Nasopharyngeal temperature probes: is South Africa’s current decontamination process adequate?

Background: The standard practice in many institutions incorporates nasopharyngeal probes for temperature monitoring in patients undergoing general anaesthesia. Current disinfection guidelines for these devices are not clear and they are poorly adhered to. In South Africa, these temperature probes are reused and subjected to unstandardized decontamination processes. This study sought to investigate nasopharyngeal temperature probes as possible source for cross-contamination, and assess the efficacy of current disinfection practices for these probes. Methodology: This was an analytical double-blind randomized study of 4 different disinfection protocols for 48 nasopharyngeal temperature probes. The probes were randomized to disinfection protocols that included water wash, dry wipe, hibitane® and cidex® wash. After decontamination by the respective protocol, the probes were aseptically placed in nutrient broths, manually agitated and removed, and the broths were then inoculated onto blood agar plates. After 48 hours of aerobic culture incubation at 37oC, plates were examined for growth and bacteria identified using automated bioMérieux Vitek-2 microbial identification system. Chi square and logistic regression analyses were used to assess bacterial contamination rates of the disinfected probes, in order to infer the efficacy of the decontamination processes. Results: Of the 48 nasopharyngeal temperature probes disinfected by the different protocols, 22 (45.8%) had bacterial contamination, with frequency of isolation for coagulase negative staphylococci (44%), Bacillus cereus (20%), Staphylococcus aureus (10%), Enterobacter cloaca (7%), Pseudomonas aeruginosa (4%), Pseudomonas fluorescens (3%), Acinetobacter baumannii (3%), amongst other bacterial species. Dry wipe, and water and soap methods, had statistically significant higher contamination rates of 83.3% and 66.7% than hibitane® and cidex®, with 25.0% and 8.3% respectively (X2=17.69, p<0.0001). The odds of contamination when water-wipe was used as a cleaning method was 6 times (OR=6.000; 95% CI=1.018-35.374, p=0.048) that of hibitane® method while the odds for dry-wipe was 15 times (OR=15.000, 95% CI=2.024-111.174, p=0.008). No statistically significant difference was observed in the contamination rates between cidex® and hibitane® disinfection methods(OR=0.273, 95% CI=0.024-3.093, p=0.294). Conclusion: These data shows that nasopharyngeal temperature probes are possible source of crosscontamination and pathogen transmission due to inadequacy of the decontamination processes for these temperature probes

Histamine and Tyramine Content of South African Wine

The histamine content of 184 wines and tyramine content of 156 wines, produced in South Africa was measured. The histamine and tyramine content of the wine was found to be similar to those of wines produced in other countries. The average histamine content of South African red wines that had undergone malo-lactic fermentation was more than double that of red wines that had not undergone malo-lactic fermentation. All the red wines containing relatively large amounts of histamine had pH's above 3, 7. Six selected strains of malo-lactic bacteria were tested for their ability to form histamine and tyramine in white and red wine. No histamine or tyramine was formed

Online counselling services for Youth@risk

Youth today suffer from many socio-economic problems and struggle to operate in the current economic environment. Wellbeing service provision to youth@risk is inadequate to deal with the complexities of societal challenges which are amplified by the fast technology advances in a continuously changing environment. This paper aims to consider the provision of online counselling to enhance current face-to-face services from the provider’s perspective. The case of a volunteer-based online counselling service that has been in operation since 2010 is considered to establish the aspects that influence this type pf service. Related literature was reviewed to determine the issues reported from current studies and a taxonomy of digital services was used to analyse the service objectives of the service provider. Data collected from sessions with the facilitators and observations of a chat session was analysed to establish their experience of online counselling. The findings were interpreted to answer the research question. The contribution of this paper is in response to the many appeals for more empirical research on real cases. It can be concluded that an online counselling service is a viable extension of face-to-face counselling but more research is needed to understand its benefit to the clients and the ability to ensure a sustained service, especially in developing contexts

Improvement in the modelling of geomagnetically induced currents in Southern Africa

One of the consequences of the geomagnetic storms resulting from adverse space weather is the induction of geomagnetically induced currents (GICs) in power lines. The GICs that flow in a power transmission network are driven by the induced electric field at the Earth's surface. The electric field, in turn, is affected by the changing magnetic field during a magnetic storm. These GICs can cause extensive and expensive damage to transformers in the power transmission system. Understanding the behaviour of the magnetic field during a magnetic storm is a crucial step in modelling and predicting the electric field and ultimately the GICs in a power transmission network. We present a brief overview of the present status of GIC modelling in southern Africa and then discuss whether it is sufficient to use geomagnetic data from a single magnetic observatory alone to model GICs over the subcontinent. A geomagnetic interpolation method is proposed to improve the modelling of GICs in southern Africa. This improved model is one step closer to our being able to predict GICs accurately in the subcontinent, which will enable power distribution companies to take the necessary precautions to minimize possible transformer damage

The use of ultraviolet radiation as a non-thermal treatment for the inactivation of alicyclobacillus acidoterrestris spores in water, wash water from a fruit processing plant and grape juice concentrate

Alicyclobacillus acidoterrestris is a non-pathogenic, spore-forming bacterium that can survive the commercial pasteurisation processes commonly used during fruit juice production. Surviving bacterial endospores germinate, grow and cause spoilage of high acid food products. Fruit juices can be treated using ultraviolet light (UV-C) with a wavelength of 254 nm, which has a germicidal effect against micro-organisms. In this study, A. acidoterrestris was inoculated into water, used wash water from a fruit processing plant and grape juice concentrate. Ultraviolet dosage levels (J L−1) of 0, 61, 122, 183, 244, 305 and 367 J L−1 were applied using a novel UV-C turbulent flow system. The UV treatment method was shown to reliably achieve in excess of a 4 log10 reduction (99.99%) per 0.5 kJ L-1 of UV-C dosage in all the liquids inoculated with A. acidoterrestris. The applied novel UV technology could serve as an alternative to thermal treatments of fruit juices for the inactivation of Alicyclobacillus spores as well as in the treatment of contaminated wash water used in fruit processing.Department of HE and Training approved lis

Electronic health record system in the public health care sector of South Africa: A systematic literature review

Background: South Africa is planning to implement the National Health Insurance (NHI) scheme in the near future. The NHI is intended to improve the accessibility of quality health care services for all South African citizens. For the NHI to achieve this objective, an electronic health record (EHR) system to register and track patients who visit different health care providers will have to be developed. Aim: To identify critical success factors for the implementation of EHRs in South Africa’s public health care sector. Setting: This study reviewed studies on EHR implementation in African countries published between 2006 and 2017. Methods: The study made use of a systematic literature review to identify barriers to the implementation of EHRs in the public health care sector. Results: Fifteen articles were included in the study. The study identified technical, social and environmental barriers to the implementation of EHRs. The barriers could further be broken down into lack of supporting infrastructure; user training and commitment; political influence or strategy; legislation and regulations; and the lack of a framework for implementation and management of EHRs. The study suggests six main recommendations for the successful implementation of EHRs in South Africa’s public health care sector. Conclusion: The study recommended investing in alternative infrastructure facilities, incentivising the health informatics field to attract and retain information and communication technology professionals and to encourage the participation of all stakeholders in the development process to develop context-relevant e-health implementation strategies, legislation and frameworks. Government should also allocate separate budgets for e-health projects