Does whole-cell pertussis vaccine protect black South African infants? Assessment of post-vaccination events and antibody responses to pertussis toxin, filamentous haemagglutinin and agglutinogens 2 and 3

The whole-cell pertussis vaccine currently used in South Africa has not been adequately evaluated for post-vaccination events and immunogenicity. A trial of this vaccine combined with diphtheria and tetanus toxoids (DTP) was undertaken in 115 black babies who received primary vaccination at 2, 4 and 6 months of age. Serological IgG responses to the major antigens of Bordetella pertussis, filamentous haemagglutinin (FHA), pertussis toxin (PT) and fimbriae (agglutinogens 2 and 3 (AGG 2 + 3), were evaluated by enzyme-linked immunosorbent assay in sera obtained at birth, and before vaccination at 2,4 and 6 months and at 9 months. Surprisingly, after 3 doses of DTP, responses to PT and FHA were found merely to restore levels of IgG to PT and FHA to those found in cord blood. In contrast with the positive increases in these antibodies found in other series of whole-cell vaccination, the anti-PT seroconversion rate was only 19% and the anti-FHA rate only 24%. High levels of anti-AGG 2 + 3 were produced with 67,2% seroconversion.The frequency and nature of post-vaccination events were recorded. Incidences of all reactions to the vaccine were low (7,6%): Fever (3,2%) and excessive crying (2,4%) were the most frequency occurring minor events. The rate of neurological post-vaccination events (without sequelae) during the brief follow-up period was 2 hypotonic-hyporesponsive  episodes (8,03/1 000 doses) and 1 convulsion (4,02/1000 doses).Significant pertussis antibody levels were found in maternal and cord sera with levels in the latter frequently being higher. Three cases of pertussis occurred during the study period. Only 1 of the subjects had completed primary vaccination. In view of these findings, the need for a proper efficacy and safety study of the currently used DTP vaccine is urgently indicated in South Africa

Scope and Limitations of Barbituric and Thiobarbituric Amino Acid Derivatives as Protecting Groups for Solid-Phase Peptide Synthesis: Towards a Green Protecting Group

DMB (Dimethylbarbituric) and DETB (Diethylthiobarbituric) are both barbituric and thiobarbituric acid derivatives respectively, that forms enamines with the Nα amine of amino acids. These compounds were found to be stable crystalline solids and show stability in the standard acidic and basic conditions used for solid-phase peptide synthesis (SPPS) strategies. These protecting groups are cleaved by a mild solution of 2 % hydrazine hydrate in DMF and 2 % hydroxylamine in DMF, both at short reaction times. Their use in SPPS showed that DMB-protected amino acids allow the preparation of peptides and therefore could be an alternative to the Fmoc strategy currently used. A further advantage of these protecting groups is that their preparation does not involve the concourse of phosgene derivatives and therefore they could be considered greener protecting groups than the carbamate-based one.This work was funded in part by the National Research Foundation (NRF) (#105892 and Blue Sky's Research Programme#120386). The authors thank the Deanship of Scientific Research at King Saud University for funding this work through research group no. (RG-1441-365, Saudi Arabia). Special thanks go to Merck-Millipore-Sigma Aldrich for financial support and Dr. Peter White for continuous advice.Peer reviewe

Mapping indicators of sexually transmitted infection services in the South African public health sector.

BACKGROUND: Prevention and early treatment of sexually transmitted infections (STIs) is a high public health priority in South Africa. In 2002 a national survey of public health care (PHC) facilities was conducted to develop measurable indicators for monitoring and evaluation of the National STI programme. In this paper we present maps of key indicators obtained from the survey, and discuss their programmatic implications. We also address some methodological issues that arise in the context of producing appropriate maps. METHODS: A national sample, stratified by subdistrict/municipality, of 962 PHC facilities was randomly selected. In each facility the senior nurse was telephonically contacted and interviewed to answer questions related to the implementation of STI prevention and management from a structured questionnaire. Responses were validated through a second phone call, and inconsistencies recorded. The following key variables were mapped: stock-outs of drugs and condoms, knowledge of correct treatment procedures, consistent record keeping, number of STI clients seen per month per 1000 adult population, number of condoms distributed per adult male, and number of trained nurses per 1000 population. Using conditional autoregressive models and Markov Chain Monte Carlo (MCMC) simulation, smoothed subdistrict level clinic responses were computed and 95% confidence limits estimated. RESULTS AND DISCUSSION: Drug stock-outs were reported by 13% [95% CI 10-15%] and condom stock-outs were reported by 4% [95% CI 2-5%] of facilities. Underlying geographical patterns of risk were more clearly observed when maps had been smoothed and were not dominated by sampling error. Smoothed maps show that there is a finite, low risk of drug stock-outs in all areas with higher risk regions more clearly identified. The maps of indicators of STI services at PHC facilities show that there are important differences in quality of service within South Africa and underscore the usefulness of facility level routine data both for local programme monitoring and planning and for providing a national "bird's eye view" of programme performance

Relationship between depression, anxiety, cognitive distortions, and psychological well-being among nursing students

Bahadir Yilmaz, Emel/0000-0003-1785-3539; Yuksel, Arzu/0000-0001-7819-2020WOS: 000490906000022PubMed: 31140627Purpose The aim of this study was to determine the relationship between depression, anxiety, cognitive distortions, and psychological well-being among nursing students. Design and Methods This descriptive, correlational, cross-sectional study was conducted with 330 nursing students. Data were collected using the Beck Depression Inventory (BDI), the Beck Anxiety Inventory (BAI), the Cognitive Distortion Scale (CDS), and the Psychological Well-being Scale (PWBS). Findings The PWBS negatively correlated with the BDI, BAI, and CDS (P < .05). Preoccupation with danger was the strongest predictor, followed by hopelessness, self-blame, total CDS and BDI (P < .05). Practice Implications Nursing students should be evaluated for psychological well-being to prevent psychiatric symptoms such as anxiety and depression.oral presentation at the 1st CongressThe authors would like to thank all study participants for participating in the study. This study is accepted as an oral presentation at the 1st Congress of Cognitive Behavioral Psychotherapies, Ankara, Turkey, from 18 October 2018 to 21 October 2018