RESUMO
Comparative tests of Wade's "purified acillus suspension" and the standard lepromin prepared from the same pool of leproma have been made in the Philippiones, Netherlands New Guinea, East Africa and South Africa. Consistently in the comparisons the standard lepromin gave more positive Mitsuda reactions, or more strong reactions, than the suspension; and in the healthy children tested the PBS sometimes gave negative results when the reactions to lepromin were positive. For this reason alone it would not be satisfactory for use in field work in which children are involved. Lepromin gave more early reactions than the suspension in the cases for which that effect was reported (Philippines), suggesting that in the preparation of the latter the immediately-available antigenic elements had partly been eliminated. The suspension on the whole caused somewhat less ulceration of the reaction lesions, which is a point in its favor. However, contrary findings were not infrequent, so use of the product could not be advocated strongly on that ground. The results in tuberculoid cases permit comparison of the reactivities of the four different regional groups, whether considering average sizes of the reaction lesions or the percentage of the stronger reactions. Despite the high percentages of positive reactors in the Philippine subjects, the New Guinea people proved to be distinctly more so, and the East African cases the most reactive of all. The South African cases were much less reactive in comparison. The question of why people living in different environments differ materially in reactivity remains an intriguing problem.
Assuntos
Antígeno de Mitsuda/classificação , Hanseníase , Hanseníase/classificaçãoRESUMO
To ascertain whether or not high dilutions of lepromin would be practical for the field testing of normal populations, two series of tests were made with healthy schoolchildren aged 6-9 years. The first series comprised five groups averaging 116 children each, all of Opon poblacion (town), the second one five groups averaging 92 each, all of outlying barrios (rural villages). None had been lepromin tested before or BCG vaccinated, and none was given more than one injection of lepromin. In the first series two lepromins made by different methods (M, by Mabalay, and W, By Wade) were compared with each other and with the Dharmendra antigen, and two dilutions (1/10 and 1/20) of the stock W lepromin were also used. The tests in the second series were with five concentrations of the W lepromin: 1/1 (i.e., undiluted), 1/10, 1/20, 1/40 and 1/80. With respect to the late reaction, the two lepromins in Series 1 gave the same results, 75 per cent positives. The M stock, however, elicited fewer early reactions than the W stock, suggesting that boiling may be less effective than autoclaving in freeing the soluble antigenic elements involved in that reaction. In series 2 the full-dose W lepromin gave rise to more positive reactions of both kinds than it had in Series 1, and the dilutions gave increasingly large differences with respect to the late reaction. The Dharmendra antigen proved ineffective in eliciting either type of response in these very young and immature subjects, this result with the late reaction probably due to the extraction of the lipids during manufacture....
Assuntos
Criança , Antígeno de Mitsuda/administração & dosagem , Antígeno de Mitsuda/efeitos adversos , Hanseníase/classificação , Hanseníase/diagnósticoRESUMO
1- Approximately 40 per cent of the sera from healthy children residing in an area endemic for leprosy gave positive results when tested for antituberculopolysaccharides. The titers approached those seen in normal individuals generally. 2- There was no apparent correlation between lepromin reactivity of the donors and the reactivity of their sera. 3- Differences in specificities of the test antigens is present by way of explanation.
Assuntos
Antígeno de Mitsuda , Hanseníase , Hanseníase/classificação , Hanseníase/diagnósticoRESUMO
1- A field study of leprosy in the Virgin Islands has demonstrated that the disease is about ten times as prevalent in St. Croix (10-14 per 1,000) as in St. Thomas (1-1.5 per 1,00), and previous reports (3, 4) indicate that for a least 100 years the relative frequency has been much the same. St. Thomas has been favored, economically; its people have a more adequate diet; it has had a higher level of health and sanitation, and it has had considerably lower general mortality and morbidity rates than St. Croix. 2- In two-thirds of the cases of leprosy the first signs of disease appeared before 20 years of age, a smaller proportion than in Cebu, Philippine Islands (1). It is suggested that the greater prevalence in Cebu may favor earlier infection. 3- Prevalence in the Virgin Islands increases with age and it is greater in persons over 50 years old than in most other localities where intensive surveys have been made. The large proportion of cases in older age groups is interpreted as suggestive evidence of declining incidence. 4- Leprosy is about equally prevalent in females and males in the Virgin Islands, a condition similar to that found in West African natives, but in marked contrast to that found in the Philippines and most other areas. If males are more susceptible to the disease they would be expected to exhibit higher prevalence universally and not in certain localities only. It is suggested therefore that in the Philippines males may be more exposed than females, whereas in the Virgin Islands exposure may be approximately equal. It should be borne in mind, however, that even where infections are equally common in females and in males, a greater proportion may conceivably remain latent in one sex than in the other, because of some environmental variation. 5- Leprosy was found to be more prevalent in Negroes than in other racial groups in the Virgin Islands. 6- A history of contact with antecedent cases, either within or without the household, was obtained in nearly 70 per cent of patients under 20 years of age but in a much smaller proportion of older cases. 7- Leprosy was found to be much more frequent among the lower economic classes where there are found also higher morbidity rates for other diseases, less cleanliness, less favorable housing conditions and more inadequate diet. 8- Lepromatous leprosy comprises less than 30 per cent and neural leprosy more than 70 per cent of all cases in the Virgin Islands. These proportions...