Lack of institutional services: the impact on household food Insecurity in Ntambanana, KwaZulu-Natal

The aim of this study was to explore how food security at household level is affected by lack of institutional services. This study particularly looks at how these constraints affect access to food and assess the availability of institutional services such as the availability of extension services in Ntambanana. The availability of institutional support in rural areas is regarded as means of rural development which eliminate problems of access to food and other services. The general findings of the study reveal that assessment and evaluation of policies that are based on rural development and food security is very important. These include improving communication amongst various stakeholders, creating an enabling environment for local businesses, ensuring the availability of facilities such as storage, communication and transport facilities. The results reflect that socio – economic conditions play an important role in accessing food by looking at the level of purchasing power in the community. This study concludes that the cost effective ways to improve access to food is to assist local small scale businesses to earn cash through creating market for them and invest in institutional services that lead to improving food security. The study recommends that improved rural institutional services sustains food security as well as contributes to the improvement in the living conditions of rural households

Quantifiable plasma tenofovir among South African women using daily oral pre-exposure prophylaxis during the ECHO trial

Access to data from the ECHO study may be requested through submission of a research concept to ude.wu@crci. The concept must include the research question, data requested, analytic methods, and steps taken to ensure ethical use of the data. Access will be granted if the concept is evaluated to have scientific merit and if sufficient data protections are in place. As of the time of publication, data access applications are in process with the governing institutional review boards of the ECHO study to make deidentified data publicly available.BACKGROUND : HIV endpoint–driven clinical trials provide oral pre-exposure prophylaxis (PrEP) as HIV prevention standard of care. We evaluated quantifiable plasma tenofovir among South African women who used oral PrEP during the Evidence for Contraceptive Options and HIV Outcomes (ECHO) Trial. METHODS : ECHO, a randomized trial conducted in 4 African countries between 2015 and 2018, assessed HIV incidence among HIV-uninfected women, aged 16–35 years, randomized to 1 of 3 contraceptives. Oral PrEP was offered onsite as part of the HIV prevention package at the South African trial sites. We measured tenofovir in plasma samples collected at the final trial visit among women reporting ongoing PrEP use. We used bivariate and multivariate logistical regression to assess demographic and sexual risk factors associated with plasma tenofovir quantification. RESULTS : Of 260 women included, 52% were ≤24 years and 22% had Chlamydia trachomatis at enrollment. At PrEP initiation, 68% reported inconsistent/nonuse of condoms. The median duration of PrEP use was 90 days (IQR: 83–104). Tenofovir was quantified in 36% (n = 94) of samples. Women >24 years had twice the odds of having tenofovir quantified vs younger women (OR = 2.12; 95% confidence interval = 1.27 to 3.56). Women who reported inconsistent/nonuse of condoms had lower odds of tenofovir quantification (age-adjusted OR = 0.47; 95% confidence interval = 0.26 to 0.83). CONCLUSIONS : Over a third of women initiating PrEP and reporting ongoing use at the final trial visit had evidence of recent drug exposure. Clinical trials may serve as an entry point for PrEP initiation among women at substantial risk for HIV infection with referral to local facilities for ongoing access at trial end. CLINICAL TRIAL NUMBER : NCT02550067.The Bill & Melinda Gates Foundation, the American people through the United States Agency for International Development, the Swedish International Development Cooperation Agency, the South Africa Medical Research Council, and the United Nations Population Fund. Contraceptive supplies were donated by the Government of South Africa and US Agency for International Development.http://journals.lww.com/jaidshj2023Family MedicineMedical Microbiolog

High levels of pretreatment HIV-1 drug resistance mutations among South African women who acquired HIV during a prospective study

Access to data from the ECHO Study may be requested through submission of a research concept to [email protected]. The concept must include the research question, data requested, analytic methods, and steps taken to ensure ethical use of the data. Access will be granted if the concept is evaluated to have scientific merit and if sufficient data protections are in place. As of the time of publication, data access applications are in process with the governing institutional review boards of the ECHO Study to make de-identified data publicly available.BACKGROUND : Pretreatment HIV drug resistance (PDR) undermines individual treatment success and threatens the achievement of UNAIDS 95-95-95 targets. In many African countries, limited data are available on PDR as detection of recent HIV infection is uncommon and access to resistance testing is limited. We describe the prevalence of PDR among South African women with recent HIV infection from the Evidence for Contraceptive Options and HIV Outcomes (ECHO) Trial. METHODS : HIV-uninfected, sexually active women, aged 18–35 years, and seeking contraception were enrolled in the ECHO Trial at sites in South Africa, from 2015 to 2018. HIV testing was done at trial entry and repeated quarterly. We tested stored plasma samples collected at HIV diagnosis from women who seroconverted during follow-up and had a viral load >1000 copies/mL for antiretroviral resistant mutations using a validated laboratory-developed population genotyping assay, which sequences the full protease and reverse transcriptase regions. Mutation profiles were determined using the Stanford Drug Resistance Database. RESULTS : We sequenced 275 samples. The median age was 23 years, and majority (98.9%, n = 272) were infected with HIV-1 subtype C. The prevalence of surveillance drug resistance mutations (SDRMs) was 13.5% (n = 37). Nonnucleoside reverse transcriptase inhibitor (NNRTI) mutations were found in 12.4% of women (n = 34). Few women had NRTI (1.8%, n = 5) and protease inhibitor (1.1%, n = 3) mutations. Five women had multiple NRTI and NNRTI SDRMs. CONCLUSIONS : The high levels of PDR, particularly to NNRTIs, strongly support the recent change to the South African national HIV treatment guidelines to transition to a first-line drug regimen that excludes NNRTIs.The Bill & Melinda Gates Foundation, the American people through the United States Agency for International Development, the Swedish International Development Cooperation Agency, the South Africa Medical Research Council, and the United Nations Population Fund.http://journals.lww.com/jaidshj2023Family MedicineMedical Microbiolog

Vaccine efficacy of ALVAC-HIV and bivalent subtype C gp120–MF59 in adults

BACKGROUND : A safe, effective vaccine is essential to eradicating human immunodeficiency virus (HIV) infection. A canarypox–protein HIV vaccine regimen (ALVAC-HIV plus AIDSVAX B/E) showed modest efficacy in reducing infection in Thailand. An analogous regimen using HIV-1 subtype C virus showed potent humoral and cellular responses in a phase 1–2a trial in South Africa. Efficacy data and additional safety data were needed for this regimen in a larger population in South Africa. METHODS : In this phase 2b–3 trial, we randomly assigned 5404 adults without HIV-1 infection to receive the vaccine (2704 participants) or placebo (2700 participants). The vaccine regimen consisted of injections of ALVAC-HIV at months 0 and 1, followed by four booster injections of ALVAC-HIV plus bivalent subtype C gp120–MF59 adjuvant at months 3, 6, 12, and 18. The primary efficacy outcome was the occurrence of HIV-1 infection from randomization to 24 months. RESULTS : In January 2020, prespecified criteria for non-efficacy were met at an interim analysis; further vaccinations were subsequently halted. The median age of the trial participants was 24 years; 70% of the participants were women. The incidence of adverse events was similar in the vaccine and placebo groups. During the 24-month followup, HIV-1 infection was diagnosed in 138 participants in the vaccine group and in 133 in the placebo group (hazard ratio, 1.02; 95% confidence interval, 0.81 to 1.30; P = 0.84). CONCLUSIONS : The ALVAC–gp120 regimen did not prevent HIV-1 infection among participants in South Africa despite previous evidence of immunogenicity.Supported by grants (HHSN272201300033C and HHSN272201600012C) to Novartis Vaccines and Diagnostics (now part of the GlaxoSmithKline [GSK] Biologicals) by the National Institute of Allergy and Infectious Diseases (NIAID) of the National Institutes of Health (NIH) for the selection and process development of the two gp120 envelope proteins TV1.C and 1086.C; by the Bill and Melinda Gates Foundation Global Health Grant (OPP1017604) and NIAID for the manufacture and release of the gp120 clinical grade material; and by U.S. Public Health Service Grants — UM1 AI068614 to the HIV Vaccine Trials Network (HVTN), UM1 AI068635 to the HVTN Statistical and Data Management Center, and UM1 AI068618 to the HVTN Laboratory Center — from the NIAID. GSK Biologicals contributed financially to the provision of preexposure prophylaxis to trial participants. The South African Medical Research Council supported its affiliated research sites.http://www.nejm.orgam2022School of Health Systems and Public Health (SHSPH

The Impact of Poor Governance on Public Service Delivery: A Case Study of the South African Local Government

South African local government has seen numerous service delivery protests stemming from community dissatisfaction. Lack of accountability and consequence management has had a negative impact on good governance in the local government sphere, putting the provision of basic services at risk. South African citizens have expressed their dissatisfaction by forcibly removing high-ranking public officials from their communities, claiming that they failed to keep promises made during the election campaigning phase. Local government's financial situation has also been hampered by a lack of good governance, which has a negative impact on public service delivery. In the fiscal year 2020/2021, 41 municipalities received clean audits out of 257, demonstrating the extent of the lack of consequence management and poor governance in local government. This paper seeks to analyze the impact of poor governance on service delivery and propose strategies or areas for improvement in order to improve good governance for the prioritization of public service delivery in South Africa. This paper is timely because local governments are struggling to maintain their core function of being a vehicle for effective and efficient service delivery. Because of the higher rates of unemployment and poverty, the majority of South African citizens rely on public service delivery. Because poor governance leads to poor service delivery, marginalized citizens bear the brunt of the impact of poor governance in South African government

Strategies to improve historically disadvantaged university staff’s wellbeing and administration of academic programmes during COVID-19: A descriptive survey study

The coronavirus (COVID-19) pandemic has brought the world to a standstill, impacting negatively on human mortality and morbidity. Currently, most countries are on a national lockdown as a way of curbing the rapid spread of the virus. Although desirable, nationwide lockdown continues to hamper the smooth running of the government’s key strategic sectors including the schooling system. In this descriptive qualitative study, we explored university staff (n = 87; Meanage = 38.54; males = 50.6%, females = 49.4%) views on strategies that could improve their wellbeing and administration of academic programmes during-and-immediately after the COVID-19 national lockdown. Participants were sampled conveniently and responded to an open-ended questionnaire online. The participating staff recommended five key strategies that were thematically analysed, which are as follows: a) improved communication; b) provision of efficient ICT infrastructure; c) consideration of compensatory academic measures; d) on-campus COVID-19 risk management strategy; and e) provision of online and on-campus psychological services. Based on these findings, it is recommended that the historically disadvantaged universities should consider implementing strategies for enhancing the staff’s wellbeing and administration of academic activities. However, whether the suggested strategies could yield positive results, post-implementation evaluation research may be needed. For future preparedness, present findings imply that institutions of higher learning need to put in place contingency plans for efficient communication in times of crises similar to COVID-19 while investing in efficient ICT infrastructure for remote learning, teaching, and research

TEA CONSUMPION PATTERNS OF 13-25 YEAR-OLDS IN HE VAAL TRIANGLE, SOUTH AFRICA

This study formed part of a larger project in which food and beverage fortification as a way to address specific micronutrient deficiencies was evaluated in selected subjects in the Vaal Triangle. The objective of this study was to examine the suitability of the habit of tea drinking as a vehicle for fortification. This was achieved through a survey which sought information about the amount of tea consumed, the type of tea mostly consumed, additions to the tea, when tea is consumed, the reasons for tea consumption and preference for tea or other beverages. The study was conducted in a randomly selected sample of 500 male and female Africans, aged 13 to 25 years in the Vaal Triangle, South Africa. A combination of qualitative and quantitative research methods were used simultaneously and sequentially to collect data. Questionnaires were designed in which open questions addressing the objectives of the research were validated and sent out to collect the information. The results showed that most respondents (92.9 %) consumed at least one cup of tea daily, with rooibos tea selected as the most popular in this study (50 % of tea consumed). Sugar (40.4 %) and milk (37.0 %) are added most often to the tea. Respondents indicated that the preferred times for tea consumption are at breakfast, early morning and evening. According to the preference scales of these respondents, tea was the third most consumed beverage in summer and the first most consumed beverage in winter. Key words: fortification, micronutrient deficiencies, tea consumption. Résumé LES MODELES DE CONSOMMATION DE THE DE 13-25 ANNEE VIEILLE DANS LE TRIANGLE DE VAAL, SA Cette étude formé d'un grand projet dans lequel nourriture et comme une façon adresser spécifique micronutrient a été évalué dans choisi sujets dans le Vaal . L'objectif de cette étude était d'examiner le suitability de l'habitude de boire de thé comme un véhicule pour fortification. Ceci a été atteint par une étude qui a cherché information de la quantité de thé consommé, le type de thé surtout , additions au thé, quand thé est consommé, les raisons pour thé et préférence pour thé ou autre boissons. {The study was conducted in a randomly selected sample of 500 male and female Africans, aged 13 to 25 years old in the Vaal Triangle, South Africa. A combination of qualitative and quantitative research methods were used simultaneously and sequentially to collect data. Questionnaires were designed in which open questions addressing the objectives of the research were validated and sent out to collect the information.} Les résultats ont montré que la plupart des répondants (92.9 %) a consommé au moins une tasse de thé quotidien, avec le thé de rooibos a choisi comme le plus populaire dans cette étude (50 % de thé a consommé). Le sucre (40.4 %) et le lait (37.0 %) sont ajouté le plus souvent au thé. Répondants a indiqué que le préféré temps pour thé sont à petit déjeuner, premier matin et soir. Selon la préférence de ces répondants, thé était le tiers plus consommé dans été et le premièrement dans hiver. Le mots principal: fortification, les déficiences de micronutrient, la consommation de thé. (Af. J. Food and Nutritional Sciences: 2002 2 (1): 38-45

Tea Consumption Patterns Of 13-25 Year Olds In The Vaal Triangle, South Africa

This study formed part of a larger project in which food and beverage fortification as a way to address specific micronutrient deficiencies was evaluated in selected subjects in the Vaal Triangle. The objective of this study was to examine the suitability of the habit of tea drinking as a vehicle for fortification. This was achieved through a survey which sought information about the amount of tea consumed, the type of tea mostly consumed, additions to the tea, when tea is consumed, the reasons for tea consumption and preference for tea or other beverages. The study was conducted in a randomly selected sample of 500 male and female Africans, aged 13 to 25 years in the Vaal Triangle, South Africa. A combination of qualitative and quantitative research methods were used simultaneously and sequentially to collect data. Questionnaires were designed in which open questions addressing the objectives of the research were validated and sent out to collect the information. The results showed that most respondents (92.9 %) consumed at least one cup of tea daily, with rooibos tea selected as the most popular in this study (50 % of tea consumed). Sugar (40.4 %) and milk (37.0 %) are added most often to the tea. Respondents indicated that the preferred times for tea consumption are at breakfast, early morning and evening. According to the preference scales of these respondents, tea was the third most consumed beverage in summer and the first most consumed beverage in winter

Antifungal compounds from the leaves of Rhynchosia minima

Rhynchosia minima, commonly known as jumby bean, is used as a remedy for respiratory ailments in various parts of the world. It is also used by South African traditional healers to treat heart or chest pain. This study aimed to investigate the bioactive constituents of the leaf extracts of R. minima against selected fungal isolates that have been identified as risk factors in respiratory illness. Rhynchosia minima leaves were extracted sequentially using hexane, dichloromethane, ethyl acetate and methanol in increasing order of polarity. The extracts were subjected to repeated chromatographic techniques, for phytochemical isolation. The extracts and isolated compounds were screened against Candida albicans and Cryptococcus neoformans by determining the minimum concentration that inhibited fungal growth. Six flavonoids, one norisoprenoid and one cyclitol were isolated and characterized by 1D and 2D NMR and HR-ESI-MS. The extracts obtained in the study had moderate to weak antifungal activities, with MICs ranging from 312.5 to 1250.0 μg/mL against both fungi. Four isolated compounds were also screened, with two of them exhibiting activity against C. albicans (MIC=6.25 μg/mL) that was comparable to amphotericin B, the positive control. These two compounds also had better antifungal potential against C. neoformans with an MIC=6.25 μg/mL, compared to the MIC of 12.5 μg/mL of amphotericin B. Seven of the eight isolated compounds were obtained from the extracts of Rhynchosia minima for the first time. Two of the isolated compounds demonstrated activity comparable or superior to amphotericin B activity. The notable potency displayed by these compounds warrants further investigation on their development as antifungal agents.The National Research Foundation, Indigenous Knowledge System) South Africa and the University of Pretoria.https://onlinelibrary.wiley.com/journal/16121880hj2023ChemistryParaclinical Science