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Knowledge, attitude and practice (KAP) towards epilepsy in secondary school students in Tanzania.

Persons with epilepsy are shunned and discriminated against in education, employment, and marriage in Africa, because epilepsy is seen as a highly contagious and shameful disease in the eyes of the public. These observations come from many studies carried out in Africa including recent ones in Nigeria and Liberia. The KAP towards epilepsy among school children in Tanzania has not been studied and this information is essential before a health education programme on epilepsy can be designed for incorporation into the school curriculum. Therefore a study was carried out on 426 secondary school children in Mahenge to find out their KAP towards epilepsy. Forty six pc (193 of 420, students attributed epilepsy to heredity, brain injury, brain infection and witchcraft in that order. About 60 pc (186 of 331) considered epilepsy to be contagious through physical contact, saliva, and breath. Hospital treatment was considered by 62.7 pc (248 of 395) students and 80 pc (346 of 422) considered epilepsy to be controllable. Over 90 pc (385 of 414) of the students believed an epileptic person to be mentally subnormal and considered this a major reason for not sending an epileptic child to school. Their belief in the contagiousness of epilepsy was a major reason for discriminating against an epileptic child or person playing with other children; going to school; sharing the same plate or bed and as a marriage partner and this was significantly more so in the lower than upper classes.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗

Indirect immunofluorescence for the diagnosis of Lassa fever infection.

The indirect immunofluorescent technique is a rapid method for identification of Lassa virus and Lassa virus antibody. In the study reported here, Lassa virus antigen was detected by this method in Vero cell cultures within 24 hours of their inoculation with an infected human blood specimen. A diagnosis could be made from field-collected specimens within 3 days of their receipt.Fluorescent antibodies against Lassa virus were detected in human serum as early as 7 to 10 days after onset of illness, and were detected as long as 61 months after infection. Complement fixing antibodies were not as long lasting.No antigenic differences were noted by the indirect immunofluorescence technique between several Lassa virus strains isolated from Nigeria, Liberia, and Sierra Leone over a 6-year period.

Animals↗

Sequence analysis of an immunogenic and neutralizing domain of the human T-cell lymphoma/leukemia virus type I gp46 surface membrane protein among various primate T-cell lymphoma/leukemia virus isolates including those from a patient with both HTLV-I-associated myelopathy and adult T-cell leukemia.

Human T-cell lymphoma/leukemia virus type I (HTLV-I) causes adult T-cell leukemia/lymphoma and HTLV-I-associated myelopathy. Specific regions within the outer envelope proteins of other retroviruses, e.g., human immunodeficiency virus type 1, are highly immunogenic and, because of the selective pressure of the host immune system, quite variable. Mutations in the external envelope protein gene of murine retroviruses and human immunodeficiency virus type 1 influence cellular tropism and disease pathogenesis. By contrast, no disease-specific viral mutations have been identified in HTLV-I-infected patients. However, all isolates studied thus far have originated from leukemic cell lines, peripheral blood mononuclear cells, or cerebrospinal fluid lymphocytes from patients with HTLV-I-associated myelopathy and adult T-cell leukemia/lymphoma and, therefore, may not truly reflect tissue-associated variation. The midregion of the HTLV-I gp46 external envelope glycoprotein (amino acids 190-209) induces an antibody response in 90% of infected individuals, and a hexapeptide in this region (amino acids 191-196) elicits antibodies in rabbits which inhibit syncytia formation and infection of target lymphocytes. Because of the above, we expected the neutralizing domain of the gp46 env gene of HTLV-I to possess disease or organ-associated mutations selected by the infected host's immune system. Hence, we amplified, cloned, and sequenced HTLV-I DNA directly from in vivo central nervous system, spleen, and kidney specimens, and a leukemic cell line from a patient (M. J.) with both HTLV-I-associated myelopathy and adult T-cell leukemia/lymphoma to discern the possibility of tissue- and/or disease-specific variants. In addition, we sequenced several HTLV-I isolates from different regions of the world, including Papua New Guinea, Bellona, and Liberia, and compared them to other previously published HTLV-I and related retroviral sequences. The 239-base pair sequence corresponding to amino acids 178 to 256 in gp46 displayed minor tissue-specific variation in clones derived from central nervous system tissues from patient M. J., but overall was highly conserved at both the DNA and amino acid levels. Variation was observed in this region among the other HTLV-I, simian T-cell lymphoma virus type I, and HTLV-II isolates in a pattern that was consistent with their known phylogenetic relationship. No consistent disease-related changes were observed.(ABSTRACT TRUNCATED AT 400 WORDS)

Amino Acid Sequence↗

Cryopreservation of infective larvae of Onchocerca volvulus (Filarioidea: Onchocercidae).

Infective larvae (L3) of Onchocerca volvulus were procured in Liberia, West Africa, in the natural black fly vector, Simulium yahense. A cryobiological technique was developed to preserve L3 of O. volvulus that were fully viable after thawing. Larvae were treated before cooling with 4 cryoprotective compounds. Three compounds, dimethyl sulfoxide (DMSO), glycerol, and ethylene glycol, were prepared with distilled water. The fourth compound was DMSO prepared in different concentrations with 0.25 M sucrose. The treatment with DMSO + 0.25 M sucrose cryoprotectant resulted in the highest survival of infective larvae. Five cooling rates between 0.5 C/min and 20.0 C/min were applied. The highest survival of L3 was with the cooling rate of 1.0 C/min. Two-step cooling of L3 was applied. In the first step, L3's were frozen to 5 levels from -10.0 C to -20.0 C, -30.0 C, -40.0 C, -60 C, and -80.0 C, and in the second step, larvae were transferred into liquid nitrogen at -196 C for rapid cooling and storage. The survival was the highest when larvae were cooled to approximately -40 C prior to transfer into liquid nitrogen. Slow, gradual, and rapid thawing procedures were applied. The survival was the highest in rapid warming.

Animals↗

Epidemiology of epilepsy in developing countries.

Epilepsy is an important health problem in developing countries, where its prevalence can be up to 57 per 1000 population. This article reviews the epidemiology of epilepsy in developing countries in terms of its incidence, prevalence, seizure type, mortality data, and etiological factors. The prevalence of epilepsy is particularly high in Latin America and in several African countries, notably Liberia, Nigeria, and the United Republic of Tanzania. Parasitic infections, particularly neurocysticercosis, are important etiological factors for epilepsy in many of these countries. Other reasons for the high prevalence include intracranial infections of bacterial or viral origin, perinatal brain damage, head injuries, toxic agents, and hereditary factors. Many of these factors are, however, preventable or modifiable, and the introduction of appropriate measures to achieve this could lead to a substantial decrease in the incidence of epilepsy in developing countries.

Adolescent↗

Five cases of Plasmodium falciparum malaria in active duty Navy personnel participating in Operation Assured Response.

During Operation Assured Response in Liberia and Sierra Leone, between May and July 1996, five confirmed cases of falciparum malaria occurred in U.S. Navy personnel. The threat of malaria in west central Africa was recognized from the outset, and preventive medicine guidance was given to all the units participating in Operation Assured Response. The use of personal protective measures as well as drug chemoprophylaxis (daily doxycycline) was stressed. Among these cases, all patients admitted to either not using personal protective measures or not taking the medication as directed. This report serves to review the individual cases and remind the reader of the need to comply with prophylaxis, daily use of doxycycline, when prescribed.

Adult↗

One thousand days until the target date for global poliomyelitis eradication.

On April 6, only 1000 days will remain until the end of 2000, the target date established by the World Health Assembly in 1988 for the eradication of poliomyelitis and included as a year 2000 goal by the World Summit for Children in 1990. Progress toward this goal has included elimination of endemic polio from the Western Hemisphere in 1991 and apparent elimination of endemic transmission in 1997 from both the Western Pacific and European (except Turkey and Tajikistan) regions of the World Health Organization (WHO). In addition, globally, reported polio cases have decreased >90% since 1988. These accomplishments underscore the feasibility of global eradication. All countries with endemic polio, except for Democratic Republic of Congo, Liberia, Sierra Leone, and Somalia, have conducted National Immunization Days, one of the key strategies advocated by WHO to achieve polio eradication.

Global Health↗

[Poisonous caterpillars in French Guyana. 5 cases].

BACKGROUND: Certain caterpillars produce venomous substances and cases of human envenomation are regularly published. CASE REPORTS: We report 5 cases of caterpillar-induced envenomation observed in French Guyana. The caterpillar bites produced variable clinical manifestations. Automeris liberia provoked acute pain and skin necrosis: Dirphia tarquinia, erythema; Hylesia, persistent erythematous plaque (4 days); Megalopyge, erythematous and edematous lesions at the site of the bite and distant skin lesions; Automeris, syncopal pain and edematous infiltration of the thigh lasting several days. DISCUSSION: Caterpillar envenomation necessitates consultation, emergency unit care, or even hospitalization. It is important to identify the causal caterpillar species in case of envenomation in order to evaluate risk. Lonomia achelous must always be suspected because this species can cause major fibrinogenolysis.

Adult↗

Jonas E. Salk.

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Famous Persons↗