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Protective correlates against HIVs may have evolved in human populations in the areas of historic occurrence of primate-to-man transmissions of SIVs ancestral to HIVs: studies in these populations may provide crucial insights for treatment and prevention of HIV infection.

Recent findings suggest that Human Immunodeficiency Viruses, HIV-1 and 2, might have been transmitted to humans from particular primate species. It is thought that some Simian Immunodeficiency Viruses (SIVs), from which HIVs presumably originated, existed in their primate hosts for ages. Behavioral characteristics increasing the probability of contact between these primates and humans (such as keeping monkeys for pets, hunting monkeys for food, improper handling of the monkey meat, etc.) documented in some African countries could have facilitated cross-species transmissions (CSTs) of HIVs. As it has been shown, multiple CSTs took place for both HIVs (1 and 2) and then, in a globalizing world, these local events led to the pandemic. Here, it is brought forward that in the regions of epizooty of SIVs closely related to HIVs, some human populations might have had exposure history to these viruses dating back hundreds years. Lacking the important framework for further spread provided by nowadays globalization, these CSTs could have led to isolated local HIV outbreaks limited to particular tribes or groups. The infections could have extinguished some populations while on the other hand provided evolutionary pressure to select for mechanisms protective for HIV infection and/or disease. Thus, here it is hypothesized that in the areas of the habitat of primates infected with SIVs, from which HIVs are thought to be originated, there could be historically exposed populations which might possess biological correlates of protection from HIVs. Current knowledge on the distribution of primates hosting HIV-related SIVs suggests that epidemiological, primatological, anthropological and molecular biological studies in the areas of Cameroon, Gabon, both Congos and Equatorial Guinea (for HIV-1) and Guinea-Bissau, Senegal, Guinea, Ivory Cost, Sierra Leone and Liberia (for HIV-2) could lead to the discoveries of correlates of protection against HIVs. It is also hypothesized that virology studies in the same areas might reveal less virulent and/or infective viruses which could provide insights in the HIV pathogenesis and vaccinology.

Acquired Immunodeficiency Syndrome↗

Mast cells in onchocercomas from patients with hyperreactive onchocerciasis (sowda).

In onchocerciasis, variations of the host's immune responsiveness produce a spectrum of clinical manifestations ranging from the common generalized to the rare hyperreactive form (sowda). For further characterization of the immune response, the localization and frequency of mast cells in onchocercomas from untreated and ivermectin-treated patients with hyperreactive onchocerciasis from Liberia and the Yemen were analysed and compared to the generalized form by immunohistochemistry with antibodies specific for human mast cell tryptase and chymase, histamine and IgE. The nodules were selected with special regard to only one pair of live, microfilariae-producing Onchocerca volvulus. Throughout the nodular tissue of the hyperreactive form, mast cells accumulated in the strong inflammatory infiltrates, especially near eosinophils and around cellular attacks on microfilariae as well as perivascularly. Their number was significantly higher in the whole nodular tissue compared to the generalized form. The highest numbers occurred in the nodule centre. Mast cells carried IgE and appeared activated. No mast cells were observed in the cystic parts or attached to adult worms or microfilariae. In onchocercomas, 1 and 3 days after treatment with ivermectin, microgranuloma formation by eosinophils and macrophages around damaged microfilariae was enhanced and accompanied by numerous mast cells. Attacks of neutrophils were also pronounced, but attacks by mast cells were not observed. In conclusion, hyperreactivity against microfilariae in onchocercomas clearly correlates with a strong mastocytosis and IgE production parallel to tissue eosinophilia.

Adult↗

Skewed contraceptive method mix: why it happens, why it matters.

Contraceptive prevalence has been central to family planning research over the past few decades, but researchers have given surprisingly little consideration to method mix, a proxy for method availability or choice. There is no 'ideal' method mix recognized by the international community; however, there may be reason for concern when one or two methods predominate in a given country. In this article method skew is operationally defined as a single method constituting 50% or more of contraceptive use in a given country. Of 96 countries examined in this analysis, 34 have this type of skewed method mix. These 34 countries cluster in three groups: (1) sixteen countries in which traditional methods dominate, most of which are in sub-Saharan Africa; (2) four countries in which female sterilization predominates (India, Brazil, Dominican Republic and Panama); and (3) fourteen countries that rely on a single reversible method (the pill in Algeria, Kuwait, Liberia, Morocco, Sudan and Zimbabwe; the IUD in Cuba, Egypt, Kazakhstan, Kyrgyz Republic, Moldova, Turkmenistan and Uzbekistan; and the injectable in Malawi). A review of available literature on method choice in these countries provides substantial insight into the different patterns of method skew. Method skew in some countries reflects cultural preferences or social norms. Yet it becomes problematic if it stems from restrictive population policies, lack of access to a broad range of methods, or provider bias.

Contraceptive Devices, Female↗

Enzyme polymorphism and the identity of Trypanosoma brucei gambiense.

Thirty-two isolates from man in known areas of Gambian trypanosomiasis, in the Sudan, Kenya, Zaire, Nigeria, Ivory Coast, Burkina Faso, Liberia and Senegal, were examined by isoenzyme electrophoresis of 11 enzymes. Comparisons were also made with our previously published results on 23 other stocks of similar origins, which had been examined in the same manner. All those stocks of low initial virulence to laboratory rodents, which thus conform to the accepted view of the behaviour of Trypanosoma brucei gambiense can be identified by characteristic combinations of enzyme patterns, especially certain aminotransferase markers. A limited study of superoxide dismutase polymorphism suggested a further marker of value. The isolates of high initial virulence to rodents, which are thus behaviourally akin to T. b. rhodesiense, did not share these characteristics. We conclude that there exists a homogeneous group of trypanosomes of wide dispersion throughout tropical Africa, characterized by certain isoenzyme combinations and low initial virulence to rodents, which corresponds to the classical concept of T. b. gambiense. The features of limited antigenic repertoire, high resistance to normal human serum and restriction fragment length polymorphisms of the genes for certain variant surface glycoproteins also appear to be characteristic of this group.

Africa↗

Strain differentiation of Onchocerca volvulus from Uganda using DNA probes.

Polymerase chain reaction (PCR) combined with non-radioactive DNA hybridization was applied for the detection and characterization of a 150 bp tandem repeat of Onchocerca volvulus. DNA of worms from western Uganda was amplified and then probed with a digoxygenin-labelled oligonucleotide, specific for the forest form of O. volvulus and compared to samples from various African countries. Hybridization was only observed with PCR products from the forest in Liberia, south-eastern Ghana, Benin and southern Cameroon, but not with worms from Uganda or the savannah in Burkina Faso and northern Ghana. A nested PCR using primers derived form the forest form-specific DNA sequence confirmed these results. Morphometric studies revealed length differences between the microfilariae of Ugandan O. volvulus to those of West Africa, especially to those of the savannah in Burkina Faso. It is concluded that the forest/savannah classification of O. volvulus from West Africa is not suitable for Simulium neavei-transmitted O. volvulus from Uganda.

Africa, Western↗

Trypanosoma congolense: the distribution of enzymic variants in east and west Africa.

A total of 114 stocks of Trypanosoma congolense originating from Kenya, Uganda, Tanzania, Zambia and Sudan, but including, for comparison, stocks from The Gambia, Liberia, Ivory Coast, Nigeria and Cameroun, were compared by isoenzyme electrophoresis for 6 enzymes. The zymodemes were grouped, both from a dendrogram and using a cladistic method, after calculating the dissimilarity, or distance, between profiles. Previous observations are broadly confirmed, the zymodemes clustering separately according to geographical origin and ecological zone. Thus, one group was composed almost entirely of East African stocks, and another of stocks from both East and West Africa, although each group was of savanna origin. A third group was composed of stocks from the humid, rain-forest zones of West Africa, and was particularly characterized by isoenzyme variants of superoxide dismutase and glucose-phosphate isomerase. Two stocks from the Kenyan coast formed a markedly separate group, which may be taxonomically distinct.

Africa, Eastern↗

Unexpected anthropophagic behaviour in Anopheles quadriannulatus.

The strongly anthropophilic behaviour of Anopheles gambiae Giles sensu stricto (Diptera: Culicidae), the most important malaria vector in Africa, has been demonstrated by field and laboratory studies. Other members of the An. gambiae complex express varied degrees of anthropophily. Anopheles quadriannulatus (Theobald) species A and B are more zoophilic members of the complex and hence are considered to be of no medical importance. Olfactometer experiments with An. quadriannulatus species A have demonstrated attraction to both human and cow odour. To extend these olfactometer observations a choice experiment was conducted in an outdoor cage with a human and a calf as baits, using laboratory-reared mosquitoes. Anopheles gambiae s.s. (from Liberia) and two strains of An. quadriannulatus species A (SKUQUA from South Africa, SANGQUA from Zimbabwe), marked with different coloured fluorescent powders for identification purposes, were released simultaneously and given an equal opportunity to feed on either host. The experiment was repeated six times. Bloodmeals were identified using the precipitin technique. Anopheles gambiae s.s. showed highly anthropophagic behaviour, taking 88% of bloodmeals from the human host. In contrast, both strains of An. quadriannulatus fed with equal frequency on the human or the calf; the response to either host was not significantly different. These results confirm the olfactometer findings and demonstrate anthropophagic behaviour not previously recorded in this species. This finding has implications for prospective manipulation of host preference for genetic control purposes.

Animals↗

Antibodies to a non-repeat region of Plasmodium falciparum antigen Pf155/RESA in individuals from malaria-endemic areas.

Human antibodies to the repeat regions of the Plasmodium falciparum asexual blood stage antigen Pf155/RESA interfere with parasite growth in vitro, but the significance in this respect of antibodies to non-repetitive epitopes is less clear. In this study the levels of antibodies to a non-repetitive part of Pf155/RESA (residue 199-221) in malaria-exposed individuals were analysed, as was the parasite-inhibitory capacity of such antibodies. Residue 199-221 is of particular interest since it includes a sequence homologous to a cytoadherence-related motif from band 3. Sera from donors in Liberia and Tanzania were analysed for reactivity in ELISA with synthetic peptides together overlapping this part of Pf155/RESA. High antibody reactivity was observed in most of the sera with two peptides including residues 199-211 and 202-214, respectively. Specific antibodies were affinity-purified from selected sera using these peptide sequences and were shown to react with Pf155/RESA by immunofluorescence and Western blotting. The purified antibodies were furthermore shown to inhibit parasite growth in vitro. The results suggest that both repeat and non-repeat epitopes in Pf155/RESA elicit antibodies with potential to protect against malaria infection.

Amino Acid Sequence↗

Stabilized viral nucleic acids in plasma as an alternative shipping method for NAT.

BACKGROUND: Preservation of the integrity of viral nucleic acids in blood specimens during shipping and handling is crucial for NAT and viral load monitoring. An economical and convenient method is described for nucleic acid stabilization by using an RNA stabilizing solution (RNAlater, Ambion) in plasma that is designed for the shipment of samples to tropical countries. STUDY DESIGN AND METHODS: HCV, HIV, and HBV FFP were compared with RNAlater-treated plasma and dried plasma spots (DPSs) after incubation at 37 degrees C, which was chosen as an upper limit of ambient shipping temperature, for up to 28 days. HCV-infected chimpanzee plasma was shipped at either room temperature after RNAlater treatment or as frozen plasma in liquid nitrogen from Liberia to New York City. They were then compared for HCV RNA levels. The nucleic acid stabilities were determined by quantitative PCR by using a molecular beacon assay on a sequence detection system (ABI 7700, PE-Biosystems) and by visualizing the PCR components on an acrylamide gel. RESULTS: Quantitative PCR data showed that a 60:40 or greater ratio of RNAlater:plasma volume successfully stabilized HCV RNA and HIV RNA in plasma for up to 28 days at 37 degrees C. HBV DNA in plasma was stable for up to 14 days at 37 degrees C without any stabilizing solution. DPSs on filter paper stabilized viral nucleic acids, but the recoveries were 3 to 10 times less than those with frozen plasma. The integrity of the 5' UTR region of HCV RNA in RNA later-treated chimpanzee plasma was intact when its PCR component was viewed on an acrylamide gel. CONCLUSION: The DPS method stabilized nucleic acids, at least with the extraction method used, was less sensitive than use of RNAlater, and required tedious manual handling. RNAlater provides a convenient way of stabilizing viral nucleic acid in plasma at ambient temperature during sample transportation.

5' Untranslated Regions↗

Development by injection in Simulium damnosum s.l. of two Onchocerca species from the wart hog to infective larvae resembling type D larvae (Duke, 1967).

Four wart hogs (Phacochoerus aethiopicus) examined in the Sudan savanna of North-Cameroon were all found infected with two types of skin microfilariae. One was O. ramachandrini Bain, Wahl and Renz, 1993, the adult worms of which live in the subcutaneous tissues of the feet. The other, smaller type belongs to a new Onchocerca species, the adult worms of which were not yet found. O. ramachandrini-microfilariae were evenly distributed across the whole body surface, those of Onchocerca sp. were concentrated on the back. The two species of microfilariae were isolated from an infected hide separated under the dissecting microscope and injected into the thorax of pupae-hatched S. squamosum and S. damnosum s.slr. females. Both filariae developed in both flies at high rates (33-47% of injected microfilariae) and without pathological forms to infective larvae L3). Both L3-species had a caudal tip, were long, slender and very motile and had a conspicuous glandular oesophagus. L3 from O. ramachandrini-microfilariae had a long glandular oesophagus (55% of total L3 length), a round head and measured an average of 955 microns long and 19.2 microns wide. L3 from the other microfilaria-species were shorter (845 microns, P < 0.001) and thinner (16.7 microns, P < 0.001) and had a shorter glandular oesophagus (36%, P < 0.001), a shorter tail (P < 0.01) and a conical head. Both L3-species, by their caudal tip, their long and slender silhouette, their great motility and their conspicuous glandular oesophagus resemble non-O. volvulus filarial L3 known, since many years, to occur in "wild" S. damnosum s.l. in Cameroon (Type D larvae, Duke, 1967) and in Liberia (Agamofilaria Type VI, Voelker and Garms, 1972). During our study, L3 such larvae were found in 12 wild S. damnosum s.l. from two geographically different areas of North Cameroon and all identified as O. ramachandrini. The excellent development of the two Onchocerca species from the wart hog in S. damnosum s.l. after artificial infection, and the identification of all recently examined wild Type D larvae as O. ramachandrini suggest that S. damnosum s.l. is a natural vector of O. ramachandrini and that most (if not all) of the Type D larvae in onchocerciasis vectors in North-Cameroon originate from wart hogs.

Animals↗

Solomon Carter Fuller, M.D. (1872-1953): American pioneer in Alzheimer's disease research.

The appointment of Alois Alzheimer to Emil Kraepelin's clinic and laboratory at the Royal Psychiatric Hospital, University of Munich in 1903 offered new opportunities for clinical and pathological studies of the brain. At the opening of the facility in 1904, Alzheimer selected five foreign visiting students as his graduate research assistants, among whom was an American, Dr. Solomon Carter Fuller. A glimpse of Fuller's background as an African-American (born in Liberia) at the turn of the century, his continuing research after leaving Germany in 1906, and his critical view of the Alzheimer dementia entity are recounted. He was held in high esteem as a practicing neuropsychiatrist and teacher in the Boston area.

Alzheimer Disease↗

Cuticular-hydrocarbon discrimination between Anopheles gambiae s.s. and An. arabiensis larval karyotypes.

Examination of chromatograms of karyotyped larvae of Anopheles gambiae s.s. and Anopheles arabiensis has revealed that there are differences in the profile of their epicuticular hydrocarbons. A discriminant analysis of the quantitative hydrocarbon data has shown that the An. gambiae Mopti 2Rbc/bc karyotype from Mali could be separated from the Forest 2La/a karyotype from Liberia in > 80% of cases. Similar analysis permitted > 80% separation of individuals of two karyotypes of Anopheles arabiensis: 2Rab/ + from Burkina Faso, and 2Rb/b from Madagascar.

Animals↗

Enzyme polymorphism and the distribution of Trypanosoma congolense isolates.

Conditions were established for demonstrating, by electrophoresis, polymorphism in 12 soluble enzymes from Trypanosoma congolense. Three enzymes had identical mobilities in every stock, variation occurring among the remaining nine. Enzyme profiles were determined in 78 stocks collected from various hosts in a number of African countries, and were used by the computer to establish relationships within the collection. The major groupings formed solely from the isoenzymes corresponded remarkably closely to the origins of the stocks. Two distinct enzymic divisions formed, related only at the 20% level; Division A consisted entirely of stocks isolated in the humid coastal areas of West Africa, while Division B consisted mostly of stocks from drier zones throughout Africa. Some large groupings within these two main divisions also correlated with particular areas of origin within the major ecologic zones. The dry zone Division B included one group almost exclusively from East Africa, and two quite distinct enzymic groups from The Gambia; isolates from Liberia and Ivory Coast tended to fall into separate groups within the humid zone Division A. It is suggested that the differences between the major divisions may be associated with infraspecific adaptation to the different vector species occupying the separate habitats.

Africa↗

Comparison of the sex-pheromone components of Lutzomyia longipalpis (Diptera:Psychodidae) from areas of visceral and atypical cutaneous leishmaniasis in Honduras and Cost Rica.

The terpene components of extracts prepared from male Lutzomyia longipalpis (Diptera: Psychodidae) collected from four sites in Honduras and one in Costa Rica were analysed by high-performance liquid chromatography, gas chromatography and coupled gas chromatography--mass spectrometry. The terpene components of Lu. longipalpis from other regions of South America have previously been shown to be sex pheromones. The flies from the four areas of Honduras, where Leishmania chagasi infection may lead to visceral or atypical cutaneous leishmaniasis, were found to be homogenous, all producing 9-methylgermacrene-B. Three types of terpene (9-methylgermacrene-B, a novel homosesquiterpene and a small amount of diterpene) were detected in pools of flies from Liberia, Costa Rica, where only atypical cutaneous leishmaniasis has been found. These results indicate that there are probably at least two and possibly three distinct populations of Lu. longipalpis in this region. The clinical manifestation of Leishmania chagasi infection does not appear to be dependent on which population of Lu. longipalpis transmitted the parasite.

Animals↗

Increased incidence of cycloguanil resistance in malaria cases entering France from Africa, determined as point mutations in the parasites' dihydrofolate-reductase genes.

The incidence of cycloguanil resistance in 501 Plasmodium falciparum isolates from individuals entering France from Africa was estimated by a method based on PCR-restriction-fragment-length polymorphisms. None of the subjects had taken antifol prophylaxis. Annual incidence of the resistance, detected as a point mutation at codon 108 in the parasite's dihydrofolate-reductase gene, increased from 19.8% in 1995 to 43.6% in 1997 (P < 0.001). The proportion of isolates found to be susceptible (i.e. wild-type) among travellers returning from the African countries known as Group 2 in France (i.e. Burkina Faso, Côte d'Ivoire, Gambia, Ghana, Guinea, Liberia, Madagascar, Mali, Mauritania, Niger, Senegal, Sierra Leone, Tchad and Togo) was reasonably high (62.9%) and much higher than in the other subjects returning from other identifiable countries in Africa (35.3%). The antimalarial prophylaxis recommended in France to those travelling to Group-2 countries, chloroquine-proguanil, therefore still seems reasonable, although cycloguanil resistance may seriously undermine the efficacy of this drug combination in the future.

Africa↗

Body size and form of children of predominantly black ancestry living in West and Central Africa, North and South America, and the West Indies.

Stature, sitting height, hip width, arm and calf circumferences and body weight have been measured in black children of Richland County, South Carolina. Lower limb height and three indices of body shape were obtained from the measurements. Sample size exceeded 200 for each of five age-sex groups representing girls and boys aged 6 years, girls and boys aged 9 years, and boys aged 11 years. Comparisons are made with findings from previous research on children of predominantly black ancestry living in west and central Africa, the West Indies, and North, Central and South America. Black children of Richland County measured during 1974--77 are taller than black children studied since 1960 in Angola, Chad, Ghana, Liberia, Nigeria, Senegal, Uganda, Anguilla, Barbados, Cuba, Guyana, Jamaica, Nevis, St. Kitts, St. Vincent, and Surinam. Children of well-to-do black families in Accra and Ibadan are no taller or heavier than black children of Richland County taken without regard to socio-economic status. In hip width, averages for Richland County black children are larger than those for children of the Hutu and Yoruba tribes; in arm girth they are larger than children of the Hutu and Tutsi tribes. Age changes and group differences are reported for hip width relative to lower limb height, and lower limb height relative to sitting height. During childhood, the hip/lower limb index decreases, and the lower limb/sitting height index increases. Almost identical hip/lower limb indices characterize black populations in Africa, Cuba, and the United States.

Africa↗

Revisiting sub-Saharan African countries' drug problems: health, social, economic costs, and drug control policy.

This article takes an international perspective on the drug problem in sub-Saharan Africa. This analysis borrows ideas from physical and economic geography as a heuristic device to conceptualize the global narcoscapes in which drug trafficking occurs. Both the legitimate and the illegal drug trade operate within the same global capitalist system and draw on the same technological innovations and business processes. Central to the paper's argument is evidence that sub-Saharan African countries are now integrated into the political economy of drug consumption due to the spill-over effect. These countries are now minor markets for "hard drugs" as the result of the activities of organizations and individual traffickers that use Africa as a staging point in their trade with Europe and the United States. As a result, sub-Saharan African countries have drug consumption problems that were essentially absent prior to 1980, along with associated health, social, and economic costs. The emerging drug problem has forced African countries to develop their own drug control policy. The sub-Saharan African countries mentioned below vary to some extent in the level of drug use and misuse problems: Burundi, Comoros, Djibouti, Eritrea, Ethiopia, Kenya, Madagascar, Malawi, Mauritius, Mozambique, Reunion, Rwanda, Seychelles, Somalia, Tanzania, Uganda, Zambia, Angola, Cameroon, Central African Republic, Chad, Congo, Congo (Zaire), Equatorial Guinea, Gabon, Sao Tome and Principe, Botswana, Lesotho, Namibia, South Africa, Swaziland, Benin, Burkina Faso, Cape Verde, Cote d'Ivoire, Gambia, Ghana, Guinea, Guinea Bissau, Liberia, Mali, Mauritania, Niger, Nigeria, Senegal, Sierra Leone, and Togo. As part of this effort, African countries are assessing the health, social, and economic costs of drug-use-related problems to pinpoint methods which are both effective and inexpensive, since their budgets for social programs are severely constrained. Many have progressed to the point of adopting anti-drug laws or legislation, or of establishing a drug control agency. They are also cooperating regionally to coordinate drug control measures and working with the Organization of African Unity (OAU). In addition, almost all the sub-Saharan African countries are signatories to all United Nations drug conventions. Since the drug problem in Africa has international origins, it will take concerted international cooperation and coordinated effort to combat the "social cancer" of drugs.

Africa South of the Sahara↗