A preliminary study of the effects of aircraft noise on families who reside in close proximity to an airport

Background: The use of air transportation has grown in the last century, escalating the noise exposure of families residing in close proximity to airports. The audiological effects need to be assessed to determine the impact of this increase on children and young adults living near to airports in South Africa. Method: Hearing patterns for these individuals were compared to those residing 30 km away from the airport. Sixty people, between the ages of 12-30 years, were assessed. Participants completed a questionnaire and were subjected to a diagnostic audiological test battery and tested using diagnostic distortion product otoacoustic emissions (DPOAEs). Results: Participants residing in close proximity to the airport presented with a notch configuration in the high frequencies, as opposed to those who lived further away. DPOAEs indicated a change in hearing in the high frequencies between the test populations. The positive relationship between the pure tone results and the DPOAEs strengthens the claim that aircraft noise has an effect on the hearing patterns of individuals living near to airports. Participants also experienced annoyance resulting from such noise. Conclusion: The results highlight the need for investigation into the hearing of individuals who reside in close proximity to airports. Comprehensive studies will be informative and beneficial to the field of audiology in South Africa. The highlighted health and safety issues require in-depth study to formulate a stronger argument for monitoring the hearing of families who are exposed to aircraft noise.Keywords: aircraft noise exposure, hearing patterns, distortion product otoacoustic emissions (DPOAEs

Adolescent antiretroviral management: Understanding the complexity of non-adherence

This case-based discussion highlights challenges in adolescent antiretroviral management, focusing on non-disclosure of status and the subsequent impact of suboptimal treatment adherence. Despite the scale-up of antiretroviral therapy (ART) and recommendations made by the World Health Organization (WHO) for ART for all human immunodeficiency virus (HIV)-infected paediatric patients, ART coverage in adolescents lags behind that in adults. Challenges of sustaining lifelong ART in children and adolescents require consideration of specific behavioural, physiological and psychosocial complexities associated with this special group. To preserve future drug options and sustain lifelong access to therapy, addressing non-adherence to treatment is critical to minimising acquisition of ART drug resistance and treatment failure. We review the psychosocial and developmental components that influence the course of the disease in adolescents and consider the complexities arising from perinatal exposure to ART and the growing risk of transmitted ART drug resistance in high-burden resourcelimited settings

Celebration, preservation and promotion of struggle narratives with a focus on South African women of Indian heritage

The relevance and value of oral history practices and principles and its impact on community history gives credence to its relationship with the liberation struggle. The liberation struggle heroines that formed the cohort of interviewees for this research were members of the South African Indian community. This interview- research process provides a platform that allows the veteran South African female of Indian Heritage to reflect almost 50 years later and be a part of the celebration, preservation and promotion of struggle narratives. The women who were interviewed for this research shed light on celebrating political achievements, whilst remembering and recalling the educational, material and economic assistance from international sources. Furthermore, these women referred to the preservation of South Africa’s unique heritage as, South Africa is united in its diversity. Promoting the values of the liberation struggle by sharing her anecdotes, honouring the cadres, relating experiences, retelling tales and sometimes possibly reliving military camp days completed the oral history interview process and eventually added to the body of knowledge that already exists and partially filled the gaps that exist. Contribution: From a multidisplinary religious perspective, this article contributes to the historical and social-cultural discourse on liberation theology within a paradigm in which the intersection of social sciences and humanities generates a transdisciplinary contested discourse

HIV-Associated Tuberculosis in the Newborn and Young Infant

Each year, approximately 250 000 women die during pregnancy, delivery, or postpartum. Maternal mortality rates due to tuberculosis (TB) and HIV in Sub-Saharan Africa now supersede obstetric-related causes of mortality. The majority of cases occur in population-dense regions of Africa and Asia where TB is endemic. The vertical transmission rate of tuberculosis is 15%, the overall vertical transmission rate of HIV in resource-limited settings with mono- or dual-ARV therapy varies from 1.9% to 10.7%. If the millennium development goals are to be achieved, both HIV and TB must be prevented. The essential aspect of TB prevention and detection in the newborn is the maternal history and a positive HIV status in the mother. Perinatal outcomes are guarded even with treatment of both diseases. Exclusive breast feeding is recommended. The community and social impact are crippling. The social issues aggravate the prognosis of these two diseases

Women for science and science for women: Gaps, challenges and opportunities towards optimizing pre-exposure prophylaxis for HIV-1 prevention

Preventing new HIV infections remains a global challenge. Young women continue to bear a disproportionate burden of infection. Oral pre-exposure prophylaxis (PrEP), offers a novel women-initiated prevention technology and PrEP trials completed to date underscore the importance of their inclusion early in trials evaluating new HIV PrEP technologies. Data from completed topical and systemic PrEP trials highlight the role of gender specific physiological and social factors that impact PrEP uptake, adherence and efficacy. Here we review the past and current developments of HIV-1 prevention options for women with special focus on PrEP considering the diverse factors that can impact PrEP efficacy. Furthermore, we highlight the importance of inclusion of female scientists, clinicians, and community advocates in scientific efforts to further improve HIV prevention strategies

Early initiation of antiretroviral therapy following in utero HIV infection is associated with low viral reservoirs but other factors determine subsequent plasma viral rebound

BACKGROUND: Early HIV diagnosis allows combination antiretroviral therapy (cART) initiation in the first days of life following in utero (IU) infection. The impact of early cART initiation on infant viral reservoir size in the setting of high-frequency cART non-adherence is unknown. METHODS: Peripheral blood total HIV DNA from 164 early treated (day 0-21 of life) IU HIV-infected South African infants was measured using droplet digital PCR at birth and following suppressive cART. We evaluated the impact of cART initiation timing on HIV reservoir size and decay, and on the risk of subsequent plasma viraemia in cART-suppressed infants. FINDINGS: Baseline HIV DNA (median 2.8 log10 copies/million PBMC, range 0.7 - 4.8) did not correlate with age at cART initiation (0-21 days) but instead with maternal antenatal cART use. In 98 infants with plasma viral suppression on cART, HIV DNA half-life was 28 days. However, the probability of maintenance of plasma aviraemia was low (0.46 at 12 months) and not influenced by HIV DNA load. Unexpectedly, longer time to viral suppression was associated with protection against subsequent viral rebound. CONCLUSIONS: With effective prophylaxis against mother-to-child transmission, cART initiation timing in the first 3 weeks of life is not critical to reservoir size

Distinct genital tract HIV-specific antibody profiles associated with tenofovir gel

The impact of topical antiretrovirals for pre-exposure prophylaxis on humoral responses following HIV infection is unknown. Using a binding antibody multiplex assay, we investigated HIV-specific IgG and IgA responses to envelope glycoproteins, p24 Gag and p66, in the genital tract (GT) and plasma following HIV acquisition in women assigned to tenofovir gel (n=24) and placebo gel (n=24) in the CAPRISA 004 microbicide trial to assess if this topical antiretroviral had an impact on mucosal and systemic antibody responses. Linear mixed effect modeling and partial least squares discriminant analysis was used to identify multivariate antibody signatures associated with tenofovir use. There were significantly higher response rates to gp120 Env (P=0.03), p24 (P=0.002), and p66 (P=0.009) in plasma and GT in women assigned to tenofovir than placebo gel at multiple time points post infection. Notably, p66 IgA titers in the GT and plasma were significantly higher in the tenofovir compared with the placebo arm (P<0.05). Plasma titers for 9 of the 10 HIV-IgG specificities predicted GT levels. Taken together, these data suggest that humoral immune responses are increased in blood and GT of individuals who acquire HIV infection in the presence of tenofovir gel.United States. National Institutes of Health (AI51794)United States. National Institutes of Health (AI104387)United States. National Institutes of Health (AI115981)United States. National Institutes of Health (AI116086)United States. Agency for International Development (GP00-08-00005-00 subproject agreement PPA-09-046