Philosophiae Doctor - PhD / The rapid expansion of the ART programme in South Africa has placed an additional service demand on an already stretched public health infrastructure. The main aim of this study was therefore to analyse the implementation of the ART programme in KwaZulu- Natal province using the Donabedian Model of structure, process and outcome in order to develop an ART delivery model. Ethical approval to conduct this research was issued by the University’s Senate Research Committee. The first phase of the study used a descriptive quantitative approach to review existing data from government departments to analyse the ART programme. A checklist with the list of indicators for the three elements of the study; the structure, process and outcome were used to collect data. A pilot study was conducted and the Cronbach Alpha test was used to determine the rigour of the study. In the second phase, a systematic review of studies on implementation of the existing models of ART programme was conducted using quantitative descriptive approach. The Quality Appraisal Tool was used to determine the validity of the research findings from the literature. In phase 3, both qualitative and quantitative approaches were used to conduct the Delphi study which included a group of experts in the field of HIV and ART programme. Responses from the participants were modified to determine the reliability of the study. The study found that there were structural problems such as shortages of antiretroviral drugs and delays in the return of laboratory results. The systematic literature review found that there were only two community-based ART models in South Africa, namely; the adherence clubs and community-based adherence clubs. These two models of ART delivery were implemented only in Cape Town.

In South Africa, two biotypes of type species 1 of the Lyssavirus genus are maintained independently among the members of the Herpestidae and Canidae families, respectively. Canid rabies is a relatively new addition to the African subcontinent, having been introduced from infectious cycles, which had existed among dogs in Angola, in the early 1940s. Two epidemics, believed to have originated from dog endemic regions which had existed in the southern Maputo district of Mozambique since 1952, have occurred among domestic dogs in the KwaZulu Natal province in recent years. The first of these epidemics started in 1964, and ended by 1968, while the second epidemic which started in 1976, has proven to be intractable, despite the concerted efforts which have been implemented to bring it under control. In order to contribute to the understanding of the molecular epidemiology of rabies in the KwaZulu Natal province, and to thereby assist in future surveillance and control efforts, we conducted a molecular sequence analysis of representative panel of viral isolates which were obtained from the province during the year 2003. A 591 nt. sequence encompassing the G-L intergenic region and glycoprotein cytoplasmic domain was sequenced for 128 viral isolates, which were obtained from the different magisterial districts and affected host species of the province, and was subsequently used to characterize these viruses phylogenetically. Characterization of the KwaZulu Natal variants, and comparison of the obtained sequence data, to sequences data which was obtained from rabies endemic regions from elsewhere in South Africa and Zimbabwe, in general supported the pattern of spread which led to the introduction of rabies into the province, as was previously suggested from the literature. The phylogeny which was established from the analyses, indicated that the viral isolates from the province were highly related to each other, and could be divided into two groups, which although belonging to the canid biotype, were in general distinguishable from canid rabies virus isolates which were obtained from elsewhere in South Africa and Zimbabwe. The observation that these subfamilies showed a low genetic divergence, as well as that they shared a unique recent common ancestor, suggested that they were introduced recently into the northern reaches of the province, probably from the same geographical region (i.e. southern Mozambique). logenetic characterization of the KwaZulu Natal isolates further suggested that at least three enzootic fronts are currently responsible for the introduction of rabies into the northern and southern regions of the province. The first of these fronts was hypothesized to have spread directly across the southern Mozambique border (possibly via southeastern Swaziland), into the northeastern coastal regions of KwaZulu Natal, while the second front represented the south-eastwards spread of synergistic dog-jackal cycles from southeastern Mpumalanga, into the northern and northeastern regions of the province. The third front on the other hand, represented the possible spread of a remnant infectious cycle, left over from the 1964-1968 epidemic, from the northern region of the Eastern Cape, into southern KwaZulu Natal. logenetic characterization further proved useful for identifying the distribution of viral variants, and allowed us to propose a pathway by which the disease might have spread throughout the province. The proposed pathway of spread suggested that viral variants may have been translocated over long distances, and highlighted the role that major routes of human transportation may play in the dissemination of the disease. The regional characterization of viral variants from KwaZulu Natal, further demarked the location where the identified viral variants circulated in individual host populations, allowing us to place the current epidemic into an epidemiological framework which attempts to explain the long term persistence of the disease. This provided clues as to the intractability of the second epidemic, and allowed us to develop a proposal as to how current control strategies may be altered, in order to contain the current outbreak in the province. initial phylogeny which was established from the study provides an epidemiological framework, which will play an important role in determining the origin of future human spillover cases, and for tracking the spread of viral variants throughout the affected regions of the province. It is further envisaged that the data which was generated during the course of the project will be utilized in future surveillance efforts, targeted to the evaluation of the efficacy of potentially implemented control campaigns. / Dissertation (MSc (Microbiology))--University of Pretoria, 2007. / Microbiology and Plant Pathology / unrestricted

In order to be able to determine the contribution of the tourism sector to the KwaZulu-Natal economy, the study starts by reviewing some economic indicators that show the contribution of different economic sectors to GDP and to the economy in general. Where possible a comparison was made with other provinces and the RSA. These comparisons showed that the KwaZulu-Natal economy still has many problems, such as a relatively low gross geographical product per capita and a high unemployment rate (32,2 per cent). However, it has the potential to be the largest contributor to the GDP of the country despite the political problems that are still prevalent in some areas of the province, and also the fact that it has the largest population compared to other provinces. The manufacturing sector is the highest contributor to GDP and during 1988 to 1994 its average contribution was 30,3 per cent, followed by trade and government sectors with 16 per cent and 13,4 per cent respectively. The study reviewed the economic principles underlying the tourism industry, and also attempted to put the tourism industry into perspective with other economic sectors. This revealed that the tourism industry by its nature falls into the category of service industries and that it is governed by the same economic principles that govern any market namely, demand and supply forces. Most importantly however, is the realisation that this industry has a significant macroeconomic impact, for example, on inflation, employment, balance of payments and economic growth. The study has attempted to elicit the views of those involved in tourism activities and through the use of secondary sources examined the position of the South African tourism industry to that in the world and more importantly the relative position of the KwaZulu-Natal tourism industry. This data showed that there is a steady increase in the tourists inflow from 1985 to 199 5 (from 728 000 to 4.5 million) and also revealed their spending patterns. Based on this data, projections were made for 1998 to 2006, and these projections are in line with most of the economic analysts' speculations that there will be a steady increase of foreign tourist arrivals for the next five to ten years. Thus, the study has taken both a qualitative and a quantitative approach. It was also found that in order for the tourism industry to contribute successfully to the economic growth of the province, it has to be properly developed and managed, which means that there has to be a policy that will guide the actions of all the interest groups, and all the appropriate structures has to be put in place following market development principles. The roles of different institutions, whether government, private sector or non-governmental organisations have to be defined and co-ordinated towards the same goals, that is, to have a tourism industry that is economically viable and that benefits all the communities. / Dissertation (MCom)--University of Pretoria, 2013. / Economics / unrestricted

This study presents an exploration of the structure, dynamics and utilisation of woody plants in vegetation units of northern Maputaland. Animal (in Tembe Elephant Park) and human (in the rural community of Manqakulane) utilisation of woody plants were compared against a control area (Tshanini Community Conservation Area) where animals were extirpated and people were precluded through tribal rules. The tree assemblages of the unique Sand Forest were explored, and compared with previous studies. A new classification was proposed and a new subcommunity was established. Contrary to previous studies, a gradient from Short to Intermediate to Tall Sand Forest was defined, and it was suggested that structurally different Sand Forest subcommunities represent a mosaic of different evolutionary states, rather than stationary states as perceived currently. Animal utilisation appeared to have transformed Sand Forest in conserved land to such an extent that it no longer resembled Sand Forest outside conserved areas. The structure of Sand Forest and woodlands of the region was evaluated at the vegetation unit level (21 vegetation units), through a size and height class distribution analysis of woody plants. Humans and animals had clearly modified the woodlands and appeared to force succession from closed woodland to open woodland. The Sand Forest appeared to benefit from low intensity animal utilisation, with increased diversity, and possibly enhanced dynamics. However, signs that current animal utilisation have negative effects were perceived. The size class distribution of Sand Forest and woodland woody species was presented and an analysis of species grain was performed. The grain concept was successfully applied to woodland species for the first time. It appeared that nearly all vegetation units were fine-grained, and therefore governed by small-scale dynamics. Frequent small disturbances are necessary to maintain diversity. There was cause for concern that current animal and human utilisation threaten such fine-scale dynamics. The utilisation level by the browsing mammals guild in Tembe Elephant Park and by small browsers and people in Manqakulane Rural Community were evaluated over two periods. Small to medium browsers utilised more woody species and height classes than any other agent, but with short-term effects. However, utilisation marks linked to elephants and people were accumulating significantly, and the long-term effects of these agents were threatening the dynamics of Maputaland vegetation. The case of woody species utilisation by elephants was evaluated further and compared with a previous study. Overall utilisation by elephants reached 100% of individuals for several woody species, while other species’ regeneration potential was severely threatened. Woody species preferred in 1994 were nearly extirpated. Utilisation of woody species by elephants throughout Tembe Elephant Park appeared correlated with distance to permanent water points during a dry spell. In conclusion, it appeared clear that policies in favour of high animal numbers in formally conserved areas were not suited for northern Maputaland and this result should be considered when the expansion of the South African protected areas of Maputaland into Mozambique becomes effective. Community-based conservation appeared promising, but novel ways of generating income should be investigated. / Thesis (PhD (Wildlife Management))--University of Pretoria, 2008. / Animal and Wildlife Sciences / unrestricted

This research article is an overview of the traditional and current cuisine of the Mbila community. The Mbila community lives in the area of Sodwana Bay, Maputaland situated on the north eastern coast of South Africa. The community has a high unemployment rate which leads to poverty. The promotion of the Mbila cuisine as a sustainable tourism product could be used to uplift the community. The tourism industry of Sodwana Bay was also investigated and discussed according to sustainable tourism principles. The focus was on the three aspects of sustainable tourism, namely: the economy, the environment and the host community. The main goal is to investigate and describe the traditional and current cuisine of the Mbila community and the place thereof in the tourism industry of Sodwana Bay. Guidelines for the implementation of the research project are provided. The implementation of the research project can play a positive role in the community. It could result in employment, entrepreneurial activities, improvement of infrastructure, development of secondary trades and the expansion of food production. There are other similar communities in South Africa that could benefit from the implementation of this research project. Copyright / Dissertation (M Consumer Science (Food Management))--University of Pretoria, 2007. / Consumer Science / unrestricted

If tourism is to contribute to the reduction of poverty and create employment, tourists also need to be attracted to smaller towns and rural areas. Development of rural tourism routes are often supply-side driven and the role of marketing is not well understood. This study therefore explores the experiences and insights of key supply-side stakeholders in two rural KwaZulu-Natal tourism routes, regarding the marketing of these routes, as well as the critical success factors that ensure future sustainable competitiveness, which may lead to local economic development and thus poverty relief. The researcher adopted an interpretivist epistemology along with subjectivist ontology, to allow for empathetic investigation of the perceptions of the stakeholders in rural tourism routes and of the marketing of such routes. Three approaches converged in the empirical study namely: a qualitative approach which allowed the researcher to gain more in-depth understanding of the factors related to route marketing; an exploratory approach which allowed the researcher to pursue new issues uncovered during the research process; and a case study approach which triangulates a variety of sources of information. Two very different routes were selected to provide wider insight into the research problem, namely the Midlands Meander and the Battlefields Route. The population was restricted to supply-side stakeholders and semi-structured, in-depth interviews were conducted with 29 respondents, selected through a combination of purposive and snowball sampling. The literature review explores rural tourism as a catalyst for economic development. The role of stakeholders in tourism routes is examined and the range of stakeholders is identified. The concept of societal marketing as an orientation that may give support to local economic development is explored. Destination marketing and the destination marketing mix, is discussed as the foundation of tourism route marketing. Particular attention is paid to destination branding and positioning, and a number of critical success factors in destination marketing are identified. The nature of tourism route marketing, the elements in the route marketing mix, and critical success factors in rural tourism route marketing are identified from the literature. The marketing practices of several international rural tourism routes are examined to determine good practice. Existing marketing activities and structures within KwaZulu-Natal are described as the background against which the two routes market their offerings. The empirical findings of the study reports on the benefits of rural tourism routes as perceived for various stakeholders. The roles of product owners on the route, the local community, and municipal and tourism marketing structures are described. Strategic route marketing issues are reported on, including sustainability of a route, insufficient visitors, responsibility to market the route, market targeting and factors that impact on marketing success. The elements of the route marketing mix are reported on with reference to the route product offering and experience, people, physical evidence and signage, pricing, and promotion. The study revealed a number of enabling factors that need to be in place for a route to succeed, namely leadership and co-operation on all levels; a functional route structure with broad representation; financial viability of the route; and route accessibility and signage. Several factors critical for the successful marketing of rural tourism routes are identified. These include the establishment of a strong identity and brand; providing a unique experience; balancing the route product mix, promotion of the route by all stakeholders; and effective use of electronic media. Recommendations are made for further research on rural tourism routes. / Dissertation (MPhil)--University of Pretoria, 2011. / Tourism Management / unrestricted

In South Africa, trypanosomosis also known as Nagana, transmitted by Glossina brevipalpis and G. austeni, is the major cause of anaemia and chronic debilitating condition in cattle. There is a wealth of entomological information on the ecology of the two tsetse species generated following the devastating outbreak in cattle due to Nagana in 1990. However, it is unfortunate that these entomological data has not been supported by parallel studies on the epidemiology of the disease. Therefore, the present study presents the first intensive epidemiological investigations since 1990 to address the problem of animal trypanosomosis in South Africa. The relationship between trypanosomes herd average prevalence (HAP), herd average anaemia (HAA) and herd average packed cell volume (HA-PVC) were investigated in cattle in three communal diptanks located by the Hluhluwe-uMfolozi Game Reserve by regular monthly sampling for 15 months. The tsetse challenge with G. brevipalpis in two of the diptanks, Mvutshini and Ekuphindisweni, was high but low in the third (Ocilwane). In addition, G. brevipaplis and G. austeni coexist in Mvutshini diptank. This high and low tsetse challenge presented different disease scenarios. Cattle at Mvutshini and Ekuphindisweni diptanks had the highest HAP of 12.3% and 8.9%, respectively, which is significantly different (p = 0.001) from the HAP obtained from cattle at Ocilane (2.9%). Both cattle herds at Mvutshini and Ekuphindisweni diptanks also had the highest HAA, 27.7 and 33.4%, respectively, while cattle at Ocilwane had the lowest, 11.1% (statistically different; p = 0.001). Conversely, cattle at Ocilwane diptank had the highest HA-PCV, ranging between 29-32% while cattle at Mvutshini and Ekuphindisweni diptanks had the lowest HA-PCV (24-29%). The interaction between HAP and HAA is significant (p = 0.021). The overall effect of HAP on the animal health condition is clearly demonstrated when comparing the anaemia in trypanosomes infected and uninfected cattle at the 3 diptanks. Fifty percent, 63% and 100% of trypanosomes infected cattle were anaemic at Mvutshini, Ekuphindisweni and Ocilwane diptanks, respectively. In comparison, the prevalence of anaemia in uninfected cattle in the 3 diptanks was 20, 30 and 10% at Mvutshini, Ekuphindisweni and Ocilwane diptanks, respectively. By combining the data from the 3 diptanks (1,800 observations), the overall HAA in infected and uninfected cattle was 62 and 20%, respectively The results of trypanosomes seasonal surveys conducted at 7 communal diptanks in tsetse infested areas, showed that all cattle at the diptanks were infected with trypanosomes with mean HAP and HAA of 10.3 and 35.3%, respectively. The highest HAP (range 15-31%, n=4) was recorded in Ngwenyambili diptank. This high infection in the cattle herds produced high values of HAA (50%; range 40-60). The infection rate with trypanosomes in G. brevipalpis caught from the field showed immature infections in the midgut of 3.5% (16/458) while only one fly was found with mature infection in the proboscis (1/458, 0.22%). Very few G. austeni were collected (total of 9) during the same period and dissected. The infection rate with trypanosomes immature and mature infections was found to be very high; 5/9 (55.5%). Blood samples were collected from a total of 132 buffaloes randomly immobilized for tuberculosis testing by the Hluhluwe-uMfolozi Game Reserve Authority. Two buffaloes were found to have T. congolense infection by the buffy coat technique. The presence of trypanosomes infected buffaloes in this study confirms the occurrence of sylvatic cycle at the tsetse/livestock/Hluhluwe-uMfolozi Game Reserve, thus, presenting a high risk of serious disease to cattle. The objective of the study on the strategic treatment of trypanosomosis conducted on one farm in endemic area was to treat adult cows and calves at an arbitrary HAP threshold before the disease produces any clinical symptoms or production losses. The strategic use of ethidium bromide and novidium chloride produced attractive results whereby cattle were protected for an extended period of 3 to 6 months with no development of anaemia during this period. Therefore, two to four treatments per year may be sufficient to keep cattle productivity on the farm under the tsetse challenge Copyright / Dissertation (MSc)--University of Pretoria, 2012. / Veterinary Tropical Diseases / unrestricted

Babesia bovis outbreaks were reported in cattle alleged to be immunised with the commercially available live-blood vaccine in the Swartberg region of KwaZulu-Natal, South Africa and an investigation into the nature of parasites causing the outbreaks was carried out. The H isolate was obtained from a clinically ill animal on the Haistings farm and characterised using BvVA1 and Bv80 size analysis coupled with Bv80 and 18S rRNA V4 hypervariable region sequence analysis. In total, four South African B. bovis isolates were analysed: the vaccine stock (S) at passage 11 and 23 and field isolates H and F. The S23 strain used to infect vaccine donor animals could not be detected in the H isolate and could not be responsible for the severe disease symptoms observed in the field animals. Sequence profiles of the Bv80 and 18S rRNA V4 hypervariable regions for all detectable strains were compiled and now serve as a basis for the investigation of future babesiosis outbreaks. It was determined that the Bv80 PCR is not able to detect animals at the carrier stage of infection and that non-specific primer binding to Boophilus microplus and Boophilus decoloratus tick DNA occurs. For this reason, the Bv80 PCR is not suitable for investigating the nature of B. bovis infections in ticks. The BvVA1 PCR reaction required extensive optimisation and did not detect all strains present in the isolates and was therefore not used as a basis for strain discrimination. Microaerophilous stationary phase cultures of the vaccine strain at passage 24 (S24) and the H strain were initiated as a potential source of soluble parasite antigens. Continuous cultivation was not possible despite the alteration of a number of conditions. Currently there is no culture adapted B. bovis strain in South Africa and the availability of such a strain would form the basis of studies on the development of alternative vaccines. / Dissertation (MSc)--University of Pretoria, 2008. / Veterinary Tropical Diseases / unrestricted

The objective of this study was to use molecular biological reagents (primers targeting different genomic loci) and methods (PCR and RFLP) to detect and characterize trypanosomes in cattle, wild animals and tsetse flies in KwaZulu-Natal, thus contributing to improved understanding of the genetic diversity of trypanosome species infecting cattle at the game/livestock interface in the KwaZulu-Natal Province of South Africa. Primers based on sequences of different loci in the trypanosome genome were used in conducting polymerase chain reactions (PCRs) on samples collected from cattle at 14 diptanks and one commercial farm around the Hluhluwe-Umfolozi Game Reserve, wild animals within Hluhluwe-Umfolozi Game Reserve and tsetse flies from the commercial farm, Hluhluwe-Umfolozi Game Reserve and two other Game Reserves. Trypanosome isolates were grown under laboratory conditions in cattle, rodents and culture medium for molecular characterizations. Overall, a total of 673 cattle, 266 tsetse flies, 141 buffaloes and 6 rhinoceros samples were analyzed. The following observations were made: two species of trypanosomes are present in KZN; T.congolense and T. vivax. The two species were found as single and as mixed infections in cattle. There are two genotypic groups of T. congolense in KZN; the Savannah- and the Kilifi-type. The two genotypic groups were found as mixed infections in cattle and in tsetse flies. Lastly, there are at least five “genomic variants” of Savannah-type T. congolense in KZN. The infection rate in cattle ranged from 5.2-91%; in tsetse flies, 11-97.5% and in wild animals it was 4.3%. Mixed infection of T. congolense and T. vivax were only observed in samples from one diptank. Mixed infections of Savannah- and Kilifi-type T. congolense were observed in samples from Boomerang commercial farm, and in tsetse flies. Copyright / Dissertation (MSc)--University of Pretoria, 2008. / Veterinary Tropical Diseases / unrestricted

A total of 143 blood samples of nyala (Tragelaphus angasii) from two regions in South Africa were tested for the presence of tick-borne haemoparasites by means of polymerase chain reaction (PCR) and reverse line blot (RLB) hybridisation. While most blood samples taken in EDTA blood turned out negative for the presence of haemoparasites, the majority of blood samples collected on Whatman® filter paper contained several different haemoparasites, often in combination. Samples from the Eastern Cape Province as well as from KwaZulu- Natal turned out positive. Prevalent haemoparasites were Theileria sp. (kudu), T. buffeli, T. bicornis, Theileria sp. (sable), T. taurotragi, Ehrlichia sp. Omatjenne, Anaplasma bovis and A. marginale. This serves as the first report of T. buffeli, T. sp. (kudu), T. bicornis, T. taurotragi, Ehrlichia sp. Omatjenne, A. marginale and A. bovis in nyala. Copyright / Dissertation (MSc (Veterinary Tropical Diseases))--University of Pretoria, 2009. / Veterinary Tropical Diseases / unrestricted