Medical Graduate Exhilarated Over Cum Laude Pass

Medical Graduate Exhilarated Over <em>Cum Laude</em> Pass
Beating the odds to achieve success, Dr Kgotso Lawrence Sambo.

‘I am struggling to explain to my family the importance of this great achievement,’ said Medical cum laude graduate, Dr Kgotso Lawrence Sambo.

Sambo - living proof that it doesn’t matter where you come from but where you are going - completed his matric at Sehlakabje High School in rural Acornhoek in Mpumalanga.

‘My family doesn’t know what this cum laude thing is all about! They are happy that I completed the degree in record time but I don’t think they fully appreciate what it means to graduate cum laude,’ said Sambo.

Sambo has always wanted to be an academic high achiever but never thought it would actually happen. ‘I feel great but am still in some shock about the cum laude award. It really means a lot to me and most importantly, it proves to me that everything is possible. It has also helped me realise my potential,’ he said.

Sambo loves teaching and was involved in academic mentorship programmes on campus.

‘I want to become a lecturer someday. I hope to study further and specialise in Internal Medicine or General Surgery. The future will reveal which specialty exactly.’

Nombuso Dlamini

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HIV Positive Black isiZulu-Speaking Women at High Risk of Depression During Pregnancy – Study Finding

HIV Positive Black isiZulu-Speaking Women at High Risk of Depression During Pregnancy – Study Finding
Ms Puvashnee Nydoo graduated with a Masters in Medical Sciences, cum laude.

Newly-diagnosed, HIV-infected Black isiZulu-speaking women are at a high risk of developing depression during pregnancy, a UKZN study conducted by Miss Puvashnee Nydoo has revealed.

Titled: “A Comparison of Depressive Scores Amongst Newly-Diagnosed HIV-Infected and Uninfected Pregnant Women Using the Edinburgh Depression Scale”, the study also found that young age and unemployment influenced depression.

Nydoo was awarded a Masters in Medical Science degree (cum laude) specialising in Obstetrics and Gynaecology, under the supervision of Professor Jagidesa Moodley.

Her research was conducted among Black IsiZulu-speaking women in their second or third trimester of pregnancy.

Of the total study population, 9.8% suffered from depression, irrespective of HIV status, while prevalence rates of antenatal depression did not differ significantly between the HIV-infected and uninfected cohorts.

The research found that a new diagnosis of HIV infection and maternal age were risk factors for antenatal depression whereas unemployment was a borderline risk factor for the development of antenatal depression.

The cross-sectional study was done at antenatal clinics at two regional hospitals in KwaZulu-Natal on newly HIV-tested Black African pregnant women. ‘Women’s socio-demographic and clinical data were recorded before being assessed for depression using an isiZulu version of the Edinburgh Depression Scale,’ said Nydoo.

According to Nydoo, her study provided an important step in documenting the need for screening for antenatal depression in HIV-associated pregnancies in a South African population group.

‘Given that the antenatal rate of HIV infection in KZN is high and the condition is a considerable health concern having the potential to compromise the well-being of both mother and infant, this study was very important to clarify any association between a new diagnosis of HIV infection and the development of antenatal depression,’ she said.

Nydoo is currently registered with the School of Clinical Medicine to do her PhD. ‘I have a flair for research, particularly in the area of psychology, maternal health and HIV/AIDS and would really love to continue my journey in this field.’

She has always tried to maintain a balance between her work and social life, and is extremely passionate about sport, gaining her KZN colours in both surfing and swimming. ‘My family is the backbone of my success and have always supported and encouraged me in whatever I do. My parents are both educators and have instilled in me and my two sisters the importance of education.’ 

Nombuso Dlamini

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Quality of Life of HIV-Infected People in Durban Examined in PhD Study

Quality of Life of HIV-Infected People in Durban Examined in PhD Study
Dr Prishah Narsai graduated with a PhD in Public Health.

A doctoral study evaluated the Health Related Quality of Life (HRQoL) of people living in lower socio-economic areas, comparing People Living with HIV (PLWHIV) on antiretroviral therapy (ART) and HIV negative respondents, and factors associated with their HRQoL.

The thesis by PhD in Public Health graduate Dr Prishah Narsai, who is the eThekwini Municipality’s Chief Policy Analyst, was titled: “An Investigation of the Housing Conditions and the Health-Related Quality of Life of Clients in the Built Environment in the eThekwini Municipality During the HIV and AIDS Epidemic”.

The work also investigated the relationship between social networks and the health and housing status of people living with HIV on ART and HIV negative respondents, residing in the four housing typologies in the built environment.

Said Narsai: ‘As the urban population continues to grow and focus shifts from a rural to an urban emphasis, the provision of basic services and adequate settlements in rural locations must continue. Spatial analysis geographical information system (GIS) technology has long been in use in city planning, demography and epidemiology in all three spheres of government. For more complete, accurate and comprehensive geocoded data on resources, government needs to be more open with the availability of its data sets by allowing researchers access and forming partnerships to develop community initiatives.’

She believes the results will assist in studying the built environment to focus on communities in new ways, ‘This should lead to improved interventions and improve citizens HRQoL by developing healthy homes and healthy built environments.’

According to Narsai, appropriate public health interventions will help improve the quality of life of people living with HIV and AIDS. ‘Physical, psychological, social and environmental health factors should be taken into account when implementing these interventions,’ said Narsai.

The cross sectional descriptive study was conducted at the eThekwini Municipality under the supervision of Professor Myra Taylor and Professor Champaklal Jinabhai. It was a two-phased study - phase one comprised a household survey and phase two was the antiretroviral therapy (ART) clinic survey.

The community-based household survey was conducted in four lower socio-economic housing typologies with randomly selected household heads or their representatives to investigate their housing and health needs.

The clinic-based survey investigated the housing and health needs of randomly selected HIV patients on ART attending local hospitals. ‘The same study instrument was used for both phases in anonymous interviews with each respondent,’ said Narsai.

The respondents lived in four housing typologies - Reconstruction and Development Programme (RDP) houses, informal settlements (IS), inner-city apartments (IC), and traditional rural (TR) housing.

Narsai, who holds a Master’s Degree in Public Health Law, received an HIV/AIDS Training Scholarship from Columbia University in the United States and successfully completed a South African Netherlands Research Programme on Alternatives in Development (SANPAD).

The mother of three, said it was a challenge to balance her family, work and completing her PhD. Her husband, Sastri, their children - Achim, Ethan and Alina - and the rest of the family were proud of her achievement.

Nombuso Dlamini

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Traditional Medicine Study Results in PhD for UKZN Senior Lecturer

Traditional Medicine Study Results in PhD for UKZN Senior Lecturer
A proud moment for Dr Mlungisi Ngcobo.

A Senior Lecturer in Traditional Medicine, Dr Mlungisi Ngcobo, graduated with a PhD in Health Sciences (Traditional Medicine) following a study which compared the immunomodulatory effects of a commercial traditional medicine product to a traditional immune tonic produced by a traditional healer.

Ngcobo’s study provided evidence that traditional medicines can modulate the immune response in a laboratory setting and in bacteria-infected animal models.

‘This study could have implications for the treatment of immune-related diseases such as cancer and tuberculosis,’ said Ngcobo. Supervised by Professor Nceba Gqaleni, the study has resulted in at least six articles being published in national and international peer-reviewed journals.

‘With the increase in the number of diseases that affect the immune system, there has been a huge increase in the number of commercial traditional medicine products claiming to have immune boosting powers.

The majority of these products are not owned by traditional healers,’ said Ngcobo.

He says strengthening the immune system through various medicinal interventions is very important in the African traditional healing philosophy.

Titled: "Evaluation of Immunomodulatory Mechanisms of South African Traditional Medicines Using in vitro and in vivo models”, the theses aimed to comparatively evaluate the biochemical immunomodulatory effects of the commercial immune booster, uMakhonya®, and a traditional energy tonic prepared by a traditional healer using in vitro models, with the ultimate aim of studying one of these products using an in vivo model.

‘In the in vitro phase comparative studies on the effects of the uMakhonya® and the traditional energy tonic were undertaken,’ said Ngcobo. ‘These included immune toxicology, genotoxicology, free radical scavenging, lipid peroxidation, secretion of inflammatory cytokines, secretion of chemokines, chemotaxis, levels of soluble interleukin 2 receptors, and transcriptional activity of NF-?ß in PBMCs from normal human blood and THP-1 monocytes.’

He said further in vivo studies related to acute toxicity in Sprague Dawley rats and possible immune stimulating effects in Staphylococcus aureus-infected Sprague Dawley rats were conducted using the traditional energy tonic extract.

‘The results in various models of PBMCs showed that uMakhonya® can induce both pro-inflammatory and anti-inflammatory effects depending on the initial stimuli applied to immune cells. However, the traditional energy tonic doses showed better toxicological and immune stimulating profiles in all three models of PBMCs,’ said Ngcobo.

According to Ngcobo the traditional energy tonic did not show any toxicity in rats at 2 000 mg/mL/kg body weight and modulated the immune response of rat models infected with S. aureus.

According to Ngcobo, further studies on other animal models were necessary to further understand the energy stimulating and possible antimicrobial effects of this traditional energy tonic.

Ngcobo is also involved in a number of research related projects and is advocating for better basic education for township schools. ‘Seeing people succeed in doing good things is the most satisfying thing to witness and that motivates me to want to do the same and more,’ declared Ngcobo.

He has five siblings. ‘We were fortunate that our parents valued education so much that all of us went to school despite very tight finances. My family is proud of me and hopefully our next generation will go on to achieve bigger and better things.’  

Nombuso Dlamini

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Tuberculous Meningitis Examined in PhD Research

Tuberculous Meningitis Examined in PhD Research
A proud moment for PhD graduate, Dr Ikanyeng Dolly Seipone.

Post-doctoral Research Fellow in the Discipline of Public Health Medicine, Dr Ikanyeng Dolly Seipone of Botswana, graduated from UKZN with a PhD in Virology.

Her research investigated HIV replication characteristics in the cerebrospinal fluid versus blood of individuals with meningitis, including tuberculous meningitis (TBM), and explored immunological biomarkers for the disease.

‘The Southern Africa region has the highest burden of HIV that is further exacerbated by co-infection with TB, hence my interest in HIV/TB co-infection research,’ said Seipone.

‘I personally believe we cannot win the battle against AIDS if we do not also fight TB, since TB is the leading cause of morbidity and mortality in HIV-infected individuals in Africa. Tuberculous meningitis is a common complication in HIV infected people and a diagnosis of TBM still poses a major problem. Data is particularly lacking on HIV-1 subtype C that dominate the sub-Saharan region, and concomitant TB infection of the Central Nervous System (CNS).’

Her PhD study aimed to provide aid in enhancing knowledge on HIV-1 subtype C pathogenesis in tuberculous meningitis co-infection. This led to her pursuing her PhD project on HIV/TB co-infection in the CNS in the HIV Pathogenesis Programme (HPP). Seipone says she was blessed to have met one of the leading international scientists in HIV/AIDS research Professor Thumbi Ndung’u who became her supervisor and mentor for her PhD. 

Seipone says that there is a knowledge gap on the HIV subtype C which predominates in sub-Saharan Africa.  The impact of tuberculosis in the central nervous system on HIV replication dynamics and evolution are unknown and effective diagnosis of TBM still remains a major problem in developing countries.

On analysis, the study found that tuberculous meningitis was associated with high cerebrospinal fluid viral load and there was evidence of distinct viral strains in the cerebrospinal fluid compared to blood in some patients. The study data suggest that TB co-infection of the CNS is associated with enhanced HIV-1 viral replication and higher HIV-1 quasispecies diversity. Markers that may distinguish tuberculous meningitis from other meningitides were identified and may provide a foundation on biomarkers that can be investigated as possible diagnosis tools for TBM.

‘This study has improved our understanding and has enhanced our knowledge of HIV/TB co-infection of the central nervous system and forms a basis for further research on pathogenesis and diagnosis,’ said Seipone. ‘It offers significant insight on Subtype C HIV-1 evolution and adaptation to the CNS during TB co-infection and might be valuable in the prevention of HIV-neurological disorders and thus managing HIV/TB co-infection.  Data from this study has been presented in both local and international conferences and work is in progress for publication of two articles, one in the Journal of Acquired Immune Deficiency Syndromes and the other in the Journal of Virology.

‘I am very humbled and ecstatic. It is still sinking in that I now sit amongst the few African women under 40 with a PhD in Science. I firmly believe we are blessed in order to bless others and therefore aspire to inspire a girl child and make her believe she can achieve anything she wants.’

Seipone says she is in the process of establishing a mentorship programme and has received a number of young aspiring professionals requesting her to mentor them.  The driven young doctor is also in the process of registering a woman in science organisation in Botswana to support women in science in her country.

Seipone hopes to one day be a health policy maker at a global level and a leading medical research scientist in Africa. ‘I am passionate about health issues and making a difference.’

Seipone grew up in the village of Kang in the southern part of Botswana. She lost her mother at a very young age and was raised by her father who ensured she received a good education. 

‘My ideal world is where people live equal lives and have equal opportunities. This is the same passion that drew me to the post-doctoral project that I am about to embark on which is based on improving the health conditions of refugees and combating diseases of poverty amongst this population and volunteering with organisations such as the Cancer Association of South Africa (CANSA).’

Lihle Sosibo

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Newcastle Graduate First Medical Doctor in His Family

Newcastle Graduate First Medical Doctor in His Family
Dr Lindokuhle Wiseman Ndaba is the first medical doctor in his family.

Medical graduate, Dr Lindokuhle Wiseman Ndaba, became the first doctor in his family after he obtained his degree cum laude.

Ndaba, who completed his matric at a local farm school in Osizweni in Newcastle, said his family was extremely proud of his achievement, ‘This has been the cherry on top for me.  Completing my degree and being the first doctor in my family,’ he said proudly.

‘It is difficult to explain how elated I am completing my degree cum laude. It is great that my years of consistent hard work have been recognised with this honour,’ said Ndaba.

‘This result has opened my mind to what is possible when you channel your energy towards a specific goal and consistently put in the work towards realising that goal. It has shown me that possibilities are endless,’ he added.

Ndaba’s future plans includes specialising as a physician and then obtaining his PhD, ‘I want to groom future doctors and make a lasting contribution in the field of internal medicine.’

The need to raise the bar for his family and to show them what they are capable of if they put in the work keeps Ndaba motivated.

‘These marks aren’t everything. Don’t let marks on a piece of paper define you or your self-worth, rather focus on improving yourself every day.

‘Remember your best is always good enough. If you know in your heart of hearts you have given it your all, then that is all that matters. Do whatever works for you,’ said Ndaba.

Nombuso Dlamini

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Record Number of Medical Students Graduate Cum Laude

Record Number of Medical Students Graduate <em>Cum Laude</em>
Making history, 18 cum laude Medical graduates.

A record number of 18 Medical students graduated cum laude through UKZN’s College of Health Sciences this year.

They are Dr’s Shannon Keshnie Pillay, Joedene Chetty, Krisantha Moodley, Rumaisa Hassim, Neliksha Singh, Ulisha Naidoo, Lisha Narayan, Nazeerah Kajee, Verushka Singh, Yugeshni Naidoo, Shamima Dokrat, Kgotso Lawrence Sambo, Lindokuhle Wiseman Ndaba, Rodney Govender, Vidaisha Naidoo, Babuse Ndlovu, Adebayo Ojewole and Brian Odhiambo Odindo.

‘I feel great and am still in disbelief about my achievement,’ said Sambo, who struggled to explain the cum laude significance to his family. ‘They don’t know what this cum laude thing is all about. They were happy that I completed the degree in record time but I don’t think that they fully appreciate what it means to complete with such honours.’

Sambo loves teaching and was involved in academic mentorship programmes on campus. ‘I would love to become a lecturer someday. I hope to study further and specialise in Internal Medicine or General Surgery.’

Said Kajee: ‘It feels amazing, really. I could not be happier after all the hard work that went into it.’

Also the first doctor in her family, Kajee said her achievement had brought an immense amount of happiness to everyone close to her. ‘I couldn’t have achieved this without the continuous support of my parents and family. I am grateful that I have made them proud.’   Kajee wants to specialise in Internal Medicine but is keeping her options open.

‘Graduating cum laude in Medicine certainly stands out from my other academic achievements and puts me in a good place for my postgraduate endeavours,’ said Singh, currently doing her internship at the Pietermaritzburg Hospital complex.

Singh received numerous academic awards in high school and held several leadership positions. ‘In my spare time I enjoy creative work be it decorating a cake or working on my scrapbooks. I also enjoy ice skating, playing board games and spending time with friends and family.’

‘With dedication and hard work you can achieve almost anything,’ said Ulisha Naidoo. ‘The six years of hard work paid off.’

Naidoo hopes to discover what to specialise in during her internship and community service years. As a student, she enjoyed Internal Medicine and Dermatology,

She advised other students, including her sister who is doing third year at Medical School, to stay focused, believe in their abilities and not to be afraid to ask for help. ‘At the end of the day we are studying not merely for the mark but for our patients – don’t lose sight of that,’ she said. 

‘I am glad it’s over,’ laughed Ndlovu. ‘I am over the moon. It was always my desire to get great results but that hope sort of faded away half way through the degree.’

Ndlovu says the achievement symbolises God’s faithfulness and unfailing love, ‘It also reminds me that I can do anything I put my mind to.’

Nombuso Dlamini

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Government HIV and AIDS Prevention Interventions Not Working in Chatsworth – Research Finding

Government HIV and AIDS Prevention Interventions Not Working in Chatsworth – Research Finding
An elated PhD graduate, Dr Yogandra Naidoo.

A study by PhD graduate Dr Yogandra Dhee Naidoo revealed that Government HIV and AIDS prevention interventions were not working in Chatsworth.

According to Naidoo, there is lack of knowledge in the Chatsworth community about HIV behavioural interventions, biomedical interventions and structural barriers.

The study titled: “Government’s HIV and AIDS Prevention, Treatment and Care Programmes: An Exploration of Lay Experiences in the South African Indian Community of Chatsworth", earned Naidoo a PhD in Public Health.

Supervised by Professor Myra Taylor, Naidoo aimed to gain insight into the behavioural, biomedical and structural factors underlying HIV and AIDS prevention, treatment and care in the community.

‘My goal was to understand factors that contribute to the effectiveness of the government’s HIV and AIDS treatment, care and prevention programmes as experienced by the Chatsworth community,’ said Naidoo.

‘These barriers comprise lack of awareness of HIV prevention and care programmes, low condom usage, multiple sexual partners, early sexual debut and low participation in HIV testing and treatment.’

He said very little was known about HIV/AIDS among the South African Indian community.

Naidoo’s study drew on the national HIV/AIDS crisis and its growth and how it is affecting the South African Indian community as well as how it is perceived, spoken about and responded to by the people of Chatsworth in terms of their perceptions, attitudes and beliefs surrounding the government’s prevention, treatment and care programmes.

Naidoo conducted 35 in-depth interviews and five focus group discussions among community members, including people who are living with HIV in Chatsworth.

‘After the interviews had been transcribed I used Atlas TI - a qualitative analysis software programme - to code my data and thereafter looked for codes which were combined into themes and important issues that had been raised by the respondents. This resulted in the generation of patterns, categories and themes.’

Naidoo said there was an urgent need to further strengthen HIV prevention, treatment and care efforts within the South African Indian community. ‘As the long-term queue for HIV treatment lengthens, the continuing high rate of new HIV infections threatens the practical feasibility of the South African efforts to provide nationwide access to antiretroviral therapy for those who need it.

‘Despite the clear need for stronger efforts to prevent HIV - prevention, treatment and care programmes are lacking in communities in South Africa such as the Indian community of Chatsworth. This was evident from the data collected from this study.’

Naidoo is currently doing post-doctoral work at the Human Sciences Research Council in the Unit of HIV/AIDS, STIs and TB within the programme of Social, Behavioural and Biomedical Interventions. He aims to work towards becoming an established researcher within public health, focusing on impacts of diseases on communities.

Naidoo is a people’s person who loves travelling and is family orientated, ‘I come from a close extended family where we all live next door to each other.’ He has an older brother, Shavan and a younger sister, Kamantha. 

‘I also view my cousins as my siblings because we live next door to each other and are very close,’ he said

Naidoo’s parents, aunties and uncles are proud of his achievements. Said Naidoo: ‘My family members are my pillars. They are extremely excited and proud of my achievement.'

Nombuso Dlamini

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Lack of Education and Disturbed Family Structures Put Young KZN Girls at Risk for Cervical Cancer - PhD Study Finding

Lack of Education and Disturbed Family Structures Put Young KZN Girls at Risk for Cervical Cancer - PhD Study Finding
Researching cervical cancer earned Dr Joyce Nonhlanhla Mbatha a PhD.

A lack of knowledge about HIV and homes without a “father figure” put young girls in KwaZulu-Natal at a higher risk of contracting cervical cancer, according to a UKZN researcher.

The PhD study by Dr Joyce Nonhlanhla Mbatha on HIV-infected and uninfected young girls is believed to be the first such community-based investigation involving high school girls in KwaZulu-Natal.

Mbatha graduated with a doctorate in Medical Microbiology for her work titled: “Genotyping, Clearance and Persistence of High-Risk Human Papillomavirus (HPV) and Evaluation of Self-Sampling Techniques in HIV-Infected and Uninfected Young Women in Selected Regions of KwaZulu-Natal”.

Mbatha enrolled teenage girls as participants in her study because of the South African Government Initiative in which human papillomavirus (HPV) vaccine is administered to school-going girls to protect them against cervical cancer.

She then identified a need to describe high-risk HPV genotypes circulating in KwaZulu-Natal in order for locals to have an idea of what they were faced with. ‘Research on HPV is sparse in KZN - most HPV research has been conducted in the Western Cape and Gauteng. Another reason for involving young women in this research was to create some awareness about the causal relationship between HPV and cervical cancer as well as that of HPV vaccine,’ Mbatha explained.

A finding from the study recommends the introduction of education in schools on HPV and cervical cancer. Also mentioned was how the absence of a father figure in the home can affect a girl’s behaviour and plays a role in girls being exposed to the dangers of cervical cancer.

Mbatha is a Medical Technologist and has 12 years’ experience as a lecturer. She is currently a lecturer and head of programme at the Durban University of Technology (DUT) where she teaches Introduction to Medical Technology, Foundation Biochemistry and Biochemistry 2 and Integrated Pathophysiology 4.

She also moderates microbiology, chemical pathology and laboratory techniques subjects.

Mbatha has supervised three masters students to graduation and is currently supervising two masters students at DUT. She has led the curriculum development of a new degree - Bachelor of Health Sciences in Medical Laboratory Science - which has been approved by the Council for Higher Education (CHE) to start at DUT next year.

‘I feel a great sense of confidence and excitement that I finished what I started,’ said Mbatha. ‘I now aim to further my research. When I first registered for my PhD, I was going through a very challenging period but gained strength from God and from the support I received from my family, friends and most importantly from my supervisors and project leaders.

‘I could not have done it without my supervisor, Dr Z L Kwitshana and co-supervisor, Dr M Baay.’

Mbatha, who grew up in Empangeni and has three children and two grandchildren, loves the outdoor life and spending time with her family.

Lihle Sosibo

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Five UKZN Medical Students Graduate Summa Cum Laude

Five UKZN Medical Students Graduate <em>Summa Cum Laude</em>
Five summa cum laudes in Medicine.

Five Medical students in the Class of 2016 graduated summa cum laude from UKZN’s Nelson R Mandela School of Medicine this year.

They are Dr’s Preyanka Pillay, Kristy Herridge, Karishma Heeramun, Siveshin Moodley and Yusuf Khatib.

‘It was a huge surprise to receive the news,’ said Herridge. ‘My family is very proud to have a doctor in the family and glad to see my hard work paid off. Right now I’m concentrating on surviving internship so I can’t say exactly what the future holds for me. 

‘The pursuit of excellence keeps me going – mediocrity is just not good enough,’ she said.

Durban-born Herridge had this advice for other aspirants: ‘Hard work, perseverance and discipline are the key to success and that means missing parties, nights out and holidays.  It’s all about getting priorities right.’

Herridge comes from a very supportive family, ‘When I quit my good job in Johannesburg to study Medicine, I received nothing but unconditional love and support. Both emotional and financial.

‘I’m not a genius. What I do have in abundance, however, is a desire and drive to excel, reach my potential and accomplish goals I set for myself! I say this because these achievements are not limited to those gifted with superior intellect. They are in reach of every student who puts in the effort. It’s not rocket science. It’s the daily grind.’

Completing his Medical degree summa cum laude came as a shock to Moodley, ‘I confirmed it several times but I only really believed it after the announcement by the Deputy Vice-Chancellor.

‘The news brought great joy to my family. It was something surreal to tell the truth. One of my goals in life is to do my best and make my family proud and I have managed that.

‘I would never have been able to achieve what I did without my family influences and no amount of words can describe the gratitude I have for them. I achieved what I did through the cumulative input of my social influences, my family and my lifestyle.

 ‘It also showed me that I am in the right profession because although the road was tough, I thoroughly enjoyed myself. I was never a nerd to the point that studying was my life. Quite the contrary actually.’

Moodley has always enjoyed a challenge, ‘I believe in pushing myself. I know I have boundaries but I always strive to push myself to the limits and if possible beyond. I try to have a balanced life. Exercise is life for me. I would go crazy if all I did was study. I find exercise to be the best release of stress.’

He advised those still studying to enjoy life and flourish. ‘Some people say stop dreaming and face reality; I say keep dreaming and make reality. Don't follow where the path may lead. Go, instead, where there is no path and leave your trail.’

Heeramun said it was ‘amazing’ to complete her degree summa cum laude. ‘I am so grateful that all the years of hard work have paid off. These six years have been full of challenges with hardly a dull moment in Medical School.'

Her family was overwhelmed when they heard the news. ‘They were so excited that they started phoning all our relatives to tell them. They have been so supportive towards me over these years, it feels really good to see how happy and proud I have made them.

‘These six years have been full of challenges with hardly a dull moment in Medical School.

She is currently doing her internship in the Free State and hopes to specialise in Paediatrics.

Khatib said his results were motivation for him to continue to strive for excellence in the field of Medicine, ‘I hope to specialise as a physician and I would also like to be at the forefront of technology and innovation in healthcare.’  Khatib’s achievement fulfilled his late grandfather’s dream of having a doctor in the family.

Pillay, who is also the top Medical student in her class, is thrilled about her success. ‘The reality is the harder you work for something the greater the sense of achievement. I have always aimed for excellence in the hope that success would follow.

‘My family is extremely proud and happy that I accomplished my goals. These results have given me a sense of accomplishment knowing that my hard work and sacrifice have paid off. I am very grateful to my family for their love and support.’

Pillay is currently doing her internship at the Pietermaritzburg Hospital Complex.

Although she has not decided what to specialise in, she wants to be involved in research and the integration of medicine with technology in order to contribute to improvements and innovation in Medicine.

Her advice to students is: ‘Never give up, work hard, stay grounded and run your own race. Imagine, believe, achieve.’

Nombuso Dlamini

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Lack of Information on Breast Tuberculosis – Study Finding

Lack of Information on Breast Tuberculosis – Study Finding
A proud moment for Professor Richard Hift as he congratulates his student, Dr Dibuseng Ramaema.

There is a lack of evidence-based information on breast tuberculosis (BTB), a UKZN study has found.

The research was conducted by the Head of the Clinical Unit in the Department of Radiology, Dr Dibuseng Ramaema, whose thesis was titled: “Radiologic Evaluation of Breast Disorders Related to Tuberculosis Amongst Women in Durban”.

Earning Ramaema a PhD in Radiology, the study showed that a lot still has to be done in educating the public and healthcare workers about breast diseases.

According to Ramaema, her thesis aimed to compare the effectiveness of various radiological technologies to identify breast problems.  ‘Women in KwaZulu-Natal are at high risk of developing BTB due to the increased incidence of HIV. However, there is a general lack of knowledge regarding the various diseases that can affect the breast.

‘This is compounded by problems with the national breast screening programme. As a result, many patients with breast cancer (BCA) and BTB are initially misdiagnosed by clinicians,’ she said.

The study consisted of three phases - all based at eThekwini Municipality tertiary referral hospitals - supervised by the School of Clinical Medicine’s Professor Richard Hift.

‘The first phase aimed to determine the prevalence of BTB using retrospective data,’ said Ramaema. ‘The same data further provided information on the clinical and radiological manifestations of BTB.

‘This study concluded that while BTB is not common, it shares clinical and radiology features with breast cancer (BCA), and is difficult to diagnose with current pathology methods.’

The second phase was done prospectively by recruiting patients newly-diagnosed with BTB. ‘The aim was to evaluate the use of modern imaging techniques to further describe the radiology patterns of BTB and to determine the radiological parameters that may be used in disease monitoring,’ said Ramaema.

The results provided insight into disease extent and showed that it was usually more severe than perceived with current diagnostic methods.

The third phase was performed with a retrospective image analysis of patients who had BCA and BTB, using modern radiology techniques.  The goal was to identify salient features that differentiate BTB from BCA.

‘Several radiology parameters were identified as possible biomarkers for differentiation between the two conditions. The knowledge of their respective features will assist in the timeous diagnosis of both conditions, particularly in cases where the pathology results are inconclusive for various reasons,’ said Ramaema.

She said the study confirmed the low prevalence of BTB, however, at this stage some of their findings were preliminary and would require validation through future research.

With her doctorate complete, Ramaema is now focusing on her Department’s academic and service improvements.

Nombuso Dlamini

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Deaf People Can Do Anything Except Hear!

Deaf People Can Do Anything Except Hear!
Hearing impaired Ms Kalindi Persadh graduates with an Honours degree.

Deaf people can do anything except hear, is the philosophy of hearing-impaired Ms Kalindi Persadh, who proved just that when she graduated from UKZN with a Bachelor of Medical Science (Medical Microbiology) Honours degree.

Persadh (23), now busy with her Master’s degree in Medical Sciences, said: ‘I aim to study further and work my way towards a PhD degree in health sciences and contribute to the science community and people in general.

‘I am profoundly deaf in my right ear with 10% hearing in the other. I have the ability to lip-read, which helps me understand what people are saying. I also rely on a powerful hearing aid which I use in my barely capable ear,’ she said.

‘It was very difficult trying to hear in a full lecture theatre and it is not easy to lip-read and take notes at the same time. I also have language and vocabulary deficiencies as my speech is unclear so I miss a great deal of crucial information usually gained through everyday conversations,’ said Persadh.

‘What helped me were my hearing aid and lecturers kind enough to wear an FM transmitting device which I provided. I am also grateful for the assistance and extra time given to me by my lecturers. I try to overcome all my obstacles by working hard every day.’

Persadh says she has strong belief in God and her parents have also motivated and guided her every step of the way. 

Persadh chose Medical Science because she loves science. ‘I have always been curious about health-related issues because of my hearing impairment. Hopefully, one day I will be able to help those in the same predicament. 

‘My experience at UKZN was fulfilling - the professors and lecturers were compassionate and always very helpful.  I am grateful to the UKZN Disability Unit for all their assistance and to the University for accepting me as a student to do my Masters in Health Sciences.

Persadh loves spending time with her family and friends, reading, swimming, and travelling. She is a strict vegetarian, her favourite dish is pasta and her favourite cook is her mom!

She has two younger siblings who are studying at UKZN. She feels fortunate to have wonderful parents who guide and allow her to study further.  

‘I want to encourage and motivate students with hearing or any other disability to pursue their dreams.’ 

Lihle Sosibo

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Guillain-Barre Syndrome Common in HIV Positive Women – Study Finding

Guillain-Barre Syndrome Common in HIV Positive Women – Study Finding
Dr Ansuya Naidoo.

The Guillain-Barre Syndrome (GBS) occurs commonly in young HIV positive women, a study by a Master of Medicine graduate has found.

The study was conducted by Dr Ansuya Naidoo, a lecturer in UKZN’s School of Clinical Medicine and Consultant Neurologist at Greys Academic Hospital in Pietermaritzburg.

GBS, also known as Acute Inflammatory Demyelinating Polyneuropathy (AIDP), is a primarily demyelinating polyradiculo-neuropathy, characterised by rapidly evolving symmetrical limb weakness which overshadows sensory symptoms and signs.

‘The purpose of this study was to review all cases of GBS admitted to tertiary neurology referral centres at  Inkosi Albert Luthuli Memorial Hospital in Durban and Greys Hospital in Pietermaritzburg over a seven-year period,’ said Naidoo. ‘We aimed to compare the epidemiological, clinical, biochemical, and neurophysiological features between the subgroups of HIV associated GBS (HIV positive) and non-HIV associated GBS (HIV negative).’

The study found that sensory symptoms and signs predominate in HIV-associated GBS which is more prone to developing axonal variants of GBS.

‘HIV-associated GBS presents with higher CSF protein levels than previously described and a CSF pleocytosis does not persist in the presence of HIV- associated GBS. HIV-associated GBS occurred at lower CD4 counts than previously described. Non-HIV associated GBS patients display a better recovery and lower mortality,’ said Naidoo.

Naidoo says the study enables a better understanding of the clinical picture of GBS in HIV positive versus negative patients.

It was titled: “A Retrospective Study of Epidemiological Data, Clinical Presentation, Neurophysiological Features and Laboratory Features of Patients with Guillain-Barre Syndrome (GBS) Admitted to Two Tertiary Neurology Referral Centres in KwaZulu-Natal, South Africa”.

Naidoo believes the study is novel and will help in the early clinical detection and treatment of the condition and thus improve recovery outcomes.

‘The association between HIV infection and GBS has been well described. Although multiple worldwide reports of the syndrome exist, there has been no large systematic study of GBS comparing the characteristics of HIV- associated and non-HIV associated GBS performed in the South African setting.’

She said it was uncertain whether a distinct pattern of the syndrome existed in HIV associated GBS. ‘This study aims to better delineate this.’

She said 72 patients, 39 of whom were HIV positive, with a final diagnosis of GBS were identified. HIV status was known in 59 patients. The mean age of the cohort was 34 years (range 12 -76). In the HIV-associated GBS group, 60% of patients were female and in the non-HIV associated GBS group, 27% were female.

Nombuso Dlamini

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Study Develops Framework to Engage Chronic Kidney Disease (CKD) Patients with their Integrated Management

Study Develops Framework to Engage Chronic Kidney Disease (CKD) Patients with their Integrated Management
PhD in Public Health medicine for Dr Geldine Chironda.

UKZN PhD graduate Dr Geldine Chironda has ensured that Chronic Kidney Disease (CKD) patients adequately manage their condition.

‘Effective management of CKD entails patients engaging with their dialysis plan, medication, fluid and dietary restriction to reduce complications and progression of the disease to end of life stages,’ said Chironda.

In this regard, she developed a framework which would facilitate engagement of CKD patients with their integrated management in selected tertiary hospitals in the eThekwini District. ‘The study used a sequential explanatory mixed method design where quantitative data was collected and analysed first, followed by the collection and analysis of qualitative data,’ she said.

‘Firstly, the level of engagement with integrated management was established using descriptive cross sectional design. Thereafter, participants with the highest and lowest level of engagement, including their respective caregivers and healthcare workers, were selected to reveal the motivators of and barriers to engagement with integrated management using qualitative case study. Findings from the quantitative and qualitative phases were converged to develop a framework for engagement of CKD patients with their integrated management.’

According to Chironda, there is a new discovery associated with the study. ‘New information on varying engagement behaviours and the reasons were discovered from the South African context. Further, a comprehensive framework that will promote patient engagement was developed using results from the quantitative and qualitative phase.

‘The care of CKD is complex as it requires different people to co-ordinate the care of these patients, that is why the perceptions of caregivers and healthcare professionals regarding the integrated management of CKD patients were included in the study.’

Chironda says resource constraints regarding CKD treatment in public hospitals in South Africa results in issues of distributive justice. ‘Hence the strict selection criteria introduced by the Department of Health as a legal measure to aid in selection of CKD patients. The criterion for admission of CKD patients to the CKD programme is eligibility for a kidney transplant and this directly impacts on those CKD patients who do not match the criteria as well as their respective families and communities in society.’

‘Kidney transplant is acknowledged as a major advance of modern medicine which provides high-quality years to patients with irreversible kidney failure. Although a successful renal transplant is advantageous in terms of patient quality of life, a shortage of donor organs has resulted in dialysis becoming the dominating treatment. Hence, the  study recommended media engagement  in educating the society about CKD, such as advertising a low-salt diet and healthy living behaviours, and creating awareness about organ donation to increase the number of kidneys for transplantation in healthcare settings.’

She thanked the Dean of Research in the College of Health Sciences, Professor Moses Chimbari, for his assistance and support, and her supervisor, Professor Busi Bhengu, for her untiring guidance and encouragement. 

Chironda works for the Human Resources for Health (HRH) programme as a training specialist at the University of New York’s Rory Meyers College of Nursing.  At present she is at the University of Rwanda’s School of Medicine and Health Sciences where she is a training specialist.

Nombuso Dlamini

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Senior Lecturer Graduates with a PhD in Public Health

Senior Lecturer Graduates with a PhD in Public Health
Public Health medicine specialist, Dr Tivani Mashamba-Thompson.

Public Health scientist, Dr Tivani Mashamba-Thompson, graduated with a PhD for a study titled: “Evaluating the Accessibility and Utility of HIV-Related Point of Care (POC) Diagnostics for Maternal Health in Rural South Africa”.

“Point-of-care” (POC) diagnostics is an approach to improve healthcare access.

Supervised by Professor Paul Drain and Professor Benn Sartorius, Mashamba-Thompson’s study evaluated the existing HIV and maternal health POC diagnostic services with the aim of identifying potential challenges and barriers related to the implementation of POC diagnostics services for rural and resource-limited settings.

According to Mashamba-Thompson, identifying these barriers and challenges will assist to inform planned improvements to existing POC diagnostics and implementation of new POC diagnostics.

‘My research identified potential life-saving and transformative POC tests that need to be prioritised during implementation of POC diagnostics in rural and resource-limited settings.’

She said it also showed issues related to facilitators, and the challenges and barriers related to the implementation of POC diagnostics in rural primary healthcare (PHC) clinics in South Africa.

‘Although the study shows that several POC tests were widely available, and tests for HIV and CD4 were most frequently performed, there remains a significant need for additional POC tests to improve detection and management of both communicable and non-communicable priority disease conditions.’

The study also demonstrated the impact of the HIV POC test with improved maternal outcomes as well as the association between syphilis POC diagnostics and reduced maternal mortality ratio.

The study identified a number of barriers to implementation of POC diagnostics ie. poor supply chain management, poor infrastructure and limited knowledge of POC tests amongst users.

It also identified poor quality management systems and poor compliance with standards or guidelines as major challenges to the implementation of rural PHC clinic-based POC diagnostics services for the improvement of maternal outcomes.

‘To maximise the potential of new POC tests, the above barriers and challenges need to be addressed prior to implementation,’ she said.

Based on the findings of this study, Mashamba-Thompson, proposed a framework for improving POC diagnostics training strategies for health care workers in PHC clinics. Her study has produced 10 manuscripts, seven of which are published and accessible via this link.

She said her study would be expanded to Zimbambwe, Zambia and Ghana through three PhD students, who Mashamba-Thompson is supervising.

She is currently involved in undergraduate and postgraduate teaching in the Department of Public Health Medicine and is supervising masters and PhD students.

She was recently invited to participate in a POC testing stakeholder workshop held by the International Diagnostics Centre (IDC) of the London School of Hygiene and Tropical Medicine and the African Society for Laboratory Medicine in Cape Town.

A married mother of three, she grew up in the village of Mulamula in Limpopo and spent most of her adult life in England, completing her honours degree at the University of Surrey and a postgraduate diploma at the University of Greenwhich in London.

Nombuso Dlamini

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Health and Well-Being of Street Children in Cameroon in the Spotlight in Doctoral Thesis

Health and Well-Being of Street Children in Cameroon in the Spotlight in Doctoral Thesis
Dr Samuel Cumber.

PhD graduate Dr Samuel Nambile Cumber of Cameroon investigated the health and well-being of street children in his country.

His thesis was titled: “A Situational Analysis of the Health Status and Risky Factors of Street Children in Cameroon with the aim to develop an appropriate intervention model to improve their health”.

Cumber’s study also sought to determine the health, social and psychological challenges and associated risk factors for street children and from there propose an intervention model to improve their situation and also get them off the streets.

According to Cumber, Cameroon does not have any intervention programme for street children. ‘In order to implement an intervention, specific information on the children was required.’

He surveyed 399 participants, 80% male and 20% female, aged between 12 and 17 using structured questionnaires analysed through the Statistical Package for Social Sciences (SPSS) version 14.

Cumber found the most common psychoactive substances used by the street kids were alcohol and tobacco, and 73% had been involved in a fight after usage. In order to survive, some beg, steal, and do sex work.

He said 91% have heard of HIV/AIDS but 53% did not know that unsafe sex was risky. ‘Above 70% indicated that their source of HIV information was friends, 53% had never used a condom and all participants said condoms were too expensive to buy. More than 90% had no access to street services or support.’

The challenges reported in the survey were supported by results from interviews with key informants and focus group discussions with street children as well as from the systematic literature review.

‘Addressing all these challenges will need a comprehensive approach to the phenomenon of street children, aimed at improving their health, welfare and their quality of life. These should include tackling hunger, hygiene, disease, homelessness, and other problems.’

In collaboration with his supervisor, Professor Joyce Tsoka-Gwegweni, he published six articles from his thesis within a year.  

Cumber plans to begin his post-doctoral studies soon under the supervision of Tsoka-Gwegweni.

Married with three children, Cumber says he was raised by a single mother. ‘My siblings sacrificed a lot for me to go to school. I have depended on family support, especially from my siblings who gave up their education to go to work due to family circumstances.’

While doing his PhD, Cumber faced a challenging life situation when his pregnant wife was seriously hurt in a train accident. ‘I had to deal with the accident situation and the unborn baby who stayed miraculously in my wife’s womb for another two months, despite the accident and the numerous surgeries performed on her. I thank God because of his mercy and the support I received from friends and family, I was able to stand firm and continue with my research.’

He has a Bachelor’s Degree in Anthropology from the University of Yaoundé and obtained three masters degrees while studying in Sweden.

Nombuso Dlamini

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Bone Study to Estimate Age Researched by PhD Graduate

Bone Study to Estimate Age Researched by PhD Graduate
Dr Keseri Padayachy is elated about graduating with a PhD.

‘Anatomy has always been fascinating for me, and I am extremely excited to be awarded my PhD in Anatomy,’ said Dr Keseri Padayachy.

Padayachy has been in private practice as a chiropractor for the past 11 years and has lectured part-time at UKZN since 2006.

She says her study involved estimating skeletal/bone age by concentrating on morphometric measurements for each bone of the wrist from birth to 20 years of age.

‘Bone age is a measure of developmental age or physiological maturity, and refers to how far an individual has progressed towards full skeletal maturity. Skeletal maturation is evidenced by an orderly and reproducible sequence of recognisable changes in the appearance of the skeleton during childhood. Such changes include the timing and sequence of the appearance of centres of ossification, specific alterations in the morphology, and the timing and sequence of the ultimate closure of the growth plates which is particularly useful in the clinical evaluation of early and late maturation.

‘Bone age is frequently performed for the evaluation of growth and the diagnosis and management of a multitude of endocrine disorders and paediatric syndromes such as hyperandrogenism, hypogonadism and interpreting hormone levels at pubertal age. The indications for bone age estimations are well recognised in paediatrics both clinically and forensically,’ said Padayachy.

The aim of the study therefore was to analyse the wrist of infants up to early adulthood within the indigenous population in KwaZulu-Natal, using radiographs in order to record the morphometric changes and development of the wrist bones, to elaborate on changes in ossification centres in the wrist bones with the intention of establishing normative values in the South African indigenous population.

Padayachy believes her study is the first of its kind in South Africa. ‘Previous research in this country compared data to the skeletal aging atlas developed by Greulich and Pyle which was established in 1959 in the United States, whereas my research entailed morphometric measurements that resulted in the formation of data specific to KwaZulu-Natal.

‘Study results show a growth rate variation in the South African population when compared to the standard bench mark GP atlas, thus making the current research data more appropriate for skeletal age estimation in this country, thereby reducing the degree of error in calculating the skeletal age in our current population. This therefore benefits the fields of forensic medicine, anthropology, radiology, endocrine paediatrics, and clinical medicine, among others,’ said Padayachy.

‘I believe that hard work, faith and dedication will certainly lead to success in all that we do. I have always been motivated to reach for the stars.’

Her study entailed collecting data from provincial hospitals in distant places such as Rietvlei and Ngwelezane, which meant lots of long distance driving for her research associate Dr Fazila Ally and herself.

She thanked her husband, parents and sisters for their support during her studies as well as her supervisor, Professor K.S. Satyapal.

Padayachy hopes to begin her post-doctoral studies soon, examining skeletal aging of the wrist in patients presenting with HIV, MDR-TB and nutritional disorders prevalent in South Africa to compare growth changes. She also hopes to author a skeletal aging Atlas for South Africa.  ‘I believe that my passion for the academic and research environment makes me an asset to an academic institution and I hope to dedicate my time, effort and passion to ensure I see my research get results.’

Lihle Sosibo

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HIV Vaccine Development Research Results in Doctorate in Virology for UKZN Lecturer

HIV Vaccine Development Research  Results in Doctorate in Virology for UKZN Lecturer
Dr Bongiwe Ndlovu elated with her PhD.

A lecturer in the School of Laboratory Medicine and Medical Sciences, Dr Bongiwe Ndlovu, has been awarded a PhD in Virology working under the supervision of Professor Thumbi Ndung’u.

Ndlovu’s research was in the field of HIV-1 subtype C vaccine development, characterising the evolution of both binding and neutralising antibody responses in acute/early HIV subtype-C infection.

She says her interest in HIV-1 research was spurred by the high HIV prevalence in South Africa, especially in young women who are responsible for nearly 30% of all new infections in the country. She wanted to contribute to scientific knowledge and the development of HIV-1 vaccines in the field.

Studies have shown that there are 113 000 new infections in young women in South Africa every year - four times higher than the incidence in men.  

‘We are doing cutting-edge research in characterising HIV-1 specific binding antibodies in HIV-1 acute-infected individuals in South Africa,’ said Ndlovu.  ‘This is the first study to look at HIV-1 specific binding antibody responses in HIV-1 acute infections in South Africa. However, broadly neutralising antibodies have been studied extensively at the Centre for HIV and STIs at the National Institute of Communicable Diseases (NICD) in Johannesburg in collaboration with CAPRISA where a few individuals were discovered that developed very potent broadly cross-neutralising antibodies,’ she said.

Ndlovu and her research team are working in collaboration with scientists to identify more individuals who develop potent antibodies in other cohorts. She spent three months at NICD learning techniques used to screen participants for broadly neutralising antibodies and successfully transferred the technique to their laboratory in Durban.

Her study analysed retrospectively a group of 34 HIV-1-infected people in Durban and found that p24 and gp41-specific IgG were associated with HIV-1 slower disease progression. Her research team also identified 3/20 individuals who developed broadly neutralising antibodies. The team plans to study these participants extensively to identify some of the factors associated with the development of BNAbs.  

‘Broadly neutralising antibodies bind to diverse virus strains and block HIV-1 infection, thus they can be used to provide sterilising immunity. Here they have mapped the epitopes targeted by these antibodies and found that they target glycans at position 276 of the CD4 binding site and position 332 of the V3 loop on the HIV-1 envelope respectively. The third patient did not target any of the known specificities,’ she said.

Ndlovu’s PhD study highlights important aspects in the development of neutralising antibodies which could contribute to the design of an antibody-based vaccine. She says her work is important in defining early antibody responses and the role these antibodies may play in HIV pathogenesis.

Ndlovu, who grew up in Ixopo, said: ‘Academically, I have always been a determined and inquisitive person - my dream was to become a medical scientist.

‘Poverty was the main challenge as my parents were both unemployed and the family survived on social grants. I also did both my primary and high school education in disadvantaged schools that didn’t have resources such as computers.

‘I drew my strength from the Lord, Jesus Christ. He is the source of my strength.

‘I’m very excited about this achievement, it was not easy but it was worth it in the end. My plan is to visit a variety of institutions overseas to learn new laboratory techniques that I need to continue with my research. In addition, I’m planning to do my post-doctoral fellowship overseas or in collaboration with some leading scientists in the field.’

Ndlovu, who won various awards during her doctoral studies, is the youngest in her family and mother of an 11-year-old daughter.

‘We are a very close family and are able to talk about lots of things. I especially thank my late mother, dad, brother, sister and daughter for unconditional love and support throughout my academic studies. I love them so much and I would not have made it this far without them.’  

Ndlovu thanked her supervisor Professor Ndung’u for his continuous guidance, encouragement and support throughout her studies. She also thanked her collaborators Professor Bruce Walker, Professor Lynn Morris, Professor Penny Moore, Dr Galit Alter, Dr Jennifer Mabuka and Dr Amy Chung for their contributions.

She also received a lot of support from friends and colleagues.

Ndlovu enjoys reading, jogging and spending time with her family. Her favourite dish is spaghetti bolognaise.

Lihle Sosibo

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Nigerian Microbiologist Awarded PhD from UKZN

Nigerian Microbiologist Awarded PhD from UKZN
Graduating with a PhD is Dr Osaretin Emmanuel Asowata.

Nigerian-born Dr Osaretin Emmanuel Asowata, a post-doctoral Research Fellow in the School of Laboratory Medicine and Medical Sciences at the Nelson R Mandela School of Medicine, has graduated with a PhD in Medical Microbiology.

His research focused on factors influencing the effectiveness of a monovalent rotavirus vaccine among children five years and under in KwaZulu-Natal.

The project was part of a bigger diarrhoeal project investigating the aetiologies of diarrhoea among infants and young children.

‘I chose this area of research because preliminary outbreak data showed that Rotavirus was responsible for more than 50% of these diarrhoeal cases and the rotavirus vaccination coverage in KwaZulu-Natal was more than 90%,’ said Asowata.

Rotavirus post-vaccination effective studies have been done in Africa, however, only one such rotavirus study has been reported in South Africa. 

Asowata’s study reported for the first time the effect of rotavirus specific immunoglobulin G (IgG) avidity and sub-optimal vaccine storage temperature on the effectiveness of the monovalent Rotavirus vaccine.

This study revealed that genetic diversity of rotaviruses and poor immunogenicity of this monovalent rotavirus vaccine are possible factors influencing the effectiveness of this vaccine. In addition, findings from this study revealed that the Rotarix® vaccine is highly potent and fit for use in low income settings, including in KwaZulu-Natal, because the vaccine potency was maintained even after exposure to sub-optimal temperature. However, reasons for the maintained potency after vaccines exposure to these sub-optimal temperatures are still unknown.

Although this study only explored the effect of a constant “adverse” temperature on vaccine potency and not the effect of temperature fluctuations on vaccine potency, further exploration is needed in this area.

Asowata said the benefits of this study were that it would give parents, especially nursing mothers, a better understanding of the importance of the rotavirus vaccination exercise; enlighten people that the vaccine was only developed to protect against rotavirus associated with diarrhoeal hospitalisation and not all diarrhoea; and to educate society that not all infections are vaccine preventable. ‘In addition, this study revealed that the rotavirus vaccine effectiveness is low in KwaZulu-Natal and other low income settings in comparison to the higher vaccine effectiveness observed in the high income settings.’

A devoted Roman Catholic, Asowata thanked God for the strength he enjoyed during his studies. ‘My parents and siblings were also a source of strength because they believed in me even when I didn’t believe in myself. My supervisor, Professor Prashini Moodley, was also a source of strength through her constant encouragement and support.’

Asawata also thanked Professor AW Sturm and Dr Olubisi Ashiru for their support.

Asowata completed his Bachelor of Science honours degree and Master’s degree in Microbiology at the University of Lagos after which he applied to do his doctorate at UKZN’s School of Laboratory Medicine and Medical Sciences.

He was awarded a travel fellowship by the Bill & Melinda Gates Foundation to present some of his doctoral research findings at the 12th International Double Stranded RNA Virus Symposium in India in October 2015.  Asowata also presented at the 6th Federation of Infectious Diseases Societies of Southern Africa (FIDSSA) congress in South Africa in November 2015.

After completing his PhD, he got a global health travel scholarship to present a poster at a keystone symposium titled: “Translational Vaccinology for Global Health in London”.

He spends a lot of time doing research but also enjoys cooking, travelling and surfing the internet.

Lihle Sosibo

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Research Exposes Dangers of using Herb Hypoxis hemerocallidea to Combat HIV/AIDS

Research Exposes Dangers of using Herb <em>Hypoxis hemerocallidea</em> to Combat HIV/AIDS
Dr Ayoola Isaac Jegede graduated with a PhD in Anatomy.

The findings of PhD research by a Nigerian anatomist have shown the use of a popular herbal anti-HIV product - extract of Hypoxis hemerocallidea – to be detrimental to men, possibly leading to infertility.

Researcher and lecturer, Dr Ayoola Isaac Jegede, said the main objective of his research was to scientifically evaluate the benefits or otherwise of HIV-positive patients using the herb. Studies were done specifically on the herb’s effect on the sperm and testicular structure and to establish how this adjuvant use may interact with antiretroviral therapy. His study was conducted under the supervision of Dr Onyemaechi Azu.

Jegede said the findings of his research were ‘alarming’ and sounded a warning against the adjuvant use of the extract of Hypoxis hemerocallidea with HAART, especially in the reproductive active population. The use of the extract with HIV medications were found to be deleterious to the epididymal sperm and the testis and could result in male infertility.

Another novel finding of the study was the establishment of a direct link between hypertension and testicular morphological alterations. ‘To the best of my knowledge based on the available literature, this is the first documented report of the effect of hypertension on the testicular morphology,’ he said.

Jegede, a lecturer with more than 15 years’ experience, says he felt fulfilled and blessed to obtain his PhD in Clinical Anatomy from UKZN. He lectures in the Department of Anatomy at the Ladoke Akintola University of Technology in Nigeria, and in addition to his recently obtained doctorate, has a BSc (Honours) degree in Human and Clinical Anatomy, and an MSc degree in Reproductive and Endocrine Toxicology. His newly obtained PhD also focuses on reproduction and endocrine.

Jegede’s research topic was born out of the rate at which people consume the herb product, especially in southern sub-Saharan Africa, and the claims about its potency and potential to cure many diseases and boost the immune system of HIV positive patients.

‘Right from my primary school days, I have dreamed of being a teacher and a researcher but I never knew how the two could be combined until my undergraduate days when I realised that by being a lecturer, one can also be a researcher!

‘I was very close to giving up on my PhD until I decided to come to South Africa to start all over again. I drew my strength from my late father who always believed in my abilities even more than I believed in myself.’

Lihle Sosibo

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Children Treated with Abacavir-Based Regimen Have Good Probability of Virological Suppression

Children Treated with Abacavir-Based Regimen Have Good Probability of Virological Suppression
Dr Stephane Montgomery celebrates with her husband, graduating with a Masters of Medicine in Paediatrics.

A study which demonstrated that HIV positive children treated with an abacavir- based regimen have a good probability of virological suppression, earned Dr Stephane Montgomery a Master of Medicine degree in Paediatrics.

‘The primary objectives of my thesis, based on HIV therapy; were to describe the demographic characteristics, baseline characteristics and the virological responses in children at six months and 12 months in the abacavir cohort and to compare these to children in the stavudine cohort,’ said Montgomery.

She found no statistical difference between patients initiating an abacavir-based regimen versus a stavudine based regimen, saying her findings were in line with data from several clinical trials and supported the World Health Organization (WHO) recommendation of an abacavir-based regimen for infants and children initiating antiretroviral treatment.

UNAIDS has estimated that in 2014 just over 160 000 children in South Africa were receiving HAART, accounting for 20% of the global HAART cohort.

‘Finding the appropriate HAART regimen that is safe, well tolerated and efficacious is of extreme importance in ensuring continued and ongoing success of the Paediatric HAART programme,’ said Montgomery. ‘In 2010 the WHO, due to concerns of short and long term stavudine toxicity, changed the recommendation regarding first line HAART regimen from a stavudine-based regimen. In South Africa, an abacavir-based regimen was chosen as the preferred background regimen. However, questions have been raised as to whether this change has replaced the safety concerns associated with stavudine with a less efficacious regimen,’ she said.

Montgomery conducted a retrospective chart review to evaluate the virological responses at 6 and 12 months in a cohort of children initiated on an abacavir-based regimen at Durban’s King Edward VIII Hospital between January and December 2012.

Data on 94 children under the age of 12 years who were initiated on abacavir and lamivudine with either lopinavir/ritonavir or efavirenz regimen (abacavir cohort) were analysed using Fisher’s exact test and logistical regression to evaluate virological suppression at 12 months.

The data was compared to a prior retrospective chart review conducted between 2004 and 2010 at King Edward VIII Hospital during which a stavudine and lamivudine with either Lopinavir/ritonavir or efavirenz (stavudine cohort) was the standard of care.

In both the abacavir cohort and stavudine cohort there was no difference in gender distribution and the mean age of initiation was six years old.

The study demonstrated that children treated with an abacavir-based regimen have a good probability of virological suppression.

Montgomery is currently working as a Paediatrician at Netcare Umhlanga hospital.

She is a long distance runner and finished the Comrades Marathon in 2015 and 2016. This year she completed the Dusi Canoe Marathon. ‘Sport is my passion and it helps with relieving the stress of my job. It especially helped with reducing stress levels during my Registrar training.’

Nombuso Dlamini

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Pregnant Women on HAART may be at Risk of Increased Obstetric Complications

Pregnant Women on HAART may be at Risk of Increased Obstetric Complications
Celebrating with the HOD of Obstetrics and Gynaecology, Dr Sebitloane, is her proud family.

Pregnant women accessing highly active antiretroviral treatment (HAART) remain at increased risk of infectious morbidity and may possibly experience heightened morbidity from obstetric conditions, a PhD study conducted by HOD: Department of Obstetrics and Gynaecology, Dr Motshedisi Sebitloane, has found.

Titled: “Maternal Complications in HIV-Infected Women Receiving Combination Antiretroviral Treatment in a Resource Constraint Setting”, the study aimed to determine maternal and obstetric outcomes of women receiving HAART before and during pregnancy.

It also aimed to describe the clinical outcomes as well as the immunological and cytokine changes according to the duration of HAART.

‘My thesis showed residual increased risk of medical and obstetric complications in pregnant women receiving HAART,’ said Sebitloane. ‘This is in the background of a predominantly pro-inflammatory cytokine profile, which can be dampened with the use of HAART. The latter, however, also suppresses the preferable Th2 cytokines, identified in most normal pregnancies.’

The study associated HAART with an increased risk of hypertensive disorders of pregnancy. It also found an apparent association between HAART and increased risk of obstetric haemorrhage. 

‘The cytokine expression of women on prolonged HAART indicates a Th2 to Th1 cytokine profile shift which may be related to adverse pregnancy outcomes such as preterm delivery demonstrated in the audit or increased risk of HDP seen in both the audit and the secondary analysis.’

She said the predominantly pro-inflammatory cytokine profile of HIV negative controls and women treated with HAART initiated during pregnancy may reflect the background or residual increased risk of infectious complications in our resource constrained setting.

‘The thesis described residual infectious morbidity despite the use of HAART but in addition, unmasked how some of the obstetric conditions are possibly worsened in the presence of HAART.

‘The cytokine work described deficiencies in cytokine changes seen in women on HAART, which could explain the adverse effects seen in patients receiving long-term HAART,’ said Sebitloane.

Her study, supervised by renowned obstetrician Professor Jagidesa Moodley, earned Sebitloane her PhD in Obstetrics and Gynaecology.

Sebitloane, who believes her thesis serves as one of the first alerts to increase awareness regarding the care of pregnant women, plans to do a follow up on the women in order to make an association between the laboratory findings and clinical outcomes. She is currently supervising several masters students, ‘looking closely at the clinical outcomes of interest and associations with use of HAART’.

Sebitloane, married with two sons, is grateful to her family for their support. She is also thankful to the ‘Lord Almighty’ for the space she finds herself in now, ‘It’s been a long and arduous journey, but the Lord has been my strength.

‘My family is very proud of my achievements, and I believe the boys are greatly inspired, having seen all the toiling and eventually the desired outcome. My greatest pleasure would be to see that my hard work has positively impacted their attitude towards life.’

Nombuso Dlamini

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