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Womens health update: Bacterial vaginosis prevalence in South Africa

Sexually transmitted infections (STI) are a major public health concern in Southern Africa. Their impact is greatest among women and unborn children, causing acute illness and chronic complications that include infertility, ectopic pregnancy and death. Having Bacterial Vaginosis or BV can increase the chances of getting other STDs, such as chlamydia, gonorrhea, and HIV. Women with HIV who get BV increase the chances of passing HIV to a sexual partner. Treatment of symptomatic STIs can reduce new HIV infections by as much as 30 - 45%.

The prevalence of STIs (either gonorrhoea, chlamydial infection, trichomoniasis or recent / active syphilis) is high in South Africa. Rates are highest among women who engage in sex work, however rates are also high among women in the general South African community due to poor quality services, low rates of partner treatment, poor understanding of and response to symptoms, and high levels of population mobility and migration.

In South Africa, 25% of women have at least one STI. As a norm 75% of sex workers have at least one STI and whilst 35% have multiple infections; among pregnant women corresponding rates are 50% and 20%; and among women attending family planning clinics rates were 30% and 10%.

BV is the most common cause of vaginal infection (vaginitis). Infection is frequently asymptomatic (60%) or unrecognised. Signs associated with STIs such as lower abdominal pain, burning urine, vaginal discharge, genital itch, genital ulceration are frequently not recognised or not acted upon. Moreover, quality of treatment is poor: only 10 - 40% of patients presenting with an STI to family doctors or primary care clinics were given correct drugs. Most of the remaining women with symptomatic infections delay or defer seeking treatment. Only about 2% of infections are treated within a reasonable time.

Many women try to avoid the inconvenience of a visit to the clinic by using an OTC medication. More than 60% of women who make a self assessment of the cause for their abnormal discharge are mistaken. If they suffer from Bacterial Vaginosis (BV), Trichomoniasis (a common sexually transmitted disease), OTC treatments can not cure these diseases, and getting proper treatment is delayed.

Likewise, in 40% of bacterial and parasitic infections cases, physicians who count on visual checks, misdiagnose. As the symptoms of the diseases may be similar, and physicians at clinics are many times under time pressure, bacterial and parasitic infections may not detected, especially when the patient suffers from multiple vaginal infections.

With the VI-SENSE kit, patients can self-test for Bacterial Vaginosis (BV), Trichomoniasis, Candidiasis (yeast, a fungal infection) and non-infectious transient irritations - due to food, medication, or allergies. As any combination of these causes may be the source of an infections, none can be ruled out without performing additional tests. However, self testing with the VI-SENSE panty-liner can indicate whether the patient may suffer from BV and/or Trichomoniasis.

Positive test results should be followed by a visit to a clinic for anti-fungal medications and irritation-relief treatments. Whereas BV and Trichomoniasis are treated with antibiotics, prescribed by physicians, test results for Candida could be followed by self-treatment with OTC medications.

The VI-SENSE Kit, which is comprised of a non-intrusive panty-liner, offers a simple to use classification tool that uses colour identification for interpretation of the results. The patient simply wear the panty liner as she would wear any regular panty liner. After 6 hours (or as soon as a discharge appears), the indicator strip is removed from the panty liner by pulling the tail of the indicator and the strip placed in the drying unit. After 10 minutes the results can be read.

Veterinary update: Newly developed Feline Parvovirus test

RapidDiscovery.biz is pleased to inform the South African veterinary industry that two new developed rapid diagnostic tests are now available. The prototypes are FHW (Feline Heartworm Test) and FPV (Feline Parvovirus test).

If you want to get samples for the evaluation, please approach us via email.

Plant diseases update: Pregnancy tests for plants now in the RSA

Read article in Engineering News: "Pocket diagnostic system finds agricultural use"

Pregnancy tests to identify plant diseases are now available in South Africa. Antibodies are used to detect the 'target' - a disease-causing organism, whether it is a fungus, virus or bacterium. One line means 'negative', while two lines means 'positive' or'plant disease detected'

Pocket Diagnostic tests were developed specifically for use out in the fields, so they have to be easy to do and robust to carry around. The tests are very simple to use, and it only takes a few minutes to check the health of your crop.

All you need to do is to take a sample from part of the plant which is showing signs of possible disease and you'll know in a few minutes if it is disease or not.

It's very important to take the sample from a part of the plant showing symptoms because it's possible for a plant to be infected with disease but to have leaves and parts of the roots and stem which aren't affected.

During the 1990s, the UK government wanted to provide its plant health inspectors with on-site tests to identify virus in seed potatoes. Research to identify the most suitable form of test kits was funded by the government at Central Science Laboratory, one of the main public-sector laboratories in the UK. The result were the first Pocket Diagnostic tests.

Having established the principle of the test, the technology was widened out to other diseases in which the UK plant health inspectors were interested - in most cases these were quarantine diseases. Because of these government origins, the full range of Pocket Diagnostic tests are firmly grounded on good science, and this is very important for any diagnostic test.

In 2007, Central Science Laboratory sold the test manufacturing and development part of its business to the private sector, and Forsite Diagnostics Ltd was created. Forsite has invested heavily in research and manufacturing facilities to make sure the quality of the tests is consistently high.

Horticulture is an international business, and organisms that cause plant diseases don't recognise national boundaries. Pocket Diagnostic tests are very robust and can be stored at room temperature so they'll work just as well in South Africa as anywhere else in the world.
For example, many of the world's pelargonium plants are grown in Africa. A disease caused by the bacterium Ralstonia was detected several years ago, and sale of all pelargonium plants to Europe and America were totally banned while the problem was overcome. This is a good example of where a Pocket Diagnostic test was used to help monitor nurseries and the supply chain as part of the 'clean-up' process.

Horticultural produce, including propagation material, is traded all over the world, and growers need to be aware of quarantine diseases in their export markets.

Most tests are used by growers and crop advisors, but there is also a market among laboratories which find the tests useful as a way of narrowing down the possibilities as they try to identify diseases, especially as the tests cost less than traditional laboratory methods.

Growers and crop advisors will 'walk the crop' as part of the normal management routine, looking for anything that might reduce yields or suggest there was a problem with the crop. If suspicious symptoms are seen, a test can be carried out. In most cases, the crop manager would probably have an idea of what the disease is, and the test would confirm his provisional diagnosis.

This is important because diseases need managing carefully to control and prevent spread of the infection and reductions in crop quality or yield, and until a grower is certain what the disease is he can't be sure of the control steps necessary. In the past, samples had to be sent away to a laboratory, which could mean a delay of several days or a week before proper action could be taken. Pocket Diagnostic tests can be run in the field in just a few minutes, so action can be taken straight away, which reduces losses to a minimum.
Where diseases have particular significance, such as quarantine diseases, accurate diagnosis is essential.
The important point to remember about Pocket Diagnostic tests is that they are best used to confirm symptoms seen by the crop manager. This is different from trying to use the tests to detect disease before symptoms are visible to the naked eye. In general, the tests are not sensitive enough to detect disease before it is visible.

Pocket Diagnostic tests are specific to the disease, not the crop. So, the tests can be used on any crops on which the diseases occur. For example, tomato crops in South Africa can be infected with several viruses, such as tomato spotted wilt virus, for which there are tests, and tobacco plants are susceptible to infection by Potato Virus Y, and the test will pick this up.
Phytophthora is a problem in many crops in South Africa, just as it is elsewhere - strawberries, citrus and apples are affected. The Phytophthora test can be used on soft, leafy plants like strawberry, or on woody plants like citrus. At Rapid Technologies, we will be working with farmers to identify where the most effective use of the tests can be made.

Getting a positive result on a test is the first step in managing the problem. The next step may be to send a sample to a laboratory for confirmatory testing, spraying the crop with the right chemicals, or taking other measures to prevent further spread of the infection. If severe measures such as destroying the crop are an option, the grower would be advised to get a confirmatory laboratory test before making the final decision.

The test result means that he can make these decisions with more confidence. And he has that information available now.

Pocket Diagnostic tests give the grower information which will help them manage their crops to deliver the best possible yields, and can also help to reduce the amount of chemical spraying used, which is something we're all concerned about these days, and do it much more quickly and at lower cost than traditional laboratory tests.

We at Rapid Technologies are working with Forsite Diagnostics in the UK to understand the requirements of the South African farmers and growers. As we identify diseases of importance, we will pass this information to Forsite, and new tests may be developed. It is a learning experience for us, but it is also a learning experience for the farmers to understand how these tests can best be used.

- Raz Cohen, Rapid Discovery

Life Sciences | Biotechnology resources