Editorial

No Abstrac

Editorial

Bariatric surgery, addictive-like eating behaviour and obesit

Screening for microvascular complications of diabetes mellitus: missed opportunities

No Abstract

Sarcopaenia: Where do we stand after two decades of research?

No Abstract

Knowledge, attitudes and practices regarding iodine among patients with hyperthyroidism in the Free State, South Africa

Objectives: To gather baseline information on the knowledge, attitudes and practices regarding iodine and iodised salt among patients with hyperthyroidism in the Free State.Subjects and Setting: The study was part of a large cohort study that included the first 96 patients aged 13 years or older diagnosed with hyperthyroidism and referred to Universitas Academic Hospital in Bloemfontein, South Africa during 2005.Methods: The patients were interviewed in their language using a structured validated questionnaire. Descriptive statistics were used fordata analysis.Results: The majority of the patients (86.9%) did not know what iodine was. Similarly, a higher percentage of patients (76.7%) were unaware of the most important or main source of iodine in the food of South Africans. Regarding knowledge of the most important harmful effect on the health of children if they did not get enough iodine, almost all of the patients (89.1%) did not know what it was. Ninety-five per cent of salt was obtained from the local shops, and only 36.1% of the patients read the labelling on the package during purchase. A very small proportion of patients (1.6%) stored salt in closed containers and away from sunlight, while about half of them (49.2%) stored salt in open containers without lids, 36.1% stored it in rigid plastic containers with holes at the top, and 13.1% stored it in the open plastic bags in which the salt was bought.Conclusions: Patients with hyperthyroidism lacked knowledge of iodine, as well as of the storage of iodised salt, and this could have contributed to the persisting endemic goitre reported in previous studies. An aggressive awareness programme, targeting policy makers and the public, is recommended to ensure sustainable elimination of iodine deficiency disorders in South Africa.  Keywords: hyperthyroidism; iodine; iodised salt; knowledge-attitude-practice study; South Afric

Viral zoonotic risk is homogenous among taxonomic orders of mammalian and avian reservoir hosts

The notion that certain animal groups disproportionately maintain and transmit viruses to humans due to broad-scale differences in ecology, life history, and physiology currently influences global health surveillance and research in disease ecology, virology, and immunology. To directly test whether such “special reservoirs” of zoonoses exist, we used literature searches to construct the largest existing dataset of virus–reservoir relationships, consisting of the avian and mammalian reservoir hosts of 415 RNA and DNA viruses along with their histories of human infection. Reservoir host effects on the propensity of viruses to have been reported as infecting humans were rare and when present were restricted to one or two viral families. The data instead support a largely host-neutral explanation for the distribution of human-infecting viruses across the animal orders studied. After controlling for higher baseline viral richness in mammals versus birds, the observed number of zoonoses per animal order increased as a function of their species richness. Animal orders of established importance as zoonotic reservoirs including bats and rodents were unexceptional, maintaining numbers of zoonoses that closely matched expectations for mammalian groups of their size. Our findings show that variation in the frequency of zoonoses among animal orders can be explained without invoking special ecological or immunological relationships between hosts and viruses, pointing to a need to reconsider current approaches aimed at finding and predicting novel zoonoses

A Bayesian approach for inferring the dynamics of partially observed endemic infectious diseases from space-time-genetic data

We describe a statistical framework for reconstructing the sequence of transmission events between observed cases of an endemic infectious disease using genetic, temporal and spatial information. Previous approaches to reconstructing transmission trees have assumed all infections in the study area originated from a single introduction and that a large fraction of cases were observed. There are as yet no approaches appropriate for endemic situations in which a disease is already well established in a host population and in which there may be multiple origins of infection, or that can enumerate unobserved infections missing from the sample. Our proposed framework addresses these shortcomings, enabling reconstruction of partially observed transmission trees and estimating the number of cases missing from the sample. Analyses of simulated datasets show the method to be accurate in identifying direct transmissions, while introductions and transmissions via one or more unsampled intermediate cases could be identified at high to moderate levels of case detection. When applied to partial genome sequences of rabies virus sampled from an endemic region of South Africa, our method reveals several distinct transmission cycles with little contact between them, and direct transmission over long distances suggesting significant anthropogenic influence in the movement of infected dogs

The role of viral evolution in rabies host shifts and emergence

Despite its ability to infect all mammals, Rabies virus persists in numerous species-specific cycles that rarely sustain transmission in alternative species. The determinants of these species-associations and the adaptive significance of genetic divergence between host-associated viruses are poorly understood. One explanation is that epidemiological separation between reservoirs causes neutral genetic differentiation. Indeed, recent studies attributed host shifts to ecological factors and selection of ‘preadapted’ viral variants from the existing viral community. However, phenotypic differences between isolates and broad scale comparative and molecular evolutionary analyses indicate multiple barriers that Rabies virus must overcome through adaptation. This review assesses various lines of evidence and proposes a synthetic hypothesis for the respective roles of ecology and evolution in Rabies virus host shifts

Ophthalmoscopy versus non-mydriatic fundus photography in the detection of diabetic retinopathy in black patients

The contribution of non-mydriatic fundus photography in the detection of diabetic retinopathy before and after dilatation of the pupils in black diabetics was investigated and compared with direct ophthalmoscopy. Eighty-six patients were examined and good-quality photographs were obtained for 54,7% of eyes before and 86,6% of eyes after dilatation. Photographically documented retinopathy was detected by ophthalmoscopy in only 64,7% of eyes. The two methods were concordant for the presence of retinopathy in 62,2% of eyes before and 56,9% of eyes after dilatation. Photography through dilated pupils also i.mproved the rate of detection of diabetic retinopathy from 24% to 30%. The 45° non-mydriatic fundus camera was found to be a valuable adjunct in the detection of diabetic retinopathy in a busy diabetic clinic

Diabetes mellitus, pulmonary tuberculosis and chronic calcific pancreatitis revisited

The prevalence of chronic calcific pancreatitis (CCP) was determined in 25 successive patients with both diabetes mellitus and newly diagnosed pulmonary tuberculosis. Twenty patients (80%) were alcoholics and all were black. Of these, 9 (45%) had CCP. In only 3 of these 9 patients was the history compatible with the condition diagnosed. Clinical steatorrhoea was absent in the patients with CCP. PulmonarY tuberculosis was extensive with major involvement of three or more lung zones in 36% of patients. Mainly basal involvement of the lungs was present in 8% of patients