Browsing by Author "Coovadia, Yacoob Mahomed."

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Clinical and mycological predictors of cryptococcosis-associated immune reconstitution inflammatory syndrome.
(Wolters Kluwer Health., 2013) Chang, Christina C.; Dorasamy, Afton A.; Gosnell, Bernadett I.; Elliott, Julian H.; Spelman, Tim.; Omarjee, Saleha.; Naranbhai, Vivek.; Ndung'u, Peter Thumbi.; Moosa, Mahomed Yunus Suleman.; Lewin, Sharon R.; French, Martyn A.; Coovadia, Yacoob Mahomed.
Abstract available in PDF file.
Invasive pneumococcal disease in neonates prior to pneumococcal conjugate vaccine use in South Africa : 2003-2008.
(2018) Moodley, Krishnee.; Coovadia, Yacoob Mahomed.
Abstract not available.
Primary capreomycin resistance is common and associated with early mortality in patients with extensively drug-resistant tuberculosis in KwaZulu-Natal, South Africa.
(Wolters Kluwer., 2015) O’Donnell, Max Roe.; Pillay, Melendhran.; Pillay, Manormoney.; Werner, Lise.; Master, Iqbal.; Wolf, Allison.; Mathema, Barun.; Coovadia, Yacoob Mahomed.; Mlisana, Koleka Patience.; Horsburgh, Charles Robert.; Padayatchi, Nesri.
Abstract available in pdf.
Rifampicin mono-resistance in mycobacterium tuberculosis in KwaZulu-Natal, South Africa : A significant phenomenon in a high prevalence TB-HIV region.
(PLoS One, 2013) Coovadia, Yacoob Mahomed.; Mahomed, Sharana.; Pillay, Melendhran.; Werner, Lise.; Mlisana, Koleka Patience.
Setting: The dual epidemics of HIV-TB including MDR-TB are major contributors to high morbidity and mortality rates in South Africa. Rifampicin (RIF) resistance is regarded as a proxy for MDR-TB. Currently available molecular assays have the advantage of rapidly detecting resistant strains of MTB, but the GeneXpert does not detect isoniazid (INH) resistance and the GenoTypeMTBDRplus(LPA) assay may underestimate resistance to INH. Increasing proportions of rifampicin monoresistance resistance (RMR) have recently been reported from South Africa and other countries. Objective: This laboratory based study was conducted at NHLS TB Laboratory, Durban, which is the reference laboratory for culture and susceptibility testing in KwaZulu-Natal. We retrospectively determined, for the period 2007 to 2009, the proportion of RMR amongst Mycobacterium tuberculosis (MTB) isolates, that were tested for both RIF and INH, using the gold standard of culture based phenotypic drug susceptibility testing (DST). Gender and age were also analysed to identify possible risk factors for RMR. Design: MTB culture positive sputum samples from 16,748 patients were analysed for susceptibility to RIF and INH during the period 2007 to 2009. RMR was defined as MTB resistant to RIF and susceptible to INH. For the purposes of this study, only the first specimen from each patient was included in the analysis. Results: RMR was observed throughout the study period. The proportion of RMR varied from a low of 7.3% to a high of 10.0% [overall 8.8%]. Overall, males had a 42% increased odds of being RMR as compared to females. In comparison to the 50 plus age group, RMR was 37% more likely to occur in the 25–29 year age category. Conclusion: We report higher proportions of RMR ranging from 7.3% to 10% [overall 8.8%] than previously reported in the literature. To avoid misclassification of RMR, detected by the GeneXpert, as MDR-TB, culture based phenotypic DST must be performed on a second specimen, as recommended by the SA NDOH TB guidelines as well as WHO. We suggest that two sputum samples should be obtained at the first visit. The second sputum sample should be stored at 4uC. The latter sample is then readily available for performing additional DST (phenotypic or genotypic) for 2nd lines drugs, resulting in a decreased waiting period for DST results to become available.
A study of epidemiology and microbiology of peritonitis in continuous ambulatory peritoneal dialysis patients at Inkosi Albert Luthuli Central Hospital, Durban, South Africa.
(2015) Ikabu, A Samuel.; Assounga, Alain Guy Honore.; Coovadia, Yacoob Mahomed.
End Stage Renal Disease is a serious burden for both patients and health care professional mainly in the public service in South Africa. Haemodialysis is currently overstretched. All patients accepted in the state renal programme have to start with Continuous Ambulatory Peritoneal Dialysis (CAPD). Our study focused on patients treated by CAPD. One of the most common complications of CAPD is peritonitis. The files of 115 patients who attended the Renal Unit were reviewed and 91 met our inclusion criteria. This is a case control study where the cases were patients with peritonitis. Forty five patients developed peritonitis. The racial composition was: twenty four Indians (53. 3%), followed by the eighteen Africans (40%), the coloured and white group had two and one respectively, a total of three participants (6.7%). The study revealed that females were significantly more affected by peritonitis than males p=0.00466 There was no significant difference between Africans and Indians (p=0.2048). The study showed that among the co morbidities, only obesity and Diabetes Mellitus (DM) were significantly associated with the development of peritonitis. While bacterial peritonitis was the most prevalent at any stage, fungal peritonitis occurred only after one year. In conclusion this study highlights the spectrum of microbiology of peritonitis in CAPD patients. Furthermore the study showed there is a need to broaden the laboratory routine method screening for emerging microorganisms like Rhodotorula sp, a fungus isolated during our study, to reduce the percentage of culture negative peritonitis.