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A middle-aged male resident of Benghazi, northeastern Libya, with radiological features of skeletal fluorosis associated with cervical radiculomyelopathy is reported. This is believed to be the first documentation of such a disorder from this non-tropical, non-endemic region.
An enzyme-linked immunosorbent assay (ELISA) was developed together with a western blotting technique for the detection of total and specific IgG and IgM antibodies to the contagious ecthyma (orf) virus in camel (Camelus dromedarius) sera and for identifying the seroreactive antigens of the virus. An outbreak of generalised contagious ecthyma in camels was diagnosed for the first time in Libya; the seropositivity rate in a herd with clinically affected camels was 37.9% (and was related to clinical signs) and in apparently normal herds was 0% to 6.8%. Two viral antigenic determinants (22 and 40 kDa) were shared by the western blotting patterns of all the positive camel sera tested, another viral antigenic component of 28 kDa was shared by the positive sera with high ELISA titres. Very close similarity was seen with the western blot of orf-positive sheep sera. It is considered that the ELISA technique was valid for orf serodiagnosis in the camel and could be usefully applied to other species at risk of orf infection.
This paper presents the latest results of geoarchaeological research on the Upper Pleistocene sequence in the Jebel Gharbi (previously called Jebel Nafusah), a mountain range located in Tripolitania, northwestern Libya. Numerous archaeological sites are found adjacent to springs that formed as a consequence of tectonic activities. The springs originated when Upper Pleistocene earthquakes produced ground displacements that created water outlets, some of which are still active. Springs are spread all along the massif and at the foot of the mountains in Jebel Gharbi. We suggest that they offered attractive resources to populations coming from drier parts of North Africa or the near-by Sahara. The earliest sites associated with the springs include Aterian lithic techno-complexes that have been dated between 80,000 and 40,000 BP. Since then, these springs have attracted many populations, as documented here by settlements belonging to the Later Stone Age (Upper Palaeolithic), Iberomaurusian (Late Upper Palaeolithic or Epipalaeolithic), Neolithic, Roman period, and present time.
Mitochondrial DNA (12S rRNA, 16S rRNA) sequences were analysed within Tarentola mauritanica and other selected species of Tarentola. Several highly genetically distinct lineages occur in North Africa, revealing phylogroups in southern and central Morocco, northern Morocco, Algeria, Tunisia, and Libya. A single haplotype characterizes populations across Spain, Portugal, Italy, Menorca, Crete, and Tunisia raising the possibility of an anthropogenic introduction followed by rapid population expansion throughout southern Europe. T. mauritanica is paraphyletic with respect to T. angustimentalis, a Canary islands endemic. The high genetic diversity observed across North Africa suggests T. mauritanica may represent a species complex.
In 1998, outbreaks of human immunodeficiency virus type 1 (HIV-1) and hepatitis C virus (HCV) infection were reported in children attending Al-Fateh Hospital in Benghazi, Libya. Here we use molecular phylogenetic techniques to analyse new virus sequences from these outbreaks. We find that the HIV-1 and HCV strains were already circulating and prevalent in this hospital and its environs before the arrival in March 1998 of the foreign medical staff (five Bulgarian nurses and a Palestinian doctor) who stand accused of transmitting the HIV strain to the children.
Lipoid proteinosis is an autosomal recessive condition associated with variable scarring and infiltration of skin and mucosae. The disorder has recently been shown to result from loss-of-function mutations in the extracellular matrix protein 1 gene (ECM1) on 1q21. Extracellular matrix protein 1 has important physiological and biological roles in aspects of epidermal differentiation, binding of dermal collagens and proteoglycans, and in regulation of angiogenesis. Thus far pathogenic mutations have been described in 16 different families with lipoid proteinosis throughout the world. In this report, we describe the clinico-pathological features of a 10-year-old boy with lipoid proteinosis from a consanguineous Libyan family. By direct sequencing of the affected individual's genomic DNA, we identified a homozygous nonsense mutation in exon 2 of the ECM1 gene, Q32X. This mutation is the most 5' of all ECM1 mutations described thus far and is predicted to ablate the ECM1a, ECM1b and ECM1c splice variants of the ECM1 gene and to result in a severe clinical phenotype. Sequencing of DNA from the affected individual's five siblings revealed that four were heterozygous carriers of Q32X, findings that have important implications for genetic counselling given the high frequency of consanguineous marriages in Libya.
In a representative sample of 201 diabetic patients of Tripoli, Libya, 138 were obese. The highest percent of diabetics and obese belong to the age group 41-50 years. In all age groups, there was a parallel increase/decrease in obesity with diabetes. Regulation of body weight should be considered very important in control of diabetes.
A 44-year-old German fell ill in Libya, where he had been living for 10 years, with high fever, rigor and a nonitching centrifugally spreading macular rash, which had spared the head, hands and soles. In addition, a systolic cardiac murmur was heard. The Weil-Felix reaction had a titre rising within 3 days from 1:160 to 1:640, confirming the diagnosis of rickettsial disease, the total clinical picture indicating typhus. On treatment with chloramphenicol (1 g three times daily i.v.) the fever subsided within 5 days. On the ninth day treatment was changed to oral doxycyclin, 200 mg daily for 3 weeks. Echocardiography surprisingly revealed a floating thrombus, about 4 x 8 cm, attached to the hypo- and even akinetic apex of the left ventricle. In addition there was single-vessel coronary disease. Since the segmental contraction abnormality persisted after the typhus had been cured, a causal connection with the rickettsial disease is unlikely. The thrombus was removed at the time of a aortocoronary bypass operation: his course has been unremarkable since then.
The endemicity of cutaneous leishmaniasis in northwest Libya was confirmed. Although the strains isolated from man had variable biological properties they were all biochemically similar according to the tests used. The Libyan strains resemble those of zoonotic cutaneous leishmaniasis in parts of the Middle East, but can be differentiated from urban or highland strains. It is suggested that the recent discovery of the disease is due partly to the improvement in medical services, and partly to the development of new areas of land for agriculture and housing.
Preliminary results show cutaneous leishmaniasis in Libya to be, sometimes at least, a rural zoonotic infection. The parasites are transmitted, probably by Phlebotomus papatasi, between the rodents Psammomys obesus and Meriones libycus. The banks and 'islands' in the main channel of seasonal wadis provide the right combination of vegetation and permanence for the maintenance of an intense focus.
Forty-nine samples of raw cow's milk and 20 samples of fresh white soft cheese were collected directly from 20 local dairy factories in the north-west of Libya and analysed for the presence of aflatoxin M1 (AFM1). The samples were analysed using a high-performance liquid chromatography technique for toxin detection and quantification. Thirty-five of the 49 milk samples (71.4%) showed AFM1 levels between 0.03 and 3.13 ng ml(-1) milk. Multiple analyses of five milk samples free of AFM1 artificially contaminated with concentrations of AFM1 at 0.01, 0.05, 0.1, 1.0 and 3.0 ng ml(-1) showed average recoveries of 66.85, 72.41, 83.29, 97.94 and 98.25%, with coefficients of variations of 3.77, 4.11, 1.57, 1.29 and 0.54%, respectively. Fifteen of 20 white soft cheese samples (75.0%) showed the presence of AFM1 in concentrations between 0. 11 and 0.52 ng g(-1) of cheese. Multiple assays of five cheese samples free of AFM1 spiked with different concentration of AFM1 (0.1, 0.5, 1.0 and 3.0 ng g(-1)) showed average recoveries of 63.23, 78.14,83.29 and 88.68%, with coefficients of variation of 1.53, 9.90, 4.87 and 3.79%, respectively. The concentrations of AFM1 were lower in the cheese products than in the raw milk samples.
A study was performed in a pediatric hospital in Tripoli, Libya where the familial backgrounds of 50 marasmic infants were compared with those of a group of 50 essentially healthy infants of similar age. Families with marasmic infants had more children but lived in smaller homes than the comparison families. Total income was similar in both sets of families and major consumer items such as television sets, cars, and refrigerators were widely present in both groups. Families with marasmic infants, however, had less literate mothers who tended to breastfeed for shorter periods and to feed purchased pureed baby foods more frequently. The causation of marasmus in these circumstances is probably unhygienic infant feeding despite the availability of clean water and modern kitchen facilities. All 3 factors, adequate housing, adequate income, and an adequately educated mother appear to be necessary simultaneously before infantile marasmus can be prevented.
In resource-limited countries, nosocomial transmission of bloodborne pathogens is a major public health concern. After a major outbreak of human immunodeficiency virus (HIV) infection in approximately 400 children in 1998 in Libya, we tested HIV, hepatitis C virus (HCV), and hepatitis B virus (HBV) markers in 148 children and collected epidemiological data in a subgroup of 37 children and 46 parents. HIV infection was detected in all children but one, with HCV or HBV coinfection in 47% and 33%, respectively. Vertical transmission was ruled out by analysis of parents' serology. The children visited the same hospital 1-6 times; at each visit, invasive procedures with potential blood transmission of virus were performed. HIV and HCV genotypic analyses identified a HIV monophyletic group, whereas 4 clusters of HCV sequences were identified. To our knowledge, this is the largest documented outbreak of nosocomial HIV transmission.
Twenty-two consecutive patients with rickets were studied in Benghazi, Libya. All were less than 2 years old. Rickets was associated with traditional cultural habits that limited sunshine exposure of the mothers and their infants, and with breast-feeding. Serum concentrations of the vitamin D metabolites 25-hydroxyvitamin D (25-OHD), 1,25-dihydroxyvitamin D, and 24,25-dihydroxyvitamin D, and other parameters of mineral metabolism were typical of vitamin D deficiency disease, as was the biochemical and clinical response to treatment. Minimum safe serum levels of 25-OHD (20 nmol/L), and the serum levels of vitamin D metabolites in response to vitamin D treatment, were identical to previously obtained results from native Norwegian and Norwegian immigrant children with rickets, suggesting lack of racial differences in response to vitamin D. Fifty percent of the patients had adequate levels of vitamin D metabolites at the time of diagnosis, indicating that they had recently received oral vitamin D or cutaneous exposure to sunshine. Many cases of rickets in the area may, therefore, be spontaneously cured when the children's maturity allows adequate mobility and independence to achieve exposure to sunshine.
BACKGROUND: There are, as yet, no data available about the incidence of celiac disease in Libya. The aim of this study was to test the occurrence of serologic markers in a group of Libyan children with positive clinical and histologic findings indicative of celiac disease diagnosis. METHODS: Thirty-nine children with untreated celiac disease and 50 healthy school children, all younger than 14 years, were included in the study. Enzyme-linked immunosorbent assay for immunoglobulin G and immunoglobulin A (IgA) antigliadin, antitissue transglutaminase, and anticalreticulin antibodies was used to evaluate the serologic markers of the celiac patients. Immunoglobulin A antiendomysial antibodies were detected by indirect immunofluorescence using human umbilical cord tissue. RESULTS: Clinical symptoms at presentation were weight loss (82%), abdominal distension (61.5%), diarrhea or steatorrhea (59%), pallor (41%), abdominal pain (20.5%), constipation (15%), vomiting (10%), and short stature (7.7%). Most of these symptoms disappeared after introduction of a gluten-free diet. Of 39 patients, only 23 (59%) were endomysium positive and positive also in all other serologic markers. The second group of patients with positive clinical and biopsy findings but antiendomysial antibody-negative findings was subdivided into two subgroups according to the IgA antigliadin antibody results. Individuals in the IgA gliadin-negative subgroup also lacked IgA autoantibodies. CONCLUSIONS: The authors' findings stress the importance of serologic testing not only for screening but also for confirmation of celiac disease.
Radiocarbon data from 150 archaeological excavations in the now hyper-arid Eastern Sahara of Egypt, Sudan, Libya, and Chad reveal close links between climatic variations and prehistoric occupation during the past 12,000 years. Synoptic multiple-indicator views for major time slices demonstrate the transition from initial settlement after the sudden onset of humid conditions at 8500 B.C.E. to the exodus resulting from gradual desiccation since 5300 B.C.E. Southward shifting of the desert margin helped trigger the emergence of pharaonic civilization along the Nile, influenced the spread of pastoralism throughout the continent, and affects sub-Saharan Africa to the present day.
A countrywide search for Creutzfeldt-Jakob disease in Israel disclosed 29 cases with onset between 1963 and 1972. Incidence in various ethnic groups varied in the narrow range of 0.4 to 1.9 per million population except among Jewish immigrants from Libya, among whom the incidence was 31.3 per million. An extraordinary excess of Creutzfeldt-Jakob disease exists in this ethnic group.
Mycobacterium tuberculosis, the etiological agent of tuberculosis, has lost many coding and noncoding regions in its genome during the course of evolution. We performed region-of-difference (RD) analysis using PCR-based genotyping of 131 M. tuberculosis clinical isolates obtained from four different countries, namely, India, Peru, Libya, and Angola. Our studies revealed that RD patterns are often distinct for strains circulating in specific geographical regions and can be used to trace the descent and spread of an isolate from its original reservoir. We describe our findings, which show that no single isolate from the four countries (n = 131) had all the 15 RDs either deleted or retained. Tuberculosis-specific deletion 1 (TbD1) was found to be conserved in 23% of the Indian isolates, indicating their possible ancient origin. RD9 was the most conserved region, RD11 was predominantly deleted, and RD6 was the most variable among the isolates in our collection irrespective of their geographic region. In contrast to earlier reports, our results demonstrate that the deletion of RD1 does not correlate with a decrease in the virulence potential of M. tuberculosis, as Indian isolates (n = 30) examined by us were from diseased individuals and yet had lost the RD1 region. Our results further illustrated that the intactness of the RD5 region may be associated with increased virulence of the organism. This study highlights that the RDs in M. tuberculosis genomes are geographically distributed and specific and may possibly be associated with virulence spectrum.