Southern African Journal of Infectious Diseases最新文献

{"title":"Probable endometrial tuberculosis in a patient with rhupus.","authors":"Nimmisha Govind,&nbsp;Tamara Romanini,&nbsp;Lai Ling Winchow","doi":"10.4102/sajid.v38i1.543","DOIUrl":"https://doi.org/10.4102/sajid.v38i1.543","url":null,"abstract":"<p><p>Endometrial tuberculosis (TB) is an uncommon manifestation of disseminated TB. Rhupus is the coexistence of rheumatoid arthritis (RA) and systemic lupus erythematosus (SLE). We describe a case of endometrial TB in rhupus patient an immunosuppressed.</p><p><strong>Contribution: </strong>We describe an uncommon presentation of disseminated TB, endometrial TB, in a rare rheumatic disease, rhupus. A high index of suspicion for TB is imperative in immunocompromised patients presenting with chronic urogenital symptoms especially in an endemic area.</p>","PeriodicalId":44007,"journal":{"name":"Southern African Journal of Infectious Diseases","volume":"38 1","pages":"543"},"PeriodicalIF":0.9,"publicationDate":"2023-10-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10623593/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71487183","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A case of pericardial schistosomiasis and non-Hodgkin high grade B-cell lymphoma.","authors":"Michael J Boyd,&nbsp;Marc Mendelson,&nbsp;Sipho K Dlamini,&nbsp;Sean Wasserman,&nbsp;Ghaalied Fakier,&nbsp;Riyaadh Roberts,&nbsp;Nectarios S Papavarnavas","doi":"10.4102/sajid.v38i1.524","DOIUrl":"10.4102/sajid.v38i1.524","url":null,"abstract":"<p><p>Chronic schistosomiasis affects either the genitourinary or gastrointestinal tract. Rarely, schistosomes cause ectopic disease, such as in the case of a South African woman from a non-endemic province, who presented with suspected pericardial tamponade because of tuberculosis. However, histology and polymerase chain reaction from pericardial biopsy confirmed <i>Schistosoma haematobium.</i> A finding of mediastinal non-Hodgkin lymphoma came to light when our patient's clinical condition unexpectedly deteriorated.</p><p><strong>Contribution: </strong>This case highlights an unusual manifestation of schistosomiasis.</p>","PeriodicalId":44007,"journal":{"name":"Southern African Journal of Infectious Diseases","volume":"38 1","pages":"524"},"PeriodicalIF":0.9,"publicationDate":"2023-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10546256/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41165364","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Severe efavirenz associated neurotoxicity: A retrospective cohort study.","authors":"Priyadarshini Arnab,&nbsp;Roland Croxford,&nbsp;Janet Scott,&nbsp;Sameshan Perumal,&nbsp;Zahraa Mohammed,&nbsp;Lubbe Wiesner,&nbsp;Karen Cohen,&nbsp;Sean Wasserman","doi":"10.4102/sajid.v38i1.522","DOIUrl":"10.4102/sajid.v38i1.522","url":null,"abstract":"Background Efavirenz (EFV) is associated with neuropsychiatric symptoms. Severe neurotoxicity has been reported but the clinical phenotype and risk factors are poorly defined. Objectives To characterise clinical presentations, risk factors and outcomes to help clinicians recognise severe neurotoxicity earlier. Method The authors retrospectively identified adults with supratherapeutic EFV concentrations (> 4 mg/L) obtained during routine clinical care in Cape Town, South Africa. Clinical and laboratory data at the time of EFV quantification were extracted from medical records. Logistic regression was performed to identify associations with neuropsychiatric symptoms, and with severe neurotoxicity. Results Eighty one patients were included; 62 with neuropsychiatric manifestations (most frequently ataxia [n = 20] and psychomotor slowing [n = 24]); and 19 with hepatotoxicity. Overall, 28 (34.6%) were male, 49 (60.5%) had concomitant isoniazid exposure, and median EFV concentration was 12.1 mg/L (interquartile range [IQR]: 6.6–20.0). Neuropsychiatric symptoms were associated with longer duration of EFV therapy, adjusted odds ratio (aOR) 1.3/180-day increment (95% confidence interval [CI]: 1.0–1.7); higher EFV concentrations, aOR 1.2/1 mg/L increase (95% CI: 1.0–1.4) and isoniazid exposure, aOR 8.2 (95% CI: 2.5–26.7). Severe neuropsychiatric symptoms occurred in 47 (75%) patients at a median of 5.9 months (IQR: 2.1–40.8) after EFV initiation. Severe symptoms odds were 1.2-fold higher (95% CI: 1.1–1.4) per 1 mg/L increase in EFV concentration. Symptoms resolved completely within 1 month in 25 (76%) patients with severe neurotoxicity who discontinued EFV. Conclusion A concentration–effect relationship for severe neurotoxicity exists, which occurred late and resolved in most patients after EFV discontinuation. Contribution The authors highlighted clinical heterogeneity and morbidity of EFV-associated neurotoxicity.","PeriodicalId":44007,"journal":{"name":"Southern African Journal of Infectious Diseases","volume":"38 1","pages":"522"},"PeriodicalIF":0.9,"publicationDate":"2023-07-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10397354/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41164412","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Low prevalence of <i>Schistosoma haematobium</i> infection in pregnant women in Buffalo City district.","authors":"Remco P H Peters, Mandisa Mdingi, Hyunsul Jung, Freedom Mukomana, Ranjana M S Gigi, Andrew Medina-Marino, Jeffrey D Klausner","doi":"10.4102/sajid.v38i1.521","DOIUrl":"10.4102/sajid.v38i1.521","url":null,"abstract":"Adverse pregnancy outcomes such as stillbirth, pre-term birth and low birth weight are common in South Africa. The aetiology of these conditions is multifactorial and infections play an important role. Studies have shown an increased risk of adverse pregnancy outcomes associated with sexually transmitted infection (STI) during pregnancy.1 Urogenital Schistosoma haematobium is another infection that should be considered for adverse pregnancy outcomes.2","PeriodicalId":44007,"journal":{"name":"Southern African Journal of Infectious Diseases","volume":"38 1","pages":"521"},"PeriodicalIF":0.9,"publicationDate":"2023-06-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10331169/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9805266","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"COVID-19 vaccine hesitancy among pregnant women in an antenatal clinic in Durban, South Africa.","authors":"Sahra Ashkir,&nbsp;Tashlen Abel,&nbsp;Olive P Khaliq,&nbsp;Jagidesa Moodley","doi":"10.4102/sajid.v38i1.516","DOIUrl":"https://doi.org/10.4102/sajid.v38i1.516","url":null,"abstract":"<p><strong>Background: </strong>Mass administration of vaccines against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is the most efficient intervention against the coronavirus disease 2019 (COVID-19) pandemic. Recently, vaccinations were shown to be safe and effective during pregnancy. However, vaccination rates are low in low- and middle-income countries, and vaccine hesitancy is a major limiting factor.</p><p><strong>Objectives: </strong>To investigate the rate of COVID-19 vaccine hesitancy among pregnant women.</p><p><strong>Method: </strong>A cross-sectional questionnaire-based investigation of 313 unvaccinated pregnant women attending an antenatal clinic in Durban, South Africa (SA). The questionnaire included clinical and socio-demographic data, and reasons for vaccine hesitancy were recorded and evaluated.</p><p><strong>Results: </strong>Of 313 women participating, 126 (40.3%) were vaccinated against COVID-19, 21/313 = 6.7%; for those unvaccinated, 21/187 (13.9%) were planning to be vaccinated. However, most unvaccinated women, 174 of 187 (93%), showed COVID-19 vaccine hesitancy.</p><p><strong>Conclusion: </strong>The COVID-19 vaccination hesitancy among pregnant women in Durban, SA, is exceptionally high. This requires urgent attention by the relevant health authorities (both professional health organisations and the SA Department of Health) as many countries experience different waves of the variants of SARS-CoV-2 and herd immunity may not have been achieved.</p><p><strong>Contribution: </strong>This study showed a high vaccine acceptance hesitancy rate among pregnant women in SA.</p>","PeriodicalId":44007,"journal":{"name":"Southern African Journal of Infectious Diseases","volume":"38 1","pages":"516"},"PeriodicalIF":0.9,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10476234/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10168395","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Demographic profile of HIV and helminth-coinfected adults in KwaZulu-Natal, South Africa.","authors":"Miranda N Mpaka-Mbatha,&nbsp;Pragalathan Naidoo,&nbsp;Md Mazharul Islam,&nbsp;Ravesh Singh,&nbsp;Zilungile L Mkhize-Kwitshana","doi":"10.4102/sajid.v38i1.466","DOIUrl":"https://doi.org/10.4102/sajid.v38i1.466","url":null,"abstract":"<p><strong>Background: </strong>Helminth and HIV infections are endemic among poor populations. Studies investigating the socio-demographic and economic risk factors associated with dual HIV and helminth coinfection are scarce.</p><p><strong>Objectives: </strong>This study aimed to describe risk factors associated with HIV and helminth coinfections among peri-urban South African adults residing in poorly developed areas with high poverty levels, lack of sanitation and a clean water supply.</p><p><strong>Method: </strong>Adult participants (<i>n</i> = 414) were recruited from clinics in the south of Durban, KwaZulu-Natal, South Africa. Participants' demographic, socio-economic, sanitation and household information, anthropometric measurements and HIV status were collected. Stool samples were donated for coproscopy to detect helminths using the Kato-Katz and Mini Parasep techniques. Blood was collected to confirm participants' HIV status and to determine <i>Ascaris lumbricoides</i>-specific immunoglobulin E (IgE) and immunoglobulin G4 (IgG4) levels to improve microscopy sensitivity.</p><p><strong>Results: </strong>Overall coinfection was 15%, and single helminth and HIV prevalence were 33% and 52%, respectively. <i>Ascaris lumbricoides</i> was predominant (18%). Univariate analysis of variance (ANOVA) showed that coinfection was 11.9% and 19.8%, respectively, among the 18-34 years and 35-59 years age groups (<i>p</i> = 0.0006), 16.4% and 19.9%, respectively, for the no income and < R1000.00 groups (<i>p</i> = 0.0358) and 22.8% and 17.1%, respectively, for the pit or public toilets and toilets not connected to sewage groups (<i>p</i> = 0.0007).</p><p><strong>Conclusion: </strong>Findings suggest that the dual infection with HIV and helminth infections among adults residing in under-resourced areas with poor sanitary conditions is frequent. Older age, poor toilet use and low income are associated with coinfection. More attention is required to break the cycle of coinfections and possible disease interactions.</p><p><strong>Contribution: </strong>The study highlights the importance of determining and treating helminth infections among adult population during HIV and helminth coinfection and the influence of poor sanitation and socioeconomic status on disease transmission.</p>","PeriodicalId":44007,"journal":{"name":"Southern African Journal of Infectious Diseases","volume":"38 1","pages":"466"},"PeriodicalIF":0.9,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9900356/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9252874","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical application of Vitek-derived minimum inhibitory concentration values: Proof of concept study.","authors":"Warren Lowman","doi":"10.4102/sajid.v38i1.498","DOIUrl":"https://doi.org/10.4102/sajid.v38i1.498","url":null,"abstract":"<p><strong>Background: </strong>Minimum inhibitory concentration (MIC) values are useful in guiding appropriate antimicrobial therapy however, routine provision and interpretation of MIC values to guide clinical decision-making is challenging.</p><p><strong>Objectives: </strong>This proof of concept study aims to demonstrate the clinical utility and application of Vitek^®-derived MIC values through categorisation of clinical isolates as wild type.</p><p><strong>Method: </strong>A random selection of clinically relevant Gram negative isolates routinely tested on the Vitek^® instrument were included. The Vitek^® MIC values, for selected antimicrobials at the lowest calling range of that card, were compared to the broth microdilution reference method. The specified end-point was concordance between the two results if the reference MIC was less than or equal to the EUCAST-defined epidemiological cut-off value (ECOFF) for that drug-bug combination.</p><p><strong>Results: </strong>A total of 525 isolates were included (468 Enterobacterales and 57 <i>Pseudomonas aeruginosa</i>), with an overall concordance rate of 96.4% (508/525). Correct ECOFF categorisation by the Vitek^® was highest for ceftazidime and piperacillin (100%, <i>n</i> = 48 and <i>n</i> = 55, respectively) and lowest for cefepime (81.8%, <i>n</i> = 66).</p><p><strong>Conclusion: </strong>Vitek^®-derived MIC values can be used to categorise organisms as wild-type if the MIC is reported at the card's lowest calling range (≤) as there is high likelihood that the MIC is at or below the ECOFF. This has important implications for antimicrobial management, assisting in choice of agent and in improving probability of target attainment for desired pharmacodynamic targets which can translate into improved clinical outcomes.</p><p><strong>Contribution: </strong>Minimum inhibitory concentration data from an automated antimicrobial susceptibility testing instrument can be used to guide clinical decisions.</p>","PeriodicalId":44007,"journal":{"name":"Southern African Journal of Infectious Diseases","volume":"38 1","pages":"498"},"PeriodicalIF":0.9,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10091181/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9308997","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Accuracy of C-reactive protein and a differentiated white cell count in diagnosing tuberculosis.","authors":"Gideon Ruder,&nbsp;Richard M N Carter,&nbsp;Gina Joubert","doi":"10.4102/sajid.v38i1.481","DOIUrl":"https://doi.org/10.4102/sajid.v38i1.481","url":null,"abstract":"<p><strong>Background: </strong>Tuberculosis (TB) is treatable with a high cure rate. In South Africa, 70% of pulmonary TB is microbiologically confirmed. Autopsy studies of HIV-positive people found 45.7% undiagnosed TB cases.</p><p><strong>Objectives: </strong>The primary objective investigated whether CRP and a differentiated white cell count (WCC) and ratios thereof are useful screening tools for TB.</p><p><strong>Method: </strong>This retrospective cross-sectional study included adult patients admitted to two tertiary hospitals in Bloemfontein with TB workups between April 2016 and September 2019. National Health Laboratory Service (NHLS) provided laboratory data. Tuberculosis Xpert^® MTB/RIF, Xpert^® MTB/RIF Ultra and TB culture were used as reference standard for TB diagnosis.</p><p><strong>Results: </strong>The study population comprised 1294 patients; 15.1% had TB, 56.0% were male and 63.1% HIV-positive. Patients with TB were younger (<i>p</i> < 0.0001; 95% CI: -8;-3 years). In the total population, WCC had the highest area under the curve (0.59). White cell count (<i>p</i> < 0.0001), neutrophils (<i>p</i> = 0.0003) and lymphocytes (<i>p</i> = 0.0394) were lower in TB patients, and CRP-WCC ratio (CWR) (<i>p</i> = 0.0009) and CRP-lymphocyte ratio (CLR) (<i>p</i> = 0.0386) higher. In HIV-positive patients, WCC (<i>p</i> = 0.0003), neutrophils (<i>p</i> = 0.002) and lymphocytes (<i>p</i> = 0.0491) were lower in TB patients and CWR (<i>p</i> = 0.0043) higher. No parameter reached the World Health Organization screening targets of 70% specificity with 90% sensitivity.</p><p><strong>Conclusion: </strong>Differentiated WCC and CRP are not useful in screening hospitalised patients for TB in our setting.</p><p><strong>Contribution: </strong>Our study guides future research to augment current screening and diagnostic algorithms for TB, specifically in advanced HIV disease.</p>","PeriodicalId":44007,"journal":{"name":"Southern African Journal of Infectious Diseases","volume":"38 1","pages":"481"},"PeriodicalIF":0.9,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10244949/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9965046","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Adult intussusception in the era of HIV/AIDS: A case report.","authors":"Tshepang A Motsepe,&nbsp;Thekganang A Machete,&nbsp;Noluthando Ziqubu","doi":"10.4102/sajid.v38i1.534","DOIUrl":"https://doi.org/10.4102/sajid.v38i1.534","url":null,"abstract":"<p><p>The high incidence of HIV infection in South Africa has been associated with a proportional increase in AIDS-defining cancers, including non-Hodgkin's lymphomas (NHL). Intussusception is a rare presentation of NHL, accounting for 1% - 5% of all cases of small bowel obstruction.</p><p><strong>Contribution: </strong>To our knowledge, this is the first reported case of B-cell NHL presenting with intussusceptions and small bowel obstruction in South Africa.</p>","PeriodicalId":44007,"journal":{"name":"Southern African Journal of Infectious Diseases","volume":"38 1","pages":"534"},"PeriodicalIF":0.9,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10476221/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10160212","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cutaneous tuberculosis: An infrequent manifestation of a common pathogen in South Africa.","authors":"Jennifer K van Heerden,&nbsp;Alistair G B Broadhurst,&nbsp;Ruan S de Jager,&nbsp;Wesley du Plessis,&nbsp;Nabilah Ebrahim,&nbsp;Ayanda T Mnguni,&nbsp;Denzil Schietekat,&nbsp;Graeme Meintjes","doi":"10.4102/sajid.v38i1.526","DOIUrl":"https://doi.org/10.4102/sajid.v38i1.526","url":null,"abstract":"<p><p>Cutaneous tuberculosis is an infrequent form of extra-pulmonary tuberculosis, even in high-prevalence settings. We present the case of a patient living with advanced HIV who developed extensive cutaneous tuberculosis. The polymorphic skin lesions were the most striking clinical manifestation of underlying disseminated tuberculosis.</p><p><strong>Contribution: </strong>This case report highlights an unusual presentation of tuberculosis. Cutaneous tuberculosis has a wide spectrum of clinical presentations and may be under-recognised by clinicians. We recommend early biopsy for microbiological diagnosis.</p>","PeriodicalId":44007,"journal":{"name":"Southern African Journal of Infectious Diseases","volume":"38 1","pages":"526"},"PeriodicalIF":0.9,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10331026/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9812385","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}