Epidemiology of ocular chlamydial infection in a trachoma-hyperendemic area

Article Abstract:

Trachoma, an eye disease caused by repeated infections with Chlamydia trachomatis, is the most prevalent infectious cause of blindness in the world today. Chlamydia eye infection develops as active follicular disease in children, scarring in younger adults, and trichiasis/entropion (the infolding of the margins of the eyelids and associated hairs) in older adults. The latter condition leads to blindness in some individuals. Children of preschool age are the most frequent reservoirs of trachoma. A total of 1,574 children, aged 1 to 9 years old, from 9 villages in Tanzania were included in this epidemiological study. Risk factor assessments were conducted, and demographic data concerning age, sex, personal hygiene and cleanliness of the home, proximity to water, animals present, number of flies around the doorway, type of roof on the house, and religion were collected for each participant. Specimens for cultures of Chlamydia trachomatis and fluorescent antibody studies were obtained from 1,085 of the children; specimens for laboratory testing were not collected from the remaining 31 percent. There was no difference in the proportion of clinical disease in the two groups (cultured and not cultured). The roles of risk factors in the dissemination of trachoma are discussed. Principal risk factors associated with Chlamydia eye infection are: an infected sibling; an excess of flies around the home; cattle herding; a traditional roof on the house; and practicing the local, undefined religion. Younger children and girls were at greater risk of clinical disease, but not of positive laboratory findings. (Consumer Summary produced by Reliance Medical Information, Inc.)

Risk factors, Disease transmission, Chlamydia trachomatis, Tanzania, Trachoma

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Community-based treatment of onchocerciasis with ivermectin: safety, efficacy, and acceptability of yearly treatment

Article Abstract:

Onchocerciasis is a connective tissue disease that can cause blindness. It is caused by a worm known as Onchocerca volvulus (formerly called Filaria volvulus). The disease is common in Latin America and in Africa. It is estimated that 17.5 million people have this disease, 85 million are at high risk for developing the disease, and 1 million people have problems with their vision as a result of the disease. Ivermectin is the drug of choice for treating onchocerciasis. To determine the effectiveness and safety of ivermectin, it was tested in 14,000 people living on a rubber plantation in a tropical rain forest in Liberia. In this population, more than 80 percent of the adults have onchocerciasis. Ivermectin was distributed throughout the community. The treatment program involved taking the drug once a year for three years. The effectiveness of ivermectin was determined by measuring the amount of Onchocerca volvulus present in a small area of skin. After two years of treatment with ivermectin, the amount of Onchocerca in the skin was reduced by 84 percent. Approximately 10 of every 1,000 people experienced an unfavorable reaction to the first treatment of ivermectin, and 4 of every 1,000 people had a bad reaction to the second treatment. Adverse reactions included rash, swelling of the arms and face, body pain and headache. During the third year, 98 percent of the population accepted treatment, indicating that the drug was well received. The results demonstrate that ivermectin is a safe and effective treatment for onchocerciasis. (Consumer Summary produced by Reliance Medical Information, Inc.)

Evaluation, Causes of, Drug therapy, Blindness, Eye diseases, Nematoda, Onchocerciasis, Ivermectin

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Association of nonmelanoma skin cancer and actinic keratosis with cumulative solar ultraviolet exposure in Maryland watermen

Article Abstract:

Skin cancer is the most common cancer found among the white population of the United States. It is estimated that 500,000 people will develop basal cell carcinoma or squamous cell carcinoma of the skin each year. Actinic keratoses are benign tumors of the skin which are widely regarded as a premalignant condition. It is estimated that 10 to 12 percent of actinic keratoses will develop into squamous cell carcinoma of the skin. To correlate the prevalence of these skin conditions with exposure to the sun, 808 watermen, who commercially gather fish, oysters, and crabs, were interviewed and examined. Twenty-five percent had actinic keratoses. Squamous cell carcinoma was observed in 4.3 percent of the subjects, and basal cell carcinoma was noted in 4.1 percent. Seven men (0.9 percent) had both types of skin cancer. Older age, childhood freckling, and blue eyes correlated with all three types of tumor. Watermen with higher annual ultraviolet B exposure were more likely to have squamous cell carcinoma and actinic keratoses, while watermen who sunburned more readily were more likely to have basal cell carcinoma and actinic keratoses, but not squamous cell carcinoma. The association of squamous cell carcinoma and ultraviolet B exposure was clear, whereas the relationship between ultraviolet light exposure and basal cell carcinoma is uncertain. This suggests that these two types of cancers may have different mechanisms of development. (Consumer Summary produced by Reliance Medical Information, Inc.)

Physiological aspects, Demographic aspects, Squamous cell carcinoma, Skin cancer, Solar radiation, Basal cell carcinoma, Actinic keratosis

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