scholarly journals Neuropsychological functioning and cognitive reserve in newly HIV diagnosed antiretroviral-naïve South African adults from peri-urban and informal settlements

PLoS ONE ◽  
2021 ◽  
Vol 16 (12) ◽  
pp. e0260260
Author(s):  
Kalpesh Narsi ◽  
Andrew Tomita ◽  
Suvira Ramlall
Keyword(s):  
South Africa ◽  
Cognitive Reserve ◽  
Neuropsychological Functioning ◽  
Informal Settlement ◽  
Informal Settlements ◽  
Sub Saharan Africa ◽  
Hiv Positive ◽  
Structural Level ◽  
Newly Diagnosed ◽  
Psychomotor Speed

Despite lower incidences of HIV-associated dementia due to antiretroviral therapy, neuropsychological impairment (NPI) remains a persistent challenge in sub-Saharan Africa. Improving cognitive reserve (CR) can mitigate NPI, but there are few investigations on neuropsychological (NP) performance, and its association with CR in newly diagnosed ART-naïve HIV-positive individuals to inform early treatment strategies. A comprehensive battery of tests were administered to assess various NP domains (International HIV Dementia Scale [for memory, motor speed, psychomotor speed], Digit Span Test [for attention], Action Fluency Test [for language] and Clock Drawing Test [for executive/visuospatial function]), and CR (using Cognitive Reserve Index Questionnaire) among 211 newly diagnosed ART-naïve HIV-positive participants from two clinics that serve peri-urban and informal settlement communities in KwaZulu-Natal, South Africa. Regression models were fitted to assess the association between NP performance and CR controlling for socioeconomic and clinical factors. Test results revealed high levels of impairment across NP domains: language (96.7%), memory and psychomotor speed (82.5%), concentration (17.5%), executive function (15.2%) and visuo-spatial function (3.3%). Low CR and educational attainment were the only factors consistently associated with poor NP performance based on regression. High levels of impairment were found in certain NP domains in a relatively young group of newly diagnosed ART-naïve HIV-positive individuals. Residents of peri-urban and informal settlements face multitude of complex challenges in South Africa. An early multilevel intervention targeting clinical- (e.g. CR) and structural-level challenges (e.g. access to education) is needed for mitigating HIV-associated NPI and promoting long-term healthy living.

scholarly journals Towards an automated monitoring of human settlements in South Africa using high resolution SPOT satellite imagery

2015 ◽  
Vol XL-7/W3 ◽  
pp. 1389-1394 ◽  
Author(s):  
T. Kemper ◽  
N. Mudau ◽  
P. Mangara ◽  
M. Pesaresi
Keyword(s):  
South Africa ◽  
Satellite Imagery ◽  
Urban Areas ◽  
Informal Settlement ◽  
Informal Settlements ◽  
Image Features ◽  
Sub Saharan Africa ◽  
Image Feature ◽  
Data Set ◽  
Spot 5

Urban areas in sub-Saharan Africa are growing at an unprecedented pace. Much of this growth is taking place in informal settlements. In South Africa more than 10% of the population live in urban informal settlements. South Africa has established a National Informal Settlement Development Programme (NUSP) to respond to these challenges. This programme is designed to support the National Department of Human Settlement (NDHS) in its implementation of the Upgrading Informal Settlements Programme (UISP) with the objective of eventually upgrading all informal settlements in the country. Currently, the NDHS does not have access to an updated national dataset captured at the same scale using source data that can be used to understand the status of informal settlements in the country. <br><br> This pilot study is developing a fully automated workflow for the wall-to-wall processing of SPOT-5 satellite imagery of South Africa. The workflow includes an automatic image information extraction based on multiscale textural and morphological image features extraction. The advanced image feature compression and optimization together with innovative learning and classification techniques allow a processing of the SPOT-5 images using the Landsat-based National Land Cover (NLC) of South Africa from the year 2000 as low-resolution thematic reference layers as. The workflow was tested on 42 SPOT scenes based on a stratified sampling. The derived building information was validated against a visually interpreted building point data set and produced an accuracy of 97 per cent. Given this positive result, is planned to process the most recent wall-to-wall coverage as well as the archived imagery available since 2007 in the near future.

Community-Centred Infrastructure Design Process for Resilience Building in South African Informal Settlements: The “Genius of Space” Solid Waste and Greywater Infrastructure Project

2018 ◽  
Vol 2 (1) ◽  
pp. 1-10
Author(s):  
Lauren Hermanus ◽  
Sean Andrew
Keyword(s):  
South Africa ◽  
Local Governments ◽  
Informal Settlements ◽  
Interdisciplinary Approach ◽  
Urban Environments ◽  
Sub Saharan Africa ◽  
Wastewater Management ◽  
Western Cape ◽  
Water And Sanitation ◽  
Public And Private Sector

Due to a lack of adequate water and sanitation infrastructure, growing, unplanned urban settlements in South Africa and elsewhere have been linked to pollution of critical river systems. The same dynamics undermine local resilience, understood as the capacity to adapt and develop in response to changes, persistent social and ecological risks, and disasters. Water and sanitation challenges undermine resilience by causing and compounding risks to individuals, and to household and community health and livelihoods, in a complex context in which communities and local governments have limited capacity and resources to respond appropriately. Household and community resilience in informal settlements is drawing increasing policy focus, given the persistence of these kinds of neighbourhoods in cities and towns in Sub-Saharan Africa and South Africa, in particular. This case considers whether bottom-up responses that combine public and private sector resources, including community participation, and use an interdisciplinary approach can support the production of novel resilience-fostering solutions. This article presents an analysis of the case of Genius of Space waste and wastewater management infrastructure in the Western Cape, South Africa. While the process has been imperfect and slow to show results, this analysis reflects on the gains, lessons and potential for replication that this work has produced. The Genius of Space approach adds to a growing area of practice-based experimentation focussed on incrementalism and adaptive development practices in urban environments, particularly in developing countries.

scholarly journals The seroprevalence of HIV in patients undergoing lower limb Total Joint Arthroplasty (TJA) in South Africa

SICOT-J ◽  
2020 ◽  
Vol 6 ◽  
pp. 3
Author(s):  
Zia Maharaj ◽  
Jurek Rafal Tomasz Pietrzak ◽  
Nkhodiseni Sikhauli ◽  
Dick van de Jagt ◽  
Lipalo Mokete
Keyword(s):  
South Africa ◽  
Total Joint Arthroplasty ◽  
Demographic Data ◽  
Joint Arthroplasty ◽  
Hiv Positive ◽  
Newly Diagnosed ◽  
Highly Active ◽  
Femoral Head Osteonecrosis ◽  
Significant Burden ◽  
Total Knee

Aim: The aim was to assess the seroprevalence of Human Immunodeficiency Virus (HIV) in non-haemophilic patients undergoing primary Total Joint Arthroplasty (TJA) at an academic hospital in South Africa. Methods: A retrospective review of all Total Hip Arthroplasty (THA) and Total Knee Arthroplasty (TKA) patients from January 2017 to December 2018 was conducted. All patients awaiting TJA were offered HIV screening and their demographic data were recorded. Consenting patients were tested or the refusal of testing was documented. The CD4+ T-cell count (CD4+) and viral load (VL) was measured for all HIV-positive patients and newly diagnosed patients were initiated on Highly Active Antiretroviral Treatment (HAART). Results: We included 1007 patients in the study. The TJA population HIV seroprevalence was 10.7% (n = 108). The seroprevalence for THA was 14.9% (n = 78) and that for TKA was 6.2% (n = 30). There were 93 patients (9.2%) who refused screening. There were 12 (15.4%) and 3 patients (10%) that were newly diagnosed in the THA and TKA seropositive populations, respectively. The average CD4+ for THA and TKA was 569 cells/mm3 (105–1320) and 691 cells/mm3 (98–1406), respectively. The VL was undetectable in 75.9% (n = 82) of HIV-positive patients. Overall 12 HIV-positive patients (11.12%) had CD4+ <200 cells/mm3, 8 of these patients (66%) were newly diagnosed. The average age of the seropositive population was 58 ± 6.5 years and 66 ± 8.5 years for THA and TKA, respectively (p = 0.03). Femoral head osteonecrosis was the underlying pathology for 65.38% (n = 51) of seropositive patients for THA. Conclusion: The seroprevalence of HIV in patients undergoing THA in our South African institution is greater than the seroprevalence in the general population. The seroprevalence of HIV in THA is significantly greater than that in TKA. This may reflect the association between HIV, HAART and hip joint degeneration. Our findings draw attention to the significant burden HIV has on TJA.

scholarly journals Access to improved sanitation facilities in low-income informal settlements of East African cities

2014 ◽  
Vol 5 (1) ◽  
pp. 89-99 ◽  
Author(s):  
K. Okurut ◽  
R. N. Kulabako ◽  
P. Abbott ◽  
J. M. Adogo ◽  
J. Chenoweth ◽  
...  
Keyword(s):  
Low Income ◽  
Urban Areas ◽  
Informal Settlement ◽  
Informal Settlements ◽  
Sub Saharan Africa ◽  
East African ◽  
Basic Sanitation ◽  
Improved Sanitation ◽  
Joint Monitoring ◽  
Sub Saharan

Throughout Africa, the population in urban areas is increasing rapidly, often exceeding the capacity and the resources of the cities and towns to accommodate the people. In sub-Saharan Africa, the majority of urban dwellers live in informal settlements served by inadequate sanitation facilities. These settlements present unique challenges to the provision of sustainable and hygienic sanitation, and there is insufficient information on access to improved facilities. This paper reports findings of a study undertaken in low-income informal settlements using a mixed methods approach to assess access to sanitation and identify the barriers to household uptake of improved sanitation facilities. More than half of the respondents (59.7%) reported using sanitation facilities that are included in the WHO/UNICEF Joint Monitoring Programme definition of improved sanitation. However, a high proportion of these facilities did not provide access to basic sanitation. Less than 5% of all the respondents did not report problems related to sustainable access to basic sanitation. The findings highlight the urgent need to develop specific and strategic interventions for each low-income informal settlement, to upscale the sustainable access and use of improved sanitation in urban centres.

scholarly journals Initiation of Isoniazid Prophylactic Therapy among Newly Diagnosed HIV-Positive Persons in Three High HIV-Burden Districts of South Africa

2020 ◽  
Vol 10 (02) ◽  
pp. 107-118
Author(s):  
H. N. Fomundam ◽  
A. R. Tesfay ◽  
S. A. Mushipe ◽  
H. T. Nyambi ◽  
A. Larsen ◽  
...  
Keyword(s):  
South Africa ◽  
Hiv Positive ◽  
Prophylactic Therapy ◽  
Newly Diagnosed

scholarly journals INVESTIGATING THE USE OF 3D GEOVISUALIZATIONS FOR URBAN DESIGN IN INFORMAL SETTLEMENT UPGRADING IN SOUTH AFRICA

2016 ◽  
Vol XLI-B2 ◽  
pp. 425-431
Author(s):  
V. Rautenbach ◽  
S. Coetzee ◽  
A. Çöltekin
Keyword(s):  
South Africa ◽  
Urban Design ◽  
Spatial Data ◽  
Informal Settlement ◽  
Informal Settlements ◽  
3D Models ◽  
Design Activities ◽  
Feasible Alternative ◽  
Visualization Design ◽  
The Impact

Informal settlements are a common occurrence in South Africa, and to improve in-situ circumstances of communities living in informal settlements, upgrades and urban design processes are necessary. Spatial data and maps are essential throughout these processes to understand the current environment, plan new developments, and communicate the planned developments. All stakeholders need to understand maps to actively participate in the process. However, previous research demonstrated that map literacy was relatively low for many planning professionals in South Africa, which might hinder effective planning. Because 3D visualizations resemble the real environment more than traditional maps, many researchers posited that they would be easier to interpret. Thus, our goal is to investigate the effectiveness of 3D geovisualizations for urban design in informal settlement upgrading in South Africa. We consider all involved processes: 3D modelling, visualization design, and cognitive processes during map reading. We found that procedural modelling is a feasible alternative to time-consuming manual modelling, and can produce high quality models. When investigating the visualization design, the visual characteristics of 3D models and relevance of a subset of visual variables for urban design activities of informal settlement upgrades were qualitatively assessed. The results of three qualitative user experiments contributed to understanding the impact of various levels of complexity in 3D city models and map literacy of future geoinformatics and planning professionals when using 2D maps and 3D models. The research results can assist planners in designing suitable 3D models that can be used throughout all phases of the process.

scholarly journals Diagnosing Diabetes Mellitus With Glycated Haemoglobin in Newly Diagnosed HIV-positive Patients in Buffalo City Municipality, South Africa: A Cross-sectional Study

2019 ◽  
Vol 12 (1) ◽  
pp. 263-268
Author(s):  
Olufunso O. Sogbanmu ◽  
Larry O. Obi ◽  
Daniel T. Goon ◽  
Anthony Okoh ◽  
Benson Iweriebor ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
South Africa ◽  
Logistic Regression ◽  
Glycated Haemoglobin ◽  
Cross Sectional Study ◽  
Hiv Positive ◽  
Newly Diagnosed ◽  
Sectional Study ◽  
Hiv Patients ◽  
Cross Sectional

Background: The HbA1c estimates long-term glycaemic control in individuals. However, scanty data exist on the determination of Diabetes Mellitus (DM) in newly diagnosed HIV patients using the HbA1c screening tool in the South African context. Thus, this study examines the prevalence of diabetes mellitus in newly diagnosed HIV-positive patients in Buffalo City Municipality, East London, South Africa. Methodology: This was a cross-sectional study of 335 newly HIV-diagnosed patients between August 2016 and July 2017. Demographic (age, gender, residence, employment status and level of education) and behavioural variables (smoking and alcohol use (past 30 days)) were by self-reporting. Information on HbA1c and other clinical variables were obtained from the medical records of the patients. Diabetes mellitus was defined based on the Society for Endocrinology, Metabolism and Diabetes of South Africa (SEMDSA) 2017 guideline of HbA1c of above 6.5%. Weight and height were measured using standard protocols. Logistic regression analyses were applied to determine the predictors of abnormal glycated haemoglobin. Results: Majority of the participants were female (72%). The prevalence of patients with HbA1c greater than 6.5% was 6%. The multivariate analysis indicates only age (p=0.031) and race (0.019) significantly shows a correlation to increase the risk of development of DM in newly diagnosed HIV positive patients. The binary logistic regression analysis shows that age (above 46 years) (p=0.001; AOR (6.60); CI (2.08-20.9) was directly related to the development of DM. Conclusion: Consistent with other studies, the exclusive non-fasting HbA1c, which is a marker of glycaemic control, only underestimate glycemia in HIV patients with diabetes in this present study. Notwithstanding, HIV patients who are over 40 years are likely to develop DM. As such, screening older individuals diagnosed with HIV is crucial in offering a timely point of care and interventions.

Informal Settlement Characteristics in a Rural Land Restitution Case: Elandskloof, South Africa

2000 ◽  
Vol 5 (2) ◽  
pp. 95-103
Author(s):  
Michael Barry ◽  
David Mayson
Keyword(s):  
South Africa ◽  
Land Tenure ◽  
Informal Settlement ◽  
Informal Settlements ◽  
Western Cape ◽  
Land Resources ◽  
Rural Land ◽  
Western Cape Province ◽  
Land Administration ◽  
Land Restitution

Research in informal settlements in South Africa has shown that conflict is inherent between groups within a settlement and between the broader community and the land administration authorities. In general, groups and sub-groups continually form, reform and dissolve within informal settlements. Moreover, the internal rules that a community creates relating to land tenure tend to be manipulated by sub-groups as they compete for land, resources and power. Internal rules are not static but are subject to continual change. Similar characteristics were observed in Elandskloof, a rural land restitution case in the Western Cape province of South Africa.

Playing by the rules? New institutionalism, path dependency and informal settlements in Sub-Saharan Africa

2017 ◽  
Vol 49 (11) ◽  
pp. 2558-2577 ◽  
Author(s):  
Nicky Morrison
Keyword(s):  
Informal Settlement ◽  
New Institutionalism ◽  
Informal Settlements ◽  
Path Dependency ◽  
Status Quo ◽  
Sub Saharan Africa ◽  
Government Officials ◽  
The Status ◽  
Sub Saharan ◽  
The Way

The scale of contemporary urbanization in Sub-Saharan Africa has culminated in the proliferation of informal settlements, with governments claiming a legitimate right to remove them. Drawing on new institutionalism as a conceptual framework and presenting the case of Old Fadama, an informal settlement within central Accra in Ghana, this paper sheds light on the way in which both formal and informal rules shape these legally unauthorized spaces. Using the analogy of a game, the author devises a novel typology to highlight the way in which different players maximize their personal advantage from maintaining the status quo. The paper concludes that as long as different interests are served by the existing socio-political arrangements then path dependency will endure, with government officials as the dominant playmaker in the locality ultimately controlling the rules and pace of the game.

scholarly journals HIV risk behaviour among public primary healthcare patients with tuberculosis in South Africa

2013 ◽  
Vol 14 (3) ◽  
pp. 125-130 ◽  
Author(s):  
Karl Peltzer
Keyword(s):  
South Africa ◽  
Condom Use ◽  
Sexual Intercourse ◽  
Hiv Risk ◽  
Primary Healthcare ◽  
Informal Settlement ◽  
Risk Behaviour ◽  
Hiv Positive ◽  
Cross Sectional Survey ◽  
Cross Sectional

Objective. To identify factors associated with HIV in tuberculosis (TB) patients in a public primary healthcare (PHC) setting in South Africa (SA).Method. Among 4 900 consecutively selected TB patients (54.5% men; women 45.5%) from 42 public PHC clinics in 3 districts in SA, a cross-sectional survey was performed to assess new TB and new TB retreatment patients within one month of anti-TB treatment.Results. The sample comprised 76.6% new TB patients and 23.4% TB retreatment patients. Of those who had tested for HIV, 59.9% were HIV-positive; 9.6% had never tested for HIV. In multivariate analysis, older age (odds ratio (OR) 5.86; confidence interval (CI) 4.07 - 8.44), female gender (OR 0.47; CI 0.37 - 0.59), residing in an informal settlement (OR 1.55; CI 1.13 - 2.12), being a TB retreatment patient (OR 0.55; CI 0.42 - 0.72), occasions of sexual intercourse with condom use (OR 1.07; CI 1.02 - 1.13) and having a sexual partner receiving antiretroviral treatment (ART) (OR 7.09, CI 4.35 - 11.57) were associated with an HIV-positive status in TB patients.Conclusion. This study revealed high HIV risk behaviour (e.g. unprotected last sexual intercourse and alcohol and drug use in the context of sexual intercourse) among TB patients in SA. Various factors were associated with HIV risk behaviour. Condom use and substance use risk reduction need to be considered as HIV-prevention measures when planning such strategies for TB patients.

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