Bovine Ephemeral fever virus (BEFV) is endemic in South Africa and has a negative economic impact on the meat and dairy industries. Bovine ephemeral fever or three‐day stiff‐sickness is controlled ...through annual vaccination with a live attenuated virus manufactured by Onderstepoort Biological Products (South Africa). We announce the genome sequences of two South African Bovine Ephemeral Virus strains; the live attenuated vaccine strain (14 876 nucleotides) and a field strain (14 883 nucleotides). A mutation in the alpha 3 open reading frame rendered the gene non‐functional in both genomes. Phylogenetic analysis based on the glycoprotein gene showed that the two strains clustered with the South African lineage.
Bovine ephemeral fever or three‐day stiff‐sickness is controlled through annual vaccination with a live attenuated virus manufactured by Onderstepoort Biological Products (South Africa). We announce the genome sequences of two South African Bovine Ephemeral Virus strains; the live attenuated vaccine strain (14 876 nucleotides) and a field strain (14 883 nucleotides). Phylogenetic analysis based on the glycoprotein gene showed that the 2 strains clustered with the South African lineage.
Bluetongue disease in endemic areas is predominantly controlled through vaccination with live-attenuated vaccines. Sequencing of the original master seed viruses used in the production of ...Onderstepoort Biological Products vaccine was conducted. Nucleotide identities of 82.97%-100% were obtained for all sequences when compared to South African reference strains.
There is on-going global debate and policy-setting concerning researchers' obligations to meet the health needs of people participating in HIV prevention trials in resource-poor settings. The ...perspectives of local community stakeholders on this issue are poorly understood as most of what is presented on behalf of communities where research takes place is anecdotal commentary. Using qualitative methods (130 in-depth interviews and 20 focus groups) we assessed perceived fairness of different strategies to meet the health needs of women who become HIV-infected during a hypothetical vaginal microbicide trial. Respondents included HIV prevention research participants, community stakeholders and health-care service providers in ten sites in seven countries (South Africa, Malawi, Tanzania, Zimbabwe, Zambia, India, US). Many respondents perceived referrals to be a potentially fair way to address care and treatment needs but concerns were also voiced about the adequacy of local health-care options and the ability of trial participants to access options. Most respondents viewed the provision of antiretroviral treatment by researchers to HIV-infected trial participants as unfair if treatment was not sustained beyond the end of the trial. The results underscore the importance of effectively linking trial participants to sustainable, community-based treatment and care.
The objective of the treatment of cervical intraepithelial neoplasia (CIN) is the prevention of invasive carcinoma of the cervix, which still remains the most common cancer in Zimbabwean women, as in ...most other low-resource countries where screening facilities are grossly inadequate. We conducted a randomised prospective study to compare CIN treatment outcome after cryotherapy and loop electrosurgical excision procedure (LEEP) in 400 women with histologically confirmed high grade squamous intra-epithelial lesions (HGSIL). Treatment outcome measures were immediate complications, persistent disease and recurrent disease evaluated at follow-up visits. Eighty-two per cent of the women (159 cryotherapy, 168 LEEP) completed their 6-month and 12-month follow-up visits. LEEP had a significantly higher overall cure rate of 96·4% (absence of persistant or recurrent disease) compared to 88·3% cryotherapy ( P =0·026). Although cryotherapy was not superior to LEEP, its cure rate (88·3%) is acceptable and therefore provides a viable treatment option for low resource countries such as Zimbabwe where the majority of women at risk for cervical cancer reside in rural areas.
To document the socio-demographic profile, presenting symptoms, disease stage and treatment modality offered to all women attending Harare and Parirenyatwa Hospitals with a histological diagnosis of ...invasive cervical cancer in 1998.
A cross sectional study.
Parirenyatwa Hospital and Harare Central Hospital.
All women with a histological diagnosis of cervical cancer admitted between 11 January 1998 and 14 December 1998 were recruited into the study.
A total of 196 patients, with a median age of 47 years (range 24 to 80 years) were recruited into the study. A high proportion (63.3%) of the women were from rural areas. The mean age at first pregnancy was 17.9 years (SD 2.8) and 112 (63.3%) first sought treatment at the primary health care centre. Persistent vaginal discharge was the most frequent (69.4%) presenting complaint. One hundred and ninety five patients (99.5%) had histological confirmation of invasive cervical cancer (91.8% squamous cell carcinoma, 7.7% adenocarcinoma). Clinical staging by The International Federation of Gynaecology and Obstetrics (FIGO) classification confirmed that the majority (80.3%) of the cancers had spread from the cervix into the parametrium and beyond (stage 2b and above) at the time of presentation. Radiation therapy was the most commonly used (77.0%) treatment modality.
This study demonstrates that the burden of cervical cancer occurs around the peak age of 47 years and that the majority of women present with advanced disease. None of the women had ever been screened for cervical cancer. The planned introduction of a cervical cancer screening programme by visual inspection of the cervix with acetic acid (VIA), together with a health education campaign may result in a shift towards more women presenting with early curable cervical cancer cases.
Two phase 3 clinical trials showed that use of a monthly vaginal ring containing 25 mg dapivirine was well tolerated and reduced HIV-1 incidence in women by approximately 30% compared with placebo. ...We aimed to evaluate use and safety of the dapivirine vaginal ring (DVR) in open-label settings with high background rates of HIV-1 infection, an important step for future implementation.
We did a phase 3B open-label extension trial of the DVR (MTN-025/HIV Open-label Prevention Extension HOPE). Women who were HIV-1-negative and had participated in the MTN-020/ASPIRE phase 3 trial were offered 12 months of access to the DVR at 14 clinical research centres in Malawi, South Africa, Uganda, and Zimbabwe. At each visit (monthly for 3 months, then once every 3 months), women chose whether or not to accept the offer of the ring. Used, returned rings were tested for residual amounts of dapivirine as a surrogate marker for adherence. HIV-1 serological testing was done at each visit. Dapivirine amounts in returned rings and HIV-1 incidence were compared with data from the ASPIRE trial, and safety was assessed. This study is registered with ClinicalTrials.gov, NCT02858037.
Between July 16, 2016, and Oct 10, 2018, of 1756 women assessed for eligibility, 1456 were enrolled and participated in the study. Median age was 31 years (IQR 27-37). At baseline, 1342 (92·2%) women chose to take the DVR; ring acceptance was more than 79% at each visit up until 12 months and 936 (73·2%) of 1279 chose to take the ring at all visits. 12 530 (89·3%) of 14 034 returned rings had residual dapivirine amounts consistent with some use during the previous month (>0·9 mg released) and the mean dapivirine amount released was greater than in the ASPIRE trial (by 0·21 mg; p<0·0001). HIV-1 incidence was 2·7 per 100 person-years (95% CI 1·9-3·8, 35 infections), compared with an expected incidence of 4·4 per 100 person-years (3·2-5·8) among a population matched on age, site, and presence of a sexually transmitted infection from the placebo group of ASPIRE. No serious adverse events or grade 3 or higher adverse events observed were assessed as related to the DVR.
High uptake and persistent use in this open-label extension study support the DVR as an HIV-1 prevention option for women. With an increasing number of HIV-1 prophylaxis choices on the horizon, these results suggest that the DVR will be an acceptable and practical option for women in Africa.
The Microbicide Trials Network and the National Institute of Allergy and Infectious Diseases, The Eunice Kennedy Shriver National Institute of Child Health and Human Development, and the National Institute of Mental Health, all components of the US National Institutes of Health.
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