Introduction: Temporal trends in CF survival from low-middle-income settings are poorly reported. We describe changes in CF survival after diagnosis over 40 years from a South African (SA) CF center. Methods: An observational cohort study of people diagnosed with CF from 1974 to 2019. Changes in age-specific mortality rates from the year 2000 (versus before 2000) were estimated using multivariable Poisson regression. Data were stratified by current age < or ≥ 10 years and models controlled for diagnosis age, sex, ethnicity, genotype, and P. aeruginosa (PA) infection. A second analysis explored association of mortality with weight and FEV1z-scores at age 5-8 years. Results: 288 people (52% male; 57% Caucasian; 44% p.Phe508del homozygous) were included (median diagnosis age 0.5 years: Q1,Q3: 0.2, 2.5); 58 (35%) died and 30 (10%) lost to follow-up. Among age >10 years, age-specific mortality from year 2000 was significantly lower (adjusted hazard ratio aHR: 0.14; 95% CI: 0.06,0.29; p<0.001), but not among age <10 years (aHR: 0.67; 95% CI: 0.28,1.64; p=0.383). In children <10 years, Caucasian ethnicity was associated with lower mortality (aHR 0.17; 95% CI 0.05,0.63), and time since first PA infection with higher mortality (aHR 1.31; 95% CI 1.01,1.68). Mortality was 7-fold higher if FEV1z was < -2.0 at age 5-8 years (aHR 7.64; 95% CI 2.58,22.59). Conclusion: Overall, CF survival has significantly improved in SA from year 2000 in people older than 10 years. However, increased risk of mortality persists in young non-Caucasian children, and with FEV1z<-2.0 at age 5-8 years.

Cysticercosis in humans is a serious public health problem, predominantly affecting low and middle-income countries (LMICs). Cysticercosis, the infection with the larval form of the pork tapeworm, Taenia Solium has high prevalence in areas where there are poor sanitary conditions and domestic pig without adequate veterinary control. Humans are the definitive host and pigs are the main source of infection. Human infection occurs when pork is eaten raw or undercooked. Ingested eggs or proglottids hatch into larvae form, which penetrate the intestinal wall into the blood stream and migrate into different organs including subcutaneous tissues, brain, eyes and rarely heart or lung, where they mature into cysticerci. Pulmonary cysticercosis has been rarely described; case reports are predominantly in adults and are usually of disseminated disease. In children the data are very scarce, with a single case report of a two-year old child with pulmonary infiltration, eosinophilia and subcutaneous cysticercosis.