Sample records for africa lesotho swaziland

  1. Exploring the Potential of Participatory Theatre to Reduce Stigma and Promote Health Equity for Lesbian, Gay, Bisexual, and Transgender (LGBT) People in Swaziland and Lesotho.

    PubMed

    Logie, Carmen H; Dias, Lisa V; Jenkinson, Jesse; Newman, Peter A; MacKenzie, Rachel K; Mothopeng, Tampose; Madau, Veli; Ranotsi, Amelia; Nhlengethwa, Winnie; Baral, Stefan D

    2018-03-01

    Stigma and discrimination affecting lesbian, gay, bisexual, and transgender (LGBT) people compromise health and human rights and exacerbate the HIV epidemic. Scant research has explored effective LGBT stigma reduction strategies in low- and middle-income countries. We developed and pilot-tested a participatory theatre intervention (PTI) to reduce LGBT stigma in Swaziland and Lesotho, countries with the world's highest HIV prevalence. We collected preliminary data from in-depth interviews with LGBT people in Lesotho and Swaziland to enhance understanding of LGBT stigma. Local LGBT and theatre groups worked with these data to create a 2-hour PTI composed of three skits on LGBT stigma in health care, family, and community settings in Swaziland (Manzini) and Lesotho (Maseru, Mapoteng). Participants ( n = 106; nursing students, health care providers, educators, community members) completed 12 focus groups following the PTI. We conducted thematic analysis to understand reactions to the PTI. Focus groups revealed the PTI increased understanding of LGBT persons and issues, increased empathy, and fostered self-reflection of personal biases. Increased understanding included enhanced awareness of the negative impacts of LGBT stigma, and of LGBT people's lived experiences and issues. Participants discussed changes in attitude and perspective through self-reflection and learning. The format of the theatre performance was described as conducive to learning and preferred over more conventional educational methods. Findings indicate changed attitudes and awareness toward LGBT persons and issues following a PTI in Swaziland and Lesotho. Stigma reduction interventions may help mitigate barriers to HIV prevention, treatment, and care in these settings with a high burden of HIV.

  2. Situation Report--Bahrain, Central African Republic, Gabon, Iraq, Jordan, Kuwait, Lesotho, Libya, Saudi Arabia, Swaziland, Syria, Yemen Arab Republic.

    ERIC Educational Resources Information Center

    International Planned Parenthood Federation, London (England).

    Data relating to population and family planning in twelve foreign countries are presented in these situation reports. Countries included are Bahrain, Central African Republic, Gabon, Iraq, Jordan, Kuwait, Lesotho, Libya, Saudi Arabia, Swaziland, Syria, and Yemen Arab Republic. Information is provided, where appropriate and available, under two…

  3. Selection for Higher Education in Developing Countries--the Use of Tests in Admission for Pre-Entry Science Upgrading Courses in Botswana, Swaziland and Lesotho.

    ERIC Educational Resources Information Center

    Altink, Wieby M. M.

    The degree of predictive validity and the relationship with previous learning conditions were studied for measures used in admission procedures for upgrading courses in science and mathematics in Botswana, Lesotho, and Swaziland. School results, achievement tests, aptitude tests, and ability tests were evaluated for students leaving secondary…

  4. Assessment of shale-gas resources of the Karoo Province, South Africa and Lesotho, Africa, 2016

    USGS Publications Warehouse

    Brownfield, Michael E.; Schenk, Christopher J.; Klett, Timothy R.; Pitman, Janet K.; Tennyson, Marilyn E.; Gaswirth, Stephanie B.; Le, Phuong A.; Leathers-Miller, Heidi M.; Mercier, Tracey J.; Finn, Thomas M.

    2016-07-08

    Using a geology-based assessment methodology, the U.S. Geological Survey estimated undiscovered, technically recoverable mean resource of 44.5 trillion cubic feet of shale gas in the Karoo Province of South Africa and Lesotho, Africa.

  5. Characteristics of men who have sex with men in southern Africa who seek sex online: a cross-sectional study.

    PubMed

    Stahlman, Shauna; Grosso, Ashley; Ketende, Sosthenes; Mothopeng, Tampose; Taruberekera, Noah; Nkonyana, John; Mabuza, Xolile; Sithole, Bhekie; Mnisi, Zandile; Baral, Stefan

    2015-05-25

    Use of the Internet for finding sexual partners is increasing, particularly among men who have sex with men (MSM). In particular, MSM who seek sex online are an important group to target for human immunodeficiency virus (HIV)/sexually transmitted infection (STI) interventions because they tend to have elevated levels of sexual risk behavior and because the Internet itself may serve as a promising intervention delivery mechanism. However, few studies have examined the correlates of online sexual partner seeking among MSM in sub-Saharan Africa. These analyses aim to describe the prevalence of using the Internet to find new male sexual partners among MSM in two southern African countries. In addition, these analyses examine the sociodemographic characteristics, experiences of discrimination and stigma, mental health and substance use characteristics, and HIV-related knowledge, attitudes, and behaviors among MSM associated with meeting sex partners online. MSM were enrolled into a cross-sectional study across two sites in Lesotho (N=530), and one in Swaziland (N=322) using respondent-driven sampling. Participants completed a survey and HIV testing. Data were analyzed using bivariate and multivariable logistic regression models to determine which factors were associated with using the Internet to meet sex partners among MSM. The prevalence of online sex-seeking was high, with 39.4% (209/530) of MSM in Lesotho and 43.8% (141/322) of MSM in Swaziland reporting meeting a new male sexual partner online. In the multivariable analysis, younger age (adjusted odds ratio [aOR] 0.37, 95% confidence interval [CI] 0.27-0.50 per 5 years in Lesotho; aOR 0.68, 95% CI 0.49-0.93 in Swaziland), having more than a high school education (aOR 18.2, 95% CI 7.09-46.62 in Lesotho; aOR 4.23, 95% CI 2.07-8.63 in Swaziland), feeling scared to walk around in public places (aOR 1.89, 95% CI 1.00-3.56 in Lesotho; aOR 2.06, 95% CI 1.23-3.46 in Swaziland), and higher numbers of male anal sex partners

  6. Fires in South Africa, snow in Lesotho

    NASA Technical Reports Server (NTRS)

    2002-01-01

    The precipitation that brought snow fall to the Drakensberg Mountains in Lesotho in southern Africa was not enough to quench the numerous fires (marked with red dots) burning throughout the Republic of South Africa. These Moderate Resolution Imaging Spectroradiometer (MODIS) images from June 18, 2002, and July 2, 2002, show the snowfall in landlocked Lesotho contrasting sharply with the country's brown, mountainous terrain. (In the false-color image, vegetation is bright green, bare soil is brown, and burned areas are reddish-brown. In northeast Republic of South Africa, right along the border with Mozambique, the smooth, gray-brown terrain shows the boundaries of Kruger National Park. The Park was established in the late 1800s to protect game species, such as elephants, antelope, and bison, which were being hunted in great numbers. In this image, dark brown patches reveal the location of previous fires. The vegetation has yet to come back, and the landscape is virtually bare. NASA scientists study fire behavior in Kruger as part of the SAFARI field campaign. Running southward through Mozambique and into the Indian Ocean is the muddy Limpopo River--known to many through Rudyard Kipling's 'Just-so' story about how the elephant got its trunk. Credit: Jacques Descloitres, MODIS Land Rapid Response Team, NASA/GSFC

  7. Lesotho.

    PubMed

    1987-08-01

    Focus in this discussion of Lesotho is on the following: geography; the people; history; government; political conditions; the economy; foreign relations; and relations between the US and Lesotho. The population totaled 1,621,932 in 1987 with an annual growth rate of 2.7%. In 1986, the infant mortality rate was 111/1000. Life expectancy is 59 years. Lesotho's population lives primarily in the western lowlands. Much of the work force is employed from 3-9 months a year in South Africa in mining, farming, or industry. Most Basotho are Roman Catholic, but the Lesotho Evangelical Church and the Anglican Church are prominent. Basutoland (now Lesotho) was populated sparsely by Bushmen (Qhuaique) until the end of the 16th century. Between the 16th and 19th centuries, an influx of refugees from tribal wars in surrounding areas populated the region. In 1968 the country was placed under British protection. From 1884 to 1959, legislative and executive authority was vested in a British High Commission. In 1959 a new constitution gave Basutoland its 1st elected legislature. The British then acceded to the people's desire for full independence. General elections with universal adult suffrage were held in April 1965. King Moshoeshoe II is chief of state. Prior to 1970, Lesotho was a constitutional monarchy with an elected bicameral Parliament consisting of a 60-seat National Assembly and a 33-seat Senate. A Military Council degree published in January 1986 vested the executive and legislative power of the state in the King, acting on the advice of the Military Council. The reasons for the military takeover in 1986 were complex: the Jonathan regime had alienated both the Basotho power elements and the general population, and South Africa virtually had closed the land borders because of concerns over African National Congress (ANC) cross-border operations. The new government adopted a policy of national reconciliation upon assuming power. The economy of Lesotho is based on

  8. Draft Plan of Operation for a Functional Literacy Pilot Program in Swaziland June-July 1971.

    ERIC Educational Resources Information Center

    Sebenta National Inst. (Swaziland).

    A planned full-time "functional literacy" course that was to be held during June and July 1971 in Ekuhlamukeni and Nqabaneni (Swaziland) is discussed. The experimental pilot project was to be sponsored by the Sebenta National Institute, the University of Botswana, Lesotho and Swaziland Division of Extra Mural Services, and by the…

  9. Labor migration in Southern Africa and agricultural development: some lessons from Lesotho.

    PubMed

    Plath, J C; Holland, D W; Carvalho, J W

    1987-01-01

    Using Lesotho as a case study, this paper presents an analytical framework regarding certain policy issues relevant to agriculture becoming a viable alternative to migration for employment and income. 60% of adult Basotho (people of Lesotho) males between the ages of 20 and 44 are employed in the mines in South Africa. About 70% of rural households in Lesotho have at least 1 member who is a migrant. In recent years, over 40% of Lesotho's gross national product has come from mine wages. Migrant remittances contributed about 65% of rural household incomes in the late 1970s. Future opportunities for migrant employment will either remain at current levels or decline as mining becomes less labor intensive and South Africa gives priority to employing local blacks. In Lesotho, only about 2% of the land is arable. Also, the impact of so much migration to South Africa has a direct effect on labor available to Lesotho agriculture. To estimate indirectly the costs of migration, 34 Basotho migrants employed in the South African mines were interviewed in the Nyakosoba area in 1983. Results show that the cost of migration was valued at 40% of their annual average income in 1983. There is sparse ownership of and access to land and oxen; there is also a scarcity of agricultural equipment. The authors calculate that 1) returns from growing traditional field crops using traditional technology are abysmally low, 2) net return from growing the same crops with improved technology are greatly improved, and 3) the commercial planting and cultivation of fruit trees would yield net returns that far exceed the amounts most surveyed migrants indicated would be sufficient to stop them from migrating. Constraints to improved technology adoption include 1) investment in fixed capital and variable inputs, 2) higher levels of management and knowledge of how to use the technology, 3) the necessity to quit mine work and pursue agriculture full time. Production risk needs to be reduced. Orchard

  10. Distribution and establishment of the alien Australian redclaw crayfish, Cherax quadricarinatus, in South Africa and Swaziland

    PubMed Central

    Zengeya, Tsungai A.; Hoffman, Andries C.; Measey, G. John; Weyl, Olaf L.F.

    2017-01-01

    Background The Australian redclaw crayfish (Cherax quadricarinatus, von Martens), is native to Australasia, but has been widely translocated around the world due to aquaculture and aquarium trade. Mostly as a result of escape from aquaculture facilities, this species has established extralimital populations in Australia and alien populations in Europe, Asia, Central America and Africa. In South Africa, C. quadricarinatus was first sampled from the wild in 2002 in the Komati River, following its escape from an aquaculture facility in Swaziland, but data on the current status of its populations are not available. Methods To establish a better understanding of its distribution, rate of spread and population status, we surveyed a total of 46 sites in various river systems in South Africa and Swaziland. Surveys were performed between September 2015 and August 2016 and involved visual observations and the use of collapsible crayfish traps. Results Cherax quadricarinatus is now present in the Komati, Lomati, Mbuluzi, Mlawula and Usutu rivers, and it was also detected in several off-channel irrigation impoundments. Where present, it was generally abundant, with populations having multiple size cohorts and containing ovigerous females. In the Komati River, it has spread more than 112 km downstream of the initial introduction point and 33 km upstream of a tributary, resulting in a mean spread rate of 8 km year−1 downstream and 4.7 km year−1 upstream. In Swaziland, estimated downstream spread rate might reach 14.6 km year−1. Individuals were generally larger and heavier closer to the introduction site, which might be linked to juvenile dispersal. Discussion These findings demonstrate that C. quadricarinatus is established in South Africa and Swaziland and that the species has spread, not only within the river where it was first introduced, but also between rivers. Considering the strong impacts that alien crayfish usually have on invaded ecosystems, assessments of its

  11. Swaziland: country profile.

    PubMed

    Carrington, L

    1988-06-01

    Although Swaziland had been independent from colonialism for 20 years, a powerful monarch, King Mswati II, continues to control the country's political, religious, and social system. Swaziland has a population of 676,000, half of whom are under 15 years of age. The infant mortality rate is 105/1000 live births and 25% of children die before they reach their 5th birthday. Life expectancy is 54 years. Tribal chiefs, representing the king, hold and distribute about half of the national land. Most of the fertile land remains in the hands of white settler farmers. The concentration of income in foreign companies and urban centers has exacerbated poverty in rural areas. Depreciation of rand-linked local currency has boosted export earnings, but it has also raised the price of food and medical imports. Swaziland's main exports are sugar, wood pulp, chemicals, and fruit, most of which go to the UK and South Africa. The major food crops are maize, beans, groundnuts, and sorghum. About half of the working population is engaged in small-scale subsistence farming, but food yields are declining. The major producers are foreign companies attracted by Swaziland's low taxes and cheap labor supply.

  12. Cattle as a store of wealth in Swaziland: implications for livestock development and overgrazing in Eastern and Southern Africa

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Doran, M.H.; Low, A.R.C.; Kemp, R.L.

    1979-02-01

    The contention that cattle are held as a store of wealth in Swaziland is supported by a regression analysis of slaughter against price and rainfall, and by an examination of the Swazi herd structure. The failure to recognize that cattle directly satisfy both wealth and income motives in traditional societies has led to the implementation of production-oriented livestock development programs, which may worsen the serious overgrazing problem in Swaziland. Observations elsewhere indicate that there are lessons to be learned for livestock developemnt in other overgrazed parts of eastern and southern Africa. 17 references.

  13. Computer-Mediated Communications for Distance Education and Training: Literature Review and International Resources

    DTIC Science & Technology

    1991-01-01

    in Part Two on Educational Aplications . 3 A basic issue when evaluating an institution’s dropout rate is whether non-starters are included in the...Association. Africa (Botswana, Lesotho, and Swaziland) ERASMUS: (European Community Action Scheme for the Mobility of University Students) Among its

  14. Language Policy and Practice in the Multilingual Southern African Development Community

    ERIC Educational Resources Information Center

    Mooko, Theophilus

    2009-01-01

    This study explores the language policy and practice of the Southern African Development Community (SADC), an African regional economic organisation made up of 14 member states (Angola, Botswana, Democratic Republic of Congo, Lesotho, Madagascar, Malawi, Mauritius, Mozambique, Namibia, South Africa, Swaziland, United Republic of Tanzania, Zambia…

  15. Implementing Educational Policies in Sub-Saharan Africa--Review Essay.

    ERIC Educational Resources Information Center

    Thakur, Dan S.

    1991-01-01

    Reviews a series of 10 World Bank documents examining policy implementation activity in Ethiopia, Kenya, Tanzania, Lesotho, Swaziland, Uganda, Zambia, and Zimbabwe. The reports are concise and well documented and show a great conceptualization of education issues (such as deteriorating enrollments contracting educational finances) and policy…

  16. Renewable Energy Zones for the Africa Clean Energy Corridor

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Wu, Grace C.; Deshmukh, Ranjit; Ndhlukula, Kudakwashe

    Multi-criteria Analysis for Planning Renewable Energy (MapRE) is a study approach developed by the Lawrence Berkeley National Laboratory with the support of the International Renewable Energy Agency (IRENA). The approach combines geospatial, statistical, energy engineering, and economic methods to comprehensively identify and value high-quality wind, solar PV, and solar CSP resources for grid integration based on techno-economic criteria, generation profiles (for wind), and socio-environmental impacts. The Renewable Energy Zones for the Africa Clean Energy Corridor study sought to identify and comprehensively value high-quality wind, solar photovoltaic (PV), and concentrating solar power (CSP) resources in 21 countries in the East andmore » Southern Africa Power Pools to support the prioritization of areas for development through a multi-criteria planning process. These countries include Angola, Botswana, Burundi, Djibouti, Democratic Republic of Congo, Egypt, Ethiopia, Kenya, Lesotho, Libya, Malawi, Mozambique, Namibia, Rwanda, South Africa, Sudan, Swaziland, Tanzania, Uganda, Zambia, and Zimbabwe. The study includes the methodology and the key results including renewable energy potential for each region.« less

  17. The Seismotectonic Model of Southern Africa

    NASA Astrophysics Data System (ADS)

    Midzi, Vunganai; Mulabisana, Thifelimbulu; Manzunzu, Brassnavy

    2013-04-01

    Presented in this report is a summary of the major structures and seismotectonic zones in Southern Africa (Botswana, Lesotho, Namibia, South Africa and Swaziland), which includes available information on fault plane solutions and stress data. Reports published by several experts contributed much to the prepared zones. The work was prepared as part of the requirements for the SIDA/IGCP Project 601 titled "Seismotectonics and Seismic Hazards in Africa" as well as part of the seismic source characterisation of the GEM-Africa Seismic hazard study. The seismic data used are part of the earthquake catalogue being prepared for the GEM-Africa project, which includes historical and instrumental records as collected from various agencies. Seventeen seismic zones/sources were identified and demarcated using all the available information. Two of the identiied sources are faults with reliable evidence of their activity. Though more faults have been identified in unpublished material as being active, more work is being carried out to obtain information that can be used to characterise them before they are included in the seismotectonic model. Explanations for the selected boundaries of the zones are also given in the report. It should be noted that this information is the first draft of the seismic source zones of the region. Futher interpreation of the data is envisaged which might result in more than one version of the zones.

  18. Documentary evidence of climate variability during cold seasons in Lesotho, southern Africa, 1833-1900

    NASA Astrophysics Data System (ADS)

    Grab, Stefan W.; Nash, David J.

    2010-03-01

    This study presents the first 19th century cold season climate chronology for the Kingdom of Lesotho in southern Africa. The chronology is constructed using a variety of documentary sources including letters, diaries, reports, monographs and newspaper articles obtained from southern African and British archives. Information relating to cold season weather phenomena during the austral autumn, winter and early spring months were recorded verbatim. Each of the cold seasons from 1833 to 1900 was then classified as “very severe”, “severe” or “normal/mild”, with a confidence rating ranging from low (1) to high (3) awarded against each annual classification. The accuracy of the document-derived chronology was verified against temperature data for Maseru for the period 1893-1900. Excellent correspondence of the document-derived chronology with the Maseru instrumental data and also with other global proxy temperature records for the 19th century is achieved. The results indicate 12 (18% of the total) very severe, 16 (23%) severe and 40 (59%) normal/mild cold seasons between 1833 and 1900. The overall trend is for more severe and snow-rich cold seasons during the early part of the study period (1833-1854) compared with the latter half of the 19th century (with the exception of the 1880s). A reduction in the duration of the frost season by over 20 days during the 19th century is also tentatively identified. Several severe to very severe cold seasons in Lesotho follow after major tropical and SH volcanic eruptions; such years are usually characterized by early frosts, and frequent and heavy snowfalls. The blocking of solar radiation and the enhanced northward displacement of polar fronts that are directly or indirectly associated with volcanic events, may account for many of the most severe Lesotho winters during the 19th century.

  19. HIV-Related Discrimination among Grade Six Students in Nine Southern African Countries

    PubMed Central

    Maughan-Brown, Brendan; Spaull, Nicholas

    2014-01-01

    Background HIV-related stigmatisation and discrimination by young children towards their peers have important consequences at the individual level and for our response to the epidemic, yet research on this area is limited. Methods We used nationally representative data to examine discrimination of HIV-positive children by grade six students (n = 39,664) across nine countries in Southern Africa: Botswana, Lesotho, Malawi, Mozambique, Namibia, South Africa, Swaziland, Zambia and Zimbabwe. Descriptive statistics are used to compare discrimination by country, gender, geographic location and socioeconomic status. Multivariate logistic regression is employed to assess potential determinants of discrimination. Results The levels and determinants of discrimination varied significantly between the nine countries. While one in ten students in Botswana, Malawi, South Africa and Swaziland would “avoid or shun” an HIV positive friend, the proportions in Lesotho, Mozambique, Zambia and Zimbabwe were twice as high (approximately 20%). A large proportion of students believed that HIV positive children should not be allowed to continue to attend school, particularly in Zambia (33%), Lesotho (37%) and Zimbabwe (42%). The corresponding figures for Malawi and Swaziland were significantly lower at 13% and 12% respectively. Small differences were found by gender. Children from rural areas and poorer schools were much more likely to discriminate than those from urban areas and wealthier schools. Importantly, we identified factors consistently associated with discrimination across the region: students with greater exposure to HIV information, better general HIV knowledge and fewer misconceptions about transmission of HIV via casual contact were less likely to report discrimination. Conclusions Our study points toward the need for early interventions (grade six or before) to reduce stigma and discrimination among children, especially in schools situated in rural areas and poorer

  20. HIV-related discrimination among grade six students in nine Southern African countries.

    PubMed

    Maughan-Brown, Brendan; Spaull, Nicholas

    2014-01-01

    HIV-related stigmatisation and discrimination by young children towards their peers have important consequences at the individual level and for our response to the epidemic, yet research on this area is limited. We used nationally representative data to examine discrimination of HIV-positive children by grade six students (n = 39,664) across nine countries in Southern Africa: Botswana, Lesotho, Malawi, Mozambique, Namibia, South Africa, Swaziland, Zambia and Zimbabwe. Descriptive statistics are used to compare discrimination by country, gender, geographic location and socioeconomic status. Multivariate logistic regression is employed to assess potential determinants of discrimination. The levels and determinants of discrimination varied significantly between the nine countries. While one in ten students in Botswana, Malawi, South Africa and Swaziland would "avoid or shun" an HIV positive friend, the proportions in Lesotho, Mozambique, Zambia and Zimbabwe were twice as high (approximately 20%). A large proportion of students believed that HIV positive children should not be allowed to continue to attend school, particularly in Zambia (33%), Lesotho (37%) and Zimbabwe (42%). The corresponding figures for Malawi and Swaziland were significantly lower at 13% and 12% respectively. Small differences were found by gender. Children from rural areas and poorer schools were much more likely to discriminate than those from urban areas and wealthier schools. Importantly, we identified factors consistently associated with discrimination across the region: students with greater exposure to HIV information, better general HIV knowledge and fewer misconceptions about transmission of HIV via casual contact were less likely to report discrimination. Our study points toward the need for early interventions (grade six or before) to reduce stigma and discrimination among children, especially in schools situated in rural areas and poorer communities. In particular, interventions

  1. Survey of Basic Education in Eastern Africa. UNESCO/UNICEF Co-Operation Programme.

    ERIC Educational Resources Information Center

    United Nations Educational, Scientific, and Cultural Organization, Nairobi (Kenya). Regional Office of Science and Technology for Africa.

    A survey of basic education in 13 Eastern African countries (Madagascar, Burundi, Comores, Ethiopia, Mauritius, Botswana, Kenya, Lesotho, Swaziland, Tanzania, Zambia, Malawi, and Somalia) covers basic education programs and UNICEF's supporting role. Basic education is seen as a concept evolved in the region, involving formal school systems and…

  2. Embarking on the Decade for Sustainable Development: A Swaziland View

    ERIC Educational Resources Information Center

    Allen, Irma

    2005-01-01

    Tucked between South Africa and Mozambique, and usually "gowned" in green, Swaziland is one of the smallest countries in Africa, but it has great variation in landscape, geology, and climate. It also has great diversity of fauna and flora. In recognition of the importance that sound environmental management plays in the course of…

  3. Secondary Level Teachers: Supply and Demand in Swaziland. Report on the Supply of Secondary Level Teachers in English-Speaking Africa. Country Study No. 5.

    ERIC Educational Resources Information Center

    Hanson, John W.; Cammaerts, F. C. A.

    One of 14 studies on the supply of secondary level teachers in English-speaking Africa, this report begins with a survey of Swaziland's geography and economic potentials, and the financial viability of its economic growth. Despite its small size, the wide market areas available and the existence of non-agricultural opportunities give promise of…

  4. The Legal Framework for Establishing Private Universities in Swaziland

    ERIC Educational Resources Information Center

    Mbanze, C. V.; Coetzee, S. A.

    2014-01-01

    This article draws on a doctoral study which investigated the legal and management frameworks required for establishing private universities in Swaziland. The focus is particularly on the legal framework for establishing the Southern Africa Nazarene University (SANU). Managers involved in establishing SANU encountered a lack of both specific…

  5. Primary School Nutrition and Tuck Shops in Hhoho, Swaziland

    ERIC Educational Resources Information Center

    Wojcicki, Janet M.; Elwan, Deena

    2014-01-01

    Background: Obesity and associated chronic diseases are increasing in frequency in African populations that also have a high burden of disease from infectious diseases such as HIV/AIDS and tuberculosis. Obesity and diabetes mellitus are common in Swaziland, Southern Africa, where >10% of children under the age of five are already obese.…

  6. Implementing Educational Policies in Swaziland. World Bank Discussion Papers No. 88. Africa Technical Department Series.

    ERIC Educational Resources Information Center

    Magalula, Cisco

    At the time of independence in 1968, education in Swaziland was characterized by poor quality, uneven distribution of schools, high dropout and repeater rates, serious shortages of teachers, and inappropriate and highly academic curricula. This paper describes the status of present-day education in Swaziland in terms of the effect of government…

  7. Coordination and Improvement of National Information Services. Mbabane and Maseru Workshop Papers (Mbabane, Swaziland, February 24-28, 1986 and Maseru, Lesotho, March 3-7, 1986).

    ERIC Educational Resources Information Center

    Huttemann, Lutz, Ed.

    Seven papers from the Mbabane workshop are presented in the first part of this report: (1) "An Overview of the Supply of Information in Swaziland" (E. Wamala); (2) "The Place of a Documentation Centre in the Supply of Information in Swaziland: Problems and Prospects" (M. M. Nhlapo); (3) "The Concept of Cooperation in…

  8. Using Examinations To Improve Education: A Study in Fourteen African Countries. World Bank Technical Paper Number 165. Africa Technical Department Series.

    ERIC Educational Resources Information Center

    Kellaghan, Thomas; Greaney, Vincent

    A detailed description is presented of the types, functions, performance levels, governance, administration, and funding of public examinations in 14 Sub-Saharan African countries with different educational traditions, based on English, French, or other backgrounds. The countries are: (1) Kenya; (2) Lesotho; (3) Mauritius; (4) Swaziland; (5)…

  9. Knowledge and perceptions of parents regarding child sexual abuse in Botswana and Swaziland.

    PubMed

    Mathoma, Anikie M; Maripe-Perera, Dorcas B; Khumalo, Lindiwe P; Mbayi, Bagele L; Seloilwe, Esther S

    2006-02-01

    This study sought to explore the phenomenon of child sexual abuse by investigating the knowledge and perceptions of parents regarding this problem in Botswana and Swaziland. Although there are no published studies on child sexual abuse in Botswana and Swaziland, literature elsewhere has indicated that child abuse and prostitution prevail in Southern African Development Community countries and that children still continue to be rape victims within and outside the family structure [Muwanigwa, V. (1996). Child Abuse Demands More Preventive Measures. Harare: Zimbabwe. (Southern Africa News Features Southern African Research and Documentation Center)]. In Botswana in 1998, there were 300 cases of child abuse reported, of which 33 were sexual abuse cases. The same year in Swaziland, >50% of child abuse cases were sexual abuse related. In addition, the same year in Swaziland, >50% of sexual abuse case patients reporting for counseling were children younger than 21 years. Respondents of the study included 8 men (1 from Swaziland and 7 from Botswana) and 10 women (3 from Swaziland and 7 from Botswana) who were parents aged between 26 and 70 years; they were determined by way of purposive sampling. A focused interview guide with open-ended questions was used to collect data, and measures to ensure trustworthiness and ethical considerations were adhered to. Analysis of data was facilitated by categorization of themes and concepts and coding systems. The results of the study showed that the respondents acknowledged the prevalence of child sexual abuse in Botswana and Swaziland and further demonstrated their knowledge of the predisposing factors, perpetrators of the problem, and effects of sexual abuse on children. They placed major emphases on community involvement in fighting against the problem; appropriate education of children, parents, families, and community members about child sexual abuse; and improvement on the laws that protect children against sexual abuse to

  10. Supporting Clean Energy Development in Swaziland

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    2016-04-01

    Swaziland, a country largely dependent on regional fossil fuel imports to meet power needs, is vulnerable to supply changes and price shocks. To address this challenge, the country's National Energy Policy and Implementation Strategy prioritizes actions to enhance energy independence through scaling up renewable energy and energy efficiency. With approximately 70 percent of the country lacking electricity, Swaziland is also strongly committed to expanding energy access to support key economic and social development goals. Within this context, energy security and energy access are two foundational objectives for clean energy development in Swaziland. The partnership between the Swaziland Energy Regulatory Authoritymore » and the Clean Energy Solutions Center led to concrete outcomes to support clean energy development in Swaziland. Improving renewable energy project licensing processes will enable Swaziland to achieve key national objectives to expand clean energy access and transition to greater energy independence.« less

  11. Tropical Africa: Land use, biomass, and carbon estimates for 1980

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Brown, S.; Gaston, G.; Daniels, R.C.

    1996-06-01

    This document describes the contents of a digital database containing maximum potential aboveground biomass, land use, and estimated biomass and carbon data for 1980 and describes a methodology that may be used to extend this data set to 1990 and beyond based on population and land cover data. The biomass data and carbon estimates are for woody vegetation in Tropical Africa. These data were collected to reduce the uncertainty associated with the possible magnitude of historical releases of carbon from land use change. Tropical Africa is defined here as encompassing 22.7 x 10{sup 6} km{sup 2} of the earth`s landmore » surface and includes those countries that for the most part are located in Tropical Africa. Countries bordering the Mediterranean Sea and in southern Africa (i.e., Egypt, Libya, Tunisia, Algeria, Morocco, South Africa, Lesotho, Swaziland, and Western Sahara) have maximum potential biomass and land cover information but do not have biomass or carbon estimate. The database was developed using the GRID module in the ARC/INFO{sup TM} geographic information system. Source data were obtained from the Food and Agriculture Organization (FAO), the U.S. National Geophysical Data Center, and a limited number of biomass-carbon density case studies. These data were used to derive the maximum potential and actual (ca. 1980) aboveground biomass-carbon values at regional and country levels. The land-use data provided were derived from a vegetation map originally produced for the FAO by the International Institute of Vegetation Mapping, Toulouse, France.« less

  12. Urbanization in Africa since independence.

    PubMed

    Tarver, J D

    1994-01-01

    Over 185 million inhabitants were added to the urban areas of Africa between 1950 and 1990. Botswana, Lesotho, Namibia, South Africa, and Swaziland is the most highly urbanized, with 55% in 1990; while less than a quarter of Eastern Africa's population is living in urban centers. By the year 2015 more than half of Africa's population will be living in urban areas. Many parts of Africa have suffered prolonged droughts, overgrazing, locust infestations, and desertification. Millions have become refugees from natural disasters, political oppression, and rural poverty. The large exodus from Africa's rural areas has gone to cities but the large cities have attracted disproportionately large numbers of destitute migrants. Alexandria (1 million), Cairo (2.4 million) and the Witwatersrand in South Africa were the only African urban agglomerations with at least one million inhabitants in 1950. By 1990 the two Egyptian cities together had 12.7 million inhabitants and the Witwatersrand some 5 million, whereas the other 25 urban agglomerations with a million inhabitants each in 1990 had a total population of about 51 million. Lagos, Kinshasa, and Algiers ranged from 3 to 7.7 million. The capitals are the largest cities in at least 54 of the 59 countries and territories. Lagos, Nairobi, and Dar es Salaam are disproportionately larger than the next most populous cities in their countries. The 28 urban agglomerations with at least one million inhabitants had a total population of 70 million in 1990, and are projected to reach 100 million in the year 2000. Overall, Africa's urban population is projected to increase by approximately 135 million in the 1990-2000 decade (from 217 million to 352 million). About 105 million of the growth probably will occur in the smaller urban centers. The total African urban population is likely to reach one billion inhabitants within the next 50 years. It stood at 32 million in 1950. Presently, the United Nations projects 912 million urban residents

  13. Labour migration and rural transformation in post-colonial Swaziland.

    PubMed

    Simelane, H S

    1995-07-01

    This article describes the effects of labor migration in rural southern Swaziland. It is argued that wages from rural migration to mining areas were invested in agricultural implements such as tractors, in education of children, and in cattle. These effects are improvements in rural quality of life and involve women in agricultural production. Male labor migration in southern Swaziland contributed to progress and rural development for rich and poor families at the individual level. Community level changes from labor migration were not evident. The author does not suggest that all changes were due to labor migration or unique. Negative effects are recognized, such as life style changes or changes in social customs. It is stated that southern Swaziland benefited little post-independence from national development. The Lowveld benefitted from sugar and citrus plantations. The central region experienced development of industry and commerce. The northern region had sugar plantations and mining development. The western region established commercial forests. The south only had export labor, which was attracted to higher wages in South Africa. Data and arguments in this article pertain only to male labor migration to mining areas. The literature on development tends to associate male labor migration with underdevelopment. Women are left to plough the fields in traditional agricultural production. Evidence is presented for southern Swaziland, which showed periods of low agricultural production and poor health conditions. During the 1940s this was the case and male absence was very high. Although women had limitations, it is argued that the most important factor was unavailability of new technology. By the 1970s, women were able to hire private or government tractors for tilling the soil.

  14. Patterns of sexual behaviour among secondary school students in Swaziland, southern Africa.

    PubMed

    Buseh, Aaron G

    2004-07-01

    Among the many sub-Saharan African countries hardest hit by HIV/AIDS is the Kingdom of Swaziland. In an effort to reduce the spread of HIV, young people are an important group to reach with prevention messages. However, before developing such programmes, it is essential to understand young people's sexual risk behaviours. Students (n=941) from four coeducational secondary schools in Swaziland participated in a cross-sectional survey of sexual behaviours. Results indicate that considerable proportions of young people in this study were sexually experienced, irrespective of gender. Findings also suggest unacceptable high levels of sexual coercion, irrespective of age or gender. While boys may be less likely than girls to experience sexual coercion, being a male in this setting was not a protective factor. No significant differences were found on these variables in relation to location of the schools (rural vs. urban). Implications for developing and implementing HIV prevention programmes are suggested.

  15. Behavior change communication and mobile populations: the evaluation of a cross-border HIV/AIDS communication strategy amongst migrants from Swaziland.

    PubMed

    Silvestre, Eva; Weiner, Renay; Hutchinson, Paul

    2016-01-01

    This study investigates the effect of being exposed to the Soul City Southern Africa Regional OneLove campaign, a behavior change communication program, on sexual behavior and condom use among a mobile population in Swaziland. Data for this study come from a nationally representative sample of 845 individuals who reported traveling to neighboring countries for at least two weeks at any time in the previous two years. Respondents were asked about exposure to the campaign through television, radio, booklets, posters, and advertisements both in Swaziland and in the other countries where they had traveled in the previous two years. Odds ratios were used to estimate the relationships between the HIV/AIDS outcomes of interest and program exposure for the full sample as well as separately for males and females. The program had no effect on reducing known risky behaviors such as having multiple sexual partners. However, men exposed in Swaziland only (AOR = 3.4, CI 1.2-9.4) and in Swaziland and another country (AOR = 2.8, CI 1.0-7.7) were more likely to report using a condom at last sex. In the full sample, those exposed in Swaziland were more likely to report using a condom at last sex (AOR = 2.6, CI 1.3-5.3) and a condom at last sex with a regular partner (AOR = 2.3, CI 1.1-4.8). Men who reported multiple sexual partnerships and who were exposed in Swaziland and another country were nine times as likely to report condom at last sex than men with no exposure. Respondents exposed in Swaziland and another country were more likely to have been tested for HIV; this was true for the total population (AOR = 2.9, CI 1.1-7.9) and for men separately (AOR = 3.3, CI 1.1-10.1). These findings provide support for more regional HIV prevention programs in Southern Africa as a way to increase positive behaviors among mobile populations.

  16. Stigma, sexual health, and human rights among women who have sex with women in Lesotho

    PubMed Central

    Poteat, Tonia C.; Logie, Carmen H.; Adams, Darrin; Mothopeng, Tampose; Lebona, Judith; Letsie, Puleng; Baral, Stefan

    2016-01-01

    In recent years, gender and sexual minorities have become increasingly visible across sub-Saharan Africa, marking both the progression and violation of their human rights. Using data from a study with sexual minorities in Lesotho, this analysis leveraged the social ecological model to examine relationships between stigma, human rights, and sexual health among women who have sex with women in Lesotho. A community-based participatory approach was used for the mixed-method, cross-sectional study. A total of 250 women who have sex with women completed a structured questionnaire, of which 21 participated in a total of three focus group discussions. Stigma was common within and outside the health sector. Stigma and human rights abuses were associated with increased risk for HIV and STIs. Interventions to address stigma at the structural, community, and interpersonal levels are essential to ensuring sexual health and rights for women who have sex with women in Lesotho. PMID:26719002

  17. Stigma, sexual health, and human rights among women who have sex with women in Lesotho.

    PubMed

    Poteat, Tonia C; Logie, Carmen H; Adams, Darrin; Mothopeng, Tampose; Lebona, Judith; Letsie, Puleng; Baral, Stefan

    2015-11-01

    In recent years, gender and sexual minorities have become increasingly visible across sub-Saharan Africa, marking both the progression and violation of their human rights. Using data from a study with sexual minorities in Lesotho, this analysis leveraged the social ecological model to examine relationships between stigma, human rights, and sexual health among women who have sex with women in Lesotho. A community-based participatory approach was used for the mixed-method, cross-sectional study. A total of 250 women who have sex with women completed a structured questionnaire, of which 21 participated in a total of three focus group discussions. Stigma was common within and outside the health sector. Stigma and human rights abuses were associated with increased risk for HIV and STIs. Interventions to address stigma at the structural, community, and interpersonal levels are essential to ensuring sexual health and rights for women who have sex with women in Lesotho. Copyright © 2015 Elsevier Inc. All rights reserved.

  18. Conserving Conflict? Transfrontier Conservation, Development Discourses and Local Conflict Between South Africa and Lesotho

    PubMed Central

    Büscher, Bram

    2010-01-01

    This paper describes and analyses how discourses of conservation and development as well as migrant labour practices can be understood as transnational dynamics that both cement and complicate transnational relations. It also looks into how these dynamics articulate with, shape and are being shaped by ‘the local’. Focusing on the north-eastern boundary of Lesotho in the area of the ‘Maloti-Drakensberg transfrontier conservation and development project’, we show how conflictual situations put the ethnographic spotlight on the ways in which ‘local people’ in Lesotho deal with dual forces of localisation and transnationalisation. We argue that they accommodate, even appropriate, these dual pressures by adopting an increasingly flexible stance in terms of identity, alliances, livelihood options and discourses. PMID:21258433

  19. Bibliometric trends of health economic evaluation in Sub-Saharan Africa.

    PubMed

    Hernandez-Villafuerte, Karla; Li, Ryan; Hofman, Karen J

    2016-08-24

    Collaboration between Sub-Saharan African researchers is important for the generation and transfer of health technology assessment (HTA) evidence, in order to support priority-setting in health. The objective of this analysis was to evaluate collaboration patterns between countries. We conducted a rapid evidence assessment that included a random sample of health economic evaluations carried out in 20 countries (Angola, Botswana, Congo, Lesotho, Madagascar, Malawi, Mauritius, Mozambique, Namibia, Seychelles, South Africa, Swaziland, Tanzania, Zambia, Zimbabwe, Ghana, Kenya, Nigeria, Ethiopia, Uganda). We conducted bibliometric network analysis based on all first authors with a Sub-Saharan African academic affiliation and their co-authored publications ("network-articles"). Then we produced a connection map of collaboration patterns among Sub-Saharan African researchers, reflecting the number of network-articles and the country of affiliation of the main co-authors. The sample of 119 economic evaluations mostly related to treatments of communicable diseases, in particular HIV/AIDS (42/119, 35.29 %) and malaria (26/119, 21.85 %). The 39 first authors from Sub-Saharan African institutions together co-authored 729 network-articles. The network analysis showed weak collaboration between health economic researchers in Sub-Saharan Africa, with researchers being more likely to collaborate with Europe and North America than with other African countries. South Africa stood out as producing the highest number of health economic evaluations and collaborations. The development and evaluation of HTA research networks in Sub-Saharan Africa should be supported, with South Africa central to any such efforts. Organizations and institutions from high income countries interested in supporting priority setting in Sub-Saharan Africa should include promoting collaboration as part of their agendas, in order to take advantage of the potential transferability of results and methods of the

  20. Nurturing Lifelong Learning in Communities through the National University of Lesotho: Prospects and Challenges

    ERIC Educational Resources Information Center

    Preece, Julia; Croome, David; Ntene, Mankatso; Ngozwana, Nomazulu

    2011-01-01

    This paper analyses one aspect of a pan-African action research project called ITMUA (Implementing the Third Mission of Universities in Africa). This particular paper draws on the data from that project to explore the National University of Lesotho's contribution to lifelong learning in its communities. It provides background information on the…

  1. High Prevalence of Multidrug-Resistant Tuberculosis, Swaziland, 2009–2010

    PubMed Central

    Dlamini, Themba; Ascorra, Alexandra; Rüsch-Gerdes, Sabine; Tefera, Zerihun Demissie; Calain, Philippe; de la Tour, Roberto; Jochims, Frauke; Richter, Elvira; Bonnet, Maryline

    2012-01-01

    In Africa, although emergence of multidrug-resistant (MDR) tuberculosis (TB) represents a serious threat in countries severely affected by the HIV epidemic, most countries lack drug-resistant TB data. This finding was particularly true in the Kingdom of Swaziland, which has the world’s highest HIV and TB prevalences. Therefore, we conducted a national survey in 2009–2010 to measure prevalence of drug-resistant TB. Of 988 patients screened, 420 new case-patients and 420 previously treated case-patients met the study criteria. Among culture-positive patients, 15.3% new case-patients and 49.5% previously treated case-patients harbored drug-resistant strains. MDR TB prevalence was 7.7% and 33.8% among new case-patients and previously treated case-patients, respectively. HIV infection and past TB treatment were independently associated with MDR TB. The findings assert the need for wide-scale intervention in resource-limited contexts such as Swaziland, where diagnostic and treatment facilities and health personnel are lacking. PMID:22260950

  2. Difficulties facing healthcare workers in the era of AIDS treatment in Lesotho.

    PubMed

    Koto, Masebeo Veronica; Maharaj, Pranitha

    2016-01-01

    Sub-Saharan Africa is most affected by the AIDS pandemic and Lesotho is no exception. In many countries, healthcare workers are at the forefront of the fight against AIDS. This study explores the difficulties facing healthcare workers in Lesotho using a combination of qualitative methods--focus group discussions and in-depth interviews. The findings suggest that healthcare workers are afraid of contracting HIV from their patients and this affects their delivery of services. In addition, the results revealed that poor infrastructure and shortage of supplies at the facilities hinder healthcare workers from performing their duties effectively. The other concern was the heavy workload and severe time constraints which puts enormous stress on healthcare workers. Stigma and discrimination emerged as major problems for healthcare workers. Addressing the challenges facing healthcare workers is essential in effectively managing the AIDS pandemic facing the continent.

  3. The Influence of Infant Feeding Practices on Infant Mortality in Southern Africa.

    PubMed

    Motsa, Lungile F; Ibisomi, Latifat; Odimegwu, Clifford

    2016-10-01

    Objective To examine the adjusted and unadjusted effects of infant feeding practices on infant mortality in Southern Africa. Methods A merged dataset from the most recent Demographic and Health Surveys for Lesotho, Swaziland, Zambia and Zimbabwe was analysed using the Cox Proportional Hazard Model. A total number of 13,218 infants born in 5 years preceding all the surveys with information on infant feeding practices constituted the study population. Infant mortality was the outcome variable and infant feeding practices categorised into; no breastfeeding, partial breastfeeding and exclusive breastfeeding were the main explanatory variables. Maternal demographic and socio-economic characteristics and infants' bio-demographic characteristics were also studied. Results Although, exclusive breastfeeding was quite low (12 %), exclusively breastfed infants exhibited a 97 % lower risk of dying during infancy compared to infants not breastfed in the region. Variations existed by country in the levels and patterns of both infant mortality and infant feeding practices. Mother's country, highest level of education and marital status; child's sex, birth weight and preceding birth interval were the significant predictors of infant mortality in Southern Africa. Conclusions Any form of breastfeeding whether exclusive or partial breastfeeding greatly reduces the risk of infant mortality with the greatest mortality reduction effect observed among exclusively breastfed infants in Southern Africa. To reduce the upsurge of infant mortality, there is the need to step up the effectiveness of child nutrition programmes that promote breastfeeding and put emphasis on exclusive breastfeeding of infants in the region.

  4. Responses to the global HIV and AIDS pandemic: a study of the role of faith-based organisations in Lesotho.

    PubMed

    Olowu, Dejo

    2015-01-01

    This article attempts to establish the key contribution by people of faith to the global HIV pandemic response, using Lesotho as a case study. Particular focus is paid to the work of selected religious organisations in Lesotho in this context, assessing their capacities to coordinate an effective HIV and AIDS action at the grassroots levels through education, health care, development, and social service activities. Empirical evaluations and findings regarding the level and quality of faith-based engagement in this field establish the basic premise of this article, namely, that faith-based organisations are contributing energy, expertise, and experience in order to achieve the commitment of the global commitment to advance universal access to HIV prevention, treatment, and support. Although the article is particularly focused on the Lesotho context, its tremendous implications for simulated studies and approaches across Sub-Saharan Africa are accentuated.

  5. Reconceptualizing the HIV epidemiology and prevention needs of Female Sex Workers (FSW) in Swaziland.

    PubMed

    Baral, Stefan; Ketende, Sosthenes; Green, Jessie L; Chen, Ping-An; Grosso, Ashley; Sithole, Bhekie; Ntshangase, Cebisile; Yam, Eileen; Kerrigan, Deanna; Kennedy, Caitlin E; Adams, Darrin

    2014-01-01

    HIV is hyperendemic in Swaziland with a prevalence of over 25% among those between the ages of 15 and 49 years old. The HIV response in Swaziland has traditionally focused on decreasing HIV acquisition and transmission risks in the general population through interventions such as male circumcision, increasing treatment uptake and adherence, and risk-reduction counseling. There is emerging data from Southern Africa that key populations such as female sex workers (FSW) carry a disproportionate burden of HIV even in generalized epidemics such as Swaziland. The burden of HIV and prevention needs among FSW remains unstudied in Swaziland. A respondent-driven-sampling survey was completed between August-October, 2011 of 328 FSW in Swaziland. Each participant completed a structured survey instrument and biological HIV and syphilis testing according to Swazi Guidelines. Unadjusted HIV prevalence was 70.3% (n = 223/317) among a sample of women predominantly from Swaziland (95.2%, n = 300/316) with a mean age of 21(median 25) which was significantly higher than the general population of women. Approximately one-half of the FSW(53.4%, n = 167/313) had received HIV prevention information related to sex work in the previous year, and about one-in-ten had been part of a previous research project(n = 38/313). Rape was common with nearly 40% (n = 123/314) reporting at least one rape; 17.4% (n = 23/314)reported being raped 6 or more times. Reporting blackmail (34.8%, n = 113/314) and torture(53.2%, n = 173/314) was prevalent. While Swaziland has a highly generalized HIV epidemic, reconceptualizing the needs of key populations such as FSW suggests that these women represent a distinct population with specific vulnerabilities and a high burden of HIV compared to other women. These women are understudied and underserved resulting in a limited characterization of their HIV prevention, treatment, and care needs and only sparse specific and competent

  6. Swaziland: perspectives in school health.

    PubMed

    Myeni, A D; McGrath, E

    1990-09-01

    Following major quantitative expansions of the educational system in Swaziland during the two decades since independence, the focus has shifted to improving efficiency. Efficiency of any educational system depends mainly on the characteristics of children entering school. Although Swaziland is not among the poorest countries, infant child mortality rates still reflect less than optimum living conditions and parental knowledge of child nutrition and disease prevention and management. Although access to primary schooling is universal, there is substantial waste during the early years of school through dropout and repetition, both associated with low socioeconomic status. School performance can be increased at little extra cost through increasing the nutrition and health status of students before school entry and through the early school years. In Swaziland, many activities are carried out to provide physical and mental health care to students. Coordinating these efforts and formulating clear policy on school health through cooperation among key ministries and nongovernmental organizations remains to be done.

  7. Legal responses to HIV and AIDS: lessons from Swaziland.

    PubMed

    Shongwe, Musa N

    2017-12-01

    Since 1999, the HIV and AIDS epidemic in Swaziland has been declared a national disaster, and today HIV and AIDS still pose a great threat to the survival and development of Swaziland and its people. The impact of the pandemic necessitated a multi-faceted response from the government. This paper critically evaluates the Swaziland legal response to HIV and AIDS. The objective is to assess whether and to what extent Swazi law addresses human rights issues related to HIV and AIDS. Through the application of a human rights based theory, the paper analyses the domestication of Swaziland's treaty commitments, and the constitutional and the statutory frameworks. The paper advances the importance of "law" as a tool that can create an enabling environment for a national response to HIV and AIDS. It analyses how the government has successfully crafted the normative framework so as to make it responsive to the fight against HIV and AIDS, and the shortcomings of the Swaziland legal system in this fight. The paper argues that even though a credible legal and policy environment is in place, some laws still need to be supplemented, reviewed and amended so that the legal system adequately addresses the human rights issues related to HIV and AIDS. The paper suggests improvements to the legal system which mainly relate to aligning the legal framework with the Constitution of Swaziland and international conventions to which Swaziland is party.

  8. Grandmother Coresidence, Maternal Orphans, and School Enrollment in Sub-Saharan Africa

    ERIC Educational Resources Information Center

    Parker, Erin M.; Short, Susan E.

    2009-01-01

    The HIV/AIDS pandemic in sub-Saharan Africa has brought renewed attention to the role of grandmothers as caregivers of children. Using 2004 Lesotho Demographic and Health Survey data, the authors examine the relationship between coresidence with a grandmother and child schooling in Lesotho, a country with one of the highest rates of HIV infection.…

  9. South Africa

    NASA Technical Reports Server (NTRS)

    2002-01-01

    This true-color image of South Africa was acquired on May 14, 2000, by NASA's Moderate-resolution Imaging Spectroradiometer, or MODIS. The image was produced using a combination of the sensor's 250-m and 500-m resolution visible wavelength bands. As part of the opening ceremony to begin the joint U.S.-South Africa SAFARI Field Experiment, NASA presented print copies of this image as GIFts to Dr. Ben Ngubane, Minister of Arts, Science and Technology, and Honorable Advocate Ngoaka Ramathlodi, Premier of the Northern Province, South Africa. The area shown in this image encompasses seven capital cities and a number of the region's distinctive geological features can be seen clearly. Toward the northern (top) central part of the image, the browns and tans comprise the Kalahari Desert of southern Botswana. The Tropic of Capricorn runs right through the heart of the Kalahari and the Botswanan capital city of Gaborone sits on the Limpopo River, southeast of the Kalahari. Along the western coastline of the continent is the country of Namibia, where the Namib Desert is framed against the sea by the Kaokoveld Mountains. The Namibian capital of Windhoek is obscured by clouds. Looking closely in the center of the image, the Orange River can be seen running from east to west, demarcating the boundary between Namibia and South Africa. On the southwestern corner of the continent is the hook-like Cape of Good Hope peninsula and Cape Town, the parliamentary capital of South Africa. Running west to east away from Cape Town are the Great Karroo Mountains. The shadow in this image conveys a sense of the very steep grade of the cliffs along the southern coast of South Africa. Port Elizabeth sits on the southeasternmost point of South Africa, and a large phytoplankton bloom can be seen in the water about 100 miles east of there. Moving northward along the east coast, the Drakensberg Mountains are visible. The two small nations of Lesotho and Swaziland are in this region, completely

  10. A Geographic Information Systems (GIS)-based analysis of modern South African rodent distributions, habitat use, and environmental tolerances.

    PubMed

    Campbell, Timothy L; Lewis, Patrick J; Thies, Monte L; Williams, Justin K

    2012-11-01

    GOALS OF THIS STUDY WERE TO: (1) develop distributional maps of modern rodent genera throughout the countries of South Africa, Lesotho, and Swaziland by georeferencing museum specimens; (2) assess habitat preferences for genera by cross-referencing locality position with South African vegetation; and (3) identify mean annual precipitation and temperature range where the genera are located. Conterminous South Africa including the countries of Lesotho and Swaziland Digital databases of rodent museum specimens housed in the Ditsong National Museum of Natural History, South Africa (DM), and the Division of Mammals, National Museum of Natural History, Smithsonian Institution, United States (NMNH), were acquired and then sorted into a subset of specimens with associated coordinate data. The coordinate data were then used to develop distributional maps for the rodent genera present within the study area. Percent habitat occupation and descriptive statistics for six climatic variables were then determined for each genus by cross-referencing locality positions with vegetation and climatic maps. This report presents a series of maps illustrating the distribution of 35 rodent genera based on 19,471 geo-referenced specimens obtained from two major collections. Inferred habitat use by taxon is provided for both locality and specimen percent occurrence at three hierarchical habitat levels: biome, bioregion, and vegetation unit. Descriptive statistics for six climatic variables are also provided for each genus based on locality and specimen percent incidence. As rodent faunas are commonly used in paleoenvironmental reconstructions, an accurate assessment of rodent environmental tolerance ranges is necessary before confidence can be placed in an actualistic model. While the data presented here represent only a subset of the modern geographic distributions for many of the taxa examined, a wide range of environmental regimes are observed, suggesting that more research is necessary

  11. Historical Development of Western Education in Swaziland.

    ERIC Educational Resources Information Center

    Booth, Margaret Zoller

    This research project is part of a larger study that will culminate in a book entitled "Culture and Education: The Social Consequences of Westernization in Contemporary Swaziland." While the major focus of that book is concerned with present day Swaziland, this historical research was needed in order to place the present day study of…

  12. Diversity and biogeographical patterns of legumes (Leguminosae) indigenous to southern Africa

    PubMed Central

    Trytsman, Marike; Westfall, Robert H.; Breytenbach, Philippus J. J.; Calitz, Frikkie J.; van Wyk, Abraham E.

    2016-01-01

    Abstract The principal aim of this study was to establish biogeographical patterns in the legume flora of southern Africa so as to facilitate the selection of species with agricultural potential. Plant collection data from the National Herbarium, South Africa, were analysed to establish the diversity and areas covered by legumes (Leguminosae/Fabaceae) indigenous to South Africa, Lesotho and Swaziland. A total of 27,322 records from 1,619 quarter degree grid cells, representing 1,580 species, 122 genera and 24 tribes were included in the analyses. Agglomerative hierarchical clustering was applied to the presence or absence of legume species in quarter degree grid cells, the resultant natural biogeographical regions (choria) being referred to as leguminochoria. The description of the 16 uniquely formed leguminochoria focuses on defining the associated bioregions and biomes, as well as on the key climate and soil properties. Legume species with a high occurrence in a leguminochorion are listed as key species. The dominant growth form of key species, species richness and range within each leguminochorion is discussed. Floristic links between the leguminochoria are established, by examining and comparing key species common to clusters, using a vegetation classification program. Soil pH and mean annual minimum temperature were found to be the main drivers for distinguishing among legume assemblages. This is the first time that distribution data for legumes has been used to identify biogeographical areas covered by leguminochoria on the subcontinent. One potential application of the results of this study is to assist in the selection of legumes for pasture breeding and soil conservation programs, especially in arid and semi-arid environments. PMID:27829799

  13. Diversity and biogeographical patterns of legumes (Leguminosae) indigenous to southern Africa.

    PubMed

    Trytsman, Marike; Westfall, Robert H; Breytenbach, Philippus J J; Calitz, Frikkie J; van Wyk, Abraham E

    2016-01-01

    The principal aim of this study was to establish biogeographical patterns in the legume flora of southern Africa so as to facilitate the selection of species with agricultural potential. Plant collection data from the National Herbarium, South Africa, were analysed to establish the diversity and areas covered by legumes (Leguminosae/Fabaceae) indigenous to South Africa, Lesotho and Swaziland. A total of 27,322 records from 1,619 quarter degree grid cells, representing 1,580 species, 122 genera and 24 tribes were included in the analyses. Agglomerative hierarchical clustering was applied to the presence or absence of legume species in quarter degree grid cells, the resultant natural biogeographical regions (choria) being referred to as leguminochoria. The description of the 16 uniquely formed leguminochoria focuses on defining the associated bioregions and biomes, as well as on the key climate and soil properties. Legume species with a high occurrence in a leguminochorion are listed as key species. The dominant growth form of key species, species richness and range within each leguminochorion is discussed. Floristic links between the leguminochoria are established, by examining and comparing key species common to clusters, using a vegetation classification program. Soil pH and mean annual minimum temperature were found to be the main drivers for distinguishing among legume assemblages. This is the first time that distribution data for legumes has been used to identify biogeographical areas covered by leguminochoria on the subcontinent. One potential application of the results of this study is to assist in the selection of legumes for pasture breeding and soil conservation programs, especially in arid and semi-arid environments.

  14. Sustaining control: lessons from the Lubombo spatial development initiative in southern Africa.

    PubMed

    Maharaj, Rajendra; Moonasar, Devanand; Baltazar, Candrinho; Kunene, Simon; Morris, Natashia

    2016-08-12

    The Lubombo Spatial Development Initiative (LSDI) was a tri-country project between South Africa, Swaziland and Mozambique with the aim of accelerating socio-economic development in the region. The malaria component of the project was introduced to decrease the transmission of malaria in the region. This goal was met but with termination of this project resulted in an upsurge of malaria cases in the sub-region mainly as a result of migration from high transmission areas to low transmission ones. The movement of people across borders in southern Africa remains a challenge in sustaining malaria control and elimination. Malaria case data for Swaziland and South Africa were obtained from their respective national Malaria Information Systems. Data for Mozambique was obtained from the Mozambican Ministry of Health. Data obtained during the course of the LSDI project was compared to the case data post the termination of the LSDI. The 12-year period of the LSDI showed a substantial decrease in disease burden amongst the three countries involved when compared to the baseline year of 2000. The decrease in malaria cases was 99 % in South Africa and 98 % in Swaziland. Malaria prevalence in Mozambique decreased by 85 % over the same period. However, after the LSDI ended, between 2012 and 2014, there was an upward trend in case data that was counter to the goal of elimination. South Africa and Swaziland benefitted from the LSDI and were able to sustain malaria control and progress to the stage of elimination. Mozambique could not sustain the gains made during the LSDI and case numbers increased. Technical and financial resources are key challenges for malaria control and elimination interventions.

  15. Emissions of mercury in Southern Africa derived from long-term observations at Cape Point, South Africa

    NASA Astrophysics Data System (ADS)

    Brunke, E.-G.; Ebinghaus, R.; Kock, H. H.; Labuschagne, C.; Slemr, F.

    2012-05-01

    Mercury emissions in South Africa have so far been estimated only by a bottom-up approach from activities and emission factors for different processes. In this paper we derive GEM/CO (GEM being gaseous elemental mercury, Hg0), GEM/CO2, GEM/CH4, CO/CO2, CH4/CO2, and CH4/CO emission ratios from plumes observed during long-term monitoring of these species at Cape Point between March 2007 and December 2009. The average observed GEM/CO, GEM/CO2, GEM/CH4, CO/CO2, CH4/CO2, and CH4/CO emission ratios were 2.40 ± 2.65 pg m-3 ppb-1 (n = 47), 62.7 ± 80.2 pg m-3 ppb-1 (n = 44), 3.61 ± 4.66 pg m-3 ppb-1 (n = 46), 35.6 ± 25.4 ppb ppm-1 (n = 52), 20.2 ± 15.5 ppb ppm-1 (n=48), and 0.876 ± 1.106 ppb ppm-1 (n=42), respectively. The observed CO/CO2, CH4/CO2, and CH4/CO emission ratios agree within the combined uncertainties of the observations and emissions with the ratios calculated from EDGAR (version 4.2) CO2, CO, and CH4 inventories for South Africa and Southern Africa (South Africa, Lesotho, Swaziland, Namibia, Botswana, Zimbabwe, and Mozambique) in 2007 and 2008 (inventories for 2009 are not available yet). Total elemental mercury emission of 13.1, 15.2, and 16.1 t Hg yr-1 are estimated independently using the GEM/CO, GEM/CO2, and GEM/CH4 emission ratios and the annual mean CO, CO2, and CH4 emissions, respectively, of South Africa in 2007 and 2008. The average of these independent estimates of 14.8 ± 1.5 t GEM yr-1 is much less than the total emission of 257 t Hg yr-1 from older inventories. Considering that emission of GEM represents only 50-78% of all mercury emissions, our estimates come close to the total mercury emission estimates ranging between 40-50 t Hg yr-1 from more recent inventories.

  16. The majority legal status of women in southern Africa: implications for women and families.

    PubMed

    Van Hook, M P; Ngwenya, B N

    1996-01-01

    The introduction to this article, which provides an overview of the legal status of women in southern Africa, notes that the legal majority status of women is an important social policy issue with broad implications for the socioeconomic welfare of women and their families. The dual legal system (general law and customary law) which arose from colonization is a complicating factor in the legal life of women in the region. The colonial legal system legitimized the subordination of women, and during the colonial period the customary system was reinvented to the detriment of women by male African leaders working in collusion with colonial authorities. The next section of this article presents a brief description of the legal standing of women in terms of majority/minority status, marriage arrangements, and right to own immovable property in the states of Botswana, Lesotho, South Africa, Swaziland, Zambia, and Zimbabwe. The implications of the majority/minority status of women are then explored through consideration of the economic effects of majority rights, of family relationships, and of efforts to change the legal system (by changing the content and implementation of laws and by empowering women to take advantage of their rights). The barriers that impede women from asserting their rights point to the need for removal of broad-based economic, educational, and cultural constraints. Granting majority rights is an important step toward the goals of eliminating poverty and ending the marginalization of women.

  17. Mobilising indigenous resources for anthropologically designed HIV-prevention and behaviour-change interventions in southern Africa.

    PubMed

    Green, Edward C; Dlamini, Cedza; D'Errico, Nicole C; Ruark, Allison; Duby, Zoe

    2009-12-01

    HIV prevention is often implemented as if African culture were either nonexistent or a series of obstacles to overcome in order to achieve an effective, gender-equitable, human rights-based set of interventions. Similarly, traditional or indigenous leaders, such as chiefs and members of royal families, have been largely excluded from HIV/AIDS responses in Africa. This qualitative study used focus group discussions and in-depth interviews with traditional leaders and 'ritual specialists' to better understand cultural patterns and ways of working with, rather than against, culture and traditional leaders in HIV-prevention efforts. The research was carried out in four southern African countries (Botswana, Lesotho, South Africa and Swaziland). The purpose was to discover what aspects of indigenous leadership and cultural resources might be accessed and developed to influence individual behaviour as well as the prevailing community norms, values, sanctions and social controls that are related to sexual behaviour. The indigenous leaders participating in the research largely felt bypassed and marginalised by organised efforts to prevent HIV infections and also believed that HIV-prevention programmes typically confronted, circumvented, criticised or condemned traditional culture. However, indigenous leaders may possess innovative ideas about ways to change individuals' sexual behaviour in general. The participants discussed ways to revive traditional social structures and cultural mechanisms as a means to incorporate HIV-prevention and gender-sensitivity training into existing cultural platforms, such as rites of passage, chiefs' councils and traditional courts.

  18. Cost analysis of Human Papillomavirus-related cervical diseases and genital warts in Swaziland.

    PubMed

    Ginindza, Themba G; Sartorius, Benn; Dlamini, Xolisile; Östensson, Ellinor

    2017-01-01

    Human papillomavirus (HPV) has proven to be the cause of several severe clinical conditions on the cervix, vulva, vagina, anus, oropharynx and penis. Several studies have assessed the costs of cervical lesions, cervical cancer (CC), and genital warts. However, few have been done in Africa and none in Swaziland. Cost analysis is critical in providing useful information for economic evaluations to guide policymakers concerned with the allocation of resources in order to reduce the disease burden. A prevalence-based cost of illness (COI) methodology was used to investigate the economic burden of HPV-related diseases. We used a top-down approach for the cost associated with hospital care and a bottom-up approach to estimate the cost associated with outpatient and primary care. The current study was conducted from a provider perspective since the state bears the majority of the costs of screening and treatment in Swaziland. All identifiable direct medical costs were considered for cervical lesions, cervical cancer and genital warts, which were primary diagnoses during 2015. A mix of bottom up micro-costing ingredients approach and top-down approaches was used to collect data on costs. All costs were computed at the price level of 2015 and converted to dollars ($). The total annual estimated direct medical cost associated with screening, managing and treating cervical lesions, CC and genital warts in Swaziland was $16 million. The largest cost in the analysis was estimated for treatment of high-grade cervical lesions and cervical cancer representing 80% of the total cost ($12.6 million). Costs for screening only represented 5% of the total cost ($0.9 million). Treatment of genital warts represented 6% of the total cost ($1million). According to the cost estimations in this study, the economic burden of HPV-related cervical diseases and genital warts represents a major public health issue in Swaziland. Prevention of HPV infection with a national HPV immunization programme

  19. Cost analysis of Human Papillomavirus-related cervical diseases and genital warts in Swaziland

    PubMed Central

    Sartorius, Benn; Dlamini, Xolisile; Östensson, Ellinor

    2017-01-01

    Background Human papillomavirus (HPV) has proven to be the cause of several severe clinical conditions on the cervix, vulva, vagina, anus, oropharynx and penis. Several studies have assessed the costs of cervical lesions, cervical cancer (CC), and genital warts. However, few have been done in Africa and none in Swaziland. Cost analysis is critical in providing useful information for economic evaluations to guide policymakers concerned with the allocation of resources in order to reduce the disease burden. Materials and methods A prevalence-based cost of illness (COI) methodology was used to investigate the economic burden of HPV-related diseases. We used a top-down approach for the cost associated with hospital care and a bottom-up approach to estimate the cost associated with outpatient and primary care. The current study was conducted from a provider perspective since the state bears the majority of the costs of screening and treatment in Swaziland. All identifiable direct medical costs were considered for cervical lesions, cervical cancer and genital warts, which were primary diagnoses during 2015. A mix of bottom up micro-costing ingredients approach and top-down approaches was used to collect data on costs. All costs were computed at the price level of 2015 and converted to dollars ($). Results The total annual estimated direct medical cost associated with screening, managing and treating cervical lesions, CC and genital warts in Swaziland was $16 million. The largest cost in the analysis was estimated for treatment of high-grade cervical lesions and cervical cancer representing 80% of the total cost ($12.6 million). Costs for screening only represented 5% of the total cost ($0.9 million). Treatment of genital warts represented 6% of the total cost ($1million). Conclusion According to the cost estimations in this study, the economic burden of HPV-related cervical diseases and genital warts represents a major public health issue in Swaziland. Prevention of HPV

  20. Government-NGO collaboration and sustainability of orphans and vulnerable children projects in southern Africa.

    PubMed

    Rosenberg, Alana; Hartwig, Kari; Merson, Michael

    2008-02-01

    Given current donor attention to orphans and children made vulnerable by HIV/AIDS, and the need for a new framework that recognizes the complementary roles of nations and non-governmental organizations (NGOs), this analysis reviews NGO-operated community-based orphans and vulnerable children (OVC) projects in Botswana, Lesotho, Namibia, South Africa, and Swaziland. There has been a lack of attention within the field of evaluation to inter-organizational relationships, specifically those with government agencies, as a factor in sustainability. We analyzed evaluations of nine OVC projects funded by the Bristol-Myers Squibb Foundation for the influence of government-NGO collaboration on project sustainability. For eight of the nine projects, evaluations provided evidence of the importance of the government partnership for sustainability. Government collaboration was important in projects designed to help families access government grants, initiate community-based solutions, and advocate for OVC rights through legislation. Government partnerships were also critical to the sustainability of two projects involved in placing children in foster care, but these showed signs of tension with government partners. In addition to the more common factors associated with sustainability, such as organizational characteristics, donors and NGOs should concentrate on developing strong partnerships with local and national government agencies for the sustainability of their projects.

  1. Determination of the Status of Adult Education in Swaziland.

    ERIC Educational Resources Information Center

    Dube, Musa M. A.

    The status of adult education in Swaziland was examined. Data were collected through a survey of 100 practitioners at 20 institutions that elicited 66 usable responses (response rate, 66%), consultative meetings with leading scholars in adult education inside and outside Swaziland, and a review of pertinent documents and literature. Key findings…

  2. Alien Phytogeographic Regions of Southern Africa: Numerical Classification, Possible Drivers, and Regional Threats

    PubMed Central

    Hugo, Sanet; Van Rensburg, Berndt J.; Van Wyk, Abraham E.; Steenkamp, Yolande

    2012-01-01

    The distributions of naturalised alien plant species that have invaded natural or semi-natural habitat are often geographically restricted by the environmental conditions in their new range, implying that alien species with similar environmental requirements and tolerances may form assemblages and characterise particular areas. The aim of this study was to use objective numerical techniques to reveal any possible alien phytogeographic regions (i.e. geographic areas with characteristic alien plant assemblages) in southern Africa. Quarter degree resolution presence records of naturalised alien plant species of South Africa, Lesotho, Swaziland, Namibia and Botswana were analysed through a divisive hierarchical classification technique, and the output was plotted on maps for further interpretation. The analyses revealed two main alien phytogeographic regions that could be subdivided into eight lower level phytogeographic regions. Along with knowledge of the environmental requirements of the characteristic species and supported by further statistical analyses, we hypothesised on the main drivers of alien phytogeographic regions, and suggest that environmental features such as climate and associated biomes were most important, followed by human activities that modify climatic and vegetation features, such as irrigation and agriculture. Most of the characteristic species are not currently well-known as invasive plant species, but many may have potential to become troublesome in the future. Considering the possibility of biotic homogenization, these findings have implications for predicting the characteristics of the plant assemblages of the future. However, the relatively low quality of the dataset necessitates further more in-depth studies with improved data before the findings could be directly beneficial for management. PMID:22574145

  3. Christians' cut: popular religion and the global health campaign for medical male circumcision in Swaziland.

    PubMed

    Golomski, Casey; Nyawo, Sonene

    2017-08-01

    Swaziland faces one of the worst HIV epidemics in the world and is a site for the current global health campaign in sub-Saharan Africa to medically circumcise the majority of the male population. Given that Swaziland is also majority Christian, how does the most popular religion influence acceptance, rejection or understandings of medical male circumcision? This article considers interpretive differences by Christians across the Kingdom's three ecumenical organisations, showing how a diverse group people singly glossed as 'Christian' in most public health acceptability studies critically rejected the procedure in unity, but not uniformly. Participants saw medical male circumcision's promotion and messaging as offensive and circumspect, and medical male circumcision as confounding gendered expectations and sexualised ideas of the body in Swazi Culture. Pentecostal-charismatic churches were seen as more likely to accept medical male circumcision, while traditionalist African Independent Churches rejected the operation. The procedure was widely understood to be a personal choice, in line with New Testament-inspired commitments to metaphorical circumcision as a way of receiving God's grace.

  4. Alcohol use and depression: link with adherence and viral suppression in adult patients on antiretroviral therapy in rural Lesotho, Southern Africa: a cross-sectional study.

    PubMed

    Cerutti, Bernard; Broers, Barbara; Masetsibi, Motlomelo; Faturiyele, Olatunbosun; Toti-Mokoteli, Likabelo; Motlatsi, Mokete; Bader, Joelle; Klimkait, Thomas; Labhardt, Niklaus D

    2016-09-08

    Depression and alcohol use disorder have been shown to be associated with poor adherence to antiretroviral therapy (ART). Studies examining their association with viral suppression in rural Africa are, however, scarce. This study reports prevalence of depressive symptoms and alcohol use disorder, and their potential association with adherence and viral suppression in adult patients on ART in ten clinics in rural Lesotho, Southern Africa. Among 1,388 adult patients (69 % women), 80.7 % were alcohol abstinent, 6.3 % were hazardous drinkers (men: 10.7 %, women: 4.4 %, p < 0.001). The prevalence of depressive symptoms was 28.8 % (men 20.2 %, women 32.7 %, p < 0.001). Both alcohol consumption (adjusted odds-ratio: 2.09, 95 % CI: 1.58-2.77) and alcohol use disorder (2.73, 95 % CI: 1.68-4.42) were significantly associated with poor adherence. There was, however, no significant association with viral suppression. Whereas the results of this study confirm previously reported association of alcohol use disorder with adherence to ART, there was no association with viral suppression. April 28th 2014; NCT02126696 .

  5. Civic Education in Lesotho: Implications for Teaching of Democratic Citizenship

    ERIC Educational Resources Information Center

    Ngozwana, Nomazulu Alice

    2017-01-01

    This paper investigates the extent to which civic education is achieving its goals of teaching democracy and producing responsible democratic citizenship in Lesotho. This is done by analysing the conceptions of civic education, democracy, public participation, human rights, freedoms and responsibilities that appear in Lesotho's documents that are…

  6. Hesitance towards voluntary medical male circumcision in Lesotho: reconfiguring global health governance.

    PubMed

    Bulled, Nicola L

    2015-01-01

    Drawing on work examining HIV prevention initiatives in Lesotho, this paper considers the hesitation of national state actors towards the new strategy for HIV prevention - voluntary medical male circumcision (VMMC). Lesotho offers a representative case study on global health governance, given the country's high HIV burden and heavy dependence on foreign donor nations to implement local HIV prevention initiatives. In this paper, I use the case of VMMC opposition in Lesotho to examine how the new era of 'partnerships' has shifted the architecture of contemporary global health, specifically considering how global agreements are translated or negotiated into local practice. I argue that Lesotho's domestic policy-makers, in employing national statistics to assess if VMMC is an effective approach to addressing the local epidemic, are asserting a claim of expertise. In doing so, they challenge the traditional structures of global health politics, which have largely been managed by experts and funders from and in the global North. I explore the development of global VMMC policy, what drives Lesotho's resistance to comply, and consider the impact renegotiation efforts may have on future global health architecture.

  7. Household coverage of Swaziland's national community health worker programme: a cross-sectional population-based study.

    PubMed

    Geldsetzer, Pascal; Vaikath, Maria; De Neve, Jan-Walter; Bossert, Thomas J; Sibandze, Sibusiso; Bärnighausen, Till

    2017-08-01

    To ascertain household coverage achieved by Swaziland's national community health worker (CHW) programme and differences in household coverage across clients' sociodemographic characteristics. Household survey from June to September 2015 in two of Swaziland's four administrative regions using two-stage cluster random sampling. Interviewers administered a questionnaire to all household members in 1542 households across 85 census enumeration areas. While the CHW programme aims to cover all households in the country, only 44.5% (95% confidence interval: 38.0% to 51.1%) reported that they had ever been visited by a CHW. In both uni- and multivariable regressions, coverage was negatively associated with household wealth (OR for most vs. least wealthy quartile: 0.30 [0.16 to 0.58], P < 0.001) and education (OR for >secondary schooling vs. no schooling: 0.65 [0.47 to 0.90], P = 0.009), and positively associated with residing in a rural area (OR: 2.95 [1.77 to 4.91], P < 0.001). Coverage varied widely between census enumeration areas. Swaziland's national CHW programme is falling far short of its coverage goal. To improve coverage, the programme would likely need to recruit additional CHWs and/or assign more households to each CHW. Alternatively, changing the programme's ambitious coverage goal to visiting only certain types of households would likely reduce existing arbitrary differences in coverage between households and communities. This study highlights the need to evaluate and reform large long-standing CHW programmes in sub-Saharan Africa. © 2017 John Wiley & Sons Ltd.

  8. Democratic Involvement of Students in High School Governance in Lesotho

    ERIC Educational Resources Information Center

    Matsepe, Mokone W.

    2014-01-01

    This paper is premised on the thesis that there is importance and necessity of involving high school students in school governance in Lesotho as well as consideration of cultural values' impact on this issue. The possibilities and limits of involving the high school students in school governance in Lesotho are examined. There are two opposing…

  9. Measles resurgence in southern Africa: challenges to measles elimination.

    PubMed

    Shibeshi, Messeret E; Masresha, Balcha G; Smit, Sheilagh B; Biellik, Robin J; Nicholson, Jennifer L; Muitherero, Charles; Shivute, Nestor; Walker, Oladapo; Reggis, Katsande; Goodson, James L

    2014-04-01

    In seven southern African countries (Botswana, Lesotho, Malawi, Namibia, South Africa, Swaziland and Zimbabwe), following implementation of a measles mortality reduction strategy starting in 1996, the number of annually reported measles cases decreased sharply to less than one per million population during 2006-2008. However, during 2009-2010, large outbreaks occurred in these countries. In 2011, a goal for measles elimination by 2020 was set in the World Health Organization (WHO) African Region (AFR). We reviewed the implementation of the measles control strategy and measles epidemiology during the resurgence in the seven southern African countries. Estimated coverage with routine measles vaccination, supplemental immunization activities (SIA), annually reported measles cases by country, and measles surveillance and laboratory data were analyzed using descriptive analysis. In the seven countries, coverage with the routine first dose of measles-containing vaccine (MCV1) decreased from 80% to 65% during 1996-2004, then increased to 84% in 2011; during 1996-2011, 79,696,523 people were reached with measles vaccination during 45 SIAs. Annually reported measles cases decreased from 61,160 cases to 60 cases and measles incidence decreased to <1 case per million during 1996-2008. During 2009-2010, large outbreaks that included cases among older children and adults were reported in all seven countries, starting in South Africa and Namibia in mid-2009 and in the other five countries by early 2010. The measles virus genotype detected was predominantly genotype B3. The measles resurgence highlighted challenges to achieving measles elimination in AFR by 2020. To achieve this goal, high two-dose measles vaccine coverage by strengthening routine immunization systems and conducting timely SIAs targeting expanded age groups, potentially including young adults, and maintaining outbreak preparedness to rapidly respond to outbreaks will be needed. Published by Elsevier Ltd.

  10. Alien plant invasions--incorporating emerging invaders in regional prioritization: a pragmatic approach for Southern Africa.

    PubMed

    Mgidi, Theresa N; Le Maitre, David C; Schonegevel, Lucille; Nel, Jeanne L; Rouget, Mathieu; Richardson, David M

    2007-07-01

    Plant invasions are a serious threat to natural and semi-natural ecosystems worldwide. Most management-orientated research on invasions focuses on invaders that are already widespread and often have major impacts. This paper deals with "emerging" invaders-those alien species with the potential to become important problems without timely intervention. A climate matching procedure was developed to define areas of South Africa, Lesotho and Swaziland that could be invaded by 28 plant species that had previously been classified as emerging invaders. Information on the location of populations of these species in the study area was combined with information on their distributions (as native or alien) in parts of Australia and the United States of America. These two countries had the best available distribution data for this study. They also share many invasive alien plant species with South Africa. Climatic data obtained for weather stations near points of known occurrence in these countries were used to define the climatically suitable areas for each species in the study area. Almost 80% of the remaining natural environment in southern Africa was found to be vulnerable to invasion by at least one of these species, 50% by six or more and 24% by 16 or more species. The most vulnerable areas are the highveld grasslands and the eastern escarpment. The emerging invaders with the greatest potential range included Acacia podalyriifolia and Cortaderia selloana. The globally important invaders Ulex europaeus and Lythrum salicaria had a more limited invasion potential but could still become major invaders. There was no relationship between the extent of the climatically suitable areas for the different species and an expert ranking of their invasion potential, emphasising the uncertainties inherent in making expert assessments based on very little information. The methods used in this analysis establish a protocol for future modelling exercises to assess the invasion potential of

  11. Feasibility study for the Swaziland/Mozambique interconnector. EPC specifications. Export trade information

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    NONE

    1997-11-01

    This study, conducted by Black & Veatch, was funded by the U.S. Trade and Development Agency. The report, produced for the Ministry of National Resources, Energy and Environment (MNRE) of Swaziland, determines the least cost capacity expansion option to meet the future power demand and system reliability criteria of Swaziland, with particular emphasis on the proposed Interconnector between Swaziland and Mozambique. Volume 3 contains EPC Specifications and is divided into the following divisions: (1) Commercial; (2) General Technical Requirements; (3) Transmission Line Technical Requirements; (4) Substation Technical Requirements; (5) Specifications.

  12. Emissions of mercury in southern Africa derived from long-term observations at Cape Point, South Africa

    NASA Astrophysics Data System (ADS)

    Brunke, E.-G.; Ebinghaus, R.; Kock, H. H.; Labuschagne, C.; Slemr, F.

    2012-08-01

    Mercury emissions in South Africa have so far been estimated only by a bottom-up approach from activities and emission factors for different processes. In this paper we derive GEM/CO (GEM being gaseous elemental mercury, Hg0), GEM/CO2, GEM/CH4, CO/CO2, CH4/CO2, and CH4/CO emission ratios from plumes observed during long-term monitoring of these species at Cape Point between March 2007 and December 2009. The average observed GEM/CO, GEM/CO2, GEM/CH4, CO/CO2, CH4/CO2, and CH4/CO emission ratios were 2.40 ± 2.65 pg m-3 ppb-1 (n = 47), 62.7 ± 80.2 pg m-3 ppm-1 (n = 44), 3.61 ± 4.66 pg m-3 ppb-1 (n = 46), 35.6 ± 25.4 ppb ppm-1 (n = 52), 20.2 ± 15.5 ppb ppm-1 (n = 48), and 0.876 ± 1.106 ppb ppb-1 (n = 42), respectively. The observed CO/CO2, CH4/CO2, and CH4/CO emission ratios agree within the combined uncertainties of the observations and emissions with the ratios calculated from EDGAR (version 4.2) CO2, CO, and CH4 inventories for South Africa and southern Africa (South Africa, Lesotho, Swaziland, Namibia, Botswana, Zimbabwe, and Mozambique) in 2007 and 2008 (inventories for 2009 are not available yet). Total elemental mercury emission of 13.1, 15.2, and 16.1 t Hg yr-1 are estimated independently using the GEM/CO, GEM/CO2, and GEM/CH4 emission ratios and the annual mean CO, CO2, and CH4 emissions, respectively, of South Africa in 2007 and 2008. The average of these independent estimates of 14.8 t GEM yr-1 is much less than the total emission of 257 t Hg yr-1 shown by older inventories which are now considered to be wrong. Considering the uncertainties of our emission estimate, of the emission inventories, and the fact that emission of GEM represents 50-78 % of all mercury emissions, our estimate is comparable to the currently cited GEM emissions in 2004 and somewhat smaller than emissions in 2006. A further increase of mercury emissions due to increasing electricity consumption will lead to a more pronounced difference. A quantitative assessment of the difference

  13. A 30-year bibliometric analysis of research coverage on HIV and AIDS in Lesotho.

    PubMed

    Mugomeri, Eltony; Bekele, Bisrat S; Mafaesa, Mamajoin; Maibvise, Charles; Tarirai, Clemence; Aiyuk, Sunny E

    2017-03-21

    Given the well documented undesired impacts of HIV/AIDS globally, there is a need to create a statistical inventory of research output on HIV/AIDS. This need is particularly important for a country such as Lesotho, whose HIV/AIDS prevalence is one of the highest globally. Research on HIV/AIDS in sub-Saharan Africa continues to trail behind that of other regions, especially those of the developed countries. Lesotho, a sub-Saharan country, is a developing country with lower research output in this area when longitudinally compared to other countries. This study reviewed the volume and scope of the general research output on HIV/AIDS in Lesotho and assessed the coverage of the national research agenda on HIV/AIDS, making recourse to statistical principles. A bibliometric review of studies on HIV/AIDS retrieved from the SCOPUS and PubMed databases, published within the 30-year period between 1985 and 2016, was conducted. The focus of each of the studies was analysed and the studies were cross-matched with the national research agenda in accordance with bibliometric methodologies. In total, 1280 studies comprising 1181 (92.3%) journal articles, 91 (7.1%) books and 8 (0.6%) conference proceedings were retrieved. By proportion, estimation of burden of infection (40.7%) had the highest research volume, while basic (5.5%) and preventive measures (24.4%) and national planning (29.4%) had the lowest. Out of the total studies retrieved, only 516 (40.3%) matched the national research agenda. Research on maternal and child health quality of care, viral load point-of-care devices, and infant point-of-care diagnosis had hardly any publications in the high priority research category of the agenda. Notwithstanding a considerable research output on HIV/AIDS for Lesotho, there is insufficient coverage of the national research agenda in this research area. The major research gaps on general research output are in basic and preventive measures as well as national planning. There is also

  14. What lies behind gender inequalities in HIV/AIDS in sub-Saharan African countries: evidence from Kenya, Lesotho and Tanzania

    PubMed Central

    Sia, Drissa; Onadja, Yentéma; Nandi, Arijit; Foro, Anne; Brewer, Timothy

    2014-01-01

    Within sub-Saharan Africa, women are disproportionately at risk for acquiring and having human immunodeficiency virus (HIV)/acquired immunodeficiency syndrome (AIDS). It is important to clarify whether gender inequalities in HIV prevalence in this region are explained by differences in the distributions of HIV risk factors, differences in the effects of these risk factors or some combination of both. We used an extension of the Blinder–Oaxaca decomposition approach to explain gender inequalities in HIV/AIDS in Kenya, Lesotho and Tanzania using data from the demographic and health and AIDS indicator surveys. After adjusting for covariates using Poisson regression models, female gender was associated with a higher prevalence of HIV/AIDS in Kenya [prevalence ratio (PR) = 1.73, 95% confidence interval (CI) = 1.33, 2.23 in 2003] and Lesotho (PR = 1.39, 95% CI = 1.20, 1.62 in 2004/05), but not in Tanzania. Decomposition analyses demonstrated two distinct patterns over time. In Tanzania, the gender inequality in HIV/AIDS was explained by differences in the distributions of HIV risk factors between men and women. In contrast, in Kenya and Lesotho, this inequality was partly explained by differences in the effects across men and women of measured HIV/AIDS risk factors, including socio-demographic characteristics (age and marital status) and sexual behaviours (age at first sex); these results imply that gender inequalities in HIV/AIDS would persist in Kenya and Lesotho even if men and women had similar distributions of HIV risk factors. The production of gender inequalities may vary across countries, with inequalities attributable to the unequal distribution of risk factors among men and women in some countries and the differential effect of these factors between groups in others. These different patterns have important implications for policies to reduce gender inequalities in HIV/AIDS. PMID:24345343

  15. Understanding tobacco use and socioeconomic inequalities among men in Ghana, and Lesotho.

    PubMed

    Dickson, Kwamena Sekyi; Ahinkorah, Bright Opoku

    2017-01-01

    Tobacco use is one of the leading causes of preventable deaths and has become a significant public health issue. Previous studies have paid less attention to tobacco use and socio-economic equalities among men in developing countries. This study examines the relationship between tobacco use and socio-economic inequalities among men in Ghana and Lesotho. The study made use of data from the 2014 Demographic and Health Survey (DHS) from Ghana, and Lesotho. Binary logistic regression was employed to examine the associations between socio-economic inequality characteristics of respondents and tobacco use. The results showed that the prevalence of tobacco use was high in Lesotho (47.9%) as compared to that of Ghana (6.3%). Tobacco use was generally high across all age groups in Lesotho and in contrast, it was relatively low across all ages in Ghana. A statistically significant association was found between all the socio-economic variables and tobacco use in both countries. The prevalence of tobacco use was smaller in age group 15-24 years compared to the age groups 25-34 years and 35-59 years in both Ghana and Lesotho, although the association is stronger in Ghana. The AOR's in Ghana are respectively 5.3 (95% CI: 3.29-8.59) and 9.7 (95% CI: 6.20-15.06), compared to respectively 1.7 (95% CI: 1.32-2.11) and 1.7 (95% CI: 1.36-2.12). Smoking prevalence was smaller in men with higher level of education compared to men with no education in both Ghana and Lesotho, although the association was weaker in Ghana. The AOR in Ghana is 0.1 (95% CI: (0.02-0.11), compared to 0.2 (95% Cl: (0.17-0.30). The prevalence of tobacco use was smaller among men in urban areas compared to rural areas in both Ghana and Lesotho, although the association is stronger in Ghana. The AOR in Ghana is 2.1 (95% CI: 1.67-2.73), compared to 1.6 (95% CI: (1.31-1.95). In both countries, prevalence of tobacco use was higher in men who are traditionalist/spiritualists or who had no religion compared to Christians

  16. Opportunities for Distance Education in the Commonwealth African Countries.

    ERIC Educational Resources Information Center

    INTELECON Research & Consultancy Ltd., Vancouver (British Columbia).

    The geo-demographic, economic, and infrastructural makeup of 12 African countries (Botswana. Gambia, Kenya, Lesotho, Malawi, Nigeria, Sierra Leone, Swaziland, Tanzania, Uganda, Zambia, and Zimbabwe) were compared to determine the potential benefits to them of a Commonwealth of Learning (COL) distance education initiative. Data were collected on…

  17. Reckoning HIV/AIDS care: A longitudinal study of community home-based caregivers and clients in Swaziland.

    PubMed

    Root, Robin; Van Wyngaard, Arnau; Whiteside, Alan

    2015-01-01

    The article is a descriptive case study of a community home-based care (CHBC) organisation in Swaziland that depicts the convergence of CHBC expansion with substantially improved health outcomes. Comprised of 993 care supporters who tend to 3 839 clients in 37 communities across southern Swaziland, Shiselweni Home-based Care (SHBC) is illustrative of many resource-limited communities throughout Africa that have mobilised, at varying degrees of formality, to address the individual and household suffering associated with HIV/AIDS. To better understand the potential significance of global and national health policy/programming reliance on community health workers (task shifting), we analysed longitudinal data on both care supporter and client cohorts from 2008 to 2013. Most CHBC studies report data from only one cohort. Foremost, our analysis demonstrated a dramatic decline (71.4%) among SHBC clients in overall mortality from 32.2% to 9.2% between 2008 and 2013. Although the study was not designed to establish statistical significance or causality between SHBC expansion and health impact, our findings detail a compelling convergence among CHBC, improved HIV health practices, and declines in client mortality. Our analysis indicated (1) the potential contributions of community health workers to individual and community wellbeing, (2) the challenges of task-shifting agendas, above all comprehensive support of community health workers/care supporters, and (3) the importance of data collection to monitor and strengthen the critical health services assigned to CHBC. Detailed study of CHBC operations and practices is helpful also for advancing government and donor HIV/AIDS strategies, especially with respect to health services decentralisation, in Swaziland and similarly profiled settings.

  18. Assessment of climate-driven variations in malaria incidence in Swaziland: toward malaria elimination.

    PubMed

    Chuang, Ting-Wu; Soble, Adam; Ntshalintshali, Nyasatu; Mkhonta, Nomcebo; Seyama, Eric; Mthethwa, Steven; Pindolia, Deepa; Kunene, Simon

    2017-06-01

    Swaziland aims to eliminate malaria by 2020. However, imported cases from neighbouring endemic countries continue to sustain local parasite reservoirs and initiate transmission. As certain weather and climatic conditions may trigger or intensify malaria outbreaks, identification of areas prone to these conditions may aid decision-makers in deploying targeted malaria interventions more effectively. Malaria case-surveillance data for Swaziland were provided by Swaziland's National Malaria Control Programme. Climate data were derived from local weather stations and remote sensing images. Climate parameters and malaria cases between 2001 and 2015 were then analysed using seasonal autoregressive integrated moving average models and distributed lag non-linear models (DLNM). The incidence of malaria in Swaziland increased between 2005 and 2010, especially in the Lubombo and Hhohho regions. A time-series analysis indicated that warmer temperatures and higher precipitation in the Lubombo and Hhohho administrative regions are conducive to malaria transmission. DLNM showed that the risk of malaria increased in Lubombo when the maximum temperature was above 30 °C or monthly precipitation was above 5 in. In Hhohho, the minimum temperature remaining above 15 °C or precipitation being greater than 10 in. might be associated with malaria transmission. This study provides a preliminary assessment of the impact of short-term climate variations on malaria transmission in Swaziland. The geographic separation of imported and locally acquired malaria, as well as population behaviour, highlight the varying modes of transmission, part of which may be relevant to climate conditions. Thus, the impact of changing climate conditions should be noted as Swaziland moves toward malaria elimination.

  19. Quality of Life of the Elderly Receiving Old Age Pension in Lesotho.

    PubMed

    Mugomeri, Eltony; Chatanga, Peter; Khetheng, Ts'ele; Dhemba, Jotham

    2017-01-01

    The southern African country of Lesotho introduced an old age pension scheme in 2004 with the aim of enhancing the quality of life (QoL) of the nation's elderly population. This study is the first to assess the physical, psychological, social, and environmental aspects of the health-related QoL of the elderly in Lesotho since the pension scheme was adopted. Data for this study were gathered using the World Health Organization QoL-BREF questionnaire. Mean QoL scores were compared across demographic, socioeconomic, and clinical variables using analysis of variance, t test, and regression analysis. Findings indicate that respondents were least satisfied with the environmental and physical domains of QoL. They also indicate that the overall QoL of the elderly in Lesotho was mainly affected by marital status, level of education, type of housing, source of income, and level of satisfaction with income. These factors should thus be taken into account when developing interventions aimed at improving the QoL of the elderly in Lesotho.

  20. HIV Stigma and Nurse Job Satisfaction in Five African Counties

    PubMed Central

    Chirwa, Maureen L.; Greeff, Minrie; Kohi, Thecla W.; Naidoo, Joanne R.; Makoae, Lucy N.; Dlamini, Priscilla S.; Kaszubski, Christopher; Cuca, Yvette P.; Uys, Leana R.; Holzemer, William L.

    2009-01-01

    This study explored the demographic and social factors, including perceived HIV stigma, that influence job satisfaction in nurses from 5 African countries. A cross-sectional survey was conducted of nurses (n = 1,384) caring for patients living with HIV infection in Lesotho, Malawi, South Africa, Swaziland, and Tanzania. Total job satisfaction in this sample was lower than 2 comparable studies in South Africa and the United Kingdom. The subscale, Personal Satisfaction, was the highest in this sample as in the other 2. Job Satisfaction scores differed significantly among the 5 countries and these differences were consistent across all subscales. A hierarchical regression demonstrated that mental and physical health, marital status, education level, urban/rural setting, and perceived HIV stigma had significant influences on job satisfaction. Perceived HIV stigma was the strongest predictor of job dissatisfaction. These findings provide new areas for intervention strategies that might enhance the work environment for nurses in these countries. PMID:19118767

  1. Identification of recent HIV infections and of factors associated with virus acquisition among pregnant women in 2004 and 2006 in Swaziland.

    PubMed

    Bernasconi, Daniela; Tavoschi, Lara; Regine, Vincenza; Raimondo, Mariangela; Gama, Dan; Sulgencio, Leonides; Almaviva, Mauro; Galli, Claudio; Ensoli, Barbara; Suligoi, Barbara; Sukati, Hosea; Buttò, Stefano

    2010-07-01

    HIV continues to spread at high rates in sub-Saharan Africa. In particular, Swaziland is one of the countries most affected by the HIV/AIDS pandemic. Monitoring of HIV infection in Swaziland is being made by periodical investigations on HIV prevalence in pregnant women. However, knowledge of proportion of recent HIV infections is important for epidemiologic purposes to assess HIV transmission patterns. To evaluate the proportion of recent HIV infections among pregnant women and its change overtime and to analyze factors associated with recent HIV infection in Swaziland. HIV-positive sera from pregnant women were collected during the 2004 and 2006 National HIV Serosurveys conducted in Swaziland and tested for the HIV antibody avidity, in order to identify recent HIV infections. Socio-demographic and clinical information was also collected. A multivariate analysis was conducted to assess the association between recent HIV infection and socio-demographic and clinical factors. A total of 1636 serum samples were tested for HIV antibody avidity. The overall proportion of recent infections was 13.8%, with no significant difference between 2004 and 2006 (14.6% vs. 13.1%, P>0.05, respectively). At the multivariate analysis, the younger age [14-19 vs. >or=20 years; adjusted odds ratio (aOR) 2.17, 95% CI: 1.45-3.24], as well as being at first pregnancy (1 vs. >or=2; aOR 1.61, 95% CI: 1.10-2.35) was independently associated with recent HIV infection. This study shows no significant difference in the proportion of recent infections between 2004 and 2006 and suggests that young women and women at their first pregnancy are currently high-risk groups for HIV acquisition, highlighting the importance of developing targeted youth programmes to reduce the spread of HIV infection in the country. Copyright (c) 2010 Elsevier B.V. All rights reserved.

  2. Variations in Reading Achievement Across 14 Southern African School Systems: Which Factors Matter?

    NASA Astrophysics Data System (ADS)

    Hungi, Njora; Thuku, Florence W.

    2010-02-01

    In this study the authors employed a multilevel analysis procedure in order to examine the pupil and school levels factors that contributed to variation in reading achievement among Grade 6 primary school pupils in 14 southern African school systems (Botswana, Kenya, Lesotho, Malawi, Mauritius, Mozambique, Namibia, Seychelles, South Africa, Swaziland, Tanzania, Uganda, Zambia, and Zanzibar). The data for this study were collected in 2002 as part of a major project known as the Southern and Eastern Africa Consortium for Monitoring Educational Quality (SACMEQ) that sought to examine the quality of education offered in primary schools in these countries. The most important factors affecting variation in pupil achievement across most of these school systems were grade repetition, pupil socioeconomic background, speaking the language of instruction at home, and Pupil age. South Africa, Uganda and Namibia were among the school systems with the largest between-school variation while Seychelles and Mauritius had the largest within-school variation. Low social equity in reading achievement was evident in Mauritius, Seychelles and Tanzania. Policy implications of the findings are discussed.

  3. Exploring the Congruence between the Lesotho Junior Secondary Geography Curriculum and Environmental Education

    ERIC Educational Resources Information Center

    Raselimo, Mohaeka; Irwin, Pat; Wilmot, Di

    2013-01-01

    In this article, we analyse the Lesotho junior secondary geography curriculum document with the purpose of exploring the congruence between geography and environmental education. The study is based on a curriculum reform process introduced by the Lesotho Environmental Education Support Project (LEESP) in 2001. we draw theoretical insights from…

  4. Palliative care for HIV in the era of antiretroviral therapy availability: perspectives of nurses in Lesotho

    PubMed Central

    Kell, Megan E; Walley, John D

    2009-01-01

    Background Southern Africa is disproportionately affected by the HIV/AIDS epidemic. In Lesotho 23% of adults are HIV-positive, and only 26% of those in need are accessing antiretroviral treatment (ART). Consequently, about 18,000 people die from AIDS each year. In this situation, palliative care is needed towards the end of life, but is also recommended throughout the HIV disease trajectory. The World Health Organisation (WHO) has produced the Integrated Management of Adolescent and Adult Illness (IMAI) guidelines, which includes a palliative care guidebook (as well as acute and chronic ART guidebooks). IMAI aims to facilitate the implementation of integrated HIV/AIDS care in resource-poor areas. The opinions of health workers towards this integrated approach to care and the use of IMAI has not been considered in previous research studies. This paper therefore aims to address some of these issues. Methods Semi-structured interviews were conducted with six key informants and ten nurses in Lesotho. The interviews were transcribed verbatim and analysed using content thematic analysis. Results Many nurses described palliative care as synonymous with chronic care and felt that palliative care is necessary for HIV-positive patients despite the introduction of ART. It was thought that the approach taken should be holistic and integrated throughout the disease trajectory. Pain management was noted to be a particular area of need for palliative care, and it was suggested that this could be improved in Lesotho. The IMAI guidelines were thought to be useful, but knowledge of the palliative care booklet was limited. Conclusion Palliative care remains necessary for HIV despite the increasing availability of ART. However, it is currently significantly lacking in Lesotho and many other sub-Saharan African countries. Greater understanding of palliative care amongst health workers is required, as well as strong political will from the Ministry of Health. The IMAI guidelines are a

  5. Assessment of Computer Literacy of Nurses in Lesotho.

    PubMed

    Mugomeri, Eltony; Chatanga, Peter; Maibvise, Charles; Masitha, Matseliso

    2016-11-01

    Health systems worldwide are moving toward use of information technology to improve healthcare delivery. However, this requires basic computer skills. This study assessed the computer literacy of nurses in Lesotho using a cross-sectional quantitative approach. A structured questionnaire with 32 standardized computer skills was distributed to 290 randomly selected nurses in Maseru District. Univariate and multivariate logistic regression analyses in Stata 13 were performed to identify factors associated with having inadequate computer skills. Overall, 177 (61%) nurses scored below 16 of the 32 skills assessed. Finding hyperlinks on Web pages (63%), use of advanced search parameters (60.2%), and downloading new software (60.1%) proved to be challenging to the highest proportions of nurses. Age, sex, year of obtaining latest qualification, computer experience, and work experience were significantly (P < .05) associated with inadequate computer skills in univariate analysis. However, in multivariate analyses, sex (P = .001), year of obtaining latest qualification (P = .011), and computer experience (P < .001) emerged as significant factors. The majority of nurses in Lesotho have inadequate computer skills, and this is significantly associated with having many years since obtaining their latest qualification, being female, and lack of exposure to computers. These factors should be considered during planning of training curriculum for nurses in Lesotho.

  6. Information-Seeking Behaviour of Prospective Geography Teachers at the National University of Lesotho

    ERIC Educational Resources Information Center

    Bitso, Constance; Fourie, Ina

    2014-01-01

    Introduction: This paper reports a study on information-seeking behaviour of prospective geography teachers at the National University of Lesotho based on their experiences during teaching practice. It is part of a larger doctoral study on information needs and information-seeking patterns of secondary level geography teachers in Lesotho. Method:…

  7. Metabolic syndrome in patients on first-line antiretroviral therapy containing zidovudine or tenofovir in rural Lesotho, Southern Africa.

    PubMed

    Labhardt, Niklaus Daniel; Müller, Urs Franz; Ringera, Isaac; Ehmer, Jochen; Motlatsi, Mokete M; Pfeiffer, Karolin; Hobbins, Michael A; Muhairwe, Josephine A; Muser, Juergen; Hatz, Christoph

    2017-06-01

    To assess the prevalence of metabolic syndrome (MetS) among patients in rural Lesotho who are taking first-line antiretroviral therapy (ART) containing either zidovudine or tenofovir disoproxil. Cross-sectional survey in 10 facilities in Lesotho among adult (≥16 years) patients on non-nucleoside reverse transcriptase inhibitor (NNRTI)-based first-line ART for ≥6 months. MetS was defined according to the International Diabetes Federation criteria. Among 1166 patients (65.8% female), 22.2% (95% CI: 19.3-25.3) of women and 6.3% (4.1-9.1) of men met the IDF definition of MetS (P < 0.001). In both sexes, there was no significant difference in MetS prevalence between NNRTIs. However, in women taking zidovudine as nucleoside reverse transcriptase inhibitor (NRTI), MetS prevalence was 27.9%, vs. 18.8% in those taking tenofovir. In the multivariate logistic regression allowing for socio-demographic and clinical covariates, ART containing zidovudine was associated with MetS in women (aOR 2.17 (1.46-3.22), P < 0.001) but not in men. In this study, taking ART containing zidovudine instead of tenofovir disoproxil was an independent predictor of MetS in women but not in men. This finding endorses WHO's recommendation of tenofovir as preferred NRTI. © 2017 John Wiley & Sons Ltd.

  8. Feasibility study for the swaziland/mozambique interconector. Executive summary of the final report. Export trade information

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    NONE

    1997-11-01

    This study, conducted by Black & Veatch, was funded by the U.S. Trade and Development Agency. The report, produced for the Ministry of National Resources, Energy and Environment (MNRE) of Swaziland, determines the least cost capacity expansion option to meet the future power demand and system reliability criteria of Swaziland, with particular emphasis on the propsoed Interconnector between Swaziland and Mozambique. Volume 1 contains the Executive Summary and is divided into the following sections: (1.0) Study Objectives; (2.0) Swaziland and its Economy; (3.0) The Power Sector Structure in Swaziland; (4.0) Electric Power Resources; (5.0) Past Demand Growth; (6.0) Load andmore » Energy Forecasts; (7.0) Need for Power; (8.0) Generation and Transmission Capacity Addition Option; (9.0) SEB Expansion Plan Scenario Development; (10.0) EDM Expansion Plan Development; (11.0) Cost Sharing of the Interconnector; (12.0) Interconnector Options and Environmental Evaluation; (13.0) Generation/Transmission Trade Offs; (14.0) EPC RFP and Draft Interconnection Agreement; (15.0) Transmission System Study; (16.0) Conclusions and Recommendations.« less

  9. Factors contributing to the emergence of Escherichia coli O157 in Africa.

    PubMed

    Effler, E; Isaäcson, M; Arntzen, L; Heenan, R; Canter, P; Barrett, T; Lee, L; Mambo, C; Levine, W; Zaidi, A; Griffin, P M

    2001-01-01

    In 1992, a large outbreak of bloody diarrhea caused by Escherichia coli O157 infections occurred in southern Africa. In Swaziland, 40,912 physician visits for diarrhea in persons ages >5 years were reported during October through November 1992. This was a sevenfold increase over the same period during 1990-91. The attack rate was 42% among 778 residents we surveyed. Female gender and consuming beef and untreated water were significant risks for illness. E. coli O157:NM was recovered from seven affected foci in Swaziland and South Africa; 27 of 31 patient and environmental isolates had indistinguishable pulsed-field gel electrophoresis patterns. Compared with previous years, a fivefold increase in cattle deaths occurred in October 1992. The first heavy rains fell that same month (36 mm), following 3 months of drought. Drought, carriage of E. coli O157 by cattle, and heavy rains with contamination of surface water appear to be important factors contributing to this outbreak.

  10. Factors contributing to the emergence of Escherichia coli O157 in Africa.

    PubMed Central

    Effler, E.; Isaäcson, M.; Arntzen, L.; Heenan, R.; Canter, P.; Barrett, T.; Lee, L.; Mambo, C.; Levine, W.; Zaidi, A.; Griffin, P. M.

    2001-01-01

    In 1992, a large outbreak of bloody diarrhea caused by Escherichia coli O157 infections occurred in southern Africa. In Swaziland, 40,912 physician visits for diarrhea in persons ages >5 years were reported during October through November 1992. This was a sevenfold increase over the same period during 1990-91. The attack rate was 42% among 778 residents we surveyed. Female gender and consuming beef and untreated water were significant risks for illness. E. coli O157:NM was recovered from seven affected foci in Swaziland and South Africa; 27 of 31 patient and environmental isolates had indistinguishable pulsed-field gel electrophoresis patterns. Compared with previous years, a fivefold increase in cattle deaths occurred in October 1992. The first heavy rains fell that same month (36 mm), following 3 months of drought. Drought, carriage of E. coli O157 by cattle, and heavy rains with contamination of surface water appear to be important factors contributing to this outbreak. PMID:11747693

  11. Maloti Drakensberg Transfrontier Park joint management: Sehlabathebe National Park (Lesotho) and the uKhahlamba Drakensberg Park World Heritage Site (South Africa)

    Treesearch

    John M. Crowson

    2011-01-01

    On 8 April 2005, the first Joint Management Committee meeting was held at Qacha's Nek, Lesotho. This was to ensure co-operative management through joint management. The formation of a Joint Management Committee was part of the Bilateral Maloti Drakensberg Transfrontier Project agreement and consisted of officials from the Ministry of Tourism, Environment and...

  12. THE WEIGHT OF SUCCESS: THE BODY MASS INDEX AND ECONOMIC WELL-BEING IN SOUTHERN AFRICA.

    PubMed

    Wittenberg, Martin

    2013-10-01

    We show that body mass increases with economic resources among most Southern Africans, although not all. Among Black South Africans the relationship is non-decreasing over virtually the entire range of incomes/wealth. Furthermore in this group other measures of "success" (e.g., employment and education) are also associated with increases in body mass. This is true in both 1998 (the Demographic and Health Survey) and 2008 (National Income Dynamics Survey). A similar relationship holds among residents of Lesotho, Swaziland, Mozambique, Malawi, and Namibia. This suggests that body mass can be used as a crude measure of well-being. This allows us to examine the vexed question in South African labor economics whether there is involuntary unemployment. The fact that the unemployed are lighter than the employed, even when we control for household fixed effects, suggests that they are not choosing this state.

  13. Discourses of Education, Protection, and Child Labor: Case Studies of Benin, Namibia and Swaziland

    ERIC Educational Resources Information Center

    Nordtveit, Bjorn Harald

    2010-01-01

    This article analyses discontinuities between local, national and international discourse in the fields of education, protection of children, and child labor, using Benin, Namibia and Swaziland as case studies. In Benin, child abuse and child labor are related to poverty, whereas in Namibia and Swaziland they are also interrelated with HIV/AIDS.…

  14. Brief report: Mobility and circular migration in Lesotho: implications for transmission, treatment, and control of a severe HIV epidemic.

    PubMed

    Palk, Laurence; Blower, Sally

    2015-04-15

    We analyzed georeferenced data on mobility and HIV infection from the 2009 Demographic and Health Survey of Lesotho. We found ∼50% of the population traveled in the preceding year. By constructing gender-specific mobility maps, we discovered that travel is highest in the urban areas bordering South Africa and in the mountainous interior of the country. For both genders, increased mobility was associated with increased levels of "recent" sexual behavior. Notably, mobility was only associated with an increased risk of HIV infection for men who traveled frequently. We discuss the implications of our results for designing effective treatment programs and HIV interventions.

  15. Voluntary Medical Male Circumcision: Modeling the Impact and Cost of Expanding Male Circumcision for HIV Prevention in Eastern and Southern Africa

    PubMed Central

    Reed, Jason; Opuni, Marjorie; Bollinger, Lori; Heard, Nathan; Castor, Delivette; Stover, John; Farley, Timothy; Menon, Veena; Hankins, Catherine

    2011-01-01

    Background There is strong evidence showing that voluntary medical male circumcision (VMMC) reduces HIV incidence in men. To inform the VMMC policies and goals of 13 priority countries in eastern and southern Africa, we estimate the impact and cost of scaling up adult VMMC using updated, country-specific data. Methods and Findings We use the Decision Makers' Program Planning Tool (DMPPT) to model the impact and cost of scaling up adult VMMC in Botswana, Lesotho, Malawi, Mozambique, Namibia, Rwanda, South Africa, Swaziland, Tanzania, Uganda, Zambia, Zimbabwe, and Nyanza Province in Kenya. We use epidemiologic and demographic data from recent household surveys for each country. The cost of VMMC ranges from US$65.85 to US$95.15 per VMMC performed, based on a cost assessment of VMMC services aligned with the World Health Organization's considerations of models for optimizing volume and efficiencies. Results from the DMPPT models suggest that scaling up adult VMMC to reach 80% coverage in the 13 countries by 2015 would entail performing 20.34 million circumcisions between 2011 and 2015 and an additional 8.42 million between 2016 and 2025 (to maintain the 80% coverage). Such a scale-up would result in averting 3.36 million new HIV infections through 2025. In addition, while the model shows that this scale-up would cost a total of US$2 billion between 2011 and 2025, it would result in net savings (due to averted treatment and care costs) amounting to US$16.51 billion. Conclusions This study suggests that rapid scale-up of VMMC in eastern and southern Africa is warranted based on the likely impact on the region's HIV epidemics and net savings. Scaling up of safe VMMC in eastern and southern Africa will lead to a substantial reduction in HIV infections in the countries and lower health system costs through averted HIV care costs. Please see later in the article for the Editors' Summary. PMID:22140367

  16. Ethnobotanical survey of medicinal plants used in the Maseru district of Lesotho.

    PubMed

    Seleteng Kose, Lerato; Moteetee, Annah; Van Vuuren, Sandy

    2015-07-21

    Ethnobotanical knowledge in Lesotho is passed on orally from one generation to another. As a result it has not been well documented. Existing publications have relied on previous literature and are limited either in terms of scope or coverage. Furthermore, some of them are out of print. Therefore, there are gaps in the documentation of medicinal plants used in Lesotho. The purpose of the current study is to investigate common ailments in Lesotho's traditional medicine and document plants that are used in treating such ailments. Interviews were conducted in five urban and four rural areas of the capital town of Maseru, by means of questionnaires to elicit information on medicinal plant use to cure common ailments. The informants were 20 males and seven females comprising 15 traditional healers, 11 herbalists and one pharmacist. Reproductive ailments were found to be the most commonly treated, followed by respiratory, degenerative and digestive problems. A list of the 80 plants used for treating the common ailments is given. A total of 44 families is represented, with Asteraceae, Fabaceae, Asphodelaceae and Poaceae families having the highest number of species used for medicinal purposes. The most frequently mentioned medicinal plants in interviews include; Elephantorrhiza elephantina, Pentanisia prunelloides, Hypoxis hermerocallidea, Eriocephalus sp., Salvia runcinata, Scabiosa columbaria, Dicoma anomala, Morella serrata, Xysmalobium undulatum, and Leobordea lanceolata. Due to the high demand of medicinal plants, some species such as L. lanceolata, Tephrosia capensis, E. elephantina, D. anomala and P. prunelloides were reported as over-harvested. In some cases animal products are added to the medicinal plants to enhance their curative abilities. A total of 80 plants were recorded in the study as treating 38 common ailments in the Maseru district of Lesotho. Records of eight medicinal plants and 146 new medicinal uses of 34 plants that were not recorded elsewhere in

  17. Prevalence of preoperative penile abnormalities among voluntary male medical circumcision patients in Swaziland.

    PubMed

    Oddo, Anthony R; Ruedrich, Elizabeth; Zust, Christopher; Marugg, Lindsey; VanderWal, Echo; VanderWal, Harry; Sartori, Rebekah; Markert, Ronald; McCarthy, Mary C

    2017-08-01

    Circumcision has been found to be an effective strategy for lowering the transmission of HIV in Africa. The Luke Commission, a mobile hospital outreach program, has used this information to decrease the rate of HIV in Swaziland by performing voluntary male medical circumcisions throughout the country. During many of these circumcisions, genital medical conditions and penile abnormalities are simultaneously discovered and corrected. The goal of our study was to evaluate the prevalence of penile abnormalities discovered and treated during voluntary male medical circumcisions performed by The Luke Commission (TLC) throughout rural Swaziland. We completed a retrospective analysis of all male patients who underwent voluntary male medical circumcision performed by TLC during a period from June-August, 2014. The penile abnormalities included: phimosis, paraphimosis, epispadias, hypospadias, ulcers, balanitis, torsion, and foreskin adherent to the glans. Of 929 total circumcisions, 771 (83%) patients had at least one pre-existing penile abnormality identified during their examinations and procedures, totaling 1110 abnormalities. Three specific abnormalities were detected - phimosis, adherent foreskin, and hypospadias. The 6-12 and 13-19 age groups had adequate sample sizes to yield precise estimates of prevalence (age group 6-12: 87% (95% confidence interval [CI]=84-90%; age group 13-19: 79% (95% CI=74-84%). The Luke Commission is improving the lives of children and adults with limited access to healthcare through regular preoperative evaluations during male circumcision, and the organization is setting an example for other international healthcare groups. Type of Study: Prognostic Study, Level II. Copyright © 2017 Elsevier Inc. All rights reserved.

  18. Cultural consensus modeling to measure transactional sex in Swaziland: Scale building and validation.

    PubMed

    Fielding-Miller, Rebecca; Dunkle, Kristin L; Cooper, Hannah L F; Windle, Michael; Hadley, Craig

    2016-01-01

    Transactional sex is associated with increased risk of HIV and gender based violence in southern Africa and around the world. However the typical quantitative operationalization, "the exchange of gifts or money for sex," can be at odds with a wide array of relationship types and motivations described in qualitative explorations. To build on the strengths of both qualitative and quantitative research streams, we used cultural consensus models to identify distinct models of transactional sex in Swaziland. The process allowed us to build and validate emic scales of transactional sex, while identifying key informants for qualitative interviews within each model to contextualize women's experiences and risk perceptions. We used logistic and multinomial logistic regression models to measure associations with condom use and social status outcomes. Fieldwork was conducted between November 2013 and December 2014 in the Hhohho and Manzini regions. We identified three distinct models of transactional sex in Swaziland based on 124 Swazi women's emic valuation of what they hoped to receive in exchange for sex with their partners. In a clinic-based survey (n = 406), consensus model scales were more sensitive to condom use than the etic definition. Model consonance had distinct effects on social status for the three different models. Transactional sex is better measured as an emic spectrum of expectations within a relationship, rather than an etic binary relationship type. Cultural consensus models allowed us to blend qualitative and quantitative approaches to create an emicly valid quantitative scale grounded in qualitative context. Copyright © 2015 Elsevier Ltd. All rights reserved.

  19. Feasibility study for the Swaziland/Mozambique interconnector. Final report. Export trade information

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    NONE

    1997-11-01

    This study, conducted by Black & Veatch, was funded by the U.S. Trade and Development Agency. The report, produced for the Ministry of National Resources, Energy and Environment (MNRE) of Swaziland, determines the least cost capacity expansion option to meet the future power demand and system reliability criteria of Swaziland, with particular emphasis on the proposed interconnector between Swaziland and Mozambique. Volume 2, the Final Report, contains the following sections: (1.0) Introduction; (2.0) Review of SEB Power System; (3.0) SEB Load Forecast and Review; (4.0) SEB Load Forecast Revision; (5.0) The SEB Need for Power; (6.0) SEB System Development Planmore » Review; (7.0) Southern Mozambique EdM power System Review; (8.0) Southern Mozambique EdM Energy and Demand; (9.0) Supply Side Capacity Options for Swaziland and Mozambique; (10.0) SEB Expansion Plan Development; (11.0) EdM Expansion Plan Development; (12.0) Cost Sharing of the Interconnector; (13.0) Enviroinmental Evaluation of Interconnector Options; (14.0) Generation/Transmission Trade Offs; (15.0) Draft Interconnection Agreement and Contract Packages; (16.0) Transmission System Study; (17.0) Automatic General Control; (18.0) Automatic Startup and Shutdown of Hydro Electric Power Plants; (19.0) Communications and Metering; (20.0) Conclusions and Recommendations; Appendix A: Demand Side Management Primer; Appendix B. PURPA and Avoided Cost Calculations.« less

  20. Women and HIV/AIDS in the kingdom of Swaziland: culture and risks.

    PubMed

    Mathunjwa, Tengetile R; Gary, Faye A

    2006-12-01

    In Swaziland, a polygamous society in Southern Africa, the prevalence of the human immune virus/acquired immune deficiency syndrome (HIV/AIDS) is continuing to proliferate at an alarming rate. In 1992 the prevalence rate was 3.9%. However in 12 years, by 2004, the prevalence rate had reached 42.6%. This article explores some of the traditional cultural practices and experiences that increase Swazi women's vulnerability to HIV/AIDS. The traditional cultural practices fall into four categories: (1) socialization and the roles of women, (2) the minority status of women, (3) the practice of a dowry, and (4) the wife as an inheritance. The women's experiences include the Swazi men's beliefs in the virginity cure myth, the women's extreme poverty, and the Swazi men who are migrant workers in neighboring states. This article concludes with recommendations for public policy and for future research within the context of Swazi culture.

  1. Sexual identity stigma and social support among men who have sex with men in Lesotho: a qualitative analysis.

    PubMed

    Stahlman, Shauna; Bechtold, Kali; Sweitzer, Stephanie; Mothopeng, Tampose; Taruberekera, Noah; Nkonyana, John; Baral, Stefan

    2015-11-01

    Men who have sex with men (MSM) face sexual identity stigma in many settings, which can increase risk for HIV by limiting access to care. This paper examines the roles of social support, sexual identity stigma, and sexual identity disclosure among MSM in Lesotho, a lower-middle income country within South Africa. Qualitative data were collected from 23 in-depth interview and six focus group participants and content analysis was performed to extract themes. Four primary themes emerged: 1) Verbal abuse from the broader community is a major challenge faced by MSM in Lesotho, 2) participants who were open about their sexual identity experienced greater stigma but were more self-sufficient and had higher self-confidence, 3) relationships between MSM tend to be conducted in secrecy, which can be associated with unhealthy relationships between male couples and higher risk sexual practices, and 4) MSM community organisations provide significant social and emotional support. Friends and family members from outside the MSM community also offer social support, but this support cannot be utilised by MSM until the risk of disclosing their sexual identity is reduced. Greater acceptance of same-sex practices would likely result in more open, healthy relationships and greater access to social support for MSM. Copyright © 2015 Elsevier Inc. All rights reserved.

  2. The Internet in Swaziland: Services under Transformation.

    ERIC Educational Resources Information Center

    Muswazi, Paiki

    2000-01-01

    Reviews the history of libraries in Swaziland and discusses the introduction of computers in 1974 and Internet access in 1996. Topics include censorship laws that have restricted access; e-commerce; e-mail; obstacles, including limited user access in libraries and lack of computer literacy; and suggestions for extending Internet information…

  3. A comparative review of governments' views on objectives and policy instruments in the field of population and development.

    PubMed

    1982-01-01

    It is possible to assess population policies through statements and decisions taken by governments as they reflect the views and commitments of political authorities in the field of population and development. Cases in the following African countries are reviewed with focus on objectives and policy instruments: Algeria; Angola; Benin; Botswana; Cape Verde; Central African Republic; Congo; Djibouti; Egypt; Ethiopia; Guinea; Gabon; Gambia; Ghana; Equatorial Guinea; Guinea-Bissau; Ivory Coast; Kenya; Lesotho; Liberia; Libyan Arab Jamahiriya; Madagascar; Malawi; Mali; Mauritania; Mauritius; Morocco; Mozambique; Niger; Nigeria; Rwanda; Sao Tome and Principe; Senegal; Seychelles; Sierra Leone; Somalia; Sudan; Swaziland; Togo; Tunisia; Uganda; United Republic of Cameroon; Tanzania; Upper Volta; Zaire; Zambia; and Zimbabwe. The information presented was drawn from the following publications: UN Population Division, "Population Policy Briefs: Current Situation in Developing Countries and Selected Territories," and UNFPA, "Population Programs and Projects," Volume 2, 1980-1981. On the basis of this review the following conclusions are drawn, which could indicate areas in which technical assistance to the Economic Commission for Africa (ECA) member States would be required: among the 50 country members of ECA, 34 countries (68%) have as a development objective the reduction of mortality, and in particular, maternal and child mortality; the 2nd important objective is stabilizing or improving spatial distribution of population, and 44% of the 50 countries have adopted this objective which involves the distribution of population from 1 place to another within a country; the 3rd important objective consists of restricting the migratory flow from rural areas to urban areas; the countries of Botswana, Egypt, Ghana, Kenya, Lesotho, Mauritius, Morocco, Rwanda, Seychelles, Swaziland, and Tunisia adopted the objective of reducing the rate of population growth; 34% of African countries

  4. IBFAN Africa training initiatives: code implementation and lactation management.

    PubMed

    Mbuli, A

    1994-01-01

    As part of an ongoing effort to halt the decline of breast feeding rates in Africa, 35 representatives of 12 different African countries met in Mangochi, Malawi, in February 1994. The Code of Marketing of Breastmilk Substitutes was scrutinized. National codes were drafted based on the "Model Law" of the IBFAN Code Documentation Centre (ICDC), Penang. Mechanisms of implementation, specific to each country, were developed. Strategies for the promotion, protection, and support of breast feeding, which is very important to child survival in Africa, were discussed. The training course was organized by ICDC, in conjunction with IBFAN Africa, and with the support of the United Nations Children's Fund (UNICEF) and the World Health Organization (WHO). Countries in eastern, central, and southern Africa were invited to send participants, who included professors, pediatricians, nutritionists, MCH personnel, nurses, and lawyers. IBFAN Africa has also been conducting lactation management workshops for a number of years in African countries. 26 health personnel (pediatricians, nutritionists, senior nursing personnel, and MCH workers), representing 7 countries in the southern African region, attended a training of trainers lactation management workshop in Swaziland in August, 1993 with the support of their UNICEF country offices. The workshop included lectures, working sessions, discussions, and slide and video presentations. Topics covered included national nutrition statuses, the importance of breast feeding, the anatomy and physiology of breast feeding, breast feeding problems, the International Code of Marketing, counseling skills, and training methods. The field trip to a training course covering primary health care that was run by the Traditional Healers Organization (THO) in Swaziland was of particular interest because of the strong traditional medicine sector in many African countries. IBFAN Africa encourages use of community workers (traditional healers, Rural Health

  5. THE WEIGHT OF SUCCESS: THE BODY MASS INDEX AND ECONOMIC WELL-BEING IN SOUTHERN AFRICA

    PubMed Central

    Wittenberg, Martin

    2015-01-01

    We show that body mass increases with economic resources among most Southern Africans, although not all. Among Black South Africans the relationship is non-decreasing over virtually the entire range of incomes/wealth. Furthermore in this group other measures of “success” (e.g., employment and education) are also associated with increases in body mass. This is true in both 1998 (the Demographic and Health Survey) and 2008 (National Income Dynamics Survey). A similar relationship holds among residents of Lesotho, Swaziland, Mozambique, Malawi, and Namibia. This suggests that body mass can be used as a crude measure of well-being. This allows us to examine the vexed question in South African labor economics whether there is involuntary unemployment. The fact that the unemployed are lighter than the employed, even when we control for household fixed effects, suggests that they are not choosing this state. PMID:26199456

  6. Effectiveness of a training program to increase the capacity of health care providers to provide HIV/AIDS care and treatment in Swaziland.

    PubMed

    Kamiru, H N; Ross, M W; Bartholomew, L K; McCurdy, S A; Kline, M W

    2009-11-01

    Implementation of HIV care and treatment programs in sub-Saharan Africa is a complex undertaking that requires training of health care providers (HCPs). Many sub-Saharan African countries have introduced training programs to build human resources for health. Evaluation of the ongoing trainings is warranted so that programs can be improved. The purpose of this study was to evaluate Baylor International Pediatric AIDS Initiative's (BIPAI) HCP training program in Swaziland. The specific aims were: (1) to assess coverage and delivery of the training program; and (2) to determine the impact of the training program on HCPs' knowledge about HIV and pediatric practices, attitudes toward HIV/AIDS patients, and self-efficacy to provide antiretroviral therapy (ART). The evaluation was a multimethod design with two types of data collection and analysis: (1) one-group pretest-posttest survey with 101 HCPs; and (2) semi-structured in-depth interviews with seven trainers from Baylor College of Medicine and 16 local HCPs in Swaziland. Quantitative data were analyzed using Stata Statistical Software version 8.2 for descriptive and multivariate analysis while factor analysis was done using Statistical Program for Social Sciences version 14. The transcribed interviews were analyzed using a didactic approach. Process evaluation showed that the training had good coverage, was delivered as intended, and improved as the work progressed. The training program led to a significant increase (p=0.0000) in HCPs' knowledge about HIV/AIDS, ART, and relevant clinical pediatrics practices between pretest (mean 68.7% SD 13.7) and post training (mean 84.0% SD 12.0). The training program also increased trainees' self-efficacy to provide ART and their attitudes toward AIDS patients (p=0.0000 and 0.02, respectively). In conclusion, BIPAI training program in Swaziland had good coverage of all health care facilities and HCPs in Swaziland. The training was effective in imparting knowledge and skills to

  7. Targeting imported malaria through social networks: a potential strategy for malaria elimination in Swaziland.

    PubMed

    Koita, Kadiatou; Novotny, Joseph; Kunene, Simon; Zulu, Zulizile; Ntshalintshali, Nyasatu; Gandhi, Monica; Gosling, Roland

    2013-06-27

    Swaziland has made great progress towards its goal of malaria elimination by 2015. However, malaria importation from neighbouring high-endemic Mozambique through Swaziland's eastern border remains a major factor that could prevent elimination from being achieved. In order to reach elimination, Swaziland must rapidly identify and treat imported malaria cases before onward transmission occurs. A nationwide formative assessment was conducted over eight weeks to determine if the imported cases of malaria identified by the Swaziland National Malaria Control Programme could be linked to broader social networks and to explore methods to access these networks. Using a structured format, interviews were carried out with malaria surveillance agents (6), health providers (10), previously identified imported malaria cases (19) and people belonging to the networks identified through these interviews (25). Most imported malaria cases were Mozambicans (63%, 12/19) making a living in Swaziland and sustaining their families in Mozambique. The majority of imported cases (73%, 14/19) were labourers and self-employed contractors who travelled frequently to Mozambique to visit their families and conduct business. Social networks of imported cases with similar travel patterns were identified through these interviews. Nearly all imported cases (89%, 17/19) were willing to share contact information to enable network members to be interviewed. Interviews of network members and key informants revealed common congregation points, such as the urban market places in Manzini and Malkerns, as well as certain bus stations, where people with similar travel patterns and malaria risk behaviours could be located and tested for malaria. This study demonstrated that imported cases of malaria belonged to networks of people with similar travel patterns. This study may provide novel methods for screening high-risk groups of travellers using both snowball sampling and time-location sampling of networks to

  8. Education as a Gateway to Development: Case of Rural Poor at Thabaneng Village in Lesotho

    ERIC Educational Resources Information Center

    Matsepe, Mokone W.

    2015-01-01

    The study explores and unfolds the purpose of education in general, its value and the role it plays in helping development of the people in rural areas especially at Thabaneng Village in Lesotho. It reveals that education is the key to development and functions to equip the rural population in Lesotho with knowledge, training and worthwhile skills…

  9. Educating Handicapped Young People in Eastern and Southern Africa in 1981-83.

    ERIC Educational Resources Information Center

    Ross, D. H.

    This publication compiles the findings and conclusions of the 3-year first phase (1980-83) of the Unesco Sub-regional Project for Special Education in Eastern and Southern Africa. It presents the state of the art of special education and prospects for future development in Botswana, Ethiopia, Kenya, Lesotho, Malawi, Mauritius, Seychelles, Somalia,…

  10. Survival and Population Dynamics of the Marabou Stork in an Isolated Population, Swaziland

    PubMed Central

    Monadjem, Ara; Kane, Adam; Botha, Andre; Dalton, Desire; Kotze, Antoinette

    2012-01-01

    Investigating the ecology of long lived birds is particularly challenging owing to the time scales involved. Here an analysis is presented of a long term study of the survival and population dynamics of the marabou stork (Leptoptilos crumeniferus), a wide ranging scavenging bird from Sub-Saharan Africa. Using resightings data of tagged nestlings and free flying birds we show that the stork population can be divided into three general life stages with unique survival probabilities and fecundities. Fecundity of the storks is inversely related to rainfall during their breeding season. Corroborative evidence for a metapopulation structure is discussed highlighting the impact of the Swaziland birds on the ecology of the species in the broader region. The importance of tag loss or illegibility over time is highlighted. Clearly, any attempt at conserving a species will require a detailed understanding of its population structure, of the sort examined here. PMID:23029517

  11. MEDICINAL HERBS USED BY HIV-POSITIVE PEOPLE IN LESOTHO

    PubMed Central

    Mugomeri, Eltony; Chatanga, Peter; Chakane, Ntema

    2016-01-01

    Background: The use of medicinal herbs whose efficacy and toxicities are not known by HIV-positive people in Lesotho is a threat to the effectiveness of antiretroviral treatment. This study explored some medicinal herbs used by HIV-positive people in Lesotho and the reasons for their use. Methods: This was a cross sectional study based on a questionnaire distributed to purposively-sampled HIV-positive people in Leribe and Maseru districts of Lesotho. The participants’ socio-demographic and clinical variables were summarized using frequency tables in Stata version 13 statistical software. Data variables for medicinal herbs used, frequency of use, uses by the participants and in the literature, parts of plants used and the method of preparation were also explored. Results: Out of 400 questionnaires distributed to the participants, 389 were returned with data acceptable for analysis. Ages of the participants ranged from 18 to 75 years (Mean=43 + 11.6). Out of the 272 (69.9%) participants who conceded that they had used medicinal herbs at least once, 30 (7.7%) participants used medicinal herbs frequently while 242 (62.2 %) rarely used the herbs. At least 20 plant species belonging to 16 families were reportedly used by the participants. Asteraceae was the most common plant family reportedly used by the participants. Allium sativum and Dicoma anomala, reportedly used by 21.0% and 14.3% respectively, were the most commonly used medicinal herbs in this population. In addition, boosting the immune system and treating gastrointestinal ailments, apparently cited by 32% and 28% participants respectively, were the most commonly reported reasons for using medicinal herbs. Conclusion: A considerable proportion (69.9%) of HIV-positive people use medicinal herbs in this population, and 7.7% use them frequently. At least 20 plant species belonging to 16 families were reportedly used by the participants. HIV counselling protocols in Lesotho should emphasize the dangers of using

  12. MEDICINAL HERBS USED BY HIV-POSITIVE PEOPLE IN LESOTHO.

    PubMed

    Mugomeri, Eltony; Chatanga, Peter; Chakane, Ntema

    2016-01-01

    The use of medicinal herbs whose efficacy and toxicities are not known by HIV-positive people in Lesotho is a threat to the effectiveness of antiretroviral treatment. This study explored some medicinal herbs used by HIV-positive people in Lesotho and the reasons for their use. This was a cross sectional study based on a questionnaire distributed to purposively-sampled HIV-positive people in Leribe and Maseru districts of Lesotho. The participants' socio-demographic and clinical variables were summarized using frequency tables in Stata version 13 statistical software. Data variables for medicinal herbs used, frequency of use, uses by the participants and in the literature, parts of plants used and the method of preparation were also explored. Out of 400 questionnaires distributed to the participants, 389 were returned with data acceptable for analysis. Ages of the participants ranged from 18 to 75 years (Mean=43 + 11.6). Out of the 272 (69.9%) participants who conceded that they had used medicinal herbs at least once, 30 (7.7%) participants used medicinal herbs frequently while 242 (62.2 %) rarely used the herbs. At least 20 plant species belonging to 16 families were reportedly used by the participants. Asteraceae was the most common plant family reportedly used by the participants. Allium sativum and Dicoma anomala , reportedly used by 21.0% and 14.3% respectively, were the most commonly used medicinal herbs in this population. In addition, boosting the immune system and treating gastrointestinal ailments, apparently cited by 32% and 28% participants respectively, were the most commonly reported reasons for using medicinal herbs. A considerable proportion (69.9%) of HIV-positive people use medicinal herbs in this population, and 7.7% use them frequently. At least 20 plant species belonging to 16 families were reportedly used by the participants. HIV counselling protocols in Lesotho should emphasize the dangers of using medicinal herbs whose safety and

  13. "There is hunger in my community": a qualitative study of food security as a cyclical force in sex work in Swaziland.

    PubMed

    Fielding-Miller, Rebecca; Mnisi, Zandile; Adams, Darrin; Baral, Stefan; Kennedy, Caitlin

    2014-01-25

    Swaziland has the highest HIV prevalence in the world - 32% of adults are currently living with HIV - and many Swazis are chronically food insecure - in 2011 one in four Swazis required food aid from the World Food Programme. In southern Africa, food insecurity has been linked to high-risk sexual behaviors, difficulty with antiretroviral therapy (ART) adherence, higher rates of mother-to-child HIV transmission, and more rapid HIV progression. Sex workers in Swaziland are a population that is most at risk of HIV. Little is known about the context and needs of sex workers in Swaziland who are living with HIV, nor how food insecurity may affect these needs. In-depth interviews were conducted with 20 female sex workers who are living with HIV in Swaziland. Interviews took place in four different regions of the country, and were designed to learn about context, experiences, and health service needs of Swazi sex workers. Hunger was a major and consistent theme in our informants' lives. Women cited their own hunger or that of their children as the impetus to begin sex work, and as a primary motivation to continue to sell sex. Informants used good nutrition and the ability to access "healthy" foods as a strategy to manage their HIV infection. Informants discussed difficulty in adhering to ART when faced with the prospect of taking pills on an empty stomach. Across interviews, discussions of CD4 counts and ART adherence intertwined with discussions of poverty, hunger and healthy foods. Some sex workers felt that they had greater trouble accessing food through social networks as result of both their HIV status and profession. Informants described a risk cycle of hunger, sex work, and HIV infection. The two latter drive an increased need for 'healthy foods' and an alienation from social networks that offer material and emotional support against hunger. Services and interventions for sex workers which address the pathways through which food insecurity generates vulnerability

  14. Swaziland.

    PubMed

    1993-04-01

    Swaziland is a country of 17,363 sq km with 860,000 inhabitants, of whom 64% are literate. Independence was gained on September 6, 1968. The terrain consists of mountains and plateaus, with a climate variously near-temperature, subtropical, and semi-arid. English and SiSwati are spoken by Swazi, Zulu, and non-African ethnic groups, who variously hold Christian and indigenous beliefs. Life expectancy ranges between 53 and 60 years, GDP is $704 million, growing at a rate of 7%. Per capita income is $900. The country's natural resources include asbestos, coal, diamonds, timber, hydroelectric power, and clay. Sugar cane, corn, citrus, fruit, livestock, wood, pineapple, cotton, tobacco, and light manufactured and processed goods are areas of economic production. Motor vehicles, heavy machinery, fuel and lubricants, foodstuffs, and clothing are imported, and sugar, soft drink concentrate, woodpulp and wood products, manufactures, canned fruit, asbestos, and meat products are exported. In-depth information is also given on the people and history, government and principal officials, political conditions, the economy, defense, foreign relations, relations with the US, and names of US officials in the country.

  15. Rural water supply and sanitation (RWSS) coverage in Swaziland: Toward achieving millennium development goals

    NASA Astrophysics Data System (ADS)

    Mwendera, E. J.

    An assessment of rural water supply and sanitation (RWSS) coverage in Swaziland was conducted in 2004/2005 as part of the Rural Water Supply and Sanitation Initiative (RWSSI). The initiative was developed by the African Development Bank with the aim of implementing it in the Regional Member Countries (RMCs), including Swaziland. Information on the RWSS sector programmes, costs, financial requirements and other related activities was obtained from a wide range of national documents, including sector papers and project files and progress reports. Interviews were held with staff from the central offices and field stations of Government of Swaziland (GOS) ministries and departments, non-governmental organizations (NGOs), bilateral and multilateral external support agencies, and private sector individuals and firms with some connection to the sector and/or its programmes. The assessment also involved field visits to various regions in order to obtain first hand information about the various technologies and institutional structures used in the provision of water supplies and sanitation services in the rural areas of the country. The results showed that the RWSS sector has made significant progress towards meeting the national targets of providing water and sanitation to the entire rural population by the year 2022. The assessment indicated that rural water supply coverage was 56% in 2004 while sanitation coverage was 63% in the same year. The results showed that there is some decline in the incidence of water-related diseases, such as diarrhoeal diseases, probably due to improved water supply and sanitation coverage. The study also showed that, with adequate financial resources, Swaziland is likely to achieve 100% coverage of both water supply and sanitation by the year 2022. It was concluded that in achieving its own national goals Swaziland will exceed the Millennium Development Goals (MDGs). However, such achievement is subject to adequate financial resources being

  16. A national survey of childhood physical abuse among females in Swaziland

    PubMed Central

    Breiding, Matthew J.; Mercy, James A.; Gulaid, Jama; Reza, Avid; Hleta-Nkambule, Nonhlanhla

    2015-01-01

    Objective This study describes the scope and characteristics of childhood physical abuse in a nationally representative sample of 13–24 year-old females in Swaziland. The current study also examined health consequences and risk factors of childhood physical abuse. Methods The study utilized a two-stage cluster sampling design in order to conduct the household survey. Retrospective reports of childhood physical abuse and relevant risk factors were collected from 1292 females. Bivariate and multivariate logistic regression models examined associations between childhood physical abuse and both health consequences and risk factors. Results Nearly 1 in 5 females in Swaziland has experienced childhood physical abuse in their lifetime, with nearly 1 in 20 having experienced abuse that was so severe that it required medical attention. A number of risk factors for lifetime childhood physical abuse were identified including: maternal death prior to age 13; having lived with three or more families during their childhood; and having experienced emotional abuse prior to age 13. Conclusions Preventing childhood physical abuse in Swaziland may be addressed through: promoting safe, stable, and nurturing relationships between children and their caretakers; addressing social norms that contribute to harsh physical punishment; and addressing underlying stressors associated with severe social and economic disadvantage. PMID:23856568

  17. A Public-Private Partnership Improves Clinical Performance In A Hospital Network In Lesotho.

    PubMed

    McIntosh, Nathalie; Grabowski, Aria; Jack, Brian; Nkabane-Nkholongo, Elizabeth Limakatso; Vian, Taryn

    2015-06-01

    Health care public-private partnerships (PPPs) between a government and the private sector are based on a business model that aims to leverage private-sector expertise to improve clinical performance in hospitals and other health facilities. Although the financial implications of such partnerships have been analyzed, few studies have examined the partnerships' impact on clinical performance outcomes. Using quantitative measures that reflected capacity, utilization, clinical quality, and patient outcomes, we compared a government-managed hospital network in Lesotho, Africa, and the new PPP-managed hospital network that replaced it. In addition, we used key informant interviews to help explain differences in performance. We found that the PPP-managed network delivered more and higher-quality services and achieved significant gains in clinical outcomes, compared to the government-managed network. We conclude that health care public-private partnerships may improve hospital performance in developing countries and that changes in management and leadership practices might account for differences in clinical outcomes. Project HOPE—The People-to-People Health Foundation, Inc.

  18. Engaging Foreign Curriculum Experts in Curriculum Design: A Case Study of Primary School Curriculum Change in Lesotho

    ERIC Educational Resources Information Center

    Nhlapo, Molise David; Maharajh, Lokesh Ramnath

    2017-01-01

    Involvement of foreign consultants in the Lesotho curriculum design has been in operation since the beginning of formal education around 1833 in the country to-date. The expectation was that, with time, Lesotho would produce enough quality curriculum specialists who would be entrusted with the task of curriculum design. However, the trained…

  19. “There is hunger in my community”: a qualitative study of food security as a cyclical force in sex work in Swaziland

    PubMed Central

    2014-01-01

    Background Swaziland has the highest HIV prevalence in the world – 32% of adults are currently living with HIV — and many Swazis are chronically food insecure — in 2011 one in four Swazis required food aid from the World Food Programme. In southern Africa, food insecurity has been linked to high-risk sexual behaviors, difficulty with antiretroviral therapy (ART) adherence, higher rates of mother-to-child HIV transmission, and more rapid HIV progression. Sex workers in Swaziland are a population that is most at risk of HIV. Little is known about the context and needs of sex workers in Swaziland who are living with HIV, nor how food insecurity may affect these needs. Methods In-depth interviews were conducted with 20 female sex workers who are living with HIV in Swaziland. Interviews took place in four different regions of the country, and were designed to learn about context, experiences, and health service needs of Swazi sex workers. Results Hunger was a major and consistent theme in our informants’ lives. Women cited their own hunger or that of their children as the impetus to begin sex work, and as a primary motivation to continue to sell sex. Informants used good nutrition and the ability to access “healthy” foods as a strategy to manage their HIV infection. Informants discussed difficulty in adhering to ART when faced with the prospect of taking pills on an empty stomach. Across interviews, discussions of CD4 counts and ART adherence intertwined with discussions of poverty, hunger and healthy foods. Some sex workers felt that they had greater trouble accessing food through social networks as result of both their HIV status and profession. Conclusions Informants described a risk cycle of hunger, sex work, and HIV infection. The two latter drive an increased need for ‘healthy foods’ and an alienation from social networks that offer material and emotional support against hunger. Services and interventions for sex workers which address the pathways

  20. Sexual practices, identities and health among women who have sex with women in Lesotho - a mixed-methods study.

    PubMed

    Poteat, Tonia; Logie, Carmen; Adams, Darrin; Lebona, Judith; Letsie, Puleng; Beyrer, Chris; Baral, Stefan

    2014-01-01

    Despite the high prevalence of HIV and STIs among women in Africa and the growing literature on HIV and STIs among women who have sex with women, research on the sexual health of women who have sex with women in Africa is scant. This study used mixed methods to describe sexual identity, practices and health among women who have sex with women in Lesotho. Most respondents (48%) described themselves as lesbian, 29% as bisexual and 23% as heterosexual. Almost half (45%) had disclosed their same-sex attraction to family, but only 25% had done so with healthcare workers. A total of 8% reported having HIV. Self-reported HIV was associated with having three or more male partners, having male and female partners at the same time and having a history of STIs. Gender norms, the criminalisation of homosexuality, varied knowledge of, and access to, safer-sex strategies, and mixed experiences of HIV/STI testing and sexual healthcare provided social and structural contexts for HIV- and STI-related vulnerability.

  1. Water insecurity in a syndemic context: Understanding the psycho-emotional stress of water insecurity in Lesotho, Africa.

    PubMed

    Workman, Cassandra L; Ureksoy, Heather

    2017-04-01

    Syndemics occur when populations experience synergistic and multiplicative effects of co-occurring epidemics. Proponents of syndemic theory highlight the importance of understanding the social context in which diseases spread and cogently argue that there are biocultural effects of external stresses such as food insecurity and water insecurity. Thus, a holistic understanding of disease or social vulnerability must incorporate an examination of the emotional and social effects of these phenomena. This paper is a response to the call for a renewed focus on measuring the psycho-emotional and psychosocial effects of food insecurity and water insecurity. Using a mixed-method approach of qualitative interviews and quantitative assessment, including a household demographic, illness, and water insecurity scale, the Household Food Insecurity Access Scale, and the Hopkins Symptoms Checklist-25, this research explored the psycho-emotional effects of water insecurity, food insecurity, and household illness on women and men residing in three low-land districts in Lesotho (n = 75). Conducted between February and November of 2011, this exploratory study first examined the complicated interaction of water insecurity, food insecurity and illness to understand and quantify the relationship between these co-occurring stresses in the context of HIV/AIDS. Second, it sought to separate the role of water insecurity in predicting psycho-emotional stress from other factors, such as food insecurity and household illness. When asked directly about water, qualitative research revealed water availability, access, usage amount, and perceived water cleanliness as important dimensions of water insecurity, creating stress in respondents' daily lives. Qualitative and quantitative data show that water insecurity, food insecurity and changing household demographics, likely resulting from the HIV/AIDS epidemic, are all associated with increased anxiety and depression, and support the conclusion that

  2. Creating Culturally Relevant Instructional Materials: A Swaziland Case Study

    ERIC Educational Resources Information Center

    Titone, Connie; Plummer, Emily C.; Kielar, Melissa A.

    2012-01-01

    In the field of English language learning, research proves that culturally relevant reading materials improve students' language acquisition, learning motivation, self-esteem, and identity formation. Since English is the language of instruction in many distant countries, such as Swaziland, even when English is not the native language of those…

  3. HIV prevention needs for men who have sex with men in Swaziland.

    PubMed

    Sithole, Bhekie

    2017-12-01

    Men who have sex with men (MSM) have a high HIV burden and also often face multiple other challenges accessing HIV services, including legal and social issues. Although Swaziland recently started responding with interventions for MSM, significant gaps still exist both in information and programming. This study aimed to explore the HIV prevention needs of MSM in Swaziland, including factors elevating their risks and vulnerabilities to HIV infection; to find out what HIV prevention strategies exist; and to determine how best to meet the prevention needs of MSM. A total of 50 men who reported anal sex with other men in the past 12 months were recruited through simple respondent driven sampling. They completed either a structured quantitative survey (n = 35) or participated in a semi-structured qualitative interview (n = 15). Both quantitative and qualitative findings indicated perceived and experienced stigma among MSM. This predominantly manifested as internalised stigma, which may lead to alcohol abuse and sexual risky behaviours. At least 83% (29/35) of the quantitative sample had been labelled with derogatory terms because of their sexual orientation, while 66% (23/35) had experienced being avoided. There was limited knowledge of risk practices: When asked, 54% (19/35) of quantitative respondents reported that vaginal and anal sex carry an equal risk of HIV infection. Participants also had little knowledge on new HIV prevention methods such as pre-exposure prophylaxis (PrEP) and rectal microbicides. MSM needs included safe spaces in form of drop-in centres and non-hostile HIV services. Although Swaziland recently started interventions for key populations, including MSM, there is still a general lack on information to inform managers and implementers on the HIV prevention needs of MSM in Swaziland. Such information is crucial for designers of official and HIV programmes. Research is needed to increase knowledge on the HIV prevention needs for key populations

  4. Food insufficiency is associated with high-risk sexual behavior among women in Botswana and Swaziland.

    PubMed

    Weiser, Sheri D; Leiter, Karen; Bangsberg, David R; Butler, Lisa M; Percy-de Korte, Fiona; Hlanze, Zakhe; Phaladze, Nthabiseng; Iacopino, Vincent; Heisler, Michele

    2007-10-01

    Both food insufficiency and HIV infection are major public health problems in sub-Saharan Africa, yet the impact of food insufficiency on HIV risk behavior has not been systematically investigated. We tested the hypothesis that food insufficiency is associated with HIV transmission behavior. We studied the association between food insufficiency (not having enough food to eat over the previous 12 months) and inconsistent condom use, sex exchange, and other measures of risky sex in a cross-sectional population-based study of 1,255 adults in Botswana and 796 adults in Swaziland using a stratified two-stage probability design. Associations were examined using multivariable logistic regression analyses, clustered by country and stratified by gender. Food insufficiency was reported by 32% of women and 22% of men over the previous 12 months. Among 1,050 women in both countries, after controlling for respondent characteristics including income and education, HIV knowledge, and alcohol use, food insufficiency was associated with inconsistent condom use with a nonprimary partner (adjusted odds ratio [AOR] 1.73, 95% confidence interval [CI] 1.27-2.36), sex exchange (AOR 1.84, 95% CI 1.74-1.93), intergenerational sexual relationships (AOR 1.46, 95% CI 1.03-2.08), and lack of control in sexual relationships (AOR 1.68, 95% CI 1.24-2.28). Associations between food insufficiency and risky sex were much attenuated among men. Food insufficiency is an important risk factor for increased sexual risk-taking among women in Botswana and Swaziland. Targeted food assistance and income generation programs in conjunction with efforts to enhance women's legal and social rights may play an important role in decreasing HIV transmission risk for women.

  5. Entrepreneurial training for girls empowerment in Lesotho: A process evaluation of a model programme

    PubMed Central

    Berry, Mary O'Neill; Kuriansky, Judy; Lytle, Megan; Vistman, Bozhena; Mosisili, ‘Mathato S.; Hlothoane, Lieketso; Matlanyane, Mapeo; Mokobori, Thabang; Mosuhli, Silas; Pebane, Jane

    2014-01-01

    A Girls Empowerment Programme held in 2010 in Lesotho, Sub-Saharan Africa, focused on HIV/AIDS risk reduction and prevention, life skills and entrepreneurial training (income-generating activities). Entrepreneurial training was a crucial part of equipping the camp attendees with basic skills to help them develop sustainable livelihoods. Such skills and financial independence are essential to enable rural girls to complete their secondary schooling (in a fee-based educational system) and to pursue a career, as well as to further help them be less susceptible to transactional sex and its significant risks. The results of a brief process evaluation with some nested supporting data showed considerable improvement in the girls' knowledge about income-generating activities. In addition, almost half of the camp attendees participated in further entrepreneurial training and about half of these girls went on to develop small businesses. Replication of this model of camp training is recommended and being explored in other African countries. PMID:25505804

  6. Entrepreneurial training for girls empowerment in Lesotho: A process evaluation of a model programme.

    PubMed

    Berry, Mary O'Neill; Kuriansky, Judy; Lytle, Megan; Vistman, Bozhena; Mosisili, 'Mathato S; Hlothoane, Lieketso; Matlanyane, Mapeo; Mokobori, Thabang; Mosuhli, Silas; Pebane, Jane

    2013-12-01

    A Girls Empowerment Programme held in 2010 in Lesotho, Sub-Saharan Africa, focused on HIV/AIDS risk reduction and prevention, life skills and entrepreneurial training (income-generating activities). Entrepreneurial training was a crucial part of equipping the camp attendees with basic skills to help them develop sustainable livelihoods. Such skills and financial independence are essential to enable rural girls to complete their secondary schooling (in a fee-based educational system) and to pursue a career, as well as to further help them be less susceptible to transactional sex and its significant risks. The results of a brief process evaluation with some nested supporting data showed considerable improvement in the girls' knowledge about income-generating activities. In addition, almost half of the camp attendees participated in further entrepreneurial training and about half of these girls went on to develop small businesses. Replication of this model of camp training is recommended and being explored in other African countries.

  7. Prevalence of goitre and urinary iodine status of primary-school children in Lesotho.

    PubMed Central

    Sebotsa, Masekonyela Linono Damane; Dannhauser, Andre; Jooste, Pieter L.; Joubert, Gina

    2003-01-01

    OBJECTIVE: To estimate the prevalence of goitre, urinary iodine status, coverage of supplementation of iodized oil capsules, and current use of iodized salt in children in Lesotho. METHODS: Cross-sectional study of children from 50 primary schools in Lesotho. Thyroid glands of children aged 8-12 years were measured by palpation and graded according to the WHO, UNICEF, and the International Council for the Control of Iodine Deficiency's (ICCIDD) joint criteria. The use of iodized oil capsules was determined by a structured questionnaire and verified with the children's health booklets. Iodine content of household salt samples was analysed. Casual urine samples were analysed for urinary iodine. FINDINGS: Median urinary iodine concentrations of 26.3 microg/l (range 22.3-47.9 microg/l) indicated moderate iodine deficiency. More children in the mountains than in the lowlands were severely iodine deficient (17.7% vs 1.9%). Adjusted prevalence of goitre (4.9%) increased with age, was higher in girls than boys, and ranged from 2.2% to 8.8% in the different districts; this indicated no public health problem. Overall, 94.4% of salt samples were iodized, and coverage of supplementation with iodized oil capsules was 55.1%. CONCLUSION: Mild-to-moderate iodine deficiency exists in Lesotho. Iodine deficiency was more severe in the mountains than the lowlands and is still a concern for public health. Use of iodized salt coupled with iodized oil supplementation effectively controls iodine deficiency disorders. Effective monitoring programmes would ensure the use of adequately iodized salt throughout Lesotho and serve to evaluate progress towards optimal iodine nutrition. Iodized oil capsule supplementation should continue in the mountains. PMID:12640473

  8. Social cohesion, social participation, and HIV related risk among female sex workers in Swaziland.

    PubMed

    Fonner, Virginia A; Kerrigan, Deanna; Mnisi, Zandile; Ketende, Sosthenes; Kennedy, Caitlin E; Baral, Stefan

    2014-01-01

    Social capital is important to disadvantaged groups, such as sex workers, as a means of facilitating internal group-related mutual aid and support as well as access to broader social and material resources. Studies among sex workers have linked higher social capital with protective HIV-related behaviors; however, few studies have examined social capital among sex workers in sub-Saharan Africa. This cross-sectional study examined relationships between two key social capital constructs, social cohesion among sex workers and social participation of sex workers in the larger community, and HIV-related risk in Swaziland using respondent-driven sampling. Relationships between social cohesion, social participation, and HIV-related risk factors were assessed using logistic regression. HIV prevalence among the sample was 70.4% (223/317). Social cohesion was associated with consistent condom use in the past week (adjusted odds ratio [AOR] = 2.25, 95% confidence interval [CI]: 1.30-3.90) and was associated with fewer reports of social discrimination, including denial of police protection. Social participation was associated with HIV testing (AOR = 2.39, 95% CI: 1.36-4.03) and using condoms with non-paying partners (AOR = 1.99, 95% CI: 1.13-3.51), and was inversely associated with reported verbal or physical harassment as a result of selling sex (AOR = 0.55, 95% CI: 0.33-0.91). Both social capital constructs were significantly associated with collective action, which involved participating in meetings to promote sex worker rights or attending HIV-related meetings/ talks with other sex workers. Social- and structural-level interventions focused on building social cohesion and social participation among sex workers could provide significant protection from HIV infection for female sex workers in Swaziland.

  9. Social Cohesion, Social Participation, and HIV Related Risk among Female Sex Workers in Swaziland

    PubMed Central

    Fonner, Virginia A.; Kerrigan, Deanna; Mnisi, Zandile; Ketende, Sosthenes; Kennedy, Caitlin E.; Baral, Stefan

    2014-01-01

    Social capital is important to disadvantaged groups, such as sex workers, as a means of facilitating internal group-related mutual aid and support as well as access to broader social and material resources. Studies among sex workers have linked higher social capital with protective HIV-related behaviors; however, few studies have examined social capital among sex workers in sub-Saharan Africa. This cross-sectional study examined relationships between two key social capital constructs, social cohesion among sex workers and social participation of sex workers in the larger community, and HIV-related risk in Swaziland using respondent-driven sampling. Relationships between social cohesion, social participation, and HIV-related risk factors were assessed using logistic regression. HIV prevalence among the sample was 70.4% (223/317). Social cohesion was associated with consistent condom use in the past week (adjusted odds ratio [AOR]  = 2.25, 95% confidence interval [CI]: 1.30–3.90) and was associated with fewer reports of social discrimination, including denial of police protection. Social participation was associated with HIV testing (AOR = 2.39, 95% CI: 1.36–4.03) and using condoms with non-paying partners (AOR = 1.99, 95% CI: 1.13–3.51), and was inversely associated with reported verbal or physical harassment as a result of selling sex (AOR = 0.55, 95% CI: 0.33–0.91). Both social capital constructs were significantly associated with collective action, which involved participating in meetings to promote sex worker rights or attending HIV-related meetings/ talks with other sex workers. Social- and structural-level interventions focused on building social cohesion and social participation among sex workers could provide significant protection from HIV infection for female sex workers in Swaziland. PMID:24498125

  10. Sexuality Education in Rural Lesotho Schools: Challenges and Possibilities

    ERIC Educational Resources Information Center

    Khau, Mathabo

    2012-01-01

    The aim of this paper is to present and discuss some of the obstacles to effective sexuality education in rural Lesotho schools and offer some suggestions that could facilitate positive change in the current status of sexuality education. The call for education as a "vaccine" against new HIV infections places teachers at the forefront of…

  11. Women's rights, the family, and organisational culture: a Lesotho case study.

    PubMed

    Everett, E

    1997-02-01

    Traditional cultural norms have had significant implications for the work and internal structure of Lesotho Save the Children (LSC). From 1964-90, the organization's work focused entirely on the needs of neglected and abandoned boys, for whom it provided residential care. After consultation with the Department of Social Welfare, it was decided to make the residential center a haven for girls as well as boys in need of protection. Many girls in Lesotho experience physical and sexual abuse within their families; moreover, daughters in poor families are often placed in households of wealthier extended family as domestics, where further abuse occurs. Cultural discomfort acknowledging and discussing sexuality extended to Children's Village staff responsible for the care of child rape victims. Coercive sex is often a prelude to marriage in Lesotho, where many women are kidnapped and raped by their prospective bridegrooms. In-service training has enabled staff to overcome their reticence regarding sexual issues and view rape as a criminal act. Although LSC is unable to challenge the oppression of women and children implicit in the traditional family, it continues to encourage girls and women to protest sexual violence, the abuse of their daughters, and the unequal distribution of labor within the family. All children in the LSC residence perform both male- and female-defined duties and attempts are being made to reduce the division of labor among staff in which females are caretakers and males are authority figures.

  12. The Lesotho Hospital PPP experience: catalyst for integrated service delivery.

    PubMed

    Coelho, Carla Faustino; O'Farrell, Catherine Commander

    2011-01-01

    For many years, Lesotho urgently needed to replace its main public hospital, Queen Elizabeth II. The project was initially conceived as a single replacement hospital, but eventually included the design and construction of a new 425 bed public hospital and adjacent primary care clinic, the renovation and expansion of three strategically located primary care clinics in the region and the management of all facilities, equipment and delivery of all clinical services in the health network by a private operator under contract for 18 years. The project's design was influenced by the recognition that a new facility alone would not address the underlying issues in service provision. The creation of this PPP health network and the contracting mechanism has increased accountability for service quality, shifted Government to a more strategic role and may also benefit other public facilities and providers in Lesotho. The county is considering the PPP approach for other health facilities.

  13. Men's and women's experiences with HIV and stigma in Swaziland.

    PubMed

    Shamos, Sara; Hartwig, Kari A; Zindela, Nomsa

    2009-12-01

    To explore how gender differentially affects the stigma experiences of people living with HIV (PLHIV) in Swaziland, the extent and dimensions of HIV-related felt and enacted stigma and social support were analyzed. Thirty-seven semistructured, face-to-face interviews were conducted with PLHIV in Swaziland between 2004 and 2006. Through the process of conceptual analysis, themes, including felt stigma, information management, enacted stigma, and social support, were explored, coded, and analyzed in the contexts of partner and familial relationships, and workplace and neighborhood settings. Findings revealed that there were high levels of felt stigma in all contexts, yet fewer than anticipated accounts of enacted stigma in family, work, and neighborhood contexts compared to their expressions of felt stigma. The amount and characteristics of felt and enacted stigma and social support differed based on gender, as women often experienced more felt and enacted stigma than men, and had less definite financial or emotional support.

  14. Herder Identity in Lesotho: Implications for Non-Formal Education

    ERIC Educational Resources Information Center

    Pitikoe, Selloane; Preece, Julia

    2016-01-01

    This paper reports on selective findings from a larger qualitative PhD study of 30 adult herders in Lesotho. It uses theories of identity and social capital to examine their life histories and educational needs in order to inform the national Non-Formal Education (NFE) policy. The key findings of the study were that the herders demonstrated two…

  15. The Lesotho Curriculum and Assessment Policy: Opportunities and Threats

    ERIC Educational Resources Information Center

    Raselimo, Mohaeka; Mahao, Mahao

    2015-01-01

    The end of British colonial rule in 1966 provided an impetus for curriculum reform in Lesotho. Since then, a number of curriculum and assessment reforms have been attempted, albeit with a little success. In all cases, the aim has been to achieve the goals of education for national development. The "Curriculum and Assessment Policy" 2009…

  16. Depression and Social Stigma Among MSM in Lesotho: Implications for HIV and Sexually Transmitted Infection Prevention.

    PubMed

    Stahlman, Shauna; Grosso, Ashley; Ketende, Sosthenes; Sweitzer, Stephanie; Mothopeng, Tampose; Taruberekera, Noah; Nkonyana, John; Baral, Stefan

    2015-08-01

    Social stigma is common among men who have sex with men (MSM) across Sub-Saharan Africa, and may influence risks for HIV and sexually transmitted infections (STIs) via its association with depression. We conducted a cross-sectional study of 530 MSM in Lesotho accrued via respondent-driven sampling. Using generalized structural equation models we examined associations between stigma, social capital, and depression with condom use and testing positive for HIV/STIs. Depression was positively associated with social stigma experienced or perceived as a result of being MSM. In contrast, increasing levels of social cohesion were negatively associated with depression. Social stigma was associated with testing positive for HIV; however, this association did not appear to be mediated by depression or condom use. These data suggest a need for integrated HIV and mental health care that addresses stigma and discrimination and facilitates positive social support for MSM.

  17. Depression and Social Stigma among MSM in Lesotho: Implications for HIV and Sexually Transmitted Infection Prevention

    PubMed Central

    Stahlman, Shauna; Grosso, Ashley; Ketende, Sosthenes; Sweitzer, Stephanie; Mothopeng, Tampose; Taruberekera, Noah; Nkonyana, John; Baral, Stefan

    2016-01-01

    Social stigma is common among men who have sex with men (MSM) across Sub-Saharan Africa, and may influence risks for HIV and sexually transmitted infections (STIs) via its association with depression. We conducted a cross-sectional study of 530 MSM in Lesotho accrued via respondent-driven sampling. Using generalized structural equation models we examined associations between stigma, social capital, and depression with condom use and testing positive for HIV/STIs. Depression was positively associated with social stigma experienced or perceived as a result of being MSM. In contrast, increasing levels of social cohesion were negatively associated with depression. Social stigma was associated with testing positive for HIV; however, this association did not appear to be mediated by depression or condom use. These data suggest a need for integrated HIV and mental health care that addresses stigma and discrimination and facilitates positive social support for MSM. PMID:25969182

  18. Religious and cultural traits in HIV/AIDS epidemics in sub-Saharan Africa.

    PubMed

    Velayati, Ali-Akbar; Bakayev, Valerii; Bahadori, Moslem; Tabatabaei, Seyed-Javad; Alaei, Arash; Farahbood, Amir; Masjedi, Mohammad-Reza

    2007-10-01

    prevalence range from 1.9% to 7%. Albeit being traced by origin to the central part of the continent, HIV has reached the highest rates in the South, particularly Malawi (14.2%), Zambia (16.5%), South Africa (21.5%), Zimbabwe (24.6%), Lesotho (28.9%), Botswana (37.3%), and Swaziland (38.8%)-all former British colonies with dominating Christian population. In the group ranking list, a distinct North to South oriented incline in HIV rates related to prevailing religion and previous colonial history of the country was found, endorsing the preventive role of the Islam against rising HIV and the increased vulnerability to menace in states with particular colonial record.

  19. Re-focusing the Gender Lens: Caregiving Women, Family Roles and HIV/AIDS Vulnerability in Lesotho

    PubMed Central

    Harrison, Abigail; Short, Susan E.; Tuoane-Nkhasi, Maletela

    2013-01-01

    Gender and HIV risk have been widely examined in southern Africa, generally with a focus on dynamics within sexual relationships. Yet the social construction of women’s lives reflects their broader engagement with a gendered social system, which influences both individual-level risks and social and economic vulnerabilities to HIV/AIDS. Using qualitative data from Lesotho, we examine women’s lived experiences of gender, family and HIV/AIDS through three domains: 1) marriage; 2) kinship and social motherhood, and 3) multigenerational dynamics. These data illustrate how women caregivers negotiate their roles as wives, mothers, and household heads, serving as the linchpins of a gendered family system that both affects, and is affected by, the HIV/AIDS epidemic. HIV/AIDS interventions are unlikely to succeed without attention to the larger context of women’s lives, namely their kinship, caregiving, and family responsibilities, as it is the family and kinship system in which gender, economic vulnerability and HIV risk are embedded. PMID:23686152

  20. Re-focusing the gender lens: caregiving women, family roles and HIV/AIDS vulnerability in Lesotho.

    PubMed

    Harrison, Abigail; Short, Susan E; Tuoane-Nkhasi, Maletela

    2014-03-01

    Gender and HIV risk have been widely examined in southern Africa, generally with a focus on dynamics within sexual relationships. Yet the social construction of women's lives reflects their broader engagement with a gendered social system, which influences both individual-level risks and social and economic vulnerabilities to HIV/AIDS. Using qualitative data from Lesotho, we examine women's lived experiences of gender, family and HIV/AIDS through three domains: (1) marriage; (2) kinship and social motherhood, and (3) multigenerational dynamics. These data illustrate how women caregivers negotiate their roles as wives, mothers, and household heads, serving as the linchpins of a gendered family system that both affects, and is affected by, the HIV/AIDS epidemic. HIV/AIDS interventions are unlikely to succeed without attention to the larger context of women's lives, namely their kinship, caregiving, and family responsibilities, as it is the family and kinship system in which gender, economic vulnerability and HIV risk are embedded.

  1. The impact of HIV and AIDS research: a case study from Swaziland

    PubMed Central

    2011-01-01

    Background Swaziland is experiencing the world’s worst HIV and AIDS epidemic. Prevalence rose from four percent of antenatal clinic attendees in 1992 to 42.6 percent in 2004. The Report ‘Reviewing ‘Emergencies’ for Swaziland: Shifting the Paradigm in a New Era’ published in 2007 bought together social and economic indicators. It built a picture of the epidemic as a humanitarian emergency, requiring urgent action from international organisations, donors, and governments. Following a targeted communications effort, the report was believed to have raised the profile of the issue and Swaziland - a success story for HIV and AIDS research. Methods Keen to understand how, where and why the report had an impact, Health Economics and HIV/AIDS Research Division commissioned an assessment to track and evaluate the influence of the research. This tapped into literature on the significance of understanding the research-to-policy interface. This paper outlines the report and its impact. It explores key findings from the assessment and suggests lessons for future research projects. Results The paper demonstrates that, although complex, and not without methodological issues, impact assessment of research can be of real value to researchers in understanding the research-to-policy interface. Conclusion Only by gaining insight into this process can researchers move forward in delivering effective research. PMID:21679390

  2. More than just talk: the framing of transactional sex and its implications for vulnerability to HIV in Lesotho, Madagascar and South Africa

    PubMed Central

    2011-01-01

    Background 'Transactional sex' was regarded by the mid-1990s as an important determinant of HIV transmission, particularly in sub-Saharan Africa. Little attention has been paid to what the terms used to denote transactional sex suggest about how it is understood. This study provides a nuanced set of descriptions of the meaning of transactional sex in three settings. Furthermore, we discuss how discourses around transactional sex suggest linkages to processes of globalization and hold implications for vulnerability to HIV. Methods The analysis in this article is based on three case studies conducted as part of a multi-country research project that investigated linkages between economic globalization and HIV. In this analysis, we contextualize and contrast the 'talk' about transactional sex through the following research methods in three study sites: descriptions revealed through semi-structured interviews with garment workers in Lesotho; focus groups with young women and men in Antananarivo, Madagascar; and focus groups and in-depth interviews with young women and men in Mbekweni, South Africa. Results Participants' talk about transactional sex reveals two themes: (1) 'The politics of differentiation' reflects how participants used language to demarcate identities, and distance themselves from contextually-based marginalized identities; and (2) 'Gender, agency and power' describes how participants frame gendered-power within the context of transactional sex practices, and reflects on the limitations to women's power as sexual agents in these exchanges. Talk about transactional sex in our study settings supports the assertion that emerging transactional sexual practices are linked with processes of globalization tied to consumerism. Conclusions By focusing on 'talk' about transactional sex, we locate definitions of transactional sex, and how terms used to describe transactional sex are morally framed for people within their local context. We take advantage of an

  3. When patients fail UNAIDS' last 90 - the "failure cascade" beyond 90-90-90 in rural Lesotho, Southern Africa: a prospective cohort study.

    PubMed

    Labhardt, Niklaus Daniel; Ringera, Isaac; Lejone, Thabo Ishmael; Cheleboi, Molisana; Wagner, Sarah; Muhairwe, Josephine; Klimkait, Thomas

    2017-07-19

    HIV-infected individuals on first-line antiretroviral therapy (ART) in resource-limited settings who do not achieve the last "90" (viral suppression) enter a complex care cascade: enhanced adherence counselling (EAC), repetition of viral load (VL) and switch to second-line ART aiming to achieve resuppression. This study describes the "failure cascade" in patients in Lesotho. Patients aged ≥16 years on first-line ART at 10 facilities in rural Lesotho received a first-time VL in June 2014. Those with VL ≥80 copies/mL were included in a cohort. The care cascade was assessed at four points: attendance of EAC, result of follow-up VL after EAC, switch to second-line in case of sustained unsuppressed VL and outcome 18 months after the initial unsuppressed VL. Multivariate logistic regression was used to assess predictors of being retained in care with viral resuppression at follow-up. Out of 1563 patients who underwent first-time VL, 138 (8.8%) had unsuppressed VL in June 2014. Out of these, 124 (90%) attended EAC and 116 (84%) had follow-up VL (4 died, 2 transferred out, 11 lost, 5 switched to second-line before follow-up VL). Among the 116 with follow-up VL, 36 (31%) achieved resuppression. Out of the 80 with sustained unsuppressed VL, 58 were switched to second-line, the remaining continued first line. At 18 months' follow-up in December 2015, out of the initially 138 with unsuppressed VL, 56 (41%) were in care and virally suppressed, 37 (27%) were in care with unsuppressed VL and the remaining 45 (33%) were lost, dead, transferred to another clinic or without documented VL. Achieving viral resuppression after EAC (adjusted odds ratio (aOR): 5.02; 95% confidence interval: 1.14-22.09; p  = 0.033) and being switched to second-line in case of sustained viremia after EAC (aOR: 7.17; 1.90-27.04; p  = 0.004) were associated with being retained in care and virally suppressed at 18 months of follow-up. Age, gender, education, time on ART and level of VL were not

  4. Food Insufficiency Is Associated with High-Risk Sexual Behavior among Women in Botswana and Swaziland

    PubMed Central

    Weiser, Sheri D; Leiter, Karen; Bangsberg, David R; Butler, Lisa M; Percy-de Korte, Fiona; Hlanze, Zakhe; Phaladze, Nthabiseng; Iacopino, Vincent; Heisler, Michele

    2007-01-01

    Background Both food insufficiency and HIV infection are major public health problems in sub-Saharan Africa, yet the impact of food insufficiency on HIV risk behavior has not been systematically investigated. We tested the hypothesis that food insufficiency is associated with HIV transmission behavior. Methods and Findings We studied the association between food insufficiency (not having enough food to eat over the previous 12 months) and inconsistent condom use, sex exchange, and other measures of risky sex in a cross-sectional population-based study of 1,255 adults in Botswana and 796 adults in Swaziland using a stratified two-stage probability design. Associations were examined using multivariable logistic regression analyses, clustered by country and stratified by gender. Food insufficiency was reported by 32% of women and 22% of men over the previous 12 months. Among 1,050 women in both countries, after controlling for respondent characteristics including income and education, HIV knowledge, and alcohol use, food insufficiency was associated with inconsistent condom use with a nonprimary partner (adjusted odds ratio [AOR] 1.73, 95% confidence interval [CI] 1.27–2.36), sex exchange (AOR 1.84, 95% CI 1.74–1.93), intergenerational sexual relationships (AOR 1.46, 95% CI 1.03–2.08), and lack of control in sexual relationships (AOR 1.68, 95% CI 1.24–2.28). Associations between food insufficiency and risky sex were much attenuated among men. Conclusions Food insufficiency is an important risk factor for increased sexual risk-taking among women in Botswana and Swaziland. Targeted food assistance and income generation programs in conjunction with efforts to enhance women's legal and social rights may play an important role in decreasing HIV transmission risk for women. PMID:17958460

  5. Removal of helminth eggs by centralized and decentralized wastewater treatment plants in South Africa and Lesotho: health implications for direct and indirect exposure to the effluents.

    PubMed

    Amoah, Isaac Dennis; Reddy, Poovendhree; Seidu, Razak; Stenström, Thor Axel

    2018-05-01

    Wastewater may contain contaminants harmful to human health; hence, there is the need for treatment before discharge. Centralized wastewater treatment systems are the favored treatment options globally, but these are not necessarily superior in reduction of pathogens as compared to decentralized wastewater treatment systems (collectively called DEWATS). This study was therefore undertaken to assess the soil-transmitted helminth (STH) and Taenia sp. egg reduction efficiency of selected anaerobic baffled reactors and planted gravel filters compared to centralized wastewater treatment plants in South Africa and Lesotho. The risk of ascariasis with exposure to effluents from the centralized wastewater treatment plants was also assessed using the quantitative microbial risk assessment (QMRA) approach. Eggs of Ascaris spp., hookworm, Trichuris spp., Taenia spp., and Toxocara spp. were commonly detected in the untreated wastewater. The DEWATS plants removed between 95 and 100% of the STH and Taenia sp. eggs, with centralized plants removing between 67 and 100%. Helminth egg concentrations in the final effluents from the centralized wastewater treatment plants were consistently higher than those in the WHO recommended guideline (≤ 1 helminth egg/L) for agricultural use resulting in higher risk of ascariasis. Therefore, in conclusion, DEWATS plants may be more efficient in reducing the concentration of helminth eggs in wastewater, resulting in lower risks of STH infections upon exposure.

  6. Situating the Lesotho Secondary School Geography in Curriculum Relevance Debate

    ERIC Educational Resources Information Center

    Raselimo, Mohaeka

    2017-01-01

    The issue of curriculum relevance has attracted attention of academics and the general public in Lesotho where there are social, economic, environmental and political challenges confronting the society. To address these challenges education, through various school subjects, is expected to play a pivotal role. However, there are concerns that the…

  7. Lived Experiences of Parents of Children with Disabilities in Swaziland

    ERIC Educational Resources Information Center

    Thwala, S'lungile K.; Ntinda, Kayi; Hlanze, Buyisile

    2015-01-01

    Raising a child with disability is a challenge to most parents. The study explored the lived experiences of parents of children with disabilities in Swaziland. The specific objective was to determine the challenges which parents of children with disability encounter at home, school and community, which may hinder them to work collaboratively with…

  8. Community health workers in Lesotho: Experiences of health promotion activities.

    PubMed

    Seutloali, Thato; Napoles, Lizeka; Bam, Nomonde

    2018-02-27

    Lesotho adopted primary health care in 1979, and community health workers (CHWs) were included in the programme to focus on health promotion, particularly to reach people in underserved rural areas. Although the CHW programme has been successful, the heavy burden of disease because of HIV and/or AIDS and tuberculosis shifted resources from health promotion to home-based care. The study explored the lived experience of CHWs in conducting health promotion activities in Lesotho. The study was conducted in four health centres in Berea district, Lesotho. A qualitative study was conducted using an interviewer guide translated from English into Sesotho for four CHW focus group discussions, four individual interviews of key informants and four semi-structured interviews with the health centre nurses. The roles of CHWs in health promotion ranged from offering basic first aid and home-based care to increasing access to health care services by taking patients to the facilities and promoting behaviour change through health education. Their perceived successes included increased access to health care services and reduced mortality rates. CHW challenges involved their demotivation to carry out their work because of lack of or inconsistent financial incentives and supplies, work overload which compromises quality of their work and limited community involvement. This study concludes that CHWs are beneficial to health promotion and its various activities. They had a clear understanding of their roles and responsibilities, although they did not fully comprehend that what they were describing was, in fact, health promotion. When it came to advocacy, CHWs did not fully understand it, nor did they consider it as part of their roles, although they acknowledged its importance. Their role of increasing access to health care services by accompanying patients to the facilities has increased considerably because of changes in disease burden. This is affecting their ability to practise other

  9. New material and revision of Melanorosaurus thabanensis, a basal sauropodomorph from the Upper Triassic of Lesotho

    PubMed Central

    Allain, Ronan

    2016-01-01

    Melanorosaurus is a genus of basal sauropodomorph that currently includes two species from Southern Africa. In this paper, we redescribe the holotype femur of Melanorosaurus thabanensis from the Elliot Formation of Lesotho, as well as associated remains. The stratigraphic position of this taxon is reviewed, and it is clear that it comes from the Lower Elliot Formation being, therefore, Late Triassic in age, and not Early Jurassic as originally described. The knowledge of the anatomy of the basal sauropodomorph of Thabana Morena is enhanced by the description of six new skeletal elements from the type locality. The femur and the ilium from Thabana Morena are diagnostic and characterized by unusual proportions. The first phylogenetic analysis including both this specimen and Melanorosaurus is conducted. This analysis leads to the conclusion that the femur described in the original publication of Melanorosaurus thabanensis can no longer be referred to Melanorosaurus. For these reasons, we hereby create Meroktenos gen. nov. to encompass Meroktenos thabanensis comb. nov. PMID:26855874

  10. Reconsidering the orphan problem: the emergence of male caregivers in Lesotho.

    PubMed

    Block, Ellen

    2016-01-01

    Care for AIDS orphans in southern Africa is frequently characterized as a "crisis", where kin-based networks of care are thought to be on the edge of collapse. Yet these care networks, though strained by AIDS, are still the primary mechanisms for orphan care, in large part because of the essential role grandmothers play in responding to the needs of orphans. Ongoing demographic shifts as a result of HIV/AIDS and an increasingly feminized labor market continue to disrupt and alter networks of care for orphans and vulnerable children. This paper examines the emergence of a small but growing number of male caregivers who are responding to the needs of the extended family. While these men are still few in number, the strength of gendered ideologies of female care means that this group of men is socially, if not statistically significant. Men continue to be considered caregivers of last resort, but their care will close a small but growing gap that threatens to undermine kin-based networks of care in Lesotho and across the region. The adaptation of gender roles reinforces the strength and resilience of kinship networks even when working against deeply entrenched ideas about gendered division of domestic labor.

  11. Where to deploy pre-exposure prophylaxis (PrEP) in sub-Saharan Africa?

    PubMed

    Verguet, Stéphane; Stalcup, Meg; Walsh, Julia A

    2013-12-01

    Two randomised controlled trials showed that pre-exposure prophylaxis (PrEP) reduces HIV transmission between heterosexual men and women. We model the potential impact on transmission and cost-effectiveness of providing PrEP in sub-Saharan Africa. We use a deterministic, compartmental model of HIV transmission to evaluate the potential of a 5-year PrEP intervention targeting the adult population of 42 sub-Saharan African countries. We examine the incremental impact of adding PrEP at pre-existing levels of male circumcision and antiretroviral therapy (ART). The base case assumes efficacy of 68%; adherence at 80%; country coverage at 10% of the HIV-uninfected adult population; and annual costs of PrEP and ART at US$200 and US$880 per person, respectively. After 5 years, 390,000 HIV infections (95% UR 190,000 to 630,000) would be prevented, 24% of these in South Africa. HIV infections averted per 100 000 people (adult) would range from 500 in Lesotho to 10 in Somalia. Incremental cost-effectiveness would be US$5800/disability-adjusted life year (DALY) (95% UR 3100 to 13500). Cost-effectiveness would range from US$500/DALY in Lesotho to US$44 600/DALY in Eritrea. In a general adult population, PrEP is a high-cost intervention which will have maximum impact and be cost-effective only in countries that have high levels of HIV burden and low levels of male circumcision in the population. Hence, PrEP will likely be most effective in Southern Africa as a targeted intervention added to existing strategies to control the HIV pandemic.

  12. The implementation of a global fund grant in Lesotho: applying a framework on knowledge absorptive capacity.

    PubMed

    Biesma, Regien; Makoa, Elsie; Mpemi, Regina; Tsekoa, Lineo; Odonkor, Philip; Brugha, Ruairi

    2012-02-01

    One of the biggest challenges in scaling up health interventions in sub-Saharan Africa for government recipients is to effectively manage the rapid influx of aid from different donors, each with its own requirements and conditions. However, there is little empirical evidence on how governments absorb knowledge from new donors in order to satisfy their requirements. This case study applies Cuellar and Gallivan's (2006) framework on knowledge absorptive capacity (AC) to illustrate how recipient government organisations in Lesotho identified, assimilated and utilised knowledge on how to meet the disbursement and reporting requirements of Lesotho's Round 5 grant from the Global Fund to Fight AIDS, TB and Malaria (Global Fund). In-depth topic guided interviews with 22 respondents and document reviews were conducted between July 2008 and February 2009. Analysis focused on six organisational determinants that affect an organisation's absorptive capacity: prior-related knowledge, combinative capabilities, motivation, organisational structure, cultural match, and communication channels. Absorptive capacity was mostly evident at the level of the Principal Recipient, the Ministry of Finance, who established a new organisational unit to meet the requirements of Global Fund Grants, while the level of AC was less advanced among the Ministry of Health (Sub-Recipient) and district level implementers. Recipient organisations can increase their absorptive capacity, not only through prior knowledge of donor requirements, but also by deliberately changing their organisational form and through combinative capabilities. The study also revealed how vulnerable African governments are to loss of staff capacity. The application of organisational theory to analyse the interactions of donor agencies with public and non-public country stakeholders illustrates the complexity of the environment that aid recipient governments have to manage. Copyright © 2011 Elsevier Ltd. All rights reserved.

  13. "Free Primary Education" in Lesotho and the Disadvantages of the Highlands

    ERIC Educational Resources Information Center

    Urwick, James

    2011-01-01

    This article explores the effects of national policies associated with "Education for All" on a disadvantaged region, the highlands of Lesotho. Since 2000 a programme of "Free Primary Education" has improved the position of the highlands in access to primary schooling; nevertheless, highland primary schools compare poorly with…

  14. As Ye Sow, So Shall Ye Reap: From Consultant to Collaborator in the Development of a Teacher Preparation Program in Lesotho.

    ERIC Educational Resources Information Center

    Rothenberg, Julia Johnson

    This paper reports on the author's 4-week consultation with faculty of the Lesotho National Teachers College as part of the Primary Education Project which provided technical assistance with issues of primary age schooling in the Kingdom of Lesotho. The consultant worked with 12 faculty members of the National Teachers College in a process that…

  15. The Effectiveness of Mentoring in the Distance Teacher Education Programme at the Lesotho College of Education: Student Teachers' and Tutors' Perceptions

    ERIC Educational Resources Information Center

    Mohono-Mahlatsi, Lydia; van Tonder, Fanus

    2006-01-01

    In response to the need for more qualified primary school teachers in Lesotho, the Lesotho College of Education (LCE) introduced the Distance Teacher Education Programme (DT EP), an in-service training programme for unqualified and underqualified teachers. As part of the curriculum in this programme, the more than 1 200 student teachers who were…

  16. Detrital minerals from source to sink : tracing Orange River sand from Lesotho to Angola

    NASA Astrophysics Data System (ADS)

    Garzanti, Eduardo; Vermeesch, Pieter; Andò, Sergio; Resentini, Alberto; Vezzoli, Giovanni; Lustrino, Michele; Padoan, Marta; Pereira, Alcides

    2015-04-01

    Quantitative provenance analysis based on high-resolution bulk-petrography and heavy-mineral data on beach and dune sands, integrated with detrital-zircon geochronology and chemical analyses of pyroxene, garnet and staurolite, demonstrates that sand carried by the Orange River and derived from Lesotho and South Africa is carried by powerful and persistent longshore currents as far as southern Angola (Garzanti et al., 2014a). This is the longest cell of littoral sand transport documented so far on Earth, and a great test case for investigating physical controls on sand texture and composition. We have monitored textural, mineralogical and geochemical variability of beach and eolian-dune sands along a 1750 km stretch of the Atlantic coast of southern Africa by using an integrated set of techniques, including image analysis, laser granulometry, optical microscopy, Raman spectroscopy and bulk-sediment geochemistry (Garzanti et al., 2014b). Our results contrast with previous reports that feldspars and volcanic detritus break down during transport, that sand grains are rounded rapidly in shallow-marine environments, and that quartzose sands may be produced by physical processes alone. We demonstrate that basaltic rock fragments and pyroxenes, traditionally believed to be rapidly destroyed, survive healthily the 4000 km-long multistep hazardous journey from Lesotho volcanic highlands to Angola. Feldspar abundance remains remarkably constant from the Orange mouth to southern Angola, and quartz increases only very slightly, possibly as a result of local recycling. Among sedimentary and metasedimentary rock fragments, unconsolidated or strongly foliated types are readily comminuted when they enter the high-energy marine environment, but cemented sandstone/siltstone grains can survive the travel from the Karoo Basin of South Africa to northern Namibia and beyond. No detrital mineral displays a significant increase in grain roundness after 300-350 km of longshore transport in

  17. Tobacco use and mass media utilization in sub-Saharan Africa.

    PubMed

    Achia, Thomas N O

    2015-01-01

    Media utilization has been identified as an important determinant of tobacco use. We examined the association between self-reported tobacco use and frequency of mass media utilization by women and men in nine low-to middle-income sub-Saharan African countries. Data for the study came from Demographic and Health Surveys conducted in Burkina Faso, Ethiopia, Liberia, Lesotho, Malawi, Swaziland, Uganda, Zambia and Zimbabwe over the period 2006-2011. Each survey population was a cross-sectional sample of women aged 15-49 years and men aged 15-59 years, with information on tobacco use and media access being obtained by face-to-face interviews. An index of media utilization was constructed based on responses to questions on the frequency of reading newspapers, frequency of watching television and frequency of listening to the radio. Demographic and socioeconomic variables were considered as potentially confounding covariates. Logistic regression models with country and cluster specific random effects were estimated for the pooled data. The risk of cigarette smoking increased with greater utilization to mass media. The use of smokeless tobacco and tobacco use in general declined with greater utilization to mass media. The risk of tobacco use was 5% lower in women with high media utilization compared to those with low media utilization [Adjusted Odds Ratio (AOR) = 0.95, 95% confidence interval (CI):0.82-1.00]. Men with a high media utilization were 21% less likely to use tobacco compared to those with low media utilization [AOR = 0.79, 95%CI = 0.73-0.85]. In the male sample, tobacco use also declined with the increased frequency of reading newspapers (or magazines), listening to radio and watching television. Mass media campaigns, conducted in the context of comprehensive tobacco control programmes, can reduce the prevalence of tobacco smoking in sub-Saharan Africa. The reach, intensity, duration and type of messages are important aspects of the campaigns but need to also

  18. Travel patterns and demographic characteristics of malaria cases in Swaziland, 2010-2014.

    PubMed

    Tejedor-Garavito, Natalia; Dlamini, Nomcebo; Pindolia, Deepa; Soble, Adam; Ruktanonchai, Nick W; Alegana, Victor; Le Menach, Arnaud; Ntshalintshali, Nyasatu; Dlamini, Bongani; Smith, David L; Tatem, Andrew J; Kunene, Simon

    2017-09-08

    As Swaziland progresses towards national malaria elimination, the importation of parasites into receptive areas becomes increasingly important. Imported infections have the potential to instigate local transmission and sustain local parasite reservoirs. Travel histories from Swaziland's routine surveillance data from January 2010 to June 2014 were extracted and analysed. The travel patterns and demographics of rapid diagnostic test (RDT)-confirmed positive cases identified through passive and reactive case detection (RACD) were analysed and compared to those found to be negative through RACD. Of 1517 confirmed cases identified through passive surveillance, 67% reported travel history. A large proportion of positive cases reported domestic or international travel history (65%) compared to negative cases (10%). The primary risk factor for malaria infection in Swaziland was shown to be travel, more specifically international travel to Mozambique by 25- to 44-year old males, who spent on average 28 nights away. Maputo City, Inhambane and Gaza districts were the most likely travel destinations in Mozambique, and 96% of RDT-positive international travellers were either Swazi (52%) or Mozambican (44%) nationals, with Swazis being more likely to test negative. All international travellers were unlikely to have a bed net at home or use protection of any type while travelling. Additionally, paths of transmission, important border crossings and means of transport were identified. Results from this analysis can be used to direct national and well as cross-border targeting of interventions, over space, time and by sub-population. The results also highlight that collaboration between neighbouring countries is needed to tackle the importation of malaria at the regional level.

  19. Reactive case detection for malaria elimination: real-life experience from an ongoing program in Swaziland.

    PubMed

    Sturrock, Hugh J W; Novotny, Joe M; Kunene, Simon; Dlamini, Sabelo; Zulu, Zulisile; Cohen, Justin M; Hsiang, Michelle S; Greenhouse, Bryan; Gosling, Roly D

    2013-01-01

    As countries move towards malaria elimination, methods to identify infections among populations who do not seek treatment are required. Reactive case detection, whereby individuals living in close proximity to passively detected cases are screened and treated, is one approach being used by a number of countries including Swaziland. An outstanding issue is establishing the epidemiologically and operationally optimal screening radius around each passively detected index case. Using data collected between December 2009 and June 2012 from reactive case detection (RACD) activities in Swaziland, we evaluated the effect of screening radius and other risk factors on the probability of detecting cases by reactive case detection. Using satellite imagery, we also evaluated the household coverage achieved during reactive case detection. Over the study period, 250 cases triggered RACD, which identified a further 74 cases, showing the value of RACD over passive surveillance alone. Results suggest that the odds of detecting a case within the household of the index case were significantly higher than in neighbouring households (odds ratio (OR) 13, 95% CI 3.1-54.4). Furthermore, cases were more likely to be detected when RACD was conducted within a week of the index presenting at a health facility (OR 8.7, 95% CI 1.1-66.4) and if the index household had not been sprayed with insecticide (OR sprayed vs not sprayed 0.11, 95% CI 0.03-0.46). The large number of households missed during RACD indicates that a 1 km screening radius may be impractical in such resource limited settings such as Swaziland. Future RACD in Swaziland could be made more effective by achieving high coverage amongst individuals located near to index cases and in areas where spraying has not been conducted. As well as allowing the programme to implement RACD more rapidly, this would help to more precisely define the optimal screening radius.

  20. Good governance and budget reform in Lesotho Public Hospitals: performance, root causes and reality.

    PubMed

    Vian, Taryn; Bicknell, William J

    2014-09-01

    Lesotho has been implementing financial management reforms, including performance-based budgeting (PBB) since 2005 in an effort to increase accountability, transparency and effectiveness in governance, yet little is known about how these efforts are affecting the health sector. Supported by several development partners and $24 million in external resources, the PBB reform is intended to strengthen government capacity to manage aid funds directly and to target assistance to pressing social priorities. This study designed and tested a methodology for measuring implementation progress for PBB reform in the hospital sector in Lesotho. We found that despite some efforts on the national level to promote and support reform implementation, staff at the hospital level were largely unaware of the purpose of the reform and had made almost no progress in transforming institutions and systems to fully realize reform goals. Problems can be traced to a complex reform design, inadequate personnel and capacity to implement, professional boundaries between financial and clinical personnel and weak leadership. The Lesotho reform experience suggests that less complex designs for budget reform, better adapted to the context and realities of health sectors in developing countries, may be needed to improve governance. It also highlights the importance of measuring reform implementation at the sectoral level. Published by Oxford University Press in association with The London School of Hygiene and Tropical Medicine © The Author 2013; all rights reserved.

  1. The Effects of Bullying on Teenage Girls in Swaziland High Schools

    ERIC Educational Resources Information Center

    Tshotsho, Nokwanda; Thwala, S'lungile K.

    2015-01-01

    The purpose of this study was to investigate the characteristics that make teenage girls vulnerable to bullying in high schools in the Manzini region of Swaziland. It determined how personality traits of victims of different parenting styles contribute to adolescent girls being bullied. The findings of the study revealed that bullying is very rife…

  2. Women, customary law and equality: lessons from research in southern Africa.

    PubMed

    Armstrong, A

    1994-03-01

    The Women and Law in Southern Africa Research Project (WSLA) has concluded, after 6 years of study in Zimbabwe, Zambia, Swaziland, Mozambique, Lesotho, and Botswana, that the deconstruction of customary law rather than an emphasis on the concept of equality represents the most promising strategy for producing justice for women. An historical analysis indicates that customary law was, before colonialism, a family-centered, flexible system of law that favored the negotiation and settlement of disputes rather than a rigid state-centered application of a rule. Traditionally, the unifying value base of customary law was preservation of the family and protection of women and children. Marriage was viewed as a joint partnership rather than a guardian-minor relationship. Polygyny, which today constitutes a source of female subordination, was originally developed to provide the protection of marriage to women at a time when there were not enough men to go around and an unmarried woman was vulnerable. Moreover, under true customary law, family property was the norm and widows remained on the land. The responsiveness of true customary law to changing socioeconomic conditions is illustrated by the newly developed practice of Chiefs in Botswana to allow women to speak and represent themselves in court; another example is the Chief's modification of seduction damages law to stipulate payment directly to the young mother rather than to her parents. After the introduction of colonialism, customary law was reconstructed to serve the political interests of capital; even now, post-independence governments use the law as a tool to oppress women. WLSA research suggests that an emphasis on gender-neutral, equality-based laws and statutes can lead to the further oppression of women. For example, such laws have made unemployed divorced women responsible for the maintenance of their ex-husband, and could be used to promote women, as well as men, having several spouses. Needed instead is an

  3. Pioneering new approaches. Educating girls in Africa.

    PubMed

    Namuddu, K

    1993-01-01

    In Africa, the education of girls has varied with the history and development of countries. For instance, botswana, Lesotho, and Swaziland have higher enrollment of girls than boys, and in Nigeria the dropout rate for boys is higher than for girls. In Mozambique, girl's education is dependent on matrilineal or patrilineal family structure, urban or rural location, or religious preference. These and many other factors interfere with girl's access, survival, performance, and achievement in school. Strategies generally involve 1) improving access and increasing enrollment, 2) increasing survival in the school system, and 3) improving the quality of the learning environment. Most African countries are involved with the first strategy, but problems remain in selecting the appropriate age to begin school, retaining students and teachers, lowering absenteeism, providing adequate and appropriate teaching materials for students, and other factors that discourage female attendance. Solutions have involved establishing book banks and cardboard box libraries as a supplement to classroom learning. Gender stereotypes in curriculum materials are being introduced which show females in a positive and prominent way. In Zambia, an in-service training program aims to develop positive teacher attitudes toward girls, toward their work, and toward pupil's work. Program efforts in Kenya are attempting to educate parents about the importance of keeping their daughters in school, and about issues related to population, health, education, and a healthy environment. Traditional practices such as female circumcision, childhood marriages, early pregnancy, and nutritional taboos are discouraged. There are 43 district coordinators who conduct seminars and workshops to spread information to communities and households. Other countries are engaged in village meetings and workshops to persuade parents to examine their own interpersonal interaction with their daughters and the impact on their

  4. The first megatheropod tracks from the Lower Jurassic upper Elliot Formation, Karoo Basin, Lesotho

    PubMed Central

    Bordy, E. M.; Abrahams, M.; Knoll, F.; McPhee, B. W.

    2017-01-01

    A palaeosurface with one megatheropod trackway and several theropod tracks and trackways from the Lower Jurassic upper Elliot Formation (Stormberg Group, Karoo Supergroup) in western Lesotho is described. The majority of the theropod tracks are referable to either Eubrontes or Kayentapus based on their morphological characteristics. The larger megatheropod tracks are 57 cm long and have no Southern Hemisphere equivalent. Morphologically, they are more similar to the Early Jurassic Kayentapus, as well as the much younger Upper Cretaceous ichnogenus Irenesauripus, than to other contemporaneous ichnogenera in southern Africa. Herein they have been placed within the ichnogenus Kayentapus and described as a new ichnospecies (Kayentapus ambrokholohali). The tracks are preserved on ripple marked, very fine-grained sandstone of the Lower Jurassic upper Elliot Formation, and thus were made after the end-Triassic mass extinction event (ETE). This new megatheropod trackway site marks the first occurrence of very large carnivorous dinosaurs (estimated body length >8–9 meters) in the Early Jurassic of southern Gondwana, an evolutionary strategy that was repeatedly pursued and amplified in the following ~135 million years, until the next major biotic crisis at the end-Cretaceous. PMID:29069093

  5. The impact of the declining extended family support system on the education of orphans in Lesotho

    PubMed Central

    Tanga, Pius T

    2013-01-01

    This paper examines the impact of the weakening of the extended family on the education of double orphans in Lesotho through in-depth interviews with participants from 3 of the 10 districts in Lesotho. The findings reveal that in Lesotho the extended family has not yet disintegrated as the literature suggests. However, it shows signs of rupturing, as many orphans reported that they are being taken into extended family households, the incentive for these households being, presumably, the financial and other material assistance that they receive from the government and non-governmental organisations (NGOs) which supplements household income and material wellbeing. The findings show that financial and other assistance given by the government and NGOs have resulted in conflict between the orphans and caregivers. This has also prompted many extended families to shift responsibilities to the government and NGOs. Most of the extended households provided the orphans with poor living conditions, such as unhygienic houses, poor nutrition, and little or no provision of school materials, which has had a negative impact on the education of the orphans. The combined effects of economic crisis and HIV and AIDS have resulted in extended families not being able to care for the needs of the orphans adequately, whilst continuing to accept them into their households. It is recommended that although extended families are still accepting orphans, the government should strengthen and recognise the important role played by families and the communities in caring for these vulnerable children. The government should also introduce social grants for orphans and other vulnerable children and review the current meagre public assistance (R100) it provides for orphans and vulnerable children in Lesotho. Other stakeholders should concentrate on strengthening the capacity of families and communities through programmes and projects which could be more sustainable than the current handouts given by

  6. Seeing the light: The SpecUP educational spectrophotometer

    NASA Astrophysics Data System (ADS)

    Forbes, P. B. C.

    2016-09-01

    Spectrophotometry is a cross-cutting analytical technique, which finds use in disciplines ranging from chemistry to pharmacy, biochemistry, food science and physics. The SpecUP (Spectrophotometer of the University of Pretoria) is an educational spectrophotometer which was developed so that students could build their own instruments from components in a kit, and then utilise it to generate analytically useful results. This initiative allows for institutions to have more spectroscopy equipment available, as the SpecUP costs less than 40 as opposed to 2 000 which is the cost of an entry-level commercial instrument. This is of particular importance in a developing country context, where student numbers are typically high and resources are scarce. In addition, the SpecUP has moving parts and an open design which allows users to understand what is inside the "black box" of commercial instruments and to discover what happens when they adjust components, allowing for active, inquiry-based learning. The SpecUP user network currently spans South Africa, Tunisia, Namibia, Lesotho, Botswana, Kenya, Swaziland, Zimbabwe, Zambia, Ivory Coast, Egypt, Turkey and Italy.

  7. Botswana and Swaziland: report links violations of women's rights to HIV.

    PubMed

    Krauss, Kate

    2007-12-01

    In May 2007, Physicians for Human Rights (PHR) released a report investigating the links between discriminatory views against women in Botswana and Swaziland and sexual risk-taking and, in turn, extremely high HIV prevalence in those countries. The report also examines the role of women's lack of political and economic power in those countries, and the connection to HIV infection.

  8. Multiple sexual partnerships and their correlates among Facebook users in Swaziland: an online cross-sectional study.

    PubMed

    Lukhele, Bhekumusa Wellington; Techasrivichien, Teeranee; Musumari, Patou Masika; El-Saaidi, Christina; Suguimoto, S Pilar; Ono-Kihara, Masako; Kihara, Masahiro

    2016-09-01

    Social networking sites (SNSs) have been suggested to facilitate risky sexual activities. However, it is unknown and of concern how SNSs such as Facebook shape risky sexual activities in developing settings such as Swaziland, the country hardest hit by HIV and AIDS. We conducted an online cross-sectional study in 2012 to explore the prevalence of multiple sexual partnerships (MSPs) and their correlates among Facebook users in Swaziland. The response rate was 44.1% (N = 882); relatively, an equal proportion of men 82.7% (341/414) and 82.9% (388/468) women had ever had sex. Of those sexually active, 44.9% of men and 30.7% of women reported having sex with someone they met on Facebook. Approximately half of the participants (61.6% men, 41.0% women and 50.6% total) reported MSPs over the past 12 months. Multiple logistic regression analysis revealed that time spent on Facebook, "finding it easier to initiate a romantic conversation on Facebook" and having had sex with someone met on Facebook were significantly associated with having MSPs (adjusted odds ratio = 1.6-3.8). The potential impact of risky sexual behaviour among Facebook users should be appropriately addressed particularly in high HIV-prevalent settings like Swaziland.

  9. A Knowledge, Attitudes, and Practices Survey of Water and Sanitation in Swaziland.

    ERIC Educational Resources Information Center

    Green, Edward C.

    The terms of agreement of the Rural Water-Borne Disease Control Project called for a knowledge, attitudes, and practices (KAP) study relating to water and sanitation in rural Swaziland. The purpose of the study was to provide: (1) baseline data for the design of a national health education strategy aimed at reducing the incidence of water-borne…

  10. Polygyny as myth. Towards understanding extramarital relations in Lesotho.

    PubMed

    Spiegel, A D

    1991-01-01

    The nature and extent of "bonyatsi" (marital infidelity) in Lesotho is presented through the images of population. Because the practice is not morally normative, it cannot be readily explained as part of an earlier custom or as arising from the exigencies of dependency on migrant labor, but as images of the past which are regarded as their own "traditional extramarital relations." This gives meaning and cultural continuity to the present practice, and legitimizes the experience without condoning it. Thus there can be ideological control over a practice which was the result of political economic constraints. The account is in the tradition of rehumanization of ethnography and relates folk explanations to notions of the past. It is based on the author's experiences in Lesotho from the early 1970s to the 1980s. The exercise exemplifies Malinowski's notion of myth as social charter and Spiegel's idea that reformulated traditions are a response to changes in modern practices. Extramarital relations appeared widespread throughout Lesotho, and Bonyatsi individuals could be easily identified in Qacha's Nek villages where the author lived. The practice was recognized as a normal state of affairs only in private rather than in a public forum. Folk songs made reference to it. Bonyatsi is the abstract form, while nyatsi means paramour of any gender and linyatsi is the plural. The definition is one of a relationship, which may be longterm, between already married persons. Gifts may be exchanged between linyatsi, but this is different from the prostitute, who is an unattached woman who loves anyone anytime usually in urban areas, or botekatse (prostitution). The origins of bonyatsi were explained as being part of the Creation and a feature of all human social life. The ministers explained that the practice was a result of labor migration that might last for as long as 2 years. Women argued that this absence of regular sexual intercourse created severe psychological effects such

  11. Threats to Inclusive Education in Lesotho: An Overview of Policy and Implementation Challenges

    ERIC Educational Resources Information Center

    Mosia, Paseka Andrew

    2014-01-01

    This study looks at how the education of Learners with Special Education Needs (LSEN) has developed in Lesotho as a result of international policies on human rights and education. In particular, it explores various challenges to inclusive education such as proper understanding of inclusive education, the development of a policy on special and…

  12. "There's No Place Like Home": Perceptions of Home-Based HIV Testing in Lesotho

    ERIC Educational Resources Information Center

    Mantell, J. E.; DiCarlo, A. L.; Remien, R. H.; Zerbe, A.; Morris, D.; Pitt, B.; Nkonyana, J. P.; Abrams, E. J.; El-Sadr, W.

    2014-01-01

    HIV testing has the potential to reduce HIV transmission by identifying and counseling individuals with HIV, reducing risk behaviors, linking persons with HIV to care and earlier treatment, and reducing perinatal transmission. In Lesotho, a high HIV prevalence country in which a large proportion of the population has never tested for HIV,…

  13. Situating experiences of HIV-related stigma in Swaziland.

    PubMed

    Root, R

    2010-01-01

    With the world's highest antenatal HIV prevalence rate (39.2%), Swaziland has also been described as among the most stigmatising. Yet, only recently was an anti-HIV stigma and discrimination (S&D) platform included in the government's National Multisectoral HIV and AIDS Policy. This study draws on a medical anthropological project in rural Swaziland to examine experiences of stigma among people living with HIV/AIDS (PLWH). Qualitative methods included a semi-structured questionnaire and interviews (n=40) to identify patterns of stigma across three domains: verbal, physical and social. Key informant interviews (n=5) were conducted with health personnel and support group leaders. Descriptive statistics were situated within a thematic analysis of open-ended content. Among the findings, participants reported extensive HIV-related rumouring (36.4%) and pejorative name-calling (37.5%). Nearly one in five (18.2%) could no longer partake of family meals. Homesteads, which are an organising principle of Swazi life, were often markedly stigmatising environments. In contrast to documented discrimination in health care settings, the health centre emerged as a space where PLWH could share information and support. Given the UNAIDS call for national partners to 'know your epidemic' by tracking the prevalence of HIV-related S&D, results from this study suggested that unless 'knowing your epidemic' includes the lived experiences of HIV stigma that blister into discernible patterns, effectiveness of national initiatives is likely to be limited. Multidisciplinary and locale-specific studies are especially well suited in examining the cultural dynamics of HIV stigma and in providing grounded data that deepen the impact of comprehensive HIV/AIDS policies and programming.

  14. Enrollment in HIV Care Two Years after HIV Diagnosis in the Kingdom of Swaziland: An Evaluation of a National Program of New Linkage Procedures.

    PubMed

    MacKellar, Duncan A; Williams, Daniel; Storer, Nosipho; Okello, Velephi; Azih, Charles; Drummond, Jennifer; Nuwagaba-Biribonwoha, Harriet; Preko, Peter; Morgan, Rebecca L; Dlamini, Makhosazana; Byrd, Johnita; Agolory, Simon; Baughman, Andrew L; McNairy, Margaret L; Sahabo, Ruben; Ehrenkranz, Peter

    2016-01-01

    To improve early enrollment in HIV care, the Swaziland Ministry of Health implemented new linkage procedures for persons HIV diagnosed during the Soka Uncobe male circumcision campaign (SOKA, 2011-2012) and the Swaziland HIV Incidence Measurement Survey (SHIMS, 2011). Abstraction of clinical records and telephone interviews of a retrospective cohort of HIV-diagnosed SOKA and SHIMS clients were conducted in 2013-2014 to evaluate compliance with new linkage procedures and enrollment in HIV care at 92 facilities throughout Swaziland. Of 1,105 clients evaluated, within 3, 12, and 24 months of diagnosis, an estimated 14.0%, 24.3%, and 37.0% enrolled in HIV care, respectively, after adjusting for lost to follow-up and non-response. Kaplan-Meier functions indicated lower enrollment probability among clients 14-24 (P = 0.0001) and 25-29 (P = 0.001) years of age compared with clients >35 years of age. At 69 facilities to which clients were referred for HIV care, compliance with new linkage procedures was low: referral forms were located for less than half (46.8%) of the clients, and few (9.6%) were recorded in the appointment register or called either before (0.3%) or after (4.9%) their appointment. Of over one thousand clients newly HIV diagnosed in Swaziland in 2011 and 2012, few received linkage services in accordance with national procedures and most had not enrolled in HIV care two years after their diagnosis. Our findings are a call to action to improve linkage services and early enrollment in HIV care in Swaziland.

  15. Challenges to polycentric governance of an international development project tackling land degradation in Swaziland.

    PubMed

    Orchard, Steven E; Stringer, Lindsay C

    2016-11-01

    To effectively address the drivers and impacts of land degradation requires polycentric governance systems that facilitate international development projects (IDPs). This paper analyses an IDP aiming to reduce land degradation in Swaziland. A longitudinal-style qualitative approach draws on repeat household surveys, semi-structured interviews and focus groups. We aim to identify the changes that have taken place since the departure of the IDP funders, and the subsequent dynamics between stakeholders. We: (1) chart the evolution of the institutional structures and processes of the IDP; and (2) assess community perceptions of IDP outcomes. Lack of meaningful participation at various stages of the PMC caused the project to lose momentum following the departure of the funders. We discuss these findings in relation to a polycentric approach, and identify how multi-stakeholder IDP can be facilitated as part of wider polycentric governance approaches to inform policies to combat land degradation within Swaziland and more widely.

  16. An Empirical Study of Stressors That Impinge on Teachers in Secondary Schools in Swaziland

    ERIC Educational Resources Information Center

    Okeke, C. I. O.; Dlamini, Ceasar C.

    2013-01-01

    This study employed the descriptive-correlation research design to determine whether secondary school teachers experience work-related stress. Participants included 239 teachers selected from schools in the Hhohho region of Swaziland. A questionnaire was used as the instrument to determine the level of work-related stress experienced by these…

  17. Sexual stigma and discrimination as barriers to seeking appropriate healthcare among men who have sex with men in Swaziland.

    PubMed

    Risher, Kathryn; Adams, Darrin; Sithole, Bhekie; Ketende, Sosthenes; Kennedy, Caitlin; Mnisi, Zandile; Mabusa, Xolile; Baral, Stefan D

    2013-11-13

    Same-sex practices and orientation are both stigmatized and criminalized in many countries across sub-Saharan Africa. This study aimed to assess the relationship of fear of seeking healthcare and disclosure of same-sex practices among a sample of men who have sex with men (MSM) in Swaziland with demographic, socio-economic and behavioural determinants. Three hundred and twenty-three men who reported having had anal sex with a man in the past year were recruited using respondent-driven sampling and administered a structured survey instrument. Asymptotically unbiased estimates of prevalence of stigma and human rights abuses generated using the RDSII estimator are reported with bootstrapped confidence intervals (CIs). Weighted simple and multiple logistic regressions of fear of seeking healthcare and disclosure of same-sex practices to a healthcare provider with demographic, social and behavioural variables are reported. Stigma was common, including 61.7% (95% CI=54.0-69.0%) reporting fear of seeking healthcare, 44.1% (95% CI=36.2-51.3%) any enacted stigma and 73.9% (95% CI=67.7-80.1%) any perceived social stigma (family, friends). Ever disclosing sexual practices with other men to healthcare providers was low (25.6%, 95% CI=19.2-32.1%). In multiple logistic regression, fear of seeking healthcare was significantly associated with: having experienced legal discrimination as a result of sexual orientation or practice (aOR=1.9, 95% CI=1.1-3.4), having felt like you wanted to end your life (aOR=2.0, 95% CI=1.2-3.4), having been raped (aOR=11.0, 95% CI=1.4-84.4), finding it very difficult to insist on condom use when a male partner does not want to use a condom (aOR=2.1, 95% CI=1.0-4.1) and having a non-Swazi nationality at birth (aOR=0.18, 95% CI=0.05-0.68). In multiple logistic regression, disclosure of same-sex practices to a healthcare provider was significantly associated with: having completed secondary education or more (aOR=5.1, 95% CI=2.5-10.3), having used a

  18. Bringing Water to a Lesotho Village: A Classroom Simulation. Water in Africa.

    ERIC Educational Resources Information Center

    Ray, Dany M.

    The Water in Africa Project was realized over a 2-year period by a team of Peace Corps volunteers, World Wise Schools (WWS) classroom teachers, and WWS staff members. As part of an expanded, detailed design, resources were collected from over 90 volunteers serving in African countries, photos and stories were prepared, and standards-based learning…

  19. Understanding Challenges Physics Teachers Come Across as They Implement Learner-Centred Approaches in Lesotho

    ERIC Educational Resources Information Center

    Qhobela, Makomosela; Moru, Eunice Kolitsoe

    2014-01-01

    Teacher-centred strategies have dominated most physics lessons in Lesotho. This study attempted to understand the contributing factors for the choice of teacher-centred teaching instead of learner-centred teaching with the goal of informing a professional development programme designed to address this problem. The paper responds to the research…

  20. Rural Teachers' Views: What Are Gender-Based Challenges Facing Free Primary Education in Lesotho?

    ERIC Educational Resources Information Center

    Morojele, Pholoho

    2013-01-01

    This paper gives prominence to rural teachers' accounts of gender-based challenges facing Free Primary Education in Lesotho. It draws on feminist interpretations of social constructionism to discuss factors within the Basotho communities that affect gender equality in the schools. The inductive analysis offered makes use of the data generated from…

  1. Flexible kinship: caring for AIDS orphans in rural Lesotho

    PubMed Central

    Block, Ellen

    2015-01-01

    HIV/AIDS has devastated families in rural Lesotho, leaving many children orphaned. Families have adapted to the increase in the number of orphans and HIV-positive children in ways that provide children with the best possible care. Though local ideas about kinship and care are firmly rooted in patrilineal social organization, in practice, maternal caregivers, often grandmothers, are increasingly caring for orphaned children. Negotiations between affinal kin capitalize on flexible kinship practices in order to legitimate new patterns of care, which have shifted towards a model that often favours matrilocal practices of care in the context of idealized patrilineality. PMID:25866467

  2. Amietia angolensis and A. fuscigula (Anura: Pyxicephalidae) in southern Africa: a cold case reheated.

    PubMed

    Channing, Alan; Baptista, Ninda

    2013-01-01

    A study combining DNA sequences of the mitochondrial 16S rRNA gene, advertisement calls and morphology of some southern African river frogs confirms Amietia vandijki (Visser & Channing, 1997) as a good species. The form presently referred to as Amietia angolensis in southern Africa is shown to comprise two species: Amietia angolensis (Bocage, 1866) known from Angola, and Amietia quecketti (Boulenger, 1895) known from South Africa, Zimbabwe and Lesotho. Junior synonyms of A. quecketti include Rana theileri Mocquard, 1906 and Afrana dracomontana Channing, 1978. The form presently known as Amietia fuscigula is shown to consist of two distantly related taxa: Amietia fuscigula (Duméril & Bibron, 1841) from the south-western Cape and an undescribed species that we here name Amietia poyntoni sp. nov. Channing & Baptista, known from the rest of South Africa and Namibia. These five species have large differences in 16S sequences, as well as differences in morphology and advertisement call. Call and molecular data are both diagnostic, while morphology shows some overlap between taxa. An extended study of the genus across Africa is in preparation.

  3. Efficacy of Mobile Serious Games in Increasing HIV Risk Perception in Swaziland: A Randomized Control Trial (SGprev Trial) Research Protocol.

    PubMed

    Lukhele, Bhekumusa Wellington; Musumari, Patou; El-Saaidi, Christina; Techasrivichien, Teeranee; Suguimoto, S Pilar; Ono Kihara, Masako; Kihara, Masahiro

    2016-11-22

    The human immunodeficiency virus (HIV) and acquired immune deficiency syndrome (AIDS) continue to be a major public health problem in Sub-Saharan Africa (SSA), particularly in Swaziland, which has the highest HIV prevalence in this region. A wide range of strategies and interventions have been used to promote behavior change, though almost all such interventions have involved mass media. Therefore, innovative behavior change strategies beyond mass media communication are urgently needed. Serious games have demonstrated effectiveness in advancing health in the developed world; however, no rigorous serious games interventions have been implemented in HIV prevention in SSA. We plan to test whether a serious game intervention delivered on mobile phones to increase HIV risk perception, increase intention to reduce sexual partnerships, and increase intention to know own and partners HIV status will be more effective compared with current prevention efforts. This is a two-arm randomized intervention trial. We will recruit 380 participants who meet the following eligibility criteria: 18-29 years of age, own a smartphone running an Android-based operating system, have the WhatsApp messaging app, live in Swaziland, and can adequately grant informed consent. Participants will be allocated into a smartphone interactive, educational story game, and a wait-list control group in a 1:1 allocation ratio. Subsequently, a self-administered Web-based questionnaire will be issued at baseline and after 4 weeks of exposure to the game. We hypothesize that the change in HIV risk perception between pre- and post-intervention assessment is greater in the intervention group compared with the change in the control group. Our primary hypothesis is based on the assumption that increased perceived risk of HIV provides cues to engage in protective behavior. Our primary outcome measure is HIV risk perceived mean change between pre- and post-intervention compared with the mean change in the wait

  4. Health promotion and cardiovascular disease prevention in sub-Saharan Africa.

    PubMed

    Sampson, Uchechukwu K A; Amuyunzu-Nyamongo, Mary; Mensah, George A

    2013-01-01

    Recent population studies demonstrate an increasing burden of cardiovascular disease (CVD) and related risk factors in sub-Saharan Africa (SSA). The mitigation or reversal of this trend calls for effective health promotion and preventive interventions. In this article, we review the core principles, challenges, and progress in promoting cardiovascular health with special emphasis on interventions to address physical inactivity, poor diet, tobacco use, and adverse cardiometabolic risk factor trends in SSA. We focus on the five essential strategies of the Ottawa Charter for Health Promotion. Successes highlighted include community-based interventions in Ghana, Nigeria, South Africa, and Mauritius and school-based programs in Kenya, Namibia, and Swaziland. We address the major challenge of developing integrated interventions, and showcase partnerships opportunities. We conclude by calling for intersectoral partnerships for effective and sustainable intervention strategies to advance cardiovascular health promotion and close the implementation gap in accordance with the 2009 Nairobi Call to Action on Health Promotion. © 2013.

  5. LabPush: a pilot study of providing remote clinics with laboratory results via short message service (SMS) in Swaziland, Africa - a qualitative study.

    PubMed

    Hao, Wen-Rui; Hsu, Yi-Hsin; Chen, Kuan-Chen; Li, Hsien-Chang; Iqbal, Usman; Nguyen, Phung-Anh; Huang, Chih-Wei; Yang, Hsuan-Chia; Lee, Peisan; Li, Mei-Hsuan; Hlatshwayo, Sharoon Lungile; Li, Yu-Chuan Jack; Jian, Wen-Shan

    2015-01-01

    Developing countries are confronting a steady growth in the prevalence of the infectious diseases. Mobile technologies are widely available and can play an important role in health care at the regional, community, and individual levels. Although labs usually able to accomplish the requested blood test and produce the results within two days after receiving the samples, but the time for the results to be delivered back to clinics is quite variable depending on how often the motorbike transport makes trips between the clinic and the lab. In this study, we seek to assess factors facilitating as well as factors hindering the adoption of mobile devices in the Swazi healthcare through evaluating the end-users of the LabPush system. A qualitative study with semi-structured and in-depth one on one interviews were conducted over two month period July-August 2012. Purposive sampling was used; participants were those operating and using the LabPush system at the remote clinics, at the national laboratory and the supervisors of users at Swaziland. Interview questions were focused on perceived of ease of use and usefulness of the system. All interviews were recorded and then transcribed. This study had aimed its primary focus on reducing TAT, prompt patient care, reducing bouncing of patients and defaulting of patients which were challenges that the clinicians have always had. Therefore, the results revealed several barriers and facilitators to the adoption of mobile device by healthcare providers in the Swaziland. The themes Shortens TAT, Technical support, Patient-centered care, Mindset, Improved communication, Missing Reports, Workload, Workflow, Security of smart phone, Human error and Ownership are sorted by facilitators to barriers. Thus the end-users perspective, prompt patient care, reduced bouncing of patients, technical support, better communication, willing participant and social influence were facilitators of the adoption m-health in the Swazi healthcare. Copyright

  6. Impact of early initiation versus national standard of care of antiretroviral therapy in Swaziland's public sector health system: study protocol for a stepped-wedge randomized trial.

    PubMed

    Walsh, Fiona J; Bärnighausen, Till; Delva, Wim; Fleming, Yvette; Khumalo, Gavin; Lejeune, Charlotte L; Mazibuko, Sikhathele; Mlambo, Charmaine Khudzie; Reis, Ria; Spiegelman, Donna; Zwane, Mandisa; Okello, Velephi

    2017-08-18

    stepped-wedge randomized design is a causally strong and robust approach to determine if providing antiretroviral treatment for all HIV-positive individuals is a feasible intervention in a resource-limited, public sector health system. We expect our study results to contribute to health policy decisions related to the HIV response in Swaziland and other countries in sub-Saharan Africa. ClinicalTrials.gov, NCT02909218 . Registered on 10 July 2016.

  7. Case management of malaria in Swaziland, 2011-2015: on track for elimination?

    PubMed

    Dlamini, S V; Kosgei, R J; Mkhonta, N; Zulu, Z; Makadzange, K; Zhou, S; Owiti, P; Sikhondze, W; Namboze, J; Reid, A; Kunene, S

    2018-04-25

    Objective: To assess adherence to malaria diagnosis and treatment guidelines (2010 and 2014) in all health care facilities in Swaziland between 2011 and 2015. Methods: This was a cross-sectional descriptive study involving all health care facilities that diagnosed and managed malaria cases in Swaziland. Patients' age, sex, diagnosis method and type of treatment were analysed. Results: Of 1981 records for severe and uncomplicated malaria analysed, 56% of cases were uncomplicated and 14% had severe malaria. The type of malaria was not recorded for 30% of cases. Approximately 71% of cases were confirmed by rapid diagnostic tests (RDT) alone, 3% by microscopy alone and 26% by both RDT and microscopy. Of the uncomplicated cases, 93% were treated with artemether-lumefantrine (AL) alone, 5% with quinine alone and 2% with AL and quinine. Amongst the severe cases, 11% were treated with AL alone, 44% with quinine alone and 45% with AL and quinine. For severe malaria, clinics and health centres prescribed AL alone more often than hospitals (respectively 13%, 12% and 4%, P = 0.03). Conclusion: RDTs and/or microscopy results are used at all facilities to inform treatment. Poor recording of malaria type causes difficulties in assessing the prescription of antimalarial drugs.

  8. Low uptake of preventive interventions among malaria cases in Swaziland: towards malaria elimination

    PubMed Central

    Dlamini, N.; Zulu, Z.; Dlamini, S.; Kunene, S.; Sikhondze, W.; Owiti, P.; Geoffroy, E.; Zachariah, R.; Mengestu, T. K.

    2018-01-01

    Settings: Swaziland is striving to achieve sustainable malaria elimination. Three preventive interventions are vital for reaching this goal: 1) effective household utilisation of long-lasting insecticide nets (LLINs), 2) indoor residual spraying (IRS), and 3) provision of chemoprophylaxis for those travelling to malaria-endemic areas. Objectives: To assess the uptake of preventive intervention among confirmed malaria cases. Design: A longitudinal study using nation-wide programme data from 2010 to 2015. Data on malaria cases from health facilities were sourced from the Malaria Surveillance Database System. Results: Of a total 2568 confirmed malaria cases in Swaziland, 2034 (79%) had complete data on case investigations and were included in the analysis. Of 341 (17%) individuals who owned LLINs, 169 (8%) used them; 338 (17%) had IRS and 314 (15%) slept in sprayed structures. Of 1403 travellers to areas at high malaria risk, 59 (4%) used any form of malaria prevention, including chemoprophylaxis. Conclusion: The uptake of all three key malaria prevention interventions is low, and could threaten the progress made thus far toward malaria elimination. Efforts to improve this situation, including qualitative research to understand the reasons for low uptake, are urgently needed. PMID:29713591

  9. Policy as Practice: Local Appropriation of Language and Education Policies in Lesotho Primary Schools

    ERIC Educational Resources Information Center

    Backman, Stephen

    2009-01-01

    This dissertation study sets out to take a close look at the complex mix of factors on the ground, which influence the appropriation of language and education policies by local education stakeholders at Lesotho primary schools. I argue that much of the research in language policy and planning (LPP) has focused too largely on the macro-level…

  10. HIV/AIDS and disability: a pilot survey of HIV/AIDS knowledge among a deaf population in Swaziland.

    PubMed

    Groce, Nora; Yousafzai, Aisha; Dlamini, Phindile; Zalud, Sarah; Wirz, Shelia

    2006-12-01

    This study sought to establish whether there were measurable differences in the level of knowledge about HIV/AIDS between hearing individuals and individuals who identified themselves as deaf sign language users in Swaziland. A cross-sectional survey of 191 rural and urban hearing and deaf adults was undertaken in Swaziland in December 2003. A structured questionnaire was administered, seeking to establish whether there were statistically significant differences between hearing and deaf populations in their level of knowledge about HIV/AIDS symptoms, transmission and prevention, as well as differences in sources of information about HIV/AIDS. Additional questions were asked regarding whether there were differences in accessibility of HIV testing services and HIV/AIDS-related healthcare for the two groups. Significant differences in levels of knowledge about HIV/AIDS were identified between the hearing and deaf respondents. The deaf population was significantly more likely (P<0.05) to believe in incorrect modes of HIV transmission (e.g. hugging and airborne transmission) and HIV prevention (e.g. avoiding sharing utensils and eating healthy foods). Almost all of the deaf respondents (99%) reported difficulties in communicating with healthcare facility staff, which may result in less use of HIV voluntary counseling and testing services. This paper reports the results of this study, and discusses the need for targeted HIV/AIDS education campaigns and improved accessibility in healthcare facilities for deaf sign language users in countries such as Swaziland.

  11. An Analysis of the Information Behaviour of Geography Teachers in a Developing African Country--Lesotho

    ERIC Educational Resources Information Center

    Bitso, Constance

    2012-01-01

    Information behaviour studies have the potential to inform the design of effective information services that incorporate the information needs, information-seeking and preferences for information sources of target users; hence a doctoral study was conducted on the information behaviour of geography teachers in Lesotho with the aim of guiding the…

  12. Marginalization and social change processes among lesbian, gay, bisexual and transgender persons in Swaziland: implications for HIV prevention.

    PubMed

    H Logie, Carmen; Perez-Brumer, Amaya; Jenkinson, Jesse; Madau, Veli; Nhlengethwa, Winnie; Baral, Stefan

    2018-05-30

    Swaziland has among the highest national adult HIV prevalence globally. There is limited knowledge of HIV vulnerabilities and prevention engagement among lesbian, gay, bisexual and transgender (LGBT) persons in the context of Swaziland's criminalization of consensual same-sex practices. This study explored social processes of marginalization to assess how they could potentiate HIV vulnerabilities and limit engagement in HIV prevention services. Additionally, we assessed positive change to better understand existing strategies employed by LGBT persons to challenge these HIV prevention barriers. Guided by community-based research methodology and conducted in Mbabane and Manzini, Swaziland, data were collected by LGBT peer-research assistants (PRA) in collaboration with an LGBT community organization in Manzini. Semi-structured interviews were conducted by trained PRAs and explored HIV prevention, including experiences of stigma and coping. Audio files were transcribed verbatim, translated to English, and analyzed using thematic techniques. Among participants (n = 51; mean age: 26.47, SD: 4.68), 40 self-identifed as gay or lesbian (78.4%), 11 bisexual (22.6%), and 12 (23.5%) identified as transgender. Findings highlighted three primary processes of marginalization and positive change in structural, community, and internal domains. First, structural marginalization, which included criminalization, healthcare discrimination, and a scarcity of LGBT tailored HIV prevention resources was challenged by grassroots networks created to access and share specific HIV resources with LGBT persons and the Ministry of Health. Second, community marginalization included stigma and multi-dimensional forms of violence, however, this was met with LGBT persons providing mutual peer support, including for accessing HIV testing services. Thirdly, internal marginalization comprised of self-stigma and associated sexual risk practices was contrasted with coping strategies focused on self

  13. The YES Africa 2011 Symposium: A Key to Developing the Future Geoscience Workforce in Africa

    NASA Astrophysics Data System (ADS)

    Nkhonjera, E.

    2011-12-01

    Africa is facing serious challenges in geoscience education. This has been as a result of absence of or very young/small Earth Science Departments in some universities (e.g., Mauritius, Namibia, Botswana, Swaziland, Malawi): Limited capacity (staff and equipment needed for practicals) to cope with the growing number of students, compounded by brain drain of academic staffs and the fact that current tertiary programmes do not seem to produce graduates suitable for the industry are some of the contributing factors to the challenges, (UNESCO-AEON Report, 2009). As such Earth Science studies in Africa have been one of the career paths that has not been promoted or highly preferred by many students. In January 2011, the YES Network African chapter was launched through the YES Africa 2011 Symposium that took place at the University of Johannesburg South Africa in Conjunction with the 23rd Colloquium of Africa Geology from the 08-14th January 2011. The YES Africa 2011 Symposium was organized by five YES African National networks from Southern, Central, Eastern and Northern Africa to bring young geoscientists from all regions of Africa together to present their research about African geoscience topics. The symposium also included roundtable discussions about increasing the involvement of youth's participation in geoscience issues in Africa, about how to increase the number of youths in African geosciences education university programs, and about how to promote geoscience careers to university students in Africa c. Roundtable discussions revealed that many African colleges and universities do not provide adequate infrastructure and resources to support the students studying in the department. As such, most students graduate with poor preparation for geoscience careers, having gained a theoretical understanding of geology, but not the practical application of the discipline. The recommendations from the YES Africa 2011 Symposium also highlighted on the best ways of

  14. An overview of the Permian (Karoo) coal deposits of southern Africa

    NASA Astrophysics Data System (ADS)

    Cairncross, B.

    2001-08-01

    The coal deposits of southern Africa (Botswana, Malawi, Mozambique, Namibia, South Africa, Swaziland, Tanzania, Zambia and Zimbabwe) are reviewed. The coal seams formed during two periods, the Early Permian (Artinskian-Kungurian) and the Late Permian (Ufimian-Kazanian). The coals are associated with non-marine terrestrial clastic sedimentary sequences, most commonly mudrock and sandstones, assigned to the Karoo Supergroup. The Early Permian coals are most commonly sandstone-hosted while the younger coals typically occur interbedded with mudstones. The sediments were deposited in varying tectono-sedimentary basins such as foreland, intracratonic rifts and intercratonic grabens and half-grabens. The depositional environments that produced the coal-bearing successions were primarily deltaic and fluvial, with some minor shoreline and lacustrine settings. Coals vary in rank from high-volatile bituminous to anthracite and characteristically have a relatively high inertinite component, and medium- to high-ash content. In countries where coal is mined, it is used for power generation, coking coal, synfuel generation, gasification and for (local) domestic household consumption.

  15. School Violence in Lesotho: The Perceptions, Experiences and Observations of a Group of Learners

    ERIC Educational Resources Information Center

    de Wet, Corene

    2007-01-01

    School violence is a subject of great public and media interest that has stimulated a comprehensive body of research. Academic consideration of the subject began in the USA and Scandinavia in the mid-1960s and early 1970s but little evidence could be found of publications on the subject in the small landlocked Kingdom of Lesotho. To address this…

  16. Sexual stigma and discrimination as barriers to seeking appropriate healthcare among men who have sex with men in Swaziland

    PubMed Central

    Risher, Kathryn; Adams, Darrin; Sithole, Bhekie; Ketende, Sosthenes; Kennedy, Caitlin; Mnisi, Zandile; Mabusa, Xolile; Baral, Stefan D

    2013-01-01

    Introduction Same-sex practices and orientation are both stigmatized and criminalized in many countries across sub-Saharan Africa. This study aimed to assess the relationship of fear of seeking healthcare and disclosure of same-sex practices among a sample of men who have sex with men (MSM) in Swaziland with demographic, socio-economic and behavioural determinants. Methods Three hundred and twenty-three men who reported having had anal sex with a man in the past year were recruited using respondent-driven sampling and administered a structured survey instrument. Asymptotically unbiased estimates of prevalence of stigma and human rights abuses generated using the RDSII estimator are reported with bootstrapped confidence intervals (CIs). Weighted simple and multiple logistic regressions of fear of seeking healthcare and disclosure of same-sex practices to a healthcare provider with demographic, social and behavioural variables are reported. Results Stigma was common, including 61.7% (95% CI=54.0–69.0%) reporting fear of seeking healthcare, 44.1% (95% CI=36.2–51.3%) any enacted stigma and 73.9% (95% CI=67.7–80.1%) any perceived social stigma (family, friends). Ever disclosing sexual practices with other men to healthcare providers was low (25.6%, 95% CI=19.2–32.1%). In multiple logistic regression, fear of seeking healthcare was significantly associated with: having experienced legal discrimination as a result of sexual orientation or practice (aOR=1.9, 95% CI=1.1–3.4), having felt like you wanted to end your life (aOR=2.0, 95% CI=1.2–3.4), having been raped (aOR=11.0, 95% CI=1.4–84.4), finding it very difficult to insist on condom use when a male partner does not want to use a condom (aOR=2.1, 95% CI=1.0–4.1) and having a non-Swazi nationality at birth (aOR=0.18, 95% CI=0.05–0.68). In multiple logistic regression, disclosure of same-sex practices to a healthcare provider was significantly associated with: having completed secondary education or more

  17. Supporting Lesotho Teachers to Develop Resilience in the Face of the HIV and AIDS Pandemic

    ERIC Educational Resources Information Center

    Wood, Lesley; Ntaote, Grace Makeletso; Theron, Linda

    2012-01-01

    HIV and AIDS threaten to erode the wellbeing of teachers who are faced with an increasing number of children rendered vulnerable by the pandemic. This article explores the usefulness of a supportive group intervention, Resilient Educators (REds), in supporting Lesotho teachers to respond to the HIV and AIDS-related challenges. A time-series pre-…

  18. Child Participation in School Governance: The Case of Prefects at a Primary School in Lesotho

    ERIC Educational Resources Information Center

    Morojele, Pholoho; Muthukrishna, Nithi

    2011-01-01

    This paper draws on literature that has theorised child participation within the sociology of childhood framework to examine how children participate in governance within school spaces. Four children aged between 13 and 17 (in grades six and seven) who serve as prefects at a primary school in Lesotho were participants in this study. Data was…

  19. Aviation and the delivery of medical care in remote regions: the Lesotho HIV experience.

    PubMed

    Furin, Jennifer; Shutts, Mike; Keshavjee, Salmaan

    2008-02-01

    In many regions of the world plagued by high burdens of disease, there is difficulty in accessing basic medical care. This is often due to logistical constraints and a lack of infrastructure such as roads. Medical aviation can play a major role in addressing some of these crucial issues as it allows for the rapid transport of patients, personnel, and medications to remote-and sometimes otherwise inaccessible-areas. Lesotho is a mountainous nation of 2 million people that provides a good example of medical aviation as a cornerstone in the delivery of health care. The population has a reported HIV seroprevalence of 25%, and many patients live in rural areas that are inaccessible by road. Mission Aviation Fellowship has joined forces with a medical team from the nongovernmental organization Partners In Health in an effort to launch a comprehensive program to address HIV and related problems in rural Lesotho. This medical aviation partnership has allowed for the provision of HIV prevention and treatment services to thousands of people living in the mountains. This commentary describes how medical aviation has been crucial in developing models to address complex, serious health problems in remote settings.

  20. Structural and Behavioral Correlates of HIV Infection among Pregnant Women in a Country with a Highly Generalized HIV Epidemic: A Cross-Sectional Study with a Probability Sample of Antenatal Care Facilities in Swaziland.

    PubMed

    Lukhele, Bhekumusa Wellington; Techasrivichien, Teeranee; Suguimoto, S Pilar; Musumari, Patou Masika; El-Saaidi, Christina; Haumba, Samson; Tagutanazvo, Oslinah Buru; Ono-Kihara, Masako; Kihara, Masahiro

    2016-01-01

    HIV disproportionately affects women in Sub-Saharan Africa. Swaziland bears the highest HIV prevalence of 41% among pregnant women in this region. This heightened HIV-epidemic reflects the importance of context-specific interventions. Apart from routine HIV surveillance, studies that examine structural and behavioral factors associated with HIV infection among women may facilitate the revitalization of existing programs and provide insights to inform context-specific HIV prevention interventions. This cross-sectional study employed a two-stage random cluster sampling in ten antenatal health care facilities in the Hhohho region of Swaziland in August and September 2015. Participants were eligible for the study if they were 18 years or older and had tested for HIV. Self-administered tablet-based questionnaires were used to assess HIV risk factors. Of all eligible pregnant women, 827 (92.4%) participated, out of which 297 (35.9%) were self-reportedly HIV positive. Among structural factors, family function was not significantly associated with self-reported HIV positive status, while lower than high school educational attainment (AOR, 1.65; CI, 1.14-3.38; P = 0.008), and income below minimum wage (AOR, 1.81; CI, 1.09-3.01; P = 0.021) were significantly associated with self-reported HIV positive status. Behavioral factors significantly associated with reporting a positive HIV status included; ≥2 lifetime sexual partners (AOR, 3.16; CI, 2.00-5.00; P<0.001), and ever cohabited (AOR, 2.39; CI, 1.66-3.43; P = 0.00). The most cited reason for having multiple sexual partners was financial gain. HIV/AIDS-related knowledge level was high but not associated to self-reported HIV status (P = 0.319). Structural and behavioral factors showed significant association with self-reported HIV infection among pregnant women in Swaziland while HIV/AIDS-related knowledge and family function did not. This suggests that HIV interventions should be reinforced taking into consideration these

  1. Intra-seasonal rainfall variability during the maize growing season in the northern lowlands of Lesotho

    NASA Astrophysics Data System (ADS)

    Tongwane, Mphethe Isaac; Moeletsi, Mokhele Edmond

    2015-05-01

    Intra-seasonal rainfall distribution was identified as a priority gap that needs to be addressed for southern Africa to cope with agro-meteorological risks. The region in the northwest of Lesotho is appropriate for crop cultivation due to its relatively favourable climatic conditions and soils. High rainfall variability is often blamed for poor agricultural production in this region. This study aims to determine the onset of rains, cessation of rains and rainy season duration using historical climate data. Temporal variability of these rainy season characteristics was also investigated. The earliest and latest onset dates of the rainy season are during the last week of October at Butha-Buthe and the third week of November at Mapoteng, respectively. Cessation of the season is predominantly in the first week of April making the season approximately 137-163 days long depending on the location. Average seasonal rainfall ranged from 474 mm at Mapoteng to 668 mm at Butha-Buthe. Onset and cessation of the rainfall season vary by 4-7 weeks and 1 week, respectively. Mean coefficient of variation of seasonal rainfall is 39 %, but monthly variations are higher. These variations make annual crop management and planning difficult each year. Trends show a decrease in the rainfall amounts but improvements in both the temporal distribution of annual rainfall, onset and cessation dates.

  2. Choice-disability and HIV infection: a cross sectional study of HIV status in Botswana, Namibia and Swaziland.

    PubMed

    Andersson, Neil; Cockcroft, Anne

    2012-01-01

    Interpersonal power gradients may prevent people implementing HIV prevention decisions. Among 7,464 youth aged 15-29 years in Botswana, Namibia and Swaziland we documented indicators of choice-disability (low education, educational disparity with partner, experience of sexual violence, experience of intimate partner violence (IPV), poverty, partner income disparity, willingness to have sex without a condom despite believing partner at risk of HIV), and risk behaviours like inconsistent use of condoms and multiple partners. In Botswana, Namibia and Swaziland, 22.9, 9.1, and 26.1% women, and 8.3, 2.8, and 9.3% men, were HIV positive. Among both women and men, experience of IPV, IPV interacted with age, and partner income disparity interacted with age were associated with HIV positivity in multivariate analysis. Additional factors were low education (for women) and poverty (for men). Choice disability may be an important driver of the AIDS epidemic. New strategies are needed that favour the choice-disabled.

  3. Outcomes of antiretroviral treatment programmes in rural Lesotho: health centres and hospitals compared

    PubMed Central

    Labhardt, Niklaus Daniel; Keiser, Olivia; Sello, Motlalepula; Lejone, Thabo Ishmael; Pfeiffer, Karolin; Davies, Mary-Ann; Egger, Matthias; Ehmer, Jochen; Wandeler, Gilles

    2013-01-01

    Introduction Lesotho was among the first countries to adopt decentralization of care from hospitals to nurse-led health centres (HCs) to scale up the provision of antiretroviral therapy (ART). We compared outcomes between patients who started ART at HCs and hospitals in two rural catchment areas in Lesotho. Methods The two catchment areas comprise two hospitals and 12 HCs. Patients ≥16 years starting ART at a hospital or HC between 2008 and 2011 were included. Loss to follow-up (LTFU) was defined as not returning to the facility for ≥180 days after the last visit, no follow-up (no FUP) as not returning after starting ART, and retention in care as alive and on ART at the facility. The data were analysed using logistic regression, competing risk regression and Kaplan-Meier methods. Multivariable analyses were adjusted for sex, age, CD4 cell count, World Health Organization stage, catchment area and type of ART. All analyses were stratified by gender. Results Of 3747 patients, 2042 (54.5%) started ART at HCs. Both women and men at hospitals had more advanced clinical and immunological stages of disease than those at HCs. Over 5445 patient-years, 420 died and 475 were LTFU. Kaplan-Meier estimates for three-year retention were 68.7 and 69.7% at HCs and hospitals, respectively, among women (p=0.81) and 68.8% at HCs versus 54.7% at hospitals among men (p<0.001). These findings persisted in adjusted analyses, with similar retention at HCs and hospitals among women (odds ratio (OR): 0.89, 95% confidence interval (CI): 0.73–1.09) and higher retention at HCs among men (OR: 1.53, 95% CI: 1.20–1.96). The latter result was mainly driven by a lower proportion of patients LTFU at HCs (OR: 0.68, 95% CI: 0.51–0.93). Conclusions In rural Lesotho, overall retention in care did not differ significantly between nurse-led HCs and hospitals. However, men seemed to benefit most from starting ART at HCs, as they were more likely to remain in care in these facilities compared to

  4. Outcomes of antiretroviral treatment programmes in rural Lesotho: health centres and hospitals compared.

    PubMed

    Labhardt, Niklaus Daniel; Keiser, Olivia; Sello, Motlalepula; Lejone, Thabo Ishmael; Pfeiffer, Karolin; Davies, Mary-Ann; Egger, Matthias; Ehmer, Jochen; Wandeler, Gilles

    2013-11-21

    Lesotho was among the first countries to adopt decentralization of care from hospitals to nurse-led health centres (HCs) to scale up the provision of antiretroviral therapy (ART). We compared outcomes between patients who started ART at HCs and hospitals in two rural catchment areas in Lesotho. The two catchment areas comprise two hospitals and 12 HCs. Patients ≥16 years starting ART at a hospital or HC between 2008 and 2011 were included. Loss to follow-up (LTFU) was defined as not returning to the facility for ≥180 days after the last visit, no follow-up (no FUP) as not returning after starting ART, and retention in care as alive and on ART at the facility. The data were analysed using logistic regression, competing risk regression and Kaplan-Meier methods. Multivariable analyses were adjusted for sex, age, CD4 cell count, World Health Organization stage, catchment area and type of ART. All analyses were stratified by gender. Of 3747 patients, 2042 (54.5%) started ART at HCs. Both women and men at hospitals had more advanced clinical and immunological stages of disease than those at HCs. Over 5445 patient-years, 420 died and 475 were LTFU. Kaplan-Meier estimates for three-year retention were 68.7 and 69.7% at HCs and hospitals, respectively, among women (p=0.81) and 68.8% at HCs versus 54.7% at hospitals among men (p<0.001). These findings persisted in adjusted analyses, with similar retention at HCs and hospitals among women (odds ratio (OR): 0.89, 95% confidence interval (CI): 0.73-1.09) and higher retention at HCs among men (OR: 1.53, 95% CI: 1.20-1.96). The latter result was mainly driven by a lower proportion of patients LTFU at HCs (OR: 0.68, 95% CI: 0.51-0.93). In rural Lesotho, overall retention in care did not differ significantly between nurse-led HCs and hospitals. However, men seemed to benefit most from starting ART at HCs, as they were more likely to remain in care in these facilities compared to hospitals.

  5. Agency as a mediator in the pathway from transactional sex to HIV among pregnant women in Swaziland: a multigroup path analysis.

    PubMed

    Fielding-Miller, Rebecca; Dunkle, Kristin L; Hadley, Craig; Cooper, Hannah Lf; Windle, Michael

    2017-07-18

    Transactional sex is a structural driver of HIV for women and girls in sub-Saharan Africa. In transactional relationships, sexual and economic obligations intertwine and may have positive and negative effects on women's financial standing and social status. We conducted a clinic-based survey with pregnant women in Swaziland using a locally validated transactional sex scale to measure the association between subjective social status, transactional sex, and HIV status, and to assess whether this association differed according to a woman's agency within her relationship. We recruited a convenience sample of 406 pregnant women at one rural and one urban public antenatal clinic in Swaziland and administered a behavioural survey that was linked to participant HIV status using clinic records. We then conducted a multigroup path analysis to test three hypotheses: (1) that more engagement in transactional sex is associated with decreased condom use and increased subjective social status; (2) that subjective social status mediates the relationship between transactional sex and HIV status; and (3) that these relationships are different across groups according to whether or not a woman reported any indicator of constrained agency within her relationship. The amount and value of material goods received from a sexual partner was significantly and positively associated with higher subjective social status among all participants. As the amount of material goods received from a partner increased, women who reported no indicators of constrained agency were less likely to use condoms. Conversely, there was no relationship between transactional sex and condom use among women who reported any indicator of constrained relationship agency. Among women who reported any indicator of constrained agency, HIV was significantly associated with lower subjective social status. Relationship agency likely plays a key role in determining which mechanisms create HIV risk for women in transactional

  6. EXPERIENCES OF HIV/AIDS STIGMA OF PERSONS LIVING WITH HIV/AIDS AND NURSES INVOLVED IN THEIR CARE FROM FIVE AFRICAN COUNTRIES

    PubMed Central

    Greeff, Minrie; Uys, Leana R; Holzemer, William L; Makoae, Lucia N; Dlamini, Priscilla S; Kohi, Thecla W; Chirwa, Maureen L; Naidoo, Joanne R; Phetlhu, Rene D.

    2009-01-01

    The concept of stigma has received significant attention in recent years in the HIV/AIDS literature. Although there is some change towards the positive, AIDS still remains a significantly stigmatized condition. AIDS stigma and discrimination continue to influence people living with and affected by HIV (PLWA), as well as their health-care providers. Unless stigma is conquered, the illness will not be defeated. Due to the burden that HIV/AIDS places on people living in Africa, a five-year project entitled Perceived AIDS Stigma: A Multinational African Study was undertaken. The focus of the first phase of this project was on exploring and describing the meaning and effect of stigma on PLWA from the experiences of PLWA and the nurses involved in their care in five African countries: Lesotho, Swaziland, Malawi, South Africa and Tanzania. An exploratory descriptive qualitative research design was used to explore and describe the experience of stigma through the critical incident method. Purposive voluntary sampling was utilized. Forty-three focus group discussions were held with respondents to relate incidences which they themselves observed, as well as those that they themselves experienced in the community and in families. The transcribed data was analyzed through the technique of open coding using the NVivo 2.0 analysis package. Three types of stigma (received stigma, internal stigma and associated stigma) and several dimensions for each of these types of stigma emerged from the data. Recommendations were made to pursue these findings further. PMID:20052299

  7. Migration in southern Africa: a comparative perspective.

    PubMed

    Solomon, H

    1994-01-01

    Population movement can be described as intra-state, East-West, South-North, and South-South. About 20 million persons globally are considered displaced, of which about 4.1 million are internally displaced persons in South Africa. East-West movement occurred for over 400 million when the Iron Curtain came down. South-North movements of asylum seekers were estimated at 442,000 in 1990. South-South movement amounted to 4 million official refugees in Africa in 1989 and 4.4 million in 1990. African has the largest concentration of refugees. This article does not address the 265,825 contract migrant workers in South Africa. South African migration is the South-South type and can be characterized as "brain-drain" of well-trained professionals in neighboring states and unskilled and illegal migrants from Mozambique and Angola. Movement is pushed or pulled according to sociocultural factors, communications and technology, geographic proximity, precedent, demographic factors, environmental factors, economic factors, and political factors. The effects of migration in South Africa include increased stress on housing, political and social tension, increased costs, overcrowding, transmission of disease, and marginalization of migrants into low status and low paid jobs. For Lesotho migrants in South Africa remittances are a major source of national wealth. South Africa has also experienced racial discord against Mozambicans and Chinese. Political right wing groups mobilize around anti-immigration platforms. Migrants can become policy tools, and many are used in wars of liberation. International attention may focus on mistreatment of refugees. Management can be construed as "carrot" or "stick" approaches. Stick approaches include forced repatriation, limiting immigration, housing in survival-level camps, public campaigns run by host countries in sending countries, or greater control of national borders. South Africa has extensively used stick approaches, which have been only

  8. Geography Teachers' Interpretation of a Curriculum Reform Initiative: The Case of the Lesotho Environmental Education Support Project (LEESP)

    ERIC Educational Resources Information Center

    Raselimo, Mohaeka; Wilmot, Di

    2013-01-01

    This article addresses how teachers in a specific developing world context interpreted a curriculum reform initiative. It is located within a broader interpretive study that investigated the integration of Environmental Education into the formal education system of Lesotho with particular reference to secondary school geography. More specifically…

  9. An Investigation of Information-Seeking Behaviour of Geography Teachers for an Information Service Intervention: The Case of Lesotho

    ERIC Educational Resources Information Center

    Bitso, Constance; Fourie, Ina

    2012-01-01

    Introduction: This study investigates the information needs and information-seeking patterns of secondary level geography teachers in Lesotho to guide the design and implementation of an information service for these teachers. Leckie, Pettigrew and Sylvain's model of professionals' information-seeking served as a theoretical framework but was…

  10. The Cost-Effectiveness of Interactive Radio Instruction for Improving Primary School Instruction in Honduras, Bolivia and Lesotho.

    ERIC Educational Resources Information Center

    Tilson, Thomas D.; And Others

    Findings are presented from studies on the use of radio for teaching primary school children mathematics in Honduras and Bolivia and English as a Second Language in Lesotho. Interactive radio instruction (IRI) is so called because of the active participation of the students. Although lessons are presented by conventional radio, scripts are written…

  11. Occupational segregation, gender essentialism and male primacy as major barriers to equity in HIV/AIDS caregiving: Findings from Lesotho.

    PubMed

    Newman, Constance J; Fogarty, Linda; Makoae, Lucia Nthabiseng; Reavely, Erik

    2011-06-08

    Gender segregation of occupations, which typically assigns caring/nurturing jobs to women and technical/managerial jobs to men, has been recognized as a major source of inequality worldwide with implications for the development of robust health workforces. In sub-Saharan Africa, gender inequalities are particularly acute in HIV/AIDS caregiving (90% of which is provided in the home), where women and girls make up the informal (and mostly unpaid) workforce. Men's and boy's entry into HIV/AIDS caregiving in greater numbers would both increase the equity and sustainability of national and community-level HIV/AIDS caregiving and mitigate health workforce shortages, but notions of gender essentialism and male primacy make this far from inevitable.In 2008 the Capacity Project partnered with the Lesotho Ministry of Health and Social Welfare in a study of the gender dynamics of HIV/AIDS caregiving in three districts of Lesotho to account for men's absence in HIV/AIDS caregiving and investigate ways in which they might be recruited into the community and home-based care (CHBC) workforce. The study used qualitative methods, including 25 key informant interviews with village chiefs, nurse clinicians, and hospital administrators and 31 focus group discussions with community health workers, community members, ex-miners, and HIV-positive men and women. Study participants uniformly perceived a need to increase the number of CHBC providers to deal with the heavy workload from increasing numbers of patients and insufficient new entries. HIV/AIDS caregiving is a gender-segregated job, at the core of which lie stereotypes and beliefs about the appropriate work of men and women. This results in an inequitable, unsustainable burden on women and girls. Strategies are analyzed for their potential effectiveness in increasing equity in caregiving. HIV/AIDS and human resources stakeholders must address occupational segregation and the underlying gender essentialism and male primacy if there

  12. Occupational segregation, gender essentialism and male primacy as major barriers to equity in HIV/AIDS caregiving: Findings from Lesotho

    PubMed Central

    2011-01-01

    Background Gender segregation of occupations, which typically assigns caring/nurturing jobs to women and technical/managerial jobs to men, has been recognized as a major source of inequality worldwide with implications for the development of robust health workforces. In sub-Saharan Africa, gender inequalities are particularly acute in HIV/AIDS caregiving (90% of which is provided in the home), where women and girls make up the informal (and mostly unpaid) workforce. Men's and boy's entry into HIV/AIDS caregiving in greater numbers would both increase the equity and sustainability of national and community-level HIV/AIDS caregiving and mitigate health workforce shortages, but notions of gender essentialism and male primacy make this far from inevitable. In 2008 the Capacity Project partnered with the Lesotho Ministry of Health and Social Welfare in a study of the gender dynamics of HIV/AIDS caregiving in three districts of Lesotho to account for men's absence in HIV/AIDS caregiving and investigate ways in which they might be recruited into the community and home-based care (CHBC) workforce. Methods The study used qualitative methods, including 25 key informant interviews with village chiefs, nurse clinicians, and hospital administrators and 31 focus group discussions with community health workers, community members, ex-miners, and HIV-positive men and women. Results Study participants uniformly perceived a need to increase the number of CHBC providers to deal with the heavy workload from increasing numbers of patients and insufficient new entries. HIV/AIDS caregiving is a gender-segregated job, at the core of which lie stereotypes and beliefs about the appropriate work of men and women. This results in an inequitable, unsustainable burden on women and girls. Strategies are analyzed for their potential effectiveness in increasing equity in caregiving. Conclusions HIV/AIDS and human resources stakeholders must address occupational segregation and the underlying gender

  13. Impact and Programmatic Implications of Routine Viral Load Monitoring in Swaziland

    PubMed Central

    Parker, Lucy Anne; Azih, Charles; Okello, Velephi; Maphalala, Gugu; Jouquet, Guillaume; Kerschberger, Bernhard; Mekeidje, Calorine; Cyr, Joanne; Mafikudze, Arnold; Han, Win; Lujan, Johnny; Teck, Roger; Antierens, Annick; van Griensven, Johan; Reid, Tony

    2014-01-01

    Objective: To assess the programmatic quality (coverage of testing, counseling, and retesting), cost, and outcomes (viral suppression, treatment decisions) of routine viral load (VL) monitoring in Swaziland. Design: Retrospective cohort study of patients undergoing routine VL monitoring in Swaziland (October 1, 2012 to March 31, 2013). Results: Of 5563 patients eligible for routine VL testing monitoring in the period of study, an estimated 4767 patients (86%) underwent testing that year. Of 288 patients with detectable VL, 210 (73%) underwent enhanced adherence counseling and 202 (70%) had a follow-up VL within 6 months. Testing coverage was slightly lower in children, but coverage of retesting was similar between and age groups and sexes. Of those with a follow-up test, 126 (62%) showed viral suppression. The remaining 78 patients had World Health Organization–defined virologic failure; 41 (53%) were referred by the doctor for more adherence counseling, and 13 (15%) were changed to second-line therapy, equating to an estimated rate of 1.2 switches per 100 patient-years. Twenty-four patients (32%) were transferred out, lost to follow-up, or not reviewed by doctor. The “fully loaded” cost of VL monitoring was $35 per patient-year. Conclusions: Achieving good quality VL monitoring is feasible and affordable in resource-limited settings, although close supervision is needed to ensure good coverage of testing and counseling. The low rate of switch to second-line therapy in patients with World Health Organization–defined virologic failure seems to reflect clinician suspicion of ongoing adherence problems. In our study, the main impact of routine VL monitoring was reinforcing adherence rather than increasing use of second-line therapy. PMID:24872139

  14. Reasons for the low uptake of adult male circumcision for the prevention of HIV transmission in Swaziland.

    PubMed

    Maibvise, Charles; Mavundla, Thandisizwe R

    2014-09-01

    Swaziland is currently experiencing the worst impact of HIV and AIDS of any country in the world. In an effort to curb further spread of the virus, the country adopted mass male circumcision (MC) as recommended by the World Health Organization in 2007. Despite intense campaigns to promote the procedure over the past three years, the uptake of circumcision remains very low for reasons that are not very clear. The purpose of this study was to explore the reasons for the low uptake of MC in Swaziland despite the massive national MC campaigns. A qualitative research design was used, in which all men who were targeted by the mass MC campaign were eligible. Participants were identified as they came for sexual and reproductive health services at the Family Life Association of Swaziland (FLAS) Clinic, Mbabane. In-depth, individual face-to-face unstructured interviews were conducted to elicit the reasons why men were not going for circumcision. A total of 17 men were interviewed. Results showed that these reasons include fear of the procedure and the possible outcome, perception of no significant benefit of the procedure, impatience about waiting for the procedure or the healing process, religious/cultural beliefs, and worries about the fate of the foreskin. These reasons were attributed to misconceptions and lack of accurate and specific information about some aspects of the circumcision strategy of HIV preventions. Physiological changes and economic activities associated with adulthood were also found to be hindrances to MC uptake. The study recommended that a comprehensive description of the procedure and more precise facts and scientific bases of the MC strategy be incorporated and emphasised in the MC campaigns. Involvement of religious leaders will also facilitate clarification of religious or cultural misunderstandings or misconceptions. A focus on neonatal MC would also help.

  15. Bridges to Swaziland: Using Task-Based Learning and Computer-Mediated Instruction to Improve English Language Teaching and Learning

    ERIC Educational Resources Information Center

    Pierson, Susan Jacques

    2015-01-01

    One way to provide high quality instruction for underserved English Language Learners around the world is to combine Task-Based English Language Learning with Computer- Assisted Instruction. As part of an ongoing project, "Bridges to Swaziland," these approaches have been implemented in a determined effort to improve the ESL program for…

  16. Secondary School Science Teachers' Knowledge and Implementation of Effective Teaching Strategies in High-Performing Schools in Swaziland

    ERIC Educational Resources Information Center

    Mamba, Dudu; Putsoa, Bongile

    2018-01-01

    This paper investigates the teaching strategies used by secondary school science teachers in Swazi schools that perform well in national examinations. The performance of learners in science in these examinations is generally low, as indicated by the public examination results published by the Examinations Council of Swaziland. However, a few…

  17. The second Southern African Bird Atlas Project: Causes and consequences of geographical sampling bias.

    PubMed

    Hugo, Sanet; Altwegg, Res

    2017-09-01

    Using the Southern African Bird Atlas Project (SABAP2) as a case study, we examine the possible determinants of spatial bias in volunteer sampling effort and how well such biased data represent environmental gradients across the area covered by the atlas. For each province in South Africa, we used generalized linear mixed models to determine the combination of variables that explain spatial variation in sampling effort (number of visits per 5' × 5' grid cell, or "pentad"). The explanatory variables were distance to major road and exceptional birding locations or "sampling hubs," percentage cover of protected, urban, and cultivated area, and the climate variables mean annual precipitation, winter temperatures, and summer temperatures. Further, we used the climate variables and plant biomes to define subsets of pentads representing environmental zones across South Africa, Lesotho, and Swaziland. For each environmental zone, we quantified sampling intensity, and we assessed sampling completeness with species accumulation curves fitted to the asymptotic Lomolino model. Sampling effort was highest close to sampling hubs, major roads, urban areas, and protected areas. Cultivated area and the climate variables were less important. Further, environmental zones were not evenly represented by current data and the zones varied in the amount of sampling required representing the species that are present. SABAP2 volunteers' preferences in birding locations cause spatial bias in the dataset that should be taken into account when analyzing these data. Large parts of South Africa remain underrepresented, which may restrict the kind of ecological questions that may be addressed. However, sampling bias may be improved by directing volunteers toward undersampled regions while taking into account volunteer preferences.

  18. Medicinal plants used in Lesotho for treatment of reproductive and post reproductive problems.

    PubMed

    Moteetee, A; Seleteng Kose, L

    2016-12-24

    Reproductive healthcare has been highlighted as a major challenge in Lesotho mainly due to the high prevalence of HIV/AIDS and sexually transmitted infections. As a result other reproductive ailments have not received much attention, particularly because healthcare facilities are already limited and many of them are inaccessible. For these reasons, medicinal plants play a major role in primary healthcare system in the country, in addition the plants are easily accessible, more affordable, and their use forms part of the cultural heritage. However, documentation of medicinal plants used for reproductive ailments is scattered, more importantly the biological and pharmacological properties, as well as toxicity of many of these plants are not yet known. To document the plants used by both male and female Basotho (residing in Lesotho) for the treatment of reproductive ailments, to explore their recorded biological and pharmacological effects as well as their toxicity, and to establish if these plants are used for similar purposes in other southern African cultures. The results stem from published findings of recent interviews of traditional medicinal practitioners in the Maseru District of Lesotho, first author's own experiences and observations from the Qacha's Nek District as well as comprehensive literature survey including numerous books and unpublished data. Electronic databases such as Google, Google Scholar, PubMed, and ScienceDirect were also used to search for the chemical compounds, pharmacological activity, and toxicity of the plants. A total of 87 plant species are reported to be used for the treatment of several reproductive problems such as infertility, complications associated with pregnancy (twelve plants are used to treat conditions such as colic, heartburn, nausea, and constipation), cleansing and/ or toning of the uterus (with a purpose either to induce pregnancy or to get rid of the placenta, for example Withania somnifera and Zantedeschia

  19. Efficacy of Mobile Serious Games in Increasing HIV Risk Perception in Swaziland: A Randomized Control Trial (SGprev Trial) Research Protocol

    PubMed Central

    Musumari, Patou; El-Saaidi, Christina; Techasrivichien, Teeranee; Suguimoto, S. Pilar; Ono Kihara, Masako; Kihara, Masahiro

    2016-01-01

    Background The human immunodeficiency virus (HIV) and acquired immune deficiency syndrome (AIDS) continue to be a major public health problem in Sub-Saharan Africa (SSA), particularly in Swaziland, which has the highest HIV prevalence in this region. A wide range of strategies and interventions have been used to promote behavior change, though almost all such interventions have involved mass media. Therefore, innovative behavior change strategies beyond mass media communication are urgently needed. Serious games have demonstrated effectiveness in advancing health in the developed world; however, no rigorous serious games interventions have been implemented in HIV prevention in SSA. Objective We plan to test whether a serious game intervention delivered on mobile phones to increase HIV risk perception, increase intention to reduce sexual partnerships, and increase intention to know own and partners HIV status will be more effective compared with current prevention efforts. Methods This is a two-arm randomized intervention trial. We will recruit 380 participants who meet the following eligibility criteria: 18-29 years of age, own a smartphone running an Android-based operating system, have the WhatsApp messaging app, live in Swaziland, and can adequately grant informed consent. Participants will be allocated into a smartphone interactive, educational story game, and a wait-list control group in a 1:1 allocation ratio. Subsequently, a self-administered Web-based questionnaire will be issued at baseline and after 4 weeks of exposure to the game. We hypothesize that the change in HIV risk perception between pre- and post-intervention assessment is greater in the intervention group compared with the change in the control group. Our primary hypothesis is based on the assumption that increased perceived risk of HIV provides cues to engage in protective behavior. Our primary outcome measure is HIV risk perceived mean change between pre- and post-intervention compared with

  20. Distribution and diversity of Russian wheat aphid (Hemiptera: Aphididae) biotypes in South Africa and Lesotho.

    PubMed

    Jankielsohn, Astrid

    2011-10-01

    Russian wheat aphid, Diuraphis noxia (Kurdjumov) (Hemiptera: Aphididae) was recorded for the first time in South Africa in 1978. In 2005, a second biotype, RWASA2, emerged, and here we report on the emergence of yet another biotype, found for the first time in 2009. The discovery of new Russian wheat aphid biotypes is a significant challenge to the wheat, Triticum aestivum L., industry in South Africa. Russian wheat aphid resistance in wheat, that offered wheat producers a long-term solution to Russian wheat aphid control, may no longer be effective in areas where the new biotypes occur. It is therefore critical to determine the diversity and extent of distribution of biotypes in South Africa to successfully deploy Russian wheat aphid resistance in wheat. Screening of 96 Russian wheat aphid clones resulted in identification of three Russian wheat aphid biotypes. Infestations of RWASA1 caused susceptible damage symptoms only in wheat entries containing the Dn3 gene. Infestations of RWASA2 caused susceptible damage symptoms in wheat entries containing Dn1, Dn2, Dn3, and Dn9 resistant genes. Based on the damage-rating scores for the seven resistance sources, a new biotype, which caused damage rating scores different from those for RWASA1 and RWASA2, was evident among the Russian wheat aphid populations tested. This new biotype is virulent to the same resistance sources as RWASA2 (Dn1, Dn2, Dn3, and Dn9), but it also has added virulence to Dn4, whereas RWASA2 is avirulent to this resistance source.

  1. Earth Observations

    NASA Image and Video Library

    2010-08-28

    ISS024-E-012749 (28 Aug. 2010) --- Maseru, Lesotho is featured in this image photographed by an Expedition 24 crew member on the International Space Station. Maseru is the capital city of the Kingdom of Lesotho and is located along the northwestern border of the country with the Republic of South Africa. The footprint of the urban area, recognizable by street grids and distinctive blue-roofed industrial buildings at center, is only just visible against the surrounding landscape. The city has expanded eightfold (to 230,000 today) since independence from the United Kingdom of Great Britain and Northern Ireland in 1966, and is now home to one in five inhabitants in the country. The Caledon (or Mohokare) River flows adjacent to Maseru and forms a part of the border between Lesotho and South Africa. Locally, the border extends from approximately top center left to bottom center right, with the cities of Ladybrand and Manyatseng located in South Africa. Moshoeshoe I International Airport (left) provides access to the capital. Major industries in the city include flour mills, and footwear and textile companies. Tourism is also a growing part of the local economy. The Kingdom of Lesotho is completely landlocked by the surrounding Republic of South Africa. Major landforms visible in the image near Maseru include the Qeme and Berea Plateaus to the south and east respectively; these are erosional remnants of widespread horizontally layered sedimentary rocks that formed in the Karoo Basin during the Upper Triassic Period (approximately 200–229 million years ago), according to scientists.

  2. Structural and Behavioral Correlates of HIV Infection among Pregnant Women in a Country with a Highly Generalized HIV Epidemic: A Cross-Sectional Study with a Probability Sample of Antenatal Care Facilities in Swaziland

    PubMed Central

    Techasrivichien, Teeranee; Suguimoto, S. Pilar; Musumari, Patou Masika; El-saaidi, Christina; Haumba, Samson; Tagutanazvo, Oslinah Buru; Ono-Kihara, Masako; Kihara, Masahiro

    2016-01-01

    Introduction HIV disproportionately affects women in Sub-Saharan Africa. Swaziland bears the highest HIV prevalence of 41% among pregnant women in this region. This heightened HIV-epidemic reflects the importance of context-specific interventions. Apart from routine HIV surveillance, studies that examine structural and behavioral factors associated with HIV infection among women may facilitate the revitalization of existing programs and provide insights to inform context-specific HIV prevention interventions. Methods and Findings This cross-sectional study employed a two-stage random cluster sampling in ten antenatal health care facilities in the Hhohho region of Swaziland in August and September 2015. Participants were eligible for the study if they were 18 years or older and had tested for HIV. Self-administered tablet-based questionnaires were used to assess HIV risk factors. Of all eligible pregnant women, 827 (92.4%) participated, out of which 297 (35.9%) were self-reportedly HIV positive. Among structural factors, family function was not significantly associated with self-reported HIV positive status, while lower than high school educational attainment (AOR, 1.65; CI, 1.14–3.38; P = 0.008), and income below minimum wage (AOR, 1.81; CI, 1.09–3.01; P = 0.021) were significantly associated with self-reported HIV positive status. Behavioral factors significantly associated with reporting a positive HIV status included; ≥2 lifetime sexual partners (AOR, 3.16; CI, 2.00–5.00; P<0.001), and ever cohabited (AOR, 2.39; CI, 1.66–3.43; P = 0.00). The most cited reason for having multiple sexual partners was financial gain. HIV/AIDS-related knowledge level was high but not associated to self-reported HIV status (P = 0.319). Conclusions Structural and behavioral factors showed significant association with self-reported HIV infection among pregnant women in Swaziland while HIV/AIDS-related knowledge and family function did not. This suggests that HIV interventions

  3. The Connotations of "Botho Philosophy" and Its Potential Contribution towards Environmental Conservation: The Case of Tlokoeng Community in Lesotho

    ERIC Educational Resources Information Center

    Mokuku, Tšepo

    2017-01-01

    This paper explores innovative environmental education strategies to conserve biodiversity in a rural-based context, in Lesotho. A case study approach was employed to investigate the community's conception of botho philosophy and how it might promote nature conservation. Focus Group Interviews were conducted with 105 participants. The responses…

  4. What Does It Mean to Be a Boy? Implications for Girls' and Boys' Schooling Experiences in Lesotho Rural Schools

    ERIC Educational Resources Information Center

    Morojele, Pholoho

    2011-01-01

    A doctoral study on constructions of gender in Lesotho rural primary schools has found that meanings attached to children's identities play a role in undermining gender equality in schools. The study employed the social constructionist paradigm as its theoretical framework. Drawing from ethnographic data (conversations, observations and informal…

  5. Examining Secondary School Physics Teachers' Beliefs about Teaching and Classroom Practices in Lesotho as a Foundation for Professional Development

    ERIC Educational Resources Information Center

    Qhobela, Makomosela; Kolitsoe Moru, Eunice

    2014-01-01

    The classroom practices of science teachers are indicative of their beliefs and pedagogical content knowledge (PCK). PCK is an amalgam of knowledge about subject matter, pedagogy, and contextual issues. This article identifies areas where physics teachers in Lesotho may need professional development support by addressing the research question: How…

  6. Nutritional Knowledge, Attitude, and Practices among Pregnant and Lactating Women Living with HIV in the Manzini Region of Swaziland

    PubMed Central

    Masuku, Sakhile K.S.

    2014-01-01

    ABSTRACT The prevalence of HIV infection in Swaziland (26%) is among the highest in the world. We investigated nutritional knowledge, attitude, and practices (KAP) and the influence of sociodemographic factors on KAP among pregnant and lactating women living with HIV in the Manzini region of Swaziland. Interviews were conducted using a structured questionnaire to collect data from 324 subjects seeking healthcare from selected regional hospitals, health centres, and clinics in Manzini region. The results showed mean percentage scores of nutritional knowledge (67%), attitude (67%), and practices (51%) whereby educational level (p=0.002), employment status (p=0.009), income (p=0.008), religion (p=0.007), type of accommodation (p=0.006), type of transport used when going for shopping (p=0.001), and BMI (p=0.015) were significantly associated with nutritional practices. Significant positive correlations between nutritional KAP were observed: nutritional K and A (r=0.155, p=0.005), nutritional K and P (r=0.456, p=0.001), and nutritional A and P (r=0.230, p=0.001). Multiple linear regression analysis indicated that type of transport used when going for shopping (p=0.002), educational level (p=0.001), income (p=0.001), employment (p=0.038), knowledge of food proportion in a plate (p=0.000), a positive attitude towards high-fibre diet (p=0.004), and eating a variety of foods (p=0.006) were predictors of nutritional practices. Educational level was identified as a common predictor of nutritional knowledge, attitude, and practices, suggesting that both formal and informal education systems are potential factors influencing dietary practices among pregnant and lactating women living with HIV in Swaziland. PMID:25076663

  7. Nutritional knowledge, attitude, and practices among pregnant and lactating women living with HIV in the Manzini region of Swaziland.

    PubMed

    Masuku, Sakhile K S; Lan, Shu-Jan J

    2014-06-01

    The prevalence of HIV infection in Swaziland (26%) is among the highest in the world. We investigated nutritional knowledge, attitude, and practices (KAP) and the influence of sociodemographic factors on KAP among pregnant and lactating women living with HIV in the Manzini region of Swaziland. Interviews were conducted using a structured questionnaire to collect data from 324 subjects seeking healthcare from selected regional hospitals, health centres, and clinics in Manzini region. The results showed mean percentage scores of nutritional knowledge (67%), attitude (67%), and practices (51%) whereby educational level (p = 0.002), employment status (p = 0.009), income (p = 0.008), religion (p = 0.007), type of accommodation (p = 0.006), type of transport used when going for shopping (p = 0.001), and BMI (p = 0.015) were significantly associated with nutritional practices. Significant positive correlations between nutritional KAP were observed: nutritional K and A (r = 0.155, p = 0.005), nutritional K and P (r = 0.456, p = 0.001), and nutritional A and P (r = 0.230, p = 0.001). Multiple linear regression analysis indicated that type of transport used when going for shopping (p = 0.002), educational level (p = 0.001), income (p = 0.001), employment (p = 0.038), knowledge of food proportion in a plate (p = 0.000), a positive attitude towards high-fibre diet (p = 0.004), and eating a variety of foods (p = 0.006) were predictors of nutritional practices. Educational level was identified as a common predictor of nutritional knowledge, attitude, and practices, suggesting that both formal and informal education systems are potential factors influencing dietary practices among pregnant and lactating women living with HIV in Swaziland.

  8. Voluntary medical male circumcision: a cross-sectional study comparing circumcision self-report and physical examination findings in Lesotho.

    PubMed

    Thomas, Anne Goldzier; Tran, Bonnie Robin; Cranston, Marcus; Brown, Malerato Cecilia; Kumar, Rajiv; Tlelai, Matsotetsi

    2011-01-01

    Overwhelming evidence, including three clinical trials, shows that male circumcision (MC) reduces the risk of HIV infection among men. However, data from recent Lesotho Demographic and Health Surveys do not demonstrate MC to be protective against HIV. These contradictory findings could partially be due to inaccurate self-reported MC status used to estimate MC prevalence. This study describes MC characteristics among men applying for Lesotho Defence Force recruitment and seeks to assess MC self-reported accuracy through comparison with physical-examination-based data. During Lesotho Defence Force applicant screening in 2009, 241 (77%) of 312 men, aged 18-25 y, consented to a self-administered demographic and MC characteristic survey and physician-performed genital examination. The extent of foreskin removal was graded on a scale of 1 (no evidence of MC) to 4 (complete MC). MC was self-reported by 27% (n = 64/239) of participants. Of the 64 men self-reporting being circumcised, physical exam showed that 23% had no evidence of circumcision, 27% had partial circumcision, and 50% had complete circumcision. Of the MCs reportedly performed by a medical provider, 3% were Grade 1 and 73% were Grade 4. Of the MCs reportedly performed by traditional circumcisers, 41% were Grade 1, while 28% were Grade 4. Among participants self-reporting being circumcised, the odds of MC status misclassification were seven times higher among those reportedly circumcised by initiation school personnel (odds ratio = 7.22; 95% CI = 2.29-22.75). Approximately 27% of participants self-reported being circumcised. However, only 50% of these men had complete MC as determined by a physical exam. Given this low MC self-report accuracy, countries scaling up voluntary medical MC (VMMC) should obtain physical-exam-based MC data to guide service delivery and cost estimates. HIV prevention messages promoting VMMC should provide comprehensive education regarding the definition of VMMC.

  9. ‘Men usually say that HIV testing is for women’: Gender dynamics & perceptions of HIV testing in Lesotho

    PubMed Central

    DiCarlo, Abby L.; Mantell, Joanne E.; Remien, Robert H.; Zerbe, Allison; Morris, Danielle; Pitt, Blanche; Abrams, Elaine J.; El-Sadr, Wafaa

    2014-01-01

    In Lesotho, men have lower HIV testing rates, less contact with HIV clinical settings, and less knowledge of HIV prevention than women. However, women’s HIV prevalence has consistently remained higher than men’s. This paper explores gender norms, sexual decision-making, and perceptions of HIV among a sample of Basotho men and women in order to understand how these factors influence HIV testing and prevention. Two hundred women and 30 men were interviewed in Lesotho between April–July 2011. Participants reported reluctance among women to share information about HIV prevention and testing with men, and resistance of men to engage with testing and/or prevention services. Findings demonstrate a critical need for educational initiatives for men, among other strategies to engage men with HIV testing and prevention. This study highlights how gender issues shape perceptions of HIV and sexual decision-making and underlines the importance of engaging men along with women in HIV prevention efforts. More studies are needed to determine the most effective strategies to inform and engage men. PMID:24854495

  10. 'Men usually say that HIV testing is for women': gender dynamics and perceptions of HIV testing in Lesotho.

    PubMed

    DiCarlo, Abby L; Mantell, Joanne E; Remien, Robert H; Zerbe, Allison; Morris, Danielle; Pitt, Blanche; Abrams, Elaine J; El-Sadr, Wafaa M

    2014-01-01

    In Lesotho, men have lower HIV testing rates, less contact with HIV clinical settings and less knowledge of HIV prevention than women. However, women's HIV prevalence has consistently remained higher than men's. This paper explores gender norms, sexual decision-making and perceptions of HIV among a sample of Basotho men and women in order to understand how these factors influence HIV testing and prevention. A total of 200 women and 30 men were interviewed in Lesotho between April and July 2011. Participants reported reluctance among women to share information about HIV prevention and testing with men, and resistance of men to engage with testing and/or prevention services. Findings demonstrate a critical need for educational initiatives for men, among other strategies, to engage men with HIV testing and prevention. This study highlights how gender issues shape perceptions of HIV and sexual decision-making and underlines the importance of engaging men along with women in HIV prevention efforts. More studies are needed to determine the most effective strategies to inform and engage men.

  11. Language Planning at a Cross-Border University in Swaziland: The Case of Teaching and Learning, Research and Institutional Administration

    ERIC Educational Resources Information Center

    Kamwendo, Gregory Hankoni; Dlamini, Nosisi Percis

    2016-01-01

    The paper discusses language planning at a cross-border university (a Zimbabwean university) that offers academic programmes to the Kingdom of Swaziland in the Southern African region. The paper is situated within the micro-level language planning framework, and discusses language decisions that govern three areas of university business, namely:…

  12. English Teaching Profiles from the British Council: Burma, Cyprus, Czechoslovakia, Ethiopia, Ghana, India, Lesotho, New Zealand, Pakistan, Qatar, Malaysia.

    ERIC Educational Resources Information Center

    British Council, London (England). English Language and Literature Div.

    The role of English and the status of English language instruction is reported for Burma, Cyprus, Czechoslovakia, Ethiopia, Ghana, India, Lesotho, New Zealand, Pakistan, Qatar, and Malaysia. The profile for each country contains a summary of English instruction within and outside of the educational system, teacher supply and qualifications,…

  13. Lessons learned from the PMTCT program in Swaziland: challenges with accepting lifelong ART for pregnant and lactating women - a qualitative study.

    PubMed

    Katirayi, Leila; Chouraya, Caspian; Kudiabor, Kwashie; Mahdi, Mohammed Ali; Kieffer, Mary Pat; Moland, Karen Marie; Tylleskar, Thorkild

    2016-10-24

    Swaziland has one of the highest HIV prevalence rates in sub-Saharan Africa, 26 % of the adult population is infected with HIV. The prevalence is highest among pregnant women, at 41.1 %. According to Swaziland's prevention of mother-to-child transmission (PMTCT) guidelines, approximately 50 % of pregnant women are eligible for antiretroviral therapy (ART) by CD4 criteria (<350 cells/ml). Studies have shown that most mother-to-child transmission and postnatal deaths occur among women who are eligible for ART. Therefore, ensuring that ART eligible women are initiated on ART is critical for PMTCT and for mother and baby survival. This study provides insight into the challenges of lifelong ART initiation among pregnant women under Option A in Swaziland. We believe that these challenges and lessons learned from initiating women on lifelong ART under Option A are relevant and important to consider during implementation of Option B+. HIV-positive, treatment-eligible, postpartum women and nurses were recruited within maternal and child health (MCH) units using convenience and purposive sampling. Participants came from both urban and rural areas. Focus group discussions (FGDs) and structured interviews using a short answer questionnaire were conducted to gain an understanding of the challenges experienced when initiating lifelong ART. Seven FGDs (of 5-11 participants) were conducted, four FGDs with nurses, two FGDs with women who initiated ART, and one FGD with women who did not initiate ART. A total of 83 interviews were conducted; 50 with women who initiated ART and 33 with women who did not initiate. Data collection with the women was conducted in the local language of SiSwati and data collection with the nurses was done in English. FGDs were audio-recorded and simultaneously transcribed and translated into English. Analysis was conducted using thematic analysis. Transcripts were coded by two researchers in the qualitative software program MAXqda v.10. Thematic

  14. From modeling to morals: imagining the future of HIV PREP in Lesotho.

    PubMed

    Kenworthy, Nora J; Bulled, Nicola

    2013-08-01

    Amidst growing global endorsements of new biomedical HIV prevention strategies, ARV-based pre-exposure prophylaxis (ARV PrEP) has garnered considerable attention as a potentially promising prevention strategy. Though it may offer more effective protection for certain at-risk groups than conventional prevention strategies (such as sexual partner reduction, condom use, and prevention of mother-to-child transmission), PrEP is more costly. PrEP requires more ongoing contact between individuals and providers, and a level of surveillance from the health system that is not necessary with other preventive measures. In this sense, it represents a new bio-technology for HIV prevention that poses particular challenges for worldwide implementation, given developing countries' struggling health systems and incomplete HIV treatment programs. Since the emergence of PrEP has stimulated ethical discussions premised on incomplete knowledge of efficacy and implementation, this paper explores the ethical parameters of a likely scenario for PrEP usage in a single, resource-poor country. We first develop a plausible model for PrEP deployment and utilization based on current PrEP research, while carefully considering the reigning institutional values of feasibility and effectiveness in global health approaches. Drawing on ethnographic research of HIV treatment and prevention approaches in Lesotho, we address ethical questions arising from this scenario of PrEP delivery. Lesotho presents a compelling and emblematic case study of PrEP's potential successes and pitfalls in a developing country, given the country's high HIV prevalence, struggles to achieve universal access to HIV treatment regimes, continued existence of stigma around the epidemic, and difficulties in addressing persistent social inequalities that fuel infections. © 2013 John Wiley & Sons Ltd.

  15. Impact of rural water projects on hygienic behaviour in Swaziland

    NASA Astrophysics Data System (ADS)

    Peter, Graciana

    In Swaziland, access to safe water supply and sanitation has improved significantly and was expected to result in improved health and, in particular, reduced infant mortality rates. On the contrary, mortality rates in the under 5 years age group are high and have doubled from 60 in 1996, to 120 deaths per 1000 in 2006. The main objective of the study was to assess whether the water projects permit, and are accompanied by, changes in hygienic behaviour to prevent transmission of diseases. The study area was Phonjwane, located in the dry Lowveld of Swaziland, where water projects play a significant role in meeting domestic water demands. Hygienic behaviour and sanitation facilities were analysed and compared before and after project. The results of the study show that domestic water supply projects have significantly reduced distances travelled and time taken to collect water, and that increased quantities of water are collected and used. While the majority of respondents (95.6%) used the domestic water project source, the quantities allowed per household (125 l which translates to an average of 20.8 l per person) were insufficient and therefore were supplemented with harvested rainwater (57.8%), water from a polluted river (17.8%), and water from a dam (2.2%). Increased water quantities have permitted more baths and washing of clothes and hands, but significant proportions of the population still skip hygienic practices such as keeping water for washing hands inside or near toilet facilities (40%) and washing hands (20%). The study concludes that the water supply project has permitted and improved hygienic practices but not sufficiently. The health benefits of safe domestic water supplies are hampered by insufficient quantities of water availed through the projects, possible contamination of the water in the house, poor hygienic behaviours and lack of appropriate sanitation measures by some households. There is a need to provide sufficient quantities of safe water

  16. Prevalence of Arthritis in Africa: A Systematic Review and Meta-Analysis

    PubMed Central

    Usenbo, Anthony; Kramer, Veronika; Young, Taryn; Musekiwa, Alfred

    2015-01-01

    Objective In this systematic review, we estimate the prevalence of six types of arthritis in Africa; namely rheumatoid arthritis, osteoarthritis, juvenile arthritis, psoriatic arthritis, gout, and ankylosing spondylitis. Methods We comprehensively searched literature on 31 August 2014 in MEDLINE, EMBASE, Web of Science and the Cochrane Library to identify eligible studies from 1975 up to 31 July 2014. Two review authors independently selected studies, extracted data, and appraised studies. We carried out random effects meta-analysis of prevalence of arthritis and assessed heterogeneity through subgroup analyses. We performed separate analyses for population- and hospital-based studies, as well as rural and urban settings. Main Findings We included 27 cross-sectional studies (20 population-based and 7 hospital-based) from Africa reporting on the prevalence of arthritis. The majority of the studies were from South Africa (44.4%, 12/27). Rheumatoid arthritis in urban settings ranged from 0.1% in Algeria, 0.6% in the DRC, to a meta-analysis overall prevalence of 2.5% in South Africa, and in rural settings ranged from a meta-analysis overall prevalence of 0.07% in South Africa, 0.3% in Egypt, to 0.4% in Lesotho. Osteoarthritis was the most prevalent form of arthritis and in urban settings it was 55.1% in South Africa and in rural settings, all in South Africa, ranged from 29.5%, 29.7%, up to 82.7% among adults aged over 65 years. Other results include highest prevalence of 33.1% for knee osteoarthritis in rural South Africa, 0.1% for ankylosing spondylitis in rural South Africa, 4.4% for psoriatic arthritis in urban South Africa, 0.7% for gout in urban South Africa, and 0.3% for juvenile idiopathic arthritis in urban Egypt. A third of the included studies had a low risk of bias (33.3%, 9/27), 40.8% (11/27) moderate risk, and 25.9% (7/27) had a high risk of bias. Conclusions In this systematic review, we have identified the paucity of latest prevalence data on arthritis

  17. Prevalence of Arthritis in Africa: A Systematic Review and Meta-Analysis.

    PubMed

    Usenbo, Anthony; Kramer, Veronika; Young, Taryn; Musekiwa, Alfred

    2015-01-01

    In this systematic review, we estimate the prevalence of six types of arthritis in Africa; namely rheumatoid arthritis, osteoarthritis, juvenile arthritis, psoriatic arthritis, gout, and ankylosing spondylitis. We comprehensively searched literature on 31 August 2014 in MEDLINE, EMBASE, Web of Science and the Cochrane Library to identify eligible studies from 1975 up to 31 July 2014. Two review authors independently selected studies, extracted data, and appraised studies. We carried out random effects meta-analysis of prevalence of arthritis and assessed heterogeneity through subgroup analyses. We performed separate analyses for population- and hospital-based studies, as well as rural and urban settings. We included 27 cross-sectional studies (20 population-based and 7 hospital-based) from Africa reporting on the prevalence of arthritis. The majority of the studies were from South Africa (44.4%, 12/27). Rheumatoid arthritis in urban settings ranged from 0.1% in Algeria, 0.6% in the DRC, to a meta-analysis overall prevalence of 2.5% in South Africa, and in rural settings ranged from a meta-analysis overall prevalence of 0.07% in South Africa, 0.3% in Egypt, to 0.4% in Lesotho. Osteoarthritis was the most prevalent form of arthritis and in urban settings it was 55.1% in South Africa and in rural settings, all in South Africa, ranged from 29.5%, 29.7%, up to 82.7% among adults aged over 65 years. Other results include highest prevalence of 33.1% for knee osteoarthritis in rural South Africa, 0.1% for ankylosing spondylitis in rural South Africa, 4.4% for psoriatic arthritis in urban South Africa, 0.7% for gout in urban South Africa, and 0.3% for juvenile idiopathic arthritis in urban Egypt. A third of the included studies had a low risk of bias (33.3%, 9/27), 40.8% (11/27) moderate risk, and 25.9% (7/27) had a high risk of bias. In this systematic review, we have identified the paucity of latest prevalence data on arthritis in Africa. More studies are needed to

  18. Fuelwood production and use in rural Swaziland: a case-study of two communities

    USGS Publications Warehouse

    Allen, J.A.; Pimentel, D.P.; Lasoie, J.P.

    1988-01-01

    Information of fuelwood consumption and the local production of wood was collected in two small rural communities in Swaziland. Fuelwood consumption was estimated to be 0.77 t persona??1 yeara??1 in one community (Sigombeni), and 0.63 t persona??1 in the other (Bhekinkhosi). Bhekinkhosi was found to be experiencing a significant fuelwood production/consumption deficit and it expected that Sigombeni will also experience fuelwood deficits by 1990. Individual farm woodlots provided the largest proportion of annual woody biomass production in both areas, accounting for 45% of all profuction in Sigombeni and 73% in Bhekinkhosi. Thirty-seven percent of all farms in Sigombeni and 23% in Bhekinkhosi had woodlots. Virtually all these woodlots consisted primarily of black or green wattle and were established by direct seeding. Two types of community woodlots were identified a?? those established when the area was a private farm and those established with government assistance. The first type of community woodlots was found only in Sigombeni, where it accounted for at least 20% of annual fuelwood production. Community wooslots established with government assistance were an insignificant source of fuelwood in both areas. At an estimated cost of nearly US $500 haa??1, community woodlots planted with government assistance are far more expensive to establish than individual farm woodlots which require no monetary expenditure, assuming local collection of seed. The results indicate a need to increase the local production of fuelwood in rural Swaziland and that encouraging the establishment of onfarm woodlots may be the most effective means of increasing production.

  19. The Impact of an Unconditional Cash Transfer on Early Child Development: The Zambia Child Grant Program

    ERIC Educational Resources Information Center

    Seidenfeld, David; Prencipe, Leah; Handa, Sudhanshu; Hawkinson, Laura

    2015-01-01

    Little research has been conducted on unconditional cash transfers (UCTs) despite their growing prevalence in Africa, including South Africa, Zambia, Zimbabwe, Kenya, Malawi, Lesotho, and Uganda. In this study, researchers implemented a randomized control trial with over 2,500 households to investigate the impact of Africa's child grant program on…

  20. Reflections on the maternal mortality millennium goal.

    PubMed

    Lawson, Gerald W; Keirse, Marc J N C

    2013-06-01

    Nearly every 2 minutes, somewhere in the world, a woman dies because of complications of pregnancy and childbirth. Every such death is an overwhelming catastrophe for everyone confronted with it. Most deaths occur in developing countries, especially in Africa and southern Asia, but a significant number also occur in the developed world. We examined the available data on the progress and the challenges to the United Nations' fifth Millennium Development Goal of achieving a 75 percent worldwide reduction in the maternal mortality by 2015 from what it was in 1990. Some countries, such as Belarus, Egypt, Estonia, Honduras, Iran, Lithuania, Malaysia, Romania, Sri Lanka and Thailand, are likely to meet the target by 2015. Many poor countries with weak health infrastructures and high fertility rates are unlikely to meet the goal. Some, such as Botswana, Cameroon, Chad, Congo, Guyana, Lesotho, Namibia, Somalia, South Africa, Swaziland and Zimbabwe, had worse maternal mortality ratios in 2010 than in 1990, partially because of wars and civil strife. Worldwide, the leading causes of maternal death are still hemorrhage, hypertension, sepsis, obstructed labor, and unsafe abortions, while indirect causes are gaining in importance in developed countries. Maternal death is especially distressing if it was potentially preventable. However, as there is no single cause, there is no silver bullet to correct the problem. Many countries also face new challenges as their childbearing population is growing in age and in weight. Much remains to be done to make safe motherhood a reality. © 2013, Copyright the Authors, Journal compilation © 2013, Wiley Periodicals, Inc.

  1. The impact of taking or not taking ARVs on HIV stigma as reported by persons living with HIV infection in five African countries.

    PubMed

    Makoae, Lucy N; Portillo, Carmen J; Uys, Leana R; Dlamini, Priscilla S; Greeff, Minrie; Chirwa, Maureen; Kohi, Thecla W; Naidoo, Joanne; Mullan, Joseph; Wantland, Dean; Durrheim, Kevin; Holzemer, William L

    2009-11-01

    This study examined the impact of taking or not taking antiretroviral (ARV) medications on stigma, as reported by people living with HIV infection in five African countries. A two group (taking or not taking ARVs) by three (time) repeated measures analysis of variance examined change in reported stigma in a cohort sample of 1454 persons living with HIV infection in Lesotho, Malawi, South Africa, Swaziland, and Tanzania. Participants self-reported taking ARV medications and completed a standardized stigma scale validated in the African context. Data were collected at three points in time, from January 2006 to March 2007. Participants taking ARV medications self-reported a mean CD4 count of 273 and those not taking ARVs self-reported a mean CD4 count of 418. Both groups reported significant decreases in total HIV stigma over time; however, people taking ARVs reported significantly higher stigma at Time 3 compared to those not taking ARVs. This study documents that this sample of 1454 HIV infected persons in five countries in Africa reported significantly less HIV stigma over time. In addition, those participants taking ARV medications experienced significantly higher HIV stigma over time compared to those not taking ARVs. This finding contradicts some authors' opinions that when clients enroll in ARV medication treatment it signifies that they are experiencing less stigma. This work provides caution to health care providers to alert clients new to ARV treatment that they may experience more stigma from their families and communities when they learn they are taking ARV medications.

  2. A field and glacier modelling based approach to determine the timing and extent of glaciation in southern Africa

    NASA Astrophysics Data System (ADS)

    Mills, Stephanie C.; Rowan, Ann V.; Barrow, Timothy T.; Plummer, Mitchell A.; Smith, Michael; Grab, Stefan W.; Carr, Simon J.; Fifield, L. Keith

    2014-05-01

    Moraines identified at high-altitude sites in southern Africa and dated to the last glacial maximum (LGM) indicate that the climate in this region was cold enough to support glaciers. Small glaciers are very sensitive to changes in temperature and precipitation and the identification of LGM moraines in southern Africa has important palaeoclimatic implications concerning the magnitude of temperature change and the seasonality of precipitation during the last glacial cycle. This paper presents a refined time-frame for likely glaciations based on surface exposure dating using Cl-36 at sites in Lesotho and reports results of a 2D glacier energy balance and ice flow modelling approach (Plummer and Phillips, 2003) to evaluate the most likely climatic scenarios associated with mapped moraine limits. Samples for surface exposure dating were collected from glacially eroded bedrock at several locations and yield ages within the timescale of the LGM. Scatter in the ages may be due to insufficient erosion of the bedrock surface due to the small and relatively thin nature of the glaciers. To determine the most likely climatic conditions that may have caused the glaciers to reach their mapped extent, we use a glacier-climate model, driven by data from local weather stations and a 30m (ASTER) DEM (sub-sampled to 10m) representation of the topographic surface. The model is forced using modern climate data for primary climatic controls (temperature and precipitation) and for secondary climatic parameters (relative humidity, cloudiness, wind speed). Various sensitivity tests were run by dropping temperature by small increments and by varying the amount of precipitation and its seasonality relative to present-day values. Results suggest that glaciers could have existed in the Lesotho highlands with a temperature depression of ~5-6 ºC and that the glaciers were highly sensitive to small changes in temperature. The additional accumulation of mass through wind redistribution appears to

  3. Dynamic Edge Effects in Small Mammal Communities across a Conservation-Agricultural Interface in Swaziland

    PubMed Central

    Hurst, Zachary M.; McCleery, Robert A.; Collier, Bret A.; Fletcher, Robert J.; Silvy, Nova J.; Taylor, Peter J.; Monadjem, Ara

    2013-01-01

    Across the planet, high-intensity farming has transformed native vegetation into monocultures, decreasing biodiversity on a landscape scale. Yet landscape-scale changes to biodiversity and community structure often emerge from processes operating at local scales. One common process that can explain changes in biodiversity and community structure is the creation of abrupt habitat edges, which, in turn, generate edge effects. Such effects, while incredibly common, can be highly variable across space and time; however, we currently lack a general analytical framework that can adequately capture such spatio-temporal variability. We extend previous approaches for estimating edge effects to a non-linear mixed modeling framework that captures such spatio-temporal heterogeneity and apply it to understand how agricultural land-uses alter wildlife communities. We trapped small mammals along a conservation-agriculture land-use interface extending 375 m into sugarcane plantations and conservation land-uses at three sites during dry and wet seasons in Swaziland, Africa. Sugarcane plantations had significant reductions in species richness and heterogeneity, and showed an increase in community similarity, suggesting a more homogenized small mammal community. Furthermore, our modeling framework identified strong variation in edge effects on communities across sites and seasons. Using small mammals as an indicator, intensive agricultural practices appear to create high-density communities of generalist species while isolating interior species in less than 225 m. These results illustrate how agricultural land-use can reduce diversity across the landscape and that effects can be masked or magnified, depending on local conditions. Taken together, our results emphasize the need to create or retain natural habitat features in agricultural mosaics. PMID:24040269

  4. Sexual behaviors and attitudes of high school students in the kingdom of Swaziland.

    PubMed

    Mclean, P E

    1995-07-01

    The author examined the sex behaviors and attitudes of 111 high school students with a steady partner in the Kingdom of Swaziland. Data were collected through participant observation during 1987-88, discussions with key informants during 1987-88 and 1990-91, and in-depth structured interviews with the adolescents from rural and urban government high schools. 78 of the students were coitally active, with 57.5% of boys and 68.4% of girls reporting first coitus at 16 years of age or younger. 15.0% of males and no females reported beginning coitus after 18 years of age. 45.0% of the boys and 68.4% of the girls reported never using contraception; 50% of males said they used condoms. Swaziland is largely polygynous. There were, however, modest gender differences on attitudes about multiple partners and demonstrating affection. The young women mainly expected financial support from a sex partner. Since many adolescent men cannot provide such support, many of the adolescent women pursue sexual relations with older, more financially capable men. The author notes that the parents of young Swazi women do not condone such relationships, especially if the man does not seem interested in marriage. No school policy exists on teaching family life education and both unplanned pregnancy and septic abortions are real problems. School policy demands the expulsion of pregnant girls for the duration of their pregnancy. Once delivered, the young mothers may attend a another school. Finally, although parental guidance is less influential than in the past, traditional values attached to gender roles remain intact among the adolescents interviewed for this study.

  5. Workable solutions to FP in Africa.

    PubMed

    1991-12-01

    The 3rd Pan African Conference on the Integrated Family Planning, Nutrition and Parasite Control Project (PANFRICO III) was held in October 1991 and organized by JOICFP, UNFPA and IPPF. The Ghana IP Steering Committee implemented it. In addition to the 5 IP implementing countries--Ethiopia, the Gambia, Ghana, Tanzania, and Zambia--other countries attending were: Kenya, Lesotho, Madagascar, Mali, Nigeria, Senegal, Sierra Leone, Swaziland, Togo, and Uganda. Governmental and nongovernmental organizations (NGOs) and international groups such as UNFPA, IPPF, FAO, and USAID also attended. The theme was seeking a strategic approach to family planning through primary health care. Participants resolved to increase the support and involvement of African governments in IP implementation. It was recognized that self-reliance, cost effectiveness, and efficient use of resources were important to sustainability. It was also agreed that IP should integrate family planning (FP) with Maternal and Child Health (MCH) and Primary Health Care (PHC) in order to overcome traditional and cultural obstacles to FP and to gain full participation of men in the communities. Horizontal integration was the primary thrust. there was agreement that there should be collaboration between UNFPA, IPPF, and JOICFP, and relevant governments and NGOs. Country-specific attention needs to be paid to expanding IP functions within the 5 IP countries. In Ghana, IP pilot areas have been successful in increasing the FP acceptance rate from 17.4% in 1988 to 51.9% in 1991. IP experiences in Indonesia were presented, including the concept of fee-charged PHC services in order to achieve self-reliance in FP/MCH projects. The response was the request for further technical cooperation between developing countries. The workshop activities were particularly beneficial, and requests were made for discussion of IEC, management, service delivery, nutrition, environmental sanitation, self-reliance, community participation

  6. Three parallel information systems for malaria elimination in Swaziland, 2010-2015: are the numbers the same?

    PubMed

    Zulu, Z; Kunene, S; Mkhonta, N; Owiti, P; Sikhondze, W; Mhlanga, M; Simelane, Z; Geoffroy, E; Zachariah, R

    2018-04-25

    Background: To be able to eliminate malaria, accurate, timely reporting and tracking of all confirmed malaria cases is crucial. Swaziland, a country in the process of eliminating malaria, has three parallel health information systems. Design: This was a cross-sectional study using country-wide programme data from 2010 to 2015. Methods: The Malaria Surveillance Database System (MSDS) is a comprehensive malaria database, the Immediate Disease Notification System (IDNS) is meant to provide early warning and trigger case investigations to prevent onward malaria transmission and potential epidemics, and the Health Management Information Systems (HMIS) reports on all morbidity at health facility level. Discrepancies were stratified by health facility level and type. Results: Consistent over-reporting of 9-85% was noticed in the HMIS, principally at the primary health care level (clinic and/or health centre). In the IDNS, the discrepancy went from under-reporting (12%) to over-reporting (32%); this was also seen at the primary care level. At the hospital level, there was under-reporting in both the HMIS and IDNS. Conclusions: There are considerable discrepancies in the numbers of confirmed malaria cases in the HMIS and IDNS in Swaziland. This may misrepresent the malaria burden and delay case investigation, predisposing the population to potential epidemics. There is an urgent need to improve data integrity in order to guide and evaluate efforts toward elimination.

  7. The highly neglected burden of resistant hypertension in Africa: a systematic review and meta-analysis

    PubMed Central

    Nansseu, Jobert Richie N; Noubiap, Jean Jacques N; Mengnjo, Michel K; Aminde, Leopold Ndemnge; Essouma, Mickael; Jingi, Ahmadou M; Bigna, Jean Joel R

    2016-01-01

    Objective The hypertension epidemic in Africa collectively with very low rates of blood pressure control may predict an incremented prevalence of resistant hypertension (RH) across the continent. The aim of this study was to determine the prevalence of RH and associated risk factors in Africa. Data sources We conducted a comprehensive search of electronic databases (PubMed, EMBASE, Africa Wide Information and Africa Index Medicus) completed by manual search of articles, regardless of language or publication date. Methods We included studies which have reported the prevalence and/or risk factors for RH in Africa from inception to 19 May 2016. Forest plots were drawn to visualise the combined prevalence of RH and extent of statistical heterogeneity between studies. Results Out of 259 retrieved studies, only 5 from Cameroon, Nigeria, Burkina Faso, Lesotho and Algeria with a total population of 4 068 patients were finally included in this review. There was no study from the Eastern part of Africa. Though the definition of RH was not similar across studies, its prevalence was respectively 11.7%, 4.9%, 14.6%, 14.3% and 19.0%, with an overall pooled prevalence of 12.1% (95% CI 8.0% to 17.7%). Potential risk factors were: non-compliance to treatment, ageing, male sex, dyslipidaemia, metabolic syndrome, previous cardiovascular events, physical inactivity and stress, but not excessive salt intake, alcohol and coffee ingestions. Moreover, diabetes, smoking, obesity and renal insufficiency yielded discrepant results. Conclusions There is a huge dearth of research on the epidemiology of RH in Africa. Thereby, an extensive study of RH prevalence and risk factors is still largely warranted to curtail the high and continuously increasing burden of hypertension across Africa. PMID:27650760

  8. Age Targeting of Voluntary Medical Male Circumcision Programs Using the Decision Makers' Program Planning Toolkit (DMPPT) 2.0.

    PubMed

    Kripke, Katharine; Opuni, Marjorie; Schnure, Melissa; Sgaier, Sema; Castor, Delivette; Reed, Jason; Njeuhmeli, Emmanuel; Stover, John

    2016-01-01

    Despite considerable efforts to scale up voluntary medical male circumcision (VMMC) for HIV prevention in priority countries over the last five years, implementation has faced important challenges. Seeking to enhance the effect of VMMC programs for greatest and most immediate impact, the U. S. President's Plan for AIDS Relief (PEPFAR) supported the development and application of a model to inform national planning in five countries from 2013-2014. The Decision Makers' Program Planning Toolkit (DMPPT) 2.0 is a simple compartmental model designed to analyze the effects of client age and geography on program impact and cost. The DMPPT 2.0 model was applied in Malawi, South Africa, Swaziland, Tanzania, and Uganda to assess the impact and cost of scaling up age-targeted VMMC coverage. The lowest number of VMMCs per HIV infection averted would be produced by circumcising males ages 20-34 in Malawi, South Africa, Tanzania, and Uganda and males ages 15-34 in Swaziland. The most immediate impact on HIV incidence would be generated by circumcising males ages 20-34 in Malawi, South Africa, Tanzania, and Uganda and males ages 20-29 in Swaziland. The greatest reductions in HIV incidence over a 15-year period would be achieved by strategies focused on males ages 10-19 in Uganda, 15-24 in Malawi and South Africa, 10-24 in Tanzania, and 15-29 in Swaziland. In all countries, the lowest cost per HIV infection averted would be achieved by circumcising males ages 15-34, although in Uganda this cost is the same as that attained by circumcising 15- to 49-year-olds. The efficiency, immediacy of impact, magnitude of impact, and cost-effectiveness of VMMC scale-up are not uniform; there is important variation by age group of the males circumcised and countries should plan accordingly.

  9. Drivers and Dynamics of Global Environmental Change in Southern Africa

    NASA Astrophysics Data System (ADS)

    Jewitt, Graham; Munishi, Subira; Kunz, Richard; Viola, Paula

    2010-05-01

    Africa's potential to provide food, fuel, fibre and fodder for future global food and energy security has made it a target for a myriad investors from developed and developing countries alike. In many places, land grants and purchases have led to the establishment of huge monoculture production areas for food, fuel, fibre (maize, sugar cane, jatropha, plantation forestry etc) often preceded by deforestation and large scale utilisation and modification of available water resources. This coupled with the likelihood of rapid urbanisation in Africa over the next forty years and associated impacts linked to the high concentrations of inhabitants utilising and ultimately degrading available natural resources (e.g. wood for charcoal; water quality) have made Africa's ecosystems and people amongst the most vulnerable to global environmental change. Key questions that arise are how available scientific knowledge can best be utilized to reduce this vulnerability, where key gaps in knowledge in understanding the inter-linkages between societal needs and Food- Fibre-Energy-Water supply exist and how to best address the necessary complexity of considering these at different spatial and temporal scales. Drawing on the Ecosystem Goods and Services approach, we present key messages from ongoing research activities in South Africa, Swaziland, Mozambique and Tanzania and report on progress in applying management tools and systems to support decision making in these areas where development needs are critical. We also highlight lessons drawn from situations where unintended consequences have resulted from well meaning or politically expedient initiatives linked to large donor or foreign investment schemes, such as "outgrower" programmes, and where major environmental damage and ultimately the permanent loss of productivity of some landscapes has occurred.

  10. Alga-like forms in onverwacht series, South Africa: Oldest recognized lifelike forms on earth

    USGS Publications Warehouse

    Engel, A.E.J.; Nagy, B.; Nagy, L.A.; Engel, C.G.; Kremp, G.O.W.; Drew, C.M.

    1968-01-01

    Spheroidal and cupshaped, carbonaceous alga-like bodies, as well as filamentous structures and amorphous carbonaceous matter occur in sedimentary rocks of the Onverwacht Series (Swaziland System) in South Africa. The Onverwacht sediments are older than 3.2 eons, and they are probably the oldest, little-altered sedimentary rocks on Earth. The basal Onverwacht sediments lie approximutely 10,000 meters stratigraphically below the Fig Tree sedimentary rocks, from which similar organic microstructures have been interpreted as alga-like micro-fossils. The Onverwacht spheroids and filaments are best preserved in black, carbon-rich cherts and siliceous argillites interlayered with thick sequences of lavas. These lifelike forms and the associated carbonaceous substances are probably biological in origin. If so, the origins of unicellular life on Earth are buried in older rocks now obliterated by igneous and metamorphic events.

  11. Modelling Bambara Groundnut Yield in Southern Africa: Towards a Climate-Resilient Future

    NASA Technical Reports Server (NTRS)

    Karunaratne, A. S.; Walker, S.; Ruane, A. C.

    2015-01-01

    Current agriculture depends on a few major species grown as monocultures that are supported by global research underpinning current productivity. However, many hundreds of alternative crops have the potential to meet real world challenges by sustaining humanity, diversifying agricultural systems for food and nutritional security, and especially responding to climate change through their resilience to certain climate conditions. Bambara groundnut (Vigna subterranea (L.) Verdc.), an underutilised African legume, is an exemplar crop for climate resilience. Predicted yield performances of Bambara groundnut by AquaCrop (a crop-water productivity model) were evaluated for baseline (1980-2009) and mid-century climates (2040-2069) under 20 downscaled Global Climate Models (CMIP5-RCP8.5), as well as for climate sensitivities (AgMIPC3MP) across 3 locations in Southern Africa (Botswana, South Africa, Namibia). Different land - races of Bambara groundnut originating from various semi-arid African locations showed diverse yield performances with diverse sensitivities to climate. S19 originating from hot-dry conditions in Namibia has greater future yield potential compared to the Swaziland landrace Uniswa Red-UN across study sites. South Africa has the lowest yield under the current climate, indicating positive future yield trends. Namibia reported the highest baseline yield at optimum current temperatures, indicating less yield potential in future climates. Bambara groundnut shows positive yield potential at temperatures of up to 31degC, with further warming pushing yields down. Thus, many regions in Southern Africa can utilize Bambara groundnut successfully in the coming decades. This modelling exercise supports decisions on genotypic suitability for present and future climates at specific locations.

  12. Implementation of Regional and International HIV and AIDS Prevention, Treatment, Care and Support Conventions and Declarations in Lesotho, Malawi and Mozambique

    ERIC Educational Resources Information Center

    Kalanda, Boniface; Mamimine, Patrick; Taela, Katia; Chingandu, Louis; Musuka, Godfrey

    2010-01-01

    The governments across the world have endorsed numerous international Conventions and Declarations (C&Ds) that enhance interventions to reduce the impact of HIV and AIDS. The objective of this study was to assess the extent to which the governments of Lesotho, Malawi and Mozambique have implemented HIV and AIDS international and regional…

  13. Twenty-five years of change in southern African passerine diversity: nonclimatic factors of change.

    PubMed

    Péron, Guillaume; Altwegg, Res

    2015-09-01

    We analysed more than 25 years of change in passerine bird distribution in South Africa, Swaziland and Lesotho, to show that species distributions can be influenced by processes that are at least in part independent of the local strength and direction of climate change: land use and ecological succession. We used occupancy models that separate species' detection from species' occupancy probability, fitted to citizen science data from both phases of the Southern African Bird Atlas Project (1987-1996 and 2007-2013). Temporal trends in species' occupancy probability were interpreted in terms of local extinction/colonization, and temporal trends in detection probability were interpreted in terms of change in abundance. We found for the first time at this scale that, as predicted in the context of bush encroachment, closed-savannah specialists increased where open-savannah specialists decreased. In addition, the trend in the abundance of species a priori thought to be favoured by agricultural conversion was negatively correlated with human population density, which is in line with hypotheses explaining the decline in farmland birds in the Northern Hemisphere. In addition to climate, vegetation cover and the intensity and time since agricultural conversion constitute important predictors of biodiversity changes in the region. Their inclusion will improve the reliability of predictive models of species distribution. © 2015 John Wiley & Sons Ltd.

  14. The microbial quality of drinking water in Manonyane community: Maseru District (Lesotho).

    PubMed

    Gwimbi, P

    2011-09-01

    Provision of good quality household drinking water is an important means of improving public health in rural communities especially in Africa; and is the rationale behind protecting drinking water sources and promoting healthy practices at and around such sources. To examine the microbial content of drinking water from different types of drinking water sources in Manonyane community of Lesotho. The community's hygienic practices around the water sources are also assessed to establish their contribution to water quality. Water samples from thirty five water sources comprising 22 springs, 6 open wells, 6 boreholes and 1 open reservoir were assessed. Total coliform and Escherichia coli bacteria were analyzed in water sampled. Results of the tests were compared with the prescribed World Health Organization desirable limits. A household survey and field observations were conducted to assess the hygienic conditions and practices at and around the water sources. Total coliform were detected in 97% and Escherichia coli in 71% of the water samples. The concentration levels of Total coliform and Escherichia coli were above the permissible limits of the World Health Organization drinking water quality guidelines in each case. Protected sources had significantly less number of colony forming units (cfu) per 100 ml of water sample compared to unprotected sources (56% versus 95%, p < 0.05). Similarly in terms of Escherichia coli, protected sources had less counts (7% versus 40%, p < 0.05) compared with those from unprotected sources. Hygiene conditions and practices that seemed to potentially contribute increased total coliform and Escherichia coli counts included non protection of water sources from livestock faeces, laundry practices, and water sources being down slope of pit latrines in some cases. These findings suggest source water protection and good hygiene practices can improve the quality of household drinking water where disinfection is not available. The results also

  15. 'Female condoms give women greater control': a qualitative assessment of the experiences of commercial sex workers in Swaziland.

    PubMed

    Mathenjwa, Thulile; Maharaj, Pranitha

    2012-10-01

    To explore commercial sex workers' experiences with the female condom in Swaziland. This is a qualitative study that draws on two focus group discussions and ten individual in-depth interviews with female commercial sex workers in Lavumisa, Swaziland. The findings suggest that the majority of female sex workers prefer to use the female condom with their clients because it offers them greater control over the sexual encounter. Other factors that facilitate its use include the absence of side effects, the enhancement of sexual pleasure and protection against the risk of STIs (including HIV). In addition, the women reported that the female condom is stronger and more resistant to breakage than the male condom. Moreover, the female condoms can be inserted well in advance of sexual intercourse. Difficulties of insertion, partner objection and limited product availability were some of the barriers to the use of the device. There was also a tendency to reuse the female condoms because of lack of product availability and privacy to insert it. Although female condom use involves negotiation with clients, the fact that it offers sex workers an independent method of protection gives them more power and also, increases their ability to control their sexual and reproductive health.

  16. Factors affecting sustainability of rural water schemes in Swaziland

    NASA Astrophysics Data System (ADS)

    Peter, Graciana; Nkambule, Sizwe E.

    The Millennium Development Goal (MDG) target to reduce the proportion of people without sustainable access to safe drinking water by the year 2015 has been met as of 2010, but huge disparities exist. Some regions, particularly Sub-Saharan Africa are lagging behind it is also in this region where up to 30% of the rural schemes are not functional at any given time. There is need for more studies on factors affecting sustainability and necessary measures which when implemented will improve the sustainability of rural water schemes. The main objective of this study was to assess the main factors affecting the sustainability of rural water schemes in Swaziland using a Multi-Criteria Analysis Approach. The main factors considered were: financial, social, technical, environmental and institutional. The study was done in Lubombo region. Fifteen functional water schemes in 11 communities were studied. Data was collected using questionnaires, checklist and focused group discussion guide. A total of 174 heads of households were interviewed. Statistical Package for Social Sciences (SPSS) was used to analyse the data and to calculate sustainability scores for water schemes. SPSS was also used to classify sustainability scores according to sustainability categories: sustainable, partially sustainable and non-sustainable. The averages of the ratings for the different sub-factors studied and the results on the sustainability scores for the sustainable, partially sustainable and non-sustainable schemes were then computed and compared to establish the main factors influencing sustainability of the water schemes. The results indicated technical and social factors as most critical while financial and institutional, although important, played a lesser role. Factors which contributed to the sustainability of water schemes were: functionality; design flow; water fetching time; ability to meet additional demand; use by population; equity; participation in decision making on operation and

  17. Family planning practices and pregnancy intentions among HIV-positive and HIV-negative postpartum women in Swaziland: a cross sectional survey.

    PubMed

    Warren, Charlotte E; Abuya, Timothy; Askew, Ian

    2013-07-15

    In settings where sexually transmitted infection (STI) and HIV prevalence is high, the postpartum period is a time of increased biological susceptibility to pregnancy related sepsis. Enabling women living with HIV to avoid unintended pregnancies during the postpartum period can reduce vertical transmission and maternal mortality associated with HIV infection. We describe family planning (FP) practices and fertility desires of HIV-positive and HIV-negative postpartum women in Swaziland. Data are drawn from a baseline survey of a four-year multi country prospective cohort study under the Integra Initiative, which is measuring the benefits and costs of providing integrated HIV and sexual and reproductive health (SRH) services in Kenya and Swaziland. We compare data from 386 HIV-positive women and 483 HIV-negative women recruited in Swaziland between February and August 2010. Data was collected on hand-held personal digital assistants (PDAs) covering fertility desires, mistimed or unwanted pregnancies and contraceptive use prior to their most recent pregnancy. Data were analysed using Stata 10.0. Descriptive statistics were conducted using the chi square test for categorical variables. Measures of effect were assessed using multivariate fixed effects logistic regression model accounting for clustering at facility level and the results are presented as adjusted odds ratios. Majority (69.2%) of postpartum women reported that their most recent pregnancy was unintended with no differences between HIV-positive and HIV-negative women: OR: 0.96 (95% CI) (0.70, 1.32). Although, there were significant differences between HIV-positive and HIV-negative women who reported that their previous pregnancy was unwanted, (20.7% vs. 13.5%, p = 0.004), when adjusted this was not significant OR: 1.43 (0.92, 1.91). 47.2% of HIV-positive women said it was mistimed compared to 52.5%, OR: 0.79 (0.59, 1.06). 37.9% of all women said they do not want another child. Younger women were more

  18. Three parallel information systems for malaria elimination in Swaziland, 2010–2015: are the numbers the same?

    PubMed Central

    Kunene, S.; Mkhonta, N.; Owiti, P.; Sikhondze, W.; Mhlanga, M.; Simelane, Z.; Geoffroy, E.; Zachariah, R.

    2018-01-01

    Background: To be able to eliminate malaria, accurate, timely reporting and tracking of all confirmed malaria cases is crucial. Swaziland, a country in the process of eliminating malaria, has three parallel health information systems. Design: This was a cross-sectional study using country-wide programme data from 2010 to 2015. Methods: The Malaria Surveillance Database System (MSDS) is a comprehensive malaria database, the Immediate Disease Notification System (IDNS) is meant to provide early warning and trigger case investigations to prevent onward malaria transmission and potential epidemics, and the Health Management Information Systems (HMIS) reports on all morbidity at health facility level. Discrepancies were stratified by health facility level and type. Results: Consistent over-reporting of 9–85% was noticed in the HMIS, principally at the primary health care level (clinic and/or health centre). In the IDNS, the discrepancy went from under-reporting (12%) to over-reporting (32%); this was also seen at the primary care level. At the hospital level, there was under-reporting in both the HMIS and IDNS. Conclusions: There are considerable discrepancies in the numbers of confirmed malaria cases in the HMIS and IDNS in Swaziland. This may misrepresent the malaria burden and delay case investigation, predisposing the population to potential epidemics. There is an urgent need to improve data integrity in order to guide and evaluate efforts toward elimination. PMID:29713588

  19. Fairness and equity in the provision of anti-retroviral therapy: some reflections from Lesotho.

    PubMed

    Armstrong, Russell

    2010-12-01

    The number of people in immediate need of anti-retroviral treatment (ART) in the southern African region continues to significantly exceed the capacity of health systems there to provide it. Approaches to this complex rationing dilemma have evolved in different directions. The ethical concepts of fairness and equity have been suggested as a basis to guide the development of approaches to select patients for ART. This article reports the results of a case study on patient selection at a rural ART clinic in Lesotho. The purpose of the study was to examine whether or not such concepts had relevance or operative value for a treatment team providing ART in rural Lesotho. The study found that while concepts of fairness and equity were relevant to the work of the treatment team, patient selection practices did not necessarily reflect what these concepts entail. The idea of fairness as a structured, formalized selection process did not figure in the approach to ART provision at the site. A less formal, 'first-come-first-served' approach was adopted. While there was knowledge among some team members that social, economic or geographic conditions inhibit individuals and groups from gaining access to ART and that this was inequitable, it was felt that there was little they could do to try to mediate the impact of these conditions. The study's findings pose importance questions about the approach to ART programming in resource constrained settings. The findings also question the relevance of trying to achieve fairness and equity when the gap between need for care and capacity to provide it remains so large. © 2009 Blackwell Publishing Ltd.

  20. Low-cost small scale parabolic trough collector design for manufacturing and deployment in Africa

    NASA Astrophysics Data System (ADS)

    Orosz, Matthew; Mathaha, Paul; Tsiu, Anadola; Taele, B. M.; Mabea, Lengeta; Ntee, Marcel; Khakanyo, Makoanyane; Teker, Tamer; Stephens, Jordan; Mueller, Amy

    2016-05-01

    Concentrating Solar Power is expanding its deployment on the African subcontinent, highlighting the importance of efforts to indigenize manufacturing of this technology to increase local content and therefore local economic benefits of these projects. In this study a design for manufacturing (DFM) exercise was conducted to create a locally produced parabolic trough collector (the G4 PTC). All parts were sourced or fabricated at a production facility in Lesotho, and several examples of the design were prototyped and tested with collaborators in the Government of Lesotho's Appropriate Technology Services division and the National University of Lesotho. Optical and thermal performance was simulated and experimentally validated, and pedagogical pre-commercial versions of the PTC have been distributed to higher education partners in Lesotho and Europe. The cost to produce the PTC is 180 USD/m2 for a locally manufactured heat collection element (HCE) capable of sustaining 250C operation at ~65% efficiency. A version with an imported evacuated HCE can operate at 300°C with 70% efficiency. Economically relevant applications for this locally produced PTC include industrial process heat and distributed generation scenarios where cogeneration is required.

  1. Depressive symptoms and hazardous/harmful alcohol use are prevalent and correlate with stigma among TB-HIV patients in Lesotho.

    PubMed

    Hayes-Larson, E; Hirsch-Moverman, Y; Saito, S; Frederix, K; Pitt, B; Maama-Maime, L; Howard, A A

    2017-11-01

    Limited data exist on the prevalence and correlates, including stigma, of mental health conditions, including depressive symptoms and alcohol use, among patients co-infected with tuberculosis (TB) and the human immunodeficiency virus (HIV) in sub-Saharan Africa, despite their negative impact on health outcomes. To assess the prevalence and correlates of depressive symptoms and hazardous/harmful alcohol use among TB-HIV patients in the Start TB patients on ART and Retain on Treatment (START) study. START, a mixed-methods cluster-randomized trial, evaluated a combination intervention package vs. standard of care (SOC) to improve treatment outcomes in TB-HIV co-infected patients in Lesotho. Moderate/severe depressive symptoms and hazardous/harmful alcohol use were measured using baseline questionnaire data collected from April 2013 to March 2015. Demographic, psychosocial, and TB- and HIV-related knowledge and attitudes, including stigma, were assessed for association with both conditions using generalized linear mixed models. Among 371 participants, 29.8% reported moderate/severe depressive symptoms, and 24.7% reported hazardous/harmful alcohol use; 7% reported both. Depressive symptoms were significantly associated with less education, more difficulty understanding written medical information, non-disclosure of TB, greater TB stigma, and the SOC study arm. Hazardous/harmful alcohol use was significantly associated with male sex, as well as greater TB and external HIV stigma. Prevalence of depressive symptoms and hazardous/harmful alcohol use were high, suggesting a need for routine screening for, and treatment of, mental health disorders in TB-HIV patients.

  2. Situation Report--Barbados, Finland, German Democratic Republic, Italy, Lesotho, Luxembourg, Malagasy Republic (Madagascar), Malaysia (West), Netherlands, Poland, Portugal, Singapore, Sweden, Syrian Arab Republic, and Yugoslavia.

    ERIC Educational Resources Information Center

    International Planned Parenthood Federation, London (England).

    Data relating to population and family planning in 15 foreign countries are presented in these situation reports. Countries included are Barbados, Finland, German Democratic Republic, Italy, Lesotho, Luxembourg, Malagasy Republic, Malaysia (West), Netherlands, Poland, Portugal, Singapore, Sweden, Syrian Arab Republic, and Yogoslavia. Information…

  3. Are the oldest 'fossils', fossils

    NASA Technical Reports Server (NTRS)

    Schopf, J. W.

    1976-01-01

    A comparative statistical study has been carried out on populations of modern algae, Precambrian algal microfossils, the 'organized elements' of the Orgueil carbonaceous meteorite, and the oldest microfossil-like objects now known (spheroidal bodies from the Fig Tree and Onverwacht Groups of the Swaziland Supergroup, South Africa). The distribution patterns exhibited by the more than 3000 m.y.-old Swaziland microstructures bear considerable resemblance to those of the abiotic 'organized elements' but differ rather markedly from those exhibited by younger, assuredly biogenic, populations. Based on these comparisons, it is concluded that the Swaziland spheroids could be, at least in part, of nonbiologic origin; these oldest known fossil-like microstructures should not be regarded as constituting firm evidence of Archean life.

  4. The production of consumption: addressing the impact of mineral mining on tuberculosis in southern Africa

    PubMed Central

    Basu, Sanjay; Stuckler, David; Gonsalves, Gregg; Lurie, Mark

    2009-01-01

    Background Miners in southern Africa experience incident rates of tuberculosis up to ten times greater than the general population. Migration to and from mines may be amplifying tuberculosis epidemics in the general population. Discussion Migration to and from mineral mines contributes to HIV risks and associated tuberculosis incidence. Health and safety conditions within mines also promote the risk of silicosis (a tuberculosis risk factor) and transmission of tuberculosis bacilli in close quarters. In the context of migration, current tuberculosis prevention and treatment strategies often fail to provide sufficient continuity of care to ensure appropriate tuberculosis detection and treatment. Reports from Lesotho and South Africa suggest that miners pose transmission risks to other household or community members as they travel home undetected or inadequately treated, particularly with drug-resistant forms of tuberculosis. Reducing risky exposures on the mines, enhancing the continuity of primary care services, and improving the enforcement of occupational health codes may mitigate the harmful association between mineral mining activities and tuberculosis incidence among affected communities. Summary Tuberculosis incidence appears to be amplified by mineral mining operations in southern Africa. A number of immediately-available measures to improve continuity of care for miners, change recruitment and compensation practices, and reduce the primary risk of infection may critically mitigate the negative association between mineral mining and tuberculosis. PMID:19785769

  5. High risk sexual behaviors for HIV among the in-school youth in Swaziland: a structural equation modeling approach.

    PubMed

    Sacolo, Hlengiwe Nokuthula; Chung, Min-Huey; Chu, Hsin; Liao, Yuan-Mei; Chen, Chiung-Hua; Ou, Keng-Liang; Chang, Lu-I; Chou, Kuei-Ru

    2013-01-01

    Global efforts in response to the increased prevalence of the human immunodeficiency virus (HIV) are mainly aimed at reducing high risk sexual behaviors among young people. However, knowledge regarding intentions of young people to engage in protective sexual behaviors is still lacking in many countries around the world, especially in Sub-Saharan Africa where prevalence of human immunodeficiency virus is the highest. The objective of this study was to test the theory of planned behavior (TPB) for predicting factors associated with protective sexual behaviors, including sexual abstinence and condom use, among in-school youths aged between 15 and 19 years in Swaziland. This cross-sectional survey was conducted using a anonymous questionnaire. A two-stage stratified and cluster random sampling method was used. Approximately one hundred pupils from each of four schools agreed to participate in the study, providing a total sample size of 403 pupils of which 369 were ultimately included for data analysis. The response rate was 98%. Structural equation modeling was used to analyse hypothesized paths. The TPB model used in this study was effective in predicting protective sexual behavior among Swazi in-school youths, as shown by model fit indices. All hypothesized constructs significantly predicted intentions for abstinence and condom use, except perceived abstinence controls. Subjective norms were the strongest predictors of intention for premarital sexual abstinence; however, perceived controls for condom use were the strongest predictors of intention for condom use. Our findings support application of the model in predicting determinants of condom use and abstinence intentions among Swazi in-school youths.

  6. High Risk Sexual Behaviors for HIV among the In-School Youth in Swaziland: A Structural Equation Modeling Approach

    PubMed Central

    Chu, Hsin; Liao, Yuan-Mei; Chen, Chiung-Hua; Ou, Keng-Liang; Chang, Lu-I; Chou, Kuei-Ru

    2013-01-01

    Background Global efforts in response to the increased prevalence of the human immunodeficiency virus (HIV) are mainly aimed at reducing high risk sexual behaviors among young people. However, knowledge regarding intentions of young people to engage in protective sexual behaviors is still lacking in many countries around the world, especially in Sub-Saharan Africa where prevalence of human immunodeficiency virus is the highest. The objective of this study was to test the theory of planned behavior (TPB) for predicting factors associated with protective sexual behaviors, including sexual abstinence and condom use, among in-school youths aged between 15 and 19 years in Swaziland. Methods This cross-sectional survey was conducted using a anonymous questionnaire. A two-stage stratified and cluster random sampling method was used. Approximately one hundred pupils from each of four schools agreed to participate in the study, providing a total sample size of 403 pupils of which 369 were ultimately included for data analysis. The response rate was 98%. Structural equation modeling was used to analyse hypothesized paths. Results The TPB model used in this study was effective in predicting protective sexual behavior among Swazi in-school youths, as shown by model fit indices. All hypothesized constructs significantly predicted intentions for abstinence and condom use, except perceived abstinence controls. Subjective norms were the strongest predictors of intention for premarital sexual abstinence; however, perceived controls for condom use were the strongest predictors of intention for condom use. Conclusions Our findings support application of the model in predicting determinants of condom use and abstinence intentions among Swazi in-school youths. PMID:23861756

  7. Orthotomicus erosus: A new pine-infesting bark beetle in the United States

    Treesearch

    Robert A. Haack

    2004-01-01

    Established populations of yet another new exotic beetle (Scolytidae) were discovered in the United States in 2004: Othotomicus erosus. This Eurasian bark beetle, commonly called the Mediterranean pine engraver, is native to the pine (Pinus)growing areas of Europe, northern Africa, and Asia. It has also been introduced to Chile, Fiji, South Africa, and Swaziland....

  8. Emigration dynamics in Sub-Saharan Africa.

    PubMed

    Adepoju, A

    1995-01-01

    effects of draught. The interaction of all of these factors has contributed to refugee flows of acute magnitude and complexity. The next major section of the report describes the migration situation in each subregion (Western Africa, Nigeria and Ghana, the Sahel, Mail, Eastern Africa, Southern Africa, and Lesotho). The report concludes that migration in response to socioeconomic conditions will continue until conditions improve in the countries of origin.

  9. Mapping Soil Organic Carbon Resources Across Agricultural Land Uses in Highland Lesotho Using High Resolution Satellite Imagery

    NASA Astrophysics Data System (ADS)

    Knight, J.; Adam, E.

    2015-12-01

    Mapping spatial patterns of soil organic carbon (SOC) using high resolution satellite imagery is especially important in inaccessible or upland areas that have limited field measurements, where land use and land cover (LULC) are changing rapidly, or where the land surface is sensitive to overgrazing and high rates of soil erosion and thus sediment, nutrient and carbon export. Here we outline the methods and results of mapping soil organic carbon in highland areas (~2400 m) of eastern Lesotho, southern Africa, across different land uses. Bedrock summit areas with very thin soils are dominated by xeric alpine grassland; terrace agriculture with strip fields and thicker soils is found within river valleys. Multispectral Worldview 2 imagery was used to map LULC across the region. An overall accuracy of 88% and kappa value of 0.83 were achieved using a support vector machine model. Soils were examined in the field from different LULC areas for properties such as soil depth, maturity and structure. In situ soils in the field were also evaluated using a portable analytical spectral device (ASD) in order to ground truth spectral signatures from Worldview. Soil samples were examined in the lab for chemical properties including organic carbon. Regression modeling was used in order to establish a relationship between soil characteristics and soil spectral reflectance. We were thus able to map SOC across this diverse landscape. Results show that there are notable differences in SOC between upland and agricultural areas which reflect both soil thickness and maturity, and land use practices such as manuring of fields by cattle. Soil erosion and thus carbon (nutrient) export is significant issue in this region, which this project will now be examining.

  10. “The Luggage that isn’t Theirs is Too Heavy…”:Understandings of Orphan Disadvantage in Lesotho

    PubMed Central

    Goldberg, Rachel E.; Short, Susan E.

    2012-01-01

    In Southern Africa, high adult HIV prevalence has fueled concern about the welfare of children losing parents to the epidemic. A growing body of evidence indicates that parental, particularly maternal, death is negatively associated with child outcomes. However, a better understanding of the mechanisms is needed. In addition, the way orphan disadvantage and the mechanisms giving rise to it are understood on the ground is essential for the successful translation of research into policies and programs. This study employs data from 89 in-depth interviews with caregivers and key informants in Lesotho, a setting where approximately one-quarter of adults is infected with HIV, to elaborate understandings of orphan disadvantage. Our analysis focuses on two questions: (i) Do local actors perceive orphans to be disadvantaged compared to non-orphans, and if so, in what ways; and (ii) How do they explain orphans’ differential disadvantage? Analyses suggest that orphans were widely perceived to be disadvantaged; respondents described this disadvantage in material as well as affective domains. Thematic analyses reveal five broad categories of explanation: poverty, love and kin connection, caregiver character, perceptions of orphans, and community norms related to orphan care. These results underscore the need for research and policy to address (i) multiple types of disadvantage, including deficits in kindness and attention; and (ii) the social embeddedness of disadvantage, recognizing that poverty, kinship, and community interact with individual attributes to shape caregiving relationships and child experiences. The findings suggest limited success for programs and policies that do not address the emotional needs of children, or that focus on child or caregiver support to the exclusion of community outreach. PMID:22865946

  11. The Development of Instructional Units on Family Life Education for the Primary Teachers' Certificate in Swaziland. African Studies in Curriculum Development & Evaluation No. 26.

    ERIC Educational Resources Information Center

    Motha, Esness

    This discussion of the development of family life education (FLE) in Swaziland is presented in three sections. Chapter One examines social change in developing nations which has resulted in: (1) large migrations from rural to urban areas; (2) strain on the capacity and effectiveness of the schools; (3) disturbance of the traditional family…

  12. Introduction and evaluation of a ‘pre-ART care’ service in Swaziland: an operational research study

    PubMed Central

    Burtle, David; Elden, Susan; Mamvura, Canaan; Vandelanotte, Joris; Petherick, Emily; Walley, John; Wright, John

    2012-01-01

    Objective To implement and evaluate a formal pre-antiretroviral therapy (ART) care service at a district hospital in Swaziland. Design Operational research. Setting District hospital in Southern Africa. Participants 1171 patients with a previous diagnosis of HIV. A baseline patient group consisted of the first 200 patients using the service. Two follow-up groups were defined: group 1 was all patients recruited from April to June 2009 and group 2 was 200 patients recruited in February 2010. Intervention Introduction of pre-ART care—a package of interventions, including counselling; regular review; clinical staging; timely initiation of ART; social and psychological support; and prevention and management of opportunistic infections, such as tuberculosis. Primary and secondary outcome measures Proportion of patients assessed for ART eligibility, proportion of eligible patients who were started on ART and proportion receiving defined evidence-based interventions (including prophylactic co-trimoxazole and tuberculosis screening). Results Following the implementation of the pre-ART service, the proportion of patients receiving defined interventions increased; the proportion of patient being assessed for ART eligibility significantly increased (baseline: 59%, group 1: 64%, group 2: 76%; p=0.001); the proportion of ART-eligible patients starting treatment increased (baseline: 53%, group 1: 81%, group: 2, 81%; p<0.001) and the median time between patients being declared eligible for ART and initiation of treatment significantly decreased (baseline: 61 days, group 1: 39 days, group 2: 14 days; p<0.001). Conclusions This intervention was part of a shift in the model of care from a fragmented acute care model to a more comprehensive service. The introduction of structured pre-ART was associated with significant improvements in the assessment, management and timeliness of initiation of treatment for patients with HIV. PMID:22422913

  13. Leveraging tuberculosis case relative locations to enhance case detection and linkage to care in Swaziland.

    PubMed

    Brunetti, Marie; Rajasekharan, Sathyanath; Ustero, Piluca; Ngo, Katherine; Sikhondze, Welile; Mzileni, Buli; Mandalakas, Anna; Kay, Alexander W

    2018-01-01

    In Swaziland, as in many high HIV/TB burden settings, there is not information available regarding the household location of TB cases for identifying areas of increased TB incidence, limiting the development of targeted interventions. Data from "Butimba", a TB REACH active case finding project, was re-analyzed to provide insight into the location of TB cases surrounding Mbabane, Swaziland. The project aimed to identify geographical areas with high TB burdens to inform active case finding efforts. Butimba implemented household contact tracing; obtaining landmark based, informal directions, to index case homes, defined here as relative locations. The relative locations were matched to census enumeration areas (known location reference areas) using the Microsoft Excel Fuzzy Lookup function. Of 403 relative locations, an enumeration area reference was detected in 388 (96%). TB cases in each census enumeration area and the active case finders in each Tinkhundla, a local governmental region, were mapped using the geographic information system, QGIS 2.16. Urban Tinkhundla predictably accounted for most cases; however, after adjusting for population, the highest density of cases was found in rural Tinkhundla. There was no correlation between the number of active case finders currently assigned to the 7 Tinkhundla surrounding Mbabane and the total number of TB cases (Spearman rho = -0.57, p  = 0.17) or the population adjusted TB cases (Spearman rho = 0.14, p  = 0.75) per Tinkhundla. Reducing TB incidence in high-burden settings demands novel analytic approaches to study TB case locations. We demonstrated the feasibility of linking relative locations to more precise geographical areas, enabling data-driven guidance for National Tuberculosis Programs' resource allocation. In collaboration with the Swazi National Tuberculosis Control Program, this analysis highlighted opportunities to better align the active case finding national strategy with the TB disease

  14. Human immunodeficiency virus seroprevalence in an occupational cohort in a South African community.

    PubMed

    Kravitz, J D; Mandel, R; Petersen, E A; Nyaphisis, M; Human, D

    In the early years of the worldwide pandemic, there were no reported cases of acquired immunodeficiency syndrome in Lesotho, a small, mountainous country in South Africa. Since 1986, when the first case of acquired immunodeficiency syndrome was identified, reported diagnoses have risen precipitously. The initiation of the Lesotho Highlands Water Project has resulted in the influx of a migrant workforce of predominantly single males into a relatively isolated, mountainous area where human immunodeficiency virus (HIV) was previously unknown. To ascertain the HIV seroprevalence among a cohort of laborers at the Katse Dam construction site in Bokong, Lesotho. During the 5-week study period in late 1992, construction workers (age range, 15 to 59 years) who were first-time clinic users for any chief complaint were randomly selected for serological study. Surveillance complied with the Lesotho National AIDS Control Programme guidelines, which required unlinked, anonymous testing. Serum samples were screened by an enzyme-linked immunosorbent assay; the results were confirmed by the Western blot technique. Unlinked, anonymous HIV testing of 486 persons revealed a seroprevalence of 5.3% (26/486; 95% confidence interval, 3.3% to 7.3%). These data contrasted with a 0.8% seroprevalence in a similar age group in nearby villages that surrounded the construction project. Lesotho, in the early phase of the HIV/acquired immunodeficiency syndrome epidemic in Africa in the 1980s, was seemingly protected by its relative isolation. Grave concern is now warranted as the country is destined to experience a rapid rise in HIV seroprevalence. Increased surveillance, health education opportunities, and aggressive prevention activities at the Katse Dam construction site are imperative to arrest the spread of HIV from construction workers to nearby villagers.

  15. Accretionary history of the Archean Barberton Greenstone Belt (3.55-3.22 Ga), southern Africa

    NASA Technical Reports Server (NTRS)

    Lowe, D. R.

    1994-01-01

    The 3.55-3.22 Ga Barberton Greenstone Belt, South Africa and Swaziland, and surrounding coeval plutons can be divided into four tectono-stratigraphic blocks that become younger toward the northwest. Each block formed through early mafic to ultramafic volcanism (Onverwacht Group), probably in oceanic extensional, island, or plateau settings. Volcanism was followed by magmatic quiescence and deposition of fine-grained sediments, possibly in an intraplate setting. Late evolution involved underplating of the mafic crust by tonalitic intrusions along a subduction-related magmatic arc, yielding a thickened, buoyant protocontinental block. The growth of larger continental domains occurred both through magmatic accretion, as new protocontinental blocks developed along the margins of older blocks, and when previously separate blocks were amalgamated through tectonic accretion. Evolution of the Barberton Belt may reflect an Early Archean plate tectonic cycle that characterized a world with few or no large, stabilized blocks of sialic crust.

  16. Knowledge, attitude and practice of infant feeding in the first 6 months among HIV-positive mothers at the Queen Mamohato Memorial hospital clinics, Maseru, Lesotho

    PubMed Central

    Dudley, Lilian

    2018-01-01

    Background The balance between the risks of transmission of human immunodeficiency virus (HIV) through breastfeeding and its life-saving benefits complicates decisions about infant feeding among HIV-positive mothers in the first 6 months. Objective The aim of this study was to assess the knowledge, attitude and practice of infant feeding among HIV-positive mothers attending the prevention of mother-to-child transmission services in Maseru, Lesotho. Method and setting This observational cross-sectional study was done by collecting data from HIV-positive mothers attending the filter clinics of Queen Mamohato Memorial hospital in Maseru, Lesotho. HIV-positive mothers with infants below the age of 6 months attending the clinics at the time of the study were interviewed using a standardised questionnaire. We described the sociodemographic profile of the mothers, the information and education received on prevention of mother-to-child transmission (PMTCT) infant feeding options, the mothers’ knowledge, attitudes and practices of infant feeding, and assessed risk factors for improved knowledge, attitudes and practices. Results The majority (96%) of the 191 HIV-positive mothers who participated in the survey knew about the PMTCT programme and related breastfeeding services. Most of the participants chose to breastfeed (89%), while only 8% formula-fed their infants. Knowledge received during the PMTCT programme was significantly associated with the decision to exclusively breastfeed their infants. Earlier infant feeding counselling and education was associated with more exclusively breastfeeding as compared to late infant feeding counselling (p < 0.001). Conclusion The study found that HIV-positive mothers attending health clinics in Maseru, Lesotho, had high knowledge, and appropriate attitudes and practices with respect to infant feeding; and that early counselling and education improved infant feeding methods among these mothers. PMID:29781690

  17. Sub-Saharan Africa Report.

    DTIC Science & Technology

    1987-01-14

    Crisis Forcing Farmers To Face Change (Editorial; VOLKSBLAD, 24 Oct 86) 65 - c - Use of Nuclear Technology in Agriculture Foreseen (DIE BURGER, 7...requires the participation of all the countries concerned. Even the most enthusiastic supporters of sanctions recognize that the results can only be... result in the asphyxiation of the front-line countries. Objectively speaking, Lesotho, Botswana, and Zimbabwe are forced to compromise. But are Zaire

  18. Health promotion strategies for families with adolescents orphaned by HIV and AIDS.

    PubMed

    Peu, M D

    2014-06-01

    This paper aims to explore and describe health promotion strategies for adolescents orphaned by human immunodeficiency virus (HIV) and acquired immunodeficiency syndrome (AIDS), as well as the evaluation thereof. Among the Sub-Saharan countries, such as Swaziland, Botswana and Lesotho, South Africa is rated as fourth in the list of countries with the highest number of people living with HIV and AIDS. The study employed phenomenological qualitative design. The population consisted of the purposively selected health promoters working in the Hammanskraal region, directly and indirectly involved with families with adolescents orphaned by HIV and AIDS. Following the focus group interviews, data were analysed using the seven steps of Colaizzi. Four categories and eight subcategories were concluded as the strategies for adolescents orphaned by HIV and AIDS as well as the evaluation thereof. The main categories identified were: the door-to-door outcome, workshop outputs, statistical data and community projects. It is evident that the health promotion strategies informed by the four themes will be implemented. The outcomes may raise an awareness in the community, support families and provide statistics on the impact of HIV and AIDS on families. The study was limited to one subdistrict and to health promoters in a rural area, therefore the results cannot be generalized to all other subdistricts including health promoters, especially those in urban areas. The successful evaluation programme will pin out the strong points and challenges while assisting in improving the quality of work provided in the communities. Continuing professional and practice development are required to maintain the standard of health care in South Africa. Therefore the policymakers need to include relevant information regarding health promotion strategies in reducing the statistics of people living with HIV and AIDS. © 2014 International Council of Nurses.

  19. Love matters: exploring conceptions of love in Rwanda and Swaziland and relationship to HIV and intimate partner violence.

    PubMed

    Ruark, Allison; Stern, Erin; Dlamini-Simelane, Thandeka; Kakuze, Marie Fidele

    2017-12-01

    Health risks such as intimate partner violence (IPV) and HIV infection often occur within intimate sexual relationships, yet the study of love and intimacy is largely absent from health research on African populations. This study explores how women and men in Rwanda and Swaziland understand and represent love in their intimate sexual partnerships. In Rwanda, 58 in-depth interviews with 15 couples, 12 interviews with activists, and 24 focus group discussions were carried out during formative and evaluative research of the Indashyikirwa programme, which aims to reduce IPV and support healthy couple relationships. In Swaziland, 117 in-depth, life-course interviews with 14 women and 14 men focused on understanding intimate sexual partnerships. We analysed these qualitative data thematically using a Grounded Theory approach. Participants described love as being foundational to their intimate sexual partnerships. Women and men emphasised that love is seen and expressed through actions and tangible evidence such as gifts and material support, acts of service, showing intentions for marriage, sexual faithfulness, and spending time together. Some participants expressed ambivalent narratives regarding love, gifts, and money, acknowledging that they desired partners who demonstrated love through material support while implying that true love should be untainted by desires for wealth. IPV characterised many relationships and was perceived as a threat to love, even as love was seen as a potential antidote to IPV. Careful scholarship of love is critical to better understand protective and risk factors for HIV and IPV and for interventions that seek to ameliorate these risks.

  20. Biomass fuel use for household cooking in Swaziland: is there an association with anaemia and stunting in children aged 6-36 months?

    PubMed

    Machisa, Mercilene; Wichmann, Janine; Nyasulu, Peter S

    2013-09-01

    This study is the second to investigate the association between the use of biomass fuels (BMF) for household cooking and anaemia and stunting in children. Such fuels include coal, charcoal, wood, dung and crop residues. Data from the 2006-2007 Swaziland Demographic and Health Survey (a cross-sectional study design) were analysed. Childhood stunting was ascertained through age and height, and anaemia through haemoglobin measurement. The association between BMF use and health outcomes was determined in multinomial logistic regression analyses. Various confounders were considered in the analyses. A total of 1150 children aged 6-36 months were included in the statistical analyses, of these 596 (51.8%) and 317 (27.6%) were anaemic and stunted, respectively. BMF use was not significantly associated with childhood anaemia in univariate analysis. Independent risk factors for childhood anaemia were child's age, history of childhood diarrhoea and mother's anaemia status. No statistically significant association was observed between BMF use and childhood stunting, after adjusting for child's gender, age, birth weight and preceding birth interval. This study identified the need to prioritize childhood anaemia and stunting as health outcomes and the introduction of public health interventions in Swaziland. Further research is needed globally on the potential effects of BMF use on childhood anaemia and stunting.

  1. Emotional abuse of girls in Swaziland: prevalence, perpetrators, risk and protective factors and health outcomes.

    PubMed

    Meinck, Franziska; Fry, Deborah; Ginindza, Choice; Wazny, Kerri; Elizalde, Aldo; Spreckelsen, Thees F; Maternowska, M Catherine; Dunne, Michael P

    2017-06-01

    Research on emotional child abuse in sub-Saharan Africa is scarce. Few studies thus far have examined prevalence, risk and protective factors for emotional child abuse or the associations between emotional abuse and girls' health. A nationally representative two-stage, cluster-sampled, household survey of females aged 13-24 years (n = 1244) on childhood abuse victimisation was conducted. Participants completed interviewer-assisted questionnaires. Associations between emotional abuse and putative risk, and protective factors and health outcomes were analyzed using separate logistic regression models accounting for sampling design. Marginal effects of cumulative risk factors for emotional abuse victimisation were examined. Lifetime prevalence of emotional abuse was 28.5% with 58.3% of these girls reporting many abusive incidents. The most common perpetrators were female (27.8%) and male (16.7%) relatives and, more rarely, biological parents. Risk factors associated with emotional abuse were frequent caregiver changes (odds ratio (OR) 1.42, 95% confidence interval (CI) 1.03-1.970, poverty (OR 1.51, 95% CI 1.12-2.03), and physical abuse (OR 1.98, 95% CI 1.45-2.71) and sexual abuse (OR 2.22, 95% CI 1.57-3.10) victimisation. Being close to one's mother was a protective factor (OR 0.88, 95% CI 0.80-0.97). Risk for emotional abuse increased from 13% with no risk factors present to 58.4% -with all four risk factors present. Health outcomes associated with emotional child abuse were suicidal ideation (OR 1.85, 95% CI 1.30-2.63) and feeling depressed (OR 1.89, 95% CI 1.31-2.71). Girls in Swaziland experience high levels of emotional abuse victimisation. Emotional abuse is associated with economic disadvantage, family factors, other types of abuse victimisation and poor mental health. Therefore, a holistic approach to prevention is needed, incorporating poverty reduction and programmes to improve parent-child relationships, reduce the use of harsh criticism, and change

  2. Emotional abuse of girls in Swaziland: prevalence, perpetrators, risk and protective factors and health outcomes

    PubMed Central

    Meinck, Franziska; Fry, Deborah; Ginindza, Choice; Wazny, Kerri; Elizalde, Aldo; Spreckelsen, Thees F; Maternowska, M Catherine; Dunne, Michael P

    2017-01-01

    Background Research on emotional child abuse in sub–Saharan Africa is scarce. Few studies thus far have examined prevalence, risk and protective factors for emotional child abuse or the associations between emotional abuse and girls’ health. Methods A nationally representative two–stage, cluster–sampled, household survey of females aged 13–24 years (n = 1244) on childhood abuse victimisation was conducted. Participants completed interviewer–assisted questionnaires. Associations between emotional abuse and putative risk, and protective factors and health outcomes were analyzed using separate logistic regression models accounting for sampling design. Marginal effects of cumulative risk factors for emotional abuse victimisation were examined. Results Lifetime prevalence of emotional abuse was 28.5% with 58.3% of these girls reporting many abusive incidents. The most common perpetrators were female (27.8%) and male (16.7%) relatives and, more rarely, biological parents. Risk factors associated with emotional abuse were frequent caregiver changes (odds ratio (OR) 1.42, 95% confidence interval (CI) 1.03–1.970, poverty (OR 1.51, 95% CI 1.12–2.03), and physical abuse (OR 1.98, 95% CI 1.45–2.71) and sexual abuse (OR 2.22, 95% CI 1.57–3.10) victimisation. Being close to one’s mother was a protective factor (OR 0.88, 95% CI 0.80–0.97). Risk for emotional abuse increased from 13% with no risk factors present to 58.4% –with all four risk factors present. Health outcomes associated with emotional child abuse were suicidal ideation (OR 1.85, 95% CI 1.30–2.63) and feeling depressed (OR 1.89, 95% CI 1.31–2.71). Conclusions Girls in Swaziland experience high levels of emotional abuse victimisation. Emotional abuse is associated with economic disadvantage, family factors, other types of abuse victimisation and poor mental health. Therefore, a holistic approach to prevention is needed, incorporating poverty reduction and programmes to improve parent

  3. TYPES OF ALBINISM IN THE BLACK SOUTHERN AFRICA POPULATION.

    PubMed

    Kromberg, J G R; Bothwell, J; Kidson, S H; Manga, P; Kerr, R; Jenkins, T

    2012-01-01

    Oculocutaneous albinism (OCA) is the most common inherited disorder in Southern African blacks and several types have been described. Molecular techniques, where available, can be used to confirm a clinical diagnosis and the type of OCA, if necessary, and for prenatal diagnosis. To investigate and classify the different types of albinism commonly found and to determine the clinical implications for each type. A descriptive survey. Gauteng province, South Africa, and Lesotho. Three groups of subjects with OCA (96 from a genetics clinic, 62 from a dermatology clinic, and 31 from community surveys) from the black African population participated. Subjects underwent clinical and/or dermatological examinations and were then classified according to type of OCA. Four forms of OCA were identified: most (82%) subjects had OCA2 (a tyrosinase- positive type) with three sub-types: those without large freckles (ephelides) on exposed areas (named OCA 2a in this study), those with such freckles (named OCA 2b), and those with brown albinism (BOCA); the remainder had red/rufous albinism, ROCA (OCA 3). The four forms could be distinguished from each other clinically without using molecular genetic testing. The most common types of albinism found in the black population of Southern Africa are OCA2 and OCA3. Given the high prevalence of the disorder, together with the high risk of skin cancer, and the recent persecution of affected individuals in certain East African countries, these findings and their clinical implications have significance in terms of both education and awareness for health professionals and lay people caring for those with albinism.

  4. Climate and Southern Africa's Water-Energy-Food Nexus

    NASA Astrophysics Data System (ADS)

    Conway, D.; Osborn, T.; Dorling, S.; Ringler, C.; Lankford, B.; Dalin, C.; Thurlow, J.; Zhu, T.; Deryng, D.; Landman, W.; Archer van Garderen, E.; Krueger, T.; Lebek, K.

    2014-12-01

    Numerous challenges coalesce to make Southern Africa emblematic of the connections between climate and the water-energy-food nexus. Rainfall and river flows in the region show high levels of variability across a range of spatial and temporal scales. Physical and socioeconomic exposure to climate variability and change is high, for example, the contribution of electricity produced from hydroelectric sources is over 30% in Madagascar and Zimbabwe and almost 100% in the DRC, Lesotho, Malawi, and Zambia. The region's economy is closely linked with that of the rest of the African continent and climate-sensitive food products are an important item of trade. Southern Africa's population is concentrated in regions exposed to high levels of hydro-meteorological variability, and will increase rapidly over the next four decades. The capacity to manage the effects of climate variability tends, however, to be low. Moreover, with climate change annual precipitation levels, soil moisture and runoff are likely to decrease and rising temperatures will increase evaporative demand. Despite high levels of hydro-meteorological variability, the sectoral and cross-sectoral water-energy-food linkages with climate in Southern Africa have not been considered in detail. Lack of data and questionable reliability are compounded by complex dynamic relationships. We review the role of climate in Southern Africa's nexus, complemented by empirical analysis of national level data on climate, water resources, crop and energy production, and economic activity. Our aim is to examine the role of climate variability as a driver of production fluctuations in the nexus, and to improve understanding of the magnitude and temporal dimensions of their interactions. We first consider national level exposure of food, water and energy production to climate in aggregate economic terms and then examine the linkages between interannual and multi-year climate variability and economic activity, focusing on food and

  5. The costs and benefits of nurse migration on families: A Lesotho experience.

    PubMed

    Ntlale, Matsola E; Duma, Sinegugu E

    2012-02-22

    The present day migration of nurses from developing countries, to more developed countries,depletes these countries of this vital human resource, which is necessary to provide optimum quality nursing care to their populations. If nurse migration persists, the health systems of these countries face collapse.It is important that a nurse understands the costs and benefits of migration to their families, whom they leave behind. This is not only to curb the problems that may occur, but to help the migrant nurses to realise how migration affects their families, especially their children and spouses, before they decide to leave their home countries to work in foreign lands.The purpose of this study, which was exploratory, descriptive and qualitative, was to investigate and describe the experiences of family members, of migrant nurses, from the Maseru district of Lesotho, about the costs and benefits of nurse migration. The objectives were to explore and describe the disadvantageous costs and the benefits gained by the families of migrant nurses. These were explored through the research question 'What are the experiences of family members of migrating nurses with regard to the costs and benefits of nurse migration?'The target population of the study was families of migrant nurses from Lesotho. Using purposive sampling the families of two migrant nurses, who were colleagues of the researcher, were identified and approached to participate in the study. Snowball sampling was next utilised to recruit the remainder of the participants. In total, six families were identified and included in the study.The semi-structured interviews and field notes were the two data collection methods that were implemented. The Giorgi's (1970) steps for data analysis, as outlined in (Burns & Grove 2001:610), were followed and seven themes were discovered as findings. The themes that relate to the costs of nurse migration are: emotional instability, weaker family connections and increased

  6. Marriage, widowhood, divorce and HIV risks among women in sub-Saharan Africa.

    PubMed

    Tenkorang, Eric Y

    2014-03-01

    Studies on associations between marriage and HIV infection among women in sub-Saharan Africa are generally inconclusive. Not enough is known about HIV risks among divorced and widowed women. This study examined the relationship between marital status and HIV infection among women in seven sub-Saharan African countries. Retrospective data from the Demographic and Health Surveys were combined with HIV biomarker data from the AIDS Indicator Survey (AIS) for analysis. Random-effects complementary log-log models were applied to examine the relationship between marital status and HIV risks controlling for theoretically relevant covariates. Compared to never-married women, widowed women were significantly more likely to be HIV positive. Similarly, married women were more likely to be infected with HIV, compared to never-married women in Lesotho and Zimbabwe. In Tanzania and Zimbabwe, divorced women had higher risks of HIV infection, compared to never-married women. Findings suggest that specific HIV programs be directed at vulnerable women, in particular those widowed. Similar programs are needed for both poorer and wealthier women.

  7. Social responsibility, international development, and institutional commitment: lessons from the Boston University experience.

    PubMed

    Babich, Lauren P; Bicknell, William J; Culpepper, Larry; Jack, Brian W

    2008-02-01

    Boston University (BU) has a long history of a strong social mission and commitment to service. In August 2003, BU made an institutional commitment to work with the country of Lesotho to tackle the human capital implications of the HIV/AIDS epidemic. Surrounded by South Africa, and with a population of two million, Lesotho, a stable democracy, suffers the world's third-highest adult HIV prevalence rate of about 24%. The initiation of the program required a substantial initial institutional investment without any promise of payback. This allowed BU to begin work in Lesotho while searching for additional funds. The government of Lesotho and BU agreed to focus on preserving the lives of Lesotho's citizens, building the capacity of the country's workforce, and maximizing the efficiency of Lesotho's existing systems and resources. Initial activities were modest, beginning with workshops on problem solving, then the launch of a primary care clinic that offered HIV/AIDS treatment services at the nation's only teacher training college. With support from the W.K. Kellogg Foundation, the main focus is now on strengthening district-level primary care services, including the initiation of a family medicine residency training program in cooperation with the University of the Free State in Bloemfontein. The initial commitment has developed into a mutual partnership, with benefits to country and university alike. By combining the expertise from various schools and departments to focus on a single country, a university can significantly advance international development, strengthen its service mission, enrich teaching, and provide new opportunities for research.

  8. Schistosomiasis knowledge, attitude, practices, and associated factors among primary school children in the Siphofaneni area in the Lowveld of Swaziland.

    PubMed

    Maseko, Thokozani S B; Mkhonta, Nkosazana R; Masuku, Sakhile K S; Dlamini, Sabelo V; Fan, Chia-Kwung

    2018-02-01

    Schistosomiasis, a worldwide concern, has received attention in Swaziland through control programs such as deworming programs, education programs, and school health programs; however, these programs neglect the importance of monitoring and evaluation strategies such as assessing children's knowledge, attitudes and practices (KAPs) and the prevalence of the disease. Children are a high-risk group because of their water contact practices, and need to be informed about schistosomiasis to influence their attitudes and practices. Social and cultural factors are involved in schistosomiasis control because they instill myths and misconceptions about the disease. As a result, children in the community may be comfortable with bad practices. This study aimed to assess the KAPs of schoolchildren on schistosomiasis, and to identify practices that support or hinder the progress of schistosomiasis control. In 2014, a descriptive quantitative cross-sectional survey was conducted through questionnaires among Siphofaneni primary schools, an area hit by schistosomiasis in the Lowveld of Swaziland. A logistic regression model was applied to analyze the data. Moderate knowledge, good attitudes, and fairly good practices were observed in the children. However, practices of certain children were risky and they still had some misconceptions. Knowledge was correlated with practice and with predictors of good and bad practices such as male sex, always urinating in water, and always using river water for domestic practices. This study suggests that empowering children with knowledge and attempting to modify their water contact, and improved human waste disposal practices are necessary for schistosomiasis control. Copyright © 2016. Published by Elsevier B.V.

  9. The geochemical nature of the Archean Ancient Gneiss Complex and Granodiorite Suite, Swaziland: a preliminary study

    USGS Publications Warehouse

    Hunter, D.R.; Barker, F.; Millard, H.T.

    1978-01-01

    The Ancient Gneiss Complex (AGC) of Swaziland, an Archean gray gneiss complex, lies southeast and south of the Barberton greenstone belt and includes the most structurally complex and highly metamorphosed portions of the eastern Kaapvaal craton. The AGC is not precisely dated but apparently is older than 3.4 Ga. The AGC consists of three major units: (a) a bimodal suite of closely interlayered siliceous, low-K gneisses and metabasalt; (b) homogeneous tonalite gneiss; and (c) interlayered siliceous microcline gneiss, metabasalt, and minor metasedimentary rocks - termed the metamorphite suite. A geologically younger gabbro-diorite-tonalite-trondhjemite suite, the Granodiorite Suite, is spatially associated with the AGC and intrusive into it. The bimodal suite consists largely of two types of low-K siliceous gneiss: one has SiO2 14%, low Rb/Sr ratios, and depleted heavy rare earth elements (REE's); the other has SiO2 > 75%, Al2O3 < 13%, high Rb/Sr ratios, and relatively abundant REE's except for negative Eu anomalies. The interlayered metabasalt ranges from komatiitic to tholeiitic compositions. Lenses of quartz monzonitic gneiss of K2O/Na2O close to 1 form a minor part of the bimodal suite. Tonalitic to trondhjemitic migmatite locally is abundant and has major-element abundances similar to those of non-migmatitic varieties. The siliceous gneisses of the metamorphic suite show low Al2O, K2O/Na2O ratios of about 1, high Rb/Sr ratios, moderate REE abundances and negative Eu anomalies. K/Rb ratios of siliceous gneisses of the bimodal suite are very low (???130); of the tonalitic gneiss, low (???225); of the siliceous gneiss of the metamorphite suite, moderate (???300); and of the Granodiorite Suite, high (???400). Rocks of the AGC differ geochemically in several ways from the siliceous volcanic and hypabyssal rocks of the Upper Onverwacht Group and from the diapirs of tonalite and trondhjemite that intrude the Swaziland Group. ?? 1978.

  10. Sustaining the future of HIV counselling to reach 90-90-90: a regional country analysis.

    PubMed

    Bemelmans, Marielle; Baert, Saar; Negussie, Eyerusalem; Bygrave, Helen; Biot, Marc; Jamet, Christine; Ellman, Tom; Banda, Amanda; van den Akker, Thomas; Ford, Nathan

    2016-01-01

    Counselling services are recommended by the World Health Organization and have been partially adopted by national HIV guidelines. In settings with a high HIV burden, patient education and counselling is often performed by lay workers, mainly supported with international funding. There are few examples where ministries of health have been able to absorb lay counsellors into their health systems or otherwise sustain their work. We document the role of lay cadres involved in HIV testing and counselling and adherence support and discuss approaches to sustainability. We focused on a purposive sample of eight sub-Saharan African countries where Médecins Sans Frontières supports HIV programmes: Guinea, Lesotho, Malawi, Mozambique, South Africa, Swaziland, Zambia and Zimbabwe. We reviewed both published and grey literature, including national policies and donor proposals, and interviewed key informants, including relevant government staff, donors and non-governmental organizations. Lay counsellors play a critical role in scaling up HIV services and addressing gaps in the HIV testing and treatment cascade by providing HIV testing and counselling and adherence support at both the facility and community levels. Countries have taken various steps in recognizing lay counsellors, including harmonizing training, job descriptions and support structures. However, formal integration of this cadre into national health systems is limited, as lay counsellors are usually not included in national strategies or budgeting. The current trend of reduced donor support for lay counsellors, combined with lack of national prioritization, threatens the sustainability of this cadre and thereby quality HIV service delivery.

  11. The effect of major income sources on rural household food (in)security: Evidence from Swaziland and implications for policy.

    PubMed

    Mabuza, Majola L; Ortmann, Gerald F; Wale, Edilegnaw; Mutenje, Munyaradzi J

    2016-01-01

    The aim of this article was to investigate the food (in)security effect of household income generated from major economic activities in rural Swaziland. From a sample of 979 households, the results of a multinomial treatment regression model indicated that gender of household head, labor endowment, education, size of arable land, and location significantly influenced the households' choice of primary economic activity. Further results suggested that off-farm-income-dependent households were less likely to be food insecure when compared with on-farm-income-dependent households. However, on-farm-income-dependent households had a better food security status than their counterparts who depended on remittances and nonfarm economic activities.

  12. A qualitative study of community home-based care and antiretroviral adherence in Swaziland

    PubMed Central

    Root, Robin; Whiteside, Alan

    2013-01-01

    Introduction Antiretroviral therapy (ART) has rendered HIV and AIDS a chronic condition for individuals in many parts of the world. Adherence, however, is integral to achieving chronicity. Studies have shown both relatively high ART adherence rates in sub-Saharan Africa and the importance of community home-based care (CHBC) to facilitating this process. In light of diminished HIV and AIDS funding globally and increased reliance on CHBC throughout Africa, a better understanding of how CHBC may strengthen ART adherence is essential to improving patients’ quality of life, tending to the needs of care supporters and achieving healthier populations. Methods This article reports findings from a qualitative study of a CHBC organiztion serving an estimated 2500 clients in rural Swaziland. Semi-structured questionnaires with 79 HIV-positive clients [people living with HIV and AIDS (PLWHA)] yielded data on diverse aspects of being HIV positive, including insights on whether and how PLWHA perceived care supporters to facilitate ART adherence in a high stigma and structurally impoverished setting. Results Ninety-two percent of participants said their health had improved since care supporters came into their lives. A major finding was that an estimated 53% of participants said they would have died, a few from suicide had the care supporter never intervened. More than one in four participants (27.9%) sought HIV testing after a care supporter began visiting them. Nearly a third (31%) commenced ART after and largely as a consequence of care supporter intervention. Approximately one in four (23%) reported that their care supporter had helped them to disclose their HIV-positive status to family members. Twenty-seven percent said they had felt discouraged or had been discouraged from taking ART by members of their family or community. Discussion General inductive analysis of participant reports suggested two social mechanisms of CHBC impact on ART adherence: (i) cultivating client

  13. Rapid case-based mapping of seasonal malaria transmission risk for strategic elimination planning in Swaziland.

    PubMed

    Cohen, Justin M; Dlamini, Sabelo; Novotny, Joseph M; Kandula, Deepika; Kunene, Simon; Tatem, Andrew J

    2013-02-11

    As successful malaria control programmes move towards elimination, they must identify residual transmission foci, target vector control to high-risk areas, focus on both asymptomatic and symptomatic infections, and manage importation risk. High spatial and temporal resolution maps of malaria risk can support all of these activities, but commonly available malaria maps are based on parasite rate, a poor metric for measuring malaria at extremely low prevalence. New approaches are required to provide case-based risk maps to countries seeking to identify remaining hotspots of transmission while managing the risk of transmission from imported cases. Household locations and travel histories of confirmed malaria patients during 2011 were recorded through routine surveillance by the Swaziland National Malaria Control Programme for the higher transmission months of January to April and the lower transmission months of May to December. Household locations for patients with no travel history to endemic areas were compared against a random set of background points sampled proportionate to population density with respect to a set of variables related to environment, population density, vector control, and distance to the locations of identified imported cases. Comparisons were made separately for the high and low transmission seasons. The Random Forests regression tree classification approach was used to generate maps predicting the probability of a locally acquired case at 100 m resolution across Swaziland for each season. Results indicated that case households during the high transmission season tended to be located in areas of lower elevation, closer to bodies of water, in more sparsely populated areas, with lower rainfall and warmer temperatures, and closer to imported cases than random background points (all p < 0.001). Similar differences were evident during the low transmission season. Maps from the fit models suggested better predictive ability during the high

  14. Higher rates of metabolic syndrome among women taking zidovudine as compared to tenofovir in rural Africa: preliminary data from the CART-1 study.

    PubMed

    Labhardt, Niklaus Daniel; Cheleboi, Molisana; Faturyiele, Olatunbosun; Motlatsi, Mokete M; Pfeiffer, Karolin; Lejone, Thabo Ismael; Cerutti, Bernard; Muser, Jürgen; Gupta, Ravi Shankar; Lynen, Lutgarde; Hatz, Christoph

    2014-01-01

    Due to its side effects stavudine (D4T) has been replaced by zidovudine (AZT) and tenofovir (TDF) in most low- and middle-income countries (LMICs). In 2014 about 38% of adult first-line regimens contain AZT and 62% TDF [1]. Whereas the unfavourable metabolic outcomes of D4T in comparison to TDF have been described extensively, studies from LMICs comparing metabolic profiles between patients on AZT and TDF are scarce. Given the high number of patients in LMICs still taking AZT, data on their metabolic profile are needed. We present rates of metabolic syndrome (MS) in adult patients taking either AZT- or TDF-containing first-line, non-nucleoside reverse transcriptase (NNRTI)-based regimens. Data derived from a cross-sectional multi-disease screening conducted in ten facilities in two rural districts of Lesotho, Southern Africa [2]. Patients were eligible if aged ≥25 years and on NNRTI-containing first-line ART ≥6 months. The MS definition for Africa of the International Diabetes Federation was applied [3]. Assessed potential predictors for MS were age, time on ART, virologic suppression, body-mass index (BMI), alcohol consumption, wealth quintile, NNRTI (nevirapine (NVP) or Efavirenz (EFV)), history of previous D4T exposure and ART-backbone (AZT or TDF). Statistical analyses - stratified for sex - comprised univariate logistic regression for each predictor variable with subsequent construction of a multivariate model including all predictors with an association to MS at a significance level<0.1 in univariate analysis. Out of 1026 patients, 660 (64.3%) were female. MS prevalence was 9.8% (95% CI 6.9-13.4) in men and 22.9% (19.7-26.3) in women. In women, aged ≥35 years, AZT-backbone, NVP-base, BMI ≥25kg/m2 and taking ART for ≥4.5 years were associated with MS in univariate analysis. In the multivariate model only AZT (adjusted odds-ratio: 2.2, 95% CI 1.4-3.6; p=0.001) and BMI ≥25kg/m2 (9.8; 2.8-34.1, p<0.001) were associated with MS. For men, age, higher

  15. Extent of ESL Teachers' Access To, Utilisation and Production of Research

    ERIC Educational Resources Information Center

    Sibanda, Jabulani; Begede, Martin P.

    2015-01-01

    This study employed the survey design on a purposive sample of 100 English Second Language (ESL) teachers from Swaziland and South Africa's Eastern Cape Province, to investigate the extent to which they accessed, utilised and conducted research to better their practice. A survey questionnaire and follow-up structured interviews generated…

  16. The Audio-Visual Services in Fifteen African Countries. Comparative Study on the Administration of Audio-Visual Services in Advanced and Developing Countries. Part Four. First Edition.

    ERIC Educational Resources Information Center

    Jongbloed, Harry J. L.

    As the fourth part of a comparative study on the administration of audiovisual services in advanced and developing countries, this UNESCO-funded study reports on the African countries of Cameroun, Republic of Central Africa, Dahomey, Gabon, Ghana, Kenya, Libya, Mali, Nigeria, Rwanda, Senegal, Swaziland, Tunisia, Upper Volta and Zambia. Information…

  17. Variations in Reading Achievement across 14 Southern African School Systems: Which Factors Matter?

    ERIC Educational Resources Information Center

    Hungi, Njora; Thuku, Florence W.

    2010-01-01

    In this study the authors employed a multilevel analysis procedure in order to examine the pupil and school levels factors that contributed to variation in reading achievement among Grade 6 primary school pupils in 14 southern African school systems (Botswana, Kenya, Lesotho, Malawi, Mauritius, Mozambique, Namibia, Seychelles, South Africa,…

  18. Sub-Saharan Africa Report, No. 2817.

    DTIC Science & Technology

    1983-07-06

    between the two countries. During his visit to Montevideo, he will deliver a personal message from the head of state, El Hadj Omar Bongo , to his...inception. The spokesman said that unless (Khaketla) could manage to attract the minimum affection from the people of Lesotho he would never have the...socialist countries would affect religion adversely. [Text] [MB180718 Maseru Domestic Service in English 0500 GMT 18 Jun 83] JONATHAN TOUR—The

  19. A manufactu(RED) ethics: labor, HIV, and the body in Lesotho's "sweat-free" garment industry.

    PubMed

    Kenworthy, Nora J

    2014-12-01

    Employing mostly women and producing for major U.S. labels, Lesotho's primarily foreign-owned garment industry undertook efforts to become "sweat-free" in 2006; simultaneously, it also began producing for the Product(RED) campaign. This article explores the parameters and ethical challenges of an industry-wide, public-private partnership providing HIV prevention and treatment services in this industry. Here, HIV services are intimately bound up in emerging patterns of humanitarian consumption and the production of an ethical industry. Within this ethical production zone, all is not what it seems: Labor violations persist, workers confront occupational hazards, and an elaborate theatrics of ethical practice plays out on the factory floor during routine inspections. This article explores the place and purpose of HIV treatment in the context of such humanitarian fetishism, highlighting the uses to which worker bodies are put and the conceptions of bodily well-being that prevail in these new "moral" economies. © 2014 by the American Anthropological Association.

  20. Improving early childhood care and development, HIV-testing, treatment and support, and nutrition in Mokhotlong, Lesotho: study protocol for a cluster randomized controlled trial.

    PubMed

    Tomlinson, Mark; Skeen, Sarah; Marlow, Marguerite; Cluver, Lucie; Cooper, Peter; Murray, Lynne; Mofokeng, Shoeshoe; Morley, Nathene; Makhetha, Moroesi; Gordon, Sarah; Esterhuizen, Tonya; Sherr, Lorraine

    2016-11-09

    Since 1990, the lives of 48 million children under the age of 5 years have been saved because of increased investments in reducing child mortality. However, despite these unprecedented gains, 250 million children younger than 5 years in low- and middle-income countries (LMIC) cannot meet their developmental potential due to poverty, poor health and nutrition, and lack of necessary stimulation and care. Lesotho has high levels of poverty, HIV, and malnutrition, all of which affect child development outcomes. There is a unique opportunity to address these complex issues through the widespread network of informal preschools in rural villages in the country, which provide a setting for inclusive, integrated Early Childhood Care and Development (ECCD) and HIV and nutrition interventions. We are conducting a cluster randomised controlled trial in Mokhotlong district, Lesotho, to evaluate a newly developed community-based intervention program to integrate HIV-testing and treatment services, ECCD, and nutrition education for caregivers with children aged 1-5 years living in rural villages. Caregivers and their children are randomly assigned by village to intervention or control condition. We select, train, and supervise community health workers recruited to implement the intervention, which consists of nine group-based sessions with caregivers and children over 12 weeks (eight weekly sessions, and a ninth top-up session 1 month later), followed by a locally hosted community health outreach day event. Group-based sessions focus on using early dialogic book-sharing to promote cognitive development and caregiver-child interaction, health-related messages, including motivation for HIV-testing and treatment uptake for young children, and locally appropriate nutrition education. All children aged 1-5 years and their primary caregivers living in study villages are eligible for participation. Caregivers and their children will be interviewed and assessed at baseline, after

  1. A Comparative Analyses of Granulometry, Mineral Composition and Major and Trace Element Concentrations in Soils Commonly Ingested by Humans

    PubMed Central

    Ngole-Jeme, Veronica M.; Ekosse, Georges-Ivo E.

    2015-01-01

    This study compared the granulometric properties, mineralogical composition and concentrations of major and trace element oxides of commonly ingested soils (geophagic soil) collected from different countries with a view of understanding how varied they may be in these properties and to understand the possible health implications of ingesting them. Soil samples were collected from three different countries (South Africa, Swaziland and Democratic Republic of Congo (DRC)) and their granulometric properties, concentrations of major and trace element oxides as well as mineralogical composition determined. Differences were observed in the granulometric properties of geophagic soil from the three different countries with most of them having <20% clay content. The soils also showed varied degrees of weathering with values of Chemical Index of Alteration (CIA) and Chemical Index of Weathering (CIW) being between 60% and 99.9% respectively. The mineral assemblages of the soils from South Africa and Swaziland were dominated by the primary minerals quartz and feldspar whereas soils from DRC had more of kaolinite, a secondary mineral than primary minerals. Soils from DRC were associated with silt, clay, Al2O3, and CIA unlike most samples from South Africa which were associated with SiO2, sand, K2O, CaO, and MgO. The soils from Swaziland were closely associated with silt, H2O and Fe2O3(t). These associations reflect the mineralogy of the samples. These soils are not likely to serve as nutrient supplements because of the low concentrations of the nutrient elements contained. The coarse texture of the samples may also result in dental destruction during mastication. Sieving of the soils before ingestion to remove coarse particles is recommended to reduce the potential health threat associated with the ingestion of coarse-textured soils. PMID:26264010

  2. Rapid case-based mapping of seasonal malaria transmission risk for strategic elimination planning in Swaziland

    PubMed Central

    2013-01-01

    Background As successful malaria control programmes move towards elimination, they must identify residual transmission foci, target vector control to high-risk areas, focus on both asymptomatic and symptomatic infections, and manage importation risk. High spatial and temporal resolution maps of malaria risk can support all of these activities, but commonly available malaria maps are based on parasite rate, a poor metric for measuring malaria at extremely low prevalence. New approaches are required to provide case-based risk maps to countries seeking to identify remaining hotspots of transmission while managing the risk of transmission from imported cases. Methods Household locations and travel histories of confirmed malaria patients during 2011 were recorded through routine surveillance by the Swaziland National Malaria Control Programme for the higher transmission months of January to April and the lower transmission months of May to December. Household locations for patients with no travel history to endemic areas were compared against a random set of background points sampled proportionate to population density with respect to a set of variables related to environment, population density, vector control, and distance to the locations of identified imported cases. Comparisons were made separately for the high and low transmission seasons. The Random Forests regression tree classification approach was used to generate maps predicting the probability of a locally acquired case at 100 m resolution across Swaziland for each season. Results Results indicated that case households during the high transmission season tended to be located in areas of lower elevation, closer to bodies of water, in more sparsely populated areas, with lower rainfall and warmer temperatures, and closer to imported cases than random background points (all p < 0.001). Similar differences were evident during the low transmission season. Maps from the fit models suggested better predictive

  3. Effect of Offering Same-Day ART vs Usual Health Facility Referral During Home-Based HIV Testing on Linkage to Care and Viral Suppression Among Adults With HIV in Lesotho: The CASCADE Randomized Clinical Trial.

    PubMed

    Labhardt, Niklaus D; Ringera, Isaac; Lejone, Thabo I; Klimkait, Thomas; Muhairwe, Josephine; Amstutz, Alain; Glass, Tracy R

    2018-03-20

    Home-based HIV testing is a frequently used strategy to increase awareness of HIV status in sub-Saharan Africa. However, with referral to health facilities, less than half of those who test HIV positive link to care and initiate antiretroviral therapy (ART). To determine whether offering same-day home-based ART to patients with HIV improves linkage to care and viral suppression in a rural, high-prevalence setting in sub-Saharan Africa. Open-label, 2-group, randomized clinical trial (February 22, 2016-September 17, 2017), involving 6 health care facilities in northern Lesotho. During home-based HIV testing in 6655 households from 60 rural villages and 17 urban areas, 278 individuals aged 18 years or older who tested HIV positive and were ART naive from 268 households consented and enrolled. Individuals from the same household were randomized into the same group. Participants were randomly assigned to be offered same-day home-based ART initiation (n = 138) and subsequent follow-up intervals of 1.5, 3, 6, 9, and 12 months after treatment initiation at the health facility or to receive usual care (n = 140) with referral to the nearest health facility for preparatory counseling followed by ART initiation and monthly follow-up visits thereafter. Primary end points were rates of linkage to care within 3 months (presenting at the health facility within 90 days after the home visit) and viral suppression at 12 months, defined as a viral load of less than 100 copies/mL from 11 through 14 months after enrollment. Among 278 randomized individuals (median age, 39 years [interquartile range, 28.0-52.0]; 180 women [65.7%]), 274 (98.6%) were included in the analysis (137 in the same-day group and 137 in the usual care group). In the same-day group, 134 (97.8%) indicated readiness to start ART that day and 2 (1.5%) within the next few days and were given a 1-month supply of ART. At 3 months, 68.6% (94) in same-day group vs 43.1% (59) in usual care group had linked to care

  4. AZT Impairs Immunological Recovery on First-line ART: Collaborative analysis of cohort studies in Southern Africa

    PubMed Central

    WANDELER, Gilles; GSPONER, Thomas; MULENGA, Lloyd; GARONE, Daniela; WOOD, Robin; MASKEW, Mhairi; PROZESKY, Hans; HOFFMANN, Christopher; EHMER, Jochen; DICKINSON, Diana; DAVIES, Mary-Ann; EGGER, Matthias; KEISER, Olivia

    2013-01-01

    Objectives Zidovudine (AZT) is recommended for first-line antiretroviral therapy (ART) in resource limited settings. AZT may, however, lead to anemia and impaired immunological response. We compared CD4 counts over 5 years between patients starting ART with and without AZT in Southern Africa. Design Cohort study Methods Patients aged ≥16 years who started first-line ART in South Africa, Botswana, Zambia or Lesotho were included. We used linear mixed-effect models to compare CD4 cell count trajectories between patients on AZT-containing regimens and patients on other regimens, censoring follow-up at first treatment change. Impaired immunological recovery, defined as a CD4 count below 100 cells/μl at 1 year, was assessed in logistic regression. Analyses were adjusted for baseline CD4 count and haemoglobin level, age, gender, type of regimen, viral load monitoring and calendar year. Results 72,597 patients starting ART, including 19,758 (27.2%) on AZT, were analysed. Patients on AZT had higher CD4 cell counts (150 vs.128 cells/μl) and haemoglobin level (12.0 vs. 11.0 g/dl) at baseline, and were less likely to be female than those on other regimens. Adjusted differences in CD4 counts between regimens containing and not containing AZT were −16 cells/μl (95% CI −18 to −14) at 1 year and −56 cells/μl (95% CI −59 to −52) at 5 years. Impaired immunological recovery was more likely with AZT compared to other regimens (odds ratio 1.40, 95% CI 1.22–1.61). Conclusions In Southern Africa AZT is associated with inferior immunological recovery compared to other backbones. Replacing AZT with another NRTI could avoid unnecessary switches to second-line ART. PMID:23660577

  5. The Self-Perception and Cultural Dimensions: Cross-Cultural Comparison

    ERIC Educational Resources Information Center

    Akande, Adebowale W.

    2009-01-01

    The present study has been conducted with an aim to compare responses of undergraduates from Swaziland to previously reported findings with similar groups of American, Nepalese, Nigerian and Hong Kong. A total sample of 310 males and females in the age range of 20 and 21 were selected from three universities in South Africa. Self-esteem was…

  6. HIV risks and needs related to the Sustainable Development Goals among female sex workers who were commercially sexually exploited as children in Lesotho.

    PubMed

    Grosso, Ashley; Busch, Shianne; Mothopeng, Tampose; Sweitzer, Stephanie; Nkonyana, John; Mpooa, Nkomile; Taruberekera, Noah; Baral, Stefan

    2018-02-01

    Sustainable Development Goals (SDGs) about gender equality; decent work; and peace, justice, and strong institutions include a focus on eradicating trafficking and sexual exploitation of and violence against women and children. In Lesotho, 86% of women have experienced gender-based violence. In addition, overall HIV prevalence is among the highest globally, and higher among adolescent girls than boys. Moreover, nearly three quarters of female sex workers (FSW) are estimated to be living with HIV in Lesotho. In this context, sexually exploited children may be particularly vulnerable to violence and HIV acquisition risks. This study's objective is to examine the prevalence and correlates of experiencing sexual exploitation as a child among FSW in Lesotho. FSW (≥18 years) recruited through respondent-driven sampling in Maseru and Maputsoe from February to September 2014 completed HIV and syphilis testing and an interviewer-administered survey, including a question about the age at which they started providing sex for money. This study examined correlates of experiencing sexual exploitation as a child (<18 years) through multivariable logistic regression analyses for each city, controlling for current age. Across both cities, 20.0% (142/710) of participants were sexually exploited as children. Among them, 65.5% (93/142) tested positive for HIV and 31.0% (44/142) for syphilis, which was similar to those who started selling sex as adults, after adjusting for current age. Participants who experienced child sexual exploitation were more likely to have been forced to have sex before age 18 than those who started selling sex as adults (Maseru-adjusted odds ratio (aOR): 3.52, 95% Confidence Interval (CI): 1.61 to 7.66, p = 0.002; Maputsoe-aOR: 4.39, 95% CI: 1.22 to 15.75, p = 0.023). In Maseru, participants who were sexually exploited as children were more likely to avoid carrying condoms to prevent trouble with police (aOR: 3.18, 95% CI: 1.50 to 6.75, p = 0

  7. Genetic monitoring detects an overlooked cryptic species and reveals the diversity and distribution of three invasive Rattus congeners in south Africa

    PubMed Central

    2011-01-01

    Background South Africa's long and extensive trade activity has ensured ample opportunities for exotic species introduction. Whereas the rich biodiversity of endemic southern African fauna has been the focus of many studies, invasive vertebrates are generally overlooked despite potential impacts on biodiversity, health and agriculture. Genetic monitoring of commensal rodents in South Africa which uncovered the presence of Rattus tanezumi, a South-East Asian endemic not previously known to occur in Africa, provided the impetus for expanded studies on all invasive Rattus species present. Results To this end, intensified sampling at 28 South African localities and at one site in Swaziland, identified 149 Rattus specimens. Cytochrome b gene sequencing revealed the presence of two R. tanezumi, seven Rattus rattus and five Rattus norvegicus haplotypes in south Africa. Phylogenetic results were consistent with a single, recent R. tanezumi introduction and indicated that R. norvegicus and R. rattus probably became established following at least two and three independent introductions, respectively. Intra- and inter-specific diversity was highest in informal human settlements, with all three species occurring at a single metropolitan township site. Rattus norvegicus and R. rattus each occurred sympatrically with Rattus tanezumi at one and five sites, respectively. Karyotyping of selected R. rattus and R. tanezumi individuals identified diploid numbers consistent with those reported previously for these cryptic species. Ordination of bioclimatic variables and MaxEnt ecological niche modelling confirmed that the bioclimatic niche occupied by R. tanezumi in south Africa was distinct from that occupied in its naturalised range in south-east Asia suggesting that factors other than climate may influence the distribution of this species. Conclusions This study has highlighted the value of genetic typing for detecting cryptic invasive species, providing historical insights into

  8. Land cover mapping for development planning in Eastern and Southern Africa

    NASA Astrophysics Data System (ADS)

    Oduor, P.; Flores Cordova, A. I.; Wakhayanga, J. A.; Kiema, J.; Farah, H.; Mugo, R. M.; Wahome, A.; Limaye, A. S.; Irwin, D.

    2016-12-01

    Africa continues to experience intensification of land use, driven by competition for resources and a growing population. Land cover maps are some of the fundamental datasets required by numerous stakeholders to inform a number of development decisions. For instance, they can be integrated with other datasets to create value added products such as vulnerability impact assessment maps, and natural capital accounting products. In addition, land cover maps are used as inputs into Greenhouse Gas (GHG) inventories to inform the Agriculture, Forestry and other Land Use (AFOLU) sector. However, the processes and methodologies of creating land cover maps consistent with international and national land cover classification schemes can be challenging, especially in developing countries where skills, hardware and software resources can be limiting. To meet this need, SERVIR Eastern and Southern Africa developed methodologies and stakeholder engagement processes that led to a successful initiative in which land cover maps for 9 countries (Malawi, Rwanda, Namibia, Botswana, Lesotho, Ethiopia, Uganda, Zambia and Tanzania) were developed, using 2 major classification schemes. The first sets of maps were developed based on an internationally acceptable classification system, while the second sets of maps were based on a nationally defined classification system. The mapping process benefited from reviews from national experts and also from technical advisory groups. The maps have found diverse uses, among them the definition of the Forest Reference Levels in Zambia. In Ethiopia, the maps have been endorsed by the national mapping agency as part of national data. The data for Rwanda is being used to inform the Natural Capital Accounting process, through the WAVES program, a World Bank Initiative. This work illustrates the methodologies and stakeholder engagement processes that brought success to this land cover mapping initiative.

  9. High uptake of antiretroviral therapy among HIV-positive TB patients receiving co-located services in Swaziland.

    PubMed

    Pathmanathan, Ishani; Pasipamire, Munyaradzi; Pals, Sherri; Dokubo, E Kainne; Preko, Peter; Ao, Trong; Mazibuko, Sikhathele; Ongole, Janet; Dhlamini, Themba; Haumba, Samson

    2018-01-01

    Swaziland has the highest adult HIV prevalence and second highest rate of TB/HIV coinfection globally. Recently, the Ministry of Health and partners have increased integration and co-location of TB/HIV services, but the timing of antiretroviral therapy (ART) relative to TB treatment-a marker of program quality and predictor of outcomes-is unknown. We conducted a retrospective analysis of programmatic data from 11 purposefully-sampled facilities to evaluate timely ART provision for HIV-positive TB patients enrolled on TB treatment between July-November 2014. Timely ART was defined as within two weeks of TB treatment initiation for patients with CD4<50/μL or missing, and within eight weeks otherwise. Descriptive statistics were estimated and logistic regression used to assess factors independently associated with timely ART. Of 466 HIV-positive TB patients, 51.5% were male, median age was 35 (interquartile range [IQR]: 29-42), and median CD4 was 137/μL (IQR: 58-268). 189 (40.6%) were on ART prior to, and five (1.8%) did not receive ART within six months of TB treatment initiation. Median time to ART after TB treatment initiation was 15 days (IQR: 14-28). Almost 90% started ART within eight weeks, and 45.5% of those with CD4<50/μL started within two weeks. Using thresholds for "timely ART" according to baseline CD4 count, 73.3% of patients overall received timely ART after TB treatment initiation. Patients with CD4 50-200/μL or ≥200/μL had significantly higher odds of timely ART than patients with CD4<50/μL, with adjusted odds ratios of 11.5 (95% confidence interval [CI]: 5.0-26.6) and 9.6 (95% CI: 4.6-19.9), respectively. TB cure or treatment completion was achieved by 71.1% of patients at six months, but this was not associated with timely ART. This study demonstrates the relative success of integrated and co-located TB/HIV services in Swaziland, and shows that timely ART uptake for HIV-positive TB patients can be achieved in resource-limited, but integrated

  10. Voluntary medical male circumcision: logistics, commodities, and waste management requirements for scale-up of services.

    PubMed

    Edgil, Dianna; Stankard, Petra; Forsythe, Steven; Rech, Dino; Chrouser, Kristin; Adamu, Tigistu; Sakallah, Sameer; Thomas, Anne Goldzier; Albertini, Jennifer; Stanton, David; Dickson, Kim Eva; Njeuhmeli, Emmanuel

    2011-11-01

    The global HIV prevention community is implementing voluntary medical male circumcision (VMMC) programs across eastern and southern Africa, with a goal of reaching 80% coverage in adult males by 2015. Successful implementation will depend on the accessibility of commodities essential for VMMC programming and the appropriate allocation of resources to support the VMMC supply chain. For this, the United States President's Emergency Plan for AIDS Relief, in collaboration with the World Health Organization and the Joint United Nations Programme on HIV/AIDS, has developed a standard list of commodities for VMMC programs. This list of commodities was used to inform program planning for a 1-y program to circumcise 152,000 adult men in Swaziland. During this process, additional key commodities were identified, expanding the standard list to include commodities for waste management, HIV counseling and testing, and the treatment of sexually transmitted infections. The approximate costs for the procurement of commodities, management of a supply chain, and waste disposal, were determined for the VMMC program in Swaziland using current market prices of goods and services. Previous costing studies of VMMC programs did not capture supply chain costs, nor the full range of commodities needed for VMMC program implementation or waste management. Our calculations indicate that depending upon the volume of services provided, supply chain and waste management, including commodities and associated labor, contribute between US$58.92 and US$73.57 to the cost of performing one adult male circumcision in Swaziland. Experience with the VMMC program in Swaziland indicates that supply chain and waste management add approximately US$60 per circumcision, nearly doubling the total per procedure cost estimated previously; these additional costs are used to inform the estimate of per procedure costs modeled by Njeuhmeli et al. in "Voluntary Medical Male Circumcision: Modeling the Impact and Cost of

  11. Adoption of new HIV treatment guidelines and drug substitutions within first-line as a measure of quality of care in rural Lesotho: health centers and hospitals compared.

    PubMed

    Labhardt, Niklaus D; Sello, Motlalepula; Lejone, Thabo; Ehmer, Jochen; Mokhantso, Mohlaba; Lynen, Lutgarde; Pfeiffer, Karolin

    2012-10-01

    In 2007, Lesotho launched new national antiretroviral treatment (ART) guidelines, prioritising tenofovir and zidovudine over stavudine as a backbone together with lamivudine. We compared the rate of adoption of these new guidelines and substitution of first-line drugs by health centers (HC) and hospitals in two catchment areas in rural Lesotho. Retrospective cohort analysis. Patients aged ≥16 years were stratified into a HC- and a hospital-group. Type of backbone at ART-initiation (i), substitutions within first line (ii) and type of backbone among patients retained by December 2010 (iii). A multiple logistic regression model including HC vs. hospital, patient characteristics (sex, age, WHO-stage, baseline CD4-count, concurrent pregnancy, concurrent tuberculosis treatment) and year of ART-start, was used. Of 3936 adult patients initiated on ART between 2007 and 2010, 1971 started at hospitals and 1965 at HCs. Hospitals were more likely to follow the new guidelines as measured by prescription of backbones without stavudine (Odds-ratio 1.55; 95%CI: 1.32-1.81) and had a higher rate of drug substitutions while on first-line ART (2.39; 1.83-3.13). By December 2010, patients followed at health centres were more likely to still receive stavudine (2.28; 1.83-2.84). Health centers took longer to adopt the new guidelines and substituted drugs less frequently. Decentralised ART-programmes need close support, supervision and mentoring to absorb new guidelines and to adhere to them. © 2012 Blackwell Publishing Ltd.

  12. Influence of malnutrition upon all-cause mortality among children in Swaziland.

    PubMed

    Acevedo, Paula; García Esteban, María Teresa; Lopez-Ejeda, Noemí; Gómez, Amador; Marrodán, María Dolores

    2017-04-01

    To analyze the effect of the type of malnutrition, sex, age and the presence of edema upon all-cause mortality in children under 5 years of age. A cross-sectional study was conducted during 2010 and 2011 in Swaziland. Sex, age, weight and height were taken to classify nutritional status according to the 2006 WHO growth standards: stunting (low height for age), wasting (low weight for height or low body mass index for age) and underweight (low weight for age). The sample (309 boys and 244 girls under 5 years of age) was analyzed by sex and age groups (under and equal/over 12 months). The association between variables was evaluated using the χ 2 test. Cox regression analysis (HR, 95% CI) was used to assess the likelihood of mortality. The mortality risk in malnourished children under one year of age was lower among females and increased in the presence of severe edema. Wasting combined with underweight increased the mortality risk in children under 12 months of age 5-fold, versus 11-fold in older children. The combination of stunting, wasting and underweight was closely associated to mortality. Stunting alone (not combined with wasting) did not significantly increase the mortality risk. Sex, severe edema and wasting are predictors of mortality in malnourished children. Regardless of these factors, children with deficiencies referred to weight for height and weight for age present a greater mortality risk in comparison with children who present stunting only. Copyright © 2017 SEEN. Publicado por Elsevier España, S.L.U. All rights reserved.

  13. Use of dual protection among female sex workers in Swaziland.

    PubMed

    Yam, Eileen A; Mnisi, Zandile; Mabuza, Xolile; Kennedy, Caitlin; Kerrigan, Deanna; Tsui, Amy; Baral, Stefan

    2013-06-01

    Female sex workers are at heightened risk of both HIV infection and unwanted pregnancy. Nonbarrier modern contraceptives are highly effective at preventing pregnancy, but offer no HIV protection. A better understanding of sex workers' use of condoms and nonbarrier methods is needed to help them meet their contraceptive and STI protection needs. A 2011 respondent-driven sampling survey collected reproductive health and contraceptive use data from 325 female sex workers in Swaziland. Multinomial logistic regression analysis was used to identify associations between selected characteristics and four outcomes of contraceptive use over the past month: consistent condom use alone; nonbarrier modern contraceptive use (either alone or with inconsistent condom use); dual method use; and inconsistent condom use, other method use or nonuse. Adjusted predicted probabilities were also calculated to determine patterns of association. After adjustments were made for background and behavioral factors, 16% of female sex workers were found to be consistent users of condoms alone; 39% used nonbarrier modern methods (without consistent condom use); 8% were dual method users; and 38% were inconsistent condom users or used other methods or none. Women who reported recent condom failure were less likely than others to be consistent condom users (6% vs. 22%). Consistent use of condoms alone was more common among women who had had no noncommercial partners in the past month than among those who reported two or more such partners (39% vs. 3%). In addition, respondents who had children were more likely than their nulliparous counterparts to report use of nonbarrier methods alone (65% vs. 14%). Inconsistent or no condom use among nonbarrier contraceptive users underscores the need to incorporate HIV prevention into family planning interventions, particularly among female sex workers who have children and noncommercial partners.

  14. Using Learning Sets to Support UK Delivery of Off-Shore Learning in Africa

    ERIC Educational Resources Information Center

    Blackburn, Michelle

    2014-01-01

    This account of practice focuses on the delivery of Action Learning Sets in Swaziland and Malawi as part of a UK university's remote Master's degree teaching programme. It draws upon the experience of an Academic delivering the programme and the efforts made to refine the approach to action learning given time, understanding and resource…

  15. Does the distribution of healthcare utilization match needs in Africa?

    PubMed

    Bonfrer, Igna; van de Poel, Ellen; Grimm, Michael; Van Doorslaer, Eddy

    2014-10-01

    An equitable distribution of healthcare use, distributed according to people's needs instead of ability to pay, is an important goal featuring on many health policy agendas worldwide. However, relatively little is known about the extent to which this principle is violated across socio-economic groups in Sub-Saharan Africa (SSA). We examine cross-country comparative micro-data from 18 SSA countries and find that considerable inequalities in healthcare use exist and vary across countries. For almost all countries studied, healthcare utilization is considerably higher among the rich. When decomposing these inequalities we find that wealth is the single most important driver. In 12 of the 18 countries wealth is responsible for more than half of total inequality in the use of care, and in 8 countries wealth even explains more of the inequality than need, education, employment, marital status and urbanicity together. For the richer countries, notably Mauritius, Namibia, South Africa and Swaziland, the contribution of wealth is typically less important. As the bulk of inequality is not related to need for care and poor people use less care because they do not have the ability to pay, healthcare utilization in these countries is to a large extent unfairly distributed. The weak average relationship between need for and use of health care and the potential reporting heterogeneity in self-reported health across socio-economic groups imply that our findings are likely to even underestimate actual inequities in health care. At a macro level, we find that a better match of needs and use is realized in those countries with better governance and more physicians. Given the absence of social health insurance in most of these countries, policies that aim to reduce inequities in access to and use of health care must include an enhanced capacity of the poor to generate income. Published by Oxford University Press in association with The London School of Hygiene and Tropical Medicine

  16. Validation of the HIV/AIDS Stigma Instrument - PLWA (HASI-P).

    PubMed

    Holzemer, William L; Uys, Leana R; Chirwa, Maureen L; Greeff, Minrie; Makoae, Lucia N; Kohi, Thecla W; Dlamini, Priscilla S; Stewart, Anita L; Mullan, Joseph; Phetlhu, René D; Wantland, Dean; Durrheim, Kevin

    2007-09-01

    This article describes the development and testing of a quantitative measure of HIV/AIDS stigma as experienced by people living with HIV/AIDS. This instrument is designed to measure perceived stigma, create a baseline from which to measure changes in stigma over time, and track potential progress towards reducing stigma. It was developed in three phases from 2003-2006: generating items based on results of focus group discussions; pilot testing and reducing the original list of items; and validating the instrument. Data for all phases were collected from five African countries: Lesotho, Malawi, South Africa, Swaziland and Tanzania. The instrument was validated with a sample of 1,477 persons living with HIV/AIDS from all of the five countries. The sample had a mean age of 36.1 years and 74.1% was female. The participants reported they knew they were HIV positive for an average of 3.4 years and 46% of the sample was taking antiretroviral medications. A six factor solution with 33 items explained 60.72% of the variance. Scale alpha reliabilities were examined and items that did not contribute to scale reliability were dropped. The factors included: Verbal Abuse (8 items, alpha=0.886); Negative Self-Perception (5 items, alpha=0.906); Health Care Neglect (7 items, alpha=0.832); Social Isolation (5 items, alpha=0.890); Fear of Contagion (6 items, alpha=0.795); and Workplace Stigma (2 items, alpha=0.758). This article reports on the development and validation of a new measure of stigma, HIV/AIDS Stigma Instrument - PLWA (HASI-P) providing evidence that supports adequate content and construct validity, modest concurrent validity, and acceptable internal consistency reliability for each of the six subscales and total score. The scale is available is several African languages.

  17. Financing the HIV response in sub-Saharan Africa from domestic sources: Moving beyond a normative approach.

    PubMed

    Remme, Michelle; Siapka, Mariana; Sterck, Olivier; Ncube, Mthuli; Watts, Charlotte; Vassall, Anna

    2016-11-01

    Despite optimism about the end of AIDS, the HIV response requires sustained financing into the future. Given flat-lining international aid, countries' willingness and ability to shoulder this responsibility will be central to access to HIV care. This paper examines the potential to expand public HIV financing, and the extent to which governments have been utilising these options. We develop and compare a normative and empirical approach. First, with data from the 14 most HIV-affected countries in sub-Saharan Africa, we estimate the potential increase in public HIV financing from economic growth, increased general revenue generation, greater health and HIV prioritisation, as well as from more unconventional and innovative sources, including borrowing, health-earmarked resources, efficiency gains, and complementary non-HIV investments. We then adopt a novel empirical approach to explore which options are most likely to translate into tangible public financing, based on cross-sectional econometric analyses of 92 low and middle-income country governments' most recent HIV expenditure between 2008 and 2012. If all fiscal sources were simultaneously leveraged in the next five years, public HIV spending in these 14 countries could increase from US$3.04 to US$10.84 billion per year. This could cover resource requirements in South Africa, Botswana, Namibia, Kenya, Nigeria, Ethiopia, and Swaziland, but not even half the requirements in the remaining countries. Our empirical results suggest that, in reality, even less fiscal space could be created (a reduction by over half) and only from more conventional sources. International financing may also crowd in public financing. Most HIV-affected lower-income countries in sub-Saharan Africa will not be able to generate sufficient public resources for HIV in the medium-term, even if they take very bold measures. Considerable international financing will be required for years to come. HIV funders will need to engage with broader

  18. Limitations of Rapid Diagnostic Testing in Patients with Suspected Malaria: A Diagnostic Accuracy Evaluation from Swaziland, a Low-Endemicity Country Aiming for Malaria Elimination

    PubMed Central

    Ranadive, Nikhil; Kunene, Simon; Darteh, Sarah; Ntshalintshali, Nyasatu; Nhlabathi, Nomcebo; Dlamini, Nomcebo; Chitundu, Stanley; Saini, Manik; Murphy, Maxwell; Soble, Adam; Schwartz, Alanna; Greenhouse, Bryan

    2017-01-01

    Abstract Background. The performance of Plasmodium falciparum–specific histidine-rich protein 2–based rapid diagnostic tests (RDTs) to evaluate suspected malaria in low-endemicity settings has not been well characterized. Methods. Using dried blood spot samples from patients with suspected malaria at 37 health facilities from 2012 to 2014 in the low-endemicity country of Swaziland, we investigated the diagnostic accuracy of histidine-rich protein 2–based RDTs using qualitative polymerase chain reaction (PCR) (nested PCR targeting the cytochrome b gene) and quantitative PCR as reference standards. To explore reasons for false-negative and/or false-positive results, we used pfhrp2/3-specific PCR and logistic regression analyses of potentially associated epidemiological factors. Results. From 1353 patients, 93.0% of RDT-positive (n = 185) and 31.2% of RDT-negative samples (n = 340) were available and selected for testing. Compared with nested PCR, the sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of RDTs were 51.7%, 94.1%, 67.3%, and 89.1%, respectively. After exclusion of samples with parasite densities <100/μL, which accounted for 75.7% of false-negative results and 33.3% of PCR-detectable infections, the sensitivity, specificity, PPV, and NPV were 78.8%, 93.7%, 62.3%, and 97.1%. Deletions of pfhrp2 were not detected. False-positivity was more likely during the second year and was not associated with demographics, recent malaria, health facility testing characteristics, or potential DNA degradation. Conclusions. In the low-transmission setting of Swaziland, we demonstrated low sensitivity of RDT for malaria diagnosis, owing to an unexpectedly high proportion of low-density infection among symptomatic subjects. The PPV was also low, requiring further investigation. A more accurate point-of-care diagnostic may be needed to support malaria elimination efforts. PMID:28369268

  19. Limitations of Rapid Diagnostic Testing in Patients with Suspected Malaria: A Diagnostic Accuracy Evaluation from Swaziland, a Low-Endemicity Country Aiming for Malaria Elimination.

    PubMed

    Ranadive, Nikhil; Kunene, Simon; Darteh, Sarah; Ntshalintshali, Nyasatu; Nhlabathi, Nomcebo; Dlamini, Nomcebo; Chitundu, Stanley; Saini, Manik; Murphy, Maxwell; Soble, Adam; Schwartz, Alanna; Greenhouse, Bryan; Hsiang, Michelle S

    2017-05-01

    The performance of Plasmodium falciparum-specific histidine-rich protein 2-based rapid diagnostic tests (RDTs) to evaluate suspected malaria in low-endemicity settings has not been well characterized. Using dried blood spot samples from patients with suspected malaria at 37 health facilities from 2012 to 2014 in the low-endemicity country of Swaziland, we investigated the diagnostic accuracy of histidine-rich protein 2-based RDTs using qualitative polymerase chain reaction (PCR) (nested PCR targeting the cytochrome b gene) and quantitative PCR as reference standards. To explore reasons for false-negative and/or false-positive results, we used pfhrp2/3-specific PCR and logistic regression analyses of potentially associated epidemiological factors. From 1353 patients, 93.0% of RDT-positive (n = 185) and 31.2% of RDT-negative samples (n = 340) were available and selected for testing. Compared with nested PCR, the sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of RDTs were 51.7%, 94.1%, 67.3%, and 89.1%, respectively. After exclusion of samples with parasite densities <100/μL, which accounted for 75.7% of false-negative results and 33.3% of PCR-detectable infections, the sensitivity, specificity, PPV, and NPV were 78.8%, 93.7%, 62.3%, and 97.1%. Deletions of pfhrp2 were not detected. False-positivity was more likely during the second year and was not associated with demographics, recent malaria, health facility testing characteristics, or potential DNA degradation. In the low-transmission setting of Swaziland, we demonstrated low sensitivity of RDT for malaria diagnosis, owing to an unexpectedly high proportion of low-density infection among symptomatic subjects. The PPV was also low, requiring further investigation. A more accurate point-of-care diagnostic may be needed to support malaria elimination efforts. © The Author 2017. Published by Oxford University Press for the Infectious Diseases Society of America.

  20. The gendered experiences of children in child-headed households in Swaziland.

    PubMed

    Mkhatshwa, Nozipho

    2017-12-01

    This study investigated the gender dynamics of living in child-headed households (CHHs) in a rural area in Swaziland that experiences high levels of drought, poverty and HIV and AIDS. Using a qualitative research methodology, the study examined ways in which children in CHHs meet their daily family needs and address their vulnerabilities according to their gender, focusing on the experiences of the children. The study sample consisted of 10 households, with 5 boy and 5 girl-headed households from the chiefdoms within the area. A semi-structured interview guide was used to conduct interviews in the respondents' own homes. The study focused on the gendered coping strategies used by the children to sustain their household welfare. Three factors were examined: leadership, food provision and education. The findings show that birth order conferred headship or leadership to the eldest sibling irrespective of their gender. Variations in the performance of the three factors, which were influenced by the gender of the household head, were observed. Generally, the children acted in accordance with their socio-cultural norms demanded in fulfilling the role of leadership and food provision. Boy-headed households become disadvantaged because of the boys' reluctance to take tasks which would contravene traditional Swazi notions of masculinity. This was exacerbated by societal expectations of the independence of boys. Hegemonic masculinity puts boys at a disadvantage when societal expectations require them to enact their masculinity through independence, rather than by drawing on the support of their neighbours/family/social networks. However, girls conformed to traditional Swazi norms. Societal compassion with the vulnerability of girls produced sustainable social arrangements and fostered resilience in girl-headed households.

  1. [Malaria is still a leading cause of fever and death among children and pregnant women in Africa in 2015].

    PubMed

    Doumbo, Ogobara; Fall, Ibrahima Socé; Niaré, Doumbo

    2016-03-01

    The prevalence and morbidity of P. vivax, P. ovale (curisi et wallikeri) and P. malariae remain underestimated. However important progress has been made. According to the WHO World Malaria report between 2000 and 2015 the malaria incidence has decreased by 42% while the incidence of malaria deaths has decreased by 66%. This is the result of the important progress made in scaling up the main interventions such the rapid diagnosis test, Artemisinin-based combination therapies, long lasting insecticide treated nets, indoor residual house spraying, intermittent preventive treatment during pregnancy (IPTp-SP), Seasonal Malaria Chemoprophylaxis with combined antimalarial (SMClAQ-SP). In the Sahel region with a highly seasonal transmission, the use of SMC resulted in a reduction of malaria morbidity for 80% and a reduce mortality for 58%. Malaria elimination efforts are going on in many countries in Swaziland, South Africa, Namibia, Zanzibar (United Republic of Tanzania), Bioko Island (Equatorial Guinea), Sao Tome and Principe, Cape Verde, and maybe Senegal. For the time being only countries in Northern Africa and few in East Africa (Mauritius) have reached the elimination of local transmission. Despite the progress made near 500,000 malaria deaths occur annually in the African Region with 10-15% leading to disabling sequels and low school performance in children. Reaching the target of 80% for preventive and treatment interventions remain a challenge in many countries in Africa. It's important to keep in mind that the Abuja targets and MGDs were not reached by most African countries. In addition, among 12 million children eligible for SMC only 35% were covered despite the availability of resources in 2014. A huge global stock out of ACT. AQ-SP is possible. The development of an effective vaccine has been disappointing with a limited effectiveness of the RTS,S. The emerging resistance to Artemisinin derivate in South-East Asia and its possible expansion to Africa is of

  2. Effects of planned, mistimed and unwanted pregnancies on the use of prenatal health services in sub-Saharan Africa: a multicountry analysis of Demographic and Health Survey data.

    PubMed

    Amo-Adjei, Joshua; Anamaale Tuoyire, Derek

    2016-12-01

    We analysed the extent of planned, mistimed and unwanted pregnancies and how they predict optimal use of prenatal (timing and number of antenatal) care services in 30 African countries. We pooled data from Demographic and Health Surveys conducted in 30 African countries between 2006 and 2015. We described the extent of mistimed and unwanted pregnancies and further used mixed effects logistic and Poisson regression estimation techniques to examine the impacts of planned, mistimed and unwanted pregnancies on the use of prenatal health services. In total, 73.65% of pregnancies in all countries were planned. Mistimed pregnancy ranged from 7.43% in Burkina Faso to 41.33% in Namibia. Unwanted pregnancies were most common in Swaziland (39.54%) and least common in Niger (0.74%). Timely (first trimester) initiation of ANC was 37% overall in all countries; the multicountry average number of ANC visits was optimal [4.1; 95% CI: 4.1-4.2] but with notable disparities between countries. Overall, mistimed and unwanted pregnancies were strongly associated with late ANC attendance and fewer visits women made in the pooled analysis. Unintended pregnancies are critical risks to achieving improved maternal health in respect of early and optimal ANC coverage for women in Africa. Programmes targeted at advancing coverage of ANC in Africa need to deploy contextually appropriate mechanisms to prevent unintended pregnancies. © 2016 John Wiley & Sons Ltd.

  3. A comparative study of adoloscents' perceived stress and health outcomes among adolescent mothers and their infants in Lesotho.

    PubMed

    Yako, E M

    2007-03-01

    The purpose of this study was to compare perceived stress in general, stress due to pregnancy, and post partum complications between a group of unmarried adolescent first-time mothers and a group of married adolescent first-time mothers. Never-pregnant adolescents served as a comparison group on perceived stress. Health outcomes of infants of the two groups of adolescent mothers were also compared on birth weight, nutritional status (weight gain) and immunization status. The study design was non-experimental, comparative and descriptive. A convenience sample of dyads of 64 unmarried adolescent mothers and their infants, 64 married adolescents and their infants, and 64 high school students participated in this study. Data were collected in 3 hospitals, 2 health centres (clinics) and a high school in Lesotho. The differences between the three groups of adolescents in perceived stress, were determined using ANOVA. The t-test was used to determine the differences between the group of unmarried adolescent mothers and the group of married mothers on stress due to pregnancy. The difference in postpartum complications between these two groups of adolescent mothers was determined using Chi-square. The t-test was also used to determine differences in birth weight, nutritional status and immunization status between the group of infants of unmarried mothers and infants of married mothers. Findings of this study revealed significant differences in perceived stress between both groups of adolescent mothers and the group of never pregnant adolescents (p < .0001). The Chaffe' test revealed that never pregnant adolescents had lowest levels of perceived stress than both groups of adolescent mothers (p < .0001). Both groups of adolescent mothers had high levels of stress due to pregnancy and the difference between the two groups was non-significant. No differences were observed between infant health outcomes of unmarried mothers and infants of married mothers. The infants of both

  4. Dynamic Locomotor Capabilities Revealed by Early Dinosaur Trackmakers from Southern Africa

    PubMed Central

    Wilson, Jeffrey A.; Marsicano, Claudia A.; Smith, Roger M. H.

    2009-01-01

    Background A new investigation of the sedimentology and ichnology of the Early Jurassic Moyeni tracksite in Lesotho, southern Africa has yielded new insights into the behavior and locomotor dynamics of early dinosaurs. Methodology/Principal Findings The tracksite is an ancient point bar preserving a heterogeneous substrate of varied consistency and inclination that includes a ripple-marked riverbed, a bar slope, and a stable algal-matted bar top surface. Several basal ornithischian dinosaurs and a single theropod dinosaur crossed its surface within days or perhaps weeks of one another, but responded to substrate heterogeneity differently. Whereas the theropod trackmaker accommodated sloping and slippery surfaces by gripping the substrate with its pedal claws, the basal ornithischian trackmakers adjusted to the terrain by changing between quadrupedal and bipedal stance, wide and narrow gauge limb support (abduction range = 31°), and plantigrade and digitigrade foot posture. Conclusions/Significance The locomotor adjustments coincide with changes in substrate consistency along the trackway and appear to reflect ‘real time’ responses to a complex terrain. It is proposed that these responses foreshadow important locomotor transformations characterizing the later evolution of the two main dinosaur lineages. Ornithischians, which shifted from bipedal to quadrupedal posture at least three times in their evolutionary history, are shown to have been capable of adopting both postures early in their evolutionary history. The substrate-gripping behavior demonstrated by the early theropod, in turn, is consistent with the hypothesized function of pedal claws in bird ancestors. PMID:19806213

  5. Dynamic locomotor capabilities revealed by early dinosaur trackmakers from southern Africa.

    PubMed

    Wilson, Jeffrey A; Marsicano, Claudia A; Smith, Roger M H

    2009-10-06

    A new investigation of the sedimentology and ichnology of the Early Jurassic Moyeni tracksite in Lesotho, southern Africa has yielded new insights into the behavior and locomotor dynamics of early dinosaurs. The tracksite is an ancient point bar preserving a heterogeneous substrate of varied consistency and inclination that includes a ripple-marked riverbed, a bar slope, and a stable algal-matted bar top surface. Several basal ornithischian dinosaurs and a single theropod dinosaur crossed its surface within days or perhaps weeks of one another, but responded to substrate heterogeneity differently. Whereas the theropod trackmaker accommodated sloping and slippery surfaces by gripping the substrate with its pedal claws, the basal ornithischian trackmakers adjusted to the terrain by changing between quadrupedal and bipedal stance, wide and narrow gauge limb support (abduction range = 31 degrees ), and plantigrade and digitigrade foot posture. The locomotor adjustments coincide with changes in substrate consistency along the trackway and appear to reflect 'real time' responses to a complex terrain. It is proposed that these responses foreshadow important locomotor transformations characterizing the later evolution of the two main dinosaur lineages. Ornithischians, which shifted from bipedal to quadrupedal posture at least three times in their evolutionary history, are shown to have been capable of adopting both postures early in their evolutionary history. The substrate-gripping behavior demonstrated by the early theropod, in turn, is consistent with the hypothesized function of pedal claws in bird ancestors.

  6. Voluntary Medical Male Circumcision: Logistics, Commodities, and Waste Management Requirements for Scale-Up of Services

    PubMed Central

    Edgil, Dianna; Stankard, Petra; Forsythe, Steven; Rech, Dino; Chrouser, Kristin; Adamu, Tigistu; Sakallah, Sameer; Thomas, Anne Goldzier; Albertini, Jennifer; Stanton, David; Dickson, Kim Eva; Njeuhmeli, Emmanuel

    2011-01-01

    Background The global HIV prevention community is implementing voluntary medical male circumcision (VMMC) programs across eastern and southern Africa, with a goal of reaching 80% coverage in adult males by 2015. Successful implementation will depend on the accessibility of commodities essential for VMMC programming and the appropriate allocation of resources to support the VMMC supply chain. For this, the United States President’s Emergency Plan for AIDS Relief, in collaboration with the World Health Organization and the Joint United Nations Programme on HIV/AIDS, has developed a standard list of commodities for VMMC programs. Methods and Findings This list of commodities was used to inform program planning for a 1-y program to circumcise 152,000 adult men in Swaziland. During this process, additional key commodities were identified, expanding the standard list to include commodities for waste management, HIV counseling and testing, and the treatment of sexually transmitted infections. The approximate costs for the procurement of commodities, management of a supply chain, and waste disposal, were determined for the VMMC program in Swaziland using current market prices of goods and services. Previous costing studies of VMMC programs did not capture supply chain costs, nor the full range of commodities needed for VMMC program implementation or waste management. Our calculations indicate that depending upon the volume of services provided, supply chain and waste management, including commodities and associated labor, contribute between US$58.92 and US$73.57 to the cost of performing one adult male circumcision in Swaziland. Conclusions Experience with the VMMC program in Swaziland indicates that supply chain and waste management add approximately US$60 per circumcision, nearly doubling the total per procedure cost estimated previously; these additional costs are used to inform the estimate of per procedure costs modeled by Njeuhmeli et al. in “Voluntary Medical

  7. From diagnosis to case investigation for malaria elimination in Swaziland: is reporting and response timely?

    PubMed

    Dlamini, N; Zulu, Z; Kunene, S; Geoffroy, E; Ntshalintshali, N; Owiti, P; Sikhondze, W; Makadzange, K; Zachariah, R

    2018-04-25

    Background: Swaziland is one of the southern African countries that aim to eliminate malaria by 2020. In 2010, the country introduced an Immediate Disease Notification System (IDNS) for immediate reporting of notifiable diseases, including malaria. Health facilities are to report malaria cases within 24 h through a toll-free telephone number (977), triggering an alert for case investigation at the patient's household within 48 h. We assessed the completeness of reporting in the IDNS, the subsequent case investigation, and whether it was done within the stipulated timelines. Methods: A cross-sectional study using routine country-wide data. Results: Of 1991 malaria cases notified between July 2011 and June 2015, 76% were reported in the IDNS, of which 68% were investigated-a shortfall of 24% in reporting and 32% in case investigations. Of the 76% of cases reported through the IDNS, 62% were reported within 24 h and 20% were investigated within 48 h. These shortcomings were most pronounced in hospitals and private facilities. Investigated cases ( n = 1346) were classified as follows: 60% imported, 35% local and 5% undetermined. Conclusion: The utilisation of the IDNS for case reporting to trigger investigation is crucial for active surveillance. There is a need to address the reporting and investigation gaps identified to ensure that malaria cases receive appropriate interventions.

  8. Demotivating infant feeding counselling encounters in southern Africa: do counsellors need more or different training?

    PubMed

    Buskens, I; Jaffe, A

    2008-03-01

    Ethnographic research was conducted in eleven low-resource settings across Swaziland, Namibia and South Africa to explore how the perceptions and experiences of counselling health workers, pregnant women and recent mothers could be used to improve infant feeding counselling in the context of mother to child transmission (MTCT) of HIV. We found many counselling encounters to be demotivating. Mothers often reported feeling judged, stigmatised and shamed. Counsellors complained of mothers' poor compliance and passive resistance and reported suffering from stress, depression and burnout. We observed a rift between the mothers and counselling nurses, with both parties holding opposing agendas grounded in conflicting realities, expectations, experiences and needs. While the clients framed the visit as a consultation, counsellors framed it as health education, towards one exclusive purpose; to save the baby. Two communication modes prevailed in the counselling encounter: in theory, the counselling format was non-directive and client-centred but, in practice, most encounters reverted to information-based health education. Neither counselling format enabled the counsellors to acknowledge the reality of the two opposing agendas in the conversation and manage its dynamics. In order to achieve success - which, for the health service, is framed as persuading mothers to test for HIV and disclose the result - counsellors often felt compelled to be prescriptive and authoritative and reverted at times to confronting, judging and shaming mothers. Yet to adhere to their feeding choice consistently, mothers need to be motivated towards the significant behaviour change that this implies: to change their traditional roles and identities as women. For infant feeding counselling in the context of HIV/AIDS to become effective in southern Africa, a different format is therefore required; one that can acknowledge and manage these opposing agendas and conflicting realities and also enable

  9. Evaluating audio computer assisted self-interviews in urban South African communities: evidence for good suitability and reduced social desirability bias of a cross-sectional survey on sexual behaviour.

    PubMed

    Beauclair, Roxanne; Meng, Fei; Deprez, Nele; Temmerman, Marleen; Welte, Alex; Hens, Niel; Delva, Wim

    2013-01-31

    Efficient HIV prevention requires accurate identification of individuals with risky sexual behaviour. However, self-reported data from sexual behaviour surveys are prone to social desirability bias (SDB). Audio Computer-Assisted Self-Interviewing (ACASI) has been suggested as an alternative to face-to-face interviewing (FTFI), because it may promote interview privacy and reduce SDB. However, little is known about the suitability and accuracy of ACASI in urban communities with high HIV prevalence in South Africa. To test this, we conducted a sexual behaviour survey in Cape Town, South Africa, using ACASI methods. Participants (n = 878) answered questions about their sexual relationships on a touch screen computer in a private mobile office. We included questions at the end of the ACASI survey that were used to assess participants' perceived ease of use, privacy, and truthfulness. Univariate logistic regression models, supported by multivariate models, were applied to identify groups of people who had adverse interviewing experiences. Further, we constructed male-female ratios of self-reported sexual behaviours as indicators of SDB. We used these indicators to compare SDB in our survey and in recent FTFI-based Demographic and Health Surveys (DHSs) from Lesotho, Swaziland, and Zimbabwe. Most participants found our methods easy to use (85.9%), perceived privacy (96.3%) and preferred ACASI to other modes of inquiry (82.5%) when reporting on sexual behaviours. Unemployed participants and those in the 40-70 year old age group were the least likely to find our methods easy to use (OR 0.69; 95% CI: 0.47-1.01 and OR 0.37; 95% CI: 0.23-0.58, respectively). In our survey, the male-female ratio for reporting >2 sexual partners in the past year, a concurrent relationship in the past year, and > 2 sexual partners in a lifetime was 3.4, 2.6, and 1.2, respectively- far lower than the ratios observed in the Demographic and Health Surveys. Our analysis suggests that most

  10. Prevalence and risk factors for forced or coerced sex among school-going youth: national cross-sectional studies in 10 southern African countries in 2003 and 2007

    PubMed Central

    Paredes-Solís, Sergio; Milne, Deborah; Omer, Khalid; Marokoane, Nobantu; Laetsang, Ditiro; Cockcroft, Anne

    2012-01-01

    Objectives To study prevalence at two time points and risk factors for experience of forced or coerced sex among school-going youth in 10 southern African countries. Design Cross-sectional surveys, by facilitated self-administered questionnaire, of in-school youth in 2003 and 2007. Setting Schools serving representative communities in eight countries (Botswana, Lesotho, Malawi, Mozambique, Namibia, Swaziland, Zambia and Zimbabwe) in 2003 and with Tanzania and South Africa added in 2007. Participants Students aged 11–16 years present in the school classes. Main outcome measures Experience of forced or coerced sex, perpetration of forced sex. Results In 2007, 19.6% (4432/25 840) of female students and 21.1% (4080/21 613) of male students aged 11–16 years reported they had experienced forced or coerced sex. Rates among 16-year-olds were 28.8% in females and 25.4% in males. Comparing the same schools in eight countries, in an analysis age standardised on the 2007 Botswana male sample, there was no significant decrease between 2003 and 2007 among females in any country and inconsistent changes among males. In multilevel analysis using generalised linear mixed model, individual-level risk factors for forced sex among female students were age over 13 years and insufficient food in the household; school-level factors were a lower proportion of students knowing about child rights and higher proportions experiencing or perpetrating forced sex; and community-level factors were a higher proportion of adults in favour of transactional sex and a higher rate of intimate partner violence. Male risk factors were similar. Some 4.7% of female students and 11.7% of male students reported they had perpetrated forced sex. Experience of forced sex was strongly associated with perpetration and other risk factors for perpetration were similar to those for victimisation. Conclusions Forced or coerced sex remained common among female and male youth in 2007. Experience of sexual

  11. Violence in Brazil and Its Connection with Transnational Crime

    DTIC Science & Technology

    2003-04-07

    factors on violent behavior is research accomplished by the Núcleo de Estudos da Violência (Center of Studies of Violence) at the Universidade de São...53.98 Rio de Janeiro- RJ 52.68 Source: Almanaque Abril 2002 9 - Aggravation of social differences: one of the largest and most sensitive issues in the...for the worst distribution of income, after Swaziland, Nicaragua and South Africa. According to data published by Instituto Brasileiro de Geografia e

  12. What explains gender inequalities in HIV/AIDS prevalence in sub-Saharan Africa? Evidence from the demographic and health surveys.

    PubMed

    Sia, Drissa; Onadja, Yentéma; Hajizadeh, Mohammad; Heymann, S Jody; Brewer, Timothy F; Nandi, Arijit

    2016-11-03

    Women are disproportionally affected by human immunodeficiency virus (HIV)/acquired immunodeficiency syndrome (AIDS) in sub-Saharan Africa (SSA). The determinants of gender inequality in HIV/AIDS may vary across countries and require country-specific interventions to address them. This study aimed to identify the socio-demographic and behavioral characteristics underlying gender inequalities in HIV/AIDS in 21 SSA countries. We applied an extension of the Blinder-Oaxaca decomposition approach to data from Demographic and Health Surveys and AIDS Indicator Surveys to quantify the differences in HIV/AIDS prevalence between women and men attributable to socio-demographic factors, sexual behaviours, and awareness of HIV/AIDS. We decomposed gender inequalities into two components: the percentage attributable to different levels of the risk factors between women and men (the "composition effect") and the percentage attributable to risk factors having differential effects on HIV/AIDS prevalence in women and men (the "response effect"). Descriptive analyses showed that the difference between women and men in HIV/AIDS prevalence varied from a low of 0.68 % (P = 0.008) in Liberia to a high of 11.5 % (P < 0.001) in Swaziland. The decomposition analysis showed that 84 % (P < 0.001) and 92 % (P < 0.001) of the higher prevalence of HIV/AIDS among women in Uganda and Ghana, respectively, was explained by the different distributions of HIV/AIDS risk factors, particularly age at first sex between women and men. In the majority of countries, however, observed gender inequalities in HIV/AIDS were chiefly explained by differences in the responses to risk factors; the differential effects of age, marital status and occupation on prevalence of HIV/AIDS for women and men were among the significant contributors to this component. In Cameroon, Guinea, Malawi and Swaziland, a combination of the composition and response effects explained gender inequalities in HIV

  13. HIV/AIDS Education: What Works for Swaziland University Students?

    ERIC Educational Resources Information Center

    Sukati, C. W. S.; Vilakati, Nokuthula; Esampally, Chandraiah

    2010-01-01

    Background: HIV/AIDS poses a major threat to development and poverty alleviation, particularly in Sub-Saharan Africa. Education has been declared an effective preventative approach and the single most powerful weapon against HIV transmission. However, there is a paucity of research on the type of education required, the appropriate…

  14. An assessment of sex work in Swaziland: barriers to and opportunities for HIV prevention among sex workers.

    PubMed

    Chipamaunga, Shalote; Muula, Adamson S; Mataya, Ronald

    2010-10-01

    The HIV situation in virtually all southern African countries is a generalised epidemic. Despite the fact that almost all adult age and social groups have high HIV prevalence estimates, sex workers are disproportionally affected, with prevalence estimates higher than the general population. In a qualitative study of 61 male and female sex workers in Swaziland, we found that while poverty drove many into sex work, others reported motivations of pleasure or "sensation seeking", and freedoms from the burden of marriage as perceived benefits of sex work. We also found that penile-vaginal sex was not universal in male-female sexual encounters; and motivation by sex workers for non-condom use included intention to earn more money from unprotected sex, desire for sexual pleasure, and not having time to use condoms. Many sex workers expressed doubts over an alternative lifestyle, even if that change afforded them money to meet their daily necessities. The findings from this study suggest that treating sex workers as a homogenous group that is driven into, or maintain sex work only because of poverty may be problematic, and could hamper HIV-relevant interventions aimed at reducing their vulnerability to sexually transmitted infections.

  15. New species of the Afrotropical spider genus Cheiramiona Lotz & Dippenaar-Schoeman (Araneae: Eutichuridae).

    PubMed

    Lotz, L N

    2015-07-02

    Twenty-three new species of the Afrotropical sac spider genus Cheiramiona Lotz & Dippenaar-Schoeman, 1999 are described: C. baviaan sp. nov. (♀, South Africa), C. boschrandensis sp. nov. (♀, South Africa), C. debeeri sp. nov. (♂, South Africa), C. haddadi sp. nov. (♂, South Africa), C. hlathikulu sp. nov. (♂, South Africa), C. hogsbackensis sp. nov. (♀, ♂, South Africa), C. ibayaensis sp. nov. (♂, Tanzania), C. jakobsbaaiensis sp. nov. (♂, South Africa), C. kirkspriggsi sp. nov. (♀, ♂, South Africa), C. kivuensis sp. nov. (♀, ♂, Democratic Republic of Congo & Rwanda), C. lamorali sp. nov. (♂, Namibia), C. lindae sp. nov. (♂, South Africa), C. malawiensis sp. nov. (♀, ♂, Malawi), C. mkhambathi sp. nov. (♀, ♂, South Africa), C. mohalensis sp. nov. (♀, Lesotho), C. musosaensis sp. nov. (♀, Democratic Republic of Congo), C. nyungwensis sp. nov. (♂, Rwanda), C. plaatbosensis sp. nov. (♀, ♂, South Africa), C. qachasneki sp. nov. (♂, South Africa), C. robinae sp. nov. (♂, South Africa), C. saniensis sp. nov. (♀, ♂, South Africa), C. tembensis sp. nov. (♂, South Africa) and C. upperbyensis sp. nov. (♀, South Africa). The females of C. lajuma Lotz, 2002 and C. mlawula Lotz, 2002 are described for the first time.

  16. From diagnosis to case investigation for malaria elimination in Swaziland: is reporting and response timely?

    PubMed Central

    Zulu, Z.; Kunene, S.; Geoffroy, E.; Ntshalintshali, N.; Owiti, P.; Sikhondze, W.; Makadzange, K.; Zachariah, R.

    2018-01-01

    Background: Swaziland is one of the southern African countries that aim to eliminate malaria by 2020. In 2010, the country introduced an Immediate Disease Notification System (IDNS) for immediate reporting of notifiable diseases, including malaria. Health facilities are to report malaria cases within 24 h through a toll-free telephone number (977), triggering an alert for case investigation at the patient's household within 48 h. We assessed the completeness of reporting in the IDNS, the subsequent case investigation, and whether it was done within the stipulated timelines. Methods: A cross-sectional study using routine country-wide data. Results: Of 1991 malaria cases notified between July 2011 and June 2015, 76% were reported in the IDNS, of which 68% were investigated—a shortfall of 24% in reporting and 32% in case investigations. Of the 76% of cases reported through the IDNS, 62% were reported within 24 h and 20% were investigated within 48 h. These shortcomings were most pronounced in hospitals and private facilities. Investigated cases (n = 1346) were classified as follows: 60% imported, 35% local and 5% undetermined. Conclusion: The utilisation of the IDNS for case reporting to trigger investigation is crucial for active surveillance. There is a need to address the reporting and investigation gaps identified to ensure that malaria cases receive appropriate interventions. PMID:29713587

  17. Rubidium-strontium date of possibly 3 billion years for a granitic rock from antarctica.

    PubMed

    Halpern, M

    1970-09-04

    A single total rock sample of biotite granite from Jule Peaks, Antarctica, has been dated by the rubidium-strontium method at about 3 billion years. The juxtaposition of this sector of Antarctica with Africa in the Dietz and Sproll continental drift reconstruction results in a possible geochronologic fit of the Princess Martha Coast of Antarctica with a covered possible notheastern extension of the African Swaziland Shield, which contains granitic rocks that are also 3 billion years old.

  18. The feminine ideal and transactional sex: Navigating respectability and risk in Swaziland

    PubMed Central

    Fielding-Miller, Rebecca; Dunkle, Kristin L; Jama-Shai, Nwabisa; Windle, Michael; Hadley, Craig; Cooper, Hannah LF

    2016-01-01

    Women who engage in transactional sex are not only at increased risk of HIV and intimate partner violence, but also face social risks including gossip and ostracism. These social and physical risks may be dependent on both what a woman expects and needs from her partner and how her community perceives the relationship. Gender theory suggests that some of these social risks may hinge on whether or not a woman’s relationship threatens dominant masculinity. We conducted a qualitative study in Swaziland from September 2013 to October 2014 to explore transactional sex and respectable femininity through the lens of hegemonic gender theory. Using cultural consensus modeling, we identified cultural models of transactional sex and conducted 16 in-depth interviews with model key informants and 3 focus group discussions, for a total of 41 participants. We identified 4 main models of transactional relationships: One typified by marriage and high social respectability, a second in which women aspire towards marriage, a third particular to University students, and a fourth “sugar daddy” model. Women in all models expected and received significant financial support from their male partners. However, women in less respectable relationships risked social censure and stigma if they were discovered, in part because aspects of their relationship threatened hegemonic masculinity. Conversely, women who received male support in respectable relationships had to carefully select HIV risk reduction strategies that did not threaten their relationship and associated social status. Research and programming efforts typically focus only on the less socially respectable forms of transactional sex. This risks reinforcing stigma for women in relationships that are already considered socially unacceptable while ignoring the unique HIV risks faced by women in more respectable relationships. PMID:27107148

  19. The feminine ideal and transactional sex: Navigating respectability and risk in Swaziland.

    PubMed

    Fielding-Miller, Rebecca; Dunkle, Kristin L; Jama-Shai, Nwabisa; Windle, Michael; Hadley, Craig; Cooper, Hannah L F

    2016-06-01

    Women who engage in transactional sex are not only at increased risk of HIV and intimate partner violence, but also face social risks including gossip and ostracism. These social and physical risks may be dependent on both what a woman expects and needs from her partner and how her community perceives the relationship. Gender theory suggests that some of these social risks may hinge on whether or not a woman's relationship threatens dominant masculinity. We conducted a qualitative study in Swaziland from September 2013 to October 2014 to explore transactional sex and respectable femininity through the lens of hegemonic gender theory. Using cultural consensus modeling, we identified cultural models of transactional sex and conducted 16 in-depth interviews with model key informants and 3 focus group discussions, for a total of 41 participants. We identified 4 main models of transactional relationships: One typified by marriage and high social respectability, a second in which women aspire towards marriage, a third particular to University students, and a fourth "sugar daddy" model. Women in all models expected and received significant financial support from their male partners. However, women in less respectable relationships risked social censure and stigma if they were discovered, in part because aspects of their relationship threatened hegemonic masculinity. Conversely, women who received male support in respectable relationships had to carefully select HIV risk reduction strategies that did not threaten their relationship and associated social status. Research and programming efforts typically focus only on the less socially respectable forms of transactional sex. This risks reinforcing stigma for women in relationships that are already considered socially unacceptable while ignoring the unique HIV risks faced by women in more respectable relationships. Copyright © 2016 Elsevier Ltd. All rights reserved.

  20. Southern Africa: A Study of the Educational Systems of Botswana, Lesotho, South Africa, Southwest Africa/Namibia and Swaziland with an Addendum on Zimbabwe-Rhodesia: A Guide to the Academic Placement of Students in Educational Institutions of the United States.

    ERIC Educational Resources Information Center

    Cranmer, David J.; Woolston, Valerie A.

    The educational systems of Southern African countries are described, and guidelines concerning the placement of students who wish to study in U.S. institutions are provided. Information is provided on educational levels (primary, secondary, and higher education); and types of programs (technical/vocational education, teacher training, and…

  1. Conventional early infant diagnosis in Lesotho from specimen collection to results usage to manage patients: Where are the bottlenecks?

    PubMed Central

    Hoffman, Heather J.; Isavwa, Anthony; Mokone, Mafusi; Foso, Matokelo; Safrit, Jeffrey T.; Mofenson, Lynne M.; Tylleskär, Thorkild

    2017-01-01

    Introduction Early infant diagnosis is an important step in identifying children infected with HIV during the perinatal period or in utero. Multiple factors contribute to delayed antiretroviral treatment initiation for HIV-infected children, including delays in the early infant HIV diagnosis cascade. Methods We conducted a retrospective study to evaluate early infant diagnosis turnaround times in Lesotho. Trained staff reviewed records of HIV-exposed infants (aged-6-8 weeks) who received an HIV test during 2011. Study sites were drawn from Highlands, Foothills and Lowlands regions of Lesotho. Central laboratory database data were linked to facility and laboratory register information. Turnaround time geometric means (with 95% CI) were calculated and compared by region using linear mixed models. Results 1,187 individual infant records from 25 facilities were reviewed. Overall, early infant diagnosis turnaround time was 61.7 days (95%CI: 55.3–68.7). Mean time from specimen collection to district laboratory was 14 days (95%CI: 12.1–16.1); from district to central laboratory, 2 days (95%CI 0.8–5.2); results from central laboratory to district hospital, 23.3 days (95%CI: 18.7–29.0); from district hospital to health facility, 3.2 days (95%CI 1.9–5.5); and from health facility to caregiver, 10.4 days (95%CI, 7.9–13.5). Mean times from specimen transfer to the central laboratory and for result transfer from central laboratory to district hospital were significantly shorter in the Lowlands Region (0.9 and 16.2 days, respectively), compared to Highlands Region (6.0 [P = 0.030] and 34.3 days [P = 0.0099]. Turnaround time from blood draw to receipt of results was significantly shorter for HIV infected infants compared to HIV uninfected infants [p = 0.0036] at an average of 47.1 days (95%CI: 38.9–56.9) and 62 days (95%CI: 55.9–68.7) respectively. Of 47 HIV-infected infants, 36 were initiated on antiretroviral therapy at an average of 1.3 days (95%CI: 0.3, 5

  2. The Incidence Patterns Model to Estimate the Distribution of New HIV Infections in Sub-Saharan Africa: Development and Validation of a Mathematical Model

    PubMed Central

    Cori, Anne; Pufall, Erica L.; Price, Alison; Elmes, Jocelyn; Zaba, Basia; Crampin, Amelia C.; Lutalo, Tom; Gregson, Simon; Hallett, Timothy B.

    2016-01-01

    Background Programmatic planning in HIV requires estimates of the distribution of new HIV infections according to identifiable characteristics of individuals. In sub-Saharan Africa, robust routine data sources and historical epidemiological observations are available to inform and validate such estimates. Methods and Findings We developed a predictive model, the Incidence Patterns Model (IPM), representing populations according to factors that have been demonstrated to be strongly associated with HIV acquisition risk: gender, marital/sexual activity status, geographic location, “key populations” based on risk behaviours (sex work, injecting drug use, and male-to-male sex), HIV and ART status within married or cohabiting unions, and circumcision status. The IPM estimates the distribution of new infections acquired by group based on these factors within a Bayesian framework accounting for regional prior information on demographic and epidemiological characteristics from trials or observational studies. We validated and trained the model against direct observations of HIV incidence by group in seven rounds of cohort data from four studies (“sites”) conducted in Manicaland, Zimbabwe; Rakai, Uganda; Karonga, Malawi; and Kisesa, Tanzania. The IPM performed well, with the projections’ credible intervals for the proportion of new infections per group overlapping the data’s confidence intervals for all groups in all rounds of data. In terms of geographical distribution, the projections’ credible intervals overlapped the confidence intervals for four out of seven rounds, which were used as proxies for administrative divisions in a country. We assessed model performance after internal training (within one site) and external training (between sites) by comparing mean posterior log-likelihoods and used the best model to estimate the distribution of HIV incidence in six countries (Gabon, Kenya, Malawi, Rwanda, Swaziland, and Zambia) in the region. We subsequently

  3. The Incidence Patterns Model to Estimate the Distribution of New HIV Infections in Sub-Saharan Africa: Development and Validation of a Mathematical Model.

    PubMed

    Bórquez, Annick; Cori, Anne; Pufall, Erica L; Kasule, Jingo; Slaymaker, Emma; Price, Alison; Elmes, Jocelyn; Zaba, Basia; Crampin, Amelia C; Kagaayi, Joseph; Lutalo, Tom; Urassa, Mark; Gregson, Simon; Hallett, Timothy B

    2016-09-01

    Programmatic planning in HIV requires estimates of the distribution of new HIV infections according to identifiable characteristics of individuals. In sub-Saharan Africa, robust routine data sources and historical epidemiological observations are available to inform and validate such estimates. We developed a predictive model, the Incidence Patterns Model (IPM), representing populations according to factors that have been demonstrated to be strongly associated with HIV acquisition risk: gender, marital/sexual activity status, geographic location, "key populations" based on risk behaviours (sex work, injecting drug use, and male-to-male sex), HIV and ART status within married or cohabiting unions, and circumcision status. The IPM estimates the distribution of new infections acquired by group based on these factors within a Bayesian framework accounting for regional prior information on demographic and epidemiological characteristics from trials or observational studies. We validated and trained the model against direct observations of HIV incidence by group in seven rounds of cohort data from four studies ("sites") conducted in Manicaland, Zimbabwe; Rakai, Uganda; Karonga, Malawi; and Kisesa, Tanzania. The IPM performed well, with the projections' credible intervals for the proportion of new infections per group overlapping the data's confidence intervals for all groups in all rounds of data. In terms of geographical distribution, the projections' credible intervals overlapped the confidence intervals for four out of seven rounds, which were used as proxies for administrative divisions in a country. We assessed model performance after internal training (within one site) and external training (between sites) by comparing mean posterior log-likelihoods and used the best model to estimate the distribution of HIV incidence in six countries (Gabon, Kenya, Malawi, Rwanda, Swaziland, and Zambia) in the region. We subsequently inferred the potential contribution of each

  4. Investigation of the Practices, Legislation, Supply Chain, and Regulation of Opioids for Clinical Pain Management in Southern Africa: A Multi-sectoral, Cross-National, Mixed Methods Study.

    PubMed

    Namisango, Eve; Allsop, Matthew J; Powell, Richard A; Friedrichsdorf, Stefan J; Luyirika, Emmanuel B K; Kiyange, Fatia; Mukooza, Edward; Ntege, Chris; Garanganga, Eunice; Ginindza-Mdluli, Mavis Ntombifuthi; Mwangi-Powell, Faith; Mondlane, Lidia Justino; Harding, Richard

    2018-03-01

    Sub-Saharan Africa faces an increasing incidence and prevalence of life-limiting and life-threatening conditions. These conditions are associated with a significant burden of pain linked to high morbidity and disability that is poorly assessed and undertreated. Barriers to effective pain management partly relate to lack of access to opioid analgesia and challenges in their administration. To identify country-specific and broader regional barriers to access, as well as the administration of opioids, and generate recommendations for advancing pain management in Southern Africa. A parallel mixed methods design was used across three countries: Mozambique, Swaziland, and Zimbabwe. Three activities were undertaken: 1) a review of regulatory and policy documentation, 2) group interviews, and 3) a self-administered key informant survey. Barriers to accessing opioid analgesics for medical use include overly restrictive controlled medicines' laws; use of stigmatizing language in key documents; inaccurate actual opioid consumption estimation practices; knowledge gaps in the distribution, storage, and prescription of opioids; critical shortage of prescribers; and high out-of-pocket financial expenditures for patients against a backdrop of high levels of poverty. Policies and relevant laws should be updated to ensure that the legislative environment supports opioid access for pain management. Action plans for improving pain treatment for patients suffering from HIV or non-communicable diseases should address barriers at the different levels of the supply chain that involve policymakers, administrators, and service providers. Copyright © 2017 American Academy of Hospice and Palliative Medicine. Published by Elsevier Inc. All rights reserved.

  5. Cryptococcal antigen screening by lay cadres using a rapid test at the point of care: A feasibility study in rural Lesotho.

    PubMed

    Rick, Fernanda; Niyibizi, Aline Aurore; Shroufi, Amir; Onami, Kazumi; Steele, Sarah-Jane; Kuleile, Malehlohonolo; Muleya, Innocent; Chiller, Tom; Walker, Tiffany; Van Cutsem, Gilles

    2017-01-01

    Cryptococcal meningitis is one of the leading causes of death among people with HIV in Africa, primarily due to delayed presentation, poor availability and high cost of treatment. Routine cryptococcal antigen (CrAg) screening of patients with a CD4 count less than 100 cells/mm3, followed by pre-emptive therapy if positive, might reduce mortality in high prevalence settings. Using the cryptococcal antigen (CrAg) lateral flow assay (LFA), screening is possible at the point of care (POC). However, critical shortages of health staff may limit adoption. This study investigates the feasibility of lay counsellors conducting CrAg LFA screening in rural primary care clinics in Lesotho. From May 2014 to June 2015, individuals who tested positive for HIV were tested for CD4 count and those with CD4 <100 cells/mm3 were screened with CrAg LFA. All tests were performed by lay counsellors. CrAg-positive asymptomatic patients received fluconazole, while symptomatic patients were referred to hospital. Lay counsellors were trained and supervised by a laboratory technician and counsellor activity supervisor. Additionally, nurses and doctors were trained on CrAg screening and appropriate treatment. During the study period, 1,388 people were newly diagnosed with HIV, of whom 129 (9%) presented with a CD4 count <100 cells/mm3. Of these, 128 (99%) were screened with CrAg LFA and 14/128 (11%) tested positive. Twelve of the 14 (86%) were asymptomatic, and received outpatient fluconazole. All commenced ART with a median time to initiation of 15.5 days [IQR: 14-22]. Of the asymptomatic patients, nine (75%) remained asymptomatic after a median time of 5 months [IQR; 3-6] of follow up. One (8%) became co-infected with tuberculosis and died and two were transferred out. The two patients with symptomatic cryptococcal meningitis (CM) were referred to hospital, where they later died. CrAg LFA screening by lay counsellors followed by pre-emptive fluconazole treatment for asymptomatic cases, or

  6. Cryptococcal antigen screening by lay cadres using a rapid test at the point of care: A feasibility study in rural Lesotho

    PubMed Central

    Rick, Fernanda; Niyibizi, Aline Aurore; Shroufi, Amir; Onami, Kazumi; Steele, Sarah-Jane; Kuleile, Malehlohonolo; Muleya, Innocent; Chiller, Tom; Walker, Tiffany; Van Cutsem, Gilles

    2017-01-01

    Introduction Cryptococcal meningitis is one of the leading causes of death among people with HIV in Africa, primarily due to delayed presentation, poor availability and high cost of treatment. Routine cryptococcal antigen (CrAg) screening of patients with a CD4 count less than 100 cells/mm3, followed by pre-emptive therapy if positive, might reduce mortality in high prevalence settings. Using the cryptococcal antigen (CrAg) lateral flow assay (LFA), screening is possible at the point of care (POC). However, critical shortages of health staff may limit adoption. This study investigates the feasibility of lay counsellors conducting CrAg LFA screening in rural primary care clinics in Lesotho. Methods From May 2014 to June 2015, individuals who tested positive for HIV were tested for CD4 count and those with CD4 <100 cells/mm3 were screened with CrAg LFA. All tests were performed by lay counsellors. CrAg-positive asymptomatic patients received fluconazole, while symptomatic patients were referred to hospital. Lay counsellors were trained and supervised by a laboratory technician and counsellor activity supervisor. Additionally, nurses and doctors were trained on CrAg screening and appropriate treatment. Results During the study period, 1,388 people were newly diagnosed with HIV, of whom 129 (9%) presented with a CD4 count <100 cells/mm3. Of these, 128 (99%) were screened with CrAg LFA and 14/128 (11%) tested positive. Twelve of the 14 (86%) were asymptomatic, and received outpatient fluconazole. All commenced ART with a median time to initiation of 15.5 days [IQR: 14–22]. Of the asymptomatic patients, nine (75%) remained asymptomatic after a median time of 5 months [IQR; 3–6] of follow up. One (8%) became co-infected with tuberculosis and died and two were transferred out. The two patients with symptomatic cryptococcal meningitis (CM) were referred to hospital, where they later died. Conclusions CrAg LFA screening by lay counsellors followed by pre

  7. A continuous record of tectonic evolution from 3.5 Ga to 2.6 Ga in Swaziland and northern Natal

    NASA Technical Reports Server (NTRS)

    Hunter, D. R.; Wilson, A. H.; Versfeld, J. A.; Allen, A. R.; Smith, R. G.; Sleigh, D. W. W.; Groenewald, P. B.; Chutter, G. M.; Preston, V. A.

    1986-01-01

    The approx. 3.5 Ga-old bimodal suite underlying an extensive area in southwestern Swaziland comprises the oldest-dated sialic rocks in the Kaapvaal structural province. The suite consists of leucocratic, layered tonalitic-trondhjemitic gneisses and amphibolites characterized by the effects of repeated high strains. This suite is considered to represent a sialic basement on which metavolcanic and metasedimentary rocks, now preserved as scattered greenstone remnants, accumulated. Direct evidence to confirm this temporal relationship is lacking, but structural data from the Dwalile, Assegaai and Commondale areas indicate that (1) the bimodal gneisses experienced a complex structural history prior to the first recognizable deformation in the supracrustal rocks (i.e., D1 in the supracrustals is equivalent to Dn + 1 in the gneisses) and (2) scattered remnants of the Dwalile rocks infolded with the bimodal suite structurally overlie the gneisses and are preserved in synformal keels. Significant proportions of metaquartzites and metapelites are present in the Assegaai greenstone sequence, the presence of which implies the existence of felsic crust in the source area from which these sediments were derived, a conclusion that is consistent with the structural data.

  8. Interplay between economic empowerment and sexual behaviour and practices of migrant workers within the context of HIV and AIDS in the Lesotho textile industry.

    PubMed

    Tanga, Pius Tangwe; Tangwe, Magdaline Nji

    2014-01-01

    Economic empowerment brings with it a wide range of consequences, both positive and negative. The objective of this paper was to examine the relationship between economic empowerment and the sexual behaviour and practices of migrant workers within the context of HIV and AIDS in the Lesotho textile industry. Data for this paper were extracted from the findings of a larger study which had been conducted concerning HIV and AIDS in the textile industry in Lesotho. Using in-depth interviews, data were collected from 40 participants who were purposively selected from five factories which had been chosen randomly. Empowerment theory was used as a lens to provide meanings for the experiences of the participants. The findings show that the participants were empowered only in certain respects in terms of Kabeer's empowerment model of 'power to' and 'power within', on one hand, and in terms of Malhotra's comprehensive empowerment framework at the household level, on the other, as being employed in the industry enabled them to participate in the economy. Employment in the sector provided the participants with the means to be able to acquire basic needs and the ability to participate in household decision-making: for the female participants, the ability to make independent sexual decisions was also enhanced. These improvements were greeted enthusiastically, particularly by the female participants, given their previously disadvantaged status as a result of coming from rural patriarchal villages with gender-defined hegemonic notions of respectability. The findings also indicate that environmental factors and others, such as meagre salaries, encouraged some of the female workers to engage in transactional sex, while some of the male participants tended to increase their sexual relationships as a result of acquiring employment and income from the industry. It is the contention of the authors of this study that true empowerment requires both vital resources and individual and

  9. Interplay between economic empowerment and sexual behaviour and practices of migrant workers within the context of HIV and AIDS in the Lesotho textile industry

    PubMed Central

    Tanga, Pius Tangwe; Tangwe, Magdaline Nji

    2014-01-01

    Abstract Economic empowerment brings with it a wide range of consequences, both positive and negative. The objective of this paper was to examine the relationship between economic empowerment and the sexual behaviour and practices of migrant workers within the context of HIV and AIDS in the Lesotho textile industry. Data for this paper were extracted from the findings of a larger study which had been conducted concerning HIV and AIDS in the textile industry in Lesotho. Using in-depth interviews, data were collected from 40 participants who were purposively selected from five factories which had been chosen randomly. Empowerment theory was used as a lens to provide meanings for the experiences of the participants. The findings show that the participants were empowered only in certain respects in terms of Kabeer's empowerment model of ‘power to’ and ‘power within’, on one hand, and in terms of Malhotra's comprehensive empowerment framework at the household level, on the other, as being employed in the industry enabled them to participate in the economy. Employment in the sector provided the participants with the means to be able to acquire basic needs and the ability to participate in household decision-making: for the female participants, the ability to make independent sexual decisions was also enhanced. These improvements were greeted enthusiastically, particularly by the female participants, given their previously disadvantaged status as a result of coming from rural patriarchal villages with gender-defined hegemonic notions of respectability. The findings also indicate that environmental factors and others, such as meagre salaries, encouraged some of the female workers to engage in transactional sex, while some of the male participants tended to increase their sexual relationships as a result of acquiring employment and income from the industry. It is the contention of the authors of this study that true empowerment requires both vital resources and

  10. Sm-Nd, K-Ar and petrologic study of some kimberlites from eastern United States and their implication for mantle evolution

    USGS Publications Warehouse

    Basu, A.R.; Rubury, E.; Mehnert, H.; Tatsumoto, M.

    1984-01-01

    We provide new data on Sm-Nd systematics, K-Ar dating and the major element chemistry of kimberlites from the eastern United States (mostly from central New York State) and their constituent mineral phases of olivine, clinopyroxene, garnet, phlogopite and perovskite. In addition, we report Nd-isotopes in a few kimberlites from South Africa, Lesotho and from the eastern part of China. The major element compositions of the New York dike rocks and of their constituent minerals including a xenolith of eclogite are comparable with those from the Kimberley area in South Africa. The K-Ar age of emplacement of the New York dikes is further established to be 143 Ma. We have analyzed the Nd-isotopic composition of the following kimberlites and related rocks: Nine kimberlite pipes from South Africa and Lesotho, two from southern India; one from the U.S.S.R., fifteen kimberlite pipes and related dike rocks from eastern and central U.S. and two pipes from the Shandong Province of eastern China. The age of emplacement of these kimberlites ranges from 1300 million years to 90 million years. The initial Nd-isotopic compositions of these kimberlitic rocks expressed as e{open}NdIwith respect to a chondritic bulk-earth growth-curve show a range between 0 and +4, with the majority of the kimberlites being in the range 0 to +2. This range is not matched by any other suite of mantle-derived igneous rocks. This result strengthens our earlier conclusion that kimberlitic liquids are derived from a relatively primeval and unique mantle reservoir with a nearly chondritic Sm/Nd ratio. ?? 1984 Springer-Verlag.

  11. A cross-sectional assessment of population demographics, HIV risks and human rights contexts among men who have sex with men in Lesotho.

    PubMed

    Baral, Stefan; Adams, Darrin; Lebona, Judith; Kaibe, Bafokeng; Letsie, Puleng; Tshehlo, Relebohile; Wirtz, Andrea; Beyrer, Chris

    2011-07-04

    Evidence is increasing of high HIV risks among southern African men who have sex with men (MSM). This represents the first study of HIV risks and human rights contexts among MSM in Lesotho. Two hundred and fifty-two men who reported ever having anal sex with another man were accrued with snowball sampling and were administered a structured quantitative instrument in October and November 2009. Of the participants, 96.4% (240/249) were ethnic Basotho with a mean age of 26.3 years (range 18-56), 49.6% (124/250) were currently employed, and 95.2% (238/250) had at least a secondary-level education. Self-reported HIV prevalence was 11.6% (22/190); 54.5% (128/235) reported being tested for HIV in the last year. HIV knowledge was low; only 3.7% (8/212) of MSM knew that receptive anal intercourse was the highest risk for HIV and that a water-based lubricant was most appropriate to use with condoms.Bivariate associations of wearing condoms during last intercourse with men include: having easy access to condoms (OR 3.1, 95% CI 1.2-8.5, p < 0.05); being older than 26 years (OR 2.3, 95% CI 1.3-4.2, p < 0.01); knowing that receptive anal intercourse is higher risk than insertive anal intercourse (OR 2.6, 95% CI 1.2-5.9, p < 0.05); wearing condoms with female sexual partners (OR 3.5, 95% 1.4-8.3, p < 0.01); using water-based lubricants (OR 2.8, 95% CI 1.4-5.5, p < 0.01); being less likely to report having been diagnosed with a sexually transmitted infecton (OR 0.21, 95% CI 0.06-0.76, p < 0.05); and being more likely to have been tested for HIV in the last year (OR 2.0, 95% CI 1.2-3.6, p > 0.05).Human rights abuses were common: 76.2% (170/223) reported at least one abuse, including rape (9.8%, 22/225), blackmail (21.3%, 47/221), fear of seeking healthcare (22.2%, 49/221), police discrimination (16.4%, 36/219), verbal or physical harassment (59.8%, 140/234), or having been beaten (18.9%, 43/228). MSM in Lesotho are at high risk for HIV infection and human rights abuses. Evidence

  12. Feasibility and effectiveness of two community-based HIV testing models in rural Swaziland.

    PubMed

    Parker, Lucy Anne; Jobanputra, Kiran; Rusike, Lorraine; Mazibuko, Sikhathele; Okello, Velephi; Kerschberger, Bernhard; Jouquet, Guillaume; Cyr, Joanne; Teck, Roger

    2015-07-01

    To evaluate the feasibility (population reached, costs) and effectiveness (positivity rates, linkage to care) of two strategies of community-based HIV testing and counselling (HTC) in rural Swaziland. Strategies used were mobile HTC (MHTC) and home-based HTC (HBHTC). Information on age, sex, previous testing and HIV results was obtained from routine HTC records. A consecutive series of individuals testing HIV-positive were followed up for 6 months from the test date to assess linkage to care. A total of 9 060 people were tested: 2 034 through MHTC and 7 026 through HBHTC. A higher proportion of children and adolescents (<20 years) were tested through HBHTC than MHTC (57% vs. 17%; P < 0.001). MHTC reached a higher proportion of adult men than HBHTC (42% vs. 39%; P = 0.015). Of 398 HIV-positive individuals, only 135 (34%) were enrolled in HIV care within 6 months. Of 42 individuals eligible for antiretroviral therapy, 22 (52%) started treatment within 6 months. Linkage to care was lowest among people who had tested previously and those aged 20-40 years. HBHTC was 50% cheaper (US$11 per person tested; $797 per individual enrolled in HIV care) than MHTC ($24 and $1698, respectively). In this high HIV prevalence setting, a community-based testing programme achieved high uptake of testing and appears to be an effective and affordable way to encourage large numbers of people to learn their HIV status (particularly underserved populations such as men and young people). However, for community HTC to impact mortality and incidence, strategies need to be implemented to ensure people testing HIV-positive in the community are linked to HIV care. © 2015 The Authors. Tropical Medicine & International Health Published by John Wiley & Sons Ltd.

  13. EHDI Africa: advocating for infants with hearing loss in Africa.

    PubMed

    Swanepoel, DeWet; Störbeck, Claudine

    2008-01-01

    Children with hearing loss who happen to reside in Africa deserve the chance to develop according to their potential as much as their peers living in more affluent regions. This leaves a moral obligation to pursue ways of initiating, developing,and growing early hearing detection and intervention services in Africa. For these reasons, the first EHDI Africa international conference was held in Johannesburg, South Africa, in 2007 (13-14 August). The theme was 'Building bridges in Africa: Early childhood development for children with hearing loss'. This special issue contains several reports from the EHDI Africa conference.

  14. Localized collision vs regional heating: the paradoxical aspects of 2720-2670 Ma geological evolution in the Kaapvaal craton, southern Africa.

    NASA Astrophysics Data System (ADS)

    Vezinet, Adrien; Nicoli, Gautier; Moyen, Jean-François; Laurent, Oscar; Stevens, Gary

    2014-05-01

    The Kaapvaal craton (KC) in South Africa, one of the oldest cratonic nuclei on Earth, is bounded to the North by the Limpopo belt, whose Southern Marginal Zone (SMZ) is regarded as a ca. 2.7Ga collisional orogeny. This is substantiated by structural data, such as the south verging thrust system that bounds the SMZ to the South (HRSZ); metamorphic data, demonstrating that metapelites from the SMZ underwent a very fast (˜40Ma) clockwise PTt loop at ca. 2.7Ga, with a peak of metamorphism dated at 2713±8Ma. The SMZ is therefore interpreted as representing a partially molten orogenic channel behaving like modern Himalaya. However, a review of geochronological data of Limpopo Belt, KC and Zimbabwean Craton shows that geological activity at around 2.7Ga was not restricted to the Limpopo belt, but was instead scattered throughout the KC. That is not in agreement with a Himalayan model but could be a response to a general thermal event, which is recorded by: 1) The massive flood basalts of the Vendersdorp Supergroup in central South Africa. This supergroup crops out from Johannesburg in the North to Prieska in the South and records the most widespread sequence of volcanic rocks of the KC. This massive basaltic extrusion occurs between 2714±8Ma (Klipriviersberg Group) and ˜2650Ma (Transvaal Supergroup lower limit). 2) A series of granitic plutons immediately south of the HRSZ, emplaced at 2670-2680Ma; all of them include a mantle-derived component whose composition is similar to the Ventersdorp basalts. A similar and synchronous pluton, the Mashishimale, emplaces South-East of the HRSZ. 3) Further afield, in the Eastern KC, slightly older plutons (I-type (high-Ca) granitoids) emplace in Swaziland between 2720 and 2700Ma. 4) Granulite-facies metamorphism in Swaziland at ca. 2.7Ga. 5) Finally, in the Zimbabwe Craton intermediate to felsic lavas erupted at the same time as well as gneisses and granitoids from northern Botswawa However, interactions of Zimbabwe craton with

  15. A cross-sectional assessment of population demographics, HIV risks and human rights contexts among men who have sex with men in Lesotho

    PubMed Central

    2011-01-01

    Background Evidence is increasing of high HIV risks among southern African men who have sex with men (MSM). This represents the first study of HIV risks and human rights contexts among MSM in Lesotho. Methods Two hundred and fifty-two men who reported ever having anal sex with another man were accrued with snowball sampling and were administered a structured quantitative instrument in October and November 2009. Results Of the participants, 96.4% (240/249) were ethnic Basotho with a mean age of 26.3 years (range 18-56), 49.6% (124/250) were currently employed, and 95.2% (238/250) had at least a secondary-level education. Self-reported HIV prevalence was 11.6% (22/190); 54.5% (128/235) reported being tested for HIV in the last year. HIV knowledge was low; only 3.7% (8/212) of MSM knew that receptive anal intercourse was the highest risk for HIV and that a water-based lubricant was most appropriate to use with condoms. Bivariate associations of wearing condoms during last intercourse with men include: having easy access to condoms (OR 3.1, 95% CI 1.2-8.5, p < 0.05); being older than 26 years (OR 2.3, 95% CI 1.3-4.2, p < 0.01); knowing that receptive anal intercourse is higher risk than insertive anal intercourse (OR 2.6, 95% CI 1.2-5.9, p < 0.05); wearing condoms with female sexual partners (OR 3.5, 95% 1.4-8.3, p < 0.01); using water-based lubricants (OR 2.8, 95% CI 1.4-5.5, p < 0.01); being less likely to report having been diagnosed with a sexually transmitted infecton (OR 0.21, 95% CI 0.06-0.76, p < 0.05); and being more likely to have been tested for HIV in the last year (OR 2.0, 95% CI 1.2-3.6, p > 0.05). Human rights abuses were common: 76.2% (170/223) reported at least one abuse, including rape (9.8%, 22/225), blackmail (21.3%, 47/221), fear of seeking healthcare (22.2%, 49/221), police discrimination (16.4%, 36/219), verbal or physical harassment (59.8%, 140/234), or having been beaten (18.9%, 43/228). Conclusions MSM in Lesotho are at high risk for HIV

  16. Quantitative bacterial examination of domestic water supplies in the Lesotho Highlands: water quality, sanitation, and village health.

    PubMed Central

    Kravitz, J. D.; Nyaphisi, M.; Mandel, R.; Petersen, E.

    1999-01-01

    Reported are the results of an examination of domestic water supplies for microbial contamination in the Lesotho Highlands, the site of a 20-year-old hydroelectric project, as part of a regional epidemiological survey of baseline health, nutritional and environmental parameters. The population's hygiene and health behaviour were also studied. A total of 72 village water sources were classified as unimproved (n = 23), semi-improved (n = 37), or improved (n = 12). Based on the estimation of total coliforms, which is a nonspecific bacterial indicator of water quality, all unimproved and semi-improved water sources would be considered as not potable. Escherichia coli, a more precise indicator of faecal pollution, was absent (P < 0.001) in most of the improved water sources. Among 588 queried households, only 38% had access to an "improved" water supply. Sanitation was a serious problem, e.g. fewer than 5% of villagers used latrines and 18% of under-5-year-olds had suffered a recent diarrhoeal illness. The study demonstrates that protection of water sources can improve the hygienic quality of rural water supplies, where disinfection is not feasible. Our findings support the WHO recommendation that E. coli should be the principal microbial indicator for portability of untreated water. Strategies for developing safe water and sanitation systems must include public health education in hygiene and water source protection, practical methods and standards for water quality monitoring, and a resource centre for project information to facilitate programme evaluation and planning. PMID:10593031

  17. Sub-Saharan Africa Report Tables of Contents JPRS-SSA-86-096, 17 September 1986-JPRS-SSA-86-125, 30 December 1986

    DTIC Science & Technology

    1987-02-21

    Drought Victims Receive Clothing, Medicine (NOTICIAS, 20 Sep 86) 23 Cashew Nut Tree Planting Campaign in Angoche (NOTICIAS, 23 Sep 86) 25...Cultivation Study (NOTICIAS, 10 Jul 86) 49 Inhambane Cashew Marketing Campaign Ends Successfully (NOTICIAS, 25 Jul 86)... 52 Beira Port...23 Briefs Gaza Cashew Marketing Figures 25 Machanga Salt, Fish Production Hampered 25 Beira Drainage System Soon 26 SWAZILAND Briefs Warning

  18. BUTIMBA: Intensifying the Hunt for Child TB in Swaziland through Household Contact Tracing

    PubMed Central

    Alonso Ustero, Pilar; Golin, Rachel; Anabwani, Florence; Mzileni, Bulisile; Sikhondze, Welile; Stevens, Robert

    2017-01-01

    Background Limited data exists to inform contact tracing guidelines in children and HIV-affected populations. We evaluated the yield and additionality of household contact and source case investigations in Swaziland, a TB/HIV high-burden setting, while prioritizing identification of childhood TB. Methods In partnership with 7 local TB clinics, we implemented standardized contact tracing of index cases (IC) receiving TB treatment. Prioritizing child contacts and HIV-affected households, screening officers screened contacts for TB symptoms and to identify risk factors associated with TB. We ascertained factors moderating the yield of contact tracing and measured the impact of our program by additional notifications. Results From March 2013 to November 2015, 3,258 ICs (54% bacteriologically confirmed; 70% HIV-infected; 85% adults) were enrolled leading to evaluation of 12,175 contacts (median age 18 years, IQR 24–42; 45% children; 9% HIV-infected). Among contacts, 196 TB cases (56% bacteriologically confirmed) were diagnosed resulting in a program yield of 1.6% for all forms of TB. The number needed to screen (NNS) to identify a bacteriologically confirmed TB case or all forms TB case traced from a child IC <5 years was respectively 62% and 40% greater than the NNS for tracing from an adult IC. In year one, we demonstrated a 32% increase in detection of bacteriologically confirmed child TB. Contacts were more likely to have TB if <5 years (OR = 2.0), HIV-infected (OR = 4.9), reporting ≥1 TB symptoms (OR = 7.7), and sharing a bed (OR = 1.7) or home (OR = 1.4) with the IC. There was a 1.4 fold increased chance of detecting a TB case in households known to be HIV-affected. Conclusion Contact tracing prioritizing children is not only feasible in a TB/HIV high-burden setting but contributes to overall case detection. Our findings support WHO guidelines prioritizing contact tracing among children and HIV-infected populations while highlighting potential to integrate TB

  19. Informing the scaling up of voluntary medical male circumcision efforts through the use of theory of reasoned action: survey findings among uncircumcised young men in Swaziland.

    PubMed

    Gurman, Tilly A; Dhillon, Preeti; Greene, Jessica L; Makadzange, Panganai; Khumlao, Philisiwe; Shekhar, Navendu

    2015-04-01

    Assessing predictors of intention to circumcise can help to identify effective strategies for increasing uptake of voluntary medical male circumcision (VMMC). Grounded in the theory of reasoned action (TRA), the current study of uncircumcised males ages 13-29 in Swaziland (N = 1,257) employed multivariate logistic regression to determine predictors of VMMC intention. The strongest predictors were strongly disagreeing/disagreeing that sex was more painful for a circumcised man (odds ratio [OR] = 4.37; p = < .007), a Christian man should not get circumcised (OR = 2.47; p < .001), and circumcision makes penetration more painful and difficult (OR = 2.44; p = .007). Several beliefs about enhanced sexual performance, normative beliefs (parents, sexual partner, and friends), and non-TRA-related factors (e.g., importance of plowing season to daily schedule) were also statistically significant predictors. TRA proved a useful theory to explore young men's intention to circumcise and can help inform interventions aimed at increasing uptake of VMMC.

  20. Same day ART initiation versus clinic-based pre-ART assessment and counselling for individuals newly tested HIV-positive during community-based HIV testing in rural Lesotho - a randomized controlled trial (CASCADE trial).

    PubMed

    Labhardt, Niklaus Daniel; Ringera, Isaac; Lejone, Thabo Ishmael; Masethothi, Phofu; Thaanyane, T'sepang; Kamele, Mashaete; Gupta, Ravi Shankar; Thin, Kyaw; Cerutti, Bernard; Klimkait, Thomas; Fritz, Christiane; Glass, Tracy Renée

    2016-04-14

    Achievement of the UNAIDS 90-90-90 targets in Sub-Sahara Africa is challenged by a weak care-cascade with poor linkage to care and retention in care. Community-based HIV testing and counselling (HTC) is widely used in African countries. However, rates of linkage to care and initiation of antiretroviral therapy (ART) in individuals who tested HIV-positive are often very low. A frequently cited reason for non-linkage to care is the time-consuming pre-ART assessment often requiring several clinic visits before ART-initiation. This two-armed open-label randomized controlled trial compares in individuals tested HIV-positive during community-based HTC the proposition of same-day community-based ART-initiation to the standard of care pre-ART assessment at the clinic. Home-based HTC campaigns will be conducted in catchment areas of six clinics in rural Lesotho. Households where at least one individual tested HIV positive will be randomized. In the standard of care group individuals receive post-test counselling and referral to the nearest clinic for pre-ART assessment and counselling. Once they have started ART the follow-up schedule foresees monthly clinic visits. Individuals randomized to the intervention group receive on the spot point-of-care pre-ART assessment and adherence counselling with the proposition to start ART that same day. Once they have started ART, follow-up clinic visits will be less frequent. First primary outcome is linkage to care (individual presents at the clinic at least once within 3 months after the HIV test). The second primary outcome is viral suppression 12 months after enrolment in the study. We plan to enrol a minimum of 260 households with 1:1 allocation and parallel assignment into both arms. This trial will show if in individuals tested HIV-positive during community-based HTC campaigns the proposition of same-day ART initiation in the community, combined with less frequent follow-up visits at the clinic could be a pragmatic approach to

  1. Changing Antiretroviral Eligibility Criteria: Impact on the Number and Proportion of Adults Requiring Treatment in Swaziland.

    PubMed

    Bock, Naomi N; Emerson, Ruth C; Reed, Jason B; Nkambule, Rejoice; Donnell, Deborah J; Bicego, George T; Okello, Velephi; Philip, Neena M; Ehrenkranz, Peter D; Duong, Yen T; Moore, Janet S; Justman, Jessica E

    2016-03-01

    Early initiation of antiretroviral treatment (ART) at CD4 cell count ≥ 500 cells per microliter reduces morbidity and mortality in HIV-infected adults. We determined the proportion of HIV-infected people with high viral load (VL) for whom transmission prevention would be an additional benefit of early treatment. A randomly selected subset of a nationally representative sample of HIV-infected adults in Swaziland in 2012. Eight to 12 months after a national survey to determine adult HIV prevalence, 1067 of 5802 individuals identified as HIV-infected were asked to participate in a follow-up cross-sectional assessment. CD4 cell enumeration, VL measurements, and ART status were obtained to estimate the proportion of currently untreated adults and of the entire HIV-infected population with high VL (≥ 1000 copies/mL) whose treatment under a test-and-treat or VL threshold eligibility strategy would reduce HIV transmission. Of the 927 (87% of 1067) participants enrolled, 466 (50%) reported no ART use. Among them, 424 (91%) had VL ≥ 1000 copies per milliliter; of these, 148 (35%) were eligible for ART at the then existing CD4 count threshold of <350 cells per microliter; an additional 107 (25%) were eligible with expanded CD4 criterion of <500 cells per microliter; and 169 (40%) remained ART ineligible. Thus, 36% of the 466 currently untreated and 18% of the total 927 had high VL yet remained ART ineligible under a CD4 criterion of <500 cells per microliter. A test-and-treat or VL threshold for treatment eligibility is necessary to maximize the HIV transmission prevention benefits of ART.

  2. Adherence, tolerability, and outcome after 36 months of isoniazid-preventive therapy in 2 rural clinics of Swaziland

    PubMed Central

    Mueller, Yolanda; Mpala, Qhubekani; Kerschberger, Bernhard; Rusch, Barbara; Mchunu, Gugu; Mazibuko, Sikhathele; Bonnet, Maryline

    2017-01-01

    Abstract Although efficacy of 36 months isoniazid preventive therapy (IPT) among HIV-positive individuals has been proven in trial settings, outcome, tolerance, and adherence have rarely been evaluated in real-life settings. This is a prospective observational cohort study conducted in 2 primary care rural clinics in Swaziland. After negative tuberculosis symptom screening, patients either with the positive tuberculin skin test (TST) or after tuberculosis treatment were initiated on IPT for 144 weeks. In addition to routine clinic visits, adherence was assessed every semester. Of 288 eligible patients, 2 patients never started IPT (1 refusal, 1 contraindication), and 253 (87.8%), 234 (81.3%), and 228 (79.2%) were still on IPT after 48, 96, and 144 weeks, respectively (chi2P = .01). Of 41 patients who interrupted IPT before 144 weeks, 21 defaulted (of which 17 also defaulted HIV care); 16 stopped because of adverse drug reactions; 2 were discontinued by clinicians’ mistake and 1 because of TB symptoms. Five patients (1.7%) died of causes not related to IPT, 5 (1.7%) developed TB of which 2 were isoniazid-resistant, and 9 (3.1%) were transferred to another clinic. As an indicator of adherence, isoniazid could be detected in the urine during 86.3% (302/350) and 73.6% (248/337) of patient visits in the 2 clinics, respectively (chi2P < .001). The routine implementation of IPT 36 months was feasible and good patient outcomes were achieved, with low TB incidence, good tolerance, and sustained adherence. PMID:28858089

  3. Seismotectonics of the Lwandle-Nubia plate boundary between South Africa and the Southwest Indian Ridge

    NASA Astrophysics Data System (ADS)

    Hartnady, Chris; Okal, Emile; Calais, Eric; Stamps, Sarah; Saria, Elifuraha

    2013-04-01

    The Lwandle (LW) plate shares a boundary with the Nubia (NU) plate, extending from a diffuse triple junction with the Rovuma plate in Southern Mozambique to a triple junction with the Antarctic plate along a segment of the Southwest Indian Ridge (SWIR). The LW-NU boundary terminates in the ~750 km-long, complex transform of the Andrew Bain Fracture Zone (ABFZ), but its exact locus is still unclear. Recent works locate it along the eastern boundary of the submarine Mozambique Ridge, parallel to the pre-existing, oceanic transform-fault fabric. However, an early concept of the LW block ('ambiguous region' of Hartnady, 1990, Fig. 2) indicates a more westerly trajectory in the north that includes parts of South Africa, with a southerly extension across old oceanic crust of the submarine Natal Valley and Transkei Basin. This proposed boundary is marked by several, aligned epicentres of moderate to strong earthquakes (1941, 1942, 1956, 1969, 1972, 1975, 1981 and 1989). Our re-examination of seismographic records from the 1975 'intraplate' earthquake (-37.62°N, 30.98°E, mb5.0), in the oceanic crust of the distal Transkei Basin, shows a thrust-faulting focal mechanism along a nodal plane striking N272°E. The largest (ML4.2) of a series of three small earthquakes in the Natal Valley in 2009, close to a zone of recent seafloor deformation mapped in 1992, has similar first-motion patterns at Southern African seismograph stations. When the 1975 slip-vector result (N173°E) is combined with a normal-faulting slip vector (N078°E) from a 1986 onland earthquake (-30.53°N, 28.84°E, mb5.0) near the Lesotho-KZN border, and both are incorporated into the wider data-set previously used to solve for East African Rift kinematics, they produce a LW-NU rotation pole that is located south of Africa, near the Agulhas Plateau, and approximately 950 km from the Natal Valley deformation zone. The modeled low rate of right-lateral, LW-NU slip (~0.50-0.75 mm/yr) across this LW-NU boundary

  4. Africa.

    ERIC Educational Resources Information Center

    Happel, Sue; Loeb, Joyce

    Although the activities in this unit are designed primarily for students in the intermediate grades, the document's text, illustrations, and bibliographic references are suitable for anyone interested in learning about Africa. Following a brief introduction and map work, the document is arranged into six sections. Section 1 traces Africa's history…

  5. Population Health Impact and Cost-Effectiveness of Tuberculosis Diagnosis with Xpert MTB/RIF: A Dynamic Simulation and Economic Evaluation

    PubMed Central

    Menzies, Nicolas A.; Cohen, Ted; Lin, Hsien-Ho; Murray, Megan; Salomon, Joshua A.

    2012-01-01

    Background The Xpert MTB/RIF test enables rapid detection of tuberculosis (TB) and rifampicin resistance. The World Health Organization recommends Xpert for initial diagnosis in individuals suspected of having multidrug-resistant TB (MDR-TB) or HIV-associated TB, and many countries are moving quickly toward adopting Xpert. As roll-out proceeds, it is essential to understand the potential health impact and cost-effectiveness of diagnostic strategies based on Xpert. Methods and Findings We evaluated potential health and economic consequences of implementing Xpert in five southern African countries—Botswana, Lesotho, Namibia, South Africa, and Swaziland—where drug resistance and TB-HIV coinfection are prevalent. Using a calibrated, dynamic mathematical model, we compared the status quo diagnostic algorithm, emphasizing sputum smear, against an algorithm incorporating Xpert for initial diagnosis. Results were projected over 10- and 20-y time periods starting from 2012. Compared to status quo, implementation of Xpert would avert 132,000 (95% CI: 55,000–284,000) TB cases and 182,000 (97,000–302,000) TB deaths in southern Africa over the 10 y following introduction, and would reduce prevalence by 28% (14%–40%) by 2022, with more modest reductions in incidence. Health system costs are projected to increase substantially with Xpert, by US$460 million (294–699 million) over 10 y. Antiretroviral therapy for HIV represents a substantial fraction of these additional costs, because of improved survival in TB/HIV-infected populations through better TB case-finding and treatment. Costs for treating MDR-TB are also expected to rise significantly with Xpert scale-up. Relative to status quo, Xpert has an estimated cost-effectiveness of US$959 (633–1,485) per disability-adjusted life-year averted over 10 y. Across countries, cost-effectiveness ratios ranged from US$792 (482–1,785) in Swaziland to US$1,257 (767–2,276) in Botswana. Assessing outcomes over a 10-y period

  6. Africa.

    ERIC Educational Resources Information Center

    Martz, Carlton

    2001-01-01

    This publication explores issues related to Africa. It examines the U.S. response to the Barbary pirate states (Morocco, Algiers, Tunis, Tripoli) in the early 19th century; the current AIDS crisis in Africa; and 14th century Mali and other Islamic lands through the eyes of Ibn Battuta, who traveled throughout the Muslim world. Each article…

  7. Social cohesion, social participation and HIV testing among men who have sex with men in Swaziland.

    PubMed

    Grover, Elise; Grosso, Ashley; Ketende, Sosthenes; Kennedy, Caitlin; Fonner, Virginia; Adams, Darrin; Sithole, Bhekie; Mnisi, Zandile; Maziya, Sibusiso Lulu; Baral, Stefan

    2016-01-01

    Social cohesion and social participation are social factors that may help reduce HIV risks and optimize health-seeking behaviors. We examined the association between these factors and HIV testing in the last 12 months among men who have sex with men (MSM) in Swaziland using a cross-sectional survey conducted with 326 men, 18 years of age or older reporting having sex with another man in the last 12 months. Social capital analyses included measures of social cohesion and social participation. The social cohesion measurement scale was created through exploratory factor analysis using polychoric correlations to determine unidimensionality and Cronbach's Alpha to assess internal consistency. The measurement scale was divided at the 25th and 75th percentiles using "high," "medium" and "low" levels of social cohesion for between-group comparisons. The social participation index included four questions regarding participation, resulting in a participation index ranging from 0 to 4. In the final multivariate logistic regression model, an increase in the level of social participation was found to be significantly associated with HIV testing in the last 12 months, adjusting for age, income, reporting a casual partner, family exclusion and rejection by other MSM due to sexual orientation (adjusted odds ratio [aOR]: 1.3, 95% confidence interval [CI] 1.1-1.7, p < .01). MSM with high social cohesion had almost twice the odds of HIV testing in the last 12 months (aOR: 1.8, 95% CI 1.1-3.3, p < .05) as MSM with medium social cohesion, though the overall social cohesion variable was not found to be significant using a Wald test in either the adjusted or unadjusted logistic regression models. These data suggest that building solidarity and trust within and between groups may be a strategy to improve uptake of HIV testing.

  8. A qualitative study of sexual behavior change and risk compensation following adult male circumcision in urban Swaziland.

    PubMed

    Grund, Jonathan M; Hennink, Monique M

    2012-01-01

    Male circumcision has been shown to reduce the risk of heterosexual transmission of HIV infection in men by up to 60% in three randomized controlled trials. Less is known, however, about sexual behavior change in men who have been circumcised and whether male circumcision's protective effect leads to riskier sexual behaviors. This study used qualitative in-depth interviews to understand men's sexual behavior after circumcision and to determine whether and how men participated in riskier sexual behaviors following male circumcision. Men in urban Swaziland, circumcised in the previous 12 months, were recruited and asked about their perceptions of sexual risk and sexual behavior post-circumcision. Results showed that following circumcision, men experience changes in both their sexual attitudes and behavior, which can be considered both protective and risky for HIV transmission. Most of them described protective changes (e.g., more responsible attitudes towards safe sex, reducing sexual temptation and partners, easier condom use). A minority, however, experienced increased sexual risk-taking, typically during a brief period of sexual experimentation shortly after circumcision. HIV counseling and counseling throughout the circumcision process is shown to be critical in influencing protective behaviors. Findings in this study confirm the existence of risk compensation following circumcision; however, this study adds important contextual insight about precisely when and why such risk-taking occurs. Nevertheless this study suggests that male circumcision scale-up as an HIV prevention strategy is likely to foster protective behavior change among men. The integration of HIV counseling with circumcision provision remains critical for effectively mitigating HIV risk behavior as male circumcision gains momentum as a viable HIV prevention tool.

  9. Private Higher Education in Africa: The Case of Monash South Africa

    ERIC Educational Resources Information Center

    Setswe, G.

    2013-01-01

    The aim of this paper was to review the contribution of private institutions to higher education in Africa and use Monash South Africa as a case study. A literature search was conducted to gain perspective on the current situation with respect to private higher education institutions in Africa and how they are perceived in relation to public…

  10. Africa takes a more male-friendly approach to family planning.

    PubMed

    Omuodo, D O

    1996-12-01

    It has been demonstrated that men are more likely to support family planning (FP) and to use a method themselves if services and educational programs are targeted to them. Because men fear that contraception reduces their control over their wives' sexuality, male-friendly approaches can enhance gender equality in reproductive health decisions. In Togo, the media is being used to encourage positive attitudes towards FP in specific male groups. In Ghana, FP services targeted to men have resulted in increased male involvement. In Swaziland, male audiences are targeted with FP education. In Sierra Leone, men have met in groups to learn about how to prevent sexually transmitted diseases and about the benefits of FP, and in Kenya, three male-only clinics exist to provide FP services to men.

  11. Massive Open Online Courses for Africa by Africa

    ERIC Educational Resources Information Center

    Oyo, Benedict; Kalema, Billy Mathias

    2014-01-01

    Africa is known for inadequate access to all sorts of human needs including health, education, food, shelter, transport, security, and energy. Before the emergence of massive open online courses (MOOCs), open access to higher education (HE) was exclusive of Africa. However, as a generally affordable method of post-secondary education delivery,…

  12. Access to emergency hospital care provided by the public sector in sub-Saharan Africa in 2015: a geocoded inventory and spatial analysis.

    PubMed

    Ouma, Paul O; Maina, Joseph; Thuranira, Pamela N; Macharia, Peter M; Alegana, Victor A; English, Mike; Okiro, Emelda A; Snow, Robert W

    2018-03-01

    %) women of child bearing age are located more than 2-h travel time from the nearest hospital. Marked differences were observed within and between countries, ranging from less than 25% of the population within 2-h travel time of a public hospital in South Sudan to more than 90% in Nigeria, Kenya, Cape Verde, Swaziland, South Africa, Burundi, Comoros, São Tomé and Príncipe, and Zanzibar. Only 16 countries reached the international benchmark of more than 80% of their populations living within a 2-h travel time of the nearest hospital. Physical access to emergency hospital care provided by the public sector in Africa remains poor and varies substantially within and between countries. Innovative targeting of emergency care services is necessary to reduce these inequities. This study provides the first spatial census of public hospital services in Africa. Wellcome Trust and the UK Department for International Development. Copyright © 2018 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 license. Published by Elsevier Ltd.. All rights reserved.

  13. Perceived HIV stigma and life satisfaction among persons living with HIV infection in five African countries: a longitudinal study.

    PubMed

    Greeff, Minrie; Uys, Leana R; Wantland, Dean; Makoae, Lucy; Chirwa, Maureen; Dlamini, Priscilla; Kohi, Thecla W; Mullan, Joseph; Naidoo, Joanne Rachel; Cuca, Yvette; Holzemer, William L

    2010-04-01

    Descriptive literature exists on the effects of HIV-related stigma on the lives of people living with HIV infection but few empirical studies have measured perceived HIV stigma nor explored its potential relationship to quality of life (QoL) over time in people living with HIV infection. A cohort study of a purposive convenient sample of 1457 HIV-positive persons was followed for one year in a longitudinal design that examined the effects of stigma and the life satisfaction dimension of the HIV/AIDS Targeted Quality of Life Instrument (HAT-QOL) over time, as well as the influence of other demographic and assessed social variables. Data were collected three times about six months apart from December 2005 to March 2007. The average age in this sample was 36.8 years (SD=8.78, n=1454) and 72.7% (n=1056) were female. The initial sample of participants was balanced among the five countries: Lesotho, Malawi, South Africa, Swaziland, and Tanzania. An attrition analysis demonstrated few demographic differences between those who remained in the study 12 months later compared with those at baseline. However, those who completed the study and who answered the QoL questions had significantly higher life satisfaction scores at baseline than those who left the study. There was a general increase in the report of life satisfaction QoL in all countries over the one-year period. However, as stigma scores increased over time there was a significant decrease in life satisfaction with differing rates of change by country. Certain factors had a positive influence on life satisfaction QoL: positive HIV media reports, taking antiretrovirals, reduced symptom intensity, and disclosure to a friend. This cohort study is the first to document empirically in a longitudinal sample, that perceived HIV stigma has a significantly negative and constant impact upon life satisfaction QoL for people with HIV infection. In the absence of any intervention to address and reduce stigmatization, individuals

  14. Controlling Conflict in Africa

    DTIC Science & Technology

    2002-01-01

    attention to conflict management in Africa by the Clinton administration. The president himself visited the continent twice where he spoke out on the... conflict management but created new Africa programs in a range of administrative agencies, e.g. a U.S. Trade Representative (USTR) office for Africa

  15. Trends in Loss to Follow-Up among Migrant Workers on Antiretroviral Therapy in a Community Cohort in Lesotho

    PubMed Central

    Bygrave, Helen; Kranzer, Katharina; Hilderbrand, Katherine; Whittall, Jonathan; Jouquet, Guillaume; Goemaere, Eric; Vlahakis, Nathalie; Triviño, Laura; Makakole, Lipontso; Ford, Nathan

    2010-01-01

    Background The provision of antiretroviral therapy (ART) to migrant populations raises particular challenges with respect to ensuring adequate treatment support, adherence, and retention in care. We assessed rates of loss to follow-up for migrant workers compared with non-migrant workers in a routine treatment programme in Morjia, Lesotho. Design All adult patients (≥18 years) initiating ART between January 1, 2008, and December 31, 2008, and followed up until the end of 2009, were included in the study. We described rates of loss to follow-up according to migrant status by Kaplan-Meier estimates, and used Poisson regression to model associations between migrant status and loss to follow-up controlling for potential confounders identified a priori. Results Our cohort comprised 1185 people, among whom 12% (148) were migrant workers. Among the migrant workers, median age was 36.1 (29.6–45.9) and the majority (55%) were male. We found no statistically significant differences between baseline characteristics and migrant status. Rates of lost to follow up were similar between migrants and non-migrants in the first 3 months but differences increased thereafter. Between 3 and 6 months after initiating antiretroviral therapy, migrants had a 2.78-fold increased rate of defaulting (95%CI 1.15–6.73); between 6 and 12 months the rate was 2.36 times greater (95%CI 1.18–4.73), whereas after 1 year the rate was 6.69 times greater (95%CI 3.18–14.09). Conclusions Our study highlights the need for programme implementers to take into account the specific challenges that may influence continuity of antiretroviral treatment and care for migrant populations. PMID:20976289

  16. Why Africa matters: evolution of Old World Salvia (Lamiaceae) in Africa

    PubMed Central

    Will, Maria; Claßen-Bockhoff, Regine

    2014-01-01

    Background and Aims Salvia is the largest genus in Lamiaceae and it has recently been found to be non-monophyletic. Molecular data on Old World Salvia are largely lacking. In this study, we present data concerning Salvia in Africa. The focus is on the colonization of the continent, character evolution and the switch of pollination systems in the genus. Methods Maximum likelihood and Bayesian inference were used for phylogenetic reconstruction. Analyses were based on two nuclear markers [internal transcribed spacer (ITS) and external transcribed spacer (ETS)] and one plastid marker (rpl32-trnL). Sequence data were generated for 41 of the 62 African taxa (66 %). Mesquite was used to reconstruct ancestral character states for distribution, life form, calyx shape, stamen type and pollination syndrome. Key Results Salvia in Africa is non-monophyletic. Each of the five major regions in Africa, except Madagascar, was colonized at least twice, and floristic links between North African, south-west Asian and European species are strongly supported. The large radiation in Sub-Saharan Africa (23 species) can be traced back to dispersal from North Africa via East Africa to the Cape Region. Adaptation to bird pollination in southern Africa and Madagascar reflects parallel evolution. Conclusions The phenotypic diversity in African Salvia is associated with repeated introductions to the continent. Many important evolutionary processes, such as colonization, adaptation, parallelism and character transformation, are reflected in this comparatively small group. The data presented in this study can help to understand the evolution of Salvia sensu lato and other large genera. PMID:24966353

  17. A review of the stratigraphy and sedimentary environments of the Karoo-aged basins of Southern Africa

    NASA Astrophysics Data System (ADS)

    Smith, R. M. H.; Eriksson, P. G.; Botha, W. J.

    1993-02-01

    The Karoo Basin of South Africa was one of several contemporaneous intracratonic basins in southwestern Gondwana that became active in the Permo-Carboniferous (280 Ma) and continued to accumulate sediments until the earliest Jurassic, 100 million years later. At their maximum areal extent, during the early Permian, these basins covered some 4.5 million km 2. The present outcrop area of Karoo rocks in southern Africa is about 300 000 km 2 with a maximum thickness of some 8000 m. The economic importance of these sediments lies in the vast reserves of coal within the Ecca Group rocks of northern and eastern Transvaal and Natal, South Africa. Large reserves of sandstone-hosted uranium and molybdenum have been proven within the Beaufort Group rocks of the southern Karoo trough, although they are not mineable in the present market conditions. Palaeoenvironmental analysis of the major stratigraphic units of the Karoo succession in South Africa demonstrates the changes in depositional style caused by regional and localized tectonism within the basin. These depocentres were influenced by a progressive aridification of climate which was primarily caused by the northward drift of southwestern Gondwana out of a polar climate and accentuated by the meteoric drying effect of the surrounding land masses. Changing palaeoenvironments clearly influenced the rate and direction of vertebrate evolution in southern Gondwana as evidenced by the numerous reptile fossils, including dinosaurs, which are found in the Karoo strata of South Africa, Lesotho, Namibia and Zimbabwe. During the Late Carboniferous the southern part of Gondwana migrated over the South Pole resulting in a major ice sheet over the early Karoo basin and surrounding highlands. Glacial sedimentation in upland valleys and on the lowland shelf resulted in the Dwyka Formation at the base of the Karoo Sequence. After glaciation, an extensive shallow sea covered the gently subsiding shelf, fed by large volumes of meltwater

  18. Why Africa matters: evolution of Old World Salvia (Lamiaceae) in Africa.

    PubMed

    Will, Maria; Claßen-Bockhoff, Regine

    2014-07-01

    Salvia is the largest genus in Lamiaceae and it has recently been found to be non-monophyletic. Molecular data on Old World Salvia are largely lacking. In this study, we present data concerning Salvia in Africa. The focus is on the colonization of the continent, character evolution and the switch of pollination systems in the genus. Maximum likelihood and Bayesian inference were used for phylogenetic reconstruction. Analyses were based on two nuclear markers [internal transcribed spacer (ITS) and external transcribed spacer (ETS)] and one plastid marker (rpl32-trnL). Sequence data were generated for 41 of the 62 African taxa (66 %). Mesquite was used to reconstruct ancestral character states for distribution, life form, calyx shape, stamen type and pollination syndrome. Salvia in Africa is non-monophyletic. Each of the five major regions in Africa, except Madagascar, was colonized at least twice, and floristic links between North African, south-west Asian and European species are strongly supported. The large radiation in Sub-Saharan Africa (23 species) can be traced back to dispersal from North Africa via East Africa to the Cape Region. Adaptation to bird pollination in southern Africa and Madagascar reflects parallel evolution. The phenotypic diversity in African Salvia is associated with repeated introductions to the continent. Many important evolutionary processes, such as colonization, adaptation, parallelism and character transformation, are reflected in this comparatively small group. The data presented in this study can help to understand the evolution of Salvia sensu lato and other large genera. © The Author 2014. Published by Oxford University Press on behalf of the Annals of Botany Company. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

  19. On microbial contaminants, micropseudofossils, and the oldest records of life

    USGS Publications Warehouse

    Cloud, P.; Morrison, K.

    1979-01-01

    Microbial contaminants may be introduced on outcrop as well as en route to or in the laboratory. Micropseudofossils may be natural or man-made. It is possible to recognize such misleading objects and important that they are not allowed to dilute the growing record of authentic pre-Phanerozoic life. Filamentous microbial contaminants from minute cracks in samples of ancient carbonate rocks from Brazil (perhaps 1 Ga old) and South Africa (???2.3 Ga old) are similar to occurrences previously described as fossils. Published records of supposedly Archean microbial life also include microcontaminants and laboratory artifacts. Although microstructures from sedimentary rocks of the Swaziland system could be fossils, they are not demonstrably so. The oldest structurally preserved fossils yet known seem to be the filaments described by Lois Nagy from stromatolitic limestone in the ???2.3 Ga old Malmani Dolomite of South Africa. It will be difficult to establish unequivocal older records in the absence of definitive ultrastructural or micro-chemical evidence. ?? 1979.

  20. Astronomy Landscape in Africa

    NASA Astrophysics Data System (ADS)

    Nemaungani, Takalani

    2015-01-01

    The vision for astronomy in Africa is embedded in the African Space Policy of the African Union in early 2014. The vision is about positioning Africa as an emerging hub for astronomy sciences and facilities. Africa recognized the need to take advantage of its natural resource, the geographical advantage of the clear southern skies and pristine sites for astronomy. The Pan African University (PAU) initiative also presents an opportunity as a post-graduate training and research network of university nodes in five regions of Africa and supported by the African Union. The Southern African node based in South Africa concentrates on space sciences which also includes astronomy. The PAU aims to provide the opportunity for advanced graduate training and postgraduate research to high-performing African students. Objectives also include promoting mobility of students and teachers and harmonizing programs and degrees.A number of astronomy initiatives have burgeoned in the Southern African region and these include the Southern Africa Largest Optical Telescope (SALT), HESS (High Energy Stereoscopic System), the SKA (Square Kilometre Array) and the AVN (African Very Long Baseline Interferometer Network). There is a growing appetite for astronomy sciences in Africa. In East Africa, the astronomy community is well organized and is growing - the East African Astronomical society (EAAS) held its successful fourth annual conference since 2010 on 30 June to 04 July 2014 at the University of Rwanda. Centred around the 'Role of Astronomy in Socio-Economic Transformation,' this conference aimed at strengthening capacity building in Astronomy, Astrophysics and Space Science in general, while providing a forum for astronomers from the region to train young and upcoming scientists.

  1. Air Quality Impact of Diffuse and Inefficient Combustion Emissions in Africa (DICE-Africa).

    PubMed

    Marais, Eloise A; Wiedinmyer, Christine

    2016-10-04

    Anthropogenic pollution in Africa is dominated by diffuse and inefficient combustion sources, as electricity access is low and motorcycles and outdated cars proliferate. These sources are missing, out-of-date, or misrepresented in state-of-the-science emission inventories. We address these deficiencies with a detailed inventory of Diffuse and Inefficient Combustion Emissions in Africa (DICE-Africa) for 2006 and 2013. Fuelwood for energy is the largest emission source in DICE-Africa, but grows from 2006 to 2013 at a slower rate than charcoal production and use, and gasoline and diesel for motorcycles, cars, and generators. Only kerosene use and gas flaring decline. Increase in emissions from 2006 to 2013 in this work is consistent with trends in satellite observations of formaldehyde and NO 2 , but much slower than the explosive growth projected with a fuel consumption model. Seasonal biomass burning is considered a large pollution source in Africa, but we estimate comparable emissions of black carbon and higher emissions of nonmethane volatile organic compounds from DICE-Africa. Nitrogen oxide (NO x ≡ NO + NO 2 ) emissions are much lower than from biomass burning. We use GEOS-Chem to estimate that the largest contribution of DICE-Africa to annual mean surface fine particulate matter (PM 2.5 ) is >5 μg m -3 in populous Nigeria.

  2. Access to curriculum for students with disabilities at higher education institutions: How does the National University of Lesotho fare?

    PubMed Central

    2017-01-01

    Background Creating access to curricula at institutions of higher education for students with disabilities requires a concerted effort from management and other key stakeholders to identify students’ needs and create opportunities for success. Objectives This paper presents the findings of a study which examined students with disabilities’ access to curricula at a higher education institution in Lesotho. Method Data for this qualitative study were collected using three methods: in-depth interviews, focus group discussions and document analysis. Eleven students with various types of impairments and 15 academic and non-academic staff members currently working in close proximity to students with disabilities participated in this study. Results The findings reveal inconsistencies between the institution’s admission policy of non-discrimination according to disability status and its practices. These inconsistencies are discussed under the following themes: (1) access at admission level, (2) management of disability data, (3) support by the special education unit, (4) teaching strategies, (5) support by lecturers, (6) availability of assistive technology, (7) special concessions and (8) students’ coping mechanisms. Conclusion We recommend that a clear policy concerning the support of students with disabilities be developed with the following aims: guide decisions on how disability data should be used, define roles that different university departments must play in facilitating access to curricula for all students, influence suitable development of teaching and learning resources, stimulate research on success and completion rates of students with disabilities and mandate restructuring of programmes that are currently inaccessible to students with disabilities. Key stakeholders, including students with disabilities, disabled persons’ organisations, disability rights activists, and staff should be involved in such policy design. PMID:28730064

  3. Using mHealth for HIV/TB Treatment Support in Lesotho: Enhancing Patient–Provider Communication in the START Study

    PubMed Central

    Hirsch-Moverman, Yael; Daftary, Amrita; Yuengling, Katharine A.; Saito, Suzue; Ntoane, Moeketsi; Frederix, Koen; Maama, Llang B.; Howard, Andrea A.

    2017-01-01

    Background: mHealth is a promising means of supporting adherence to treatment. The Start TB patients on ART and Retain on Treatment (START) study included real-time adherence support using short-text messaging service (SMS) text messaging and trained village health workers (VHWs). We describe the use and acceptability of mHealth by patients with HIV/tuberculosis and health care providers. Methods: Patients and treatment supporters received automated, coded medication and appointment reminders at their preferred time and frequency, using their own phones, and $3.70 in monthly airtime. Facility-based VHWs were trained to log patient information and text message preferences into a mobile application and were given a password-protected mobile phone and airtime to communicate with community-based VHWs. The use of mHealth tools was analyzed from process data over the study course. Acceptability was evaluated during monthly follow-up interviews with all participants and during qualitative interviews with a subset of 30 patients and 30 health care providers at intervention sites. Use and acceptability were contextualized by monthly adherence data. Findings: From April 2013 to August 2015, the automated SMS system successfully delivered 39,528 messages to 835 individuals, including 633 patients and 202 treatment supporters. Uptake of the SMS intervention was high, with 92.1% of 713 eligible patients choosing to receive SMS messages. Patient and provider interviews yielded insight into barriers and facilitators to mHealth utilization. The intervention improved the quality of health communication between patients, treatment supporters, and providers. HIV-related stigma and technical challenges were identified as potential barriers. Conclusions: The mHealth intervention for HIV/tuberculosis treatment support in Lesotho was found to be a low-tech, user-friendly intervention, which was acceptable to patients and health care providers. PMID:27930610

  4. Using mHealth for HIV/TB Treatment Support in Lesotho: Enhancing Patient-Provider Communication in the START Study.

    PubMed

    Hirsch-Moverman, Yael; Daftary, Amrita; Yuengling, Katharine A; Saito, Suzue; Ntoane, Moeketsi; Frederix, Koen; Maama, Llang B; Howard, Andrea A

    2017-01-01

    mHealth is a promising means of supporting adherence to treatment. The Start TB patients on ART and Retain on Treatment (START) study included real-time adherence support using short-text messaging service (SMS) text messaging and trained village health workers (VHWs). We describe the use and acceptability of mHealth by patients with HIV/tuberculosis and health care providers. Patients and treatment supporters received automated, coded medication and appointment reminders at their preferred time and frequency, using their own phones, and $3.70 in monthly airtime. Facility-based VHWs were trained to log patient information and text message preferences into a mobile application and were given a password-protected mobile phone and airtime to communicate with community-based VHWs. The use of mHealth tools was analyzed from process data over the study course. Acceptability was evaluated during monthly follow-up interviews with all participants and during qualitative interviews with a subset of 30 patients and 30 health care providers at intervention sites. Use and acceptability were contextualized by monthly adherence data. From April 2013 to August 2015, the automated SMS system successfully delivered 39,528 messages to 835 individuals, including 633 patients and 202 treatment supporters. Uptake of the SMS intervention was high, with 92.1% of 713 eligible patients choosing to receive SMS messages. Patient and provider interviews yielded insight into barriers and facilitators to mHealth utilization. The intervention improved the quality of health communication between patients, treatment supporters, and providers. HIV-related stigma and technical challenges were identified as potential barriers. The mHealth intervention for HIV/tuberculosis treatment support in Lesotho was found to be a low-tech, user-friendly intervention, which was acceptable to patients and health care providers.

  5. Sampling Key Populations for HIV Surveillance: Results From Eight Cross-Sectional Studies Using Respondent-Driven Sampling and Venue-Based Snowball Sampling.

    PubMed

    Rao, Amrita; Stahlman, Shauna; Hargreaves, James; Weir, Sharon; Edwards, Jessie; Rice, Brian; Kochelani, Duncan; Mavimbela, Mpumelelo; Baral, Stefan

    2017-10-20

    In using regularly collected or existing surveillance data to characterize engagement in human immunodeficiency virus (HIV) services among marginalized populations, differences in sampling methods may produce different pictures of the target population and may therefore result in different priorities for response. The objective of this study was to use existing data to evaluate the sample distribution of eight studies of female sex workers (FSW) and men who have sex with men (MSM), who were recruited using different sampling approaches in two locations within Sub-Saharan Africa: Manzini, Swaziland and Yaoundé, Cameroon. MSM and FSW participants were recruited using either respondent-driven sampling (RDS) or venue-based snowball sampling. Recruitment took place between 2011 and 2016. Participants at each study site were administered a face-to-face survey to assess sociodemographics, along with the prevalence of self-reported HIV status, frequency of HIV testing, stigma, and other HIV-related characteristics. Crude and RDS-adjusted prevalence estimates were calculated. Crude prevalence estimates from the venue-based snowball samples were compared with the overlap of the RDS-adjusted prevalence estimates, between both FSW and MSM in Cameroon and Swaziland. RDS samples tended to be younger (MSM aged 18-21 years in Swaziland: 47.6% [139/310] in RDS vs 24.3% [42/173] in Snowball, in Cameroon: 47.9% [99/306] in RDS vs 20.1% [52/259] in Snowball; FSW aged 18-21 years in Swaziland 42.5% [82/325] in RDS vs 8.0% [20/249] in Snowball; in Cameroon 15.6% [75/576] in RDS vs 8.1% [25/306] in Snowball). They were less educated (MSM: primary school completed or less in Swaziland 42.6% [109/310] in RDS vs 4.0% [7/173] in Snowball, in Cameroon 46.2% [138/306] in RDS vs 14.3% [37/259] in Snowball; FSW: primary school completed or less in Swaziland 86.6% [281/325] in RDS vs 23.9% [59/247] in Snowball, in Cameroon 87.4% [520/576] in RDS vs 77.5% [238/307] in Snowball) than the snowball

  6. Sampling Key Populations for HIV Surveillance: Results From Eight Cross-Sectional Studies Using Respondent-Driven Sampling and Venue-Based Snowball Sampling

    PubMed Central

    Stahlman, Shauna; Hargreaves, James; Weir, Sharon; Edwards, Jessie; Rice, Brian; Kochelani, Duncan; Mavimbela, Mpumelelo; Baral, Stefan

    2017-01-01

    Background In using regularly collected or existing surveillance data to characterize engagement in human immunodeficiency virus (HIV) services among marginalized populations, differences in sampling methods may produce different pictures of the target population and may therefore result in different priorities for response. Objective The objective of this study was to use existing data to evaluate the sample distribution of eight studies of female sex workers (FSW) and men who have sex with men (MSM), who were recruited using different sampling approaches in two locations within Sub-Saharan Africa: Manzini, Swaziland and Yaoundé, Cameroon. Methods MSM and FSW participants were recruited using either respondent-driven sampling (RDS) or venue-based snowball sampling. Recruitment took place between 2011 and 2016. Participants at each study site were administered a face-to-face survey to assess sociodemographics, along with the prevalence of self-reported HIV status, frequency of HIV testing, stigma, and other HIV-related characteristics. Crude and RDS-adjusted prevalence estimates were calculated. Crude prevalence estimates from the venue-based snowball samples were compared with the overlap of the RDS-adjusted prevalence estimates, between both FSW and MSM in Cameroon and Swaziland. Results RDS samples tended to be younger (MSM aged 18-21 years in Swaziland: 47.6% [139/310] in RDS vs 24.3% [42/173] in Snowball, in Cameroon: 47.9% [99/306] in RDS vs 20.1% [52/259] in Snowball; FSW aged 18-21 years in Swaziland 42.5% [82/325] in RDS vs 8.0% [20/249] in Snowball; in Cameroon 15.6% [75/576] in RDS vs 8.1% [25/306] in Snowball). They were less educated (MSM: primary school completed or less in Swaziland 42.6% [109/310] in RDS vs 4.0% [7/173] in Snowball, in Cameroon 46.2% [138/306] in RDS vs 14.3% [37/259] in Snowball; FSW: primary school completed or less in Swaziland 86.6% [281/325] in RDS vs 23.9% [59/247] in Snowball, in Cameroon 87.4% [520/576] in RDS vs 77.5% [238

  7. Brazil-Africa geological links

    NASA Astrophysics Data System (ADS)

    Torquato, Joaquim Raul; Cordani, Umberto G.

    1981-04-01

    In this work, the main evidence and conclusions regarding geological links between Brazil and Africa are summarized, with emphasis on the geochronological aspects. Taking into account the geographical position, as well as the similarities in the geochronological pattern, the following main provinces of the two continents are correlated: The Imataca and Falawatra complexes in the Guayana Shield and the Liberian Province of West Africa. The Paraguay-Araguaia and the Rockelide Fold Belts. The Sa˜o Luiz and the West African cratonic areas. The Caririan Fold Belt of northeastern Brazil and the Pan-Africa Belt of Nigeria and Cameroon. The JequiéComplex of Bahia, the Ntem Complex of Cameroon and similar rocks of Gabon and Angola. The Ribeira Fold Belt in Brazil and the West Congo and Damara Belts in West and South Africa. In addition, other geological links are considered, such as some of the major linear fault zones which can be traced across the margins of South America and Africa, in the pre-drift reconstructions. Correlations are also made of the tectonic and stratigraphic evolution of the Paranáand Karroo syneclises, and the Brazilian and African marginal basins around the South Atlantic, during their initial stages. Finally, several similarities in the tectonic evolution of South America and Africa, during and after the onset of drifting, are shown to be compatible with a recent origin for the South Atlantic floor, as required by sea-floor spreading and continental drift between South America and Africa.

  8. Are integrated HIV services less stigmatizing than stand-alone models of care? A comparative case study from Swaziland

    PubMed Central

    Church, Kathryn; Wringe, Alison; Fakudze, Phelele; Kikuvi, Joshua; Simelane, Dudu; Mayhew, Susannah H

    2013-01-01

    Introduction Integrating HIV with primary health services has the potential to reduce HIV-related stigma through delivering care in settings disassociated with HIV. This study investigated the relationship between integrated care and felt stigma. The study design was a comparative case study of four models of HIV care in Swaziland, ranging from fully integrated to fully stand-alone HIV care. Methods An exit survey (N=602) measured differences in felt stigma across model of care; the primary outcome “perception of HIV status exposure through clinic attendance” was analyzed using multivariable logistic regression. In-depth interviews (N=22) explored whether and how measured differences in stigma experiences were related to service integration. Results There were significant differences in perceived status exposure across models of care. After adjustment for potential confounding between sites, those at a partially integrated site and a partially stand-alone site had greater odds of perceived status exposure than those at the fully stand-alone site (aOR 3.33, 95% CI 1.98–5.60; and aOR 11.84, 95% CI 6.89–20.36, respectively). There was no difference between the fully stand-alone and the fully integrated clinic. Qualitative data suggested that many clients at HIV-only sites felt greater confidentiality knowing that those around them were positive, and support was gained from other HIV care clients. Confidentiality was maintained in various ways, even in stand-alone sites, through separate waiting areas for HIV testing and HIV treatment, and careful clinic and room labelling. Conclusions The relationship between model of care and stigma was complex, and the hypothesis that stigma is higher at stand-alone sites did not hold true in this high prevalence setting. Policy-makers should ensure that service integration does not increase stigma, in particular within partially integrated models of care. PMID:23336726

  9. Hantaviruses in Africa.

    PubMed

    Witkowski, Peter T; Klempa, Boris; Ithete, Ndapewa L; Auste, Brita; Mfune, John K E; Hoveka, Julia; Matthee, Sonja; Preiser, Wolfgang; Kruger, Detlev H

    2014-07-17

    This paper summarizes the progress in the search for hantaviruses and hantavirus infections in Africa. After having collected molecular evidence of an indigenous African hantavirus in 2006, an intensive investigation for new hantaviruses has been started in small mammals. Various novel hantaviruses have been molecularly identified not only in rodents but also in shrews and bats. In addition, the first African hantavirus, Sangassou virus, has been isolated and functionally characterized in cell culture. Less is known about the ability of these hantaviruses to infect humans and to cause diseases. To date, no hantavirus genetic material could be amplified from patients' specimens collected in Africa. Serological studies in West Africa, based on a battery of screening and confirmatory assays, led to the detection of hantavirus antibodies in the human population and in patients with putative hantavirus disease. In addition to this overview, we present original data from seroepidemiological and field studies conducted in the Southern part of Africa. A human seroprevalence rate of 1.0% (n=1442) was detected in the South African Cape Region whereas no molecular evidence for the presence of hantavirus was found in 2500 small animals trapped in South Africa and Namibia. Copyright © 2014 Elsevier B.V. All rights reserved.

  10. Images of Africa: A Case Study of Pre-Service Candidates' Perceptions of Teaching Africa

    ERIC Educational Resources Information Center

    Kim, Hannah

    2017-01-01

    As much as the history and study of Africa have been incorporated into social studies curricula, Africa is still a region that is prone to misperceptions and misconceptions. Social studies teachers could provide students with an alternative image, but what if they only perpetuate misperceptions of Africa? This case study examines preservice…

  11. 'Africa Alive Corridors': Forging a new future for the people of Africa by the people of Africa

    NASA Astrophysics Data System (ADS)

    Felix Toteu, Sadrack; Malcolm Anderson, John; de Wit, Maarten

    2010-11-01

    ' Africa Alive Corridors' (AAC) addresses major stewardship goals in Africa through a selection of 20 heritage Corridors (varying from 1000 to 4000 km in length and 50 to 100 km wide). These include more than 400 heritage nodes (World Heritage Sites, Biosphere Reserves, biodiversity hotspots, Geoparks, etc.). AAC tracks Africa's journey from around 4 billion years ago to the present day through these chronologically sequenced Corridors. And so, the 4-billion-year autobiography of the continent is told. It encompasses the geological, biological and anthropological/cultural history of Africa's 54 nations - a (hi-) story without borders. The wealth of scientific and biographical knowledge archived in this network of Corridors tells the story of continental drift, mega-geohazards, climate variability and change, and the origin and extinction of biodiversity; and includes our human roots, culture and spirituality, our impact on the Earth and our potential to influence its future. In telling this story of Africa, new research avenues will be discovered and new learning methodologies will be experienced and developed and shared. In this way, the AAC provide loci along which the eight UN-Millennium Development Goals may be readily and realistically achieved. In concert, they can form the basis for a new collective endeavour - of Pan African Earth Stewardship Science. In this, the final - 2010 - phase of IYPE (the International Year of Planet Earth), we aim to make a start at bringing the ' Africa Alive Corridors' into real-life context. Whilst the concept of the Corridors has been formulated and presented at various international forums—most recently in Africa at the launch of IYPE in Arusha, Tanzania, in May 2008—here we present in brief their conceptual framework, and summarize the rationale behind the selection of the 20 African Corridors. Then, we describe, for the first time, how the AAC concept might evolve. To achieve the latter, we focus on an exploratory

  12. Africa's Economic Crisis.

    ERIC Educational Resources Information Center

    Hartman, William

    1992-01-01

    Discusses the economic situation in the non-Arab nations of Africa. Presents two opposing views of the efforts of the World Bank at adjusting the financial programs of governments of developing countries. Suggests that perhaps with cooperation the cycle of poverty and disease can be broken in Africa. (DK)

  13. Molecular phylogeny of the Afroedura nivaria (Reptilia: Gekkonidae) species complex in South Africa provides insight on cryptic speciation.

    PubMed

    Makhubo, Buyisile G; Tolley, Krystal A; Bates, Michael F

    2015-01-01

    The Afroedura nivaria species complex (A. nivaria, A. karroica, A. amatolica, A. tembulica and A. halli) is a morphologically conservative group of medium-sized flat geckos endemic to South Africa and Lesotho. Species are allopatric, as are some populations within species that are separated by large expanses of unsuitable habitat. Because of this isolation of populations we hypothesised that several cryptic species may be present. To investigate this hypothesis we constructed a molecular phylogeny using multiple markers, and included representatives of other Afroedura species. Bayesian inference and maximum likelihood analyses (439bp 16S, 593bp ND4, 948bp RAG1) strongly supported the genetic distinctiveness of the five described species. However, the A. nivaria species complex as currently described is not monophyletic, as A. karroica was positioned outside a clade containing all other Afroedura species, and A. pondolia (which was presumed to belong to a different species complex) was recovered within the A. nivaria complex. Several distinct clades within A. halli and A. nivaria were also recovered, and the narrowly-distributed A. amatolica consisted of two highly divergent clades. We also conducted a multivariate analysis using 19 morphological characters to investigate whether the clades recovered by the phylogeny were distinct in terms of head, body and limb shape. The analysis showed some variation between clades in terms of locomotor apparatus (forelimbs and feet), head and body dimensions, but overall the morphological differences were minor. This morphological conservatism in the A. nivaria complex may be a result of adaptation to similar microhabitats. Exclusive of A. karroica, the results suggest that there are at least nine species in this complex, of which four are cryptic and undescribed. Copyright © 2014 Elsevier Inc. All rights reserved.

  14. Generation 2030/Africa

    ERIC Educational Resources Information Center

    You, Danzhen; Hug, Lucia; Anthony, David

    2014-01-01

    Until relatively recently, much of Africa has been among the economically least developed and least densely populated places on earth, replete with villages and rural communities. Africa is changing rapidly, in its economy, trade and investment; in climate change; in conflict and stability; in urbanization, migration patterns, and most of all in…

  15. Telecommunications and Development in Africa.

    ERIC Educational Resources Information Center

    Kiplagat, B. A., Ed.; Werner, M. C. M., Ed.

    The Telecommunications Foundation of Africa (TFA) was created in 1992 out of a conviction that insufficient telecommunications in Africa are an impediment to economic growth, and that more resources could be mobilized to strengthen this sector. This volume was made by TFA for readers both inside and outside of Africa and the telecommunications…

  16. Dietary factors and special epidemiological situations of liver cancer in Thailand and Africa.

    PubMed

    Wogan, G N

    1975-11-01

    Incidence patterns of primary liver cancer in Swaziland and Uganda have been compared with frequency of contamination of dietary staples by aflatoxins. Geographical regions or tribal groups with elevated cancer incidence were associated with increased frequency of contamination. In further studies, aflatoxin ingestion has been quantitatively measured in populations in Thailand, Kenya, and Mozambique, in subgroups of which the incidence of primary liver cancer varied over a wide range. In each instance, elevated cancer incidence was associated with highest levels of aflatoxin intake. In view of the potency of these compounds as liver carcinogens in many animal species, these data collectively suggest that the aflatoxins are also carcinogenic for man and that regular ingestion of foods heavily contaminated with aflatoxins increases the risk of liver cancer in human populations.

  17. International Institute for Capacity Building in Africa: Strengthening Africa's Educational Institutions

    ERIC Educational Resources Information Center

    UNESCO International Institute for Capacity Building in Africa, 2006

    2006-01-01

    Established in 1999, the UNESCO International Institute for Capacity Building in Africa (IICBA) is one of six UNESCO Institutes and Centers under the direction of the UNESCO Secretariat. The only UNESCO Institute in Africa, it is mandated to strengthen the capacities of the teacher education institutions of its 53 member states, and promote…

  18. A time-motion study of cardiovascular disease risk factor screening integrated into HIV clinic visits in Swaziland.

    PubMed

    Palma, Anton M; Rabkin, Miriam; Simelane, Samkelo; Gachuhi, Averie B; McNairy, Margaret L; Nuwagaba-Biribonwoha, Harriet; Bongomin, Pido; Okello, Velephi N; Bitchong, Raymond A; El-Sadr, Wafaa M

    2018-03-01

    Screening of modifiable cardiovascular disease (CVD) risk factors is recommended but not routinely provided for HIV-infected patients, especially in low-resource settings. Potential concerns include limited staff time and low patient acceptability, but little empirical data exists. As part of a pilot study of screening in a large urban HIV clinic in Swaziland, we conducted a time-motion study to assess the impact of screening on patient flow and HIV service delivery and exit interviews to assess patient acceptability. A convenience sample of patients ≥40 years of age attending routine HIV clinic visits was screened for hypertension, diabetes, hyperlipidemia and tobacco smoking. We observed HIV visits with and without screening and measured time spent on HIV and CVD risk factor screening activities. We compared screened and unscreened patients on total visit time and time spent receiving HIV services using Wilcoxon rank-sum tests. A separate convenience sample of screened patients participated in exit interviews to assess their satisfaction with screening. We observed 172 patient visits (122 with CVD risk factor screening and 50 without). Screening increased total visit time from a median (range) of 4 minutes (2 to 11) to 15 minutes (9 to 30) (p < 0.01). Time spent on HIV care was not affected: 4 (2 to 10) versus 4 (2 to 11) (p = 0.57). We recruited 126 patients for exit interviews, all of whom indicated that they would recommend screening to others. Provision of CVD risk factor screening more than tripled the length of routine HIV clinic visits but did not reduce the time spent on HIV services. Programme managers need to take longer visit duration into account in order to effectively integrate CVD risk factor screening and counselling into HIV programmes. © 2018 The Authors. Journal of the International AIDS Society published by John Wiley & sons Ltd on behalf of the International AIDS Society.

  19. South Africa/Time Running Out.

    ERIC Educational Resources Information Center

    Clark, Todd, Ed.

    1984-01-01

    Based on the book, "South Africa: Time Running Out," a report of the Study Commission on U.S. Policy Toward Southern Africa, this 10-20 day unit of study is designed to help high school students learn about the history, geography, and present situation in South Africa and its relationship to the United States. The first of four sections…

  20. Decolonizing Bioethics in Africa

    PubMed Central

    Macaulay-Adeyelure, O.C.

    2017-01-01

    The global spread of bioethics from its North-American and European provenance to non-Western societies is currently raising some concerns. Part of the concern has to do with whether or not the exportation of bioethics in its full Western sense to developing non-Western states is an instance of ethical imperialism or bioethical neocolonialism. This paper attempts an exploration of this debate in the context of bioethics in sub-Saharan Africa. Rather than conceding that bioethics has a colonial agenda in Africa, this paper defends the position that the current bioethics trend in sub-Saharan Africa is an unintended imperialistic project. It argues that its colonizing character is not entirely a product of the Western programmed goals of training and institution building; rather, it is a structural consequence of many receptive African minds and institutions. Though bioethics in Africa is turning out as a colonizing project, one serious implication of such trend, if unchecked urgently, is that bioethics’ invaluable relevance to Africa is being incapacitated. This paper, therefore, attempts a decolonizing trajectory of bioethics in Africa. Contrary to the pretense of ‘African bioethics,’ which some African scholars are now defending, this paper through the logic of decolonization makes case for ‘bioethics in Africa’. In such logic, the principle of existential needs is prioritized over the principle of identity and authenticity that define African voice in bioethics. PMID:28344985

  1. Physics in Africa: The Case of South Africa

    NASA Astrophysics Data System (ADS)

    Mangaliso, Mzamo P.

    2009-03-01

    South Africa plays a special role in building science throughout Africa. The areas of science, particularly those related to physics, which are being developed, will be described together with the involvement of other African countries. Data will be presented that demonstrate the high attrition rate that exists especially in the science track PhD pipeline and highlight the bottleneck at the honors (fourth year) level. Programs designed to overcome this will be presented, and their success discussed. Thoughts on how to go about expanding the interactions between US scientists and South African scientists as well as with African scientists will be presented.

  2. [Matrimonial changes in Africa].

    PubMed

    Hertrich, V; Pilon, M

    1997-01-01

    A database of census and survey information on fertility and nuptiality in Africa being assembled by the French Center for Population and Development (CEPED) was the source for this analysis of changing marriage patterns. Early marriage for girls, nearly universal marriage for both sexes, rapid remarriage of reproductive-age widows and divorcees, polygamy, and a frequently large difference in the ages of the spouses are typical of African marriage. But a great variety of situations coexist. In the 1960s, the female age at first marriage was under 17.5 years on average in West Africa, while the male age was over 26. Nearly everyone married, and one-fourth to one-third of married men were polygamous. In South Africa, at the other extreme, the average age at first marriage was 20-23 for women and 26-30 for men, over 5% never married, and polygamy was rare. Nuptiality patterns were intermediate in North, Central, and East Africa. The most recent round of censuses and surveys show the geographic differences to be shrinking. Average age at first marriage for women is increasing everywhere and often exceeds 19 years. It remains lower than 17.5 in only two countries. The increase amounts to at least a half year for 30 countries and over 1 year for 15. Marriage remains nearly universal except in South Africa. Male age at marriage is rising more slowly than female age, causing the average age gap to decline. Economic difficulties and unemployment appear to play a significant role in the delay of marriage, with increased female school attendance also a factor, although secondary and higher education for females in sub-Saharan Africa is too uncommon to have perceptible effects on the national scale. In North Africa, the age at first birth has increased in tandem with increasing marriage age, but in sub-Saharan Africa the relationship has been less marked. In Lome, for example, the increasing age at first marriage for females has had no effect on age at first birth. The

  3. Prevalence, patterns, and correlates of HIV disclosure among TB-HIV patients initiating antiretroviral therapy in Lesotho.

    PubMed

    Hayes-Larson, Eleanor; Hirsch-Moverman, Yael; Saito, Suzue; Frederix, Koen; Pitt, Blanche; Maama, Bridget Llang; Howard, Andrea A

    2017-08-01

    Disclosure of HIV-positive status has important implications for patient outcomes and preventing HIV transmission, but has been understudied in TB-HIV patients. We assessed disclosure patterns and correlates of non-disclosure among adult TB-HIV patients initiating ART enrolled in the START Study, a mixed-methods cluster-randomized trial conducted in Lesotho, which evaluated a combination intervention package (CIP) versus standard of care. Interviewer-administered questionnaire data were analyzed to describe patterns of disclosure. Patient-related factors were assessed for association with non-disclosure to anyone other than a health-care provider and primary partners using generalized linear mixed models. Among 371 participants, 95% had disclosed their HIV diagnosis to someone other than a health-care provider, most commonly a spouse/primary partner (76%). Age, TB knowledge, not planning to disclose TB status, greater perceived TB stigma, and CIP were associated with non-disclosure in unadjusted models (p < .1). In adjusted models, all point estimates were similar and greater TB knowledge (adjusted odds ratio [aOR] 0.59, 95% confidence interval [CI] 0.39-0.90) and CIP (aOR 0.20, 95% CI 0.05-0.79) remained statistically significant. Among 220 participants with a primary partner, 76% had disclosed to that partner. Significant correlates of partner non-disclosure (p < .1) in unadjusted analyses included being female, married/cohabitating, electricity at home, not knowing if partner was HIV-positive, and TB knowledge. Adjusted point estimates were largely similar, and being married/cohabitating (aOR 0.03, 95% CI 0.01-0.12), having electricity at home (aOR 0.38, 95% CI 0.17-0.85) and greater TB knowledge (aOR 0.76, 95% CI 0.59-0.98) remained significant. In conclusion, although nearly all participants reported disclosing their HIV status to someone other than a health-care provider at ART initiation, nearly a quarter of participants with a primary partner had

  4. SERVIR-Africa: Developing an Integrated Platform for Floods Disaster Management in Africa

    NASA Technical Reports Server (NTRS)

    Macharia, Daniel; Korme, Tesfaye; Policelli, Fritz; Irwin, Dan; Adler, Bob; Hong, Yang

    2010-01-01

    SERVIR-Africa is an ambitious regional visualization and monitoring system that integrates remotely sensed data with predictive models and field-based data to monitor ecological processes and respond to natural disasters. It aims addressing societal benefits including floods and turning data into actionable information for decision-makers. Floods are exogenous disasters that affect many parts of Africa, probably second only to drought in terms of social-economic losses. This paper looks at SERVIR-Africa's approach to floods disaster management through establishment of an integrated platform, floods prediction models, post-event flood mapping and monitoring as well as flood maps dissemination in support of flood disaster management.

  5. Language in South Africa.

    ERIC Educational Resources Information Center

    Mesthrie, Rajend, Ed.

    This collection of 24 papers focuses on language and society in South Africa. Part 1, "The Main Language Groupings," includes (1) "South Africa: A Sociolinguistic Overview" (R. Mesthrie); (2) "The Khoesan Languages" (A. Traill); (3) "The Bantu Languages: Sociohistorical Perspectives" (Robert K. Herbert and…

  6. Poverty reduction in Africa

    PubMed Central

    Collier, Paul

    2007-01-01

    Poverty in Africa has been rising for the last quarter-century, while it has been falling in the rest of the developing world. Africa's distinctive problem is that its economies have not been growing. This article attempts to synthesize a range of recent research to account for this failure of the growth process. I argue that the reasons lie not in African peculiarities but rather in geographic features that globally cause problems but that are disproportionately pronounced in Africa. These features interact to create three distinct challenges that are likely to require international interventions beyond the conventional reliance on aid. PMID:17942702

  7. Financing Vocational Training in Sub-Saharan Africa. Africa Region Human Development Series.

    ERIC Educational Resources Information Center

    Ziderman, Adrian

    This document is part of the World Bank's comprehensive study of post-basic education and training in Sub-Sahara Africa and includes findings from three short field studies conducted in South Africa, Tanzania, and Zimbawe in early 2001. Chapter titles are as follows: Executive Summary; Introduction; Conventional Patterns of Financing Training;…

  8. Magmatism and Tectonics in the Meso-Archean Pongola Supergroup, South Africa

    NASA Astrophysics Data System (ADS)

    Wilson, Allan

    2013-04-01

    The Pongola Supergroup is one of the most extensive and well preserved volcano-sedimentary successions emplaced in a continental setting in the Meso-Archean (c. 2.95 Ga). It contrasts with both the older (Barberton type c.3.5 Ga) and younger (Belingwe type c.2.7 Ga) greenstone belts in southern Africa in that the sequence has not undergone the strong horizontal compressional tectonics typically related to greenstone belt-TTG environments. However, it is appropriate to compare this sequence with rocks of the Barberton greenstone belt by which the final phase of deposition preceded that of the juxtaposed Pongola basin with a relatively small time interval. The Pongola succession, which commenced with the first major magmatic event after the Barberton greenstone belt, overlies granitoids and remnants of greenstone belts in SE South Africa and in SW Swaziland. Formation was not in a continental rift environment but most likely in a marginal epicontinental basin with syn-depositional subsidence in a half-graben fault system in the type area. The Pongola rocks occur in two domains related to a NW-trending central basement high in the Kaapvaal Craton and achieving a maximum thickness of 8 km in the northern areas. The lower section (Nsuze group 3.7 km thick) is made up mainly of lavas and pyroclastic rocks and the upper section (Mozaan Group 4.3 km thick) is aranaceous sediments and argillites with a thick volcanic unit observed in the south-eastern facies. Chemical affinities of the lavas include tholeiite and calc-alkaline over the compositional range of basalt to rhyolite. There is a preponderance of andesites in the compositional array. The preservation of these rocks gives insight into the range of volcanic processes that took place at this stage of Earth history and in some areas it is possible to identify eruptions from a single source over several kilometres, as well as feeder-dyke systems to the lava flows. Simultaneous eruption of contrasting magmas from several

  9. Multilingualism in Southern Africa.

    ERIC Educational Resources Information Center

    Peirce, Bonny Norton; Ridge, Stanley G. M.

    1997-01-01

    Reviews recent research in multilingualism in Southern Africa, focusing on the role of languages in education, sociolinguistics, and language policy. Much of the research is on South Africa. Topics discussed include language of instruction in schools, teacher education, higher education, adult literacy, language contact, gender and linguistic…

  10. Africa's middle class women bring entrepreneurial opportunities in breast care medical tourism to South Africa.

    PubMed

    Ahwireng-Obeng, Frederick; van Loggerenberg, Charl

    2011-01-01

    Africa's distribution of specialized private health services is severely disproportionate. Mismatch between South Africa's excess supply and a huge demand potential in an under-serviced continent represents an entrepreneurial opportunity to attract patients to South Africa for treatment and recuperative holidays. However, effective demand for intra-African medical tourism could be constrained by sub-Saharan poverty. Results from interviewing 320 patients and five staff at the Johannesburg Breast care Centre of Excellence, however, reject this proposition, Africa's middle class women being the target market estimated to grow annually by one million while breast cancer incidence increases with middle-class lifestyles. Uncovering this potential involves an extensive marketing strategy. Copyright © 2010 John Wiley & Sons, Ltd.

  11. HIV prevalence and behavioral and psychosocial factors among transgender women and cisgender men who have sex with men in 8 African countries: A cross-sectional analysis.

    PubMed

    Poteat, Tonia; Ackerman, Benjamin; Diouf, Daouda; Ceesay, Nuha; Mothopeng, Tampose; Odette, Ky-Zerbo; Kouanda, Seni; Ouedraogo, Henri Gautier; Simplice, Anato; Kouame, Abo; Mnisi, Zandile; Trapence, Gift; van der Merwe, L Leigh Ann; Jumbe, Vicente; Baral, Stefan

    2017-11-01

    Sub-Saharan Africa bears more than two-thirds of the worldwide burden of HIV; however, data among transgender women from the region are sparse. Transgender women across the world face significant vulnerability to HIV. This analysis aimed to assess HIV prevalence as well as psychosocial and behavioral drivers of HIV infection among transgender women compared with cisgender (non-transgender) men who have sex with men (cis-MSM) in 8 sub-Saharan African countries. Respondent-driven sampling targeted cis-MSM for enrollment. Data collection took place at 14 sites across 8 countries: Burkina Faso (January-August 2013), Côte d'Ivoire (March 2015-February 2016), The Gambia (July-December 2011), Lesotho (February-September 2014), Malawi (July 2011-March 2012), Senegal (February-November 2015), Swaziland (August-December 2011), and Togo (January-June 2013). Surveys gathered information on sexual orientation, gender identity, stigma, mental health, sexual behavior, and HIV testing. Rapid tests for HIV were conducted. Data were merged, and mixed effects logistic regression models were used to estimate relationships between gender identity and HIV infection. Among 4,586 participants assigned male sex at birth, 937 (20%) identified as transgender or female, and 3,649 were cis-MSM. The mean age of study participants was approximately 24 years, with no difference between transgender participants and cis-MSM. Compared to cis-MSM participants, transgender women were more likely to experience family exclusion (odds ratio [OR] 1.75, 95% CI 1.42-2.16, p < 0.001), rape (OR 1.95, 95% CI 1.63-2.36, p < 0.001), and depressive symptoms (OR 1.30, 95% CI 1.12-1.52, p < 0.001). Transgender women were more likely to report condomless receptive anal sex in the prior 12 months (OR 2.44, 95% CI 2.05-2.90, p < 0.001) and to be currently living with HIV (OR 1.81, 95% CI 1.49-2.19, p < 0.001). Overall HIV prevalence was 25% (235/926) in transgender women and 14% (505/3,594) in cis-MSM. When adjusted

  12. HIV prevalence and behavioral and psychosocial factors among transgender women and cisgender men who have sex with men in 8 African countries: A cross-sectional analysis

    PubMed Central

    Ackerman, Benjamin; Diouf, Daouda; Ceesay, Nuha; Mothopeng, Tampose; Odette, Ky-Zerbo; Kouanda, Seni; Ouedraogo, Henri Gautier; Simplice, Anato; Kouame, Abo; Trapence, Gift; van der Merwe, L. Leigh Ann; Jumbe, Vicente; Baral, Stefan

    2017-01-01

    Introduction Sub-Saharan Africa bears more than two-thirds of the worldwide burden of HIV; however, data among transgender women from the region are sparse. Transgender women across the world face significant vulnerability to HIV. This analysis aimed to assess HIV prevalence as well as psychosocial and behavioral drivers of HIV infection among transgender women compared with cisgender (non-transgender) men who have sex with men (cis-MSM) in 8 sub-Saharan African countries. Methods and findings Respondent-driven sampling targeted cis-MSM for enrollment. Data collection took place at 14 sites across 8 countries: Burkina Faso (January–August 2013), Côte d’Ivoire (March 2015–February 2016), The Gambia (July–December 2011), Lesotho (February–September 2014), Malawi (July 2011–March 2012), Senegal (February–November 2015), Swaziland (August–December 2011), and Togo (January–June 2013). Surveys gathered information on sexual orientation, gender identity, stigma, mental health, sexual behavior, and HIV testing. Rapid tests for HIV were conducted. Data were merged, and mixed effects logistic regression models were used to estimate relationships between gender identity and HIV infection. Among 4,586 participants assigned male sex at birth, 937 (20%) identified as transgender or female, and 3,649 were cis-MSM. The mean age of study participants was approximately 24 years, with no difference between transgender participants and cis-MSM. Compared to cis-MSM participants, transgender women were more likely to experience family exclusion (odds ratio [OR] 1.75, 95% CI 1.42–2.16, p < 0.001), rape (OR 1.95, 95% CI 1.63–2.36, p < 0.001), and depressive symptoms (OR 1.30, 95% CI 1.12–1.52, p < 0.001). Transgender women were more likely to report condomless receptive anal sex in the prior 12 months (OR 2.44, 95% CI 2.05–2.90, p < 0.001) and to be currently living with HIV (OR 1.81, 95% CI 1.49–2.19, p < 0.001). Overall HIV prevalence was 25% (235/926) in

  13. Analysis of human resources for health strategies and policies in 5 countries in Sub-Saharan Africa, in response to GFATM and PEPFAR-funded HIV-activities.

    PubMed

    Cailhol, Johann; Craveiro, Isabel; Madede, Tavares; Makoa, Elsie; Mathole, Thubelihle; Parsons, Ann Neo; Van Leemput, Luc; Biesma, Regien; Brugha, Ruairi; Chilundo, Baltazar; Lehmann, Uta; Dussault, Gilles; Van Damme, Wim; Sanders, David

    2013-10-25

    Global Health Initiatives (GHIs), aiming at reducing the impact of specific diseases such as Human Immunodeficiency Virus (HIV), have flourished since 2000. Amongst these, PEPFAR and GFATM have provided a substantial amount of funding to countries affected by HIV, predominantly for delivery of antiretroviral therapy (ARV) and prevention strategies. Since the need for additional human resources for health (HRH) was not initially considered by GHIs, countries, to allow ARV scale-up, implemented short-term HRH strategies, adapted to GHI-funding conditionality. Such strategies differed from one country to another and slowly evolved to long-term HRH policies. The processes and content of HRH policy shifts in 5 countries in Sub-Saharan Africa were examined. A multi-country study was conducted from 2007 to 2011 in 5 countries (Angola, Burundi, Lesotho, Mozambique and South Africa), to assess the impact of GHIs on the health system, using a mixed methods design. This paper focuses on the impact of GFATM and PEPFAR on HRH policies. Qualitative data consisted of semi-structured interviews undertaken at national and sub-national levels and analysis of secondary data from national reports. Data were analysed in order to extract countries' responses to HRH challenges posed by implementation of HIV-related activities. Common themes across the 5 countries were selected and compared in light of each country context. In all countries successful ARV roll-out was observed, despite HRH shortages. This was a result of mostly short-term emergency response by GHI-funded Non-Governmental Organizations (NGOs) and to a lesser extent by governments, consisting of using and increasing available HRH for HIV tasks. As challenges and limits of short-term HRH strategies were revealed and HIV became a chronic disease, the 5 countries slowly implemented mid to long-term HRH strategies, such as formalisation of pilot initiatives, increase in HRH production and mitigation of internal migration of HRH

  14. Analysis of human resources for health strategies and policies in 5 countries in Sub-Saharan Africa, in response to GFATM and PEPFAR-funded HIV-activities

    PubMed Central

    2013-01-01

    Background Global Health Initiatives (GHIs), aiming at reducing the impact of specific diseases such as Human Immunodeficiency Virus (HIV), have flourished since 2000. Amongst these, PEPFAR and GFATM have provided a substantial amount of funding to countries affected by HIV, predominantly for delivery of antiretroviral therapy (ARV) and prevention strategies. Since the need for additional human resources for health (HRH) was not initially considered by GHIs, countries, to allow ARV scale-up, implemented short-term HRH strategies, adapted to GHI-funding conditionality. Such strategies differed from one country to another and slowly evolved to long-term HRH policies. The processes and content of HRH policy shifts in 5 countries in Sub-Saharan Africa were examined. Methods A multi-country study was conducted from 2007 to 2011 in 5 countries (Angola, Burundi, Lesotho, Mozambique and South Africa), to assess the impact of GHIs on the health system, using a mixed methods design. This paper focuses on the impact of GFATM and PEPFAR on HRH policies. Qualitative data consisted of semi-structured interviews undertaken at national and sub-national levels and analysis of secondary data from national reports. Data were analysed in order to extract countries’ responses to HRH challenges posed by implementation of HIV-related activities. Common themes across the 5 countries were selected and compared in light of each country context. Results In all countries successful ARV roll-out was observed, despite HRH shortages. This was a result of mostly short-term emergency response by GHI-funded Non-Governmental Organizations (NGOs) and to a lesser extent by governments, consisting of using and increasing available HRH for HIV tasks. As challenges and limits of short-term HRH strategies were revealed and HIV became a chronic disease, the 5 countries slowly implemented mid to long-term HRH strategies, such as formalisation of pilot initiatives, increase in HRH production and mitigation

  15. Step Into Africa: Elementary Level Activities Using Africa Is Not a Country

    ERIC Educational Resources Information Center

    Starbird, Caroline; Bahrenburg, Amy

    2004-01-01

    This book takes student inside the vast continent of Africa. The goal of these lessons is to provide young students with a look at contemporary Africa and to give them a feeling for the rich diversity of the many different nations of the continent. The lessons integrate language arts and geography, and some lessons include math. This book…

  16. The Africa South America Intercontinental Teleconnection.

    NASA Astrophysics Data System (ADS)

    Cook, K. H.; Hsieh, J.-S.; Hagos, S. M.

    2004-07-01

    The influence of heating over Africa on the South American precipitation climatology, and the influence of South America on Africa, is examined through the application of GCM simulations with idealized boundary conditions and perpetual solstice (January and July) conditions.The presence of Africa is associated with a pronounced (up to 4 mm day-1) decrease in precipitation in Brazil's Nordeste region during austral summer. Low-level moisture divergence and dry-air advection associated with the downbranch of a Walker circulation induced by heating over southern Africa is amplified over the Nordeste due to the response of the land surface. The response is much smaller during austral winter due to differences in the heat source over Africa and a reduced sensitivity in the surface heat balance over tropical South America. Forcing from South America in January shifts the position of the South Indian convergence zone (SICZ) to the southwest over southern Africa in association with the formation of the South Atlantic convergence zone (SACZ). In July, a Rossby wave train generated over South America induces a response in the surface temperature of Africa that leads to stronger precipitation in central and western Africa.This study suggests a zonal mode of variability for South American and African circulation and precipitation fields. The resulting perturbations depend as much on land surface atmosphere interactions as on the direct forcing from the adjacent continent, and the mechanisms are highly nonlinear.


  17. The Africa Collection: An Annotated Historical Resource Bibliography for the Student of Africa.

    ERIC Educational Resources Information Center

    Lynn, Karen

    This annotated bibliographic collection of resources on Africa including non-fiction, fiction, texts, poetry, draft papers, addresses, periodicals, film, records, and travel agencies is designed to aid secondary students and their teachers interested in research on Africa. An instructional approach is taken, drawing upon examples to demonstrate…

  18. Outcomes and impact of HIV prevention, ART and TB programs in Swaziland--early evidence from public health triangulation.

    PubMed

    van Schalkwyk, Cari; Mndzebele, Sibongile; Hlophe, Thabo; Garcia Calleja, Jesus Maria; Korenromp, Eline L; Stoneburner, Rand; Pervilhac, Cyril

    2013-01-01

    Swaziland's severe HIV epidemic inspired an early national response since the late 1980s, and regular reporting of program outcomes since the onset of a national antiretroviral treatment (ART) program in 2004. We assessed effectiveness outcomes and mortality trends in relation to ART, HIV testing and counseling (HTC), tuberculosis (TB) and prevention of mother to child transmission (PMTCT). Data triangulated include intervention coverage and outcomes according to program registries (2001-2010), hospital admissions and deaths disaggregated by age and sex (2001-2010) and population mortality estimates from the 1997 and 2007 censuses and the 2007 demographic and health survey. By 2010, ART reached 70% of the estimated number of people living with HIV/AIDS with CD4<350/mm(3), with progressively improving patient retention and survival. As of 2010, 88% of health facilities providing antenatal care offered comprehensive PMTCT services. The HTC program recorded a halving in the proportion of adults tested who were HIV-infected; similarly HIV infection rates among HIV-exposed babies halved from 2007 to 2010. Case fatality rates among hospital patients diagnosed with HIV/AIDS started to decrease from 2005-6 in adults and especially in children, contrasting with stable case fatality for other causes including TB. All-cause child in-patient case fatality rates started to decrease from 2005-6. TB case notifications as well as rates of HIV/TB co-infection among notified TB patients continued a steady increase through 2010, while coverage of HIV testing and CPT for co-infected patients increased to above 80%. Against a background of high, but stable HIV prevalence and decreasing HIV incidence, we documented early evidence of a mortality decline associated with the expanded national HIV response since 2004. Attribution of impact to specific interventions (versus natural epidemic dynamics) will require additional data from future household surveys, and improved routine (program

  19. Teaching about Francophone Africa.

    ERIC Educational Resources Information Center

    Merryfield, Mary; Timbo, Adama

    Lessons and resources for Social Studies and French courses are included in this document. The major goals of these materials are to help students (1) explore the history and geography of Francophone Africa, (2) examine French influences in contemporary Africa, (3) recognize and appreciate cultural differences and similarities in values and…

  20. The Regionalization of Africa in Undergraduate Geography of Africa Textbooks, 1953 to 2004

    ERIC Educational Resources Information Center

    Cole, Roy

    2008-01-01

    This study examines the regionalization of Africa through analysis of forty-two English-language geography of Africa texts written for undergraduates between 1953 and 2004. Authors identify regions with reference to one or more variables. Some authors provided no explanation for their regionalization; others labored mightily to justify their…

  1. eGY-Africa: addressing the digital divide for science in Africa

    NASA Astrophysics Data System (ADS)

    Petitdidier, Monique; Barton, Charles; Chukwuma, Victor; Cottrell, Les

    2010-05-01

    As the world of science becomes increasingly Internet-dependent, so the African scientists become increasingly isolated. eGY-Africa is a bottom-up initiative by African scientists and their collaborators to try to reduce this digital divide by a campaign of advocacy for better institutional facilities. The present status of Internet services, problems, and plans are being mapped via a combination of a survey questionnaire-based survey and direct measurement of Internet performance (the PingER Project). Information is being gathered on policy statements and initiatives aimed at reducing the Digital Divide. eGY-Africa is establishing National groups of concerned scientists and engaging with those initiatives with related goals. Finally, and perhaps most important of all, eGY-Africa is seeking to engage with the many other programs, initiatives, and bodies that share the goal of reducing the Digital Divide - either as a direct policy objective, or indirectly as a means to an end, such as the development of capabilities in science and technology in Africa. The expectation is that informed opinion from the scientific community at the institutional, national, and international levels can be used to influence the decision makers and donors who are in a position to deliver better Internet capabilities.

  2. Keep Talking & Monitoring: the importance of longitudinal research & community-based monitoring to support sustainable land management in southern Africa

    NASA Astrophysics Data System (ADS)

    Dougill, Andrew; Stringer, Lindsay

    2015-04-01

    Projects come and go with researchers, development practioners and government staff initiating new forms of community engagement in environmental monitoring and land management practices. We analyse interventions from Botswana and Swaziland and highlight that for benefits to be long-lived and lead to sustainable land management, requires community engagement in project design, implementation and for project outputs to be used in developing community-led environmental monitoring tools that can then help to guide local decision-making systems. We stress the vital importance of continued participatory engagement of researchers with community leaders and key government staff beyond the timeframe of their initial research such that longitudinal research approaches can realise significant benefits to all concerned. In dynamic (non-equilibrium) dryland environments, it is vitally important that research approaches address temporal and spatial variability by mapping patterns of change, using a range of participatory tools to enhance understandings of the causes of land degradation and the opportunities for shifts towards more sustainable land management. Decision-support tools, such as rangeland assessment guides produced for various Kalahari rangeland settings in Botswana (via a UNEP project and affiliated research), provide opportunities to support more sustainable land management. However, at present benefits are not being fully realised as project and research staff move on after projects end. Similarly, findings from mixed farming systems in Swaziland (assessing a JICA-funded project) show problems in maintaining new institutional structures to manage rangeland degradation, whilst issues on arable areas associated with parasitic weeds (Striga asiatica) remain problematic. Findings from longitudinal research in Swaziland also show that community understandings of environmental problems have evolved over 10 years and identify new problems associated with intensified

  3. In Brief: New atlas of Africa

    NASA Astrophysics Data System (ADS)

    Showstack, Randy

    2008-07-01

    A newly revised atlas of Africa features more than 300 satellite images that show striking before and after photographs of environmental changes spanning about 35 years. Africa: Atlas of Our Changing Environment, compiled by the United Nations Environment Programme (UNEP), provides visual evidence of how development choices, population growth, climate change, and, in some cases, conflicts affect Africa, often negatively. The book includes photographs of shrinking glaciers on Mount Kilimanjaro as well as on Uganda's Rwenzori Mountains; deforestation along an expanding road system in the Congo; the drying up of Lake Chad; and the expansion of urban areas such as Cape Town, South Africa, and Dakar, Senegal. Satellite images also indicate some positive signs of environmental management, including action to stop overgrazing in a Tunisian national park, the effects of a management plan for a dam in Zambia that has helped restore seasonal flooding, and positive impacts of wetlands expansion around a national park in Mauritania. For more information, visit http://www.unep.org/dewa/africa/AfricaAtlas.

  4. UNITED STATES SPECIAL OPERATIONS FORCES IN AFRICA

    DTIC Science & Technology

    2016-02-16

    AIR WAR COLLEGE AIR UNIVERSITY UNITED STATES SPECIAL OPERATIONS FORCES IN AFRICA by Keith I. Crawford, Lt Col, USAF A Research Report... Africa Command in 2007 manifested recognition that the United States has increasing strategic national interests on the continent of Africa that are...importance of airborne ISR and basing access. Introduction In February of 2007, President George W. Bush announced the creation of Africa

  5. Oncoidal granular iron formation in the Mesoarchaean Pongola Supergroup, southern Africa: Textural and geochemical evidence for biological activity during iron deposition.

    PubMed

    Smith, A J B; Beukes, N J; Gutzmer, J; Czaja, A D; Johnson, C M; Nhleko, N

    2017-11-01

    We document the discovery of the first granular iron formation (GIF) of Archaean age and present textural and geochemical results that suggest these formed through microbial iron oxidation. The GIF occurs in the Nconga Formation of the ca. 3.0-2.8 Ga Pongola Supergroup in South Africa and Swaziland. It is interbedded with oxide and silicate facies micritic iron formation (MIF). There is a strong textural control on iron mineralization in the GIF not observed in the associated MIF. The GIF is marked by oncoids with chert cores surrounded by magnetite and calcite rims. These rims show laminated domal textures, similar in appearance to microstromatolites. The GIF is enriched in silica and depleted in Fe relative to the interbedded MIF. Very low Al and trace element contents in the GIF indicate that chemically precipitated chert was reworked above wave base into granules in an environment devoid of siliciclastic input. Microbially mediated iron precipitation resulted in the formation of irregular, domal rims around the chert granules. During storm surges, oncoids were transported and deposited in deeper water environments. Textural features, along with positive δ 56 Fe values in magnetite, suggest that iron precipitation occurred through incomplete oxidation of hydrothermal Fe 2+ by iron-oxidizing bacteria. The initial Fe 3+ -oxyhydroxide precipitates were then post-depositionally transformed to magnetite. Comparison of the Fe isotope compositions of the oncoidal GIF with those reported for the interbedded deeper water iron formation (IF) illustrates that the Fe 2+ pathways and sources for these units were distinct. It is suggested that the deeper water IF was deposited from the evolved margin of a buoyant Fe 2+ aq -rich hydrothermal plume distal to its source. In contrast, oncolitic magnetite rims of chert granules were sourced from ambient Fe 2+ aq -depleted shallow ocean water beyond the plume. © 2017 John Wiley & Sons Ltd.

  6. Environmental Education and Networking in Mafeteng Primary Schools: A Participatory Approach

    ERIC Educational Resources Information Center

    Bitso, Constance

    2006-01-01

    This paper explores a participatory process of Environmental Education (EE) networking in Mafeteng primary schools. It gives an overview of the existing EE efforts in Lesotho, particularly the models schools of the National Curriculum Development Centre. It also provides information about Lesotho Environmental Information Network as the body that…

  7. Contributing to the ICNP: validating the term cultural diversity.

    PubMed

    Geyer, N; Peu, M D; Roussouw, S; Morudi, J; Uys, E

    2005-05-01

    The specific aims of this study were to: Propose a definition of the term cultural diversity; Validate the term cultural diversity; and Submit a term and definition for international utilisation to the International Council of Nurses (ICN) for consideration for inclusion in the ICNP. South Africa was one of four African countries (Botswana, South Africa, Swaziland, and Zimbabwe) funded by the WK Kellogg Foundation to participate in the ICNP project. South Africa had 2 research groups. One of the research groups identified the term cultural diversity to define. This was a qualitative study where a philosophical perspective was used to explore, explain and describe nursing practice. The combined method proposed by the International Council of Nurses (ICN) was utilised to define and validate the term cultural diversity. Validation and literature review provided sufficient support for the defined characteristics and the term was finally defined and submitted to ICN in November 2002 as: CULTURAL DIVERSITY is a type of CULTURE with the specific characteristics: co-existence of different groups, e.g. ethnic, religious, linguistic and other groups each with their own values and belief systems, traditions and different lifestyles. The research group was informed in December 2003 of the ICNP Evaluation Committee recommendation that the term cultural diversity will be included in the ICNP.

  8. Education and Indigenous Knowledge in Africa: Traditional Bonesetting and Orthopaedic Medicine in West Africa

    NASA Astrophysics Data System (ADS)

    Ezeanya, Chika A.

    The underlying philosophy of education in contemporary Africa has been established to be alien, and detached from the indigenous knowledge of the people. Modern day formal education in sub-Saharan Africa came about, for the most part, as a result of missionary activities and colonial efforts of Europe. The education bequeathed to Africa was, therefore, fundamentally European in paradigm and lacking in authenticity. The end of colonialism across sub-Saharan Africa did not herald any tangible transformation in the curriculum of study. Education in Africa is still dependent on foreign input for sustainability, thereby stifling research, creativity and innovation. Sustainable development is founded on indigenous knowledge. When such grassroots knowledge assumes the foundation of learning, home-grown development is easily fostered in all sectors of a national economy. In the field of medicine, indigenous knowledge of healing has been considered unscientific by western biomedical practitioners. Since the days of the missionaries, many Africans have considered indigenous medicine to be fetish; the Christian converts would not be associated with its practice and patronage. However, traditional bonesetting has been proven to be highly efficacious with little supernatural content, it continues to attract huge patronage from Africans, cutting across social and religious boundaries. This study attempts an exploration of the disconnect between indigenous knowledge, practices and learning, on the one hand, and formal education in Africa, on the other. With a focus on traditional bonesetting, the study seeks to determine why that branch of indigenous medicine attracts huge patronage, but is granted very little recognition by modern orthopaedic medical education.

  9. Introductory Guide to Africa.

    ERIC Educational Resources Information Center

    Wyss, Esther, Ed.

    This guide seeks to be a tool for action and a resource for understanding some of the key issues concerning Africa today. Through a series of six sessions, participants focus on a particular theme or issue that links their community with the African context. The six sessions focus on: (1) "Building Connections with Africa"; (2)…

  10. Knowledge of human social and behavioral factors essential for the success of community malaria control intervention programs: The case of Lomahasha in Swaziland.

    PubMed

    Dlamini, Sabelo V; Liao, Chien-Wei; Dlamini, Zandile H; Siphepho, Jameson S; Cheng, Po-Ching; Chuang, Ting-Wu; Fan, Chia-Kwung

    2017-04-01

    Although malaria control programs have made rapid progress recently, they neglect important social and behavioral factors associated with the disease. Social, political, and cultural factors are involved in malaria control, and individuals in a community may be comfortable in behaving in ways that, to an outsider, may seem contrary to commonly held perceptions. Malaria control efforts can no longer afford to overlook the multidimensional human contexts that create and support varying notions of malaria and its prevention, treatment, and control. This study aimed to assess the knowledge and perceptions of malaria issues in the community, and to identify practices that support or hinder the progress of malaria control programs. A triangulation study involving individual interviews, focus group discussions, and observatory analysis between 2003 and 2010 at Lomahasha, a malarious community on the eastern border of Swaziland and Mozambique, was conducted. Results indicated that a high knowledge level and good perception of the disease were observed in the age group of < 40 years, contrary to those in higher age groups, among the Lomahasha community members. However, behavior of certain community groups includes practices that are not supportive of the national control program's aspirations, such as delay in seeking medical attention, staying outdoors until late, maintaining stagnant water in roadside excavations, and seeking medical assistance from wrong sources. Malpractices are more commonly observed among men, boys, and those who drink alcohol. This study suggests a thorough community diagnosis before all intervention programs for malaria control are instituted. Copyright © 2015. Published by Elsevier B.V.

  11. Sub-Saharan Africa Report: No. 2788

    DTIC Science & Technology

    1983-04-21

    Technip CEO, Jacques Celerier Interview Technip Operations Famine Threatens 50 Million Africans (WEST AFRICA, 11 Apr 83...exports. 2 First, Jacques Celerier, chief executive officer of the Technip group, the leading French engineering company which has just been awarded the...Interview With Technip CEO Dakar AFRICA in French Mar 83 pp 79-81 [Interview with Jacques Celerier, chief executive officer of Technip: "Africa Has One

  12. Antibiotic Susceptibility of Neisseria gonorrhoeae Strains from Europe and Africa

    PubMed Central

    Piot, Peter; Van Dyck, Eddy; Colaert, Jan; Ursi, Jean-Paul; Bosmans, Eugène; Meheus, André

    1979-01-01

    The in vitro activities of 16 antimicrobial agents were tested by a plate dilution method against 268 unselected isolates of Neisseria gonorrhoeae from Belgium, Rwanda, Swaziland, and Zaire. Fifteen β-lactamase-producing strains isolated in Europe from various origins were also tested. There were significant regional variations in antimicrobial agent susceptibility, even among the African isolates, with the Rwandan and Zairean strains being most resistant. Benzylpenicillin and ampicillin were equally active in all but the β-lactamase-producing strains. Among the cephalosporins, cefotaxime was by far the most active, followed by cefuroxime, cefamandole, cefoxitin, and cefaclor, in that order. All strains were susceptible to spectinomycin, thiamphenicol, kanamycin, and rifampin, with the exception of one highly rifampin-resistant isolate and a moderately thiamphenicol-resistant strain. Twenty-six percent of the isolates were highly resistant to streptomycin. Six percent of the gonococci had a minimal inhibitory concentration for tetracycline greater than 2 μg/ml. Clavulanic acid inhibited the β-lactamase activity of the gonococci tested and improved markedly the activities of ampicillin and amoxicillin against β-lactamase-producing strains. PMID:111615

  13. Smoke in Southern Africa

    NASA Technical Reports Server (NTRS)

    2002-01-01

    This SeaWiFS true-color image acquired over Southern Africa on Sept. 4, 2000, shows a thick shroud of smoke and haze blanketing much of the southern half of the continent. The smoke in this scene is being generated by a tremendous number of fires burning over a large area across the countries of Angola, Zambia, Mozambique, Zimbabwe, Botswana, and the Northern Province of South Africa. In this image, the smoke (grey pixels) is easily distinguished from clouds (bright white pixels). Refer to the Images and Data section for a larger scale view of the fires in Southern Africa. Data from both the SeaWiFS and Terra satellites are being used by an international team of scientists participating in the SAFARI field experiment. The objective of SAFARI is to measure the effects of windblown smoke and dust on air quality and the Earth's radiant energy budget. This image was produced using SeaWiFS channels 6, 5, and 1 (centered at 670 nm, 555 nm , and 412 nm, respectively). The data were acquired and provided by the Satellite Applications Center in Pretoria, South Africa. Image courtesy Gene Feldman, SeaWiFS Project and Orbital Sciences

  14. Meteorite falls in Africa

    NASA Astrophysics Data System (ADS)

    Khiri, Fouad; Ibhi, Abderrahmane; Saint-Gerant, Thierry; Medjkane, Mohand; Ouknine, Lahcen

    2017-10-01

    The study of meteorites provides insight into the earliest history of our solar system. From 1800, about the year meteorites were first recognized as objects falling from the sky, until December 2014, 158 observed meteorite falls were recorded in Africa. Their collected mass ranges from 1.4 g to 175 kg with the 1-10 kg cases predominant. The average rate of African falls is low with only one fall recovery per 1.35-year time interval (or 0.023 per year per million km2). This African collection is dominated by ordinary chondrites (78%) just like in the worldwide falls. The seventeen achondrites include three Martian meteorite falls (Nakhla of Egypt, Tissint of Morocco and Zagami of Nigeria). Observed Iron meteorite falls are relatively rare and represent only 5%. The falls' rate in Africa is variable in time and in space. The number of falls continues to grow since 1860, 80% of which were recovered during the period between 1910 and 2014. Most of these documented meteorite falls have been recovered from North-Western Africa, Eastern Africa and Southern Africa. They are concentrated in countries which have a large surface area and a large population with a uniform distribution. Other factors are also favorable for observing and collecting meteorite falls across the African territory, such as: a genuine meteorite education, a semi-arid to arid climate (clear sky throughout the year most of the time), croplands or sparse grasslands and possible access to the fall location with a low percentage of forest cover and dense road network.

  15. Impacts of Climate Change on Malaria Transmission in Africa

    NASA Astrophysics Data System (ADS)

    Eltahir, E. A. B.; Endo, N.; Yamana, T. K.

    2017-12-01

    Malaria is a major vector-borne parasitic disease transmitted to humans by Anopheles spp mosquitoes. Africa is the hotspot for malaria transmission where more than 90% of malaria deaths occur every year. Malaria transmission is an intricate function of climatic factors, which non-linearly affect the development of vectors and parasites. We project that the risk of malaria will increase towards the end of the 21st century in east Africa, but decrease in west Africa. We combine a novel malaria transmission simulator, HYDREMATS, that has been developed based on comprehensive multi-year field surveys both in East Africa and West Africa, and the most reliable climate projections through regional dynamical downscaling and rigorous selection of GCMs from among CMIP5 models. We define a bell-shaped relation between malaria intensity and temperature, centered around a temperature of 30°C. Future risks of malaria are projected for two highly populated regions in Africa: the highlands in East Africa and the fringes of the desert in West Africa. In the highlands of East Africa, temperature is substantially colder than this optimal temperature; warmer future climate exacerbate malaria conditions. In the Sahel fringes in West Africa, temperature is around this optimal temperature; warming is not likely to exacerbate and might even reduce malaria burden. Unlike the highlands of East Africa, which receive significant amounts of annual rainfall, dry conditions also limit malaria transmission in the Sahel fringes in West Africa. This disproportionate risk of malaria due to climate change should guide strategies for climate adaptation over Africa.

  16. Internationalisation of Higher Education in Southern Africa with South Africa as a Major Exporter

    ERIC Educational Resources Information Center

    Kwaramba, Marko

    2012-01-01

    This study investigates the extent to which South Africa has strategically marketed its educational services and positioned itself as the educational hub of Southern Africa. The analysis reveals that South African universities' export of higher education services has been modeled in line with three of the four modes of supply identified in World…

  17. Differences between HIV-Infected men and women in antiretroviral therapy outcomes - six African countries, 2004-2012.

    PubMed

    2013-11-29

    Evaluation of differences between human immunodeficiency virus (HIV)-infected men and women in antiretroviral therapy (ART) enrollment characteristics and outcomes might identify opportunities to improve ART program patient outcomes and prevention impact. During September 2008-February 2012, retrospective cohort studies to estimate attrition of enrollees (i.e., from death, stopping ART, or loss to follow-up) at 6-month intervals after ART initiation were completed among samples of adult men and women (defined as aged ≥15 years or aged ≥18 years) who initiated ART during 2004-2010 in six African countries: Côte d'Ivoire in western Africa; Swaziland, Mozambique, and Zambia in southern Africa; and Uganda and Tanzania in eastern Africa. Records for 13,175 ART enrollees were analyzed; sample sizes among the six countries ranged from 1,457 to 3,682. In each country, women comprised 61%-67% of ART enrollees. Median CD4 count range was 119-141 cells/µL for men and 137-161 cells/µL for women. Compared with women, a greater percentage of men initiated ART who had World Health Organization (WHO) HIV stage IV disease. In cohorts from western Africa and southern Africa, the risk for attrition was 15%-26% lower among women compared with men in multivariable analysis. However, in eastern Africa, differences between men and women in risk for attrition were not statistically significant. Research to identify country-specific causes for increased attrition and delayed initiation of care among men could identify strategies to improve ART program outcomes among men, which might contribute to prevention of new HIV infections in female partners.

  18. Overweight and obesity among women: analysis of demographic and health survey data from 32 Sub-Saharan African Countries.

    PubMed

    Neupane, Subas; Prakash, K C; Doku, David Teye

    2016-01-13

    Overweight and obesity are risk factors for many chronic diseases globally. However, the extent of the problem in low-income countries like Sub-Saharan Africa is unclear. We assessed the magnitude and disparity of both phenomena by place of residence, level of education and wealth quintile using cross-sectional data from 32 countries. Demographic and Health Survey (DHS) data collected in 32 Sub-Saharan African countries between January 2005 and December 2013 were used. A total of 250651 women (aged 15-49 years) were analyzed. Trained personnel using a standardized procedure measured body weight and height. Body mass index (BMI) was calculated by dividing body weight by height squared. Prevalence of overweight (25.0-29.9 kg/m(2)) and obesity (≥ 30.0 kg/m(2)) were estimated for each country. Analysis of the relationships of overweight and obesity with place of residence, education and wealth index were carried out using logistic regression. The pooled prevalence of overweight for the region was 15.9% (95% CI, 15.7-16.0) with the lowest in Madagascar 5.6% (95% CI, 5.1-6.1) and the highest in Swaziland 27.7% (95% CI, 26.4-29.0). Similarly, the prevalence of obesity was also lowest in Madagascar 1.1% (95% CI, 0.9-1.4) and highest in Swaziland 23.0 (95% CI, 21.8-24.2). The women in urban residence and those who were classified as rich, with respect to the quintile of the wealth index, had higher likelihood of overweight and obesity. In the pooled results, high education was significantly associated with overweight and obesity. The prevalence of overweight and obesity varied highly between the countries and wealth index (rich vs. poor) was found to be the strongest predictor in most of the countries. Interventions that will address the socio-cultural barriers to maintaining healthy body size can contribute to curbing the overweight and obesity epidemic in Africa.

  19. Cholera outbreaks in Africa.

    PubMed

    Mengel, Martin A; Delrieu, Isabelle; Heyerdahl, Leonard; Gessner, Bradford D

    2014-01-01

    During the current seventh cholera pandemic, Africa bore the major brunt of global disease burden. More than 40 years after its resurgence in Africa in 1970, cholera remains a grave public health problem, characterized by large disease burden, frequent outbreaks, persistent endemicity, and high CFRs, particularly in the region of the central African Great Lakes which might act as reservoirs for cholera. There, cases occur year round with a rise in incidence during the rainy season. Elsewhere in sub-Saharan Africa, cholera occurs mostly in outbreaks of varying size with a constant threat of widespread epidemics. Between 1970 and 2011, African countries reported 3,221,050 suspected cholera cases to the World Health Organization, representing 46 % of all cases reported globally. Excluding the Haitian epidemic, sub-Saharan Africa accounted for 86 % of reported cases and 99 % of deaths worldwide in 2011. The number of cholera cases is possibly much higher than what is reported to the WHO due to the variation in modalities, completeness, and case definition of national cholera data. One source on country specific incidence rates for Africa, adjusting for underreporting, estimates 1,341,080 cases and 160,930 deaths (52.6 % of 2,548,227 estimated cases and 79.6 % of 209,216 estimated deaths worldwide). Another estimates 1,411,453 cases and 53,632 deaths per year, respectively (50 % of 2,836,669 estimated cases and 58.6 % of 91,490 estimated deaths worldwide). Within Africa, half of all cases between 1970 and 2011 were notified from only seven countries: Angola, Democratic Republic of the Congo, Mozambique, Nigeria, Somalia, Tanzania, and South Africa. In contrast to a global trend of decreasing case fatality ratios (CFRs), CFRs have remained stable in Africa at approximately 2 %. Early propagation of cholera outbreaks depends largely on the extent of individual bacterial shedding, host and organism characteristics, the likelihood of people coming into contact with

  20. Africa and the AIDS myth.

    PubMed

    Versi, A

    1990-04-01

    The recently released television documentary, "Monkey Business, AIDS: The African Story," has created controversy in Europe with its premise that AIDS did not originate in Africa. Although AIDS 1st appeared in New York in 1981 and was not recorded in Africa until 1983, researchers and the media have promoted the theory that AIDS came from Africa through human contact with the green monkey. Subsequent research forced the original champions of this "green monkey connection" theory to acknowledge that the AIDS virus and the green monkey virus are so dissimilar that they could not be historically linked. Then, the focus turned to the theory that a remote pygmy tribe had been endemically infected with the AIDS virus and carried the disease, by airplane, out of the country. This theory, too, was refuted by the failure to locate any HIV-positive pygmies in the Central African Republic. Still determined to prove that AIDS did not have an American or European origin, researchers reported that blood testing conducted in 1984 revealed 50-90% of Africans to be HIV-infected. Retesting with a more accurate procedure revealed the rate of infectivity to be only 0.02%; yet the media have continued to portray Africa as the source of the AIDS scourge. Moreover, it appears that AIDS cases are actually overreported from Africa--not underreported--due to confusion with conditions such as malnutrition and tropical diseases. To some, this relentless drive to vilify Africa reflects racism. Others believe that it represents an effort to cover up the possibility that the AIDS virus is man-made--a result of an accident in gene technology or microbiology.

  1. H3Africa: current perspectives

    PubMed Central

    Mulder, Nicola; Abimiku, Alash’le; Adebamowo, Sally N; de Vries, Jantina; Matimba, Alice; Olowoyo, Paul; Ramsay, Michele; Skelton, Michelle; Stein, Dan J

    2018-01-01

    Precision medicine is being enabled in high-income countries by the growing availability of health data, increasing knowledge of the genetic determinants of disease and variation in response to treatment (pharmacogenomics), and the decreasing costs of data generation, which promote routine application of genomic technologies in the health sector. However, there is uncertainty about the feasibility of applying precision medicine approaches in low- and middle-income countries, due to the lack of population-specific knowledge, skills, and resources. The Human Heredity and Health in Africa (H3Africa) initiative was established to drive new research into the genetic and environmental basis for human diseases of relevance to Africans as well as to build capacity for genomic research on the continent. Precision medicine requires this capacity, in addition to reference data on local populations, and skills to analyze and interpret genomic data from the bedside. The H3Africa consortium is collectively processing samples and data for over 70,000 participants across the continent, accompanied in most cases by rich clinical information on a variety of non-communicable and infectious diseases. These projects are increasingly providing novel insights into the genetic basis of diseases in indigenous populations, insights that have the potential to drive the development of new diagnostics and treatments. The consortium has also invested significant resources into establishing high-quality biorepositories in Africa, a bioinformatic network, and a strong training program that has developed skills in genomic data analysis and interpretation among bioinformaticians, wet-lab researchers, and health-care professionals. Here, we describe the current perspectives of the H3Africa consortium and how it can contribute to making precision medicine in Africa a reality. PMID:29692621

  2. Ethno-Mathema-tics of Basotho

    ERIC Educational Resources Information Center

    Narayanan, Ajayagosh

    2011-01-01

    Mathematics as a subject is indispensable in the development of Lesotho with respect to science, technology or any other field of knowledge. It is also a mirror to our past. In this case, Lesotho's indigenous mathematics is not fully explored and understood by Basotho. This author aims to present ethno mathematics of Basotho as compared to…

  3. Tele-Education in South Africa

    PubMed Central

    Mars, Maurice

    2014-01-01

    Introduction: Telemedicine includes the use of information and communication technology for education in the health sector, tele-education. Sub-Saharan Africa has an extreme shortage of health professionals and as a result, doctors to teach doctors and students. Tele-education has the potential to provide access to education both formal and continuing medical education. While the uptake of telemedicine in Africa is low, there are a number of successful and sustained tele-education programs. The aims of this study were (i) to review the literature on tele-education in South Africa, (ii) describe tele-education activities at the University of KwaZulu-Natal (UKZ-N) in South Africa, and (iii) review the development of these programs with respect to current thinking on eHealth project implementation. Method: A literature review of tele-education in South Africa was undertaken. The development of the tele-education services at UKZ-N from 2001 to present is described. The approaches taken are compared with current teaching on eHealth implementation and a retrospective design-reality gap analysis is made. Results: Tele-education has been in use in South Africa since the 1970s. Several forms of tele-education are in place at the medical schools and in some Provincial Departments of Health (DOH). Despite initial attempts by the National DOH, there are no national initiatives in tele-education. At UKZ-N, a tele-education service has been running since 2001 and appears to be sustainable and reaching maturity, with over 1,400 h of videoconferenced education offered per year. The service has expanded to offer videoconferenced education into Africa using different ways of delivering tele-education. Conclusion: Tele-education has been used in different forms for many years in the health sector in South Africa. There is little hard evidence of its educational merit or economic worth. What it apparent is that it improves access to education and training in resource constrained

  4. Early Archean spherule beds of possible impact origin from Barberton, South Africa: A detailed mineralogical and geochemical study

    NASA Technical Reports Server (NTRS)

    Koeberl, Christian; Reimold, Wolf Uwe; Boer, Rudolf H.

    1992-01-01

    The Barberton Greenstone belt is a 3.5- to 3.2-Ga-old formation situated in the Swaziland Supergroup near Barberton, northeast Transvaal, South Africa. The belt includes a lower, predominantly volcanic sequence, and an upper sedimentary sequence (e.g., the Fig Tree Group). Within this upper sedimentary sequence, Lowe and Byerly identified a series of different beds of spherules with diameters of around 0.5-2 mm. Lowe and Byerly and Lowe et al. have interpreted these spherules to be condensates of rock vapor produced by large meteorite impacts in the early Archean. We have collected a series of samples from drill cores from the Mt. Morgan and Princeton sections near Barberton, as well as samples taken from underground exposures in the Sheba and Agnes mines. These samples seem much better preserved than the surface samples described by Lowe and Byerly and Lowe et al. Over a scale of just under 30 cm, several well-defined spherule beds are visible, interspaced with shales and/or layers of banded iron formation. Some spherules have clearly been deposited on top of a sedimentary unit because the shale layer shows indentions from the overlying spherules. Although fresher than the surface samples (e.g., spherule bed S-2), there is abundant evidence for extensive alteration, presumably by hydrothermal processes. In some sections of the cores sulfide mineralization is common. For our mineralogical and petrographical studies we have prepared detailed thin sections of all core and underground samples (as well as some surface samples from the S-2 layer for comparison). For geochemical work, layers with thicknesses in the order of 1-5 mm were separated from selected core and underground samples. The chemical analyses are being performed using neutron activation analysis in order to obtain data for about 35 trace elements in each sample. Major elements are being determined by XRF and plasma spectrometry. To clarify the history of the sulfide mineralization, sulfur isotopic

  5. HIV prevention in favour of the choice-disabled in southern Africa: study protocol for a randomised controlled trial.

    PubMed

    Andersson, Neil; Cockcroft, Anne; Thabane, Lehana; Marokoane, Nobantu; Laetsang, Ditiro; Masisi, Mokgweetsi

    2013-08-29

    Most HIV prevention strategies assume beneficiaries can act on their prevention decisions. But some people are unable to do so. They are 'choice-disabled'. Economic and educational interventions can reduce sexual violence, but there is less evidence that they can reduce HIV. There is little research on complex interventions in HIV prevention, yet all countries in southern Africa implement combination prevention programmes. The primary objective is to reduce HIV infections among women aged 15 to 29 years. Secondary objectives are reduction in gender violence and improvement in HIV-related knowledge, attitudes and practices among youth aged 15 to 29 years.A random sample of 77 census enumeration areas in three countries (Botswana, Namibia and Swaziland) was allocated randomly to three interventions, alone or in combination, in a factorial design stratified by country, HIV rates (above or below average for country), and urban/rural location. A baseline survey of youth aged 15 to 29 years provided cluster specific rates of HIV. All clusters continue existing prevention efforts and have a baseline and follow-up survey. Cluster is the unit of allocation, intervention and analysis, using generalised estimating equations, on an intention-to-treat basis.One intervention discusses evidence about choice disability with local HIV prevention services, to help them to serve the choice-disabled. Another discusses an eight-episode audio-docudrama with community groups, of all ages and both sexes, to generate endogenous strategies to reduce gender violence and develop an enabling environment. A third supports groups of women aged 18 to 25 years to build self-esteem and life skills and to set up small enterprises to generate income.A survey in all clusters after 3 years will measure outcomes, with interviewers unaware of group assignment of the clusters. The primary outcome is HIV infection in women aged 15 to 29 years. Secondary outcomes in youth aged 15 to 29 years are gender

  6. Fetal alcohol spectrum disorder in Africa.

    PubMed

    Adnams, Colleen M

    2017-03-01

    This review aims to summarize data published in the scientific literature and available on official websites on fetal alcohol spectrum disorder (FASD) in Africa. There is a paucity of published literature and evidence-based information on prenatal exposure to alcohol in the African continent and the majority of the continent's literature on FASD emanates from South Africa. A small number of scientific publications document FASD and drinking in pregnancy in other Sub-Saharan African countries and these findings provide evidence that FASD occurs across the continent. Further evidence shows that the world's highest reported rates of FASD occur in South Africa and that this confers a significant public health and neurodevelopmental disability burden on the region. There is an established body of epidemiological, diagnostic, neurobehavioral and neuroscientific knowledge from studies in South Africa. Universal and indicated case method preventions are effective in reducing maternal alcohol consumption in high-risk areas. Throughout Africa, a policy and service implementation gap exists that impedes translation of generated knowledge into effective prevention and intervention strategies. FASD is likely a widely occurring and largely unrecognized neurodevelopmental disability in Africa. A key future direction for global agencies and research partnerships is to collaboratively address evidence gaps and knowledge translation through scalable approaches and strategies that aim to ameliorate the burden of FASD in African and other countries.

  7. Utilization of implantable defibrillators in Africa.

    PubMed

    Millar, R N Scott; Mayosi, B M

    2003-01-01

    Sub-Saharan Africa is dominated by diseases of poverty. HIV/AIDS affects 28.5 out of a total of 600 million in the region. South Africa is the only country in sub-Saharan Africa in which implantable cardiovertor defibrillators (ICDs) are implanted (0.8/million in 2001). Only 3 of the 35 new ICDs were implanted in state-funded public hospitals. The pacemaker implantation rate for South Africa was 41/million in 2001. Approximately 20% of the population consume 56% of the health care expenditure, mainly funded by Medical Insurance. A tax-funded state health care system serves the rest of the population, but is concentrated on improving sanitation and primary health care. Diversion of funds from academic tertiary hospitals has reduced specialised services, particularly cardiology and cardiac surgery, and has resulted in an exodus of skilled personnel to the private sector. In the rest of sub-Saharan Africa, tertiary health care is mainly privately funded. Cardiology and cardiac surgery is not widely available. Many countries are crippled by debt and chronic local conflicts. Only one state hospital (Groote Schuur, Cape Town) provides an electrophysiology (EP) service including catheter ablation and ICD implantation, and training in EP, by two electrophysiologists. EP services are available privately in 3 centres. No EP service exists in the rest of sub-Saharan Africa.

  8. Indicators of Terrorism Vulnerability in Africa

    DTIC Science & Technology

    2015-03-26

    the terror threat and vulnerabilities across Africa. Key words: Terrorism, Africa, Negative Binomial Regression, Classification Tree iv I would like...31 Metrics . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 32 Log -likelihood...70 viii Page 5.3 Classification Tree Description

  9. Use of ERTS imagery for natural resources research and development in Lesotho. [Southern Africa

    NASA Technical Reports Server (NTRS)

    Nixon, P. H. (Principal Investigator); Jackson, A. A.

    1974-01-01

    The author has identified the following significant results. As far as the geological aspects of the project were concerned, the project was a success. It was concluded that: (1) It is possible to trace the lithological boundaries between sedimentary rocks and basaltic rocks, both extrusive and intrusive. (2) It was possible to localize sponges in the mountain areas, some of which may conceal undiscovered diamond pipes. (3) Possible main structural axes were localized within the framework of lineaments. Due to drought which occured at the time the images were gathered by ERTS-1, the usefulness of the data was limited for agricultural purposes.

  10. Epidemiology and burden of bipolar disorder in Africa: a systematic review of data from Africa.

    PubMed

    Esan, Oluyomi; Esan, Arinola

    2016-01-01

    Bipolar disorder impacts negatively on the patient, the family, as well as the society. It taxes the health care services due to a combination of the illness with associated medical and psychiatric comorbidities. In Africa, unfortunately, knowledge of the epidemiology and burden of bipolar disorder is based mainly on studies from the USA and Europe. In this systematic review of literature from Africa, we highlight the epidemiology and burden of bipolar disorder. A systematic review of publications from Africa relating to the epidemiology and burden of bipolar disorder was conducted. Data from community surveys conducted in Nigeria and Ethiopia indicated a lifetime prevalence estimate of 0.1 % to 1.83 for bipolar disorder. Missed diagnosis rate of bipolar disorder was up to 36.2 %. In one study, 8.1 % of the males and 5.4 % of the females reported a previous suicide attempt. A study showed that up to 60 % of patients with bipolar disorder had at least one comorbidity. There were no reports on all-cause mortality and cost of illness. Bipolar disorder is a major mental health problem in Africa. Scientific findings on bipolar disorder from Africa are consistent with the existing literature from other parts of the world. There still exists a dearth of high quality studies addressing the epidemiological, clinical, social, and economic burden of the disorder.

  11. Low-Quality Housing Is Associated With Increased Risk of Malaria Infection: A National Population-Based Study From the Low Transmission Setting of Swaziland

    PubMed Central

    Dlamini, Nomcebo; Ntshalintshali, Nyasatu; Pindolia, Deepa; Allen, Regan; Nhlabathi, Nomcebo; Novotny, Joseph; Kang Dufour, Mi-Suk; Midekisa, Alemayehu; Gosling, Roly; LeMenach, Arnaud; Cohen, Justin; Dorsey, Grant; Greenhouse, Bryan; Kunene, Simon

    2017-01-01

    Abstract Background. Low-quality housing may confer risk of malaria infection, but evidence in low transmission settings is limited. Methods. To examine the relationship between individual level housing quality and locally acquired infection in children and adults, a population-based cross-sectional analysis was performed using existing surveillance data from the low transmission setting of Swaziland. From 2012 to 2015, cases were identified through standard diagnostics in health facilities and by loop-mediated isothermal amplification in active surveillance, with uninfected subjects being household members and neighbors. Housing was visually assessed in a home visit and then classified as low, high, or medium quality, based on housing components being traditional, modern, or both, respectively. Results. Overall, 11426 individuals were included in the study: 10960 uninfected and 466 infected (301 symptomatic and 165 asymptomatic). Six percent resided in low-quality houses, 26% in medium-quality houses, and 68% in high-quality houses. In adjusted models, low- and medium-quality construction was associated with increased risk of malaria compared with high-quality construction (adjusted odds ratio [AOR], 2.11 and 95% confidence interval [CI], 1.26–3.53 for low vs high; AOR, 1.56 and 95% CI, 1.15–2.11 for medium vs high). The relationship was independent of vector control, which also conferred a protective effect (AOR, 0.67; 95% CI, .50–.90) for sleeping under an insecticide-treated bed net or a sprayed structure compared with neither. Conclusions. Our study adds to the limited literature on housing quality and malaria risk from low transmission settings. Housing improvements may offer an attractive and sustainable additional strategy to support countries in malaria elimination. PMID:28580365

  12. Andreas Goes to Africa: A Comparative Historical Study of the Teachers for East Africa Programs

    ERIC Educational Resources Information Center

    Vavrus, Frances

    2018-01-01

    This article uses a comparative historical approach to examine the Teachers for East Africa (TEA) and the Teacher Education in East Africa (TEEA) programs, an influential educational development effort that involved U.S. and British college graduates in East African schools and colleges during the decade of 1961-1971. Drawing on postcolonial…

  13. Sub-Saharan Africa Report.

    DTIC Science & Technology

    1987-04-21

    south of the Save River, In the .north, the MNR benefited in 1982 from-its absorption >of groups. of Africa Livre fighters operating out of Malawi (AC...Vol 23 Nos 15, 16). One of the Africa Livre leaders was businessman Gimo; ;Phiri, ’who became the MNR’s chief representative in Malawi, operating...Zambezia province for health reasons. The president of the republic has meanwhile appointed (Hermano Gildo Queda Gamito) as BPD chair- man, Antonio

  14. Neurosyphilis in Africa: A systematic review

    PubMed Central

    Jarvis, Joseph N.; Howlett, William; Mabey, David C. W.

    2017-01-01

    Introduction Neurological involvement is one of the most important clinical manifestations of syphilis and neurological disease occurs in both early and late syphilis. The impact of HIV co-infection on clinical neurosyphilis remains unclear. The highest prevalence of both syphilis and HIV is in Africa. Therefore it might be expected that neurosyphilis would be an important and not uncommon manifestation of syphilis in Africa and frequently occur in association with HIV co-infection; yet few data are available on neurosyphilis in Africa. The aim of this study is to review data on neurosyphilis in Africa since the onset of the HIV epidemic. Methods We searched the literature for references on neurosyphilis in Africa for studies published between the 1st of January 1990 and 15th February 2017. We included case reports, case series, and retrospective and prospective cohort and case-control studies. We did not limit inclusion based on the diagnostic criteria used for neurosyphilis. For retrospective and prospective cohorts, we calculated the proportion of study participants who were diagnosed with neurosyphilis according to the individual study criteria. Depending on the study, we assessed the proportion of patients with syphilis found to have neurosyphilis, and the proportion of patients with neurological syndromes who had neurosyphilis. Due to heterogeneity of data no formal pooling of the data or meta-analysis was undertaken. Results Amongst patients presenting with a neurological syndrome, three studies of patients with meningitis were identified; neurosyphilis was consistently reported to cause approximately 3% of all cases. Three studies on stroke reported mixed findings but were limited due to the small number of patients undergoing CSF examination, whilst neurosyphilis continued to be reported as a common cause of dementia in studies from North Africa. Ten studies reported on cases of neurosyphilis amongst patients known to have syphilis. Studies from both North

  15. Neurosyphilis in Africa: A systematic review.

    PubMed

    Marks, Michael; Jarvis, Joseph N; Howlett, William; Mabey, David C W

    2017-08-01

    Neurological involvement is one of the most important clinical manifestations of syphilis and neurological disease occurs in both early and late syphilis. The impact of HIV co-infection on clinical neurosyphilis remains unclear. The highest prevalence of both syphilis and HIV is in Africa. Therefore it might be expected that neurosyphilis would be an important and not uncommon manifestation of syphilis in Africa and frequently occur in association with HIV co-infection; yet few data are available on neurosyphilis in Africa. The aim of this study is to review data on neurosyphilis in Africa since the onset of the HIV epidemic. We searched the literature for references on neurosyphilis in Africa for studies published between the 1st of January 1990 and 15th February 2017. We included case reports, case series, and retrospective and prospective cohort and case-control studies. We did not limit inclusion based on the diagnostic criteria used for neurosyphilis. For retrospective and prospective cohorts, we calculated the proportion of study participants who were diagnosed with neurosyphilis according to the individual study criteria. Depending on the study, we assessed the proportion of patients with syphilis found to have neurosyphilis, and the proportion of patients with neurological syndromes who had neurosyphilis. Due to heterogeneity of data no formal pooling of the data or meta-analysis was undertaken. Amongst patients presenting with a neurological syndrome, three studies of patients with meningitis were identified; neurosyphilis was consistently reported to cause approximately 3% of all cases. Three studies on stroke reported mixed findings but were limited due to the small number of patients undergoing CSF examination, whilst neurosyphilis continued to be reported as a common cause of dementia in studies from North Africa. Ten studies reported on cases of neurosyphilis amongst patients known to have syphilis. Studies from both North and Southern Africa continue

  16. AIDS and Africa. Introduction.

    PubMed

    Kopelman, Loretta M; van Niekerk, Anton A

    2002-04-01

    Sub-Saharan Africa is the epicenter of the HIV/AIDS epidemic, and in this issue of the Journal, seven authors discuss the moral, social and medical implications of having 70% of those stricken living in this area. Anton A. van Niekerk considers complexities of plague in this region (poverty, denial, poor leadership, illiteracy, women's vulnerability, and disenchantment of intimacy) and the importance of finding responses that empower its people. Solomon Benatar reinforces these issues, but also discusses the role of global politics in sub-Saharan Africa, especially discrimination, imperialism and its exploitation by first world countries. Given the public health crisis, Udo Schüklenk and Richard E. Ashcroft defend compulsory licensing of essential HIV/AIDS medications on consequentialist grounds. Keymanthri Moodley discusses the importance of conducting research and the need to understand a moderate form of communitarianism, also referred to as "ubuntu" or "communalism", to help some Africans understand research as an altruistic endeavour. Godfrey B. Tangwa also defends traditional African values of empathy and ubuntu, discussing how they should be enlisted to fight this pandemic. Loretta M. Kopelman criticizes the tendency among those outside Africa to dismiss the HIV/AIDS pandemic, attributing one source to the ubiquitous and misguided punishment theory of disease. The authors conclude that good solutions must be cooperative ventures among countries within and outside of sub-Saharan Africa with far more support from wealthy countries.

  17. The enigma of yellow fever in East Africa.

    PubMed

    Ellis, Brett R; Barrett, Alan D T

    2008-01-01

    Despite a safe and effective vaccine, there are approximately 200,000 cases, including 30,000 deaths, due to yellow fever virus (YFV) each year, of which 90% are in Africa. The natural history of YFV has been well described, especially in West Africa, but in East Africa yellow fever (YF) remains characterised by unpredictable focal periodicity and a precarious potential for large epidemics. Recent outbreaks of YF in Kenya (1992-1993) and Sudan (2003 and 2005) are important because each of these outbreaks have involved the re-emergence of a YFV genotype (East Africa) that remained undetected for nearly 40 years and was previously unconfirmed in a clinically apparent outbreak. In addition, unlike West Africa and South America, YF has yet to emerge in urban areas of East Africa and be vectored by Aedes (Stegomyia) aegypti. This is a significant public health concern in a region where the majority of the population remains unvaccinated. This review describes historical findings, highlights a number of disease indicators, and provides clarification regarding the natural history, recent emergence and future risk of YF in East Africa. Copyright (c) 2008 John Wiley & Sons, Ltd.

  18. Strategic investments in non-communicable diseases (NCD) research in Africa: the GSK Africa NCD Open Lab.

    PubMed

    Hall, Matthew D; Dufton, Ann M; Katso, Roy M; Gatsi, Sally A; Williams, Pauline M; Strange, Michael E

    2015-01-01

    In March 2014, GSK announced a number of new strategic investments in Africa. One of these included investment of up to 25 million Pounds Sterling (£25 million) to create the world's first R&D Open Lab to increase understanding of non-communicable diseases (NCDs) in Africa. The vision is to create a new global R&D effort with GSK working in partnership with major funders, academic centres and governments to share expertise and resources to conduct high-quality research. The Africa NCD Open Lab will see GSK scientists collaborate with scientific research centres across Africa. An independent advisory board of leading scientists and clinicians will provide input to develop the strategy and selection of NCD research projects within a dynamic and networked open-innovation environment. It is hoped that these research projects will inform prevention and treatment strategies in the future and will enable researchers across academia and industry to discover and develop new medicines to address the specific needs of African patients.

  19. Children in Africa: Key Statistics on Child Survival, Protection and Development

    ERIC Educational Resources Information Center

    UNICEF, 2014

    2014-01-01

    This report presents key statistics relating to: (1) child malnutrition in Africa; (2) HIV/AIDS and Malaria in Africa; (3) child marriage, birth registration and Female Genital Mutilation/Cutting (FGM/C); (4) education in Africa; (5) child mortality in Africa; (6) Drinking water and sanitation in Africa; and (7) maternal health in Africa.…

  20. Sub-Saharan Africa Report.

    DTIC Science & Technology

    1987-01-16

    Botha (DIE AFRIKANER, 8 Oct 86) 55 s 57 (DIE AFRIKANER, 15 Oct 86) 59 BP Oil Company Integration Plans Viewed (DIE BURGER, 17 Nov 86...among things, ban the transporta- tion of crude oil to South Africa and Namibia on Norwegian ships, ban any form of investment and trans- fer of...on November 10 on an em- bargo against the sale and transport of oil to South Africa, and calls for the setting up of a United Nations "mechanism

  1. eGY-Africa: Addressing the Digital Divide for Science in Africa

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Barton, C.E.; /Australian Natl. U., Canberra; Amory-Mazaudier, C.

    Adoption of information and communication technologies and access to the Internet is expanding in Africa, but because of the rapid growth elsewhere, a Digital Divide between Africa and the rest of the world exists, and the gap is growing. In many sub-Saharan African countries, education and research sector suffers some of the worst deficiencies in access to the Internet, despite progress in development of NRENs - National Research and Education (cyber) Networks. By contrast, it is widely acknowledged in policy statements from the African Union, the UN, and others that strength in this very sector provides the key to meetingmore » and sustaining Millennium Development Goals. Developed countries with effective cyber-capabilities proclaim the benefits to rich and poor alike arising from the Information Revolution. This is but a dream for many scientists in African institutions. As the world of science becomes increasingly Internet-dependent, so they become increasingly isolated. eGY-Africa is a bottom-up initiative by African scientists and their collaborators to try to reduce this Digital Divide by a campaign of advocacy for better institutional facilities. Four approaches are being taken. The present status of Internet services, problems, and plans are being mapped via a combination of direct measurement of Internet performance (the PingER Project) and a questionnaire-based survey. Information is being gathered on policy statements and initiatives aimed at reducing the Digital Divide, which can be used for arguing the case for better Internet facilities. Groups of concerned scientists are being formed at the national, regional levels in Africa, building on existing networks as much as possible. Opinion in the international science community is being mobilized. Finally, and perhaps most important of all, eGY-Africa is seeking to engage with the many other programs, initiatives, and bodies that share the goal of reducing the Digital Divide - either as a direct

  2. eGY-Africa: Addressing the Digital Divide for Science in Africa

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Barton, C. E.

    Adoption of information and communication technologies and access to the Internet is expanding in Africa, but because of the rapid growth elsewhere, a Digital Divide between Africa and the rest of the world exists, and the gap is growing. In many sub-Saharan African countries, education and research sector suffer some of the worst deficiencies in access to the Internet, despite progress in development of NRENs National Research and Education (cyber) Networks. By contrast, it is widely acknowledged in policy statements from the African Union, the UN, and others that strength in this very sector provides the key to meeting andmore » sustaining Millennium Development Goals. Developed countries with effective cyber-capabilities proclaim the benefits to rich and poor alike arising from the Information Revolution. This is but a dream for many scientists in African institutions. As the world of science becomes increasingly Internet-dependent, so they become increasingly isolated. eGY-Africa is a bottom-up initiative by African scientists and their collaborators to try to reduce this Digital Divide by a campaign of advocacy for better institutional facilities. Four approaches are being taken. The present status of Internet services, problems, and plans are being mapped via a combination of direct measurement of Internet performance (the PingER Project) and a questionnaire-based survey. Information is being gathered on policy statements and initiatives aimed at reducing the Digital Divide, which can be used for arguing the case for better Internet facilities. Groups of concerned scientists are being formed at the national, regional levels in Africa, building on existing networks as much as possible. Opinion in the international science community is being mobilized. Finally, and perhaps most important of all, eGY-Africa is seeking to engage with the many other programs, initiatives, and bodies that share the goal of reducing the Digital Divide either as a direct policy

  3. Astrophysics in Southern Africa

    NASA Astrophysics Data System (ADS)

    Whitelock, Patricia

    2008-03-01

    The government of South Africa has identified astronomy as a field in which their country has a strategic advantage and is consequently investing very significantly in astronomical infrastructure. South Africa now operates a 10-m class optical telescope, the Southern African Large Telescope (SALT), and is one of two countries short listed to host the Square Kilometre Array (SKA), an ambitious international project to construct a radio telescope with a sensitivity one hundred times that of any existing telescope. The challenge now is to produce an indigenous community of users for these facilities, particularly from among the black population which was severely disadvantaged under the apartheid regime. In this paper I briefly describe the observing facilities in Southern Africa before going on to discuss the various collaborations that are allowing us to use astronomy as a tool for development, and at the same time to train a new generation of astronomers who will be well grounded in the science and linked to their colleagues internationally.

  4. Compositions of Three Lunar Meteorites: Meteorite Hills 01210, Northeast Africa 001, and Northwest Africa 3136

    NASA Technical Reports Server (NTRS)

    Korotev, R. L.; Irving, A. J.

    2005-01-01

    We report on compositions obtained by instrumental neutron activation analysis on three new lunar meteorites, MET 01210 (Meteorite Hills, Antarctica; 23 g), NEA 001 (Northeast Africa, Sudan; 262 g), and NWA 3136 (Northwest Africa, Algeria or Morocco; 95 g). As in previous similar studies, we divided our samples into many (8-9) small (approximately 30 mg) subsamples prior to analysis.

  5. Echinococcus felidis in hippopotamus, South Africa.

    PubMed

    Halajian, Ali; Luus-Powell, Wilmien J; Roux, Francois; Nakao, Minoru; Sasaki, Mizuki; Lavikainen, Antti

    2017-08-30

    Hydatid cysts of Echinococcus felidis are described from the hippopotamus (Hippopotamus amphibius) from Mpumalanga Province, South Africa. Among six hippopotami investigated, hepatic hydatids were found in three. The identification was based on mitochondrial and nuclear DNA sequences. In addition, the rostellar hook morphology was analysed. This is the first morphological description of the metacestode of E. felidis, and the first molecularly confirmed report of the intermediate host of E. felidis in South Africa. The definitive host of E. felidis in South Africa is the lion (Panthera leo). Copyright © 2017 Elsevier B.V. All rights reserved.

  6. Contributing to the ICNP: validating the term 'informal settlement'.

    PubMed

    Geyer, N; Mmuwe-Hlahane, S; Shongwe-Magongo, R G; Uys, E

    2005-12-01

    The specific aims of this study were to propose a definition of the term informal settlement, validate the term informal settlement, and submit a term and definition for international utilization to the International Council of Nurses (ICN) for consideration for inclusion in the International Classification of Nursing Practice (ICNP). South Africa was one of four African countries (Botswana, South Africa, Swaziland and Zimbabwe) funded by the WK Kellogg Foundation to participate in the ICNP project. South Africa had two research groups. One of the research groups identified the term informal settlement to define. This was a qualitative study where a philosophical perspective was used to explore, explain and describe nursing practice. The combined method proposed by the ICN was utilized to define and validate the term informal settlement. Validation and literature review provided sufficient support for the defined characteristics and the term was finally defined and submitted to ICN on 12 April 2001 as informal settlement is a type of residential development with the specific characteristics--temporary residential structures, erected with limited or no formal infrastructure, densely populated, no secure tenure for occupants, no property demarcations, often associated with overcrowding/limited or no privacy, and low standard of living, being situated in high risk areas with an increased risk for disease and disasters. The ICNP Evaluation Committee recommended inclusion in the ICNP with minor changes in February 2003.

  7. Youth access to cigarettes in six sub-Saharan African countries.

    PubMed

    Chandora, Rachna; Song, Yang; Chaussard, Martine; Palipudi, Krishna Mohan; Lee, Kyung Ah; Ramanandraibe, Nivo; Asma, Samira

    2016-10-01

    Tobacco smoking is initiated and established mostly during adolescence. The World Health Organization (WHO) Framework Convention on Tobacco Control (FCTC) Article 16 outlines the obligation of parties to prohibit the sale of tobacco products to minors. This study examined where and how student smokers obtain cigarettes. We examined Global Youth Tobacco Survey (GYTS) data from 2009 to 2011 on cigarette access among students aged 13-15 in six sub-Saharan African countries. In all countries analyzed, over 20% of student smokers obtained their cigarettes in a store or shop (52.6% in South Africa, 37.7% in Republic of Congo, 28.2% in Swaziland, 27.4% in Cote d'Ivoire, 26.9% in Ghana, and 22.6% in Uganda). In Cote d'Ivoire and South Africa, 68.9% and 68.7% of student cigarette smokers, respectively, were not refused the sale of cigarettes because of age. The percentage of students who were offered free cigarettes by a tobacco company representative ranged from 4.7% in Cote d'Ivoire to 12.1% in South Africa. The method of obtaining cigarettes and access to cigarettes among students varies among sub-Saharan African countries. Adopting and enforcing interventions that prevent youth from accessing tobacco products could be an effective strategy for reducing smoking initiation among youth in sub-Saharan African countries. Copyright © 2016. Published by Elsevier Inc.

  8. Lessons Learned from Peace Operations in Africa (Africa Security Brief, Number 3, March 2010)

    DTIC Science & Technology

    2010-03-01

    flora and fauna . In financial terms, the direct and indirect cost of these conflicts is well over $700 billion.1 Peace operations are arguably the...1 Reducing the incidence of armed conflict re- mains a defining priority for Africa . The continent’s recent conflicts have killed millions and...principal inter- national instrument to curb conflict in Africa . Since 2000, the United Nations (UN) alone has spent over $32 billion on its 12

  9. Assessment of undiscovered oil and gas resources of the South Africa Coastal Province, Africa

    USGS Publications Warehouse

    Brownfield, Michael E.; Schenk, Christopher J.; Charpentier, Ronald R.; Klett, Timothy R.; Cook, Troy A.; Pollastro, Richard M.

    2012-01-01

    The South Africa Coastal Province along the South Africa coast recently was assessed for undiscovered, technically recoverable oil, natural gas, and natural gas liquids resources as part of the U.S. Geological Survey's (USGS) World Oil and Gas Assessment. Using a geology-based assessment methodology, the USGS estimated mean volumes of 2.13 billion barrels of oil, 35.96 trillion cubic feet of natural gas, and 1,115 million barrels of natural gas liquids.

  10. Ubuntu research values needed for Africa.

    PubMed

    Bateman, Chris

    2012-05-15

    Ex Africa semper aliquid novi. Africa's health researchers last month took greater collective responsibility for cultivating their continent's historically neglected and under-funded work when an international forum in Cape Town agreed on co-operative strategies to translate their findings into improving more lives on the ground.

  11. Exploring the floristic diversity of tropical Africa.

    PubMed

    Sosef, Marc S M; Dauby, Gilles; Blach-Overgaard, Anne; van der Burgt, Xander; Catarino, Luís; Damen, Theo; Deblauwe, Vincent; Dessein, Steven; Dransfield, John; Droissart, Vincent; Duarte, Maria Cristina; Engledow, Henry; Fadeur, Geoffrey; Figueira, Rui; Gereau, Roy E; Hardy, Olivier J; Harris, David J; de Heij, Janneke; Janssens, Steven; Klomberg, Yannick; Ley, Alexandra C; Mackinder, Barbara A; Meerts, Pierre; van de Poel, Jeike L; Sonké, Bonaventure; Stévart, Tariq; Stoffelen, Piet; Svenning, Jens-Christian; Sepulchre, Pierre; Zaiss, Rainer; Wieringa, Jan J; Couvreur, Thomas L P

    2017-03-07

    Understanding the patterns of biodiversity distribution and what influences them is a fundamental pre-requisite for effective conservation and sustainable utilisation of biodiversity. Such knowledge is increasingly urgent as biodiversity responds to the ongoing effects of global climate change. Nowhere is this more acute than in species-rich tropical Africa, where so little is known about plant diversity and its distribution. In this paper, we use RAINBIO - one of the largest mega-databases of tropical African vascular plant species distributions ever compiled - to address questions about plant and growth form diversity across tropical Africa. The filtered RAINBIO dataset contains 609,776 georeferenced records representing 22,577 species. Growth form data are recorded for 97% of all species. Records are well distributed, but heterogeneous across the continent. Overall, tropical Africa remains poorly sampled. When using sampling units (SU) of 0.5°, just 21 reach appropriate collection density and sampling completeness, and the average number of records per species per SU is only 1.84. Species richness (observed and estimated) and endemism figures per country are provided. Benin, Cameroon, Gabon, Ivory Coast and Liberia appear as the botanically best-explored countries, but none are optimally explored. Forests in the region contain 15,387 vascular plant species, of which 3013 are trees, representing 5-7% of the estimated world's tropical tree flora. The central African forests have the highest endemism rate across Africa, with approximately 30% of species being endemic. The botanical exploration of tropical Africa is far from complete, underlining the need for intensified inventories and digitization. We propose priority target areas for future sampling efforts, mainly focused on Tanzania, Atlantic Central Africa and West Africa. The observed number of tree species for African forests is smaller than those estimated from global tree data, suggesting that a

  12. Constitutional Reform and Violent Conflict: Lessons from Africa, for Africa

    DTIC Science & Technology

    2013-07-01

    gradual reform of Africa’s existing, centralized constitutional designs by counter-balancing them with liberal institutions, especially the separation of powers , which could foster both peace and democracy on the continent.

  13. Orphan/vulnerable child caregiving moderates the association between women's autonomy and their BMI in three African countries.

    PubMed

    Kanamori, Mariano; Carter-Pokras, Olivia; Madhavan, Sangeetha; Feldman, Robert; He, Xin; Lee, Sunmin

    2014-01-01

    Enhancement of women's autonomy is a key factor for improving women's health and nutrition. With nearly 12 million orphan and vulnerable children (OVC) in Africa due to HIV/AIDS, the study of OVC primary caregivers' nutrition is fundamental. We investigated the association between married women's autonomy and their nutritional status; explored whether this relationship was modified by OVC primary caregiving; and analyzed whether decision-making autonomy mediated the association between household wealth and body mass index (BMI). This cross-sectional study used the data from Demographic Health Surveys collected during 2006-2007 from 20- to 49-year-old women in Namibia (n = 2633), Swaziland (n = 1395), and Zambia (n = 2920). Analyses included logistic regression, Sobel, and Goodman tests. Our results indicated that women's educational attainment increased the odds for being overweight (Swaziland and Zambia) and decreased the odds for being underweight (Namibia). In Zambia, having at least primary education increased the odds for being overweight only among child primary caregivers regardless of the OVC status of the child, and having autonomy for buying everyday household items increased the odds for being overweight only among OVC primary caregivers. Decision-making autonomy mediated the association between household wealth and OVC primary caregivers' BMI in Zambia (Z = 2.13, p value = 0.03). We concluded that depending on each country's contextual characteristics, having education can decrease the odds for being an underweight woman or increase the odds for being an overweight woman. Further studies should explore why in Namibia education has an effect on women's overweight status only among women who are caring for a child.

  14. Coexistence of enriched and modern-like 142Nd signatures in Archean igneous rocks of the eastern Kaapvaal Craton, southern Africa

    NASA Astrophysics Data System (ADS)

    Schneider, Kathrin P.; Hoffmann, J. Elis; Boyet, Maud; Münker, Carsten; Kröner, Alfred

    2018-04-01

    The short-lived 146Sm-142Nd isotope system is an important tool for tracing Hadean crust-mantle differentiation processes and constraining their imprint on much younger rocks from Archean cratons. We report the first comprehensive set of high-precision 142Nd analyses for granitoids and amphibolites of the Ancient Gneiss Complex (AGC; Swaziland) and the oldest metavolcanic units of the Barberton Greenstone Belt (BGB; South Africa). The investigated samples span an age range from 3.66 Ga to 3.22 Ga and are representative of major geological units of the AGC and the lower Onverwacht Group of the BGB. Measured samples yielded μ142Nd values in the range from -8 ppm to +3 ppm relative to the JNdi-1 terrestrial standard, with typical errors smaller than 4.4 ppm. The distribution of the μ142Nd values for these 17 measured samples is bimodal with ten samples showing a tendency towards slightly negative μ142Nd anomalies, whereas seven samples have 142Nd similar to the terrestrial reference. The only confidently resolvable μ142Nd anomalies were found in a 3.44 Ga Ngwane Gneiss sample and in amphibolites of the ca. 3.45 Ga Dwalile Greenstone Remnant, revealing μ142Nd values ranging from - 7.9 ± 4.4 to - 6.1 ± 4.3 ppm. The μ142Nd deficits do not correlate with age, lithological unit, or sample locality. Instead, our results reveal that two distinct mantle domains were involved in the formation of the AGC crust. The two reservoirs can be distinguished by their μ142Nd signatures. Mantle-derived rocks tapped the enriched reservoir with negative μ142Nd at least until 3.46 Ga, whereas the granitoids preserved a negative μ142Nd signature that formed by incorporation of older AGC crust at least until 3.22 Ga. The oldest gneisses with no μ142Nd anomaly are up to 3.64 Ga in age, indicating that a modern terrestrial 142Nd reservoir was already present by early Archean times.

  15. Burn care in South Africa: a micro cosmos of Africa.

    PubMed

    Rode, H; Cox, S G; Numanoglu, A; Berg, A M

    2014-07-01

    Burn injuries in Africa are common with between 300,000 and 17.5 million children under 5 years sustaining burn injuries annually, resulting in a high estimated fatality rate. These burns are largely environmentally conditioned and therefore preventable. The Western Cape Province in South Africa can be regarded as a prototype of paediatric burns seen on the continent, with large numbers, high morbidity and mortality rates and an area inclusive of all factors contributing to this extraordinary burden of injury. Most of the mechanisms to prevent burns are not easily modified due to the restraint of low socio-economic homes, overcrowding, unsafe appliances, multiple and complex daily demands on families and multiple psycho-social stressors. Children <4 years are at highest risk of burns with an average annual rate of 6.0/10,000 child-years. Burn care in South Africa is predominantly emergency driven and variable in terms of organization, clinical management, facilities and staffing. Various treatment strategies were introduced. The management of HIV positive children poses a problem, as well as the conflict of achieving equity of burn care for all children. Without alleviating poverty, developing minimum standards for housing, burn education, safe appliances and legislation, we will not be able to reduce the "curse of poor people" and will continue to treat the consequences.

  16. [Hydatidosis in Africa in 1996: epidemiological aspects].

    PubMed

    Develoux, M

    1996-01-01

    Hydatidosis is hyperendemic in most north African countries and in several areas of East Africa. The cycle of infestation involves dogs, ruminants and man. While sheep and goats appear to be the most common domestic intermediate, camels appear to act as the intermediate in some parts of North and East Africa. Hydatidosis is considered to be essentially rural but urban cycles have been reported in North Africa. During the last decade, echotomographic, and serologic screening for human hydatidosis were carried out in Tunisia and in nomadic populations from East Africa. These surveys have provided reliable accurate prevalence data showing that hydatidosis is a major public health problem in these areas. The highest worldwide incidence in man is in the Turkana district of Kenya. This high incidence is related to promiscuity between humans and dogs in Turkana. A pilot program to control hydatid disease was started in Turkana over 10 years ago. For unknown reasons human infestation is rare in West and Southern Africa despite the presence of hydatidosis in cattle.

  17. West Africa

    NASA Technical Reports Server (NTRS)

    2002-01-01

    With its vast expanses of sand, framed by mountain ranges and exposed rock, northwestern Africa makes a pretty picture when viewed from above. This image was acquired by the Moderate-resolution Imaging Spectroradiometer (MODIS), flying aboard NASA's Terra spacecraft. The Canary Islands can be seen on the left side of the image just off Africa's Atlantic shore. The light brown expanse running through the northern two thirds of the image is the Sahara Desert. The desert runs up against the dark brown Haut Atlas mountain range of Morocco in the northwest, the Atlantic Ocean to the west and the semi-arid (light brown pixels) Sahelian region in the South. The Sahara, however, isn't staying put. Since the 1960s, the desert has been expanding into the Sahelian region at a rate of up to 6 kilometers per year. In the 1980s this desert expansion, combined with over cultivation of the Sahel, caused a major famine across west Africa. Over the summer months, strong winds pick up sands from the Sahara and blow them across the Atlantic as far west as North America, causing air pollution in Miami and damaging coral reefs in the Bahamas and the Florida Keys. The white outlines on the map represent country borders. Starting at the top-most portion of the map and working clockwise, the countries shown are Morocco, Western Sahara, Mauritania, Senegal, Mali, Burkina Fasso, Nigeria, Mali (again), and Algeria. Image by Reto Stockli, Robert Simmon, and Brian Montgomery, NASA Earth Observatory, based on data from MODIS

  18. The Macroeconomic Consequences of Renouncing to Universal Access to Antiretroviral Treatment for HIV in Africa: A Micro-Simulation Model

    PubMed Central

    Ventelou, Bruno; Arrighi, Yves; Greener, Robert; Lamontagne, Erik; Carrieri, Patrizia; Moatti, Jean-Paul

    2012-01-01

    Aim Previous economic literature on the cost-effectiveness of antiretroviral treatment (ART) programs has been mainly focused on the microeconomic consequences of alternative use of resources devoted to the fight against the HIV pandemic. We rather aim at forecasting the consequences of alternative scenarios for the macroeconomic performance of countries. Methods We used a micro-simulation model based on individuals aged 15–49 selected from nationally representative surveys (DHS for Cameroon, Tanzania and Swaziland) to compare alternative scenarios : 1-freezing of ART programs to current levels of access, 2- universal access (scaling up to 100% coverage by 2015, with two variants defining ART eligibility according to previous or current WHO guidelines). We introduced an “artificial” ageing process by programming methods. Individuals could evolve through different health states: HIV negative, HIV positive (with different stages of the syndrome). Scenarios of ART procurement determine this dynamics. The macroeconomic impact is obtained using sample weights that take into account the resulting age-structure of the population in each scenario and modeling of the consequences on total growth of the economy. Results Increased levels of ART coverage result in decreasing HIV incidence and related mortality. Universal access to ART has a positive impact on workers' productivity; the evaluations performed for Swaziland and Cameroon show that universal access would imply net cost-savings at the scale of the society, when the full macroeconomic consequences are introduced in the calculations. In Tanzania, ART access programs imply a net cost for the economy, but 70% of costs are covered by GDP gains at the 2034 horizon, even in the extended coverage option promoted by WHO guidelines initiating ART at levels of 350 cc/mm3 CD4 cell counts. Conclusion Universal Access ART scaling-up strategies, which are more costly in the short term, remain the best economic choice in the

  19. The macroeconomic consequences of renouncing to universal access to antiretroviral treatment for HIV in Africa: a micro-simulation model.

    PubMed

    Ventelou, Bruno; Arrighi, Yves; Greener, Robert; Lamontagne, Erik; Carrieri, Patrizia; Moatti, Jean-Paul

    2012-01-01

    Previous economic literature on the cost-effectiveness of antiretroviral treatment (ART) programs has been mainly focused on the microeconomic consequences of alternative use of resources devoted to the fight against the HIV pandemic. We rather aim at forecasting the consequences of alternative scenarios for the macroeconomic performance of countries. We used a micro-simulation model based on individuals aged 15-49 selected from nationally representative surveys (DHS for Cameroon, Tanzania and Swaziland) to compare alternative scenarios : 1-freezing of ART programs to current levels of access, 2- universal access (scaling up to 100% coverage by 2015, with two variants defining ART eligibility according to previous or current WHO guidelines). We introduced an "artificial" ageing process by programming methods. Individuals could evolve through different health states: HIV negative, HIV positive (with different stages of the syndrome). Scenarios of ART procurement determine this dynamics. The macroeconomic impact is obtained using sample weights that take into account the resulting age-structure of the population in each scenario and modeling of the consequences on total growth of the economy. Increased levels of ART coverage result in decreasing HIV incidence and related mortality. Universal access to ART has a positive impact on workers' productivity; the evaluations performed for Swaziland and Cameroon show that universal access would imply net cost-savings at the scale of the society, when the full macroeconomic consequences are introduced in the calculations. In Tanzania, ART access programs imply a net cost for the economy, but 70% of costs are covered by GDP gains at the 2034 horizon, even in the extended coverage option promoted by WHO guidelines initiating ART at levels of 350 cc/mm(3) CD4 cell counts. Universal Access ART scaling-up strategies, which are more costly in the short term, remain the best economic choice in the long term. Renouncing or

  20. Dengue expansion in Africa-not recognized or not happening?

    PubMed

    Jaenisch, Thomas; Junghanss, Thomas; Wills, Bridget; Brady, Oliver J; Eckerle, Isabella; Farlow, Andrew; Hay, Simon I; McCall, Philip J; Messina, Jane P; Ofula, Victor; Sall, Amadou A; Sakuntabhai, Anavaj; Velayudhan, Raman; Wint, G R William; Zeller, Herve; Margolis, Harold S; Sankoh, Osman

    2014-10-01

    An expert conference on Dengue in Africa was held in Accra, Ghana, in February 2013 to consider key questions regarding the possible expansion of dengue in Africa. Four key action points were highlighted to advance our understanding of the epidemiology of dengue in Africa. First, dengue diagnostic tools must be made more widely available in the healthcare setting in Africa. Second, representative data need to be collected across Africa to uncover the true burden of dengue. Third, established networks should collaborate to produce these types of data. Fourth, policy needs to be informed so the necessary steps can be taken to provide dengue vector control and health services.

  1. West Africa land use and land cover time series

    USGS Publications Warehouse

    Cotillon, Suzanne E.

    2017-02-16

    Started in 1999, the West Africa Land Use Dynamics project represents an effort to map land use and land cover, characterize the trends in time and space, and understand their effects on the environment across West Africa. The outcome of the West Africa Land Use Dynamics project is the production of a three-time period (1975, 2000, and 2013) land use and land cover dataset for the Sub-Saharan region of West Africa, including the Cabo Verde archipelago. The West Africa Land Use Land Cover Time Series dataset offers a unique basis for characterizing and analyzing land changes across the region, systematically and at an unprecedented level of detail.

  2. South Africa Country Analysis Brief

    EIA Publications

    2015-01-01

    South Africa has a large energy-intensive coal mining industry. The country has limited proved reserves of oil and natural gas and uses its large coal deposits to meet most of its energy needs, particularly in the electricity sector. South Africa also has a sophisticated synthetic fuels industry, producing gasoline and diesel fuels from the Secunda coal-to-liquids (CTL) and Mossel Bay gas-to-liquids (GTL) plants

  3. Low-Quality Housing Is Associated With Increased Risk of Malaria Infection: A National Population-Based Study From the Low Transmission Setting of Swaziland.

    PubMed

    Dlamini, Nomcebo; Hsiang, Michelle S; Ntshalintshali, Nyasatu; Pindolia, Deepa; Allen, Regan; Nhlabathi, Nomcebo; Novotny, Joseph; Kang Dufour, Mi-Suk; Midekisa, Alemayehu; Gosling, Roly; LeMenach, Arnaud; Cohen, Justin; Dorsey, Grant; Greenhouse, Bryan; Kunene, Simon

    2017-01-01

    Low-quality housing may confer risk of malaria infection, but evidence in low transmission settings is limited. To examine the relationship between individual level housing quality and locally acquired infection in children and adults, a population-based cross-sectional analysis was performed using existing surveillance data from the low transmission setting of Swaziland. From 2012 to 2015, cases were identified through standard diagnostics in health facilities and by loop-mediated isothermal amplification in active surveillance, with uninfected subjects being household members and neighbors. Housing was visually assessed in a home visit and then classified as low, high, or medium quality, based on housing components being traditional, modern, or both, respectively. Overall, 11426 individuals were included in the study: 10960 uninfected and 466 infected (301 symptomatic and 165 asymptomatic). Six percent resided in low-quality houses, 26% in medium-quality houses, and 68% in high-quality houses. In adjusted models, low- and medium-quality construction was associated with increased risk of malaria compared with high-quality construction (adjusted odds ratio [AOR], 2.11 and 95% confidence interval [CI], 1.26-3.53 for low vs high; AOR, 1.56 and 95% CI, 1.15-2.11 for medium vs high). The relationship was independent of vector control, which also conferred a protective effect (AOR, 0.67; 95% CI, .50-.90) for sleeping under an insecticide-treated bed net or a sprayed structure compared with neither. Our study adds to the limited literature on housing quality and malaria risk from low transmission settings. Housing improvements may offer an attractive and sustainable additional strategy to support countries in malaria elimination. © The Author 2017. Published by Oxford University Press on behalf of Infectious Diseases Society of America.

  4. Health Promoting Schools: Initiatives in Africa

    ERIC Educational Resources Information Center

    Macnab, Andrew J.; Stewart, Donald; Gagnon, Faith A.

    2014-01-01

    Purpose: The purpose of this paper is to describe the rationale for and potential of World Health Organization (WHO) health promoting schools (HPS) in Africa. Design/Methodology/Approach: Overview of the related literature and presentations at the 2011 Stellenbosch international colloquium on HPS relating to sub-Saharan Africa. Findings: Schools…

  5. The physician-scientists: rare species in Africa.

    PubMed

    Adefuye, Anthonio Oladele; Adeola, Henry Ademola; Bezuidenhout, Johan

    2018-01-01

    There is paucity of physician-scientists in Africa, resulting in overt dependence of clinical practice on research findings from advanced "first world" countries. Physician-scientists include individuals with a medical degree alone or combined with other advanced degrees (e.g. MD/MBChB and PhD) with a career path in biomedical/ translational and patient-oriented/evaluative science research. The paucity of clinically trained research scientists in Africa could result in dire consequences as exemplified in the recent Ebola virus epidemic in West Africa, where shortage of skilled clinical scientists, played a major role in disease progression and mortality. Here we contextualise the role of physician-scientist in health care management, highlight factors limiting the training of physician-scientist in Africa and proffer implementable recommendations to address these factors.

  6. The Consortium for NCD Prevention and Control in Sub-Saharan Africa (CNCD-Africa): from concept to practice.

    PubMed

    Amuyunzu-Nyamongo, Mary; Owuor, Jared O; Blanchard, Claire

    2013-12-01

    CNCD-Africa was established in July 2009 in response to and in recognition of the continuously increasing burden of diseases such as injuries, non-communicable diseases (NCDs) and mental health in low- and middle-income countries, and specifically in countries of sub-Saharan Africa. CNCD-Africa aims to comprehensively address specific and common objectives while building capacity in the region to prevent and control NCDs. With support from key partners and funders, and a keen interest in opportunities to address NCDs from health promotion and equity perspectives, the Consortium has excelled in four key areas: convening; knowledge generation and sharing; advocacy; and networking. However, the path to successful and sustainable efforts remains laden with challenges and barriers. Retaining interest of network partners through flagship efforts and continued efforts to ascertain support from local and international partners with interest in NCDs across the region remain essential to CNCD-Africa core activities. A key lesson learnt from the early years of CNCD-Africa is that existing regional platforms can and should be used to showcase what is being done locally, and to share best practices and best-buys. In addition, partnerships and stakeholder involvement have been key for CNCD-Africa and are essential to NCD action. Sustaining such partnerships requires incentives for the various partners to keep actively involved in NCD action. This can be achieved through joint inception, project planning, implementation, monitoring and evaluation. Another ingredient for success seems to be innovative financing for NCD efforts, which is possible through the establishment and sustaining of regional and global partnerships that are robust, locally relevant and respond to country needs.

  7. eGY-Africa: addressing the digital divide for science in Africa

    NASA Astrophysics Data System (ADS)

    Baki, Paul; Nguno, Anna; Barton, Charles; Amaeshi, Larry; Tenthani, Chifundo; Petitdidier, Monique; Cottrell, Les

    2013-04-01

    Adoption of information and communication technologies and access to the Internet is expanding in Africa, but because of the rapid growth elsewhere, a Digital Divide between Africa and the rest of the world exists. In many sub-Saharan African countries, education and research sector suffers some of the worst deficiencies in access to the Internet, despite progress in the development of NRENs - National Research and Education (cyber) Networks. By contrast, it is widely acknowledged in policy statements from the African Union, the UN, and others that strength in this very sector provides the key to meeting and sustaining Millennium Development Goals. Developed countries with effective cyber-capabilities proclaim the benefits to rich and poor alike arising from the Information Revolution. This is still a dream for many scientists in African institutions. As the world of science becomes increasingly Internet-dependent, so they become increasingly isolated. eGY-Africa is a bottom-up initiative by African scientists and their collaborators to try to reduce this digital divide by a campaign of advocacy for better institutional facilities. Four approaches are being taken. The present status of Internet services, problems, and plans are being mapped via a combination of direct measurement of Internet performance (the PingER Project) and a questionnaire-based survey. Information is being gathered on policy statements and initiatives aimed at reducing the digital divide, which can be used for arguing the case for better Internet facilities. Groups of concerned scientists are being formed at the national, regional levels in Africa, building on existing networks as much as possible. Opinion in the international science community is being mobilized. Finally, and perhaps most important of all, eGY-Africa is seeking to engage with the many other programs, initiatives, and bodies that share the goal of reducing the digital divide - either as a direct policy objective, or indirectly

  8. Stress-Testing South Africa: The Tenuous Foundations of One of Africa’s Stable States

    DTIC Science & Technology

    2011-07-01

    Africa 7 and unable to deliver the benefits promised to the population by the liberators . Fully 72 percent of South Africans believe some, most, or all...the apartheid-era National Intelligence Service (NIS) was downsized and integrated with the intelligence structures of the liberation movement, the...and Africa’s Energy Resources” in Portugal, os Estados Unidos e a Africa Austral (Instituto Português de Relações Internacionais, 2006). Among the

  9. Telerehabilitation in South Africa - is there a way forward?

    PubMed

    Mars, Maurice

    2011-01-01

    South Africa, like the rest of sub-Saharan Africa, has a disproportionate burden of disease and a shortage of health professionals. Telemedicine has been identified as a possible way of overcoming part of the problem but telemedicine has not been widely adopted. In the public sector hospitals in South Africa which serve 82% of the population there are 2.5 physiotherapists and 2 occupational therapists per 100,000 people served. The extent of telerehabilitation in South Africa is unknown. A literature review of telerehabilitation found no papers from South Africa. A survey of the heads of university departments of physiotherapy, occupational therapy and speech and language pathology revealed limited knowledge of telerehabilitation. Telerehabilitation services are confined to follow-up of patients at some institutions by telephone, fax or email. There is need to raise awareness among therapists if telerehabilitation is to become a reality in South Africa. Future actions are outlined.

  10. Addressing South Africa's Engineering Skills Gaps

    ERIC Educational Resources Information Center

    Hall, Jonathan; Sandelands, Eric

    2009-01-01

    Purpose: This paper aims to provide a case study of how engineering skills gaps are being addressed by Murray & Roberts in South Africa. Design/methodology/approach: The paper focuses on skills challenges in South Africa from a reflective practitioner perspective, exploring a case example from an industry leader. Findings: The paper explores…

  11. Economic Statecraft: China in Africa

    DTIC Science & Technology

    2013-01-01

    place as Africa’s lead trading partner in 2010. 15 David H. Shinn, “The Impact of China’s Growing Influence in Africa,” The European Financial ...percent in the continent’s five largest economies: South Africa (21 percent), Egypt (12 percent), Nigeria (10 percent), Algeria (7 percent), and Morocco...decade while developed economies have suffered through a financial crisis and sluggish growth. These resources have been important to help the PRC meet

  12. OER in Africa's Higher Education Institutions

    ERIC Educational Resources Information Center

    Ngugi, Catherine N.

    2011-01-01

    Higher education in Africa has had diverse histories and trajectories, and has played different roles over time. This article is concerned with the evolution and future of higher education on the continent, and the role that open educational resources (OER) might play therein. It is generally accepted that "the university in Africa and higher…

  13. Moko Jumbies: Dancing Spirits from Africa

    ERIC Educational Resources Information Center

    Bennett, S. A.; Phillips, Claire; Moore, Natalie

    2009-01-01

    The original Moko Jumbie was a spirit dancer from West Africa. "Moko" is a West African word that refers to gods and "Jumbie" means ghost. In West Africa, Moko Jumbies are known to kidnap and eat disobedient children, steal dreams and see into evildoers' hearts and terrorize them. They walk through villages on 10- to…

  14. Processes Affecting Tropospheric Ozone over Africa

    NASA Technical Reports Server (NTRS)

    Diab, Roseanne D.; Thompson, Anne M.

    2004-01-01

    This is a Workshop Report prepared for Eos, the weekly AGU magazine, The workshop took place between 26-28 January 2004 at the University of KwaZulu-Natal in Durban, South Africa and was attended by 26 participants (http//www.geography.und.ac.za). Considerable progress has been made in ozone observations except for northern Africa (large data gaps) and west Africa (to be covered by the French-sponsored AMMA program). The present-day ozone findings were evaluated and reviewed by speakers using Aircraft data (MOZAIC program), NASA satellites (MOPITT, TRMM, TOMS) and ozone soundings (SHADOZ). Besides some ozone gaps, there are challenges posed by the need to assess the relative strengths of photochemical and dynamic influences on the tropospheric ozone budget. Biogenic, biofuels, biomass burning sources of ozone precursors remain highly uncertain. Recent findings (by NASA's Chatfield and Thompson, using satellite and sounding data) show significant impact of Indian Ocean pollution on African ozone. European research on pollutants over the Mediterranean and the middle east, that suggests that ozone may be exported to Africa from these areas, also needs to be considered.

  15. [[History of Community Health in Africa. The Swiss Medical Missionaries' Endeavour in South Africa].

    PubMed

    Mabika, Hines

    2015-01-01

    It was not Dutch settlers nor British colonizers who introduced public and community health practice in north-eastern South Africa but medical doctors of the Swiss mission in southern Africa. While the history of medical knowledge transfer into 19th-20th century Africa emphasises colonial powers, this paper shows how countries without colonies contributed to expand western medical cultures, including public health. The Swiss took advantage of the local authorities' negligence, and implemented their own model of medicalization of African societies, understood as the way of improving health standards. They moved from a tolerated hospital-centred medicine to the practice of community health, which was uncommon at the time. Elim hospital's physicians moved back boundaries of segregationist policies, and sometime gave the impression of being involved in the political struggle against Apartheid. Thus, Swiss public health activities could later be seen as sorts of seeds that were planted and would partly reappear in 1994 with the ANC-projected national health policy.

  16. Regional patterns in the paragenesis and age of inclusions in diamond, diamond composition, and the lithospheric seismic structure of Southern Africa

    NASA Astrophysics Data System (ADS)

    Shirey, Steven B.; Harris, Jeffrey W.; Richardson, Stephen H.; Fouch, Matthew; James, David E.; Cartigny, Pierre; Deines, Peter; Viljoen, Fanus

    2003-12-01

    The Archean lithospheric mantle beneath the Kaapvaal-Zimbabwe craton of Southern Africa shows ±1% variations in seismic P-wave velocity at depths within the diamond stability field (150-250 km) that correlate regionally with differences in the composition of diamonds and their syngenetic inclusions. Seismically slower mantle trends from the mantle below Swaziland to that below southeastern Botswana, roughly following the surface outcrop pattern of the Bushveld-Molopo Farms Complex. Seismically slower mantle also is evident under the southwestern side of the Zimbabwe craton below crust metamorphosed around 2 Ga. Individual eclogitic sulfide inclusions in diamonds from the Kimberley area kimberlites, Koffiefontein, Orapa, and Jwaneng have Re-Os isotopic ages that range from circa 2.9 Ga to the Proterozoic and show little correspondence with these lithospheric variations. However, silicate inclusions in diamonds and their host diamond compositions for the above kimberlites, Finsch, Jagersfontein, Roberts Victor, Premier, Venetia, and Letlhakane do show some regional relationship to the seismic velocity of the lithosphere. Mantle lithosphere with slower P-wave velocity correlates with a greater proportion of eclogitic versus peridotitic silicate inclusions in diamond, a greater incidence of younger Sm-Nd ages of silicate inclusions, a greater proportion of diamonds with lighter C isotopic composition, and a lower percentage of low-N diamonds whereas the converse is true for diamonds from higher velocity mantle. The oldest formation ages of diamonds indicate that the mantle keels which became continental nuclei were created by middle Archean (3.2-3.3 Ga) mantle depletion events with high degrees of melting and early harzburgite formation. The predominance of sulfide inclusions that are eclogitic in the 2.9 Ga age population links late Archean (2.9 Ga) subduction-accretion events involving an oceanic lithosphere component to craton stabilization. These events resulted

  17. Reversing Africa's Decline. Worldwatch Paper 65.

    ERIC Educational Resources Information Center

    Brown, Lester R.; Wolf, Edward C.

    This paper highlights some of the themes that any successful strategy to reverse the decline of Africa must embrace. Africa is a continent experiencing a breakdown in the relationship between people and their natural support systems. Famine and the threat of famine are among the manifestations of this breakdown. This decline can be reversed. To do…

  18. The Flynn Effect in South Africa

    ERIC Educational Resources Information Center

    te Nijenhuis, Jan; Murphy, Raegan; van Eeden, Rene

    2011-01-01

    This is a study of secular score gains in South Africa. The findings are based on representative samples from datasets utilized in norm studies of popular mainstream intelligence batteries such as the WAIS as well as widely used test batteries which were locally developed and normed in South Africa. Flynn effects were computed in three ways.…

  19. A landslide susceptibility map of Africa

    NASA Astrophysics Data System (ADS)

    Broeckx, Jente; Vanmaercke, Matthias; Duchateau, Rica; Poesen, Jean

    2017-04-01

    Studies on landslide risks and fatalities indicate that landslides are a global threat to humans, infrastructure and the environment, certainly in Africa. Nonetheless our understanding of the spatial patterns of landslides and rockfalls on this continent is very limited. Also in global landslide susceptibility maps, Africa is mostly underrepresented in the inventories used to construct these maps. As a result, predicted landslide susceptibilities remain subject to very large uncertainties. This research aims to produce a first continent-wide landslide susceptibility map for Africa, calibrated with a well-distributed landslide dataset. As a first step, we compiled all available landslide inventories for Africa. This data was supplemented by additional landslide mapping with Google Earth in underrepresented regions. This way, we compiled 60 landslide inventories from the literature (ca. 11000 landslides) and an additional 6500 landslides through mapping in Google Earth (including 1500 rockfalls). Various environmental variables such as slope, lithology, soil characteristics, land use, precipitation and seismic activity, were investigated for their significance in explaining the observed spatial patterns of landslides. To account for potential mapping biases in our dataset, we used Monte Carlo simulations that selected different subsets of mapped landslides, tested the significance of the considered environmental variables and evaluated the performance of the fitted multiple logistic regression model against another subset of mapped landslides. Based on these analyses, we constructed two landslide susceptibility maps for Africa: one for all landslide types and one excluding rockfalls. In both maps, topography, lithology and seismic activity were the most significant variables. The latter factor may be surprising, given the overall limited degree of seismicity in Africa. However, its significance indicates that frequent seismic events may serve as in important

  20. The State of Adult and Continuing Education in Africa.

    ERIC Educational Resources Information Center

    Indabawa, Sabo A., Ed.; Oduaran, Akpovire, Ed.; Afrik, Tai, Ed.; Walters, Shirley, Ed.

    This document contains 21 papers examining the state of adult and continuing education in Africa. The following papers are included: "Introduction: An Overview of the State of Adult and Continuing Education in Africa" (Akpovire Oduaran); "Setting the Tone of Adult and Continuing Education in Africa" (Michael A. Omolewa);…