Comparative study between African-American and Caucasian Normal Tension Glaucoma patients

Purpose. To evaluate differences in optic disc and visual field damage between African-American and Caucasian Normal Tension Glaucoma (NTG) patients. Methods. We retrospectively selected 33 African-American patients with the diagnosis of NTG and age-matched them with 33 Caucasian patients with the same diagnosis. Three masked observers graded disc photographs and visual fields as being normal, globally damaged or focally damaged for both eyes of the subject. Chi-square test was used to evaluate statistically significant differences between groups. Results. The results of the visual fields showed that in the African-American group, 24% were graded normal, 30% showed global damage, and 46% showed focal damage. This data was compared with the Caucasian group which showed 41% normal graded eyes, 22% with global damage, and 37% with focal damage (p = 0.28). The results of the optic disc photos showed that in the African-American group, 25% were graded normal, 45% showed global damage, and 30% showed focal damage. This data was compared with the Caucasian group which showed 43% graded normal, 32% with global damage, and 25% with focal damage (p=0.16). Conclusions. In our study there was no difference in the frequency of globally damaged, focally damaged, and normal graded discs or visual fields between African-American and Caucasian NTG patients.

Determining the response of African biota to climate change: using the past to model the future

Prediction of biotic responses to future climate change in tropical Africa tends to be based on two modelling approaches: bioclimatic species envelope models and dynamic vegetation models. Another complementary but underused approach is to examine biotic responses to similar climatic changes in the past as evidenced in fossil and historical records. This paper reviews these records and highlights the information that they provide in terms of understanding the local- and regional-scale responses of African vegetation to future climate change. A key point that emerges is that a move to warmer and wetter conditions in the past resulted in a large increase in biomass and a range distribution of woody plants up to 400–500 km north of its present location, the so-called greening of the Sahara. By contrast, a transition to warmer and drier conditions resulted in a reduction in woody vegetation in many regions and an increase in grass/savanna-dominated landscapes. The rapid rate of climate warming coming into the current interglacial resulted in a dramatic increase in community turnover, but there is little evidence for widespread extinctions. However, huge variation in biotic response in both space and time is apparent with, in some cases, totally different responses to the same climatic driver. This highlights the importance of local features such as soils, topography and also internal biotic factors in determining responses and resilience of the African biota to climate change, information that is difficult to obtain from modelling but is abundant in palaeoecological records.

Evolving southwest African response to abrupt deglacial North Atlantic climate change events

Climate change during the last deglaciation was strongly influenced by the „bipolar seesaw‟, producing antiphase climate responses between the North and South Atlantic. However, mounting evidence demands refinements of this model, with the occurrence of abrupt events in southern low to mid latitudes occurring in-phase with North Atlantic climate. Improved constraints on the north-south phasing and spatial extent of these events are therefore critical to
understanding the mechanisms that propagate abrupt events within the climate system. We present a 19,400 year multi-proxy record of climate change obtained from a rock hyrax midden in southernmost Africa. Arid anomalies in phase with the Younger Dryas and 8.2 ka events are apparent, indicating a clear shift in the influence of the bipolar seesaw, which diminished as the Earth warmed, and was succeeded after ~14.6 ka by the emergence of a dominant interhemispheric atmospheric teleconnection.

Forecasting invasions: resource use by mussels informs invasion patterns along the South African coast

Invasive species are often more able to rapidly and efficiently utilise resources than natives, and comparing per capita resource use at different resource densities among invaders and trophically analogous natives could allow for reliable predictions of invasiveness. In South Africa, invasion by the Mediterranean mussel Mytilus galloprovincialis has transformed wave-exposed shores, negatively affecting native mussel species. Currently, South Africa is experiencing a second mussel invasion with the recent detection of the South American Semimytilus algosus. We tested per capita uptake of an algal resource by invading M. galloprovincialis, S. algosus, and the native Aulacomya atra at different algal concentrations and temperatures, representing the west and south coasts of South Africa, to examine whether their per capita resource use could be a predictor of their spread and subsequent invasiveness. Regardless of temperature, M. galloprovincialis was the most efficient consumer, significantly reducing algal cells compared to the other species when the resource was presented in both low and high starting densities. Furthermore, these findings aligned with a greater biomass of M. galloprovincialis on the shore in comparison with the other species. Resource use by the new invader S. algosus was dependent on the density of resource and, although this species was efficient at low algal concentrations at cooler temperatures, this pattern broke down at higher algal densities. This was once more reflected in lower biomass in surveys of this species along the cool west coast. We therefore forecast that S. algosus will be become established along the south coast; however, we also predict that M. galloprovincialis will maintain dominance on these shores.

Review of Slavery by Any Other Name: African Life under Company Rule in Colonial Mozambique.

Book review of Slavery by Any Other Name: African Life under Company Rule in Colonial Mozambique, by Eric Allina, Charlottesville, University of Virginia Press, 2012, 255 pp., £44.50, ISBN 978-0-8139-3272-9.

ANRIL Variants and Aggressive Periodontitis in European and African Populations

Introduction: The chromosome 9p21 locus has been identified as a marker of coronary artery disease. In this locus studies have focused on variations in the ANRIL gene that has also been identified as a strong candidate for association with aggressive periodontitis (AgP).
Objective: To investigate possible associations between gene variants of ANRIL and AgP in European and African populations.
Methods: European AgP cases (n= 213) and age-matched periodontally healthy controls (n= 81) were recruited from centres in the United Kingdom (Belfast, Glasgow, Newcastle and London). African AgP cases (n= 95) and controls (n= 105) were recruited in Khartoum, Sudan. Five single nucleotide polymorphisms (SNPs) in ANRIL were genotyped using Sequenom and analysed using Haploview with permutation testing to correct for multiple candidates. Odds ratios (OR) and 95% confidence intervals (95%CI) were calculated.
Results: In the European subjects there was a significant association between rs518394 (p=0.0013; OR = 1.81, 95%CI 1.26-2.61) and rs1333049 (p=0.0028; OR = 1.75, 95%CI 1.21-2.52) and AgP. These associations remained significant after permutation testing. In addition there was an association between rs 1360590 (p=0.035) and AgP in females. In the African subjects there was a significant association between only one SNP rs1537415 and AgP (p=0.036; OR = 1.59, 95%CI 1.04-2.43), however, this was not significant following permutation testing. There were no significant associations with rs3217992 in either population.
Conclusions: SNP variants in the ANRIL locus were shown to be significantly associated with AgP in a European population and for the first time in an African population confirming this as the best replicated locus for aggressive periodontitis.

Antibacterial Activity of Peptides from the African Volcano Frog

Introduction: Cationic, α- helical antimicrobial peptides found in skin secretions of the African Volcano Frog, Xenopus amieti include magainin-AM1, peptide glycine-leucine-amide (PGLa-AM1) and caerulein-precursor fragment (CPF-AM1). Objectives: The principle objective of this study was to determine the antibacterial activity of these peptides against a range of aerobic and anaerobic and oral pathogens. Secondary objectives were to establish their lipopolysaccharide (LPS) binding activity and determine potential cytotoxic effects against host cells. Methods: Magainin-AM1, PGLa-AM1 and CPF-AM1 were assessed for their antimicrobial activity against Fusobacteriim nucleatum, Streptococcus mutans, Lactobacillus acidophilus, Enterococcus faecalis and Streptococcus milleri using a double layer radial diffusion assay. The propensity for each peptide to bind LPS was determined using an indirect ELISA. The potential cytotoxicity of the peptides against human pulp cells in vitro was determined using the 3-(4,5-Dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide (MTT) assay. Results: Magainin-AM1, PGLa-AM1 and CPF-AM1 displayed potent antimicrobial activity against all the bacterial pathogens tested, with Magainin-AM1 being the least effective. PGLa-AM1 was most potent against S. mutans, with a minimum inhibitory concentration (MIC) of 1.2 μM. PGLa-AM1 and CPF-AM1 were both very active against F. nucleatum with MIC values of 1.5 μM and 2.2 μM respectively. The LPS binding ability of the peptides varied depending on the bacterial source of the LPS, with PGLa-AM-1 being the most effective at binding LPS. Cytotoxicity studies revealed all three peptides lacked cytotoxic effects at the concentrations tested. Conclusions: The peptides magainin-AM1, PGLa-AM1 and CPF-AM1 from the African Volcano Frog, Xenopus amieti displayed potent antimicrobial activity and LPS binding activity against a range of oral pathogens with little cytotoxic effects. These peptides merit further studies for the development of novel therapeutics to combat common oral bacterial infections.

Antifungal Activity of Peptides From the African Volcano Frog

Background: Candidal species, particularly Candida albicans are common pathogens in the oral cavity and perioral region. Many of the manifestations of candidiasis are associated with the formation of Candida biofilms on host surfaces and/or implanted biomaterials. Biofilms are clinically important due to their increased resistance to therapeutic intervention and the ability of cells within the biofilm to withstand host immune defences.
Objectives: The present study was designed to investigate the antifungal activity of two peptides found in skin secretions of the African volcano frog (Xenopus amieti) against the type strain of C. albicans NCTC 3179.
Methods: The antifungal activity of magainin-AM1 and peptide glycine-leucine-amide (PGLa-AM1) against C. albicans NCTC 3179 was studied in both planktonic and biofilm forms. Radial diffusion assays were used to obtain the minimum inhibitory concentration (MIC) of magainin-AM1 and PGLa-AM1 against planktonic C. albicans. Time kill assays were used to determine the time dependent fungicidal action of the peptides at both 4oC and 37oC. A 96 well microtitre plate model for candidal biofilm formation was employed to study the ability of the peptides to disrupt the early biofilm development (up to 24 hours) compared with the antifungal drug fluconazole. Biofilm formation was determined quantitatively using the crystal violet assay.
Results: Both magainin-AM1 and PGLa-AM1 demonstrated inhibitory activity against Candida albicans, with MIC values of 24.3 uM and 7.5uM respectively. Time-kill assays revealed bactericidal activity of both peptides at 37oC and 4oC. Magainin-AM1 and PGLa-AM1 inhibited biofilm formation in microtitre plate assays. The peptides were particularly effective during early biofilm establishment when compared with fluconazole treatment.
Conclusions: Magainin-AM1 and PGLa-AM1 are active against C albicans in both planktonic and biofilm forms. Further testing of this peptide family against candidal biofilms is recommended.

Prevalence of the different types of age-related cataract in an African population.

PURPOSE: To describe the prevalence of different types of cataract and their association with visual acuity in a Tanzanian population aged 40 years and older. METHODS: A prevalence survey for lens opacity, glaucoma, and visual impairment was carried out on all residents age 40 and older of six villages in Kongwa, Tanzania. One examiner graded the lens for presence of nuclear (NSC), posterior subcapsular (PSC), and cortical cataract (CC), using the new WHO Simplified Cataract Grading System. Visual acuity was measured in each eye, both presenting and best corrected, using an illiterate E chart. RESULTS: The proportion of eligible subjects participating was 90% (3268/3641). The prevalence of cataract was as follows: NSC, 15.6%; CC, 8.8%; and PSC, 1.9%. All types of cataract increased with age, from NSC, 1.7%; CC, 2.4%; and PSC, 0.4% for those aged 40 to 49 years to NSC, 59.2%; CC, 23.5%; and PSC, 5.9% for those aged 70 years and older (P < 0.0001 for all cataract types, chi(2) test for trend). Cataract prevalence was higher among women than men for NSC (P = 0.0001), but not for CC (P = 0.15) or PSC (P = 0.25), after adjusting for age. Prevalence rates of visual impairment (BCVA < 6/12), US blindness (< or = 6/60) and WHO blindness (< 6/120) for this population were 13.3%, 2.1%, and 1.3%, respectively. Older age and each of the major types of pure and mixed cataract were independently associated with worse vision in regression modeling. CONCLUSIONS: Unlike African-derived populations in Salisbury and Barbados, NSC rather than CC was most prevalent in this African population. The seeming lower prevalence of CC may to some extent be explained by different grading schemes, differential availability of cataract surgery, the younger mean age of the Tanzanian subjects, and a higher prevalence of NSC in this population.

Transfusion and Treatment of severe anaemia in African children (TRACT): a study protocol for a randomised controlled trial

BACKGROUND: In sub-Saharan Africa, where infectious diseases and nutritional deficiencies are common, severe anaemia is a common cause of paediatric hospital admission, yet the evidence to support current treatment recommendations is limited. To avert overuse of blood products, the World Health Organisation advocates a conservative transfusion policy and recommends iron, folate and anti-helminthics at discharge. Outcomes are unsatisfactory with high rates of in-hospital mortality (9-10 %), 6-month mortality and relapse (6 %). A definitive trial to establish best transfusion and treatment strategies to prevent both early and delayed mortality and relapse is warranted.

METHODS/DESIGN: TRACT is a multicentre randomised controlled trial of 3954 children aged 2 months to 12 years admitted to hospital with severe anaemia (haemoglobin < 6 g/dl). Children will be enrolled over 2 years in 4 centres in Uganda and Malawi and followed for 6 months. The trial will simultaneously evaluate (in a factorial trial with a 3 x 2 x 2 design) 3 ways to reduce short-term and longer-term mortality and morbidity following admission to hospital with severe anaemia in African children. The trial will compare: (i) R1: liberal transfusion (30 ml/kg whole blood) versus conservative transfusion (20 ml/kg) versus no transfusion (control). The control is only for children with uncomplicated severe anaemia (haemoglobin 4-6 g/dl); (ii) R2: post-discharge multi-vitamin multi-mineral supplementation (including folate and iron) versus routine care (folate and iron) for 3 months; (iii) R3: post-discharge cotrimoxazole prophylaxis for 3 months versus no prophylaxis. All randomisations are open. Enrolment to the trial started September 2014 and is currently ongoing. Primary outcome is cumulative mortality to 4 weeks for the transfusion strategy comparisons, and to 6 months for the nutritional support/antibiotic prophylaxis comparisons. Secondary outcomes include mortality, morbidity (haematological correction, nutritional and infectious), safety and cost-effectiveness.

DISCUSSION: If confirmed by the trial, a cheap and widely available 'bundle' of effective interventions, directed at immediate and downstream consequences of severe anaemia, could lead to substantial reductions in mortality in a substantial number of African children hospitalised with severe anaemia every year, if widely implemented.

The African Pediatric Fellowship Program: Training in Africa for Africans

Africa has a significant burden of childhood disease, with relatively few skilled health care professionals. The African Paediatric Fellowship Programme was developed by the Department of Pediatrics and Child Health at the University of Cape Town to provide relevant training for African child health professionals, by Africans, within Africa. Trainees identified by partner academic institutions spend 6 months to 2 years training in the Department of Pediatrics and allied disciplines. They then return to their home institution to build practice, training, research, and advocacy. From 2008 to 2015, 73 physicians have completed or are completing training in general pediatrics or a pediatric subspecialty. At 1 year posttraining, 98% to 100% are practicing back in their home institution. The impact of the returning fellows is evident from their practice interventions, research collaborations, and positions as stakeholders who can change health care policies. Thirty-three centers in 13 African countries are partners with the program, and the program template is now followed by other partner sites in Africa. Increasing and retaining the skills pool of African child health specialists is building a network of motivated, highly skilled clinicians who are equipped to advance child health in Africa.