Browsing by Author "Hlela, Carol"

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    Cost-effectiveness analysis of introducing HTLV-1 testing in South Africa
    (BioMed Central Ltd, 2015) Sykes, Wendy; Coleman, Charl; Beck, Genevieve; Mhlanga, Jabu; Hlela, Carol; Custer, Brian; Murphy, Edward; Vermeulen, Marion
    We have previously reported a 2013 cross-sectional study of HTLV prevalence among 46,765 South African blood donors. Confirmed HTLV-1 prevalence was 0.16% in Black donors, 0.02% in both White and Coloured donors and 0% in south Asian donors, for an overall prevalence of 0.062% extrapolated to the current blood donor population. Using these data we estimated the cost effectiveness of potential HTLV screening strategies in preventing transfusion transmitted HTLV-1 infection (TTI). Five blood donor screening strategies were considered: no screening; HTLV testing of every donation; HTLV testing each donor one time only; HTLV testing of new donors only; and universal filter leukodepletion without HTLV testing.
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    Human T cell lymphotropic virus type 1- associated infective dermatitis in KwaZulu Natal, South Africa
    (BioMed Central Ltd, 2013) Hlela, Carol; Graham, Natalie; Bhigjee, Ahmed; Taylor, Graham; Khumalo, Nonhlanhla; Mosam, Anisa
    BACKGROUND: The Human T cell lymphotropic virus type 1 (HTLV-1)-associated infective dermatitis (IDH), is a chronic relapsing dermatitis which usually presents in children older than 2years. A total of 300 cases have been reported worldwide (Latin America, the Caribbean and only 5 from Senegal). Neither IDH, nor its complications have been reported from the rest of Africa. We aimed to examine the clinical and aetiological characteristics of IDH in a cohort of South African children. METHODS: Attendees at the dermatology clinic at King Edward VIII Hospital, Durban underwent clinical examination. After obtaining consent those suspected of IDH had specimens taken for blood counts, immunoglobulins, serum protein electrophoresis, viral studies (including genotyping), skin swabs and stool examinations. RESULTS: Nineteen of 60 suspected cases recruited over 3years met the diagnostic criteria for IDH. The male-to-female ratio was 1:2; mean age 8years (range 0.7 to 15). Dermatitis mostly affected the scalp (78.9%) and axilla (73.7%); fewer children had nasal crusting (47.4%). Mean Ig A, IgG and IgM were raised, at 3.52g/l, 22.6g/l and 1.38g/l, respectively. The median CD4 cell count was 1958 cells/mm3. Viral genotyping of all tested samples were positive for the Cosmopolitan, Subtype A (HTLV-1a). CONCLUSIONS: IDH is a distinct entity which also affects South Africans. Our patients were older at presentation and the majority did not present with nasal crusting as has been described in other countries.
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    Molecular epidemiology of Staphylococcus aureus in African children from rural and urban communities with atopic dermatitis
    (2021-04-13) Ndhlovu, Gillian O N; Abotsi, Regina E; Shittu, Adebayo O; Abdulgader, Shima M; Jamrozy, Dorota; Dupont, Christopher L; Mankahla, Avumile; Nicol, Mark P; Hlela, Carol; Levin, Michael E; Lunjani, Nonhlanhla; Dube, Felix S
    Abstract Background Staphylococcus aureus has been associated with the exacerbation and severity of atopic dermatitis (AD). Studies have not investigated the colonisation dynamics of S. aureus lineages in African toddlers with AD. We determined the prevalence and population structure of S. aureus in toddlers with and without AD from rural and urban South African settings. Methods We conducted a study of AD-affected and non-atopic AmaXhosa toddlers from rural Umtata and urban Cape Town, South Africa. S. aureus was screened from skin and nasal specimens using established microbiological methods and clonal lineages were determined by spa typing. Logistic regression analyses were employed to assess risk factors associated with S. aureus colonisation. Results S. aureus colonisation was higher in cases compared to controls independent of geographic location (54% vs. 13%, p < 0.001 and 70% vs. 35%, p = 0.005 in Umtata [rural] and Cape Town [urban], respectively). Severe AD was associated with higher colonisation compared with moderate AD (86% vs. 52%, p = 0.015) among urban cases. Having AD was associated with colonisation in both rural (odds ratio [OR] 7.54, 95% CI 2.92–19.47) and urban (OR 4.2, 95% CI 1.57–11.2) toddlers. In rural toddlers, living in an electrified house that uses gas (OR 4.08, 95% CI 1.59–10.44) or utilises kerosene and paraffin (OR 2.88, 95% CI 1.22–6.77) for heating and cooking were associated with increased S. aureus colonisation. However, exposure to farm animals (OR 0.3, 95% CI 0.11–0.83) as well as living in a house that uses wood and coal (OR 0.14, 95% CI 0.04–0.49) or outdoor fire (OR 0.31, 95% CI 0.13–0.73) were protective. Spa types t174 and t1476, and t272 and t1476 were dominant among urban and rural cases, respectively, but no main spa type was observed among controls, independent of geographic location. In urban cases, spa type t002 and t442 isolates were only identified in severe AD, t174 was more frequent in moderate AD, and t1476 in severe AD. Conclusion The strain genotype of S. aureus differed by AD phenotypes and rural-urban settings. Continued surveillance of colonising S. aureus lineages is key in understanding alterations in skin microbial composition associated with AD pathogenesis and exacerbation.