The burden of hypertension in KwaZulu-Natal Province, South Africa: A 6-year perspective

Background. Hypertension (HPT) and its complications continue to pose a global threat and contribute to premature mortality worldwide. The adverse interactions between HPT, obesity and COVID-19 are currently being witnessed globally and represent a collision of pandemics. Understanding the burden that this non-communicable disease (NCD) poses in KwaZulu-Natal (KZN) Province, South Africa (SA), would help in developing improved public healthcare strategies.Objectives. To describe the burden of HPT in all the districts of KZN over a 6-year period.Methods. HPT data are routinely collected from all KZN public health facilities (both clinics and hospitals) as part of the District Health Information System (DHIS). In this retrospective study, we accessed HPT records from the DHIS over a period of 6 years (2014 - 2019, inclusive). Data collected included the number of patients screened, diagnosed and initiated on therapy for HPT, together with the number of obese patients.Results. The slopes for HPT screening were positive at both clinics and hospitals in KZN (considerably more at clinics than hospitals, with a difference in elevations of slopes of p<0.001), with a significantly greater percentage of the population having been screened at rural clinics than at hospitals (difference in elevation of slopes p<0.001). A significantly greater number of patients aged <40 years (p<0.001) were being screened for HPT at clinics than at hospitals (2017/18, 2018/19, 2019/20), while hospitals screened considerably more patients aged ≥40 years in 2017 - 2018 (p<0.001). The numbers of new hypertensives diagnosed and having treatment initiated were on an upward slope at both clinics and hospitals, with clinics having a greater elevation of slope than hospitals (p<0.001), irrespective of patient age. A significantly greater number of patients aged ≥40 years (p<0.05) were diagnosed with HPT at both clinics and hospitals in KZN (2017/18, 2018/19, 2019/20). KZN clinics remained the first port of call for known hypertensives throughout the study period. Obesity was prevalent at both clinic and hospital level, although figures were significantly higher at clinics. Over 80% of the obesity burden was carried by the rural clinics and hospitals.Conclusions. Screening, diagnosis, treatment initiation and chronic management of HPT occur mainly at rural clinic level. The SA government needs to heed these findings and redirect resources (staffing and equipment) to this level. The prevalence of obesity was highest at rural healthcare facilities (clinics more than hospitals). More needs to be done to combat the obesity pandemic if we are to win the battle against NCDs (HPT and diabetes mellitus). A significant number of patients aged <40 years are being screened for HPT, which bodes well for the province, as early diagnosis and treatment of HPT are vital to prevent complications

Genetic analysis reveals the complex structure of HIV-1 transmission within defined risk groups

We explored the epidemic history of HIV-1 subtype B in the United Kingdom using statistical methods that infer the population history of pathogens from sampled gene sequence data. Phylogenetic analysis of HIV-1 pol gene sequences from Britain showed at least six large transmission chains, indicating a genetically variable, but epidemiologically homogeneous, epidemic among men having sex with men. Through coalescent-based analysis we showed that these chains arose through separate introductions of subtype B strains into the United Kingdom in the early-to-mid 1980s. After an initial period of exponential growth, the rate of spread generally slowed in the early 1990s, which is more likely to correlate with behaviour change than with reduced infectiousness resulting from highly active antiretroviral therapy. Our results provide new insights into the complexity of HIV-1 epidemics that must be considered when developing HIV monitoring and prevention initiatives

An exploration of Grade 12 learners' use of inappropriate algorithms in calculus

Published ArticleThis study was conducted with 29 Grade 12 learners who were studying calculus. The purpose was to explore how the learners responded to questions based on the derivative and why they did so. Data was collected from the written responses of the learners to two assessments carried out over a six-month period as well as interviews with four of the learners. It was found that learners made extensive use of inappropriate formulae, drawn from other sections of the curriculum The study recommends that teachers should not focus solely on how to carry out procedures, but they should also pay attention to why certain procedures are appropriate or not

CRISPR: Challenges to South African biotechnology law

Genome editing using newly discovered tools such as CRISPR-Cas9 offers the potential to modify the genetic make-up of plants, non-human animals and humans in exact ways. Such genetic modification can serve the purpose of correcting gene defects, and can enhance certain characteristics. Apart from reigniting old ethical debates, genome editing also poses a particular challenge to legal practitioners, as this new technology does not always fit into existing definitional moulds, and it lacks clear legal precedent. In this article, we identify the most salient areas of concern in the South African legal context

The geometry of Hrushovski constructions, I. The uncollapsed case

An intermediate stage in Hrushovski's construction of flat strongly minimal structures in a relational language L produces omega-stable structures of rank omega. We analyze the pregeometries given by forking on the regular type of rank omega in these structures. We show that varying L can affect the (local) isomorphism type of the pregeometry, but not its finite subpregeometries. A sequel will compare these to the pregeometries of the strongly minimal structures.Comment: 31 page

The prospects for mathematical logic in the twenty-first century

The four authors present their speculations about the future developments of mathematical logic in the twenty-first century. The areas of recursion theory, proof theory and logic for computer science, model theory, and set theory are discussed independently.Comment: Association for Symbolic Logi

Local magnetism of isolated Mo atoms at substitutional and interstitial sites in Yb metal : Experiment and Theory

Using TDPAD experiment and local spin density calculations, we have observed large 4d moments on isolated Mo atoms at substitutional and octahedral interstitial lattice sites in Yb metal, showing Curie-Weiss local susceptibility and Korringa like spin relaxation rate. As a surprising feature, despite strong hybridization with the Yb neighbours, interstitial Mo atoms show high moment stability with small Kondo temperature. While, magnetism of Mo, at substitutional site is consistent with Kondo type antiferromagnetic d-sp exchange interaction, we suggest that moment stability at the interstitial site is strongly influenced by ferromagnetic polarization of Yb-4f5d band electrons.Comment: 4 pages, 4 figure