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Biomedical subjects

M Laga

Publications and source records attributed to M Laga.

At least 91 records · Page 5Linked to original sources
PubMed1990

Maternal gonococcal infection as a preventable risk factor for low birth weight.

With the objective of determining if specific sexually transmitted diseases (STDs) are associated with prematurity (birth weight less than or equal to 2500 g and gestational age less than or equal to 36 weeks), a case-control study was conducted to evaluate women for serologic evidence of syphilis and human immunodeficiency virus infection and microbiologic evidence of cervical infection with Neisseria gonorrhoeae, Chlamydia trachomatis, and Haemophilus species and vaginal infection with genital mycoplasma, Streptococcus agalactiae, and Enterobacteriaceae. Gram stains of vaginal secretions were evaluated for bacterial vaginosis. Among 166 cases and 175 controls, infection with N. gonorrhoeae was associated with preterm birth. Four percent of controls and 11% of cases were infected with N. gonorrhoeae (odds ratio 2.9, 95% confidence interval 1.2-7.2). This association was independent of age, rupture of membranes, and hypertension. Other STDs were not associated with preterm birth. The attributable risk of gonococcal infection was 14%. Gonococcal infection appears to be responsible for a substantial proportion of premature births and is theoretically preventable by antenatal case detection and treatment.

Adult↗
PubMed1990

The role of Neisseria gonorrhoeae and Chlamydia trachomatis in pelvic inflammatory disease and its sequelae in Zimbabwe.

The presence of antibodies to pili of Neisseria gonorrhoeae and Chlamydia trachomatis serovar L2 were assessed in women consecutively hospitalized in Zimbabwe with pelvic inflammatory disease (PID; n = 66), infertility (n = 227), and ectopic pregnancy (n = 60). Women delivering live full-term infants served as controls. Of the infertile women, 60% had secondary infertility; 59% had macroscopic evidence of a tubal abnormality. Women with PID, infertility and tubal disease, and ectopic pregnancy and tubal disease had significantly higher prevalences of antibodies against C. trachomatis and N. gonorrhoeae than did controls or women with infertility or ectopic pregnancy but no macroscopic tubal abnormalities (P less than .001 for all comparisons). The prevalence of antibody to chlamydia increased with age (P = .01), unlike the gonococcal antibody. Antibodies to C. trachomatis were associated with a history of PID, being single, a positive Treponema pallidum hemagglutination assay, and chlamydial antibody. None of the controls had human immunodeficiency virus, unlike 3.9%-7.6% of the other women. Tubal abnormalities were implicated in more than half of the cases of infertility.

Adult↗
PubMed1990

The prevalence of Chlamydia trachomatis infection among mothers of children with trachoma.

The authors studied the epidemiology of Chlamydia trachomatis infection in a trachoma-endemic area of central Kenya. Children with abnormal ocular discharge were evaluated for clinical evidence of trachoma and were cultured for C. trachomatis. Isolated strains of C. trachomatis were immunotyped with monoclonal antibodies. Overall, 221 children from 207 families were evaluated. Clinically, 91 children (41%) had trachomatous follicular inflammation, and 130 (59%) had papillary hypertrophy without visible follicle and were labeled as having mucopurulent conjunctivitis. C. trachomatis was isolated from 31 of 91 children with trachoma (34%) and 17 of 130 children with conjunctivitis (13%) (p less than 0.001). Twenty-two C. trachomatis strains were immunotyped: 17 were from children with trachoma (nine type A, one A/L2, five B, one Ba, and one E) and five were from children with conjunctivitis (two A, one Ba, one D, and one F). A total of 168 mothers were evaluated for cervical C. trachomatis infection, and seven (4%) were culture-positive. Two strains were immunotyped as serovar E. The authors conclude that C. trachomatis ocular infections are due to heterogeneous serovars in this area, that most cases of trachoma are due to C. trachomatis infection with the classic trachoma serovars (A, B, or Ba), and that cervical C. trachomatis infection is uncommon among mothers of children with trachoma.

Adolescent↗
PubMed1989

Advanced immunodeficiency as a risk factor for heterosexual transmission of HIV.

To define the rate of HIV infection and associated risk factors among heterosexual partners of HIV-infected individuals, 80 partners and 77 index cases were examined for clinical, behavioural and virological variables. The study population included 61 male and 16 female index cases, of whom 40 were European and 37 African. Multiple sexual partners in central Africa was the risk factor for HIV infection in 83%. The overall infection rate among the contact cases was 45%, 53% among female partners and 13% among male partners (P less than 0.001). Variables significantly associated with HIV infection in the partners included advanced clinical stage (AIDS-related complex or AIDS), a low concentration of T4 lymphocytes and African nationality of the index case, young age of the partner, and more than 50 instances of sexual contact with the index cases. In a logistic regression analysis, a low concentration of T4 lymphocytes, clinical stage ARC/AIDS and African nationality of the index case but not number of sexual contacts, remained as independent risk factors for HIV transmission. Our data indicate that there is a significant biological heterogeneity in sexual transmission of HIV and that advanced clinical stage and severe T cell depletion of the index case are major determinants of infectivity.

Acquired Immunodeficiency Syndrome↗
PubMed1989

Epidemiology and control of gonococcal ophthalmia neonatorum.

From a public health point of view gonococcal ophthalmia neonatorum (GCON) is important as it can rapidly lead to blindness. The frequency of GCON is determined by the prevalence of maternal gonococcal infection. In most industrialized countries the prevalence of gonorrhoea in pregnant women is less than 1%; in developing countries the rates are between 3% and 15%, more than 50% being due to penicillinase-producing Neisseria gonorrhoeae strains (PPNG). The rate of transmission from mother to newborn is between 30% and 50%. Strategies for the control of GCON include: (1) prevention of gonococcal infection in women of childbearing age, (2) detection and treatment of gonococcal infection in pregnant women, (3) eye prophylaxis in the newborn at birth, and (4) diagnosis and treatment of GCON. Eye prophylaxis by the instillation immediately after birth of either 1% silver nitrate eye drops or 1% tetracycline eye ointment is very effective. This reduces the GCON incidence by 80% to 95% and is highly cost-effective, particularly in high-risk settings.

Adult↗
PubMed1988

Prophylaxis of gonococcal and chlamydial ophthalmia neonatorum. A comparison of silver nitrate and tetracycline.

We evaluated the use of silver nitrate drops and tetracycline ointment for the prophylaxis of ophthalmia neonatorum in a controlled trial involving 2732 newborns in Nairobi, Kenya. The overall rates of prevalence of intrapartum maternal gonococcal and chlamydial infection were 6.4 and 8.9 percent, respectively. After prophylaxis with silver nitrate, the incidence rates of gonococcal, chlamydial, and nongonococcal, nonchlamydial ophthalmia neonatorum were 0.4, 0.7, and 6.2 percent, respectively, whereas after prophylaxis with tetracycline, the rates were 0.1, 0.5, and 4.5 percent. The attack rates of gonococcal ophthalmia neonatorum in newborns exposed to Neisseria gonorrhoeae at birth were 7.0 percent in those receiving silver nitrate and 3.0 percent in those receiving tetracycline (95 percent confidence interval for the difference in rates, -3.4 to 11.4 percent). As compared with historical controls, the incidence of gonococcal ophthalmia neonatorum decreased 83 percent among infants treated with silver nitrate and 93 percent among those treated with tetracycline. Failure of prophylaxis was associated with postpartum maternal endometritis (P = 0.05). Among newborns exposed to maternal infection with Chlamydia trachomatis, chlamydial conjunctivitis developed in 10.1 percent given silver nitrate and in 7.2 percent given tetracycline (95 percent confidence interval for the difference in rates, -4.7 to 10.5 percent), yielding reductions in the incidence of chlamydial ophthalmia of 68 and 77 percent, respectively, as compared with the historical controls. We conclude that tetracycline is as effective as silver nitrate in preventing gonococcal ophthalmia neonatorum.

Chlamydia Infections↗
PubMed1988

The prevalence of infection with human immunodeficiency virus over a 10-year period in rural Zaire.

In 1985 we tested 659 human serum samples, collected in the remote Equateur province of Zaire in 1976, for antibody to human immunodeficiency virus (HIV). Five (0.8 percent) were positive, and HIV was isolated from one of these. Follow-up investigations in 1985 revealed that three of the five seropositive persons had died of illnesses suggestive of acquired immunodeficiency syndrome (AIDS), and two remained healthy but seropositive. In 1986, a serosurvey we conducted using a cluster-sampling technique in the same region showed a seroprevalence of 0.8 percent in 389 randomly selected residents. The seroprevalence in 283 prostitutes was 11 percent. Patients with AIDS were identified in various hospitals in the province. Risk factors for AIDS included a greater than average number of sexual partners and residence outside the area. We believe that the long-term stability of HIV infection in residents of rural Zaire suggests that social change may have promoted the spread of AIDS in Africa.

Acquired Immunodeficiency Syndrome↗
PubMed1988

Prostitutes: a high risk group for HIV infection?

Female prostitutes are at increased risk for sexually transmitted diseases and HIV infection. However, the prevalence rate of HIV infection among prostitutes varies geographically, with the highest rates occurring in Africa and in areas with large numbers of HIV infected intravenous drug users (IVDU). In Europe the most important risk factors for HIV infection in prostitutes are intravenous drug use and unprotected intercourse with non-paying partners. Whereas in Europe, there is as yet no evidence that female prostitutes are a source of HIV infection for the heterosexual population, they are playing a major role in the spread of HIV in Africa. Education about safe sex practices should be included in prevention programmes aimed at IVDUs. HIV infection should be monitored in prostitutes, and health education on AIDS prevention should be offered to prostitutes and their clients.

Acquired Immunodeficiency Syndrome↗
PubMed1988

Infection and disease after perinatal exposure to Chlamydia trachomatis in Nairobi, Kenya.

A cohort of 49 infants exposed to maternal chlamydial infection and 40 nonexposed infants was studied after birth for a mean of 3.3 +/- 1.5 and 3 +/- 1.7 mo, respectively. Eighteen (37%) exposed infants had at least one positive culture for Chlamydia trachomatis, whereas C. trachomatis was not isolated from any of the nonexposed infants. Eighteen (37%) exposed infants developed ophthalmia neonatorum (n = 12) or infant conjunctivitis (n = 7), compared with six (15%) of the nonexposed infants (P = .04). Six (12%) exposed infants developed pneumonia, compared with none of the 40 nonexposed infants (P = .05). One infant in the exposed group died during follow-up. These results suggest that appreciable infant morbidity in Kenya may be associated with the high prevalence of maternal chlamydial infection.

Chlamydia Infections↗
PubMed1988

Microbial aetiology and diagnostic criteria of postpartum endometritis in Nairobi, Kenya.

Using a protected triple lumen device, Neisseria gonorrhoeae or Chlamydia trachomatis, or both, were isolated from the endometriums of five out of 35 women with clinical postpartum endometritis compared with none of a control group of 30 puerperal women without endometritis (p less than 0.05) in Nairobi, Kenya. These sexually transmitted agents were also found in 12 cervical specimens from women with and three without postpartum endometritis (p = 0.04). Mycoplasma hominis and Ureaplasma urealyticum were equally isolated from the endometrium in both groups. Histology showed plasma cell infiltration in 6/25 patients compared with 1/22 controls (p = 0.06). A history of foul lochia (p less than 0.01) and abdominal pain (p = 0.02) were associated with postpartum endometritis. Sexually transmitted agents appear to be major causes of puerperal upper genital tract infections in Nairobi.

Adult↗
PubMed1988

Evaluation of the WHO clinical case definition for AIDS in rural Zaire.

The clinical case definition for AIDS proposed by WHO for use in Africa was evaluated against HIV antibody status in 72 patients in rural Zaire. Twenty-one (29%) of the patients were antibody-positive. For diagnosing anti-HIV seropositivity, the case definition had a sensitivity of 52%, a specificity of 78%, a positive predictive value of 50% and a negative predictive value of 80%. Calculation of the positive predictive value at different levels of prevalence of HIV infection suggests that the case definition operates at maximum reliability in selected high-risk groups. Modifications to the case definition should be evaluated to try and improve its sensitivity and positive predictive value.

Acquired Immunodeficiency Syndrome↗
PubMed1987

Retrospective seroepidemiology of AIDS virus infection in Nairobi populations.

Among 446 sera from prostitutes in Nairobi, the prevalence of antibody to human immunodeficiency virus (HIV) rose from 4% in 1981 to 61% in 1985. None of 118 men with chancroid seen in 1980 had antibody to HIV compared with 15% of 107 such men in 1985. Among pregnant women, 2.0% were seropositive in 1985 versus none of 111 in 1981. Seropositive prostitutes and women with sexually transmitted diseases (STDs) tended to have more sex partners and had a higher prevalence of gonorrhoea, and in women with STDs, significantly more seropositive women practiced prostitution. Pregnant women and men with STDs who were born in the most-western region of Kenya were more likely to have antibody to HIV than were such groups from other geographic areas. Our results indicate that the AIDS virus was recently introduced into Kenya, that HIV can rapidly disseminate in a high-risk group of heterosexuals, and that prostitutes may have significantly contributed to the spread of the virus.

Acquired Immunodeficiency Syndrome↗