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The prevalence of insufficient iodine intake in pregnancy in Africa: Protocol for a systematic review and meta-analysis

  • Authors: Charles Bitamazire Businge , Benjamin Longo-Mbenza , Andre Pascal Kengne
  • Date: 22-8-2019
  • Language: English
  • Type: text , article
  • Identifier: http://hdl.handle.net/11260/3387 , vital:43338 , https://systematicreviewsjournal.biomedcentral.com/articles/10.1186/s13643-019-1092-7#citeas
  • Description: Background: Insufficient iodine intake in pregnancy is associated with many adverse pregnancy outcomes. About 90% of African countries are at risk of iodine deficiency due to poor soils and dietary goitrogens. Pregnancy predisposes to insufficient iodine nutrition secondary to increased physiological demand and increased renal loss. Iodine deficiency is re-emerging in countries thought to be replete with pregnant women being the most affected. This review seeks to identify the degree of iodine nutrition in pregnancy on the entire African continent before and after the implementation of national iodization programmes. Methods: A systematic search of published literature will be conducted for observational studies that directly determined the prevalence of insufficient iodine intake among pregnant women in Africa. Electronic databases and grey literature will be searched for baseline data before the implementation of population-based iodine supplementation and for follow-up data up to December 2018. Screening of identified articles and data extraction will be conducted independently by two investigators. Risk of bias and methodological quality of the included studies will be assessed using a risk of bias tool. Appropriate meta-analytic techniques will be used to pool prevalence estimates from studies with similar features, overall and by major characteristics including the region of the study, time period (before and after implementation of iodization programmes), sample size and age. Heterogeneity of the estimates across studies will be quantified and publication bias investigated. This protocol is reported according to Preferred Reporting Items for Systematic reviews and Meta-Analysis protocols (PRISMA-P) 2015 guidelines. Discussion This review will help ascertain the impact of national iodization programmes on the iodine nutrition status in pregnancy in Africa and advise policy on the necessity for monitoring and mitigating iodine deficiency in pregnancy in Africa. This review is part of a thesis that will be submitted to the Faculty of Health Sciences, University of Cape Town, for the award of a PhD in Medicine whose protocol has been granted ethics approval (UCT HREC 135/2018). In addition, the results will be published in a peer-reviewed journal.
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Integration of HIV/ AIDS, Tuberculosis and Patients’ Services into the General Health Care Systems: Implementation Challenges and Impact on TB Control Programme in O.R. Tambo District, Eastern Cape, South Africa.

  • Authors: Dlatu, Ntandazo
  • Date: 2024-08
  • Language: English
  • Type: Doctoral theses , text
  • Identifier: http://hdl.handle.net/11260/12987 , vital:76186
  • Description: Tuberculosis (TB), a disease of poverty and inequality, is a leading cause of severe illness and death among people with human immunodeficiency virus (HIV). In South Africa, both TB and HIV epidemics have been closely related and persistent, posing a significant burden for healthcare provision. Reducing morbidity and mortality from HIV-associated TB requires strong collaboration between TB and HIV services at all levels with fully integrated, people-centered models of care. Studies have observed that TB and HIV integration reduces mortality. However, the operational implementation of integrated services is still challenging. Gaps exist between the challenges of combining TB and HIV control with evidence-based knowledge, affecting the implementation process of this highly recommended strategy. Despite the policy, frameworks for integration exist; integration of TB and HIV services is far from ideal in many resource-limited countries, including South Africa. Few studies have examined the advantages and disadvantages of integrated TB and HIV care in public health facilities, and even fewer have proposed conceptual models for proven integration. Objectives: The goals of this study consisted of: (i) investigating the associations between socio-economic deprivation and tuberculosis (TB) treatment outcomes, alongside well-known TB risk factors. The effects of healthcare expenditures and their growth on trends in TB incidence from 2009 to 2013 were also assessed. (ii) Exploring patients’ and healthcare workers’ perceptions of TB and HIV integration as well as a strategy for integrating these programs. (iii) Describing patients’ perceptions on barriers to scaling up of TB-HIV integration services at selected health facilities; and (iv) Developing a paradigm for integrating TB, HIV, and patient services in a single facility and highlighting the importance of TB-HIV services for greater accessibility under one roof. Methods: In Phase 1 of the study, secondary data analysis was performed on data obtained from various sources including governmental, non-governmental, and research institutions. Indicators for TB treatment outcomes included TB death rate, TB rate among the household contacts of the Index TB cases, TB treatment failure, HIV-associated TB death rate, TB defaulter rate, and new TB smear-positive cases. Analysis of variance (ANOVA) and Turkey’s tests for post-hoc analysis were used to P a g e xvii | compare means of variables of interest considering a type I error rate of 0.05. , Thesis (PhD) -- Faculty of Medicine and Health Sciences, 2024
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Exploring the experience of clients on fixed-dose combination antiretroviral drugs at Ngangelizwe Community Health Centre, Eastern Cape

  • Authors: Macozoma, Wanda
  • Date: 2024-07
  • Language: English
  • Type: Masters theses , text
  • Identifier: http://hdl.handle.net/11260/12963 , vital:76182
  • Description: Fixed dose combination antiretroviral drugs are multiple retroviral drugs combined into a single pill, commenced in South Africa on 01 April 2013 after it was announced by the Minister of Health. The main reason for this change of treatment was to reduce pill burden and make the lives of people living with HIV and who are on ARVs simpler and easier. The purpose of this study was to describe experiences of clients on fixed dose combination antiretroviral drug at Ngangelizwe Community Health Centre, Eastern Cape. The study used a qualitative research approach and descriptive phenomenology as a research design. The target population for this study were clients initiated on a fixed dose combination antiretroviral drug. Purposive sampling was done and semi-structured individual interviews conducted to collect data, audiotape was used and field notes taken. Data saturation was reached after interviewing 12 participants. Data analysis was done guided by Tesch’s 8 steps of the coding process. Ethical principles were adhered to and informed consent obtained from participants. Findings revealed that there were physical, psychological and social experiences, from the period of first diagnosis, disclosure and medication compliance. It is recommended that health education campaigns be intensified since there is still stigmatization of HIV/AIDS that affects compliance. Also, there is need for continuing education and training for healthcare providers to encourage a supportive attitude towards clients. , Thesis (Masters) -- Faculty of Medicine and Health Sciences, 2024
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Translanguaging pedagogies and practice for social justice in a multilingual South African previously disadvantaged

  • Authors: Mpofu, Tarisai
  • Date: 2024-06
  • Subjects: Multilingualism
  • Language: English
  • Type: Doctoral theses , text
  • Identifier: http://hdl.handle.net/11260/11131 , vital:75921
  • Description: Over the last two decades, there has been a burgeoning interest in translanguaging as both a theory and a methodology, but a few studies have looked at it as a pedagogy. This has meant that while there is near-consensus on translanguaging’s contribution to knowing, there have been few studies on how it can be implemented systematically in classrooms. This study examines how translanguaging is being practiced at one South African university and makes recommendations on how translanguaging can be implemented systematically for better impact. A mixed method approach was used, meaning that it had both qualitative and quantitative elements. Data for this study were gathered using online questionnaires completed by students and lecturers, interviews with lecturers, and observation. The results show that limited translanguaging was taking place in the classroom, despite both students and staff acknowledging its value to epistemic access. This study calls for intentional and systematic implementation of translanguaging to contribute to socially-just classroom practices. The study proposes the translanguaging matrix model for practice to assist in institutionalising translanguaging through the provision of short learning courses for staff and students on translanguaging, language learning opportunities and clear pedagogical training on when translanguaging must be used in classroom contexts. Key Words: Translanguaging, Language Policy, Social Justice, Multilingalism, Pedagogy , Thesis (D.Ed) -- Faculty of Education, 2024
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Exclusive breastfeeding up to six months in very and extremly low birth weight infants and determinants of breastfeeding practices at the Frere Hospital in the Eastern Cape, South Africa

  • Authors: Haughton, Anna-Marie
  • Date: 2024-03
  • Subjects: Brestfeeding Practices
  • Language: English
  • Type: Masters theses , text
  • Identifier: http://hdl.handle.net/11260/11065 , vital:75881
  • Description: INTRODUCTION: Breastmilk provides adequate nutrition for the optimal growth and development of infants globally. Breastfeeding is an incomparable practice that cannot sufficiently be replaced by any other substance. Breastmilk and breastfeeding offer numerous medical and non-medical advantages that influence the welfare not only of infants, but also of women, their families and society. The last few decades have shown a worldwide increase in the birth and survival rate of preterm, very low birth weight (VLBW) and extremely low birth weight (ELBW) infants. These infants have an increased risk of adverse outcomes, thus necessitating optimal management including best feeding practices of this vulnerable population. AIM: This study assessed the exclusive breastfeeding (EBF) rate in VLBW and ELBW infants at their corrected six months of age and aimed to identify reasons for premature cessation of EBF as well as appraising the association between maternal socio-demographic variables and breastfeeding practices. This study also investigated the type, volume and preparation of replacement feeds given to infants that were not EBF. iii METHOD: This retrospective, cross sectional descriptive study was conducted between December 2017 to November 2018 at Frere Hospital in the Eastern Cape. A comprehensive database was compiled with all the infants’ demographics and relevant maternal socio-demographic variables at birth. Information on the changeover of primary caregiver, feeding practices, reasons stated for premature discontinuation of EBF, and the infant’s anthropometry were documented at each follow up visit and included in the database. RESULTS: The prevalence of EBF at the corrected six month follow up was 22%. Insufficient breastmilk supply (23%, 43% and 13% at one, three and six months respectively) and maternal commitments to school or work (35%, 33% and 50% at one, three and six months respectively) were the predominant reasons stated by mothers for discontinuation of EBF. The number of other children a mother had was significantly related to EBF practices at months one and six (p = .029 and .025, respectively), and EBF was also significantly related to the level of maternal education at month three (p = .006). The percentage of mothers who breastfed exclusively was proportional to the number of other children they had, and inversely proportional to the level of their education. The volume of replacement feeds was known to be incorrect in over a third of cases at months one and three (35% and 34%, respectively), and in almost half of cases at month six (48%). Replacement feeds were being prepared most incorrectly at the three month follow up with almost half (46%) of these feeds being prepared iv inaccurately. These replacement feeds comprised of exclusive formula feeds (EFF) for 95% of cases that were not EBF at month one, 88% at month three, and 97% at month six. CONCLUSIONS: The prevalence of EBF in VLBW and ELBW infants at six months in this study remains sub-optimal compared with other low- and middle-income countries (LMICs) and is much lower than the target set by the World Health Organisation (WHO). Factors that affected EBF practices in this study include mother’s perception of insufficient breastmilk supply, maternal commitments to work/school, the number of other children in the household as well as the level of maternal education. A combination of various interventions is urgently needed to effectively increase EBF rates in this population. , Thesis (Masters) -- Faculty of Medicine and Health Sciences, 2024
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Bioprospectin of medicinal cannabis from Eastern Cape, South Africa

  • Authors: Odieka, Anwuli, Endurance
  • Date: 2024-02
  • Subjects: Organic chemistry
  • Language: English
  • Type: Doctoral theses , text
  • Identifier: http://hdl.handle.net/11260/9427 , vital:73532
  • Description: Cannabis sativa L. (Family Cannabaceae) has continued to attract much interest among natural product scientists in recent time because of its known medicinal values and remarkable chemical diversity. This study reports the investigation of C. sativa cultivated in the Eastern Cape Province of South Africa, with a view to obtaining its chemical fingerprint and isolating compounds from its stem bark for possible biological applications. Fresh and dried leaves, flowers, stem barks and roots of two Cannabis cultivars were obtained under permit NO. PIA-HP-EC-2022-0023. The fresh and dried plant materials were extracted for their essential oils (EOs), using hydro-distillation method on a Clevenger apparatus set at optimum extraction condition. The EOs were characterized by a gas chromatography coupled to a mass spectrometer (GC-MS). The chemical components of the EOs were elucidated based on their retention indices, as well as with reference to literature report. Other portions of the dried leaf, inflorescence and stem bark of each cultivar were extracted with methanol. The methanol extract was profiled for its cannabinoid content using liquid chromatography mass spectrometry (LCMS) based metabolomics approach, with reference to standard cannabinoids (∆9-THC, ∆9-THCA, and CBD). Lastly, the dried stem bark of Cultivar II was investigated for its compounds. The stem bark powder was subjected to sequential extraction at room temperature with n-hexane, dichloromethane, ethyl acetate and methanol. Based on the TLC analysis, the afforded n-hexane and ethyl acetate extracts were further individually fractionated on a repeated column chromatography, using silica gel and Sephadex LH20 as stationary phases. The column fractionation process led to the isolation of seven compounds, E1-E4, A20, A21, and A23. The isolated compounds were characterized by spectroscopic and spectrometric methods on nuclear magnetic resonance (NMR) spectrometer and ultra high-performance liquid chromatography hyphenated to a mass spectrometer, respectively. The results from the study showed that the EOs of the C. sativa cultivars contain majorly sesquiterpenes in their oxygenated and non-oxygenated forms. Caryophyllene (0.6421.4%), caryophyllene oxide (1.27-20.34%), -pinene (0.35-13.21%), D-limonene (0.51-10.99%), humulene (0.37-10.56%), humulene-1,2-epoxide (0.45-5.98%), pinene (0.16-5.22%), nerolidol (0.32-4.99%), -myrcene (0.31-4.23%), -selinene (0.92-2.51%), and trans--bergamotene (0.50-2.70%), were the main terpene constituents of the EOs in both cultivars. Neutral cannabinoids were also detected in both cultivars with cannabidiol found in significant amount up to 85.03% in the fresh stem oil (LSO) of Cultivar I (Lifter). LC-MS fingerprints revealed that Cultivar I had the highest accumulation of cannabinoids with CBDA having the highest amount (88.65%) in the stembark and CBD at about 23% in the leaves. The inflorescence (flower) contained 51.55% of CBDA. Cultivar II had the least number of cannabinoids but contains the highest amount of ∆9-THCA (94.8%) in the leaf sample. Cultivar II showed ∆9-THCA and ∆9-THC dominant profiles with less than 2% of ∆8-THC. ∆9-THC, ∆8- THC were the only neutral cannabinoids detected in Cultivar II while CBD, ∆9-THC, and ∆8- THC were found in significant amounts in Cultivar I. The compounds isolated from the stem bark of Cultivar II were elucidated as five triterpenoids: Sativalenic acid ethyl ester (E1), Phyllanthone (E2), Friedelin (E3), Sativalonone (A20) and Sativaol (A23); an alkaloid, Sativacherine (E4); and a fatty acid ester, Ethyl stearate (A21). Four of these compounds are newly described, while all the compounds are reported for the first time from the Eastern Cape Cultivar (Cherrywine) of C. sativa stem. , Thesis (PHD) -- Faculty of Natural Sciences, 2024
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Knowledge, attitudes and perceptions towards hand hygine practice amongst students at a nursing colledge, Lesotho

  • Authors: Ntaote, Malehlohonolo
  • Date: 2024-02
  • Language: English
  • Type: Masters theses , text
  • Identifier: http://hdl.handle.net/11260/13000 , vital:76187
  • Description: Hands are critical vectors for microorganisms that cause hospital acquired infections, hand hygiene, being done the right way, at the right time and being given the right priority at health care setting is an effective strategy to reduce hospital acquired infections and costs. Different strategies have been put in place to help improve hand hygiene compliance among health care workers, amongst them; continuous training is advised at all levels of care. This study aimed to describe the knowledge, attitudes and perceptions towards hand hygiene in nursing students in Maluti College Berea Lesotho Methods This study was a quantitative cross-sectional study; 114 questionnaires were distributed and 103 were filled and returned by available willing students in Maluti College, that was 90% response rate. Results Females were more than males at 88% (91). Age range of the respondents were 18-35 years, with a mean of 22 years, 57% (59) were between ages 20-24 years. The students were distributed in four different class levels, lowest was third years at 19% (19) and highest was the nurse midwives at 32% (33). 75% (77) had hand hygiene training in the past three years. 62% (64) had moderate knowledge, all had positive attitudes and 61% (63) had a positive perception towards hand hygiene. There was a significant (p value=0.012) association between knowledge and training. Conclusion and recommendations The study has demonstrated a significant association between knowledge and training, indicating the pivotal role of education in shaping practices related to hand hygiene among healthcare workers. These findings underscore the importance of integrating insights garnered from this study into the existing teaching curriculum for healthcare 3 professionals. Furthermore, the results provide valuable input for enhancing the World Health Organization's (WHO) hand hygiene multimodal strategy, emphasizing the need for targeted interventions that address knowledge and training gaps. Additionally, the study findings advocate for incorporation of evidence-based practices into initiatives such as the SAFE LIFE Clean YOUR HAND campaign, thereby reinforcing the importance of continuous education and training to promote effective hand hygiene practices and mitigate the spread of healthcare-associated infections. This calls for a concerted effort from policymakers, healthcare institutions, and educational stakeholders to implement strategies that prioritize knowledge dissemination and training programs to improve hand hygiene practices among healthcare workers worldwide. , Thesis (Masters) -- Faculty of Medicine and Health Sciences, 2024
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Building sustainable economies: Navigating contemporary issues in the finance, economic complexity, and interprenuership development

Building sustainable economies: Navigating contemporary issues in the finance, economic complexity, and interprenuership development

Navigating the Antimicrobial Resistance (AMR) Landscape:Strategies and Challenges in addressing drivers of AMR

Advantages of postgraduate research supervision and publication output at a selected University in Mthatha, Eastern Cape Province

  • Authors: Cekiso-Smith, Nontuthuzelo
  • Date: 2024-01
  • Subjects: Research Supervision
  • Language: English
  • Type: Doctoral theses , text
  • Identifier: http://hdl.handle.net/11260/11090 , vital:75917
  • Description: The objective of the study was to investigate how postgraduate research supervision practices may contribute to the improvement of publication output at the selected university. Drawing from extensive literature, the significance of establishing strong supervisor-supervisee relationships was emphasised as paramount to the success of postgraduate research study. In conjunction with the theoretical framework, the research used a well-structured inductive approach, which took into account the context where the research took place, anchored by a case study as it provides tools for the researcher to study complex phenomena within the context of the study. The sample consisted of 24 participants who were purposefully selected from the selected faculty in the selected university. Data were collected through semi-structured interviews, which were conducted by the researcher in person and detailed procedures, ensuring the credibility and reliability of the study. Strict confidentiality measures were in place, ensuring participants’ anonymity and the safeguarding of their responses, fostering a trustworthy environment for honest revelations. Data were analysed and interpreted with ATLAS.ti software. Data analysis was carried out systematically, identifying themes and subthemes that answered the central research question. This rigorous analysis led to the discovery of several crucial findings. There was a notable call for academic support mechanisms like mentorship, advising and research supervision to bolster postgraduate research outputs, especially in remote universities. Financial constraints and barriers to attending research seminars and conferences emerged as significant hurdles, stressing the need for effective strategies to overcome these challenges. iii In-depth discussions revealed the criticality of fostering healthy supervisor-supervisee relationships from a development’s inception, highlighting the pivotal role of open communication. The study also identified supervisors’ need for institutional support in acquiring the necessary educational capabilities to efficiently mentor postgraduate students. Furthermore, emphasis was placed on the importance of enhancing postgraduate students’ professional writing skills for publication. However, the study did not ignore the challenges faced by research supervisors. Heavy workloads, time constraints and high expectations emerged as considerable stressors. Among the recommendations, the study called for institutional assistance in obtaining the essential educational competencies to effectively guide postgraduate students. Attention to the dire need for improved support systems, research infrastructure, incentives for supervisors and streamlined research procedures. In summation, this research underscores the significance of continuous monitoring, evaluation and engagement strategies to foster an environment conducive to advanced postgraduate research supervision and publication growth Key words: Postgraduate supervision, research publication, postgraduate students, Historically Disadvantaged University. , Thesis (D.Ed) -- Faculty of Education, 2024
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An assessment of the cost effectiveness and impact of introducing a laboratory electronic gatekeeping system at an academic hospital in Mthatha, Eastern Cape, South Africa

  • Authors: Mayekiso, Zoliswa
  • Date: 2024-00
  • Subjects: Medicine and Health Scienes
  • Language: English
  • Type: Doctoral theses , text
  • Identifier: http://hdl.handle.net/11260/13042 , vital:76864
  • Description: Monitoring laboratory expenditure is crucial to ensure that laboratory services remain sustainable and affordable. In South Africa, the National Department of Health (NDoH) and its partner, the National Health Laboratory Services (NHLS) collaborated to introduce Electronic Gate Keeping (EGK) systems across the country. Countries across the globe report an increase in expenditure associated with medical laboratory testing. In 2020, the United States Department of Health and Human Services reported that laboratory test expenditures increased by $459 million from $7.1 billion in 2018. In South Africa, laboratory testing expenditure in the public sector increased from $415 million (R4.5 billion) in 2014 to $723 million (R10.7 billion) in 2021. Many countries, including South Africa, are developing, and testing new methods to reduce the excessive demand for medical laboratory tests for patient investigations to reduce the burden of rising laboratory costs on national budgets. The aim of the study is to assess the cost-effectiveness and impact of introducing a laboratory electronic gate keeping system at an academic hospital in Mthatha, Eastern Cape, South Africa. Objectives: This study addressed four goals which are: (i) Evaluated the impact of the EGK intervention by obtaining the number of inappropriately requested test investigations averted and cost associated (cost savings) at Nelson Mandela Academic Hospital (NMAH), Eastern Cape, between 1st June 2015 to 31st May 2017. (ii) Determined the costs associated with inappropriately requested test investigations analysed prior to the implementation of EGK at NMAH, Eastern Cape, from 1st June 2013 to 31st May 2015. (iii) Determined the costs associated with inappropriately xxxiii requested test investigations analysed during the implementation of EGK at NMAH, Eastern Cape, from 1st June 2015 to 31st May 2017. (iv) Evaluated the costs and cost effectiveness analysis of introducing and implementing EGK at NMAH, Eastern Cape, between 1st June 2015 to 31st May 2017. Methods: In addressing the four objectives, this study was undergone in four phases, making use of secondary data on laboratory expenditure, primarily collected electronically by the NHLS and supplied to NMAH on monthly basis. In objective 1 and phase 1 of the study, a cross sectional study design to retrospectively audit EGK subjected tests at the NHLS in Mthatha by Nelson Mandela Academic Hospital over 24 months was employed. In objective 2 and 3 and phase 2 of the study, a cross-sectional study using an interrupted time series analysis (ITSA) to determine the impact of the EGK intervention was employed. In this phase, two periods comparing laboratory expenditure before and during the EGK intervention were analysed over a period of 24 months. In objective 4 and phase 3 of the study, a cross-sectional study that used cost effectiveness analysis (CEA) to evaluate a cost effectiveness of EGK intervention over 24 months was done. Results: In the first phase, we found that out of 448 028 tests requested, 17,480 (3.9%) were rejected after being identified as unnecessary through the EGK system. This rejection rate of 3.9% generated cost savings of $51,967.07 (R807,110.95). The top three tests that generated the most savings were the c-reactive protein with $6,077.68 (R94,393.59), free thyroxine with $5,199.92 (R80,760.94) and hepatitis A IgM with $3,813.61 (R59,229.98). In the second phase, our results demonstrated that xxxiv there was a significant reduction (211,928 fewer tests) in the number of tests performed during the intervention (434,790) compared to before the intervention (646,718). Laboratory test expenditure was $1,663,756.72 (R24,823,250.26) before the intervention period and $1,105,036.88 (R1,567,150.25) during the intervention period, demonstrating a cost savings of $558,719.84 (R8,336,100.01). In the last phase 3, results showed that implementing EGK resulted in lower costs - $515,114.96 (R7,685,515.20) and 212 fewer tests, resulting in an Incremental Cost Effectiveness Ratio (ICER) of USD 2,430.00 (R36,255.60) which is evidence is needed to evaluate the cost effectiveness of EGK in South Africa from a societal perspective. , Thesis Phd -- Faculty of Medicine and Health Sciences, 2024
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Factors influencing digital marketing adoption for female interpreneurs in small and medium enterprices of OR Thambo Municipality

  • Authors: Maduna, Siyasanga
  • Date: 2024-00
  • Subjects: Digital Marketing
  • Language: English
  • Type: Masters theses , text
  • Identifier: http://hdl.handle.net/11260/10065 , vital:74935
  • Description: The rise of the Internet has transformed the business landscape, leading to the rapid growth of major online retailers and service providers like Amazon, Facebook, and Google, all of which play significant roles in the digital economy (Kannan, 2017). Global internet usage continues to grow, with South Africa not an exception. The research seeks to explore the factors influencing digital marketing adoption for female entrepreneurs on small and medium enterprise in OR Tambo municipality. This dissertation employs a quantitative research design. The study employs structural equation modelling (SEM) techniques to analyse a comprehensive dataset gathered from 313 female entrepreneurs. The findings reveal a nuanced relationship between adoption of digital marketing and business performance. The SEM results indicate that H4, have a positive influence on adoption of digital marketing, and H5, have a positive influence on business performance. The hypotheses H1; H2 and H3 had negative relationship on adoption on adoption of digital marketing hence they were rejection. The implications of these findings are discussed in the context of factors that influence the adoption of digital marketing on enhancing business performance for SME’s. The dissertation contributes to inclusive economic development, policy implications; educational interventions; strategic business imperative and social impact. Beyond the economic aspects, the study contributes to social impact by challenging and potentially reshaping societal norms and expectations regarding women's roles in business. This research not only advances the theoretical understanding of the link between adoption of digital marketing and business performance but also provides valuable insights for designing effective marketing strategies to improve business performance on female entrepreneurs. The dissertation concludes with suggestions for future research directions to further refine an understanding of the intricate dynamics involved in the relationship between adoption of digital marketing and business performance. , Thesis (Masters) -- Faculty of Economics and Financial Sciences, 2024
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Government expenditure on health services and economic development in South Africa

  • Authors: Magida, Ngesisa
  • Date: 2024-00
  • Subjects: Government expenditure on health services
  • Language: English
  • Type: Masters theses , text
  • Identifier: http://hdl.handle.net/11260/10146 , vital:74943
  • Description: Economic development relates to economic growth and improvements in the living standards of people. South Africa is ranked among the slow developing countries in the world, based on the high percentage of people living under poor conditions. This study examines the relationship between government health expenditure and economic development in South Africa between 1994 and 2022. Human development index (HDI), government health expenditure (GHE), inflation, population growth, and unemployment are the variables used to investigate this relationship. Auto regressive distributed lag (ARDL) and Granger causality were employed to examine this relationship. Government expenditure on health services and inflation were found to have a positive short-run and long-run relationship with human development index, whereas unemployment and population growth showed a negative relationship with HDI in the long-run. Granger causality results highlighted a unidirectional causality between HDI and GHE in South Africa, among other explanatory variables. HDI Granger causes GHE and vice versa. Continuous increment and monitoring of GHE distribution, to ensure that the growing population receives proper healthcare to boost the life expectancy of the citizens and to fund the preventative measures against health epidemics in South Africa is the policy recommendation to improve HDI in South Africa. Keywords: , Thesis (Masters) -- Faculty of Economics and Financial Sciences, 2024
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Household food security status and its determinantsin Mthata Eastern Cape Province

  • Authors: Nodo, Asive
  • Date: 2024-00
  • Subjects: Food Security
  • Language: English
  • Type: Masters theses , text
  • Identifier: http://hdl.handle.net/11260/10156 , vital:74945
  • Description: Food security remains a critical issue worldwide, and South Africa is no exception. This national challenge is especially acute in the Eastern Cape Province, known as one of the poorest regions in the country. The highest rates of poverty are observed in the Eastern Cape Province, with the population largely dependent on social grants to secure their food needs. The primary objective of the study was to examine the household food security status and its determinants in Mthatha, Eastern Cape Province of South Africa. The study was conducted in Tabase and Ncise in Mthatha. The purposive sampling technique was employed in the study and 336 data points were achieved. The study used the Household Food Insecurity Access Scale (HFIAS), developed by the USAID-funded Food and Nutrition Technical Assistance II (FANTA), and leveraged Tobit regression analysis, particularly advantageous for handling censored dependent variables, to examine the determinants of food household food security. The results revealed that gender, age, crops and social grants have no statistical significant relationship with food insecurity. Education, employment status, income, livestock and dietary diversity have a statistical significant relationship with food insecurity. Results further revealed that 40.36% of households were food insecure while 4.22% were food secure, 7.83% were mildly food insecure and 40.36% were severely food insecure. The study recommends the formation of agricultural cooperatives with government support, prioritising education incentives, and strengthening existing food support initiatives. It emphasizes promoting savings clubs and subsidising nutrient-rich foods to enhance accessibility. These multifaceted recommendations aim to address household food security in Mthatha, providing a comprehensive framework for intervention and policy considerations. , Thesis (Masters) -- Faculty of Economics and Finacial Sciences, 2024
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Positioning consumer studies and intrepreneural skills acquisition in selected Eastern Cape Secondary Schools

  • Authors: Mtshatsha, Nondwe Daphne Mariana
  • Date: 2024-00
  • Subjects: Consumer studies and Entrepreneural Skilss acquisition
  • Language: English
  • Type: Doctoral theses , text
  • Identifier: http://hdl.handle.net/11260/11121 , vital:75920
  • Description: To be balanced, education should enhance the development of intellectual, emotional, physical, social, moral, occupational, and financial capabilities. In South Africa's secondary education system, entrepreneurship education is aimed at developing learners’ knowledge and skills for self-sustainability and economic development. The emergence of small businesses is one of the main forces behind a country’s economy and has a significant impact on economic expansion, job creation, and the country's ability to compete internationally. Using the human capital theory, this study aimed to explore how Consumer studies can enhance the acquisition of entrepreneurial knowledge and skills among learners in selected secondary schools in the Eastern Cape province, South Africa. The study is lensed within constructivism paradigm, with a qualitative research approach, case study design, and purposively sampled fourteen participants. Eight educators from eight public secondary schools (four in the Amathole Education District and four in Mnquma Education District), four principals (two from each education district) and two subject advisors (one from each education district) were sampled for the study. Data were collected through face-to-face semi-structured interviews, thematically analysed, and presented according to themes derived from the findings. The study revealed several varied views and experiences on the role of consumer studies in the enhancement of knowledge and skills in entrepreneurship. The findings revealed challenges experienced in the offering of Consumer studies, which include but are not limited to the shortage of adequately trained educators, inappropriate infrastructure, large learner numbers, minimal financial support, and a lack of instructional materials. If left unaddressed, these issues have the potential to undermine the value of Consumer studies as a vehicle for empowerment and change. Recommendations include targeted curriculum revision to streamline content, embracing learner-centred approaches, prioritising subject-oriented professional development, integrating technology for enhanced learning experiences, improving financial support and provision of relevant infrastructure. Keywords: Consumer studies, entrepreneurship, skills acquisition, secondary school. , Thesis (D.Ed) -- Faculty of Education, 2024
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Vertical price transmission of wheat in South Africa

  • Authors: Swapi, Asemahle
  • Date: 2024-00
  • Subjects: Commerce
  • Language: English
  • Type: Masters theses , text
  • Identifier: http://hdl.handle.net/11260/11040 , vital:75880
  • Description: The ability of markets to communicate food price signals at different levels of marketing chains is critical to understanding the nature of the competition in the chain, and development of strategies to address challengers of information symmetry and food insecurity. This study examined vertical transmission of wheat price among the main value chain, looking at the pricing behaviour of certain role players in the wheat production/supply and distribution of bread which is a major staple food consumed in South Africa. A nonlinear autoregressive distributed lag model (NARDL) model was used to analyse the yearly time series data for the period of 2000 to 2022. The results of the stationarity test showed that all variables were of order one, I(1). The study used two pairs, namely farmgate price and retail price and farmgate price and wholesale price, to examine the existence of asymmetry between these prices, with rainfall and temperature as control variables. The results indicate the existence of positive long-run asymmetry of 35,9% between farmgate price of wheat and retail price of bread, and 3,49% asymmetry between farmgate price and wholesale price of wheat. In order to develop informed policies on food security, this study suggests that the government should enhance regular access to data and sustain its monitoring and communication of food price information across the whole country. The other thing that is recommended by the study is the provision of subsidies for wheat farmers to help the wheat industry, reduce the cost of bread production, and make bread more affordable and accessible for consumers. , Thesis (Masters) -- Faculty of Economic and Financial Sciences, 2024
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Association of antiretroviral therapy adherence and Development of cardiovascular desease risk

  • Authors: Fihla, Qhayiya Mteto
  • Date: 2023-12
  • Language: English
  • Type: Masters theses , text
  • Identifier: http://hdl.handle.net/11260/12894 , vital:76176
  • Description: IAntiretroviral therapy (ART) is the standard treatment for human immunodeficiency virus (HIV). The treatment reduces HIV load to low level, relegating the disease from an acute infection to a chronic condition. Of late, there have been increased reports associating ART with increased cardiovascular disease (CVD) risk, further reducing the possibility of complete positive health outcomes for people living with HIV (PLWH). Poor adherence to the ART has been implicated in the development of some CVD risk factors but levels of adherence is not well known in the Eastern Cape. Thus, this study was designed to determine the level of ART adherence and associated cardiovascular risk factors. A cross-sectional study of a 100 participants was conducted to determine ART adherence and prevalence CVD risk factors in Mthatha. Both Male and female participants above 18 years of age were selected and ART adherence was determined using the adherence in chronic diseases scale (ACDS). The lipid profile, anthropometric measurements, and clinical parameters were used to determine CVD risk factors. Regression models were fitted to determine the association between adhrence and CVD risk factors in PLWH. All statistical analysis was performed using the statistical package for social sciences (SPSS) version 28, and the statistical significance was set at The average adherence rate was found to be 90.35% population of PLWH sampled, and 30% participants were found to have the optimum adherence rate ≥95%, which considered be adequate to effect viral progression. The prevalence of CVD risk factors was found to be 97%, with 46% of the participants having CVD. Although it was not statistically significant, the regression analyses indicated that non-adherent patients were more likely to report presence of CVD risk factors. This suggests that sub-optimal adherence to ART may be a contributing factor towards CVD risk development in patients on ART. It is possible that the results are clinically significant but there is a need to collect more data to increase the statistical power of the study , Thesis (Masters) -- Faculty of Medicine and Health Sciences, 2023
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Screening medical plants for potential immunomodulatory action on macrophages in the fight against mycobacterium tuberculosis.

  • Authors: Shauli, Mathulo Mthabiso
  • Date: 2023-12
  • Language: English
  • Type: Doctoral theses , text
  • Identifier: http://hdl.handle.net/11260/12744 , vital:76161
  • Description: Pulmonary tuberculosis remains the leading cause of death in developing countries, it is an ancient disease that was discovered in the eighteenth centuries. The World Health Organization (WHO) tuberculosis (TB) regimen entails the first line drugs, rifampicin, isoniazid, ethambutol, and pyrazinamide. These drugs are taken for long periods and the load is high, they carry some side effects like liver damage and peripheral neuropathies, hence pyridoxine that is administered with TB treatment to mitigate the toxic effects to peripheral nerves. Drug resistance has emerged because of unbearable side effects of TB treatment in TB patients. In view of all these collective challenges of TB drugs, this study draws its motivation towards exploring natural products in the form of medicinal plants toward inventing new therapies that could be easily available and safer, and the macrophages were considered the therapeutic target for this study as they are the primary cells that get infected by Mycobacterium in the lung. Therefore, the study aimed at screening medicinal plants used by traditional healers and herbalists for the management and control of signs and symptoms related to pulmonary tuberculosis, for potential immunomodulatory activity on RAW 264.7 cells, and the objectives were; to obtain information on indigenous plants used to treat pulmonary tuberculosis (PTB) from traditional healers and herbalist, to test the cytotoxicity of crude extracts on macrophages and hepatocytes (C3A cells), to determine the polarizing effects of crude extracts on macrophages, to determine the polarizing effect of the crude extract fractions on macrophages and to finally isolate and characterize the compounds in active fraction. vii All medicinal plants investigated in this study were collected through ethnobotanical survey, authenticated in Botany Department, dried, and extracted in 70% ethanol solvent. The dried crude extracts were screened for toxicity using 3-4,5-dimethylthiazole-24-25 diphenyl tetrazolium bromide (MTT) technique on RAW264.7 macrophages and dual fluorescence staining technique on C3A cells at concentration 50, 100 and 200μg/ml in cell culture system. Seven medicinal plants displayed dose dependency toxicity, while three plants did not show any signs of toxicity with cell viability maintained at 100%. The three medicinal plants (Anthrixia phylicoides, Lippia javanica and Sanicula elata) were further investigated for immunomodulatory activity (Griess method) and antioxidant activity (CellROX® Orange and Hoechst 33342). Lippia and Anthrixia were found to be anti-inflammatory with low amounts of nitric oxide (NO) production, while Sanicula displayed a considerable amount of nitric oxide when compared to the lipopolysaccharides (LPS) control. NO was the biological marker measured that demonstrated the immunomodulatory effect of plants on macrophages. Furthermore, the two plants showed antioxidant activity on liver cells at higher concentration (100 and 200μM) while Sanicula exhibited antioxidant activity across all tested concentrations. Compound profiling for Sanicula was therefore determined by UPLC-MS hyphenation technique and the major compounds profiled were phenolic compounds. The crude extracts of Sanicula were further partitioned into five fractions using partition solvent technique (n-hexane, Dichloromethane, ethyl acetate, N-butanol, and water). Anti-inflammatory activity was repeated on the five fractions, and Dichloromethane fraction and water fraction drove the macrophage switching towards the M1 phenotype viii with considerable amount of NO produced. Compound isolation and identification was conducted through chromatography techniques, and ten samples (S1-S10) were isolated. The samples were further subjected to NMR-Spectrometry analysis for elucidation and characterization of isolated compounds, and S1, S7, S9, S10 were final compounds. RAW 264.7 cells were again treated with the four compounds and results indicated absence of NO production, the opposite of the two previous outcomes where there was clear evidence of immunomodulation. The results obtained from the compounds has indicated that drugs work in synergy, and in combination, like TB treatment which is taken as combination of all drugs. We therefore conclude that indeed Sanicula immunomodulated RAW264.7 macrophages, and we present a strong observation of macrophage polarization from M0 phenotype to M1 phenotype which is capable of degrading and destroying Mycobacterium, and the antioxidant activity of the crude extracts of this medicinal plant. We therefore recommend further studies in the animal disease model. , Thesis (D.Ed) -- Faculty of Medicine and Health Sciences, 2023
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COVID-19 in Psychiatric Inpatients: A South African Descriptive Study Conducted at Fort England

  • Authors: Gwanya-Mdletye, Sisikelelwe Sylvia
  • Date: 2023-11
  • Language: English
  • Type: Masters theses , text
  • Identifier: http://hdl.handle.net/11260/12977 , vital:76184
  • Description: Psychiatric patients are known to have an increased risk of adverse outcomes from COVID-19. Some psychiatric medications are known to have cardiometabolic and immune system-related side effects and have been found to either protect from or worsen outcomes in COVID-19 illness. The interaction of COVID-19 with the cardiometabolic and immune-related aspects of psychiatric illness and treatment has not been sufficiently studied in people with mental illness. Aim: To describe the clinical and demographic characteristics, and clinical outcomes of adult inpatients at Fort England Psychiatric Hospital who contracted SARS-CoV-2 during the first wave of the COVID-19 pandemic, including statistical and case analyses of COVID-19 related deaths. Methods: The study was conducted at Fort England Hospital (FEH). Data were obtained from patient files, treatment charts, and the hospital's COVID-19 reporting schedules. Sixty-four patients were diagnosed with COVID-19 during the first wave of infections in the hospital, and five of them died. A cross-sectional research design was adopted, in which the COVID-19 outcomes of the 64 patients were described alongside their psychiatric disease and treatment factors. Descriptive statistics were used to describe the characteristics of the participants. Fisher’s exact test for contingency tables and Cramér's V effect size were computed to identify possible associations between death and specified clinical variables. Additionally, case analyses were carried out on each patient who died based on participant case notes. Results: The incidence of SARS-CoV-2 infections was 21.8% during the first wave of infections, and the case fatality rate was 7.8%. A significant association was ii found between higher age and COVID-19 related death (Fisher’s exact test p = 0.010). Two-thirds (68%) of the patients who recovered were younger than 45, whereas one of the five patients who died (20%) fell in this age group. Race was also strongly related to COVID-19 outcomes, with coloured comprising 80% of the participants who died compared to 80% of black African patients in the recovered group (Fisher’s exact test p = 0.012). All patients who died had co-morbid medical conditions compared to 58% of those who recovered, although this relationship was weak (Fisher’s exact 1-sided test p = 0.076). However, case analyses for the patients who died revealed recurring themes of multiple psychiatric comorbidities, proneness to psychotropic treatment side effects, and a history of frequent relapses among most of these patients. All who died were faced with adversity and dire life circumstances. Conclusions: This study contributes to a better understanding of clinical, demographic and social variables that impacts COVID-19 outcomes in an in-patient psychiatric population. first wave of the COVID-19 pandemic in patients with serious mental illness in an inpatient population. More studies of a larger scale are needed to describe the COVID-19 pandemic among psychiatric populations and to investigate factors that contribute to the vulnerability of psychiatric patients to adverse outcomes of COVID-19. , Thesis (Masters) -- Faculty of Medicine and Health Sciences, 2023
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