Academic and psychosocial challenges of Health Sciences students during the COVID-19 pandemic: A University of Technology perspective

The COVID-19 pandemic resulted in South African universities and institutes of higher learning experiencing an unprecedented shift to online learning in 2020, coupled by limited access to campus, in order to prevent community transmission. However, the potential impact of the outbreak on the academic and psychosocial wellbeing of students warrants further exploration, as the rapid changes and the disruption to normal academic life, has left many students feeling socially isolated and struggling to cope with massive uncertainty. In addition, Health Sciences students may experience added anxiety due to their line of work, which places them at the forefront of the healthcare environment. This study explored the academic and psychosocial challenges experienced by students enrolled in a Health Sciences faculty in a University of Technology (UoT), as they transitioned through the COVID-19 pandemic and the ensuing lockdown. A qualitative approach with an exploratory descriptive design was used to guide the study. A sample of students across all levels of study (first, second and third years as well as postgraduates) from the Faculty of Health Sciences at the Durban University of Technology (DUT) in South Africa were selected. Sample recruitment was done through non-probability sampling techniques which include purposive and convenience sampling. Data saturation was reached after interviewing 15 participants on Microsoft Teams. The interview schedule comprised key points on understanding how the COVID-19 pandemic and the ensuing lockdown affected students personally and academically. Interviews were recorded, transcribed and subjected to content and thematic analyses. Six broad themes emerged from the data, which captured the disruption students experienced within the context of their academic life, their personal fears and anxieties, struggles with online learning and connectivity issues. Students also expressed challenges whilst studying remotely at home. The findings suggested that there is an urgent need for universities to reflect on ensuring students’ mental health wellbeing as well as ensuring academic success amidst a turbulent physical and psychological environment

Epidemiological and genetic risk factors associated with asthma among children in the south Durban region, KwaZulu-Natal.

Thesis (Ph.D.)-University of KwaZulu-Natal, Durban, 2008.Several genes are associated with an increased susceptibility to respiratory diseases, including asthma, which may be exacerbated by ambient air pollution. These genes include the Gluthathione-S-Transferase family (GSTM1 and GST1l) and the NAD(P)H quinone oxidoreductase (NQO1). This, the first genetic epidemiological study conducted in Sub-Saharan Africa had 2 main objectives: I) to evaluate whether the above genotypes confer susceptibility to asthma and related phenotypes; and 2) to investigate if polymorphisms in these genes known to modulate the response to or protect from epithelial oxidative damage modify pulmonary response to ambient air pollutants. A total of 369 schoolchildren from seven primary schools in a heavily industrialized region of south Durban and a demographically similar area in north Durban, Kwa-Zulu Natal, South Africa during the period May 2004 - October 2005, participated in the study. DNA was extracted from whole blood using the GENTRA Puregene kit. Genotyping for the GSTM1 (null vs present genotype) was done using multiplex PCR while the GSTP1 (I1e105Val; AA>AG/GG) and the NQO1(Pro/Ser; CC>CT/TT) genotypes were determined using real time PCR and Taqman probes (Applied Biosystems). Persistent asthma and asthma of "any severity" was determined by questionnaires based on the ATS and BRMC questionnaires. Positive atopy was determined by at least one positive skin test reaction to the seven allergens tested. Other health assessments included spirometry, methacholine challenge testing and four cycles of three-week serial peak flow measurements. Acute respiratory measures included within day variability in FEV1 and PF and the lowest valid values on a given day. SO2. NO2, NO and PM10 were measured over a year using ultraviolet fluorescence, gas-phase chemiluminescence and gravimetric methods respectively. STATA (version 9, College Station, TX, USA) was used for data analysis. Multiple logistic models and Pearson's chi-squared tests were used to evaluate the association between asthma, BHR, atopy and genotype. Covariate-adjusted generalised estimating equations (GEE) with lags of 1-5 days were used to evaluate genotype effect modification of exposure-response. The GSTM1 gene deletion (GSTM1null) was detected in 28.9% of the study population while the distribution of GSTP1 AG/GG and the NQO1 CT/IT polymorphisms were 64.9% and 36.0% respectively. Multiple regression with the adjustment for relevant covariates indicated that individuals carrying one or more copies of the GSTP 1 minor allele had a statistically significant risk for persistent asthma. GSTM1 and NQO1 genotypes showed no significant association with any of the respiratory outcomes tested. However, we found a protective effect for those individuals carrying the GSTM1null genotype and at least one Ser allele (NQO1 CT/TT) for persistent asthma and marked BHR (OR = 0.7, Cl: 0.3-1.5 and OR= 0.3, Cl: 0.0-1.9 respectively). This protective effect is consistent with the role of NQO1 in metabolic activation. Children from the south schools had almost twice the risk of persistent asthma (OR=2.0, Cl: 1.2-3.2, p<.005) and 3 times the risk of BHR (OR=3.5, Cl: 1.4-8.4, p<.005) than those from the schools in the north. Based on symptoms, 20.4% of children from the random sample had persistent asthma and 10.3% had marked BHR (PC20< 2mg/ml). The GEE model results were consistent with modification of air pollutant-pulmonary function relationships by oxidative stress associated genotypes. Statistically significant gene*environment interactions with NO2, NO, and PM10 using FEV1 and PEF outcomes in the expected direction were more frequent for GSTP1 AA and NQO1 CC genotypes (interaction p-values <0.05). There were very few gene*environment interactions for SO2 and any of the 3 SNPs tested. The most striking finding in our study was that pollutant exposure, especially oxides of nitrogen and PM10, even at levels below the recommended limits of South African guidelines, is associated with poorer lung function and that this association is significantly modified by an individual's genotype, particularly the GSTMlnull, GSTPIAA and NQOICC genotypes. Children with the GSTMlnull GSTPI AG/GG, GSTPI AG/GG NQOI CC and GSTMlpos NQOICC gene-gene combinations showed a significant interaction with NO2, NO, and PM10 with decrement in lung function measures. The increased risk to air pollution conferred by the GSTPI and GSTMl genotypes may have clinical and public health importance because this variant is common in most populations. The findings suggest that the risk of developing respiratory symptoms is increased when genetic susceptibility is included with environmental exposures. Our models suggest significant gene*environment interactions i.e the response to the level of air pollutants, as indicated by variability in pulmonary function measures, is modified by genotype. The heightened allergic airway response may be a consequence of a decreased capacity to mount an effective cytoprotective response to oxidative stress. Studying genes may inform us about the biology of asthma which may lead to new therapies or preventative strategies. This study supports the importance of further investigation on these and other genotype variants involved in oxidative stress and respiratory phenotypes in larger cohorts

Knowledge of multidrug-resistant tuberculosis amongst Durban University of Technology students in KwaZulu-Natal, South Africa: the need for integrating public health education

Background: Kwazulu-Natal is the epicenter of South Africa’s Multidrug-resistant Tuberculosis (MDR-TB) burden which represents a growing threat to public health. Knowledge and awareness of MDR-TB are crucial for effective management and University students are an important vehicle for knowledge transfer of public health education. Objective: This study aimed to evaluate the knowledge of MDR TB and risk factors for transmission, prevention, treatment and control of MDR-TB among Durban University of Technology (DUT) students. Methods: This quantitative cross-sectional study was conducted among 150 randomly sampled undergraduate students from 3 faculties and data was collected using a validated questionnaire. Results: While a majority of participants (70.67%) had previous knowledge on TB, only 30.67% knew of MDR-TB. Only 23.49% of students reported knowledge of preventative measures associated with MDR TB. Women had a lower probability of having knowledge of MDR-TB compared to men (OR=0.45; CI:0.22,0.95; p&lt;0.05) and students from the Accounting and Informatics faculty were less likely to believe that MDR-TB was a life-threatening illness (OR=0.24; CI:0.05,1.44; p&lt;0.05) and showed limited knowledge of MDR-TB transmission.Conclusion: This study showed that students lacked knowledge of MDR-TB with respect to risk factors, treatment and prevention, which necessitates intervention strategies at a tertiary level to educate and inform students about MDR-TB. Keywords: Multi drug resistant TB; health education; public health; risk factors

Circulating soluble fms-like tyrosine kinase-1, soluble endoglin and placental growth factor during pregnancy in normotensive women in KwaZulu-Natal, South Africa

Background: Based on the increased pre-eclampsia and HIV antenatal incidence in South Africa, we determined the angiogenic profiles due to its mechanistic link in preeclampsia development, throughout uncomplicated pregnancies in HIV positive and negative women.Objective: To determine the angiogenic profiles throughout uncomplicated pregnancies in HIV positive and HIV negative women. We explored possible correlations between angiogenic serum levels and selected maternal characteristics (HIV status, gestational age, maternal factors, and pregnancy outcomes).Method: This study was conducted at a primary health care facility in Durban, South Africa. Forty-six pregnant women aged 18-45 years, were enrolled at 10-20, 22-30 and 32-38 weeks’ gestation, respectively through convenient sampling. Serum samples were collected and quantitatively evaluated using ELISAs. Clinical and epidemiological data were analysed using STATA (version 14). A probability level of p &lt; 0.05 was considered statistically significant.Results: Of those enrolled, 28.3% were nulliparous, 82% were HIV positive and none developed pre-eclampsia. Systolic and diastolic blood pressure increased slightly throughout pregnancy. Fluctuating angiogenic and anti-angiogenic levels were demonstrated during pregnancy.Conclusion: This study contributes to the current angiogenic knowledge in normotensive pregnancies, and may assist as a reference range against which these factors may be compared in HIV complicated pregnancies.Keywords: sFlt-1, PlGF, sEng, pregnancy, HIV

Circulating soluble fms-like tyrosine kinase-1, soluble endoglin and placental growth factor during pregnancy in normotensive women in KwaZulu-Natal, South Africa

Background: Based on the increased pre-eclampsia and HIV antenatal incidence in South Africa, we determined the angiogenic profiles due to its mechanistic link in preeclampsia development, throughout uncomplicated pregnancies in HIV positive and negative women. Objective: To determine the angiogenic profiles throughout uncomplicated pregnancies in HIV positive and HIV negative women. We explored possible correlations between angiogenic serum levels and selected maternal characteristics (HIV status, gestational age, maternal factors, and pregnancy outcomes). Method: This study was conducted at a primary health care facility in Durban, South Africa. Forty-six pregnant women aged 18-45 years, were enrolled at 10-20, 22-30 and 32-38 weeks\u2019 gestation, respectively through convenient sampling. Serum samples were collected and quantitatively evaluated using ELISAs. Clinical and epidemiological data were analysed using STATA (version 14). A probability level of p &lt; 0.05 was considered statistically significant. Results: Of those enrolled, 28.3% were nulliparous, 82% were HIV positive and none developed pre-eclampsia. Systolic and diastolic blood pressure increased slightly throughout pregnancy. Fluctuating angiogenic and anti-angiogenic levels were demonstrated during pregnancy. Conclusion: This study contributes to the current angiogenic knowledge in normotensive pregnancies, and may assist as a reference range against which these factors may be compared in HIV complicated pregnancies. DOI: https://dx.doi.org/10.4314/ahs.v19i2.4 Cite as: Ogunlola M, Reddy P, Sibiya MN, O\u2019Connor L, Borg D, Haffejee F, Ghuman S, Ngxongo T, Govender N. Circulating soluble fmslike tyrosine kinase-1, soluble endoglin and placental growth factor during pregnancy in normotensive women in KwaZulu-Natal, South Africa. Afri Health Sci.2019;19(2): 1821-1832. https://dx.doi.org/10.4314/ahs.v19i2.

Accepted: 2011-10-04.) © SAJEI South Afr

Original Research: GGSTM1, GSTP1 and NQO1 polymorphisms and susceptibility to asthma among South African children Gluthathione-S-transferase (GSTM1 and GSTP1) and nicotinamide quinone oxidoreductase (NQO1) genes play an important role in cellular protection against oxidative stress, which has been linked to asthma pathogenesis. We investigated whether common, functional polymorphisms in GSTM1, GSTP1, and NQO1 influence susceptibility to asthma among schoolchildren in South Africa. Genomic deoxyribonucleic acid (DNA) was extracted from 317 primary schoolchildren, aged 9-11 years, from the urban, underprivileged socio-economic communities of Durban. GSTM1 (null vs. present genotype), GSTP1 (Ile105Val; AA →AG+GG) and the NQO1 (Pro/Ser; CC →CT/TT) genotypes were determined using polymerase chain reaction. Among the children, 30% were GSTM1 null, 65% carried the G allele for GSTP1, and 36% carried the C allele for NQO1.There was a high prevalence of asthma of any severity (46.1%), with 20.4% reporting persistent asthma. The GSTP1 AG+GG polymorphic genotype was significantly associated with persistent asthma (adjusted OR = 3.98; CI = 1.39, 11.36, p-value = 0.01). Neither the GSTM1, nor the NQO1, genotype was a significant predictor of persistent asthma. Therefore, the GSTP1 A/G variant may modulate the risk of persistent asthma among our sample

Group Work in Undergraduate Research: Turning Bane into Boon

Problem-based learning (PBL) using groupwork was used to engage students in undergraduate research methodology (UGR). It is anticipated that students will develop both interpersonal and employability skills during this exercise. This study explores a student cohort experience of groupwork within the teaching and learning of UGR at a South African University of Technology (UoT). The study used a qualitative approach. Students (n=28) were invited to participate after completing each research module using a non-probability convenience sampling strategy. Data collection using virtual interviews continued until data saturation was reached (n=7). Transcribed interviews were analysed using a thematic analysis strategy. Identified themes included student experiences and challenges associated with groupwork, perceptions regarding groupwork goals, working strategies and technology use, and improving the groupwork experience. Students emphasized benefits such as sharing ideas and workloads, but there were conflicting views regarding the pedagogic reason for groupwork. Students reported an increasing dependence on technology. Shared challenges included the “freeriding” phenomenon, which caused dissent and frustration. Choosing their own group members improved their experience. Peer assessment and assessment of individual contributions were supported to subvert freeriding. Groupwork requires extensive planning and management by the lecturer, particularly for PBL and UGR

Teachers’ Choices of Teaching Methods for Environmental Education: A case study of Life Skills teachers at a primary school in South Africa

The success of environmental education has been attributed to several factors including teachers’ competencies and attitudes, teaching methodologies, availability of resources, and curriculum design. Many researchers in environmental education suggest that innovative and resourceful teaching approaches may translate into meaningful environmental education. This study provides an insight into the influence of this on environmental education in a South African classroom through a qualitative approach. Interviews were conducted to understand the teaching approaches used in the subject of Life Skills. The findings of the study suggest that the pedagogical content knowledge and identity of the teacher are determining factors for teachers’ pedagogical choices. This paper suggests that it is not the resources that are crucial to learning, rather the presence of a resourceful teacher. A resourceful teacher is able to introduce innovation regardless of the availability of teaching resources. This information could inform pre-service teacher training programmesin focusing on the development of a resourceful environmental education teacher. Keywords: environmental education, Life Skills, teaching approaches, Pedagogical Content Knowledge (PCK), educational resource

Demographic stratification of Type 2 diabetes and comorbidities in district healthcare in KwaZulu-Natal

Background: Diabetes has been reported as the second leading cause of death and the top leading cause of death amongst women in South Africa; it is important to evaluate any epidemiological or demographic transition related to diabetes. This study evaluated the demographically stratified prevalence of type 2 diabetes mellitus (T2DM) and existing comorbidities amongst an outpatient population in a district healthcare facility in Kwazulu-Natal (KZN).Methods: This retrospective cross-sectional study was conducted at a district hospital, and a retrospective record review of all outpatients who reported to the hospital to be treated for T2DM between the period, August 2018–January 2019, was used. Data, such as age, sex, ethnicity and any coexisting morbidity, were collected from outpatient hospital registers and electronically captured using a record review tool.Results: There were significantly more female patients (3072) compared to male patients (1050) (p 0.001) with a mean age of 59.21 years. Hypertension (77.9%) and cardiovascular problems (11.16%) were most frequent. Approximately 84% of women presented with T2DM and either one or two morbidities simultaneously. Female patients were at significantly higher risk of presenting with hypertension (odds ratio [OR] = 1.44, 95% confidence interval [CI]: 1.20;1.71), whilst their risk for cardiovascular problems was significantly lower compared to male patients (OR = 0.67, 95% CI: 0.54;0.83).Conclusion: The prevalence of T2DM and comorbidities differed by demographic factors, such as sex, ethnicity and age. There is a need for flexible and adaptive approaches for the prevention and management of T2DM cases in order to allocate medical resources efficiently and according to the true burden of disease because of T2DM complications

Efficiency of chlorine and UV in the inactivation of Cryptosporidium and Giardia in wastewater.

Wastewater from different sources is contaminated by protozoan parasites including Cryptosporidium and Giardia. Many protozoan parasites are becoming resistant to chemical treatment. The challenge of finding alternatives is presented to researchers by exploring other methods of eliminating protozoan parasites from wastewater. The aim of this study was to assess the speciation and the viability of Cryptosporidium and Giardia in environmental samples with the specific objective of evaluating if effluent chlorination and UV affect the viability. Different doses of chlorine with different exposure times were experimented with both distilled water and waste water spiked with (oo)cysts derived from environmental samples. UV irradiation at different doses was also experimented using the same spiked samples. Two methods of quantification and detection, namely, microscopy and flow cytometry, were used in the experiment. Two vital dyes, Syto-9+PI and DAPI+PI, were the used for staining the collected wastewater samples. It was found that the (oo)cysts responded to chlorination and UV treatments with Giardia responding better than Cryptosporidium. Giardia responded very well to UV irradiations with almost 0 percent remaining viable after a low dose of UV. Cryptosporidium was found to be resistant to chlorination even at high doses but responded well to high UV doses. DAPI+PI dye gave a lower mean percentage viability values than Syto-9+PI. Flow cytometry gave higher mean percentage than microscopy from the results. It is concluded that UV is a promising alternative to Chlorine in removing Cryptosporidium and Giardia from waste water. Appropriate treatment method for wastewater is necessary to minimize water resources pollution when wastewater is released into water systems