Local plants as repellents against Anopheles arabiensis, in Mpumalanga Province, South Africa

OBJECTIVE: To assess the repellency effect of three local plants; fever tea (Lippia javanica), rose geranium (Pelargonium reniforme) and lemon grass (Cymbopogon excavatus) against laboratory reared Anopheles arabiensis mosquitoes. DESIGN: A laboratory experimental study. SETTING: Mpumalanga Province, South Africa. SUBJECTS: Three adult male volunteers. MAIN OUTCOME MEASURES: Affordable alternatives to synthetic repellents against biting of Anopheles arabiensis mosquitoes. RESULTS: All three alcohol plant extracts provided significantly more protection (p = 0.012) than alcohol control. The alcohol plant extract of L. javanica provided 76.7% protection against An. arabiensis after a four hour period, and C. excavatus and P. reniforme provided 66.7% and 63.3% protection for three hours, respectively. At five hours post application only L. javanica alcohol extract provided appreciable protection (59.3%) against An. arabiensis. CONCLUSION: The results of this study indicate that L. javanica, P. reniforme and C. excavatus protect against An. arabiensis mosquito bites with the repellent effect of L. javanica lasting significantly longer than that of the other two plants.     

Addressing gaps in pharmacovigilance practices in the antiretroviral therapy program in the Eastern Cape Province, South Africa

BackgroundThe use of antiretrovirals (ARVs) is associated with considerable concern regarding adverse drug reactions (ADRs), including both short- and long-term complications. Currently, there is a general underreporting of ADRs in South Africa. In May 2007, the Eastern Cape regional training centre introduced a pharmacovigilance plan for antiretroviral therapy (ART) to improve reporting practices in the area.ObjectivesThe aim of this study was to gain insight on attitudes and experiences regarding ADR detection and reporting among health care providers (HCPs) shortly after the first formal pharmacovigilance plan for ART was introduced.MethodsThree focus-group discussions were conducted with 12 HCPs. There were 7 nurses, 3 pharmacists, 1 doctor, and 1 auxiliary staff, all recruited from public hospitals and local health authorities in 2 towns in the Eastern Cape Province, South Africa.ResultsIt was observed that senior HCPs knew that ADRs from ARVs should be reported formally, whereas junior staff did not demonstrate the same knowledge. The participants thought that underreporting from the primary health care level was a major problem. HCPs identified various reasons for underreporting ADRs: problems with filling out the reporting form, lack of training, high workload, lack of feedback, and fears of not being taken seriously. Lack of adequate training in pharmacovigilance led to lack of confidence among the professional nurses in managing ADRs.ConclusionsIncreased focus on pharmacovigilance with adequate, continuous training, especially for nurses managing down-referred patients in primary health care on identification and management of ADRs, and practical use of the ADR form may be necessary to improve pharmacovigilance practices in the area.     

The nutritional status of a rural community in KwaZulu-Natal, South Africa: the Ndunakazi project.

OBJECTIVES: To assess the nutritional status of six month to 11 year old rural Black children and their mothers as a first phase in a nutrition intervention project. DESIGN: Cross sectional study. SETTING: A rural African community +/- 60 km northwest of Durban, KwaZulu-Natal, South Africa. SUBJECTS: A random sample of 127 mothers and 105 pre-school and 131 primary school children were selected from this community. MAIN OUTCOME MEASURES: Anthropometric (height and weight), biochemical and dietary and socio-demographic information was collected. RESULTS: Among the pre-schoolers anaemia was present in 23.8%, iron deficiency in 19.8%, while marginal vitamin A deficiency was observed in 44.9%. Urinary iodine levels indicated moderate iodine deficiency in 31.8% and severe iodine deficiency in 9.1%. In primary school children the prevalence of anaemia was 22%, while marginal vitamin A deficiency was observed in 50.8%. Moderate iodine deficiency was observed in 37.9% of primary school children while 13.6% presented with severe iodine deficiency. The prevalence of goitre in this group was 22.1%. Almost 22% of mothers were anaemic and 18.9% were iron deficient. Only 1.6% of mothers were marginally vitamin A deficient. An enlarged thyroid was observed in 26.7% of mothers of which 17.3% were palpable and 9.4% visible. Of mothers 43.4% were overweight while 33.8% were obese. CONCLUSION: The rural community in KwaZulu-Natal, showed a high prevalence of anaemia, marginal vitamin A deficiency and iodine deficiency. The information gathered during this cross sectional study served as a basis to plan and implement an intervention study aimed at addressing the nutritional deficiencies.     

Risk of Malaria in Visitors to the Kruger National Park, South Africa

Background: The risk of malaria to visitors to South Africa's nature reserves is unknown. Current recommendations for travelers are based on malaria incidence rates in local communities. These rates may well overestimate travelers'malaria risk and lead to unnecessary use of antimalarial prophylaxis with associated drug-related adverse events. This study investigated the incidence of malaria in visitors to South Africa's Kruger National Park (KNP).
Methods: Postal questionnaires were sent to the cohort of visitors staying in the KNP during April 1996, 6 to 8 weeks after they returned to their homes. Nonrespondents received duplicate questionnaires 8 weeks later. Responses from 3267 groups, representing 11,107 visitors (56.8%) allowed determination of the malaria attack rate in this group of travelers and assessment of associations between malaria risk and a number of factors, including type of accommodation used during the visit; duration of stay; use of chemoprophylaxis; and use of personal protection measures. All travelers indicating that they had suffered an episode of malaria following their visit were telephonically contacted and their health providers traced to determine the basis of diagnosis and clinical outcome.
Results: One clinically suspected and four confirmed cases of Plasmodium falciparum malaria among the visitors suggest a low attack rate of 4.5 cases per 10,000 visitors during April, the highest risk month for malaria in South Africa. No association was found between malaria risk and accommodation type, duration of stay, use and type of chemoprophylaxis, and use and number of personal protection measures.
Conclusions: These findings confirm the importance of careful assessment of local malaria risk before individualized advice is provided to travelers.     

South Africa: a toxicologist's goldmine.

The emerging nation of South Africa, in common with some other countries, notably Eastern Europe, is heir to decades of neglect with regards to the exposure of the majority of its population to toxic materials. In this short review, the major toxic health hazards are described. For most of these risks there are now programs in place to improve the situation, but co-ordination and financial constraints, along with the fact that the majority of the population neither live, nor work, in a controlled environment, mean that much remains to be done. The recent formation of a South African Toxicology society, which strives to bring together environmental, industrial, forensic and clinical toxicology should assist in an improvement, both in the epidemiology of toxicity in South Africa and in improved measures to reduce the incidence of preventable noncommunicable diseases related to both acute and chronic exposure to toxins. The South African scene also provides a "window' of opportunity to study the more fundamental aspects of exposure in human subjects and to couple these to animal and in vitro studies to elucidate the underlying mechanisms where these are unknown.     

南非：充满魅力的市场

南非位于非洲大陆最南端,濒临印度洋和大西洋,是世界上唯一同时存在3个首都的国家。南非被誉为非洲大陆经济的＂火车头＂,虽然其国土面积仅占非洲的4%,人口占非洲的5%,而GDP却占全非的26.5%,对外贸易额占全非的23.3%,居非洲之首。近年来,     

Electronic transmission of rapid alerts in pharmacovigilance: A pilot EC experiment

Though electronic communication and transfer of data is becoming commonplace, it is still rare between administrations. This is why CEC DGXIII started the European Nervous System (ENS) programme, to promote the use of telematics to facilitate the work of administrations. Pharmacovigilance is one of the pilots of CARE, an ENS project in health care. This pilot involves Instituto de Salud Carlos III (Spain), Medicines Control Agency (UK), and the French Pharmacovigilance System (France) along with Norsistemas Consultores (Spain). Its objective is to explore the possibilities of telematic transmission of Pharmacovigilance data between national administrations. The technical approach has tested the transmission of urgent drug alerts, information equivalent to that of the existing Rapid Alert scheme, up to now transmitted by fax. The network using international standards (Unix, X400, and EDI, based on X25 networks) has been set up between the three participating countries. The data structure for the drug alerts has been described and submitted to future European users. The message structure itself has been entered into the registration and validation process for EDIFACT certification. The application for message transmission has been written and is being tested and re-evaluated. The information contained in these messages will be initially entered manually, but could be generated from national databases. Though this network at the present only concerns three countries, it is expected that most EC countries will be linked in the near future.     

Initiation of a pharmacovigilance programme at a tertiary care hospital in South India

Objective India is a country with the availability of a large number of pharmaceutical preparations as branded generics. At the time of this study there was no established pharmacovigilance system at the national level except a co‐ordinating centre at the national capital. The study site was a tertiary care teaching hospital with a bed capacity of 500 and with an average of 200 outpatient visits and 50 inpatient admissions per day. The hospital did not have any system of monitoring and documenting adverse drug reactions. The objective of the study was to introduce an adverse drug reaction (ADR) monitoring programme at a tertiary care teaching hospital and assess ADR‐related issues in both inpatient and outpatient departments. Method All departments willing to report ADRs were included in the study, which was carried out for one year. Physicians and nurses filled in the notification forms when they encountered suspected ADR cases. These cases were then assessed by a panel of four judges. According to Naranjo's algorithm, the ADRs were assessed and classified based on World Health Organization (WHO) classification. Key findings A total of 288 suspected cases were reported and 264 ADRs were confirmed by the panel. According to Naranjo's probability scale, 83 cases were categorized as ‘probable’, 181 cases were classified as ‘possible’, and none were classified as ‘unlikely’ or ‘definite’. The most common classes of drugs involved were antibiotics (25%), psychotropics (20%), analgesic and cardiovascular agents (14% each). Generalised itch and rash, tremors, urticarial drug reaction, oral ulcer, gastritis and akathesia and extrapyramidal symptoms were found to be the most common ADRs observed; 2.1% of the patients in the studied departments had ADRs. Conclusion The ADR reporting system was initiated at the hospital and was well received by the physicians. Appreciable participation of physicians was noted during the study in reporting ADRs. The study also gave an insight into the awareness of physicians about ADR‐related issues. The number of ADRs reported was reasonably comparable with the findings of other authors from India.