Objective-To examine the potential impact of deferral ofblood donors at high risk of HIV infection in a west African city where blood is screened for HIV antibodies but no other special measures are taken to protect the blood supply. Design-Cross sectional study. Setting-National Blood Transfusion Centre and Project RETRO-CI, an international collaborative AIDS research project, Abidjan, Cote d'Ivoire. Subjects-1257 male first time blood donors. Interventions-Blood donors were interviewed about demographic and behavioural characteristics and tested for HIV antibodies by enzyme immunoassay and, ifpositive, synthetic peptide based tests. Main outcome measures-HIV antibody status in relation to presence of behavioural risk factors; calculation of sensitivity, specificity, and predictive values of specific criteria for excluding HIV infected donors. Results-The overall prevalence of HIV infection was 11.4%. The most important risk factors for HIV positivity were prostitute contact and being aged 30-39 years. For identifying seropositive donors individual criteria had sensitivity, specificity, and positive predictive values ranging from 15% to 98%, 38% to 91%, and 17% to 300/o respectively. Prostitute contact in the past five years would have excluded 31% of all donors and 730/o of HIV infected donors. 27% of those excluded would have been HIV positive. Conclusions-The widespread assumption that donor deferral is not feasible in sub-Saharan Africa needs reassessment. In Abidjan this approach was well accepted and potentially effective. Donor deferral requires evaluation as a strategy for improving blood safety in resource poor areas with high rates of HIV infection.

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Objective: The European pharmacopeia prescribes that, during the manufacture of blood derivates, the first homogeneous pool of plasma (for example, after removal of cryoprecipitate) must be tested for hepatitis B virus surface antigen (HBsAg), for hepatitis C virus (HCV) antibodies and for human immunodeficiency virus (HIV) antibodies using test methods of suitable sensitivity and specificity, in order to reduce the residual risk of infection originating from blood products. The present study was performed to verify if commercially available immunoassays, which are licensed for the screening of single serum and plasma samples, are suitable for the determination of HBsAg, anti-HCV, and anti-HIV in plasma pools. Design: Plasma pools originating from different countries were spiked with HBsAg- and anti-HCV-positive standards (National Institut für Biological Standards, Hertfordshire, UK) and anti-HIV-positive serum. For the determination of HBsAg with and without immune complex dissociation (ICD), anti-HCV and anti-HIV antibodies the Abbott (Delkenheim, Germany) IMx system was used. Results: In contrast to the testing for anti-HIV and anti-HCV, the detection of HBsAg (0.125 IU/ml detection limit) was influenced by the presence of anti-HBs in plasma pools. Statistically significant differences could be observed between anti-HBs-positive plasma pools and anti-HBs-negative serum samples spiked with HBsAg. The kinetics of HBsAg-anti-HBs complex formation showed that in a plasma pool with a high anti-HBs (329.4 IU/ml) concentration HBsAg was not detectable after 5 h of incubation. After ICD, HBsAg was still detectable in the pool with high anti-HBs content. Anti-HIV antibodies could be detected up to a dilution of 1/480,000, anti-HCV up to a dilution of 1/80, both in a spiked negative serum. Overall, the divergences between spiked plasma and serum were relatively low for anti-HCV and anti-HIV detection. Conclusions: The Abbott IMx assay permits a highly sensitive detection of HBsAg (after ICD or immediately after thawing of anti-HBs-positive plasma pools), anti-HCV, and anti-HIV in plasma pools. However, in case of a contamination with donations originating from individuals with acute HBV, HIV, or HCV infection or with a poor humoral immune response, serologic testing for HBsAg, anti-HIV, and anti-HCV may fail to detect potentially infectious plasma pools.

Between 1979 and 1981 31 children aged from one to 14 years who had been given atropine eye drops to measure refraction presented with the following side-effects: increased temperature (9/31), dry red skin (8/31), reddened eye (3/31) and periorbital dermatitis (2/31) after single (22/31) or repeated (9/31) administration of atropine. In the epicutaneous test with atropine eye drops 1% (readings after 24, 48 and 72 hours) not a single child showed an allergic or toxic reaction. The rarity of an allergy after administration of atropine drops is emphasized by the fact that periorbital dermatitis was observed in only two cases. Clinical experience shows that incipient allergy owing to the anatomical structure of the conjunctiva and eye lids first becomes apparent in the region of the eye, even if the epicutaneous test is not necessarily positive in the dorsum skin. In view of the necessity of administering atropine prior to emergency surgery it is advisable to carry out epicutaneous tests if side-effects have been observed in the eye, to make sure that the patient is not allergic to the drug.

In der Dermatologie und Unfaliheilkunde bestand schon immer ein Bedürfnis nach lokal anwendbaren, antibakteriell wirksamen Medikamenten. Seit der Entdeckung der Sulfonamide hatte der Marfanil-Prontalbin-Puder (MP-Puder) eine beherrschende Rolle gespielt. Seine sensibilisierende Eigenschaft hatihn in den Hintergrund gedrängt. Das seit 1945 in Amerika benutzte Nitrofurazon (Furacin®) (14) hat neben den Antibiotika 1953 auch in Deutschland angefangen, diese Lücke zu füllen.