Appraisal of wastewater final effluents and river water as reservoirs of cholera and non-cholera causing vibrio species : case study of the Amatole and OR Tambo District Municipalities
- Authors: Nontongana, Nolonwabo
- Date: 2018
- Subjects: Vibrio -- South Africa -- Eastern Cape Vibrio cholerae Disease Reservoirs
- Language: English
- Type: Thesis , Doctoral , Microbiology
- Identifier: http://hdl.handle.net/10353/9929 , vital:35146
- Description: Vibrio infections remain a serious threat to public health. In the last decade, Vibrio disease outbreaks have created a painful awareness of the personal, economic, societal, and public health costs associated with the impact of inadequately treated wastewater effluents. This study was therefore designed to assess the occurrence of cholera and non-cholera causing Vibrio species in the final effluents of wastewater treatment plants and river waters in the Amatole (BT WWTP) and OR Tambo District municipalities (MT WWTP and QN River) of the Eastern Cape Province. Samples were collected monthly from December 2016 to November 2017 from the final effluent, 500 meters upstream and downstream of the discharge points and analysed for physicochemical parameters, Vibrio pathogens prevalence and their antibiogram characteristics using both culture-based and molecular techniques. Samples were collected aseptically using sterile 1L glass bottles containing 0.5 ml of sterile sodium thiosulphate solution and transported on ice to the laboratory for analyses within 6hrs of collection. The membrane filtration method was used for enumeration of presumptive Vibrio densities on thiosulfate citrate bile salt (TCBS) agar plates. Polymerase chain reaction (PCR) was then used to confirm the identities of the presumptive Vibrio species using the species-specific primers. The confirmed isolates were further subjected to molecular characterization to confirm their respective pathotypes. Antimicrobial susceptibility testing was done by the standard disc diffusion method recommended by the Clinical and Laboratory Standards Institute. The recovered Vibrio species were tested against a panel of 17 antibiotics. Physicochemical parameters measured include pH, temperature, electrical conductivity, salinity, turbidity, total dissolved solid (TDS), dissolved oxygen (DO), biochemical oxygen demand (BOD) and chlorine (only for BT WWTP). Unacceptably high levels of the assayed parameters were observed in many cases for TDS (66 - 879 mg/l), turbidity (2.0 -722.33 NTU) and DO (2.5 – 9.7 mg/l) as well as chlorine (0.2 – 3.2 mg/L). Presumptive Vibrio densities varied from 2.91 to 3.91 log10 CFU/100 ml and 2.67 to 3.18 log CFU/100ml, for BT WWTP and MT WWTP respectively. The densities for the QN River ranged between 2.51 to 3.99 log10 CFU/100mL. Out of 720 presumptive isolates recovered, 619 (86 percent) were found to be positive for the Vibrio genus. Molecular confirmation of the presumptive Vibrio species revealed the presence of V. fluvialis (16), V. vulnificus (12), V aliginolyticus (9), V. parahaemolyticus (37) and V. cholerae (5) isolates were confirmed. The susceptibility against 17 different antibiotics by the recovered species were examined. V. cholerae was notably resistant against nalidixic acid (3) and Ampicilin (2), all the V. vulnificus isolates were resistant against ampicillin (16), V. fluvialis showed resistance against ciprofloxacin and nalidixic acid, all (9) isolates for V. alginolyticus were resistant against ampicillin. V. parahaemolyticus showed resistance against cefutoxime (16), cefuxime (8) and ampicillin (13). The recovery of Vibrio in the discharged effluents throughout the sampling period even in adequately disinfected effluents is not acceptable considering that Vibrio are pathogenic bacteria. The findings of this study underline the need for constant monitoring of the physicochemical and microbiological qualities of discharged effluents and might also be suggestive for a review of the disinfection methods used at the treatment works as this might pose adverse health risk to the communities which still rely heavily on these surface waters.
- Full Text:
- Authors: Nontongana, Nolonwabo
- Date: 2018
- Subjects: Vibrio -- South Africa -- Eastern Cape Vibrio cholerae Disease Reservoirs
- Language: English
- Type: Thesis , Doctoral , Microbiology
- Identifier: http://hdl.handle.net/10353/9929 , vital:35146
- Description: Vibrio infections remain a serious threat to public health. In the last decade, Vibrio disease outbreaks have created a painful awareness of the personal, economic, societal, and public health costs associated with the impact of inadequately treated wastewater effluents. This study was therefore designed to assess the occurrence of cholera and non-cholera causing Vibrio species in the final effluents of wastewater treatment plants and river waters in the Amatole (BT WWTP) and OR Tambo District municipalities (MT WWTP and QN River) of the Eastern Cape Province. Samples were collected monthly from December 2016 to November 2017 from the final effluent, 500 meters upstream and downstream of the discharge points and analysed for physicochemical parameters, Vibrio pathogens prevalence and their antibiogram characteristics using both culture-based and molecular techniques. Samples were collected aseptically using sterile 1L glass bottles containing 0.5 ml of sterile sodium thiosulphate solution and transported on ice to the laboratory for analyses within 6hrs of collection. The membrane filtration method was used for enumeration of presumptive Vibrio densities on thiosulfate citrate bile salt (TCBS) agar plates. Polymerase chain reaction (PCR) was then used to confirm the identities of the presumptive Vibrio species using the species-specific primers. The confirmed isolates were further subjected to molecular characterization to confirm their respective pathotypes. Antimicrobial susceptibility testing was done by the standard disc diffusion method recommended by the Clinical and Laboratory Standards Institute. The recovered Vibrio species were tested against a panel of 17 antibiotics. Physicochemical parameters measured include pH, temperature, electrical conductivity, salinity, turbidity, total dissolved solid (TDS), dissolved oxygen (DO), biochemical oxygen demand (BOD) and chlorine (only for BT WWTP). Unacceptably high levels of the assayed parameters were observed in many cases for TDS (66 - 879 mg/l), turbidity (2.0 -722.33 NTU) and DO (2.5 – 9.7 mg/l) as well as chlorine (0.2 – 3.2 mg/L). Presumptive Vibrio densities varied from 2.91 to 3.91 log10 CFU/100 ml and 2.67 to 3.18 log CFU/100ml, for BT WWTP and MT WWTP respectively. The densities for the QN River ranged between 2.51 to 3.99 log10 CFU/100mL. Out of 720 presumptive isolates recovered, 619 (86 percent) were found to be positive for the Vibrio genus. Molecular confirmation of the presumptive Vibrio species revealed the presence of V. fluvialis (16), V. vulnificus (12), V aliginolyticus (9), V. parahaemolyticus (37) and V. cholerae (5) isolates were confirmed. The susceptibility against 17 different antibiotics by the recovered species were examined. V. cholerae was notably resistant against nalidixic acid (3) and Ampicilin (2), all the V. vulnificus isolates were resistant against ampicillin (16), V. fluvialis showed resistance against ciprofloxacin and nalidixic acid, all (9) isolates for V. alginolyticus were resistant against ampicillin. V. parahaemolyticus showed resistance against cefutoxime (16), cefuxime (8) and ampicillin (13). The recovery of Vibrio in the discharged effluents throughout the sampling period even in adequately disinfected effluents is not acceptable considering that Vibrio are pathogenic bacteria. The findings of this study underline the need for constant monitoring of the physicochemical and microbiological qualities of discharged effluents and might also be suggestive for a review of the disinfection methods used at the treatment works as this might pose adverse health risk to the communities which still rely heavily on these surface waters.
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Factors affecting patient perceptions od service delivery in Postmasburg Hospital in the Z.F. McGawu District, Northern Cape Province, South Africa
- Rakumakoe, Jacob Mogapi Chocky
- Authors: Rakumakoe, Jacob Mogapi Chocky
- Date: 2018
- Subjects: Public health -- South Africa -- Northern Cape Medical care -- South Africa -- Northern Cape Health services accessibility
- Language: English
- Type: Thesis , Masters , MPH
- Identifier: http://hdl.handle.net/10353/17805 , vital:41262
- Description: Background: There is a requirement to provide proper and safe quality service to patients, hence a view from patients was deemed important as it can help the hospital to improve services rendered to them. There were two Provincial assessments done on National Core Standards in Postmasburg Hospital (overall scores were 32percent in 2013 and 48percent in 2014) and on both occasions, the Hospital failed to comply with the assessments and the implication were a suspected negative impact on the Hospital service delivery. The repercussions could be that the hospital might not be certified or not funded through National Health Insurance following a national assessment if the status quo remains. Aim: The aim of the study was to describe the factors affecting patients’ perceptions of service delivery in order to inform health policy decisions to improve service delivery. Methodology: A quantitative descriptive design was used to collect data on 133 adult patients admitted for a minimum of three days in the different hospital wards. Participants were administered a structured pre-tested questionnaire to collect data relating to their employment status, the number of hospital admissions and the reason for hospital admission. Results: About 41.4percent of participants were neutral or not sure whether the nurses/doctors came often to the ward where they were admitted. The majority (51.9percent) were neutral or not sure whether the quality of food in the hospital was good; 53.4percent expressed uncertainty concerning the adequacy of benches/chairs in the hospital for patients to sit while waiting to be seen by the health worker; and 55.6percent participants were neural or not sure whether the ward/room had enough space for consulting. Asked whether the hospital was user-friendly to disabled persons, 53.4percent participants were not sure. About 43.6percent participants expressed uncertainty regarding the registration satisfactory nature of the procedures in the hospital; the water cleanliness for patients in the hospital (42.1percent); whether their privacy was respected by all the staff within the hospital (51.9percent); permission to be examined and treated (51.1percent); the nurse/doctor who treated them being polite (53.4percent); and the nurse/doctor who treated them being able to answer all their questions about their illness (56.8percent). On whether they will visit the hospital again, 49.6percent participants were uncertain. The majority (69.7percent) agreed that all prescribed medicine was available in the hospital; the staff explained to them on how to use the medicine/pills (67percent); and they were told on how to store their pills/medication (47percent). Gender, education and employment status of the participants affect exactly one dimension each. Females, those with secondary education and employed were more satisfied on the respective dimensions. Conclusion: Patient involvement is an essential feature in healthcare services. Patients influence outcome quality through compliance, defining the right symptoms and physically experiencing treatment. Patient perceptions and satisfaction with service delivery is a multi-dimensional concept that should be studied by operationalising it within its context. Consequently, a conceptual model to understand and measure patient perception and satisfaction of service delivery and care quality in hospital health care services is proposed.
- Full Text:
- Authors: Rakumakoe, Jacob Mogapi Chocky
- Date: 2018
- Subjects: Public health -- South Africa -- Northern Cape Medical care -- South Africa -- Northern Cape Health services accessibility
- Language: English
- Type: Thesis , Masters , MPH
- Identifier: http://hdl.handle.net/10353/17805 , vital:41262
- Description: Background: There is a requirement to provide proper and safe quality service to patients, hence a view from patients was deemed important as it can help the hospital to improve services rendered to them. There were two Provincial assessments done on National Core Standards in Postmasburg Hospital (overall scores were 32percent in 2013 and 48percent in 2014) and on both occasions, the Hospital failed to comply with the assessments and the implication were a suspected negative impact on the Hospital service delivery. The repercussions could be that the hospital might not be certified or not funded through National Health Insurance following a national assessment if the status quo remains. Aim: The aim of the study was to describe the factors affecting patients’ perceptions of service delivery in order to inform health policy decisions to improve service delivery. Methodology: A quantitative descriptive design was used to collect data on 133 adult patients admitted for a minimum of three days in the different hospital wards. Participants were administered a structured pre-tested questionnaire to collect data relating to their employment status, the number of hospital admissions and the reason for hospital admission. Results: About 41.4percent of participants were neutral or not sure whether the nurses/doctors came often to the ward where they were admitted. The majority (51.9percent) were neutral or not sure whether the quality of food in the hospital was good; 53.4percent expressed uncertainty concerning the adequacy of benches/chairs in the hospital for patients to sit while waiting to be seen by the health worker; and 55.6percent participants were neural or not sure whether the ward/room had enough space for consulting. Asked whether the hospital was user-friendly to disabled persons, 53.4percent participants were not sure. About 43.6percent participants expressed uncertainty regarding the registration satisfactory nature of the procedures in the hospital; the water cleanliness for patients in the hospital (42.1percent); whether their privacy was respected by all the staff within the hospital (51.9percent); permission to be examined and treated (51.1percent); the nurse/doctor who treated them being polite (53.4percent); and the nurse/doctor who treated them being able to answer all their questions about their illness (56.8percent). On whether they will visit the hospital again, 49.6percent participants were uncertain. The majority (69.7percent) agreed that all prescribed medicine was available in the hospital; the staff explained to them on how to use the medicine/pills (67percent); and they were told on how to store their pills/medication (47percent). Gender, education and employment status of the participants affect exactly one dimension each. Females, those with secondary education and employed were more satisfied on the respective dimensions. Conclusion: Patient involvement is an essential feature in healthcare services. Patients influence outcome quality through compliance, defining the right symptoms and physically experiencing treatment. Patient perceptions and satisfaction with service delivery is a multi-dimensional concept that should be studied by operationalising it within its context. Consequently, a conceptual model to understand and measure patient perception and satisfaction of service delivery and care quality in hospital health care services is proposed.
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Secrets that kill : reflections on violation of cultural rights enshrined in the constitution and human rights through traditional circumcision
- Authors: Mlisa, Lily Rose Nomfundo
- Date: 2018
- Subjects: Human rights--South Africa Circumcision Circumcision--Law and legislation
- Language: English
- Type: Thesis , Masters , Public Health
- Identifier: http://hdl.handle.net/10353/11150 , vital:37176
- Description: The study was based on four research objectives: (1) to identify philosophy, psychology, cultural reasons behind the harsh and traumatic experiences of young Xhosa boys and their mothers during ukwaluka (male circumcision) as a mark for transition to manhood; (2) to review perceptions concerning the role of mothers during the male circumcision (MC) process (3) identify cultural and psycho-social construction and meaning of MC and (4) to explore recommended possible strategies on managing MC-related traumas and deaths in the Sub-Saharan region and Eastern Cape Province in particular. Desktop literature review methodology was followed. An in depth literature review was conducted on diverse website search engines using a set of inclusion criteria. Published articles from 1995 to 2015 were selected. Thematic content analysis was used to categorise and interpret emerging themes from the reviewed articles as aligned to set research objectives. Results revealed diverse philosophical and cultural perceptions around MC, its construction and meaning among different cultures whether circumcising or non-circumcising cultures. In addition, various reasons are laid out for the harsh treatment given to initiates in different settings. Results also indicated that the MC is no longer a secret due to social media profuse publications about it. The impact of education and health care benefits around medical male circumcision (MMC) has influenced women from both non-circumcising and circumcising cultures to accept it. It is recommended that MC should continue under strict observation of prescribed protocols to lessen or prevent malpractices in the process. MMC is also highly recommended. In addition, the government and traditional leaders have to continue to conduct capacity building of traditional surgeons, prospective initiates and initiates including nurses and family members about crucial protocols and health matters around MC. Finally, results recommend best practices that could be learnt from other circumcising cultures to restore the respect of MC in the Eastern Cape, as well as inclusion of women in the MC process management.
- Full Text:
- Authors: Mlisa, Lily Rose Nomfundo
- Date: 2018
- Subjects: Human rights--South Africa Circumcision Circumcision--Law and legislation
- Language: English
- Type: Thesis , Masters , Public Health
- Identifier: http://hdl.handle.net/10353/11150 , vital:37176
- Description: The study was based on four research objectives: (1) to identify philosophy, psychology, cultural reasons behind the harsh and traumatic experiences of young Xhosa boys and their mothers during ukwaluka (male circumcision) as a mark for transition to manhood; (2) to review perceptions concerning the role of mothers during the male circumcision (MC) process (3) identify cultural and psycho-social construction and meaning of MC and (4) to explore recommended possible strategies on managing MC-related traumas and deaths in the Sub-Saharan region and Eastern Cape Province in particular. Desktop literature review methodology was followed. An in depth literature review was conducted on diverse website search engines using a set of inclusion criteria. Published articles from 1995 to 2015 were selected. Thematic content analysis was used to categorise and interpret emerging themes from the reviewed articles as aligned to set research objectives. Results revealed diverse philosophical and cultural perceptions around MC, its construction and meaning among different cultures whether circumcising or non-circumcising cultures. In addition, various reasons are laid out for the harsh treatment given to initiates in different settings. Results also indicated that the MC is no longer a secret due to social media profuse publications about it. The impact of education and health care benefits around medical male circumcision (MMC) has influenced women from both non-circumcising and circumcising cultures to accept it. It is recommended that MC should continue under strict observation of prescribed protocols to lessen or prevent malpractices in the process. MMC is also highly recommended. In addition, the government and traditional leaders have to continue to conduct capacity building of traditional surgeons, prospective initiates and initiates including nurses and family members about crucial protocols and health matters around MC. Finally, results recommend best practices that could be learnt from other circumcising cultures to restore the respect of MC in the Eastern Cape, as well as inclusion of women in the MC process management.
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The right of access to information as a means to empower citizens to participate in democratic processes : a case study of Zwelitsha, King Williams Town
- Authors: Ngcuka, Simtembile
- Date: 2018
- Subjects: Freedom of information Freedom of information -- South Africa
- Language: English
- Type: Thesis , Masters , (MPhil)Human Rights
- Identifier: http://hdl.handle.net/10353/10839 , vital:35858
- Description: The Republic of South Africa is embedded from a society that has been beleaguered. Apartheid laws were used to treat people unequally, based on race, gander, ethnic group, background, colour, belief, culture and language. These laws prohibited association of people from different races and groups. The education system was also used to instil inferiority to disadvantaged people. This system promoted a culture of secrecy and unresponsive government. The new Constitution of the Republic of South Africa was adopted in 1996. This Constitution promotes democracy and equality amongst citizens of this country. It was also adopted to bridge injustices of the past. Democracy is about allowing every citizen to participate in the processes which are meant for the development of the country. The new Constitution provided that every citizen is equal; this means every citizen must enjoy equal human Rights. This includes the Right to participate in democratic processes which are taking place. Studies show that the Right of Access to Information empowers people to participate in democratic processes. This study examines the exercise in section 32 of the Republic of South Africa Constitution (1996), by Zwelitsha community as means to empower people in participating in democratic processes taking place in their community. This Right is reinforced by Promotion of Access to Information Act No. 2 of 2000 (PAIA). The research reveals that the community of Zwelitsha is not exercising this Right which often leads to violation of other Rights. The exercise of the Right of Access to Information increases awareness and knowledge of other existing Rights, and how they can be realised and defended. The recommendations in the study underscore the need to promote the Right of Access to Information as a means to empower citizens to participate in the democratic processes in their community. This study will take the community a step closer to reaching equality. It will also educate the community of the need and importance of exercising the Right of Access to Information. It will assist the community to be able to protect other Rights. An informed community is an empowered community that can also hold the state to account.
- Full Text:
- Authors: Ngcuka, Simtembile
- Date: 2018
- Subjects: Freedom of information Freedom of information -- South Africa
- Language: English
- Type: Thesis , Masters , (MPhil)Human Rights
- Identifier: http://hdl.handle.net/10353/10839 , vital:35858
- Description: The Republic of South Africa is embedded from a society that has been beleaguered. Apartheid laws were used to treat people unequally, based on race, gander, ethnic group, background, colour, belief, culture and language. These laws prohibited association of people from different races and groups. The education system was also used to instil inferiority to disadvantaged people. This system promoted a culture of secrecy and unresponsive government. The new Constitution of the Republic of South Africa was adopted in 1996. This Constitution promotes democracy and equality amongst citizens of this country. It was also adopted to bridge injustices of the past. Democracy is about allowing every citizen to participate in the processes which are meant for the development of the country. The new Constitution provided that every citizen is equal; this means every citizen must enjoy equal human Rights. This includes the Right to participate in democratic processes which are taking place. Studies show that the Right of Access to Information empowers people to participate in democratic processes. This study examines the exercise in section 32 of the Republic of South Africa Constitution (1996), by Zwelitsha community as means to empower people in participating in democratic processes taking place in their community. This Right is reinforced by Promotion of Access to Information Act No. 2 of 2000 (PAIA). The research reveals that the community of Zwelitsha is not exercising this Right which often leads to violation of other Rights. The exercise of the Right of Access to Information increases awareness and knowledge of other existing Rights, and how they can be realised and defended. The recommendations in the study underscore the need to promote the Right of Access to Information as a means to empower citizens to participate in the democratic processes in their community. This study will take the community a step closer to reaching equality. It will also educate the community of the need and importance of exercising the Right of Access to Information. It will assist the community to be able to protect other Rights. An informed community is an empowered community that can also hold the state to account.
- Full Text:
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