Female sex work and international sport events - no major changes in demand or supply of paid sex during the 2010 Soccer World Cup: a cross-sectional study

BACKGROUND

Important unanswered questions remain on the impact of international sporting events on the sex industry. Speculation about increased demand and supply of sex work often generates significant attention, but also additional funding for HIV programmes. This study assessed whether changes occurred in the demand and supply of paid sex during the 2010 Soccer World Cup in South Africa.

METHODS

Trained sex worker interviewers conducted face-to-face semi-structured interviews among consenting female sex workers during May-September 2010. Using bivariate analyses we compared supply, demand, sexual risk-taking, and police and health services contact pre-World Cup, to levels during the World Cup and after the event.

RESULTS

No increases were detected in indicators of sex work supply, including the proportion of sex workers newly arrived in the city (< 2.5% in each phase) or those recently entering the trade (≤ 1.5%). Similarly, demand for sex work, indicated by median number of clients (around 12 per week) and amount charged per transaction ($13) remained similar in the three study periods. Only a third of participants reported observing any change in the sex industry ascribed to the World Cup. Self-reported condom-use with clients remained high across all samples (> 92.4% in all phases). Health-care utilisation decreased non-significantly from the pre- to during World Cup period (62.4% to 57.0%; P = 0.075). Across all periods, about thirty percent of participants had interacted with police in the preceding month, two thirds of whom had negative interactions.

CONCLUSIONS

Contrary to public opinion, no major increases were detected in the demand or supply of paid sex during the World Cup. Although the study design employed was unable to select population-based samples, these findings do not support the public concern and media speculation prior to the event, but rather signal a missed opportunity for public health action. Given the media attention on sex work, future sporting events offer strategic opportunities to implement services for sex workers and their clients, especially as health service utilisation might decrease in this period.

The prevalence of strabismus in schizophrenic patients in Durban, KwaZulu Natal

Purpose:    The psychosocial implications of a strabismus have not received sufficient attention and yet may have a significantly negative effect on a person’s life.  Schizophrenia is the fourth leading cause of mental disability in the developed world.  Both schizophrenia and strabismus appear to share a genetic and neurological origin.  This study thus set out to assess the prevalence of strabismus in a sample of schizophrenic subjects. Setting:  The study was carried out in Durban, Kwazulu-Natal inSouth Africa specifically at the Durban and Coastal Mental Health Institution. Method:  Fifty schizophrenic subjects residing at the Durban and Coastal Mental Health (DMH) Institution were assessedfor the presence of strabismus using the cover test and modified Krimsky test.  The inclusion criteria were all subjects diagnosed with schizophrenia, of both genders and any race.  The subjects werebetween fifteen to seventy years of age.  The exclusion criteria included any other mental illness, systemic disease or medication other than that usedon schizophrenic patients.  Results:   The prevalence of strabismus in this sample was found tobe 74% which was considerably higher than thatreported by other studies1,2.  There was a greater incidence of exotropia as opposed to esotropia.  The mean distance exotropia as detected with the cover test was 33 prism dioptres.  Similarly, the near cover test indicated a mean of 11 prism dioptres exotropia, and with the modified Krimsky test a mean of 9 prism dioptres exotropia.   Most of the strabismic subjects (86.5%) presented with a strabismus when fixating a near target.  Generally the strabismus was found to be constant and unilateral and no gender bias was found.  Conclusion:There appears to be a strong relationship between strabismus and schizophrenia.  Health care professionals, especially those dealing with paediatric care, parents and the public should be made awareof this relationship so that psychological adviceand early intervention can be sought for strabismic children. (S Afr Optom 2011 70(3) 101-108)

Impact of blood processing variations on natural killer cell frequency, activation, chemokine receptor expression and function

Understanding the role of natural killer (NK) cells in human disease pathogenesis is crucial and necessitates study of patient samples directly ex vivo. Manipulation of whole blood by density gradient centrifugation or delays in sample processing due to shipping, however, may lead to artifactual changes in immune response measures. Here, we assessed the impact of density gradient centrifugation and delayed processing of both whole blood and peripheral blood mononuclear cells (PBMC) at multiple timepoints (2-24 h) on flow cytometric measures of NK cell frequency, activation status, chemokine receptor expression, and effector functions. We found that density gradient centrifugation activated the NK cells and modified the chemokine receptor expression. Delays in processing beyond 8h activated NK cells in PBMC but not in whole blood. Likewise, processing delays decreased chemokine receptor (CCR4 and CCR7) expression in both PBMC and whole blood. Finally, delays in processing PBMC were associated with a decreased ability of NK cells to degranulate (as measured by CD107a expression) or secrete cytokines (IFN-γ and TNF-α). In summary, our findings suggest that density gradient centrifugation and delayed processing of PBMC can alter measures of clinically relevant NK cell characteristics including effector functions; and therefore should be taken into account in designing clinical research studies.

Tubular ectasia of the rete testis associated with azoospermia: a case report

Tubular ectasia of the rete testis (TERT) is a rare benign condition of the testis due to dilatation of the tubules of the rete testis. It must be differentiated from neoplastic disease of the testis clinically by patient's age, mode of presentation, tumour marker status and characteristic ultrasound and colour Doppler findings. Awareness and diagnosis of TERT should prevent unnecessary surgical intervention such as orchidectomy or biopsy. We report a case of severe bilateral tubular ectasia of the rete testis associated with azoospermia and review the relevant literature. This association has not been reported before in the literature to the best of our knowledge.

Self-monitoring dysfunction and the positive symptoms of schizophrenia

Frith has proposed that symptoms of alien control in schizophrenia result from a defect in a metarepresentational process leading to a failure to properly monitor self-willed intentions and actions. To examine this hypothesis, a group of 40 schizophrenic patients, all meeting DSM-III-R criteria, and rated for current symptoms on the basis of a detailed clinical interview, were compared with 36 non-patient controls, using a battery of tests which included measures of self-monitoring, general cognitive function and attention. In comparison with controls, patients were impaired on two tests of self-monitoring. These differences were preserved when measures of current IQ, attention, and recognition memory were entered as covariates. Amongst patients, self-monitoring performance was related to the severity and extent of positive symptoms. These findings provide further experimental support for the proposal that positive symptoms of schizophrenia arise as a result of deficiencies in self-monitoring.

Clinical and chest radiographic features of tuberculosis associated with human immunodeficiency virus in Zimbabwe

In the developing world, the diagnosis of tuberculosis is dependent on clinical and radiologic features as culture facilities are not readily available. It has been reported that tuberculosis in HIV-positive persons can present with atypical clinical and radiographic features. The object of this study was to examine how often atypical features occur in HIV-positive compared with HIV-negative persons and how these findings correspond to sputum-smear findings. Detailed demographic, clinical, and chest radiographic features of tuberculosis were assessed in 202 HIV-positive adults and 220 HIV-negative patients admitted consecutively. Using univariate analysis, several of these features were found to be significantly associated with being HIV-positive, but after multiple regression analysis only, age group (15 to 42 yr), a negative tuberculin response, intrathoracic lymphadenopathy, and lack of cavitation but not sputum-smear status remained significant.

Acute lower respiratory tract infection in hospitalized children in Zimbabwe

A descriptive study was undertaken to document clinical and socio-demographic features and also to identify risk factors for mortality in children hospitalized with acute lower respiratory tract infection (ALRI). A total of 704 children aged from 1 month to 5 years admitted to Harare Central Hospital were studied. The peak age group was between 1 and 6 months. Seventy per cent of the children were found to have normal nutrition and 12% severe malnutrition. Seventy-eight per cent had severe and the remainder moderate ALRI (WHO classification). Clinical HIV infection was diagnosed in 219 (31%) children. One hundred and four children died, an overall case fatality rate (CFR) of 15%. In the clinically HIV-infected children, a CFR of 28% occurred, which constituted 60% of the overall ALRI mortality. A much lower CFR of 9% was found in the clinically non-HIV-infected children. Malnutrition, severe ALRI, age of 1 to 6 months, concurrent diarrhoea, duration of cough > or = 14 days and previous history of admission for ALRI were significant risk factors for mortality in ALRI. Low birthweight was not found to be a risk factor in this study. The impact of HIV infection on mortality in children with ALRI is of major concern in Zimbabwe and should be an important component of the national ALRI programme.

Complications in percutaneous transluminal angioplasty: relationships with patient age

Five hundred consecutive attempted lower limb angioplasties for ischaemic disease (370 patients, mean age 65.6 years, range 33-91 years) were reviewed. Significant complications occurred in 44 cases (8.8%). Nine patients (1.8%) underwent emergency surgery related to a complication. A further 12 patients (2.4%) underwent elective surgery related to a complication. In addition, four patients died within 30 days of the procedure; one following surgery performed because of a complication of angioplasty, one following a myocardial infarction, one following severe bleeding associated with subsequent thrombolytic therapy and one during emergency surgery related to a complication of angioplasty. A correlation was found between complication rate and age. This relationship was independent of the approach to, the position of, and the severity of the treated lesion. Elderly patients are at increased risk of complication in lower limb angioplasty.