A suicide risk screening scale for HIVinfected persons in the immediate postdiagnosis period

Background. The risk of suicidal tendencies in HIV-infected persons appears high and may parallel the increasing prevalence of suicidal behaviour in South Africa. Objective. To construct a brief suicide risk  screening scale (SRSS) as a self-administered instrument to screen for suicidal ideation in recently diagnosed HIV-infected persons.Methods. An SRSS was developed, drawing 14 items from two established screening tests, and assessed using a sample of 150 HIV-infected consenting adults identified at a voluntary counselling and testing (VCT) clinic at an academic district level hospital in Durban, South Africa. Participants returned three weeks after their initial assessment for a re-assessment.Results. The internal consistency of the SRSS was good (Cronbach’s alpha, 0.87), and its sensitivity (81%) was higher than its specificity (47%). The findings suggest that, despite certain limitations, the SRSS may be a valuable screening tool for suicidal ideation at VCT clinics.Conclusion. Screening for suicide risk and possible suicidal behaviour in HIV-positive persons may form a routine aspect of comprehensive patient care at VCT clinics to assist with effective prevention and treatment

Regulatory Compliance and Private Education Provision in South Africa: Boon or a Bane?

This paper explores the impact of certain regulations on private higher education (PHEI) provision and delivery in South Africa. By scrutinizing relevant legislation and policies, the researchers demonstrate that although various government policy documents, inter-alia, the National Development Plan-2030, allude to the important role of private higher education providers in South Africa, the various polices and legislation do not seem to create a very conducive and enabling climate. Ranging from funding to accreditation, the perception among private HE providers is that there is little support for PHEIs

Mortality estimates for juvenile dusky sharks carcharhinus Obscurus in South Africa using mark-recapture data

A maximum likelihood model is developed, using mark-recapture data, to estimate total and fishing mortality rates for the dusky shark Carcharhinus obscurus in South Africa. The model accounts for tag-shedding, nonreportingof recaptured tags, the multiple release and single recapture nature of the study and the usage of two different types of tags (sheep-ear and ORI tags). Tag shedding was quantified as tags washed up on beaches andfouling of tags in protective shark nets, which amounted to 17% of all tags recovered between 1986 and 1993. The ORI tag had a higher tag-shedding rate than the sheep-ear tag. Assuming a 75% reporting rate for recaptureddusky sharks, an instantaneous fishing mortality rate was estimated to be 0.27.year–1, with a 95% confidence level ranging between 0.19 and 0.44.year–1

Late termination of pregnancy by intracardiac potassium chloride injection: 5 years’ experience at a tertiary referral centre

Objectives. To report our experience with intracardiac potassium chloride (KCl) injection as a method of feticide for severe congenital abnormalities beyond 24 weeksf gestation.Method. A retrospective chart review. Patient demographics and types of fetal anomalies were analysed according to the groups that acceptedor declined late termination of pregnancy (LTOP, .24 weeks) for severe congenital abnormalities.Results. Of 3 896 women referred to the Fetal Medicine Unit at Inkosi Albert Luthuli Central Hospital, KwaZulu-Natal, 2 209 (56.7%) were at .24weeksf gestation at their first visit. LTOP for severe congenital  abnormalities was offered to 253 (11.5%), of whom 191 (75.5%) accepted. Differences in maternal age, parity, race and religion were not statistically significant. The type of fetal abnormalities and gestational age at diagnosis influenced the decision-making process in >80% of the women. The most frequent indications for LTOP were brain and spinal  abnormalities (53.0%), and aneuploidy (20.6%). Feticide by ultrasound-guided intracardiac KCl injection was performed in 138/191 cases (72.2%); 53 women who accepted LTOP did not undergo feticide for a variety of reasons. The mean interval between diagnosis and performance of feticide was 10 days (range 0 - 42 days). Fetal asystole was achieved in all cases within 2 minutes by a single-needle injection of intracardiac KCl; the mean duration of the procedure was 12 minutes (range 6 - 25 minutes). There were no maternal complications, and stillbirths occurred in all cases.Conclusion. Feticide by ultrasound-guided intracardiac KCl injection was an acceptable, safe and effective method for LTOP. Further studies are needed to determine the minimum dosage of KCl required to achieve the desired effect

Suicidal ideation in seropositive patients seen at a South African HIV voluntary counselling and testing clinic

Objective: Suicidal behaviour and HIV/AIDS are significant public health concerns. The aim of this study was to investigate suicidal ideation in patients who were referred to a voluntary HIV counselling and testing (VCT) clinic and who were found to be seropositive. This in order to improve suicide prevention and intervention strategies amongst such patients. Method: The sample studied consisted of volunteer adult patients referred over a three-month period to a HIV VCT clinic based at a university-affiliated general state hospital. Patients completed a questionnaire on sociodemographic data. Suicidal ideation was measured using the Beck Hopelessness Scale and the Beck Depression Inventory (BDI), at two time points (within 72 hours after notification and again at a 6 week follow-up). All patients received extensive pre-and post-test counselling. Results: HIV-test results were available for 189 (99.5%) of the original sample of 190 patients studied, with 157 (83.1%) testing positive. More females tested positive as did unemployed and single/divorced patients. The mean age for HIV-positive patients was 33.49 (SD = 9.449), and for HIV-negative patients it was 37.94 (SD = 15.238). Age was a significant factor in that for each year increase in age, the risk of testing HIV-positive decreased by 4.1%. Lower education and traditional beliefs were also significantly associated with testing HIV-positive. At 72 hours suicidal ideation was present in 17.1% (95% confidence interval 12.16% to 23.45%), and at 6 weeks in 24.1% (95% confidence interval 17.26% to 32.39%) of the seropositive patients. Their average BDI scores were 15.20 and 14.23 respectively at the two time points. Conclusion: Suicidal ideation was present in a significant number of the seropositive cohort studied and increased over a six week period among these patients. The average BDI scores at both time points imply a clinical depression. The findings also suggest an association between positive HIV-test results and certain socio-demographic variables that can act as indicators for suicidal ideation in HIV-infected persons, although this requires further research. Although the relationship between suicidal ideation and HIV-infection is complex, it is an important consideration when assessing patient suicide vulnerability at HIV VCT clinics and when implementing suicide prevention and management strategies.Keywords: Suicidal ideation; HIV-infection; Voluntary counselling and testin

Soft-tissue tumour of the fetal thigh

No Abstract. South African Medical Journal Vol. 96 (3) 2006: 187-18

Isolation of hydrolase producing bacteria from Sua pan solar salterns and the production of endo-1, 4-bxylanase from a newly isolated haloalkaliphilic Nesterenkonia sp.

Eighty seven bacterial isolates were obtained from evaporator ponds using culture enrichment technique and screened for xylanase, mannanase and cellulase activity. Based on biochemical and phenotypic characteristics, the isolates were divided into 18 groups. Thirteen groups were Bacillusspecies, four were Halomonas species, while one group belonged to the genus Nesterenkonia. Four Bacillus isolates, Sua-BAC005, Sua-BAC012, Sua-BAC017 and Sua-BAC019, as well as Nesterenkonia sp. Sua-BAC020 were studied further. Isolate Sua-BAC005 affiliated with Bacillus amyloliquefaciens secreted 12.6 U/ml and 9.0 U/ml b-mannanase and b-xylanase, respectively, while isolates Sua-BAC012, Sua-BAC017 and Sua-BAC019 affiliated with Bacillus licheniformis, produced less than 2 U/ml of xylanase, cellulase and mannanase. Nesterenkonia sp. Sua-BAC020 grew at 0 – 20% NaCl with anoptimum at 2.5% NaCl, and at pH 7 – 9.5 with an optimum at pH 9. This isolate produced 3.5 U/ml xylanase when cultivated at pH 8 in 10% NaCl. Five xylanase activity bands were detected on Native-PAGE coupled with zymogram

Mainstreaming Underutilized Indigenous and Traditional Crops into Food Systems: A South African Perspective

Business as usual or transformative change? While the global agro-industrial food system is credited with increasing food production, availability and accessibility, it is also credited with giving birth to ‘new’ challenges such as malnutrition, biodiversity loss, and environmental degradation. We reviewed the potential of underutilized indigenous and traditional crops to bring about a transformative change to South Africa’s food system. South Africa has a dichotomous food system, characterized by a distinct, dominant agro-industrial, and, alternative, informal food system. This dichotomous food system has inadvertently undermined the development of smallholder producers. While the dominant agro-industrial food system has led to improvements in food supply, it has also resulted in significant trade-offs with agro-biodiversity, dietary diversity, environmental sustainability, and socio-economic stability, especially amongst the rural poor. This challenges South Africa’s ability to deliver on sustainable and healthy food systems under environmental change. The review proposes a transdisciplinary approach to mainstreaming underutilized indigenous and traditional crops into the food system, which offers real opportunities for developing a sustainable and healthy food system, while, at the same time, achieving societal goals such as employment creation, wellbeing, and environmental sustainability. This process can be initiated by researchers translating existing evidence for informing policy-makers. Similarly, policy-makers need to acknowledge the divergence in the existing policies, and bring about policy convergence in pursuit of a food system which includes smallholder famers, and where underutilized indigenous and traditional crops are mainstreamed into the South African food system

Otolaryngological and head and neck manifestations in HIV-infected patients seen at Steve Biko Academic Hospital in Pretoria, South Africa

Background. Sub-Saharan Africa has the highest incidence of HIV infection. According to recent census statistics, 5.6 million people in South Africa (SA) are HIV-positive, the highest number of infected individuals worldwide. Over 80% of HIV-infected individuals will present with ear, nose and throat (ENT) manifestations. Previous studies show that oral diseases seem to be the most common ENT-related manifestation, reported in about 40 - 50% of HIV-infected patients. In SA, there is lack of local information regarding the otolaryngological and head and neck manifestations in HIV-infected individuals.Objective. To ascertain our local trends of ENT and head and neck manifestations in HIV-infected patients seen at our specialised ENT-HIV Clinic, Steve Biko Academic Hospital, Pretoria, Gauteng Province, SA.Methods. A 1-year prospective study involving 153 HIV-infected patients was conducted in the clinic from January to December 2011. Patient history was taken and examinations were performed based on the World Health Organization (WHO) HIV/AIDS classification system. Data analysis was performed using Epi Info 7 software.Results. The most common manifestations were adenoid  hypertrophy/hyperplasia followed by cervical lymphadenopathy, chronic suppurative otitis media, otitis media with effusion and sensory-neural hearing loss.Conclusion. Patients typically presented with early manifestations during symptomatic WHO stages I and II in contrast to results reported in similar developing world studies from Iran, Nigeria and India. A possible explanation may lie in the SA government HIV Counselling and Testing campaign and the antiretroviral rollout programme, the effectiveness of which is becoming evident