Empirical investigation of ethical issues raised by two research ethics committees reviewing biomedical research in South Africa.

Doctor of Philosophy in Psychology. University of KwaZulu-Natal, Pietermaritzburg 2017Abstract available in PDF file

Molecular detection and drug susceptibility of Mycobacterium tuberculosis complex in raw milk from a major dairy farm in the Nkonkobe region, Eastern Cape Province, South Africa

Mycobacterium tuberculosis complex (MTBC) organisms are the causative agents of tuberculosis in humans as well as animals. The study aimed to use molecular techniques for detection and drug susceptibility testing of MTBC in raw milk from cattle at a dairy farm in the Nkonkobe region of South Africa. Two hundred samples (100mL each) were collected and processed using the modified Petroff’s method. DNA was isolated using the Zymo Research bacterial DNA kit and amplified using the Seeplex® MTB Nested ACE assay. Drug susceptibility testing was performed using the Genotype® MTBDRplus assay. MTBC DNA was detected in 11 (6percent) of the samples tested. Resistance to both rifampicin and isoniazid was detected in 90.9percent of the positive samples. The most frequent rpoB mutations detected were H526Y (90percent), H526D (80percent), S531L (60percent) and D516V (20percent). No mutation was detected in the katG gene. All isoniazid resistant samples harboured mutations in the inhA gene. The most frequent (100percent) mutation conferring low level isoniazid resistance was the T8A substitution. The inhA mutations C15T, A16G and T8C were equally represented with 60percent frequency. A high prevalence of multi-drug resistance was noted in the Nkonkobe region. Therefore, the results of this study have clinico-veterinary and epidemiological significance and calls for further studies and necessary actions to delineate the situation.Thesis (MSc) -- Faculty of Science and Agriculture, 201

An ethics of anthropology-informed community engagement with COVID-19 clinical trials in Africa

The COVID-19 pandemic has reinforced the critical role of ethics and community engagement in designing and conducting clinical research during infectious disease outbreaks where no vaccine or treatment already exists. In reviewing current practices across Africa, we distinguish between three distinct roles for community engagement in clinical research that are often conflated: 1) the importance of community engagement for identifying and honouring cultural sensitivities; 2) the importance of recognising the socio-political context in which the research is proposed; and 3) the importance of understanding what is in the interest of communities recruited to research according to their own views and values. By making these distinctions, we show that current practice of clinical research could draw on anthropology in ways which are sometimes unnecessary to solicit local cultural values, overlook the importance of socio-political contexts and wider societal structures within which it works, potentially serving to reinforce unjust political or social regimes, and threaten to cast doubt on the trustworthiness of the research. We argue that more discerning anthropological engagement as well as wider collaboration with other social scientists and those working in the humanities is urgently needed to improve the ethics of current biomedical and pharmaceutical research practice in Africa

Molecular Detection and Drug Resistance of Mycobacterium tuberculosis Complex from Cattle at a Dairy Farm in the Nkonkobe Region of South Africa: A Pilot Study

Mycobacterium tuberculosis complex (MTBC) causes tuberculosis (TB) in humans and animals. We investigated the presence of MTBC in cattle milk and its drug resistance using polymerase chain reaction (PCR). Two hundred samples (100 mL each) were obtained from a dairy farm in the Nkonkobe region of South Africa. The samples were processed using the modified Petroff method. DNA was isolated using a Zymo Bacterial DNA kit and amplified using Seeplex® MTB Nested ACE assay. The Genotype® Mycobacterium tuberculosis-multidrug resistantplus (MTBDRplus) assay was used to perform drug susceptibility and detection of mutations conferring resistance to isoniazid (INH) and rifampicin (RIF). Eleven samples tested positive for MTBC DNA using the Seeplex® MTB Nested ACE assay. The Genotype® MTBDRplus assay showed that 10/11 samples were resistant to both INH and RIF i.e., multi-drug resistant (MDR). The most and least frequent rpoB mutations detected in RIF resistant samples were H526Y (9/10) and D516V (2/10) respectively. None of the INH resistant samples harbored mutations in the katG gene. However, all of them harbored the T8A mutation in the inhA gene. These results have clinical and epidemiological significance and calls for further studies and necessary actions to delineate the situation