Browsing by Author "Du Plessis, L."

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    Burden, spectrum and outcomes of children with tuberculosis diagnosed at a district-level hospital in South Africa
    (International Union Against Tuberculosis and Lung Disease, 2018) Du Preez, K.; Du Plessis, L.; O’Connell, N.; Hesseling, A. C.
    SETTING: The Khayelitsha subdistrict has the highest burden of reported tuberculosis (TB) cases in Cape Town, Western Cape Province, South Africa. OBJECTIVES: To characterise the TB burden, spectrum and treatment outcomes among children managed at a district-level hospital, the Khayelitsha District Hospital. DESIGN: Retrospective medical record review of all children (age <13 years) diagnosed with TB in January–July 2014. A lay health care worker completed daily surveillance and supported linkage to TB care. Symptoms and investigations at presentation, TB disease spectrum, referral pathways and outcomes were reported. RESULTS: Most children were aged ≤2 years (84/99, 85%), 18/96 (19%) were infected with the human immunodeficiency virus, 31/91 (34%) were malnourished and 80/99 (81%) had pulmonary TB only. The majority of the children (63/80, 79%) presented with cough of acute onset (<2 weeks). Only 5/36 (14%) eligible child contacts had documentation of receiving isoniazid preventive therapy. Twelve (13%) children had bacteriologically confirmed pulmonary TB. Overall, 93/97 (96%) children successfully continued TB care after hospital discharge. Favourable TB treatment outcomes were recorded in only 77 (78%) children. CONCLUSIONS: Children with TB managed at this district-level hospital were young, and frequently had acute symptoms and substantial comorbidities. Missed opportunities for TB prevention were identified. Linkage to care support resulted in excellent continuation of TB care; however, treatment outcomes could be further improved.
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    Comparison of infant-feeding practices in two health subdistricts with different baby-friendly status in Mpumalanga province
    (MedPharm Publications, 2015) Van der Merwe, S.; Du Plessis, L.; Jooste, H.; Nel, D.
    Objectives: The objective of the study was to compare the infant-feeding practices of two subdistricts with different baby-friendly status in Mpumalanga province, South Africa. Design: This was a cross-sectional, descriptive, observational study with an analytical component. Eighteen fieldworkers assisted with the data collection, utilising two sets of interviewer-administered questionnaires – one on socio-demographic information and the other on infantfeeding practices. Subjects: Mothers with infants from birth to six months old, attending postnatal care at public sector primary health care facilities in Emalahleni and Mbombela health subdistricts on the days of data collection were included. A total of 435 mother and infant pairs were included in the study. Outcome measures: Five infant-feeding indicators were used, namely the early initiation of breastfeeding, exclusive breastfeeding, exclusive replacement feeding and mixed feeding rates, as well as the age at which complementary food was introduced. Results: There was a significantly higher early initiation of breastfeeding (57% vs. 43%), exclusive breastfeeding rates (60% vs 48%), and a lower exclusive replacement feeding rate (18% vs. 33%) in Emalahleni subdistrict, where all the public sector maternity facilities are accredited as being baby friendly, compared to that in Mbombela subdistrict, where none of the public sector maternity facilities are baby friendly. The mixed feeding rate (19% vs. 15%) and the mean age of the introduction of complementary foods (50 days versus 35 days) did not differ significantly between the two subdistricts. Conclusion: Implementation of the Baby-Friendly Hospital Initiative (BFHI) in a health subdistrict was associated with more optimal infant feeding practices in mothers with infants aged six months and younger. It is concluded that strengthening practices prescribed within the BFHI would improve infant-feeding practices at community level.
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    The identification of two low-density lipoprotein receptor gene mutations in South African familial hypercholesterolaemia
    (Health & Medical Publishing Group, 1989) Kotze, M. J.; Langenhoven, E.; Warnich, Louise; Du Plessis, L.; Marx, M. P.; Oosthuizen, C. J. J.; Retief, A. E.
    Two point mutations were discovered in the low-density lipoprotein genes of patients with familial hypercholesterolaemia (FH). Defective genes were cloned and/or amplified by the polymerase chain reaction (PCR) method and the DNA sequences determined. A guanine to adenine base transition in exon 4 was found to be the molecular defect in 20% of cases of FH in the Afrikaner population. A second mutation, a guanine to adenine base substitution in exon 9, was identified in two homozygous FH individuals. Restriction enzyme analysis of PCR-amplified DNA from blood and tissue samples now permits accurate diagnosis of these mutations.
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    Nutritional health of young children in South Africa over the first 16 years of democracy
    (SAJCH, 2011-09) Iversen, P. O.; Du Plessis, L.; Marais, D.; Morseth, M.; Hoisaether, E. A.; Herselman, M.
    ENGLISH ABSTRACT: Objectives. Malnutrition among young children is a major health problem in post-apartheid South Africa. Despite implementation of numerous health and nutrition programmes, these extensive efforts to alleviate the situation have not been adequately reviewed. Methods. We provide an overview of various aspects of the current nutritional health status of young children. The reviewed data are from the time period 1994 - 2010, and were collected from literature databases and official reports, as well as our own experience with field research in various urban and rural parts of the country. Results. Both smaller province-based studies as well as three large nationwide surveys conclude that many young South African children have inadequate nutritional status. Rates of stunting, micronutrient deficiencies and hunger and food insecurity are all unacceptably high. Coexisting HIV/AIDS and tuberculosis add to this burden. A gradual transition to a westernised diet characterised by energy-dense food has led to a worrying increase in overweight and obesity. Conclusion. A major challenge for the South African health authorities is still the fight against childhood undernutrition and hunger, which in turn are rooted in poverty and social inequalities. The double burden of disease adds to the scale and complexity of this challenge.
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    Ostrich ejaculate characteristics and male libido around equinox and solstice dates
    (Springer, 2020) Muvhali, P. T.; Bonato, M.; Malecki, I. A.; Du Plessis, L.; Soley, J. T.; Cloete, S. W. P. (Schalk Willem Petrus van der Merwe)
    The study evaluated the effect of time of the year in which changes in photoperiod occurs on ostrich semen characteristics and male libido. Semen was collected for 5 days before, on and 5 days after winter solstice (21 June 2016), spring equinox (22 September 2016), summer solstice (21 December 2016) and autumn equinox (20 March 2017) in the southern hemisphere. Semen was collected from 10 South African Black ostrich males (average age ± standard deviation; 4.5 ± 2.27 years) using the dummy female. Semen volume, sperm concentration, total sperm per ejaculate, sperm motility traits, percentage of normal sperm, head and tail abnormalities and percentage of affected sperm in the hypo-osmotic swelling test (HOS) were evaluated. Male libido defined as the willingness of males to mount the dummy female was also recorded. Semen samples collected around summer solstice, spring and autumn equinox were higher in sperm concentration and sperm output compared with winter solstice (P < 0.05). Study periods did not influence semen volume, sperm motility traits, the percentage of normal sperm, head abnormalities and HOS. Tail abnormalities were higher around winter solstice than around spring equinox (P < 0.05). Male libido and the success of semen collection were significantly higher around spring equinox (P < 0.05). Changes in photoperiod in the southern hemisphere do not affect semen production in ostriches. However, high sperm output and male libido around spring equinox and summer solstice dates suggest that these periods may be preferred for semen collection for artificial insemination and storage purposes.
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    Presentation and outcome of culture-confirmed isoniazid-resistant rifampicin-susceptible tuberculosis in children
    (International Union Against Tuberculosis and Lung Disease, 2016) Garcia-Prats, Anthony J.; Du Plessis, L.; Draper, H. R.; Burger, A.; Seddon, J. A.; Zimri, K.; Hesseling, Anneke C.; Schaaf, H. Simon
    Setting: Isoniazid-resistant rifampicin-susceptible (HRRS) tuberculosis (TB) is the most prevalent form of drug-resistant TB globally, and may be a risk factor for poor outcomes. HRRS-TB in children has been poorly described. Objective: To characterize the clinical presentation, treatment, and clinical and microbiological outcomes, and factors associated with poor outcomes among children with culture-confirmed HRRS-TB. Design: Retrospective hospital-based cohort study. Results: Of the 72 children included, median age 50.1 months (IQR 21.5-102.5), 42% were male. Forty-four (51%) had a potential source case; only 13 were confirmed HRRS-TB. Twelve of 66 tested (17%) were HIV-infected, and 36 of 60 (60%) with pulmonary TB had severe disease. Seventy had treatment data; median total duration was 11.3 months (IQR 9-12.3); 25 (36%) initiated treatment with a 3-drug intensive phase; 52 (74%) received a fluoroquinolone. Of 63 with known outcome, 55 (88%) had a favourable outcome; 1 died and 3 had treatment failure. Ten had positive follow-up cultures at ≥2 months after starting treatment (17% of all PTB and 27% of those with follow-up culture data); older age (p=0.008), previous TB treatment (p=0.023) and severe PTB (p=0.018) were associated with failure to culture-convert at ≥2 months. Conclusions: Although overall outcomes were good, prolonged culture positivity and cases of treatment failure emphasize the need for additional attention to clinical management of children with HRRS-TB.