Title:
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Serological investigations in East African glomerulonephritis
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The high incidence of glomerulonephritis in East Africa has
been reported by several workers. Most of these studies
associate the prevalence of glomerulonephritis with
Plasmodium malariae infections. Although it appears that
the causal agent is in the local environment, and most
likely to be an infection, there are many other parasites
more prevalent in the area than Plasmodium malariae.
The present work is based on a study on 175 Kenyan renal
patients of which 70 were biopsied. Special emphasis wa s
given to parasitic infections with Schistosoma mansoni ,
Plasmodium malariae, Plasmodium falciparum, Leishmania
donovani, filariasis, ascaris and hydatidosis. Antibodies
in the serum of the patients were detected by crossed
(Immunoelectrophoresis against prepared parasitic antigens.
Composition of circulating immune complexes and the
complement profile of the patients was analysed. Hepatitis
B viral antigen, anti-streptolysin 0 titre and total IgE of
some of the patients was also determined.
An enzyme immunoassay technique was developed to study the
antigens in circulating complexes. Antisera against
Schistosoma mansoni eggs and worms and Ascaris suum were
raised in rabbits. The antibodies were labelled with
peroxidase and used for the enzyme immunoassay. Serum from
acutely infected patients was used in place of antiserum in
the cases where antigens could not be obtained to immunise
rabbits.
The enzyme immunoassay technique mentioned above was used to
study the cross reaction between the antibodies of patients
with the circulating complexes of other patients, using
peroxidase-labelled globulins to react with the complexed
antigens in their own serum and that of other patients.
The association between infections and glomerulonephritis
for all the parasites was analysed. The results in the
Kenyan patients have been compared with glomerulonephritis
in the patients studied in London, largely of European
origin, and not resident in East Africa. Analyses of the
results show that because of the overlap in parasitic
infections, no single parasite studied could cause all of
the common type of glomerulonephritis in the area.
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