Moringa Plant Effective in Reducing ARV-Induced Toxicity in the Liver
Dr Siqiniseko Ndlovu.Dr Siqiniseko Ndlovu of Nquthu in the Umzinyathi District of KwaZulu-Natal who is currently a postdoctoral Fellow in UKZN’s Occupational Health Discipline was thrilled to graduate with a PhD in Medical Biochemistry.
Co-supervised by the College of Health Sciences’ Dean of Research, Professor Anil Chuturgoon and Dr Terisha Ghazi, her study confirmed that extracts from the Moringa Oleifera Lam plant can reduce the toxicity of highly active antiretroviral therapy (HAART) in the liver (Hepg2) cells of HIV-infected individuals.
Ndlovu said that because antiretroviral (ARV) drugs cannot eliminate HIV, they are a life-long treatment, and their long-term side effects are of significant concern. She noted that South Africa carries the largest burden of HIV infections worldwide and that long-term use of HAART is associated with adverse health outcomes, particularly changes to the metabolic syndrome, nervous disorders and impaired kidney functions through inducing mitochondrial dysfunction, oxidative stress and inflammation. ‘Continuous assessment and improvement of ARV drug formulations without compromising their efficacy is thus essential.’
Ndlovu added that the use of adjuvant or “safe” supplementary medicine is a potential solution. ‘The medicinal plant Moringa Oleifera Lam is considered one of the most important sources of novel nutritionally and pharmacologically bioactive compounds that have been shown to prevent and treat various diseases.’
Her study showed that ARVs [Tenofovir disoproxil fumarate (TDF), Emtricitabine (FTC) and Lamivudin (3TC)] induce oxidative stress and inflammation and that Moringa Oleifera significantly reduces their toxicity. Two articles from the study were published in Multidisciplinary Digital Publishing Institute journals.
‘I am very humbled by this accomplishment. Indeed, our background does not determine our future. I aim to lead by example and create platforms to support young researchers to achieve their dreams, and most of all, encourage them to be innovative and create jobs,’ said Ndlovu. She thanked her supervisors and her family for their support.
She is passionate about improving people’s health. ‘South Africa is a developing country and we face a lot of diseases, but thanks to God we have many medicinal plants. I strongly believe that the use of medical plants is making a significant difference in treating certain diseases or managing the side effects of certain medications. As scientists, we need to optimise these for human pathophysiology.’
Ndlovu is a lover of conversations that shift her perspective for the better and she thus frequently listens to podcasts and reads a lot. ‘I also like sport. I exercise, do yoga and recently started playing tennis.’
Words: Lunga Memela
Photograph: Supplied
author : .author email : .Using Technology to Treat Substance Use Disorder
PhD graduate, Dr Sarah Kiburi based her study on the use of digital interventions in treating opioid use disorder.Addiction psychiatrist, Dr Sarah Kiburi was awarded a PhD for her important study on the use of digital interventions in treating opioid use disorder. This complex illness is characterised by compulsive use of opioid drugs even when the person wants to stop, or when using the drugs negatively affects the person’s physical and emotional well-being.
The study was piloted at a methadone clinic in Nairobi, Kenya.
Opioids are a class of drugs that include the illegal drug heroin, synthetic opioids such as fentanyl, and pain relievers available legally by prescription, such as oxycodone (OxyContin®), hydrocodone (Vicodin®), codeine, morphine, and many others.
Kiburi said that her research was motivated by the fact that substance abuse is a significant challenge in Africa, particularly following the COVID-19 pandemic. Her study assessed the feasibility and acceptability of a mobile phone text message-based intervention with people attending the methadone clinic. The mixed methods study found that the intervention was well-received, paving the way for more robust controlled trials using technologies to assist people with addiction problems, particularly in low-resource settings. The study was co-supervised by the Head of Psychiatry at UKZN, Professor Bonginkosi Chiliza and Professor Saeeda Paruk, findings from which elicited how a digital approach can help improve access to care for those with substance use disorders, given the burden of disease that arises from these disorders.
Kiburi said that while there are several evidence-based interventions for substance use disorder treatment, there are low levels of implementation in Kenya. ‘The challenges include the limited number of healthcare providers to deliver treatment.’ Shortly after completing her graduate training in psychiatry, she attended a short course on the use of information and communication technology in healthcare that sparked her interest in assessing digital technology use in mental health. The outbreak of the COVID-19 pandemic restricted access to treatment, further motivating her to explore digital treatment approaches.
‘I am very happy and grateful to have completed my PhD. I gained many skills and my study highlights several areas that need to be addressed to improve care of individuals with substance use disorder and other psychiatric illness,’ Kiburi said.
Her immediate plans are to assess the application of the intervention she used in her study with a broader study population. ‘I hope to continue growing in practice, engaged in both clinical care of patients as well as academia and research.
‘I always wanted to be a doctor and to help people. My first role model was my mother who was a nurse. During my undergraduate training, I enjoyed psychiatry rotations and became interested in specialising in psychiatry.’
Kiburi holds an MMed in Psychiatry and another in Addiction Studies. ‘My theses for the two degrees involved assessing the prevalence of adverse childhood experiences among individuals with substance use disorders and examining the associations between use of cannabis during adolescence and psychosis later in life, respectively.’
Chiliza said: ‘Sarah joined one of our research weeks, perhaps the last one before COVID-19 hit, very soon after losing a very close member of her family. She persevered despite numerous challenges and published three peer-reviewed articles, with two more under review. She also published other original research and systematic reviews in the area of addiction.
Kiburi’s hobbies include working out at home, spending time with her family, listening to music and reading.
Words and Photograph: Lunga Memela
author : .author email : .Research Highlights the Risk of Intestinal Worms Among Adult TB Patients
Mrs Khethiwe Bhengu. It was a bittersweet moment when Mrs Khethiwe Bhengu graduated without her late husband with her Masters in Medical Microbiology - a dream he had supported from the onset of her studies.
Bhengu was left to raise their four children after the passing of her husband, Khumbulani. He looked after the children while she pursued her BTech in Biomedical Technology at Mangosuthu University of Technology (MUT). However, she drew strength from her fond memories and looks forward to registering for a PhD and obtaining a National Research Foundation rating.
Bhengu, who works as a Control Industrial Technician in MUT’s Biomedical Science Department found that helminth infection (intestinal worms) alters the immune responses to tuberculosis (TB) in cases of helminth-coinfection, resulting in poor TB prognosis and treatment outcomes.
Her study also raises awareness of the prevalence of helminths in adults and offers insights to policy-makers on the need to include screening for worms in TB treatment management programmes and indirectly HIV, because TB is a common opportunistic pathogen in HIV-infected patients.
Bhengu said helminth infection is highly prevalent in adults aged 18 and older. ‘This is a public health concern because most deworming programmes in South Africa focus on children and school-going learners.’ She added: ‘Our research group will be presenting the findings to the community that participated in the study in order to raise awareness.’
Bhengu said that, while parasitology is becoming a neglected discipline, evidence shows that parasitic worms are highly prevalent in developing countries like South Africa. ‘TB has also persisted for years and has resulted in high fatality rates in HIV and TB-coinfected patients. The bidirectional relationship between TB and HIV has been extensively studied, but that of helminths and TB remains unclear. My supervisor, Professor Zilungile Mkhize-Kwitshana is also passionate about this field of research. She applied for funding that enabled me to embark on my research journey.
‘We faced many challenges at the beginning of our study, one of which was COVID-19. We had just started recruiting participants in March 2020 when the pandemic hit and the country went on lockdown. This extended my study period because our study required interaction with clinic participants. Post-lockdown, when we resumed recruiting participants, very few patients attended the clinic for fear of contracting COVID-19. This caused further delays and challenges in recruiting the required sample size.
‘UKZN is a well-equipped Institution, which made it possible for various analyses required for the study to be performed on-site,’ said Bhengu. ‘The other benefit is that critical equipment is connected to generators, meaning that laboratory work continued amidst load shedding because I was pressed for time to complete it. The facilities were adequate for multiple students in the Department to perform their experiments.’
Bhengu said she was on cloud nine after completing her master’s at the age of 41. ‘Having watched the Graduation ceremonies online, I always longed to be a part of the festivities.’ She added that her family are very proud of her. ‘I want to pursue my PhD so that I do not lose my momentum. I plan to continue researching and publishing in medical research journals, thus putting UKZN and MUT on the national and international map.’
In her spare time, Bhengu likes reading and watching TV, and she is learning beadwork. ‘My new hobby is exercising; it frees my mind and soul.’
Words and photograph: Lunga Memela
author : .author email : .Addressing Mental Health to Improve Adolescents’ Adherence to ART
Dr Anthony Olashore graduated with a PhD in Psychiatry.Senior lecturer at the University of Botswana, Dr Anthony Olashore was overjoyed to graduate with his PhD in Psychiatry.
His study, which explored the impact of psychological interventions on mental health and anti-retroviral therapy (ART) adherence among mentally-ill adolescents living with HIV (ALWHIV) in Botswana, was co-supervised by the Head of Psychiatry at UKZN, Professor Bonginkosi Chiliza and the Discipline’s Professor Saeeda Paruk.
‘This is a major milestone. I am confident that I can accomplish anything by focusing my mind. My next goal is to secure a National Institutes of Health grant, broaden the scope of my project, and establish myself as a highly regarded academic professor,’ he said.
Olashore compared a cohort of ALWHIV that was infected from birth with one that contracted HIV later in life. He noted that HIV-positive African children and adolescents may suffer from depression and cognitive impairment and that addressing mental health issues could improve treatment adherence and reduce new infections in countries like Botswana, where a third of new infections occur among adolescents. This would benefit society at large as well as the individuals concerned.
The study found that many ALWHIV struggle with treatment adherence, with depression being the main related disorder. Olashore developed a short psychological intervention that was tested and found to be effective. ‘This has important implications for cost-effective treatment approaches in resource-constrained settings like Botswana and may effectively reduce the high rate of HIV spread,’ he said. The findings suggest the need to do away with the one-size-fits-all approach adopted in many African settings, as adolescents have different psychosocial needs, calling for tailored approaches to improve their mental health care. ‘More importantly, the results reiterate the need to consider the mode of infection when providing care to ALWHIV in this setting,’ said Olashore.
He added that he has been drawn to working with often overlooked or marginalised adolescents throughout his career.
‘My master’s dissertation focused on adolescents who found themselves in conflict with the law or were deemed beyond parental control. I hoped to continue this work at PhD level but found it challenging to conduct research on this population in Botswana. As a result, I shifted my focus to those living with HIV. This group accounts for more than 30% of new infections and has been under-researched, making it a crucial study area.’
COVID-19 and being a foreigner in Botswana did not deter Olashore. ‘I had a fantastic time at UKZN, mainly due to the outstanding facilities provided. The software is state-of-the-art, and the team was incredibly supportive. They were very concerned about my well-being, including my mental health during the pandemic. Professors Chiliza and Paruk, my supervisors, were more than just mentors; they were also my friends who went the extra mile to ensure I completed the programme on time. The study environment was stimulating and welcoming, with helpful staff who made my experience even more enjoyable.’
Born in the rural town of Ijebu Igbo in Ogun State, Nigeria, Olashore’s family worked as public servants. Education was not a choice but a must, as it was the only legacy within their grasp. ‘In Nigeria, where everything, including education, comes at a cost, and with fierce competition and limited resources, failure was not an option. This drove me to cultivate a relentless work ethic and to make sacrifices to achieve my goals. Through unwavering determination, I completed my medical studies without any hiccups.’
‘I am especially proud that Anthony completed a clinical study despite the COVID-19 pandemic. Botswana had very strict lockdown laws and he had to make serious adjustments that took a few iterations to get right. He did all of this despite being a foreigner in Botswana with threats to the longevity of his contract in the background,’ said Chiliza.
Olashore published six peer-reviewed articles from his study, as well as other peer-reviewed articles from another study on adolescents and an editorial.
In his spare time, he enjoys spending quality time with friends, jogging to stay fit, listening to soulful music, playing the piano, indulging in some light reading and cooking up a storm in the kitchen.
Words: Lunga Memela
Photograph: Sethu Dlamini
author : .author email : .A Model of Care for Caregivers of Children with Autism Spectrum Disorder
UKZN staffer, Dr Deborah Fewster graduated with a PhD in Occupational Therapy.Lecturer in Occupational Therapy at UKZN Dr Deborah Leigh Fewster was awarded her PhD in Occupational Therapy during the UKZN Spring Graduation for her research on Developing a Quality of Life Model of Care for Primary Caregivers of Children with Autism Spectrum Disorder within a South African Context.
The study aimed to address the unique challenges confronted by primary caregivers (parents and family members living with the child) of children with autism spectrum disorder (ASD).
Supervised by Professors Catharina J E Uys and Pragashnie Govender, Fewster’s comprehensive mixed-method study developed a quality-of-life practice model tailored to the needs of primary caregivers in South Africa. Her research sheds light on the systemic shortcomings in healthcare, education, and societal support for individuals with ASD and their families.
Fewster commented, ‘The healthcare system, educational system, and society at large have failed individuals with autism spectrum disorder and their families. The process of diagnosis and subsequent care is marred by delays, inadequacies and, at times, a complete lack of support.’
She added that the limited and expensive educational opportunities for children with ASD, as well as the pervasive stigma that creates occupational barriers, hinder their participation in everyday activities. This inevitably impacts their quality of life as well as that of their primary caregivers.
Fewster’s model, which is the first of its kind, ‘has the potential to inform the content, structure, and delivery mechanisms of interventions for these caregivers. It also provides crucial guidelines for the healthcare, education, and government sectors to enhance the care provided to children with autism, thereby improving the quality of life of their caregivers. Recognising and supporting their caregivers is essential, as they play a vital role in the care of the child.’
Fewster expressed humility and pride in her accomplishment, noting the sacrifices made and the valuable lessons learned. She hopes to explore the practical implications of her PhD findings and continue her research in future postdoctoral endeavours. She acknowledged the support of the College of Health Sciences and the University Capacity Development Programme and expressed her gratitude for her supervisors’ exceptional mentoring.
Fewster has participated in national and international conferences and was part of the World Health Organization’s project to develop a rehabilitation package for ASD. She has received recognition as an emerging researcher and has authored several articles and co-authored a book chapter on caregiving.
Words: Nombuso Dlamini
Photograph: Lunga Memela
author : .author email : .Global Recognition for PhD Study on Hearing Loss
Dr Okikioluwa Aladeyelu graduated with a PhD in Clinical Anatomy for his research on hearing loss among the South African youth.Dr Okikioluwa Aladeyelu was awarded a PhD in Clinical Anatomy for his novel research that will assist otologic surgeons - head and neck doctors who perform surgery on the middle ear - in better understanding pneumatisation of the temporal bone from early childhood to early adulthood in the South African population.
Hearing loss is increasing across the world, and, according to the World Health Organization, middle-ear infection is part of the global burden of diseases. Aladeyelu said that the major causes of hearing loss remain unknown; however, it has been posited that pneumatisation around the temporal bone could be responsible. This bone contributes to the lower lateral walls of the skull, and its pneumatisation occurs when there are air-filled cavities in the bone, inevitably leading to conditions such as hearing dysfunction.
Co-supervised by Drs Carmen Rennie, Andile Sibiya and Wonder-Boy Mbatha, Aladeyelu’s study highlighted how the development of temporal bone pneumatisation relates to middle-ear disease and is implicated in many ear-related surgeries, lateral skull-based surgeries, and traumatic skull fractures, as well as a determining the size and location of related blood vessels.
Using radio-imaging techniques, he established the normal expected growth of air cells in pneumatisation at every stage of post-natal development, the degree of pneumatisation, and its influence on related vasculature in the South African population. The study developed a concise classification of the degree of pneumatisation for diagnostic and surgical purposes. Aladeyelu said he was thrilled when outputs from this study were published in the international journals PLoS ONE, Scientific Reports, Folia Morphologica, and Surgical and Radiologic Anatomy.
‘The study provides new information on pediatric normal temporal bone pneumatisation which could serve as a key indicator in probing the onset of middle-ear infection among South African children. It also offers insights on the prevalence of aberrant vasculatures that are responsible for hearing dysfunction, which could result in an increased incidence of hearing problems and raise awareness of potential surgical pitfalls which otologic surgeons should avoid when planning ear-related and lateral skull-based surgeries,’ said Aladeyelu. He added that he was blessed to have the opportunity to present his research results to otolaryngologists and clinical anatomists at local and international symposia.
He described UKZN as a conducive learning environment. ‘I have been determined to become a Professor in Clinical Anatomy from my undergraduate days. Now that I have my PhD, with about 26 publications in Scopus and PubMed, and more than 50 citations as well as serving as an expert reviewer for quality, high-impact factor journals, I thank the Almighty God that I am indeed closer to my dream.’
When not hard at work, Aladeyelu enjoys reading, teaching, conducting research, singing, dancing, playing and watching soccer.
Words: Lunga Memela
Photograph: Sethu Dlamini
author : .author email : .Study Reports Increase in HIV-infected Patients with Bone Marrow Cancer in KZN
Dr Lungisile Chili (right) accompanied by her mother, Bonisile Margaret Chili, to Graduation.Senior Registrar and KwaZulu-Natal (KZN) Academic Complex Haematopathologist at Inkosi Albert Luthuli Central Hospital’s (IALCH) Haematology Department, Dr Lungisile Chili, beamed with pride and joy when her name was read out before graduating with her Master of Medicine degree in Haematology.
Her passion for innovation in medicine stems from her suffering from chronic allergic rhinitis as a child, which upset her whole family. She is satisfied with her latest accomplishment, and optimistic about her department’s contribution to health research and policy-making. ‘I hope to conduct more impactful research that ultimately contributes to improving the quality of life in developing countries,’ said Chili.
Her dissertation, profile and Outcome of Multiple Myeloma With and Without HIV Treated at a Tertiary Hospital in KwaZulu-Natal, South Africa is a novel study. It was co-supervised by Professor Irene Mackraj of the School of Laboratory and Medical Sciences and Dr Nadine Rapiti who heads the Haematology KZN Academic Complex at IALCH.
The study confirmed an increase in the number of HIV-infected patients newly-diagnosed with a type of bone marrow cancer known as multiple myeloma (MM) in KwaZulu-Natal. The province’s patient profile differed from that of other regions in that it points to female predominance, but was similar in advanced-stage presentation and bone fracture predominance. ‘Statistically significant differences between the HIV-negative patients and people living with HIV were observed in terms of age distribution and the mutational landscape. Further studies are required in this area,’ Chili said.
Like her fellow scientists and researchers, Chili’s study was challenged by the outbreak of COVID-19 but her desire to improve patient care through meaningful research encouraged her to persevere.
‘Heartfelt congratulations to Dr Chili who has demonstrated exceptional aptitude for research and is well-positioned for continued achievement in pursuit of a doctoral degree. She is a role model for young researchers in her field,’ said Mackraj.
‘Congratulations Dr Chili on your accomplishment! This marks the end of a challenging journey in learning, and the beginning of your career as a research leader, teacher and mentor in haematology. Your research highlighted the long time to diagnosis, and the need for myeloma education and supportive care, which you’ve already initiated. Invaluable work, and patients are already reaping the rewards,’ Rapiti said.
Chili said she enjoys spending time with her daughter, singing, listening to music, dancing and the arts. She is keen to assist and support other keen professionals. ‘I enjoy innovative and meaningful engagement.’
Words: Lunga Memela
Photograph: Sethu Dlamini
author : .author email : .KZN’s Health Workforce Strengthened by Four New Surgeons
Newly graduated surgeons from left: Drs Qedusizi Goodwill Dube, Mark Lubo Kashasha and Sayuri Naidu.Four new surgeons have graduated from UKZN with Masters of Medicine in Surgery. They are Drs Qedusizi Goodwill Dube, Mark Lubo Kashasha, Tende Makofane and Sayuri Naidu.
Dr Boitumelo Phakathi, Head of General Surgery said, ‘As the Discipline of General Surgery, we are very proud of our graduates and we officially welcome them to the body of Masters in General Surgery across the country and the world at large. We understand it was not an easy journey, but we are here to witness and celebrate the rewards and fruits of their perseverance, hard work and determination to cross the MMed finishing line.
‘Congratulations to all of them. We trust that this is not the end of their research journey but rather a building block towards many research projects they will undertake either as principal investigators towards their PhD degrees or supervisors of undergraduate and MMED research projects. We wish you all the best in your future endeavours.’
Kashasha became interested in surgery after a relative underwent a transmastoid inner ear abscess drainage. Despite several challenges due to political instability, war and the need to move from one province to another in the Democratic Republic of the Congo (DRC), he never gave up on his dream. Disheartened by the assassination of DRC President Laurent Kabila, Kashasha moved to South Africa in 2001 to train as a specialist. He is the first medical specialist in his family of engineers.
Kashasha’s study recommends the aspiration technique as the first line treatment for breast non-lactating abscesses as opposed to incision and drainage which is costly and causes unsightly scarring. The aspiration technique involves a thin needle being inserted into an area of abnormal-appearing tissue or body fluid.
Naidu, who grew up in the township of Shallcross south of Durban, completed Grade 12 at Wingen Heights Secondary. Her parents made many sacrifices to fund her undergraduate education and that of her siblings.
Naidu was inspired to pursue a career in Medicine by her grandmother who was a seamstress. She is currently serving as a consultant in the Pietermaritzburg Hospital Complex, working in a unit that is in her area of interest, foregut pathology. Naidu commented, ‘I am a true alumnus of this University having completed both my undergraduate and postgraduate training at the Nelson R. Mandela School of Medicine. I have been inspired by many great surgeons such as Professor B Singh, Mr A A Gounden and Mr D Maharaj, who taught me to think out of the box.’
Naidu’s study was entitled, Routine Blood Draws in a Trauma Intensive Care Unit - Are We Doing Too Many and Do We Act on the Results? The observational study described the relationship between abnormal blood investigation, results and action taken and was conducted in the Intensive Care Unit (ICU) at the Inkosi Albert Luthuli Central Hospital. It demonstrated that routine blood investigations in the ICU setting are redundant, with clinically directed investigations offering more benefits than a blanket routine approach.
Words: MaryAnn Francis
Photographs: Sethu Dlamini and Supplied
author : .author email : .Harnessing Natural Sources to Treat Viral Diseases
Dr Akwasi Boadu graduated with a doctoral degree in Pharmaceutical Chemistry.‘I have learned a great deal that I intend to use to enhance my skills and contribute to the betterment of society. My vision is to establish pharmaceutical manufacturing companies specialising in medicines derived from natural sources, offering an alternative to conventional medications.’
These were the words of Dr Akwasi Boadu who graduated with a PhD in Pharmaceutical Chemistry. Boadu, who is the Director of Wesbury College of Science in Ghana, conducted a comprehensive study titled Phytochemistry and Pharmacological Analysis of Leaf Extracts of Spondias Mombin Linn as Potential Antiviral Agents under the guidance of Professors Rajshekhar Karpoormath and Manimbulu Nlooto.
Spondias Mombin is a fruit tree that is grown in a number of African countries. Boadu’s findings indicated that leaf extracts from the tree could pave the way for further research on the treatment of viral diseases. The compounds found in the leaf extracts were identified as potential therapeutic agents against SARS-CoV-2, Ebola, Marburg, and Rhinovirus that pose significant health challenges.
Reflecting on the significance of his research, Boadu noted, ‘My work has direct implications for the treatment of re-emerging and emerging viral diseases. It provides a scientific basis for potential improvements and policy changes regarding the use of herbal extracts, particularly within the African continent.’
Ground-breaking aspects of his investigation included the discovery of two novel compounds in Spondias Mombin leaf extracts, namely 6-methyl heptyl pentadecanoate and 6-methyl heptyl 15-(1,2,3,4,4a,8a-hexahydronaphthalen-1-yl) pentadecanoate.
The most significant challenge Boadu faced was the complete lockdown of campuses and laboratories during the 2020 COVID-19 pandemic. He also struggled to balance the demands of his research which involved spending an hour-and-a-half each day travelling to and from the laboratory with caring for his three young children, as his wife, a nurse, worked long hours away from home. However, he noted that he overcame these and other hurdles through unwavering determination.
Words: Nombuso Dlamini
Photograph: Albert Hirasen
author : .author email : .PhD Study Informs the Design of Future TB Treatment Options
Dr Rubeshan Perumal graduated with a PhD in Clinical Medicine. Vigorous efforts to achieve the global collective vision of a TB-free world drove senior scientist in the Centre for the AIDS Programme of Research in South Africa (CAPRISA) and Specialist Physician and Pulmonologist in the Department of Pulmonology and Critical Care at Inkosi Albert Luthuli Central Hospital (IALCH), Dr Rubeshan Perumal to conduct his doctoral study on Optimising the pharmacological treatment of drug-susceptible pulmonary tuberculosis.
Co-supervised by world-class scientists, Professors Kogie Naidoo and Nesri Padayatchi from CAPRISA, the study investigated the relationship between first-line anti-tuberculosis (TB) drug pharmacokinetics and treatment outcomes.
The findings provide key insights for optimising the treatment of drug-susceptible TB, including the importance of vigilance for unexpected drug-drug interactions in the design of novel treatment regimens and therapeutic drug monitoring’s potential to improve drug exposure in critically ill TB patients. This will inform the design of future treatment options.
Perumal said: ‘The studies within my thesis advance our understanding of first-line TB drug pharmacokinetics, provide a robust evaluation of a fluoroquinolone-containing regimen for recurrent TB, identify potential challenges from unexpected, altered drug exposure from drug-drug interactions, illuminate the problem of low rifampicin concentrations in critically ill patients with TB, and provide evidence to support the implementation of therapeutic drug monitoring for dose-optimisation in this patient population.’
Taken together, the results contribute to improving the treatment of TB, and will help to guide future research on new drug strategies for the disease. Several make new and valuable findings in this field.
Perumal said TB and HIV have shaped the global health landscape in recent decades, leading to tremendous human suffering and loss of life. ‘Despite being a curable infectious disease, TB kills more than 1.5 million people each year, and a substantial amount of work remains to be done if we are to turn the tide on this ancient relentless scourge.’
His early career mentorship by esteemed Professors Salim Abdool Karim, Quarraisha Abdool Karim, Naidoo, Padayatchi, and Keertan Dheda nurtured his commitment to a scientific career in TB and HIV research. ‘Their examples serve as a constant reminder of what can be achieved through unwavering dedication to pioneering and meticulous science combined with a deeply personal commitment to responding to the most pressing problems in global health.
‘I am truly delighted to have had the opportunity to fulfill this long-held academic aspiration. I am also deeply grateful to my supervisors, mentors, and family for their unflinching support and commitment to my academic development. Professors Kogie Naidoo and Nesri Padayatchi have been inspirational in their ongoing pursuit of incisive, pioneering, robust, and meticulous science. I hope to continue my development as an independent clinician-scientist as I redouble my efforts to achieve the global collective vision of a TB-free world.’
Perumal persevered despite several of his projects being brought to a halt during the COVID-19 pandemic as his attention shifted to his work in the intensive care unit and as research laboratories pivoted to the urgent scientific needs of that time. ‘While the pandemic significantly delayed my PhD, I have no regrets about completely dedicating that part of my life to the care of the most gravely ill patients in our intensive care units.’
He expressed his gratitude to his supervisors, whom he described as ‘a source of enriching intellectual engagements. They inspired my passion for locally relevant and globally impactful science. Their rich constructive feedback and constant vigilance for new opportunities to strengthen my scientific growth were instrumental to my development.’
One of the examiners of his PhD said: ‘The student has far exceeded the requirements for a PhD. The thesis represents an incredible amount of work that has been executed meticulously. In reading your acknowledgements and dedication, one gets the sense that you have made your supervisors and family incredibly proud.’ Another said: ‘This is a very impressive body of work - well structured, comprehensive, detailed and with some valuable results that are likely to have an impact in the TB field. I believe the requirements for a PhD have been fulfilled a few times over.’
Born and raised in Reservoir Hills, Durban, where a strong sense of community, educational aspiration, and service to humanity were deeply entrenched in shared values, his father, the late Professor Ronnie Perumal, served as his compass and guide, and a shining example of the incredible joy that emanates from a lifelong dedication to education, scholarship, and service to humanity. ‘All that I am and all that I hope to be is inspired by his selfless career at UKZN and his courageous pursuit of progress for the disadvantaged and under-served.’
Perumal’s passion for both science and the arts made Medicine a natural fit ‘as life as a doctor straddles the beautiful and poetic intersection between the purity of scientific empiricism and the deeply humane artistry inherent in the delivery of sincere and compassionate care.’
He holds masters’ degrees in Medicine, Public Health and Philosophy - each of which he feels has contributed to his scientific competence and deepened his commitment to pursuing his academic journey.
Perumal enjoys long trail walks with his family and immersing himself in the wonders of the natural world. ‘When time permits (an increasing rarity), I enjoy watching foreign-language movies or shows at the theatre.’
Words: Lunga Memela
Photograph: Sethu Dlamini
author : .author email : .Senior Technician Earns PhD in Obstetrics and Gynaecology
Dr Shoohana Singh graduated with a PhD in Obstetrics and Gynaecology.Family, friends and colleagues of senior medical technician at UKZN, Dr Shoohana Singh, were extremely proud to witness her graduating with a PhD in Obstetrics and Gynaecology on 21 September.
She is a reminder that not only academics but also professional services staff push themselves to PhD level in their respective disciplines.
Conducted at the College of Health Sciences’ Optics and Imaging Centre (OIC) and supervised by its Head, Professor Thajasvarie (Anita) Naicker and Professor Jagidesa Moodley, Singh evaluated the renin-angiotensin-aldosterone system (a system of hormones, proteins, enzymes and reactions that regulate blood pressure and blood volume on a long-term basis) in the placenta and placental bed of preeclamptic, HIV-infected women of African ancestry. Preeclampsia is a high blood pressure disorder that occurs during pregnancy.
The research findings showed significant dysregulation in expression of angiotensin receptors (a class of G protein-coupled receptors with angiotensin II as their ligands) in both the placenta and placental bed (innermost lining of the uterus) - receptors which are related to vascular function and ultimately hypertension.
‘We had to consider the complication with HIV-infection, which also affects these receptors. It has been established that current receptor-blocking medication cannot be used on preeclamptic women. The findings may serve as a basis for drug development to enhance the vaso-dilating receptor function (widening of blood vessels),’ said Singh.
Singh experienced first-hand the dangerous effects of late-onset preeclampsia during her first pregnancy and was disheartened to discover that two decades on, there was still inadequate intervention in treating this life-threatening condition. ‘Furthermore, the rate of HIV-infected pregnant women in our province of KwaZulu-Natal (KZN) is unacceptably high at 40.9%, and we lose 127 mothers for every 100 000 live births. The goal should be to collate study findings in order to educate and improve all women’s quality of life,’ she said.
‘When I initially enrolled for my PhD, the COVID-19 pandemic had just been unleashed. Specimen collection and access to hospitals was the greatest challenge. Laboratory bench time had to be carefully scheduled with valid permits. The fear of contracting COVID-19 was the worst; however, the stringent safety standards enforced by UKZN eased the situation. My colleagues’ team spirit and support from my supervisors and management team were of great assistance,’ remarked Singh.
‘It feels surreal that I have completed my PhD. The journey was challenging but rewarding. It’s never easy trying to manage a family and a career, but my family’s unwavering support was instrumental in my success. My objective as a future academic is to focus more on research and to acquire scholarships for young researchers entering this profession.’
She added: ‘It is with a sense of pride and dignity that I fly the UKZN flag high. We stand tall at international conferences, and our research contributions are acknowledged on a global scale. It is encouraging to know that I have made a positive contribution to the College of Health Sciences’ research output.’
Singh was born in Ladysmith in northern KwaZulu-Natal. ‘I come from a female-dominated family, with three sisters and a remarkable mother who always believed education was the one thing no one could take from you. With that conviction and her constant support, I began my undergraduate studies at the former University of Natal (Pietermaritzburg campus) in 1999.’
Singh completed her Bachelor of Biomedical Science degree in Durban as part of the first cohort to complete this degree. Her initial inclination was to study Medicine, but she quickly realised that Medical Science was her true passion.
‘I pursued a Bachelor of Medical Science Honours before landing a position at the Centre for AIDS Programme of Research in South Africa (CAPRISA). My experience at CAPRISA and the research exposure I received were invaluable. At this point, I realised I wanted to expand my knowledge in HIV-related research, so I enrolled in a master’s programme. In 2007, I turned full circle and returned to my alma mater as the Senior Medical Technician in the Physiology Discipline in the School of Laboratory Medicine and Medical Sciences.’
Apart from spending quality time with her children and husband, Singh enjoys acquiring new skills such as nail art and design. She also enjoys rollercoaster riding and dancing.
She is a recipient of the National Cancer Research Institute (US) and CAPRISA’s Southern African Fogarty AITRP HIV/AIDS-Associated Kaposi’s Sarcoma Award. She received second prize and, a travel grant, for staff presentations at the College of Health Science’s Research Symposium in 2015.
The International AIDS Society funded Singh to present at the 21st International AIDS Conference in 2016. She received the School of Laboratory Medicine and Medical Sciences’ travel grant to attend and present at the 2023 meeting of the International Federation of Placenta Associations in Rotorua, New Zealand.
Singh’s book chapter is due for release this year in Springer Nature Books - Biomedical Visualization, Vol. 2: Microscopy Techniques for Biomedical Education and Healthcare Practice (2023). She has published five articles, with six manuscripts under review.
Words: Lunga Memela
Photograph: Albert Hirasen
author : .author email : .PhD Study Focuses on Treatment of Tuberculosis
Dr Suraj Shinde graduated with a PhD in Pharmaceutical Chemistry.No single drug exists to successfully treat Tuberculosis (TB).
Supervised by Professor Rajshekhar Karpoormath, Dr Suraj Raosaheb Shinde was awarded a PhD in Pharmaceutical Chemistry for his research on molecules that work like drugs to treat it. The preliminary results show great promise, paving the way to develop novel drugs to treat Mycobacterium tuberculosis.
He said that he had a great study experience at UKZN. ‘It’s a great workplace, it has highly qualified staff, and the facilities are amazing. I have learnt a lot from UKZN.’
Shinde holds a Bachelor’s degree in Chemistry and a Masters in Organic Chemistry from the University of Pune, India. He is currently employed as a research scientist at Sai Life Science in Hyderabad, India.
Words: Nombuso Dlamini
Photograph: Supplied
author : .author email : .PhD Study Identifies Potential Anticancer Drugs
Dr Abdul Rashid Issahaku celebrates graduating with a PhD in Pharmaceutical Chemistry.Dr Abdul Rashid Issahaku earned his PhD in Pharmaceutical Chemistry for his study on a Computational Exploration of Molecular Determinants in the Inhibition of Selected Critical Oncogenic Targets in Cancer Therapy.
Supervised by Professor Mahmoud Soliman, Issahaku employed computer-aided drug design (CADD) techniques to probe the molecular factors involved in inhibiting crucial oncogenic targets in cancer therapy, focusing on Kirsten rat sarcoma (KRAS), Bruton’s tyrosine kinase (BTK), and Methyltransferase-like 3 (METTL3) proteins.
He noted that, ‘The findings serve as a roadmap for the identification of potential anticancer drugs derived from natural compounds found in South Africa.’
His study offers invaluable insights into the atomic and structural characteristics of KRAS, BTK, and METTL3 proteins that contribute to their resistance against drug inhibition. The findings pave the way for the development of affordable, less toxic anticancer drugs.
‘This achievement has solidified my long-standing aspiration to become a respected researcher in the field of cancer,’ said Issahaku. However, his research journey was not without its challenges. ‘The initial unexpected outcomes in the early stages of my research were both frustrating and disheartening. However, with the guidance and encouragement of my colleagues, I managed to overcome these obstacles.’
He praised UKZN for its unwavering support and for providing him with abundant resources that enabled him to accomplish his research goals: ‘The University offered me numerous opportunities in the form of workshops and seminars, which greatly contributed to my personal and professional growth.’
Issahaku’s professional journey began as a medical laboratory scientist in Ghana, where he worked in a private setting for three years before transitioning to the field of pharmaceutical chemistry research. He also holds a master’s degree in Health Sciences (cum laude), specialising in Pharmaceutical Chemistry. In his leisure time, he enjoys literature and engaging in philosophical discussions.
Words: Nombuso Dlamini
Photograph: Sethu Dlamini
author : .author email : .HPP Celebrates Two Virology Masters
Ms Wenzile Ntshangase (left) and Ms Sanam Maharaj.UKZN’s HIV Pathogenesis Programme (HPP), a centre for research excellence based at the Nelson R Mandela School of Medicine, applauded the hard work of two of its students who were awarded Master’s degrees in Virology during the College of Health Sciences Spring 2023 Graduations.
Ms Wenzile Ntshangase and Ms Sanam Maharaj were supervised by HPP scientists, Drs Paradise Madlala and Jaclyn Mann, respectively.
Ntshangase’s project aimed to characterise the genetic and functional variation in central nervous system (CNS) and plasma derived HIV-1 subtype C LTR and associate this with markers of disease progression such as viral load among tuberculous meningitis (TBM) co-infected individuals.
The findings add to the pool of data generated by other researchers seeking to characterise the exacerbated viral load in the CNS of TBM individuals.
Ntshangase said she was grateful to receive an HPP bursary that funded her research from start to finish as she was raised by her late grandparents in Vryheid: ‘My resilience and patience paid off.’ She added that she was fortunate to be part of the research centre.
Ntshangase completed her BSc majoring in Biochemistry and Genetics and BSc Honours in Biochemistry at UKZN. Her honours project, which focused on prolonged wound healing in diabetic physiology, sparked her interest in research and development.
Born and raised in a small suburb on Durban’s Dolphin Coast, Maharaj said her journey to the scientific world began with her Bachelor of Medical Science in Anatomy. She was awarded her Honours in Medical Microbiology summa cum laude, confirming that she belongs in the Health Sciences.
In 2021, Maharaj registered for a Master of Medical Science degree in Virology at the HPP. She received scholarships from UKZN, the National Research Foundation (NRF) and the Poliomyelitis Research Foundation (PRF). Her study investigated whether envelope (Env) infectivity and co-receptor usage varies between HIV-1 subtypes that are circulating in East and West Africa. ‘Env is essential to HIV-1-host attachment, making it an important factor in infectivity. Co-receptor usage also significantly influences the disease progression rate and possibly subtype prevalence of HIV-1,’ she said.
The study found that circulating recombinant forms (CRFs) possibly have higher infectivity than other subtypes, and that co-receptor usage, even in the rarer CRF subtypes, appears to be predominantly chemokine receptor type 5 (CCR5) usage. The results contribute new knowledge which is essential for the development of an effective vaccine, cure, or other regimen against the virus.
Maharaj said completing her master’s degree with an average of 74% taught her a wide array of skills which she plans to use during her career in the medical sciences.
The students were congratulated by HPP’s Scientific Director and world-class scientist, Professor Thumbi Ndung’u.
Words: Lunga Memela
Photographs: Sethu Dlamini
author : .author email : .Master’s Research Contributes to Fight Against STIs
Dr Gloria Sukali accompanied by her brother and mother to Graduation.Determining a population’s antifungal resistance will help the health authorities to improve syndromic management of sexually transmitted infections (STIs) presented by patients.
Dr Gloria Sukali’s Master of Medical Science in Medicine contributed to this quest by characterising Candida isolates from South African pregnant and non-pregnant women.
Candidiasis is a fungal infection caused by a yeast (a type of fungus) called Candida. Supervised by Professor Nathlee Abbai and Dr Nonkululeko Mabaso, Sukali’s study investigated the antimicrobial resistance profiles of Candida clinical isolates to amphotericin B - an antifungal medication used for serious fungal infections.
The findings revealed a high prevalence of Candida in both pregnant and non-pregnant women. It also found a high level of resistance to the antifungal amphotericin B. ‘In the local setting, resistance patterns to commonly used antifungals to treat Candida infections are not being monitored,’ said Sukali. ‘There is a need for antifungal resistance monitoring in order to reduce the risk of future persistent and untreatable infections,’ she advised.
Her study was a sub-study of a larger one that investigated susceptibility to the antifungal fluconazole. ‘In that study, we did observe resistance to fluconazole. In this study, we then decided to now look at another antifungal to see if we are seeing resistance to different classes of antifungals,’ she said.
‘I had to overcome many challenges to complete my studies so I feel extremely proud. Having been born in the Democratic Republic of the Congo and raised in South Africa, I aim to contribute to the quest to improve access to healthcare across Africa, especially among women. I plan to use what I have learnt over the years as a researcher in the health sector to refine my techniques and contribute to research on diseases such as hepatitis B virus (HBV) and human immunodeficiency virus (HIV) that have a high prevalence on the continent.’
She described her study experience at UKZN as ‘amazing’ and thanked her supervisors for their support.
In her spare time, Sukali enjoys exploring new coffee shops and restaurants. ‘I am always keen to try new cuisines from different parts of the world.’
Words: Lunga Memela
Photograph: Sethu Dlamini
author : .author email : .Global Experts Supervise PhDs on HIV-Related Preeclampsia
From left are Drs Tashlen Abel, Shoohana Singh, Nitalia Naidoo and Sumeshree Govender.Five students under the supervision of global experts in Women’s Health, HIV and Preeclampsia - a pregnancy-specific disorder - graduated with PhDs from UKZN’s Obstetrics and Gynaecology (O&G) Discipline and Optics and Imaging Centre (OIC).
Given the O&G Discipline’s mission to improve women’s health, collaboration with the OIC, a biomedical core research microscopy facility within the College of Health Sciences assisted in understanding the synergy of preeclampsia and HIV infection.
Drs Tashlen Abel, Sumeshree Govender, Merantha Moodley, Nitalia Naidoo and Shoohana Singh were supervised by O&G Emeritus Professor Jack Moodley and HIV and Maternal Health Expert, and OIC Head, Professor Thajasvarie (Anita) Naicker.
Abel evaluated the genetic polymorphisms within the vascular endothelial growth factor receptor 2 (VEGFR-2) gene in HIV-infected women diagnosed with preeclampsia. His study found that VEGFR-2 was decreased in preeclampsia and HIV-infected placentae, potentially contributing to both conditions. Highly topical during the time of his study, the research also reviewed and highlighted microRNA dysregulation in preeclampsia, HIV and COVID-19.
With preeclampsia and HIV infection being the main direct and indirect causes of maternal mortality and morbidity in South Africa, Govender’s study provided an extensive review of the expression of single nucleotide polymorphisms within the C1q gene and complement protein C1q plasma concentrations in the synergy of HIV infection comorbid with preeclampsia in women of African ancestry. The findings indicated dysregulation of the complement system, thus affecting the host’s innate defence by exacerbating placental and foetal injury. This study is in line with the United Nations’ Sustainable Development Goal to reduce maternal and perinatal deaths.
Moodley’s study focused on neutrophil extracellular traps (NETs) in the synergy of preeclampsia and HIV infection. It highlighted the role of NETs and neutrophil reverse migration from the placenta as potential early indicators of preeclampsia in HIV-infected women.
While the cause of preeclampsia is unclear, genes and infection may be involved. This led Naidoo to investigate gene polymorphisms and placental immunoexpression of neuropilin-1, a marker of angiogenesis and immune regulation, in HIV-infected preeclamptic African women. Variations in the neuropilin-1 gene showed a higher prevalence of preeclampsia and HIV-complicated preeclampsia, indicating genetic susceptibility. Placental neuropilin-1 immunoexpression was reduced in preeclampsia and HIV infection independently, with a further decrease in synergy.
Singh evaluated the renin angiotensin-aldosterone system on the placenta and placenta bed of preeclamptic, HIV-infected women of African ancestry. Her thesis and publications reported pivotal findings on the renin angiotensin aldosterone system in blood pressure regulation. The study demonstrated differential morphometric immunoexpression of angiotensin 1, 2 and 4 receptors within the placenta and placental bed based on pregnancy type, HIV status, and gestational age. Angiotensin 2 and 4 receptors were downregulated in contrast to angiotensin 1 in the synergy of preeclampsia and HIV infection, thereby affecting cell signalling and function. Singh’s findings are significant as they have the potential to identify an alternative and safer drug development route in the treatment of preeclampsia co-morbid with HIV.
Naicker and Moodley said that they are proud of the high calibre of the students’ studies that is evident in the number of papers they produced.
Words: Lunga Memela
Photographs: Sethu Dlamini
author : .author email : .