Perspectives on establishing a public cord blood inventory in South Africa.

The South African population is highly diverse, both ethnically and genetically. This diversity is particularly true for the African ancestry and various mixed ancestry population groups. These groups are under-represented in national and international bone marrow and peripheral blood donor registries, making it challenging to identify HLA-matched and mismatched unrelated donors when patients from these groups require allogeneic hematopoietic stem and progenitor cell transplantation. In most high-income countries, banked cord blood (CB) units provide an attractive source of hematopoietic progenitor cells for genetically diverse populations. SA does not have a public CB inventory, leaving many patients without access to this important treatment modality. Haploidentical transplantation provides an alternative. In recent years, the use of post-transplant cyclophosphamide has significantly reduced the incidence of graft-versus-host disease after haploidentical transplantation and has improved transplantation outcomes. However, it is difficult to identify suitable haploidentical donors in SA because of family disruption and a high prevalence of HIV. Here the authors provide a brief historical overview of the ethnic and genetic diversity of the country and region. The authors provide a southern African perspective on HLA diversity, consider the allogeneic hematopoietic stem and progenitor cell transplantation landscape and explore the need to establish a public CB bank (CBB) in SA. The health policy and regulatory frameworks that will impact on a CBB in the country SA are also explored. Finally, the authors discuss several matters we believe require attention when considering the establishment of a sustainable public CBB in the South African context.

SARS-CoV-2 Variants, Vaccines, and Host Immunity.

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is a new beta coronavirus that emerged at the end of 2019 in the Hubei province of China. SARS-CoV-2 causes coronavirus disease 2019 (COVID-19) and was declared a pandemic by the World Health Organization (WHO) on 11 March 2020. Herd or community immunity has been proposed as a strategy to protect the vulnerable, and can be established through immunity from past infection or vaccination. Whether SARS-CoV-2 infection results in the development of a reservoir of resilient memory cells is under investigation. Vaccines have been developed at an unprecedented rate and 7 408 870 760 vaccine doses have been administered worldwide. Recently emerged SARS-CoV-2 variants are more transmissible with a reduced sensitivity to immune mechanisms. This is due to the presence of amino acid substitutions in the spike protein, which confer a selective advantage. The emergence of variants therefore poses a risk for vaccine effectiveness and long-term immunity, and it is crucial therefore to determine the effectiveness of vaccines against currently circulating variants. Here we review both SARS-CoV-2-induced host immune activation and vaccine-induced immune responses, highlighting the responses of immune memory cells that are key indicators of host immunity. We further discuss how variants emerge and the currently circulating variants of concern (VOC), with particular focus on implications for vaccine effectiveness. Finally, we describe new antibody treatments and future vaccine approaches that will be important as we navigate through the COVID-19 pandemic.

PERFORMANCE OF THE TUBERCULIN SKIN TEST IN MYCOBACTERIUM BOVIS-EXPOSED AND -UNEXPOSED AFRICAN LIONS (PANTHERA LEO).

Lion (Panthera leo) populations, classified as vulnerable under the International Union for Conservation of Nature red list of threatened species, are facing a variety of threats, including tuberculosis (TB) caused by Mycobacterium bovis. The lack of knowledge on pathogenesis and diagnosis of TB, the prolonged course of the disease, the existence of subclinical infection, and nonspecific clinical signs hamper management of TB in both free-ranging and captive lion populations. Early and accurate antemortem diagnosis of M. bovis infections is important for disease management. In this study, we investigate the suitability of the single intradermal cervical test (SICT), developed with free-ranging Kruger National Park (KNP) lions exposed to M. bovis, for use in other lion populations. Using the recommended interpretation, the specificity of the SICT was low in disease-free captive lions, leading to false-positive diagnoses in 54% of individuals in the present study. Alternative interpretations of the tuberculin skin test are proposed that significantly reduce false-positive diagnosis in the sampled captive lions without significantly affecting diagnoses in the KNP lions; these changes may facilitate screening for M. bovis infection regardless of the exposure status of the lion population being investigated.

DDT exposure of frogs: A case study from Limpopo Province, South Africa.

Amphibians are globally under pressure with environmental contaminants contributing to this. Despite caution aired more than 80 years ago of threats posed to amphibians by DDT spraying for disease vector control, no data have been published on concentrations or effects of DDT contamination in frogs from areas where DDT is actively sprayed to control the insect vectors of malaria. In this study, we sampled fat bodies of Xenopus laevis and Xenopus muelleri naturally occurring in an area where indoor residual spraying of DDT is employed and from adjacent, non-sprayed, areas. ΣDDT concentrations ranged between 

Mycobacterium bovis infection in the lion (Panthera leo): Current knowledge, conundrums and research challenges.

Mycobacterium bovis has global public-health and socio-economic significance and can infect a wide range of species including the lion (Panthera leo) resulting in tuberculosis. Lions are classified as vulnerable under the IUCN Red List of Threatened Species and have experienced a 30% population decline in the past two decades. However, no attempt has been made to collate and critically evaluate the available knowledge of M. bovis infections in lions and potential effects on population. In this review we set out to redress this. Arguments suggesting that ingestion of infected prey animals are the main route of infection for lions have not been scientifically proven and research is needed into other possible sources and routes of infection. The paucity of knowledge on host susceptibility, transmission directions and therefore host status, manifestation of pathology, and epidemiology of the disease in lions also needs to be addressed. Advances have been made in diagnosing the presence of M. bovis in lions. However, these diagnostic tests are unable to differentiate between exposure, presence of infection, or stage of disease. Furthermore, there are contradictory reports on the effects of M. bovis on lion populations with more data needed on disease dynamics versus the lion population's reproductive dynamics. Knowledge on disease effects on the lion reproduction and how additional stressors such as drought or co-morbidities may interact with tuberculosis is also lacking. Filling these knowledge gaps will contribute to the understanding of mycobacterial infections and disease in captive and wild lions and assist in lion conservation endeavours.

Halogenated pollutants in terrestrial and aquatic bird eggs: converging patterns of pollutant profiles, and impacts and risks from high levels.

We investigated the presence, levels, relationships, and risks of HCHs, DDTs, chlordanes, mirex, PCBs, and brominated flame retardants (BFRs) in terrestrial and aquatic bird eggs from an area in South Africa where DDT is used for malaria control. We found one of the highest ΣDDT levels reported this century; 13,000 ng/g wm (wet mass) in Grey Heron eggs which exceeds critical levels for reproductive success (3000 ng/g wm) calculated for Brown Pelicans, with a no-effect level estimated at 500 ng/g wm. Even higher ΣDDT levels at 16,000 ng/g wm were found in House Sparrow eggs (possibly the highest ever recorded for sparrows), with a maximum of 24,400 ng/g wm. Significant eggshell thinning in Cattle Egrets (33% between thickest and thinnest) was associated with increased levels of p,p'-DDT and p,p'-DDE. There were indications of unknown use of DDT and lindane. Relative to DDT, PCBs and BFRs levels were quite low. Ordinated data showed that different terrestrial pollutant profiles converged to a homogenised aquatic profile. Converging profiles, high levels of DDT in heron and sparrow eggs, and thinning eggs shells, indicate risk and impacts at release, in the aquatic environment, and in between. If characteristic life-strategies of birds in warm areas (e.g. longer-lived and fewer eggs per clutch) increases the risk compared with similar birds living in colder regions when both experience the same environmental pollutant levels, then malaria control using DDT probably has more significant impacts on biota than previously realised. Therefore, risk assessment and modelling without hard data may miss crucial impacts and risks, as the chemical use patterns and ecologies in Africa and elsewhere may differ from the conditions and assumptions of existing risk assessment and modelling parameters. Consideration of other findings associated with DDT from the same area (intersex in fish and urogental birth defects in baby boys), together with the findings of this study (high levels of DDT in bird eggs, eggshell thinning in the Cattle Egrets, and the apparent absence of breeding piscivore birds in the sprayed area) are strongly suggestive of negative impacts from DDT spraying for Malaria control. Our data presents strong arguments for an expedited process of replacing DDT with sustainable methods.