Browsing by Author "Eley, B."
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- ItemImpact of age and sex on mycobacterial immunity in an area of high tuberculosis incidence(2010) Gallant, C. J.; Cobat, A.; Simkin, L.; Black, G. F.; Stanley, K.; Hughes, J.; Doherty, T. M.; Hanekom, W. A.; Eley, B.; Beyers, Nulda; Jais, J-P.; Van Helden, Paul D.; Abel, L.; Alcais, A.; Hoal, E. G.; Schurr, E.SETTING: The extent of immune reactivity measured by the tuberculin skin test (TST) and interferon-gamma (IFN-γ) T-cell assays is usually not analysed. OBJECTIVE: To determine the impact of age and sex on assay positivity and on the extent of reactivity of both TST and T-cell assays in young persons in an area of South Africa with high TB transmission. RESULTS: Age had a strong impact on assay positivity for all seven immune phenotypes tested (P < 0.0007). Among positive responders, the extent of purified protein derivative (PPD) triggered IFN-γ release (P < 0.003) was sensitive to age. ESAT-6 triggered IFN-γ release (day 7, P = 0.03) and the frequency of PPD-specific IFN-γ+CD4+ (P = 0.03) and IFN-γ+CD8+ cells (P = 0.04) were weakly dependent on age. By contrast, the extent of TST induration was insensitive to age (P > 0.05), and sex had no significant impact on any phenotype measured (P > 0.05). The high proportion of positive responders in the 1-10 year age-group observed with long-term whole blood assays, but not with 3-day assays and TST, suggests that long-term whole blood assays may be confounded by bacille Calmette-Guérin vaccination in this age group. CONCLUSION: There is a significant impact of age, but not sex, on different assays of immune reactivity in this high TB transmission setting. © 2010 The Union.
- ItemInvestigation and management of primary immunodeficiency in South African children(Health and Medical Publishing Group, 2014) Eley, B.; Esser, M.ENGLISH ABSTRACT: The primary immunodeficiency diseases (PIDs) are inherited, non-communicable diseases that cause immunological dysfunction. PIDs are seldom reported in South Africa (SA). Based on a mid-2013 population estimate of 52.98 million and assuming that the prevalence of PIDs is similar to that in well-resourced settings, the total number of individuals with PIDs in our country should range between 2 850 and 45 723. However, fewer than 500 cases of PID have been reported in SA. Between five and 15 new, fully characterised PIDs are reported annually. Our understanding of the physiology of the immune system has been substantially enhanced by these discoveries, and consequently the international classification of PIDs has been updated.
- ItemManagement of mental health disorders and central nervous system sequelae in HIV-positive children and adolescents(AOSIS Publishing, 2014-09) Nassen, R.; Donald, K.; Walker, K.; Paruk, S.; Vujovic, M.; Duncan, W.; Laughton, Barbara; Moos, B.; Eley, B.; Lachman, A.; Wilmshurst, J.HIV-positive children and adolescents are at increased risk of both central nervous system (CNS) sequelae and mental disorders owing to a number of factors, including the impact of HIV infection on the brain, social determinants of health (e.g. poverty and orphanhood) and psychosocial stressors related to living with HIV. Every effort should be made to identify perinatally HIV-infected children and initiate them on antiretroviral therapy early in life. HIV clinicians should ideally screen for mental health and neurocognitive problems, as part of the routine monitoring of children attending antiretroviral clinics. This guideline is intended as a reference tool for HIV clinicians to support the early identification, screening and management of mental health disorders and/or CNS impairment in children and adolescents. This guideline covers mental disorders (section 1) and HIV-associated neurocognitive disorders (section 2) among children and adolescents.
- ItemUnexplained HIV-1 infection in children : documenting cases and assessing for possible risk factors(Health and Medical Publishing Group (HMPG), 2004-03) Hiemstra, R.; Rabie, H.; Schaaf, H. Simon; Eley, B.; Cameron, N.; Mehtar, Shaheen; Janse van Rensburg, A.; Cotton, M. F.Background. In the year 2000 we reported possible horizontal transmission of HIV-1 infection between two siblings. An investigation of three families, each with an HIV-infected child but seronegative parents, permitted this finding. Sexual abuse and surrogate breast-feeding were though unlikely. The children had overlapping hospitalisation in a regional hospital. Since then several cases of unexplained HIV infection in children have been reported. A registry was established at Tygerberg Children's Hospital for collection of data on the extent of horizontal or unexplained transmission of HIV in children. Study design. Retrospective chart review. Results. Fourteen children were identified, 12 from the Western Cape and 1 each from the Eastern Cape and KwaZulu-Natal. Thirteen (92%) had been hospitalised previously. In the Western Cape, children had been hospitalised in 8 hospitals. Ten of 13 (77%) were admitted as neonates and 9 of 13 (69%0 had 2 or more admissions. Intravascular cannulation and intravenous drug administration occurred in all but 2 children before HIV diagnosis. Conclusion. We have confirmed HIV infection in a number of cases where the source of infection has been inadequately explained. Circumstantial evidence supports but does not prove nosocomial transmission. Further studies and identification of medical procedures conducive to the spread of HIV are urgently needed.