4. Electronic Theses and Dissertations (ETDs) - Faculties submissions
Permanent URI for this communityhttps://hdl.handle.net/10539/37773
Browse
3 results
Search Results
Item Effects of binge alcohol consumption on the development of the femur of adolescent Sprague Dawley rats(University of the Witwatersrand, Johannesburg, 2024) Mngoma, Ndabenzinhle Ronald; Bhika, AkaashniExcessive alcohol consumption adversely affects bone metabolism, thus resulting in reduced bone length, density, and strength. While excessive alcohol consumption is an established risk factor for osteoporotic fractures, there remains a dearth of information in literature regarding bone effects of binge alcohol consumption in adolescents. Therefore, our study aimed to examine the effects of binge alcohol consumption in an acute and chronic binge model, on the development and growth of the adolescent femur. Forty-eight Sprague Dawley rats (24 male and 24 female) aged 7 weeks were randomly allocated to one of the 4 treatment groups (n= 12/group) receiving binge alcohol (3g/kg of 20% alcohol) or caloric equivalent of maltose dextrin (pair-fed control), via oral gavage. The treatment groups were; A1, receiving alcohol on 3 alternating days for one week, C1, receiving the caloric equivalent of maltose dextrin in the same manner as A1 (acute), A4 and C4 received treatments in the same manner as A1 and C1 for four consecutive weeks (chronic). Trabecular morphometry in both the proximal and distal epiphysis, and cortical dimensions were assessed by using three-dimensional Micro- Focus X-ray Computed Tomography (3D-μCT) and Volume Graphics Studio® software. The morphology of the epiphyseal growth plate was examined by Haematoxylin and Eosin staining, whereas Ki-67 immunostaining was employed to quantify the proliferation of chondrocytes in the proliferative zone of the growth plate. A three-point bending test was employed to examine the effects of alcohol on bone strength. Results showed that binge alcohol consumption causes thinner trabeculae that are more widely spaced and with a smaller bone to volume ratio (BV/TV). However, the tensile strength was similar in the alcohol exposed rats and paired fed groups in male rats, whereas it appeared improved in female rats exposed to alcohol. A binge model also affected the number of chondrocytes in the proliferative zone negatively. All the adverse changes observed in the osseous tissue in the current study were shown in the male rats. Our study found alcohol to have no adverse effects on female rats, which could be due to hormonal differences.”Item Virological response in children and adolescents switching to dolutegravir based regimens in Johannesburg, South Africa – A Longitudinal Cohort Study(University of the Witwatersrand, Johannesburg, 2023) Mafora, Tshiamo; Technau, KarlIntroduction: Dolutegravir (DTG) was introduced into South African HIV management guidelines in November 2019, and has since been the mainstay of both adult and paediatric first line antiretroviral treatment (ART) regimens. Following its rapid and widespread introduction we assessed the rate of virological suppression over two years in paediatric patients switching to DTG as part of first line treatment. Methods: We performed a retrospective cohort study at Rahima Moosa Mother and Child Hospital in Johannesburg, South Africa. Children and adolescents already on first line ART who switched to DTG (between November 2019 and November 2021) were included. Baseline characteristics (at DTG switch) included age, weight, gender, viral load (VL), CD4, and pre-switch regimen. Past ART exposure and past viraemic periods (years VL >1000 copies/ml) were assessed and VL suppression rates (< 50 copies/ml) were calculated at 6, 12 and 24 months post-switch. Associations with non-suppression were assessed using uni- and multivariate analysis. Results: Of the 747 participants that were switched to DTG, 724 (97%) qualified for a VL and 697 (96%) of those had at least one VL done after switch. Overall, 83% (450/543) were suppressed at 6 months, 86% (434/504) at 12, 91% (487/534) at 24 months. Overall, at a median of 637 days after switch, 90% (624/697) were suppressed at their last VL. Factors associated with not being suppressed at the last VL included: missing a follow-up visit by more than 90 days post-switch to DTG (OR: 3.2 [CI:1.5-6.8], p=0.003), switching to DTG with a VL of 50-1000 rather than <50 copies/ml (OR 2.0 [CI:1.1-3.9], p=0.042), having the blood test done during July December (OR 2.0 [CI:1.2-3.4], p=0.011), and having had exposure to viraemia ≥1000 copies/ml for more than two years between first ART start and DTG switch (OR: 1.9 [CI: 0.9-3.7], p=0.071). Conclusion: In our population, similar to other studies, VL suppression was effectively maintained in the majority of patients after switching to DTG. The switch did however result in a loss of suppression in some patients and caution is needed in children and adolescents with missed visits and extensive prior viraemiaItem Adherence to Antiretroviral Therapy (ART) Amongst black adolescents. A case study on the perceptions of HIV/AIDS adolescent male patients in Ekurhuleni, South Africa(University of the Witwatersrand, Johannesburg, 2024-01) Monyai, Bradley Mothusi; Nkomo, Thobeka SSouth Africa continues to upscale in the advancement of programmatic interventions towards HIVand AIDS, however, this epidemic is observed to be affecting a high proportion of adolescents and exacerbates critical social, psychological, economic, and educational challenges (Poku & Poku, 2020). In the estimated 7.8 million of South Africans living with HIV, the second highest prevalence rate is considered to be amongst black adolescent males. Within this cohort, adolescent males reported high risky sexual behaviours related to HIV. moreover, in their adolescent-hood, HIV risk factors were correlated with lower levels of HIV and AIDS related information, low rates of viral suppression and condom attitudes. There is a noted inconstant adherence to ART (Anti-Retroviral Therapy) amongst adolescent males. Such being the case, drivers of non-adherence, retention in care that is poor and mental health challenges differs with each adolescent demographic background and the mode of infection. Such notable variances indicates that studies which merge adolescent males and their counterparts living with HIV may blur social, psychological, structural, and clinical experiences of these two diverse sub-populations. This qualitative research study aimed to explore adherence to antiretroviral therapy amongst black adolescent males living with HIV. A qualitative case study design was employed and twelve adolescent males from Ekurhuleni health care facilities were purposely sampled in the study. The data collection method that was used, was a semi structured focus group and face to face interviews whereby an interview and a focus group schedule were utilised. The different themes that emanated from the participant’s experiences were analysed using thematic content analysis. Major findings highlight that, societal stigma profoundly impacts self-perception, leading to a pervasive sense of shame and low self-worth among black adolescent males, influencing their reluctance to disclose their HIV status. The intersectionality of identity, encompassing socioeconomic factors, sexual orientation, and race, intricately intersects with health status, illuminating the challenges faced by economically disadvantaged adolescent males managing a chronic health condition. Moreover, the intricate dynamics of HIV status disclosure within families contribute to adolescent fears of social isolation, exacerbated by poor support for medication routines. Lastly, challenges in healthcare accessibility and patient experience, characterised by discomfort with healthcare facilities and dissatisfaction with human interactions, underscored the need for a more patient-centric approach and comprehensive interventions to address systemic barriers.