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PubMed2005

Gender and race distribution of dental graduates (1985-2004) and first year dental students (2000-2005) in South Africa.

This paper, written at the close of a decade of democracy in South Africa, sets out to analyse the demographic profile of dental graduates from 1985-2004 at the five Faculties/Schools of Dentistry in South Africa. A comparison of the profiles for the pre-democracy (1985-1994) and post-apartheid (1995-2004) periods has been made. The demographic profile of first year dental students from 2000-2005 is also presented. From 1985-1994, most dental graduates were male (79%), but this changed substantially from 1995-2004, with females comprising 46% of those graduating. In the pre-democracy period, more than three-quarters of all graduates were White (78%), decreasing to 46% in the post-apartheid period under review. Black graduates increased from 6% to 24% across the two study periods. Amongst the first year dental student intake from 2000-2005, females comprised 57%. There was an almost equal distribution across the White, Black and Asian groups. Dental faculties/schools have made important strides in transforming the demographic profile of their students. The percentage of Black graduates, however, needs to be significantly increased if it is to reflect the national population. Faculties/schools must further ensure that able students from working class background are identified and considered for acceptance into the undergraduate dental programme, and should then be offered the necessary academic and mentoring support to enable success.

Asian People↗
PubMed2006

Rates and causes of child mortality in an area of high HIV prevalence in rural South Africa.

OBJECTIVE: To determine child mortality rates in a rural area of South Africa with high HIV prevalence. METHODS: A community-based survey was conducted between 1 January 2000 and 31 December 2002 on deaths in children under the age of 15 years. Children were followed up through four monthly home visits. Cause of death was ascertained by verbal autopsy. Rates were calculated using Poisson regression. RESULTS: Mortality ratios were 59.6 deaths per 1000 live births for infants and 97.1 for children under 5 years of age. Infant and under-5 mortality rates were, respectively, 67.5 and 21.1 deaths per 1000 person-years. HIV/AIDS was attributed to 41% of deaths in the under-5 age group, with a mortality rate of 8.6 per 1000 person-years. Lower respiratory infections caused an estimated 24.9 deaths per 1000 person-years in children under 1 year of age. CONCLUSIONS: In rural South Africa, infant and child mortality levels are high, with HIV/AIDS estimated as the single largest cause of death. Interventions to reduce child mortality are required urgently.

Adolescent↗
PubMed2002

Morphological, cultural and pathogenic characteristics of Coniothyrium zuluense isolates from different plantation regions in South Africa.

Coniothyrium canker caused by Coniothyrium zuluense, is a serious stem canker disease of Eucalyptus species in sub-tropical regions of South Africa. This disease is typified by necrotic bark lesions that coalesce to form large kino-impregnated cankers along the stems of trees. The strategy currently used to manage Coniothyrium canker in plantations is to deploy Eucalyptus species or clones that are resistant to the disease. Considerable success has already been achieved in this regard, but the long-term durability of resistance is of concern. Thus, forest managers are interested in the genetic diversity of the pathogen and its potential to overcome disease resistance in planting stock. In this study, 344 isolates of C. zuluense from different plantation regions in South Africa were compared on the basis of colony colour, conidial morphology, growth characteristics on agar and pathogenicity to a susceptible E. grandis clone. Conidia of all C. zuluense isolates measured were similar in size and shape. The fungus is slow growing in culture, which is indicative of its apparent biotrophic habit, with optimum growth observed at 30 degrees C. Isolates of C. zuluense displayed considerable variation in colony colour and pathogenicity in inoculation trials. Variation in morphology and pathogenicity amongst isolates suggests that C. zuluense has been present in South Africa for an extended period of time, or that it is changing rapidly due to strong directional selection pressures.

Animals↗
PubMed2004

An analysis of opinions from veterinarians in South Africa regarding business management skills.

The changing role of veterinarians in the global market is a current topic of debate and discussion. Few countries including South Africa have formally examined the changing dynamics of this profession. Therefore, the present study addressed 2 objectives. The 1st was to examine basic information about veterinarians in South Africa including their age, gender and distribution across provinces, the percentage whose practice was urban, rural or periurban, the numbers working with specific animal species, and the extent of business management and skills previously gained. The 2nd objective was to obtain opinions and insights from veterinarians in South Africa about the challenges and opportunities facing their business practices to better understand what they considered important dynamics to their businesses today. Several areas of business on which they were questioned and which were included in this study were: marketing, vision, human resources, leadership, financial management, ethics, competition, day-to-day operations, interpersonal skills and information management. This is the 1st known survey to employ a questionnaire to gain insights and opinions from veterinarians about business management skills.

Demography↗
PubMed1999

Bloodborne viruses in forensic medical practice in South Africa.

Health care workers are at risk of exposure to bloodborne viruses including human immunodeficiency virus types 1 and 2 (HIV-1 and -2), hepatitis B virus (HBV) and hepatitis C virus (HCV). However, limited data is available regarding these risks to forensic medical personnel who are exposed daily to large numbers of severely traumatized bodies in South Africa, a country that has an existing and growing HIV epidemic and a high HBV seroprevalence. Because no specific prescriptions ensuring occupational safety in this regard exist for forensic medical personnel in South Africa, the prevalence of bloodborne viruses within this setting must be determined. Blood was taken randomly from 263 bodies examined at the Medicolegal Laboratory in Pretoria. Serologic tests to detect antibodies to HIV, HCV, and human T-cell lymphotropic virus types I and II (HTLV-I and -II) and to detect the presence of HBV surface antigen (HBsAg) were performed and positive results confirmed using conventional serologic assays. Serologic tests detected at least one of the four bloodborne viruses in 21% of cases. The overall seroprevalence for HIV-1/2 was 11%, rising to 19% in the sexually active reproductive age group (15 - 49 years). The HBsAg prevalence overall was 8%, rising to 9% in sexually active reproductive individuals. There was a low overall HCV seroprevalence of 1% and an even lower HTLV-I/II seroprevalence of 0.01%. Forensic medical personnel in South Africa are therefore at risk of exposure to bloodborne viral pathogens in, on average, 1 of 5 bodies autopsied. This risk is compounded by the high daily workload, traumatized state of many of the bodies, and adverse working conditions. It is imperative that occupational health safety guidelines be created for the forensic medicine discipline and crime scene attendants in South Africa.

Adolescent↗
PubMed2002

Environmental health challenges in South Africa: policy lessons from case studies.

In South Africa, the challenges of economic growth, job creation and effective service delivery are regarded as key to the long-term development of the country. The provision of basic environmental health services is acknowledged as an important factor impacting on the quality of living environments and the health of communities. This paper outlines the environmental health challenges faced by local authorities in the context of national policy, the wider local government development framework and the backlog in the provision of basic services. Using South African examples, the paper concludes with a synopsis of the gaps in policy and delivery drawing on the policy framework of the World Health Organisation, Health for All in the 21st Century. Many of the insights highlighted are likely to parallel the experiences in other developing countries.

Air Pollution↗
PubMedDate not supplied

One year surveillance of HIV-1 infection in Johannesburg, South Africa.

A sero-epidemiological surveillance study to monitor the prevalence of HIV-1 infection in Johannesburg, South Africa, was commenced in February 1988. The population selected for study were attenders at clinics for sexually transmitted diseases (STD) and at family planning (FP) clinics. In the 12 months of the study 6631 sera were tested. Of the STD attenders, 15 of 1224 black females (1.2%) and 21 of 2482 black males (0.8%) were positive. Of the 449 white males tested 49 were homosexual, amongst whom 10 (20.4%) were positive; in the heterosexual white male group 4 of 400 (1.0%) were positive. Of the FP clinic attenders, 4 of 1459 black females (0.3%) were positive. 68 of the 6631 sera tested were indeterminate for infection. No attenders were positive for HIV-2 infection. These data confirmed the entry of HIV infection into the black population in South Africa.

Ambulatory Care Facilities↗
PubMedDate not supplied

Foster care in Soweto, South Africa: under assault from a politically hostile environment.

Institutionalized discrimination has progressively eroded the formerly cohesive black family structure in South Africa, resulting in an increased need for alternative care for black children, as shown most prominently in South Africa's most populous black urban area. Foster care's inherent problems are compounded not only by apartheid but also by the political unrest in the country. This article offers a profile of Sowetan foster families and the problems they face.

Black or African American↗
PubMed1991

An economic analysis of family size decision making with reference to the developing areas of South Africa.

A neoclassical utility framework is used to analyze links between decisions about family size and socioeconomic variables using data for 175 women in KwaZulu, South Africa. The demand curve for children is specified within a simultaneous model of family decision-making. "Child education, women's opportunity cost of time and formal market participation were negatively related to fertility, reflecting substitution from numbers of children (time intensive) to fewer, more educated children (less time intensive) as opportunity costs rise. Child labour was positively related to fertility. Strategies to reduce population growth rates should therefore include improvements in women's education and employment opportunities to raise their time costs, and time-saving devices to reduce demand for child labour."

Adolescent↗
PubMed2004

Infections with nontyphoidal Salmonella species producing TEM-63 or a novel TEM enzyme, TEM-131, in South Africa.

Salmonella spp. producing extended-spectrum beta-lactamases (ESBLs) have been reported in many countries, but there is no information on their prevalence in Africa. ESBL-producing Salmonella enterica serotype Isangi and S. enterica serotype Typhimurium strains have been noted in South Africa since 2001. A total of 160 consecutive isolates of Salmonella spp. were collected from 13 hospitals located in different cities in South Africa over a 5-month period from December 2002 to April 2003. All strains were screened for production of ESBLs by the double disk diffusion test and for AmpC production by assessing resistance to cefoxitin. bla(SHV), bla(TEM), bla(CTX-M), and bla(CMY-2) were sought from all ESBL-positive and cefoxitin-resistant isolates. A total of 15.6% (25 of 160) isolates produced SHV or TEM ESBLs, and 1.9% (3 of 160) produced CMY-2. Nine S. enterica serotype Typhimurium, eight S. enterica serotype Isangi, and three S. enterica serotype Muenchen strains produced either TEM-63 or a derivative of TEM-63 designated TEM-131. Both TEM-63 and TEM-131 have an isoelectric point of 5.6, and their sequences have the following amino acid substitutions compared to the TEM-1 sequence: Leu21Phe, Glu104Lys, Arg164Ser, and Met182Thr. Additionally, TEM-131 has an Ala237Thr substitution. ESBL-producing Salmonella spp. have become a significant public health problem in South Africa with particular implications for the treatment of serious nontyphoidal Salmonella infections in children, for whom extended-spectrum cephalosporins were the preferred treatment.

Anti-Bacterial Agents↗
PubMed1987

The state of psychiatry in South Africa today.

The very idea/philosophy behind the South African government's policy of Apartheid (separation), is insulting and humiliating to the black people and tends to incite arrogance and a sense of superiority, even omnipotence, in the whites. Personality development is skewed along racial lines. The mental effects of malnutrition and certain physical diseases, both of which are widespread in South African blacks, especially among their children, are well known. The torture to which security-police detainees have been subjected has resulted in thousands of cases of mental ill-health, as well as physical ill-health, and about 100 deaths, in the past 30 years. Authoritative reports about the in-patient psychiatric facilities for blacks have shocked the world medical, psychiatric and lay communities, and out-patient services for blacks are only sparsely existent, especially in the rural areas (the so-called 'independent homelands' and 'self-governing national states'). The socio-political climate makes interracial therapy, necessary because of the paucity of trained black professionals, particularly difficult. This fact, and the psychological implications of Apartheid, have, until very recently, hardly ever been addressed by psychiatrists and psychologists practising in South Africa. The United Nations and its agency, the World Health Organization, have taken unequivocally oppositional stands for decades but the (West-oriented) World Medical Association and the (mostly-Western) World Psychiatric Association have yet to speak out on this issue, like they have on those involving the Soviet Union and other Eastern Bloc countries.

Black or African American↗
PubMed2005

Nutrition security, livelihoods and HIV/AIDS: implications for research among farm worker households in South Africa.

OBJECTIVE: Previous research on the health transition and nutrition security in black South African households revealed the need for further research among farm workers who belong to the poorest population categories. This article gives an overview of the link between nutrition security, livelihoods and HIV/AIDS in South Africa, drawing conclusions for research among farm worker households. DESIGN AND SETTING: A literature review, observations on farms and interviews with farmers and key informants were carried out in 2003 and 2004. Peer examination was done with South African and German researchers from the natural and social sciences. RESULTS: Farm workers face poverty and nutrition insecurity and continue to be a tragically underserved population group, also in terms of research. There is furthermore a lack of in-depth research on underlying causes for nutrition security in South Africa and on the link with livelihoods, poverty and HIV/AIDS. Micro-social qualitative research from the household and gender perspective is required, as valid data on households, their internal dynamics and therefore the reflection of social realities are missing. A multidisciplinary research approach based on a new conceptual framework was developed to address the situation of farm worker households. CONCLUSION: The outlined research contributes to existing programmes on farms in the North West Province, with the findings being valid also for other parts of southern Africa facing poverty, nutrition insecurity and HIV/AIDS.

Agriculture↗
PubMed1987

Afrotropical Culicoides: a redescription of C. (Avaritia) kanagai Khamala & Kettle, 1971, reared from elephant dung in the Kruger National Park, South Africa.

The discovery of Culicoides kanagai in South Africa represents a new record for this species. The female is redescribed, and the male is described for the first time. Culicoides (A.) dasyops Clastrier, 1958 is shown to be closely related to it but C. (A.) alticola is only superficially related. Short notes on the larval habitat of C. kanagai, the dung of the African elephant, Loxodonta africana, are given. The dung of both the white rhinoceros, Ceratotherium simum, and the black rhinoceros, Diceros bicornis, is considered to be a possible alternative site for the immatures of C. kanagai.

Animals↗
PubMed2002

Condom use and sexual behaviors among individuals procuring free male condoms in South Africa: a prospective study.

BACKGROUND: Although the South African government has increased the number of male condoms distributed free to the public, there is no understanding of whether these are being used effectively to prevent the spread of sexually transmitted diseases, including HIV infection. GOAL: The study goal was to determine sexual behaviors and barriers to condom use among individuals procuring condoms distributed free to the public sector. STUDY DESIGN: In a prospective study, individuals who procured condoms from 12 public health facilities across South Africa were recruited and observed for the next 5 weeks. RESULTS: The 384 successfully observed subjects reported 3262 sexual contacts, of which 2637 (81%) involved protection with a condom. In multivariate analysis, alcohol consumption and use of other contraceptives were associated with unprotected sexual intercourse. CONCLUSION: The levels of condom use are relatively high in this population, but these data highlight several important barriers to condom use that may be targeted by future interventions.

Adult↗
PubMedDate not supplied

Continuing education in South Africa.

An overview of continuing education in South Africa reveals that despite strong philosophical support a number of factors impede the developmental of an effective system of such education. Existing inadequacies have been exacerbated by the introduction in 1986 of a comprehensive program for entry into the profession, resulting in an overwhelming demand for continuing education for nurses who trained prior to that. Rural nurses in particular are disadvantaged, with nondegree continuing education being largely inaccessible. However, efforts to meet these needs are afoot, and two recent initiatives are described.

Education, Nursing, Continuing↗
PubMed2004

Nine-locus Y-chromosome STR profiling of Caucasian and Xhosa populations from Cape Town, South Africa.

Y-chromosome STR markers are not widely used in forensic case work in South Africa. To begin assessing the forensic value of these markers in South Africa, samples were collected from 100 English-speaking Caucasian males and 99 Xhosa males, living in the Cape Town metropolitan area. Allele and haplotype frequencies were determined for nine Y-chromosome STR loci (DYS19, DYS389-I, DYS389-II, DYS390, DYS391, DYS392, DYS393, and the duplicated locus DYS385). Unique haplotypes were obtained for 47 Xhosa males and 66 Caucasians.

Chromosomes, Human, Y↗
PubMed2006

The mammalian fauna associated with an archaic hominin skullcap and later Acheulean artifacts at Elandsfontein, Western Cape Province, South Africa.

The Elandsfontein site, Western Cape Province, South Africa, is well known for an archaic hominin skullcap associated with later Acheulean artifacts. The site has also provided nearly 13,000 mammalian bones that can be identified to skeletal part and taxon. The assemblage derives from 49 species, 15 of which have no historic descendants. Comparisons to radiometrically dated faunas in eastern Africa indicate an age between 1 million and 600 thousand years ago. Unique features of the fauna, including the late occurrence of a dirk-toothed cat and a sivathere, may reflect its geographic origin in a region that was notable historically for its distinctive climate and high degree of biotic endemism. Together, taxonomic composition, geomorphic setting, and pollen extracted from coprolites indicate the proximity of a large marsh or pond, maintained by a higher water table. The small average size of the black-backed jackals implies relatively mild temperatures. The sum of the evidence places bone accumulation during one of the mid-Pleistocene interglacials that were longer and cooler than later ones, including the Holocene. The geomorphic context of the fauna presents no evidence for catastrophe, and most deaths probably resulted from attritional factors that disproportionately killed the young and old. However, only the dental-age profile of long-horned buffalo supports this directly. Field collection methods biased skeletal-part representation, but originally, it probably resembled the pattern in the younger, marsh-edge Acheulean occurrence at Duinefontein 2, 45 km to the south. Excavation there exposed multiple vertebral spreads, which probably mark carcasses from which hominins or large carnivores removed the meatier elements. Bone damage at both sites suggests that, despite abundant artifacts, hominins were much less important than carnivores in the bone accumulation. Together with limited observations from other sites, Elandsfontein and Duinefontein provisionally suggest that Acheulean-age hominins obtained few large mammals, whether by hunting or scavenging.

Animals↗