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PubMed1989

HIV infection in South Africa, 1982-1988--a review.

A review of human immunodeficiency virus (HIV) infection and acquired immune deficiency syndrome (AIDS) in South Africa between 1982 -1988 is presented. One hundred and sixty-six cases of AIDS have been seen in South Africa so far, with a mortality rate of 59.2%. There has been a predicted and alarming increase in the number of cases of AIDS in the black population. A total of 1857 HIV antibody-positive sera have been tested by various laboratories in the RSA, but this figure excludes sera found to be positive in the mining industry. The HIV-positive and AIDS cases include members of all population groups. A number of surveillance studies are presented. These revealed that beyond the groups at high risk for HIV infection the prevalence of this infection is still very low. Of an estimated 710,000 blood donors tested, 244 were positive for HIV-1 antibodies. Although 1 case of HIV-2 infection was detected in South Africa, this does not constitute a problem at present. No evidence of infection with HIV-1 was detected in southern and central African sera taken between 1970 and 1974. In the absence of a vaccine and specific treatment a change of sexual behavior to one of safer sex practices through education is the only means we have of containing the spread of the epidemic.

Acquired Immunodeficiency Syndrome↗
PubMed1985

Serum antibodies to human T-cell leukaemia virus type I in different ethnic groups and in non-human primates in South Africa.

The prevalence of humoral antibodies to human T-cell leukaemia virus type I (HTLV-I) was investigated in different ethnic groups and in non-human primates in South Africa. Serum antibody levels were determined by enzyme-linked immunosorbent assay (ELISA) using either disrupted whole HTLV-I or purified p24 core protein (p24 HTLV-I) as antigens. ELISA was complemented by direct radio-immunoprecipitation assays using either purified iodinated p24 HTLV-I or radiolabelled lysates of an HTLV-producing cell line as antigen followed by sodium dodecyl sulphate polyacrylamide gel electrophoresis of the immunoprecipitates, and by immunofluorescence using the HTLV-I-producing cell line HUT-102 as antigen. Antibodies were demonstrated in 3,5% of Asians, 3,5% of blacks and 4,1% of coloureds, but not in whites, and also in 29% of vervet monkeys and 33% of baboons. We conclude that HTLV-I or closely related viruses cause widespread infection in non-human primates in South Africa and in a lower percentage of humans, including apparently healthy blood donors. We are currently isolating retroviruses from seropositive reactors and investigating the possible relevance to disease in South Africa.

Adult↗
PubMed1988

[Hereditary elliptocytosis in West Africa: frequency and repartition of spectrin variants].

Hereditary Elliptocytosis (HE) is a hemolytic disorder inherited as autosomal-dominant trait and characterized by elliptically shaped erythrocytes. Preliminary studies in France have showed a high proportion of HE patients of black extraction (West Africa and Antilles). In order to confirm this prevalence, we made a systematic search for HE in West Africa: Benin, Burkina Faso, Ivory Coast, Togo. The diagnosis of elliptocytosis was established by the observation of a high percentage (greater than 70%) of characteristic regular and symmetric elliptic red cells after fixation in 0.3% glutaraldehyde saline buffer. The diagnosis of HE was confirmed by cytological studies of related members and/or the discovery of a well defined molecular variant of spectrin, the main protein of erythrocyte membrane skeleton. We found: in Abidjan centre 6 HE out of 1,000 subjects representative of main ethnic groups; in Lome Centre 6 cases out of 750 subjects originated from the South or Central areas of Togo; in Cotonou Centre 5 cases out of 1,000 subjects originated from the South area of Benin; in Bobo Dioulasso centre 6 HE out of 700 subjects. From this multicentre studies HE appears roughly 10 times more frequent in West Africa than in Europe or USA where incidence was estimated at between 2.5 and 5 cases per 10,000. Tryptic digestion of spectrin revealed that: 10 patients from different ethnic groups have the most frequent variant found in our laboratory (21 kindreds) and named spectrin alpha I/65. Five cases originated from limited areas in the South of Benin and Togo and related to closed ethnic groups have the variant Sp alpha I/46.

Africa, Western↗
PubMed1979

Use of drugs for malaria control in tropical Africa.

At present, in countries of tropical Africa, chemotherapy is the main and often the only operationally, administratively, and financially feasible method of malaria control. This applies particularly in rural areas. This article reviews experience with chemotherapy in Africa since the late 1940s with mepacrine, proguanil, pyrimethamine, chloroquine, amodiaquine, and sulfones and sulfonamides in combination with dihydrofolate reductase inhibitors. Chloroquine has proved to be the most effective compound and it is the drug of choice as long as malarial parasites remain susceptible to it. Because of reports from East Africa of strains of Plasmodium falciparum resistant to 4-aminoquinolines, it is essential that national and regional policies be developed for the rational use of antimalarials.In most of the countries, the scope of activities is still limited to the administration of antimalarial drugs to sick persons through a limited network of health institutions. In some countries, however, attempts have been made to extend the coverage of drug administration by involving voluntary collaborators or through the provision of suppressive treatment to vulnerable groups of the population (such as infants, young children, pregnant women, nursing mothers, and schoolchildren) but the efficacy of such methods depends on the degree of involvement of voluntary collaborators, primary health workers, and communities.

Africa↗
PubMed1987

Use of indicators in achieving 'Health for All' in South Africa, 1987.

This review evaluates South Africa's performance in achieving health when measured against the World Health Organization's global indicators designed to achieve 'Health for All' by the year 2000. As this programme has not been implemented in South Africa, a need exists for this country to announce indicators and targets. South Africa meets the World Health Organization's targets in terms of health expenditure but available information on many of the other indicators suggest that a large segment of the population falls outside the targets set. Lack of immunisation and poor nutrition are reflected in unacceptably high infant mortality rates and relatively low life expectancies. As accurate data are needed for planning at both national and local levels a national health survey should be conducted.

Health Status Indicators↗
PubMed1985

[Shadows and lights of malaria prevention in Africa].

According to the statistics provided by the World Health Organization in 1984, some 6.5 million cases of malaria were notified in 1982, an improvement in comparison with 1981, when the number of cases was 7.8 million. But these figures are incomplete and statistical data from sub-Saharan Africa are not included in the total. Out of the population of the world (in 1982) of 4,600 million about 2,100 million live in areas where malaria had never occurred or where indigenous malaria had disappeared. Some 2,100 million people live in areas where specific measures have greatly decreased the incidence of malaria. However, about 370 millions live in areas where no antimalaria activities took place, with the exception of some urban centres. On the African continent in countries north of the Sahara, out of the population of 100 million about 75 million are in areas, which were malarious 20 years ago, but today the amount of disease has been drastically reduced. The number of cases notified was 561 in 1982, against 482 in 1981, and most of them had been imported from tropical Africa. In Africa south of the Sahara out of 400 millions at least 350 million people live in malarious areas, where the prevalence of the disease has not changed for many years. The number of clinical cases of malaria has been estimated as between 70 and 100 million, with a mortality of about 1 million among small children.(ABSTRACT TRUNCATED AT 250 WORDS)

Africa↗
PubMedDate not supplied

Management of advanced breast cancer in Africa: strategies in the absence of hormone receptor assay data.

The oncologist in Africa and many other Third World countries is hampered in the management of breast cancer by the absence of hormone receptor assays in most teaching hospitals. The little information that is available in the literature on hormone receptors in black, breast cancer patients as well as other available hormone receptor information can serve as a data base for the development of a rational approach to this management dilemma. Using the available information, an approach, in the form of a flow chart, has been developed for the management of breast cancer in Africa. It is further suggested that breast cancer should be managed using protocols designed to answer various questions about breast cancer in Africa.

Adult↗
PubMed1979

Peptic ulcer in Rwanda, Africa: influence of geography and dietary habits.

There are areas of Africa with an extremely high incidence of peptic ulcer disease, while most of Africa has a low incidence of ulcer disease. The reason for this variation is unknown. Thirty-three patients with peptic ulcer disease in Rwanda, Africa, were studied in an attempt to determine why they had ulcer disease. High basal acid studies (mean of 10.3 mq per hour) were found in the patients with duodenal peptic ulcers. The males predominated over the females and the Batutsi predominated over the Bahutu in having much more peptic ulcer disease. The male population and patients with ulcers had the custom of eating only one large meal per day. There is a definite correlation between the incidence of peptic ulcers among certain tribes and going for long periods without eating.

Adolescent↗
PubMedDate not supplied

Measles immunity and immunization in developing countries of Africa: a review.

Although an effective vaccine against measles has been available for several years, the disease is still prevelant in Africa. The disease is characterized by its occurrence in younger age groups and high morbidity and mortality. The African child is born with a high transplacentally acquired measles antibody level. However, the antibody declines rapidly, so that it is virtually absent after the age of 6 months. The measles vaccine with which the African child is immunized is of reduced potency because of poor storage and transportation facilities and the adverse effect of tropical climate on the vaccine. The pattern of measles immunity in Africa is different from that in developed countries. Measles immunization schedule in Africa, as in any other part of the world, must be based on sound epidemiological and serological data.

Africa↗
PubMed1984

[Epidemiology of Kaposi's sarcoma in Africa].

The epidemiology of Kaposi's sarcoma in Africa south of the Sahara is reviewed. The disease is characterized by its high incidence in natives only and by the presence of the lymphadenopathic form of children with fast evolution, but is otherwise not very different from the classical form. Incidence increases with age. The mean younger age of patients is a consequence of the demographic structure. The disease prevails always in males even, though to a lesser extent, in children. Maximal incidence is observed in the center of the continent and decreases at distance from the equator. No defined risk factor has been identified, geographical, tribal or socio-economical. Associations to other malignancies, especially lymphomas, appear uncommon in Africa, but might be underestimated. The three main clinical forms of the disease are probably epidemiologically different and the infantile form could be related to some unidentified immunosuppressive factor. The disease appears ancient in Africa and not directly related to the present A.I.D.S. epidemic, though a recent increase in aggressive Kaposi's sarcoma cases may be associated with it.

Adolescent↗
PubMed1984

Opportunities for study of lymphoid neoplasia in Africa.

Animal models have strongly suggested that lymphoid leukaemias and malignant lymphomas might have a viral etiology. Following the first report by Ludwig Gross in 1951 of the transmission of mouse leukaemia by cell-free filtrates inoculated into newborn mice and the subsequent identification of many tumour-inducing type-C viruses in animals, attention was focused on the RNA retroviruses. However, it was work in Africa which led to the recognition of Burkitt's lymphoma as an entity and to the discovery of the Epstein-Barr virus. Many refer to this DNA virus as the first recognized human tumour virus. The research that these early studies stimulated has resulted in enormous progress in our understanding of human carcinogenesis and in highly significant advances in therapy. More recently, the first human retrovirus was identified and characterized in the laboratory of Dr Robert Gallo. There is increasing evidence that this virus, isolated from a patient with a T-cell lymphoma, is etiologically associated with a specific type of T-cell neoplasm first described in Japan. Africa may be considered the cradle of geographical pathology and the potential for generating unique information on cancer etiology and cancer control is still enormous. Lymphoid neoplasms are excellent models for the study of human cancer, particularly in Africa, since as tumours of the immune system, their induction and evolution is strongly influenced by those environmental factors, such as infection and nutrition, which have a profound effect on the immune response. In addition, there is good evidence that at least some of the tumours in this group are associated with specific transforming viruses. There is an immediate need to collect accurate, reproducible and comparable data on the incidence and characteristics of the different types of lymphoid neoplasia and on the populations in which they occur in the various African countries. Such data will provide the basis for undertaking simultaneous or subsequent etiological and therapeutic studies. Realistic approaches to these goals are considered and specific studies relating to questions posed by available information discussed.

Adolescent↗
PubMed1982

Tuberculosis in the 1980s, with particular reference to South Africa.

Tuberculosis is a major health problem in South Africa. More than 40 000 new cases are notified annually and there is good evidence that this represents only a proportion of all patients with active disease. Despite the fact that approximately R35 million is spent on tuberculosis control in South Africa each year. In the 1970s our death rate from this disease probably approximated that which pertained in the UK in the 1940s just before antituberculosis drugs came into general use. Current concepts in tuberculosis and its control are reviewed and the suggestion made that a specialized task force be set up to improve control measures in South Africa.

Black or African American↗
PubMed1982

Hypertension and ischaemic heart disease in Indian people living in South Africa and in India.

In a random house-to-house study of 1 000 Indians in Durban the prevalence of primary hypertension according to World Health Organization criteria was found to be 19% (females 22%, males 15%). This prevalence was higher than that in published data from India. Hypertension among Indians in South Africa was found to be closely associated with diabetes mellitus and obesity and to be more common in widows or separated people, in those from the lower socio-economic groups and in those with poor education. Hindu males were more commonly affected than Muslim males. Ischaemic heart disease was also found to be more common in Indians in South Africa than in those in India. Cardiovascular diseases are just as much an 'epidemic' among the Indians of South Africa as among the the Whites, and the 'epidemic' of ischaemic heart disease, cerebrovascular disease and hypertensive disease is of more serious proportions in Indians than in Whites. It appears that emigrant Indian populations have a higher incidence of vascular disease than Indians in India. This is because of the combination of hypertension and diabetes mellitus.

Adolescent↗
PubMed1982

Deaths from destructive lifestyles (largely preventable among economically active Whites in South Africa, 1968--1977.

In South Africa, 60% of the deaths economically active (EA) White males and 40--50% among EA White females in recent years were largely preventable, being a result of destructive lifestyles. The most common cause of death was ischaemic heart disease (IHD), accounting for 30% of deaths among EA males and 20% of deaths among EA females. The next most common cause of death was motor vehicle accidents in males (10%), and cerebrovascular diseases (CVA) in females (10%). However, among males in England, Wales and Scotland, lung cancer was the second most common cause of death, and as from 1974 this was also the case among American males. Age-adjusted mortality rates (MRs) of White South African males were compared with the MRs of males in the USA, Australia, England and Wales, and Scotland over the period 1968--1977. The MRs of White South African males were higher than those males in the other populations for IHD, CVA, motor vehicle accidents and suicides, but not for lung cancer and chronic respiratory diseases (highest MR among Scottish males). Over the period 1968--1977 the MRs for IHD were unchanged among males in South Africa (220-250/00 000), Scotland (190/00 000) and England and Wales (150/00 000), but those of males in the USA and Australia fell by 25% and 21% respectively to around 150/00 000 by 1977. MRs for motor vehicle accidents in White males in South Africa fell by 33% in 1974 due to the strict enforcement of lowered speed limits at the start of the oil crisis.

Accidents, Traffic↗
PubMed1994

The virtual absence of Culicoides imicola (Diptera: Ceratopogonidae) in a light-trap survey of the colder, high-lying area of the eastern Orange Free State, South Africa, and implications for the transmission of arboviruses.

Altogether 52 078 Culicoides biting midges of 35 species were collected during February 1990 and 1993 in 40 light-trap collections made on 17 cattle and/or sheep farms in the Bethlehem and Fouriesburg districts of the colder, high-lying eastern Orange Free State. Culicoides (Avaritia) bolitinos was by far the most abundant species, representing 50.9% of all specimens collected. Culicoides (A.) imicola, considered to be the most common stock-associated species in the summer rainfall areas of southern Africa, and the only proven vector of bluetongue virus (BTV) and African horsesickness virus (AHSV) in the subregion, was uncommon, comprising only 1.4%. While AHS is apparently absent, BT and bovine ephemeral fever (BEF) are endemic in this cooler, high-lying area of South Africa. The virtual absence of C. imicola implies that other Culicoides species, such as C. bolitinos and C. cornutus, may be involved in transmitting BT virus (and perhaps BEF) in the eastern Orange Free State, and possibly elsewhere in Africa. Virus isolation attempts made on 45 single species pools of C. bolitinos, C. pycnostictus, C. milnei, C. leucostictus, C. zuluensis and C. gulbenkiani were, however, negative. Finally, 20 of 28 blood-engorged Culicoides of 11 species, which were tested against cattle, sheep, horse, pig and bird antisera, tested only positive against cattle antisera.

Animals↗
PubMed1993

[The present status of the conquest of tropical Africa by Pulex irritans Linnaeus, 1758].

Owing to human parasites, two fleas, namely Pulex irritans Linné, 1758 and Tunga penetrans (L., 1758) were brought from America to intertropical Africa. The conquest of Africa by Pulex irritans, was really effective since the fifties, evidently by european strains. Some examples selected in occidental and oriental Africa show the reality of this fact. Accordingly, the epidemiological modalities in plague's african foci can be strongly changed.

Africa↗
PubMed1978

The future of veterinary services in the Republic of South Africa.

Future developments will depend mainly on new information generated by research and on effective application of preventive medicine. In the latter case, the various diagnostic centres in South Africa will have to be developed to their full extent, leading to the drawing up of computerised disease profiles and monitoring of the incidence of scheduled diseases. Dealing with these problems will require further knowledge to be generated by research. Problems of increasing drug, insecticide and acaricide resistance and problems of virus bionomics will call for attack at the molecular, biochemical, biophysical and immunological levels. This will demand adjustment of post-graduate veterinary education and of ever closer collaboration with scientists well-versed in the basic disciplines. Despite the argument that animal production will be ousted by crop production, the former, particularly in South Africa, is bound to develop and will call for more attention to the physiology of digestion and metabolism and to diseases of metabolism of ruminants. Concern is expressed that so few young veterinarians take up research as a career, as South Africa has many veterinary problems peculiar to itself.

Animals↗
PubMed1994

Animal traction in South Africa: research priorities in veterinary science.

During June 1994, members of numerous organisations with a vested interest in animal traction in South Africa met for a one-day workshop, the initial activity of a Forum on Working Animals. The workshop was sponsored by the Foundation for Research Development in South Africa. The individuals who attended were representatives of academic and government institutions, farmer and civic organisations, and included veterinarians and veterinary scientists, administrators, traction experts from the region and from abroad, agricultural engineers, sociologist, anthropologists and animal welfare experts. The objectives of the workshop were twofold: to address research priorities in veterinary science for traction animals and to identify future actions. Since it was a one-day workshop only, there was insufficient time to address issues in depth. However, problems were identified and appropriate actions were suggested. These actions were then delegated to a number of participants, to be refined and reported on at a subsequent workshop. Two key questions were considered and discussed by the participants, and a consensus reached for each. The first was to consider which species of traction animals are best suited to South African conditions. It was agreed that, in order of suitability, these are donkeys, cattle, mules and horses. The second question concerned the criteria which determine the usefulness of traction animals to South African communities. Two recommendations were made by the participants. The first recommendation was to design a questionnaire which would address the role of traction animals in the South African community and to identify communities in which the questionnaire would be implemented. At present, no information exists on the demographics of traction animals and their users. A list of questions was suggested and a working group from 6 institutions was identified to address this action. The second recommendation was to develop a research programme to study the 4 species which are most suitable for animal traction in South Africa.

Animals↗