Natural ventilation as a means of airborne tuberculosis infection control in minibus taxis

Airborne infection control measures are used extensively in health-care settings to curtail the spread of airborne infectious diseases. Few such measures are applied in public congregate spaces outside health facilities, such as those associated with public transport. In minibus taxis – a popular form of public transport in South Africa – poor ventilation creates conditions that allow for transmission of airborne diseases, particularly tuberculosis. In this study, we focused on developing quantitative ventilation profiles for the 16-seater Toyota Quantum Ses’fikile model commonly used in the Cape Town metropole. We studied the ventilation rates achievable in an occupied taxi under varying operational conditions, such as driving speed and open window configurations, which were based on observations made during preliminary taxi journeys. Two open-window configurations were found to provide ventilation rates close to or exceeding WHO recommended per-person requirements for high-risk clinical areas and are therefore likely to be effective in reducing the risk of tuberculosis transmission.

Improving health-care delivery in low-resource settings with nanotechnology: Challenges in multiple dimensions

In the two decades after 1990, the rates of child and maternal mortality dropped by over 40% and 47%, respectively. Despite these improvements, which are in part due to increased access to medical technologies, profound health disparities exist. In 2015, a child born in a developing region is nearly eight times as likely to die before the age of 5 than one born in a developed region and developing regions accounted for nearly 99% of the maternal deaths. Recent developments in nanotechnology, however, have great potential to ameliorate these and other health disparities by providing new cost-effective solutions for diagnosis or treatment of a variety of medical conditions. Affordability is only one of the several challenges that will need to be met to translate new ideas into a medical product that addresses a global health need. This article aims to describe some of the other challenges that will be faced by nanotechnologists who seek to make an impact in low-resource settings across the globe.

Novel device to conduct flash-heat treatment in efforts to reduce mother-to-child HIV transmission in low-resource areas

The objective of this design project was to create a device to prevent mother-to-child transmission (MTCT) of HIV through breast milk in preterm infants. Our team created a robust and intuitive device which utilizes Flash Heat Treatment (FHT), an established method to inactivate HIV. The FHT method heats jarred breast milk in boiling water for a short amount of time, enough to denature HIV reverse transcriptase while preserving the nutritional value of breast milk. Thorough observation of users and available resources in Cape Town, South Africa enabled establishment of a design that can be used in urban/peri-urban areas. User research conveyed that low cost and effortless household adaptability were the most important elements of the design. As a result, a modified electric kettle was designed to function as a breast milk pasteurization device. Published data illustrating temperature curves during FHT with corresponding virology tests on the pasteurized milk were used to verify whether the device is likely to function effectively. Experimental results indicate that the device matches the required temperature profile. After virology experimentation is complete, the new device may be incorporated into hospitals as well as households in the Cape Town area, and may be expanded to other low resource periurban/urban areas as well.

Do we have the data to take informed decisions in Healthcare Technology Management (HTM) related issues? A Conceptual HTM-IS Framework

This paper considers the data and information needs for a broad range of environments, focusing on information-poor environments that may be well resourced in other respects. A generic framework for the establishment of a comprehensive healthcare technology management information system (HTMIS) is suggested.

Integrated healthcare resource planning and management

Management information systems (MIS) and decision support systems (DSS), used as part of broader healthcare technology management, are considered to be health technologies. As such, they should meet the criteria of affordability, appropriateness, cost-effectiveness, ease of use and sustainability if they are to be implementable and have a lasting impact on healthcare service delivery. They should also facilitate and support improved quality of healthcare. We have developed a suite of management-support tools around a concept of integrated healthcare resource planning and management (iHRPM). We believe that these tools meet the above-mentioned criteria and therefore lend themselves to widespread applicability in diverse healthcare and socio-economic contexts, not least in supporting performance monitoring and benchmarking.

Late potentials, ventricular stimulation and ventricular tachycardia

Late potentials are depolarizations which arise from areas of delayed ventricular activation and may indicate a propensity for ventricular tachycardia. Sixty-four subjects were assessed by non-invasive measurement. Late potentials were not present in 20 subjects with normal hearts nor in 6 patients with cardiac disease but with no evidence of ventricular tachycardia (VT). Seventeen of 20 patients with recurrent sustained ventricular tachycardia (RSVT) and 2 of 10 patients with unsustained VT had late potentials. None of the 6 patients with automatic VT or the 2 patients with torsades de pointe had late potentials. In a subgroup of 28 symptomatic patients in whom programmed ventricular stimulation was performed, late potentials correlated with inducibility of sustained VT (P less than 0.05). Late potentials may therefore serve as a useful marker of RSVT and confirm a re-entrant mechanism of VT.