Comment on: Funke N and Nienaber S (2012) Promoting uptake and use of conservation science in South Africa by government (Water SA 38 (1) 105-113)

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Depression in African women presenting for psychological services at a general hospital

Objective: Despite the increase in knowledge of depression, little is known about depression among African populations, especially African woman. In South Africa, inadequate mental health services generally and specifically for African people in our society, has led to under reporting and under diagnosing of the disorder. The object of the study was to understand depression in African women attending a state health service. Method: Clinical records of all patients presenting with depression to a general hospital located in a densely populated African township, over a 2 year period, were examined. Results: The epidemiological data is described. Depression in these women was related to poverty, overcrowding, unemployment, high levels of crime, lack of services and sexual abuse. Conclusion: African women return to a social context within which depression is increasingly prevalent. Establishing psychological services relevant to needs as well as means of ensuring that therapeutic gains extend to their social context are considered. Keywords: Depression, Health in African women, Cross-cultural health, Mental healthAfrican Journal of Psychiatry Vol. 11 (2) 2008 pp. 133-13

Best practice programme in the standardisation of traditional medicines: Evaluation of an immune booster formulated by traditional healers of the Vaal Triangle, South Africa

Background: Regulation and standardization of African traditional medicines (ATM) prescribed by traditional healers in South Africa is still far from being implemented. This is despite the fact that more people are using ATM products than ever. In an effort to demonstrate that collaboration with traditional health practitioners (THPs) can yield standardized TM products, this study aimed to evaluate the immunomodulatory effects of an herbal immune booster formulated by traditional healers from the Vaal Region, South Africa.Materials and Methods: Using normal and lipopolysaccharide (LPS) stimulated human peripheral blood mononuclear cells (PBMCs) models, doses of the immune booster ranging from 1000 to 10 μg/mL were evaluated for their cytotoxicity, inflammatory cytokines and chemokines secretion, nitric oxide (NO) secretion, malondialdehyde (MDA) assay, and 1,1-diphenyl-2-picrylhydrazyl (DPPH) assay.Results: The immune booster induced a dose dependent cytotoxic effect on both normal and LPS stimulated PBMCs with higher doses showing cytotoxicity while lower dose from 100μg/mL did not show any cytotoxicity. When re-dissolved in aqueous PBS immune booster doses up to 100 μg/mL showed better DPPH radical inhibition (41%) than ascorbic acid at 40μg/mL (33%). The immune booster also decreased lipid peroxides significantly (p< 0.05) and this was comparable to ascorbic acid. There was also a significant (p< 0.05) increase in nitrite (NO) after treatment of LPS stimulated PBMCs with immune booster doses when compared to untreated samples. The immune booster stimulated inflammatory cytokines secretion in normal PBMCs (IL 1α, IL 1β, IL 6, IL 10 and TNFα while showing a decrease in IFNγ at the higher dose) while in LPS stimulated PBMCs some cytokines were decreased (IL 1α, IL 17α and at lower doses IL 10 and TNFα) and others were increased (IFNγ, TNFα and GM-CSF) depending on the dose used. In both normal and LPS stimulated PBMCs the immune booster significantly (p< 0.05) increased (MIP 1α) while causing significant (p< 0.05) decreases in IP 10 (high dose), I-TAC and MIG secretion.Conclusions: This immune booster showed potential immunostimulatory effects by increasing nitric oxide, inflammatory cytokines and chemokines secretion in both normal and LPS stimulated PBMCs. This TM also showed promising antioxidant potential in the MDA and DPPH assays. Further in vitro and animal studies are warranted.Keywords: Traditional healers, traditional medicines, regulation, standardization, immune stimulatio

Effects of Sutherlandia frutescens Extracts on Normal T-Lymphocytes In Vitro

Sutherlandia frutescens (SF), a popular traditional medicinal plant found in various parts of southern Africa, is used for treatment or management of HIV/AIDS and other diseases including cancer. However, its toxicity profile has not been fully established. The aims of this study were to examine the effects of 70% ethanol (SFE) and deionised water (SFW) extracts on normal isolated human T cells. An experimental study on normal human lymphocytes treated with doses SF extract doses ranging from 0.25 to 2.5 mg/ml. Untreated, vehicle-treated (Ethanol) and camptothecin (CPT) treated normal T cells were used as controls. Induction of cell death, changes in intracellular ATP, caspase-3/-7 activity and nuclear changes were analysed using flow cytometry, luminometry and nuclear staining (Hoechst) respectively. The highest concentration (2.5 mg/ml) of SFE extract induced significant necrosis (95%), depletion of ATP (76%), and inhibition of caspase-3/-7 activity (11%) following a 24 hour incubation period (p< 0.001). The 2.5 mg/ml concentration of SFW showed the same trend but were less effective (necrosis- 26%, ATP- 91%, & caspase-3/-7- 15%). These effects showed a time-dependence over 48 hours of incubation, with high doses of SFE extracts eliminating viable cells by necrosis, depleting ATP levels and decreasing caspase-3/-7 activity (p< 0.001). The activity of SFE extract was independent of ethanol. The SFW extract dilutions were less toxic than the SFE extracts. Significant DNA fragmentation as demonstrated by Hoechst staining was also seen over 48-hour incubation for high doses of both types of SF extracts. These results showed that although high concentrations of SF extracts can be toxic to normal T cells in vitro, SFW fractions were relatively safe for use.Keywords: Sutherlandia frutescens, T lymphocytes, flow cytometry, luminometry, necrosis, apoptosi

“They come and knock at the gate until the neighbours see”. Perceived barriers and benefits of implementing HIV care at the community level in Tshwane district : a qualitative study

Little is known about the barriers and benefits of home-based HIV services offered by community health workers. These are especially important as the South African government embarks on scaling up community-based health services, which include HIV care. This study set out to understand potential benefits and barriers of these services in Tshwane district and develop recommendations for improvement. From June to August 2019, seven focus group discussions were conducted with 58 participants: four with 36 ward-based outreach team (WBOT) members and three with 22 people living with HIV (PLWHIV). Three aspects of care were explored: 1. Experience of performing, receiving or observing homebased HIV care; 2. Barriers to conducting home visits; and 3. The perceived value of WBOTs and home-based HIV care. While home-based HIV care was seen as a support strategy which could motivate patients to take their medication, the unpredictability of patients’ responses to HIV test results, incorrect addresses (driven by the need for identity documents), fear of stigma through association with WBOTs, especially those in uniform, little or no preparation of patients for home-based care, and lack of confidentiality and trust were raised as potential barriers. To successfully implement effective home-based HIV care in South Africa, perceived barriers should be addressed and recommendations offered by people providing and receiving these services should be seriously considered. Pertinent recommendations include integrating WBOTs into clinics and existing support structures, improving training on confidentiality and HIV testing, and rethinking the recruitment, scope of work and safety of WBOTs. In addition, research should be conducted into the impact of the requirements for identity documents and community health worker uniforms.Supporting information: S1 Table. Interview guide.http://www.plosone.orgpm2020Family MedicineImmunolog

Describing an online co-development process of VAWG prevention intervention activities with young high school learners, in Eastern Cape Province, South Africa

This is the author accepted manuscript. The final version is available from SAGE Publications via the DOI in this record. Evidence suggests that co-developed participatory interventions to prevent violence against women and girls (VAWG) may support behavior change. Yet, adolescents are often excluded from intervention development. Moreover, there remains a gap in understanding if intervention co-development can occur online. Our study explored the feasibility of undertaking an online co-development process for a participatory VAWG prevention intervention. We worked with a small group of high school learners (18–19 years), from the Eastern Cape Province, South Africa. We collected session notes and audio recorded sessions. Adolescents enjoyed the level of autonomy and their depth of involvement in the process. They were eager to be involved, and they appreciated being “heard.” Adolescents found it easy to build rapport online amongst each other, and with the facilitator. There were also challenges, the main one being young people’s, and facilitator’s, histories of didactic communication. Understanding the strengths and limitations of online co-development processes is crucial, to strengthen them.Nelson Mandela UniversitySouth African National Research FoundationSouth African Medical Research CouncilUniversity of Exete

Physical, anthropometric and physiological profiles of experienced junior male and female South African Taekwondo athletes

The research was aimed at identifying the anthropometric, physical and physiological characteristics of junior Taekwondo athletes to achieve an international status. Data were collected from 25 males and 11 females aged 15.5 ±2.6 years. Measurements consisted of body composition (body fat percentage (%BF), sum of 6 skinfolds), flexibility (sit & reach, hip flexor (HF) and quadriceps flexibility (QF), lower extremity explosive power (vertical jump (Diff VJ) and vertical jump relative power (R Power), muscle endurance (sit-ups and push-ups), muscular strength (handgrip right and left), hexagonal agility (HEX) and agility T-test, aerobic power (20 m bleep test (20MST) converted to maximum oxygen uptake (VO2max.). Data were analyzed using t-test for independent samples and Z-score statistics. Significant higher %BF and sum of skinfolds were recorded in junior female players. No differences in body mass, stature and BMI were found. Male athletes had higher (p<0.001) VO2max (42.2±6.8 ml/kg/min) compared to females (31.7±6.5 ml/kg/min). Female athletes showed lower (p<0.001) results in push-ups (9.0±6.5 reps) compared to males (25.6±10.5 reps). Maximal grip strength (kg) of both hands was higher (p<0.05) in males. No differences in sit-ups, explosive leg power and agility were found between males and females. The analysis of individual Z-score for assessment of fitness variables has practical implications contributing to the trainability and performance of junior taekwondo athletes.http://www.ajol.info/journal_index.php?jid=153&ab=ajpherd2017-12-31am201

Advances in childhood immunisation in South Africa: where to now? Programme managers’ views and evidence from systematic reviews.

Background: The Expanded Programme on Immunisation (EPI) is one of the most powerful and cost-effective public health programmes to improve child survival. We assessed challenges and enablers for the programme in South Africa, as we approach the 2015 deadline for the Millennium Development Goals. Methods: Between September 2009 and September 2010 we requested national and provincial EPI managers in South Africa to identify key challenges facing EPI, and to propose appropriate solutions. We collated their responses and searched for systematic reviews on the effectiveness of the proposed solutions; in the Health Systems Evidence, Cochrane Library, and PubMed electronic databases. We screened the search outputs, selected systematic reviews, extracted data, and assessed the quality of included reviews (using AMSTAR) and the quality of the evidence (using GRADE) in duplicate; resolving disagreements by discussion and consensus. Results: Challenges identified by EPI managers were linked to healthcare workers (insufficient knowledge of vaccines and immunisation), the public (anti-immunisation rumours and reluctance from parents), and health system (insufficient financial and human resources). Strategies proposed by managers to overcome the challenges include training, supervision, and audit and feedback; strengthening advocacy and social mobilisation; and sustainable EPI funding schemes, respectively. The findings from reliable systematic reviews indicate that interactive educational meetings, audit and feedback, and supportive supervision improve healthcare worker performance. Structured and interactive communication tools probably increase parents’ understanding of immunisation; and reminders and recall, use of community health workers, conditional cash transfers, and mass media interventions probably increase immunisation coverage. Finally, a national social health insurance scheme is a potential EPI financing mechanism; however, given the absence of high-quality evidence of effects, its implementation should be pilot-tested and the impacts and costs rigorously monitored. Conclusion: In line with the Millennium Development Goals, we have to ensure that our children’s right to health, development and survival is respected, protected and promoted. EPI is central to this vision. We found numerous promising strategies for improving EPI performance in South Africa. However, their implementation would need to be tailored to local circumstances and accompanied by high-quality monitoring and evaluation. The strength of our approach comes from having a strong framework for interventions before looking for systematic reviews. Without a framework, we would have been driven by what reviews have been done and what is easily researchable; rather than the values and preferences of key immunisation stakeholders