Understanding Pregnant Women's Perspective for late booking of antenatal care services in Mthatha area in Eastern Cape , South Africa
- Authors: Ramprakash Kaswa
- Date: 2016
- Subjects: Medicine , Family Medicine
- Language: English
- Type: Thesis, Masters
- Identifier: http://hdl.handle.net/11260/2144 , vital:40904
- Full Text: false
- Authors: Ramprakash Kaswa
- Date: 2016
- Subjects: Medicine , Family Medicine
- Language: English
- Type: Thesis, Masters
- Identifier: http://hdl.handle.net/11260/2144 , vital:40904
- Full Text: false
Exploring the curriculum content knowledge and skills bearing acquired by acquired by advanced certificate in education graduates in a selected institution of higher learning
- Authors: Mnukwa Zolile Maxwell
- Date: 2015
- Subjects: Educational Management and Development
- Language: English
- Type: Thesis, D Ed
- Identifier: http://hdl.handle.net/11260/2207 , vital:40916
- Description: Abstract
- Full Text: false
- Authors: Mnukwa Zolile Maxwell
- Date: 2015
- Subjects: Educational Management and Development
- Language: English
- Type: Thesis, D Ed
- Identifier: http://hdl.handle.net/11260/2207 , vital:40916
- Description: Abstract
- Full Text: false
IMMUNE RESPONSE TO SPECIFIC MYCOBACTERIUM TUBERCULOSIS ANTIGENS AMONG PARASITE INFECTED SCHOOL CHILDREN IN MTHATHA
- Authors: NTOMBIZODUMO NXASANA
- Date: 2015
- Subjects: IMMUNE RESPONSE, MYCOBACTERIUM TUBERCULOSIS ANTIGENS
- Language: English
- Type: Masters, Msc
- Identifier: http://hdl.handle.net/11260/2369 , vital:41452
- Description: Children from low socio-economic communities in the Eastern Cape Province of South Africa and in South Africa at large are frequently infected by intestinal parasites. The parasites are diverse and complex pathogens that include multi-cellular helminths and single-celled protozoa. Because of this diversity, immunity to parasites is more difficult to sustain. Tuberculosis also, remains a problem in South Africa and worldwide. Infection with Mycobacterium tuberculosis can result either in the disease itself or, more commonly, latent infection. A variety of mechanisms that include both humoral and cell mediated immunity achieve host protection against mycobacterial pathogens. Macrophages and cell-mediated immunity are the primary defence mechanisms against mycobacteria. According to the literature, parasitic infections impair the body’s immune response to tuberculosis, but these diseases are not adequately researched in this province. The extent to which the school children of Mthatha are infected with intestinal parasites and latent tuberculosis, or even how their immune systems respond to these infections have not been investigated. Therefore, the immune response of school children, both of those infected and those not infected with parasites, to specific Mycobacterium tuberculosis antigens was evaluated. The present study used two study design methods: firstly, a descriptive cross-sectional design for the prevalence rates of intestinal parasites and, secondly, a case-control study for comparison of interferon gamma and T-helper 1 and T-helper 2 cytokines in parasite infected and non-parasite infected participants. A total of 137 school children participated in the survey and all were analyzed for parasites. Due to the high cost of the reagent kits, only 75 participants were included in the case-control study. Data collection methods: i) for the prevalence of intestinal parasites, formalin ethyl acetate sedimentation technique was used to process stool specimens, ii) for immune response to Mycobacterium tuberculosis antigens (measurement of interferon gamma for latent tuberculosis),the QuantiFeron TB Gold In-Tube assay was used, and iii) for the quantification of Th1 and Th2 cytokines, the Bio-Plex Pro assay was used. Out of 137 school children analyzed, 66.4% (91/137) were positive for parasites (ova and cysts). The most prevalent parasite was the pathogenic helminth, Ascaris lumbricoides at 21.9% (30/137), followed by Trichuris trichiura at 8.8%. The pathogenic protozoa, Giardia lamblia and Blastocystis hominis were both at 2.9% (4/137). The non-pathogenic protozoa, Entamoeba coli and Endolimax nana had high prevalence rates at 32.1% (44/137) and 29.2% (40/137) respectively. Associations between parasitic infections and sociodemographics showed a significant difference in participants whose parents had a low level of education and those who were unemployed (P = 0.004; P = 0.005 respectively). Out of 75 participants analyzed for tuberculosis, 53.3% (40/75) were positive. In conclusion, the present study demonstrates high prevalence rates of parasitic as well as latent tuberculosis infections in Mthatha. The study also showed that intestinal parasites, especially helminths, interfere with immune responses to TB by down-regulating Th1 response leading to reduced production of interferon gamma, a cytokine that mediates protection against TB.
- Full Text:
- Authors: NTOMBIZODUMO NXASANA
- Date: 2015
- Subjects: IMMUNE RESPONSE, MYCOBACTERIUM TUBERCULOSIS ANTIGENS
- Language: English
- Type: Masters, Msc
- Identifier: http://hdl.handle.net/11260/2369 , vital:41452
- Description: Children from low socio-economic communities in the Eastern Cape Province of South Africa and in South Africa at large are frequently infected by intestinal parasites. The parasites are diverse and complex pathogens that include multi-cellular helminths and single-celled protozoa. Because of this diversity, immunity to parasites is more difficult to sustain. Tuberculosis also, remains a problem in South Africa and worldwide. Infection with Mycobacterium tuberculosis can result either in the disease itself or, more commonly, latent infection. A variety of mechanisms that include both humoral and cell mediated immunity achieve host protection against mycobacterial pathogens. Macrophages and cell-mediated immunity are the primary defence mechanisms against mycobacteria. According to the literature, parasitic infections impair the body’s immune response to tuberculosis, but these diseases are not adequately researched in this province. The extent to which the school children of Mthatha are infected with intestinal parasites and latent tuberculosis, or even how their immune systems respond to these infections have not been investigated. Therefore, the immune response of school children, both of those infected and those not infected with parasites, to specific Mycobacterium tuberculosis antigens was evaluated. The present study used two study design methods: firstly, a descriptive cross-sectional design for the prevalence rates of intestinal parasites and, secondly, a case-control study for comparison of interferon gamma and T-helper 1 and T-helper 2 cytokines in parasite infected and non-parasite infected participants. A total of 137 school children participated in the survey and all were analyzed for parasites. Due to the high cost of the reagent kits, only 75 participants were included in the case-control study. Data collection methods: i) for the prevalence of intestinal parasites, formalin ethyl acetate sedimentation technique was used to process stool specimens, ii) for immune response to Mycobacterium tuberculosis antigens (measurement of interferon gamma for latent tuberculosis),the QuantiFeron TB Gold In-Tube assay was used, and iii) for the quantification of Th1 and Th2 cytokines, the Bio-Plex Pro assay was used. Out of 137 school children analyzed, 66.4% (91/137) were positive for parasites (ova and cysts). The most prevalent parasite was the pathogenic helminth, Ascaris lumbricoides at 21.9% (30/137), followed by Trichuris trichiura at 8.8%. The pathogenic protozoa, Giardia lamblia and Blastocystis hominis were both at 2.9% (4/137). The non-pathogenic protozoa, Entamoeba coli and Endolimax nana had high prevalence rates at 32.1% (44/137) and 29.2% (40/137) respectively. Associations between parasitic infections and sociodemographics showed a significant difference in participants whose parents had a low level of education and those who were unemployed (P = 0.004; P = 0.005 respectively). Out of 75 participants analyzed for tuberculosis, 53.3% (40/75) were positive. In conclusion, the present study demonstrates high prevalence rates of parasitic as well as latent tuberculosis infections in Mthatha. The study also showed that intestinal parasites, especially helminths, interfere with immune responses to TB by down-regulating Th1 response leading to reduced production of interferon gamma, a cytokine that mediates protection against TB.
- Full Text:
Learners' Attitudes Influencing their performance in the study of Mathematics in Seven Selected Senior Secondary Schools in the Mthatha Education District
- Authors: Gyeke, Yirenkyi - Darko
- Date: 2015
- Subjects: Mathematics Education
- Language: English
- Type: Thesis, D Ed
- Identifier: http://hdl.handle.net/11260/2222 , vital:40919
- Full Text: false
- Authors: Gyeke, Yirenkyi - Darko
- Date: 2015
- Subjects: Mathematics Education
- Language: English
- Type: Thesis, D Ed
- Identifier: http://hdl.handle.net/11260/2222 , vital:40919
- Full Text: false
Opening Doors: Investigating Mental Health Service Delivery in The Eastern Cape, to develop an Integrated Service Delivery in the Eastern cape, to develop an integrated service delivery plan
- Authors: Kiran Sukeri
- Date: 2015
- Subjects: Psychiatry, Mental Health
- Language: English
- Type: Thesis, Doctoral, PhD
- Identifier: http://hdl.handle.net/11260/2130 , vital:40900
- Full Text: false
- Authors: Kiran Sukeri
- Date: 2015
- Subjects: Psychiatry, Mental Health
- Language: English
- Type: Thesis, Doctoral, PhD
- Identifier: http://hdl.handle.net/11260/2130 , vital:40900
- Full Text: false
Phenotypic and molecular characterization of clinical isolates of s. Aureus and s. Epidermidis in the Eastern Cape province, South Africa : evaluation of plant-derived compounds
- Mthethwa, Ntombeziningi Shirley
- Authors: Mthethwa, Ntombeziningi Shirley
- Date: 2015
- Language: English
- Type: PhD Manuscript
- Identifier: http://hdl.handle.net/11260/2030 , vital:40805 , Doctor Of Philosophy (Health Sciences) Medical Microbiology
- Description: Staphylococcal species are known pathogens that are responsible for an extensive array of clinical manifestations in humans of diverse age groups in different settings and countries. They are responsible for cases of food poisoning, toxic shock syndrome, staphylococcal scalded skin syndrome, carbuncles, meningitis, among others. High level of antibiotic resistance patterns are common among isolates from different sources. The quest to discover alternative therapeutic regimes by use of medicinal plants are now topical and the subject of research activities. The aim of this study was to determine the prevalence and antibiotic resistant patterns of Staphylococcus aureus and Staphylococcus epidermidis isolated from patients attending different hospitals and clinics in rural communities around Mthatha; determine the activity of medicinal plants against S. aureus and S. epidermidis, including the characterisation of active compounds; ascertain phylogenetic relatedness of isolates; determine the genes coding for resistance in both pathogens and assess the role of human sera samples from different blood groups against S. aureus and S. epidermidis . In order to achieve these goals, the following aspects were explored and are hereby presented in chapters. Chapter one focused on the general introduction and literature review. The morphology, cultural characteristics, laboratory diagnosis, pathogenesis, antibiograms and clinical manifestations of Staphylococcus epidermidis and Staphylococcus aureus were reviewed. Furthermore the activities of medicinal plants and their various applications in the management of infections in different countries, including their possible active compounds and toxicity levels were also explored in an endeavour to provide suitable background for the study. iii The activity of human serum samples from different blood groups and their kinetics were also foregrounded. In Chapter 2, the antimicrobial susceptibility, genes coding for resistance and pathogenesis, and phylogenetic relatedness in S. aureus and S. epidermidis were investigated. Samples were collected from the Nelson Mandela Academic Hospital, Mthatha General Hospital and other samples were received from surrounding satellite hospitals. Samples were analysed using Kirby Bauer disk diffusion (antibiotic susceptibility testing), micro-broth dilution (MIC) and conventional PCR for the investigation of the genes (mecA, luks-lukf, msrA, ermA, ermC and icaA) responsible for resistance, virulence and pathogenesis of isolates. RAPD-PCR (Random Amplified Polymorphic DNA – Polymerase Chain Reaction) was used to determine phylogenetic relatedness amongst the S. aureus and S. epidermidis isolates. Results indicated that wound swabs and blood cultures were identified as the main sources of S. aureus and S. epidermidis and prevalence rates in children less than eleven years (25.7%) (S. aureus) and (7%) (S. epidermidis) were recorded. Vancomycin had the highest activity against both S. aureus and S. epidermidis, penicillin had the lowest activity.There were no significant differences in resistance patterns among different age groups and gender (p>0.01). Ninety three percent of S. aureus that were confirmed as MRSA with PCR method possessed mecA gene, whilst 16% of S. epidermidis had mecA and 33% possessed icaA gene. Fifty eight percent (58%) of S. aureus possessed luks-lukf PVL gene suggesting that it may have been acquired from the community. Forty two percent 42% of msrA was detected in S. epidermidis, 43% ermC and 34% ermA were detected in S. aureus isolates. Eleven percent 11% of S. aureus isolates were found to carry both ermA and ermC genes. mecA and luks-lufPV genes are implicated in iv methicillin resistant S. aureus that causes necrotizing pnemoniae and icaA is implicated in the formation of biofilm, another mechanism of resistance in S. epidermidis. RAPD profile resulting in DNA amplification fragments ranged in size from 300 to 1500 bp. The RAPD patterns obtained showed various trends among isolates meaning that S. aureus and S. epidermidis isolates investigated had high diversity among them. Dendograms constructed with each oligonucleotide showed that PCR patterns obtained with primer OPL11 (S. aureus) and ERIC1 (S. epidermidis) strains had genetic similarity indices ranging from 0.009 to 0.329. This wide range of similarity indices indicated a high level of DNA polymorphism among S. aureus and S. epidermidis isolates. Knowledge of the genes coding for resistance in this study will address the gaps in the mechanisms of resistance for effective intervention strategies. The infections caused by multi-resistant strains of Staphylococcal species represent an important problem that affects many health institutions. Due to the large number of patients infected with S. aureus and S. epidermidis and the diverse possibilities of contamination, it is always necessary to review the evolution of antimicrobial resistance and the therapeutic responses of the bacterial strains. This aspect of the study provides updated data on susceptibility patterns of local isolates of S. aureus and S. epidermidis for use in empiric management of patients including the various genes coding for resistance in the designated pathogens and their phylogenetic relatedness. Chapter 3 presents the antimicrobial and anti-HIV1 activities of selected medicinal plants from the Eastern Cape Province used for treating skin and respiratory tract infections. Anti-HIV activities were investigated because of the role of staphylococcal v species as opportunistic pathogens in HIV infections. Four medicinal plants were evaluated for antimicrobial activities and cytotoxicity on clinical isolates of S. aureus and S. epidermidis. Medicinal plants used in this study were Cassine transvaalensis, Croton gratissimus, Vangueria infausta and Vitex ferruginea. The Kirby-Bauer disk diffusion and 96 well microtiter plate methods were used in the antimicrobial activity studies but for the anti-HIV1 activity, MAGI assay was used. Microtetrazolium assay (MTT) was used for the evaluation of cytotoxicity of plants. Bio-autographic assay was used to locate the position of the active compound using Rf value; thin layer chromatography and column chromatography were used in the isolation of active compounds and NMR was used in the identification and structural elucidation of the active compounds. C. transvaalensis and V. infausta were found to possess high activity against S. aureus and S. epidermidis with the lowest MIC of 0.02. In the anti HIV1 MAGI assay, C. transvaalensis and C. gratissimus showed activity against HIV1. C. transvaalensis and C. grattisimus possessed high level of toxicity with CC50 reading of 0.2 while V. infausta and V. ferruginea had reading of 0.1. Two triterpenoids were successfully isolated in C. transvaalensis. Elucidation of the structure of active compounds of plant extracts of medicinal plants provides suitable templates for candidate drug designs and drug discovery. Such potential application will be contingent on the results of cytotoxicity testing and this underlines the significance of the test. Human serum is an important host defence mechanism against disease causing agents. Chapter four evaluates the bactericidal activity of different blood groups. Blood samples of different blood groups were screened for the presence of antibodies against S. aureus and S. epidermidis using agglutination test. Serum sensitivity assay vi was employed for susceptibility testing of S. aureus and S. epidermidis to blood samples. The Gunea-pig serum was used to determine the role of complement in serum bactericidal activity. The results showed that S. aureus and S. epidermidis were highly sensitive to normal human sera from blood group B with a percentage of 61% (S. aureus) and 83.3% (S. epidermidis). When the role of complement in bactericidal activity of the serum to staphylococci species was assessed it was shown that when both S. aureus and S. epidermidis were incubated with individual sera of blood groups and pooled serum of the same blood groups, the organisms were serum sensitive. The findings showed that different individual and pooled serum samples had a role to play in the defence mechanisms of individuals against S. aureus and S. epidermidis. In general the study provides a reference document on S. aureus and S. epidermidis in terms of their antibiograms, molecular characterization, sensitivity to human sera and susceptibility to medicinal plant extracts. Cytotoxicity profiles of the medicinal plants are also reported. Due to the on-going need to expand on the frontiers of knowledge, it is therefore recommended, as a way of building on this study, extensive investigations on the epidemiology of S. epidermidis, S. aureus and related pathogens to be conducted because studies of this nature have been limited by the fact that S. epidermidis strains are often considered to be contaminants. High-level surveillance of clinical samples of MRSA to define the instance and spread of CA-MRSA and HA-MRSA in hospital settings including health care workers and patients are also warranted in addition to further anti -cancer activities and cytotoxicity tests.
- Full Text:
- Authors: Mthethwa, Ntombeziningi Shirley
- Date: 2015
- Language: English
- Type: PhD Manuscript
- Identifier: http://hdl.handle.net/11260/2030 , vital:40805 , Doctor Of Philosophy (Health Sciences) Medical Microbiology
- Description: Staphylococcal species are known pathogens that are responsible for an extensive array of clinical manifestations in humans of diverse age groups in different settings and countries. They are responsible for cases of food poisoning, toxic shock syndrome, staphylococcal scalded skin syndrome, carbuncles, meningitis, among others. High level of antibiotic resistance patterns are common among isolates from different sources. The quest to discover alternative therapeutic regimes by use of medicinal plants are now topical and the subject of research activities. The aim of this study was to determine the prevalence and antibiotic resistant patterns of Staphylococcus aureus and Staphylococcus epidermidis isolated from patients attending different hospitals and clinics in rural communities around Mthatha; determine the activity of medicinal plants against S. aureus and S. epidermidis, including the characterisation of active compounds; ascertain phylogenetic relatedness of isolates; determine the genes coding for resistance in both pathogens and assess the role of human sera samples from different blood groups against S. aureus and S. epidermidis . In order to achieve these goals, the following aspects were explored and are hereby presented in chapters. Chapter one focused on the general introduction and literature review. The morphology, cultural characteristics, laboratory diagnosis, pathogenesis, antibiograms and clinical manifestations of Staphylococcus epidermidis and Staphylococcus aureus were reviewed. Furthermore the activities of medicinal plants and their various applications in the management of infections in different countries, including their possible active compounds and toxicity levels were also explored in an endeavour to provide suitable background for the study. iii The activity of human serum samples from different blood groups and their kinetics were also foregrounded. In Chapter 2, the antimicrobial susceptibility, genes coding for resistance and pathogenesis, and phylogenetic relatedness in S. aureus and S. epidermidis were investigated. Samples were collected from the Nelson Mandela Academic Hospital, Mthatha General Hospital and other samples were received from surrounding satellite hospitals. Samples were analysed using Kirby Bauer disk diffusion (antibiotic susceptibility testing), micro-broth dilution (MIC) and conventional PCR for the investigation of the genes (mecA, luks-lukf, msrA, ermA, ermC and icaA) responsible for resistance, virulence and pathogenesis of isolates. RAPD-PCR (Random Amplified Polymorphic DNA – Polymerase Chain Reaction) was used to determine phylogenetic relatedness amongst the S. aureus and S. epidermidis isolates. Results indicated that wound swabs and blood cultures were identified as the main sources of S. aureus and S. epidermidis and prevalence rates in children less than eleven years (25.7%) (S. aureus) and (7%) (S. epidermidis) were recorded. Vancomycin had the highest activity against both S. aureus and S. epidermidis, penicillin had the lowest activity.There were no significant differences in resistance patterns among different age groups and gender (p>0.01). Ninety three percent of S. aureus that were confirmed as MRSA with PCR method possessed mecA gene, whilst 16% of S. epidermidis had mecA and 33% possessed icaA gene. Fifty eight percent (58%) of S. aureus possessed luks-lukf PVL gene suggesting that it may have been acquired from the community. Forty two percent 42% of msrA was detected in S. epidermidis, 43% ermC and 34% ermA were detected in S. aureus isolates. Eleven percent 11% of S. aureus isolates were found to carry both ermA and ermC genes. mecA and luks-lufPV genes are implicated in iv methicillin resistant S. aureus that causes necrotizing pnemoniae and icaA is implicated in the formation of biofilm, another mechanism of resistance in S. epidermidis. RAPD profile resulting in DNA amplification fragments ranged in size from 300 to 1500 bp. The RAPD patterns obtained showed various trends among isolates meaning that S. aureus and S. epidermidis isolates investigated had high diversity among them. Dendograms constructed with each oligonucleotide showed that PCR patterns obtained with primer OPL11 (S. aureus) and ERIC1 (S. epidermidis) strains had genetic similarity indices ranging from 0.009 to 0.329. This wide range of similarity indices indicated a high level of DNA polymorphism among S. aureus and S. epidermidis isolates. Knowledge of the genes coding for resistance in this study will address the gaps in the mechanisms of resistance for effective intervention strategies. The infections caused by multi-resistant strains of Staphylococcal species represent an important problem that affects many health institutions. Due to the large number of patients infected with S. aureus and S. epidermidis and the diverse possibilities of contamination, it is always necessary to review the evolution of antimicrobial resistance and the therapeutic responses of the bacterial strains. This aspect of the study provides updated data on susceptibility patterns of local isolates of S. aureus and S. epidermidis for use in empiric management of patients including the various genes coding for resistance in the designated pathogens and their phylogenetic relatedness. Chapter 3 presents the antimicrobial and anti-HIV1 activities of selected medicinal plants from the Eastern Cape Province used for treating skin and respiratory tract infections. Anti-HIV activities were investigated because of the role of staphylococcal v species as opportunistic pathogens in HIV infections. Four medicinal plants were evaluated for antimicrobial activities and cytotoxicity on clinical isolates of S. aureus and S. epidermidis. Medicinal plants used in this study were Cassine transvaalensis, Croton gratissimus, Vangueria infausta and Vitex ferruginea. The Kirby-Bauer disk diffusion and 96 well microtiter plate methods were used in the antimicrobial activity studies but for the anti-HIV1 activity, MAGI assay was used. Microtetrazolium assay (MTT) was used for the evaluation of cytotoxicity of plants. Bio-autographic assay was used to locate the position of the active compound using Rf value; thin layer chromatography and column chromatography were used in the isolation of active compounds and NMR was used in the identification and structural elucidation of the active compounds. C. transvaalensis and V. infausta were found to possess high activity against S. aureus and S. epidermidis with the lowest MIC of 0.02. In the anti HIV1 MAGI assay, C. transvaalensis and C. gratissimus showed activity against HIV1. C. transvaalensis and C. grattisimus possessed high level of toxicity with CC50 reading of 0.2 while V. infausta and V. ferruginea had reading of 0.1. Two triterpenoids were successfully isolated in C. transvaalensis. Elucidation of the structure of active compounds of plant extracts of medicinal plants provides suitable templates for candidate drug designs and drug discovery. Such potential application will be contingent on the results of cytotoxicity testing and this underlines the significance of the test. Human serum is an important host defence mechanism against disease causing agents. Chapter four evaluates the bactericidal activity of different blood groups. Blood samples of different blood groups were screened for the presence of antibodies against S. aureus and S. epidermidis using agglutination test. Serum sensitivity assay vi was employed for susceptibility testing of S. aureus and S. epidermidis to blood samples. The Gunea-pig serum was used to determine the role of complement in serum bactericidal activity. The results showed that S. aureus and S. epidermidis were highly sensitive to normal human sera from blood group B with a percentage of 61% (S. aureus) and 83.3% (S. epidermidis). When the role of complement in bactericidal activity of the serum to staphylococci species was assessed it was shown that when both S. aureus and S. epidermidis were incubated with individual sera of blood groups and pooled serum of the same blood groups, the organisms were serum sensitive. The findings showed that different individual and pooled serum samples had a role to play in the defence mechanisms of individuals against S. aureus and S. epidermidis. In general the study provides a reference document on S. aureus and S. epidermidis in terms of their antibiograms, molecular characterization, sensitivity to human sera and susceptibility to medicinal plant extracts. Cytotoxicity profiles of the medicinal plants are also reported. Due to the on-going need to expand on the frontiers of knowledge, it is therefore recommended, as a way of building on this study, extensive investigations on the epidemiology of S. epidermidis, S. aureus and related pathogens to be conducted because studies of this nature have been limited by the fact that S. epidermidis strains are often considered to be contaminants. High-level surveillance of clinical samples of MRSA to define the instance and spread of CA-MRSA and HA-MRSA in hospital settings including health care workers and patients are also warranted in addition to further anti -cancer activities and cytotoxicity tests.
- Full Text:
THE EFFECT OF DIET ON THE PATTERN OF GASTROOESOPHAGEAL REFLUX IN THE RURAL SETTING OF THE EASTERN CAPE
- Authors: NDEBIA EUGENE JAMOT
- Date: 2015
- Language: English
- Type: PhD Manuscript
- Identifier: http://hdl.handle.net/11260/2051 , vital:40807
- Description: Gastro-oesophageal reflux is the return of stomach contents back up into the oesophagus. Excessive reflux of acid content into the oesophagus can cause oesophageal disorders such as heartburn, gastro-oesophageal reflux disease and oesophagitis. The prevalence of oesophageal disorders appears to be high in North America, Europe, japan and China while epidemiology data from Africa, South America and Middle East are unknown. More data is required in Africa because population diversity in reflux symptoms may exist and it is important that standard reference ranges of reflux profiles are established for African countries. The aims of this study was to establish a data base of gastro-oesophageal reflux pattern in the Eastern Cape rural area, to compare our findings with similar western studies and to establish the effect diet, H. pylori infection, gender, weight and age on the observed reflux pattern. The reflux pattern was evaluated in healthy subjects for 24h using the newer technique involving the recording of eosophageal intraluminal impedance and pH simultaneously. The technique gives quantitative data on the frequency, nature, type, and duration, and correlates them to the pH of the reflux. The diet survey was done using the usual pattern diet questionnaire, the body mass index (BMI) was calculated and the quantification of H. pylori antibodies IgG was determined in the serum of each participant using an ELISA kit. In total, 77 participants including 48 females and 29 males were included in the study. The mean age was 35 (range 18 - 60) years for females and 37 (range 18 - 54) for males. The mean BMI was 29 (range 19 - 42) for females and 23 (range 18- ii 30) for males. The total number of refluxes recorded in 24h in this population was presented as median, 25th, 75th and 95th percentile corresponding to 49, 29, 65 and 97, respectively. Of these, 37 % were acidic, 43 % were weakly acidic and 20 % were non-acidic. In term of reflux composition 12 % were liquid, 24 % were gas (belches) and 64 % were mixed (gas and liquid). The oesophageal bolus clearance time was 18 s while the acidity of the reflux was completely neutralised 30 s after a reflux. The oesophageal bolus exposure time was 14 min/day and while acid exposure time was 15 min/day. More refluxes were found in upright position compared to supine position. They were a higher number of refluxes and a predominance of non-acid reflux in the present study compared to western countries. We found that most refluxes were postprandial and some parameters of the pattern of gastro-oesophageal reflux were significantly influenced by the traditional diet. Higher carbohydrate, protein and fat in the meal were associated with a high frequency of refluxes most of which were acidic and weakly acidic while higher fruit and vegetable consumption was associated with fewer refluxes. An increased number of non-acid refluxes were observed in high carbohydrate maize based diet. Nearly all participants of the present study were positive for H. pylori and those with a higher concentration of H. pylori IgG in the serum had less oesophageal acid exposure. Females, older and overweight participants presented with an increased frequency of reflux. This study provides normal references values for the pattern of Gastrooesophageal reflux in the rural population of South Africa. The observed pattern of reflux is positively influenced by the traditional diet which is mainly carbohydrate maize based and also by BMI, weight and gender
- Full Text:
- Authors: NDEBIA EUGENE JAMOT
- Date: 2015
- Language: English
- Type: PhD Manuscript
- Identifier: http://hdl.handle.net/11260/2051 , vital:40807
- Description: Gastro-oesophageal reflux is the return of stomach contents back up into the oesophagus. Excessive reflux of acid content into the oesophagus can cause oesophageal disorders such as heartburn, gastro-oesophageal reflux disease and oesophagitis. The prevalence of oesophageal disorders appears to be high in North America, Europe, japan and China while epidemiology data from Africa, South America and Middle East are unknown. More data is required in Africa because population diversity in reflux symptoms may exist and it is important that standard reference ranges of reflux profiles are established for African countries. The aims of this study was to establish a data base of gastro-oesophageal reflux pattern in the Eastern Cape rural area, to compare our findings with similar western studies and to establish the effect diet, H. pylori infection, gender, weight and age on the observed reflux pattern. The reflux pattern was evaluated in healthy subjects for 24h using the newer technique involving the recording of eosophageal intraluminal impedance and pH simultaneously. The technique gives quantitative data on the frequency, nature, type, and duration, and correlates them to the pH of the reflux. The diet survey was done using the usual pattern diet questionnaire, the body mass index (BMI) was calculated and the quantification of H. pylori antibodies IgG was determined in the serum of each participant using an ELISA kit. In total, 77 participants including 48 females and 29 males were included in the study. The mean age was 35 (range 18 - 60) years for females and 37 (range 18 - 54) for males. The mean BMI was 29 (range 19 - 42) for females and 23 (range 18- ii 30) for males. The total number of refluxes recorded in 24h in this population was presented as median, 25th, 75th and 95th percentile corresponding to 49, 29, 65 and 97, respectively. Of these, 37 % were acidic, 43 % were weakly acidic and 20 % were non-acidic. In term of reflux composition 12 % were liquid, 24 % were gas (belches) and 64 % were mixed (gas and liquid). The oesophageal bolus clearance time was 18 s while the acidity of the reflux was completely neutralised 30 s after a reflux. The oesophageal bolus exposure time was 14 min/day and while acid exposure time was 15 min/day. More refluxes were found in upright position compared to supine position. They were a higher number of refluxes and a predominance of non-acid reflux in the present study compared to western countries. We found that most refluxes were postprandial and some parameters of the pattern of gastro-oesophageal reflux were significantly influenced by the traditional diet. Higher carbohydrate, protein and fat in the meal were associated with a high frequency of refluxes most of which were acidic and weakly acidic while higher fruit and vegetable consumption was associated with fewer refluxes. An increased number of non-acid refluxes were observed in high carbohydrate maize based diet. Nearly all participants of the present study were positive for H. pylori and those with a higher concentration of H. pylori IgG in the serum had less oesophageal acid exposure. Females, older and overweight participants presented with an increased frequency of reflux. This study provides normal references values for the pattern of Gastrooesophageal reflux in the rural population of South Africa. The observed pattern of reflux is positively influenced by the traditional diet which is mainly carbohydrate maize based and also by BMI, weight and gender
- Full Text:
The Role of Biomarkers in the Management of Stroke in Eastern Cape Province
- Authors: Collin Asongapha Forka
- Date: 2015
- Language: English
- Type: Masters
- Identifier: http://hdl.handle.net/11260/2846 , vital:42964
- Description: ABSTRACT Stroke is defined as rapidly developed clinical signs of focal (or global) disturbance of the cerebral function, lasting more than 24 hours with no apparent cause other than a vascular origin. A biomarker is defined as “a physiological characteristic that can be objectively measured and evaluated as an indicator of normal biological or pathogenic process as well as pharmacological responses to a therapeutic interventions. The aim of this study was to investigate the role of biomarkers in defining inflammation, endogenous oxidants/antioxidant status (oxidative stress imbalance) and traditional cardiovascular risk factors. This case (stroke types and subtypes) – control (healthy) study (matched for gender and age) was conducted between December 2012 and June 2015. Mthatha Hospital complex served as the study setting. Nelson Mandela Academic Hospital (NMAH) is a tertiary facility that provides health care to South African population, majority of whom dwell in rural areas around the hospital. Student t-test and ANOVA served to compare means between 2 groups and across >3 groups. Chi – square test was used to compare proportions between 2 groups. Multivariate (multiple linear regression, binary logistic regression, and discriminant functions) analyses were used to identify the most important risk factors of all strokes and fibrinogen to discriminate stroke types and subtypes. ROC method obtained specific ethnic cut–off points of biomarkers that associated independently with all strokes. In total 67 participants were examined: 37 cases of strokes (11 ischemic, 26 haemorrhagic, 11 lacunar ischemic, 13 intra-cerebral hematomas and 8 haemorrhagic brain ischaemia) versus 28 controls. Low socio – economic status (OR=10.3 95%CI 3.3- 32.9 p<0.0001), physical inactivity (OR=13 95% CI 3.3-51.6 p<0.0001), rural residence(OR=6.5 95% CI 1.6-26.5 p=0.004), RDW(OR=3.7 95% CI 1.3-10.9 p=0.016), D – dimer (OR=17.4 95% CI 2.9-104 p=0.002), Fibrinogen (OR=35.1 95% CI 3.5-356.5 p=0.003), and BMI(OR=1.387 95% CI 0.985-2 p=0.06) were the most independent risk factors of all strokes. RDW, Platelets, D-dimer, and Neutrophils were the most discriminant of absence of strokes, ischaemic and haemorrhagic types of stroke. Only Fibrinogen and BNP were the most discriminant of stroke subtypes in low socio–economic status. Meanwhile, Platelets, Neutrophils, and CRP were the most discriminant of stroke subtypes in high socio – economic status. The cut-off points of RDW>14%, Fibrinogen>3.5 g/L, and D-dimer>0.5g/mL separated efficiently all stroke types and controls. Independent variations (R2 = 48%) of Fibrinogen in all participants were explained by increase in CRP (Beta = 0.315; P = 0.003), Platelets (Beta = 0.280; P = 0.004), BMI (Beta = 0.268; P = 0.006), and Monocytes (Beta = 0.241; P = 0.014).iii In conclusion, increased levels of Biomarkers of inflammation, thrombosis, hypercoagulability, but opposite variations of innate immunity (increase in monocytes, decrease or increase in neutrophils), overweight/Obesity, low socio-economic status, physical inactivity, and rural residence were the major risk factors of all strokes. Biomarkers of inflammation have superior performance to diagnose all strokes and to discriminate stroke types and to predict the severity of stroke subtypes than the few traditional cardiovascular risk factors. Education, adequate diet, exercise, reduction of poverty, other measures of secondary prevention, applied research, and integration of chemical pathology in the management of strokes are needed in personalised medicine with cheap tools (RDW, platelets and Fibrinogen) in absence of neuro – imaging in the poorest Eastern Cape province of South Africa.
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- Authors: Collin Asongapha Forka
- Date: 2015
- Language: English
- Type: Masters
- Identifier: http://hdl.handle.net/11260/2846 , vital:42964
- Description: ABSTRACT Stroke is defined as rapidly developed clinical signs of focal (or global) disturbance of the cerebral function, lasting more than 24 hours with no apparent cause other than a vascular origin. A biomarker is defined as “a physiological characteristic that can be objectively measured and evaluated as an indicator of normal biological or pathogenic process as well as pharmacological responses to a therapeutic interventions. The aim of this study was to investigate the role of biomarkers in defining inflammation, endogenous oxidants/antioxidant status (oxidative stress imbalance) and traditional cardiovascular risk factors. This case (stroke types and subtypes) – control (healthy) study (matched for gender and age) was conducted between December 2012 and June 2015. Mthatha Hospital complex served as the study setting. Nelson Mandela Academic Hospital (NMAH) is a tertiary facility that provides health care to South African population, majority of whom dwell in rural areas around the hospital. Student t-test and ANOVA served to compare means between 2 groups and across >3 groups. Chi – square test was used to compare proportions between 2 groups. Multivariate (multiple linear regression, binary logistic regression, and discriminant functions) analyses were used to identify the most important risk factors of all strokes and fibrinogen to discriminate stroke types and subtypes. ROC method obtained specific ethnic cut–off points of biomarkers that associated independently with all strokes. In total 67 participants were examined: 37 cases of strokes (11 ischemic, 26 haemorrhagic, 11 lacunar ischemic, 13 intra-cerebral hematomas and 8 haemorrhagic brain ischaemia) versus 28 controls. Low socio – economic status (OR=10.3 95%CI 3.3- 32.9 p<0.0001), physical inactivity (OR=13 95% CI 3.3-51.6 p<0.0001), rural residence(OR=6.5 95% CI 1.6-26.5 p=0.004), RDW(OR=3.7 95% CI 1.3-10.9 p=0.016), D – dimer (OR=17.4 95% CI 2.9-104 p=0.002), Fibrinogen (OR=35.1 95% CI 3.5-356.5 p=0.003), and BMI(OR=1.387 95% CI 0.985-2 p=0.06) were the most independent risk factors of all strokes. RDW, Platelets, D-dimer, and Neutrophils were the most discriminant of absence of strokes, ischaemic and haemorrhagic types of stroke. Only Fibrinogen and BNP were the most discriminant of stroke subtypes in low socio–economic status. Meanwhile, Platelets, Neutrophils, and CRP were the most discriminant of stroke subtypes in high socio – economic status. The cut-off points of RDW>14%, Fibrinogen>3.5 g/L, and D-dimer>0.5g/mL separated efficiently all stroke types and controls. Independent variations (R2 = 48%) of Fibrinogen in all participants were explained by increase in CRP (Beta = 0.315; P = 0.003), Platelets (Beta = 0.280; P = 0.004), BMI (Beta = 0.268; P = 0.006), and Monocytes (Beta = 0.241; P = 0.014).iii In conclusion, increased levels of Biomarkers of inflammation, thrombosis, hypercoagulability, but opposite variations of innate immunity (increase in monocytes, decrease or increase in neutrophils), overweight/Obesity, low socio-economic status, physical inactivity, and rural residence were the major risk factors of all strokes. Biomarkers of inflammation have superior performance to diagnose all strokes and to discriminate stroke types and to predict the severity of stroke subtypes than the few traditional cardiovascular risk factors. Education, adequate diet, exercise, reduction of poverty, other measures of secondary prevention, applied research, and integration of chemical pathology in the management of strokes are needed in personalised medicine with cheap tools (RDW, platelets and Fibrinogen) in absence of neuro – imaging in the poorest Eastern Cape province of South Africa.
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AN ETHNOGRAPHIC STUDY ON MEANINGS CREATED WHEN BEADWORK IS USED FOR RESTORATION OF AFRICAN ETHNIC IDENTITY: A CASE OF ABATHEMBU FROM QUNU VILLAGE, EASTERN CAPE PROVINCE, SOUTH AFRICA
- Authors: ROZANI CARINA NOMFUZO
- Date: 2014
- Subjects: RESTORATION OF AFRICAN ETHNIC IDENTITY, BEADWORK
- Language: English
- Type: Masters, MA
- Identifier: http://hdl.handle.net/11260/2377 , vital:41453
- Description: This study is an assessment on the meanings created when beadwork is used for restoration of African identity among AbaThembu. The research site is Qunu village. The research presents some insights on learners and community members’ perceptions towards integration of beadwork (IK) into the formal curricula. The results further respond to questions on how respondents think beadwork can be used for restoration of ethnic identity, and its possible inclusion into the school curricula. Questions surrounding the complex relations arising from an interface between indigenous knowledge and Eurocentric ideals are answered. The importance of the study is its potential to present knowledge on the identities created when beadwork is used for restoration of ethnic identity. A structured interview schedule was administered at selected schools and this was complemented by in-depth interviews which involved learners and parents. Ethnography and observation also featured. Photographic documentation of beadwork was also done. Learners were targeted due to wide assumptions that the young generation shun indigenous lifestyles. Quantitative data was analyzed using Statistical Package for Social Sciences (SPSS) IBM 20 version while qualitative data was analyzed manually. The study was underpinned by frameworks founded on Critical Theory which seeks to interpret social aspects from a constructivist point of view. In that regard people’s day to day activities are upheld as key in understanding their way of life and dealing with challenges they encounter(Guess, 1981). Specifically, the Kaupapa Maori theory developed in New Zealand was used. Although it is rooted in arguments highlighting the Maori worldviews, philosophical foundations, cultural values and languages it was found useful in interpreting the state of indigenous knowledge usage in the South African context (Smith, 1999). EZiko siPheka siSophula theoretical framework was further used to interprete social aspects in the study. It was found to be appropriate because it explains issues from a holistic, relational and participatory angle (Goduka, 2012). Findings revealed complexities facing customary practices in the modern context amid different perceptions held towards reliance on the practices to restore ethnic identity. The study noted that through curricula transformation, it could be possible that identities representing abaThembu culture can be re-invented to suit the modern context and appeal to the younger generation. One of the key recommendations includes infusion of indigenous activities such as beadwork into modern institutions like education in efforts to promote people’s identities and beadwork entrepreneurship to sustain livelihoods.
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- Authors: ROZANI CARINA NOMFUZO
- Date: 2014
- Subjects: RESTORATION OF AFRICAN ETHNIC IDENTITY, BEADWORK
- Language: English
- Type: Masters, MA
- Identifier: http://hdl.handle.net/11260/2377 , vital:41453
- Description: This study is an assessment on the meanings created when beadwork is used for restoration of African identity among AbaThembu. The research site is Qunu village. The research presents some insights on learners and community members’ perceptions towards integration of beadwork (IK) into the formal curricula. The results further respond to questions on how respondents think beadwork can be used for restoration of ethnic identity, and its possible inclusion into the school curricula. Questions surrounding the complex relations arising from an interface between indigenous knowledge and Eurocentric ideals are answered. The importance of the study is its potential to present knowledge on the identities created when beadwork is used for restoration of ethnic identity. A structured interview schedule was administered at selected schools and this was complemented by in-depth interviews which involved learners and parents. Ethnography and observation also featured. Photographic documentation of beadwork was also done. Learners were targeted due to wide assumptions that the young generation shun indigenous lifestyles. Quantitative data was analyzed using Statistical Package for Social Sciences (SPSS) IBM 20 version while qualitative data was analyzed manually. The study was underpinned by frameworks founded on Critical Theory which seeks to interpret social aspects from a constructivist point of view. In that regard people’s day to day activities are upheld as key in understanding their way of life and dealing with challenges they encounter(Guess, 1981). Specifically, the Kaupapa Maori theory developed in New Zealand was used. Although it is rooted in arguments highlighting the Maori worldviews, philosophical foundations, cultural values and languages it was found useful in interpreting the state of indigenous knowledge usage in the South African context (Smith, 1999). EZiko siPheka siSophula theoretical framework was further used to interprete social aspects in the study. It was found to be appropriate because it explains issues from a holistic, relational and participatory angle (Goduka, 2012). Findings revealed complexities facing customary practices in the modern context amid different perceptions held towards reliance on the practices to restore ethnic identity. The study noted that through curricula transformation, it could be possible that identities representing abaThembu culture can be re-invented to suit the modern context and appeal to the younger generation. One of the key recommendations includes infusion of indigenous activities such as beadwork into modern institutions like education in efforts to promote people’s identities and beadwork entrepreneurship to sustain livelihoods.
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Beliefs, Attitudes, Practices, Response to Interventions and Therapeutic Education of Obese and Normal Weight Type 2 Diabetes Mellitus Patients attending the Diabetic Clinic in Nelson Mandela Academic Hospital, Mthatha
- Authors: Odufu Alexander Abiodun
- Date: 2014
- Language: English
- Type: Masters
- Identifier: http://hdl.handle.net/11260/2854 , vital:42965 , Type 2 diabetes, belief, attitudes, practices, responses to intervention, therapeutic education
- Description: ABSTRACT INTRODUCTION: Education is the cornerstone of diabetes care. Because of lack of awareness, most patients suffer from diabetes complications. This study was conducted to determine the knowledge, attitude, practices and responses to interventions and therapeutic education of obese and normal weight type 2 diabetes mellitus patients. OBJECTIVES: The objectives of the study were: to determine the knowledge, beliefs, attitudes and practices among patients with T2DM; to estimate the proportions of uncontrolled blood glucose, poor quality of life, and no adherence to medications and diet among patients with T2DM; to explore food choices and nutrition practices and behavior related to T2DM; and to develop from responses, educational programs towards self and health professional management. Methods: This descriptive study included two hundred T2DM. A modified version of the Diabetes knowledge, attitude and practice (KAP) questionnaires were used for data collection. The participants were recruited using convenience sampling technique and all data collected was analyzed using SPSS version 18. The patient‟s knowledge, attitudes and practice about the disease, the proportion of uncontrolled blood glucose and no adherence to medication and diet, nutrition practices and behavior related to T2DM were the main outcome measures. Results: The mean age of the patients were 49.0±16.6 years for men and 48.2±15.8 years for females with the male to female ratio being 1:1. The population was formed by adults and elderly adults, who were between 18 and 80 years of age. Most were obese (43.0%); married (50.5%) and overweight (27.7%). Patients‟ awareness about diabetes was high. The overall knowledge on the etiology and features of T2DM was good. Answers for glycemic control, risk factors and complications were very good. Awareness about eye and renal complications was also high. A majority also noted eye problems as the complication of DM yet only 69% have visited an ophthalmologist. More than half of the sample population correctly answers questions regarding dietary requirements in diabetes.80% of the patients responded that alcohol is not good for a diabetic, that losing weight can prevent diabetic from getting worse and that smoking can worsen diabetes. 20% of the population does not know that the above mentioned factors are important in the management of their condition. The percentage of uncontrolled blood sugar and HbA1c among T2DM residing in Mthatha was good as 80% of the patients have their previous and current blood sugar level and HbA1c as normal. Conclusions: The knowledge, attitude and practice scores were high in most areas of diabetes care. However, the majority of the patients were obese emphasizing the need for additional educational efforts in life style modification.
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- Authors: Odufu Alexander Abiodun
- Date: 2014
- Language: English
- Type: Masters
- Identifier: http://hdl.handle.net/11260/2854 , vital:42965 , Type 2 diabetes, belief, attitudes, practices, responses to intervention, therapeutic education
- Description: ABSTRACT INTRODUCTION: Education is the cornerstone of diabetes care. Because of lack of awareness, most patients suffer from diabetes complications. This study was conducted to determine the knowledge, attitude, practices and responses to interventions and therapeutic education of obese and normal weight type 2 diabetes mellitus patients. OBJECTIVES: The objectives of the study were: to determine the knowledge, beliefs, attitudes and practices among patients with T2DM; to estimate the proportions of uncontrolled blood glucose, poor quality of life, and no adherence to medications and diet among patients with T2DM; to explore food choices and nutrition practices and behavior related to T2DM; and to develop from responses, educational programs towards self and health professional management. Methods: This descriptive study included two hundred T2DM. A modified version of the Diabetes knowledge, attitude and practice (KAP) questionnaires were used for data collection. The participants were recruited using convenience sampling technique and all data collected was analyzed using SPSS version 18. The patient‟s knowledge, attitudes and practice about the disease, the proportion of uncontrolled blood glucose and no adherence to medication and diet, nutrition practices and behavior related to T2DM were the main outcome measures. Results: The mean age of the patients were 49.0±16.6 years for men and 48.2±15.8 years for females with the male to female ratio being 1:1. The population was formed by adults and elderly adults, who were between 18 and 80 years of age. Most were obese (43.0%); married (50.5%) and overweight (27.7%). Patients‟ awareness about diabetes was high. The overall knowledge on the etiology and features of T2DM was good. Answers for glycemic control, risk factors and complications were very good. Awareness about eye and renal complications was also high. A majority also noted eye problems as the complication of DM yet only 69% have visited an ophthalmologist. More than half of the sample population correctly answers questions regarding dietary requirements in diabetes.80% of the patients responded that alcohol is not good for a diabetic, that losing weight can prevent diabetic from getting worse and that smoking can worsen diabetes. 20% of the population does not know that the above mentioned factors are important in the management of their condition. The percentage of uncontrolled blood sugar and HbA1c among T2DM residing in Mthatha was good as 80% of the patients have their previous and current blood sugar level and HbA1c as normal. Conclusions: The knowledge, attitude and practice scores were high in most areas of diabetes care. However, the majority of the patients were obese emphasizing the need for additional educational efforts in life style modification.
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Biochemical Evaluation Of Pregnant Women Practicing Geophagia With Special Reference To Iron Nutritional Status In The King Sabata Dalindyebo Municipality
- Authors: Abiodun Adams
- Date: 2014
- Language: English
- Identifier: http://hdl.handle.net/11260/2878 , vital:42970 , Geophagia, pregnant women, iron nutritional status, iron-deficiency anaemia.
- Description: Abstract Introduction There is no information on iron deficiency anaemia and ferritin-related oxidative stress as a potential result of geophagia during pregnancy in the King Sabatha Dalyindyebo Municipality, South Africa. Aim The aim of the study was to assess the magnitude of geophagia (soil eating) associated with biochemical and haematological indices of iron nutritional status of pregnant women. Materials and Methods A cross sectional study was carried out among 210 (response rate=95.5% of 220 eligible) pregnant women living in the Mthatha areas of the King Sabata Dalyindebo Municipality attending 3 selected clinics during 2012. Data (socio-demographic, geophagia, haematological indices, serum iron and transferrin saturation) were analyzed using univariate analysis (mean, proportions, percentiles, Odd Ratio and 95%CI, ANOVA and chi-square) and multivariate analysis (Odd Ratio and 95% CI and logistic regression model) was performed. P-Value <0.05 was significant. Results In all cases, 98.6% (n=207) and 100% (n=210) defined by serum iron ≤ 30µmol/l and <40µmol/l, presented with iron deficiency, respectively. However, iron deficiency, defined by serum ferritin <12µg/l and by transferrin saturation <16%, was present in 25.7% (n=54) and 61.9% (n=130) of all cases, respectively. Iron-deficiency anaemia was present in 51.4% (n=108) and 18.6% (n=39) using WHO haemoglobin and serum iron cut-offs and WHO haemoglobin and serum ferritin cut-offs, respectively. However,ii 37.1% (n=78/210) had an iron deficiency, defined by serum iron <10 µmol/l and 30.5% (n=64/210) defined by transferrin saturation <10%. In geophagics, 98.7% (n=76) had iron-deficiency anaemia (using serum iron cut-offs) whereas only 24.1% (n=32) of non geophagics presented with iron deficiency anaemia. However, using serum ferritin cut-offs, geophagics had iron deficiency anaemia estimated at 69.2% (n=27/59) but non geophagics had iron deficiency anaemia estimated at 30.8% (n=12/39). The optimal cut-offs of serum iron <10 µmol/l and transferrin saturation <10% are the best discriminants of iron deficiency as defined by serum ferritin <12 µg/l. Ferritin-related oxidative stress was present among 24.8% in the study population (the highest quartile of serum ferritin being >30.01 µg/l). The most important factors associated with iron deficiency anaemia in all pregnant women were geophagic behaviour (OR=2.1 95% CI 1.1-4.2; P=0.029), MCHC decreases (<30.5 0R=16.6 95%CI 6.8-40.2; P=0.006) and MCHC decreases (30.5-31.5 OR=2.9 95%CI 1.4-6.1; P=0.006). In all pregnant women, serum iron <14 (OR=6.2 95%CI 1.2-31.7; P=0.030), platelets <228 (OR=3.9 95%CI 1.6-10.8; P=0.008), age ≥28years (OR=4.2 95%CI 1.7-10.4; P=0.002), transferrin saturation ≥18% (OR=51.3 95%CI 8.9-295.2; P=<0.0001), were identified as the most significant independent determinants of ferritin-related oxidative stress. However, increase in age, depletion in iron, decrease in platelet count but increase in transferrin saturation were the significant independent determinants of ferritin-related oxidative stress among geophagic pregnant women (Y=0.282 x Age – 1.007 x iron – 0.023 platelet +0.946 transferrin saturation). In non-geophagic pregnant women, only a decrease in iron and an increase in transferrin saturation were the significant characteristics of ferritin-related oxidative stress (Y=-3.21-0.309 x iron + 0.379 transferrin saturation). Conclusioniii Geophagia induces a high level of anaemia, iron deficiency anaemia and ferritin-related oxidative stress. The most independent determinants of iron deficiency anaemia in all pregnant women were geophagic behaviour and MCHC decrease. Independent and important determinants of ferritin-related oxidative stress in all pregnant women were severe categories of decreased iron and platelets with higher levels of age ≥28 years, transferrin saturation (≥18%)
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- Authors: Abiodun Adams
- Date: 2014
- Language: English
- Identifier: http://hdl.handle.net/11260/2878 , vital:42970 , Geophagia, pregnant women, iron nutritional status, iron-deficiency anaemia.
- Description: Abstract Introduction There is no information on iron deficiency anaemia and ferritin-related oxidative stress as a potential result of geophagia during pregnancy in the King Sabatha Dalyindyebo Municipality, South Africa. Aim The aim of the study was to assess the magnitude of geophagia (soil eating) associated with biochemical and haematological indices of iron nutritional status of pregnant women. Materials and Methods A cross sectional study was carried out among 210 (response rate=95.5% of 220 eligible) pregnant women living in the Mthatha areas of the King Sabata Dalyindebo Municipality attending 3 selected clinics during 2012. Data (socio-demographic, geophagia, haematological indices, serum iron and transferrin saturation) were analyzed using univariate analysis (mean, proportions, percentiles, Odd Ratio and 95%CI, ANOVA and chi-square) and multivariate analysis (Odd Ratio and 95% CI and logistic regression model) was performed. P-Value <0.05 was significant. Results In all cases, 98.6% (n=207) and 100% (n=210) defined by serum iron ≤ 30µmol/l and <40µmol/l, presented with iron deficiency, respectively. However, iron deficiency, defined by serum ferritin <12µg/l and by transferrin saturation <16%, was present in 25.7% (n=54) and 61.9% (n=130) of all cases, respectively. Iron-deficiency anaemia was present in 51.4% (n=108) and 18.6% (n=39) using WHO haemoglobin and serum iron cut-offs and WHO haemoglobin and serum ferritin cut-offs, respectively. However,ii 37.1% (n=78/210) had an iron deficiency, defined by serum iron <10 µmol/l and 30.5% (n=64/210) defined by transferrin saturation <10%. In geophagics, 98.7% (n=76) had iron-deficiency anaemia (using serum iron cut-offs) whereas only 24.1% (n=32) of non geophagics presented with iron deficiency anaemia. However, using serum ferritin cut-offs, geophagics had iron deficiency anaemia estimated at 69.2% (n=27/59) but non geophagics had iron deficiency anaemia estimated at 30.8% (n=12/39). The optimal cut-offs of serum iron <10 µmol/l and transferrin saturation <10% are the best discriminants of iron deficiency as defined by serum ferritin <12 µg/l. Ferritin-related oxidative stress was present among 24.8% in the study population (the highest quartile of serum ferritin being >30.01 µg/l). The most important factors associated with iron deficiency anaemia in all pregnant women were geophagic behaviour (OR=2.1 95% CI 1.1-4.2; P=0.029), MCHC decreases (<30.5 0R=16.6 95%CI 6.8-40.2; P=0.006) and MCHC decreases (30.5-31.5 OR=2.9 95%CI 1.4-6.1; P=0.006). In all pregnant women, serum iron <14 (OR=6.2 95%CI 1.2-31.7; P=0.030), platelets <228 (OR=3.9 95%CI 1.6-10.8; P=0.008), age ≥28years (OR=4.2 95%CI 1.7-10.4; P=0.002), transferrin saturation ≥18% (OR=51.3 95%CI 8.9-295.2; P=<0.0001), were identified as the most significant independent determinants of ferritin-related oxidative stress. However, increase in age, depletion in iron, decrease in platelet count but increase in transferrin saturation were the significant independent determinants of ferritin-related oxidative stress among geophagic pregnant women (Y=0.282 x Age – 1.007 x iron – 0.023 platelet +0.946 transferrin saturation). In non-geophagic pregnant women, only a decrease in iron and an increase in transferrin saturation were the significant characteristics of ferritin-related oxidative stress (Y=-3.21-0.309 x iron + 0.379 transferrin saturation). Conclusioniii Geophagia induces a high level of anaemia, iron deficiency anaemia and ferritin-related oxidative stress. The most independent determinants of iron deficiency anaemia in all pregnant women were geophagic behaviour and MCHC decrease. Independent and important determinants of ferritin-related oxidative stress in all pregnant women were severe categories of decreased iron and platelets with higher levels of age ≥28 years, transferrin saturation (≥18%)
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EVALUATION OF THE EFFECTIVENESS OF AN OPTICS TEACHING MODULE IN ENHANCING CONCEPTUAL UNDERSTANDING OF GRADE 11 LEARNERS AT A SELECTED SCHOOL IN MTHATHA
- Authors: MERLIN JOHN
- Date: 2014
- Language: English
- Type: PhD Manuscript
- Identifier: http://hdl.handle.net/11260/2065 , vital:40812 , DOCTOR OF EDUCATION
- Description: This study aimed at investigating the conceptions and alternative conceptions regarding the optical phenomena ‘reflection’, ‘refraction’ and ‘total internal reflection’ amongst Grade 11 learners at a selected school in Mthatha, Eastern Cape, South Africa and developing remedies to enhance their conceptual understanding of this area. The study adopted a quasi-experimental pre-test – post-test design. To enhance the credibility of the findings of the study, the data were collected using mixed methods (both questionnaires and interviews). The questionnaires developed for the study were 4 tier Optics Diagnostic Instruments (4ODIs) which were designed in such a way that both qualitative and quantitative data could be collected. To explore the findings from the pre-tests, face-to-face interviews with selected learners from both the groups were conducted. This stage was followed by the design an optics teaching module which aimed at enhancing the experimental group learners’ conceptual understanding of the optical phenomena, whereas the comparison group was taught in the traditional teaching method. To test the effectiveness of the designed teaching module, the 4ODIs were administered as post-tests to both groups. To enhance the credibility of the findings from the post-tests, face-to-face interviews were conducted with some selected learners from the experimental group. Since the aim of the interviews at this stage was to test how the designed optics teaching module helped the experimental group learners in enhancing their conceptual understanding, the comparison group learners were not interviewed at this stage since they were taught in the traditional teaching method. The quantitative analyses were carried out using Microsoft Excel and the statistical software, IBM SPSS Version 20. The qualitative analysis was carried out manually by coding and categorizing the learners’ responses from the questionnaires and the interviews. The item analysis of the 1st tiers was carried out using Microsoft Excel. The statistical comparisons of the test scores of the 1st tiers of the tests (pre-test – post-test comparison of both the groups and the experimental group – comparison group comparison of both the pre-tests and the post-tests) were performed using t-tests (independent samples t-test and paired samples t-test). The 2nd tiers (learners’ confidence levels in their responses to the corresponding 1st tiers) and the 4th tiers (learners’ confidence levels in their responses to the corresponding 3rd tiers) were analysed by (using SPSS) calculating measures of central tendencies of their responses. The 3rd tiers (open-ended questions) and the interviews were analysed manually by coding and categorizing learners’ responses. Before the implementation of the optics teaching module, both the experimental and the comparison groups were found to hold a variety of alternative conceptions about the optical phenomena. Moreover, the performances of both the groups were the same. It was also found that the learners from both the groups were not confident when they approached the pre-tests. The qualitative analyses of the learners’ responses to the 3rd tiers and the interviews suggested that most of the correct responses given by the learners to tier-1 of the pre-test questionnaires originated from a faulty or vague understanding of the scientific concepts. Moreover, some of the incorrect responses identified could not be considered as alternative conceptions because of the very low confidence levels the learners displayed in these responses. Such responses were categorized as ‘errors due to lack of knowledge’. The analyses of the post-test questionnaires, and face-to-face interviews conducted immediately after the post-tests, revealed that the experimental group outperformed the comparison group in terms of their conceptual understanding of the optical phenomena. In other words, the number of experimental group learners who held scientifically-accepted concepts increased for some questions of the post-tests and in some other questions, the experimental group learners developed new scientific understanding of many situations with regard to the optical phenomena. To conclude, the findings of the study proved that the Grade 11 learners in the selected school held a variety of alternative conceptions and errors due to lack of knowledge. However, the optics teaching module, which was designed by taking into consideration the learners’ prior knowledge regarding the particular learning area, could remedy most of the alternative conceptions and errors which were merely due to lack of knowledge.
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- Authors: MERLIN JOHN
- Date: 2014
- Language: English
- Type: PhD Manuscript
- Identifier: http://hdl.handle.net/11260/2065 , vital:40812 , DOCTOR OF EDUCATION
- Description: This study aimed at investigating the conceptions and alternative conceptions regarding the optical phenomena ‘reflection’, ‘refraction’ and ‘total internal reflection’ amongst Grade 11 learners at a selected school in Mthatha, Eastern Cape, South Africa and developing remedies to enhance their conceptual understanding of this area. The study adopted a quasi-experimental pre-test – post-test design. To enhance the credibility of the findings of the study, the data were collected using mixed methods (both questionnaires and interviews). The questionnaires developed for the study were 4 tier Optics Diagnostic Instruments (4ODIs) which were designed in such a way that both qualitative and quantitative data could be collected. To explore the findings from the pre-tests, face-to-face interviews with selected learners from both the groups were conducted. This stage was followed by the design an optics teaching module which aimed at enhancing the experimental group learners’ conceptual understanding of the optical phenomena, whereas the comparison group was taught in the traditional teaching method. To test the effectiveness of the designed teaching module, the 4ODIs were administered as post-tests to both groups. To enhance the credibility of the findings from the post-tests, face-to-face interviews were conducted with some selected learners from the experimental group. Since the aim of the interviews at this stage was to test how the designed optics teaching module helped the experimental group learners in enhancing their conceptual understanding, the comparison group learners were not interviewed at this stage since they were taught in the traditional teaching method. The quantitative analyses were carried out using Microsoft Excel and the statistical software, IBM SPSS Version 20. The qualitative analysis was carried out manually by coding and categorizing the learners’ responses from the questionnaires and the interviews. The item analysis of the 1st tiers was carried out using Microsoft Excel. The statistical comparisons of the test scores of the 1st tiers of the tests (pre-test – post-test comparison of both the groups and the experimental group – comparison group comparison of both the pre-tests and the post-tests) were performed using t-tests (independent samples t-test and paired samples t-test). The 2nd tiers (learners’ confidence levels in their responses to the corresponding 1st tiers) and the 4th tiers (learners’ confidence levels in their responses to the corresponding 3rd tiers) were analysed by (using SPSS) calculating measures of central tendencies of their responses. The 3rd tiers (open-ended questions) and the interviews were analysed manually by coding and categorizing learners’ responses. Before the implementation of the optics teaching module, both the experimental and the comparison groups were found to hold a variety of alternative conceptions about the optical phenomena. Moreover, the performances of both the groups were the same. It was also found that the learners from both the groups were not confident when they approached the pre-tests. The qualitative analyses of the learners’ responses to the 3rd tiers and the interviews suggested that most of the correct responses given by the learners to tier-1 of the pre-test questionnaires originated from a faulty or vague understanding of the scientific concepts. Moreover, some of the incorrect responses identified could not be considered as alternative conceptions because of the very low confidence levels the learners displayed in these responses. Such responses were categorized as ‘errors due to lack of knowledge’. The analyses of the post-test questionnaires, and face-to-face interviews conducted immediately after the post-tests, revealed that the experimental group outperformed the comparison group in terms of their conceptual understanding of the optical phenomena. In other words, the number of experimental group learners who held scientifically-accepted concepts increased for some questions of the post-tests and in some other questions, the experimental group learners developed new scientific understanding of many situations with regard to the optical phenomena. To conclude, the findings of the study proved that the Grade 11 learners in the selected school held a variety of alternative conceptions and errors due to lack of knowledge. However, the optics teaching module, which was designed by taking into consideration the learners’ prior knowledge regarding the particular learning area, could remedy most of the alternative conceptions and errors which were merely due to lack of knowledge.
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IMPACTS OF ANTHROPOGENIC ACTIVITIES ON THE STABLE ISOTOPIC DYNAMICS OF PARTICULATE ORGANIC MATTER IN MBASHE RIVER, EASTERN CAPE, SOUTH AFRICA
- Authors: MUNETSI ZVAVAHERA
- Date: 2014
- Subjects: stable isotopes, anthropogenic activities, enrichment, depletion
- Language: English
- Type: Masters, MSc
- Identifier: http://hdl.handle.net/11260/2361 , vital:41451
- Description: Mbashe River passes through three districts of Eastern Cape, South Africa, with catchments that have been modified by anthropogenic activities. To determine the effects of anthropogenic activities on the river particulate organic matter, (δ13CPOM), (δ15NPOM) and C/N ratios of particulate organic matter were investigated. Six sampling sites from three sections of the river were identified and selected according to anthropogenic activity occurring close to the river and sampled over a period of twelve months. The results indicated that different anthropogenic activities had significant effect on the POM stable isotope dynamics, resulting in uniquely distinct stable isotopes signatures varying both temporally and spatially. The C/N ratios, (δ13CPOM), and (δ15NPOM) isotopic values varied significantly (95% confidence interval) and revealed that POM was derived from different sources in the river catchment. Anthropogenic activities affected C/N ratios and δ15NPOM temporally, spatially and between river sections. The upstream was δ15NPOM depleted (4.5‰) while downstream the river δ15NPOM was enriched (5.8 ‰). The δ13CPOM values ranged from -12‰ to -32‰ temporally during the study period. The study revealed that POM was mainly derived from allochthonous sources (C/N ratios >8). The (δ15NPOM) revealed that upstream was more affected by anthropogenic activities than downstream. Our findings suggest that anthropogenic activities had more temporal effect than site to site. Further research is recommended and required to check whether isotopic dynamics observed can be replicated and determine whether the effect of anthropogenic activities is increasing or decreasing.
- Full Text:
- Authors: MUNETSI ZVAVAHERA
- Date: 2014
- Subjects: stable isotopes, anthropogenic activities, enrichment, depletion
- Language: English
- Type: Masters, MSc
- Identifier: http://hdl.handle.net/11260/2361 , vital:41451
- Description: Mbashe River passes through three districts of Eastern Cape, South Africa, with catchments that have been modified by anthropogenic activities. To determine the effects of anthropogenic activities on the river particulate organic matter, (δ13CPOM), (δ15NPOM) and C/N ratios of particulate organic matter were investigated. Six sampling sites from three sections of the river were identified and selected according to anthropogenic activity occurring close to the river and sampled over a period of twelve months. The results indicated that different anthropogenic activities had significant effect on the POM stable isotope dynamics, resulting in uniquely distinct stable isotopes signatures varying both temporally and spatially. The C/N ratios, (δ13CPOM), and (δ15NPOM) isotopic values varied significantly (95% confidence interval) and revealed that POM was derived from different sources in the river catchment. Anthropogenic activities affected C/N ratios and δ15NPOM temporally, spatially and between river sections. The upstream was δ15NPOM depleted (4.5‰) while downstream the river δ15NPOM was enriched (5.8 ‰). The δ13CPOM values ranged from -12‰ to -32‰ temporally during the study period. The study revealed that POM was mainly derived from allochthonous sources (C/N ratios >8). The (δ15NPOM) revealed that upstream was more affected by anthropogenic activities than downstream. Our findings suggest that anthropogenic activities had more temporal effect than site to site. Further research is recommended and required to check whether isotopic dynamics observed can be replicated and determine whether the effect of anthropogenic activities is increasing or decreasing.
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Intestinal Helminth Infection among HIV Infected adults in Mthatha General Hospital, South Africa
- Authors: OLukayode Ademola Adeleke
- Date: 2014
- Subjects: Medicine, Family Medicine
- Language: English
- Type: Thesis, Masters
- Identifier: http://hdl.handle.net/11260/2151 , vital:40906
- Full Text: false
- Authors: OLukayode Ademola Adeleke
- Date: 2014
- Subjects: Medicine, Family Medicine
- Language: English
- Type: Thesis, Masters
- Identifier: http://hdl.handle.net/11260/2151 , vital:40906
- Full Text: false
INVESTIGATION INTO PROBLEMS OF IMPLEMENTATION OF CURRICULUM 2005 IN THE SOUTH AFRICAN EDUCATION SYSTEM IN FOUR SELECTED DISTRICTS AND SCHOOLS IN THE EASTERN CAPE PROVINCE
- Authors: Nthabiseng Joyce Mokhantso
- Date: 2014
- Subjects: Management and Policy
- Language: English
- Type: Masters. Ed
- Identifier: http://hdl.handle.net/11260/2345 , vital:41449
- Description: This study investigated problems of implementation of C2005 in the South African Education System, which eventually led to its demise in 2010 replaced by CAPS. Its aim was to identify the common factors and the programmes and actions that could be used to help implement curriculum successfully. Theoretically, the literature review formed an essential part of the research process and constituted part of the whole project in itself. It was a critical synthesis of previous researches, which have been undertaken that helped to validate the need for the study to be conducted. In retrospect, the evaluation of the literature reviewed led logically to the formulation of the research questions that constituted the bases for the formulation of the, which formed the instrumentation for the collection of the main primary data required to complete the study. Methodologically, the researcher identified the need to discern an elaborate methodological choice, design and application using qualitative, quantitative and participatory research paradigms constituting the triangulation approach. This was the most important part of the research study, which guided the whole process to a successful conclusion. Through the methodological application, the study produced data from which findings were deduced and recommendations made to respond to the research problem. The conclusion that could be drawn is that curriculum reform and implementation should be considered in terms of the curriculum cycle if set aims and objectives were to be achieved successfully. Sporadic curriculum implementation leads to its apparent failure as was the case with C2005. The fear of the researcher is that CAPs might go the same way since its introduction and implementation did not subscribe to the curriculum cycle perspective. I
- Full Text:
- Authors: Nthabiseng Joyce Mokhantso
- Date: 2014
- Subjects: Management and Policy
- Language: English
- Type: Masters. Ed
- Identifier: http://hdl.handle.net/11260/2345 , vital:41449
- Description: This study investigated problems of implementation of C2005 in the South African Education System, which eventually led to its demise in 2010 replaced by CAPS. Its aim was to identify the common factors and the programmes and actions that could be used to help implement curriculum successfully. Theoretically, the literature review formed an essential part of the research process and constituted part of the whole project in itself. It was a critical synthesis of previous researches, which have been undertaken that helped to validate the need for the study to be conducted. In retrospect, the evaluation of the literature reviewed led logically to the formulation of the research questions that constituted the bases for the formulation of the, which formed the instrumentation for the collection of the main primary data required to complete the study. Methodologically, the researcher identified the need to discern an elaborate methodological choice, design and application using qualitative, quantitative and participatory research paradigms constituting the triangulation approach. This was the most important part of the research study, which guided the whole process to a successful conclusion. Through the methodological application, the study produced data from which findings were deduced and recommendations made to respond to the research problem. The conclusion that could be drawn is that curriculum reform and implementation should be considered in terms of the curriculum cycle if set aims and objectives were to be achieved successfully. Sporadic curriculum implementation leads to its apparent failure as was the case with C2005. The fear of the researcher is that CAPs might go the same way since its introduction and implementation did not subscribe to the curriculum cycle perspective. I
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Management of discipline policy for educators by school management teams in the Maluti district, Eastern Cape Province (RSA): a case study of two selected schools
- Authors: Lishman, Bilibane Thabo
- Date: 2014
- Subjects: Educational Management and Policy
- Language: English
- Type: Masters, Ed
- Identifier: http://hdl.handle.net/11260/2353 , vital:41450
- Description: This research project was an attempt to determine School Management Teams (SMTs) management of teacher discipline at school using the discipline policy (code of conduct for educators) as a frame of reference. This was because procedures and processes for managing teacher discipline were new to principals and their SMTs. The main aim was to investigate the practices and experiences of SMTs regarding management of discipline policy for better or improved teacher conduct. Again, the study sought to understand and explain the gap between discipline policy and its implementation as SMTs seemed to be grappling with the implementation process thereof. The study is located in an interpretive and qualitative perspective where a case study research design was used. Face-to-face interviews were used to collect data from participants selected from two schools (school A and school B). The participants were sampled purposively out of a population of 245 principals and 245 site stewards. The principal and site steward of each school were interviewed because they were found to be relevant to the case of discipline policy implementation. The principal of each school represented the SMT while the site stewards represented the teaching staff. There were therefore four participants who contributed to data collection. During the data collection process, all issues of ethics like voluntary participation, permission, informed consent, confidentiality, anonymity and rights of participants were considered. As data were collected using face-to-face interviews, they were analysed qualitatively, using interim analysis of coding, segmentation, categorising and theming. This research project is grounded in two theories, namely, progressive discipline theory and decentralisation of power theory. The researcher‟s use of progressive discipline as a framework of analysis is based on the fact that the theory focuses on discipline as a corrective measure and not a punitive measure. It also focuses on a series of steps in ii which the disciplinary action is taken each time an educator commits an act of misconduct. The decentralisation-of-power theory is used as a frame of reference because it states that a current trend in education reform is the decentralisation of decision-making powers from a central level to a school level, hence there is schoolbased management. The literature sourced for this study is also based on these two theories. Major findings were established, discussed and recommendations were made. The literature, together with the major findings, generally agreed that all schools had SMTs to manage schools on a day-to-day basis. It was also revealed that the discipline policy for educators was there in every school and was clear, actionable and was the product of collective participation. The onus is upon the capacity of the SMTs to implement the policy for the benefit of quality education. The findings and recommendations suggest that for the implementation of this discipline policy, SMTs must first improve the school culture and school climate.
- Full Text:
- Authors: Lishman, Bilibane Thabo
- Date: 2014
- Subjects: Educational Management and Policy
- Language: English
- Type: Masters, Ed
- Identifier: http://hdl.handle.net/11260/2353 , vital:41450
- Description: This research project was an attempt to determine School Management Teams (SMTs) management of teacher discipline at school using the discipline policy (code of conduct for educators) as a frame of reference. This was because procedures and processes for managing teacher discipline were new to principals and their SMTs. The main aim was to investigate the practices and experiences of SMTs regarding management of discipline policy for better or improved teacher conduct. Again, the study sought to understand and explain the gap between discipline policy and its implementation as SMTs seemed to be grappling with the implementation process thereof. The study is located in an interpretive and qualitative perspective where a case study research design was used. Face-to-face interviews were used to collect data from participants selected from two schools (school A and school B). The participants were sampled purposively out of a population of 245 principals and 245 site stewards. The principal and site steward of each school were interviewed because they were found to be relevant to the case of discipline policy implementation. The principal of each school represented the SMT while the site stewards represented the teaching staff. There were therefore four participants who contributed to data collection. During the data collection process, all issues of ethics like voluntary participation, permission, informed consent, confidentiality, anonymity and rights of participants were considered. As data were collected using face-to-face interviews, they were analysed qualitatively, using interim analysis of coding, segmentation, categorising and theming. This research project is grounded in two theories, namely, progressive discipline theory and decentralisation of power theory. The researcher‟s use of progressive discipline as a framework of analysis is based on the fact that the theory focuses on discipline as a corrective measure and not a punitive measure. It also focuses on a series of steps in ii which the disciplinary action is taken each time an educator commits an act of misconduct. The decentralisation-of-power theory is used as a frame of reference because it states that a current trend in education reform is the decentralisation of decision-making powers from a central level to a school level, hence there is schoolbased management. The literature sourced for this study is also based on these two theories. Major findings were established, discussed and recommendations were made. The literature, together with the major findings, generally agreed that all schools had SMTs to manage schools on a day-to-day basis. It was also revealed that the discipline policy for educators was there in every school and was clear, actionable and was the product of collective participation. The onus is upon the capacity of the SMTs to implement the policy for the benefit of quality education. The findings and recommendations suggest that for the implementation of this discipline policy, SMTs must first improve the school culture and school climate.
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Moralising female identity in Cameroon in the 1990s: female prostitution and the song “you gu cry”
- Authors: Enongene Mirabeau Sone
- Date: 2014
- Subjects: Misse Ngoh; females; identity; prostitution; Cameroon; modernity; music
- Language: English
- Type: Journal Article
- Identifier: http://hdl.handle.net/11260/2672 , vital:42313
- Description: Between the 1970s and early 1980s, when Cameroon was still at the juncture of promising social plenitude, popular music genres like Makossa were a mere auditory art instead of a profit-making activity as we have in Cameroon today. Popular music at that time was simply “music for the ears”, meant to produce emotional sounds, pleasant to listen to. Bars, night clubs and streets were common environs where dancing took place as the physical expression of pleasure from music. The explosion of early music such as Makossa did not match the precarious marketable opportunities at that time. As a result, music appeared as a hobby, and not because singers derived income from its production. The themes focused on varying social experiences and problems, from love and emotional pathos to (im)morality. As such, one is tempted to assert that singers hardly expressed demur or outright lampoonery against public transgressions such as corruption, prostitution or swindling, as is the case nowadays. The themes were far less what we find in contemporary Cameroonian literate culture, namely cinema, media and popular music. This paper focuses on Misse Ngoh’s popular song titled “you gu cry” as a medium of social reform through the beguiling fantasies of a female archetype, Mary, in Cameroon in the nineties. The paper contends that though this song produces laughter, rendering it a humorous piece with potential enough to entertain, the same humour turns out serious, handling prostitution and women involved in this activity in a very negative way. This is achieved when Misse Ngoh, using his female archetype Mary, constructs a problematic image of females in the Cameroon urban sphere. Taking these into consideration, Cameroon popular music as seen from Misse Ngoh’s “you gu cry” takes on a different significance. Finally, in the iconography of Mary, this paper sets out to explore the agency of females who were baffled within the intricacies of urban life and modernity in the nineties. It examines the challenges of the new urban spaces (as notorious corners of prostitution) that such women chose.
- Full Text:
- Authors: Enongene Mirabeau Sone
- Date: 2014
- Subjects: Misse Ngoh; females; identity; prostitution; Cameroon; modernity; music
- Language: English
- Type: Journal Article
- Identifier: http://hdl.handle.net/11260/2672 , vital:42313
- Description: Between the 1970s and early 1980s, when Cameroon was still at the juncture of promising social plenitude, popular music genres like Makossa were a mere auditory art instead of a profit-making activity as we have in Cameroon today. Popular music at that time was simply “music for the ears”, meant to produce emotional sounds, pleasant to listen to. Bars, night clubs and streets were common environs where dancing took place as the physical expression of pleasure from music. The explosion of early music such as Makossa did not match the precarious marketable opportunities at that time. As a result, music appeared as a hobby, and not because singers derived income from its production. The themes focused on varying social experiences and problems, from love and emotional pathos to (im)morality. As such, one is tempted to assert that singers hardly expressed demur or outright lampoonery against public transgressions such as corruption, prostitution or swindling, as is the case nowadays. The themes were far less what we find in contemporary Cameroonian literate culture, namely cinema, media and popular music. This paper focuses on Misse Ngoh’s popular song titled “you gu cry” as a medium of social reform through the beguiling fantasies of a female archetype, Mary, in Cameroon in the nineties. The paper contends that though this song produces laughter, rendering it a humorous piece with potential enough to entertain, the same humour turns out serious, handling prostitution and women involved in this activity in a very negative way. This is achieved when Misse Ngoh, using his female archetype Mary, constructs a problematic image of females in the Cameroon urban sphere. Taking these into consideration, Cameroon popular music as seen from Misse Ngoh’s “you gu cry” takes on a different significance. Finally, in the iconography of Mary, this paper sets out to explore the agency of females who were baffled within the intricacies of urban life and modernity in the nineties. It examines the challenges of the new urban spaces (as notorious corners of prostitution) that such women chose.
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Morphology and histochemistry of the digestive tract in the Banded Tilapia (Tilapia Sparrmanii, Smith 1840)
- Authors: Bongile, Bhomela
- Date: 2014
- Subjects: Tilapia sparrmanii, fish; Tilapia; teleost; stomach; digestive system; light microscopy; light microscopy; histology; morphology Teleostei, digestive tube, histology
- Language: English
- Type: Masters, Msc Zoology
- Identifier: http://hdl.handle.net/11260/2401 , vital:41456
- Description: The digestive system of Tilapia sparrmanii, Smith 1894, a small sized cichlid fish widely distributed in Southern Africa and of little economic importance was studied by light microscopy as part of establishing base-line data for future references. The gut in T. sparrmanii was a simple long coiled tube. With greater fish length, the gut progressed into a complexly-coiled definitive form. Strong linear correlations were observed between fish size and gut length. The esophagus was relatively very short and the stomach sac-like and small. Histologically, T. sparrmanii displayed a stratified esophagus epithelium with goblet cells which displayed both neutral and acid mucus at the anterior region. The stomach of T. sparrmanii was divided into three distinct segments the cardiac, fundic, and pyloric portions. The study revealed that the gastric wall is composed of several tunicae: mucosa, submucosa, muscularis and serosa. The tunica mucosa was thrown up into a number of high longitudinal folds projecting into a lumen. The mucosal surface had surface epithelial cells. The epithelium in this region was simple columnar devoid of goblet cells, with glandular regions in the lamina propria. The mucosa of the fundic region had gastric pits lined by columnar epithelium, and simple tubular glands filled most of the lamina propria. The pyloric part of the stomach was very short and its mucosa was slightly folded and devoid of both gastric pits and mucous glandular cells. The lining epithelium of this portion of the stomach was simple columnar and a few goblet cells were seen at its junction with the first part of the intestine. The tunica muscularis of the stomach contained skeletal muscle in the initial and terminal regions, usually intermingled with smooth muscle fibres. Skeletal muscle fibres were also observed in the first portion of the proximal intestine, iii near the junction with the stomach. Gastric pits were present as invaginations of the mucosal surface. Their epithelium secreted both neutral and acid mucins. Simple, straight, tubular unbranched gastric glands occupied most of the surface of the mucosa, and were lined with cells that had eosinophilic granules. The tunica muscularis of the stomach consisted of skeletal muscles usually mixed with smooth muscle fibres. Also, the stomach was separated from the proximal intestine by a pyloric sphincter. Results demonstrate that the intestine was a relatively undifferentiated muscular tube lined with a simple columnar epithelium interspersed with goblet cells. The proximal region had a greater surface area, as revealed by the presence of elongated mucosal ridges. The enterocytes were covered apically with uniform microvilli. The number of goblet cells were moderate in the proximal intestine and fewer in the medial intestine. All segments of the intestine contained neutral and acidic mucins. The distal intestine mucosa was thinner and less elaborately folded and consisted of columnar cells with shorter and sparser microvilli. After the intestinerectal valve, the rectum displayed lower mucosal folds, numerous goblet cells and a thicker muscularis. An ileorectal valve was observed. This confirms that separate intestine and rectum does exist in T. sparrmanii.
- Full Text:
- Authors: Bongile, Bhomela
- Date: 2014
- Subjects: Tilapia sparrmanii, fish; Tilapia; teleost; stomach; digestive system; light microscopy; light microscopy; histology; morphology Teleostei, digestive tube, histology
- Language: English
- Type: Masters, Msc Zoology
- Identifier: http://hdl.handle.net/11260/2401 , vital:41456
- Description: The digestive system of Tilapia sparrmanii, Smith 1894, a small sized cichlid fish widely distributed in Southern Africa and of little economic importance was studied by light microscopy as part of establishing base-line data for future references. The gut in T. sparrmanii was a simple long coiled tube. With greater fish length, the gut progressed into a complexly-coiled definitive form. Strong linear correlations were observed between fish size and gut length. The esophagus was relatively very short and the stomach sac-like and small. Histologically, T. sparrmanii displayed a stratified esophagus epithelium with goblet cells which displayed both neutral and acid mucus at the anterior region. The stomach of T. sparrmanii was divided into three distinct segments the cardiac, fundic, and pyloric portions. The study revealed that the gastric wall is composed of several tunicae: mucosa, submucosa, muscularis and serosa. The tunica mucosa was thrown up into a number of high longitudinal folds projecting into a lumen. The mucosal surface had surface epithelial cells. The epithelium in this region was simple columnar devoid of goblet cells, with glandular regions in the lamina propria. The mucosa of the fundic region had gastric pits lined by columnar epithelium, and simple tubular glands filled most of the lamina propria. The pyloric part of the stomach was very short and its mucosa was slightly folded and devoid of both gastric pits and mucous glandular cells. The lining epithelium of this portion of the stomach was simple columnar and a few goblet cells were seen at its junction with the first part of the intestine. The tunica muscularis of the stomach contained skeletal muscle in the initial and terminal regions, usually intermingled with smooth muscle fibres. Skeletal muscle fibres were also observed in the first portion of the proximal intestine, iii near the junction with the stomach. Gastric pits were present as invaginations of the mucosal surface. Their epithelium secreted both neutral and acid mucins. Simple, straight, tubular unbranched gastric glands occupied most of the surface of the mucosa, and were lined with cells that had eosinophilic granules. The tunica muscularis of the stomach consisted of skeletal muscles usually mixed with smooth muscle fibres. Also, the stomach was separated from the proximal intestine by a pyloric sphincter. Results demonstrate that the intestine was a relatively undifferentiated muscular tube lined with a simple columnar epithelium interspersed with goblet cells. The proximal region had a greater surface area, as revealed by the presence of elongated mucosal ridges. The enterocytes were covered apically with uniform microvilli. The number of goblet cells were moderate in the proximal intestine and fewer in the medial intestine. All segments of the intestine contained neutral and acidic mucins. The distal intestine mucosa was thinner and less elaborately folded and consisted of columnar cells with shorter and sparser microvilli. After the intestinerectal valve, the rectum displayed lower mucosal folds, numerous goblet cells and a thicker muscularis. An ileorectal valve was observed. This confirms that separate intestine and rectum does exist in T. sparrmanii.
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Pulse amplitude tonometry and angiogenic factors in preeclampsia in rural African women
- Authors: Meeme, Allen
- Date: 2014
- Language: English
- Type: Doctor of Philosophy (Ph.D) (Health Sciences, Physiology)
- Identifier: http://hdl.handle.net/11260/2009 , vital:40800
- Description: The pathogenesis of preeclampsia remains a puzzle despite extensive research that has been carried out over the years. Endothelial dysfunction and altered angiogenic balance have now been shown to play a significant role in the protean manifestations of this syndrome. There are several direct and indirect methods that have been used for assessing endothelial function during pregnancy. The most commonly used non-invasive method for assessing endothelial function in pregnancy has been the flow-mediated ultrasonic method. Because this method requires a skilled sonographer and a good quality ultrasound machine, it is not readily available for routine investigational use. Pulse amplitude tonometry using the EndoPAT 2000 is a novel non-invasive automated method that has been used rather extensively in recent years for assessing endothelial dysfunction in non-pregnant subjects, with only a few reports in pregnancy. This study set out to assess pulse amplitude tonometry using EndoPAT 2000 in normotensive and hypertensive pregnant women in rural African women to determine whether it can demonstrate endothelial dysfunction associated with preeclampsia. In addition, angiogenic factors known to be associated with preeclampsia were measured to assess whether there are any differences in their levels between normotensive and hypertensive pregnant women in the rural African setting. As HIV, a common condition in this population of antenatal mothers, is known to affect endothelial function, secondary evaluation was carried out based on the HIV status to assess if there are any differences in the tested parameters. This was a prospective case-control study conducted in Mthatha Hospital Complex, Eastern Cape, South Africa. A total of two hundred and fifteen (215) participants with known HIV status were recruited into the study; 105 women had preeclampsia (cases) and 110 were normotensive pregnant women (controls). Endothelial function was assessed using EndoPAT 2000 technique that measured pulse amplitude tonometry using the reactive hyperemia index (RHI, arbitrary units). Blood samples were also taken from the subjects and the serum was stored at -70°C until assayed for soluble fms-like tyrosine kinase (sFlt-1), placental growth factor (PlGF). Nitric oxide levels were measured indirectly using nitrite and nitrate levels in serum from blood samples taken from the test arm about 5 minutes after the end of the pulse amplitude tonometry, and these were measured using the Cayman colorimetric method. sFLt-1 and PIGF levels were quantified using specific enzyme linked immunosorbent assays (ELISA). Statistix 8.0 and Graphpad Prism 5 software were used for data analysis. Data were summarised as means ± standard error of the mean (SEM) for normally distributed data and medians (interquartile range, IQR) for non-normally distributed data. Two sample Student’s t-test was used to compare means while Mann-Whitney U test was used to compare medians. Spearman’s correlation and multiple regression analyses were used to determine correlations between variables. Secondary analysis was carried based on whether the cases were early onset or late onset and whether cases and controls were HIV-positive or negative. Kruskal-Wallis and one way ANOVA were used to compare means between cases and controls. Statistical significance was set at a p value of <0.05. Women with preeclampsia were found to have significantly lower RHI [1.70(1.04-3.61)au vs.1.81 (1.18-4.62) au; p˂0.05], lower PIGF levels (90.26 ± 8.99 pg/ml vs. 172.80 ± 20.24 pg/ml; p˂0.01) and higher sFlt1, (2087.3 ± 200.1 pg/ml vs. 1546.5 ± 91.9 pg/ml; p˂0.01) compared to normotensive controls. The sFlt1/PIGF ratio was also found to be higher among women with preeclampsia (66.77 ± 18.66 vs. 22.26 ± 2.95; p˂0.01) compared to the normotensive controls. Unlike the lower RHI, the nitrite and nitrate levels did not differ between preeclamptic and normotensive pregnant women (6.04 ± 0.52 µM vs 6.12 ± 0.49 µM; p>0.05). No significant relationship was observed between RHI and nitrite/nitrate levels (r=-0.08, p>0.05), RHI and pro-angiogenic factor PIGF (r=0.101, p>0.05) or RHI and anti-angiogenic factor sFlt1 (r= 0.002, p>0.05). There was also no significant relationship between RHI and the sFlt1/PlGF ratio (r=-0.047, p>0.05). HIV-positive status significantly affected sFlt1, baseline pulse wave amplitude and augmentation index compared to HIV-negative status in the different groups of women. RHI, PlGF and the sFlt1/PlGF ratio differences were not statistically significant. Pulse amplitude tonometry measured as reactive hyperemia index (RHI) using EndoPAT 2000 revealed the presence of endothelial dysfunction in rural African women with preeclampsia, thus suggesting that this technique can be used reliably to assess endothelial dysfunction in pregnant women. To our knowledge this is the first such report involving rural African women. The significant differences in the levels and ratios of angiogenic factors found in the preeclamptic women when compared with the normotensive controls in this study also confirm what has been reported in the literature. Although endothelial dysfunction was clearly demonstrable in the preeclamptic rural African women, this appears not to have been associated with either reduced or elevated levels of nitric oxide, as assessed using nitrite/ nitrate levels when compared with normotensive controls. This finding adds to the current conflicting reports on nitric oxide levels in preeclampsia reported in the literature. The RHI in both cases and control pregnant women was also not significantly correlated with the levels of nitrites/nitrates. Although this might raise some questions about the actual role of nitric oxide in endothelial dysfunction in rural African women with preeclampsia, the explanation for this finding might simply be the fact that NO has a very short half-life, and has to be measured indirectly using its more stable metabolites such as nitrites and nitrates. The absence of significant correlation between RHI and angiogenic factors demonstrated in this study could mean that the effect of sFlt1 may be more on the larger arteries than small resistance arteries from which RHI is obtained. It is recommended that prospective studies are carried out to determine whether the RHI becomes abnormal before the onset of clinical preeclampsia or not as the search for predictors of preeclampsia continues.
- Full Text:
- Authors: Meeme, Allen
- Date: 2014
- Language: English
- Type: Doctor of Philosophy (Ph.D) (Health Sciences, Physiology)
- Identifier: http://hdl.handle.net/11260/2009 , vital:40800
- Description: The pathogenesis of preeclampsia remains a puzzle despite extensive research that has been carried out over the years. Endothelial dysfunction and altered angiogenic balance have now been shown to play a significant role in the protean manifestations of this syndrome. There are several direct and indirect methods that have been used for assessing endothelial function during pregnancy. The most commonly used non-invasive method for assessing endothelial function in pregnancy has been the flow-mediated ultrasonic method. Because this method requires a skilled sonographer and a good quality ultrasound machine, it is not readily available for routine investigational use. Pulse amplitude tonometry using the EndoPAT 2000 is a novel non-invasive automated method that has been used rather extensively in recent years for assessing endothelial dysfunction in non-pregnant subjects, with only a few reports in pregnancy. This study set out to assess pulse amplitude tonometry using EndoPAT 2000 in normotensive and hypertensive pregnant women in rural African women to determine whether it can demonstrate endothelial dysfunction associated with preeclampsia. In addition, angiogenic factors known to be associated with preeclampsia were measured to assess whether there are any differences in their levels between normotensive and hypertensive pregnant women in the rural African setting. As HIV, a common condition in this population of antenatal mothers, is known to affect endothelial function, secondary evaluation was carried out based on the HIV status to assess if there are any differences in the tested parameters. This was a prospective case-control study conducted in Mthatha Hospital Complex, Eastern Cape, South Africa. A total of two hundred and fifteen (215) participants with known HIV status were recruited into the study; 105 women had preeclampsia (cases) and 110 were normotensive pregnant women (controls). Endothelial function was assessed using EndoPAT 2000 technique that measured pulse amplitude tonometry using the reactive hyperemia index (RHI, arbitrary units). Blood samples were also taken from the subjects and the serum was stored at -70°C until assayed for soluble fms-like tyrosine kinase (sFlt-1), placental growth factor (PlGF). Nitric oxide levels were measured indirectly using nitrite and nitrate levels in serum from blood samples taken from the test arm about 5 minutes after the end of the pulse amplitude tonometry, and these were measured using the Cayman colorimetric method. sFLt-1 and PIGF levels were quantified using specific enzyme linked immunosorbent assays (ELISA). Statistix 8.0 and Graphpad Prism 5 software were used for data analysis. Data were summarised as means ± standard error of the mean (SEM) for normally distributed data and medians (interquartile range, IQR) for non-normally distributed data. Two sample Student’s t-test was used to compare means while Mann-Whitney U test was used to compare medians. Spearman’s correlation and multiple regression analyses were used to determine correlations between variables. Secondary analysis was carried based on whether the cases were early onset or late onset and whether cases and controls were HIV-positive or negative. Kruskal-Wallis and one way ANOVA were used to compare means between cases and controls. Statistical significance was set at a p value of <0.05. Women with preeclampsia were found to have significantly lower RHI [1.70(1.04-3.61)au vs.1.81 (1.18-4.62) au; p˂0.05], lower PIGF levels (90.26 ± 8.99 pg/ml vs. 172.80 ± 20.24 pg/ml; p˂0.01) and higher sFlt1, (2087.3 ± 200.1 pg/ml vs. 1546.5 ± 91.9 pg/ml; p˂0.01) compared to normotensive controls. The sFlt1/PIGF ratio was also found to be higher among women with preeclampsia (66.77 ± 18.66 vs. 22.26 ± 2.95; p˂0.01) compared to the normotensive controls. Unlike the lower RHI, the nitrite and nitrate levels did not differ between preeclamptic and normotensive pregnant women (6.04 ± 0.52 µM vs 6.12 ± 0.49 µM; p>0.05). No significant relationship was observed between RHI and nitrite/nitrate levels (r=-0.08, p>0.05), RHI and pro-angiogenic factor PIGF (r=0.101, p>0.05) or RHI and anti-angiogenic factor sFlt1 (r= 0.002, p>0.05). There was also no significant relationship between RHI and the sFlt1/PlGF ratio (r=-0.047, p>0.05). HIV-positive status significantly affected sFlt1, baseline pulse wave amplitude and augmentation index compared to HIV-negative status in the different groups of women. RHI, PlGF and the sFlt1/PlGF ratio differences were not statistically significant. Pulse amplitude tonometry measured as reactive hyperemia index (RHI) using EndoPAT 2000 revealed the presence of endothelial dysfunction in rural African women with preeclampsia, thus suggesting that this technique can be used reliably to assess endothelial dysfunction in pregnant women. To our knowledge this is the first such report involving rural African women. The significant differences in the levels and ratios of angiogenic factors found in the preeclamptic women when compared with the normotensive controls in this study also confirm what has been reported in the literature. Although endothelial dysfunction was clearly demonstrable in the preeclamptic rural African women, this appears not to have been associated with either reduced or elevated levels of nitric oxide, as assessed using nitrite/ nitrate levels when compared with normotensive controls. This finding adds to the current conflicting reports on nitric oxide levels in preeclampsia reported in the literature. The RHI in both cases and control pregnant women was also not significantly correlated with the levels of nitrites/nitrates. Although this might raise some questions about the actual role of nitric oxide in endothelial dysfunction in rural African women with preeclampsia, the explanation for this finding might simply be the fact that NO has a very short half-life, and has to be measured indirectly using its more stable metabolites such as nitrites and nitrates. The absence of significant correlation between RHI and angiogenic factors demonstrated in this study could mean that the effect of sFlt1 may be more on the larger arteries than small resistance arteries from which RHI is obtained. It is recommended that prospective studies are carried out to determine whether the RHI becomes abnormal before the onset of clinical preeclampsia or not as the search for predictors of preeclampsia continues.
- Full Text:
The Influence of School Environmental Factors on Grade 12 Learners’ Academic Performances
- Authors: SIKUZA PUMLA MARJORIE
- Date: 2014
- Language: English
- Type: Masters
- Identifier: http://hdl.handle.net/11260/2822 , vital:42959
- Full Text:
- Authors: SIKUZA PUMLA MARJORIE
- Date: 2014
- Language: English
- Type: Masters
- Identifier: http://hdl.handle.net/11260/2822 , vital:42959
- Full Text: