University of Cape Town

Module no: 38

Contact: Dr M Hsiao ([e-mail])

Tel: [phone]

Title: Evaluation of Infant HIV diagnosis tests

No of Students: 4

Summary: Mother to child transmission (MTCT) of HIV may occur either during pregnancy, during labour, or through breast feeding. Despite effort to prevent MTCT, HIV infections unfortunately still occur. The identification of early infant HIV infection, commonly referred to as “Early Infant Diagnosis” or EID, is important because these HIV infected infants can benefit from early antiretrovirals therapy.
Currently HIV polymerase chain reaction (HIV PCR) is the diagnostic test of choice for EID in South Africa. PCR requires large, costly equipment that needs to be operated by trained staff. For this reason PCRs are largely performed in centralised virology laboratories in each of the provinces and diagnosis of infant HIV in remote areas is therefore delayed. In order to reduce the delay, there is substantial interest in developing a cheap and easy assay that can be used at the remote clinics or laboratories.
This module will require the student to read up on the rationale and technologies behind infant diagnosis of HIV infection. Students will be introduced to laboratory tools of EID during their time in the laboratory. Once they are familiar with the performance, strengths and weaknesses for each of the tools, they will write a report on the appropriate placement of these tools at various levels of health and laboratory facilities.
Module no: 39
Contact: Dr Andrew Whitelaw

[e-mail]

021 404 5295

Title: Antibiotic stewardship – are antibiotics being

used appropriately

No of students: 4

Summary: The misuse of antibiotics is a growing global concern. Inappropriate use is one of the main drivers of antibiotic resistance. However, inadequate dosing and inappropriate administration may also impact on clinical outcomes. The South African Antibiotic Stewardship programme thus aims to encourage use of antibiotics only when needed, a well as to optimise the way they drugs are administered. wo of the issues that have been identified as potential problems are the hang time (the time it takes for an antibiotic to be administered once it has been ordered), as well as the use of therapeutic drug monitoring to ensure adequate dosing.
Two students will be assigned to review the “hang time” of antimicrobials. This will be done by a combination of prospective monitoring, as well as retrospective review of records. More importantly, factors that affect the hang time need to be identified in order to effect improvements. The other two students will review the use of vancomycin. The students will identify patients receiving vancomycin, and will assess what the indication for vancomycin was, as well as whether appropriate therapeutic drug monitoring is taking place.

Module No: 40

Contact: Charles Shey Wiysonge

[e-mail]

Tel: [phone]

No of students: 6

Type: Systematic review

Title: Mobile phone text messaging for increasing

childhood vaccination coverage

Summary: Vaccination is widely acknowledged as one of the most powerful interventions for improving child survival. However, more than seven million children in Africa do not receive the full series of recommended vaccines before reaching one year of age. As wireless telecommunications networks have spread rapidly throughout Africa, sending text-messages on wireless mobile telephones has become an extremely popular means of communication among people in all sectors of society. Mobile phone text-messaging, also called short messaging service (SMS), has been proposed as an approach to improve vaccination coverage. This module will enhance students’ knowledge of systematic reviews. The students will be expected to conduct a literature review to determine whether mobile phone text-messaging is efficacious in improving vaccination coverage. A written report will be submitted at the end of the module.
Human Genetics:

Module no: 41

Contact: Dr Karen Fieggen

[e-mail]

Tel. [phone]

Title: The role of amniocentesis at Groote Schuur

Hospital in antenatally detected club feet and ventriculomegaly.

No. of students: 2

Type: Cohort study

Summary: Ventriculomegaly and club feet (talipes equinovarus) are both fetal

abnormalities which are quite commonly detected in isolation yet have an association

with chromosome abnormalities. The pregnancy counselling clinic at Groote Schuur

Hospital is a referral fetal medicine unit where level 3 ultrasounds are performed on

women at risk for or suspected of having a congenital abnormality. Counselling is

provided and further investigations and management as appropriate are discussed and

planned. The study would involve identification cases of club feet and of

ventriculomegaly of diagnosed antenatal at GSH> Information on whether

amniocentesis was offered / accepted and the results would be collated. This would be

expected to inform future practice and improve consistency and provide local data on

the risk of chromosome abnormality in these settings. The students would be exposed

to the medical genetic environment. They would attend the pregnancy counseling

clinic as well as paediatric genetic clinics to gain more insight into counselling and

congenital abnormalities. They would also be exposed to the cytogenetic laboratory and

learn how chromosomes are analysed. Expected outcome would be to assist in

formalising a policy document for management of isolated ventriculomegaly and club

foot. There is potential for presentation or even publication if good quality information

is obtained as there is no published data on this in South Africa or Sub-Saharan Africa.