Oocyst ingestion as an important transmission route of Toxoplasma gondii in Brazilian urban children.

Toxoplasmosis is a cosmopolitan protozoan infection. Data regarding risk factors for the post-natal acquisition of Toxoplasma gondii infection in childhood are limited. We conducted a serological survey for T. gondii IgG antibodies and associated risk factors in 1,217 children 4-11-yr-old from Salvador, Brazil, using a commercial ELISA kit; antibodies were found in 17.5% of the children. Age (OR  =  2.18; 95% CI: 1.50-3.17) and maternal schooling level (OR  =  0.62; 95% CI: 0.42-0.92) were negatively associated with infection. A greater number of siblings (OR  =  1.53; 95% CI: 1.12-2.09), cat at home (OR  =  1.54; 95% CI: 1.06-2.24), house with non-treated piped water (OR  =  2.54; 95% CI: 1.22-5.31), and the absence of a flush toilet at home (OR  =  1.45; 95% CI: 1.04-2.01) were positively associated with T. gondii infection. Our data suggest that low socioeconomic levels and poor hygiene habits are important factors in favoring T. gondii infection.

Investigational drugs for treatment use: an avenue of hope for minority populations.

The Food and Drug Administration in its efforts to facilitate the drug approval process so that promising treatments may be offered to seriously ill or dying patients has established an innovative regulation, commonly known as the Treatment Investigational New Drugs (TIND). The benefits of this new policy should prove to be particularly appealing to black Americans. Traditionally blacks, due to numerous social, political, economic, and cultural factors, have had the poorest health status of any other population in the United States. The implementation of strategies to eradicate such factors will ultimately provide considerable improvement of the health status of blacks. Until then, the utilization of the TIND may prove to be one of the most significant influences in the advancement of our health care. Barriers to the use of the TIND regulation in the black community must be addressed as well.

Beta blockers, hypertension, and blacks--is the answer really in?

It has been reported that beta blockers are not effective antihypertensives in black populations. A review of the literature revealed that, for the most part, studies drawing this conclusion were of small sample size, lacked controls, and did not represent the demographics of the US black population. The largest US study (Veterans Administration Cooperative Study) showed propranolol to be effective in at least one half of the black patients, with white patients responding better, but diuretics were more effective in both races. More recent studies show beta blockers with alpha-antagonistic properties to be effective in black hypertensives. The question is raised whether enough data have been analyzed to suggest these drugs are ineffective for black hypertensives.