Abstract
Infection with Pneumocystis carinii is prevalent in healthy Gambian children
Wakefield, A. E.
Stewart, T. J.
Moxon, E. R.
Marsh, K.
Hopkin, J. M.
Trans R Soc Trop Med Hyg. 1990; 84800-2
Permanent descriptor
https://doi.org/10.1016/0035-9203(90)90087-uPneumocystis pneumonia is rarely identified in the many immunosuppressed individuals with acquired immune deficiency syndrome (AIDS) and malnutrition in Africa. To test whether infection with Pneumocystis carinii occurs in the continent we conducted a comparative serological study, measuring by enzyme-linked immunosorbent assay antibodies to the parasite in 150 healthy young individuals from both Britain and the Gambian savanna. The prevalence of significant titres of antibody to P. carinii steadily increased with age and included more than 70% of both populations by 8 years of age. Infection with P. carinii is, therefore, common in the Gambia. Thus opportunistic pneumocystis pneumonia may be an important but largely unrecognized disease in the continent, though its impact is probably diminished by the prevalence of fatal tuberculous infection, particularly in the AIDS population.
The prevalence of sero-positivity toward Pneumocystis carinii parasite antigens was determined in 150 British subjects aged 3 months-40years, and in 150 Gambians of the same age age range. The Gambians were from Katabas villages north of the Gambian river. The sera were tested with an ELISA assay developed from parasites and cysts isolated from rats, which were previously shown to share many antigens with organisms from humans. IgG titers reactive with P. carinii increased with age in the British and Gambian subjects, with essentially no positives at ages 3-6 months, to a peak of 70% positive in both groups by age 8 years. British children and parents were questioned about history of pneumonia illness, with negative findings. There are very few reports of P. carinii infections, judging from sputum and bronchoscopic lavage, in African AIDS patients. 2 cases of Cryptococcus have been reported, but tuberculosis is a common and rapidly lethal infection in African AIDS patients.
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