The use of a spatial information system in the management of HIV/AIDS in South Africa

BACKGROUND: South Africa is experiencing an HIV/AIDS pandemic of shattering dimensions. The availability and provision of antiretroviral (ARV) drugs could bring relief to the situation, but the treatment is unfortunately complex with each patient being assigned a different antiretroviral therapy varying in diet-medication regiment. The context of South Africa, its variety of urban and rural settings adds to the challenge of administering and monitoring the HIV+ person throughout the treatment, which will last for the rest of their lives. The lack of physical infrastructure, reliable statistics and adequate resources hinder the efficient management of HIV/AIDS. RESULTS: The collection of reliable data will be a first step to assess the status of HIV/AIDS in communities. A number of hospitals have started this process using the conventional approach to collect information about their patients using a paper-based system. Since time is of essence in the fight against the pandemic, data exchange between various hospitals, municipalities and decision-making bodies is becoming more and more important. The logical response to such a need is a computerised system, which will collect and administer HIV/AIDS related information within the local context and allow a monitored access to the data from a number of stakeholders. CONCLUSIONS: The purpose of this study was to design and develop an HIV/AIDS database, which is embedded in a Spatial Information Management System. The pilot study area is the Gugulethu township in Cape Town where more than 27% of the 325 000 residents are HIV+. It is shown that the implementation of the HIV/AIDS database and the Spatial Information Management System can play a critical role in determining where and when to intervene, improving the quality of care for HIV+ patients, increasing accessibility of service and delivering a cost-effective mode of information

Development and implementation of an HIV/AIDS trials management system: A geographical information systems approach

Introduction. Researchers, practitioners and policymakers make decisions at all levels – from local to international. Accessible, integrated and up-to-date evidence is essential for successful and responsive decision-making. A current trials register of randomised and clinically controlled trials of HIV/AIDS interventions can provide invaluable information to decision-making processes. Using the newly emerging geographical information systems (GIS) technology, we have developed a tool which assists such decisions. Objective. To demonstrate how the tool provides consistent, quantitative information in an accessible format, making it a key tool in evidence-based decision-making. Methods. We identified all HIV/AIDS trials in relation to publications for the period 1980 - 2007, using both electronic and manual search methods. To facilitate searching the trials register, studies were coded by using a comprehensive but user-friendly coding sheet. We captured the geographical co-ordinates for each trial and used the ArcGIS 9 mapping software to design and develop a geodatabase of trials. Results. The geodatabase delivered the complete requirements for a data-driven information system, featuring the following functions: (i) a clear display of the spatial distribution of HIV/AIDS trials around the world; (ii) identification of and access to information about any particular trial on a map; and (iii) a global resource of potential information on the safety and efficacy of prevention and treatment measures. Conclusions. The building of a functioning HIV/AIDS trials management system can provide policymakers, researchers and practitioners with accessible, integrated and up-to-date evidence that is essential to successful and dynamic decision-making. Southern African Journal of HIV Medicine Vol. 9 (2) 2008: pp. 58-6

Scope and geographical distribution of African medical journals active in 2005

Objectives: To identify all African medical journals actively publishing in 2005, and to create a geodatabase of these to evaluate and monitor future journal activity.Design: A search was done for relevant African medical journals on electronic databases, library catalogues and internet sites, and a list was compiled of active journals. A survey was conducted via questionnaire of editors of all listed African medical journals defined as having an editorial base on the continent.Results: One hundred and fifty-eight African medical journals were identified, published in 33 countries. One hundred and fifty-three editors were surveyed via email, post and/or fax. There was a 39% response rate from editors based in 17 countries. Fifty-one journals were published in English, 7 in French and 1 in Portuguese. Most journals were owned by an association or a society and were funded from a combination of sources. Journals covered general medical and specialist medical interest equally. Most (41 of 59 journals) had a circulation below 1 000, and most (52/59) published 4 or fewer issues a year. Almost all the journals included original research, and articles were peer reviewed. Few were indexed on Medline (N = 18) and EMBASE (N = 10). Plotting journal location using Geographic Information Systems (GIS) software provided a snapshot view of current journal activity. Conclusions: This study is likely to represent the most comprehensive list of current African medical journals. It confirms growth in African health care research and journal activity on the continent. Limited inclusion in international databases and accessibility to African researchers remain challenges in achieving publication of high-quality African research in high-quality African journals.South African Medical Journal Vol. 96(6) 2006: 533-53

Outcomes of severe meconium aspiration syndrome in a resource restricted hospital, Cape Town, South Africa

Paediatrics and Child Healt

How far will we need to go to reach HIV-infected people in rural South Africa?

Background: The South African Government has outlined detailed plans for antiretroviral (ART) rollout in KwaZulu-Natal Province, but has not created a plan to address treatment accessibility in rural areas in KwaZulu-Natal. Here, we calculate the distance that People Living With HIV/AIDS (PLWHA) in rural areas in KwaZulu-Natal would have to travel to receive ART. Specifically, we address the health policy question 'How far will we need to go to reach PLWHA in rural KwaZulu-Natal?'. Methods: We developed a model to quantify treatment accessibility in rural areas; the model incorporates heterogeneity in spatial location of HCFs and patient population. We defined treatment accessibility in terms of the number of PLWHA that have access to an HCF. We modeled the treatment-accessibility region (i.e. catchment area) around an HCF by using a two-dimensional function, and assumed that treatment accessibility decreases as distance from an HCF increases. Specifically, we used a distance-discounting measure of ART accessibility based upon a modified form of a two-dimensional gravity-type model. We calculated the effect on treatment accessibility of: (1) distance from an HCF, and (2) the number of HCFs. Results: In rural areas in KwaZulu-Natal even substantially increasing the size of a small catchment area (e.g. from 1 km to 20 km) around an HCF would have a negligible impact (~2%) on increasing treatment accessibility. The percentage of PLWHA who can receive ART in rural areas in this province could be as low as ~16%. Even if individuals were willing (and able) to travel 50 km to receive ART, only ~50% of those in need would be able to access treatment. Surprisingly, we show that increasing the number of available HCFs for ART distribution ~ threefold does not lead to a threefold increase in treatment accessibility in rural KwaZulu-Natal. Conclusion: Our results show that many PLWHA in rural KwaZulu-Natal are unlikely to have access to ART, and that the impact of an additional 37 HCFs on treatment accessibility in rural areas would be less substantial than might be expected. There is a great length to go before we will be able to reach many PLWHA in rural areas in South Africa, and specifically in KwaZulu-Natal.David P Wilson and Sally Blowe

The Munch Variations: A postmodern exploration of the "munch" hashtag on Instagram.

Using context collapse as my point of departure, I take an exploratory approach to the “munch” hashtag on Instagram in this thesis. Because of the homonymy between the artist Edvard Munch’s last name and the English verb “to munch”, Instagram displays the artist’s work together with food posts and other, at times more bizarre things, in the search results for posts tagged with “munch”. Context collapse occurs here and creates an absurd collage on the platform. I find context collapse to be ubiquitous in the age of hyperconnectivity and social media and decided therefore to explore what this situation reflects of contemporary life. During a period spanning over a year and a half, I have followed the “munch” hashtag on Instagram, identified key accounts relating to the tag, and collected screenshots of my search results on the platform daily for one month. During this process, multiple narratives and, occasionally, a lack of narratives, have been traced, which are analyzed as exemplary incidences of our relationship with Instagram as a social media platform. Sometimes, the hashtag adds new storytelling elements, while at other times, it seems to work as a utilitarian mechanic for indexing posts on the platform. Guided by theories of postmodernism, I explore the different social, political and technological contexts of the posts as they intertwine with, contradict and supplement each other on Instagram. To do so, I conduct a qualitative thematic analysis of the “munch” hashtag. A thematic analysis of the “munch” search results on Instagram allows me to explore the platform from multiple theoretical vantage points: field theory, surrealism, semiotics and aesthetics. Each of these perspectives form one basis of and specific vantage point for The Munch Variations explored in this thesis. In the analysis chapters, I expound the ways in which Instagram is a manifestation of the postmodern condition as a platform on which multiple meanings are expressed simultaneously. In the discussion section, I argue that our awareness of the neoliberal and postmodern logics of Instagram, and the ways those logics in turn affect our making sense of our world, make our relationship with the platform post-postmodern, or, as Vermeulen and van den Akker (2010) would describe it, metamodern