Providendum Female Health Practice

18/03/2022

The only thing better than working with the team at In Touch Therapy Centre is when we have the privilege to boast about the achievements of one of our team mates.

A huge congratulations to Helena van der Wall on obtaining her Masters degree in Physiotherapy. We are so proud to have you as one of our team.

17/02/2022

🍬HPV vaccine🍬

The HPV vaccine has been one of the biggest success stories regarding vaccines and plays a fantastic role in protecting our girls from cervical cancer. Cancer of the cervix is the 3rd most common cancer among women worldwide and the 2nd leading cause of cancer deaths in South Africa. Cervical cancer kills one woman every 2 minutes in South Africa.

🍬What is cervical cancer?🍬

Cervical cancer develops in the cervix, the narrow mouth of the uterus that opens into the va**na. It is usually caused by HPV, primarily transmitted through s*xual activity.

🍬What is HPV?🍬

Human Papilloma Virus (HPV) is a common virus spread through direct skin-to-skin contact during s*xual activity. Most s*xually active people will get HPV at some time in their lives, though most will never even know it.

There are about 40 types of HPV that can infect the ge***al area. Most HPV types cause no symptoms and go away on their own. But some types can cause cervical cancer in women and cancers of the a**s, p***s, va**na, v***a, and oropharynx in women and men.

HPV can sometimes cause ge***al warts. They are not life-threatening but can spread HPV when someone comes into contact with them.

New research suggests that HPV may be linked to heart disease as well.

🍬What is the HPV vaccine?🍬

The HPV vaccine contains no viruses and is not made from HPV. The active ingredients in the HPV vaccine are proteins that are similar to those found in HPV, which are purified and mixed into a sterile, water-based solution.

HPV infections and abnormal cervical cells on the cervix that can lead to cancer have dropped significantly since the vaccine has been in use.

The HPV vaccine is not a replacement for using condoms to protect against other strains of HPV — and other STDs — when having s*x.

🍬What are the types of the HPV vaccine?🍬

🗯Gardasil 4 – The current HPV vaccine available in South Africa. Protects against HPV types 16 and 18, which are the 2 types that cause 75% of cervical cancer cases. HPV types 6 and 11 are also included, which cause 90% of ge***al warts.
🗯Gardasil 9 – Unfortunately not available in South Africa yet, but I'm holding thumbs. A vaccine covering the 9 most common HPV strains associated with cervical cancer. Another 5 types of HPV (types 31, 33, 45, 52, and 58) are included in this vaccine to protect against cancer of the cervix, a**s, v***a/va**na, p***s, or throat.
🗯Cervarix – One of the vaccines available in South Africa. It covers against 2 strains, nr 16 and 18. If you consent, your child will receive this vaccine through the school health vaccination program.

🍬Who should get the HPV vaccine?🍬

According to the government's vaccination schedule, all girls aged 9-13 need 2 doses 6 months apart. Children who get the first vaccine after 14 years need three injections over 6 months. People need to be vaccinated preferably before 26 years but can still be vaccinated until 45 years. The younger the child is when receiving the vaccine (pre-pubertal and before exposure), the better the response to the vaccine is immunologically.

Ideally, girls should get the vaccine before they become s*xually active and are exposed to HPV. However, s*xually active girls may not have been infected with the HPV types prevented by the vaccines, so they could still be protected by getting vaccinated.

The vaccine is not recommended in pregnancy.

🍬What about boys?🍬

The HPV vaccine is licensed for use in boys and is safe and effective.Vaccinating boys against HPV might help protect girls from the virus by decreasing transmission. Certain types of HPV have also been linked to cancers in the mouth, throat, p***s, and a**s, so the HPV vaccine likely offers some protection against these cancers for boys.

🍬Will getting the vaccine not show my child I consent them to have s*x? 🍬

One of the reasons the HPV vaccine is controversial is because it prevents a s*xually transmitted infection, which some people think is inappropriate for children. But the vaccine works best if you get it long before you have s*x. Research has shown that receiving the vaccine at a young age isn't linked to an earlier start of s*xual activity.

🍬Will it be of benefit if the child is already s*xually active?🍬

Even if you already have one strain of HPV, you could still benefit from the vaccine because it can protect you from other strains that you don't yet have. The vaccine can't treat an existing HPV infection. The vaccines protect you only from specific strains of HPV you haven't been exposed to already.

🍬Is the vaccine safe?🍬

The CDC has licensed the HPV vaccine, and they have approved this vaccine as safe and effective after extensive research and studies. The vaccine was studied in thousands of people worldwide for more than ten years, and it showed no safety concerns.

Remember, a vaccine gets tested extensively for years in clinical trials before rolling out to the public. If you want to learn more about vaccine trials, here is the post: https://m.facebook.com/story.php?story_fbid=259120342451159&id=100050595844490

Side effects reported in these studies were pain where the injection was given, mild fever due to the immunity effect, dizziness, and nausea.

As with all other vaccines, vaccine safety continues to be monitored by CDC.

Fainting can occur after the HPV vaccination. Fainting after any vaccination or medical procedure is more common in children and teens due to feeling queasy by being around needles.

The anti-vaxxing community has posted many horror stories about side effects and deaths due to the vaccine. The side effects and deaths are reported to the Vaccine Adverse Event Reporting System. There were 117 deaths as of September 2015, none of which could be directly tied to the HPV vaccine. Public health investigators concluded that the HPV vaccine was unlikely to cause these events. Vaccination before each adverse event seemed to be a simple coincidence.

Life-threatening allergic reactions from vaccines are very rare. If they do occur, it would be within a few minutes to a few hours after the vaccination.

In a 2013 study of over 1 million girls, the overall HPV vaccine safety for teenage girls was reaffirmed. There appear to be no links between serious adverse events and the HPV vaccines. This is in line with numerous other large-size epidemiological studies of HPV vaccines.

The Management Group (PMG) represents the vast majority of paediatricians in private practice in South Africa. They support the use of the vaccine in South Africa and reassure the public of its safety.

Rather refrain from asking on social media about the vaccine's safety, opinions on "Mom-groups" don't trump science.

🍬What about a pap smear?🍬

Girls do not need to get a pap smear before getting the vaccine. Girls must continue to get pap smears if they are s*xually active, even after getting the HPV vaccine, because the vaccine does not protect against all types of cervical cancer.

🍬How long does the vaccine last?🍬

Studies have followed vaccinated individuals for ten years and show no evidence of weakened protection over time.

🍬So, no cancer if my child gets the vaccine?🍬

The vaccine does not protect against all HPV types, so it will not prevent all types of cervical cancer. It is still essential for women to continue getting pap smears to pick up those cancers. The vaccine also does not prevent other s*xually transmitted infections (STIs).

In a study done in the USA, within 6 years of the HPV vaccine introduction, there was a 64% decrease in HPV type prevalence among females aged 14 to 19 years and a 34% decrease among those aged 20 to 24 years.

Cervical cancer is cancer. We have been dreaming about a vaccine against cancer for many years, and here it is. I will vaccinate both my daughters, and if I maybe decide to have a son in the future, I will vaccinate him as well.

Thanks to Ria Coetzee and Nicky Thompson for helping me with the post. Visit the Pro Vaccination South Africa page for more info about vaccinations.

Photo by Mae Mu on Unsplash

22/01/2022

EXCITING NEWS!!!
We joined the RUACH fertility and gynaecology team, expanding female health in Central South Africa!
Visit us at our new address:
Suite 51 First floor
Preller square
Graaf Reinet str
Dan pienaar
Bloemfontein
9301

22/01/2022

EXCITING news!!
We joined the RUACH fertility and gynaecology team!!
Expanding female health in Central South-Africa!
Come and visit us at our new address
Suite 51
First floor
Preller square
Dan pienaar
Bloemfontein

24/11/2021

https://us02web.zoom.us/webinar/register/WN_dtx_T2dlTk26mG5EjRHyDA

Dr Jaco Strydom is an Infertility and Reproductive Medicine Specialist with expertise in minimally invasive gynaecological surgery. He will share his expertise on infertility and reproductive health in a sports context.

24/11/2021

Not to be missed!!
Sport infertility and reproductive health!!
Register on the link below!

30/03/2021

💨Respiratory syncytial virus (RSV)💨

You might think parents are overprotective when they don’t want people kissing their babies. This is why.

RSV is currently filling paediatric wards around South Africa at the moment. The cooler weather brings along with it the usual sneezes, but it can also increase your baby’s risk of RSV.

RSV is one of the most common causes of bronchiolitis in children.

💨What is bronchiolitis?💨

Bronchiolitis is a lower respiratory tract infection caused by a virus. Many viruses can cause bronchiolitis, but RSV is the most well-known one. It occurs predominantly in children below 2 years of age, particularly infants.

RSV is highly contagious, and nearly all children have been infected at least once by the time they reach their second birthday. It causes cold-like symptoms that can lead to breathing difficulties and hospital admission.

RSV causes up to 90% of bronchiolitis hospitalisations and up to 50% of hospital admissions in winter with pneumonia.

💨What time of year does RSV occur?💨

RSV is usually seasonal, peaking in autumn and winter. In South Africa, the peak in RSV season varies slightly by province, with the onset of the epidemic usually in KwaZulu-Natal from December to January, in Gauteng from February to March, and followed by the Western Cape in March. RSV peaks from February to June, before the influenza season, which occurs from May to September.

💨How is RSV transmitted?💨

RSV is transmitted from person to person through physical contact, coughing, and sneezing. It can live for hours on surfaces.

Therefore I cannot reiterate this message any louder:

‼️DO NOT KISS SOMEONE ELSE’S BABY!‼️

Your one kiss or touch can be life-threatening.

Other contributing factors that increase the risk are exposure to to***co smoke, having school-age siblings, attending daycare, and living in crowded conditions.

💨Who is more at risk for RSV?💨

Due to their underdeveloped lungs, premature babies and children with chronic lung or conge***al heart disease are at the highest risk of severe disease and hospitalisation and may require intensive care.

While adults and healthy children can generally cope with the mild cold-like symptoms of an infection, at-risk infants are at a high risk of being admitted into hospital. Preterm infants are 2-5 times more likely than full-term infants to be admitted to the hospital for RSV-related symptoms in their first six months of life.

However, even healthy children can be severely affected by RSV and need hospital admission. They may even die from it.

💨What are the symptoms of RSV?💨

RSV usually begins with a mild fever, runny nose, sore throat, mild cough, blocked nose, and ear infection.

It appears to be a common cold because, technically, it is!

Most older children and adults will have these symptoms, and the condition subsides. It is essential to understand not every child contracting RSV will end up in hospital; mostly, they just present with a common cold, but if it complicates, then they will most likely need admission.

💨What are the danger signs?💨

If the symptoms progress and worsen, you may see wheezing, difficulty breathing, and trouble eating, drinking, or sleeping. Infants, being unable to breathe, won’t feed well, resulting in dehydration, which is one of the reasons for admission.

As the illness progresses, the lung tissue becomes inflamed and sloughs off and blocks airways. This leads to wheezing and difficulty breathing. In some very severe cases, the child would need to be put on a ventilator in ICU to help them overcome this respiratory distress.

If you notice your baby's chest pulling in with every breath they take, you should seek medical attention right away. Short, shallow, or rapid breathing and lethargy are red flags for parents during RSV season.

💨How is RSV treated?💨

Treatment at home for RSV (or the common cold, as you won’t know how to tell the difference) include using nasal saline drops, a humidifier to keep the air moist, ensuring the baby drinks enough, and using age-appropriate pain and fever medication.

As this is a viral infection, antibiotics would not be indicated.

Most children will recover in 1-2 weeks but can spread the virus for 1-3 weeks, even after recovery.

In-hospital treatment can see children receive intravenous fluids, humidified oxygen, or mechanical ventilation.

💨How can RSV be prevented?💨

✅Regular washing of hands with soap and water.
✅Teaching kids proper coughing and sneezing etiquette.
✅Keep your child below 2 years away from other people with cold symptoms during the RSV season if possible.
✅Wash toys and surfaces that have come in contact with children with symptoms of a cold.
✅Discourage other people from kissing your baby.
✅Don’t expose your baby to second or third-hand smoke.
✅Try to breastfeed as long as possible.

💨Is there a vaccine against RSV?💨

There is no vaccine to prevent RSV, but there is a medication called Palivizumab (Synagis) that may prevent severe LRTI’s in children.

It contains virus-fighting antibodies. This is not a vaccine, but it’s an injection given once a month throughout RSV season. This medication is highly costly and is only indicated for children with an extremely high risk of contracting the disease.

High-risk children are infants born prematurely and who are 6 months of age or younger at the beginning of RSV season, as well as babies with lung and/or heart disease.

In South Africa, the injections are usually started in January till around June.

Scientists are working toward developing a vaccine for RSV, but right now, no vaccine for the illness is licensed anywhere in the world.

💨What are the long-term effects of RSV?💨

Unfortunately, being infected once with RSV does not protect the child from contracting it again.

Some children with complicated RSV continue to have recurrent respiratory symptoms throughout childhood due to lung tissue breakdown and inflammation. It is estimated that, of children admitted to hospital with RSV, almost a third will still suffer recurrent wheezing episodes 10 years later, which may be mistaken for asthma.

RSV can be severe, and it's important to remember that it's okay to say no to an invitation if you're not feeling well or reschedule if a prospective guest tells you they've got a little cold. Sometimes, minor colds can turn into big problems for little babies.

28/03/2021

🦠🤧Influenza and the flu-vaccine🦠🤧

The past year our focus has been on one virus, COVID. However, there is another virus that is also very serious and deadly: Influenza.

The picture attached is actually all the flu vaccines I bought last week to protect my family and those around us against influenza!

Apologies for the lengthy post, but it’s such an important topic!

🦠What is influenza?🦠

Influenza is a contagious disease caused by a virus. It kills between 6000-11000 South Africans every year. It is also known commonly as flu. Unfortunately, many people wrongly refer to a common cold as the flu.

Read more on the common cold here: https://www.facebook.com/1442008255941830/posts/1460034124139243/?d=n

Influenza can lead to severe health conditions like pneumonia or bacterial infections. Each year many children and adults are hospitalized with influenza, and some of them die from it. People with certain health conditions are at higher risk for flu complications.

Even one death is too many – we need to work together to protect ourselves and others from this.

🦠What types of influenza viruses are there?🦠

There are 3 types of seasonal influenza – A, B, and C. Type A influenza viruses are further typed into subtypes according to different kinds and combinations of virus surface proteins. Among many subtypes of Influenza A viruses, currently, A(H1N1) and A(H3N2) subtypes are circulating among humans. Type C cases occur much less frequently than A and B.

🦠What is swine flu?🦠

Swine flu is an influenza type A virus infecting humans. Initially, this virus was thought to be a type of influenza virus that infects pigs and sometimes spreads to humans. However, studies have revealed that it is a virus formed by the recombination of several different genetic elements from pigs, birds, and human species. Therefore, swine flu is just a seasonal type of influenza.

🦠What are the differences and similarities between influenza and COVID?🦠

Both are diseases caused by viruses that cause contagious respiratory diseases. The Influenza virus causes flu, and COVID is caused by the SARS-COV-2 virus.

SARS-COV-2 seems to be more contagious and deadly than flu and may cause more severe illness than influenza. It also has more long-term effects.

The risk of complications for healthy children is higher for flu compared to COVID. However, children with underlying medical conditions are at increased risk for both flu and COVID.

🦠What are the symptoms of flu?🦠

Symptoms usually appear about 1-4 days after infection.

Common symptoms of flu include fever above 38˚C, cough, sore throat, and body aches. It can also cause headaches, fatigue, muscle pains, chills, vomiting, and diarrhoea.

The symptoms of flu and COVID are pretty similar, so it may be hard to tell the difference if you are ill. Testing may be needed to help confirm the diagnosis.

🦠How is flu treated?🦠

Medications for symptomatic relief of pain and fever will help with icky feelings. Ensure you drink plenty of clear fluids, rest, and keep warm. Do not give children under 18 years Aspirin. Seek medical care if the symptoms worsen or do not resolve.

Influenza is caused by a virus. Therefore antibiotics will not be effective against it. If you develop a secondary bacterial infection, antibiotics will be needed, but this will be at the discretion of your doctor.

Certain antiviral medications can be prescribed by your doctor but are only effective if given early in the disease.

🦠How can influenza be prevented?🦠

The most effective way to prevent influenza is the same as with other viruses. Was your hands and limit contact with others.

However, there is another excellent way to prevent Influenza:

Get 💉Vaccinated💉 for Seasonal Influenza Every Year!

💉More about the flu vaccine💉

The flu vaccine contains 3 different types of inactivated flu viruses or parts of those viruses called sub-units. Inactivated means that the viruses have been changed (killed) and cannot make you sick.

The flu injection viruses are named for the year they were found and the place they were found. The WHO (World Health Organisation) yearly recommends which strains are most common and need to be included in the vaccine.

The following strains are in this year’s vaccine (Vaxigrip Tetra):

🔺A/Victoria/2570/2019 (H1N1)pdm09-like virus;
🔺A/Hong Kong/2671/2019 (H3N2)-like virus;
🔺B/Washington/02/2019 (B/Victoria lineage)-like virus
🔺B/Phuket/3073/2013 (B/Yamagata lineage)-like virus.

💉Who needs to get the flu vaccine?💉

All people 6 months and older need a flu vaccine each year.

Babies cannot get vaccinated until they are 6 months old. It is therefore critical that people who live with or care for those children get vaccinated.

The same goes for children and adults with immunodeficiencies, who can’t make antibodies when vaccinated. This is called “cocooning,” where you protect those by having those around them get vaccinated. Hence all the vaccines I bought that you can see in the picture. I need to protect my daughter, Lara, who has an immunodeficiency.

As soon as the baby turns 6 months, it is still beneficial to vaccinate them, even if it is later in the year.

Adults with chronic illnesses, especially heart and lung diseases, should be encouraged to get the flu vaccine.

When children are healthy, they can go to child care or school, and parents can go to work. Getting the flu vaccine is the best way to make sure everyone can continue participating in these important activities.

💉Who should not get the flu vaccine?💉

Previous severe reaction to the vaccine or any component of the vaccine, including egg protein.

Babies below 6 months cannot get the flu vaccine.

💉Is the flu vaccine recommended in pregnancy and breastfeeding?💉

It is absolutely recommended. Since babies below 6 months cannot be vaccinated, mothers can transfer antibodies created from the vaccine given during pregnancy via the placenta, and newborns will be protected. By breastfeeding, you can also share these antibodies through breastmilk.

💉How is the flu vaccine administered?💉

Babies from 6 months onwards until adulthood get 0.5ml injected.

Any child below 9 years who has not had a flu vaccine before should get a second dose 4 weeks later. The first dose primes the immune system, while the second dose actually provides the immunity.

Do not give your child any pain medications like Paracetamol or Ibuprofen, 4 hours before or 4 hours after the shot. It has been shown to decrease the immune response if given within the time mentioned. Same goes for any other vaccine for that matter.

💉Can you get the flu vaccine if you are snotty or ill?💉

People with cold or flu symptoms can still receive the vaccine, but it is recommended that if you have a fever, you wait until you are fever-free.

You can get the vaccine if you are taking anitbiotics.

💉How effective is the flu vaccine?💉

The vaccine is about 60% effective in healthy adults. It is important to note that the vaccine does not protect against other viruses causing colds during the winter season. It only prevents influenza viruses. It does not protect against COVID.

It takes about 2-3 weeks after the vaccine administration to create enough antibodies to be protective.

💉Will you get ill from the flu vaccination?💉

Some people may get a slight fever and soreness around the site of the vaccine. It is a total misconception that the flu vaccine makes you ill, as the viruses in the vaccine are inactivated. The sick feeling is most probably just the immune system being activated to create antibodies, which is a good thing!

💉Why is it essential to get the flu vaccine during the COVID pandemic?💉

While getting a flu vaccine won’t protect you against COVID, it still is more important than ever to get your flu shot.

Not only do you protect yourself against severe illness, hospitalisation, and death; by getting more people vaccinated against flu, fewer people will get flu and become hospitalised. This lessens the burden on the already overburdened healthcare system caused by COVID.

💉Is the flu vaccine available for 2021 already?💉

Yes, it is, but they are already flying off the shelves. Get yours before they sell out.

Please see your doctor if you suspect you may have influenza or need more flu vaccine information.

25/02/2021

🆘 J&J vaccine trial data released 🆘

Yesterday J&J released their ENSEMBLE trial data in preparation for their meeting with the FDA (Food and Drug Administration) in the US for emergency use approval. And it looks goooooooood!

It looks as if the vaccine provides strong protection against severe disease and death from COVID, and it may reduce the spread of SARS-COV2 by people that are vaccinated!

Here is a small summary of the findings so you can all be in the loop.

📍There were 43783 participants in this trial data, 21895 received the vaccine, and 21888 received the placebo.
📍The vaccine had an overall efficacy of 72% in the US and 64% in South Africa, even with our new strain. This is 7% higher efficacy in SA than was initially reported in earlier data.
📍The vaccine showed an 86% overall efficacy in the US against severe COVID and 82% in South Africa, meaning a vaccinated person has a significantly lower risk of being hospitalised or die.
📍0 people (yes, none!) in the vaccine group needed ventilation or ICU admission, compared to 5 in the placebo group. 0 people in the vaccine group died of COVID, compared to 7 in the placebo group. This is so significant. Read the number of people vaccinated in the first point of this post!
📍The data shows this vaccine is safe with much fewer mild side-effects than the Pfizer and Moderna vaccines. The most reported side-effects were pain at the injection site, fatigue, muscle pains, nausea, and headache. About 9% of the volunteers had a fever. Younger participants were more likely to develop side effects than their older counterparts. There were no reported cases of severe allergic reactions like anaphylaxis.
📍The vaccine’s protective effect was consistent among the different races it was tested on and the different age groups. They also included people with comorbidities, 40.8% of the sample.
📍It appears as if the vaccine also protects against transmission of the virus, as the vaccine had a 74% efficacy against asymptomatic infections. They tested about 1000 participants at 71 days after their vaccination for specific antibodies. This was a sign that they were infected with SARS-COV2, but they never experienced any symptoms.
2 of those that were vaccinated had antibodies showing infection, compared to 16 in the placebo group. These numbers are small, but it’s promising! They are busy following up with a larger group of participants for more data.
📍Vaccine antibody titers stabilized after 71 days, so the immune response gets even more robust as time passes.
📍They also included their sub-study (basically a smaller study within a study), called DART. They gave female rats the vaccine. They did not have any adverse effects relating to their fertility and pregnancy. This is very promising news, meaning the vaccine will probably be safe in pregnancy as predicted.

🆘So why is this an excellent vaccine for SA?🆘

📌It’s a single-shot vaccine. The administration and logistics of getting people vaccinated are just a lot easier. There is no need for people to come for an additional vaccine like the other approved vaccines. More people can also be fully immunized with fewer vaccines; for instance, if we received 1000 vaccines, 1000 people would be fully vaccinated, rather than 500 that would need 2 shots.
📌It’s relatively stable at normal low temperatures. It can be stored in normal refrigeration temperatures for at least 3 months. No need for high-tech ultracold freezers that are needed with the other approved vaccines abroad. This also helps with transportation a ton.
📌The vaccine was tested in South Africa, with South African volunteers (About 5000 of them). The data is close to home. We know it is reliable as it was tested in real-life against our prominent mutated variant.
📌This vaccine significantly decreases the rate of hospital admissions and death. Our healthcare system will breathe a sigh of relief.
📌Having another approved vaccine world-wide means a boost in overall global supplies of vaccines, meaning South Africans can get their hands on vaccines sooner to roll-out to other people other than healthcare workers.
📌The suggested data on the decreased transmission of the virus is SO promising!

🆘Should we worry about the lower efficacy compared to other vaccines?🆘

The Pfizer and Moderna vaccines have an efficacy rate of around 95%, which is fantastic. However, we need to remember that they have a decrease in neutralizing antibodies towards our current mutated variant. This does, however, not mean lower efficacy per se; it will need to be tested further to confirm full efficacy. When we look at the rates of hospitalisations and deaths, they are still really comparable.

The Novavax vaccine only showed a 49% efficacy toward the South African mutated variant. We know the AstraZeneca-Oxford vaccine’s efficacy was also not great (about 10%).

The other vaccines aren’t available in SA yet. The J&J vaccine is available now, and our Healthcare workers are being immunized as we speak, making that the perfect vaccine for SA at the moment.

🆘So what next?🆘

With this great data, the chances of the FDA not approving this vaccine are very low. We will probably hear tomorrow if it is approved, which will then mean widespread roll-out world-wide. Then other regulators will be in line to approve the vaccine.

They will also probably plan further studies on children and pregnant women. J&J also has another massive study underway to see if a second dose of its vaccine works better. If the data indicates this, there might be a booster shot needed later.

Time will tell.

Photo by Daniel Schludi on Unsplash.

&johnson