RESUMO
This study examined acute-convalescent changes in diagnostic anti-streptococcal antibodies by the anti-streptolysin O (ASO) and anti-DNAase B (ADAB) tests among patients (n 28) with lymphedema and recurrent erisipela of the lower limb, comparing them with endemic normal control residents (n=25). The study was based in Villa Francisca, an urban focus of Bancroftian filariasis in eastern Santo Domingo, capital of the Dominican Republic. The acute signs and symptoms of erisipela were consistent with a diagnosis of bacterial cellulitis. The ASO test was especially successful at demonstrating a rise in mean titer during convalescence, whereas the ADAB produced about the same frequency of significant increases (0.2 log titer) as did the ASO. When subjects were scored as responders if mounting a minimal titer increase by either test, patients were found more frequently positive than were controls (chi2=5.3, P=0.02). About half (54%) of all patients mounted at least a minimal antibody increase. Filaria-specific IgG4 antibodies were absent from all sera of 20 residents of a nonendemic Dominican mountain town but appeared in about two-thirds of the sampled residents of the endemic barrio. Notably however, levels did not change between the acute phase and convalescence. These findings are consistent with the hypothesis that recurrent streptococcal invasion of the lymphatics may be a significant factor triggering or amplifying lymphedema and elephantiasis in patients with chronic filariasis.
Assuntos
Filariose Linfática/epidemiologia , Erisipela/epidemiologia , Linfadenite/etiologia , Linfangite/etiologia , Linfedema/etiologia , Adolescente , Adulto , Idoso , Animais , Anticorpos Antibacterianos/sangue , Anticorpos Anti-Helmínticos/sangue , Proteínas de Bactérias , Desoxirribonucleases/imunologia , República Dominicana/epidemiologia , Filariose Linfática/complicações , Filariose Linfática/imunologia , Ensaio de Imunoadsorção Enzimática , Erisipela/complicações , Erisipela/imunologia , Feminino , Humanos , Imunoglobulina G/sangue , Masculino , Pessoa de Meia-Idade , Streptococcus/imunologia , Estreptolisinas/imunologia , Wuchereria bancrofti/imunologiaRESUMO
This study evaluated the content of health warning labels on 240 varieties of cigarettes sold in 28 countries of South America, Central America, and the Caribbean. Warning practices in the different countries were compared, with special attention to the phrasing of the message and the product origin: imported, national, or foreign brands made in the country under a manufacturing permit. It was found that cigarette packages in the largest countries regularly carried warning labels, but in other countries such labeling was infrequent or nonexistent. In 12 countries, imported cigarettes had no warning label or were labeled only in the language of the country of origin. Another 12 countries with permits to manufacture foreign products locally added their own warning label. In three other countries, no warning labels were found, either on domestic cigarettes or locally made foreign brands. The content of the warnings varied considerably from one country to another. In many cases a tendency was observed to use wording that was not forceful and did not provide sufficient information to the consumer. The author believes that the warnings could be improved if their content and presentation were changed.
Assuntos
Promoção da Saúde/métodos , Nicotiana , Plantas Tóxicas , Rotulagem de Produtos/estatística & dados numéricos , Revelação da Verdade , Promoção da Saúde/estatística & dados numéricos , Humanos , América Latina , Fumar/efeitos adversos , Índias Ocidentais , RedaçãoRESUMO
A survey of cigarette smoking in Santo Domingo was conducted among residents of 499 households in two neighborhoods. Residents over 14 years old were classified as current smokers (34.6%), former smokers (11.3%), and never smokers (54.1%). Most of the 200 current smokers interviewed (83%) had started smoking by age 20, but over half (59%) were relatively light smokers, consuming < or = 10 cigarettes per day. Remarkably for Latin America, smoking was nearly as common among women (32.9%) as among men (36.3%). Over 90% of the interview subjects disapproved of smoking by adults, the practice being considered undesirable by most because of its effects on health. Most of the adolescents interviewed viewed smoking as a mark of maturity (82.3%) and as "in" among their friends (53.7%). Even though few respondents understood the specific nature of health threats posed by smoking, health was the single most important factor motivating cessation. Most of the current smokers (87.0%) wanted to quit, and over two-thirds (67.5%) reported making at least one serious attempt to do so. Tobacco industry figures show that between 1962 and 1988 the total apparent cigarette consumption of the Dominican Republic rose 3.7-fold. Most of that increase was the result of promotion by Philip Morris, which now dominates the Dominican market. At present cigarettes are heavily advertised without health warnings and are sold to minors without significant restrictions. Such activities should be of particular concern in this and other developing countries with high fertility rates and young populations.
Assuntos
Fumar/epidemiologia , Adulto , Consumo de Bebidas Alcoólicas/epidemiologia , Atitude Frente a Saúde , República Dominicana/epidemiologia , Feminino , Humanos , Entrevistas como Assunto , Masculino , Prevalência , Fumar/efeitos adversos , Fumar/psicologia , Abandono do Hábito de Fumar/psicologia , Abandono do Hábito de Fumar/estatística & dados numéricos , Fatores Socioeconômicos , População Urbana/estatística & dados numéricosAssuntos
Filariose Linfática/epidemiologia , Linfedema/epidemiologia , Adolescente , Adulto , Aedes/parasitologia , Idoso , Animais , Criança , Culex/parasitologia , República Dominicana , Feminino , Humanos , Insetos Vetores/parasitologia , Masculino , Pessoa de Meia-Idade , Wuchereria bancrofti/isolamento & purificaçãoRESUMO
Between January 1981 and March 1982, a filariasis survey was conducted among 668 Haitian immigrants and 155 Southeast Asian refugees residing in Florida, U.S.A. Microfilariae were detected only in Haitians, with 6.7% positive for Wuchereria bancrofti and 1.3% positive for Mansonella ozzardi. The majority of individuals with bancroftian filariasis came from five coastal urban areas including Port-au-Prince, Duvalierville, Gonaïves, Leógane and Cap-Haitien. No unequivocal signs of bancroftian filariasis or mansonellosis were seen. Membrane feeding of several species and strains of laboratory-reared mosquitoes on blood from a volunteer microfilaremic with W. bancrofti showed that Aedes aegypti and A. taeniorhynchus, but not Culex quinquefasciatus, were susceptible to infection with the Haitian strain of W. bancrofti. Culicoides furens, a known vector of M. ozzardi in Haiti and present in Florida, was not tested. Further studies are needed to determine the competence of Florida vectors for transmitting W. bancrofti and M. ozzardi to the indigenous human population.