210 research outputs found
Drug resistance maps to guide intermittent preventive treatment of malaria in African infants.
No full textIntermittent preventive treatment of infants (IPTi) with sulphadoxine pyrimethamine (SP) is recommended as an additional malaria control intervention in high transmission areas of sub-Saharan Africa, provided its protective efficacy is not compromised by SP resistance. A significant obstacle in implementing SP-IPTi, is in establishing the degree of resistance in an area. Since SP monotherapy is discontinued, no contemporary measures of in vivo efficacy can be made, so the World Health Organisation has recommended a cut-off based upon molecular markers, stating that SP-IPTi should not be implemented when the prevalence of the dhps 540E mutation among infections exceeds 50%. We created a geo-referenced database of SP resistance markers in Africa from published literature. By selecting surveys of malaria infected blood samples conducted since 2004 we have mapped the contemporary prevalence of dhps 540E. Additional maps are freely available in interactive form at http://www.drugresistancemaps.org/ipti/. Eight countries in East Africa are classified as unsuitable for SP-IPTi when data are considered at a national level. Fourteen countries in Central and West Africa were classified as suitable while seven countries had no available contemporary data to guide policy. There are clear deficiencies in molecular surveillance data coverage. We discuss requirements for ongoing surveillance of SP resistance markers in support of the use of SP-IPTi
Writing women in solitary: shifting narratives to make research count by Shanthini Naidoo
No full textAuthor Shanthini Naidoo reflects on her decision to change the focus of her Master’s dissertation in order to uncover the narratives of anti-apartheid women activists in South Africa. This research formed the basis of her recently published book Women in Solitary: Inside the Female Resistance to Apartheid, which focuses particularly on four women: Joyce Sikhakhane-Rankin, Shanthie Naidoo, Nondwe Mankahla and Rita Ndzanga. As the UK celebrates Black History Month in October, Naidoo reflects on the importance of uncovering stories that not only evidence bravery and courage, but also the power of love and friendship in daily life
Book review: Women in solitary: inside the female resistance to apartheid by Shanthini Naidoo
No full textIn Women in Solitary: Inside the Female Resistance to Apartheid, Shanthini Naidoo offers a new account based around the narratives of four women – Joyce Sikhakhane-Rankin, Shanthie Naidoo, Rita Ndzanga and Nondwe Mankahla – who experienced detention and torture in South Africa in the late 1960s when the regime tried to stage a trial to convict leading anti-apartheid activists. This timely book not only accords the four women and others their place in the history of the struggle for freedom in South Africa, but also weaves their experiences into the historical development of the anti-apartheid movement, writes Tony Trew. If you are interested in this book review, you may also like to read an LSE RB essay by author Shanthini Naidoo on her decision to change the focus of her Master’s dissertation to uncover the narratives of anti-apartheid women activists in South Africa
Healthcare seeking patterns for TB symptoms: Findings from the first national TB prevalence survey of South Africa, 2017–2019
No full textBackground Although tuberculosis (TB) symptoms have limited sensitivity they remain an important entry point into the TB care cascade. Objectives To investigate self-reported healthcare seeking for TB symptoms in participants in a community-based survey. Methods We compared reasons for not seeking care in participants reporting ≥1 of four TB screening symptoms (cough, weight loss, night sweats, fever) in the first South African national TB prevalence survey (2017–2019). We used logistic regression analyses to identify sociodemographic and clinical characteristics associated with healthcare seeking. Results 5,168/35,191 (14.7%) survey participants reported TB symptoms and 3,442/5168 had not sought healthcare. 2,064/3,442(60.0%) participants intended to seek care, 912 (26.5%) regarded symptoms as benign, 399 (11.6%) reported access barriers(distance and cost), 36 (1.0%) took other medications and 20(0.6%) reported health system barriers. Of the 57/98 symptomatic participants diagnosed with bacteriologically confirmed TB who had not sought care: 38(66.7%) intended to do so, 8(14.0%) regarded symptoms as benign, and 6(10.5%) reported access barriers. Among these 98, those with unknown HIV status(OR 0.16 95% CI 0.03–0.82), p = 0.03 and those who smoked tobacco products(OR 0.39, 95% CI 0.17–0.89, p = 0.03) were significantly less likely to seek care. Conclusions People with TB symptoms delayed seeking healthcare, many regarded symptoms as benign while others faced access barriers. Those with unknown HIV status were significantly less likely to seek care. Strengthening community-based TB awareness and screening programmes together with self-screening models could increase awareness of the significance of TB symptoms and contribute to improving healthcare seeking and enable many people with TB to enter the TB care cascade
Following the path of most resistance: dhps K540E dispersal in African Plasmodium falciparum.
No full textChloroquine resistant malaria (CQR) emerged in East Africa during the late 1970s and then spread westward. A molecular marker only became available in the late 1990s, and by that time CQR had permeated throughout Africa. By contrast, resistance to sulphadoxine-pyrimethamine (SPR) has emerged during an era of molecular surveillance, and the changing prevalence of SPR conferred by point mutations in the dhfr and dhps genes has been recorded in hundreds of sites across Africa. We have collated and mapped reports of the dhps K540E mutation, a uniquely informative marker of SPR, and used these to describe the geography of its dispersal through time. Like CQR, dhps K540E appeared first in East Africa and spread west. We discuss whether there are common principles governing resistance dispersal in Africa and how these might guide surveillance in future
Mapping 'partially resistant', 'fully resistant', and 'super resistant' malaria.
No full textSulfadoxine-pyrimethamine (SP) is used throughout Africa for intermittent preventive treatment (IPT) of malaria, but resistance threatens its efficacy. We found marked regional differences in the genotypes responsible for SP resistance when mapping recent surveys of dihydrofolate reductase (dhfr) and dihydropteroate synthase (dhps) mutations. In West Africa, a 'partially resistant' combination of dhfr N51I, N59R, and S108N with dhps A437G predominates, whereas in East Africa the 'fully resistant' combination of dhfr N51I, N59R, and S108N with dhps A437G+K540E is found. There are three East African foci where 'fully resistant' populations have additionally acquired dhps 581G and/or dhfr 164L to become 'super resistant'. SP-IPT in infants and pregnant women is reported to have failed in super resistant areas prompting review of SP-IPT use in affected areas
Why did schistosomiasis disappear from the southern part of the Eastern Cape?
No full textWe reviewed the early literature and maps of the occurrence of urogenital schistosomiasis (bilharzia) in the Eastern Cape, South Africa from the 1860s until its decline from about 1900 and reappearance in 2002. Although this decline in transmission has received little attention to date, clinical descriptions of the disease over this period indicate that infection was common, probably patchy, although sometimes with severe morbidity. The long period of quiescence between 1900 and 2002 is thought to be as a result of several factors, but primarily because of the impact of the area's cold winters and drought-prone climate on the survival and reproduction of both the snail intermediate host Bulinus africanus and the intramolluscan stages of the parasite. The concept of an outbreak area is invoked to describe the occurrence of intense urogenital schistosomiasis transmission in localised areas for relatively short periods of up to 35 years in this the southernmost part of its range in Africa, a suboptimal environment for transmission
Why did schistosomiasis disappear from the southern part of the Eastern Cape?
No full textWe reviewed the early literature and maps of the occurrence of urogenital schistosomiasis (bilharzia) in the Eastern Cape, South Africa from the 1860s until its decline from about 1900 and reappearance in 2002. Although this decline in transmission has received little attention to date, clinical descriptions of the disease over this period indicate that infection was common, probably patchy, although sometimes with severe morbidity. The long period of quiescence between 1900 and 2002 is thought to be as a result of several factors, but primarily because of the impact of the area's cold winters and drought-prone climate on the survival and reproduction of both the snail intermediate host Bulinus africanus and the intramolluscan stages of the parasite. The concept of an outbreak area is invoked to describe the occurrence of intense urogenital schistosomiasis transmission in localised areas for relatively short periods of up to 35 years in this the southernmost part of its range in Africa, a suboptimal environment for transmission
In Conversation with Beverley Naidoo: On Crossing Boundaries through Reading and Writing
No full textBorn into a white, middle-class family in Johannesburg, South Africa, children's author Beverley Naidoo grew up under the oppressive apartheid regime until the age of twenty-one. She has written a variety of children’s and young adult novels, picturebooks, collections of short stories, plays, and adult nonfiction. Her books have won many awards, including the Carnegie Medal for The Other Side of Truth, and she also published her PhD, called Through Whose Eyes? Exploring Racism, Reader Text and Context, which investigated the possibilities of challenging racism through reading in a school context. In this article Julia Hope, Head of the MA Children's Literature at Goldsmiths College, asks Beverley to talk about her own education, school themes that arise in her writing, her PhD, and wider perceptions of the educative power of literature
Susceptibility of schistosome host snails to predation by sciomyzid flies (Diptera: Sciomyzidae) in South Africa
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