| Objectives:The main objective of this study is to compare the factors which cause the immunocompetent patients to develop Herpes Zoster in Tanzania and Dalian,China.In this comparative study we measure the immunoglobulins IgG,IgM,complements C3,C4,serological test for HIV and CD4+ T lymphocyte within these countries.Methods:A total of 121 patients involved in this study,and include 70(57.85%)patients from the United Republic of Tanzania,51(42.15%)from the People's Republic of Dalian China.The age ranges20-95 years.In Tanzania males were 26(37.10%),females 44(62.90%)and in Dalian China,males were 21(41.20%)females 30(58.80%).The duration of the study for both countries were 4 months.The patients in Tanzania were examined from Dar es Salaam,Cost and Morogoro regions in out patients departments in all clinics where as in Dalian China the patients were examined from in and outpatients in Dermatology departments at First Hospital of Dalian Medical University.The questionnaires which include age,gender,associated diseases,complications,history of chickenpox and treatments were administered for each patients followed by thorough mucocutaneous examination to exclude other diseases to select patients who are eligible for the study.The counseling was done for each patient before taking blood tests.Then the blood samples were sent to the Laboratory for tests and examination.The serological tests for HIV antibodies were tested by the ELISA method.Serum immunoglobulins(IgG,)in gm/dl.Complements(C3,C4)mg/L levels were determined by commercial Nephrolometry assay using a BN-11 device(Turbid metric inhibition immune assay)(Dade Behring,Marburg,Germany).(CD4cells count was expressed in percentage the Cytometer machine were used to measure CD4 counts in percentage).(Flow Cytometry Machine from Beckman Coulter Company from USA was used for measuring the CD4 cell counts),Finally the blood sample for CD4cell count was done and all the results were collected for analysis,In Tanzania CD4 counts expressed in cell/mm3then calculation was done and all results of CD4 cell cauntValues were expressed in percentage where as complements were expressed mg/L.The same instruments were used in both countries.Then all results were collected for statistical data analysis using Version 19.0 SPSS technic.Results There was significant difference between two countries on comparison of the variables.The young adults in Tanzania are more affected than in Dalian China with statistical significant different,and P<0.01.Likewise the females in both countries are affected more than males.In Tanzania the males were 37.10%and female 62.90%while in Dalian China males were 48.205%and females 51.80%.Statistically there are significant different as females are more affected than male P<0.05(P<0.026).Comparison of immunoglobulins particularly IgG and IgM as well as complements C3 and C4 between two groups.The IgG in Dalian China was 1317.60±25.60mg/dl while in Tanzania was 383.50±344.60mg/dl and was significantly different the P<0.01(P<0.000),the IgM Tanzania is 69.50±39.10mg/while in Dalian China was 105.40±71.10mg/dl,also there is significant different between these two countries as the P<0.01(P<0.001).The complement C3,there was also significant differences among patients who was seen Tanzania with the mean value 448.70±224.10mg/L and in Dalian China was 1158.30±179.90 mg/L,the P<0.01(P<0.000).In C4 the mean values are also statistical significant different in both countries Tanzania 216.80±138.10 mg/L and Dalian China 241.00±110.10 mg/L with P<0.05(P<0.016).The mean level of IgG,IgM,C3 and C4 of Chinese patients were within normal ranges.There is significant different statistically on comparing the serological tests for HIV in Tanzania and Dalian China.The 62(88.60%)was found positive in Tanzania and 1(2%)only was in Dalian China P<0.01(P<0.000).While in Dalian China 50(98%)was found HIV negative in Tanzania was 8(11.40%),it was statistically significant and different P<0.05(P<0.000).The major factors was the comparison of the percentage of CD4+ T lymphocyte in Tanzania and Dalian China.In Dalian China the percentage of CD4+ T lymphocyte was 38.30±8.80 which was in the normal range while in Tanzania 16.60±15.30 which was abnormal.There was a significant difference between two countries.P<0.01(P<0.000).Conclusions:HIV infection plays a major role in patients who develop Herpes Zoster especially in young age group in Tanzania.The advanced age shows significant importance in developing of Herpes Zoster in Dalian China.The major factor in developing of Herpes Zoster is the impairment of Cell mediated immunity;this is obvious to the patients who decreased of CD4+T lymphocyte in Tanzania.However the cellular immunity and humoral immunity functions are normal for the patients in Dalian China.In this thesis more studies are essentially needed to find out other factors which lead to decline of Cell-mediated immunity especially in Malaria Endemic area in relation to the occurrences of Herpes zoster(Like Tanzania),More emphasis on Gene analysis in Hans's population in Dalian China who develops Herpes zoster after excluding other factors. |
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