Science.gov

Sample records for cape town uct

  1. Bricolage: Re-Discovering History through Intermediality and Performance. A Report on the UCT/CityVarsity Production of "A Day, Across" at the Cape Town Fringe 2014

    ERIC Educational Resources Information Center

    Muftic, Sanjin

    2016-01-01

    "A Day, Across," performed by the CityVarsity School of Creative Arts at the Cape Town Fringe 2014, was a student production that investigated the link between the youth of South Africa and the centennial of the start of World War I. This paper presents a brief analysis of the rehearsal process as well as certain performance sequences in…

  2. Bricolage: Re-Discovering History through Intermediality and Performance. A Report on the UCT/CityVarsity Production of "A Day, Across" at the Cape Town Fringe 2014

    ERIC Educational Resources Information Center

    Muftic, Sanjin

    2016-01-01

    "A Day, Across," performed by the CityVarsity School of Creative Arts at the Cape Town Fringe 2014, was a student production that investigated the link between the youth of South Africa and the centennial of the start of World War I. This paper presents a brief analysis of the rehearsal process as well as certain performance sequences in…

  3. The Role of Postgraduate Students in Co-Authoring Open Educational Resources to Promote Social Inclusion: A Case Study at the University of Cape Town

    ERIC Educational Resources Information Center

    Hodgkinson-Williams, Cheryl; Paskevicius, Michael

    2012-01-01

    Like many universities worldwide, the University of Cape Town (UCT) in South Africa has joined the open educational resources (OER) movement, making a selection of teaching and learning materials available through its OER directory, UCT OpenContent. However, persuading and then supporting busy academics to share their teaching materials as OER…

  4. The Role of Postgraduate Students in Co-Authoring Open Educational Resources to Promote Social Inclusion: A Case Study at the University of Cape Town

    ERIC Educational Resources Information Center

    Hodgkinson-Williams, Cheryl; Paskevicius, Michael

    2012-01-01

    Like many universities worldwide, the University of Cape Town (UCT) in South Africa has joined the open educational resources (OER) movement, making a selection of teaching and learning materials available through its OER directory, UCT OpenContent. However, persuading and then supporting busy academics to share their teaching materials as OER…

  5. 77 FR 29929 - Safety Zone; Town of Cape Charles Fireworks, Cape Charles Harbor, Cape Charles, VA

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-05-21

    ... Harbor in Cape Charles, VA in support of the Fourth of July Fireworks event. This action is intended to... rule, when finalized, will be effective on July 4th and 5th, 2012. Public Participation and Request for.... Basis and Purpose On July 4, 2012 the Town of Cape Charles will sponsor a fireworks display on the...

  6. The transport of atmospheric sulfur over Cape Town

    NASA Astrophysics Data System (ADS)

    Jenner, Samantha L.; Abiodun, Babatunde J.

    2013-11-01

    Cape Town, renowned for its natural beauty, is troubled by an unpleasant brown haze pollution, in which atmospheric sulfur plays a major role. This study investigates whether Cape Town is a net producer or recipient of anthropogenic sulfur pollution. In the study, two atmospheric chemistry-transport models (RegCM and WRF) are used to simulate atmospheric flow and chemistry transport over South Africa for two years (2001 and 2002). Both models reproduce the observed seasonal variability in the atmospheric flow and SO2 concentration over Cape Town. The models simulations agree on the seasonal pattern of SO2 over South Africa but disagree on that of SO4. The simulations show that ambient sulfur in Cape Town may be linked with pollutant emissions from the Mpumalanga Highveld, South Africa's most industrialized region. While part of atmospheric SO2 from the Highveld is transported at 700 hPa level toward the Indian Ocean (confirming previous studies), part is transported at low level from the Highveld toward Cape Town. In April, a band of high concentration SO2 extends between the Highveld and Cape Town, following the south coast. Extreme sulfur pollution events in Cape Town are associated with weak flow convergence or stagnant conditions over the city, both of which encourage the accumulation of pollution. However the study suggests that atmospheric sulfur is being advected from Mpumalanga Highveld to Cape Town and this may contribute to atmospheric pollution problems in Cape Town.

  7. Transport of atmospheric NOx and HNO3 over Cape Town

    NASA Astrophysics Data System (ADS)

    Abiodun, B. J.; Ojumu, A. M.; Jenner, S.; Ojumu, T. V.

    2013-05-01

    Cape Town, the most popular tourist city in Africa, usually experiences air pollution with unpleasant odour in winter. Previous studies have associated the pollution with local emission of pollutants within the city. The present study examines the transport of atmospheric pollutants (NOx and HNO3) over South Africa and shows how the transport of pollutants from the Mpumalanga Highveld may contribute to the pollution in Cape Town. The study analysed observation data (2001-2008) from Cape Town air quality network and simulation data (2001-2004) from regional climate model (RegCM4) over southern Africa. The simulation accounts for the influence of complex topography, atmospheric condition, and atmospheric chemistry on emission and transport of pollutants over southern Africa. Flux budget analysis was used to examine whether Cape Town is a source or sink for NOx and HNO3 during the extreme pollution events. The results show that extreme pollution events over Cape Town are associated with the low-level (surface-850 hPa) transport of NOx from the Mpumalanga Highveld to Cape Town, and with a tongue of high concentration of HNO3 that extends from the Mpumalanga Highveld to Cape Town along the south coast of South Africa. The prevailing atmospheric conditions during the extreme pollution events feature an upper-level (700 hPa) anticyclonic flow over South Africa and a low-level col over Cape Town. The anticyclonic flow induces a strong subsidence motion, which prevents vertical mixing of the pollutants and caps high concentration of pollutants close to the surface as they are transported from the Mpumalanga Highveld toward Cape Town, while the col accumulates the pollutants over the city. This study shows that Cape Town can be a sink for the NOx and HNO3 during extreme pollution events and suggests that the accumulation of pollutants transported from other areas (e.g. Mpumalanga Highveld) may contribute substantially to the air pollution in Cape Town.

  8. The Cape Town Statement on Geoethics

    NASA Astrophysics Data System (ADS)

    Di Capua, Giuseppe; Peppoloni, Silvia; Bobrowsky, Peter

    2017-04-01

    The interest of geoscientists in (geo)ethical aspects of geoscience knowledge, education, research and practice is rising and today geoethics has a significant visibility. This prominence is the result of hard work done in the last 4 years by the IAPG - International Association for Promoting Geoethics (http://www.geoethics.org), a not-for-profit, multidisciplinary, scientific network (with more than 1350 members in 107 countries) established for widening the discussion and creating awareness about problems of ethics applied to the geosciences. IAPG has produced a strong conceptual substratum on which to base the future development of geoethics, by clarifying the meaning of the word Geoethics, formalizing its definition, and identifying a framework of reference values on which the geoscience community can base more effective codes of conduct. IAPG members have published numerous books and articles in peer reviewed international journals, and organized scientific sessions to bring geoethics at the most important geoscience conferences. Geoethical issues have been included in the European project ENVRI-Plus, dedicated to the environmental and solid Earth research infrastructures. Moreover, the most prestigious geoscience organizations around the world now recognize geoethics as an important issue that warrants attention. This success was confirmed by the high quality of contents and the large participation of scientists in the 6 technical sessions and single panel session on geoethics organized by IAPG at the 35th IGC - International Geological Congress, held in 2016 in Cape Town (South Africa), with the cooperative work of different geoscience organizations (IUGS-TGGP - Task Group on Global Geoscience Professionalism; GSL - Geological Society of London; EFG - European Federation of Geologists; EGS - EuroGeoSurveys; AGI - American Geosciences Institute; AGU - American Geophysical Union, and AAWG - African Association of Women in Geosciences). IAPG considers the 35th

  9. Peritoneal Dialysis in Cape Town, South Africa

    PubMed Central

    Okpechi, Ikechi G.; Rayner, Brian L.; Swanepoel, Charles R.

    2012-01-01

    ♦ Background: Chronic kidney disease is a major public health problem in sub-Saharan Africa (SSA), which encompasses 70% of the least-developed countries in the world. Most people in SSA have no access to any form of renal replacement therapy (RRT). Given its ease of performance and patient independence, peritoneal dialysis (PD) should be an ideal form of RRT in SSA, but several complex and interdependent factors make PD a difficult option in SSA. The present review describes the practice of PD in SSA, with emphasis on Cape Town, South Africa. ♦ Methods and Results: After a review of the recent PubMed literature on RRT in SSA and an appraisal of nephrology practice in South Africa, factors that make the provision of RRT (especially PD) a challenge in SSA include the low number of qualified health care workers, socio-demographic issues (poor housing, electricity, and water supplies), and the cost of PD fluids in the region. Although South Africa has the largest PD population in all of SSA, the growth of PD in South Africa is specifically impeded by the system of RRT rationing, which favors HD; the methods of funding for dialysis and for remuneration of doctors in private practice; and many other socio-economic factors. The peritonitis rate remains relatively high, and it is a significant contributor to morbidity in PD patients in Cape Town. ♦ Conclusions: In many parts of SSA, PD could be the main dialysis modality. However, African governments must start taking responsibility for their people by providing adequate funds for renal replacement programs. Attempts to produce PD fluids locally and to train and educate health care workers will greatly improve the use of PD as a RRT option in SSA. PMID:22641735

  10. Tropospheric ozone and its regional transport over Cape Town

    NASA Astrophysics Data System (ADS)

    Nzotungicimpaye, Claude-Michel; Abiodun, Babatunde J.; Steyn, Douw G.

    2014-04-01

    As part of efforts to understand the sources of air pollution in Cape Town, this study investigates the local variation of tropospheric ozone (O3) and identifies possible advection paths of O3 pollution from a remote source to Cape Town. Measurements of O3 and wind from three sites in the Cape Town area were analyzed to study the local variations of O3. At each site, the diurnal variation of O3 is found to be mainly driven by photochemical production while the seasonal variation of O3 is mostly driven by wind conditions. The highest concentration of O3 is observed at the remote site (Cape Point) while lowest O3 concentration is observed at the sub-urban site (Goodwood), where there are chemical sinks of O3 such as NOx. Atmospheric pollution over southern Africa was simulated to study the regional transport of O3. The simulations show that extreme O3 levels in Cape Town can be caused by air pollution transported from the industrial Highveld of South Africa, in the lower troposphere. Such extreme O3 pollution events over Cape Town are simulated to occur in January (14%), March (44%), April (28%) and September (14%). Lagrangian trajectories suggest four paths by which air parcels can be transported from the industrial Highveld to Cape Town: a north-easterly path which is the most frequent route, a tropical deviation route, a deviation along the south coastline and an oceanic deviation path which is the less frequent route. The major advection paths associated with poor air quality in Cape Town are the north-easterly route and the path along the south coastline of the country. Hence the study suggests that emissions in the industrial Highveld may contribute to O3 concentration in the Cape Town area.

  11. Enabling disability inclusive practices within the University of Cape Town curriculum: A case study.

    PubMed

    Ohajunwa, Chioma; Mckenzie, Judith; Lorenzo, Theresa

    2015-01-01

    Disability inclusion in the curricula of higher education institutions contributes to socially responsive graduates with a capacity to address the cross-cutting issue of disability in development. This article discusses a study conducted at the University of Cape Town (UCT), South Africa, to explore disability inclusion. An instrumental case study approach was adopted and a thematic analysis of data was done. Academic staff found a variety of ways to include disability, such as discussions in class, practice and service learning, but mainly as part of disciplinary requirements. Including disability as an issue of social justice stems mostly from the personal interest of staff, and is done in an ad hoc manner. Disability should be valued, and integrated into the curriculum in a structured manner as a perspective on diversity with which to interrogate our beliefs about ourselves and society. Theorising on disability is needed, as well as the unique perspectives that emerge across interdisciplinary boundaries, especially within the African context.

  12. "Cape Town, South Africa taken from Atlantis during STS-106"

    NASA Image and Video Library

    2000-09-19

    STS106-713-057 (19 September 2000) --- One of the STS-106 crew members on board the Space Shuttle Atlantis used a handheld 70mm camera to photograph this image of Cape Town and the Karroo Ranges in South Africa. Cape Town occupies the north end of the Cape of Good Hope peninsula and extends to the shore of False Bay. The city is home to about 2.7 million people. Tourism and viticulture contribute importantly to the local economy, and the city is a service center for government and industry -- particularly mining. The great folded mountain ranges of South Africa were formed during the assembly of the ancient super continent of Gondwana. Broad N-trending folds of the Cedarburg range, South Africa formed first, according to geologists, about 230 million years ago, and the W-trending Karroo ranges formed a little later.

  13. Cape Town, South Africa, Anaglyph, Landsat Image over SRTM Elevation

    NASA Technical Reports Server (NTRS)

    2004-01-01

    Cape Town and the Cape of Good Hope, South Africa, appear on the left (west) of this anaglyph view generated from a Landsat satellite image and elevation data from the Shuttle Radar Topography Mission (SRTM). The city center is located between Table Bay (upper left) and Table Mountain (just to the south), a 1,086-meter (3,563-foot) tall sandstone and granite natural landmark.

    Cape Town enjoys a Mediterranean climate but must deal with the limited water supply characteristic of that climate. Until the 1890s the city relied upon streams and springs along the base of Table Mountain, then built a small reservoir atop Table Mountain to capture and store rainfall there (visible in this anaglyph when viewed at full resolution). Now the needs of a much larger population are met in part by much larger reservoirs such as seen well inland (upper right) at the Theewaterskloof Dam.

    False Bay is the large bay to the southeast (lower right) of Cape Town, just around the Cape of Good Hope. It is one of the largest bays along the entire South African coast, but nearby Cape Town has its harbor at Table Bay. False Bay got its name because mariners approaching Cape Town from the east would see the prominent bay and falsely assume it to be the entrance to Cape Town harbor. Similarly, people often mistake the Cape of Good Hope as the southernmost point of Africa. But the southernmost point is actually Cape Agulhas, located just to the southeast (lower right) of this scene.

    This anaglyph was created by draping a Landsat visible light image over an SRTM elevation model, and then generating two differing perspectives, one for each eye. When viewed through special glasses, the anaglyph is a vertically exaggerated view of the Earth's surface in its full three dimensions. Anaglyph glasses cover the left eye with a red filter and cover the right eye with a blue filter.

    Elevation data used in this image was acquired by the Shuttle Radar Topography Mission (SRTM) aboard

  14. Cape Town, South Africa, Anaglyph, Landsat Image over SRTM Elevation

    NASA Technical Reports Server (NTRS)

    2004-01-01

    Cape Town and the Cape of Good Hope, South Africa, appear on the left (west) of this anaglyph view generated from a Landsat satellite image and elevation data from the Shuttle Radar Topography Mission (SRTM). The city center is located between Table Bay (upper left) and Table Mountain (just to the south), a 1,086-meter (3,563-foot) tall sandstone and granite natural landmark.

    Cape Town enjoys a Mediterranean climate but must deal with the limited water supply characteristic of that climate. Until the 1890s the city relied upon streams and springs along the base of Table Mountain, then built a small reservoir atop Table Mountain to capture and store rainfall there (visible in this anaglyph when viewed at full resolution). Now the needs of a much larger population are met in part by much larger reservoirs such as seen well inland (upper right) at the Theewaterskloof Dam.

    False Bay is the large bay to the southeast (lower right) of Cape Town, just around the Cape of Good Hope. It is one of the largest bays along the entire South African coast, but nearby Cape Town has its harbor at Table Bay. False Bay got its name because mariners approaching Cape Town from the east would see the prominent bay and falsely assume it to be the entrance to Cape Town harbor. Similarly, people often mistake the Cape of Good Hope as the southernmost point of Africa. But the southernmost point is actually Cape Agulhas, located just to the southeast (lower right) of this scene.

    This anaglyph was created by draping a Landsat visible light image over an SRTM elevation model, and then generating two differing perspectives, one for each eye. When viewed through special glasses, the anaglyph is a vertically exaggerated view of the Earth's surface in its full three dimensions. Anaglyph glasses cover the left eye with a red filter and cover the right eye with a blue filter.

    Elevation data used in this image was acquired by the Shuttle Radar Topography Mission (SRTM) aboard

  15. From Cape Town to Cambridge: Orthopaedic trauma in contrasting environments.

    PubMed

    Lawrence, John E; Khanduja, Vikas

    2016-05-18

    To compare the trauma experience gained by a trainee at a United Kingdom major trauma centre and a secondary level hospital in South Africa. A profile of inpatient trauma cases during a five-week period in Addenbrooke's Hospital, Cambridge and Somerset Hospital, Cape Town was created. This was achieved by recording various parameters for each patient admitted including age, gender, injury, mechanism of injury and postal/area code. This, together with details of the departments themselves, allows a comparison of the amount and variety of orthopaedic trauma cases experienced by an individual trainee in each setting. The trauma profiles differed significantly. Patients in Cape Town were younger and more likely to be male. In the young, injury in Cape Town was more likely to occur due to assault or being struck by a vehicle, whilst patients in Cambridge were more likely to be injured whilst in a vehicle or in high energy falls. In older patients, trauma at both centres was almost exclusively due to mechanical falls. In a given age group, injuries at the two centres were similar, however the majority of patients admitted to Addenbrooke's were elderly, resulting in less variation in the overall injury profile. The trauma profile of a major trauma centre in the United Kingdom is less varied than that of a South African secondary centre, with significantly fewer cases per surgeon. This suggests a more varied training experience in the developing world with a greater caseload.

  16. Enabling disability inclusive practices within the University of Cape Town curriculum: A case study

    PubMed Central

    Ohajunwa, Chioma

    2015-01-01

    Background Disability inclusion in the curricula of higher education institutions contributes to socially responsive graduates with a capacity to address the cross-cutting issue of disability in development. This article discusses a study conducted at the University of Cape Town (UCT), South Africa, to explore disability inclusion. Methodology An instrumental case study approach was adopted and a thematic analysis of data was done. Findings Academic staff found a variety of ways to include disability, such as discussions in class, practice and service learning, but mainly as part of disciplinary requirements. Including disability as an issue of social justice stems mostly from the personal interest of staff, and is done in an ad hoc manner. Conclusion Disability should be valued, and integrated into the curriculum in a structured manner as a perspective on diversity with which to interrogate our beliefs about ourselves and society. Theorising on disability is needed, as well as the unique perspectives that emerge across interdisciplinary boundaries, especially within the African context. PMID:28730025

  17. Tuberculosis in Cape Town: an age-structured transmission model

    PubMed Central

    Blaser, Nello; Zahnd, Cindy; Hermans, Sabine; Salazar-Vizcaya, Luisa; Estill, Janne; Morrow, Carl; Egger, Matthias; Keiser, Olivia; Wood, Robin

    2015-01-01

    Background Tuberculosis (TB) is the leading cause of death in South Africa. The burden of disease varies by age, with peaks in TB notification rates in the HIV-negative population at ages 0-5, 20-24 and 45-49 years. There is little variation between age groups in the rates in the HIV-positive population. The drivers of this age pattern remain unknown. Methods We developed an age-structured simulation model of Mycobacterium tuberculosis (Mtb) transmission in Cape Town, South Africa. We considered five states of TB progression: susceptible, infected (latent TB), active TB, treated TB and treatment default. Latently infected individuals could be re-infected; a previous Mtb infection slowed progression to active disease. We further considered three states of HIV progression: HIV negative, HIV positive, on antiretroviral therapy. To parameterize the model, we analysed treatment outcomes from the Cape Town electronic TB register, social mixing patterns from a Cape Town community and literature estimates for other parameters. To investigate the main drivers behind the age patterns, we conducted sensitivity analyses on all parameters related to the age structure. Results The model replicated the age patterns in HIV-negative TB notification rates of Cape Town in 2009. Simulated TB notification rate in HIV-negative patients was 1,000/100,000 person-years (pyrs) in children aged < 5 years and decreased to 51/100,000 in children 5-15 years. The peak in early adulthood occurred at 25-29 years (463/100,000 pyrs). After a subsequent decline, simulated TB notification rates gradually increased from the age of 30 years. Sensitivity analyses showed that the dip after the early adult peak was due to the protective effect of latent TB and that retreatment TB was mainly responsible for the rise in TB notification rates from the age of 30 years. Conclusion The protective effect of a first latent infection on subsequent infections and the faster progression in previously treated patients

  18. Tuberculosis in Cape Town: An age-structured transmission model.

    PubMed

    Blaser, Nello; Zahnd, Cindy; Hermans, Sabine; Salazar-Vizcaya, Luisa; Estill, Janne; Morrow, Carl; Egger, Matthias; Keiser, Olivia; Wood, Robin

    2016-03-01

    Tuberculosis (TB) is the leading cause of death in South Africa. The burden of disease varies by age, with peaks in TB notification rates in the HIV-negative population at ages 0-5, 20-24, and 45-49 years. There is little variation between age groups in the rates in the HIV-positive population. The drivers of this age pattern remain unknown. We developed an age-structured simulation model of Mycobacterium tuberculosis (Mtb) transmission in Cape Town, South Africa. We considered five states of TB progression: susceptible, infected (latent TB), active TB, treated TB, and treatment default. Latently infected individuals could be re-infected; a previous Mtb infection slowed progression to active disease. We further considered three states of HIV progression: HIV negative, HIV positive, on antiretroviral therapy. To parameterize the model, we analysed treatment outcomes from the Cape Town electronic TB register, social mixing patterns from a Cape Town community and used literature estimates for other parameters. To investigate the main drivers behind the age patterns, we conducted sensitivity analyses on all parameters related to the age structure. The model replicated the age patterns in HIV-negative TB notification rates of Cape Town in 2009. Simulated TB notification rate in HIV-negative patients was 1000/100,000 person-years (pyrs) in children aged <5 years and decreased to 51/100,000 in children 5-15 years. The peak in early adulthood occurred at 25-29 years (463/100,000 pyrs). After a subsequent decline, simulated TB notification rates gradually increased from the age of 30 years. Sensitivity analyses showed that the dip after the early adult peak was due to the protective effect of latent TB and that retreatment TB was mainly responsible for the rise in TB notification rates from the age of 30 years. The protective effect of a first latent infection on subsequent infections and the faster progression in previously treated patients are the key determinants of the

  19. Fifty years of porphyria at the University of Cape Town.

    PubMed

    Meissner, Peter N; Corrigall, Anne V; Hift, Richard J

    2012-03-02

    The porphyrias are a group of disorders resulting from defective haem biosynthesis. One form, variegate porphyria, is common in South Africa as a result of a founder effect. Over the past 50 years, the University of Cape Town Faculty of Health Sciences has built and maintained an international reputation for excellence in the field of porphyria. The porphyria group is respected for its research and for its accumulated experience in the management of these disorders. Equally important has been the comprehensive and holistic care offered to patients with porphyria, and to their families.

  20. From Biloxi to Cape Town: curricular integration of service learning.

    PubMed

    Richards, Elizabeth A Libby; Novak, Julie Cowan

    2010-01-01

    Team Reach Out started as a student-initiated service-learning project with the goal of providing on-going assistance to the victims of Hurricane Katrina. Four years after Hurricane Katrina, Team Reach Out refocused efforts to Cape Town, South Africa, where 4 senior nursing students and 1 science student integrated their leadership skills with the application of public health knowledge, compassion, and concern to work in partnership with several international health agencies. This article reviews the service-learning framework, course planning, and implementation of a recent service-learning project.

  1. The transport of atmospheric NOx and HNO3 over Cape Town

    NASA Astrophysics Data System (ADS)

    Abiodun, B. J.; Ojumu, A. M.; Jenner, S.; Ojumu, T. V.

    2014-01-01

    Cape Town, the most popular tourist city in Africa, usually experiences air pollution with unpleasant odour in winter. Previous studies have associated the pollution with local emission of pollutants within the city. The present study examines the transport of atmospheric pollutants (NOx and HNO3) over South Africa and shows how the transport of pollutants from the Mpumalanga Highveld, a major South African industrial area, may contribute to the pollution in Cape Town. The study analysed observation data (2001-2008) from the Cape Town air-quality network and simulation data (2001-2004) from a regional climate model (RegCM) over southern Africa. The simulation accounts for the influence of complex topography, atmospheric conditions, and atmospheric chemistry on emission and transport of pollutants over southern Africa. Flux budget analysis was used to examine whether Cape Town is a source or sink for NOx and HNO3 during the extreme pollution events. The results show that extreme pollution events in Cape Town are associated with the lower level (surface - 850 hPa) transport of NOx from the Mpumalanga Highveld to Cape Town, and with a tongue of high concentration of HNO3 that extends from the Mpumalanga Highveld to Cape Town along the south coast of South Africa. The prevailing atmospheric conditions during the extreme pollution events feature an upper-level (700 hPa) anticyclone over South Africa and a lower-level col over Cape Town. The anticyclone induces a strong subsidence motion, which prevents vertical mixing of the pollutants and caps high concentration of pollutants close to the surface as they are transported from the Mpumalanga Highveld toward Cape Town. The col accumulates the pollutants over the city. This study shows that Cape Town can be a sink for the NOx and HNO3 during extreme pollution events and suggests that the accumulation of pollutants transported from other areas (e.g. the Mpumalanga Highveld) may contribute to the air pollution in Cape Town.

  2. An evaluation of University of Cape Town medical students’ community placements in South Africa

    PubMed Central

    Zweigenthal, Virginia; Irlam, James; London, Leslie; Keikelame, Johannah

    2012-01-01

    Abstract Background Fourth-year medical students at the University of Cape Town (UCT) work closely with stakeholders in community teaching sites to conduct community-based research projects and follow-up health promotion interventions during their Public Health training. Objectives This study evaluated the placements as a learning experience from the perspectives of past students and community stakeholders. Methods A total of 32 projects were randomly selected out of 232 projects undertaken during 2006, 2008 and 2009. Two students and a stakeholder involved with each project were sampled. A standardised survey was emailed to students and in-depth interviews were held with stakeholders. Results Fifty two per cent of 64 students and 57% of 25 stakeholders responded. Most students felt that the placements enhanced their academic experience and confidence in research skills, and were an effective form of learning. Perceived challenges included time constraints and, for a minority, inadequately prepared settings and stakeholders. Stakeholders felt that the placements empowered the communities and prepared students for the realities of working as a medical professional. They viewed students as a valuable resource and believed that student projects addressed important community myths and health problems. Recommendations from students and stakeholders included more time for the Public Health block, follow-up interventions for greater continuity, and better alignment of projects with stakeholder programmes. Conclusion The evaluation reveals both the importance and challenges of community placements and identifies areas of improvement. Despite the limited duration of the placements, they offered valuable community-based learning experiences for the students and worthwhile benefits for the communities.

  3. Characteristics of Students Receiving Counselling Services at the University of Cape Town, South Africa.

    ERIC Educational Resources Information Center

    Flisher, Alan J.; De Beer, Jeremy P.; Bokhorst, Frank

    2002-01-01

    The aim of the study was to document the correlates of receiving counseling services at the University of Cape Town, South Africa. Results reveal that non-English speakers, humanities students, undergraduates, first-year students, students who were eligible to receive financial assistance, and students from outside Cape Town were significantly…

  4. Anaesthesia - what has the University of Cape Town contributed?

    PubMed

    Thomas, Jennifer M; Reed, Anthony R; Reed, Anthony R; Gordon, Peter C; Gordon, Peter C; Dyer, Robert A; Dyer, Robert A; James, Michael F; James, Michael F

    2012-03-23

    From humble beginnings, the University of Cape Town's Department of Anaesthesia has played a major role in the development of anaesthesia as a speciality, in South Africa and internationally. We highlight these contributions in clinical service, teaching and research, with particular emphasis on the department's leading role in the evolution of anaesthetic safety in adults and children: from the development of the treatment of malignant hyperthermia, to unique studies in mortality associated with anaesthesia, and modern contributions to improved drug safety. Innovations in anaesthetic techniques have contributed to significant surgical developments, including the first heart transplant. Furthermore, our research has contributed to major advances in obstetric and endocrine anaesthesia, and training in the department is recognised as being among the best in the world.

  5. International interest in space assets under the Cape Town Convention

    NASA Astrophysics Data System (ADS)

    Ametova, Lutfiie

    2013-12-01

    Private human access to outer space is impossible without space equipment. Nowadays space equipment is increasingly being financed by private sector. Private sector financiers, naturally, seek to secure their interest in space equipment. At the same time, increasing international cooperation in space industry leads to some problems of legal character. Thus, space equipment involved in international cooperation programs crosses national borders and is subject to a certain jurisdiction in a given period of time. The problem is that when an interest is created in one jurisdiction, it may not necessarily be recognised in another one. In order to provide a unified approach to interests vested in space equipment an international legal instrument is necessary. The Cape Town Convention represents an international instrument designed to provide a unified approach to interests vested in mobile equipment, including space assets.

  6. A medical geography of perinatal mortality in Metropolitan Cape Town.

    PubMed

    Rip, M R; Keen, C S; Kibel, M A

    1986-09-27

    An infant's weight at birth as well as its socio-economic environment are recognized as constituting two of the major risk factors associated with perinatal mortality. Spatial analyses of birth weight, socio-economic status and perinatal mortality in Metropolitan Cape Town for the year 1982 are presented in an attempt to assess the relationship between these variables at the suburb (or community) level. Variations in perinatal mortality for each suburb were found to be highly correlated with variations in the distribution of low birth weights. Overall, it would appear that the geography of the interrelationship between low birth weight and perinatal mortality tends, in part, to mirror long-standing gradients in socio-economic status--particularly for those coloured communities which show high perinatal death rates. To what extent these variations are associated with available antenatal and infant health care services can only be postulated. Points for possible community intervention are suggested.

  7. The burden of sickle cell disease in Cape Town.

    PubMed

    Wonkam, Ambroise; Ponde, Chido; Nicholson, Nan; Fieggen, Karen; Ramessar, Raj; Davidson, Alan

    2012-06-28

    South Africa has a low incidence of sickle cell disease (SCD). However, its demographics are changing because of immigration from sub-Saharan African countries where SCD is prevalent. We aimed to determine the frequency of SCD presenting to the Haematology/Oncology Service at Red Cross War Memorial Children's Hospital in Cape Town and to measure the associated disease burden. This was a retrospective cross-sectional study of patients first attending the Haematology Service between January 2001 and June 2010. A total of 58 SCD patients were identified, with an annual frequency that increased over the study period by 300 - 400%. Up to 93.1% (n=54) were originally from other African countries, mainly the Democratic Republic of Congo (62.1%, n=36). One patient had sickle D-Punjab genotype, and all the other patients had the homozygous sickle cell anaemia genotype (Hb SS). Their haematological parameters demonstrated a normocytic anaemia with high white cell counts. The mean number of clinic visits per patient per year was 22.2 (range 0 - 64), and the mean number of hospital admissions per patient per year was 1.2 (range 0 - 5). All the patients were on antibiotic prophylaxis. The majority had at least one blood transfusion (65.5%, n=38), and a significant proportion required intravenous analgesia on admission (29.3%, n=17) and hydroxyurea treatment (36.2%, n=21). Over the past 10 years the frequency of SCD has increased considerably, imposing a significant burden and new challenges to the health services in Cape Town.

  8. The use of garden boreholes in Cape Town, South Africa: lessons learnt from Perth, Western Australia

    NASA Astrophysics Data System (ADS)

    Saayman, I. C.; Adams, S.

    The similarities in climate and geology offer water resource managers in Cape Town and Perth an opportunity to learn from each other's experiences. While Cape Town relies mostly on surface water for supply, Perth uses 50% groundwater for its domestic and industrial use. It is proposed that certain aspects of Perth's water supply infrastructure could successfully be transposed for the exploitation of Cape Towns' groundwater resources. In Perth private boreholes is used to tap a shallow phreatic aquifer for garden irrigation. The Government of Western Australia encourages this practice. Cape Town has an opportunity to use water from the Cape Flats Aquifer in a similar manner. In this paper the use of the Cape Flats Aquifer for private garden irrigation is evaluated. By encouraging private landowners to develop private wells, large savings could be made in the amount of treated bulk water supply required by Cape Town. The Cape Flats Aquifer has the potential to meet a large part of the city's garden irrigation requirements. Though the impact of pollution on water quality remains uncertain and a concern, the general quality of water in the aquifer is adequate for irrigation requirements. If the use of private garden boreholes is to be successful, education of the public will be vital. It is envisaged that the City of Cape Town and the Department of Water Affairs and Forestry in partnership with private, education and research institutions take the lead in such education and the development of appropriate legislation and guidelines.

  9. Earth observations Cape Town, South Africa taken during the STS-97 mission

    NASA Image and Video Library

    2000-12-10

    STS097-711-069 (30 Nov. - 11 Dec. 2000) This view featuring Cape Town and the Western Cape Province in the Republic of South Africa was provided by one of the STS-97 astronauts using a 70mm handheld camera aboard the Earth-orbiting Space Shuttle Endeavour. The capital and largest city of Western Cape Province, Cape Town (1995 population in the urban and suburban area shows in excess of 1.9 million), is visible between False Bay (large, U-shaped bay) and a smaller bay along the Atlantic coast of the peninsula. Within the urban built-up area some of the infrastructure of Cape Town, including the city center and the harbor and waterfront facilities, can be identified near the small bay (middle left edge of the image). Table Mountain elevation of 3563 feet (1086 meters above sea level) separates the city center (north of the mountain) from the southern suburbs of Cape Town. The Cape of Good Hope, long famous as the gateway from the Atlantic Ocean to the Indian Ocean, is located at the southern tip of the claw-shaped peninsula. False Bay is a popular recreational region for the local residents of the greater Cape Town region, as well as a tourist attraction for people who live beyond the borders of South Africa. The lighter-colored terrain, mainly north of Cape Town, shows a landscape of large, cultivated field patterns. These coastal plains are separated from the interior by a chain of folded mountain ranges that include the Cedarberg (dark, linear, north/south aligned feature in the upper right corner) and the more complex, folded Herrivierberge Mountains (dark structure, right middle) that are located northeast of Cape Town.

  10. Inherited anaemias in the Greek community of Cape Town.

    PubMed Central

    Bonafede, R P; Botha, M C; Beighton, P

    1979-01-01

    Cape Town has a Greek community of about 5000, of whom approximately 75% originate from the island of Lesbos. In a survey of inherited haematological conditions in this population, 250 unrelated volunteers were investigated. The prevalence of heterozygous beta-thalassaemia was found to be 6.4%, with a gene frequency of 0.033. G6PD deficiency was detected in 10 males and it can be estimated that the prevalence in the male members of this population is 6.7%, with a gene frequency of 0.067. Hereditary spherocytosis was found in three respondents and this represents a prevalence of 1.2%, with a gene frequency of 0.006. One subject was heterozygous for the sickle cell trait (HbS) and another volunteer had haemoglobin Lepore, which had already been diagnosed in Greece. Our findings with respect to beta-thalassaemia and G6PD deficiency are similar to those reported from regions in Greece where malaria is not highly endemic. PMID:469897

  11. AIDS conspiracy beliefs and unsafe sex in Cape Town.

    PubMed

    Grebe, Eduard; Nattrass, Nicoli

    2012-04-01

    This paper uses multivariate logistic regressions to explore: (1) potential socio-economic, cultural, psychological and political determinants of AIDS conspiracy beliefs among young adults in Cape Town; and (2) whether these beliefs matter for unsafe sex. Membership of a religious organisation reduced the odds of believing AIDS origin conspiracy theories by more than a third, whereas serious psychological distress more than doubled it and belief in witchcraft tripled the odds among Africans. Political factors mattered, but in ways that differed by gender. Tertiary education and relatively high household income reduced the odds of believing AIDS conspiracies for African women (but not men) and trust in President Mbeki's health minister (relative to her successor) increased the odds sevenfold for African men (but not women). Never having heard of the Treatment Action Campaign (TAC), the pro-science activist group that opposed Mbeki on AIDS, tripled the odds of believing AIDS conspiracies for African women (but not men). Controlling for demographic, attitudinal and relationship variables, the odds of using a condom were halved amongst female African AIDS conspiracy believers, whereas for African men, never having heard of TAC and holding AIDS denialist beliefs were the key determinants of unsafe sex.

  12. Urban infrastructure and natural resource flows: evidence from Cape Town.

    PubMed

    Hyman, Katherine

    2013-09-01

    The current economic development trajectory is fundamentally unsustainable. However, decoupling economic growth from excessive natural resource consumption can be adopted as a means to deviate from this current trajectory. Decoupling enables economic growth and human development through non-material growth, without the environmental and social casualties of the incumbent model. Cities are the current and future context for socio development as well as a significant part of the cause and solution to sustainability challenges. Cities account for the majority of production and consumption activities leading to environmental degradation, and they are also the primary location for economic, institutional, and human capital. Innovative responses to global challenges generally emerge during the interaction between these kinds of capital. This paper presents the case of three of Cape Town's resource flows namely; electricity, water and solid waste, as mediated by networked urban infrastructure, to demonstrate the possibility of urban scale decoupling. Conclusions indicate that while decoupling can occur at the city scale, it is unlikely to be sufficient for the realization of sustainable urban development. Purposive interventions are therefore critical for successful, sustainable urban transitions.

  13. Cape of Storms or Cape of Good Hope? Educational Technology in a Changing Environment

    ERIC Educational Resources Information Center

    Czerniewicz, Laura

    2004-01-01

    This article locates and describes the work of the Multimedia Education Group (MEG) at the University of Cape Town (UCT). This work is contextualised by three national and international challenges, these being (1) the need to increase access to new technologies and overcome the digital divide, (2) the need to respond to a new communication order,…

  14. Cape of Storms or Cape of Good Hope? Educational Technology in a Changing Environment

    ERIC Educational Resources Information Center

    Czerniewicz, Laura

    2004-01-01

    This article locates and describes the work of the Multimedia Education Group (MEG) at the University of Cape Town (UCT). This work is contextualised by three national and international challenges, these being (1) the need to increase access to new technologies and overcome the digital divide, (2) the need to respond to a new communication order,…

  15. The Cape Town boyfriend and the Joburg boyfriend: women’s sexual partnerships and social networks in Khayelitsha, Cape Town

    PubMed Central

    Swartz, Alison; Colvin, Christopher; Harrison, Abigail

    2016-01-01

    In South Africa, young people’s “multiple” or “concurrent” partnerships have been increasingly prominent in public health discourses – as drivers of HIV transmission. Multiple partnerships are typically framed in moralising, negative terms and depicted primarily as male-driven, within a broader framework of women’s vulnerability and use of sex for survival and material gain. Based on ethnographic fieldwork with adolescents and young adults in Khayelitsha township near Cape Town, this article investigates young women’s partnerships by exploring their complex interpersonal and social dynamics. We unpack women’s multiple motivations for, and careful management strategies of, both sexual and social relationships in a broader context of socioeconomic exclusion, threats to health and wellbeing, social obligations and relationships of care. The meanings and practices associated with young people’s relationships are more than the sum of individual sexual behaviours, rigid cultural scripts or simply a locus of “risk.” The data presented here highlight some of the limitations of “prevention” approaches that do not take into account this nuanced and multilayered view of such relationships. The affective and empathetic dimensions of young peoples’ relationships, as well as the socioeconomic contexts in which they occur should also be considered. Without accounting for this context, standard “prevention” approaches are less likely to succeed. PMID:28366972

  16. Developing a Strategic Approach to Social Responsiveness at the University of Cape Town, South Africa

    ERIC Educational Resources Information Center

    Favish, Judith; McMillan, Janice; Ngcelwane, Sonwabo V.

    2012-01-01

    Collaborative community-engaged scholarship has roots in many parts of the world, and engaged practitioners and researchers are increasingly finding each other and sharing resources globally. This article focuses on a "social responsiveness" initiative at the University of Cape Town. Its story, told here by three University of Cape Town…

  17. Discourse, Differentiation, and Agency: Muslim Community Schools in Postapartheid Cape Town

    ERIC Educational Resources Information Center

    Fataar, Aslam

    2005-01-01

    This article explores the establishment of schools set up by Muslim communities in Cape Town, South Africa, after 1994. Twelve schools have been set up across the city: four primary schools, three high schools, four schools that have grades 1-12, and one school that has grades 1-3 and 8-10. They are registered with the Western Cape Education…

  18. Intimate Partner Violence among Adolescents in Cape Town, South Africa

    PubMed Central

    Russell, Marcia; Cupp, Pamela K.; Jewkes, Rachel K.; Gevers, Anik; Mathews, Catherine; LeFleur-Bellerose, Chantel; Small, Jeon

    2013-01-01

    GOAL To describe potentially preventable factors in intimate partner violence (IPV) perpetration and victimization among South African 8th grade students. METHOD Data were collected during a pilot evaluation of a classroom 8th grade curriculum on gender-based violence prevention in 9 public schools in Cape Town through self-completed interviews with 549 8th grade students, 238 boys and 311 girls. Structural equation models (SEM) predicting IPV were constructed with variables a priori hypothesized to be associated. RESULTS The majority of students (78.5%) had had a partner in the past three months, and they reported high rates of IPV during that period (e.g., over 10% of boys reported forcing a partner to have sex, and 39% of girls reported physical IPV victimization). A trimmed version of the hypothesized SEM (CFI =.966; RMSEA=.051) indicated that disagreement with the ideology of male superiority and violence predicted lower risk of IPV (p<.001), whereas the frequency of using negative conflict resolution styles (e.g., walking off angrily, sending angry text messages, or refusing to talk to them) predicted high IPV risk (p<.001) and mediated the impact of heavy alcohol drinking on IPV (Sobel test, z=3.16; p<.001). The model fit both girls and boys, but heavy drinking influenced negative styles of resolving conflict more strongly among girls than boys. CONCLUSIONS Findings suggest that interventions to reduce IPV among South African adolescents should challenge attitudes supportive of male superiority and violence; encourage use of positive conflict resolution styles; and discourage heavy alcohol use among both boys and girls. PMID:23743796

  19. Intimate partner violence among adolescents in Cape Town, South Africa.

    PubMed

    Russell, Marcia; Cupp, Pamela K; Jewkes, Rachel K; Gevers, Anik; Mathews, Catherine; LeFleur-Bellerose, Chantel; Small, Jeon

    2014-06-01

    This study aimed to describe potentially preventable factors in intimate partner violence (IPV) perpetration and victimization among South African 8th grade students. Data were collected during a pilot evaluation of a classroom 8th grade curriculum on gender-based violence prevention in nine public schools in Cape Town through self-completed interviews with 549 8th grade students, 238 boys and 311 girls. Structural equation models (SEM) predicting IPV were constructed with variables a priori hypothesized to be associated. The majority of students (78.5 %) had had a partner in the past 3 months, and they reported high rates of IPV during that period (e.g., over 10 % of boys reported forcing a partner to have sex, and 39 % of girls reported physical IPV victimization). A trimmed version of the hypothesized SEM (CFI = .966; RMSEA = .051) indicated that disagreement with the ideology of male superiority and violence predicted lower risk of IPV (p < .001), whereas the frequency of using negative conflict resolution styles (e.g., walking off angrily, sending angry text messages, or refusing to talk to them) predicted high IPV risk (p < .001) and mediated the impact of heavy alcohol drinking on IPV (Sobel test, z = 3.16; p < .001). The model fit both girls and boys, but heavy drinking influenced negative styles of resolving conflict more strongly among girls than boys. Findings suggest that interventions to reduce IPV among South African adolescents should challenge attitudes supportive of male superiority and violence; encourage use of positive conflict resolution styles; and discourage heavy alcohol use among both boys and girls.

  20. A Fog Climatology for Cape Town International Airport

    NASA Astrophysics Data System (ADS)

    van Schalkwyk, L.; Dyson, L. L.

    2010-07-01

    Cape Town International Airport (CTIA) is situated off the cold Benguela current on the extreme southern side of the west coast of South Africa and experiences fog more frequently than any other international airport in South Africa. The aim of this research is ultimately to improve fog forecasts and to determine the characteristics of fog at CTIA by means of a comprehensive fog climatology. A fog climatology is derived making use of 06:00Z observations over a period of 31 years (1978-2008). The fog season for CTIA is observed to start in March and persists till August, while May is found to be the month with the highest frequency of fog events. Analysis of advection and radiation fog events shows that the occurrence of advection fog events dominate during the earlier part of the fog season, whilst radiation fog occurrences increase towards the latter part. Advection fog events at CTIA have been shown to occur frequently from a northwesterly and a southerly wind direction, but monthly wind roses for CTIA at 06:00Z show that a northeasterly wind (land breeze) is dominant during advection events in July and August. This suggests a third type of fog event, namely advected radiation fog, which accounts for fog that forms due to radiative processes to the east and northeast of the aerodrome, where after it is advected towards the airport when the land breeze is at its strongest prior to sunrise. The climatology is supplemented by an analysis of hourly data which are available for the limited period of 2004-2007. With the aid of hourly data, more accurate estimations of the average time of onset and dissipation of fog are determined as well as duration time: information critical to the aviation forecaster.

  1. Decline in adolescent treatment admissions for methamphetamine use in Cape Town.

    PubMed

    Pluddemann, A; Dada, S; Parry, C

    2013-04-19

    The purpose of this report is to describe the changing trends in adolescent treatment admissions for methamphetamine in Cape Town, and to discuss possible implications. Data were collected on admissions for drug abuse treatment through a regular monitoring system involving drug treatment centres and programmes in Cape Town, every 6 months as part of the South African Community Epidemiology Network on Drug Use (SACENDU). A one-page form was completed by treatment centre personnel for each patient to collect demographic and substance abuse data. The results indicate that between 2004 and 2006, a significant increase in the proportion of adolescent treatment admissions for methamphetamine abuse occurred, while a significant decrease occurred between 2006 and 2011. The initial increase in adolescent treatment admissions for methamphetamine abuse from 2004 to 2006, and subsequent decrease between 2006 and 2011, may suggest a change in methamphetamine abuse patterns among adolescents in Cape Town.

  2. Azanian: Zandi Zwane Talks about Being Black, Lesbian, and Activist in Cape Town

    ERIC Educational Resources Information Center

    Vaught, Sabina

    2006-01-01

    Zandi Zwane is a media activist and educator living and working in Cape Town, South Africa. She identifies herself as Black, Nguni, lesbian, female--and "Azanian: a term that was created in pre-colonial times by the members of the Black Consciousness Movement in resistance to colonialism." In this interview, Zwane explores the…

  3. Dental needs of intellectualy disabled children attending six special educational facilities in Cape Town.

    PubMed

    Roberts, T; Chetty, M; Kimmie-Dhansay, F; Fieggen, K; Stephen, L X G

    2016-05-25

    To assess the dental needs of a group of children with intellectual disability (ID) attending six special educational facilities in Cape Town, South Africa. Methods. This was a cross-sectional study based on a convenience sampling method. One hundred and fifty-seven children with ID attending six special educational facilities in Cape Town were included in the survey. Five schools were exclusively funded by the State and one school received additional private financial support. The oral examinations complied with guidelines drafted by Special Olympics Special Smiles programme and the Centers for Disease Control, USA. The most common dental disorders requiring management were gingival disease (69%) and untreated dental caries (68%). Almost 50% of the children had missing teeth. Twenty-nine percent needed orthodontic correction of malocclusion and 7% had structural abnormalities of their teeth that required either aesthetic or functional intervention. Fillings were evident in only 8% of the children. Females required more dental treatment than males. The dental needs of children with ID increased with age. There were no significant differences in the dental needs of children attending State-funded schools and those attending the single school that received additional financial assistance. The frequency of unmet dental needs of children with ID attending special educational facilities in Cape Town was high and the dental care available to them was minimal. The study highlights the need for improved dental services to ensure that optimal oral health is accessible to children with ID attending special educational facilities in Cape Town.

  4. Defying Monolingual Education: Alternative Bilingual Discourse Practices in Selected Coloured Schools in Cape Town

    ERIC Educational Resources Information Center

    Banda, Felix

    2010-01-01

    This paper explores how bilingual learners and teachers challenge the monolingual discourses prescribed in language education policy and models in pursuit of voice and agency in classroom interaction. Through an examination of observation, interview and classroom interaction data in selected coloured primary and secondary schools in Cape Town, the…

  5. The Effects of Community Violence on Children in Cape Town, South Africa

    ERIC Educational Resources Information Center

    Shields, Nancy; Nadasen, Kathy; Pierce, Lois

    2008-01-01

    Objective: The primary objective of the study was to investigate the relationship between exposure to community violence (neighborhood, school, police, and gang violence) and psychological distress in a sample of children living in the Cape Town, South Africa area. Another objective was to identify variables that moderate and mediate the…

  6. Introductory Astronomy Course at the University of Cape Town: Probing Student Perspectives

    ERIC Educational Resources Information Center

    Rajpaul, Vinesh; Allie, Saalih; Blyth, Sarah-Louise

    2014-01-01

    We report on research carried out to improve teaching and student engagement in the introductory astronomy course at the University of Cape Town. This course is taken by a diverse range of students, including many from educationally disadvantaged backgrounds. We describe the development of an instrument, the Introductory Astronomy Questionnaire…

  7. The Tangled Web: Investigating Academics' Views of Plagiarism at the University of Cape Town

    ERIC Educational Resources Information Center

    de Jager, Karin; Brown, Cheryl

    2010-01-01

    This article considers the problematic question of student plagiarism, its causes and manifestations, and how it is addressed in academic environments. A literature survey was conducted to establish how higher education institutions approach these issues, and a twofold investigation was conducted at the University of Cape Town. Data was gathered…

  8. Anonymous Examination Marking at University of Cape Town: The Quest for an "Agonising-Free Zone"

    ERIC Educational Resources Information Center

    Shay, S.; Jones, B.

    2006-01-01

    In 2003 the University of Cape Town introduced an anonymous examination policy. This article reports on a study of the impact of the implementation of this policy on student performance. Comparisons of student results pre- and post policy implementation showed no evidence of negative or positive discrimination of students in the examination…

  9. An Islamic University in Cape Town Grows from Roots in East Asia

    ERIC Educational Resources Information Center

    Lindow, Megan

    2007-01-01

    This article features the International Peace University South Africa in Cape Town. The university, which was established in 2004, resulted from the merger of two local "madrassas", or religious colleges, yet seeks to prepare its students for success in the secular world. Its Islamic roots are not in the Middle East, but in East Asia.…

  10. The Cape Town Statement on Characteristic Elements of a Lifelong Learning Higher Education Institution.

    ERIC Educational Resources Information Center

    International Journal of Lifelong Education, 2001

    2001-01-01

    This statement from the Conference on Lifelong Learning, Higher Education, and Active Citizenship (Cape Town, South Africa, October 2000) outlines six elements necessary to support lifelong learning in higher education institutions: (1) overarching regulatory, financial, and sociocultural frameworks; (2) strategic partners; (3) research; (4)…

  11. An Islamic University in Cape Town Grows from Roots in East Asia

    ERIC Educational Resources Information Center

    Lindow, Megan

    2007-01-01

    This article features the International Peace University South Africa in Cape Town. The university, which was established in 2004, resulted from the merger of two local "madrassas", or religious colleges, yet seeks to prepare its students for success in the secular world. Its Islamic roots are not in the Middle East, but in East Asia.…

  12. Methamphetamine Use and Sexual Risk Behavior among High School Students in Cape Town, South Africa

    ERIC Educational Resources Information Center

    Pluddemann, Andreas; Flisher, Alan J.; McKetin, Rebecca; Parry, Charles D.; Lombard, Carl J.

    2012-01-01

    Objective: To investigate whether methamphetamine use is associated with sexual risk behavior among adolescents. Method: A cross-sectional survey of 1,561 male and female high school students in Cape Town (mean age 14.9 years) was conducted using items from the Problem Oriented Screening Instrument for Teenagers (POSIT) HIV Risk Scale. Results:…

  13. Language Policy as a Sociocultural Tool: Insights from the University of Cape Town

    ERIC Educational Resources Information Center

    Karjalainen, Magda

    2016-01-01

    This theoretically oriented article draws on the author's previous research, which examined language policy and planning (LPP) of the University of Cape Town within the context of post-apartheid transformation driven by need to redress inequalities of the past, and demands of globalization. Drawing on critical linguistics, but indicating…

  14. Introductory Astronomy Course at the University of Cape Town: Probing Student Perspectives

    ERIC Educational Resources Information Center

    Rajpaul, Vinesh; Allie, Saalih; Blyth, Sarah-Louise

    2014-01-01

    We report on research carried out to improve teaching and student engagement in the introductory astronomy course at the University of Cape Town. This course is taken by a diverse range of students, including many from educationally disadvantaged backgrounds. We describe the development of an instrument, the Introductory Astronomy Questionnaire…

  15. Intervening in Children's Involvement in Gangs: Views of Cape Town's Young People

    ERIC Educational Resources Information Center

    Ward, Catherine L.; Bakhuis, Karlijn

    2010-01-01

    Gangs have a long history in Cape Town and children tend to begin involvement around age 12. Children's views on causes of children's involvement in gangs and appropriate interventions, were sought for inclusion in policy recommendations. Thirty focus group discussions were held with in- and out-of-school youth in different communities.…

  16. "Us" and "Them": The Discursive Construction of "the Other" in Greenmarket Square, Cape Town

    ERIC Educational Resources Information Center

    Dyers, Charlyn; Wankah, Foncha John

    2012-01-01

    This paper is based on research done on intercultural communication at Greenmarket Square in the heart of Cape Town, South Africa. The Square is well known as a market for informal traders (mainly from other parts of Africa), local people and tourists from all over the world. Using originally collected discursive evidence from market traders, the…

  17. Cytogenetics at the University of Cape Town: A 45-year journey.

    PubMed

    Smart, R D; Schutte, G; Ruppelt, T; Greenberg, L J

    2016-05-25

    This article is a brief record of the cytogenetics laboratory from its birth in 1971, under the auspices of the University of Cape Town, throughout its development within the Department of Human Genetics, under the leadership of Professor Peter Beighton, to its present position at Groote Schuur Hospital, as a multidisciplinary unit run by the National Health Laboratory Service.

  18. Defying Monolingual Education: Alternative Bilingual Discourse Practices in Selected Coloured Schools in Cape Town

    ERIC Educational Resources Information Center

    Banda, Felix

    2010-01-01

    This paper explores how bilingual learners and teachers challenge the monolingual discourses prescribed in language education policy and models in pursuit of voice and agency in classroom interaction. Through an examination of observation, interview and classroom interaction data in selected coloured primary and secondary schools in Cape Town, the…

  19. Methamphetamine Use and Sexual Risk Behavior among High School Students in Cape Town, South Africa

    ERIC Educational Resources Information Center

    Pluddemann, Andreas; Flisher, Alan J.; McKetin, Rebecca; Parry, Charles D.; Lombard, Carl J.

    2012-01-01

    Objective: To investigate whether methamphetamine use is associated with sexual risk behavior among adolescents. Method: A cross-sectional survey of 1,561 male and female high school students in Cape Town (mean age 14.9 years) was conducted using items from the Problem Oriented Screening Instrument for Teenagers (POSIT) HIV Risk Scale. Results:…

  20. Education, Ethnic Homogenization and Cultural Hybridization (Brussels, Belgium, and Cape Town, South Africa).

    ERIC Educational Resources Information Center

    Leman, Johan, Ed.

    1999-01-01

    The eight chapters of this theme issue examine the ways in which autochthonous communities regard the supply side of education. The supply side is segregational in nature, and immigrants themselves move toward ethnic homogenization. The focus is on urban minorities in Brussels (Belgium). Compares the situation in Cape Town (South Africa). (SLD)

  1. Language Policy as a Sociocultural Tool: Insights from the University of Cape Town

    ERIC Educational Resources Information Center

    Karjalainen, Magda

    2016-01-01

    This theoretically oriented article draws on the author's previous research, which examined language policy and planning (LPP) of the University of Cape Town within the context of post-apartheid transformation driven by need to redress inequalities of the past, and demands of globalization. Drawing on critical linguistics, but indicating…

  2. A Principal's Perspective of School Integration: The First School To Integrate in Cape Town, South Africa.

    ERIC Educational Resources Information Center

    Wieder, Alan

    2001-01-01

    Presents the historical context of Cape Town, South Africa, and its struggles against apartheid and apartheid education. It offers a case study of Allen Powell, a white teacher and administrator who worked to integrate Plumstead High School, an act that defied South African commonplace and the views of most white South Africans. Analyzes Powell's…

  3. Child Abuse Services at a Children's Hospital in Cape Town, South Africa.

    ERIC Educational Resources Information Center

    Argent, Andrew C.; And Others

    1995-01-01

    All child abuse-related patients (n=503) seen at 1 Cape Town (South Africa) hospital over a 1-year period were reviewed. Abuse was confirmed in 389 cases (160 physical abuse and 229 sexual abuse). Most (81 percent) of the young children were seen by residents with minimal pediatric training. Lack of staff speaking Xhosa (spoken by 134 of the…

  4. Disrespecting Teacher: The Decline in Social Standing of Teachers in Cape Town, South Africa

    ERIC Educational Resources Information Center

    Hammett, Daniel

    2008-01-01

    This paper examines the declining levels of respect for teachers in two communities in Cape Town, South Africa. Education has been identified as a key area of reform and redress, but a critical skills shortage and under-resourced schools are hindering progress. Data from current and former teachers illustrate how the social and institutional…

  5. Education, Ethnic Homogenization and Cultural Hybridization (Brussels, Belgium, and Cape Town, South Africa).

    ERIC Educational Resources Information Center

    Leman, Johan, Ed.

    1999-01-01

    The eight chapters of this theme issue examine the ways in which autochthonous communities regard the supply side of education. The supply side is segregational in nature, and immigrants themselves move toward ethnic homogenization. The focus is on urban minorities in Brussels (Belgium). Compares the situation in Cape Town (South Africa). (SLD)

  6. "Us" and "Them": The Discursive Construction of "the Other" in Greenmarket Square, Cape Town

    ERIC Educational Resources Information Center

    Dyers, Charlyn; Wankah, Foncha John

    2012-01-01

    This paper is based on research done on intercultural communication at Greenmarket Square in the heart of Cape Town, South Africa. The Square is well known as a market for informal traders (mainly from other parts of Africa), local people and tourists from all over the world. Using originally collected discursive evidence from market traders, the…

  7. The Tangled Web: Investigating Academics' Views of Plagiarism at the University of Cape Town

    ERIC Educational Resources Information Center

    de Jager, Karin; Brown, Cheryl

    2010-01-01

    This article considers the problematic question of student plagiarism, its causes and manifestations, and how it is addressed in academic environments. A literature survey was conducted to establish how higher education institutions approach these issues, and a twofold investigation was conducted at the University of Cape Town. Data was gathered…

  8. Intervening in Children's Involvement in Gangs: Views of Cape Town's Young People

    ERIC Educational Resources Information Center

    Ward, Catherine L.; Bakhuis, Karlijn

    2010-01-01

    Gangs have a long history in Cape Town and children tend to begin involvement around age 12. Children's views on causes of children's involvement in gangs and appropriate interventions, were sought for inclusion in policy recommendations. Thirty focus group discussions were held with in- and out-of-school youth in different communities.…

  9. Parental Investment, Club Membership, and Youth Sexual Risk Behavior in Cape Town

    ERIC Educational Resources Information Center

    Camlin, Carol S.; Snow, Rachel C.

    2008-01-01

    This study examines whether parental investment and membership in social clubs are associated with safer sexual behaviors among South African youth. Participants comprised 4,800 randomly selected adolescents age 14 to 22 living in the Cape Town area in 2002. Logistic regression was used to examine associations between measures of parental…

  10. The influence of older classmates on adolescent sexual behavior in Cape Town, South Africa.

    PubMed

    Lam, David; Marteleto, Letícia J; Ranchhod, Vimal

    2013-06-01

    This study examines the influence of exposure to older within-grade peers on sexual behavior among students in urban South Africa. Data are drawn from the Cape Area Panel Study, a longitudinal survey of young people conducted in metropolitan Cape Town from 2002 to 2006. The combination of early sexual debut, high rates of school enrollment into the late teens, and grade repetition create an environment in which young people who progress through school ahead of many in their cohort interact with classmates who may be several years older. We construct a measure of cumulative exposure to classmates who are at least two years older and show that such exposure is statistically significantly associated with early sexual initiation among adolescent girls. This exposure also increases the age difference between these girls and their first sexual partner, and helps explain a significant proportion of the earlier sexual debut of African girls, compared with colored and white girls in Cape Town.

  11. Stress, Substance Use and Sexual Risk Behaviors among Primary Care Patients in Cape Town, South Africa

    PubMed Central

    Avalos, Lyndsay Ammon; Mertens, Jennifer R.; Ward, Catherine L.; Flisher, Alan J.; Bresick, Graham F.; Weisner, Constance M.

    2009-01-01

    We assessed the relationship between stress, substance use and sexual risk behaviors in a primary care population in Cape Town, South Africa. A random sample of participants (and over-sampled 18–24 year olds) from 14 of the 49 clinics in Cape Town's public health sector using stratified random sampling (N=2,618), was selected. We evaluated current hazardous drug and alcohol use and three domains of stressors (Personal Threats, Lacking Basic Needs, and Interpersonal Problems). Several personal threat stressors and an interpersonal problem stressor were related to sexual risk behaviors. With stressors included in the model, hazardous alcohol use, but not hazardous drug use, was related to higher rates of sexual risk behaviors. Our findings suggest a positive screening for hazardous alcohol use should alert providers about possible sexual risk behaviors and vice versa. Additionally, it is important to address a broad scope of social problems and incorporate stress and substance use in HIV prevention campaigns. PMID:19205865

  12. Attitudes toward couples-based HIV counseling and testing among MSM in Cape Town, South Africa.

    PubMed

    Stephenson, Rob; Rentsch, Christopher; Sullivan, Patrick; McAdams-Mahmoud, Ayesha; Jobson, Geoff; Struthers, Helen; McIntyre, James

    2013-05-01

    Couples-based voluntary HIV counseling and testing (CVCT) allows couples to receive their HIV test results together and has been demonstrated to be effective in reducing HIV transmission, increasing and sustaining condom use, and reducing sexual risk-taking among at-risk heterosexual couples. However, the acceptability of CVCT among MSM has yet to be evaluated in an African setting. The results from seven focus group discussions and 29 in-depth interviews conducted in Cape Town, South Africa exhibit overwhelmingly high acceptance of CVCT. Participants were attracted to the counseling components of the service, stating that these would allow for the couple to increase their commitment and to explore methods of how to effectively reduce their risk of acquiring or transmitting HIV in the presence of a trained counselor. These results suggest CVCT would be highly welcomed and could work to fill the significant lack of services available and accessible to MSM couples in Cape Town.

  13. Indicators of substance abuse treatment demand in Cape Town, South Africa (1997-2001).

    PubMed

    Myers, B; Parry, C D H; Plüddemann, M A

    2004-05-01

    Few studies have investigated the demand for substance abuse treatment in South Africa. This article uses data collected from specialist substance abuse treatment centres to describe substance abuse treatment demand and patterns of service utilisation in Cape Town for the period January 1997 to December 2001. Findings suggest that although treatment demand for alcohol-related problems remains high, treatment demand for substances other than alcohol has increased over time. Patterns of treatment service utilisation suggest that women and black South Africans remain underserved. The need for comprehensive and accessible substance abuse treatment services in Cape Town is highlighted and recommendations are made for improving access to treatment services, and undertaking comprehensive evaluations of existing treatment facilities.

  14. Cape Town, South Africa, Perspective View, Landsat Image over SRTM Elevation

    NASA Technical Reports Server (NTRS)

    2004-01-01

    Cape Town and the Cape of Good Hope, South Africa, appear in the foreground of this perspective view generated from a Landsat satellite image and elevation data from the Shuttle Radar Topography Mission (SRTM). The city center is located at Table Bay (at the lower left), adjacent to Table Mountain, a 1,086-meter (3,563-foot) tall sandstone and granite natural landmark.

    Cape Town enjoys a Mediterranean climate but must deal with the limited water supply characteristic of that climate. Until the 1890s the city relied upon streams and springs along the base of Table Mountain, then built a small reservoir atop Table Mountain to capture and store rainfall there. Now the needs of a much larger population are met in part by much larger reservoirs such as seen here far inland (mid-distance left) at the Theewaterskloof Dam.

    False Bay is the large bay to the south (right) of Cape Town, just around the Cape of Good Hope. It is one of the largest bays along the entire South African coast, but nearby Cape Town has its harbor at Table Bay. False Bay got its name because mariners approaching Cape Town from the east would see the prominent bay and falsely assume it to be the entrance to Cape Town harbor. Similarly, people often mistake the Cape of Good Hope as the southernmost point of Africa. But the southernmost point is actually Cape Agulhas, located just to the southeast (upper right) of this scene.

    This Landsat and SRTM perspective view uses a 2-times vertical exaggeration to enhance topographic expression. The back edges of the data sets form a false horizon and a false sky was added. Colors of the scene were enhanced by image processing but are the natural color band combination from the Landsat satellite.

    Elevation data used in this image was acquired by the Shuttle Radar Topography Mission (SRTM) aboard the Space Shuttle Endeavour, launched on February 11, 2000. SRTM used the same radar instrument that comprised the Spaceborne Imaging Radar

  15. Cape Town, South Africa, Perspective View, Landsat Image over SRTM Elevation

    NASA Technical Reports Server (NTRS)

    2004-01-01

    Cape Town and the Cape of Good Hope, South Africa, appear in the foreground of this perspective view generated from a Landsat satellite image and elevation data from the Shuttle Radar Topography Mission (SRTM). The city center is located at Table Bay (at the lower left), adjacent to Table Mountain, a 1,086-meter (3,563-foot) tall sandstone and granite natural landmark.

    Cape Town enjoys a Mediterranean climate but must deal with the limited water supply characteristic of that climate. Until the 1890s the city relied upon streams and springs along the base of Table Mountain, then built a small reservoir atop Table Mountain to capture and store rainfall there. Now the needs of a much larger population are met in part by much larger reservoirs such as seen here far inland (mid-distance left) at the Theewaterskloof Dam.

    False Bay is the large bay to the south (right) of Cape Town, just around the Cape of Good Hope. It is one of the largest bays along the entire South African coast, but nearby Cape Town has its harbor at Table Bay. False Bay got its name because mariners approaching Cape Town from the east would see the prominent bay and falsely assume it to be the entrance to Cape Town harbor. Similarly, people often mistake the Cape of Good Hope as the southernmost point of Africa. But the southernmost point is actually Cape Agulhas, located just to the southeast (upper right) of this scene.

    This Landsat and SRTM perspective view uses a 2-times vertical exaggeration to enhance topographic expression. The back edges of the data sets form a false horizon and a false sky was added. Colors of the scene were enhanced by image processing but are the natural color band combination from the Landsat satellite.

    Elevation data used in this image was acquired by the Shuttle Radar Topography Mission (SRTM) aboard the Space Shuttle Endeavour, launched on February 11, 2000. SRTM used the same radar instrument that comprised the Spaceborne Imaging Radar

  16. From comprehensive medicine to public health at the University of Cape Town: a 40-year journey.

    PubMed

    Hoffman, M; Coetzee, D; Hodes, R; London, L

    2012-03-23

    We explore the history of the School of Public Health at the University of Cape Town and its relationship to changes in the understanding of the role of public health both nationally and internationally. We draw from primary and secondary sources to trace the emergence, growth and development of the School, and to situate these processes within the socio-political, clinical and public health contexts in South Africa and internationally.

  17. Substance Use and Psychosocial Predictors of High School Dropout in Cape Town, South Africa

    ERIC Educational Resources Information Center

    Flisher, Alan J.; Townsend, Loraine; Chikobvu, Perpetual; Lombard, Carl F.; King, Gary

    2010-01-01

    The aims of this study were to examine whether use of tobacco, alcohol, and illicit drugs predicts dropout among secondary school students in Cape Town, South Africa. A self-report instrument was administered to 1,470 Grade 8 students. The proportion of students that dropped out of school between the onset of the study and 4 years later was 54.9%.…

  18. Taxonomy and ecology of the Cape Town Spider Crab, Macropodia falcifera (Stimpson, 1858) (Crustacea: Decapoda: Brachyura: Inachidae).

    PubMed

    Ng, Peter K L; Richer De Forges, Bertrand; Jones, Georgina

    2013-01-01

    The nomenclature and taxonomy of the Cape Town Spider Crab, Macropodia falcifera Stimpson, 1858, is treated. The species is rediagnosed and figured, and its ecology discussed. A key is also provided of the Indo-West Pacific species of Macropodia.

  19. Exploring urban health in Cape Town, South Africa: an interdisciplinary analysis of secondary data.

    PubMed

    Mumm, Rebekka; Diaz-Monsalve, Sonia; Hänselmann, Eva; Freund, Johanna; Wirsching, Michael; Gärtner, Jan; Gminski, Richard; Vögtlin, Katrin; Körner, Mirjam; Zirn, Lena; Wittwer-Backofen, Ursula; Oni, Tolu; Kroeger, Axel

    2017-02-01

    With modern information technology, an overwhelming amount of data is available on different aspects of societies. Our research investigated the feasibility of using secondary data sources to get an overview of determinants of health and health outcomes in different population strata of Cape Town, a large city of South Africa. The methodological approach of secondary-data analysis was similar in the different disciplines: Biological Anthropology, Public Health, Environmental Health, Mental Health, Palliative Care, Medical Psychology and Sociology at the University of Freiburg and Public Health at the University of Cape Town. The teams collected information on Cape Town through Internet searches and published articles. The information was extracted, analyzed, condensed, and jointly interpreted. Data show the typical picture of a population in epidemiological and demographic transition exposed to often difficult social, mental, and physical environmental conditions. Comparison between low and higher socioeconomic districts demonstrated that the former had higher air pollution, poorer water quality, and deficient sanitary conditions in addition to sub-optimal mental health services and palliative care. Although important information gaps were identified, the data draw attention to critical public health interventions required in poor health districts, and to motivate for pro-equity policies.

  20. Pulling teeth for fashion: dental modification in modern day Cape Town, South Africa.

    PubMed

    Friedling, L J; Morris, A G

    2007-04-01

    Friedling and Morris (2005) have reported that intentional removal of incisors as a form of dental modification is relatively common in Cape Town. In this paper we further report on the style of modification and the reasons for the modification. A survey of eight adjoining areas in the northern suburbs of the Cape Town Metropole in the Western Cape was done to investigate the current prevalence of this practice. The survey was conducted by means of a questionnaire. Three groups of study subjects (scholars, working people and retired people) were included to gain a perspective of the community in general. The individual ages ranged from 15 to 83-years-old. A total of 2167 individuals participated in this study. Forty one percent had modified their teeth. More males (44,8%) than females (37,9%) were involved in this practice. Six "styles" of modification were identified. The removal of the upper four incisors was by far the most common modification (93,7%). There were four reported reasons for dental modification i.e. gangsterism, peer pressure, fashion and medical (dental) or accidental. More than two thirds (69,8%) of individuals with modifications also wore dentures.

  1. UCT's contribution to medical genetics in Africa - from the past into the future.

    PubMed

    Beighton, Peter; Fieggen, Karen; Wonkam, Ambroise; Ramesar, Raj; Greenberg, Jacquie

    2012-03-02

    The Division of Human Genetics (DHG), Faculty of Health Sciences, University of Cape Town (UCT) - established in 1972 - recently celebrated its 40th anniversary. We review its history, current status and future objectives. Dr Stuart Saunders, former Professor of Medicine and Vice-Chancellor of UCT, played a pivotal role in initiating the DHG. Dr Peter Beighton served as Professor of Human Genetics from 1972 to 1999. In this period, the initial focus was on medical genetics and the development of cytogenetic, biochemical and molecular laboratories, with the help of Prof Jacquie Greenberg. Fourteen clinical and scientific DHG members obtained doctorates; of these, 8 achieved full professorial status. Current Head of the Department, Prof Raj Ramesar, succeeded to the Chair in 1999. Expansion of the molecular laboratories followed. The DHG now has comprehensive programmes for postgraduate scientific training, research and service. Publications during the lifetime of the DHG include more than 540 articles in peer-reviewed medical, genetic and scientific journals, 20 books and contributions to over 40 chapters/editorials in scientific and medical genetic books.

  2. Reciprocal seasonal variation in vitamin D status and tuberculosis notifications in Cape Town, South Africa

    PubMed Central

    Martineau, Adrian R.; Nhamoyebonde, Shepherd; Oni, Tolu; Rangaka, Molebogeng X.; Marais, Suzaan; Bangani, Nonzwakazi; Tsekela, Relebohile; Bashe, Lizl; de Azevedo, Virginia; Caldwell, Judy; Venton, Timothy R.; Timms, Peter M.; Wilkinson, Katalin A.; Wilkinson, Robert J.

    2011-01-01

    Vitamin D deficiency is associated with susceptibility to tuberculosis (TB) in HIV-uninfected people in Europe, but it is not known whether such an association exists among HIV-infected people in subtropical Africa. We conducted a cross-sectional study to determine whether vitamin D deficiency was associated with susceptibility to active TB in HIV-uninfected (n = 196) and HIV-infected (n = 174) black Africans in Cape Town, South Africa. We also investigated whether there was evidence of seasonal variation in vitamin D status and TB notifications in this setting over an 8-y period. Vitamin D deficiency (serum 25-hydroxyvitamin D [25(OH)D] <50 nmol/L) was present in 232 (62.7%) of 370 participants and was associated with active TB in both HIV-uninfected (odds ratio = 5.2, 95% confidence interval: 2.8–9.7; P < 0.001) and HIV-infected (odds ratio = 5.6, 95% confidence interval: 2.7–11.6; P < 0.001) people. Vitamin D status varied according to season: The mean serum 25(OH)D concentration was highest in January through March and lowest in July through September (56.8 vs. 30.7 nmol/L, respectively; P < 0.001). Reciprocal seasonal variation in TB notifications was observed: The mean number of TB notifications per quarter for Cape Town in 2003 to 2010 was lowest in April through June and highest in October through December (4,222 vs. 5,080; P < 0.001). Vitamin D deficiency is highly prevalent among black Africans in Cape Town and is associated with susceptibility to active TB both in the presence and absence of HIV infection. Reciprocal seasonal variation in serum 25(OH)D concentration and TB notifications suggests that seasonal variations in vitamin D status and TB incidence in this setting are causally related. PMID:22025704

  3. Prevalence, Causes and Socio-Economic Determinants of Vision Loss in Cape Town, South Africa

    PubMed Central

    Cockburn, Nicky; Steven, David; Lecuona, Karin; Joubert, Francois; Rogers, Graeme; Cook, Colin; Polack, Sarah

    2012-01-01

    Purpose To estimate the prevalence and causes of blindness and visual impairment in Cape Town, South Africa and to explore socio-economic and demographic predictors of vision loss in this setting. Methods A cross sectional population-based survey was conducted in Cape Town. Eighty-two clusters were selected using probability proportionate to size sampling. Within each cluster 35 or 40 people aged 50 years and above were selected using compact segment sampling. Visual acuity of participants was assessed and eyes with a visual acuity less than 6/18 were examined by an ophthalmologist to determine the cause of vision loss. Demographic data (age, gender and education) were collected and a socio-economic status (SES) index was created using principal components analysis. Results Out of 3100 eligible people, 2750 (89%) were examined. The sample prevalence of bilateral blindness (presenting visual acuity <3/60) was 1.4% (95% CI 0.9–1.8). Posterior segment diseases accounted for 65% of blindness and cataract was responsible for 27%. The prevalence of vision loss was highest among people over 80 years (odds ratio (OR) 6.9 95% CI 4.6–10.6), those in the poorest SES group (OR 3.9 95% CI 2.2–6.7) and people with no formal education (OR 5.4 95% CI 1.7–16.6). Cataract surgical coverage was 68% in the poorest SES tertile (68%) compared to 93% in the medium and 100% in the highest tertile. Conclusions The prevalence of blindness among people ≥50 years in Cape Town was lower than expected and the contribution of posterior segment diseases higher than previously reported in South Africa and Sub Saharan Africa. There were clear socio-economic disparities in prevalence of vision loss and cataract surgical coverage in this setting which need to be addressed in blindness prevention programs. PMID:22363476

  4. Health outcomes for children born to teen mothers in Cape Town, South Africa1

    PubMed Central

    Ardington, Cally; Leibbrandt, Murray

    2014-01-01

    This paper analyzes whether children born to teen mothers in Cape Town, South Africa are disadvantaged in terms of their health outcomes because their mother is a teen. Exploiting the longitudinal nature of the Cape Area Panel Study, we assess whether observable differences between teen mothers and slightly older mothers can explain why first-born children of teen mothers appear disadvantaged. Our balanced regressions indicate that observed characteristics cannot explain the full extent of disadvantage of being born to a teen mother, with children born to teen mothers continuing to have significantly worse child health outcomes, especially among coloured children. In particular, children born to teens are more likely to be underweight at birth and to be stunted with the disadvantage for coloured children four times the size for African children. PMID:26052156

  5. Health outcomes for children born to teen mothers in Cape Town, South Africa.

    PubMed

    Branson, Nicola; Ardington, Cally; Leibbrandt, Murray

    2015-04-01

    This paper analyzes whether children born to teen mothers in Cape Town, South Africa are disadvantaged in terms of their health outcomes because their mother is a teen. Exploiting the longitudinal nature of the Cape Area Panel Study, we assess whether observable differences between teen mothers and slightly older mothers can explain why first-born children of teen mothers appear disadvantaged. Our balanced regressions indicate that observed characteristics cannot explain the full extent of disadvantage of being born to a teen mother, with children born to teen mothers continuing to have significantly worse child health outcomes, especially among coloured children. In particular, children born to teens are more likely to be underweight at birth and to be stunted with the disadvantage for coloured children four times the size for African children.

  6. Mourning the support of women postpartum: The experiences of migrants in Cape Town, South Africa.

    PubMed

    Hunter-Adams, Jo

    2016-09-01

    The maintenance of social networks amongst migrant diasporas has been previously emphasized. When caring for a new baby in particular, however, hands-on social supports are needed. These social supports are poorly understood for migrants. This qualitative study of maternal postpartum support included 23 in-depth interviews with postpartum migrant women and nine focus groups with adult men and women (N = 48) in Cape Town. The absence of nonworking women specifically, and social support generally, was central to migrants' descriptions of stress and infant feeding. The absence of elder and other nonworking women in migrant contexts may add vulnerability to already marginal communities.

  7. Research to action to address inequities: the experience of the Cape Town Equity Gauge

    PubMed Central

    Scott, Vera; Stern, Ruth; Sanders, David; Reagon, Gavin; Mathews, Verona

    2008-01-01

    Background While the importance of promoting equity to achieve health is now recognised, the health gap continues to increase globally between and within countries. The description that follows looks at how the Cape Town Equity Gauge initiative, part of the Global Equity Gauge Alliance (GEGA) is endeavouring to tackle this problem. We give an overview of the first phase of our research in which we did an initial assessment of health status and the socio-economic determinants of health across the subdistrict health structures of Cape Town. We then describe two projects from the second phase of our research in which we move from research to action. The first project, the Equity Tools for Managers Project, engages with health managers to develop two tools to address inequity: an Equity Measurement Tool which quantifies inequity in health service provision in financial terms, and a Equity Resource Allocation Tool which advocates for and guides action to rectify inequity in health service provision. The second project, the Water and Sanitation Project, engages with community structures and other sectors to address the problem of diarrhoea in one of the poorest areas in Cape Town through the establishment of a community forum and a pilot study into the acceptability of dry sanitation toilets. Methods A participatory approach was adopted. Both quantitative and qualitative methods were used. The first phase, the collection of measurements across the health subdistricts of Cape Town, used quantitative secondary data to demonstrate the inequities. In the Equity Tools for Managers Project further quantitative work was done, supplemented by qualitative policy analysis to study the constraints to implementing equity. The Water and Sanitation Project was primarily qualitative, using in-depth interviews and focus group discussions. These were used to gain an understanding of the impact of the inequities, in this instance, inadequate sanitation provision. Results The studies both

  8. Glucose-6-phosphate dehydrogenase deficiency in the Greek population of Cape Town.

    PubMed

    Bonafede, R P; Botha, M C; Beighton, P

    1984-04-07

    A sample of 250 unrelated members of the Greek community of Cape Town was studied in order to establish the prevalence of glucose-6-phosphate dehydrogenase (G-6-PD) deficiency in the community. A gene frequency of 0,067 in males and a prevalence of 6,7% are estimated for this group. It is recommended that persons with G-6-PD deficiency should have access to a list of medicinal agents which have the potential for precipitating acute haemolytic crises and that they should wear Medic-Alert discs bearing information concerning the disorder.

  9. The UNESCO biosphere reserve concept as a tool for urban sustainability: the CUBES Cape Town case study.

    PubMed

    Stanvliet, R; Jackson, J; Davis, G; De Swardt, C; Mokhoele, J; Thom, Q; Lane, B D

    2004-06-01

    The Cape Town Case Study (CTCS) was a multi-institutional collaborative project initiated by CUBES, a knowledge networking initiative of UNESCO's Ecological Sciences Division and the Earth Institute at Columbia University. Cape Town was selected as a CUBES site on the basis of its high biological and cultural significance, together with its demonstrated leadership in promoting urban sustainability. The CTCS was conducted by the Cape Town Urban Biosphere Group, a cross-disciplinary group of specialists drawn from national, provincial, municipal, and civil society institutions, mandated to examine the potential value of the UNESCO Biosphere Reserve concept as a tool for environmental management, social inclusion, and poverty alleviation in Cape Town. This article provides a contextualization of the CTCS and its collaborative process. It also reviews the biosphere reserve concept relative to urban sustainability objectives and proposes a more functional application of that concept in an urban context. A detailed analysis of key initiatives at the interface of conservation and poverty alleviation is provided in table format. Drawing on an examination of successful sustainability initiatives in Cape Town, specific recommendations are made for future application of the biosphere reserve concept in an urban context, as well as a model by which urban areas might affiliate with the UNESCO World Network of Biosphere Reserves, and criteria for such affiliation.

  10. Local-level mortality surveillance in resource-limited settings: a case study of Cape Town highlights disparities in health

    PubMed Central

    Bradshaw, Debbie; Daniels, Johann; Zinyakatira, Nesbert; Matzopoulos, Richard; Bourne, David; Shaikh, Najma; Naledi, Tracey

    2010-01-01

    Abstract Objective To identify the leading causes of mortality and premature mortality in Cape Town, South Africa, and its subdistricts, and to compare levels of mortality between subdistricts. Methods Cape Town mortality data for the period 2001–2006 were analysed by age, cause of death and sex. Cause-of-death codes were aggregated into three main cause groups: (i) pre-transitional causes (e.g. communicable diseases, maternal causes, perinatal conditions and nutritional deficiencies), (ii) noncommunicable diseases and (iii) injuries. Premature mortality was calculated in years of life lost (YLLs). Population estimates for the Cape Town Metro district were used to calculate age-specific rates per 100 000 population, which were then age-standardized and compared across subdistricts. Findings The pattern of mortality in Cape Town reflects the quadruple burden of disease observed in the national cause-of-death profile, with HIV/AIDS, other infectious diseases, injuries and noncommunicable diseases all accounting for a significant proportion of deaths. HIV/AIDS has replaced homicide as the leading cause of death. HIV/AIDS, homicide, tuberculosis and road traffic injuries accounted for 44% of all premature mortality. Khayelitsha, the poorest subdistrict, had the highest levels of mortality for all main cause groups. Conclusion Local mortality surveillance highlights the differential needs of the population of Cape Town and provides a wealth of data to inform planning and implementation of targeted interventions. Multisectoral interventions will be required to reduce the burden of disease. PMID:20539858

  11. Experiences of violence and association with decreased drug abstinence among women in Cape Town, South Africa.

    PubMed

    Reed, Elizabeth; Myers, Bronwyn; Novak, Scott P; Browne, Felicia A; Wechsberg, Wendee M

    2015-01-01

    Drug abuse is a contributing factor in women's HIV risk in low-income communities in Cape Town, South Africa. This study assessed whether experiencing violence is associated with reduced drug abstinence among adult women (n = 603) participating in a randomized field trial for an HIV prevention study in Cape Town. In relation to drug abstinence at 12-month follow-up, multivariable regression models were used to assess (1) baseline partner and non-partner victimization, and (2) victimization at 12-month follow-up among participants reporting baseline victimization. Baseline partner (AOR = 0.6; 95 % CI 0.4-0.9) and non-partner victimization (AOR = 0.6; 95 % CI 0.4-0.9) were associated with a reduced likelihood of drug abstinence at follow-up. Among participants who reported victimization at baseline, those no longer reporting victimization at follow-up did not differ significantly in drug abstinence compared with those who reported victimization at follow-up. The study findings highlight the lasting impact of victimization on women's drug use outcomes, persisting regardless of whether violence was no longer reported at follow-up. Overall, the findings support the need for the primary prevention of violence to address the cycle of violence, drug use, and HIV among women in this setting.

  12. Firearm injuries to children in Cape Town, South Africa: impact of the 2004 Firearms Control Act.

    PubMed

    Campbell, N M; Colville, J G; van der Heyde, Y; van As, A B

    2013-07-31

    Before the introduction of the Firearms Control Act in 2004, the epidemiology of childhood firearm injuries from 1991 to 2001 in Cape Town, South Africa, was reported. This study analyses current data as a comparator to assess the impact of the Act. Firearm injuries seen at Red Cross War Memorial Children's Hospital, Cape Town, from 2001 to 2010 were respectively reviewed. Data recorded included the patients' folder numbers, gender, date of birth, age, date of presentation, date discharged and inpatient stay, firearm type, number of shots, circumstances, injury sites, injury type, treatment, resulting morbidities and survival. These data were compared with the 1991 - 2001 data. One hundred and sixty-three children presented with firearm injuries during this period. The results showed a decrease in incidence from 2001 to 2010. Older children and males had a higher incidence than younger children and females. Most injuries were to an extremity and were unintentional. Mortality had reduced significantly from the previous study (6% to 2.6%), as did the total number of inpatient days (1 063 to 617). Compared with the earlier study, this study showed a significant reduction in the number of children presenting with a firearm-related injury. Mortality and inpatient stay were also significantly reduced. The study shows the impact that the Firearms Control Act has had in terms of paediatric firearm-related injury and provides evidence that the medical profession can play an important role in reducing violence.

  13. Contraception usage and timing of pregnancy among pregnant teenagers in Cape Town, South Africa.

    PubMed

    Vollmer, Linda R; van der Spuy, Zephne M

    2016-06-01

    To evaluate knowledge and use of contraception among pregnant teenagers in the Cape Town metropolitan area. A cross-sectional study enrolled women aged 16 to 19 years who were pregnant and attending prenatal clinics, and prenatal and labor wards at regional hospitals and midwife-run obstetric clinics in the Cape Town area between March 1, 2011 and September 30, 2011. Data were collected using an administered questionnaire. The study enrolled 314 participants. Of the participants, 240 (76.4%) felt their pregnancies had occurred at the "wrong time" but only 38 (12.1%) were using contraception at the time of conception. The form of contraception that participants most commonly had knowledge of was injectable hormonal contraception (274 [87.3%]). Contraception use was low, with 126 (40.1%) participants having never used contraception. The forms of contraception used most commonly were the male condom (106 [33.8%]) and injectable contraception (98 [31.2%]). The majority of participants found it easy to get contraception (192 [61.1%]) and felt that information regarding contraception was readily available (233 [74.2%]). Contraception use is suboptimal but this may not simply be a reflection of ineffective family-planning services. Further research is needed to fully explain the lack of contraceptive use in this population. Copyright © 2016 International Federation of Gynecology and Obstetrics. Published by Elsevier Ireland Ltd. All rights reserved.

  14. Epidemiology of Staphylococcus aureus bacteraemia at a tertiary children's hospital in Cape Town, South Africa.

    PubMed

    Naidoo, Reené; Nuttall, James; Whitelaw, Andrew; Eley, Brian

    2013-01-01

    Staphylococcus aureus is an important pathogen in paediatric patients with bloodstream infections. The epidemiology of S. aureus bacteraemia, however, has not been well documented in children in South Africa. A retrospective study was conducted at a children's hospital in Cape Town, South Africa, to investigate the epidemiology of S. aureus bacteraemia from 2007-2011. The incidence, clinical presentation, risk factors, management and outcomes of methicillin sensitive S. aureus (MSSA) and methicillin resistant S. aureus (MRSA) bacteraemia were compared. Over the five year study period, 365 episodes of S. aureus bacteraemia were identified. The annual incidence was 3.28 cases per 1000 hospital admissions. MRSA was responsible for 26% of S. aureus bacteraemia and 72% of nosocomial infections. Only six possible cases of community-acquired MRSA infections were described. MSSA bacteraemia was more likely to present as pulmonary and bone or joint infections, while bacteraemia without a source was the most common presentation with MRSA.  Infants, children with malnutrition, and residents of long-term care facilities were at highest risk for MRSA bacteraemia. The overall case fatality rate for S. aureus bacteraemia was 8.8% over five years, with MRSA being the only significant risk factor for mortality. The incidence of S. aureus bacteraemia and MRSA bacteraemia in children has remained stable over the past five years. MRSA is a predominantly nosocomial pathogen in children with S. aureus bacteraemia in Cape Town, South Africa.

  15. Parental Investment, Club Membership, and Youth Sexual Risk Behavior in Cape Town

    PubMed Central

    Camlin, Carol S.; Snow, Rachel C.

    2010-01-01

    This study examines whether parental investment and membership in social clubs are associated with safer sexual behaviors among South African youth. Participants comprised 4,800 randomly selected adolescents age 14 to 22 living in the Cape Town area in 2002. Logistic regression was used to examine associations between measures of parental investment and associational membership with reported condom use at first and most recent sexual intercourse, net of effects of HIV knowledge, age, education, population group, parental coresidence, and household income. Interaction terms were used to examine gender differences in associations between risk behavior and parental investment and between risk behavior and group membership. Participation in clubs and community groups is associated with safer behaviors. A mother’s financial support (for clothing, school fees and uniforms, and pocket money) is negatively associated with condom use, particularly among young women, suggesting that material need impels vulnerability to higher risk behaviors. Social resources in households and communities mediate HIV risk behaviors among youth in Cape Town. PMID:18375613

  16. Healthcare experiences of lesbian and bisexual women in Cape Town, South Africa.

    PubMed

    Smith, Riley

    2015-01-01

    Understanding the health needs and experiences of South African lesbian and bisexual women is imperative for implementing effective and inclusive public health strategies. Such understanding, however, is limited due to the exclusion of these women from most existing research on healthcare access in the region. This paper bridges that gap by investigating the healthcare experiences of lesbian and bisexual women in Cape Town. Data were gathered from 22 interviews with self-identified lesbian and bisexual community members and university students in the Cape Town area. Interviews explored obstacles women face in accessing affirming services, different experiences with public and private healthcare, fear of stigma/discrimination, availability of relevant sexual health information and suggestions to improve existing programmes. Findings suggest that South African lesbians and bisexual women may have a range of both positive and negative experiences in public and private health services, that they use protective strategies when 'coming out' and that they find that sexual health information pertinent to them is largely unavailable. These discussions contribute to a more inclusive understanding of the experiences of lesbian and bisexual women accessing healthcare and other services and help to inform providers, thereby enabling them to deliver more meaningful care to lesbian, gay, bisexual and transgender persons in South Africa.

  17. Monitoring the prevalence of methamphetamine-related presentations at psychiatric hospitals in Cape Town, South Africa.

    PubMed

    Plüddemann, A; Dada, S; Parry, C D H; Kader, R; Parker, J S; Temmingh, H; van Heerden, S; de Clercq, C; Lewis, I

    2013-01-01

    This study aimed to determine a demographic profile of methamphetamine (MA)-related admissions to major psychiatric services in Cape Town, obtain a substance use profile from admitted patients, a profile of common MA-related symptoms encountered during the assessment of the patients presenting with MA-related problems, and a brief profile of the psychiatric diagnoses made. Staff in six psychiatric hospitals or wards in Cape Town collected data on methamphetamine related admissions between July and December 2008 using a one-page record review form. The data collection form consisted of the patient's demographic details, presenting symptoms, previous admission details, current MA and other substance use information, and DSM-IV diagnosis. A total of 235 forms were completed. Most patients were male (69%) and the mean age was 25 years. The most common presenting symptoms were aggressive behaviour (74%), followed by delusions (59%) and hallucinations (57%). Males were two times more likely to present with aggression as compared to females, while females were significantly more likely to present with depressed mood or euphoric/elevated mood. The majority of patients had substance-induced psychotic disorder (41%), followed by schizophrenia (31%). Twelve percent (12%) had bipolar mood disorder. MA-related psychiatric admissions pose serious challenges to all health services dealing with these patients. Further training and treatment protocol development and distribution is indicated.

  18. Adolescent methamphetamine use and sexual risk behaviour in secondary school students in Cape Town, South Africa.

    PubMed

    Plüddemann, Andreas; Flisher, Alan J; Mathews, Catherine; Carney, Tara; Lombard, Carl

    2008-11-01

    This study investigated involvement in substance use and sexual activities among adolescents in Cape Town, and specifically the associations between methamphetamine use and sexual risk behaviours. Data were collected from 15 randomly selected and 15 matched schools in Cape Town via quantitative questionnaires. Students used hand-held computers (PDAs) to answer the questions. A total of 4605 grade 9 students were sampled. Male and female students were almost equally likely to have used methamphetamine at least once (13% versus 12%). Students who had used methamphetamine in the past 30 days were significantly more likely to have had vaginal, anal or oral sex than students who had never used it, to have been pregnant/been responsible for a pregnancy and to have been diagnosed with a sexually transmitted infection. Logistic regression analysis indicated significant associations between methamphetamine use in the past 12 months and engaging in vaginal and anal sex. Drug abuse and sexually transmitted infections (STI) prevention services should incorporate the link between drugs and STI into their prevention and education strategies, especially those aimed at school-going adolescents.

  19. Biomedical engineering at UCT - challenges and opportunities.

    PubMed

    Douglas, Tania S

    2012-03-02

    The biomedical engineering programme at the University of Cape Town has the potential to address some of South Africa's unique public health challenges and to contribute to growth of the local medical device industry, directly and indirectly, through research activities and postgraduate education. Full realisation of this potential requires engagement with the clinical practice environment and with industry.

  20. Providing local color?: "cape coloreds," "cockneys," and Cape Town's identity from the late nineteenth century to the 1970s.

    PubMed

    Bickford-Smith, Vivian

    2012-01-01

    Jim Dyos, founding-father of British urban history, argued that cities have commonly acknowledged “individual characteristics” that distinguish them. Such distinctive characteristics, though usually based on material realities, are promoted through literary and visual representations. This article argues that those who seek to convey a city’s distinctiveness will do so not only through describing its particular topography, architecture, history or functions but also by describing its “local colour”: the supposedly unique customs, manner of speech, dress, or other special features of its inhabitants. In colonial cities this process involved white racial stereotyping of “others”. In Cape Town, depictions of “Coloured” inhabitants as unique “city types” became part of the city’s “destination branding”. The article analyses change and continuity in such representations. To this end it draws on the insights of Gareth Stedman Jones into changing depictions of London’s “Cockneys” and the insights of Stephen Ward into historical “place-selling”.

  1. Mobile HIV screening in Cape Town, South Africa: clinical impact, cost and cost-effectiveness.

    PubMed

    Bassett, Ingrid V; Govindasamy, Darshini; Erlwanger, Alison S; Hyle, Emily P; Kranzer, Katharina; van Schaik, Nienke; Noubary, Farzad; Paltiel, A David; Wood, Robin; Walensky, Rochelle P; Losina, Elena; Bekker, Linda-Gail; Freedberg, Kenneth A

    2014-01-01

    Mobile HIV screening may facilitate early HIV diagnosis. Our objective was to examine the cost-effectiveness of adding a mobile screening unit to current medical facility-based HIV testing in Cape Town, South Africa. We used the Cost Effectiveness of Preventing AIDS Complications International (CEPAC-I) computer simulation model to evaluate two HIV screening strategies in Cape Town: 1) medical facility-based testing (the current standard of care) and 2) addition of a mobile HIV-testing unit intervention in the same community. Baseline input parameters were derived from a Cape Town-based mobile unit that tested 18,870 individuals over 2 years: prevalence of previously undiagnosed HIV (6.6%), mean CD4 count at diagnosis (males 423/µL, females 516/µL), CD4 count-dependent linkage to care rates (males 31%-58%, females 49%-58%), mobile unit intervention cost (includes acquisition, operation and HIV test costs, $29.30 per negative result and $31.30 per positive result). We conducted extensive sensitivity analyses to evaluate input uncertainty. Model outcomes included site of HIV diagnosis, life expectancy, medical costs, and the incremental cost-effectiveness ratio (ICER) of the intervention compared to medical facility-based testing. We considered the intervention to be "very cost-effective" when the ICER was less than South Africa's annual per capita Gross Domestic Product (GDP) ($8,200 in 2012). We projected that, with medical facility-based testing, the discounted (undiscounted) HIV-infected population life expectancy was 132.2 (197.7) months; this increased to 140.7 (211.7) months with the addition of the mobile unit. The ICER for the mobile unit was $2,400/year of life saved (YLS). Results were most sensitive to the previously undiagnosed HIV prevalence, linkage to care rates, and frequency of HIV testing at medical facilities. The addition of mobile HIV screening to current testing programs can improve survival and be very cost-effective in South Africa and

  2. Mobile HIV Screening in Cape Town, South Africa: Clinical Impact, Cost and Cost-Effectiveness

    PubMed Central

    Bassett, Ingrid V.; Govindasamy, Darshini; Erlwanger, Alison S.; Hyle, Emily P.; Kranzer, Katharina; van Schaik, Nienke; Noubary, Farzad; Paltiel, A. David; Wood, Robin; Walensky, Rochelle P.; Losina, Elena; Bekker, Linda-Gail; Freedberg, Kenneth A.

    2014-01-01

    Background Mobile HIV screening may facilitate early HIV diagnosis. Our objective was to examine the cost-effectiveness of adding a mobile screening unit to current medical facility-based HIV testing in Cape Town, South Africa. Methods and Findings We used the Cost Effectiveness of Preventing AIDS Complications International (CEPAC-I) computer simulation model to evaluate two HIV screening strategies in Cape Town: 1) medical facility-based testing (the current standard of care) and 2) addition of a mobile HIV-testing unit intervention in the same community. Baseline input parameters were derived from a Cape Town-based mobile unit that tested 18,870 individuals over 2 years: prevalence of previously undiagnosed HIV (6.6%), mean CD4 count at diagnosis (males 423/µL, females 516/µL), CD4 count-dependent linkage to care rates (males 31%–58%, females 49%–58%), mobile unit intervention cost (includes acquisition, operation and HIV test costs, $29.30 per negative result and $31.30 per positive result). We conducted extensive sensitivity analyses to evaluate input uncertainty. Model outcomes included site of HIV diagnosis, life expectancy, medical costs, and the incremental cost-effectiveness ratio (ICER) of the intervention compared to medical facility-based testing. We considered the intervention to be “very cost-effective” when the ICER was less than South Africa's annual per capita Gross Domestic Product (GDP) ($8,200 in 2012). We projected that, with medical facility-based testing, the discounted (undiscounted) HIV-infected population life expectancy was 132.2 (197.7) months; this increased to 140.7 (211.7) months with the addition of the mobile unit. The ICER for the mobile unit was $2,400/year of life saved (YLS). Results were most sensitive to the previously undiagnosed HIV prevalence, linkage to care rates, and frequency of HIV testing at medical facilities. Conclusion The addition of mobile HIV screening to current testing programs can improve survival

  3. Correlates of lifetime trauma exposure among pregnant women from Cape Town, South Africa

    PubMed Central

    Myers, Bronwyn; Jones, Hendrée E.; Doherty, Irene A.; Kline, Tracy L.; Key, Mary E.; Johnson, Kim; Wechsberg, Wendee M.

    2015-01-01

    A cross-sectional survey of 298 pregnant women from Cape Town, South Africa was conducted to examine socio-demographic, reproductive health, mental health, and relationship correlates of lifetime trauma exposure and whether these correlates vary as a function of age. Overall, 19.8% of participants reported trauma exposure. We found similarities and differences in correlates of trauma exposure among women in emerging adulthood and older women. Prior termination of pregnancy was associated with trauma exposure in both age groups. Difficulties in resolving arguments, lifetime substance use, and a prior sexually transmitted infection were associated with trauma exposure among women in emerging adulthood. In contrast, depression and awareness of substance abuse treatment programmes were associated with trauma exposure among older women. These findings highlight the need for interventions that prevent and treat trauma exposure among vulnerable women. Such interventions should be tailored to address the correlates of trauma exposure in each age group. PMID:27087804

  4. The Cape Town Declaration on Vaccines 2012: Unlocking the full potential of vaccines in Africa.

    PubMed

    Wiysonge, Charles S; Waggie, Zainab; Hawkridge, Anthony; Schoub, Barry D; Madhi, Shabir A; Rees, Helen; Hussey, Gregory D

    2016-07-19

    Delegates at the first International African Vaccinology Conference noted, with dismay, that many African children have limited access to existing and new vaccines as a consequence of weak immunisation programmes, lack of political will, and high vaccine prices. This inequality is a denial of the African child her basic right to a healthy life, and jeopardises long term economic growth on the continent. In addition, there is insufficient emphasis in Africa on adolescent and adult immunisation. The delegates documented various concerns and made various commitments; contained in this Cape Town Declaration on Vaccines, adopted on 11 November 2012. Finally, delegates confirmed their agreement with the goals and strategic objectives of the Global Vaccine Action Plan, and committed to hold African leaders accountable for its implementation during the Decade of Vaccines. The full list of registered conference delegates is provided as supplementary data to this manuscript. Copyright © 2016.

  5. Introductory astronomy course at the University of Cape Town: Probing student perspectives

    NASA Astrophysics Data System (ADS)

    Rajpaul, Vinesh; Allie, Saalih; Blyth, Sarah-Louise

    2014-12-01

    We report on research carried out to improve teaching and student engagement in the introductory astronomy course at the University of Cape Town. This course is taken by a diverse range of students, including many from educationally disadvantaged backgrounds. We describe the development of an instrument, the Introductory Astronomy Questionnaire (IAQ), which we administered as pre- and posttests to students enrolled in the course. The instrument comprised a small number of questions which probed three areas of interest: student motivation and expectations, astronomy content, and worldview. Amongst our findings were that learning gains were made in several conceptual areas, and that students appeared to develop a more nuanced view of the nature of astronomy. There was some evidence that the course had a positive impact on students' worldviews, particularly their attitudes towards science. We also identified a promising predictor of course success that could in the future be used to identify students requiring special teaching intervention.

  6. Making unhealthy places: The built environment and non-communicable diseases in Khayelitsha, Cape Town.

    PubMed

    Smit, Warren; de Lannoy, Ariane; Dover, Robert V H; Lambert, Estelle V; Levitt, Naomi; Watson, Vanessa

    2015-06-29

    In this paper, we examine how economic, social and political forces impact on NCDs in Khayelitsha (a predominantly low income area in Cape Town, South Africa) through their shaping of the built environment. The paper draws on literature reviews and ethnographic fieldwork undertaken in Khayelitsha. The three main pathways through which the built environment of the area impacts on NCDs are through a complex food environment in which it is difficult to achieve food security, an environment that is not conducive to safe physical activity, and high levels of depression and stress (linked to, amongst other factors, poverty, crime and fear of crime). All of these factors are at least partially linked to the isolated, segregated and monofunctional nature of Khayelitsha. The paper highlights that in order to effectively address urban health challenges, we need to understand how economic, social and political forces impact on NCDs through the way they shape built environments.

  7. Making unhealthy places: The built environment and non-communicable diseases in Khayelitsha, Cape Town.

    PubMed

    Smit, Warren; de Lannoy, Ariane; Dover, Robert V H; Lambert, Estelle V; Levitt, Naomi; Watson, Vanessa

    2016-05-01

    In this paper, we examine how economic, social and political forces impact on NCDs in Khayelitsha (a predominantly low income area in Cape Town, South Africa) through their shaping of the built environment. The paper draws on literature reviews and ethnographic fieldwork undertaken in Khayelitsha. The three main pathways through which the built environment of the area impacts on NCDs are through a complex food environment in which it is difficult to achieve food security, an environment that is not conducive to safe physical activity, and high levels of depression and stress (linked to, amongst other factors, poverty, crime and fear of crime). All of these factors are at least partially linked to the isolated, segregated and monofunctional nature of Khayelitsha. The paper highlights that in order to effectively address urban health challenges, we need to understand how economic, social and political forces impact on NCDs through the way they shape built environments.

  8. Report of the 7th African Rotavirus Symposium, Cape Town, South Africa, 8th November 2012.

    PubMed

    Seheri, L M; Mwenda, J M; Page, N

    2014-11-12

    The 7th African Rotavirus Symposium was held in Cape Town, South Africa, on the 8th November 2012 as a Satellite Symposium at the First International African Vaccinology Conference. Over 150 delegates participated in this symposium including scientists, clinicians, health officials, policymakers and vaccine manufacturers from across Africa. Key topics discussed included rotavirus surveillance, rotavirus vaccine introduction, post rotavirus vaccine impact analysis and intussusception data and surveillance in Africa. The symposium provided early rotavirus vaccine adopter countries in Africa (South Africa, Ghana and Botswana) an opportunity to share up-to-date information on vaccine introduction, and allowed colleagues to share experiences in establishing routine rotavirus surveillance (Tanzania, Niger and Rwanda). Overall, the symposium highlighted the high burden of rotavirus in Africa, and the need to continue to strengthen efforts in preventing rotavirus diarrhoea in Africa.

  9. Stories of Change: e/merge @ the University of Cape Town

    NASA Astrophysics Data System (ADS)

    Carr, Tony

    The Center for Educational Technology (CET) is located at the University of Cape Town, which is a leading South African research and teaching university. This implies great opportunities and challenges since we are poised between the experience of and conditions faced by colleagues in other parts of Africa and those of the colleagues in first-world countries. We have access to the intellectual and professional networks of the first world and our university features on global rankings, yet our resourcing, while generous in terms of most other universities in our continent, is a fraction of that enjoyed by first-world universities of similar size and scope. Both globalization and developmental imperatives require us to rapidly extend the effective use of educational technology in our university for teaching and learning. The received models of e-Learning integration developed mostly in first-world countries need to be adapted for contexts with scarce resources.

  10. Poverty and psychological health among AIDS-orphaned children in Cape Town, South Africa.

    PubMed

    Cluver, Lucie; Gardner, Frances; Operario, Don

    2009-06-01

    This study examined associations between AIDS-orphanhood status, poverty indicators, and psychological problems (depression, anxiety, post-traumatic stress, peer problems, delinquency, conduct problems) among children and adolescents in townships surrounding Cape Town, South Africa. One thousand and twenty-five children and adolescents completed standardized and culturally sensitive cross-sectional surveys. Children orphaned by AIDS had more psychological problems including depression, peer problems, post-traumatic stress, and conduct problems. Specific poverty indicators including food security, access to social welfare grants, employment in the household and access to school were associated with better psychological health. Poverty indicators mediated associations of AIDS-orphanhood with psychological problems. Food security showed the most consistent association with reduced psychological problems. Poverty alleviation measures have the potential to improve psychological health for AIDS-orphaned children in South African townships.

  11. Correlates of lifetime trauma exposure among pregnant women from Cape Town, South Africa.

    PubMed

    Myers, Bronwyn; Jones, Hendrée E; Doherty, Irene A; Kline, Tracy L; Key, Mary E; Johnson, Kim; Wechsberg, Wendee M

    2015-06-01

    A cross-sectional survey of 298 pregnant women from Cape Town, South Africa was conducted to examine socio-demographic, reproductive health, mental health, and relationship correlates of lifetime trauma exposure and whether these correlates vary as a function of age. Overall, 19.8% of participants reported trauma exposure. We found similarities and differences in correlates of trauma exposure among women in emerging adulthood and older women. Prior termination of pregnancy was associated with trauma exposure in both age groups. Difficulties in resolving arguments, lifetime substance use, and a prior sexually transmitted infection were associated with trauma exposure among women in emerging adulthood. In contrast, depression and awareness of substance abuse treatment programmes were associated with trauma exposure among older women. These findings highlight the need for interventions that prevent and treat trauma exposure among vulnerable women. Such interventions should be tailored to address the correlates of trauma exposure in each age group.

  12. When students become patients: TB disease among medical undergraduates in Cape Town, South Africa.

    PubMed

    Van der Westhuizen, Helene-Mari; Dramowski, Angela

    2017-05-24

    Medical students acquire latent tuberculosis (TB) infection at a rate of 23 cases/100 person-years. The frequency and impact of occupational TB disease in this population are unknown. A self-administered questionnaire was distributed via email and social media to current medical students and recently graduated doctors (2010 - 2015) at two medical schools in Cape Town. Individuals who had developed TB disease as undergraduate students were eligible to participate. Quantitative and qualitative data collected from the questionnaire and semi-structured interviews were analysed with descriptive statistics and a framework approach to identify emerging themes. Twelve individuals (10 female) reported a diagnosis of TB: pulmonary TB (n=6), pleural TB (n=3), TB lymphadenitis (n=2) and TB spine (n=1); 2/12 (17%) had drug-resistant disease (DR-TB). Mean diagnostic delay post consultation was 8.1 weeks, with only 42% of initial diagnoses being correct. Most consulted private healthcare providers (general practitioners (n=7); pulmonologists (n=4)), and nine underwent invasive procedures (bronchoscopy, pleural fluid aspiration and tissue biopsy). Substantial healthcare costs were incurred (mean ZAR25 000 for drug-sensitive TB, up to  ZAR104 000 for DR-TB). Students struggled to obtain treatment, incurred high transport costs and missed academic time. Students with DR-TB interrupted their studies and experienced severe side-effects (hepatotoxicity, depression and permanent ototoxicity). Most participants cited poor TB infection-control practices at their training hospitals as a major risk factor for occupational TB. Undergraduate medical students in Cape Town are at high risk of occupationally acquired TB, with an unmet need for comprehensive occupational health services and support.

  13. Dating violence and self-efficacy for delayed sex among adolescents in Cape Town, South Africa.

    PubMed

    Boafo, Isaac M; Dagbanu, Emmanuel A; Asante, Kwaku Oppong

    2014-06-01

    In South Africa, dating violence is known to be widespread among adolescents, and is therefore a major public health issue because of its association with sexual risk behaviours. The objective of the study was to examine the relationship between dating violence and self-efficacy for delayed sex among school-going adolescents in Cape Town, South Africa. The study is based on analyses of data from a school-based health education programme targeting sexual and reproductive health issues.The study involved 3,655 school-going adolescents aged between 12 and 17 in Cape Town, South Africa. The data was collected by means of a self-administered questionnaire composed of 153 items on sexual and reproductive health, dating violence as well as sociodemographic characteristics. The results indicated that males showed a higher percentage of both dating violence victimization and perpetration, as compared to females. It was also found that adolescents from lower socio-economic backgrounds were more likely to be the victims of dating violence as compared to those from a higher socio-economic background. Female learners showed higher levels of self-efficacy for delayed sex than their male counterparts. Although the result revealed that there was a significant association between self-efficacy for delayed sex and socio-economic status, this link decreased with age. It is concluded that educational programmes aimed solely at improving self-efficacy for delayed sex is insufficient. Such programmes must also aim at preventing dating violence and equipping adolescents with the skills to negotiate their way out of dating violence.

  14. HIV testing and sero-prevalence among methamphetamine users seeking substance abuse treatment in Cape Town.

    PubMed

    Gouse, Hetta; Joska, John A; Lion, Ryan R; Watt, Melissa H; Burnhams, Warren; Carrico, Adam W; Meade, Christina S

    2016-09-01

    Methamphetamine use is highly prevalent in parts of South Africa, and there is concern this will contribute to the country's substantial HIV epidemic. We examined the feasibility of implementing routine HIV testing at a community-based substance abuse treatment centre in Cape Town and determined the HIV sero-prevalence among methamphetamine users seeking treatment at this site. In this cross-sectional study, 293 participants completed measures of demographics, substance use and HIV treatment. HIV sero-prevalence was determined by a rapid finger-prick HIV test, and prior HIV diagnosis was confirmed via clinic records. The majority of participants were male and self-identified as 'Coloured', with a mean age of 28 years. The HIV sero-prevalence was 3.8%. Of the 11 participants who tested HIV positive, four were newly diagnosed. HIV-positive and HIV-negative participants were comparable on demographic and substance use factors. Uptake of HIV testing among all clients at the drug treatment centre increased from <5% prior to study initiation to 89% after study completion. Measures implemented to ensure high rates of HIV testing were regarded as sustainable. Our study suggests that integrating routine HIV testing into substance abuse treatment is feasible in a community-based health centre. The low HIV prevalence among this sample of treatment-seeking methamphetamine users highlights the potential benefits of supporting expanded efforts to optimise HIV prevention with this young adult population. [Gouse H, Joska JA, Lion RR, Watt MH, Burnhams W, Carrico AW, Meade CS. HIV testing and sero-prevalence among methamphetamine users seeking substance abuse treatment in Cape Town. Drug Alcohol Rev 2016;35:580-583]. © 2015 Australasian Professional Society on Alcohol and other Drugs.

  15. Continuity and Change in Community Organisations. Trends in Greater Cape Town from 1989 to 1991. CORE Working Paper No. 1.

    ERIC Educational Resources Information Center

    Walters, Shirley

    This paper gives an overview of some trends and issues for community organizations in the greater Cape Town (South Africa) area from 1989-1991. Section 1 provides first a brief overview of the sociopolitical developments during those years as a background to the developments within community organizations. Then, it discusses key issues for…

  16. A Comparison of the Effects of Witnessing Community Violence and Direct Victimization among Children in Cape Town, South Africa

    ERIC Educational Resources Information Center

    Shields, Nancy; Nadasen, Kathy; Pierce, Lois

    2009-01-01

    This study is based on a sample of children from the Cape Town area in South Africa. The study compares the effects of witnessing school or neighborhood violence compared with being victimized in each context on psychological distress. The findings suggest that in the context of the school, victimization has a somewhat stronger effect on distress…

  17. Brief Report: Social and Neighbourhood Correlates of Adolescent Drunkenness--A Pilot Study in Cape Town, South Africa

    ERIC Educational Resources Information Center

    Parry, Charles D. H.; Morojele, Neo K.; Saban, Amina; Flisher, Alan J.

    2004-01-01

    Aim: To identify social and neighbourhood correlates of drunkenness among adolescents. Design: A cross-sectional, community study. Participants: A multi-stage cluster sampling strategy was used to select 90 adolescents aged 11-17 years from nine distinct communities in Cape Town, South Africa. The sample was stratified by race, income, and gender.…

  18. "Learning Service" in International Contexts: Partnership-Based Service-Learning and Research in Cape Town, South Africa

    ERIC Educational Resources Information Center

    McMillan, Janice; Stanton, Timothy K.

    2014-01-01

    In this paper we explore an approach to developing and implementing service-learning and community-based research in a study-abroad program in Cape Town, South Africa. Drawing on a notion of partnerships reflecting the values of accompaniment and transparency, and influenced by the importance of learning service, we outline an intentional, engaged…

  19. A Comparison of the Effects of Witnessing Community Violence and Direct Victimization among Children in Cape Town, South Africa

    ERIC Educational Resources Information Center

    Shields, Nancy; Nadasen, Kathy; Pierce, Lois

    2009-01-01

    This study is based on a sample of children from the Cape Town area in South Africa. The study compares the effects of witnessing school or neighborhood violence compared with being victimized in each context on psychological distress. The findings suggest that in the context of the school, victimization has a somewhat stronger effect on distress…

  20. Brief Report: Social and Neighbourhood Correlates of Adolescent Drunkenness--A Pilot Study in Cape Town, South Africa

    ERIC Educational Resources Information Center

    Parry, Charles D. H.; Morojele, Neo K.; Saban, Amina; Flisher, Alan J.

    2004-01-01

    Aim: To identify social and neighbourhood correlates of drunkenness among adolescents. Design: A cross-sectional, community study. Participants: A multi-stage cluster sampling strategy was used to select 90 adolescents aged 11-17 years from nine distinct communities in Cape Town, South Africa. The sample was stratified by race, income, and gender.…

  1. The "Affective Place-Making" Practices of Girls at a High School in Cape Town, South Africa

    ERIC Educational Resources Information Center

    Rinquest, Elzahn; Fataar, Aslam

    2016-01-01

    This article focuses on the "affective place-making" practices of girls at a private high school on the outskirts of Cape Town. The article responds to the question: How do high school girls' affects and social bodies contribute to their place-making practices and to the type of place they make of their school? Our focus is on…

  2. From Digital Divide to Digital Equity: Learners' ICT Competence in Four Primary Schools in Cape Town, South Africa

    ERIC Educational Resources Information Center

    Gudmundsdottir, G. B.

    2010-01-01

    This study explores factors influencing the digital divide in four schools in Cape Town, South Africa. Three of the schools are for disadvantaged learners whereas the fourth was previously for whites only. All the schools use ICT in their curriculum delivery and thereby support the emphasis of provincial educational authorities on ICT access for…

  3. A qualitative study of methamphetamine initiation in Cape Town, South Africa.

    PubMed

    Hobkirk, Andréa L; Watt, Melissa H; Myers, Bronwyn; Skinner, Donald; Meade, Christina S

    2016-04-01

    Despite a significant rise in methamphetamine use in low- and middle-income countries, there has been little empirical examination of the factors that contribute to individuals' initiation of methamphetamine use in these settings. The goal of this study was to qualitatively examine factors associated with methamphetamine initiation in South Africa. In-depth interviews were conducted with 30 active methamphetamine users (13 women and 17 men) in Cape Town, South Africa. Interviews included narrative descriptions of the circumstances surrounding methamphetamine initiation. Interviews were audio recorded, transcribed, and translated. Transcripts were analyzed with document memos, data display matrices, and a constant comparison technique to identify themes. On average, participants began regularly using methamphetamine around age 21 and had used for seven years. Four major themes emerged related to the initiation of methamphetamine use. The prevalence of methamphetamine users and distributors made the drug convenient and highly accessible to first time users. Methamphetamine has increased in popularity and is considered "trendy", which contributes to social pressure from friends, and less often, family members to initiate use. Initiation is further fueled by a lack of opportunities for recreation and employment, which leads to boredom and curiosity about the rumored positive effects of the drug. Young people also turn to methamphetamine use and distribution through gang membership as an attempt to generate income in impoverished communities with limited economic opportunities. Finally, participants described initiating methamphetamine as a means of coping with the cumulative stress and psychological burden provoked by the high rates of violence and crime in areas of Cape Town. The findings highlight the complex nature of methamphetamine initiation in low- and middle-income countries like South Africa. There is a need for community-level interventions to address the

  4. Food items consumed by students attending schools in different socioeconomic areas in Cape Town, South Africa.

    PubMed

    Temple, Norman J; Steyn, Nelia P; Myburgh, Neil G; Nel, Johanna H

    2006-03-01

    We investigated the food consumption patterns of adolescent students at schools. Our findings are intended to reveal the overall nutritional quality of foods eaten by students at school, including foods brought to school and foods purchased at school. A questionnaire was completed by 476 students, mostly from grades 7 and 10, from 14 schools in Cape Town, South Africa. The schools were representative of the various ethnic groups and socioeconomic strata of the population. The questionnaire requested information on eating habits at school, foods brought to school and food purchases, and breakfast consumption before school. We also tested whether students knew which foods are healthy and which are less healthy choices. The students were mostly 12 to 16 y of age (mean age 14.5 y). The large majority had breakfast before school (77.8%) and ate at school (79.7%). Food was brought to school by 41% to 56%, whereas 69.3% purchased food at school, mainly at the school store (tuck shop). Predefined "unhealthy" foods brought to school outnumbered "healthy" ones by 2 to 1. Among students who purchased food at school, 70.0% purchased no healthy items, whereas 73.2% purchased two or more unhealthy items. With six foods 84% of students correctly stated whether they were healthy or unhealthy; however, with cola drinks, samoosas (deep-fried pastry with spicy filling), and pies, only 47% to 61% knew that these were less healthy choices. Students' scores on this question were unrelated to whether they purchased healthy or unhealthy foods. Students who attended schools of high socioeconomic status were twice as likely to bring food to school (64.7% versus 31.0%, P<0.001), scored higher marks on the quiz of healthy versus unhealthy foods (P<0.01), but were no more likely to purchase healthy food. The large majority of food eaten by adolescent students in Cape Town is classified as being unhealthy choices. This applies to foods brought to school and food purchases. Consideration needs

  5. Coital frequency and condom use in monogamous and concurrent sexual relationships in Cape Town, South Africa

    PubMed Central

    Delva, Wim; Meng, Fei; Beauclair, Roxanne; Deprez, Nele; Temmerman, Marleen; Welte, Alex; Hens, Niel

    2013-01-01

    Introduction A decreased frequency of unprotected sex during episodes of concurrent relationships may dramatically reduce the role of concurrency in accelerating the spread of HIV. Such a decrease could be the result of coital dilution – the reduction in per-partner coital frequency from additional partners – and/or increased condom use during concurrency. To study the effect of concurrency on the frequency of unprotected sex, we examined sexual behaviour data from three communities with high HIV prevalence around Cape Town, South Africa. Methods We conducted a cross-sectional survey from June 2011 to February 2012 using audio computer-assisted self-interviewing to reconstruct one-year sexual histories, with a focus on coital frequency and condom use. Participants were randomly sampled from a previous TB and HIV prevalence survey. Mixed effects logistic and Poisson regression models were fitted to data from 527 sexually active adults reporting on 1210 relationship episodes to evaluate the effect of concurrency status on consistent condom use and coital frequency. Results The median of the per-partner weekly average coital frequency was 2 (IQR: 1–3), and consistent condom use was reported for 36% of the relationship episodes. Neither per-partner coital frequency nor consistent condom use changed significantly during episodes of concurrency (aIRR=1.05; 95% confidence interval (CI): 0.99–1.24 and aOR=1.01; 95% CI: 0.38–2.68, respectively). Being male, coloured, having a tertiary education, and having a relationship between 2 weeks and 9 months were associated with higher coital frequencies. Being coloured, and having a relationship lasting for more than 9 months, was associated with inconsistent condom use. Conclusions We found no evidence for coital dilution or for increased condom use during concurrent relationship episodes in three communities around Cape Town with high HIV prevalence. Given the low levels of self-reported consistent condom use, our

  6. A qualitative study of methamphetamine initiation in Cape Town, South Africa

    PubMed Central

    Hobkirk, Andréa L.; Watt, Melissa H.; Myers, Bronwyn; Skinner, Donald; Meade, Christina S.

    2015-01-01

    Background Despite a significant rise in methamphetamine use in low- and middle-income countries, there has been little empirical examination of the factors that contribute to individuals’ initiation of methamphetamine use in these settings. The goal of this study was to qualitatively examine factors associated with methamphetamine initiation in South Africa. Methods In-depth interviews were conducted with 30 active methamphetamine users (13 women and 17 men) in Cape Town, South Africa. Interviews included narrative descriptions of the circumstances surrounding methamphetamine initiation. Interviews were audio recorded, transcribed, and translated. Transcripts were analyzed with document memos, data display matrices, and a constant comparison technique to identify themes. Results On average, participants began regularly using methamphetamine around age 21 and had used for seven years. Four major themes emerged related to the initiation of methamphetamine use. The prevalence of methamphetamine users and distributors made the drug convenient and highly accessible to first time users. Methamphetamine has increased in popularity and is considered “trendy”, which contributes to social pressure from friends, and less often, family members to initiate use. Initiation is further fueled by a lack of opportunities for recreation and employment, which leads to boredom and curiosity about the rumored positive effects of the drug. Young people also turn to methamphetamine use and distribution through gang membership as an attempt to generate income in impoverished communities with limited economic opportunities. Finally, participants described initiating methamphetamine as a means of coping with the cumulative stress and psychological burden provoked by the high rates of violence and crime in areas of Cape Town. Conclusion The findings highlight the complex nature of methamphetamine initiation in low- and middle-income countries like South Africa. There is a need for

  7. Prenatal Alcohol Exposure and Interhemispheric Transfer of Tactile Information: Detroit and Cape Town Findings

    PubMed Central

    Dodge, Neil C.; Jacobson, Joseph L.; Molteno, Christopher D.; Meintjes, Ernesta M.; Bangalore, Sumana; Diwadkar, Vaibhav; Hoyme, Eugene H.; Robinson, Luther K.; Khaole, Nathaniel; Avison, Malcolm J.; Jacobson, Sandra W.

    2009-01-01

    Background Previous research has demonstrated that heavy prenatal alcohol exposure affects the size and shape of the corpus callosum (CC) and compromises interhemispheric transfer of information. The aim of this study was to confirm the previous reports of poorer performance on a finger localization test (FLT) of interhemispheric transfer in a cohort of heavily exposed children and to extend these findings to a cohort of moderately exposed young adults. Methods In Study 1, the FLT was administered to 40 heavily-exposed and 23 non-exposed children from the Cape Coloured community of Cape Town, South Africa, who were evaluated for fetal alcohol syndrome (FAS) dysmorphology and growth. Anatomical images of the CC were obtained using structural MRI on a subset of these children. In Study 2, the FLT was administered to a cohort of 85 moderate-to heavily exposed young adults participating in a 19-year follow-up assessment of the Detroit Prenatal Alcohol Exposure cohort, whose alcohol exposure had been ascertained prospectively during gestation. Results In Study 1, children with FAS showed more transfer-related errors than controls after adjustment for confounding, and increased transfer-related errors were associated with volume reductions in the isthmus and splenium of the CC. In Study 2, transfer-related errors were associated with quantity of alcohol consumed per occasion during pregnancy. More errors were made if the mother reported binge drinking (≥ 5 standard drinks) during pregnancy than if she drank regularly (M ≥ 1 drink/per day) without binge drinking. Conclusions These findings confirm a previous report of impaired interhemispheric transfer of tactile information in children heavily exposed to alcohol in utero and extend these findings to show that these deficits are also seen in more moderately exposed individuals, particularly those exposed to binge-like pregnancy drinking. PMID:19519722

  8. The mental health experiences and needs of methamphetamine users in Cape Town: A mixed methods study.

    PubMed

    Watt, Melissa H; Myers, Bronwyn; Towe, Sheri L; Meade, Christina S

    2015-09-21

    South Africa has a burgeoning problem of methamphetamine use, particularly in the Western Cape. Although methamphetamine has been associated with elevated psychological distress, there has been little examination of the mental health needs of out-of-treatment methamphetamine users in South Africa. To describe the mental health experiences and needs of out-of-treatment methamphetamine users in Cape Town. Active methamphetamine users were recruited using respondent driven sampling techniques. Eligible participants (n=360) completed a computer-assisted assessment and clinical interview, where they provided data on mental health symptoms and treatment seeking behaviour. A subset of 30 participants completed qualitative in-depth interviews where they provided narrative accounts of their mental health experiences and needs. Analysis of the mixed-methods data was conducted using a concurrent triangulation strategy, whereby both methods contributed equally to the analysis and were used for cross-validation.  About half of survey participants met screening criteria for depression and traumatic stress, and there were some indications of paranoia. Using substances to cope with psychological distress was common, with participants talking about using methamphetamine to numb their feelings or forget stressful memories. One-third of women and 13`% of men had previously tried to commit suicide. Despite the huge mental health burden in this population, very few had ever received mental health treatment. The data indicates a need for integrated care that addresses both substance use and psychiatric needs in this population. Mental health and drug treatment services targeting methamphetamine users should have a particular focus on suicide prevention.

  9. The impact of methamphetamine ("tik") on a peri-urban community in Cape Town, South Africa.

    PubMed

    Watt, Melissa H; Meade, Christina S; Kimani, Stephen; MacFarlane, Jessica C; Choi, Karmel W; Skinner, Donald; Pieterse, Desiree; Kalichman, Seth C; Sikkema, Kathleen J

    2014-03-01

    Over the last decade, South Africa's Western Cape has experienced a dramatic increase in methamphetamine ("tik") use. Our study explored local impressions of the impact of tik use in a peri-urban township community in Cape Town, South Africa. We conducted individual in-depth interviews with 55 women and 37 men who were regular attendees of alcohol-serving venues. Interviews were recorded and transcribed. A content analysis approach was used to identify themes related to the impact of tik use based on levels of the socio-ecological framework (individual, inter-personal and community). Tik use was reported to be a greater issue among Coloureds, compared to Blacks. At an individual level, respondents reported that tik use had adverse effects on mental, physical, and economic well-being, and limited future opportunities through school drop-out and incarceration. At an inter-personal level, respondents reported that tik use contributed to physical and sexual violence as well as increased rates of sexual risk behaviour, particularly through transactional sex relationships. Respondents described how tik use led to household conflict, and had negative impacts on children, including neglect and poor birth outcomes. At a community level, respondents linked tik use to increased rates of crime, violence and corruption, which undercut community cohesion. Our results highlight the negative impact that tik is having on individuals, households and the overall community in a peri-urban setting in South Africa. There is a clear need for interventions to prevent tik use in South Africa and to mitigate and address the impact of tik on multiple levels. Copyright © 2013 Elsevier B.V. All rights reserved.

  10. Patients' perceptions of the triage system in a primary healthcare facility, Cape Town, South Africa.

    PubMed

    Adeniji, Adeloye A; Mash, Bob

    2016-06-17

    In public healthcare facilities, where the patient numbers and the available resources are often disproportionate, triage is used to prioritise when patients are seen. Patients may not understand the triage process and have strong views on how to improve their experience. This study explored the views of patients who had undergone triage in the emergency centre of a primary care facility. Gugulethu Community Health Centre, Cape Town. A purposive sample consisted of five women (one coded green, three orange, one yellow) and four men (one coded green and three yellow). A semi-structured qualitative interview was conducted in either Xhosa or English and the transcripts analysed using the framework method. All of the respondents complained of a lack of information and poor understanding of the triage process. Those coded green experienced the process as biased and unfair and reported that the triage nurse was rude and unprofessional. By contrast, those coded yellow or orange found the triage nurse to be helpful and professional. Most patients turned to support staff (e.g. security staff or cleaners) for assistance in dealing with the triage system. Most patients waited longer than the guidelines recommend and the green-coded patients complained about this issue. Patients did not have a good experience of the triage system. Managers of the triage system need to design better strategies to improve patient acceptance and share information. The important role of support staff needs to be recognised and strengthened.

  11. Patients’ perceptions of the triage system in a primary healthcare facility, Cape Town, South Africa

    PubMed Central

    Adeniji, Adeloye Amoo

    2016-01-01

    Background In public healthcare facilities, where the patient numbers and the available resources are often disproportionate, triage is used to prioritise when patients are seen. Patients may not understand the triage process and have strong views on how to improve their experience. Aim This study explored the views of patients who had undergone triage in the emergency centre of a primary care facility. Setting Gugulethu Community Health Centre, Cape Town. Methods A purposive sample consisted of five women (one coded green, three orange, one yellow) and four men (one coded green and three yellow). A semi-structured qualitative interview was conducted in either Xhosa or English and the transcripts analysed using the framework method. Results All of the respondents complained of a lack of information and poor understanding of the triage process. Those coded green experienced the process as biased and unfair and reported that the triage nurse was rude and unprofessional. By contrast, those coded yellow or orange found the triage nurse to be helpful and professional. Most patients turned to support staff (e.g. security staff or cleaners) for assistance in dealing with the triage system. Most patients waited longer than the guidelines recommend and the green-coded patients complained about this issue. Conclusion Patients did not have a good experience of the triage system. Managers of the triage system need to design better strategies to improve patient acceptance and share information. The important role of support staff needs to be recognised and strengthened. PMID:27380788

  12. A new tetrahymena (ciliophora, oligohymenophorea) from groundwater of cape town, South Africa.

    PubMed

    Quintela-Alonso, Pablo; Nitsche, Frank; Wylezich, Claudia; Arndt, Hartmut; Foissner, Wilhelm

    2013-01-01

    The identification of species within the genus Tetrahymena is known to be difficult due to their essentially identical morphology, the occurrence of cryptic and sibling species and the phenotypic plasticity associated with the polymorphic life cycle of some species. We have combined morphology and molecular biology to describe Tetrahymena aquasubterranea n. sp. from groundwater of Cape Town, Republic of South Africa. The phylogenetic analysis compares the cox1 gene sequence of T. aquasubterranea with the cox1 gene sequences of other Tetrahymena species and uses the interior-branch test to improve the resolution of the evolutionary relationships. This showed a considerable genetic divergence of T. aquasubterranea to its next relative, T. farlyi, of 9.2% (the average cox1 divergence among bona fide species of Tetrahymena is ~ 10%). Moreover, the analysis also suggested a sister relationship between T. aquasubterranea and a big clade comprising T. farleyi, T. tropicalis, T. furgasoni and T. mobilis. The morphological data available for these species show that they share with T. aquasubterranea a pyriformis-like life style and at least two of them, T. farleyi and T. mobilis, a similar type II silverline pattern consisting of primary and secondary meridians. Tetrahymena aquasubterranea exhibits a biphasic life cycle with trophonts and theronts, is amicronucleate, and feeds on bacteria. © 2013 The Author(s) Journal of Eukaryotic Microbiology © 2013 International Society of Protistologists.

  13. HIV Prevalence and Risk Factors Among Male Foreign Migrants in Cape Town, South Africa.

    PubMed

    Giorgio, Margaret; Townsend, Loraine; Zembe, Yanga; Cheyip, Mireille; Guttmacher, Sally; Carter, Rebecca; Mathews, Cathy

    2017-03-01

    While migration has been shown to be a risk factor for HIV, variation in HIV prevalence by subgroups of migrants needs further exploration. This paper documents the HIV prevalence and key characteristics among male foreign migrants in Cape Town, South Africa and the effectiveness of respondent-driven sampling (RDS) to recruit this population. Participants in this cross-sectional study completed a behavioral risk-factor questionnaire and provided a dried blood sample for HIV analysis. Overall HIV prevalence was estimated to be 8.7 % (CI 5.4-11.8) but varied dramatically by country of origin. After adjusting for country of origin, HIV sero-positivity was positively associated with older age (p = 0.001), completing high school (p = 0.025), not having enough money for food (p = 0.036), alcohol use (p = 0.049), and engaging in transactional sex (p = 0.022). RDS was successful in recruiting foreign migrant men. A better understanding of the timing of HIV acquisition is needed to design targeted interventions for migrant men.

  14. Routine programmatic delivery of isoniazid preventive therapy to children in Cape Town, South Africa.

    PubMed

    Osman, M; Hesseling, A C; Beyers, N; Enarson, D A; Rusen, I D; Lombard, C; van Wyk, S S

    2013-09-21

    Fourteen primary health care facilities in Cape Town, South Africa. To determine the proportion and characteristics of infectious adult tuberculosis (TB) cases that identify children aged <5 years who qualify for isoniazid preventive therapy (IPT), and to determine the proportion of children who initiate and complete IPT. A retrospective clinical record review conducted as a stratified cluster survey. Of 1179 records of infectious adult cases, 33.3% had no documentation of contacts. Of the remaining 786 records, 525 contacts aged <5 years were identified, representing 0.7 child contacts per infectious adult case. Older age, male, human immunodeficiency virus (HIV) positive, smear-negative and retreatment TB cases were all associated with no documentation of contacts. Of the 525 child contacts identified, less than half were screened for TB, 141 initiated IPT and 19 completed it. Less than 67% of infectious TB case records had documentation of contacts. Younger, female, HIV-negative and new smear-positive TB cases were more likely to have had contacts identified. Less than 14% of children already initiated on IPT completed 6 months of treatment.

  15. Making assessment locally relevant: measuring functioning for maternal depression in Khayelitsha, Cape Town.

    PubMed

    Schneider, Marguerite; Baron, Emily; Davies, Thandi; Bass, Judith; Lund, Crick

    2015-05-01

    We developed a locally relevant functioning assessment instrument (FAI) for pregnant women and mothers of young babies to complement a widely validated instrument-the World Health Organization's Disability Assessment Schedule (WHODAS) 12-item version. The FAI is an outcome measure in a randomised controlled trial on the effectiveness of a lay counsellor administered intervention for distressed pregnant women in Khayelitsha, Cape Town. Nine items most commonly reported by 40 pregnant women or mothers with young babies in qualitative interviews were selected for the instrument, with a 10th item 'Other'. The FAI was validated with 142 pregnant women and mothers in Khayelitsha. Analysis was conducted to assess internal reliability, exploratory factor analysis and convergent validity. The FAI had good internal reliability (Cronbach's alpha = 0.77) and the explanatory factor analysis showed a clear 3-factor solution, relating to domestic, childcare and social activities. The FAI scores showed floor effects, but were positively correlated with the two measures of functioning (WHODAS 2.0 and Washington Group Short Set). The FAI scores also correlated with the measure of depression (Edinburgh Postnatal Depression Scale-EPDS), reflecting increased functional limitations associated with increased depressive symptoms. The results show that the FAI has good internal reliability, and good convergent and construct validity as a measure of functioning for this context. This paper reports on the process of developing an instrument and highlights the importance of using instruments that are locally relevant to ensure accurate measurement of functional status.

  16. Routine programmatic delivery of isoniazid preventive therapy to children in Cape Town, South Africa

    PubMed Central

    Hesseling, A. C.; Beyers, N.; Enarson, D. A.; Rusen, I. D.; Lombard, C.; van Wyk, S. S.

    2013-01-01

    Setting: Fourteen primary health care facilities in Cape Town, South Africa. Objective: To determine the proportion and characteristics of infectious adult tuberculosis (TB) cases that identify children aged <5 years who qualify for isoniazid preventive therapy (IPT), and to determine the proportion of children who initiate and complete IPT. Design: A retrospective clinical record review conducted as a stratified cluster survey. Results: Of 1179 records of infectious adult cases, 33.3% had no documentation of contacts. Of the remaining 786 records, 525 contacts aged <5 years were identified, representing 0.7 child contacts per infectious adult case. Older age, male, human immunodeficiency virus (HIV) positive, smear-negative and retreatment TB cases were all associated with no documentation of contacts. Of the 525 child contacts identified, less than half were screened for TB, 141 initiated IPT and 19 completed it. Conclusion: Less than 67% of infectious TB case records had documentation of contacts. Younger, female, HIV-negative and new smear-positive TB cases were more likely to have had contacts identified. Less than 14% of children already initiated on IPT completed 6 months of treatment. PMID:26393029

  17. The MobiSan approach: informal settlements of Cape Town, South Africa.

    PubMed

    Naranjo, A; Castellano, D; Kraaijvanger, H; Meulman, B; Mels, A; Zeeman, G

    2010-01-01

    Pook se Bos informal settlement and the Cape Town Water & Sanitation Services Department are partnering on an urban sanitation project with a Dutch Consortium consisting of Lettinga Associates Foundation (LeAF), Landustrie Sneek and Vitens-Evides International. The aim of the project is to improve the basic sanitation services provided in informal settlements through the implementation of the MobiSan approach. The approach consists of a communal Urine-Diversion and Dehydration Toilet (UDDT) built in a former sea shipping container. The system is independent of water, electricity or sewerage connection and it is maintained by full-time community caretakers who also act as hygiene promoters. The project seeks to link sanitation services with hygiene promotion in informal settlements while enhancing user satisfaction and reducing costs in providing basic sanitation services. This paper describes the preliminary experiences and lessons learnt during the implementation and evaluation of the MobiSan prototype and discusses its potential for replication. The MobiSan has proved to be an appropriate option by means of dealing successfully with shallow groundwater table, land availability and high settlement densities. In addition it has been demonstrated to be cost-competitive in terms of operating cost compared to chemical toilets.

  18. Family Ties and Young Fathers’ Engagement in Cape Town, South Africa

    PubMed Central

    Clark, Shelley; Cotton, Cassandra; Marteleto, Leticia J.

    2015-01-01

    Young South African fathers are often engaged in their children’s lives even if they do not live together. Using longitudinal data on children (n = 1,209) from the Cape Town area, the authors show that although only 26% of young fathers live with their children, 66% of nonresidential fathers maintain regular contact, and 61% provide financial support. The father–child relationship, however, is embedded in broader family ties. The type of father–mother relationship is strongly associated with whether fathers coreside with their children, but not with fathers’ contact with nonresidential children. Close mother and maternal grandmother bonds reduce the likelihood that fathers live with their children, whereas close ties between fathers and paternal grandmothers increase the chance that fathers visit nonresidential children. Family ties do not affect fathers’ financial contributions, which are driven by men’s current economic situation. These findings illustrate that father–child relationships are best understood in the context of interacting family systems. PMID:25774066

  19. Economic empowerment and black disabled entrepreneurs: negotiating partnerships in Cape Town, South Africa.

    PubMed

    Lorenzo, T; van Niekerk, L; Mdlokolo, P

    2007-03-15

    This paper presents a second part reporting on Community Disability Entrepreneurship Project (CoDEP) which was initiated in order to contribute to the development of entrepreneurial skills of disabled people living in informal settlements around Cape Town, South Africa. The aim of CoDEP has been the upliftment and economic empowerment of disabled people. This paper describes the point of departure, the theoretical framework of participatory action research (PAR), the development of research parameters, and continued focus. A participatory action research (PAR) approach was initiated in order to monitor and inform the effective development of CoDEP. This cyclic methodology allowed all participants to engage in decision-making and development of the programme. While negotiating partnerships with disabled entrepreneurs, the six spheres within which optimal interaction could take place emerged as: (i) the choice of occupation; (ii) changing a culture of receiving; (iii) nurturing teamwork by negotiating roles and responsibilities; (iv) a focus on ability; (v) understanding the research process; and (vi) organizational development dynamics. Committed interaction emerged as the quintessence of these partnerships.

  20. Pricing landfill externalities: emissions and disamenity costs in Cape Town, South Africa.

    PubMed

    Nahman, Anton

    2011-01-01

    The external (environmental and social) costs of landfilling (e.g. emissions to air, soil and water; and 'disamenities' such as odours and pests) are difficult to quantify in monetary terms, and are therefore not generally reflected in waste disposal charges or taken into account in decision making regarding waste management options. This results in a bias against alternatives such as recycling, which may be more expensive than landfilling from a purely financial perspective, but preferable from an environmental and social perspective. There is therefore a need to quantify external costs in monetary terms, so that different disposal options can be compared on the basis of their overall costs to society (financial plus external costs). This study attempts to estimate the external costs of landfilling in the City of Cape Town for different scenarios, using the benefits transfer method (for emissions) and the hedonic pricing method (for disamenities). Both methods (in particular the process of transferring and adjusting estimates from one study site to another) are described in detail, allowing the procedures to be replicated elsewhere. The results show that external costs are currently R111 (in South African Rands, or approximately US$16) per tonne of waste, although these could decline under a scenario in which energy is recovered, or in which the existing urban landfills are replaced with a new regional landfill.

  1. 'A bothersome death'--narrative accounts of infant mortality in Cape Town, South Africa.

    PubMed

    Lerer, L B; Butchart, A; Blanche, M T

    1995-04-01

    Traditional measures of health status such as mortality rates and cause-of-death information give limited insight into the role of caregivers and health care providers in infant illness and death. To the extent that the behaviours of these parties can be accurately mapped, they may reveal important sites for effective community interventions and the improvement of medical care. This possibility is explored in relation to infant mortality in Cape Town, South Africa, by analysing verbal histories provided by the caregivers of 70 infants in the course of obtaining police death certification. From these verbal histories it appears that acute respiratory infection and diarrhoeal disease caused the majority of deaths. Infants with a respiratory condition were likely to have been taken for medical attention prior to death. By contrast, the parents of infants with diarrhoeal disease, while more active towards these infants, were less likely to seek medical care--these infants typically being found dead in bed or dying en route to the hospital or clinic. A story of infant death at home following recent medical care was obtained in over half the cases. This study demonstrates a simple method for the examination of the content and structure of lay accounts of illness and death. The implications for health care of such accounts are discussed in terms of the behavioural antecedents of infant mortality due to acute respiratory infections and diarrhoeal disease.

  2. Social and cultural contexts of concurrency in a township in Cape Town, South Africa.

    PubMed

    Mah, Timothy L; Maughan-Brown, Brendan

    2013-01-01

    Understanding the social and cultural context in which concurrent sexual partnerships exist is important, given recent interventions to reduce their prevalence. This qualitative study seeks to improve the understanding of concurrent partnerships and perceptions of the link between concurrency and HIV risk in a South African township in Cape Town. Small-group discussion and focus-group participants reported that concurrency was a common phenomenon in their township. The most commonly cited reasons for participating in concurrent partnerships were material and financial exchange or gain and sexual dissatisfaction with partners. Although participants believed that being in a concurrent relationship increases the risk of acquiring HIV, they did not believe this discourages many people from engaging in these behaviours. This study highlights that concurrency in this context may be a social norm that is resistant to change. The efficacy of current programmes aimed at reducing concurrency needs to be examined in this context. Our findings suggest that improving economic independence at the individual level and improving sexual satisfaction within partnerships may have some leverage for concurrency reduction. An alternative approach to strengthen combination HIV-prevention strategies could be to increase condom use with the additional/side partners, whose predominant role is often perceived in terms of sex, with messages centred on the notion that sex with additional partner(s) should not endanger the main partner.

  3. Silence, blame and AIDS conspiracy theories among the Xhosa people in two townships in Cape Town.

    PubMed

    Sivelä, Jonas Samuel

    2015-01-01

    Conspiratorial expressions about the origins of HIV/AIDS have been recognised as an outcome of the AIDS epidemic in South Africa. This article examines the reasons behind AIDS conspiracy theories, which include a reoccurring repertory of themes, motifs and characters. In these expressions, the malevolent antagonist is the replaced apartheid regime, along with other more archetypal adversaries. So far, AIDS conspiracy theories have been interpreted in terms of currently perceived injustices and frustrations related to the complex past of South Africa. Based on ethnographic fieldwork conducted among Xhosa people in two townships in Cape Town, this article goes further to examine how AIDS conspiracy theories in South Africa can be ascribed to gender-based communication. Sporadic but pronounced expressions of conspiratorial thinking should be understood as connected to local traditions of avoidance and respect. Moreover, the fact that conspiratorial expressions are more common among men can be seen in terms of a counter-narrative mechanism, which is to some extent due to the blame that is cast on men for being the main culprits behind the spread of HIV/AIDS.

  4. Perceived vulnerability and HIV testing among youth in Cape Town, South Africa.

    PubMed

    Tenkorang, Eric Y

    2016-06-01

    The importance of perceived vulnerability to risk-reducing behaviors, including HIV testing, is fairly established, especially among youth in sub-Saharan Africa. Yet, the majority of studies that examined this important relationship used cross-sectional data that inherently assume that perceived vulnerability does not change. While these studies have been useful, the assumption of perceived vulnerability as time invariant is a major flaw and has largely limited the practical usefulness of this variable in AIDS prevention and programing. Using longitudinal data and applying random-effects logit models, this study makes a major contribution to scholarship by examining if changes in perceived vulnerability associate with a change to test for HIV among 857 young people in Cape Town, South Africa. Results show that female youth who changed their risk perceptions were more likely to also change to test for HIV, but the effects were completely attenuated after controlling for theoretically relevant variables. No significant relationships were observed for males. Also, females who were virgins at wave 2 but had sex between waves were significantly more likely to have changed to test for HIV. Of most importance was that sexual behavior eliminated the effects of change in risk perceptions suggesting that a change in perception may have occurred as a result of changes in sexual behavior. AIDS prevention programs must pay particular attention to helping youth become aware of their vulnerability to HIV risks, especially as these have implications for risk-reducing behaviors, especially for females who are burdened.

  5. New constraints on historical dipole field decay: Four centuries of archaeointensity from Cape Town, South Africa.

    NASA Astrophysics Data System (ADS)

    Hare, V. J.; Gallet, Y.; Genevey, A.

    2015-12-01

    Current global geomagnetic field models suffer from strong bias towards Northern Hemisphere data. Absolute intensity measurements from the Southern Hemisphere are key to understanding the evolution of the field over the historical era, especially recent strengthening of non-dipole contributions, and the appearance of the South Atlantic Magnetic Anomaly (SAMA). I present the first archaeointensity data for locally-fired historical bricks from several well-dated sites (1660-2009 AD) in Cape Town, South Africa. These data constitute the first archaeomagnetic intensity variation curve for southern Africa for the past few centuries. The ages of the sites are tightly constrained by historical and archaeological considerations. Archaeointensity data obtained by the Thellier and Thellier method (modified by Coe), are corrected for both TRM anisotropy and cooling rate dependence of TRM acquisition. Analysis of magnetic mineralogy was performed to aid selection of fragments. Reliable archaeointensity determinations were obtained for 48 of 80 specimens, and 45 were retained in the final analysis. Intensity results vary from 24.3 ± 0.6 μT (modern brick) to 40.7 ± 0.8 μT (1660 AD), corresponding to Virtual Axial Dipole Moments (VADMs) between 6.1 ± 0.2 and 10.2 ± 0.2 נ1022 Am2. Results are generally not in agreement with current field models, but are coherent with other archaeomagnetic datasets from the Southern Hemisphere. The possible reasons for this are discussed, as well as implications for the historical evolution of the field.

  6. HIV prevalence and risk behaviours among foreign migrant women residing in Cape Town, South Africa.

    PubMed

    Townsend, Loraine; Giorgio, Maggie; Zembe, Yanga; Cheyip, Mireille; Mathews, Catherine

    2014-10-01

    HIV prevalence and risk behaviour among foreign migrants in South Africa has not been explored. This paper describes the effectiveness of respondent-driven sampling (RDS) to recruit foreign migrant women residing in Cape Town, reports HIV prevalence, and describes key characteristics among them. We conducted a biological and behavioural surveillance survey using RDS. After written informed consent, participants completed an audio computer assisted self-interview and provided a dried blood sample for HIV analysis. HIV prevalence was estimated to be 7 % (CI 4.9-9.5) among 935 women. HIV sero-positivity was associated with older age (p = 0.001), country of origin (p < 0.000), being unmarried (p < 0.000), having lived in South Africa for 3-5 years (p = 0.023), sexual debut at ≥15 years (p = 0.047), and having used a condom at last sex with a main partner (p = 0.007). Few women reported early sexual debut, or multiple sexual partners. RDS was successful in recruiting foreign migrant women.

  7. Acute appendicitis in the public and private sectors in Cape Town, South Africa.

    PubMed

    Yang, Estin; Cook, Colin; Kahn, Delawir

    2015-07-01

    South Africa has a low incidence of acute appendicitis, but poor outcomes. However, South African studies on appendicitis focus solely on public hospitals, neglecting those who utilize private facilities. This study aims to compare appendicitis characteristics and outcomes in public and private hospitals in South Africa. A prospective cohort study was conducted among two public and three private hospitals in the Cape Town metropole, from September 2013 to March 2014. Hospital records, operative notes, and histology results were reviewed for patients undergoing appendectomy for acute appendicitis. Patients were interviewed during their hospitalization and followed up at monthly intervals until normal function was attained. A total of 134 patients were enrolled, with 73 in the public and 61 in the private sector. Education and employment were higher among private sector patients. Public sector patients had a higher rupture rate (30.6 vs 13.2 %, p = 0.023). Times to presentation were not statistically different between the two cohorts. Public sector patients had longer hospital stays (5.3 vs 2.9 days, p = 0.036) and longer return to work times (23.0 vs 12.1 days, p < 0.0001). Although complication rates were similar, complications in public hospitals were more severe. Public sector patients in South Africa with appendicitis have higher rupture rates, worse complications, longer hospital stays, and longer recoveries than private sector patients. Patients with perforation had longer delays in presentation than patients without perforation.

  8. HIV risk behavior among methamphetamine users entering substance abuse treatment in Cape Town, South Africa

    PubMed Central

    Meade, Christina S.; Lion, Ryan R.; Cordero, Daniella M.; Watt, Melissa H.; Joska, John A.; Gouse, Hetta; Burnhams, Warren

    2016-01-01

    South Africa is experiencing a growing methamphetamine problem, and there is concern that methamphetamine use may accelerate HIV transmission. There has been little research on the HIV prevention needs of methamphetamine users receiving substance abuse treatment in South Africa. This study assessed the prevalence and correlates of HIV risk behaviors among 269 methamphetamine users entering substance abuse treatment in two clinics in Cape Town. The prevalence of sexual risk behaviors was high among sexually active participants: 34% multiple partners, 26% unprotected intercourse with a casual partner, and 24% sex trading for money/methamphetamine. The strongest predictor of all sexual risk behaviors was concurrent other drug use. Over half had not been HIV tested in the past year, and 25% had never been tested, although attitudes toward HIV testing were overwhelmingly positive. This population of primarily heterosexual, non-injecting methamphetamine users is a high-risk group in need of targeted HIV prevention interventions. Substance abuse treatment is an ideal setting in which to reach methamphetamine users for HIV services. PMID:26873492

  9. Are elderly pedestrians allowed enough time at pedestrian crossings in Cape Town, South Africa?

    PubMed

    Amosun, S L; Burgess, T; Groeneveldt, L; Hodgson, T

    2007-01-01

    A descriptive, cross-sectional analytical study was conducted to determine whether the recommended walking speed of 1.2 ms(-1) would allow elderly pedestrians to safely clear pedestrian crossings in Cape Town, South Africa. Male and female volunteers (n = 47), aged 65-93 years and resident in four homes for older persons, were recruited. Pedestrian clearance intervals at 40 traffic lights within 5-km radius of the selected homes were measured. The mean walking speed required at these traffic lights was 0.86 +/- 0.32 ms(1). The maximal walking speed over 12 m was measured without carrying any load and when carrying a predetermined weight of an average shopping bag. Participants' emotions associated with pedestrian road safety were also assessed through an interview. The mean maximal unloaded and loaded walking speeds were 1.36 +/- 0.31 ms(-1) (0.73-2.03 ms(-1)), and 1.36 +/- 0.33 ms(-1) (0.58-2.12 ms(-1)), respectively. Over 30% of the participants walked slower than the recommended walking speed of 1.2 ms(-1). Participants felt that traffic lights did not allow for sufficient time to cross roads (51.1%) and reported emotions of apprehension (44.7%), anxiety (17.0%), and fear (10.6%) when crossing. A review of traffic planning and public policy is recommended to ensure older pedestrians safely clear pedestrian crossings.

  10. Gender and Sex Trading Among Active Methamphetamine Users in Cape Town, South Africa.

    PubMed

    Lion, Ryan R; Watt, Melissa H; Wechsberg, Wendee M; Meade, Christina S

    2017-05-12

    South Africa has experienced a tremendous rise in methamphetamine use since the year 2000. Sex trading is a global phenomenon that has been observed in active drug users and has been associated with risks for HIV infection and violence. This paper describes and examines the correlates of sex trading among active methamphetamine users in Cape Town, South Africa. Through peer referral, 360 (201 male; 159 female) active methamphetamine users were recruited in a peri-urban township. Demographics, sex trading, drug use, trauma, and mental health were assessed by a structured clinical interview and computer survey. Logistic regression models were used to examine predictors of sex trading for men and women. In the past 3 months, 40% of men and 33% of women endorsed trading sex for methamphetamine or money. Among these, they reported trading with same sex partners (33%), high rates of inconsistent condom use (73%), and incidences of physical (23%) and sexual (27%) assault when sex trading. Increased drug use severity was correlated with sex trading. Women with experiences of violence and trauma were also more likely to trade sex. Conclusions/importance: The results stress a need for linkage to drug treatment, as addiction may be fueling sex trading. Targeted interventions geared towards safe sex practices may reduce risky sexual behaviors. Women need interventions that are attuned to their specific vulnerabilities. More research is needed to explore the experiences of men who have sex with men given their particularly high rates of sex trading behavior.

  11. Mediators of interpersonal violence and drug addiction severity among methamphetamine users in Cape Town, South Africa

    PubMed Central

    Hobkirk, Andréa L.; Watt, Melissa H.; Green, Kimberly T.; Beckham, Jean C.; Skinner, Donald; Meade, Christina S.

    2014-01-01

    South Africa has high rates of interpersonal violence and a rapidly growing methamphetamine epidemic. Previous research has linked experiences of interpersonal violence to higher rates of substance use, and identified mental health constructs as potential mediators of this association. The aim of this study was to examine the relationship between interpersonal violence and addiction severity among active methamphetamine users in Cape Town, South Africa, and to explore symptoms of posttraumatic stress disorder (PTSD) and substance use coping as mediators of this relationship. A community sample of 360 methamphetamine users was recruited through respondent driven sampling and surveyed on their experiences of violence, mental health, coping, and drug use and severity. A series of one-way ANOVAs were conducted to examine the relationship of self-reported interpersonal violence with drug addiction severity, and multiple mediation analyses were used to determine if PTSD symptoms and substance use coping mediated this relationship. The majority (87%) of the sample reported experiencing at least one instance of interpersonal violence in their lifetime, and the number of violent experiences was associated with increased drug addiction severity. PTSD and substance use coping were significant mediators of this association. Only the indirect effect of substance use coping remained significant for the female sample when the mediation model was conducted separately for men and women. The findings point to the need for integrated treatments that address drug use and PTSD for methamphetamine users in South Africa and highlight the importance of coping interventions for women. PMID:25479528

  12. Use of crystal methamphetamine among male adolescents in Cape Town, South Africa: Caregivers' experiences.

    PubMed

    Asante, Kwaku Oppong; Lentoor, Antonio G

    2017-03-27

    Against the background that crystal methamphetamine (colloquially known as "tik") is extensively used by the emerging working class Coloured youth in Cape Town, South Africa, this exploratory qualitative study was conducted to explore the experience of mothers whose children use methamphetamine. The researchers conducted one-to-one semi-structured in-depth interviews with sixteen (16) purposively selected caregivers (mothers) whose sons use methamphetamine. Interviews were recorded and simultaneously translated and transcribed. Thematic analysis was used to identify themes related to the experiences of caregivers of youth with methamphetamine problems. Findings showed that youth misbehaviour provided a context that led to feelings of shame and embarrassment. Participants also experienced personal challenges which included emotional problems, fear and self-blame. Participants also expressed family disruptions and financial drain as adverse experiences as a results of their sons' misbehaviour. The study results highlight the psychosocial challenges for caregivers of children who use methamphetamine. These findings underscore the need for effort to be directed at the development of formal support interventions for mothers of youth who are troubled with addiction.

  13. HIV Risk Behavior Among Methamphetamine Users Entering Substance Abuse Treatment in Cape Town, South Africa.

    PubMed

    Meade, Christina S; Lion, Ryan R; Cordero, Daniella M; Watt, Melissa H; Joska, John A; Gouse, Hetta; Burnhams, Warren

    2016-10-01

    South Africa is experiencing a growing methamphetamine problem, and there is concern that methamphetamine use may accelerate HIV transmission. There has been little research on the HIV prevention needs of methamphetamine users receiving substance abuse treatment in South Africa. This study assessed the prevalence and correlates of HIV risk behaviors among 269 methamphetamine users entering substance abuse treatment in two clinics in Cape Town. The prevalence of sexual risk behaviors was high among sexually active participants: 34 % multiple partners, 26 % unprotected intercourse with a casual partner, and 24 % sex trading for money/methamphetamine. The strongest predictor of all sexual risk behaviors was concurrent other drug use. Over half had not been HIV tested in the past year, and 25 % had never been tested, although attitudes toward HIV testing were overwhelmingly positive. This population of primarily heterosexual, non-injecting methamphetamine users is a high-risk group in need of targeted HIV prevention interventions. Substance abuse treatment is an ideal setting in which to reach methamphetamine users for HIV services.

  14. Mediators of interpersonal violence and drug addiction severity among methamphetamine users in Cape Town, South Africa.

    PubMed

    Hobkirk, Andréa L; Watt, Melissa H; Green, Kimberly T; Beckham, Jean C; Skinner, Donald; Meade, Christina S

    2015-03-01

    South Africa has high rates of interpersonal violence and a rapidly growing methamphetamine epidemic. Previous research has linked experiences of interpersonal violence to higher rates of substance use, and identified mental health constructs as potential mediators of this association. The aim of this study was to examine the relationship between interpersonal violence and addiction severity among active methamphetamine users in Cape Town, South Africa, and to explore symptoms of posttraumatic stress disorder (PTSD) and substance use coping as mediators of this relationship. A community sample of 360 methamphetamine users was recruited through respondent driven sampling and surveyed on their experiences of violence, mental health, coping, and drug use and severity. A series of one-way ANOVAs were conducted to examine the relationship of self-reported interpersonal violence with drug addiction severity, and multiple mediation analyses were used to determine if PTSD symptoms and substance use coping mediated this relationship. The majority (87%) of the sample reported experiencing at least one instance of interpersonal violence in their lifetime, and the number of violent experiences was associated with increased drug addiction severity. PTSD and substance use coping were significant mediators of this association. Only the indirect effect of substance use coping remained significant for the female sample when the mediation model was conducted separately for men and women. The findings point to the need for integrated treatments that address drug use and PTSD for methamphetamine users in South Africa and highlight the importance of coping interventions for women. Copyright © 2014 Elsevier Ltd. All rights reserved.

  15. Urban catchment management in a developing country: the Lotus River project, Cape Town, South Africa.

    PubMed

    Grobicki, A M

    2001-01-01

    This paper describes a 2-year pilot project undertaken in an urban catchment in Cape Town, South Africa. The impermeable area of the Lotus River catchment has doubled over 15 years, from 17% in 1983 to 34% in 1997. Following the abolition of urban influx control in 1990, informal settlements in the catchment grew rapidly and now house about 90,000 out of the catchment's total population of 380,000 people. The informal areas are still largely unserviced, despite a commitment from local government to speed up service delivery to the poorest areas of the city. Within the Lotus River project, hydrological and ecological assessments of the urban watercourses were undertaken, through physico-chemical and microbiological sampling programmes, macro-invertebrate counts, and vegetation sampling. All available information regarding the catchment was integrated within a GIS platform, including demographic and socio-economic data on the various communities, and hydrogeological information on the underlying aquifer obtained from earlier studies. The integrated nature of the project allows a number of conclusions and recommendations to be drawn, regarding the management of this particular catchment. However, important general lessons have also been learned which can be applied by local authorities responsible for urban catchments in developing countries. The necessity of providing the required institutional structures cannot be overemphasised.

  16. Nitrogen deposition in a southern hemisphere biodiversity hotspot within and surrounding Cape Town, South Africa

    NASA Astrophysics Data System (ADS)

    Angstmann, J. L.; Hall, S.; February, E.; West, A. G.; Allsopp, N.; Bond, W.

    2011-12-01

    Anthropogenic nitrogen (N) emissions have increased dramatically since the agricultural and industrial revolutions leading to N deposition in the northern hemisphere that is estimated to be an order of magnitude greater than preindustrial fluxes. N deposition rates of 5-15 kg N ha-1 yr-1 in Europe and N. America decrease plant species diversity, increase invasive species, and lead to eutrophication of surface waters. The southern hemisphere is home to over 50% of the world's biodiversity hotspots, including the 90,000 km2 Cape Floristic Region which houses 9,030 vascular plant species, 69% of which are endemic. However, to date, N deposition rates in the southern hemisphere are highly uncertain, with global models of N deposition based upon sparse datasets at best. Many terrestrial systems, such as fynbos shrublands, are adapted to low N availability and exhibit high species diversity and endemism, rendering them susceptible to ecological changes from N deposition. In this research, we quantified the spatial and temporal distribution of wet and dry N deposition across 30 protected fynbos ecosystems within the urban airshed of Cape Town, South Africa. We predicted that 1) total inorganic N deposition varies predictably along the urban-rural gradient (highest near the city centre), 2) N deposition varies seasonally, with higher fluxes in the winter months when atmospheric stability causes a build-up of N gases in and around the city, and 3) total inorganic N deposition will exceed the critical load of 10-15 kg N ha-1 yr-1 for Mediterranean shrublands, past which negative ecosystem effects have been shown to occur. Estimates of N deposition based on NO2 concentrations within the city suggest that total N deposition ranges from 8-13 kg N ha-1 yr-1 . However, we show that N deposition measured by ion-exchange resin collectors is far less than expected, averaging less than 2 kg N ha-1 yr-1 (range 0.5 - 5.5 kg N ha-1 yr-1 ), and is is dominated by NO3-, suggesting

  17. Characteristics and outcome of children with juvenile dermatomyositis in Cape Town: a cross-sectional study.

    PubMed

    Okong'o, Lawrence Owino; Esser, Monika; Wilmshurst, Jo; Scott, Christiaan

    2016-11-11

    Juvenile dermatomyositis (JDM) is a rare idiopathic inflammatory childhood myopathy of uncertain aetiology. The demographic and clinical presentation of JDM may differ by race and geographic regions. Few studies have described the characteristics of JDM patients from Africa. We conducted a retrospective observational study to determine clinical characteristics and outcomes of patients satisfying the Bohan and Peter criteria for probable JDM seen between 2004 and 2013 in three hospitals in Cape Town, South Africa. Twenty five cases were identified: 16 female and 9 male; thirteen (52 %) were of indigenous African, eleven (44 %) mixed and one (4 %) European ancestry. The median ages at disease onset and diagnosis were 6.75 (range 2.0-9.7) and 7.9 (range 3.4-9.75) years respectively. Eleven patients had calcinosis while the mortality was 2/25 (8 %). Only 40 % of the patients had clinically inactive disease by PRINTO criteria (modified) at last review. There was no statistically significant difference in racial distribution (p-value = 1), age at disease onset (p-value = 0.87) and disease duration prior to treatment initiation (p-value = 0.75) between patients who had clinically active and inactive disease. The demographic characteristics of children with JDM were similar to that from most other regions of the world with female predominance and similar age at onset. Majority of the patients remained with clinically active disease, which put them at risk of further disease complications. Long term follow up and use of appropriate treatment guidelines may be indicated in management of JDM patients for optimum treatment outcomes.

  18. Pilot programme for the rapid initiation of antiretroviral therapy in pregnancy in Cape Town, South Africa.

    PubMed

    Myer, Landon; Zulliger, Rose; Black, Samantha; Pienaar, David; Bekker, Linda-Gail

    2012-01-01

    Initiation of antiretroviral therapy (ART) in pregnancy is an important intervention to prevent the mother-to-child transmission (MTCT) of HIV and to promote maternal health. Early initiation of ART is particularly important to achieve viral suppression rapidly before delivery. However, current approaches to start ART in pregnancy may be problematic in many settings, with referrals between antenatal care (ANC) and ART services, and delays for patient preparation before ART initiation. These steps contribute to a sizable proportion of women failing to receive adequate duration of ART before delivery, increasing the risk of MTCT. To address these limitations, we developed the rapid initiation of antiretroviral therapy in pregnancy (RAP) programme. The programme featured the use of point-of-care CD4 testing to identify ART-eligible women with CD4 cell counts ≤ 350 cells/µl; immediate ART initiation in women on the same day that eligibility was determined, if possible; and intensive counselling and support for ART initiation during the first few weeks on ART. We implemented RAP in an antenatal clinic setting in Cape Town South Africa. Between February and August 2011, a total of 221 HIV-infected women were referred to the programme for CD4 cell count testing and 101 (46%) were eligible for ART. Of these, 98 women (97%) started therapy during pregnancy, 89 (91%) on the day of referral to the service. In-depth interviews suggested that although there were substantial challenges facing HIV-infected women initiating ART in pregnancy, the availability of immediate services and counselling support played an important role in addressing these. While further research is needed, this evaluation demonstrates that a novel service delivery approach may facilitate rapid ART initiation in pregnancy.

  19. Child pedestrian safety knowledge, behaviour and road injury in Cape Town, South Africa.

    PubMed

    Koekemoer, Karin; Van Gesselleen, Megan; Van Niekerk, Ashley; Govender, Rajen; Van As, Arjan Bastiaan

    2017-02-01

    Pedestrian injuries are a leading cause of death among South African children, and young children residing in low-income communities are more at risk, due to various factors such as inadequate road infrastructure, exposure to traffic due to reliance on walking as a means of transport, and lack of supervision. This study used a cross-sectional, non-randomized self-report survey to assess pedestrian safety knowledge, road-crossing behaviour and pedestrian injuries of primary school children in selected low-income settings in Cape Town. The survey focused on three primary schools that had joined the Safe Kids Worldwide Model School Zone Project and was administered to 536 children aged 6-15 years, in their home language of isiXhosa. Descriptive and bivariate analyses as well as multivariate regression analyses were conducted to investigate potential predictor variables for pedestrian collision severity and unsafe road-crossing behaviour. Walking was the sole form of travel for 81% of the children, with a large proportion regularly walking unsupervised. Children who walk to or from school alone were younger and reported riskier road-crossing behaviour, although children who walk accompanied tended to have higher pedestrian collision severity. "Negligent Behaviour" related to road-crossing was significantly associated with higher pedestrian collision severity, with predictors of "Negligent Behaviour" including the lack of pedestrian safety knowledge and greater exposure to traffic in terms of time spent walking. More than half of the reported pedestrian collisions involved a bicycle, and older boys (10-15 years) were most at risk of experiencing a severe pedestrian injury. The findings substantiate emerging evidence that children in low-income settings are at greater risk for child pedestrian injury, and emphasise the need for evidence-based safety promotion and injury prevention interventions in these settings. Copyright © 2016. Published by Elsevier Ltd.

  20. Supernumerary registrar experience at the University of Cape Town, South Africa.

    PubMed

    Peer, S; Burrows, S A; Mankahla, N; Fagan, J J

    2016-12-21

    Despite supernumerary registrars (SNRs) being hosted in South African (SA) training programmes, there are no reports of their experience. To evaluate the experience of SNRs at the University of Cape Town, SA, and the experience of SNRs from the perspective of SA registrars (SARs). SNRs and SARs completed an online survey in 2012. Seventy-three registrars responded; 42 were SARs and 31 were SNRs. Of the SNRs 47.8% were self-funded, 17.4% were funded through private organisations, and 34.8% were funded by governments. Average annual income was ZAR102 349 (range ZAR680 - 460 000). Funding was considered insufficient by 61.0%. Eighty-seven percent intended to return to their home countries. Personal sacrifices were deemed worthwhile from academic (81.8%) and social (54.5%) perspectives, but not financially (33.3%). Only a small majority were satisfied with the orientation provided and with assimilation into their departments. Almost half experienced challenges relating to cultural and social integration. Almost all SARs supported having SNRs. SNRs reported xenophobia from patients (23.8%) and colleagues (47.8%), and felt disadvantaged in terms of learning opportunities, academic support and on-call allocations. SNRs are fee-paying students and should enjoy academic and teaching support equal to that received by SARs. Both the university and the teaching hospitals must take steps to improve the integration of SNRs and ensure that they receive equal access to academic support and clinical teaching, and also need to take an interest in their financial wellbeing. Of particular concern are perceptions of xenophobia from SA medical colleagues.

  1. The Cape Town Clinical Decision Rule for Streptococcal Pharyngitis in Children.

    PubMed

    Engel, Mark E; Cohen, Karen; Gounden, Ronald; Kengne, Andre P; Barth, Dylan Dominic; Whitelaw, Andrew C; Francis, Veronica; Badri, Motasim; Stewart, Annemie; Dale, James B; Mayosi, Bongani M; Maartens, Gary

    2017-03-01

    Existing clinical decision rules (CDRs) to diagnose group A streptococcal (GAS) pharyngitis have not been validated in sub-Saharan Africa. We developed a locally applicable CDR while evaluating existing CDRs for diagnosing GAS pharyngitis in South African children. We conducted a prospective cohort study and enrolled 997 children 3-15 years of age presenting to primary care clinics with a complaint of sore throat, and whose parents provided consent. Main outcome measures were signs and symptoms of pharyngitis and a positive GAS culture from a throat swab. Bivariate and multivariate analyses were used to develop the CDR. In addition, the diagnostic effectiveness of 6 existing rules for predicting a positive culture in our cohort was assessed. A total of 206 of 982 children (21%) had a positive GAS culture. Tonsillar swelling, tonsillar exudates, tender or enlarged anterior cervical lymph nodes, absence of cough and absence of rhinorrhea were associated with positive cultures in bivariate and multivariate analyses. Four variables (tonsillar swelling and one of tonsillar exudate, no rhinorrhea, no cough), when used in a cumulative score, showed 83.7% sensitivity and 32.2% specificity for GAS pharyngitis. Of existing rules tested, the rule by McIsaac et al had the highest positive predictive value (28%), but missed 49% of the culture-positive children who should have been treated. The new 4-variable CDR for GAS pharyngitis (ie, tonsillar swelling and one of tonsillar exudate, no rhinorrhea, no cough) outperformed existing rules for GAS pharyngitis diagnosis in children with symptomatic sore throat in Cape Town.

  2. Making assessment locally relevant: measuring functioning for maternal depression in Khayelitsha, Cape Town

    PubMed Central

    Baron, Emily; Davies, Thandi; Bass, Judith; Lund, Crick

    2015-01-01

    Purpose We developed a locally relevant functioning assessment instrument (FAI) for pregnant women and mothers of young babies to complement a widely validated instrument—the World Health Organization’s Disability Assessment Schedule (WHODAS) 12-item version. The FAI is an outcome measure in a randomised controlled trial on the effectiveness of a lay counsellor administered intervention for distressed pregnant women in Khayelitsha, Cape Town. Methods Nine items most commonly reported by 40 pregnant women or mothers with young babies in qualitative interviews were selected for the instrument, with a 10th item ‘Other’. The FAI was validated with 142 pregnant women and mothers in Khayelitsha. Analysis was conducted to assess internal reliability, exploratory factor analysis and convergent validity. Results The FAI had good internal reliability (Cronbach’s alpha = 0.77) and the explanatory factor analysis showed a clear 3-factor solution, relating to domestic, childcare and social activities. The FAI scores showed floor effects, but were positively correlated with the two measures of functioning (WHODAS 2.0 and Washington Group Short Set). The FAI scores also correlated with the measure of depression (Edinburgh Postnatal Depression Scale—EPDS), reflecting increased functional limitations associated with increased depressive symptoms. Conclusion The results show that the FAI has good internal reliability, and good convergent and construct validity as a measure of functioning for this context. This paper reports on the process of developing an instrument and highlights the importance of using instruments that are locally relevant to ensure accurate measurement of functional status. PMID:25567235

  3. Defining and improving the role of emergency medical services in Cape Town, South Africa.

    PubMed

    Anest, Trisha; Stewart de Ramirez, Sarah; Balhara, Kamna S; Hodkinson, Peter; Wallis, Lee; Hansoti, Bhakti

    2016-08-01

    Low and middle income countries bear a disproportionate burden of paediatric morbidity and mortality. South Africa, a middle income country, has unacceptably high mortality in children less than 5 years of age. Many factors that contribute to the child mortality rate are time sensitive and require efficient access to emergency care. Delays and barriers within the emergency medical services (EMS) system increase paediatric morbidity and mortality from time sensitive illnesses. This study is a qualitative evaluation of the prehospital care system for paediatric patients in Cape Town, South Africa. A purposive sample of healthcare personnel within and interacting with the EMS system were interviewed. A structured interview form was used to gather data. All interviews were audio recorded and transcribed; two independent reviewers performed blinded content analysis of the transcribed script. 33 structured interviews were conducted over a 4 week period. Eight broad themes were identified during coding, including: access, communication, community education, equipment, infrastructure, staffing, training and triage. Subcategories were used to identify areas for targeted intervention. Overall agreement between the two independent coders was 93.36%, with a κ coefficient of 0.69. The prehospital system is central to delivering time sensitive care for paediatric patients. In a single centre middle income setting, communication barriers between dispatch personnel and medical facilities/EMS personnel were deemed to be a high priority intervention in order to improve care delivery. Other areas for targeted interventions should include broadening the advanced life support provider base and introducing basic medical language in dispatch staff training. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

  4. Intentional injury and violence in Cape Town, South Africa: an epidemiological analysis of trauma admissions data

    PubMed Central

    Schuurman, Nadine; Cinnamon, Jonathan; Walker, Blake Byron; Fawcett, Vanessa; Nicol, Andrew; Hameed, Syed Morad; Matzopoulos, Richard

    2015-01-01

    Background Injury is a truly global health issue that has enormous societal and economic consequences in all countries. Interpersonal violence is now widely recognized as important global public health issues that can be addressed through evidence-based interventions. In South Africa, as in many low- and middle-income countries (LMIC), a lack of ongoing, systematic injury surveillance has limited the ability to characterize the burden of violence-related injury and to develop prevention programmes. Objective To describe the profile of trauma presenting to the trauma centre of Groote Schuur Hospital in Cape Town, South Africa – relating to interpersonal violence, using data collected from a newly implemented surveillance system. Particular emphasis was placed on temporal aspects of injury epidemiology, as well as age and sex differentiation. Design Data were collected prospectively using a standardized trauma admissions form for all patients presenting to the trauma centre. An epidemiological analysis was conducted on 16 months of data collected from June 2010 to October 2011. Results A total of 8445 patients were included in the analysis, in which the majority were violence-related. Specifically, 35% of records included violent trauma and, of those, 75% of victims were male. There was a clear temporal pattern: a greater proportion of intentional injuries occur during the night, while unintentional injury peaks late in the afternoon. In total, two-third of all intentional trauma is inflicted on the weekends, as is 60% of unintentional trauma. Where alcohol was recorded in the record, 72% of cases involved intentional injury. Sex was again a key factor as over 80% of all records involving alcohol or substance abuse were associated with males. The findings highlighted the association between violence, young males, substance use, and weekends. Conclusions This study provides the basis for evidence-based interventions to reduce the burden of intentional injury

  5. Intentional injury and violence in Cape Town, South Africa: an epidemiological analysis of trauma admissions data.

    PubMed

    Schuurman, Nadine; Cinnamon, Jonathan; Walker, Blake Byron; Fawcett, Vanessa; Nicol, Andrew; Hameed, Syed Morad; Matzopoulos, Richard

    2015-01-01

    Injury is a truly global health issue that has enormous societal and economic consequences in all countries. Interpersonal violence is now widely recognized as important global public health issues that can be addressed through evidence-based interventions. In South Africa, as in many low- and middle-income countries (LMIC), a lack of ongoing, systematic injury surveillance has limited the ability to characterize the burden of violence-related injury and to develop prevention programmes. To describe the profile of trauma presenting to the trauma centre of Groote Schuur Hospital in Cape Town, South Africa - relating to interpersonal violence, using data collected from a newly implemented surveillance system. Particular emphasis was placed on temporal aspects of injury epidemiology, as well as age and sex differentiation. Data were collected prospectively using a standardized trauma admissions form for all patients presenting to the trauma centre. An epidemiological analysis was conducted on 16 months of data collected from June 2010 to October 2011. A total of 8445 patients were included in the analysis, in which the majority were violence-related. Specifically, 35% of records included violent trauma and, of those, 75% of victims were male. There was a clear temporal pattern: a greater proportion of intentional injuries occur during the night, while unintentional injury peaks late in the afternoon. In total, two-third of all intentional trauma is inflicted on the weekends, as is 60% of unintentional trauma. Where alcohol was recorded in the record, 72% of cases involved intentional injury. Sex was again a key factor as over 80% of all records involving alcohol or substance abuse were associated with males. The findings highlighted the association between violence, young males, substance use, and weekends. This study provides the basis for evidence-based interventions to reduce the burden of intentional injury. Furthermore, it demonstrates the value of locally

  6. Emergency medicine educational resource use in Cape Town: modern or traditional?

    PubMed

    Kleynhans, A C; Oosthuizen, A H; van Hoving, D J

    2017-05-01

    The integration of online resources and social media into higher education and continued professional development is an increasingly common phenomenon. To describe the usage of various traditional and modern educational resources by members of the divisions of emergency medicine at Stellenbosch University and the University of Cape Town. Members affiliated with the divisions during 2014 were invited to participate in an online survey. Participants were given 8 weeks to complete the questionnaire; with weekly reminders until they responded or the deadline expired. Summary statistics were used to describe the variables. Eighty-seven divisional members completed the survey (69.6% response rate). The resources most preferred were textbooks (n=78, 89.7%), open access educational resources (n=77, 88.5%) and journals (n=76, 87.4%). Emergency medicine trainees (n=31, 92.1%) and respondents ≤30 years (n=17, 94.4%) were more inclined to use social media. International Emergency Medicine and Critical Care blogs are frequently being used by 71% of respondents. YouTube (35%) and podcasts (21%) were the most commonly used multimedia resources. Computers (desktop and laptop) were most frequently used to access educational resources except for social media where smart phones were preferred. The use of modern and electronic resources is relatively common, but traditional educational resources are still preferred. This study illustrates an opportunity for greater integration of online resources and social media in educational activities to enhance multimodal and self-directed learning. Specific training in the use of these resources and how to appraise them may further improve their utility. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

  7. Intentional injury and violence in Cape Town, South Africa: an epidemiological analysis of trauma admissions data.

    PubMed

    Schuurman, Nadine; Cinnamon, Jonathan; Walker, Blake Byron; Fawcett, Vanessa; Nicol, Andrew; Hameed, Syed Morad; Matzopoulos, Richard

    2015-01-01

    Background Injury is a truly global health issue that has enormous societal and economic consequences in all countries. Interpersonal violence is now widely recognized as important global public health issues that can be addressed through evidence-based interventions. In South Africa, as in many low- and middle-income countries (LMIC), a lack of ongoing, systematic injury surveillance has limited the ability to characterize the burden of violence-related injury and to develop prevention programmes. Objective To describe the profile of trauma presenting to the trauma centre of Groote Schuur Hospital in Cape Town, South Africa - relating to interpersonal violence, using data collected from a newly implemented surveillance system. Particular emphasis was placed on temporal aspects of injury epidemiology, as well as age and sex differentiation. Design Data were collected prospectively using a standardized trauma admissions form for all patients presenting to the trauma centre. An epidemiological analysis was conducted on 16 months of data collected from June 2010 to October 2011. Results A total of 8445 patients were included in the analysis, in which the majority were violence-related. Specifically, 35% of records included violent trauma and, of those, 75% of victims were male. There was a clear temporal pattern: a greater proportion of intentional injuries occur during the night, while unintentional injury peaks late in the afternoon. In total, two-third of all intentional trauma is inflicted on the weekends, as is 60% of unintentional trauma. Where alcohol was recorded in the record, 72% of cases involved intentional injury. Sex was again a key factor as over 80% of all records involving alcohol or substance abuse were associated with males. The findings highlighted the association between violence, young males, substance use, and weekends. Conclusions This study provides the basis for evidence-based interventions to reduce the burden of intentional injury

  8. Pricing landfill externalities: Emissions and disamenity costs in Cape Town, South Africa

    SciTech Connect

    Nahman, Anton

    2011-09-15

    Highlights: > The paper estimates landfill externalities associated with emissions, disamenities and transport. > Transport externalities vary from 24.22 to 31.42 Rands per tonne. > Costs of emissions (estimated using benefits transfer) vary from 0.07 to 28.91 Rands per tonne. > Disamenities (estimated using hedonic pricing) vary from 0.00 to 57.46 Rands per tonne. > Overall, external costs for urban landfills exceed those of a regional landfill. - Abstract: The external (environmental and social) costs of landfilling (e.g. emissions to air, soil and water; and 'disamenities' such as odours and pests) are difficult to quantify in monetary terms, and are therefore not generally reflected in waste disposal charges or taken into account in decision making regarding waste management options. This results in a bias against alternatives such as recycling, which may be more expensive than landfilling from a purely financial perspective, but preferable from an environmental and social perspective. There is therefore a need to quantify external costs in monetary terms, so that different disposal options can be compared on the basis of their overall costs to society (financial plus external costs). This study attempts to estimate the external costs of landfilling in the City of Cape Town for different scenarios, using the benefits transfer method (for emissions) and the hedonic pricing method (for disamenities). Both methods (in particular the process of transferring and adjusting estimates from one study site to another) are described in detail, allowing the procedures to be replicated elsewhere. The results show that external costs are currently R111 (in South African Rands, or approximately US$16) per tonne of waste, although these could decline under a scenario in which energy is recovered, or in which the existing urban landfills are replaced with a new regional landfill.

  9. Determinants of cigarette smoking in the black township population of Cape Town.

    PubMed Central

    Strebel, P; Kuhn, L; Yach, D

    1989-01-01

    There is concern about the increasing tobacco consumption in developing countries, especially in urban communities. Little information is available on the prevalence and determinants of smoking in black townships in South Africa. We therefore conducted a survey of the smoking practices in three such townships in Cape Town, in which 673 higher primary schoolchildren and 1320 adults were interviewed using a WHO questionnaire translated into Xhosa. Results were analysed using a multiple logistic regression model. In higher primary schoolpupils, boys smoked much more than girls [adjusted odds ratio (ORa) = 17.8; 95% confidence interval (CI): 5.2-60.9]; and smoking prevalence increased with age (ORa = 1.6; 95% CI: 1.3-1.9), peer pressure (ORa = 4.4; 95% CI: 1.9-6.9), and poor health knowledge (ORa = 3.1; 95% CI: 1.6-5.8). In adults, smoking prevalence was 53% in men compared to 6% in women. In men, an urban experience of 6 or more years was significantly associated with smoking (ORa = 1.9; 95% CI: 1.2-3.0) after adjustment for age, health knowledge and occupation. No association was found between level of education and smoking prevalence. Men in higher paid occupations smoked more than those in low paid occupations (ORa = 1.7; 95% CI: 1.0-2.8). Unemployment, however, was not associated with smoking prevalence. The findings emphasise the need for primary prevention of smoking in women and boys. Urbanisation and increased earning power appear to boost tobacco consumption in the absence of active anti-smoking efforts. PMID:2607296

  10. Temporal trends in TB notification rates during ART scale-up in Cape Town: an ecological analysis.

    PubMed

    Hermans, Sabine; Boulle, Andrew; Caldwell, Judy; Pienaar, David; Wood, Robin

    2015-01-01

    Although antiretroviral therapy (ART) reduces individual tuberculosis (TB) risk by two-thirds, the population-level impact remains uncertain. Cape Town reports high TB notification rates associated with endemic HIV. We examined population trends in TB notification rates during a 10-year period of expanding ART. Annual Cape Town TB notifications were used as numerators and mid-year Cape Town populations as denominators. HIV-stratified population was calculated using overall HIV prevalence estimates from the Actuarial Society of South Africa AIDS and Demographic model. ART provision numbers from Western Cape government reports were used to calculate overall ART coverage. We calculated rates per 100,000 population over time, overall and stratified by HIV status. Rates per 100,000 total population were also calculated by ART use at treatment initiation. Absolute numbers of notifications were compared by age and sub-district. Changes over time were described related to ART provision in the city as a whole (ART coverage) and by sub-district (numbers on ART). From 2003 to 2013, Cape Town's population grew from 3.1 to 3.7 million inhabitants, and estimated HIV prevalence increased from 3.6 to 5.2%. ART coverage increased from 0 to 63% in 2013. TB notification rates declined by 16% (95% confidence interval (CI), 14-17%) from a 2008 peak (851/100,000) to a 2013 nadir (713/100,000). Decreases were higher among the HIV-positive (21% (95% CI, 19-23%)) than the HIV-negative (9% (95% CI, 7-11%)) population. The number of HIV-positive TB notifications decreased mainly among 0- to 4- and 20- to 34-year-olds. Total population rates on ART at TB treatment initiation increased over time but levelled off in 2013. Overall median CD4 counts increased from 146 cells/µl (interquartile range (IQR), 66, 264) to 178 cells/µl (IQR 75, 330; p<0.001). Sub-district antenatal HIV seroprevalence differed (10-33%) as did numbers on ART (9-29 thousand). Across sub-districts, infant HIV-positive TB

  11. Expanding contraceptive options for PMTCT clients: a mixed methods implementation study in Cape Town, South Africa

    PubMed Central

    2014-01-01

    Background Clients of prevention of mother-to-child transmission (PMTCT) services in South Africa who use contraception following childbirth rely primarily on short-acting methods like condoms, pills, and injectables, even when they desire no future pregnancies. Evidence is needed on strategies for expanding contraceptive options for postpartum PMTCT clients to include long-acting and permanent methods. Methods We examined the process of expanding contraceptive options in five health centers in Cape Town providing services to HIV-positive women. Maternal/child health service providers received training and coaching to strengthen contraceptive counseling for postpartum women, including PMTCT clients. Training and supplies were introduced to strengthen intrauterine device (IUD) services, and referral mechanisms for female sterilization were reinforced. We conducted interviews with separate samples of postpartum PMTCT clients (265 pre-intervention and 266 post-intervention) to assess knowledge and behaviors regarding postpartum contraception. The process of implementing the intervention was evaluated through systematic documentation and interpretation using an intervention tracking tool. In-depth interviews with providers who participated in study-sponsored training were conducted to assess their attitudes toward and experiences with promoting voluntary contraceptive services to HIV-positive clients. Results Following the intervention, 6% of interviewed PMTCT clients had the desired knowledge about the IUD and 23% had the desired knowledge about female sterilization. At both pre- and post-intervention, 7% of clients were sterilized and IUD use was negligible; by comparison, 75% of clients used injectables. Intervention tracking and in-depth interviews with providers revealed intervention shortcomings and health system constraints explaining the failure to produce intended effects. Conclusions The intervention failed to improve PMTCT clients’ knowledge about the IUD

  12. Expanding contraceptive options for PMTCT clients: a mixed methods implementation study in Cape Town, South Africa.

    PubMed

    Hoke, Theresa; Harries, Jane; Crede, Sarah; Green, Mackenzie; Constant, Deborah; Petruney, Tricia; Moodley, Jennifer

    2014-01-10

    Clients of prevention of mother-to-child transmission (PMTCT) services in South Africa who use contraception following childbirth rely primarily on short-acting methods like condoms, pills, and injectables, even when they desire no future pregnancies. Evidence is needed on strategies for expanding contraceptive options for postpartum PMTCT clients to include long-acting and permanent methods. We examined the process of expanding contraceptive options in five health centers in Cape Town providing services to HIV-positive women. Maternal/child health service providers received training and coaching to strengthen contraceptive counseling for postpartum women, including PMTCT clients. Training and supplies were introduced to strengthen intrauterine device (IUD) services, and referral mechanisms for female sterilization were reinforced. We conducted interviews with separate samples of postpartum PMTCT clients (265 pre-intervention and 266 post-intervention) to assess knowledge and behaviors regarding postpartum contraception. The process of implementing the intervention was evaluated through systematic documentation and interpretation using an intervention tracking tool. In-depth interviews with providers who participated in study-sponsored training were conducted to assess their attitudes toward and experiences with promoting voluntary contraceptive services to HIV-positive clients. Following the intervention, 6% of interviewed PMTCT clients had the desired knowledge about the IUD and 23% had the desired knowledge about female sterilization. At both pre- and post-intervention, 7% of clients were sterilized and IUD use was negligible; by comparison, 75% of clients used injectables. Intervention tracking and in-depth interviews with providers revealed intervention shortcomings and health system constraints explaining the failure to produce intended effects. The intervention failed to improve PMTCT clients' knowledge about the IUD and sterilization or to increase use of

  13. Non-communicable disease risk factors and treatment preference of obese patients in Cape Town

    PubMed Central

    Manning, Kathryn; Senekal, Marjanne

    2016-01-01

    Background Insights into the characteristics of treatment seekers for lifestyle changes and treatment preferences are necessary for intervention planning. Aim To compile a profile of treatment-seeking obese patients with non-communicable diseases (NCDs) or NCD risk factors and to compare patients who choose group-based (facility-based therapeutic group [FBTG]) versus usual care (individual consultations) treatment. Setting A primary healthcare facility in Cape Town, South Africa. Methods One hundred and ninety-three patients were recruited in this cross-sectional study. Ninety six chose FBTG while 97 chose usual care. A questionnaire, the hospital database and patients’ folders were used to collect data. Weight, height and waist circumference were measured. STATA 11.0 was used for descriptive statistics and to compare the two groups. Results The subjects’ mean age was 50.4 years, 78% were women and of low education levels and income, and 41.5% had type 2 diabetes, 83.4% hypertension and 69.5% high cholesterol. Mean (s.d.) HbA1c was 9.1 (2.0)%, systolic BP 145.6 (21.0) mmHg, diastolic BP 84.5 (12.0) mmHg, cholesterol 5.4 (1.2) mmol/L), body mass indicator (BMI) 39.3 (7.3) kg/m2 and waist circumference 117 (12.6) cm). These figures were undesirable although pharmacological treatment for diabetes and hypertension was in place. Only 14% were physically active, while TV viewing was > 2h/day. Mean daily intake of fruit and vegetables (2.2 portions/day) was low while added sugar (5 teaspoons) and sugar-sweetened beverages (1.3 glasses) were high. Usual care patients had a higher smoking prevalence, HbA1c, number of NCD risk factors and refined carbohydrate intake, and a lower fruit and vegetable intake. Conclusion Treatment seekers were typically middle-aged, low income women with various modifiable and intermediate risk factors for NCDs. Patients choosing usual care could have more NCD risks. PMID:27380784

  14. Women's experiences seeking informal sector abortion services in Cape Town, South Africa: a descriptive study.

    PubMed

    Gerdts, Caitlin; Raifman, Sarah; Daskilewicz, Kristen; Momberg, Mariette; Roberts, Sarah; Harries, Jane

    2017-10-02

    In settings where abortion is legally restricted, or permitted but not widely accessible, women face significant barriers to abortion access, sometimes leading them to seek services outside legal facilities. The advent of medication abortion has further increased the prevalence of informal sector abortion. This study investigates the reasons for attempting self-induction, methods used, complications, and sources of information about informal sector abortion, and tests a specific recruitment method which could lead to improved estimates of informal sector abortion prevalence among an at-risk population. We recruited women who have sought informal sector abortion services in Cape Town, South Africa using respondent driven sampling (RDS). An initial seed recruiter was responsible for initiating recruitment using a structured coupon system. Participants completed face-to-face questionnaires, which included information about demographics, informal sector abortion seeking, and safe abortion access needs. We enrolled 42 women, nearly one-third of whom reported they were sex workers. Thirty-four women (81%) reported having had one informal sector abortion within the past 5 years, 14% reported having had two, and 5% reported having had three. These women consumed home remedies, herbal mixtures from traditional healers, or tablets from an unregistered provider. Twelve sought additional care for potential warning signs of complications. Privacy and fear of mistreatment at public sector facilities were among the main reported reasons for attempting informal sector abortion. Most women (67%) cited other community members as their source of information about informal sector abortion; posted signs and fliers in public spaces also served as an important source of information. Women are attempting informal sector abortion because they seek privacy and fear mistreatment and stigma in health facilities. Some were unaware how or where to seek formal sector services, or believed the

  15. Methamphetamine use, aggressive behavior and other mental health issues among high-school students in Cape Town, South Africa.

    PubMed

    Plüddemann, Andreas; Flisher, Alan J; McKetin, Rebecca; Parry, Charles; Lombard, Carl

    2010-06-01

    Methamphetamine use has become a growing problem in a number of countries over the past two decades, but has only recently emerged in South Africa. This study investigated the prevalence of methamphetamine use among high-school students in Cape Town and whether students reporting methamphetamine use were more likely to be at risk for mental health and aggressive behavior problems. A cross-sectional survey of 15 randomly selected high schools in Cape Town, of 1561 males and females grade 8-10 students (mean age 14.9), was conducted using the Problem Oriented Screening Instrument for Teenagers (POSIT) and the Beck Depression Inventory (BDI). Findings indicated that 9% of the students had tried methamphetamine at least once. Ordinal logistic regression analyses showed that methamphetamine use in the past year was significantly associated with higher aggressive behavior scores (OR=1.81, 95% CI: 1.04-3.15, p<0.05), mental health risk scores (OR=2.04, 95% CI: 1.26-3.31, p<0.01) and depression scores (OR=2.65, 95% CI: 1.64-4.28, p<0.001). Methamphetamine use has become a serious problem in Cape Town, particularly among adolescents. Screening adolescents in school settings for methamphetamine use and behavior problems may be useful in identifying youth at risk for substance misuse, providing an opportunity for early intervention. These findings have implications for other parts of the world where methamphetamine use may be occurring at younger ages and highlight the importance of looking at co-morbid issues related to methamphetamine use. Copyright (c) 2010 Elsevier Ireland Ltd. All rights reserved.

  16. Methamphetamine use, aggressive behavior and other mental health issues among high school students in Cape Town, South Africa

    PubMed Central

    Plüddemann, Andreas; Flisher, Alan J.; McKetin, Rebecca; Parry, Charles; Lombard, Carl

    2010-01-01

    Objective Methamphetamine use has become a growing problem in a number of countries over the past two decades, but has only recently emerged in South Africa. This study investigated the prevalence of methamphetamine use among high-school students in Cape Town and whether students reporting methamphetamine use were more likely to be at risk for mental health and aggressive behavior problems. Method A cross-sectional survey of 15 randomly selected high-schools in Cape Town, of 1561 male and female grade 8–10 students (mean age 14.9), was conducted using the Problem Oriented Screening Instrument for Teenagers (POSIT) and the Beck Depression Inventory (BDI). Results Findings indicated that 9% of the students had tried methamphetamine at least once. Ordinal logistic regression analyses showed that methamphetamine use in the past year was significantly associated with higher aggressive behavior scores (OR = 1.81, 95% CI: 1.04–3.15, p < 0.05), mental health risk scores (OR = 2.04, 95% CI: 1.26–3.31, p < 0.01) and depression scores (OR = 2.65, 95% CI: 1.64–4.28, p < 0.001). Conclusions Methamphetamine use has become a serious problem in Cape Town, particularly among adolescents. Screening adolescents in school settings for methamphetamine use and behavior problems may be useful in identifying youth at risk for substance misuse, providing an opportunity for early intervention. These findings have implications for other parts of the world where methamphetamine use may be occurring at younger ages and highlight the importance of looking at co-morbid issues related to methamphetamine use. PMID:20064699

  17. Managing HIV in the PICU--the experience at the Red Cross War Memorial Children's Hospital in Cape Town.

    PubMed

    Argent, A C

    2008-06-01

    The HIV pandemic has affected children throughout the developing world. This article describes the experience of the Paediatric Intensive Care Unit at the Red Cross War Memorial Children's Hospital in Cape Town, South Africa. Over the last 20 years we have improved our management of HIV infected children requiring intensive care admission. In the absence of anti-retroviral therapy, long term outcomes from PICU admission of HIV infected children have not improved significantly, and it is debatable whether PICU admission is justified. Once anti-retroviral therapy is available to children, there may be significant improvements in outcome and possible affected children should be admitted to the PICU if resources are available.

  18. Nine-locus Y-STR profiles of Afrikaner Caucasian and mixed ancestry populations from Cape Town, South Africa.

    PubMed

    Ehrenreich, Liezle; Benjeddou, Mongi; Davison, Sean; D'Amato, Maria; Leat, Neil

    2008-07-01

    Samples were collected from 108 Afrikaner males and 114 males of mixed ancestry. The term mixed ancestry is being used to denote a complex community which was established with contributions from Asians, Caucasians and Indigenous populations and constitutes a significant proportion of the Cape Town metropolitan population. Allele and haplotype frequencies were determined for nine Y-STR loci (DYS19, DYS389-I, DYS389-II, DYS390, DYS391, DYS392, DYS393 and the duplicated locus DYS385). Unique haplotypes were obtained for 64 Afrikaner males and 90 males of mixed ancestry. Both population groups shared the same most common haplotype.

  19. Relationship difficulties postrape: being a male intimate partner of a female rape victim in Cape Town, South Africa.

    PubMed

    van Wijk, Evalina; Harrison, Tracie C

    2014-01-01

    In a longitudinal phenomenological study, the lived experience of being a male intimate partner (MIP) of a female rape victim in Cape Town, South Africa, is presented. Nine men participated in four face-to-face, semistructured interviews. The authors describe changes in communication and sexual intimacy postrape and how these changes spiralled into a dysfunctional relationship. Participants were interested in interventions for both partners and particularly for education to improve their communication and sexual relationships postrape. Researchers need to reconsider existing policies related to training programs to develop interventions that can address the needs of couples postrape and, ultimately, enhance their recovery.

  20. "They must understand we are people": Pregnancy and maternity service use among signing Deaf women in Cape Town.

    PubMed

    Gichane, Margaret W; Heap, Marion; Fontes, Mayara; London, Leslie

    2017-07-01

    Women with disabilities are at disproportionate risk for adverse pregnancy outcomes, however, there is limited information on their pregnancy histories. This mixed-methods study focuses on signing Deaf women whose access to health care may be compromised by language barriers related to their disability. To describe and compare the pregnancy outcomes and maternity service use of a sample of signing Deaf women of child-bearing age in Cape Town to the population of the Western Cape of South Africa. We interviewed 42 Deaf women selected by non-probability snowball sampling, using a structured questionnaire in South African Sign Language in Cape Town in July 2016. Average parity of the sample was similar to that of the Western Cape population. Most women had one or two children (74%). Thirty-one percent of women had experienced a miscarriage and 19% had terminated a pregnancy. Almost all women (96%) attended at least one antenatal appointment during their pregnancies, and all deliveries occurred at a health facility. Women primarily relied on writing to communicate during antenatal visits and labor/delivery. The majority of women reported communication issues due to limited interpretation services, and some reported experiencing mistreatment from hospital staff. This study provides novel information on the pregnancy histories of Deaf women. While maternal service usage was high, the quality of services were inadequate with reports of linguistic barriers and mistreatment. Findings suggest the need to improve maternity care for Deaf women through implementing interpretation services and providing sensitivity training to health care providers. Copyright © 2017 The Authors. Published by Elsevier Inc. All rights reserved.

  1. Intergration of LiDAR Data with Aerial Imagery for Estimating Rooftop Solar Photovoltaic Potentials in City of Cape Town

    NASA Astrophysics Data System (ADS)

    Adeleke, A. K.; Smit, J. L.

    2016-06-01

    Apart from the drive to reduce carbon dioxide emissions by carbon-intensive economies like South Africa, the recent spate of electricity load shedding across most part of the country, including Cape Town has left electricity consumers scampering for alternatives, so as to rely less on the national grid. Solar energy, which is adequately available in most part of Africa and regarded as a clean and renewable source of energy, makes it possible to generate electricity by using photovoltaics technology. However, before time and financial resources are invested into rooftop solar photovoltaic systems in urban areas, it is important to evaluate the potential of the building rooftop, intended to be used in harvesting the solar energy. This paper presents methodologies making use of LiDAR data and other ancillary data, such as high-resolution aerial imagery, to automatically extract building rooftops in City of Cape Town and evaluate their potentials for solar photovoltaics systems. Two main processes were involved: (1) automatic extraction of building roofs using the integration of LiDAR data and aerial imagery in order to derive its' outline and areal coverage; and (2) estimating the global solar radiation incidence on each roof surface using an elevation model derived from the LiDAR data, in order to evaluate its solar photovoltaic potential. This resulted in a geodatabase, which can be queried to retrieve salient information about the viability of a particular building roof for solar photovoltaic installation.

  2. A point-prevalence survey of public hospital inpatients with palliative care needs in Cape Town, South Africa.

    PubMed

    van Niekerk, L; Raubenheimer, P J

    2014-02-01

    To assess the need for palliative care among inpatients occupying acute beds in the public sector hospitals of the Cape Town Metropole. A cross-sectional, contemporaneous, point-prevalence study was performed at 11 public sector hospitals in the Cape Town Metropole using a standardised palliative care identification tool. Data were collected on the socio-demographic characteristics, diagnoses, and prior and current care planning of patients. The case notes of 1 443 hospital inpatients were surveyed, and 16.6% were found to have an active life-limiting disease. The mean age of the group was 56 years. The diagnoses were cancer in 50.8%, organ failure in 32.5%, and HIV/tuberculosis in 9.6%. The greatest burden of disease was in the general medical wards, to which an overall 54.8% of patients meeting the requirements for palliative care were admitted. This study provides evidence for the need for palliative care services in public sector hospitals and in the health system as a whole. The young age of patients and the high prevalences of end-stage renal failure and HIV are unique, and the burden in the general medical wards suggests a focus for initial inpatient programmes.

  3. Awareness and Interest in Intrauterine Contraceptive Device Use among HIV-Positive Women in Cape Town, South Africa

    PubMed Central

    Todd, Catherine S.; Jones, Heidi E.; Garber, Tracy C.; Afnan-Holmes, Hoviyeh; Woolgar, Helen; Bekker, Linda-Gail; Myer, Landon

    2012-01-01

    Objective. To assess awareness of and interest in intrauterine contraceptive device (IUCD) use among HIV-positive women in Cape Town, South Africa. Design. Cross-sectional survey. Methods. HIV-positive women aged 18 through 45 years presenting for care at a primary health care clinic in Cape Town, South Africa participated in this study. Consented participants completed a staff-administered questionnaire in a private setting. Descriptive statistics were generated. Comparisons between demographic and reproductive health-related variables and IUCD awareness and interest were performed with multiple logistic regression. Analyses for IUCD interest excluded women with prior surgical sterilization. Results. Of 277 HIV-positive women, 37% were aware of the IUCD; awareness was independently associated with greater age (adjusted odds ratio (AOR) = 1.15, 95%; confidence interval (CI): 1.10–1.20) and not switching contraceptive methods in the last year (AOR = 2.45, 95% CI: 1.03–5.83). Following an IUCD information session, 86% of women (n = 206/240) were interested in IUCD use. IUCD interest was inversely associated with age (AOR = 0.91, 95% CI: 0.86–0.97) and marginally positively associated with current menstrual bleeding pattern complaints (AOR = 2.14, 95% CI: 0.98–4.68). Conclusions. Despite low levels of method awareness, HIV-positive women in this setting are frequently interested in IUCD use, indicating need for programming to expand method access. PMID:22778537

  4. Epidemiology of Staphylococcus aureus Bacteraemia at a Tertiary Children’s Hospital in Cape Town, South Africa

    PubMed Central

    Naidoo, Reené; Nuttall, James; Whitelaw, Andrew; Eley, Brian

    2013-01-01

    Background Staphylococcus aureus is an important pathogen in paediatric patients with bloodstream infections. The epidemiology of S. aureus bacteraemia, however, has not been well documented in children in South Africa. Methods A retrospective study was conducted at a children’s hospital in Cape Town, South Africa, to investigate the epidemiology of S. aureus bacteraemia from 2007-2011. The incidence, clinical presentation, risk factors, management and outcomes of methicillin sensitive S. aureus (MSSA) and methicillin resistant S. aureus (MRSA) bacteraemia were compared. Results Over the five year study period, 365 episodes of S. aureus bacteraemia were identified. The annual incidence was 3.28 cases per 1000 hospital admissions. MRSA was responsible for 26% of S. aureus bacteraemia and 72% of nosocomial infections. Only six possible cases of community-acquired MRSA infections were described. MSSA bacteraemia was more likely to present as pulmonary and bone or joint infections, while bacteraemia without a source was the most common presentation with MRSA.  Infants, children with malnutrition, and residents of long-term care facilities were at highest risk for MRSA bacteraemia. The overall case fatality rate for S. aureus bacteraemia was 8.8% over five years, with MRSA being the only significant risk factor for mortality. Conclusion The incidence of S. aureus bacteraemia and MRSA bacteraemia in children has remained stable over the past five years. MRSA is a predominantly nosocomial pathogen in children with S. aureus bacteraemia in Cape Town, South Africa. PMID:24167621

  5. Incidence and aetiology of traumatic spinal cord injury in Cape Town, South Africa: a prospective, population-based study.

    PubMed

    Joseph, C; Delcarme, A; Vlok, I; Wahman, K; Phillips, J; Nilsson Wikmar, L

    2015-09-01

    Prospective, regional population-based study. To provide the incidence, aetiology and injury characteristics of traumatic spinal cord injury (TSCI) in the City of Cape Town, South Africa. All government-funded hospitals within the City of Cape Town, South Africa. All survivors of acute TSCI, given that they met the inclusion criteria, were prospectively included for a 1-year period. The International Spinal Cord injury Core Data Set was used and systematically completed by specialist doctors. Further, international standards for neurological classification were adhered to. In total, 147 cases of acute TSCI were identified and 145 were included in the study. The male to female ratio was 5.9:1 and the mean age was 33.5 years, ranging from 18 to 93. The crude incidence rate was 75.6 per million (95% CI: 64.3-88.8) with assault as the main cause of injury, accounting for 59.3% of the cases, followed by motor vehicle accidents (26.3%) and falls (11.7%). Most injuries occurred in the cervical spine (53.1%), and American Spinal Injury Association Impairment Scale A severity was most common (39.3%) in the cohort. The incidence rate of TSCI in a region of South Africa was high when compared to previously postulated figures for the country. There is a need for primary preventative strategies to target younger men that are exposed to violent activities. A national study is required to learn whether these findings are only locally applicable or generalisable.

  6. Surge in treatment admissions related to methamphetamine use in Cape Town, South Africa: implications for public health.

    PubMed

    Plüddemann, Andreas; Myers, Bronwyn J; Parry, Charles D H

    2008-03-01

    In the past decade, methamphetamine has become increasingly a drug of concern globally. The purpose of this study is to describe the changing trends in treatment admissions for methamphetamine abuse in Cape Town, South Africa and to highlight the implications of these changes for policy, practice and research. Data were collected on admissions for drug abuse treatment through a regular monitoring system involving drug treatment centres and programmes in Cape Town every 6 months as part of the South African Community Epidemiology Network on Drug Use (SACENDU). A one-page form was completed by treatment centre personnel to obtain demographic data, the patients' primary and secondary substances of abuse, the mode, frequency and age of first use of substance and information on prior treatment. The results indicate that between 2004 and 2006 a dramatic increase in treatment admissions for methamphetamine abuse occurred, a large proportion of the methamphetamine patients are adolescents and that the drug is almost exclusively smoked. The rapid increase in admissions for methamphetamine abuse is of great concern, particularly as the drug has a number of serious, often chronic, side effects and that a large proportion of the patients are adolescents. The implications for public health are discussed.

  7. Emerging roles and competencies of district and sub-district pharmacists: a case study from Cape Town.

    PubMed

    Bradley, Hazel; Lehmann, Uta; Butler, Nadine

    2015-11-24

    District and sub-district pharmacist positions were created during health sector reform in South Africa. High prevalence of HIV/AIDS, tuberculosis and increasing chronic non-communicable diseases have drawn attention to their pivotal roles in improving accessibility and appropriate use of medicines at the primary level. This research describes new roles and related competencies of district and sub-district pharmacists in Cape Town. Between 2008 and 2011, the author (HB) conducted participatory action research in Cape Town Metro District, an urban district in the Western Cape Province of South Africa, partnering with pharmacists and managers of the two government primary health care (PHC) providers. The two providers function independently delivering complementary PHC services across the entire geographic area, with one provider employing district pharmacists and the other sub-district pharmacists. After an initiation phase, the research evolved into a series of iterative cycles of action and reflection, each providing increasing understanding of district and sub-district pharmacists' roles and competencies. Data was generated through workshops, semi-structured interviews and focus groups with pharmacists and managers which were recorded and transcribed. Thematic analysis was carried out iteratively during the 4-year engagement and triangulated with document reviews and published literature. Five main roles for district and sub-district pharmacists were identified: district/sub-district management; planning, co-ordination and monitoring of pharmaceuticals; information and advice; quality assurance and clinical governance; and research (district pharmacists)/dispensing at clinics (sub-district pharmacists). Although the roles looked similar, there were important differences, reflecting the differing governance and leadership models and services of each provider. Five competency clusters were identified: professional pharmacy practice; health system and public health

  8. "Coming to town": the impact of urbanicity, cigarette advertising, and network norms on the smoking attitudes of black women in Cape Town, South Africa.

    PubMed

    Williams, Chyvette T; Grier, Sonya A; Marks, Amy Seidel

    2008-07-01

    This study was conducted to examine the effect of urban living on smoking attitudes among black African women in South Africa. We examine how urbanicity affects attitudes toward smoking and how it moderates the relationship between both advertising exposure and network norms on black women's smoking attitudes. Respondents were 975 black women currently living in Cape Town townships, some of which were raised in rural villages or small towns. Respondents completed a cross-sectional survey, which included data on smoking attitudes, norms, and exposure to cigarette advertising. Multiple linear regression analysis was performed with smoking attitudes as the response variable, and urbanicity, cigarette advertising exposure, and network smoking norms as primary explanatory variables. Interactions were tested to determine whether urbanicity modified the effect of advertising exposure and network norms on smoking attitudes. Independent effects of urbanicity, exposure to cigarette advertising, and greater smoking prevalence within women's networks were associated with more favorable smoking attitudes. In addition, urbanicity moderated the relationship between network smoking norms and smoking attitudes, but not cigarette advertising exposure and smoking attitudes. Urbanicity, cigarette advertising, and networks play important roles in women's attitudes toward smoking, and potentially, smoking behavior. Overall, our results suggest that strong and creative anti-smoking efforts are needed to combat the potential for a smoking epidemic among an increasingly urbanized population of black women in South Africa and similar emerging markets. Additional research is warranted.

  9. Survey of infections transmissible between baboons and humans, Cape Town, South Africa.

    PubMed

    Drewe, Julian A; O'Riain, M Justin; Beamish, Esme; Currie, Hamish; Parsons, Sven

    2012-02-01

    Baboons on South Africa's Cape Peninsula come in frequent contact with humans. To determine potential health risks for both species, we screened 27 baboons from 5 troops for 10 infections. Most (56%) baboons had antibodies reactive or cross-reactive to human viruses. Spatial overlap between these species poses low but potential health risks.

  10. Health Sciences undergraduate education at UCT: a story of transformation.

    PubMed

    Hartman, Nadia; Kathard, Harsha; Perez, Gonda; Reid, Steve; Irlam, James; Gunston, Geney; Janse van Rensburg, Vicki; Burch, Vanessa; Duncan, Madeleine; Hellenberg, Derek; Van Rooyen, Ian; Smouse, Mantoa; Sikakane, Cynthia; Badenhorst, Elmi; Ige, Busayo

    2012-03-02

    Undergraduate education and training in the Faculty of Health Sciences at the University of Cape Town has become socially responsive. A story of transformation that is consonant with wider societal developments since the 1994 democratic elections, outlining the changes in undergraduate curricula across the faculty, is presented.

  11. "Taking care of business": alcohol as currency in transactional sexual relationships among players in Cape Town, South Africa.

    PubMed

    Townsend, Loraine; Ragnarsson, Anders; Mathews, Catherine; Johnston, Lisa Grazina; Ekström, Anna Mia; Thorson, Anna; Chopra, Mickey

    2011-01-01

    In this article we examine the dynamics of social relationships in which alcohol use and risky sexual behaviors cooccur. As part of a larger biological and behavioral HIV surveillance survey, 20 men who lived in an urban, informal settlement on the outskirts of Cape Town, South Africa participated in in-depth interviews. Interview transcripts were analyzed according to a latent content analysis. Findings highlight the latent association between alcohol and transactional sex, and enable an in-depth examination of the normative role that alcohol plays in the formation of casual sexual partnerships characterized by exchange. We build on an existing conceptual model that traces the potential pathways by which alcohol use and transactional sex are linked to sexual risk behaviors. The study findings point to the need for multilevel HIV risk-reduction interventions among men to reduce excessive alcohol use, risky sexual behaviors, and underlying perceptions of ideal masculinity.

  12. Impact of Sexual Trauma on HIV Care Engagement: Perspectives of Female Patients with Trauma Histories in Cape Town, South Africa.

    PubMed

    Watt, Melissa H; Dennis, Alexis C; Choi, Karmel W; Ciya, Nonceba; Joska, John A; Robertson, Corne; Sikkema, Kathleen J

    2016-11-19

    South African women have disproportionately high rates of both sexual trauma and HIV. To understand how sexual trauma impacts HIV care engagement, we conducted in-depth qualitative interviews with 15 HIV-infected women with sexual trauma histories, recruited from a public clinic in Cape Town. Interviews explored trauma narratives, coping behaviors and care engagement, and transcripts were analyzed using a constant comparison method. Participants reported multiple and complex traumas across their lifetimes. Sexual trauma hindered HIV care engagement, especially immediately following HIV diagnosis, and there were indications that sexual trauma may interfere with future care engagement, via traumatic stress symptoms including avoidance. Disclosure of sexual trauma was limited; no women had disclosed to an HIV provider. Routine screening for sexual trauma in HIV care settings may help to identify individuals at risk of poor care engagement. Efficacious treatments are needed to address the psychological and behavioral sequelae of trauma.

  13. The Institution of a Standardized Investigation Protocol for Sudden Infant Death in the Eastern Metropole, Cape Town, South Africa(,)().

    PubMed

    Dempers, Johan J; Coldrey, Jean; Burger, Elsie H; Thompson, Vonita; Wadee, Shabbir A; Odendaal, Hein J; Sens, Mary Ann; Randall, Brad B; Folkerth, Rebecca D; Kinney, Hannah C

    2016-11-01

    The rate for the sudden infant death syndrome (SIDS) in Cape Town, South Africa, is estimated to be among the highest in the world (3.41/1000 live births). In several of these areas, including those of extreme poverty, only sporadic, nonstandardized infant autopsy, and death scene investigation (DSI) occurred. In this report, we detail a feasibility project comprising 18 autopsied infants with sudden and unexpected death whose causes of death were adjudicated according to the 1991 NICHD definitions (SIDS, n = 7; known cause of death, n = 7; and unclassified, n = 4). We instituted a standardized autopsy and infant DSI through a collaborative effort of local forensic pathology officers and clinical providers. The high standard of forensic investigation met international standards, identified preventable disease, and allowed for incorporation of research. We conclude that an effective infant autopsy and DSI protocol can be established in areas with both high sudden unexpected infant death, and elsewhere. (SUID)/SIDS risk and infrastructure challenges.

  14. Concurrent partnerships in Cape Town, South Africa: race and sex differences in prevalence and duration of overlap.

    PubMed

    Beauclair, Roxanne; Hens, Niel; Delva, Wim

    2015-01-01

    Concurrent partnerships (CPs) have been suggested as a risk factor for transmitting HIV, but their impact on the epidemic depends upon how prevalent they are in populations, the average number of CPs an individual has and the length of time they overlap. However, estimates of prevalence of CPs in Southern Africa vary widely, and the duration of overlap in these relationships is poorly documented. We aim to characterize concurrency in a more accurate and complete manner, using data from three disadvantaged communities of Cape Town, South Africa. We conducted a sexual behaviour survey (n = 878) from June 2011 to February 2012 in Cape Town, using Audio Computer-Assisted Self-Interviewing to collect sexual relationship histories on partners in the past year. Using the beginning and end dates for the partnerships, we calculated the point prevalence, the cumulative prevalence and the incidence rate of CPs, as well as the duration of overlap for relationships begun in the previous year. Linear and binomial regression models were used to quantify race (black vs. coloured) and sex differences in the duration of overlap and relative risk of having CPs in the past year. The overall point prevalence of CPs six months before the survey was 8.4%: 13.4% for black men, 1.9% for coloured men, 7.8% black women and 5.6% for coloured women. The median duration of overlap in CPs was 7.5 weeks. Women had less risk of CPs in the previous year than men (RR 0.43; 95% CI: 0.32-0.57) and black participants were more at risk than coloured participants (RR 1.86; 95% CI: 1.17-2.97). Our results indicate that in this population the prevalence of CPs is relatively high and is characterized by overlaps of long duration, implying there may be opportunities for HIV to be transmitted to concurrent partners.

  15. Concurrent partnerships in Cape Town, South Africa: race and sex differences in prevalence and duration of overlap

    PubMed Central

    Beauclair, Roxanne; Hens, Niel; Delva, Wim

    2015-01-01

    Introduction Concurrent partnerships (CPs) have been suggested as a risk factor for transmitting HIV, but their impact on the epidemic depends upon how prevalent they are in populations, the average number of CPs an individual has and the length of time they overlap. However, estimates of prevalence of CPs in Southern Africa vary widely, and the duration of overlap in these relationships is poorly documented. We aim to characterize concurrency in a more accurate and complete manner, using data from three disadvantaged communities of Cape Town, South Africa. Methods We conducted a sexual behaviour survey (n=878) from June 2011 to February 2012 in Cape Town, using Audio Computer-Assisted Self-Interviewing to collect sexual relationship histories on partners in the past year. Using the beginning and end dates for the partnerships, we calculated the point prevalence, the cumulative prevalence and the incidence rate of CPs, as well as the duration of overlap for relationships begun in the previous year. Linear and binomial regression models were used to quantify race (black vs. coloured) and sex differences in the duration of overlap and relative risk of having CPs in the past year. Results The overall point prevalence of CPs six months before the survey was 8.4%: 13.4% for black men, 1.9% for coloured men, 7.8% black women and 5.6% for coloured women. The median duration of overlap in CPs was 7.5 weeks. Women had less risk of CPs in the previous year than men (RR 0.43; 95% CI: 0.32–0.57) and black participants were more at risk than coloured participants (RR 1.86; 95% CI: 1.17–2.97). Conclusions Our results indicate that in this population the prevalence of CPs is relatively high and is characterized by overlaps of long duration, implying there may be opportunities for HIV to be transmitted to concurrent partners. PMID:25697328

  16. Burden, genotype and phenotype profiles of adult patients with sickle cell disease in Cape Town, South Africa.

    PubMed

    Pule, G D; Mnica, K; Joubert, M; Mowla, S; Novitsky, N; Wonkam, A

    2017-01-30

    An exponential increase in the number of sickle cell disease (SCD) patients in paediatric services in Cape Town, South Africa, has been reported. The trend in adult/adolescent services has not been investigated. To evaluate epidemiological trends of SCD and the profile of patients affected by SCD attending the Haematology Clinic at Groote Schuur Hospital (GSH), Cape Town. (i) A retrospective review of the number of SCD patients over the past 20 years; (ii) a cross-sectional analysis of clinical and haematological characteristics of SCD patients; and (iii) molecular analysis of the haemoglobin S mutation, the haplotype in the β-globin-like genes cluster, the 3.7 kb α-thalassaemia gene deletion and 19 selected single-nucleotide polymorphisms (SNPs) associated with fetal haemoglobin (HbF) levels. From 1995 to 2016, 81 adolescent/adult patients with SCD were registered, mostly originating from other African countries (n=61, 75.3%). There was an increase of over 200% in new cases (n=47) during the last quarter of the two decades investigated. Data from 34 of 58 regular attendees (58.6%) were analysed. The mean age of the patients was 26.1 years (standard deviation (SD) 9.8), and 70.6% were male. With the exception of four patients with sickle/β-thalassaemia, all the patients had SCD (haemoglobin SS). The co-inheritance of a single 3.7 kb α-globin deletion was found in 42.3% of cases (n=11). The Bantu haplotype was the most observed (65.4% of chromosomes). Most HbF-promoting SNPs were not associated with variable levels of haematological indices. There is an increasing burden of adult SCD patients at GSH. National health and academic institutions need to adapt policies and healthcare professional training accordingly.

  17. The influence of male circumcision for HIV prevention on sexual behaviour among traditionally circumcised men in Cape Town, South Africa.

    PubMed

    Eaton, L A; Cain, D N; Agrawal, A; Jooste, S; Udemans, N; Kalichman, S C

    2011-11-01

    We examined the relationship between HIV prevention beliefs related to male circumcision and sexual behaviour/sexually transmitted infection (STI) acquisition among traditionally circumcised men in Cape Town, South Africa. HIV-negative men (n = 304), circumcised for cultural/religious reasons, attending a health clinic in Cape Town, South Africa, completed cross-sectional surveys. Generalized linear models were used to analyse the relationships between unprotected vaginal sex acts, number of female sexual partners, STI diagnoses and male circumcision-related beliefs and risk perceptions. Men who were aware that circumcision offers protection against HIV (relative risk [RR] = 1.19, 95% confidence interval [CI] = 1.06-1.32, P < 0.01), endorsed risk compensation related to male circumcision (RR = 1.15, 95% CI = 1.11-1.12, P < 0.01) and perceived lower risk of HIV infection when circumcised (RR = 1.08, 95% CI = 1.04-1.12, P < 0.01) were more likely to report unprotected vaginal sex acts. Similar patterns were also identified when predicting number of female sexual partners. Men who were more likely to endorse risk compensation related to male circumcision were also more likely to be diagnosed with a chronic STI (odds ratio [OR] = 1.64, 95% CI = 1.06-2.53, P < 0.05). Our findings suggest that we must not overlook the effects of beliefs towards male circumcision for HIV prevention among men traditionally circumcised; doing so may undermine current efforts to reduce HIV transmission through male circumcision.

  18. The mass miniature chest radiography programme in Cape Town, South Africa, 1948 - 1994: The impact of active tuberculosis case finding.

    PubMed

    Hermans, S M; Andrews, J R; Bekker, L-G; Wood, R

    2016-12-01

    Tuberculosis (TB) control programmes rely mainly on passive detection of symptomatic individuals. The resurgence of TB has rekindled interest in active case finding. Cape Town (South Africa) had a mass miniature radiography (MMR) screening programme from 1948 to 1994. To evaluate screening coverage, yield and secular trends in TB notifications during the MMR programme. We performed an ecological analysis of the MMR programme and TB notification data from the City of Cape Town Medical Officer of Health reports for 1948 - 1994. Between 1948 and 1962, MMR screening increased to 12% of the population per annum with yields of 14 cases per 1 000 X-rays performed, accounting for >20% of total annual TB notifications. Concurrent with increasing coverage (1948 - 1965), TB case notification decreased in the most heavily TB-burdened non-European population from 844/100 000 population to 415/100 000. After 1966, coverage declined and TB notifications that initially remained stable (1967 - 1978) subsequently increased to 525/100 000. MMR yields remained low in the European population but declined rapidly in the non-European population after 1966, coincidental with forced removals from District 6. An inverse relationship between screening coverage and TB notification rates was observed in the non-European adult population. Similar secular trends occurred in infants and young children who were not part of the MMR screening programme. MMR of a high-burdened population may have significantly contributed to TB control and was temporally associated with decreased transmission to infants and children. These historical findings emphasise the importance of re-exploring targeted active case finding strategies as part of population TB control.

  19. Temperature Variability and Occurrence of Diarrhoea in Children under Five-Years-Old in Cape Town Metropolitan Sub-Districts.

    PubMed

    Musengimana, Gentille; Mukinda, Fidele K; Machekano, Roderick; Mahomed, Hassan

    2016-08-29

    This paper describes the relationship between temperature change and diarrhoea in under five-year-old children in the Cape Town Metropolitan Area (CTMA) of South Africa. The study used climatic and aggregated surveillance diarrhoea incidence data of two peak periods of seven months each over two consecutive years. A Poisson regression model and a lagged Poisson model with autocorrelation was performed to test the relationship between climatic parameters (minimum and maximum temperature) and incidence of diarrhoea. In total, 58,617 cases of diarrhoea occurred in the CTMA, which is equivalent to 8.60 cases per 100 population under five years old for the study period. The mixed effect overdispersed Poisson model showed that a cluster adjusted effect of an increase of 5 °C in minimum and maximum temperature results in a 40% (Incidence risk ratio IRR: 1.39, 95% CI 1.31-1.48) and 32% (IRR: 1.32, 95% CI: 1.22-1.41) increase in incident cases of diarrhoea, respectively, for the two periods studied. Autocorrelation of one-week lag (Autocorrelation AC 1) indicated that a 5 °C increase in minimum and maximum temperature led to 15% (IRR: 1.46, 95% CI: 1.09-1.20) and 6% (IRR: 1.06, 95% CI: 1.01-1.12) increase in diarrhoea cases, respectively. In conclusion, there was an association between an increase in minimum and maximum temperature, and the rate at which diarrhoea affected children under the age of five years old in the Cape Town Metropolitan Area. This finding may have implications for the effects of global warming and requires further investigation.

  20. Men (and Women) as “Sellers” of Sex in Alcohol-Serving Venues in Cape Town, South Africa

    PubMed Central

    Pitpitan, Eileen V.; Kalichman, Seth C.; Eaton, Lisa A.; Watt, Melissa H.; Sikkema, Kathleen J.; Skinner, Donald; Pieterse, Desiree; Cain, Demetria

    2013-01-01

    Background The relationship between transactional sex, HIV risk, and partner violence has been well documented in South Africa, but research has focused primarily on women and has not been conducted in high-risk social contexts. The aim of this study was to examine associations between transactional sex and HIV risk among women and men in alcohol-serving venues in Cape Town, South Africa. Methods We surveyed 1,989 women and 2,468 men attending alcohol-serving venues in Cape Town, South Africa to assess transactional sex behavior (i.e., receiving money or goods in exchange for sex), alcohol and drug use, history of childhood abuse, current relationship violence, and sexual risk behaviors. Results Among both women and men, trading sex was related to higher alcohol use, greater likelihood of drug use, substance use in sexual contexts, and a greater likelihood of experiencing physical and sexual violence. Compared to other women, women who traded sex reported a greater proportion of condom-unprotected sex; this relationship was not found for men. Analyses showed that men were almost twice as more likely to report trading sex for items, including money or alcohol, than women (9.7% vs. 5.8%). Overall, men who traded sex were similar to their female counterparts. Conclusions Similar associations between trading sex and different risk behaviors were found among women and men with limited economic means and substance use problems. Future research should more closely study transactional sex in high-risk venues as it relates to violence and should examine men who trade sex as a potential bridge population between heterosexual women and men who have sex with men. PMID:23494405

  1. Men (and women) as "sellers" of sex in alcohol-serving venues in Cape Town, South Africa.

    PubMed

    Pitpitan, Eileen V; Kalichman, Seth C; Eaton, Lisa A; Watt, Melissa H; Sikkema, Kathleen J; Skinner, Donald; Pieterse, Desiree; Cain, Demetria

    2014-06-01

    The relationship between transactional sex, HIV risk, and partner violence has been well documented in South Africa, but research has focused primarily on women and has not been conducted in high-risk social contexts. The aim of this study was to examine associations between transactional sex and HIV risk among women and men in alcohol-serving venues in Cape Town, South Africa. We surveyed 1,989 women and 2,468 men attending alcohol-serving venues in Cape Town, South Africa to assess transactional sex behavior (i.e., receiving money or goods in exchange for sex), alcohol and drug use, history of childhood abuse, current relationship violence, and sexual risk behaviors. Among both women and men, trading sex was related to higher alcohol use, greater likelihood of drug use, substance use in sexual contexts, and a greater likelihood of experiencing physical and sexual violence. Compared to other women, women who traded sex reported a greater proportion of condom-unprotected sex; this relationship was not found for men. Analyses showed that men were almost twice as more likely to report trading sex for items, including money or alcohol, than women (9.7 vs. 5.8 %). Overall, men who traded sex were similar to their female counterparts. Similar associations between trading sex and different risk behaviors were found among women and men with limited economic means and substance use problems. Future research should more closely study transactional sex in high-risk venues as it relates to violence and should examine men who trade sex as a potential bridge population between heterosexual women and men who have sex with men.

  2. Temperature Variability and Occurrence of Diarrhoea in Children under Five-Years-Old in Cape Town Metropolitan Sub-Districts

    PubMed Central

    Musengimana, Gentille; Mukinda, Fidele K.; Machekano, Roderick; Mahomed, Hassan

    2016-01-01

    This paper describes the relationship between temperature change and diarrhoea in under five-year-old children in the Cape Town Metropolitan Area (CTMA) of South Africa. The study used climatic and aggregated surveillance diarrhoea incidence data of two peak periods of seven months each over two consecutive years. A Poisson regression model and a lagged Poisson model with autocorrelation was performed to test the relationship between climatic parameters (minimum and maximum temperature) and incidence of diarrhoea. In total, 58,617 cases of diarrhoea occurred in the CTMA, which is equivalent to 8.60 cases per 100 population under five years old for the study period. The mixed effect overdispersed Poisson model showed that a cluster adjusted effect of an increase of 5 °C in minimum and maximum temperature results in a 40% (Incidence risk ratio IRR: 1.39, 95% CI 1.31–1.48) and 32% (IRR: 1.32, 95% CI: 1.22–1.41) increase in incident cases of diarrhoea, respectively, for the two periods studied. Autocorrelation of one-week lag (Autocorrelation AC 1) indicated that a 5 °C increase in minimum and maximum temperature led to 15% (IRR: 1.46, 95% CI: 1.09–1.20) and 6% (IRR: 1.06, 95% CI: 1.01–1.12) increase in diarrhoea cases, respectively. In conclusion, there was an association between an increase in minimum and maximum temperature, and the rate at which diarrhoea affected children under the age of five years old in the Cape Town Metropolitan Area. This finding may have implications for the effects of global warming and requires further investigation. PMID:27589772

  3. Computer Applications in Information Systems. Proceedings of a Workshop (Cape Town, South Africa, November 26-27, 1985). Continuing Education Series Number 1.

    ERIC Educational Resources Information Center

    Bleimschein, Sue, Ed.

    Sixteen papers from a workshop on computer applications sponsored by the University of Cape Town (South Africa) School of Librarianship are presented in this volume: (1) "Introduction to the Use of Information Technology" (Sue Bleimschein); (2) "Searching Remote Databases" (Steve Rossouw); (3) "SABINET [South African Bibliographic and Information…

  4. Staff Attitudes and Services Provided by Community-Based Organizations for Alcohol and Other Drug Users in Cape Town, South Africa: Implications for Training and Education

    ERIC Educational Resources Information Center

    Pasche, Sonja; Myers, Bronwyn; Louw, Johann

    2008-01-01

    Aims: The aims of this study were: (i) to describe the nature of and the extent to which community-based organizations (CBOs) in Cape Town provide services to people who have alcohol and other drug (AOD) problems; (ii) to examine the relationship between CBOs' attitudes towards individuals with AOD problems and the types of services provided; and…

  5. Computer Applications in Information Systems. Proceedings of a Workshop (Cape Town, South Africa, November 26-27, 1985). Continuing Education Series Number 1.

    ERIC Educational Resources Information Center

    Bleimschein, Sue, Ed.

    Sixteen papers from a workshop on computer applications sponsored by the University of Cape Town (South Africa) School of Librarianship are presented in this volume: (1) "Introduction to the Use of Information Technology" (Sue Bleimschein); (2) "Searching Remote Databases" (Steve Rossouw); (3) "SABINET [South African Bibliographic and Information…

  6. Flexible Weaving: Investigating the Teaching and Learning Opportunities in the Practices of Theatre-Makers and Performers from Selected Townships in Cape Town

    ERIC Educational Resources Information Center

    Morris, Gay

    2013-01-01

    In 2005-2009, the author researched the theatre-making practices of young people in selected black townships near Cape Town, South Africa. Township theatre groups comprised secondary school learners and out-of-school youth who join together to learn about and make theatre, perform and watch each other. These theatre practitioners do not describe…

  7. Flexible Weaving: Investigating the Teaching and Learning Opportunities in the Practices of Theatre-Makers and Performers from Selected Townships in Cape Town

    ERIC Educational Resources Information Center

    Morris, Gay

    2013-01-01

    In 2005-2009, the author researched the theatre-making practices of young people in selected black townships near Cape Town, South Africa. Township theatre groups comprised secondary school learners and out-of-school youth who join together to learn about and make theatre, perform and watch each other. These theatre practitioners do not describe…

  8. A Comparison of the Motor Ability of 8 and 9 Year Old Primary School Children in Hamburg, Melbourne and Cape Town--An Exploratory Study

    ERIC Educational Resources Information Center

    Kretschmer, Jurgen; Saunders, John; Bressan, Liz; Erhorn, Jan; Wirszing, Daniel

    2013-01-01

    An increasing worldwide concern about a decline in the quality of the motor ability of children was the motivation for this exploratory comparative study. It involves a comparison of the motor ability of children aged 8 and 9 years from Hamburg (n = 774), Melbourne (n = 141) and Cape Town (n = 81). Since each of these global cities represents a…

  9. Staff Attitudes and Services Provided by Community-Based Organizations for Alcohol and Other Drug Users in Cape Town, South Africa: Implications for Training and Education

    ERIC Educational Resources Information Center

    Pasche, Sonja; Myers, Bronwyn; Louw, Johann

    2008-01-01

    Aims: The aims of this study were: (i) to describe the nature of and the extent to which community-based organizations (CBOs) in Cape Town provide services to people who have alcohol and other drug (AOD) problems; (ii) to examine the relationship between CBOs' attitudes towards individuals with AOD problems and the types of services provided; and…

  10. Complainants With Learning Disabilities In Sexual Abuse Cases: A 10-Year Review Of A Psycho-Legal Project In Cape Town, South Africa

    ERIC Educational Resources Information Center

    Dickman, Beverley Jo; Roux, Amanda Jane

    2005-01-01

    We describe a project established in 1990 to assist complainants with learning disabilities in sexual assault cases in Cape Town, South Africa. Complainants are prepared for court and psychologists advise investigating officers and prosecutors, and provide expert testimony. There has been an enormous increase in the utilization of the project by…

  11. Complainants With Learning Disabilities In Sexual Abuse Cases: A 10-Year Review Of A Psycho-Legal Project In Cape Town, South Africa

    ERIC Educational Resources Information Center

    Dickman, Beverley Jo; Roux, Amanda Jane

    2005-01-01

    We describe a project established in 1990 to assist complainants with learning disabilities in sexual assault cases in Cape Town, South Africa. Complainants are prepared for court and psychologists advise investigating officers and prosecutors, and provide expert testimony. There has been an enormous increase in the utilization of the project by…

  12. Methamphetamine use and sexual risk behaviour in Cape Town, South Africa: a review of data from 8 studies conducted between 2004 and 2007.

    PubMed

    Parry, C D H; Plüddemann, A; Myers, B; Wechsberg, W M; Flisher, A J

    2011-11-01

    Community studies and studies of admissions to drug treatment centers indicate a dramatic increase in the prevalence of methamphetamine use in Cape Town since 2003. There has also been a substantial increase over this time period in the prevalence of HIV infection among women attending public antenatal clinics in the Western Cape province. This study aimed to review research conducted in Cape Town on the link between methamphetamine use and sexual risk behaviour. A review of published research conducted in Cape Town between 2004 and 2007 was undertaken using PubMed, EBSCOhost and Science Direct. Eight studies were identified, both quantitative and qualitative, and focusing on diverse populations, such as learners in school, out of school youth, adults in the community, men who have sex with men and sex workers. The total sample across the studies was 8153. Across multiple studies methamphetamine was fairly consistently associated with early vaginal sex, condom use during sex, having casual sex and other HIV risk behaviours. For some sub-groups the direction of the relationship was in an unexpected direction. The consistency of the findings across studies highlights the increased risk for contracting HIV among methamphetamine users, and reinforces the importance of interventions addressing both methamphetamine use and unsafe sexual behaviour among young people and other sectors of the population. The need for further research is also considered, particularly research that will explain some of the racial differences that were found.

  13. Single-centre experience of allogeneic haemopoietic stem cell transplant in paediatric patients in Cape Town, South Africa.

    PubMed

    Van Eyssen, A; Novitsky, N; De Wit, P; Schlaphoff, T; Thomas, V; Pillay, D; Hendricks, M; Davidson, A

    2017-02-27

    Allogeneic haemopoietic stem cell transplant (Allo-HSCT) is a specialised and costly intervention, associated with significant morbidity and mortality. It is used to treat a broad range of paediatric conditions. South Africa (SA) is an upper middle-income country with limitations on healthcare spending. The role of paediatric Allo-HSCT in this setting is reviewed. To review paediatric patients who underwent Allo-HSCT at the Groote Schuur Hospital/University of Cape Town Private Academic Hospital transplant unit in Cape Town, South Africa, and received post-transplant care at Red Cross War Memorial Children's Hospital, over the period January 2006 - December 2014 in respect of indications for the transplant, donor sources, conditioning regimens, treatment-related morbidity and overall survival (OS). A retrospective analysis of patient records was performed and a database was created in Microsoft Access. Descriptive analyses of relevant demographic, clinical and laboratory data were performed. Summary statistics of demographic and clinical parameters were derived with Excel. OS was calculated from the date of transplant to the date of an event (death) or last follow-up using the Kaplan-Meier method in Statistica. A total of 48 children received Allo-HSCT: 24 for haematological malignancies, 20 for non-oncological haematological conditions, 3 for immune disorders and 1 for adrenoleukodystrophy. There were 28 boys (median age 7.5 years) and 20 girls (8.5 years). There were 31 sibling matched peripheral-blood stem cell (PBSC) transplants and 1 maternal haploidentical PBSC transplant. Stem cells were mobilised from bone marrow into peripheral blood by administering granulocyte-colony stimulating factor to donors. PBSCs were harvested by apheresis. Eight patients received 10/10 HLA-matched grafts from unrelated donors. Six were PBSC grafts and 2 were bone marrow grafts. Three of the unrelated PBSC grafts were from SA donors. Eight transplants used umbilical cord blood

  14. The clinical and molecular spectrum of galactosemia in patients from the Cape Town region of South Africa

    PubMed Central

    Henderson, Howard; Leisegang, Felicity; Brown, Ruth; Eley, Brian

    2002-01-01

    Background The objective of this study was to document the clinical, laboratory and genetic features of galactosemia in patients from the Cape Town metropolitan region. Methods Diagnoses were based on thin layer chromatography for galactosuria/galactosemia and assays of erythrocyte galactose-1-phosphate uridyltransferase (GALT) and galactokinase activities. Patients were screened for the common S135L and Q188R transferase gene mutations, using PCR-based assays. Screening for the S135L mutation in black newborns was used to estimate the carrier rate for galactosemia in black South Africans. Results A positive diagnosis of galactosemia was made in 17 patients between the years 1980 to 2001. All had very low or absent galactose-1-phosphate uridyltransferase (GALT) activity, and normal galactokinase levels. The mean age at diagnosis was 5.1 months (range 4 days to 6.5 months). A review of 9 patients showed that hepatomegaly (9/9), and splenomegaly, failure to thrive, developmental delay, bilateral cataracts (6/9) were the most frequent features at diagnosis. Six had conjugated hyperbilirubinemia. Four experienced invasive E. coli infection before diagnosis. Ten patients were submitted to DNA analysis. All 4 black patients and 2 of mixed extraction were homozygous for the S135L allele, while all 3 white patients were homozygous for the Q188R allele. The remaining patient of mixed extraction was heterozygous for the Q188R allele. The estimated carrier frequency of the S135L mutation in 725 healthy black newborns was 1/60. Conclusions In the absence of newborn screening the delay in diagnosis is most often unacceptably long. Also, carrier frequency data predict a galactosemia incidence of approximately 1/14 400 for black newborns in the Cape Metropole, which is much higher than the current detection rate. It is thus likely that many patients go undetected. PMID:12350230

  15. The impact of methamphetamine (“tik”) on a peri-urban community in Cape Town, South Africa

    PubMed Central

    Watt, Melissa H.; Meade, Christina S.; Kimani, Stephen; MacFarlane, Jessica C.; Choi, Karmel W.; Skinner, Donald; Pieterse, Desiree; Kalichman, Seth C.; Sikkema, Kathleen J.

    2014-01-01

    Background Over the last decade, South Africa’s Western Cape has experienced a dramatic increase in methamphetamine (“tik”) use. Our study explored local impressions of the impact of tik use in a peri-urban township community in Cape Town, South Africa. Methods We conducted individual in-depth interviews with 55 women and 37 men who were regular attendees of alcohol-serving venues. Interviews were recorded and transcribed. A content analysis approach was used to identify themes related to the impact of tik use based on levels of the socio-ecological framework (individual, inter-personal and community). Results Tik use was reported to be a greater issue among Coloureds, compared to Blacks. At an individual level, respondents reported that tik use had adverse effects on mental, physical, and economic well-being, and limited future opportunities through school drop-out and incarceration. At an inter-personal level, respondents reported that tik use contributed to physical and sexual violence as well as increased rates of sexual risk behaviour, particularly through transactional sex relationships. Respondents described how tik use led to household conflict, and had negative impacts on children, including neglect and poor birth outcomes. At a community level, respondents linked tik use to increased rates of crime, violence and corruption, which undercut community cohesion. Conclusions Our results highlight the negative impact that tik is having on individuals, households and the overall community in a peri-urban setting in South Africa. There is a clear need for interventions to prevent tik use in South Africa and to mitigate and address the impact of tik on multiple levels. PMID:24246503

  16. HIV testing attitudes, AIDS stigma, and voluntary HIV counselling and testing in a black township in Cape Town, South Africa

    PubMed Central

    Kalichman, S; Simbayi, L

    2003-01-01

    Objectives: A cornerstone of HIV prevention in South Africa is voluntary HIV antibody counselling and testing (VCT), but only one in five South Africans aware of VCT have been tested. This study examined the relation between HIV testing history, attitudes towards testing, and AIDS stigmas. Methods: Men (n = 224) and women (n = 276) living in a black township in Cape Town completed venue intercept surveys; 98% were black, 74% age 35 or younger. Results: 47% of participants had been tested for HIV. Risks for exposure to HIV were high and comparable among people tested and not tested. Comparisons on attitudes toward VCT, controlling for demographics and survey venue, showed that individuals who had not been tested for HIV and those tested but who did not know their results held significantly more negative testing attitudes than individuals who were tested, particularly people who knew their test results. Compared to people who had been tested, individuals who were not tested for HIV demonstrated significantly greater AIDS related stigmas; ascribing greater shame, guilt, and social disapproval to people living with HIV. Knowing test results among those tested was not related to stigmatising beliefs. Conclusions: Efforts to promote VCT in South Africa require education about the benefits of testing and, perhaps more important, reductions in stigmatising attitudes towards people living with AIDS. Structural and social marketing interventions that aim to reduce AIDS stigmas will probably decrease resistance to seeking VCT. PMID:14663117

  17. A qualitative exploration of HIV-positive pregnant women's decision-making regarding abortion in Cape Town, South Africa.

    PubMed

    Orner, Phyllis; de Bruyn, Maria; Harries, Jane; Cooper, Diane

    2010-08-01

    HIV-positive women's abortion decisions were explored by: (i) investigating influencing factors; (ii) determining knowledge of abortion policy and public health services; and (iii) exploring abortion experiences. In-depth interviews were held with 24 HIV-positive women (15 had an abortion; 9 did not), recruited at public health facilities in Cape Town, South Africa. Negative perceptions towards HIV-positive pregnant women were reported. Women wanted abortions due to socio-economic hardship in conjunction with HIV-positive status. Respondents were generally aware that women in South Africa had a right to free abortions in public health facilities. Both positive and negative abortion experiences were described. Respondents reported no discrimination by providers due to their HIV-positive status. Most respondents reported not using contraceptives, while describing their pregnancies as 'unexpected'. The majority of women who had abortions wanted to avoid another one, and would encourage other HIV-positive women to try to avoid abortion. However, most felt abortions were acceptable for HIV-positive women in some circumstances. Data suggested that stigma and discrimination affect connections between abortion, pregnancy and HIV/AIDS, and that abortion may be more stigmatised than HIV/AIDS. Study results provide important insights, and any revision of reproductive health policy, services, counselling for abortion and HIV/AIDS care should address these issues.

  18. Sensation seeking, alcohol use, and sexual behaviors among sexually transmitted infection clinic patients in Cape Town, South Africa.

    PubMed

    Kalichman, Seth C; Simbayi, Leickness C; Jooste, Sean; Cain, Demetria; Cherry, Charsey

    2006-09-01

    Alcohol use is associated with risks for HIV/AIDS. The association between alcohol and sexual risk may be accounted for by sensation seeking personality. However, sensation seeking in relation to substance use and HIV risk has not been examined in Africa. In this study, 292 men and 219 women receiving sexually transmitted infection (STI) diagnostic and treatment services in Cape Town, South Africa, completed anonymous behavioral surveys. Structural modeling was used to test a model of alcohol use and sensation seeking in relation to sexual risk behaviors. Results showed that sensation seeking and alcohol use in sexual contexts were related to HIV risks, controlling for gender and marital status. The association between sensation seeking and HIV risk was partly accounted for by alcohol use in proximity to sex. In contrast to studies conducted in the United States, sensation seeking was not related to alcohol-sex outcome expectancies. These findings suggest that alcohol use is an important HIV transmission risk factor for many STI clinic patients and that interventions for individuals who are characterized as sensation seekers are urgently needed in South Africa.

  19. Costs and process of in-patient tuberculosis management at a central academic hospital, Cape Town, South Africa

    PubMed Central

    Marais, F.; Mehtar, S.; Baltussen, R. M. P. M.

    2012-01-01

    Setting: South Africa reports more cases of tuberculosis (TB) than any other country, but an up-to-date, precise estimate of the costs associated with diagnosing, treating and preventing TB at the in-patient level is not available. Objective: To determine the costs associated with TB management among in-patients and to study the use of personal protective equipment (PPE) at a central academic hospital in Cape Town. Design: Retrospective and partly prospective cost analysis of TB cases diagnosed between May 2008 and October 2009. Results: The average daily in-patient costs were US$238; the average length of stay was 9.7 days. Mean laboratory and medication costs per stay were respectively US$26.82 and US$8.68. PPE use per day cost US$0.99. The average total TB management costs were US$2373 per patient. PPE was not always properly used. Discussion: The costs of in-patient TB management are high compared to community-based treatment; the main reason for the high costs is the high number of in-patient days. An efficiency assessment is needed to reduce costs. Cost reduction per TB case prevented was approximately US$2373 per case. PPE use accounted for the lowest costs. Training is needed to improve PPE use. PMID:26392953

  20. Cost-effectiveness of a package of interventions for expedited antiretroviral therapy initiation during pregnancy in Cape Town, South Africa.

    PubMed

    Zulliger, Rose; Black, Samantha; Holtgrave, David R; Ciaranello, Andrea L; Bekker, Linda-Gail; Myer, Landon

    2014-04-01

    Initiating antiretroviral therapy (ART) early in pregnancy is an important component of effective interventions to prevent the mother-to-child transmission of HIV (PMTCT). The rapid initiation of ART in pregnancy(RAP) program was a package of interventions to expedite ART initiation in pregnant women in Cape Town, South Africa. Retrospective cost-effectiveness, sensitivity and threshold analyses were conducted of the RAP program to determine the cost-utility thresholds for rapid initiation of ART in pregnancy. Costs were drawn from a detailed micro-costing of the program. The overall programmatic cost was US$880 per woman and the base case cost-effectiveness ratio was US$1,160 per quality-adjusted lifeyear (QALY) saved. In threshold analyses, the RAP program remained cost-effective if mother-to-child transmission was reduced by C0.33 %; if C1.76 QALY were saved with each averted perinatal infection; or if RAP-related costs were under US$4,020 per woman. The package of rapid initiation services was very cost-effective, as compared to standard services in this setting. Threshold analyses demonstrated that the intervention required minimal reductions in perinatal infections in order to be cost-effective. Interventions for the rapid initiation of ART in pregnancy hold considerable potential as a cost-effective use of limited resources for PMTCT in sub-Saharan Africa.

  1. Cost-effectiveness of a package of interventions for expedited antiretroviral therapy initiation during pregnancy in Cape Town, South Africa

    PubMed Central

    ZULLIGER, Rose; BLACK, Samantha; HOLTGRAVE, David R.; CIARANELLO, Andrea L.; BEKKER, Linda–Gail; MYER, Landon

    2014-01-01

    Initiating antiretroviral therapy (ART) early in pregnancy is an important component of effective interventions to prevent the mother-to-child transmission of HIV (PMTCT). The Rapid initiation of ART in Pregnancy (RAP) program was a package of interventions to expedite ART initiation in pregnant women in Cape Town, South Africa. Retrospective, cost-effectiveness, sensitivity and threshold analyses were conducted of the RAP program to determine the cost-utility thresholds for rapid initiation of ART in pregnancy. Costs were drawn from a detailed microcosting of the program. The overall programmatic cost was US$880 per woman and the base case cost-effectiveness ratio was US$1,160 per quality-adjusted life year (QALY) saved. In threshold analyses, the RAP program remained cost-effective if mother-to-child transmission was reduced by ≥0.33%; if ≥1.76 QALY were saved with each averted perinatal infection; or if RAP-related costs were under US$4,020 per woman. The package of rapid initiation services was very cost-effective, as compared to standard services in this setting. Threshold analyses demonstrated that the intervention required minimal reductions in perinatal infections in order to be cost-effective. Interventions for the rapid initiation of ART in pregnancy hold considerable potential as a cost-effective use of limited resources for PMTCT in sub-Saharan Africa. PMID:24122044

  2. Ambient Air Pollution Exposure and Respiratory, Cardiovascular and Cerebrovascular Mortality in Cape Town, South Africa: 2001–2006

    PubMed Central

    Wichmann, Janine; Voyi, Kuku

    2012-01-01

    Little evidence is available on the strength of the association between ambient air pollution exposure and health effects in developing countries such as South Africa. The association between the 24-h average ambient PM10, SO2 and NO2 levels and daily respiratory (RD), cardiovascular (CVD) and cerebrovascular (CBD) mortality in Cape Town (2001–2006) was investigated with a case-crossover design. For models that included entire year data, an inter-quartile range (IQR) increase in PM10 (12 mg/m3) and NO2 (12 mg/m3) significantly increased CBD mortality by 4% and 8%, respectively. A significant increase of 3% in CVD mortality was observed per IQR increase in NO2 and SO2 (8 mg/m3). In the warm period, PM10 was significantly associated with RD and CVD mortality. NO2 had significant associations with CBD, RD and CVD mortality, whilst SO2 was associated with CVD mortality. None of the pollutants were associated with any of the three outcomes in the cold period. Susceptible groups depended on the cause-specific mortality and air pollutant. There is significant RD, CVD and CBD mortality risk associated with ambient air pollution exposure in South Africa, higher than reported in developed countries. PMID:23202828

  3. 'Why do an MPH?' Motivations and intentions of physicians undertaking postgraduate public health training at the University of Cape Town.

    PubMed

    Zweigenthal, Virginia E M; Marquez, Emma; London, Leslie

    2016-01-01

    Background Public health (PH) approaches underpin the management and transformation of health systems in low- and middle-income countries. Despite the Master of Public Health (MPH) rarely being a prerequisite for health service employment in South Africa, many physicians pursue MPH qualifications. Objectives This study identifies their motivations and career intentions and explored MPH programme strengths and gaps in under- and post-graduate PH training. Design A cross-sectional study using an online questionnaire was completed by physicians graduating with an MPH between 2000 and 2009 and those enrolled in the programme in 2010 at the University of Cape Town. Results Nearly a quarter of MPH students were physicians. Of the 65 contactable physicians, 48% responded. They were mid-career physicians who wished to obtain research training (55%), who wished to gain broader perspectives on health (32%), and who used the MPH to advance careers (90%) as researchers, policy-makers, or managers. The MPH widened professional opportunities, with 62% changing jobs. They believed that inadequate undergraduate exposure should be remedied by applying PH approaches to clinical problems in community settings, which would increase the attractiveness of postgraduate PH training. Conclusions The MPH allows physicians to transition from pure clinical to research, policy and/or management work, preparing them to innovate changes for effective health systems, responsive to the health needs of populations. Limited local job options and incentives are important constraining factors. Advocacy for positions requiring qualifications and benchmarking exit competencies of programmes nationally may promote enrolment.

  4. 'Why do an MPH?' Motivations and intentions of physicians undertaking postgraduate public health training at the University of Cape Town.

    PubMed

    Zweigenthal, Virginia E M; Marquez, Emma; London, Leslie

    2016-01-01

    Public health (PH) approaches underpin the management and transformation of health systems in low- and middle-income countries. Despite the Master of Public Health (MPH) rarely being a prerequisite for health service employment in South Africa, many physicians pursue MPH qualifications. This study identifies their motivations and career intentions and explored MPH programme strengths and gaps in under- and post-graduate PH training. A cross-sectional study using an online questionnaire was completed by physicians graduating with an MPH between 2000 and 2009 and those enrolled in the programme in 2010 at the University of Cape Town. Nearly a quarter of MPH students were physicians. Of the 65 contactable physicians, 48% responded. They were mid-career physicians who wished to obtain research training (55%), who wished to gain broader perspectives on health (32%), and who used the MPH to advance careers (90%) as researchers, policy-makers, or managers. The MPH widened professional opportunities, with 62% changing jobs. They believed that inadequate undergraduate exposure should be remedied by applying PH approaches to clinical problems in community settings, which would increase the attractiveness of postgraduate PH training. The MPH allows physicians to transition from pure clinical to research, policy and/or management work, preparing them to innovate changes for effective health systems, responsive to the health needs of populations. Limited local job options and incentives are important constraining factors. Advocacy for positions requiring qualifications and benchmarking exit competencies of programmes nationally may promote enrolment.

  5. Language choice and sexual communication among Xhosa speakers in Cape Town, South Africa: implications for HIV prevention message development

    PubMed Central

    Cain, Demetria; Schensul, Stephen; Mlobeli, Regina

    2011-01-01

    Communicating about sex is a vital component of human immunodeficiency virus (HIV) prevention and influences how HIV educators convey messages to communities and how couples negotiate safer sex practices. However, sexual communication inevitably confronts culturally based behavioral guidelines and linguistic taboos unique to diverse social contexts. The HIV interventionist needs to identify the appropriate language for sexual communication given the participants and the message. Ethnographic research can help facilitate the exploration of how sex terminology is chosen. A theoretical framework, developed to guide HIV interventionists, suggests that an individual's language choice for sexual communication is influenced by gender roles and power differentials. In-depth interviews, free listing and triadic comparisons were conducted with Xhosa men and women in Cape Town, South Africa, to determine the terms for male genitalia, female genitalia and sexual intercourse that are most appropriate for sexual communication. Results showed that sexual terms express cultural norms and role expectations where men should be powerful and resilient and women should be passive and virginal. For HIV prevention education, non-mother tongue (English and Zulu) terms were recommended as most appropriate because they are descriptive, but allow the speaker to communicate outside the restrictive limits of their mother tongue by reducing emotive cultural connotations. PMID:21059802

  6. Community perceptions of risk factors for interpersonal violence in townships in Cape Town, South Africa: A focus group study.

    PubMed

    Makanga, Prestige Tatenda; Schuurman, Nadine; Randall, Ellen

    2017-10-01

    Interpersonal violence is a major contributor to the burden of disease globally, and in South Africa, it is the leading cause of injury. There is an emerging consensus that the development of actionable policy and effective prevention strategies for interpersonal violence requires an understanding of the contextual matters that elevate risk for interpersonal violence. The objective of this study was to explore community perceptions of risks for interpersonal violence in five townships in Cape Town, South Africa, with high rates of violence. Focus group discussions were conducted with community members to identify key factors in that contributed to being either a perpetrator or victim of interpersonal violence. The ecological framework was used to classify the risk factors as occurring at individual, relationship, community or society levels. Some of the risk factors identified included alcohol abuse, poverty, informality of settlements and cultural norms. Differences in how each of these risk factors are expressed and experienced in the five communities are also elucidated. This approach enabled the collection of contextual community-based data that can complement conventional surveillance data in the development of relevant community-level strategies for interpersonal violence prevention.

  7. Gender-based violence, alcohol use, and sexual risk among female patrons of drinking venues in Cape Town, South Africa.

    PubMed

    Pitpitan, Eileen V; Kalichman, Seth C; Eaton, Lisa A; Cain, Demetria; Sikkema, Kathleen J; Skinner, Donald; Watt, Melissa H; Pieterse, Desiree

    2013-06-01

    Gender-based violence is a well-recognized risk factor for HIV infection among women. Alcohol use is associated with both gender-based violence and sexual risk behavior, but has not been examined as a correlate of both in a context of both high HIV risk and hazardous drinking. The purpose of this paper is to examine the association between recent abuse by a sex partner with alcohol and sexual risk behavior among female patrons of alcohol serving venues in South Africa. Specifically, the aim of this study is to determine whether sexual risk behaviors are associated with gender-based violence after controlling for levels of alcohol use. We surveyed 1,388 women attending informal drinking establishments in Cape Town, South Africa to assess recent history of gender-based violence, drinking, and sexual risk behaviors. Gender-based violence was associated with both drinking and sexual risk behaviors after controlling for demographics among the women. A hierarchical logistic regression analysis showed that after controlling for alcohol use sexual risk behavior remained significantly associated with gender-based violence, particularly with meeting a new sex partner at the bar, recent STI diagnosis, and engaging in transactional sex, but not protected intercourse or number of partners. In South Africa where heavy drinking is prevalent women may be at particular risk of physical abuse from intimate partners as well as higher sexual risk. Interventions that aim to reduce gender-based violence and sexual risk behaviors must directly work to reduce drinking behavior.

  8. Completeness and accuracy of electronic recording of paediatric drug-resistant tuberculosis in Cape Town, South Africa

    PubMed Central

    Schaaf, H. S.; du Preez, K.; Seddon, J. A.; Garcia-Prats, A. J.; Zimri, K.; Dunbar, R.; Hesseling, A. C.

    2013-01-01

    Setting: Cape Town, South Africa. Objective: To assess the completeness and accuracy of electronic recording of drug-resistant tuberculosis (DR-TB) in children. Design: Retrospective cohort study. All children aged <15 years treated for DR-TB during 2012 were included, with clinical data collected from routine health services. Matching was performed between clinical data and an extracted data set from an electronic register for DR-TB (EDR.web), and data sources were compared. Results: Seventy-seven children were identified clinically, of whom only 49 (64%) were found in EDR.web. Most data in EDR.web were complete and accurate, but there were some internal inconsistencies for confirmed TB. Only 4.4% of all EDR.web entries were children. Conclusion: Only two thirds of children clinically treated for DR-TB were recorded in the electronic reporting system, suggesting under-reporting. We also found a lower than expected prevalence of childhood DR-TB, probably suggesting both under-diagnosis and under-recording of DR-TB in children. Clinicians at facility level should be able to access the electronic reporting system, and data transfer between clinical paper-based and electronic sources should be simplified. Cross-linking between electronic registers for drug-susceptible and DR-TB or consolidation of registers could improve the accuracy of recording. Improved recording and reporting of DR-TB in children is needed. PMID:26393032

  9. Immediate and long-term results of mitral valve replacement with University of Cape Town mitral valve prosthesis

    PubMed Central

    Schrire, Velva; Barnard, Christiaan N.

    1970-01-01

    We describe seven years' experience with the University of Cape Town lenticular mitral valve prosthesis in 122 patients. All the patients had severe mitral valve disease. In 98 severe mitral stenosis was present with or without incompetence and in 24 the dominant or sole lesion was mitral incompetence. Other valves, particularly the tricuspid, were also frequently affected. The disability was severe or total in almost every patient. One hundred and five patients were discharged from hospital, and in 90 per cent of these the clinical improvement was most gratifying, with the disappearance of pulmonary oedema, paroxysmal dyspnoea, angina pectoris, and congestive cardiac failure. Return to full normal activity including physical work was the rule. The hospital mortality was 14 per cent and a further 38 per cent died during the follow-up period. The major post-operative complication was systemic embolism which could occur at any time after operation. The most important factor influencing the frequency of this complication was the nature of the valve seat. A bare steel seat was associated with a 100 per cent embolism, and a significant reduction occurred when a cloth-covered seat of Dacron-velour was introduced. Anticoagulant therapy appeared to prevent large or fresh clots but had no effect on the deposition of fibrin or platelet thrombi. The only other factor of importance was the age of the patient: after the age of 50 life expectancy and trouble-free long-term survival was reduced. Images PMID:5440520

  10. Afriflu2--second international workshop on influenza vaccination in the African continent--8 November 2012, Cape Town (South Africa).

    PubMed

    Schoub, Barry D; Gessner, Bradford D; Ampofo, William; Cohen, Adam L; Steffen, Christoph A

    2013-08-02

    The second meeting of the Afriflu conferences took place in Cape Town, South Africa, with over 60 participants from 15 countries in Africa and also outside the continent. Significant progress in surveillance has been made in better understanding the illness burden of influenza on the continent, which limited evidence suggests is greater than that in the developed world. In southern Africa HIV and TB coinfections play a major role in increasing hospitalisation and mortality, while elsewhere in Africa other cofactors still need to be determined. There is currently no indigenous vaccine production in sub-Saharan Africa and only one facility, based in South Africa, capable of filling imported bulk. Innovative vaccine strategies will need to be explored, such as maternal immunisation, and also the possibility of other influenza vaccine options, such as live attenuated influenza vaccine for young children. Sustained indigenous vaccine production is essential for the continent to have vaccine security in the event of a pandemic even though establishing local production faces considerable challenges especially ensuring adequate markets on the continent. There is an urgent need to develop effective communication messages for decision makers as well as healthcare workers addressing the importance of influenza even in the face of the major competing health burdens of the continent.

  11. Language choice and sexual communication among Xhosa speakers in Cape Town, South Africa: implications for HIV prevention message development.

    PubMed

    Cain, Demetria; Schensul, Stephen; Mlobeli, Regina

    2011-06-01

    Communicating about sex is a vital component of human immunodeficiency virus (HIV) prevention and influences how HIV educators convey messages to communities and how couples negotiate safer sex practices. However, sexual communication inevitably confronts culturally based behavioral guidelines and linguistic taboos unique to diverse social contexts. The HIV interventionist needs to identify the appropriate language for sexual communication given the participants and the message. Ethnographic research can help facilitate the exploration of how sex terminology is chosen. A theoretical framework, developed to guide HIV interventionists, suggests that an individual's language choice for sexual communication is influenced by gender roles and power differentials. In-depth interviews, free listing and triadic comparisons were conducted with Xhosa men and women in Cape Town, South Africa, to determine the terms for male genitalia, female genitalia and sexual intercourse that are most appropriate for sexual communication. Results showed that sexual terms express cultural norms and role expectations where men should be powerful and resilient and women should be passive and virginal. For HIV prevention education, non-mother tongue (English and Zulu) terms were recommended as most appropriate because they are descriptive, but allow the speaker to communicate outside the restrictive limits of their mother tongue by reducing emotive cultural connotations.

  12. Poverty, sexual behaviour, gender and HIV infection among young black men and women in Cape Town, South Africa.

    PubMed

    Nattrass, Nicoli; Maughan-Brown, Brendan; Seekings, Jeremy; Whiteside, Alan

    2012-12-01

    This article contributes methodologically and substantively to the debate over the importance of poverty, sexual behaviour and circumcision in relation to HIV infection, using panel data on young black men and women in Cape Town, South Africa. Methodological challenges included problems of endogeneity and blunt indicator variables, especially for the measurement of sexual behaviour. Noting these difficulties, we found that the importance of socioeconomic and sexual-behavioural factors differed between men and women. While we found a clear association between the number of years of sexual activity and HIV status among both men and women, we found that past participation in a concurrent sexual partnership increased the odds of HIV infection for men but not women. Women, but not men, who made the transition from school to tertiary education (our key indicator of socioeconomic status) were less likely to be HIV-positive than those who made the transition from school to unemployment. Both poverty and sexual behaviour matter to individuals' HIV risk, but in gendered ways.

  13. The kick with the kite: an analysis of kite surfing related off shore rescue missions in Cape Town, South Africa

    PubMed Central

    Exadaktylos, A; Sclabas, G; Blake, I; Swemmer, K; McCormick, G; Erasmus, P; Muhm, M; Curatolo, M

    2005-01-01

    Methods: The observation period for this study started on October 1, 2003 and ended on May 1, 2004 and included 30 air rescue missions. Data and information were collected prospectively. Results: The Air Mercy Service in Cape Town Province responded to 30 requests for help. Twenty five accidents were attributed to inability to detach the kite from the harness. Injuries occurred in five incidents and included fractures of the upper arm, ribs and ankle, and lacerations and contusions to the head and neck. Two patients suffered from hypothermia and one experienced severe exhaustion. All surfers were rescued successfully and there were no fatal accidents. Discussion: The risk potential of this new sport is unclear. Dangerous situations can occur despite proper training and safety precautions due to unpredictable conditions and difficulties with equipment. Safety should be stressed. Surfers should sailing with a fellow kiter and should wear a life vest. More efforts must be taken to make this booming new water sport safer. PMID:15849279

  14. Mental health and HIV sexual risk behavior among patrons of alcohol serving venues in Cape Town, South Africa.

    PubMed

    Sikkema, Kathleen J; Watt, Melissa H; Meade, Christina S; Ranby, Krista W; Kalichman, Seth C; Skinner, Donald; Pieterse, Desiree

    2011-07-01

    Alcohol-serving venues in South Africa provide a location for HIV prevention interventions due to risk factors of patrons in these establishments. Understanding the association between mental health and risk behaviors in these settings may inform interventions that address alcohol use and HIV prevention. Participants (n = 738) were surveyed in 6 alcohol-serving venues in Cape Town to assess post-traumatic stress disorder (PTSD) and depression symptoms, traumatic experiences, sexual behavior, and substance use. Logistic regression models examined whether traumatic experiences predicted PTSD and depression. Generalized linear models examined whether substance use, PTSD, and depressive symptoms predicted unprotected sexual intercourse. Men and women were analyzed separately. Participants exhibited high rates of traumatic experiences, PTSD, depression, alcohol consumption, and HIV risk behaviors. For men, PTSD was associated with being hit by a sex partner, physical child abuse, sexual child abuse and HIV diagnosis; depression was associated with being hit by a sex partner, forced sex and physical child abuse. For women, both PTSD and depression were associated with being hit by a sex partner, forced sex, and physical child abuse. Unprotected sexual intercourse was associated with age, frequency and quantity of alcohol use, drug use, and PTSD for men and frequency and quantity of alcohol use, depression, and PTSD for women. Mental health in this setting was poor and was associated with sexual risk behavior. Treating mental health and substance-use problems may aid in reducing HIV infection. Sexual assault prevention and treatment after sexual assault may strengthen HIV prevention efforts.

  15. A 10-year review of fatal community assault cases at a regional forensic pathology facility in Cape Town, South Africa.

    PubMed

    Herbst, Celeste Ingrid; Tiemensma, Marianne; Wadee, Shabir Ahmed

    2015-09-19

    An increase in autopsied community assault (CA) fatalities was observed at the Tygerberg Forensic Pathology Services (FPS), Cape Town, South Africa (SA). There is a paucity of information on the incidence and prevalence of these cases in SA. To determine the patterns and trends of injuries sustained in so-called CA fatalities. A retrospective and descriptive study was conducted. Fatal CA cases admitted to the Tygerberg FPS over the 10-year period 1 January 2003-31 December 2012 were reviewed. Data were collected from autopsy/postmortem reports, contemporaneous notes, attached hospital records, the South African Police Services (SAPS) 180 form (completed by the SAPS representative) and other FPS documentation. A total of 424 cases of fatal CA were seen during the study period, with an annual increase between 2003 and 2007 and a second peak in 2012. The cause of death in most cases was multiple injuries (42.0%), with blunt-force trauma being the basis of most injuries sustained. The area with the greatest burden of injury was the township of Mfuleni (73 CA deaths per 100,000 population). There was a predominance of males, with only one female fatality recorded. Adequate policing in prevalent areas is essential to address unnecessary loss of life and the burden imposed by these cases on the criminal justice system and healthcare services.

  16. Condom negotiation, HIV testing, and HIV risks among women from alcohol serving venues in Cape Town, South Africa.

    PubMed

    Pitpitan, Eileen V; Kalichman, Seth C; Cain, Demetria; Eaton, Lisa A; Carey, Kate B; Carey, Michael P; Harel, Ofer; Simbayi, Leickness C; Mehlomakhulu, Vuyelwa; Mwaba, Kelvin

    2012-01-01

    Women in South Africa are at particularly high-risk for HIV infection and are dependent on their male partners' use of condoms for sexual risk reduction. However, many women are afraid to discuss condoms with male partners, placing them at higher risk of HIV infection. To examine the association between fear of condom negotiation with HIV testing and transmission risk behaviors, including alcohol use and sexual risks among South African women. Women (N = 1333) residing in a primarily Xhosa-speaking African township in Cape Town and attending informal alcohol-serving venues (shebeens) completed anonymous surveys. Logistic regression was used to test the hypothesis that fear of condom negotiation would be associated with increased risk for HIV. Compared to women who did not fear condom negotiation, those who did were significantly less likely to have been tested for HIV, were more likely to have experienced relationship abuse, and to report more alcohol use and more unprotected sex. For women in South Africa, fear of condom negotiation is related to higher risk of HIV. HIV prevention efforts, including targeted HIV counseling and testing, must directly address gender issues.

  17. Condom Negotiation, HIV Testing, and HIV Risks among Women from Alcohol Serving Venues in Cape Town, South Africa

    PubMed Central

    Pitpitan, Eileen V.; Kalichman, Seth C.; Cain, Demetria; Eaton, Lisa A.; Carey, Kate B.; Carey, Michael P.; Harel, Ofer; Simbayi, Leickness C.; Mehlomakhulu, Vuyelwa; Mwaba, Kelvin

    2012-01-01

    Background Women in South Africa are at particularly high-risk for HIV infection and are dependent on their male partners' use of condoms for sexual risk reduction. However, many women are afraid to discuss condoms with male partners, placing them at higher risk of HIV infection. Purpose To examine the association between fear of condom negotiation with HIV testing and transmission risk behaviors, including alcohol use and sexual risks among South African women. Method Women (N = 1333) residing in a primarily Xhosa-speaking African township in Cape Town and attending informal alcohol-serving venues (shebeens) completed anonymous surveys. Logistic regression was used to test the hypothesis that fear of condom negotiation would be associated with increased risk for HIV. Results Compared to women who did not fear condom negotiation, those who did were significantly less likely to have been tested for HIV, were more likely to have experienced relationship abuse, and to report more alcohol use and more unprotected sex. Conclusions For women in South Africa, fear of condom negotiation is related to higher risk of HIV. HIV prevention efforts, including targeted HIV counseling and testing, must directly address gender issues. PMID:23056211

  18. "Nothing Is Free": A Qualitative Study of Sex Trading Among Methamphetamine Users in Cape Town, South Africa.

    PubMed

    Watt, Melissa H; Kimani, Stephen M; Skinner, Donald; Meade, Christina S

    2016-05-01

    South Africa is facing an established epidemic of methamphetamine, known locally as "tik." Globally, methamphetamine has been linked to high rates of sexual risk behaviors, including sex trading. The goal of this study was to qualitatively examine the experiences of sex trading among methamphetamine users in Cape Town, South Africa. Individual in-depth interviews were conducted with 30 active methamphetamine users (17 men and 13 women) recruited from the community. Interviews were conducted in local languages using a semi-structured guide that included questions on sex trading experiences and perceptions of sex trading among methamphetamine users. Interviews were audio-recorded, transcribed, and analyzed using analytic memos and coding with constant comparison techniques. The data revealed that in a setting of high levels of addiction and poverty, sex was an important commodity for acquiring methamphetamine. Women were more likely to use sex to acquire methamphetamine, but men reported opportunistic cases of trading sex for methamphetamine. Four models of sex trading emerged: negotiated exchange, implicit exchange, relationships based on resources, and facilitating sex exchange for others. The expectation of sex trading created a context in which sexual violence against female methamphetamine users was common. Multiple sexual partners and inconsistent condom use in acts of sex trading put methamphetamine users at high risk of HIV. Interventions in this setting should address addiction, which is the primary driver of sex trading among methamphetamine users. Harm reduction interventions may include education about HIV and other sexually transmitted infections, availability of condoms and HIV testing, and sexual violence prevention.

  19. The pH Levels of Different Methamphetamine Drug Samples on the Street Market in Cape Town

    PubMed Central

    Grobler, Sias R.; Chikte, Usuf; Westraat, Jaco

    2011-01-01

    The purpose of this study was to determine the pH levels of 29 different samples of methamphetamine on the street market in Cape Town. The sample was dissolved in water and the pH of each sample determined. The pH levels varied from 3.02 to 7.03 with an average of 5.0. Seventy-two percent (21) of the samples had a pH level below the saliva “critical pH point of 5.6” and therefore should cause significant damage to enamel, especially in hyposalivation subjects without a saliva flow. However, about 26% of the samples had a pH level close to the neutral point and should cause minor damage to enamel. To lessen enamel damage, subjects should exercise good oral hygiene practice, rinse with a fluoride-containing mouth rinse, drink artificially sweetened drinks, and eat cheese. It is concluded that most of the methamphetamine samples have a low enough pH to cause direct damage to enamel especially in hyposalivation subjects. PMID:21991491

  20. A prospective study of methamphetamine use as a predictor of high school non-attendance in Cape Town, South Africa

    PubMed Central

    2010-01-01

    Background This prospective study investigated the association between life-long methamphetamine and other drug use and high school non-attendance, in a sample of high school students in Cape Town, South Africa. Methods A random sample of 1535 high school students completed a baseline questionnaire in 2006, and were asked to complete a follow-up questionnaire 12 months later. The questionnaire included questions on substance use, including tobacco, alcohol, methamphetamine and cannabis use, demographic factors, and questions relating to school attendance and performance. Results Forty-three percent of the students surveyed at baseline did not complete a follow-up questionnaire after 12 months. Compared with students who were not using selected substances, an adjusted logistic regression model showed that life-time methamphetamine use in addition to other substances was significantly associated with non-attendance (OR = 2.58, 95% CI: 1.24 - 5.36) when other non-substance use factors (repeating a year at school and being older than the norm for current grade) were taken into account. Conclusions Early identification of students with methamphetamine and other substance use problems, and a supportive rather than punitive school policy, may be valuable in improving high school completion and student retention rates. PMID:20964830

  1. The pH Levels of Different Methamphetamine Drug Samples on the Street Market in Cape Town.

    PubMed

    Grobler, Sias R; Chikte, Usuf; Westraat, Jaco

    2011-01-01

    The purpose of this study was to determine the pH levels of 29 different samples of methamphetamine on the street market in Cape Town. The sample was dissolved in water and the pH of each sample determined. The pH levels varied from 3.02 to 7.03 with an average of 5.0. Seventy-two percent (21) of the samples had a pH level below the saliva "critical pH point of 5.6" and therefore should cause significant damage to enamel, especially in hyposalivation subjects without a saliva flow. However, about 26% of the samples had a pH level close to the neutral point and should cause minor damage to enamel. To lessen enamel damage, subjects should exercise good oral hygiene practice, rinse with a fluoride-containing mouth rinse, drink artificially sweetened drinks, and eat cheese. It is concluded that most of the methamphetamine samples have a low enough pH to cause direct damage to enamel especially in hyposalivation subjects.

  2. A prospective study of methamphetamine use as a predictor of high school non-attendance in Cape Town, South Africa.

    PubMed

    Plüddemann, Andreas; Flisher, Alan J; McKetin, Rebecca; Parry, Charles D; Lombard, Carl J

    2010-10-21

    This prospective study investigated the association between life-long methamphetamine and other drug use and high school non-attendance, in a sample of high school students in Cape Town, South Africa. A random sample of 1535 high school students completed a baseline questionnaire in 2006, and were asked to complete a follow-up questionnaire 12 months later. The questionnaire included questions on substance use, including tobacco, alcohol, methamphetamine and cannabis use, demographic factors, and questions relating to school attendance and performance. Forty-three percent of the students surveyed at baseline did not complete a follow-up questionnaire after 12 months. Compared with students who were not using selected substances, an adjusted logistic regression model showed that life-time methamphetamine use in addition to other substances was significantly associated with non-attendance (OR = 2.58, 95% CI: 1.24-5.36) when other non-substance use factors (repeating a year at school and being older than the norm for current grade) were taken into account. Early identification of students with methamphetamine and other substance use problems, and a supportive rather than punitive school policy, may be valuable in improving high school completion and student retention rates.

  3. Food insufficiency, substance use, and sexual risks for HIV/AIDS in informal drinking establishments, Cape Town, South Africa.

    PubMed

    Kalichman, Seth C; Watt, Melissa; Sikkema, Kathleen; Skinner, Donald; Pieterse, Desiree

    2012-12-01

    HIV/AIDS is concentrated in impoverished communities. Two critical aspects of poverty are food insufficiency and substance abuse, and both are associated with sexual risks for HIV/AIDS in southern Africa. The current study is the first to examine both hunger and substance use in relation to sexual risks for HIV infection in South African alcohol serving establishments. Anonymous venue-based intercept surveys were completed by men (n = 388) and women (n = 407) patrons of six informal drinking places (e.g., shebeens) in Cape Town, South Africa. Food insufficiency and its more extreme form hunger were common in the sample, with 24 % of men and 53 % of women experiencing hunger in the previous 4 months. Multiple regression analyses showed that quantity of alcohol use was related to higher rates of unprotected sex for men and women. Trading sex to meet survival needs was related to food insufficiency and methamphetamine use among men but not women. Food insufficiency and substance use may both contribute to HIV risks in South African shebeens. However, the influence of hunger and substance use on sexual risks varies for men and women. Interventions to reduce HIV transmission risks may be bolstered by reducing both food insufficiency and substance use.

  4. Pregnant and nonpregnant women in cape town, South Africa: drug use, sexual behavior, and the need for comprehensive services.

    PubMed

    Jones, Hendrée E; Browne, Felicia A; Myers, Bronwyn J; Carney, Tara; Ellerson, Rachel Middlesteadt; Kline, Tracy L; Poulton, Winona; Zule, William A; Wechsberg, Wendee M

    2011-01-01

    The multiple risks associated with methamphetamine use are of serious concern for women. These risks and consequences are magnified during pregnancy. This secondary analysis of a parent study compared 26 pregnant to 356 nonpregnant women in Cape Town, South Africa, on selected demographic, psychosocial, and HIV-risk domains to identify their treatment service needs. Proportionally, more pregnant than nonpregnant women are using methamphetamine, P = .01, although a very high rate of women used methamphetamine. Women reported similar monthly rates of sexual intercourse, but pregnant women were significantly less likely to report condom use, P < .0001, maintaining their risky behavior. Both groups reported elevated Center for Epidemiological Studies Depression Scale CES-D means, suggesting a need for depression treatment. Results demonstrate a pervasive need for women's comprehensive treatment, regardless of pregnancy status. Moreover, findings support the urgent need for women-focused and pregnancy-specific treatment services for methamphetamine use. Finally, a job-skills training/employment component focus is suggested.

  5. Dynamics of Indian Ocean Slavery Revealed through Isotopic Data from the Colonial Era Cobern Street Burial Site, Cape Town, South Africa (1750-1827).

    PubMed

    Kootker, Lisette M; Mbeki, Linda; Morris, Alan G; Kars, Henk; Davies, Gareth R

    2016-01-01

    The Dutch East India Company (VOC) intended the Cape of Good Hope to be a refreshment stop for ships travelling between the Netherlands and its eastern colonies. The indigenous Khoisan, however, did not constitute an adequate workforce, therefore the VOC imported slaves from East Africa, Madagascar and Asia to expand the workforce. Cape Town became a cosmopolitan settlement with different categories of people, amongst them a non-European underclass that consisted of slaves, exiles, convicts and free-blacks. This study integrated new strontium isotope data with carbon and nitrogen isotope results from an 18th-19th century burial ground at Cobern Street, Cape Town, to identify non-European forced migrants to the Cape. The aim of the study was to elucidate individual mobility patterns, the age at which the forced migration took place and, if possible, geographical provenance. Using three proxies, 87Sr/86Sr, δ13Cdentine and the presence of dental modifications, a majority (54.5%) of the individuals were found to be born non-locally. In addition, the 87Sr/86Sr data suggested that the non-locally born men came from more diverse geographic origins than the migrant women. Possible provenances were suggested for two individuals. These results contribute to an improved understanding of the dynamics of slave trading in the Indian Ocean world.

  6. Dynamics of Indian Ocean Slavery Revealed through Isotopic Data from the Colonial Era Cobern Street Burial Site, Cape Town, South Africa (1750-1827)

    PubMed Central

    Morris, Alan G.; Kars, Henk; Davies, Gareth R.

    2016-01-01

    The Dutch East India Company (VOC) intended the Cape of Good Hope to be a refreshment stop for ships travelling between the Netherlands and its eastern colonies. The indigenous Khoisan, however, did not constitute an adequate workforce, therefore the VOC imported slaves from East Africa, Madagascar and Asia to expand the workforce. Cape Town became a cosmopolitan settlement with different categories of people, amongst them a non-European underclass that consisted of slaves, exiles, convicts and free-blacks. This study integrated new strontium isotope data with carbon and nitrogen isotope results from an 18th-19th century burial ground at Cobern Street, Cape Town, to identify non-European forced migrants to the Cape. The aim of the study was to elucidate individual mobility patterns, the age at which the forced migration took place and, if possible, geographical provenance. Using three proxies, 87Sr/86Sr, δ13Cdentine and the presence of dental modifications, a majority (54.5%) of the individuals were found to be born non-locally. In addition, the 87Sr/86Sr data suggested that the non-locally born men came from more diverse geographic origins than the migrant women. Possible provenances were suggested for two individuals. These results contribute to an improved understanding of the dynamics of slave trading in the Indian Ocean world. PMID:27309532

  7. Women's experiences with cervical cancer screening in a colposcopy referral clinic in Cape Town, South Africa: a qualitative analysis

    PubMed Central

    Momberg, Mariette; Botha, Matthys H; Van der Merwe, Frederick H; Moodley, Jennifer

    2017-01-01

    Objective The aim of this study was to explore and understand women's experience with cervical cancer screening and with the referral pathways for abnormal Papanicolau (Pap) smears. Design and setting Focus group discussions were conducted with first time colposcopy clinic attendees at a tertiary hospital colposcopy clinic in Cape Town, South Africa during November 2014. A thematic analysis was conducted to identify key themes. Initial coding categories were drawn from the interview guide. Participants 27 women participated in 4 focus group discussions. Results Participants mean age was 34 years, most did not complete secondary level education and were unemployed. Negative community opinions relating to Pap smears and colposcopy referral might deter women from seeking treatment. Having a gynaecological symptom was the most commonly cited reason for having a Pap smear. Fear of having a HIV test performed at the same time as Pap smear and low encouragement from peers, were factors identified as potential access barriers. Participants commented on insufficient or lack of information from primary providers on referral to the colposcopy clinic and concerns and apprehension during waiting periods between receiving results and the colposcopy appointment were discussed. Conclusions There is a strong and urgent need to improve current knowledge about cervical cancer and Pap smears and the necessity and benefits of timely access to screening programmes, results and treatment. Strategies such as community health education programmes and mass media interventions could be employed to disseminate cervical cancer information and address negative community perceptions. Better training and support mechanisms to equip healthcare providers with the skills to convey cervical cancer information to women are needed. The use of short message service (SMS) to deliver Pap smear results and provide patients with more information should be considered to improve waiting times for results

  8. Women's experiences with cervical cancer screening in a colposcopy referral clinic in Cape Town, South Africa: a qualitative analysis.

    PubMed

    Momberg, Mariette; Botha, Matthys H; Van der Merwe, Frederick H; Moodley, Jennifer

    2017-02-17

    The aim of this study was to explore and understand women's experience with cervical cancer screening and with the referral pathways for abnormal Papanicolau (Pap) smears. Focus group discussions were conducted with first time colposcopy clinic attendees at a tertiary hospital colposcopy clinic in Cape Town, South Africa during November 2014. A thematic analysis was conducted to identify key themes. Initial coding categories were drawn from the interview guide. 27 women participated in 4 focus group discussions. Participants mean age was 34 years, most did not complete secondary level education and were unemployed. Negative community opinions relating to Pap smears and colposcopy referral might deter women from seeking treatment. Having a gynaecological symptom was the most commonly cited reason for having a Pap smear. Fear of having a HIV test performed at the same time as Pap smear and low encouragement from peers, were factors identified as potential access barriers. Participants commented on insufficient or lack of information from primary providers on referral to the colposcopy clinic and concerns and apprehension during waiting periods between receiving results and the colposcopy appointment were discussed. There is a strong and urgent need to improve current knowledge about cervical cancer and Pap smears and the necessity and benefits of timely access to screening programmes, results and treatment. Strategies such as community health education programmes and mass media interventions could be employed to disseminate cervical cancer information and address negative community perceptions. Better training and support mechanisms to equip healthcare providers with the skills to convey cervical cancer information to women are needed. The use of short message service (SMS) to deliver Pap smear results and provide patients with more information should be considered to improve waiting times for results and alleviate apprehension during waiting periods. Published by

  9. Dietary Intake of the Urban Black Population of Cape Town: The Cardiovascular Risk in Black South Africans (CRIBSA) Study

    PubMed Central

    Steyn, Nelia P.; Jaffer, Nasreen; Nel, Johanna; Levitt, Naomi; Steyn, Krisela; Lombard, Carl; Peer, Nasheeta

    2016-01-01

    Introduction: To determine dietary intake of 19 to 64 years old urban Africans in Cape Town in 2009 and examine the changes between 1990 and 2009. Methods: A representative cross-sectional sample (n = 544), stratified by gender and age was randomly selected in 2009 from the same areas sampled in 1990. Socio-demographic data and a 24-h dietary recall were obtained by trained field workers. The associations of dietary data with an asset index and degree of urbanization were assessed. Results: Fat intakes were higher in 19–44-year-old men (32% energy (E)) and women (33.4%E) in 2009 compared with 1990 (men: 25.9%E, women: 27.0%E) while carbohydrate intakes were lower in 2009 (men 53.2%E, women: 55.5%E) than in 1990 (men: 61.3%E; women: 62%E) while sugar intake increased significantly (p < 0.01) in women. There were significant positive correlations between urbanization and total fat (p = 0.016), saturated fat (p = 0.001), monounsaturated fat (p = 0.002) and fat as a %E intake (p = 0.046). Urbanization was inversely associated with intake of carbohydrate %E (p < 0.001). Overall micronutrient intakes improved significantly compared with 1990. It should also be noted that energy and macronutrient intakes were all significant in a linear regression model using mean adequacy ratio (MAR) as a measure of dietary quality in 2009, as was duration of urbanization. Discussion: The higher fat and lower carbohydrate %E intakes in this population demonstrate a transition to a more urbanized diet over last two decades. These dietary changes reflect the nutrition transitions that typically occur as a longer time is spent in urban centers. PMID:27187459

  10. An integrated community TB-HIV adherence model provides an alternative to DOT for tuberculosis patients in Cape Town.

    PubMed

    Kaplan, R; Caldwell, J; Hermans, S; Adriaanse, S; Mtwisha, L; Bekker, L-G; Jennings, K; Wood, R

    2016-09-01

    Cape Town, South Africa. To evaluate anti-tuberculosis treatment outcomes and rate of antiretroviral therapy (ART) initiation using weekly community-based adherence support compared to daily directly observed therapy (DOT). This was a retrospective analysis comparing two cohorts treated for tuberculosis (TB) in 70 TB clinics during 6-month periods before and after the introduction of a new adherence model comprising treatment literacy sessions during 2 weeks of DOT, followed by weekly home visits by community care workers to eligible patients managing their own treatment. Odds ratios (ORs) of treatment success and ART initiation were calculated using multivariable random effects logistic regression models. Hazard ratios (HRs) of default and death were calculated using multivariable random effects Cox regression models. The pre-intervention cohort comprised 11 896 patients with TB and the post-intervention cohort 11 314. There was no difference in pre- and post-intervention anti-tuberculosis treatment success rates (respectively 82.8% and 82.5%, adjusted OR [aOR] 1.02, 95%CI 0.89-1.17, P = 0.76) nor an increased hazard of death (adjusted HR [aHR] 0.98, 95%CI 0.80-1.21, P = 0.87) or default (aHR 0.97, 95%CI 0.81-1.15, P = 0.69). The ART initiation rate increased from 67% to 74% (aOR 1.43; 95%CI 1.01-1.85, P < 0.01). Weekly community-based adherence support was a viable alternative to daily DOT, with no deterioration in anti-tuberculosis treatment outcomes and an increase in ART initiation.

  11. Linkage to HIV, TB and non-communicable disease care from a mobile testing unit in Cape Town, South Africa.

    PubMed

    Govindasamy, Darshini; Kranzer, Katharina; van Schaik, Nienke; Noubary, Farzad; Wood, Robin; Walensky, Rochelle P; Freedberg, Kenneth A; Bassett, Ingrid V; Bekker, Linda-Gail

    2013-01-01

    HIV counseling and testing may serve as an entry point for non-communicable disease screening. To determine the yield of newly-diagnosed HIV, tuberculosis (TB) symptoms, diabetes and hypertension, and to assess CD4 count testing, linkage to care as well as correlates of linkage and barriers to care from a mobile testing unit. A mobile unit provided screening for HIV, TB symptoms, diabetes and hypertension in Cape Town, South Africa between March 2010 and September 2011. The yield of newly-diagnosed cases of these conditions was measured and clients were followed-up between January and November 2011 to assess linkage. Linkage to care was defined as accessing care within one, three or six months post-HIV diagnosis (dependent on CD4 count) and one month post-diagnosis for other conditions. Clinical and socio-demographic correlates of linkage to care were evaluated using Poisson regression and barriers to care were determined. Of 9,806 clients screened, the yield of new diagnoses was: HIV (5.5%), TB suspects (10.1%), diabetes (0.8%) and hypertension (58.1%). Linkage to care for HIV-infected clients, TB suspects, diabetics and hypertensives was: 51.3%, 56.7%, 74.1% and 50.0%. Only disclosure of HIV-positive status to family members or partners (RR=2.6, 95% CI: 1.04-6.3, p=0.04) was independently associated with linkage to HIV care. The main barrier to care reported by all groups was lack of time to access a clinic. Screening for HIV, TB symptoms and hypertension at mobile units in South Africa has a high yield but inadequate linkage. After-hours and weekend clinics may overcome a major barrier to accessing care.

  12. HIV viraemia and mother-to-child transmission risk after antiretroviral therapy initiation in pregnancy in Cape Town, South Africa.

    PubMed

    Myer, L; Phillips, T K; McIntyre, J A; Hsiao, N-Y; Petro, G; Zerbe, A; Ramjith, J; Bekker, L-G; Abrams, E J

    2017-02-01

    Maternal HIV viral load (VL) drives mother-to-child HIV transmission (MTCT) risk but there are few data from sub-Saharan Africa, where most MTCT occurs. We investigated VL changes during pregnancy and MTCT following antiretroviral therapy (ART) initiation in Cape Town, South Africa. We conducted a prospective study of HIV-infected women initiating ART within routine antenatal services in a primary care setting. VL measurements were taken before ART initiation and up to three more times within 7 days postpartum. Analyses examined VL changes over time, viral suppression (VS) at delivery, and early MTCT based on polymerase chain reaction (PCR) testing up to 8 weeks of age. A total of 620 ART-eligible HIV-infected pregnant women initiated ART, with 2425 VL measurements by delivery (median gestation at initiation, 20 weeks; median pre-ART VL, 4.0 log10 HIV-1 RNA copies/mL; median time on ART before delivery, 118 days). At delivery, 91% and 73% of women had VL ≤ 1000 and ≤ 50 copies/mL, respectively. VS was strongly predicted by time on therapy and pre-ART VL. The risk of early MTCT was strongly associated with delivery VL, with risks of 0.25, 2.0 and 8.5% among women with VL < 50, 50-1000 and > 1000 copies/mL at delivery, respectively (P < 0.001). High rates of VS at delivery and low rates of MTCT can be achieved in a routine care setting in sub-Saharan Africa, indicating the effectiveness of currently recommended ART regimens. Women initiating ART late in pregnancy and with high VL appear substantially less likely to achieve VS and require targeted research and programmatic attention. © 2016 British HIV Association.

  13. The dimensionality of disclosure of HIV status amongst post-partum women in Cape Town, South Africa.

    PubMed

    Hunter-Adams, Jo; Zerbe, Allison; Philips, Tamsin; Rini, Zanele; Myer, Landon; Petro, Greg; Abrams, Elaine

    2017-07-01

    Disclosure of HIV status to sexual partners and others has been presented as positive health behaviour and is widely encouraged by antiretroviral treatment (ART) programmes, providers and policies. However, disclosure is also highly contextual and its positive effects are not universal. We explore the dimensions of disclosure amongst post-partum women who initiated ART during pregnancy in Cape Town, South Africa. Forty-seven semi-structured interviews with post-partum women were conducted as part of the Maternal Child Health-Antiretroviral Therapy (MCH-ART) study. Primary elements of disclosure were coded and interpreted according to dominant themes and subthemes. Disclosure was commonplace in the sample, ranging from widely disclosing status (rare); to disclosing to some family, friends and partners; to tacit disclosure, where participants took medication in front of others without explicitly discussing their status. Women described reasons for non-disclosure in terms of not being ready, fear of negative reactions (including violence and loss of financial support), and fear of their status being widely known. Self-reported adherence was uniformly high throughout the range of disclosure. Even those who made special efforts to avoid disclosure, such as attending clinics distant from their homes, reported good adherence. Those who disclosed experienced a range of responses to their disclosure, from support to shunning. Despite access to ART, stigma remained a persistent feature in descriptions of disclosure, particularly in relation to partner disclosure. Our findings suggest that disclosure is not always positive and adherence can be maintained within a wide range of disclosure behaviours. It is important that clinic settings allow women to retain control over their disclosure process.

  14. Caregivers’ Experiences of Pathways to Care for Seriously Ill Children in Cape Town, South Africa: A Qualitative Investigation

    PubMed Central

    Jones, Caroline H. D.; Ward, Alison; Hodkinson, Peter W.; Reid, Stephen J.; Wallis, Lee A.; Harrison, Sian; Argent, Andrew C.

    2016-01-01

    Purpose Understanding caregivers’ experiences of care can identify barriers to timely and good quality care, and support the improvement of services. We aimed to explore caregivers’ experiences and perceptions of pathways to care, from first access through various levels of health service, for seriously ill and injured children in Cape Town, South Africa, in order to identify areas for improvement. Methods Semi-structured, qualitative interviews were conducted with primary caregivers of children who were admitted to paediatric intensive care or died in the health system prior to intensive care admission. Interviews explored caregivers’ experiences from when their child first became ill, through each level of health care to paediatric intensive care or death. A maximum variation sample of transcripts was purposively sampled from a larger cohort study based on demographic characteristics, child diagnosis, and outcome at 30 days; and analysed using the method of constant comparison. Results Of the 282 caregivers who were interviewed in the larger cohort study, 45 interviews were included in this qualitative analysis. Some caregivers employed ‘tactics’ to gain quicker access to care, including bypassing lower levels of care, and negotiating or demanding to see a healthcare professional ahead of other patients. It was sometimes unclear how to access emergency care within facilities; and non-medical personnel informally judged illness severity and helped or hindered quicker access. Caregivers commonly misconceived ambulances to be slow to arrive, and were concerned when ambulance transfers were seemingly not prioritised by illness severity. Communication was often good, but some caregivers experienced language difficulties and/or criticism. Conclusions Interventions to improve child health care could be based on: reorganising the reception of seriously ill children and making the emergency route within healthcare facilities clear; promoting caregivers’ use of

  15. Linkage to HIV, TB and Non-Communicable Disease Care from a Mobile Testing Unit in Cape Town, South Africa

    PubMed Central

    Govindasamy, Darshini; Kranzer, Katharina; van Schaik, Nienke; Noubary, Farzad; Wood, Robin; Walensky, Rochelle P.; Freedberg, Kenneth A.; Bassett, Ingrid V.; Bekker, Linda-Gail

    2013-01-01

    Background HIV counseling and testing may serve as an entry point for non-communicable disease screening. Objectives To determine the yield of newly-diagnosed HIV, tuberculosis (TB) symptoms, diabetes and hypertension, and to assess CD4 count testing, linkage to care as well as correlates of linkage and barriers to care from a mobile testing unit. Methods A mobile unit provided screening for HIV, TB symptoms, diabetes and hypertension in Cape Town, South Africa between March 2010 and September 2011. The yield of newly-diagnosed cases of these conditions was measured and clients were followed-up between January and November 2011 to assess linkage. Linkage to care was defined as accessing care within one, three or six months post-HIV diagnosis (dependent on CD4 count) and one month post-diagnosis for other conditions. Clinical and socio-demographic correlates of linkage to care were evaluated using Poisson regression and barriers to care were determined. Results Of 9,806 clients screened, the yield of new diagnoses was: HIV (5.5%), TB suspects (10.1%), diabetes (0.8%) and hypertension (58.1%). Linkage to care for HIV-infected clients, TB suspects, diabetics and hypertensives was: 51.3%, 56.7%, 74.1% and 50.0%. Only disclosure of HIV-positive status to family members or partners (RR=2.6, 95% CI: 1.04-6.3, p=0.04) was independently associated with linkage to HIV care. The main barrier to care reported by all groups was lack of time to access a clinic. Conclusion Screening for HIV, TB symptoms and hypertension at mobile units in South Africa has a high yield but inadequate linkage. After-hours and weekend clinics may overcome a major barrier to accessing care. PMID:24236170

  16. Predictors of poor adherence among people on antiretroviral treatment in Cape Town, South Africa: A case-control study

    PubMed Central

    Dewing, Sarah F; Mathews, Cathy; Lurie, Mark; Kagee, Ashraf; Padayachee, Trishanta; Lombard, Carl J

    2015-01-01

    A case-control study was conducted to describe the frequency with which structural- and individual-level barriers to adherence are experienced by people receiving antiretroviral (ARV) treatment and to determine predictors of nonadherence. Three hundred adherent and 300 non-adherent patients from 6 clinics in Cape Town completed the LifeWindows Information-Motivation-Behavioral Skills ART Adherence Questionnaire, the Substance Abuse and Mental Illness Symptoms Screener and the Structural Barriers to Clinic Attendance (SBCA) and Medication-taking (SBMT) scales. Overall, information-related barriers were reported most frequently followed by motivation and behaviour skill defects. Structural barriers were reported least frequently. Logistic regression analyses revealed that gender, behaviour skill deficit scores, SBCA scores and SBMT scores predicted non-adherence. Despite the experience of structural barriers being reported least frequently, structural barriers to medication-taking had the greatest impact on adherence (OR: 2.32, 95% CI: 1.73 to 3.12), followed by structural barriers to clinic attendance (OR: 2.06, 95% CI: 1.58 to 2.69) and behaviour skill deficits (OR: 1.34, 95% CI: 1.05 to 1.71). Our data indicate the need for policy directed at the creation of a health-enabling environment that would enhance the likelihood of adherence among antiretroviral therapy users. Specifically, patient empowerment strategies aimed at increasing treatment literacy and management skills should be strengthened. Attempts to reduce structural barriers to antiretroviral treatment adherence should be expanded to include increased access to mental health care services and nutrition support. PMID:25559444

  17. Gender-based Violence, Alcohol use, and Sexual Risk Among Female Patrons of Drinking Venues in Cape Town, South Africa

    PubMed Central

    Pitpitan, Eileen V.; Kalichman, Seth C.; Eaton, Lisa A.; Cain, Demetria; Sikkema, Kathleen J.; Skinner, Donald; Watt, Melissa H.; Pieterse, Desiree

    2013-01-01

    Gender-based violence is a well-recognized risk factor for HIV infection among women. Alcohol use is associated with both gender-based violence and sexual risk behavior, but has not been examined as a correlate of both in a context of both high HIV risk and hazardous drinking. The purpose of this paper is to examine the association between recent abuse by a sex partner with alcohol and sexual risk behavior among female patrons of alcohol serving venues in South Africa. Specifically, the aim of this study is to determine whether sexual risk behaviors are associated with gender-based violence after controlling for levels of alcohol use. We surveyed 1,388 women attending informal drinking establishments in Cape Town, South Africa to assess recent history of gender-based violence, drinking, and sexual risk behaviors. Gender-based violence was associated with both drinking and sexual risk behaviors after controlling for demographics among the women. A hierarchical logistic regression analysis showed that after controlling for alcohol use sexual risk behavior remained significantly associated with gender-based violence, particularly with meeting a new sex partner at the bar, recent STI diagnosis, and engaging in transactional sex, but not protected intercourse or number of partners. In South Africa where heavy drinking is prevalent women may be at particular risk of physical abuse from intimate partners as well as higher sexual risk. Interventions that aim to reduce gender-based violence and sexual risk behaviors must directly work to reduce drinking behavior. PMID:22526526

  18. Human papillomavirus genotypes and clinical management of genital warts in women attending a colposcopy clinic in Cape Town, South Africa.

    PubMed

    Tayib, Shahila; Allan, Bruce; Williamson, Anna-Lise; Denny, Lynette

    2015-09-21

    Genital human papillomavirus (HPV) infection is the most common sexually transmitted viral disease in the world. HPV infection of the genital epithelium is associated with genital warts and malignancies of the lower genital tract. To describe the distribution, phenotypic appearance and HPV type associated with genital warts in women. This was a prospective observational study of all women with genital warts who attended the Colposcopy Clinic, Groote Schuur Hospital, Cape Town, South Africa, during 2010 and fulfilled the inclusion and exclusion criteria. One hundred and thirteen women were tested for HPV using the Roche Linear Array HPV genotyping kit to determine the HPV genotypes causing genital warts. The median age of the women was 27 years (range 15 - 53); 90 (79.6%) were HIV-positive, and two-thirds were on antiretroviral treatment. Treatment involved ablation with topical agents, cauterisation or carbon dioxide laser. At 3 months' follow-up after treatment, 56.6% of the women, the majority of whom were HIV-positive, had recurrent/persistent disease. In both HIV-positive and HIV-negative women, HPV was detected in over 90% of cases. However, over half the HIV-positive women as opposed to 2/18 of the HIV-negative women were infected with multiple HPV genotypes. The commonest HPV genotypes in HIV-positive and HIV-negative women were types 11, 6, 89, 61, 55 and 62 and types 11 and 6, respectively. The majority of the patients were HIV-positive and had multiple HPV infections. While this did not alter the phenotypic appearance of the warts, recurrence/persistence after treatment was more common.

  19. Building freeways: piloting communication skills in additional languages to health service personnel in Cape Town, South Africa.

    PubMed

    Claassen, Joel; Jama, Zukile; Manga, Nayna; Lewis, Minnie; Hellenberg, Derek

    2017-06-07

    This study reflects on the development and teaching of communication skills courses in additional national languages to health care staff within two primary health care facilities in Cape Town, South Africa. These courses were aimed at addressing the language disparities that recent research has identified globally between patients and health care staff. Communication skills courses were offered to staff at two Metropolitan District Health Services clinics to strengthen patient access to health care services. This study reflects on the communicative proficiency in the additional languages that were offered to health care staff. A mixed-method approach was utilised during this case study with quantitative data-gathering through surveys and qualitative analysis of assessment results. The language profiles of the respective communities were assessed through data obtained from the South African National census, while staff language profiles were obtained at the health care centres. Quantitative measuring, by means of a patient survey at the centres, occurred on a randomly chosen day to ascertain the language profile of the patient population. Participating staff performed assessments at different phases of the training courses to determine their skill levels by the end of the course. The performances of the participating staff during the Xhosa and Afrikaans language courses were assessed, and the development of the staff communicative competencies was measured. Health care staff learning the additional languages could develop Basic or Intermediate Xhosa and Afrikaans that enables communication with patients. In multilingual countries such as South Africa, language has been recognised as a health care barrier preventing patients from receiving quality care. Equipping health care staff with communication skills in the additional languages, represents an attempt to bridge a vital barrier in the South African health care system. The study proves that offering communication

  20. Costs of measures to control tuberculosis/HIV in public primary care facilities in Cape Town, South Africa.

    PubMed Central

    Hausler, Harry Peter; Sinanovic, Edina; Kumaranayake, Lilani; Naidoo, Pren; Schoeman, Hennie; Karpakis, Barbara; Godfrey-Faussett, Peter

    2006-01-01

    OBJECTIVE: To measure the costs and estimate the cost-effectiveness of the ProTEST package of tuberculosis/human immunodeficiency virus (TB/HIV) interventions in primary health care facilities in Cape Town, South Africa. METHODS: We collected annual cost data retrospectively using ingredients-based costing in three primary care facilities and estimated the cost per HIV infection averted and the cost per TB case prevented. FINDINGS: The range of costs per person for the ProTEST interventions in the three facilities were: US$ 7-11 for voluntary counselling and testing (VCT), US$ 81-166 for detecting a TB case, US$ 92-183 for completing isoniazid preventive therapy (IPT) and US$ 20-44 for completing six months of cotrimoxazole preventive therapy. The estimated cost per HIV infection averted by VCT was US$ 67-112. The cost per TB case prevented by VCT (through preventing HIV) was US$ 129-215, by intensified case finding was US$ 323-664 and by IPT was US$ 486-962. Sensitivity analysis showed that the use of chest X-rays for IPT screening decreases the cost-effectiveness of IPT in preventing TB cases by 36%. IPT screening with or without tuberculin purified protein derivative screening was almost equally cost-effective. CONCLUSION: We conclude that the ProTEST package is cost saving. Despite moderate adherence, linking prevention and care interventions for TB and HIV resulted in the estimated costs of preventing TB being less than previous estimates of costs of treating it. VCT was less expensive than previously reported in Africa. PMID:16878226

  1. Opportunities for technology-based HIV prevention programming among high school students in Cape Town, South Africa.

    PubMed

    Ybarra, Michele L; Mwaba, Kelvin; Prescott, Tonya L; Roman, Nicolette V; Rooi, Bronwyn; Bull, Sheana

    2014-01-01

    One in three new cases of HIV in South Africa is among adolescents. Given that adolescents are particularly affected, scalable, and cost-effective prevention programs are urgently needed. This study aims to identify opportunities to integrate technology into youth HIV prevention efforts. In 2012, 1107 8th-11th graders completed a paper-and-pencil survey. Respondents were enrolled in one of three public high schools in Langa, a lower income community in Cape Town, South Africa. Eighty-nine percent of respondents have used text messaging (SMS) and 86% have gone online. If an HIV prevention program was offered online, 66% of youth would be somewhat or extremely likely to access it; slightly fewer (55%) felt the same about SMS-based programming. In comparison, 85% said they would be somewhat or extremely likely to access a school-based HIV prevention program. Interest in Internet- (60%) and SMS-based (54%) HIV prevention programming was similar for youth who had a self-appraised risk of HIV compared to youth who appraised their risk to be lower, as it was for youth who were tired of hearing messages about HIV prevention. Technology use is common - even among high school students who live in lower income communities. At the same time, these data reveal that it is not uncommon for youth to be tired of hearing messages about HIV prevention, and many of the typical topics key to HIV prevention have low interest levels among youth. HIV prevention researchers need to be mindful of the extent of existing programming that youth are exposed to. Technology-based programming may be especially amenable to meeting these requirements because of its novelty especially in developing countries, and because interactive functionality can be easily integrated into the program design. Given the preference for school- and Internet-based programming, it seems that a hybrid approach is likely feasible and acceptable.

  2. Risk factors for teenage pregnancy among sexually active black adolescents in Cape Town. A case control study.

    PubMed

    Vundule, C; Maforah, F; Jewkes, R; Jordaan, E

    2001-01-01

    Teenage pregnancy is an important health and social problem in South Africa. So far research on adolescent sexual activity has been almost exclusively descriptive; as a result there is considerable knowledge about practices of adolescents in general and outcomes of their pregnancies, but very limited understanding of factors that place particular adolescents at increased risk of teenage pregnancy. Without this understanding, our ability to intervene effectively to reduce teenage pregnancy rates is limited. To undertake an exploratory study to investigate risk factors for teenage pregnancy among sexually active adolescents in an urban and peri-urban context. The study used a matched case-control design, with 191 cases and 353 age-matched controls from the same school or neighbourhood. Subjects were under 19 years of age and were recruited from township areas of Cape Town. A structured questionnaire was used to obtain information on socio-economic factors, contraceptive knowledge and use, and sexual behaviour. Conditional logistical regression was used to analyse the relationship between teenage pregnancy and the factors investigated. Teenage pregnancy was found to be most strongly associated with having frequent sex (risk ratio (RR) 30.81) without reliable contraceptive protection (RR 24.35), forced sexual initiation (RR 14.42), not owning a television set (RR 10.33), larger household size (RR 2.44), not living in a brick house (RR 5.09), not living with the biological father (RR 3.26), talking openly about sex with a boyfriend (RR 4.72), and perceiving most friends to be pregnant (RR 4.38). The findings suggest associations between the promotion of sexual health among adolescents and broader social development and promotion of gender equality. Although further research is needed, it is likely that important foci for short-term strategies should include developing assertiveness, enhancing decision-making competence, and promoting contraception and condoms as part of

  3. “Nothing is free”: A qualitative study of sex trading among methamphetamine users in Cape Town, South Africa

    PubMed Central

    Watt, Melissa H.; Kimani, Stephen M.; Skinner, Donald; Meade, Christina S.

    2015-01-01

    South Africa is facing an established epidemic of methamphetamine, known locally as “tik”. Globally, methamphetamine has been linked to high rates of sexual risk behaviors, including sex trading. The goal of this study was to qualitatively examine the experiences of sex trading among methamphetamine users in Cape Town, South Africa. Individual in-depth interviews were conducted with 30 active methamphetamine users (17 men and 13 women) recruited from the community. Interviews were conducted in local languages using a semi-structured guide that included questions on sex trading experiences and perceptions of sex trading among methamphetamine users. Interviews were audio-recorded, transcribed, and analyzed using analytic memos and coding with constant comparison techniques. The data revealed that in a setting of high levels of addiction and poverty, sex was an important commodity for acquiring methamphetamine. Women were more likely to use sex to acquire methamphetamine, but men reported opportunistic cases of trading sex for methamphetamine. Four models of sex trading emerged: negotiated exchange, implicit exchange, relationships based on resources, and facilitating sex exchange for others. The expectation of sex trading created a context in which sexual violence against female methamphetamine users was common. Multiple sexual partners and inconsistent condom use in acts of sex trading put methamphetamine users at high risk of HIV. Interventions in this setting should address addiction, which is the primary driver of sex trading among methamphetamine users. Harm reduction interventions may include education about HIV and other sexually transmitted infections, availability of condoms and HIV testing, and sexual violence prevention. PMID:25567071

  4. Demographic and circumstantial accounts of burn mortality in Cape Town, South Africa, 2001-2004: An observational register based study

    PubMed Central

    Van Niekerk, A; Laubscher, R; Laflamme, L

    2009-01-01

    Background Burns are a persisting public health problem in low- and middle-income countries; however, epidemiologic data for these settings is scarce. South Africa is no exception although there is an emerging knowledge base, especially for paediatric burns. The current study describes the epidemiology of burn mortality across the lifespan in Cape Town (2.9 million inhabitants in 2001), one of the six South African metropolitan centres. Methods The distribution of burn mortality across socio-demographic groups and also their circumstances of occurrence were investigated using four year (2001 to 2004) surveillance data from the National Injury Mortality Surveillance System (n = 1024 cases). Results Burn mortality occurred at a rate of 7.9 per 100 000 person-years (95% CI: 7.3-8.3). Males sustained fatal rates 2.2 times more than that for females (p < 0.001), with rates significantly higher in the 25 to 38 and 39 to 50 age groups than at other ages (p < 0.001). The greatest difference between male and female deaths was observed in the 25 to 38 year age group, when almost three male deaths occurred for every female one. The vast majority of fatal burns were registered as accidental and occurred in the home, either over the cold and wet months or during recreational periods over weekends and across the year. Alcohol intoxication was reported for the majority of those adults whose alcohol blood levels were tested (i.e. 52.6% of cases aged 16+ years). Conclusion Besides paediatric burns, the high prevalence and circumstances of occurrence of burns among middle age men are a source of concern. There are reasons to believe that this over-representation is a reflection of detrimental living conditions, life-style and poor socio-economic status. It is recommended that there be greater prioritisation of prevention activities that involve the control or management of kerosene heat sources, the provision of alternatives to flammable housing materials, and the implementation of

  5. Lupus nephritis is associated with poor pregnancy outcomes in pregnant SLE patients in Cape Town: a retrospective analysis

    PubMed Central

    Mbuli, Lindisa; Mapiye, Darlington; Okpechi, Ikechi

    2015-01-01

    Introduction Systemic lupus erythematosus (SLE) is a multi-system auto-immune disease common in females of child-bearing age. The effect of pregnancy on SLE and vice versa have not been well characterised in Africans. The aim of this study is to describe the pregnancy outcomes of patients with SLE presenting to the maternity department of Groote Schuur Hospital, Cape Town. Methods This study was designed as a retrospective review of records of pregnant women known with SLE and followed-up at the maternity section of Groote Schuur Hospital. The duration of survey was from the 1st January 2003 to 31st December 2013. Results There were 61 pregnancies reviewed in 49 patients; 80.3% of the pregnancies were in patients of mixed ancestry and the rest (19.7%) in black African patients. The mean age at presentation of the current pregnancy was 27.2±5.0 years. Mean gestational age at presentation and delivery was 13.0 ± 6.0 weeks and 28.9 ± 9.8 weeks respectively and 47.5% of the pregnancies were in patients with lupus nephritis (LN). Thirty nine (63.9%) pregnancies reached the third trimester and 11.5% of all pregnancies ended in the first trimester. There was a lower number of live births to mothers of African ancestry than to those of mixed ancestry (p=0.001). In 55.7% of the pregnancies, no flare was reported while a renal flare was reported in 23%. Pregnancies in patients with LN had higher frequencies of flares (58.6% vs 31.3%; p=0.032), pre-eclampsia (34.5% vs 12.5%; p=0.041), longer stay in hospital (12.0 ± 9.1 days vs 6.1 ± 5.1 days; p=0.004) and low birth weight babies (1.94 ± 1.02 kg vs 2.55±0.95 kg; p=0.046) than in patients without LN. Only 36 (59%) of the neonates were discharged home alive and of these 2 (5.6%) were to mothers of black African ancestry (p=0.001). Conclusion Increased lupus activity in pregnant SLE patients may account for the increased deaths of neonates born to SLE mothers. Patients of black African descent and those with LN tend to

  6. Illegal yet developmentally normative: a descriptive analysis of young, urban adolescents’ dating and sexual behaviour in Cape Town, South Africa

    PubMed Central

    2013-01-01

    Background In South Africa, it is illegal for adolescents under age 16 years to engage in any sexual behaviour whether kissing, petting, or penetrative sex, regardless of consent. This cross-sectional study investigated the extent to which young adolescents engage in various sexual behaviours and the associations between dating status and sexual behaviours. Method Grade 8 adolescents (N = 474, ages 12–15 years, mean = 14.14 years) recruited from Cape Town schools completed surveys providing information about their sociodemographic backgrounds, dating experience, sexual behaviour, and substance use. Results Lower hierarchy sexual behaviours, such as kissing (71.4% of girls; 88.4% of boys), were more common than oral (3.9% of girls; 13.8% of boys), vaginal (9.3% of girls; 30.0% of boys), or anal (1.4% of girls; 10.5% of boys) sex. Currently dating girls and boys were more likely to engage in sexual behaviours including several risk behaviours in comparison to their currently non-dating counterparts. These risk behaviours included penetrative sex (21.1% of dating vs. 4.5% of non-dating girls; 49.4% of dating vs. 20.2% of non-dating boys), sex with co-occurring substance use (22.2% of dating vs. 0 non-dating girls; 32.1% of dating vs. 40% of non-dating boys), and no contraceptive use (26.1% of sexually experienced girls; 44.4% of sexually experienced boys). Among girls, there were significant associations between ever having penetrative sex and SES (OR = 2.592, p = 0.017) and never dating (OR = 0.330, p = 0.016). Among boys, there were significant associations between ever having penetrative sex and never dating (OR = 0.162, p = 0.008). Although the currently dating group of young adolescents appear to be a precocious group in terms of risk behaviour relative to the currently non-dating group, teenagers in both groups had experience in the full range of sexual behaviours. Conclusions Many young adolescents are engaging in a variety

  7. Differing Patterns of Overweight and Obesity among Black Men and Women in Cape Town: The CRIBSA Study

    PubMed Central

    Peer, Nasheeta; Lombard, Carl; Steyn, Krisela; Gwebushe, Nomonde; Levitt, Naomi

    2014-01-01

    Objectives To ascertain the prevalence and determinants of overweight/obesity in the 25–74-year-old urban black population of Cape Town and examine the changes between 1990 and 2008/09. Methods In 2008/09, a representative cross-sectional sample, stratified for age and sex, was randomly selected from the same townships sampled in 1990. Data were collected by questionnaires, clinical measurements and biochemical analyses. Gender-specific linear regression models evaluated the associations with overweight/obesity. Results There were 1099 participants, 392 men and 707 women (response rate 86%) in 2008/09. Mean body mass index (BMI) and waist circumference (WC) were 23.7 kg/m2 (95% confidence interval (CI): 23.1–24.2) and 84.2 cm (95% CI: 82.8–85.6) in men, and 33.0 kg/m2 (95% CI: 32.3–33.7) and 96.8 cm (95% CI: 95.5–98.1) in women. Prevalence of BMI ≥25 kg/m2 and raised WC were 28.9% (95% CI: 24.1–34.3) and 20.1% (95% CI: 15.9–24.9) in men, and 82.8% (95% CI: 79.3–85.9) and 86.0% (95% CI: 82.9–88.6) in women. Among 25–64-year-olds, BMI ≥25 kg/m2 decreased between 1990 (37.3%, 95% CI: 31.7–43.1) and 2008/09 (27.7%, 95% CI: 22.7–33.4) in men but increased from 72.7% (95% CI: 67.6–77.2) to 82.6% (95% CI: 78.8–85.8) in women. In the regression models for men and women, higher BMI was directly associated with increasing age, wealth, hypertension and diabetes but inversely related to daily smoking. Also significantly associated with rising BMI were raised low-density lipoprotein cholesterol and being employed compared to unemployed in men, and having >7 years of education in women. Conclusions Overweight/obesity, particularly in urban black women, requires urgent action because of the associations with cardiovascular disease risk factors and their serious consequences. PMID:25221948

  8. Differential obesity indices identify the metabolic syndrome in Black men and women in Cape Town: the CRIBSA study.

    PubMed

    Peer, N; Steyn, K; Levitt, N

    2016-03-01

    To determine the obesity indices, specifically waist circumference (WC), that identified ≥2 other metabolic syndrome (MS) components (2009 criteria) in 25- to 74-year-old Africans in Cape Town. Data were collected from a cross-sectional sample by administered questionnaires, clinical measurements and biochemical analyses. The obesity cut points were estimated by the Youden Index. Logistic regression analyses determined whether obesity cut points identifying ≥2 MS components occurred at true inflection points. Among the 1099 participants, the calculated cut points and 95% confidence intervals (CI) were: men, WC 83.9 cm (81.6-86.2), waist-to-hip ratio (WHR) 0.89 (0.87-0.90), waist-to-height ratio (WHtR) 0.50 (0.48-0.52) and body mass index (BMI) 24.1 kg/m(2) (22.0-26.1); women, WC 94.0 cm (92.6-95.3), WHR 0.85 (0.83-0.87), WHtR 0.59 (0.57-0.60) and BMI 32.1 kg/m(2) (29.7-34.6). Raised WC was significantly associated with ≥2 MS components in men: WC 84.0-93.9 cm (odds ratio (OR): 3.19, 95% confidence interval (CI): 1.73-5.85) and WC ≥94.0 cm (OR: 8.50, 95% CI: 4.44-16.25) compared with WC <84.0 cm, and in women: WC 80.0-93.9 cm (OR: 2.93, 95% CI: 1.32-6.54) and WC ≥94.0 cm (OR: 5.33, 95% CI: 2.40-11.85) compared with WC <80.0 cm. In the logistic model with BMI for women, obesity (OR: 3.60, 95% CI: 1.82-7.10) but not overweight (P = 0.063) was significantly associated with ≥2 MS components. Obesity cut points for Africans should be re-evaluated and adjusted accordingly. © The Author 2015. Published by Oxford University Press on behalf of Faculty of Public Health. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  9. Opportunities for technology-based HIV prevention programming among high school students in Cape Town, South Africa

    PubMed Central

    Mwaba, Kelvin; Prescott, Tonya L.; Roman, Nicolette V.; Rooi, Bronwyn; Bull, Sheana

    2014-01-01

    One in three new cases of HIV in South Africa is among adolescents. Given that adolescents are particularly affected, scalable and cost-effective prevention programs are urgently needed. This study aims to identify opportunities to integrate technology into youth HIV prevention efforts. In 2012, 1,107 8th – 11th graders completed a paper-and-pencil survey. Respondents were enrolled in one of three public high schools in Langa. Because it is the closest black township to Cape Town, Langa has the highest density of people in the region. Eighty-nine percent of respondents have used text messaging (SMS) and 86% have gone online. If an HIV prevention program was offered online, 66% of youth would be somewhat or extremely likely to access it; slightly fewer (55%) felt the same about SMS-based programming. In comparison, 85% said they would be somewhat or extremely likely to access a school-based HIV prevention program. Interest in Internet-(60%) and SMS-based (54%) HIV prevention programming was similar for youth who had a self-appraised risk for HIV compared to youth who appraised their risk to be lower, as it was for youth who were tired of hearing messages about HIV prevention. Technology use is common – even among high school students who live in lower income communities. At the same time, these data reveal that it is not uncommon for youth to be tired of hearing messages about HIV prevention, and many of the typical topics key to HIV prevention have low interest levels among youth. HIV prevention researchers need to be mindful of the extent of existing programming that youth are exposed to. Technology-based programming may be especially amenable to meeting these requirements because of its novelty especially in developing countries, and because interactive functionality can be easily integrated into the program design. Given the preference for school- and Internet-based programming, it seems that a hybrid approach is likely feasible and acceptable. PMID:25022287

  10. Perceived need for substance use treatment among young women from disadvantaged communities in Cape Town, South Africa

    PubMed Central

    2014-01-01

    Background Initiation of treatment for substance use disorders is low among young women from disadvantaged communities in Cape Town, South Africa. Yet little is known about the factors that influence perceived need for treatment (a determinant of treatment entry) within this population. Methods Baseline data on 720 young, drug-using women, collected as part of a randomized field experiment were analyzed to identify predisposing, enabling and health need factors associated with perceived need for treatment. Results Overall, 46.0% of our sample perceived a need for treatment. Of these participants, 92.4% wanted treatment for their substance use problems but only 50.1% knew where to access services. In multivariable logistic regression analyses, we found significant main effects for ethnicity (AOR = 1.54, 95% CI = 1.05-1.65), income (AOR = 0.96, 95% CI = 0.93-0.99), anxiety (AOR = 1.22, 95% CI = 1.05-1.45), and not having family members with drug problems (AOR = 1.45, 95% CI = 1.05-2.04) on perceived need for treatment. When the sample was stratified by methamphetamine use, income (AOR = 0.87, 95% CI = 0.79-0.96), awareness of treatment services (AOR =1.84, 95% CI = 1.03-3.27), anxiety (AOR =1.41, 95% CI = 1.06-1.87) and physical health status (AOR = 6.29, 95% CI = 1.56-25.64) were significantly associated with perceived need for treatment among those who were methamphetamine-negative. No variables were significantly associated with perceived need for treatment among participants who were methamphetamine-positive. Conclusions A sizeable proportion of young women who could benefit from substance use treatment do not believe they need treatment, highlighting the need for interventions that enhance perceived need for treatment in this population. Findings also show that interventions that link women who perceive a need for treatment to service providers are needed. Such interventions should address barriers that

  11. Perceived need for substance use treatment among young women from disadvantaged communities in Cape Town, South Africa.

    PubMed

    Myers, Bronwyn; Kline, Tracy L; Doherty, Irene A; Carney, Tara; Wechsberg, Wendee M

    2014-04-04

    Initiation of treatment for substance use disorders is low among young women from disadvantaged communities in Cape Town, South Africa. Yet little is known about the factors that influence perceived need for treatment (a determinant of treatment entry) within this population. Baseline data on 720 young, drug-using women, collected as part of a randomized field experiment were analyzed to identify predisposing, enabling and health need factors associated with perceived need for treatment. Overall, 46.0% of our sample perceived a need for treatment. Of these participants, 92.4% wanted treatment for their substance use problems but only 50.1% knew where to access services. In multivariable logistic regression analyses, we found significant main effects for ethnicity (AOR = 1.54, 95% CI = 1.05-1.65), income (AOR = 0.96, 95% CI = 0.93-0.99), anxiety (AOR = 1.22, 95% CI = 1.05-1.45), and not having family members with drug problems (AOR = 1.45, 95% CI = 1.05-2.04) on perceived need for treatment. When the sample was stratified by methamphetamine use, income (AOR = 0.87, 95% CI = 0.79-0.96), awareness of treatment services (AOR =1.84, 95% CI = 1.03-3.27), anxiety (AOR =1.41, 95% CI = 1.06-1.87) and physical health status (AOR = 6.29, 95% CI = 1.56-25.64) were significantly associated with perceived need for treatment among those who were methamphetamine-negative. No variables were significantly associated with perceived need for treatment among participants who were methamphetamine-positive. A sizeable proportion of young women who could benefit from substance use treatment do not believe they need treatment, highlighting the need for interventions that enhance perceived need for treatment in this population. Findings also show that interventions that link women who perceive a need for treatment to service providers are needed. Such interventions should address barriers that limit young women's use of services for substance use disorders.

  12. The role of urban food policy in preventing diet-related non-communicable diseases in Cape Town and New York.

    PubMed

    Libman, K; Freudenberg, N; Sanders, D; Puoane, T; Tsolekile, L

    2015-04-01

    Cities are important settings for production and prevention of non-communicable diseases. This article proposes a conceptual framework for identification of opportunities to prevent diet-related non-communicable diseases in cities. It compares two cities, Cape Town in South Africa and New York City in the United States, to illustrate municipal, regional, national and global influences in three policy domains that influence NCDs: product formulation, shaping retail environments and institutional food practices, domains in which each city has taken action. Comparative case study. Critical analysis of selected published studies and government and non-governmental reports on food policies and systems in Cape Town and New York City. While Cape Town and New York City differ in governance, history and culture, both have food systems that make unhealthy food more available in low-income than higher income neighborhoods; cope with food environments in which unhealthy food is increasingly ubiquitous; and have political economies dominated by business and financial sectors. New York City has more authority and resources to take on local influences on food environments but neither city has made progress in addressing deeper social determinants of diet-related NCDs including income inequality, child poverty and the disproportionate political influence of wealthy elites. Through their intimate connections with the daily lives of their residents, municipal governments have the potential to shape environments that promote health. Identifying the specific opportunities to prevent diet-related NCDs in a particular city requires intersectoral and multilevel analyses of the full range of influences on food environments. Copyright © 2014 The Royal Society for Public Health. Published by Elsevier Ltd. All rights reserved.

  13. Impact of the 2010 FIFA (Federation Internationale de Football Association) World Cup on Pediatric Injury and Mortality in Cape Town, South Africa.

    PubMed

    Zroback, Chris; Levin, David; Manlhiot, Cedric; Alexander, Angus; van As, Ab Sebastian; Azzie, Georges

    2014-02-01

    To examine how a mass-gathering event (the Federation Internationale de Football Association World Cup, 2010, South Africa) impacts trauma and mortality in the pediatric (≤ 18 years) population. We investigated pediatric emergency visits at Cape Town's 3 largest public trauma centers and 3 private hospital groups, as well as deaths investigated by the 3 city mortuaries. We compared the 31 days of World Cup with equivalent periods from 2007-2009, and with the 2 weeks before and after the event. We also looked at the World Cup period in isolation and compared days with and without games in Cape Town. There was significantly decreased pediatric trauma volume during the World Cup, approximately 2/100,000 (37%) fewer injuries per day, compared with 2009 and to both pre- and post-World Cup control periods (P < .001). This decrease occurred within a majority of injury subtypes, but did not change mortality. There were temporal fluctuations in emergency visits corresponding with local match start time, with fewer all-cause emergency visits during the 5 hours surrounding this time (-16.4%, P = .01), followed by a subsequent spike (+26.2%, P = .02). There was an increase in trauma 12 hours following matches (+15.6%, P = .06). In Cape Town, during the 2010 Federation Internationale de Football Association World Cup, there were fewer emergency department visits for traumatic injury. Furthermore, there were fewer all-cause pediatric emergency department visits during hometown matches. These results will assist in planning for future mass-gathering events. Copyright © 2014 Mosby, Inc. All rights reserved.

  14. Genetic basis of rifampicin resistance in methicillin-resistant Staphylococcus aureus suggests clonal expansion in hospitals in Cape Town, South Africa.

    PubMed

    Jansen van Rensburg, Melissa J; Whitelaw, Andrew C; Elisha, Brenda G

    2012-03-26

    Since 2001, several studies have reported high rifampicin resistance rates (45 - 100%) among methicillin-resistant Staphylococcus aureus (MRSA) isolates from South Africa. The authors previously characterised 100 MRSA isolates from hospitals in Cape Town, South Africa; forty-five percent of these isolates were rifampicin-resistant. The majority (44/45) corresponded to ST612-MRSA-IV, which is prevalent in South Africa, but has not been reported frequently elsewhere. The remaining rifampicin-resistant isolate corresponded to ST5-MRSA-I. The aim of this study was to investigate further the prevalence and genetic basis of rifampicin-resistance in MRSA isolates from hospitals in Cape Town. Between July 2007 and June 2011, the prevalence of rifampicin-resistant MRSA in hospitals in Cape Town ranged from 39.7% to 46.4%. Based on the results of the aforementioned study, nine ST612-MRSA-IV isolates, the rifampicin-resistant ST5-MRSA-I isolate, and two rifampicin-susceptible MRSA isolates were investigated. Four previously described ST612-MRSA-IV isolates, including two each from South Africa and Australia, were also included.The ST5-MRSA-I isolate carried a single mutational change, H481Y, commonly associated with high-level rifampicin resistance. All ST612-MRSA-IV isolates carried an uncommon double amino acid substitution in RpoB, H481N, I527M, whilst one of the Australian ST612-MRSA-IV isolates carried an additional mutation within rpoB, representing a novel rpoB genotype: H481N, I527M, K579R. All ST612-MRSA-IV isolates also shared a unique silent single nucleotide polymorphism (SNP) within rpoB. That local ST612-MRSA-IV isolates described here share an uncommon rpoB genotype and a unique silent SNP suggests this clone may have undergone clonal expansion in hospitals in Cape Town. Further, the data suggest that these isolates may be related to rifampicin-resistant ST612-MRSA-IV previously described in South Africa and Australia.

  15. Genetic basis of rifampicin resistance in methicillin-resistant Staphylococcus aureus suggests clonal expansion in hospitals in Cape Town, South Africa

    PubMed Central

    2012-01-01

    Background Since 2001, several studies have reported high rifampicin resistance rates (45 - 100%) among methicillin-resistant Staphylococcus aureus (MRSA) isolates from South Africa. The authors previously characterised 100 MRSA isolates from hospitals in Cape Town, South Africa; forty-five percent of these isolates were rifampicin-resistant. The majority (44/45) corresponded to ST612-MRSA-IV, which is prevalent in South Africa, but has not been reported frequently elsewhere. The remaining rifampicin-resistant isolate corresponded to ST5-MRSA-I. The aim of this study was to investigate further the prevalence and genetic basis of rifampicin-resistance in MRSA isolates from hospitals in Cape Town. Results Between July 2007 and June 2011, the prevalence of rifampicin-resistant MRSA in hospitals in Cape Town ranged from 39.7% to 46.4%. Based on the results of the aforementioned study, nine ST612-MRSA-IV isolates, the rifampicin-resistant ST5-MRSA-I isolate, and two rifampicin-susceptible MRSA isolates were investigated. Four previously described ST612-MRSA-IV isolates, including two each from South Africa and Australia, were also included. The ST5-MRSA-I isolate carried a single mutational change, H481Y, commonly associated with high-level rifampicin resistance. All ST612-MRSA-IV isolates carried an uncommon double amino acid substitution in RpoB, H481N, I527M, whilst one of the Australian ST612-MRSA-IV isolates carried an additional mutation within rpoB, representing a novel rpoB genotype: H481N, I527M, K579R. All ST612-MRSA-IV isolates also shared a unique silent single nucleotide polymorphism (SNP) within rpoB. Conclusions That local ST612-MRSA-IV isolates described here share an uncommon rpoB genotype and a unique silent SNP suggests this clone may have undergone clonal expansion in hospitals in Cape Town. Further, the data suggest that these isolates may be related to rifampicin-resistant ST612-MRSA-IV previously described in South Africa and Australia. PMID

  16. Our surgical heritage: the role of the Department of Paediatric Surgery in the development of paediatric surgery in Cape Town, in Africa, and around the world.

    PubMed

    Rode, Heinz; Millar, Alastair J W

    2012-03-23

    The Department of Paediatric Surgery at the University of Cape Town has made a remarkable contribution to the academic body of knowledge of Paediatric Surgery both in South Africa and around the world. It has played a key role in the development of the specialty in South Africa and through the South African diaspora has trained many paediatric surgeons who have made their mark internationally. More recently it has become a major focus of teaching and training for African paediatric surgeons. This article traces this legacy through its origins in the early 1920s to its current prominent position in the world paediatric surgical community.

  17. Heat effects of ambient apparent temperature on all-cause mortality in Cape Town, Durban and Johannesburg, South Africa: 2006-2010.

    PubMed

    Wichmann, Janine

    2017-06-01

    Due to climate change, an increase of 3-4°C in ambient temperature is projected along the South African coast and 6-7°C inland during the next 80years. The objective of this study was to investigate the association between daily ambient apparent temperature (Tapp) and daily all-cause non-accidental mortality (hereafter mortality) in Cape Town, Durban and Johannesburg during a 5-year study period (2006-2010). Susceptibility by sex and age groups (<15years, 15-64years and ≥65years) was also investigated. The associations were investigated with the time-stratified case-crossover epidemiological design. Models were controlled for PM10, public holidays and influenza epidemics. City-specific Tapp thresholds were determined using quasi-Poisson generalised additive models. The pooled estimates by sex and age groups were determined in meta-analyses. The city-specific Tapp thresholds were 18.6°C, 24.8°C and 18.7°C, respectively for Cape Town, Durban and Johannesburg. A 3.3%, 2.6% and 2.8% increase in mortality per IQR increase in Tapp (lag0-1) was observed in Cape Town, Durban and Johannesburg, respectively above the city-specific thresholds. The elderly were more at risk in Cape Town and Johannesburg. No difference in risk was observed for males and females in the three cities. In the meta-analysis an overall significant increase of 0.9% in mortality per 1°C increase in Tapp (lag0-1) was observed for all age groups combined in the three cities. For the ≥65year group a significant increase of 2.1% in mortality was observed. In conclusion, the risks for all age groups combined and the elderly are similar to those reported in studies from developed and developing countries. The results can be used in present-day early warning systems and in risk assessments to estimate the impact of increased Tapp in the country due to climate change. Future research should investigate the association between Tapp and cause-specific mortality and also morbidity.

  18. The Impact of Densification by Means of Informal Shacks in the Backyards of Low-Cost Houses on the Environment and Service Delivery in Cape Town, South Africa

    PubMed Central

    Govender, Thashlin; Barnes, Jo M.; Pieper, Clarissa H.

    2011-01-01

    This paper investigates the state-sponsored low cost housing provided to previously disadvantaged communities in the City of Cape Town. The strain imposed on municipal services by informal densification of unofficial backyard shacks was found to create unintended public health risks. Four subsidized low-cost housing communities were selected within the City of Cape Town in this cross-sectional survey. Data was obtained from 1080 persons with a response rate of 100%. Illegal electrical connections to backyard shacks that are made of flimsy materials posed increased fire risks. A high proportion of main house owners did not pay for water but sold water to backyard dwellers. The design of state-subsidised houses and the unplanned housing in the backyard added enormous pressure on the existing municipal infrastructure and the environment. Municipal water and sewerage systems and solid waste disposal cannot cope with the increased population density and poor sanitation behaviour of the inhabitants of these settlements. The low-cost housing program in South Africa requires improved management and prudent policies to cope with the densification of state-funded low-cost housing settlements. PMID:21695092

  19. Contribution of Water Pollution From Inadequate Sanitation and Housing Quality to Diarrheal Disease in Low-Cost Housing Settlements of Cape Town, South Africa

    PubMed Central

    Barnes, Jo M.; Pieper, Clarissa H.

    2011-01-01

    Objectives. We investigated the effects of failing sanitation, poor housing conditions, and fecal pollution in runoff water on the health—particularly the incidence of diarrheal disease—of residents of low-cost housing settlements in Cape Town, South Africa. Methods. In November 2009, we conducted a cross-sectional survey with structured interviews in 4 communities (n = 336 dwellings; 1080 persons). We used Colilert defined-substrate technology to determine Escherichia coli levels in runoff water samples taken from the study communities. Results. Almost 15% of households disposed of soiled products in storm water drains and 6% disposed of soiled products in the street. In only 26% of the dwellings were toilets washed daily. Approximately 59% of dwellings lacked a tap near the toilet for hand washing, and 14% of respondents suffered 1 or more attacks of diarrhea in the 2 weeks preceding their interview. E.coli counts of runoff environmental water samples ranged from 750 to 1 580 000 000 per 100 milliliters. Conclusions. A holistic and integrated approach is needed to improve housing quality and sanitation among Cape Town's low-income citizens. PMID:21566018

  20. Gender-based Violence and HIV Sexual Risk Behavior: Alcohol Use and Mental Health Problems as Mediators among Women in Drinking Venues, Cape Town

    PubMed Central

    Pitpitan, Eileen V.; Kalichman, Seth C.; Eaton, Lisa A.; Sikkema, Kathleen J.; Watt, Melissa H.; Skinner, Donald

    2012-01-01

    Gender-based violence is a key determinant of HIV infection among women in South Africa as elsewhere. However, research has not examined potential mediating processes to explain the link between experiencing abuse and engaging in HIV sexual risk behavior. Previous studies suggest that alcohol use and mental health problems may explain how gender-based violence predicts sexual risk. In a prospective study, we examined whether lifetime history of gender-based violence indirectly affects future sexual risk behavior through alcohol use, depression and post-traumatic stress disorder (PTSD) in a high-risk socio-environmental context. We recruited a cohort of 560 women from alcohol drinking venues in a Cape Town, South African township. Participants completed computerized interviews at baseline and 4 months later. We tested prospective mediating associations between gender-based violence, alcohol use, depression, PTSD, and sexual risk behavior. There was a significant indirect effect of gender-based violence on sexual risk behavior through alcohol use, but not mental health problems. Women who were physically and sexually abused drank more, which in turn predicted more unprotected sex. We did not find a mediated relationship between alcohol use and sexual risk behavior through the experience of recent abuse or mental health problems. Alcohol use explains the link between gender-based violence and sexual risk behavior among women attending drinking venues in Cape Town, South Africa. Efforts to reduce HIV risk in South Africa by addressing gender-based violence must also address alcohol use. PMID:22832324

  1. Outcomes of a community-based HIV-prevention pilot programme for township men who have sex with men in Cape Town, South Africa

    PubMed Central

    Batist, Elizabeth; Brown, Benjamin; Scheibe, Andrew; Baral, Stefan D; Bekker, Linda-Gail

    2013-01-01

    Introduction Men who have sex with men (MSM) in Cape Town's townships remain in need of targeted HIV-prevention services. In 2012, a pilot community-based HIV-prevention programme was implemented that aimed to reach MSM in five Cape Town townships, disseminate HIV-prevention information and supplies, and promote the use of condoms and HIV services. Methods Convenience sampling was used to recruit self-identified MSM who were 18 years old or older in five Cape Town townships. The six-month pilot programme trained five community leaders who, along with staff, provided HIV-prevention information and supplies to MSM through small-group meetings, community-based social activities and inter-community events. After the completion of the pilot programme, in-depth interviews and focus group discussions (FGDs) were conducted with a subset of conveniently sampled participants and with each of the community leaders. Qualitative data were then analyzed thematically. Results Overall, 98 mostly gay-identified black MSM consented to participate, 57 community-based activities were facilitated and 9 inter-community events were conducted. Following their enrolment, 60% (59/98) of participants attended at least one pilot activity. Of those participants, 47% (28/59) attended at least half of the scheduled activities. A total of 36 participants took part in FGDs, and five in-depth interviews were completed with community leaders. Participants reported gaining access to MSM-specific HIV-prevention information, condoms and water-based lubricant through the small-group meetings. Some participants described how their feelings of loneliness, social isolation, self-esteem and self-efficacy were improved after taking part. Conclusions The social activities and group meetings were viable strategies for disseminating HIV-prevention information, condoms and water-based lubricant to MSM in this setting. Many MSM were also able to receive social support, reduce social isolation and improve their

  2. The first human heart transplant and further advances in cardiac transplantation at Groote Schuur Hospital and the University of Cape Town - with reference to : the operation. A human cardiac transplant : an interim report of a successful operation performed at Groote Schuur Hospital, Cape Town.

    PubMed

    Brink, J G; Hassoulas, J

    2009-01-01

    Christiaan (Chris) Barnard was born in 1922 and qualified in medicine at the University of Cape Town in 1946. Following surgical training in South Africa and the USA, Barnard established a successful open-heart surgery programme at Groote Schuur Hospital and the University of Cape Town in 1958. In 1967, he led the team that performed the world's first human-to-human heart transplant. The article describing this remarkable achievement was published in the South African Medical Journal just three weeks after the event and is one of the most cited articles in the cardiovascular field. In the lay media as well, this first transplant remains the most publicised event in world medical history. Although the first heart transplant patient survived only 18 days, four of Groote Schuur Hospital's first 10 patients survived for more than one year, two living for 13 and 23 years, respectively. This relative success amid many failures worldwide did much to generate guarded optimism that heart transplantation would eventually become a viable therapeutic option. This first heart transplant and subsequent ongoing research in cardiac transplantation at the University of Cape Town and in a few other dedicated centres over the subsequent 15 years laid the foundation for heart transplantation to become a well-established form of therapy for end-stage cardiac disease. During this period from 1968 to 1983, Chris Barnard and his team continued to make major contributions to organ transplantation, notably the development of the heterotopic ( 'piggy-back') heart transplants; advancing the concept of brain death, organ donation and other related ethical issues; better preservation and protection of the donor heart (including hypothermic perfusion storage of the heart; studies on the haemodynamic and metabolic effects of brain death; and even early attempts at xenotransplantation.

  3. HIV risk and prevention among men who have sex with men (MSM) in peri-urban townships in Cape Town, South Africa.

    PubMed

    Jobson, Geoffrey; de Swardt, Glenn; Rebe, Kevin; Struthers, Helen; McIntyre, James

    2013-05-01

    Current guidelines on HIV prevention for MSM emphasise the need for 'combination prevention' based on context-specific understandings of HIV risk. MSM in South Africa are a population with a high risk of HIV infection, however there is little research available on the drivers of this risk. In the context of a focus on combination prevention, this paper argues that effective HIV prevention for MSM in South Africa requires an understanding of the factors at multiple 'distances' from individuals that contribute to HIV risk. Based on qualitative research with MSM in Cape Town, South Africa, we situate HIV risk using a socio-ecological framework and identify factors at distal, proximal, and personal, levels that contribute to MSM's high risk of HIV infection. By understanding the interactions and linkages between risk environments and the risk situations in which HIV is transmitted, HIV prevention programmes will be more effectively able to address the multiple drivers of HIV risk in this population.

  4. Pregnant in a foreign city: A qualitative analysis of diet and nutrition for cross-border migrant women in Cape Town, South Africa.

    PubMed

    Hunter-Adams, Jo; Rother, Hanna-Andrea

    2016-08-01

    How do migrant women navigate their food environment during pregnancy? Foods are imbued with new meanings in a new place, and in low-and-middle-income countries including South Africa, a changing food environment leaves the poor, including many migrants, vulnerable to malnutrition. Thus, one of the ways economic and social vulnerability may be experienced and reproduced is via the foods one consumes. Examining food perceptions in the context of pregnancy offers a potentially powerful lens on wellbeing. Nine focus group discussions (N = 48) with Somali, Congolese, and Zimbabwean men and women, and 23 in-depth interviews with Congolese, Somali and Zimbabwean women living in Cape Town were conducted, exploring maternal and infant nutrition. We used thematic analysis to guide analysis. (1) Participants described longing for self-categorised "traditional" foods, yet had limited access and little time and space to prepare these foods in the manner they had back home. (2) Sought-after foods available-and even celebratory-for migrants in Cape Town during pregnancy tended to be calorie-dense, nutrient poor fast foods and junk foods. (3) The fulfilment of cravings was presented as the embodiment of health during pregnancy. (4) Iron-folic acid supplementation was perceived as curative rather than preventive. (5) While participants did not describe hunger during pregnancy, food scarcity seemed possible. Food perceptions during pregnancy reflected migrants' orientation towards home. Fast foods were widely acceptable and available during pregnancy. These foods were not perceived to have negative health consequences. Nutrition interventions targeting migrants should consider the symbolic nature of food, the increasingly globalised food environment in urban LMIC settings, as well as the contexts in which health perceptions evolve. Copyright © 2016 Elsevier Ltd. All rights reserved.

  5. Effect of distance to health facility on the maintenance of INR therapeutic ranges in rheumatic heart disease patients from Cape Town: no evidence for an association.

    PubMed

    Barth, Dylan D; Zühlke, Liesl J; Joachim, Alexia; Hoegger, Tyler; Mayosi, Bongani M; Engel, Mark E

    2015-06-05

    Lack of adherence to international normalised ratio (INR) monitoring in rheumatic heart disease (RHD) patients is a contributor to cardio-embolic complications. This population-based observational study investigated whether the distance between home and an INR clinic affects the maintenance of therapeutic INR in RHD patients on warfarin. Residential addresses, INR clinics, and INR results of patients with RHD were extracted from the Cape Town component of the Global Rheumatic Heart Disease Registry (REMEDY) database. Addresses of homes and INR clinics were converted to geographical coordinates and verified in ArcGIS 10®. ArcGIS 10® and Google Maps® were used for spatial mapping and obtaining shortest road distances respectively. The travel distance between the home and INR clinic was correlated with time within therapeutic range (TTR) using the Rosendaal linear interpolation method, and with the fraction of INR within range, based on an average of three INR readings of patients and compared with recommended therapeutic ranges. RHD patients (n = 133) resided between 0.2 km and 50.8 km (median distance, 3.60 km) from one of 33 INR clinics. There was no significant difference in the achievement of the therapeutic INR between patients who travelled a shorter distance compared to those who travelled a longer distance (in range = 3.50 km versus out of range = 3.75 km, p = 0.78). This finding was the same for patients with mechanical valve replacement (n = 105) (3.50 km versus 3.90 km, p = 0.81), and native valves (3.45 km versus 2.75 km, p = 0.84). There is no association between the maintenance of INR within therapeutic range amongst RHD patients in Cape Town and distance from patients' residence to the INR clinic.

  6. "Not on the agenda": A qualitative study of influences on health services use among poor young women who use drugs in Cape Town, South Africa.

    PubMed

    Myers, Bronwyn; Carney, Tara; Wechsberg, Wendee M

    2016-04-01

    Poor young women who use alcohol and other drugs (AODs) in Cape Town, South Africa, need access to health services to prevent HIV. Efforts to link young women to services are hampered by limited information on what influences service initiation. We explored perceptions of factors that influence poor AOD-using young women's use of health services. We conducted four focus groups with young women (aged 16-21) who used AODs and were recruited from two township communities in Cape Town. We also conducted 14 in-depth interviews with health and social welfare service planners and providers. Discussion topics included young women's use of health services and perceived influences on service use. Qualitative data were analysed using a framework approach. The findings highlighted structural, contextual, and systemic influences on the use of health services by young women who use AODs. First, young women were absent from the health agenda, which had an impact on the provision of women-specific services. Resource constraints and gender inequality were thought to contribute to this absence. Second, gender inequality and stigma toward young women who used AODs led to their social exclusion from education and employment opportunities and health care. Third, community poverty resulted in the emergence of perverse social capital and social disorder that limited social support for treatment. Fourth, the health care system was unresponsive to the multiple service needs of these young women. To reach young women who use AODs, interventions need to take cognisance of young women's risk environment and health systems need to adapt to respond better to their needs. For these interventions to be effective, gender must be placed on the policy agenda. Copyright © 2016 Elsevier B.V. All rights reserved.

  7. “Not on the agenda”: A qualitative study of influences on health services use among poor young women who use drugs in Cape Town, South Africa

    PubMed Central

    Myers, Bronwyn; Carney, Tara; Wechsberg, Wendee M.

    2016-01-01

    Background Poor young women who use alcohol and other drugs (AODs) in Cape Town, South Africa, need access to health services to prevent HIV. Efforts to link young women to services are hampered by limited information on what influences service initiation. We explored perceptions of factors that influence poor AOD-using young women’s use of health services. Methods We conducted four focus groups with young women (aged 16 to 21) who used AODs and were recruited from two township communities in Cape Town. We also conducted 14 in-depth interviews with health and social welfare service planners and providers. Discussion topics included young women’s use of health services and perceived influences on service use. Qualitative data were analysed using a framework approach. Results The findings highlighted structural, contextual, and systemic influences on the use of health services by young women who use AODs. First, young women were absent from the health agenda, which had an impact on the provision of women-specific services. Resource constraints and gender inequality were thought to contribute to this absence. Second, gender inequality and stigma toward young women who used AODs led to their social exclusion from education and employment opportunities and health care. Third, community poverty resulted in the emergence of perverse social capital and social disorder that limited social support for treatment. Fourth, the health care system was unresponsive to the multiple service needs of these young women. Conclusion To reach young women who use AODs, interventions need to take cognisance of young women’s risk environment and health systems need to adapt to respond better to their needs. For these interventions to be effective, gender must be placed on the policy agenda. PMID:26797188

  8. Ethnic differences in alcohol and drug use and related sexual risks for HIV among vulnerable women in Cape Town, South Africa: implications for interventions

    PubMed Central

    2013-01-01

    Background Alcohol and other drug (AOD) use among poor Black African and Coloured women in South Africa compounds their sexual risk for HIV. Given South Africa’s history of ethnic disparities, ethnic differences in sex risk profiles may exist that should be taken into account when planning HIV risk reduction interventions. This paper aims to describe ethnic differences in AOD use and AOD-related sexual risks for HIV among vulnerable women from Cape Town, South Africa. Method Cross-sectional data on 720 AOD-using women (324 Black African; 396 Coloured) recruited from poor communities in Cape Town were examined for ethnic differences in AOD use and AOD-related sexual risk behavior. Results Ethnic differences in patterns of AOD use were found; with self-reported drug problems, heavy episodic drinking and methamphetamine use being most prevalent among Coloured women and cannabis use being most likely among Black African women. However, more than half of Black African women reported drug-related problems and more than a third tested positive for recent methamphetamine use. More than a third of women reported being AOD-impaired and having unprotected sex during their last sexual encounter. Coloured women had four-fold greater odds of reporting that their last sexual episode was AOD-impaired and unprotected than Black African women. In addition, close to one in two women reported that their sexual partner was AOD-impaired at last sex, with Coloured women having three-fold greater odds of reporting that their partner was AOD-impaired at last sex than Black African women. Conclusions Findings support the need to develop and test AOD risk reduction interventions for women from both ethnic groups. In addition, findings point to the need for tailored interventions that target the distinct profiles of AOD use and AOD-related sex risks for HIV among Black African and Coloured women. PMID:23442318

  9. Gender-based violence and HIV sexual risk behavior: alcohol use and mental health problems as mediators among women in drinking venues, Cape Town.

    PubMed

    Pitpitan, Eileen V; Kalichman, Seth C; Eaton, Lisa A; Sikkema, Kathleen J; Watt, Melissa H; Skinner, Donald

    2012-10-01

    Gender-based violence is a key determinant of HIV infection among women in South Africa as elsewhere. However, research has not examined potential mediating processes to explain the link between experiencing abuse and engaging in HIV sexual risk behavior. Previous studies suggest that alcohol use and mental health problems may explain how gender-based violence predicts sexual risk. In a prospective study, we examined whether lifetime history of gender-based violence indirectly affects future sexual risk behavior through alcohol use, depression and post-traumatic stress disorder (PTSD) in a high-risk socio-environmental context. We recruited a cohort of 560 women from alcohol drinking venues in a Cape Town, South African township. Participants completed computerized interviews at baseline and 4 months later. We tested prospective mediating associations between gender-based violence, alcohol use, depression, PTSD, and sexual risk behavior. There was a significant indirect effect of gender-based violence on sexual risk behavior through alcohol use, but not mental health problems. Women who were physically and sexually abused drank more, which in turn predicted more unprotected sex. We did not find a mediated relationship between alcohol use and sexual risk behavior through the experience of recent abuse or mental health problems. Alcohol use explains the link between gender-based violence and sexual risk behavior among women attending drinking venues in Cape Town, South Africa. Efforts to reduce HIV risk in South Africa by addressing gender-based violence must also address alcohol use. Copyright © 2012 Elsevier Ltd. All rights reserved.

  10. Ethnic differences in alcohol and drug use and related sexual risks for HIV among vulnerable women in Cape Town, South Africa: implications for interventions.

    PubMed

    Myers, Bronwyn; Kline, Tracy L; Browne, Felicia A; Carney, Tara; Parry, Charles; Johnson, Kim; Wechsberg, Wendee M

    2013-02-26

    Alcohol and other drug (AOD) use among poor Black African and Coloured women in South Africa compounds their sexual risk for HIV. Given South Africa's history of ethnic disparities, ethnic differences in sex risk profiles may exist that should be taken into account when planning HIV risk reduction interventions. This paper aims to describe ethnic differences in AOD use and AOD-related sexual risks for HIV among vulnerable women from Cape Town, South Africa. Cross-sectional data on 720 AOD-using women (324 Black African; 396 Coloured) recruited from poor communities in Cape Town were examined for ethnic differences in AOD use and AOD-related sexual risk behavior. Ethnic differences in patterns of AOD use were found; with self-reported drug problems, heavy episodic drinking and methamphetamine use being most prevalent among Coloured women and cannabis use being most likely among Black African women. However, more than half of Black African women reported drug-related problems and more than a third tested positive for recent methamphetamine use. More than a third of women reported being AOD-impaired and having unprotected sex during their last sexual encounter. Coloured women had four-fold greater odds of reporting that their last sexual episode was AOD-impaired and unprotected than Black African women. In addition, close to one in two women reported that their sexual partner was AOD-impaired at last sex, with Coloured women having three-fold greater odds of reporting that their partner was AOD-impaired at last sex than Black African women. Findings support the need to develop and test AOD risk reduction interventions for women from both ethnic groups. In addition, findings point to the need for tailored interventions that target the distinct profiles of AOD use and AOD-related sex risks for HIV among Black African and Coloured women.

  11. Education for Democratic Participation. An Analysis of Self-Education Strategies within Certain Community Organisations in Cape Town in the 1980s. Adult and Non-Formal Education Thesis Series.

    ERIC Educational Resources Information Center

    Walters, Shirley

    This book describes self-education within community organizations in Cape Town (South Africa) where a primary concern was the promotion of democratic participation. Part I describes the participatory research approach. Part II focuses on the historical contexts in which voluntary associations have developed and the specific theory and practice…

  12. “Coming to Town”: The Impact of Urbanicity, Cigarette Advertising, and Network Norms on the Smoking Attitudes of Black Women in Cape Town, South Africa

    PubMed Central

    Williams, Chyvette T.; Marks, Amy Seidel

    2008-01-01

    This study was conducted to examine the effect of urban living on smoking attitudes among black African women in South Africa. We examine how urbanicity affects attitudes toward smoking and how it moderates the relationship between both advertising exposure and network norms on black women’s smoking attitudes. Respondents were 975 black women currently living in Cape Town townships, some of which were raised in rural villages or small towns. Respondents completed a cross-sectional survey, which included data on smoking attitudes, norms, and exposure to cigarette advertising. Multiple linear regression analysis was performed with smoking attitudes as the response variable, and urbanicity, cigarette advertising exposure, and network smoking norms as primary explanatory variables. Interactions were tested to determine whether urbanicity modified the effect of advertising exposure and network norms on smoking attitudes. Independent effects of urbanicity, exposure to cigarette advertising, and greater smoking prevalence within women’s networks were associated with more favorable smoking attitudes. In addition, urbanicity moderated the relationship between network smoking norms and smoking attitudes, but not cigarette advertising exposure and smoking attitudes. Urbanicity, cigarette advertising, and networks play important roles in women’s attitudes toward smoking, and potentially, smoking behavior. Overall, our results suggest that strong and creative anti-smoking efforts are needed to combat the potential for a smoking epidemic among an increasingly urbanized population of black women in South Africa and similar emerging markets. Additional research is warranted. PMID:18563573

  13. A multi-level analysis of risk perception, poverty and sexual risk-taking among young people in Cape Town, South Africa.

    PubMed

    Tenkorang, Eric Y; Maticka-Tyndale, Eleanor; Rajulton, Fernando

    2011-03-01

    Various studies have underscored the relevance of community-level factors to sexual behavior and HIV/AIDS prevention efforts in Africa. However, there is a paucity of research and theorizing in this area compared to the preponderance of prevention models that focus solely on individual-level factors. Using data from the Cape Area Panel Survey and hierarchical linear models, this study examines the effects of a combination of individual-level factors and community-level poverty on sexual behaviors. Male and female respondents who perceived themselves to be at great risk of HIV infection were less likely to indulge in risky sexual behaviors. For females, race and community-level poverty were confounded such that race mediated the effects of community-level poverty. Results from this study indicate that multiple rationalities affect sexual behaviors in Cape Town, South Africa and that there is a need to consider both the social embeddedness of sexual behaviors and the rational components of decision making when designing HIV/AIDS prevention programs.

  14. The built environment & the impact of neighborhood characteristics on youth sexual risk behavior in Cape Town, South Africa

    PubMed Central

    Burns, Paul A.; Snow, Rachel C.

    2012-01-01

    Youth sexual risk behavior is often described in social terms, and there has been limited attention to date on how measures of the built environment, including access to municipal services, impact sexual risk behavior, particularly in resource-limited countries. Using the Cape Area Panel Study, we assessed the impact of neighborhood conditions (six single items and a built environment index (BEI)), net of individual socio-demographic factors. The results suggest that built environment factors are associated with sexual risk behavior. Also, the magnitude of associations between built environment factors and sexual risk behavior was more pronounced for females than for males. PMID:22704913

  15. The prevalence of human papillomavirus infections and associated risk factors in men-who-have-sex-with-men in Cape Town, South Africa.

    PubMed

    Müller, Etienne E; Rebe, Kevin; Chirwa, Tobias F; Struthers, Helen; McIntyre, James; Lewis, David A

    2016-08-22

    We investigated the prevalence of human papillomavirus (HPV) infection and associated behavioural risk factors in men-who-have-sex-with-men (MSM) attending a clinical service in Cape Town, South Africa. MSM were enrolled at the Ivan Toms Centre for Men's Health in Cape Town. A psychosocial and sexual behavioral risk questionnaire was completed for each participant and urine, oro-pharyngeal and anal swabs were collected for HPV testing using the Linear Array HPV Genotyping Test. Logistic regression analyses were performed to determine sexual risk factors associated with HPV infection at the three anatomical sites. The median age of all 200 participants was 32 years (IQR 26-39.5), of which 31.0 % were black, 31.5 % mixed race/coloured and 35.5 % white. The majority of the participants (73.0 %) had completed high school, 42.0 % had a tertiary level qualification and 69.0 % were employed. HPV genotypes were detected in 72.8 % [95 % CI: 65.9-79.0 %], 11.5 % [95 % CI: 7.4-16.8 %] and 15.3 % [95 % CI: 10.5-21.2 %] of anal, oro-pharyngeal and urine specimens, respectively. Prevalence of high-risk (HR)-HPV types was 57.6 % [95 % CI: 50.3-64.7 %] in anal samples, 7.5 % [95 % CI: 4.3-12.1 %] in oro-pharyngeal samples and 7.9 % [95 % CI: 4.5-12.7 %] in urine, with HPV-16 being the most common HR-HPV type detected at all sites. HPV-6/11/16/18 was detected in 40.3 % [95 % CI: 33.3-47.6 %], 4.5 % [95 % CI: 2.1-8.4 %] and 3.2 % [95 % CI: 1.2-6.8 %] of anal, oro-pharyngeal and urine samples, respectively. Multiple HPV types were more common in the anal canal of MSM while single HPV types constituted the majority of HPV infections in the oropharynx and urine. Among the 88 MSM (44.0 %) that were HIV positive, 91.8 % [95 % CI: 83.8-96.6 %] had an anal HPV infection, 81.2 % [95 % CI: 71.2-88.8 %] had anal HR-HPV and 85.9 % [95 % CI: 76.6-92.5 %] had multiple anal HPV types. Having sex with men only, engaging in group sex in lifetime, living with HIV and

  16. Exploration of Deaf People's Health Information Sources and Techniques for Information Delivery in Cape Town: A Qualitative Study for the Design and Development of a Mobile Health App.

    PubMed

    Chininthorn, Prangnat; Glaser, Meryl; Tucker, William David; Diehl, Jan Carel

    2016-11-11

    Many cultural and linguistic Deaf people in South Africa face disparity when accessing health information because of social and language barriers. The number of certified South African Sign Language interpreters (SASLIs) is also insufficient to meet the demand of the Deaf population in the country. Our research team, in collaboration with the Deaf communities in Cape Town, devised a mobile health app called SignSupport to bridge the communication gaps in health care contexts. We consequently plan to extend our work with a Health Knowledge Transfer System (HKTS) to provide Deaf people with accessible, understandable, and accurate health information. We conducted an explorative study to prepare the groundwork for the design and development of the system. To investigate the current modes of health information distributed to Deaf people in Cape Town, identify the health information sources Deaf people prefer and their reasons, and define effective techniques for delivering understandable information to generate the groundwork for the mobile health app development with and for Deaf people. A qualitative methodology using semistructured interviews with sensitizing tools was used in a community-based codesign setting. A total of 23 Deaf people and 10 health professionals participated in this study. Inductive and deductive coding was used for the analysis. Deaf people currently have access to 4 modes of health information distribution through: Deaf and other relevant organizations, hearing health professionals, personal interactions, and the mass media. Their preferred and accessible sources are those delivering information in signed language and with communication techniques that match Deaf people's communication needs. Accessible and accurate health information can be delivered to Deaf people by 3 effective techniques: using signed language including its dialects, through health drama with its combined techniques, and accompanying the information with pictures in

  17. The child rape epidemic : assessing the incidence at Red Cross Hospital, Cape Town, and establishing the need for a new national protocol.

    PubMed

    Cox, S; Andrade, G; Lungelow, D; Schloetelburg, W; Rode, H

    2007-10-01

    There were 52 733 reported rapes in South Africa in 2003/2004, almost half of them involving children. South Africa is faced with the challenge of developing an appropriate management strategy to foster effective treatment and curtail the incidence of sexual assault. A child sexual assault protocol for the Western Cape exists, but does not address the specialised needs of the child. We aimed to ascertain the incidence of child rape seen at Red Cross War Memorial Children's Hospital, Cape Town, with emphasis on the circumstances that surround the victimisation of children. We also aimed to demonstrate the need for a new national standard protocol of specialised care for child victims' injuries. A retrospective review of medical records of sexual assault victims from 2003 to 2005. There were 294 patients, 254 females and 40 males. Victims ranged from 10 months to 13 years in age (mean 5.8 years). The number of cases and severity of injuries increased annually. There were 14 third-degree, 22 second-degree and 91 first-degree injuries. Seventy-nine per cent of assaults were by a perpetrator known to the victim. All but 5 perpetrators were male. Fifty-eight per cent of rapes occurred in the patient's own home or that of a friend or relative. The number and severity of injuries have increased yearly. This shift is consistent with the overall increase in reported sexual assaults. Policy makers must respond to this call. Finalising sexual assault policy, clinical management and evidence collection guidelines and ensuring that they are disseminated and implemented nationally must be prioritised. Educational drives targeting parents and patients with the demonstrated demographics must be established.

  18. Methamphetamine use is associated with childhood sexual abuse and HIV sexual risk behaviors among patrons of alcohol-serving venues in Cape Town, South Africa

    PubMed Central

    Meade, Christina S.; Watt, Melissa H.; Sikkema, Kathleen J.; Deng, Lisa X.; Ranby, Krista W.; Skinner, Donald; Pieterse, Desiree; Kalichmann, Seth C.

    2012-01-01

    Background South Africa’s Western Cape has experienced a dramatic increase in methamphetamine (“meth”) use over the past decade. There is concern that meth may further fuel the HIV epidemic in this country because of its association with risky sexual behaviors. This study describes the prevalence of meth use and its relation to HIV sexual risk behaviors among patrons of alcohol-serving venues. Methods Participants (N=3,328) were surveyed in 12 venues in a mixed race township. Logistic regression models were used to examine the relations between meth use and sexual risk behaviors, and structural equation models were used to test whether meth use mediates the relationship between childhood sexual abuse and current sexual risk. Results Meth use in the past 4 months was more common among Coloured than Black persons (10.5% vs. 3.5%). Meth users were more likely than non users to use marijuana, inhalants, and injection drugs, have a history of childhood sexual and/or physical abuse, and experience and/or perpetrate intimate partner violence. Among both men and women, meth use was associated with greater odds of engaging in sexual risk behaviors, and meth use partially mediated the relationships between childhood sexual abuse and all sexual risk behaviors. Conclusions Meth users in this setting are at increased risk for HIV due to their greater likelihood of engaging in sexual risk behaviors and being in violent relationships. There is an urgent need to provide targeted HIV prevention and substance abuse treatment to meth users living in townships in Cape Town. PMID:22717338

  19. Methamphetamine use is associated with childhood sexual abuse and HIV sexual risk behaviors among patrons of alcohol-serving venues in Cape Town, South Africa.

    PubMed

    Meade, Christina S; Watt, Melissa H; Sikkema, Kathleen J; Deng, Lisa X; Ranby, Krista W; Skinner, Donald; Pieterse, Desiree; Kalichmann, Seth C

    2012-11-01

    South Africa's Western Cape has experienced a dramatic increase in methamphetamine ("meth") use over the past decade. There is concern that meth may further fuel the HIV epidemic in this country because of its association with risky sexual behaviors. This study describes the prevalence of meth use and its relation to HIV sexual risk behaviors among patrons of alcohol-serving venues. Participants (N=3328) were surveyed in 12 venues in a mixed race township. Logistic regression models were used to examine the relations between meth use and sexual risk behaviors, and structural equation models were used to test whether meth use mediates the relationship between childhood sexual abuse and current sexual risk. Meth use in the past 4 months was more common among Coloured than Black persons (10.5% vs. 3.5%). Meth users were more likely than non users to use marijuana, inhalants, and injection drugs, have a history of childhood sexual and/or physical abuse, and experience and/or perpetrate intimate partner violence. Among both men and women, meth use was associated with greater odds of engaging in sexual risk behaviors, and meth use partially mediated the relationships between childhood sexual abuse and all sexual risk behaviors. Meth users in this setting are at increased risk for HIV due to their greater likelihood of engaging in sexual risk behaviors and being in violent relationships. There is an urgent need to provide targeted HIV prevention and substance abuse treatment to meth users living in townships in Cape Town. Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.

  20. "The sun has set even though it is morning": Experiences and explanations of perinatal depression in an urban township, Cape Town.

    PubMed

    Davies, Thandi; Schneider, Marguerite; Nyatsanza, Memory; Lund, Crick

    2016-06-01

    This study examined experiences and explanations of depression amongst Xhosa-speaking pregnant women, mothers, and health workers in an urban township in Cape Town, South Africa. The study was conducted as part of formative research for a randomised controlled trial to develop and evaluate a task-sharing counselling intervention for maternal depression in this setting. We conducted qualitative semi-structured interviews with 12 depressed and 9 nondepressed pregnant women and mothers of young babies, and 13 health care providers. We employed an in-depth framework analysis approach to explore the idioms, descriptions, and perceived causes of depression particular to these women, and compared these with the ICD-10 and DSM-5 criteria for major depression. We found that symptoms of major depression are similar in this township to those described in international criteria (withdrawal, sadness, and poor concentration), but that local descriptions of these symptoms vary. In addition, all the symptoms described by participants were directly related to stressors occurring in the women's lives. These stressors included poverty, unemployment, lack of support from partners, abuse, and death of loved ones, and were exacerbated by unwanted or unplanned pregnancies and the discovery of HIV positive status at antenatal appointments. The study calls attention to the need for specifically designed counselling interventions for perinatal depression that are responsive to the lived experiences of these women and grounded in the broader context of poor socioeconomic conditions and living environments in South Africa, all of which have a direct impact on mental health.

  1. A description of common mental disorders in men who have sex with men (MSM) referred for assessment and intervention at an MSM clinic in Cape Town, South Africa.

    PubMed

    Stoloff, Kevin; Joska, John A; Feast, Dorothy; De Swardt, Glenn; Hugo, Johan; Struthers, Helen; McIntyre, James; Rebe, Kevin

    2013-05-01

    Men who have sex with men (MSM) have a higher prevalence of common mental disorders (CMD), as compared with heterosexual men. HIV infection is independently associated with higher rates of CMD. Given this context, and the high background community prevalence of HIV in South Africa, MSM are at even greater risk of developing CMD. The aim of this research was to investigate neuropsychiatric symptoms and disorders in MSM who were referred for assessment and management of mental health problems, in an MSM Clinic in urban Cape Town, South Africa. Twenty-five men were screened using the MINI, AUDIT, DUDIT, and IPDE Screener. Depression, suicidality, as well as alcohol and drug use disorders were highly prevalent in this group (44, 56, 48, and 56 % respectively). The personality disorder screening was suggestive of a high prevalence of personality disorders. The high prevalence of neuropsychiatric disorders in this sample supports the idea that integrated mental health services are needed to address the complex needs of this population. Adequate input into the mental health needs of this population could reduce the potential for HIV acquisition and transmission, improve adherence to treatment and care, and ensure the provision a comprehensive health service for MSM.

  2. ‘Why do an MPH?’ Motivations and intentions of physicians undertaking postgraduate public health training at the University of Cape Town

    PubMed Central

    Zweigenthal, Virginia E.M.; Marquez, Emma; London, Leslie

    2016-01-01

    Background Public health (PH) approaches underpin the management and transformation of health systems in low- and middle-income countries. Despite the Master of Public Health (MPH) rarely being a prerequisite for health service employment in South Africa, many physicians pursue MPH qualifications. Objectives This study identifies their motivations and career intentions and explored MPH programme strengths and gaps in under- and post-graduate PH training. Design A cross-sectional study using an online questionnaire was completed by physicians graduating with an MPH between 2000 and 2009 and those enrolled in the programme in 2010 at the University of Cape Town. Results Nearly a quarter of MPH students were physicians. Of the 65 contactable physicians, 48% responded. They were mid-career physicians who wished to obtain research training (55%), who wished to gain broader perspectives on health (32%), and who used the MPH to advance careers (90%) as researchers, policy-makers, or managers. The MPH widened professional opportunities, with 62% changing jobs. They believed that inadequate undergraduate exposure should be remedied by applying PH approaches to clinical problems in community settings, which would increase the attractiveness of postgraduate PH training. Conclusions The MPH allows physicians to transition from pure clinical to research, policy and/or management work, preparing them to innovate changes for effective health systems, responsive to the health needs of populations. Limited local job options and incentives are important constraining factors. Advocacy for positions requiring qualifications and benchmarking exit competencies of programmes nationally may promote enrolment. PMID:27741958

  3. Is Younger Really Safer? A Qualitative Study of Perceived Risks and Benefits of Age-Disparate Relationships among Women in Cape Town, South Africa

    PubMed Central

    Beauclair, Roxanne; Delva, Wim

    2013-01-01

    Young women in age-asymmetric relationships may be at an elevated risk for acquisition of HIV, since relationships with older men are also correlated with other risk behaviors like less condom use. Qualitative studies have shown that women are motivated to participate in these relationships for money and emotional support. However, there is a paucity of research on women’s perceived risks of these relationships, particularly in South Africa. To this end, we conducted in-depth interviews with 23 women recruited from three urban communities in Cape Town. A thematic question guide was used to direct the interviews. Thematic content analysis was used to explore women’s perceived risks of age-disparate and non-age-disparate relationships, the benefits of dating older men, and risk perceptions that influence decisions around beginning or ending a relationship. A plurality of women thought that dating an older man does not bring any adverse consequences, although some thought that older men do not use condoms and may be involved in concurrent partnerships. Many women were less inclined to date same-age or younger men, because they were viewed as being disrespectful and abusive. This study points to the need for more awareness raising about the risks of age-disparate relationships. In addition to these initiatives, there is an urgent need to implement holistic approaches to relationship health, in order to curb intimate partner violence, improve gender equity and make non-age-disparate relationships more attractive. PMID:24260585

  4. Child road traffic crash injuries at the Red Cross War Memorial Children's Hospital in Cape Town, South Africa in 1992, 2002 and 2012.

    PubMed

    Isaac, Kihurani N; Van Niekerk, Ashley; Van As, Arjan Bastiaan

    2015-01-01

    Road traffic crashes are a significant cause of the disease burden among children, with the highest mortality in low- and middle-income countries. This observational study explores such injuries in Cape Town, South Africa through an analysis of data for cases in 1992, 2002 and 2012 at the Red Cross War Memorial Children's Hospital, a referral paediatric hospital for children younger than 13 years. Descriptive and time trend analysis of demographic data as well as of the causes, severity and place of injury was conducted. Logistic regression and generalised linear models described factors influencing hospital admission. In the years 1992, 2002 and 2012, a total of 4690 patients presented with injuries sustained as a result of a road traffic crash. Nearly 50% (n = 2201) of them were between five and nine years of age, with 1.7 males for every female. Three-quarters of those who got injured were pedestrians while the second most commonly injured ones were unrestrained passengers. The majority had minor injuries (58%), but with notably higher proportions with moderate to severe injuries in the years 2002 and 2012. Forty per cent were admitted for inpatient treatment, with the highest proportion (50%) in 2002. Admission was related to mechanism and severity. The epidemiological factors assessed remain largely unchanged over the assessment points calling into question the impact of local safety strategies.

  5. An Approach to Developing a Prediction Model of Fertility Intent Among HIV-Positive Women and Men in Cape Town, South Africa: A Case Study.

    PubMed

    Bai, Dan; Leu, Cheng-Shiun; Mantell, Joanne E; Exner, Theresa M; Cooper, Diane; Hoffman, Susie; Kelvin, Elizabeth A; Myer, Landon; Constant, Debbie; Moodley, Jennifer

    2017-02-01

    As a 'case-study' to demonstrate an approach to establishing a fertility-intent prediction model, we used data collected from recently diagnosed HIV-positive women (N = 69) and men (N = 55) who reported inconsistent condom use and were enrolled in a sexual and reproductive health intervention in public sector HIV care clinics in Cape Town, South Africa. Three theoretically-driven prediction models showed reasonable sensitivity (0.70-1.00), specificity (0.66-0.94), and area under the receiver operating characteristic curve (0.79-0.89) for predicting fertility intent at the 6-month visit. A k-fold cross-validation approach was employed to reduce bias due to over-fitting of data in estimating sensitivity, specificity, and area under the curve. We discuss how the methods presented might be used in future studies to develop a clinical screening tool to identify HIV-positive individuals likely to have future fertility intent and who could therefore benefit from sexual and reproductive health counseling around fertility options.

  6. The influence of environmental variables on the presence of white sharks, Carcharodon carcharias at two popular Cape Town bathing beaches: a generalized additive mixed model.

    PubMed

    Weltz, Kay; Kock, Alison A; Winker, Henning; Attwood, Colin; Sikweyiya, Monwabisi

    2013-01-01

    Shark attacks on humans are high profile events which can significantly influence policies related to the coastal zone. A shark warning system in South Africa, Shark Spotters, recorded 378 white shark (Carcharodon carcharias) sightings at two popular beaches, Fish Hoek and Muizenberg, during 3690 six-hour long spotting shifts, during the months September to May 2006 to 2011. The probabilities of shark sightings were related to environmental variables using Binomial Generalized Additive Mixed Models (GAMMs). Sea surface temperature was significant, with the probability of shark sightings increasing rapidly as SST exceeded 14 °C and approached a maximum at 18 °C, whereafter it remains high. An 8 times (Muizenberg) and 5 times (Fish Hoek) greater likelihood of sighting a shark was predicted at 18 °C than at 14 °C. Lunar phase was also significant with a prediction of 1.5 times (Muizenberg) and 4 times (Fish Hoek) greater likelihood of a shark sighting at new moon than at full moon. At Fish Hoek, the probability of sighting a shark was 1.6 times higher during the afternoon shift compared to the morning shift, but no diel effect was found at Muizenberg. A significant increase in the number of shark sightings was identified over the last three years, highlighting the need for ongoing research into shark attack mitigation. These patterns will be incorporated into shark awareness and bather safety campaigns in Cape Town.

  7. Emtonjeni-A Structural Intervention to Integrate Sexual and Reproductive Health into Public Sector HIV Care in Cape Town, South Africa: Results of a Phase II Study.

    PubMed

    Mantell, J E; Cooper, D; Exner, T M; Moodley, J; Hoffman, S; Myer, L; Leu, C-S; Bai, D; Kelvin, E A; Jennings, K; Stein, Z A; Constant, D; Zweigenthal, V; Cishe, N; Nywagi, N

    2017-03-01

    Integration of sexual and reproductive health within HIV care services is a promising strategy for increasing access to family planning and STI services and reducing unwanted pregnancies, perinatal HIV transmission and maternal and infant mortality among people living with HIV and their partners. We conducted a Phase II randomized futility trial of a multi-level intervention to increase adherence to safer sex guidelines among those wishing to avoid pregnancy and adherence to safer conception guidelines among those seeking conception in newly-diagnosed HIV-positive persons in four public-sector HIV clinics in Cape Town. Clinics were pair-matched and the two clinics within each pair were randomized to either a three-session provider-delivered enhanced intervention (EI) (onsite contraceptive services and brief milieu intervention for staff) or standard-of-care (SOC) provider-delivered intervention. The futility analysis showed that we cannot rule out the possibility that the EI intervention has a 10 % point or greater success rate in improving adherence to safer sex/safer conception guidelines than does SOC (p = 0.573), indicating that the intervention holds merit, and a larger-scale confirmatory study showing whether the EI is superior to SOC has merit.

  8. Developing a spatially and temporally resolved emission inventory for photochemical modeling in the City of Cape Town and assessing its uncertainty

    NASA Astrophysics Data System (ADS)

    Sowden, Miles; Cairncross, Eugene; Wilson, Gary; Zunckel, Mark; Kirillova, Elena; Reddy, Vis; Hietkamp, Sibbele

    In an urban environment where reactive pollutants are emitted, it is critically important that atmospheric chemistry be considered in modeling and air quality management including the evaluation of secondary pollutants such as ozone. This may be achieved through photochemical modeling, which is reliant on detailed, grid resolved emissions inventories. The US-EPA's approved Emissions Processing System (EPS) is used to develop a temporally and spatially resolved emissions inventory for the City of Cape Town for use in the Dynamic Air Pollution Prediction System (DAPPS). Included in this inventory are large and small point sources, mobile sources, and emissions from residential fuel burning and biogenic sources. Large point sources are usually well defined unlike the other source types that can have large uncertainties associated with them. In these circumstances, surrogate data are used to estimate emission rates. The FRamework for the Assessment of Uncertainties in Large-scale Emission INventories (FRAULEIN) approach to assessing uncertainty in the emissions inventory is adapted for DAPPS. A reasonable level of confidence exists for the characterization of large point sources but the two biggest source contributors namely vehicle and biogenic emissions, needs improvement.

  9. The Influence of Environmental Variables on the Presence of White Sharks, Carcharodon carcharias at Two Popular Cape Town Bathing Beaches: A Generalized Additive Mixed Model

    PubMed Central

    Weltz, Kay; Kock, Alison A.; Winker, Henning; Attwood, Colin; Sikweyiya, Monwabisi

    2013-01-01

    Shark attacks on humans are high profile events which can significantly influence policies related to the coastal zone. A shark warning system in South Africa, Shark Spotters, recorded 378 white shark (Carcharodon carcharias) sightings at two popular beaches, Fish Hoek and Muizenberg, during 3690 six-hour long spotting shifts, during the months September to May 2006 to 2011. The probabilities of shark sightings were related to environmental variables using Binomial Generalized Additive Mixed Models (GAMMs). Sea surface temperature was significant, with the probability of shark sightings increasing rapidly as SST exceeded 14°C and approached a maximum at 18°C, whereafter it remains high. An 8 times (Muizenberg) and 5 times (Fish Hoek) greater likelihood of sighting a shark was predicted at 18°C than at 14°C. Lunar phase was also significant with a prediction of 1.5 times (Muizenberg) and 4 times (Fish Hoek) greater likelihood of a shark sighting at new moon than at full moon. At Fish Hoek, the probability of sighting a shark was 1.6 times higher during the afternoon shift compared to the morning shift, but no diel effect was found at Muizenberg. A significant increase in the number of shark sightings was identified over the last three years, highlighting the need for ongoing research into shark attack mitigation. These patterns will be incorporated into shark awareness and bather safety campaigns in Cape Town. PMID:23874668

  10. I am not "umqwayito'': a qualitative study of peer pressure and sexual risk behaviour among young adolescents in Cape Town, South Africa.

    PubMed

    Selikow, Terry-Ann; Ahmed, Nazeema; Flisher, Alan J; Mathews, Catherine; Mukoma, Wanjiru

    2009-06-01

    Young people in South Africa are susceptible to HIV infection. They are vulnerable to peer pressure to have sex, but little is known about how peer pressure operates. The aim of the study was to understand how negative peer pressure increases high risk sexual behaviour among young adolescents in Cape Town, South Africa. Qualitative research methods were used. Eight focus groups were conducted with young people between the ages of 13 and 14 years. Peer pressure among both boys and girls undermines healthy social norms and HIV prevention messages to abstain, be faithful, use a condom and delay sexual debut. HIV prevention projects need to engage with peer pressure with the aim of changing harmful social norms into healthy norms. Increased communication with adults about sex is one way to decrease the impact of negative peer pressure. Peer education is a further mechanism by which trained peers can role model healthy social norms and challenge a peer culture that promotes high risk sexual behaviour. Successful HIV prevention interventions need to engage with the disconnect between educational messages and social messages and to exploit the gaps between awareness, decision making, norms, intentions and actions as spaces for positive interventions.

  11. The state of housing, water and sanitation in the greater metropolitan area of Cape Town, 1995: report of a survey on access to basic subsistence facilities.

    PubMed

    Barron, P; Lewin, S; London, L; Rumbelow, R; Seager, J; Truter, H

    1996-09-01

    This article summarizes key findings from a survey of access to facilities during 1994-95, among environmental health offices in Greater Metropolitan Cape Town, South Africa. The offices were situated in Parow, Goodwood, Elsies River, Constantia, Grassy Park, Durbanville, Atlantis, Bellville, Paarl, Stellenbosch, Belhar, Khanya, and Milnerton. Sampling was stratified by housing type (formal, unserviced shacks, site and service shacks, and shacks with communal facilities). Within the residential types, sampling was performed with cluster, random, and systematic sampling techniques to yield 7152 units. Information was obtained on access to drinking water, sanitation, and storm drainage; quality of housing; and demography. Findings indicate that 7% of the population (86,000 people) lived in shacks that did not have access to basic services. 2.9% of dwellings (8300) did not have access to water within 50 m. About 10% of dwellings lacked access to refuse removal services. All regions had some housing without access to refuse removal. 25% of units lacked a functioning stormwater drainage system. Lack of access to basic services was greatest in number/rate in the most populated regions of Khanya and Stellenbosch. Stellenbosch posed difficulties due to the dispersed population, and the location of dwellings on private property. 61% lived in formal housing, 12% lived in shacks with access to services, and 21% lived in informal housing. 74% of the unserviced shacks were in the Khanya area, and 25% were in the Stellenbosch area.

  12. Feasibility and Acceptability of Screening and Brief Interventions to Address Alcohol and Other Drug Use among Patients Presenting for Emergency Services in Cape Town, South Africa

    PubMed Central

    Myers, Bronwyn; Stein, Dan J.; Mtukushe, Bulelwa; Sorsdahl, Katherine

    2012-01-01

    Despite evidence from high income countries, it is not known whether screening and brief interventions (SBI) for alcohol and other drug (AOD) use are feasible to implement in low and middle income countries. This paper describes the feasibility and acceptability of a peer-led SBI for AOD-using patients presenting with injuries at emergency services in Cape Town, South Africa. Data were extracted from program records on the number of eligible patients screened and the number of program refusals. A questionnaire examined preliminary responses to the intervention for 30 patients who had completed the program and 10 emergency personnel. Peer counselors were also interviewed to identify barriers to implementation. Of the 1458 patients screened, 21% (305) met inclusion criteria, of which 74% (225) were enrolled in the intervention. Of the 30 patients interviewed, most (83%) found the program useful. Emergency personnel were supportive of the program but felt that visibility and reach could improve. Peer counselors identified the need for better integration of the program into emergency services and for additional training and support. In conclusion, with limited additional resources, peer-led SBIs for AOD use are feasible to conduct in South African emergency services and are acceptable to patients and emergency personnel. PMID:23198159

  13. A social network typology and sexual risk-taking among men who have sex with men in Cape Town and Port Elizabeth, South Africa.

    PubMed

    de Voux, Alex; Baral, Stefan D; Bekker, Linda-Gail; Beyrer, Chris; Phaswana-Mafuya, Nancy; Siegler, Aaron J; Sullivan, Patrick S; Winskell, Kate; Stephenson, Rob

    2016-01-01

    Despite the high prevalence of HIV among men who have sex with men in South Africa, very little is known about their lived realities, including their social and sexual networks. Given the influence of social network structure on sexual risk behaviours, a better understanding of the social contexts of men who have sex with men is essential for informing the design of HIV programming and messaging. This study explored social network connectivity, an understudied network attribute, examining self-reported connectivity between friends, family and sex partners. Data were collected in Cape Town and Port Elizabeth, South Africa, from 78 men who have sex with men who participated in in-depth interviews that included a social network mapping component. Five social network types emerged from the content analysis of these social network maps based on the level of connectivity between family, friends and sex partners, and ranged from disconnected to densely connected networks. The ways in which participants reported sexual risk-taking differed across the five network types, revealing diversity in social network profiles. HIV programming and messaging for this population can greatly benefit from recognising the diversity in lived realities and social connections between men who have sex with men.

  14. 'When you visit a man you should prepare yourself': male community care worker approaches to working with men living with HIV in Cape Town, South Africa.

    PubMed

    Gittings, Lesley

    2016-08-01

    Caring is typically constructed as a feminised practice, resulting in women shouldering the burden of care-related work. Health-seeking behaviours are also constructed as feminine and men have poorer health outcomes globally. Employing men as carers may not only improve the health of the men they assist but also be transformative with regards to gendered constructions of caring. Using semi-structured interviews and observational home visits, this study explored the techniques that community care workers employ when working with male clients. The empirical analysis draws on the perspectives of eight care workers and three of their male clients from the Cape Town area. Interviews reveal how care workers and clients perform and negotiate masculinities as they navigate hegemonic masculine norms that require men to act tough, suppress emotions and deny weakness and sickness. Both parties bump up against ideals of what it means to be a man as they strive to provide care and receive support. Community care workers avoid rupturing client performances of hegemonic masculinities which inhibit confession and support. To do this, they use techniques of indirectly broaching sensitive subjects, acting in a friendly way and being clear about the intention of their work.

  15. The association between psychopathology and substance use: adolescent and young adult substance users in inpatient treatment in Cape Town, South Africa.

    PubMed

    Saban, Amina; Flisher, Alan; Laubscher, Ria; London, Leslie; Morojele, Neo

    2014-01-01

    Evidence suggests that comorbid psychopathology can negatively affect treatment outcomes in substance users. In South Africa, limited information exists regarding the prevalence, nature and role of psychiatric comorbidity in substance users. This study examined psychiatric comorbidity and its association with specific substance use, and young adult substance users in treatment for substance use. Male and female inpatient substance users (n=95; ages 17-30 years) were sampled consecutively in order of admission from three clinics in Cape Town. An interview schedule was administered to elicit patients' sociodemographic and substance use history details. The computer-assisted Diagnostic Interview Schedule DSM IV (C-DIS IV) was administered to screen patients for current psychiatric disorders. The sample was largely male, Coloured, Muslim and single. Cannabis (51.6%) and crystal methamphetamine (17.9%) were the most common first substances of use. Heroin (53.7%) and crystal methamphetamine (33.7%) were the most common substances for which treatment was sought (primary substances). The most common comorbid psychopathologies were anti-social personality disorder (ASPD 87.4%) and conduct disorder (CD 67.4%). Regression analyses showed a marginally significant association between specific phobia and first use of cannabis, but indicated no statistically significant associations between psychopathology and substance use. The results demonstrated a high proportion of previously unidentified comorbid psychopathology in inpatient substance users. Further research is needed to investigate psychiatric comorbidity in inpatient substance users.

  16. Introduction: Highlights of HeartWeek 2013 at the Sixth World Congress of Paediatric Cardiology and Cardiac Surgery in Cape Town South Africa.

    PubMed

    Jacobs, Jeffrey Phillip

    2013-12-01

    This December issue of Cardiology in the Young represents the 11th annual publication generated from the two meetings that compose "HeartWeek in Florida". "HeartWeek in Florida", the joint collaborative project sponsored by the Cardiac Center at the Children's Hospital of Philadelphia, Pennsylvania, together with Johns Hopkins All Children's Heart Institute of Saint Petersburg, Florida, averages over 1000 attendees every year and is now recognised as one of the major planks of continuing medical and nursing education for those working in the fields of diagnosis and treatment of cardiac disease in the foetus, neonate, infant, child,and adult. "HeartWeek in Florida" combines the International Symposium on Congenital Heart Disease,organised by All Children's Hospital and Johns Hopkins Medicine and entering its 14th year, with the Annual Postgraduate Course in Pediatric Cardiovascular Disease, organised by The Children's Hospital of Philadelphia and entering its 17th year.This December, 2013 issue of Cardiology in the Young highlights the sessions from HeartWeek 2013 that were held at The Sixth World Congress of Paediatric Cardiology and Cardiac Surgery in Cape Town, South Africa. We would like to acknowledge the tremendous contributions made to medicine by John Brown, and therefore we dedicate this HeartWeek 2013 issue of Cardiology in the Young to him.

  17. A survey of the physical health status of pupils aged 10-14 years in Standards 3-5 at three schools in New Crossroads, near Cape Town in the Western Cape.

    PubMed

    Ramphele, M A; Heap, M; Trollip, D K

    1995-10-01

    Although adolescence is most commonly associated with risk-taking behaviour, mortality due to poverty-related conditions is high among black African children aged 10-14 years. This paper describes a study carried out in October 1991 to assess the physical health status of 860 underprivileged pupils aged 10-14 years in Standards 3-5 at three schools in New Crossroads, near Cape Town. Data on nutritional status, age at menarche, blood pressure, eyesight, physical abnormalities, injuries and use of hospitals were obtained. The response rate was 90%. Of all the children, 7.2% were below the 5th percentile weight-for-age. The proportion of boys (13.1%) below the 5th percentile weight-for-age was significantly higher than that of girls (3.7%). Of all the children, 19.5% were below the 5th percentile height-for-age. The proportion of boys (24.4%) below the 5th percentile height-for-age was also significantly higher than that of girls (16.7%). The average age at menarche was 13 years, similar to that (12.8 years) reported for the UK. In 5% of the children, the diastolic blood pressure was > 90 mmHg and the findings show some increase with age. Red Cross War Memorial Children's Hospital accounted for 30.9% of hospital attendances. 'Chest' complaints (19.5%) were frequent reasons for consultations, while 15.2% of the children reported being injured, with car accidents (16.0%), fractures (27.5%) and burns (20.6%) being the most common injuries. It is suggested that the provision of a 24-hour day hospital will ease the load on the referral hospital, i.e. Red Cross War Memorial Children's Hospital.(ABSTRACT TRUNCATED AT 250 WORDS)

  18. The effect of phlebotomy training on blood sample rejection and phlebotomy knowledge of primary health care providers in Cape Town: A quasi-experimental study

    PubMed Central

    Mukinda, Fidele K.; Namane, Mosedi

    2017-01-01

    Background There is an increasing amount of blood sample rejection at primary health care facilities (PHCFs), impacting negatively the staff, facility, patient and laboratory costs. Aim The primary objective was to determine the rejection rate and reasons for blood sample rejection at four PHCFs before and after a phlebotomy training programme. The secondary objective was to determine whether phlebotomy training improved knowledge among primary health care providers (HCPs) and to develop a tool for blood sample acceptability. Study setting Two community health centres (CHCs) and two community day centres (CDCs) in Cape Town. Methods A quasi-experimental study design (before and after a phlebotomy training programme). Results The sample rejection rate was 0.79% (n = 60) at CHC A, 1.13% (n = 45) at CHC B, 1.64% (n = 38) at CDC C and 1.36% (n = 8) at CDC D pre-training. The rejection rate remained approximately the same post-training (p > 0.05). The same phlebotomy questionnaire was administered pre- and post-training to HCPs. The average score increased from 63% (95% CI 6.97‒17.03) to 96% (95% CI 16.91‒20.09) at CHC A (p = 0.039), 58% (95% CI 9.09‒14.91) to 93% (95% CI 17.64‒18.76) at CHC B (p = 0.006), 60% (95% CI 8.84‒13.13) to 97% (95% CI 16.14‒19.29) at CDC C (p = 0.001) and 63% (95% CI 9.81‒13.33) to 97% (95% CI 18.08‒19.07) at CDC D (p = 0.001). Conclusion There is no statistically significant improvement in the rejection rate of blood samples (p > 0.05) post-training despite knowledge improving in all HCPs (p < 0.05). PMID:28470073

  19. The impact of ART on TB case fatality stratified by CD4 count for HIV-positive TB patients in Cape Town, South Africa (2009–2011)

    PubMed Central

    Kaplan, Richard; Caldwell, Judy; Middelkoop, Keren; Bekker, Linda-Gail; MMed, Robin Wood

    2014-01-01

    Objective To identify determinants of TB case fatality including the impact of antiretroviral therapy (ART) at different CD4 thresholds for HIV-positive adult and adolescent TB patients. Methods Through a retrospective analysis of the electronic TB database, we identified the HIV status of newly registered patients ≥15 yrs. Multivariable Cox proportional hazard models were used to determine risk factors for TB case fatality in these patients. Results In 2009, 2010 and 2011, 25,841, 26,104 and 25,554 newly registered adult TB patients were treated in primary health care clinics in Cape Town, of whom 49.7%, 50.4% and 50.9% were HIV-positive. ART uptake increased over the three years from 43% to 64.9% and case fatality of the HIV-positive patients decreased from 7.0% to 5.8% (p<0.001). Female gender, increasing age, retreatment TB, low CD4 counts and extrapulmonary TB (EPTB) were associated with increased case fatality while patients on ART had a substantial decrease in case fatality. The difference in case fatality between patients on ART and not on ART was most pronounced at low CD4 counts with the positive influence of ART noted up to a CD4 count threshold of 350 cells/mm3 (p<0.001). Despite improvements in ART uptake, in 2011, 21% of patients with CD4 counts <350 cells/mm3 did not start ART during TB treatment. Conclusion This study showed a relatively poor uptake of ART among severely immune-compromised TB patients. Patients with CD4 counts <350 cells/mm3 were shown to clearly benefit from ART during TB treatment and ART initiation should be prioritised for this category of patients. PMID:24820105

  20. Polybrominated diphenyl ethers (PBDEs) and 2,2',4,4',5,5'-hexabromobiphenyl (BB-153) in landfill leachate in Cape Town, South Africa.

    PubMed

    Daso, Adegbenro P; Fatoki, Olalekan S; Odendaal, James P; Olujimi, Olanrewaju O

    2013-01-01

    An assessment of the concentrations of selected polybrominated diphenyl ether (PBDE) congeners as well as BB 153 in leachate samples collected from three landfill sites within the city of Cape Town was conducted. A liquid-liquid extraction technique was employed for the isolation of all the target compounds from the leachate samples. Extracts obtained were further subjected to multi-layer column chromatography employing different forms of silica gel. The prepared samples were analysed using a high capillary gas chromatograph equipped with a micro-electron capture detector (GC-μECD). The overall mean concentrations of the total PBDEs, including BDE 209 ranged between 5.65 and 2,240, 0.28-20.5 and 1.66-1,170 ng/l for Bellville, Coastal Park, and Vissershok landfill sites, respectively. The mean concentrations of BB 153, which were generally low in most of the samples analysed, were 70.4, 7.14 and 8.16 ng/l for Bellville, Coastal Park and Vissershok sites, respectively. The influence of precipitation on the characteristics and quantity of leachate produced from the landfill sites investigated was most pronounced during the August/September sampling regime. Generally, the trend observed in this study clearly indicated a wide variation in the levels of these contaminants in all the landfill sites studied from one sampling period to the other. However, the principal component analysis revealed that the release of these contaminants might be associated with two or three possible sources. This study further confirmed the relevance of landfill leachate as an important source of PBDE contamination of the environment, especially the groundwater and surface water sources.

  1. 'A thing full of stories': Traditional healers' explanations of epilepsy and perspectives on collaboration with biomedical health care in Cape Town.

    PubMed

    Keikelame, Mpoe Johannah; Swartz, Leslie

    2015-10-01

    The experience of epilepsy is profoundly culturally mediated and the meanings attributed to the condition can have a great impact on its social course. This qualitative study used Kleinman's Explanatory Model framework to explore traditional healers' perspectives on epilepsy in an urban township in Cape Town, South Africa. The healers who participated in the study were Xhosa-speaking, had experience caring for patients with epilepsy, and had not received any training on epilepsy. Six individual in-depth interviews and one focus group with nine traditional healers were conducted using a semi-structured interview guide. Traditional healers identified several different names referring to epilepsy. They explained epilepsy as a thing inside the body which is recognized by the way it presents itself during an epileptic seizure. According to these healers, epilepsy is difficult to understand because it is not easily detectable. Their biomedical explanations of the cause of epilepsy included, among others, lack of immunizations, child asphyxia, heredity, traumatic birth injuries and dehydration. These healers believed that epilepsy could be caused by amafufunyana (evil spirits) and that biomedical doctors could not treat the supernatural causes of epilepsy. However, the healers believed that western medicines, as well as traditional medicines, could be effective in treating the epileptic seizures. Traditional healers were supportive of collaboration with western-trained practitioners and highlighted that the strategy must have formal agreements in view of protection of intellectual property, accountability and respect of their indigenous knowledge. The findings suggest a need for interventions that promote cultural literacy among mental health practitioners. Research is urgently needed to assess the impact of such collaborations between biomedical services and traditional healers on epilepsy treatment and care.

  2. Epidemiology of acute spinal cord injuries in the Groote Schuur Hospital Acute Spinal Cord Injury (GSH ASCI) Unit, Cape Town, South Africa, over the past 11 years.

    PubMed

    Sothmann, Johan; Stander, Juliette; Kruger, Nicolas; Dunn, Robert

    2015-09-19

    Spinal cord injury (SCI) is devastating to both patient and society, with acute management and ongoing care being extremely expensive. Few epidemiological data are available on SCIs in South Africa (SA). To identify the epidemiological profile of SCI patients at Groote Schuur Hospital (GSH), Cape Town, SA, and identify seasonal trends and peak periods. As the majority of the injuries are preventable, these data are important to develop prevention strategies. A retrospective review of prospectively collected data was conducted on all patients admitted to the Acute Spinal Cord Injury (ASCI) Unit at GSH from 1 April 2003 to 31 March 2014. All cases registered on a prospectively maintained database were included in the study. The total number of patients admitted to the ASCI Unit was 2,042, with an average of 185 admissions per year. The male/female ratio was 5.25:1. The 21-30-year-old age category was the largest, comprising 33.5% of the patients. The most prevalent cause of injury was motor vehicle accidents (44.6%), followed by violence-related injuries (27.2%). Thirty-two point two per cent of patients needed ventilatory support, and 91.5% of mechanically ventilated patients were successfully weaned. December was the busiest month in the unit. In patients in whom neurological deficit was incomplete, the average motor function improvement was 16.0%. Data capturing and analysis of SCIs should be encouraged in SA to guide management and prevention strategies, and to optimise outcomes. This study establishes the ASCI Unit at GSH to be one of the key role players in acute SCI management in SA.

  3. The impact of the roll-out of rapid molecular diagnostic testing for tuberculosis on empirical treatment in Cape Town, South Africa

    PubMed Central

    Caldwell, Judy; Kaplan, Richard; Cobelens, Frank; Wood, Robin

    2017-01-01

    Abstract Objective To investigate the impact of introducing a rapid test as the first-line diagnostic test for drug-sensitive tuberculosis in Cape Town, South Africa. Methods Xpert® MTB/RIF (Xpert®), an automated polymerase-chain-reaction-based assay, was rolled out between 2011 and 2013. Data were available on 102 007 adults treated for pulmonary tuberculosis between 2010 and 2014. Tuberculosis notification rates per 100 000 population were calculated for each calendar year and for each year relative to the test roll-out locally, overall and by bacteriological confirmation. Empirical treatment was defined as treatment given without bacteriological confirmation by Xpert®, sputum smear microscopy or sputum culture. Findings Between 2010 and 2014, the proportion of human immunodeficiency virus (HIV)-negative patients treated empirically for tuberculosis declined from 23% (2445/10 643) to 11% (1149/10 089); in HIV-positive patients, it declined from 42% (4229/9985) to 27% (2364/8823). The overall tuberculosis notification rate decreased by 12% and 19% among HIV-negative and HIV-positive patients, respectively; the rate of bacteriologically confirmed cases increased by 1% and 3%, respectively; and the rate of empirical treatment decreased by 56% and 49%, respectively. These changes occurred gradually following the test’s introduction and stabilized after 3 years. Conclusion Roll-out of the rapid test in a setting with a high prevalence of pulmonary tuberculosis and HIV infection was associated with a halving of empirical treatment that occurred gradually after the test’s introduction, possibly reflecting the time needed for full implementation. More than a quarter of HIV-positive patients with tuberculosis were still treated empirically, highlighting the diagnostic challenge in these patients. PMID:28804167

  4. Constrictive pericarditis requiring pericardiectomy at Groote Schuur Hospital, Cape Town, South Africa: causes and perioperative outcomes in the HIV era (1990-2012).

    PubMed

    Mutyaba, Arthur K; Balkaran, Sarvesh; Cloete, Robert; du Plessis, Naude; Badri, Motasim; Brink, Johan; Mayosi, Bongani M

    2014-12-01

    The causes of constrictive pericarditis and predictors of perioperative outcome after pericardiectomy have not been clearly elucidated, especially in Africa, where the disease characteristics differ from those in developed countries. Furthermore, the effect of human immunodeficiency virus (HIV)/acquired immunodeficiency syndrome (AIDS) on pericardial constriction and outcomes after surgery is unknown. We investigated the causes of constrictive pericarditis, outcomes after pericardiectomy, and predictors of mortality in Cape Town, South Africa, during a 22-year period of high HIV/AIDS prevalence. A retrospective review of the medical records of all patients who had undergone pericardiectomy for constrictive pericarditis at Groote Schuur Hospital from January 1, 1990 to December 31, 2012 was performed. Of 121 patients, 36 (29.8%) had proven tuberculosis, 74 (61.2%) had presumed tuberculosis, 6 (5%) had idiopathic causes, and 5 (4%) had miscellaneous causes of constrictive pericarditis. Seventeen patients (14%) died perioperatively with low cardiac output syndrome the main cause of mortality. On multivariable analysis, serum sodium (hazard ratio, 0.88; 95% confidence interval, 0.80-0.97; P = .009) and preoperative New York Heart Association class IV (hazard ratio, 3.42; 95% confidence interval, 1.29-9.08; P = .014; vs combined class I-III) were independent predictors of early mortality. Of the 121 patients, 14 (11.6%) were HIV positive, with a mean CD4 cell count of 284 ± 133 cells/μL. No early deaths occurred in the HIV-positive patients. Tuberculosis is the main cause of constrictive pericarditis in South Africa. Despite its efficacy at relieving the symptoms of heart failure, pericardiectomy is associated with high perioperative mortality that was not influenced by HIV status. New York Heart Association functional class IV and hyponatremia predict for early mortality after pericardiectomy. Copyright © 2014 The American Association for Thoracic Surgery. Published

  5. Impact of Birth HIV-PCR Testing on the Uptake at Follow-Up Early Infant Diagnosis Services in Cape Town, South Africa.

    PubMed

    Dunning, Lorna; Kroon, Max; Fourie, Lezanne; Ciaranello, Andrea; Myer, Landon

    2017-07-27

    PCR testing at birth ('birth-testing') is suggested by new World Health Organization guidelines for rapid diagnosis of infants infected with HIV in utero. However, there are few data on the implementation of this approach in sub-Saharan Africa and whether birth-testing affects uptake of subsequent routine early infant diagnosis (EID) testing at 6-10 weeks of age is unknown. We reviewed 575 consecutive infants undergoing targeted high-risk birth-testing in Cape Town, South Africa, and matched those testing HIV-negative at birth (n=551) to HIV-exposed infants who did not receive birth-testing (n=551). Maternal and infant clinical and demographic data, including EID testing uptake, were abstracted from routine records. Overall 3.8% of all birth-tests conducted were positive, while later EID testing positivity rates were 0.5% for those infants testing HIV-negative at birth and 0.4% for those without birth-testing. Infants who underwent birth-testing were less likely to present for later EID compared with those without a birth-test (73% vs 85%; p<0.001). This difference persisted after adjusting for maternal and infant characteristics (adjusted odds ratio,0.60 95% confidence interval, 0.41-0.86) and across demographic and clinical subgroups. Infants undergoing birth-testing also presented for later EID at a significantly older age (mean age 60 vs 50 days, p<0.001). While the yield of targeted high-risk birth testing in this setting appears high, neonates testing HIV-negative at birth may be less likely to present for subsequent EID testing. For birth-testing implementation to contribute to overall EID program goals, structured interventions are required to support follow-up EID services after negative birth-test results.

  6. Factors associated with alcohol use prior to and during pregnancy among HIV-infected pregnant women in Cape Town, South Africa.

    PubMed

    Brittain, Kirsty; Remien, Robert H; Phillips, Tamsin; Zerbe, Allison; Abrams, Elaine J; Myer, Landon; Mellins, Claude A

    2017-04-01

    Alcohol use during pregnancy is prevalent in South Africa, but there are few prospectively-collected data exploring patterns of consumption among HIV-infected women, which may be important to improve maternal and child health outcomes. We examined patterns of and factors associated with alcohol use prior to and during pregnancy among HIV-infected pregnant women in Cape Town, South Africa. Participants were enrolled when entering antenatal care at a large primary care clinic, and alcohol use was assessed using the AUDIT (Alcohol Use Disorders Identification Test). In analysis, the AUDIT-C scoring was used as a measure of hazardous drinking, and we examined factors associated with patterns of alcohol use in logistic regression models. Among 580 women (median age: 28.1 years), 40% reported alcohol use during the 12 months prior to pregnancy, with alcohol use characterised by binge drinking and associated with single relationship status, experience of intimate partner violence (IPV), and lower levels of HIV-related stigma. Of this group, 65% had AUDIT-C scores suggesting hazardous alcohol use, with hazardous alcohol users more likely to report having experienced IPV and having higher levels of education. Among hazardous alcohol users, 70% subsequently reported reduced levels of consumption during pregnancy. Factors independently associated with reduced consumption included earlier gestation when entering antenatal care and report of a better patient-healthcare provider relationship. These unique data provide important insights into alcohol use trajectories in this context, and highlight the urgent need for an increased focus on screening and intervention at primary care level. Copyright © 2017 Elsevier B.V. All rights reserved.

  7. The relevance of social contexts and social action in reducing substance use and victimization among women participating in an HIV prevention intervention in Cape Town, South Africa.

    PubMed

    Reed, Elizabeth; Emanuel, Andrea N; Myers, Bronwyn; Johnson, Kim; Wechsberg, Wendee M

    2013-01-01

    To examine qualitatively how women's social context and community mobilization (eg, mobilizing women to take social action and engaging their community in social change) influence substance use abstinence and victimization among women participating in a human immunodeficiency virus (HIV) intervention in Cape Town, South Africa. Thirty women who had participated in a randomized controlled trial of a group-delivered intervention to address substance use, gender-based violence, and associated risk for HIV (The Women's Health CoOp) were selected to participate in semi-structured interviews about their perceived impact of the intervention on their substance use and exposure to victimization. The Women's CoOp intervention involved creating a new positive social environment for women within a group setting that also fostered women's social action (eg, educating peers or family members) in the community. Interviews were analyzed using content analysis and coded to examine women's descriptions of social contexts and social action, and the influence of these on women's substance use abstinence and exposure to victimization. Social support (eg, via program staff and other participants) and social action (eg, engaging others in the community on issues relevant to substance use prevention or other health topics) promoted within the program, as well as outside social influences within women's life contexts (eg, support from non-substance using family or male partners, leaving male partners or other peer relationships characterized by drug use, or finding employment) were key factors reported by women in terms of facilitating their substance use abstinence and in reducing women's exposures to victimization. Findings highlight the potential for group-delivered interventions that include mobilizing women to take social action in the larger community to be effective approaches for facilitating substance use abstinence, reductions in victimization, and ultimately, to address the

  8. Implementation and Operational Research: Community-Based Adherence Clubs for the Management of Stable Antiretroviral Therapy Patients in Cape Town, South Africa: A Cohort Study.

    PubMed

    Grimsrud, Anna; Lesosky, Maia; Kalombo, Cathy; Bekker, Linda-Gail; Myer, Landon

    2016-01-01

    Community-based models of antiretroviral therapy (ART) delivery are widely discussed as a priority in the expansion of HIV treatment services, but data on their effectiveness are limited. We examined outcomes of ART patients decentralized to community-based adherence clubs (CACs) in Cape Town, South Africa and compared these to patients managed in the community health center. The analysis included 8150 adults initiating ART from 2002 to 2012 in a public sector service followed until the end of 2013. From June 2012, stable patients (on ART >12 months, suppressed viral load) were referred to CACs. Loss to follow-up (LTFU) was compared between services using proportional hazards models with time-varying covariates and inverse probability weights of CAC participation. Of the 2113 CAC patients (71% female, 7% youth ages ≤ 24 years), 94% were retained on ART after 12 months. Among CAC patients, LTFU [adjusted hazard ratio (aHR): 2.17, 95% confidence interval (CI): 1.26 to 3.73 ] and viral rebound (aHR 2.24, 95% CI: 1.00 to 5.04) were twice as likely in youth (16-24 years old) compared with older patients, but no difference in the risk of LTFU or viral rebound was observed by sex (P-values 0.613 and 0.278, respectively). CAC participation was associated with a 67% reduction in the risk of LTFU (aHR: 0.33, 95% CI: 0.27 to 0.40) compared with community health centre, and this association persisted when stratified by patient demographic and clinic characteristics. CACs are associated with reduced risk of LTFU compared with facility-based care. Community-based models represent an important development to facilitate ART delivery and possibly improve patient outcomes.

  9. Pregnancy intent among a sample of recently diagnosed HIV-positive women and men practicing unprotected sex in Cape Town, South Africa.

    PubMed

    Mantell, Joanne E; Exner, Theresa M; Cooper, Diane; Bai, Dan; Leu, Cheng-Shiun; Hoffman, Susie; Myer, Landon; Moodley, Jennifer; Kelvin, Elizabeth A; Constant, Debbie; Jennings, Karen; Zweigenthal, Virginia; Stein, Zena A

    2014-12-01

    Sexual and reproductive health (SRH) services for HIV-positive women and men often neglect their fertility desires. We examined factors associated with pregnancy intent among recently diagnosed HIV-positive women (N = 106) and men (N = 91) who reported inconsistent condom use and were enrolled in an SRH intervention conducted in public sector HIV care clinics in Cape Town. Participants were recruited when receiving their first CD4 results at the clinic. All reported unprotected sex in the previous 3 months. Logistic regression identified predictors of pregnancy intent for the total sample and by gender. About three fifths of men and one fifth of women reported intent to conceive in the next 6 months. In the full-sample multiple regression analysis, men [adjusted odds ratio (AOR = 6.62)] and those whose main partner shared intent to conceive (AOR = 3.80) had significantly higher odds of pregnancy intent; those with more years of education (AOR = 0.81) and more biological children (AOR = 0.62) had lower odds of intending pregnancy. In gender-specific analyses, partner sharing pregnancy intent was positively associated with intent among both men (AOR = 3.53) and women (AOR = 13.24). Among men, odds were lower among those having more biological children (AOR = 0.71) and those unemployed (AOR = 0.30). Among women, relying on hormonal contraception was negatively associated with intent (AOR = 0.08), and main partner knowing her HIV status (AOR = 5.80) was positively associated with intent to conceive. Findings underscore the importance of providing integrated SRH services, and we discuss implications for clinical practice and care.

  10. Depression, alcohol use, and stigma in younger versus older HIV-infected pregnant women initiating antiretroviral therapy in Cape Town, South Africa.

    PubMed

    Wong, Marcia; Myer, Landon; Zerbe, Allison; Phillips, Tamsin; Petro, Greg; Mellins, Claude A; Remien, Robert H; Shiau, Stephanie; Brittain, Kirsty; Abrams, Elaine J

    2017-02-01

    HIV-infected pregnant women in sub-Saharan Africa are at risk for depression and alcohol abuse. Young women may be more vulnerable, but little is known about the psychosocial functioning of this population. We compared younger (18-24 years old) and older (≥25 years old) HIV-infected pregnant women initiating antiretroviral therapy (ART) in Cape Town, South Africa. Women were assessed on a range of psychosocial measures, including the Alcohol Use Disorders Identification Test and the Edinburgh Postnatal Depression Scale (EPDS). Among 625 women initiating ART, 16 % reported risky alcohol use and 21 % alcohol-related harm; these percentages were similar across age groups. When younger women were stratified by age, 37 % of 18-21 years old versus 20 % of 22-24 years old reported alcohol-related harm (p = 0.02). Overall, 11 % of women had EPDS scores suggesting probable depression, and 6 % reported self-harming thoughts. Younger women reported more depressive symptoms. Report of self-harming thoughts was 11 % in younger and 4 % in older women (p = 0.002). In multivariable analysis, age remained significantly associated with depressive symptoms and report of self-harming thoughts. Level of HIV-related stigma and report of intimate partner violence modified the association between age and depressive symptoms. Young HIV-infected pregnant women in South Africa were more likely to report depressive symptoms and self-harming thoughts compared to older women, and the youngest women reported the highest levels of alcohol-related harm. HIV-related stigma and intimate partner violence may be moderating factors. These findings have implications for maternal and infant health, underscoring the urgent need for effective targeted interventions in this vulnerable population.

  11. A High Burden of Hypertension in the Urban Black Population of Cape Town: The Cardiovascular Risk in Black South Africans (CRIBSA) Study

    PubMed Central

    Peer, Nasheeta; Steyn, Krisela; Lombard, Carl; Gwebushe, Nomonde; Levitt, Naomi

    2013-01-01

    Objective To determine the prevalence, associations and management of hypertension in the 25–74-year-old urban black population of Cape Town and examine the change between 1990 and 2008/09 in 25–64-year-olds. Methods In 2008/09, a representative cross-sectional sample, stratified for age and sex, was randomly selected from the same townships sampled in 1990. Cardiovascular disease risk factors were determined by administered questionnaires, clinical measurements and fasting biochemical analyses. Logistic regression models evaluated the associations with hypertension. Results There were 1099 participants, 392 men and 707 women (response rate 86%) in 2008/09. Age-standardised hypertension prevalence was 38.9% (95% confidence interval (CI): 35.6–42.3) with similar rates in men and women. Among 25–64-year-olds, hypertension prevalence was significantly higher in 2008/09 (35.6%, 95% CI: 32.3–39.0) than in 1990 (21.6%, 95% CI: 18.6–24.9). In 2008/09, hypertension odds increased with older age, family history of hypertension, higher body mass index, problematic alcohol intake, physical inactivity and urbanisation. Among hypertensive participants, significantly more women than men were detected (69.5% vs. 32.7%), treated (55.7% vs. 21.9%) and controlled (32.4% vs. 10.4%) in 2008/09. There were minimal changes from 1990 except for improved control in 25–64-year-old women (1990∶14.1% vs. 2008/09∶31.5%). Conclusions The high and rising hypertension burden in this population, its association with modifiable risk factors and the sub-optimal care provided highlight the urgent need to prioritise hypertension management. Innovative solutions with efficient and cost-effective healthcare delivery as well as population-based strategies are required. PMID:24250798

  12. Pregnancy Intent Among a Sample of Recently Diagnosed HIV-Positive Women and Men Practicing Unprotected Sex in Cape Town, South Africa

    PubMed Central

    Exner, Theresa M.; Cooper, Diane; Bai, Dan; Leu, Cheng-Shiun; Hoffman, Susie; Myer, Landon; Moodley, Jennifer; Kelvin, Elizabeth A.; Constant, Debbie; Jennings, Karen; Zweigenthal, Virginia; Stein, Zena A.

    2014-01-01

    Background: Sexual and reproductive health (SRH) services for HIV-positive women and men often neglect their fertility desires. We examined factors associated with pregnancy intent among recently diagnosed HIV-positive women (N = 106) and men (N = 91) who reported inconsistent condom use and were enrolled in an SRH intervention conducted in public sector HIV care clinics in Cape Town. Methods: Participants were recruited when receiving their first CD4+ results at the clinic. All reported unprotected sex in the previous 3 months. Logistic regression identified predictors of pregnancy intent for the total sample and by gender. Results: About three fifths of men and one fifth of women reported intent to conceive in the next 6 months. In the full-sample multiple regression analysis, men [adjusted odds ratio (AOR = 6.62)] and those whose main partner shared intent to conceive (AOR = 3.80) had significantly higher odds of pregnancy intent; those with more years of education (AOR = 0.81) and more biological children (AOR = 0.62) had lower odds of intending pregnancy. In gender-specific analyses, partner sharing pregnancy intent was positively associated with intent among both men (AOR = 3.53) and women (AOR = 13.24). Among men, odds were lower among those having more biological children (AOR = 0.71) and those unemployed (AOR = 0.30). Among women, relying on hormonal contraception was negatively associated with intent (AOR = 0.08), and main partner knowing her HIV status (AOR = 5.80) was positively associated with intent to conceive. Conclusions: Findings underscore the importance of providing integrated SRH services, and we discuss implications for clinical practice and care. PMID:25436819

  13. Longitudinal developmental profile of children from low socio-economic circumstances in Cape Town, using the 1996 Griffiths Mental Development Scales

    PubMed Central

    Laughton, B; Springer, PE; Grove, D; Seedat, S; Cornell, M; Kidd, M; Madhi, SA; Cotton, MF

    2012-01-01

    Background The Griffiths Mental Development Scales (GMDS) have not been standardised in South African children Neurodevelopmental scores of infants from deprived environments decline with age, but there is no evidence on how young South African children from such backgrounds perform on serial assessments. Aim To describe the longitudinal developmental profile of infants from low socio-economic backgrounds at Tygerberg Children’s Hospital by comparing the GMDS scores performed at 10 - 12 months and 20 - 22 months. Methods Infants born to HIV-uninfected women attending the public service programme were recruited from a vaccine study in Cape Town, South Africa. The GMDS 0 - 2 years and a neurological examination were performed between 10 and 12 months and between 20 and 22 months. Results Thirty-one infants (14 girls, 17 boys) were assessed. Their mean (standard deviation (SD)) age was 11.6 (0.8) months and 21.0 (0.5) months at the first and second assessments, respectively. The mean (SD) general quotient decreased significantly from 107.3 (11.7) to 95.0 (11.0) (p<0.001). All sub-quotients decreased significantly except for locomotor. The hearing and language sub-quotient was most affected, with a decrease in mean quotients from 113.0 to 93.2 (p<0.001). There was no evidence of intercurrent events to explain the decline. Interpretation Scores on the GMDS of this group of children from low socio-economic backgrounds were normal at 11 months and, other than locomotor, decreased significantly at 21 months, with language the most affected. Further research is needed to determine the specific reasons for the decline. PMID:22984637

  14. The prevalence and functional impact of musculoskeletal conditions amongst clients of a primary health care facility in an under-resourced area of Cape Town.

    PubMed

    Parker, Romy; Jelsma, Jennifer

    2010-01-04

    The extent of disease burden of musculoskeletal conditions (MSC) not due to injury has not been well determined in sub-Saharan Africa. The 1999 Global Burden of Disease study estimated the prevalence of osteoarthritis and rheumatoid arthritis to be 150/100,000 compared to 1,500/100,000 in Europe. The objective of the study was to determine the prevalence of MSC and the functional implications in a sample of people attending community health centres in Cape Town, South Africa. A cross-sectional, descriptive study was conducted in clinics in two resource poor communities. Phase I consisted of screening and those who screened positive for peripheral or spinal joint pain went on to complete Phase II, which included the Stanford Health Assessment Questionnaire. 1005 people were screened in Phase I. Of these, 362 (36%) reported MSC not due to injury in the past three months. Those with MSC had higher rates of co-morbidities in every category than those without. The mean Disability Index for those with MSC was mild to moderate and moderate to severe in those over 55 years. Although the sample may not be representative of the general community, the prevalence is considerably greater than those reported elsewhere even when the population of the catchment area is used as a denominator, (367/100 000). The common presentation of MSC with co-morbid diabetes and hypertension requires holistic management by appropriately trained health care practitioners. Any new determination of burden of disease due to MSC should recognise that these disorders may be more prevalent in developing countries than previously estimated.

  15. Longitudinal developmental profile of children from low socio-economic circumstances in Cape Town, using the 1996 Griffiths Mental Development Scales.

    PubMed

    Laughton, B; Springer, Pe; Grove, D; Seedat, S; Cornell, M; Kidd, M; Madhi, Sa; Cotton, Mf

    2010-12-01

    BACKGROUND: The Griffiths Mental Development Scales (GMDS) have not been standardised in South African children Neurodevelopmental scores of infants from deprived environments decline with age, but there is no evidence on how young South African children from such backgrounds perform on serial assessments. AIM: To describe the longitudinal developmental profile of infants from low socio-economic backgrounds at Tygerberg Children's Hospital by comparing the GMDS scores performed at 10 - 12 months and 20 - 22 months. METHODS: Infants born to HIV-uninfected women attending the public service programme were recruited from a vaccine study in Cape Town, South Africa. The GMDS 0 - 2 years and a neurological examination were performed between 10 and 12 months and between 20 and 22 months. RESULTS: Thirty-one infants (14 girls, 17 boys) were assessed. Their mean (standard deviation (SD)) age was 11.6 (0.8) months and 21.0 (0.5) months at the first and second assessments, respectively. The mean (SD) general quotient decreased significantly from 107.3 (11.7) to 95.0 (11.0) (p<0.001). All sub-quotients decreased significantly except for locomotor. The hearing and language sub-quotient was most affected, with a decrease in mean quotients from 113.0 to 93.2 (p<0.001). There was no evidence of intercurrent events to explain the decline. INTERPRETATION: Scores on the GMDS of this group of children from low socio-economic backgrounds were normal at 11 months and, other than locomotor, decreased significantly at 21 months, with language the most affected. Further research is needed to determine the specific reasons for the decline.

  16. Suicidal ideation and behaviour among persons seeking HIV testing in peri-urban areas of Cape Town, South Africa: a lost opportunity for suicide prevention.

    PubMed

    Bantjes, Jason; Kagee, Ashraf; Saal, Wylene

    2016-12-28

    Suicidal ideation and behaviour (SIB) are among the psychiatric sequela of HIV/AIDS. Few studies have however examined the prevalence and correlates of SIB among persons seeking HIV testing. We set out to document the prevalence and correlates of SIB among people seeking HIV testing in peri-urban areas of Cape Town, South Africa (SA). A cross-sectional research design was used to recruit a sample (n = 500) of individuals seeking HIV testing. Self-report measures were used to assess two-week prevalence of SIB as well as life-time prevalence of suicide attempt. A structured clinical interview was used to assess common mental disorders (CMDs). Regression analysis was used to determine if CMD and socio-demographic variables predicted suicidal ideation. The mean age of the sample was 36 years, 51.6% were female and 46.6% were unemployed. The two-week prevalence of suicidal ideation was 24.27% while the two-week prevalence of suicide attempt and suicide plans was 2.8%. Suicidal ideation was not associated with age, gender, employment status, family income or household food insecurity. CMDs were significantly associated with suicidal ideation; individuals with depressive disorders were approximately 5.5 times more likely to report suicidal ideation, while those with generalised anxiety disorder, trauma-related disorders and alcohol use disorder were approximately 7, 4.7 and 2.8 times more likely to report suicidal ideation, respectively. Results suggest that persons seeking HIV testing may be a well-delineated group of persons at risk of suicide in this region of SA. Contact with the health care system during HIV testing provides an opportunity for targeted suicide prevention interventions in what appears to be a high risk group.

  17. Addiction and treatment experiences among active methamphetamine users recruited from a township community in Cape Town, South Africa: a mixed-methods study

    PubMed Central

    Meade, Christina S.; Towe, Sheri L.; Watt, Melissa H.; Lion, Ryan R.; Myers, Bronwyn; Skinner, Donald; Kimani, Stephen; Pieterse, Desiree

    2015-01-01

    Background Since 2000, there has been a dramatic increase in methamphetamine use in South Africa, but little is known about the experiences of out-of-treatment users. This mixed-methods study describes the substance use histories, addiction symptoms, and treatment experiences of a community-recruited sample of methamphetamine users in Cape Town. Methods Using respondent driven sampling, 360 methamphetamine users (44% female) completed structured clinical interviews to assess substance abuse and treatment history and computerized surveys to assess drug-related risks. A sub-sample of 30 participants completed in-depth interviews to qualitatively explore experiences with methamphetamine use and drug treatment. Results Participants had used methamphetamine for an average of 7.06 years (SD=3.64). They reported using methamphetamine on an average of 23.49 of the past 30 days (SD=8.90); 60% used daily. The majority (90%) met ICD-10 criteria for dependence, and many reported severe social, financial, and legal consequences. While only 10% had ever received drug treatment, 90% reported that they wanted treatment. In the qualitative interviews, participants reported multiple barriers to treatment, including beliefs that treatment is ineffective and relapse is inevitable in their social context. They also identified important motivators, including desires to be drug free and improve family functioning. Conclusion This study yields valuable information to more effectively respond to emerging methamphetamine epidemics in South Africa and other low- and middle-income countries. Interventions to increase uptake of evidence-based services must actively seek out drug users and build motivation for treatment, and offer continuing care services to prevent relapse. Community education campaigns are also needed. PMID:25977205

  18. Tuberculosis Disease during Pregnancy and Treatment Outcomes in HIV-Infected and Uninfected Women at a Referral Hospital in Cape Town

    PubMed Central

    Bekker, Adrie; Schaaf, Hendrik S.; Draper, Heather R.; Kriel, Magdalena; Hesseling, Anneke C.

    2016-01-01

    Background Tuberculosis during pregnancy and treatment outcomes are poorly defined in high prevalence tuberculosis and HIV settings. Methods A prospective cohort study of pregnant and postpartum women identified to be routinely on antituberculosis treatment was conducted at Tygerberg Hospital, Cape Town, South Africa, from January 2011 through December 2011. Maternal tuberculosis disease spectrum and tuberculosis-exposed newborns were characterized by maternal HIV status. Maternal tuberculosis treatment outcomes were documented and a multivariable regression model identified predictors of unfavourable tuberculosis treatment outcomes. Infant outcomes were also described. Results Seventy-four women with tuberculosis, 53 (72%) HIV-infected, were consecutively enrolled; 35 (47%) were diagnosed at delivery or postpartum and 22 (30%) of women reported previous antituberculosis treatment. HIV-infected women were 5.67 times more likely to have extrapulmonary tuberculosis (95% CI 1.18–27.25, p = 0.03). All 5 maternal deaths were amongst HIV-infected women. Birth outcomes were available for 75 newborns (2 sets of twins, missing data for 1 stillbirth). Of the 75 newborns, 49 (65%) were premature and 44 (59%) were low birth weight (LBW; <2500 grams). All 6 infants who died and the 4 stillbirths were born to HIV-infected women. Unfavourable tuberculosis treatment outcomes were documented in 33/74 (45%) women. Unfavourable maternal tuberculosis outcome was associated with delivery of LBW infants (OR 3.83; 95% CI 1.40–10.53, p = 0.009). Conclusions A large number of pregnant women with tuberculosis presented at a provincial referral hospital. All maternal and infant deaths occurred in HIV-infected women and their newborns. Maternal tuberculosis treatment outcomes were poor. PMID:27812086

  19. ‘A Thing Full of Stories’: Traditional healers’ explanations of epilepsy and perspectives on collaboration with biomedical health care in Cape Town

    PubMed Central

    Keikelame, Mpoe Johannah; Swartz, Leslie

    2015-01-01

    The experience of epilepsy is profoundly culturally mediated and the meanings attributed to the condition can have a great impact on its social course. This qualitative study used Kleinman’s Explanatory Model framework to explore traditional healers’ perspectives on epilepsy in an urban township in Cape Town, South Africa. The healers who participated in the study were Xhosa-speaking, had experience caring for patients with epilepsy, and had not received any training on epilepsy. Six individual in-depth interviews and one focus group with nine traditional healers were conducted using a semi-structured interview guide. Traditional healers identified several different names referring to epilepsy. They explained epilepsy as a thing inside the body which is recognized by the way it presents itself during an epileptic seizure. According to these healers, epilepsy is difficult to understand because it is not easily detectable. Their biomedical explanations of the cause of epilepsy included, among others, lack of immunizations, child asphyxia, heredity, traumatic birth injuries and dehydration. These healers believed that epilepsy could be caused by amafufunyana (evil spirits) and that biomedical doctors could not treat the supernatural causes of epilepsy. However, the healers believed that western medicines, as well as traditional medicines, could be effective in treating the epileptic seizures. Traditional healers were supportive of collaboration with western-trained practitioners and highlighted that the strategy must have formal agreements in view of protection of intellectual property, accountability and respect of their indigenous knowledge. The findings suggest a need for interventions that promote cultural literacy among mental health practitioners. Research is urgently needed to assess the impact of such collaborations between biomedical services and traditional healers on epilepsy treatment and care. PMID:25680366

  20. Activated carbon fiber felt and polymer fiber as biofilm carrier in a modified University of Cape Town process for sewage treatment.

    PubMed

    Zhou, Dongkai

    2013-01-01

    Biofilms on fiber-based carriers have attracted much concern in wastewater treatment processes recently. In this study: (1) a novel sandwich structure fiber-based biofilm carrier was produced, which consisted of an inner core composed of polyacrylonitrile-based activated carbon fiber felt (PAN-ACFF) and an outer coat made of polyester reticular cloth with polypropylene fiber loops; (2) the novel carrier was filled in a step-feeding pilot-scale modified University of Cape Town process (MUCT) for sewage treatment; the MUCT contained a series of pre-anoxic/anaerobic/anoxic-1/anoxic-2/oxic tanks, wherein nitrification liquor was recycled to the anoxic-2 tank and an extra liquor return from the anoxic-1 to the pre-anoxic tank was set up; and (3) the removal efficiencies of chemical oxygen demand (COD), total nitrogen (TN) and total phosphorus (TP) were continuously tested for two periods as operational parameters alternated. The optimum values were collected in Period II, when the influent loads were 2,100.6 ± 120.3 gCOD/(d m(3)), 205.5 ± 20.4 gTN/(d m(3)), 39.9 ± 3.9 gTP/(d m(3)), the removal percentages were 93.1 ± 1.1% of COD, 39.4 ± 3.5% of TN, and 84.6 ± 3.4% of TP. For COD, NH4(+)-N, and TP, the specific removal loads of filler were 291.5 ± 18.2, 22.9 ± 3.1, 4.8 ± 0.5 (g d)/kg.

  1. Addiction and treatment experiences among active methamphetamine users recruited from a township community in Cape Town, South Africa: A mixed-methods study.

    PubMed

    Meade, Christina S; Towe, Sheri L; Watt, Melissa H; Lion, Ryan R; Myers, Bronwyn; Skinner, Donald; Kimani, Stephen; Pieterse, Desiree

    2015-07-01

    Since 2000, there has been a dramatic increase in methamphetamine use in South Africa, but little is known about the experiences of out-of-treatment users. This mixed-methods study describes the substance use histories, addiction symptoms, and treatment experiences of a community-recruited sample of methamphetamine users in Cape Town. Using respondent driven sampling, 360 methamphetamine users (44% female) completed structured clinical interviews to assess substance abuse and treatment history and computerized surveys to assess drug-related risks. A sub-sample of 30 participants completed in-depth interviews to qualitatively explore experiences with methamphetamine use and drug treatment. Participants had used methamphetamine for an average of 7.06 years (SD=3.64). They reported using methamphetamine on an average of 23.49 of the past 30 days (SD=8.90); 60% used daily. The majority (90%) met ICD-10 criteria for dependence, and many reported severe social, financial, and legal consequences. While only 10% had ever received drug treatment, 90% reported that they wanted treatment. In the qualitative interviews, participants reported multiple barriers to treatment, including beliefs that treatment is ineffective and relapse is inevitable in their social context. They also identified important motivators, including desires to be drug free and improve family functioning. This study yields valuable information to more effectively respond to emerging methamphetamine epidemics in South Africa and other low- and middle-income countries. Interventions to increase uptake of evidence-based services must actively seek out drug users and build motivation for treatment, and offer continuing care services to prevent relapse. Community education campaigns are also needed. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

  2. Rapid assessment of drug use and sexual HIV risk patterns among vulnerable drug-using populations in Cape Town, Durban and Pretoria, South Africa.

    PubMed

    Parry, Charles; Petersen, Petal; Carney, Tara; Dewing, Sarah; Needle, Richard

    2008-09-01

    This exploratory study examines the links between drug use and high-risk sexual practices and HIV in vulnerable drug-using populations in South Africa, including commercial sex workers (CSWs), men who have sex with men (MSM), injecting drug users (IDUs) and non-injecting drug users who are not CSWs or MSM (NIDUs). A rapid assessment ethnographic study was undertaken using observation, mapping, key informant interviews and focus groups in known 'hotspots' for drug use and sexual risk in Cape Town, Durban and Pretoria. Key informant (KI) and focus group interviews involved drug users and service providers. Purposeful snowball sampling and street intercepts were used to recruit drug users. Outcome measures included drug-related sexual HIV risk behaviour, and risk behaviour related to injection drug use, as well as issues related to service use. HIV testing of drug-using KIs was conducted using the SmartCheck Rapid HIV-1 Antibody Test. Non-injection drug use (mainly cannabis, methaqualone, crack cocaine and crystal methamphetamine) and injection drug use (mainly heroin) was occurring in these cities. Drug users report selling sex for money to buy drugs, and CSWs used drugs before, during and after sex. Most (70%) of the drug-using KIs offered HIV testing accepted and 28% were positive, with rates highest among CSWs and MSM. IDUs reported engaging in needle sharing and needle disposal practices that put them and others at risk for contracting HIV. There was a widespread lack of awareness about where to access HIV treatment and preventive services, and numerous barriers to accessing appropriate HIV and drug-intervention services were reported. Multiple risk behaviours of vulnerable populations and lack of access to HIV prevention services could accelerate the diffusion of HIV. Targeted interventions could play an important role in limiting the spread of HIV in and through these under-reached and vulnerable populations.

  3. The Relationship of Alcohol and Other Drug Use Typologies to Sex Risk Behaviors among Vulnerable Women in Cape Town, South Africa.

    PubMed

    Wechsberg, Wendee M; Myers, Bronwyn; Kline, Tracy L; Carney, Tara; Browne, Felicia A; Novak, Scott P

    2012-07-20

    BACKGROUND: Alcohol and other drug (AOD) use remains an important contributing factor to the spread of HIV in South Africa, mainly because of the strong associations found between AOD use and sex risk behaviors. Specifically, AOD use can lead to disinhibition and impaired judgment that may result in inconsistent condom use and other risky sex behaviors among vulnerable and disempowered women. METHODS: Latent Class Analysis was used to identify AOD use typologies among 720 vulnerable women from a randomized trial baseline assessment in Cape Town, South Africa and to examine whether these AOD use classes predict sex risk for HIV. RESULTS: Three classes emerged with distinct differences in AOD use: the Marijuana and Alcohol class (34.6%) mainly comprised participants who used marijuana and drank alcohol frequently; the High AOD Risk class (26.1%) mainly comprised participants who used methamphetamine and marijuana, reported heavy drinking, and moderate probabilities of Mandrax use; and the Polydrug use class (39.3%) predominately comprised participants who used methamphetamine, marijuana, and Mandrax. Participants in the Marijuana and Alcohol class were less likely to report past-month unprotected sex with their main sex partner compared with participants in the Polydrug Use class. When examining the adjusted model, Black African women were significantly less likely to report past-month unprotected sex with their main sex partner compared with Coloured women. Women who were HIV negative were more likely to report unprotected sex with their main sex partner than women who were HIV positive. CONCLUSION: The fewer substances that women used seemed to serve as protective factors against engaging in AOD-impaired sex. This study provides an important contribution to understand the intersection of AOD use and sexual risk for HIV by measuring polydrug use among vulnerable women and its association with sexual risk taking.

  4. Tuberculosis Disease during Pregnancy and Treatment Outcomes in HIV-Infected and Uninfected Women at a Referral Hospital in Cape Town.

    PubMed

    Bekker, Adrie; Schaaf, Hendrik S; Draper, Heather R; Kriel, Magdalena; Hesseling, Anneke C

    2016-01-01

    Tuberculosis during pregnancy and treatment outcomes are poorly defined in high prevalence tuberculosis and HIV settings. A prospective cohort study of pregnant and postpartum women identified to be routinely on antituberculosis treatment was conducted at Tygerberg Hospital, Cape Town, South Africa, from January 2011 through December 2011. Maternal tuberculosis disease spectrum and tuberculosis-exposed newborns were characterized by maternal HIV status. Maternal tuberculosis treatment outcomes were documented and a multivariable regression model identified predictors of unfavourable tuberculosis treatment outcomes. Infant outcomes were also described. Seventy-four women with tuberculosis, 53 (72%) HIV-infected, were consecutively enrolled; 35 (47%) were diagnosed at delivery or postpartum and 22 (30%) of women reported previous antituberculosis treatment. HIV-infected women were 5.67 times more likely to have extrapulmonary tuberculosis (95% CI 1.18-27.25, p = 0.03). All 5 maternal deaths were amongst HIV-infected women. Birth outcomes were available for 75 newborns (2 sets of twins, missing data for 1 stillbirth). Of the 75 newborns, 49 (65%) were premature and 44 (59%) were low birth weight (LBW; <2500 grams). All 6 infants who died and the 4 stillbirths were born to HIV-infected women. Unfavourable tuberculosis treatment outcomes were documented in 33/74 (45%) women. Unfavourable maternal tuberculosis outcome was associated with delivery of LBW infants (OR 3.83; 95% CI 1.40-10.53, p = 0.009). A large number of pregnant women with tuberculosis presented at a provincial referral hospital. All maternal and infant deaths occurred in HIV-infected women and their newborns. Maternal tuberculosis treatment outcomes were poor.

  5. Toxin A-negative toxin B-positive ribotype 017 Clostridium difficile is the dominant strain type in patients with diarrhoea attending tuberculosis hospitals in Cape Town, South Africa.

    PubMed

    Kullin, B; Wojno, J; Abratt, V; Reid, S J

    2017-01-01

    The molecular epidemiology of C. difficile strains causing disease in South Africa is currently unknown. Previously, multidrug resistant ribotype (RT)017 strains were those most commonly isolated from patients with diarrhoea attending Groote Schuur Hospital in Cape Town, South Africa. This larger study aimed to investigate the molecular epidemiology and antibiotic susceptibility profiles of C. difficile strains in the greater Cape Town and regional areas. C. difficile strains were isolated from patients with diarrhoea attending hospitals in the Western Cape region of South Africa that tested positive using the GeneXpert CDiff diagnostic test. Ribotyping and multilocus variable-number tandem-repeat analysis (MLVA) were used to type isolates, and their susceptibilities to several antibiotics were determined by gradient diffusion test strips. A total of 269 non-repeat C. difficile isolates were obtained. A large proportion of isolates (64.3 %) belonged to the RT017 group, many of which were clonally related when investigated by MLVA. RT017 strains were particularly prevalent in patients attending specialist tuberculosis (TB) hospitals. The majority of RT017 isolates were co-resistant to moxifloxacin and rifampicin, two antibiotics which are used intensively during anti-TB therapy. Non-RT017 strains were generally susceptible to both antibiotics. Resistance to erythromycin was observed for both groups of strains. RT017 C. difficile strains are the most commonly isolated strains from patients attending healthcare facilities in the greater Cape Town and regional areas. The presence of multidrug resistant RT017 strains in patients with diarrhoea attending local TB hospitals reflects a potential reservoir for future infections.

  6. 76 FR 27970 - Safety Zone; Cape Charles Fireworks, Cape Charles Harbor, Cape Charles, VA.

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-05-13

    ... in Cape Charles, VA in support of the Fourth of July Fireworks event. This action is necessary to... notice. Basis and Purpose On July 3, 2011 the Town of Cape Charles will sponsor a fireworks display on... established in the vicinity of Cape Charles, VA from 9 p.m. to 10 p.m. on July 3, 2011, with a rain date of...

  7. Adherence to antiretroviral therapy in young children in Cape Town, South Africa, measured by medication return and caregiver self-report: a prospective cohort study

    PubMed Central

    Davies, Mary-Ann; Boulle, Andrew; Fakir, Tanzeem; Nuttall, James; Eley, Brian

    2008-01-01

    Background Antiretroviral therapy (ART) dramatically improves outcomes for children in Africa; however excellent adherence is required for treatment success. This study describes the utility of different measures of adherence in detecting lapses in infants and young children in Cape Town, South Africa. Methods In a prospective cohort of 122 HIV-infected children commenced on ART, adherence was measured monthly during the first year of treatment by medication return (MR) for both syrups and tablets/capsules. A questionnaire was administered to caregivers after 3 months of treatment to assess experience with giving medication and self-reported adherence. Viral and immune response to treatment were assessed at the end of one year and associations with measured adherence determined. Results Medication was returned for 115/122 (94%) children with median age (IQR) of 37 (16 – 61) months. Ninety-one (79%) children achieved annual average MR adherence ≥ 90%. This was an important covariate associated with viral suppression after adjustment for disease severity (OR = 5.5 [95%CI: 0.8–35.6], p = 0.075), however was not associated with immunological response to ART. By 3 months on ART, 13 (10%) children had deceased and 11 (10%) were lost to follow-up. Questionnaires were completed by 87/98 (90%) of caregivers of those who remained in care. Sensitivity of poor reported adherence (missing ≥ 1 dose in the previous 3 days) for MR adherence <90% was only 31.8% (95% CI: 10.7% – 53.0%). Caregivers of 33/87 (38.4%) children reported difficulties with giving medication, most commonly poor palatability (21.8%). Independent socio-demographic predictors of MR adherence ≥ 90% were secondary education of caregivers (OR = 4.49; 95%CI: 1.10 – 18.24) and access to water and electricity (OR = 2.65; 95%CI: 0.93 – 7.55). Taking ritonavir was negatively associated with MR adherence ≥ 90% (OR = 0.37; 95%CI: 0.13 – 1.02). Conclusion Excellent adherence to ART is possible in

  8. High prevalence of metabolic syndrome in the Black population of Cape Town: The Cardiovascular Risk in Black South Africans (CRIBSA) study.

    PubMed

    Peer, Nasheeta; Lombard, Carl; Steyn, Krisela; Levitt, Naomi

    2015-08-01

    To determine the metabolic syndrome prevalence by the 2009 harmonised criteria in 25-74-year-old urban Africans in Cape Town. In 2008/2009, a representative cross-sectional sample, stratified by age and gender, was randomly selected. Cardiovascular risk factors were determined with questionnaires, clinical measurements and biochemical analyses, including fasting blood samples. Logistic regression analysis assessed the independent effects of socio-demographic variables on metabolic syndrome. There were 1099 participants, 392 of whom were men and 707 women (response rate 86%). Crude and age-standardised (SEGI) prevalence of metabolic syndrome was 30.7% (95% confidence interval (CI): 27.4-34.1) and 31.7% (95% CI: 28.4-35.3), respectively, with higher rates among women (43.5%, 95% CI: 39.2-47.9 and 44.9%, 95% CI: 40.5-49.3) than men (16.5%, 95% CI: 12.7-21.2 and 17.3%, 95% CI: 13.4-21.9) (p < 0.001). Overall, metabolic syndrome components that were higher in women compared with men were central obesity (86.0% vs. 20.1%) and low high-density lipoprotein cholesterol (75.0% vs. 33.4%) while in men, raised blood pressure (51.4%) was the most frequent. In the multiple logistic models, higher age (55-64 years (peak age) versus 25-34 years: odds ratio (OR): 7.35, 95% CI: 3.27-16.56, p < 0.001) and wealth (highest versus lowest tertile: OR: 1.87, 95% CI: 1.14-3.08, p = 0.014) in women, and higher age (p = 0.002) and employment compared with unemployment (OR: 3.01, 95% CI: 1.18-7.67, p = 0.021) in men were significantly associated with metabolic syndrome. The high metabolic syndrome prevalence underscores the frequent clustering of cardiovascular risk factors, the need to determine other risk factors, if a single risk factor is present, and the need for comprehensive integrated approaches to tackle cardiovascular disease. © The European Society of Cardiology 2014.

  9. Performance of re-used pacemakers and implantable cardioverter defibrillators compared with new devices at Groote Schuur Hospital in Cape Town, South Africa.

    PubMed

    Jama, Zimasa V; Chin, Ashley; Badri, Motasim; Mayosi, Bongani M

    2015-01-01

    Little is known about the performance of re-used pacemakers and implantable cardioverter defibrillators (ICDs) in Africa. We sought to compare the risk of infection and the rate of malfunction of re-used pacemakers and ICDs with new devices implanted at Groote Schuur Hospital in Cape Town, South Africa. This was a retrospective case comparison study of the performance of re-used pacemakers and ICDs in comparison with new devices implanted at Groote Schuur Hospital over a 10-year period. The outcomes were incidence of device infection, device malfunction, early battery depletion, and device removal due to infection, malfunction, or early battery depletion. Data for 126 devices implanted in 126 patients between 2003 and 2013 were analysed, of which 102 (81%) were pacemakers (51 re-used and 51 new) and 24 (19%) were ICDs (12 re-used and 12 new). There was no device infection, malfunction, early battery depletion or device removal in either the re-used or new pacemaker groups over the median follow up of 15.1 months [interquartile range (IQR), 1.3-36.24 months] for the re-used pacemakers, and 55.8 months (IQR, 20.3-77.8 months) for the new pacemakers. In the ICD group, no device infection occurred over a median follow up of 35.9 months (IQR, 17.0-70.9 months) for the re-used ICDs and 45.7 months (IQR, 37.6-53.7 months) for the new ICDs. One device delivered inappropriate shocks, which resolved without intervention and with no harm to the patient. This re-used ICD subsequently needed generator replacement 14 months later. In both the pacemaker and ICD groups, there were no procedure-non-related infections documented for the respective follow-up periods. No significant differences were found in performance between re-used and new pacemakers and ICDs with regard to infection rates, device malfunction, battery life and device removal for complications. Pacemaker and ICD re-use is feasible and safe and is a viable option for patients with bradyarrhythmias and

  10. The impact of provider-initiated (opt-out) HIV testing and counseling of patients with sexually transmitted infection in Cape Town, South Africa: a controlled trial.

    PubMed

    Leon, Natalie; Naidoo, Pren; Mathews, Catherine; Lewin, Simon; Lombard, Carl

    2010-01-30

    The effectiveness of provider-initiated HIV testing and counseling (PITC) for patients with sexually transmitted infection (STI) in resource-constrained settings are of particular concern for high HIV prevalence countries like South Africa. This study evaluated whether the PITC approach increased HIV testing amongst patients with a new episode of sexually transmitted infection, as compared to standard voluntary counseling and testing (VCT) at the primary care level in South Africa, a high prevalence and low resource setting. The design was a pragmatic cluster-controlled trial with seven intervention and 14 control clinics in Cape Town. Nurses in intervention clinics integrated PITC into standard HIV care with few additional resources, whilst lay counselors continued with the VCT approach in control clinics. Routine data were collected for a six-month period following the intervention in 2007, on new STI patients who were offered and who accepted HIV testing. The main outcome measure was the proportion of new STI patients tested for HIV, with secondary outcomes being the proportions who were offered and who declined the HIV test. A significantly higher proportion of new STI patients in the intervention group tested for HIV as compared to the control group with (56.4% intervention versus 42.6% control, p = 0.037). This increase was achieved despite a significantly higher proportion intervention group declining testing when offered (26.7% intervention versus 13.5% control, p = 0.0086). Patients were more likely to be offered HIV testing in intervention clinics, where providers offered the HIV test to 76.8% of new STI patients versus 50.9% in the control group (p = 0.0029). There was significantly less variation in the main outcomes across the intervention clinics, suggesting that the intervention also facilitated more consistent performance. PITC was successful in three ways: it increased the proportion of new STI patients tested for HIV; it increased the proportion

  11. Quality of life in individuals living with HIV/AIDS attending a public sector antiretroviral service in Cape Town, South Africa.

    PubMed

    Nglazi, Mweete D; West, Sacha J; Dave, Joel A; Levitt, Naomi S; Lambert, Estelle V

    2014-07-03

    Health related quality of life (HRQoL) is an important outcome helping to understand the impact of antiretroviral therapy (ART). We examined and compared the HRQoL in relation to ART status among HIV-infected patients in a public sector service in Cape Town, South Africa. In addition, we aimed to examine the relationship between ART status and HRQoL according to CD4 count strata. A cross sectional study sample of 903 HIV-infected patients who were categorized as not receiving ART (ART-naïve) or receiving first-line ART for > 6 months (ART). HRQoL outcomes were compared in the two groups. HRQoL was assessed using the EQ-5D (five domains) and Visual Analogue Scale (EQ-5D VAS). Of the total sample, 435 were categorised as ART naïve (76% women) and 468 were on ART (78% women). There were no significant associations between groups for most of the EQ-5D domains, however ART-naïve experienced a significantly greater problem with mobility than the ART group. Being ART-naïve (adjusted odds ratio (aOR) 3.08 95% confidence interval (CI) 1.63- 7.89) and obese 2.78 (95% CI 1.24- 6.22) were identified as predictors for increased mobility problems in multivariate analysis. In addition, receiving ART (5.61 difference; 95% CI 2.50 - 8.72) and having some source of income (4.76; 95% CI 1.63 -7.89) were identified as predictors for a higher EQ-5D VAS score. When grouped according to CD4 count strata, there were no significant difference between groups for most of the EQ-5D domains, however the ART-naïve group indicated having significantly greater problems under the CD4 count of >500 cells/μL in the anxiety/depression domain (22.4% vs 8.8%, p = 0.018) and significantly lower EQ-5D VAS scores under the CD4 counts of ≤ 200 cells/μL (median 80 (IQR 60-90) vs 90 (IQR 80-100), p = 0.0003) and 201-350 cells/μL (median 80 (IQR 70-90) vs 90 (80-100), p = 0.0004) compared to ART group. HRQoL (self-rated health state) was improved with ART use, including those with immunocompromised

  12. An implementation science protocol of the Women's Health CoOp in healthcare settings in Cape Town, South Africa: A stepped-wedge design.

    PubMed

    Wechsberg, Wendee M; Ndirangu, Jacqueline W; Speizer, Ilene S; Zule, William A; Gumula, Winnifred; Peasant, Courtney; Browne, Felicia A; Dunlap, Laura

    2017-09-18

    HIV persists as a public health emergency in South Africa, especially among women of childbearing age. In response to the HIV epidemic, the Joint United Nations Programme on HIV/AIDS has put forth the 90-90-90 global goals to achieve an AIDS-free generation by 2020. This goal aspires to have 90% of people living with HIV diagnosed; 90% of those who test positive on sustained antiretroviral therapy (ART); and 90% of those on ART be virally suppressed. Ensuring access to ART is an important first step in reducing HIV incidence, especially among vulnerable populations such as women who use substances and bear the burden of HIV in South Africa. Additionally, alcohol and other drug (AOD) use and exposure to gender-based violence are associated with increased risk of HIV infection and reduced adherence to ART. However, no research has estimated ART adherence rates for women who use substances in South Africa since the government approved the provision of ART to all people living with HIV. The Women's Health CoOp (WHC) is an evidence-based, woman-focused, behavioral intervention that addresses the intersecting risks of AODs, sex behaviors, and violence and victimization, with the primary goal of increasing skills and knowledge to reduce substance abuse and HIV risks and to improve ART adherence. The WHC has been packaged for further dissemination. This article describes the study protocol used to assess the feasibility and acceptability of implementing the WHC intervention into standard of care in Cape Town health clinics and substance abuse rehabilitation centers to reduce HIV risk behavior and increase ART adherence among women who use substances and are living with HIV. Because few of the interventions that demonstrate efficacy for HIV prevention and ART adherence in randomized trials are sustainable, studies to adapt and test intervention variations are needed to determine the best strategies for implementing them in real-world, high-risk settings. However

  13. Sexual risk behavior, alcohol use, and social media use among secondary school students in informal settlements in Cape Town and Port Elizabeth, South Africa.

    PubMed

    Kaufman, Z A; Braunschweig, E N; Feeney, J; Dringus, S; Weiss, H; Delany-Moretlwe, S; Ross, D A

    2014-09-01

    South Africa's HIV prevalence among young people remains among the highest in the world. A cross-sectional study was carried out in 2012 to estimate prevalences of sexual risk behavior and hazardous alcohol use (HAU) (via the Alcohol Use Disorder Identification Test) as well as to investigate potential associations between these outcomes and social media use. In all, 4485 students (mean age 15.66 years, SD 1.39) at 46 secondary schools in informal settlements in Cape Town and Port Elizabeth completed mobile-phone-assisted, self-administered baseline questionnaires within a cluster-randomized trial. In all, 312 females (12.5 %) and 468 males (23.5 %) screened positive for HAU (AOR = 1.98, 95 % CI 1.69-2.34). 730 males (39.9 %) and 268 females (11.8 %) reported having had two or more partners in the last year (AOR = 3.46, 95 % CI 2.87-4.16). Among females, having a Facebook account was associated with reported multiple partnerships in the last year (AOR = 1.81, 95 % CI 1.19-2.74), age-disparate sex in the last year (AOR = 1.96, 95 % CI 1.16-3.32) and HAU (AOR = 1.97, 95 % CI 1.41-2.74). Using Mxit-a popular mobile instant messaging application-was associated with higher odds of reported multiple partnerships in the last year among both males (AOR = 1.70, 95 % CI 1.35-2.14) and females (AOR = 1.45, 95 % CI 1.07-1.96) and with HAU among both males (AOR = 1.47, 95 % CI 1.14-1.90) and females (AOR = 1.50, 95 % CI 1.18-1.90). Further longitudinal and qualitative research should explore in more depth the observed links between social media and risk behavior.

  14. Prevalence and socio-demographic correlates of physical activity levels among South African adults in Cape Town and Mount Frere communities in 2008-2009.

    PubMed

    Malambo, Pasmore; Kengne, Andre P; Lambert, Estelle V; De Villiers, Anniza; Puoane, Thandi

    2016-01-01

    Physical activity has been linked to reduced risk of various cardiometabolic disease, cancer, and premature mortality. We investigated the prevalence and socio-demographic correlates of physical activity among adults in urban and rural communities in South Africa. Methods: This was a cross-sectional survey comprising 1733 adults aged ≥35 years from the Cape Town (urban) and Mount Frere (rural) sites of the Prospective Urban Rural Epidemiology study. Physical activity was assessed using the validated International Physical Activity Questionnaire. Multinomial logistic regressions were used to relate physical activity with socio-demographic characteristics. Overall, 74% of participants engaged in moderate-to-vigorous physical activity. In the adjusted regression models, women were 34% less likely to engage in vigorous physical activity (OR =0.66, 95%-CI = 0.47-0.93). Physical activity decreased with age, varied with marital status, education and occupation, always in differential ways between urban and rural participants (all interactions p ≤ 0.047). For instance, in urban settings, those with secondary education were more likely to engage in moderate physical activity (OR = 2.06, 95%-CI = 1.08-3.92) than those with tertiary education. Single people were more likely to engage in high physical activity (OR = 2.10, 95%-CI = 1.03-4.28) than divorced. Overall, skilled participants were more likely to engage in vigorous physical activity (OR = 2.07, 95%-CI = 1.41-3.05) driven by significant effect in rural area (OR = 2.70, 95%-CI = 1.51-4.83). Urban participants were more likely to engage in moderate physical activity (OR = 1.67, 95%-CI = 1.31-2.13) than rural participants. To prevent chronic diseases among South Africans, attention should be paid to specific policies and interventions aimed at promoting PA among young adults in rural and urban setting, and across the social-economic diversity.

  15. Feasibility, Yield, and Cost of Active Tuberculosis Case Finding Linked to a Mobile HIV Service in Cape Town, South Africa: A Cross-sectional Study

    PubMed Central

    Kranzer, Katharina; Lawn, Stephen D.; Meyer-Rath, Gesine; Vassall, Anna; Raditlhalo, Eudoxia; Govindasamy, Darshini; van Schaik, Nienke; Wood, Robin; Bekker, Linda-Gail

    2012-01-01

    Background The World Health Organization is currently developing guidelines on screening for tuberculosis disease to inform national screening strategies. This process is complicated by significant gaps in knowledge regarding mass screening. This study aimed to assess feasibility, uptake, yield, treatment outcomes, and costs of adding an active tuberculosis case-finding program to an existing mobile HIV testing service. Methods and Findings The study was conducted at a mobile HIV testing service operating in deprived communities in Cape Town, South Africa. All HIV-negative individuals with symptoms suggestive of tuberculosis, and all HIV-positive individuals regardless of symptoms were eligible for participation and referred for sputum induction. Samples were examined by microscopy and culture. Active tuberculosis case finding was conducted on 181 days at 58 different sites. Of the 6,309 adults who accessed the mobile clinic, 1,385 were eligible and 1,130 (81.6%) were enrolled. The prevalence of smear-positive tuberculosis was 2.2% (95% CI 1.1–4.0), 3.3% (95% CI 1.4–6.4), and 0.4% (95% CI 1.4 015–6.4) in HIV-negative individuals, individuals newly diagnosed with HIV, and known HIV, respectively. The corresponding prevalence of culture-positive tuberculosis was 5.3% (95% CI 3.5–7.7), 7.4% (95% CI 4.5–11.5), 4.3% (95% CI 2.3–7.4), respectively. Of the 56 new tuberculosis cases detected, 42 started tuberculosis treatment and 34 (81.0%) completed treatment. The cost of the intervention was US$1,117 per tuberculosis case detected and US$2,458 per tuberculosis case cured. The generalisability of the study is limited to similar settings with comparable levels of deprivation and TB and HIV prevalence. Conclusions Mobile active tuberculosis case finding in deprived populations with a high burden of HIV and tuberculosis is feasible, has a high uptake, yield, and treatment success. Further work is now required to examine cost-effectiveness and affordability and

  16. Self-assessment of eligibility for early medical abortion using m-Health to calculate gestational age in Cape Town, South Africa: a feasibility pilot study.

    PubMed

    Momberg, Mariette; Harries, Jane; Constant, Deborah

    2016-04-16

    Although abortion is legally available in South Africa, barriers to access exist. Early medical abortion is available to women with a gestational age up to 63 days and timely access is essential. This study aimed to determine women's acceptability and ability to self-assess eligibility for early medical abortion using an online gestational age calculator. Women's acceptability, views and preferences of using mobile technology for gestational age (GA) determination were explored. No previous studies to ascertain the accuracy of online self-administered calculators in a non-clinical setting have been conducted. A convenience sample of abortion seekers were recruited from two health care clinics in Cape Town, South Africa in 2014. Seventy-eight women were enrolled and tasked with completing an online self-assessment by entering the first day of their last menstrual period (LMP) onto a website which calculated their GA. A short survey explored the feasibility and acceptability of employing m-Health technology in abortion services. Self-calculated GA was compared with ultrasound gestational age obtained from clinical records. Participant mean age was 28 (SD 6.8), 41% (32/78) had completed high school and 73% (57/78) reported owning a smart/feature phone. Internet searches for abortion information prior to clinic visit were undertaken by 19/78 (24%) women. Most participants found the online GA calculator easy to use (91%; 71/78); thought the calculation was accurate (86%; 67/78) and that it would be helpful when considering an abortion (94%; 73/78). Eighty-three percent (65/78) reported regular periods and recalled their LMP (71%; 55/78). On average women overestimated GA by 0.5 days (SD 14.5) and first sought an abortion 10 days (SD 14.3) after pregnancy confirmation. Timely access to information is an essential component of effective abortion services. Advances in the availability of mobile technology represent an opportunity to provide accurate and safe abortion

  17. Clinical characterisation and phylogeny of respiratory syncytial virus infection in hospitalised children at Red Cross War Memorial Children's Hospital, Cape Town.

    PubMed

    Oladokun, Regina; Muloiwa, Rudzani; Hsiao, Nei-Yuan; Valley-Omar, Ziyaad; Nuttall, James; Eley, Brian

    2016-05-31

    Respiratory syncytial virus (RSV) is a major cause of lower respiratory tract infection in young children in both the community and hospital setting. The clinical presentation, patient and phylogenetic characteristicsof laboratory-confirmed cases of RSV, as well as risk factors for nosocomial infectionat Red Cross War Memorial Children's Hospital in Cape Town were analysed. A multiplex PCR assay that detects 7 respiratory viruses was used to identify RSV nucleic acid on respiratory specimens. A total of 226 children were studied, ages ranging between 1 week and 92.5 months (median: 2.8 months, IQR: 1.3-6.3 months) and 51.8 % were males. The median duration of symptoms prior to diagnosis was 2 days (IQR: 1-4 days). Nosocomial infections wereidentified in 22 (9.7 %) children. There were pre-existing medical conditions in 113 (50.0 %) excluding HIV, most commonly prematurity (n = 58, 50.0 %) and congenital heart disease (n = 34, 29.3 %). The commonest presenting symptoms were cough (196, 86.7 %), difficulty in breathing (115, 50.9 %) and fever (91, 41.6 %).A case fatality rate of 0.9 % was recorded. RSV group A predominated (n = 181, 80.1 %) while group B accounted for only 45 (19.9 %) of the infections. The prevalent genotypes were NA1 (n = 127,70.1 %), ON1 (n = 45,24.9 %) and NA2 (n = 9,5.0 %) for group A while the only circulating RSV B genotype was BA4. There was no significant difference in the genotype distribution between the nosocomial and community-acquired RSV infections. Age ≥ 6 months was independently associated with nosocomial infection. A large percentage of children with RSV infection had pre-existing conditions. Approximately one tenth of the infections were nosocomial with age 6 months or older being a risk factor. Though both RSV groups co-circulated during the season, group A was predominant and included the novel ON1 genotype. Continued surveillance is necessary to identify prevalent and newly

  18. A Cross Sectional Analysis of Gonococcal and Chlamydial Infections among Men-Who-Have-Sex-with-Men in Cape Town, South Africa

    PubMed Central

    Kamkuemah, Monika

    2015-01-01

    Background Men-who-have-sex-with-men (MSM) are at high risk of HIV and sexually transmitted infection (STI) transmission. Asymptomatic STIs are common in MSM and remain undiagnosed and untreated where syndromic management is advocated. Untreated STIs could be contributing to high HIV rates. This study investigated symptomatic (SSTI) and asymptomatic STIs (ASTIs) in MSM in Cape Town. Methods MSM, 18 years and above, were enrolled into this study. Participants underwent clinical and microbiological screening for STIs. Urine, oro-pharyngeal and anal swab specimens were collected for STI analysis, and blood for HIV and syphilis screening. A psychosocial and sexual questionnaire was completed. STI specimens were analysed for Neisseria gonorrhoeae (NG) and Chlamydia trachomatis (CT) infection. Results 200 MSM were recruited with a median age of 32 years (IQR 26–39.5). Their median number of sex partners within the last year was 5 (IQR 2–20). 155/200 (78%) reported only male sex partners while 45/200 (23%) reported sex with men and women. 77/200 (39%) reported transactional sex. At enrolment, 88/200 (44%) were HIV positive and 8/112 (7%) initially HIV-negative participants seroconverted during the study. Overall, 47/200 (24%) screened positive for either NG or CT. There were 32 MSM (16%) infected with NG and 7 (3.5%) of these men had NG infections at two anatomical sites (39 NG positive results in total). Likewise, there were 23 MSM (12%) infected with CT and all these men had infections at only one site. Eight of the 47 men (17%) were infected with both NG and CT. ASTI was more common than SSTI irrespective of anatomical site, 38 /200 (19%) versus 9/200 (5%) respectively (p<0.001). The anus was most commonly affected, followed by the oro-pharynx and then urethra. Asymptomatic infection was associated with transgender identity (OR 4.09 CI 1.60–5.62), ≥5 male sex partners in the last year (OR 2.50 CI 1.16–5.62) and transactional sex (OR 2.33 CI 1.13–4.79) but

  19. Homophobic stigma, depression, self-efficacy and unprotected anal intercourse for peri-urban township men who have sex with men in Cape Town, South Africa: a cross-sectional association model.

    PubMed

    Tucker, Andrew; Liht, Jose; de Swardt, Glenn; Jobson, Geoffrey; Rebe, Kevin; McIntyre, James; Struthers, Helen

    2014-01-01

    While research now highlights that men who have sex with men (MSM) in places such as South Africa are at particular risk of HIV infection, left relatively unexplored are potential relationships between one of the most pressing social issues affecting peri-urban MSM - namely homophobic stigma - and sexual risk-taking behaviour. Drawing on research from the Ukwazana baseline study of 316 township MSM in Cape Town we examine how homophobic stigma relates to psychosocial factors such as depression and self-efficacy and the risk activity of unprotected anal intercourse (UAI). By deploying cross-sectional association models, we examine a series of relationships between these variables and offer evidence to suggest that HIV prevention programmes aimed at sexual minority groups should be mindful of potentially complex relationships between social stigmas such as homophobia and sexual risk-taking behaviour.

  20. Cost-effectiveness of a diabetes group education program delivered by health promoters with a guiding style in underserved communities in Cape Town, South Africa.

    PubMed

    Mash, Robert; Kroukamp, Roland; Gaziano, Tom; Levitt, Naomi

    2015-05-01

    This study aimed to evaluate the cost-effectiveness of a group diabetes education program delivered by health promoters in community health centers in the Western Cape, South Africa. The effectiveness of the education program was derived from the outcomes of a pragmatic cluster randomized controlled trial (RCT). Incremental operational costs of the intervention, as implemented in the trial, were calculated. All these data were entered into a Markov micro-simulation model to simulate clinical outcomes and health costs that were expressed as an Incremental Cost Effectiveness Ratio (ICER). The only significant effect from the RCT at one year was a reduction in blood pressure (systolic blood pressure -4.65 mmHg (95%CI:-9.18 to -0.12) and diastolic blood pressure -3.30 mmHg (95%CI:-5.35 to -1.26)). The ICER for the intervention, based on the assumption that the costs would recur every year and the effect could be maintained, was 1862 $/QALY gained. A structured group education program performed by mid-level trained healthcare workers at community health centers, for the management of Type II diabetes in the Western Cape, South Africa is therefore cost-effective. This cost-effectiveness analysis supports the more widespread implementation of this intervention in primary care within South Africa. Copyright © 2015 The Authors. Published by Elsevier Ireland Ltd.. All rights reserved.

  1. Exploration of Deaf People’s Health Information Sources and Techniques for Information Delivery in Cape Town: A Qualitative Study for the Design and Development of a Mobile Health App

    PubMed Central

    Glaser, Meryl; Tucker, William David; Diehl, Jan Carel

    2016-01-01

    Background Many cultural and linguistic Deaf people in South Africa face disparity when accessing health information because of social and language barriers. The number of certified South African Sign Language interpreters (SASLIs) is also insufficient to meet the demand of the Deaf population in the country. Our research team, in collaboration with the Deaf communities in Cape Town, devised a mobile health app called SignSupport to bridge the communication gaps in health care contexts. We consequently plan to extend our work with a Health Knowledge Transfer System (HKTS) to provide Deaf people with accessible, understandable, and accurate health information. We conducted an explorative study to prepare the groundwork for the design and development of the system. Objectives To investigate the current modes of health information distributed to Deaf people in Cape Town, identify the health information sources Deaf people prefer and their reasons, and define effective techniques for delivering understandable information to generate the groundwork for the mobile health app development with and for Deaf people. Methods A qualitative methodology using semistructured interviews with sensitizing tools was used in a community-based codesign setting. A total of 23 Deaf people and 10 health professionals participated in this study. Inductive and deductive coding was used for the analysis. Results Deaf people currently have access to 4 modes of health information distribution through: Deaf and other relevant organizations, hearing health professionals, personal interactions, and the mass media. Their preferred and accessible sources are those delivering information in signed language and with communication techniques that match Deaf people’s communication needs. Accessible and accurate health information can be delivered to Deaf people by 3 effective techniques: using signed language including its dialects, through health drama with its combined techniques, and accompanying

  2. Influences of social network sites on the occupational performance of adolescents in a secondary school in Cape Town, South Africa: a phenomenological study.

    PubMed

    Mthembu, Thuli G; Beets, Charmaine; Davids, Gafeedha; Malyon, Kelly; Pekeur, Marchelle; Rabinowitz, Avital

    2014-06-01

    The habit of using social networking sites among adolescents has grown exponentially; there is little accompanying research to understand the influences on adolescents' occupational performance with this technology. The majority of adolescents are engaging in social network as part of their daily routines. Occupational performance is the act of doing and accomplishing a selected occupation that results from the dynamic transaction among the person, the environment and the occupation components. This study aimed to explore the influences of social networking on occupational performance of adolescents in a high school in Western Cape Province, South Africa. A phenomenological approach was used. Adolescents aged 13-17 years in a high school were purposively recruited for the study. Semi-structured interviews were conducted with four participants (two adolescents and two teachers) and two focus groups were undertaken with adolescents, analysed using thematic analysis. Four major themes emerged: 'It's a good way to keep in touch', 'It's part of me and it's not a bad thing', 'There is a time and place for it' and 'There's an urgency to be on the phone'. This study highlighted that social networking sites play a major role in the social life of adolescents, though it can result in occupational imbalance on their occupational performance. Furthermore, this study contributes to the knowledge of occupational therapists who work with adolescents in communities and health promoting school settings. Thus, collaboration between teachers, parents and occupational therapists can help to develop adolescents' time management and learning skills. © 2013 Occupational Therapy Australia.

  3. Aggressive behaviour among drug-using women from Cape Town, South Africa: ethnicity, heavy alcohol use, methamphetamine and intimate partner violence.

    PubMed

    Carney, Tara; Myers, Bronwyn; Kline, Tracy L; Johnson, Kim; Wechsberg, Wendee M

    2017-09-30

    Women have generally been found to be the victims of violence, but scant attention has been paid to the characteristics of women who perpetrate aggression and violence. In South Africa, violence is a prevalent societal issue, especially in the Western Cape. This study aimed at identifying factors that were associated with aggression among a sample of 720 substance-using women. We conducted multivariate logistic regression to identify factors that are significantly associated with these behaviours. Ethnicity (Wald Χ(2) = 17.07(2), p < 0.01) and heavy drinking (Wald Χ(2) = 6.60 (2), p = 0.01) were significantly related to verbal aggression, methamphetamine use was significantly related to physical (Wald Χ(2) = 2.73 (2), p = 0.01) and weapon aggression (Wald Χ(2) = 7.94 (2), p < 0.01) and intimate partner violence was significantly related to verbal (Wald Χ(2) = 12.43 (2), p < 0.01) and physical aggression (Wald Χ(2) = 25.92 (2), p < 0.01). The findings show high levels of aggression among this sample, and highlight the need for interventions that address methamphetamine, heavy drinking and intimate partner violence among vulnerable substance-using women.

  4. Making COD statistics useful for public health at local level in the city of Cape Town: utilidad para la salud pública a nivel local en Ciudad del Cabo.

    PubMed

    Bradshaw, Debbie; Groenewald, Pamela; Bourne, David E; Mahomed, Hassan; Nojilana, Beatrice; Daniels, Johan; Nixon, Jo

    2006-03-01

    To review the quality of the coding of the cause of death (COD) statistics and assess the mortality information needs of the City of Cape Town. Using an action research approach, a study was set up to investigate the quality of COD information, the accuracy of COD coding and consistency of coding practices in the larger health subdistricts. Mortality information needs and the best way of presenting the statistics to assist health managers were explored. Useful information was contained in 75% of death certificates, but nearly 60% had only a single cause certified; 55% of forms were coded accurately. Disagreement was mainly because routine coders coded the immediate instead of the underlying COD. An abridged classification of COD, based on causes of public health importance, prevalent causes and selected combinations of diseases was implemented with training on underlying cause. Analysis of the 2001 data identified the leading causes of death and premature mortality and illustrated striking differences in the disease burden and profile between health subdistricts. Action research is particularly useful for improving information systems and revealed the need to standardize the coding practice to identify underlying cause. The specificity of the full ICD classification is beyond the level of detail on the death certificates currently available. An abridged classification for coding provides a practical tool appropriate for local level public health surveillance. Attention to the presentation of COD statistics is important to enable the data to inform decision-makers.

  5. Improving the quality of papers submitted to dental journals: Transcription of session for editors, associate editors, publishers and others with an interest in scientific publishing held at IADR meeting in Cape Town on Wednesday, 25 June 2014.

    PubMed

    Eaton, Kenneth A; Giannobile, William V; Sourgen, Deborah L; Balaji, S M; Honkala, Eino; Lynch, Christopher D

    2015-08-01

    This satellite symposium was the fourth in a series for editors, publishers, reviewers and all those with an interest in scientific publishing. It was held on Wednesday 25th June 2014 at the IADR International meeting in Cape Town, South Africa. The symposium attracted more than 180 attendees. This symposium placed an emphasis on how the quality of papers submitted to dental journals could be improved. The panel included representation from editors, researchers and publishers from North America, India and the Gulf States. The symposium identified a number of challenges for editors and publishers, including the poor quality of many papers submitted to dental and other scientific journals, plagiarism, attempted duplicate publication and sometimes fraudulent results. Where possible speakers are identified by name. A subsequent symposium was held during the IADR meeting in Boston on March 11th 2015. Involvement open to editors, associate editors, publishers and others with an interest in scientific publishing. Copyright © 2015. Published by Elsevier Ltd.. All rights reserved.

  6. The intercalated BSc (Med) Honours/MB ChB and integrated MB ChB/PhD tracks at the University of Cape Town: models for a national medical student research training programme.

    PubMed

    Katz, A A; Futter, M; Mayosi, B M

    2014-02-01

    The Faculty of Health Sciences at the University of Cape Town is addressing the shortage of clinician-scientists in South Africa by introducing two research training tracks in parallel with the professional MB ChB programme, namely the intercalated BSc (Med) Hons/MB ChB track and the integrated MB ChB/PhD track. The BSc (Med) Hons/MB ChB track is available to MB ChB students who have completed the first two years of study. The track comprises a course in Molecular Medicine given concurrently with the MB ChB third-year curriculum, followed by a BSc (Med) Hons as a 'year out' of MB ChB. Subsequently students may enroll into the integrated MB ChB/PhD track that enables them to undertake a PhD concurrently with MB ChB studies, which will be spread over additional years, or alternatively to undertake a PhD after completion of the MB ChB. These tracks, which were launched in 2011, represent an opportunity to train a new cadre of young African clinician-scientists at the undergraduate level.

  7. Electrocotyle whittingtoni n. gen., n. sp. (Monogenea: Monocotylidae: Heterocotylinae) from the gills of a captive onefin electric ray, Narke capensis (Narkidae) at Two Oceans Aquarium, Cape Town, South Africa.

    PubMed

    Vaughan, David B; Chisholm, Leslie A; Hansen, Haakon

    2016-09-01

    Electrocotyle whittingtoni n. gen., n. sp. (Monogenea: Monocotylidae) is described from the gills of a captive female onefin electric ray, Narke capensis, collected for exhibition at Two Oceans Aquarium in Cape Town, South Africa. Electrocotyle n. gen. is most similar to the heterocotyline genera Heterocotyle and Potamotrygonocotyle but could not be accommodated easily in either of these groups. The new genus is characterised by a haptor with one central and eight peripheral loculi, four unsclerotised structures on the dorsal surface of the haptor, a single unsclerotised non-sinous ridge on the ventral surface of the haptoral septa, large hamuli with a long handle and reduced guard, a vagina with sclerotised walls, and tetrahedral eggs. Molecular phylogenetic analyses based on 28S sequences strongly support the separate genus status of Electrocotyle n. gen and thus support our morphological conclusion. The Heterocotylinae is amended to accommodate the new genus, and the new species is fully described and illustrated herein. This is the first record of a monocotylid from the Narkidae. Electrocotyle whittingtoni n. gen. n. sp. is considered potentially pathogenic given its negative impact on the health of its captive host kept in the quarantine facility at Two Oceans Aquarium.

  8. Details for Manuscript Number SSM-D-06-00290R2 “Internalized Stigma, Discrimination, and Depression among Men and Women Living with HIV/AIDS in Cape Town, South Africa”

    PubMed Central

    Simbayi, Leickness C.; Strebel, Anna; Cloete, Allanise; Henda, Nomvo; Mqeketo, Ayanda

    2014-01-01

    AIDS stigmas interfere with HIV prevention, diagnosis and treatment and can become internalized by people living with HIV/AIDS. However, the effects of internalized AIDS stigmas have not been investigated in Africa, home to two-thirds of the more than 40 million people living with AIDS in the world. The current study examined the prevalence of discrimination experiences and internalized stigmas among 420 HIV positive men and 643 HIV positive women recruited from AIDS services in Cape Town, South Africa. The anonymous surveys found that 40% of persons with HIV/AIDS had experienced discrimination resulting from having HIV infection and one in five had lost a place to stay or a job because of their HIV status. More than one in three participants indicated feeling dirty, ashamed, or guilty because of their HIV status. A hierarchical regression model that included demographic characteristics, health and treatment status, social support, substance use, and internalized stigma significantly predicted cognitive-affective depression. Internalized stigma accounted for 4.8% of the variance in cognitive-affective depression scores over and above the other variables. These results indicate an urgent need for social reform to reduce AIDS stigmas and the design of interventions to assist people living with HIV/AIDS to adjust and adapt to the social conditions of AIDS in South Africa. PMID:17337318

  9. Making COD statistics useful for public health at local level in the city of Cape Town: utilidad para la salud pública a nivel local en Ciudad del Cabo.

    PubMed Central

    Bradshaw, Debbie; Groenewald, Pamela; Bourne, David E.; Mahomed, Hassan; Nojilana, Beatrice; Daniels, Johan; Nixon, Jo

    2006-01-01

    OBJECTIVE: To review the quality of the coding of the cause of death (COD) statistics and assess the mortality information needs of the City of Cape Town. METHODS: Using an action research approach, a study was set up to investigate the quality of COD information, the accuracy of COD coding and consistency of coding practices in the larger health subdistricts. Mortality information needs and the best way of presenting the statistics to assist health managers were explored. FINDINGS: Useful information was contained in 75% of death certificates, but nearly 60% had only a single cause certified; 55% of forms were coded accurately. Disagreement was mainly because routine coders coded the immediate instead of the underlying COD. An abridged classification of COD, based on causes of public health importance, prevalent causes and selected combinations of diseases was implemented with training on underlying cause. Analysis of the 2001 data identified the leading causes of death and premature mortality and illustrated striking differences in the disease burden and profile between health subdistricts. CONCLUSION: Action research is particularly useful for improving information systems and revealed the need to standardize the coding practice to identify underlying cause. The specificity of the full ICD classification is beyond the level of detail on the death certificates currently available. An abridged classification for coding provides a practical tool appropriate for local level public health surveillance. Attention to the presentation of COD statistics is important to enable the data to inform decision-makers. PMID:16583080

  10. Availability and acceptability of HIV counselling and testing services. A qualitative study comparing clients' experiences of accessing HIV testing at public sector primary health care facilities or non-governmental mobile services in Cape Town, South Africa.

    PubMed

    Meehan, Sue-Ann; Leon, Natalie; Naidoo, Pren; Jennings, Karen; Burger, Ronelle; Beyers, Nulda

    2015-09-02

    The South African government is striving for universal access to HIV counselling and testing (HCT), a fundamental component of HIV care and prevention. In the Cape Town district, Western Cape Province of South Africa, HCT is provided free of charge at publically funded primary health care (PHC) facilities and through non-governmental organizations (NGOs). This study investigated the availability and accessibility of HCT services; comparing health seeking behaviour and client experiences of HCT across public PHC facilities (fixed sites) and NGO mobile services. This qualitative study used semi-structured interviews. Systematic sampling was used to select 16 participants who accessed HCT in either a PHC facility (8) or a NGO mobile service (8). Interviews, conducted between March and June 2011, were digitally recorded, transcribed and where required, translated into English. Constant comparative and thematic analysis was used to identify common and divergent responses and themes in relation to the key questions (reasons for testing, choice of service provider and experience of HCT). The sample consisted of 12 females and 4 males with an age range of 19-60 years (median age 28 years). Motivations for accessing health facilities and NGO services were similar; opportunity to test, being affected by HIV and a perceived personal risk for contracting HIV. Participants chose a particular service provider based on accessibility, familiarity with and acceptability of that service. Experiences of both services were largely positive, though instances of poor staff attitude and long waiting times were reported at PHC facilities. Those attending NGO services reported shorter waiting times and overall positive testing experiences. Concerns about lack of adequate privacy and associated stigma were expressed about both services. Realised access to HCT is dependent on availability and acceptability of HCT services. Those who utilised either a NGO mobile service or a public PHC

  11. Screening and Brief Interventions for Alcohol and Other Drug Use Among Pregnant Women Attending Midwife Obstetric Units in Cape Town, South Africa: A Qualitative Study of the Views of Health Care Professionals.

    PubMed

    Petersen Williams, Petal; Petersen, Zaino; Sorsdahl, Katherine; Mathews, Catherine; Everett-Murphy, Katherine; Parry, Charles D H

    2015-01-01

    Despite the negative consequences of alcohol and other drug use during pregnancy, few interventions for pregnant women are implemented, and little is known about their feasibility and acceptability in primary health care settings in South Africa. As part of the formative phase of screening, brief intervention, and referral to treatment for substance use among women presenting for antenatal care, the present study explored health care workers' attitudes and perceptions about screening, brief intervention, and referral to treatment among this population. Forty-three health care providers at 2 public sector midwife obstetric units in Cape Town, South Africa, were interviewed using an open-ended, semistructured interview schedule designed to identify factors that hinder or support the implementation of screening, brief intervention, and referral to treatment for substance use in these settings. Transcribed interviews were analyzed using the framework approach. Health care providers agreed that there is a substantial need for screening, brief intervention, and referral to treatment for substance use among pregnant women and believe such services potentially could be integrated into routine care. Several women-, staff-, and clinic-level barriers were identified that could hinder the successful implementation in antenatal services. These barriers included the nondisclosure of alcohol and other drug use, the intervention being considered as an add-on service or additional work, negative staff attitudes toward implementation of an intervention, poor staff communication styles such as berating women for their behavior, lack of interest from staff, time constraints, staff shortages, overburdened workloads, and language barriers. The utility of screening, brief intervention, and referral to treatment for addressing substance use among pregnant women in public health midwife obstetric units was supported, but consideration will need to be given to addressing a variety of

  12. Adherence to Referral Criteria at Admission and Patient Management at a Specialized Burns Centre: The Case of the Red Cross War Memorial Children’s Hospital in Cape Town, South Africa

    PubMed Central

    Hasselberg, Marie; Kronblad, Emil; Kim, So-Mang; Wallis, Lee; Rode, Heinz; Laflamme, Lucie

    2017-01-01

    Referral guidelines for burn care are meant to assist in decision-making as regards patient transfer and admissions to specialized units. Little is known, however, concerning how closely they are followed and whether they are linked to patient care. This is the object of the current study, focused on the paediatric burns centre of the Red Cross War Memorial Children’s Hospital in Cape Town, South Africa. All patients admitted to the centre during the winters of 2011–2015 (n = 1165) were included. The patient files were scrutinized to clarify whether the referral criteria in place were identified (seven in total) and to compile data on patient and injury characteristics. A case was defined as adherent to the criteria when at least one criterion was fulfilled and adherence was expressed as a percentage with 95% confidence intervals, for all years aggregated as well as by year and by patient or injury characteristics. The association between adherence to any individual criterion and hospital care (surgery or longer length of stay) was measured using logistic regressions. The overall adherence was 93.4% (100% among children under 2 years of age and 86% among the others) and it did not vary remarkably over time. The two criteria of “injury sustained at a specific anatomical site” (85.2%) and “young age” (51.9%) were those most often identified. Children aged 2 years or older were more likely to undergo surgery or to stay longer than those of young age (although a referral criterion) and so were those with higher injury severity (a referral criterion). In this specialized paediatric burns centre, children are admitted mainly according to the guidelines. However, given the high prevalence of paediatric burns in the region and the limited resources at the burns centre, adherence to the guidelines need to be further studied at all healthcare levels in the province. PMID:28684713

  13. Phylogenetic Exploration of Nosocomial Transmission Chains of 2009 Influenza A/H1N1 among Children Admitted at Red Cross War Memorial Children's Hospital, Cape Town, South Africa in 2011.

    PubMed

    Valley-Omar, Ziyaad; Nindo, Fredrick; Mudau, Maanda; Hsiao, Marvin; Martin, Darren Patrick

    2015-01-01

    Traditional modes of investigating influenza nosocomial transmission have entailed a combination of confirmatory molecular diagnostic testing and epidemiological investigation. Common hospital-acquired infections like influenza require a discerning ability to distinguish between viral isolates to accurately identify patient transmission chains. We assessed whether influenza hemagglutinin sequence phylogenies can be used to enrich epidemiological data when investigating the extent of nosocomial transmission over a four-month period within a paediatric Hospital in Cape Town South Africa. Possible transmission chains/channels were initially determined through basic patient admission data combined with Maximum likelihood and time-scaled Bayesian phylogenetic analyses. These analyses suggested that most instances of potential hospital-acquired infections resulted from multiple introductions of Influenza A into the hospital, which included instances where virus hemagglutinin sequences were identical between different patients. Furthermore, a general inability to establish epidemiological transmission linkage of patients/viral isolates implied that identified isolates could have originated from asymptomatic hospital patients, visitors or hospital staff. In contrast, a traditional epidemiological investigation that used no viral phylogenetic analyses, based on patient co-admission into specific wards during a particular time-frame, suggested that multiple hospital acquired infection instances may have stemmed from a limited number of identifiable index viral isolates/patients. This traditional epidemiological analysis by itself could incorrectly suggest linkage between unrelated cases, underestimate the number of unique infections and may overlook the possible diffuse nature of hospital transmission, which was suggested by sequencing data to be caused by multiple unique introductions of influenza A isolates into individual hospital wards. We have demonstrated a functional

  14. Phylogenetic Exploration of Nosocomial Transmission Chains of 2009 Influenza A/H1N1 among Children Admitted at Red Cross War Memorial Children’s Hospital, Cape Town, South Africa in 2011

    PubMed Central

    Hsiao, Marvin; Martin, Darren Patrick

    2015-01-01

    Traditional modes of investigating influenza nosocomial transmission have entailed a combination of confirmatory molecular diagnostic testing and epidemiological investigation. Common hospital-acquired infections like influenza require a discerning ability to distinguish between viral isolates to accurately identify patient transmission chains. We assessed whether influenza hemagglutinin sequence phylogenies can be used to enrich epidemiological data when investigating the extent of nosocomial transmission over a four-month period within a paediatric Hospital in Cape Town South Africa. Possible transmission chains/channels were initially determined through basic patient admission data combined with Maximum likelihood and time-scaled Bayesian phylogenetic analyses. These analyses suggested that most instances of potential hospital-acquired infections resulted from multiple introductions of Influenza A into the hospital, which included instances where virus hemagglutinin sequences were identical between different patients. Furthermore, a general inability to establish epidemiological transmission linkage of patients/viral isolates implied that identified isolates could have originated from asymptomatic hospital patients, visitors or hospital staff. In contrast, a traditional epidemiological investigation that used no viral phylogenetic analyses, based on patient co-admission into specific wards during a particular time-frame, suggested that multiple hospital acquired infection instances may have stemmed from a limited number of identifiable index viral isolates/patients. This traditional epidemiological analysis by itself could incorrectly suggest linkage between unrelated cases, underestimate the number of unique infections and may overlook the possible diffuse nature of hospital transmission, which was suggested by sequencing data to be caused by multiple unique introductions of influenza A isolates into individual hospital wards. We have demonstrated a functional

  15. Cape Cod

    Atmospheric Science Data Center

    2014-05-15

    article title:  Cape Cod, Massachusetts     View Larger ... Pilgrims landed, is located on the west side of Cape Cod Bay, shown in this Multi-angle Imaging SpectroRadiometer (MISR) ... Terra orbit 1708. South of the distinctively-shaped Cape Cod are Nantucket Island and Martha's Vineyard. Further west is Block Island, ...

  16. Cape Cod

    Atmospheric Science Data Center

    2014-05-15

    article title:  Winter in Cape Cod     View Larger Image Cape Cod extends over 50 miles into the Atlantic Ocean. Its rugged coastline, ... February 18, 2001 - Snow and thin clouds over Cape Cod. project:  MISR category:  gallery ...

  17. Conjoined twins--the Cape Town experience.

    PubMed

    Cywes, S; Millar, A J; Rode, H; Brown, R A

    1997-04-01

    This paper records our experience in the management of 25 sets of conjoined twins seen over a 32 year period (1964 - 1996). The twins were classified into 14 complete and symmetrical sets and 11 incomplete or heteropagus. The 14 symmetrical sets included 9 thoracopagus, 2 ischiopagus, 1 craniopagus and 1 omphalopagus twins. In the incomplete heteropagus group there was 1 ischiopagus, one twin being anencepahlic, 2 dipygus, 5 parasitic, 2 fetus-in-fetu and I cranial and caudal. The management is detailed case by case. Overall 10 of 14 symmetrical sets underwent attempts at separation with 16 surviving the procedure, but there were 3 late deaths. In the incomplete group 10 of 11 were operated on with 9 survivors. The importance of a multi-disciplinary approach, the extensive investigations required pre-operatively to define areas of organ and bony conjunction, congenital anomalies of each twin and surgical teamwork is emphasized. Specific problems encountered were identified. In thoracopagus twins the hearts were of paramount importance as conjuction was usually fatal, being associated with major congenital defects. The greater the extent of thoracic cage fusion the greater the chance of associated severe anomaly. Skin expansion to assist coverage of the defects after separation was of great assistance, as was the use of collagen coated vicryl. Evaluation of the liver and pancreatico-biliary systems with isotope excretion scanning was crucial to pre-operative planning. Where there was fusion of the duodenum a single pancreatico-biliary system could be expected and prior strategies for separation and Roux-en-Y enteric drainage of both pancreatic and biliary secretion should be planned. Gastro-oesophageal reflux led to considerable morbidity in both twins of a thoraco-omphalopagus set. In ischiopagus and dipygus conjoined twins bilateral posterior iliac osteotomies were an essential component to anatomic reconstruction of the pelvic ring and wound closure. Also in this group, due to the frequency and extent of shared genital, urinary and ano-rectal structures, long-term morbidity was expected and a component of this might be due to spinal cord tethering, or as in one of our cases, a progressive hydrosyringomyelia. Timing of separation was ideally set at between 5 and 9 months with 6 to 8 weeks of prior tissue expansion but earlier operation was frequently required because of cardio-respiratory problems or organ failure in one twin. In most cases the goal of obtaining separate, independent and intact individuals was achieved.

  18. Anti-retroviral Therapy Based HIV Prevention Among a Sample of Men Who Have Sex with Men in Cape Town, South Africa: Use of Post-exposure Prophylaxis and Knowledge on Pre-exposure Prophylaxis.

    PubMed

    Hugo, J M; Stall, R D; Rebe, K; Egan, J E; De Swardt, G; Struthers, H; McIntyre, J A

    2016-12-01

    Men who have Sex with Men (MSM) have been affected disproportionately by the global HIV pandemic. Rates of consistent condom-use are low and there is a need for further biomedical prevention interventions to prevent new HIV infections. Post exposure prophylaxis (PEP) can reduce the risk of HIV, but uptake among MSM is low. Pre-exposure prophylaxis (PrEP), an innovative anti-retroviral-based HIV prevention tool might be an appropriate intervention for MSM who have recently accessed PEP that involves HIV negative individuals taking daily tenofovir+emtricitabine for HIV prevention. 44 MSM, attending a primary health-care level MSM-focused sexual health clinic in Cape Town, South Africa, who had initiated PEP were enrolled in this study. Participants were followed up after 2, 4 and 12 weeks. Self-administered electronic surveys were completed at the initial, 4 and 12 week visit. Barriers and facilitators to accessing PEP and remaining adherent were examined, as was knowledge about PrEP. Thirty-two participants (80 %) were <40 years of age (range 20-65 years). 35 % of the participants reported their reason for requiring PEP as condomless receptive anal intercourse. A further 20 % required PEP following condomless penetrative anal intercourse; 27.5 % required PEP due to a broken condom during receptive anal sex and 2 participants during insertive anal sex. Three participants did not complete 28 days of PEP or were lost to follow up. Over half (58.5 %) of the participants reported being completely adherent to their regime; under a third (31.7 %) reported missing one PEP dose; and 9.8 % reported missing more than one dose. 36/40 (90 %) had heard of PrEP and 30/40 (75 %) indicated that they would use PrEP if it were accessible to them. That we enrolled 44 MSM who accessed PEP from a Department of Health affiliated clinic over 12 months, speaks to the low uptake by MSM of PEP services in South Africa. Adherence was high and demonstrates that adherence

  19. Exploring how different modes of governance act across health system levels to influence primary healthcare facility managers' use of information in decision-making: experience from Cape Town, South Africa.

    PubMed

    Scott, Vera; Gilson, Lucy

    2017-09-15

    Governance, which includes decision-making at all levels of the health system, and information have been identified as key, interacting levers of health system strengthening. However there is an extensive literature detailing the challenges of supporting health managers to use formal information from health information systems (HISs) in their decision-making. While health information needs differ across levels of the health system there has been surprisingly little empirical work considering what information is actually used by primary healthcare facility managers in managing, and making decisions about, service delivery. This paper, therefore, specifically examines experience from Cape Town, South Africa, asking the question: How is primary healthcare facility managers' use of information for decision-making influenced by governance across levels of the health system? The research is novel in that it both explores what information these facility managers actually use in decision-making, and considers how wider governance processes influence this information use. An academic researcher and four facility managers worked as co-researchers in a multi-case study in which three areas of management were served as the cases. There were iterative cycles of data collection and collaborative analysis with individual and peer reflective learning over a period of three years. Central governance shaped what information and knowledge was valued - and, therefore, generated and used at lower system levels. The central level valued formal health information generated in the district-based HIS which therefore attracted management attention across the levels of the health system in terms of design, funding and implementation. This information was useful in the top-down practices of planning and management of the public health system. However, in facilities at the frontline of service delivery, there was a strong requirement for local, disaggregated information and experiential

  20. Cape Verde.

    PubMed

    1986-10-01

    This summary background paper for the Cape Verde Islands, by the U.S. State Department, includes geography, people, history, government, politics, economy and foreign relations. Cape Verde, located 650 km west of Senegal, has 10 volcanic islands inhabited by 339,000 people of combined African and Portuguese descent. The annual growth rate is 1.4%, although numbers of Cape Verdeans emigrate or work abroad. Per capita income is about $350; resources include volcanic rock, fish, salt, ship repair and light industry, subsistence and tropical agricultural products, although there has been a drought since 1968. Cape Verde has been independent since 1975. There is one political party, and a constitutional government. The country is nonaligned, and is on good terms with many other nations, accepting foreign aid from several sources. A significant proportion of the GNP derives from Cape Verde nationals working abroad.

  1. Suit - Cape

    NASA Image and Video Library

    1962-02-05

    S62-00249 (1962) --- View of astronaut John H. Glenn Jr. being fitted with gloves for his spacesuit during preflight training activities at Cape Canaveral, Florida. Glenn is assisted by suit technician Joe Schmitt. Photo credit: NASA

  2. 76 FR 38302 - Safety Zone; Cape Charles Fireworks, Cape Charles Harbor, Cape Charles, VA

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-06-30

    ... of the Fourth of July Fireworks event. This action is necessary to provide for the safety of life on.... DATES: This rule is effective from 9 p.m. until 10 p.m. on July 3, 2011, with a rain date of July 4... Purpose On July 03, 2011 the Town of Cape Charles will sponsor a fireworks display on the shoreline of the...

  3. Our Town

    ERIC Educational Resources Information Center

    Robinson, Amanda

    2015-01-01

    This article outlines an issue-based lesson for a physical science course in which students investigate potential alternative energy sources for Alternatown, a fictitious city. Students are randomly selected to serve as town council members or as representatives of different alternative energy source options put before the council. The…

  4. Terrace Town

    ERIC Educational Resources Information Center

    Sabin, Heather

    2010-01-01

    The "Terrace Town" program brings architecture and city planning curriculum to elementary schools in Madison, Wisconsin, and surrounding areas. Over eight weeks, classrooms discuss what makes a community livable, sustainable, and kid-friendly. Throughout the process, students gain a better understanding of their own city environments and…

  5. Tox Town

    MedlinePlus

    ... Text Version Neighborhoods Locations Chemicals For Educators Español City View Farm View Port View US Southwest View Town View What's New Visit the Storms and Floods page to learn about preparation and clean-up efforts after storms, hurricanes, and tornadoes. Visit ...

  6. Town & Gown.

    PubMed

    King, Beth M; Gordon, Shirley C; Barry, Charlotte D; Goodman, Rhonda; Jannone, Laura T; Foley, Marie; Resha, Cheryl; Hendershot, Candace

    2017-01-01

    Innovative approaches for building "town and gown" relationships between practicing school nurses, community partners, and universities/colleges are presented through exemplars relating to research, education, policy, and practice. The exemplars demonstrate the critical factors of successful partnerships as validated by their outcomes.

  7. Terrace Town

    ERIC Educational Resources Information Center

    Sabin, Heather

    2010-01-01

    The "Terrace Town" program brings architecture and city planning curriculum to elementary schools in Madison, Wisconsin, and surrounding areas. Over eight weeks, classrooms discuss what makes a community livable, sustainable, and kid-friendly. Throughout the process, students gain a better understanding of their own city environments and…

  8. Our Town

    ERIC Educational Resources Information Center

    Robinson, Amanda

    2015-01-01

    This article outlines an issue-based lesson for a physical science course in which students investigate potential alternative energy sources for Alternatown, a fictitious city. Students are randomly selected to serve as town council members or as representatives of different alternative energy source options put before the council. The…

  9. "It's Not Their Job to Share Content": A Case Study of the Role of Senior Students in Adapting Teaching Materials as Open Educational Resources at the University of Cape Town

    ERIC Educational Resources Information Center

    Hodgkinson-Williams, Cheryl; Paskevicius, Michael

    2013-01-01

    Inspired by the Massachusetts Institute of Technology's landmark decision to make its teaching and learning materials freely available to the public as OpenCourseWare (OCW), many other higher education institutions have followed suit sharing resources now more generally referred to as Open Educational Resources (OER). The University of Cape Town…

  10. "It's Not Their Job to Share Content": A Case Study of the Role of Senior Students in Adapting Teaching Materials as Open Educational Resources at the University of Cape Town

    ERIC Educational Resources Information Center

    Hodgkinson-Williams, Cheryl; Paskevicius, Michael

    2013-01-01

    Inspired by the Massachusetts Institute of Technology's landmark decision to make its teaching and learning materials freely available to the public as OpenCourseWare (OCW), many other higher education institutions have followed suit sharing resources now more generally referred to as Open Educational Resources (OER). The University of Cape Town…

  11. EPA Cape Cod 208 Plan 2015 Update Approval Letter

    EPA Pesticide Factsheets

    EPA approval letter re: certification by the Governor of MA that the Cape Cod WQM Plan Update is consistent with CWA section 208(b)(3) & accepted the Commonwealth’s reaffirmation of the existing designations of Cape Cod Towns as waste management agencies.

  12. Cape Verde

    NASA Technical Reports Server (NTRS)

    2007-01-01

    This Mars Exploration Rover Opportunity Pancam 'super resolution' mosaic of the approximately 6 m (20 foot) high cliff face of the Cape Verde promontory was taken by the rover from inside Victoria Crater, during the rover's descent into Duck Bay. Super-resolution is an imaging technique which utilizes information from multiple pictures of the same target in order to generate an image with a higher resolution than any of the individual images. Cape Verde is a geologically rich outcrop and is teaching scientists about how rocks at Victoria crater were modified since they were deposited long ago. This image complements super resolution mosaics obtained at Cape St. Mary and Cape St. Vincent and is consistent with the hypothesis that Victoria crater is located in the middle of what used to be an ancient sand dune field. Many rover team scientists are hoping to be able to eventually drive the rover closer to these layered rocks in the hopes of measuring their chemistry and mineralogy.

    This is a Mars Exploration Rover Opportunity Panoramic Camera image mosaic acquired on sols 1342 and 1356 (November 2 and 17, 2007), and was constructed from a mathematical combination of 64 different blue filter (480 nm) images.

  13. Cape Verde.

    PubMed

    1989-11-01

    The Republic of Cape Verde has an area of 1,5557 square miles, a population of 364,207, and a growth rate of 2.02%/year. Rugged volcanic islands comprise the terrain and the climate is dry and temperate. The ethnic groups consist of Creole, a mix of African and Portuguese, African, and European. The religions are Roman Catholic and Protestant, and the languages are Portuguese and Crioulo. The infant mortality rate is 11/100 and life expectancy is 61 years. The government consists of a republic with a president, a council of ministers, and a national assembly. The gross national product is $193.5 million with a 6.8% growth rate. They have natural resources of salt, pozzolana, and limestone; agricultural products are bananas, corn, beans, sugarcane, coffee, fruits, vegetables, and livestock. The main industries are fishing, salt, construction, building, materials ship repair, clothing, shoes, furniture, metal products and beverages. In 1462 Portuguese settled in Cape Verde, in 1951 the colony became a province, and in 1975 Cape Verde became an independent republic. The government is neutral and seeks cooperative relations from many states. The US has had a long and cordial relation with Cape Verde, and assists in economic and social development.

  14. Cape Verde

    NASA Technical Reports Server (NTRS)

    2007-01-01

    This Mars Exploration Rover Opportunity Pancam 'super resolution' mosaic of the approximately 6 m (20 foot) high cliff face of the Cape Verde promontory was taken by the rover from inside Victoria Crater, during the rover's descent into Duck Bay. Super-resolution is an imaging technique which utilizes information from multiple pictures of the same target in order to generate an image with a higher resolution than any of the individual images. Cape Verde is a geologically rich outcrop and is teaching scientists about how rocks at Victoria crater were modified since they were deposited long ago. This image complements super resolution mosaics obtained at Cape St. Mary and Cape St. Vincent and is consistent with the hypothesis that Victoria crater is located in the middle of what used to be an ancient sand dune field. Many rover team scientists are hoping to be able to eventually drive the rover closer to these layered rocks in the hopes of measuring their chemistry and mineralogy.

    This is a Mars Exploration Rover Opportunity Panoramic Camera image mosaic acquired on sols 1342 and 1356 (November 2 and 17, 2007), and was constructed from a mathematical combination of 64 different blue filter (480 nm) images.

  15. CAPE for CaPE

    NASA Technical Reports Server (NTRS)

    Brooks, Joni

    1993-01-01

    In an effort to improve short-term forecasting for the Kennedy Space Center region, Holle et al. (1992) investigated the effects of low level wind regimes on the distribution of cloud-to-ground lightning in central Florida. With a study period of 455 days, Holle et al. (1992) found 'southwest flow contributed 66 percent of the total network flashes while also occurring on the most days (142).' Relationships among mesoscale thermodynamic variables and precipitation and/or lightning have been addressed in previous studies in Canada and the Tennessee valley. Zawadzki et al. (1981) found 'soundings, surface pressure, temperature and humidity obtained from a standard observation network were correlated with rain rates given by raingages and radar.' Buechler et al. (1990) found 'a fair relationship between CAPE (convective available potential energy) and daily cloud-to-ground activity' with a correlation coefficient of r = 0.68. The present research will investigate the relationships among rainfall, cloud-to-ground (CG) lightning, CAPE, and low level wind flow using data collected during the CaPE (Convection and Precipitation/Electrification Experiment) field program. The CaPE field program was conducted in east central Florida from July 8, 1991 to August 18, 1991.

  16. Burden of tuberculosis in intensive care units in Cape Town, South Africa, and assessment of the accuracy and effect on patient outcomes of the Xpert MTB/RIF test on tracheal aspirate samples for diagnosis of pulmonary tuberculosis: a prospective burden of disease study with a nested randomised controlled trial.

    PubMed

    Calligaro, Gregory L; Theron, Grant; Khalfey, Hoosain; Peter, Jonathan; Meldau, Richard; Matinyenya, Brian; Davids, Malika; Smith, Liezel; Pooran, Anil; Lesosky, Maia; Esmail, Aliasgar; Miller, Malcolm G; Piercy, Jenna; Michell, Lancelot; Dawson, Rodney; Raine, Richard I; Joubert, Ivan; Dheda, Keertan

    2015-08-01

    There are few prospective data about the incidence and mortality associated with pulmonary tuberculosis in intensive care units (ICUs), and none on the accuracy and clinical effect of the Xpert-MTB/RIF assay in this setting. We aimed to measure the frequency of culture-positive tuberculosis in ICUs in Cape Town, South Africa and to assess the performance and effect on patient outcomes of Xpert MTB/RIF versus smear microscopy for diagnosis of tuberculosis. We did a prospective burden of disease study with a randomised controlled substudy at the ICUs of four hospitals in Cape Town. Mechanically ventilated adults (≥18 years) with suspected pulmonary tuberculosis admitted between Aug 1, 2010, and July 31, 2013 (irrespective of the reason for admission), were prospectively investigated by culture, and by Xpert-MTB/RIF testing or smear microscopy, of tracheal aspirate samples. In the substudy, patients were randomly assigned (1:1), via a computer-generated allocation list, to smear microscopy or Xpert MTB/RIF. Participants, caregivers, and outcome assessors were not masked to group assignment. Only the laboratory staff were blinded to the clinical details of the participants. In November, 2012, Xpert MTB/RIF was adopted as the initial diagnostic test for respiratory samples in Western Cape province. Thereafter, patients received Xpert MTB/MIF and culture as standard of care. For the whole study cohort, the primary outcome was the frequency of bacteriologically confirmed tuberculosis. The primary endpoint of the randomised substudy was the proportion of culture-positive patients on treatment at 48 h after enrolment. The randomised substudy is registered with ClinicalTrials.gov, number NCT01530568. We investigated 341 patients for suspected pulmonary tuberculosis out of a total of 2309 ICU admissions. 46 (15%) of 317 patients included in the final analysis had a positive test for tuberculosis (Xpert MTB/RIF or culture). Culture-positive patients who failed to initiate

  17. John Herschel and the Cape flora, 1834 - 1839.

    NASA Astrophysics Data System (ADS)

    Rourke, J. P.

    John Herschel's interest in botany was stimulated by his contact with the species-rich Cape flora while resident in Cape Town, 1834 - 1838. The comparative study of his extensive living collection of bulbous plants, mainly of the Iridaceae, Liliaceae, Amarayllidaceae and Orchidaceae led him to consider some basic aspects of the origin of species and of taxonomic theory, in letters to colleagues in Europe.

  18. E-Powering the People: South Africa's Smart Cape Access Project

    ERIC Educational Resources Information Center

    Valentine, Susan

    2004-01-01

    This document examines the launch of the Smart Cape Access Project in Cape Town, South Africa. In a city where more than 80 percent of the citizens do not have access to computers and fewer still can access the Internet, public officials set out to build a "smart city," where "informed people could connect to the world and to each other by the…

  19. E-Powering the People: South Africa's Smart Cape Access Project

    ERIC Educational Resources Information Center

    Valentine, Susan

    2004-01-01

    This document examines the launch of the Smart Cape Access Project in Cape Town, South Africa. In a city where more than 80 percent of the citizens do not have access to computers and fewer still can access the Internet, public officials set out to build a "smart city," where "informed people could connect to the world and to each other by the…

  20. Townes-Brocks syndrome

    PubMed Central

    Powell, C.; Michaelis, R.

    1999-01-01

    Townes-Brocks syndrome (TBS) is an autosomal dominant disorder with multiple malformations and variable expression. Major findings include external ear anomalies, hearing loss, preaxial polydactyly and triphalangeal thumbs, imperforate anus, and renal malformations. Most patients with Townes-Brocks syndrome have normal intelligence, although mental retardation has been noted in a few.


Keywords: Townes-Brocks syndrome; chromosome 16q12.1; SALL1 PMID:10051003

  1. Game Changers? Multilingual Learners in a Cape Town Primary School

    ERIC Educational Resources Information Center

    Kerfoot, Caroline; Bello-Nonjengele, Basirat Olayemi

    2016-01-01

    This article engages with Bourdieu's notion of field as a "space of play" to explore what happens to the educational field and the linguistic regimes operating within it in a site in which new discourses and practices of identity, language, "race", and ethnicity become entangled with local economies of meaning. The context is a…

  2. Game Changers? Multilingual Learners in a Cape Town Primary School

    ERIC Educational Resources Information Center

    Kerfoot, Caroline; Bello-Nonjengele, Basirat Olayemi

    2016-01-01

    This article engages with Bourdieu's notion of field as a "space of play" to explore what happens to the educational field and the linguistic regimes operating within it in a site in which new discourses and practices of identity, language, "race", and ethnicity become entangled with local economies of meaning. The context is a…

  3. "Stressed and Sexy": Lexical Borrowing in Cape Town Xhosa

    ERIC Educational Resources Information Center

    Dowling, Tessa

    2011-01-01

    Codeswitching by African language speakers in South Africa (whether speaking English or the first language) has been extensively commented on and researched. Many studies analyse the historical, political and sociolinguistic factors behind this growing phenomenon, but there appears to be a little urgency about establishing a database of new…

  4. "Stressed and Sexy": Lexical Borrowing in Cape Town Xhosa

    ERIC Educational Resources Information Center

    Dowling, Tessa

    2011-01-01

    Codeswitching by African language speakers in South Africa (whether speaking English or the first language) has been extensively commented on and researched. Many studies analyse the historical, political and sociolinguistic factors behind this growing phenomenon, but there appears to be a little urgency about establishing a database of new…

  5. Popular Education in Three Organisations in Cape Town, South Africa

    ERIC Educational Resources Information Center

    Endresen, Kristin

    2013-01-01

    In the past, non-formal education in South Africa was committed to supporting the Mass Democratic Movement (MDM) in opposition to apartheid. Such non-formal political education was concerned with education for democracy. Post 1994, South African adult education policy has exclusively concentrated on vocational training, shifting the focus away…

  6. Company Town Shutdown.

    ERIC Educational Resources Information Center

    Turnage, Martha A.

    Saltville, Virginia, is a former company town whose main employer, a soda ash plant, shut down on July 1, 1971. The closure of the chemical plant displaced 700 workers, and created a crisis that threatened not only the existence of the town, but of the entire region. In response, Virginia Highlands Community College (VHCC), in cooperation with the…

  7. Town and Townships.

    ERIC Educational Resources Information Center

    Anderson, Pat

    Long range effects of early public land surveys, the distinction between towns and townships, and the significance of town government in modern Wisconsin are portrayed in this teacher's guide for upper elementary grades. With supplementary materials it could be used in a unit on local or Wisconsin geography, as an introduction to problems of urban…

  8. Company Town Shutdown.

    ERIC Educational Resources Information Center

    Turnage, Martha A.

    Saltville, Virginia, is a former company town whose main employer, a soda ash plant, shut down on July 1, 1971. The closure of the chemical plant displaced 700 workers, and created a crisis that threatened not only the existence of the town, but of the entire region. In response, Virginia Highlands Community College (VHCC), in cooperation with the…

  9. Cape of Good Hope

    Atmospheric Science Data Center

    2013-04-16

    article title:  Aerosol retrieval over Cape of Good Hope   ... Da image in the southern part of South Africa - the aerosol retrieval picks it up, and also the slightly clearer area in the middle. Also, ... MISR Science Teams Aug 23, 2000 - Aerosol retrieval over Cape of Good Hope. project:  MISR ...

  10. Cape of Good Hope

    Atmospheric Science Data Center

    2016-08-24

    article title:  Aerosol retrieval over Cape of Good Hope (Enlargement)     ... (MISR) image is an enlargement of the  aerosol retrieval over Cape of Good Hope, August 23, 2000 , showing a more detailed ... energy, so MISR's contribution is not only the aerosol retrieval necessary to do the correction, but the multi-angular integration. ...

  11. Town Square for Kids.

    ERIC Educational Resources Information Center

    Parker, Dan

    2001-01-01

    Presents design features of the Dawson Elementary School (Corpus Chriti, Texas) where an atmosphere of an old town square and the feeling of community have been created. Photos and a floor plan are provided. (GR)

  12. Memories of Charles Townes

    NASA Astrophysics Data System (ADS)

    Garmire, Elsa

    2015-06-01

    Charles Townes, the Nobel laureate acclaimed for his pioneering work on lasers and nonlinear optics, sadly passed away in January this year. Here I offer personal reflections of working with him as one of his graduate students.

  13. Cape Cod Easterly Shore Beach Erosion Study. Volume 2

    DTIC Science & Technology

    1979-04-01

    fcur different series of glacial deposits have been recognized on the outer Cape from Orleans northward. They are differentiated on the basis of...the combined erigean sprinq tide results in an even greater tidal range. When the moon’s orbit is oil or close to the equator (that is, when the...industry. For this reason, the towns feel strongly that differential pricing for beach use (resident/nonresident) is appropriate and necessary. The rise in

  14. The Cape Observatory: all Categories of Heritage

    NASA Astrophysics Data System (ADS)

    Glass, Ian S.

    2012-09-01

    In this presentation I will give an outline of the various types of heritage related to the Royal Observatory, Cape of Good Hope, established in 1820 and now the headquarters campus of the South African Astronomical Observatory, located quite close to downtown Cape Town. In terms of tangible, fixed heritage, the campus itself, the domes and the various other buildings are obviously relevant. This category includes the Classical Revival Main Building of 1828 and the McClean dome of 1895 by the leading colonial architect Herbert Baker as well as many other buildings and even the graves of two directors. Tangible movable items include, in principle, the telescopes, the accessory instruments and many pieces of apparatus that have been preserved. In addition, extensive collections of antique paintings, drawings, furniture and books add to the site's cultural significance. Many of the Observatory's archives are still kept locally. The intangible heritage of the Observatory consists for example of its history, its major discoveries, its interaction with the City, its central role in the history of science in South Africa and its appeal as a living cultural institution. Especially notable were the observations by Henderson (ca 1831) leading to the distance of a Cen and the early sky survey known as the Cape Photographic Durchmusterung.

  15. Panorama from 'Cape Verde'

    NASA Technical Reports Server (NTRS)

    2007-01-01

    NASA's Mars Exploration Rover Opportunity captured this vista of 'Victoria Crater' from the viewpoint of 'Cape Verde,' one of the promontories that are part of the scalloped rim of the crater. Opportunity drove onto Cape Verde shortly after arriving at the rim of Victoria in September 2006. The view combines hundreds of exposures taken by the rover's panoramic camera (Pancam). The camera began taking the component images during Opportunity's 970th Martian day, or sol, on Mars (Oct. 16, 2006). Work on the panorama continued through the solar conjunction period, when Mars was nearly behind the sun from Earth's perspective and communications were minimized. Acquisition of images for this panorama was completed on Opportunity's 991st sol (Nov. 7, 2006).

    The top of Cape Verde is in the immediate foreground at the center of the image. To the left and right are two of the more gradually sloped bays that alternate with the cliff-faced capes or promontories around the rim of the crater. 'Duck Bay,' where Opportunity first reached the rim, is to the right. Beyond Duck Bay counterclockwise around the rim, the next promontory is 'Cabo Frio,' about 150 meters (500 feet) from the rover. On the left side of the panorama is 'Cape St. Mary,' the next promontory clockwise from Cape Verde and about 40 meters (130 feet) from the rover. The vantage point atop Cape Verde offered a good view of the rock layers in the cliff face of Cape St. Mary, which is about 15 meters or 50 feet tall. By about two weeks after the Pancam finished collecting the images for this panorama, Opportunity had driven to Cape St. Mary and was photographing Cape Verde's rock layers.

    The far side of the crater lies about 800 meters (half a mile) away, toward the southeast.

    This approximately true-color view combines images taken through three of the Pancam's filters, admitting light with wavelengths centered at 750 nanometers (near infrared), 530 nanometers (green) and 430 nanometers (violet).

  16. VizieR Online Data Catalog: Nainital-Cape Survey. IV. (Joshi+, 2016)

    NASA Astrophysics Data System (ADS)

    Joshi, S.; Martinez, P.; Chowdhury, S.; Chakradhari, N. K.; Joshi, Y. C.; van Heerden, P.; Medupe, T.; Kumar, Y. B.; Kuhn, R. B.

    2016-04-01

    For the Nainital-Cape Survey, the high-speed photometric observations of Ap and Am star candidates are carried out from ARIES using a high-speed photoelectric photometer attached to the 1.04-m Sampurnanand telescope, the Modular Photometer attached to the 0.5-m telescope and the University of Cape Town Photometer attached to the 0.75-m and 1.0-m telescopes at the Sutherland site of SAAO. (4 data files).

  17. Cape Province, South Africa as seen from STS-58

    NASA Image and Video Library

    1993-10-30

    STS058-77-083 (18 Oct-1 Nov 1993) --- In this scene of the south coast of Africa, Cape Agulhas, the southernmost point on the continent, appears as the leftmost cape. Viewed with the Earth's limb top left, clouds at bottom, the view direction is west and north top right. The Cape of Good Hope, with Cape Town nearby, is the thin spike beyond. The great bay in the foreground is Algoa Bay with the city of Port Elizabeth. This was the first time European voyagers are known to have rounded the Cape of Good Hope in their quest to reach India by sea. The entire fold mountain belt of southern Africa is visible: these mountains appear as green (forested) wavy structures stretching west form the foreground, to the Cape of Good Hope, and then northwards some distance. One theory about their origin is that the Falkland Plateau, now an undersea extension of South America, was jostled up against Africa more than 150 million years ago, in times before the Atlantic Ocean existed, before Africa and South America drifted apart from one another. The jostling caused the evolution of the fold mountain belt.

  18. Cape Canaveral, Florida as seen from STS-66 Atlantis

    NASA Image and Video Library

    1994-11-14

    This nadir photograph of the Cape Canaveral area on Florida's eastern coast was taken by the STS-66 crew in November, 1994. The Space Shuttle Vehicle Assembly area and the runways used by the returning Shuttles can be seen near the center of this photograph as part of the John F. Kennedy Space Center (KSC). Launch Pads A and B as well as many other launch pads and a runway can be seen on Cape Canaveral. Cape Canaveral is located to the east of KSC. South of the launch area is Port Canaveral and Cocoa Beach on the Atlantic coast with the towns of Cocoa, Merrit Island and Titusville situated along the Intercoastal Waterway.

  19. A town conserves

    SciTech Connect

    Thomas, S.

    1993-07-15

    With encouragement from a TV personality, a Wisconsin town saves energy. This article describes how a TV program host mediated between Northern States Power, local businesses, and the people of a Wisconsin town for a demand side management program demonstration of the Wisconsin Public Service Commission. The key to acceptance and use of the program was public education of consumers, combined with making available experts who could answer questions on product availability and installation. The demonstration project is designed to show that the least expensive means to achieve energy efficiency for the customer is to foster a sense of community ownership of the program.

  20. Hepatitis E virus: Western Cape, South Africa

    PubMed Central

    Madden, Richie G; Wallace, Sebastian; Sonderup, Mark; Korsman, Stephen; Chivese, Tawanda; Gavine, Bronwyn; Edem, Aniefiok; Govender, Roxy; English, Nathan; Kaiyamo, Christy; Lutchman, Odelia; van der Eijk, Annemiek A; Pas, Suzan D; Webb, Glynn W; Palmer, Joanne; Goddard, Elizabeth; Wasserman, Sean; Dalton, Harry R; Spearman, C Wendy

    2016-01-01

    AIM To conduct a prospective assessment of anti-hepatitis E virus (HEV) IgG seroprevalence in the Western Cape Province of South Africa in conjunction with evaluating risk factors for exposure. METHODS Consenting participants attending clinics and wards of Groote Schuur, Red Cross Children’s Hospital and their affiliated teaching hospitals in Cape Town, South Africa, were sampled. Healthy adults attending blood donor clinics were also recruited. Patients with known liver disease were excluded and all major ethnic/race groups were included to broadly represent local demographics. Relevant demographic data was captured at the time of sampling using an interviewer-administered confidential questionnaire. Human immunodeficiency virus (HIV) status was self-disclosed. HEV IgG testing was performed using the Wantai® assay. RESULTS HEV is endemic in the region with a seroprevalence of 27.9% (n = 324/1161) 95%CI: 25.3%-30.5% (21.9% when age-adjusted) with no significant differences between ethnic groups or HIV status. Seroprevalence in children is low but rapidly increases in early adulthood. With univariate analysis, age ≥ 30 years old, pork and bacon/ham consumption suggested risk. In the multivariate analysis, the highest risk factor for HEV IgG seropositivity (OR = 7.679, 95%CI: 5.38-10.96, P < 0.001) was being 30 years or older followed by pork consumption (OR = 2.052, 95%CI: 1.39-3.03, P < 0.001). A recent clinical case demonstrates that HEV genotype 3 may be currently circulating in the Western Cape. CONCLUSION Hepatitis E seroprevalence was considerably higher than previously thought suggesting that hepatitis E warrants consideration in any patient presenting with an unexplained hepatitis in the Western Cape, irrespective of travel history, age or ethnicity. PMID:27956810

  1. Hepatitis E virus: Western Cape, South Africa.

    PubMed

    Madden, Richie G; Wallace, Sebastian; Sonderup, Mark; Korsman, Stephen; Chivese, Tawanda; Gavine, Bronwyn; Edem, Aniefiok; Govender, Roxy; English, Nathan; Kaiyamo, Christy; Lutchman, Odelia; van der Eijk, Annemiek A; Pas, Suzan D; Webb, Glynn W; Palmer, Joanne; Goddard, Elizabeth; Wasserman, Sean; Dalton, Harry R; Spearman, C Wendy

    2016-11-28

    To conduct a prospective assessment of anti-hepatitis E virus (HEV) IgG seroprevalence in the Western Cape Province of South Africa in conjunction with evaluating risk factors for exposure. Consenting participants attending clinics and wards of Groote Schuur, Red Cross Children's Hospital and their affiliated teaching hospitals in Cape Town, South Africa, were sampled. Healthy adults attending blood donor clinics were also recruited. Patients with known liver disease were excluded and all major ethnic/race groups were included to broadly represent local demographics. Relevant demographic data was captured at the time of sampling using an interviewer-administered confidential questionnaire. Human immunodeficiency virus (HIV) status was self-disclosed. HEV IgG testing was performed using the Wantai(®) assay. HEV is endemic in the region with a seroprevalence of 27.9% (n = 324/1161) 95%CI: 25.3%-30.5% (21.9% when age-adjusted) with no significant differences between ethnic groups or HIV status. Seroprevalence in children is low but rapidly increases in early adulthood. With univariate analysis, age ≥ 30 years old, pork and bacon/ham consumption suggested risk. In the multivariate analysis, the highest risk factor for HEV IgG seropositivity (OR = 7.679, 95%CI: 5.38-10.96, P < 0.001) was being 30 years or older followed by pork consumption (OR = 2.052, 95%CI: 1.39-3.03, P < 0.001). A recent clinical case demonstrates that HEV genotype 3 may be currently circulating in the Western Cape. Hepatitis E seroprevalence was considerably higher than previously thought suggesting that hepatitis E warrants consideration in any patient presenting with an unexplained hepatitis in the Western Cape, irrespective of travel history, age or ethnicity.

  2. ASTRONAUT SHEPARD, ALAN - CAPE

    NASA Image and Video Library

    1961-05-05

    S61-01927 (5 May 1961) --- Mercury-Redstone 3 (MR-3), the United States' first manned spaceflight, is launched from Cape Canaveral on a suborbital mission. Astronaut Alan B. Shepard Jr. was the pilot of the Mercury spacecraft, designated "Freedom 7". The spacecraft attained a maximum speed of 5,180 miles per hour (mph), reached an altitude of 116 1/2 statute miles, and landed 302 statute miles downrange from Cape Canaveral, Florida. Photo credit: NASA or National Aeronautics and Space Administration

  3. Space Radar Image of Cape Cod, Massachusetts

    NASA Technical Reports Server (NTRS)

    1994-01-01

    This spaceborne radar image shows the famous 'hook' of Cape Cod, Massachusetts. The Cape, which juts out into the Atlantic Ocean about 100 kilometers (62 miles) southeast of Boston, actually consists of sandy debris left behind by the great continental ice sheets when they last retreated from southern New England about 20,000 years ago. Today's landscape consists of sandy forests, fields of scrub oak and other bushes and grasses, salt marshes, freshwater ponds, as well as the famous beaches and sand dunes. In this image, thickly forested areas appear green, marshes are dark blue, ponds and sandy areas are black, and developed areas are mostly pink. The dark L-shape in the lower center is the airport runways in Hyannis, the Cape's largest town. The dark X-shape left of the center is Otis Air Force Base. The Cape Cod Canal, above and left of center, connects Buzzards Bay on the left with Cape Cod Bay on the right. The northern tip of the island of Martha's Vineyard is seen in the lower left. The tip of the Cape, in the upper right, includes the community of Provincetown, which appears pink, and the protected National Seashore areas of sand dunes that parallel the Atlantic coast east of Provincetown. Scientists are using radar images like this one to study delicate coastal environments and the effects of human activities on the ecosystem and landscape. This image was acquired by Spaceborne Imaging Radar-C/X-band Synthetic Aperture Radar (SIR-C/X-SAR) onboard the space shuttle Endeavour on April 15, 1994. The image is 81.7 kilometers by 43.1 kilometers (50.7 miles by 26.7 miles) and is centered at 41.8 degrees north latitude, 70.3 degrees west longitude. North is toward the upper right. The colors are assigned to different radar frequencies and polarizations of the radar as follows: red is L-band, horizontally transmitted and received; green is C-band, horizontally transmitted, vertically received; and blue is C-band, horizontally transmitted and received. SIR

  4. Tox Town Farm

    MedlinePlus

    ... download the Flash player. City Farm Town Port US Southwest U.S. National Library of Medicine 8600 Rockville Pike Bethesda, MD 20894 1-888-FIND-NLM National Institutes of Health Department of Health & Human Services ... Updates Contact Us: tehip@teh.nlm.nih.gov Copyright Privacy Freedom ...

  5. Reviving the Town Meeting.

    ERIC Educational Resources Information Center

    Grove, Tim

    1996-01-01

    Discusses the use of the National Issues Forum's (NIF's) town meetings in efforts to increase citizen participation in democratic processes. Describes the Catholic adaptation of the NIF approach, providing examples of its use at the high school, college, and community level. (MAB)

  6. Reviving the Town Meeting.

    ERIC Educational Resources Information Center

    Grove, Tim

    1996-01-01

    Discusses the use of the National Issues Forum's (NIF's) town meetings in efforts to increase citizen participation in democratic processes. Describes the Catholic adaptation of the NIF approach, providing examples of its use at the high school, college, and community level. (MAB)

  7. Small Town Girl.

    ERIC Educational Resources Information Center

    Horning, Kathleen T.

    2000-01-01

    This interview with Kimberly Willis Holt, an author of young adult fiction who recently won the National Book Award for Young People's Literature, discusses her background, how she began her writing career, childhood influences, small-town life, and how she develops her characters. (LRW)

  8. Building up College Towns

    ERIC Educational Resources Information Center

    Powers, Elia

    2007-01-01

    When it comes to college towns and neighborhoods near urban campuses, quaint will not cut it anymore. An increasing number of institutions are finding ways--directly or indirectly--to promote a mix of commercial and residential development just beyond their borders that they hope will lure students and faculty. This article discusses how…

  9. Building up College Towns

    ERIC Educational Resources Information Center

    Powers, Elia

    2007-01-01

    When it comes to college towns and neighborhoods near urban campuses, quaint will not cut it anymore. An increasing number of institutions are finding ways--directly or indirectly--to promote a mix of commercial and residential development just beyond their borders that they hope will lure students and faculty. This article discusses how…

  10. New Town--New Library.

    ERIC Educational Resources Information Center

    Eccles, Steven

    1979-01-01

    Provides a brief background of the new town development in England during the past 20 years, describes the problems caused by lack of community identity and employment in the new town of Skelmersdale, and discusses the role of the library and its services in the new town setting. (JD)

  11. Town Meeting and Community Engagement.

    ERIC Educational Resources Information Center

    Uline, Cynthia L.

    1998-01-01

    Draws upon the history of the American town meeting as a vehicle for understanding this institution. Considers how a New England public school district has used town meetings effectively as a reform vehicle. Town meetings should be considered an honorable, truly democratic forum, not a symbolic gesture to improve public relations. (24 references)…

  12. The Cape Fear Plan.

    ERIC Educational Resources Information Center

    Conrath, Richard C.

    In spring 1992, Cape Fear Community College (CFCC) completed its long-range strategic plan. The consultant who helped guide the institution through the process presented the plan to the Board of Trustees with 60 recommendations for implementation. The Chairman of the Board established task forces to study the recommendations for each major…

  13. The Townes Laser Institute

    NASA Astrophysics Data System (ADS)

    Richardson, Martin

    2009-06-01

    The State of Florida has recently established a new center of excellence in advanced core laser technologies, associated with the College of Optics & Photonics. This center, dedicated in 2007 in tribute to the pioneering work of Charles Townes, whose insight lead to the development of the maser and the laser, will invest in next generation laser technologies for applications to medicine, advanced manufacturing and defense. It joins the cluster of photonics-related centers at UCF, adding a focused national center for the education and training of scientists and engineers in laser technology. This paper describes the mission and objectives of the Townes Institute, the educational and training programs it is creating, its current investments and opportunities, and the future institutional and industrial partnerships and global reach it hopes to create.

  14. Cape Baleia, Caravelas, Brazil

    NASA Technical Reports Server (NTRS)

    1993-01-01

    Cape Baleia (17.5N, 39.0W), on the north central coast of Brazil illustrates a good example of multiple coastal sand spits. Over a several thousand year time period, shifting regimes of wave and current patterns have piled up sand onto a series of beach ridges and tidal lagoons. Offshore, several prominent reefs and sandbanks can be seen paralleling the coast. The largest is the Recife da Pedra Grande (Big Rocks Reef).

  15. Cape Agulhas, South Africa

    NASA Image and Video Library

    2016-10-13

    The southernmost tip of Africa is marked by the Cape Agulhas lighthouse. The warm Atlantic Agulhas current meets the cold water Indian Ocean Benguela current, creating treacherous seas that have claimed many ships over the last 450 years. The image covers an area of 22.5 by 41.1 kilometers, was acquired September 27, 2006, and is located at 34.8 degrees south, 20 degrees east. http://photojournal.jpl.nasa.gov/catalog/PIA21014

  16. Vals Cape, New Guinea

    NASA Image and Video Library

    1994-09-30

    STS068-261-062 (30 September-11 October 1994) --- Vals Cape (left) is the prominent point of the island of New Guinea (Indonesia's Irian Jaya) that juts southwest into the Arafura Sea, pointing towards Australia. The part of New Guinea in this northwest-looking view is entirely low-lying swampland with very low population density. The Digul River, snaking across the middle of the view, drains the high mountain chain, which runs along the spine of the island.

  17. County town -- jian-zhi town differentials and migration to towns in China.

    PubMed

    Ma, R

    1993-07-01

    China's urbanization process is unique in having been due to economic systems and migration policies. Towns and townships in rural areas are different from cities in their social and economic characteristics and their structure and function. The urban system in China is initially described with the distinction drawn between cities, "jian-zhi towns", (organic town) which are officially recognized, and rural areas. Analysis is provided f the economic and residential registration status of town residents and migration in northern China. Data were obtained from a 1987 survey of 1314 households in Wongnioute Banner in Inner Mongolia, and a 1985 migration survey of 2089 rural households in 41 villages. The study area was selected because jian-zhi town status was easily obtained and the are needed more towns for local administration and trade; the area was similar in geographic, social, economic, and cultural characteristics to other northern and northwestern regions. The Wongnioute Banner comprises 5 towns (Qiaotou, Wufendi, Hairesu, Wuduentaohai, and Wutonghua) and 1 country town (Wudan). All citizens from birth have an agricultural or nonagricultural status, which can be changed by passing national exams or completing a university education, joining the military and becoming an officer, marrying someone with a nonagricultural status, reunifying the family, or holding a special program. Quotas are set annually for status changes, e.g. in Tibet Autonomous Region the annual quota was 3%. Town residents may have either status. In the sample, 56.6% lived in town and had a nonagricultural status; 17.7% of heads of household town residents had an agricultural status and had stronger ties to villages because of family connections. Commuters are a third group and comprise 8.9%. County towns and jian-zhi towns are grouped the same, but are quite different in population size. Wudan had a population of 27,600 spread over an area of 480 hectares. The jian-zhi towns each had an

  18. JWST Town Meeting

    NASA Technical Reports Server (NTRS)

    Mather, John

    2004-01-01

    The James Webb Space Telescope (JWST) Science Working Group has published the key scientific study areas for the mission: the end of the dark ages, the assembly of galaxies, the birth of stars and protoplanetary systems, and planetary systems and the origins of life. With these objectives establishing the major scientific capabilities of the observatory, the JWST Project has successfully completed major reviews of the telescope architecture and budget plan and has reached agreement on the contributions for all three international partners (NASA, ESA, and the Canadian Space Agency). Northrop Grumman Space Technologies (NGST) is the prime contractor responsible for the spacecraft, telescope, and integration. GSFC/NASA oversees the development and integration of the science instruments. The Space Telescope Science Institute is developing the JWST Science & Operations Center. The JWST will be launched to L2 2011 using an Ariane V. At this town hall, the mission's Project Scientists will present the technical and scientific status of the mission, concentrating on those areas that have changed over the last year. This will be an excellent opportunity to learn about JWST and catch up on the most recent developments. Questions from the audience will be welcomed. The town hall speakers will be John Mather, Peter Jakobsen, John Hutchings, and Peter Stockman.

  19. Glenn at the Cape

    NASA Technical Reports Server (NTRS)

    1964-01-01

    Astronaut John H. Glenn Jr. in his silver Mercury spacesuit during pre- flight training activities at Cape Canaveral. On February 20, 1962 Glenn lifted off into space aboard his Mercury Atlas (MA-6) rocket and became the first American to orbit the Earth. After orbiting the Earth 3 times, Friendship 7 landed in the Atlantic Ocean 4 hours, 55 minutes and 23 seconds later, just East of Grand Turk Island in the Bahamas. Glenn and his capsule were recovered by the Navy Destroyer Noa, 21 minutes after splashdown.

  20. Student Planning of Town Configuration

    ERIC Educational Resources Information Center

    Baird, John C.; And Others

    1972-01-01

    Two experiments are presented on the planning of ideal towns by undergraduates. The basic approach involved a modified map-sketching technique in which subjects placed sixteen town elements into two-dimensional physical environments. Results were analyzed by information theory, cluster analysis, and multidimensional scaling. (BL)

  1. New Schools for New Towns.

    ERIC Educational Resources Information Center

    Rice Univ., Houston, TX. School of Architecture.

    Development of new concepts related to educational systems in new towns resulted from a two week concentrated idea session among architects, specialists from other fields, and students, Six teams were given programs by educators related to new towns and various educational goals. The resulting solutions reflected both the influence of new…

  2. RadTown USA: Basic Information

    MedlinePlus

    ... Burbs Countryside Waterfront Downtown Did you know? RadTown Games Educational Materials Bring RadTown into the classroom with ... Waterfront Downtown Educational Materials RadTown A to Z Games Link to Us Glossary News Feeds Podcasts EPA ...

  3. New western boom towns

    SciTech Connect

    Daneke, G.A.

    1980-09-30

    The Mountain West, particularly isolated rural communities, can expect rapid growth which cannot be accurately predicted by the usual population-forecasting techniques. Mining and defense projects, combined with a general population shift to the South and West, have already brought some anticipatory migration to areas that have not prepared an infrastructure to handle the social and economic demands of boom towns. The relationship between meeting the physical and human needs of a community are poorly understood, with the result that most local planners concentrate on the water, sewer, and street planning of traditional urban-sprawl patterns and contribute to community disintegration. A carefully planned infrastructure which incorporates social-service planning could anticipate many problems and introduce innovative environmental and energy-saving ideas. (DCK)

  4. 33 CFR 80.525 - Cape Lookout, NC to Cape Fear, NC.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 33 Navigation and Navigable Waters 1 2012-07-01 2012-07-01 false Cape Lookout, NC to Cape Fear, NC... INTERNATIONAL NAVIGATION RULES COLREGS DEMARCATION LINES Fifth District § 80.525 Cape Lookout, NC to Cape Fear... southeast side of the Inlet. (g) Except as provided elsewhere in this section from Cape Lookout to Cape...

  5. 33 CFR 80.525 - Cape Lookout, NC to Cape Fear, NC.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 33 Navigation and Navigable Waters 1 2013-07-01 2013-07-01 false Cape Lookout, NC to Cape Fear, NC... INTERNATIONAL NAVIGATION RULES COLREGS DEMARCATION LINES Fifth District § 80.525 Cape Lookout, NC to Cape Fear...) Except as provided elsewhere in this section from Cape Lookout to Cape Fear, lines drawn parallel...

  6. 33 CFR 80.525 - Cape Lookout, NC to Cape Fear, NC.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 33 Navigation and Navigable Waters 1 2014-07-01 2014-07-01 false Cape Lookout, NC to Cape Fear, NC... INTERNATIONAL NAVIGATION RULES COLREGS DEMARCATION LINES Fifth District § 80.525 Cape Lookout, NC to Cape Fear...) Except as provided elsewhere in this section from Cape Lookout to Cape Fear, lines drawn parallel...

  7. 33 CFR 80.525 - Cape Lookout, NC to Cape Fear, NC.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 33 Navigation and Navigable Waters 1 2011-07-01 2011-07-01 false Cape Lookout, NC to Cape Fear, NC... INTERNATIONAL NAVIGATION RULES COLREGS DEMARCATION LINES Fifth District § 80.525 Cape Lookout, NC to Cape Fear... southeast side of the Inlet. (g) Except as provided elsewhere in this section from Cape Lookout to Cape...

  8. 33 CFR 80.525 - Cape Lookout, NC to Cape Fear, NC.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 33 Navigation and Navigable Waters 1 2010-07-01 2010-07-01 false Cape Lookout, NC to Cape Fear, NC... INTERNATIONAL NAVIGATION RULES COLREGS DEMARCATION LINES Fifth District § 80.525 Cape Lookout, NC to Cape Fear... southeast side of the Inlet. (g) Except as provided elsewhere in this section from Cape Lookout to Cape...

  9. Local Authority and Town Planning.

    ERIC Educational Resources Information Center

    Duder, Bruce

    1987-01-01

    Provides an overview and definition of local authority and town planning in New Zealand. Demonstrates the relevance of planning matters to the teaching of geography. Reviews objectives of geography and specific planning methods used in several districts. (BR)

  10. IN and CCN Measurements on RV Polarstern and Cape Verde

    NASA Astrophysics Data System (ADS)

    Welti, André; Herenz, Paul; Henning, Silvia; Stratmann, Frank

    2016-04-01

    Two field campaigns, one situated on RV Polarstern (Oct. - Dec. 2015) and one on the Cape Verde islands (Jan. - Feb. 2016) measuring ice nuclei (IN) and cloud condensation nuclei (CCN) concentrations as a function of supersaturation and temperature are presented. The Polarstern cruise from Bremerhaven to Cape Town yields a cross section of IN and CCN concentrations from 54°N to 35°S and passes the Cape Verde Islands at 15°N. Measurements were conducted using the commercial CCNC and SPIN instruments from DMT. During both campaigns, a comprehensive set of aerosol characterization data including size distribution, optical properties and chemical information were measured in parallel. The ship based measurements provide a measure of variability in IN/CCN concentration with geographic position. As an example a clear influence on IN and CCN number concentration of the Saharan desert dust outflow between the Canary Islands and Cape Verde or the continental aerosol from Europe and South Africa was observed. The measurements on Cape Verde provide information on the temporal variability at a fixed position varying between clean marine and dust influenced conditions. Both datasets are related to auxiliary data of aerosol size distribution and chemical composition. The datasets are used to distinguish the influence of local sources and background concentration of IN/CCN. By combining of the geographically fix measurements with the geographical cross section, typical ranges of IN and CCN concentration are derived. The datasets will be part of the BACCHUS database thereby providing valuable input for future climate modeling activities.

  11. Townes' contribution to nonlinear optics

    NASA Astrophysics Data System (ADS)

    Garmire, Elsa

    2015-03-01

    In honour of the Fiftieth Anniversary of the Nobel Prize in Physics, this talk introduced the contributions of Nicholas Basov and Alexei Prokhorov, who shared the prize with Charles Townes. The talk then detailed the quantum electronics research of Townes, particularly at MIT, which was related to nonlinear optics. The years from 1961 to 1968 were particularly exciting, as the ruby laser enabled a wide variety of new physics to be discovered and explored.

  12. Opportunity View Leaving Cape York

    NASA Image and Video Library

    2013-06-07

    NASA Mars Exploration Rover Opportunity used its navigation camera to acquire this view looking toward the southwest. The scene includes tilted rocks at the edge of a bench surrounding Cape York, with Burns formation rocks exposed in Botany Bay.

  13. Media Rich, Resource Poor: Practical Work in an Impractical Environment

    ERIC Educational Resources Information Center

    van der Vliet, Emma; Deacon, Andrew

    2004-01-01

    Film and media courses appear well placed to exploit technology convergence in exposing students both to practical skills and to theoretical concepts. For the University of Cape Town's (UCT) large film and media studies courses, it is impractical simply to use the technology of professionals as this would typically be too expensive to purchase and…

  14. The Web and Information Literacy: Scaffolding the use of Web Sources in a Project-Based Curriculum

    ERIC Educational Resources Information Center

    Walton, Marion; Archer, Arlene

    2004-01-01

    In this article we describe and discuss a three-year case study of a course in web literacy, part of the academic literacy curriculum for first-year engineering students at the University of Cape Town (UCT). Because they are seen as practical knowledge, not theoretical, information skills tend to be devalued at university and rendered invisible to…

  15. Dance Pedagogy: Backup Plan or Branch into the Future?

    ERIC Educational Resources Information Center

    Wilson, Lisa

    2016-01-01

    This article focuses on Lisa Wilson's recent teaching experiences at the School of Dance, University of Cape Town (UCT), where dance pedagogy courses are established curricular components of its two undergraduate programs, the three-year Diploma in Dance Education (DipEd) and the four-year Bachelor of Music (BMus) degree in dance. The DipEd…

  16. Students and Their Presenting Concerns at a Student Counselling Service at a South African University

    ERIC Educational Resources Information Center

    Schreiber, B. M.

    2007-01-01

    This article presents a summary of the concerns and the demographic data collected from clients at the Student Counselling Service (SCS) at the University of Cape Town (UCT), South Africa, during the period of March 2001 to April 2003. First-time presenting clients who are enrolled students, were asked to ill out an anonymous questionnaire, of…

  17. Fruits of Democratic Transformation Education in a South African University in 1998: Perspectives of Students in the School of Education, University of Capetown

    ERIC Educational Resources Information Center

    Taylor, Philip J.

    2004-01-01

    This article is based on a doctoral study of educational change in the School of Education (SOE) of the University of Cape Town (UCT) in South Africa. It is an exploration of "a moment in time" that bore witness to institutional and human transformation in South African higher education. This transformation involved a development from…

  18. Media Rich, Resource Poor: Practical Work in an Impractical Environment

    ERIC Educational Resources Information Center

    van der Vliet, Emma; Deacon, Andrew

    2004-01-01

    Film and media courses appear well placed to exploit technology convergence in exposing students both to practical skills and to theoretical concepts. For the University of Cape Town's (UCT) large film and media studies courses, it is impractical simply to use the technology of professionals as this would typically be too expensive to purchase and…

  19. Assessing and Teaching Competence

    ERIC Educational Resources Information Center

    Grant, Terri

    2004-01-01

    The Professional Communication Unit (PCU) at the University of Cape Town (UCT) recently conducted a business communication needs analysis to determine student perceptions of their communicative competence and the teaching strategies being used to develop such competence. Students felt that the specialist, stand-alone communication program was more…

  20. Postgraduate Diploma Collaborative Assignment: Implications for ESL Students and Curriculum Design

    ERIC Educational Resources Information Center

    Grant, T.

    2008-01-01

    The commerce faculty at the University of Cape Town (UCT) offers a 1-year, postgraduate management diploma that is regarded as a mini-MBA. It appeals to a wide variety of mainly English-as-second language (ESL) students. In the past, core course diploma lecturers in marketing, tourism and leisure, enterprise management and sport management…

  1. Postgraduate Diploma Collaborative Assignment: Implications for ESL Students and Curriculum Design

    ERIC Educational Resources Information Center

    Grant, T.

    2008-01-01

    The commerce faculty at the University of Cape Town (UCT) offers a 1-year, postgraduate management diploma that is regarded as a mini-MBA. It appeals to a wide variety of mainly English-as-second language (ESL) students. In the past, core course diploma lecturers in marketing, tourism and leisure, enterprise management and sport management…

  2. Assessing and Teaching Competence

    ERIC Educational Resources Information Center

    Grant, Terri

    2004-01-01

    The Professional Communication Unit (PCU) at the University of Cape Town (UCT) recently conducted a business communication needs analysis to determine student perceptions of their communicative competence and the teaching strategies being used to develop such competence. Students felt that the specialist, stand-alone communication program was more…

  3. The Alignment of Software Testing Skills of IS Students with Industry Practices--A South African Perspective

    ERIC Educational Resources Information Center

    Scott, Elsje; Zadirov, Alexander; Feinberg, Sean; Jayakody, Ruwanga

    2004-01-01

    Software testing is a crucial component in the development of good quality systems in industry. For this reason it was considered important to investigate the extent to which the Information Systems (IS) syllabus at the University of Cape Town (UCT) was aligned with accepted software testing practices in South Africa. For students to be effective…

  4. Dance Pedagogy: Backup Plan or Branch into the Future?

    ERIC Educational Resources Information Center

    Wilson, Lisa

    2016-01-01

    This article focuses on Lisa Wilson's recent teaching experiences at the School of Dance, University of Cape Town (UCT), where dance pedagogy courses are established curricular components of its two undergraduate programs, the three-year Diploma in Dance Education (DipEd) and the four-year Bachelor of Music (BMus) degree in dance. The DipEd…

  5. Meeting the Knowledge Needs of the Academy and Industry: A Case Study of a Partnership between a University and a Large Energy Company in South Africa

    ERIC Educational Resources Information Center

    Cele, Mlungisi Gabriel

    2005-01-01

    This case study examines the evolution of the 21-year research partnership between the University of Cape Town (UCT) and the South African Coal Oil and Gas Corporation (SASOL). The study finds that an individual academic has played a significant role in steering transformation research activities and culture in the university?s Chemical…

  6. Shanghai Academic Ranking of World Universities (ARWU) and the "Big Five" South African Research Universities

    ERIC Educational Resources Information Center

    Boshoff, N.

    2009-01-01

    This article critically examines the methodology of the Shanghai Academic Ranking of World Universities (ARWU) by generating raw scores for the "big five" South African research universities (Stellenbosch, Cape Town, Kwazulu-Natal, Pretoria and the Witwatersrand, henceforth referred to as SU, UCT, UKZN, UP and WITS) using the ARWU…

  7. Students and Their Presenting Concerns at a Student Counselling Service at a South African University

    ERIC Educational Resources Information Center

    Schreiber, B. M.

    2007-01-01

    This article presents a summary of the concerns and the demographic data collected from clients at the Student Counselling Service (SCS) at the University of Cape Town (UCT), South Africa, during the period of March 2001 to April 2003. First-time presenting clients who are enrolled students, were asked to ill out an anonymous questionnaire, of…

  8. The Effect of Instruction on Students' Ideas on Data Handling of Under Prepared Students at Two Historically Advantaged South African Universities.

    ERIC Educational Resources Information Center

    Rollnick, Marissa; Lubben, Fred; Dlamini, Betty; Lotz, Sandra

    This study investigated the effect of two different approaches to practical work on the procedural understanding of foundation level students at two historically similar universities in South Africa, the University of Cape Town (UCT) and the University of the Witwatersrand (Wits), both of which run programs to improve the access of disadvantaged…

  9. Shanghai Academic Ranking of World Universities (ARWU) and the "Big Five" South African Research Universities

    ERIC Educational Resources Information Center

    Boshoff, N.

    2009-01-01

    This article critically examines the methodology of the Shanghai Academic Ranking of World Universities (ARWU) by generating raw scores for the "big five" South African research universities (Stellenbosch, Cape Town, Kwazulu-Natal, Pretoria and the Witwatersrand, henceforth referred to as SU, UCT, UKZN, UP and WITS) using the ARWU…

  10. Meeting the Knowledge Needs of the Academy and Industry: A Case Study of a Partnership between a University and a Large Energy Company in South Africa

    ERIC Educational Resources Information Center

    Cele, Mlungisi Gabriel

    2005-01-01

    This case study examines the evolution of the 21-year research partnership between the University of Cape Town (UCT) and the South African Coal Oil and Gas Corporation (SASOL). The study finds that an individual academic has played a significant role in steering transformation research activities and culture in the university?s Chemical…

  11. An OER Framework, Heuristic and Lens: Tools for Understanding Lecturers' Adoption of OER

    ERIC Educational Resources Information Center

    Cox, Glenda; Trotter, Henry

    2017-01-01

    This paper examines three new tools--a framework, an heuristic and a lens--for analysing lecturers' adoption of OER in higher educational settings. Emerging from research conducted at the universities of Cape Town (UCT), Fort Hare (UFH) and South Africa (UNISA) on why lecturers adopt--or do not adopt--OER, these tools enable greater analytical…

  12. Marketing the Uniqueness of Small Towns. Small Town Strategy.

    ERIC Educational Resources Information Center

    Hogg, David H.; Dunn, Douglas

    A small town can strengthen its local economy as a result of business people and concerned citizens collectively identifying that community's uniqueness and then capitalizing on it via advertising, personal selling, sales promotion, or publicity. This publication relates the science of marketing to communities. Seven simple techniques are provided…

  13. High Resolution Mapping of the Impermeable Surfaces of Barnstable County, Cape Cod and their Relationship to Water Quality

    NASA Astrophysics Data System (ADS)

    Stone, T.; Fiske, G.; Schlesinger, P.

    2003-12-01

    We have developed several impermeable surface maps for all Cape Cod (Barnstable County) to help assess the contribution of paved and other impermeable surfaces to declines in local and regional water quality. These maps have been assembled with the cooperation of many town planning departments, the Cape Cod National Seashore, Mass Military Reservation, the Cape Cod Commission, the Association to Preserve Cape Cod (APCC) and from IKONOS data. The map are being used to predict where new impermeable surface will occur, define current and future hotspots of non-point pollution, and to map the relationships of impermeable surfaces to the zones of contribution (ZOC) of municipal wells. The maps are also used to define the percentage of impermeable surfaces in buffer zones around ponds and estuaries. Combining these data with census data on housing and population density allows us to define the importance of impervious surface as minor or major factors in water pollution.

  14. Genetics Home Reference: Townes-Brocks Syndrome

    MedlinePlus

    ... links) American Society for Surgery of the Hand: Congenital Hand Differences Cincinnati Children's Hospital Medical Center: Anorectal Malformations Disease InfoSearch: Townes-Brocks syndrome MalaCards: townes-brocks ...

  15. View of 'Cape St. Mary' from 'Cape Verde' (Altered Contrast)

    NASA Technical Reports Server (NTRS)

    2006-01-01

    As part of its investigation of 'Victoria Crater,' NASA's Mars Exploration Rover Opportunity examined a promontory called 'Cape St. Mary' from the from the vantage point of 'Cape Verde,' the next promontory counterclockwise around the crater's deeply scalloped rim. This view of Cape St. Mary combines several exposures taken by the rover's panoramic camera into an approximately true-color mosaic with contrast adjusted to improve the visibility of details in shaded areas.

    The upper portion of the crater wall contains a jumble of material tossed outward by the impact that excavated the crater. This vertical cross-section through the blanket of ejected material surrounding the crater was exposed by erosion that expanded the crater outward from its original diameter, according to scientists' interpretation of the observations. Below the jumbled material in the upper part of the wall are layers that survive relatively intact from before the crater-causing impact. Near the base of the Cape St. Mary cliff are layers with a pattern called 'crossbedding,' intersecting with each other at angles, rather than parallel to each other. Large-scale crossbedding can result from material being deposited as wind-blown dunes.

    The images combined into this mosaic were taken during the 970th Martian day, or sol, of Opportunity's Mars-surface mission (Oct. 16, 2006). The panoramic camera took them through the camera's 750-nanometer, 530-nanometer and 430-nanometer filters.

  16. Reimagining Education in Small Towns

    ERIC Educational Resources Information Center

    Carr, Patrick J.; Kefalas, Maria J.

    2010-01-01

    Things are not going so well in small-town America. While the so-called "Great Recession" of the moment has focused considerable attention on the travails of Main Street and Middle America, the truth is that the troubles that plague such places have been a long time in the making. For the past 30 years, nonmetropolitan counties and the…

  17. The Cheapest Apartments in Town

    ERIC Educational Resources Information Center

    Ankele, Chad; Sommer, Robert

    1973-01-01

    Several surveys are reported of tenants in a low-rent apartment complex in a university town before and after renovation. The tenants were willing to trade off the lack of amenities and anomie in return for low rent and casual lease arrangements. (JP)

  18. The Buried Town of Beaver.

    ERIC Educational Resources Information Center

    Jostad, Karen

    Local history as source material for environmental education is uniquely portrayed in this resource kit. Utilizing a Winona County Historical Society publication, "The Beaver Story" and accompanied by a teacher's guide, "The Buried Town of Beaver," and other teaching aids, a case study of the area can be developed. Based on the reminiscences of…

  19. Our Town's Planning Commission Meeting.

    ERIC Educational Resources Information Center

    Vort, Jeanine VanDe

    1997-01-01

    Discusses the development and implementation of a simulation game for a sixth-grade class that used the structure of Thornton Wilder's play, "Our Town," to examine the geographical issues involved in community planning. The land development issue discussed was based on a real-life local concern. (MJP)

  20. The Cheapest Apartments in Town

    ERIC Educational Resources Information Center

    Ankele, Chad; Sommer, Robert

    1973-01-01

    Several surveys are reported of tenants in a low-rent apartment complex in a university town before and after renovation. The tenants were willing to trade off the lack of amenities and anomie in return for low rent and casual lease arrangements. (JP)

  1. Reimagining Education in Small Towns

    ERIC Educational Resources Information Center

    Carr, Patrick J.; Kefalas, Maria J.

    2010-01-01

    Things are not going so well in small-town America. While the so-called "Great Recession" of the moment has focused considerable attention on the travails of Main Street and Middle America, the truth is that the troubles that plague such places have been a long time in the making. For the past 30 years, nonmetropolitan counties and the…

  2. Democratic Designs for Electronic Town Meetings.

    ERIC Educational Resources Information Center

    Abramson, Jeffrey B.

    The 1992 presidential campaign put the idea of the electronic town meeting firmly on the political scene, and each of the presidential debates during that campaign experimented with the town meeting format. This paper reviews the tradition of town meeting democracy in the United States and proposes ways to carry that tradition on with the help of…

  3. Marketing the Uniqueness of Small Towns. Revised.

    ERIC Educational Resources Information Center

    Dunn, Douglas; Hogg, David H.

    The key to marketing a town is determining and promoting the town's "differential advantage" or uniqueness that would make people want to visit or live there. Exercises to help communities gain important insights into the town's competitive edge include a brainstorming session with knowledgeable community members, a visitor…

  4. Urbanization: priority to development of towns.

    PubMed

    1997-02-01

    This news brief discusses the development of new towns and socioeconomic development in rural areas in China. The Ministry of Construction is currently engaged in piloting the promotion of rural urbanization in 500 selected towns in all provinces. Suburban towns in Beijing, Tianjin, and Tangshan were selected as demonstration areas. 1200 towns will be formulating their own plans based on local conditions. The Ministry of Construction aims to establish new towns by the year 2000 and to create favorable conditions for the movement of over 30 million surplus laborers. The Chinese government also plans to modernize 20% of its towns. Guidelines will strictly control the growth of large cities, reasonably developing medium-sized cities, small cities, and vigorously developing towns. China has about 55,000 towns and 3.7 million villages. The National Program for Town and Village Development is responsible for the transfer of surplus labor to the new towns. It is estimated that the urban town population will reach over 200 million. The aim is to establish over 10,000 economically developed towns, of which each of 2000 should have a population of over 10,000. The development will require 2.79 billion sq. m of space for housing. 42% of the new housing will have access to running water, and 55% should have access to paved roads. 16% of urban acreage will be devoted to green cover, which amounts to about 2.85 sq. m per person in public areas.

  5. Wisconsin Gas eases town`s recovery from train explosion

    SciTech Connect

    Hilliker, C.

    1997-04-01

    One quiet morning last winter, while most of Weyauwega slept in their warm homes, an 81-car freight train carrying millions of pounds of hazardous materials pummeled down the Wisconsin Central Ltd. railroad. On the frigid Monday morning of March 4, 1996, more than 35 cars, with 14 containing 1 million pounds of propane liquid gas. Some of the mammoth time bombs exploded into flames just 100 feet from a Wisconsin Gas natural gas gate station and the main gas line feeding the town of Weyauwega. Once the all-clear signal was given 15 days later, the utility went house-to-house in the empty town to shut off all 700 meters. Next, the crew made minor repairs to the gate station and repressurized and purged the gas mains, leaving the system on test overnight. To begin re-entry, Waupaca County emergency services staff devised a strategy in which Weyauwega was divided into four zones based on the Wisconsin Gas restoration plan. This helped in the coordination of buses and routing of families back into the town. A convoy of 40 Wisconsin Gas technical services employees from Milwaukee and other offices drove to Weyauwega to assist with the relighting efforts. Using gas leak detection equipment, they swept each building and secured it. They were teamed with electric, water and construction crews who assessed any damage to homes and appliances. The primary owner of a residence or business was allowed on the premises with the inspection crew and was allowed to return permanently only after it was declared safe. With the exception of some water damage, no other severe scarring was done to the homes. The restoration of service to the town was completed in just three days.

  6. 33 CFR 165.530 - Safety Zone: Cape Fear and Northeast Cape Fear Rivers, NC.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 33 Navigation and Navigable Waters 2 2011-07-01 2011-07-01 false Safety Zone: Cape Fear and Northeast Cape Fear Rivers, NC. 165.530 Section 165.530 Navigation and Navigable Waters COAST GUARD... § 165.530 Safety Zone: Cape Fear and Northeast Cape Fear Rivers, NC. (a) Location. The following area...

  7. 33 CFR 165.530 - Safety Zone: Cape Fear and Northeast Cape Fear Rivers, NC.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 33 Navigation and Navigable Waters 2 2010-07-01 2010-07-01 false Safety Zone: Cape Fear and Northeast Cape Fear Rivers, NC. 165.530 Section 165.530 Navigation and Navigable Waters COAST GUARD... § 165.530 Safety Zone: Cape Fear and Northeast Cape Fear Rivers, NC. (a) Location. The following area...

  8. 33 CFR 165.530 - Safety Zone: Cape Fear and Northeast Cape Fear Rivers, NC.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 33 Navigation and Navigable Waters 2 2013-07-01 2013-07-01 false Safety Zone: Cape Fear and Northeast Cape Fear Rivers, NC. 165.530 Section 165.530 Navigation and Navigable Waters COAST GUARD... § 165.530 Safety Zone: Cape Fear and Northeast Cape Fear Rivers, NC. (a) Location. The following area...

  9. 33 CFR 165.530 - Safety Zone: Cape Fear and Northeast Cape Fear Rivers, NC.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 33 Navigation and Navigable Waters 2 2014-07-01 2014-07-01 false Safety Zone: Cape Fear and Northeast Cape Fear Rivers, NC. 165.530 Section 165.530 Navigation and Navigable Waters COAST GUARD... § 165.530 Safety Zone: Cape Fear and Northeast Cape Fear Rivers, NC. (a) Location. The following area...

  10. 33 CFR 165.530 - Safety Zone: Cape Fear and Northeast Cape Fear Rivers, NC.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 33 Navigation and Navigable Waters 2 2012-07-01 2012-07-01 false Safety Zone: Cape Fear and Northeast Cape Fear Rivers, NC. 165.530 Section 165.530 Navigation and Navigable Waters COAST GUARD... § 165.530 Safety Zone: Cape Fear and Northeast Cape Fear Rivers, NC. (a) Location. The following area...

  11. 46 CFR 7.140 - Cape Blanco, OR to Cape Flattery, WA.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 46 Shipping 1 2010-10-01 2010-10-01 false Cape Blanco, OR to Cape Flattery, WA. 7.140 Section 7.140 Shipping COAST GUARD, DEPARTMENT OF HOMELAND SECURITY PROCEDURES APPLICABLE TO THE PUBLIC BOUNDARY LINES Pacific Coast § 7.140 Cape Blanco, OR to Cape Flattery, WA. (a) A line drawn from the seaward...

  12. 77 FR 9699 - Cape Cod National Seashore Advisory Commission; Cape Cod National Seashore, South Wellfleet, MA

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-02-17

    ... National Park Service Cape Cod National Seashore Advisory Commission; Cape Cod National Seashore, South... Stat. 770, 5 U.S.C. App 1, Section 10) of a meeting of the Cape Cod National Seashore Advisory Commission. DATES: The meeting of the Cape Cod National Seashore Advisory Commission will be held on March...

  13. 76 FR 8768 - Cape Cod National Seashore, South Wellfleet, MA; Cape Cod National Seashore Advisory Commission

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-02-15

    ... National Park Service Cape Cod National Seashore, South Wellfleet, MA; Cape Cod National Seashore Advisory... Stat. 770, 5 U.S.C. App 1, Section 10) of a meeting of the Cape Cod National Seashore Advisory Commission. DATES: The meeting of the Cape Cod National Seashore Advisory Commission will be held on March...

  14. 76 FR 44606 - Cape Cod National Seashore; South Wellfleet, MA; Cape Cod National Seashore Advisory Commission

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-07-26

    ... National Park Service Cape Cod National Seashore; South Wellfleet, MA; Cape Cod National Seashore Advisory.... 770, 5 U.S.C. App 1, Section 10) of a meeting of the Cape Cod National Seashore Advisory Commission. DATES: The meeting of the Cape Cod National Seashore Advisory Commission will be held on September...

  15. 76 FR 66082 - Cape Cod National Seashore, South Wellfleet, MA; Cape Cod National Seashore Advisory Commission

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-10-25

    ... National Park Service Cape Cod National Seashore, South Wellfleet, MA; Cape Cod National Seashore Advisory... Stat. 770, 5 U.S.C. App 1, Section 10) of a meeting of the Cape Cod National Seashore Advisory Commission. DATES: The meeting of the Cape Cod National Seashore Advisory Commission will be held on...

  16. 76 FR 81965 - Cape Cod National Seashore Advisory Commission; Cape Cod National Seashore, South Wellfleet, MA

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-12-29

    ... National Park Service Cape Cod National Seashore Advisory Commission; Cape Cod National Seashore, South... Stat. 770, 5 U.S.C. App 1, Section 10) of a meeting of the Cape Cod National Seashore Advisory Commission. DATES: The meeting of the Cape Cod National Seashore Advisory Commission will be held on...

  17. 75 FR 34479 - Cape Cod National Seashore; South Wellfleet, MA; Cape Cod National Seashore Advisory Commission

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-06-17

    ... National Park Service Cape Cod National Seashore; South Wellfleet, MA; Cape Cod National Seashore Advisory... Stat. 770, 5 U.S.C. App 1, Section 10) of a meeting of the Cape Cod National Seashore Advisory Commission. DATES: The meeting of the Cape Cod National Seashore Advisory Commission will be held on July...

  18. 75 FR 5622 - Cape Cod National Seashore, South Wellfleet, MA; Cape Cod National Seashore Advisory Commission

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-02-03

    ... Cape Cod National Seashore, South Wellfleet, MA; Cape Cod National Seashore Advisory Commission AGENCY.... App 1, Section 10) of a meeting of the Cape Cod National Seashore Advisory Commission. DATES: The meeting of the Cape Cod National Seashore Advisory Commission will be held on March 22, 2010 at 1...

  19. 75 FR 77900 - Cape Cod National Seashore, South Wellfleet, MA; Cape Cod National Seashore Advisory Commission

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-12-14

    ... National Park Service Cape Cod National Seashore, South Wellfleet, MA; Cape Cod National Seashore Advisory... Stat. 770, 5 U.S.C. App 1, Section 10) of a meeting of the Cape Cod National Seashore Advisory Commission. DATES: The meeting of the Cape Cod National Seashore Advisory Commission will be held on...

  20. 75 FR 63854 - Cape Cod National Seashore, South Wellfleet, MA; Cape Cod National Seashore Advisory Commission

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-10-18

    ... National Park Service Cape Cod National Seashore, South Wellfleet, MA; Cape Cod National Seashore Advisory... Stat. 770, 5 U.S.C. App 1, Section 10) of a meeting of the Cape Cod National Seashore Advisory Commission. DATES: The meeting of the Cape Cod National Seashore Advisory Commission will be held on...