Maternal serum fructosamine values after delivery of macrosomic babies and unexplained stillbirths

Measurement of serum fructosamine and haemoglobin A, levels and glucose tolerance tests were performed in 75 women in the immediate postpartum period. None had predisposing factors to gestational diabetes. They were divided into three groups: group I consisted of 15 women who delivered an unexplained stillbirth; group 11 of 30 women who gave birth to babies weighing between 2500 g and 3900 g at term; and group III of 30 women who delivered babies weighing≥ 4000 g. There was a significant difference in the mean level of serum fructosamine between the unexplained stillbirth and control groups (P < 0,001). Although the HbA, values varied in the three groups, there was a significant difference between the unexplained stillbirth group and the macrosomic infant group (P < 0,05). All patients had normal glucose tolerance tests

Nuchal translucency as a method of first-trimester screening for aneuploidy

Objective. To determine the effectiveness of nuchal translucency (NT) screening in predicting aneuploidy and structural abnormalities in a South African population. Study design. Descriptive study. Setting. Chris Hani Baragwanath Hospital fetal medicine unit. Outcome measures. An adjusted risk was derived from the combination of maternal age-related risk and the risk derived from NT screening. A positive screen was denoted by an adjusted risk of more than 1/300 and a negative screen by an adjusted risk of less than 1/300. In order to determine the number of undiagnosed abnormalities in the group, all babies were examined by a paediatrician at birth to detect and describe dysmorphic features. Results. A total of 428 patients underwent first-trimester screening between July 2003 and July 2005. Three per cent were lost to follow-up. Of the 415 patients analysed, 59 screened positive and 356 screened negative. The mean age for both groups of patients was 30.1 years. Of the 57 patients who screened positive, 24 elected to have chorionic villus sampling (CVS). This resulted in the detection of 6 chromosomal abnormalities and 2 structural abnormalities. Among the remaining 356 patients, who had screened negative, 2 had an increase in the adjusted risk when the risk was compared with the background risk, and 1 chromosomal abnormality was detected in this group; 8 elected to have CVS because of a previous history of a chromosomal abnormality, and there were no abnormalities among them. Conclusions. The use of these screening methods has enabled prenatal karyotyping to become cost effective, and allows concentration on pregnancies at highest risk for chromosomal abnormalities, regardless of age.South African Medical Journal Vol. 98 (4) 2008: pp. 295-29

South Africa's salt reduction strategy: Are we on track, and what lies ahead?

On 2 September 2016, 25 local and international participants from various sectors met in Cape Town to take stock of South Africa (SA)’s progress in salt reduction and develop a roadmap for action. SA is centre stage on salt reduction globally, being the first country to mandate salt reduction across a wide range of processed foods. Excessive salt intake contributed by processed foods and discretionary sources motivated SA to implement a public awareness campaign in parallel with legislation to reduce salt intake to the World Health Organization target of 5 g per day. Five priority areas were identified for continued action on salt reduction, including obtaining research funds for continued monitoring and compliance of salt reduction targets. Determining the contribution of foods eaten out of home to total salt intake and implementing strategies to address this sector were also highlighted as key actions. Lastly, implementing the next stage of the Salt Watch awareness campaign to change

Impact of computer experience on the viability and repeatability of the Moorfields Motion Displacement Test (MMDT) in a developing and underserved African setting.

Background: The current study was designed to explore the effect of computer experience on the viability and testretest repeatability of the Moorfields Motion Displacement Test (MMDT), a novel computer-driven glaucoma screening device, in an African community setting. Methods: 164 healthy subjects were recruited from a semi-rural Mozambican environment, and stratified according to computer experience (computer naïve: n=85, computer familiar: n=79). A suprathreshold screening test algorithm was employed, and the global probability of true damage (GPTD), testing time (TT) and false positive (FP) response rate were recorded. The visual field test was conducted twice on the same eye, and results compared to determine intra-sessional repeatability. Results: No inter-group differences in GPTD or TT (p\u3e0.05) were observed between computer subgroups, although FP response rate was significantly higher among computer naïve subjects (p=0.00 for both tests). No inter-sessional differences were observed for GPTD, TT and FP (p\u3e0.05 for all) for either subgroup. A statistically significant positive correlation was found between repeat GPTD, TT and FP measures for all subgroups (

Projections of rapidly rising surface temperatures over Africa under low mitigation.

An analysis of observed trends in African annual-average near-surface temperatures over the last five decades reveals drastic increases, particularly over parts of the subtropics and central tropical Africa. Over these regions, temperatures have been rising at more than twice the global rate of temperature increase. An ensemble of high-resolution downscalings, obtained using a single regional climate model forced with the sea-surface temperatures and sea-ice fields of an ensemble of global circulation model (GCM) simulations, is shown to realistically represent the relatively strong temperature increases observed in subtropical southern and northern Africa. The amplitudes of warming are generally underestimated, however. Further warming is projected to occur during the 21st century, with plausible increases of 4-6 °C over the subtropics and 3-5 °C over the tropics by the end of the century relative to present-day climate under the A2 (a low mitigation) scenario of the Special Report on Emission Scenarios. High impact climate events such as heat-wave days and high fire-danger days are consistently projected to increase drastically in their frequency of occurrence. General decreases in soil-moisture availability are projected, even for regions where increases in rainfall are plausible, due to enhanced levels of evaporation. The regional dowscalings presented here, and recent GCM projections obtained for Africa, indicate that African annual-averaged temperatures may plausibly rise at about 1.5 times the global rate of temperature increase in the subtropics, and at a somewhat lower rate in the tropics. These projected increases although drastic, may be conservative given the model underestimations of observed temperature trends. The relatively strong rate of warming over Africa, in combination with the associated increases in extreme temperature events, may be key factors to consider when interpreting the suitability of global mitigation targets in terms of African climate change and climate change adaptation in Africa.SP2016http://iopscience.iop.org/article/10.1088/1748-9326/10/8/08500

Keeping our heads above water: A systematic review of fatal drowning in South Africa

Background. Drowning is defined as the process of experiencing respiratory impairment from submersion/immersion in liquid, and can have one of three outcomes – no morbidity, morbidity or mortality. The World Health Organization African region accounts for approximately 20% of global drowning, with a drowning mortality rate of 13.1 per 100 000 population. The strategic implementation of intervention programmes driven by evidence-based decisions is of prime importance in resource-limited settings such as South Africa (SA).Objective. To review the available epidemiological data on fatal drowning in SA in order to identify gaps in the current knowledge base and priority intervention areas.Methods. A systematic review of published literature was conducted to review the available epidemiological data describing fatal drowning in SA. In addition, an internet search for grey literature, including technical reports, describing SA fatal drowning epidemiology was conducted.Results. A total of 13 published research articles and 27 reports obtained through a grey literature search met the inclusion and exclusion criteria. These 40 articles and reports covered data collection periods between 1995 and 2016, and were largely focused on urban settings. The fatal drowning burden in SA is stable at approximately 3.0 per 100 000 population, but is increasing as a proportion of all non-natural deaths. Drowning mortality rates are high in children aged <15 years, particularly in those aged <5.Conclusions. This review suggests that SA drowning prevention initiatives are currently confined to the early stages of an effective injury prevention strategy. The distribution of mortality across age groups and drowning location differs substantially between urban centres and provinces. There is therefore a need for detailed drowning surveillance to monitor national trends and identify risk factors in all SA communities.