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One hundred consecutive patients admitted to the Port Sudan Hospital with a temperature greater than or equal to 100 degrees F were evaluated. Enteric fever was diagnosed in 19 patients and malaria in 13. Virologic studies identified 21 cases of dengue infection. One dengue 1 and 17 dengue 2 infections were diagnosed by viral isolation. Three untyped dengue infections were identified serologically. The clinical presentation and course of patients infected with dengue virus were most consistent with classic dengue fever. There was no evidence of hemorrhagic phenomena or shock in any of the dengue-infected patients. Both dengue 1 and 2 must be considered causes of acute fever in East Africa.

Fifty-three adults hospitalized with Shigella dysentery were empirically treated with trimethoprim (200 mg) twice/day for 5 days, a single dose of trimethoprim (600 mg), or placebo in a randomized double-blind trial. During the first 24 hr of therapy, there was a reduction in the number of stools in 18/21 (86%) of patients treated with the 5-day regimen (trimethoprim-5) and 13/15 (87%) of patients treated with a single dose (trimethoprim-1), compared with 7/17 (41%) of the placebo group (P < 0.025, both comparisons). The mean number of stools passed in the first 24 hr of therapy was 10.6, 10.8, and 21.3 stools in the trimethoprim-5, trimethoprim-1, and placebo groups, respectively. The mean (+ or - SD) change in number of stools from baseline among treated patients during the first 24 hr was -4.9 (6.6) and -6.3 (6.3) for the trimethoprim-5 and trimethoprim-1 groups, respectively, compared with an increase of +2.4 (14.8) for the placebo group. there was a clinical failure at 48 hr in 9% of the trimethoprim-5 patients and 13% of trimethoprim-1 patients compared with 70% of placebo patients (P < 0.005, both comparisons). Although we were unable to demonstrate a difference in efficacy between the two dosage schedules of trimethoprim, we conclude that both treatment regimens are effective for the treatment of Shigella dysentery. Keywords: Antibiotics. Reprints.

Clinical records of 58 infections with the Vietnam Smith strain of Plasmodium falciparum in human volunteers were studied in order to 1) characterize the clinical course of infections; 2) investigate the effects of race, weight, age, method of induction, and previous malaria experience on the course of infection using methods of multiple regression; and 3) establish whether differences in drug-treatment groups may have influenced the current study results. We found that blacks tolerated infection better than whites, that heterologous as well as homologous strain immunity persists after infection and that these results could not be attributed to differences in treatment. The clinical course of infections with the Vietnam Smith strain of P. falciparum is described.