South African medical journal = Suid-Afrikaanse tydskrif vir geneeskunde
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Unspoken victims: A national study of male rape incidents and police investigations in South Africa.
The burden of sexual violence has been well described in children of both sexes and in women, but there is minimal literature on adult male rape victims. Studies of adult male rape victims have mainly been conducted among incarcerated males or military personnel, and in high-income countries. ⋯ While there is political commitment to understanding sexual violence against women as a societal problem, work on such violence against men lags behind and is little understood. Rape of males needs to be acknowledged, and their vulnerabilities to sexual abuse and rape need to be addressed. Prevention efforts to end violence against women and girls, especially in relation to children, can be used to address violence against men and boys.
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While adolescent mothers' postpartum return to school offers long-term benefits, returning too early in the absence of sufficient support may impede the healthy development of their children. This study assessed the rates of adolescent mothers' return to school in South Africa (SA) and examined how many months after birth school-aged girls resumed schooling. Two independent studies recruited 1 114 adolescent mothers in Eastern Cape Province and Durban, respectively. ⋯ Our findings indicate a mismatch between SA's national policy recommendations and actual return patterns, showing that a large proportion of mothers returned to school much earlier than advised. This study also highlights a particular need to amend school policies that support early-returners and their children. Additional research on the needs of mother-child dyads and studies on the impact of different timescales on educational and health outcomes are needed to further inform policy and practice regarding adolescent mothers' return to school.
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Urinary tract infection (UTI) is one of the most common infections during pregnancy, which can lead to significant maternal and perinatal morbidity and mortality if left untreated. Challenges when treating UTIs in pregnancy include fetal protection and resistance development of uropathogens. Currently, the Essential Medicines List recommends nitrofurantoin to treat cystitis and ceftriaxone to treat pyelonephritis in pregnant women. ⋯ E. coli is unsurprisingly the most common cause of UTI in pregnancy in KwaZulu-Natal. Susceptibility to ceftriaxone and nitrofurantoin remains good. Among Gram positives, GBS is prevalent and susceptible to penicillin, while E. faecalis is susceptible to ampicillin. As antimicrobial resistance evolves, routine surveillance is necessary to modify recommended empirical antibiotic use.
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Streptococcus agalactiae or group B streptococcus (GBS) is a significant cause of neonatal sepsis. Intrapartum antibiotic prophylaxis is recommended for pregnant women identified to be rectovaginally colonised between 34 and 37 weeks' gestational age to decrease the risk of invasive disease in their newborns. An effective multivalent GBS vaccine may prevent a broader scope of GBS-associated diseases, such as GBS early-onset disease, GBS late-onset disease, spontaneous abortion, stillbirth and maternal bacteraemia. Serotype distribution of GBS isolates is essential to determine the efficacy of such a vaccine. ⋯ GBS-colonising isolates remain susceptible to penicillin, which remains the drug of choice for intrapartum antibiotic prophylaxis and treatment of invasive disease in newborns. Macrolides should only be used if clinically indicated due to the high prevalence of intermediate resistance. A pentavalent GBS vaccine currently in phase I trials should provide coverage for 97% of the isolates identified in this study.
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Reports indicate that children infected with SARS-CoV-2 have thus far presented with less severe disease than adults. Anxiety regarding a greater ability to transmit the virus is largely unfounded and has played a significant role in the decision to allow children to return to school. In some patients, however, especially in infants and in those with underlying comorbidities, severe disease must be anticipated and planned for accordingly. ⋯ The impact of the pandemic on the economic and social wellbeing of children, including food insecurity and care when parents are ill, cannot be ignored. During this pandemic, it is imperative to ensure access to routine and emergency medical services to sick children. In so doing, potentially devastating medical and socioeconomic consequences can be mitigated.