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Biomedical subjects

L Brabin

Publications and source records attributed to L Brabin.

44 records · Page 3Linked to original sources
PubMed1984

Polygyny: an indicator of nutritional stress in African agricultural societies?

"The object of this paper will be to present some of the anthropological literature on polygyny, both to illustrate [the variety among societies] and to suggest which aspects of polygyny should be investigated for their relationship to nutritional status." The geographical focus is on Africa. "The paper indicates that there are differences between societies which do not practise polygyny and those which do; that there are regional differences which affect how women experience polygyny as well as differences in individual societies related to economic change." (summary in FRE)

Africa↗
PubMed1984

Referral of children for nutritional interventions in an under-fives clinic: would weight-for-height assessment help?

This study investigates decision making in an under-fives clinic by examining the referral of children for nutritional help on the basis of weight-for-age assessments ('Road to Health Card'). The weight-for-age status of each child is compared with his weight-for-height status. Children with a weight-for-height status of less than 89% and who were still failing to gain weight were considered 'at risk' and in need of referral. Of 28 such children, only four were referred. The growth curves of five wasted children who were not referred showed acute weight loss. It is suggested that community health nurses may experience problems in interpreting the trend of a child's growth curve, possibly because the information is inadequate or because they fail to interpret the given information correctly. Alternatively, community health nurses may have other reasons for nonreferral and these are also discussed. The study also considers whether incorporating a weight-for-height assessment into the clinic routine would increase the efficiency of nutritional intervention. However, there appears to be no obvious advantage if children's ages are known and the majority of children are not severely malnourished. The emphasis should be on training, not on new techniques.

Body Height↗
PubMedDate not supplied

Two populations of women with high and low spleen rates living in the same area of Madang, Papua New Guinea, demonstrate different immune responses to malaria.

Specific malaria and total IgM antibody responses were measured in 2 linguistically distinct coastal Papua New Guinean populations living in the same endemic malarious area, but exhibiting different adult female spleen rates (51% and 30%), in order to establish whether the higher spleen rates in the former group were due to hyper-reactive malarious splenomegaly (HMS). Malaria parasite rates were comparable, and geometric mean titres of IgG malaria antibody were the same, in both groups, indicating comparable exposure to malaria. A higher mean total IgM was observed in the high spleen (HS) rate group (6.07 g/litre, compared with 4.62 g/litre), a higher proportion was seropositive for IgM antibody to Plasmodium falciparum (63% compared with 54%), and HMS was found rather more frequently (4.7% compared with 2.6%). In both groups total IgM concentrations increased significantly with rising parity, and the mean level of 5.27 g/litre in young nulliparous women from the HS group suggested that IgM levels in this group at least were elevated from childhood. In both groups a rise in total IgM was associated with higher P. falciparum IgM geometric mean titres of antibody activity, a fall in parasite rates (HS group: 30% to 15%, P = 0.02; LS group: 24% to 0%, P = 0.034), and higher spleen rates (HS group: 38% to 65%, P = 0.001; LS group: 20% to 67%, P = 0.00012). It is concluded that the difference in spleen rates between the 2 groups was the result of differing degrees of acquired immunity to malaria, probably due to genetic differences in immune responses.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMedDate not supplied

The relationship between splenomegaly and antibody to the circumsporozoite protein of Plasmodium falciparum in two groups of women with high and low enlarged spleen rates in Madang, Papua New Guinea.

The objective of this study was to determine the prevalence of antibodies recognizing the circumsporozoite (CS) protein of Plasmodium by an enzyme-linked immunosorbent assay, in 2 subpopulations of women with significantly different enlarged spleen rates but similar exposure to malaria, on the north coast of Papua New Guinea. Antibody levels of immunoglobulin G (IgG) antibody to CS protein in the high and low spleen rate groups were similar (56.2% and 55.1%) but there was a significant difference in IgM (29.6% and 16.7%). In neither group did antibodies increase with parity (age). In both groups a high level of either IgG or IgM antibody to CS protein was associated with a high spleen rate and women with hyper-reactive malarious splenomegaly were more likely to be positive for both. Lower parasite rates were associated only with increased IgM antibody titres. High levels of antibody to blood-stage parasites were also present in the high spleen rate group, suggesting that antibodies to the CS protein were not protective. It is considered that cell-mediated immunity may be deficient in women with persistent splenomegaly.

Adolescent↗
PubMedDate not supplied

Difficulties of interpreting PPD reactions of women living in Madang, Papua New Guinea.

Malaria surveys in Madang, Papua New Guinea, previously distinguished 2 populations of women with significantly different spleen rates and immune responses to malaria. Differences between the high (HS) and low (LS) spleen rate groups suggested a defect in cellular immunity in the HS group. This paper reports a survey of purified protein derivative (PPD) responses in a sample of HS and LS women. Eighty-eight of 162 women were PPD positive (reaction size > 5 mm). There was a marked difference in the range and size of PPD reaction between the HS and LS groups. Mean size in the LS group was 20.7 mm and in the HS group it was 12.1 mm (P = 0.02). Failure to show differences in other indicators of specific malaria immunity indicated that the difference in PPD response was not the result of malaria-specific cell-mediated immune suppression. Many women were PPD non-responders in spite of evidence of multiple bacillus Calmette-Guérin (BCG) vaccination scars. There was no difference between HS and LS groups in the level of non-response to PPD. The results confirm an early tuberculosis survey indicating that New Guineans rapidly lose PPD reactivity to BCG vaccination. Ability to maintain a PPD response, and the quality of response, may vary according to sex and genetic background.

Antibody Formation↗
PubMedDate not supplied

Tetanus antibody levels among adolescent girls in developing countries.

Neonatal and maternal tetanus infections remain an important cause of death in many countries. Few studies have reported tetanus toxoid antibody levels of adolescent girls. As part of the Expanded Programme on Immunization most girls receive up to 3 injections in early childhood, and many subsequently do not receive booster vaccinations until pregnant. We determined (by ELISA) tetanus antibody seropositivity in adolescent girls from Malawi (in 1996), Nigeria (in 1993) and Pakistan (in 1996), and response to tetanus vaccination in adolescent girls from Pakistan. Geometric mean titres (GMT, IU/mL) were 0.94 in 117 Malawian, 0.32 in 154 Nigerian and 1.08 in 162 Pakistani girls. In Nigeria, 54.7% of adolescents were seronegative, of whom 26.8% had a history of unsafe abortion. In Malawi and Pakistan all girls were seropositive and in Pakistan, following a booster vaccination, titres increased 3-fold, with a lower response in older girls. The results indicated that adequate childhood immunization is likely to provide protective levels through adolescence. Booster vaccination in late childhood/early adolescence should protect the majority of women throughout their reproductive lives. This practice would reduce the risks of girls exposed to infection through unsafe abortions, and may be the best option for countries seeking to improve their vaccination schedule, especially where tetanus vaccine coverage in pregnant women is unacceptably low.

Adolescent↗
PubMedDate not supplied

The epidemiological significance of Chagas' disease in women.

Little is known about the risks associated with Trypanosoma cruzi infection in non-pregnant and pregnant women. From a limited number of studies it appears that in rural areas, parasite rates and rates of serological positivity are similar in both sexes. Abnormal ECG tracings are consistently more frequent in men suggesting that immunity to T. cruzi may be different in females. Complications arising from Chagas' disease in pregnancy are only infrequently reported. Evidence for increased risk of abortion or prematurity is inconclusive except in cases of congenital infection. Most cases of congenital Chagas' disease have been reported from non-endemic areas and there is a suggestion that parasitemic episodes during pregnancy may influence pregnancy outcome. Preliminary evidence indicates that chronic infection can result in in-utero sensitization via passively acquired maternal antibodies. The review concludes that maternal T. cruzi infection carries risks for the child and these warrant systematic research because of their public health significance.

Chagas Disease↗