Renée A. Street

Effects of Cd and Al stress on secondary metabolites, antioxidant and antibacterial activity of Hypoxis hemerocallidea Fisch. & C.A. Mey

This study investigated the effects of cadmium (Cd) and aluminium (Al) on the accumulation of phenolics, flavonoids and the bioactive compound hypoxoside in Hypoxis hemerocallidea. In addition, antioxidant scavenging and antibacterial activity were assessed to evaluate if Cd and Al stress affect the accumulation of bioactive compounds in H.xa0hemerocallidea. Inxa0vitro grown plantlets of H.xa0hemerocallidea were acclimatized for seven months in a greenhouse. Thereafter plants were exposed to various concentrations of Cd and Al both singularly and in combination in the form of Cd(NO3)2 (2, 5, 10xa0mg Cd/L); Al3(NO3)3 (500, 1000, 1500xa0mg Al/L) and combinations of Cd and Al (Cd 2:Al 500, Cd 5:Al 1000 and Cd 10:Al 1500xa0mg/L) for a further six weeks. The highest amounts of Cd and Al translocated to the shoot were 34 and 1608xa0mg/L respectively. Phytochemical screening showed significantly high amounts of total phenolics and flavonoids at the moderate Cd treatment (5xa0mg/L) compared to the controls. Exposure to Cd and Al significantly decreased the accumulation of hypoxoside. There was a significant increase in diphenylpicrylhydrazyl (DPPH) antioxidant scavenging activity in most of the metal-treated plants compared to the positive control ascorbic acid. Extracts from Cd 2xa0mg/L treatment exhibited moderate antibacterial activity against Staphylococcus aureus compared to the control. The results of the present study revealed that cultivating H.xa0hemerocallidea on metal contaminated soils affects the accumulation of the bioactive compound, hypoxoside.

The generational effect on age disparate partnerships and the risk for human immunodeficiency virus and sexually transmitted infections acquisition

In South Africa, a large proportion of young women are in age disparate relationships, which is believed to be a risk factor for human immunodeficiency virus (HIV). The aim of this study was to determine the generational effect of age disparity on HIV and sexually transmitted infection (STI) incidence. Socio-demographic and behavioural data were collected from women, aged 16 and older, who were followed for up to 24 months. Women who reported having a steady sexual partner older than themselves were categorised into: (1) non-age disparate partnerships (age difference between partners was 0–4 years); (2) intra-generational age disparate partnerships (5–9 year age gap between sexual partners); and (3) inter-generational age disparate partnerships (age gap of 10 years or more between sexual partners). Of the 1355 women included in the analysis, 759, 429 and 167 were in non-age disparate, intra-generational age disparate and inter-generational age disparate partnerships, respectively. Strong predictors of inter-generational age disparate partnerships include age, marital status and concurrency of sexual partners. No significant relationship between age disparity and risk of HIV acquisition was found. The highest crude STI incidence was observed among those in intra-generational age disparate relationships followed by those in non-age disparate relationships (31.86 [26.41–38.44] and 25.60 [21.92–29.91] per 100 person-years, respectively). Reduction of multiple partnerships remains key to HIV prevention; however, in light of partner concurrency being more prevalent than individual concurrency partnerships, female-initiated HIV prevention options remain critical.

Predictors of perceived male partner concurrency among women at risk for HIV and STI acquisition in Durban, South Africa

BackgroundWomen in sub-Saharan Africa continue to be at greater risk for HIV acquisition than men. Concurrency, viz. multiple sexual partnerships that overlap over time, has been studied as a possible risk factor for HIV transmission. The aim of this study was to identify predictors of perceived male partner concurrency among sexually active, HIV negative women.MethodsSocio-demographic and behavioural data from women enrolled in a biomedical HIV prevention clinical trial were assessed in relation to perceived male partner concurrency using the Chi squared test. Univariate and multivariate logistic regression was performed to assess the independent predictors of perceived male partner concurrency. Kaplan–Meier survival estimates were obtained for HIV and STI incidence in relation to male partner concurrency. A Cox Proportional Hazards model was used to assess the association between perceived male partner concurrency and HIV and STI incidence.ResultsThe results revealed that 29xa0% of women reported their male partners to be in concurrent sexual relationships, 22xa0% reported partners that were not engaging in concurrency, whilst 49xa0% reported not knowing their partners concurrency status. Older women, having never married, experiencing economic abuse, and women reporting individual concurrency, were found to be significant predictors of perceived male partner concurrency in the studied population. Perceived male partner concurrency was not found to be a significantly associated with incident HIV and STI infections in this analysis.ConclusionsThe study provides insight into predictors of perceived male partner concurrency among women at high risk for STI and HIV acquisition. These results may inform the design of behavioural and biomedical interventions, to address the role of multiple sexual partnerships in HIV prevention.

Unpacking the new proposed regulations for South African traditional health practitioners.

South Africa (SA) has legislation that regulates almost all of its healthcare systems. The Traditional Health Practitoners Act finally provides legitimisation of an overwhelmingly popular indigenous healthcare system. However, as a consequence of the legal acknowledgement of traditional health practitioners, traditional medicine products must now also be brought under regulatory measures. If traditional medicines are to be prescribed, marketed and sold as part of a healthcare system recognised under SA law, they must meet the same stringent standards.

Indoor Temperatures in Patient Waiting Rooms in Eight Rural Primary Health Care Centers in Northern South Africa and the Related Potential Risks to Human Health and Wellbeing

Increased temperatures affect human health and vulnerable groups including infants, children, the elderly and people with pre-existing diseases. In the southern African region climate models predict increases in ambient temperature twice that of the global average temperature increase. Poor ventilation and lack of air conditioning in primary health care clinics, where duration of waiting time may be as long as several hours, pose a possible threat to patients seeking primary health care. Drawing on information measured by temperature loggers installed in eight clinics in Giyani, Limpopo Province of South Africa, we were able to determine indoor temperatures of waiting rooms in eight rural primary health care facilities. Mean monthly temperature measurements inside the clinics were warmer during the summer months of December, January and February, and cooler during the autumn months of March, April and May. The highest mean monthly temperature of 31.4 ± 2.7 °C was recorded in one clinic during February 2016. Maximum daily indoor clinic temperatures exceeded 38 °C in some clinics. Indoor temperatures were compared to ambient (outdoor) temperatures and the mean difference between the two showed clinic waiting room temperatures were higher by 2–4 °C on average. Apparent temperature (AT) incorporating relative humidity readings made in the clinics showed ‘realfeel’ temperatures were >4 °C higher than measured indoor temperature, suggesting a feeling of ‘stuffiness’ and discomfort may have been experienced in the waiting room areas. During typical clinic operational hours of 8h00 to 16h00, mean ATs fell into temperature ranges associated with heat–health impact warning categories of ‘caution’ and ‘extreme caution’.

Ethnopharmacological use of potassium permanganate in South African traditional medicine

BACKGROUNDnPotassium permanganate (KMnO4), which is widely available, is often used by traditional health practitioners (THPs) in South Africa (SA) without taking its potentially harmful properties into account. The crystalline KMnO4 salt is sold at traditional medicine markets and shops throughout SA. However, to date, traditional uses of KMnO4 remain undocumented.nnnOBJECTIVEnTo describe KMnO4 use by THPs in KwaZulu-Natal, SA.nnnMETHODSnThis sub-study is part of a larger study investigating substances used in SA traditional medicine that are collectively known as imikhando in isiZulu - literally translated as ore. THPs (N=201) were interviewed in the local language (isiZulu) by trained interviewers. Information on the reasons for using/not using KMnO4, the source of information on its use and modes of administration were collected.nnnRESULTSnKMnO4 was used as a constituent of traditional medicine by 158 (79%) THPs. Their knowledge of KMnO4 use was acquired predominantly from fellow THPs (n=134; 85%). Reasons for use included skin rash or wounds (n=99, 63%) and to treat aches, pains and swelling (n=74; 47%). The main modes of administration were in the bath (n=94; 60%), orally (n=67; 42%) and in herbal compresses (n=66; 42%). The principal reason of the 43 THPs for not administering KMnO4 was not knowing how to use it (n=29; 71%).nnnCONCLUSIONSnThis study has identified traditional medicine users at risk of manganese toxicity owing to commonly used sociocultural practices. In particular, reports of oral ingestion and use in enemas are cause for concern. This public health issue needs regulatory measures and education programmes to enlighten the population against possible harm caused by KMnO4 exposure.

‘These people who dig roots in the forests cannot treat HIV’: Women and men in Durban, South Africa, reflect on traditional medicine and antiretroviral drugs

ABSTRACT Relatively few empirical investigations of the intersection of HIV biomedical and traditional medicine have been undertaken. As part of preliminary work for a longitudinal study investigating health-seeking behaviours among newly diagnosed individuals living with HIV, we conducted semi-structured interviews with 24 urban South Africans presenting for HIV testing or newly enrolled in HIV care; here we explored participants’ views on African traditional medicine (TM) and biomedical HIV treatment. Notions of acceptance/non-acceptance were more nuanced than dichotomous, with participants expressing views ranging from favourable to reproachful, often referring to stories they had heard from others rather than drawing from personal experience. Respect for antiretrovirals and biomedicine was evident, but indigenous beliefs, particularly about the role of ancestors in healing, were common. Many endorsed the use of herbal remedies, which often were not considered TM. Given people’s diverse health-seeking practices, biomedical providers need to recognise the cultural importance of traditional health practices and routinely initiate respectful discussion of TM use with patients.

Bibliometric trends of South African environmental health articles between 1998 and 2015: Making local research visible and retrievable

BACKGROUNDnSouth Africa (SA) has to grapple with multiple burdens of disease for which environmental factors have a role to play in both causation and prevention. This article describes a bibliometric review of environmental health indexed literature for SA over an 18-year period.nnnOBJECTIVESnTo provide an overview of the nature of SA-based published environmental health indexed research and to identify search challenges, frequently researched topics, and gaps and opportunities for future research.nnnMETHODSnThe Web of Science, PubMed and Science Direct were used to search for original, peer-reviewed and review articles with the inclusion criteria environmental health and South Africa available online and published between 1998 and 2015, inclusively.nnnRESULTSnA total of 230 journal articles were included in the bibliometric analysis. The highest number of articles (n=54) was published in 2015. The majority of the first authors were affiliated with SA institutions (n=160, 69.5%). For the articles where funding was explicitly declared (n=148), the three most frequently occurring agencies that funded the published research were the National Research Foundation in SA (n=17), the South African Medical Research Council (n=13) and the Water Research Commission (n=9). There was little inter-annual/environmental health category variation over time owing to the relatively small sample size. The largest number of retrieved journal articles was in the area of environmental pollution control (n=76), followed by environmental health lifestyle and behaviour-related topics (n=42) and then water monitoring (n=26).nnnCONCLUSIONSnDespite the research needed to solve large environmental health challenges in SA, environmental health was only used as a keyword in title, author keywords or abstract for 230 SA-based studies over an 18-year period. This makes it extremely difficult for environmental health research to be located and used to inform the profession as well as the research agenda. Several issues that environmental health practitioners are typically tasked to implement and monitor are not indexed as environmental health topics. The need for authors to use environmental health as a keyword is emphasised, particularly if research is to inform decision-making and policy support, as well as guide future research in the country.

0050 Working towards assessing occupational carcinogenic exposures in an african lower and middle income country

Aim We aim to use the Canadian CAREX (CARcinogen EXposure) tool, adapted for local context, as a method to assess prevalence and level of exposure to priority occupational carcinogens in South Africa. Methods The work entails first understanding the CAREX tool, and adapting it as well as reviewing its use in other countries (phase 1). Once the tool and database are prepared, we will gather publicly available data (i.e. Census data, information on chemical use, trade data, published and grey literature, expert consultation, etc.) on occupational exposure to carcinogens as well as exposure monitoring data (phase 2). We will consider all occupational health and safety legislation and its regulations regarding occupational exposure limits, and those carcinogens prioritised locally and internationally, for example by the International Agency for Research on Cancer. All data will be used to estimate the number of South African workers occupationally exposed to carcinogens (and where possible, their level of exposure) (phase 3). Ultimately, this will help guide the development of appropriate health promotion and worker protection programmes, among other resources aimed at cancer prevention (phase 4). Results Here we will present the experience of the team during phase 1 of the project, including challenges and opportunities encountered. Expected outcomes Key future outcomes include prevalence of exposure to occupational environmental carcinogens in the South African workplace; also proportions of the workforce in various occupational groups exposed to specific carcinogens; key occupational groups in need of protection; data and information that can be used to guide prevention programs.

Sun exposure, sun-related symptoms, and sun protection practices in an African informal traditional medicines market

Informal workers in African market trade have little formal protection against sun exposure. We aimed to examine sun exposure, sun-related symptoms, and sun protection practices in an informal occupational setting. Trained fieldworkers asked 236 workers in the Warwick Junction market about their workplace, skin and eye sensitivity and skin colour, symptoms faced at work during the summer due to heat, and preventive measures. Data were analyzed using univariate logistic regression to assess the effect of gender and the risk of experiencing symptoms to sun exposure in relation to pre-existing diseases and perception of sun exposure as a hazard. Of the 236 participants, 234 were Black African and 141 (59.7%) were female. Portable shade was the most commonly used form of sun protection (69.9%). Glare from the sun (59.7%) and excessive sweating (57.6%) were commonly reported sun-related health symptoms. The use of protective clothing was more prevalent among those who perceived sun exposure as a hazard (p = 0.003). In an informal occupational setting, sun exposure was high. Protective clothing and portable shade to eliminate heat and bright light were self-implemented. Action by local authorities to protect informal workers should consider sun exposure to support workers in their efforts to cope in hot weather.