Chemical and thermal properties of VIP latrine sludge

This study investigated the chemical and thermal properties of faecal sludge from 10 dry VIP latrines in Bester’s Camp in the eThekwini Municipality, Durban, South Africa. Faecal sludge samples were selected at different depths and from the front and back sections of 10 VIP latrines during a manual emptying process. The samples were analysed for: moisture content; volatile solids; chemical oxygen demand; ammonia; total Kjeldahl nitrogen; pH; orthophosphate; thermal conductivity; calorific value and heat capacity. These properties will facilitate the design of faecal sludge emptying and treatment equipment. A manual sorting of the pit contents was carried out to determine the categories and amounts of household waste present. There was a significant difference in the moisture, volatile solids, chemical oxygen demand, ammonia, total Kjeldahl nitrogen and orthophosphate content of the faecal sludge between the front and back sections of the pit. There was minimal change in the thermal properties within the pit. The median values through the pit of each property analysed were: moisture content – 0.81 g water/g wet mass; volatile solids – 1.5 g VS/g ash; COD – 1.7 g COD/g ash; ammonia nitrogen – 10 mg NH3-N/g dry mass; TKN – 39 mg N/g dry mass; pH – 8.03; orthophosphate – 0.06 mg PO4/g dry mass; thermal conductivity – 0.55 W/m K; calorific value – 14 kJ/g dry mass; heat capacity – 2.4x103 kJ/kg K. On average, 87% of pit content is faecal sludge; the remainder consists of wastes such as paper, plastics and textiles.Keywords: faecal sludge, VIP latrines, chemical properties, thermal propertie

Prevalence of tobacco use among adults in South Africa: Results from the first South African National Health and Nutrition Examination Survey

Background. Data on tobacco use have informed the effectiveness of South Africa (SA)’s tobacco control strategies over the past 20 years.Objective. To estimate the prevalence of tobacco use in the adult SA population according to certain demographic variables, and identify the factors influencing cessation attempts among current smokers.Methods. A multistage disproportionate nationally representative stratified cluster sample of households was selected for the South African National Health and Nutrition Examination Survey, conducted in 2012. A sample of 10 000 households from 500 census enumerator areas was visited. A detailed questionnaire was administered to all consenting adults in each consenting household.Results. Of adult South Africans, 17.6% (95% confidence interval (CI) 6.3 - 18.9) currently smoke tobacco. Males (29.2%) had a prevalence four times that for females (7.3%) (odds ratio 5.20, 95% CI 4.39 - 6.16; p<0.001). The provinces with the highest current tobacco smoking prevalence were the Western Cape (32.9%), Northern Cape (31.2%) and Free State (27.4%). Among current tobacco smokers, 29.3% had been advised to quit smoking by a healthcare provider during the preceding year, 81.4% had noticed health warnings on tobacco packages, and 49.9% reported that the warning labels had led them to consider quitting.Conclusion. A large proportion of adult South Africans continue to use tobacco. While considerable gains have been made in reducing tobacco use over the past 20 years, tobacco use and its determinants need to be monitored to ensure that tobacco control strategies remain effective

Family Planning Among Hiv Positive And Negative Clients In A Resource Poor Setting In South Africa

Objective: To investigate family planning needs, knowledge of HIV transmission and HIV disclosure in a cohort sample that had undergone PMTCT in a resource poor setting. Design. Cross-sectional survey. Setting: Five clinics implementing PMTCT from Qaukeni Local Service Area, O.R. Tambo District in the Eastern Cape. Subjects: The sample at postnatal care consisted of one postnatal interview (n= 1310) when the infants were aged three months or less (n= 141, 10.8%), 4-6 months (n=200, 15.3%), 7-12 months (n=785, 59.9%), or 13-18 months (n=183, 14.0%). Results: One hundred and sixteen women were found HIV positive, 642 HIV negative and 552 with unknown HlV status. Considering those with HIV test results, 15.3% were HIV positive. Almost four out of five women got counselling on safe sex during pregnancy but only two out of three women practiced safe sex during pregnancy. Postnatally, almost all women received counselling on family planning, yet use of contraceptives and condoms were low. HIV positive women used condoms more often than HIV negative women. HIV positive women were significantly more likely than HIV negative women to say that they did not intend to have more children. For HIV positive women PMTCT knowledge was a positive predictor for the intention to have a child, while age, having a partner, HIV disclosure to partner and number of children were not significant. Pregnancy desire did not differ between HIV positive and HIV negative women regarding marital status, having two or more live births and HIV disclosure. Conclusion: High pregnancy desires, low contraceptive and condom use were found among HIV positive women. The incorporation of HIV prevention into promotion of contraceptives by family planning programmes and service providers needs to be improved. East African Medical Journal Vol. 85 (3) 2008: pp. 20-2

Analisis Curah Hujan dan Debit Model Swat dengan Metode Moving Average di DAS Ciliwung Hulu

Watershed can be regarded as a hydrological system that has a function in transforming rainwater as an input into outputs such as flow and sediment. The transformation of inputs into outputs has specific forms and properties. The transformation involves many processes, including processes occurred on the surface of the land, river basins, in soil and aquifer. This study aimed to apply the SWAT model in Ciliwung Hulu Watershed, asses the effect of average rainfall on 3 days, 5 days, 7 days and 10 days of the hydrological characteristics in Ciliwung Hulu Watershed. The correlation coefficient (r) between rainfall and discharge was positive, it indicated that there was an unidirectional relationship between rainfall and discharge in the upstream, midstream and downstream of the watershed. The upper limit ratio of discharge had a downward trend from upstream to downstream, while the lower limit ratio of discharge had an upward trend from upstream to downstream. It showed that the discharge peak in Ciliwung Hulu Watershed from upstream to downstream had a downward trend while the baseflow from upstream to downstream had an upward trend. It showed that the upstream of Ciliwung Hulu Watershed had the highest ratio of discharge peak and baseflow so it needs the soil and water conservations and technical civil measures. The discussion concluded that the SWAT model could be well applied in Ciliwung Hulu Watershed, the most affecting average rainfall on the hydrological characteristics was the average rainfall of 10 days. On average rainfall of 10 days, all components had contributed maximally for river discharge

Comparative durability of nevirapine versus efavirenz in first-line regimens during the first year of initiating antiretroviral therapy among Swaziland HIV-infected adults

Nevirapine (NVP) and Efavirenz (EFV) have generally comparable clinical and virologic efficacy. However, data comparing NVP durability to EFV are imprecise. We analyzed cohort data to compare durability of NVP to EFV among patients initiating ART in Mbabane, Swaziland. The primary outcome was poor regimen durability defined as any modification of NVP or EFV to the ART regimen. Multivariate Cox proportional hazards models were employed to estimate the risk of poor regimen durability (all-cause) for the two regimens and also separately to estimate risk of drug-related toxicity. We analyzed records for 769 patients initiating ART in Mbabane, Swaziland from March 2006 to December 2007. 30 patients (3.9%) changed their NVP or EFV-based regimen during follow up. Cumulative incidence for poor regimen durability was 5.3 % and 2.7 % for NVP and EFV, respectively. Cumulative incidence for drug-related toxicity was 1.9 % and 2.7 % for NVP and EFV, respectively. Burden of TB was high and 14 (46.7%) modifications were due to patients substituting NVP due to beginning TB treatment. Though the estimates were imprecise, use of NVP - based regimens seemed to be associated with higher risk of modifications compared to use of EFV - based regimens (HR 2.03 95%CI 0.58 - 7.05) and NVP - based regimens had a small advantage over EFV - based regimens with regard to toxicity - related modifications (HR 0.87 95%CI 0.26 - 2.90). Due to the high burden of TB and a significant proportion of patients changing their ART regimen after starting TB treatment, use of EFV as the preferred NNRTI over NVP in high TB endemic settings may result in improved first-line regimen tolerance. Further studies comparing the cost-effectiveness of delivering these two NNRTIs in light of their different limitations are required.Key words: Tolerability, Toxicity, Efavirenz, Nevirapine, Antiretroviral therapy, Resource limited setting, Swazilan

Age at sexual debut: A determinant of multiple partnership among South African youth

Age at sexual debut is an important determinant of HIV infection. The paper investigates the effects of age at sexual debut on sexual behaviour among South African youth. Among 2 875 respondents who ever had sexual intercourse, 39% had early sexual debut (sexual debut at age 16 years and below). Males (44.6%) were significantly more likely than females (35.1%) to report early sexual debut (odds ratio (OR)=1.45, p-value <0.001). Multiple sexual partners are significantly more common among those that had early sexual debut (10.4% vs. 4.8%) than those who had late sexual debut, (OR=2.29, p-value<0.001). Those aged 15 to 19 years were 1.4 times more likely to report multiple partners compared to those aged 20 to 24 years. Delaying sexual debut is a strategy many national programmes are promoting. The results of this study provide additional arguments to support such initiatives and show the need to strengthen intervention targeting youth (Afr. J. Reprod. Health 2010; 14[2]:47-54)

National HIV incidence measures - new insights into the South African epidemic

Background and objectives. Currently South Africa does not have national HIV incidence data based on laboratory testing of blood specimens. The 2005 South African national HIV household survey was analysed to generate national incidence estimates stratified by age, sex, race, province and locality type, to compare the HIV incidence and HIV prevalence profiles by sex, and to examine the relationship between HIV prevalence, HIV incidence and associated risk factors. Method. The detection of recent infections was performed on confirmed HIV-positive samples, using the BED capture enzyme immunoassay optimised for dried blood spot (DBS) specimens. BED HIV incidence calculations applied adjustment procedures that were recently revised and approved by the Centers for Disease Control and Prevention for subtype C blood specimens. Results. HIV incidence in the study population aged 2 years and older was 1.4% per year, with 571 000 new HIV infections estimated for 2005. An HIV incidence rate of 2.4% was recorded for the age group 15 - 49 years. The incidence of HIV among females peaked in the 20 - 29-year age group at 5.6%, more than six times the incidence found in 20 - 29-year-old males (0.9%). Among youth aged 15 - 24 years, females account for 90% of the recent HIV infections. Non-condom use among youth, current pregnancy and widowhood were the socio-behavioural factors associated with the highest HIV incidence rates. Conclusions. The HIV incidence estimates reflect the underlying transmission dynamics that are currently at work in South Africa. The findings suggest that the current prevention campaigns are not having the desired impact, particularly among young women.South African Medical Journal Vol. 97 (2) 2007: pp.194-19

Marital status and risk of HIV infection in South Africa

Objective. Available evidence on the relationship between marital status and HIV is contradictory. The objective of this study was to determine HIV prevalence among married people and to identify potential risk factors for HIV infection related to marital status in South Africa. Methods. A multistage probability sample involving 6 090 male and female respondents, aged 15 years or older was selected. The sample was representative of the South African population by age, race, province and type of living area, e.g. urban formal, urban informal, etc. Oral fluid specimens were collected to determine HIV status. A detailed questionnaire eliciting information on socio-demographic, sex behaviour and biomedical factors was administered through face-to-face interviews from May to September 2002. Results. HIV prevalence among married people was 10.5% compared with 15.7% among unmarried people (p-value < 0.001). The risk of HIV infection did not differ significantly between married and unmarried people (odds ratio (OR) = 0.85, 95% confidence interval (CI): 0.71 - 1.02) when age, sex, socio-economic status, race, type of locality, and diagnosis of a sexually transmitted infection (STI) were included in the logistical regression model. However, the risk of HIV infection remained significantly high among unmarried compared with married people when only sex behaviour factors were controlled for in the model (OR 0.55; 95% CI: 0.47 - 0.66). Conclusions. The relationship between marital status and HIV is complex. The risk depends on various demographic factors and sex behaviour practices. Increased prevention strategies that take socio-cultural context into account are needed for married people. S Afr Med J 2004; 94: 537-543