Paper malabsorption in Africa

Cook, Gordon

doi:10.1016/0035-9203(74)90065-0

Cited by 21 publications

(11 citation statements)

References 101 publications

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“…Just over half our total series of patients were infected in the Indian subcontinent and South-East Asia, but, of seven M-2 subjects, three were infected in Africa, two in the Middle East, and one each in Italy and Leningrad. Malabsorption associated with giardiasis has a wider geographical distribution than tropical sprue, for this entity has not been encountered in Africa (Cook, 1974). Though there is no specific feature which distinguishes tropical sprue, it usually improves in response to a prolonged course of antibiotics, often with folate or vitamin B12 supplements (Guerra et al, 1965;O'Brien and England, 1971;Rickles et al, 1972).…”

Section: Discussionmentioning

confidence: 99%

Giardiasis: clinical and therapeutic aspects.

Wright¹,

Tomkins²,

Ridley³

1977

Gut

122

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SUMMARY Malabsorption was present in 29 of 40 symptomatic patients with giardiasis. Twentythree had impaired D-xylose absorption; in 20 vitamin B12 absorption was low, and 15 patients had steatorrhoea. More severe malabsorption was associated with more marked histological abnormalities. Metronidazole, 2-0 g as a single daily dose on three successive days, produced a parasitological cure rate of 91%. In contrast, the standard course of mepacrine, 100 mg thrice daily for 10 days, eradicated the parasite in only 63% of patients. Improvements in absorption and jejunal morphology followed anti-giardial treatment. Tetracycline in eight patients failed to eradicate the parasite, intestinal absorption was unaltered, and histological appearances of the jejunal mucosa often deteriorated.

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Section: Discussionmentioning

confidence: 99%

Giardiasis: clinical and therapeutic aspects.

Wright¹,

Tomkins²,

Ridley³

1977

Gut

122

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“…Sixteen had jejunal biopsies and 15 are said to have had normal histology. This is surprising, as the high prevalence of tropical enteropathy in other parts of Africa (Cook, 1974) leads us to expect the same in Kenya. These patients were not treated with antibiotics but Foy et al (1951) had previously shown a response to penicillin.…”

Section: Discussionmentioning

confidence: 93%

“…The evidence in favour of a nutritional cause and against tropical sprue is therefore inconclusive and tropical sprue certainly could have been missed in this study. Cook (1974) has never seen a case of tropical sprue while working in Nigeria, Uganda and Zambia, but has not published a study where he had specifically looked. He describes 85 Zambian megaloblastic anaemias, mostly in females, of whom only one male had malabsorption.…”

Section: Discussionmentioning

confidence: 99%

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Endemic tropical sprue in Rhodesia.

Thomas¹,

Clain²

1976

Gut

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SUMMARY The existence of tropical sprue in Africa is controversial. In this paper we present 31 cases seen in Rhodesia over a 15 month period. They have the clinical features, small intestinal morphology, malabsorption pattern, and treatment response of tropical sprue. Other causes of malabsorption, and primary malnutrition, have been excluded. The severity of the clinical state and intestinal malabsorption distinguish these patients from those we have described with tropical enteropathy. The previous work on tropical sprue in Africa is reviewed and it is apparent that, when it has been adequately looked for, it has been found. It is clear that the question of tropical sprue in Africa must be re-examined and that its existence may have hitherto been concealed by the assumption that primary malnutrition is responsible for the high prevalence of deficiency states.

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“…Cook (1974) has drawn attention to the lower prevalence of actue gastrointestinal infections in Africa, compared with India and South East Asia. If, as has been suggested, repeated attacks of gastroenteritis have a causative relationship with tropical enteropathy, this lighter exposure could account for the milder form seen in Africa.…”

Section: Discussionmentioning

confidence: 99%

Tropical enteropathy in Rhodesia.

Thomas¹,

Clain²,

Wicks³

1976

Gut

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SUMMARY Tropical enteropathy, which may be related to tropical sprue, has been described in many developing countries including parts of Africa. The jejunal changes of enteropathy are seen in Rhodesians of all social and racial categories. Xylose excretion, however, is related to socioeconomic status, but not race. Upper socioeconomic Africans and Europeans excrete significantly more xylose than lower socioeconomic Africans. Vitamin B12 and fat absorption are normal, suggesting predominant involvement of the proximal small intestine. Tropical enteropathy in Rhodesia is similar to that seen in Nigeria but is associated with less malabsorption than is found in the Caribbean, the

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Paper malabsorption in Africa

Cited by 21 publications

References 101 publications

Giardiasis: clinical and therapeutic aspects.

Giardiasis: clinical and therapeutic aspects.

Endemic tropical sprue in Rhodesia.

Tropical enteropathy in Rhodesia.

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