Hen egg white bovine colostrum supplement reduces symptoms of mild/moderate COVID-19: a randomized control trial

Aim: The ability of a hen egg white bovine colostrum supplement to prevent severe COVID-19 was tested in a double-blind randomized control study. Methods: Adults with mild/moderate COVID-19, risk factors for severe disease, and within 5 days of symptom onset were assigned to the intervention (n = 77) or placebo (n = 79) arms. Symptoms were documented until day 42 post-enrollment and viral clearance was assessed at 11-13 days post-symptom onset. Results: One participant developed severe COVID-19. The severe-type symptom score was lower in the active arm at 11-13 days post-symptom onset (p = 0.049). Chest pain, fever/chills, joint pain/malaise, and sore throat were significantly less frequent in the active arm. No differences in viral clearance were observed. Conclusion: The intervention reduced symptoms of mild/moderate COVID-19

Predictors of tuberculosis (TB) and antiretroviral (ARV) medication non-adherence in public primary care patients in South Africa: A cross sectional study

Background: Despite the downward trend in the absolute number of tuberculosis (TB) cases since 2006 and the fall in the incidence rates since 2001, the burden of disease caused by TB remains a global health challenge. The co-infection between TB and HIV adds to this disease burden. TB is completely curable through the intake of a strict anti-TB drug treatment regimen which requires an extremely high and consistent level of adherence.The aim of this study was to investigate factors associated with adherence to anti-TB and HIV treatment drugs. Methods: A cross-sectional survey method was used. Three study districts (14 primary health care facilities in each) were selected on the basis of the highest TB caseload per clinic. All new TB and new TB retreatment patients were consecutively screened within one month of anti-tuberculosis treatment. The sample comprised of 3107 TB patients who had been on treatment for at least three weeks and a sub-sample of the total sample were on both anti-TB treatment and anti-retro-viral therapy(ART) (N = 757). Data collection tools included: a Socio-Demographic Questionnaire; a Post-Traumatic-Stress-Disorder (PTSD) Screen; a Psychological Distress Scale; the Alcohol Use Disorder Identification Test (AUDIT); and self-report measures of tobacco use, perceived health status and adherence to anti-TB drugs and ART. Results: The majority of the participants (N = 3107) were new TB cases with a 55.9% HIV co-infection rate in this adult male and female sample 18 years and older. Significant predictors of non-adherence common to both anti-TB drugs and to dual therapy (ART and anti-TB drugs) included poverty, having one or more co-morbid health condition, being a high risk for alcohol mis-use and a partner who is HIV positive. An additional predictor for non-adherence to anti-TB drugs was tobacco use. Conclusions: A comprehensive treatment programme addressing poverty, alcohol mis-use, tobacco use and psycho-social counseling is indicated for TB patients (with and without HIV). The treatment care package needs to involve not only the health sector but other relevant government sectors, such as social development.IS

Teenage pregnancy rates and associations with other health risk behaviours: a threewave cross-sectional study among South African school-going adolescents

BACKGROUND: Teenage pregnancy still remains high in low and middle-income countries (LMIC), as well as in highincome countries (HIC). It is a major contributor to maternal and child morbidity and mortality rates. Furthermore, it has social consequences, such as perpetuating the cycle of poverty including early school dropout by the pregnant adolescent, especially in sub-Saharan Africa (SSA). Few studies in SSA have investigated the trends in teenage pregnancy and the associated factors, while this is critical in fully understanding teenage pregnancy and for promotion of reproductive health among adolescents at large in SSA. METHODS: To examine the trends in teenage pregnancy and to identify associations with other health risk behaviours in South Africa (SA), a total of 31 816 South African school-going adolescents between 11 to 19 years of age were interviewed in three cross-sectional surveys. Data from the first (2002, n = 10 549), second (2008, n = 10 270) and the third (2011, n = 10 997) nationally representative South African youth risk behaviour surveys (YRBS) were used for this study. RESULTS: The overall prevalence of having ever been pregnant among the combined 3-survey sample was selfreported to be 11.0 % and stable across the three surveys. Sexual intercourse among adolescents in SA has decreased from 41.9 % in 2002 to 36.9 % in 2011. However, pregnancy among girls who ever had sex increased from 17.3 % (95 % CI: 0.16–0.19) in 2002, to 23.6 % (95 % CI: 0.21–0.26) in 2008 and decreased to 21.3 % (95 % CI: 0.19–0.23) in 2011. The odds for ever been pregnant were higher for girls who had 2 or more sexual partners (OR: 1.250, 95 % CI: 1.039–1.503), girls who ever used alcohol before sex (OR: 1.373, 95 % CI: 1.004–1.878), practised binge-drinking during the last month (OR: 0.624, 95 % CI: 0.503–0.774), and girls who used mandrax (OR: 1.968, 95 % CI: 1,243–3.117). The odds for never been pregnant were lower for those who used condoms (OR: 0.462, 95 % CI: 0.309–0.691). CONCLUSIONS: Girls continue to become pregnant at unacceptably high rates in SA. Sexual intercourse among adolescents in SA has decreased slightly. However, among those who are sexually active pregnancy prevalence rates have increased. More over, this is in the context of high prevalence of HIV and other STI. There is a need to address adolescents’ sexual and reproductive health, and several health risk behaviours, including substance use, that are associated with teenage pregnancy in SA.IS

Second-generation mother-to-child HIV transmission in South Africa is characterized by poor outcomes

Objective: The worldwide incidence of pregnancy for women living with perinatal HIV infection is increasing. Subsequently, there is growing risk of second-generation mother-to-child HIV transmission. The infant clinical outcomes for such a phenomenon have yet to be described. Design: As part of a wider observational study in KwaZulu-Natal, South Africa, six infants with in-utero HIV infection were identified as being born to mothers with perinatal HIV infection. Methods: Blood results and clinical data were collected in the first 3 years of life. In two cases, sample availability allowed confirmation by phylogenetic analysis of grandmother-to-mother-to-child HIV transmission. Results: Outcomes were poor in all six cases. All six mothers had difficulty administering twice daily combination antiretroviral therapy to their infants due to difficulties with acceptance, disclosure, poor health and being themselves long-term nonprogressors. Nonnucleoside reverse transcriptase inhibitor-resistant virus was detected in all mothers tested. None of the infants maintained suppression of viraemia on combination antiretroviral therapy. One infant died, and another was lost to follow-up. Conclusion: As the numbers of second-generation mother-to-child transmissions increase, it is important to highlight that this mother–infant dyad represents an extremely vulnerable group. In order for them to survive and thrive, these infants’ mothers require their specific needs to be addressed and given intensive support

Rainfall simulation to identify the storm-scale mechanisms of gully bank retreat

Gully erosion is one of the main causes of soil loss in drylands. Understanding the dominant mechanisms of erosion is important to achieve effective erosion control, thus in this study our main objective was to quantify the mechanisms involved in gully bank retreat as a result of three processes, falling of entire soil aggregates, transport of soil material by splash and by water running along gully banks (runoff). during rainfall events. The study was conducted in the sloping lands of the KwaZulu-Natal province, a region that is highly affected by gully erosion. Artificial rain was applied at 60 mm h(-1) for 45 min at the vertical wall of a gully bank typical to the area. The splash material was collected by using a network of 0.045 m(2) buckets. The sediments in the running water were assessed by sampling the runoff collected from a microplot inserted within the base of the bank, and collecting the fallen aggregates after the rainfall simulation was complete. Results indicated that the overall erosion for the simulation was 721 g m(-2) h(-1). Runoff erosion proved to be the dominant mechanism and amounted to 450g m(-2) h(-1), followed by splash and fall down of aggregates (about 170 g m(-2) h(-1)). Gully bank retreat occurred at a rate of 0.55 mm h(-1) and assuming that the soil bulk density is 1.3 g cm(-3), this corresponds to a retreat of 8.8 mm y(-1). Extrapolations to the watershed level, where about 500 m(2) of gully bank are observed per hectare, would lead to an erosion rate of 4.8 t ha(-1) y(-1). These limited results based on a simulated storm show that the three main mechanisms (runoff, splash and fall down of aggregates) are responsible for the retreat of gully banks and that to mitigate gully erosion, appropriate measures are required to control all three mechanisms. Further research studies are needed to confirm and to scale up, both in time and space, as these data are obtained at one location and from a single artificial storm

“Motherhood is hard” : exploring the complexities of unplanned motherhood among HIV-positive adolescents in South Africa

Abstract: For any woman, pregnancy and giving birth are major life-changing experiences. This period is argued to indicate a shift from girlhood into womanhood. However, this experience takes on new meaning when the woman is very young—an adolescent, who is still in school—and learns that she is HIV-positive. For such adolescent, becoming a mother, just like living with HIV/ AIDS, involves moving from a known, current reality to an unknown, new reality. To understand how HIV-positive adolescent mothers grapple with the demands and responsibilities of unplanned motherhood while living with HIV, this study explores the complexities of their experiences in South Africa. Drawing on qualitative methods, this study examines their meaning to motherhood while meeting their personal health needs. Through in-depth interviews conducted among 10 HIV-positive adolescent mothers living in Johannesburg, this article presents an empirical study of their narratives and how they negotiate these complexities in their unplanned new realities. Emerging themes from the interview transcripts were identified, coded, and analyzed thematically following an interpretivist approach. From the interviews conducted, it is evident that HIV-positive adolescent mothers perceive unplanned motherhood as difficult and this negatively affects their future childbearing decisions. Given the importance of motherhood and adolescents globally, this article advocates for feminist policies that would facilitate larger transformative narratives. It also recommends the implementation of relevant policy that would alleviate the difficulties of HIV-positive adolescent mothers generally