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- Southern African Journal of Epidemiology and Infection
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- Volume 23, Issue 2, 2008
Southern African Journal of Epidemiology and Infection - Volume 23, Issue 2, 2008
Volume 23, Issue 2, 2008
The Federation of Infectious Diseases Societies of Southern Africa (FIDSSA) - four years since inception : editorialAuthor A. BrinkSource: Southern African Journal of Epidemiology and Infection 23, pp 3 –4 (2008)More Less
In 2005, FIDDSA was formed from an amalgamation of existing societies representing infectious diseases (Infectious Diseases Society of Southern Africa - IDSSA), sexually transmitted diseases, (Sexually Transmitted Diseases Society of Southern Africa - STDSSA), infection control (Infection Control Society of South Africa - ICSSA) and antimicrobial surveillance (National Antimicrobial Surveillance Forum - NASF). The reasons for the amalgamation included the establishment of a common administrative structure which would provide secretarial and administrative support for its member societies, to improve communication between member societies and interest groups, to generate support and contributions towards a single scientific journal and to improve support for a joint biennial congress at which all societies would be equally represented. Additional objectives included the fostering of greater collaboration between the clinically and laboratory-based divisions of the disciplines.
Source: Southern African Journal of Epidemiology and Infection 23 (2008)More Less
Public health is the process of mobilising local, state, national and international resources to ensure the conditions in which people can be healthy. It has impact on all levels of society in every country, whether rich or poor, eastern or western, big or small. Patterns of diseases can be influenced by and in turn influence human behaviour, socio-economic factors and health systems of a country. At one end of the spectrum, communicable diseases such as tuberculosis, HIV and malaria cause extensive disease and have significant public health implications, particularly in developing countries. On the other hand, non-communicable diseases such as diabetes, obesity and hypertension are gradually becoming a silent killer not only in developed but also in developing countries. Countries like South Africa are now facing a quadruple burden of diseases which is crippling its already overstretched health system.
Source: Southern African Journal of Epidemiology and Infection 23, pp 9 –10 (2008)More Less
A 52-year-old man traveled overland from South Africa to Tanzania via Mozambique and Malawi, where he visited Lake Malawi and the Kasunga National Park. He took mefloquine for malaria chemoprophylaxis, and received pre-travel hepatitis and yellow fever vaccination. During the trip the family camped, swam in Lake Malawi, drank bottled water and ate local food. He gave a history of being bitten by a number of insects, especially mosquitoes, during his travels. He developed fever, rigors, headache and confusion while in Tanzania, six days after having left the Kasunga National Park in Malawi, and he was transferred back to South Africa. There was no cough, diarrhoea, arthralgia or myalgia.
Author M. Thomas FileSource: Southern African Journal of Epidemiology and Infection 23, pp 13 –15 (2008)More Less
Community-associated methicillin-resistant Staphylococcus aureus (CA-MRSA) infections are defined as occurring in patients who have no association with the healthcare setting. CA-MRSA has emerged as a common cause of community infections in the US and are distinct from MRSA strains classically associated with healthcare-associated infections from genotypic and phenotypic perspectives. They are frequently susceptible to non-beta-lactam antimicrobials, express the SCCmec type IV or V gene and contain the Panton-Valentine leukocidin virulence factor. They most commonly cause mild skin infections, but have been associated with severe soft tissue infection and with necrotising pneumonia.
Source: Southern African Journal of Epidemiology and Infection 23, pp 17 –19 (2008)More Less
Prevalence of Pneumocystis jirovecii and Mycoplasma pneumoniae in patients presenting with pneumonia at hospitals in Port Elizabeth : original researchSource: Southern African Journal of Epidemiology and Infection 23, pp 21 –24 (2008)More Less
The study was conducted to determine the prevalence of Pneumocystis jirovecii and Mycoplasma pneumoniae in patients presenting with community-acquired pneumonia, in order to improve treatment management programmes. Sputum specimens from 45 patients presenting with pneumonia/symptoms of pneumonia admitted to hospitals in the Port Elizabeth region were assessed. Details of patient's gender, age, HIV and Mycobacterium tuberculosis status were provided by the hospitals. PCRs were performed employing primers directed at the following genes : P. jirovecii for detection of mitochondrial large subunit ribosomal RNA (mtLSUrRNA) and for cotrimoxazole resistance mutation analysis dihrdropteroate synthase (DHPS) and dihydrofolate reductase (DHFR); M. pneumoniae for detection of P1 adhesin and 16SrRNA. Women were seen to be at high risk for community-acquired P. jirovecii colonisation. Overall, prevalence of P. jirovecii was 73% (33/45 patients). P. jirovecii was mainly associated with HIV (28/30 P. jirovecii-positive patients for which clinical data were available) and co-colonisation with M. tuberculosis was observed in 10 HIV cases and one HIV-negative patient. DHPS and DHFR primers seriously lacked sensitivity and on six and four PCR products obtained, respectively, no resistance associated mutations were found. M. pneumoniae was detected in one patient. The high prevalence of P. jirovecii and presence of M. pneumoniae in cases of pneumonia investigated emphasises that in the absence of definitive diagnoses, it is crucial to monitor treatment responses carefully, especially when first line antibiotic preferences are ß-lactams or cephalosporins.
In vitro activity of medicinal plants of the Venda region, South Africa, against Trichomonas vaginalis : original researchSource: Southern African Journal of Epidemiology and Infection 23, pp 26 –29 (2008)More Less
Trichomonas vaginalis is an important and common cause of urogenital infections in both developed and in developing countries. In view of the high prevalence, increase in resistance to drug therapy and associated risk of acquisition and transmission of HIV, we screened the aqueous extracts of 29 plants. These plants are used to treat venereal diseases and infections in the Venda region. Extracts of four plants showed trichomonicidal activity : Securidaca longepedunculata Fresen. (Polygalaceae; 0.10 mg/ml), Solanum aculeastrum Dun. (Solanaceae; 1.06 mg/ml), Piper capense L.f. (Piperaceae; 11.19 mg/ml) and Cassine transvaalensis (Burtt. Davy) Codd (Celastraceae; 9.69 mg/ml). Further investigations are required to determine whether these plants possess the potential to be developed as new drugs for the treatment of trichomoniasis.
Source: Southern African Journal of Epidemiology and Infection 23, pp 31 –42 (2008)More Less
Objective : To revise the existing South African community-acquired pneumonia guideline in the light of the following factors :
- Increasing antibiotic resistance
- Introduction of new antibiotics
- International trends based on evidence published since the previous guideline.
- The main aim of the guideline is to recommend an initial choiceof antibiotics in patients with community-acquired pneumonia encompassing the following subgroups :
- Adults without co-morbid illness
- The elderly and/or those with associated co-morbid illness, including patients with concomitant human immunodeficiency virus (HIV) infection
- Patients with severe pneumonia
Outcomes : The empiric antibiotic therapy covers all commonly encountered organisms in patients with community-acquired pneumonia and is likely to achieve the best prognosis.
Evidence : Working group of clinicians and clinical microbiologists, following detailed literature review, particularly of studies performed in South Africa.
Benefits, harms and costs : The guideline pays particular attention to cost-effectiveness in South Africa and promotes rational antibiotic prescribing with the aim of limiting emergence of antibiotic resistance.
Recommendations : These include details of likely pathogens, an appropriate diagnostic approach, indicators of severity of illness, need for hospitalisation and antibiotic treatment options.
Validation : The guideline was updated by a working group of the South African Thoracic Society, which included members of the Critical Care Society of Southern Africa, and the Federation of Infectious Diseases Societies of Southern Africa. Reference was made to the recently updated international guidelines from the UK, Europe, Canada and the USA.
Endorsement : The guideline is endorsed by the South African Thoracic Society, the Federation of Infectious Diseases Societies of Southern Africa, and the Critical Care Society of Southern Africa.
National Antibiotic Surveillance Forum - private susceptibility data : July - December 2007 : surveillance dataSource: Southern African Journal of Epidemiology and Infection 23, pp 44 –48 (2008)More Less