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Day C, Deetlefs M, O'Brien A, Smith J, Boyd M, Embling N, Patel S, Moody K, Ramabele T, Budge A, Tarwa T, Jim O, Maharaj T, Pandy S, Abrahams JM, Panieri A, Verhage S, Van der Merwe M, Geragotellis A, Amanjee W, Joseph C, Zhao Z, Moosa S, Bunting M, Pulani Y, Mukhari P, De Paiva M, Deyi G, Wonkam RP, Mancotywa N, Dunge A, Msimanga T, Singh A, Monnaruri O, Molale B, Butler TAG, Browde K, Muller C, Van der Walt J, Whitelaw R, Cronwright D, Sinha S, Binase U, Francis I, Boakye D, Dlamini S, Mendelson M, Peter J. Self-reported beta-lactam allergy in government and private hospitals in Cape Town, South Africa. S Afr Med J 2023; 113:69-74. [PMID: 36757070 DOI: 10.7196/samj.2023.v113i2.16760] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2023] [Indexed: 02/10/2023] Open
Abstract
BACKGROUND Up to a quarter of inpatients in high-income countries (HICs) self-report beta-lactam allergy (BLA), which if incorrect,increases the use of alternative antibiotics, worsening individual health outcomes and driving bacterial resistance. In HICs, up to 95% ofself-reported BLAs are incorrect. The epidemiology of BLA in low- and middle-income African countries is unknown. OBJECTIVES To describe the epidemiology and de-labelling outcomes of self-reported BLA in hospitalised South African (SA) patients. METHODS Point-prevalence surveys were conducted at seven hospitals (adult, paediatric, government and privately funded, district andtertiary level) in Cape Town, SA, between April 2019 and June 2021. Ward prescription records and in-person interviews were conductedto identify and risk-stratify BLA patients using the validated PEN-FAST tool. De-labelling was attempted at the tertiary allergy clinic atGroote Schuur Hospital. RESULTS A total of 1 486 hospital inpatients were surveyed (1 166 adults and 320 children). Only 48 patients (3.2%) self-reported a BLA,with a higher rate in private than in government-funded hospitals (6.3% v. 2.8%; p=0.014). Using the PEN-FAST tool, only 10.4% (n=5/48)of self-reported BLA patients were classified as high risk for true penicillin hypersensitivity. Antibiotics were prescribed to 70.8% (n=34/48)of self-reported BLA patients, with 64.7% (n=22/34) receiving a beta-lactam. Despite three attempts to contact patients for de-labelling atthe allergy clinic, only 3/36 underwent in vivo testing, with no positive results, and 1 patient proceeded to a negative oral challenge. CONCLUSION Unlike HICs, self-reported BLA is low among inpatients in SA. The majority of those who self-reported BLA were low risk fortype 1 hypersensitivity, but outpatient de-labelling efforts were largely unsuccessful.
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Affiliation(s)
- C Day
- Division of Allergology and Clinical Immunology, Department of Medicine, Groote Schuur Hospital and Faculty of Health Sciences, University of Cape Town, South Africa.
| | - M Deetlefs
- Division of Allergology and Clinical Immunology, Department of Medicine, Groote Schuur Hospital and Faculty of Health Sciences, University of Cape Town, South Africa.
| | - A O'Brien
- Faculty of Health Sciences, University of Cape Town, South Africa.
| | - J Smith
- Faculty of Health Sciences, University of Cape Town, South Africa.
| | - M Boyd
- Department of Medicine, Faculty of Health Sciences, University of Cape Town, South Africa.
| | - N Embling
- Faculty of Health Sciences, University of Cape Town, South Africa.
| | - S Patel
- Faculty of Health Sciences, University of Cape Town, South Africa.
| | - K Moody
- Faculty of Health Sciences, University of Cape Town, South Africa.
| | - T Ramabele
- Faculty of Health Sciences, University of Cape Town, South Africa.
| | - A Budge
- Department of Paediatrics, Faculty of Health Sciences, University of Cape Town, South Africa.
| | - T Tarwa
- Molecular Mycobacteriology Research Unit, Division of Medical Microbiology, Department of Pathology, Faculty of Health Sciences, University of Cape Town, South Africa.
| | - O Jim
- Faculty of Health Sciences, University of Cape Town, South Africa.
| | - T Maharaj
- Faculty of Health Sciences, University of Cape Town, South Africa.
| | - S Pandy
- Faculty of Health Sciences, University of Cape Town, South Africa.
| | - J-M Abrahams
- Division of Allergology and Clinical Immunology, Department of Medicine, Groote Schuur Hospital and Faculty of Health Sciences, University of Cape Town, South Africa.
| | - A Panieri
- Faculty of Health Sciences, University of Cape Town, South Africa.
| | - S Verhage
- Faculty of Health Sciences, University of Cape Town, South Africa.
| | - M Van der Merwe
- Faculty of Health Sciences, University of Cape Town, South Africa.
| | - A Geragotellis
- Faculty of Health Sciences, University of Cape Town, South Africa.
| | - W Amanjee
- Faculty of Health Sciences, University of Cape Town, South Africa.
| | - C Joseph
- Faculty of Health Sciences, University of Cape Town, South Africa.
| | - Z Zhao
- Faculty of Health Sciences, University of Cape Town, South Africa.
| | - S Moosa
- Faculty of Health Sciences, University of Cape Town, South Africa.
| | - M Bunting
- Faculty of Health Sciences, University of Cape Town, South Africa.
| | - Y Pulani
- Faculty of Health Sciences, University of Cape Town, South Africa.
| | - P Mukhari
- Faculty of Health Sciences, University of Cape Town, South Africa.
| | - M De Paiva
- Faculty of Health Sciences, University of Cape Town, South Africa.
| | - G Deyi
- Faculty of Health Sciences, University of Cape Town, South Africa.
| | - R P Wonkam
- Faculty of Health Sciences, University of Cape Town, South Africa.
| | - N Mancotywa
- Faculty of Health Sciences, University of Cape Town, South Africa.
| | - A Dunge
- Faculty of Health Sciences, University of Cape Town, South Africa.
| | - T Msimanga
- Faculty of Health Sciences, University of Cape Town, South Africa.
| | - A Singh
- Faculty of Health Sciences, University of Cape Town, South Africa.
| | - O Monnaruri
- Faculty of Health Sciences, University of Cape Town, South Africa.
| | - B Molale
- Faculty of Health Sciences, University of Cape Town, South Africa.
| | - T A G Butler
- Department of Paediatrics, Faculty of Health Sciences, University of Cape Town, South Africa.
| | - K Browde
- Division of Allergology and Clinical Immunology, Department of Paediatrics, Red Cross War Memorial Children's Hospital and Faculty of Health Sciences, University of Cape Town, South Africa.
| | - C Muller
- Allergy and Immunology Unit, University of Cape Town Lung Institute, Cape Town, South Africa.
| | - J Van der Walt
- Allergy and Immunology Unit, University of Cape Town Lung Institute, Cape Town, South Africa.
| | - R Whitelaw
- Department of Medicine, Faculty of Health Sciences, University of Cape Town, South Africa.
| | - D Cronwright
- Department of Medicine, Faculty of Health Sciences, University of Cape Town, South Africa.
| | - S Sinha
- Faculty of Health Sciences, University of Cape Town, South Africa.
| | - U Binase
- Faculty of Health Sciences, University of Cape Town, South Africa.
| | - I Francis
- Department of Medicine, Faculty of Health Sciences, University of Cape Town, South Africa.
| | - D Boakye
- Department of Medicine, Faculty of Health Sciences, University of Cape Town, South Africa.
| | - S Dlamini
- Division of Infectious Diseases and HIV Medicine, Department of Medicine, Faculty of Health Sciences, University of Cape Town, South Africa.
| | - M Mendelson
- Division of Infectious Diseases and HIV Medicine, Department of Medicine, Faculty of Health Sciences, University of Cape Town, South Africa.
| | - J Peter
- Division of Allergology and Clinical Immunology, Department of Medicine, Groote Schuur Hospital and Faculty of Health Sciences, University of Cape Town, South Africa; Allergy and Immunology Unit, University of Cape Town Lung Institute, Cape Town, South Africa.
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Fossette S, Witt MJ, Miller P, Nalovic MA, Albareda D, Almeida AP, Broderick AC, Chacón-Chaverri D, Coyne MS, Domingo A, Eckert S, Evans D, Fallabrino A, Ferraroli S, Formia A, Giffoni B, Hays GC, Hughes G, Kelle L, Leslie A, López-Mendilaharsu M, Luschi P, Prosdocimi L, Rodriguez-Heredia S, Turny A, Verhage S, Godley BJ. Pan-atlantic analysis of the overlap of a highly migratory species, the leatherback turtle, with pelagic longline fisheries. Proc Biol Sci 2014; 281:20133065. [PMID: 24523271 PMCID: PMC4027393 DOI: 10.1098/rspb.2013.3065] [Citation(s) in RCA: 71] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Large oceanic migrants play important roles in ecosystems, yet many species are of conservation concern as a result of anthropogenic threats, of which incidental capture by fisheries is frequently identified. The last large populations of the leatherback turtle, Dermochelys coriacea, occur in the Atlantic Ocean, but interactions with industrial fisheries could jeopardize recent positive population trends, making bycatch mitigation a priority. Here, we perform the first pan-Atlantic analysis of spatio-temporal distribution of the leatherback turtle and ascertain overlap with longline fishing effort. Data suggest that the Atlantic probably consists of two regional management units: northern and southern (the latter including turtles breeding in South Africa). Although turtles and fisheries show highly diverse distributions, we highlight nine areas of high susceptibility to potential bycatch (four in the northern Atlantic and five in the southern/equatorial Atlantic) that are worthy of further targeted investigation and mitigation. These are reinforced by reports of leatherback bycatch at eight of these sites. International collaborative efforts are needed, especially from nations hosting regions where susceptibility to bycatch is likely to be high within their exclusive economic zone (northern Atlantic: Cape Verde, Gambia, Guinea Bissau, Mauritania, Senegal, Spain, USA and Western Sahara; southern Atlantic: Angola, Brazil, Namibia and UK) and from nations fishing in these high-susceptibility areas, including those located in international waters.
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Affiliation(s)
- S Fossette
- Department of Biosciences, College of Science, Swansea University, , Swansea SA2 8PP, UK, Environment and Sustainability Institute, University of Exeter, , Penryn Campus, Penryn TR10 9FE, UK, Centre for Ecology and Conservation, University of Exeter, , Penryn Campus, Penryn TR10 9FE, UK, Centro de Investigación y Conservación Marina, , El Pinar, Canelones 15008, Uruguay, Virginia Institute of Marine Science, , 1208 Greate Road, Gloucester Point, VA 23062, USA, Comité Régional des Pêches et Elevages Marins de Guyane, Port de Pêche du Larivot, , Matoury 97351, French Guiana, Aquamarina, , Del Besugo 1525, Pinamar, Buenos Aires 7167, Argentina, Jardín Zoológico de la Ciudad de Buenos Aires, Republica de la India 3000, , Buenos Aires 1425, Argentina, Regional Program for Sea Turtles Research and Conservation of Argentina (PRICTMA) Smith 37, , 1876-Bernal, Provincia de Buenos Aires, Argentina, ICMBio-Reserva Biológica de Comboios, , Linhares, ES 29900-970, Brazil, Asociación LAST, , Apdo 496-1100, Tibás, Costa Rica, SEATURTLE.org, , 1 Southampton Place, Durham, NC 27705, USA, Dirección Nacional de Recursos Acuáticos, , Constituyente 1497, Montevideo 11200, Uruguay, WIDECAST, , 1348 Rusticview Drive, Ballwin, MO 63011, USA, Biology and Natural Resources Department, Principia College, , 1 Maybeck Place, Elsah, IL 62028, USA, Sea Turtle Conservancy, , 4424 NW 13th St., Suite B11, Gainesville, FL 32609, USA, Karumbé - Av. Rivera 3245 (Zoo Villa Dolores), Montevideo 11600, Uruguay, Rue Victor Hugo, 25120 Maiche, France, Wildlife Conservation Society, Global Conservation Program, , 2300 Southern Boulevard, Bronx, NY 10460, USA, Fundação Pró-TAMAR, , Postal 2219, Rio Vermelho, Salvador, Bahia, Brazil, Centre for Integrative Ecology, School of Life and Environmental Sciences, Deakin University, , Warrnambool, Victoria 3280, Australia, 183 Amber Valley, P/Bag X30, Howick 3290, South Africa, WWF Guianas, , Henck Arronstraat 63 Suriname and 5 lot Katoury, Cayenne 9
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Witt MJ, Augowet Bonguno E, Broderick AC, Coyne MS, Formia A, Gibudi A, Mounguengui Mounguengui GA, Moussounda C, NSafou M, Nougessono S, Parnell RJ, Sounguet GP, Verhage S, Godley BJ. Tracking leatherback turtles from the world's largest rookery: assessing threats across the South Atlantic. Proc Biol Sci 2011; 278:2338-47. [PMID: 21208949 DOI: 10.1098/rspb.2010.2467] [Citation(s) in RCA: 65] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Despite extensive work carried out on leatherback turtles (Dermochelys coriacea) in the North Atlantic and Indo-Pacific, very little is known of the at-sea distribution of this species in the South Atlantic, where the world's largest population nests in Gabon (central Africa). This paucity of data is of marked concern given the pace of industrialization in fisheries with demonstrable marine turtle bycatch in African/Latin American waters. We tracked the movements of 25 adult female leatherback turtles obtaining a range of fundamental and applied insights, including indications for methodological advancement. Individuals could be assigned to one of three dispersal strategies, moving to (i) habitats of the equatorial Atlantic, (ii) temperate habitats off South America or (iii) temperate habitats off southern Africa. While occupying regions with high surface chlorophyll concentrations, these strategies exposed turtles to some of the world's highest levels of longline fishing effort, in addition to areas with coastal gillnet fisheries. Satellite tracking highlighted that at least 11 nations should be involved in the conservation of this species in addition to those with distant fishing fleets. The majority of tracking days were, however, spent in the high seas, where effective implementation of conservation efforts is complex to achieve.
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Affiliation(s)
- Matthew J Witt
- Centre for Ecology and Conservation, School of Biosciences, University of Exeter, Exeter, UK
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Fossette S, Girard C, López-Mendilaharsu M, Miller P, Domingo A, Evans D, Kelle L, Plot V, Prosdocimi L, Verhage S, Gaspar P, Georges JY. Atlantic leatherback migratory paths and temporary residence areas. PLoS One 2010; 5:e13908. [PMID: 21085472 PMCID: PMC2976686 DOI: 10.1371/journal.pone.0013908] [Citation(s) in RCA: 43] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2010] [Accepted: 09/29/2010] [Indexed: 11/23/2022] Open
Abstract
Background Sea turtles are long-distance migrants with considerable behavioural plasticity in terms of migratory patterns, habitat use and foraging sites within and among populations. However, for the most widely migrating turtle, the leatherback turtle Dermochelys coriacea, studies combining data from individuals of different populations are uncommon. Such studies are however critical to better understand intra- and inter-population variability and take it into account in the implementation of conservation strategies of this critically endangered species. Here, we investigated the movements and diving behaviour of 16 Atlantic leatherback turtles from three different nesting sites and one foraging site during their post-breeding migration to assess the potential determinants of intra- and inter-population variability in migratory patterns. Methodology/Principal Findings Using satellite-derived behavioural and oceanographic data, we show that turtles used Temporary Residence Areas (TRAs) distributed all around the Atlantic Ocean: 9 in the neritic domain and 13 in the oceanic domain. These TRAs did not share a common oceanographic determinant but on the contrary were associated with mesoscale surface oceanographic features of different types (i.e., altimetric features and/or surface chlorophyll a concentration). Conversely, turtles exhibited relatively similar horizontal and vertical behaviours when in TRAs (i.e., slow swimming velocity/sinuous path/shallow dives) suggesting foraging activity in these productive regions. Migratory paths and TRAs distribution showed interesting similarities with the trajectories of passive satellite-tracked drifters, suggesting that the general dispersion pattern of adults from the nesting sites may reflect the extent of passive dispersion initially experienced by hatchlings. Conclusions/Significance Intra- and inter-population behavioural variability may therefore be linked with initial hatchling drift scenarios and be highly influenced by environmental conditions. This high degree of behavioural plasticity in Atlantic leatherback turtles makes species-targeted conservation strategies challenging and stresses the need for a larger dataset (>100 individuals) for providing general recommendations in terms of conservation.
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Affiliation(s)
- Sabrina Fossette
- Département Ecologie, Physiologie et Ethologie, Université de Strasbourg, IPHC, Strasbourg, France.
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