Nosocomial transmission of extensively drug-resistant tuberculosis in a rural hospital in South Africa.

Background: Extensively drug-resistant tuberculosis (XDR-tuberculosis) is a global public health threat, but few data exist elucidating factors driving this epidemic. The initial XDR-tuberculosis report from South Africa suggested transmission is an important factor, but detailed epidemiologic and molecular analyses were not available for further characterization.

Methods: We performed a retrospective, observational study among XDR-tuberculosis patients to identify hospital-associated epidemiologic links.

Zinc or multiple micronutrient supplementation to reduce diarrhea and respiratory disease in South African children: a randomized controlled trial.

Background: Prophylactic zinc supplementation has been shown to reduce diarrhea and respiratory illness in children in many developing countries, but its efficacy in children in Africa is uncertain.

Objective: To determine if zinc, or zinc plus multiple micronutrients, reduces diarrhea and respiratory disease prevalence.

Design: Randomized, double-blind, controlled trial.

Vitamin A supplementation of South African children with severe diarrhea: optimum timing for improving biochemical and clinical recovery and subsequent vitamin A status.

Background: Vitamin A has well-recognized benefits for prevention of diarrhea, but the impact of therapeutic doses given during diarrhea on biochemical and clinical outcomes is less clear. We investigated these potential therapeutic benefits within a study of the optimum time for vitamin A supplementation to promote vitamin A status.

Methods: Young children with severe diarrhea were randomized to receive 60 mg of retinol as retinyl palmitate during acute diarrhea or once symptoms had resolved, usually after 5 to 8 days.

Micronutrient utilisation during measles treated with vitamin A or placebo.

Micronutrients (zinc, vitamins A and E) and related proteins (retinol binding protein (RBP), prealbumin, albumin) were measured in the serum of African children with measles, and the changes induced in these by vitamin A supplementation (offered in a randomised, double blind, placebo controlled trial) were studied. All these substances were significantly reduced early in the exanthem in measles patients as compared to controls; they attained control values by day 8 after the rash, except for serum albumin which became normal by day 42. Vitamin A and prealbumin levels on day 8 were significantly increased in the supplemented over the placebo group.