Search PubMed⌕ Search

Biomedical subjects

P Piot

Publications and source records attributed to P Piot.

At least 145 records · Page 8Linked 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

Human T cell lymphotropic virus type I (HTLV-I) among female prostitutes in Kinshasa, Zaire.

Three hundred seventy-seven prostitutes from Kinshasa, Zaire, were enrolled in a study to determine associated risk factors for human immunodeficiency virus type 1 (HIV-1) and human T cell lymphotropic virus type I (HTLV-I) infection. Twelve samples (3.2%) were seropositive for HTLV-I; results for HIV-1 (101 [26.8%]) are reported elsewhere. HTLV-I prevalence increased with age, and seven of the seropositive women originated from the Equateur region, a remote area in northwestern Zaire. The prevalence among women from Equateur (7.2%) was higher than that of women from all other regions (1.8%, P = .02). Presence of HTLV-I antibodies was not associated with frequency or type of sex practice. In a subsequent study, 350 serum samples were obtained from a variety of subjects in the Equateur region in 1986. Nineteen (5.4%) showed antibodies to HTLV-I. These data and a recent report of a cluster of patients with tropical spastic paraparesis from this region suggest that HTLV-I is endemic in the Equateur region of Zaire.

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

HIV infection among lower socioeconomic strata prostitutes in Nairobi.

A cohort of 418 lower socioeconomic strata prostitutes were enrolled in a study of the epidemiology of sexually transmitted diseases (STDs) between January and April 1985. Sixty-two per cent of the women were seropositive for HIV infection at enrollment. Significant associations were found between HIV seropositivity and Tanzanian origin (OR = 2.12, CI 95% = 1.18-3.81, P less than 0.03), younger age, a shorter duration of prostitution, reduced fecundity, use of oral contraceptives (OR = 1.8, CI 95% = 1.1-2.9, P less than 0.05) and genital ulcer disease (OR = 3.32, P less than 0.00001). No associations were noted with other STD. Stepwise logistic regression analysis confirmed independent associations between HIV infection and Tanzanian origin (OR = 2.27, CI 95% = 1.25-4.14, P less than 0.007), reduced fecundity (OR = 0.83, CI 95% = 0.74-0.94, P less than 0.003), oral contraceptive use (OR = 2.02, CI 95% = 1.22-3.35, P less than 0.006) and duration of prostitution (OR = 0.39, CI 95% = 0.23-0.65, P less than 0.004). Oral contraceptives may increase susceptibility to HIV or may be a marker for other factors which increase risk of acquisition. Further studies are necessary to confirm this association.

Acquired Immunodeficiency Syndrome↗
PubMed1990

Infection with HIV as a risk factor for adverse obstetrical outcome.

We carried out a case-control study to investigate the role of sexually transmitted diseases (STDs), including infection with HIV, as risk factors for adverse outcome of pregnancy. Overall, 1507 women were enrolled within 24 h of delivery. Cases (n = 796) were mothers of low-birthweight infants (less than 2500 g) or of stillborns. Low-birthweight infants were divided into preterms (n = 373) and neonates small for gestational age (n = 234). Stillborns were separated into intrauterine fetal deaths (n = 120), and intrapartum fetal deaths (n = 69). Controls were selected from mothers delivering a live baby of greater than or equal to 2500 g (n = 711). The maternal HIV seroprevalence in the control group was 3.1%. Prematurity was associated with maternal HIV antibody [8.6% seropositive; adjusted odds ratio (OR) 2.1; 95% confidence interval (CI) 1.1-4.0], as was being born small for gestational age (7.7% seropositive; adjusted OR 2.3; 95% CI 1.2-4.2). In mothers who delivered a stillborn baby, both intrauterine fetal death (11.7% seropositive; adjusted OR 2.7; 95% CI 1.3-5.5) and intrapartum fetal death (11.6% seropositive; adjusted OR 2.9; 95% CI 1.3-6.5) were independently associated with HIV seropositivity in the mother. Maternal syphilis was confirmed as an important risk factor for intrauterine fetal death (14.3% positive; adjusted OR 4.8; 95% CI 2.4-9.5). No significant association was found between other STDs, including gonococcal and chlamydial infection, and adverse obstetrical outcome. These results suggest an association between maternal HIV infection and adverse obstetrical outcome, defined as low birthweight and stillbirth.

Abortion, Spontaneous↗
PubMed1990

Characterization, in vitro susceptibility, and clinical significance of CDC group HB-5 from Rwanda.

From June 1984 until July 1988, CDC group HB-5 isolates were recovered from the exudates of genital ulcers in 25 of 675 (3.6%) patients (204 women, 471 men) in Kigali, Rwanda. Among a group of 145 men presenting with urethritis but without genital ulcers, a positive culture for HB-5 of a specimen from the coronal groove of the penis of only 1 man (0.7%) was found. During the same period, the organism was not obtained in cultures of vaginal specimens from 838 women without genital ulcer disease. The main biochemical characteristics of the isolated microorganisms included weak oxidase positivity, catalase negativity, indole positivity, reduction of nitrate to nitrite, acid production from D-glucose and fructose, and H2S production. A total of 75% of the organisms were susceptible to penicillin G. beta-Lactamase production was detected by the chromogenic cephalosporin test in a quarter of the strains. This study confirms that HB-5 can be found in the genital tract. HB-5 was associated with genital ulcer disease in Rwanda. However, its etiologic role in patients with this condition remains unclear.

Drug Resistance, Microbial↗
PubMed1990

Evaluation of an rRNA-derived oligonucleotide probe for culture confirmation of Neisseria gonorrhoeae.

The reliability of an rRNA-derived oligonucleotide probe for Neisseria gonorrhoeae was tested with 187 N. gonorrhoeae isolates, 81 Neisseria meningitidis isolates, and several strains of other bacterial species. The probe proved to be 100% specific and 100% sensitive. N. gonorrhoeae cells could also be reliably identified in contaminated cultures with the oligonucleotide probe. The 2.6-megadalton cryptic plasmid used as a probe for N. gonorrhoeae was shown to be less sensitive, detecting 179 of 181 N. gonorrhoeae isolates.

DNA Probes↗
PubMed1990

Towards developing a diagnostic algorithm for Chlamydia trachomatis and Neisseria gonorrhoeae cervicitis in pregnancy.

C trachomatis and N gonorrhoeae are major causes of maternal and neonatal morbidity and mortality in developing countries. To identify characteristics predictive of cervical infection, we examined pregnant women attending an antenatal clinic in Nairobi, Kenya. C trachomatis was isolated from 14/178 (8%), and N gonorrhoeae from 17 (10%); cervical infection with either pathogen was present in 28 (16%). Two characteristics were independently predictive of cervical infection by logistic regression analysis; the presence of either endocervical mucopus or induced endocervical bleeding, relative risk 4.2 (95% confidence interval (CI) 2.2 to 8.0) and having more than one sexual partner during pregnancy, relative risk 3.3 (95% CI 1.4 to 7.6). A screening programme for cervical infection which tested women with one or both risk markers would have a sensitivity of 68% (95% CI 51 to 85%) and a positive predictive value of 0.35 (95% CI 0.22 to 0.47). In countries where resources are limited, diagnostic algorithms incorporating clinical signs and behavioural characteristics may be useful in identifying pregnant women at high risk of cervical infection.

Adult↗
PubMed1990

HIV-1 infection in HIV-1 enzyme-linked immunoassay seronegative patients in Kinshasa, Zaire.

Serum samples of 62 African patients who had clinical manifestations of HIV-1 infection but were seronegative for HIV-1 by ELISA (Organon) were subsequently further tested by another HIV-1 ELISA test (Wellcozyme), HIV-1 IgG Western blot, HIV-1 antigen detection and HIV-2 ELISA. Patients' lymphocytes were cultured for HIV-1 and 2. Because of limited quantities of serum available all tests were not performed on all samples. Seven (26%) of 27 sera of patients meeting the WHO clinical case definition of AIDS were Western-blot-positive. In contrast, of 35 patients' sera with possible HIV related disease, only one (3%) was Western blot positive (P = 0.02) and none of 75 sera from HIV-1 ELISA (Organon) seronegative blood donors (P less than 0.01) were Western blot positive. Of 30 HIV-1 ELISA (Organon) seronegative patients tested with the HIV-1 ELISA Wellcozyme assay only one was seropositive (this patient's serum was also Western blot positive). Of 17 HIV-1 ELISA (Organon) seronegative patients tested, HIV-1 antigen was found in 1 case (6%) (this patient's serum was Western blot negative). None of the 34 patients tested by HIV-2 serology was HIV-2 seropositive. HIV-1 was isolated by culture in 3 (21%) of 14 HIV-1 ELISA seronegative patients (sera of the 3 patients were Western blot negative). In total, 12 (19%) of 62 HIV-1 ELISA (Organon) seronegative patients were found to be positive for HIV, either by Western blot HIV antigen testing or viral culture.(ABSTRACT TRUNCATED AT 250 WORDS)

AIDS Serodiagnosis↗
PubMed1990

[Retinitis in an infant infected with HIV].

A 7 month-old HIV-infected infant of African origin was admitted to the hospital. A routinely performed fundoscopy showed the presence of an unilateral left retinitis. Urine culture was positive for cytomegalovirus (CMV). Treatment with AZT (3.5 mg/kg/6 hr) was started concomitantly with monthly 350 mg/kg gammaglobulin intravenous administration. The retinitis resolved after 3 weeks and no recurrence was observed after 4 months of follow-up. The difficulties in establishing a diagnosis and in evaluating a response to treatment are briefly discussed.

Cytomegalovirus Infections↗
PubMed1990

[Neisseria gonorrhoea in Pikine (Senegal): survey of antibiotic sensitivity].

The antimicrobial sensitivity of 96 strains of Neisseria gonorrhoeae, isolated in 1987-88 in Pikine, Senegal was determined. Twenty four percent of isolates produced beta-lactamase (PPNG). Among the beta-lactamase negative strains, 27% showed a decreased sensitivity to penicillin (MIC 0.125-0.25 mg/l) and 3% were resistant (MIC greater than or equal to 0.5 mg/l). Seventeen percent of isolates showed a decreased sensitivity to thiamphenicol (MIC 1-4 mg/l) and 7% were moderately resistant to tetracycline (MIC 2-4 mg/l). All isolates were sensitive to spectinomycin and sensitive to moderately sensitive to kanamycin. During an earlier survey performed in 1981, chromosomal resistance to tetracycline was not seen and only 4% of strains were beta-lactamase positive. These results suggest a decreasing antimicrobial sensitivity of N. gonorrhoeae in Pikine. Spectinomycin can be used as a first choice antimicrobial and thiamphenicol may be recommended as a valuable alternative treatment of gonorrhoea in Pikine, Senegal.

Drug Resistance, Microbial↗
PubMed1990

The epidemiology of sexually transmitted diseases in Africa and Latin America.

We review some aspects of the epidemiology of sexually transmitted diseases (STDs) in the developing countries of Africa and Latin America. Apart from their elevated prevalence, they are responsible for important morbidity in mother and child. Stillbirth, premature delivery, conjunctivitis, and respiratory tract morbidity of the neonate are frequently caused by STDs. Sequelae in adult women include pelvic inflammatory disease, ectopic pregnancy, and infertility. The emergence of antimicrobial resistance has complicated the picture in recent times. Genital ulcer disease is very common in developing countries, the most important being chancroid. Both continents are experiencing major epidemics of the acquired immunodeficiency syndrome (AIDS) and human immunodeficiency virus (HIV) infection with different epidemiological characteristics than in the industrialized world. A link might exist between the high prevalence of STDs and the rapid heterosexual spread of HIV infection.

Acquired Immunodeficiency Syndrome↗
PubMed1990

The epidemiology of HIV and other sexually transmitted infections in the developing world.

As for several other infectious diseases, sexually transmitted diseases (STD) in many developing countries are characterized by a high incidence and prevalence, a high rate of complications and sequelae (particularly in women and neonates), a different clinical spectrum (more genital ulcer disease), and a severe problem of antimicrobial resistance (in N. gonorrhoeae and C. trachomatis). In Africa, HIV is mainly spread heterosexually, resulting in a major problem vertically acquired HIV infection in children. STDs, in particular those associated with genital ulceration, are enhancing the efficiency of sexual transmission of HIV, and their high prevalence may partly explain the occurrence of a major heterosexual epidemic of HIV in Africa, as opposed to Europe. Factors contributing to the spread of STDs are to a large extent demographic, sociobehavioural and medical such as a larger pool of adolescents and young adults, prostitution, urban migration, indiscriminate use of antibiotics and inadequate medical facilities and STD control programmes. Programmes for the prevention and control of STD and AIDS should be an immediate priority in many developing countries.

Developing Countries↗
PubMed1990

Isolation of mycobacteria from stools and intestinal biopsies from HIV seropositive and HIV seronegative patients with and without diarrhea in Kinshasa, Zaïre. Preliminary results.

To determine the role of mycobacteria as etiologic agent in HIV related enteritis in Africa, the following study was performed in 1986, in the department of Internal Medicine in Mama Yemo Hospital in Kinshasa, Zaire. Stool and intestinal biopsies were obtained from HIV seropositive and HIV seronegative patients with and without diarrhea. Patients with known Mycobacterium tuberculosis infection were not enrolled. Acid fast bacilli were found in fecal smears of 6 (10%) of 59 HIV seropositive patients and in none of 41 HIV seronegative patients (p = 0.04). Isolation rates of mycobacteria were slightly lower in HIV seropositive patients than in HIV seronegative patients (25% vs 44%, p = 0.08) and significantly lower in patients with diarrhea than in patients without diarrhea (15% vs 44%, p = 0.02). Mycobacterium avium-intracellulare was the species most frequently isolated from stools, in 12% of the HIV seropositive and in 22% of the HIV seronegative patients. Mycobacteria were not isolated from any of the intestinal biopsies obtained in 17 HIV seropositive patients with persistent diarrhea and any of these biopsies showed histological evidence of a mycobacterial infection. This study suggests that mycobacteria do not seem to play a major role in causing diarrhea in HIV seropositive patients.

Adult↗
PubMed1989

Treatment of adult gonococcal keratoconjunctivitis with oral norfloxacin.

We evaluated the efficacy of oral norfloxacin in 15 patients with culture-proven gonococcal eye disease caused by Neisseria gonorrhoeae. The first seven patients received 1,200 mg of oral norfloxacin for three consecutive days. The other eight patients were each treated with a single oral dose of 1,200 mg of norfloxacin. All control cultures were negative, and there was no progression of the corneal lesions after treatment was initiated. No adverse effects were observed. The results of this study suggested that a single dose of oral norfloxacin may be a valuable alternative to the currently recommended treatment regimens for gonococcal eye disease because it combines high efficacy and low toxicity with low cost and excellent patient compliance.

Administration, Oral↗