20 research outputs found
Microbiology of vaginal discharge with emphasis on gardnerella vaginalis.
Thesis (M. Med. Sci.)- University of Natal, Department of Microbiology. 1990The microbiological aetiology of vaginal discharge was studied in 208 women
attending various outpatient clinics at King Edward VIII Hospital.
Specimens from the lower genital tract were collected for microscopy and
culture. Vaginal wet smear examination, amine liberation test and vaginal pH
estimation were performed and assessed for their reliability for the rapid
diagnosis of vaginal infections.
Vaginal and endo-cervical infections were present in 163 (78,4%) women. G.
vaginalis (65,4%), T. vaginalis (37,9%), genital yeasts (37,0%), M. hominis
(59,6%), g. urealyticum (48,1%), anaerobic bacteria (32,6%), N. gonorrhoeae
(11,1%), f. trachomatis (22,1%) and Herpes simplex virus (0,9%) were
detected. Of the 104 women in • whom vaginal infections were detected,
bacterial vaginosis was present as the sole infection in 32 (22,2%), I.
vaginalis in 35 (24,3%) and C. albicans in 23 (15,9%). Bacterial vaginosis
occurred concurrently with T. vaginalis and f. albicans in 24 (16,5%) and 11
(7,5%) women respectively; whilstT. vaginalis and f. albicans occurred
concurrently in 14 (9,7%) women. In 6 (4,1%) women all three infections were
present. No vaginal or endo-cervical pathogens were detected in 45 (21,6%)
women.
Women with bacterial vaginosis were found to be significantly colonised with
G. vaginalis, M, hominis, anaerobic bacteria and curved Gram-negative
bacilli (p < 0,05).
Vaginal wet smear microscopy detected T.. vaginalis in 29% and "clue" cells
in 41,3% of smears. The presence of "clue" cells (91,8%) and a positive
amine test (76,7%) was significantly associated with bacterial vaginosis.
Although a raised vaginal pH was also significantly associated with
bacterial vaginosis, this test was less specific (65,2%) than "clue" cells
(85,9%) and the amine test (95,5%). The vaginal Gram stain, as performed in
this study, was found to be unreliable for the detection of "clue" cells.
G. vaginalis biotypes 1 and 5 were significantly associated with bacterial
vaginosis, however the serotyping scheme did not distinguish between strains
isolated from women with and without bacterial vaginosis. The antimicrobial
susceptibility pattern of 93 strains of G. vaginalis was not typical of
either Gram-positive or Gram-negative bacteria.
Serological tests revealed reactive syphilis serology in 47 (22,6%) and the
presence of hepatitis B surface antigen in 16 (7,7%) women. Antibody to
human immunodeficiency virus was detected in 4 (1,9%) women attending the
colposcopy clinic.
This study clearly demonstrates the high prevalence of vaginal and/or
endo-cervical infections in women locally, the majority of whom were
asymptomatic. The high frequency of concurrent infections is of concern and
there is a need for the recognition, and appropriate management of such
infections
Calymmatobacterium granulomatis: culture, electron microscopic studies and molecular analysis.
Doctoral Degree. University of KwaZulu-Natal, Durban.Abstract available in PDF.Publications on page vi.
Presentations at scientific meetings on page vii
HIV infection and AIDS in Sub-Saharan Africa : current status, challenges and opportunities.
CAPRISA, 2016.Abstract available in PDF file
Strengthening HIV surveillance: measurements to track the epidemic in real time.
CAPRISA, 2016.Abstract available in pdf
A review of progress on HIV, AIDS and Tuberculosis.
As a United Nations member state, South Africa is signatory to the Millennium
Declaration and is committed to achieve the Millennium Development Goals
(MDGs) and targets for 2015. This chapter provides an overview of the status of
South Africa’s response to MDG 6 with a specific focus on the progress made to date
with respect to HIV and tuberculosis (TB) – two intertwined epidemics contributing
disproportionately to morbidity and premature mortality in South Africa. These
epidemics are also closely linked to MDG 4 and 5 outcomes. Any progress made
by South Africa to reverse current trends will have substantial implications for the
global MDG targets as well as country level outcomes. This chapter will use available
evidence to document the status of HIV and TB in South Africa relative to the
South African Ministry of Health’s strategy to address these diseases
Progress of UNAIDS 90-90-90 targets in a district in KwaZulu-Natal, South Africa, with high HIV burden, in the HIPSS study : a household-based complex multilevel community survey.
CAPRISA, 2017.Abstract available in pdf
High prevalence of abnormal Pap smears among young women co-infected with HIV in rural South Africa – implications for cervical cancer screening policies in high HIV prevalence populations.
Objective. To establish the relationship between HIV infection and cervical dysplasia in young women in rural South Africa.
Methods. This cross-sectional study was conducted at a primary health care clinic in Vulindlela, KwaZulu-Natal. Standardised questionnaires were used to collect sociodemographic and clinical presentation data from women attending family planning and other reproductive health services. Pap smears were done using standard methods. Pap smear data were linked to HIV serostatus. Results. Four hundred and sixty-six women were included in the study. The median age was 24.3 years (range 15 - 55 years), and 80% were younger than 30 years. The HIV prevalence rate was 24.5% (95% confidence interval: 20.7 - 28.7%) and the prevalence of abnormal Pap smears was 16.9 - 6.4% ASCUS (atypical squamous cells of undetermined significance), 9.2% LGSIL (low-grade squamous intraepithelial lesions), and 1.3% HGSIL (high-grade squamous intraepithelial lesions). The association between HIV seropositivity and abnormal Pap results was statistically significant (p < 0.05). Conclusion. There is a need for more data on cervical changes in HIV co-infected women and for review of guidelines on selective Pap smear screening in high HIV prevalence settings such as sub-Saharan Africa and where access to antiretroviral treatment remains limited
TB treatment outcomes following directly-observed treatment at an urban outpatient specialist TB facility in South Africa.
The treatment of 450 consecutive new patients with pulmonary TB was evaluated to determine outcome following directly-observed treatment. In all,176 (39.1%) patients were cured, 23 (5.1%) completed treatment, 80 (17.8%) defaulted treatment, 24 (5.3%) died, 54 (12.0%) were lost to follow-up and 93 (20.7%) were transferred out. Increasing age was significant for death. Males were more likely to default and those with negative pretreatment sputum smears and those who were unemployed were more likely to be lost to follow-up.The overall treatment success rate remains low. Our data suggests that greater emphasis is needed to improveTB treatment success
Increasing burden of pulmonary tuberculosis in young women.
Scientific letter.No abstract available
Utilizing nucleic acid amplification to identify acute HIV infection.
No abstract available