Browsing by Author "Van Stuijvenberg, M. E."

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    Endemic goitre in a rural community of KwaZulu-Natal
    (Health & Medical Publishing Group, 1997) Benade, J. G.; Oelofse, A.; Van Stuijvenberg, M. E.; Jooste, P. L.; Weight, M. J.; Benade, A. J. S.
    Objective. To quantify the prevalence of goitre and iodine deficiency. Setting. Ndunakazi, a rural community of approximately 8 000 people in KwaZulu-Natal. Design. A cross-sectional community-based survey and a school-based survey. Participants. The 127 mothers and 114 children aged 6 -11 years, selected during the cross-sectional survey, and 304 children aged 6 -14 years, from the school-based survey. Methods. Urinary iodine levels and thyroid size were determined and categorised according to guidelines proposed jointly by the WHO, UNICEF and the ICCIDD. Z-score anthropometric indicators were calculated, and mid-year exam marks of goitrous and non-goitrous pupils for Zulu and mathematics were compared. Results. In school-aged children, both surveys demonstrated a goitre prevalence in the 20 - 29.9% range and a median urinary iodine level in the 2 - 4.9 ug/dl range, indicating iodine deficiency of moderate severity. Goitrous subjects scored consistently worse in their Zulu exam papers than those without goitre. Stunting was not more prevalent than in the rest of KwaZulu-Natal. Iodised salt was not available in any of the three community shops. Conclusion. This level of iodine deficiency in children can adversely affect their neuropsycho-intellectual development. Factors contributing to deficient iodine intake in Ndunakazi are present in many rural areas, and South Africa cannot afford to be overly confident about the apparent absence of iodine deficiency as a public health problem.
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    Is it time for South Africa to end the routine high-dose vitamin A supplementation programme?
    (South African Medical Association, 2019-11-27) Coutsoudis, A.; Sanders, D.; Dhansay, Muhammad A.; Van Stuijvenberg, M. E.; Benn, C. S.
    In accordance with World Health Organization guidelines, South Africa (SA) introduced routine periodic high-dose vitamin A supplementation (VAS) in 2002. These guidelines were developed after research in the 1980s and 1990s showed the efficacy of VAS in reducing childhood mortality. However, two recent studies in low- to middle-income countries (2013 and 2014) have shown no effect of high-dose VAS on mortality. Additionally, there is no clear research evidence that 6-monthly doses of vitamin A result in a sustained shift in serum retinol levels or reduce subclinical vitamin A deficiency. These two points should encourage SA to re-examine the validity of these guidelines. A long-term view of what is in the best interests of the majority of the people is needed. The short-term intervention of administering vitamin A capsules not only fails to improve serum retinol levels but may create dependence on a ‘technical fix’ to address the fundamental problem of poor nutrition, which is ultimately underpinned by poverty. It may also cause harm. Although there are those, some with vested interests, who will argue for continuation of the routine high-dose VAS programmes, SA policymakers and scientists need to evaluate the facts and be prepared to rethink this policy. There is cause for optimism: SA’s health policymakers have previously taken bold stands on the basis of evidence. The examples of regulation of tobacco products and taxation of sugar-sweetened beverages, ending the free distribution of formula milk for HIV-positive mothers and legislating against the marketing of breastmilk substitutes provide precedents. Here is a time yet again for decision-makers to make bold choices in the interests of the people of SA. While the cleanest choice would be national discontinuation of the routine VAS programme, there may be other possibilities, such as first stopping the programme in Northern Cape Province (where there is clear evidence of hypervitaminosis A), followed by the other provinces in time.
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    Plasma vitamin A, E, C and B6 levels in myocardial infarction
    (Health & Medical Publishing Group, 1987-5) Labadarios, D.; Brink, P. A.; Weich, H. F. H.; Visser, L.; Louw, M. E. J.; Shephard, G. S.; Van Stuijvenberg, M. E.
    ENGLISH ABSTRACT: Vitamin A, E, C and B6 status was studied in 30 patients with myocardial infarction and in 19 age- and sex-matched patients after elective surgery or trauma. Plasma levels of the four vitamins studied were low, remained low or decreased transiently in both groups of patients during the acute catabolic response phase, and began to return to normal after the third day from the start of the catabolic response. These changes in plasma levels are therefore neither of any special pathophysiological importance in nor specific to myocardial infarction.