The case of cholera preparedness, response and prevention in the SADC region: A need for proactive and multi-level communication and co-ordination

In this paper the authors seek to identify the most appropriate model for a regional co-ordination mechanism for cholera preparedness, response and prevention. The qualitative mixed-method data collection approach that was followed revealed the need for alternative solutions, including a socio-political understanding of cholera responses at different levels of scale and at different stages of an outbreak. Important areas that need to be understood include the multiplicity of actors and the complexity of their interaction, the importance of building local capacity, the need for varying responses at different levels of scale, the need for improved inter- and intra-country co-ordination and information exchange, the importance of cultural belief systems and the impact of the media on the response to cholera outbreaks. Ultimately, despite the proposed co-ordinating role that the Southern African Development Community (SADC) can play in a regional cholera response effort, the onus remains on states to build capacity at the local level and to capacitate local communities to drive response efforts semi-autonomously.Keywords: Cholera prevention, preparedness and response, socio-political understanding of cholera, socio-cultural understanding of cholera, transboundary disease, Southern African Development Community (SADC), choler

A Comparison Of Aerosol-Layer And Convective Boundary-Layer Structure Over A Mountain Range During Staaarte '97

The temporal evolution and spatial structure of the aerosol layer (AL) height as observed with an airborne downlooking lidar over the Swiss Alps were investigated with a three-dimensional mesoscale numerical model and a particle dispersion model. Convective boundary-layer (CBL) heights were derived from the mesoscale model output, and the behaviour of surface-released particles was investigated with the particle dispersion model. While a previous investigation, using data from the same field study, equated the observed AL height with the CBL height, the results of the current investigation indicate that there is a considerable difference between AL and CBL heights caused by mixing and transport processes between the CBL and the free atmosphere. CBL heights show a more terrain-following behaviour and are lower than AL heights. We argue that processes causing the difference between AL and CBL heights are common over mountainous terrain and that the AL height is a length scale that needs to be considered in air pollution studies in mountainous terrai

Contraception for the first time users: a problem-orientated guide to product selection and safe prescription

No Abstract South African Family Practice Vol. 49 (8) 2007: pp.44-5

A neuronal network model of interictal and recurrent ictal activity

We propose a neuronal network model which undergoes a saddle-node bifurcation on an invariant circle as the mechanism of the transition from the interictal to the ictal (seizure) state. In the vicinity of this transition, the model captures important dynamical features of both interictal and ictal states. We study the nature of interictal spikes and early warnings of the transition predicted by this model. We further demonstrate that recurrent seizures emerge due to the interaction between two networks.Comment: 9 pages, 7 figure

Prevalence and determinants of stunting and overweight in 3-year-old black South African children residing in the Central Region of Limpopo Province, South Africa

OBJECTIVES: To determine the prevalence of stunting, wasting and overweight and their determinants in 3-year-old children in the Central Region of Limpopo Province, South Africa. DESIGN: Prospective cohort study. SETTING: Rural villages in the Central Region of the Limpopo Province, South Africa. SUBJECTS: One hundred and sixty-two children who were followed from birth were included in the study. Anthropometric measurements and sociodemographic characteristics of the children were recorded. RESULTS: Height-for-age Z-scores were low, with a high prevalence of stunting (48%). The children also exhibited a high prevalence of overweight (22%) and obesity (24%). Thirty-one (19%) children were both stunted and overweight. Gaining more weight within the first year of life increased the risk of being overweight at 3 years by 2.39 times (95% confidence interval (CI) 1.96-4.18) while having a greater length at 1 year was protective against stunting (odds ratio (OR) 0.41; 95% CI 0.17-0.97). Having a mother as a student increased the risk for stunting at 3 years by 18.21 times (95% CI 9.46-34.74) while having a working mother increased the risk for overweight by 17.87 times (95% CI 8.24-38.78). All these factors also appeared as risks or as being protective in children who were both overweight and stunted, as did living in a household having nine or more persons (OR 5.72; 95% CI 2.7-12.10). CONCLUSION: The results of this study highlight the importance of evaluating anthropometric status in terms of both stunting and overweight. Furthermore, it is important to realise the importance of normal length and weight being attained at 1 year of age, since these in turn predict nutritional status at 3 years of age

Hormonal contraceptive methods and risk of HIV acquisition in women : a systematic review of epidemiological evidence

Peer reviewedPublisher PD

Dietary intake and barriers to dietary compliance in black type 2 diabetic patients attending primary health-care services

OBJECTIVE: To determine the dietary intake, practices, knowledge and barriers to dietary compliance of black South African type 2 diabetic patients attending primary health-care services in urban and rural areas. DESIGN: A cross-sectional survey. Dietary intake was assessed by three 24-hour recalls, and knowledge and practices by means of a structured questionnaire (n = 133 men, 155 women). In-depth interviews were then conducted with 25 of the patients to explore their underlying beliefs and feelings with respect to their disease. Trained interviewers measured weight, height and blood pressure. A fasting venous blood sample was collected from each participant in order to evaluate glycaemic control. SETTING: An urban area (Sheshego) and rural areas near Pietersburg in the Northern Province of South Africa. SUBJECTS: The sample comprised 59 men and 75 women from urban areas and 74 men and 80 women from rural areas. All were over 40 years of age, diagnosed with type 2 diabetes for at least one year, and attended primary health-care services in the study area over a 3-month period in 1998. RESULTS: Reported dietary results indicate that mean energy intakes were low ( or = 30 kg m(-2)) was prevalent in 15 to 16% of men compared with 35 to 47% of women; elevated blood pressure (> or = 160/95 mmHg) was least prevalent in rural women (25.9%) and most prevalent in urban men (42.4%). CONCLUSIONS: The majority of black, type 2 diabetic patients studied showed poor glycaemic control. Additionally, many had dyslipidaemia, were obese and/or had an elevated blood pressure. Quantitative and qualitative findings indicated that these patients frequently received incorrect and inappropriate dietary advice from health educators

The performance of RAMS in representing the convective boundary layer structure in a very steep valley

Data from a comprehensive field study in the Riviera Valley of Southern Switzerland are used to investigate convective boundary layer structure in a steep valley and to evaluate wind and temperature fields, convective boundary layer height, and surface sensible heat fluxes as predicted by the mesoscale model RAMS. Current parameterizations of surface and boundary layer processes in RAMS, as well as in other mesoscale models, are based on scaling laws strictly valid only for flat topography and uniform land cover. Model evaluation is required to investigate whether this limits the applicability of RAMS in steep, inhomogeneous terrain. One clear-sky day with light synoptic winds is selected from the field study. Observed temperature structure across and along the valley is nearly homogeneous while wind structure is complex with a wind speed maximum on one side of the valley. Upvalley flows are not purely thermally driven and mechanical effects near the valley entrance also affect the wind structure. RAMS captured many of the observed boundary layer characteristics within the steep valley. The wind field, temperature structure, and convective boundary layer height in the valley are qualitatively simulated by RAMS, but the horizontal temperature structure across and along the valley is less homogeneous in the model than in the observations. The model reproduced the observed net radiation, except around sunset and sunrise when RAMS does not take into account the shadows cast by the surrounding topography. The observed sensible heat fluxes fall within the range of simulated values at grid points surrounding the measurement sites. Some of the scatter between observed and simulated turbulent sensible heat fluxes are due to sub-grid scale effects related to local topograph

Academic and quantitative literacy in higher education: Relationship with cognate school-leaving subjects

Academic and quantitative literacies (AQL) are essential to success in higher education. These literacies are largely not explicitly taught, but acquired indirectly, mostly through practices in various school subjects. The National Benchmark Tests (NBT) Project assesses students’ AQL competencies to assist in identifying students who need support, with placement into appropriate programmes and with curriculum development. We analyse the performance on the NBT AQL test of students who took the school-leaving examinations in Mathematics, Mathematical Literacy, English Home Language and English First Additional Language. We use the subject choice as a representation of the level of a candidate’s quantitative competence and language proficiency respectively, and investigate the relative contributions made by these subject choices to a student’s AQL. Students who paired Mathematics with English as Home Language subject had the statistically significant highest mean AQL score and those who took both English First Additional Language and Mathematical Literacy had the lowest. Language competence has a stronger effect than mathematical competence on AQL. Students who took the subject combination Mathematics and English Home Language at school are better prepared for the academic demands of higher education than their counterparts who took the alternate subjects. Treating these subjects as equivalent to English Home Language and Mathematics for admissions purposes ignores the differences in preparedness of these students

The roles of community health workers in management of non-communicable diseases in an urban township

BACKGROUND: Community health workers (CHWs) are increasingly being recognised as a crucial part of the health workforce in South Africa and other parts of the world. CHWs have taken on a variety of roles, including community empowerment, provision of services and linking communities with health facilities. Their roles are better understood in the areas of maternal and child health and infectious diseases (HIV infection, malaria and tuberculosis). AIM: This study seeks to explore the current roles of CHWs working with non-communicable diseases (NCDs). Setting: The study was conducted in an urban township in Cape Town, South Africa. Method: A qualitative naturalistic research design utilising observations and in-depth interviews with CHWs and their supervisors working in Khayelitsha was used. Results: CHWs have multiple roles in the care of NCDs. They act as health educators, advisors, rehabilitation workers and support group facilitators. They further screen for complications of illness and assist community members to navigate the health system. These roles are shaped both by expectations of the health system and in response to community needs. CONCLUSION: This study indicates the complexities of the roles of CHWs working with NCDs. Understanding the actual roles of CHWs provides insights into not only the competencies required to enable them to fulfil their daily functions, but also the type of training required to fill the present gaps. Introduction Community health workers (CHWs) are increasingly being recognised as a crucial part of the health workforce.1 In South Africa and worldwide, CHWs have provided health care to communities for many decades and have assumed a variety of roles, including communityWeb of Scienc