Formulation of Fish Feed from Supermarket Food Waste
- Authors: Vundisa, Noluyolo
- Date: 2024
- Subjects: Food waste , Aquafeed , Retail sector , Sustainable aquaculture , Resource recovery , Specific growth rate
- Language: English
- Identifier: http://hdl.handle.net/11260/13401 , vital:78701
- Description: Food waste (FW) represents a significant anthropogenic burden, driving economic losses, environmental degradation, and social disparities. This study aimed to elucidate the seasonal variability and compositional heterogeneity of FW generated within the retail sector, specifically focusing on its potential as a novel aqua-feed resource. A comprehensive 12-month sampling protocol was implemented across four retail departments, followed by a detailed proximate chemical analysis of processed FW. Three experimental diets were formulated, incorporating 0%, 25%, and 50% FW, and evaluated in a six-week feeding trial using tilapia. Seasonal analysis revealed a consistent dominance of vegetable waste, with peak contributions reaching 65.7% in spring and a notable contribution from fruit waste. Conversely, bakery and grain waste constituted minor fractions of the overall FW stream. Diet 1 exhibited the highest overall specific growth rate, reaching 1.54±0.12, surpassing diet 3 (0.86±0.57) and diet 2 (0.74±0.62). Specific growth rate analysis demonstrated a statistically significant advantage for the control diet, highlighting the need for further nutritional optimization of FW-based diets. This research quantifies the substantial daily FW generation within retail environments, emphasizing the critical need for targeted waste mitigation strategies. Moreover, it establishes the potential for sustainable FW repurposes within aquaculture, offering a viable alternative to conventional feed ingredients. Future investigations should prioritize optimizing FW processing techniques, rigorous safety assessments, and developing nutritionally balanced feed formulations to enhance digestibility and promote sustainable aquaculture practices. , Thesis (Doctoral)
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- Authors: Vundisa, Noluyolo
- Date: 2024
- Subjects: Food waste , Aquafeed , Retail sector , Sustainable aquaculture , Resource recovery , Specific growth rate
- Language: English
- Identifier: http://hdl.handle.net/11260/13401 , vital:78701
- Description: Food waste (FW) represents a significant anthropogenic burden, driving economic losses, environmental degradation, and social disparities. This study aimed to elucidate the seasonal variability and compositional heterogeneity of FW generated within the retail sector, specifically focusing on its potential as a novel aqua-feed resource. A comprehensive 12-month sampling protocol was implemented across four retail departments, followed by a detailed proximate chemical analysis of processed FW. Three experimental diets were formulated, incorporating 0%, 25%, and 50% FW, and evaluated in a six-week feeding trial using tilapia. Seasonal analysis revealed a consistent dominance of vegetable waste, with peak contributions reaching 65.7% in spring and a notable contribution from fruit waste. Conversely, bakery and grain waste constituted minor fractions of the overall FW stream. Diet 1 exhibited the highest overall specific growth rate, reaching 1.54±0.12, surpassing diet 3 (0.86±0.57) and diet 2 (0.74±0.62). Specific growth rate analysis demonstrated a statistically significant advantage for the control diet, highlighting the need for further nutritional optimization of FW-based diets. This research quantifies the substantial daily FW generation within retail environments, emphasizing the critical need for targeted waste mitigation strategies. Moreover, it establishes the potential for sustainable FW repurposes within aquaculture, offering a viable alternative to conventional feed ingredients. Future investigations should prioritize optimizing FW processing techniques, rigorous safety assessments, and developing nutritionally balanced feed formulations to enhance digestibility and promote sustainable aquaculture practices. , Thesis (Doctoral)
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Health Care Professionals’ Attitudes Towards Patients with Mental Illness at Nelson Mandela Central Hospital
- Authors: Mateta, Silwana P Z
- Date: 2024
- Subjects: Mental illness , Health care professionals , Nelson Mandela Central Hospital
- Language: English
- Type: Masters (Thesis)
- Identifier: http://hdl.handle.net/11260/13472 , vital:78934
- Description: The belief that persons with mental illness are dangerous and unpredictable has been noted in several studies. This perception is often associated with fear in those who hold this belief. The unpredictable nature of mental illness may also be a factor in how health care professionals react to and provide care for mentally ill patients. This may lead to an increase in negative attitudes towards mentally ill patients thereby resulting in negative patient outcomes. In South Africa (SA) there is paucity of literature regarding attitudes towards mental illness. Most studies done in SA have focused on patients’ experience of stigma and community attitudes towards people with mental illness. This research was conducted against this background to assess health care professionals’ attitudes towards patients with mental illness at the study site, which was at Nelson Mandela Central Hospital, in the Eastern Cape. The aim of this study was thus to investigate the attitudes of health care professionals working at Nelson Mandela Central Hospital towards patients with mental illness… , Degree: M. Medicine (Psychiatry)
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- Authors: Mateta, Silwana P Z
- Date: 2024
- Subjects: Mental illness , Health care professionals , Nelson Mandela Central Hospital
- Language: English
- Type: Masters (Thesis)
- Identifier: http://hdl.handle.net/11260/13472 , vital:78934
- Description: The belief that persons with mental illness are dangerous and unpredictable has been noted in several studies. This perception is often associated with fear in those who hold this belief. The unpredictable nature of mental illness may also be a factor in how health care professionals react to and provide care for mentally ill patients. This may lead to an increase in negative attitudes towards mentally ill patients thereby resulting in negative patient outcomes. In South Africa (SA) there is paucity of literature regarding attitudes towards mental illness. Most studies done in SA have focused on patients’ experience of stigma and community attitudes towards people with mental illness. This research was conducted against this background to assess health care professionals’ attitudes towards patients with mental illness at the study site, which was at Nelson Mandela Central Hospital, in the Eastern Cape. The aim of this study was thus to investigate the attitudes of health care professionals working at Nelson Mandela Central Hospital towards patients with mental illness… , Degree: M. Medicine (Psychiatry)
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Molecular analysis of Tigecycline Resistance in Carbapenem-Resistant Enterobacterales (CRE) in Mthatha and surrounding hospitals
- Authors: Vumba, Luyolo
- Date: 2024
- Subjects: Tigecycline resistance , E-test CRE infections , Risk factors associated with tigecycline resistance , Tet(X) genes , PCR
- Language: English
- Type: Masters (Thesis)
- Identifier: http://hdl.handle.net/11260/13529 , vital:78944
- Description: The emergency of carbapenem-resistant Enterobacterales is prevalent and poses a significant threat to health systems worldwide. The European Center for Disease Control and Prevention has reported a mortality rate of about 50% in patients with CRE bloodstream infections. This study aimed to conduct a molecular analysis of tigecycline resistance in 100 CRE in clinical isolates from Mthatha and surrounding hospitals. The results showed a notable high prevalence of CRE infections in neonatal, male surgical, and maternal and pediatric wards, predominantly driven by Klebsiella spp. (53.4%), followed by Enterobacter spp. (20.5 %), then Escherichia coli (6.7%). The present study performed tigecycline AST using an E-test on 100 CRE hospital isolates., A total of 92.8 % CRE was susceptible to tigecycline, 1.6 % intermediate resistant to tigecycline, and 5.8 % resistant to tigecycline. A multiplex SYBR green-based PCR assay for rapid detection of tet(X) and its variants, including tet(X1), tet(X2), and high-level tigecycline resistance genes tet(X3), tet(X4), and tet(X5) were developed. The results in 100 CRE clinical isolates studied indicated that there were no tet (X) gene detected that was responsible for tigecycline resistance. The risk factors associated with tigecycline resistance in CRE include age, pre-exposure to antibiotics, prolonged hospitalization, and undergoing invasive procedures indicated by strong r2 =0.9501. CRE gradually evolves, posing a significant threat to patients of all ages. Early detection of carbapenemase production in clinical infections, carriage states, or both is essential to prevent hospital based outbreaks. As using Tigecycline is the last line of treatment for CRE infection, the high rate of tigecycline resistance in this study is alarming for the healthcare system in South Africa. Tigecycline combination therapy is recommended when treating critically ill patients. Tet (X) genes are not responsible for tigecycline resistance in the sample of this study. The risk factors associated with tigecycline resistance in CRE include age, pre exposure to antibiotics, prolonged hospitalization, and undergoing invasive procedures. , Degree: M. Science (Medical Microbiology)
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- Authors: Vumba, Luyolo
- Date: 2024
- Subjects: Tigecycline resistance , E-test CRE infections , Risk factors associated with tigecycline resistance , Tet(X) genes , PCR
- Language: English
- Type: Masters (Thesis)
- Identifier: http://hdl.handle.net/11260/13529 , vital:78944
- Description: The emergency of carbapenem-resistant Enterobacterales is prevalent and poses a significant threat to health systems worldwide. The European Center for Disease Control and Prevention has reported a mortality rate of about 50% in patients with CRE bloodstream infections. This study aimed to conduct a molecular analysis of tigecycline resistance in 100 CRE in clinical isolates from Mthatha and surrounding hospitals. The results showed a notable high prevalence of CRE infections in neonatal, male surgical, and maternal and pediatric wards, predominantly driven by Klebsiella spp. (53.4%), followed by Enterobacter spp. (20.5 %), then Escherichia coli (6.7%). The present study performed tigecycline AST using an E-test on 100 CRE hospital isolates., A total of 92.8 % CRE was susceptible to tigecycline, 1.6 % intermediate resistant to tigecycline, and 5.8 % resistant to tigecycline. A multiplex SYBR green-based PCR assay for rapid detection of tet(X) and its variants, including tet(X1), tet(X2), and high-level tigecycline resistance genes tet(X3), tet(X4), and tet(X5) were developed. The results in 100 CRE clinical isolates studied indicated that there were no tet (X) gene detected that was responsible for tigecycline resistance. The risk factors associated with tigecycline resistance in CRE include age, pre-exposure to antibiotics, prolonged hospitalization, and undergoing invasive procedures indicated by strong r2 =0.9501. CRE gradually evolves, posing a significant threat to patients of all ages. Early detection of carbapenemase production in clinical infections, carriage states, or both is essential to prevent hospital based outbreaks. As using Tigecycline is the last line of treatment for CRE infection, the high rate of tigecycline resistance in this study is alarming for the healthcare system in South Africa. Tigecycline combination therapy is recommended when treating critically ill patients. Tet (X) genes are not responsible for tigecycline resistance in the sample of this study. The risk factors associated with tigecycline resistance in CRE include age, pre exposure to antibiotics, prolonged hospitalization, and undergoing invasive procedures. , Degree: M. Science (Medical Microbiology)
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Morpho-physiological and biochemical responses of five Zea mays cultivars to drought stress
- Authors: Gwexa, Sinazo Yonela
- Date: 2024
- Subjects: Antioxidant enzymes , Drought stress , Maize
- Language: English
- Type: Masters (Thesis)
- Identifier: http://hdl.handle.net/11260/13453 , vital:78933
- Description: Maize (Zea mays) is essential for global food security, providing sustenance to billions, especially in developing countries. With the global population projected to reach 9.7 billion by 2050, maize demand will significantly increase, requiring improved agricultural practices and resilient varieties. However, drought is a major threat to maize production, particularly in semi-arid regions like South Africa, where rainfall is often scarce. This study aims at investigating the morphological, physiological, and biochemical responses of five maize cultivars—CY2 DKC72-76BR, CY3 DKC74-26R, CW1 DKC75-65BR, CY1 DKC71-44B, and CW3 DKC78-45BRGEN—with the goal of identifying specific traits indicative of drought tolerance. The plants were subjected to well-watered and water-deprived conditions for 21 days. Key parameters, including shoot and root growth, relative water content (RWC), H2O2, lipid peroxidation, and antioxidant enzymes (ascorbate peroxidase and superoxide dismutase), were measured to assess drought tolerance. The results revealed that drought stress significantly reduced shoot and root lengths, weights, and RWC of water-deprived cultivars when compared to the well-watered cultivars. Elevated hydrogen peroxide (H2O2) and lipid peroxidation indicated increased oxidative stress under water deprivation. Drought tolerant varieties exhibited higher antioxidant enzyme activity, suggesting a potential mitigation of oxidative stress… , Degree: M.Botany
- Full Text:
- Authors: Gwexa, Sinazo Yonela
- Date: 2024
- Subjects: Antioxidant enzymes , Drought stress , Maize
- Language: English
- Type: Masters (Thesis)
- Identifier: http://hdl.handle.net/11260/13453 , vital:78933
- Description: Maize (Zea mays) is essential for global food security, providing sustenance to billions, especially in developing countries. With the global population projected to reach 9.7 billion by 2050, maize demand will significantly increase, requiring improved agricultural practices and resilient varieties. However, drought is a major threat to maize production, particularly in semi-arid regions like South Africa, where rainfall is often scarce. This study aims at investigating the morphological, physiological, and biochemical responses of five maize cultivars—CY2 DKC72-76BR, CY3 DKC74-26R, CW1 DKC75-65BR, CY1 DKC71-44B, and CW3 DKC78-45BRGEN—with the goal of identifying specific traits indicative of drought tolerance. The plants were subjected to well-watered and water-deprived conditions for 21 days. Key parameters, including shoot and root growth, relative water content (RWC), H2O2, lipid peroxidation, and antioxidant enzymes (ascorbate peroxidase and superoxide dismutase), were measured to assess drought tolerance. The results revealed that drought stress significantly reduced shoot and root lengths, weights, and RWC of water-deprived cultivars when compared to the well-watered cultivars. Elevated hydrogen peroxide (H2O2) and lipid peroxidation indicated increased oxidative stress under water deprivation. Drought tolerant varieties exhibited higher antioxidant enzyme activity, suggesting a potential mitigation of oxidative stress… , Degree: M.Botany
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Navigating the Antimicrobial Resistance (AMR) Landscape:Strategies and Challenges in addressing drivers of AMR
- Authors: Vasaikar, Sandeep D
- Date: 2024
- Subjects: Antimicrobial Resistance (AMR) Landscape:Strategies and Challenges in addressing drivers of AMR Antimicrobial Resistance (AMR) Cancer -- Patients
- Language: English
- Type: text , Lectures
- Identifier: http://hdl.handle.net/11260/10409 , vital:75125
- Full Text:
- Authors: Vasaikar, Sandeep D
- Date: 2024
- Subjects: Antimicrobial Resistance (AMR) Landscape:Strategies and Challenges in addressing drivers of AMR Antimicrobial Resistance (AMR) Cancer -- Patients
- Language: English
- Type: text , Lectures
- Identifier: http://hdl.handle.net/11260/10409 , vital:75125
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Stigma In Women With Infertility In A Rural Community In The Eastern Cape Province: A Qualitative Study
- Authors: Nqeketo, Nasiphi
- Date: 2024
- Subjects: Infertility in women , Stigma and infertility , Eastern Cape
- Language: English
- Type: Masters (Thesis)
- Identifier: http://hdl.handle.net/11260/13414 , vital:78866
- Description: The stigma surrounding infertility is a problem linked with different psychological and social difficulties, particularly for women, as well as a sense of shame and concealment. Infertile women experience high levels of stigma in South Africa. The infertility stigma is regarded as one of the greatest challenges in most societies for reproduction and sexual health of infertile women. This study aims to explore the intersection of stigma, demographic characteristics, experiences, and coping mechanisms among women with infertility in Mount Ayliff, Eastern Cape Province… , Degree: M. Public Health
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- Authors: Nqeketo, Nasiphi
- Date: 2024
- Subjects: Infertility in women , Stigma and infertility , Eastern Cape
- Language: English
- Type: Masters (Thesis)
- Identifier: http://hdl.handle.net/11260/13414 , vital:78866
- Description: The stigma surrounding infertility is a problem linked with different psychological and social difficulties, particularly for women, as well as a sense of shame and concealment. Infertile women experience high levels of stigma in South Africa. The infertility stigma is regarded as one of the greatest challenges in most societies for reproduction and sexual health of infertile women. This study aims to explore the intersection of stigma, demographic characteristics, experiences, and coping mechanisms among women with infertility in Mount Ayliff, Eastern Cape Province… , Degree: M. Public Health
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The Potrayal of Violence Against Women in Selected Sesotho Prose Fiction
- Authors: Letuka, Moeketsi
- Date: 2024
- Subjects: Gender-Based Violence , Violence against women , African feminism , Psychological violence
- Language: English
- Type: Masters (Thesis)
- Identifier: http://hdl.handle.net/11260/13503 , vital:78940
- Description: Violence Against Women (VAW) in Sesotho prose fiction has received little attention. Yet, there are prose narratives that portray this form of violence. The focus of this research is on these acts of VAW, how they are portrayed and how they affect women. The study is guided by the research question: How is Violence against women portrayed in selected Sesotho prose fiction? The understanding is that in typical Basotho patriarchal society, women were, and still are, in some parts of the country, regarded as inferior and are receivers of violence from males. This is the case in love relationships, whether married or not. It is also a case in general, where men mostly dominate women. This form of violence may be verbal or emotional or physical, men being instigators. Regardless of whether verbal or physical, the harm is destructive to women. Feminism, particularly African feminism is used as a theoretical framework in this study. Feminist theory seeks to raise awareness and address this form of violence, along with other related injustices, against women in general. Nevertheless, it should be realised that women in different continents, countries and races may have different yet similar challenges which they seek to address. The Feminist theory that is employed as a theoretical framework in this research is African Feminism, which addresses the challenges of Black African Women. A secondary theory that is used in this study is psychoanalysis theory, which seeks to analyse reasons why certain characters behave as they do. The study uses desktop research as its methodology, where four Sesotho prose fiction texts were be used as primary data collection sources and were analysed using Textual Analysis theory. The collected data was analysed using thematic analysis. The study has found that physical violence affects women psychologically; and children often find themselves in the middle of the crossfire between two fighting parents, which influences their psychological development. , Degree: M. Arts
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- Authors: Letuka, Moeketsi
- Date: 2024
- Subjects: Gender-Based Violence , Violence against women , African feminism , Psychological violence
- Language: English
- Type: Masters (Thesis)
- Identifier: http://hdl.handle.net/11260/13503 , vital:78940
- Description: Violence Against Women (VAW) in Sesotho prose fiction has received little attention. Yet, there are prose narratives that portray this form of violence. The focus of this research is on these acts of VAW, how they are portrayed and how they affect women. The study is guided by the research question: How is Violence against women portrayed in selected Sesotho prose fiction? The understanding is that in typical Basotho patriarchal society, women were, and still are, in some parts of the country, regarded as inferior and are receivers of violence from males. This is the case in love relationships, whether married or not. It is also a case in general, where men mostly dominate women. This form of violence may be verbal or emotional or physical, men being instigators. Regardless of whether verbal or physical, the harm is destructive to women. Feminism, particularly African feminism is used as a theoretical framework in this study. Feminist theory seeks to raise awareness and address this form of violence, along with other related injustices, against women in general. Nevertheless, it should be realised that women in different continents, countries and races may have different yet similar challenges which they seek to address. The Feminist theory that is employed as a theoretical framework in this research is African Feminism, which addresses the challenges of Black African Women. A secondary theory that is used in this study is psychoanalysis theory, which seeks to analyse reasons why certain characters behave as they do. The study uses desktop research as its methodology, where four Sesotho prose fiction texts were be used as primary data collection sources and were analysed using Textual Analysis theory. The collected data was analysed using thematic analysis. The study has found that physical violence affects women psychologically; and children often find themselves in the middle of the crossfire between two fighting parents, which influences their psychological development. , Degree: M. Arts
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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
- Full Text:
- 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
- Full Text:
- 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
- Full Text:
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
- Full Text:
- 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
- Full Text:
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
- Full Text:
- 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
- Mtshatsha, Nondwe Daphne Mariana
- 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
- Full Text:
- 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
- Full Text:
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
- Full Text:
- 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
- Full Text:
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
- Full Text:
- 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
- Full Text:
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
- Full Text:
- 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
- Full Text:
COVID-19 in Psychiatric Inpatients: A South African Descriptive Study Conducted at Fort England
- Gwanya-Mdletye, Sisikelelwe Sylvia
- 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
- Full Text:
- 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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Impact of novel software on laboratory expenditure at an academic hospital in South Africa
- Mayekiso, Zoliswa, Oladimeji, E Kelechi, Estrada, Pulido A Guillermo, Apalata, R. Teke
- Authors: Mayekiso, Zoliswa , Oladimeji, E Kelechi , Estrada, Pulido A Guillermo , Apalata, R. Teke
- Date: 2023/11
- Subjects: Gatekeeping , Medical laboratory expenditure , Cost effectiveness , Intervention , Rural academic hospital , South Africa , Interrupted time series
- Language: English
- Type: Article
- Identifier: http://hdl.handle.net/11260/13388 , vital:78679 , DOI: 10.4102/ajlm.v12i1.2159
- Description: Background: 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 US dollars (USD) from $7.1 billion USD in 2018. In South Africa, laboratory testing expenditure in the public sector increased from $415 million USD in 2014 to $723 million USD in 2021. Objective: This study aimed to evaluate the impact of an innovative software, electronic gatekeeping (EGK), on medical laboratory test expenditures at Nelson Mandela Academic Hospital, in the Eastern Cape, South Africa. Methods: In this cross-sectional study, an interrupted time series analysis technique was used to evaluate trends in expenditure during a 48-month study period. To measure the impact of EGK on laboratory expenditure, we analysed laboratory expenditure over two study periods: a period of 24 months occurring before EGK implementation (01 June 2013 to 31 May 2015) and a period of 24 months occurring during EGK implementation (01 June 2015 to 30 May 2017). Results: There was a significant reduction (211928 fewer tests) in the number of tests performed during the intervention (434790) compared to before the intervention (646718). Laboratory test expenditure was $1 663 756.72 USD before the intervention period and $1 105 036.88 USD during the intervention period, demonstrating a cost savings of $558 719.84 USD. Conclusion: Electronic gatekeeping is a cost-effective intervention for managing medical laboratory expenditures. We recommend that the health sector scale up this intervention nationally.
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- Authors: Mayekiso, Zoliswa , Oladimeji, E Kelechi , Estrada, Pulido A Guillermo , Apalata, R. Teke
- Date: 2023/11
- Subjects: Gatekeeping , Medical laboratory expenditure , Cost effectiveness , Intervention , Rural academic hospital , South Africa , Interrupted time series
- Language: English
- Type: Article
- Identifier: http://hdl.handle.net/11260/13388 , vital:78679 , DOI: 10.4102/ajlm.v12i1.2159
- Description: Background: 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 US dollars (USD) from $7.1 billion USD in 2018. In South Africa, laboratory testing expenditure in the public sector increased from $415 million USD in 2014 to $723 million USD in 2021. Objective: This study aimed to evaluate the impact of an innovative software, electronic gatekeeping (EGK), on medical laboratory test expenditures at Nelson Mandela Academic Hospital, in the Eastern Cape, South Africa. Methods: In this cross-sectional study, an interrupted time series analysis technique was used to evaluate trends in expenditure during a 48-month study period. To measure the impact of EGK on laboratory expenditure, we analysed laboratory expenditure over two study periods: a period of 24 months occurring before EGK implementation (01 June 2013 to 31 May 2015) and a period of 24 months occurring during EGK implementation (01 June 2015 to 30 May 2017). Results: There was a significant reduction (211928 fewer tests) in the number of tests performed during the intervention (434790) compared to before the intervention (646718). Laboratory test expenditure was $1 663 756.72 USD before the intervention period and $1 105 036.88 USD during the intervention period, demonstrating a cost savings of $558 719.84 USD. Conclusion: Electronic gatekeeping is a cost-effective intervention for managing medical laboratory expenditures. We recommend that the health sector scale up this intervention nationally.
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A Comparative Analysis of PSA Trends of Conventional vs Hypo-fractionated External Beam Radiotherapy for the Treatment of Localised Prostate Cancer at Frere Hospital
- Authors: Mistry, Himal
- Date: 2023-10
- Language: English
- Type: Masters theses , text
- Identifier: http://hdl.handle.net/11260/12906 , vital:76177
- Description: External beam radiotherapy with a moderate hypofractionated regimen has largely replaced conventional schedules. The change in regimen is based on the premise that prostate cancer, due to its low the alpha/beta ratio, demonstrates a higher sensitivity to a larger dose per fraction of radiation. Prostate Specific Antigen (PSA) is a specific indicator of prostate cancer treatment outcomes. The serum PSA trend is an indication of treatment response and risk for relapse. The time to nadir and the value of the PSA nadir are important predictors of biochemical control or failure. The lower the PSA level, the more durable the probability of maintained biochemical disease free survival. This study focuses on the biochemical control of patients treated with two different fractionation regimens at Frere Hospital. Aim To illustrate that the use of a moderate hypofractionated regimen for the treatment of intermediate and high risk prostate cancer is non inferior to a conventional regimen. Methodology The study took place at the department of radiation oncology, Frere Hospital, East London, Eastern Cape, South Africa. The study population consisted of 26 patients treated with conventional fractionation (2.00Gy x 36 fractions) in 2018 and 36 patients treated with the newly adopted hypofractionated regimen (3.00Gy x 20 fractions) in 2019. A comparison is made of the post treatment PSA trend over a 24 month period. Impact of study The study is projected to support the change in fractionation regimens at an institutional level. 2 Results: 41.9% of patients were enrolled in the conventional regimen, 58.1% were enrolled in the moderately hypo-fractionated arm. The participants were classified into high risk and intermediate risk in the two treatment arms and these were distributed equally. There was a clear decline in the serum PSA values over the two-year follow-up period. All four groups showed a similar pattern in that from the baseline to the first quarter, there was a sharp decline in the serum PSA values and this was significant for all four groups , Thesis (Masters) -- Faculty of Medicine and Health Sciences, 2023
- Full Text:
- Authors: Mistry, Himal
- Date: 2023-10
- Language: English
- Type: Masters theses , text
- Identifier: http://hdl.handle.net/11260/12906 , vital:76177
- Description: External beam radiotherapy with a moderate hypofractionated regimen has largely replaced conventional schedules. The change in regimen is based on the premise that prostate cancer, due to its low the alpha/beta ratio, demonstrates a higher sensitivity to a larger dose per fraction of radiation. Prostate Specific Antigen (PSA) is a specific indicator of prostate cancer treatment outcomes. The serum PSA trend is an indication of treatment response and risk for relapse. The time to nadir and the value of the PSA nadir are important predictors of biochemical control or failure. The lower the PSA level, the more durable the probability of maintained biochemical disease free survival. This study focuses on the biochemical control of patients treated with two different fractionation regimens at Frere Hospital. Aim To illustrate that the use of a moderate hypofractionated regimen for the treatment of intermediate and high risk prostate cancer is non inferior to a conventional regimen. Methodology The study took place at the department of radiation oncology, Frere Hospital, East London, Eastern Cape, South Africa. The study population consisted of 26 patients treated with conventional fractionation (2.00Gy x 36 fractions) in 2018 and 36 patients treated with the newly adopted hypofractionated regimen (3.00Gy x 20 fractions) in 2019. A comparison is made of the post treatment PSA trend over a 24 month period. Impact of study The study is projected to support the change in fractionation regimens at an institutional level. 2 Results: 41.9% of patients were enrolled in the conventional regimen, 58.1% were enrolled in the moderately hypo-fractionated arm. The participants were classified into high risk and intermediate risk in the two treatment arms and these were distributed equally. There was a clear decline in the serum PSA values over the two-year follow-up period. All four groups showed a similar pattern in that from the baseline to the first quarter, there was a sharp decline in the serum PSA values and this was significant for all four groups , Thesis (Masters) -- Faculty of Medicine and Health Sciences, 2023
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The Detection of Mutations and Genotyping of Drug-Resistant Mycobacterium tuberculosis Strains Isolated from Patients in the Rural Eastern Cape Province
- Faye, M Lindiwe, Hosu, C Mojisola, Oostvogels, Selien, Dippenaar, Anzaan, Warren, M Robin, Sineke, Ncomeka, Vasaikar, Sandeep, Teke, Apalata
- Authors: Faye, M Lindiwe , Hosu, C Mojisola , Oostvogels, Selien , Dippenaar, Anzaan , Warren, M Robin , Sineke, Ncomeka , Vasaikar, Sandeep , Teke, Apalata
- Date: 2023/10
- Subjects: Drug-resistant TB , Heteroresistance , Mutations , Spoligotyping
- Language: English
- Type: Article
- Identifier: http://hdl.handle.net/11260/13589 , vital:78960 , DOI: https://doi.org/10.3390/idr15040041
- Description: Drug-resistant tuberculosis (DR-TB) is still a major public health concern in South Africa. Mutations in M. tuberculosis can cause varying levels of phenotypic resistance to anti-TB medications. There have been no prior studies on gene mutations and the genotyping of DR-TB in the rural Eastern Cape Province; hence, we aimed to identify DR-TB mutations, genetic diversity, and allocated lineages among patients in this area. Using Xpert® MTB/RIF, we assessed the rifampin resistance of sputum samples collected from 1157 patients suspected of having tuberculosis. GenoType MTBDR plus VER 2.0 was used for the detection of mutations causing resistance to anti-TB medications. The next step was to spoligotype 441 isolates. The most prevalent rifampin resistance-conferring mutations were in rpoB codon S531L in INH-resistant strains; the katG gene at codon S315TB and the inhA gene at codon C-15TB had the most mutations; 54.5% and 24.7%, respectively. In addition, 24.6% of strains showed mutations in both the rpoB and inhA genes, while 69.9% of strains showed mutations in both the katG and rpoB genes. Heteroresistance was seen in 17.9% of all cases in the study. According to spoligotyping analysis, Beijing families predominated. Investigation of the evolutionary lineages of M. tuberculosis isolates can be carried out using the information provided by the study’s diversity of mutations. In locations wherein these mutations have been discovered, decision-making regarding the standardization of treatment regimens or individualized treatment may be aided by the detection frequency of rpoB, katG, and inhA mutations in various study areas.
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- Authors: Faye, M Lindiwe , Hosu, C Mojisola , Oostvogels, Selien , Dippenaar, Anzaan , Warren, M Robin , Sineke, Ncomeka , Vasaikar, Sandeep , Teke, Apalata
- Date: 2023/10
- Subjects: Drug-resistant TB , Heteroresistance , Mutations , Spoligotyping
- Language: English
- Type: Article
- Identifier: http://hdl.handle.net/11260/13589 , vital:78960 , DOI: https://doi.org/10.3390/idr15040041
- Description: Drug-resistant tuberculosis (DR-TB) is still a major public health concern in South Africa. Mutations in M. tuberculosis can cause varying levels of phenotypic resistance to anti-TB medications. There have been no prior studies on gene mutations and the genotyping of DR-TB in the rural Eastern Cape Province; hence, we aimed to identify DR-TB mutations, genetic diversity, and allocated lineages among patients in this area. Using Xpert® MTB/RIF, we assessed the rifampin resistance of sputum samples collected from 1157 patients suspected of having tuberculosis. GenoType MTBDR plus VER 2.0 was used for the detection of mutations causing resistance to anti-TB medications. The next step was to spoligotype 441 isolates. The most prevalent rifampin resistance-conferring mutations were in rpoB codon S531L in INH-resistant strains; the katG gene at codon S315TB and the inhA gene at codon C-15TB had the most mutations; 54.5% and 24.7%, respectively. In addition, 24.6% of strains showed mutations in both the rpoB and inhA genes, while 69.9% of strains showed mutations in both the katG and rpoB genes. Heteroresistance was seen in 17.9% of all cases in the study. According to spoligotyping analysis, Beijing families predominated. Investigation of the evolutionary lineages of M. tuberculosis isolates can be carried out using the information provided by the study’s diversity of mutations. In locations wherein these mutations have been discovered, decision-making regarding the standardization of treatment regimens or individualized treatment may be aided by the detection frequency of rpoB, katG, and inhA mutations in various study areas.
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Voices from the Patients: A Qualitative Study of the Integration of Tuberculosis, Human Immunodeficiency Virus and Primary Healthcare Services in O.R. Tambo District, Eastern Cape, South Africa
- Dlatu, Ntandazo, Oladimeji, Elizabeth Kelechi, Apalata, Teke
- Authors: Dlatu, Ntandazo , Oladimeji, Elizabeth Kelechi , Apalata, Teke
- Date: 2023/10
- Subjects: TB-HIV integration , Challenges and barriers , Patients , O.R. Tambo district , Eastern Cape , South Africa
- Language: English
- Type: Article
- Identifier: http://hdl.handle.net/11260/13590 , vital:78959 , DOI: https://doi.org/10.3390/idr15020017
- 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. Studies have observed that TB-HIV integration reduces mortality. The operational implementation of integrated services is still challenging. This study aimed to describe patients’ perceptions on barriers to scaling up of TB-HIV integration services at selected health facilities (study sites) in Oliver Reginald (O.R) Tambo Municipality, Eastern Cape province, South Africa. We purposely recruited twenty-nine (29) patients accessing TB and HIV services at the study sites. Data were analyzed using qualitative content analysis and presented as emerging themes. Barriers identified included a lack of health education about TB and HIV; an inadequate counselling for HIV and the antiretroviral drugs (ARVs); and poor quality of services provided by the healthcare facilities. These findings suggest that the O.R. Tambo district needs to strengthen its TB-HIV integration immediately.
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- Authors: Dlatu, Ntandazo , Oladimeji, Elizabeth Kelechi , Apalata, Teke
- Date: 2023/10
- Subjects: TB-HIV integration , Challenges and barriers , Patients , O.R. Tambo district , Eastern Cape , South Africa
- Language: English
- Type: Article
- Identifier: http://hdl.handle.net/11260/13590 , vital:78959 , DOI: https://doi.org/10.3390/idr15020017
- 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. Studies have observed that TB-HIV integration reduces mortality. The operational implementation of integrated services is still challenging. This study aimed to describe patients’ perceptions on barriers to scaling up of TB-HIV integration services at selected health facilities (study sites) in Oliver Reginald (O.R) Tambo Municipality, Eastern Cape province, South Africa. We purposely recruited twenty-nine (29) patients accessing TB and HIV services at the study sites. Data were analyzed using qualitative content analysis and presented as emerging themes. Barriers identified included a lack of health education about TB and HIV; an inadequate counselling for HIV and the antiretroviral drugs (ARVs); and poor quality of services provided by the healthcare facilities. These findings suggest that the O.R. Tambo district needs to strengthen its TB-HIV integration immediately.
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