Aquaponics production simulations using the decision-making tool

Aquaponics have related food and nutrition security benefit that are important for this country (South Africa). The aim of this study was to apply  aquaponics decision-making tool to provide potential aquaponics production data and information for South Africa. This study was designed as  2×3×3 factorial study giving 18 interactions. Because aquaponics are the production of fish and crops concurrently, yield production had two levels-  fish and crop, fish stocking density had three levels- low, optimum and higher and aquaponics scale of production had 3 levels- hobby, subsistence  and commercial scale. The summary of data of aquaponics variables from the literature was used as optimum level, lower and higher levels were  based on experimental design. Yield production (kg) of both fish and plants increased significantly (p<0.05) as fish stocking density was increased. In  hobby scale, plants yield was higher than fish yield in all levels of fish stocking density, the plant-fish yield (kg) was 40-33, 80-67 and 150-133,  respectively. In subsistence scale, fish-plant yield (kg) was 240-200, 300-267 and 400-333, respectively. In commercial scale, fish-plant yield (kg) was  600-533, 1 100-1 000, 1 500-1 333, respectively. Daily fish feed increased significantly with increase in fish stocking density across all scale of  aquaponics production (hobby<subsistence<commercial). In hobby scale, at low fish stocking, 0.65kg feed produced 1 kg fish, at optimum, 0.65kg  feed produced 1 kg fish and at higher fish stocking, 0.37kg feed produced 1 kg fish. In subsistence scale at low fish stocking density, 0.38kg feed  produced 1 kg fish, at optimum level, 0.63kg feed produced 1 kg fish and at higher level, 0.65kg feed produced 1 kg fish. In commercial scale, in low  fish stocking, 0.64kg feed produced 1 kg fish, at optimum, 0.63kg feed produced 1 kg fish and at higher fish stocking, 0.64kg feed produced 1 kg  fish. Plant culture have more yield output than fish culture in all aquaponics scale of production. Hobby scale produced the lowest yield than  subsistence than commercial scale of production. Hobby scale practise could not produce sufficient yield to support human subsistence. Fish feed  closely mirrored yield production. Lower fish stocking density maybe adopted in subsistence scale. Higher fish stocking density maybe adopted in  commercial scale. Fish feed could become an economic sustainability constraint in aquaponics production, particularly in a developing country like South Africa. Water availability and quality effects on yield was not determine especially in African context

Revitalising the “good” in good local governance : calling for active participatory citizenship

Good governance is a principle and a practice much sought after in the contemporary world, but most countries, including South Africa, struggle to meet the ideals of (the) “good” in “good governance”, despite the fact that the relevant principles have been institutionalised in policy frameworks, and despite the scrutiny of “compliance watchdogs” to safeguard compliance. This article explores the roles that active citizenship and citizen participation should play in holding the State accountable and in instilling a “culture of good governance” in the sphere of local government. Government processes created to ensure good local governance should allow citizen participation spaces through which citizens can experience a sense that they can influence, direct, control and own their own development. Active citizenship, citizen participation and protest action are fundamental instruments to hold local government accountable and to ensure good governance in order to enable social transformation. The article is based on a literature survey, previous research and participatory observation by both authors, as well as the outcomes of participatory workshops with municipal officials during the facilitation of programmes on citizen participation and good governance. Good governance as a concept and universal norm is unpacked, and active citizen participation as a key governance tool is explored. The article makes recommendations on improving good local governance through active citizenship

Women’s experiences on the use of Implanon as a contraceptive method in a selected primary healthcare facility in KwaZulu-Natal

Background: The South African department of health recently introduced subdermal Implanon contraceptive implant with the aim to reduce teenage pregnancy and maternal mortality. First used in all public healthcare facilities across the country since early 2014, this method of contraception has been described as highly effective. However, some women have reported unbearable side effects, forcing them to remove the contraceptive implant early before its expiry date. Negligible emphasis has been placed on staff training and development to equip the nurses with new protocol and policies on Implanon. Objectives: The objective of this study was to explore experiences of women using Implanon as method of contraception at a selected primary healthcare facility in KwaZulu-Natal province of South Africa. Methods: A qualitative, descriptive and exploratory study design was used. A purposive sampling technique was used and a sample of seven women aged between 15 and 50 years was selected for this study. Semi-structured interviews were used in the data collection process. The Tesch’s method for data coding and data analysis was utilised. Necessary ethical measures were taken to ensure that the study is trustworthy. The study was conducted at Community Health Centre, KwaZulu-Natal between June 2017 and December 2018. Results: The findings showed that some participants were still willing to continue using this method of contraception regardless of the unwanted side effects. Major side effects reported were heavy menstrual bleeding, pain and discomfort, weight loss, insomnia and decreased sexual interest, which resulted in most participants stopping the use of Implanon. Conclusion: Most of the participants’ experience unwanted side effects because of poor screening, counselling and support. There is a clear demand to develop a screening tool and facilitate training of healthcare workers when initiating the use of Implanon. Keywords: Implanon; Implanon users; experiences; perceptions; primary healthcar

Using joint models to study the association between CD4 count and the risk of death in TB/HIV data

BACKGROUND: The association structure linking the longitudinal and survival sub-models is of fundamental importance in the joint modeling framework and the choice of this structure should be made based on the clinical background of the study. However, this information may not always be accessible and rationale for selecting this association structure has received relatively little attention in the literature. To this end, we aim to explore four alternative functional forms of the association structure between the CD4 count and the risk of death and provide rationale for selecting the optimal association structure for our data. We also aim to compare the results obtained from the joint model to those obtained from the time-varying Cox model. METHODS: We used data from the Centre for the AIDS Programme of Research in South Africa (CAPRISA) AIDS Treatment programme, the Starting Antiretroviral Therapy at Three Points in Tuberculosis (SAPiT) study, an open-label, three armed randomised, controlled trial between June 2005 and July 2010 (N=642). In our analysis, we combined the early and late integrated arms and compared results to the sequential arm. We utilized the Deviance Information Criterion (DIC) to select the final model with the best structure, with smaller values indicating better model adjustments to the data. RESULTS: Patient characteristics were similar across the study arms. Combined integrated therapy arms had a reduction of 55% in mortality (HR:0.45, 95% CI:0.28-0.72) compared to the sequential therapy arm. The joint model with a cumulative effects functional form was chosen as the best association structure. In particular, our joint model found that the area under the longitudinal profile of CD4 count was strongly associated with a 21% reduction in mortality (HR:0.79, 95% CI:0.72-0.86). Where as results from the time-varying Cox model showed a 19% reduction in mortality (HR:0.81, 95% CI:0.77-0.84). CONCLUSIONS: In this paper we have shown that the “current value” association structure is not always the best structure that expresses the correct relationship between the outcomes in all settings, which is why it is crucial to explore alternative clinically meaningful association structures that links the longitudinal and survival processes

Hen egg white bovine colostrum supplement reduces symptoms of mild/moderate COVID-19: a randomized control trial

Aim: The ability of a hen egg white bovine colostrum supplement to prevent severe COVID-19 was tested in a double-blind randomized control study. Methods: Adults with mild/moderate COVID-19, risk factors for severe disease, and within 5 days of symptom onset were assigned to the intervention (n = 77) or placebo (n = 79) arms. Symptoms were documented until day 42 post-enrollment and viral clearance was assessed at 11-13 days post-symptom onset. Results: One participant developed severe COVID-19. The severe-type symptom score was lower in the active arm at 11-13 days post-symptom onset (p = 0.049). Chest pain, fever/chills, joint pain/malaise, and sore throat were significantly less frequent in the active arm. No differences in viral clearance were observed. Conclusion: The intervention reduced symptoms of mild/moderate COVID-19

Prevalence of sexually transmitted infections among young people in South Africa: A nested survey in a health and demographic surveillance site

BACKGROUND: Sexually transmitted infections (STIs) and bacterial vaginosis (BV) are associated with increased transmission of HIV, and poor reproductive and sexual health. The burden of STIs/BV among young people is unknown in many high HIV prevalence settings. We conducted an acceptability, feasibility, and prevalence study of home-based sampling for STIs/BV among young men and women aged 15-24 years old in a health and demographic surveillance site (HDSS) in rural KwaZulu-Natal, South Africa. METHODS AND FINDINGS: A total of 1,342 young people, stratified by age (15-19 and 20-24 years) and sex were selected from the HDSS sampling frame; 1,171/1,342 (87%) individuals had ≥1 attempted home visit between 4 October 2016 and 31 January 2017, of whom 790 (67%) were successfully contacted. Among the 645 who were contacted and eligible, 447 (69%) enrolled. Consenting/assenting participants were interviewed, and blood, self-collected urine (men), and vaginal swabs (women) were tested for herpes simplex virus type 2 (HSV-2), chlamydia, gonorrhoea, syphilis, trichomoniasis, and BV. Both men and women reported that sample collection was easy. Participants disagreed that sampling was painful; more than half of the participants disagreed that they felt anxious or embarrassed. The weighted prevalence of STIs/BV among men and women, respectively, was 5.3% and 11.2% for chlamydia, 1.5% and 1.8% for gonorrhoea, 0% and 0.4% for active syphilis, 0.6% and 4.6% for trichomoniasis, 16.8% and 28.7% for HSV-2, and 42.1% for BV (women only). Of the women with ≥1 curable STI, 75% reported no symptoms. Factors associated with STIs/BV included having older age, being female, and not being in school or working. Among those who participated in the 2016 HIV serosurvey, the prevalence of HIV was 5.6% among men and 19% among women. Feasibility was impacted by the short study duration and the difficulty finding men at home. CONCLUSIONS: A high prevalence of STIs/BV was found in this rural setting with high HIV prevalence in South Africa. Most STIs and HIV infections were asymptomatic and would not have been identified or treated under national syndromic management guidelines. A nested STI/BV survey within a HDSS proved acceptable and feasible. This is a proof of concept for population-based STI surveillance in low- and middle-income countries that could be utilised in the evaluation of STI/HIV prevention and control programmes

Indonesian adolescents’ experiences during pregnancy and early parenthood: a qualitative study

Background: This study explored Indonesian adolescents’ experiences of (premarital-conceived) pregnancy and early parenthood. The findings provide insight into participants’ journeys with a central thread of culture and religion running through them. Methods: Using an exploratory qualitative approach, purposive and snowball sampling techniques were used to recruit 20 participants. Overall, 36 one-to-one, in-depth interviews were conducted. Data were thematically analyzed using an inductive approach and coauthors confirmed the credibility of the analytical process. Findings: Cultural and religious ideologies about premarital sex strongly influenced government policies, social practices and unwritten social ideology, norms, values and behavior. Pre-marital pregnancy was socially unacceptable. Access to education and work was limited. Participants were nurtured by their parents with emotional, financial and nutritional support if they complied to marry and adopt socially acceptable roles. Adolescent males overwhelmingly wanted to undertake their responsibilities whilst the distress for females was overwhelming. Spirituality provided participants a way to manage their distress, seek forgiveness and develop transformational self-belief. Conclusion: Indonesian adolescents and young parents’ experiences revealed the powerful influence of cultural and religion upon policy and social structure. The study shows a unique insight into the influence of spirituality and the compliant and nurturing behavior within a family structure

Predictors of tuberculosis (TB) and antiretroviral (ARV) medication non-adherence in public primary care patients in South Africa: A cross sectional study

Background: Despite the downward trend in the absolute number of tuberculosis (TB) cases since 2006 and the fall in the incidence rates since 2001, the burden of disease caused by TB remains a global health challenge. The co-infection between TB and HIV adds to this disease burden. TB is completely curable through the intake of a strict anti-TB drug treatment regimen which requires an extremely high and consistent level of adherence.The aim of this study was to investigate factors associated with adherence to anti-TB and HIV treatment drugs. Methods: A cross-sectional survey method was used. Three study districts (14 primary health care facilities in each) were selected on the basis of the highest TB caseload per clinic. All new TB and new TB retreatment patients were consecutively screened within one month of anti-tuberculosis treatment. The sample comprised of 3107 TB patients who had been on treatment for at least three weeks and a sub-sample of the total sample were on both anti-TB treatment and anti-retro-viral therapy(ART) (N = 757). Data collection tools included: a Socio-Demographic Questionnaire; a Post-Traumatic-Stress-Disorder (PTSD) Screen; a Psychological Distress Scale; the Alcohol Use Disorder Identification Test (AUDIT); and self-report measures of tobacco use, perceived health status and adherence to anti-TB drugs and ART. Results: The majority of the participants (N = 3107) were new TB cases with a 55.9% HIV co-infection rate in this adult male and female sample 18 years and older. Significant predictors of non-adherence common to both anti-TB drugs and to dual therapy (ART and anti-TB drugs) included poverty, having one or more co-morbid health condition, being a high risk for alcohol mis-use and a partner who is HIV positive. An additional predictor for non-adherence to anti-TB drugs was tobacco use. Conclusions: A comprehensive treatment programme addressing poverty, alcohol mis-use, tobacco use and psycho-social counseling is indicated for TB patients (with and without HIV). The treatment care package needs to involve not only the health sector but other relevant government sectors, such as social development.IS