Retrospective analysis of birth HIV PCR testing and follow-up of positive HIV PCR results in Nelson Mandela Bay Health District
- Authors: Makubalo, Nomlindo Princess
- Date: 2020
- Subjects: HIV infections -- South Africa -- Nelson Mandela Bay
- Language: English
- Type: Thesis , Masters , MSc
- Identifier: http://hdl.handle.net/10948/46351 , vital:39580
- Description: BACKGROUND HIV infection contributes significantly to infant morbidity and mortality, especially in high-prevalence, low-income countries. In view of this evidence-based knowledge, South Africa’s National Department of Health, in April 2015, released the National Consolidated Guidelines of Human Immunodeficiency Virus (HIV) stipulating that all HIV-exposed babies should have a HIV Polymer Chain Reaction (PCR) test performed at birth. Early infant diagnosis (EID) means early initiation of combined antiretroviral treatment (cART) and a reduction in the incidence of early infant HIV-related mortality. However, these guidelines can only be successful if implemented properly across all public sector healthcare institutions. Thus,the research question was,“How well has the Nelson Mandela Bay Health District implemented the EID?”AIM The aim of the study was to review the impact of the consolidated HIV guidelines on birth HIV-PCR testing and initiation of treatment in the Nelson Mandela Bay Health District. METHOD A retrospective quantitative longitudinal non-experimental design was used.The study consisted of two components,namely,analysis of NHLS databases, particularly HIV birth PCR results of infants over a three-year period (June 2015 to June 2018),and analysis of feedback received from the primary health care clinics. The feedback focused on infants with a positive-birth PCR test, using a purpose-designed data collection tool that was used by the clinics for the duration of the same three-year period. The paper-based tool documented antenatal care attendance, enrolment into the prevention of mother-to-child transmission (PMTCT) programme and initiation of ART. RESULTS Over the three-year period, there were approximately 13,096 live births to HIV-positive women in the study area, and a total of 11,066 HIV birth PCR tests were done over xiiithe three-year study period (84.5% of HIV-exposed infants). The birth HIV PCR was negative in 10,909 (98.6%) neonates, while 130 (1.2%) of neonates had positive-birth HIV PCR tests,and a further 27 (0.2%) had indeterminate results. The birth HIV PCR positivity rate reduced from 1.4%(2015)to 1%(2018)over the three-year study period. Of the 130 infants with positive-birth HIV PCR, the files of 42 children were excluded, and further analysis conducted on the files of 88 infants. cART was initiated within seven days in only nine of the 88 infants (10.2%). ARV initiation was delayed for 58 infants (65.9%) and 21 neonates (23.9%) were never initiated on cART. Among the 88 mothers of infants, more than one-third (38.6%) of pregnant women did not attend antenatal care, thus,compromising their opportunity to be enrolled on the PMTCT programme. Of those who attended antenatal care, only 39.1% were reported to attend antenatal care before 20 weeks CONCLUSION AND RECOMMENDATIONS The incidence of positive-birth HIV PCR has reduced from 1.4% in 2015 to 1% in 2018 whilst there has been an increase in birth HIV PCR testing. However, initiation of cART within seven days was achieved in only 10.2% of infants with positive-birth HIV PCR test results. Implementation of point-of-care birth HIV PCR testing would ensure that results are immediately available resulting in increasing the proportion of infants initiated on cART within seven days.
- Full Text:
- Date Issued: 2020
- Authors: Makubalo, Nomlindo Princess
- Date: 2020
- Subjects: HIV infections -- South Africa -- Nelson Mandela Bay
- Language: English
- Type: Thesis , Masters , MSc
- Identifier: http://hdl.handle.net/10948/46351 , vital:39580
- Description: BACKGROUND HIV infection contributes significantly to infant morbidity and mortality, especially in high-prevalence, low-income countries. In view of this evidence-based knowledge, South Africa’s National Department of Health, in April 2015, released the National Consolidated Guidelines of Human Immunodeficiency Virus (HIV) stipulating that all HIV-exposed babies should have a HIV Polymer Chain Reaction (PCR) test performed at birth. Early infant diagnosis (EID) means early initiation of combined antiretroviral treatment (cART) and a reduction in the incidence of early infant HIV-related mortality. However, these guidelines can only be successful if implemented properly across all public sector healthcare institutions. Thus,the research question was,“How well has the Nelson Mandela Bay Health District implemented the EID?”AIM The aim of the study was to review the impact of the consolidated HIV guidelines on birth HIV-PCR testing and initiation of treatment in the Nelson Mandela Bay Health District. METHOD A retrospective quantitative longitudinal non-experimental design was used.The study consisted of two components,namely,analysis of NHLS databases, particularly HIV birth PCR results of infants over a three-year period (June 2015 to June 2018),and analysis of feedback received from the primary health care clinics. The feedback focused on infants with a positive-birth PCR test, using a purpose-designed data collection tool that was used by the clinics for the duration of the same three-year period. The paper-based tool documented antenatal care attendance, enrolment into the prevention of mother-to-child transmission (PMTCT) programme and initiation of ART. RESULTS Over the three-year period, there were approximately 13,096 live births to HIV-positive women in the study area, and a total of 11,066 HIV birth PCR tests were done over xiiithe three-year study period (84.5% of HIV-exposed infants). The birth HIV PCR was negative in 10,909 (98.6%) neonates, while 130 (1.2%) of neonates had positive-birth HIV PCR tests,and a further 27 (0.2%) had indeterminate results. The birth HIV PCR positivity rate reduced from 1.4%(2015)to 1%(2018)over the three-year study period. Of the 130 infants with positive-birth HIV PCR, the files of 42 children were excluded, and further analysis conducted on the files of 88 infants. cART was initiated within seven days in only nine of the 88 infants (10.2%). ARV initiation was delayed for 58 infants (65.9%) and 21 neonates (23.9%) were never initiated on cART. Among the 88 mothers of infants, more than one-third (38.6%) of pregnant women did not attend antenatal care, thus,compromising their opportunity to be enrolled on the PMTCT programme. Of those who attended antenatal care, only 39.1% were reported to attend antenatal care before 20 weeks CONCLUSION AND RECOMMENDATIONS The incidence of positive-birth HIV PCR has reduced from 1.4% in 2015 to 1% in 2018 whilst there has been an increase in birth HIV PCR testing. However, initiation of cART within seven days was achieved in only 10.2% of infants with positive-birth HIV PCR test results. Implementation of point-of-care birth HIV PCR testing would ensure that results are immediately available resulting in increasing the proportion of infants initiated on cART within seven days.
- Full Text:
- Date Issued: 2020
Synthesis of fluorescent polymers with coumarin backbones by "click" polymerization
- Authors: Okerio, Jaspher Mosomi
- Date: 2013
- Subjects: Polymerization , Fluorescent polymers
- Language: English
- Type: Thesis , Masters , MSc
- Identifier: vital:10431 , http://hdl.handle.net/10948/d1020132
- Description: Click chemistry is one of the growing areas of research which is applied in the design and synthesis of a wide range of polymeric architectures. This investigation focuses on the synthesis of fluorescent coumarin based polymers by “click” A-B step growth polymerization process and evaluation of their photophysical properties. Non-fluorescent azide-alkyne functionalized coumarin-based monomers were synthesized in multiple steps from 2,4-dihydroxybenzaldehyde in reasonable yields. Polymers with coumarin backbone were synthesized from azide-alkyne functionalized coumarin monomers via the Cu(I) catalyzed 1,3-dipolar cycloaddition reaction between azides and alkynes, a typical click reaction, to form polymers whose repeating units are connected by a 1,2,3-triazole ring. The structures of the synthesized polymers were confirmed by NMR and FT-IR spectroscopy. Finally, the photophysical properties of the synthesized monomers and polymers were evaluated in DMF. All coumarin based monomers showed reduced fluorescent properties due to the quenching effect from the azido group. Although all polymers absorbed at maximum wavelength of 340 nm, a characteristic for coumarin chromophore, the homo-polymers emitted at a shorter wavelength of 413 nm as compared to the co-polymers which emitted at 421 nm.
- Full Text:
- Date Issued: 2013
- Authors: Okerio, Jaspher Mosomi
- Date: 2013
- Subjects: Polymerization , Fluorescent polymers
- Language: English
- Type: Thesis , Masters , MSc
- Identifier: vital:10431 , http://hdl.handle.net/10948/d1020132
- Description: Click chemistry is one of the growing areas of research which is applied in the design and synthesis of a wide range of polymeric architectures. This investigation focuses on the synthesis of fluorescent coumarin based polymers by “click” A-B step growth polymerization process and evaluation of their photophysical properties. Non-fluorescent azide-alkyne functionalized coumarin-based monomers were synthesized in multiple steps from 2,4-dihydroxybenzaldehyde in reasonable yields. Polymers with coumarin backbone were synthesized from azide-alkyne functionalized coumarin monomers via the Cu(I) catalyzed 1,3-dipolar cycloaddition reaction between azides and alkynes, a typical click reaction, to form polymers whose repeating units are connected by a 1,2,3-triazole ring. The structures of the synthesized polymers were confirmed by NMR and FT-IR spectroscopy. Finally, the photophysical properties of the synthesized monomers and polymers were evaluated in DMF. All coumarin based monomers showed reduced fluorescent properties due to the quenching effect from the azido group. Although all polymers absorbed at maximum wavelength of 340 nm, a characteristic for coumarin chromophore, the homo-polymers emitted at a shorter wavelength of 413 nm as compared to the co-polymers which emitted at 421 nm.
- Full Text:
- Date Issued: 2013
The relationship between psychological capital and psychological well-being
- Authors: De Andrade, Ruaan Kriel
- Date: 2013
- Subjects: Organizational sociology -- Research , Clinical health psychology , Psychology -- Management -- Social aspects
- Language: English
- Type: Thesis , Masters , MA
- Identifier: vital:9412 , http://hdl.handle.net/10948/d1020096
- Description: A study of the available literature on Psychological WellQBeing and Positive Organisational Scholarship revealed that enormous potential existed for further research. This is a relatively new field with limited literature and research evidence available. It became very clear from the beginning that the relationships between these constructs could successfully be researched. It was therefore decided to embark on an academic research journey in order to contribute to the existing knowledge available on these constructs within the South African Private Healthcare Industry. This quantitative research was used to obtain more clarity about the relationships between the two constructs and to gather the responses from the research population. The research sample consisted of 152 nursing staff. Two questionnaires were integrated to develop the Nursing Psychological WellQBeing Questionnaire and consisted of i) PsyCap Questionnaire developed by Luthans, Youssef and Avolio2007, and ii) Psychological WellQBeing Questionnaire developed by Ryff 2000. A total of 152 nursing staff responded to an 87–item paperQbased questionnaire. Four research questions were formulated and covered the following: •The content, validity and portability of the measuring instruments; •The configuration of the various constructs; • Relationships between some of the variables . The content and the structure of the measuring instruments were assessed by means of Confirmatory Factor Analysis (CFA) and) Exploratory Factor Analyses (EFA). These assessments showed that the original measuring instruments are not portable to a culture which is different to the one where they were originally developed. The relationship between dimensions of Psychological WellQBeing and PsyCap sense of achievement and optimism is a significant finding. The significance of the findings of this study and the contribution that it makes to the existing theory is seen in the importance of the portability of measuring instruments. Recommendations in this regard have been made in Chapter 5. Various findings have also highlighted the relationships between Psychological WellQBeing and PsyCap. The importance of future research topics has been recommended.
- Full Text:
- Date Issued: 2013
- Authors: De Andrade, Ruaan Kriel
- Date: 2013
- Subjects: Organizational sociology -- Research , Clinical health psychology , Psychology -- Management -- Social aspects
- Language: English
- Type: Thesis , Masters , MA
- Identifier: vital:9412 , http://hdl.handle.net/10948/d1020096
- Description: A study of the available literature on Psychological WellQBeing and Positive Organisational Scholarship revealed that enormous potential existed for further research. This is a relatively new field with limited literature and research evidence available. It became very clear from the beginning that the relationships between these constructs could successfully be researched. It was therefore decided to embark on an academic research journey in order to contribute to the existing knowledge available on these constructs within the South African Private Healthcare Industry. This quantitative research was used to obtain more clarity about the relationships between the two constructs and to gather the responses from the research population. The research sample consisted of 152 nursing staff. Two questionnaires were integrated to develop the Nursing Psychological WellQBeing Questionnaire and consisted of i) PsyCap Questionnaire developed by Luthans, Youssef and Avolio2007, and ii) Psychological WellQBeing Questionnaire developed by Ryff 2000. A total of 152 nursing staff responded to an 87–item paperQbased questionnaire. Four research questions were formulated and covered the following: •The content, validity and portability of the measuring instruments; •The configuration of the various constructs; • Relationships between some of the variables . The content and the structure of the measuring instruments were assessed by means of Confirmatory Factor Analysis (CFA) and) Exploratory Factor Analyses (EFA). These assessments showed that the original measuring instruments are not portable to a culture which is different to the one where they were originally developed. The relationship between dimensions of Psychological WellQBeing and PsyCap sense of achievement and optimism is a significant finding. The significance of the findings of this study and the contribution that it makes to the existing theory is seen in the importance of the portability of measuring instruments. Recommendations in this regard have been made in Chapter 5. Various findings have also highlighted the relationships between Psychological WellQBeing and PsyCap. The importance of future research topics has been recommended.
- Full Text:
- Date Issued: 2013
Phytoplankton associated with mesoscale eddies in the Mozambique Channel
- Authors: O'Reilly, Bevan James
- Date: 2012
- Subjects: Mozambique Channel. , Phytoplankton
- Language: English
- Type: Thesis , Masters , MSc
- Identifier: vital:10622 , http://hdl.handle.net/10948/d1010967 , Mozambique Channel. , Phytoplankton
- Description: The study undertaken was an attempt to provide information on the effect that oceanographic features common in the Mozambique Channel have on primary production. Oligotrophic conditions dominated the Mozambique Channel at the time of sampling and the introduction of nutrients into the euphotic zone by upwelling processes were identified as cyclonic eddies. Differences in physico-chemical variables between surface and F-max across all sites proved to be stronger than the physico-chemical variables between 4 grouped oceanographic features. This was revealed by stronger variations in phytoplankton community structure and chlorophyll a concentration between surface and F-max compared to oceanographic features sampled. One of the hypotheses presented for the study was that diatoms would dominate phytoplankton communities within a cyclonic eddy. This was not the case as the coccolithophorid, Emiliania huxleyi Lohmann (Hay and Mohler 1967) dominated F-max and surface water in the cyclonic eddies and most other sites. Phytoplankton community structure did not differ significantly between the oceanographic features sampled which contradicted another one of hypotheses presented in the study. Chlorophyll a concentration in surface water of the cyclonic eddies was significantly higher than in surface waters within the anti-cyclonic eddy. F-max was not significantly different in phytoplankton biomass between these two system types. The cyclonic eddies and anti-cyclone had similar phytoplankton diversity which did not verify the hypothesis that there would be less phytoplankton species diversity within cyclonic eddies compared to the anti-cyclonic eddy. Phytoplankton community structure differed between F-max (depth at which maximum chlorophyll a is found) and the surface. This phytoplankton community difference was linked to differences in physico-chemical variables between the two depths. The diatoms Thalassionema nitzschioides, Pseudo-nitzschia sp.A, Pseudo-nitzschia sp.B, Thalassiosira sp.C, Thalassiosira sp.E, Bacteriastrum furcatum, Guinardia cylindrus, Nitzschia closterium, Hemiaulus hauckii, and Nitzschia braarudii revealed the only discernible ecological similarity amongst phytoplankton species across all sites and depths. This is important as it revealed that these species were regularly found occupying similar depths and potentially similar physico-chemical ranges in the water column which suggest these diatom species responded to a dominant source of variation. Distribution patterns of species and of ecologically defined groups support the hypothesis that diatom species and assemblages are good indicators of the changing character of an upwelling system. These statements lead to the assumption that the diatom grouping found in this study indicates areas of upwelling where water temperatures are reduced and nutrients are more readily available. One must keep in mind that ordination techniques are only descriptive and no significance is tested. The coccolithophorid D. anthos and the dinoflagellate Phalacroma spp. were noted as being most dissimilar to all other phytoplankton species with regards to their position in the water column and their response to physico-chemical variables. Finally, the dominance of E. huxleyi in the Mozambique Channel during November/December of 2009 reveals the potential vulnerability of phytoplankton in the channel to ocean acidification.
- Full Text:
- Date Issued: 2012
- Authors: O'Reilly, Bevan James
- Date: 2012
- Subjects: Mozambique Channel. , Phytoplankton
- Language: English
- Type: Thesis , Masters , MSc
- Identifier: vital:10622 , http://hdl.handle.net/10948/d1010967 , Mozambique Channel. , Phytoplankton
- Description: The study undertaken was an attempt to provide information on the effect that oceanographic features common in the Mozambique Channel have on primary production. Oligotrophic conditions dominated the Mozambique Channel at the time of sampling and the introduction of nutrients into the euphotic zone by upwelling processes were identified as cyclonic eddies. Differences in physico-chemical variables between surface and F-max across all sites proved to be stronger than the physico-chemical variables between 4 grouped oceanographic features. This was revealed by stronger variations in phytoplankton community structure and chlorophyll a concentration between surface and F-max compared to oceanographic features sampled. One of the hypotheses presented for the study was that diatoms would dominate phytoplankton communities within a cyclonic eddy. This was not the case as the coccolithophorid, Emiliania huxleyi Lohmann (Hay and Mohler 1967) dominated F-max and surface water in the cyclonic eddies and most other sites. Phytoplankton community structure did not differ significantly between the oceanographic features sampled which contradicted another one of hypotheses presented in the study. Chlorophyll a concentration in surface water of the cyclonic eddies was significantly higher than in surface waters within the anti-cyclonic eddy. F-max was not significantly different in phytoplankton biomass between these two system types. The cyclonic eddies and anti-cyclone had similar phytoplankton diversity which did not verify the hypothesis that there would be less phytoplankton species diversity within cyclonic eddies compared to the anti-cyclonic eddy. Phytoplankton community structure differed between F-max (depth at which maximum chlorophyll a is found) and the surface. This phytoplankton community difference was linked to differences in physico-chemical variables between the two depths. The diatoms Thalassionema nitzschioides, Pseudo-nitzschia sp.A, Pseudo-nitzschia sp.B, Thalassiosira sp.C, Thalassiosira sp.E, Bacteriastrum furcatum, Guinardia cylindrus, Nitzschia closterium, Hemiaulus hauckii, and Nitzschia braarudii revealed the only discernible ecological similarity amongst phytoplankton species across all sites and depths. This is important as it revealed that these species were regularly found occupying similar depths and potentially similar physico-chemical ranges in the water column which suggest these diatom species responded to a dominant source of variation. Distribution patterns of species and of ecologically defined groups support the hypothesis that diatom species and assemblages are good indicators of the changing character of an upwelling system. These statements lead to the assumption that the diatom grouping found in this study indicates areas of upwelling where water temperatures are reduced and nutrients are more readily available. One must keep in mind that ordination techniques are only descriptive and no significance is tested. The coccolithophorid D. anthos and the dinoflagellate Phalacroma spp. were noted as being most dissimilar to all other phytoplankton species with regards to their position in the water column and their response to physico-chemical variables. Finally, the dominance of E. huxleyi in the Mozambique Channel during November/December of 2009 reveals the potential vulnerability of phytoplankton in the channel to ocean acidification.
- Full Text:
- Date Issued: 2012
Barriers confronting small and micro tourism enterprises of previously disadvantaged entrepreneurs in the Nelson Mandela Metropole
- Authors: Clay, Mzwake Richard
- Date: 2005
- Subjects: Small business -- South Africa -- Nelson Mandela Metropole , Tourism -- South Africa -- Nelson Mandela Metropole , Entrepreneurship -- South Africa -- Nelson Mandela Metropole
- Language: English
- Type: Thesis , Masters , MBA
- Identifier: vital:8536 , http://hdl.handle.net/10948/422 , Small business -- South Africa -- Nelson Mandela Metropole , Tourism -- South Africa -- Nelson Mandela Metropole , Entrepreneurship -- South Africa -- Nelson Mandela Metropole
- Description: The research problem in this study was to look at barriers confronting small and micro tourism enterprises of the previously disadvantaged entrepreneurs in the Nelson Mandela Metropole. To achieve this objective, literature on the barriers confronting these enterprises, was reviewed. The empirical results obtained indicate a strong concurrence with the literature study emphasizing the importance of the barriers identified and the possible ways of resolving them. The main problems identified in the literature review were: lack of institutional support, legislation, lack of access to finance, and lack of entrepreneurial skill (planning and organizing, marketing, training and human resources, time management, conflict resolution and negotiation skill). These barriers identified in the literature study were then used to develop a questionnaire to test the extent to which small and micro tourism enterprises are constrained by barriers when starting up and how these barriers can be resolved. A sample of 18 small and micro tourism businesses was taken, one from Uitenhage and 17 from Port Elizabeth. The main results were that there are few small and micro tourism businesses of the previously disadvantaged entrepreneurs in the Nelson Mandela Metropole. The main reason for this is that previously disadvantaged entrepreneurs are not given adequate support by government institutions created for that purpose. iv Most of these businesses are not getting enough financial support during start-up because of problems with the owners’ credit records. The results also indicate that small and micro tourism businesses of the previously disadvantaged entrepreneurs view legislation intended to develop them, as actually stifling their development, such as the municipal credit laws. The study recommends that more institutional support should be given to small and micro tourism businesses that are starting up, and government institutions responsible for the development of small and micro businesses need to target the previously disadvantaged communities with their marketing. The Nelson Mandela Metropolitan Municipality and the Small Enterprise Development Agency (SEDA) need to conduct research on alternative non-collateral financing for small and micro businesses. More training programmes on business skills have also to be conducted.
- Full Text:
- Date Issued: 2005
- Authors: Clay, Mzwake Richard
- Date: 2005
- Subjects: Small business -- South Africa -- Nelson Mandela Metropole , Tourism -- South Africa -- Nelson Mandela Metropole , Entrepreneurship -- South Africa -- Nelson Mandela Metropole
- Language: English
- Type: Thesis , Masters , MBA
- Identifier: vital:8536 , http://hdl.handle.net/10948/422 , Small business -- South Africa -- Nelson Mandela Metropole , Tourism -- South Africa -- Nelson Mandela Metropole , Entrepreneurship -- South Africa -- Nelson Mandela Metropole
- Description: The research problem in this study was to look at barriers confronting small and micro tourism enterprises of the previously disadvantaged entrepreneurs in the Nelson Mandela Metropole. To achieve this objective, literature on the barriers confronting these enterprises, was reviewed. The empirical results obtained indicate a strong concurrence with the literature study emphasizing the importance of the barriers identified and the possible ways of resolving them. The main problems identified in the literature review were: lack of institutional support, legislation, lack of access to finance, and lack of entrepreneurial skill (planning and organizing, marketing, training and human resources, time management, conflict resolution and negotiation skill). These barriers identified in the literature study were then used to develop a questionnaire to test the extent to which small and micro tourism enterprises are constrained by barriers when starting up and how these barriers can be resolved. A sample of 18 small and micro tourism businesses was taken, one from Uitenhage and 17 from Port Elizabeth. The main results were that there are few small and micro tourism businesses of the previously disadvantaged entrepreneurs in the Nelson Mandela Metropole. The main reason for this is that previously disadvantaged entrepreneurs are not given adequate support by government institutions created for that purpose. iv Most of these businesses are not getting enough financial support during start-up because of problems with the owners’ credit records. The results also indicate that small and micro tourism businesses of the previously disadvantaged entrepreneurs view legislation intended to develop them, as actually stifling their development, such as the municipal credit laws. The study recommends that more institutional support should be given to small and micro tourism businesses that are starting up, and government institutions responsible for the development of small and micro businesses need to target the previously disadvantaged communities with their marketing. The Nelson Mandela Metropolitan Municipality and the Small Enterprise Development Agency (SEDA) need to conduct research on alternative non-collateral financing for small and micro businesses. More training programmes on business skills have also to be conducted.
- Full Text:
- Date Issued: 2005
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