MSc (Microbiology) / Department of Microbiology / BACKGROUND: Medicinal plants form an important part of the Southern African cultural heritage. Indigenous populations, for example the Vha-Venda people, tend to use medicinal plants in formulations rather than western medicines for health and survival. In order to certify and give scientific credibility to the use of medicinal plants formulations used by Vha-Venda people for the treatment of diseases, several assays were carried out. The present study was aimed at assessing phytochemical content, antimicrobial, antioxidant and cytotoxic activities of four indigenous Venda medicinal plants in a formulation and compare their activity with each plant used individually. METHODS: Peltophorum africanum (roots), Pterocarpus angolensis (bark), Terminalia sericea (roots) and Ximenia caffra (roots) were collected from the Thohoyandou area. The collected plant parts were extracted with methanol and water respectively. Individual plant extracts and Five designed formulations were tested for their antimicrobial activity against Staphylococcus aureus ATCC 25923 (Methicillin Resistant), Staphylococcus aureus ATCC 33591(Methicillin Susceptible), beta lactamase producing Klebsiella pneumonia (ATCC 700603) and extended spectrum beta lactamase producing E. coli (ATCC 35218), four clinical isolates of Candida spp and Cryptococcus neoformans using the Broth dilution method. Minimum bactericidal concentration (MBC) of the extracts was determined by culturing the contents of minimum inhibitory concentration (MIC) on nutrient agar. Similarly, minimum fungicidal concentration (MFC) was also determined by culturing contents of MIC in sabouraud dextrose agar (SDA). Extracts were further assessed for their total phenolic content, total flavonoid content and Qualitative phytochemical analysis. The antioxidant ability of the plants extracts and formulations to scavenge free radical DPPH was also determined. The plant formulations were assessed for their anti-HIV activity using the reverse transcriptase colorimetric assay kit. Cytotoxicity against human lymphatic endothelial cells (HLEC) was determined using MTT assay. RESULTS: Methanolic and aqueous extracts of T. sericea exhibited the best antifungal and antibacterial activities whilst P. angolensis and X. caffra showed poor activities. Methanolic plant formulations showed good activities compared to aqueous formulations. However, Fractional Inhibition Concentration Index showed that there was 1 synergistic interaction, 25 additive interactions and 14 antagonistic interactions between the plant extracts. The methanolic formulation 3 showed the best overall phenolic content at 11.85±0.109 mgGAE/g whilst aqueous X. caffra extract showed the least content at 4.546±0.104 mgGAE/g. Higher total flavonoid contents were seen in methanolic formulation 4 at 2.75±0.02 mgQE/g. Qualitative phytochemical analysis revealed the presence of flavonoids, phenolics, terpenoids, tannins, saponins and steroids in 80% of the tested plant extracts and formulations. All plant extracts and formulations exhibited good antioxidant activity against DPPH. The methanolic formulation showed the best antioxidant activity with IC50 of 0.094 ± 0.33μg/ml. For anti- HIV inhibition, all formulations at 200μg/ml exhibited higher percentage of HIV-1 reverse transcriptase inhibition with methanolic mixture 3 being the best overall at 97.5% activity whilst aqueous mixture5 was the least active with 63.03% inhibition activity. Moreover, the best anti-HIV activity at 100μg/ml was exhibited by methanolic mixture 3 at 71% inhibition. Furthermore, aqueous X. caffra, mixture 2 inhibited 26% and 51% at 12.5mg/ml and 3.125mg/ml respectively. Peltophorum africanum and mixture 5 inhibited 34%, 54% and 43% at 3.125mg/ml, 6.25mg/ml and 12.5 mg/ml respectively of Human Lymphatic Endothelial cells growth. CONCLUSIONS: The results from the study indicated that most of the commonly used traditional medicinal Plants in the Venda region when mixed together have merit for use in traditional medical practice as they have shown good antimicrobial activities, good antioxidant xviii activities, good phytochemical activities and good cell proliferation activity. However some formulations showed antagonistic interaction against bacteria. Some Individual medicinal plants showed toxicity at higher concentrations against immune cells. Whereas formulations promoted cell proliferation, therefore, the use of such individual plants in the treatment of infections should be highly monitored as they may pose a health threat to normal immune cells. Generally, plants are potential pharmacological agents which needs to be preserved and harvested with care. / NRF

MSc (Microbiology) / Department of Microbiology / See the attached abstract below

MSc (Microbiology) / Department of Microbiology / See the attached abstract below

PhD (Microbiology) / Department of Microbiology / Diarrhoea is still a major problem worldwide. Enteric pathogens such as Enteroaggregative E. coli (EAEC), Enteropathogenic E. coli (EPEC) and Enterotoxigenic E. coli (ETEC) have been reported to cause diarrhoea in children under the age of 5 years. The incidences of these pathogens are due to factors such as poor water quality, sanitation and hygiene practices. Infections with these pathogens result in diarrhoea and have been reported to result in severe disease outcomes more especially in children under 2 years of age. EPEC infections have been well studied using in vitro analyses, with studies highlighting the adherence traits, proteins and virulence genes involved in pathogenesis and inflammatory responses. EPEC is characterized by localized adherence with microcolony formation at the site of infection. In vivo studies have reported on human EPEC infection. However, the current animal models have not been able to replicate clinical outcomes (such as diarrhoea and weigh loss) of EPEC infection similar to humans. Therefore, there is still a need for a suitable small animal model that mimic clinical outcomes of human EPEC infections in vivo. Children living in poor environmental conditions are more susceptible to diarrhoeal pathogens. Furthermore, the incidences of children being exposed to co-infections (more than one pathogen at the same time) is relatively high. The EAEC/EPEC (A/P) and EPEC/ETEC (P/T) co-infections have been increasingly detected in children with and without diarrhoea. It has been suggested that patients infected with these co-infections might result in severe disease outcome than those infected with single pathogens. Pathogens are constantly evolving and the microbe-microbe interaction in the host can result in these pathogens competing for the same niche and thus result in increased virulence. Interaction of co-infections can lead to increased inflammatory responses thus affecting the infected host. The first objective of this study was to develop an EPEC murine model using weaned C57BL/6 mice that have been pretreated with antibiotic cocktail. Mice were orally infected with wild-type (WT) typical EPEC, bfp- and escN mutant strains. The WT had transient weight loss and wet stools with mucous; and the bfp- infected mice also had transient weight loss and bloody stool appearance. Increase in inflammatory biomarkers MPO, LCN-2, CRP, IL-6 and SAA were observed in the WT and bfp- infected mice. The mice infected with escN mutant did not exhibit any weight changes and the stools were similar to the uninfected mice. Furthermore, no inflammatory biomarkers were observed in mice infected with the escN mutant. Metabolic perturbations were observed in WT EPEC infected mice at day 3 post infection with the TCA cycle metabolites (reduced succinate, citrate, fumarate, cis-aconitate) being excreted at lower quantities indicating that the energy production in the infected mice was greatly affected. The second objective of this study was to determine the interaction between the P/T coinfections using in vitro and in vivo analyses. In vitro, human colorectal tumour 8 (HCT-8) cells were infected with single strains of ETEC, EPEC and both the pathogens and incubated for 3 hours. After infection the cells were analysed for bacterial adherence using real-time PCR. The single strains adhered at the same rate similar to the P/T coinfected cells. IL-8, as a marker of inflammatory response, was measured using ELISA. The results indicated that the P/T co-infected cells had a significant increase in IL-8 response higher than the single infections. The P/T co-infections were further analysed in vivo using the EPEC murine model developed in this study. Interestingly, mice infected with P/T co-infections developed severe diarrhoea accompanied with significant increased weight loss and some mice died during the 3-day infection period. The inflammatory responses MPO, LCN-2 and SAA were higher in the co-infected mice indicating a synergistic effect. The bfp and eltA virulence genes were significantly increased in the P/T co-infections. The third objective of this study was to determine the interaction between A/P coinfections using in vitro and in vivo analyses. HeLa cells and HCT-8 cells were infected with EAEC, EPEC and both the pathogens at the same time in order to determine adherence and inflammatory responses. EAEC adherence was higher than EPEC and A/P co-infections adherence. A/P co-infections did not have increased IL-8 response in HCT-8 cells when compared to EAEC alone. The virulence genes involved in EPEC adherence and Type 3 Secretion System (bfp, eae, tir, ler, per, espB and espA) were significantly reduced in A/P co-infected cells. An interesting adherence trait was observed between the A/P co-infections in HeLA cells, EAEC was found to adhere around EPEC altering the localized adherence pattern. The A/P co-infections were further analysed using the EPEC murine model developed in this study. The A/P infected mice had diminished weight changes and EAEC shedding was enhanced when EPEC was present. Faecal inflammatory biomarkers MPO and LCN-2 in A/P infected mice did not have any additive effect. The findings of this study contributed significantly to the knowledge of human EPEC infection in weaned C57BL/6 mice, highlighting clinical outcomes, inflammatory responses and metabolic perturbations. Furthermore, this study also highlighted the interaction of P/T and A/P co-infections using in vitro and in vivo analyses in order to determine the disease severity and outcomes. It was observed in this study that coinfections can result in either synergistic or antagonistic effects. Further studies are therefore, required in order to understand the underlying mechanisms that are involved during co-infections and this can further assist in the development of therapeutic interventions. / NRF

MSc (Microbiology) / Department of Microbiology / See the attached abstract below

MSc (Microbiology) / Department of Microbiology / See the attached abstract below

PhD (Microbiology) / Department of Microbiology / Globally, one in ten child deaths before the age of 5 years is due to diarrheal disease, causing almost 800,000 mortalities worldwide, which mostly occur in Sub-Saharan Africa and South Asia. Eighty-eight percent (88%) of diarrheal deaths worldwide are attributable to unsafe water, inadequate sanitation and poor hygiene. Unsanitary environments and poor hygiene practices allow diarrhea causing pathogens including viruses, bacteria and parasites to spread more easily. Norovirus (NoV) are now considered the most common cause of outbreaks of nonbacterial gastroenteritis. However, the factors which control the genetic diversity, the sources of sporadic NoV infections, the transmission and persistence of infection are poorly understood. Limited data are available for NoVs strains in South Africa, especially in rural and peri-urban areas. Despite the excessive burden of diarrhea disease in developing countries, NoVs outbreaks have been to date mostly reported in developed countries. Given that the contribution of the various pathogens to diarrhea may differ substantially between regions depending on local meteorological, geographic, and socio-economic conditions, there is a need to investigate intensively the role of viral agents associated with diarrhea in different settings in Africa continent. How would poor living conditions in rural setting impact the prevalence and genetic characteristics of Norovirus strains circulating Limpopo province is the research question of this study. ix To determine the prevalence and genetic diversity of NoVs strains circulating in the rural communities in the Limpopo Province, South Africa and investigate the genetic relationship between NoVs strains, a cross-sectional study was performed on human stools collected from rural communities. We used qualitative variables of poor living environmental conditions including type of water used at the household of child’s parent or guardian, use of toilet seat, presence of livestock at the household and parent employment status to assess possible environmental risk factors of NoV infection within the study area. Prior to this prospective study, we conducted a systematic review of the PubMed and EMBASE databases for published articles of Human NoVs in Africa between 1990 and 2013 in order to assess the contribution of Human NoVs to diarrhoeal diseases in Africa. This review provides a picture of Human NoVs studies in Africa and reveals that unreported sporadic gastroenteritis cases of Human NoVs are common in Africa. Most are community-associated infections reported from urban settings. Possible environmental transmission routes have been documented. Combined environmental and clinical studies are required for targeted actions to control transmission of Human NoVs in Africa. Between July 2014 and April 2015, outpatient children under 5 years of age from rural communities of Vhembe district, South Africa, were enrolled for the study. A total of 303 stool specimens were collected from those with diarrhea (n=253) and without (n=50) diarrhea. NoVs were identified using real-time one-step RT-PCR. Nucleotide sequencing methods were performed to genotype the strains. Phylogenetic analyses x were performed to compare identified NoVs genotypes to the worldwide circulating strains. One hundred and four (41.1%) NoVs were detected. NoV detection rates in symptomatic and asymptomatic children (OR = 1.24; 95% CI 0.66 – 2.33) were not significantly different. Comparison of the median CT values for NoV in symptomatic and asymptomatic children revealed significant statistical difference of estimated GII viral load from both groups, with a much higher viral burden in symptomatic children to our knowledge this is the first study reporting on the differences in estimated viral load of GII and GI NoV positive cases and controls. The study findings may have implications for the diagnosis of NoV disease and future vaccine development, which may only need to consider GII as the genogroup associated with diarrhea in the South African population. Sequence analyses demonstrated multiple NoV genotypes identified in rural communities of Vhembe district. The most prevalent NoV genotypes were GII.4 Sydney 2012 variants (n=7) among the capsid genotypes, GII.Pe (n=9) among the polymerase genotypes and GII.Pe/GII.4 Sydney 2012 (n=8) putative recombinants among the RdRp/Capsid genotypes. Two unassigned GII.4 variants and an unusual RdRp genotype GII.P15 were found. With note, the rare GII.P15 identified in this study, has a common ancestor with GII.P15 strain from Japan previously reported as GII / untypeable recombinant strain implicated in a gastroenteritis outbreak. To our knowledge this is the first report of this unusual genotype in the African continent. Though not proven predictive of diarrhea disease in this study, the high detection rate of NoV reflects the substantial exposure of children from rural communities to enteric xi pathogens possibly. However in this study no risk factor has been found between NoV positive and qualitative environmental variables of poor living conditions in rural setting. The results also suggest that the difference between asymptomatic and symptomatic children with NoV may be at the level of the viral load of NoV genogroups involved. The findings highlighted NoV genetic diversity and revealed continuous pandemic spread and predominance of GII.Pe/GII.4 Sydney 2012, indicative of increased NoV activity. An unusual RdRp genotype GII.P15 and two unassigned GII.4 variants were also identified from rural settings of the Vhembe district/South Africa. NoV surveillance / NRF