The family as the basic unit of society plays an important role in the lives of individuals especially children. The HIV/AIDS epidemic has devastated the family structure which is already strained by other detrimental factors such as urbanisation and poverty. The increased death rate of young parents due to AIDS-related diseases has led to an escalating number of orphaned children growing in child headed households (CHH) without adult care. A qualitative study was undertaken to develop an understanding of the barriers that hinder the integration of orphaned children into extended family folds and to obtain suggestions on how to overcome these barriers. Semi-structured, face-to-face interviews were conducted in Bushbuckridge, Mpumalanga Province, with a sample of children heading CHH, relatives of these children and social workers who were rendering social work services to these client-systems. The study revealed that the level of suffering faced by CHH began with the illness of the parents. This was further exacerbated by the death of the parents as these children were not absorbed by their extended families. Barriers that hindered the integration of orphaned children into extended family folds go beyond the extended families’ economic capacity to absorb the children. There is an interplay of barriers that are poverty related, relational and family related, culturally related, circumstances that are related to the orphaned children as well as limitations in social work service delivery. The findings indicate that CHH is not a good option to care and protect orphaned children as it exposes them to pervasive adversities with little resources and support. The integration of orphaned children is embraced as a good option to care for the children because of its potential value, amongst others, of enabling the extended families to relieve the CHH from the burden of care. From the findings of this study, practice guidelines were developed to enhance the efficacy of integrating orphaned children into extended families to prevent the CHH phenomenon.

The purpose of this study was to explore the lived experiences of older caregivers of adult AIDS ill children in Umlazi Township in the province of Kwa- Zulu Natal. A qualitative research design which was exploratory was executed with a sample of purposively selected participants who are the members of the organization that provides support to the older caregivers. Data saturation occurred after focus group and in depth individual interview with ten participants. The findings revealed that older caregivers experience lot of challenges which ranges from emotional, physical, financial, psychological, social and time constraints when caring for their adult AIDS ill children .The study further revealed that older caregivers developed a wide range of coping strategies to face their challenging caregiving task and most of the older caregivers utilized positive coping strategies. Recommendations that are described focus on the inclusion and consultation of older caregivers in all decisions and programmes about them. / Appendix C (Interview guide) in English as well as in Zulu / Social Work / M.A. (Social Behaviour Studies in HIV/AIDS)

The aim of this study was to isolate and characterize antifungal compounds from the most active medicinal plant species that could be used to address secondary infection problems in immunocompromised patients. An ethnobotanical study was conducted and 45 medicinal plant species used traditionally to treat candidiasis and related infections in HIV/AIDS patients were identified and documented. The most popular plant species used included Acacia caffra, Clerodendrum glabrum, Croton gratissimus, Elaeodendron transvaalense, Faurea saligna, Hippocratea longipetiolata, Osyris lanceolata, Richardia brasiliensis, Schkuhria pinnata, Schotia brachypetala, Spilanthes acmella, Strychnos potatorum, Vangueria infausta subsp. infausta and Withania somnifera. The plant parts used in the therapeutic preparations were roots (26.7%), bark (22.2%), and a combination of roots and bark (17.7%). Decoctions (44.4%), infusions (20%) and macerations (17.7%) were used. Most of the herbal remedies were administered orally. Chemical profiles of the plant species were established by using thin layer chromatography. Leaf extracts of these plant species were tested for antimicrobial activity against two common pathogenic fungal species in humans (Candida albicans and Cryptococcus neoformans) and four nosocomial bacteria (Staphylococcus aureus, Enterococcus faecalis, Escherichia coli and Pseudomonas aeruginosa) using a two-fold serial microdilution method and bioautography. All plant species investigated had some degree of antimicrobial activity against the test microorganisms. The hexane and the acetone extracts of Clerodendrum glabrum, Hippocratea longipetiolata, Schkuhria pinnata and Withania somnifera were the most active with MIC values ranging from 0.06 to 0.08 mg/ml. The most susceptible pathogen to the test samples was C. neoformans while C. albicans was resistant to most of the plant extracts. The water extracts of Withania somnifera and Hippocratea longipetiolata (14%) had MIC < 1 mg/ml against C. albicans. C. neoformans was susceptible to nine water plant extracts (64%) with MIC < 1 mg/ml and the promising activity was observed in Hippocratea longipetiolata and Faurea saligna extracts with MIC values of 0.16 and 0.31 mg/ml respectively. The hexane extract of C. glabrum was the most active against C. albicans with an MIC value of 0.06 mg/ml and total activity of 550 ml/g. In the bioautography, most plant extracts tested had few active compounds, others had no active components at all and this may be attributed to the disruption of synergism by the thin layer chromatography. C. glabrum had eight active antifungal compounds on bioautograms and most of these components were observed in the EMW solvent system. Based on this and its wide distribution in rural areas, C. glabrum was chosen for further study. The antioxidant activity and possible immune boosting potential of the species were determined using 1, 1-diphenyl-2-picrylhydrazyl radical (DPPH), 2, 2’ azinobis-(3-ethylbenzthiazoline-6-sulfonic acid (ABTS) and ferric reducing antioxidant power (FRAP) assays. In the DPPH qualitative assay, the aqueous plant extracts had several prominent antioxidant components than the organic plant extracts. The aqueous plant extracts which had the most prominent antioxidant activity were F. saligna with 8 compounds, followed by E. transvaalense, H. longipetiolata O. lanceolata, R. brasiliensis and S.brachypetala, with five compounds each and their Rf values ranged from 0;06 to 0.94. This appears to validate the ethnomedicinal use of the plant species to some extent because decoction is the most common method used in the preparation of the remedy by the traditional healers. With regard to the organic plant extracts, only one plant extract, F. saligna had two prominent antioxidant components at Rf values 0.81 and 0.88. A third of the plant species had a high level of free radical scavenging activities in the DPPH, ABTS and FRAP assays. However, all plant extracts had lower antioxidant activity than the positive control (Trolox) used. The selected plant species were also evaluated for their in vitro toxicity against the Vero monkey kidney cell line using 3-(4, 5-dimethylthiazolyl-2)-2, 5-diphenyltetrazolium bromide (MTT) assay. The acetone plant extracts of O. lanceolata, S. acmella, S. pinnata and S. brachypetala had high cytotoxic activity against Vero cells with IC50 values of 13.7±0, 19.9±0.001, 21.6±0.001 and 28.34±0.001 μg/ml respectively. However, their IC50 values were higher than that of the positive control, doxorubicin (IC50 = 9.9±0 μg/ml). The rest of the acetone plant extracts (64%) had moderate cytotoxic activity (30 < IC50<100 μg/ml). The aqueous plant extracts were relatively non-toxic to the Vero cells with IC50 values ranging from 137 to > 500 µg/ml. This supports the use of aqueous extracts in the traditional medicine. However, their low selectivity index values ranging from 0.26 to 1.68 suggest that the plant extracts are probably suitable for external use only. Fractionation of the hexane extract of the leaves of C. glabrum by chromatographic techniques yielded six fractions of which fractions C and D had significant antifungal activity (average MIC value = 0.1 mg/ml) against C. albicans and C. neoformans. From these fractions, one new triterpenoid, 3-(1-oxobutyl)-11α-hydroxytaraxast-20(30)-ene-24,28-dioic acid (clerodendrumic acid) (1) was isolated along with known heptadecanoic acid (2). C. albicans was relatively insensitive to clerodendrumic acid (1) (MIC value = 125 µg/mL) and was resistant to heptadecanoic acid (2) (MIC value = 188 µg/ml). Compounds 1 and 2 were non-toxic against monkey kidney Vero cells in vitro with IC50 values of 202.6 and 108.4 µg/ml respectively. Due to its low antifungal activity, the novel compound clerodendrumic acid (1) is not a viable candidate for drug development which could be used to combat candidiasis and related fungal infections. However, due to its relative safety, it may possibly be used as a lead compound to produce new chemically modified active derivatives or could be used together with known antibiotics to mitigate their undesirable side effects. To the best of our knowledge, the isolation of a novel, clerodendrumic acid (1) and a known heptadecanoic acid (2) compounds from leaf extracts of C. glabrum is reported herein for the first time. The results obtained from this study generally substantiate the rationale behind the use of the selected plant species in the traditional medicine to treat candidiasis and related infections to some extent. This study showed the potential of studying traditional medicine in the search for effective plant extracts or new lead compounds that could be developed into drugs for combating microbial infections among the rural poor people. / Thesis (PhD)--University of Pretoria, 2013. / gm2013 / Paraclinical Sciences / Unrestricted

MPH / Department of Public Health / See the attached abstract below

MA (Psychology) / Department of Psychology / The aim of the study was to explore the psycho-social experiences of children living with vertically transmitted HIV/AIDS in Messina Hospital, South Africa. The study utilised the qualitative approach, in particular the exploratory research design. The population of the study comprised both male and female children between the ages of 12-17 years, who are receiving care and support at Fountain of Hope Clinic in Messina Hospital. Non-probability sampling, in particular its sub-type, purposive sampling, was used to select the children who participated in the study. Eleven participants (11) were interviewed, and the sample size of the study was guided by data saturation during data collection. Semi-structured, open-ended face to face interviews were used to collect data. In order to analyse data, the researcher adopted thematic content analysis, following Tech’s eight steps of qualitative data analysis. Three main themes emerged from the raw data, namely living with HIV/AIDS infection; challenges of living with HIV/AIDS infection; and coping with HIV/AIDS. Sub-themes emerged from the main themes. Ethical considerations were observed and trustworthiness was ensured in the study. The study results were analysed and recommendations based on the results were formulated to enhance the experiences of children living with vertically transmitted HIV/AIDS. / NRF

Evidence suggests that caring for orphans and vulnerable children affected by HIV and AIDS remains one of the greatest challenges facing South Africa. Statistics indicate that there are 1.91 million AIDS orphans in the country (UNICEF, 2012; Statistics South Africa, 2009:8)). The majority of these orphans live in rural and poor urban households. Caring for orphans and vulnerable children places severe strain on support systems, such as the extended family; this spills over into the community. Providing care and support also places an extra burden on the already overstretched welfare sector and drains state resources. The primarily objective of this study was to explore community resilience strategies on challenges faced by orphans and vulnerable children affected by HIV and AIDS in Ekurhuleni Metropolitan Municipality, Gauteng. A purposive sample of 32 participants was selected and field data were collected over a period of two months using a structured research guide. A combination of data collection methods was employed in order to explore different perspectives of community resilience strategies on challenges faced by orphans and vulnerable children affected by HIV and AIDS in Benoni. Emerging data illustrate a clear account on the impact of the AIDS epidemic in Benoni. All of the respondents were directly or indirectly affected by the epidemic. This should be located within the high prevalence of HIV and AIDS and the high number of orphans in Ekurhuleni. The study findings further suggest a correlation between socioeconomic challenges and the AIDS epidemic in Ekurhuleni. This is demonstrated through the challenges experienced by orphans and vulnerable children in Benoni, which include: non-disclosure by parents of their illness; economic deprivation and disrupted schooling; children caring for an ill parent with AIDS and child-headed households; emotional, sexual and economic exploitation, stigmatisation and discrimination. Despite these challenges, through community resilience the Benoni community has taken some initiatives to mitigate against these challenges. This includes the establishment of a community based organisation which provides basic services to orphans and vulnerable children in Benoni. To date this organisation has successfully provided material and psychosocial to more than 278 orphans. The success of this initiative confirms the importance of community driven interventions using the resilience framework to supports orphans and vulnerable, rather than dependency on the government imposed programmes- top down approach. However, community based programmes need to be strengthened by the government and non-governmental organisations in order to maximise benefits. / Psychology / M.A. (Social Behaviour Studies)

This study was a situation analysis of the socio-economic conditions of orphans and vulnerable children in Dessie Town. Specifically the study assessed the educational attainment, economic status, social isolation, adjustment, discrimination and psycho-social status of OVCs, the characteristics of the care-givers of OVCs and the support systems for OVCs. Therefore, 270 OVCs, 130 guardians and 4 OVCs service-providing organisations were selected as respondents. A survey research design was used. The study found that OVCs and their households faced problems such as school dropout, low educational performance; economic and food insecurity, lack of adequate clothing; social isolation and emotional hardships due to separation of siblings; discrimination, and neglect. Children’s housing conditions, toilet facilities, and access to clean water and health facilities were poor. The majority of guardians were unemployed and unable to fulfil the needs of the OVCs in their care. It is recommended that support systems for OVCs be strengthened. / Sociology / M.A. (Sociology)

Text in Afrikaans / Die MIV/vigs-pandemie in Suid-Afiika- van die ergste in die wereld- toon geen tekens van afname nie. Miljoene kinders is reeds of wees gelaat of hewig geaffekteer deur die magdom impakte daarvan op gesinne en gemeenskappe. Die epidemie het voortdurend stygende sterftesyfers tot gevolg en die hewige las van die siekte rus swaar op MIV-positiewe sowel as MIV-negatiewe individue. Verder word tradisionele ondersteuningsnetwerke oorbelaai en/of gaan hulle tot niet. Gesinne en gemeenskappe verloor hul ekonomiese, sosiale en kulturele lewensvatbaarheid. Die pandemie hou, veral onder die armes, 'n geweldige bedreiging vir die gesondheid, welstand en regte van babas, kinders en jongmense in. 'n Groot gedeelte van die impak van MIV/vigs hou verband met die feit dat sommige kinders en hul gesinne beperkte toegang tot die elemente van 'n gesonde omgewing en goeie gesondheid het. Regerings, gemeenskappe en gesinne wat deur MIV/vigs geraak word, het minder tyd, energie en finansiële hulpbronne beskikbaar om op voorkomende gesondheidsorg te fokus. Benewens die impak op gesondheidstatus, word kinders se omstandighede ook as gevolg van MIV/vigsverwante probleme bemoeilik. Dit sluit verhoogde gesinsarmoede, 'n hoer risiko van verlating en weeslating, geforseerde migrasie, onterwing, sielkundige trauma, uitsluiting en diskriminasie, en fisiese en seksuele mishandeling in. Die derde vlaag van die epidemie, welke vlaag nou betree word, word gekenmerk deur 'n ontsettende hoe sterftesyfer, 'n ontploffing in die getal sorgbehoewende en weeskinders en 'n verhoging in menslike pyn en lyding. Die reg speel 'n baie belangrike rol in die beperking van hierdie impak van die MIV/vigs-pandemie op die lewens van alle kinders. MIV/vigs-reg is in die proses van evolusie of vorming en reeds bestaande teorieë kan aangewend word ten einde sekere vrae te beantwoord en probleme daaromtrent aan te spreek. Tog is daar 'n dringende behoefte aan MIV/vigs-spesifieke wetgewing en teorieë ten einde die impak van die pandemie op alle vlakke suksesvol te beheer. Verder het die Kinderreg so 'n mate van ontwikkeling bereik dat daar algemeen aanvaar word dat kinders 'n spesiale belangegroep binne die gemeenskap vorm. Die regsreëls met betrekking tot kinders verander gedurig en is ook nie geskik om volgens die tradisionele wyse, as privaat- of publiekreg, geklassifiseer te word nie. In die hieropvolgende proefskrif word die impak van MIV/vigs op sekere publiekregtelike, maar oorwegend privaatregtelike aspekte van die Suid-Afiikaanse kinderreg ondersoek, sowel as enkele metodes waarop die reg moontlik hierdie impak kan absorbeer en hanteer. Daar word ook in aparte hoofstukke na die impak van MIV/vigs op die lewens van kinders. sorgbehoewende kinders, egskeiding en die ouer-kind-verhouding verwys The HIV/aids pandemic in South Africa - one of the worst in the world - does not seem to be decreasing. Millions of children have already been either orphaned or heavily affected by the numerous impacts on families and communities associated with it. The epidemic brings on an ever-increasing mortality rate and the extreme burden thereof weighs down heavily on HIV-positive as well as HIV-negative individuals. Traditional support networks are further being heavily burdened or perish entirely. Families and communities lose their economical, social and cultural viability. The pandemic threatens, especially among the poorest, the health, wellbeing and rights of infants, children and young people. The impact of HIV/aids is to a great extent the result of the fact that some children and their families do not have sufficient access to a healthy environment and good health. Governments, communities and families affected by HIV/aids have less time, energy and financial resources available in order to enable them to focus on preventive healthcare. In addition to the impact on health status, children's circumstances are also being encumbered by HIV/aids-related problems, including family poverty, a higher risk of being abandoned or orphaned, forced migration, disinheritance, psychological trauma, ostracism and discrimination and physical and sexual abuse. The third wave of the epidemic, which wave is presently being experienced, is characterised by a high mortality rate, an increasing amount of children in need of care and orphaned children and an increase in human pain and suffering. The law plays an important role in the limitation of the impact of the HIV/aids pandemic on the lives of children. HIV/aids law is in the process of evolution or forming and existing theories can be used in order to answer certain questions and address certain issues relating to it. However, there is an urgent need for HIV/aids-specific legislation and theories in order to successfully manage the impact of the pandemic on all levels. Child law has also reached such an extent of development that children is now viewed as a special interest group within the community. The legal principles regarding children change constantly and cannot be classified in the traditional way, which is either as private or public law. In this thesis the impact of HIV/aids on certain aspects of the public and private law pertaining to children is examined. Ways in which the impact can be absorbed and managed by the law is also examined. The impact of HIV/aids on divorce, the parent-child relationship, children in need of care, and the impact of HIV/aids on the lives of children is examined in separate chapters. / Jurisprudence / LL. D.

Human Immuno-Deficiency Virus (HIV) and Acquired Immune Deficiency Syndrome (AIDS) have many devastating impacts, including the growing number of AIDS-orphans left without care. In the study, semi-structured interviews, incomplete sentences and Kinetic family drawings were used to explore the life-experiences and perceptions of AIDS-orphans living in kinship foster care, from a Gestalt perspective. The study revealed that the majority of the AIDS-orphans included were making good contact at the contact boundary and all the respondents were not familiar with the term 'foster care'. The researcher therefore recommended that children are educated about foster care at school, thus possibly increasing the awareness of foster care in South Africa, thus possibly increasing the provision of homes for the vastly growing numbers of AIDS-orphans in our country and perhaps make a difference in society. / Sociology / M. Diac. (Play therapy)

Text in Afrikaans / Die MIV/vigs-pandemie in Suid-Afiika- van die ergste in die wereld- toon geen tekens van afname nie. Miljoene kinders is reeds of wees gelaat of hewig geaffekteer deur die magdom impakte daarvan op gesinne en gemeenskappe. Die epidemie het voortdurend stygende sterftesyfers tot gevolg en die hewige las van die siekte rus swaar op MIV-positiewe sowel as MIV-negatiewe individue. Verder word tradisionele ondersteuningsnetwerke oorbelaai en/of gaan hulle tot niet. Gesinne en gemeenskappe verloor hul ekonomiese, sosiale en kulturele lewensvatbaarheid. Die pandemie hou, veral onder die armes, 'n geweldige bedreiging vir die gesondheid, welstand en regte van babas, kinders en jongmense in. 'n Groot gedeelte van die impak van MIV/vigs hou verband met die feit dat sommige kinders en hul gesinne beperkte toegang tot die elemente van 'n gesonde omgewing en goeie gesondheid het. Regerings, gemeenskappe en gesinne wat deur MIV/vigs geraak word, het minder tyd, energie en finansiële hulpbronne beskikbaar om op voorkomende gesondheidsorg te fokus. Benewens die impak op gesondheidstatus, word kinders se omstandighede ook as gevolg van MIV/vigsverwante probleme bemoeilik. Dit sluit verhoogde gesinsarmoede, 'n hoer risiko van verlating en weeslating, geforseerde migrasie, onterwing, sielkundige trauma, uitsluiting en diskriminasie, en fisiese en seksuele mishandeling in. Die derde vlaag van die epidemie, welke vlaag nou betree word, word gekenmerk deur 'n ontsettende hoe sterftesyfer, 'n ontploffing in die getal sorgbehoewende en weeskinders en 'n verhoging in menslike pyn en lyding. Die reg speel 'n baie belangrike rol in die beperking van hierdie impak van die MIV/vigs-pandemie op die lewens van alle kinders. MIV/vigs-reg is in die proses van evolusie of vorming en reeds bestaande teorieë kan aangewend word ten einde sekere vrae te beantwoord en probleme daaromtrent aan te spreek. Tog is daar 'n dringende behoefte aan MIV/vigs-spesifieke wetgewing en teorieë ten einde die impak van die pandemie op alle vlakke suksesvol te beheer. Verder het die Kinderreg so 'n mate van ontwikkeling bereik dat daar algemeen aanvaar word dat kinders 'n spesiale belangegroep binne die gemeenskap vorm. Die regsreëls met betrekking tot kinders verander gedurig en is ook nie geskik om volgens die tradisionele wyse, as privaat- of publiekreg, geklassifiseer te word nie. In die hieropvolgende proefskrif word die impak van MIV/vigs op sekere publiekregtelike, maar oorwegend privaatregtelike aspekte van die Suid-Afiikaanse kinderreg ondersoek, sowel as enkele metodes waarop die reg moontlik hierdie impak kan absorbeer en hanteer. Daar word ook in aparte hoofstukke na die impak van MIV/vigs op die lewens van kinders. sorgbehoewende kinders, egskeiding en die ouer-kind-verhouding verwys The HIV/aids pandemic in South Africa - one of the worst in the world - does not seem to be decreasing. Millions of children have already been either orphaned or heavily affected by the numerous impacts on families and communities associated with it. The epidemic brings on an ever-increasing mortality rate and the extreme burden thereof weighs down heavily on HIV-positive as well as HIV-negative individuals. Traditional support networks are further being heavily burdened or perish entirely. Families and communities lose their economical, social and cultural viability. The pandemic threatens, especially among the poorest, the health, wellbeing and rights of infants, children and young people. The impact of HIV/aids is to a great extent the result of the fact that some children and their families do not have sufficient access to a healthy environment and good health. Governments, communities and families affected by HIV/aids have less time, energy and financial resources available in order to enable them to focus on preventive healthcare. In addition to the impact on health status, children's circumstances are also being encumbered by HIV/aids-related problems, including family poverty, a higher risk of being abandoned or orphaned, forced migration, disinheritance, psychological trauma, ostracism and discrimination and physical and sexual abuse. The third wave of the epidemic, which wave is presently being experienced, is characterised by a high mortality rate, an increasing amount of children in need of care and orphaned children and an increase in human pain and suffering. The law plays an important role in the limitation of the impact of the HIV/aids pandemic on the lives of children. HIV/aids law is in the process of evolution or forming and existing theories can be used in order to answer certain questions and address certain issues relating to it. However, there is an urgent need for HIV/aids-specific legislation and theories in order to successfully manage the impact of the pandemic on all levels. Child law has also reached such an extent of development that children is now viewed as a special interest group within the community. The legal principles regarding children change constantly and cannot be classified in the traditional way, which is either as private or public law. In this thesis the impact of HIV/aids on certain aspects of the public and private law pertaining to children is examined. Ways in which the impact can be absorbed and managed by the law is also examined. The impact of HIV/aids on divorce, the parent-child relationship, children in need of care, and the impact of HIV/aids on the lives of children is examined in separate chapters. / Jurisprudence / LL. D.