Effectiveness of shortcourse quinine and singledose sulfadoxinepyrimethamine in the treatment of Plasmodium falciparum malaria in Mpumalanga Province, South Africa

Introduction. Quinine therapy for 7 days remains the mainstay for treating hospitalised malaria cases in South Africa. However, limited resources, including available beds and staff, often result in early discharge of non-severe cases, with quinine tablets for outpatient use. The effectiveness of shorter course quinine therapy coupled with a long-acting antimalarial drug has never been established in Africa, in particular in a population without malaria immunity.Methods. A study was conducted to evaluate the effectiveness of a 3-day course of therapy with quinine sulphate (10 mg/ kg 8-hourly) followed by a single dose of sulfadoxinepyrimethamine (SP) according to weight category, before discharge, for 133 hospitalised patients with uncomplicated Plasmodium falciparum malaria at Shongwe Hospital, Mpumalanga province, between February and July 1998. Study endpoints included clinical recovery and parasitological cure, including polymerase chain reaction (PCR) 42 days after initiating treatment.Results. One hundred and thirty of 131 patients (99%) successfully followed up for 42 days demonstrated clinical and parasitological cure. The remaining patient, who had evidence of a recrudescent infection on PCR, was 1 of 61 patients who were still parasitaemic on discharge from hospital.Conclusion. The abbreviated course of quinine therapy coupled with a single dose of SP for the treatment of nonsevere hospitalised cases of P. falciparum malaria, in an area with demonstrated low levels of SP resistance, was highly effective. This approach has potential benefits, including reduced duration of hospitalisation, fewer quinine-associated adverse events and protection against the evolution of quinine resistance by limiting unsupervised quinine therapy in the community. It may, however, be prudent to document a negative blood film before discharge from hospital

Factors impacting the selection of psychiatric hospitals for community service placement of nurses

Background. As a strategy to promote access to quality health services, including psychiatric nursing, compulsory community service for nurses wasintroduced in January 2008.Objective. To determine the factors impacting the KwaZulu-Natal College of Nursing (KZNCN) student nurses’ selection of psychiatric hospitals as theirplacement areas for community service.Methods. A quantitative, exploratory, descriptive research design was adopted. Convenience sampling was used to select 125 respondents from sixcampuses of KZNCN. An electronic 5-point Likert scale-based self-administered questionnaire was used to collect data. SPSS version 26 (IBM Corp.,USA) was used for data analysis.Results. The study found that the following factors impacted the selection of psychiatric hospitals for community service: insufficient time allocated forthe practice of psychiatry during training; fear of exposure to threat; poor infrastructure and scarce facilities; and insufficient danger allowance.Conclusion. A positive practice environment should be created in psychiatric hospitals to attract student nurses and retain them in the psychiatricenvironment after community service

Prevalence of soil transmitted nematodes on Nukufetau, a remote Pacific island in Tuvalu

BACKGROUND: The population of Nukufetau, a remote coral atoll island in Tuvalu in the Western Pacific, received annual mass drug administration (MDA) of diethylcarbamazine and albendazole under the Pacific Elimination of Lymphatic Filariasis program in 2001, 2002 and 2003, with the last MDA occurring six months before a cross-sectional survey of the whole population for soil transmitted helminths (STH). METHODS: A cross-sectional survey in May 2004 recruited 206 residents (35.2% of the population) who provided a single faecal sample that was preserved, concentrated and examined microscopically. RESULTS: Overall prevalence of STH was 69.9%; only hookworm and Trichuris trichiura were diagnosed. Trichuris was present in 68.4% with intensity of infection being light in 56.3%, medium in 11.7% and heavy in 0.5%. Hookworm occurred in 11.7% with intensity of infection 11.2% being light and medium in 0.5%. Twenty individuals (9.7%) had dual infections. The prevalence of Trichuris was constant across all ages while the prevalence of hookworm was significantly lower in residents below 30 years of age. In the age group 5–12 years comparison of results with a 2001 survey [1] suggested that the prevalence of STH has declined minimally, due to sustained high prevalence of Trichuris, while hookworm has declined dramatically from 34.4% to 1.6%. CONCLUSION: The results of this survey suggest that although the MDA appears to have reduced hookworm prevalence in residents below 30 years of age, there has been minimal effect on Trichuris prevalence. An integrated program to control STH is required

The African intellectuals’ project

Soon after taking the position of editor of IJARS at the beginning of 2019, I was contacted by the dean of Unisa’s College of Graduate Studies (CGS), Prof. Lindiwe Zungu, who informed me that the university’s principal and vice-chancellor, Prof. Mandla Makhanya, had decided to revive his project, the African Intellectuals’ Project (AIP). I was asked to coordinate this project, through which Makhanya sought to invite scholars, academics, and intellectuals, both on and outside of the African continent, to deliver presentations reflecting on the ills afflicting Africa and, at the same time, to offer possible solutions. In pursuing the AIP, Prof. Makhanya was carrying on a perennial tradition

Uraemic tumoral calcinosis in patients on haemodialysis in the renal unit at Dr George Mukhari Hospital, Pretoria

Objective. Uraemic tumoral calcinosis refers to metastatic calcifications that occur rarely on the extensor surfaces of joints in patients undergoing long-term haemodialysis. The aim of the study was to assess the incidence of uraemic tumoral calcinosis in participants undergoing haemodialysis and to investigate any relationship that might exist between the development of uraemic tumoral calcinosis and the length of time on dialysis. Design. Twenty-four of the 25 patients on haemodialysis at the time of the study underwent radiographs of their shoulders and hips to look for calcinosis, which were then read by the researcher and two independent readers to assess for calcinosis. Study setting. Dr George Mukhari Hospital, Pretoria. Results. Eight per cent (N=2) of participants were found to have asymptomatic calcinosis of the hips. No relationship to length of time on dialysis was found. Conclusions. The study was constrained by a small sample size but the presence of calcinosis in 8% of the participants indicates that an extensive study of a larger sample could prove to be useful in determining the true incidence of uraemic tumoral calcinosis in the region. Long-term follow-up could provide more information on the development of calcinosis and length of time on dialysis