Department of Public Health / MPH

The effects of HIV/AIDS and subsequent opportunistic infections and/or associated conditions on the development of infected children are substantial. Considerable delays and/or disorders in communication development have been noted in the HIV/AIDS infected child, as well as the need for Early Communication Intervention (ECI) services for this population. A dearth of locally relevant data regarding the speech, language and hearing development of HIV/AIDS infected children within the South African context currently exists. The objective of this study was to describe the characteristics of a group of HIV/AIDS infected children being managed at an outreach clinic of regional hospital in Gauteng. A cross-sectional, retrospective, non-experimental, descriptive, quantitative research design was used in this study. The main objective was achieved by analysing the clinic records of 203 children infected with HIV/AIDS between the ages of 0 – 5 years 11months through the use of a pre-designed checklist. A questionnaire completed by four medical doctors practicing at the HIV/AIDS clinic within the hospital was also used. This allowed for the perceptions and practices of the medical doctors to be described. Results revealed that the majority HIV/AIDS infected children being managed at the outreach clinic were significantly immunocompromised and diagnosed with Stage III or Stage IV HIV/AIDS infection. Furthermore, results indicated the presence of several opportunistic infections and HIV/AIDS associated conditions (such as Tuberculosis, Candidiasis and Encephalopathy). A positive finding was that 76% of the HIV/AIDS infected children (n=153) were receiving Highly Active Antiretroviral Therapy (HAART) at the time of data collection. The most outstanding finding was that very few of the children with HIV/AIDS being managed at the outreach clinic were recorded as having speech, language and/or hearing delays and/or disorders. Similarly, referrals to other professionals as recorded in the children’s hospital records seemed to be limited to Social Workers and Dietitians, with only one child recorded as being referred to a Speech-Language Therapist and Audiologist for further management. It was unclear whether more children were in fact referred for additional intervention by other professionals and this was simply not recorded in the children’s records, or whether these referrals were in fact not made. Results from the questionnaires completed by the medical doctors working with the pediatric HIV/AIDS population within the outreach clinic were significant. Findings indicated that the majority of the respondents believed that HIV/AIDS infected infants were more at risk for developmental and communicative delays and/or disorders than the general population, and that this population would likely benefit from Speech-Language Therapy and/or Audiology intervention services. Respondents indicated that medical doctors working with the pediatric HIV/AIDS population were often not adequately informed regarding the effects of HIV/AIDS on communication development and that they would benefit from further training in this regard. The need for further research regarding the characteristics of the pediatric HIV/AIDS population, particularly on a larger sample, was described. This would assist in the development of a guideline for ECI service delivery for children infected with HIV/AIDS. The need for further training of other professionals regarding the effects that HIV/AIDS has on the communication development of the infected child, to assist with necessary referrals and teamwork, was also highlighted. AFRIKAANS : Suid-Afrika is een van die lande ter wêreld, wat die hoogste voorkoms van Menslike Immuniteitsgebrekvirus/ Verworwe Immuniteitsgebreksindroom (MIV/VIGS), toon - met die pediatriese populasie op die voorfront van hierdie epidemie. Die effek wat MIV/VIGS en opeenvolgende opportunistiese infeksies en/of ander geassosieerde toestande op die ontwikkeling van kinders het, is verreikend. Internasionale literatuur beskryf agterstande en/of akwykings in die kommunikasie ontwikkeling van kinders wat met MIV/VIGS geinfekteer is. Die behoefte vir Vroeë Kommunikasie Intervensie (VKI) vir hierdie populasie word ook gemeld. Daar bestaan egter slegs ‘n beperkte hoeveelheid relevante, plaaslike literatuur met betrekking tot die spraak-, taal- en gehoorontwikkeling van kinders met MIV/VIGS binne die Suid-Afrikaanse konteks. Die doelwit van hierdie studie was om die kenmerke van ‘n groep kinders, wat met MIV/VIGS besmet is en by ‘n streekshospitaal in Gauteng behandel word, te beskryf. ‘n Kwantitatiewe, nie-eksperimentele, terugwerkende, dwarsdeurige, beskrywende navorsingsontwerp is gebruik. Die hoofdoelwit was bereik deur die kliniekrekords van kinders wat met MIV/VIGS besmet is, te analiseer deur van ‘n vooraf-ontwerpte merklys gebruik te maak. Data is ook ingesamel deur middel van vraelyste wat deur mediese dokters, wat by MIV/VIGS klinieke binne die hospitale werk, voltooi is. Dit het toegelaat dat die persepsies en praktyke van die mediese dokters ook beskryf kon word. Resultate het getoon dat die meerderheid kinders met MIV/VIGS, wat by klinieke behandel word, se immuunsisteme ernstig onderdruk was en dat hulle met stadium III of stadium IV van MIV/VIGS gediagnoseer was. Die resultate het verder ook die voorkoms van verskeie opportunistiese infeksies en MIV/VIGS geassosieerde toestande aangedui. ‘n Positiewe bevinding was dat 76% van die kinders (n=153), wat met MIV/VIGS geinfekteer was, tydens die proses van data-insameling reeds Hoogsaktiewe Antiretrovirale Terapie (HAART) ontvang het. Die mees uitstaande bevinding was dat slegs ‘n geringe hoeveelheid kinders met MIV/VIGS by die kliniek, as met ‘n agterstand en/of afwyking in spraak, taal en/of gehoor, aangeteken is. Beperkte verwysings na ander professionele persone is ook in die kliniekrekords opgemerk. Verwysings was beperk tot Maatskaplike Werkers en Dieëtkundiges. Daar was slegs een aantekening van ‘n kind wat vir behandeling na ‘n Spraak- en Taalterapeut en Oudioloog verwys is. Dit is egter onduidelik of daar werklik meer verwysings na ander professionele persone gemaak is, maar net nie in die kinders se kliniekrekords aangedui is nie, of dat daar werklik min verwysings na ander professionele dissiplines gemaak is. Bykomend, was die resultate van voltooide vraelyste deur mediese dokters, wat met die pediatriese MIV/VIGS populasie in die kliniek werk, insiggewend. Bevindings dui aan dat die meerderheid proefpersone, wat aan die studie deelgeneem het, van mening is dat kinders wat met MIV/VIGS besmet is wel ‘n hoër risiko toon vir ontwikkelings- en kommunikasie agterstande en/of afwykings in vergeleke met die algemene populasie. Die proefpersone is verder ook van mening dat hierdie populasie wel van spraak- en taalterapie en/of oudiologiese intervensie sal baatvind. Proefpersone het verder aangedui dat mediese dokters, wat met die pediatriese MIV/VIGS populasie werk, nie ten volle ingelig is omtrent die effek van MIV/VIGS op kommunikasie ontwikkeling en dat hulle van verdere opleiding sal baatvind. Die behoefte vir verdere navorsing in die veld van pediatriese MIV/VIGS en kommunikasie ontwikkeling, binne die Suid-Afrikaanse konteks, word in hierdie studie beskryf. Dit sal as riglyn vir VKI dienslewering aan hierdie populasie dien. Daar is ook ‘n groot behoefte vir verdere opleiding van ander mediese professionele persone met betrekking tot pediatriese MIV/VIGS en die effek wat die op die kind se kommunikasie ontwikkeling het. / Dissertation (MCommunication Pathology)--University of Pretoria, 2010. / Speech-Language Pathology and Audiology / unrestricted

Text in English with abstracts and keywords in English, Tswana and Sepedi / Providing support to employees living with HIV to adhere with treatment at home and at work is the key to prolong life and wellbeing of those who are infected and affected by HIV/AIDS pandemic. This study was qualitative explorative research. The study used qualitative method of collecting data which allowed the researcher to conduct interviews at the natural settings where it was convenient for participants to take interview calls. The purpose of this study was to explore how implementation of ART programmes support employees living with HIV (ELWHIV) to adhere with treatment at home and work so that gaps and areas of improvement are identified. The study took place at SWHAP companies that are based in Ekurhuleni, Gauteng. The study used purposive sampling to identify key informants who were directly involved in the implementation of the ART programmes. Data was largely analysed using content, thematic and triangulation analysis. Theory of social ecology and empowerment theory were applied as companies are seen using workplaces as safe space to provide counselling and psychosocial support to ELWHIV through Reality Wellness. Findings: The findings of the study revealed that ART programmes are in place in SWHAP companies and are also ongoing. The study also reveals that Reality Wellness provided counselling and psychosocial support to ELWHIV to adhere with treatment at home and at work. The study further reveals that ELWHIV fear to disclose their HIV status because of stigma and discrimination. Recommendations: More dialogue and further studies on ART programmes particularly on ART adherence at home and at work need to be done. Management should take ownership and get involved directly with ART programmes and enhance support to ELWHIV to adhere with treatment at home and at work. / Go tshegetsa badiri ba ba tshelang ka mogare wa HIV gore ba obamele tiriso ya kalafi kwa gae le kwa tirong go botlhokwa go tshegetsa botshelo le itekanelo ya ba ba tshwaeditsweng le ba ba amilweng ke leroborobo la AIDS. Thutopatlisiso eno e ne e lebelela mabaka mme e tlhotlhomisa. Mokgwa wa go lebelela mabaka go kokoanya data o letlile mmatlisisi go dira dipotsolotso mo mafelong a tlwaelo a banni-le-seabe moo go neng go le bonolo mo go bone go araba megala ya dipotsolotso. Maikemisetso a thutopatlisiso eno, e ne e le go tlhotlhomisa ka moo go tsenngwa tirisong ga mananeo a ART go tshegetsang badiri ba ba tshelang ka HIV (ELWHIV) ka go na go obamela tiriso ya kalafi kwa gae le kwa tirong gore go kgone go supiwa diphatlha le dikarolo tse di ka tokafadiwang. Thutopatlisiso e dirilwe kwa ditlamong tsa SWHAP tse di kwa Ekurhuleni, Gauteng. Go diragaditswe mokgwa wa go tlhopha sampole go ya ka maikaelelo a thutopatlisiso go supa basedimosetsi ba botlhokwa ba ba neng ba na le seabe ka tlhamalalo mo go tsenngweng tirisong ga mananeo a ART. Go lokolotswe data go dirisiwa molokololo wa diteng, morero le tiriso ya melebo e e farologaneng go lokolola. Go dirisitswe tiori ya ikholoji ya loago le tiori ya maatlafatso ka ntlha ya fa ditlamo di bonwa di dirisa mafelo a tiro jaaka dibaka tse di bolokesegileng tsa go tlamela tshegetso ya maikutlo le tshegetso ya tlhaloganyoloago go badiri ba ba tshelang ka HIV ka itekanelo ya nnete. Diphitlhelelo: Diphitlhelelo tsa thutopatlisiso di bontsha gore mananeo a ART a gona mo ditlamong tsa SWHAP mme a tswelela pele. Itekanelo ya nnete e tlamela ka tshegetso ya maikutlo le ya tlhaloganyoloago go badiri ba ba tshelang ka HIV gore ba obamele tiriso ya kalafi kwa gae le kwa tirong. Gape thutopatlisiso e bontsha gore badiri ba ba tshelang ka HIV ba tshaba go senola seemo sa bona sa HIV ka ntlha ya sekgobo le go tlhaolwa. Dikatlenegiso: Go tshwanetse ga nna le dipuisano le dithutopatlisiso tse dingwe tsa manaeo a ART, bogolo segolo kobamelo ya tiriso ya ART kwa gae le kwa tirong. Botsamaisi bo tshwanetse go nna beng ba, e bile bo nne le seabe ka tlhamalalo mo mananeong a ART le go tshegetsa badiri ba ba tshelang ka HIV gore ba obamele tiriso ya kalafi kwa gae le kwa tirong. / Go fa bašomi bao ba phelago ka HIV gore ba obamele go nwa dihlare ka gae le mošomong ke selo se bohlokwa go dira gore ba phele lebaka le letelele le gore bao ba fetetšwego le go angwa ke leuba la AIDS ba phele gabotse. Dinyakišišo tše di bile tša boleng le tša go utolla. Mokgwa wa go kgoboketša tshedimošo wa boleng o kgontšhitše monyakišiši go dira dipoledišano ka seemong sa tlhago sa mokgathatema fao go bilego bonolo go yena go araba megala ya dipoledišano. Maikemišetšo a dinyakišišo tše e bile go utolla ka fao go tsenya tirišong ga mananeo a ART go thekgago bašomi bao ba phelago ka HIV (ELWHIV) go obamela go nwa dihlare ka gae le mošomong gore dikgoba le dibaka tša kaonafalo di tsebje. Dinyakišišo tše di dirilwe ka dikhamphaning tša SWHAP tšeo di lego ka Ekurhuleni, Gauteng. Go dira sampole ka maikemišetšo go phethagaditšwe ka nepo ya go tseba baseboši ba bohlokwa bao ba bego ba kgatha tema thwii ka mananeong a ART. Tshedimošo e sekasekilwe ka go šomiša tshekatsheko ya diteng, ya morero le ya seemokhutlotharo. Teori ya ekholotši ya leago le theori ya maatlafatšo di dirišitšwe ka ge dikhamphani di bonwa e le tšeo di šomišago mafelo a mošomong bjalo ka mafelo ao a bolokegilego a go fana ka keletšo le thekgo ya tša menagano go ELWHIV ka go diriša temogo ya seemo sa makgonthe. Dikutollo: Dikutollo tša dinyakišišo di utolla gore mananeo a ART a tsentšwe tirišong ka dikhamphaning tša SWHAP ebile a tšwela pele. Temogo ya seemo sa makgonthe e fana ka keletšo le thekgo ya menagano go ELWHIV ka nepo ya gore ba omabele go nwa dihlare ka gae le mošomong. Dinyakišišo di tšwela pele go utolla gore ELWHIV ba tšhoga go tsebagatša maemo a bona a HIV ka lebaka la kgobošo le kgethologanyo. Ditšhišinyo: Dingangišano tše dingwe le dinyakišišo go tšwela pele ka go mananeo a ART, kudukudu mabapi le go obamela go nwa dihlare tša ART ka gae le mošomong, di swanetše go dirwa. Ba taolo ba swanetše go tšea maikarabelo a mananeo a ART le go kgatha tema ka go ona thwii le go maatlafatša thekgo go ELWHIV ka nepo ya go obamela go nwa dihlare ka gae le mošomong. / Health Studies / M.A. (Social Behaviour Studies in HIV/AIDS)

Human immunodeficiency virus type 1 (HIV-1) still causes a chronic infection that affects millions of individuals worldwide. The infection remains incurable and presents a huge challenge for treatment, as it tends to disable a patient’s immune system. Although the current HIV-1 treatment regime possesses the ability to reduce the viral load to undetectable limits, complete eradication of the virus cannot be achieved while latent HIV-1 reservoirs go unchallenged. These viral reservoirs are established early on during HIV-1 infection and are a major hurdle since they remain unaffected by antiretroviral drugs and have the ability to replenish systemic infections once treatment is interrupted. Further ailments with the highly active antiretroviral therapy (HAART) include issues such as the cumbersome lifelong treatment, development of drug resistant strains of HIV-1 and adverse side effects. Contrarily, early diagnosis of the HIV-1 infection and HIV-1 treatment is a major challenge in resource-limited countries. The current available diagnostic tools for HIV-1 infection have shown to be highly accurate in monitoring CD4+ T lymphocyte count and viral load measurements. However, these tests such as enzyme-linked immunosorbent assay (ELISA) and polymerase chain reaction (PCR) which are highly efficient, are usually very expensive with complex operation, time consuming, require skilled personnel and training that makes them incompatible for the application in resource-limited areas. Therefore, this raises the urgent need for developing an HIV point of care (POC) diagnostic tool that is label-free, highly specific and sensitive as well as therapeutic modalities, which can be used to address the previously mentioned challenges. Much research has been conducted to resolve these problems but to date, there has not been application of laser and/or photonics in HIV research. Therefore, in this thesis a femtosecond laser was used in HIV infected cells for targeted antiretroviral drug delivery while preserving their viability. For the first time according to our knowledge, antiretrovirals (ARVs) that target all the life stages of the HIV-1 life cycle were utilized and they proved to be significant in reducing HIV-1 infection. Furthermore, through the employment of a continuous wave laser at 640 nm, for the first time, surface plasmon resonance was conducted to facilitate label-free detection of HIV-1. Success of these laser based technologies will open doors for incorporation in POC HIV diagnostic tools for the detection and treatment monitoring of HIV in resource-limited settings. / Physics / Ph. D. (Physics)

The aim of this study was to assess the extent on how effective was the prevention of mother-to-child transmission of Human Immunodeficiency Virus (HIV) infection at Oshakati District Health Centre. Explanatory survey was used to conduct the research. A total of 160 nurses experienced in prevention of mother-to-child transmission and women who attended antenatal care and post natal care services participated in the study. Respondents expressed unsatisfactory with the promoting involvement of male partners, high quality voluntary counselling and testing services, couple counselling and testing, integration of Highly Active Antiretroviral Therapy services, administration of short course of Zidovudine to pregnant mothers and the provision of antiretroviral drugs to infants. Therefore, promoting involvement of male partners, couple counselling and testing, administration of short course of Zidovudine to pregnant mothers and educating women about exclusive breastfeeding prior to delivery are some of recommendations for effective prevention of mother-to-child transmission of HIV infections. / Health Studies / M.A. (Public Health)

The research objectives were to describe the age and gender of adult HIV positive clients on ART who received IPT; the incidence of tuberculosis among clients that received IPT and the defaulter rate among those that were commenced on IPT. Quantitative non-experimental descriptive retrospective cohort study was undertaken to ascertain the incidence of tuberculosis among adult HIV positive clients who received IPT. 104 clinic records of HIV positive adult clients accessing care at Isithebe Clinic, iLembe-South Africa who were commenced on IPT between 01 July 2010 and 30 November 2011 were analysed. The study found that 66 of 104 (63.5%) study respondents completed the course of IPT and the majority of those that defaulted were due to poor quality of care. Gender was statistically found to have played a role on whether a patient completes IPT. None of the study respondents that completed IPT was diagnosed with TB disease. / Health Studies / M.A. (Public Health)

No description available.

The research objectives were to describe the age and gender of adult HIV positive clients on ART who received IPT; the incidence of tuberculosis among clients that received IPT and the defaulter rate among those that were commenced on IPT. Quantitative non-experimental descriptive retrospective cohort study was undertaken to ascertain the incidence of tuberculosis among adult HIV positive clients who received IPT. 104 clinic records of HIV positive adult clients accessing care at Isithebe Clinic, iLembe-South Africa who were commenced on IPT between 01 July 2010 and 30 November 2011 were analysed. The study found that 66 of 104 (63.5%) study respondents completed the course of IPT and the majority of those that defaulted were due to poor quality of care. Gender was statistically found to have played a role on whether a patient completes IPT. None of the study respondents that completed IPT was diagnosed with TB disease. / Health Studies / M.P.H.

No description available.