68 research outputs found
Infect Dis Obstet Gynecol
No full textWhile 6- to 12-month courses of isoniazid for tuberculosis prevention are considered safe in pregnant women, the effects of longer-term isoniazid prophylaxis or isoniazid in combination with antiretroviral therapy (ART) are not established in human-immunodeficiency-virus-(HIV-) infected women who experience pregnancy during the course of therapy.|Nested study of pregnancy outcomes among HIV-infected women participating in a placebo-controlled, TB-prevention trial using 36 months daily isoniazid. Pregnancy outcomes were collected by interview and record review.|Among 196 pregnant women, 103 (52.6%) were exposed to isoniazid during pregnancy; all were exposed to antiretroviral drugs. Prior to pregnancy they had received a median of 341 days (range 1-1095) of isoniazid. We observed no isoniazid-associated hepatitis or other severe isoniazid-associated adverse events in the 103 women. Pregnancy outcomes were 132 term live births, 42 premature births, 11 stillbirths, 8 low birth weight, 6 spontaneous abortions, 4 neonatal deaths, and 1 congenital abnormality. In a multivariable model, neither isoniazid nor ART exposure during pregnancy was significantly associated with adverse pregnancy outcome (adjusted odds ratios 0.6, 95% CI: 0.3-1.1 and 1.8, 95% CI 0.9-3.6, resp.).|Long-term isoniazid prophylaxis was not associated with adverse pregnancy outcomes, such as preterm delivery, even in the context of ART exposure
PLoS One
No full textBackgroundParticipant non-adherence and loss to follow-up can compromise the validity of clinical trial results. An assessment of these issues was made in a 3-year tuberculosis prevention trial among HIV-infected adults in Botswana.Methods and FindingsBetween 11/2004\u201307/2006, 1995 participants were enrolled at eight public health clinics. They returned monthly to receive bottles of medication and were expected to take daily tablets of isoniazid or placebo for three years. Non-adherence was defined as refusing tablet ingestion but agreeing to quarterly physical examinations. Loss to follow-up was defined as not having returned for appointments in 6560 days. Between 10/2008\u201304/2009, survey interviews were conducted with 83 participants identified as lost to follow-up and 127 identified as non-adherent. As a comparison, 252 randomly selected adherent participants were also surveyed. Multivariate logistic regression analysis was used to identify associations with selected risk factors. Men had higher odds of being non-adherent (adjusted odds ratio (AOR), 2.24; 95% confidence interval [95%CI] 1.24\u20134.04) and lost to follow-up (AOR 3.08; 95%CI 1.50\u20136.33). Non-adherent participants had higher odds of reporting difficulties taking the regimen or not knowing if they had difficulties (AOR 3.40; 95%CI 1.75\u20136.60) and lower odds associated with each year of age (AOR 0.95; 95%CI 0.91\u20130.98), but other variables such as employment, distance from clinic, alcohol use, and understanding study requirements were not significantly different than controls. Among participants who were non-adherent or lost to follow-up, 40/210 (19.0%) reported that they stopped the medication because of work commitments and 33/210 (15.7%) said they thought they had completed the study.ConclusionsMen had higher odds of non-adherence and loss to follow-up than women. Potential interventions that might improve adherence in trial participants may include:targeting health education for men, reducing barriers, clarifying study expectations, educating employers about HIV/AIDS to help reduce stigma in the workplace, and encouraging employers to support employee health.Trial RegistrationClinicalTrials.gov NCT0016428120111023
Green and sustainable solvents for biocatalytic oxidations
No full textThe discovery that enzymes could function efficiently in organic solvents revolutionized their use in industry but represented a change from the natural “green” solvent, water, to a host of environmentally undesirable solvents. Considerable effort is being devoted to making such processes greener again. Bio-based solvents, derived from waste biomass, possess the desirable attributes of traditional organic solvents but are more conducive to a circular bio-based economy. Although biocatalytic oxidations have only been tested in bio-based ether solvents, there is considerable scope for expanding this to include bio-based ester solvents. Alternatively, both ionic liquids and deep eutectic solvents, with tunable properties, are proving very interesting solvents for biocatalytic oxidations. In particular, oxidative depolymerization of lignin, catalyzed by laccases, has been extensively investigated. Finally, designer amphiphiles can facilitate the formation of micelles that act as hydrophobic nanoreactors for performing biocatalytic oxidation processes while surrounded by aqueous buffer as solvent.Green Open Access added to TU Delft Institutional Repository ‘You share, we take care!’ – Taverne project https://www.openaccess.nl/en/you-share-we-take-care Otherwise as indicated in the copyright section: the publisher is the copyright holder of this work and the author uses the Dutch legislation to make this work public.BT/Biocatalysi
African philosophy (of education) and post-apartheid South African schools: a critical analysis of the Curriculum Assessment Policy Statement
No full textIn South Africa, indigenous (African) knowledge is at the heart of a single detailed national Curriculum Assessment Policy Statement (2012). Against this background, the study on which this article is based, examined two long-standing genres of philosophy: Western philosophy, as a critical academic discipline and African philosophy, as a collective worldview. The article shows that universal philosophy and, by implication, a universal knowledge system transcends these seemingly particular, opposite and irreconcilable Euro- centred and Afro-centred schools of thought. In doing so, the article proposes that universal philosophy as an inclusive, rational and reflective practice makes it possible to merge Western and African philosophies to form a single knowledge system. Unfortunately, the Curriculum Assessment Policy Statement emphasises indigenous African knowledge systems – thus, regresses to narrow African provincialism. In the end, the author (re)establishes a universal knowledge system as a sound African philosophy of education in post-apartheid South African schools
People's Education (for People's Power)
No full textThe central feature of Athenian citizens' rights, that is, people's participation in government, is also enshrined in the South African Constitution. This article argues for the Athenian style of participatory democracy as a viable model of participation in governing South African schools. The author claims that 'people's education', which had its origins in the principles of the Freedom Charter¹ - was diluted during the negotiationsfor South Africa's new democratic government. As a result, the political and educational ideal of 'people's education for 'people's power' has given way to democratic elitism in post-apartheid South African schools
PLoS One
No full textBackgroundNon-tuberculous mycobacteria (NTM) can cause pulmonary infection and disease especially among people living with HIV (PLHIV). PLHIV with NTM disease may clinically present with one of the four symptoms consistent with tuberculosis (TB). We describe the prevalence of NTM and Mycobacterium tuberculosis complex (MTBC) isolated among PLHIV who presented for HIV care and treatment.MethodsAll PLHIV patients presenting for HIV care and treatment services at 22 clinical sites in Botswana were offered screening for TB and were recruited. Patients who had 651 TB symptom were asked to submit sputa for Xpert MTB/RIF and culture. Culture growth was identified as NTM and MTBC using the SD-Bioline TB Ag MPT64 Kit and Ziehl Neelsen microscopy. NTM and MTBC isolates underwent species identification by the Hain GenoType CM and AS line probe assays.ResultsAmong 16, 259 PLHIV enrolled 3068 screened positive for at least one TB symptom. Of these, 1940 submitted 651 sputum specimen, 427 (22%) patients had 651 positive-culture result identified phenotypically for mycobacterial growth. Of these 247 and 180 patients were identified as having isolates were NTM and MTBC, respectively. Of the 247 patients identified with isolates containing NTM; 19 were later excluded as not having NTM based on additional genotypic testing. Among the remaining 408 patients 228 (56%, 95% confidence interval, 46\u201366%) with NTM. M. intracellulare was the most common isolated (47.8%). Other NTMs commonly associated with pulmonary disease included M. malmoense (3.9%), M. avium (2.2%), M. abscessus (0.9%) and M. kansasii (0.4%). After excluding NTM isolates that were non-speciated and M. gordonae 154 (67.5%) of the NTM isolates were potential pathogens.ConclusionsIn the setting of HIV care and treatment, over-half (56%) of a positive sputum culture among PLHIV with TB symptoms was NTM. Though we were not able to distinguish in our study NTM disease and colonization, the study suggests culture and species identification for PLHIV presenting with TB symptoms remains important to facilitate NTM diagnosis and hasten time to appropriate treatment.201729272273PMC57412331063
Multiscale Modelling of Environmentally Transmitted Infectious Diseases
No full textPhD (Mathematics)Department of Mathematics and Applied MathematicsIn the field of mathematical biology, researchers are beginning to witness an overwhelming appreciation
of multiscale modelling as an essential and suitable technique as opposed to a traditional
single-scale modelling approach in predicting the dynamics of infectious disease systems.
Yet, there is still a lack of evidence that generally indicates which among the different categories
of multiscale models of infectious disease systems is more appropriate to use in multiscale modelling
of infectious disease systems at different levels of their organization. This research study
is the first of its kind to compare the suitability of the two fundamental categories of multiscale
models of infectious disease systems which are nested multiscale models and embedded
multiscale models in predicting disease dynamics with specific reference to environmentallytransmitted
diseases. Two environmentally transmitted diseases are used as case studies, namely
ruminant paratuberculosis and human ascariasis, to compare the two fundamental categories of
multiscale models in predicting disease dynamics. The two environmentally-transmitted diseases
considered in this study represent infectious disease systems with replication-cycle at microscale
(i.e. ruminant paratuberculosis) and infectious disease systems without replication cycle
at the microscale (i.e. human ascariasis). Firstly, the author develop a single-scale model at the
host-level that we progressively extend to different categories of multiscale models that we later
compare. The findings of this study (through both mathematical and numerical analysis of the
multiscale models) are that for ruminant paratuberculosis which has a pathogen replication-cycle
at the within-host scale both nested and embedded multiscale models can be used because both
the models provide the same prediction of disease dynamics. However, for human ascariasis the
findings are such that nested multiscale model is not appropriate in characterizing the disease
dynamics, only the embedded is appropriate. Although the comparison of different categories of
multiscale models in disease prediction carried out in this study are specific to paratuberculosis
in ruminants and human ascariasis, the results obtained in this study are robust enough to be applicable
to other infectious disease systems. Our results can be generalized to imply that for any
level of organization of an infectious disease systems, if the disease has a replication cycle at the
microscale, the nested multiscale and the embedded multiscle model provide the same accuracy
in predicting disease dynamics. However, when the disease has no replication cycle at the microscale,
only the embedded multiscle model is appropriate for predicting disease dynamics. In
such a case, a nested multiscale model is inappropriate. We anticipate that this study will enable
modelers to choose appropriate multiscale model category in the study of infectious diseases.NR
Human rights and neo-liberal education in post-apartheid South Africa
No full textInternationally, human rights are considered innate, natural and inalienable. The article offers proffers a historical account of the natural law philosophy as the basis upon which human rights are ascribed to a supernatural force and human agency, on the one hand, and to the struggle for human existence, on the other hand. The author shows how the social contract that stems from human rationality underpins global, regional and domestic human rights frameworks. Based on a neo-liberal ideology, governance and policies, I argue that the education agenda in post-apartheid South Africa does not guarantee equal access to education. In light of this, the article maintains that, despite the anti-apartheid struggle movement’s achievements in human rights, the right to education is yet to be fully realised. In the end, I employ political philosophy to help us clarify fundamental problems of education within neo-liberalism that need to be addressed in post-apartheid South Africa
Lipase-Catalysed Enzymatic Kinetic Resolution of Aromatic Morita-Baylis-Hillman Derivatives by Hydrolysis and Transesterification
No full textAcylated Morita-Baylis-Hillman (MBH) adducts were synthesised and subjected to enzymatic kinetic resolution (EKR) by hydrolysis employing various lipase enzymes: from P. fluorescens, P. cepacia (PCL), C. antarctica A (CAL−A), C. antarctica B (CAL−B) and Novozyme 435. In a number of instances enantiopure Morita-Baylis-Hillman acetates or butyrates and their corresponding hydrolysed MBH adducts were obtained with ee values of >90 %, at ca. 50 % conversion, corresponding to enantiomeric ratio (E) values of >200. Enantioselective transesterification reactions on MBH adducts was achieved using acyl anhydrides in THF or the greener organic solvent 2-MeTHF in the presence of CAL−A. This is the first report of successful lipase-catalysed EKR of aromatic MBH adducts by transesterification in organic medium.BT/Biocatalysi
Pan Afr Med J
No full textIntroductionThe World Health Organization endorsed (2010) the use of Xpert MTB/RIF and countries are shifting from smear microscopy (smear)-based to Xpert MTB/RIF-based tuberculosis (TB) diagnostic algorithms. As with smear, sputum quality may predict the likelihood of obtaining a bacteriologically-confirmed TB when using Xpert MTB/RIF.MethodsFrom 08/12-11/2014, all people living with HIV were recruited at 22 clinics. For patients screened positive using the four TB symptoms their sputa were tested by Xpert MTB/RIF and smear. Laboratorians assessed and recorded sputum appearance and volume. The yield of bacteriologically-positive sputum evaluated using Xpert MTB/RIF and smear, likelihood-ratios were calculated.ResultsAmong 6,041 patients enrolled 2,296 were presumptive TB, 1,305 (56.8%) had > 1 sputa collected and 644/1,305 (49.3%) had both Xpert MTB/RIF and smear results. Since >1 sputa collected from 644 patients 954 sputa were tested by Xpert MTB/RIF and smear. Bacteriologically-positive sputum was two-fold higher with Xpert MTB/RIF 11.4% versus smear 5.3%, p < 0.001. Sputum appearance and quantity were not predictive of bacteriologically-positive results, except volume of 2ml to < 3ml, tested by Xpert MTB/RIF LR+= 1.26 (95% CI, 1.05\u20131.50).ConclusionXpert MTB/RIF test yield to bacteriologically-positive sputum was superior to smear. Sputum quality and quantity, however, were not consistently predictive of bacteriologically-positive results by Xpert MTB/RIF or smear
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