Endomyocardial fibrosis in Uganda (Davies' disease). II. An epidemiologic, clinical, and pathologic study.
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Biomedical subjects
Publications and source records attributed to M S Hutt.
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The histological diagnosis in 77 cases of the nephrotic syndrome occurring in Uganda is presented. Plasmodium malariae was detected in 31 cases and all but one of these showed diffuse proliferative or focal glomerulonephritis. Pure membranous glomerulonephritis was seen in nine cases; none of these had parasitaemia. Children (63%) had a higher incidence of parasitaemia than adults (40%) in the cases examined.
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Seeking to determine whether there is a relationship in New Guineans between hepatic sinusoidal infiltration and splenomegaly on the one hand and malaria on the other, the authors studied 24 adults from a village protected from malaria for 5 years by 6-monthly DDT spraying and 34 adults from an unprotected village with hyperendemic malaria.It was found that clinical splenomegaly tended to be associated with greater hepatic sinusoidal infiltration among persons from the malarious village and that higher malaria antibody titres were more common in patients with splenomegaly in this village. In adults in the protected village the prevalence of malaria parasitaemia was much lower than in the malarious village and the sinusoidal infiltrates were also diminished.No associations between parasitaemia, malaria antibody titre, and hepatic sinusoidal infiltration could be demonstrated in the malarious village. The implications of these findings are discussed and the question of malaria being responsible for the marked splenomegaly encountered in tropical practice is discussed.
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