Assessment and 2-year follow-up of some factors associated with severity of respiratory infections in early childhood

No Abstract

Does whole-cell pertussis vaccine protect black South African infants? Assessment of post-vaccination events and antibody responses to pertussis toxin, filamentous haemagglutinin and agglutinogens 2 and 3

The whole-cell pertussis vaccine currently used in South Africa has not been adequately evaluated for post-vaccination events and immunogenicity. A trial of this vaccine combined with diphtheria and tetanus toxoids (DTP) was undertaken in 115 black babies who received primary vaccination at 2, 4 and 6 months of age. Serological IgG responses to the major antigens of Bordetella pertussis, filamentous haemagglutinin (FHA), pertussis toxin (PT) and fimbriae (agglutinogens 2 and 3 (AGG 2 + 3), were evaluated by enzyme-linked immunosorbent assay in sera obtained at birth, and before vaccination at 2,4 and 6 months and at 9 months. Surprisingly, after 3 doses of DTP, responses to PT and FHA were found merely to restore levels of IgG to PT and FHA to those found in cord blood. In contrast with the positive increases in these antibodies found in other series of whole-cell vaccination, the anti-PT seroconversion rate was only 19% and the anti-FHA rate only 24%. High levels of anti-AGG 2 + 3 were produced with 67,2% seroconversion.The frequency and nature of post-vaccination events were recorded. Incidences of all reactions to the vaccine were low (7,6%): Fever (3,2%) and excessive crying (2,4%) were the most frequency occurring minor events. The rate of neurological post-vaccination events (without sequelae) during the brief follow-up period was 2 hypotonic-hyporesponsive  episodes (8,03/1 000 doses) and 1 convulsion (4,02/1000 doses).Significant pertussis antibody levels were found in maternal and cord sera with levels in the latter frequently being higher. Three cases of pertussis occurred during the study period. Only 1 of the subjects had completed primary vaccination. In view of these findings, the need for a proper efficacy and safety study of the currently used DTP vaccine is urgently indicated in South Africa

Pattern of biochemical and immune recovery in protein calorie malnutrition

Thirty-two Black children with protein calorie malnutrition were studied with a view to assessing the duration of derangement of biochemical and immunological factors. It was shown that the majority of biochemical parameters were back to normal within 20 days, while the return to normal of the immunological indlces was more protracted. Reference is made to the patients who died, and to the factors contributing to their deaths.S. Afr. Med. J., 48, 1375 (1974)

Hepatitis B infection in black children from residential care facilities in KwaZulu-Natal

No Abstract

Loss of maternal measles antibody in black South African infants in the first year of life implications for age of vaccination

In order to investigate the feasibility of measles vaccination before the age of 9 months the duration of passive immunity against measles was estimated by conducting a longitudinal study of measles antibody levels in 20 black neonates delivered at term. Measles serum antibody (lgG) was measured by enzyme-linked immunosorbent assay in the mother at childbirth and on consecutive samples taken from the infants from birth until 9 months of age. Protective measles antibody level was defined as > 200 mlU. Unprotective levels were found in 88% (95% confidence interval (Cl) 81 - 99%) of 6-month-old infants, while at 9 months all were susceptible. The mean antibody level was 192 mlU (Cl 104 - 348%) at 4 months; 34 mlU (Cl 15 - 73%) at 6 months and 13 mlU (Cl 6-24%) at 9 months of age. Our data support the recent World Health Organisation recommendation to immunise children in developing countries at 6 months with the 'high titre' Edmonston-Zagreb measles vaccine, since most infants in our study had lost passive immunity against measles by this age

Book Reviews

Book Review 1Book Title: Modern Coloproctology: Surgical Grand Rounds from St Mark's HospitalBook Authors: Robin Phillips & John Northover (Eds.)pp. 195. illustrated. London: Edward Arnold. 1993. ISBN 0-340-55258-1Book Review 2Book Title: Diagnostic Molecular Pathology: A Practical Approach. Vol. I & IIBook Authors: C.S. Herringron & J.O'D. McGee (Eds.)Pp. Vol. I xviii + 270; Vol. II xvi + 217. Cape Town: Oxford University Press. 1992. ISBN Vol. I 0-19-963236-7, Vol. II 0-19-963238-3.Book Review 3Book Title: Training Therapy: Prophylaxis and RehabilitationBook Authors: Rolf Gustavsen & Renate Streeck2nd revised ed. Pp. viii + 230. Illustrated. Stuttgart: George Thieme Verlag. 1993. ISBN 3-13-672502-6.Book Review 4Book Title: Handbook of Bereavement: Theory, Research and InterventionBook Authors: Margaret S. Stroebe, Wolfgang Stroebe & Robert O. Hansson (Eds.)Pp. xii + 546. Cambridge: Cambridge University Press. 1993. ISBN 0-521-39315-9 hardback, ISBN 0-52144853-0 paperback.Book Review 5Book Title: Atlas of Gynecologic PathologyBook Authors: J. Donald Woodruff, Teresita L. Angruaco & Tim H. Pannley (Eds.)pp.321. New York: Raven Press. 1993. ISBN 0-7817-0056-6.Book Review 6Book Title: Our Planet, Our Health: Report of the WHO Commission on Health and EnvironmentBook Author: World Health OrganisationPp. 282. Geneva. 1992. ISBN 92-4-156148-3.Book Review 7Book Title: Neonatal Tetanus Elimination Field Guide. Technical Paper No 35Book Author: Pan American Health OrganisationPp. v +37. Washington: Pan American Health Organisation. 1993. ISBN 92-75-13035-3

Exchange Transfusion Failure in in Fulminant Hepatic Children

Of 43 children with fulminant hepatic failure, 24 had an exchange transfusion, and 7 survived (29%). The remaining 19 received routine therapy and 1 survived (5%). Investigations are compared with those of children with infective hepatitis admitted during the same period and who did not suffer fulminant hepatic failure