Where is the health in the health care system?
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Biomedical subjects
Publications and source records attributed to C Gardiner.
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The prevalence of antibodies against the newly described human T-cell lymphoma virus, type I (HTLV-I) in two communities in Ghana, West Africa, is described. There was no difference by community (urban, 3.6% and rural, 4.0%). Prevalence increased with age, being 5.9% among persons greater than 10 years old, but did not differ by sex. There was no difference when data were analysed by housing status or crowding. Non-confirmed reactions in the assay system were frequent and correlated with both prevalence and titer of antibody against malaria. Possible explanations include vector-borne transmission like that of malaria, but the relationship is more probably due to a polyclonal stimulation of B cells, enhancing the potential for detecting reactivity in the assay. Because assay systems vary and because most laboratories do not routinely use a confirmation assay, results presented by different groups must be interpreted cautiously.
A comparative cross-sectional survey was undertaken in two populations, urban and rural, in southern Ghana to assess the impact of urbanization on the prevalence of malaria parasitaemia and antibodies. At the same time, a survey of antimalarial practices was conducted on sample populations in the two communities. The results showed a low parasite rate (1.6%) and correspondingly low titres of malaria antibodies in a significant proportion of the urban community, particularly in children less than 10 years old. This was associated with widespread use in the urban community of antimalarial drugs, particularly chloroquine, as prophylaxis. The parasite rate in the rural community was 22%, and 97% of the sample population over 1 year of age had antibodies against Plasmodium falciparum. These results demonstrate that a substantial proportion of urban children are growing up with little exposure to malaria, even in a region considered endemic for malaria. The implications of these findings are discussed.
Both Epstein-Barr virus and malaria have been implicated as possible factors in Burkitt's lymphoma. To examine this implication a cross-sectional serological survey of an urban and a rural population in Ghana was conducted. Malaria was more prevalent in the rural areas, but there was no difference in antiviral capsid antigen (VCA) antibody titres between urban and rural dwellers. There was also no correlation between anti-malaria antibody titres and anti-VCA antibody titres. Thus malaria does not seem to influence immunological response to Epstein-Barr virus infection, as measured by anti-VCA antibodies. These results suggest that if Epstein-Barr virus infection and malaria are important in the aetiology of Burkitt's lymphoma, they produce their effects independently. The survey also showed that those in rural areas seroconverted earlier than those in urban areas, and that antibody levels were consistently higher in females than in males in every age-group. Case-control studies and screening programmes involving anti-VCA levels will therefore have to take these two findings into account.
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