HIV epidemic in SA resulting in an increasing number of people losing their lives to secondary pneum
May 06, 2011 HIV epidemic in SA resulting in an increasing number of people losing their lives to secondary pneum
The HIV epidemic in South Africa is claiming the lives of more South Africans, particularly children, than ever before, largely the result of two secondary infections: pneumococcal pneumonia and influenza. During the last 20 years, the two infections have become South Africa’s second-biggest killers, say two internationally-recognised Wits-based researchers.
Streptococcus pneumoniae, or pneumococcus, is the bacterium responsible for pneumococcal pneumonia. Examining and understanding the sombre ‘shadow’ cast by this bacterium, and undertaking internationally groundbreaking research, are National Research Foundation A-rated Wits medical scientists, Professor Charles Feldman and Professor Shabir Madhi. These two researchers will present significant aspects of their research findings at the 5th Faculty of Health Sciences Prestigious Research Lecture to be held 25 May 2011.
Streptococcus pneumoniae was first described over 100 years ago and there are now effective antibiotics available for the treatment of pneumococcal infections in humans. However, as the HIV/Aids epidemic has spread, the incidence of death in adults and children caused by pneumococcus in developing countries has increased steadily. Sadly, there has been a massive increase in the number of people who contract the HI virus and then succumb to pneumococcal disease, say Madhi and Feldman.
Many children and some adults, especially those that are HIV-infected harbour pneumococci in their nose and throat and acquire these from other carriers. Sometimes these organisms may invade the body and cause active disease. When they do they can cause different symptoms depending on the part of the body they infect. Commonly they cause pneumonia, but may also cause serious blood infections and even meningitis (inflammation of the lining of the brain).
“Although vaccines are widely available to most children in developed countries, the challenge remains in making these vaccines available and affordable to children where childhood mortality from pneumococcal disease is greatest, says Madhi, who has focused much of his research on pneumococcal vaccines and the many issues surrounding their use, especially in developing countries.
“The battle against pneumococci is slowly being won, but it remains to be seen whether this bacterium will adapt to the antibiotics currently being used and continue to be “The Captain of Death of Men” in developing countries. Until then, prevention of pneumococcal disease needs to be coupled with optimising the management and treatment of individuals who become ill because of this dreaded bacterium,” says Madhi.
Madhi is currently Professor of Vaccinology in the Wits Faculty of Health Sciences and is co-director of the Medical Research Council (MRC) - Respiratory and Meningeal Pathogens Research Unit. He also holds the Department of Science and Technology/National Research Foundation South African Research Initiative Chair in Vaccine Preventable Disease. Madhi is an international leader in his field and has been involved in research on vaccine preventable diseases for the past 13 years and has contributed to over 110 publications, including many in leading international peer-reviewed journals.
“Studies have clearly indicated that combining antibiotics is associated with a better outcome, in general, than the use of certain agents on their own. However, the exact reasons for this are presently unclear,” says Feldman, who has spent many years investigating the impact of antibiotics on the outcome of pneumococcal infections.
“Further research will involve studying possible mechanisms and investigating the effects of different classes of antibiotics used for the treatment of pneumococcal infections in the pneumococcus itself, as well as in the human host,” says Feldman.
Feldman’s research interest is in the field of community-acquired pneumonia, and in particular pneumococcal pneumonia. In addition to being part of large international clinical collaborations recruiting cases of community-acquired pneumonia, he has also contributed to basic research studies, investigating the effects of various pneumococcal virulence factors on human ciliated epithelium as well as the effects of antibiotics on pneumococcal growth and expression of virulence factors. He has more than 300 publications in books, book chapters, and peer reviewed journals.
These new approaches to prevention and treatment will also be discussed at the lecture, and audience members will have the opportunity to voice questions and concerns.
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