Field evaluation of a malaria rapid diagnostic test (ICT Pf)

Background. Malaria rapid diagnostic tests (MRDTs) are quickand easy to perform and useful for diagnosing malaria in primary health care settings. In South Africa most malaria infections are due to Plasmodium falciparum, and HRPII-based MRDTs have been used since 2001. Previous studies in Africa showed variability in sensitivity and specificity of HRPIIbased MRDTs; hence, we conducted a field evaluation in Limpopo province to determine the accuracy of the MRDTcurrently used in public sector clinics and hospitals.Methods. A cross-sectional observational study was conductedto determine the sensitivity and specificity of an ICT Pf MRDT. We tested 405 patients with fever with ICT Pf MRDT and compared the results with blood film microscopy (the gold standard).Results. The overall sensitivity of the ICT Pf MRDT was 99.48% (95% confidence interval (CI) 96.17 - 100%), while specificity was 96.26% (95% CI 94.7 - 100%). The positive predictive value of the test was 98.48 (99% CI 98.41 - 100%), and the negative predictive value was 99.52% (95% CI 96.47 – 100%).Conclusions. The ICT Pf MRDT is an appropriate test to use in the field in South Africa where laboratory facilities are not available. It has a high degree of sensitivity and acceptable level of specificity in accordance with the World Health Organization criteria. However, sensitivity of MRDT at low levels of parasitaemia

Lichens in area of meteorological and radar station Kojšovská hol’a (Volovec Mountains, se Slovakia)

The Volovec Mts (Volovské vrchy) have insufficiently been investigated area for lichens. Kojšovská hol’a is one of the highest parts in the Volovec Mts. No records of lichens were published from here. Some historical collections need revision. The list of 35 lichen species collected by the authors is presented from the investigated areas. Three interesting and vulnerable lichens are characterised in more details: Cladonia ciliata var. tenuis, Cladonia cornuta and Umbilicaria vellea. The area of Kojšovská hoľa gives further opportunities for new findings

COMPARISON BETWEEN TETRACYCLINE RESISTANT ENTEROCOCCI ISOLATED FROM SHEEP AND TYPICAL CHEESE IN THE GEOGRAPHICAL AREA OF “PARCO NAZIONALE DEI MONTI SIBILLINI”

Enterococci were isolated from sheep faeces and cheese taken in the «Parco nazionale dei monti Sibillini»; then they were submitted to the antibiotic susceptibility test and to the PCR reaction to amplify tet M and tet O genes. The analysis showed that 23,64% of Enterococci from sheep and 30,77% from cheese were resistant to tetracycline; 14 strains from sheep and 5 from cheese contained tet M and tet O genes as genetic determinants of resistance. These results allow to say that resistant bacteria and genes have the possibility to be transferred from animals to derived food; therefore reducing antibiotic use in farm animals could affect the amount of resistant microorganisms that can reach human beings using this way of diffusion

Quality and turnaround times of viral load monitoring under prevention of mother-to-child transmission of HIV Option B+ in six South African districts with a high antenatal HIV burden

Background. Barriers to monitoring maternal HIV viral load (VL) and achieving 90% viral suppression during pregnancy and breastfeeding still need to be understood in South Africa (SA).Objectives. To measure quality of VL care and turnaround times (TATs) for returning VL results to women enrolled in the prevention of mother-to-child transmission of HIV (PMTCT) programme in primary healthcare facilities.Methods. Data were obtained from a 2018 cross-sectional evaluation of the PMTCT Option B+ programme in six SA districts with high antenatal and infant HIV prevalence. Quality of VL care was measured as the proportion of clients reporting that results were explained to them. TATs for VL results were calculated using dates abstracted from four to five randomly selected facility-based client records to report overall facility ‘short TAT’ (≥80% of records with TAT ≤7 days). Logistical regression and logit-based risk difference statistics were used.Results. Achieving overall short TAT was uncommon. Only 50% of facilities in one rural district, zero in one urban metro district and 9 - 38% in other districts had short TAT. The significant difference between districts was influenced by the duration of keeping results in facilities after receipt from the laboratory. Expected quality of VL care received ranged between 66% and 85%. Client-related factors significantly associated with low quality of care, observed in two urban districts and one rural district, included lower education, recent initiation of antiretroviral treatment and experiencing barriers to clinic visits. Experiencing clinic visit barriers was also negatively associated with short TATs.Conclusions. We demonstrate above-average quality of care and delayed return of results to PMTCT clients. Context-specific interventions are needed to shorten TATs

CONSIDERATIONS ON MEAT INSPECTION PROCEDURES IN THE LIGHT OF CONDEMNATIONS AT AN ITALIAN EU SLAUGHTERHOUSE IN THE PERIOD 2004-2009

Post-mortem findings of 373.901 cattle slaughtered at an EC abattoir are reported. Results show high incidence of pneumonia and hepatic lesions. Total condemnation of the whole carcass has happened 91 times in Bovine species, 1073 times in swine species, 40 in sheep. In the light of the EC Regulation N.854/2004 of the European parliament and of the council of 29th April 2004 that lays down specific rules for the organization of official controls of products of animal origin destined for human consumption, authors outline the examples of simplification and partial redrafting of the existing laws on the basis of the opinions expresses by the EFSA. Comparison to other European countries and an estimate of economic damage are discussed

Child health, infant formula funding and South African health professionals: Eliminating conflict of interest

Despite clear evidence of the benefits of exclusive and continued breastfeeding for children, women and society, far too few children in South Africa (SA) are breastfed. One of the major impediments to improving this situation is the continued and aggressive marketing of breastmilk substitutes (BMSs) and infiltration of the BMS industry into contexts with exposure to health professionals. In this article we, as academics, practitioners and child health advocates, describe contraventions of the regulations that protect breastfeeding in SA and argue that bold, proactive leadership to eliminate conflict of interest in respect of the BMS industry is urgently required, together with far greater investments in proven interventions to promote and support breastfeeding

The mucous cyst, a rare and delayed complication after rhinoplasty

Rhinoplasty is frequently performed worldwide, and patients and surgeons both expect good cosmetic results without any deformity recurrence. We report a rare case of mucous cyst occurred after post-traumatic rhinoseptoplasty. Observation A 27-year old woman presented a median mass of the nose root 7 years after prior rhinoseptoplasty. Investigations showed a subcutaneous lesion of 10.5 × 24.5 mm. The surgery consisted on an external rhinoplasty allowing cyst removal, bilateral osteotomies and reconstruction of the nasal dorsum by deep temporal fascia graft. Histological examination confirmed the diagnosis of begnin mucous cyst. No recurrence was observed at 1-year follow-up. Discussion Mucous cyst post rhinoplasty is rare and is probably due to accidental mucosal material implantation into the subcutaneous plane during rhinoplasty. This complication can be avoided by adequate infiltration and hydrodissection, careful dissection, and avoidance of unnecessary trauma during osteotomies