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PubMed1993

A simple questionnaire survey method for studying migration and residential displacement in informal settlements in South Africa.

"My aim in this article is to describe a cheap and reliable questionnaire survey method which can be used to identify patterns in migration and residential displacement." The method is described in the context of measuring migration in informal settlements in South Africa. "The merit of the method which I have described...lies in the fact that it allows questions of residential movement to be addressed in a routine manner, in much the same way that questions are used concerning, for example, household income."

Africa↗
PubMed2004

Prevalence of stroke survivors in rural South Africa: results from the Southern Africa Stroke Prevention Initiative (SASPI) Agincourt field site.

BACKGROUND AND PURPOSE: The importance of stroke in low-income regions such as sub-Saharan Africa has recently been emphasized. However, little is known about the burden of stroke in sub-Saharan Africa. We investigated the prevalence of stroke survivors in the Agincourt Health and Population Unit, a demographic surveillance site in the rural northeast of South Africa. METHODS: Census workers asked household informants 2 screening questions for stroke during the annual census. If either question was answered positively, a clinician visited individuals aged > or =15 years to confirm the likely diagnosis of stroke. We performed a detailed assessment and defined stroke according to the World Health Organization criteria. RESULTS: A total of 42 378 individuals were aged > or =15 years. There were 982 positive responses to the questionnaire, and we examined 724 individuals (74%). We identified 103 strokes (crude prevalence, 243/100 000). After adjustment for those we did not examine, the prevalence was 300/100 000 (95% CI, 250 to 357). Sixty-six percent of stroke survivors needed help with at least 1 activity of daily living (Segi age-standardized prevalence, 200/100 000). CONCLUSIONS: Stroke prevalence in rural South Africa is higher than previously documented in Africa but lower than in high-income countries. However, the prevalence of stroke survivors requiring help with at least 1 activity of daily living is already at high-income country levels. South Africa suffers from a huge burden of HIV/AIDS and diseases of poverty and violence and now faces the challenge of adapting its health systems to face the coming epidemic of vascular disease.

Adolescent↗
PubMed2003

Does knowing someone with AIDS affect condom use? An analysis from South Africa.

Prior research in Africa suggests that personally knowing someone with HIV/AIDS or who died of AIDS (PWA) may positively influence HIV-preventive behaviors such as condom use, by countering denial and increasing perceived risk. This article uses data from the 1998 South Africa Demographic and Health Survey (DHS) of women to examine this hypothesis in South Africa, where AIDS mortality is high. Logistic regression was applied to assess whether knowing a PWA was associated with condom use, net of the effects of possible confounders. Contrary to previous findings, analyses showed no association between condom use and having known a PWA. Condom use was strongly associated with knowledge that condoms can prevent HIV/AIDS, sex with a non-marital partner, higher education level, younger age, and urban residency. Findings suggest that communities should expand preventive efforts given the current level of AIDS mortality. Campaigns must reinforce messages that condoms are effective, and reach rural, less educated women, for whom HIV risk is high in South Africa.

Acquired Immunodeficiency Syndrome↗
PubMed1998

Private sector health reform in South Africa.

This paper discusses some of the trends, debates and policy proposals in relation to the financing of the private health sector in South Africa. The public and private sectors in South Africa are of equivalent size in terms of overall expenditure, but cover substantially different population sizes. Within this context the government has reached the unavoidable conclusion that the private sector has to play some role in ensuring that equity, access and efficiency objectives are achieved for the health system as a whole. However, the private sector is some way off from taking on this responsibility. Substantial increases in per capita costs over the past 15 years, coupled with a degree of deregulation by the former government, have resulted in increasing instability and volatility. The development of a very competitive medical scheme (health insurance) market reinforced by intermediaries with commercial interests has accelerated trends toward excluding high health risks from cover. The approach taken by the government has been to define a new environment which leaves the market open for extensive competition, but removes from schemes the ability to compete by discriminating against high health risks. The only alternatives left to the private market, policy makers hope, will be to go out of business, or to survive through productivity improvements.

Costs and Cost Analysis↗
PubMed1990

Geographic distribution of phage types among cultures of Mycobacterium tuberculosis. II. Cultures from India and South Africa.

Mycobacterium tuberculosis cultures obtained from India and South Africa were phage-typed to determine distribution patterns according to phage type in these two geographic locations. Of the 74 Indian strains, 14.9% were type 1, 32.4% were type 2, 28.4 were type 7, and 24.3% were type 8, whereas of the 78 South African strains, 20.5% were type 1, 47.5% were type 2, 1.3% were type 4, 11.5% were type 7, 19.2% were type 8. The phage types were then subdivided according to the lytic patterns produced by the six auxillary phages. The phage type distribution in the Indian and South African strains was compared with the type distribution in cultures from the United States and Southeast Asia, and differences were found in the four widely separated geographic areas.

Asia, Southeastern↗
PubMed1997

Veterinary parasitology in South Africa: some highlights of the past 100 years.

The reasons for the wide range of parasites occurring in South Africa are mentioned. An account is given of the establishment of veterinary research and training in South Africa. Some major breakthroughs and advances in the study or the control of ecto- and endoparasites as well as protozoal diseases are listed.

Animals↗
PubMed1999

Antibacterial activity of some indigenous plants used for the treatment of wounds in the Eastern Cape, South Africa.

The use of medicinal plants in the world, and especially in South Africa, contributes significantly to primary health care. This paper presents the findings of an initial survey of plants used for the treatment of wounds in the Eastern Cape Province, South Africa. Ethnomedical information gathered from surveys at clinics, hospitals as well as interviews with traditional healers and rural dwellers has revealed that Grewia occidentalis, Polystichum pungens, Cheilanthes viridis and Malva parvifolia are the most commonly used plants for the treatment of wounds in the province. The methanol extracts of G. occidentalis, P. pungens and C. viridis showed significant inhibition against gram-positive and gram-negative bacteria, while the acetone extract of P. pungens inhibited the gram-positive bacteria only. Extracts from M. parvifolia did not show any antibacterial activity at 5.0 mg/ml. Generally, the antibacterial property of the plants appears to have justified their use for the treatment of wounds, which are contaminated through bacterial infection, in the province.

Anti-Bacterial Agents↗
PubMed1998

The geographical distribution of diagnostic medical and dental X-ray services in South Africa

AIM: The aim of this study was threefold, viz.: (i) to evaluate the availability and accessiblity of medical and dental X-ray services in South Africa; (ii) to evaluate geographical information systems (GIS) as a tool for management of health care technologies; and (iii) to guide policy and develop a process to provide optimal utilisation of X-ray services in South Africa. METHODS: Information supplied by the Department of Health on licensed X-ray equipment was integrated with census data and processed with GIS. Four key areas were assessed, viz. distribution, accessibility, age and availability of X-ray services in South Africa. RESULTS: The analysis shows a vast inequity in the distribution of X-ray services on a provincial as well as a district level, although on the national level the distribution of X-ray services meets the World health Organisation criteria. CONCLUSION: GIS is a useful tool in evaluating and planning of essential health services/techniques. However, care must be taken in interpreting the data on a macro level, as this masks vast inequities on the district level. RECOMMENDATIONS: The indicators of coverage should be expanded, similar reports should be prepared for the nine provinces, and these data should be integrated into the clinic planning programme. Radiological services should be added to and managed as part of an essential district health care technology package.

Journal Article↗
PubMed1996

An Archean Geomagnetic Reversal in the Kaap Valley Pluton, South Africa

The Kaap Valley pluton in South Africa is a tonalite intrusion associated with the Archean Barberton Greenstone Belt. Antipodal paleomagnetic directions determined from the central and marginal parts of the pluton record a geomagnetic reversal that occurred as the pluton cooled. The age of the reversal is constrained by an 40Ar/39Ar plateau age from hornblende at 3214 +/- 4 million years, making it the oldest known reversal. The data presented here suggest that Earth has had a reversing, perhaps dipolar, magnetic field since at least 3.2 billion years ago.

Journal Article↗
PubMed1980

Trends in the distribution of medical manpower in South Africa.

Trends in the distribution of doctors in South Africa have been demonstrated by analysis of the medical registers for the years 1936, 1946, 1960 and 1975. The data are presented in terms of urban hierarchies, universities of undergraduate medical education and specialist/non-specialist ratios.

Medicine↗
PubMed2002

With recent changes in environmental factors among Africans in South Africa, how have cancer occurrences been affected?

In South Africa, with changes in environmental factors, varyingly, there have been measures of westernization of diet, with slight rises in intakes of energy and fat, with more of animal, but less of plant foods, being eaten, and with a fall in dietary fibre intake. Smoking practice has increased, particularly in males, likewise alcohol consumption. Physical activity has fallen, especially in urban dwellers. Changes in cancer incidence rates, as reported in the South African Cancer Registry for the periods 1986 and 1993-1995 have been investigated. Additionally, changes in percentages of cancers in hospitals in Johannesburg during 1953-1955 and in Durban during 1994-1996, have been looked into. The high occurrences of oesophageal and cervix cancers have fallen slightly, although more so in respect of liver cancer. But there have been rises, widely varying, in the cases of cancers of the lung, prostate and breast. While some of these changes would be expected from the changes in environmental factors, many cancer occurrence situations remain problematical, e.g. the continuing low occurrence of colorectal cancer. Recently, the rapidly rising epidemic of HIV/AIDS has slightly increased the occurrence of certain cancers, particularly Kaposi's sarcoma and non-Hodgkin's lymphoma. Regarding prevention, chances of cancer control in Africans, through lessening personal risk factors, are very remote, which unfortunately also prevails in large measure in western populations, regarding their reluctance to make the recommended beneficial changes.

Adult↗
PubMed2001

Partnerships, community participation and intersectoral collaboration in South Africa.

Five community partnerships (CP) were initiated in South Africa as demonstration projects aimed at the re-orientation of health professionals' education (HPE) to be more community responsive and interprofessional. A cluster evaluation of these partnerships has demonstrated that, in addition to motivating all stakeholders to forge closer working relationships, it is necessary for partnerships to pay close attention to a variety of structural and operational dimensions, the lack of which could prove to be major constraints to effective partnership functioning. This study critically reviews the challenges to collaborative working as experienced by the South African cluster. Within the context of the post-apartheid restructuring and development, the discussion highlights the insights that partnerships offer to clarify the extent to which potential barriers could affect the stakeholder groups. The paper identifies potential impediments, and makes explicit how they impact on partnership fostering. Evidence is also presented for their early detection and possible solutions are identified. The lessons learnt from these South African cases are that wide representation, commitment and a sense of ownership, sound leadership skills, regular and effective communication, reliable member expertise and capabilities and attention to power issues are crucial elements in the partnership equation. The paper concludes with an invitation to health administrators and partnership executives to devote attention to the array of interacting components that, collectively, could impinge on the effectiveness of the multifaceted nature of interprofessional joint working arrangements.

Cluster Analysis↗
PubMed2005

Reductions in blood lead levels among school children following the introduction of unleaded petrol in South Africa.

Epidemiological studies have indicated that in the 1980s and early 1990s (a period in which petrol lead concentrations in South Africa ranged from 0.836 to 0.4 g/L), large proportions of urban South African children were at risk of excessive exposure to environmental lead. In 1991, when the maximum permissible petrol lead concentration in the country equaled 0.4 g/L, a study determined that the mean blood lead level among children attending inner city schools in the Cape Peninsula equaled 16 microg/dL, with well over 90% of children having blood lead levels equaling or exceeding the internationally accepted guideline level of 10 microg/dL. Socio economic status, housing conditions, and proximity of children's schools and homes to heavily trafficked roads were among the factors significantly associated with blood lead concentrations. In 1996, unleaded petrol was introduced in South Africa. A study undertaken in 2002 (at the same schools as in 1991), when unleaded petrol constituted around 30% of the market share of petrol in the country, has shown significant reductions in the mean blood lead concentration among Cape Peninsula inner city children and in the proportion of children with elevated blood lead levels. The mean blood lead level for the total sample (n = 429) of children whose mean age equaled 7 years (range: 5-11 years) was 6.4 microg/dL (range: 1.0-24.5 microg/dL) and 10% of children had blood lead levels equalling or exceeding 10 microg/dL. The mean blood lead levels among children attending schools in an inner city and in a less heavily trafficked periurban suburb were 6.9 and 4.8 microg/dL, respectively.

Child↗
PubMed1993

Health professionals and South Africa: supporting change in the health sector.

Now that political change is on the way in South Africa, what should be the position of doctors who are invited to visit the country? Does the "academic boycott" still have relevance? Waterston and Zwi review the case for and against an academic boycott policy, using evidence collected during the recent visit by Physicians for Human Rights (UK) and the Johannes Wier Foundation. The health system in South Africa is still inequitable, and despite progress towards desegregation in hospitals there is little momentum towards universal provision of primary health care, especially in the rapidly growing townships around big cities. The authors consider that pressure on the government should be maintained by outside organisations but that support directed towards appropriate health care should be encouraged, particularly in public health and primary health care.

Attitude↗
PubMed2005

Conceptualisation of community-based basic nursing education in South Africa: a grounded theory analysis.

Community-based education is about a decade old in basic nursing education in South Africa. An extensive review of literature revealed that although CBE was a familiar concept in South Africa, there was however, limited understanding of what this phenomenon means. The purpose of the study was to analyse the concept 'community-based education' with the aim of discovering shared understanding of this phenomenon in basic nursing education within the South African context. Strauss and Corbin's (1990) grounded theory approach was used to guide the research process. The South African Nursing Council's (SANC) education committee, the National Department of Health, human resources division representatives as well as seven nursing education institutions with well-established CBE programmes participated in the study. The data was collected by means of observations, interviews and document analysis. Purposive sampling and later theoretical sampling was used for selecting interviewees. This resulted in a total of 45 interviewees. The data collection and initial data analysis took place concurrently. Descriptive analysis followed by conceptual analysis was performed using Strauss and Corbin's model. The findings in this study revealed that community-based education is education that uses the community extensively, especially the under-developed and under-resourced settings, for learning purposes in order to enhance relevance of nursing education to the needs of the South African population. The core discriminatory characteristics of CBE were found to include; primacy of the community as a learning environment; the early exposure of students to community-based learning experiences; community-based learning experiences dominating the curriculum, exposure to community-based learning experiences throughout the curriculum, vertical sequencing of community-based learning experiences in a curriculum, starting from primary settings to secondary and later tertiary health care settings to facilitate the development of competencies required when serving in all these settings, and lastly, learning through providing service to the under-resourced communities. Community involvement and partnership, problem-centred learning, valid assessment of learning emanated as important characteristics of CBE but which were identified as gaps in the existing programmes. Recommendations focused on these gaps as well as to the problem of community-based learning experiences which were mainly concentrated in first and/or second year levels in most of the programmes.

Attitude of Health Personnel↗
PubMed1979

The role of the occupational health nurse in South Africa.

The improvement of the quality and quantity of occupational health care is a major issue in South Africa. The role of the nurse in the delivery of this care was examined at a workshop conference on 'The role of the occupational health nurse in South Africa'. In this article, the conclusions of the conference are reported, and the problems identified in developing the role of the nurse in this field are discussed.

Accident Prevention↗
PubMed1988

The first isolations of Campylobacter mucosalis from pigs in South Africa.

The first isolations of Campylobacter mucosalis in South Africa are described. Isolations were made from a 6-week-old weaner pig with necrotic enteritis and from 2 gingival swabs of suckling piglets from herds with histories of porcine intestinal adenomatosis. The isolates were serologically identified as being serotype A strains.

Animals↗