People’s Education (for People’s Power) — a promise unfulfilled

The central feature of Athenian citizens’ rights, that is, people’s participation in government, is also enshrined in the South African Constitution. This article argues for the Athenian style of participatory democracy as a viable model of participation in governing South African schools. The author claims that ‘people’s education’, which had its origins in the principles of the Freedom Charter¹ — was diluted during the negotiations for South Africa’s new democratic government. As a result, the political and educational ideal of ‘people’s education for ‘people’s power’ has given way to democratic elitism in post-apartheid South African schools.Keywords: democracy; education; elitism; Freedom Charter; participation; people’s education; Representative Councils of Learners; School Governing Bodie

Bioceramic hydroxyapatite coating fabricated on TI-6AL-4V using Nd:YAG laser

A method of synthesising a biocompatible HAP coating is presented. In the current study, Nd:YAG laser was used to directly melt pre-place HAP powder beds on Ti-6Al-4V. The processing parameters used were 750 W laser power, 5 mm/s scanning speed and 27° inclined beam plane. The coating was studied under white light and scanning electron microscope where it was possible to characterise the microstructures. The produced coating was characterised of mixed morphologies of HAP, short and elongated titanium needles at the surface while in the middle of the coating dendrite trunks without arms were observed. This observation is related to the heat inputs, dilution and melting of the substrate and powder during processing. The absence of the arms growing from the trunks indicated low heat inputs. In addition, the microstructure of the HAP after soaking in Hanks’ solution indicated octagonal and hexagonal crystals of HAP. The hardness values indicated good metallurgical bonding at the interface. In conclusion, this study was successful in fabricating a desirable coating of HAP on Ti-6Al-4V for biomedical applications. This work highlights that even though laser power and scanning speed are predominantly influential parameter settings, it is also necessary to consider the angle at which the laser beam is scanned across the material

In vitro antibacterial activity of Venda medicinal plants

Ethanolic and aqueous extracts of ten medicinal plants used in folklore medicine in Venda (South Africa) were screened for their in vitro activity against some Grampositive and Gram-negative pathogenic bacteria using the disc diffusion method. Root and stembark extracts of Datura stramonium at a concentration of 50mgml-1 were inhibitory to most of the organisms with a diameter of zone of inhibition of growth ranging from 12–19mm. Warburgia salutaris was also inhibitory to most of the bacteria with a diameter of zone of inhibition of growth ranging from 8–17mm at a concentration of 50mgml-1. A range of 10–16mm was observed for Peltophorum africanum at a concentration of 40mgml-1 against the Gram-negative bacteria tested. Other plants showed moderate or no activity, compared to a 30μgml-1 oxytetracycline control antibiotic. The use of these plants by the indigenes of Venda against diseases apparently caused by these organisms may be of some value

Factors associated with repeat genital symptoms among sexually transmitted infection service attendees in South Africa, 2015 - 2016

Background. South African guidelines recommend a syndromic approach for the management of sexually transmitted infections (STIs), based on the presence of genital symptoms. However, the guidelines do not prescribe specific indications for microbiology testing for patients presenting with or without repeat genital symptoms.Objectives. To describe the prevalence of and factors associated with repeat genital symptoms among STI service attendees at primary care facilities.Methods. This was a cross-sectional study at 7 STI primary care facilities participating in the aetiological surveillance of STIs between January 2015 and December 2016. Demographic and clinical information and appropriate genital specimens were collected from participants presenting with vaginal discharge syndrome (VDS), male urethral syndrome (MUS) and/or genital ulcer syndrome (GUS). Repeat genital symptoms were defined as self-reported history of the same STI-related genital symptoms in the preceding 12 months. Multivariable logistic regression identified factors associated with repeat genital symptoms.Results. Of 1 822 eligible participants, 480 (30%) had repeat genital symptoms (25% and 75% in the preceding 3 months and 12 months, respectively). Of those with repeat genital symptoms, the median age was 28 (interquartile range (IQR) 24 - 32) years, and 54% were females. The most common aetiological agents among participants with VDS, MUS and GUS were bacterial vaginosis (n=132; 55%), Neisseria gonorrhoeae (n=172; 81%) and ulcers (n=67; 63%), respectively. One hundred and seven (20%) participants had no detectable common STI aetiology. In the multivariable analysis, repeat genital symptoms were associated with HIV co-infection (adjusted odds ratio (aOR) 1.43; 95% confidence interval (CI) 1.14 - 1.78), VDS diagnosis (aOR 1.39; 95% CI 1.10 - 1.76), self-reported condom use (aOR 1.56; 95% CI 1.20 - 2.03) and age 25 - 34 years (aOR 1.33; 95% CI 1.03 - 1.71).Conclusions. Our study found a high prevalence of repeat genital symptoms ‒ a significant proportion without STI aetiology. Identified factors of repeat genital symptoms highlight the need for improved integration of HIV and STI prevention and management. Further research is needed to determine the aetiology of repeat genital symptoms and the contribution of non-STI causes

Comparison of the amplitude of accommodation determined subjectively and objectively in South African university students

Abstract: Background: Historically, two clinical methods have been used for measuring the amplitude of accommodation, which are the push-up and minus lens methods. However, it has been documented that the push-up method overestimates amplitude of accommodation, while the minus lens method underestimates it. Aim: The purpose of this study was to compare subjective and objective procedures for determining the monocular amplitude of accommodation in young optometry students. Setting: The study was conducted in the optometry clinic at the university. Methods: Amplitude of accommodation was measured on 45 optometry students (17 males and 28 females, whose ages ranged from 21 to 27 years) using the push-up, push-down, minus lens, modified dynamic retinoscopy and Pascal dynamic retinoscopy methods. Data were collected by three different examiners in this study. One examiner measured all the subjective tests, while another examiner measured the modified dynamic retinoscopy. The third examiner measured the Pascal heterodynamic retinoscopy. Results: The highest amplitude of accommodation was obtained using the push-up method (10.23 ± 1.67 D), while the minus lens method gave the lowest subjective finding (8.43 ± 1.68 D). However, the subjective methods generally produced comparable results. Both retinoscopic methods showed the lowest mean amplitude of accommodation of approximately 6.50 ± 1.40 D. However, there was a high correlation between the various methods. Conclusion: The push-up and push-down methods overestimate the true amplitude of accommodation because of the relative magnification, while the minus lens method creates an abnormal viewing environment in which the target is stationary but the stimulus becomes increasingly minified. Subjective amplitude of accommodation is an inadequate measure to assess any true accommodation because it fails to differentiate between passive depth of focus and an active accommodative power change in the eye. Therefore, subjective measurement of the amplitude of accommodation may suggest that accommodation is present when it is not. Further research is needed to further validate dynamic retinoscopy as the optimal or best possible routine clinical method to assess the true amplitude of accommodation

Factors associated with repeat genital symptoms among sexually transmitted infection service attendees in South Africa, 2015-2016

BACKGROUND. South African guidelines recommend a syndromic approach for the management of sexually transmitted infections (STIs), based on the presence of genital symptoms. However, the guidelines do not prescribe specific indications for microbiology testing for patients presenting with or without repeat genital symptoms. OBJECTIVES. To describe the prevalence of and factors associated with repeat genital symptoms among STI service attendees at primary care facilities. METHODS. This was a cross-sectional study at 7 STI primary care facilities participating in the aetiological surveillance of STIs between January 2015 and December 2016. Demographic and clinical information and appropriate genital specimens were collected from participants presenting with vaginal discharge syndrome (VDS), male urethral syndrome (MUS) and/or genital ulcer syndrome (GUS). Repeat genital symptoms were defined as self-reported history of the same STI-related genital symptoms in the preceding 12 months. Multivariable logistic regression identified factors associated with repeat genital symptoms. RESULTS. Of 1 822 eligible participants, 480 (30%) had repeat genital symptoms (25% and 75% in the preceding 3 months and 12 months, respectively). Of those with repeat genital symptoms, the median age was 28 (interquartile range (IQR) 24 - 32) years, and 54% were females. The most common aetiological agents among participants with VDS, MUS and GUS were bacterial vaginosis (n=132; 55%), Neisseria gonorrhoeae (n=172; 81%) and ulcers (n=67; 63%), respectively. One hundred and seven (20%) participants had no detectable common STI aetiology. In the multivariable analysis, repeat genital symptoms were associated with HIV co-infection (adjusted odds ratio (aOR) 1.43; 95% confidence interval (CI) 1.14 - 1.78), VDS diagnosis (aOR 1.39; 95% CI 1.10 - 1.76), self-reported condom use (aOR 1.56; 95% CI 1.20 - 2.03) and age 25 - 34 years (aOR 1.33; 95% CI 1.03 - 1.71). CONCLUSIONS. Our study found a high prevalence of repeat genital symptoms ‒ a significant proportion without STI aetiology. Identified factors of repeat genital symptoms highlight the need for improved integration of HIV and STI prevention and management. Further research is needed to determine the aetiology of repeat genital symptoms and the contribution of non-STI causes.The SA National Department of Health through a core surveillance funding grant to the National Institute for Communicable Diseases (NICD).http://www.samj.org.zaam2021School of Health Systems and Public Health (SHSPH

Rapid impact of effective treatment on transmission of multidrug-resistant tuberculosis

BACKGROUND: Effective treatment for drug-susceptible tuberculosis (TB) rapidly renders patients noninfectious, long before conversion of sputum acid-fast smear or culture to negative. Multidrug-resistant TB (MDR-TB) patients on treatment are currently assumed to remain infectious for months. While the resources required for prolonged hospitalization are a barrier to the scale-up of MDR-TB treatment, the safety of community treatment is clear. OBJECTIVES : To estimate the impact of treatment on infectiousness among MDR-TB patients. METHODS: A series of five human-to-guinea pig TB transmission studies was conducted to test various interventions for infection control. Guinea pigs in adjacent chambers were exposed to exhaust air from a hospital ward occupied by mostly sputum smear- and culture-positive MDR-TB patients. The guinea pigs then underwent tuberculin skin testing for infection. Only the control groups of guinea pigs from each study (no interventions used) provide the data for this analysis. The number of guinea pigs infected in each study is reported and correlated with Mycobacterium tuberculosis drug susceptibility relative to treatment. RESULTS : Despite exposure to presumably infectious MDR-TB patients, infection percentages among guinea pigs ranged from 1% to 77% in the five experiments conducted. In one experiment in which guinea pigs were exposed to 27 MDR-TB patients newly started on effective treatment for 3 months, there was minimal transmission. In four other experiments with greater transmission, guinea pigs had been exposed to patients with unsuspected extensively drug-resistant tuberculosis who were not on effective treatment. CONCLUSIONS : In this model, effective treatment appears to render MDR-TB patients rapidly noninfectious. Further prospective studies on this subject are needed.NIOSH R01OH009050http://www.ingentaconnect.com/content/iuatld/ijtldhb201

Feasibility and acceptability of conducting HIV vaccine trials in adolescents in South Africa: Going beyond willingness to participate towards implementation

Background. HIV/AIDS remains a leading cause of death in adolescents (aged 15 - 25 years), and in sub-Saharan Africa HIV-related deaths continue to rise in this age group despite a decline in both adult and paediatric populations. This is attributable in part to high adolescent infection rates and supports the urgent need for more efficacious prevention strategies. In particular, an even partially effective HIV vaccine, given prior to sexual debut, is predicted to significantly curb adolescent infection rates. While adolescents have indicated willingness to participate in HIV vaccine trials, there are concerns around safety, uptake, adherence, and ethical and logistic issues.Objectives. To initiate a national, multisite project with the aim of identifying obstacles to conducting adolescent HIV vaccine trials in South Africa (SA).Method. A simulated HIV vaccine trial was conducted in adolescents aged 12 - 17 years across five SA research sites, using the already licensed Merck human papillomavirus vaccine Gardasil as a proxy for an HIV vaccine. Adolescents were recruited at community venues and, following a vaccine discussion group, invited to participate in the trial. Consent for trial enrolment was obtained from a parent or legal guardian, and participants aged 16 - 17 years were eligible only if sexually active. Typical vaccine trial procedures were applied during the five study visits, including the administration of vaccination injections at study visits 2, 3 and 4.Results. The median age of participants was 14 years (interquartile range 13 - 15), with 81% between the ages of 12 and 15 years at enrolment. Overall, 98% of screened participants opted to receive the vaccine, 588 participants enrolled, and 524 (89%) attended the final visit.Conclusions. This trial showed that adolescents can be recruited, enrolled and retained in clinical prevention trials with parental support. While promising, these results were tempered by the coupling of sexual-risk eligibility criteria and the requirement for parental/guardian consent, which was probably a barrier to the enrolment of high-risk older adolescents. Further debate around appropriate consent approaches for such adolescents in HIV prevention studies is required