1,005 results on '"South Africa epidemiology"'
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2. SIVagm infection in wild African green monkeys from South Africa: epidemiology, natural history, and evolutionary considerations.
- Author
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Dongzhu Ma, Anna Jasinska, Jan Kristoff, J Paul Grobler, Trudy Turner, Yoon Jung, Christopher Schmitt, Kevin Raehtz, Felix Feyertag, Natalie Martinez Sosa, Viskam Wijewardana, Donald S Burke, David L Robertson, Russell Tracy, Ivona Pandrea, Nelson Freimer, Cristian Apetrei, and International Vervet Research Consortium
- Subjects
Immunologic diseases. Allergy ,RC581-607 ,Biology (General) ,QH301-705.5 - Abstract
Pathogenesis studies of SIV infection have not been performed to date in wild monkeys due to difficulty in collecting and storing samples on site and the lack of analytical reagents covering the extensive SIV diversity. We performed a large scale study of molecular epidemiology and natural history of SIVagm infection in 225 free-ranging AGMs from multiple locations in South Africa. SIV prevalence (established by sequencing pol, env, and gag) varied dramatically between infant/juvenile (7%) and adult animals (68%) (p
- Published
- 2013
- Full Text
- View/download PDF
3. Measles outbreak in South Africa: epidemiology of laboratory-confirmed measles cases and assessment of intervention, 2009-2011.
- Author
-
Genevie M Ntshoe, Johanna M McAnerney, Brett N Archer, Sheilagh B Smit, Bernice N Harris, Stefano Tempia, Mirriam Mashele, Beverley Singh, Juno Thomas, Ayanda Cengimbo, Lucille H Blumberg, Adrian Puren, Jocelyn Moyes, Johann van den Heever, Barry D Schoub, and Cheryl Cohen
- Subjects
Medicine ,Science - Abstract
BackgroundSince 1995, measles vaccination at nine and 18 months has been routine in South Africa; however, coverage seldom reached >95%. We describe the epidemiology of laboratory-confirmed measles case-patients and assess the impact of the nationwide mass vaccination campaign during the 2009 to 2011 measles outbreak in South Africa.MethodsSerum specimens collected from patients with suspected-measles were tested for measles-specific IgM antibodies using an enzyme-linked immunosorbent assay and genotypes of a subset were determined. To estimate the impact of the nationwide mass vaccination campaign, we compared incidence in the seven months pre- (1 September 2009-11 April 2010) and seven months post-vaccination campaign (24 May 2010-31 December 2010) periods in seven provinces of South Africa.ResultsA total of 18,431 laboratory-confirmed measles case-patients were reported from all nine provinces of South Africa (cumulative incidence 37 per 100,000 population). The highest cumulative incidence per 100,000 population was in children aged ConclusionWe observed a reduction in measles incidence following the nationwide mass vaccination campaign even though it was conducted approximately one year after the outbreak started. A booster dose at school entry may be of value given the high incidence in persons >5 years.
- Published
- 2013
- Full Text
- View/download PDF
4. SIVagm Infection in Wild African Green Monkeys from South Africa: Epidemiology, Natural History, and Evolutionary Considerations
- Abstract
Pathogenesis studies of SIV infection have not been performed to date in wild monkeys due to difficulty in collecting and storing samples on site and the lack of analytical reagents covering the extensive SIV diversity. We performed a large scale study of molecular epidemiology and natural history of SIVagm infection in 225 free-ranging AGMs from multiple locations in South Africa. SIV prevalence (established by sequencing pol, env, and gag) varied dramatically between infant/juvenile (7%) and adult animals (68%) (p<0.0001), and between adult females (78%) and males (57%). Phylogenetic analyses revealed an extensive genetic diversity, including frequent recombination events. Some AGMs harbored epidemiologically linked viruses. Viruses infecting AGMs in the Free State, which are separated from those on the coastal side by the Drakensberg Mountains, formed a separate cluster in the phylogenetic trees; this observation supports a long standing presence of SIV in AGMs, at least from the time of their speciation to their Plio-Pleistocene migration. Specific primers/probes were synthesized based on the pol sequence data and viral loads (VLs) were quantified. VLs were of 104-106 RNA copies/ml, in the range of those observed in experimentally-infected monkeys, validating the experimental approaches in natural hosts. VLs were significantly higher (107-108 RNA copies/ml) in 10 AGMs diagnosed as acutely infected based on SIV seronegativity (Fiebig II), which suggests a very active transmission of SIVagm in the wild. Neither cytokine levels (as biomarkers of immune activation) nor sCD14 levels (a biomarker of microbial translocation) were different between SIV-infected and SIV-uninfected monkeys. This complex algorithm combining sequencing and phylogeny, VL quantification, serology, and testing of surrogate markers of microbial translocation and immune activation permits a systematic investigation of the epidemiology, viral diversity and natural history of SIV infection in wild
- Published
- 2013
5. SIVagm Infection in Wild African Green Monkeys from South Africa: Epidemiology, Natural History, and Evolutionary Considerations
- Abstract
Pathogenesis studies of SIV infection have not been performed to date in wild monkeys due to difficulty in collecting and storing samples on site and the lack of analytical reagents covering the extensive SIV diversity. We performed a large scale study of molecular epidemiology and natural history of SIVagm infection in 225 free-ranging AGMs from multiple locations in South Africa. SIV prevalence (established by sequencing pol, env, and gag) varied dramatically between infant/juvenile (7%) and adult animals (68%) (p<0.0001), and between adult females (78%) and males (57%). Phylogenetic analyses revealed an extensive genetic diversity, including frequent recombination events. Some AGMs harbored epidemiologically linked viruses. Viruses infecting AGMs in the Free State, which are separated from those on the coastal side by the Drakensberg Mountains, formed a separate cluster in the phylogenetic trees; this observation supports a long standing presence of SIV in AGMs, at least from the time of their speciation to their Plio-Pleistocene migration. Specific primers/probes were synthesized based on the pol sequence data and viral loads (VLs) were quantified. VLs were of 104-106 RNA copies/ml, in the range of those observed in experimentally-infected monkeys, validating the experimental approaches in natural hosts. VLs were significantly higher (107-108 RNA copies/ml) in 10 AGMs diagnosed as acutely infected based on SIV seronegativity (Fiebig II), which suggests a very active transmission of SIVagm in the wild. Neither cytokine levels (as biomarkers of immune activation) nor sCD14 levels (a biomarker of microbial translocation) were different between SIV-infected and SIV-uninfected monkeys. This complex algorithm combining sequencing and phylogeny, VL quantification, serology, and testing of surrogate markers of microbial translocation and immune activation permits a systematic investigation of the epidemiology, viral diversity and natural history of SIV infection in wild
- Published
- 2013
6. Peritonitis in children on peritoneal dialysis in Cape Town, South Africa: epidemiology and risks.
- Abstract
01 oktober 2010, Contains fulltext : 89800raaijmakers.pdf (publisher's version ) (Closed access), Peritonitis is a frequent complication of peritoneal dialysis (PD) in children as well in adults. Data on PD and peritonitis in pediatric patients are very scarce in developing countries. A retrospective cohort study was performed between 2000 and 2008 with the aim to evaluate PD treatment and peritonitis epidemiology in pediatric patients in South Africa and identify risk factors for peritonitis. Baseline characteristics and potential risk factors of peritonitis were recorded, including housing, socio-economic circumstances, distance to PD center, type of PD, mode of catheter placement, race, presence of gastrostomy tube, weight, and height. Outcome indices for peritonitis were peritonitis rate, time to first peritonitis, and number of peritonitis-free patients. The patient cohort comprised 67 patients who were on PD for a total of 544 months. The total number of peritonitis episodes was 129. Median peritonitis rate was one episode every 4.3 patient months (2.8 episodes/patient-year, range 0-21.2). Median time to first infection was 2.03 months (range 0.1-21.5 months), and 28.4% of patients remained free from peritonitis. Patients with good housing and good socio-economic circumstances had a significantly lower peritonitis rate and a longer time to first peritonitis episode. Peritonitis rate was high in this cohort, compared to numbers reported for the developed world; the characteristics of causative organisms are comparable. The most important risk factors for the development of peritonitis were poor housing and poor socio-economic circumstances. More intensive counseling may be beneficial, but improvement of general socio-economic circumstances will have the greatest influence on PD success.
- Published
- 2010
7. Peritonitis in children on peritoneal dialysis in Cape Town, South Africa: epidemiology and risks.
- Abstract
01 oktober 2010, Contains fulltext : 89800raaijmakers.pdf (publisher's version ) (Closed access), Peritonitis is a frequent complication of peritoneal dialysis (PD) in children as well in adults. Data on PD and peritonitis in pediatric patients are very scarce in developing countries. A retrospective cohort study was performed between 2000 and 2008 with the aim to evaluate PD treatment and peritonitis epidemiology in pediatric patients in South Africa and identify risk factors for peritonitis. Baseline characteristics and potential risk factors of peritonitis were recorded, including housing, socio-economic circumstances, distance to PD center, type of PD, mode of catheter placement, race, presence of gastrostomy tube, weight, and height. Outcome indices for peritonitis were peritonitis rate, time to first peritonitis, and number of peritonitis-free patients. The patient cohort comprised 67 patients who were on PD for a total of 544 months. The total number of peritonitis episodes was 129. Median peritonitis rate was one episode every 4.3 patient months (2.8 episodes/patient-year, range 0-21.2). Median time to first infection was 2.03 months (range 0.1-21.5 months), and 28.4% of patients remained free from peritonitis. Patients with good housing and good socio-economic circumstances had a significantly lower peritonitis rate and a longer time to first peritonitis episode. Peritonitis rate was high in this cohort, compared to numbers reported for the developed world; the characteristics of causative organisms are comparable. The most important risk factors for the development of peritonitis were poor housing and poor socio-economic circumstances. More intensive counseling may be beneficial, but improvement of general socio-economic circumstances will have the greatest influence on PD success.
- Published
- 2010
8. Peritonitis in children on peritoneal dialysis in Cape Town, South Africa: epidemiology and risks.
- Abstract
1 oktober 2010, Contains fulltext : 89800raaijmakers.pdf (publisher's version ) (Closed access), Peritonitis is a frequent complication of peritoneal dialysis (PD) in children as well in adults. Data on PD and peritonitis in pediatric patients are very scarce in developing countries. A retrospective cohort study was performed between 2000 and 2008 with the aim to evaluate PD treatment and peritonitis epidemiology in pediatric patients in South Africa and identify risk factors for peritonitis. Baseline characteristics and potential risk factors of peritonitis were recorded, including housing, socio-economic circumstances, distance to PD center, type of PD, mode of catheter placement, race, presence of gastrostomy tube, weight, and height. Outcome indices for peritonitis were peritonitis rate, time to first peritonitis, and number of peritonitis-free patients. The patient cohort comprised 67 patients who were on PD for a total of 544 months. The total number of peritonitis episodes was 129. Median peritonitis rate was one episode every 4.3 patient months (2.8 episodes/patient-year, range 0-21.2). Median time to first infection was 2.03 months (range 0.1-21.5 months), and 28.4% of patients remained free from peritonitis. Patients with good housing and good socio-economic circumstances had a significantly lower peritonitis rate and a longer time to first peritonitis episode. Peritonitis rate was high in this cohort, compared to numbers reported for the developed world; the characteristics of causative organisms are comparable. The most important risk factors for the development of peritonitis were poor housing and poor socio-economic circumstances. More intensive counseling may be beneficial, but improvement of general socio-economic circumstances will have the greatest influence on PD success.
- Published
- 2010
9. Glaucoma in Zulus: a population-based cross-sectional survey in a rural district in South Africa. (Epidemiology And Biostatistics)
- Author
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Rotchford, Alan P. and Johnson, Gordon J.
- Subjects
Zulu (African people) -- Health aspects ,Glaucoma -- Demographic aspects ,Prevalence studies (Epidemiology) -- Analysis ,Health - Abstract
Objectives: To determine the prevalence and the main types of glaucoma in a representative adult population in rural Zululand, and to describe the distribution of glaucoma-related variables in healthy subjects and those with glaucoma. Design: A population-based, cross-sectional study. Setting: Hlabisa district, Northern KwaZulu-Natal Province, South Africa. Participants: Resident individuals of Zulu ethnic origin, 40 years or older. Main Outcome Measures: Glaucoma was diagnosed by means of strict objective criteria, based on binocular indirect ophthalmoscopic optic disc appearances validated by results of disc photography and threshold visual field testing. Results: From an eligible sample of 1115 subjects, 1005 (90.1%) were examined in the survey. The adjusted prevalence of glaucoma of all types was 4.5%, and primary open-angle glaucoma accounted for 2.7%. Secondary glaucoma occurred with an adjusted prevalence of 1.7%, of which the principal contributors were exfoliative and aphakic glaucoma. The prevalence of primary angle-closure glaucoma was low. Normal tension (intraocular pressure, [less than or equal to] 21 mm Hg) was measured in 16 (57.1%) of 28 cases of primary open-angle glaucoma. Age- and sex-adjusted prevalence of bilateral blindness was 3.2%, which was exclusively due to glaucoma in 9 (22.0%) of 41 cases. Conclusions: Primary and secondary glaucoma constitute a significant public health problem in rural Zululand. The prevalence and types of glaucoma vary among different black populations. Arch Ophthalmol. 2002;120:471-478
- Published
- 2002
10. University of Cape Town Details Findings in Spinocerebellar Ataxias (Spinocerebellar ataxia type 7 in South Africa: Epidemiology, pathogenesis and therapy)
- Subjects
Physical fitness -- Reports ,Epidemiology -- Reports ,Health ,University of Cape Town -- Reports - Abstract
2016 SEP 24 (NewsRx) -- By a News Reporter-Staff News Editor at Obesity, Fitness & Wellness Week -- Investigators publish new report on Genetic Diseases and Conditions - Spinocerebellar Ataxias. [...]
- Published
- 2016
11. Spinocerebellar ataxia type 7 in South Africa: Epidemiology, pathogenesis and therapy.
- Author
-
Watson L, Smith DC, Scholefield J, Ballo R, Kidson S, Greenberg LJ, and Wood MJ
- Subjects
- Gene Silencing, Haplotypes, Humans, Induced Pluripotent Stem Cells cytology, Models, Biological, South Africa epidemiology, Spinocerebellar Ataxias physiopathology, Founder Effect, Molecular Biology methods, Spinocerebellar Ataxias epidemiology
- Abstract
Disorders of the nervous system represent a significant proportion of the global burden of non-communicable diseases, due to the trend towards ageing populations. The Department (now Division) of Human Genetics at the University of Cape Town (UCT) has been involved in pioneering research into these diseases since the appointment of Prof. Peter Beighton as Head of Department in 1972. Beighton's emphasis on understanding the genetic basis of disease laid the groundwork for investigations into several monogenic neurodegenerative conditions, including Huntington's disease and the polyglutamine spinocerebellar ataxias (SCAs). In particular, SCA7, which occurs at an unusually high frequency in the South African (SA) population, was identified as a target for further research and therapeutic development. Beginning with early epidemiological surveys, the SCA7 project progressed to molecular genetics-based investigations, leading to the identification of a founder effect in the SA SCA7 patient population in the mid-2000s. Capitalising on the founder haplotype shared by many SCA7 patients, UCT researchers went on to develop the first population-specific gene-silencing approach for the disease. More recently, efforts have shifted to the development of a more accurate model to decipher the precise mechanisms of neurodegeneration, using induced pluripotent stem cells derived from SA SCA7 patients. In many ways, the SA SCA7 journey reflects the legacy and vision of Prof. Peter Beighton, and his efforts to establish world-class, collaborative research into diseases affecting the African continent.
- Published
- 2016
- Full Text
- View/download PDF
12. Peritonitis in children on peritoneal dialysis in Cape Town, South Africa: epidemiology and risks
- Abstract
Peritonitis is a frequent complication of peritoneal dialysis (PD) in children as well in adults. Data on PD and peritonitis in pediatric patients are very scarce in developing countries. A retrospective cohort study was performed between 2000 and 2008 with the aim to evaluate PD treatment and peritonitis epidemiology in pediatric patients in South Africa and identify risk factors for peritonitis. Baseline characteristics and potential risk factors of peritonitis were recorded, including housing, socio-economic circumstances, distance to PD center, type of PD, mode of catheter placement, race, presence of gastrostomy tube, weight, and height. Outcome indices for peritonitis were peritonitis rate, time to first peritonitis, and number of peritonitis-free patients. The patient cohort comprised 67 patients who were on PD for a total of 544 months. The total number of peritonitis episodes was 129. Median peritonitis rate was one episode every 4.3 patient months (2.8 episodes/patient-year, range 0-21.2). Median time to first infection was 2.03 months (range 0.1-21.5 months), and 28.4% of patients remained free from peritonitis. Patients with good housing and good socio-economic circumstances had a significantly lower peritonitis rate and a longer time to first peritonitis episode. Peritonitis rate was high in this cohort, compared to numbers reported for the developed world; the characteristics of causative organisms are comparable. The most important risk factors for the development of peritonitis were poor housing and poor socio-economic circumstances. More intensive counseling may be beneficial, but improvement of general socio-economic circumstances will have the greatest influence on PD success.
- Published
- 2010
13. Suppurative keratitis at Groote Schuur Hospital, South Africa: epidemiology, clinical features, and microbiology
- Author
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Osman, Lina, Cockburn, Nicky, Fawad, Muhammad, Razavi, Hessom, Abdull, Mohammed, Mutombo, Théodore Kadima, and Leite, Claudia
- Subjects
MSc SUMMARIES ,Article - Published
- 2008
14. SIVagm infection in wild African green monkeys from South Africa: epidemiology, natural history, and evolutionary considerations.
- Author
-
Ma D, Jasinska A, Kristoff J, Grobler JP, Turner T, Jung Y, Schmitt C, Raehtz K, Feyertag F, Martinez Sosa N, Wijewardana V, Burke DS, Robertson DL, Tracy R, Pandrea I, Freimer N, and Apetrei C
- Subjects
- Animals, Base Sequence, Female, Host-Pathogen Interactions, Male, Molecular Sequence Data, Mutation Rate, Recombination, Genetic, Repetitive Sequences, Nucleic Acid, Simian Acquired Immunodeficiency Syndrome virology, Simian Immunodeficiency Virus genetics, South Africa epidemiology, Chlorocebus aethiops, Evolution, Molecular, Genetic Variation, Simian Acquired Immunodeficiency Syndrome epidemiology, Simian Immunodeficiency Virus isolation & purification
- Abstract
Pathogenesis studies of SIV infection have not been performed to date in wild monkeys due to difficulty in collecting and storing samples on site and the lack of analytical reagents covering the extensive SIV diversity. We performed a large scale study of molecular epidemiology and natural history of SIVagm infection in 225 free-ranging AGMs from multiple locations in South Africa. SIV prevalence (established by sequencing pol, env, and gag) varied dramatically between infant/juvenile (7%) and adult animals (68%) (p<0.0001), and between adult females (78%) and males (57%). Phylogenetic analyses revealed an extensive genetic diversity, including frequent recombination events. Some AGMs harbored epidemiologically linked viruses. Viruses infecting AGMs in the Free State, which are separated from those on the coastal side by the Drakensberg Mountains, formed a separate cluster in the phylogenetic trees; this observation supports a long standing presence of SIV in AGMs, at least from the time of their speciation to their Plio-Pleistocene migration. Specific primers/probes were synthesized based on the pol sequence data and viral loads (VLs) were quantified. VLs were of 10(4)-10(6) RNA copies/ml, in the range of those observed in experimentally-infected monkeys, validating the experimental approaches in natural hosts. VLs were significantly higher (10(7)-10(8) RNA copies/ml) in 10 AGMs diagnosed as acutely infected based on SIV seronegativity (Fiebig II), which suggests a very active transmission of SIVagm in the wild. Neither cytokine levels (as biomarkers of immune activation) nor sCD14 levels (a biomarker of microbial translocation) were different between SIV-infected and SIV-uninfected monkeys. This complex algorithm combining sequencing and phylogeny, VL quantification, serology, and testing of surrogate markers of microbial translocation and immune activation permits a systematic investigation of the epidemiology, viral diversity and natural history of SIV infection in wild African natural hosts.
- Published
- 2013
- Full Text
- View/download PDF
15. Measles outbreak in South Africa: epidemiology of laboratory-confirmed measles cases and assessment of intervention, 2009-2011.
- Author
-
Ntshoe GM, McAnerney JM, Archer BN, Smit SB, Harris BN, Tempia S, Mashele M, Singh B, Thomas J, Cengimbo A, Blumberg LH, Puren A, Moyes J, van den Heever J, Schoub BD, and Cohen C
- Subjects
- Adolescent, Adult, Age Distribution, Child, Child, Preschool, Female, Genotype, Humans, Immunoglobulin M immunology, Incidence, Infant, Male, Measles genetics, Measles immunology, Measles Vaccine administration & dosage, Measles Vaccine immunology, Reproducibility of Results, South Africa epidemiology, Vaccination, Clinical Laboratory Techniques, Disease Outbreaks prevention & control, Measles epidemiology, Measles prevention & control
- Abstract
Background: Since 1995, measles vaccination at nine and 18 months has been routine in South Africa; however, coverage seldom reached >95%. We describe the epidemiology of laboratory-confirmed measles case-patients and assess the impact of the nationwide mass vaccination campaign during the 2009 to 2011 measles outbreak in South Africa., Methods: Serum specimens collected from patients with suspected-measles were tested for measles-specific IgM antibodies using an enzyme-linked immunosorbent assay and genotypes of a subset were determined. To estimate the impact of the nationwide mass vaccination campaign, we compared incidence in the seven months pre- (1 September 2009-11 April 2010) and seven months post-vaccination campaign (24 May 2010-31 December 2010) periods in seven provinces of South Africa., Results: A total of 18,431 laboratory-confirmed measles case-patients were reported from all nine provinces of South Africa (cumulative incidence 37 per 100,000 population). The highest cumulative incidence per 100,000 population was in children aged <1 year (603), distributed as follows: <6 months (302/100,000), 6 to 8 months (1083/100,000) and 9 to 11 months (724/100,000). Forty eight percent of case-patients were ≥ 5 years (cumulative incidence 54/100,000). Cumulative incidence decreased with increasing age to 2/100,000 in persons ≥ 40 years. A single strain of measles virus (genotype B3) circulated throughout the outbreak. Prior to the vaccination campaign, cumulative incidence in the targeted vs. non-targeted age group was 5.9-fold higher, decreasing to 1.7 fold following the campaign (P<0.001) and an estimated 1,380 laboratory-confirmed measles case-patients were prevented., Conclusion: We observed a reduction in measles incidence following the nationwide mass vaccination campaign even though it was conducted approximately one year after the outbreak started. A booster dose at school entry may be of value given the high incidence in persons >5 years.
- Published
- 2013
- Full Text
- View/download PDF
16. SIVagm infection in wild African green monkeys from South Africa: epidemiology, natural history, and evolutionary considerations
- Author
-
Yoon Jung, Natalie Martinez Sosa, Dongzhu Ma, Russell P. Tracy, Christopher A. Schmitt, Nelson B. Freimer, J. Paul Grobler, Viskam Wijewardana, Donald S. Burke, David Robertson, Felix Feyertag, Anna J. Jasinska, Kevin D. Raehtz, Trudy R. Turner, Ivona Pandrea, Cristian Apetrei, and Jan Kristoff
- Subjects
Male ,animal diseases ,viruses ,Simian Acquired Immunodeficiency Syndrome ,Pathogenesis ,medicine.disease_cause ,law.invention ,Serology ,South Africa ,Immunodeficiency Viruses ,Mutation Rate ,law ,Chlorocebus aethiops ,Biology (General) ,Polymerase chain reaction ,Recombination, Genetic ,Genetics ,0303 health sciences ,Ecology ,Viral Load ,Host-Pathogen Interaction ,Host-Pathogen Interactions ,Female ,Simian Immunodeficiency Virus ,Viral load ,Research Article ,QH301-705.5 ,Molecular Sequence Data ,Immunology ,Biology ,Microbiology ,Microbial Ecology ,Evolution, Molecular ,03 medical and health sciences ,Phylogenetics ,Virology ,medicine ,Animals ,Molecular Biology ,Repetitive Sequences, Nucleic Acid ,030304 developmental biology ,Base Sequence ,Molecular epidemiology ,030306 microbiology ,Immunity ,Genetic Variation ,Simian immunodeficiency virus ,RC581-607 ,Animal Models of Infection ,Parasitology ,Viral replication ,Immunologic diseases. Allergy ,Viral Transmission and Infection - Abstract
Pathogenesis studies of SIV infection have not been performed to date in wild monkeys due to difficulty in collecting and storing samples on site and the lack of analytical reagents covering the extensive SIV diversity. We performed a large scale study of molecular epidemiology and natural history of SIVagm infection in 225 free-ranging AGMs from multiple locations in South Africa. SIV prevalence (established by sequencing pol, env, and gag) varied dramatically between infant/juvenile (7%) and adult animals (68%) (p, Author Summary We simultaneously assessed, for the first time in a natural host, the epidemiology, diversity and natural history of SIVagmVer infection in wild vervet populations from South Africa. We report that African green monkeys (AGMs) have likely been infected with SIVagm for a long period, ranging from the time of their speciation to Plio-Pleistocene migrations, refuting previous molecular clock calculations suggesting SIVagm to be of recent occurrence. As a result of virus-host coadaptation, SIVagmVer infection is characterized by a lack of disease progression in spite of robust viral replication. We show that very active SIVagm transmission in adult AGMs contrasts with a very limited transmission to their offspring, in spite of massive exposure to SIVagm both in utero and through breastfeeding. The observation that some AGMs remain uninfected in spite of life-long exposure to SIVagm identifies wild vervets as an acceptable animal model for the exposed uninfected individuals, which can be used to identify correlates of resistance to HIV/SIV infection.
- Published
- 2013
17. Spinocerebellar ataxia type 7 in South Africa: Epidemiology, pathogenesis and therapy
- Author
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Janine Scholefield, Matthew J.A. Wood, Danielle C. Smith, Robea Ballo, L J Greenberg, Susan H. Kidson, and Lauren M Watson
- Subjects
0301 basic medicine ,Gerontology ,medicine.medical_specialty ,Pathology ,Induced Pluripotent Stem Cells ,Population ,Disease ,Models, Biological ,South Africa ,03 medical and health sciences ,0302 clinical medicine ,Molecular genetics ,Epidemiology ,medicine ,Humans ,Spinocerebellar Ataxias ,Gene Silencing ,education ,Molecular Biology ,education.field_of_study ,business.industry ,General Medicine ,medicine.disease ,Founder Effect ,Human genetics ,Patient population ,030104 developmental biology ,Haplotypes ,Spinocerebellar ataxia ,business ,030217 neurology & neurosurgery ,Founder effect - Abstract
Disorders of the nervous system represent a significant proportion of the global burden of non-communicable diseases, due to the trend towards ageing populations. The Department (now Division) of Human Genetics at the University of Cape Town (UCT) has been involved in pioneering research into these diseases since the appointment of Prof. Peter Beighton as Head of Department in 1972. Beighton's emphasis on understanding the genetic basis of disease laid the groundwork for investigations into several monogenic neurodegenerative conditions, including Huntington's disease and the polyglutamine spinocerebellar ataxias (SCAs). In particular, SCA7, which occurs at an unusually high frequency in the South African (SA) population, was identified as a target for further research and therapeutic development. Beginning with early epidemiological surveys, the SCA7 project progressed to molecular genetics-based investigations, leading to the identification of a founder effect in the SA SCA7 patient population in the mid-2000s. Capitalising on the founder haplotype shared by many SCA7 patients, UCT researchers went on to develop the first population-specific gene-silencing approach for the disease. More recently, efforts have shifted to the development of a more accurate model to decipher the precise mechanisms of neurodegeneration, using induced pluripotent stem cells derived from SA SCA7 patients. In many ways, the SA SCA7 journey reflects the legacy and vision of Prof. Peter Beighton, and his efforts to establish world-class, collaborative research into diseases affecting the African continent.
- Published
- 2016
18. Perspectives of intellectual disability in South Africa: epidemiology, policy, services for children and adults.
- Author
-
Adnams CM
- Subjects
- Adult, Brain Injuries complications, Brain Injuries psychology, Child, Child Nutrition Disorders complications, Child Nutrition Disorders psychology, Female, Fetal Alcohol Spectrum Disorders psychology, HIV Infections complications, HIV Infections psychology, Humans, Intellectual Disability etiology, Intellectual Disability therapy, Pregnancy, Prevalence, South Africa epidemiology, Tuberculosis, Meningeal complications, Tuberculosis, Meningeal psychology, Intellectual Disability epidemiology, Public Policy, Social Work
- Abstract
Purpose of Review: This review aims to summarize data published in the scientific literature and available on official websites on the epidemiology, policies and services for children and adults with intellectual disability in South Africa., Recent Findings: There is a paucity of published literature on intellectual disability in South Africa. The lack of evidence-based publications within the prescribed review period of 12-18 months precludes an accurate description of the prevailing epidemiology and burden of disablement in this country. The few studies yielding epidemiological data were conducted prior to 2002. These suggest that the prevalence rate of intellectual disability is greater than in high-income countries. There is little data describing intellectual disability geographically and across population and age groups, further rendering it difficult to identify inequalities and differences in distribution. There is a high burden of preventable causes of intellectual disability., Summary: Despite the existence of policies and services for the population with intellectual disabilities in South Africa, recognition of and provision for their needs carries low priority. It is imperative that the information gap in epidemiology and the burden of disability be recognized in order to plan for and meet the needs of those with intellectual disability across the lifespan.
- Published
- 2010
- Full Text
- View/download PDF
19. Perspectives of intellectual disability in South Africa: epidemiology, policy, services for children and adults
- Author
-
Colleen M. Adnams
- Subjects
Gerontology ,Adult ,medicine.medical_specialty ,Social Work ,MEDLINE ,Public policy ,HIV Infections ,Public Policy ,Scientific literature ,Child Nutrition Disorders ,South Africa ,Pregnancy ,Intellectual Disability ,Intellectual disability ,Epidemiology ,medicine ,Prevalence ,Humans ,Sociology ,Psychiatry ,Child ,Social work ,medicine.disease ,Psychiatry and Mental health ,Fetal Alcohol Spectrum Disorders ,Brain Injuries ,Tuberculosis, Meningeal ,Female - Abstract
This review aims to summarize data published in the scientific literature and available on official websites on the epidemiology, policies and services for children and adults with intellectual disability in South Africa.There is a paucity of published literature on intellectual disability in South Africa. The lack of evidence-based publications within the prescribed review period of 12-18 months precludes an accurate description of the prevailing epidemiology and burden of disablement in this country. The few studies yielding epidemiological data were conducted prior to 2002. These suggest that the prevalence rate of intellectual disability is greater than in high-income countries. There is little data describing intellectual disability geographically and across population and age groups, further rendering it difficult to identify inequalities and differences in distribution. There is a high burden of preventable causes of intellectual disability.Despite the existence of policies and services for the population with intellectual disabilities in South Africa, recognition of and provision for their needs carries low priority. It is imperative that the information gap in epidemiology and the burden of disability be recognized in order to plan for and meet the needs of those with intellectual disability across the lifespan.
- Published
- 2010
20. Cercaria hastatasp. nov. (Digenea: Trematoda) inBullia digitalis, a sandy beach surfing whelk from the Western Cape coast of South Africa: epidemiology and sex linked phenomena
- Author
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S.C. Webb
- Subjects
Bullia ,Whelk ,biology ,Ecology ,Gastropoda ,Intermediate host ,Bullia digitalis ,Trematoda ,biology.organism_classification ,Mollusca ,Ecology, Evolution, Behavior and Systematics ,Digenea - Abstract
Morphometric and sex linked phenomena in male Bullia digitalis, from the Western Cape coast of South Africa, are related to infection with a digenean microphallid larva described here for the first time and named Cercaria hastata. Penis shedding in Bullia is not uncommon. Most of the stumps are found on infected whelks, and this is probably due to parasitic inhibition of an otherwise rapid regeneration. The infection also abolishes sperm production. Stumps were never seen on sperm producing males, all of which have large penes, and in non-infected males, shedding occurs only in non-producers. In large non-infected Bullia, those which have underdeveloped penes and are non-producers of sperm may be transient intersexes. This is supported by the exhibition of protandry indicators such as brooding, nonsize preferential mate selection and gregariousness. Infection prevalence is size dependent, large whelks being more commonly infected; but parasitic gigantism is thought unlikely as Bullia is iteroparous.
- Published
- 1991
21. Paradoxical helminthiasis and giardiasis in Cape Town, South Africa: epidemiology and control.
- Author
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Adams VJ, Markus MB, Adams JF, Jordaan E, Curtis B, Dhansay MA, Obihara CC, and Fincham JE
- Subjects
- Adolescent, Age Factors, Child, Cross-Sectional Studies, Female, Giardiasis prevention & control, Helminthiasis prevention & control, Humans, Male, Poverty Areas, Prevalence, Primary Prevention, Sex Factors, South Africa epidemiology, Giardiasis epidemiology, Helminthiasis epidemiology
- Abstract
Background: South Africa has endorsed a World Health Assembly (WHA) resolution calling for control of soil-transmitted helminths (STHs). In Cape Town, services and housing that exist in old-established suburbs should minimise the prevalence of intestinal parasitic infections, even when residents are poor. Where families live in shacks in densely-populated areas without effective sanitation, more than 90% of children can be infected by STHs. The humoral immune response to worms theoretically favours infection by Mycobacterium tuberculosis and HIV., Objectives: Obtain estimates of gender-, age-, school-related and overall prevalence of helminthiasis and giardiasis in a low-income but well-serviced community. Assess possible sources of infection. Alert health services to the need for control measures and the threat from protozoal pathogens. Warn that the immune response to intestinal parasites may favour tuberculosis (TB) and HIV/AIDS., Methods: A cross-sectional study of the prevalence of helminthiasis and giardiasis was carried out in a large, non-selective sample of children attending nine schools. Gender, school and age effects were related to non-medical preventive services, sewage disposal practices and possible sources of infection., Results: The overall STH infestation rate was 55.8%. Prevalence was inluenced by school and age but not by gender. Eggs and cysts were seen at the following prevalence: Ascaris 24.8%; Trichuris 50.6%; Hymenolepis nana 2.2%; Enterobius 0.6%; Giardia 17.3%; hookworm 0.08%; and Trichostrongylus 0.1%. Approximately 60% of sewage sludge is used in a form that will contain viable eggs and cysts., Conclusion: Prevalence trends in this old community in Cape Town could indicate infection by swallowing eggs or cysts on food or in water, more than by exposure to polluted soil. Sewage sludge and effluent might be sources of infection. In adjacent, under serviced, newer communities, promiscuous defecation occurs. Probable vectors are discussed. The immune response to intestinal parasites might be a risk factor for HIV/AIDS and TB.
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- 2005
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22. ERRATUM- Paradoxical helminthiasis and giardiasis in Cape Town, South Africa: epidemiology and control
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Adams, V J, Markus, M B, Adams, J F, Jordaan, E, Curtis, B, Dhansay, M A, Obihara, C C, and Fincham, J E
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Ascaris ,Enterobius ,HIV/AIDS ,hookworm ,IgE ,Trichuris ,tuberculosis - Abstract
Background: South Africa has endorsed a World Health Assembly (WHA) resolution calling for control of soil-transmitted helminths (STHs). In Cape Town, services and housing that exist in old-established suburbs should minimise the prevalence of intestinal parasitic infections, even when residents are poor. Where families live in shacks in densely-populated areas without effective sanitation, more than 90% of children can be infected by STHs. The humoral immune response to worms theoretically favours infection by Mycobacterium tuberculosis and HIV. Objectives: Obtain estimates of gender-, age-, school-related and overall prevalence of helminthiasis and giardiasis in a lowincome but well-serviced community. Assess possible sources of infection. Alert health services to the need for control measures and the threat from protozoal pathogens. Warn that the immune response to intestinal parasites may favour tuberculosis (TB) and HIV/ AIDS. Methods: A cross-sectional study of the prevalence of helminthiasis and giardiasis was carried out in a large, non-selective sample of children attending nine schools. Gender, school and age effects were related to non-medical preventive services, sewage disposal practices and possible sources of infection. Results: The overall STH infestation rate was 55.8%. Prevalence was in.uenced by school and age but not by gender. Eggs and cysts were seen at the following prevalence: Ascaris 24.8%; Trichuris 50.6%; Hymenolepis nana 2.2%; Enterobius 0.6%; Giardia 17.3%; hookworm 0.08%; and Trichostrongylus 0.1%. Approximately 60% of sewage sludge is used in a form that will contain viable eggs and cysts. Conclusions: Prevalence trends in this old community in Cape Town could indicate infection by swallowing eggs or cysts on food or in water, more than by exposure to polluted soil. Sewage sludge and effluent might be sources of infection. In adjacent, under serviced, newer communities, promiscuous defecation occurs. Probable vectors are discussed. The immune response to intestinal parasites might be a risk factor for HIV/AIDS and TB. Keywords: Ascaris; Enterobius; HIV/AIDS; hookworm; IgE; Trichuris; tuberculosis African Health Sciences Vol. 5 (3) 2005: pp. 276-280
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- 2007
23. Measles Outbreak in South Africa: Epidemiology of Laboratory-Confirmed Measles Cases and Assessment of Intervention, 2009–2011
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Barry D. Schoub, Ayanda Cengimbo, Genevie Ntshoe, Cheryl Cohen, Lucille Blumberg, Stefano Tempia, Beverley Singh, Jocelyn Moyes, Juno Thomas, Bernice Nerine Harris, Brett N. Archer, Sheilagh B. Smit, Adrian Puren, Johann Van den Heever, Mirriam Mashele, and Johanna M. McAnerney
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Male ,Viral Diseases ,Epidemiology ,Population Modeling ,Disease Outbreaks ,South Africa ,Cumulative incidence ,Child ,education.field_of_study ,Multidisciplinary ,biology ,Incidence ,Incidence (epidemiology) ,Vaccination ,Immunizations ,Infectious Diseases ,Child, Preschool ,Medicine ,Female ,Public Health ,Research Article ,Adult ,medicine.medical_specialty ,Adolescent ,Genotype ,Infectious Disease Control ,Clinical Research Design ,Science ,Measles Vaccine ,Population ,Measles ,Infectious Disease Epidemiology ,Measles virus ,Age Distribution ,medicine ,Humans ,education ,Biology ,Population Biology ,Clinical Laboratory Techniques ,business.industry ,Infant ,Reproducibility of Results ,Computational Biology ,medicine.disease ,biology.organism_classification ,Virology ,Immunoglobulin M ,Measles vaccine ,Infectious Disease Modeling ,business ,Demography - Abstract
BackgroundSince 1995, measles vaccination at nine and 18 months has been routine in South Africa; however, coverage seldom reached >95%. We describe the epidemiology of laboratory-confirmed measles case-patients and assess the impact of the nationwide mass vaccination campaign during the 2009 to 2011 measles outbreak in South Africa.MethodsSerum specimens collected from patients with suspected-measles were tested for measles-specific IgM antibodies using an enzyme-linked immunosorbent assay and genotypes of a subset were determined. To estimate the impact of the nationwide mass vaccination campaign, we compared incidence in the seven months pre- (1 September 2009-11 April 2010) and seven months post-vaccination campaign (24 May 2010-31 December 2010) periods in seven provinces of South Africa.ResultsA total of 18,431 laboratory-confirmed measles case-patients were reported from all nine provinces of South Africa (cumulative incidence 37 per 100,000 population). The highest cumulative incidence per 100,000 population was in children aged ConclusionWe observed a reduction in measles incidence following the nationwide mass vaccination campaign even though it was conducted approximately one year after the outbreak started. A booster dose at school entry may be of value given the high incidence in persons >5 years.
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- 2013
24. Cercaria hastatasp. nov. (Digenea: Trematoda) inBullia digitalis, a sandy beach surfing whelk from the Western Cape coast of South Africa: epidemiology and sex linked phenomena
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Webb, S.C., primary
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- 1991
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25. Protocol for the OCAY study: a cohort study of orphanhood and caregiver loss in the COVID-19 era to explore the impact on children and adolescents
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Steventon Roberts, Kathryn J, Du Toit, Stefani, Mawoyo, Tatenda, Tomlinson, Mark, Cluver, Lucie D, Skeen, Sarah, Laurenzi, Christina A, and Sherr, Lorraine
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Adolescent ,public health ,COVID-19 ,psychiatry ,South Africa - epidemiology ,Cohort Studies ,Caregivers ,SDG 3 - Good Health and Well-being ,COVID-19 - epidemiology ,Humans ,Longitudinal Studies ,Child ,Pandemics ,community child health - Abstract
Globally, no person has been untouched by the COVID-19 pandemic. Yet, little attention has been given to children and adolescents in policy, provision and services. Moreover, there is a dearth of knowledge regarding the impact of COVID-19-associated orphanhood and caregiver loss on children. This study aims to provide early insights into the mental health and well-being of children and adolescents experiencing orphanhood or caregiver loss in South Africa. Data will be drawn from a quantitative longitudinal study in Cape Town, South Africa. A sample of children and adolescents between the ages of 9 and 18 years, experiencing parental or caregiver loss from COVID-19, will be recruited together with a comparison group of children in similar environments who did not experience loss. The study aims to recruit 500 children in both groups. Mental health and well-being among children will be explored through the use of validated and study-specific measures. Participants will be interviewed at two time points, with follow-up data being collected 12-18 months after baseline. A combination of analytical techniques (including descriptive statistics, regression modelling and structural equation modelling) will be used to understand the experience and inform future policy and service provision. This study received ethical approval from the Health Research Ethics Committee at Stellenbosch University (N 22/04/040). Results will be disseminated via academic and policy publications, as well as national and international presentations including high-level meetings with technical experts. Findings will also be disseminated at a community level via various platforms.
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- 2023
26. Does pre-COVID impulsive behaviour predict adherence to hygiene and social distancing measures in youths following the COVID-19 pandemic onset? Evidence from a South African longitudinal study
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Haag, Katharina, Du Toit, Stefani, Mikus, Nace, Skeen, Sarah, Steventon Roberts, Kathryn, Marlow, Marguerite, Notholi, Vuyolwethu, Sambudla, Akhona, Chideya, Yeukai, Sherr, Lorraine, and Tomlinson, Mark
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Male ,Impulsivity ,Adolescent ,Public Health, Environmental and Occupational Health ,Hygiene ,COVID-19 - epidemiology - prevention & control ,South Africa - epidemiology ,Adolescence ,LMIC ,Pandemics - prevention & control ,Impulsive Behavior ,Longitudinal ,Humans ,Female ,Longitudinal Studies ,COVID - Abstract
Background Engagement in protective behaviours relating to the COVID-19 pandemic has been proposed to be key to infection control. This is particularly the case for youths as key drivers of infections. A range of factors influencing adherence have been identified, including impulsivity and risk taking. We assessed the association between pre-COVID impulsivity levels and engagement in preventative measures during the COVID-19 pandemic in a longitudinal South African sample, in order to inform future pandemic planning. Methods Data were collected from N = 214 youths (mean age at baseline: M = 17.81 (SD = .71), 55.6% female) living in a South African peri-urban settlement characterised by high poverty and deprivation. Baseline assessments were taken in 2018/19 and the COVID follow-up was conducted in June–October 2020 via remote data collection. Impulsivity was assessed using the Balloon Analogue Task (BART), while hygiene and social distancing behaviours were captured through self-report. Stepwise hierarchical regression analyses were performed to estimate effects of impulsivity on measure adherence. Results Self-rated engagement in hygiene behaviours was high (67.1–86.1% “most of the time”, except for “coughing/sneezing into one’s elbow” at 33.3%), while engagement in social distancing behaviours varied (22.4–57.8% “most of the time”). Higher impulsivity predicted lower levels of hygiene (β = .14, p = .041) but not social distancing behaviours (β = −.02, p = .82). This association was retained when controlling for a range of demographic and COVID-related factors (β = .14, p = .047) and was slightly reduced when including the effects of a life-skills interventions on hygiene behaviour (β = −.13, p = .073). Conclusions Our data indicate that impulsivity may predict adolescent engagement in hygiene behaviours post COVID-19 pandemic onset in a high risk, sub-Saharan African setting, albeit with a small effect size. For future pandemics, it is important to understand predictors of engagement, particularly in the context of adversity, where adherence may be challenging. Limitations include a small sample size and potential measure shortcomings.
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- 2023
27. Peritonitis in children on peritoneal dialysis in Cape Town, South Africa: epidemiology and risks
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Priya Gajjar, Cornelis H. Schröder, Peter Nourse, and Renske Raaijmakers
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Male ,medicine.medical_specialty ,Energy and redox metabolism [NCMLS 4] ,Adolescent ,medicine.medical_treatment ,Prevalence ,Peritonitis ,Peritoneal dialysis ,Cohort Studies ,South Africa ,Internal medicine ,Epidemiology ,medicine ,Humans ,Pediatrics, Perinatology, and Child Health ,Intensive care medicine ,Child ,Developing Countries ,Renal disorder [IGMD 9] ,Retrospective Studies ,Outcome ,Pediatric ,business.industry ,Socio-economic circumstances ,Infant ,Retrospective cohort study ,medicine.disease ,Risk factors ,Nephrology ,Child, Preschool ,Pediatrics, Perinatology and Child Health ,Cohort ,Female ,Original Article ,Complication ,business ,Peritoneal Dialysis ,Cohort study - Abstract
Contains fulltext : 89800raaijmakers.pdf (Publisher’s version ) (Closed access) Peritonitis is a frequent complication of peritoneal dialysis (PD) in children as well in adults. Data on PD and peritonitis in pediatric patients are very scarce in developing countries. A retrospective cohort study was performed between 2000 and 2008 with the aim to evaluate PD treatment and peritonitis epidemiology in pediatric patients in South Africa and identify risk factors for peritonitis. Baseline characteristics and potential risk factors of peritonitis were recorded, including housing, socio-economic circumstances, distance to PD center, type of PD, mode of catheter placement, race, presence of gastrostomy tube, weight, and height. Outcome indices for peritonitis were peritonitis rate, time to first peritonitis, and number of peritonitis-free patients. The patient cohort comprised 67 patients who were on PD for a total of 544 months. The total number of peritonitis episodes was 129. Median peritonitis rate was one episode every 4.3 patient months (2.8 episodes/patient-year, range 0-21.2). Median time to first infection was 2.03 months (range 0.1-21.5 months), and 28.4% of patients remained free from peritonitis. Patients with good housing and good socio-economic circumstances had a significantly lower peritonitis rate and a longer time to first peritonitis episode. Peritonitis rate was high in this cohort, compared to numbers reported for the developed world; the characteristics of causative organisms are comparable. The most important risk factors for the development of peritonitis were poor housing and poor socio-economic circumstances. More intensive counseling may be beneficial, but improvement of general socio-economic circumstances will have the greatest influence on PD success. 01 oktober 2010
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28. Differences in and drivers of mental, social, functional, and financial well-being during COVID-19: Evidence from Australia, France, Germany, and South Africa
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Arvid Hoffmann, Daria Plotkina, Marie-Hélène Broihanne, Anja Göritz, Stefanie Kleimeier, Department of Accounting and Finance, RS-Research Line Innovation (part of LIRS program), Finance, and RS: GSBE MORSE
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South Africa ,South Africa/epidemiology ,Multidisciplinary ,Germany ,Communicable Disease Control ,Australia/epidemiology ,Germany/epidemiology ,Australia ,COVID-19 ,Humans ,COVID-19/epidemiology - Abstract
COVID-19 has a substantial and unexpected impact on individuals’ daily life around the world. Unprecedented public health restrictions such as lockdowns have the potential to affect multiple dimensions of individuals’ well-being, while the severity of such restrictions varies across countries. However, a holistic perspective comparing differences in and drivers of the different dimensions of well-being across countries differentially affected by COVID-19 is missing to date. We address this gap in the literature by examining the mental, social, functional, and financial well-being of 2,100 individuals across Australia, France, Germany, and South Africa by means of a survey administered during May of 2021. Supporting our holistic approach, we find that the different dimensions of well-being are correlated, with survey respondents from France reporting the lowest and those from Australia reporting the highest overall level of well-being. Respondents’ subjective and objective evaluations of their living conditions during lockdowns as well as positive health and financial behaviors are positively associated with their well-being during the pandemic.
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- 2022
29. Emergence of SARS-CoV-2 Omicron lineages BA.4 and BA.5 in South Africa
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Tegally, Houriiyah, Moir, Monika, Everatt, Josie, Giovanetti, Marta, Scheepers, Cathrine, Wilkinson, Eduan, Subramoney, Kathleen, Makatini, Zinhle, Moyo, Sikhulile, Amoako, Daniel G, Baxter, Cheryl, Althaus, Christian L, Anyaneji, Ugochukwu J, Kekana, Dikeledi, Viana, Raquel, Giandhari, Jennifer, Lessells, Richard J, Maponga, Tongai, Maruapula, Dorcas, Choga, Wonderful, Matshaba, Mogomotsi, Mbulawa, Mpaphi B, Msomi, Nokukhanya, Naidoo, Yeshnee, Pillay, Sureshnee, Sanko, Tomasz Janusz, San, James E, Scott, Lesley, Singh, Lavanya, Magini, Nonkululeko A, Smith-Lawrence, Pamela, Stevens, Wendy, Dor, Graeme, Tshiabuila, Derek, Wolter, Nicole, Preiser, Wolfgang, Treurnicht, Florette K, Venter, Marietjie, Chiloane, Georginah, McIntyre, Caitlyn, O'Toole, Aine, Ruis, Christopher, Peacock, Thomas P, Roemer, Cornelius, Pond, Sergei L Kosakovsky, Williamson, Carolyn, Pybus, Oliver G, Bhiman, Jinal N, Glass, Allison, Martin, Darren P, Jackson, Ben, Rambaut, Andrew, Laguda-Akingba, Oluwakemi, Gaseitsiwe, Simani, von Gottberg, Anne, and de Oliveira, Tulio
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South Africa/epidemiology ,SARS-CoV-2 ,COVID-19 ,610 Medicine & health ,General Medicine ,General Biochemistry, Genetics and Molecular Biology ,Spike Glycoprotein, Coronavirus/genetics ,South Africa ,360 Social problems & social services ,SARS-CoV-2/genetics ,Spike Glycoprotein, Coronavirus ,Animals ,Humans ,Amino Acids ,COVID-19/epidemiology - Abstract
Three lineages (BA.1, BA.2 and BA.3) of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) Omicron variant of concern predominantly drove South Africa’s fourth Coronavirus Disease 2019 (COVID-19) wave. We have now identified two new lineages, BA.4 and BA.5, responsible for a fifth wave of infections. The spike proteins of BA.4 and BA.5 are identical, and similar to BA.2 except for the addition of 69–70 deletion (present in the Alpha variant and the BA.1 lineage), L452R (present in the Delta variant), F486V and the wild-type amino acid at Q493. The two lineages differ only outside of the spike region. The 69–70 deletion in spike allows these lineages to be identified by the proxy marker of S-gene target failure, on the background of variants not possessing this feature. BA.4 and BA.5 have rapidly replaced BA.2, reaching more than 50% of sequenced cases in South Africa by the first week of April 2022. Using a multinomial logistic regression model, we estimated growth advantages for BA.4 and BA.5 of 0.08 (95% confidence interval (CI): 0.08–0.09) and 0.10 (95% CI: 0.09–0.11) per day, respectively, over BA.2 in South Africa. The continued discovery of genetically diverse Omicron lineages points to the hypothesis that a discrete reservoir, such as human chronic infections and/or animal hosts, is potentially contributing to further evolution and dispersal of the virus.
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- 2022
30. Risk Factors for Coronavirus Disease 2019 (COVID-19) Death in a Population Cohort Study from the Western Cape Province, South Africa
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Boulle, Andrew, Davies, Mary-Ann, Hussey, Hannah, Ismail, Muzzammil, Morden, Erna, Vundle, Ziyanda, Zweigenthal, Virginia, Mahomed, Hassan, Paleker, Masudah, Pienaar, David, Tembo, Yamanya, Lawrence, Charlene, Isaacs, Washiefa, Mathema, Hlengani, Allen, Derick, Allie, Taryn, Bam, Jamy-Lee, Buddiga, Kasturi, Dane, Pierre, Heekes, Alexa, Matlapeng, Boitumelo, Mutemaringa, Themba, Muzarabani, Luckmore, Phelanyane, Florence, Pienaar, Rory, Rode, Catherine, Smith, Mariette, Tiffin, Nicki, Zinyakatira, Nesbert, Cragg, Carol, Marais, Frederick, Mudaly, Vanessa, Voget, Jacqueline, Davids, Jody, Roodt, Francois, van Zyl Smit, Nellis, Vermeulen, Alda, Adams, Kevin, Audley, Gordon, Bateman, Kathleen, Beckwith, Peter, Bernon, Marc, Blom, Dirk, Boloko, Linda, Botha, Jean, Boutall, Adam, Burmeister, Sean, Cairncross, Lydia, Calligaro, Gregory, Coccia, Cecilia, Corin, Chadwin, Daroowala, Remy, Dave, Joel A, De Bruyn, Elsa, De Villiers, Martin, Deetlefs, Mimi, Dlamini, Sipho, Du Toit, Thomas, Endres, Wilhelm, Europa, Tarin, Fieggan, Graham, Figaji, Anthony, Frankenfeld, Petro, Gatley, Elizabeth, Gina, Phindile, Govender, Evashan, Grobler, Rochelle, Gule, Manqoba Vusumuzi, Hanekom, Christoff, Held, Michael, Heynes, Alana, Hlatswayo, Sabelo, Hodkinson, Bridget, Holtzhausen, Jeanette, Hoosain, Shakeel, Jacobs, Ashely, Kahn, Miriam, Kahn, Thania, Khamajeet, Arvin, Khan, Joubin, Khan, Riaasat, Khwitshana, Alicia, Knight, Lauren, Kooverjee, Sharita, Krogscheepers, Rene, Kruger, Jean Jacque, Kuhn, Suzanne, Laubscher, Kim, Lazarus, John, Le Roux, Jacque, Lee Jones, Scott, Levin, Dion, Maartens, Gary, Majola, Thina, Manganyi, Rodgers, Marais, David, Marais, Suzaan, Maritz, Francois, Maughan, Deborah, Mazondwa, Simthandile, Mbanga, Luyanda, Mbatani, Nomonde, Mbena, Bulewa, Meintjes, Graeme, Mendelson, Marc, Möller, Ernst, Moore, Allison, Ndebele, Babalwa, Nortje, Marc, Ntusi, Ntobeko, Nyengane, Funeka, Ofoegbu, Chima, Papavarnavas, Nectarios, Peter, Jonny, Pickard, Henri, Pluke, Kent, Raubenheimer, Peter J, Robertson, Gordon, Rozmiarek, Julius, Sayed, A, Scriba, Matthias, Sekhukhune, Hennie, Singh, Prasun, Smith, Elsabe, Soldati, Vuyolwethu, Stek, Cari, van den berg, Robert, van der Merwe, Le Roux, Venter, Pieter, Vermooten, Barbra, Viljoen, Gerrit, Viranna, Santhuri, Vogel, Jonno, Vundla, Nokubonga, Wasserman, Sean, Zitha, Eddy, Lomas-Marais, Vanessa, Lombard, Annie, Stuve, Katrin, Viljoen, Werner, Basson, De Vries, Le Roux, Sue, Linden-Mars, Ethel, Victor, Lizanne, Wates, Mark, Zwanepoel, Elbe, Ebrahim, Nabilah, Lahri, Sa’ad, Mnguni, Ayanda, Crede, Thomas, de Man, Martin, Evans, Katya, Hendrikse, Clint, Naude, Jonathan, Parak, Moosa, Szymanski, Patrick, Van Koningsbruggen, Candice, Abrahams, Riezaah, Allwood, Brian, Botha, Christoffel, Botha, Matthys Henndrik, Broadhurst, Alistair, Claasen, Dirkie, Daniel, Che, Dawood, Riyaadh, du Preez, Marie, Du Toit, Nicolene, Erasmus, Kobie, Koegelenberg, Coenraad F N, Gabriel, Shiraaz, Hugo, Susan, Jardine, Thabiet, Johannes, Clint, Karamchand, Sumanth, Lalla, Usha, Langenegger, Eduard, Louw, Eize, Mashigo, Boitumelo, Mhlana, Nonte, Mnqwazi, Chizama, Moodley, Ashley, Moodley, Desiree, Moolla, Saadiq, Mowlana, Abdurasiet, Nortje, Andre, Olivier, Elzanne, Parker, Arifa, Paulsen, Chané, Prozesky, Hans, Rood, Jacques, Sabela, Tholakele, Schrueder, Neshaad, Sithole, Nokwanda, Sithole, Sthembiso, Taljaard, Jantjie J, Titus, Gideon, Van Der Merwe, Tian, van Schalkwyk, Marije, Vazi, Luthando, Viljoen, Abraham J, Yazied Chothia, Mogamat, Naidoo, Vanessa, Wallis, Lee Alan, Abbass, Mumtaz, Arendse, Juanita, Armien, Rizqa, Bailey, Rochelle, Bello, Muideen, Carelse, Rachel, Forgus, Sheron, Kalawe, Nosi, Kariem, Saadiq, Kotze, Mariska, Lucas, Jonathan, McClaughlin, Juanita, Murie, Kathleen, Najjaar, Leilah, Petersen, Liesel, Porter, James, Shaw, Melanie, Stapar, Dusica, Williams, Michelle, Aldum, Linda, Berkowitz, Natacha, Girran, Raakhee, Lee, Kevin, Naidoo, Lenny, Neumuller, Caroline, Anderson, Kim, Begg, Kerrin, Boerlage, Lisa, Cornell, Morna, de Waal, Renée, Dudley, Lilian, English, René, Euvrard, Jonathan, Groenewald, Pam, Jacob, Nisha, Jaspan, Heather, Kalk, Emma, Levitt, Naomi, Malaba, Thoko, Nyakato, Patience, Patten, Gabriela, Schneider, Helen, Shung King, Maylene, Tsondai, Priscilla, Van Duuren, James, van Schaik, Nienke, Blumberg, Lucille, Cohen, Cheryl, Govender, Nelesh, Jassat, Waasila, Kufa, Tendesayi, McCarthy, Kerrigan, Morris, Lynn, Hsiao, Nei-yuan, Marais, Ruan, Ambler, Jon, Ngwenya, Olina, Osei-Yeboah, Richard, Johnson, Leigh, Kassanjee, Reshma, and Tamuhla, Tsaone
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sub-Saharan Africa ,0301 basic medicine ,Microbiology (medical) ,Adult ,Male ,Tuberculosis ,antiretroviral ,030106 microbiology ,Population ,HIV Infections ,HIV Infections/complications ,Cohort Studies ,South Africa ,03 medical and health sciences ,0302 clinical medicine ,Risk Factors ,Major Article ,Medicine ,Humans ,030212 general & internal medicine ,education ,Proportional Hazards Models ,education.field_of_study ,South Africa/epidemiology ,business.industry ,Proportional hazards model ,SARS-CoV-2 ,Hazard ratio ,HIV ,Correction ,COVID-19 ,medicine.disease ,Confidence interval ,AcademicSubjects/MED00290 ,Infectious Diseases ,Standardized mortality ratio ,tuberculosis ,Attributable risk ,business ,Viral load ,Demography - Abstract
Background Risk factors for coronavirus disease 2019 (COVID-19) death in sub-Saharan Africa and the effects of human immunodeficiency virus (HIV) and tuberculosis on COVID-19 outcomes are unknown. Methods We conducted a population cohort study using linked data from adults attending public-sector health facilities in the Western Cape, South Africa. We used Cox proportional hazards models, adjusted for age, sex, location, and comorbidities, to examine the associations between HIV, tuberculosis, and COVID-19 death from 1 March to 9 June 2020 among (1) public-sector “active patients” (≥1 visit in the 3 years before March 2020); (2) laboratory-diagnosed COVID-19 cases; and (3) hospitalized COVID-19 cases. We calculated the standardized mortality ratio (SMR) for COVID-19, comparing adults living with and without HIV using modeled population estimates. Results Among 3 460 932 patients (16% living with HIV), 22 308 were diagnosed with COVID-19, of whom 625 died. COVID-19 death was associated with male sex, increasing age, diabetes, hypertension, and chronic kidney disease. HIV was associated with COVID-19 mortality (adjusted hazard ratio [aHR], 2.14; 95% confidence interval [CI], 1.70–2.70), with similar risks across strata of viral loads and immunosuppression. Current and previous diagnoses of tuberculosis were associated with COVID-19 death (aHR, 2.70 [95% CI, 1.81–4.04] and 1.51 [95% CI, 1.18–1.93], respectively). The SMR for COVID-19 death associated with HIV was 2.39 (95% CI, 1.96–2.86); population attributable fraction 8.5% (95% CI, 6.1–11.1). Conclusions While our findings may overestimate HIV- and tuberculosis-associated COVID-19 mortality risks due to residual confounding, both living with HIV and having current tuberculosis were independently associated with increased COVID-19 mortality. The associations between age, sex, and other comorbidities and COVID-19 mortality were similar to those in other settings.
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- 2021
31. Evidence to support a food-based dietary guideline on sugar consumption in South Africa
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Steyn N.P., Myburgh N.G., and Nel J.H.
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Dietary sucrose/administration and dosage ,Dietary sucrose/adverse effects ,Dietary carbohydrates/administration and dosage ,Energy intake ,Diet/standards ,Dental caries/prevention and control ,Protein-energy malnutrition/prevention and control ,Obesity/prevention and control ,Nutritive value ,Micronutrients ,Chronic disease ,Food habits/ethnology ,Guidelines ,Nutrition policy ,Rural health ,Urban health ,South Africa/epidemiology ,South Africa/ethnology ,Public aspects of medicine ,RA1-1270 - Abstract
Since 1997, South Africa has been developing and implementing food-based dietary guidelines for people aged >6 years. The complexity of the population, which contains different ethnic groups, as well as the rapid urbanization that is taking place, means that food-based dietary guidelines need to consider both overnutrition and undernutrition. The initial guidelines did not include guidance on sugar, and the Department of Health was not prepared to approve them until appropriate guidance on sugar was included. This paper summarizes the evidence available for such a guideline and the nature of that evidence. Other low- and middle-income countries, particularly those in Africa, may face a similar dilemma and might learn from our experience.
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- 2003
32. Why have socioeconomic explanations been favoured over cultural ones in explaining the extensive spread of HIV in South Africa?
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Chris Kenyon, Sizwe Zondo, Robert Colebunders, and Sipho Dlamini
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HIV, South Africa, epidemiology, sexuality, concurrency, prevention ,Public aspects of medicine ,RA1-1270 ,Infectious and parasitic diseases ,RC109-216 - Abstract
The HIV prevalence in South Africa’s various racial/ethnic groups differs by more than an order of magnitude. These differences are determined not by the lifetime number of sexual partners, but by how these partnerships are more likely to be arranged concurrently in African communities. The available evidence demonstrates that neither HIV nor concurrency rates are determined by socio-economic factors. Rather, high concurrency rates are maintained by a culturally sanctioned tolerance of concurrency. Why then do socio-economic explanations trump cultural ones in the South African HIV aetiological literature? In this article, we explore how three factors (a belief in monogamy as a universal norm, HIV’s emergence in a time of the construction of non-racialism, and a simplified understanding of HIV epidemiology) have intersected to produce this bias and therefore continue to hinder the country’s HIV prevention efforts.
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- 2012
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33. Novel SARS-CoV-2 variants: the pandemics within the pandemic
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Boehm, Erik, Kronig, Ilona, Neher, Richard A, Eckerle, Isabella Anne, Vetter, Pauline, and Kaiser, Laurent
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ddc:616 ,South Africa/epidemiology ,COVID-19/epidemiology/transmission/virology ,United Kingdom/epidemiology ,Genetic Variation ,macromolecular substances ,SARS-CoV-2/genetics/immunology ,Antibodies ,Neutralizing/immunology ,Epidemiological Monitoring ,Mutation ,Brazil/epidemiology ,Humans ,Viral/immunology ,Pandemics - Abstract
Many new variants of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) have been termed variants of concern/interest (VOC/I) because of the greater risk they pose due to possible enhanced transmissibility and/or severity, immune escape, diagnostic and/or treatment failure, and reduced vaccine efficacy.
- Published
- 2021
34. Accessing healthcare as a person with a rugby-related spinal cord injury in South Africa: the injured player’s perspective
- Author
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Mike Lambert, Evert Verhagen, Willem van Mechelen, Marelise Badenhorst, James Brown, Public and occupational health, AMS - Sports, APH - Health Behaviors & Chronic Diseases, APH - Societal Participation & Health, Human Physiology and Sports Physiotherapy Research Group, and Physiotherapy, Human Physiology and Anatomy
- Subjects
030506 rehabilitation ,medicine.medical_treatment ,Population ,Physical Therapy, Sports Therapy and Rehabilitation ,Health Services Accessibility ,Nonprobability sampling ,03 medical and health sciences ,South Africa ,0302 clinical medicine ,Quality of life (healthcare) ,Nursing ,Health care ,medicine ,Humans ,Spinal Cord Injuries/rehabilitation ,education ,Spinal cord injury ,Spinal Cord Injuries ,education.field_of_study ,South Africa/epidemiology ,Rehabilitation ,business.industry ,medicine.disease ,Quality of Life ,Rugby ,Thematic analysis ,0305 other medical science ,business ,Inclusion (education) ,030217 neurology & neurosurgery - Abstract
BACKGROUND: Rugby carries a risk for serious injuries, including acute spinal cord injuries. The lifetime health consequences of these injuries may be far-reaching. PURPOSE: In this study, we aimed to describe barriers and facilitators to healthcare and rehabilitation, in individuals with rugby-related spinal cord injuries in South Africa. METHODS: This study adopted a pragmatic qualitative approach. Stratified purposive sampling was used to select interviews from players from a variety of socio-economic status and geographical areas for inclusion in this study. The final sample consisted of thirty-one (n = 31) participants. Thematic analysis was used to analyze the data. RESULTS: Participants described long-term, accessible, affordable, quality healthcare and rehabilitation as important contributors to their quality of life. Even though public healthcare is accessible from a cost point of view, quality of care, availability of rehabilitation services and factors such as affordability and availability of adequate transport remain a barrier for lower socio-economic groups. CONCLUSION: This population was unique, as the support from a dedicated organization enabled participants to overcome some barriers, highlighting the challenges of the healthcare system in maintaining the health of people with spinal cord injuries. Every effort should be made to create equitable access to healthcare and rehabilitation for persons with spinal cord injuries in South Africa.
- Published
- 2021
35. Rickettsioses in Denmark: A retrospective survey of clinical features and travel history
- Author
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Sigurdur Skarphedinsson, Anne-Mette Lebech, Steen Villumsen, Karen A. Krogfelt, Ram Benny Dessau, Bo Bødker Jensen, and Lukas Frans Ocias
- Subjects
Male ,0301 basic medicine ,Pediatrics ,Denmark ,Disease ,African tick bite fever ,Serology ,South Africa ,Ticks ,0302 clinical medicine ,Communicable Diseases, Imported ,Surveys and Questionnaires ,Registries ,Rickettsia ,Travel ,Tick-borne disease ,South Africa/epidemiology ,Medical record ,Antibodies, Bacterial/blood ,Antibodies, Bacterial ,Hospitalization ,Infectious Diseases ,Tick-Borne Diseases ,language ,Female ,medicine.medical_specialty ,Africa, Southern/epidemiology ,030231 tropical medicine ,030106 microbiology ,Biology ,Microbiology ,Africa, Southern ,Danish ,03 medical and health sciences ,Rickettsia/genetics ,medicine ,Animals ,Humans ,Communicable Diseases, Imported/epidemiology ,Rickettsia Infections/diagnosis ,Retrospective Studies ,Public health ,Rickettsia Infections ,Retrospective cohort study ,medicine.disease ,Denmark/epidemiology ,language.human_language ,Insect Science ,Parasitology ,Ticks/microbiology - Abstract
Rickettsia spp. can be found across the globe and cause disease of varying clinical severity, ranging from life-threatening infections with widespread vasculitis to milder, more localized presentations. Vector and, to some degree, reservoir are hematophagous arthropods, with most species harboured by ticks. In Denmark, rickettsiae are known as a cause of imported travel-related infections, but are also found endemically in ticks across the country. Data are, however, lacking on the geographical origin and clinical features of diagnosed cases. In this study, we have examined the travel history and clinical features of two groups of patients; 1) hospital-patients diagnosed with rickettsioses in the years 2010–2015 and 2) patients from primary health care (PHC) centers in Denmark having demonstrated anti-rickettsia antibodies in the years 2012–2015. The patients were identified using the Danish National Patient Registry (DNPR) and through the serological database at the State Serum Institute, where the laboratory diagnosis of rickettsioses is currently centralized. Data were collected for 86 hospital patients and 26 PHC center patients by reviewing hospital medical records and performing telephone interviews with PHC centers. Of the hospital patients, 91% (78/86) had a history of international travel 14 days prior to symptom start, with most having imported their infection from southern Africa, South Africa in particular (65%), and presenting with a clinical picture most compatible with African tick-bite fever caused by R. africae. Only two patients presented with a CRP > 100 mg/L and no mortalities were reported. At the PHC centers, most patients presented with mild flu-like symptoms and had an unknown (50%) or no history (19%) of international travel, raising the possibility of endemic rickettsioses. In view of our findings, rickettsioses do not appear to constitute a major public health problem in Denmark, with most cases being imported infections and potential endemic cases presenting as mild infections.
- Published
- 2018
36. Efficacy and Safety of Tenofovir Disoproxil Fumarate Versus Low-Dose Stavudine Over 96 Weeks : A Multicountry Randomized, Noninferiority Trial
- Author
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Venter, Willem Daniel Francois, Kambugu, Andrew, Chersich, Matthew F, Becker, Stephen, Hill, Andrew, Arulappan, Natasha, Moorhouse, Michelle, Majam, Mohammed, Akpomiemie, Godspower, Sokhela, Simiso, Poongulali, Selvamuthu, Feldman, Charles, Duncombe, Chris, Ripin, David H Brown, Vos, Alinda, and Kumarasamy, Nagalingeswaran
- Subjects
Adult ,Male ,stavudine DEXA ,HIV Infections/drug therapy ,resource allocation ,India ,Equivalence Trials as Topic ,Kidney/drug effects ,Young Adult ,South Africa ,Double-Blind Method ,parasitic diseases ,Tenofovir/therapeutic use ,Journal Article ,Humans ,Uganda ,Pharmacology (medical) ,South Africa/epidemiology ,Research Support, Non-U.S. Gov't ,public health ,Bone and Bones/drug effects ,Uganda/epidemiology ,toxicity ,HIV ,trial ,Stavudine/therapeutic use ,tenofovir ,Multicenter Study ,Infectious Diseases ,dose reduction ,Anti-HIV Agents/therapeutic use ,Randomized Controlled Trial ,Female ,renal ,Research Support, U.S. Gov't, Non-P.H.S - Abstract
Background:Reducing doses of antiretroviral drugs, including stavudine (d4T), may lower toxicity, while preserving efficacy. There are substantial concerns about renal and bone toxicities of tenofovir disoproxil fumarate (TDF).Setting:HIV-1-infected treatment-naive adults in India, South Africa, and Uganda.Methods:A phase-4, 96-week, randomized, double-blind, noninferiority trial compared d4T 20 mg twice daily and TDF, taken in combination with lamivudine (3TC) and efavirenz (EFV). The primary endpoint was the proportion of participants with HIV-1 RNA
- Published
- 2019
37. The human microbiota is associated with cardiometabolic risk across the epidemiologic transition
- Author
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Jack A. Gilbert, Louise Lie, Stephanie Kliethermes, Lara R. Dugas, Brian T. Layden, Danny Baghdan, Jacob Plange-Rhule, Neil Gottel, Estelle V. Lambert, Walter F. Riesen, Beatriz Penalver Bernabe, Wolfgang Korte, Pascal Bovet, Kweku Bedu-Addo, Na Fei, Amy Luke, Terrence Forrester, and Loor, Juan J
- Subjects
0301 basic medicine ,Male ,Aging ,Epidemiology ,Physiology ,Blood Pressure ,Gut flora ,Cardiovascular ,Vascular Medicine ,Ghana ,Geographical Locations ,South Africa ,0302 clinical medicine ,Risk Factors ,Medicine and Health Sciences ,Prevotella ,Uncategorized ,2. Zero hunger ,0303 health sciences ,Multidisciplinary ,biology ,Human microbiome ,Genomics ,Middle Aged ,Medical Microbiology ,Cardiovascular Diseases ,030220 oncology & carcinogenesis ,Medicine ,Female ,Waist Circumference ,Research Article ,Adult ,Jamaica ,General Science & Technology ,Science ,Veillonella ,Microbial Genomics ,Microbiology ,03 medical and health sciences ,Metabolic Diseases ,Clinical Research ,Genetics ,Humans ,Dental/Oral and Craniofacial Disease ,Feces ,030304 developmental biology ,Nutrition ,Mouth ,Bacteria ,030306 microbiology ,Prevention ,Gut Bacteria ,Lachnospiraceae ,Organisms ,Biology and Life Sciences ,Cardiovascular Diseases/epidemiology ,Cardiovascular Diseases/microbiology ,Gastrointestinal Microbiome ,Ghana/epidemiology ,Jamaica/epidemiology ,Metabolic Diseases/epidemiology ,Metabolic Diseases/microbiology ,Mouth/microbiology ,South Africa/epidemiology ,United States/epidemiology ,biology.organism_classification ,United States ,030104 developmental biology ,Blood pressure ,Medical Risk Factors ,People and Places ,Africa ,North America ,Microbiome ,Lipoprotein - Abstract
Oral and fecal microbial biomarkers have previously been associated with cardiometabolic (CM) risk, however, no comprehensive attempt has been made to explore this association in minority populations or across different geographic regions. We characterized gut- and oral-associated microbiota and CM risk in 655 participants of African-origin, aged 25-45, from Ghana, South Africa, Jamaica, and the United States (US). CM risk was classified using the CM risk cut-points for elevated waist circumference, elevated blood pressure and elevated fasted blood glucose, low high-density lipoprotein (HDL), and elevated triglycerides. Gut-associated bacterial alpha diversity negatively correlated with elevated blood pressure and elevated fasted blood glucose. Similarly, gut bacterial beta diversity was also significantly differentiated by waist circumference, blood pressure, triglyceridemia and HDL-cholesterolemia. Notably, differences in inter- and intra-personal gut microbial diversity were geographic-region specific. Participants meeting the cut-points for 3 out of the 5 CM risk factors were significantly more enriched with Lachnospiraceae, and were significantly depleted of Clostridiaceae, Peptostreptococcaceae, andPrevotella. The predicted relative proportions of the genes involved in the pathways for lipopolysaccharides (LPS) and butyrate synthesis were also significantly differentiated by the CM risk phenotype, whereby genes involved in the butyrate synthesis via lysine, glutarate and 4-aminobutyrate/succinate pathways and LPS synthesis pathway were enriched in participants with greater CM risk. Furthermore, inter-individual oral microbiota diversity was also significantly associated with the CM risk factors, and oral-associatedStreptococcus, Prevotella, andVeillonellawere enriched in participants with 3 out of the 5 CM risk factors. We demonstrate that in a diverse cohort of African-origin adults, CM risk is significantly associated with reduced microbial diversity, and the enrichment of specific bacterial taxa and predicted functional traits in both gut and oral environments. As well as providing new insights into the associations between the gut and oral microbiota and CM risk, this study also highlights the potential for novel therapeutic discoveries which target the oral and gut microbiota in CM risk.
- Published
- 2019
38. Global epidemiology of breast cancer based on risk factors: a systematic review.
- Author
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Roheel, Amna, Khan, Aslam, Anwar, Fareeha, Akbar, Zunaira, Akhtar, Muhammad Furqan, Khan, Mohammad Imran, Sohail, Mohammad Farhan, and Ahmad, Rizwan
- Subjects
EPIDEMIOLOGY of cancer ,DISEASE risk factors ,BREAST cancer ,BRCA genes ,GENETIC variation - Abstract
Background: Numerous reviews of the epidemiology and risk factors for breast cancer have been published previously which heighted different directions of breast cancer. Aim: The present review examined the likelihood that incidence, prevalence, and particular risk factors might vary by geographic region and possibly by food and cultural practices as well. Methods: A systematic review (2017-2022) was conducted following Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guidelines, reporting on epidemiological and risk factor reports from different world regions. Medical Subject Heading (MeSH) terms: "Breast neoplasm" "AND" country terms such as "Pakistan/epidemiology", "India/epidemiology", "North America/epidemiology", "South Africa/epidemiology" were used to retrieve 2068 articles from PubMed. After applying inclusion and exclusion terms, 49 papers were selected for systematic review. Results: Results of selected articles were summarized based on risk factors, world regions and study type. Risk factors were classified into five categories: demographic, genetic and lifestyle risk factors varied among countries. This review article covers a variety of topics, including regions, main findings, and associated risk factors such as genetic factors, and lifestyle. Several studies revealed that lifestyle choices including diet and exercise could affect a person's chance of developing breast cancer. Breast cancer risk has also been linked to genetic variables, including DNA repair gene polymorphisms and mutations in the breast cancer gene (BRCA). It has been found that most of the genetic variability links to the population of Asia while the cause of breast cancer due to lifestyle modifications has been found in American and British people, indicating that demographic, genetic, and, lifestyle risk factors varied among countries. Conclusion: There are many risk factors for breast cancer, which vary in their importance depending on the world region. However, further investigation is required to better comprehend the particular causes of breast cancer in these areas as well as to create efficient prevention and treatment plans that cater to the local population. [ABSTRACT FROM AUTHOR]
- Published
- 2023
- Full Text
- View/download PDF
39. A prospective cohort study of school-going children investigating reproductive and neurobehavioral health effects due to environmental pesticide exposure in the Western Cape, South Africa: study protocol
- Author
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Chetty-Mhlanga, Shala, Basera, Wisdom, Fuhrimann, Samuel, Probst-Hensch, Nicole, Delport, Steven, Mugari, Mufaro, Van Wyk, Jennifer, Röösli, Martin, Dalvie, Mohamed Aqiel, One Health Chemisch, dIRAS RA-2, Division of Occupational Therapy, Faculty of Health Sciences, One Health Chemisch, and dIRAS RA-2
- Subjects
Male ,Testis/pathology ,Research design ,Neuropsychological Tests ,Co-exposures ,010501 environmental sciences ,01 natural sciences ,Cohort Studies ,South Africa ,Study Protocol ,0302 clinical medicine ,Low exposures ,Breast/pathology ,Neuropsychological Tests/statistics & numerical data ,Testis ,Epidemiology ,Breast ,Longitudinal Studies ,Prospective Studies ,030212 general & internal medicine ,Gonadal Steroid Hormones ,Child ,Reproductive health ,Gonadal Steroid Hormones/blood ,South Africa/epidemiology ,lcsh:Public aspects of medicine ,Cambridge Neuropsychological Test Automated Battery ,Agriculture ,Organ Size ,Rural communities ,Research Design ,Air and water ,Female ,Cohort study ,medicine.medical_specialty ,Adolescent ,Endocrine disruption ,Cognition Disorders/chemically induced ,Pesticides/adverse effects ,03 medical and health sciences ,Neurobehaviour ,School-going children ,Environmental health ,medicine ,Humans ,Pesticides ,0105 earth and related environmental sciences ,business.industry ,Public health ,Public Health, Environmental and Occupational Health ,lcsh:RA1-1270 ,Environmental Exposure ,Structured interview ,Biostatistics ,Cognition Disorders ,business ,Environmental Exposure/adverse effects - Abstract
Background Research on reproductive health effects on children from low-level, long-term exposure to pesticides currently used in the agricultural industry is limited and those on neurobehavioral effects have produced conflicting evidence. We aim at investigating the association between pesticide exposure on the reproductive health and neurobehavior of children in South Africa, by including potential relevant co-exposures from the use of electronic media and maternal alcohol consumption. Methods The design entails a prospective cohort study with a follow-up duration of 2 years starting in 2017, including 1000 school going children between the ages of 9 to 16 years old. Children are enrolled with equal distribution in sex and residence on farms and non-farms in three different agricultural areas (mainly apple, table grapes and wheat farming systems) in the Western Cape, South Africa. The neurobehavior primary health outcome of cognitive functioning was measured through the iPad-based CAmbridge Neuropsychological Test Automated Battery (CANTAB) including domains for attention, memory, and processing speed. The reproductive health outcomes include testicular size in boys and breast size in girls assessed in a physical examination, and blood samples to detect hormone levels and anthropometric measurements. Information on pesticide exposure, co-exposures and relevant confounders are obtained through structured questionnaire interviews with the children and their guardians. Environmental occurrence of pesticides will be determined while using a structured interview with farm owners and review of spraying records and collection of passive water and air samples in all three areas. Pesticide metabolites will be analysed in urine and hair samples collected from the study subjects every 4 months starting at baseline. Discussion The inclusion of three different agricultural areas will yield a wide range of pesticide exposure situations. The prospective longitudinal design is a further strength of this study to evaluate the reproductive and neurobehavioural effects of different pesticides on children. This research will inform relevant policies and regulatory bodies to improve the health, safety and learning environments for children and families in agricultural settings.
- Published
- 2018
40. A Serum Circulating miRNA Signature for Short-Term Risk of Progression to Active Tuberculosis Among Household Contacts
- Author
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Fergal J. Duffy, Ethan Thompson, Katrina Downing, Sara Suliman, Harriet Mayanja-Kizza, W. Henry Boom, Bonnie Thiel, January Weiner III, Stefan H. E. Kaufmann, Drew Dover, David L. Tabb, Hazel M. Dockrell, Tom H. M. Ottenhoff, Gerard Tromp, Thomas J. Scriba, Daniel E. Zak, Gerhard Walzl, the GC6-74 Consortium, S. H. E. Kaufmann, S. K. Parida, R. Golinski, J. Maertzdorf, J. Weiner, M. Jacobson, G. McEwen, G. Walzl, G. Black, G. van der Spuy, K. Stanley, M. Kriel, N. Du Plessis, N. Nene, A. Loxton, N. N. Chegou, S. Suliman, T. Scriba, H. Mahomed, M. Erasmus, O. Xasa, A. Veldsman, J. Hughes, K. Downing, A. Penn-Nicholson, H. Mulenga, B. Abel, M. Bowmaker, B. Kagina, W. Kwong C, W. Hanekom, T. H. M. Ottenhoff, M. R. Klein, M. C. Haks, K. L. Franken, A. Geluk, K. E. van Meijgaarden, S. A. Joosten, D. van Baarle, F. Miedema, W. H. Boom, B. Thiel, J. Sadoff, D. Sizemore, S. Ramachandran, L. Barker, M. Brennan, F. Weichold, S. Muller, L. Geiter, G. Schoolnik, G. Dolganov, T. Van, H. Mayanja-Kizza, M. Joloba, S. Zalwango, M. Nsereko, B. Okwera, H. Kisingo, H. Dockrell, S. Smith, P. Gorak-Stolinska, Y.-G. Hur, M. Lalor, J.-S. Lee, A. C. Crampin, N. French, B. Ngwira, A. B. Smith, K. Watkins, L. Ambrose, F. Simukonda, H. Mvula, F. Chilongo, J. Saul, K. Branson, D. Kassa, A. Abebe, T. Mesele, B. Tegbaru, R. Howe, A. Mihret, A. Aseffa, Y. Bekele, R. Iwnetu, M. Tafesse, L. Yamuah, M. Ota, J. Sutherland, P. Hill, R. Adegbola, T. Corrah, M. Antonio, T. Togun, I. Adetifa, S. Donkor, P. Andersen, I. Rosenkrands, M. Doherty, K. Weldingh, and Translational Immunology Groningen (TRIGR)
- Subjects
Male ,0301 basic medicine ,Oncology ,Circulating mirnas ,Tuberculosis, Pulmonary/blood ,Machine Learning ,South Africa ,0302 clinical medicine ,Immunology and Allergy ,Medicine ,Uganda ,030212 general & internal medicine ,Original Research ,South Africa/epidemiology ,microRNA ,biology ,3. Good health ,tuberculosis ,Disease Progression ,biomarker ,Biomarker (medicine) ,Female ,Area under the roc curve ,lcsh:Immunologic diseases. Allergy ,Adult ,Risk ,medicine.medical_specialty ,Tuberculosis ,Adolescent ,household contact ,Immunology ,Mycobacterium tuberculosis ,Young Adult ,03 medical and health sciences ,Active tb ,Internal medicine ,Pulmonary/blood ,Humans ,Circulating MicroRNA/blood ,Circulating MicroRNA ,Tuberculosis, Pulmonary ,correlate of risk ,business.industry ,Uganda/epidemiology ,biology.organism_classification ,medicine.disease ,Active tuberculosis ,030104 developmental biology ,Contact Tracing ,lcsh:RC581-607 ,business ,Biomarkers/blood ,Biomarkers - Abstract
Biomarkers that predict who among recently Mycobacterium tuberculosis (MTB)-exposed individuals will progress to active tuberculosis are urgently needed. Intracellular microRNAs (miRNAs) regulate the host response to MTB and circulating miRNAs (c-miRNAs) have been developed as biomarkers for other diseases. We performed machine-learning analysis of c-miRNA measurements in the serum of adult household contacts (HHCs) of TB index cases from South Africa and Uganda and developed a c-miRNA-based signature of risk for progression to active TB. This c-miRNA-based signature significantly discriminated HHCs within 6 months of progression to active disease from HHCs that remained healthy in an independent test set [ROC area under the ROC curve (AUC) 0.74, progressors
- Published
- 2018
41. Rickettsioses in Denmark:A retrospective survey of clinical features and travel history
- Author
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Ocias, Lukas Frans, Jensen, Bo Bødker, Villumsen, Steen, Lebech, Anne-Mette, Skarphedinsson, Sigurdur, Dessau, Ram Benny, and Krogfelt, Karen Angeliki
- Subjects
Emerging infectious diseases ,Male ,Africa, Southern/epidemiology ,African tick-bite fever ,Tick-borne infections ,Intracellular bacteria ,Imported infections ,Rickettsioses ,Rickettsia/genetics ,Surveys and Questionnaires ,Journal Article ,Humans ,Animals ,Registries ,Communicable Diseases, Imported/epidemiology ,Rickettsia Infections/diagnosis ,Retrospective Studies ,Travel ,Tick-borne pathogens ,South Africa/epidemiology ,Travel-related infections ,Antibodies, Bacterial/blood ,Vector-borne infections ,Denmark/epidemiology ,Hospitalization ,Arthropod-borne infections ,Tick-Borne Diseases ,Female ,Ticks/microbiology - Abstract
Rickettsia spp. can be found across the globe and cause disease of varying clinical severity, ranging from life-threatening infections with widespread vasculitis to milder, more localized presentations. Vector and, to some degree, reservoir are hematophagous arthropods, with most species harboured by ticks. In Denmark, rickettsiae are known as a cause of imported travel-related infections, but are also found endemically in ticks across the country. Data are, however, lacking on the geographical origin and clinical features of diagnosed cases. In this study, we have examined the travel history and clinical features of two groups of patients; 1) hospital-patients diagnosed with rickettsioses in the years 2010-2015 and 2) patients from primary health care (PHC) centers in Denmark having demonstrated anti-rickettsia antibodies in the years 2012-2015. The patients were identified using the Danish National Patient Registry (DNPR) and through the serological database at the State Serum Institute, where the laboratory diagnosis of rickettsioses is currently centralized. Data were collected for 86 hospital patients and 26 PHC center patients by reviewing hospital medical records and performing telephone interviews with PHC centers. Of the hospital patients, 91% (78/86) had a history of international travel 14 days prior to symptom start, with most having imported their infection from southern Africa, South Africa in particular (65%), and presenting with a clinical picture most compatible with African tick-bite fever caused by R. africae. Only two patients presented with a CRP > 100 mg/L and no mortalities were reported. At the PHC centers, most patients presented with mild flu-like symptoms and had an unknown (50%) or no history (19%) of international travel, raising the possibility of endemic rickettsioses. In view of our findings, rickettsioses do not appear to constitute a major public health problem in Denmark, with most cases being imported infections and potential endemic cases presenting as mild infections.
- Published
- 2018
42. Impact of district mental health care plans on symptom severity and functioning of patients with priority mental health conditions: the Programme for Improving Mental Health Care (PRIME) cohort protocol
- Author
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Vikram Patel, Fred Kigozi, Rahul Shidhaye, Sujit D Rathod, Vaibhav Murhar, Mark Tomlinson, Crick Lund, One Selohilwe, Girmay Medhin, Inge Petersen, Nagendra P. Luitel, Mark J. D. Jordans, Juliet Nakku, Mary De Silva, Joshua Ssebunnya, Emily Baron, Martin Prince, Charlotte Hanlon, Abebaw Fedaku, Centre for Public Mental Health, Faculty of Health Sciences, RS: CAPHRI - R4 - Health Inequities and Societal Participation, Metamedica, and Promovendi PHPC
- Subjects
Male ,ETHIOPIA ,Alcohol use disorder ,Severity of Illness Index ,Cohort Studies ,Study Protocol ,0302 clinical medicine ,lcsh:Psychiatry ,SCHIZOPHRENIA ,Medicine ,SCREENING QUESTIONNAIRES ,030212 general & internal medicine ,10. No inequality ,Depression (differential diagnoses) ,Alcohol Use Disorders Identification Test ,South Africa/epidemiology ,1. No poverty ,Cohort ,ALCOHOL-USE DISORDERS ,Low-income populations ,Alcohol dependence ,RANDOMIZED CONTROLLED-TRIAL ,DEPRESSION ,SOUTH-AFRICA ,3. Good health ,PREVALENCE ,Psychiatry and Mental health ,Mental Health ,Schizophrenia ,INDIA ,Female ,Cohort study ,Adult ,medicine.medical_specialty ,Nepal/epidemiology ,lcsh:RC435-571 ,Ethiopia/epidemiology ,IDENTIFICATION TEST AUDIT ,03 medical and health sciences ,Young Adult ,Caregivers/psychology ,Primary Health Care/methods ,Humans ,Epilepsy ,business.industry ,Uganda/epidemiology ,medicine.disease ,Psychosis ,Disabled Persons/psychology ,Mental health ,030227 psychiatry ,Patient Health Questionnaire ,India/epidemiology ,Community Mental Health Services/methods ,depression ,Family medicine ,business ,Primary healthcare ,Mental Disorders/epidemiology ,Follow-Up Studies - Abstract
BackgroundThe Programme for Improving Mental Health Care (PRIME) sought to implement mental health care plans (MHCP) for four priority mental disorders (depression, alcohol use disorder, psychosis and epilepsy) into routine primary care in five low- and middle-income country districts. The impact of the MHCPs on disability was evaluated through establishment of priority disorder treatment cohorts. This paper describes the methodology of these PRIME cohorts.MethodsOne cohort for each disorder was recruited across some or all five districts: Sodo (Ethiopia), Sehore (India), Chitwan (Nepal), Dr. Kenneth Kaunda (South Africa) and Kamuli (Uganda), comprising 17 treatment cohorts in total (N = 2182). Participants were adults residing in the districts who were eligible to receive mental health treatment according to primary health care staff, trained by PRIME facilitators as per the district MHCP. Patients who screened positive for depression or AUD and who were not given a diagnosis by their clinicians (N = 709) were also recruited into comparison cohorts in Ethiopia, India, Nepal and South Africa. Caregivers of patients with epilepsy or psychosis were also recruited (N = 953), together with or on behalf of the person with a mental disorder, depending on the district. The target sample size was 200 (depression and AUD), or 150 (psychosis and epilepsy) patients initiating treatment in each recruiting district. Data collection activities were conducted by PRIME research teams. Participants completed follow-up assessments after 3 months (AUD and depression) or 6 months (psychosis and epilepsy), and after 12 months. Primary outcomes were impaired functioning, using the 12-item World Health Organization Disability Assessment Schedule 2.0 (WHODAS), and symptom severity, assessed using the Patient Health Questionnaire (depression), the Alcohol Use Disorder Identification Test (AUD), and number of seizures (epilepsy).DiscussionCohort recruitment was a function of the clinical detection rate by primary health care staff, and did not meet all planned targets. The cross-country methodology reflected the pragmatic nature of the PRIME cohorts: while the heterogeneity in methods of recruitment was a consequence of differences in health systems and MHCPs, the use of the WHODAS as primary outcome measure will allow for comparison of functioning recovery across sites and disorders.
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- 2018
43. Independent association of resting energy expenditure with blood pressure: confirmation in populations of the African diaspora
- Author
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Pascal Bovet, Jacob Plange-Rhule, Guichan Cao, Dale A. Schoeller, Chloe Creber, Estelle V. Lambert, Terrence Forrester, Lara R. Dugas, Amy Luke, Wolfgang Korte, Richard S. Cooper, Walter F. Riesen, MRC/UCT RU for Exercise and Sport Medicine, and Faculty of Health Sciences
- Subjects
Adult ,Male ,medicine.medical_specialty ,lcsh:Diseases of the circulatory (Cardiovascular) system ,Physiology ,Adipose tissue ,Black People ,030209 endocrinology & metabolism ,Blood Pressure ,030204 cardiovascular system & hematology ,Seychelles ,Ghana ,Body Mass Index ,Adiposity/ethnology ,African Continental Ancestry Group ,Basal Metabolism ,Chi-Square Distribution ,Female ,Ghana/epidemiology ,Humans ,Hypertension/ethnology ,Hypertension/metabolism ,Hypertension/physiopathology ,Linear Models ,Multivariate Analysis ,Obesity/ethnology ,Obesity/metabolism ,Obesity/physiopathology ,Risk Factors ,Seychelles/epidemiology ,South Africa/epidemiology ,United States/epidemiology ,Blood pressure ,Hypertension ,Obesity ,Resting energy expenditure ,03 medical and health sciences ,South Africa ,0302 clinical medicine ,medicine ,Risk factor ,Angiology ,Adiposity ,2. Zero hunger ,business.industry ,medicine.disease ,United States ,lcsh:RC666-701 ,Basal metabolic rate ,Cardiology and Cardiovascular Medicine ,business ,Body mass index ,Research Article - Abstract
Background Obesity is a major risk factor for hypertension, however, the physiologic mechanisms linking increased adiposity to elevations in blood pressure are not well described. An increase in resting energy expenditure (REE) is an obligatory consequence of obesity. Previous survey research has demonstrated that REE is an independent predictor of blood pressure, and eliminates the co-linear association of body mass index. This observation has received little attention and there have been no attempts to provide a causal explanation. Methods At baseline in an international comparative study on obesity, 289 participants aged 25–44 were recruited from communities in the US, the Seychelles, Ghana and South Africa and had REE measured with indirect calorimetry. All participants were thought to be free of major illness. Results In multivariate regression models, both systolic and diastolic blood pressure were positively associated with REE (p
- Published
- 2018
44. Tuberculosis mortality and the male survival deficit in rural South Africa: an observational community cohort study
- Author
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Reniers, Georges, Blom, Sylvia, Lieber, Judith, Herbst, Abraham J, Calvert, Clara, Bor, Jacob, Barnighausen, Till, Zaba, Basia, Li, Zehang R, Clark, Samuel J, Grant, Alison D, Lessells, Richard, Eaton, Jeffrey W, and Hosegood, Victoria
- Subjects
Male ,Rural Population ,RNA viruses ,Bacterial Diseases ,Epidemiology ,lcsh:Medicine ,HIV Infections ,Rural Health ,Pathology and Laboratory Medicine ,Cohort Studies ,South Africa ,Immunodeficiency Viruses ,Risk Factors ,Medicine and Health Sciences ,Public and Occupational Health ,lcsh:Science ,Middle Aged ,Infectious Diseases ,Medical Microbiology ,HIV epidemiology ,Viral Pathogens ,Viruses ,Female ,Pathogens ,Research Article ,Adult ,Death Rates ,General Science & Technology ,Microbiology ,Adult Cohort Studies Female HIV Infections/complications/*epidemiology/mortality Humans Life Expectancy/*trends Male Middle Aged Risk Factors Rural Health Rural Population/*statistics & numerical data Sex Factors South Africa/epidemiology Survival Analysis Tuberculosis, Pulmonary/complications/*epidemiology/mortality Wounds and Injuries/complications/*epidemiology/mortality ,Life Expectancy ,Sex Factors ,Population Metrics ,Retroviruses ,MD Multidisciplinary ,Humans ,Adults ,Tuberculosis ,Tuberculosis, Pulmonary ,Microbial Pathogens ,Population Biology ,Lentivirus ,lcsh:R ,Organisms ,Biology and Life Sciences ,HIV ,Tropical Diseases ,Survival Analysis ,Age Groups ,People and Places ,Wounds and Injuries ,Population Groupings ,lcsh:Q - Abstract
Background: Women live on average five years longer than men, and the sex difference in longevity is typically lower in populations with high mortality. South Africa – a high mortality population with a large sex disparity – is an exception, but the causes of death that contribute to this difference are not well understood. Methods: Using data from a demographic surveillance system in rural KwaZulu-Natal (2000-2014), we estimate differences between male and female adult life expectancy by HIV status. The contribution of causes of death to these life expectancy differences are computed with demographic decomposition techniques. Cause of death information comes from verbal autopsy interviews that are interpreted with the InSilicoVA tool.Results: Adult women lived an average of 10.4 years (95% confidence Interval 9.0-11.6) longer than men. Sex differences in adult life expectancy were even larger when disaggregated by HIV status: 13.1 (95% confidence interval 10.7-15.3) and 11.2 (95% confidence interval 7.5-14.8) years among known HIV negatives and positives, respectively. Elevated male mortality from pulmonary tuberculosis (TB) and external injuries were responsible for 43% and 31% of the sex difference in life expectancy among the HIV negative population, and 81% and 16% of the difference among people living with HIV.Conclusions: The sex differences in adult life expectancy in rural KwaZulu-Natal are exceptionally large, atypical for an African population, and largely driven by high male mortality from pulmonary TB and injuries. This is the case for both HIV positive and HIV negative men and women, signalling a need to improve the engagement of men with health services, irrespective of their HIV status.
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- 2017
45. Unimagined Community : Sex, Networks, and AIDS in Uganda and South Africa
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Thornton, Robert J. and Thornton, Robert J.
- Published
- 2008
46. Rheumatoid arthritis-specific cardiovascular risk scores are not superior to general risk scores: a validation analysis of patients from seven countries
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Crowson, Cynthia S, Gabriel, Sherine E, Semb, Anne Grete, van Riel, Piet L C M, Karpouzas, George, Dessein, Patrick H, Hitchon, Carol, Pascual-Ramos, Virginia, Kitas, George D, A Trans-Atlantic Cardiovascular Consortium for Rheumatoid Arthritis, and Clinical sciences
- Subjects
rheumatoid arthritis ,Male ,Internationality ,Comorbidity ,030204 cardiovascular system & hematology ,Cardiovascular ,Severity of Illness Index ,Arthritis, Rheumatoid ,Cohort Studies ,South Africa ,risk prediction ,0302 clinical medicine ,cardiovascular disease ,Rheumatoid ,Medicine ,Pharmacology (medical) ,Myocardial infarction ,Cardiovascular Diseases/diagnosis ,Netherlands ,education.field_of_study ,Framingham Risk Score ,South Africa/epidemiology ,Norway ,United Kingdom/epidemiology ,Incidence ,risk assessment ,Clinical Science ,Middle Aged ,Cardiovascular disease ,Prognosis ,United States/epidemiology ,Norway/epidemiology ,comorbidity ,Heart Disease ,Cardiovascular Diseases ,Predictive value of tests ,Public Health and Health Services ,Arthritis, Rheumatoid/diagnosis ,Cohort studies ,Female ,Risk assessment ,Trans-Atlantic Cardiovascular Consortium for Rheumatoid Arthritis ,Algorithms ,Cohort study ,Adult ,medicine.medical_specialty ,Canada ,Clinical Sciences ,Immunology ,Population ,Netherlands/epidemiology ,Risk Assessment ,Healthcare improvement science Radboud Institute for Health Sciences [Radboudumc 18] ,03 medical and health sciences ,Age Distribution ,Rheumatology ,Clinical Research ,Predictive Value of Tests ,Internal medicine ,Severity of illness ,Mexico/epidemiology ,Humans ,Sex Distribution ,education ,Mexico ,Aged ,030203 arthritis & rheumatology ,business.industry ,Arthritis ,Prevention ,medicine.disease ,United States ,United Kingdom ,Arthritis & Rheumatology ,Physical therapy ,incidence ,business - Abstract
Item does not contain fulltext Objectives: Cardiovascular disease (CVD) risk calculators developed for the general population do not accurately predict CVD events in patients with RA. We sought to externally validate risk calculators recommended for use in patients with RA including the EULAR 1.5 multiplier, the Expanded Cardiovascular Risk Prediction Score for RA (ERS-RA) and QRISK2. Methods: Seven RA cohorts from UK, Norway, Netherlands, USA, South Africa, Canada and Mexico were combined. Data on baseline CVD risk factors, RA characteristics and CVD outcomes (including myocardial infarction, ischaemic stroke and cardiovascular death) were collected using standardized definitions. Performance of QRISK2, EULAR multiplier and ERS-RA was compared with other risk calculators [American College of Cardiology/American Heart Association (ACC/AHA), Framingham Adult Treatment Panel III Framingham risk score-Adult Treatment Panel (FRS-ATP) and Reynolds Risk Score] using c-statistics and net reclassification index. Results: Among 1796 RA patients without prior CVD [mean ( s . d .) age: 54.0 (14.0) years, 74% female], 100 developed CVD events during a mean follow-up of 6.9 years (12430 person-years). Estimated CVD risk by ERS-RA [mean ( s . d .) 8.8% (9.8%)] was comparable to FRS-ATP [mean ( s . d .) 9.1% (8.3%)] and Reynolds [mean ( s . d .) 9.2% (12.2%)], but lower than ACC/AHA [mean ( s . d .) 9.8% (12.1%)]. QRISK2 substantially overestimated risk [mean ( s . d .) 15.5% (13.9%)]. Discrimination was not improved for ERS-RA (c-statistic = 0.69), QRISK2 or EULAR multiplier applied to ACC/AHA compared with ACC/AHA (c-statistic = 0.72 for all) or for FRS-ATP (c-statistic = 0.75). The net reclassification index for ERS-RA was low (-0.8% vs ACC/AHA and 2.3% vs FRS-ATP). Conclusion: The QRISK2, EULAR multiplier and ERS-RA algorithms did not predict CVD risk more accurately in patients with RA than CVD risk calculators developed for the general population.
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- 2017
47. Efficacy and Safety of Tenofovir Disoproxil Fumarate Versus Low-Dose Stavudine Over 96 Weeks : A Multicountry Randomized, Noninferiority Trial
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Adult ,Male ,stavudine DEXA ,HIV Infections/drug therapy ,Non-P.H.S ,resource allocation ,India ,Equivalence Trials as Topic ,Kidney/drug effects ,Research Support ,Young Adult ,South Africa ,Double-Blind Method ,parasitic diseases ,Tenofovir/therapeutic use ,Journal Article ,Humans ,Uganda ,Pharmacology (medical) ,Non-U.S. Gov't ,South Africa/epidemiology ,public health ,Bone and Bones/drug effects ,Uganda/epidemiology ,toxicity ,HIV ,trial ,Stavudine/therapeutic use ,tenofovir ,Multicenter Study ,Infectious Diseases ,dose reduction ,Anti-HIV Agents/therapeutic use ,Randomized Controlled Trial ,Female ,renal ,U.S. Gov't - Abstract
Background:Reducing doses of antiretroviral drugs, including stavudine (d4T), may lower toxicity, while preserving efficacy. There are substantial concerns about renal and bone toxicities of tenofovir disoproxil fumarate (TDF).Setting:HIV-1-infected treatment-naive adults in India, South Africa, and Uganda.Methods:A phase-4, 96-week, randomized, double-blind, noninferiority trial compared d4T 20 mg twice daily and TDF, taken in combination with lamivudine (3TC) and efavirenz (EFV). The primary endpoint was the proportion of participants with HIV-1 RNA
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- 2019
48. Apelin concentrations are associated with altered atherosclerotic plaque stability mediator levels and atherosclerosis in rheumatoid arthritis
- Author
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Linda Tsang, Sule Gunter, Gavin R. Norton, Ahmed Solomon, Patrick H Dessein, Aletta M.E. Millen, Chanel Robinson, Angela J. Woodiwiss, and Rheumatology
- Subjects
0301 basic medicine ,Carotid Artery Diseases ,Male ,Matrix metalloproteinase ,Carotid Intima-Media Thickness ,Arthritis, Rheumatoid ,South Africa ,0302 clinical medicine ,Carotid Artery Diseases/blood ,Risk Factors ,African Continental Ancestry Group ,Subclinical infection ,education.field_of_study ,South Africa/epidemiology ,medicine.diagnostic_test ,Confounding ,Matrix Metalloproteinase 2/blood ,Interleukin ,Middle Aged ,Plaque, Atherosclerotic ,Apelin ,Matrix Metalloproteinase 9 ,Inflammation Mediators/blood ,Rheumatoid arthritis ,Erythrocyte sedimentation rate ,Intercellular Signaling Peptides and Proteins/blood ,Intercellular Signaling Peptides and Proteins ,Matrix Metalloproteinase 2 ,Female ,Matrix Metalloproteinase 9/blood ,Inflammation Mediators ,Cardiology and Cardiovascular Medicine ,medicine.medical_specialty ,Arthritis, Rheumatoid/blood ,European Continental Ancestry Group ,Population ,Black People ,Blood Sedimentation ,White People ,03 medical and health sciences ,Internal medicine ,medicine ,Humans ,education ,Aged ,030203 arthritis & rheumatology ,Rupture, Spontaneous ,business.industry ,Interleukin-6 ,medicine.disease ,030104 developmental biology ,Endocrinology ,Logistic Models ,Asymptomatic Diseases ,Multivariate Analysis ,Linear Models ,Interleukin-6/blood ,business ,Biomarkers/blood ,Biomarkers - Abstract
Background and aims Apelin-APJ signaling reduces cardiovascular disease (CVD) risk. In rheumatoid arthritis (RA), the atherosclerosis burden and plaque vulnerability to rupture are increased. We explored relationships between apelin concentrations and subclinical CVD in RA. Methods Apelin levels were measured in 235 (114 black, 121 white) RA patients. Associations between apelin concentrations and ultrasound determined carotid artery intima-media thickness (cIMT) and plaque, and levels of matrix metalloproteinase (MMP)-2 and -9 that mediate plaque stability and vulnerability respectively, were identified in confounder adjusted multivariate regression analysis. Results In all patients, apelin concentrations were directly associated with those of MMP-2 (β (SE) = 0.324 (0.112), p = 0.004) and inversely with those of MMP-9 (β (SE) = -0.239 (0.060), p = 0.000). Apelin concentration-subclinical CVD relations were influenced by population origin, RA disease activity, erythrocyte sedimentation rate (ESR) and interleukin (IL)-6 concentrations (interaction p = 0.001 to 0.04). Accordingly, the apelin-MMP-2 concentration relationship was reproduced in white (β (SE) = 0.367 (0.146), p = 0.01) but not black RA patients (β (SE) = 0.197 (0.220), p = 0.4), and only in those without (but not with) large erythrocyte sedimentation rates (β (SE) = 0.428 (0.143), p = 0.003) or interleukin-6 levels (β (SE) = 0.485 (0.288), p = 0.04). By contrast, the apelin-MMP-9 concentration relation was reproduced more consistently. Apelin levels were inversely related to cIMT in patients with RA remission or mild (β (SE) = -0.068 (0.033), p = 0.04) but not moderate or high disease activity (β (SE) = 0.015 (0.112), p = 0.7). Conclusions Apelin concentrations are associated with altered plaque stability mediator levels and atherosclerosis in patients with RA. These relations are partially dependent on population origin and systemic inflammatory status.
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- 2016
49. Posttraumatic stress disorder associated with unexpected death of a loved one: Cross-national findings from the world mental health surveys
- Author
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Jordi Alonso, Ronald C. Kessler, Silvia Florescu, Marina Piazza, Jose Posada-Villa, Norito Kawakami, Siobhan O'Neill, Elie G. Karam, Alan M. Zaslavsky, Evelyn J. Bromet, Jean Pierre Lepine, Sing Lee, Dan J. Stein, Lukoye Atwoli, Giovanni de Girolamo, Sergio Aguilar-Gaxiola, Koen Demyttenaere, Maria Petukhova, Fernando Navarro-Mateu, Josep Maria Haro, B. E. Pennell, Margreet ten Have, Nancy A. Sampson, and Andrew J. King
- Subjects
Male ,Esdeveniments vitals de canvi ,Salut mental -- Enquestes ,cross-national ,Categorical grant ,Stress Disorders, Post-Traumatic ,South Africa ,0302 clinical medicine ,Epidemiology ,Prevalence ,Child ,media_common ,Stress Disorders, Post-Traumatic/epidemiology/psychology ,South Africa/epidemiology ,South America/epidemiology ,PTSD ,United States/epidemiology ,Europe ,Substance abuse ,Death ,Psychiatry and Mental health ,Clinical Psychology ,trauma ,Health Surveys/statistics & numerical data ,Child, Preschool ,international ,Female ,epidemiology ,Psychology ,Administration (government) ,Adult ,Risk ,medicine.medical_specialty ,Asia ,Attitude to Death ,Adolescent ,media_common.quotation_subject ,purl.org/pe-repo/ocde/ford#3.02.24 [https] ,purl.org/pe-repo/ocde/ford#5.01.00 [https] ,behavioral disciplines and activities ,Article ,Europe/epidemiology ,Life Change Events ,03 medical and health sciences ,Young Adult ,mental disorders ,medicine ,Trastorn per estrès posttraumàtic ,Humans ,Psychiatry ,Asia/epidemiology ,Public health ,Infant ,South America ,medicine.disease ,Health Surveys ,Mental health ,United States ,030227 psychiatry ,Logistic Models ,Socioeconomic Factors ,life events/stress ,National Comorbidity Survey ,Mort ,Welfare ,030217 neurology & neurosurgery - Abstract
BACKGROUND: Unexpected death of a loved one (UD) is the most commonly reported traumatic experience in cross-national surveys. However, much remains to be learned about posttraumatic stress disorder (PTSD) after this experience. The WHO World Mental Health (WMH) survey initiative provides a unique opportunity to address these issues. METHODS: Data from 19 WMH surveys (n = 78,023; 70.1% weighted response rate) were collated. Potential predictors of PTSD (respondent sociodemographics, characteristics of the death, history of prior trauma exposure, history of prior mental disorders) after a representative sample of UDs were examined using logistic regression. Simulation was used to estimate overall model strength in targeting individuals at highest PTSD risk. RESULTS: PTSD prevalence after UD averaged 5.2% across surveys and did not differ significantly between high-income and low-middle income countries. Significant multivariate predictors included the deceased being a spouse or child, the respondent being female and believing they could have done something to prevent the death, prior trauma exposure, and history of prior mental disorders. The final model was strongly predictive of PTSD, with the 5% of respondents having highest estimated risk including 30.6% of all cases of PTSD. Positive predictive value (i.e., the proportion of high-risk individuals who actually developed PTSD) among the 5% of respondents with highest predicted risk was 25.3%. CONCLUSIONS: The high prevalence and meaningful risk of PTSD make UD a major public health issue. This study provides novel insights into predictors of PTSD after this experience and suggests that screening assessments might be useful in identifying high-risk individuals for preventive interventions. The World Health Organization World Mental Health (WMH) Survey Initiative is supported by the National Institute of Mental Health (NIMH; R01 MH070884 and R01 MH093612-01), the John D. and Catherine T. MacArthur Foundation, the Pfizer Foundation, the US Public Health Service (R13-MH066849, R01-MH069864, and R01 DA016558) and the Fogarty International Center (FIRCA R03- TW006481). The São Paulo Megacity Mental Health Survey is supported by the State of São Paulo Research Foundation (FAPESP) Thematic Project grant 03/00204-3. The ESEMeD project is funded by the European Commission (contracts QLG5-1999-01042; SANCO 2004123, and EAHC 20081308; the Piedmont Region [Italy]), Fondo de Investigación Sanitaria, Instituto de Salud Carlos III, Spain (FIS 00/0028), Ministerio de Ciencia y Tecnología, Spain (SAF 2000-158-CE), Departament de Salut, Generalitat de Catalunya, Spain and Instituto de Salud Carlos III (CIBER CB06/02/0046, RETICS RD06/0011 REM-TAP) . The World Mental Health Japan (WMHJ) survey is supported by the Grant for Research on Psychiatric and Neurological Diseases and Mental Health (H13-SHOGAI-023, H14-TOKUBETSU026, H16-KOKORO-013) from the Japan Ministry of Health, Labour and Welfare. The Lebanese Evaluation of the Burden of Ailments and Needs of the Nation (L.E.B.A.N.O.N.) is supported by the Lebanese Ministry of Public Health and the WHO (Lebanon), National Institute of Health/Fogarty International Center (R03 TW006481-01). The South Africa Stress and Health Study (SASH) is supported by the US National Institute of Mental Health (R01-MH059575). The Ukraine Comorbid Mental Disorders during Periods of Social Disruption (CMDPSD) study is funded by the US National Institute of Mental Health (RO1-MH61905). The US National Comorbidity Survey Replication (NCS-R) is supported by the National Institute of Mental Health (NIMH; U01-MH60220) with supplemental support from the National Institute of Drug Abuse (NIDA), the Substance Abuse and Mental Health Services Administration (SAMHSA), the Robert Wood Johnson Foundation (RWJF; grant 044708), and the John W. Alden Trust
- Published
- 2016
50. Obesity and its Relation With Diabetes and Hypertension: A Cross-Sectional Study Across 4 Geographical Regions
- Author
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Shivani A. Patel, Vilma Irazola, Muhammad Ashique Haider Chowdhury, Yangfeng Wu, Xian Li, Ali Tanweer Siddiquee, Naomi S. Levitt, Masood Kadir, Thomas A. Gaziano, Adolfo Rubinstein, William Checkley, Antonio Bernabe-Ortiz, Laura Gutierrez, J. Jaime Miranda, Mohammed K. Ali, Lijing L. Yan, Roopa Shivashankar, Dorairaj Prabhakaran, and Dewan S. Alam
- Subjects
Gerontology ,Male ,obesity ,Epidemiology ,Cross-sectional study ,Ciencias de la Salud ,030204 cardiovascular system & hematology ,Body Mass Index ,Cohort Studies ,South Africa ,0302 clinical medicine ,Peru ,Prevalence ,Medicine ,Pakistan ,purl.org/pe-repo/ocde/ford#3.02.04 [https] ,030212 general & internal medicine ,Chile ,China/epidemiology ,Bangladesh ,South Africa/epidemiology ,diabetes ,Argentina/epidemiology ,Middle Aged ,Circumference ,Obesity, Abdominal ,Hypertension ,symbols ,Diabetes Mellitus/epidemiology ,Female ,Waist Circumference ,Cardiology and Cardiovascular Medicine ,Cohort study ,Adult ,China ,Waist ,hypertension ,CIENCIAS MÉDICAS Y DE LA SALUD ,Uruguay/epidemiology ,Argentina ,India ,Article ,03 medical and health sciences ,symbols.namesake ,Young Adult ,Chile/epidemiology ,Hypertension/epidemiology ,Diabetes mellitus ,Diabetes Mellitus ,Epidemiología ,Humans ,Poisson regression ,Obesity ,Bangladesh/epidemiology ,Aged ,Community and Home Care ,Obesity, Abdominal/epidemiology ,business.industry ,Obesity/epidemiology ,medicine.disease ,India/epidemiology ,Cross-Sectional Studies ,Uruguay ,business ,Body mass index ,Pakistan/epidemiology ,Peru/epidemiology ,Demography - Abstract
Background The implications of rising obesity for cardiovascular health in middle-income countries has generated interest, in part because associations between obesity and cardiovascular health seem to vary across ethnic groups. Objective We assessed general and central obesity in Africa, East Asia, South America, and South Asia. We further investigated whether body mass index (BMI) and waist circumference differentially relate to cardiovascular health; and associations between obesity metrics and adverse cardiovascular health vary by region. Methods Using baseline anthropometric data collected between 2008 and 2012 from 7 cohorts in 9 countries, we estimated the proportion of participants with general and central obesity using BMI and waist circumference classifications, respectively, by study site. We used Poisson regression to examine the associations (prevalence ratios) of continuously measured BMI and waist circumference with prevalent diabetes and hypertension by sex. Pooled estimates across studies were computed by sex and age. Results This study analyzed data from 31,118 participants aged 20 to 79 years. General obesity was highest in South Asian cities and central obesity was highest in South America. The proportion classified with general obesity (range 11% to 50%) tended to be lower than the proportion classified as centrally obese (range 19% to 79%). Every standard deviation higher of BMI was associated with 1.65 and 1.60 times higher probability of diabetes and 1.42 and 1.28 times higher probability of hypertension, for men and women, respectively, aged 40 to 69 years. Every standard deviation higher of waist circumference was associated with 1.48 and 1.74 times higher probability of diabetes and 1.34 and 1.31 times higher probability of hypertension, for men and women, respectively, aged 40 to 69 years. Associations of obesity measures with diabetes were strongest in South Africa among men and in South America among women. Associations with hypertension were weakest in South Africa among both sexes. Conclusions BMI and waist circumference were both reasonable predictors of prevalent diabetes and hypertension. Across diverse ethnicities and settings, BMI and waist circumference remain salient metrics of obesity that can identify those with increased cardiovascular risk. Fil: Patel, Shivani A.. University of Emory; Estados Unidos. Centre For Control Of Chronic Conditions; India Fil: Ali, Mohammed K.. University of Emory; Estados Unidos. Centre For Control Of Chronic Conditions; India Fil: Alam, Dewan. University of York; Reino Unido. Li Ka Shing Knowledge Institute; Canadá Fil: Yan, Lijing L.. Peking University; China. Duke Kunshan University; China Fil: Levitt, Naomi S.. University Of Cape Town; Sudáfrica Fil: Bernabe Ortiz, Antonio. Cronicas Centro de Excelencia En Enfermedades Crónicas; Perú Fil: Checkley, William. University Johns Hopkins; Estados Unidos Fil: Wu, Yangfeng. Peking University; China Fil: Irazola, Vilma. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentina. Instituto de Efectividad Clínica y Sanitaria; Argentina Fil: Gutierrez, Laura. Instituto de Efectividad Clínica y Sanitaria; Argentina Fil: Rubinstein, Adolfo Luis. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentina. Instituto de Efectividad Clínica y Sanitaria; Argentina Fil: Shivashankar, Roopa. Public Health Foundation of India; India Fil: Li, Xian. Peking University; China Fil: Miranda, J. Jaime. Cronicas Centro de Excelencia En Enfermedades Crónicas; Perú. Universidad Peruana Cayetano Heredia; Perú Fil: Chowdhury, Muhammad Ashique Haider. International Centre For Diarrhoeal Disease Research Bangladesh; Bangladesh Fil: Siddiquee, Ali Tanweer. International Centre For Diarrhoeal Disease Research Bangladesh; Bangladesh Fil: Gaziano, Thomas A.. Harvard University. Harvard School of Public Health; Estados Unidos. Brigham And Women's Hospital; Estados Unidos Fil: Kadir, M. Masood. The Aga Khan University; Pakistán Fil: Prabhakaran, Dorairaj. Public Health Foundation of India; India
- Published
- 2016
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