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- Volume 27, Issue 2, 2012
Southern African Journal of Epidemiology and Infection - Volume 27, Issue 2, 2012
Volume 27, Issue 2, 2012
Author Wamda B. AbuelhassanSource: Southern African Journal of Epidemiology and Infection 27, pp 43 –44 (2012)More Less
Hepatitis C infection is a leading cause of chronic hepatitis, cirrhosis and hepatocellular carcinoma. It is also an important indication for liver transplantation in the USA and Europe, yet it is potentially curable. It is estimated that 3% of the world population (170 million people) are infected with hepatitis C. The highest prevalence is in North Africa and the Eastern Mediterranean. The prevalence in South Africa is not known, but is estimated to be in the range of 0.1-1.7%.
Antimicrobial susceptibility patterns of Escherichia coli strains isolated from urine samples in South Africa from 2007-2011 : reviewSource: Southern African Journal of Epidemiology and Infection 27, pp 46 –52 (2012)More Less
Escherichia coli is the most common cause of urinary tract infections. Knowledge of its local antimicrobial susceptibility patterns can be used to inform choice of empiric antimicrobial therapy. In this article, we review data on antimicrobial susceptibility patterns of E. coli isolated from unselected urine specimens, in both the private and public sectors of South Africa from 2007-2011. Between 65 000-84 000 E. coli urinary isolates were reported annually from 19 laboratories located across South Africa. Susceptibility to fluoroquinolone and beta-lactam antibiotics decreased significantly and steadily in both private and public sectors over the five-year period, although laboratory-based surveillance data may underestimate susceptibility rates due to selection bias and lack of differentiation between community- and hospital-acquired infections. Our data suggest that fluoroquinolones, co-amoxiclav and first- and second-generation cephalosporins can still be used for empiric treatment in many local settings, but clinicians should be alert to the risk of treatment failure. With the withdrawal of nitrofurantoin from the local market, other oral antibiotic options are limited, and fosfomcyin may become increasingly important. Given their sustained high susceptibility rates, aminoglycosides should be considered to treat pyelonephritis more often. Judicious use of laboratory testing is advised and further research and surveillance is warranted.
Microbiological evaluation and antimicrobial treatment of complicated intra-abdominal infections : reviewAuthor Helen Van der PlasSource: Southern African Journal of Epidemiology and Infection 27, pp 53 –57 (2012)More Less
Intra-abdominal infection is a major cause of morbidity and mortality. The principles of management of intra-abdominal infections include adequate surgical procedures, as well as antimicrobial therapy. This review provides insights into the microbiology of complicated intra-abdominal infections and offers an approach to the microbiological evaluation, as well as antimicrobial treatment strategies, in the South African context. Local antibiotic guidelines for the management of intra-abdominal infections are urgently required to optimise clinical outcomes, while limiting the emergence of resistance, toxicity and the selection of pathogenic organisms.
Gender differences in characteristics, occupational exposure, and infection control practices among dental professionals in Edo State, Nigeria : original researchSource: Southern African Journal of Epidemiology and Infection 27, pp 61 –65 (2012)More Less
The objective of this study was to assess the gender differences in the characteristics of dental professionals in Edo State, Nigeria, their occupational exposure to percutaneous injuries, and their infection control practices. A cross-sectional surveywas conducted among dental professionals working in two tiers of healthcare delivery across Edo State, from December 2008-February 2009. A self-administered questionnaire elicited information on demography, and prevalence of percutaneous injuries and infection control practices, such as hand hygiene, glove use, eye protection, protective clothing, and hepatitis B vaccination. A total of 90 questionnaires were returned, yielding a response rate of 93.8%. There was significant gender difference in the age (p-value = 0.008) and profession of the respondents (p-value = 0.001), with more male dental surgeons (65.6%), and more female dental auxiliaries (73.1%). There was a gender difference in percutaneous occupational exposure (p-value = 0.602) and hepatitis B vaccination (p-value = 0.687), but these values were not significant. For infection control practices, females were more likely to comply with hand hygiene (p-value = 0.016) and eye protection (p-value = 0.044), while more males regularly wore protective clothing (p-value = 0.035). There were gender differences in age and professional categories among oral health workers. However, there appear to be no gender differences in terms of general infection control guidelines, except for three infection control measures: hand hygiene (favoured by women), eye protection (preferred by women) and protective clothing (favoured by men).
Factors associated with the motivation of community drug distributors in the Lymphatic Filariasis Elimination Programme in Kenya : original researchSource: Southern African Journal of Epidemiology and Infection 27, pp 66 –70 (2012)More Less
Annual mass drug administration (MDA) is the main strategy for elimination of lymphatic filariasis (LF), globally. In Kenya, community drug distributors (CDDs) are used to deliver drugs to household members. To determine factors influencing CDDs' motivation, a retrospective cross-sectional study based on qualitative data was conducted in Kwale and Malindi districts after the 2008 MDA. In Kwale, Tsimba location represented high and Gadini low compliance while in Malindi, Goshi and Gongoni locations represented high and low compliance areas, respectively. Fifteen CDDs, 80 opinion leaders, 80 LF patients, five health personnel, four LF coordinators and the National Programme Manager were purposively selected and interviewed. Sixteen focus group discussions (FGDs) were conducted with single-sex adult and youth male and female groups. The factors that possibly had a positive influence on CDDs' motivation were: higher education level, trust and familiarity with community members. All CDDs reported that getting recognised, being trained on LF and an innate desire to help their communities raised their motivation. Factors that possibly had negative influence included: inadequate training, drug supplies and community sensitisation and lack of supervision. The majority of the CDDs reported a lack of or outdated record-keeping books, a limited drug distribution period, inadequate moral support and incentives as negative factors on their motivation. Factors that motivate CDDs are those that enhance their capacities to perform their duties and endear respect in the communities where they serve.
ART patients' satisfaction level regarding comprehensive HIV and AIDS care management and antiretroviral treatment programme in Pretoria : original researchSource: Southern African Journal of Epidemiology and Infection 27, pp 71 –75 (2012)More Less
The purpose of this cross-sectional study was to investigate patients' satisfaction levels regarding access to, and quality of, comprehensive human immunodeficiency virus (HIV) and acquired immune deficiency syndrome (AIDS) care management and antiretroviral treatment programme (CCMT). A total of 402 patients were selected from three hospitals by stratified random sampling techniques. A self-administered questionnaire was used to assess patients' satisfaction levels. Almost all the patients (> 93%) gave positive response towards access to CCMT services, and mentioned that the doctor was kind, polite, and showed them respect; the nurse was kind, polite, and showed them respect; doctors provided full attention during consultations; and they felt comfortable talking to the healthcare provider about their problems. More than a tenth (12%) of the patients were dissatisfied with regard to privacy during consultation, and another 13% regarded the receptionist or booking clerk as unkind, impolite, disrespectful and unhelpful towards them. The majority (> 90%) of the patients were very satisfied, or satisfied, with obtaining medication, with the explanation on how to take it, and with the counselling and privacy. Patients were mostly dissatisfied with HIV-specific material (19%), assessment of financial status (19%), and explanation of laboratory results (8%). Access to, and quality of, the CCMT programme in the three hospitals in the Tshwane District is excellent, and in line with what has been prescribed in the operational plan. The availability of HIV-specific material has to be strengthened in order to help educate patients, so that they can better access healthcare facilities, and especially patients on the CCMT programme.
Source: Southern African Journal of Epidemiology and Infection 27, pp 77 –83 (2012)More Less
Tuberculosis is a global health problem. Continuous efforts are needed to understand the genetic diversity and geographical distribution of Mycobacterium tuberculosis. The objective of this study was to determine the genetic diversity of M. tuberculosis strains in Soshanguve, Pretoria. Eighty-nine isolates that were sputum culture-positive in Mycobacterium Growth Indicator Tube 960®, and positively identified by Accuprobe Probe assay as M. tuberculosis complex, were used in the study. The samples were sub-cultured on Lowenstein-Jensen (L-J) slants to ensure purity. Spoligotyping was performed, with slight modifications according to the manufacturer's specifications. Genotypic data were compared to the international spoligotyping database 4 (SpolDB4) and that suggested by Streicher et al. Spoligotyping identified 12 genotypes. Of the 89 isolates studied, 75 could be grouped into 11 clusters. The Beijing genotype family formed the largest group, with 21 isolates (28%). The remaining isolates were distributed among the Latino-American-Mediterranean (LAM) family: LAM3 (13%), LAM4 (4%), LAM9 (3%); the T family: T1 (23%), T2 (9%), and T3 (3%); the S family (8%); the X3 family (4%); CAS1-KILI (3%); and LAM11-ZWE (3%). Fourteen (16%) of the isolates had spoligotypes that did not match any of the spoligotype patterns deposited in the SpolDB4 database. Beijing was the most common genotype family, identified in 28% of the cases, followed by T1 (23%). The high prevalence of Beijing and T1 in this study reflects transmission of these genotype families within this community. The results of this study showed the dire need for more robust prevention strategies in tuberculosis control programmes. Other genotyping methods with a higher discriminatory power, such as restriction fragment length polymorphism, will be useful in defining the transmission patterns in this community.
Source: Southern African Journal of Epidemiology and Infection 27, pp 84 –86 (2012)More Less
Author Chikwe IhekweazuSource: Southern African Journal of Epidemiology and Infection 27, pp 87 –88 (2012)More Less
I have always wondered why there are not more books that are written in plain language to summarise the amazing research that has examined the emergence and spread of infectious diseases, and the response of the medical and scientific communities thereto. The raw material is available in thousands of publications, in peer-reviewed journals. However, only a minuscule proportion of these research findings have been "translated" into language that is accessible to non-scientists. Often, when they are translated into a more accessible language, the temptation for journalists is to focus on the "headlines", and to over-sensationalise a particular aspect of the research study. The story of human immunodeficiency virus (HIV)/acquired immune deficiency syndrome (AIDS) is perhaps an exception, and has been somewhat better documented than any other infectious disease in books and films. In all of these, the "origin" of AIDS remains an intriguing question. As much as scientists argue that the search for the source of AIDS has been a lesser priority than the search for a future cure, there is something obsessively human in our need to understand the beginning of the existence of this relatively new virus, that has caused the largest epidemic in modern times. Although scientists first identified HIV as the cause of AIDS in 1984, we know that the virus spread among people long before that.