The impact of regional integration on Southern African agriculture

Your Conference Organising Committee has done me a signal honour in asking me to deliver the Simon Brand Memorial Lecture. Indeed, I feel doubly honoured since Simon Brand was a personal friend of mine and someone whom I held in high esteem. He was a man of integrity, and this, together with his intellectual rigour, led to his being highly respected by all shades of political opinion. He played an important role in supporting socio-political change in South Africa, and I have no doubt that, but for his untimely death, he would have assumed an even more important role in the new South Africa post-1994. One of the fields in which he had become increasingly interested was that of economic cooperation across the Southern African region. As Simon Brand was an agricultural economist by training, I hope he would have approved of the topic which I have chosen to consider in this lecture.Community/Rural/Urban Development,

Professional caregivers: stress and coping in the face of loss and trauma

Professional caregivers who work with the trauma and suffering of others, such as doctors, nurses and psychologists, may face significant challenges along with the risk of adverse, long-term mental and physical health problems. Caregivers with responsibility for dependants outside their professional work reported more stress. This finding is of particular relevance in respect of caregivers in underdeveloped countries such as Zimbabwe, where many households have taken in additional children who have been orphaned, whose parents are ill, or whose parents have temporarily gone elsewhere in search of work. For the purposes of the study, a qualitative phenomenological research design was selected as appropriate to the focus on human experience. An interpretative approach was adopted to explore and explicate the lived experiences of the participants and the meaning they attached to them. The major sources of stress for professional caregivers emerged as being resource constraints, interpersonal issues, and personal issues. Factors found to promote coping include the caregiver’s meaning making perspective, making a difference, and constructing a sense of personal control

Integrated freight and logistics strategic framework and action plan for the eThekwini municipality

The Port of Durban is the busiest in South Africa. As the port has expanded over time, freight and logistics developments have located in close proximity to the port, leading to the infiltration of trucking into all areas around the city, and this has affected businesses, residents, public transport and general traffic. The permeation of trucking throughout the municipal area impacts negatively on air quality, road safety, road maintenance and general business efficiency in the city. This paper commences with a status quo assessment which included a comprehensive literature review on port cities and innovative transport and logistics solutions. Interviews were held with key stakeholders. The analysis covered freight commodity flows, hazardous and abnormal goods movement, freight movements (including empty containers), container depots, impacts of truck overloading on the municipal road network, and assessment of freight accident records. The status quo analysis was followed by a 20-year phased strategic framework which developed a vision for freight and logistics in the municipal area that identifies, describes and explains each intervention and the anticipated time frame over which interventions need to be implemented. Interventions were categorised into short-, medium- and long-term freight and logistics solutions for the eThekwini Municipal Area (EMA). Short-term interventions were taken through a more detailed planning process, the implementation of which will commence in the next five years. Budgets were prepared and an indication was given of the responsibilities of different spheres of government and parastatals such as Transnet, the KwaZulu-Natal Department of Transport, DubeTradePort and SANRAL.Paper presented at the 34th Annual Southern African Transport Conference 6-9 July 2015 "Working Together to Deliver - Sakha Sonke", CSIR International Convention Centre, Pretoria, South Africa.The Minister of Transport, South AfricaTransportation Research Board of the US

Diabetes, HIV and other health determinants associated with absenteeism among formal sector workers in Namibia

<p>Abstract</p> <p>Background</p> <p>As countries in sub-Saharan Africa develop their economies, it is important to understand the health of employees and its impact on productivity and absenteeism. While previous studies have assessed the impact of single conditions on absenteeism, the current study evaluates multiple health factors associated with absenteeism in a large worker population across several sectors in Namibia.</p> <p>Methods</p> <p>From March 2009 to June 2010, PharmAccess Namibia conducted a series of cross-sectional surveys of 7,666 employees in 7 sectors of industry in Namibia. These included a self-reported health questionnaire and biomedical screenings for certain infectious diseases and non-communicable disease (NCD) risk factors. Data were collected on demographics, absenteeism over a 90-day period, smoking behavior, alcohol use, hemoglobin, blood pressure, blood glucose, cholesterol, waist circumference, body mass index (BMI), HIV status, and presence of hepatitis B antigens and syphilis antibodies. The associations of these factors to absenteeism were ascertained using negative binomial regression.</p> <p>Results</p> <p>Controlling for demographic and job-related factors, high blood glucose and diabetes had the largest effect on absenteeism (IRR: 3.67, 95%CI: 2.06-6.55). This was followed by anemia (IRR: 1.59, 95%CI: 1.17-2.18) and being HIV positive (IRR: 1.47; 95%CI: 1.12-1.95). In addition, working in the fishing or services sectors was associated with an increased incidence of sick days (IRR: 1.53, 95%CI: 1.23-1.90; and IRR: 1.70, 95%CI: 1.32-2.20 respectively). The highest prevalence of diabetes was in the services sector (3.6%, 95%CI:-2.5-4.7). The highest prevalence of HIV was found in the fishing sector (14.3%, 95%CI: 10.1-18.5).</p> <p>Conclusion</p> <p>Both NCD risk factors and infectious diseases are associated with increased rates of short-term absenteeism of formal sector employees in Namibia. Programs to manage these conditions could help employers avoid costs associated with absenteeism. These programs could include basic health care insurance including regular wellness screenings.</p

Neutrophil degranulation, NETosis and platelet degranulation pathway genes are co-induced in whole blood up to six months before tuberculosis diagnosis

Mycobacterium tuberculosis (M.tb) causes tuberculosis (TB) and remains one of the leading causes of mortality due to an infectious pathogen. Host immune responses have been implicated in driving the progression from infection to severe lung disease. We analyzed longitudinal RNA sequencing (RNAseq) data from the whole blood of 74 TB progressors whose samples were grouped into four six-month intervals preceding diagnosis (the GC6-74 study). We additionally analyzed RNAseq data from an independent cohort of 90 TB patients with positron emission tomography-computed tomography (PET-CT) scan results which were used to categorize them into groups with high and low levels of lung damage (the Catalysis TB Biomarker study). These groups were compared to non-TB controls to obtain a complete whole blood transcriptional profile for individuals spanning from early stages of M.tb infection to TB diagnosis. The results revealed a steady increase in the number of genes that were differentially expressed in progressors at time points closer to diagnosis with 278 genes at 13-18 months, 742 at 7-12 months and 5,131 detected 1-6 months before diagnosis and 9,205 detected in TB patients. A total of 2,144 differentially expressed genes were detected when comparing TB patients with high and low levels of lung damage. There was a large overlap in the genes upregulated in progressors 1-6 months before diagnosis (86%) with those in TB patients. A comprehensive pathway analysis revealed a potent activation of neutrophil and platelet mediated defenses including neutrophil and platelet degranulation, and NET formation at both time points. These pathways were also enriched in TB patients with high levels of lung damage compared to those with low. These findings suggest that neutrophils and platelets play a critical role in TB pathogenesis, and provide details of the timing of specific effector mechanisms that may contribute to TB lung pathology

South African Thoracic Society position statement on the management of non-cystic fibrosis bronchiectasis in adults: 2023

Background. Bronchiectasis is a chronic lung disorder that affects the lives of many South Africans. Post-tuberculosis (TB) bronchiectasis is an important complication of previous pulmonary TB and a common cause of bronchiectasis in South Africa (SA). No previous statements on the management of bronchiectasis in SA have been published. Objectives. To provide a position statement that will act as a template for the management of adult patients with bronchiectasis in SA. Methods. The South African Thoracic Society appointed an editorial committee to compile a position statement on the management of adult non-cystic fibrosis (CF) bronchiectasis in SA. Results. A position statement addressing the management of non-CF bronchiectasis in adults in SA was compiled. This position statement covers the epidemiology, aetiology, diagnosis, investigations and various aspects of management of adult patients with non-CF bronchiectasis in SA. Conclusion. Bronchiectasis has largely been a neglected lung condition, but new research has improved the outlook for patients. Collaboration between interprofessional team members in patient management is important. In SA, more research into the epidemiology of bronchiectasis, especially post-TB bronchiectasis and HIV-associated bronchiectasis, is required

Distinct serum biosignatures are associated with different tuberculosis treatment outcomes.

Biomarkers for TB treatment response and outcome are needed. This study characterize changes in immune profiles during TB treatment, define biosignatures associated with treatment outcomes, and explore the feasibility of predictive models for relapse. Seventy-two markers were measured by multiplex cytokine array in serum samples from 78 cured, 12 relapsed and 15 failed treatment patients from South Africa before and during therapy for pulmonary TB. Promising biosignatures were evaluated in a second cohort from Uganda/Brazil consisting of 17 relapse and 23 cured patients. Thirty markers changed significantly with different response patterns during TB treatment in cured patients. The serum biosignature distinguished cured from relapse patients and a combination of two clinical (time to positivity in liquid culture and BMI) and four immunological parameters (TNF-?, sIL-6R, IL-12p40 and IP-10) at diagnosis predicted relapse with a 75% sensitivity (95%CI 0.38-1) and 85% specificity (95%CI 0.75-0.93). This biosignature was validated in an independent Uganda/Brazil cohort correctly classifying relapse patients with 83% (95%CI 0.58-1) sensitivity and 61% (95%CI 0.39-0.83) specificity. A characteristic biosignature with value as predictor of TB relapse was identified. The repeatability and robustness of these biomarkers require further validation in well-characterized cohorts

The impact of regional integration on Southern African agriculture

Your Conference Organising Committee has done me a signal honour in asking me to deliver the Simon Brand Memorial Lecture. Indeed, I feel doubly honoured since Simon Brand was a personal friend of mine and someone whom I held in high esteem. He was a man of integrity, and this, together with his intellectual rigour, led to his being highly respected by all shades of political opinion. He played an important role in supporting socio-political change in South Africa, and I have no doubt that, but for his untimely death, he would have assumed an even more important role in the new South Africa post-1994. One of the fields in which he had become increasingly interested was that of economic cooperation across the Southern African region. As Simon Brand was an agricultural economist by training, I hope he would have approved of the topic which I have chosen to consider in this lecture