ETD Collection

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    The influence of infant feeding practices on infant mortality in Southern Africa.
    (2014-09-17) Motsa, Lungile F.
    Context: Despite the many initiatives implemented over the past decades as part of the global priority on child survival, there still exists high infant mortality in Southern Africa. Although studies have examined factors contributing to poor child health outcomes including the effect of the HIV/AIDS pandemic, there is paucity of studies on the possible effect of infant feeding practices on infant mortality in the region. This study examines the association between infant feeding practices and infant mortality in Southern Africa. The need to reduce infant mortality is a global health concern hence the United Nations through the Millennium Development Goals (MDGs) declared the reduction of infant and child mortality as one of its major targets by the year 2015. Methods: A merged dataset from the most recent Demographic and Health Surveys for Lesotho, Swaziland, Zambia and Zimbabwe was analysed in this study. A total number of 13, 218 infants born in the last five years preceding the surveys whose information on infant feeding practices was available formed the analysis sample. The outcome variable was infant mortality and infant feeding practices which had the categories, no breastfeeding, partial breastfeeding and exclusive breastfeeding was the main explanatory variable of the study. Other explanatory variables used in the study pertained to maternal demographic and socioeconomic characteristics as well as the infants’ bio-demographic characteristics. The Cox Hazard Regression Model was employed to examine both the unadjusted and adjusted effect of infant feeding practices on infant mortality in Southern Africa. Results: Although, exclusive breastfeeding was quite low (12%), its mortality reduction effect was significant, and infants who were exclusively breastfed exhibited a 97% lower risk of dying during infancy compared to no breastfeeding in the region. Further, variations exist by country in the levels and patterns of both infant mortality and infant feeding practices. Country, highest educational level, marital status, sex of child, preceding birth interval and birth weight were the significant predictors of infant mortality in Southern Africa. Conclusions: Overall, the study found that any form of breastfeeding whether exclusive or partial breastfeeding greatly reduces the risk of infant mortality, with the mortality reduction effect being higher among exclusively breastfed infants in the Southern African region. Thus, in order to reduce the upsurge of infant mortality, there is need to step up the effectiveness of child nutrition programmes that promote breastfeeding and put emphasis on exclusive breastfeeding of infants in the region.
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    Spatial and temporal variation in domestic biofuel consumption rates in southern Africa
    (2008-12-04T07:15:56Z) Tshikalanke, Rabelani Phillip
    Biomass burning is an important source of trace gases such as CO2, CO and NO, which influence regional and global atmospheric chemistry. Biomass is burnt in bush fires as well as in households as an energy source. Even though there have been numerous studies on domestic biofuel use in Africa over the last two decades there is still a lack of consumption data on the continent. Biofuel is used in rural and urban areas in Africa, but this project focuses on rural consumption. This project aims to quantify biofuel use at representative rural sites around southern Africa and to investigate the spatial and temporal variation. Three sites, one in the south, central and northern parts were selected in each of seven countries (Botswana, Namibia, South Africa, Mozambique, Zambia, Zimbabwe and Malawi). Consumption rates for all fuel types were determined by weighing the fuel used throughout the day. The survey was conducted during the months of May 2003 to February 2004. The forms of biofuel used over southern Africa were found to be wood, charcoal and to a lesser extent maize residue. To obtain a consumption estimate for the whole of rural southern Africa consumption values for Swaziland and Lesotho from previously studies were included. The total annual rural fuelwood consumption in southern Africa is estimated to be 54.7 ± 3.5 Tg with an average daily consumption of 2.55 kg person-1 day-1 . South Africa has the highest consumption of wood and Swaziland the least. While fuelwood was used in all countries charcoal was only consumed in the rural areas of South Africa, Zambia and Mozambique. Rural southern Africa is estimated to consume 8.1 ± 0.8 Tg of charcoal per year. Malawi was the only country to consume maize residue at an average rate of 0.51 ± 0.16 kg person-1 day-1, leading to a consumption of 1.8 ± 0.1 Tg yr-1 over the whole region. The total rural biofuel consumption over southern Africa was estimated to be 64.6 ± 3.6 Tg yr-1. Namibia and South Africa had increased consumption rates between August and October, and Zambia shows slightly higher consumptions between May and July. The other countries show little monthly variation with no specific seasonal trends. There was a slight positive relationship (r2 = 0.168; p = 0.065) between consumption rate and altitude, but the data is very scattered due to monthly variation. Slopes are only shown to be significant between January and March. Altitude is therefore not shown to be a significant controlling factor of biofuel consumption in this study.
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    Social involution? : The impact of economic restructuring on the working class in Zambia
    (2008-11-24T12:38:47Z) Chembe, Martin David
    Countries in southern Africa have been implementing economic liberalisation policies for over two decades, with the aim of reversing years of economic decline. This process of economic liberalisation has been largely been influenced by the International Monetary Fund (IMF) and the World Bank policy prescription. While the developed world has been piling pressure on countries in the Sub-Saharan region to integrate their national economies into the global economic, different countries have responded differently in opening up their economies. For some, the new economic policy regime has entailed a shift from a state-run economy and focusing more on a free market economy. While some countries have taken a cautious approaching to economic liberalisation, Zambia went for rapid liberalisation, which has led to negative social consequences on employment and the livelihoods of the working class. Through the adoption and implementation of labour market flexibility policies, Zambia and other countries in the region have seen an upswing in new forms of employment such as casual labour, subcontracting and temporary employment, which have no protection and have exposed workers to exploitation. Employment levels have also dropped as the capitalist investors shed off massive numbers of workers in order to reduce labour costs. Local manufacturing industries, in most cases, have been forced to close down and lay-off workers due to unfair competition with cheap imported goods. Liberalisation in developing countries in general and southern Africa in particular, has entailed weakening the role of the state in national economic management. Governments are increasingly succumbing to the dictates of multinationals and are failing to enforce regulatory measures needed to protect the welfare of workers and their working conditions.
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    Interactions between sexually transmitted infections and human immunodeficiency virus in Southern Africa
    (2007-02-26T12:31:40Z) Htun, Ye
    Epidemiological information on sexually transmitted infections (STIs) is necessary to assess the magnitude of the burden of infections, to identify vulnerable population groups, to mobilise resources for intervention activities and to monitor the impact of these activities. In addition, specific STI surveillance systems, such as studies on the relative prevalence of aetiological agents of STI syndromes and their antimicrobial susceptibility patterns, are aimed at improving patient care. The studies included in this thesis were designed and implemented to improve our understanding of the epidemiology of STIs and HIV infection in southern Africa. In all the study populations, we observed that high level STI epidemics preceded the explosive spread of HIV infection among high-risk individuals. The studies reported here also demonstrate the importance of triangulating data collected from different recommended STI surveillance components, using a tiered surveillance approach. The studies reported here also explored the bidirectional interactions of HIV and STIs. We observed that different STIs have shown different magnitudes of interaction with HIV infection. We found particularly strong interactions between genital herpes and HIV. At the individual level, HIV-seropositive patients with genital herpes were more frequently found to have atypical clinical presentations, delays in spontaneous healing, longer duration of HSV shedding and increased association with HIV shedding from ulcer and genital exudates. Mixed infections involving chancroid and genital herpes were found to be common, particularly in HIV-seropositive patients. The effectiveness of syndromic treatment targeting only bacterial causes of genital ulceration was significantly reduced due to persistent ulcerations as a result of co-infection with genital herpes. The successful treatment of herpes in men and women was found to be associated with a decline or cessation in HIV shedding into ulcer exudates or genital fluid. The studies have also shown that HIV plasma viral load is the main determinant for HIV shedding in both men and women presenting with STIs. As was the case with HSV infection, there was a strong association between HIV and HPV infection in both men and women. A higher prevalence of HPV infection was found among HIV-seropositive patients in our study population and this may reflect the higher frequency of recurrences and/or longer duration of infection (i.e. persistency). The studies also found that the biological false positive reactions in syphilis serology (i.e. RPR) are not a common occurrence in our HIV-seropositive study population. On the other hand, syphilis serology could be falsely negative in patients with PCR-confirmed primary syphilis who are co-infected with HIV and other aetiological agents causing GUD. In conclusion, the findings of our studies have supported the bidirectional nature of interactions between conventional STIs and HIV infection in southern Africa.
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    Spatial and temporal distribution of tropospheric ozone over Southern Africa
    (2006-11-16T09:49:16Z) Bundi, Peter Miriti
    Tropospheric ozone over southern Africa is characterised using the Southern Africa Regional Science Initiative (SAFARI) 2000 aircraft datasets collected from surface to just above the boundary layer, and satellite remotely sensed ozone column depth. Ozonesonde datasets for Irene, South Africa; Lusaka, Zambia; Nairobi and Malindi, both Kenyan stations were, used to supplement the aircraft and satellite data. The period studied is the dry biomass burning season between August and September, 2000 Source areas of ozone precursors have been identified by trajectory analysis. Fivepoint, back trajectory clusters in the region reveal well-defined air mass transport corridors. Enhanced ozone concentrations, above 70 ppb, were regularly encountered in the lower troposphere (3.5 km above ground level) in air masses distributed over the sub-region by distinct re-circulation pathways, which prevailed during the study period. Occasional, episodes of significant higher ozone pollution, above 100 ppbv are identified. Savannah fire products transported from seasonal biomass burning regions of western Zambia, northern Zimbabwe and Mozambique have been found to be the major sources of ozone pollution over the sub-region. Another source, though on a lesser scale, is the Highveld industrial region of South Africa. In situ air observations established that the western and eastern sectors of the southern Africa, north of 23°S latitude, were the major sources of regional ozone precursor gases. The regions southwards of 23°S were observed to have lower ozone pollution.