Microbicide trials for preventing HIV/AIDS in South Africa: Phase II trial participants' experiences and psychological needs

The Microbicide Division of the Department of Medical Microbiology at MEDUNSA, South Africa, recently completed a phase II expanded safety trial of the candidate microbicide Carraguard. A microbicide is a vaginal product that women might use, if proven safe and effective, to protect themselves from HIV and possibly other sexually transmitted infections (STIs). The study participants were from Ga-Rankuwa and its neighbouring areas, an historically disadvantaged residential township near Pretoria. We conducted six focus group discussions with phase II trial participants to evaluate their experiences with trial participation and their psychological needs. Participants spontaneously talked about their experiences with the study gel and speculum examinations. They felt that they had received high quality medical care. They indicated that their personal hygiene and knowledge of the female reproductive system, HIV and other STIs had improved, which helped their families and empowered them as women. Participants valued being able to discuss their anxiety about HIV/AIDS with study staff. They felt that the study provided them with a supportive environment in which their personal problems (not necessarily restricted to HIV/AIDS) could be addressed. Some recommended that the study staff improve their professionalism and punctuality. They suggested the formation of participant support groups, and expressed a preference to remain involved in the trial. Some participants appeared to have become dependent on services provided during the trial. We have taken the results of these focus group discussions into account during planning for a phase III efficacy trial of Carraguard to be conducted in the same and other similar communities. SAHARA-J (2004) 1(2): 78-86 Keywords: HIV prevention, South Africa, microbicide, ethical challenges in microbicide trials. RÉSUMÉ La Division de Microbicide du Département de Microbiologie Médicale de l'Université Médicale d'Afrique Australe, MEDUNSA, Afrique du Sud, a récemment accompli la phase II de l' épreuve de sûreté renforcée du candidat microbicide Carraguard. Un microbicide est un produit vaginal que les femmes pourraient employer, s'il est prouvé sûr et efficace, pour se protéger elles-mêmes contre le VIH et probablement d'autres infections sexuellement transmises (STIs). Les participantes à l'étude étaient de Ga-Rankuwa et de ses environs, une banlieue noire résidentielle historiquement désavantagée près de Pretoria.Nous avons conduit des discussions en six groupes d'étude avec les participants à la phase II de l'épreuve pour évaluer leurs expériences concernant la participation à l'épreuve et leurs besoins psychologiques. Les participantes ont spontanément parlé de leurs expériences relatives aux études du gel et aux examens du speculum. Elles ont estimé qu'elles avaient reçu le soin médical de haute qualité. Elles ont indiqué que leur hygiène et connaissance personnelles du système reproducteur femelle, de VIH et de tout autre STIs s'étaient améliorées, qui ont aidé leurs familles et les ont émancipées comme femmes. Les participantes ont estimé qu'elles étaient en mesure de discuter leur inquiétude au sujet de VIH/SIDA avec le personnel de l'étude. Ils ont estimé que l'étude leur a fourni un environnement de soutien dans lequel leurs problèmes personnels (pas nécessairement limités au VIH/SIDA) pourraient être adressés. Certaines ont recommandé que le personnel d'étude améliore son professionnalisme et ponctualité. Elles ont suggéré la formation des groupes de soutien de participantes, et ont exprimé leur préférence de rester impliquées dans l'épreuve. Quelques participantes ont semblé être devenues dépendantes des services fournis pendant l'épreuve. Nous avons tenu compte des résultats de ces discussions de groupe d'étude pour la planification de la phase III de l'épreuve d'efficacité du Carraguard qui devra être conduite dans la même communauté et d'autres communautés semblables. SAHARA-J (2004) 1(2): 78-86 Mots clés: Prévention de VIH, Afrique du Sud, microbicide, défis éthiques dans des épreuves de microbicid

Adenosine Deaminase Activity Is a Sensitive Marker for the Diagnosis of Tuberculous Pleuritis in Patients with Very Low CD4 Counts

Background: Adenosine Deaminase Activity (ADA) is a commonly used marker for the diagnosis of tuberculous pleural effusion. There has been concern about its usefulness in immunocompromised patients, especially HIV positive patients with very low CD4 counts. The objective of this study was to evaluate the sensitivity of ADA in pleural fluid in patients with low CD4 counts. Materials and Methods: This was a retrospective case control study. Medical files of patients with tuberculous pleuritis and non-tuberculous pleuritis were reviewed. Clinical characteristics, CD4 cell counts in blood and biochemical markers in pleural fluid, including ADA were recorded. Results: One ninety seven tuberculous pleuritis and 40 non- tuberculous pleuritis patients were evaluated. Using the cut-off value of 30 U/L, the overall sensitivity, specificity, positive likelihood ratio, and negative likelihood ratio of ADA was 94%, 95%, 19, and 0.06 respectively. The mean CD4 cell counts among TB pleuritis patients was 29 and 153 cells/microL in patients with CD4 ,50 cells/microL and .50 cells/microL, (p,0.05) respectively. The corresponding mean ADA values for these patients were 76 U/L and 72 U/L respectively (p.0.5). There was no correlation between ADA values and CD4 cell counts (r =20.120, p = 0.369). Conclusion: ADA analysis is a sensitive marker of tuberculous pleuritis even in HIV patients with very low CD4 counts in a high TB endemic region. The ADA assay is inexpensive, rapid, and simple to perform and is of great value for the immediate diagnosis of tuberculous pleuritis while waiting for culture result and this has a positive impact on patient outcome

The SARAO MeerKAT 1.3 GHz Galactic Plane Survey

We present the SARAO MeerKAT Galactic Plane Survey (SMGPS), a 1.3 GHz continuum survey of almost half of the Galactic Plane (251\deg $\le l \le$ 358\deg and 2\deg $\le l \le$ 61\deg at $|b| \le 1.5\deg$). SMGPS is the largest, most sensitive and highest angular resolution 1 GHz survey of the Plane yet carried out, with an angular resolution of 8" and a broadband RMS sensitivity of $\sim$10--20 $\mu$ Jy/beam. Here we describe the first publicly available data release from SMGPS which comprises data cubes of frequency-resolved images over 908--1656 MHz, power law fits to the images, and broadband zeroth moment integrated intensity images. A thorough assessment of the data quality and guidance for future usage of the data products are given. Finally, we discuss the tremendous potential of SMGPS by showcasing highlights of the Galactic and extragalactic science that it permits. These highlights include the discovery of a new population of non-thermal radio filaments; identification of new candidate supernova remnants, pulsar wind nebulae and planetary nebulae; improved radio/mid-IR classification of rare Luminous Blue Variables and discovery of associated extended radio nebulae; new radio stars identified by Bayesian cross-matching techniques; the realisation that many of the largest radio-quiet WISE HII region candidates are not true HII regions; and a large sample of previously undiscovered background HI galaxies in the Zone of Avoidance

The MeerKAT Galaxy Cluster Legacy Survey: I. Survey overview and highlights

Please abstract in the article.The South African Radio Astronomy Observatory (SARAO), the National Research Foundation (NRF), the National Radio Astronomy Observatory, US National Science Foundation, the South African Research Chairs Initiative of the DSI/NRF, the SARAO HCD programme, the South African Research Chairs Initiative of the Department of Science and Innovation.http://www.aanda.orghj2022Physic

Paediatric cardiac services in South Africa

The original publication is available at http://www.samj.org.zaSouth Africa has failed to treat its children well, as demonstrated by our failure to achieve adequate progress towards the Millennium Development Goal of reducing the under-5 mortality rate, doing far worse than many poorer countries.Publishers' versio

Microbicide trials for preventing HIV/AIDS in South Africa: phase II trial partricipants' experiences and psychological needs

The Microbicide Division of the Department of Medical Microbiology at MEDUNSA, South Africa, recently completed a phase II expanded safety trial of the candidate microbicide Carraguard. A microbicide is a vaginal product that women might use, if proven safe and effective, to protect themselves from HIV and possibly other sexually transmitted infections (STIs). The study participants were from Ga-Rankuwa and its neighbouring areas, an historically disadvantaged residential township near Pretoria. We conducted six focus group discussions with phase II trial participants to evaluate their experiences with trial participation and their psychological needs. Participants spontaneously talked about their experiences with the study gel and speculum examinations. They felt that they had received high quality medical care. They indicated that their personal hygiene and knowledge of the female reproductive system, HIV and other STIs had improved, which helped their familie and empowered them as women. Participants valued being able to discuss their anxiety about HIV/AIDS wit study staff. They felt that the study provided them with a supportive environment in which their personal problems (not necessarily restricted to HIV/AIDS) could be addressed. Some recommended that the study staf improve their professionalism and punctuality. They suggested the formation of participant support groups, an expressed a preference to remain involved in the trial. Some participants appeared to have become dependent o services provided during the trial. We have taken the results of these focus group discussions into account during planning for a phase III efficacy trial of Carraguard to be conducted in the same and other similar communitie