School-based human papillomavirus vaccination: An opportunity to increase knowledge about cervical cancer and improve uptake of screening

Background. Poor knowledge about cervical cancer plays a role in limiting screening uptake. HPV vaccination provides an untested platform to distribute information that could possibly improve knowledge and screening coverage.Objective. To measure changes in knowledge and screening uptake when information and screening opportunities were provided to mothers of adolescent HPV vaccine recipients.Methods. During an HPV vaccine implementation project in the Western Cape (WC) and Gauteng Province (GP), South Africa, information about cervical cancer was provided to parents during a lecture, written information was distributed, and mothers were then invited to either screen at their clinic (WC) or use a self-screening kit (GP). A structured questionnaire was used to test cervical cancer knowledge and screening practices, comparing these before and after the project and between the two screening groups.Results. Complete data for both questionnaires were available for 777 of 906 recruited women. Initial knowledge was poor, but on retesting 6 months later, knowledge about symptoms (p<0.005), screening (p<0.005) and vaccination (p<0.05) improved significantly after the information session and school-based HPV vaccination. In the second questionnaire, women reported significantly more screening and the last reported screening test was more recent. This improvement was more favourable in GP than in the WC (41% v. 26% reporting screening in the past 12 months).Conclusion. These results demonstrate how adolescent HPV vaccine programmes can help to control cervical cancer among mothers by offering information and screening. It is important not to lose this opportunity to educate mothers and their daughters and offer effective methods to prevent cervical cancer in both generations

Long-stay medical-surgical intensive care unit patients in South Africa : quality of life and mortality 1 year after discharge

BACKGROUND. Although mortality is the primary measure of critical care outcome, the health-related quality of life (HRQOL) of survivors is often diminished. There is a paucity of South African research on HRQOL in intensive care unit (ICU) survivors. OBJECTIVES. To evaluate the 1-year post-discharge data of long-stay ICU patients, a group known to consume 20 - 40% of ICU resources. METHODS. A 1-year prospective observational study was conducted in a multidisciplinary medical-surgical ICU. Adult patients who were mechanically ventilated beyond 6 days were included. Clinical and mortality data were collected. Pre-admission and 6- and 12-month HRQOL were measured with the Short Form-36 questionnaire. Physical and mental component summary scores (PCS and MCS) were calculated. Associations between 12-month mortality and poor HRQOL scores were determined. RESULTS. Of 119 patients enrolled, 40.3% had sustained trauma, 19.3% were post-surgical and 40.3% had medical conditions; 29.2% were HIV-positive (HIV status was known for 74.8% of the cohort). The hospital and 12-month mortality rates were 42.9% and 57.4% (n=66/115), respectively. Age, longer ICU stay, higher disease severity scores and vasopressor use were associated with 12-month mortality. The survivors’ median PCS and MCS at 6 and 12 months were significantly lower compared with pre-admission scores (both p<0.001). At 12 months, 53.1% of survivors demonstrated a poor PCS and 42.9% a poor MCS. Associations with poor 12-month PCS included longer ICU stay, male gender and trauma, while trauma and sepsis were associated with a poor 12-month MCS. Among the 19 trauma survivors, 78.9% had a poor MCS and/or PCS. Of previously employed patients, 54.8% were unemployed at 12 months. CONCLUSIONS. Patients ventilated beyond 6 days in a multidisciplinary ICU had a high mortality. Poor HRQOL at 12 months post discharge was frequently observed among survivors. Trauma was associated with poor 12-month outcomes. These findings highlight the need to further explore the outcomes of long-stay ICU patients in Africa.South African Critical Care Society research grant.http://www.samj.org.zadm2022Critical Car

Suicide cases investigated at the state mortuary in Bloemfontein, 2003–2007

Background: Up to 8 000 South Africans commit suicide annually. This study aimed to investigate the profile of suicide cases in Bloemfontein and the southern Free State province.Methods: A cross-sectional descriptive study was performed. Suicides in the Bloemfontein and southern Free State areas (Xhariep and Motheo districts) investigated at the state mortuary in Bloemfontein in 2003 to 2007 were included. Data were collected retrospectively by using a specially designed data-capturing form.Results: A total of 469 suicide cases were included in the study. The estimated suicide rate for this part of the Free State province was 10.9/100 000 of the population per year. The majority (82.1%) of the victims were men. In total, 338 (72.1%) of the victims were black, 122 (26.0%) were white, five (1.1%) were coloured and three (0.6%) were Indian. The most common methods were hanging (262; 55.9%), shooting (99; 21.1%) and overdosing on pills (43; 9.2%). Most cases (57.8%) occurred in victims 21 to 40 years of age. Five (1.1%) victims were children younger than 11 years of age, while 12 (2.6%) were older than 65 years. More than half (267 cases; 56.9%) of the suicide victims were unemployed. The majority(43.1%) of suicides occurred in January to April of each year, with the highest incidence (67 cases; 14.3%) in January. Conclusion: The rate of suicide and the profile of victims with regard to the variables investigated corresponded to findings reported from other studies. The information obtained could make a meaningful contribution to suicide-preventionprogrammes.Keywords: suicide; profile; rate; prevention; Free State Provinc

Evaluation of nutrition care to adult patients on HAART attending primary healthcare facilities in Mpumalanga

CITATION: Schiever, J. F. et al. 2019. Evaluation of nutrition care to adult patients on HAART attending primary healthcare facilities in Mpumalanga, South African Journal of Clinical Nutrition, 32(1):13-20. doi:10.1080/16070658.2017.1412183The original publication is available at https://www.tandfonline.com/toc/ojcn20/currentObjectives: This study aimed to evaluate nutrition care and nursing professional knowledge received by adults on highly active antiretroviral therapy attending primary health care (PHC) facilities Design: Cross-sectional, descriptive study. Subjects and setting: The study was conducted on 263 adults and 75 nursing professionals, recruited from 19 facilities in the Mbombela sub-district, Mpumalanga. Outcome measures: Interviewer-administered questionnaires were completed for each patient. Nursing professionals completed a self-administered questionnaire. Assessment tools were completed for each facility. Results: Some 41% of patients were either overweight or obese, and most females (n = 87; 51.8%) had a BMI ≥ 25 kg/m2. Based on waist circumference, 52.7% (n = 88) of females and 8.4% (n = 8) of males showed increased risk of cardiovascular disease. Although nurses were aware of a nutrition supplementation programme, knowledge of national nutrition guidelines was inadequate. Clinical judgement, rather than eligibility criteria, was used to identify suitable patients, with 13.3% (n = 35) receiving supplementation whereas only 4.9% (n = 13) qualified. Facilities generally had sufficient equipment and fair storage conditions, but stock shortages of nutrition supplements were problematic. Conclusions: Whilst certain positive findings emerged, nutrition care could be improved, largely through adequate training and support to professional nurses. Training should focus on correct execution of assessment measurements and appropriate nutritional counselling, emphasising balanced eating, food security and prevention of over-nutrition. Nurses should be familiarised with national nutrition guidelines and have access to a constant nutrition supplementation supply. Improved monitoring and evaluation of nutrition care to adults on treatment at PHC facilities is needed.https://www.tandfonline.com/doi/full/10.1080/16070658.2017.1412183Publisher’s versio

Nitrogen dynamics in land cleared of alien vegetation (Acacia saligna) and impacts on groundwater at Riverlands Nature Reserve (Western Cape, South Africa)

Woody invading alien plants, many of which are nitrogen-fixing legumes (Fabaceae family), are currently cleared in South African catchments to reduce water loss and preserve streamflow, and for the restoration of the ecosystem. This study tested the hypothesis that clearing invasive alien vegetation may disturb the vegetation-micro-organism-soil N cycling system by producing a large once-off input of fresh tree litterfall rich in N and by eliminating a large N sink. Three experimental plots were established at the Riverlands Nature Reserve (Western Cape, South Africa): a site invaded by Acacia saligna to be used as control; a site cleared of Acacia saligna; and a site with natural vegetation to be used as background. Nitrogen concentrations in soil and groundwater, volumetric soil water contents, root density and weather conditions were measured during 2007. Oxidised forms of nitrogen, in particular NO3-, were dominant in the system. Recharge and leachate were simulated with the HYDRUS-2D model and used as inputs into Visual MODFLOW to predict the spatial distribution of nitrate plus nitrite (NOx) in groundwater. NOx levels in soil and groundwater were higher in alien-invaded areas compared to fynbos-covered land. A quick release of NOx into groundwater was observed due to high residual N reserves in the rooting zone, decreased&#160; evapotranspiration and increased recharge in the treatment cleared of alien vegetation. In the long run, high NOx concentrations in groundwater underlying cleared land will last only until all the excess nitrogen has been leached from the soil. A decrease in NOx concentration in groundwater can be expected thereafter. Clearing land of alien invasive legumes may therefore have a beneficial effect by reducing groundwater contamination from NOx and reducing water losses in catchments

Straight Line Orbits in Hamiltonian Flows

We investigate periodic straight-line orbits (SLO) in Hamiltonian force fields using both direct and inverse methods. A general theorem is proven for natural Hamiltonians quadratic in the momenta in arbitrary dimension and specialized to two and three dimension. Next we specialize to homogeneous potentials and their superpositions, including the familiar H\'enon-Heiles problem. It is shown that SLO's can exist for arbitrary finite superpositions of $N$-forms. The results are applied to a family of generalized H\'enon-Heiles potentials having discrete rotational symmetry. SLO's are also found for superpositions of these potentials.Comment: laTeX with 6 figure

A Panel of Ancestry Informative Markers for the Complex Five-Way Admixed South African Coloured Population

Admixture is a well known confounder in genetic association studies. If genome-wide data is not available, as would be the case for candidate gene studies, ancestry informative markers (AIMs) are required in order to adjust for admixture. The predominant population group in the Western Cape, South Africa, is the admixed group known as the South African Coloured (SAC). A small set of AIMs that is optimized to distinguish between the five source populations of this population (African San, African non-San, European, South Asian, and East Asian) will enable researchers to cost-effectively reduce false-positive findings resulting from ignoring admixture in genetic association studies of the population. Using genome-wide data to find SNPs with large allele frequency differences between the source populations of the SAC, as quantified by Rosenberg et. al's -statistic, we developed a panel of AIMs by experimenting with various selection strategies. Subsets of different sizes were evaluated by measuring the correlation between ancestry proportions estimated by each AIM subset with ancestry proportions estimated using genome-wide data. We show that a panel of 96 AIMs can be used to assess ancestry proportions and to adjust for the confounding effect of the complex five-way admixture that occurred in the South African Coloured population.Department of HE and Training approved lis

Diseases of groundnut in the Southern African Development Community (SADC) region and their management

Groundnut is an important food and cash crop in the Southern African Development Community (SADC) region, and is grown largely by smallholder farmers under low input conditions. Constraints are many and varied, both between and within the member states, but diseases are generally regarded as major constraints to groundnut production throughout the region. A large number of fungal, viral, nematode, and bacterial diseases of groundnut have been reported. Most of the diseases are widespread, but only a few of them are economically important on a regional basis. In this paper, the current distribution and economic importance of leaf spots, web blotch, rust, gray mould, pod rots, blackhull, Sclerotinia blight, stem rot, seedling diseases, aflatoxin contamination, rosette, groundnut streak necrosis, pod nematode, and pod scab nematode diseases, and various options (chemical control, host-plant resistance and cultural practices) for their management, are briefly reviewed. Future research needs on groundnut diseases in the region are discussed

PLoS Pathog.

Transmission of Helicobacter pylori is thought to occur mainly during childhood, and predominantly within families. However, due to the difficulty of obtaining H. pylori isolates from large population samples and to the extensive genetic diversity between isolates, the transmission and spread of H. pylori remain poorly understood. We studied the genetic relationships of H. pylori isolated from 52 individuals of two large families living in a rural community in South Africa and from 43 individuals of 11 families living in urban settings in the United Kingdom, the United States, Korea, and Colombia. A 3,406 bp multilocus sequence haplotype was determined for a total of 142 H. pylori isolates. Isolates were assigned to biogeographic populations, and recent transmission was measured as the occurrence of non-unique isolates, i.e., isolates whose sequences were identical to those of other isolates. Members of urban families were almost always infected with isolates from the biogeographic population that is common in their location. Non-unique isolates were frequent in urban families, consistent with familial transmission between parents and children or between siblings. In contrast, the diversity of H. pylori in the South African families was much more extensive, and four distinct biogeographic populations circulated in this area. Non-unique isolates were less frequent in South African families, and there was no significant correlation between kinship and similarity of H. pylori sequences. However, individuals who lived in the same household did have an increased probability of carrying the same non-unique isolates of H. pylori, independent of kinship. We conclude that patterns of spread of H. pylori under conditions of high prevalence, such as the rural South African families, differ from those in developed countries. Horizontal transmission occurs frequently between persons who do not belong to a core family, blurring the pattern of familial transmission that is typical of developed countries. Predominantly familial transmission in urban societies is likely a result of modern living conditions with good sanitation and where physical contact between persons outside the core family is limited and regulated by societal rules. The patterns observed in rural South African families may be representative of large parts of the developing world