South African Medical Research Council (SAMRC) Repository
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Update on the national vaccination programme, including the Sisonke study
No full textPresentation made at Business for SA (B4SA) webinar for the Healthcare Sector: Update on national vaccine programme / Phase 1 + 2
Report on weekly deaths in South Africa: Week 42
No full textThis report provides estimates of the weekly number of deaths of all persons in South Africa for epidemiological Week 42 of 2021, covering the period 17 - 23 October 2021
Report on weekly deaths in South Africa: Week 40
No full textThis report provides estimates of the weekly number of deaths of all persons in South Africa for epidemiological Week 40 of 2021, covering the period 3 - 9 October 2021
Rapid review of the effects of cloth and medical masks for preventing transmission of SARS-CoV-2 in community and household settings
No full textBackground. Evidence on mask use in the general population is needed to inform SARS-CoV-2 responses.
Objectives. To assess the effectiveness of cloth and medical masks for preventing SARS-CoV-2 transmission in community settings.
Methods. Two rapid reviews were conducted searching three electronic databases (PubMed, Embase, Cochrane Library) and two clinical trials registries on 30 and 31 March 2020.
Results. We screened 821 records and assessed nine full-text articles for eligibility. One and seven RCTs were included for cloth and medical mask reviews, respectively. No SARS-CoV-2-specific RCTs and no cloth mask RCTs in community settings were identified. A single hospital-based RCT provided indirect evidence that, compared with medical masks, cloth masks probably increase clinical respiratory illnesses (relative risk (RR) 1.56; 95% confidence interval (CI) 0.98 - 2.49) and laboratory-confirmed respiratory virus infections (RR 1.54; 95% CI 0.88 - 2.70). Evidence for influenza-like illnesses (ILI) was uncertain (RR 13.00; 95% CI 1.69 - 100.03). Two RCTs provide low-certainty evidence that medical masks may make little to no difference to ILI infection risk versus no masks (RR 0.98; 95% CI 0.81 - 1.19) in the community setting. Five RCTs provide low-certainty evidence that medical masks may slightly reduce infection risk v. no masks (RR 0.81; 95% CI 0.55 - 1.20) in the household setting.
Conclusions. Direct evidence for cloth and medical mask efficacy and effectiveness in the community is limited. Decision-making for mask use may consider other factors such as feasibility and SARS-CoV-2 transmission dynamics; however, well-designed comparative effectiveness studies are required
Report on weekly deaths in South Africa: Week 33
No full textThis report provides estimates of the weekly number of deaths of all persons in South Africa for epidemiological Week 33 of 2021, covering the period 15 – 21 Aug 2021
Predictors of in-hospital mortality among HIV-positive patients presenting with an acute illness to the emergency department
Get PDFObjectives: Despite better access to antiretroviral therapy (ART) over recent years, HIV remains a major global cause of mortality. The present study aimed to identify predictors of in-hospital mortality among HIV-positive patients presenting to an emergency department (ED).
Methods: In this cross-sectional study, HIV-positive patients presenting to the Charlotte Maxeke Johannesburg Academic Hospital adult ED between 07 July 2017 and 18 October 2018 were prospectively enrolled. Data were compared between participants who survived to hospital discharge and those who died. The data were further subjected to univariate and multivariate logistic regression analyses to determine variables that were associated with in-hospital mortality.
Results: Of a total of 1224 participants, the in-hospital mortality was 13.6% (n = 166). On multivariate analysis, respiratory rate > 20 breaths/min [odds ratio (OR) = 1.90, P = 0.012], creatinine > 120 μmol/L (OR = 1.97, P = 0.006), oxygen saturation 2 mmol/L (OR = 4.83, P = 0.000) and cryptococcal meningitis (OR = 6.78, P = 0.000) were significantly associated with in-hospital mortality.
Conclusions: Routine clinical and laboratory parameters are useful predictors of in-hospital mortality in HIV-positive patients presenting to the ED with an acute illness. These parameters may be of value in guiding clinical decision-making, directing the appropriate use of resources and influencing patient disposition, and may also be useful in developing an outcome prediction tool
COVID-19 and children, adolescents and families: Impacts, issues and the role of vaccines
No full textPresented at Johns Hopkins-University of Washington Symposium, USA
The joint effects of diet and dietary supplements in relation to obesity and cardiovascular disease over a 10‐year follow‐up: A longitudinal study of 69,990 participants in Australia
No full textIt is unknown whether a healthy diet or unhealthy diet combined with specific supplements may jointly contribute to incidence of obesity and cardiovascular disease (CVD). We included 69,990 participants from the 45 and Up Study who completed both baseline (2006-2009) and follow-up (2012-2015) surveys. We found that compared to participants with a long-term healthy diet and no supplement consumption, those with a long-term healthy diet combined with multivitamins and minerals (MVM) or fish oil consumption were associated with a lower incidence of CVD (p < 0.001); whilst those with an unhealthy diet and no MVM or fish oil consumption were associated with a higher risk of obesity (p < 0.05). Compared to participants with a long-term healthy diet and no calcium consumption, the combination of a long-term healthy diet and calcium consumption was linked to a lower risk of CVD (IRR = 0.87, 95% CI: 0.78; 0.96). In conclusion, a long-term healthy diet combined with MVM or fish oil was associated with a lower incidence of CVD. Participants who maintained a healthy diet and used calcium supplements were associated with a lower incidence of obesity. However, these associations were not found among those with an unhealthy diet, despite taking similar supplements
Longitudinal associations of pubertal timing and tempo with adolescent mental health and risk behavior initiation in urban South Africa
No full textPurpose: In high-income countries, early and rapid pubertal development is consistently associated with poor adjustment and increased risk behavior in adolescence. This study contributes to the meager knowledge of these associations in lower income countries.
Methods: We used longitudinal data from 1,784 urban black South Africans in the Birth to Twenty Plus cohort. We used regression analyses to assess associations between age at menarche and latent classes of pubertal timing and tempo and adolescent internalizing and externalizing emotional and behavioral problems, eating attitudes, and patterns of health risk behavior initiation.
Results: Relatively earlier and faster pubertal timing and tempo were associated with increased health risk behavior initiation (e.g., adjusted odds ratio [95% confidence interval] high- vs. low-risk pattern = 5.7 [1.7, 19.06] for male genital development; adjusted odds ratio = 3.45 [1.13, 10.49] for female breast development). Among males, earlier and faster pubertal timing and tempo were associated with increased externalizing problems in early adolescence and increased oppositional defiant problems in midadolescence, whereas later and slower pubertal timing and tempo were associated with decreases. Among females, earlier and faster pubertal timing and tempo were associated with increased internalizing and externalizing problems in midadolescence and increased dieting behaviors in early and late adolescence (β [95% confidence interval] = 2.51 [.87, 4.15] for pubic hair development), whereas later and slower pubertal timing and tempo were associated with decreases.
Conclusions: In this urban South African cohort, relatively earlier and faster pubertal development was detrimental to mental health and risk behavior activity, whereas later and slower maturation was somewhat protective.The authors would like to acknowledge the generous support of the NIH Fogarty International Center (R25TW009337), Bill & Melinda Gates Foundation (OPP1164115), Wellcome Trust (077210/Z/05/Z), the DSI-NRF Centre of Excellence hosted by the University of the Witwatersrand, and the South African Medical Research Council