INTRODUCTION: The Ponseti method for the treatment of idiopathic club foot is the gold standard of treatment in South Africa. A study in New York reviewed attainment of eight gross motor milestones in these children and found that independent ambulation was delayed on average by 2 months compared to unaffected children. METHODS: A retrospective review of gross motor milestones was performed in patients treated at a South African clubfoot clinic. All patients were ambulating independently at review and ages at attainment of three motor milestones were recorded (sitting, crawling and walking independently). The World Health Organisation (WHO) published the normal range for achievement of these milestones in six regions across the world. We compared the results of our patients to the 50th percentile in that study. RESULTS: Results show that patients in our study sat at a mean of 5.8 (standard deviation ± 1.3) months and crawled at a mean of 8.3 (SD ± 1.7) months, both equal to the WHO 50th centiles for unaffected children. Independent walking, however, was achieved at a mean of 15.3 (SD ± 2.3) months which is statistically significantly different to the 50th centile for unaffected children in the WHO study (p<0.05). In our study, 86% of children achieved independent walking within 18 months. No statistical difference was found between unilateral and bilateral cases. CONCLUSION: Children treated for idiopathic clubfoot (unilateral or bilateral) can expect no delays in sitting or crawling. Minimal delays in achieving independent walking of about three months can be expected with an 86% chance of walking within the accepted normal range for unaffected children.

Sm14 is a 14-kDa vaccine candidate antigen from Schistosoma mansoni that seems to be involved in cytoplasmic trafficking of fatty acids. Although schistosomes have a high requirement for lipids, they are not able to synthesize fatty acids and sterols de novo. Thus, they must acquire host lipids. In order to determine whether Sm14 is present in different stages of the life cycle of the parasite, we performed RT-PCR. Sm14 mRNA was identified in all stages of the life cycle studied, mainly schistosomulum, adult worm and egg. Additionally, we used a rabbit anti-Sm14 polyclonal antibody in an indirect immunofluorescence assay to localize Sm14 in adult worm sections. The basal lamella of the tegument and the gut epithelium were strongly labeled. These tissues have a high flow of and demand for lipids, a finding that supports the putative role of Sm14 as an intracellular transporter of fatty acids from host cells.