Southern African Journal of Epidemiology and Infection

Lung cancer is regarded by the World Health Organization as a leading cause of death globally. Limited data are available on lung cancer epidemiology in South Africa. This study aimed to determine the profile of patients with lung cancer who were seen at a local pulmonology clinic. A retrospective audit was conducted on patients ≥ 18 years of age who were diagnosed with primary lung cancer at the Universitas Academic Hospital (Pulmonology Division) between 1 January 2010 and 31 December 2011. Information was collected with regard to demographic variables, smoking status, performance status, histological subtype and stage of disease. Ninety-two patients' records were included in the study. The median age was 61.2 years (a range of 44-86 years). 57.6% of patients were black, 33.7% white and 8.7% coloured. The male to female ratio was 3:1. The largest group of patients was black men (46.7%). Most patients were current or previous smokers. 45.2% of white patients had a history of ≥ 30 smoking pack years (one pack year of smoking was defined as 20 cigarettes smoked every day for a year), compared to 26.4% of black and 37.5% of coloured patients. Squamous cell carcinoma (SCC) and adenocarcinoma were diagnosed in 34.8% and 32.6% of patients, respectively. Adenocarcinoma occurred more commonly in white patients (38.7%), while SCC was diagnosed more frequently in black patients (34%). The majority of patients presented with advanced stage of disease. Thorough record-keeping on the epidemiology of lung cancer in South Africa is necessary to enable the planning and implementation of a national strategy with regard to treatment options and prevention.

South Africa has one of the highest incidence of tuberculosis in the world, which can partly be attributed to poor infection control in public healthcare (PHC) facilities. The aim of the study was to explore the extent of tuberculosis and infection control training, as well as facility-level managerial, administrative, environmental and personal protection, infection control measures, at PHC facilities. Cross-sectional surveys were conducted at 127 PHC facilities across three districts of South Africa. Data collection was achieved through interviews with tuberculosis nurses, observations of infection control practices and a review of the clinic records. Univariate analysis was performed using SPSS® version 17. Limited implementation of World Health Organization infection control measures was identified. In terms of facility controls, 43.3% of the clinics did not have an infection control committee and 40.9% did not have a clinic specific infection control plan. In terms of administrative controls, 94.5% of clinics did not have the tuberculosis signs and symptoms screening tool, 48.8% did not separate coughing patients from other patients, and only 35.4% provided coughing patients with masks or tissues. In terms of environmental controls, only 18.9% of the clinics had an open window register. In terms of personal protection, there was a dire shortage of N95 respirators. In addition, only a third of the professional nurses and one in 10 community health workers had received training on infection control practices. Tuberculosis infection control training for PHC clinic staff, as well as the appropriate implementation of simple and inexpensive infection control measures, is required.

Sindbis virus (SINV), the prototype virus in the genus, Alphavirus, is an arbovirus with an extensive geographical distribution. Birds are the main vertebrate hosts for SINV, while Culex mosquitoes serve as vectors and occasionally transmit the virus to humans, causing a febrile illness with a maculopapular rash and arthritis. Currently, little information exists on the genetic diversity within SINV strains from South Africa. The E2 envelope glycoprotein gene was partially sequenced for a panel of 27 South African and African Sindbis virus isolates derived from a human case and from mosquito pools. A phylogenetic analysis was performed using these sequences, together with 65 partial E2 gene sequences from Sindbis virus isolates from elsewhere in the world. The resulting phylogenetic tree suggested five distinct Sindbis virus genotypes. The South African Sindbis virus isolates were grouped within genotype I, together with isolates from Sweden, Finland, Germany and Norway. The phylogeny of Sindbis virus reflects its geographical distribution and corresponds with the major migratory bird flyways, indicating that birds play a major role in Sindbis virus distribution.