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Biomedical subjects

P Piot

Publications and source records attributed to P Piot.

At least 199 records · Page 11Linked to original sources
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

Serologic and immunologic studies in patients with AIDS in North America and Africa. The potential role of infectious agents as cofactors in human immunodeficiency virus infection.

Serologic and immunologic studies were performed in 38 African and 60 US patients with acquired immunodeficiency syndrome (AIDS), 100 African and 100 US heterosexual men and women, and 100 US homosexual men to examine the potential role of infectious agents in human immunodeficiency virus (HIV) infection. There were no significant differences in the prevalence of antibodies to cytomegalovirus, Epstein-Barr virus, hepatitis A and B viruses, herpes simplex virus, syphilis, and toxoplasmosis among the African and US patients with AIDS, African heterosexual controls, and US homosexual men. However, these four groups all demonstrated a significantly greater prevalence of antibodies to each of these infectious agents compared with US heterosexual men. Immunologic studies demonstrated a significant elevation of activated lymphocytes (HLA-DR and T3 positive) and immune complexes in both AIDS populations and African heterosexual and US homosexual populations, compared with the US heterosexual population. These data demonstrate that the immune systems of African heterosexuals, similar to those of US homosexual men, are in a chronically activated state associated with chronic viral and parasitic antigenic exposure, which may cause them to be particularly susceptible to HIV infection or disease progression.

Acquired Immunodeficiency Syndrome↗
PubMed1987

Comparison of enzyme immunoassays and an immunofluorescence test for detection of antibody to human immunodeficiency virus in African sera.

A total of 152 sera from African subjects were tested for presence of antibody to human immunodeficiency virus using four enzyme immunoassays (EIA) marketed by Abbott Diagnostics, Organon Teknika, Wellcome and Diagnostics Pasteur respectively, an indirect immunofluorescence assay (IFA) and an immunoblot assay (IBA) as reference test. The sensitivity (95% confidence limits, CL) of the EIAs and the IFA ranged between 80.9% and 99.1%. The specificity of the Abbott EIA was lower (95% CL: 38.1-72%) than that of the other assays (95% CL: 83.5-100%). The use of an IFA or the Wellcome competitive EIA as confirmatory test on initially EIA positive sera yielded a specificity of 85.5-100% (95% CL) compared with the IBA. The costs of screening by an EIA, followed by confirmatory testing of reactive sera with IFA or the Wellcome EIA and IBA on discrepant test results was similar for all combinations with the exception of initial screening with the Abbott EIA which was more expensive. Using a limited number of sera from African subjects no one test system yielded a significantly superior degree of specificity or sensitivity.

Acquired Immunodeficiency Syndrome↗
PubMed1987

Enzyme profile of Haemophilus ducreyi strains isolated on different continents.

Two hundred strains of Haemophilus ducreyi, isolated in different parts of the world, were investigated using the API-ZYM system, which included 95 different substrates. All strains produced aminopeptidase against beta-naphthylamide derivatives of L-lysine, glycine, L-arginine, L-alanine, D-L-methionine, glycyl-glycine, glycyl-L-alanine and L-leucine. All strains also produced alkaline and acid phosphatase and phosphohydrolase. Nearly all strains showed esterase activity against butyrate, valerate, caproate and caprylate, but the reactions were very weak. No glycosidase activity could be detected. Of the 47 aminopeptidase tests showing variable reactions, only the results for S-benzyl-L-cystine, L-ornithine, L-alanyl-L-phenyl-alanyl-L-proline, L-hystidyl-L-leucyl-L-histidine and L-histidyl-L-serine arylamidase obtained on strains from Asia, Africa and Europe were significantly different (p less than 0.05). On the basis of test results for L-ornithine arylamidase and L-alanyl-L-phenyl-alanyl-L-proline arylamidase, the distribution of three biovars found among the isolates of the different continents was significantly different (p less than 0.0001), whereas African strains isolated in Kenya and South Africa yielded the same enzymatic pattern. Thus, these enzymes may constitute a marker system for the epidemiological study of Haemophilus ducreyi.

Acid Phosphatase↗
PubMed1987

Incidence and bacterial aetiology of neonatal conjunctivitis.

Two hundred and twenty-nine infants born consecutively at the maternity ward of the Middelheim Hospital in Antwerp, over a period of 5 months, and an additional 55 randomly selected infants born at the same hospital were clinically and microbiologically investigated before leaving the maternity ward. All infants born at this maternity ward received argyrol eye drops immediately after birth. Twenty-six (11%) of the infants consecutively investigated had neonatal conjunctivitis diagnosed before leaving the maternity ward, where they stayed from 7-10 days. Another 29 infants were reported to have developed sticky eyes and/or red eyes after leaving the maternity hospital and before 1 month of age. The instantaneous risk of developing, a conjunctivitis was equal for each day of the first month of life. Chlamydia trachomatis was isolated from the eyes of 11 of the 229 (4.8%) consecutively born infants but only one had conjunctivitis symptoms before leaving the maternity ward. Overall one or more bacterial species could be isolated from the eyes of 143 (48%) of the infants, but only viridans streptococci and Staphylococcus aureus were cultured significantly more often from the eyes of cases with conjunctivitis than from the eyes of the infants without conjunctivitis (P less than 0.001).

Bacteria↗
PubMed1987

Treatment of clue cell-positive discharge with 200 mg povidone-iodine pessaries. A double-blind and placebo-controlled trial.

In a double-blind randomized study we evaluated the efficacy of povidone-iodine in the treatment of clue cell-positive discharge (CCPD). Vaginal pessaries (200 mg povidone-iodine or placebo) were taken twice daily for five consecutive days. Although the regimen was reasonably well accepted, 'messiness' was reported by 13 of 33 women (39%). Of 44 women enrolled, treatment efficacy was evaluated in 28 women who had both follow-up visits. There was no significant difference in the efficacy of povidone-iodine and placebo pessaries, at either the first or the second follow-up visit (p values 0.46 and 1 respectively). It is concluded that the use of povidone-iodine pessaries, at least in the regimen described, cannot be regarded as an effective therapy for CCPD.

Adult↗
PubMed1987

Immunofluorescence tests for HIV antibody and their value as confirmatory tests.

The enzyme-linked immunosorbent assay (ELISA) is currently being used as a sensitive screening test for HIV antibody. The immunoblot assay (IBA) and indirect immunofluorescence (IF) techniques are two recommended confirmation tests for EIA-positive sera. An indirect IF test has been developed by various laboratories using acetone fixed mixtures of uninfected and HIV-infected cells, which facilitated the reading, since nonspecific reactions were easily differentiated from specific staining. Similar results have been obtained with H9-, CEM-, and HUT78-HIV-infected and uninfected cells. Anti-nuclear antibodies and auto-antibodies resulting in false-positive EIA results, could easily be differentiated by the IF test. Aspecific fluorescence can be removed by absorption of the specimens with non-infected cells. However, IF is not suitable for the screening of large series of specimens. IF is especially well suited for quantitative analysis of serum antibody levels. Whereas serum antibody titers rise initially after infection, they decrease as AIDS develops. Heat inactivation of sera did not affect reactivity in IF, in contrast to a high rate of false-positive results obtained with heat inactivated sera in some ELISAs. A well characterized serum from an AIDS patient can be used to perform IF in order to monitor HIV infection of susceptible cells. It has been claimed that titers of neutralizing antibodies significantly correlate with the levels of IF anti-HIV antibodies. An overall correlation of 99% between IF and IBA was reported by different laboratories, when HIV ELISA-reactive European and North American sera were tested. The concordance with IBA was 97% when HIV ELISA-reactive African sera were tested.(ABSTRACT TRUNCATED AT 250 WORDS)

Antibodies, Viral↗
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↗
PubMed1987

Postpartum upper genital tract infections in Nairobi, Kenya: epidemiology, etiology, and risk factors.

We investigated the frequency of clinically defined upper genital tract infection (UGTI) and its relation to sexually transmitted diseases and other risk factors among 1,013 women initially studied while in labor at a Nairobi, Kenya maternity hospital. Women were enrolled during labor and followed up at seven days and one month postpartum. Cultures for Neisseria gonorrhoeae and Chlamydia trachomatis were done at enrollment and at day 7. The prevalence of gonococcal and chlamydial infections was 6.7% and 20.8%, respectively. The overall prevalence of UGTI was 20.3%. The development of UGTI was significantly correlated with gonococcal infection (odds ratio, 4.4; P less than .0001), chlamydial infection (odds ratio, 1.7; P less than .02), presence of ophthalmia neonatorum (odds ratio, 2.6; P less than .0001), labor greater than 12 hr (odds ratio, 1.8; P less than .01), and area of residence (odds ratio, 1.5; P less than .05). Postpartum UGTI, an enormous public health problem in Nairobi, would be partially susceptible to antenatal intervention programs focusing on sexually transmitted diseases.

Chlamydia Infections↗
PubMed1987

Amoxycillin, amoxycillin-clavulanic acid and metronidazole in the treatment of clue cell-positive discharge. A comparative clinical and laboratory study.

In an open study, 30 women with clue cell-positive discharge (CCPD) were treated for seven days with either amoxycillin, amoxycillin-clavulanic acid or metronidazole (ten in each group). Patients were monitored on days 2, 4, 9 and 15. Clinical and microscopical parameters were used to assess treatment efficacy. Gas-liquid chromatography of vaginal secretions was also performed. The succinate-lactate ratio had good correlation with the clinical findings. All patients treated with metronidazole were cured by day 4, suggesting that a three-day course is as effective as the standard seven-day regimen. Treatment with amoxycillin-clavulanic acid was less effective resulting in the cure of seven patients by day 15. Amoxycillin established normal secretions in only four patients. Gastro-intestinal complaints, although common in patients treated with amoxycillin-clavulanic acid, were generally mild. We consider amoxycillin-clavulanic acid a possible alternative in the treatment of CCPD.

Adult↗
PubMed1987

Single-dose ceftriaxone for chancroid.

Men with genital ulcers that were culture positive for Haemophilus ducreyi were treated with intramuscular ceftriaxone and randomized to three different dose regimens. All but 1 of 50 men treated with 1 g of intramuscular ceftriaxone were cured. Similarly, 0.5 and 0.25 g cured 43 of 44 men and 37 of 38 men, respectively. A single dose of 250 mg of intramuscular ceftriaxone is an effective treatment for chancroid.

Adult↗
PubMed1987

Norfloxacin versus thiamphenicol for treatment of uncomplicated gonorrhea in Rwanda.

In an open prospective study, single oral doses of norfloxacin (800 mg) and thiamphenicol (2.5 g) were used to treat, respectively, 122 and 46 consecutive patients with uncomplicated gonorrhea. Neisseria gonorrhoeae was eradicated from 119 (97.5%) patients treated with norfloxacin and from 35 (76.0%) patients treated with thiamphenicol. Norfloxacin treatment failure was not related to drug resistance or to insufficient absorption of the drug. Thiamphenicol failure correlated with low in vitro susceptibility of the infecting strain. In a single oral dose of 800 mg, norfloxacin appeared to be an excellent alternative treatment regimen for uncomplicated gonorrhea in an area with a high prevalence of penicillin-resistant gonococci.

Female↗
PubMed1987

Isolation of human immune deficiency virus from African AIDS patients and from persons without AIDS or IgG antibody to human immune deficiency virus.

We previously reported a high incidence of acquired immune deficiency syndrome (AIDS) in Kinshasa, Zaire, as well as a high frequency of antibody to human immunodeficiency virus (HIV), which includes HTLV-III and LAV viruses, in persons without AIDS. In this report we assessed the frequency of HIV virus infection in persons with and without clinical AIDS and the association of virus isolation to presence of antibody. We isolated HIV from 27 (77%) of 35 patients with AIDS, and 5 of 9 patients with AIDS-related complex (ARC). Virus was also isolated from plasma and cerebrospinal fluid of patients in the study. The presence of antibody was a reliable marker for virus infection in African patients with AIDS. HIV was isolated from 5 of 27 control patients without AIDS, 3 of whom had normal T helper to T suppressor ratios and normal numbers of T helper cells. Two of these patients had no detectable antibody to HIV by ELISA or Western blot methods. In a population, such as the general heterosexual population of Kinshasa, with frequent infection by HIV and with few clearly definable risk groups, screening for antibodies to HIV may not be sufficient to identify some virus infected persons.

AIDS-Related Complex↗