South Africa's HIV prevalence rate is estimated to be 5.7 million and at the end of2007 a total of 45845 HIV/AIDS adult patients were taking antiretroviral therapy (ART). The global incidence of HIV/AIDS has been slowly decreasing over the years but is still widespread. This disease is still more prevalent in sub-Saharan Africa than in other parts of the world, with more than 60% people living with HIV/AIDS. Highly active antiretroviral therapy (HAART), the treatment of choice, slows the progression of the human immunovirus but demands a high adherence rate in excess of 95%. Patients who are poorly informed about antiretrovirals (ARVs) and misunderstand medicine-taking instructions or experience unexpected side effects may interrupt therapy, predisposing them to the development of resistance. Such patients need information but, given the poor literacy skills prevalent in South Africa, written information is often not fully comprehended and is often written at too high a reading level. The objectives of this research project were to design, modify and evaluate HIV / AIDS patient education materials for low-literate isiXhosa speaking adults residing in Grahamstown and to examine their impact on the understanding of various aspects of the disease and its treatment. Pictograms illustrating common side effects of ARVs (e.g. stavudine, efavirenz, lamivudine), as well as various sources 'for purchasing nonprescription medicines, storage and medicine-taking instructions were designed and evaluated both qualitatively, using group discussions, and quantitatively through individual interviews where interpretation of the pictograms was assessed. These pictograms were incorporated in a patient information leaflet (PIL) which had been specifically designed for people with limited reading skills and was a simple document containing the minimum of essential text. A previously developed PIL was modified in collaboration with the target population and two versions were produced, one incorporating pictograms illustrating side effects, the other with none. Pictograms were used in both to illustrate other medicine-taking instructions. The PILs were tested objectively to assess the readability, format, content, and general design. They were translated into isiXhosa prior to being qualitatively and quantitatively evaluated in a low-literate isiXhosa speaking population. Understanding of the PILs was assessed by asking a series of questions about the PIL content. Participant opinion of the readability and appearance of the PIL was recorded. The relationship between PIL understanding and selected demographic variables was investigated. Findings from this study illustrated that well designed pictograms assist in the location of information in written leaflets and they may enhance understanding of the information. It was further demonstrated that education influences total understanding of PIL content thus emphasizing the need for tailor-written information in accordance with the education level of the target population. A desire to receive PILs incorporating pictograms was expressed by the majority of participants. Collaboration with the intended target population is essential to design culturally acceptable, easily interpreted pictograms and to produce user-friendly, easy-to-read, comprehensible patient education materials. The rigorous, iterative design, modification and testing process described in this study is one that should be adopted in producing all health-related education materials.

This qualitative study explored traditional healers’ perceptions on collaborating with bio medical professionals. Purposive sampling was used to select study participants, and individual in-depth interviews were used to collect data. Thematic data analysis was conducted. The main findings of the study were that healers are very popular and highly respected amongst African communities. Traditional healers experienced mistrust and disrespect by biomedical health professionals who demonstrated ignorance on traditional medicine. Lack of motivation, incentives and financial support to conduct collaboration activities was another key finding including lack of clear policies and management structures for collaboration. Due to concern for their patients, healers resorted to practising covert collaboration such as not using official referral slips. Positively, healers experienced transformation in terms of knowledge gained from the training on basic HIV-TB epidemiology. There was clear evidence of high ethical practices amongst healers where they put their patients’ welfare ahead of their business interests / Health Studies / M.A. (Public Health)

MAAS / Centre for African Studies / The study sought to explore the use of traditional healing modalities in the provision of mental illness in the Vhembe district of Limpopo province. Traditional medicine has been used for thousands of years by indigenous people in South Africa and Africa as a whole, and demonstrated efficacy in treating a wide range of health issue. Many of the medicines in contemporary biomedical treatment are derived from plants and herbs used by indigenous people throughout the world. The objectives of the study were to describe the profile of the clients that visit the traditional healers, to explain traditional healers’ diagnostic strategies of mental illness, to explain the traditional healing treatment modalities in the treatment of various forms of mental illness and to discuss traditional healers’ prevention methods of mental illness. The study was guided by indigenous theory of health and illness as a theoretical framework, and for supporting the literature, a theory of African perspective theory was used. A qualitative research approach was used in order to have an in-depth understanding of the modalities of traditional healing in the provision of mental health care. Case study approach was used. Participants were selected purposively around Vhembe district in Limpopo province and snowball sampling technique was applied in order to identify and recruit relevant participants. The researcher conducted semi -structured interviews to gather the relevant data. Data analysis was based on the interpretative philosophy that aimed at examining meaning and symbolic content of qualitative data. Thematic analysis method was employed. The findings of the study confirmed that traditional healing is still widely used in the communities in the provision of mental illness and that there are a variety of diagnostic, treatment and prevention methods in the provision of mental illness. The findings also show that as much as there are challenges facing traditional healing in treatment of mental illness, there is a need to introduce their modalities in the healthcare system of South Africa, Africa and the whole world. Programs that aim to educate the communities about traditional healing modalities should also be established by the Department of Health and the relevant stakeholders such as traditional healers’ organizations. / NRF

MSc (Microbiology) / Department of Microbiology / BACKGROUND: Antibiotic resistance amongst microbial pathogens has become a challenge over past decades, bringing about genuine and frequently deadly contaminations that can't be dealt with by ordinary means. This has led to a search on developing solutions to this problem by searching for new source of antimicrobial agents or chemically altering the existing ones. Traditional medicinal plants and nanoparticles are highly targeted as promising agents to address the challenge. Pyrenacantha grandiflora Baill from Icacenaceae family possess pharmaceutical activities and is used by Vhavenda people to cure gastrointestinal related infections, diarrhea and tooth pain. OBJECTIVES: The present study aimed to synthesize, characterize and evaluate the efficacy of Pyranacantha grandiflora extracts alone and when conjugated with selected nanoparticles against pathogenic microorganisms. Furthermore, this study investigated the efficacy of selected antibiotics when conjugated with nanoparticles against selected pathogenic microbes. METHODS: Pyrenacantha grandiflora Baill (tubers) were collected from Masisi area. Bioactive compounds were extracted using different solvents such as methanol, acetone, hot water, dichloromethane and chloroform. Preliminary phytochemical screening was done to identify different phytochemicals in the extracts and their functional groups were identified by Fourier Transform Infrared spectroscopy (FTIR). Extracts were further assessed for their total phenolic and flavonoids content. Thin layer chromatography was used to separate the compounds from the plant extracts and active compounds/group of compounds were identified by bioautography. The antioxidant ability of the extracts to scavenge free radical DPPH was also determined. Silver and gold nanoparticles were synthesized using chemical and biological methods, characterized by Ultraviolet-Visible Spectrophotometry (UV-VIS), Transmission Electron Microscopy (TEM) and Energy dispersive X-ray analysis (EDX). Plant extracts, nanoparticles and antibiotics were xix conjugated differently, and conjugates were analyzed by FTIR and their antimicrobial activities were evaluated against different bacteria and fungi. The conjugates were tested for antimicrobial activity against extended beta-lactamase producing Escherichia coli (ATCC 35218), Escherichia coli (ATCC 25922), methicillin-resistant Staphylococcus aureus (ATCC 25923), methicillin-susceptible Staphylococcus aureus (ATCC 33591) and beta-lactamase producing Klebsiella pneumonia (ATCC 700603) using agar diffusion assay and the minimum inhibitory concentrations (MIC) were determined using the microdilution method. The minimum bactericidal concentration (MBC) and minimum fungicidal concentration (MFC) were determined by sub-culturing from the MIC plates on Mueller-Hinton Agar. RESULTS: Pyrenacantha grandiflora was found to contain phenolics, saponins, alkaloids, tannin, steroids, terpenoids and flavonoids. FTIR spectroscopic studies revealed different characteristic peak values with various functional compounds similar in most extracts but differed with transmittance values. The total phenolic contents in the examined extracts ranged from 14.167 to 19.02 mg GA/g. The total flavonoid content in the examined extracts ranged from 26.603 to 34.621 mg QE/g. Thin-layer chromatography revealed various Rf values and when analyzed with bioautography, well-defined inhibition zones within the Rf value of 0.236 was identified against E. coli and K. pneumonia. The MICs of the extracts were determined, and all the extracts showed some antimicrobial activity against all tested strains ranging from 0.06-7.5 mg ml/g. Some extracts appeared to be fungicidal and hot water extracts were more active against Cryptococcus neoformans with the MFC value of 0.06 mg/ml. The methanol extract was also active against most tested strains including Candida tropicalis with the minimum fungicidal concentration value of 3.75 mg/ml. Pyrenacantha grandiflora tuber extracts conjugated with silver or gold nanoparticles exhibited a good antibacterial activity against all bacterial strain used and very few were able to exhibit bactericidal activity. Penicillin showed improvement of antibacterial activity xx when conjugated with compounds from the acetone extracts and vancomycin was found to be more effective when conjugated with silver nanoparticles and water extracts. CONCLUSION: The present study validated the efficacy of conjugated P. grandiflora tuber extracts which is used in traditional medicine. The results revealed that water extracts which are generally used by the traditional healers are active against most microorganisms tested as well as methanol and acetone extracts and the synergistic effect was observed when they were conjugated to gold and silver nanoparticles. The results of the present investigation clearly indicate that antimicrobial activity of Pyrenacantha grandiflora Baill tuber when conjugated with selected nanoparticles and antibiotics vary with test strain and the type of solvent used during extraction, thus giving hope for future development of drug leads. / NRF

Medicinal plants of Thulamela municipality are experiencing challenges due to human activities, resulting in some of the medicinal plants becoming difficult to find, declining, endangered or even extinct. Unsustainable harvesting is threatening the survival of certain medicinal plant species used as a source of primary healthcare in the area. This study investigates aspects related to traditional healers' perceptions with regard to collection, ethnobotanical importance and conservation status of indigenous medicinal plants used by traditional healers around Thulamela municipality. Information on medicinal plants was gathered by means of semi-structured interviews, field walks, personal observation and a literature review. A total of 90 medicinal plant species, which belong to 47 families, from a total of 82 genera commonly used by traditional healers to treat different ailments, were recorded. About 87% of traditional healers indicated that some medicinal plants are difficult to find; only 13% of healers did not experience difficulties in finding some medicinal plants. / Environmental Sciences / M. Sc. (Ornamental Horticulture)

A study of the relevant theoretical concepts and empirical research was undertaken to explore the role of the social worker pertaining to the problem of epilepsy in the black community of Mamelodi. The sample comprised 40 families in which there was a person with epilepsy. Data were obtained through an interview schedule administered by the researcher. The literature study highlighted the phenomenon epilepsy, causes of epilepsy/ psychosocial effects of epilepsy on the epileptic and his family and the treatment of the epileptic. However/ it became quite clear that a multi-disciplinary team approach is vital importance in the treatment of an epileptic Furthermore/ significant others like traditional healers, faith healers, priests, relatives and friends were identified as some of the important informal support systems. Although the findings of study cannot be generalised to the entire population they can be of great significance for further research. / 'n Studie van die relevante konsepte asook empiriese navorsing is gedoen om die rol van die maatskaplike werker met betrekking tot die probleem van epilepsie in die swart gemeenskap van Mamelodi te eksploreer. Die steekproef is saamgestel uit 'n groep van 40 gesinne met 'n epileptikus in hul midde. Inlighting is verkry deur groep van onderhoudskedule. Die literatuurstudie beklemtoon die volgende: die verskynsel van epilepsie, oorsake van epilepsie, psigososiale gevolge van epilepsie op die per soon met epilepsie en sy gesin en die behandeling van die epileptikus. Dit het egter duidelik na vore gekom dat 'n multi-dissiplinere spanbenadering van die uiterste belang is in die behandeling van die epilepsielyer. Dit het ook duidelik geword dat betekenisvolle ander persone soos tradisionele genesers, geloofsgenesers priesters, familie en vriende van die mees belangrike steunstelsels is. Alhoewel bevindinge van die studie nie veralgemeen kan word en van toepassing gemaak kan word op die bevolking as geheel nie, kan dit egter van groot belang vir verdere navorsing wees. / Social Work / M.A. (Social Science)

This study focuses on the use of the Athrixia phylicoides plant in Tshwane, Gauteng, South Africa. The plant is used within the domestic domain as a beverage, for medicinal purposes, as well as for the manufacturing of domestic brooms. The aim of the study was to investigate the use and market of Athrixia phylicoides in two of the Tshwane markets, namely; Denneboom and Marabastad. Case study design, participant observation and interviews were employed to collect data. A literature review was conducted to construct a theoretical framework. The study reveals that traditional healers, broom makers and customers have a remarkable knowledge about Athrixia phylicoides, which has been untapped thus far. In addition, the study indicates that possible extinction of the Athrixia phylicoides plant, due to over-harvesting and lack of conservation, will pose a challenge to the market. / Anthropology / M.A. (Anthropology)

A study of the relevant theoretical concepts and empirical research was undertaken to explore the role of the social worker pertaining to the problem of epilepsy in the black community of Mamelodi. The sample comprised 40 families in which there was a person with epilepsy. Data were obtained through an interview schedule administered by the researcher. The literature study highlighted the phenomenon epilepsy, causes of epilepsy/ psychosocial effects of epilepsy on the epileptic and his family and the treatment of the epileptic. However/ it became quite clear that a multi-disciplinary team approach is vital importance in the treatment of an epileptic Furthermore/ significant others like traditional healers, faith healers, priests, relatives and friends were identified as some of the important informal support systems. Although the findings of study cannot be generalised to the entire population they can be of great significance for further research. / 'n Studie van die relevante konsepte asook empiriese navorsing is gedoen om die rol van die maatskaplike werker met betrekking tot die probleem van epilepsie in die swart gemeenskap van Mamelodi te eksploreer. Die steekproef is saamgestel uit 'n groep van 40 gesinne met 'n epileptikus in hul midde. Inlighting is verkry deur groep van onderhoudskedule. Die literatuurstudie beklemtoon die volgende: die verskynsel van epilepsie, oorsake van epilepsie, psigososiale gevolge van epilepsie op die per soon met epilepsie en sy gesin en die behandeling van die epileptikus. Dit het egter duidelik na vore gekom dat 'n multi-dissiplinere spanbenadering van die uiterste belang is in die behandeling van die epilepsielyer. Dit het ook duidelik geword dat betekenisvolle ander persone soos tradisionele genesers, geloofsgenesers priesters, familie en vriende van die mees belangrike steunstelsels is. Alhoewel bevindinge van die studie nie veralgemeen kan word en van toepassing gemaak kan word op die bevolking as geheel nie, kan dit egter van groot belang vir verdere navorsing wees. / Social Work / M.A. (Social Science)

Sickness is a problem that has not escaped any society and thus is on the agenda of every culture. Since time immemorial cultures have searched for answers to the questions raised by the phenomenon of sickness but none have provided solutions, as it has become clear that sickness is part of our human existence. Many people have resorted to religion in search consolation in times of affliction and the Roman Catholic Church is not immune to this expectation, as we see many leaving the church in search of healing in the African Traditional Religions and other Christian churches because they feel that the church is inadequately dealing with the problem. In this study the author undertakes a research journey within the Diocese of Witbank of the RCC to investigate as to why the church’s healing ministry is not effective. Through engagement with participants in the research field and relevant literature the author discovered that the RCC is seen to be suspicious of the African worldview and consequently does not take its members’ fears and frustrations around the phenomenon of sickness serious as it judges them to be superstitious. This suggests that there is nothing that Western Christianity can learn from African cultures maintaining its superior attitude and further alienating indigenous communities. The author suggests that in order for the RCC to responds with relevance to this problem it needs to reconcile the Christian worldview, which is western, with the African worldview. He puts high on the agenda of Christian theology the urgent call to African theologians to develop an African theology that will give birth to a genuine African Christianity. In conclusion as a solution the author proposes an integrated and intercultural healing ministry for the Diocese of Witbank. This model is aimed at appropriating African values, idioms and language in the RCC to create an atmosphere where the church is seen as a welcome guest who comes bearing gifts but at the same time expects to be taken care of by its host. / Philosophy, Practical and Systematic Theology / M. Th. (Pastoral Therapy)

The purpose of this study was to explore and describe contributing factors that influence the perceptions of women with fibroids from diverse cultures regarding hysterectomy. The area of research was delimited to issues of hysterectomy among women with fibroid uterus. The study employed a descriptive explorative method and data were collected by means of structured questionnaires. The study was conducted in one academic referral hospital, over a period of six months. The respondents were the patients with fibroid uterus and the doctors and nurses in the gynaecological units of the hospital. The majority of the patients indicated that they were afraid of undergoing a hysterectomy because of the social stigma associated with this life-saving procedure, such as alienation or marginalization by members of their respective communities. The nursing staff and gynaecologists in the unit emphasized the deep-seated fear of hysterectomy amongst women from diverse cultures. The study found that women need information about their bodies and how they function. Health education is also needed for women and their communities. Research is needed amongst members of different communities and diverse cultures to voice their perceptions of women undergoing hysterectomy because of ill health. / Health Studies / M.A. (Health studies)