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PubMed1994

Biographical profile of practising veterinarians in South Africa.

To identify the current South African practising veterinarians' profile, a survey was conducted by means of a questionnaire in 1992. The list of registered veterinarians according to the South African Veterinary Board was used as a frame for the sample. Five hundred questionnaires were processed. The general profile of a practising veterinarian in South Africa was male, between 30-40 years of age, city-dweller, English speaking and working in a mixed practice.

Adult↗
PubMed1993

Problems and prospects for health sector links in the southern African region: the role of South Africa.

Recent political developments in South Africa provide many opportunities for the development and extension of health sector links in the Southern African region and the possibility to move away from past hostilities towards a constructive future. The need to address health issues at an inter-governmental level is becoming more urgent as poverty, drought and homelessness take their toll on the health of the region's population. This paper examines the prospects for and problems with regional integration in the health sector. It begins by outlining the historical context of regional health sector links and by discussing crucial issues that have to be addressed in relation to future regional activities. It is suggested that future regional co-operation should be based on a new approach to regional security which seeks to overcome adverse relationships, to encourage collective action and responsibility, non-interference in domestic affairs and peaceful resolution of disputes. The second part of the paper examines areas in the health sector that would benefit from co-operation. These include disease control, nutrition, medicines, health services, health personnel and research and development. Potential problems related to health sector links are explored and possible mechanisms for regional integration in the health sector are briefly considered.

Africa, Southern↗
PubMed2004

Exploration of different methods for measuring DDT exposure among malaria vector-control workers in Limpopo Province, South Africa.

DDT compounds are used in many developing countries, including South Africa, for the control of malaria vectors. This study investigated biological exposures among workers in relation to job history. A cross-sectional study of 59 workers at the Malaria Control Centre (MCC) in Tzaneen, South Africa, was performed. Tests included a job history questionnaire and the measurement of serum o'p' and p'p' isomers of DDE, DDT, and DDD, corrected for serum total lipids. Forty-seven (80%) workers donated a blood sample for the determination of serum DDT. The mean number of years worked at the MCC (malaria years) was 15.8+/-7.8 years and the mean serum DDT was 94.3+/-57.1 microg/g of lipid. There were no significant associations between short-to-medium-term serum DDT exposure measures (o'p'-DDE and o'p' and p'p' isomers of DDD and DDT) and malaria years. The long-term exposure measure, p'p'-DDE, was significantly associated with malaria years (beta=3.0+/-1.2 microg/g lipid/year; P=0.001; n=47; adjusted for age), but only 27% variance of p'p'-DDE was explained. Blood total DDT uncorrected for lipid content was strongly related to corrected levels (B=0.74+/-0.48, P=0.00, R2=0.77), but uncorrected p'p'-DDE had a weaker association (B=0.0024+/-0.0013, P=0.074; R2=0.53) with malaria years than did corrected levels (beta=0.042+/-0.017; P=0.016; R2=0.56). The results show that serum DDT levels for malaria vector-control workers in South Africa with a long-term spraying history are high. Job history information on DDT exposures must be very detailed in order to provide valid estimates of exposure.

Animals↗
PubMed2004

Caries status and treatment needs in South Africa: report of the 1999-2002 National Children's Oral Health Survey.

A third national children's oral health survey was conducted in South Africa between July 1999 and June 2002. OBJECTIVE AND METHODOLOGY: One of the objectives of the survey was to determine the prevalence and severity of dental caries and the treatment needs for dental caries in 4- to 5-, 6-, 12- and 15-year-old South African school children. The sample comprised 30876 children from the nine provinces of South Africa. RESULTS: The results of the survey show that 39.7 per cent of the 6-year-old group were caries free. This figure, 39.7 per cent, is below the goal of 50 per cent set by the Department of Health for 6-year-old children in South Africa for the year 2000. The DMFT of 1.1 for the 12-year-old group on the other hand was below the goal of 1.5 set for South Africa for the year 2000. The highest DMFT/dmft scores were recorded in the Western Cape Province and the lowest in the Limpopo Province. More than 80 per cent of caries in children go untreated while the greatest need for treatment in South African school children was for preventive services, restorations and extractions. The results for the 12-year-old-group show a reduction in dental caries severity in the permanent dentition in that the DMFT decreased from 2.5 in 1982 to 1.1 for the current survey. CONCLUSIONS: Although dental caries severity in South Africa is classified as low by WHO standards, the high levels of untreated caries in all age groups in South Africa is a cause for concern.

Adolescent↗
PubMed1989

Nursing education in South Africa.

Basic nursing education in South Africa has recently changed from a series of single registrations to a 4 year integrated programme. Diploma nursing education has also been moved into the mainstream of post-secondary education by the establishment of Nursing Colleges affiliated to Universities. These structural changes have put nursing education on a healthy footing, which should serve it well for the next decade.

Curriculum↗
PubMed1998

[Spotted fever after travel to South Africa].

Three patients developed fever, malaise and a typical maculopapular rash a few days after returning to Norway from South Africa. In South Africa they had been bitten by ticks several times while hunting. Two patients, with lesions compatible with eschar, were hospitalized, and a diagnosis of rickettsial spotted fever was established based on the clinical presentation and positive Rickettsia conorii serology. Rickettsial diseases are extremely rare in Scandinavia, and a survey on rickettsioses is presented in this paper.

Boutonneuse Fever↗
PubMed2005

Abrupt and gradual extinction among Late Permian land vertebrates in the Karoo basin, South Africa.

The Karoo basin of South Africa exposes a succession of Upper Permian to Lower Triassic terrestrial strata containing abundant terrestrial vertebrate fossils. Paleomagnetic/magnetostratigraphic and carbon-isotope data allow sections to be correlated across the basin. With this stratigraphy, the vertebrate fossil data show a gradual extinction in the Upper Permian punctuated by an enhanced extinction pulse at the Permian-Triassic boundary interval, particularly among the dicynodont therapsids, coinciding with negative carbon-isotope anomalies.

Animals↗
PubMed2005

Sequence analysis of near full-length HIV type 1 subtype D primary strains isolated in Cape Town, South Africa, from 1984 to 1986.

South Africa has one of the fastest growing HIV-1 epidemics worldwide, consisting mostly of subtype C. However, HIV-1 subtype B and subtype D viruses were isolated in the beginning of the epidemic in the early 1980s. This study describes the amplification, cloning, and near full-length genome sequencing of four HIV-1 subtype D primary strains, isolated from 1984 to 1986 in Cape Town, in what seems to have been a small restricted subtype D epidemic in the country.

Disease Outbreaks↗
PubMed2005

A catastrophe in the 21st century: the public health situation in South Africa following HIV/AIDS.

During the early 1900s, African populations in South Africa were subject to very widespread infections which especially affected the young. This resulted in high mortality rates and a low life expectancy of 20-25 years. By the mid-century, mortality rates from infections had decreased considerably. Moreover, the occurrences of non-communicable diseases, even in urban areas, remained very low. In the 1970s, the proportion of Africans aged 50 or over that reached 70 years was 38.5%, higher than that in the juxtaposed white population, which was 35.5%. And by 1985, the life expectancy of Africans reached 61 years for males and 63 years for females, probably the highest in sub-Saharan African populations. Since then, however, the African continent has been devastated by the AIDS epidemic. In 2001, HIV was responsible for the death of a third of the African population in South Africa, but even higher proportions prevailed in Botswana and in Tanzania. The calamitous advent of the HIV infection has caused major falls in life expectancy, in the case of Africans in South Africa reducing this to just 43 years. With little hope of meaningful changes occurring in sexual habits or of an early vaccine becoming available, the infection's high morbidity/mortality burden is likely to continue.

Acquired Immunodeficiency Syndrome↗
PubMed1999

Tuberculosis and health sector reform: experience of integrating tuberculosis services into the district health system in rural South Africa.

SETTING: Hlabisa health district, South Africa. OBJECTIVE: To describe the integration of a 'vertical' tuberculosis control programme into an emerging 'horizontal' district health system, within the context of health sector reform. DESIGN: Descriptive account of the process of integration of the programme into the health system. RESULTS: A highly 'vertical' system of delivering tuberculosis treatment (with poor programme outcomes) was converted into a 'horizontal' team, integrated within the district health system, that used available resources such as village clinics and community health workers, with improved programme outcomes. CONCLUSIONS: In some settings at least, integration of tuberculosis 'programmes' into the district health system as tuberculosis 'teams' is feasible, and may produce highly cost-effective outcomes.

Delivery of Health Care, Integrated↗
PubMedDate not supplied

Human rights, environmental justice, and the health of farm workers in South Africa.

Despite the democratization of South Africa in 1994, which brought the agricultural sector within the ambit of legal protection, farm workers remain vulnerable to an undue burden of social and health problems. Alcohol abuse due to the DOP system, pesticide poisonings, and other occupational hazards illustrate that the likely success of efforts at redress depends on a greater awareness of the rights and justice dimensions of the health problems facing these workers. International trade policies may exacerbate inequalities that deprive them of opportunities to realize their rights at national level. A public health agenda must integrate into programs and policies to address the health of farm workers the recognition that violations of their rights underlie much of their burden of ill health.

Agricultural Workers' Diseases↗
PubMed2005

Key challenges to achieving health for all in an inequitable society: the case of South Africa.

The health inequalities in South Africa are rapidly worsening. Since 1994, the new democratic government has initiated a number of large-scale policies and programs with explicit pro-equity objectives that have improved access to health care and other social resources. However, these policies and programs have been constrained by macroeconomic policies that dictate fiscal restraint and give priority to technical rather than developmental considerations. We propose an approach to improving health for all that focuses on equity in the allocation of health resources. The implementation of pro-equity policies requires, in addition to technically efficacious interventions, both advocacy initiatives and communication with, and the involvement of, affected communities. The Cape Town Equity Gauge project is presented as one example of a response to the challenge of inequity.

Community Participation↗
PubMed2006

Estimation of mortality from vital registrations in South Africa.

Sentinel surveillance surveys combined with epidemiological/demographic models have been used in monitoring trends in mortality due to HIV in South Africa as in most other countries. The potential biases in such surveys have been highlighted in recent studies. South Africa's HIV prevalence (29.5% among pregnant women attending antenatal clinics in 2004) is one of the highest in the world. National HIV prevalence from population-based survey has been carried out twice in South Africa, but is of limited use as a surveillance system independent of antenatal data. The use of vital registration in monitoring HIV related mortality has been largely unexplored. This study utilises data on registered deaths for the period 1997-2001 to estimate trends in mortality and TB/HIV related death rates in South Africa. The analysis utilizes the Growth Balance method to estimate the completeness of the death records from the registration system, and hence an adjustment factor for the registered deaths including TB/HIV related deaths in the period. The results indicate that coverage of registration of deaths in South Africa has increased over time but the completeness of registration of female deaths lags behind completeness of registration of male deaths. The absolute number of deaths is estimated to have increased from about 400,000 in 1997 to about 565,000 in 2002. Crude HIV related plus TB-AIDS death rate is estimated to have increased from about 9.6 per 10,000 in 1997 to about 19.1 per 10,000 in 2002. The increase in the number of deaths could not be attributed to population growth.

AIDS-Related Opportunistic Infections↗
PubMed1997

District level information systems: two cases from South Africa.

The health system in South Africa has to date been fragmented and centralised. The priority of the new government is to establish an integrated and decentralised district health system of which a key element is the development of district health and management information systems (H & MIS). This paper presents experiences from two projects in the Western Cape in which a process to establish a district-based H & MIS was initiated and a situation analysis of the information systems was done. The two projects applied different research methods but the results show with remarkable consistency that much time is used on data collection, but information is not used at local level. The projects have applied different approaches towards developing a district H & MIS but in both important pre-requisites for a successful, action-led H & MIS include local ownership and motivation, a process based around existing local management structures and the active involvement of the community.

Delivery of Health Care↗
PubMed1982

Diverticular disease in urban Africans in South Africa.

At Baragwanath Hospital, Johannesburg, South Africa, during a 3-year period diverticular disease was diagnosed in 42 Black patients (16 men, 26 women), from an urban population approaching 1,5 million. Patients presented mainly with rectal bleeding, abdominal mass or pain. Of average age 62 years, all were among the more privileged. The persisting very low frequency of the disease, which is in consonance with low frequencies of other bowel diseases (appendicitis, ulcerative colitis, colon cancer), is deemed valid. The mean daily dietary fibre intake, 26.5 +/- 8.5 g, was higher than that of local Whites, 22.4 +/- 6.0 g, but significantly less than that of a sex-age matched urban Black control group, 32.5 +/- 11.4 g. Although a measure of westernization of diet has obviously occurred, its extent, also the period of exposure, would seem to have been insufficient to have evoked significant rises in the occurrence of diverticular disease.

Adult↗
PubMed1997

Developing community mental health services for children in South Africa.

As a result of South Africa's Apartheid history, mental health care for black people, especially in rural areas, has been grossly inadequate and even non-existent in many areas. Children have been severely neglected in this regard. This paper describes an attempt by clinical psychologists to develop a community intervention programme for children with emotional problems. From their hospital base the authors set out, on a monthly basis, to outlying areas up to 250 km away to (1) train primary care nurses and other personnel in the basic techniques of identifying and dealing with uncomplicated psychological problems of childhood, and (2) render consultations to psychologically disturbed children. The paper argues the need to provide primary care workers with mental health skills and thus integrate childhood mental health care into the primary care structure. Such a move could make mental health care accessible to all inhabitants, thus deviating from the policies of the past.

Child↗
PubMed2001

Rapid and recent origin of species richness in the Cape flora of South Africa.

The Cape flora of South Africa grows in a continental area with many diverse and endemic species. We need to understand the evolutionary origins and ages of such 'hotspots' to conserve them effectively. In volcanic islands the timing of diversification can be precisely measured with potassium-argon dating. In contrast, the history of these continental species is based upon an incomplete fossil record and relatively imprecise isotopic palaeotemperature signatures. Here we use molecular phylogenetics and precise dating of two island species within the same clade as the continental taxa to show recent speciation in a species-rich genus characteristic of the Cape flora. The results indicate that diversification began approximately 7-8 Myr ago, coincident with extensive aridification caused by changes in ocean currents. The recent origin of endemic species diversity in the Cape flora shows that large continental bursts of speciation can occur rapidly over timescales comparable to those previously associated with oceanic island radiations.

Ecosystem↗