Risk profile of postnatal women and their babies attending a rural district hospital in South Africa

BackgroundMaternal and neonatal mortality remain unacceptably high and inequitably distributed in South Africa, with the postnatal period being a dangerous time for both mother and baby. The aim of this paper is to describe the risk factors for poor postnatal outcomes, including postnatal mental health disorders, in a population of postnatal women and their babies utilising rural district hospital services in Limpopo Province, with a focus on HIV. We also describe health care provider compliance with relevant guidelines.MethodsAll women discharged from the postnatal ward of the district hospital who consented to participate were enrolled. A research nurse used a structured questionnaire to collect data about sociodemographic information, pregnancy and pre-existing conditions, complications during labour and birth, pregnancy outcomes and mental health risk factors.ResultsThe questionnaire was completed for 882 women at the time of discharge. Only 354 (40.2%) of participants had completed secondary education, and 105 (11.9%) reported formal employment. Chronic hypertension was recorded in 20 women (2.3%), with an additional 49 (5.6%) developing a hypertensive disorder during pregnancy. HIV prevalence was 22.8%. 216 women (24.5%) had a mental health risk factor, with 40 reporting more than one (4.5%). Having no income, no antenatal care, having HIV and any hypertensive disorder were significantly associated with a positive mental health risk screen in multivariable analysis. There were 31 stillbirths and early neonatal deaths (3.5%), and 119 babies (13.4%) were born at a low birth weight. Stillbirth or early neonatal death was significantly associated with no antenatal care in multivariable analysis.ConclusionsWomen and babies in this study experienced multiple risk factors for poor outcomes in the postpartum period. Postnatal care should be strengthened in order to address the dominant risks to mothers and babies, including socioeconomic challenges, HIV and hypertension, and risks to mental health. Tools to identify mothers and babies at risk of postnatal complications would allow limited resources to be allocated where they are most needed

Challenges militating against community participation on the Integrated Development Plan Process in Thulamela Local Municipality

MAdminDepartment of Public and Development AdministrationThe study focusses on the challenges militating against community participation on the Integrated Development Plan (IDP) process in Thulamela Local Municipality (TLM) and to find strategies to be used to enhance community participation on Integrated Development Plan. The study is based on matters of community participation and IDP in order to find out how community participation in the municipalities can influence the planning process in an integrated manner. The Constitution of the Republic of South Africa, 1996 (Act No. 108 of 1996) mandates local government to encourage the involvement of communities and community organisations in the matters of local government. IDP is the rightful platform to fulfil the aforementioned mandate in the local government. In this study, the researcher made use of a mixed research method where both qualitative and quantitative research methods are used. The research is qualitative in nature, but the quantitative method is also used in data interpretation, because data collected was based on the views and opinions of a large number of respondents and the analysis of results based on statistical significance. The researcher used the non-probability sampling and its subtype purposive sampling method to select the participants in this study. Questionnaires, interviews as well as literature were used to gather data in this research. Two types of data analysis were used when analysing the data. For data collected through interview, the researcher used thematic analysis (Narrative form) and for data collected through questionnaire, the researcher used International Business Machinery (IBM)- Statistical Product in Service Solutions (SPSS) Statistics V25. The researcher followed research ethics before conducting the study. The major findings of the study are: • The study found out that 38 (76%) of the respondents agreed that community members actively participate in IDP process. This is an indication that community members of Thulamela Local Municipality actively participate in IDP process. • The researcher found out that the majority of the respondents at 45 which constitutes 90% agreed that active community participation in IDP process plays an important role in the improvement of the basic service delivery. • The researcher found out that majority of the respondents at 35 which constitutes 70% of the respondents in the study agreed that community members are well informed about different types of participation in IDP process. • The researcher found out that majority of the respondents at 38 which constitutes 76% of the respondents in the study disagreed that there are enough resources to capacitate community members in order to participate actively in IDP process. v The main recommendations are: • The researcher recommends that community members should take a share of responsibility to actively participate in IDP process. Thus, the community members should consider it necessary that they strive to make community participation on IDP process fashionable. • The researcher recommends that there should be active community participation in IDP process because it plays an important role in the improvement of basic service delivery. Community participation in IDP process needs to be active for the basic service delivery to be improved. • The researcher recommends that community members should be well informed about different types of participation on IDP process. It is the responsibility of the municipality to inform community members about different types of community participation that they can use to participate in IDP process. • The researcher recommends that the municipality should make enough resources to capacitate community members in order to participate actively in IDP process available. The municipality should embark on a journey to raise funds either from other government sectors and/or private sectors.NR

A study of ethnoveterinary medicine in the North West Province, South Africa

M (Indigenous Knowledge Systems), North-West University, Mahikeng CampusEthnoveterinary medicine (EVM) is a component of Indigenous Knowledge Systems derived from African Traditional Medicine (ATM) and used for animal health care in African communities. The introduction of Western veterinary medicine during colonisation of Africa led to a decline in use and loss of some of this valuable knowledge. However, Western veterinary medicine is expensive and inaccessible to poorly resourced and remote farmers. Among these farmers, the use of ethnoveterinary medicine is dominant. The South African government recognises the value of traditional healing, especially as a primary health care solution and supports the integration of the Western and traditional health care systems. Through the National Indigenous Knowledge Systems Office (NIKSO), the government also promotes EVM, its preservation and its integration into the development of higher education curriculums. Exploratory surveys to document and preserve knowledge of ethnoveterinary medicine have been conducted in some parts of South Africa. However, vast areas of the country still remain unexplored. Furthermore, the success of any government proposed integration endeavours depends on the perceptions of different stakeholders in the veterinary field. Although many studies have been conducted to evaluate the perceptions of ATM among Western-trained human-health practitioners, such studies among Western-trained animal health practitioners (WTAHPs) have been neglected. The purpose of this study was to document knowledge of EVM in the previously unexplored Mahikeng Local Municipality and to determine perceptions of EVM among state veterinarians and animal health technicians (AHTs) in the North-West Province. A mixed method research design was adopted to address the two objectives. Qualitative research methods were used to collect and analyse ethnoveterinary know ledge among indigenous farmers in four villages in Mahikeng Local Municipality while quantitative methods were used to collect and analyse data obtained from Western-trained animal health practitioners to determine their perceptions of EVM. The qualitative approach generated a wealth of highly trusted Batswana ethnoveterinary medicine knowledge systems, including ethnodiagnostic methods, medicinal plants and non-plant remedies, surgical and metaphysical procedures. A total of thirty-one ethnoveterinary medicinal plant species, three non-plant remedies and nine procedures were documented. Among the medicinal plants recorded, Senna italica (sebetebete) emerged as a plant of cultural importance in the study area, with the highest frequency in terms of recurrence and multiple animal treatment health indications. Culturally significant medicinal plants among Batswana for the treatment of coughs, retained placenta, gala, fractures and diarrheoa were also determined. In addition, the concern for the loss of EVM knowledge through time, due to modernisation and disinterest of the younger generation was also exposed. This study revealed a need for further ethnoveterinary exploratory surveys conducted in other unexplored areas of the North West Province for purposes of knowledge preservation. On the other hand, the quantitative approach revealed that most state WTAHPs were aware of EVM and that a moderate majority agreed with the use of EVM by farmers. However, most of WT AHPs were not sure of the effectiveness of ethnoveterinary medicine and perceived EVM as lacking a scientific base which shows a lack of appreciation of the value of EVM. The study also found that there is moderate support in terms of integration of EVM into veterinary and para-veterinary curriculums. The findings of the study revealed the need for integration of EVM into the curriculum of veterinary and para-veterinary education in order to promote EVM. Such integration will be a step towards decolonisation of South Africa's educational system and also assist in the preservation of knowledge. Overall, it is therefore recommended that urgent documentation of ethnoveterinary medicine knowledge be done in other parts of the country. Furthermore, promotional activities are also recommended in order to improve perceptions among WT AHPs for the purpose of decolonising the minds and also to prevent the impact of negative perceptions on government suggested integration processes.Master

A study of ethnoveterinary medicine in the North West Province, South Africa

M (Indigenous Knowledge Systems), North-West University, Mahikeng CampusEthnoveterinary medicine (EVM) is a component of Indigenous Knowledge Systems derived from African Traditional Medicine (ATM) and used for animal health care in African communities. The introduction of Western veterinary medicine during colonisation of Africa led to a decline in use and loss of some of this valuable knowledge. However, Western veterinary medicine is expensive and inaccessible to poorly resourced and remote farmers. Among these farmers, the use of ethnoveterinary medicine is dominant. The South African government recognises the value of traditional healing, especially as a primary health care solution and supports the integration of the Western and traditional health care systems. Through the National Indigenous Knowledge Systems Office (NIKSO), the government also promotes EVM, its preservation and its integration into the development of higher education curriculums. Exploratory surveys to document and preserve knowledge of ethnoveterinary medicine have been conducted in some parts of South Africa. However, vast areas of the country still remain unexplored. Furthermore, the success of any government proposed integration endeavours depends on the perceptions of different stakeholders in the veterinary field. Although many studies have been conducted to evaluate the perceptions of ATM among Western-trained human-health practitioners, such studies among Western-trained animal health practitioners (WTAHPs) have been neglected. The purpose of this study was to document knowledge of EVM in the previously unexplored Mahikeng Local Municipality and to determine perceptions of EVM among state veterinarians and animal health technicians (AHTs) in the North-West Province. A mixed method research design was adopted to address the two objectives. Qualitative research methods were used to collect and analyse ethnoveterinary know ledge among indigenous farmers in four villages in Mahikeng Local Municipality while quantitative methods were used to collect and analyse data obtained from Western-trained animal health practitioners to determine their perceptions of EVM. The qualitative approach generated a wealth of highly trusted Batswana ethnoveterinary medicine knowledge systems, including ethnodiagnostic methods, medicinal plants and non-plant remedies, surgical and metaphysical procedures. A total of thirty-one ethnoveterinary medicinal plant species, three non-plant remedies and nine procedures were documented. Among the medicinal plants recorded, Senna italica (sebetebete) emerged as a plant of cultural importance in the study area, with the highest frequency in terms of recurrence and multiple animal treatment health indications. Culturally significant medicinal plants among Batswana for the treatment of coughs, retained placenta, gala, fractures and diarrheoa were also determined. In addition, the concern for the loss of EVM knowledge through time, due to modernisation and disinterest of the younger generation was also exposed. This study revealed a need for further ethnoveterinary exploratory surveys conducted in other unexplored areas of the North West Province for purposes of knowledge preservation. On the other hand, the quantitative approach revealed that most state WTAHPs were aware of EVM and that a moderate majority agreed with the use of EVM by farmers. However, most of WT AHPs were not sure of the effectiveness of ethnoveterinary medicine and perceived EVM as lacking a scientific base which shows a lack of appreciation of the value of EVM. The study also found that there is moderate support in terms of integration of EVM into veterinary and para-veterinary curriculums. The findings of the study revealed the need for integration of EVM into the curriculum of veterinary and para-veterinary education in order to promote EVM. Such integration will be a step towards decolonisation of South Africa's educational system and also assist in the preservation of knowledge. Overall, it is therefore recommended that urgent documentation of ethnoveterinary medicine knowledge be done in other parts of the country. Furthermore, promotional activities are also recommended in order to improve perceptions among WT AHPs for the purpose of decolonising the minds and also to prevent the impact of negative perceptions on government suggested integration processes.Master

Genotypic Characterization of Shigella Species Isolated from Abattoirs in the North West Province, South Africa Using PCR Analysis

Foodborne pathogens pose a serious threat to food safety especially in developing countries where hygiene facilities are not well developed and operational practices in abattoirs and retail shops are often poor. Shigella species are known to cause foodborne complications in humans including shigellosis that is not only characterized by destruction of the epithelium of the colon but usually results to an inflammatory response. The transmission of Shigella species to humans most often results through the consumption of contaminated food, meat and water. The aim of this study was to isolate and identify Shigella species from carcass of cattle in some abattoirs in the North West Province, South Africa and determine the virulence gene profiles of the isolates using PCR assays. A total of 97 carcass swabs were obtained from the abattoirs that were sampled. Swabs were properly labeled and transported on ice to the laboratory for analysis. The swabs were washed in 2% (w/v) peptone water and plated on Salmonella-Shigella agar. Standard identification tests (Gram staining, oxidase test, TSI test and 16S rRNA) were used to confirm the identities of 97 (one from each sample) presumptive isolates. Large proportions (85% to 100%) of the isolates from Rustenburg and Zeerust were oxidase positive. None of the isolates produced hydrogen sulphide gas on TSI medium but utilize glucose as a source of carbon. A large proportion (75.3%) of the isolates was positively identified as Shigella species based on PCR analysis. The number of isolates confirmed as Shigella species was higher in Zeerust (54.8%) than in Rustenburg (45.2%). Shigella species were most often isolated from samples that were collected outside than inside the carcass. Generally a large proportion (74.0%) of the isolates possessed the IpaH gene while64.4% of these isolates were positive for the IpaBCD gene that encodes for the invasion plasmid antigen. An analysis of the isolates from the different sampling sections indicated that 46.3% and 55.3% of the isolates from Zeerust possessed the IpaH and the IpaBCD genes, respectively while 53.7% and 44.7% of the isolates from Rustenburg possessed these genes. The detection of virulent Shigella species in beef carcasses demonstrates the need for a continued surveillance of this pathogen in meat in order to ensure the implementation of improved food safety measures

Canine aflatoxicosis outbreak in South Africa (2011): A possible multi-mycotoxins aetiology

This study analysed 60 dog food samples obtained from commercial outlets following the 2011 aflatoxicosis outbreak in South Africa. Results obtained from the selected dog food samples revealed that 87% of samples were contaminated with aflatoxins (AFs) (mainly AFB1 and AFB2). Amongst these samples, 45 (75%) were above the 20 parts per billion (ppb) set by most countries and 10 ppb regulated by the Fertilizers, Farm Feeds, Agricultural Remedies and Stock Remedies Act (Act No. 36 of 1947) for South Africa. In addition to AFs, other mycotoxins were also detected in the same samples with fumonisins (FBs) (mainly FB1and FB2) contaminating 98% of samples with 49 (81.81) above the tolerable limit of 1000 ppb in feedstuff set up by the Federal Drug Agency (FDA) (USA). The FBs mean obtained was 1556 ppb (Table 1) with contamination varying between 5.2 and 4653.8 ppb. Ochratoxin A (OTA) was detected in 41 (68%) of the analysed samples, with a mean value of 13.7 ppb. Amongst these samples, 15 (25%) were above the 20 ppb highest limit set by the Codex Alimentarius standard. Zearalenone (ZEA) was detected in 96% of samples, with a mean value of 354.1 ppb. Thirty-three samples (55%) were above the regulated level 1000 ppb tolerable limit. The recoveries were up to ten times the tolerable daily limits of the FDA and EU. The correlation between mycotoxin findings and clinical signs reported on patients presented for aflatoxicosis led to the conclusion that the outbreak was associated with the presence of other mycotoxins found simultaneously in the analysed samples by additive or synergistic effects

Molecular Detection of Integrons, Colistin and β-lactamase Resistant Genes in Salmonella enterica Serovars Enteritidis and Typhimurium Isolated from Chickens and Rats Inhabiting Poultry Farms

The rapid growth of multidrug-resistant Salmonella is a global public health concern. The aim of this study was to detect integrons, colistin and β-lactamase resistance genes in Salmonella enteritidis and typhimurium. A total of 63 isolates of S. enteritidis (n = 18) and S. typhimurium (n = 45) from fecal samples of layers and rats at chicken farms were screened for antibiotic resistant genes. Conventional PCR was performed for the detection of integrons (classes 1, 2, and 3), colistin (mcr-1-5) and β-lactamase (blaCTX-M, blaCTX-M-1, blaCTX-M-2, blaCTX-M-9, blaCTX-M-15, blaTEM, blaSHV, and blaOXA) resistant genes. Of these isolates, 77% and 27% of S. typhimurium and S. enteritidis harboured the mcr-4 encoded gene for colistin, respectively. The prevalence of class 1 integrons for S. typhimurium and S. enteritidis was 100% for each serovar, while for class 2 integrons of S. typhimurium and S. enteritidis it was 49% and 33% respectively, while class 3 integron genes was not detected. Our study also detected high levels of β-lactamase encoding genes (bla gene), namely blaCTX-M, blaCTX-M-1, blaCTX-M-9 and blaTEM from both S. typhimurium and S. enteritidis. This, to our knowledge, is the first report of mcr-4 resistance gene detection in Salmonella serovars in South Africa. This study also highlights the importance of controlling rats at poultry farms in order to reduce the risk of transmission of antibiotic resistance to chickens and eventually to humans

Heavy metal poisoning as a possible cause of massive fish mortality and mongoose in the gold mining area around Khutsong, North west province , South Africa

Abstract: Ten composite samples each of water, sediment, fish and organs samples of mongoose from the Wonderfontein area were analysed for the presence of As, Pb, Cd and Cr using atomic absorption spectrophotomery in order to investigate the massive fish mortality in the Wonderfontein stream. Follow up samples of water and sediment were similarly analysed a year later. Abundance of metals followed the trend As>Pb>Cd>Cr, Cr>As>Pb>Cd and As>Cd>Pb>Cr in water, fish and mongoose respectively. The concentrations of As, Pb, Cd and Cr in the initial water samples were 510, 121, 90 and 73 ppm respectively. Water samples collected 12 months later had lower levels of metals at 256, 60, 60, and 50ppm respectively. Cr was highest in fish samples at 56 ppm, while As was highest in mongoose kidney at 25.7ppm. Water concentrations of As, Pb, Cd and Cr were 10 205, 8 020, 2 425 and 733 times higher than the EC/WHO/EPA recommended threshold for potable water while those of Cd and Pb were 36 and 11.2 times higher than those recommended for fish. Levels of metals in sediments were generally higher than those in water. Severe heavy metal pollution with As, Pb, Cd and Cr was revealed in this study, and was also most linked to the mortality of fish and mongoose in the stream. Frequent biomonitoring is therefore recommended in order to safeguard public and animal health in the area. [Nyirenda M, Thekiso V.V, Dzoma B.M, Motsei L.E, Ndou R.V, Bakunzi F.R. Heavy metal poisoning as a possible cause of massive fish mortality and mongoose in the gold mining area around Khutsong, North west province, South Africa. Life Sci J 2012;9(3

Antibiotic resistance and virulence profiles of Proteus mirabilis isolated from broiler chickens at abattoir in South Africa

Abstract Background Proteus mirabilis has been identified as an important zoonotic pathogen, causing several illnesses such as diarrhoea, keratitis and urinary tract infections. Objective This study assessed the prevalence of P. mirabilis in broiler chickens, its antibiotic resistance (AR) patterns, ESBL‐producing P. mirabilis and the presence of virulence genes. Methods A total of 26 isolates were confirmed as P. mirabilis from 480 pooled broiler chicken faecal samples by polymerase chain reaction (PCR). The disk diffusion method was used to evaluate the antibacterial susceptibility test, while nine virulence genes and 26 AR genes were also screened by PCR. Results All 26 P. mirabilis isolates harboured the ireA (siderophore receptors), ptA, and zapA (proteases), ucaA, pmfA, atfA, and mrpA (fimbriae), hlyA and hpmA (haemolysins) virulence genes. The P. mirabilis isolates were resistant to ciprofloxacin (62%) and levofloxacin (54%), while 8 (30.7%) of the isolates were classified as multidrug resistant (MDR). PCR analysis identified the blaCTX‐M gene (62%), blaTEM (58%) and blaCTX‐M‐2 (38%). Further screening for AMR genes identified mcr‐1, cat1, cat2, qnrA, qnrD and mecA, 12%, 19%, 12%, 54%, 27% and 8%, respectively for P. mirabilis isolates. The prevalence of the integron integrase intI1 and intI2 genes was 43% and 4%, respectively. Conclusions The rise of ciprofloxacin and levofloxacin resistance, as well as MDR strains, is a public health threat that points to a challenge in the treatment of infections caused by these zoonotic bacteria. Furthermore, because ESBL‐producing P. mirabilis has the potential to spread to humans, the presence of blaCTX‐M‐producing P. mirabilis in broilers should be kept under control. This is the first study undertaken to isolate P. mirabilis from chicken faecal samples and investigate its antibiotic resistance status as well as virulence profiles in South Africa

Prevalence and antimicrobial resistance profiles of Campylobacter species in South Africa: a “One Health” approach using systematic review and meta-analysis

Objectives: This study investigated the prevalence and antibiotic resistance (AR) profiles of Campylobacter spp. isolated from animals, humans, and the environment in South Africa based on available published data. Methods: Original articles published from January 1, 1990 to January 1, 2021 were searched from PubMed, ScienceDirect, Google Scholar, Africa Index Medicus, Scopus, and African Journal Online databases. Data were analyzed with Comprehensive Meta-Analysis (version 3.0). Results: After screening, articles on animals (n = 25), humans (n = 7), environment (n = 3), animals/environment (n = 2), and a (n = 1) study on animals, humans, and the environment were included in this review. The pooled prevalence estimates (PPEs) were 28.8%, 16.4%, and 28.4% in animals, humans, and the environment, respectively. The Campylobacter jejuni and Campylobacter coli species were commonly isolated from humans, animals, and the environment in South Africa. The AR profiles were screened from 2032 Campylobacter spp., with the highest PPE of AR observed against clindamycin (76.9%) and clarithromycin (76.5%). Campylobacter isolates tested with the disk diffusion assay and minimum inhibitory concentration methods recorded an overall AR prevalence of 35.3% and 37.1%, respectively, whereas multidrug resistance PPE was 35.3%. Conclusion: Regular surveillance of Campylobacter spp. prevalence and its antimicrobial resistance strains is recommended, as well as the formulation of a “One Health” approach for better management and control of Campylobacter spp. infection in South Africa