Browsing by Author "Jackson, T. F. H. G."

Now showing 1 - 2 of 2
  • Thumbnail Image
    Item
    Control of an amoebiasis outbreak in the Philippi area near Cape Town
    (Health & Medical Publishing Group, 1994) Whittaker, S.; Jackson, T. F. H. G.; Gathiram, V.; Regensberg, L. D.
    Previous studies in Durban have shown that serological investigations, in combination with iso-enzyme electrophoresis, are invaluable for monitoring the endemicity of pathogenic strains of Entamoeba histolytica. We therefore proposed that antibody profiles could be used to detect epidemic situations. An outbreak of amoebiasis in the normally non-endemic Philippi area near Cape Town provided an opportunity for testing this hypothesis. Seven of 9 patients presenting at a district hospital with invasive amoebiasis originated from a single farm in Philippi. Iso-enzyme electrophoresis and serological investigations were used to monitor the endemicity of amoebiasis on 16 of the 49 farms in this district. In an attempt to contain disease transmission all inhabitants on farms from which patients came (including those where cyst-passers were identified) and all seropositive subjects were treated. The antibody profiles proved invaluable for confirming that the farm from which the hospitalised patients originated was the central focus of the outbreak, and also identified subjects infected with pathogenic zymodemes of E. histolytica on the adjacent 4 farms. On all 5 of these farms, 62,5-100% of seropositive subjects were strongly positive. In contrast weak to negative serological responses occurred on the remaining 11 farms. In addition the success of treatment was indicated by a notable drop in strong seropositive responses on the affected 5 farms to 11,5% within 9 months. The infection pathways implied that the pathogenic strain of E. histolytica was introduced into this non-endemic area by a foreigner from an endemic area; this suggests that the pathogenicity of E. histolytica is an immutable stable feature.
  • Thumbnail Image
    Item
    Synchronized and regular deworming of children and women in South Africa : Policy and practice
    (Academy of Science of South Africa, 2005) Fincham, J. E.; Markus, M. B.; Ngobeni, J. T.; Mayosi, B. N.; Adams, V. J.; Kwitshana, Z. L.; Obihara, C. C.; Dhansay, M. A.; Jackson, T. F. H. G.
    SOUTH AFRICA IS A SIGNATORY TO WORLD Health Assembly (WHA) resolution 54.19 (May 2001), which calls for regular, synchronized treatment of helminthiasis in developing countries, particularly where the prevalence of worm infestation exceeds 50%. Helminthic infection is usually a hallmark of poverty and reasons why it should be controlled in disadvantaged communities are compelling. However, existing South African legislation regulating the procurement and use of anthelmintic medicines effectively renders group-based deworming as agreed to by WHA member states, and endorsed by the South African minister of health, non-implementable in practice. In order to make deworming sustainable, low-cost, unregistered anthelmintics must be imported from international procurement agencies. At present, this is not permitted. Another problem is that both medical and non-medical personnel are confused by out-of-date information in package-inserts regarding safety for young children and pregnant women. Albendazole and praziquantel should be de-scheduled and ivermectin, levamisole and possibly nitazoxanide should be registered in a way that permits treatment by non-medical personnel. Rational alternation of medication is important because reliance on mebendazole will lead to resistance. All batches of anthelmintics ought to comply with pharmacological quality specifications and testing should be routine. Facilities for doing this are available in South Africa.