On the epidemiology of tuberculosis in some selected countries: highlights and prospects for control and eradication. I

Hepatitis C virus infection in a Japanese leprosy sanatorium for the past 67 years

Oku-Komyo-En is one of the national leprosy sanatoria, located on a small island in Setouchi city, Okayama prefecture of Japan since 1938. Since autopsies were carried out routinely on almost all patients who had died in the sanatorium up to 1980, approximately 1,000 formalin-fixed autopsy tissue samples were available for analysis. When these samples were reviewed, the pathological data indicated a sharp rise in the death rate caused by cirrhosis of the liver and hepatocellular carcinoma (HCC) since 1960 and 1970, respectively. Hepatitis C virus (HCV) infection is a common cause of HCC in Japan. The presence of HCV RNA was demonstrated in paraffin sections prepared from the autopsied liver tissue fixed in formalin for a prolonged period of time, by employing nested RT-PCR using type-specific primers. The data showed that HCV RNA was detectable in samples of the liver archived as early as 1940, representing the liver tissues kept in formalin for up to 67 years. HCV genotypes 1b and 2a were found by RT-PCR at 85.7% and 14.3%, respectively, in patients with leprosy.

Disease rate as an artifact of the health care system: tuberculosis in Puerto Rico

It is demonstrated that the reported rates of tuberculosis in Puerto Rico comprise a direct, positive measurement of location, infrastructure and numbers of personnel in the health care system. The disease map does not reflect true geographic prevalence, but it is a measurable artifact of the health care system. Areas of high and low reporting and zones of minimum patient contact, are identified in the interests of program management.

Gynaecological tuberculosis in Victoria: a 20-year survey

A review of the 181 cases of gynaecological tuberculosis notified in Victoria between the years 1961 and 1980 is made. The incidence of the disease is gradually falling and is currently 0.16 per 100,000. The majority of affected women were found to be immigrants to Australia with Southern European patients predominating. Nearly 46% of the women presented with infertility, while 43% were investigated for various symptoms. Twenty-one patients had children before the diagnosis was made, but only 4 conceived after treatment. A comparison with overseas studies is made.