A Prospective Study of Demographic Features and Quality of Life in HIV-Positive Women with Cervical Cancer Treated at Tygerberg Hospital

Background: Cervical cancer and human immunodeficiency virus (HIV) infection/acquired immune deficiency syndrome (AIDS) both have a high incidence in South Africa. Cervical cancer treatment of HIV-positive women poses challenges. Treatment-related changes in quality of life (QOL) of such women are important to future treatment protocols.Aim: To examine demographic data of HIV-negative and HIV-positive women at diagnosis of cervical cancer and describe their changes in QOL as a result of treatment.Methods and materials: All newly diagnosed patients with cervical cancer at Tygerberg Hospital were approached to participate in the study. The European Organisation for Research and Treatment of Cancer Quality of Life Core Questionnaire (EORTC QLQ-C30) and the Cervix Cancer Module (QLQ-CX24) were used. General QOL was measured with the EORTC QLQ-C30 and cervical-specific QOL with the QLQ-CX24 questionnaire. The patients completed the questionnaire at diagnosis; on completion of treatment and at 3 months' follow-up.Results: The study included a total of 221 women of whom 22% were HIV-positive; the latter were younger and of higher educational level than the rest. Mean monthly income and stage distribution was similar between the two groups. HIV-positive patients underwent radiation therapy more commonly than chemoradiation. HIV-positive women showed statistically significantly higher loss to follow-up during the study. HIV-positive women experienced no improvement in insomnia; appetite loss; nausea; vomiting; diarrhoea; social role or any of the sexual domains. In contrast; HIV-negative women experienced statistically significant improvement in all sexual domains other than sexual/vaginal functioning. The QOL improvement of HIV-negative women was statistically significantly greater than their HIV-positive counterparts in the majority of QOL domains. Global health improved in both groups; with HIV-negative women experiencing greater improvement. HIV-positive women experienced an initial decline of peripheral neuropathy (PN) symptoms post treatment with a return to pretreatment values at 3 months' follow-up. The change in PN was statistically significant between the HIV-negative and HIV-positive women.Conclusion: Demographic differences exist between the HIV-negative and HIV-positive groups. The differential outcome in the QOL of HIV-positive and HIV-negative women treated for cervical cancer might be related to persistence of AIDS-related symptoms on completion of cervical cancer treatment

Characteristics of Children with Pervasive Developmental Disorders Attending a Developmental Clinic in the Western Cape Province; South Africa

Background. Little has been published on autism in Africa; and it is not known whether South African children present with the same characteristics and challenges as described internationally.Objectives. To describe the demographics; history; clinical features; co-morbidity and yield of aetiological investigations in children diagnosed with a pervasive developmental disorder (PDD).Methods. This was a retrospective review of medical records of children fulfilling Diagnostic and Statistical Manual of Mental Disorders; 4th edition; text revision (DSM-IV-TR) criteria for a PDD who attended a tertiary developmental clinic at Tygerberg Hospital; Western Cape; South Africa; over a 2-year period (2008 - 2010) Results. Fifty-eight children were included. The median age at diagnosis was 42 months (range 15 - 106 months); and 45 (77.6) were boys. Forty per cent had complex autism (dysmorphism with or without microcephaly); and 12.1were macrocephalic. Most children (72.4 were non-verbal (using fewer than 10 non-echoed words); and 89.0had behavioural problems as reported by caregivers. The diagnostic yield of investigations was low.Conclusion. The profile of children with PDD attending a tertiary hospital developmental clinic in the Western Cape revealed that a high proportion had severe language impairment; behavioural problems and complex autism