AA 2005 Supplementum 1

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Browsing AA 2005 Supplementum 1 by Author "Rigouts, Leen"

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    Challenges to effective control of tuberculosis and drug resistance in African countries
    (University of the Free State, 2005) Rigouts, Leen; Portaels, Francois
    English: Drug-resistant tuberculosis (TB) appeared soon after the introduction of chemotherapy and is considered a man-made phenomenon. Despite the efficacy of short course chemotherapy, which includes a cocktail of drugs and has been generally recommended since the 1960s, increasing numbers of multi-drug-resistant (MDR) cases were reported worldwide in the early 1990s. In the WHO’s 2004 report on surveillance of drug-resistant TB, MDRTB is reported from over 100 countries. Although little data is available on drug-resistant TB in Africa, this paper presents an overview of the current situation on the African continent, which is severely affected by the TB epidemic.
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    DNA fingerprinting analyses of M tuberculosis-complex isolates from the Free State, South Africa, as part of a multidisciplinary study
    (University of the Free State, 2005) Van der Spoel-van Dijk, Anneke; Mokhethi, Zac; Khumalo, Macala; Shamputa, Choala; Matebesi, Zacheus; Van Rensburg, Dingie; Portaels, Françoise; Rigouts, Leen
    English: The objective of this study was to serve as a complement to socio-economic analyses of TB patients in a DOTS system, providing microbiological data and documenting the TB population dynamics. Sputum samples were collected from smear-positive TB patients in the Goldfields, Thaba Nchu and Qwaqwa areas. Laboratory analyses comprised the culturing of Mycobacterium tuberculosis isolates and DNA fingerprinting. The primary aim was hampered by problems encountered during specimen sampling, inadequate resources, and a low culture-positivity rate. Nevertheless, the fingerprinting data of a random sample showed a heterogenous TB population, suggesting that reactivation might be an important factor in the area studied. Clustering was the highest in the mining area. Preliminary data from serial isolates also detected possible re-infection during treatment or initial mixed infections in five of the eleven patients.
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    High strain diversity among isoniazid-resistant M tuberculosis isolates from the Free State and Northern Cape provinces
    (University of the Free State, 2005) Mokhethi, Zac; Van der Spoel-Van Dijk, Anneke; Van der Zanden, Adri; Rigouts, Leen
    English: This study set out to determine the diversity of the isoniazid-resistant M tuberculosis isolates causing pulmonary tuberculosis in the Free State and Northern Cape provinces of South Africa. Thirty-seven isoniazid-resistant isolates from a nation-wide survey could be fingerprinted by IS6110-based RFLP. Spoligotyping and MIRU-VNTR typing were performed to confirm inconclusive results. The number of IS6110 copies per isolate varied from 2 to 18, with nine (24.3%) isolates harbouring five insertions or fewer. Nine (24.3%) of 37 cases grouped into four RFLP-clusters. The clustered isolates with fewer than five IS6110 copies were all shown to be different when subjected to spoligotyping and MIRU-VNTR typing, whereas the clustering of the high-copy isolates was confirmed. The high degree of diversity among H-resistant isolates in the Free State suggests a low recent transmission rate, but this should be investigated by long-term analyses. For the Northern Cape province, representative sampling is needed before proper conclusions can be drawn.
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    Social capital and community TB care in the Free State, South Africa
    (University of the Free State, 2005) Meulemans, Herman; Van Ouytsel, Jeff; Rigouts, Leen; Mortelmans, Dimitri; Heunis, Christo; Matebesi, Zacheus; Van Rensburg, Dingie
    English: Where do TB patients turn for help in the South African health care system? Do they go to a clinic or a community health centre for ambulant treatment, thus retaining contact with their families and local communities? Or are they hospitalised, which means that they can no longer perform their normal duties? In order to answer these questions, a data set was compiled on the basis of oral interviews with a stratified random sample of 310 pulmonary TB patients in the Free State province. A logistic regression analysis of the data revealed that TB patients who can rely on an extended network of relationships, with relatively large amounts of social capital at their disposal, generally make use of clinic treatment and community TB care. Clinics play a central role in TB control programmes, not only as a locus of treatment, but also as a point from which patients can be referred to higher echelons in the healthcare system.