Browsing by Author "Dhansay, M. A."

Now showing 1 - 6 of 6
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    Association of deworming with reduced eosinophilia : implications for HIV/AIDS and co-endemic diseases
    (Academy of Science of South Africa, 2003-04) Fincham, J. E.; Markus, M. B.; Adams, V. J.; Lombard, C. J.; Bentwich, Z.; Mansvelt, E. P. G.; Dhansay, M. A.; Schoeman, S. E.
    Eosinophil counts in venous blood were monitored during a randomized controlled deworming trial (n = 155 children) that lasted for a year, and in a whole-school deworming programme (range 174-256 children) of 2 years' duration. Mean eosinophil counts (x109/I) decreased from 0.70 in the randomized trial, and 0.61 in the whole-school study, to well within the normal paediatric range of 0.05-0.45 (P < 0.05). The prevalence of eosinophilia declined from 57% to 37% in the randomized trial (mean for 400, 800 and 1200 mg albendazole doses); and from 47% to 24% in the whole-school study (500 mg stat mebendazole). Benzimidazole anthelminthics were highly effective against Ascaris but less so against Trichuris. Activated eosinophils are effector and immunoregulatory leucocytes of the T-helper cell type 2 (Th2) immune response to parasitic helminths and atopic disorders. Under conditions of poverty where soil-transmitted helminths are hyperendemic, Th2 polarization of the immune profile is characteristic. Regular anthelminthic treatment should reduce contact with worm antigens, and this may contribute to re-balancing of the immune profile. Suppression of eosinophil recruitment and activation, together with related cellular and molecular immunological changes, might have positive implications for prevention and treatment of co-endemic diseases, including HIV/AIDS, cholera, tuberculosis and atopic disorders.
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    The effect of severe pre-eclampsia on maternal and cord erythrocyte membrane essential fatty acid profiles
    (Health & Medical Publishing Group, 1998) Kirsten, G. F.; Smuts, C. M.; Tichelaar, H. Y.; Smith, J.; Hall, D.; Faber, M.; Dhansay, M. A.
    Objective. To examine the effect of severe pre-eclampsia on maternal and cord erythrocyte membrane essential fatty acid profiles. Design. Clinical trial. Setting. Obstetric High Care Unit, Tygerberg Hospital. Patients. Erythrocyte membrane (EM) essential fatty acid profiles were determined in 17 women with severe preeclampsia, in 17 normotensive pregnant women, and in the cord blood of their respective infants. Results. Pre-eclamptic women had lower EM phosphatidylcholine linoleic acid (C18:2n-6; LA) and cclinolenic acid (C18:3n-3; ALA) levels and lower EM phosphatidylethanolamine ALA levels than the normotensive women with lower cord blood docosahexaenoic acid levels (C22:6n-3; DHA) in both phospholipid fractions. All cord blood arachidonic acid (C20:4n-6; AA) levels were higher than the maternal levels. Conclusions. Pre-eclamptic women have lower LA and ALA levels than normotensive pregnant women, but AA and DHA levels in the two groups are similar. The cord blood DHA levels of infants of pre-eclamptic women are lower than those of the infants of normotensive women. Infants born to pre-eclamptic women may need dietary DHA to replenish DHA stores. This can be obtained from breast-milk or from a formula enriched with DHA.
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    Enriching diets for childhood mental and physical development
    (AOSIS OpenJournals, 2001) Kruger, H. S.; Labadarios, D. L.; Dhansay, M. A.
    Malnutrition is a public health problem in South Africa, especially among rural black children. Intakes below 67% of the Recommended Dietary Allowance (RDA) are common for calcium, iron, zinc, selenium, vitamin A, C, D, E, riboflavin, niacin and vitamin B6. Key nutrients for growth and development include calcium, iron, zinc, vitamin A, folate and other B-vitamins. Calcium is essential for bone mineralisation during the adolescent growth spurt. Iron deficiency is associated with impaired growth, delayed psychomotor development and impaired immunity. Zinc is associated with normal growth, bone mineralisation and neuropsychological function. Vitamin A is essential for normal growth, eyesight and immunity. Folate is necessary for the development of new cells, especially during phases of accelerated growth. Other B-vitamins are linked to a variety of behavioural and cognitive outcomes. Factors compromising the nutritional status of children include amongst others, an inadequate nutrient intake due to poverty, inadequate nutrition education, diarrhoeal diseases, teenage dieting and allergies. To ensure optimal growth and development, strict diets should be discouraged and sound meal patterns should be encouraged, including starting the day with breakfast, and eating a variety of foods to ensure adequate intakes of nutrients and fibre. Regular physical activity promotes a healthy body weight and normal bone mineralisation.
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    Estimating the burden of disease attributable to iron deficiency anaemia in South Africa in 2000
    (Health and Medical Publishing Group (HMPG), 2007-08) Nojilana, B.; Norman, R.; Dhansay, M. A.; Labadarios, D.; Van Stuijvenberg, M.E.; Bradshaw D.; South African Comparative Risk Assessment Collaborating Group
    Objectives. To estimate the extent of iron deficiency anaemia (IDA) among children aged 0 - 4 years and pregnant women aged 15 - 49 years, and the burden of disease attributed to IDA in South Africa in 2000. Design. The comparative risk assessment (CRA) methodology of the World Health Organization (WHO) was followed using local prevalence and burden estimates. IDA prevalence came from re-analysis of the South African Vitamin A Consultative Group study in the case of the children, and from a pooled estimate from several studies in the case of the pregnant women (haemoglobin level < 11 g/dl and ferritin level < 12 μg/l). Monte Carlo simulation-modelling was used for the uncertainty analysis. Setting. South Africa. Subjects. Children under 5 years and pregnant women 15-49 years. Outcome measures. Direct sequelae of IDA, maternal and perinatal deaths and disability-adjusted life years (DALYs) from mild mental disability related to IDA. Results. It is estimated that 5.1% of children and 9-12% of pregnant women had IDA and that about 7.3% of perinatal deaths and 4.9% of maternal deaths were attributed to IDA in 2000. Overall, about 174 976 (95% uncertainty interval 150 344-203 961) healthy years of life lost (YLLs), or between 0.9% and 1.3% of all DALYs in South Africa in 2000, were attributable to IDA. Conclusions. This first study in South Africa to quantify the burden from IDA suggests that it is a less serious public health problem in South Africa than in many other developing countries. Nevertheless, this burden is preventable, and the study highlights the need to disseminate the food-based dietary guidelines formulated by the National Department of Health to people who need them and to monitor the impact of the food fortification programme.
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    Factors affecting body composition in preterm infants : assessment techniques and nutritional interventions
    (Elsevier, 2019) Strydom, K.; Van Niekerk, Evette; Dhansay, M. A.
    Limited research has been conducted that elucidates the growth and body composition of preterm infants. It is known that these infants do not necessarily achieve extra-utero growth rates and body composition similar to those of their term counterparts. Preterm infants, who have difficulty in achieving these growth rates, could suffer from growth failure. These infants display an increased intra-abdominal adiposity and abnormal body composition when they achieve catch-up growth. These factors affect the quality of weight gain, as these infants are not only shorter and lighter than term infants, they also have more fat mass (FM) and less fat-free mass (FFM), resulting in a higher total fat percentage. This could cause metabolic syndrome and cardiovascular problems to develop later in a preterm infant's life. The methods used to determine body composition in preterm infants should be simple, quick, non-invasive and inexpensive. Available literature was reviewed and the Dauncey anthropometric model, which includes skinfold thickness at two primary sites and nine body dimensions, is considered in this review the best method to accurately determine body composition in preterm infants, especially in resource-poor countries. It is imperative to accurately assess the quality of growth and body composition of this fragile population in order to determine whether currently prescribed nutritional interventions are beneficial to the overall nutritional status and quality of life—in the short- and long-term—of the preterm infant, and to enable timely implementation of appropriate interventions, if required.
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    Synchronized and regular deworming of children and women in South Africa : Policy and practice
    (Academy of Science of South Africa, 2005) Fincham, J. E.; Markus, M. B.; Ngobeni, J. T.; Mayosi, B. N.; Adams, V. J.; Kwitshana, Z. L.; Obihara, C. C.; Dhansay, M. A.; Jackson, T. F. H. G.
    SOUTH AFRICA IS A SIGNATORY TO WORLD Health Assembly (WHA) resolution 54.19 (May 2001), which calls for regular, synchronized treatment of helminthiasis in developing countries, particularly where the prevalence of worm infestation exceeds 50%. Helminthic infection is usually a hallmark of poverty and reasons why it should be controlled in disadvantaged communities are compelling. However, existing South African legislation regulating the procurement and use of anthelmintic medicines effectively renders group-based deworming as agreed to by WHA member states, and endorsed by the South African minister of health, non-implementable in practice. In order to make deworming sustainable, low-cost, unregistered anthelmintics must be imported from international procurement agencies. At present, this is not permitted. Another problem is that both medical and non-medical personnel are confused by out-of-date information in package-inserts regarding safety for young children and pregnant women. Albendazole and praziquantel should be de-scheduled and ivermectin, levamisole and possibly nitazoxanide should be registered in a way that permits treatment by non-medical personnel. Rational alternation of medication is important because reliance on mebendazole will lead to resistance. All batches of anthelmintics ought to comply with pharmacological quality specifications and testing should be routine. Facilities for doing this are available in South Africa.