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.
- Full Text:
- 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.
- Full Text:
Comparison of the Therapeutic Effectiveness of Abacavir and Stavudine as part of the First Line Antiretroviral Therapy Nucleoside Reverse Transcriptase Backbone for Children in East London, South Africa
- Authors: Cheree Ann Goldswain
- Date: 2016
- Subjects: Paediatrics, Medicine
- Language: English
- Type: Thesis, Masters
- Identifier: http://hdl.handle.net/11260/2137 , vital:40902
- Full Text: false
- Authors: Cheree Ann Goldswain
- Date: 2016
- Subjects: Paediatrics, Medicine
- Language: English
- Type: Thesis, Masters
- Identifier: http://hdl.handle.net/11260/2137 , vital:40902
- Full Text: false
Disserminating Knowledge about the value of indigenous food plants through e-learning programmes: a case study of communities within a rural village in Mthatha, Eastern Cape, South Africa
- Authors: Alfred John Mwanza
- Date: 2016
- Language: English
- Type: Thesis, Doctoral, PhD
- Identifier: http://hdl.handle.net/11260/2100 , vital:40887
- Full Text: false
- Authors: Alfred John Mwanza
- Date: 2016
- Language: English
- Type: Thesis, Doctoral, PhD
- Identifier: http://hdl.handle.net/11260/2100 , vital:40887
- Full Text: false
Disserminating Knowledge about the value of indigenous food plants through e-learning programmes: a case study of communities within a rural village in Mthatha, Eastern Cape, South Africa
- Authors: Alfred John Mwanza
- Date: 2016
- Language: English
- Type: Thesis, Doctoral, PhD
- Identifier: http://hdl.handle.net/11260/2099 , vital:40888
- Full Text: false
- Authors: Alfred John Mwanza
- Date: 2016
- Language: English
- Type: Thesis, Doctoral, PhD
- Identifier: http://hdl.handle.net/11260/2099 , vital:40888
- Full Text: false
EXPLORING THE SUPPORT PROVIDED TO SCHOOL PRINCIPALS BY CIRCUIT MANAGERS IN THE NGCOBO DISTRICT IN THE EASTERN CAPE PROVINCE, SOUTH AFRICA
- Authors: SAKHIWO TOLBERT MPOPOSHE
- Date: 2016
- Subjects: Education Management
- Language: English
- Type: Thesis, Doctoral, PhD
- Identifier: http://hdl.handle.net/11260/2165 , vital:40908
- Full Text: false
- Authors: SAKHIWO TOLBERT MPOPOSHE
- Date: 2016
- Subjects: Education Management
- Language: English
- Type: Thesis, Doctoral, PhD
- Identifier: http://hdl.handle.net/11260/2165 , vital:40908
- Full Text: false
Language And Gender Interaction In Bakossi Proverbial Discourse
- Authors: Enongene Mirabeau Sone
- Date: 2016
- Subjects: Language use, gender, sexist, sexism, Bakossi, proverbs, discourse
- Language: English
- Type: Journal Article
- Identifier: http://hdl.handle.net/11260/2616 , vital:42294
- Description: Language can be seen as a systematic means which human beings use in the communication of thoughts, ideas, values, norms and feelings. As a pervasive aspect of our lives, it is a verbal means with which we communicate and conduct social interaction. This paper examines specific aspects of proverbial language of the Bakossi people of the South West Region of Cameroon and determines through a feminist analysis how this language use illustrates in-built sexist connotation in the sense that it generally indicates positive things for males while negative connotations are assumed for women. Proverbs, pronominal forms and idiomatic expressions are collected and analysed to ascertain the above argument. The evidence in this paper serves as a reference point for women of sexism that is built into language use in these old pithy sayings which are meant to encapsulate pearls of wisdom
- Full Text:
- Authors: Enongene Mirabeau Sone
- Date: 2016
- Subjects: Language use, gender, sexist, sexism, Bakossi, proverbs, discourse
- Language: English
- Type: Journal Article
- Identifier: http://hdl.handle.net/11260/2616 , vital:42294
- Description: Language can be seen as a systematic means which human beings use in the communication of thoughts, ideas, values, norms and feelings. As a pervasive aspect of our lives, it is a verbal means with which we communicate and conduct social interaction. This paper examines specific aspects of proverbial language of the Bakossi people of the South West Region of Cameroon and determines through a feminist analysis how this language use illustrates in-built sexist connotation in the sense that it generally indicates positive things for males while negative connotations are assumed for women. Proverbs, pronominal forms and idiomatic expressions are collected and analysed to ascertain the above argument. The evidence in this paper serves as a reference point for women of sexism that is built into language use in these old pithy sayings which are meant to encapsulate pearls of wisdom
- Full Text:
Oxidative Stress and Antioxidant status in type 2 diabetic patients with retinopathy in Mthatha, Eastern Cape Province of South Africa
- Authors: Ganjifrokwala Farzana Anis
- Date: 2016
- Language: English
- Type: Thesis, Doctoral, Phd
- Identifier: http://hdl.handle.net/11260/2109 , vital:40889
- Full Text: false
- Authors: Ganjifrokwala Farzana Anis
- Date: 2016
- Language: English
- Type: Thesis, Doctoral, Phd
- Identifier: http://hdl.handle.net/11260/2109 , vital:40889
- Full Text: false
Swazi oral literature, eco-culture and environmental apocalypse
- Authors: Enongene Mirabeau Sone
- Date: 2016
- Subjects: Swazi oral literature; eco-culture; eco-literature; eco-criticism; environmental sustainability
- Language: English
- Type: Journal Article
- Identifier: http://hdl.handle.net/11260/2632 , vital:42302
- Description: The main objective of this paper is to show how oral literature is engaged by Swazis with regards to environmental sustainability. It demonstrates the relationship between nature and culture as reflected in Swazi oral literature and how indigenous knowledge embedded in this literature can be used to expand the concepts of eco-literature and eco-criticism. The paper argues that the indigenous environmental expertise among the Swazi people, encapsulated in their oral literature, can serve as a critical resource base for the process of developing a healthy environment. Furthermore, the paper contends that eco-criticism, which is essentially a Western concept, can benefit by drawing inspiration from the indigenous knowledge contained in Swazi culture and expressed in their oral literature. The paper concludes by recommending the need to strengthen traditional and customary knowledge and practices by protecting and recognizing the values of such systems in the conservation of biodiversity for sustainable development
- Full Text:
- Authors: Enongene Mirabeau Sone
- Date: 2016
- Subjects: Swazi oral literature; eco-culture; eco-literature; eco-criticism; environmental sustainability
- Language: English
- Type: Journal Article
- Identifier: http://hdl.handle.net/11260/2632 , vital:42302
- Description: The main objective of this paper is to show how oral literature is engaged by Swazis with regards to environmental sustainability. It demonstrates the relationship between nature and culture as reflected in Swazi oral literature and how indigenous knowledge embedded in this literature can be used to expand the concepts of eco-literature and eco-criticism. The paper argues that the indigenous environmental expertise among the Swazi people, encapsulated in their oral literature, can serve as a critical resource base for the process of developing a healthy environment. Furthermore, the paper contends that eco-criticism, which is essentially a Western concept, can benefit by drawing inspiration from the indigenous knowledge contained in Swazi culture and expressed in their oral literature. The paper concludes by recommending the need to strengthen traditional and customary knowledge and practices by protecting and recognizing the values of such systems in the conservation of biodiversity for sustainable development
- Full Text:
The Interrelationship between oral literature and museum studies
- Authors: Enongene Mirabeau Sone
- Date: 2016
- Subjects: folklore; interrelationship; museum studies; oral literature
- Language: English
- Type: Journal Article
- Identifier: http://hdl.handle.net/11260/2696 , vital:42324
- Description: Oral literature and museums are intimately related to each other. While the former is an academic discipline, the latter is an institution. This article examines the historical background of the study of oral literature and the historical development of the museum so that the relationship between the two can be easily appreciated. The article argues that oral literature, as a form of folklore, can help to create good museums and that the museum, on the other hand, can contribute to the study of oral literature. This interrelationship, once appreciated by both oral literature scholars (folklorists) and museologists (museum scholars), will be of tremendous benefit to the study of oral literature as an academic discipline and to the development of more thematic museums, especially in Africa where oral literature is a dynamic aspect of societal life.
- Full Text:
- Authors: Enongene Mirabeau Sone
- Date: 2016
- Subjects: folklore; interrelationship; museum studies; oral literature
- Language: English
- Type: Journal Article
- Identifier: http://hdl.handle.net/11260/2696 , vital:42324
- Description: Oral literature and museums are intimately related to each other. While the former is an academic discipline, the latter is an institution. This article examines the historical background of the study of oral literature and the historical development of the museum so that the relationship between the two can be easily appreciated. The article argues that oral literature, as a form of folklore, can help to create good museums and that the museum, on the other hand, can contribute to the study of oral literature. This interrelationship, once appreciated by both oral literature scholars (folklorists) and museologists (museum scholars), will be of tremendous benefit to the study of oral literature as an academic discipline and to the development of more thematic museums, especially in Africa where oral literature is a dynamic aspect of societal life.
- Full Text:
The relationship between grade 9 mathematics teachers content knowledge and their learners' understanding of linear graphs
- Authors: Msebenzi Rabaza
- Date: 2016
- Language: English
- Type: Thesis, D Ed
- Identifier: http://hdl.handle.net/11260/2235 , vital:40920
- Full Text: false
- Authors: Msebenzi Rabaza
- Date: 2016
- Language: English
- Type: Thesis, D Ed
- Identifier: http://hdl.handle.net/11260/2235 , vital:40920
- Full Text: false
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
Ageing, exposure to pollution, and interactions between climate change and local seasons as oxidant conditions predicting incident hematologic malignancy at KINSHASA University clinics, Democratic Republic of CONGO (DRC)
- Mireille Solange Nganga Nkanga, Benjamin Longo-Mbenza, Oladele Vincent Adeniyi, Jacques Bikaula Ngwidiwo, Antoine Lufimbo Katawandja, Paul Roger Beia Kazadi, Alain Nganga Nzonzila
- Authors: Mireille Solange Nganga Nkanga , Benjamin Longo-Mbenza , Oladele Vincent Adeniyi , Jacques Bikaula Ngwidiwo , Antoine Lufimbo Katawandja , Paul Roger Beia Kazadi , Alain Nganga Nzonzila
- Date: 2017
- Language: English
- Type: Journal Article
- Identifier: http://hdl.handle.net/11260/3988 , vital:43980
- Full Text:
- Authors: Mireille Solange Nganga Nkanga , Benjamin Longo-Mbenza , Oladele Vincent Adeniyi , Jacques Bikaula Ngwidiwo , Antoine Lufimbo Katawandja , Paul Roger Beia Kazadi , Alain Nganga Nzonzila
- Date: 2017
- Language: English
- Type: Journal Article
- Identifier: http://hdl.handle.net/11260/3988 , vital:43980
- Full Text:
Antibacterial activity of crude extracts of some South African medicinal plants against multidrug resistant etiological agents of diarrhoea
- Mary A. Bisi-Johnson, Chikwelu L. Obi, Babatunde B Samuel, Jacobus N. Eloff, Anthony I. Okoh
- Authors: Mary A. Bisi-Johnson , Chikwelu L. Obi , Babatunde B Samuel , Jacobus N. Eloff , Anthony I. Okoh
- Date: 2017
- Language: English
- Type: Journal Article
- Identifier: http://hdl.handle.net/11260/3710 , vital:43932
- Full Text:
- Authors: Mary A. Bisi-Johnson , Chikwelu L. Obi , Babatunde B Samuel , Jacobus N. Eloff , Anthony I. Okoh
- Date: 2017
- Language: English
- Type: Journal Article
- Identifier: http://hdl.handle.net/11260/3710 , vital:43932
- Full Text:
Decreased total antioxidant levels and increased oxidative stress in South African type 2 diabetes mellitus patients
- FA Ganjifrockwala, JT Joseph, G George
- Authors: FA Ganjifrockwala , JT Joseph , G George
- Date: 2017
- Language: English
- Type: Journal Article
- Identifier: http://hdl.handle.net/11260/3686 , vital:43925
- Full Text:
- Authors: FA Ganjifrockwala , JT Joseph , G George
- Date: 2017
- Language: English
- Type: Journal Article
- Identifier: http://hdl.handle.net/11260/3686 , vital:43925
- Full Text:
Implications of Risks and Vulnerability challenges for Teaching and Learning in Libode - Mega District Rural Schools: Eastern Cape: South Africa
- Authors: Noloyiso Nongalo
- Date: 2017
- Subjects: Educational Management
- Language: English
- Type: Thesis, D Ed
- Identifier: http://hdl.handle.net/11260/2214 , vital:40917
- Full Text: false
- Authors: Noloyiso Nongalo
- Date: 2017
- Subjects: Educational Management
- Language: English
- Type: Thesis, D Ed
- Identifier: http://hdl.handle.net/11260/2214 , vital:40917
- Full Text: false