Investigation of the effect of the low learner pass rate in mathematics on unemployment in KwaZulu-Natal Schools.

Master’s Degree. University of KwaZulu-Natal, Durban.ABSTRACT Unemployment is very high in South Africa. During the last quarter of 2016, unemployment was more than 25%. At the same time, the failure rate in mathematics in the Grade 12 examinations in South Africa is also very high. The aim of the study is to establish if there is any relationship between the high unemployment rate and the low rate of learner achievement in mathematics. Hence, the topic of the research is “Investigation of the effect of low learner pass rate in mathematics on unemployment in the KwaZulu-Natal schools”. In this study, the researcher employed both quantitative and qualitative analysis to uncover the facts about the problem at hand. In this research, the samples were taken at random and consisted of participants from the Amajuba District, to represent the province. The participants consisted of circuit managers, high school principals, deputy principals, subject heads of departments, teachers of mathematics and commerce and mathematics lecturers at Amajuba Technical College. A total of 156 questionnaires were distributed and 112 were completed and returned. Based on the questionnaire responses and the literature review, unemployment is caused by the lack of skills and the scarcity of mathematics qualifications among the workforce. Accordingly, many students fail mathematics and leave school early. Such students do not possess the skills that are required by the labour market. Hence, they constitute a considerable component of the unemployment rate.It was concluded that the low learner pass rate in mathematics actually contributes to the high unemployment rate in KwaZulu-Natal and in the whole country. The researcher recommends the establishment of a special school that would teach entrepreneurship and simultaneously re-teach mathematics to the out-of-school youth who obtained low symbols in mathematics at the Grade 12 level. The researcher further recommends the founding of an in-service centre for the newly-appointed mathematics teachers and for the teachers whose learner pass rate in mathematics is low.Abstract available in the PDF

Evaluation of the Alere Afinion™ AS100 for measuring the levels of C-Reactive Protein in an aged population.

Masters Degree. University of KwaZulu-Natal, Durban.Introduction The Alere Afinion™ AS100 analyser is a compact bench-top, multi-assay, point-of-care (POC) analyser that provides valuable near patient testing at the point of care. It utilises the latest technology to measure C-Reactive Protein and other analytes to monitor patients’ disease progression. The main objective of the study was to evaluate the performance of the Alere Afinion™ AS100 analyser compared with a reference laboratory test method, ABX Pentra 400 for the measurement of C-Reactive Protein (CRP). Methods This study was a retrospective analysis in which stored serum samples obtained from a cross-sectional study referred to as Sexual Health, HIV infection and comorbidity with non-communicable diseases among Older Persons (SHIOP) were tested for the quantification of the CRP. The primary aim of SHIOP was to describe sexuality, sexual health and the comorbidity of HIV and sexually transmitted infections with chronic non-communicable diseases in adults aged ≥50 years in a setting of high HIV prevalence. Serum stored at -20 ⁰C from participants that consented to long term storage(n=183) was used to perform this evaluation. The serum samples were used to measure CRP on the Alere Afinion™ AS100 and ABX Pentra 400, respectively. Lin’s correlation coefficient was used to assess the agreement between the two analysers for the measurement of CRP. Risk factors associated with elevated CRP levels were assessed through this study. Results A total of 183 serum samples were tested in the study. The mean age of the study participants was 7.62 years (SD 8.15). Male participants were slightly older than female participants (61 vs 58years, p90% of the CRP results when compared to the ABX Pentra 400. Bland-Altman analysis and linear regression analysis showed an excellent agreement (correlation concordance 0.97) between the two analysers. This study showed that being obese (Odds Ratio [OR]: 1.98, 95% Confidence Interval [CI]: 1.3616, 2.889, p<0.001) and having low HDL levels (OR: 1.64, 95% CI: 1.158, 2.307, p= 0.005) were the only significant risk factors that were associated with elevated CRP levels. Conclusion This study showed that the Alere Afinion™ AS100 can be used for the measurement of CRP in instances where CRP is greater than 5mg/L and this may enhance the process of patient care and management in low resource settings. Keywords: C-Reactive Protein (CRP), Affinion AS100, Sexual Health, HIV infection and comorbidity with non-communicable diseases among Older Persons (SHIOP), ABX Pentra 400

Transferability of policies and organisational practices across public and private health service delivery systems : a case study of selected hospitals in the Eastern Cape : exploring lessons, ambiguities and contradictions

Philosophiae Doctor - PhDSince the advent of South Africa's democracy in 1994 there have been several changes in the policy and legislative arena specifically promoting public-private-partnerships in the health sector. These initiatives have given rise to opportunities for inter-sectoral policy transfer under the rubric of ―best practices‖. This exploratory study examines the character, obstacles and contested nature of a selection of policy transfers between private and public health institutions in a single province of South Africa. The study looks at the dynamics at play around envisaged, current and past transfers of policies and organisational practices in relation to administrative systems and technologies used in four different hospital settings – two public and two private hospitals in the Eastern Cape Province of South Africa. This thesis explores the views of managers and labour organisations about policy transfer focusing on local contexts, and how various parties construct policy transfer, hence providing a perspective of policy at the ―plant‖ level. In this research, special focus is placed on different agents' role and understandings of their contexts and how and why policies move and contradictions of these developments. In-depth interviews were conducted at four major Eastern Cape hospitals. The thesis argues that in practice, policy transfer is messy, politicized and traversed by power and vested interests and that organised labour plays a key role in policy transfer process. The thesis focuses on the different philosophical/ideological underpinnings, socio-political values and operational environments in each sector. This study is designed to contribute to existing knowledge on practices particularly between the public and private sectors in order to widen the understanding of the complexity of transferability

Does antiretroviral therapy use affect the accuracy of HIV rapid diagnostic assays? Experience from a demographic health and surveillance site in rural South Africa

Rapid diagnostic tests (RDTs) are the mainstay of HIV diagnosis in the developing world but might have poor sensitivity among individuals taking antiretroviral therapy (ART). We leveraged a home-based HIV testing program linked to clinical data to compare the sensitivity of RDTs between individuals using versus not using ART. Field workers tested 6802 individuals using 2 HIV RDTs, which were compared to a single HIV immunoassay tested on dried blood spots. Approximately 5% (371/6802) tested positive by immunoassay, of whom 157 (42%) were currently on ART. The sensitivity of the Abon RDT among those never versus currently on ART was 91.6% (95% CI 88.3–94.3) and 96.6% (95% CI 88.3–94.3), respectively, and 95.4% (95% CI 92.8–97.3) versus 99.3% (95% CI 95.2–99.7) for the Advanced Quality assay. We report similar sensitivity of RDTs in ART-naïve and ART-experienced individuals, which mitigates concerns about their use among treated individuals in population-based epidemiologic surveys and those transferring care

An Investigation into the Acute and Subacute Toxicity of Extracts of Cassipourea flanaganii Stem Bark In Vivo

The conventional use of medicinal plants is in part based on the widespread belief that plant crude extracts are non-toxic. In South Africa, traditional preparations of Cassipourea flanaganii used to treat hypermelanosis have accordingly been regarded by many as non-toxic. Whether that is so impacts on the potential of bark extracts to be developed as a commercial drug to treathypermelanosis, given their documented capacity to inhibit tyrosinase activity. Our study investigated the acute and subacute toxicity of the methanol extract of C. flanaganii bark in rats. Wistar rats were randomly assigned into different treatment groups. The rats received a daily oral gavage of crude extract for acute and subacute toxicity tests. Haematological, biomechanical, clinical and histopathology examinations were carried out to evaluate the possible toxicity of C. flanaganii. The results were subjected to the Student&rsquo;s test and ANOVA. For both acute and subacute toxicity, there was no statistical difference between the groups. There were no clinical or behavioral signs of toxicity observed in the rats. No treatment-related gross pathology lesions and no histopathology were observed. The findings of this study demonstrate the absence of acute or subacute toxicity after oral treatment with C. flanaganii stem bark extracts in Wistar rats at the levels administered. Chemical profiling of the total extract using LC-MS tentatively identified eleven (11) compounds as the major chemical constituents

Fast-track interventions for HIV and AIDS epidemic control among key populations: A rapid review

Background: Targeted interventions for key populations remain critical for realisation of epidemic control for human immunodeficiency virus (HIV) infection because of the causal relationship between HIV infection in the general population and among key population groups. Aim: To consolidate evidence on the fast-track interventions towards achieving HIV epidemic control among key populations. Methods: A rapid scoping review was conducted using the methodological framework by Arksey and O’ Malley. The Population, Intervention, Context and Outcome (PICO) framework was used to identify relevant studies using key words with Boolean operators in electronic data bases, namely CINHAL, Web of Science, Psych Info and Sabinet. Studies were extracted using a modified data extraction tool, and results were presented narratively. Results: A total of 19 articles were included in this review. Most articles were primary studies (n = 17), while another involved the review of existing literature and policies (n = 2) and routinely collected data (n = 1). Most studies were conducted in the United States of America (n = 6), while another were conducted in China, Kenya, Botswana, South Africa and Mozambique. All studies revealed findings on tested interventions to achieve HIV epidemic control among key populations. Conclusion: Effective interventions for HIV epidemic control were stand-alone behavioural preventive interventions, stand-alone biomedical preventive strategies and combination prevention approaches. Furthermore, the findings suggest that effective activities to achieve HIV epidemic control among key populations should be centred around prevention. Contribution: The findings of this study have policy and practice implications for high HIV burden settings such as South Africa in terms of interventions to facilitate realisation of the Joint United Nations Programme on HIV/AIDS (UNAIDS) 95-95-95 targets, thereby contributing to HIV epidemic control

Melasma in people with darker skin types : a scoping review protocol on prevalence, treatment options for melasma and impact on quality of life

ADDITIONAL FILE 1. PRISMA ScR.AVAILABILITY OF DATA AND MATERIALS : All data generated or analysed during this study will be included in the published scoping review article and will be available upon request.BACKGROUND : Melasma is one of the most encountered dermatoses in dermatology and skin care clinics. It is a challenging chronic, recurrent condition associated with hyperpigmentation. Its aetiology is poorly understood. Melasma affects all races and gender but is more prevalent in women with darker skin types. Being a facial lesion, melasma has a severe impact on quality of life due to its disfigurement. While many modalities of treatment for melasma exists, unfortunately, effectiveness and safety remain a huge concern. Treatment modalities are variable and often unsatisfactory. The objective of this scoping review is to systemically map available evidence from literature regarding melasma on people with darker skin types, garner insight as to how melasma affects the quality of life and begin to investigate and gain understanding on effectiveness of different treatments used for melasma. METHODS : A scoping review guided by Arksey and O’Malley’s framework, the enhancements and recommendations of Levac, Colquhoun and O’Brien, Daudt and associates and the 2015 Johanna Briggs Institute’s guidelines will be conducted. Systematic electronic searches of databases and search engines will include Scopus, PubMed, CINAHL Complete, Cochrane, Science Direct, and Web of Science which will be conducted to attain published peer reviewed articles of all study designs excluding reviews and grey literature. All literature that meets the inclusion criteria, research question and sub-question will be included in this review. All the retrieved literature will be exported to an Endnote X20 library. Quality appraisal of the included articles will be conducted using the mixed methods appraisal tool (MMAT) 2018 version. DISCUSSION : We anticipate mapping relevant literature on the melasma, investigating the effectiveness of treatment options of melasma as well as evaluating its association with quality of life in people with darker skin types. This study is likely to reveal research gaps, which could guide future implementation research on melasma treatment interventions. SYSTEMATIC REVIEW REGISTRATION : This protocol has been registered a priori with OSF and is accessible on this link: https:// osf. io/ ru3jc/.The Durban University of Technology Seed Funding grant and funding from UNICEF and with support from Future Africa, the University of Pretoria.https://systematicreviewsjournal.biomedcentral.com/am2024Department of Library ServicesSDG-03:Good heatlh and well-bein

Pitfalls of Single Measurement Screening for Diabetes and Hypertension in Community-Based Settings

Background: Cross-sectional screening programs are used to detect and refer individuals with non-communicable diseases to healthcare services. We evaluated the positive predictive value of cross-sectional measurements for Diabetes Mellitus (DM) and hypertension (HTN) as part of a community-based disease screening study, ‘Vukuzazi’ in rural South Africa. Methods: We conducted community-based screening for HTN and DM using the World Health Organization STEPS protocol and glycated haemoglobin A1c (HbA1c) testing, respectively. Nurses conducted follow-up home visits for confirmatory diagnostic testing among individuals with a screening BP above 140/90 mmHg and/or HbA1c above 6.5% at the initial screen, and without a prior diagnosis. We assessed the positive predictive value of the initial screening, compared to the follow up measure. We also sought to identify a screening threshold for HTN and DM with greater than 90% positive predictive value. Results: Of 18,027 participants enrolled, 10.2% (1,831) had a screening BP over 140/90 mmHg. Of those without a prior diagnosis, 871 (47.6%) received follow-up measurements. Only 51.2% (451) of those with completed follow-up measurements had a repeat BP>140/90 mmHg at the home visit and were referred to care. To achieve a 90% correct referral rate, a systolic BP threshold of 192 was needed at first screening. For DM screening, 1,615 (9.0%) individuals had an HbA1c > 6.5%, and of those without a prior diagnosis, 1,151 (71.2%) received a follow-up blood glucose. Of these, only 34.1% (395) met criteria for referral for DM. To ensure a 90% positive predictive value i.e. a screening HbA1c of >16.6% was needed. Conclusions: A second home-based screening visit to confirm a diagnosis of DM and HTN reduced health system referrals by 48% and 66%, respectively. Two-day screening programmes for DM and HTN screening might save individual and healthcare resources and should be evaluated carefully in future cost effectiveness evaluations

Prevalence of Mycobacterium tuberculosis in sputum and reported symptoms among clinic attendees compared to a community survey in rural South Africa

BACKGROUND: Tuberculosis (TB) case finding efforts typically target symptomatic people attending health facilities. We compared the prevalence of Mycobacterium tuberculosis (Mtb) sputum culture-positivity among adult clinic attendees in rural South Africa with a concurrent, community-based estimate from the surrounding demographic surveillance area (DSA). METHODS: Clinic: Randomly-selected adults (≥18 years) attending two primary healthcare clinics were interviewed and requested to give sputum for mycobacterial culture. HIV and antiretroviral therapy (ART) status were based on self-report and record review. Community: All adult (≥15 years) DSA residents were invited to a mobile clinic for health screening, including serological HIV testing; those with ≥1 TB symptom (cough, weight loss, night sweats, fever) or abnormal chest radiograph were asked for sputum. RESULTS: Clinic: 2,055 patients were enrolled (76.9% female, median age 36 years); 1,479 (72.0%) were classified HIV-positive (98.9% on ART) and 131 (6.4%) reported ≥1 TB symptom. Of 20/2,055 (1.0% [95% CI 0.6-1.5]) with Mtb culture-positive sputum, 14 (70%) reported no symptoms. Community: 10,320 residents were enrolled (68.3% female, median age 38 years); 3,105 (30.3%) tested HIV-positive (87.4% on ART) and 1,091 (10.6%) reported ≥1 TB symptom. Of 58/10,320 (0.6% [95% CI 0.4-0.7]) with Mtb culture-positive sputum, 45 (77.6%) reported no symptoms.In both surveys, sputum culture positivity was associated with male sex and reporting >1 TB symptom. CONCLUSIONS: In both clinic and community settings, most participants with Mtb culture-positive sputum were asymptomatic. TB screening based only on symptoms will miss many people with active disease in both settings