RESUMO
OBJECTIVE: To determine the frequency of later respiratory tract morbidity after respiratory syncytial virus (RSV) disease in infancy. DESIGN: Cohort study with passive, clinic-based surveillance. SETTING: Outpatient department in The Gambia. SUBJECTS: One hundred five children admitted to the hospital with severe RSV disease (case cohort), 105 control children matched for age not admitted to the hospital during the previous RSV season (control cohort 1), and 102 control children born after the RSV season (control cohort 2). MAIN OUTCOME MEASURES: Frequencies of pneumonia, wheezing, and hospital admission with acute lower respiratory tract infection. RESULTS: Pneumonia was more common in case children than in both control groups (adjusted incidence rate ratio [IRR, 95% CI]: 3.80 [2.73, 6. 10]), as was wheezing (IRR 7.33 [3.10,17.54]), pneumonia or wheezing (IRR 3.96 [2.60, 6.04]), and admission with pneumonia or wheezing (IRR 3.40 [1.87, 6.15]). The incidence rate per 100 child-years for pneumonia in the dry season for 12-month-old children was 27 for case patients, 8.1 for control cohort 1, and 6.51 for control cohort 2. By 3 years of age, the rates had fallen to low levels in all groups. CONCLUSIONS: Pneumonia and wheezing are significantly more common in children after RSV-associated lower respiratory tract disease than in control subjects, but the incidence declines rapidly with increasing age.
Assuntos
Infecções por Vírus Respiratório Sincicial/complicações , Doenças Respiratórias/etiologia , Doença Aguda , Asma/etiologia , Pré-Escolar , Estudos de Coortes , Gâmbia , Humanos , Vigilância da População , Estações do AnoRESUMO
Transplacental transfer of specific IgG antibodies was studied in 46 pairs of human immunodeficiency virus type 1 (HIV-1)-seropositive women and their neonates and in 53 pairs of healthy HIV-seronegative mothers and their newborns. Neonatal and maternal sera were assessed by nephelometry for total levels of serum IgG and by ELISA for IgG antibodies to herpes simplex virus (HSV), varicella-zoster virus (VZV), measles virus, tetanus toxoid, streptolysin O, and Streptococcus pneumoniae capsular antigens. Placental transfer of IgG antibodies to VZV, tetanus toxoid, measles, streptolysin O, and S. pneumoniae was decreased by maternal HIV infection. Maternal levels of total IgG had an independent effect on transfer of antibodies to HSV, VZV, measles, and S. pneumoniae. Neonatal antibody levels to tetanus toxoid, measles, and S. pneumoniae were significantly lower in the HIV group. Both maternal hypergammaglobulinemia and maternal HIV infection may contribute to these low antibody levels at birth and thus lead to early infection in this high-risk population.
Assuntos
Infecções por HIV/imunologia , Soropositividade para HIV/imunologia , HIV-1 , Imunidade Materno-Adquirida/imunologia , Imunoglobulina G/sangue , Anticorpos Antibacterianos/sangue , Anticorpos Antibacterianos/imunologia , Anticorpos Antivirais/sangue , Anticorpos Antivirais/imunologia , Cápsulas Bacterianas/imunologia , Proteínas de Bactérias , Feminino , Sangue Fetal/imunologia , Herpesvirus Humano 3/imunologia , Humanos , Recém-Nascido , Vírus do Sarampo/imunologia , Simplexvirus/imunologia , Streptococcus pneumoniae/imunologia , Estreptolisinas/imunologia , Toxoide Tetânico/imunologiaRESUMO
Three populations of Anopheles darlingi were studied for cuticular hydrocarbons, isoenzymes and patterns of peak biting activity. Differences were found in specimens from Costa Marques, a malaria endemic area; Dourado, a site with a very exophilic population and Juturnaíba, located near the type locality. Twelve hour collections from sunset to sunrise showed that An. darlingi from Costa Marques had a bimodal biting activity profile with a major peak at sunset and a minor peak at sunrise. At Dourado, the pattern was trimodal, with peaks at both morning and evening periods of twilight and near midnight. The Juturnaíba population showed a slight increase in activity near 2000 and 0100 h. Nei's genetic distances, determined by isoenzyme electrophoresis between pairs of populations, were low (D < or = 0.049). Using discriminant analysis for the cuticular hydrocarbons, 92.4% of the specimens from Costa Marques, 91.2% of the specimens from Dourado and 61.3% from Juturnaíba were correctly identified. Cuticular hydrocarbon and isoenzyme results matched very well: the smaller the Nei's distance, the more misidentifications occurred in the jackknife estimator used in the cuticular hydrocarbon analysis. This is the first report of cuticular hydrocarbon analysis in combination with isoenzymes to investigate neotropical anopheline species.