Regulation of international mobile roaming in the Southern African Development Community

The Southern African Development Community (SADC) experiences high levels of cross border human traffic due to trade, cultural and language links across the fifteen countries. Technological advances and increased domestic competition have contributed to lower domestic retail tariffs for mobile cellular services. Unfortunately, this has not extended to international mobile roaming (IMR) retail tariffs which remain unacceptably high. These high tariffs have attracted harsh criticism from commentators and prompted calls for regulatory intervention. This study investigates the level of international mobile roaming (IMR) retail tariffs, usage and demand elasticity. It further considers whether competition or regulation play a greater role in reducing these tariffs and whether regulatory intervention is likely to reduce competition. The research took the form of a quantitative study and used an online survey questionnaire as the data collection tool. The results of the study confirmed that international mobile roaming (IMR) retail tariffs are indeed high, resulting in poor uptake by cost conscious travellers who pay for their own cellular usage. The finding that competition plays a greater role than regulation in reducing IMR retail tariffs is not significant. It was concluded that neither competition nor regulation are sufficient on their own to provide increased social welfare. The best result is obtained when competition is allowed to flourish, underpinned by an enabling regulatory framework. CopyrightDissertation (MBA)--University of Pretoria, 2010.Gordon Institute of Business Science (GIBS)unrestricte

A Systematic Review of the Prevalence and Pattern of Imaging Defined Post-TB Lung Disease

Background Tuberculosis is an important risk factor for chronic respiratory disease in resource poor settings. The persistence of abnormal spirometry and symptoms after treatment are well described, but the structural abnormalities underlying these changes remain poorly defined, limiting our ability to phenotype post-TB lung disease in to meaningful categories for clinical management, prognostication, and ongoing research. The relationship between post-TB lung damage and patient-centred outcomes including functional impairment, respiratory symptoms, and health related quality of life also remains unclear. Methods We performed a systematic literature review to determine the prevalence and pattern of imaging-defined lung pathology in adults after medical treatment for pleural, miliary, or pulmonary TB disease. Data were collected on study characteristics, and the modality, timing, and findings of thoracic imaging. The proportion of studies relating imaging findings to spirometry results and patient morbidity was recorded. Study quality was assessed using a modified Newcastle-Ottowa score. (Prospero Registration number CRD42015027958) Results We identified 37 eligible studies. The principle features seen on CXR were cavitation (8.3–83.7%), bronchiectasis (4.3–11.2%), and fibrosis (25.0–70.4%), but prevalence was highly variable. CT imaging identified a wider range of residual abnormalities than CXR, including nodules (25.0–55.8%), consolidation (3.7–19.2%), and emphysema (15.0–45.0%). The prevalence of cavitation was generally lower (7.4–34.6%) and bronchiectasis higher (35.0–86.0%) on CT vs. CXR imaging. A paucity of prospective data, and data from HIV-infected adults and sub-Saharan Africa (sSA) was noted. Few studies related structural damage to physiological impairment, respiratory symptoms, or patient morbidity. Conclusions Post-TB structural lung pathology is common. Prospective data are required to determine the evolution of this lung damage and its associated morbidity over time. Further data are required from HIV-infected groups and those living in sSA

Household Air Pollution and Acute Lower Respiratory Infections in Adults: A Systematic Review.

INTRODUCTION: Household air pollution from solid fuel burning kills over 4 million people every year including half a million children from acute lower respiratory infections. Although biologically plausible, it is not clear whether household air pollution is also associated with acute lower respiratory infections in adults. We systematically reviewed the literature on household air pollution and acute lower respiratory infection in adults to identify knowledge gaps and research opportunities. METHODS: Ten bibliographic databases were searched to identify studies of household air pollution and adult acute lower respiratory infection. Data were extracted from eligible studies using standardised forms. RESULTS: From 4617 titles, 513 abstracts and 72 full-text articles were reviewed. Eight studies met the inclusion criteria of which 2 found a significant adjusted increased risk of acute lower respiratory infection, 2 identified a univariate association whilst 4 found no significant association. Study quality was generally limited. Heterogeneity in methods and findings precluded meta-analysis. DISCUSSION: A systematic review of the literature found limited evidence for an association between household air pollution and risk of acute lower respiratory infection in adults. Additional research, with carefully defined exposure and outcome measures, is required to complete the risk profile caused by household air pollution in adults. REGISTRATION NUMBER: CRD42015028042

A Systematic Review of the Prevalence and Pattern of Imaging Defined Post-TB Lung Disease.

Tuberculosis is an important risk factor for chronic respiratory disease in resource poor settings. The persistence of abnormal spirometry and symptoms after treatment are well described, but the structural abnormalities underlying these changes remain poorly defined, limiting our ability to phenotype post-TB lung disease in to meaningful categories for clinical management, prognostication, and ongoing research. The relationship between post-TB lung damage and patient-centred outcomes including functional impairment, respiratory symptoms, and health related quality of life also remains unclear.We performed a systematic literature review to determine the prevalence and pattern of imaging-defined lung pathology in adults after medical treatment for pleural, miliary, or pulmonary TB disease. Data were collected on study characteristics, and the modality, timing, and findings of thoracic imaging. The proportion of studies relating imaging findings to spirometry results and patient morbidity was recorded. Study quality was assessed using a modified Newcastle-Ottowa score. (Prospero Registration number CRD42015027958).We identified 37 eligible studies. The principle features seen on CXR were cavitation (8.3-83.7%), bronchiectasis (4.3-11.2%), and fibrosis (25.0-70.4%), but prevalence was highly variable. CT imaging identified a wider range of residual abnormalities than CXR, including nodules (25.0-55.8%), consolidation (3.7-19.2%), and emphysema (15.0-45.0%). The prevalence of cavitation was generally lower (7.4-34.6%) and bronchiectasis higher (35.0-86.0%) on CT vs. CXR imaging. A paucity of prospective data, and data from HIV-infected adults and sub-Saharan Africa (sSA) was noted. Few studies related structural damage to physiological impairment, respiratory symptoms, or patient morbidity.Post-TB structural lung pathology is common. Prospective data are required to determine the evolution of this lung damage and its associated morbidity over time. Further data are required from HIV-infected groups and those living in sSA

Studies reporting severity scores of residual changes on CXR imaging performed following treatment for pulmonary TB.

<p>Studies reporting severity scores of residual changes on CXR imaging performed following treatment for pulmonary TB.</p

Template for literature search: Pulmonary, pleural or military tuberculosis AND [CXR imaging OR CT imaging].

<p>Template for literature search: Pulmonary, pleural or military tuberculosis AND [CXR imaging OR CT imaging].</p

PRISMA flow chart.

<p>PRISMA flow chart.</p

Studies reporting prevalence of imaging patterns on CT imaging on completion of treatment for pulmonary tuberculosis.

<p>Studies reporting prevalence of imaging patterns on CT imaging on completion of treatment for pulmonary tuberculosis.</p