Complementary clinical effects of red complex bacteria on generalized periodontitis in a caucasian population.

OBJECTIVES: To relate five periodontopathogenic bacteria, including the red complex, to the severity, extent, and inflammation of the periodontal lesion in Caucasian patients with generalized aggressive and chronic periodontitis and to explore whether tobacco use is associated with a specific bacterial profile. MATERIALS AND METHODS: A cross-sectional and analytic study was conducted in patients with aggressive and chronic periodontitis. Data were gathered on socio-demographic and periodontal variables, and RH-PCR was used to determine subgingival bacterial profile. Linear and logistic regression analyses were performed. RESULTS: The study included 60 patients with aggressive and 123 with chronic periodontitis. Total red complex bacteria count was higher in aggressive periodontitis, mainly due to T. denticola (P = 0.015). In both periodontitis types, models showed an association between T. forsythia count and probing depth (B = 0.157, P = 0.030) and between T. denticola count and higher bleeding scores (B = 2.371, P = 0.027). Smoking did not affect the red complex bacteria count in either disease. CONCLUSIONS: The prevalence of red complex bacteria was similar between aggressive and chronic periodontitis, but their count was higher in the former. In both diseases, T. forsythia was associated with greater severity and T. denticola with more severe bleeding. Tobacco smoking was not associated with the presence of red complex bacteria in either disease.

Differential visibility of treponemal disease in pre-Columbian stratified societies: does rank matter?

Treponemal disease is known to be associated with the compromised community health of permanent village settlement. This association explains its high visibility in the village-based, arguably chiefdom level, agriculturalist societies of late prehistoric (AD 1300-1600) North America. Within chiefdom-level societies, health differences have often been demonstrated between mortuary-defined "elite" and "nonelite" individuals. This theoretically should predict status-based differences in treponemal disease visibility. The prediction is tested in a five-site osteological sample (N = 650) from the Dallas phase (AD 1300-1550), a simple mortuary-defined two-tiered presumptive chiefdom level maize agriculturalist socioeconomic context from lower east Tennessee. The Dallas phase results affirm a general pre-Colombian North American pattern of no sex differences and display comparable adult to subadult frequencies. The study also reveals that given a sufficient sample size, "elites" do indeed exhibit a significantly lower frequency of tertiary stage treponemal disease. This can be attributed to better baseline health, which has been previously demonstrated in this sample. It may also be affected by the mortuary inclusion of achieved status individuals whose good health may have facilitated sociopolitical advancement. Another pattern that emerged is an apparent young adult age bias in disease visibility. This suggests that tertiary treponemal disease morbidity may either directly or synergistically factor in early adult age at death. Future research will address the veracity of this association.

Skin and treponemal diseases among Asian domestic house-helpers in northern Saudi Arabia.

BACKGROUND: Asian domestic house-helpers in Saudi Arabia come from a different socioeconomic setting with a different disease pattern from that of their host country. This study reports the incidence of skin and treponemal diseases in this group seen at a referral hospital in northern Saudi Arabia. METHODS: The study was based on the analysis of the dermatologic and serologic examinations of 1520 domestic house-helpers during resident permit issue, and a retrospective study of clinical records of house-helpers with skin disorders. RESULTS: Routine examination revealed significant skin disease in 374 (24.6%) individuals, and the disease was transmissible in 126 (8.3%). Treponemal infection (5, 0.3%) and leprosy (1, 0.07%) were seen. Hand dermatitis and chicken pox were the most common causes of hospital attendance. Psychologic skin disorders included three cases of neurotic excoriations, two cases of delusion of parasitosis, and a case of dermatitis artefacta. CONCLUSIONS: The prevalence of transmissible skin diseases in Asian domestic house-helpers is low compared with that in their home countries. Excluding individuals with stigmata of atopic dermatitis from employment as house-helpers, adequate counselling will reduce the incidence of hand dermatitis and psychologic skin disorders. There is a need for continuous surveillance to prevent the introduction of skin diseases not normally seen in the native population.

Serological markers for hepatitis B and treponemal infection among HIV carriers from Ethiopia.

A group of 52 HIV carriers among immigrants who arrived in Israel from Ethiopia in Operation Solomon, 1991, is described. A control group was randomly chosen from the same population. HBV serology and treponemal antibodies were obtained from both groups. The frequency of HBV markers was similar in both groups (70% among the HIV carriers and 78.8% in the controls). HBsAg was more frequently found among HIV carriers (20%) than in the control group (8.6%). Treponemal antibodies were common among HIV carriers (31%), and infrequent in the controls (3%). These data indicate that HIV infection in this community is linked to treponemal infection and that these carriers handle HBV less efficiently then HIV-negative subjects.

PIP: In Jerusalem and the Negev, physicians examined and took blood samples from recent Jewish immigrants older than 10 years who came to Israel from Ethiopia during Operation Solomon in 1991. The physicians and other colleagues compared data on the 52 people who were HIV positive with 139 who were HIV negative to examine HIV's relationships with treponemal infection and hepatitis B infection. The 2 groups were essentially the same age (37 years for cases and 35.5 years for controls). No significant difference in the prevalence of hepatitis B virus (HBV) markers existed between the 2 groups (70% for HIV-positive migrants and 78.8% for HIV-negative migrants). This confirmed other research that HBV is transmitted vertically in developing countries. Yet, HIV-positive migrants were more likely to have markers for hepatitis B surface antigen than HIV-negative migrants (20% vs. 8.6%; p = .018). The HIV-positive migrants had a higher prevalence of treponemal markers than did HIV-negative migrants (31% vs. 3%), indicating that treponemal disease increased their risk of HIV infection. The earlier group of Jewish immigrants from Ethiopia during 1984-1985 (Operation Moses) also had a high prevalence of treponemal antibodies but no one had HIV infection. These immigrants walked through a rural area to a refugee camp in Sudan from which they were taken to Israel by air. The newer immigrants rode buses to Addis Ababa and waited 1 year before they immigrated to Israel. The results of this study suggests that the new immigrants (an ethnic homogenous group just like their earlier counterparts) became infected with HIV during the short period in Addis Ababa. Israeli physicians have designed a study to follow the HIV-positive immigrants to determine whether the environment in Africa is responsible for the different clinical picture of AIDS.

Prevalence of herpesvirus, human T-lymphotropic virus type 1, and treponemal infections in Southeast Asian refugees.

Sera obtained for treponemal serology (VDRL) from 193 Southeast Asian refugees representing five ethnic groups seen in a primary care clinic were examined for antibodies to human T-lymphotropic virus type 1 (HTLV-1), human herpes-virus-6 (HHV-6), Epstein-Barr virus (EBV), and cytomegalovirus (CMV). The seroprevalence was highest for EBV (99%), followed in decreasing order by CMV (95%), HHV-6 (26%), and HTLV-1 (0.6%). The VDRL was positive in 15% of patients. The highest seroprevalence to HHV-6 was noted in the Chinese (33%) and the lowest in the Laotian hilltribes, the Mien and Hmong (14%). Antibody to HHV-6 was most prevalent among patients under 20 and those between 60 and 69 years of age. Differences were not found among ethnic groups in the seroprevalence of HTLV-1, EBV, or CMV.

Cutaneous infections in blacks.

We have described briefly a variety of cutaneous infections seen commonly but not exclusively in blacks. Some disorders are prevalent in blacks because of geography (high temperatures, humidity), environment, and low socioeconomic status causing over-crowding, malnutrition, and poor or delayed access to medical care. Only a few occur as a result of the unique way black hair or skin responds to trauma or infection. Physicians managing black patients with dermatologic problems should be aware of and must consider all the factors that initiate, aggravate, and perpetuate cutaneous responses under these conditions.

[Sero-epidemiological study in Mauritania (1985-1986): incidence of treponematosis, hepatitis B virus, HIV virus and viral hemorrhagic fevers]. / Etude séro-épidémiologique en Mauritanie (1985-1986): fréquence des tréponématoses, du virus de l'hépatite B, du virus VIH et des fièvres hémorragiques virales.

A serological serosurvey was made in different ethnic groups of Mauritania in 1985. A very high prevalence of hepatitis B markers was found with more than 20% of HBs antigen carriers. Treponema specific antibodies in low-age classes observed is a reflect of endemic syphilis. The seroprevalence of antibody against HIV and viral haemorrhagic fever viruses (Rift Valley fever, Crimean-Congo haemorrhagic fever and haemorrhagic fever with renal syndrome) was very low.

PIP: A serological survey in Mauritania in 1985-86 provided data on certain viral and bacterial markers whose frequency has been well established in countries neighboring this gateway between North Africa and subSaharan Africa. Blood samples from 1230 male blood donors and 983 pregnant women at the hospital in Nouakchott were analyzed for treponema infection, hepatitis B, HIV, and for antibodies to certain viruses causing hemorrhagic fever. Positive results for treponema specific antibodies using the Kline reaction were obtained in 76 of 2213 serums examined. High positive rates in young age groups reflect endemic nonvenereal treponematosis. 16 of 218 persons aged 10-19 tested positive compared to 10 of 593 aged 30-39 and 2 of 133 aged over 40. Observed differences between ethnic groups were highly significant. Infection rates were higher among males except among the Poulars. A very high prevalence of hepatitis B markers was found with more than 20% of hepatitis B surface antigen carriers among the 766 samples studied. 88.68% of the 813 subjects studied had been infected with the hepatitis B virus. The results suggest that nomadism, or the hygienic conditions of nomadism, favor contamination by the hepatitis B virus. 3 of the 510 samples examined were positive for HIV. Only 1 of the positive samples was from a Mauritanian, a 28-year-old male Poular. The other 2 positive results were obtained from foreigners temporarily residing at Nouakchott. The prevalence of antibodies against the viruses responsible for hemorrhagic fever was very low: 1/965 for the Crimee-Congo, 2/965 for the Rift Valley fever virus, and 3/965 for the Hantaan virus.