published_or_final_version / Medicine / Master / Master of Medical Sciences

Thesis (M. P. H.)--University of Hong Kong, 2006. / Also available in print.

Thesis (M. Med. Sc.)--University of Hong Kong, 2007.

Thesis (M.P.H.)--University of Hong Kong, 2006.

In this thesis I will review the current knowledge of community-acquired pneumonia, including its classification, pathogenesis, pathology, aetiology, diagnosis, and antibiotic therapy and report my experience with severe community-acquired pneumonia in patients requiring admission to our respiratory intensive care unit. The original research in this thesis comprises a prospective, descriptive analysis of 196 cases of severe community-acquired pneumonia requiring admission to the Respiratory Intensive Unit at Groote Schuur Hospital from January 1987 until December 1992, with emphasis on the influence of aetiology on the severity of pneumonia, the· aetiological diagnosis of pneumonia in severely ill patients, measures of severity of pneumonia, and an audit of ICU therapy and outcome. In addition, different aspects of novel therapies and specific aetiological varieties of pneumonia which have been investigated over the past ten years will be presented.

No description available.

Thesis (M.Med. (Internal Medicine))--University of the Witwatersrand, Faculty of Health Sciences, 2013. / Background Cryptococcus is a life-threatening opportunistic infection; data is limited regarding early infection. Treatment of cryptococcal antigenaemia may impact on disease progression. Screening those most at risk for cryptococcal antigenaemia is necessary to be cost effective. The prevalence of cryptococcal antigenaemia in patients hospitalised with community acquired pneumonia (CAP) at Chris Hani Baragwanath Academic Hospital (CHBAH) was evaluated. Methods 200 patients admitted to CHBAH with presumed CAP were enrolled. Clinical and laboratory data were collected and a Cryptococcal Lateral Flow Immunoassay was done on whole blood. Results Of the 200 patients, 185 (92.5%) were HIV-infected. Amongst the HIV-infected group, the median CD4 cell count was 47 cells/mm3 and 111 subjects (60%) had a CD4 cell count < 100 cells/mm3. The prevalence of cryptococcal antigenaemia was 0.5% (CI 0.01-2.75). Conclusion The prevalence of cryptococcal antigenaemia amongst inpatients with CAP was low. Routine screening of this group would not be cost-effective.

DSc (Med), Faculty of Health Sciences, University of the Witwatersrand, 2009.

published_or_final_version / Community Medicine / Master / Master of Public Health

M.Sc.(Med.), Faculty of Health Sciences, University of the Witwatersrand, 2009 / Community-acquired pneumonia (CAP) is a major cause of morbidity and mortality worldwide. Knowledge of the predominant agents associated with CAP locally is essential, as it represents the basis for empiric antibiotic treatment. The objective of this study was to establish polymerase chain reaction (PCR)-based methods that could be used to identify CAP pathogens. Real-time PCR assays were developed to detect 10 viral and 5 non-viral pathogens as well as 2 internal controls using SYBR Green I and TaqMan probes, in singleplex and multiplex reactions. Six multiplex assays, with sensitivities of 1-10 copies/μl, were successfully developed to simultaneously detect 12 organisms. These reactions were used to test a limited number of patient and simulated samples. Data from the real-time PCR methods compared favourably to those from commercially available conventional PCR kits. These detection methods could be used to complement each other in prevalence studies and in selected diagnostic applications.