Rapid detection of rotaviruses--are laboratories underestimating infection in infants?
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Humans↗
Biomedical subjects
M de Beer
Publications and source records attributed to M de Beer.
Prevalence of rotavirus, adenovirus and astrovirus infection in young children with gastroenteritis in Gaborone, Botswana.
OBJECTIVE: To determine the prevalence of three enteric viruses, namely rotavirus, adenovirus and astrovirus, as agents of diarrhoea in and around Gaborone, Botswana. DESIGN: The sample were categorised into four groups according to the age of the patient: 0-3 months, 4-6 months, 7-12 months and 25-60 months. Total monthly samples across age groups formed basis for calcultating seasonal prevalence of rotavirus infection. SETTING: Stool samples were collected from three medical laboratories in Gaborone and one in the town of Mochudi. These were collected from children under the age of five years with gastroenteritis. SUBJECTS: Stool samples were collected between March 2001 and February 2002 from 346 children less than five years of age suffering from gastroenteritis. These samples had been sent to medical laboratories for microbiological examination. METHODS: The samples were screened for rotavirus (RV), adenovirus (Ad) and astrovirus (AsV) antigens using commercially available ELISA kits. The Ad positive samples were further analysed by commercially available group specific Ad type 40/41 Enzyme Immuno Assays (EIA). RESULTS: Shedding of RV was detected in 9.2%, Ad in 7.8% and AsV in 2.7% of the samples analysed. The enteric Ad (types 40 and 41) were detected in 2% of the samples and the remaining 5.8% of Ad positive samples were non-enteric Ad. An increase of RV was noted in the autumn-winter season but no seasonal pattern was observed in Ad shedding. Seasonal prevalence of AsV could not be determined. The average age of children infected with these agents was less than one year. CONCLUSION: The incidence of rotavirus infection amongst children in Botswana appears to be relatively low. The prevalence rate of adenovirus and astrovirus is similar to other studies in parts of Southern Africa. However, continued enteric virus surveillance and epidemiology amongst this group is required.
Adenovirus Infections, Human↗
The impact of service provision on contraceptive usage and immunisation coverage.
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Adolescent↗
Comparison of electron microscopy, enzyme-linked immunosorbent assay and latex agglutination for the detection of bovine rotavirus in faeces.
The performance characteristics of 2 enzyme immunoassays (ELISAs) and 4 latex agglutination assays (LXs) were evaluated for the detection of bovine rotavirus in faecal specimens of young calves with diarrhoea. A total of 26 specimens from calves less than 5 months of age were examined with different commercial assays and compared with electron microscopy (EM) as the gold standard and with polyacrylamide gel electrophoresis (PAGE) for the detection of atypical, non-group A rotaviruses. In the 2nd study, EIA (Dako) and LX (Murex), the assays of choice, were used to analyse 97 further faecal specimens from calves with diarrhoea. The ELISAs proved to be the most sensitive compared with the other tests used. The EM and PAGE are 100% specific although slightly less sensitive than the commercial assays. The results show that all the commercial assays can accurately detect rotavirus in the stools of calves with gastroenteritis, although the suitability and choice of assay will depend upon the requirements of individual laboratories.
Animals↗
A respiratory survey in a black Johannesburg workforce.
BACKGROUND: The burden and determinants of airway disease in the population of southern Africa, which is currently undergoing rapid, often uncontrolled, urbanisation and industrialisation, are unknown. Previous surveys have focused on specific occupational groups and few have included women. This paper describes the respiratory status in a 30% probability sample of 206 men and 203 women drawn from an urban black Johannesburg workforce of almost 1500, all working for an educational institution. METHODS: Subjects answered a respiratory questionnaire and performed spirometric tests. Symptom rates and age and height standardised forced vital capacity (FVC), forced expiratory volume in one second (FEV1), FEV1/FVC%, and forced expiratory flow (FEF25-75) were analysed by gender in relation to smoking, past work exposures, past and recent respiratory conditions, and socioeconomic indicators. RESULTS: Symptom prevalence was high, bronchitic symptoms in men being related to smoking and previous occupational exposure, and in women to smoking despite the low intensity of their habit. Phlegm and wheezing were related to childhood respiratory illness in both men and women. FVC and FEV1, based on all subjects including smokers, were higher than previously reported for black residents of southern Africa. FVC was also positively related to education and job category. Higher values for ever smokers than for never smokers suggested health selection into the habit, while significant negative smoking effects were seen only on FEV1/FVC% and only in women. CONCLUSIONS: Despite the high prevalence of symptoms--some smoking related--in this urban workforce, lung function levels were higher than previously reported in African blacks, and may reflect improving socioeconomic conditions.
Adult↗
Molecular epidemiology and subgroup analysis of bovine group A rotaviruses associated with diarrhea in South African calves.
Rotavirus-positive specimens were recovered from 143 Afrikander calves on two farms in the northeastern Cape of South Africa during late 1988 and 1989. The rotavirus strains were analyzed by polyacrylamide gel electrophoresis of the RNA genome, and four rotavirus RNA electrophoretypes, each with a long profile, were identified. A distinct RNA profile was identified on the farms during 1988, but by early 1989, two patterns existed, one unique to each farm. Over the next 8 months a new electrophoretic pattern emerged on one farm, whereas the pattern on the other farm remained unchanged. The rotavirus subgroup I antigen was detected in all specimens examined with subgroup-specific monoclonal antibodies. Non-group A rotaviruses were not identified by RNA genome analysis of 82 specimens from calves with diarrhea negative for group A rotaviruses by an enzyme-linked immunosorbent assay.
Animals↗
Cor pulmonale and silicosis: a necropsy based case-control study.
The presence of cor pulmonale at death in relation to other factors such as emphysema, silicosis, and thromboembolism was analysed in a case-control study of 732 South African gold miners. Marked emphysema was the highest risk factor with an odds ratio of 21.32 (95% confidence interval (95% CI) 5.02-90.7), then extensive silicosis (OR 4.95, 95% CI 2.92-8.38) and thromboembolic disease (OR 1.92, 95% CI 1.37-2.69). Age and smoking were not significant predictors of cor pulmonale.
Aged↗
The reliability of mortality data in Johannesburg.
Information on deaths in Johannesburg is collected on a voluntary basis by the Johannesburg City Health Department from the Department of Home Affairs regional offices as well as state mortuaries in the area. The reliability of these routinely collected data was assessed. Records of deaths of Asians, coloureds and whites from 1 July 1989 to 31 December 1989 were included in the study. Burial orders obtained from the different cemeteries and crematoria in the area were compared with the routinely collected mortality data. Two thousand eight hundred and thirty-seven deaths were included in the study. One hundred and ninety (6%) deaths in the department's records could not be found among the corresponding burial orders while 1,019 (36%) burial order records were not found among the department's routinely collected mortality data. Underreporting of deaths was greatest among the aged (43%) and infants (39%). When this underreporting was taken into account, the corrected infant mortality rate was 19.1/1,000 live births as opposed to 14.1. Recommendations are made for the improvement of the quality of routinely collected mortality data.
Adolescent↗
Perceptions and knowledge about AIDS among family planning clinic attenders in Johannesburg.
Many studies assessing the impact of national AIDS prevention programmes on knowledge, attitudes and practices have been published world-wide. Most have found that, while general knowledge increased, there was little change in behaviour. A survey of a random sample of 50 women attending a family planning clinic in Johannesburg determined the current knowledge, attitudes and practices of these sexually active women, aged 20-29 years. All selected respondents agreed to participate and a pretested structured questionnaire was completed. Most individuals had in excess of 7 years' schooling (78.0%), were single (58.0%) and domestic workers (28.6%). The majority were aware of AIDS (88.0%), but only 13.7% felt their knowledge was adequate. Fifty-two per cent knew sexual intercourse was a mode of transmission. Many misconceptions existed, 64.0% cited toilet seats, 47.1% sharing of utensils and 70.1% donating blood as routes by which HIV infection could be acquired. Only 47.1% and 34.1%, respectively, knew that the contraceptive pill and intra-uterine contraceptive device did not protect against HIV infection. Eighty-six per cent of the women were sexually active and 8.0% admitted to currently having more than one sexual partner. None used condoms and, generally, feelings regarding condom use were negative. Most (88.6%) believed AIDS patients should be hospitalised, 68.2% said in isolation wards, and 27.3% felt that AIDS patients should not be allowed to stay in the community. The implications of these findings are discussed and certain recommendations are made.
Acquired Immunodeficiency Syndrome↗
Malabsorption of carbohydrate foods by urban blacks.
Prevalences of non-infective bowel diseases are very low in South African urban blacks compared with the white population. In seeking elucidation, using breath hydrogen measurements in series of black and white subjects, small-bowel transit time was determined, and the malabsorption of maize, wheat, and rice investigated. Median transit times in both ethnic groups were similar. Rice was fully, but wheat incompletely absorbed by both groups. Maize, the staple food of blacks, was incompletely absorbed by them, although completely absorbed by the white subjects. Carbohydrate consumption is high in the black population (60-65% of total energy intake). It is probable that in blacks, despite their now eating a low-fibre diet, an expected increase in large-bowel diseases has been inhibited in part by the protective mechanism of fermentation of malabsorbed maize and wheat.
Adult↗
Glycaemic responses to different carbohydrate foods in healthy and diabetic blacks in Soweto.
Diabetes mellitus is uncommon in rural southern African blacks. With urbanisation and lifestyle changes, incidence rises to that in western populations. To assess associated changes in carbohydrate metabolism, glycaemic responses to glucose, refined maize, refined rice and bread were studied in 8 healthy and 8 non-insulin-dependent diabetic urban blacks. Additionally, in the healthy group serum insulin responses were measured. In the healthy, maize (the staple food of blacks) elicited the highest glucose response (207 mmol/l/min) and bread the lowest (107 mmol/l/min). The glycaemic indices of maize and glucose were similar. Serum insulin responses to maize were significantly lower than that of bread at 90 minutes (maize 66 muU/ml; bread 93 muU/ml; P = 0.02). In diabetics, maize and glucose elicited similar glycaemia (928 mmol/l/min and 921 mmol/l/min respectively). The high glucose response to maize could relate to its processing and physical form. The low insulin secretion could be due to inadequate stimulation by the 'entero-insular' axis. Moreover, variability in glucose insulin responses could stem from ethnic or genetic reasons. In the dietary management of black diabetics, refined maize should be replaced by other cereals.
Adult↗
Evaluation of an AIDS awareness campaign using city buses in Johannesburg.
The Johannesburg City Health Department embarked on an AIDS awareness campaign using messages placed on the outside of 30 city buses. The selection of the message and the campaign are outlined briefly. An evaluation to assess the overall effectiveness and the cost-effectiveness of using buses as a "vehicle' for exposing the local community to AIDS awareness messages is described. Two cross-sectional studies using telephone interviews were done 2 1/2 and 6 months after the campaign began; 30.2% and 31.5%, respectively, of respondents had seen the message. Accurate recall of the message was generally poor. The overall cost of the campaign was R7 627. Various other aspects of the study are discussed. The study revealed that signs on buses are a cost-effective means of conveying simple and brief health-related messages.
Acquired Immunodeficiency Syndrome↗
Child health and childminding.
With the objective of determining whether training childminders could improve the health of the children in their care, a controlled trial was conducted among volunteer childminders in a white working-class community in Johannesburg. A small sample of non-volunteer childminders studied did not differ significantly from the minders who did volunteer to participate in the study, except in that they claimed to have more difficulty in attending the training course. The results show that demographic features and scores for the trainee and control groups did not differ significantly before training. After training there were improvements in 4 of the 5 measured scores for the trainee group as opposed to the control group, namely the number of physically detected medical problems, the children's immunisation status, the physical and emotional environment provided by the childminders, and the childminders' knowledge of first aid. The medium-term findings of this study show that training childminders is worthwhile in this community.
Child↗
'Birth to Ten'--pilot studies to test the feasibility of a birth cohort study investigating the effects of urbanisation in South Africa.
'Birth to Ten' is a birth cohort study currently being conducted in the Johannesburg-Soweto area. This paper describes the various pilot studies that were undertaken to investigate the feasibility of a cohort study in an urban area. These studies were designed to determine the monthly birth rate, the timing, frequency and duration of maternal antenatal visits, the timing and frequency of visits to well-baby clinics and the accuracy and reliability of routinely collected growth data. In addition, a birth data collection form was tested to ascertain the appropriateness of its use in clinics within the study area.
Birth Rate↗
Perceptions and knowledge about the acquired immunodeficiency syndrome among students in university residences.
Using an anonymous questionnaire to obtain baseline data on sexual behaviour and knowledge of the acquired immunodeficiency syndrome (AIDS) among students in university residences, the following information was obtained: Knowledge of AIDS was found to be high, although misconceptions regarding transmission of the virus were prevalent. Mosquito bites (15%) and the donating of blood (31%) were incorrectly identified as methods of transmission of the virus. Deep kissing was recognised by only 27% of the students as a possible method of transmission while 22% and 13% of the students, respectively, failed to identify the sharing of razor blades and blood transfusions as possible means of contracting HIV infection. The students' knowledge had not greatly affected sexual behaviour. Two-thirds of the respondents had previously had sexual contact; 38% were sexually active at the time of the study, and of these 74% had engaged in unprotected intercourse with casual partners in the previous 6 months. There was a negative attitude towards condom use and over 80% of sexually active students did not perceive themselves to be at risk of contracting AIDS. Campus Health (82%), State health services (51%), and public advertisements (60%) were preferred sources of AIDS information. Newspapers/magazines (80%) and leaflets (69%) were identified as the preferred media. In reality, significantly fewer students obtained their information from Campus Health (15%; P less than 0.05), State health services (19%, P less than 0.05) and leaflets (44%; P less than 0.05). It can be concluded that education programmes should be developed by credible organisations to ensure that an awareness of AIDS results in appropriate sexual behaviour.
Acquired Immunodeficiency Syndrome↗
Alpha-L-fucosidase as a serum marker of hepatocellular carcinoma in southern African blacks.
The purpose of this study was to compare alpha-L-fucosidase and alpha-fetoprotein as serum markers of hepatocellular carcinoma in 72 southern African blacks with this tumour and 64 matched patients with benign hepatic diseases which might be mistaken clinically for hepatocellular carcinoma. Alpha-L-fucosidase activity was assayed using p-nitrophenyl-L-fucopyranoside (pNpf) as a substrate and alpha-fetoprotein concentrations were measured by radioimmunoassay. Serum alpha-L-fucosidase activity in the patients with hepatocellular carcinoma (mean 1,268, s.e.m. +/- 83.7, median 1,150 and range 38-3,698 nmol pNpf ml-1 h-1) was significantly higher than that in the matched controls (mean 798, s.e.m. +/- 65.8, median 648 and range 273-3,825 nmol pNpf ml-1 h-1) (P = 0.0001). However, alpha-L-fucosidase was both less sensitive (75 versus 87%) and less specific (70 versus 87%) than alpha-fetoprotein as a serum marker of hepatocellular carcinoma. When, in an endeavour to eliminate false-positive results, the diagnostic cut-off level for alpha-L-fucosidase was increased to 1,500 nmol pNpf ml-1 h-1 and for alpha-fetoprotein to 400 ng ml-1, the sensitivity of alpha-L-fucosidase fell to 21% whereas that of alpha-fetoprotein remained satisfactory at 78%. If the two markers were used together, the number of false-negative alpha-fetoprotein results was reduced from 13 to 5.5%. We conclude that alpha-L-fucosidase is less useful than alpha-fetoprotein as a single marker of hepatocellular carcinoma in southern African blacks. However, the two markers can profitably be used together.
Africa, Southern↗
Photosensitivity and anti-Ro (SS-A) antibodies in black patients with systemic lupus erythematosus (SLE).
Ninety-two patients with SLE, 36 black and 56 white, were studied prospectively for photosensitivity and anti-Ro (SS-A) and anti-La (SS-B) antibodies. Photosensitivity was found in 19% of black patients, compared to 71% of white patients (p = 0.001). Anti-Ro antibodies were found in 69% of black and 54% of white patients (p = 0.013). Photosensitivity was present in 87% of Ro-positive white patients and in 54% of Ro-negative white patients (p = 0.007). However, in black patients with SLE there was a strong negative association: 4% of Ro-positive patients were photosensitive while 55% of Ro-negatives were photosensitive (p = 0.001). This suggests that black SLE patients may possess a factor which 'blocks' photosensitivity, perhaps by preventing local tissue damage caused by the interaction of Ro antibodies and ultraviolet light.
Antibodies, Antinuclear↗
Factors associated with oesophageal cancer in Soweto, South Africa.
Cancer of the oesophagus was a rare disease in the South African black population until the last few decades. Increases in incidence have occurred and at present it is the commonest cancer in black men in many parts of South Africa. A case-control study of 200 oesophageal cancer patients and 391 hospital controls has been carried out in order to determine the risk factors in the urban black population of Soweto. The results indicate that the cancer patients were long-term urban residents from a very low socio-economic group. The association between smoking pipe tobacco and oesophageal cancer previously noted in South Africa is confirmed. In addition, consumption of traditional beer was found to be a major risk factor.
Adult↗