Bronchiectasis in African children: disease burden, aetiology and clinical spectrum at a paediatric tertiary hospital in Cape Town, South Africa

Childhood bronchiectasis is a common cause of chronic lung disease globally, particularly in lower-middle-income countries (LMIC). Data from LMIC is lacking. We aimed to describe the disease burden, aetiology, and clinical spectrum of bronchiectasis in children attending a tertiary hospital in Cape Town, South Africa. Methods Data was collected by chart review of all patients 3 months to 15 years attending the respiratory clinic at red cross war memorial children's hospital between January – December 2019. We included children who had a diagnosis of bronchiectasis based on history of a recurrent (> 3 episodes/year) or persistent (> 4 weeks) wet cough, a clinical phenotype characterized by any of; exertion dyspnea, recurrent chest infections, growth failure, finger clubbing and chest deformity associated with radiographic features of bronchiectasis on plain chest radiography or HRCT reported by a paediatric radiologist. Patients with cystic fibrosis were excluded. Results Of 337 children seen during the study period, 58 (17.2%) had bronchiectasis that was diagnosed at a mean age of 34 months (SD 26). There were 32 (55.0%) female participants. The commonest causes of bronchiectasis were post-infectious (25, 43.1%), and underlying immunodeficiencies (19, 32.8%) including 16/58 (27.6%) who were HIV-infected and 3 (5.1 %) with primary immunodeficiency. Other causes included aspiration syndrome (8, 13.8 %) and anatomical abnormalities (4, 6.9%). Of the participants with post infectious bronchiectasis, tuberculosis was the commonest organism that was isolated (16, 64.0%) and commonest in children living with HIV (11/16, 68.8%). Cough was common (48, 82.8%) with wet cough being predominant (41, 85.4%), course crepitations accounted for 37 (63.8%), hyperinflation 24 (41.4%) finger clubbing 21 (36.2%), wheeze 16 (29.3%) and exertional dyspnea in 7 (12.0%). Conclusion: Bronchiectasis is a common cause of chronic lung disease in South African children mostly resulting from previous pneumonias, with tuberculosis being the commonest infective cause. The importance of identifying underlying treatable causes is highlighted

Exploring economics neo-pentecostalism and scientific rationality: a critical reflection on imagining a better pentecostal theology

Abstracts in English and TsongaThis study explored the lack of integrating a scientific imagination and rationality in the hermeneutic and theological practices of neo-Pentecostal churches in the town of Livingstone, Zambia. Although the vantage point of the study was primarily practical theology, the researcher adopted both an interdisciplinary and a multidisciplinary approach. This assisted the researcher in understanding the different theoretical nuances that inform neo-Pentecostal theological practices as propagated by its proponents. An in-depth scientific analysis premised on the critical theory approach was conducted to find out whether or not neo-Pentecostal communicative practices contribute positively to the economic conditions of local church members in Livingstone. The theological framework for this study was based on the “pastoral cycle”, which ought to be at the very heart of any contemporary practical theology (Ballard & Pritchard 2006). The research methodology consisted of data collection, interpretation and analysis (comparing and contrasting primary sources in the light of the data collected). Research participants' personal narratives of their experience of neo-Pentecostal practices were heard in a semi-structured format. These aided in establishing ecclesiastical views on the causes of the lack of integrating a scientific imagination and rationality in neo-Pentecostal spiritual experience; and consequently informed the study on whether the current theological orientations of neo-Pentecostal congregations in Livingstone have a positive or negative impact on the economic conditions of members. Two forms of data collection were employed, namely qualitative interviews and observation instruments.Ndzavisiso lowu wu langutisa ku pfumaleka ka vuanakanyi hi vuntshwa bya xisayense na ku va na ngqhondo eka mamfambiselo ya vulavisisi na vuxopaxopi ku hlamusela matsalelo na mafambiselo ya swa vugandzeri eka tikereke ta Pentakosta leyintshwa edorobeni ra Livingston, eZambia. Hambileswi masungulo ya ndzavisiso a ku ri mafambiselo ya vugandzeri, mulavisisi u tirhise fambiselo ra interdisciplinary na multidisciplinary. Leswi swi pfunete mulavisisi ku twisisa ku hambana eka swa thiyori leyi yi nga xiseketelo xa Pentakosta leyintshwa ya swa vugandzeri na mafambiselo ya kona tanhilaha swi endliwaka hi lava nga vachumayeri va yona pentakosta leyintshwa. Vuxopaxopi bya xisayense byi seketeriwe hi thiyori yo xopaxopa leyi nga endliwa ku kuma leswo xana mafambiselo ya Pentakosta leyintshwa ya pfuneta eka swiyimo swa ikhonomi eka swirho swa kereke swa yona eLivingston. Rimba ra swa vugandzeri eka ndzavisiso lowu wu seketeriwe hi ndzhenzheleko wa vurisi bya kereke ku nga "pastoral cycle", lowu wu faneleke ku va mbilu ya mafambiselo wahi na wahi ya vugandzeri (Ballard & Pritchard 2006). Methodoloji ya ndzavisiso a yi katsa ku hlengeletea vutivi, ku byi toloka no byi xopaxopa (ku kotlanisa na ku pimanisa swihlovo swa vutivi hi ku landza data leyi yi nga hlengeletiwa). Lava a va ri na xiavo eka ndzavisiso, va endle marungula ya vona na ntokoto wa vona hi mafambiselo ya Pentekosta leyintshwa ya yingiseriwile hi fomati yo ka yi nga kunguhatiwangi swinene ku nga semi-structured format. Leswi swi pfunete ekusunguleni mianakanyo ya kereke ya vukreste hi swivangelo swa ku pfumaleka ka ku hlanganisa na ku anakanya hi vuntshwa mavonelo na ntokoto eka swa moya hi swa Pentekosta leyintshwa; hi ku landza swona leswi, swi pfunete ndzavisiso hi leswo xana mavonelo yo hambana hi swa vugandzeri bya Pentakosta leyintshwa eka nhlengeletano eLivingston leswo xana yi na vuyelo lebyinene kumbe lebyi nga ri ku lebyinene eka swiyimo swa ikhonomi ya swirho. Ku tirhisiwe minxaka mimbirhi ya nhlengeleto ya vutivi, ku nga qualitative interviews na xitirho xa ku languta kunene leswi endlekaka (observation instruments).Practical TheologyD. Th. (Practical Theology

The geochronological framework of the Irumide Belt: A prolonged crustal history along the margin of the Bangweulu Craton.

Ion microprobe U-Th-Pb analyses of zircon from 40 granitoid rocks collected from the late Mesoproterozoic Irumide Belt in Central Southern Africa, along the southern margin of the Archean to Paleoproterozoic Bangweulu Block, provide a comprehensive set of age data for this complex orogen. The data indicate that the Irumide Belt is constructed on a basement of principally Paleoproterozoic (ca. 2.05–1.93 Ga) age with a subordinate Neoarchean (ca. 2.73 Ga) component, which is overlain by a platformal quartzite-pelite succession known as the Muva Supergroup. Previously published U-Pb detrital zircon data for the Paleoproterozoic Muva Supergroup, which show age populations that match all of the pre-1.9 Ga basement components identified within the Irumide Belt, suggest that the pre-Muva basement was assembled as a coherent block by ~1.8 Ga, which we refer to as the Bangweulu Craton. The southern margin of the Bangweulu Craton was then intruded by a previously unrecognized suite of biotite-bearing granitoid rocks between 1.66 and 1.55 Ga, not recorded elsewhere in the region, and was later the site of emplacement of voluminous granitoid magmatism during the Irumide Orogeny at between 1.05 and 1.00 Ga. Hf isotopic data from zircon in these suites indicate variable influence from cryptic Archean rocks in the lower crustal melting zone of the Bangweulu Block. U-Pb analyses of inherited zircon cores in magmatic zircon in these granitoid rocks, directly confirm the presence of this reworked cryptic Archean basement of the Bangweulu Craton.The age data confirm previously proposed tectonic models for the Mesoproterozoic evolution of central Africa, refuting the presence of a continent-spanning Grenvillian-aged Orogen, including the Kibaran Belt, Irumide Belt and Choma-Kalomo Block of central Africa and connecting with Mesoproterozoic terranes further south along the margins of the Kalahari Craton. The data clearly show that the Proterozoic tectonic evolution of the Bangweulu Craton, which became attached to the southern margin of the larger Congo Craton during the Mesoproterozoic, involved a series of distinct convergent orogenic episodes affecting and reworking its southern (passive) margin. The mismatch in timing of Mesoproterozoic orogenic activity along the Bangweulu Craton, compared to that on the margins of the Kalahari, is compatible with the notion that these continental fragments were not juxtaposed along these Mesoproterozoic belts and in their present-day relative positions at the time. Whether either of these central and southern African cratons did form part of Rodinia, however, remains a matter for debate

Duration of cART Before Delivery and Low Infant Birthweight Among HIV-Infected Women in Lusaka, Zambia

To estimate the association between duration of combination antiretroviral therapy (cART) during pregnancy and low infant birthweight (LBW), among women ≥37 weeks gestation

Bronchiectasis in African children : challenges and barriers to care

Bronchiectasis (BE) is a chronic condition aecting the bronchial tree. It is characterized by the dilatation of large and medium-sized airways, secondary to damage of the underlying bronchial wall structural elements and accompanied by the clinical picture of recurrent or persistent cough. Despite an increased awareness of childhood BE, there is still a paucity of data on the epidemiology, pathophysiological phenotypes, diagnosis, management, and outcomes in Africa where the prevalence is mostly unmeasured, and likely to be higher than high-income countries. Diagnostic pathways and management principles have largely been extrapolated from approaches in adults and children in high-income countries or from data in children with cystic fibrosis. Here we provide an overview of pediatric BE in Africa, highlighting risk factors, diagnostic and management challenges, need for a global approach to addressing key research gaps, and recommendations for practitioners working in Africa.http://www.frontiersin.org/Pediatricsdm2022Paediatrics and Child Healt

Challenges to implementing environmental-DNA monitoring in Namibia

By identifying fragments of DNA in the environment, eDNA approaches present a promising tool for monitoring biodiversity in a cost-effective way. This is particularly pertinent for countries where traditional morphological monitoring has been sparse. The first step to realising the potential of eDNA is to develop methodologies that are adapted to local conditions. Here, we test field and laboratory eDNA protocols (aqueous and sediment samples) in a range of semi-arid ecosystems in Namibia. We successfully gathered eDNA data on a broad suite of organisms at multiple trophic levels (including algae, invertebrates and bacteria) but identified two key challenges to the implementation of eDNA methods in the region: 1) high turbidity requires a tailored sampling technique and 2) identification of taxa by eDNA methods is currently constrained by a lack of reference data. We hope this work will guide the deployment of eDNA biomonitoring in the arid ecosystems of Namibia and neighbouring countries

A risk score to identify HIV-infected women most likely to become lost to follow-up in the postpartum period

Access to lifelong combination antiretroviral therapy (cART) is expanding among HIV-infected pregnant and breastfeeding women throughout sub-Saharan Africa. For this strategy to meaningfully improve maternal HIV outcomes, retention in HIV care is essential. We developed a risk score to identify women with high likelihood of loss to follow-up (LTFU) at 6 months postpartum from HIV care, using data from public health facilities in Lusaka, Zambia. LTFU was defined as not presenting for HIV care within 60 days of the last scheduled appointment. We used logistic regression to assess demographic, obstetric, and HIV predictors of LTFU and to develop a simple risk score. Sensitivity and specificity were assessed at each risk score cut-point. Among 2,029 pregnant women initiating cART between 2009 and 2011, 507 (25%) were LTFU by 6 months postpartum. Parity, education, employment status, WHO clinical stage, duration of cART during pregnancy, and number of antenatal care visits were associated with LTFU (p-value<0.10). A risk score cut-point of 11 (42nd percentile) had 85% sensitivity (95% CI 82%, 88%) and 22% specificity (95% CI 20%, 24%) to detect women LTFU and would exclude 20% of women from a retention intervention. A risk score cut-point of 18 (69th percentile) identified the 23% of women with the highest probability of LTFU and had sensitivity 32% (95% CI 28%, 36%) and specificity 80% (95% CI 78%, 82%). A risk score approach may be useful to triage a subset of women most likely to be LTFU for targeted retention interventions