Taxation of illegal schemes : – should the term ‘received by’ in the definition of gross income be interpreted with reference to the taxpayers subjective intention?

No abstract available.Dissertation (LLM)--University of Pretoria, 2011.Mercantile Lawunrestricte

HIV in Children in a General Population Sample in East Zimbabwe: Prevalence, Causes and Effects

There are an estimated half-million children living with HIV in sub-Saharan Africa. The predominant source of infection is presumed to be perinatal mother-to-child transmission, but general population data about paediatric HIV are sparse. We characterise the epidemiology of HIV in children in sub-Saharan Africa by describing the prevalence, possible source of infection, and effects of paediatric HIV in a southern African population.From 2009 to 2011, we conducted a household-based survey of 3389 children (aged 2-14 years) in Manicaland, eastern Zimbabwe (response rate: 73.5%). Data about socio-demographic correlates of HIV, risk factors for infection, and effects on child health were analysed using multi-variable logistic regression. To assess the plausibility of mother-to-child transmission, child HIV infection was linked to maternal survival and HIV status using data from a 12-year adult HIV cohort.HIV prevalence was (2.2%, 95% CI: 1.6-2.8%) and did not differ significantly by sex, socio-economic status, location, religion, or child age. Infected children were more likely to be underweight (19.6% versus 10.0%, p = 0.03) or stunted (39.1% versus 30.6%, p = 0.04) but did not report poorer physical or psychological ill-health. Where maternal data were available, reported mothers of 61/62 HIV-positive children were deceased or HIV-positive. Risk factors for other sources of infection were not associated with child HIV infection, including blood transfusion, vaccinations, caring for a sick relative, and sexual abuse. The observed flat age-pattern of HIV prevalence was consistent with UNAIDS estimates which assumes perinatal mother-to-child transmission, although modelled prevalence was higher than observed prevalence. Only 19/73 HIV-positive children (26.0%) were diagnosed, but, of these, 17 were on antiretroviral therapy.Childhood HIV infection likely arises predominantly from mother-to-child transmission and is associated with poorer physical development. Overall antiretroviral therapy uptake was low, with the primary barrier to treatment appearing to be lack of diagnosis

Verbal autopsy can consistently measure AIDS mortality: a validation study in Tanzania and Zimbabwe

BACKGROUND: Verbal autopsy is currently the only option for obtaining cause of death information in most populations with a widespread HIV/AIDS epidemic. METHODS: With the use of a data-driven algorithm, a set of criteria for classifying AIDS mortality was trained. Data from two longitudinal community studies in Tanzania and Zimbabwe were used, both of which have collected information on the HIV status of the population over a prolonged period and maintained a demographic surveillance system that collects information on cause of death through verbal autopsy. The algorithm was then tested in different times (two phases of the Zimbabwe study) and different places (Tanzania and Zimbabwe). RESULTS: The trained algorithm, including nine signs and symptoms, performed consistently based on sensitivity and specificity on verbal autopsy data for deaths in 15-44-year-olds from Zimbabwe phase I (sensitivity 79%; specificity 79%), phase II (sensitivity 83%; specificity 75%) and Tanzania (sensitivity 75%; specificity 74%) studies. The sensitivity dropped markedly for classifying deaths in 45-59-year-olds. CONCLUSIONS: Verbal autopsy can consistently measure AIDS mortality with a set of nine criteria. Surveillance should focus on deaths that occur in the 15-44-year age group for which the method performs reliably. Addition of a handful of questions related to opportunistic infections would enable other widely used verbal autopsy tools to apply this validated method in areas for which HIV testing and hospital records are unavailable or incomplete

Patterns of self-reported behaviour change associated with receiving voluntary counselling and testing in a longitudinal study from Manicaland, Zimbabwe.

Voluntary counselling and testing (VCT) is promoted as a potential HIV prevention measure. We describe trends in uptake of VCT for HIV, and patterns of subsequent behaviour change associated with receiving VCT in a population-based open cohort in Manicaland, Zimbabwe. The relationship between receipt of VCT and subsequent reported behaviour was analysed using generalized linear models with random effects. At the third survey, 8.6% of participants (1,079/12,533), had previously received VCT. Women who received VCT, both those positive and negative, reduced their reported number of new partners. Among those testing positive, this risk reduction was enhanced with time since testing. Among men, no behavioural risk reduction associated with VCT was observed. Significant increases in consistent condom use, with regular or non-regular partners, following VCT, were not observed. This study suggests that, among women, particularly those who are infected, behavioural risk reduction does occur following VCT

Creating and Validating an Algorithm to Measure AIDS Mortality in the Adult Population using Verbal Autopsy

BACKGROUND: Vital registration and cause of death reporting is incomplete in the countries in which the HIV epidemic is most severe. A reliable tool that is independent of HIV status is needed for measuring the frequency of AIDS deaths and ultimately the impact of antiretroviral therapy on mortality. METHODS AND FINDINGS: A verbal autopsy questionnaire was administered to caregivers of 381 adults of known HIV status who died between 1998 and 2003 in Manicaland, eastern Zimbabwe. Individuals who were HIV positive and did not die in an accident or during childbirth (74%; n = 282) were considered to have died of AIDS in the gold standard. Verbal autopsies were randomly allocated to a training dataset (n = 279) to generate classification criteria or a test dataset (n = 102) to verify criteria. A rule-based algorithm created to minimise false positives had a specificity of 66% and a sensitivity of 76%. Eight predictors (weight loss, wasting, jaundice, herpes zoster, presence of abscesses or sores, oral candidiasis, acute respiratory tract infections, and vaginal tumours) were included in the algorithm. In the test dataset of verbal autopsies, 69% of deaths were correctly classified as AIDS/non-AIDS, and it was not necessary to invoke a differential diagnosis of tuberculosis. Presence of any one of these criteria gave a post-test probability of AIDS death of 0.84. CONCLUSIONS: Analysis of verbal autopsy data in this rural Zimbabwean population revealed a distinct pattern of signs and symptoms associated with AIDS mortality. Using these signs and symptoms, demographic surveillance data on AIDS deaths may allow for the estimation of AIDS mortality and even HIV prevalence

Hyperparasitaemia and low dosing are an important source of anti-malarial drug resistance

BACKGROUND: Preventing the emergence of anti-malarial drug resistance is critical for the success of current malaria elimination efforts. Prevention strategies have focused predominantly on qualitative factors, such as choice of drugs, use of combinations and deployment of multiple first-line treatments. The importance of anti-malarial treatment dosing has been underappreciated. Treatment recommendations are often for the lowest doses that produce "satisfactory" results. METHODS: The probability of de-novo resistant malaria parasites surviving and transmitting depends on the relationship between their degree of resistance and the blood concentration profiles of the anti-malarial drug to which they are exposed. The conditions required for the in-vivo selection of de-novo emergent resistant malaria parasites were examined and relative probabilities assessed. RESULTS: Recrudescence is essential for the transmission of de-novo resistance. For rapidly eliminated anti-malarials high-grade resistance can arise from a single drug exposure, but low-grade resistance can arise only from repeated inadequate treatments. Resistance to artemisinins is, therefore, unlikely to emerge with single drug exposures. Hyperparasitaemic patients are an important source of de-novo anti-malarial drug resistance. Their parasite populations are larger, their control of the infection insufficient, and their rates of recrudescence following anti-malarial treatment are high. As use of substandard drugs, poor adherence, unusual pharmacokinetics, and inadequate immune responses are host characteristics, likely to pertain to each recurrence of infection, a small subgroup of patients provides the particular circumstances conducive to de-novo resistance selection and transmission. CONCLUSION: Current dosing recommendations provide a resistance selection opportunity in those patients with low drug levels and high parasite burdens (often children or pregnant women). Patients with hyperparasitaemia who receive outpatient treatments provide the greatest risk of selecting de-novo resistant parasites. This emphasizes the importance of ensuring that only quality-assured anti-malarial combinations are used, that treatment doses are optimized on the basis of pharmacodynamic and pharmacokinetic assessments in the target populations, and that patients with heavy parasite burdens are identified and receive sufficient treatment to prevent recrudescence

An assessment of the impact of results based management system on organisational performance 2012 -2014: Case of Zimbabwe United Passenger Company

Zimbabwe United Passenger Company (ZUPCO) is a state enterprise that has the mandate to provide safe and reliable passenger transport services to rural and urban dwellers of Zimbabwe. However, the company has not been able to execute its mandate efficiently due to a lot of inefficiencies that has to do with the management of scarce resources within the organisation. In January 2012, the company adopted the Results Based Management (RBM) system as a management strategy to improve performance. This again did not improve the performance of the company. It is then the premise of this study to assess the impact of RBM system on organisational performance. The main objective of this study was therefore to find out if the introduction of RBM has improved performance at ZUPCO. Literature has shown that if RBM if properly implemented, indeed it does improve performance as what happened in the Malaysian case for example. However, literature also highlighted the issues of inapplicability of the system within the Zimbabwean context. Literature has also shown that there are other factors that also affect the performance of any organisation like operating environment, culture of employees and the issue of incentives and motivation of employees. The study used stratified random sampling to select the sample of those who participated in the study. The major research question was to establish whether the introduction of RBM had improved performance at Zupco. The objectives of the study were met and reliability analysis which was done showed that the items measured were consistent. The response of the study rate was at 100%. The study showed that RBM system has not improved performance at ZUPCO and that there is need to train all the employees on the system because knowledge of the system is related to its effectiveness was supported and accepted as a hypothesis. The study then recommended training of all employees on the system as this will also help in changing the culture of employees and have them to be results centred. Rewarding performance is another recommendation that was made as it was seen as the other factor that affects performance regardless of having implemented RBM system or not

A Model for Developing Critical Thinking Skills in Teaching History: Lessons from Zimbabwe

Developing critical thinking skills in students has proved to be elusive for Zimbabwean history teachers. Using critical theory and its strands of critical pedagogy and constructivism, this qualitative case study engrained in the interpretive paradigm investigates whether the current practices by history teachers enhance the development of critical thinking skills and then discusses how classroom practitioners can develop critical thinking in teaching. A multiple case study design was adopted to generate data using document analysis, interviews and lessons observations. The sample, chosen for detailed study through purposive sampling, included three history teachers from three secondary schools in the Gweru Urban District in the Midlands province of Zimbabwe.  Evidence from the study reveals that history teachers continue to use teacher-centred methods of teaching, textbooks as the only resource, poor questioning techniques, and traditional assessment procedures that do not promote the development of critical thinking skills. It is recommended that history teaching must focus on the development of critical thinking skills rather than on the mastery of content for sustainable development to happen as dictated by the demands of the 21st century. To support that, the study proposes a transformative-interactive model to enhance the development of critical thinking skills. The research concludes that critical thinking skills do not happen arbitrarily but are developed. This study extends scholarship on history teaching by challenging and encouraging teachers to reflect on their role in the teaching of history to transform them into the designers of, and researchers of, curriculum methodology