Research Articles (University of Pretoria)

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Contributions of a community health worker program in improving district health system performance in South Africa, using routine health service variables in a quasi-experimental study design
(BioMed Central, 2025-08) Thomas, Leena Susan; Jordaan, Joyce; Pillay, Yogan; Buch, Eric; leena.thomas@up.ac.za
BACKGROUND : Globally low- and middle-income countries are investing in community health worker (CHW) programs. These programs are viewed as fundamental to ensuring universal health coverage for all. Where CHW programs are doing what they should be doing and doing it adequately, they should make a difference in population health outcomes, reflecting health system changes. However, there are not many studies exploring the contributions and effectiveness of large-scale, comprehensive community health worker programs on health system performance. METHODS : This study takes place in the Ekurhuleni health district, in urban South Africa. A before (pre) and after (post) intervention study (quasi-experimental) using routine health service variables (secondary data) from district clinics over nine years was conducted. Performance of intervention clinics with community health worker teams that had more than 60% population coverage were compared to similar control clinics that had no teams or teams with less than 30% coverage. RESULTS : Both groups of clinics generally improved over time for routine health service variables for maternal, child health, infectious diseases, and cervical cancer programmes. Over nine years, intervention clinics showed more improved performance, statistically significant, in six health variables while controls improved in four. But importantly, intervention clinics improved proportionately better pre to post in seven of the nine (78%) variables studied compared to controls, demonstrating reduced diarrhoeal disease and pneumonia in children, better Vitamin A coverage, fewer severely malnourished children, better testing for HIV, and better screening for Tuberculosis and cervical cancer. Illustrating the comprehensive range of services provided by CHWs, the seven routine health service variables represented maternal, child health, infectious and non-communicable diseases. We also observed less uncontrolled hypertensive and diabetics in intervention clinics compared to control clinics. CONCLUSION : Large-scale, sustained and comprehensive community health worker programs adequately covering populations contributed to improved urban district health system performance in Ekurhuleni, demonstrating their effectiveness. This was explored through improvements in health system performance over time. These findings, using routine health service variables, have policy implications for financial and other resource allocations in health districts in low- and middle-income countries.
The effect of semiorganic iodine-containing compounds on the antibiotic susceptibility of pathogenic microorganisms
(MDPI, 2025-08) Kenesheva, Sabina T.; Turganbay, Seitzhan; Jumagaziyeva, Ardak B.; Askhatkyzy, Gaukhar; Askarova, Dana A.; Azembayev, Amir A.; Ilin, Alexandr I.; Reva, Oleg N.; Karpenyuk, Tatyana A.; oleg.reva@up.ac.za
OBJECTIVES : The global rise in multidrug resistance underscores the urgent need for the development of novel and effective antimicrobial agents. Semi-organic iodine-containing complexes, owing to their unique properties, low likelihood of resistance development, and stability under various conditions, represent a promising avenue for the design of new therapeutic strategies. This study describes the synthesis of semi-organic iodine-containing complexes and the in vitro evaluation of their impact on antibiotic susceptibility modulation in the multidrug-resistant pathogenic microorganisms S. aureus and E. coli. METHODS: The physicochemical properties of the semiorganic compounds were characterized using UV-Vis spectroscopy, potentiometric, and titrimetric methods. Evaluation of antimicrobial activity was obtained according to CLSI protocols. The impact of semiorganic compounds on the in vitro susceptibility of MDR strains was evaluated by the disk diffusion method. RESULTS : This study evaluated the effects of iodine-containing complexes KC-270 and KC-271 on the antibiotic susceptibility of Staphylococcus aureus BAA-39 and Escherichia coli BAA-196. The most pronounced effect was observed with KC-270 applied during the lag phase, which enhanced the activity of several antibiotics and, in some cases, restored susceptibility. KC-271 exhibited a weaker and more limited impact. The findings suggest that KC-270 has potential as a modulator of antibiotic susceptibility, particularly when administered at early stages of bacterial growth. CONCLUSIONS : The results support the ability of amino acid-based iodine coordination compounds to influence the antibiotic susceptibility of pathogenic bacteria, highlighting their potential as adjuvant agents to improve the effectiveness of current antimicrobial therapies. However, although changes in susceptibility were detected, neither compound fully eliminated resistance in the multidrug-resistant strains, indicating the necessity for further research into their mechanisms of action and possible synergistic interactions with antibiotics.
In vitro photoprotective and skin aging-related enzyme in-hibitory activities of Cylindrospermum alatosporum (NR125682) and Loriellopsis cavernicola (NR117881) extracts
(MDPI, 2025-09) Sithole, Siphesihle Z.; Ikhane, Albert O.; Osunsanmi, Foluso Oluwagbemiga; Mosa, Rebamang Anthony; Opoku, Andrew Rowland; rebamang.mosa@up.ac.za
The use of cyanobacteria has gained considerable interest in many industries, including the cosmetic industry, due to its rich array of bioactive metabolites. This study evaluates the in vitro photoprotective properties and the effect of Cylindrospermum alatosporum (NR125682) and Loriellopsis cavernicola (NR117881) extracts on slowing down the enzymes associated with skin aging. Various crude extracts were prepared using hexane, dichloromethane, and ethanol solvents. The resulting crude extract solvents were completely distilled to obtain their bioactive compounds, based on selected polarities. The sulfhydryl content of the crude extracts was determined and the aging-associated enzymes’ activity (collagenase, elastase, hyaluronidase, and tyrosinase) in the crude extracts was investigated. Furthermore, the in vitro photoprotective activity of the extracts was assessed by measuring UVA and UVB photoprotection. Most of the extracts contained varying amounts of sulfhydryl compounds (10.88–78.15 mg/g). All of the extracts demonstrated in vitro inhibitory activity against tyrosinase, hyaluronidase (IC50 6 µg/mL), and collagenase (IC50 50–70 µg/mL); weak elastase inhibitory activities were also observed. The crude extracts also showed appreciable UVA and UVB photoprotective activity. Meanwhile, L. cavernicola extracts demonstrated the highest UVB photoprotective activity (SPF 14.67–78.96). It is noteworthy that the crude extracts possessed anti-skin-aging potency with notable photoprotective capability.
Oligochitosan conjugates of the antimalarials dihydroartemisinin and lumefantrine : synthesis, stability, cell viability, and antiplasmodial studies
(Wiley, 2025-10) Matshe, William; Mvango, Sindisiwe; Malabi, Rudzani; Tantoh, Asongwe; Andraos, Charlene; Famuyide, Ibukun Michael; McGaw, Lyndy Joy; Baijnath, Sooraj; Pilcher, Lynne A.; Balogun, Mohammed; mohammedbalogun@tuks.co.za
Malaria is treatable with several combinations of drugs, the most well-known and currently most effective being artemisinin-based therapies. Gastrointestinal absorption of these drugs can be poor and erratic if not taken with a fatty meal. Nausea and the loss of appetite, common symptoms of even mild malaria, can therefore jeopardize the effectiveness of the treatment. To enhance the bioavailability of artemisinin-based combination therapies, several lipid-based formulations and delivery systems have been investigated. In this study, we synthesized oligochitosan conjugates of the antimalarial drugs dihydroartemisinin and lumefantrine and examined their physical stability and biological activities. The hydrodynamic properties of both conjugates varied unpredictably under pH conditions like those found at different stages along the gastrointestinal tract and in plasma. The viability of Caco-2 cells exposed to the conjugates was also investigated in comparison to the free drugs. Both conjugates demonstrated significantly lower cytotoxicity compared to the free drugs at concentrations up to 0.5 mg/mL, particularly during the first 24 h of exposure. Despite this, they retained their antiplasmodial effect against Plasmodium falciparum in an in vitro assay at 1 µg/mL and 5 µg/mL. These new chitosan biomaterials hold great potential for further development into oral therapeutics that would not require fatty meal intake due to the intrinsic mucoadhesiveness of chitosan.
PrEP awareness and willingness to use oral PrEP among males ≥ 18 years attending VMMC services in Gauteng, South Africa
(Springer, 2025) Shangase, Nosipho; Tobaiwa, Ocean; Cutler, Ewalde; Singh, Beverley; Brukwe, Zinhle; Pillay, Erushka; Dorrell, Philip; Moyo, Khumbulani; Zondi, Lindokuhle; Pillay, Yogan; Patrick, Sean Mark; Puren, Adrian; Kufa, Tendesayi
Integration of voluntary medical male circumcision (VMMC) with pre-exposure prophylaxis (PrEP) services may increase access to and/or uptake of combination HIV prevention strategies. We examined awareness of and willingness to use oral PrEP among adult males attending VMMC services in Gauteng province, South Africa. A cross-sectional study was conducted among HIV-negative males aged ≥ 18 years seeking healthcare at one of six high-volume public VMMC clinics from June-October 2021. Participants provided written informed consent, completed an interviewer-administered questionnaire (covering demographics, clinical history, sexual behavioural and risk perception, PrEP eligibility, PrEP awareness and PrEP willingness), and underwent a rapid dual HIV/syphilis test. Logistic regression models (adjusted for education, age and sexual debut) were used to determine factors associated with PrEP awareness and PrEP willingness. Among the participants, 40% were at substantial risk of HIV and thus eligible for PrEP, 45% were aware of PrEP and 80% were likely/highly likely to use oral PrEP. Awareness of PrEP was lower among males who reported being at substantial risk of HIV than males not at substantial risk (aOR = 0.59, 95% CI: 0.41–0.86). PrEP willingness was higher in males who reported: (1) not being married, separated or widowed compared to married males (aOR = 2.28, 95% CI: 1.14–4.54); (2) being aware of PrEP (aOR = 1.91, 95% CI: 1.19–3.08) than those who were not aware of PrEP; and (3) having high/very high self-perceived HIV risk compared to those with lower self-perceived HIV risk (aOR = 1.94, 95% CI: 1.01–3.73). Considering the significant proportion of males attending VMMC who are at risk of HIV, integrating PrEP and VMMC services can significantly impact HIV prevention efforts by increasing awareness and uptake. Programs should prioritize PrEP awareness campaigns and highlight the combined benefits of VMMC and PrEP.
Injury and illness epidemiology in elite athletes during the Olympic, Youth Olympic and Paralympic Games : a systematic review and meta-analysis
(BMJ Publishing Group, 2025-09) Torvaldsson, Kalle; Fagher, Kristina; Derman, Wayne; Engebretsen, Lars; Lindblom, Hanna; Lopes, Alexandre Dias; Runciman, Phoebe; Schwellnus, Martin Peter; Soligard, Torbjorn; Sonesson, Sofi; Steffen, Kathrin; Hagglund, Martin
OBJECTIVE : To systematically review and synthesise the incidence and characteristics of injuries and illnesses among athletes participating in the Olympic, Youth Olympic and Paralympic Games. DESIGN : Systematic review and meta-analysis. DATA SOURCES : PubMed, Embase, CINAHL, Scopus and Web of Science were searched up to 2 July 2024, and Google Scholar, ClinicalTrials.gov and WHO International Clinical Trials Registry Platform up to 12 December 2023. ELIGIBILITY CRITERIA FOR SELECTING STUDIES : Cohort studies conducted during the Games reporting injuries and illnesses among athletes. Risk of bias was assessed using the Joanna Briggs Institute critical appraisal tool for prevalence studies, and certainty of evidence using the Grading of Recommendations, Assessment, Development and Evaluation framework. RESULTS : 27 articles were included (10 Olympic, 4 Youth Olympic and 13 Paralympic Games). 23 articles had low, 3 moderate and 1 high risk of bias. Certainty of evidence was high to moderate for Olympic, high to low for Youth Olympic and low for Paralympic Games. Injury incidences per 1000 athlete-days were 6.5 (95% CI 5.9 to 7.2) during Olympic, 10.5 (95% CI 9.4 to 11.8) during Youth Olympic and 14.3 (95% CI 9.9 to 20.7) during Paralympic Games. Illness incidences per 1000 athlete-days were 3.6 (95% CI 2.8 to 4.7), 6.9 (95% CI 6.1 to 7.8) and 9.7 (95% CI 6.5 to 14.4), respectively. Lower limb injuries were frequent during Olympic and Youth Olympic Games, upper limb injuries during Paralympic Games and respiratory illnesses across all Games cohorts. CONCLUSIONS : Injury and illness incidences were highest in Paralympic Games, followed by Youth Olympic and Olympic Games. Incidences and patterns of injury and illness were sport and context specific, which could inform future prevention strategies.
Shape and variability of the normal medial coronoid process by computed tomography in young adult labrador retrievers
(Wiley, 2025-11) Van der Laan, Luzanne; Kirberger, Robert M.; Fosgate, Geoffrey Theodore; Le Roux, Christelle
Medial coronoid process disease (MCPD) is the most frequently observed cause of elbow dysplasia, resulting in lameness in young, fast‐growing large‐breed dogs, including Labrador Retrievers (LRs). Computed tomography (CT) is the diagnostic imaging modality of choice for evaluating the medial coronoid process (MCP), as it is noninvasive and eliminates superimposition of the process by the radial head. This retrospective descriptive study aimed to describe the shape of the normal MCP on CT, to assess its variability within the LR breed, and to determine the normal Hounsfield units (HUs) of the MCP, medial radial head (MRH), and lateral radial head (LRH). Normal elbow CT studies of 51 South African guide dog LRs were reviewed. Using a repeatable imaging alignment technique, three principal MCP shapes were identified: ovoid, triangular, and softly pointed and were found to be dependent on the level of assessment. Males had significantly lower mean MCP HU compared to females. The mean HU of the MRH was consistently higher than the LRH and was also greater in attenuation on subjective assessment. Measuring MCP and radial head HU too proximally was suboptimal, as volume averaging was frequently encountered. The results of this study showed that although different alignment techniques may result in HU variations, they will not affect the HU to such an extent that the MCP would be misclassified as abnormal.
Echocardiographic examination of 16 eastern grey kangaroos (Macropus giganteus) and one red kangaroo (Osphranter rufus)
(Wiley, 2025-09) Carstens, Ann; Dutton, Geoffrey J.; Stannard, Hayley J.; Birckhead, Alice; Barkman, William D.; Connolly, Joanne H.
Habitat loss, road trauma, predation, disease, and natural disasters impact the health and survival of the family Macropodidae, including kangaroos. Cardiac disease has been reported, including hypertrophic cardiomyopathy (HCM), dilated cardiomyopathy (DCM), nutritional myodegeneration, valvular pathology, cardiovascular parasites, toxoplasmosis, and toxicities. Human research has evaluated macropod pericardium and aortic valves as possible bioprostheses. The goals of this prospective anatomic study were to echocardiographically evaluate opportunistically presented kangaroos: 14 clinically normal eastern grey kangaroos (EGK-Macropus giganteus), two sick EGKs, and one sick red kangaroo (RK, Osphranter rufus). Similar techniques as described in the dog were used. Standard B-mode images, M-mode mensuration, and Doppler measurements were attained; values were descriptively compared with published normal values. The clinically normal animals' M-mode values were similar to the closest weight-related kangaroo values. Most of the animals showed thicker-than-expected left ventricular and interventricular septal walls, and relative wall thickness (RWT) of 0.5 and 0.6; this may be the norm for macropods, but since an RWT>0.45 may indicate human HCM, this should be considered in the kangaroo. The sick animals were euthanized. Necropsy revealed highly suspect HCM in one EGK, and myxomatous mitral valve degeneration with suspect DCM in the other EGK and RK. In conclusion, there are weight-related similarities between previously published kangaroo values. More work is required on a larger number of weight and age cohorts of kangaroos. Subclinical HCM may be present in apparently normal animals. Findings can be used during clinical health assessments and for further research into macropod cardiac conditions.
A grammar of trinitarian experience? On Sarah Coakley’s théologie totale
(AOSIS, 2024-12-12) Delport, Khegan M.
The Anglican theologian Sarah Coakley has attempted to think trinitarian doctrine in explicitly experiential terms. Her erotically-charged, pneumatically-centred account of salvific incorporation attempts to articulate, on the one hand, an account of the purgation of desire and the senses through ascetic practice, contemplative prayer and liturgical habituation, while also maintaining, on the other hand, the priority of spiritual appetition as being itself the route through which believers are, gradually, drawn into the trinitarian life. INTRADISCIPLINARY AND/OR INTERDISCIPLINARY IMPLICATIONS :: The study makes a contribution by critically articulating an aspect of Coakley’s ‘théologie totale’, a new proposal for the method of systematic and dogmatic theology, one that is centrally focused on bringing in a wider interdisciplinary focus to the practice of systematic theology.
Soft computing for the posterior of a matrix t graphical network
(Elsevier, 2025-05) Pillay, Jason; Bekker, Andriette, 1958-; Ferreira, Johannes Theodorus; Arashi, Mohammad; andriette.bekker@up.ac.za
Modeling noisy data in a network context remains an unavoidable obstacle; fortunately, random matrix theory may comprehensively describe network environments. Noisy data necessitates the probabilistic characterization of these networks using matrix variate models. Denoising network data using a Bayesian approach is not common in surveyed literature. Therefore, this paper adopts the Bayesian viewpoint and introduces a new version of the matrix variate t graphical network. This model's prior beliefs rely on the matrix variate gamma distribution to handle the noise process flexibly; from a statistical learning viewpoint, such a theoretical consideration benefits the comprehension of structures and processes that cause network-based noise in data as part of machine learning and offers real-world interpretation. A proposed Gibbs algorithm is provided for computing and approximating the resulting posterior probability distribution of interest to assess the considered model's network centrality measures. Experiments with synthetic and real-world stock price data are performed to validate the proposed algorithm's capabilities and show that this model has wider flexibility than the model proposed by [13]. HIGHLIGHTS • Expanding the framework for denoising financial data inside the realm of graphical network theory, where the assumption of normality in the model is inadequate to account for the variation. • Introduction of the matrix variate gamma and inverse matrix variate gamma as priors for the covariance matrices; the univariate scale parameter β may be fixed or subject to a prior. • Following Bayesian inference with more flexible priors, there is an improvement based on relevant accuracy measures. • Experimental results indicate that our proposed framework and results outperform those of [13].
Numerical investigation of heat transfer performance of hybrid nanofluid in porous substrate in microchannel heat sink
(Springer, 2025-07) Oladetan, Jeremiah O.; Fujah, Faridat M.; Omosehin, Oluwasegun S.; Atofarati, Emmanuel O.; Nwabuko, Uzo; Olakoyejo, Olabode T.; Adelaja, Adekunle O.; omosehin.os@up.ac.za
With the increasing integration of integrated circuits (ICs) in electronic devices such as electric vehicles, computer data centers, heat pipe technology, solar energy, and heating ventilation, air conditioning, and refrigeration (HVACR) systems, optimizing heat transfer becomes essential to ensure optimal performance and longevity. This study numerically investigates the thermal and hydraulic performance of a microchannel heat sink (MCHS) enhanced by hybrid nanofluids and porous substrate integration. A two-phase Eulerian–Eulerian model implemented in ANSYS Fluent is employed to simulate Al₂O₃/Cu–water hybrid nanofluid flow at volume concentrations ranging from 0.1 to 3.0%, and flow Reynolds number (200 < Re < 1000) with a porous substrate embedded midway along the flow path. The results reveal that both the nanoparticle concentration and Reynolds number significantly enhance heat transfer, reflected in higher average Nusselt numbers and reduced thermal resistance. The incorporation of a porous substrate further amplifies heat transfer, achieving a maximum enhancement of 80.29% compared to the baseline configuration. Overall, employing hybrid nanofluids and porous substrates improves MCHS performance, offering augmented heat transfer efficiency and thermal performance.
A bi-cylindrical lens for a DRGH antenna
(Wiley, 2025-09) Roodt, Pieter; Odendaal, Johann Wilhelm; Joubert, Johan; Jacobs, Bennie; wimpie@up.ac.za
Broadband double-ridged guide horn (DRGH) antennas are extensively used in antenna measurement and electromagnetic compatibility and interference testing, especially the 1–18 GHz DRGH antenna, which is widely accepted as a standard for this band. Increasing the gain of the DRGH will result in higher field strengths for EMI testing and increased sensitivity in antenna testing facilities. In this paper, a complete wideband near-field E- and H-plane phase center analysis is performed with CST, at observation points over a region inside the flared section and also outside the aperture of the DRGH. A new plano-convex intersecting bi-cylindrical lens was designed using the two discrete phase centers corresponding to the statistical mode of samples from the population of phase centers obtained from the simulated phase distributions. This new lens is a practical implementation with both convex surfaces on the inside and a planar surface on the outside of the DRGH. This makes manufacturing and mounting the lens much easier without significantly increasing the size of the DRGH antenna. The bi-cylindrical lens significantly increases the boresight gain of the DRGH antenna, while simultaneously reducing the variation in 3 dB beamwidth over most of the operating band.
Women’s experiences of alcohol-related severe intimate partner violence : findings from formative research in South Africa
(Kettil Bruun Society for Social and Epidemiological Research on Alcohol , Canada, 2025-03) Ramsoomar, Leane; Willan, Samantha; Paile, Charntel; Mtimkulu, Maureen; Ketelo, Asiphe; Zembe, Amanda; Pass, Desiree; Nothling, Jani; Machisa, Mercilene; Abrahams, Naeemah; Shai, Nwabisa; Jewkes, Rachel
INTRODUCTION : Gender-based violence (GBV) is a threat to the health and well-being of women globally, and a key barrier to the achievement of the Sustainable Development Goals 3.3 and 5.2. Harmful alcohol use is a recognised risk factor for the perpetration and experience of GBV, particularly, intimate partner violence, and for the severity of intimate partner violence. This paper seeks to explore the role of alcohol in women’s experience of severe intimate partner violence (SIPV) in South Africa. METHODS : We conducted a qualitative study, using six focus group discussions and 20 in-depth interviews with 62 demographically diverse adult women from three provinces in South Africa (Gauteng, KwaZulu-Natal, and the Western Cape) who sought help for SIPV. FINDINGS : Women reported alcohol-related SIPV, frequently describing that her partner intentionally started arguments after he had been drinking. Their abuse included controlling and coercive behavior that restricted their movement and ability to participate in daily activities, economic abuse, and instances of severe physical and sexual intimate partner violence and attempted femicide. They viewed men's alcohol use as a ‘right’ associated with masculinity, that often intersected with expressions of masculinity, including controlling behavior, dominance, and aggression, and performing a provider role, especially among friends in taverns and bars. CONCLUSIONS : Planning for effective prevention, providing services and policy efforts requires an understanding of the complexity of the interaction between men's alcohol abuse and their perpetration of SIPV particularly in a context like South Africa, where both harmful alcohol use and GBV are prevalent.
The effect of hot corrosion on mechanical properties of the tin-doped titanium aluminide alloy
(Springer, 2025-01) Magogodi, Steven; Mathabathe, Maria Ntsoaki; Rikhotso-Mbungela, Rirhandzu; Vilane, Velile; Siyasiya, Charles Witness; Bolokang, Amogelang Sylvester
Please read abstract in the article.
Occurrence of tick-borne haemoparasites in South African rodent species evidence of Babesia microti-like sequence variants in two Rhabdomys species
(Elsevier, 2025-04) Troskie, Milana; Matthee, Sonja; Penzhorn, Barend Louis; Jansen, Raymond; Oosthuizen, Marinda C.; marinda.oosthuizen@up.ac.za
In recent years, vector-borne viral, bacterial and parasitic diseases have emerged or re-emerged in many geographic regions, causing health and economic problems. Wildlife can act as reservoirs for many human and livestock diseases and that arthropods are often involved in the transmission of these pathogens. Little is known about the zoonotic pathogens that naturally occur in wild rodent and insectivorous shrew species in South Africa. The aims of the study were to: 1) record the tick-borne haemoparasite diversity associated with rodents and shrews at several localities in South Africa, and 2) characterise Babesia microti that occur in rodents using Sanger sequencing of the parasite 18S ribosomal RNA (rRNA) gene and internal transcribed spacer region 1 (ITS1). Nine wild rodent genera (species: n = 412) and two insectivorous shrew genera (species: n = 11) were simultaneously screened for the presence of Theileria, Babesia, Ehrlichia and Anaplasma species using the Reverse Line Blot (RLB) hybridization assay. The RLB PCR amplicons obtained from Mastomys spp., Micaelamys namaquensis, Mus musculus, Rhabdomys dilectus and R. pumilio hybridized with the following RLB species-specific probes: Babesia microti (11.3%), Anaplasma bovis (3.5%), Anaplasma phagocytophilum (1.8%) and Ehrlichia ruminantium (3.5%). The near full-length 18S rRNA gene and partial ITS1 spacer region of 12 of the specimens were cloned and the recombinants sequenced. Babesia microti-like 18S rDNA and ITS1 sequence variants were recorded in two rodent species (Rhabdomys dilectus and Rhabdomys pumilio). The B. microti-like 18S rDNA sequence variants, obtained in this study, clustered phylogenetically within the established B. microti-like clade (Clade I). Nevertheless, they formed a distinct South African group that seems to differ significantly from B. microti sensu stricto and could potentially represent a fifth distinct lineage within the B. microti-like clade.The study highlights the potential of small mammals acting as important reservoirs for vector-borne haemoparasites in South Africa. HIGHLIGHTS • Most extensive study on haemoparasites associated with small mammals in Southern Africa to date. • 63.3% rodent samples positive for Theileria/Babesia/Ehrlichia/Anaplasma DNA. • Regional-specific Babesia microti-like sequence variants recorded in two commensal and wide-spread rodent species.
Clinical difficulties related to direct composite restorations : a multinational survey
(Elsevier, 2025-04) Lehmann, Anna; Nijakowski, Kacper; Jankowski, Jakub; Donnermeyer, David; Ramos, Joao Carlos; Drobac, Milan; Martins, Joao Filipe Brochado; Hatipoglu, Omer; Omarova, Bakhyt; Javed, Muhammad Qasim; Alharkan, Hamad Mohammad; Bekjanova, Olga; Wyzga, Sylvia; Alkhawas, Moataz-Bellah Ahmed Mohamed; Kudenga, Rutendo; Surdacka, Anna
AIMS : Composite materials are widely used in dentistry for direct tooth restorations. However, they are highly sensitive to the working technique employed during the restorative procedure. Even minor procedural errors can have a significant impact on the quality including the longevity of the restoration. Hence the aim of this study was to determine the material preferences and analyse the clinical problems associated with direct composite restorations in a cohort of dentists. METHODS : A 20-item online questionnaire was created in English and administered 1830 general dentists and specialists in 13 countries. The first section of the questionnaire included four questions to elicit demographic data, and the second section comprised 16 questions focused on material preferences for conservative restorations, durability of composite restorations, and the most challenging stages the dentists faced during the composite restorative procedures. RESULTS : Respondents decided most often to use composite materials for the tooth restorations (OR 997.4, 95% CI 233.8-4254.8, P value <.001). Most respondents indicated that the durability of composite restorations was approximately 7 to 10 years (41.5%). Among the factors affecting durability, maintenance of a dry cavity was the most often reported reason (47.1%) and the foremost challenge faced by dentists (61.0%) during the composite restorative procedures. CONCLUSIONS : Our study confirmed that resin-based composites are the most popular material for direct restoration in many countries. Although working with this material is difficult and involves multiple steps, maintaining a dry cavity during bonding, and material application may affect the therapeutic success and durability of these restorations. Clinicians need to be attentive to this issue and be prepared to adapt their decision-making and consider opting for alternative restorative materials, if appropriate.
Comparison of infant feeding practices by maternal HIV status, and associated factors, in a rural district, South Africa 2019
(BioMed Central, 2025-04) Mukhula, Victoria Temwanani; Zunza, Moleen; Mbira, Thandiwe Elsie; Ramokolo, Vundli; Prendergast, Andrew J.; Tylleskar, Thorkild; Van de Perre, Phillippe; Goga, Ameena Ebrahim; Ngandu, Nobubelo K.
BACKGROUND : The prevalence of exclusive breastfeeding (EBF) during the first 6 months and breastfeeding up to 24 months in all mothers, regardless of HIV status, in high HIV prevalence settings of South Africa is not frequently evaluated. This study aimed to describe practices of EBF and breastfeeding beyond 12 months, compare these between HIV exposed (HE(s)) and unexposed infants (HU(s)), and determine associated factors. METHODS : A secondary objective analysis of data from a cross-sectional study conducted during September-December-2019 in a rural South African district, was performed. Mothers living with HIV (MLHIV) paired with their infants in the following age groups: 0 to 3, > 3 to 6, > 6 to 12, and > 12 to 24 months; and mother-infant pairs without HIV with infants aged > 3 to 6 months and > 12 to 24 months, were enrolled. Descriptive statistics and bivariate and multivariable binomial regression were used for analyses. RESULTS : A total of 771 mother-infant pairs, 62% being MLHIV, were enrolled. Among HEs (including 10 living with HIV), the prevalence of EBF was 41.0% and 16.7% in 0–3, and, 3–6 months age-groups, respectively, and breastfeeding prevalence was 19% in 12–24 months age-group. Among HUs, the prevalence of EBF was 7.9% among 3–6 months old and breastfeeding prevalence was 38.0% among > 12–24 months old. Overall, 79.8% and 45.5% HUs and HEs aged 3–6 months were still breastfeeding, respectively. HEs were more likely to exclusively breastfeed at 3–6 months age compared to HUs (adjusted prevalence ratio [aPR] 3.84; 95% confidence interval (CI) 1.55, 9.53). Breastfeeding practice at 12–24 months age was significantly less likely among HEs (versus HUs) and in infants with unmarried/non-cohabiting mothers (versus married/co-habiting) (aPR 0.42; 95% CI 0.27, 0.63 and aPR 0.66; 95% CI 0.47, 0.92), respectively). Among HEs, breastfeeding beyond 6 months was more likely among MLHIV with known HIV-negative male partners (versus known HIV concordant relationships). CONCLUSION : In this study population, EBF was comparably more likely among HEs while breastfeeding beyond 12 months was more likely among HUs. Maternal marital status, frequency of antenatal care attendance and male partner’s HIV status also influenced breastfeeding practice. Overall, there is still room for improvement regardless of infant HIV status, requiring continued client-sensitive strengthening of the implementation of the recommended breastfeeding practices.
Evaluating the economic effect of sustainable agricultural practices on small-scale farmers in the Eastern Cape Province : a propensity score matching analysis
(Taylor and Francis, 2025) Mdoda, Lelethu; Loki, Olwethu; Sikwela, Misery M.
Agricultural productivity in sub-Saharan Africa is low, worsened by the COVID-19 pandemic and climate change. Sustainable Agricultural Practices (SAPs) offer pathways to improve productivity and resilience. This study assessed the impact of SAPs on the farm income of small-scale farmers in Eastern Cape Province. Using a cross-sectional research design and multistage sampling, data were collected from 168 smallholder farmers through semi-structured questionnaires. Descriptive statistics, binary logistic regression, and propensity score matching were used for analysis. Results showed that 70% of farmers were female, averaging 45, and six household members worked as family labour. The study found that 64% of farmers who adopted SAPs had improved farm returns. Empirical results revealed that adopting all five SAPs positively impacted farm income more than adopting one or two. The study concludes that SAPs enhance farmers' welfare and livelihood. Based on the results, the study recommends a gradual transition to these practices, restoring soil health, controlling weeds, reducing erosion, and aligning with the UN's Sustainable Development Goals.
Unpacking the understanding of social justice in higher education from the perspectives of educators in law, health and social work
(International Network for Higher Education in Africa, University of Kwazulu-Natal, 2025-06) Schiller, Ulene; Hlophe, Yvette Nkondo; Van Coller, Arthur; Singh, Shenuka; Moema, Esmey Baratwa Esther; yvette.hlope@up.ac.za
ABSTRACT : Social justice-informed pedagogy remains the bedrock for ensuring that educational programmes in higher education in South Africa are responsive to unmet learning needs and are contextualised within students' lived experiences. This paper documents the reflections of five senior academics (the authors) on how social justice can be applied to Law, Medicine, Dentistry, and Social Work, respectively. These academics were part of the Teaching Advancement at Universities (TAU) fellowship programme. Using Kim’s Critical Reflective Inquiry Model and Nancy Fraser’s concept of participatory parity, the authors interrogated the structural barriers to equitable education and the role of discipline-specific pedagogical practices in advancing or inhibiting social justice. Findings reveal that while social justice is a guiding principle across the identified disciplines, its implementation is inconsistent and often constrained by entrenched institutional norms and economic disparities. Legal education struggles to move beyond doctrinal teaching to cultivate critical consciousness; health sciences education largely embeds social justice in patient-centred care but overlooks the lived experiences of students; and social work education emphasises equity yet still faces structural barriers in practice-based learning. The study highlights the necessity of embedding participatory parity in higher education and fostering an emancipatory pedagogy that moves beyond content delivery to active student engagement. The paper concludes with recommendations for higher education institutions to institutionalise social justice principles through curriculum reform, inclusive teaching strategies, and structural changes that promote equal access and participation. RESUME : La pédagogie fondée sur la justice sociale permet de garantir que les programmes éducatifs de l'enseignement supérieur en Afrique du Sud répondent aux besoins d'apprentissage non satisfaits et soient contextualisés dans les expériences des étudiants. Cet article documente les réflexions de cinq universitaires chevronnés (les auteurs) sur la manière dont la justice sociale peut être appliquée au droit, à la médecine, à l'odontologie et au travail social, respectivement. Ces universitaires faisaient partie du programme de bourses Teaching Advancement at Universities (TAU). En s'appuyant sur le modèle d'enquête critique et réfléchie de Kim et sur le concept de parité participative de Nancy Fraser, les auteurs se sont interrogés sur les obstacles structurels à une éducation équitable et sur le rôle des pratiques pédagogiques propres à chaque discipline dans la promotion ou l'inhibition de la justice sociale. Les résultats révèlent que si la justice sociale est un principe directeur dans toutes les disciplines identifiées, sa mise en œuvre est incohérente et souvent limitée par des normes institutionnelles enracinées et des disparités économiques. L'enseignement juridique peine à dépasser l'enseignement doctrinal pour cultiver une conscience critique; l'enseignement des sciences de la santé intègre largement la justice sociale dans les soins centrés sur le patient mais néglige les expériences vécues par les étudiants; et l'enseignement du travail social met l'accent sur l'équité mais se heurte encore à des barrières structurelles dans l'apprentissage basé sur la pratique. L'étude souligne la nécessité d'intégrer la parité participative dans l'enseignement supérieur et d'encourager une pédagogie émancipatrice qui aille au-delà de la transmission de contenus pour favoriser l'engagement actif des étudiants. Le document se termine par des recommandations à l'intention des établissements d'enseignement supérieur pour qu'ils institutionnalisent les principes de justice sociale par le biais d'une réforme des programmes, de stratégies d'enseignement inclusives et de changements structurels qui favorisent l'égalité d'accès et de participation.
Managing African armyworm outbreaks in sub-Saharan Africa : current strategies and future directions
(MDPI, 2025-06) Kinyanjui, Grace; Mawcha, Kahsay Tadesse; Malinga, Lawrence Nkosikhona; Soobramoney, Kaitlyn; Nethononda, Phophi; Assefa, Yoseph; Okonkwo, Chibuzor Onyinye; Ndolo, Dennis; phophi.nethononda@fabi.up.ac.za
The African armyworm Spodoptera exempta (Lepidoptera: Noctuidae) is a significant pest that affects cereal crops and pasture grasses in sub-Saharan Africa. This migratory pest causes extensive defoliation, which can result in significant yield losses, particularly in maize. This review focuses on the recent outbreaks of the African armyworm and identifies key factors contributing to its success across sub-Saharan Africa. Understanding these factors is essential for developing effective and sustainable pest management strategies. This review emphasizes the importance of innovative technologies and data-driven approaches in managing pest outbreaks and underscores the need to implement technology-enabled integrated pest management (IPM) strategies to control the African armyworm effectively. SIMPLE SUMMARY The African armyworm is a destructive, migratory pest that threatens cereal crops and pasture grasses in sub-Saharan Africa, with recent outbreaks resulting in significant agricultural and economic losses. This review addresses the urgent need for improved management strategies by examining the drivers of frequent outbreaks, including climate change, the pest’s biological traits, and gaps in current control practices. This paper aims to evaluate existing surveillance and control methods—such as chemical, biological, and cultural approaches—and to explore innovative technologies, including predictive modeling, artificial intelligence, Bt maize technology, molecular biology, and nanotechnology. This study finds that, while traditional methods offer some control, their limitations necessitate integrated, technology-enabled pest management solutions. It concludes that adopting holistic, regionally coordinated strategies that incorporate farmer education, advanced tools, and updated policy frameworks will significantly improve outbreak response and mitigation. These findings are valuable to society as they provide a roadmap for sustainable pest control, helping to safeguard food security, support farmer livelihoods, and enhance agricultural resilience in the face of escalating climate and pest pressures.

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