Adolescent alcohol use in rural South African high schools

Objective: To examine psychosocial correlates of lifetime alcohol use among adolescents in rural South African high schools.Method: Questionnaires were administered to 1600 students from 20 randomly selected high schools in the Mankweng district within Limpopo province. Self-report data on alcohol use, demographic, environmental and psychosocial variables were collected.Results: About 22% of the students had ever used alcohol. Males were 2.4 times more likely to use alcohol than females. For students who attended religious services, the odds of ever having used alcohol were double those of students who did not attend religious services. The fitted logistic regression model shows that gender, age, ever having smoked a cigarette, ever damaged property, walking home alone at night, easy availability of alcohol, thinking alcohol use was wrong, attending religious servicesand number of friends who used alcohol are the best predictors of alcohol use among high school students in this setting.Conclusion: The results underline the importance of addressing personal, family, peer and school conduct factors as part of alcohol education initiatives. Efforts to prevent alcohol use among rural high school students should focus on changing drinking behaviour and on reducing risk factors for problem drinking

Injury-related behaviour among South African high-school students at six sites

Objectives. To document and compare prevalence rates of adolescent injury-related risk behaviours at six sites in South Africa. Design. The identical self-administered instrument was used at all sites. Prevalence rates (with 95% confidence intervals) were calculated taking the multistage cluster sampling strategy into account. Setting and subjects. In Cape Town, Durban, Port Elizabeth and Mankweng participants were drawn from either grades 8 or 9, and grade 11, while in Queenstown and Umtata they were drawn from grade 11 only. We selected 39 schools in Cape Town and Durban, 33 in Port Elizabeth and 20 in each of the rural areas. Outcome measures. Road-related risk behaviour, violence, and suicide attempts. Results. Across the sites there were high rates of risk behaviour in all domains. For example, in the 12 months preceding the survey an estimated 52.8% of grade 11 males in Cape Town had travelled in the front seat of a motor vehicle without a seatbelt, 33.0% of grade 8 males in Mankweng had bullied others, while 44.5% of the same group had been bullied, and 18.6% of females in Port Elizabeth had attempted suicide. Rates were lower in rural areas for behaviour involving motor vehicles, but there were no consistent urban-rural findings for violence-related behaviour. Females were at higher risk of suicidal behaviour and males were at higher risk of other injury-related behaviour. Conclusions. There is a need for effective interventions to reduce the extent of injury-related risk behaviour in adolescents in urban and rural settings

The Pan-University Network for Global Health: framework for collaboration and review of global health needs

In the current United Nations efforts to plan for post 2015-Millennium Development Goals, global partnership to address non-communicable diseases (NCDs) has become a critical goal to effectively respond to the complex global challenges of which inequity in health remains a persistent challenge. Building capacity in terms of wellequipped local researchers and service providers is a key to bridging the inequity in global health. Launched by Penn State University in 2014, the Pan University Network for Global Health responds to this need by bridging researchers at more than 10 universities across the globe. In this paper we outline our framework for international and interdisciplinary collaboration, as well the rationale for our research areas, including a review of these two themes. After its initial meeting, the network has established two central thematic priorities: 1) urbanization and health and 2) the intersection of infectious diseases and NCDs. The urban population in the global south will nearly double in 25 years (approx. 2 billion today to over 3.5 billion by 2040). Urban population growth will have a direct impact on global health, and this growth will be burdened with uneven development and the persistence of urban spatial inequality, including health disparities. The NCD burden, which includes conditions such as hypertension, stroke, and diabetes, is outstripping infectious disease in countries in the global south that are considered to be disproportionately burdened by infectious diseases. Addressing these two priorities demands an interdisciplinary and multi-institutional model to stimulate innovation and synergy that will influence the overall framing of research questions as well as the integration and coordination of research

Monalysin, a Novel ß-Pore-Forming Toxin from the Drosophila Pathogen Pseudomonas entomophila, Contributes to Host Intestinal Damage and Lethality

Pseudomonas entomophila is an entomopathogenic bacterium that infects and kills Drosophila. P. entomophila pathogenicity is linked to its ability to cause irreversible damages to the Drosophila gut, preventing epithelium renewal and repair. Here we report the identification of a novel pore-forming toxin (PFT), Monalysin, which contributes to the virulence of P. entomophila against Drosophila. Our data show that Monalysin requires N-terminal cleavage to become fully active, forms oligomers in vitro, and induces pore-formation in artificial lipid membranes. The prediction of the secondary structure of the membrane-spanning domain indicates that Monalysin is a PFT of the ß-type. The expression of Monalysin is regulated by both the GacS/GacA two-component system and the Pvf regulator, two signaling systems that control P. entomophila pathogenicity. In addition, AprA, a metallo-protease secreted by P. entomophila, can induce the rapid cleavage of pro-Monalysin into its active form. Reduced cell death is observed upon infection with a mutant deficient in Monalysin production showing that Monalysin plays a role in P. entomophila ability to induce intestinal cell damages, which is consistent with its activity as a PFT. Our study together with the well-established action of Bacillus thuringiensis Cry toxins suggests that production of PFTs is a common strategy of entomopathogens to disrupt insect gut homeostasis

Bacillus sphaericus Binary Toxin Elicits Host Cell Autophagy as a Response to Intoxication

Bacillus sphaericus strains that produce the binary toxin (Bin) are highly toxic to Culex and Anopheles mosquitoes, and have been used since the late 1980s as a biopesticide for the control of these vectors of infectious disease agents. The Bin toxin produced by these strains targets mosquito larval midgut epithelial cells where it binds to Cpm1 (Culex pipiens maltase 1) a digestive enzyme, and causes severe intracellular damage, including a dramatic cytoplasmic vacuolation. The intoxication of mammalian epithelial MDCK cells engineered to express Cpm1 mimics the cytopathologies observed in mosquito enterocytes following Bin ingestion: pore formation and vacuolation. In this study we demonstrate that Bin-induced vacuolisation is a transient phenomenon that affects autolysosomes. In addition, we show that this vacuolisation is associated with induction of autophagy in intoxicated cells. Furthermore, we report that after internalization, Bin reaches the recycling endosomes but is not localized either within the vacuolating autolysosomes or within any other degradative compartment. Our observations reveal that Bin elicits autophagy as the cell's response to intoxication while protecting itself from degradation through trafficking towards the recycling pathways

External quality assessment of SARS-CoV-2-sequencing: An ESGMD-SSM pilot trial across 15 European laboratories

Objective: This first pilot on external quality assessment (EQA) of SARS-CoV-2 whole genome sequencing, initiated by the ESCMID Study Group for Genomic and Molecular Diagnostics (ESGMD) and Swiss Society for Microbiology (SSM), aims to build a framework between laboratories in order to improve pathogen surveillance sequencing.Methods: Ten samples with varying viral loads were sent out to 15 clinical laboratories who had free choice of sequencing methods and bioinformatic analyses. The key aspects on which the individual centres were compared on were identification of 1) SNPs and indels, 2) Pango lineages, and 3) clusters between samples.Results: The participating laboratories used a wide array of methods and analysis pipelines. Most were able to generate whole genomes for all samples. Genomes were sequenced to varying depth (up to 100-fold difference across centres). There was a very good consensus regarding the majority of reporting criteria, but there were a few discrepancies in lineage and cluster assignment. Additionally, there were inconsistencies in variant calling. The main reasons for discrepancies were missing data, bioinformatic choices, and interpretation of data.Conclusions: The pilot EQA was an overall success. It was able to show the high quality of participating labs and provide valuable feedback in cases where problems occurred, thereby improving the sequencing setup of laboratories. A larger follow-up EQA should, however, improve on defining the variables and format of the report. Additionally, contamination and/or minority variants should be a further aspect of assessment.</p

Clinical PerspectiveQualitative adolescent health research — focus groups: a rural South African example

This paper introduces nine steps that are recommended in conducting focus group discussions in rural communities and gives an example of how they can appropriately and fruitfully be employed in adolescent health behavioural research. The paper also reviewed issues related to methods of data collection, data analysis, reliability and validity in qualitative research. Focus group discussions took place in classrooms in three schools in Mankweng, Limpopo Province of South Africa. Three groups (boys only, girls only and mixed) took part in each school. Participants were selected from the pool of standard seven (grade 9) students from the chosen schools. The nine steps that were involved in using focus group discussions as a research method and the Mankweng experience is discussed. These steps include: (1) conducting a social influence analysis; (2) identifying the specific information to collect; (3) designing focus group discussion guide; (4) choosing the participants for the focus group discussion; (5) selecting focus group discussion moderators; (6) training focus group discussion moderators; (7) conducting the focus group discussion; (8) analysing the data collected; (9) formulating study conclusions and policy recommendations. Little adolescent health research in South Africa has been based upon methods that can capture the complexity of the role of significant others in adolescent health and development and the powerlessness of rural communities in dealing with the ‘new morbidity\' of adolescent risk behaviours. Understanding what sort of power relations, for example, that are involved in being relatively disadvantaged and how the power of such social groups can be increased is common concern of development managers and other individuals and institutions engaged in policy changes and implementation and deserve to be an essential component of child and adolescent health research.Well-collected and well-analysed qualitative data is needed in order to clearly understand some of the underlying predisposing, enabling and reinforcing factors that could account for adolescent risk behaviours in rural communities. Qualitative research method is important in that they capture the complexity of life, rather than trying to ‘reduce\' this complexity, and the potential for gaining an understanding of what is going on in the situation with the phenomenon is greater. Focus group discussions, a qualitative research methodology, can yield valuable data.Journal of Child and Adolescent Mental Health 2004, 16(2): 117–12

Factors at first diagnosis of tuberculosis associated with compliance with the Directly Observed Therapy (DOT) in the Limpopo Province, South Africa

The aim of this study is to compare and contrast health beliefs, demographic and socio-economic variables, causative beliefs, knowledge, health-seeking behaviour and health provider-patient interaction of compliant and non-compliant tuberculosis patients. The sample included 219 consecutive new sputum-smear and/or culture positive pulmonary tuberculosis patients registered between October 1999 and March 2000 in three hospitals in the Limpopo Province of South Africa. The patients were 144 (65.8%) men and 75 (34.2%) women in the age range of 18 to 79 years (M age 35.9 yr., SD= 12.6). The consultation at first diagnosis was observed and tape-recorded. Thereafter an interview was conducted and a questionnaire was face-to-face administered with the patient including knowledge, causative beliefs, health seeking, and Health Belief Model items. Discriminant analysis between compliant and non-compliant groups after six months follow-up showed that the quality of the health practitioner-patient interaction and causative belief were associated with compliance behaviour whereas knowledge, onset of TB, sociodemographic variables, health care seeking, and health beliefs were not associated