Institutional arrangements for the implementation of the provincial growth and development strategies (PGDSs) of Limpopo Province

A research report submitted in partial fulfillment of the requirements for the degree: Masters of Management in the field of Public Policy (MMPP) at the school of governance, University of the Witwatersrand, Johannesburg October 2017Since 2004, Limpopo provincial government has been developing and implementing the Provincial Growth and Development Strategies (PGDSs). The rationale of the development of the PGDSs is to provide a vision for development for the province that reflects a growth and development trajectory. However, such a vision should be informed by the national development agenda. In order to implement and actualise the vision, priorities and programmes of the PGDSs should be implemented by various actors, institutions and structures within the policy environment. These will include, but are not limited to, provincial departments and municipalities, etc. Therefore, the provincial government revived and strengthened the existing institutions and established new ones in order to implement the PGDSs, across spheres of government. The critical success factors of these institutional arrangements are integrated planning, collaboration and cooperation amongst each other and with other non-state actors from the private sector and civil society. In practice, the functionality of these institutional arrangements is not leading towards achievement of desired results and outcomes as silo mentality amongst actors seem to prevail, both in planning and implementation. As a result, the objectives and targets of the PGDS have not been optimally achieved. Therefore, the study is intended to assess the functionality of the institutional arrangements for the implementation of the PGDSs, and to find out if these policy actors within these policy networks or institutional arrangements are adequate, relevant, appropriate, effective and sustainable towards the achievement of the objectives of the PGDSs. The findings from the study reveal that the provincial government has relatively adequate, relevant and appropriate institutional arrangements. What seems to be lacking, in order to make them effective and sustainable, however, is the adoption of a shared vision and commitment to the course by most actors in the policy networks and across all spheres of government amongst institutions themselves.MT 201

Cutaneous tuberculosis in HIV-infected individuals: Lessons learnt from a case series

Introduction: Extrapulmonary tuberculosis (TB) causes a significant burden of disease worldwide, especially among HIV-infected individuals and those with other immunosuppressive conditions. Cutaneous TB is an important manifestation of extrapulmonary TB but is uncommonly reported in South Africa despite the high burden of HIV and TB co-infection. There is a paucity of published data on clinical presentation and outcome of cutaneous TB in this context. Raising awareness of this condition among clinicians is imperative to improve early diagnosis and optimise treatment outcomes. Patient presentation: In this series, we present three cases of cutaneous TB, two adults and one child, referred to a tertiary hospital from two primary healthcare centres and from a general practitioner. We demonstrate that the clinical presentation is diverse, ranging from papular lesions to abscesses, and that concordant pulmonary TB may be present. Management: In particular, we show the importance of performing diagnostic procedures (e.g. aspiration) in individuals presenting with an abscess that does not respond to broad spectrum antimicrobial treatment, particularly in those with advanced immunosuppression. Outcome and conclusion: The outcome of our three patients was poor, highlighting the need for earlier diagnosis in this WHO Stage 4 condition and intensive management of clinical cases. Keywords: HIV-medicine; Retro-Viral Disease; Mycobacteria; Tuberculosis; Multidrug Resistance; Cutaneous Tuberculosis; Cutaneous Disease; immunocompromised

First report of a whole-genome shotgun sequence of a clinical Enterococcus faecalis sequence type 6 strain from South Africa

Enterococcus faecalis is a lactic acid-producing Gram-positive bacterium commonly found in the intestinal tract of humans and animals; it is implicated in multidrug-resistant nosocomial infections. The draft genome of this E. faecalis sequence type 6 (ST6) strain consists of 3,215,228 bp, with 37.20% GC content, 3,048 predicted coding sequences, and 61 RNA genes.Grant 94445 from the NHLShttp://genomea.asm.orgam2018Medical Microbiolog

South Africa's business interests in the African continent: a case study of the Democratic Republic of Congo (DRC) 1994-2006

South Africa’s growing economic presence across the African continent has triggered debates in public and scholarly circles as to its intentions. As a result, this paper traces South Africa’s economic diplomacy in the African continent, in the DRC in particular. It argues that South Africa’s foreign policy objectives have been largely geared towards peaceful resolution of African conflicts. This research will therefore scrutinise how South Africa managed to achieve measurable gains in the DRC since 1998. It is further argued that Pretoria’s involvement in the DRC’s complex conflict was boosted and informed by its long-term economic interests in the region, and advancement of the New Partnership for Africa’s Development (Nepad), which puts both its parastatals and private corporations under the spotlight in the DRC

Outbreak of carbapenem-resistant Providencia rettgeri in a tertiary hospital

The emergence of resistance to multiple antimicrobial agents in pathogenic bacteria is a significant public health threat, as there are limited effective antimicrobial agents for infections caused by multidrug-resistant (MDR) bacteria. Several MDR bacteria are now frequently detected. Carbapenem resistance in Enterobacteriaceae is often plasmid mediated, necessitating stringent infection control practices. We describe an outbreak of carbapenem-resistant Providencia rettgeri involving 4 patients admitted to intensive care and high-care units at a tertiary hospital. Clinical and demographic characteristics of 4 patients with carbapenem-resistant P. rettgeri were documented. All P. rettgeri isolated in these cases had a carbapenem-resistant antibiogram, with resistance to imipenem, ertapenem and meropenem. These cases could be epidemiologically linked. A multiprong approach, simultaneously targeting antibiotic stewardship, universal precautions and appropriate transmission-based precaution practices, is integral to prevention and control of nosocomial infections

Draft genome sequence of a clinical Enterococcus faecium sequence type 18 strain from South Africa

We report the first draft genome sequence of an Enterococcus faecium sequence type 18 (ST18) strain isolated from a tuberculosis patient in Africa. The genome is comprised of 3,202,539 bp, 501 contigs, 37.70% GC content, 3,202 proteinencoding genes, and 61 RNA genes. The resistome and virulome of this important pathogen are presented herein.Grant 94445 of the National Health Laboratory Services of South Africa.http://genomea.asm.orgam2018Medical Microbiolog