Browsing by Subject "vaccination"

Now showing 1 - 6 of 6
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    A pilot school health service in southwestern Swaziland, 1961, 62, 63
    (1965) Laufer, Walter Ernst
    Swaziland is a British Protectorate of approximately 6,700 square miles. It is a subtropical country, border in the East by Mozambique and in the North, West and South by the Transvaal. There are approximately 270,000 Africans and 10,000 persons of other races living in the Territory. The country is divided into Highveld, Middleveld and Lowveld regions. The work described here was carried out in the South Western highveld. This is mountainous terrain, with an approximate altitude of 3,500 feet and an annual rainfall of about 30". The terrain is a succession of mountains and valleys, with several perennial streams and rivers coursing through it. The climate is variable, with hot summers and cold winters, with rainfall predominantly in the summer. Large man made forests are scattered throughout the area, and there is some cutting and processing of timber, but industries as such are not found in that part of the Territory.
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    A retrospective study of patients with biologics treatment at Groote Schuur and Red Cross Children's War Memorial Hospitals
    (2020) Ahmed, Mohammed Awad Eltoum; Hodkinson, Bridget; Gcelu, Ayanda
    Introduction. The high cost and concern of adverse events, particularly infections, limit the use of biologic disease-modifying anti-rheumatic (bDMARD) therapies. We undertook this retrospective study to document their use for immune-mediated diseases (IMDs) and explore the efficacy, safety, adherence and screening practices prior to initiating bDMARDs in a tertiary referral hospital. Methods. A folder review of all adult and paediatric patients treated for IMDs with bDMARDs at Groote Schuur and Red Cross Hospitals between January 2013 and December 2019. Clinico-demographic particulars, details of bDMARD therapy, and adverse events were collated. Changes in disease activity were measured by diseasespecific tools at 6, 12, 24-months and at the last available visit, and patient adherence to bDMARDs was explored by folder and pharmacy record review. Results. We studied 151 folders, with 182 bDMARDs uses (29 patients used more than 1 bDMARD). Patients were from rheumatology (n= 38: 13 rheumatoid arthritis; 10 spondyloarthritis, 5 Systemic Lupus Erythematosus (SLE) , 5 inflammatory myositis and 5 other conditions); gastroenterology (n=31; 26 Crohn`s and 5 Ulcerative Colitis), dermatology (n=9; psoriasis), neurology (n=4, ophthalmology (n= 25; 6 scleritis, 18 uveitis, 1 optic neuritis), and paediatrics (n= 45, 26 juvenile idiopathic arthritis , 12 SLE, 7 other conditions). The bDMARDs used were TNF inhibitors (112), rituximab (55), tocilizumab (10), anakinra (3), abatacept (1), and tofacitinib (1). The vast majority of patients had an excellent response and were in low disease activity or remission at their last available visit. Adverse events included severe infection (4), tuberculosis (TB) (2), mild infection (4), severe allergic reaction (3), mild skin reaction (14), elevated liver enzymes (2), and worsening interstitial lung disease ILD (1). bDMARD Therapy was discontinued in 18 patients, most commonly due to adverse reaction (9), lack of response (3), poor adherence (2), or remission (1). bDMARD Therapy was changed to alternative therapy in 29 patients, most commonly because of poor response (14), or adverse effects (9) or poor adherence (3). Poor adherence or patients lost to follow-up was noted in 18/182 (9.9%). Complete latent TB infection screening with chest x-ray and TB skin test was performed in only 55 (36.4 %) but INH prophylaxis was given to 51/88 (57.9%) of patients prescribed TNFi therapy. Hepatitis B screening performed in 93 (61.6 %) patients, but most patients (72.2 %) were not tested for Hepatitis B core ab. Hepatitis C screening was performed in 81 (53.6 %) patients. Only 88 (58.3%) patients had a recent HIV test. The majority (17.2%) received the influenza vaccine, but only 24 (15.8 %) received pneumococcal vaccination. Discussion and Conclusion. bDMARD therapy was an effective treatment, and the most common adverse effect was infection (7.2%), with 2 TB infections. Vaccination and screening for TB, viral hepatitis and HIV was suboptimal. Of concern, poor adherence to bDMARDs was frequently encountered.
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    Calling the shots on vaccination: when is the state justified in overturning a refusal to vaccinate?
    Blignaut, Jessica; Anne Pope
    Public perceptions of vaccination have changed greatly since George Bernard Shaw unleashed his diatribe against the practice. Today it is recognised that, far from spreading disease, vaccination is one of the cheapest and most effective public health interventions. Immunization against infectious diseases has drastically reduced mortality and morbidity, particularly among children, and has diminished the disease burden caused by poliomyelitis, rubella, measles, tetanus, diphtheria, and whooping cough, amongst others. By one estimation, paediatric immunization worldwide prevents approximately 3 million child deaths each year, and saves 750 000 more from disability.
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    Congenital rubella: Is it nearly time to take action?
    (Health and Medical Publishing Group, 2012) Boshoff, L; Tooke, L
    Congenital rubella syndrome (CRS) is a rare but potentially debilitating disease with lifelong consequences. Although there is no cure, it is almost completely preventable by an effective immunisation programme. We present two confirmed cases of CRS diagnosed in the neonatal unit at Groote Schuur Hospital in 2011 and discuss aspects of the disease and its prevention.
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    Global Disparities in Hepatitis B Elimination—A Focus on Africa
    (2022-01-03) Sonderup, Mark W.; Spearman, C. Wendy
    In 2016, WHO member states at the World Health Assembly adopted a Global Health Sector Strategy that included a policy of eliminating viral hepatitis. Clear targets were established to assist in achieving this by 2030. The strategy, while achievable, has exposed existing global disparities in healthcare systems and their ability to implement such policies. Compounding this, the regions with most disparity are also those where the hepatitis B prevalence and disease burden are the greatest. Foundational to hepatitis B elimination is the identification of both those with chronic infection and crucially pregnant women, and primary prevention through vaccination. Vaccination, including the birth dose and full three-dose coverage, is key, but complete mother-to-child transmission prevention includes reducing the maternal hepatitis B viral load in the third trimester where appropriate. Innovations and simplified tools exist in order to achieve elimination, but what is desperately required is the will to implement these strategies through the support of appropriate investment and funding. Without this, disparities will continue.
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    High uptake of Gardasil vaccine among 9 - 12-year-old schoolgirls participating in an HPV vaccination demonstration project in KwaZulu-Natal Province
    (2013) Moodley, Indres; Mubaiwa, V; Tathiah, N; Denny, L
    Background. Cervical cancer is linked to infection of the cervix by oncogenic human papillomavirus (HPV) subtypes. The quadrivalent Gardasil vaccine (against HPV types 6, 11, 16, 18), recommended in girls 9 - 12 years of age, has been shown to be safe, immunogenic and efficacious, with minimal or no side-effects. Aim. To demonstrate the capacity of school health teams to carry out vaccinations within a school environment. Objectives. To assess the uptake of 3 doses of the vaccine, document lessons learnt and provide recommendations for a national rollout of school-based HPV vaccination for learners. Methods. Female learners (age 9 - 12 years) from 31 primary schools in Nongoma and Ceza districts (KwaZulu-Natal province, South Africa) were identified for inclusion in the vaccination programme. The 3 doses of vaccine were administered by existing school health teams. Education and training sessions were held with all stakeholders: provincial departments of health and education; school health teams; primary healthcare nurses; hospital doctors and nurses; private practitioners; school principals, teachers and governing bodies; parents; and community and traditional leaders. Results. The overall uptake of the vaccine was found to be high: 99.7%, 97.9% and 97.8% for the first, second and third doses respectively (N=963). No adverse events were attributed to the HPV vaccine. Conclusion. This project demonstrated the successful implementation of HPV vaccination among learners (ages 9 - 12 years) using school health teams.