Background Stavudine (d4T) is an antiretroviral drug used in developing countries for the management of HIV due to its efficacy and low cost. Concerns over its toxic side effects has led the WHO to recommend that it be phased out. The study aim was to ascertain whether a low, yet efficacious dose of d4T (20 mg twice daily) would lead to fewer incidences of toxicity. Objectives This study compared incidence of toxicity in patients on low dose d4T (20 mg) versus the higher doses (30 mg /40 mg). Methods A retrospective analysis using STATA 12 was conducted on 1086 patients in a South African HIV treatment cohort. They were stratified into 3 d4T dose groups; 20 mg (n=43); 30 mg (n=707); and 40 mg (n=336). Time to onset of toxicity was assessed using survival analysis. Toxicity incidence rates were estimated using Poisson regression. Cox models were used to determine risk factors. Results Median time to onset of toxicity was 217, 137 and 55 weeks for the d4T 20 mg, d4T 30 mg and d4T 40 mg groups, respectively. Toxicity incidence rates per 100 person-years were 43 (95%CI 25 - 76), 67 (95%CI 54 - 83) and 174 (95%CI 143 - 211), respectively. Patients on d4T 20 mg were less likely to develop toxicity compared to the other doses, hazard ratio 0.36 (95%CI 0.20 - 0.65). Female sex was a risk factor for toxicity, hazard ratio 1.58 (95%CI 1.25 2.00). Other identified risk factors included the presence of renal dysfunction as well as BMI. Conclusion d4T 20 mg twice daily led to fewer incidences of toxicity. Further clinical trials are needed to compare this drug dose to other antiretrovirals. / Dissertation (MSc)--University of Pretoria, 2015. / School of Health Systems and Public Health (SHSPH) / MSc / Unrestricted

Tuberculosis (TB) is a major cause of death worldwide, especially in Asia and Africa. Genotyping methods such as insertion sequence 6110-restriction fragment length polymorphism (IS6110-RFLP), spoligotyping and mycobacterial interspersed repetitive units variable number of tandem repeats (MIRU-VNTR) have expanded the ability to investigate and understand TB. Genotyping of M. tuberculosis has shown that certain M. tuberculosis strains are more prevalent in certain geographic regions, thus raising questions about bacterial factors in pathogenesis, presentation of disease and treatment response. Given the diversity in insertions, deletions and single nucleotide polymorphisms seen in M. tuberculosis, it is plausible that the genetics of the pathogen play a role in presentation of disease and response to treatment. However, there is very limited evidence on the influence of M. tuberculosis genotypes on treatment outcome of TB around the world. Whether response to TB treatment differs among the different genotypes is unknown. It is important to investigate the influence M. tuberculosis genotypes may have on treatment response; to develop effective control strategies for tuberculosis. This study aimed to determine the genetic diversity of M. tuberculosis strains in Tshwane metropolitan area and to determine the association of those genotypes with the laboratory based-treatment response using the eight weeks culture result as a marker for treatment response. In addition the study explored the association of genotypes with drug resistance and patient demographics (age and gender). In this study a total of 108 consecutive M. tuberculosis isolates resistant to either rifampicin and/or isoniazid were collected between September 2011 and December 2011from the National Health Laboratory Services (NHLS), Tshwane academic division laboratory . Two isolates were excluded from the study due to contamination. The study population included 50 females (47.17 %) and 47 males (44.34 %) with 9 patients (8.49 %) that did not have gender available. The age range for the study population was from 2 days to 79 years. Genotyping was performed using two different PCR-based methods; spoligotyping, and 24 loci MIRU-VNTR typing. Comparison of Spoligotyping results of the 106 M. tuberculosis isolates with the SpolDB4 database showed that 73% (83/106) isolates belonged to 21 previously described shared types (ST); while 27% (23/106) were not found in the SpolDB4 database and were considered as orphans. Spoligotyping identified seven major distinct families of TB including Beijing, East African Indian (EAI), Latin American and Mediterranean (LAM), T family, X family, CAS as well as Manu 2 families. Spoligotyping identified 14 clusters, giving a clustering rate of 50%. However no cluster was identified with 24-loci MIRU-VNTR typing. The study did not find any as association of. In this study only 46 patients out of the 106 of the study population had the 8 weeks follow up result and no genotypes were associated with treatment outcome in this population. The study also did not find any association of specific genotype with gender, age or drug resistance to INH or Rif. Resistance to RIF was associated with treatment failure (patients failed to convert after 8 weeks), with P value of 0.006. However, no significant association was found between INH resistance and treatment outcome. In conclusion the study showed high genetic diversity of strains in Tshwane Metropolitan area. No association was found between genotypes and treatment response. However more than 50% did not have eight weeks follow up result. The study did however find Rifampicin (Rif) mono resistance to be associated with treatment failure. Further studies are needed to confirm the present study finding. / Dissertation (MSc)--University of Pretoria, 2015. / Medical Microbiology / MSc / Unrestricted

The motif of Jacob s vision in John 1:51 is used to prove that Jesus was the apocalyptic Son of Man who fulfilled the promise that was given to Jacob through his dream in Genesis 28:12. This dream was different from Joseph s (Gn 37:9) or Abimelech s (Gn 20:8). From the gate of heaven that Jacob mentioned after the dream, it is possible to interpret the vision of Jacob eschatologically. In Ezekiel s vision (Ezk 1:1) and Daniel s vision (Dn 7:13), there are eschatological approaches about the open heaven and the one that comes from heaven. Therefore the vision of Jacob through the dream in Bethel was interpreted eschatologically by later traditions. The interpretation of the Rabbinic tradition about Jacob s dream has an eschatological perspective. For example: the author of Jacob s Ladder, the first century CE Pseudepigraphon, interpreted it as an eschatological vision according to their interpretation of the archangel in Genesis 5-7. The Rabbi in Genesis Rabba also interpreted it as a celestial icon as it is perceived in mysticism. Jacob s dream is mentioned in the Testament of Levi, and the dream of Levi is added to it. The dream of Levi is an extension of Jacob s dream. Levi was invited to heaven by the angel to receive the priesthood. It is a celestial interpretation of Jacob s vision. In the tradition of the intertestamental period, the Son of Man was understood as an eschatological figure. / Thesis (PhD)--University of Pretoria, 2015. / tm2016 / New Testament Studies / PhD / Unrestricted

Thesis (PhD)--University of Pretoria, 2015. / tm2016 / Practical Theology / PhD / Unrestricted

This study Mission in Revelation culminates in a point-by-point summary.1 Firstly, the eight most important role players in the account of Revelation are identified and symbolically represented by the colours of the rainbow.2 Their identity and role in the account of Revelation are briefly described in conjunction with the theological motif that relates specifically to each role player. Second, the theological motifs of Revelation are rendered point by point in a Theological-thematic manner and are outlined with reference to the face of a clock.3 Consequently, Mission as a theological motive in Revelation is grounded theologically, the objective of mission is explained, and the aim of this study is achieved. Both the role players in the account of Revelation and the theological motifs in the scripture of Revelation are found in mainly the vision of the throne in Revelation 4 and 5. It can be summarised as follows: 1 There was a throne (white) in heaven with Someone sitting on it. (Doxology). 2 Between the throne and the elders stood a Lamb (red) that had been slain. (Christology and Soteriology). 3 Before the throne, seven lamps (orange) were blazing. These were the seven spirits of God and the seven eyes of the Lamb sent out into all the earth (Pneumatology and Missiology). 4 Surrounding the throne, the living creatures and the elders, there was a multitude of angels (yellow) who sang in a loud voice: "Worthy is the Lamb, who was slain, to receive power and wealth and wisdom and strength and honour and glory and praise!" (Angelology and Satanology). 5 A rainbow, resembling an emerald (green), encircled the throne and before the throne there was what looked like a sea of glass, clear as crystal (Biblical Cosmology). 6 All creation, every creature in heaven (light blue) and on earth and under the earth and on the sea, and all that is in them, the great multitude from every nation, tribe, people and language, cried out: "To Him who sits on the throne and to the Lamb be praise and honour and glory and power, for ever and ever!" (Biblical Anthropology and Eschatology). 7 Around the throne, were four living creatures (dark blue), and they were covered with eyes, in front and behind. Day and night they never stopped saying: "Holy, holy, holy is the Lord God Almighty, who was, and is, and is to come". Then the twenty-four elders fell down before Him who sat on the throne, and worshipped Him who lives for ever and ever and said: "...for you created all things, and by your will they were created and have their being" (Deaconology). 8 Surrounding the throne were twenty-four other thrones and seated on them were twenty-four elders (purple). The four living creatures and the twenty-four elders fell down before the Lamb, and the twenty-four elders each had a harp and they were holding golden bowls full of incense, which were the prayers of the saints, and they sang a new song (Ecclesiology). / Thesis (PhD)--University of Pretoria, 2015. / tm2016 / New Testament Studies / PhD / Unrestricted

Upon entering into a marital relationship, an African Christian couple is faced with both biblical and cultural perspectives regarding the patriarchal idea of male headship and female submission in marriage. This is because headship and submission are both cultural and biblical issues. The African culture, just as the Bible, defines the position and the role of males and females and this presents a challenge for the African Christian couple regarding practice. It is important for pastoral care givers to gain insight into influences on married couples understanding and practice of headship and submission and the implication this has for gender disparity as well as the consequences of gender disparity for the lives of people. The study aims to explore biblical and cultural ideas of headship and submission in order to develop an understanding of, describe and explain African Christians perceptions, attitudes and practices with regard to male headship and female submission in marriage. The context of the study is that of Shona culture in Zimbabwe. In order to gain an understanding of the issues on a grassroots level, 30 (15 males and 15 females) married Shona Christians from different churches in Zimbabwe were interviewed. The participants were selected by means of the random sampling and purposive sampling methods. Four main themes were identified and conceptualised. Data was analysed and discussed in dialogue with the theoretical underpinnings of the study in order to present a pastoral perspective. / Dissertation (MA (Theol))--University of Pretoria, 2015. / tm2016 / Practical Theology / MA (Theol) / Unrestricted

This study concerns itself with the task of creating a pastoral model in order to provide effective spiritual care to domestic violence victims by alcohol abusing brass band men. The African Independent Churches are experiencing a growing number of brass band men who abuse alcohol. I therefore undertook to do a study on the problem to ascertain whether the churches create alcoholics or the alcoholics are attracted to the brass band ministry. The most important objective of this study is to: Help to develop a counselling model for the wounded women. Develop a pastoral care method that will empower and reconstruct the behaviour of the brass band men. Create a caring model of helping those affected congregants. Questionnaires designed for men, women and congregants were given to them to find out if alcohol and alcoholism is a problem to the churches. Realizing that the questionnaires may not be sufficient, five case studies were used. These case studies are real stories from different women. They are more detailed and shed a light to the problem of alcoholism among brass band men. Through the questionnaires and case studies, the researcher found that ministerial stress, family stress, financial problems, lack of recreational time and peer pressure contributes to men being alcoholics. This study was not aimed at stopping the brass band men from using alcohol, but to help the brass band men to realize what alcohol do to their ministry, families, congregants and themselves so that they make wise choices when it comes to taking alcohol. / Dissertation (MA (Theol))--University of Pretoria, 2015. / tm2016 / Practical Theology / MA (Theol) / Unrestricted

The vexata quaestio of the letter to the Romans is both the starting point and destination of this study. This vexata quaestio of Romans owes its existence to a hermeneutical conundrum: At first glance, the situational context, in which Paul was situated at the time of his writing, does not seem to correspond to its theological context, in which Paul s theological perspectives could be substantiated. In other words, this hermeneutical conundrum drives a wedge between why Paul wrote this letter and what/how Paul spoke of in this letter. When it comes to the situational context of Romans, it is not easily concretized into the epistolary framework of this letter. As a result, speculation looms large in reconstructing such a situational context more than the text of Romans itself can support, and thereby the theological context of this letter comes to be contingent on the speculation of the why of the matter. It is for this reason that we are faced with various implications of the vexata quaestio of the letter to the Romans in the scholarly arena of Pauline studies. Especially, the vexata quaestio of this letter revolves around (1) Paul s overall purpose in writing it to the Roman church he neither founded nor visited beforehand; and (2) Paul s use of quotations from the Jewish Scriptures in the course of his argumentation, which appears to be frequent but concentrated in this letter more than in his other letters. In order to steer away from too much speculation, this study draws attention to distinctive epistolary conventions such as the letter opening, the thanksgiving period, the apostolic parousia, and the letter closing. A comparative study of the form and function of distinctive epistolary conventions will give a glimpse of the why, namely Paul s overall purpose in writing this letter. It is considered that the reason why Paul wrote this letter is to proclaim his gospel according to his apostolic responsibility. This overall purpose functions as standard controls in reading the content (Jervis 1991:27). It compels us to look into the contours of Paul s argumentation in Romans 1 11, which will be interdependent with the overall purpose of the letter. In doing so, we come to the conclusion that the following pattern unfolds as an essential literary texture of Romans 1 11, namely themanner of a rhetorical question + Paul s response with ?? ??????? in an emphatic manner + his use of quotations from the Jewish Scriptures. Including such an essential literary texture of Romans 1 11, it is worth noting that Paul s use of quotations from the Jewish Scriptures appears to be coupled with its respective rhetorical questions at several significant points in the course of Paul s argumentation in Romans 1 11. It necessitates launching into the three-dimensional approach to Paul s use of quotations from the Jewish Scriptures in order to better understand how Paul managed to unfold what he spoke of in the letter body. The three-dimensional approach consists of the tradition-historical investigation, textual version comparison, and hermeneutical investigation, which serves to shed more light on the functional dimension in this quest for the Vorlage (Steyn 2011:24). This three-dimensional approach allows us to delve into Paul s theological perspectives. In doing so, we come to the conclusion that Paul s use of quotations from the Jewish Scriptures carries a soteriological significance. All in all, this study is aimed at dealing with this vexata quaestio of Paul s letter to the Romans, which revolves around the literary genre, Paul s overall purpose in writing this letter, and his use of quotations from the Jewish Scriptures, in a holistic manner. In doing so, this study can pave the way for a better understanding of how Paul managed to unfold what he spoke of in the letter body in terms of why he wrote this letter to the Roman church. / Thesis (PhD)--University of Pretoria, 2015. / tm2016 / New Testament Studies / PhD / Unrestricted

Although HIV and AIDS has become a common phenomenon in Zimbabwe and the world over, it still remains a bone of contention for many people with regards to its spread and consequences. Thirty-five years has gone by since the advent of HIV and AIDS in Zimbabwe. A number of factors, such as unprotected sex; handling of AIDS patients without proper and adequate facilities; and the usage of used needles have been accused of influencing the spread of HIV and AIDS in some parts of Zimbabwe. However, factors influencing the spread of HIV and AIDS among the Tonga females are different from what has been said concerning other parts of country .Factors such as cultural practices which are oppressive to females are responsible for fuelling the spread of AIDS pandemic among the Tonga females. In view of this, the study is therefore meant to examine the validity of the claim which presupposes that those cultural practices such as polygamy; marrying of a spouse whose husband is believed to have died of AIDS; child marriage among others, as responsible for the spread of HIV and AIDS among the Tonga females. It is also the study s aim to validate or falsify the assumption that the Tonga females are more vulnerable to HIV and AIDS than their male counterparts. Since the study seeks to establish the plight of the Tonga females of the Pashu community in the context of HIV and AIDS, about 98% of the respondents or participants are females. The reason for this is to maximise a female voice. In other words, more females were interviewed than males. The gathered data during interviews had been analysed. The study findings confirmed the assumed problem of the Tonga females suffering from HIV and AIDS due to the mentioned factors. Presumably the subsequent consequences of HIV and AIDS have necessitated a pastoral oversight to the afflicted females. In some cases, family relationships are broken. Some witchcraft accusations have also caused hatred among some family members. Seemingly pain and suffering in this case has superseded joy. These findings have influenced a recommendation that a further study on specific cultural practices mentioned above be pursued. The study has revealed and addressed the issues affecting the Tonga females in the context of HIV and AIDS. / Thesis (PhD)--University of Pretoria, 2015. / tm2016 / Practical Theology / PhD / Unrestricted

Psalm 104 paints a picture of Yahweh dressed in the royal robes of both Aten and Baal. The variety of references to Ancient Near Eastern gods points to a rich and complicated history of the origins of Psalm 104, Israel and Israelite theology. The origins of Psalm 104 in all likelyhood include oral traditions, cultic contexts and years of redactional rearrangement and rewriting. Akhenaten used a centralised cult and monolatrism to achieve political stability in Egypt. Years later Hammurabi used Marduk as chief deity in Babylonia to centralise power and create political and religious stability in his kingdom. It is within this Ancient Near Eastern tradition of using religion and one specific deity to achieve political stability that Psalm 104 finds its origins and cultic context. The early Israelite monarchy finds itself amidst uncertain political circumstances. The early kings used a centralised monarchy and monolatrism to achieve economic and political stability. The early Israelite government also used other Egyptian influences including governing methods, policies and the use of Egyptian scribes. The monarchy used cultic personal to communicate politically sanctioned theology and contact between cultic personal and Egyptian scribes intertwined with a Canaanite heritage has a cosmopolitan and culturally diverse Psalm 104 at its end. The psalm is used as a war liturgy, with Chaoskampf-motifs to legitimise the Israelite king s military action and kingship. This is done by ritual re-enactment on cultic level connecting Yahweh s mythic action to that of the king s present conflict. / Thesis (PhD)--University of Pretoria, 2015. / tm2016 / Old Testament Studies / PhD / Unrestricted