The first 1000 days

The first 1000 days

“The first 1000 days: from the mother’s womb to infanthood is an important but often forgotten period of the pathway to a healthy life”. In Lancet Infectious Diseases Dr Joseph Freer and colleagues today describe the effect of schistosomiasis during the first 1000 days-the period from conception to a child’s second birthday. These days can have lifelong effects on health, because this is a crucial phase of growth and development. There is increasing recognition of the burden and potential effects of schistosomiasis in women of reproductive age and young children. Exposure to schistosomes during pregnancy can modulate infant immune development and schistosomiasis can occur from early infancy, such that the high disease burden found in adolescents is often due to accumulation of infections with long-lived schistosomes from early life. Women of reproductive age and young children are largely neglected in mass drug administration programmes, but early treatment could avert subsequent disease. We evaluate the evidence that early schistosomiasis has adverse effects on birth, growth, and development. We also discuss the case for expanding public health interventions for schistosomiasis in women of reproductive age and preschool-age children, and the need for further research to evaluate the potential of treating women pre-conception to maximise health across the life course. The Lancet Infectious Diseases: DOI:...
Rural field work

Rural field work

Marking 5 years of clinical research in Ilembe the team is closing for the exam period. “We have recently seen very severe cases of Female Genital Schistosomiasis (FGS)”, says Nurse Nombeko Mpofana (right). “Some have no choice but to use the river for laundry and personal hygiene”. She is one of the senior nurses who have come out of retirement to be a youth research nurse. Staff members may work as drivers who fetch young women in schools, or interviewers and HIV counsellors who can handle sensitive issues, there is a teen liaison officer who is a “mother” in the waiting room, and the fact verification officer and the data manager make sure that the collected data makes sense. “The research team has two major goals”, says Sister Mpofana, “namely to make sure our study participants are treated well and we provide reliable information”. The research in adolescents roughly covers 4 areas: (1) Biharzia as a risk factor for HIV. (2) Staging the disease: what is going on at different time points (3) Diagnosis at the point of care (4) Treatment. Read more...
The WHO Pocket Atlas used in FGS study in Nigeria

The WHO Pocket Atlas used in FGS study in Nigeria

Professor Uwen Ekpo of Nigeria and his team in Ogun State have identified the first twenty adult women with FGS using the WHO Pocket Atlas for Female Genital Schistosomiasis (image). Fourteen of the 20 women had FGS (70·0%). Ten had grainy-sandy patches (image), 6 had homogenous yellow sandy patches. It is noteworthy that one patient was found to have rubbery papules as it is the first case outside Madagascar. Read here: Female genital schistosomiasis (FGS) in Ogun State, Nigeria: a pilot survey on genital symptoms and clinical findings. Parasitology Open (2017), Vol. 3, e10; page 1 of 9. U. F. Ekpo, O. M. Odeyemi, S. O. Sam-Wobo, O. B. Onunkwor, H. O. Mogaji, A. S. Oluwole, H. O. Abdussalam , J. R....
Automatic diagnosis of genital schistosomiasis

Automatic diagnosis of genital schistosomiasis

Dr Sigve Holmen’s PhD thesis showed an interesting, innovative non-invasive approach to the diagnosis of Female Genital Schistosomiasis (FGS), representing an original contribution to the knowledge in the field. BRIGHT Researcher, Sigve Homen (right), defended his PhD thesis against United Kingdom opponents Professor Gabriel Landini and Professor Albert Singer (left). The sensitivity for detection of FGS of (83%) and specificity of (73%)  might not at first appear to be as high as desirable and a mobile app must be developed further. However, the figures are very good for a first attempt to make an objective diagnostic tool for FGS. Professor Albert Singer who is an expert colposcopist emphasised that the technique holds the possibility to both train health professionals in FGS and ensure quality control of the diagnosis. We congratulate Dr Holmen with a unique and significant contribution to female health. Title: “Computer Image Analysis as a Diagnostic Tool in Female Genital Schistosomiasis” PhD registered: University of Oslo (UoO), Norway Main supervisor: Professor Eyrun F Kjetland (Oslo University Hospital/University of KwaZulu-Natal) Co-supervisors: Professor Mathias Onsrud (Gynaecology, Oslo University Hospital/UoO) and Professor Fritz Albregtsen (Informatics, UoO)...
Human papillomavirus types in young women

Human papillomavirus types in young women

BRIGHT Researcher, Nonhlanhla Mbatha (right) was awarded a PhD for her work on virus types in rural young women that may cause cancer. High-risk human papillomavirus infections occur frequently in young women. The available vaccines cover up to seven high-risk-HPV types and two low-risk types. Amongst 1223 rural young women of KwaZulu-Natal 301 (25%) were positive for hr-HPV. The nine predominant genotypes in descending order were HPV types 16 (22 %), 51 (13 %), types 18 (13 %), 35 (11%), 33 (11%), 56 (9 %), 45 (8 %), 52 (7 %) and type 59 (7 %). The types HPV 35, 51, 56 and 59 – representing as many as 40.62% of the dangerous viruses, are not covered by any vaccine. These types were among the most prevalent in the young women of KwaZulu-Natal. This poses an important hurdle in the fight against cervical cancer and new vaccines should be developed. We congratulate Dr Mbatha and her main tutor (Dr Zilungile Kwitshana, left) with the eminent work. Title: “Human papillomavirus in adolescents in rural KwaZulu-Natal, South Africa” PhD registered: University of KwaZulu-Natal (UKZN), South Africa Main supervisor: Dr Zilungile Kwitshana (Mangosuthu University of Technology, South Africa/UKZN) Co-supervisors: Professor Myra Taylor (UKZN) and Dr Marc Baay (University of Antwerp,...
Otimati Clinic opens for youth

Otimati Clinic opens for youth

The BRIGHT Otimati Youth Research Clinic in Ilembe had the honour of welcoming dignitaries from the National Department of Health (DoH) Head office in Tshwane. The dignitaries were led by the Director for Communicable Disease Control Ms Tsakani Furumele and the Head of Helminth Control Mrs Takalani Nemungadi. Also present were six of their team members and a representative from the Ilembe DoH, Mrs Nontobeko Ndadane. This comes as the BRIGHT research team embarks on the world’s first a randomized control trial on important research questions. Young women in Ilembe and King Cetshwayo Districts will again be invited for world class investigations. The dignitaries were given a tour of the research clinic and staff members presented the study recruitment activities, from driving to get the high school learners to how they go about with the procedures. The delegation was in KZN for a three day meeting dedicated to several aspects of Helminthic diseases, Bilharzia has been found to be very common in King Cetshwayo and Ilembe...