RESUMO
A comparative study has been made of the reactions in healthy Cebu children to lepromin, to human, avian and Battey PPD's, and to heat-killed suspensions of whole M. tuberculosis and M. avium. The bacillary suspensions were given only to nonreactors to the homologous tuberculins to avopid violent reactions and on the assumption that all tuberculin reactors would have responded to the homologous whole bacillus antigen. Of the 746 children in the study, 15.3 per cent gave positive early lepromin (Fernandez) reactions, while 74.1 per cent showed positive late lepromin (Mitsuda) reactions. Of these children 194 had been vaccinated with BCG at some time in the past; there was no difference between these children and others with respect to the frequency of either early or late reactions ....
Assuntos
Antígeno de Mitsuda , Hanseníase , Hanseníase/classificação , Hanseníase/microbiologiaRESUMO
In a duplicate experiment on lepromatous leprosy carried out at two leprosaria in the Philippines, Central Luzon Sanitarium near Manila and Eversley Childs Sanitarium near Cebu City, four groups of patients were treated respectively with 4 butoxy - 4' dimethylaminodiphenyl thiourea (SU 1906), amodiaquin (camoquin), a higher dose of DDS (4 mgm. per kgm. of body weight) and a lower dose of DDS (2.5 mgm. per kgm.) Treatment was continued for 96 weeks, except in the amodiaquin group in which the drug was discontinued at 72 weeks; most of the patients of this group were continued on DDS. At both institutions the superiority of DDS over amodiaquin was evident from the physical examinations at 72 weeks, and this was confirmed at 96 weeks in spite of the fact that most of the amodiaquin patients had received DDS from the 73rd week. SU 1906 likewise was superior to amodiaquin. In comparison with both higher and lower doses of DDS, however, SU 1906 showed consistently lower rates of improvement at each examination, but the differences were small. The patients on the higher dosage of DDS did not improve in greater proportion than those in the lower dose, as far as the clinical evidence goes. As had been found in our previous studies, healing of ulceration of the nasal septum took longer than is usually supposed, and new ulcerations occurred under continuous therapy with either DDS or SU 1906. At Eversley Childs, where the treatment schedules were more closely adhered to than at Central Luzon the value of sulfone treatment was indicated by a higher percentage of healing and a lower frequency of patients developing new ulcerations...
Assuntos
Hanseníase , Hanseníase Virchowiana/diagnóstico , Hanseníase Virchowiana/tratamento farmacológicoRESUMO
This study deals with lepromin reactivity of the Mitsuda type, observed in apparently healthy children on MActan Island, Cebu, Philippines. The principal theories which have been offered to explain this type of reactivity are prior infection with M. leprae, with M. tuberculosis, or with some other species of mycobacteria. It is improbable that the majority of these children, and especially those under three years of age, could have been exposed to leprosy. Although there is a positive correlation between reactivity to tuberculin and that to lepromin, the excess of lepromin reactors among tuberculin positives over the number e´xpected if there were no association comprises a very small fraction of the total number reacting to lepromin. This is true both for small doses of tuberculin, reaction to which is regarded as specific for infection with M. tuberculosis, and for larger doses which may indicate prior infection with other species of Mycobacterium. This suggests that lepromin reactivity among these children is caused in most instances by some factor other than infection with M. tuberculosis or any related species. The theory that the test dose of lepromin is the responsible sensitizing factor is not in itself adequate as far as can be judget from the effect of a second lepromin test in a controlled study...
Assuntos
Antígeno de Mitsuda/efeitos adversos , Hanseníase , Hanseníase/diagnósticoRESUMO
1- A report is made of an effort to determine the relative importance of natural causes, initial lepromin testing, and vaccination with BCG in producing reactivity to lepromin and to tuberculin. The possibility is admitted that the final lepromin test may itself cause reactivity of the Mitsuda type but there is no available means of separating this efffect from that of natural causes. 2- The subjects were 550 apparently healthy children, 6 months to 35 months of age, having no known contact with leprosy, living in their homes on Mactan Island, Cebu, Philippines, of whom 483 completed all requirements of the study. 3- A random sample of one-fifth constituted a basic control group, given initially only a tuberculin test (PPD-S, 0.0001 mgm.). The remainder were tested with lepromin and PPD-S, and those negative to both were divided at random into four subgroups. Two were vaccinated intradermally with BCG, one with a fresh preparation and the other with a lyophilized one. The other subgroups were given diphtheria toxoid and saline, respectively. Ninety to 100 days after the BCG and other inoculations, and, on the average, 143 days after the initial tests, all children including the basic controls were tested with lepromin and PPD-S of the same lots, and in the same dosages, as those used at the outset...