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We describe a case of prolonged SARS-CoV-2 RNA shedding in an HIV-negative 21-year-old man recovering from abdominal and thoracic trauma. Nasopharyngeal (NP) swabs collected at 12 time points over a 95-day span all tested positive for SARS-CoV-2 by reverse transcription polymerase chain reaction (RT-PCR). Genotyping revealed canonical beta-variant E484K and N501Y mutations at earlier time points. Human rhinovirus, coronavirus NL63 and respiratory syncytial virus B were detected at different time points by RT-PCR. Full blood analysis at time point 9 (day 82) showed leukopenia with lymphocytosis. The patient’s NP swab tested negative for SARS-CoV-2 by RT-PCR 101 days after the first positive test. The prolonged duration of SARS-CoV-2 RNA shedding in the context of trauma presented here is unique and has important implications for COVID-19 diagnosis, management and policy guidelines.

Cape Town’s water injustices are entrenched by the mismatch between government interventions and the lived realities in many informal settlements and other low-income areas. This transdisciplinary ...

The rapid emergence and spread of numerous severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) variants across the globe underscores the crucial need for continuous SARS-CoV-2 surveillance to ensure that potentially more pathogenic variants are detected early and contained. Whole genome sequencing (WGS) is currently the gold standard for COVID-19 surveillance; however, it remains cost-prohibitive and requires specialized technical skills. To increase surveillance capacity, especially in resource-scarce settings, supplementary methods that are cost- and time-effective are needed. Real-time multiplex PCR genotyping assays offer an economical and fast solution for screening circulating and emerging variants while simultaneously complementing existing WGS approaches. In this study we evaluated the AllplexTM SARS-CoV-2 Variants II multiplex real-time PCR genotyping assay, Seegene (South Korea), and implemented it in retrospectively characterizing circulating SARS-CoV-2 variants in a rural South African setting between April and October 2021, prior to the emergence of the Omicron variant in South Africa. The AllplexTM SARS-CoV-2 Variants II real-time PCR assay demonstrated perfect concordance with whole-genome sequencing in detecting Beta and Delta variants and exhibited high specificity, sensitivity and reproducibility. Implementation of the assay in characterization of SARS-CoV-2 variants between April and October 2021 in a rural South African setting revealed a rapid shift from the Beta to the Delta variant between April and June. All specimens successfully genotyped in April were Beta variants and the Delta variant was not detected until May. By June, 78% of samples genotyped were Delta variants and in July >95% of all genotyped samples were Delta variants. The Delta variant continued to predominate through to the end of our analysis in October 2021. Taken together, a commercial SARS-CoV-2 variant genotyping assay detected the rapid rate at which the Delta variant displaced the Beta variant in Limpopo, an under-monitored province in South Africa. Such assays provide a quick and cost-effective method of monitoring circulating variants and should be used to complement genomic sequencing for COVID-19 surveillance especially in resource-scarce settings.

Includes bibliographical references (leaves 78-82)., The process of rehabilitating State Patients requires that they go out on leave of absence (LOA), once their psychiatric condition has settled to spend time with their families away from the hospital environment. The cooperation of the family or relatives is crucial as the patient is going to need supervision while he is at home. The family therefore should be prepared to accept him. The research was conducted at Valkenberg Hospital in the Western Cape. A qualitative approach was used to explore and describe the factors that cause the rejection of State Patients by their families and relatives and the effects of the rejection on the patient. A random sample was drawn from patients who are currently occupying beds in the forensic wards at Valkenberg Hospital, and have not been out on leave for at least one year and above. Ten patients were selected and relatives of these patients were interviewed. Emergent findings were that relatives were not willing to accept the patients because of lack of knowledge and understanding of the illness and also out of the fear of not knowing if and when the patient will re-offend. Substance abuse and aggression emerged as the main factors that families were struggling with and a high percentage of the respondents mentioned these as major difficulties for them. The patients who were interviewed appeared to be struggling with expressing their feelings, and could not articulate how the rejection affected their mental state or whether it affected them at all.