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16 September 2024 | Story André Damons | Photo Supplied
Dr Mampoi Jonas and Prof Jan Du Plessis
Dr Mampoi Jonas, senior lecturer in Paediatric Oncology and Prof Jan Du Plessis, Head of the Paediatric Oncology Unit at the University of the Free State (UFS).

A campaign like Childhood Cancer Awareness Month is vital in creating awareness and educating people about the early signs and symptoms of certain cancers. This can significantly improve the survival rate of young patients. More than 50% of people diagnosed with cancer live for more than five years, and some types of cancer have survival rates as high as 90%.

This is according to Prof Jan Du Plessis, Head of the Paediatric Oncology Unit, and Dr Mampoi Jonas, senior lecturer in Paediatric Oncology, at the University of the Free State (UFS).

“Early diagnosis is crucial because early-stage cancer is more responsive to treatment and less likely to be fatal. Due to the rarity of childhood cancer, many children get misdiagnosed or diagnosed too late with advanced stage disease. The delayed detection and diagnosis diminish the chances of successful treatment.

“Cancer awareness educates families, communities, primary-care nurses and doctors about the early signs and symptoms of certain cancers. When people are aware of these, they are more likely to be on the lookout for them when children present with suspicious clinical symptoms and signs. This also gives parents the confidence to seek help early and even make people better able to support those with the disease once a diagnosis is made,” say the paediatric oncologists.

Recorded incidences on the rise

Though childhood cancer is rare, representing only 1.2% of all cancers worldwide, the recorded incidences are increasing. In the US cancer is the number one cause of death among children, while more than 100 000 children worldwide die because of cancer.

Prof Du Plessis says there are more than 12 major types of childhood cancers and multiple subtypes. The most common types are leukaemia, lymphoma (tumours that begin in the lymph glands), brain tumours, nephroblastoma (cancer of the kidneys) and soft tissue sarcomas. Most cancers in children are thought to develop as a result of mutations in genes that lead to uncontrolled cell growth and eventually cancer.

According to Dr Jonas, most cancers in children are thought to develop because of mutations in genes that lead to uncontrolled cell growth and eventually cancer. Although environmental pollutants have been implicated in some cancers, our experience has been that most paediatric cancers rather occur sporadically.

The reasons for the increase of reported incidence of cancer in children, could be to the increase in population numbers and better awareness of childhood cancers. Another reason might be that more children are being diagnosed who were previously misdiagnosed, explains Prof Du Plessis.

Treatments

Childhood cancers are treated with chemotherapy, surgery and radiation therapy under the care of a paediatric oncologist. Not much can be done about the genetic mutations, but parents can ensure that their children stay safe in the sun (slip, slop, slap campaign – slip on a shirt, slop on some suncream and slap on a hat), get their children vaccinated against HPV infection, help their children stay active and keep a healthy weight and talk to them about smoking.

Prof Du Plessis says the South African paediatric oncology community are currently busy with a few research studies regarding standardising treatment protocols for certain childhood cancers. This is to find out how our children are responding to these protocols and to see if there are different factors affecting the outcomes of South African children. These protocols are based on international treatment protocols with a few adjustments for local circumstances and resources.

They are involved with the Hodgkins lymphoma, neuroblastoma, retinoblastoma, germ cell tumour studies and contributed to a research study evaluating the nutritional status and interventions to improve the nutritional status of local patients. Registrars presented local (Bloemfontein) data at an international conference (SIOP Africa) on hepatoblastomas and osteosarcomas.

“For many childhood cancer may not be a priority or something they would like to think about. Unfortunately for many of my patient’s parents the truth is that the day before their children were diagnosed with cancer, they were also not a cancer parent. However, their lives changed for ever with these four words: ‘Your child has cancer’.

“Childhood cancer is more than chemo and no hair. It is rather about resilience, strength, hope, family, courage, cuddles, and bravery. Your life will be changed for ever if you have ever seen a child fight cancer. Their smiles will make your heart melt and make you realise the importance of the simple things in life,” declare Prof Du Plessis and Dr Jonas.

Early warning signs for parents

The Childhood Cancer Foundation South Africa (CHOC) has a campaign which emphasises the importance of recognising the early warning signs of childhood cancer. They use Siluan’s Early Warning Signs to raise awareness and promote early diagnosis which are:

• S – Seek medical help early for ongoing symptoms
• I – White spot in the eye, new squint, sudden blindness or bulging eyeball.
• L – Lump on the stomach, pelvis, head, arms, legs, testicle, or glands
• U – Unexplained fever present for over two weeks, weight loss, fatigue, pale appearance, easy bruising, and bleeding
• A – Aching bones, joints, back, and easy fractures

• N – Neurological signs, a change in walk, balance or speech, regression, continuous headaches with/without vomiting, and an enlarged head

While these symptoms can be subtle or easily attributed to other causes, it’s important to consult a doctor if they persist or worsen. If you notice any of these symptoms in a child or teen, seek professional medical help promptly. Early detection of cancer saves lives in both children and teens.

News Archive

Inaugural lecture: Prof Robert Bragg, Dept. of Microbial, Biochemical and Food Biotechnology
2006-05-17



Attending the inaugural lecture were in front from the left Prof Robert Bragg (lecturer at the Department of Microbial, Biochemical and Food Biotechnology) and Frederick Fourie (Rector and Vice-Chancellor).  At the back from the left were Prof James du Preez (Departmental Chairperson:  Department of Microbial, Biochemical and Food Biotechnology) and Prof Herman van Schalkwyk (Dean: Faculty of Natural and Agricultural Sciences). Photo: Stephen Collett
 

A summary of an inaugural lecture delivered by Prof Robert Bragg at the University of the Free State:

CONTROL OF INFECTIOUS AVIAN DISEASES – LESSONS FOR MAN?

Prof Robert R Bragg
Department of Microbial, Biochemical and Food Biotechnology
University of the Free State

“Many of the lessons learnt in disease control in poultry will have application on human medicine,” said Prof Robert Bragg, lecturer at the University of the Free State’s (UFS) Department of Microbial, Biochemical and Food Biotechnology during his inaugural lecture.

Prof Bragg said the development of vaccines remains the main stay of disease control in humans as well as in avian species.  Disease control can not rely on vaccination alone and other disease-control options must be examined.  

“With the increasing problems of antibiotic resistance, the use of disinfection and bio security are becoming more important,” he said.

“Avian influenza (AI) is an example of a disease which can spread from birds to humans.  Hopefully this virus will not develop human to human transmission,” said Prof Bragg.

According to Prof Bragg, South Africa is not on the migration route of water birds, which are the main transmitters of AI.  “This makes South Africa one of the countries less likely to get the disease,” he said.

If the AI virus does develop human to human transmission, it could make the 1918 flu pandemic pale into insignificance.  During the 1918 flu pandemic, the virus had a mortality rate of only 3%, yet more than 50 million people died.

Although the AI virus has not developed human-to-human transmission, all human cases have been related to direct contact with infected birds. The mortality rate in humans who have contracted this virus is 67%.

“Apart from the obvious fears for the human population, this virus is a very serious poultry pathogen and can cause 100% mortality in poultry populations.  Poultry meat and egg production is the staple protein source in most countries around the world. The virus is currently devastating the poultry industry world-wide,” said Prof Bragg.

Prof Bragg’s research activities on avian diseases started off with the investigation of diseases in poultry.  “The average life cycle of a broiler chicken is 42 days.  After this short time, they are slaughtered.  As a result of the short generation time in poultry, one can observe changes in microbial populations as a result of the use of vaccines, antibiotics and disinfectants,” said Prof Bragg.   

“Much of my research effort has been directed towards the control of infectious coryza in layers, which is caused by the bacterium Avibacterium paragallinarum.  This disease is a type of sinusitis in the layer chickens and can cause a drop in egg product of up to 40%,” said Prof Bragg.

The vaccines used around the world in an attempt to control this disease are all inactivated vaccines. One of the most important points is the selection of the correct strains of the bacterium to use in the vaccine.

Prof Bragg established that in South Africa, there are four different serovars of the bacterium and one of these, the serovar C-3 strain, was believed to be unique to Southern Africa. He also recently discovered this serovar for the first time in Israel, thus indicating that this serovar might have a wider distribution than originally believed.

Vaccines used in this country did not contain this serovar.  Prof Bragg established that the long term use of vaccines not containing the local South African strain resulted in a shift in the population distribution of the pathogen.

Prof Bragg’s research activities also include disease control in parrots and pigeons.   “One of the main research projects in my group is on the disease in parrots caused by the circovirus Beak and Feather Disease virus. This virus causes serious problems in the parrot breeding industry in this country. This virus is also threatening the highly endangered and endemic Cape Parrot,” said Prof Bragg.

Prof Bragg’s research group is currently working on the development of a DNA vaccine which will assist in the control of the disease, not only in the parrot breeding industry, but also to help the highly endangered Cape Parrot in its battle for survival.

“Not all of our research efforts are directed towards infectious coryza or the Beak and Feather Disease virus.  One of my Masters students is currently investigating the cell receptors involved in the binding of Newcastle Disease virus to cancerous cells and normal cells of humans. This work will also eventually lead to a possible treatment of cancer in humans and will assist with the development of a recombinant vaccine for Newcastle disease virus,” said Prof Bragg.

We are also currently investigating an “unknown” virus which causes disease problems in poultry in the Western Cape,” said Prof Bragg.
 
“Although disinfection has been extensively used in the poultry industry, it has only been done at the pre-placement stage. In other words, disinfectants are used before the birds are placed into the house. Once the birds are placed, all use of disinfectants stops,” said Prof Bragg.

“Disinfection and bio security can be seen as the ‘Cinderella’ of disease control in poultry.  This is also true for human medicine. One just has to look at the high numbers of people who die from hospital-acquired infections to realise that disinfection is not a concept which is really clear in human health care,” said Prof Bragg.

Much research has been done in the control of diseases through vaccination and through the use of antibiotics. “These pillars of disease control are, however, starting to crumble and more effort is needed on disinfection and bio security,” said Prof Bragg.

Prof Bragg has been working in close co-operation with a chemical manufacturing company in Stellenbosch to develop a unique disinfectant which his highly effective yet not toxic to the birds.

As a result of this unique product, he has developed the continual disinfection program for use in poultry. In this program the disinfectant is used throughout the production cycle of the birds. It is also used to ensure that there is excellent pre-placement disinfection.

“The program is extensively used for the control of infectious diseases in the parrot-breeding industry in South Africa and the product has been registered in 15 countries around the world with registration in the USA in the final process,” said Prof Bragg.

“Although the problem of plasmid mediated resistance to disinfectants is starting to rear its ugly head, this has allowed for the opening of a new research field which my group will hopefully exploit in the near future,” he said.

 

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