Effectiveness of pneumococcal conjugate vaccine and rotavirus vaccine introduction into the South African public immunisation programme

KMImmunisation has contributed greatly to the control of vaccine-preventable diseases and therefore to improvements in health and survival, especially among young children, and remains one of the most successful and cost-effective public health interventions. This remains true for many of the newer, more expensive vaccines. Vaccines against invasive pneumococcal disease and rotavirus infection were introduced into the South African Expanded Programme on Immunization in April 2009. This article describes the rationale for and process of the introduction of these two vaccines, pneumococcal conjugate vaccine and rotavirus vaccine. It also aims to evaluate the success of and challenges related to their introduction, in terms of both achieving universal coverage and improving survival and health in South African children

Exploring Positive Living in the Face of HIV and AIDS: Implications for Life Skills

This is a research-based article outlining how HIV/AIDS affects men’s and women’s adjustment to positive living. It explores issues of challenge, survival and sexuality and offers culturally appropriate and sensitive life skills that may be adopted in schools, families and communities. Life skills education for risk reduction and living positively with HIV and AIDS needs to be carefully planned and executed, or else it runs the risk of increasing risk taking behaviour (Visser 2005), an important consideration that this article heeds

Best practice programme in the standardisation of traditional medicines: Evaluation of an immune booster formulated by traditional healers of the Vaal Triangle, South Africa

Background: Regulation and standardization of African traditional medicines (ATM) prescribed by traditional healers in South Africa is still far from being implemented. This is despite the fact that more people are using ATM products than ever. In an effort to demonstrate that collaboration with traditional health practitioners (THPs) can yield standardized TM products, this study aimed to evaluate the immunomodulatory effects of an herbal immune booster formulated by traditional healers from the Vaal Region, South Africa.Materials and Methods: Using normal and lipopolysaccharide (LPS) stimulated human peripheral blood mononuclear cells (PBMCs) models, doses of the immune booster ranging from 1000 to 10 μg/mL were evaluated for their cytotoxicity, inflammatory cytokines and chemokines secretion, nitric oxide (NO) secretion, malondialdehyde (MDA) assay, and 1,1-diphenyl-2-picrylhydrazyl (DPPH) assay.Results: The immune booster induced a dose dependent cytotoxic effect on both normal and LPS stimulated PBMCs with higher doses showing cytotoxicity while lower dose from 100μg/mL did not show any cytotoxicity. When re-dissolved in aqueous PBS immune booster doses up to 100 μg/mL showed better DPPH radical inhibition (41%) than ascorbic acid at 40μg/mL (33%). The immune booster also decreased lipid peroxides significantly (p< 0.05) and this was comparable to ascorbic acid. There was also a significant (p< 0.05) increase in nitrite (NO) after treatment of LPS stimulated PBMCs with immune booster doses when compared to untreated samples. The immune booster stimulated inflammatory cytokines secretion in normal PBMCs (IL 1α, IL 1β, IL 6, IL 10 and TNFα while showing a decrease in IFNγ at the higher dose) while in LPS stimulated PBMCs some cytokines were decreased (IL 1α, IL 17α and at lower doses IL 10 and TNFα) and others were increased (IFNγ, TNFα and GM-CSF) depending on the dose used. In both normal and LPS stimulated PBMCs the immune booster significantly (p< 0.05) increased (MIP 1α) while causing significant (p< 0.05) decreases in IP 10 (high dose), I-TAC and MIG secretion.Conclusions: This immune booster showed potential immunostimulatory effects by increasing nitric oxide, inflammatory cytokines and chemokines secretion in both normal and LPS stimulated PBMCs. This TM also showed promising antioxidant potential in the MDA and DPPH assays. Further in vitro and animal studies are warranted.Keywords: Traditional healers, traditional medicines, regulation, standardization, immune stimulatio

Credit provision by banks: a case study analysis of small businesses in South Africa

Small business sector is considered as an important economic driver by many countries. In South Africa, small business sector has been acknowledged as the driving force to boost the economic growth and an important source of job creation. This article aims at identifying factors that are a challenge in obtaining bank finance by small businesses in South Africa.Primary data for this study involved a survey questionnaire directed to owners of small businesses operating in Ekurhuleni Metropolitan area, Gauteng, South Africa. Factors that were deemed to influence bank loan decision were examined. The research findings revealed that factors such as age of business, business plans availability, educational background of business owner, experience of business owner and availability of a collateral have an influence on the bank loan decisions. This research also found that the accessibility of loan funding from banks was a constraint on business operations and growth. The findings of this study indicate that the mentioned factors are a challenge for small businesses in accessing bank loans to fund their operations.The findings of this study will be of great value to small business owners and policy makers in finding solutions to address the identified barriers

Synthesis of prenylated benzoquinones.

Thesis (M.Sc.)-University of KwaZulu-Natal, Pietermaritzburg, 2010.The research presented in this study demonstrates the critical role that organic synthesis plays in natural product chemistry. The biological activity demonstrated by 2-methyl-6-(3-methyl-2- butenyl)benzo-1,4-quinone prompted an investigation into the synthesis of this compound. This natural product showed significant activity against Staphylococcus epidermidis. Therefore the aim of this study was to synthesise 2-methyl-6-(3-methyl-2-butenyl)benzo-1,4- quinone and structural analogues. The regioselective synthetic route formulated for the synthesis of 2-methyl-6-(3-methyl-2- butenyl)benzo-1,4-quinone involved five steps. Different strategies towards the synthesis of this compound were investigated. The regioselective C-alkylation step was proving to be the most challenging. The synthetic strategies investigated included carbon alkylation of a phenoxide, directed-o-metallation, metal-halogen exchange and copper(II) Grignard-type metal halogen exchange. Problems were encountered with regioselectivity when carbon alkylation of a phenoxide was employed for the o-prenylation of o-cresol. The C-prenylated isomer was formed along with the O-prenylated isomer. When the reaction temperature was lowered, the yield of the desired C-prenylated isomer improved, whereas the yield of O-prenylated isomer declined. Although the reaction was performed under different conditions, the formation of the O-prenylated isomer could not be prevented. Therefore, another synthetic strategy was considered. The directed-o-metallation reaction was subsequently employed because of the associated regioselectivity. Unfortunately the desired product was not obtained when this method was employed. The reaction was attempted using different conditions, but the product could not be isolated. Since the directed-o-metallation protocol did not yield the desired results, another method was considered. Therefore, a metal-halogen exchange reaction was employed. The metal-halogen exchange transformation was preceded by the preparation of the o-brominated precursor. Regioselectivity-related problems were initially encountered during the synthesis of the obrominated precursor. The o-brominated isomer was formed in a 1:1 ratio with the pbrominated isomer. Further investigation led to a synthetic protocol that afforded the desired o-brominated isomer in a better yield. The metal-halogen exchange transformation was subsequently attempted, but the product was obtained in an unsatisfactory yield. Therefore, another method was employed in an effort to achieve regioselective C-alkylation with a better yield. Copper(II) Grignard-type metal-halogen exchange was successfully employed to achieve regioselective C-alkylation in good yield. The subsequent step was the deprotection, although problems were encountered, it was eventually achieved. The final step was the oxidation to obtain the desired compound, 2-methyl-6-(3-methyl-2-butenyl)benzo-1,4- quinone. The same procedure was successfully applied in the synthesis of structural analogues 2-isopentyl-6-methylbenzo-1,4-quinone, 2-(3,7-dimethylocta-2,6-dienyl)-6-methyl-1,4- benzoquinone and 2-(3,7-dimethyl-octyl)-6-methyl-1,4-benzoquinone

Effects of Sutherlandia frutescens Extracts on Normal T-Lymphocytes In Vitro

Sutherlandia frutescens (SF), a popular traditional medicinal plant found in various parts of southern Africa, is used for treatment or management of HIV/AIDS and other diseases including cancer. However, its toxicity profile has not been fully established. The aims of this study were to examine the effects of 70% ethanol (SFE) and deionised water (SFW) extracts on normal isolated human T cells. An experimental study on normal human lymphocytes treated with doses SF extract doses ranging from 0.25 to 2.5 mg/ml. Untreated, vehicle-treated (Ethanol) and camptothecin (CPT) treated normal T cells were used as controls. Induction of cell death, changes in intracellular ATP, caspase-3/-7 activity and nuclear changes were analysed using flow cytometry, luminometry and nuclear staining (Hoechst) respectively. The highest concentration (2.5 mg/ml) of SFE extract induced significant necrosis (95%), depletion of ATP (76%), and inhibition of caspase-3/-7 activity (11%) following a 24 hour incubation period (p< 0.001). The 2.5 mg/ml concentration of SFW showed the same trend but were less effective (necrosis- 26%, ATP- 91%, & caspase-3/-7- 15%). These effects showed a time-dependence over 48 hours of incubation, with high doses of SFE extracts eliminating viable cells by necrosis, depleting ATP levels and decreasing caspase-3/-7 activity (p< 0.001). The activity of SFE extract was independent of ethanol. The SFW extract dilutions were less toxic than the SFE extracts. Significant DNA fragmentation as demonstrated by Hoechst staining was also seen over 48-hour incubation for high doses of both types of SF extracts. These results showed that although high concentrations of SF extracts can be toxic to normal T cells in vitro, SFW fractions were relatively safe for use.Keywords: Sutherlandia frutescens, T lymphocytes, flow cytometry, luminometry, necrosis, apoptosi

Effectiveness of pneumococcal conjugate vaccine and rotavirus vaccine introduction into the South African public immunisation programme

Immunisation has contributed greatly to the control of vaccine-preventable diseases and therefore to improvements in health and survival, especially among young children, and remains one of the most successful and cost-effective public health interventions. This remains true for many of the newer, more expensive vaccines. Vaccines against invasive pneumococcal disease and rotavirus infection were introduced into the South African Expanded Programme on Immunization in April 2009. This article describes the rationale for and process of the introduction of these two vaccines, pneumococcal conjugate vaccine and rotavirus vaccine. It also aims to evaluate the success of and challenges related to their introduction, in terms of both achieving universal coverage and improving survival and health in South African children.

Using e-Delphi to formulate and appraise the guidelines for women’s health concerns at a coal mine: A case study

Background: E-Delphi is an online method widely used in health and social research to strengthen decision-making processes and reach consensus on developing guidelines for health services. Objectives: The e-Delphi technique was designed to formulate and appraise a set of criterion-referenced guidelines for women’s health concerns of mineworkers at a selected coal mine in Mpumalanga, South Africa. Method: The University Learning Management System’s discussion forum was customised to suit the characteristics of e-Delphi as the second phase of a primary study on the formulation of guidelines for women’s health concerns. Six purposively sampled experts with extensive experience in Occupational Health and in Women’s Health participated. Online engagements on the formulation and appraisal of the guidelines for women’s health concerns took 7 weeks, divided into four phases as preparatory, exploratory, consensus and refinement. From the experts’ inputs, guidelines were drafted. Experts were invited to evaluate the guidelines by using a 7-point Likert scale with AGREE II criteria. Consensus was reached in two e-rounds. Results: Eight guidelines were formulated, appraised and adopted as: change management, control of hazardous environments, suitable psychosocial working environment, provision of health care service, uphold human dignity and adherence to human rights, effective measures for safety participation compliance, accessible, available and relevant on-site health care services and hope and resilience. Each guideline has rationale, operational strategies and anticipated outcomes. Conclusion: E-Delphi platform used various tools to deliberate on the process of guidelines formulation and appraisal. The platfo

Human papillomavirus vaccination acceptance and hesitancy in South Africa: Research and policy agenda

Cervical cancer is responsible for one-quarter of a million deaths per year worldwide. In South Africa (SA), cervical cancer is the leading cause of cancer deaths among women aged 15 - 44 years. Human papillomavirus (HPV) vaccines provide a safe and highly effective means to reduce the burden of cervical cancer. The World Health Organization initiated a plan for the elimination of cervical cancer; the programme’s success relies on the introduction and high uptake of HPV vaccines globally. SA introduced a school-based HPV vaccination programme in 2014, but uptake is not as high as expected. Suboptimal HPV vaccination coverage may result from various factors, including vaccine hesitancy. Vaccine-hesitant parents may delay or refuse HPV vaccination for their daughters. Tailored interventions are needed to address this. However, knowledge regarding vaccine hesitancy and policies to address this hesitancy in SA are currently limited. While SA has taken commendable steps in cervical cancer prevention by implementing and financing the HPV vaccination programme, it is imperative that there are clear policies in place to help strengthen the programme. These policies need to clarify areas of uncertainty that may lead to mistrust, and pre-empt factors that will cause hesitancy. Equally important is that local research should be conducted to better understand HPV vaccination hesitancy and other determinants of uptake to further inform and shape national policies