A Recent HIV Diagnosis Is Associated with Non-Completion of Isoniazid Preventive Therapy in an HIV-Infected Cohort in Cape Town

Introduction

Despite high rates of successful treatment TB incidence in South Africa remains high, suggesting ongoing transmission and a large reservoir of latently infected persons. Isoniazid preventive therapy (IPT) is recommended as preventive therapy in HIV-infected persons. However, implementation has been slow, impeded by barriers and challenges including the fear of non-adherence.

Objective and Methods

The aim was to evaluate predictors of IPT non-completion. One hundred and sixty four antiretroviral therapy (ART)-naïve HIV-infected patients with tuberculin skin test ≥5 mm were recruited from Khayelitsha day hospital and followed up monthly. A questionnaire was used to collect demographic information.

Results

The overall completion rate was 69%. In multivariable analysis, there was a 29% decrease in risk of non-completion for every year after HIV diagnosis (OR 0.81; 95% C.I. 0.68–0.98). Self-reported alcohol drinkers (OR 4.05; 95% C.I. 1.89–9.06) also had a four-fold higher risk of non-completion, with a strong association between alcohol drinkers and smoking (χ² 27.08; p<0.001).

Conclusion

We identify patients with a recent HIV diagnosis, in addition to self-reported drinkers and smokers as being at higher risk of non-completion of IPT. The period of time since HIV diagnosis should therefore be taken into account when initiating IPT. Our results also suggest that smokers and alcohol drinkers should be identified and targeted for adherence interventions when implementing IPT on a wider scale.     

Risk factors of porcine cysticercosis in the Eastern Cape Province, South Africa

There is a high prevalence of Taenia solium taeniosis/cysticercosis in humans and pigs in the Eastern Cape Province (ECP) of South Africa. The objective of this study was to identify risk factors of porcine cysticercosis in select districts of the ECP. Data were collected in 2003 by interviewing 217 pig producers from the area. Blood samples were collected from 261 of their pigs, which were tested using two enzyme-linked immunosorbent assays (ELISA) for the presence of antibodies to cysticercosis. Frequencies of both owner- and pig-level characteristics were determined. For pig-level analysis, all bivariable and multivariable associations were determined using the surveylogistic procedure of the SAS/STAT? software to accommodate for the intraclass correlation that exists for clusters of pigs within one owner and for clusters of owners within a district. All tests for significance were performed at the α?=?0.05 level, and adjusted odds ratios (aOR) and 95% confidence intervals (CI) were determined. Among the respondents, 48% of their households lacked a latrine, 98% slaughtered pigs at home, and 99% indicated that meat inspection services were not available. On bivariable analysis, there was a significant association between porcine infection and district (p?=?0.003), breed (p?=?0.041) and the absence of a latrine (p?=?0.006). On multivariable analysis, the absence of a latrine was the only variable significantly associated with porcine infection (aOR?=?1.89; 95% CI?=?1.07, 3.35) (p?=?0.028). The increased odds of porcine infection with households lacking a latrine contributes to our understanding of the transmission of this parasite in the ECP. Determining and addressing the risk factors for T. solium infection can potentially lower the very high prevalence in humans and pigs in this endemic area.     

Biology,host range and varietal preference of the leaf-feeding geometrid, <Emphasis Type="Italic">Leptostales ignifera</Emphasis>, a potential biocontrol agent for <Emphasis Type="Italic">Lantana camara</Emphasis> in South Africa,under laboratory conditions

Lantana camara L. (Verbenaceae) is a weed of major importance in South Africa. It invades indigenous forests and veld, valuable commercial and agricultural forests, plantations and orchards, as well as river-catchment areas. Several natural enemies, including insect and pathogen species, have been released in South Africa, some of which established successfully. These do not exert sufficient control and additional natural enemies are required. Leptostales ignifera Warren (Lepidoptera: Geometridae), one of several new species being investigated as potential biocontrol agents, was collected in the subtropical parts of Florida, USA and Mexico. Host specificity trials indicated L. camara to be the preferred host plant of this quick-developing, voracious leaf-feeder, with some of the African indigenous Lippia species qualifying as very marginal hosts. The possible preference that L. ignifera might have for different South African naturalized L. camara varieties was studied during quarantine laboratory preference trials. Variety 029WP was the most suitable host for L. ignifera, although the other four tested varieties were able to support viable populations of the insect. Not taking other abiotic and biotic factors such as climate and predation into consideration, once released, L. ignifera should be able to establish on all five of the tested varieties in the field and contribute to the biological control of the complex of L. camara as a whole. Based on the above studies, permission has been granted for the release of L. ignifera in South Africa.     

Biology and host range of Mada polluta,a potential biological control agent of Tecoma stans in South Africa

The host range of Mada polluta Mulsant (Coleoptera:Coccinnellidae) was studied to assess its suitability as a biological control agent of Tecoma stans (L.) Juss ex Kunth var stans (Bignoniaceae), an invasive weed in South Africa. Biology of M. polluta and its host range were determined in the laboratory using no-choice and multi-choice feeding, oviposition and larval survival tests. Out of 36 plant species from 12 plant families (Bignoniaceae, Acanthaceae, Asteraceae, Verbenaceae, Lamiaceae, Oleaceae, Cucurbitaceae, Fabaceae, Scrophulariaceae, Solanaceae, Apiaceae, Chenopodiaceae and Poaceae) within the order Lamiales that were tested during the host specificity testing, M. polluta showed a very strong preference for T. stans, depositing its eggs on T. stans and none on non-target plant species. In no-choice tests, an average of 246 eggs was laid on T. stans, and from these, 133 larvae developed to adulthood. The beetle also showed very promising biological attributes that will contribute to its success as a biological control agent of T. stans. These attributes include highly damaging larvae and adults, high fecundity (532 eggs/female) and a short life cycle (four weeks). The short life cycle will enable multiple generations per year and rapid population increase in the field. It is concluded that M. polluta is sufficiently host-specific to be released against T. stans in South Africa. It is, therefore, strongly recommended that permission be granted to release this beetle from quarantine for biological control of T. stans in South Africa.     

Pre-release evaluation of Heikertingerella sp. as a potential biocontrol agent for Tecoma stans in South Africa

Native to Central America, Tecoma stans (L.) Juss ex Kunth var. stans (Bignoniaceae) is a small tree that is invasive in South Africa and neighbouring countries. The plant was targeted for biological control in South Africa in 2003, with two insect agents released and established so far. The root-feeding flea beetle, Heikertingerella sp. (Coleoptera: Galerucinae: Alticini), was imported from Mexico as an additional biocontrol agent and its biology and host specificity was assessed under quarantine conditions. The beetle displayed a generation time (i.e. from adult to adult) of 49 to 67 days, ensuring four annual generations under laboratory conditions. The beetle's larval and adult stages inflicted high levels of damage on the root system and the leaves of T. stans, respectively. No-choice tests with 40 test-plant species revealed adult feeding on only two non-target species, Tecoma × alata and T. capensis (Thunb.) Spach, with feeding four times higher on T. stans. Larvae developed to adulthood on T. stans only. Multi-choice tests involving the three Tecoma species confirmed these trends, demonstrating that Heikertingerella sp. is host specific. Since T. × alata is a hybrid of T. stans with invasive tendencies, any unlikely attacks by Heikertingerella sp. would be inconsequential in South Africa. The native T. capensis, which suffered little leaf damage and produced no F1 adults, is also at minimal risk of attack. We conclude that Heikertingerella sp. is a suitable biocontrol agent for T. stans and that permission for its release in South Africa be sought.