Municipal solid-waste collection and disposal management using geospatial techniques in Maseru City, Lesotho

The use of geospatial techniques plays a crucial role in solid waste management. Collection and transportation of solid waste must be done in an efficient manner to avoid negative environmental impacts. At the time of study, there are no collection and routing system in Maseru City, leading to haphazard collection and disposal of Municipal Solid Waste (MSW). The aims of the study are: (i) To get an understanding and address the challenges faced by relevant stakeholders in solid waste management for Maseru City, (ii) To minimize adverse environmental impacts due to unscientific location of a disposal site and (iii) To minimize transportation costs and time during collection. The objectives of this study are summarized in the following: assess the current solid waste management, model suitable disposal/dump sites, determine MSW collection points and develop an optimal route for MSW collection and disposal in Maseru City. To assess the current solid waste management, 130 households, 73 community waste pickers, 15 Maseru City Council (MCC) management staff and 3 drivers were interviewed, and relevant data collected. Both primary and secondary data collection methods were used. Primary data collection methods included interviews, questionnaires and observations and creating feature classes in a geo database. Secondary data collection was done from relevant government repositories, digitization, and internet web sites. Simple random, area, cluster, and convenience sampling techniques were applied. Geographical Information Systems (GIS) and Remote sensing techniques were used to carry out suitability and network analysis, and location of MSW collection points. The study found out that the dump site (Ts'osane) was used by MCC and was not suitably located, hence more suitable alternative dump sites have been proposed. However, Ts'osane dump site was adopted in the analysis as it is the one used by MCC at the time of study. The researcher also found out that there were no designated MSW collection points and optimal routes, and that solid waste collection was done by both MCC and CBOs. In this regard, 334 collection points have been determined based on population and generated solid waste per Constituency and were randomly located in the study area. However, due to the policy that within 25m from the road no development could take place, only collection points which fell v within 25m from the road were selected and used in the routing analysis. One truck was used in the analysis, although more trucks could be used as it was at the time of study. For future research, there is a need to research on policy so that criteria for locating solid waste disposal and location of collection points is explicitly specified in the law to be able to conduct scientific analyses. A multi modal network analysis that would include all the vehicles used by MCC and the CBOs to develop a comprehensive network analysis that would also include necessary attributes such as road names, type, class, and length is needed

Factors that influence household health care utilization patterns in two districts of Zambia : a rural - urban comparative evaluation

Includes bibliographical references (leaves 111-116).This research project was undertaken with the primary objective of determining whether there are differential household health care utilization patterns between rural and urban areas in Zambia and what factors, if any, are responsible for such spatial variations. The factors considered in this study include: the gender of the household head, age of individual household members, religious affiliation of the household, the marital status of the household head, the size of the household, the educational status of the household head, the household head's employment status, and the socio-economic status of the household. The data was collected using a household health survey with questionnaires administered to the household head. A total of 660 households (3,150 persons) were sampled, 320 households (1,696 persons) in Chipata District and 340 households (1,454 persons) in Ndola District. The data included information on socio-economic and demographic factors that have been regularly considered in the theoretical literature and empirical evidence as impacting upon household and individual decision-making when it comes to utilization of both formal and informal care. A multinomial logistic regression model was used to analyse the data quantitatively in Stata® Version 8.0 software. Close to a quarter ofthe overall sample admitted to suffering an illness or injury in the 4-week period preceding the interview. Self-care at the household level was the most frequently reported type of care chosen for minor and moderate illnesses or injuries (35.80 percent). Bivariate analysis and the multinomial logistic regression results indicate that the variables considered not only produce differential effects on household health care utilization patterns in both districts but also that the effects are different depending on location of the household. The results from our sample analyses show that household religious affiliation (Christianity) is negatively associated with formal health care utilization in the urban area while the age of the individual increases the household's utilization of formal and informal care, and the gender of the household head (female), hislher marital status, educational attainment, and employment status all have a positive impact on formal health care use in the rural area

Predominance of Methicillin Resistant Staphylococcus Aureus -ST88 and New ST1797 causing Wound Infection and Abscesses.

Although there has been a worldwide emergence and spread of methicillin-resistant Staphylococcus aureus (MRSA), little is known about the molecular epidemiology of MRSA in Tanzania. In this study, we characterized MRSA strains isolated from clinical specimens at the Bugando Medical Centre, Tanzania, between January and December 2008. Of 160 S. aureus isolates from 600 clinical specimens, 24 (15%) were found to be MRSA. Besides molecular screening for the Panton Valentine leukocidin (PVL) genes by PCR, MRSA strains were further characterized by Multi-Locus Sequence Typing (MLST) and spa typing. Despite considerable genetic diversity, the spa types t690 (29.1%) and t7231 (41.6%), as well as the sequence types (ST) 88 (54.2%) and 1797 (29.1%), were dominant among clinical isolates. The PVL genes were detected in 4 isolates; of these, 3 were found in ST 88 and one in ST1820. Resistance to erythromycin, clindamicin, gentamicin, tetracycline and co-trimoxazole was found in 45.8%, 62.5%, 41.6%, 45.8% and 50% of the strains, respectively. We present the first thorough typing of MRSA at a Tanzanian hospital.  Despite considerable genetic diversity, ST88 was dominant among clinical isolates at the Bugando Medical Centre. Active and standardized surveillance of nosocomial MRSA infection should be conducted in the future to analyse the infection and transmission rates and implement effective control measures

Organisational culture and trust as influences over the implementation of equity-oriented policy in two South African case study hospitals

BACKGROUND: This paper uses the concepts of organisational culture and organisational trust to explore the implementation of equity-oriented policies - the Uniform Patient Fee Schedule (UPFS) and Patients' Rights Charter (PRC) - in two South African district hospitals. It contributes to the small literatures on organisational culture and trust in low- and middle-income country health systems, and broader work on health systems' people-centeredness and "software". METHODS: The research entailed semi-structured interviews (Hospital A n = 115, Hospital B n = 80) with provincial, regional, district and hospital managers, as well as clinical and non-clinical hospital staff, hospital board members, and patients; observations of policy implementation, organisational functioning, staff interactions and patient-provider interactions; and structured surveys operationalising the Competing Values Framework for measuring organisational culture (Hospital A n = 155, Hospital B n = 77) and Organisational Trust Inventory (Hospital A n = 185, Hospital B n = 92) for assessing staff-manager trust. RESULTS: Regarding the UPFS, the hospitals' implementation approaches were similar in that both primarily understood it to be about revenue generation, granting fee exemptions was not a major focus, and considerable activity, facility management support, and provincial support was mobilised behind the UPFS. The hospitals' PRC paths diverged quite significantly, as Hospital A was more explicit in communicating and implementing the PRC, while the policy also enjoyed stronger managerial support in Hospital A than Hospital B. Beneath these experiences lie differences in how people's values, decisions and relationships influence health system functioning and in how the nature of policies, culture, trust and power dynamics can combine to create enabling or disabling micro-level implementation environments. CONCLUSIONS: Achieving equity in practice requires managers to take account of "unseen" but important factors such as organisational culture and trust, which are key aspects of the organisational context that can profoundly influence policies. In addition to implementation "hardware" such as putting in place necessary staff and resources, it emphasises "software" implementation tasks such as relationship management and the negotiation of values, where equity-oriented policies might be interpreted as challenging health workers' status and values, and paying careful attention to how policies are practically framed and translated into practice, to ensure key equity aspects are not neglected

The relationship between exposure to Soul City Educational Programme and knowledge and practices of South African women aged 16-65 years on cancer of the cervix

MSc(Med), Epidemiology and Biostatistics, Faculty of Health Sciences, 2009Background: Soul City Institute for Health and Development Communication (SC IHDC), a Non Governmental Organisation (NGO) set up to promote health through media tackled cervical cancer in 2006. The Soul City cervical cancer educational programme was developed and broadcasted on South African Broadcasting Cooperation (SABC1) television and radio stations across the country. This paper assesses the relationship between exposure to educational programme and knowledge and practise of South African women on cervical cancer. Objective: To investigate if there is an association between exposure to Soul City educational programme on cervical cancer and knowledge and practice of South African women in relation to cervical cancer. Methods: An analytical cross sectional study design was employed. Secondary data from a Soul City study was used and all South African women aged 16 – 65 years who enrolled into the 2006 leg of the study were included. The data was analysed using Stata 9 utilising logistic regression models. Results: There were 1013 women aged between 16 and 65 years in this study and the average age was 35 years. Most women lived in metropolitan areas (53%), were employed (41%), had secondary education (74%) and had knowledge about cervical cancer and Pap smear (>50%). Lack of knowledge about cervical cancer and Pap smear was observed amongst rural residents (>60%), illiterate women (>54%), and Black South African women (>54%). Generally, participation in cervical screening was low among these women. The iv majority of women had never been screened for cervical cancer in the past (49%) as well as in the previous 12 months (79%). However, a higher proportion of women aged 30 years and above had been for cervical screening test in the past (59%). Although many women aged 30 years and above had been screened sometime in the past, more than three quarters of them were not screened in the last 12 months. Low uptake of Pap smear in 2006 was observed amongst rural residents (6%), older women (9%), illiterate (4%), Coloured (20%) and Black (20%) South African women. Overall knowledge about cervical cancer and Pap smear was associated with exposure to Soul City educational programme on cervical cancer through different media more especially television. Women who watched Soul City on television were more likely to have knowledge about cervical cancer (OR = 1.97, and 95% CI = (1.12; 3.47)) and Pap smear (OR = 2.08, and 95% CI = (1.24; 3.47)) than those who did not watch the programme. Participation of women aged 30 years and above in cervical cancer screening in 2006 was not associated with exposure to the Soul City educational programme. Conclusion: The study findings suggest that Soul City educational programme is associated with knowledge about cervical cancer and Pap smear. There was no evidence that exposure to Soul City educational programme was associated with participation in cervical cancer screening in 2006

Parenting styles and the adjustment of black South African grade I children in single parent households

The present study examined the relationship between parenting styles and the socioemotional adjustment of children at school. A sample size of 90 research participants was selected and included black South African grade I school children aged between 6 and 7 years from single parent households in Pretoria Central. Factor analyses and Cronbach's alphas were determined in order to establish the validity and reliability (alpha= 0.89 and 0. 72 respectively) of the measurement instruments. In general, results were inconsistent with previous findings: The three parenting styles had no direct relationship with children's socio-emotional adjustment at school. Except for two links, non- significant relations between parenting styles and six subscales of socio-emotional adjustment were detected. However, maternal age, preschool attendance and gender of the child interacted in different combinations with four of the six subscales of socio-emotional adjustment. Future studies investigating parenting styles should take account of other areas of adjustment.PsychologyM.A. (Psychology

Conservation manager's perceptions regarding biodiversity in the North-West Parks and Tourism Board

Biodiversity perceptions of conservation managers in the North West Parks and Tourism Board are "teased out" to find how they view biodiversity issues in general and also how they perceive the functioning of their organisation. This report is the discussion and interpretation of responses to the questionnaire by managers at different ranks of the organisational structure. The results intend to show areas where the organisation is seen to be doing well and where it seen to be lacking. The tables and the appendices are used to indicate trends if any between high level managers and lower level managers (which level tends to rate the organisation lower or higher most of the time).Dissertation (M Inst Agrar ( Sustainable Ecological Management))--University of Pretoria, 2007.Zoology and Entomologyunrestricte

Analysis of single nucleotide polymorphisms with opposite effects on serum iron parameters in South African patients with multiple sclerosis

Thesis (MMed)--Stellenbosch University, 2014.ENGLISH ABSTRACT: There is growing interest in how genetic and environmental risk factors interact to confer risk for dysregulated iron homeostasis, which is considered a possible pathogenic mechanism in multiple sclerosis (MS). While iron deficiency has been associated with greater disability and disease progression, cerebral accumulation and overload of insoluble iron has also been reported in MS patients. Variation in the matriptase-2 (TMPRSS6) gene has recently been described that may lead to reduced iron levels, which raised the question of whether it may be involved in dysfunctional iron regulation as a pathogenic mechanism in MS. The aims of the study were as follows: 1)) comparison of the allele frequencies and genotype distribution for TMPRSS6 A736V (rs855791, c.2207C>T) and HFE C282Y (rs1800562, c.845G>A) between patients diagnosed with MS and unaffected controls; 2) determination of the effects of clinical characteristics, relevant lifestyle factors and genotype on serum iron parameters in MS patients compared to population matched controls; and 3) determination of clinical outcome in relation to age of onset and degree of disability in MS patients. The study population included 121 Caucasian MS patients and 286 population-matched controls. Serum iron, transferrin, ferritin and transferrin saturation levels were available from previous studies and lifestyle factors were subsequently documented in a subgroup of 68 MS patients and 143 controls using the study questionnaire. Genotyping of TMPRSS6 A736V and HFE C282Y were performed using allele-specific TaqMan technology. The genotype distribution and allele frequencies of TMPRSS6 A736V and HFE C282Y did not differ between MS patients and controls. MS patients homozygous for the iron-lowering minor T-allele of TMPRSS6 A736V had significantly lower serum iron levels (p=0.03) and transferrin saturation levels (p=0.03) compared to CC homozygotes. In MS patients the iron-loading minor A-allele of HFE C282Y was also associated with a paradoxical decrease in serum ferritin (p<0.01) compared to GG homozygotes. When considering the combined effect of the minor alleles of TMPRSS6 A736V and HFE C282Y with opposite effects on iron levels, we found a significant reduction in serum ferritin levels (p<0.05), independent of age, sex, body mass index (BMI) or dietary red meat intake in MS patients. A similar effect was not observed in the population- and age-matched controls. Higher dietary red meat intake correlated significantly with increased ferritin only in controls (p=0.01 vs. 0.21 for MS patients). In the presence of the minor allele of HFE C282Y, the TMPRSS6 A736V CT and TT genotypes were associated with a significantly earlier age of onset of MS when the post hoc test was applied (p=0.04). All the study aims were successfully accomplished. Our results support the possibility of an epistatic effect between TMPRSS6 A736V and HFE C282Y associated with reduced ferritin levels in MS patients. Pathology-supported genetic testing (PSGT) applied in this study as a new concept for analysis of complex diseases with a genetic component, is well placed to optimise clinical management in patients with MS.AFRIKAANSE OPSOMMING: Daar heers toenemende belangstelling in hoe die wisselwerking tussen genetiese en omgewingsfaktore die risiko tot wanregulering van yster-homeostase beïnvloed. Laasgenoemde is ‘n moontlike patogeniese meganisme vir meervoudige sklerose (MS). Alhoewel verhoogde gestremdheid en siekteprogressie met ystertekort geassosieer is, is ysterophoping in die serebrum asook ‘n oormaat onoplosbare yster al by MS-pasiënte gevind. Variasie in die matriptase-2 (TMPRSS6) geen wat tot verlaging in ystervlakke kan lei, is onlangs beskryf en laat die vraag ontstaan of dit betrokke is by wanregulering van yster-homeostase as patogeniese meganisme in MS. Die doelwitte van die studie was as volg: 1) vergelyking van alleelfrekwensies en genotipeverspreiding vir TMPRSS6 A736V (rs855791, c.2207C>T) en HFE C282Y (rs1800562, c.845G>A) tussen MS-pasiënte en ongeaffekteerde kontroles; 3) bepaling van die effekte van kliniese indikators, relevante leefstylfaktore en genotipe op serum yster parameters in MS-pasiënte in vergelyking met populasie-ooreenstemmende kontroles; en 4) bepaling van kliniese uitkoms ten opsigte van aanvangsouderdom en graad van MS-aantasting. Die studiepopulasie het uit 121 kaukasiese MS-pasiënte en 286 kontroles van dieselfde populasie, wat nie die siekte het nie, bestaan. Serum yster, transferrin, ferritien en transferrien-versadigingsvlakke was beskikbaar vanaf vorige studies. Leefstylfaktore is in ‘n subgroep van 68 MS-pasiënte en 143 kontroles gedokumenteer met behulp van die studie-vraelys. TMPRSS6 A736V en HFE C282Y genotipering is met alleel-spesifieke TaqMan-tegnologie uitgevoer. Beide pasiënte en kontroles het dieselfde genotipeverspreiding en alleelfrekwensies getoon. Die A-alleel van HFE C282Y is met ‘n paradoksale verlaging in serum ferritien geassosieer (p<0.01) in MS-pasiënte met TMPRSS6 A736V, moontlik weens geen-geen interaksie wat nie deur ouderdom, liggaamsmassa-indeks of inname van rooivleis in die dieet beïnvloed is nie (p<0.05) en nie by kontroles gevind is nie. MS-pasiënte wat homosigoties is vir die T-alleel van TMPRSS6 A736V, het statisties betekenisvolle laer serum ystervlakke (p=0.03) en transferrienversadiging (p=0.03) getoon in vergelyking met CC-homosigote. In MS-pasiënte was die yster-oorlading A-alleel van HFE C282Y ook geassosieer met ‘n paradoksale afname in serum ferritien (p<0.01) in vergelyking met GG-homosigote. Wanneer die gekombineerde effek van die risiko-geassosieerde allele van TMPRSS6 A736V en HFE C282Y met teenoorgestelde effekte op ystervlakke geanaliseer word, is daar ‘n statisties beteknisvolle afname in serum ferritienvlakke (p<0.05), onafhanklik van ouderdom, geslag, liggaamsmassa-indeks of rooivleisinname in MS-pasiënte. ‘n Soortgelyke effek is nie waargeneem in populasie- en geslag-gelyke kontroles nie. Die inname van rooivleis in die dieet was betekenisvol minder by MS-pasiënte teenoor kontroles (p=0.03) en dit het slegs betekenisvol met verhoogde ferritien by kontroles gekorreleer (p=0.01 teenoor 0.21 by MS-pasiënte). In die teenwoordigheid van die risiko-geassosieerde alleel van HFE C282Y, is die TMPRSS6 A736V CT en TT genotipes geassosieer met ‘n statisties-betekenisvolle vroeër aanvangsouderdom van MS soos bepaal met die post hoc-toets (p=0.04). Al die doelwitte van die studie is suksesvol uitgevoer. Die resultate ondersteun die moontlikheid van ‘n epistatiese effek tussen TMPRSS6 A736V en HFE C282Y wat geassosieer is met ‘n verlaging in ferritienvlakke in MS-pasiënte. Patologie-gesteunde genetiese toetsing soos toegepas in hierdie studie as ‘n nuwe konsep vir analise van komplekse siektes met ‘n genetiese komponent, is goed geplaas om kliniese hantering van MS-pasiënte te optimaliseer

Pain management in people living with HIV in home based care

The purpose of this study was to determine how pain in PLHIV on community home based care programme was managed using the Roy adaptation model (RAM) as the theoretical framework. This study used a descriptive mixed method research design which allowed for the research topic to be investigated and described in terms of both narrative qualitative accounts and descriptive statistics. A sequential exploratory approach was adopted in which qualitative data collection was conducted in the initial phase followed by quantitative data collection. Ten qualitative interviews, guided by the components of the RAM were conducted in the initial phase and a structured interview schedule (questionnaire) partially based on the result of the qualitative phase and (which was also structured in accordance with the RAM) was administered to 120 respondents who met the inclusion criteria of being on CHBC. Convenience sampling was used to select study participants and respondents in both phases of the study. Peripheral neuropathy was the most common pain syndrome experienced by patients. More females suffered numbness/tingling sensation of toes, followed by chest pains than their male counterparts. Pain experienced was moderate to severe which was not treated effectively. The study findings could assist health care providers, policy makers and researchers to invest into improving pain management for PLHIV, strengthen education of patients and their primary caregivers on the causes of pain and modalities to employ for pain relief and implement palliative care guidelines for PLHIV.Health StudiesD. Litt. et Phil. (Health Studies