Diabetes mellitus: preliminary health-promotion activity based on service-learning principles at a South African national science festival

Objectives: To investigate the effects of a service-learning-based health promotion elective in influencing knowledge of diabetes mellitus (DM) and ways to prevent it. Method: A computer-based quiz, an information poster, interactive models and a take-home information leaflet on DM were developed as part of an exhibit during the 2009 National Festival of Science and Technology held in Grahamstown, South Africa. Predominantly school students visited the exhibit and took part in the quiz and other educational activities. Results: The majority of the 119 junior and 332 senior quiz participants were male students attending government schools in the Eastern Cape, South Africa. After an educational intervention, there was significant improvement in the junior quiz participants’ overall percentage knowledge scores (p-value = 0.024), while the senior quiz participants showed a markedly significant improvement in the overall percentage knowledge scores (p-value < 0.001). The results showed significant gender differences for both the pre- and post-intervention mean percentage scores among both groups, with better scores for female participants. Conclusion: The health-promotion elective was successful in raising awareness of DM. This approach may offer an additional tool that can be used in the continuous, concerted health promotion activities and advocacy by all healthcare professionals to address the prevention of DM.Keywords: diabetes, health promotion, pharmacists, chronic noncommunicable diseases, service learning, school learner

Securing Africa’s health sovereignty : why investing in science and innovation matters

This paper aims at provoking broad-based dialogues and debates on ways and means of securing Africa’s health sovereignty. It argues that health sovereignty is about the realization of specific national constitutional and policy objectives on citizens’ access to and enjoyment of good health, resilient to COVID-19 and related disease pandemics. The paper also emphasizes the urgency of African countries fulfilling their commitments under global and regional declarations on health research. Investing in research, knowledge and innovation is critical to fight and win the war against COVID-19 and other diseases that undermine economic productivity and competitiveness of African countries. There is also a need for venture capitalists to demonstrate bankable ideas emanating from the science academies and funded by National Science Foundations. The base teachings at school level need to significantly invest in the “African philosophy” to create a shift in mind-set from the “grab and own without use mentality that is currently predominant on the continent. The paper recommends that executive, political and science leadership are needed to strengthen national health research and innovation systems through improved evidence-based policy implementation. With these thrusts working effectively together, rather than in silos, will afford the African continent to emerge victoriously in the combat against COVID-19 and other disease burdens

Mid-upper arm circumference (MUAC) performance versus weight for height in South African children (0–59 months) with acute malnutrition

Objectives: The objective of this study was to compare mid upper arm circumference (MUAC) and weight for height (W/H) as indices of acute malnutrition in children aged 0–59 months in South Africa. Design: A cross-sectional weighted survey of households was performed. Subjects and setting: Children aged 0–59 months and their mothers/caregivers were included in the study in iLembe district conducted between April and September 2014. Outcome measures: W/H and MUAC were measured and z-scores were calculated using the 2006 World Health Organisation (WHO) child growth standards. Results: Of the 572 child participants, 44 were malnourished (7.7%) using W/H measurements in comparison to 38 children (6.6%) using MUAC. There was ~54.0% agreement between the two indices when categorised in standard deviation (SD) bands and the significant Kappa statistic value of 0.27 constituted fair agreement. Similar percentages of male (1.1%) and female (1.1%) children under five years of age were detected with severe acute malnutrition (SAM) using W/H. In children aged 0–6 months W/H identified ten children as malnourished compared to only one child identified as malnourished using MUAC. Conclusions: The study found W/H to be a more sensitive measure. At a facility level W/H is considered the anthropometric measure of choice in children aged 0–59 months as nurses are trained in obtaining this measure. At the household level MUAC is preferred as a quick and easy measuring tool. In South Africa, the Road to Health Card, given at the clinics, records the W/H of children up to five years of age to assist in the prevention of childhood malnutrition. Future studies are recommended using both indicators in community settings in children particularly during 0–6 months as it is during this critical age period that moderate acute malnutrition (MAM) and SAM can be detected for timeous treatment and management of malnutrition

Securing Africa’s health sovereignty: why investing in science and innovation matters

This paper aims at provoking broad-based dialogues and debates on ways and means of securing Africa’s health sovereignty. It argues that health sovereignty is about the realization of specific national constitutional and policy objectives on citizens’ access to and enjoyment of good health, resilient to COVID-19 and related disease pandemics. The paper also emphasizes the urgency of African countries fulfilling their commitments under global and regional declarations on health research. Investing in research, knowledge and innovation is critical to fight and win the war against COVID-19 and other diseases that undermine economic productivity and competitiveness of African countries. There is also a need for venture capitalists to demonstrate bankable ideas emanating from the science academies and funded by National Science Foundations. The base teachings at school level need to significantly invest in the “African philosophy” to create a shift in mind-set from the “grab and own without use mentality that is currently predominant on the continent. The paper recommends that executive, political and science leadership are needed to strengthen national health research and innovation systems through improved evidence-based policy implementation. With these thrusts working effectively together, rather than in silos, will afford the African continent to emerge victoriously in the combat against COVID-19 and other disease burdens

Anaphylactic and nonanaphylactic reactions to SARS-CoV-2 vaccines: a systematic review and meta-analysis

Background: Currently there is no systematic review and meta-analysis of the global incidence rates of anaphylactic and nonanaphylactic reactions to SARS-CoV-2 vaccines in the general adult population. Objectives: To estimate the incidence rates of anaphylactic and nonanaphylactic reactions after COVID-19 vaccines and describe the demographic and clinical characteristics, triggers, presenting signs and symptoms, treatment and clinical course of confirmed cases. Design: A systematic review and meta-analysis. Preferred Reporting Items for Systematic Reviews and Meta-Analyses [PRISMA] statement was followed. Methods: Electronic databases (Proquest, Medline, Embase, Pubmed, CINAHL, Wiley online library, and Nature) were searched from 1 December 2020 to 31 May 2021 in the English language using the following keywords alone or in combination: anaphylaxis, non-anaphylaxis, anaphylactic reaction, nonanaphylactic reaction, anaphylactic/anaphylactoid shock, hypersensitivity, allergy reaction, allergic reaction, immunology reaction, immunologic reaction, angioedema, loss of consciousness, generalized erythema, urticaria, urticarial rash, cyanosis, grunting, stridor, tachypnoea, wheezing, tachycardia, abdominal pain, diarrhea, nausea, vomiting and tryptase. We included studies in adults of all ages in all healthcare settings. Effect sizes of prevalence were pooled with 95% confidence intervals (CIs). To minimize heterogeneity, we performed sub-group analyses. Results: Of the 1,734 papers that were identified, 26 articles were included in the systematic review (8 case report, 5 cohort, 4 case series, 2 randomized controlled trial and 1 randomized cross-sectional studies) and 14 articles (1 cohort, 2 case series, 1 randomized controlled trial and 1 randomized cross-sectional studies) were included in meta-analysis. Studies involving 26,337,421 vaccine recipients [Pfizer-BioNTech (n = 14,505,399) and Moderna (n = 11,831,488)] were analyzed. The overall pooled prevalence estimate of anaphylaxis to both vaccines was 5.0 (95% CI 2.9 to 7.2, I2 = 81%, p = \u3c 0.0001), while the overall pooled prevalence estimate of nonanaphylactic reactions to both vaccines was 53.9 (95% CI 0.0 to 116.1, I2 = 99%, p = \u3c 0.0001). Vaccination with Pfizer-BioNTech resulted in higher anaphylactic reactions compared to Moderna (8.0, 95% CI 0.0 to 11.3, I2 = 85% versus 2.8, 95% CI 0.0 to 5.7, I2 = 59%). However, lower incidence of nonanaphylactic reactions was associated with Pfizer-BioNTech compared to Moderna (43.9, 95% CI 0.0 to 131.9, I2 = 99% versus 63.8, 95% CI 0.0 to 151.8, I2 = 98%). The funnel plots for possible publication bias for the pooled effect sizes to determine the incidence of anaphylaxis and nonanaphylactic reactions associated with mRNA COVID-19 immunization based on mRNA vaccine type appeared asymmetrical on visual inspection, and Egger’s tests confirmed asymmetry by producing p values \u3c 0.05. Across the included studies, the most commonly identified risk factors for anaphylactic and nonanaphylactic reactions to SARS-CoV-2 vaccines were female sex and personal history of atopy. The key triggers to anaphylactic and nonanaphylactic reactions identified in these studies included foods, medications, stinging insects or jellyfish, contrast media, cosmetics and detergents, household products, and latex. Previous history of anaphylaxis; and comorbidities such as asthma, allergic rhinitis, atopic and contact eczema/dermatitis and psoriasis and cholinergic urticaria were also found to be important. Conclusion: The prevalence of COVID-19 mRNA vaccine-associated anaphylaxis is very low; and nonanaphylactic reactions occur at higher rate, however, cutaneous reactions are largely self-limited. Both anaphylactic and nonanaphylactic reactions should not discourage vaccination