106 research outputs found
Reflections: A Somalia mission experience
Reports about The Horn of Africa Famine Crisis in 2011 flooded our news bulletins and newspapers. Yet the nations of the world failed to respond and alleviate the unfolding disaster. In August 2011, the Gift of the Givers Foundation mobilised what was to become the largest humanitarian mission ever conducted by an African organisation. Almost a year later, the effort continues, changing the face of disaster medicine as we know it
Particular legal issues in international trade : a critique of the multilateral agreement on agriculture from the perspective of South Africa and Brics.
LL.M. University of KwaZulu-Natal, Durban 2014.Abstract not available
L-Arginine promotes gut hormone release and reduces food intake in rodents
Aims: To investigate the anorectic effect of Lâarginine (LâArg) in rodents.
Methods: We investigated the effects of LâArg on food intake, and the role of the anorectic gut hormones glucagonâlike peptideâ1 (GLPâ1) and peptide YY (PYY), the Gâproteinâcoupled receptor family C group 6 member A (GPRC6A) and the vagus nerve in mediating these effects in rodents.
Results: Oral gavage of LâArg reduced food intake in rodents, and chronically reduced cumulative food intake in dietâinduced obese mice. Lack of the GPRC6A in mice and subdiaphragmatic vagal deafferentation in rats did not influence these anorectic effects. LâArg stimulated GLPâ1 and PYY release in vitro and in vivo. Pharmacological blockade of GLPâ1 and PYY receptors did not influence the anorectic effect of LâArg. LâArgâmediated PYY release modulated net ion transport across the gut mucosa. Intracerebroventricular (i.c.v.) and intraperitoneal (i.p.) administration of LâArg suppressed food intake in rats.
Conclusions: LâArg reduced food intake and stimulated gut hormone release in rodents. The anorectic effect of LâArg is unlikely to be mediated by GLPâ1 and PYY, does not require GPRC6A signalling and is not mediated via the vagus. I.c.v. and i.p. administration of LâArg suppressed food intake in rats, suggesting that LâArg may act on the brain to influence food intake. Further work is required to determine the mechanisms by which LâArg suppresses food intake and its utility in the treatment of obesity
High HIV prevalence in an early cohort of hospital admissions with COVID-19 in Cape Town, South Africa
Background. South Africa (SA) has a high prevalence of HIV and tuberculosis. Cape Town was the SA metropole most affected in the early stages of the COVID-19 pandemic. Early observational data from Africa may provide valuable insight into what can be expected as the pandemic expands across the continent.Objectives. To describe the prevalence, clinical features, comorbidities and outcome of an early cohort of HIV-positive and HIV-negative patients admitted with COVID-19.Methods. This was a descriptive observational study of an early cohort of adults with COVID-19 pneumonia admitted from 25 March to 11 May 2020.Results. Of 116 patients (mean age 48 years, 61% female) admitted, 24 were HIV-positive (21%). The most common symptoms reported were cough (n=88; 73%), shortness of breath (n=78; 69%), fever (n=67; 59%), myalgia (n=29; 25%) and chest pain (n=22; 20%). The most common comorbidities were hypertension (n=46; 41%), diabetes mellitus (n=43; 38%), obesity (n=32; 28%) and HIV (n=24; 21%). Mortality was associated with older age (mean (standard deviation) 55 (12) years v. 46 (14) years; p<0.01); the presence of hypertension or hypertension along with diabetes and/or obesity; lower partial pressure of arterial oxygen to fraction of inspired oxygen ratio; and higher urea level, white cell count, neutrophil count, and C-reactive protein, lactate dehydrogenase and ferritin levels, and high neutrophil to lymphocyte ratio. The overall survival rate for all hospital admissions was 86/116 (73%). In this early cohort, survival was similar in patients with HIV (n=18; 75%) compared with those without HIV (n=67; 75%) (p=1). Of the 74 patients admitted to the wards, 63 (85%) survived, whereas 22 of 42 (52%) admitted to the intensive care unit survived.Conclusions. Patients with HIV infection represented a large proportion of all COVID-19 admissions. The presentation and outcome of patients with HIV did not differ significantly from those of patients without HIV
Development and internal validation of the HIV In-hospital mortality prediction (HIV-IMP) risk score
BACKGROUND : Despite advances in availability and access to antiretroviral therapy (ART), HIV still ranks as a major cause of global mortality. Hence, the aim of this study was to develop and internally validate a risk score capable of accurately predicting in-hospital mortality in HIV-positive patients requiring hospital admission.
METHODS : Consecutive HIV-positive patients presenting to the Charlotte Maxeke Johannesburg Academic Hospital adult emergency department between 7 July 2017 and 18 October 2018 were prospectively enrolled. Multivariate logistic regression was used to determine parameters for inclusion in the final risk score. Discrimination and calibration were assessed by means of the area under the receiver operating curve (AUROC) and the HosmerâLemeshow goodness-of-fit test, respectively. Internal validation was conducted using the regular bootstrap technique.
RESULTS : The overall in-hospital mortality rate was 13.6% (n = 166). Eight predictors were included in the final risk score: ART non-adherence or not yet on ART, Glasgow Coma Scale 20 breaths/min, oxygen saturation 120 ÎŒmol/L, lactate > 2 mmol/L and albumin < 35 g/L. After internal validation, the risk score maintained good discrimination [AUROC 0.83, 95% confidence interval (CI): 0.78â0.88] and calibration (HosmerâLemeshow Ï2 = 2.26, p = 0.895).
CONCLUSION : The HIV In-hospital Mortality Prediction (HIV-IMP) risk score has overall good discrimination and calibration and is relatively easy to use. Further studies should be aimed at externally validating the score in varying clinical settings.http://www.wileyonlinelibrary.com/journal/hivhj2022Critical Car
First report of an imported case of haemorrhagic fever with renal syndrome in South Africa
Haemorrhagic fever with renal syndrome (HFRS) is caused by hantavirus infection. Hantaviruses are not endemic to South Africa, and
we report the first detection of an imported case of HFRS in the country. The case involved a traveller from Croatia who presented to a
Johannesburg hospital with an acute febrile illness with renal dysfunction. The patient reported visiting rurally located horse stables in
Croatia before falling ill, and that a worker in the stables with similar illness was diagnosed with HFRS. Given the exposure history and
clinical findings of the case, a clinical diagnosis of HFRS was made and confirmed by laboratory testing.The NICD, a division of the National Health Laboratory Service.http://www.samj.org.zadm2022Medical Virolog
Human rabies associated with domestic cat exposures in South Africa, 1983â2018
Rabies is a fatal encephalitic disease caused by lyssaviruses belonging to the family Rhabdoviridae.
At the time of this report, a total of 16 species of lyssaviruses, which included the prototype rabies
virus (RABV), and 2 related but unclassified bat lyssaviruses, Taiwan and Kothalati, had been
recognised by the International Committee on Taxonomy of Viruses (ICTV 2019). Globally RABV,
also referred to as âclassic rabiesâ, circulates in natural transmission cycles involving domestic
dogs and various wildlife species. In the Americas, RABV is found in certain insectivorous and
haematophagous bat species (Banyard et al. 2013). The public health burden of rabies is, however,
very closely related to the occurrence of the disease in domestic dogs; thus, human cases of rabies
are mostly reported from areas where dog rabies is uncontrolled (Hampson et al. 2015). An annual
estimation of 59 000 human deaths occur worldwide with 95% of rabies cases occurring in Africa
and Asia (Hampson et al. 2015). In South Africa, RABV circulates both in domestic animals and
wildlife cycles, involving the canid and mongoose variants of the virus (Nel, Thomson & Von
Teichman 1993). The urban cycle involves domestic dogs reported from various locations in the
country, but particularly from the KwaZulu-Natal, Eastern Cape, Limpopo and Mpumalanga
provinces (Cohen et al. 2007; Zulu, Sabeta & Nel 2009). Sylvatic cycles of the canid variant RABV
in bat-eared foxes and black-backed jackal (Zulu et al. 2009) and the mongoose variant RABV in
certain species of mongoose occur in South Africa (Van Zyl, Markotter & Nel 2010). Apart from
the reservoir species, canid and mongoose RABV infections are reported in an array of domestic
and wildlife species in the country, with these animals primarily serving as dead-end hosts (Sabeta
et al. 2018). Laboratory-confirmed human rabies cases in South Africa are predominantly dogmediated,
and seven cases of rabies linked to other domestic species and wildlife have been
reported (Weyer et al. 2011).http://www.jsava.co.zaam2020Medical VirologyVeterinary Tropical Disease
A point-prevalence study of body mass indices in HIV-positive and HIV-negative patients admitted to hospital with COVID-19 in South Africa
Background. Obesity is now well recognised as a risk factor for severe COVIDâ19, but the true prevalence of obesity in hospitalised adults with COVIDâ19 remains unclear because formal body mass indices (BMIs) are not routinely measured on admission.
Objectives. To describe the true prevalence of obesity measured by the BMI, and associated comorbidities, in patients hospitalised with severe COVIDâ19, including people with HIV (PWH).
Methods. We conducted a pointâprevalence study of measured BMI in consecutive patients with severe COVIDâ19 admitted to the medical COVIDâ19 wards in a tertiary academic hospital in Cape Town, South Africa (SA). Patients were enrolled over a 2âweek period during the peak of the first COVIDâ19 wave in SA.
Results. We were able to measure the BMI in 122 of the 146 patients admitted during the study period. The prevalence of HIV was 20% (n=24/122). Most of the participants were overweight or obese (n=104; 85%), and 84 (68.9%) met criteria for obesity. The mean (standard deviation) BMI was 33 (7.5), and 34.5 (9.1) in PWH. Of PWH, 83% (n=20/24) were overweight or obese and 75% (n=18) met criteria for obesity. Multimorbidity was present in 22 (92%) of PWH.
Conclusion. We found that most patients, including PWH, met criteria for being overweight or obese. The high prevalence of obesity in PWH and severe COVIDâ19 reinforces the need for targeted management of nonâcommunicable diseases, including obesity, in PWH
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