Biomedical subjects
Publications and source records attributed to D A Ogunmekan.
An increase in the number of cases of tuberculosis, especially in children, has been observed recently. Post-vaccination conversion rate in babies immunised with BCG was assessed. Sensitization was detected as early as 4 weeks after BCG inoculation. Although 84.2% had physical evidence of BCG inoculation only 69.8% had developed detectable sensitization to the tubercle bacilli as shown by the Mantoux test.
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Serological studies in a group of children showed that there was a high degree of immunity to measles at birth (100%), but this decreased rapidly so that by the age of 5 months there was 36% immunity and by 7-8 months the level had dropped to 5%. However, there was a gradual rise from the age of 9 months onwards, so that by the age 6-9 years there was 75% immunity and from 10 years onwards there was 100% immunity. The findings suggest that measles vaccination can be given from the age of 6 months onwards, but this needs to be confirmed by further studies. There is need to compare children under the age of 5 years who are blind or deaf with a control group in order to determine the aetiological role of measles infection in these handicaps in Lagos.
The decline of maternally acquired haemagglutination inhibiting antibodies against measles virus in Nigerian children born in Lagos was studied. At birth all the 303 children whose cord blood serum was tested had measurable antibodies. The antibody titre remained detectable in all the children up to four months of age, and in over 90% at five months of age. At six months 65% of the children were without detectable antibodies. At seven and eight months the proportion of children without measurable antibodies was reduced to 50% and 42% respectively, indicating a slight but progressive improvement in the immune status of the children. These findings provide a serological basis for starting anti-measles immunization of Nigerian children at six months.
Ninety-eight children between five and nine months were given measles vaccine. Bloodsamples were taken before and again six to eight weeks after immunization and tested for haemagglutination inhibition antibodies to measles virus. It was found that the sero-conversion rate was significantly lower (p less than 0.05) in infants under seven months than over this age. The results suggest that although some immunized at six months of age show seroconversion, the proportion is too small to justify extensive immunization at this age. It is proposed that children in Lagos should be immunized from the age of eight to nine months.
Groups of school children aged 6-14 years were tested with PPDS and one of the following five antigens simultaneously, namely PPDA, PPDF, PPDG, PPDPL and PPDY, PPDS was prepared from the human tubercle bacillus, and the others were prepared from M. avium, M. fortuitum, the 'Gause' organisms, M. marinum and M. kansasii respectively. It was observed that there was some increase in induration size to PPDA, PPDG, PPDL, PPDS and PPDY with increase in age, while M. fortuitum gave a preponderance of small reactions with no increase of size with age. It was also observed that there was evidence of cross sensitization between PPDS and all the other antigens, particularly in those who had negative or doubtful reactions.
3505 school children aged 6 to 15 years were tested with PPDS and at the same time one of the following tuberculins, namely, PPDG, PPDPL, PPDA, PPDF and PPDY. The tuberculins were prepared from human tubercle bacillus, the Gause organism, M. marinum, M. avium, M. fortuitum and M. kansasii respectively. PPDY, PPDA and PPDG gave more reactions of greater than 2 mm induration than did PPDS. Furthermore, tests with PPDY, PPDA, PPDG and PPDPL showed a significant proportion of children with reactions of 10 mm or more, suggesting that many of them had been sensitized to these antigens, particularly in the older age groups. The tuberculin sensitivity profile of these children resembled that found for a small community in Georgia, U.S.A., which had been studied previously. The profile also resembled that of guinea pigs which had been experimentally infected with the Gause organism. This supports the conclusion that a high proportion of these children had past or present infection with either the Gause organism or antigenically related mycobacteria. Finally, PPDS gave the highest percentage of children who had reactions greater than 10 mm. It is suggested that 10 mm might be a useful size of induration to divide opportunist mycobacterial infection from infection by M. tuberculosis in Lagos.
A pilot survey was done on a sample of 141 women in Lagos to find out the influence of their social, economic and educational background on the level of immunization of their children against the common childhood infections. The level of immunization was generally low, the lowest being for poliomyelitis (28%). The following factors are important for improvement in the level of immunization of the children: a reduction in the number of attendances required to a minimum, easy availability, accessibility and acceptability of health services, raising the educational level of the people and their socio-economic status, and ensuring maximum utilization of health services by health education of the people.
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A random sample of school children was tested with PPD-S and one of the following antigens simultaneously namely PPD-F, PPD-G, PPD-PL, and PPD-A. The antigens were prepared from the human tubercle bacillus, Mycobacterium Fortuitum, M. Kansasii the Gause Organism, M. Marinum and M. avium respectively. It was observed that for those who had had no BCG, age had a significant effect on the induration size to PPD-S. The age effect was a linear regression effect, the F for regression being significant at the 1% level. The regression coefficient was found to be 0.4 and the equation to the regression line was Y = -0.6 + 0.4X where X is age and Y is induration size. For all the other antigens, age had no significant effect on the size of induration.
School children in lagos were tested with PPD-S and one of the following tuberculins simultaneously namely PPD-G, PPD-A, PPD-Y, PPD-F, and PPD-PL. The tuberculins were prepared from Mycobacterium tuberculosis, the Gause organism, M. avium, M. Kansasii, M. fortuitum and M. marinum respectively. It was found that for the different antigens, among those children who had indurations from 0 to 4 mm those small sized reactions wer generally due to sensitization by opportunist mycobacteria. In contrast to this, among those who had indurations over 10 mm, the reactions were due to sensitization by the human tubercle bacillus. Testing of patients with bacteriologically and radiologically proved tuberculosis showed that practically all of them reacted in an expected manner, i.e. PPD-S elicited larger reactions than PPD-Y, PPD-A, PPD-G, PPD-LL and PPD-F.