Effect of exposure to clinic-based health education interventions on behavioural intention to prevent mother-to-child transmission of HIV infection

HIV and AIDS incidence among infants in South Africa is on the increase.The uptake of prevention of motherto- child transmission (PMTCT) interventions is often said to be dependent on the beliefs and educational needs of those requiring PMTCT services.This study therefore sought to examine the effect of clinic-based health education interventions (HEI) on behavioural intention of PMTCT among 300 pregnant women from 4 primary health care clinics in Tshilidzini Hospital catchments area, South Africa. An interview schedule was used to obtain information regarding participants' demographic characteristics, level of exposure to clinic-based HEI, salient beliefs and behavioural intention on PMTCT.The major findings included that approximately 85% of the participants had heard of PMTCT.There was very little association between frequency of antenatal clinic (ANC) visits and level of exposure to PMTCT information. Condom use had the lowest set of salient belief scores. Control belief was the most common belief contributing to behavioural intention. Generally, the association between PMTCT salient beliefs and behavioural intention was weak. Clinic-based HEI had an impact on behavioural intention of HIV testing, normative belief of regular ANC visit and nevirapine use.The vital contribution of alternative PMTCT information sources such as the radio and television was observed. Enhancing initiatives that empower women, and a better coordination of the existing HEI through better implementation of health education strategy may strengthen the prevailing moderate PMTCT intention in the area investigated. Keywords: PMTCT, HIV/AIDS, health education intervention, vertical transmission, nevirapine, behavioural intention, theory of planned behaviour. Résumé Le cas de VIH/SIDA augmente parmi les bébés en Afrique du Sud. L'assimilation des interpositions de prévention de transmission mère á enfant (PMTCT) est souvent vu d'être dépendante de croyances et de besoins éducatifs de ceux qui ont besoin des services PMTCT. Cette étude a pour but de vérifier l'effet des interpositions de l'éducation sanitaire clinique-basées (HEI) sur l'intention comportementale de PMTCT auprès de 300 femmes enceintes originaires de 4 services de santé primaire dans les bassins de captation de l'hôpital Tshilidzini, en Afrique du Sud. Un barème d'entretien a été utilisé pour obtenir des informations concernant les caractéristiques démographiques des participants, le niveau d'être exposé aux HEI clinique-basées, les croyances principales et l'intention comportementale sur les PMTCT. Les résultats principaux ont démontré qu'approximativement 85% de participants avaient déjà entendu parlé de PMTCT. Il y a eu une association très étroite entre la fréquence de visites antenatales et le niveau d'être exposé à l'information de PMTCT. L'utilisation du préservatif avait les résultats de croyances principales les plus bas. La croyance de commande était la croyance la plus commune qui contribue à l'intention comportementale. En général, l'association entre les croyances principales des PMTCT et l'intention comportementale était faible. Les HEI clinique-basées avaient un impact sur l'intention comportementale du dépistage de VIH, la croyance normative des visites antenatales régulières et la prise du nevirapine. La contribution primordiale des sources alternatives d'informations sur les PMTCT comme la radio et la télévision a été observée. Rehausser les initiatives vers le développement des femmes et la coordination meilleure de HEI qui existent à travers une meilleure mise en oeuvre de la stratégie de l'éducation sanitaire pourraient renforcer l'actuelle intention modérée des PMTCT dans le lieu en question. Mots clés: PMTCT,VIH/SIDA, interposition de l'éducation sanitaire, infection verticale, nevirapine, intention comportementale, théorie d'un comportement prévu

Human Campylobacteriosis in Developing Countries1

Campylobacteriosis is a collective description for infectious diseases caused by members of the bacterial genus Campylobacter. The only form of campylobacteriosis of major public health importance is Campylobacter enteritis due to C. jejuni and C. coli. Research and control efforts on the disease have been conducted more often in developed countries than developing countries. However, because of the increasing incidence, expanding spectrum of infections, potential of HIV-related deaths due to Campylobacter, and the availability of the complete genome sequence of C. jejuni NCTC 11168, interest in campylobacteriosis research and control in developing countries is growing. We present the distinguishing epidemiologic and clinical features of Campylobacter enteritis in developing countries relative to developed countries. National surveillance programs and international collaborations are needed to address the substantial gaps in the knowledge about the epidemiology of campylobacteriosis in developing countries

Further screening of Venda medicinal plants for activity against HIV type 1 reverse transcriptase and integrase

The use of medicinal plants for AIDS-related conditions is common in South Africa. In order to establish an antiviral rationale for the use of these plants we screened fractions of the methanol extracts of medicinal plants for activity against HIV-1 reverse transcriptase (RT) and integrase (IN). The n-butanol fraction obtained from the crude methanol extracts of the roots of Bridelia micrantha (Hochst) Baill. (Euphorbiaceae) was observed to be as the most active inhibiting the RNA-dependent-DNA polymerization (RDDP) activity of HIV-1 RT with an IC50 of 7.3 g/ml. However, it had no activity on the 3’-end processing activity of HIV integrase. Bioassay-guided fractionation of the n-butanol fraction yielded friedelin and -sistosterol, which did not inhibit the RDDP of RT or 3’-end processing functions of IN even at a concentration of 500 M. An uncharacterized fraction obtained in the bioassay-guided fractionating process inhibited the RDDP with an IC50 of 9.6 g/ml, but had no inhibition on IN. Phytochemical screening indicated the presence of flavonoids and tannins in the uncharacterized fraction.Key words: HIV-1; reverse transcriptase; integrase; medicinal plants; inhibition; Venda; South Afric

Anti-staphylococcal, anti-HIV and cytotoxicity studies of four South African medicinal plants and isolation of bioactive compounds from Cassine transvaalensis (Burtt. Davy) codd

Background: Medicinal plants represent an important opportunity to rural communities in Africa, as a source of affordable medicine and as a source of income. Increased patient awareness about safe usage is important as well as more training with regards to traditional medicine. The aim of this study was to evaluate the ethnomedicinal prowess of some indigenous South African plants commonly used in Eastern Cape Province of South Africa for the treatment of skin and respiratory tract infections, HIV and their toxicity potential. Methods: Cassine transvaalensis, Vangueria infausta, Croton gratissimus and Vitex ferruginea were tested for antibacterial activities against Staphylococcus aureus and Staphylococcus epidermidis using Kirby-Bauer disk diffusion and minimum inhibition concentration (MIC). Cytotoxic and anti-HIV-1 activities of plants were tested using MTT Assay (3- (Dimethylthiozole-2-yl-2,5-diphenyltetrazolium bromide)) and anti- HIV-1iib assay. In search of bioactive lead compounds, Cassine transvaalensis which was found to be the most active plant extract against the two Staphylocoous bacteria was subjected to various chromatographic. Thin layer chromatography, Column chromatography and Nuclear Magnetic Resonance (NMR), (1H-1H, 13C-13C, in DMSO_d6, Bruker 600 MHz) were used to isolate and characterize 3-Oxo-28-hydroxylbetuli-20(29)-ene and 3,28-dihydroxylbetuli-20(29)-ene bioactive compounds from C. transvaalensis. Results: The four plants studied exhibited bioactive properties against the test isolates. The zones of inhibition rangedbetween 16 mm to 31 mm for multi-drug resistant staphylococci species. MIC values varied between 0.6 and 0.02 μg/ml. C. gratissimus and C. transvaalensis exhibited the abilities to inhibit HIV-1iib. Two bioactive compounds were isolated from C. transvaalensis. Conclusion: Data from this study reveals the use of these plant by traditional healers in the Eastern Cape. Furthermore, C. transvaalensis and C. gratissimus were found to be more active as against HIV-1iib. While C. transvaalensis was most active against the two Staphylococcus bacteria

Municipal Wastewater Effluents as a Source of Listerial Pathogens in the Aquatic Milieu of the Eastern Cape Province of South Africa: A Concern of Public Health Importance

We evaluated the effluent quality of an urban wastewater treatment facility in South Africa and its impact on the receiving watershed for a period of 12 months. The prevalence and antimicrobial susceptibility of potential Listeria pathogens (L. ivanovii and L. innocua) and the physicochemical quality of the treated wastewater effluent was assessed, with a view to ascertain the potential health and environmental hazards of the discharged effluent. Total listerial density varied between 2.9 × 100 and 1.2 × 105 cfu/mL; free living Listeria species were more prevalent (84%), compared to Listeria species attached to planktons (59–75%). The treated effluent quality fell short of recommended standards for turbidity, dissolved oxygen, chemical oxygen demand, nitrite, phosphate and Listeria density; while pH, temperature, total dissolved solids and nitrate contents were compliant with target quality limits after treatment. The Listeria isolates (23) were sensitive to three (15%) of the 20 test antibiotics, and showed varying (4.5–91%) levels of resistance to 17 antibiotics. Of seven resistance gene markers assayed, only sulII genes were detected in five (22%) Listeria strains. The study demonstrates a potential negative impact of the wastewater effluent on the receiving environment and suggests a serious public health implication for those who depend on the receiving watershed for drinking and other purposes

Bacterial Contamination of Vhuswa - A Local Weaning Food and Stored Drinking-water in Impoverished Households in the Venda Region of South Africa

Bacterial contaminants of Vhuswa, a traditional maize-based weaning food, and domestic drinking-water stored in impoverished rural households in Venda of Limpopo province, South Africa, were determined. One hundred and twenty-five samples of Vhuswa fed to children aged less than five years were assessed for Escherichia coli , Campylobacter jejuni , Salmonella , and Shigella . The microbiological quality of 125 drinking-water samples was also evaluated using total coliforms, faecal coliforms, and faecal streptococci as indicators. The frequency of isolation of E. coli, Salmonella, Shigella, and C. jejuni from the Vhuswa samples was 70%, 5%, 5%, and 2% respectively. The geometric mean counts of total coliforms, faecal coliforms, and faecal streptococci in tap-water stored in household containers ranged from 4.9x102 to 5.8x103 cfu 100 mL-1 , 2.6x102 to 3.7x103 cfu 100 mL-1 , and 3.1x103 to 5.8x103 cfu 100 mL-1 respectively, and for stored spring water it was 5.1x103 cfu 100 mL-1 , 3.2x103 cfu 100 mL-1 , and 5.1x103 cfu 100 mL-1 respectively. The frequent contamination of water and food samples in this study has important implications for the health of children from impoverished communities

Molecular Characteristics and Antibiotic Resistance Profiles of Klebsiella

The increase in the incidence of extended-spectrum β-lactamase- (ESBL-) producing Klebsiella species has become a serious problem worldwide, because of their incrimination in antibiotic resistance. The objective of this study is to investigate the resistance genes responsible for ESBL-producing Klebsiella species and carbapenemase-producing Klebsiella (CRE) isolated in Mthatha and to study their epidemiology. A prospective, descriptive study of 202 nonrepetitive samples from patients was obtained from Nelson Mandela Academic Hospital. The cultured Klebsiella isolates were subjected to antimicrobial susceptibility tests and the polymerase chain reaction of blaCTX-M, blaTEM, blaSHV, blaKPC, and blaNDM genes. Overall K. pneumoniae were the majority with 169 (83.7%) species isolates, followed by K. oxytoca with 29 (14.4%), while K. ozaenae and Raoultella ornithinolytica were 2 (0.9%) each. The prevalence of ESBL production in all Klebsiella species was 117 (57.9%). ESBL-genotypic resistance is driven in Mthatha by blaSHV 121 (77.1%) followed by blaTEM 105 (66.9%) and blaCTX-M at 89 (56.7%). The most common ESBL genotype combination among the Klebsiella was blaTEM+blaSHV + blaCTX-M at 79 (50.3%). There is a steady increase in the rate of ESBL genes in the last five years

Antibiotic Susceptibilities of Enterococcus Species Isolated from Hospital and Domestic Wastewater Effluents in Alice, Eastern Cape Province of South Africa

Background: Antimicrobial resistance in microorganisms are on the increase worldwide and are responsible for substantial cases of therapeutic failures. Resistance of species of Enterococcus to antibiotics is linked to their ability to acquire and disseminate antimicrobial resistance determinants in nature, and wastewater treatment plants (WWTPs) are considered to be one of the main reservoirs of such antibiotic resistant bacteria. We therefore determined the antimicrobial resistance and virulence profiles of some common Enterococcus spp that are known to be associated with human infections that were recovered from hospital wastewater and final effluent of the receiving wastewater treatment plant in Alice, Eastern Cape. Methods: Wastewater samples were simultaneously collected from two sites (Victoria hospital and final effluents of a municipal WWTP) in Alice at about one to two weeks interval during the months of July and August 2014. Samples were screened for the isolation of enterococci using standard microbiological methods. The isolates were profiled molecularly after targeted generic identification and speciation for the presence of virulence and antibiotic resistance genes. Results: Out of 66 presumptive isolates, 62 were confirmed to belong to the Enterococcus genusof which 30 were identified to be E. faecalis and 15 E. durans. The remaining isolates were not identified by the primers used in the screening procedure. Out of the six virulence genes that were targeted only three of them; ace, efaA, and gelE were detected. There was a very high phenotypic multiple resistance among the isolates and these were confirmed by genetic analyses. Conclusions: Analyses of the results obtained indicated that hospital wastewater may be one of the sources of antibiotic resistant bacteria to the receiving WWTP. Also, findings revealed that the final effluent discharged into the environment was contaminated with multi-resistant enterococci species thus posing a health hazard to the receiving aquatic environment as these could eventually be transmitted to humans and animals that are exposed to it

In-vitro cytotoxicity and antimicrobial activities, against clinical isolates of Campylobacter species and Entamoeba histolytica, of local medicinal plants from the Venda region, in South Africa

In the quest for alternative treatments against Campylobacter jejuni and Entamoeba histolytica, which are both aetiological agents of diarrhoea world-wide, the in-vitro activities against the two pathogens of extracts of 18 South African medicinal plants have recently been assessed. Forty extracts from the 18 plant species were prepared and tested against 110 clinical isolates of Campylobacter spp. In addition, extracts from eight of the plant species were tested against a standard strain (HM-1:IMSS) of E. histolytica, and the cytotoxicity of each of 19 extracts from 15 of the plant species was explored using Vero cell cultures and microdilution assays. At least one extract of each plant species investigated was found to be active against some of the Campylobacter isolates. Extracts of Lippia javanica and Pterocarpus angolensis had the highest antibacterial activity, each giving a minimum inhibitory concentration (MIC) of 90 μg/ml. Of the extracts tested against E. histolytica, however, only those of P. angolensis and Syzigium cordatum were found to have anti-amoebic activity, with MIC of 1.2 and 7.5 mg/ml, respectively. Although most of the extracts showed little toxicity against Vero cells, with most of the median inhibitory concentrations (IC50) recorded exceeding 400 μg/ml, an extract of Bauhinia galpini was quite toxic, with an IC50 of just 2.7 μg/ml. Acetone and methanol extracts of several of the plants show promise as templates for the design of new anti-diarrhoeal therapies