/análiseRESUMO
A large outbreak of group A Streptococcus (GAS) pharyngitis occurred among 285 cadets at the Chulachomklao Royal Military Academy, Nakhon Nayok between September 22 and 27, 1996. An epidemiologic investigation was conducted to determine the source of infection. It seemed that respiratory droplets were the mechanism of spread, although foodborne transmission could not be excluded. To assess the presence of the outbreak strain in the community, conventional serotyping and molecular typing by emm sequencing were performed. The results demonstrated the advantage of molecular typing compared to serotyping and suggested that the outbreak was caused by the same strain. Interestingly, the involvement of the causative emm79 strain, which is an uncommon type of GAS disease, in a large number of patients may imply the invasive potential of this organism.
