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Incidence of hepatitis A virus (HAV) infection in rural Liberia.

To provide background for future hepatitis A vaccine trials, sera were collected from 0- to 4-year-old Liberian infants and their mothers on two occasions an average of 14.75 months apart and tested for antibody to hepatitis A virus (anti-HAV). The prevalence of anti-HAV rose from 2.5% in infants 0-6 months of age to 70% in children 3-4 years of age and did not differ between male and female infants. The annual incidence of new infections was slightly lower in the first year of life (35%) than in the subsequent 3 years, when it averaged 45%. The presence of HBV infection did not affect the incidence of HAV seroconversion. No clinical hepatitis was recognized in the subjects who seroconverted. Dual hepatitis A and B virus infection were observed; these were all clinically inapparent. The extraordinary incidence of HAV infection documented in the present study offers an opportunity for vaccine efficacy trials requiring minimal numbers of subjects.

Adolescent↗

Sickle cell-beta +-thalassaemia: a haematological and clinical study in Liberia.

Clinical and haematological features of 20 patients of several Liberian ethnic groups with sickle cell-beta +-thalassaemia are reported. Haemoglobin analysis showed increased Hb A2 values, high Hb A levels (median 25%), variable amounts of Hb F and a slight imbalance of non alpha/alpha globin chain synthesis ratios. The clinical and other haematological findings varied but the disease seems to run a relatively mild course in the majority of the patients.

Adolescent↗

Lassa virus antibodies in hospital personnel in western Liberia.

The sera of 844 Liberian hospital staff memebers were positive for Lassa Virus (LV) antibodies in a survey using the indirect fluorescent antibody technique (IFAT). In two hospitals in Lofa County near the Sierra Leone border, the prevalence, 15.4%, was significantly higher than the 8.4% in seven others. There were near differences between the prevalence among laboratory workers, 15.3%, and other workers, 7.7%, and between midwifery students, 21.2%, and midwives, 4.2%, suggesting their infection from patients or their blood products. However, the over-all prevalence among those with patient contacts was the same as that among those without direct patient contact; most LV infections were apparently acquired from sources other than patients in hospital. This finding, the lack of evidence of hospital outbreaks and the presence of comparable prevalences in all age groups suggest that LV infections occur on a continuing basis in this population. In one hospital the comparison of the results of IFAT and complement fixation tests revealed some who reacted by one technique and not by the other. In one person the titre by IFAT had dropped from 1:32 to undetectable levels in two years. This finding prompts caution in the interpretation of results.

Adolescent↗