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- Southern African Journal of Epidemiology and Infection
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- Volume 24, Issue 2, 2009
Southern African Journal of Epidemiology and Infection - Volume 24, Issue 2, 2009
Volume 24, Issue 2, 2009
The demise of ciprofloxacin - another class of anti-gonococcal antibiotics bites the dust : editorialAuthor David A. LewisSource: Southern African Journal of Epidemiology and Infection 24, pp 3 –4 (2009)More Less
The South African national sexually transmitted infections (STIs) guideline was changed significantly from the previous version in 2008. The new guideline contains an important change in antibiotic class for the treatment of presumptive gonococcal infection, namely from quinolones to cephalosporins.
Revision of the national guideline for first-line comprehensive management and control of sexually transmitted infections : what's new and why? : guidelineSource: Southern African Journal of Epidemiology and Infection 24, pp 6 –9 (2009)More Less
A revised national guideline for the management and control of sexually transmitted infections (STIs) has recently been published by the national Department of Health according to the Essential Drugs List. Since 2004, there has been a marked rise in resistance to ciprofloxacin among Neisseria gonorrhoeae isolates in several South African cities, requiring a change from quinolones to cephalosporins to treat presumptive gonorrhoea. In keeping with WHO recommendations, acyclovir has been added as part of first-line therapy for the management of genital ulceration. The national guideline has been revised accordingly in order to improve management of several key STI syndromes.
Source: Southern African Journal of Epidemiology and Infection 24, pp 11 –13 (2009)More Less
A previously healthy 31-year-old man presented in September 2007 to his doctor with a recurrence of painless ulcers on his left leg. He had traveled into Angola over 10 years for work involving diamond alluvial mining. He stayed mainly in the diamond province of Lunda Note, in an area called Capemba Camulembe. He was exposed to fresh water while working on the open mines on the banks of the rivers as well as while swimming, bathing or taking a shower in the tributaries of the Cuango River. During this time he frequently experienced cuts / abrasions of his skin. In 10 years he had been treated for malaria three times.
Source: Southern African Journal of Epidemiology and Infection 24, pp 14 –16 (2009)More Less
The aim of this study was to characterise acute poisoning cases admitted to a number of selected hospitals in South Africa. All cases admitted to eight hospitals, from January 2005 to June 2005, were evaluated retrospectively. Data obtained from the hospital medical records included the following: demographic characteristics, toxic agents, length of hospital stay, circumstances of poisoning, morbidity and mortality information on the poisoned patients. From a total of 424 patients admitted for treatment, whose median age was 17.6 years, 57.8 % were females, and 89.6% black Africans. Fifty-nine percent of the poisonings were accidental, and the involved toxic agents were, in descending order: household chemicals (45.7%), modern medicines (17.5%), animal/insect bites (15.8%), agrochemical chemicals (9.7%), food poisoning (5.4%), drugs of abuse (3.3%), traditional medicines (2.4%), and plants (0.2%). Poisoning by drugs of abuse was commoner in males than females, but the percentage of females poisoned by all other toxic agents was higher than in males. Most patients spent less than two days in hospital, but more females (70.1%) than males (29.9%) stayed for more than two days. The overall case fatality rate was 2.4%. Of those who died, 80% were black Africans, aged 13 to 19 years and it was deliberate poisoning through drugs of abuse, carbon monoxide and agricultural chemicals. Acute poisoning reviewed in some selected hospitals in South Africa revealed that more black African females were involved, who spent more than two days hospitalised. The case fatality rate was 2.4%, mainly due to drugs of abuse, carbon monoxide and agricultural chemicals. These findings suggest that further studies are needed to understand the motivation(s) for this emerging problem and that these should focus primarily on the female black African.
Source: Southern African Journal of Epidemiology and Infection 24, pp 18 –20 (2009)More Less
Cancer of the cervix is a significant burden on women's health throughout the world despite it being a largely preventable disease. In South Africa, the launch of the National Guideline on Cervical Cancer Screening in 2000 aimed to reduce the incidence of cervical cancer in the country. The aim of this research is to review the status of cervical screening in clinics of eThekwini municipal area in Durban, KwaZulu-Natal, South Africa. A cross-sectional, descriptive study of clinics involving 22 nurses working in fixed clinics offering cervical screening in the eThekwini municipal area was carried out. Interviews were conducted with professional nurses from the clinics using a semi-structured questionnaire. Questions focused on the availability of resources to implement cervical screening, nurses' knowledge, attitudes and beliefs towards cervical screening. Interview data were verified and complemented by direct observation of screening facilities. The equipment in the clinics was always adequate for taking cervical smears. No patient education material was available to promote cervical screening or provide information about cervical cancer. The median number of women screened was 20 per month in accordance with a quota system currently in place. When given a hypothetical cytology result to interpret, 27% of nurses identified the correct management regimen; 64% recognised that they needed more training in the interpretation of cytology results. Most cervical screening in the clinics was done for diagnostic reasons rather than as population-based screening. Barriers to effective cervical screening included: insufficient nursing staff, a quota system limiting the number of smears that could be taken and inadequate patient educational material on cervical cancer.
Staphylococcus aureus on computer mice and keyboards in intensive care units of the Universitas Academic Hospital, Bloemfontein, and ICU staff's knowledge of its hazards and cleaning practices : original researchSource: Southern African Journal of Epidemiology and Infection 24, pp 22 –26 (2009)More Less
Nosocomial infections result in severe health and financial difficulties for patients and healthcare facilities. The objective of the study was to determine the presence of Staphylococcus aureus on computer mice and keyboards in the intensive care units (ICUs) of Universitas Academic Hospital, Bloemfontein, and ICU staff's knowledge regarding cleaning of computer mice and keyboards and their potential hazard as reservoirs for pathogens. Swab specimens from computer mice and keyboards (14 each) were investigated for S. aureus. Swabbing was repeated six months later. Standard microbiology laboratory methods were used to culture and identify organisms. An anonymous questionnaire completed by the ICU staff determined their awareness of computer mice and keyboards as potential sources of nosocomial infections. In addition to various environmental microorganisms and normal human flora, S. aureus was initially isolated from one computer mouse, and from two keyboards and five mice six months later. The questionnaire response rate was 85.6%. Seventy-one percent of respondents stated that they regarded keyboards and mice as an important source of nosocomial infections. Nevertheless, 62% of doctors and 40.3% of nurses indicated that they never washed their hands before or after using the computer. Ninety-seven percent of respondents were not aware of an official cleaning policy for computer equipment. In order to prevent nosocomial infections resulting from microbial transmission between equipment, staff and patients, proper cleaning policies should be implemented.
Antimicrobial susceptibility patterns of selected invasive pathogens from public sector hospitals in South Africa, 2007 : antimicrobial surveillance 2007Source: Southern African Journal of Epidemiology and Infection 24, pp 28 –30 (2009)More Less
Retrospective antibiotic surveillance data of selected invasive pathogens isolated from blood and cerebrospinal fluid at public sector hospitals in South Africa in 2007 are presented. Antimicrobial susceptibilities were determined according to the 2007 Clinical and Laboratory Standards Institute criteria. Klebsiella pneumoniae remains a highly resistant pathogen, with approximately half of all strains producing extended-spectrum beta-lactamases. All laboratories reported considerable resistance among Acinetobacter spp. Approximately 50-60% of Staphylococcus aureus isolates from blood were resistant to cloxacillin. Among Streptococcus pneumoniae isolates from blood and cerebrospinal fluid, resistance to penicillin ranged from 0% to 6% at most laboratories and 16-42% of isolates were classified with intermediate resistance to penicillin. Resistance to ceftriaxone in S. pneumoniae was rare.
Author M. Van AswegenSource: Southern African Journal of Epidemiology and Infection 24, pp 32 –34 (2009)More Less
Although international business has existed for centuries, the world has entered an era of extraordinary global economic activity. This would include a substantial increase in worldwide production, distribution, and joint ventures. As a result of the growth in international business, the need for extensive international travelling has also increased tremendously. This need for international business travel has led to very high demands being placed on the people who need to conduct such international travelling.
One of the most challenging issues facing companies in the new global village is the management of the human resources required to ensure the successful coordination of their diverse international interests, To successfully manage these international interests, companies typically make use of three types of international travellers, namely short trippers (mostly executives who do not spend longer than one month in a specific country), short term assignees (technical specialists who spend one to six months at a foreign operation to complete a specific project), and expatriates (longer-term assignees who are sent to operations in foreign countries for a period of six months and longer).
A major task of the international traveller is to remain emotionally healthy, despite being faced with numerous challenges - both at a professional and a personal level. According to a World Bank and Hyatt Hotel survey, insurance claims for health problems tend to increase among employees who travel often. The study found that employees who travel overseas are twice as likely to file health claims for psychological problems. The study also found that travellers are up to three times more likely to suffer psychological disorders than their non-travelling colleagues. The more business trips that are taken, the greater the likelihood is of a person making a medical claim. Similar results were found for people involved with international assignments.