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Walter Sisulu University’s (WSU) health sciences faculty continues to champion and contribute to medical research that changes the face of healthcare after its latest involvement in ground-breaking research that looks at the use of steroids and the impact thereof in patients with TB pericarditis-associated HIV cases.
WSU’s Professor Abolade Awotedu, in the faculty’s Department of Internal Medicine, chronicles the role played by the University in an African-led multi-country study led by Professor Bongani Mayosi of Department of Medicine UCT, which is envisaged to change the clinical management of patients with TB pericarditis, an inflammation of the pericardium (the fibrous sac surrounding the heart), and sets new standard for south-led clinical trial.
“The Nelson Mandela Academic Hospital (NMAH) together with WSU medical staff were pivotal in recruitment and management of patients enrolled in most of the studies on pericarditis. This present study in which a total of 1 400 participants were enrolled saw NMAHC, where WSU does most of its clinical work , contributing the highest number of patients – 25%,” says Awotedu.
The study was conducted across Africa in countries such as Kenya, Malawi, Mozambique, Nigeria, Sierra Leone, South Africa, Uganda and Zimbabwe in 19 hospitals.
The great work carried out by the University in this particular study was also acknowledged at an awards ceremony held in Cape Town recently, with WSU scooping three awards for the highest contributing site; for extreme diligence in data collection; and dedication in following up participants.
“The University’s superlative efforts in pericarditis research in the country have been further recognised by the South African Medical Research Council (SAMRC), which recently awarded WSU a flagship grant of R8.25 million to carry out further studies on pericarditis over the next three years,” says Awotedu proudly.
The study, led by Groote Schuur Hospital Head of Medicine and the University of Cape Town’s (UCT) Professor Bongani Mayosi, has found that the addition of steroids to TB therapy for HIV-positive patients increases the risk of cancer and should be avoided.
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The result of the study lays to rest uncertainty about the use of steroids in TB pericarditis and highlights the increased risk of cancer when these patients are co-infected with HIV.
“Findings from the study suggest it may be reasonable to add steroids to regular treatment in TB pericarditis patients who aren’t infected with HIV to prevent constriction of the heart. However, this strategy should be avoided in HIV-positive people because of the increased risk of malignancy,” says Mayosi.
Patients were supplied with prednisolone and a placebo as identical tablets, and followed for 600 days.
“While previous studies were too small to provide a definitive answer to this question, our study was designed specifically to address it, and provide a reliable answer because of its large size and relatively long follow up period,” adds Mayosi.
Mayosi was gleeful of the achievements involved in this study, showering praise upon all those whose commitment to the body of work had made it such a great success.
“This is an African-led study with little funding initially, yet in its context it set new standards for data quality and completeness of follow up in large African clinical trials. It challenged the perception that ‘Africans can’t do it’,” says Mayosi.
