Metabolic Profile of HIV-Infected Women in Mangaung; Free State

Objective: To determine the biochemical nutritional status of HIV-infected women in Mangaung. Design: Cross-sectional. Setting: The community of Mangaung; Free State; South Africa. Subjects: A representative group of 500 black women (25-44 years) was selected randomly to participate. Outcome measures: Biochemical analyses were performed for total lymphocytes; serum protein; serum albumin; plasma fibrinogen; serum insulin; serum glucose; serum triglycerides and serum cholesterol using standard methodology. Values were compared to standard references; and between HIV-infected and HIV-uninfected women. Results: After screening for eligibility; 488 women qualified. Sixty-one per cent of the younger women (25-34 years) and 38of the older women (35-44 years) were HIV-infected. HIV-infected women had significantly lower median blood values for total lymphocytes (p = 0.0001 and p = 0.02 for younger and older group respectively) and serum albumin (p = 0.0001 for both age groups); but significantly higher median concentrations of serum protein (p = 0.0001 for both age groups) than uninfected women. Plasma fibrinogen and serum insulin concentrations were significantly lower in HIV-infected younger women than in their uninfected counterparts (p = 0.002 for both parameters). Older HIV-infected women had significantly lower total serum cholesterol values (p = 0.01) than older HIV-uninfected women. Serum glucose and serum triglycerides did not differ significantly between HIV-infected and HIV-uninfected women. Conclusions: The results indicate a possible impact of HIV infection on serum protein and serum albumin; which may adversely affect biochemical nutritional status and the course of HIV progression. Future research into the causes and possible treatment of metabolic changes in women in this community should be prioritised

An analysis of dietary micronutrient intakes in two age groups of black South African women.

OBJECTIVE: To assess micronutrient intake of black women living in Mangaung, South Africa. SUBJECTS AND METHOD: A sample of 500 pre-menopausal black South African women (496 qualified to participate) from two age groups (25-34 and 35-44 years) were selected randomly in Mangaung, the black residential area of Bloemfontein. A validated Quantitative Food Frequency Questionnaire (QFFQ) was used to determine dietary intake of participants. Data were categorized into the two age groups. Median micronutrient intakes were compared to the Recommended Dietary Allowance (RDA) and Adequate Intake (AI). The prevalence of women with intakes < or = 67% of the RDA was calculated. RESULTS: Median calcium and vitamin D intakes were lower than the AI. Of all women, 46.2% to 62.2% consumed < or = 67% of the RDA for total iron, selenium, folate and vitamin C, and more than 94% consumed < or = 67% of the RDA for selenium. At least 25% of all women consumed < or = 67% of the RDA for vitamin A and E. The vitamin B6 intake of older women was inadequate and a fairly large percentage of the total sample consumed < or = 67% of the RDA. CONCLUSION: Generally, micronutrient intakes were adequate in this population. Attention should be given to those micronutrients where median intakes were < or = 67% of the RDA and those that were not at or above the respective AI in these groups of women.

Micronutrient Intake of HIV-Infected Women in Mangaung; Free State

Background. Poor nutritional status in HIV/AIDS patients can affect immune function profoundly; leading to faster disease progression and earlier death.Objective. To determine the micronutrient intake of HIV-infected women in Mangaung.Design and setting. A cross-sectional study was undertaken in Mangaung; Bloemfontein; Free State.Subjects and methods. A representative group of 500 pre-menopausal women (25 - 44 years) was randomlyselected to participate in the study. Micronutrient intake was determined using a Quantitative Food FrequencyQuestionnaire (QFFQ). Median micronutrient intakes were compared with the Recommended Dietary Allowance(RDA) or Adequate Intake (AI) values. The prevalence of women with intakes 67of the RDA or AI was calculated. Median micronutrient intakes were compared between HIV-infected and uninfected women using non-parametric 95confidence intervals (CIs) and the Mann-Whitney test.Results. Sixty-one per cent of women in the younger age group (25 - 34 years) and 38of older women (35 - 44 years) were HIV-infected. Between 46.6and 70.7of all women consumed 67of the RDA or AI for calcium;total iron; selenium; folate and vitamin C. At least 25of HIV-infected women did not meet either the RDA or the AI for vitamins A; D and E. Younger HIV-infected women had significantly higher intakes of calcium (p = 0.046);phosphorus (p = 0.04); potassium (p = 0.04); vitamin B12 (p = 0.01); vitamin D (p = 0.03) and vitamin E (p = 0.04)than their HIV-uninfected counterparts. Older HIV-infected women had significantly lower intakes of haem iron (p = 0.03); non-haem iron (p = 0.04) and selenium (p = 0.04) than their HIV-uninfected counterparts.Conclusions. Insufficient micronutrient intakes are common in both HIV-infected and uninfected women. A well-balanced diet and micronutrient supplementation seem warranted to ensure optimal health and survival; particularly in HIV-infected women

Cardiac findings in children admitted to a hospital general ward in South Africa: a comparison of HIV-infected and uninfected children.

The aim of this prospective observational study was to determine the presence of cardiac abnormalities in HIV infected versus uninfected children who were admitted to a general paediatric ward during a two-month period. HIV status was determined by antibody and p24 antigen testing. Clinical information, echocardiography and electrocardiography (ECG) were performed for all children. There were 90 HIV-infected and 118 uninfected children. The median age was 9.6 and 11.8 months for infected and uninfected children, respectively. Baseline left ventricular dysfunction, defined as a shortening fraction < or = 25%, was found in 13 (17%) of the HIV-infected children compared to 5 (8%) uninfected children (p < 0.05). Left ventricular end-diastolic enlargement above the 98th percentile for age was found in 24% of the infected and 20% of uninfected children. Pericardial effusions, although common, were sub-clinical and not different in the groups. ECG findings and resting heart rates were also similar. Left ventricular dysfunction was the most significant cardiac abnormality present in hospitalised HIV-infected children. Other abnormalities, although common, were mostly asymptomatic and found with the same frequency in uninfected children. Further studies are indicated.

Evaluation of clinical teaching and professional development in a problem- and community-based nursing module.

In South Africa the main focus is on primary health care. This affects the education and training of nurses, and training schools must respond by developing appropriate teaching modules. A school of nursing developed, implemented and revised a problem- and community-based learning module over a period of three years (1996-1998). This student-centered module focuses on students' needs, active participation, collaboration, accountability, self-assessment, self-study, life-long learning and appropriate skills. In the formal clinical teaching environment PBL was the main approach. However, this approach was also supported by a variety of strategies, for example group discussions and scenarios. The knowledge, attitudes and professional development skills acquired in the PBL approach were then applied informally in the community setting (CBE). The purpose of the study was to evaluate a first year clinical teaching module as part of an extensive programme. A quantitative research method, a descriptive design, and a variety of data collection techniques were used. Conclusions were that clinical teaching was effective within the problem- (PBL) and community-based (CBE) approaches; 78% of respondents were positive about the clinical learning environment; 61% stated that expectations were met; 81% preferred group activities, and 67% indicated that they had developed professional skills. Facilitators agreed that clinical teaching met the requirements of PBL & CBE. The pass rate also improved.

Explaining national road fatalities.

The purpose of this paper is to report on a model that can be used to explain the differences in road fatalities of individual countries. National infrastructure, transportation and socio-economic variables from international databases were considered as possible variables. The model was developed by means of stepwise regression analyses. It was found that the passenger car ownership is a better predictor of fatalities per 100000 passenger cars than vehicle ownership as a predictor of fatalities per 100000 vehicles. Many individual infrastructure and socio-economic variables have a significant effect on the fatality rate. The final model includes passenger car ownership, the Human Development Index (HDI), and the percentage of other vehicles as explanatory variables.

Trisomy 5 in Ph+ chronic myeloid leukemia in association with megakaryocytosis.

A patient with a megakaryocytosis associated with a Philadelphia chromosome-positive chronic myeloid leukemia (CML) was found to have a trisomy of chromosome five. To our knowledge, this is the first case of trisomy 5 associated with a Ph + CML, particularly one with a megakaryocytosis. The trisomy 5 may be associated with the resistance to cytostatic drugs found in this patient.

Serological reactions to Leptospira species in buffalo (Syncerus caffer) from the Kruger National Park.

Four hundred and six serum samples from buffalo (Syncerus caffer) were tested for leptospirosis, using the microscopic agglutination test. Seven buffaloes (1.7%) reacted positive and 27 (6.6%) inconclusive. Reactions against L. tarassovi and L. hardjo were the most prevalent.