Across cultures.
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In a study of 565 hepatitis B antigen (HBsAg) positive persons from the Auckland region, antibody to the hepatitis delta virus was detected in 38. The largest number were in Samoans (61%) although the infection was present in some other Pacific Islanders. Among HBsAg positive healthy blood donors, antenatal patients and acute hepatitis patients between 3.8 and 4.8% were anti-delta positive; while 28% of chronic hepatitis patients were positive suggesting an association between this disease and delta infection. Some positive results were also found in sera from intravenous drug addicts. By contrast, anti-delta was uncommon in New Zealand born Maoris or Europeans. Delta infection can be detected in some Pacific Islanders, some European immigrants as well as intravenous drug addicts and has the potential to spread in an epidemic form to HBsAg carriers in the general community. Widespread vaccination against hepatitis B is recommended to eventually reduce the number of HBsAg carriers in New Zealand.
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The data from the first 3 years of the Samoan pilot filariasis control programme were reanalysed using incidence instead of prevalence statistics. With these statistics, failures of diethylcarbamazine treatment can be roughly divided into three groups: primary treatment failures, manifested by persistent microfilaraemia; secondary treatment failures, manifested by microfilaraemia recurring within the prepatent period after apparently successful treatment; and new infections. When cases of persistent and recurrent microfilaraemia are excluded by appropriate statistical manipulations, the incidence of new infections is seen to be many times higher in persons who originally showed microfilaraemia. This suggests that susceptibility or exposure, or both, are not homogeneously distributed in the population, and indicates that proposed mathematical models of filarial epidemiology must be further refined. It also indicates that filariasis control programmes should devote more attention to studies and control methods aimed at this high-risk subgroup of the population.
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A 24-year-old Samoan woman had rhabdomyolysis, myoglobinuria, and acute renal failure, secondary to tropical pyomyositis. The pathogenesis, clinical manifestations, and management of pyomyositis and myoglobinuric renal failure are reviewed.
The purpose of this paper is to alert practitioners to the possibility of leprosy by giving practical points from local experience together with a modicum of background information. Local experience of 45 patients is described in the form of a recent survey done in 1979 in Auckland together with illustrative records.