Towards Medical Education that is Responsive to Community Needs, while Recognising Community Assets and Capabilities

Medical education today is under severe tension between “maintenance of standards” and “relevance to the needs of the population served”. A standard is a level of excellence and conventional schools tend to separate “standards” from “relevance” whereas innovative schools do not. This battle has been going on for sometime and in many places including South Africa. de Klerk (1979) warns that South African doctors should not allow the medical standards they have set for themselves to deteriorate because of the pragmatic problems encountered in attempting to attain the primary health care ideal. Daubenton (1990), on the other hand, states that one is excellent only if one is relevant. According to Daubenton, medical education can only be considered excellent if it is responsive and relevant to local needs

The Prevalence and Reasons for Interruption of Antituberculosis Treatment by Patients at Mbekweni Health Centre in King Sabata Dalidyebo (KSD) District in the Eastern Cape Province

Background: In spite of effective therapy, tuberculosis (TB) is still a major health problem in developing countries. In 1993, therefore, the World Health Organization declared TB a global emergency. In South Africa, TB is one of the most prevalent diseases, with an incidence of 556 per 100 000 population. In spite of free TB drugs in the public service and the directly observed treatment short course (DOTS) strategies, there is still a high prevalence of TB and a high treatment interruption rate in rural South Africa. Methods: The objectives of this study were to establish the prevalence of TB and reasons for the interruption of TB treatment by patients attending Mbekweni Health Centre in King Sabata Dalidyebo (KSD) district in the Eastern Cape province. This was a cross- sectional study in which data were collected from 15 July 2004 to 15 January 2005 from patients who were on TB treatment and interrupted their treatment between 6 August 2001 and 30 December 2003. Results: Of the 255 TB patients who attended for treatment, 121 (47.5%) had interrupted their treatment. Reasons given for interrup- tion included change of living place (18.96%), no money to go to the clinic (15.52%), feeling better (13.78%), side effects of the drug (6.90%), did not know the treatment course (5.17%), physical disability either old or too sick to collect treatment and nobody to help (5.17%), clinic too far (1.73%), drug not available in the clinic (13.83%) and no reasons (8.62%). Conclusion: The prevalence of treatment interruption was high in this study. Change of living place, lack of money for visiting the clinic to collect treatment, feeling better, and no drugs at the clinic were the major reasons given for interruption of treatment. Ensuring the availability of TB drugs at the health centre/clinic, patient education about TB and strengthening the DOTS programme, including a stipend for the DOTS supervisors, would help to reduce the prevalence of treatment interruption. South African Family Practice Vol. 50 (6) 2008: pp. 47-47

Implementation of a facebook crawler for opinion monitoring and trend analysis purposes: a case study of government service delivery in Dwesa

The Internet has shifted from the Web 1.0 era to the Web 2.0 era. In the contemporary era of web 2.0, the Internet is being used to build and reflect social relationships among people who share similar interests and activities. This is done through services such as Social Networking Sites (Facebook, Twitter etc.) and the web blogs. Currently, there is a very high usage of Social Networking Sites (SNSs) and blogs where people share their views, opinions, and thoughts. This leads to the production of a lot of data by people who post such content on SNSs. As a result, SNSs and blogs become the ideal platforms for opinion monitoring and the trend analysis. These SNSs and Blogs could be used by service providers for tracking what the public thinks or requires. The reason being, having such knowledge can help in decision making and future planning. If service providers can keep track of such views, opinions or thoughts with regard to the services they provide, they can better their understanding about the public or clients’ needs and improve the provision of relevant services. This research project presents a system prototype for performing opinion monitoring and trend analysis on Facebook. The proposed system crawl Facebook, indexes the data and provides user interface (UI) where end users can search and see the trending of a topics of their choice. The system prototype could also be used to check the trending topics without having to search. The main objective of this research project was to develop a framework that will contribute in improving the way government officials, companies or any service providers and normal citizens communicate regarding services they provide. This research project is premised on the conceptualization that if the government officials, companies or any service providers can keep track of the citizen’s opinions, views and thoughts with regards to services they provide it can help improve the delivery of such services. This research and the implementation of the trend analysis tool is undertaken in the context of the Siyakhula Living Lab (SLL), an Information and Communication Technologies for Development (ICTD) intervention for Dwesa marginalized community

An investigation into conditions that enable or constrain sustainable paper usage at Rhodes University

The interest in this study was initiated by the rapid global transition of paper usage to digital systems in teaching and learning at tertiary institutions, particularly those that are signatories to the Talloires Declaration, which include Rhodes University (RU). It was discovered that there are two earlier studies (Leslie et al. 2009; Amutenya et al. 2009) that investigated and proposed recommendations towards sustainable paper usage at Rhodes University (RU). This study then investigated the response of RU to the proposed recommendations of the above mentioned studies and evaluated the conditions that promote and constrain sustainable paper usage in teaching and learning, and the attitudes of users thereof

Primary care morbidity in Eastern Cape Province

Background. Primary health care in rural South Africa is predominantly provided by remote clinics and health centres. In 1994, health centres were upgraded and new health centres developed to serve as a health care filter between community clinics and district hospitals.Aim. To describe the spectrum of clinical problems encountered at a new health centre in an area of high economic deprivation and compare this with an adjacent community clinic and district hospital.Design. Cross-sectional survey.Setting. A rural clinic, health centre and district hospital in Eastern Cape Province, South Africa.Methods. The International Classification of Primary Care-2(ICPC-2) was used to code data collected over a 13-week period from patients presenting at a community clinic, health centre and district hospital.Results. Altogether, 4 383 patient encounters were recorded across all three sites. Most contacts at the clinic (97%) and the health centre (80%) were with a nurse. Females over 15 years of age comprised over half of all contacts at health facilities (53%). The most common diagnosis category was respiratory (23%). Cough was the most common symptom.Thirty per cent of children up to 5 years of age were seen for immunisations. Most childhood immunisations (79%) werecarried out at the health centre.Conclusion. Of all the health care facilities surveyed, the health centre had the highest throughput of patients, indicating that the health centre is an efficient filter between the community and hospital. The ICPC-2 can be successfully used to monitor encounters at similar African health care facilities.S Afr Med J 2010; 100: 309-312

Intimate partner violence and infant morbidity: evidence of an association from a population-based study in eastern Uganda in 2003

<p>Abstract</p> <p>Background</p> <p>Although recent studies suggest that there is an association between intimate partner violence and child mortality, the underlying mechanisms are still unknown. It is against this background that as a secondary objective, we set out to explore whether an association exists between intimate partner violence and illness in infants.</p> <p>Methods</p> <p>We conducted a population based household survey in Mbale, eastern Uganda in 2003. Participants were 457 women (with 457 infants) who consented to participate in the study. We measured socio-demographics of women and occurrence of intimate partner violence. We measured socio-demographics, immunization, nutritional status, and illness in the previous two weeks of the children.</p> <p>Results</p> <p>The mean age of the women was 25 years (SD 5.7) while the mean age of the infants was 6 months (SD 3.5). The prevalence of lifetime intimate partner violence was 54% (95% CI 48%–60%). During the previous two weeks, 50% (95% CI 50%–54%) of the children had illness (fever, diarrhoea, cough and fast breathing). Lifetime intimate partner violence was associated with infant illness (OR 1.8, 95% CI 1.2–2.8) and diarrhoea (OR 2.0, 95% CI 1.2–3.4).</p> <p>Conclusion</p> <p>Our findings suggest that infant illnesses (fever, diarrhoea, cough and fast breathing) are associated with intimate partner violence, and provide insights into previous reports that have shown an association between intimate partner violence and child mortality, suggesting possible underlying mechanisms. Our findings also highlight the importance of intimate partner violence on the health of children, and the need for further research in this area.</p

Selective extraction of Cyclopia for enhanced in vitro phytoestrogenicity

Thesis (MSc (Biochemistry))--University of Stellenbosch, 2008.Phytoestrogens are plant compounds whose ability to mimic the action of estrogens has resulted in their usage for the treatment of menopausal symptoms. Despite uncertainties about the safety and effectiveness of phytoestrogens in humans, the use of market phytoestrogenic nutraceuticals and botanicals is on the increase. Positive epidemiological study findings coupled to an entrenched belief in many societies about the superiority of what they view as “natural” remedies, as well as the reluctance of women to use the traditional hormone replacement therapy due to its association with detrimental health effects as reported by studies such as the World Health Initiative, the Million Women and the Kronos Early Estrogen Prevention studies, are thought to be instrumental in the growth of the phytoestrogen market. As the subject of the current thesis, we investigated the candidacy of extracts of the honeybush plant (genus Cyclopia), which is used for the manufacture of popular tea beverages, for use in the formulation of a high quality phytoestrogenic nutraceutical with a competitive market edge. We evaluated four harvestings of Cyclopia (M6-9) available in bulk and selected 2 harvestings (M6 and M7) for further extraction using solvents of differing polarity and also mimicking the preparation of a cup of tea. Our findings clearly demonstrate that of the resultant 22 extracts the SM6Met and SM6EAc extracts had the highest in vitro potency and efficacy, respectively. Another exciting finding from our study is the unequivocal demonstration of phytoestrogenic activity by extracts prepared in the same manner as the traditional cup of honeybush tea. Additionally, our study has highlighted the importance and the influence of experimental variables such as the specific harvesting evaluated and the characteristics of the extraction solvent (e.g. polarity and temperature) on the yield and the estrogenic activity of the extracts. In addition, the advantage of certain in vitro assays over others for discriminating between estrogenic substances based on their efficacies and potencies was demonstrated with the alkaline phosphatase assay being most suitable for discriminating efficacy and the E-screen most suitable for discriminating potency. Furthermore, our study has imparted a valuable lesson about the pharmacological behavior of estrogenic substances by presenting a conundrum in the form of the two desirable pharmacological parameters (potency and efficacy) occurring in different extracts, an outcome that complicates the central aim of our study, which is the preparation of an extract that embodies both parameters. Additionally, the low quantity of known putative phytoestrogens and the presence of unidentified polyphenols in M6, the source of our choice extracts (SM6Met and SM6EAc), makes the high estrogenic potency and efficacy of the choice extracts that much more intriguing. Nonetheless, benchmarking against four market phytoestrogen extracts indicate that the Cyclopia extracts have comparable estrogenicity suggesting potential as marketable phytoestrogenic preparations. The combination of the achievement of aims and the birth of new questions from that very achievement, which are the hallmark of scientific endeavors, have made this study a rewarding experience and we hope to share the feeling in its entirety with the reader