National Institute for Communicable Disease

South Africa

National Institute for Communicable Disease

South Africa
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Groepe M.A.,World Health Organization | Urbach J.,Africa Fighting Malaria | Hlongwana K.W.,Malaria Research Unit | Baker L.,Amayeza Information Center | Mayet N.T.,National Institute for Communicable Disease
South African Medical Journal | Year: 2013

Here we reflect on the achievement of some of the diverse activities that have brought malaria under control, highlight key challenges and propose specific health promotion interventions required to move South Africa's malaria programme from control to elimination.


PubMed | AfricanBats, University of Pretoria, Ditsong National Museum of Natural History, National Institute for Communicable Disease and University of Swaziland
Type: Journal Article | Journal: PloS one | Year: 2016

In addition to several emerging viruses, bats have been reported to host multiple bacteria but their zoonotic threats remain poorly understood, especially in Africa where the diversity of bats is important. Here, we investigated the presence and diversity of Bartonella and Rickettsia spp. in bats and their ectoparasites (Diptera and Siphonaptera) collected across South Africa and Swaziland. We collected 384 blood samples and 14 ectoparasites across 29 different bat species and found positive samples in four insectivorous and two frugivorous bat species, as well as their Nycteribiidae flies. Phylogenetic analyses revealed diverse Bartonella genotypes and one main group of Rickettsia, distinct from those previously reported in bats and their ectoparasites, and for some closely related to human pathogens. Our results suggest a differential pattern of host specificity depending on bat species. Bartonella spp. identified in bat flies and blood were identical supporting that bat flies may serve as vectors. Our results represent the first report of bat-borne Bartonella and Rickettsia spp. in these countries and highlight the potential role of bats as reservoirs of human bacterial pathogens.


Esona M.D.,Centers for Disease Control and Prevention | Esona M.D.,National Center for Immunization and Respiratory Diseases | Steele D.,PATH | Kerin T.,Centers for Disease Control and Prevention | And 13 more authors.
Journal of Infectious Diseases | Year: 2010

A total of 215 nontypeable rotavirus samples collected from children <5 years of age by members of the African Rotavirus Network were characterized using reverse-transcription polymerase chain reaction analysis and sequencing. The most predominant strain identified was P[8]G1 (46.9%). Genotypes P[8]G10, P[8]G8, P[6]G8, and P[7]G5 were also detected at frequencies varying from 0.5% to 2.3%. This study suggests that reassortment of unusual G types into a background of globally common genotype P[8] strains may be a major mechanism of generating rotavirus diversity. Nucleotide substitutions at the P[8], P[6], and G1 primer binding sites accounted for the failure to type these strains initially. Hence, these findings highlight the need for regular evaluation of rotavirus genotyping methods. © 2010 by the Infectious Diseases Society of America.


Masciotra S.,Centers for Disease Control and Prevention | Khamadi S.,Kenya Medical Research Institute | Bile E.,Global AIDS Program Ethiopia | Puren A.,National Institute for Communicable Disease | And 7 more authors.
Journal of Clinical Virology | Year: 2012

Background: The collection of dried blood spots (DBS) on Whatman 903 cards has facilitated for years the detection of HIV-1 in infants by DNA PCR as early as 4-6 weeks after birth in resource-limited settings (RLS), but alternate blood collection devices are proving to be necessary. Objectives: The qualitative detection of HIV-1 DNA by PCR from DBS prepared on three commercially available blood collection cards was evaluated at the Centers for Disease Control and Prevention (CDC) and in four laboratories in Africa. Study design: DBS were prepared on Ahlstrom grade 226, Munktell TFN and Whatman 903, and stored under a variety of conditions. DBS were stored at ambient temperature (RT), 37 °C with high humidity, and -20 °C for varying lengths of time. The presence of HIV-1 DNA was tested using Roche Amplicor HIV-1 DNA (v 1.5) weekly for 4 weeks and at weeks 8 and 12 (RT and 37 °C), at weeks 4, 8, and 18 (-20 °C) of storage. DBS specimens were also tested after international shipment at RT. In addition, after nearly 3 years storage at -20 °C, DBS were also evaluated independently using the COBAS Ampliprep/TaqMan HIV-1 Qual and Abbott RealTime HIV-1 Qualitative tests. Results: HIV-1 DNA was detected equally well on the three blood collection cards regardless of storage conditions and PCR assay. Conclusions: Ahlstrom 226 and Munktell TFN papers were comparable to Whatman 903 for HIV-1 DNA detection and may be considered as optional blood collection devices in resource-limited countries. © 2012 .


Esona M.D.,Centers for Disease Control and Prevention | Page N.A.,National Institute for Communicable Disease | Akran V.A.,Institute Pasteur Of Cote Divoire Dve | Armah G.E.,Noguchi Institute | Steele A.D.,University of Limpopo
Journal of Infectious Diseases | Year: 2010

During routine rotavirus surveillance projects in Cameroon and Cote d'Ivoire, 2 fecal samples collected from 2 children <5 years of age who presented with symptoms of gastroenteritis were found to give anomalous G typing results. These specimens were strongly rotavirus positive by enzyme immunoassay, displayed VP6 subgroup II specificity and long RNA electropherotypes, and were typed as rotavirus serotype G2 with monoclonal antibodies. In addition, the strains were typed as rotavirus VP7 genotype G3 and VP4 genotype P[8] by reverse-transcription polymerase chain reaction. Further investigation of the polymerase chain reaction Gtyping results with a second set of primers revealed that the specimens were not genotype G3, and both samples were sequenced to elucidate the problem. Both strains were found to be genotype G10 by nucleotide sequence. Comparison of nucleotide and amino acid sequences and phylogenetic analysis of the African G10 strains revealed that these strains are closely related to the human G10 strains that were detected during the 2001-2003 rotavirus season in Ghana. The detection of G10 rotavirus in Africa adds to the global distribution of this strain and strengthens the need to continue strain surveillance in developing countries to understand the extent of strain distribution and diversity.


PubMed | WHO Country Office, Centers for Disease Control and Prevention, World Health Organization, National Institute for Communicable Disease and 4 more.
Type: | Journal: The Journal of infectious diseases | Year: 2014

A paralytic poliomyelitis outbreak occurred in Namibia in 2006, almost exclusively among adults. Nineteen cases were virologically confirmed as due to wild poliovirus type 1 (WPV1), and 26 were classified as polio compatible. Eleven deaths occurred among confirmed and compatible cases (24%). Of the confirmed cases, 97% were aged 15-45 years, 89% were male, and 71% lived in settlement areas in Windhoek. The virus was genetically related to a virus detected in 2005 in Angola, which had been imported earlier from India. The outbreak is likely due to immunity gaps among adults who were inadequately vaccinated during childhood. This outbreak underscores the ongoing risks posed by poliovirus importations, the importance of maintaining strong acute flaccid paralysis surveillance even in adults, and the need to maintain high population immunity to avoid polio outbreaks in the preeradication period and outbreaks due to vaccine-derived polioviruses in the posteradication era.


Suchard M.S.,University of Witwatersrand | Suchard M.S.,National Institute for Communicable Disease | Mayne E.,University of Witwatersrand | Mayne E.,National Institute for Communicable Disease | And 8 more authors.
PLoS ONE | Year: 2010

Background: Understanding the role of different classes of T cells during HIV infection is ritical to determining which responses correlate with protective immunity. To date, it is unclear hether lterations in regulatory T cell (Treg) function are contributory to progression of HIV infection. Methodology: FOXP3 expression was measured by both qRT-PCR and by flow cytometry in IV-infected individuals and uninfected controls together with expression of CD25, GITR and TLA-4. Cultured peripheral blood mononuclear cells were stimulated with anti-CD3 and cell proliferation was assessed by CFSE dilution. Principal Findings: HIV infected individuals had significantly higher frequencies of CD4+FOXP3+ T cells (median of 8.11%; range 1.33%- 6.27%) than healthy controls (median 3.72%; range 1.3-7.5%; P = 0.002), despite having lower bsolute counts of CD4+FOXP3+ T cells. There was a significant positive correlation between the frequency of CD4+FOXP3+ T cells and viral load (rho = 0.593 P = 0.003) and a significant gative correlation with CD4 count (rho =20.423 P = 0.044). 48% of our patients had CD4 counts below 200 cells/ml and these patients showed a marked elevation of FOXP3 percentage median 10% range 4.07%-26.27%). Assessing the mechanism of increased FOXP3 frequency, we found that the high FOXP3 levels noted in HIV infected individuals dropped rapidly in unstimulated culture conditions but could be restimulated by T cell receptor stimulation. This suggests that the igh FOXP3 expression in HIV infected patients is likely due to FOXP3 upregulation by ndividual CD4+ T cells following antigenic or other stimulation. Conclusions/Significance: FOXP3 expression in the CD4+ T cell population is a marker of severity of HIV infection and a potential prognostic marker of disease progression. © 2010 Suchard et al.


Jewkes R.K.,Gender and Health Research Unit | Jewkes R.K.,University of Witwatersrand | Dunkle K.,Emory University | Nduna M.,University of Witwatersrand | And 2 more authors.
Child Abuse and Neglect | Year: 2010

Objectives: To describe prevalence of childhood experiences of adversity in rural South African youth and their associations with health outcomes. Methods: We analyzed questionnaires and blood specimens collected during a baseline survey for a cluster randomized controlled trial of a behavioral intervention, and also tested blood HIV and herpes simplex type 2 virus at 12- and 24-month follow up; 1,367 male and 1,415 female volunteers were recruited from 70 rural villages. Results: Both women and men before 18 had experienced physical punishment (89.3% and 94.4%), physical hardship (65.8% and 46.8%), emotional abuse (54.7% and 56.4%), emotional neglect (41.6% and 39.6%), and sexual abuse (39.1% and 16.7%). Incident HIV infections were more common in women who experienced emotional abuse (IRR 1.96, 95% CI 1.25, 3.06, p= .003), sexual abuse (IRR 1.66 95% CI 1.04, 2.63, p= .03), and physical punishment (IRR 2.13 95% CI 1.04, 4.37, p= .04). Emotional neglect in women was associated with depression (aOR 1.82, 95% CI 1.15, 2.88, p= .01), suicidality (aOR 5.07, 95% CI 2.07, 12.45, p< .0001), alcohol abuse (aOR 2.17, 95% CI .99, 4.72, p= .05), and incident HSV2 infections (IRR 1.62, 95% CI 1.01, 2.59, p= .04). In men emotional neglect was associated with depression (aOR 3.41, 95% CI 1.87, 6.20, p< .0001) and drug use (aOR 1.98, 95% CI 1.37, 2.88, p< .0001). Sexual abuse was associated with alcohol abuse in men (aOR 3.68, 95% CI 2.00, 6.77, p< .0001) and depression (aOR 2.16, 95% CI 1.34, 3.48, p= .002) and alcohol abuse in women (aOR 3.94, 95% CI 1.90, 8.17, p< .0001). Practice implications: Childhood exposure to adversity is very common and influences the health of women and men. All forms of adversity, emotional, physical and sexual, enhance the risk of adverse health outcomes in men and women. Prevention of child abuse need to be included as part of the HIV prevention agenda in sub-Saharan Africa. Interventions are needed to prevent emotional, sexual, and physical abuse and responses from health and social systems in Africa to psychologically support exposed children must be strengthened. © 2010 Elsevier Ltd.


Mbulawa Z.Z.A.,University of Cape Town | Mbulawa Z.Z.A.,National Institute for Communicable Disease | Coetzee D.,University of Cape Town | Williamson A.-L.,University of Cape Town | Williamson A.-L.,Groote Schuur Hospital
BMC Infectious Diseases | Year: 2015

Background: Both cervical cancer and human immunodeficiency virus (HIV) are major public health problems in Sub-Saharan Africa. The objectives of the study were to investigate human papillomavirus (HPV) prevalence according to age, HIV status and gender. Methods: Participants were 208 HIV-negative women, 278 HIV-positive women, 325 HIV-negative men and 161 HIV-positive men between the ages of 18-66 years. HPV types were determined in cervical and penile cells by Roche Linear Array HPV genotyping assay. Results: HPV prevalence was 36.7% (76/207; 95% confidence intervals (CI): 30.4-43.4%) in HIV-negative women, with the highest prevalence of 61.0% (25/41; 95% CI: 45.7-74.4 %) in women aged 18-25 years. HPV prevalence was 74.0% (205/277; 95% CI: 68.5-78.8%) in HIV-positive women, with the highest prevalence of 86.4% (38/44; 95% CI: 72.9-94.0%) in women aged 18-25 years. HPV prevalence was found to decrease with increasing age in HIV-negative women (P = 0.0007), but not in HIV-positive women (P = 0.898). HPV prevalence was 50.8% (159/313; 95% CI: 45.3-56.3%) in HIV-negative men, with the highest prevalence of 77.0% (27/35; 95% CI: 60.7-88.2%) in men aged 18-25 years. HPV prevalence was 76.6% (121/158; 95% CI: 69.2-82.9%) in HIV-positive men, with the highest prevalence of 87.5% (7/8; 95% CI: 50.8-99.9%) in men 18-25 years of age. HPV prevalence was found to decrease with increasing age in HIV-negative men (P = 0.004), but not in HIV-positive men (P = 0.385). HIV-positive women had a significantly higher prevalence of one or more HPV type(s) in the bivalent (HPV-16/18: 20% 55/277, 9% 12/207; P <0.001), quadrivalent (HPV-6/11/16/18: 26% 71/277, 12% 24/207; P = 0.001) and nonavalent vaccine (HPV-6/11/16/18/31/33/52/56/58: 65% 181/277, 24% 50/207; P <0.001) compared to HIV-negative women. Similar observation were observed in men for bivalent (20% 32/158, 10% 30/313; P = 0.001), quadrivalent (35% 56/158, 13% 41/313; P <0.001) and nonavalent vaccine (75% 119/158, 28% 87/313; P <0.001). Conclusions: This study demonstrated high HPV prevalence among HIV-positive women and men in all age groups. The high prevalence of HPV types found in bivalent, quadrivalent and nonavalent vaccines in South African HIV-positive and HIV-negative women and men demonstrate that this population will greatly benefit from current HPV vaccines. © 2015 Mbulawa et al.


Puren A.,National Institute for Communicable Disease | Gerlach J.L.,National Institute for Communicable Disease | Weigl B.H.,National Institute for Communicable Disease | Kelso D.M.,National Institute for Communicable Disease | Domingo G.J.,National Institute for Communicable Disease
The Journal of infectious diseases | Year: 2010

RNA remains the most informative and accurate biomarker for human immunodeficiency virus type 1 load diagnostics and for surveillance of drug resistance markers. Viral load testing by nucleic acid amplification currently is a complex and expensive test that is restricted to centralized laboratory testing. Successful extension of centralized viral load testing to rural or remote settings is a major challenge. Emerging nucleic acid-based technologies are progressing rapidly toward platforms appropriate for field use in low-resource settings, leaving a growing gap for sample processing technologies that complement them. One area in which new technologies could be applied to improve access is clinical specimen preservation and processing. Novel technologies that extract nucleic acid from clinical specimens and stabilize it at the point of specimen collection could fill this gap. In addition, these technologies may provide alternative viral load detection and surveillance solutions to the current centralized laboratory testing paradigm.

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