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PubMed1979

[Studies on the serological manifestation of the hepatitis B-virus-infections in the Republic of Liberia (author's transl)].

The prevalence of hepatitis B virus infections was examined in four groups from Liberia using radioimmunoassays for HBsAg, anti-HBs and anti-HBc. At the age of 15-19 years 90% have been infected, at the age of 40 years 100%. In a rubber plantation 30% had HBsAg, in the remaining 3 groups only 13% were HBsAg-positive. In the first group onchocerciasis was also a more frequent finding. However the parasitic infection was not the cause of the HBs-antigenemia. The HBsAg-concentration is mostly lower in the positive Liberians than in German HBsAg-carriers. Apparently the HBV caused frequently latent infections with low production of viral antigens in Liberia.

Adolescent↗
PubMed1983

Frequency of haematuria and proteinuria among Schistosoma haematobium infected children of two communities from Liberia and Tanzania.

The frequencies of haematuria and proteinuria among children of two rural communities with different Schistosoma haematobium endemicity from Liberia and Tanzania were compared. Although the prevalence and intensity of S. haematobium infections were lower in the Tanzanian community, the frequencies of haematuria and proteinuria were significantly higher when compared to the Liberian community. The semi-quantitative dip stick tests for haematuria and proteinuria showed a comparable, good specificity (haematuria 85%, proteinuria 80%), but a community-specific sensitivity. The dip stick test for haematuria detected 85% (proteinuria 82%) of all S. haematobium infected subjects in Tanzania compared to 68% (proteinuria 57%) in Liberia. The significance of these observations in relation to S. haematobium related morbidity is discussed.

Adolescent↗
PubMed1982

Human paragonimiasis caused by Paragonimus uterobilateralis in Liberia and Guinea, West Africa.

In the children from Liberia and one woman from Guinea an infection with the lung fluke Paragonimus uterobilateralis was diagnosed, being the first cases of human paragonimiasis recorded in these two West African countries. Species determination was based on measurements and morphological structure of the parasite ova isolated from sputum and stool of the patients, and supported by biological and epidemiological evidence of the occurrence of this parasite species in natural animal hosts and P. uterobilateralis--metacercariae in freshwater crab populations in various parts of Liberia.

Adolescent↗
PubMed1983

The distribution and interaction of haemoglobin variants and the beta thalassaemia gene in Liberia.

In a population survey in Liberia, West Africa, 12 major tribes were examined for the prevalence of Hb S, Hb C, and the beta thalassaemia (beta Thal) gene. Hb C is rare; Hb S and beta Thal occur in polymorphic frequencies. The distribution of both genes shows an inverse correlation. The beta Thal trait was diagnosed by quantitation of Hb A2 on DE 52-microchromatography. This method proved to be reliable and useful for mass screening.

Adolescent↗
PubMed1993

Classification of clinical falciparum malaria and its use for the evaluation of chemosuppression in children under six years of age in Liberia, west Africa.

The possible role of malaria as cause of morbidity was assessed during one year in 262 children aged 6 months to 6 years living in two villages in a rural area of Liberia. The study population was followed by weekly clinics and three-monthly surveys and the children were randomly allocated to receive either chloroquine or placebo every 3 weeks. The morbidity of the children was evaluated by criteria based on the history and the clinical condition into four different stages, in order to describe the probability that an observed clinical event could be attributed to malaria infection, based on the presence of detectable parasites in the blood, the history the previous week, and the clinical status of the child. The level of anaemia, splenomegaly and measured body temperature supported that malaria was the major contributor to the overall morbidity observed. Based on the stage classification of clinical illness, children were classified as having 'possible clinical malaria' or 'probable clinical malaria'. Malaria appeared to be an important cause of febrile episodes during both dry and rainy seasons. During the rainy season more than 60% of the children experienced at least one clinical malaria episode, and during the dry season more than 50% of the children experienced at least one clinical attack of malaria. Children receiving chemosuppression had overall fewer clinical malaria attacks, and the effect of the chemosuppression was most pronounced in the dry season, the odds ratio comparing children receiving regular chemosuppression with children receiving presumptive treatment only was estimated to 0.39 (0.25-0.62).

Anemia↗
PubMed1977

Seroepidemiology of the poliovirus in Monrovia (Liberia).

Neutralizing antibodies against poliovirus have been studied in 265 persons in Monrovia (Liberia). 34% of the individuals studied possessed antibodies against the three polioviruses, 23% against two, 26% against one; the remaining 17% showed none. The three poliovirus antibodies were evenly distributed amongst the population, although there was an indication that antibodies to polio 2 occurred more commonly in females than in males. The distribution of the antibodies did not seem to be influenced by place of residence, source of drinking water or social class. Significant variations in the immunological state according to age were noted. The study of concordance and discordance of antibody titre in the blood of neonates and their mothers revealed that the lower percentage of titre concordance for polio 3 has no statistical value. The low titre in the neonates (an average for each poliovirus scarcely above 1:16) is a sign of insufficient titre in the adults. The need for a massive antipoliomyelitis campaign among infants and adult women is stressed.

Age Factors↗
PubMed1979

Malaria and haemoglobin A2 levels in northern Liberia.

The influence of malaria on HbA2 levels was investigated in two groups of children aged two to nine years from the Mano tribe of northern Liberia. One group, 174 children living in a town where there is malaria control, had a parasite rate of 6.5%, only a few having palpable spleens, but 282 children living in an area of intense malaria transmission had a parasite rate of 92%. All but one child in this group had enlarged spleens. However, the difference in proportions of elevated HbA2 values within the limits for beta-thalassaemia, 8% and 10.3% respectively, was not statistically significant (0.5 greater than P greater than 0.1). It was concluded that the influence of malaria on HbA2 levels is not significant and that this parameter is valid for detecting beta-thalassaemia trait in this population. Further, iron deficiency may be a more important factor than malaria to consider when assessing the results of HbA2 estimations.

Child↗
PubMed1984

Endemic Lassa fever in Liberia. II. Serological and virological findings in hospital patients.

Patients admitted with fever to four Liberian hospitals were tested for Lassa fever (LF) by means of the indirect fluorescent antibody technique and by virus isolation. The incidence of LF and presumptive LF among consecutive febrile adult patients was 14% and 17% in two hospitals located in the interior; no cases of LF were found among 24 consecutive patients in a hospital near the coast. In the three inland hospitals the incidence of confirmed or presumptive LF among the patients in whom the diagnosis was seriously considered varied from 13% to 36%. Lassa virus was isolated from 17 patients out of the 59 cases found in this survey. LF is a common cause of fever in northern Liberia. The diagnosis depends upon the readiness of the staff to consider the diagnosis, the collection of blood specimens at appropriate times, and the preservation of sera at sub-freezing temperatures to permit survival of active virus and its subsequent recovery in an appropriate laboratory.

Adolescent↗
PubMed1985

Endemic Lassa fever in Liberia. III. Characterization of Lassa virus isolates.

Sixty-three virus isolates were obtained by inoculation of Vero cells with sera from 50 hospital in-patients in Liberia with acute febrile illnesses. 57 of the isolates were presumptively identified as Lassa virus (LV) by direct fluorescent antibody (DFA) staining of inoculated Vero cells. These, and six additional isolates obtained only by titration of supernatant fluids from inoculated Vero cells, were definitively identified as LV in a neutralization test. Two additional LV isolates were obtained from a patient's sera from Nigeria. By cross-neutralization tests, the Nigerian LV strains were serologically identical to the prototype Nigerian LV strain (PP) but were distinct from both a reference LV strain from Sierra Leone (SL), and from the Liberian (LIB) strains isolated in this study. The LIB and SL strains were closely related to each other, but not to the Nigerian LV strains. LIB LV strains were tested for virulence in strain 2 and 13 guinea-pigs, and a spectrum of virulence was observed which correlated only approximately with disease severity for human patients. Two human-lethal isolates killed all inoculated strain 2 and 13 guinea-pigs, whereas nine isolates from mildly ill patients were benign for guinea-pigs. Yet some LV isolates from severely ill or lethally infected patients, especially those from pregnant women and infants, were totally benign for guinea-pigs. These data suggest that antigenically distinct LV strains exist in nature, and that antigenically indistinguishable LV isolates may differ in virulence potential for various hosts.

Animals↗
PubMed1986

In vitro susceptibility of Plasmodium falciparum to amodiaquine, mefloquine, quinine and chloroquine in Liberia, West Africa.

The in vitro susceptibility of seven Plasmodium falciparum isolates to four schizonticidal drugs was studied in Yekepa area, northern Liberia, by the Rieckmann 24-hour micro method. The seven patients were successfully treated with the standard chloroquine regimen. The results of the individual in vitro tests all indicated full susceptibility to the four drugs. By probit analysis, the drug concentrations achieving 50% (EC 50) and 99% (EC 99) inhibition, respectively, were 0.2 and 0.7 microM chloroquine, 0.04 and 0.2 microM amodiaquine, 0.01 and 0.07 microM mefloquine and 1.4 and 3.0 microM quinine.

Amodiaquine↗
PubMedDate not supplied

Age-dependent occurrence of protective anti-Plasmodium falciparum sporozoite antibodies in a holoendemic area of Liberia.

Antibodies to Plasmodium falciparum sporozoites were detected in children aged 6 months to 9 years, and in adults, in a holendemic village near Yekepa, Liberia, by enzyme linked immunosorbent assay (ELISA) using the recombinant circumsporozoite protein R32tet32 or by inhibition of sporozoite invasion (ISI) of hepatoma cells. Both assays were significantly correlated with each other and showed that anti-sporozoite antibodies increase with age. ISI was more sensitive than ELISA and demonstrated significantly increased anti-sporozoite antibodies at age 5-6 years, when young children show partial clinical resistance to malaria. These results suggest that anti-sporozoite antibodies, as measured by ISI, may contribute to protection against malaria.

Adult↗
PubMed1990

Burn injury and management in Liberia.

Burn care in developing countries remains a challenge. This paper reviews the acute burn care of 21 patients admitted during a 1-year period to a hospital in Liberia. Lack of supplies and education, coupled with the local belief system, reflect on patient management. The study population totalled 21 patients, ranging from 1 to 62 years of age. TBSA burns ranged from 2 to 60 per cent (mean 21 per cent), 61 per cent of patients were grafted. The time between burn and graft varied between 5 and 96 days (mean 29.8). Graft take varied between 40 and 100 per cent (mean 81 per cent). Of the grafted patients 66.6 per cent received blood (average 732 ml). At the time of presentation 61.9 per cent of patients had other illness. The average number of hospital days was 37.9 (range 2-76). The mortality rate was 14.2 per cent. When managing burns in a developing country, adoption of a simple, clearly defined method of treatment, together with education of the care-givers, is suggested. As in the developed world, however, prevention is the critical factor.

Acute Disease↗
PubMed2005

Vaccination coverage survey versus administrative data in the assessment of mass yellow fever immunization in internally displaced persons--Liberia, 2004.

Yellow fever (YF) is a mosquito-borne vaccine-preventable disease with high mortality. In West Africa, low population immunity increases the risk of epidemic transmission. A cluster survey was conducted to determine the effectiveness of a mass immunization campaign using 17D YF vaccine in internally displaced person (IDP) camps following a reported outbreak of YF in Liberia in February 2004. Administrative data of vaccination coverage were reviewed. A cluster sample size was determined among 17,384 shelters using an 80% vaccination coverage threshold. A questionnaire eliciting demographic information, household size, and vaccination status was distributed to randomly selected IDPs. Data were analyzed to compare vaccination coverage rates of administrative versus survey data. Among 87,000 persons estimated living in IDP camps, administrative data recorded 49,395 (57%) YF vaccinated persons. A total of 237 IDPs were surveyed. Of survey respondents, 215 (91.9%, 95% CI 88.4-95.4) reported being vaccinated during the campaign and 196 (83.5%, 95% CI 78.6-88.5) possessed a valid campaign vaccination card. The median number of IDPs living in a shelter was 4 (range, 1-8) and 69,536 persons overall were estimated to be living in IDP camps. Coverage rates from a rapid survey exceeded 90% by self-report and 80% by evidence of a vaccination card, indicating that the YF immunization campaign was effective. Survey results suggested that administrative data overestimated the camp population by at least 20%. An emergency, mop-up vaccination campaign was avoided. Coverage surveys can be vital in the evaluation of emergency vaccination campaigns by influencing both imminent and future immunization strategies.

Adolescent↗
PubMedDate not supplied

Antimicrobial resistance of Neisseria gonorrhoeae in Liberia.

The prevalence and molecular characteristics of penicillinase-producing Neisseria gonorrhoeae (PPNG) and tetracycline-resistant N. gonorrhoeae (TRNG) were determined in 10 clinics in Monrovia, Liberia, to assess the likely effectiveness of the current standard treatment with penicillin or tetracycline. One hundred gonococcal strains were isolated from 146 urethral swabs and 261 cervical swabs and screened for susceptibility to ceftriaxone, penicillin, spectinomycin and tetracycline by the disk diffusion method; 83% were resistant to penicillin and 63% to tetracycline. Twenty-one strains from 18 men and 3 women with uncomplicated gonorrhoea were subjected to more detailed characterization. These 21 strains belonged to 5 auxotype/serovar classes; 86% were PPNG/TRNG. Three PPNG harboured the 4.4 MDa penicillinase plasmid and 16 the 3.2 MDa plasmid. All TRNG harboured the 25.2 MDa plasmid and their MICs for tetracycline were > 32 mg/L. They gave a PCR product which, according to its restriction pattern, corresponded to the American type tetM gene. By the agar dilution method, all strains exhibited intermediate resistance to sulphamethoxazole-trimethoprim (19:1) (co-trimoxazole) with MICs of 8-32 mg/L. All strains were susceptible to spectinomycin and ciprofloxacin. The MICs for gentamicin were 4-8 mg/L. The use of effective and affordable antimicrobial chemotherapy with either 500 mg ciprofloxacin or a single dose of gentamicin is discussed, with consideration of molecular biological, pharmacological and public health aspects.

Ceftriaxone↗
PubMed1995

Pre-marital fertility in Liberia.

This analysis of the 1986 Liberia Demographic and Health Survey data finds remarkably high fertility levels among women who have never married or lived with a man, reflecting widespread pre-marital sex and a lack of use of contraception. It is found that single Liberian women are more likely to foster out children than married Liberian women of the same age.

Adolescent↗
PubMed1994

Religious affiliation and fertility in Liberia.

This study examines fertility differentials by religious affiliation in Liberia, within the context of two competing hypotheses: the characteristic and particularised theology. Using a subsample of currently married women from the 1986 Liberian Demographic and Health Survey, the study examines the fertility of five religious groups: Catholic, Protestant, Moslem, traditional, and other women. Overall, the findings are more consistent with the characteristic hypothesis, because the small fertility differentials by religious affiliation are largely accounted for by differences in the socioeconomic and demographic characteristics of these women.

Adolescent↗
PubMedDate not supplied

Tinea capitis due to Trichophyton soudanense in Cincinnati, Ohio, in internationally adopted children from Liberia.

Two sisters, ages 5 and 6 years, who were adopted from Liberia, presented in Cincinnati, Ohio, with tinea capitis. Fungal cultures grew Trichophyton soudanense, a dermatophyte rarely seen in North America. Both girls had multiple other infections. They responded well to therapy with oral griseofulvin and topical selenium sulfide. With the current increase in international travel and adoption, nonendemic dermatophyte infections such as this need to be recognized.

Antifungal Agents↗