Biochemical Evaluation Of Pregnant Women Practicing Geophagia With Special Reference To Iron Nutritional Status In The King Sabata Dalindyebo Municipality
- Authors: Abiodun Adams
- Date: 2014
- Language: English
- Identifier: http://hdl.handle.net/11260/2878 , vital:42970 , Geophagia, pregnant women, iron nutritional status, iron-deficiency anaemia.
- Description: Abstract Introduction There is no information on iron deficiency anaemia and ferritin-related oxidative stress as a potential result of geophagia during pregnancy in the King Sabatha Dalyindyebo Municipality, South Africa. Aim The aim of the study was to assess the magnitude of geophagia (soil eating) associated with biochemical and haematological indices of iron nutritional status of pregnant women. Materials and Methods A cross sectional study was carried out among 210 (response rate=95.5% of 220 eligible) pregnant women living in the Mthatha areas of the King Sabata Dalyindebo Municipality attending 3 selected clinics during 2012. Data (socio-demographic, geophagia, haematological indices, serum iron and transferrin saturation) were analyzed using univariate analysis (mean, proportions, percentiles, Odd Ratio and 95%CI, ANOVA and chi-square) and multivariate analysis (Odd Ratio and 95% CI and logistic regression model) was performed. P-Value <0.05 was significant. Results In all cases, 98.6% (n=207) and 100% (n=210) defined by serum iron ≤ 30µmol/l and <40µmol/l, presented with iron deficiency, respectively. However, iron deficiency, defined by serum ferritin <12µg/l and by transferrin saturation <16%, was present in 25.7% (n=54) and 61.9% (n=130) of all cases, respectively. Iron-deficiency anaemia was present in 51.4% (n=108) and 18.6% (n=39) using WHO haemoglobin and serum iron cut-offs and WHO haemoglobin and serum ferritin cut-offs, respectively. However,ii 37.1% (n=78/210) had an iron deficiency, defined by serum iron <10 µmol/l and 30.5% (n=64/210) defined by transferrin saturation <10%. In geophagics, 98.7% (n=76) had iron-deficiency anaemia (using serum iron cut-offs) whereas only 24.1% (n=32) of non geophagics presented with iron deficiency anaemia. However, using serum ferritin cut-offs, geophagics had iron deficiency anaemia estimated at 69.2% (n=27/59) but non geophagics had iron deficiency anaemia estimated at 30.8% (n=12/39). The optimal cut-offs of serum iron <10 µmol/l and transferrin saturation <10% are the best discriminants of iron deficiency as defined by serum ferritin <12 µg/l. Ferritin-related oxidative stress was present among 24.8% in the study population (the highest quartile of serum ferritin being >30.01 µg/l). The most important factors associated with iron deficiency anaemia in all pregnant women were geophagic behaviour (OR=2.1 95% CI 1.1-4.2; P=0.029), MCHC decreases (<30.5 0R=16.6 95%CI 6.8-40.2; P=0.006) and MCHC decreases (30.5-31.5 OR=2.9 95%CI 1.4-6.1; P=0.006). In all pregnant women, serum iron <14 (OR=6.2 95%CI 1.2-31.7; P=0.030), platelets <228 (OR=3.9 95%CI 1.6-10.8; P=0.008), age ≥28years (OR=4.2 95%CI 1.7-10.4; P=0.002), transferrin saturation ≥18% (OR=51.3 95%CI 8.9-295.2; P=<0.0001), were identified as the most significant independent determinants of ferritin-related oxidative stress. However, increase in age, depletion in iron, decrease in platelet count but increase in transferrin saturation were the significant independent determinants of ferritin-related oxidative stress among geophagic pregnant women (Y=0.282 x Age – 1.007 x iron – 0.023 platelet +0.946 transferrin saturation). In non-geophagic pregnant women, only a decrease in iron and an increase in transferrin saturation were the significant characteristics of ferritin-related oxidative stress (Y=-3.21-0.309 x iron + 0.379 transferrin saturation). Conclusioniii Geophagia induces a high level of anaemia, iron deficiency anaemia and ferritin-related oxidative stress. The most independent determinants of iron deficiency anaemia in all pregnant women were geophagic behaviour and MCHC decrease. Independent and important determinants of ferritin-related oxidative stress in all pregnant women were severe categories of decreased iron and platelets with higher levels of age ≥28 years, transferrin saturation (≥18%)
- Full Text:
- Authors: Abiodun Adams
- Date: 2014
- Language: English
- Identifier: http://hdl.handle.net/11260/2878 , vital:42970 , Geophagia, pregnant women, iron nutritional status, iron-deficiency anaemia.
- Description: Abstract Introduction There is no information on iron deficiency anaemia and ferritin-related oxidative stress as a potential result of geophagia during pregnancy in the King Sabatha Dalyindyebo Municipality, South Africa. Aim The aim of the study was to assess the magnitude of geophagia (soil eating) associated with biochemical and haematological indices of iron nutritional status of pregnant women. Materials and Methods A cross sectional study was carried out among 210 (response rate=95.5% of 220 eligible) pregnant women living in the Mthatha areas of the King Sabata Dalyindebo Municipality attending 3 selected clinics during 2012. Data (socio-demographic, geophagia, haematological indices, serum iron and transferrin saturation) were analyzed using univariate analysis (mean, proportions, percentiles, Odd Ratio and 95%CI, ANOVA and chi-square) and multivariate analysis (Odd Ratio and 95% CI and logistic regression model) was performed. P-Value <0.05 was significant. Results In all cases, 98.6% (n=207) and 100% (n=210) defined by serum iron ≤ 30µmol/l and <40µmol/l, presented with iron deficiency, respectively. However, iron deficiency, defined by serum ferritin <12µg/l and by transferrin saturation <16%, was present in 25.7% (n=54) and 61.9% (n=130) of all cases, respectively. Iron-deficiency anaemia was present in 51.4% (n=108) and 18.6% (n=39) using WHO haemoglobin and serum iron cut-offs and WHO haemoglobin and serum ferritin cut-offs, respectively. However,ii 37.1% (n=78/210) had an iron deficiency, defined by serum iron <10 µmol/l and 30.5% (n=64/210) defined by transferrin saturation <10%. In geophagics, 98.7% (n=76) had iron-deficiency anaemia (using serum iron cut-offs) whereas only 24.1% (n=32) of non geophagics presented with iron deficiency anaemia. However, using serum ferritin cut-offs, geophagics had iron deficiency anaemia estimated at 69.2% (n=27/59) but non geophagics had iron deficiency anaemia estimated at 30.8% (n=12/39). The optimal cut-offs of serum iron <10 µmol/l and transferrin saturation <10% are the best discriminants of iron deficiency as defined by serum ferritin <12 µg/l. Ferritin-related oxidative stress was present among 24.8% in the study population (the highest quartile of serum ferritin being >30.01 µg/l). The most important factors associated with iron deficiency anaemia in all pregnant women were geophagic behaviour (OR=2.1 95% CI 1.1-4.2; P=0.029), MCHC decreases (<30.5 0R=16.6 95%CI 6.8-40.2; P=0.006) and MCHC decreases (30.5-31.5 OR=2.9 95%CI 1.4-6.1; P=0.006). In all pregnant women, serum iron <14 (OR=6.2 95%CI 1.2-31.7; P=0.030), platelets <228 (OR=3.9 95%CI 1.6-10.8; P=0.008), age ≥28years (OR=4.2 95%CI 1.7-10.4; P=0.002), transferrin saturation ≥18% (OR=51.3 95%CI 8.9-295.2; P=<0.0001), were identified as the most significant independent determinants of ferritin-related oxidative stress. However, increase in age, depletion in iron, decrease in platelet count but increase in transferrin saturation were the significant independent determinants of ferritin-related oxidative stress among geophagic pregnant women (Y=0.282 x Age – 1.007 x iron – 0.023 platelet +0.946 transferrin saturation). In non-geophagic pregnant women, only a decrease in iron and an increase in transferrin saturation were the significant characteristics of ferritin-related oxidative stress (Y=-3.21-0.309 x iron + 0.379 transferrin saturation). Conclusioniii Geophagia induces a high level of anaemia, iron deficiency anaemia and ferritin-related oxidative stress. The most independent determinants of iron deficiency anaemia in all pregnant women were geophagic behaviour and MCHC decrease. Independent and important determinants of ferritin-related oxidative stress in all pregnant women were severe categories of decreased iron and platelets with higher levels of age ≥28 years, transferrin saturation (≥18%)
- Full Text:
Comprehensive data on the mechanical properties and biodegradation profile of polylactide composites developed for hard tissue repairs
- Abraham K. Aworinde, Samson O. Adeosun, Festus A. Oyawale, Eyere Emagbetere, Felix A. Ishola, Obafemi Olatunji, Stephen A. Akinlab, Sunday O. Oyedepo, Oluseyi O. Ajayi, Esther T. Akinlabi
- Authors: Abraham K. Aworinde , Samson O. Adeosun , Festus A. Oyawale , Eyere Emagbetere , Felix A. Ishola , Obafemi Olatunji , Stephen A. Akinlab , Sunday O. Oyedepo , Oluseyi O. Ajayi , Esther T. Akinlabi
- Date: 2020
- Type: Journal Article
- Identifier: http://hdl.handle.net/11260/4152 , vital:44032
- Full Text:
- Authors: Abraham K. Aworinde , Samson O. Adeosun , Festus A. Oyawale , Eyere Emagbetere , Felix A. Ishola , Obafemi Olatunji , Stephen A. Akinlab , Sunday O. Oyedepo , Oluseyi O. Ajayi , Esther T. Akinlabi
- Date: 2020
- Type: Journal Article
- Identifier: http://hdl.handle.net/11260/4152 , vital:44032
- Full Text:
Disserminating Knowledge about the value of indigenous food plants through e-learning programmes: a case study of communities within a rural village in Mthatha, Eastern Cape, South Africa
- Authors: Alfred John Mwanza
- Date: 2016
- Language: English
- Type: Thesis, Doctoral, PhD
- Identifier: http://hdl.handle.net/11260/2100 , vital:40887
- Full Text: false
- Authors: Alfred John Mwanza
- Date: 2016
- Language: English
- Type: Thesis, Doctoral, PhD
- Identifier: http://hdl.handle.net/11260/2100 , vital:40887
- Full Text: false
Disserminating Knowledge about the value of indigenous food plants through e-learning programmes: a case study of communities within a rural village in Mthatha, Eastern Cape, South Africa
- Authors: Alfred John Mwanza
- Date: 2016
- Language: English
- Type: Thesis, Doctoral, PhD
- Identifier: http://hdl.handle.net/11260/2099 , vital:40888
- Full Text: false
- Authors: Alfred John Mwanza
- Date: 2016
- Language: English
- Type: Thesis, Doctoral, PhD
- Identifier: http://hdl.handle.net/11260/2099 , vital:40888
- Full Text: false
Molecular analysis and Photodynamic inactivation of multidrug-resistant strains of Acinetobacter baumannii from clinical, abattoir and aquatic samples: Public Health Impact
- Authors: ANANE YAW ADJEI
- Date: 2020
- Language: English
- Type: PhD Manuscripts
- Identifier: http://hdl.handle.net/11260/2080 , vital:40816 , DOCTOR OF PHILOSOPHY (PhD) HEALTH SCIENCES (MEDICAL MICROBIOLOGY)
- Description: Acinetobacter baumannii is an important hospital-acquired pathogen, frequently associated with morbidity and mortality in immunocompromised patients causing a wide range of clinical complications, such as pneumonia, septicaemia, urinary tract infection, surgical site infection, wound infection, and meningitis. Much of the interest in A. baumannii has been attributed to its genetic plasticity, with its ability to acquire and express resistance in plasmids and chromosome particularly to carbapenems, the drug of choice to treat Acinetobacter infections. Carbapenem resistance in A. baumannii is a growing public health concern and represents a serious problem for treatment of the infection. This situation is not restricted to only clinical settings but also occurs in the extra-hospital settings where these areas can serve as reservoirs for multidrug-resistant (MDR) A. baumannii. The increasing limited access of therapeutic agents against A. baumannii infections and the development of MDR have led to the necessity for alternative strategies to control infections caused by MDR pathogens. Antimicrobial Photodynamic Inactivation (APDI) is a promising treatment modality in the field of biocide research that in the future may have widespread applications, replacing conventional antibiotics. The overall aim of this study was to determine the efficacy of APDI against MDR A. baumannii isolated from clinical, aquatic and abattoir settings, to investigate carbapenem resistance mechanisms and the genetic relationship among isolates circulating in our settings in Mthatha, Eastern Cape, South Africa. The thesis consists of seven chapters. With the exception of chapters 1, 2 and 7, each chapter is designed as a publishable unit. iv The 1 st chapter gives a comprehensive account of the background to the study and the literature review. Here the history of classification, morphology, natural habitat, laboratory diagnosis, infections, epidemiology, virulence and pathogenicity, antimicrobial resistance, A. baumannii in extra-hospital environment (abattoir and aquatic environment), treatment options of A. baumannii and the mechanism of action of APDI were reviewed. Chapter 2 described the techniques and general methods used for sampling, identification, antimicrobial susceptibility testing, PCR extraction and amplification and sequencing processes involved in this work. It covers the general experimental section of chapters 3, 4, 5 and 6. Chapter 3 evaluated the prevalence of antibiotic resistance and frequency of carbapenemase-encoding genes as well as the roles of insertion sequence one (ISAba1) and class 1 integrons (intI1) in MDR A. baumannii clinical isolates obtained from the National Health Laboratory Service (NHLS) at Nelson Mandela Academic Hospital (NMAH). Between August 2016 to July 2017, 100 non-duplicate MDR A. baumannii strains were recovered from various clinical samples. Identification and antimicrobial susceptibility tests of the isolates were performed using the VITEK® 2 automated systems with Gram-negative identification cards and the MicroScan autoSCAN-4 system Gram-negative ID type 2 panel. Minimum inhibitory concentration to imipenem, meropenem and colistin was rechecked by E-test (BioMérieux, France). Colistin susceptibility testing was confirmed using broth microdilution method according to the CLSI and by ComASP™ Colistin according to the manufacturer’s recommendations. Suspected colonies were verified using v Acinetobacter specific primer set Ac436f and Ac676r to amplify the 16S rRNA gene and identification was further confirmed by PCR amplification of the intrinsic blaOXA51-like. The detection of oxacillinase carbapenemase genes (blaOXA-23-like, blaOXA-24-like, blaOXA-51-like and blaOXA-58-like) and metallo-β-lactamase (MBL) genes (blaIMP-1, blaVIM, blaNDM-1 and blaSIM) as well as blaAmpC was carried out by real-time PCR assay using Roche LightCycler 2.0. The occurrence of the activating ISAba1 element upstream of the blaOXA-23-like and blaOXA-51-like genes was also carried out in a PCR assay. Isolates were also assayed for intI1. All strains were resistant to penicillins and cephalosporins except cefepime (87%). Resistant rates against other tested antibiotics were as follows: piperacillin/tazobactam (100%), ampicillin/sulbactam (100%), levofloxacin (91%), ciprofloxacin (89%), tobramycin (87%), gentamicin (84%), meropenem (83%), imipenem (81%), tetracycline (64%), amikacin (50%) and tigecycline (48%). All strains were fully susceptible to colistin. The screening of carbapenemase-encoding genes showed that all strains were found to harbour at least one of the OXA-type carbapenemases. The intrinsic blaOXA-51-like gene was detected in all isolates, 70% of the strains had blaOXA-23-like, 5% had blaOXA-24-like and 8% had blaOXA-58-like genes. For the MBLs, 4% isolates were positive for blaIMP-1, 3% strains were positive for blaVIM and 2% positive for blaNDM-1. Genes encoding blaSIM and blaAmpC enzymes were absent in all the strains. Co-occurrence of blaOXA-23-like and blaIMP-1 or blaOXA-58-like was detected in 1% and 2% MDR A. baumannii strains respectively. A key feature of this study was the co-harbouring of blaOXA-23-like, blaOXA-58-like and blaIMP-1 detected in 2% of the strains and this is the first report in the Eastern Cape province of South Africa. The ISAba1/blaOXA-51-like and ISAba1/blaOXA-23-like were detected in 15% and 40% vi isolates respectively whilst intI1 was detected in 80% isolates. Our data revealed a high antibiotic resistance to carbapenems and provide direct evidence of the spread of carbapenemase-encoding genes especially blaOXA-23-like in our local settings. Also the high presence of ISAba1 element upstream of the blaOXA-51-like and blaOXA-23-like increases expression of these carbapenemases and presents an emerging threat in our study setting. The study has also revealed specific insights into the interplay of different mechanisms causing rapid increase in antibiotic resistance in A. baumannii in our local setting. To prevent the development of carbapenem-resistant A. baumannii (CRAB), routine implementation of simple and cost-effective screening methods to detect carbapenemase production in our hospitals is crucial in enhancing infection control practices and finally establishing antimicrobial stewardship programs. Chapter 4 investigated the prevalence of MDR A. baumannii strains in extra-hospital settings, to study its susceptibility to antibiotics and to determine the frequency of carbapenemase-encoding genes. Various samples were obtained from Umzikantu Red Meat Abattoir and Mthatha Dam. Isolates were presumptively identified by direct plating on chromogenic CHROMagar Acinetobacter with supplement Ref. CR102 which allows the growth of CRAB isolates. Species identification and antimicrobial susceptibility testing were carried out using MicroScan autoSCAN-4 automated System. Confirmation of A. baumannii isolates were carried out by PCR analysis of the presence of inherent blaOXA-51-like genes. The presence of the carbapenemase-encoding genes was assessed. Results for 48 and 52 MDR A. baumannii isolated recovered from the abattoir and dam respectively revealed a high resistance rate to some frequently used antimicrobials such as piperacillin [abattoir vii (84%), aquatic (73%)], ceftazidime [abattoir (84%), aquatic (83%)], ciprofloxacin [abattoir (71%), aquatic (70%)]. The percentage of resistant strains to trimethoprim/sulfamethoxazole, amikacin, gentamycin, cefotaxime, and cefepime in abattoir and aquatic isolates were (100%, 92%), (41%, 42%), (81%, 75%), (81%, 79%) and (72%, 72%) respectively. High resistance of (75%, 73%) and (74%, 71%) to imipenem and meropenem were observed in abattoir and aquatic strains respectively. The detection of carbapenemase-encoding genes showed that all MDR A. baumannii strain were positive for blaOXA-51-like. The blaOXA-23-like was detected in 32 (66.7%) of the abattoir strains whereas 11 (21.2%) of the aquatic strains had blaOXA23-like. The blaOXA-58-like was detected in 7 (14.6%) and 4 (7.7%) of abattoir and aquatic isolates respectively. No strain had blaOXA-24-like, blaIMP-type, blaVIM-type, blaNDM-1, blaSIM, and blaAmpC genes among both groups of strains. All the strains lacked ISAba1/blaOXA-23-like and ISAba1/blaOXA-51-like as well as intI1. A high level of multiple antibiotic resistance indexes ranging from 0.22-0.51 indicates that the strains emerged from high-risk sources, in line with conventional standards. In conclusion, the presence of MDR A. baumannii in the extra-hospital environment such as abattoir and aquatic environments may be a threat to public health considering that this may provide an extra-hospital reservoir for the spread of these opportunistic pathogen into both community and hospital settings. Chapter 5 was designed to investigate the genetic relationship among CRAB strains obtained from clinical and extra-hospital sources using the Pasteur MLST scheme. A phylogenetic analysis was performed on 33 representative proportions of A. baumannii strains from clinical, abattoir and aquatic sources. Multi-locus sequence typing was performed using seven fragments of housekeeping genes cpn60, fusA, viii gltA, pyrG, recA, rplB and rpoB provided by Pasteur Institute MLST. Five existing sequence types (STs) were identified in the clinical strains by eBURST algorithm. The most dominant ST for clinical strains was ST2 accounting for 68.8 % (n = 11), followed by ST25 12.5% (n = 2) and 3 STs (ST1, ST85 and ST215) represented by a single strain (singletons) were identified. Extra-hospital isolates had two existing STs, ST1 and ST2 identified in three and fourteen strains respectively. Clonal relation analysis revealed that ST1, ST2, ST25, ST85 and ST215 belonged to the CC1, CC2, CC25, CC85 and CC215 lineage respectively. Phylogenetic tree analysis show that most of the extra-hospital strains were related to each other and also did cluster among the clinical strains. Resistance to carbapenems was related to blaOXA-23-like (all strains), blaOXA-58-like (2 strains) and blaOXA-24-like (1 strain). This study highlights the wide dissemination of highly related blaOXA-23-like producing CRAB belonging to the international clonal complex 2 in Mthatha, South Africa. Thus, appropriate infection control measures are recommended in order to control this clone. As a whole, phylogenetic analysis provided a global view of the molecular epidemiology of A. baumannii in Mthatha, South Africa. In chapter 6, in vitro APDI effect mediated by Protoporphyrin IX (PpIX) and methylene blue (MB) as photosensitizers and with halogen lamp as a light source on A. baumannii biofilm was evaluated. Three MDR A. baumannii strains recovered from clinical, abattoir and aquatic samples were used. The irradiation source has a maximum light dose of 30 Jcm-2 . We studied the APDI according to low or high concentration of MB and PpIX along with exposure time. After treatment, the antibacterial effect of the APDI was assessed by counting colony-forming units per millilitre (CFU/mL). Antimicrobial photodynamic inactivation test groups (L+P1+ and ix L+P2+) showed significant reduction of CFUs compared to the control group (L−P−). The log survival fraction of the treated groups as a percentage of that of L−P− at a concentration of 20 µM is as follows: L+P1+ (5×10-6%), L+P2+ (2×10- 6%); L−P− (100%). (L+P2+ P = 0.0001). The most effective dye was MB which showed higher bacterial reduction of 7.0 log10 whilst PpIX yielded 6.0 log10 CFU/mL at a concentration of 20 µM and light dose of 30 Jcm-2 . Results showed that the efficacy of APDI is dependent on PpIX and MB concentration and light dose. Similar APDI effectiveness was achieved regardless of the origin and minimum inhibitory concentration of isolate indicating that regardless of the origin and resistant rate of isolate, similar APDI effectiveness could be reached. Lastly, general conclusions and recommendations on various parts of findings were captured in chapter 7. The study provides a comprehensive data and information on antimicrobial drug resistance, genes coding for resistance and phylogenetic profiles of local MDR A. baumannii strains and highlights the importance of surveillance. This is essential for epidemiological purposes and specifically in situation requiring empirical treatment. Also in vitro APDI could be considered as an alternative approach to traditional antibiotic therapy if there is an optimized interplay between combinations of different types of photosensitisers and their concentrations, exposure time and light dose. Further research studies employing whole genome sequencing and next generation sequencing, massively parallel or deep technologies are required to understand greater detail of these many unique findings
- Full Text:
- Authors: ANANE YAW ADJEI
- Date: 2020
- Language: English
- Type: PhD Manuscripts
- Identifier: http://hdl.handle.net/11260/2080 , vital:40816 , DOCTOR OF PHILOSOPHY (PhD) HEALTH SCIENCES (MEDICAL MICROBIOLOGY)
- Description: Acinetobacter baumannii is an important hospital-acquired pathogen, frequently associated with morbidity and mortality in immunocompromised patients causing a wide range of clinical complications, such as pneumonia, septicaemia, urinary tract infection, surgical site infection, wound infection, and meningitis. Much of the interest in A. baumannii has been attributed to its genetic plasticity, with its ability to acquire and express resistance in plasmids and chromosome particularly to carbapenems, the drug of choice to treat Acinetobacter infections. Carbapenem resistance in A. baumannii is a growing public health concern and represents a serious problem for treatment of the infection. This situation is not restricted to only clinical settings but also occurs in the extra-hospital settings where these areas can serve as reservoirs for multidrug-resistant (MDR) A. baumannii. The increasing limited access of therapeutic agents against A. baumannii infections and the development of MDR have led to the necessity for alternative strategies to control infections caused by MDR pathogens. Antimicrobial Photodynamic Inactivation (APDI) is a promising treatment modality in the field of biocide research that in the future may have widespread applications, replacing conventional antibiotics. The overall aim of this study was to determine the efficacy of APDI against MDR A. baumannii isolated from clinical, aquatic and abattoir settings, to investigate carbapenem resistance mechanisms and the genetic relationship among isolates circulating in our settings in Mthatha, Eastern Cape, South Africa. The thesis consists of seven chapters. With the exception of chapters 1, 2 and 7, each chapter is designed as a publishable unit. iv The 1 st chapter gives a comprehensive account of the background to the study and the literature review. Here the history of classification, morphology, natural habitat, laboratory diagnosis, infections, epidemiology, virulence and pathogenicity, antimicrobial resistance, A. baumannii in extra-hospital environment (abattoir and aquatic environment), treatment options of A. baumannii and the mechanism of action of APDI were reviewed. Chapter 2 described the techniques and general methods used for sampling, identification, antimicrobial susceptibility testing, PCR extraction and amplification and sequencing processes involved in this work. It covers the general experimental section of chapters 3, 4, 5 and 6. Chapter 3 evaluated the prevalence of antibiotic resistance and frequency of carbapenemase-encoding genes as well as the roles of insertion sequence one (ISAba1) and class 1 integrons (intI1) in MDR A. baumannii clinical isolates obtained from the National Health Laboratory Service (NHLS) at Nelson Mandela Academic Hospital (NMAH). Between August 2016 to July 2017, 100 non-duplicate MDR A. baumannii strains were recovered from various clinical samples. Identification and antimicrobial susceptibility tests of the isolates were performed using the VITEK® 2 automated systems with Gram-negative identification cards and the MicroScan autoSCAN-4 system Gram-negative ID type 2 panel. Minimum inhibitory concentration to imipenem, meropenem and colistin was rechecked by E-test (BioMérieux, France). Colistin susceptibility testing was confirmed using broth microdilution method according to the CLSI and by ComASP™ Colistin according to the manufacturer’s recommendations. Suspected colonies were verified using v Acinetobacter specific primer set Ac436f and Ac676r to amplify the 16S rRNA gene and identification was further confirmed by PCR amplification of the intrinsic blaOXA51-like. The detection of oxacillinase carbapenemase genes (blaOXA-23-like, blaOXA-24-like, blaOXA-51-like and blaOXA-58-like) and metallo-β-lactamase (MBL) genes (blaIMP-1, blaVIM, blaNDM-1 and blaSIM) as well as blaAmpC was carried out by real-time PCR assay using Roche LightCycler 2.0. The occurrence of the activating ISAba1 element upstream of the blaOXA-23-like and blaOXA-51-like genes was also carried out in a PCR assay. Isolates were also assayed for intI1. All strains were resistant to penicillins and cephalosporins except cefepime (87%). Resistant rates against other tested antibiotics were as follows: piperacillin/tazobactam (100%), ampicillin/sulbactam (100%), levofloxacin (91%), ciprofloxacin (89%), tobramycin (87%), gentamicin (84%), meropenem (83%), imipenem (81%), tetracycline (64%), amikacin (50%) and tigecycline (48%). All strains were fully susceptible to colistin. The screening of carbapenemase-encoding genes showed that all strains were found to harbour at least one of the OXA-type carbapenemases. The intrinsic blaOXA-51-like gene was detected in all isolates, 70% of the strains had blaOXA-23-like, 5% had blaOXA-24-like and 8% had blaOXA-58-like genes. For the MBLs, 4% isolates were positive for blaIMP-1, 3% strains were positive for blaVIM and 2% positive for blaNDM-1. Genes encoding blaSIM and blaAmpC enzymes were absent in all the strains. Co-occurrence of blaOXA-23-like and blaIMP-1 or blaOXA-58-like was detected in 1% and 2% MDR A. baumannii strains respectively. A key feature of this study was the co-harbouring of blaOXA-23-like, blaOXA-58-like and blaIMP-1 detected in 2% of the strains and this is the first report in the Eastern Cape province of South Africa. The ISAba1/blaOXA-51-like and ISAba1/blaOXA-23-like were detected in 15% and 40% vi isolates respectively whilst intI1 was detected in 80% isolates. Our data revealed a high antibiotic resistance to carbapenems and provide direct evidence of the spread of carbapenemase-encoding genes especially blaOXA-23-like in our local settings. Also the high presence of ISAba1 element upstream of the blaOXA-51-like and blaOXA-23-like increases expression of these carbapenemases and presents an emerging threat in our study setting. The study has also revealed specific insights into the interplay of different mechanisms causing rapid increase in antibiotic resistance in A. baumannii in our local setting. To prevent the development of carbapenem-resistant A. baumannii (CRAB), routine implementation of simple and cost-effective screening methods to detect carbapenemase production in our hospitals is crucial in enhancing infection control practices and finally establishing antimicrobial stewardship programs. Chapter 4 investigated the prevalence of MDR A. baumannii strains in extra-hospital settings, to study its susceptibility to antibiotics and to determine the frequency of carbapenemase-encoding genes. Various samples were obtained from Umzikantu Red Meat Abattoir and Mthatha Dam. Isolates were presumptively identified by direct plating on chromogenic CHROMagar Acinetobacter with supplement Ref. CR102 which allows the growth of CRAB isolates. Species identification and antimicrobial susceptibility testing were carried out using MicroScan autoSCAN-4 automated System. Confirmation of A. baumannii isolates were carried out by PCR analysis of the presence of inherent blaOXA-51-like genes. The presence of the carbapenemase-encoding genes was assessed. Results for 48 and 52 MDR A. baumannii isolated recovered from the abattoir and dam respectively revealed a high resistance rate to some frequently used antimicrobials such as piperacillin [abattoir vii (84%), aquatic (73%)], ceftazidime [abattoir (84%), aquatic (83%)], ciprofloxacin [abattoir (71%), aquatic (70%)]. The percentage of resistant strains to trimethoprim/sulfamethoxazole, amikacin, gentamycin, cefotaxime, and cefepime in abattoir and aquatic isolates were (100%, 92%), (41%, 42%), (81%, 75%), (81%, 79%) and (72%, 72%) respectively. High resistance of (75%, 73%) and (74%, 71%) to imipenem and meropenem were observed in abattoir and aquatic strains respectively. The detection of carbapenemase-encoding genes showed that all MDR A. baumannii strain were positive for blaOXA-51-like. The blaOXA-23-like was detected in 32 (66.7%) of the abattoir strains whereas 11 (21.2%) of the aquatic strains had blaOXA23-like. The blaOXA-58-like was detected in 7 (14.6%) and 4 (7.7%) of abattoir and aquatic isolates respectively. No strain had blaOXA-24-like, blaIMP-type, blaVIM-type, blaNDM-1, blaSIM, and blaAmpC genes among both groups of strains. All the strains lacked ISAba1/blaOXA-23-like and ISAba1/blaOXA-51-like as well as intI1. A high level of multiple antibiotic resistance indexes ranging from 0.22-0.51 indicates that the strains emerged from high-risk sources, in line with conventional standards. In conclusion, the presence of MDR A. baumannii in the extra-hospital environment such as abattoir and aquatic environments may be a threat to public health considering that this may provide an extra-hospital reservoir for the spread of these opportunistic pathogen into both community and hospital settings. Chapter 5 was designed to investigate the genetic relationship among CRAB strains obtained from clinical and extra-hospital sources using the Pasteur MLST scheme. A phylogenetic analysis was performed on 33 representative proportions of A. baumannii strains from clinical, abattoir and aquatic sources. Multi-locus sequence typing was performed using seven fragments of housekeeping genes cpn60, fusA, viii gltA, pyrG, recA, rplB and rpoB provided by Pasteur Institute MLST. Five existing sequence types (STs) were identified in the clinical strains by eBURST algorithm. The most dominant ST for clinical strains was ST2 accounting for 68.8 % (n = 11), followed by ST25 12.5% (n = 2) and 3 STs (ST1, ST85 and ST215) represented by a single strain (singletons) were identified. Extra-hospital isolates had two existing STs, ST1 and ST2 identified in three and fourteen strains respectively. Clonal relation analysis revealed that ST1, ST2, ST25, ST85 and ST215 belonged to the CC1, CC2, CC25, CC85 and CC215 lineage respectively. Phylogenetic tree analysis show that most of the extra-hospital strains were related to each other and also did cluster among the clinical strains. Resistance to carbapenems was related to blaOXA-23-like (all strains), blaOXA-58-like (2 strains) and blaOXA-24-like (1 strain). This study highlights the wide dissemination of highly related blaOXA-23-like producing CRAB belonging to the international clonal complex 2 in Mthatha, South Africa. Thus, appropriate infection control measures are recommended in order to control this clone. As a whole, phylogenetic analysis provided a global view of the molecular epidemiology of A. baumannii in Mthatha, South Africa. In chapter 6, in vitro APDI effect mediated by Protoporphyrin IX (PpIX) and methylene blue (MB) as photosensitizers and with halogen lamp as a light source on A. baumannii biofilm was evaluated. Three MDR A. baumannii strains recovered from clinical, abattoir and aquatic samples were used. The irradiation source has a maximum light dose of 30 Jcm-2 . We studied the APDI according to low or high concentration of MB and PpIX along with exposure time. After treatment, the antibacterial effect of the APDI was assessed by counting colony-forming units per millilitre (CFU/mL). Antimicrobial photodynamic inactivation test groups (L+P1+ and ix L+P2+) showed significant reduction of CFUs compared to the control group (L−P−). The log survival fraction of the treated groups as a percentage of that of L−P− at a concentration of 20 µM is as follows: L+P1+ (5×10-6%), L+P2+ (2×10- 6%); L−P− (100%). (L+P2+ P = 0.0001). The most effective dye was MB which showed higher bacterial reduction of 7.0 log10 whilst PpIX yielded 6.0 log10 CFU/mL at a concentration of 20 µM and light dose of 30 Jcm-2 . Results showed that the efficacy of APDI is dependent on PpIX and MB concentration and light dose. Similar APDI effectiveness was achieved regardless of the origin and minimum inhibitory concentration of isolate indicating that regardless of the origin and resistant rate of isolate, similar APDI effectiveness could be reached. Lastly, general conclusions and recommendations on various parts of findings were captured in chapter 7. The study provides a comprehensive data and information on antimicrobial drug resistance, genes coding for resistance and phylogenetic profiles of local MDR A. baumannii strains and highlights the importance of surveillance. This is essential for epidemiological purposes and specifically in situation requiring empirical treatment. Also in vitro APDI could be considered as an alternative approach to traditional antibiotic therapy if there is an optimized interplay between combinations of different types of photosensitisers and their concentrations, exposure time and light dose. Further research studies employing whole genome sequencing and next generation sequencing, massively parallel or deep technologies are required to understand greater detail of these many unique findings
- Full Text:
Molecular Detection of Carbapenemase-Encoding Genes in Multidrug-Resistant Acinetobacter baumannii Clinical Isolates in South Africa
- Anane, Yaw Adjei, Okuthe, Grace Emily, Apalata, Teke, Vasaikar, Sandeep, Songca, Sandile
- Authors: Anane, Yaw Adjei , Okuthe, Grace Emily , Apalata, Teke , Vasaikar, Sandeep , Songca, Sandile
- Date: 2020
- Language: English
- Type: Journal Article
- Identifier: http://hdl.handle.net/11260/4351 , vital:44108
- Full Text:
- Authors: Anane, Yaw Adjei , Okuthe, Grace Emily , Apalata, Teke , Vasaikar, Sandeep , Songca, Sandile
- Date: 2020
- Language: English
- Type: Journal Article
- Identifier: http://hdl.handle.net/11260/4351 , vital:44108
- Full Text:
May Measurement Month 2018: an analysis of blood pressure screening results in South Africa
- Angela J. Woodiwiss1, Ruan Kruger, Gavin R. Norton, Aletta E. Schutte, Caitlynd Myburgh
- Authors: Angela J. Woodiwiss1 , Ruan Kruger , Gavin R. Norton , Aletta E. Schutte , Caitlynd Myburgh
- Date: 2020
- Language: English
- Type: Journal Article
- Identifier: http://hdl.handle.net/11260/4331 , vital:44105
- Full Text:
- Authors: Angela J. Woodiwiss1 , Ruan Kruger , Gavin R. Norton , Aletta E. Schutte , Caitlynd Myburgh
- Date: 2020
- Language: English
- Type: Journal Article
- Identifier: http://hdl.handle.net/11260/4331 , vital:44105
- Full Text:
Turnover of benthic macroinvertebrates along the Mthatha River, Eastern Cape, South Africa: implications for water quality bio-monitoring using indicator species
- Augustine Niba, Selunathi Sakwe
- Authors: Augustine Niba , Selunathi Sakwe
- Date: 2018
- Language: English
- Type: Journal Article
- Identifier: http://hdl.handle.net/11260/4272 , vital:44058
- Full Text:
- Authors: Augustine Niba , Selunathi Sakwe
- Date: 2018
- Language: English
- Type: Journal Article
- Identifier: http://hdl.handle.net/11260/4272 , vital:44058
- Full Text:
Phytomedicinal Studies Of Medicinal Plants Used For The Treatment Of Gastro-Intestinal Disorders (Diarrhoea And Stomach Ache), In The Three Districts Of The Eastern Cape Province, South Africa
- Authors: Babalwa N Mbolekwa
- Date: 2013
- Language: English
- Type: Masters
- Identifier: http://hdl.handle.net/11260/2862 , vital:42968
- Description: GENERAL ABSTRACT The use of plants for medicinal purposes has involved many plants exhibiting healing powers for many diverse illnesses and circumstances and one of those being diarrhoea. In different areas of the OR Tambo, Ukhahlamba and Alfred Nzo District Municipalities, in the Eastern Cape Province of South Africa it has been long-established that native plants are the main components of traditional health care systems. The study aimed at identifying and documenting plants frequently used for the treatment of gastro-intestinal disorders (diarrhoea and stomach ache), evaluating their efficacy and isolation of active compounds in the crude extracts. Ethnobotanical information of the commonly used plants was collected and documented through the use of questionnaires with traditional healers, herbalists and community members. In the study area, the ethnobotanical data revealed that 51 plant species belonging to 36 families were used in treating diarrhoea and stomach ache. According to the ethnobotanical information, Acacia mearnsii (idywabasi) was the most frequently used plant for treating diarrhoea and was selected for further studies because of its frequent use in most sites within the study area. Four extracts (hexane, ethyl acetate, dichloromethane and methanol) from the bark of Acacia mearnsii were screened against five Gram-positive bacteria strains (Staphylococcus aureus, Staphylococcus epidermidis, Bacillus cereus, Micrococcus kristinae and Streptococcus faecalis.) and five Gram-negative bacteria strains (Escherichia coli, Pseudomonas aeruginosa, Shigella flexneri, Klebsiella pneumonia and Serratia marcescens). The antibacterial activities were determined by minimum inhibitory concentrations (MIC) and bio-autographic methods. The extracts showed various degrees of activity. Ethyl acetate extract showed higher activity against bacterial species used during the antibacterial assay and was further investigated for isolation of active compounds. Bio-autography results showed one compound separated on the TLC with activity against the test organisms Staphylococcus aureus, Staphylococcus epidermidis and Bacillus cereus. In the future, this study may serve as a foundation for choosing the common, active medicinal plants to use in traditional medicine practices.
- Full Text:
- Authors: Babalwa N Mbolekwa
- Date: 2013
- Language: English
- Type: Masters
- Identifier: http://hdl.handle.net/11260/2862 , vital:42968
- Description: GENERAL ABSTRACT The use of plants for medicinal purposes has involved many plants exhibiting healing powers for many diverse illnesses and circumstances and one of those being diarrhoea. In different areas of the OR Tambo, Ukhahlamba and Alfred Nzo District Municipalities, in the Eastern Cape Province of South Africa it has been long-established that native plants are the main components of traditional health care systems. The study aimed at identifying and documenting plants frequently used for the treatment of gastro-intestinal disorders (diarrhoea and stomach ache), evaluating their efficacy and isolation of active compounds in the crude extracts. Ethnobotanical information of the commonly used plants was collected and documented through the use of questionnaires with traditional healers, herbalists and community members. In the study area, the ethnobotanical data revealed that 51 plant species belonging to 36 families were used in treating diarrhoea and stomach ache. According to the ethnobotanical information, Acacia mearnsii (idywabasi) was the most frequently used plant for treating diarrhoea and was selected for further studies because of its frequent use in most sites within the study area. Four extracts (hexane, ethyl acetate, dichloromethane and methanol) from the bark of Acacia mearnsii were screened against five Gram-positive bacteria strains (Staphylococcus aureus, Staphylococcus epidermidis, Bacillus cereus, Micrococcus kristinae and Streptococcus faecalis.) and five Gram-negative bacteria strains (Escherichia coli, Pseudomonas aeruginosa, Shigella flexneri, Klebsiella pneumonia and Serratia marcescens). The antibacterial activities were determined by minimum inhibitory concentrations (MIC) and bio-autographic methods. The extracts showed various degrees of activity. Ethyl acetate extract showed higher activity against bacterial species used during the antibacterial assay and was further investigated for isolation of active compounds. Bio-autography results showed one compound separated on the TLC with activity against the test organisms Staphylococcus aureus, Staphylococcus epidermidis and Bacillus cereus. In the future, this study may serve as a foundation for choosing the common, active medicinal plants to use in traditional medicine practices.
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Factors affecting specialist psychiatry training in South Africa: Bullying during specialist psychiatric training?
- Beath, Natalie, Moxley, Karis, Subramaney, Ugasvaree, Zingela, Zukiswa, Chiliza, Bonginkosi, Joska, John, Kotzé, Carla, Seedat, Soraya
- Authors: Beath, Natalie , Moxley, Karis , Subramaney, Ugasvaree , Zingela, Zukiswa , Chiliza, Bonginkosi , Joska, John , Kotzé, Carla , Seedat, Soraya
- Date: 2021
- Language: English
- Type: Journal article
- Identifier: http://hdl.handle.net/11260/3839 , vital:43955
- Full Text:
- Authors: Beath, Natalie , Moxley, Karis , Subramaney, Ugasvaree , Zingela, Zukiswa , Chiliza, Bonginkosi , Joska, John , Kotzé, Carla , Seedat, Soraya
- Date: 2021
- Language: English
- Type: Journal article
- Identifier: http://hdl.handle.net/11260/3839 , vital:43955
- Full Text:
Relationship between Endothelial Function, Antiretroviral Treatment and Cardiovascular Risk Factors in HIV Patients of African Descent in South Africa: A Cross-Sectional Study
- Benedicta N. Nkeh-Chungag, Goswami, Nandu, Engwa, Godwill Azeh, Sewani-Rusike, Constance R, Mbombela, Vuyolwethu, Ingrid WebsterPatrick De Boever, Kessler, Harald H, Stelzl, Evelyn
- Authors: Benedicta N. Nkeh-Chungag , Goswami, Nandu , Engwa, Godwill Azeh , Sewani-Rusike, Constance R , Mbombela, Vuyolwethu , Ingrid WebsterPatrick De Boever , Kessler, Harald H , Stelzl, Evelyn
- Date: 2021
- Language: English
- Type: Journal article
- Identifier: http://hdl.handle.net/11260/3998 , vital:43982
- Full Text:
- Authors: Benedicta N. Nkeh-Chungag , Goswami, Nandu , Engwa, Godwill Azeh , Sewani-Rusike, Constance R , Mbombela, Vuyolwethu , Ingrid WebsterPatrick De Boever , Kessler, Harald H , Stelzl, Evelyn
- Date: 2021
- Language: English
- Type: Journal article
- Identifier: http://hdl.handle.net/11260/3998 , vital:43982
- Full Text:
Factors impeding African immigrant entrepreneurs’ progression in selected small and medium enterprises: Evidence from a local municipality in South Africa
- Bernard L. Ngota, Eric E. Mang’unyi, Sookdhev Rajkaran
- Authors: Bernard L. Ngota , Eric E. Mang’unyi , Sookdhev Rajkaran
- Language: English
- Type: Journal Article
- Identifier: http://hdl.handle.net/11260/4743 , vital:44174
- Full Text:
- Authors: Bernard L. Ngota , Eric E. Mang’unyi , Sookdhev Rajkaran
- Language: English
- Type: Journal Article
- Identifier: http://hdl.handle.net/11260/4743 , vital:44174
- Full Text:
Drought Influences on Food Insecurity in Africa: A Systematic Literature Review
- Bethuel Sibongiseni Ngcamu, Felix Chari
- Authors: Bethuel Sibongiseni Ngcamu , Felix Chari
- Date: 2020
- Language: English
- Type: Journal article
- Identifier: http://hdl.handle.net/11260/3964 , vital:43977
- Full Text:
- Authors: Bethuel Sibongiseni Ngcamu , Felix Chari
- Date: 2020
- Language: English
- Type: Journal article
- Identifier: http://hdl.handle.net/11260/3964 , vital:43977
- Full Text:
Predictors of institutional delivery service utilization among women of reproductive age in Senegal: a population-based study
- Betregiorgis Zegeye, Bright Opoku Ahinkorah, Dina Idriss-Wheelr, Olanrewaju Oladimeji, Comfort Z. Olorunsaiye, Sanni Yaya
- Authors: Betregiorgis Zegeye , Bright Opoku Ahinkorah , Dina Idriss-Wheelr , Olanrewaju Oladimeji , Comfort Z. Olorunsaiye , Sanni Yaya
- Date: 2021
- Subjects: Institutional delivery, Women, Reproductive age, Senegal, Maternal health, Global health, Sub-Saharan Africa
- Language: English
- Type: Journal Article
- Identifier: http://hdl.handle.net/11260/4496 , vital:44126
- Description: Background: In Senegal, sub-Saharan Africa, many women continue to die from pregnancy and childbirth complications. Even though health facility delivery is a key intervention to reducing maternal death, utilization is low. There is a dearth of evidence on determinants of health facility delivery in Senegal. Therefore, this study investigated the predictors of health facility-based delivery utilization in Senegal. Methods: Data from the 2017 Senegal Continuous Survey were extracted for this study, and approximately 11,487 ever-married women aged 15–49 years participated. Chi-square test was used to select significant variables and multivariable logistic regression analysis was performed to identify statistically significant predictors at a 95% confidence interval with a 0.05 p-value using Stata version 14 software. Results: Facility-based delivery utilization was 77.7% and the main predictors were maternal educational status (primary school Adjusted Odds Ratio [aOR] = 1.44, 95% CI; 1.14–1.83; secondary school aOR = 1.62, 95% CI; 1.17– 2.25), husband’s educational status (primary school aOR = 1.65, 95% CI; 1.24–2.20, secondary school aOR = 2.17, 95% CI; 1.52–3.10), maternal occupation (agricultural-self-employed aOR = 0.77, 95% CI; 0.62–0.96), ethnicity (Poular aOR = 0.74, 95% CI; 0.56–0.97), place of residence (rural aOR = 0.57, 95% CI; 0.43, 0.74), media exposure (yes aOR = 1.26, 95% CI; 1.02–1.57), economic status (richest aOR = 5.27, 95% CI; 2.85–9.73), parity (seven and above aOR =0.46, 95% CI; 0.34–0.62), wife beating attitude (refuse aOR =1.23, 95% CI; 1.05–1.44) and skilled antenatal care (ANC) (yes aOR = 4.34, 95% CI; 3.10–6.08). Conclusion: Uptake of health facility delivery services was seen among women who were educated, exposed to media, wealthy, against wife-beating, attended ANC by skilled attendants and had educated husbands. On the other hand, women from ethnic groups like Poular, those working in agricultural activities, living in rural setting, and those who had more delivery history were less likely to deliver at a health facility. Therefore, there is the need to empower women by encouraging them to use skilled ANC services in order for them to gain the requisite knowledge they need to enhance their utilization of health facility delivery, whiles at the same time, removing socio-economic barriers to access to health facility delivery that occur from low education, poverty and rural dwelling.
- Full Text:
- Authors: Betregiorgis Zegeye , Bright Opoku Ahinkorah , Dina Idriss-Wheelr , Olanrewaju Oladimeji , Comfort Z. Olorunsaiye , Sanni Yaya
- Date: 2021
- Subjects: Institutional delivery, Women, Reproductive age, Senegal, Maternal health, Global health, Sub-Saharan Africa
- Language: English
- Type: Journal Article
- Identifier: http://hdl.handle.net/11260/4496 , vital:44126
- Description: Background: In Senegal, sub-Saharan Africa, many women continue to die from pregnancy and childbirth complications. Even though health facility delivery is a key intervention to reducing maternal death, utilization is low. There is a dearth of evidence on determinants of health facility delivery in Senegal. Therefore, this study investigated the predictors of health facility-based delivery utilization in Senegal. Methods: Data from the 2017 Senegal Continuous Survey were extracted for this study, and approximately 11,487 ever-married women aged 15–49 years participated. Chi-square test was used to select significant variables and multivariable logistic regression analysis was performed to identify statistically significant predictors at a 95% confidence interval with a 0.05 p-value using Stata version 14 software. Results: Facility-based delivery utilization was 77.7% and the main predictors were maternal educational status (primary school Adjusted Odds Ratio [aOR] = 1.44, 95% CI; 1.14–1.83; secondary school aOR = 1.62, 95% CI; 1.17– 2.25), husband’s educational status (primary school aOR = 1.65, 95% CI; 1.24–2.20, secondary school aOR = 2.17, 95% CI; 1.52–3.10), maternal occupation (agricultural-self-employed aOR = 0.77, 95% CI; 0.62–0.96), ethnicity (Poular aOR = 0.74, 95% CI; 0.56–0.97), place of residence (rural aOR = 0.57, 95% CI; 0.43, 0.74), media exposure (yes aOR = 1.26, 95% CI; 1.02–1.57), economic status (richest aOR = 5.27, 95% CI; 2.85–9.73), parity (seven and above aOR =0.46, 95% CI; 0.34–0.62), wife beating attitude (refuse aOR =1.23, 95% CI; 1.05–1.44) and skilled antenatal care (ANC) (yes aOR = 4.34, 95% CI; 3.10–6.08). Conclusion: Uptake of health facility delivery services was seen among women who were educated, exposed to media, wealthy, against wife-beating, attended ANC by skilled attendants and had educated husbands. On the other hand, women from ethnic groups like Poular, those working in agricultural activities, living in rural setting, and those who had more delivery history were less likely to deliver at a health facility. Therefore, there is the need to empower women by encouraging them to use skilled ANC services in order for them to gain the requisite knowledge they need to enhance their utilization of health facility delivery, whiles at the same time, removing socio-economic barriers to access to health facility delivery that occur from low education, poverty and rural dwelling.
- Full Text:
Morphology and histochemistry of the digestive tract in the Banded Tilapia (Tilapia Sparrmanii, Smith 1840)
- Authors: Bongile, Bhomela
- Date: 2014
- Subjects: Tilapia sparrmanii, fish; Tilapia; teleost; stomach; digestive system; light microscopy; light microscopy; histology; morphology Teleostei, digestive tube, histology
- Language: English
- Type: Masters, Msc Zoology
- Identifier: http://hdl.handle.net/11260/2401 , vital:41456
- Description: The digestive system of Tilapia sparrmanii, Smith 1894, a small sized cichlid fish widely distributed in Southern Africa and of little economic importance was studied by light microscopy as part of establishing base-line data for future references. The gut in T. sparrmanii was a simple long coiled tube. With greater fish length, the gut progressed into a complexly-coiled definitive form. Strong linear correlations were observed between fish size and gut length. The esophagus was relatively very short and the stomach sac-like and small. Histologically, T. sparrmanii displayed a stratified esophagus epithelium with goblet cells which displayed both neutral and acid mucus at the anterior region. The stomach of T. sparrmanii was divided into three distinct segments the cardiac, fundic, and pyloric portions. The study revealed that the gastric wall is composed of several tunicae: mucosa, submucosa, muscularis and serosa. The tunica mucosa was thrown up into a number of high longitudinal folds projecting into a lumen. The mucosal surface had surface epithelial cells. The epithelium in this region was simple columnar devoid of goblet cells, with glandular regions in the lamina propria. The mucosa of the fundic region had gastric pits lined by columnar epithelium, and simple tubular glands filled most of the lamina propria. The pyloric part of the stomach was very short and its mucosa was slightly folded and devoid of both gastric pits and mucous glandular cells. The lining epithelium of this portion of the stomach was simple columnar and a few goblet cells were seen at its junction with the first part of the intestine. The tunica muscularis of the stomach contained skeletal muscle in the initial and terminal regions, usually intermingled with smooth muscle fibres. Skeletal muscle fibres were also observed in the first portion of the proximal intestine, iii near the junction with the stomach. Gastric pits were present as invaginations of the mucosal surface. Their epithelium secreted both neutral and acid mucins. Simple, straight, tubular unbranched gastric glands occupied most of the surface of the mucosa, and were lined with cells that had eosinophilic granules. The tunica muscularis of the stomach consisted of skeletal muscles usually mixed with smooth muscle fibres. Also, the stomach was separated from the proximal intestine by a pyloric sphincter. Results demonstrate that the intestine was a relatively undifferentiated muscular tube lined with a simple columnar epithelium interspersed with goblet cells. The proximal region had a greater surface area, as revealed by the presence of elongated mucosal ridges. The enterocytes were covered apically with uniform microvilli. The number of goblet cells were moderate in the proximal intestine and fewer in the medial intestine. All segments of the intestine contained neutral and acidic mucins. The distal intestine mucosa was thinner and less elaborately folded and consisted of columnar cells with shorter and sparser microvilli. After the intestinerectal valve, the rectum displayed lower mucosal folds, numerous goblet cells and a thicker muscularis. An ileorectal valve was observed. This confirms that separate intestine and rectum does exist in T. sparrmanii.
- Full Text:
- Authors: Bongile, Bhomela
- Date: 2014
- Subjects: Tilapia sparrmanii, fish; Tilapia; teleost; stomach; digestive system; light microscopy; light microscopy; histology; morphology Teleostei, digestive tube, histology
- Language: English
- Type: Masters, Msc Zoology
- Identifier: http://hdl.handle.net/11260/2401 , vital:41456
- Description: The digestive system of Tilapia sparrmanii, Smith 1894, a small sized cichlid fish widely distributed in Southern Africa and of little economic importance was studied by light microscopy as part of establishing base-line data for future references. The gut in T. sparrmanii was a simple long coiled tube. With greater fish length, the gut progressed into a complexly-coiled definitive form. Strong linear correlations were observed between fish size and gut length. The esophagus was relatively very short and the stomach sac-like and small. Histologically, T. sparrmanii displayed a stratified esophagus epithelium with goblet cells which displayed both neutral and acid mucus at the anterior region. The stomach of T. sparrmanii was divided into three distinct segments the cardiac, fundic, and pyloric portions. The study revealed that the gastric wall is composed of several tunicae: mucosa, submucosa, muscularis and serosa. The tunica mucosa was thrown up into a number of high longitudinal folds projecting into a lumen. The mucosal surface had surface epithelial cells. The epithelium in this region was simple columnar devoid of goblet cells, with glandular regions in the lamina propria. The mucosa of the fundic region had gastric pits lined by columnar epithelium, and simple tubular glands filled most of the lamina propria. The pyloric part of the stomach was very short and its mucosa was slightly folded and devoid of both gastric pits and mucous glandular cells. The lining epithelium of this portion of the stomach was simple columnar and a few goblet cells were seen at its junction with the first part of the intestine. The tunica muscularis of the stomach contained skeletal muscle in the initial and terminal regions, usually intermingled with smooth muscle fibres. Skeletal muscle fibres were also observed in the first portion of the proximal intestine, iii near the junction with the stomach. Gastric pits were present as invaginations of the mucosal surface. Their epithelium secreted both neutral and acid mucins. Simple, straight, tubular unbranched gastric glands occupied most of the surface of the mucosa, and were lined with cells that had eosinophilic granules. The tunica muscularis of the stomach consisted of skeletal muscles usually mixed with smooth muscle fibres. Also, the stomach was separated from the proximal intestine by a pyloric sphincter. Results demonstrate that the intestine was a relatively undifferentiated muscular tube lined with a simple columnar epithelium interspersed with goblet cells. The proximal region had a greater surface area, as revealed by the presence of elongated mucosal ridges. The enterocytes were covered apically with uniform microvilli. The number of goblet cells were moderate in the proximal intestine and fewer in the medial intestine. All segments of the intestine contained neutral and acidic mucins. The distal intestine mucosa was thinner and less elaborately folded and consisted of columnar cells with shorter and sparser microvilli. After the intestinerectal valve, the rectum displayed lower mucosal folds, numerous goblet cells and a thicker muscularis. An ileorectal valve was observed. This confirms that separate intestine and rectum does exist in T. sparrmanii.
- Full Text:
Pharmacotherapeutic interventions for bipolar disorder type II: addressing multiple symptoms and approaches with a particular emphasis on strategies in lower and middle-income countries
- Brian Godman, Antony P Martind, Christoffel Grobler, Marianne Van-De-Lisleh, Janney Wale, Wallace Breno Barbosa, Amos Masselek, Philip Opondo, Guenka Petrova, Konstantin Tachkov, Israel Sefah, Suhaj Abdulsalimo, Alian A. Alrasheedy, Mazhuvancherry Kesavan Unnikrishnanp, Kristina Garuolieneq, Kayode Bamitaler, Dan Kibuule, Francis Kalemeerar, Joseph Fadares, Tanveer Ahmed Khan, Shahzad Hussain, Tomasz Bochene, Aubrey Chichonyi Kalungia, James Mwanza, Ruaraidh Hilly, Corrado Barbui
- Authors: Brian Godman , Antony P Martind , Christoffel Grobler , Marianne Van-De-Lisleh , Janney Wale , Wallace Breno Barbosa , Amos Masselek , Philip Opondo , Guenka Petrova , Konstantin Tachkov , Israel Sefah , Suhaj Abdulsalimo , Alian A. Alrasheedy , Mazhuvancherry Kesavan Unnikrishnanp , Kristina Garuolieneq , Kayode Bamitaler , Dan Kibuule , Francis Kalemeerar , Joseph Fadares , Tanveer Ahmed Khan , Shahzad Hussain , Tomasz Bochene , Aubrey Chichonyi Kalungia , James Mwanza , Ruaraidh Hilly , Corrado Barbui
- Date: 2019
- Language: English
- Type: Journal Article
- Identifier: http://hdl.handle.net/11260/4711 , vital:44166
- Full Text:
- Authors: Brian Godman , Antony P Martind , Christoffel Grobler , Marianne Van-De-Lisleh , Janney Wale , Wallace Breno Barbosa , Amos Masselek , Philip Opondo , Guenka Petrova , Konstantin Tachkov , Israel Sefah , Suhaj Abdulsalimo , Alian A. Alrasheedy , Mazhuvancherry Kesavan Unnikrishnanp , Kristina Garuolieneq , Kayode Bamitaler , Dan Kibuule , Francis Kalemeerar , Joseph Fadares , Tanveer Ahmed Khan , Shahzad Hussain , Tomasz Bochene , Aubrey Chichonyi Kalungia , James Mwanza , Ruaraidh Hilly , Corrado Barbui
- Date: 2019
- Language: English
- Type: Journal Article
- Identifier: http://hdl.handle.net/11260/4711 , vital:44166
- Full Text:
Predictors of consent to cell line creation and immortalisation in a South African schizophrenia genomics study
- Campbell, Megan M, de Vries, Jantina, Mqulwana, Sibonile G, Mndini, Michael M, Ntola, Odwa A, Jonker, Deborah, Malan, Megan, Pretorius, Adele, Zingela, Zukiswa, van Wyk, Stephanus, Stein, Dan J, Susser, Ezra
- Authors: Campbell, Megan M , de Vries, Jantina , Mqulwana, Sibonile G , Mndini, Michael M , Ntola, Odwa A , Jonker, Deborah , Malan, Megan , Pretorius, Adele , Zingela, Zukiswa , van Wyk, Stephanus , Stein, Dan J , Susser, Ezra
- Date: 2018
- Language: English
- Type: Journal Article
- Identifier: http://hdl.handle.net/11260/5232 , vital:44412
- Full Text:
- Authors: Campbell, Megan M , de Vries, Jantina , Mqulwana, Sibonile G , Mndini, Michael M , Ntola, Odwa A , Jonker, Deborah , Malan, Megan , Pretorius, Adele , Zingela, Zukiswa , van Wyk, Stephanus , Stein, Dan J , Susser, Ezra
- Date: 2018
- Language: English
- Type: Journal Article
- Identifier: http://hdl.handle.net/11260/5232 , vital:44412
- Full Text:
Factors associated with glycemic control among South African adult residents of Mkhondo municipality living with diabetes mellitus
- Charity Masilela, Oladele Vincent Adeniy, Brendon Pearce, Joven Jebio Ongole, Mongi Benjeddou
- Authors: Charity Masilela , Oladele Vincent Adeniy , Brendon Pearce , Joven Jebio Ongole , Mongi Benjeddou
- Date: 2020
- Language: English
- Type: Journal Article
- Identifier: http://hdl.handle.net/11260/4642 , vital:44148
- Full Text:
- Authors: Charity Masilela , Oladele Vincent Adeniy , Brendon Pearce , Joven Jebio Ongole , Mongi Benjeddou
- Date: 2020
- Language: English
- Type: Journal Article
- Identifier: http://hdl.handle.net/11260/4642 , vital:44148
- Full Text:
Genomic Association of Single Nucleotide Polymorphisms with Blood Pressure Response to Hydrochlorothiazide among South African Adults with Hypertension
- Charity Masilela, Oladele Vincent Adeniyi, Joven Jebio Ongole, Mongi Benjeddou, Brendon Pearce
- Authors: Charity Masilela , Oladele Vincent Adeniyi , Joven Jebio Ongole , Mongi Benjeddou , Brendon Pearce
- Language: English
- Type: Journal Article
- Identifier: http://hdl.handle.net/11260/4675 , vital:44157
- Full Text:
- Authors: Charity Masilela , Oladele Vincent Adeniyi , Joven Jebio Ongole , Mongi Benjeddou , Brendon Pearce
- Language: English
- Type: Journal Article
- Identifier: http://hdl.handle.net/11260/4675 , vital:44157
- Full Text:
Diagnostic performance of several biomarkers for identification of cases of non-communicable diseases among Central Africans
- Charles Bitamazire Businge, Benjamin Longo-Mbenza, Oladele Vincent Adeniyi, Moise Mvitu Muaka, Georges Mvumbi Lelo, Mireille Solange Nganga Nkanga, Jean-Marie Kavembe, Baudoin Buassa-bu-Tsumbu, Jean-Rene’ M’buyamba Kabangu, Daniel Ter Goon
- Authors: Charles Bitamazire Businge , Benjamin Longo-Mbenza , Oladele Vincent Adeniyi , Moise Mvitu Muaka , Georges Mvumbi Lelo , Mireille Solange Nganga Nkanga , Jean-Marie Kavembe , Baudoin Buassa-bu-Tsumbu , Jean-Rene’ M’buyamba Kabangu , Daniel Ter Goon
- Date: 2018
- Language: English
- Type: Journal Article
- Identifier: http://hdl.handle.net/11260/4845 , vital:44292
- Full Text:
- Authors: Charles Bitamazire Businge , Benjamin Longo-Mbenza , Oladele Vincent Adeniyi , Moise Mvitu Muaka , Georges Mvumbi Lelo , Mireille Solange Nganga Nkanga , Jean-Marie Kavembe , Baudoin Buassa-bu-Tsumbu , Jean-Rene’ M’buyamba Kabangu , Daniel Ter Goon
- Date: 2018
- Language: English
- Type: Journal Article
- Identifier: http://hdl.handle.net/11260/4845 , vital:44292
- Full Text: