Demet Kaya

Assessment of HAV and HEV seroprevalence in children living in post-earthquake camps from Düzce, Turkey.

The aim of the study was to investigate the prevalance of enterically transmitted hepatitis among children living in post-earthquake camps, and to assess the efficacy of the measurements during and after the disaster in Düzce and Golyaka. In the second half of 1999, North-western Turkey, was struck by two massive earthquakes in less than 3months. The first, on 17 August 1999, involving Golyaka, was struck, measuring between 7.4 and 7.8 on the Richter scale. Irregularity about providing clean water and necessary sanitary facilities were observed after the first earthquake because of confusion. The second quake, on 12 November 1999, which rated 7.2 on the Richter scale, shook Düzce. Necessary precautions were applied rapidly at the second quake about shelter, clean drinking water, food and control of distribution of the aids by government and civil aid organisations. Anti-HEV(IgG) and anti-HAV(IgG) antibodies were determined in 476 sera of the children who was living in six camps. HAV prevalence of the children who were living in Düzce and Golyaka temporary houses was 44.4 and 68.8% respectively, OR: 0.37, CI 95%: 0.22–0.61, p=0.0005. HEV prevalence of the children was 4.7 and 17.2% respectively, OR: 0.24, CI 95%: 0.11–0.51, p=0.0007. In conclusion, HAV and HEV prevalence of children were lower than that in endemic areas but higher than that in developed countries. This study has pointed out the importance of providing urgent need of the sufficient sanitary facilities after disasters for preventing or reducing the incidence of enterically transmitted hepatitis, especially in the regions which were at risk for various disasters. Essential precautions such as providing clean water and food supply must be taken and an emergency action plan for preventing the infectious disease must be prepared before disasters such as earthquakes.

Dermatophytes in the rural area of Duzce, Turkey

A total of 227 subjects (112 were male and 115 female), who were residents of the rural region of Duzce, were examined for dermatomycosis. A total of 120 samples (47 nail fragments, 73 skin scales) were collected from 81 patients for mycological analysis on the basis of the results of clinical evaluation. All specimens collected were analysed by direct microscopy and culture. Positive results were detected in the cultures of 53 (44.1%) of the 120 samples. About 46 (86.7%) samples also presented positive results in direct microscopy. In the cases of seven samples positive results were found in culture and negative results with direct microscopy. Both culture and direct microscopy presented negative results in 67 (55.8%) samples. The most frequently isolated aetiological agents were 33 Trichophyton rubrum (62.2%), and nine T. mentagrophytes (16.9%). In conclusion, traditional and religious habits such as cohabitation and performing ritual ablutions may affect the prevalence of dermatophyte infections. The performance of ritual ablutions is not in itself a risk factor for acquiring dermatophyte infection; rather it is not drying the extremities after ablutions, that is the main risk factor for this group. Tinea capitis was not found in any of the subjects in spite of the fact that it is one of the most common infectious conditions in children. This is the first paper to report the prevalence of fungal infections in Duzce, a western Black Sea region of Turkey.

Effects of melatonin on Candida sepsis in an experimental rat model.

As an immunomodulator, melatonin reportedly exhibits protective effects in severe sepsis/shock induced by bacterial lipopolysaccharides in animal models. The present study was conducted to evaluate the possible protective effects of melatonin against experimentalCandida sepsis in rats. A total of 40 adult male Wistar rats were randomly assigned to 4 groups: control, melatonin-treated control, septic, and melatonin-treated septic. Melatonin (200 μg/kg/d, intraperitoneally) injections were begun a week prior to sepsis induction and were continued daily for 3 wk until the end of the study. Cyclophosphamide was administered to animals in all groups as an immunosuppressive agent as a single dose 4 d prior to yeast inoculation. To cause sepsis, theCandida albicans (ATCC 10259) strain was administered intravenously. Amphotericin B was given as an antimycotic therapeutic agent as a single dose to septic rats. Plasma levels of interleukin-6 (IL-6), tumor necrosis factor-α (TNF-α), vascular cell adhesion molecule-1, and E-selectin were measured on the first and 15th days of sepsis. IL-6, TNF-α, vascular cell adhesion molecule-1, and E-selectin levels of septic rats were higher than those of controls. Melatonin reduced IL-6 levels and shortened time to improvement in animals withCandida sepsis. Levels of TNF-α and adhesion molecules in melatonin-treated septic rats were decreased compared with those in septic rats, but this difference was not statistically significant. In light of the current results, investigators conclude that melatonin may have therapeutic benefits inCandida sepsis and in classic antimycotic treatment because of its immune regulatory effects.

Dermatophytoses in forestry workers and farmers

To assess the frequency of superficial mycoses in forestry workers and farmers in the rural region of Duzce, a total of 467 residents of the rural region were examined for dermatomycosis infection. Of these, 349 were forestry workers and 118 farmers. All specimens collected were analysed by direct microscopy and culture. Tinea pedis et manus was found in 23 (19.4%), and onycomycosis in 21 (17.7%) farmers. Tinea pedis et manus was found in 50 (14.3%), and onycomycosis in 28 (8%) forestry workers. One tinea corporis, two tinea inguinalis and two erosio interdigitalis cases were determined in the farmer group but no cases of tinea corporis, tinea inguinalis, or erosio interdigitalis were found in the forestry group. In total, five tinea versicolor cases were found in the two groups on clinical examination but no agent positivity was yielded in mycological cultures. The most frequently isolated agent in the two groups was Trichophyton rubrum. The frequencies of superficial mycosis and onychomycosis were found to be higher in the farmer group than in the forestry group, although similar aetiological agents were isolated in both groups. The farmers had greater rates of contact with pathogenic fungi present in soil as well as from infected farm animals than the foresters; furthermore, animal husbandry, and the wearing of rubber shoes and nylon socks were more frequent in the farmer group. These results suggest that habits such as the wearing of rubber shoes and nylon socks, and the practice of animal husbandry may be the most important factors in determining the frequency of superficial mycoses and aetiological agents in forestry workers and farmers. To our knowledge, there is no previous report about dermatophytoses in forestry workers.