scholarly journals Research priorities for control of zoonoses in South Africa

2021 ◽  
Author(s):  
Greg Simpson ◽  
Fabiola Quesada ◽  
Pranab Chatterjee ◽  
Manish Kakkar ◽  
Matthew F Chersich ◽  
...  
Keyword(s):  
South Africa ◽  
Complex Disease ◽  
Reference Group ◽  
Research Priorities ◽  
Health Study ◽  
Anthropogenic Factors ◽  
Valley Fever ◽  
Research Priority ◽  
Systems Research ◽  
Wilderness Areas

Abstract Background Zoonoses pose major threats to the health of humans, domestic animals and wildlife, as seen in the COVID-19 pandemic. Zoonoses are the commonest source of emerging human infections and inter-species transmission is facilitated by anthropogenic factors such as encroachment and destruction of wilderness areas, wildlife trafficking and climate change. South Africa was selected for a ‘One Health’ study to identify research priorities for control of zoonoses due to its complex disease burden and an overstretched health system. Methods A multidisciplinary group of 18 experts identified priority zoonotic diseases, knowledge gaps and proposed research priorities for the next 5 y. Each priority was scored using predefined criteria by another group of five experts and then weighted by a reference group (n=28) and the 18 experts. Results Seventeen diseases were mentioned with the top five being rabies (14/18), TB (13/18), brucellosis (11/18), Rift Valley fever (9/11) and cysticercosis (6/18). In total, 97 specific research priorities were listed, with the majority on basic epidemiological research (n=57), such as measuring the burden of various zoonoses (n=24), followed by 20 on development of new interventions. The highest research priority score was for improving existing interventions (0.77/1.0), followed by health policy and systems research (0.72/1.0). Conclusion Future zoonotic research should improve understanding of zoonotic burden and risk factors and new interventions in public health. People with limited rural services, immunocompromised, in informal settlements and high-risk occupations, should be the highest research priority.

scholarly journals The kidney cancer research priority-setting partnership: Identifying the top 10 research priorities as defined by patients, caregivers, and expert clinicians

2017 ◽  
Vol 11 (12) ◽  
pp. 379-87 ◽  
Author(s):  
Jennifer Jones ◽  
Jaimin Bhatt ◽  
Jonathan Avery ◽  
Andreas Laupacis ◽  
Katherine Cowan ◽  
...  
Keyword(s):  
Cancer Research ◽  
Kidney Cancer ◽  
Priority Setting ◽  
Research Priorities ◽  
Research Network ◽  
Cancer Research Network ◽  
Research Priority ◽  
Funding Agencies ◽  
James Lind Alliance ◽  
Priority Setting Partnership

It is critically important to define disease-specific research priorities to better allocate limited resources. There is growing recognition of the value of involving patients and caregivers, as well as expert clinicians in this process. To our knowledge, this has not been done this way for kidney cancer. Using the transparent and inclusive process established by the James Lind Alliance, the Kidney Cancer Research Network of Canada (KCRNC) sponsored a collaborative consensus-based priority-setting partnership (PSP) to identify research priorities in the management of kidney cancer. The final result was identification of 10 research priorities for kidney cancer, which are discussed in the context of current initiatives and gaps in knowledge. This process provided a systematic and effective way to collaboratively establish research priorities with patients, caregivers, and clinicians, and provides a valuable resource for researchers and funding agencies.

scholarly journals Survey of canine babesiosis in South Africa

2000 ◽  
Vol 71 (3) ◽  
Author(s):  
M.G. Collett
Keyword(s):  
South Africa ◽  
Trypan Blue ◽  
Western Cape ◽  
Supportive Treatment ◽  
Canine Babesiosis ◽  
Liver Support ◽  
Treatment Regimens ◽  
Research Priority ◽  
High Parasitaemia ◽  
Shock Lung

A questionnaire, designed to obtain qualitative information on a number of variables concerning canine babesiosis (biliary fever) in South Africa, was sent to 510 veterinary practices in late 1993. Of the 157 practices that responded, all were presented with cases of babesiosis and most were situated in Gauteng, the Western Cape and KwaZulu-Natal. Apart from the Western Cape, a winter-rainfall region, the prevalence of babesiosis cases in dogs was highest in summer. Most of the respondent practices treated between 1000 and 5000 sick dogs that included 100 to 500 babesiosis cases each year. Respondents identified cerebral babesiosis, enterorrhagia, 'red' or haemoconcentrated babesiosis, acute renal failure and pulmonary babesiosis or 'shock lung', amongst others, as the most prevalent forms of complicated ('atypical') babesiosis. Diminazene, imidocarb and trypan blue were the most popular antibabesials. Trypan blue was most often used in shocked patients, whereas diminazene and imidocarb were preferred when there was a high parasitaemia in the absence of shock. At least 19 antibabesial treatment regimens were used in practices. These comprised the use of single doses of antibabesial drugs; split doses with repeat injections, and combined drug variations, some of which are undesirable due to possible sterilisation of Babesia infection or potential toxicity. Side-effects were most commonly associated with imidocarb use. Ninety-six percent of respondents used supportive treatment (e.g. corticosteroids, vitamins and 'liver support') in all cases of babesiosis. The use of blood transfusion as supportive treatment varied according to practice and severity of the case. Most practices never cross-matched blood to be transfused, and transfusion reactions were rare. Diminazene was most frequently incriminated in cases where drug 'resistance' or relapses occurred. Cerebral and 'red' cases resulted in high mortality. Treatment of babesiosis costs the dog-owning public in South Africa more than R20 million each year. Information on the distribution and possible complicating role of Ehrlichia canis was obtained. Development of a vaccine was the first research priority identified.

scholarly journals Rethinking collaboration: developing a learning platform to address under-five mortality in Mpumalanga province, South Africa

2019 ◽  
Vol 34 (6) ◽  
pp. 418-429 ◽  
Author(s):  
Lucia D’Ambruoso ◽  
Maria van der Merwe ◽  
Oghenebrume Wariri ◽  
Peter Byass ◽  
Gerhard Goosen ◽  
...  
Keyword(s):  
South Africa ◽  
Health Policy ◽  
Health Systems ◽  
Health Priorities ◽  
Local Data ◽  
Under Five ◽  
Systems Research ◽  
Learning Platform ◽  
Institutional Infrastructure ◽  
The Right

Abstract Following 50 years of apartheid, South Africa introduced visionary health policy committing to the right to health as part of a primary health care (PHC) approach. Implementation is seriously challenged, however, in an often-dysfunctional health system with scarce resources and a complex burden of avoidable mortality persists. Our aim was to develop a process generating evidence of practical relevance on implementation processes among people excluded from access to health systems. Informed by health policy and systems research, we developed a collaborative learning platform in which we worked as co-researchers with health authorities in a rural province. This article reports on the process and insights brought by health systems stakeholders. Evidence gaps on under-five mortality were identified with a provincial Directorate after which we collected quantitative and qualitative data. We applied verbal autopsy to quantify levels, causes and circumstances of deaths and participatory action research to gain community perspectives on the problem and priorities for action. We then re-convened health systems stakeholders to analyse and interpret these data through which several systems issues were identified as contributory to under-five deaths: staff availability and performance; service organization and infrastructure; multiple parallel initiatives; and capacity to address social determinants. Recommendations were developed ranging from immediate low- and no-cost re-organization of services to those where responses from higher levels of the system or outside were required. The process was viewed as acceptable and relevant for an overburdened system operating ‘in the dark’ in the absence of local data. Institutional infrastructure for evidence-based decision-making does not exist in many health systems. We developed a process connecting research evidence on rural health priorities with the means for action and enabled new partnerships between communities, authorities and researchers. Further development is planned to understand potential in deliberative processes for rural PHC.

scholarly journals Ten Research Priorities Related to Youth Sport, Physical Activity, and Health

2020 ◽  
Vol 17 (9) ◽  
pp. 920-929
Author(s):  
Erin K. Howie ◽  
Justin M. Guagliano ◽  
Karen Milton ◽  
Stewart A. Vella ◽  
Sjaan R. Gomersall ◽  
...  
Keyword(s):  
Physical Activity ◽  
Sport Participation ◽  
Wide Spectrum ◽  
Research Priorities ◽  
Youth Sport ◽  
Evidence Base ◽  
Current Evidence ◽  
Activity Levels ◽  
Main Research ◽  
Research Priority

Background: Sport has been identified as one of the 7 best investments for increasing physical activity levels across the life span. Several questions remain on how to effectively utilize youth sport as a strategy for increasing physical activity and improving health in youth. The purpose of this paper is to identify the main research priorities in the areas of youth sport and physical activity for health. Methods: An international expert panel was convened, selected to cover a wide spectrum of topics related to youth sport. The group developed a draft set of potential research priorities, and relevant research was scoped. Through an iterative process, the group reached consensus on the top 10 research priorities. Results: The 10 research priorities were identified related to sport participation rates, physical activity from sport, the contribution of sport to health, and the overall return on investment from youth sport. For each research priority, the current evidence is summarized, key research gaps are noted, and immediate research needs are suggested. Conclusion: The identified research priorities are intended to guide researchers, policymakers, and practitioners to increase the evidence base on which to base the design, delivery, and policies of youth sport programs to deliver health benefits.

Abstract MP26: Sleep duration and risk of stroke mortality among Chinese adults in Singapore: the Singapore Chinese Health Study

Circulation ◽  
2014 ◽  
Vol 129 (suppl_1) ◽  
Author(s):  
An Pan ◽  
Jian-Min Yuan ◽  
Woon-Puay Koh
Keyword(s):  
Sleep Duration ◽  
Reference Group ◽  
Total Mortality ◽  
Health Study ◽  
Stroke Mortality ◽  
Chinese Adults ◽  
Short Sleep Duration ◽  
Increased Risk ◽  
Long Sleep ◽  
Singapore Chinese

Introduction: Short or long sleep hours are associated with adverse health outcomes, including diabetes, hypertension, coronary heart disease (CHD) and total mortality. However, the prospective relation between sleep duration and stroke risk is less studied, particularly in Asians. Thus, we assessed the hypothesis that short (≤5 hours) and long (≥9 hours) sleep durations were related to increased risk of stroke mortality among Chinese adults residing in Singapore. Methods: The Singapore Chinese Health Study is a population-based cohort that recruited 63,257 Chinese adults aged 45-74 years during 1993 and 1998. Sleep duration was assessed at baseline and categorized to five groups: ≤5, 6, 7, 8 or ≥9 hours. Death information was identified via registry linkage up to December 31, 2011, with ICD-9 codes 430-438 for all stroke deaths, 430-432 for hemorrhagic, and 433-438 for ischaemic or non-specified stroke deaths. Cox proportional hazard models were used to calculate hazard ratios (HRs) with adjustment for socio-demographic, lifestyle and comorbidities. Results: We documented 1,381 total stroke deaths (322 hemorrhagic and 1,059 ischaemic or non-specified strokes) during 926,752 person-years of follow-up. Compared to the reference group of sleeping for 7 hours, the multivariate-adjusted HR (95% confidence interval) for total stroke mortality was 1.25 (1.05-1.50) for ≤5 hours, 1.01 (0.87-1.18) for 6 hours, 1.09 (0.95-1.26) for 8 hours, and 1.54 (1.28-1.85) for ≥9 hours. The increased risk was also observed for ischaemic or non-specified stroke deaths with short (1.37; 1.12-1.68) and long (1.68; 1.36-2.06) sleep durations, but not for hemorrhagic stroke deaths (0.92 [0.62-1.36] and 1.14 [0.76-1.72], respectively). We observed significant interaction with baseline hypertension (P-interaction=0.04): positive association was found for short (1.54; 1.16-2.03) and long (1.95; 1.48-2.57) sleep durations among individuals with baseline hypertension, but not among those without baseline hypertension (1.07 [0.85-1.36] and 1.27 [0.98-1.63], respectively). Furthermore, in participants without baseline CHD/stroke, short and long sleep durations were related to an increased risk (HR 1.30 [1.07-1.57] and 1.43 [1.16-1.76], respectively); while in CHD/stroke patients, only long sleep duration was associated with an increased risk (2.34; 1.53-3.57), but not the short sleep duration (0.96; 0.57-1.62). Conclusions: In this large cohort study of Chinese adults, both short and long sleep durations were significantly associated with increased risks of stroke mortality. The associations were significant and stronger in hypertensive participants, but not in those without hypertension. Further studies are needed to confirm the interaction with hypertension and explore the mechanisms linking sleep quantity and stroke mortality.

Distribution of HOMA-IR in a population-based cohort and proposal for reference intervals

2021 ◽  
Vol 0 (0) ◽  
Author(s):  
Bassel Matli ◽  
Andreas Schulz ◽  
Thomas Koeck ◽  
Tanja Falter ◽  
Johannes Lotz ◽  
...  
Keyword(s):  
Insulin Resistance ◽  
Fasting Glucose ◽  
Reference Group ◽  
Reference Interval ◽  
Population Based ◽  
Reference Intervals ◽  
Health Study ◽  
Specific Reference ◽  
Model Assessment ◽  
Significant Difference

Abstract Objectives Insulin resistance (IR) is a hallmark of type 2 diabetes mellitus (DM). The homeostatic model assessment of insulin resistance (HOMA-IR) provides an estimate for IR from fasting glucose and insulin serum concentrations. The aim of this study was to obtain a reference interval for HOMA-IR for a specific insulin immunoassay. Methods The Gutenberg Health Study (GHS) is a population-based, prospective, single-center cohort study in Germany with 15,030 participants aged 35–74 years. Fasting glucose, insulin, and C-peptide were available in 10,340 participants. HOMA-IR was calculated in this group and three reference subgroups with increasingly more stringent inclusion criteria. Age- and sex-dependent distributions of HOMA-IR and reference intervals were obtained. In a substudy three insulin assays were compared and HOMA-IR estimated for each assay. Results Among the 10,340 participants analyzed there were 6,590 non-diabetic, 2,901 prediabetic, and 849 diabetic individuals. Median (interquartile range [IQR]) HOMA-IR was 1.54 (1.13/2.19), 2.00 (1.39/2.99), and 4.00 (2.52/6.51), respectively. The most stringently selected reference group consisted of 1,065 persons. Median (IQR) HOMA-IR was 1.09 (0.85/1.42) with no significant difference between men and women. The 97.5th percentile was 2.35. There was a non-significant trend towards higher values with older age. Comparison of three immunoassays for insulin showed an unsatisfactory correlation among the assays and systematic differences in calculated HOMA-IR. Conclusions We present HOMA-IR reference intervals for adults derived by more or less stringent selection criteria for the reference cohort. In addition we show that assay specific reference intervals for HOMA-IR are required.

scholarly journals Draft Genome Sequences of Potentially Pathogenic Clostridium perfringens Strains from Environmental Surface Water in the North West Province of South Africa

2019 ◽  
Vol 8 (32) ◽  
Author(s):  
Johannes Cornelius Jacobus Fourie ◽  
Tomasz J. Sanko ◽  
Cornelius Carlos Bezuidenhout ◽  
Charlotte Mienie ◽  
Rasheed Adegbola Adeleke
Keyword(s):  
South Africa ◽  
Surface Water ◽  
Clostridium Perfringens ◽  
Draft Genome ◽  
Anthropogenic Factors ◽  
Genome Sequences ◽  
Content Type ◽  
North West ◽  
The North ◽  
North West Province

Surface water systems in South Africa are experiencing a major decline in quality due to various anthropogenic factors. This poses a possible health risk for humans. Here, we present the draft genome sequences of three Clostridium perfringens isolates obtained from a fecally polluted river system in the North West province of South Africa.

scholarly journals Research priorities in regional anaesthesia education and training: an international Delphi consensus survey

BMJ Open ◽  
2019 ◽  
Vol 9 (6) ◽  
pp. e030376 ◽  
Author(s):  
Alwin Chuan ◽  
Reva Ramlogan
Keyword(s):  
Knowledge Translation ◽  
Curriculum Design ◽  
Regional Anaesthesia ◽  
Research Collaboration ◽  
Research Priorities ◽  
Education And Training ◽  
Delphi Consensus ◽  
Research Priority ◽  
American Society ◽  
And Training

ObjectivesEducation in regional anaesthesia covers several complex and diverse areas, from theoretical aspects to procedural skills, professional behaviours, simulation, curriculum design and assessment. The objectives of this study were to summarise these topics and to prioritise these topics in order of research importance.DesignElectronic structured Delphi questionnaire over three rounds.SettingInternational.Participants38 experts in regional anaesthesia education and training, identified through the American Society of Regional Anesthesia Education Special Interest Group research collaboration.Results82 topics were identified and ranked in order of prioritisation. Topics were categorised into themes of simulation, curriculum, knowledge translation, assessment of skills, research methodology, equipment and motor skills. Thirteen topics were ranked as essential research priority, with four topics each on simulation and curriculum, three topics on knowledge translation, and one topic each on methodology and assessment.ConclusionsResearchers and educators can use these identified topics to assist in planning and structuring their research and training in regional anaesthesia education.

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