Mustafa Ulukanligil

Cutaneous leishmaniasis in Sanliurfa: epidemiologic and clinical features of the last four years (1997–2000)

Background Sanliurfa is located in south‐east Anatolia, the region with the largest focus of anthroponotic cutaneous leishmaniasis (CL) in Turkey. The present study was designed to determine the epidemiological and clinical patterns of cases of CL in the Sanliurfa area over a period of 4 years (1997–2000).

Oxidative stress of platelets and thrombocytopenia in patients with vivax malaria

Oxidative stress and antioxidative capacity of platelets and the relationship with thrombocytopenia were determined in patients with vivax malaria and compared with those of healthy subjects. Whole blood thrombocyte count, platelet superoxide dismutase and glutathione peroxidase activities of patients with vivax malaria were lower and platelet lipid peroxidation levels were higher in patients than those of healthy subjects. There was an important negative correlation between whole blood thrombocyte count and platelet lipid peroxidation level. The antioxidative mechanisms of thrombocytes were insufficient in malaria patients and caused oxidative stress. The oxidative damage of thrombocytes might be important in the ethiopathogenesis of thrombocytopenia occurring in malaria.

Environmental pollution with soil-transmitted helminths in Sanliurfa, Turkey

Soil transmitted helminth (STH) infection are endemic in developing countries. A study was carried out of sewage farms, streams and vegetables to determine the sources and routes of STH infection in Sanliurfa, Turkey. Stool samples from farmhouse inhabitants as well as soil and vegetable samples from the gardens were collected and examined. In addition, water samples from streams and vegetable samples from the city market were collected and examined. One hundred and eighty-seven (59.5%) of a total of 314 samples, including 88.4% of the stool samples, 60.8% of the water samples, 84.4% of the soil samples and 14% of the vegetable samples, were found to be positive for STH eggs. These results indicate that the water, soil and vegetables are heavily contaminated, and suggest a vicious circle between humans and the environment. Improving environmental sanitation is imperative for the control of soil-transmitted helminthiasis in Sanliurfa.

Demographic and parasitic infection status of schoolchildren and sanitary conditions of schools in Sanliurfa, Turkey

BackgroundThe design and development of school health programmes will require information at demographic characteristics of schoolchildren and the major health burdens of the school-age group, the opportunities for intervention and the appropriateness of the available infrastructure. This study aims to analyse demographic and parasitic infections status of schoolchildren and sanitary conditions of schools in Sanliurfa province of south-eastern Turkey.MethodThree primary schools were randomly selected in the shantytown, apartment and rural districts. A total of 1820 schoolchildren between 7–14 years age were took part to the survey of whom 1120 (61.5%) were boys and 700 (38.4%) were girls. A child form (including childs name, sex, age, school grade and parasitic infections) and school survey form (including condition of water supply, condition of latrines, presence of soaps on the basins and presence of garbage piles around to the schools) were used for demographic, parasitic and sanitary surveys. Stool samples were examined by cellophane thick smear technique for the eggs of intestinal helminths.ResultsThe demographic survey showed that number of schoolchildren was gradually decreased as their ages increase in shantytown school. The sex ratio was proportional until the second grade, after which the number of females gradually decreased in children in shantytown and rural schools while, in apartment area, schoolchildren was proportionally distributed between age groups and gender even the high-grade students. The prevalence of helminthic infections was %77.1 of the schoolchildren in shantytown, 53.2% in apartment district and 53.1% of rural area. Ascaris lumbricoides was the most prevalent species and followed by Trichuris trichiura, Hymenolepis nana and Taenia species in three schools. Sanitation survey indicated that the tap water was limited in shantytown school, toilets sanitation was poor, available no soaps on lavatories and garbage piles were accumulated around the schools in shantytown and rural area, while, the school in apartment area was well sanitised.ConclusionsThese results indicated that burden of parasitic infections and poor sanitation conditions constituted public health importance among to the shantytown schoolchildren. School health programmes including deworming and sanitation activities through the health education and improvement of sanitation conditions in the schools have a potential to better health and education for schoolchildren. These programmes also offer the potential to reach significant numbers of population in the shantytown schools with high level of absenteeism.

A comparative study on the different staining methods and number of specimens for the detection of acid fast bacilli

The presence of acid fast bacilli in multiple specimens was investigated comparatively with Ziehl-Neelsen (ZN) and fluorescence microscopy (FM) staining in order to determine sensitivity in detecting tuberculosis (TB). A total of 465 specimens obtained from 295 patients were analysed at Harran University Medical School Hospital between March 1998 and March 2000. The culture was employed as the reference method. Sixty-eight patients (23.1%) were diagnosed as having TB by culture. The ZN and FM staining sensitivities were 67.6% (46/68) and 85.2% (58/68) respectively. Two hundred and one patients (68.1%) submitted one specimen to the laboratory. TB positivity was detected in 42 (20.9%) of these patients by culture. The sensitivities of ZN and FM stains were found to be 61% and 83% in these patients. However, in 18 patients (6.1%) who submitted two specimens to the laboratory, the TB was positive in six of them (33.3%) and ZN and FM sensitivities were 66% and 83% respectively. When three specimens or more were collected from the patients (76 patients, 25.8%), TB positivity was determined in 20 of them (26.3%) and the sensitivities were 80% and 92% in the ZN- and FM-stained smears, respectively. Our data indicate that in the diagnosis of TB, FM has greater sensitivity than ZN. In particular, in the case of a single specimen, the diagnostic value of FM is quite significant. It is, therefore, possible to conclude that both ZN and FM staining can be used for the diagnosis of TB when there are more than two specimens. However, if only one or two specimens are available, FM staining is preferable.

Anthropometric status, anaemia and intestinal helminthic infections in shantytown and apartment schoolchildren in the Sanliurfa province of Turkey

Objective: To study anthropometric status, anaemia and intestinal helminthic infections of schoolchildren living in better and worse socio-economic and environmental conditions in the Sanliurfa province of Turkey.Design: Cross-sectional school-based survey.Setting: The sample was selected using a multistage random cluster sampling technique. The urban area of the province is stratified into two strata on the basis of environmental conditions: shantytowns and apartment areas. A total of 12 schools in the shantytown areas and five schools in the apartment areas were randomly selected based on probability proportional size in the two strata. A third class (including 9–10 y-old children) was randomly selected in each school and all children in this class were selected for the survey.Subjects: A total of 806 children, 572 of them from shantytown schools and 234 from apartment schools, took part in the surveys. Height for age, weight for age and weight for height were calculated by New Anthro software using the NCHS/WHO international reference values. The haemoglobin concentration was measured by the cyanmethaemoglobin method. Stool samples were examined by the semiquantative Kato–Katz technique.Results: Evidence of chronic ill health was common due to undernutrition, anaemia and helminthic infections in shantytown schools. Both male and female children in shantytown schools had higher stunting rates than those of apartment schools. Underweight was significantly associated with the sex of the children in shantytown schools in that the boys had a significantly higher underweight rate than girls (P: 0.04), but this rate did not differ between sexes in apartment schools. Wasting was significantly associated with the type of settlements; the girls in apartment schools had a significantly higher wasting rate than those of shantytown schools (P: 0.02). The children in shantytown schools had significantly higher anaemia rates (45%) than those of apartment schools (15%) (P: 0.01). The prevalence of intestinal helminthic infections was significantly higher in shantytown schools (63%) than apartment schools (37%) (P<0.0001). Ascaris lumbricoides was the most prevalent helminth and followed by Trichuris trichiura, Hymenolepis nana and Taenia species in both the study areas. Infection in children was significantly related to stunting in shantytown schools (multiple R=0.147; P: 0.005) and in apartment schools (multiple R=0.171; P: 0.02).Conclusion: These results indicated that the prevalence of stunting, anaemia and intestinal helminth infections constitutes an important public health problem among shantytown schoolchildren. School health programmes including deworming, feeding and micronutrient iron supplements through health education have a potentially beneficial effect on the health and education of schoolchildren.

Antimonial Therapy Induces Circulating Proinflammatory Cytokines in Patients with Cutaneous Leishmaniasis

ABSTRACT The objective of this study was to evaluate the association between antimonial therapy and circulating levels of proinflammatory cytokines in patients with cutaneous leishmaniasis (CL). Patients were treated with conventional chemotherapy by using pentavalent antimonium salts (Glucantime) for 3 weeks. Circulating plasma levels of the proinflammatory cytokines interleukin-1β (IL-1β), IL-6, IL-8, and tumor necrosis factor alpha (TNF-α) were determined for CL patients and healthy subjects before and 3 weeks after the treatment was started. Plasma IL-1β, IL-6, IL-8, and TNF-α levels were significantly higher for pretreatment CL patients than for healthy subjects. Proinflammatory cytokines significantly increased after 21 days postinfection compared to levels for the pretreatment patients. These increments were approximately 3-fold for IL-1β and TNF-α levels, 10-fold for IL-6 levels, and 20-fold for IL-8 levels in patients with CL. Taken together these results indicate that circulating proinflammatory cytokine levels were increased in patients with CL as a consequence of host defense strategies, and antimonial therapy may induce these cytokines by affecting the macrophage or other components of the host defense system.

Diagnostic performance characteristics of rapid dipstick test for Plasmodium vivax malaria

We compared the diagnostic performance characteristics of newly developed method, the rapid dipstick test, which provides colorimetric determination by developing antibody to the lactate dehydrogenase enzyme of parasites, with conventional standard thick-blood film examination. For the rapid test, OptiMAL commercial kits were used. The results were also evaluated with clinical findings from patients. The parasites were determined by microscopic examination of thick-blood films from 81 patients with vivax malaria from southeastern Anatolia, Turkey. The OptiMAL test results were found to be negative in five patients who were diagnosed clinically and through thick-film testing as having vivax malaria. There was no false positivity observed with the OptiMAL test. We concluded that this rapid malaria test has a lower level of sensitivity than the classical thick-blood-film test for malaria, but that these methods have equal specificity.

Relationship between levels of DNA damage in lymphocytes and histopathological severity of chronic hepatitis C and various clinical forms of hepatitis B

Background and Aim:  A significant proportion of cancer is attributable to DNA damage caused by chronic infection and inflammation. Because both hepatitis B and C viruses (HBV and HCV, respectively) cause chronic infection and inflammatory disease, the aim of the present study was to investigate whether there is a difference in peripheral DNA damage in patients with chronic HCV compared with patients with chronic HBV; and whether there is an association in the level of peripheral DNA damage with a natural history of HBV infection.

Şanlıurfa'da kronik C hepatitinde hepatit B virüs enfeksiyonu ile karşılaşma sıklığı

We aimed to investigate the rate of hepatitis B virus exposure in subjects with chronic hepatitis C infection who were immunocompetent and not treated with antiviral agent. Materials and methods: Twenty-two patients with chronic hepatitis C (9 female, 13 male, mean age: 52±9.7) were enrolled into this study. Hepatitis B profile was investigated by EIA and hepatitis C virus RNA and hepatitis B virus DNA by real time PCR. Results: AntiHBc antibody positivity, which suggested exposure to hepatitis B virus, was 68.2% in chronic hepatitis C patients. Four patients (18.2%) in the study group were seronegative and 3 patients (13.6%) were vaccinated against hepatitis B virus infection. Only 2 (9.1%) of 22 patients were HBsAg positive, and taking into account hepatitis B virus DNA positivity, 3 patients (20%) had replicative hepatitis B virus infection of 15 patients who were exposed to hepatitis B virus. Conclusions: According to our results, the rate of hepatitis B virus exposure and permanency of hepatitis B virus infection are higher in chronic hepatitis C patients than in the general population. Especially in regions endemic for hepatitis B virus, the occult hepatitis B virus infection, which can increase the severity or deteriorate the prognosis of the disease, should be investigated by sensitive PCR technique in patients with chronic hepatitis C virus infection.