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- Southern African Journal of Infectious Diseases
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- Volume 30, Issue 4, 2015
Southern African Journal of Infectious Diseases - Volume 30, Issue 4, 2015
Volume 30, Issue 4, 2015
Health policy implications of blood transfusion-related human T-cell lymphotropic virus type 1 infection and disease : case reportSource: Southern African Journal of Infectious Diseases 30, pp 4 –5 (2015) http://dx.doi.org/10.1080/23120053.2016.1118845More Less
Human T-cell lymphotropic virus type 1 (HTLV-1) is the causative agent for HTLV-1-associated myelopathy (HAM) or tropical spastic paraparesis (TSP), and adult T-cell leukaemia (ATL). The virus is transmitted vertically from mother to child, and horizontally by sexual intercourse and the transfusion of blood. We describe a case of HAM/TSP, thought to have been acquired by blood transfusion. The South African National Blood Transfusion Services (SANBS) does not currently offer routine screening for HTLV-1. We searched the literature for surveillance studies, and asked the SANBS to provide us with data from any unpublished studies. We identified one study published by the Natal Blood Transfusion Services in 1990, and the SANBS provided us with data from studies conducted in 1996 and 2013. None of the donors were found to be positive from the 5 603 donors who were tested in 1990. This study included 1 502 black, 2 569 white, 102 coloured and 1 430 Asian donors. Three donors out of 37 496 were found to be positive in 1996. Sixty donors were found to be positive in the 2013 survey in which 46 764 donors were tested. The rates in the different population groups in the most recent survey were as follows: black Africans [58 in 34 176 (0.17%)], whites [1 in 5 644 (0.02%)], coloured (mixed ancestry) [1 in 6 038 (0.02%)] and Asians of Indian descent [0 in 909 (0%)].
The changing HTLV-1 seroprevalence data with respect to South African blood donors provides compelling evidence for the need for the introduction of routine screening of HTLV-1 by the SANBS.
Response to article entitled, Health policy implications of blood transfusion-related human T-cell lymphotropic virus type 1 infection and disease : letterSource: Southern African Journal of Infectious Diseases 30 (2015) http://dx.doi.org/10.1080/23120053.2016.1118847More Less
The authors of the article titled, Health policy implications of blood transfusion-related human T-cell lymphotropic virus type 1 infection and disease, attempt to make a case for the inclusion of human T-cell lymphotropic virus type 1 (HTLV-1) screening of blood donations in South Africa.
Among other elements, a discussion on health policy should include the effectiveness of a proposed intervention within a health system, particularly in a resource-constrained setting. The routine screening of all blood donations, leucoreduction, or screening of first-time donors only, are the proposed interventions in the publication with respect to the HTLV-1 screening of donors, but a discussion of the effectiveness thereof in South Africa is not included.
Application of geographical information system and remote sensing in malaria research and control in South Africa : a review : review articleSource: Southern African Journal of Infectious Diseases 30, pp 7 –14 (2015) http://dx.doi.org/10.1080/23120053.2015.1106765More Less
This paper presents a review of numerous items of published literature on the use of spatial technology for malaria epidemiology in South Africa between 1930 and 2013. In particular, focus is on the use of statistical and mathematical models as well as geographic information science (GIS) and remote sensing (RS) technology for malaria research. First, the review takes cognisance of the use of predictive models to determine the association between climatic factors and malaria epidemics only in KwaZulu-Natal province. Similar studies in other endemic regions such as Limpopo and Mpumalanga provinces have not been reported in the literature. While the integration of GIS with remote sensing has the potential of identifying, characterising, and monitoring breeding habitats and mapping malaria risk areas in South Africa, studies on the application of spatial technology in malaria research and control in South Africa are inexhaustive and have not been reported in the literature. As a result, a critical robust malaria warning system, which uses GIS and RS in South Africa, is yet to be realised. It is recommended that the wide range of datasets available from different sources including RS and global positioning systems (GPS) ought to be integrated into a GIS system, which is a core spatial technology vital for understanding the epidemiological processes of malaria and hence support in decision-making in malaria control.
Discrepancies in the identification of methicillin-resistant Staphylococcus aureus and the absence of mecC in surveillance isolates in South Africa : short articleSource: Southern African Journal of Infectious Diseases 30, pp 15 –17 (2015) http://dx.doi.org/10.1080/23120053.2015.1107256More Less
We investigated instances of phenotypic and genotypic discrepancies in the identification of methicillin-resistant Staphylococcus aureus in a reference laboratory in South Africa. Organism identification and antimicrobial susceptibility testing were performed using automated systems; and, the detection of mecA, mecC and nuc was performed using real-time and conventional PCR methods. Staphylococcal cassette chromosome mec (SCCmec) typing was done using conventional typing methods. Ninety-nine percent of phenotypic and genotypic results correlated; however, there were some discrepancies. The mecC gene was not detected in any of isolates tested. Although modest in number, the awareness of potential discrepancies is important and should be noted. However, our findings suggest that such discrepancies are rare and that phenotypic identification methods are acceptable.
Epidemiological description of cholera outbreak in Mpumalanga Province, South Africa, December 2008-March 2009 : research articleSource: Southern African Journal of Infectious Diseases 30, pp 18 –21 (2015) http://dx.doi.org/10.1080/23120053.2015.1107263More Less
Background : In developing countries, cholera often occurs in large-scale outbreaks and causes high burden of disease and leads to death in some cases. The purpose of the study was to describe and characterise cholera cases, and also to identify environmental health factors that contributed to the outbreak.
Methods : A descriptive, retrospective study was conducted to describe the outbreak and to identify environmental health factors that contributed to the outbreak. The preliminary assessment was done by means of Microsoft Excel 2003 and thereafter followed by statistical analysis of the database using Epi Info statistical software. STATA 11 was used for the calculation of correlation coefficient between cholera and sanitation factors.
Results : A total of 6 278 cholera positive cases were recorded between December 2008 and March 2009 with 30 deaths, which translate into a case-fatality rate of 0.48%. The overall attack rate for cholera during the outbreak was 3.3 per 1 000. The cumulative incidence was the highest (0.55 per 100 persons) in Mbombela sub-district with 4 049 cases and lowest (0.02 per 100 persons) in uMjindi with 120 cases recorded. On average the male-to-female case ratio was 1:1.5 across all age groups. Most cases 79% (n =5011) had access to tap water, 12% (n = 784) depended on rivers while 9% (n = 9) cases sourced water from streams, boreholes and springs.
Conclusions : This study, along with evidence from the epidemiology of other diarrhoeal diseases, suggests that safe water supply, adequate sanitation and community awareness campaigns, are the best means of preventing cholera, as well as other diarrhoeal diseases in large-scale outbreaks.
Characteristics of women requesting legal termination of pregnancy in a district hospital in Hammanskraal, South Africa : researchSource: Southern African Journal of Infectious Diseases 30, pp 22 –26 (2015) http://dx.doi.org/10.1080/23120053.2015.1107265More Less
Introduction : Worldwide, the most commonly reported reason stated by women for undergoing a termination of pregnancy (TOP) is to postpone or stop childbearing. The second most common cited reason is socio-economic concerns, which include a disruption to education or employment, lack of support from the father, a desire to provide schooling for existing children, relationship conflict, poverty, unemployment or the inability to afford additional children. There are particular characteristics for women that are associated with their reasons for opting to have a TOP. Thus, this study sought to determine the characteristics of women seeking a TOP at Jubilee Hospital, Hammanskraal, South Africa.
Method : A cross-sectional survey was performed on women presenting for a TOP. One hundred and fifty-five participants completed a self-report, standardised questionnaire on TOP.
Results : The mean age of the participants was 27.9 years. Most of the women were parity 1 or 2, widowed or single, unemployed, had completed high school, were living with their parents and were Christian. One hundred and thirty-three (85%) were undergoing their first TOP, 15 (10%) had had one previous TOP and 7 (5%) had had two or more previous TOPs. Most of the participants (74%) reported substantial conflict with their partner. Financial difficulties, the lack of a committed relationship and partner problems were common reasons given by the women for opting to undergo a TOP.
Conclusion : The women in this study were characterised as being young; poorly educated; unemployed; dependent on their parents; often already widowed or single; and, involved in a conflictual relationship with their intimate partner. Financial and relationship problems, not being ready to become a parent and the need to complete studying were reasons given for choosing to undergo TOP. Efforts should be made to target this group to ensure that they have access to reproductive health services.
Source: Southern African Journal of Infectious Diseases 30, pp 27 –29 (2015) http://dx.doi.org/10.1080/23120053.2015.1107290More Less
Background : The development of antibiotic resistance is a globally recognised human health threat. Overuse of antibiotics is a major contributory factor to the development of resistance. As end users, the public play a role in antibiotic use and the development and spread of resistance. The purpose of the study was to assess the knowledge, attitudes and behaviour of the general population of Namibia accessing care in the private sector regarding antibiotic use.
Methodology : A cross-sectional survey based on self-administered questionnaire was distributed to 600 patients through pharmacies in Windhoek, Namibia. The survey was conducted from March to June 2013.
Results : A total of 446 completed questionnaires were collected. Eighty percent (80%) of respondents reported to have used antibiotics in the past year mainly for colds and flu symptoms. The majority of respondents obtained antibiotics through a valid doctor's prescription. A prevalence of fifteen percent (15%) of self-medication with antibiotics mainly obtained from pharmacies without a prescription was reported. Eighty percent (80%) of respondents reported completing the antibiotic course. Gaps in population understanding of antibiotics were observed. Sixty-four percent (64%) of the respondents thought that antibiotics were effective against viruses with just less than half revealing that they should take an antibiotic for a cold. Seventy-two percent (72%) of respondents understood that unnecessary use of antibiotics makes them ineffective.
Conclusion : Major findings of this study include the sale of antibiotics without a prescription; over prescribing of antibiotics for self-limiting upper respiratory tract infections; and, the presence of gaps in knowledge, attitudes and behaviour of the general population towards antibiotics and their use.
Source: Southern African Journal of Infectious Diseases 30, pp 30 –31 (2015) http://dx.doi.org/10.1080/23120053.2015.1107293More Less
Cryptococcus neoformans is a fungus which rarely infects immune competent children. It commonly affects the lung and central nervous system in immunodeficient individuals. Osteomyelitis is extremely rare and this case report presents an eight-year-old immune competent boy with a tibial osteomyelitis treated with surgical debridement and antifungal therapy and reviews of the literature pertaining to this case.
A high seroprevalence of Toxoplasma gondii antibodies in a population of feral cats in the Western Cape province of South Africa : researchSource: Southern African Journal of Infectious Diseases 30, pp 32 –35 (2015) http://dx.doi.org/10.1080/23120053.2015.1107295More Less
Toxoplasma gondii is an obligate intracellular protozoan pathogen that causes toxoplasmosis; and, is of global importance. T. gondii is highly pathogenic to both humans and animals due to its ability to infect almost all mammals and birds. Felids are the only known definitive host of T. gondii. The aim of this study was to determine the seroprevalence of T. gondii antibodies in the serum of a sample of feral cats (Felis catus), which were trapped in population control programs in the Western Cape Province of South Africa. Overall, 159 feral cats were included in this study. There were 95 (59.8%) females and 64 (40.3%) males. One hundred and twenty-one (76.1%) of the cats were adults (>12 months old) and 38 (23.9%) were juvenile (≤ 12 months old). The sera were tested by an Indirect Immunofluorescence test. IgG and IgM antibodies were detected in 59 (37.1%, 95% CI: 0.2960-0.4462) and 14 (8.8%, 95% CI: 0.0440-0.1321) cats, respectively. Both IgG and IgM antibodies were detected in 10 cats (6.3%). Correlation between serum IgG, serum IgM, sex and age of cats were investigated. This is the first report on surveillance of feral cats for T. gondii in South Africa.