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PubMed2005

European origin of Bradyrhizobium populations infecting lupins and serradella in soils of Western Australia and South Africa.

We applied a multilocus phylogenetic approach to elucidate the origin of serradella and lupin Bradyrhizobium strains that persist in soils of Western Australia and South Africa. The selected strains belonged to different randomly amplified polymorphic DNA (RAPD)-PCR clusters that were distinct from RAPD clusters of applied inoculant strains. Phylogenetic analyses were performed with nodulation genes (nodA, nodZ, nolL, noeI), housekeeping genes (dnaK, recA, glnII, atpD), and 16S-23S rRNA intergenic transcribed spacer sequences. Housekeeping gene phylogenies revealed that all serradella and Lupinus cosentinii isolates from Western Australia and three of five South African narrow-leaf lupin strains were intermingled with the strains of Bradyrhizobium canariense, forming a well supported branch on each of the trees. All nodA gene sequences of the lupin and serradella bradyrhizobia formed a single branch, referred to as clade II, together with the sequences of other lupin and serradella strains. Similar patterns were detected in nodZ and nolL trees. In contrast, nodA sequences of the strains isolated from native Australian legumes formed either a new branch called clade IV or belonged to clade I or III, whereas their nonsymbiotic genes grouped outside the B. canariense branch. These data suggest that the lupin and serradella strains, including the strains from uncultivated L. cosentinii plants, are descendants of strains that most likely were brought from Europe accidentally with lupin and serradella seeds. The observed dominance of B. canariense strains may be related to this species' adaptation to acid soils common in Western Australia and South Africa and, presumably, to their intrinsic ability to compete for nodulation of lupins and serradella.

Bacterial Proteins↗
PubMed2004

Incidence and patterns of violent and/or traumatic deaths between 1993 and 1999 in the Transkei region of South Africa.

BACKGROUND: Incidence and patterns of violent and/or traumatic deaths among 4,525 victims over a 7-year period in the Transkei region of South Africa were investigated. METHOD: Retrospective review and analysis was performed of all medicolegal autopsies (n = 6,181) between January 1993 and December 1999, of which 4,525 were violent or traumatic deaths. RESULTS: During the 7-year period (January 1993-December 1999), violent and/or traumatic deaths in the Transkei region accounted for an average annual rate of 162 per 100,000 of the population. The common causes of deaths per 100,000 of population per year were as follows: motor vehicle collisions, 63; firearm injuries, 43; stab wounds, 32; and blunt trauma, 24. Male subjects outnumbered female subjects by a 3.3:1 ratio. The murder rate in female subjects was 18 per 100,000 population. The murder rate in this area increased from 94 per 100,000 in 1993 to 121 in 1999. Nearly 50% of the violent and/or traumatic deaths occurred in the 21- to 40-year age group. There has been an increase in nontraumatic deaths such as hanging (1.5 times) and poisoning (5 times). CONCLUSION: The average annual incidence of violent and/or traumatic deaths in the Transkei region of South Africa is 162 per 100,000 population. Firearm-related deaths, at 43 per 100,000 of the population per year, have contributed substantially to this high incidence. This is a major cause of concern.

Accidents, Traffic↗
PubMed2000

The role of 'African chemists' in the health care system of the Eastern Cape province of South Africa.

Self-medication is documented as an integral part of health care therapy in developing countries such as Ethiopia, Cameroon, Uganda and Mexico. In South Africa the types of illnesses and health problems that are referred to both traditional healers and biomedical practices have been well documented. However, very little literature exists on self-diagnosis, self-medication or sources of the medicines used for self-medication. This bias in the literature has come about largely because anthropological studies have focused on the later stages of the illness referral system when treatment is sought from a specialist for symptoms which have not responded to forms of self-medication. As a result of this, health care studies have documented the more exceptional exotic healing rituals and culturally bound syndromes of a particular society or community, and not discussed the more ordinary practices of self-medication of everyday illness. Self-medication is however an important initial response to illness and many illnesses are successfully managed at this stage. Amayeza stores (singular-iyeza store)--or 'African chemists'--are an important source of medicines for self-diagnosed illnesses. The current discussion focuses on the types of medicines and treatments that are obtained from amayeza stores without professional consultation in the Eastern Cape province of South Africa.

Animals↗
PubMed1995

Molecular epidemiology of rabies virus in South Africa: evidence for two distinct virus groups.

In order to derive phylogenetic relationships between rabies virus isolates from different geographical locations and host species in South Africa, two genome regions of the virus, viz. the cytoplasmic domain of the glycoprotein and the G-L intergenic region (pseudogene), were sequenced. A high level of nucleic acid sequence conservation indicated a close phylogenetic relationship between virus isolates from domestic dogs, jackals and bat-eared foxes, i.e. Canidae. These isolates appeared to be distinct from but closely related to European strains of rabies virus. However, a phylogenetically distinguishable and distant group, which contained isolates from mongooses (i.e. Viverridae) was identifiable. The latter group appears to be distantly related to European and vaccine strains of rabies virus and may have evolved uniquely on the central plateau of South Africa. Our data also indicate that spillover from mongooses (or other viverrids) to canid hosts occurs occasionally.

Animals↗
PubMed2000

Racism and medical science in South Africa's Cape Colony in the mid- to late nineteenth century.

Racism has been a particular focus of the history of Western medicine in colonial South Africa. Much of the research to date has paradoxically interpreted Western medicine as both a handmaiden of colonialism and as a racist gatekeeper to the benefits of Western medical science. This essay suggests that while these conclusions have some validity, the framework in which they have been devised is problematic. Not only is that framework contradictory in nature, it underplays differences within Western medicine, privileges the history of explicit and intentional racial discrimination in medicine, and encourages a separate analysis of racism in law, in the medical profession, and in medical theory and practice. Using the example of the Cape Colony in South Africa, this paper shows how legislation, class, institutional setting, and popular stereotypes could influence the form, timing, and degree of racism in the medical professional, and in medical theory and practice. It also argues for an analytical distinction between 'racist medicine' and 'medical racism.'

Colonialism↗
PubMedDate not supplied

Quality assessment of malaria laboratory diagnosis in South Africa.

To assess the quality of malaria diagnosis in 115 South African laboratories participating in the National Health Laboratory Service Parasitology External Quality Assessment Programme we reviewed the results from 7 surveys from January 2000 to August 2002. The mean percentage incorrect result rate was 13.8% (95% CI 11.3-16.9%), which is alarmingly high, with about 1 in 7 blood films being incorrectly interpreted. Most participants with incorrect blood film interpretations had acceptable Giemsa staining quality, indicating that there is less of a problem with staining technique than with blood film interpretation. Laboratories in provinces in which malaria is endemic did not necessarily perform better than those in non-endemic areas. The results clearly suggest that malaria laboratory diagnosis throughout South Africa needs strengthening by improving laboratory standardization and auditing, training, quality assurance and referral resources.

Clinical Laboratory Techniques↗
PubMed2000

Mitochondrial DNA analysis of Sporothrix schenckii in South Africa and Australia.

Clinical isolates of Sporothrix schenckii were investigated for mitochondrial DNA (mtDNA) types using restriction fragment length polymorphism patterns with HaeIII. The 62isolates in South Africa comprised Types 3 (9.7%), 4 (1.6%), 11 (9.7%), 17 (77.4%) and 23 (1.6%) while the 23 Australian isolates comprised Types 3 (26.0%), 4 (56.5%), 7 (8.6%) and 21 (8.6%). In a phylogenetic tree based on the sequence divergence of mtDNA, the mtDNA types were clustered into two groups, A and B. The results suggested that isolates in South Africa mainly belong to Group A and isolates in Australia mainly belong to Group B.

Australia↗
PubMed1991

The cholera epidemic in South Africa, 1980-1987. Epidemiological features.

During the cholera epidemic in South Africa, 1980-1987, 25,251 cases of cholera were bacteriologically proven. The case-fatality rate was 1.4%. Outbreaks occurred in the summer rainfall season. Age-specific attack rates followed the pattern typically found during the 'epidemic phase' of the disease in most years. The vast majority of patients were black South Africans living in rural areas with an average annual rainfall in excess of 600 mm. The containment strategy employed is summarised. Despite the apparent eradication of the disease, it is strongly recommended that vigilance should be maintained and investigations of all possible sources of infection and all human contacts of any new proven case should be carried out speedily and thoroughly.

Adolescent↗
PubMed2005

Characterization of human immunodeficiency virus type 1 from a previously unexplored region of South Africa with a high HIV prevalence.

HIV prevalence in the Limpopo Province has increased rapidly within the past 10 years, as in other parts of South Africa. Little is known about the genetic and biological properties of HIV circulating in this region including the baseline drug resistance profiles. We therefore collected blood samples from 42 HIV-1-infected patients residing in this region for analysis. All samples were shown to belong to HIV-1 subtype C by env and gag heteroduplex mobility assay (HMA). Viral isolates from 14 of these patients were shown to use the CCR5 coreceptor exclusively and had gp120 V3 loop sequences consistent with this phenotype. Sequence analysis of both protease and reverse transcriptase genes showed that none of 13 isolates harbored primary resistance mutations. These data suggest that HIV-1 subtype C is the predominant subtype circulating in the Limpopo Province, and that viral strains from this region are indistinguishable from those found in other parts of South Africa.

Adult↗
PubMed2003

Psychometric characteristics of the Science Teaching Efficacy Belief Inventory in South Africa.

The psychometric properties of the Science Teaching Efficacy Belief Inventory are reported, based on responses of 200 (88 men and 112 women) elementary science teachers in the Eastern Cape, South Africa. Previous factor analytic studies of this inventory have identified a two-factor solution but this has not been investigated in a South African context. The reliability estimated as internal consistency (Cronbach alpha) was .87. Principal components analysis with varimax rotation indicated a two-factor solution accounting for 38.1% of variance, with Cronbach alphas of .92 and .73 for the Personal Science Teaching Efficacy Belief subscale (Factor 1) and the Science Teaching Outcome Expectancy subscale (Factor 2), respectively. Principal components analysis of the Science Teaching Efficacy Belief Inventory yielded two conceptually meaningful components, similar to those reported in literature. Although one item did not meet the conditions for acceptance, this inventory may be useful in understanding science teachers' efficacy beliefs in South Africa. These particular findings are preliminary but hopeful. Studies using confirmatory analysis to address the cross-national invariance of this inventory are needed.

Adult↗
PubMed1999

Ethnicity and patterns of spondyloarthritis in South Africa--analysis of 100 patients.

OBJECTIVE: To determine the spectrum and ethnic differences of spondyloarthritis disease patterns in patients attending the Rheumatic Diseases Unit, University of Cape Town, South Africa. METHODS: A retrospective survey of case records of 100 patients with spondyloarthritis seen between January 1988 and January 1995. RESULTS: Of these 100 patients, 71 were male, 53 were Colored [mixed race descendants of Khoisan (Hottentot and Bushmen), Whites, Malays and Black Africans], 40 White, 5 Black and 2 Indian (descendants of immigrants from the Indian subcontinent). Our results show that the prevalence and disease patterns of spondyloarthritis in this South African cohort are comparable to those seen in Europe and North America with respect to clinical and radiological features, as well as therapeutic and orthopedic surgical requirements. No major ethnic differences in disease patterns were observed in White and Colored patients studied. CONCLUSION: The spectrum of spondyloarthritis in South Africa is similar to that seen elsewhere in the world. Our study confirmed the rarity of these conditions in Black South Africans.

Age of Onset↗
PubMed2003

Anopheles arabiensis and An. quadriannulatus resistance to DDT in South Africa.

The malaria control programme of KwaZulu-Natal Province, South Africa, includes Mamfene and Mlambo communities. Western-type houses there are currently sprayed with deltamethrin, whereas traditional houses are sprayed with DDT for malaria control. In 2002, mosquitoes of the Anopheles gambiae complex (Diptera: Culicidae) were collected from DDT-sprayed houses, by window exit traps, and from man-baited nets outdoors. Larval collections were also carried out at Mzinweni Pan near Mlambo. Species of the An. gambiae complex were identified by rDNA polymerase chain reaction assay. The majority of samples collected by window trap and baited nets were identified as the malaria vector An. arabiensis Patton, with a few An. merus Dönitz and An. quadriannulatus (Theobald). The larval collections were predominantly An. quadriannulatus with a small number of An. arabiensis. Standard WHO insecticide susceptibility tests using 4% DDT and 0.05% deltamethrin were performed on both wild-caught females and laboratory-reared progeny from wild-caught females. Wild-caught An. arabiensis samples from window traps gave 63% and 100% mortality 24-h post-exposure to DDT or deltamethrin, respectively. Wild-caught An. arabiensis samples from man-baited net traps gave 81% mortality 24-h post-exposure to DDT. The F1 progeny from 22 An. arabiensis females showed average mortality of 86.5% 24-h post-exposure to DDT. Less than 80% mortality was recorded from five of these families. Biochemical analyses of samples from each of the families revealed comparatively high levels of glutathione-S-transferases and non-specific esterases in some families, but without significant correlation to bioassay results. Wild-caught An. quadriannulatus larvae were reared through to adults and assayed on 4% DDT, giving 47% (n = 36) mortality 24-h post-exposure. Finding DDT resistance in the vector An. arabiensis, close to the area where we previously reported pyrethroid-resistance in the vector An. funestus Giles, indicates an urgent need to develop a strategy of insecticide resistance management for the malaria control programmes of southern Africa.

Africa, Southern↗
PubMed1999

Prevalence of asthma and respiratory symptoms in south-central Durban, South Africa.

The prevalence of asthma and respiratory symptoms in south-central Durban, one of the most heavily polluted areas of South Africa, has been determined using a cross-sectional survey of 213 households in the communities of Merewent (97% Indians) and Austerville (98% coloreds). The study population consisted of 367 children (less than 17 years old) and 693 adults. About 10% of the children and 12% of adults reported doctor diagnosed asthma. The self-reported prevalence rates for wheezing (3740%) and attacks of shortness of breath with wheeze (16-28%) were much higher than that for doctor diagnosed asthma and common co-occurrence of the three symptoms is found. The prevalence rates for other respiratory symptoms include 33-35% for chronic cough, 31-32% for chronic phlegm, 44-50% for frequent blocked-runny nose, and 16-27% for sinusitis. Factors in the community that were associated with asthma, wheeze and shortness of breath with wheeze among the adult population included cigarette smoking, use of insecticides (coils and pump spray) and home ownership. An association between asthma among children and a number of household risk factors including dampness, carpet, pets or use of pesticides was not apparent in the community. Asthma prevalence was strongly correlated with missing of school by children (odds ratio (OR): 44; 95% confidence interval (CI): 13-141). The study serves to draw attention to a growing but neglected public health problem in urban areas of Africa.

Adolescent↗
PubMed2006

Influence of cooking and heating fuel use on 1-59 month old mortality in South Africa.

OBJECTIVES: To determine the association between the combustion of wood, animal dung, coal and paraffin (polluting fuels) for cooking and heating and 1-59 month old mortality in South Africa, whilst adjusting for a number of confounders. METHODS: Data from 3,556 children (142 deaths) living in 2,828 households were extracted from the 1998 South African Demographic and Health Survey (SADHS) database. The SADHS was the first national health survey conducted across the entire country and provided the opportunity to examine the prevalence and determinants of various morbidity and mortality outcomes in a representative national population. RESULTS: The results suggest that exposure to cooking and heating smoke from polluting fuels is significantly associated with 1-59 month mortality, after controlling for mother's age at birth, water source, asset index and household crowdedness (RR=1.95; 95% CI=1.04, 3.68). CONCLUSIONS: Although there is potential for residual confounding despite adjustment, the better documented evidence on outdoor air pollution and mortality suggest this association may be real. As nearly half of households in South Africa still rely on polluting fuels and women of childbearing age perform most cooking tasks, the attributable risk arising from this association, if confirmed, could be substantial. It is trusted that more detailed analytical intervention studies will scrutinise these results in order to develop integrated intervention programmes to reduce children's exposure to air pollution emanating from cooking and heating fuels.

Adolescent↗
PubMed1998

Understanding the epidemic of HIV in South Africa. Analysis of the antenatal clinic survey data.

OBJECTIVES: To investigate the magnitude and the time course of the HIV epidemic in the provinces of South Africa from the antenatal clinic HIV surveys. DESIGN: We analysed the data on the provincial prevalences of HIV infection from 1990 to 1996 using maximum likelihood methods to determine the intrinsic growth rate and probable asymptotic prevalence of HIV among women attending antenatal clinics. SUBJECTS: Women attending antenatal clinics and included in the national HIV prevalence surveys conducted by the Department of Health. RESULTS: 1. In KwaZulu-Natal the epidemic is likely to peak at a prevalence of about 23% (95% confidence interval (CI) 19-36%). 2. The intrinsic doubling time does not differ significantly among the provinces. 3. The average length of the intrinsic doubling time is 12.0 months (95% CI 11.3-12.8 months). 4. The force of infection is approximately 1.00/year at age 16 years and declines at a rate of about 5% per year of age above 16 years. CONCLUSIONS: South Africa is likely to experience one of the worst HIV epidemics in Africa. The lack of statistically significant differences between the growth rates of the epidemic in the various provinces constrains the possible explanations that can be advanced to explain the time course of the epidemic and may in part be a consequence of migrancy. The intrinsic growth rate is higher than previous estimates and it is possible that in those provinces where the prevalence is still low it will eventually reach the same levels as in KwaZulu-Natal.

Acquired Immunodeficiency Syndrome↗
PubMed2005

Sexual violence and youth in South Africa: the need for community-based prevention interventions.

OBJECTIVES: South Africa is reported to have one of the highest rates of sexual violence in the world, with adolescent girls between the ages of 12-17 being particularly at risk. Given that adolescence is considered a critical developmental period for establishing normative sexual behavior, this study explored multiple levels of risk influences that render adolescent girls vulnerable to becoming victims of sexual violence and adolescent boys vulnerable to becoming perpetrators of such abuse in one South African community. METHOD: A case study approach using qualitative rapid focused ethnographic methods was used. This involved 10 focus group interviews and 10 individual interviews with a volunteer convenience sample of adolescent boys and girls between the ages of 14 and 16 years. RESULTS: Inductive thematic analysis revealed that there were indeed multiple levels of risk influences for adolescent girls and boys becoming either victims or perpetrators of sexual violence. Using the Theory of Triadic Influence as a framework, influences at the distal socio-cultural/environmental level included traditional notions of masculinity and normalization of inter-personal violence as well as poverty and the commodification of sex leading to rape supportive attitudes. Influences at the proximal situation context/social normative level included high-risk social norms as well as a weak adult and community protective shield. Finally, influences at the intra-personal level included low self-esteem and self-efficacy as well as inter-personal affective anger. CONCLUSION: Given the multiple levels of risk influences that need to be addressed to protect youth from becoming either perpetrators or victims of sexual violence in the South African context, prevention programs should necessarily be comprehensive, developmentally timed, and community-based.

Adolescent↗
PubMed2003

Mortality of children in the Transkei region of South Africa.

This study attempted to unfold, perhaps for the first time, the problem of childhood mortality resulting from trauma in the Eastern Cape Province of South Africa. This study was carried out in the Umtata and Ngqeleni magisterial districts, which have a combined population of about 400,000. Most people there have very few resources and have historically relied on money repatriated by migrant workers. In the Transkei region, unemployment is at a very high level: 48.5%. Assault on children is very common in this region, and this may result in death. The aim of this study was to establish the state of deaths resulting from pediatric trauma, and to formulate recommendations that could probably help prevent or reduce these deaths. The objective was to gather epidemiologic information on the victims of pediatric trauma. The study was designed as a descriptive study, using reviews of traumatic deaths in pediatric age groups during the period January 1993 to December 1999. This study was carried out on cases that were brought to the medicolegal laboratory at Umtata General Hospital, Umtata, in the Transkei region of the Eastern Cape Province, South Africa. There were 6181 autopsies conducted from 1993 to 1999. All the medicolegal autopsies were divided into two groups: pediatric (15 years of age or younger) and adult (older than 15 years). Of the autopsies, 89.4% (n = 5587) were in the adult group, and 10.6% (n = 594) were in the pediatric group. Of the pediatric deaths, 64% (n = 383) were related to trauma. The highest numbers were in the 11- to 15-year (n = 146, 38%) and the 6- to 10-year (n = 135, 34%) age groups. Of the children who died of trauma, 112 (28%) were aged 0 to 5 years. Unintentional injuries from motor vehicle accidents were the leading cause of death (59%), whereas intentional injuries (41%) were associated with murder. Nearly a quarter (22%) of pediatric traumatic deaths were due to penetrating injuries: stab (12%) and gunshot (10%) wounds. Most of the pediatric deaths occurred during the festive months of December, January, and April; the death toll during these months was three to four times higher than in the rest of the year. It was concluded that 64% of pediatric deaths in the Transkei region were the result of trauma. This represents 1 pediatric trauma death for every 10 adult trauma deaths. Forty-one percent of the child trauma deaths were due to intentional injuries, usually murder. It is recommended that the government set targets and put into place strategies for the reduction of pediatric deaths due to trauma. The different deaths so called "rule of reversal" could be considered as an indicator of social health.

Accidents, Traffic↗