Recent Submissions
Item Open Access South African women's perspectives on self-sampling for cervical cancer screening: A mixed-methods study(South African Medical Journal (SAMJ), 2018-12-13)Background: Self-sampling as a method of screening for cervical cancer and its precursors is an attractive option for low-resource settings. However, to allow successful integration of self-sampling into national screening programmes, it is necessary to understand women's perceptions and beliefs surrounding this method of sampling the cervix. Objectives: To explore women's attitudes to self-collection of samples for cervical screening in a low-resource setting in South Africa (SA). Methods: Mixed methods were used to meet the study objectives. We recruited women aged 30 - 65 years into a study in Cape Town, SA, to participate in a cross-sectional survey. All women collected a vaginal self-sample, and underwent visual inspection with acetic acid, colposcopy, and collection of cervical samples and appropriate histology specimens by a doctor. Women had a quantitative questionnaire-based exit interview. A subset of these women participated in focus group discussions (FGDs). Results: A total of 822 women answered the exit survey questionnaire and 41 women participated in the FGDs. Most women from the survey had a positive perception of self-sampling, with 93.6% of the women reporting not feeling embarrassed and 89.4% reporting experiencing no discomfort at all when taking a self-sample. This was corroborated by the FGD participants, who found self-sampling easier, more comfortable and less embarrassing than clinician sampling. However, many women (64.7%) felt more confident when the sample was taken by a clinician, despite having a positive attitude towards self-sampling. In most cases this was because they thought that the clinician would take a better sample, as explained by the FGD participants. Although 93.9% of the women were willing to collect a self-sample, the women in the FGDs expressed a preference for doing so at the health facility rather than at home. There were many reasons for this, including the cost of returning to the clinic with the sample. Conclusions: Attitudes regarding self-sample collection were positive in this study population. Participants were willing to perform self-sampling, but expressed concerns regarding the quality of the specimen and the financial implications of returning to the clinic with it. Pilot implementation studies will be useful before this method of sampling is adopted and integrated into screening programmes.Item Open Access Taking stock of 10 years of published research on the ASHA programme: Examining India's national community health worker programme from a health systems perspective(BMC, 2019-03-25)Background: As India's accredited social health activist (ASHA) community health worker (CHW) programme enters its second decade, we take stock of the research undertaken and whether it examines the health systems interfaces required to sustain the programme at scale. Methods: We systematically searched three databases for articles on ASHAs published between 2005 and 2016. Articles that met the inclusion criteria underwent analysis using an inductive CHW-health systems interface framework. Results: A total of 122 academic articles were identified (56 quantitative, 29 mixed methods, 28 qualitative, and 9 commentary or synthesis); 44 articles reported on special interventions and 78 on the routine ASHA program. Findings on special interventions were overwhelmingly positive, with few negative or mixed results. In contrast, 55% of articles on the routine ASHA programme showed mixed findings and 23% negative, with few indicating overall positive findings, reflecting broader system constraints. Over half the articles had a health system perspective, including almost all those on general ASHA work, but only a third of those with a health condition focus. The most extensively researched health systems topics were ASHA performance, training and capacity-building, with very little research done on programme financing and reporting, ASHA grievance redressal or peer communication. Research tended to be descriptive, with fewer influence, explanatory or exploratory articles, and no predictive or emancipatory studies. Indian institutions and authors led and partnered on most of the research, wrote all the critical commentaries, and published more studies with negative results. Conclusion: Published work on ASHAs highlights a range of small-scale innovations, but also showcases the challenges faced by a programme at massive scale, situated in the broader health system. As the programme continues to evolve, critical comparative research that constructively feeds back into programme reforms is needed, particularly related to governance, intersectoral linkages, ASHA solidarity, and community capacity to provide support and oversight.Item Open Access Dihydroartemisinin inhibits prostate cancer via JARID2/miR-7/miR-34a-dependent downregulation of Axl(Springer Nature, 2019-02-19)Axl expression is deregulated in several cancer types, predicts poor overall patient survival and is linked to resistance to drug therapy. Here, we evaluated a library of natural compounds for inhibitors of Axl and identified dihydroartemisinin, the active principle of the anti-malarial drug artemisinin, as an Axl-inhibitor in prostate cancer. Dihydroartemisinin blocks Axl expression leading to apoptosis, decrease in cell proliferation, migration, and tumor development of prostate cancer cells. Dihydroartemisinin treatment synergizes with docetaxel, a standard of care in metastatic prostate cancer increasing overall survival of mice with human xenografts. Dihydroartemisinin control of miR-34a and miR-7 expression leads to inhibition of Axl expression in a process at least partially dependent on regulation of chromatin via methylation of histone H3 lysine 27 residues by Jumonji, AT-rich interaction domain containing 2 (JARID2), and the enhancer of zeste homolog 2. Our discovery of a previously unidentified miR-34a/miR-7/JARID2 pathway controlling dihydroartemisinin effects on Axl expression and inhibition of cancer cell proliferation, migration, invasion, and tumor formation provides new molecular mechanistic insights into dihydroartemisinin anticancer effect on prostate cancer with potential therapeutic implications.Item Open Access Metal-resistance encoding gene-fingerprints in some bacteria isolated from wastewaters of selected printeries in Ibadan, South-western Nigeria(Taylor & Francis, 2019-1-4)Several studies have reported the occurrence of metal-resistant bacteria and their genes in different wastewater, but there is a dearth of information on wastewater generated from printing operations as a probable source. This study aimed at fingerprinting metal-resistance encoding genes in bacteria recovered from wastewaters of selected printeries in Ibadan, Nigeria. Wastewaters from 10 selected printeries in Ibadan were collected monthly for 12 months. The metal composition of wastewater was determined using Atomic Absorption Spectrophotometry. Metal-resistant bacteria were isolated on metal-supplemented nutrient medium, and characterized using 16S rRNA gene sequencing. Metal-resistance genes were detected using specific primers and the presence of plasmids was determined using alkaline-lysis method. Forty metal-resistant bacteria belonging to six genera; Bacillus, Klebsiella, Pseudomonas, Citrobacter, Providencia and Proteus were identified. cusCBA, encoding resistance to copper and silver was detected in nine bacteria, while pbrA (encoding lead resistance) was detected in seven Pseudomonas aeruginosa isolates. chrA, encoding resistance to chromate ions, was detected in Proteus mirabilis PW3a and two isolates of Pseudomonas aeruginosa, while chrB was detected in Providencia vermicola PWAP3 and Proteus mirabilis PW4c. Bacillus stratosphericus PW1b possessed the copper-resistance genes, pcoA and pcoR. Thirty-six bacteria (90%) of the total bacteria possessed plasmids larger than 10 Kb in size. In conclusion, wastewater generated from printing operations could be a potential source of metal-resistant bacteria and their genes.Item Open Access Occurrence of phenolic derivatives in Buffalo River of Eastern Cape South Africa: Exposure risk evaluation(Elsevier, 2019-01-25)Phenolic derivatives are compounds used in the production of pesticides, pharmaceutical products and several other industrial applications. These compounds are discharged into freshwater from industrial effluents, domestic sewage, urban and agricultural run-offs which leads to pollution. Water at six sampling locations along the course of Buffalo River; namely Buffalo river estuary (BRE), Mdantsane (MSN), Zwelitsha (ZW), King William's Town (KWT), Izele Town (IZ) and Maden dam (MD) in the Eastern Cape Province, South Africa, were evaluated for phenolic contamination using eleven phenolic derivatives of United State Environmental Protection Agency (USEPA) priority pollutants. Samples were extracted using liquid-liquid extraction technique, derivatized with acetic anhydride and analyzed with gas chromatography mass spectrometry (GC-MS). The levels of the individual pollutants in the river water were higher in summer (< LOD to 12246 ng/L) than in autumn (< LOD to 713 ng/L). Their concentrations were found higher than the USEPA recommended limit (500 ng/L) in most of the sampling sites. The most prominent pollutant was 2-NP. However, the cancer risk assessment values and hazard quotient were below USEPA maximum limits of 10−6 and 1, respectively. Conclusively, the concentrations of these organic pollutants could be a threat to public health and should be managed to be below the recommended limit though the present levels are unlikely to cause cancer to both human and wildlife.
Communities in SAMRC InfoSpace
Select a community to browse its collections.