Investigating the spatial distribution of diabetes in Africa using both classical and Bayesian approaches.

Master of Science in Statistics. University of KwaZulu-Natal, Durban, 2017.Abstract available in PDF file

Examining the Relative Roles of Domestic and Foreign Direct Investments in Nigeria

This study examines the relative relevance of domestic investment (DI) and foreign direct investment (FDI) on economic performance in Nigeria (1980-2014). In an attempt to achieve this broad objective, annual time series data sourced from the Central Bank of Nigeria’s Statistical Bulletin, which was estimated using vector error correction technique, among others. The results, inter alia, show that both DI and FDI had significant effect on Nigeria’s economic performance; however, the influence of the former was observed to be far greater than the latter with marked difference both in terms of the level of significance and size. Thus, the study recommends, among others, the need for government to create the ambience that will enable domestic investors to thrive, on one hand, and be complemented by foreign investment, on the othe

Examining the Relative Roles of Domestic and Foreign Direct Investments in Nigeria

This study examines the relative relevance of domestic investment (DI) and foreign direct investment (FDI) on economic performance in Nigeria (1980-2014). In an attempt to achieve this broad objective, annual time series data sourced from the Central Bank of Nigeria (CBN)'s Statistical Bulletin, which was estimated using Vector Error Correction (VEC) technique, among others. The results, inter alia, show that both DI and FDI had significant effect on Nigeria's economic performance; however, the influence of the former was observed to be far greater than the latter with marked difference both in terms of the level of significance and size. Thus, the study recommends, among others, the need for government to create the ambience that will enable domestic investors to thrive, on one hand, and be complemented by foreign investment, on the other. Keywords: Domestic investment, Foreign direct investment, Economic performance, Vector error correction model JEL Classifications: F21; F2

An evaluation of the use of the South African Triage Scale in an urban district hospital in Durban, South Africa

Background: Emergency centres in South Africa are among the busiest in the world and serve as entry points for hospital care for most of the population. The South African Triage Scale (SATS) is a validated tool introduced nationally in 2006 and intended to increase the efficiency of emergency centres through a process of prioritisation of the severely ill patient. The objective of this study was to evaluate the use of the SATS in a busy urban district hospital in Durban, South Africa. Methods: A chart review of triaged patients was performed. The hospital uses a one-page SATS sheet and manages both medical and surgical patients. The triage history, physiological parameters, application of discriminator lists, final triage code and outcome was audited and compared with findings from the patients’ clinical records. Results: The mean triage early warning score was 1.50 (95% CI 1–2) and average time to treatment was 59 min (95% CI 51–67). Essential bedside investigations were missing on some very ill patients, there was poor documentation in many fields and confirmed time to treatment was within recommended timescales for only 48% of patients. Use of the discriminator list resulted in over-triage of 66.7% and an under-triage of 14%. Some 76% of patients were discharged from the emergency centre, 15% were admitted and 5.5% were transferred out. Conclusion: Nurse-led triage has been successfully implemented at the emergency centre of this hospital using SATS but some notable gaps were identified. (Full text of the research articles are available online at www.medpharm.tandfonline.com/ojfp) S Afr Fam Pract 2017; DOI: 10.1080/20786190.2017.130790

Spatial Variation and Factors Associated with Unsuppressed HIV Viral Load among Women in an HIV Hyperendemic Area of KwaZulu-Natal, South Africa

New HIV infections among young women remains exceptionally high and to prevent onward transmission, UNAIDS set ambitious treatment targets. This study aimed to determine the prevalence, spatial variation and factors associated with unsuppressed HIV viral load at ≥400 copies per mL. This study analysed data from women aged 15–49 years from the HIV Incidence Provincial Surveillance System (HIPSS) enrolled in two sequential cross-sectional studies undertaken in 2014 and 2015 in rural and peri-urban KwaZulu-Natal, South Africa. Bayesian geoadditive model with spatial effect for a small enumeration area was adopted using Integrated Nested Laplace Approximation (INLA) function to analyze the findings. The overall prevalence of unsuppressed HIV viral load was 45.2% in 2014 and 38.1% in 2015. Factors associated with unsuppressed viral load were no prior knowledge of HIV status, had a moderate-to-low perception of acquiring HIV, not on antiretroviral therapy (ART), and having a low CD4 cell count. In 2014, women who ever consumed alcohol and in 2015, ever ran out of money, had two or more lifetime sexual partners, ever tested for tuberculosis, and ever diagnosed with sexually transmitted infection were at higher risk of being virally unsuppressed. The nonlinear effect showed that women aged 15 to 29 years, from smaller households and had fewer number of lifetime HIV tests, were more likely to be virally unsuppressed. High viral load risk areas were the north-east and south-west in 2014, with north and west in 2015. The findings provide guidance on identifying key populations and areas for targeted interventions

Spatiotemporal Variation and Predictors of Unsuppressed Viral Load among HIV-Positive Men and Women in Rural and Peri-Urban KwaZulu-Natal, South Africa

Unsuppressed HIV viral load is an important marker of sustained HIV transmission. We investigated the prevalence, predictors, and high-risk areas of unsuppressed HIV viral load among HIV-positive men and women. Unsuppressed HIV viral load was defined as viral load of ≥400 copies/mL. Data from the HIV Incidence District Surveillance System (HIPSS), a longitudinal study undertaken between June 2014 to June 2016 among men and women aged 15–49 years in rural and peri-urban KwaZulu-Natal, South Africa, were analysed. A Bayesian geoadditive regression model which includes a spatial effect for a small enumeration area was applied using an integrated nested Laplace approximation (INLA) function while accounting for unobserved factors, non-linear effects of selected continuous variables, and spatial autocorrelation. The prevalence of unsuppressed HIV viral load was 46.1% [95% CI: 44.3–47.8]. Predictors of unsuppressed HIV viral load were incomplete high school education, being away from home for more than a month, alcohol consumption, no prior knowledge of HIV status, not ever tested for HIV, not on antiretroviral therapy (ART), on tuberculosis (TB) medication, having two or more sexual partners in the last 12 months, and having a CD4 cell count of <350 cells/μL. A positive non-linear effect of age, household size, and the number of lifetime HIV tests was identified. The higher-risk pattern of unsuppressed HIV viral load occurred in the northwest and northeast of the study area. Identifying predictors of unsuppressed viral load in a localized geographic area and information from spatial risk maps are important for targeted prevention and treatment programs to reduce the transmission of HIV