Fatal parathion poisoning in Sierra Leone.
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In May and June 1986, 49 persons in Sierra Leone were acutely poisoned by the organothiophosphate insecticide, parathion. Fourteen people died. Illness occurred in three episodes at two different locations that were 44 km apart. A study of 21 cases and 22 household controls was undertaken to explore which factors were associated with the development of the symptoms. Cases were more likely than controls to have eaten bread in the 4 hours before becoming ill (odds ratio, 12.7; 95% confidence interval, 2.4-83.8). Scrapings of residue from the floor of the truck that had brought the wheat flour from the mill to the general store where the baker purchased it were positive for parathion, suggesting that the flour had been contaminated during transport. Pesticide poisoning is a common problem in the developing world, and public health measures such as restricting the use of parathion may help to prevent fatal poisonings. (+info)
Human monkeypox.
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Between October 1970 and May 1971, six cases of human infection with monkeypox virus were identified in Liberia, Nigeria, and Sierra Leone. Four of the cases were confirmed by virus isolation and two were diagnosed on the basis of epidemiological and serological investigations. All the cases occurred in unvaccinated individuals.Post-infection serological studies showed high haemagglutination-inhibition and neutralizing titres to pox group virus in four of the cases. Repeated challenge vaccination of all cases with potent smallpox vaccine resulted in equivocal reactions.In all, 24 susceptible household contacts were exposed to the infected cases, but none developed disease. All the contacts subsequently responded to vaccination with a primary reaction, thus confirming their susceptibility and ruling out asymptomatic infection. (+info)
Isolation and properties of the causal agent of a new variola-like disease (monkeypox) in man.
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The causal agent of a case of disease in man occurring in the Democratic Republic of the Congo with a similar clinical picture to smallpox was isolated and studied. The agent was identified as monkeypox virus. A comparative study of the isolated strain (Congo-8) and of viruses isolated from similar cases of illness in Liberia (Liberia-1 and Liberia-2 strains) and Sierra Leone (V-70 1 266 strain) showed that they were identical. A number of local species of monkeys and apes were examined serologically in the Congo region to determine the probability of human infection with monkeypox virus. It was confirmed that the animals had had contact with an agent of the poxvirus group. In 2 of the 7 sera examined, antibodies of the variola-vaccinia group of poxviruses were discovered (virus-neutralizing antibodies, precipitins, and antihaemagglutinins). In a chimpanzee, antihaemagglutinins were found in a titre of 1: 1 280, and in the same animal a variola-like virus was isolated from the kidneys. In the course of the investigation, it was shown conclusively that monkeypox virus and the strains under investigation could be distinguished from o dinary variola and vaccinia viruses on the basis of their behaviour in pig embryo kidney continuous cell line culture. (+info)
A comparison of the levels of faecal indicator bacteria in water and human faeces in a rural area of a tropical developing country (Sierra Leone).
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The levels of faecal coliforms (FC), indole-positive FC (presumptive Escherichia coli), faecal streptococci (FS), Streptococcus faecalis and Clostridium perfringens in the natural water sources used by 29 rural settlements in Sierra Leone were investigated. Levels of the same indicators in human faeces were also investigated. The incidence of Salmonella spp. in both habitats and the temperature, pH and conductivity of water sources were also recorded. All water sources were contaminated with the indicator bacteria, mean numbers of which occurred in the relationship FC greater than presumptive E. coli congruent to FS congruent to C. perfringens greater than S. faecalis. FC were also predominant in human faeces, the relationship of means being FC congruent to presumptive E. coli greater than FS greater S. faecalis greater than C. perfringens. The need for confirmation of FC counts obtained from water sources was indicated by the large number of positive tubes produced in the FC multiple-tube dilution test from some samples which could not be confirmed as presumptive E. coli. Salmonella spp. Were isolated from 13 water sources and 6% of faecal samples. Mean water temperature was high (26.2 degrees C), pH low (5.04) and conductivity low (34 microS cm-1). Presumptive E. coli was considered the most appropriate indicator of faecal pollution of the types of water investigated. (+info)
Conjunctival excision or lamellar scleral autograft in 38 Mooren's ulcers from Sierra Leone.
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Ulcus rodens corneae (Mooren's ulcer) was studied in 30 patients with 38 corneal ulcers. Although the clinical picture resembled Mooren's description, the West African type of ulcus rodens is different in that it has a higher prevalence, a tendency towards perforation, is most frequent in the age group 20-40 years, and is often associated with ankylostomiasis. Conjunctival excision with thermocoagulation gave some relief at the site of the ulcers, but recurrences at other places occurred in at least 52% of cases. Six eyes with a progressive iris prolapse and a flat anterior chamber were reconstructed with lamellar scleral autografts in the absence of donor corneas. (+info)
Vocational training: work in a developing country and British general practice.
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I present evidence from my personal experience of vocational training followed by 18 months' work in an African hospital, to show that:1. By extending and reinforcing vocational training, my time abroad was relevant to my future career as a British general practitioner.2. Vocational training is a good preparation for any doctor intent on spending a limited time working in a developing country. (+info)
Blindness from uveitis in a hospital population in Sierra Leone.
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A retrospective study was conducted to assess the causes of blindness and visual impairment in patients who visited an eye hospital in Sierra Leone, West Africa, in 1989 and 1992. These data were compared with figures from 1981. Throughout the years, senile cataract was the major cause of blindness, followed by uveitis (including onchocerciasis). Uveitis remained the second most important cause of blindness in this population, despite the significant decrease in blindness from onchocerciasis (from 30% in 1981 to 15% in 1992). An increasing number of patients with uveitis from non-onchocercal origin was observed: almost 10% of the blindness found in 1992 was due to uveitis of non-onchocercal origin. A reduction in visual handicap in patients with non-onchocercal uveitis could be achieved if local hospitals could obtain more accurate diagnoses in these patients. (+info)