Browsing by Author "Van Zyl, G. U."

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    High burden of viral respiratory co-infections in a cohort of children with suspected pulmonary tuberculosis
    (BMC (part of Springer Nature), 2020-12-04) Van Der Zalm, M. M.; Walters, E.; Claassen, M.; Palmer, M.; Seddon, J. A.; Demers, A. M.; Shaw, M. L.; McCollum, E. D.; Van Zyl, G. U.; Hesseling, A. C.
    Background: The presentation of pulmonary tuberculosis (PTB) in young children is often clinically indistinguishable from other common respiratory illnesses, which are frequently infections of viral aetiology. As little is known about the role of viruses in children with PTB, we investigated the prevalence of respiratory viruses in children with suspected PTB at presentation and follow-up. Methods: In an observational cohort study, children < 13 years were routinely investigated for suspected PTB in Cape Town, South Africa between December 2015 and September 2017 and followed up for 24 weeks. Nasopharyngeal aspirates (NPAs) were tested for respiratory viruses using multiplex PCR at enrolment, week 4 and 8. Results: Seventy-three children were enrolled [median age 22.0months; (interquartile range 10.0–48.0); 56.2% male and 17.8% HIV-infected. Anti-tuberculosis treatment was initiated in 54.8%; of these 50.0% had bacteriologically confirmed TB. At enrolment, ≥1 virus were detected in 95.9% (70/73) children; most commonly human rhinovirus (HRV) (74.0%). HRV was more frequently detected in TB cases (85%) compared to ill controls (60.6%) (p = 0.02). Multiple viruses were detected in 71.2% of all children; 80% of TB cases and 60.6% of ill controls (p = 0.07). At follow-up, ≥1 respiratory virus was detected in 92.2% (47/51) at week 4, and 94.2% (49/52) at week 8. Conclusions: We found a high prevalence of viral respiratory co-infections in children investigated for PTB, irrespective of final PTB diagnosis, which remained high during follow up. Future work should include investigating the whole respiratory ecosystem in combination with pathogen- specific immune responses.
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    Surveillance of transmitted resistance to antiretroviral drug classes among young children in the western cape province of SOUTH AFRICA
    (2010) Van Zyl, G. U.; Cotton, M. F.; Claassen, M.; Abrahams, C.; Preiser, Wolfgang
    There are limited data on transmitted antiretroviral resistance in young children who require antiretroviral therapy. We adapted the World Health Organization surveillance strategy, testing antiretroviral naive infants (<18 months) in the Western Cape Province of South Africa, and detecting only 3 non-nucleoside reverse transcriptase inhibitors (NNRTI) and no NRTI or protease inhibitor surveillance mutations in 49 patients. The estimated NRTI and protease inhibitor transmitted antiretroviral resistance prevalence is low (<5%), predicting good therapeutic response in Western Cape infants. Copyright © 2010 by Lippincott Williams & Wilkins.