http://hdl.handle.net/10386/58 2026-04-11T17:49:28Z http://hdl.handle.net/10386/5392 Clinical and dermoscopic features of acral melanocytic nevi in African Patients, Pietersburg Hospital Molapo Ramolapo Antony Background: Acral melanocytic nevi (AMN) of volar skin are common in Asians, Africans, Caucasians and Indians. Some cutaneous melanomas arise from AMN, and it is difficult to determine which nevus will become malignant clinically. Dermoscopic evaluation of nevi has been used to describe various patterns, some of which have been found to be associated with melanoma. Most of these studies were conducted in Caucasians and hence a paucity of literature in Africans. Objective: To describe the clinical and dermoscopic features of acral melanocytic nevi in African patients at Pietersburg Hospital. Methodology: A quantitative, cross-sectional method was used in the study. A total of 269 adult African patients with AMN were examined. The findings were recorded photographically, and descriptive statistics were used to organise the data. The Chi-squared test was used to test for associations. Results: A total of 269 patients were enrolled. The age ranged between 18 and 87 years and the mean was 37.1 years. Females were 67%, and males 33%. Majority (99.26%) AMN were macules, more commonly observed on the right palm (54.6%). Commonest colours were brown (84.4%) and black (14.9%). Dermoscopically, the commonest patterns were: parallel furrow pattern (59.9%), globular pattern (10.0%), fibrillar pattern (9.7%) and homogeneous pattern (8.6%). The fibrillar pattern was found to be higher in females (p=0.016), than in males. Conclusion: The parallel furrow pattern was most prevalent, followed by the globular and homogeneous patterns in the study. A rare arciform clinical morphology was reported in two AMN (0.74%). Thesis (M. Med. (Dermatology)) -- University of Limpopo, 2025 2025-01-01T00:00:00Z http://hdl.handle.net/10386/5172 Determination of the diagnostic accuracy of rapid molecular assays for diagnosis of bloodstream infections in Pietersburg Hospital, Limpopo Province in South Africa Maswanganyi, N. A. Background Bloodstream infections (BSIs) are infections caused by the presence of viable microorganisms in the bloodstream and are an essential cause of morbidity and mortality, especially among immunocompromised individuals. Blood culture is still considered the gold standard for diagnosing BSI; however, prolonged turnaround times limit its use for rapid clinical decision-making. Rapid molecular techniques such as BioFire FilmArray Blood Culture Identification 2 (BCID2) and metagenomics sequencing offer faster turnaround time for pathogen detection than blood cultures, in which bacteria, fungi, and their resistance profiles are detected. Aim This study aimed to evaluate the diagnostic accuracy of rapid molecular assays for the identification of pathogens that causes bloodstream infections at Pietersburg Hospital in Limpopo Province, South Africa. Objectives Compare the effectiveness of VITEK2 and BCID2 in identifying pathogens present in positive blood culture samples. Metagenomics was used to resolve the discrepant results between the VITEK2 and BCID2. To assess the sensitivity, specificity, and overall diagnostic accuracy of the BCID2 and metagenomics in relation to the VITEK2. Methods This prospective diagnostic cross-sectional study was conducted at Pietersburg Hospital, Polokwane, Limpopo Province, South Africa. Participants included patients suspected of BSI from various regional hospitals and clinics of Limpopo Province. Blood samples sent to the National Health Laboratory Service (NHLS) from May to December 2023 were included. Blood culture bottles were incubated in a BacT/ALERT 3D system. Positive cultures were processed using VITEK 2 and BCID2, with discrepancies resolved by 16s metagenomics sequencing. Data were analyzed using SPSS (v29.0.0.0) and MedCalc (v22.026). Results Of the 247 samples, 78% (193/247) were Gram-negative bacteria, 17% (43/247) Gram-positive bacteria, and 4% (11/247) yeast. The ICU and paediatric units contributed 34% (83/247) and 29% (72/247) of samples, respectively. A total of 72% (179/247) were monomicrobial, while 28% (68/247) were polymicrobial. A total of nine off-panel organisms were detected in monomicrobial while seven were detected in polymicrobial samples. BCID2 achieved sensitivity, specificity, and accuracy rates of 95.7%, 95.5%, and 96%, respectively. CTX-M was the most common resistance gene (40%), while van A/B and VIM were rare (0.5% each). Metagenomics confirmed BCID2 in 72% of cases and VITEK 2 in 48%, detecting additional off-panel pathogens. Conclusions The BioFire FilmArray Blood Culture Identification 2 test gave a very good diagnostic performance with 96% and a faster detection of pathogens in 60 minutes, making it appropriate in emergency cases. VITEK 2 had a better diagnostic performance but relatively slower and surpassed BCID2 in some pathogens. Metagenomics sequencing, being the most comprehensive technique, confirmed 72% of results from BCID2 and identified novel ones. These findings highlight the complementary roles of BCID2, VITEK 2 and metagenomics in optimizing bloodstream infection diagnosis in poor resource settings Thesis (M. Sc. (Medical Sciences)) -- University of Limpopo, 2025 2025-01-01T00:00:00Z http://hdl.handle.net/10386/5163 Determination of the association between measures of diabetes mellitus and biomarkers of lung health among adult African population residing in the Dikgale, Mamabolo, Mothiba population health research centre, Limpopo Province South Africa Lubisi, Samukelisiwe Rebecca Diabetes mellitus (DM) affects various organs in the body (Kharroubi, 2015), including the lungs. Chronic obstructive pulmonary disease (COPD) is a slowly progressing condition that generally results in a gradual decline in lung function over time. One approach to monitoring lung tissue degradation caused by DM, beyond repeated lung function tests is through biomarkers of lung health. These biomarkers can serve as a sensitive indicator of disease activity and may assist in predicting lung function. Objective To investigate the association between DM and lung health measurements by utilizing desmosine biomarkers within a rural adult population at the DIMAMO Health and Demographic Surveillance System (HDSS). Methods This study employed a retrospective, cross-sectional, and partially prospective correlation design, conducted at DIMAMO HDSS. This study utilized data from the AWI-Gen Phase One dataset. Data on measures of Diabetes mellitus and other demographic and vi biomedical measures were extracted from 222 participants (79 men and 143 women). Desmosine levels were quantified using competitive ELISA assay (DES-LISA-kit). Data analysis was performed using SPSS version 27, with a p-value <0.05. Results No significant associations were observed between glucose and desmosine levels (p=0.230), HOMA-IR and desmosine levels (p=0.820), or insulin and desmosine levels (p=0.438). Even after performing backward linear regression, where less significant variables were systematically removed, no significant associations were identified between desmosine and these diabetes-related variables. Conclusion This study found no linear association between DM measures (glucose, insulin and HOMA-IR) and lung health as indicated by desmosine levels. After conducting backward linear regression, desmosine levels remained unassociated with any of the diabetes-related covariates included in the model. In conclusion, there is no evidence of an association between DM measures and lung health markers in this study. Thesis (M. Sc. (Medical Sciences)) -- University of Limpopo, 2025 2025-01-01T00:00:00Z http://hdl.handle.net/10386/5155 The impact of comorbidities on outcome of patients admitted with Coronavirus disease 2019 infected at Pietersburg Hospital, Polokwane, Limpopo Province Moabelo, Koena Johannes Background: The emergence of the novel Coronavirus disease 2019 (COVID-19), causative agent identified as severe acute respiratory syndrome-coronavirus type 2 (SARS-CoV-2), in late 2019 in Wuhan City, has led to a global outbreak of COVID-19 culminating in the declaration of a pandemic by the World Health Organization (WHO). As of 2nd of October 2022, the cumulative number of cases have reached the 600 million mark, with just over 6.5 million deaths reported to WHO. Purpose: To determine the relationship between comorbidities and adverse outcome in patients admitted with COVID-19 infection at Pietersburg Hospital from March 2020 to March 2021. Methods: This was a retrospective study using secondary data extracted from DATCOV portal, a web-based disease surveillance system of patients admitted with laboratory-confirmed SARS-CoV-2 PCR results. Variables extracted from the portal include demographics and clinical data such as comorbidities, management strategies and adverse outcomes (need for oxygenation, organ failure, admission to high care or intensive care unit (ICU) and death). Data was analysed using SSPS 27.0. Variables were presented as numbers, percentages and cross-tabulations. Results: There were 446 eligible study participants, 225(50.4%) were females and 221(49,6%) were males, and 311(70%) had comorbidities. The median age of patients was 57 (13-96) years. The most prevalent comorbidity was hypertension in 208 patients (46%) followed by diabetes in 153 patients (34%).Both hypertension and diabetes largely contributed to the reported adverse outcome of death. A total of 159 (36%) deaths related to COVID-19 infection were reported during the study period. Using the logistic regression model, the odds of non-survival were significantly associated with two variables, age and ward setting. An increase in patient’s age by 1 year, increased the odds of dying by 1.09 as compared to being alive (OR 1.094, 95% CI: 1.038-1.153, p-value<0.001). Being admitted to intensive care unit (ICU) was associated with a higher death rate ( OR 0.020, 95% CI: 0.001-0.292, p-value 0.004). Conclusion: Hypertension and diabetes (p-values of 0.020 and 0.009 respectively) appeared to be significantly related to patient’s adverse outcome of non-survival, with hypertension being the common factor in all deaths reported. Thesis (M. Med. (Internal Medicine)) -- University of Limpopo, 2025 2025-01-01T00:00:00Z