Leadership and early strategic response to the SARS-CoV-2 pandemic at a COVID-19 designated hospital in South Africa

While many countries are preparing to face the COVID-19 pandemic, the reported cases in Africa remain low. With a high burden of both communicable and non-communicable disease and a resource-constrained public healthcare system, sub-Saharan Africa is preparing for the coming crisis as best it can. We describe our early response as a designated COVID-19 provincial hospital in Cape Town, South Africa (SA).While the first cases reported were related to international travel, at the time of writing there was evidence of early community spread. The SA government announced a countrywide lockdown from midnight 26 March 2020 to midnight 30 April 2020 to stem the pandemic and save lives. However, many questions remain on how the COVID-19 threat will unfold in SA, given the significant informal sector overcrowding and poverty in our communities. There is no doubt that leadership and teamwork at all levels is critical in influencing outcomes

Maternal behavior in animals

Maternal behavior is that behavior exhibited bymothers towards their young which is presumed to aid the young in their survival growth and development, both physically and behaviorally. Maternal behavior is a characteristic of mammals that the females suckle their young from specially developed mammary glands, which produce mild sufficiently nutrition to sustain the young during the early stage of life. It is therefore, appropriate to restrict the term [maternal behavior[to females and to use the general heading] parental behavior] when considering other animals [birds like pigeons] .Maternal behavior has two phases: 1] general motivation to approach and nurse a neonate and 2] specific identification of the neonate as one's own.General maternal behavior is triggered by the events of parturition especially the fall in estrogen and progesterone and the appearance of a foal - like creature - small, wet, uncoordinated, with a foreshortened face and a high pitched neigh. Signaling a critical period during which the odor of the neonate encountered will belearned . Subsequently all other neonates will be rejected. The sense she uses is probably not from the main olfactory system, but from the vomeronasal organ. In sheep, blockage of the entrance to the vomeronasal organ results in promiscuous ewes who will allow lambs other than their own to suckle. The same is probably true of horses

Common Opportunistic Infections in HIV Infected Infants and Children : Part 2 Non-Respiratory Infections

Increased susceptibility to infections is the major cause of disease; end organ damage and death in human immunodeficiency virus (HIV)-infected children. This article will focus on prevention; diagnosis and management of the most common and less common severe infections that are specifically associated with HIV-related immune compromise; as well as some aspects relating to immune reconstitution inflammatory syndrome (IRIS)

Maintaining infants and children on highly active antiretroviral therapy

It needs to be emphasized that human immuno-deficiency virus (HIV) infection is not a curable disease and therefore highly active antiretroviral therapy (HAART) requires a life long commitment. This is why it is of paramount importance to ensure adequate preparation before HAART is initiated and to continue supporting the child and the caregiver/family throughout. Strict and non-wavering adherence is more important in the treatment of HIV than in any other infectious or chronic disease. This is clearly demonstrated by the fact that at least 95adherence is required to ensure an optimal virologic response in the majority of children. (Table 1) Achieving an optimal virologic response (undetectable viral load) is vital; as the development of drug resistance is far more rapid if this is not attained. Due to the rapidity with which resistance may develop; treatment failure is always a concern and careful follow-up is required to ensure treatment