Zoonotic diseases are diseases that are transmitted from animals or vectors to humans and vice versa. The public together with veterinarian authorities should readily access disease information as it is vital in rapidly controlling resultant zoonotic outbreak threats through improved awareness. Currently, the reporting of disease information in South Africa is predominantly limited to traditional methods of Information Communication Technologies (ICTs) like faxes, monthly newspaper reports, radios, phones and televisions. Although these are effective ways of communication, their disadvantage is that the information that most of them offer can only be accessed at specific times during a crisis. New technologies like the internet have become the most efficient way of distributing information in near-real-time. Many developed countries have used web-based reporting platforms to deliver timely information through temporal and geographic visualisation techniques. There has been an attempt in the use of web-based reporting in South Africa but most of these sites are characterised by heavy text which makes them time consuming to use or maintain. As a result most sites have not been updated or have ceased to exist because of the work load involved. The success of web reporting mechanisms in developed countries offers evidence that web-based reporting systems when appropriately visualised can improve the easy understanding of information and efficiency in the analysis of that data. In this thesis, a web-based reporting prototype was proposed after gathering information from different sources: literature related to disease reporting and the visualisation of infectious diseases; the exploration of the currently deployed web systems; and the investigation of user requirements from relevant parties. The proposed prototype system was then developed using Adobe Flash tools, Java and MySQL languages. A focus group then reviewed the developed system to ascertain that the relevant requirements had been incorporated and to obtain additional ideas about the system. This led to the proposal of a new prototype system that can be used by the authorities concerned as a plan to develop a fully functional disease reporting system for South Africa.

The WHO member countries undertook to eliminate poliomyelitis globally by the year 2000. Acute flaccid paralysis (AFP) surveillance finds paralytic cases of polio so that swift action can be taken and shows that wild poliovirus has been eliminated when polio cases no longer occur. Mpumalanga Province, a rural province in the north-east of South Africa, developed a rapid reporting system where infection control nurses at the public and private sector hospitals report weekly to the AFP surveillance Officer, including zero reporting, on 9 infectious disease syndromes that require rapid action on clinical presentation alone. This system was implemented in 1998 and included AFP. The non-polio AFP reporting rate increased from 0.37 in 1997 to 0.55 during 1998 with more than 80% of the units reporting weekly. The binomial exact confidence intervals however include 1. A hospital record review of all paediatric admissions revealed that only 2 AFP cases were missed by the system. The AFP reporting rate remains below the international standard of 1 per 100 000 children under 15 years of age despite an adequate reporting system. The role of chance variation, particularly in small geographical areas, has not been discussed in official polio-eradication guidelines but it is . imperative that population size be taken into account when judging the rate of AFP case detection. With the low international reference rate and play of chance variation it is possible that regions with relatively small populations, low non-polio AFP detection rates and no cases of polio detected for an extended period may have adequate surveillance systems supporting polio free certification. In these areas additional criteria for determining the adequacy of the surveillance system should also be considered. / Dissertation (MMed)--University of Pretoria, 2006. / School of Health Systems and Public Health (SHSPH) / Unrestricted

Thesis (M.Med. (Paediatrics and Child Health)) -- University of Limpopo, 2022 / Introduction: Pleural empyema in children is associated with high morbidity and high mortality. Staphylococcus aureus has been shown to be the most common causative organism in developing countries. Study design: This study applied a retrospective quantitative descriptive study design. Study population: The population of the study is comprised of children (between 1 years and 13 years) admitted to Pietersburg Provincial Hospital with pleural empyema from January 2016 until December 2020. Objectives: The study aimed to determine the causative organisms of pleural empyema, the treatment outcomes, and the relationship between pleural empyema, TB, and HIV infection. Data collection: The National Health Laboratory Services database was used to identify patients who had pleural empyema. A self-generated data collection tool was used to obtain secondary data related to all patients who met the operational definition of pleural empyema during the defined time period. Results: Eleven participants met inclusion criteria. The mean age of participants was 42 months with 43.8 standard deviation and 64% were males and females were 36% . Of these participants, 40% cultured S. Aureus in the pleural fluid, 10% Streptococcus pneumoniae, 30% were sterile and 20% cultured other organisms such as Klebsiella pneumoniae and Haemophilus influenzae. Cloxacillin was the most prescribed antibiotic. Intercostal drainage was inserted in 91% of the participants of which 18% were successful, no further surgical intervention needed,73% had thoracotomy and VATS was offered to 91% of participants and it was followed by thoracotomy. Fibrinolytics were not offered to the participants in this study. The majority of patients, 55%, were discharged back to their peripheral hospitals and 27% of them died. PCV immunisation status of the children was not documented hence the relationship between pleural empyema and PCV immunisation could not be established. There was a positive correlation between age of patients with pleural empyema and ICU length of stay (r=89%; p=0,01) while another strong correlation was depicted between HIV status and hospital length of stay (r=88%, p=0,019). Results further show a positive association between outcome and surgery intervention offered (Chi=7,00; p=0,02). Conclusion: Our study showed that S. aureus is the leading cause of pleural empyema, with a predominance of thoracocentesis and thoracotomy offered as surgical interventions.

Morbidity data for chlamydia {CT) and gonorrhea (GC) reported to San Joaquin County (SJC) Department of Health Services (DHS) from 1997 to 2006 was analyzed to geographically locate high risk areas and populations. The largest city in SJC is Stockton, which had the highest incidence rates and highest rates of repeat infections per population, and therefore is the primary focus of this analysis. Rates were determined by dividing the number of infections per census tract by the census 2000 population of each tract. Maps were made first for incidence (cumulative and annual), then for repeat infections, and then coinfections. Census tracts that continually showed high rates of infections were then mapped at the block level to locate more focused areas of infection. Demographic characteristics such as age, gender, race/ethnicity, incarceration, and poverty provided information on the high risk population. Case information was also examined by provider location and the treatment administered. By examining the population characteristics with the highest risk, along with the geographic location, outreach efforts by SJC DHS were far more focused and productive at targeting the core transmissions groups. Also through understanding where the cases were seeking treatment, or identifying a lack of medical availability in certain areas, SJC DHS can contact providers to distribute updated treatment guidelines and educational information to pass on to their patients.

Thesis (M. A. (Physiology)) -- University of Limpopo, 2022 / Background: Metabolic syndrome (MetS) is amongst the underlying causes of mortality and morbidity globally. However, lifestyle habits such as frequent consumption of sugar-sweetened beverages (SSBs) contributes to its onset. The study was aimed at investigating the association between MetS and SSBs intake among Ellisras rural youth. Additionally, to find the best obesity indices to predict MetS. Methods: The current study included a total of 593 Ellisras rural youth, aged 22 to 30 years (289 males and 304 females). Anthropometric measurements, blood pressure (BP), and biochemical assessment were taken using standards procedures. A validated 24hrs recall questionnaire and food manuals were used to collect SSBs data. Binary logistic regression was applied to determine the association between SSBs intake and MetS components for the adjusted model. Confirmatory factor analysis was used to test the best single-factor models to predict MetS on commonly selected obesity indices. Results: The SSBs quartile 4 was associated with a high risk of high fasting blood glucose (FBG) for adjusted (OR=2.32; CI=1.15-4.70; p<0.05) and unadjusted (OR=2.34; CI=1.16-4.73; p<0.05) models were a significant linear trend (p for trend=0.049) in males was found. Low risk of reduced high density lipoprotein cholesterol (HDL-C) was associated with the second and fourth SSBs quartiles for unadjusted ((OR=0.40; CI=0.18-0.85; p<0.05; OR=0.37; CI=0.13-0.80; p<0.05) respectively and adjusted model (OR=0.40; CI=0.18-0.85; p<0.05; OR=0.37; CI=0.17-0.80; p<0.05) respectively in females. Moreover, the fourth SSBs quartile was likely to decrease the risk of high triglycerides (TG) for unadjusted (OR=0.12; CI=0.01-0.87; p<0.05) and adjusted (OR=0.10; CI=0.01-0.83; p<0.05) models were the significant linear trend (p= trend 0.006) was observed also in females. There was a significant linear trend association between SSBs quartiles consumption and high TG in males and high waist circumference (WC) in females, but logistic regression analysis didn’t depict any significant association (p>0.05). In males, single model fit built based on WC (comparative fit index (CFI)=1.00; turker lewis index (TLI)=1.05; RMSEA=0.00; akaike information criterion (AIC)=-2680) and waist to height ratio v (WHtR) (RMSEA=0.00, CFI=1.00; AIC=-2662, TLI=1.05;) suggested a better fit index as compared to body mass index (BMI) and neck circumference (NC). Among females, a single model fit built on NC obtained a better fit index (RMSEA=0.05, CFI=0.90, and AIC= -429.21, TLI=0.71). Conclusion: In this study, there was an association between SSBs consumption and some MetS components (high TG, reduced HDL-C, and high FBG). Obesity indices including WHtR, NC, and WC were the best predictors of MetS. Future studies are recommended to further investigate the association of the risk of MetS and the consumption SSBs and the best obesity indices to predict MetS to assist in efforts to help curb MetS and related risk factors in rural areas of South Africa.