Nov-Dec 2014 The Faculty ends 2014 on a high note with a bumper November/December edition of the Research Newsletter. From the activities displayed in this Newsletter, it is evident that research is alive and well and thriving in the Wits Faculty of Health Sciences! Faculty researchers have made a significant contribution to the University’s research enterprise over the last few years and must be complimented on their ground-breaking findings, productivity, capacity development, entrepreneurial spirit and hard work! Well done to you all! We wish you a restful festive season and hope that you will return with renewed energy to face the research opportunities of 2015! With warm wishes on behalf of the Editorial team, Bev Kramer Congratulations to Professor Ugo Ripamonti and Professor Geoffrey Candy for being awarded the Blue Skies Funding Instrument - Concept Notes (BSCN) NRF Grant for 2015. Professor Ripamonti received the grant for his research entitled ‘Transfiguration of neoplastic tumoral masses into bone for superior surgical debridement’. Ugo is the Director of the Bone Research Laboratory, School of Oral Health Sciences. To read more about his research see page 5. Professor Candy from the Department of Surgery, School of Clinical Medicine was awarded the grant to determine whether the ulcer causing bacterium, Helicobacter pylori, produces cardiotonic steroid-substances known to affect blood pressure. His research is entitled ‘Cardiotonic steroids produced by gut microflora in hypertension and other disease’. To read the summary of Professor Candy’s research see page 5. NOV_DEC 2014|RESEARCH NEWS |2 Congratulations to the Wits Health Sciences researchers who have received new ratings or re-ratings for 2015 for a period of five years. Professor Justus Hofmeyr, Professor Kathy Kahn and Associate Professor Penny Moore attained B ratings, Professor Lize Maree and Associate Professor Gill Nelson received C ratings. Associate Professor Sandy van Vuuren and Associate Professor Aimee Stewart both received a re-ratings and Dr Wendy van der Spuy received a Y2 rating. In the past two months the MRC: Respiratory and Meningeal Pathogens Research Unit (RMPRU)/ DST/ NRF SARCHI on Vaccine Preventable Disease (VPD), School of Pathology, University of Witwatersrand, has been awarded three grants from the Bill & Melinda Gates Foundation with a total value of approximately R100 million. These funds will be used for independent studies with the global aim to define the public-health importance of three infectious diseases during the first few months of life. One project, which received R8 million, will focus on determining the burden of pertussis disease in South Africa, with a particular focus on infants under six months of age, who could theoretically be protected against pertussis through vaccination of their mothers during pregnancy. The study will be undertaken during 12 months among young infants hospitalized at Chris Hani Baragwanath Academic Hospital in Soweto. R31 million was allocated to the RMPRU/VPD to evaluate the effectiveness of influenza vaccination of pregnant women against influenza-associated hospitalization in HIV-exposed and HIV-unexposed infants under six months of age. With these funds RMPRU/VPD aims to increase the coverage of influenza vaccination of pregnant women in Soweto to at least 50% during the course of the next three years. A further R60 million will be used to coordinate a multicentre study that will measure the prevalence of Group B Streptococcus (GBS) colonization at delivery and the vertical acquisition rate of GBS in newborns of colonized women in eight countries in South Asia and Africa. Standardized methods for sample collection, bacterial culture and bacteria identification across the different study sites will be implemented under RMPRU/VPD supervision. The purpose of this three year project is to contribute towards delineating the public-health importance of invasive GBS disease across different low/middle income countries and particularly the likely role of GBS as the cause of invasive disease during the newborn period. The study will explore maternal GBS colonization at birth and rate of transfer to the newborns, GBS serotype distribution associated with colonization and natural acquired serotype-specific anti-capsular antibody in different countries. These results will be used in a modelling exercise to determine the expected incidence of invasive GBS disease across different low/middle income countries. WITS | HEALTH SCIENCES Nov_Dec 2014|RESEARCH NEWS |3 Congratulations to the Antiviral Gene Therapy Research Unit (AGTRU) which recently received MRC extramural unit status. This is an exceptional achievement. The AGTRU is led by Professor Patrick Arbuthnot. The long term objectives of AGTRU are to advance gene therapy for treatment of viral infections, develop human capacity in the field through the training of young scientists and to translate the Unit’s technologies into products. The AGTRU is equipped as a modern molecular biology research laboratory and has expertise in a range of techniques. These are advanced methods of nucleic acid manipulation, gene transfer to mammalian cells, use of lipoplex and recombinant viral vectors. AGTRU is set up to investigate efficacy of antiviral compounds in vivo in murine (e.g. HBV transgenic mice) and cell culture models of viral replication. Professor Charles Feldman, Professor of Pulmonology, Chief Physician and Director of the Pulmonary Infections Research Unit was honoured by the European Respiratory Society. He was elected to be one of the first group of 125 Foundation Fellows of the European Respiratory Society for his continued contribution to research in the respiratory field. Professor Feldman is a member of various local, national and international bodies, including, more recently, the following: Immediate past-President of the South Africa Pulmonology Society; Member (and past Chairman) of the Johannesburg Regional Branch of the Critical Care Society of South Africa; International Governor for South Africa for the American College of Chest Physicians. Associate Professor Colin Menezes was awarded the TH Bothwell research prize for 2014, the premier research prize in the Department of Internal Medicine. Professor Menezes is a Principal Specialist in the Division of Infectious Diseases, Department of Internal Medicine, School of Clinical Medicine. He completed his PhD in 2013 and has been involved in several HIV and TB researchrelated projects. Congratulations to Professor Karen Sliwa who was recently elected President of the South African Heart Association. At the recent Annual General Meeting which took place in October in Durban. Professor Sliwa is the Director of the Hatter Institute for Cardiovascular Research in Africa, University of Cape Town and Director of the Soweto Cardiovascular Research Unit (SOCRU), University of the Witwatersrand. She is internationally recognized for her outstanding work in the area of heart failure. Peripartum cardiomyopathy is a subject close to Professor Sliwa's heart and her research in this field over the past two decades has helped identify the underlying mechanism and straightforward interventions. WITS | HEALTH SCIENCES Nov_Dec 2014|RESEARCH NEWS |4 Congratulations to Professor Mervyn Mer who has received a large Educational Grant from AstraZeneca. The grant will assist in enhancing research being carried out in the domain of Critical Care in the Faculty. It will also further enhance the collaboration with Professor Jeffrey Lipman from the University of Queensland. Professor Mer is a hands-on clinician; he is involved in various aspects of clinical research, and has participated in more than 850 lectures and presentations, both nationally and internationally. He has received numerous awards; recently he was the first recipient of the Hilda Datnow Jacobson award (awarded to the most competent, caring and capable doctor in the profession, irrespective of field of interest). Well done to Mervyn on obtaining the grant. The Faculty acknowledged the support of AstraZeneca. The Bert Myburgh Award ceremony is an annual event in the Department of Surgery to showcase research undertaken throughout the year by Departmental registrars and researchers. This year’s winner is Dr Daniel Surridge, whose research focus on determining the reason for blockage which sometimes occurs following an operation to remove haemorrhoids. Dr Surridge and Dr Bebington his co-author, used an animal model to demonstrate that a blockage would result from using a stapler outside the suture. Alan Gould won 2nd Prize for his on-going research on an indigenous herb used by traditional healers for wound healing. Finally, thrombocytopenia is common in burn victims. Dr Imtiaz Bahemia from the Burns Unit at Chris Hani Baragwanath Hospital won third prize by showing that decline in platelets on day 3 and 10 after admission were poor predictors of survival in burn victims. Photograph (left to right): Surgery’s Martin Smith congratulating the winners of this year’s Bert Myburgh Research Forum 1st Prize winner Daniel Surridge, and runners up Alan Gould (2nd Prize) and Imtiaz Bahemia. WITS | HEALTH SCIENCES Nov_Dec 2014|RESEARCH NEWS |5 Following important discoveries on the induction of bone formation by the third mammalian transforming growth factor-β3 (TGF-β3), the Bone Research Laboratory (BRL) of the University of the Witwatersrand has recently shown novel mechanistic insights on the induction of bone formation by the recombinant human TGF-β3. Doses of the hTGF-β3 Rapid induction of bone formation from transformation of the rectus abdominis muscle of a Chacma baboon Papio ursinus upon intramuscular heterotopic implantation of 125 µg hTGF-β3 protein initiate the cascade of bone formation via the The NRF-supported study on the ‘Transfiguration of expression of several profiled bone morphogenetic neoplastic tumoral masses into bone for superior protein genes. The BRL has also shown that the surgical hTGF-β3 protein is the most powerful bone inductive Professor Ugo Ripamonti and Dr Raquel Duarte, morphogen so far tested in non-human primates. The together with a team of molecular and cellular BRL has proposed novel concept notes to the biologists, Drs Therese Dix-Peek, Brenda Milner, National Research Foundation (NRF) because of the Caroline Dickens and Roland Klar debridement’ will be undertaken by rapid and substantial transformation of the rectus abdominis striated muscle into newly formed induced bone. The morphological and molecular evidence of the rapid transfiguration of muscle tissue into bone by hTGF-β3 has indicated to the BRL a further novel biological function of the hTGF-β3 isoform, i.e. its injection into malignant neoplastic primary and secondary masses to induce rapid transfiguration of the injected tumours into bone, thus facilitating tumoral ablation and its surgical debridement. Transfiguration of neoplastic masses will also transfigure this novel oncologic treatment into the tissue engineering paradigm whereby neoplastic masses are engineered by soluble morphogenetic signals into debridement. bone for later more surgical Professor Geoff Candy was recently awarded a NRF Blue Skies research grant to determine whether the ulcer-causing bacterium, Helicobacter pylori, produces cardiotonic steroids – substances known to affect blood pressure. In 1976 it was shown that the presence of indigenous gastrointestinal microbial flora lowered gut mucosal Na+/K+-ATPase pump activity in mice. Data presented at the 2014 Faculty Research Day (Nel & Candy, 2014) showed that WITS | HEALTH SCIENCES Nov_Dec 2014|RESEARCH NEWS |6 ouabain, a cardiotonic steroid and ATPase pump training programmes that are common practice in inhibitor, also blocked arginine uptake associated South Africa. Due to the high incidence of post stroke with nitric oxide production. Independently the survivors with HIV it was important to establish if this researchers have shown that antibiotic treatment to training programme produces comparable effects in eradicate H. pylori is associated with changes in HIV-positive and HIV-negative subjects. blood pressure. This study may demonstrate a role •••••••••••••••••••••••••••••••••••••••• for gut microbes in hypertension. •••••••••••••••••••••••••••••••••••••••• A total of 144 subjects with stroke were stratified The available resources for and randomly assigned to one of three training stroke and groups. Six sessions of sixty minutes each were rehabilitation are lacking in conducted for the task and strength groups. The developing countries control group attended one multidisciplinary training Africa, session during the study period. The primary particularly in rural areas. objective was to assess walking competency, which Currently with includes measurement of walking endurance, gait stroke are discharged from speed, functional balance and mobility (Salbach et hospitals al., 2004). including care South patients in the public healthcare sector within six to 14 days of having a The task group showed a significant difference stroke, because of the pressure for hospital beds greater than the strength of control groups in (Mudzi, 2009; Reid et al., 2005; Hale et al., 2004). As walking endurance, gait speed, functional mobility a result, patients are not being rehabilitated and a and balance at the six month follow-up. This finding large number of persons with disabilities are demonstrates that the provision of as little as six discharged and the burden of care is placed on the sessions of task training (in a developing country, families who do not know how to cope, in under where persons with sub-acute stroke have had no resourced communities. It is extremely concerning previous that there is little or no rehabilitation provided to competency to a significantly greater extent than stroke survivors in the public healthcare sector in either a strength intervention of equal intensity, or a South Africa (Mudzi, 2009; Rhoda and Hendry 2003; control intervention programme. rehabilitation) improves walking Hale and Wallner, 1996; Stewart et al., 1994). There were no significant differences among the With this in mind, the aim of the study by Dr Megan groups in the change scores for the measures of Knox, who recently graduated from the Department walking competency between the HIV-positive and of Physiotherapy with a PhD, was to determine if an HIV-negative subjects throughout the study period. out-patient-based training The results of this study demonstrate that an programme conducted with only six sessions would extremely limited intensity of a group-based task improve walking competency more than the current training programme resulted in significantly greater task oriented group WITS | HEALTH SCIENCES Nov_Dec 2014|RESEARCH NEWS |7 improvements in walking competency than the Dr Knox presented this research at the Stroke and current therapeutic approaches. These results are far Hypertension Congress 2014 and won first prize for reaching as six to eight patients can receive the Best Paper Presentation in the Discovery Health rehabilitation in the same amount of time as one. Clinical Excellence Awards. Her project was entitled ‘Does a little go a long way? Efficient rehabilitation of persons with stroke in the public health-care sector in RSA’. population-level transmission, impact and price of the gel thresholds on at HIV which widespread product introduction would be as costeffective as male circumcision in urban South Africa. Using a dynamic HIV/STI transmission model, Women are at an increased risk for HIV infection in sub-Saharan Africa and there is an urgent need to develop methods for HIV prevention that are under their direct control. Pre-Exposure Prophylaxis (PrEP) involves the use of antiretroviral parameterised and fitted to Gauteng HIV prevalence in an earlier collaboration, the impact of gel use over 15 years was estimated. •••••••••••••••••••••••••••••••••••••••• (ART)-based products prior to sexual exposure to prevent HIV infection. In 2010, the results of the CAPRISA 004 trial provided proof-of-concept for topically applied products or microbicides that can be used at PrEP. In this trial, tenofovir gel applied before and after sex was shown to reduce HIV infection by 39%. Currently, Wits investigators Professor Helen Rees and Professor Glenda Gray are leading a phase III trial, FACTS 001, to confirm the initial findings that tenofovir gel can be used to prevent HIV infection in women, and ensure licensure of this product for •••••••••••••••••••••••••••••••••••••••• The findings showed that tenofovir gel use could lead to a 12.5% reduction in population-level HIV incidence within 15 years. Microbicide introduction was predicted by the model to be highly costeffective at < $300 per DALY averted, though the widespread use. dose price would need to be just $0.12 to be In anticipation of the results of the FACTS 001 trial, highly effective (83% HIV efficacy per sex-act) equivalent to male circumcision. A single dose or Professor Sinead Delany-Moretlwe and Professor Helen Rees collaborated with colleagues from the London School of Hygiene and Tropical Medicine in the UK to conduct a cost-effectiveness analysis using the CAPRISA trial findings to estimate the regimen would allow for more realistic threshold prices ($0.25 and $0.33 per dose, respectively) highlighting the need to reduce product costs. Agreements are already in place to ensure transfer to local production in South Africa should the FACTS WITS | HEALTH SCIENCES Nov_Dec 2014|RESEARCH NEWS |8 001 trial produce a positive result that leads to hypertensive, sleep-deprived, obesity-resistant, licensure by the MCC. fever-resistant, ageing-resistant, and tumour-prone compared to rodents housed at temperatures that Terris-Prestholt F, Foss AM, Cox AP, Heise L, Meyer-Rath G, Delany-Moretlwe S, Mertenskoetter T, Rees H, Vickerman P and Watts CH. Cost-effectiveness of tenofovir gel in urban South Africa: model projections of HIV impact and threshold product prices. BMC Infectious Diseases 2014, 14:14 doi: 10.1186/1471-2334-14-14 are comfortable for them. Increasing the awareness of the thermoneutral zone and the effects of ambient temperature on rodent physiology is important if we hope to improve the translation of experimental results from rodents to humans. Indeed, potentially every experiment performed on genetically modified mice is irrelevant to human physiology if those mice live at traditional animal house temperature. Maloney SK, Fuller A, Mitchell D, Gordon C and Overton JM. Translating animal model research: does it matter that our rodents are cold? Physiology. 2014: 29; 413-420. Professors Shane Maloney (Honorary Professorial Research Fellow), Andrea Fuller and Duncan Mitchell from the Brain Function Research Group in the School of Physiology, with international colleagues, addressed this question in a recent review in the Rotavirus is the leading cause of diarrhoeal morbidity prestigious journal Physiology. and mortality in children under five years of age, By necessity, many interventional studies that are of interest to human biology and medicine are carried out on laboratory rodents. Humans working indoors are comfortable at ambient temperatures of about 20 to 24°C, within their thermoneutral zone, and so they maintain animal housing facilities, including the rooms at the Wits Central Animal Services, within that range of air temperatures. However, rodents, and other small mammals, have much higher thermoneutral zones, above 30°C. When rodents are housed at a traditional animal house temperature (usually 21-22°C) they are cold stressed. Maloney and his co-authors showed that the ambient temperature at which laboratory rodents are housed profoundly alters the phenotype of the animal. The chronic cold stress that the animals are exposed to alters not just the animal’s thermoregulation, but also makes the animals hypermetabolic, accounting for an estimated 453 000 global deaths in 2008 with >90% of mortality occurring in lowincome countries in Africa and Asia. South Africa was the first African country to introduce rotavirus vaccine into its national immunisation programme, beginning August 2009, with vaccination recommended at 6 and 14 weeks of age. The effectiveness of hospitalisation the for rotavirus acute vaccine against rotavirus-diarrhoea in children under two years of age was evaluated in a multi-centered study led by the Respiratory and Meningeal Pathogens Research Unit (RMPRU). These results were published recently in the highest ranking infectious diseases journal, Lancet Infectious Diseases, by Dr Michelle Groome, a senior researcher and epidemiologist at the RMPRU, and colleagues. The study found that between April 2010 and October 2012, South African children under two years old who were fully vaccinated against rotavirus WITS | HEALTH SCIENCES Nov_Dec 2014|RESEARCH NEWS |9 were 57% less likely to be hospitalised for rotavirus diarrhoea compared to unvaccinated children. The University of the Witwatersrand and the National Additionally, children who received just one dose of rotavirus vaccine were still 40% less likely to be hospitalised for rotavirus diarrhoea. The study also showed that protection from severe rotavirus diarrhoea was sustained throughout the first two years of life, and similar protection was found in both HIV-exposed but uninfected children and HIVunexposed children. The vaccine was also found to be effective against severe rotavirus diarrhoea hospitalisations for a variety of rotavirus strains. Institute for Communicable Diseases (NICD) released important research information showing that rates of invasive pneumococcal disease (IPD) – including cases caused by antibiotic-resistant bacteria – have fallen substantially in South Africa following the introduction of a pneumococcal conjugate vaccine (PCV) in 2009. The study ‘Effects of vaccination on invasive pneumococcal disease in South Africa’, published in the prestigious New England Journal of Medicine (NEJM), compares IPD incidence after the introduction of PCV (post-introduction: 2011 and 2012) to incidence prior to its introduction (20052008), focusing on high-risk groups. This study showed a significant decline in IPD in children under two years of age: overall incidence of Figure 1: Vaccine effectiveness against hospitalisation for acute rotavirus-diarrhoea, stratified by age group and rotavirus strain. These results are encouraging and establish the public health value of rotavirus vaccine in an African setting, especially as rotavirus vaccines are introduced into an increasing number of African countries. It is estimated that globally the lives of over 200 000 children could be saved annually, were rotavirus vaccine to be introduced in low-income countries. IPD declined by nearly 70% after PCV introduction, and rates of IPD caused by bacteria specifically targeted by the vaccine decreased by nearly 90%. In addition, disease declined in unvaccinated adults, which demonstrated the indirect protection conferred by herd effects – the infants and children are no longer carrying the bacteria to spread them to unvaccinated individuals. The study also demonstrated reductions in pneumococcal disease cases caused by bacteria resistant to one or more antibiotics. Lead author of this publication was Dr Anne von Gottberg, a clinical microbiologist at the Groome MJ, Page N, Cortese MM, Moyes J, Zar HJ, Kapongo CN, et al. Effectiveness of monovalent human rotavirus vaccine against admission to hospital for acute rotavirus diarrhoea in South African children: a casecontrol study. Lancet Infect Dis. 2014; 14:1096-1104. NICD and Associate Professor in the School of Pathology at Wits. Although the majority of childhood pneumococcal deaths occur in Africa, evidence of the potential impact of pneumococcal vaccines in routine use has largely been drawn from high-income countries. WITS | HEALTH SCIENCES N o v _ D e c 2 0 1 4 | R E S E A R C H N E W S | 10 Two further publications (see below) from the School of Public Health at Wits and the NICD have demonstrated PCVs to be effective in preventing pneumococcal disease among South African children in conditions of routine vaccine use. The first paper generated estimates of pneumococcal conjugate vaccine effectiveness in HIV-uninfected and -infected children which is an important aspect of monitoring vaccine performance in routine use. Dr Cheryl Cohen, lead author of this paper, is a clinical epidemiologist at the NICD and senior lecturer in the School of Public Health at Wits. An additional paper by Dr Claire von Mollendorf, a PhD student registered in the School of Public Health at Wits, showed that HIVinfected children and HIV-exposed-uninfected children are at substantially increased risk of pneumococcal disease. This is important as it highlights the potential for this vaccine to reduce health disparities in these vulnerable groups. 1. Von Gottberg A, de Gouveia L, Tempia S, Quan V, Meiring S, von Mollendorf C, Madhi SA, Zell ER, Verani JR, O'Brien KL, Whitney CG, Klugman KP, Cohen C. Effects of vaccination on invasive pneumococcal disease in South Africa. N Engl J Med 2014; 371:1889-99. 2. Cohen C, von Mollendorf C, de Gouveia L, Naidoo N, Meiring S, Quan V, Nokeri V, Fortuin-de Smidt M, MalopeKgokong B, Moore D, Reubenson G, Moshe M, Madhi SA, Eley B, Hallbauer U, Kularatne R, Conklin L, O'Brien KL, Zell ER, Klugman K, Whitney CG, von Gottberg A. Effectiveness of 7-Valent Pneumococcal Conjugate Vaccine Against Invasive Pneumococcal Disease in HIV-Infected and Uninfected Children in South Africa: A Matched CaseControl Study. Clin Infect Dis 2014; 59:808-18. 3. Von Mollendorf C, Cohen C, de Gouveia L, Naidoo N, Meiring S, Quan V, Lindani S, Moore D, Reubenson G, Moshe M, Eley B, Hallbauer UM, Finlayson H, Madhi SA, Conklin L, Zell ER, Klugman KP, Whitney CG, von Gottberg A. Risk Factors for Invasive Pneumococcal Disease among Children less Than 5 Years of Age in a High HIV-Prevalence Setting, South Africa, 2010 to 2012. Pediatr Infect Dis J 2014. Photograph (top to bottom): Dr Claire von Mollendorf, Dr Anne von Gottberg and Dr Cheryl Cohen. WITS | HEALTH SCIENCES N o v _ D e c 2 0 1 4 | R E S E A R C H N E W S | 11 Dr Christopher Ealand obtained both In October the University of the Senate House, and BSc & Physiology) and his BSc Honours degree (Microbiology) from the University in of East the Witwatersrand. He subsequently left Johannesburg Campus. The (Microbiology Biotechnology hosted the 6th CrossSymposium undergraduate degree Witwatersrand Graduate Support Division Faculty his and completed his PhD at the Faculty of University of Cape Town. Health Sciences Winners were: Oral Presentation category: Sibusiso Senzani (pictured with the Wits Vice Chancellor, Professor Adam Habib) from the DST/NRF Centre of Excellence for Biomedical TB Research, School of Pathology received the first prize, the second prize was awarded to Anna Haw from the School of Physiology and Tamzyn Baartman from the School of Physiology was awarded third prize. Poster Displays category: Zaahida Sheik Ismail from the DST/NRF Centre of Excellence for Biomedical TB Research, School of Pathology received the first prize. Nicholas Bacci from the School of Anatomical Sciences was awarded second prize and the third prize was awarded to Mhlengi Magubane from the School of marine His biotechnology-based project focused on trying to characterise the disease defence response of the red macro-algae Gracilaria gracilis under the supervision of Associate Professor Vernon Coyne in the Department of Molecular and Cell Biology. Upon completion of his PhD, he returned to Johannesburg where he joined the Centre of Excellence for Biomedical Tuberculosis Research (CBTBR), University of the Witwatersrand, under the mentorship of Professor Bavesh Kana. Here he undertook a project on the human pathogen Mycobacterium tuberculosis, the causative agent of tuberculosis, which entails the characterisation of enzymes capable of remodelling the peptidoglycan layer in the bacterial cell wall. He aims to Physiology. study how these enzymes contribute to the complex The Faculty was honoured to have one of its setting. Ultimately, he envisages that his project will aid nature of tuberculosis pathogenesis in the clinical postgraduate students awarded the most prestigious award of the entire Symposium. Well done to Sibusiso Senzani who took joint first place for the Prestigious Plenary Cross-Faculty Oral Congratulations to all the winners! presentation. in the identification tuberculosis. of novel drug targets for Aspects of Dr Ealand’s work have been presented at several local conferences but, more notably, at the international Keystone Symposia on Tuberculosis. In November 2014, Dr. Ealand was awarded the MRC career development award to continue his research at the CBTBR. WITS | HEALTH SCIENCES N o v _ D e c 2 0 1 4 | R E S E A R C H N E W S | 12 Dr Carren Postdoctoral Ginsburg, Fellow a at the MRC/Wits Rural Public Health and Health Transitions Research Unit (Agincourt) was also awarded a MRC Career Development Award. The award aims to build research capacity and leadership by creating new positions for postdoctoral scientists with potential to become established researchers. Dr Ginsburg’s research is on migration, urbanization and health in Agincourt and the INDEPTH Network. Fellowship is a component of a joint research project between Wits and the University of Colorado, Boulder. Dr Adedini’s research interests are in the area of health demography, including maternal and child health, reproductive health and mortality studies. He works under the mentorship of Professor Clifford Odimegwu, the Head of the Demography and Population Studies Programme. An elated mentor, Professor Odimegwu reacted thus: “The DPS Programme continues to prove that it is a trail blazer despite all the challenges we face. Despite being one of the smallest programmes in the University with only two staff members, DPS is making history in different aspects of the academic project. We are showing that with good mentorship and myriads of writing retreats, our students and graduates can do a lot. I am proud of Sunday….and challenge those who hold the levers of power in the University to give DPS two more staff and we will paint this University red with publications. I am grateful to Professors Jane Menken of the University of Colorado and Steve Tollman of our School of Public Health, who made this award possible, and to Jill Williams of the University of Colorado for facilitating the process of the award. Dr Sunday Demography Adedini, and a Postdoctoral Population Fellow Studies in (DPS) Programme, Schools of Public Health and Social Science, has produced an exceptional research output in 2014. He has published eight papers in ISI accredited journals and was the first author on four of At the 10th Public Health Association of South Africa (PHASA) 2014 congress, a registrar from the Department of Community Health, School of Public the papers. Health presented her research. Dr Charlotte Makoma Dr Adedini is not a stranger to Wits. He started his award for her research entitled ‘A retrospective review doctoral studies in 2011 and completed them in 2013. of malaria cases and deaths reported in Gauteng, 2012’. In recognition of his excellent performance, he was Dr Mlangheni was supervised by Dr Julia Moorman and awarded a Fogarty Foundation Postdoctoral Fellowship Professor Lucille Blumberg. Mlangheni was awarded the Best Oral presentation through Wits University. The Fogarty Postdoctoral WITS | HEALTH SCIENCES N o v _ D e c 2 0 1 4 | R E S E A R C H N E W S | 13 Dr Babalwa Dunga, also a registrar from the Department was ‘Bridging the Divide’. Congratulations to Dr Farouk of Community Health, School of Public Health, attended Mamdoo, a Lecturer in the Division of Cardiology, the Johannesburg Health District Research Conference Department of Internal Medicine who was awarded the 2014. She presented her research entitled ‘Factors Best Oral Presentation Award for his research entitled associated with the first antenatal care booking in ‘New data for rheumatic mitral regurgitation by 3D Johannesburg, 2013’. She received the Best Oral echocardiology in Sub-Saharan- insights for surgical presentation award for her presentation. Dr Dunga was repair?’ under the supervision of Dr Debashis Basu. Congratulations too, to Dr Keir McKutchen, Dr Kim A third registrar from the Department of Community Lamont and Dr Ruchika Meel who presented their Health, School of Public Health, Dr Carmen Whyte research and were awarded Best Poster Presentation attended the 14 th Annual Ekurhuleni Research Awards. Their research was entitled ‘The DEBB (Drug- Conference. Her research on ‘Implementation of the Eluting Balloon in Bifurcations) Study’, ‘Low systolic ward based primary health care outreach teams in the blood pressure and high resting heart rate as Ekurhuleni Health district: process evaluation’ won the predictors of outcome in patients with Peripartum Best Oral presentation award. She was supervised by Dr Cardiomyopathy’ and ‘Assessment of left atrial and left Mary Kawonga and Dr Leena Thomas. ventricular In addition to all the prizes the registrars have won at function in chronic rheumatic mitral regurgitation by strain imaging’ respectively. the various conferences, three senior registrars were awarded their MMed research reports with distinction. Dr Heinrich Volmink was awarded his MMed for his research entitled ‘Occupational stress in a South African Workforce: Instrument Testing, Prevalence Measurement and Risk Factor Analysis’. Dr Odette Abrahams research project was entitled ‘Occupations and breast cancer in women treated at a tertiary hospital in Johannesburg’. Dr Pieter de Jager received his MMed degree for his research work entitled ‘An outbreak of New Delhi metallo-beta-lactamase-1 (NDM-1) producing Enterobacteriaceae in a South African hospital: a casecontrol study’. Congratulations to all the registrars for Professors Lesley Scott, Wendy Stevens and their team won an award at the Gauteng Accelerator Programme (GAP) Innovation Competition for 2014, in the Bioscience category. The award was made for their ‘SmartSpot’ business plan. They were awarded R500K in seed funding to be used by the business over the next year. They also have incubation support at the Innovation Hub for a year. their outstanding achievements! The 15th Annual SA Heart Congress 2014 was held in Durban in October 2014. The theme of the congress WITS | HEALTH SCIENCES N o v _ D e c 2 0 1 4 | R E S E A R C H N E W S | 14 attended the conference. The information presented is always cutting edge, resulting in conferences which serve as a forum and touchstone for the world’s leaders in mesothelioma to contribute toward the shared goal of Dr Heleen Hanekom from the Department attended of the Oceanian Radiology 15 th Asian Congress of Radiology (AOCR) hosted by the Japan Radiological Society in conjunction with the 50th Autumn Assembly of Japan Radiological Society. The theme of the conference was “Borderless Alliance- Education and Friendship” with a focus on education for young and training radiologists. This theme was evident throughout the congress with numerous educational lectures specifically aimed at registrars focusing on emergency radiology and general approaches to different imaging techniques. Heleen presented her poster entitled ‘Computerised Tomography Findings of Lymphobronchial Tuberculosis in Children: a Comparison between Infants and Older Children.’ from the AOCR. She was the only recipient of the scholarship from the African continent. The scholarship was established to encourage and support young professionals under the age of 40 to attend the AOCR This is a wonderful increasingly environmental disease. IMIG currently boasts a governing board of scientists from the USA, UK, Netherlands, France, Australia, Egypt, Japan, Switzerland, South Africa and Finland. South African Board member, Dr Jim Te Water Naude, served as this year’s conference chairperson. The South African Mesothelioma Interest Group (SAMIG) won the bid to host IMIG2014 in Cape Town, with other redoubtable contenders being Paris, Vancouver, Washington DC and Honolulu. IMIG2014 was special for a number of reasons including it being held exactly 50 years after the 1964 Selikoff conference in New York, which was the first global meeting of scientists on asbestos and involved Dr Chris Wagner, whose work conclusively determined the asbestos-mesothelioma link. This was achievement. Congratulations Heleen! IMIG has held a conference in Africa and the conference which activists from around the world shared the work they perform to help those suffering from asbestosrelated diseases, and the campaigns they run to end the use of asbestos. Despite being a long-haul destination for most, close to 300 delegates attended the conference. There were about 160 oral presentations, 30 poster discussions, and 150 posters. South Africa was honoured and privileged to host the International Mesothelioma the first time included a social advocacy session and exhibit tables in Heleen received the "Young Investigator Scholarship" 2014. ending this deadly and preventable occupational and Interest Group (IMIG) biennial conference in Cape Town from 21-24 October 2014. Professor Jill Murray, Professor Gill Nelson and Mrs Ntombizodwa Ndlovu from School of Public Health WITS | HEALTH SCIENCES N o v _ D e c 2 0 1 4 | R E S E A R C H N E W S | 15 partnerships. The conference aimed to nurture/mentor young researchers, foster collaborations between On the 30th October, the Health Sciences Research Office hosted the Carnegie Fellows Symposium. The symposium was held at the Department of Cardiology, Universities, to expose researchers to emerging research areas in spatial statistics and its applications and to improve quality of teaching and research. Chris Hani Baragwanath Academic Hospital. The attendees were honoured to have the DVC: Research, Professor Zeblon Vilakazi, deliver the opening address. The symposium provided the Carnegie Fellows with an opportunity to present and highlight their research. The following Fellows presented their research: Dr Martin Brand, Dr Kapila Hari, Dr Susan Williams, Dr Glendah Kalunga, Dr Nirthi Maharaj, Dr Ziyaad Dangor and Dr Nimmisha Govind. The symposium was very well attended. Photograph (left to right): One of the participants from Namibia, Mr Owen Mtambo with Professor Tobias Chirwa; Ms Busi Mdhletse, Wits School of Public Health Course Admin and Exams Officer giving a token of appreciation to the keynote speaker Professor Andrew Lawson (Professor of Biostatistics in the Division of Biostatistics, Department of Public Health Sciences, College of Medicine, Medical University of South Carolina (MUSC) Nearly 1,400 researchers, advocates, policy-makers and journalists gathered in Cape Town in October for The Division of Epidemiology and Biostatistics in the School of Public Health hosted the first Sub-Saharan African conference on spatial and spatiotemporal statistics. The theme of the conference was nurturing the future generation of spatial epidemiologists and statisticians in Africa. The inaugural conference aimed to bridge the gap of data availability and lack of suitable expertise to process it. It allowed an opportunity to different role players to promote and HIV Research for Prevention (HIV R4P)—the first conference to bring together the different fields of biomedical prevention research in one forum. Professor Helen Rees, Executive Director of Wits RHI, was a conference co-chair. As our understanding of the HIV epidemic deepens, the need to expand the range of effective prevention options becomes more apparent, to accommodate diverse prevention needs and contexts. explore new collaborations and to solidify existing WITS | HEALTH SCIENCES N o v _ D e c 2 0 1 4 | R E S E A R C H N E W S | 16 Archbishop Desmond Tutu, speaking at the opening ceremony via video link, said, “No single method of prevention can end this epidemic on its own.” Professor Rees, in her opening address, explained the importance of breaking down walls between vertical conferences covering specific biomedical prevention options such as microbicides and vaccines. She said, “There are commonalities. There are issues which HIV vaccine basic scientists might be looking at which may also be very important for microbicide or pre-exposure prophylaxis (PrEP) scientists too, and vice versa.” anniversary To commemorate 20 proud years working towards better health outcomes in the field of sexual and reproductive health, the Wits Reproductive & HIV Institute (RHI) held an open symposium on the evening of the 13th of November at the Wits Great Hall. A number of prestigious guests gathered to debate HIV R4P also examined the challenges of adherence to study drugs and ways to modify trial design to accelerate Wits RHI hosts a symposium to celebrate its 20-year the research process, as well as mechanisms that link socio-behavioural research to basic science. issues around resource allocation in South Africa, including RHI Executive Director Professor Helen Rees and Wits Vice-Chancellor Professor Adam Habib; Professor Karen Hofman, Director of PRICELESS SA; public health specialist Dr Neil Cameron; RHI Deputy Executive Director Professor Francois Venter; and By holding one conference on biomedical prevention Professor Martin Veller, Dean of the Faculty of Health research for HIV, “we were able to look at these Sciences at Wits. A special guest from the National commonalities Department of Health, Deputy Director-General Dr together while not losing the uniqueness of these specific fields,” said Professor Rees. Yogan Pillay, was also part of the panel. The symposium proved to be a fascinating and thought-provoking discussion. Professor Rees opened with a brief history of South Africa’s public health challenges and responses from 1994 through to the present, and also gave the audience some insight into RHI’s beginnings as a small Wits research unit, the Reproductive Health Research Unit, and its progress through the years. Dr Neil Cameron then took the audience on a journey to rural Madwaleni in the Eastern Cape, and described some of the challenges in making sure that all South Africans have access to lifesaving vaccinations. He pointed out that immunisation Photograph: Professor Rees welcomes Mpho Tutu, daughter of Archbishop Desmond Tutu, on the inauguration of the Desmond Tutu Award for HIV Prevention and Human Rights is a critical component in a functioning health system, a topic then picked up by Professor Karen Hoffman. Her talk explored how public health campaigns such as vaccinations could be made as cost-effective as WITS | HEALTH SCIENCES N o v _ D e c 2 0 1 4 | R E S E A R C H N E W S | 17 possible, given that South Africa has a constrained budget and a number of pressing health concerns. When deciding how to spend money, the choice of public health interventions must be based on solid evidence. Professor Francois Venter’s dissection of the lack of evidence behind some of our most common perceptions about health was both surprising and entertaining, but ultimately provided a great deal of food for thought. Professor Adam Habib’s comments highlighted how important it is for public policy to serve those who need it most, and called for greater accountability from not only the state, but also the private sector. Dr Yogan Pillay spoke on behalf of the Department of Health and the Minister of Health, Dr Aaron Motsoaledi, on how health systems need to be strengthened to achieve public health goals and meet the needs of the underprivileged. Professor Martin Veller closed the symposium by thanking the speakers, and by thanking Wits RHI for its remarkable academic output. The evening was rounded off with a cocktail Tuesday, 2nd December 2014 saw Professor Mervyn Mer (Principal Specialist in the Division of Critical Care and Pulmonology, Department of Internal Medicine, Wits) and Professor Jeffrey Lipman, a Wits Alumnus (Director of the Department of Intensive Care Medicine, Royal Brisbane and Womens’ Hospital, Professor and Head of Anaesthesiology and Critical Care, University of Queensland) present the eleventh lecture in the Prestigious Research Lecture series. The lecture was entitled ‘Beyond Superbugs: Critical lessons in life and medicine from Africa to the first world!’ “Emphasis should be on maximizing efficiency and minimizing toxicity”, said Professor Jeffrey Lipman. Addressing the audience Professor Lipman summarized a career in the relatively ‘young’ discipline of critical reception. care, commencing with his establishment of the first RHI would like to thank all those who contributed later heading up the ICU at Baragwanath Hospital. In towards the evening’s success, including the guest speakers, the organisers, and all those who attended. We look forward to what the next 20 years will bring! intensive care unit (ICU) at JG Strijdom Hospital, and his nearly forty years of research into the critically ill, Lipman’s focus has been on determining adequate dosing in critical care patients, whose response to drugs is not typical of drug trials performed on relatively ‘healthy’ and non-critical test subjects. Lipman cited differences in volumes of distribution as well as augmented renal clearance as key factors in drug inefficiency in current ‘standard’ approaches to dosing. “One size does not fit all”, he iterated, alluding to the fact that current dosing guidelines do not make adjustments for factors such as weight, which might well impact drug efficacy. In South Africa, there are significant implications particularly when for considering Lipman’s the research, treatment of critically ill TB patients and the rise of multi-drug resistant strains of TB. WITS | HEALTH SCIENCES N o v _ D e c 2 0 1 4 | R E S E A R C H N E W S | 18 Professor Mer presented on the human aspect and the To local burden of these deadly diseases. He showed how Professor Charles Feldman (Professor of Pulmonology, famous individuals who have been diagnosed with TB Chief Physician, Director of the Pulmonology Infection have responded to having the disease. ‘One person Research Unit and the Head of the Division of dies from TB every 20 seconds globally and one in 100 Pulmonology at the Charlotte Maxeke Johannesburg South Africans has TB’, said Professor Mer. “We may Academic well not be treating TB patients adequately”, said Witwatersrand) gave an insightful commentary. Professor Mervyn Mer, speaking alongside Professor Lipman at the Prestigious Lecture. He discussed the various clinical findings that critically ill individuals with TB can present with. He also emphasized that doctors can do better- they can improve TB treatment. The take home message from Professor Mer’s talk was summarized by the legendary Mandela’s words ‘It is in end off the two outstanding presentations, Hospital and the University of the Professor Lipman visited Wits in December as part of the Carnegie-Wits Alumni Diaspora Programme. Initiated by the Health Sciences Research Office, the programme ‘brings home’ research active health sciences alumni, to establish ongoing collaborations with their alma mater. your hands to make a difference, to make this world a better place’. WITS | HEALTH SCIENCES research N o v _ D e c 2 0 1 4 | R E S E A R C H N E W S | 19 Who are you and what is your academic/scientific training and background? I am a medical doctor, class of 1987 (Wits). I have done postgraduate studies in sports science, sports medicine, emergency medicine, aviation medicine and submarine / diving medicine. I was awarded a travelling Fellowship with the International Sports Medicine Federation and am a professional Fellow of that Federation. I am a member of the American College of Sports Medicine. I received an exceptional service award from the South African Sports Medicine Association, which also awarded me lifetime membership. I have received awards and recognition for contribution to a number of sports and events including athletics, Paralympics, Olympic Games and FIFA World Cup 2010. I received a Faculty of Health Sciences research award in 2010. Explain the nature of the research that you are currently undertaking. I have a broad interest in sport and the role of exercise in chronic disease. Currently I am looking at a number of aspects of drugs in sport; including the use amongst university student-athletes and prevention strategies; androgen profiles in urine and the effect of a number of substances in performance enhancement. I am interested in risk factors for sudden cardiac arrest amongst young athletes. I am gathering data on exercise and cardiac disease management and about to start research with organ transplant patients. What do you think is the most pertinent/relevant/significant contribution you have made to research/science/your field? I would consider that the most pertinent contribution is not in a specific research area, but in having created an environment of research in this field at Wits. We are starting to see the blossoming of the seeds that have been planted in the Centre for Exercise Science and Sports Medicine with a significant growth of research in this field over the last few years. My scientifically relevant research I believe is what I am currently embarking on in the field of methylphenidate and human performance. Did you have a particular mentor or supervisor who inspired you in research? There are in fact many, many people that have inspired me from different perspectives. From my mother (who was a teacher) who has always had an astute, critical, and inquiring mind; high school teachers who made me think for myself, to the rich environment of my medical training with the privilege of having been taught by the likes of Professors Tobias, Allen, Myburgh, Barlow, Schamroth, Mitchell, Veriava and many many more that I wish I could name here. I must mention that I have been fortunate in having been mentored and inspired by Tim Noakes, Michael Lambert and Alan Rothberg. WITS | HEALTH SCIENCES N o v _ D e c 2 0 1 4 | R E S E A R C H N E W S | 20 Tell us about what you do when you're not busy at work and carrying out cutting-edge research. I love spending time with my kids, even though they are no longer little. I like playing with Dynamite, Alaska and Oscar (my three Chows) and discussing the daily news with Flash (my Parrot fish). I love listening to rock music and reading esoteric books Read one of Demitri’s papers: Gradidge P. J-L, Constantinou D and Goldberg L. Risk of sudden cardiac arrest in young athletes. The South African Journal of Sports Medicine 2013; 25(2):53-54. Thank you to all who contributed to this issue. Do you have any significant research news you would like us to include, or comments you would like to make? Please contact [email protected] (news items to reach us by 14 January 2015) The newsletter is edited by Professor Bev Kramer, Professor Andrea Fuller, Suretha Erasmus and Nomfundo Sibiya. WITS | HEALTH SCIENCES Wits Health Sciences Research News
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