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At least 19 recordsLinked to original sources
PubMed1999

Randomized trial testing the effect of vitamin A supplementation on pregnancy outcomes and early mother-to-child HIV-1 transmission in Durban, South Africa. South African Vitamin A Study Group.

OBJECTIVE: Poor vitamin A status has been associated with a higher risk for mother-to-child transmission of HIV-1 and there is contradictory evidence on the impact of vitamin A on perinatal outcome. We therefore assessed the effect of vitamin A supplementation to mothers on birth outcome and mother-to-child transmission of HIV-1. DESIGN AND METHODS: In Durban, South Africa 728 pregnant HIV infected women received either vitamin A (368) or placebo (360) in a randomized, double-blind trial. The vitamin A treatment consisted of a daily dose of 5000 IU retinyl palmitate and 30 mg beta-carotene during the third trimester of pregnancy and 200000 IU retinyl palmitate at delivery. HIV infection results were available on 632 children who were included in the Kaplan-Meier transmission analysis. Results are reported on mother-to-child transmission rates up to 3 months of age. RESULTS: There was no difference in the risk of HIV infection by 3 months of age between the vitamin A [20.3%; 95% confidence interval (CI), 15.7-24.9] and placebo groups (22.3%; 95% CI, 17.5-27.1), nor were there differences in foetal or infant mortality rates between the two groups. Women receiving vitamin A supplement were, however, less likely to have a preterm delivery (11.4% in the vitamin A and 17.4% in the placebo group; P = 0.03) and among the 80 preterm deliveries, those assigned to the vitamin A group were less likely to be infected (17.9%; 95% CI, 3.5-32.2) than those assigned to the placebo group (33.8%; 95% CI, 19.8-47.8). CONCLUSION: Vitamin A supplementation, a low-cost intervention, does not appear to be effective in reducing overall mother-to-child transmission of HIV; however, its potential for reducing the incidence of preterm births, and the risk of mother-to-child transmission of HIV in these infants needs further investigation.

Adult↗
PubMed1999

Establishing networks for health promoting schools in South Africa.

South African schools were segregated by years of discriminatory practice. Apartheid policies adversely affected the health and social status of children in South Africa. The conceptual framework suggested by the health promoting schools movement was adopted in South Africa to address school health comprehensively. This approach provides a useful framework because it focuses not on the curriculum but on the school environment, community involvement, policy development, and appropriate health and social services. Currently, several initiatives in South Africa focus on developing networks of health promoting schools. Initiatives seen as a mechanism to address the historical inequities among children in South Africa are described.

Child↗
PubMed1996

International migration: a case study of South Africa.

"South Africa, which has traditionally been a popular destination for international migrants, is currently experiencing a net loss of legal migrants, but an enormous gain of illegal immigrants. This article analyses trends in legal international migration to and from South Africa and provides a demographic profile of legal immigrants and emigrants. The reasons for and results of the influx of illegal immigrants into the country are discussed, and possible policies and strategies to reduce this influx are presented."

Africa↗
PubMed2000

A review of health and human rights after five years of democracy in South Africa.

South Africa became a democratic state with a supreme Constitution and Bill of Rights in 1994. Between 1994 and 1996 South Africans drafted a new constitution which came into force in 1997. While, the right to health, as well as socio-economic rights is provided for, the health care system in post-apartheid South Africa still mirrors that which existed during the apartheid years. There are still two health care systems. The poorly funded public sector services the majority, while the well-funded private sector services the privileged few. A lack of resources is blamed by the state for its inability to provide better and more widespread health services. This article examines, from a human rights perspective, the successes and challenges in developing the right to health between 1994 to 1999, and provides an overview of the present state of health in South Africa. This article further examines the constitutional provisions on health, and discusses recent constitutional court decisions relevant to the right to health. New and controversial health laws and regulations, affecting health care professionals, medical aid schemes and the availability of pharmaceuticals, are critiqued. The move to devolving health care to the provinces is described. Also discussed are the controversial steps taken by the Department of Health to restructure health structures and services. Progress on key health issues such as HIV/Aids, tobacco, tuberculosis, polio, measles, hepatitis, malaria and abortion are also described. Attention is focused on the role of the Truth and Reconciliation Commission's health hearings in bringing to light violations of human rights in health during apartheid as well as the recommendations made to address these problems.

Abortion, Legal↗
PubMed1985

Issues for cross-cultural psychiatric research in South Africa.

South Africa's heterogenous society offers many opportunities for cross-cultural psychiatric research, but researchers in the country are subject to a number of restraints. Apart from legally enforced segregation, there are strict censorship laws and restricted access to certain types of information. The issues surrounding categorization of cultures and factors affecting publishing research from South Africa have important implications for the type of work that is done. It is a central argument of this article that the issues affecting research in South Africa are relevant to other countries as well, and parallels between the local and international context are drawn. The South African experience suggests that analysis of the research enterprise itself is a useful part of the business of cross-cultural psychiatric research.

Cross-Cultural Comparison↗
PubMed1995

Interventional cardiology in South Africa.

South Africa is a country in political and cultural flux. Because of the iniquitous system of apartheid, inequalities have been perpetuated at all levels including health care. Due to the high prevalence of ischemic heart disease and rheumatic heart disease, coronary angiography, PTCA, intracoronary stenting, and balloon valvuloplasty have become established cardiological procedures in South Africa. However, a new political dispensation promises changes to health care, which will impact on interventional cardiology. With a proposed emphasis on primary health care, resources for tertiary health care will probably be curtailed. Thus consideration will have to be given to reducing expenditure by careful review of indications for expensive interventional procedures and developing new ideas to contain costs. This will be the challenge facing cardiologists in a "New South Africa".

Adolescent↗
PubMed2001

Adolescent pregnancy and parenthood in South Africa.

South Africa's total fertility rate is estimated to be one of the lowest in sub-Saharan Africa, fewer than three births per woman nationally and declining. At the same time, adolescent childbearing levels remain high: More than 30 percent of 19-year-old girls are reported to have given birth at least once. Evidence from focus-group discussions conducted in urban and rural areas in South Africa with young black women and men, and with the parents of teenage mothers, is used to consider the experience of early parenthood, including the role of paternity, education, work opportunities, and subsequent fertility. In South Africa, in contrast to many other settings, teenage mothers may return to school once they have given birth, and this opportunity is strongly related to a long delay before the birth of a second child. Educated girls also tend to bring more bridewealth, which may encourage parents to support their daughters' schooling, and perhaps their return to school following childbirth. The support of the child, however, is often subject to paternal recognition and commitment, even though boys are unwilling to admit paternity because it jeopardizes their educational and employment opportunities.

Adaptation, Psychological↗
PubMed2000

A survey of feline babesiosis in South Africa.

South Africa appears to be the only country where feline babesiosis is a significant clinical entity in domestic cats. Little is known about its epidemiology or the clinical challenges facing practitioners. A questionnaire posted to 1760 South African veterinarians was returned by 16%, representing approximately 40% of practices. Just over half reported seeing feline babesiosis, with most cases occurring in the coastal areas of the Western Cape, Eastern Cape and KwaZulu-Natal Provinces. Overall incidence is highest in summer, but seasonality is less pronounced in non-seasonal and winter rainfall areas. No age, breed or sex predisposition was identified. Weight loss, weakness, anaemia, fever and icterus are common clinical findings. Complications include hepatopathy, renal failure, pulmonary oedema, cerebral signs, immune-mediated haemolytic anaemia and concurrent infections. The antibabesial drug of choice is primaquine phosphate. Response to therapy is generally good, but recurrence and chronic infections were identified as problems. The average mortality rate was 15%. Approximately 3000 cases are seen annually by the respondents, at an estimated cost of R750 000 to the owners. Feline babesiosis is a significant problem in South Africa, and further investigations of taxonomic status, concurrent infections, chemotherapy, complications and management of refractory cases are warranted.

Animals↗
PubMed2002

Inequity in occupational health services for government hospital workers in South Africa.

South Africa's inequitable public health system is mainly delivered by provincial health departments, and exemplifies the potential and problems of occupational health services in middle-income countries. The occupational health services for 153 265 employees in all of South Africa's 370 provincial hospitals were described and compared. Information was obtained from 303 (82%) hospitals, using a self-completed questionnaire and telephone interviews. Thirty-two per cent of hospitals had an occupational health clinic, but 61% of employees worked in hospitals with a clinic. Occupational health clinics were more likely to be present in larger hospitals, and were strongly associated with provision of primary care and chronic disease services to workers. Thirty-nine per cent of hospitals had a safety officer, 41% had access to an industrial hygienist or environmental health officer, and 80% had health and safety committees, as required by law. While occupational health services were more likely in larger hospitals, workforce size did not explain the marked differences between provinces. The study shows that substantial occupational health services exist, but that important gaps persist, even in wealthier provinces and especially in provinces without coherent occupational health policies.

Female↗
PubMed1988

Drug regulation in South Africa.

South Africa has a population of approximately 30 million people. The country has a mixture of advanced industrial and rural economies, but the medicine control system is consistent with similar systems established in the major industrial countries of Western Europe and North America. Because most of South Africa's population lives in conditions more closely akin to the developing world than to the Western nations, it is important to examine whether the country is optimally served by this drug regulation model and to define critically the strengths and limitations of the established system. The conclusions might be relevant for other countries at a comparable stage of development.

Drug Industry↗
PubMed1995

Health and social policies in the new South Africa.

South Africa's first democratic government is today confronted with the challenge of recasting apartheid social and health policies, transforming a moribund bureaucracy's mode of governance, and restructuring a variety of public and private institutions, including the national Department of Health. In the attempt to redress racial, gender, and class inequities, enormous barriers confront health policy analysts and planners, progressive politicians, and activists within civil society who work in the field of health. This article sets the broad social policy context for the emerging strategies, documents some of the continuing inequities in the health sector, and recounts some recent experiences in one of the nine provinces (KwaZulu-Natal). to illustrate the difficulties and potentials that change of this magnitude presents under the prevailing conditions of neoliberal politics and economics.

Democracy↗
PubMed1979

[Symptoms of rabies in pets and domestic animals in South Africa and South West Africa (author's transl)].

The most obvious symptoms of rabies in farm animals and pets in South Africa and South-West Africa are discussed in the light of information obtained during routine examination of specimens for the 10-year-period 1967--1976. More than 55% of the cases encountered were cattle in which the most obvious symptoms were salivation (92%), bellowing (69%), aggressiveness (47%), paresis or paralysis (30%) and straining (12%). Unlike cattle, the most obvious symptom in goats was aggressiveness (83%). Salivation was observed in ony 29% of goats but, like bellowing in cattle, bleating was very obvious in 72% of cases. Sheep were usually quiet, but 67% were aggressive. Salivation was observed in 30%, while 27% showed an abnormal sexual desire. The second highest incidence of rabies was recorded in dogs (20%). Aggressiveness was the most obvious symptom (71%) followed by salivation (48%), paresis and paralysis (28%) and barking (11%). With the exception of salivation and paresis, which were rarely encountered, aggressiveness was the only symptom observed in cats. Several cats were encountered with rabies-like symptoms due to organic phosphate poisoning. The most obvious symptoms in horses and donkeys were aggressiveness (77%), paresis or paralysis 33%), the chewing of foreign matter (33%) and salivation 22%). It is obvious that other conditions can easily be confused with rabies. Therefore every possible cause for rabies-like behaviour must be considered and eliminated to avoid unnecessary destruction of animals.

Animals↗
PubMed1989

Research on the health implications of the use of recycled water in South Africa.

South Africa has an inadequate and unreliable supply of water. It is expected that water resources will be a limiting factor to development by the year 2020. Reclamation and reuse of sewage effluent is one possible method of supplementing existing supplies. Windhoek has had direct supplementation of its water supply for over a decade. Guidelines for using recycled sewage as a source of potable water are given and South African studies on chemical, microbiological and virological aspects of reclaimed water are reviewed. Epidemiological studies, retrospective in Windhoek and prospective for Cape Town, are discussed.

Fresh Water↗
PubMedDate not supplied

The sociological spread of HIV/AIDS in South Africa.

South Africa (SA) now accounts for more than 50% of newly reported HIV cases in sub-Saharan Africa annually. In 1993, approximately 90% of those reported as HIV positive in SA were of African descent. This paper examines sociological factors in the spread of HIV in SA through the application of Lalonde's (1974) Health Field Concept. SA's emerging District Health System (DHS) is discussed, as well as barriers to effective implementation and recommendations. Through Lalonde's sociopolitical view of health, a coordinated and multisectorial approach to HIV/AIDS in SA can be established. Without this approach, health care interventions will fail to target the population effectively, thereby reducing effectiveness and sustainability.

Adolescent↗
PubMed2001

Genetic analysis of the complete gag and env genes of HIV type 1 subtype C primary isolates from South Africa.

South Africa has one of the fastest growing HIV-1 epidemics, with an estimated 4.7 million people infected. To better understand the genetic diversity of this epidemic and its potential impact on vaccine development, we have cloned and sequenced the complete gag and env genes of 13 primary virus isolates. Phylogenetic analysis of our sequences and 69 complete env genes from the Los Alamos and GenBank databases revealed multiple subclusters within subtype C. The V3 loop region was relatively conserved in all our strains when compared with other subtypes, but the region immediately downstream was highly variable. No intersubtype recombinant forms were observed when comparing the gag and env sequences. Characterization of the complete gag and env genes enabled us to select specific strains for further vaccine development.

Amino Acid Sequence↗
PubMed2000

The value of advocacy in promoting social change: implementing the new Domestic Violence Act in South Africa.

South Africa's first democratic government passed the Domestic Violence Act (DVA) into law in 1998 as part of local and international commitments to protecting the human rights of women. Although the Act was welcomed as groundbreaking legislation, delays in implementing it led to increasing frustration. This paper describes an advocacy campaign conducted by the Soul City Institute for Health and Development Communication in partnership with the National Network on Violence against Women, to ensure the effective implementation of the DVA. Lessons from the campaign stress the importance of coalition building to draw on diverse strengths, and the use of a combination of advocacy tools, including lobbying, media advocacy and social mobilisation to achieve campaign goals. Given the critical role NGOs dealing with victims/survivors of domestic violence and the justice system played in lobbying for change and drafting the new law, their exclusion from the implementation process was ironic. While many advocacy efforts focus on the development of policy and legislation, ongoing efforts are needed to ensure effective implementation, the commitment of adequate resources and monitoring to identify gaps and propose new solutions. Our experience highlights the important role of policy advocates in connecting the multiple streams at play in the policy and legislative arena.

Communication↗
PubMed1999

The current status and future needs of education and training in family medicine and primary care in South Africa.

South Africa is undergoing tremendous political and social change affecting every sphere of society, including medical education and the delivery of health services. The legacy of its history created a health system that in some respects can be compared to the best in the world, but one also characterized by inequity, discrimination and lack of access to even basic services for the rural and the poor. Its medical education system trails behind modern trends such as problem-based learning, community-based education and the utilizing of general/family practitioners as trainers. Vocational training in family practice is not compulsory for independent practice. The discipline of family practice has nevertheless developed the programmes and core infrastructure for such a future undertaking in the form of masters programmes in family medicine at all medical schools. The recently introduced system of compulsory recertification through continuous professional development provides a window of opportunity to develop locally relevant curricula and appropriate education and training methods for family practitioners. Challenges for family practice include the establishment of the role and value of the discipline in a developing country with a health system based on a nurse-driven primary care service and the re-orientation of family medicine teachers, trained in a biomedical paradigm, to the patient-centred approach. The aspirations of family practice are to define the core content of the discipline, establish and nurture a culture of research in primary care, and to develop and introduce appropriate under and postgraduate training programmes for the new generation of family doctors.

Education, Medical, Continuing↗
PubMed2001

The role of primary school teachers in HIV prevention in South Africa.

South Africa has the fastest growing HIV epidemic in the world. The need for an intensive campaign against its spread cannot be overemphasised. Such efforts may be particularly effective if introduced prior to the onset of risk behaviour. The purpose of this study was to investigate the knowledge of grade 3 and 4 schoolteachers on HIV/AIDS and their opinion on educating their pupils about HIV prevention. A self-administered questionnaire with knowledge, perception and sociodemographic variables was sent to all 120 grade 3 and 4 teachers in the Southern Bushveld district of Northern Province. Descriptive statistics and multiple regression analysis were used to analyse the data. The response rate was 67% (N = 81) and 87.7% were females. The mean age of the respondents was 37.7 (+/- 8.7 SD) years, 55% had a 3-year teacher's training qualification and 27% had a 4-year training qualification. The average teaching experience was 12 years. Most respondents (93.8%) had knowledge of what HIV/AIDS is, but only 85.2% indicated it could be prevented. 14.8% either did not know HIV/AIDS could be prevented or were not sure. Some teachers had an incomplete understanding of the transmission and prevention of HIV/AIDS. Furthermore only 9% mentioned education as a way to prevent HIV/AIDS and 16% abstinence. Of the respondents, 58% indicated teaching HIV prevention to their pupils. Of those who do not teach HIV prevention, 41.2% believed that the pupils were too young, and 20.6% claimed non-availability of guidelines and resources as reasons for not teaching. A significant negative correlation was found between level of qualification and teaching of HIV to pupils (p < 0.05). In conclusion, many primary school teachers were found to be wanting in their HIV/AIDS knowledge. This suggests that the schoolteachers would need to be adequately trained prior to their involvement in HIV/AIDS education to pupils. Grade 3 and 4 teachers may be considered suitable to provide HIV education to their pupils, but there is a need for structured educational programmes they can follow. This study also suggests that teachers were not aware of the Department of Education's HIV policy of providing age-appropriate education to all pupils.

Acquired Immunodeficiency Syndrome↗