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Biomedical subjects

H H Kleeberg

Publications and source records attributed to H H Kleeberg.

At least 19 recordsLinked to original sources
PubMed1992

Primary and acquired drug resistance in adult black patients with tuberculosis in South Africa: results of a continuous national drug resistance surveillance programme involvement.

Drug resistance is a major problem in the treatment of tuberculosis, and monitoring programmes are essential in control of this disease. The extent of primary resistance in a community is an important indication of the effectiveness of treatment schedules. Since 1965 the Tuberculosis Research Institute (TBRI) of the South African Medical Research Council has performed 25 annual surveys of drug resistance in adult black tuberculosis patients where the disease is most prevalent. Methodology for patient selection, specimen collection, laboratory procedures and criteria for drug resistance were strictly adhered to. All specimens were processed in a central laboratory supervised by the same two technologists. Between 1965 and 1988 a total of 33,111 strains of Mycobacterium tuberculosis were isolated from new cases and 19,134 from old cases. Both primary and acquired resistance to the 5 major antituberculosis drugs has decreased dramatically. Sex and age do not influence resistance rates, while patients' ethnic origin and geographical location do. The results indicate that current tuberculosis treatment practices are satisfactory. The prevalence of primary drug resistance in black South Africans is now intermediate between those countries where eradication of tuberculosis is well advanced and those where the disease remains a public health problem. Also, it can be shown that comparable and clinically significant data can be obtained from a central laboratory employing unsophisticated and inexpensive drug susceptibility testing procedures.

Black or African American↗
PubMed1989

Mononuclear leucocyte function in patients with lichen planus and cutaneous lupus erythematosus during chemotherapy with clofazimine.

Mitogen-induced transformation and the production of reactive oxidants by mononuclear leucocytes (MNLs) from patients with chronic dermatological disorders were investigated in vitro before and during the administration of the antimycobacterial/immunosuppressive agent clofazimine (200 mg 3 times weekly). Seven patients, 4 with lichen planus and 3 with cutaneous lupus erythematosus, were included in the study. Clofazimine administration did not influence the mitogen-induced proliferative responses of patients' MNLs. However, chemotherapy with this drug stimulated the production of reactive oxidants by MNLs. Since reactive oxidants are immunosuppressive it is possible that these effects may be involved in the pharmacotherapeutic activity of clofazimine.

Adolescent↗
PubMed1987

Pulmonary tuberculosis treated with isoprodian and rifampicin or pyrazinamide.

Three regimens of 9 months' duration, 2 containing Isoprodian (isoniazid, prothionamide and dapsone) and either rifampicin or pyrazinamide and the third, a former standard regimen, isoniazid, streptomycin and pyrazinamide, were allocated at random to 436 untreated African tuberculosis patients. In the course of the trial 83 were excluded for various reasons and 93 were lost. After 3 months of hospitalization, patients took either Isoprodian or isoniazid at home for 6 months and were then followed up for 24 months. The Isoprodian plus rifampicin regimen achieved 97% bacteriological cure, the Isoprodian plus pyrazinamide regimen 86% and the standard regimen 91%. Of 35 patients found to harbour drug-resistant strains 22 were cured. There were 15 relapses in all. Absconding was the most common cause of failure.

Adult↗
PubMed1983

The tolerability and efficacy of a 6-month antituberculosis regimen containing rifampicin, isoniazid and pyrazinamide.

The tolerability and efficacy of a 6-month daily regimen of rifampicin (RMP), isoniazid (INH) and pyrazinamide (PZA) were tested in 130 hospitalized patients, mostly Black, with previously untreated pulmonary tuberculosis. PZA was discontinued at the end of the 2nd month. In 6 cases treatment was discontinued because of drug intolerance. The symptoms were severe rash, mild thrombocytopenia, deteriorating haematological and renal condition and in the remaining 3 patients hyperbilirubinaemia. Of the 125 patients who could be assessed bacteriologically, 110 were infected with organisms which were fully susceptible to INH and RMP, and 95% of their cultures and 77% of their smears had converted to negative after 2 months of treatment. Similar results were obtained for all but 2 of the 15 patients with drug-resistant bacilli. Cavitation of the lungs was reduced in 78% of the patients and the extent of other tuberculous lesions diminished in 87%.

Adolescent↗
PubMed1980

Follow-up tuberculosis prevalence survey of Transkei.

After 5 years a follow-up prevalence survey was conducted in Transkei on a randomly selected sample of the rural population. The parameters investigated were bacteriological prevalence of tubercle bacilli in sputum, radiological prevalence of chest abnormalities associated with tuberculosis in adults, and hypersensitivity to tuberculin in children. Bacteriological positivity was 2.1% on smear microscopy and 4.3% on culture. Radiological evidence of tuberculosis was demonstrable in 12.5% of subjects, of whom 8.7% were considered active and 3.8% inactive. The mean prevalence of tuberculin positivity according to the Mantoux test was 30.1%. An annual risk of infection of 4% was calculated, showing a continuous decrease of 5% per year on the 7% risk of infection encountered in 1972. Compared with the first survey, a general reduction in prevalence of tuberculosis is evident.

Adolescent↗
PubMed1979

First tuberculosis prevalence survey in KwaZulu.

The results of a prevalence survey undertaken during 1974 are presented. A stratified 3-stage sampling technique was used to select 3 789 people from 10 randomly chosen sites in KwaZulu. One Heaf test and 2 Mantoux tests were performed on each of 1 769 children under 18 years of age, of whom 28,7% were found to have BCG scars. Of the radiographs taken of persons 15 years of age and older, 893 were found to be negative, 25 (2,7%) disclosed active tuberculosis (TB) and 3 (0,3%) miliary TB. Of the 1 136 sputum specimens collected and examined by fluorescence microscopy, 15 (1,3%) were found to be positive and 9 of them were confirmed by culture. Culture of 1 149 specimens yielded 9 (0,8%) isolations of Mycobacterium tuberculosis and 17 strains of other mycobacteria. The annual rate of infection was calculated at 1,4% by applying Styblo's epidemiological model, and a downward trend was indicated. A follow-up survey after 5 years is needed to confirm this trend.

Adolescent↗
PubMed1979

Phenotyping of South African black tuberculosis patients for inactivation of isoniazid.

Studies of isoniazid inactivation rates in black tuberculosis patients from South Africa and Birmingham, Alabama, showed a higher frequency of fast inactivation than those of North American Caucasian patients. After an oral test dose of 10 mg/kg isoniazid the percentage of fast inactivators in black patients of South Africa and Alabama was close to 60% while in North American white participants (Canadian and Birmingham Caucasians), the frequency of fast inactivation was approximately 40%.

Administration, Oral↗
PubMed1979

Comparison of isoniazid phenotyping of black and white patients with emphasis on South African blacks.

Black tuberculosis patients from South Africa (S. A.) as well as from Birmingham, Alabama, U.S.A., showed a higher percentage of fast inactivators of isoniazid (INH) than that found in the North American white population, simultaneously sampled. In S. A. blacks, the frequency of fast inactivation was 57.9--59.6%, while in American blacks of Birmingham it amounted to 60.3%; in comparison to the above groups the rate of fast acetylators in Canadian Caucasians was 41.9% and in the USA white population 41.0%. For phenotyping of isoniazid inactivators a urine test was used. In this method the concentrations of INH (including isoniazidhydrazones) as well as acetylisoniazid were determined in the specimens collected 6--8 hrs following a test dose of 10 mg/kg INH.

Administration, Oral↗
PubMed1978

The significance of the tuberculosis infection risk and its application in Pretoria.

The value of the infection risk index for the determination of the TB situation and for the planning and evaluation of specific control measures is discussed. From tuberculin studies performed on schoolchildren in Pretoria since 1972, the annual risk of contracting a TB infection or of reinfection has been determined for all races in Pretoria; it is 0,05% for Whites, 0,53% for Coloureds, 0,68% for Asians, and 0,64% and 1,05% for Blacks in Atteridgeville and Mamelodi respectively. A downward trend of the risk could be shown for all population groups.

Ethnicity↗
PubMed1978

Tuberculosis in laboratory animals.

Tuberculosis can cause great losses in captive colonies of various animal species. In South Africa the culprit is the human type of tubercle bacillus. Interspecific transmission of tuberculosis infection amongst laboratory animals, notably primates, is known to occur, and often handlers and caretakers act as the source of infection. The need for preventive measures in laboratory colonies and procedures for case finding and treatment of tuberculous animals are discussed. Indiscriminate destruction of diseased animals is opposed. The South African situation as revealed by questionnaire survey is described.

Animals↗
PubMed1977

Evaluation of BCG vaccines and a new method of multipuncture administration.

In comparative investigations the Japanese vaccinating tool was found to be more satisfactory for BCG administration than the Heaf multipuncture apparatus. Not only were the immune responses achieved by 27 punctures made by the Japanese applicator equal to those produced by 40 punctures made by the Heaf apparatus, but the results were similar to those obtained with the intradermal method of vaccination. The Japanese applicator can be sterilized effectively, it is simple to use, durable, usable up to 100 times and cheap. All pre- and post-vaccination tuberculin testing was done intradermally with 2 tuberculin units of human PPD RT23. The studies also confirmed the high quality of the Japanese intradermal and percutaneous BCG vaccines. Administration of the potent percutaneous Japanese BCG vaccine with the Japanese applicator is an ideal, effective and safe method of BCG vaccination.

BCG Vaccine↗
PubMed1977

Mycobacterioses.

Explore the source record for details and available documents.

Antitubercular Agents↗
PubMed1977

Pulmonary disease associated with mycobacteria other than tubercle bacilli in miners.

Five patients with lung disease caused by mycobacteria other than tubercle (MOTT) bacilli are described. Mycobacterium kansasii was the causative organism in 4 patients and M. scrofulaceum in 1 patient. The species were repeatedly isolated from sputum specimens cultured on Löwenstein-Jensen medium. The clinical features, mycobacterial isolations, bacteriological properties of the pathogens and the therapeutic problems encountered are discussed.

Adult↗
PubMed1977

Sputum induction by saline aerosol.

A simple technique for inducing sputum production with vaporized 15% aqueous NaCl is described. Fifteen inhalations of saline aerosol, followed by a waiting period of 15-30 minutes, were sufficient to induce a productive cough in 93% of the persons tested. The apparatus is portable, cheap, easily maintained and suitable for use under field or hospital conditions.

Aerosols↗