Browsing by Author "Newman, Howard"
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- ItemHepatitis A in Nelson Mandela Bay and Sarah Baartman districts, Eastern Cape, South Africa(Medpharm Publications, 2018) Newman, Howard; Tshabalala, Donald; Estrada, Guillermo A. Pulido; Nguetchueng, Romuald KomBackground: Hepatitis A is the most common cause of acute viral hepatitis, not only in South Africa, but in many other countries. In South Africa, there is a lack of data regarding the true incidence of hepatitis A, and even fewer data regarding hepatitis A cases requiring hospitalisation. In the Eastern Cape province of South Africa in particular, there is a paucity of published data that could be used to guide public health officials. An analysis of all the laboratory-confirmed cases in the area over a period of time may help to better describe the extent of the problem. Methods: This was a retrospective study analysing the laboratory-confirmed cases of hepatitis A in the Nelson Mandela Bay and Sarah Baartman districts of the Eastern Cape province in South Africa for the three-year period from 2015 to 2017. Results: A total of 194 laboratory-confirmed cases of hepatitis A were identified for the three-year period from 2015 to 2017. Of these, 138 (71%) cases were children 16 years old or younger, with adults accounting for 56 cases (29%). There was no overall seasonality associated with laboratory-confirmed cases of hepatitis A. Conclusions: Hepatitis A is a serious problem in the Eastern Cape region. More studies are needed to determine the exact cause of the continuing epidemic.
- ItemMolecular characterisation and epidemiology of enterovirus-associated aseptic meningitis in the Western and Eastern Cape Provinces, South Africa 2018–2019(Elsevier B.V., 2021-04) Nkosi, Nokwazi; Preiser, Wolfgang; Van Zyl, Gert; Claassen, Mathilda; Cronje, Nadine; Maritz, Jean; Newman, Howard; McCarthy, Kerrigan; Ntshoe, Genevie; Essel, Vivien; Korsman, Stephen; Hardie, Diana; Smuts, HeidiBackground: Enteroviruses are amongst the most common causes of aseptic meningitis. Between November 2018 and May 2019, an outbreak of enterovirus-associated aseptic meningitis cases was noted in the Western and Eastern Cape Provinces, South Africa. Objectives: To describe the epidemiology and phylogeography of enterovirus infections during an aseptic meningitis outbreak in the Western and Eastern Cape Provinces of South Africa. Methods: Cerebrospinal fluid samples from suspected cases were screened using a polymerase chain reaction targeting the 5’UTR. Confirmed enterovirus-associated meningitis samples underwent molecular typing through species–specific VP1/VP2 primers and pan-species VP1 primers. Results: Between November 2018 and May 2019, 3497 suspected cases of aseptic meningitis were documented in the Western and Eastern Cape Provinces. Median age was 8 years (range 0–61), interquartile range (IQR=4–13 years), 405/735 (55%) male. 742/3497 (21%) cases were laboratory – confirmed enterovirus positive by routine diagnostic PCR targeting the 5’UTR. 128/742 (17%) underwent molecular typing by VP1 gene sequencing. Echovirus 4 (E4) was detected in 102/128 (80%) cases. Echovirus 9 was found in 7%, Coxsackievirus A13 in 3%. 10 genotypes contributed to the remaining 10% of cases. Synonymous mutations were found in most cases, with sporadic amino acid changes in 13 (12.7%) cases. Conclusion: The aseptic meningitis outbreak was associated with echovirus 4. Stool samples are valuable for molecular typing in CSF confirmed EV-associated aseptic meningitis.
- ItemPrevalence and determinants of congenital cytomegalovirus infection at a rural South African central hospital in the Eastern Cape(Medpharm Publications, 2018) Tshabalala, Donald; Newman, Howard; Businge, Charles; Mabunda, Sikhumbuzo A.; Kemp, Waldette; Beja, PakamaBackground: The Nelson Mandela Academic Hospital (NMAH) in Mthatha, Eastern Cape, is a rural central hospital, serving one of the poorest districts in South Africa. The prevalence of and risk factors for congenital cytomegalovirus (CMV) in this area are not known. The aim was to evaluate the prevalence of congenital CMV and associated risk factors for babies born at NMAH. Methods: This was a cross-sectional study to determine the prevalence of congenital CMV infection among babies born at Nelson Mandela Academic Hospital. Mother–baby pairs delivered consecutively from Monday to Friday, who gave informed consent, were included. Demographic information was collected on a questionnaire. All babies were tested for congenital CMV using a saliva swab PCR within the first week of life. Results: A total of 302 births were assessed. Congenital CMV was prevalent in 18 births (5.96%; 95% CI 3.29–8.63) and had an equal prevalence between HIV-exposed and HIV-unexposed newborns (prevalence ratio [PR] = 1.00; 95% CI 0.94–1.06; p = 0.869). Conclusions: The prevalence of congenital CMV of 5.96% is similar to findings from other resource-limited settings. There was no significant association between maternal HIV status and congenital CMV. With the prevalence of congenital CMV being as high as it is in the studied setting, clinicians are advised to have a high index of suspicion, especially when mothers are CMV seropositive.
- ItemA qualitative PCR minipool strategy to screen for virologic failure and antiretroviral drug resistance in South African patients on first-line antiretroviral therapy(Elsevier, 2014-08) Newman, Howard; Breunig, Lukas; Van Zyl, Gert; Stich, August; Preiser, Wolfgang; Stellenbosch University. Faculty of Medicine and Health Sciences. Dept. of Pathology: Medical Virology.ENGLISH ABSTRACT: Background: The high cost of commercial HIV-1 viral load tests for monitoring of patients on antiretroviral treatment limits their use in resource-constrained settings. Commercial genotypic antiretroviral resistance testing is even more costly, yet it provides important benefits. Objectives: We sought to determine the sensitivity and negative predictive value of a qualitative PCR targeting partial reverse transcriptase for detection of virologic failure when 5 patient specimens are pooled. Study Design: A total of 300 South African routine patient samples were included and tested in 60 pools of 5 samples each. A qualitative nested PCR was optimised for testing pools and individual samples from positive pools. All positive samples were sequenced to detect drug resistance-associated mutations. Results were compared to those of conventional viral load monitoring. Results: Twenty-two of 60 pools tested positive. Individual testing yielded 29 positive individual samples. Twenty-six patients had viral loads of above 1000 copies per millilitre. The pooling algorithm detected 24 of those 26 patients, resulting in a negative predictive value of 99.3%, and a positive predictive value of 89.7%. The sensitivity for detecting patients failing therapy was 92%, with a specificity of 98.9%. Of the patients failing first-line ART, 83.3% had NRTI and 91.7% NNRTI resistance mutations. Conclusions: The pooled testing algorithm presented here required 43% fewer assays than conventional viral load testing. In addition to offering a potential cost saving over individual viral load testing, it also provided drug resistance information which is not available routinely in resourced-limited settings.
- ItemRapid testing for respiratory syncytial virus in a resource-limited paediatric intensive care setting(2020-12-08) Newman, Howard; Tshabalala, Donald; Mabunda, SikhumbuzoWe analysed the performance characteristics of the respiratory syncytial virus lateral flow rapid antigen assay in use when compared to a multiplex polymerase chain reaction for detection of respiratory viruses. The study was conducted at a tertiary paediatric hospital in Port Elizabeth, South Africa, from 01 January 2017 to 31 December 2018. We found the clinical sensitivity (36.8%) of the rapid test to be too low for routine diagnostic use. Knowledge of assay performance characteristics of rapid tests are important for appropriate interpretation of rapid test results.