Characterization of a murine gammaherpesvirus in vitro latency system

The human gammaherpesviruses EBV and KSHV realize their oncogenic potential during latent infection. The species specificity of the human gammaherpesviruses has hindered the study of latency in animal models. Murine gammaherpesvirus MHV-68 (MHV-68) may be used as a representative gammaherpesvirus for the study of latency. The goal was to establish an in vitro model of MHV-68 latency using replication defective MHV-68. ORF50 has been identified as the major viral trans-activator essential for entry into the lytic replication cycle and necessary and sufficient for reactivation of MHV-68 virus from latency. ORF50 null mutants (A50) can theoretically be used to infect cells in vitro to facilitate an analysis of virus gene expression and episome maintenance during latency. In this project A50 mutants containing the luciferase or green fluorescence protein (GFP) under OW50 promoter control were used to infect a variety of cell types. 3T3 fibroblasts are a permissive cell line and were used for an initial characterization of the ability of A50 MHV-68 to establish latency. B lymphocytes and macrophages are the major reservoirs of persistence in vivo thus the ability of A50 mutants to establish latency in NSO B and RAW macrophage cell lines was explored. Latency was readily established and maintained in 3T3 and RAW cells. The low infectability of NSO B- cells restricted the utility of this cell line in studies of latency. Examination of patterns of lytic and latent transcription in 3T3 and RAW cells coordinately infected with A50 MHV-68 revealed reactivation efficiencies of 40-60%. Following long-term passage A50 exhibited stable transcription of two latency related genes M2 and ORF73, with episomal maintenance of the viral genome, in the absence of contaminating lytic infection. The results demonstrate the utility of A50 mutants for studies of gammaherpesvirus latency in vivo

An assessment of the challenges of police child protection unit in providing services to vulnerable children in Alice, Eastern Cape Province

The study set out to assess the challenges that are faced by the South African Police child protection unit in providing services to vulnerable children in Alice, Eastern Cape Province. The study used the qualitative design. Data was collected using in-depth interviews in which twenty individual participants took part. The results indicate that the challenges of SAP child protection unit in providing services to vulnerable children in Alice, Eastern Cape Province are mainly financial based, emotionally stressful, labour related, and can be caused by parental oversight, legal constraints that begets lack of trust and also policing illegal child immigrants. These factors make the police child protection unit’s work challenging thereby hampering its effectiveness. It has therefore been recommended that the police child protection unit should be given the support due to them so as to make service delivery to vulnerable children in Alice effective. Also it has been recommended that children be educated that the police are there to enforce the law, assist and not to harm them

A survey of the Victoria Falls with a view to repositioning this key tourist attraction in Zimbabwe.

Thesis (MBA)- University of Kwazulu-Natal, 2004.This study looks at the ailing Zimbabwean tourism industry and efforts to reverse the negative trend in tourist arrivals. Despite this sector of the economy enjoying positive growth both globally and at a regional level, the local industry had been adversely affected by negative perceptions about the country. The Zimbabwe Tourism Authority (ZTA), whose mission is to professionally market Zimbabwe as a leading tourist destination, has embarked on various initiatives. Unfortunately however, the organisation has enjoyed limited success in recapturing the demand experienced in the years prior to 1999. In order to investigate other avenues to pursue, this study sought the perspectives of two major stakeholders of the local tourism industry. These were namely "buyers" comprising the international tourist, who were probed for their motivations in selecting a holiday destination. In addition, local "suppliers" to the sector who interface directly with the international traveller, were asked to give their perspective on the performance of the ZTA in fulfilling its mission. Personal interviews were conducted in the resort town of Victoria Falls. This area was chosen over other attractions in Zimbabwe because our neighbouring competitors, South Africa and Zambia have promoted the resort for their own benefit, at the expense of the local industry. Another reason is the worldwide recognition and appeal of the attraction, owing to its historical significance. The study established that the resort still enjoys immense popularity, with international visitors opting to return several times in order to gaze at the scenic wonder. However, since the falls lack a truly Zimbabwean identity or image, travel agents and tour operators have either channeled tourist to the Zambian side or flown them in via South Africa as day visitors. The resultant effect has been minimal financial benefit to Zimbabwe by way of receipts from tourist expenditure. Adopting a co-operative strategic orientation with these neighbouring countries is recommended. At a local level the study found that the local tourism industry lacked a unified approach in tackling the challenges facing sector

Post natal care in Bubi district deserves more attention

A CAJM medical article.Objectives: To establish whether, where and when women in Bubi District attend Post Natal Care (PNC), the factors that influence attendance, the quality of services and traditional or cultural practices felated to PNC. Design: A cross sectional survey. Setting: Bubi District, Matebeleland North Province, Zimbabwe. Subjects: A multistage sample of 200 women with a child aged three to 12 months, convenience samples of .96 women with a child zero to 12 months who had attended PNC; 112 elderly women from the community and 10 nurses. Main Outcome Measures: PNC attendance, place and timing of PNC visit, quality of PNC, knowledge and attitudes towards PNC and traditional practices Results: 61% of the women had attended PNC. Factors associated with non-attendance were higher age and parity, home delivery and long distance between home and health facility. Almost all women attended PNC in a district health facility. Eighty three percent were seen at six weeks post par turn. Forty percent of the mothers and 36.1% of the babies had received a full examination, but 37.7% and 4.9% respectively had not been examined at all. Nine of the 10 nurses interviewed were not aware of a PNC policy. Knowledge on PNC among the women in the community was poor. Some potentially beneficial and harmful traditional practices related to mother and baby were identified. Conclusion: PNC attendance in this study was almost three times the attendance reported through the routine National Health Information System, but lower than elsewhere in Zimbabwe. The quality of the services was rather poor and more geared towards the baby than the mother. Both health workers and the community need to better understand the importance of PNC. Because the first two weeks postpartum is the period with highest morbidity and mortality, women should be advised to make a PNC visit within 14 days, or whenever they have problems, rather than at six weeks. All health facilities, including the mobile teams should be able to offer PNC. There is need to develop an ‘ evidence-based’ PNC policy to guide nurses on what to offer to both mother and baby, also taking into consideration common traditional practices

Economic evaluation of psychological treatments for common mental disorders in low- and middle-income countries: a systematic review

Common mental disorders (CMDs) constitute a major public health and economic burden on low- and middle-income countries (LMICs). Systematic reviews of economic evaluations of psychological treatments for CMDs are limited. This systematic review examines methods, reports findings and appraises the quality of economic evaluations of psychological treatments for CMDs in LMICs. We searched a range of bibliographic databases (including PubMed, EconLit, APA-PsycINFO and Cochrane library) and the African Journals Online (AJoL) and Google Scholar platforms. We used a pre-populated template to extract data and the Drummond & Jefferson checklist for quality appraisal. We present results as a narrative synthesis. The review included 26 studies, mostly from Asia (12) and Africa (9). The majority were cost-effectiveness analyses (12), some were cost-utility analyses (5), with one cost–benefit analysis or combinations of economic evaluations (8). Most interventions were considered either cost-effective or potentially cost-effective (22), with 3 interventions being not cost-effective. Limitations were noted regarding appropriateness of conclusions drawn on cost-effectiveness, the use of cost-effectiveness thresholds and application of ‘societal’ incremental cost-effectiveness ratios to reflect value for money (VfM) of treatments. Non-specialist health workers (NSHWs) delivered most of the treatments (16) for low-cost delivery at scale, and costs should reflect the true opportunity cost of NSHWs’ time to support the development of a sustainable cadre of health care providers. There is a 4-fold increase in economic evaluations of CMD psychological treatments in the last decade over the previous one. Yet, findings from this review highlight the need for better application of economic evaluation methodology to support resource allocation towards the World Health Organization recommended first-line treatments of CMDs. We suggest impact inventories to capture societal economic gains and propose a VfM assessment framework to guide researchers in evaluating cost-effectiveness

Risk profile of postnatal women and their babies attending a rural district hospital in South Africa

BackgroundMaternal and neonatal mortality remain unacceptably high and inequitably distributed in South Africa, with the postnatal period being a dangerous time for both mother and baby. The aim of this paper is to describe the risk factors for poor postnatal outcomes, including postnatal mental health disorders, in a population of postnatal women and their babies utilising rural district hospital services in Limpopo Province, with a focus on HIV. We also describe health care provider compliance with relevant guidelines.MethodsAll women discharged from the postnatal ward of the district hospital who consented to participate were enrolled. A research nurse used a structured questionnaire to collect data about sociodemographic information, pregnancy and pre-existing conditions, complications during labour and birth, pregnancy outcomes and mental health risk factors.ResultsThe questionnaire was completed for 882 women at the time of discharge. Only 354 (40.2%) of participants had completed secondary education, and 105 (11.9%) reported formal employment. Chronic hypertension was recorded in 20 women (2.3%), with an additional 49 (5.6%) developing a hypertensive disorder during pregnancy. HIV prevalence was 22.8%. 216 women (24.5%) had a mental health risk factor, with 40 reporting more than one (4.5%). Having no income, no antenatal care, having HIV and any hypertensive disorder were significantly associated with a positive mental health risk screen in multivariable analysis. There were 31 stillbirths and early neonatal deaths (3.5%), and 119 babies (13.4%) were born at a low birth weight. Stillbirth or early neonatal death was significantly associated with no antenatal care in multivariable analysis.ConclusionsWomen and babies in this study experienced multiple risk factors for poor outcomes in the postpartum period. Postnatal care should be strengthened in order to address the dominant risks to mothers and babies, including socioeconomic challenges, HIV and hypertension, and risks to mental health. Tools to identify mothers and babies at risk of postnatal complications would allow limited resources to be allocated where they are most needed

Access to and Satisfaction with Basic Services in Informal Settlements: Results from a Baseline Assessment Survey

Subjective responses of satisfaction with basic services delivery is an indicator of service delivery performance. This study provides an overview of the status of basic service delivery and determines the factors associated with service delivery satisfaction within informal settlements targeted for upgrading in South Africa. A multinomial logistic regression was used to analyze the relationship between satisfaction with basic services of water, sanitation, refuse and electricity with several predictors including individual factors, household factors, community factors and service-related factors. The most common source of drinking water, toilet facility and refuse disposal method were communal tap (55%) pit latrine (53%) and local authorities (34%), respectively. Approximately 52% of the respondents in the study reported not having access to electricity. Results also show that satisfaction in basic services delivery varies and is influenced by service-related factors. Interventions targeted at improving the quality of basic service provided are essential to meet the targets set out in the sustainable development goals

Multifocal extramammary Paget’s disease-associated adenocarcinoma: a rare condition of flexoral skin of multiple sites

Extramammary Paget disease (EMPD) is a rare malignant neoplasm of apocrine sweat glands that is morphologically and histologically identical to Paget disease of the breast. The primary lesion is usually a solitary, well-demarcated, erythematous, scaly plaque that may contain crust, erosions, or ulcerations. The vulva is the most common site, but any area containing apocrine sweat glands may be involved. We present a case of triple extramammary Paget disease of the groin and bilateral axillae in a diabetic patient whose axillary lesions appeared consistent with acanthosis nigricans. This case demonstrates the need to consider EMPD in the evaluation of acanthosis of the axilla given its ability to mimic more common conditions