Biomedical subjects
Publications and source records attributed to S Darougar.
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The causes of conjunctivitis and keratoconjunctivitis in 388 patients who attended eye casualty departments in Karachi, Pakistan, during a 5 month period were investigated. Most of these infections were diagnosed as adenovirus (291, 75%) or bacterial (71, 18.3%). Of the remainder, 9 cases (2.3%) were caused by herpes simplex virus and 7 (1.8%) by Chalmydia trachomatis. There was no evidence of typical active trachoma in this urban population. Bacteria or Candida albicans were also grown from 44 of the adenovirus cases (15%). Many of the bacteria grown from eyes in this study were resistant to antibiotics, probably because of inadequate and/or inappropriate self-medication with antibiotics in this community.
The serodiagnostic methods commonly used for the detection of antibodies in various chlamydial infections, the value of serodiagnosis, and the role of humoral responses in human immunity are reviewed. The methods most commonly used for serodiagnosis of chlamydial infections are indirect immunofluorescence tests and enzyme-linked immunosorbent assays. These tests are highly sensitive and have been extensively used in epidemiologic and clinical studies of chlamydial infections. The evidence suggests that these tests are cost effective for population screening and that the presence of a high level of specific IgG or IgM in blood or of IgG or IgA in local discharges is a useful indicator for the provisional diagnosis of chlamydial infection.
By use of triple-culture tests of each site, Chlamydia trachomatis was isolated from 112 women: from cervical material from 110, urethral material from 32, and rectal material from 19. Triple swabs provided 89 (81%) of 110 diagnoses of cervical infection; the first swab yielded 65 (59%), the second an additional 15 (14%), and the third an additional nine (8%). Three sets of cervical scrapings provided 102 (93%) of 110 diagnoses of cervical infections; the first scrapings yielded 76 (69%), the second an additional 22 (20%), and the third another four (4%). Of 32 women with positive urethral cultures, the first swab was positive in 28 (88%), and the second in the remaining four. Of 19 women with positive rectal cultures, the first swab yielded 11 (58%), the second an additional five (26%), and the third an additional three (16%). The results show that positive culture results obtained by use of a single swab underestimate the prevalence of chlamydial infection.
In a retrospective study, the prevalence of antibodies to Chlamydia trachomatis serovars D to K, C. pneumoniae, and C. psittaci in cases attending a genitourinary clinic was examined. Blood samples were collected from 7,002 cases attending the clinic in Doncaster, England between May 1983 and May 1990. Sera from these samples were tested by a modified microimmunofluorescence test using panels of microdots of egg-grown, purified elementary bodies representing a pool of C. trachomatis D to K, a single C. pneumoniae agent, a single C. psittaci agent, and a negative control. Serum specimens were tested for the presence of IgG and IgM at starting dilutions of 1/16 and 1/8, respectively. Chlamydial IgG at a level of 1/16 or higher and IgM at a level of 1/8 or higher was present in 66.6% and 2.6% of samples, respectively. Species-specific or cross-reactive IgG against C. trachomatis D to K, C. pneumoniae, and C. psittaci was present in 32.6%, 25.1%, and 0.1% of the samples, respectively. In 8.7% of samples, the level of IgG was similar against two or all three species (group-specific). IgM against C. trachomatis D to K, C. pneumoniae, or C. psittaci was present in 2.5%, 0.03%, and 0.04% of the samples, respectively. The results of the study show that antibodies to C. pneumoniae and C. psittaci account for up to half of all chlamydia IgG positive cases attending genitourinary clinics.(ABSTRACT TRUNCATED AT 250 WORDS)