4. Electronic Theses and Dissertations (ETDs) - Faculties submissions

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    Investigation of Contamination of Community Groundwater Sources with Antibiotics in Informal Settlements of Kisumu, Kenya
    (University of the Witwatersrand, Johannesburg, 2023-09) Karimi, Kellen Joyce; Ahmad, Aijaz; Duse, Adriano; Mwanthi, Mutuku
    Antibiotics have been used to cure diseases, but there are growing concerns about the risk to human health caused by inadvertent exposure to low levels of antibiotics in the environment. Despite extensive reporting from the developed world on antibiotic pollution of groundwater, relatively little study has been conducted on antibiotic contamination of groundwater in the developing countries, particularly informal settlements. Antibiotic usage and misuse have long been seen as clinical events, with little understanding of the role of disposal in the development of environmentally induced resistance. Exposure pathways that contribute to groundwater contamination in informal settlements put residents at odds because they already face inequalities, such as a high disease burden exacerbated by antibiotic resistance; thus, proper antibiotic disposal is critical in protecting human and environmental health. The purpose of this cross-sectional study was to establish the prevalence of groundwater contamination with the common antibiotics’ such as sulfamethoxazole, trimethoprim, and metronidazole, and the related antibiotic resistance and the human health risk of exposure. Ethical clearance to conduct research was obtained from three institutions as follows: - the Health Research Ethic Committee of the university of the Witwatersrand (HREC. Protocol Number M190412); the Kenyatta National Hospital and University of Nairobi Ethics and Research Committee (KNH/UoN-ERC. Ref No. P71910/2018); and the National Commission for Science, Technology, and Innovation (Ref No. NACOSTI/P/19/3232/28732). Each respondent gave informed consent to participate in the study. Anonymity was maintained at all levels of the study to protect the study participants from identification. Antibiotic use, which is connected to antibiotic disposal, was evaluated in a random sample of 447 families. From the 188 mapped groundwater sources, a random sample of 49 groundwater sources was chosen, and water samples were taken for antibiotic concentration analysis utilising a solid-phase extraction and liquid chromatography coupled to magnetic sector high resolution mass spectrometry (SPE-LC-MS/MS). The Kirky-Bauber diffusion method was used to test antibiotic resistance in Escherichia coli. The community's potential groundwater contamination routes were assessed by determining antibiotic use and disposal among households as well as assessing the environmental risk of exposure. In the households visited, 75% (n=337) were female and 25% (n=110) were male. The prevalence of antibiotic use in informal settlements was 43% (n=193), with 70% (n=137) users reporting that they obtained the antibiotics through a prescription from a health practitioner. A significant relationship was observed between having HIV/AIDS and acquiring antibiotics through a prescription; p=0.001. An association was also observed among the informal settlements, where a lower number of MNY B dwellers did not receive a prescription for the antibiotics acquired. There was no statistically significant difference in antibiotic use between males and females; odds ratio=1.33; whereas there was a difference in HIV/AIDS status; odds ratio=0.313; and among informal settlements where the odds of using antibiotics were reduced in NY B; odds ratio=0.42. Respondents who used antibiotics either kept the unused antibiotics for future use 87.1% (n=27) or disposed them. Among the disposals 51.6% (n=16) disposed in pit latrines, 16.1% (n=5) dispose in compost pits, and 6.5% (n=2) dispose the remaining antibiotics by burning. Females completed their antibiotic doses at a higher rate (36.3%; n=117) than males (32.5%; n=39). Significant difference was observed in completion rate among the HIV/AIDS positive and negative respondents as well as among informal settlements; p<0.000 and p=0.001 respectively. On the other hand, groundwater use in these communities is widespread. Respondents used it for a variety of purposes, including drinking (9%; n=39), though they declined to report. Awareness of the health consequences of drinking antibiotic-contaminated water was also low (35%; n=158), especially among households that reported antibiotic use; p=0.003. Only Sulfamethoxazole was detected in 7 out of 49 groundwater samples at a detection frequency of 14.3%; with concentrations ranging from nd to 258 ng/L. Escherichia coli and Cryptosporidium parvum were isolated from all the 49 water samples and E. coli isolates from 3 (6%) water samples were resistant to sulfamethoxazole with Inhibition Zone Diameters of 0.8 mm, 10.5 mm, and 11.5 mm. The 3 water samples were however not among samples where sulfamethoxazole was detected. The Hazard Quotient was 0 (zero), and therefore no risk of exposure to sulfamethoxazole in the environment, but the level of antibiotics that trigger antibiotic resistance is not known. Because of the rising problem of antibiotic resistance due to overuse and incorrect disposal, teaching on safe antibiotic prescription should be incorporated into medical training for all cadres. In addition to educating patients on proper use and disposal, the ministries of health should ensure the antimicrobial stewardship standards are adhered to both locally and worldwide. Follow-up research of antibiotic resistance discovered in three groundwater sources must be done to eliminate the possible sources and prevent further spread. This study is instrumental in informing the inclusion of antibiotics on the list of frequently monitored contaminants during water treatment, as well as serving as a starting point for antibiotic surveillance in Kenya.
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    The Role of Climate Change Governance in Community Adaptation in Kwazulu-Natal: A Study of uMkhanyakude District Municipality
    (University of the Witwatersrand, Johannesburg, 2024) Sibiya, Nomfundo Patricia; Simatele, Mulala Danny
    It can be argued that, although South Africa has developed good climate change initiatives, policies, and strategies, the implementation of these policies seems to present difficulties, as those for whom they have been developed do not seem to have any knowledge of their effectiveness in helping them build resilience against extreme weather events. Additionally, the findings demonstrate the existence of structures tasked with coordinating climate change matters across all government sectors affected, comprising inter-departmental arrangements, departmental arrangements, other institutions, and stakeholders. The inter-departmental arrangements consist of forums whose purpose is to ensure inter-sectoral coordination of climate change matters. The national Department of Forestry, Fisheries and the Environment assumes leadership and coordination responsibilities in developing and implementing responses to climate change adaptation in South Africa. The findings also revealed that government officials employed at the Department of Forestry, Fisheries and the Environment unanimously believe that the institutional arrangement of climate change at the national level effectively drives the climate change agenda. Conversely, government officials at the provincial and local levels exhibit diverse perspectives regarding the effectiveness of the institutional arrangements. Consequently, one can posit that there is inadequate coordination of climate change adaptation horizontally among national government departments and sectors affected by climate change impacts, as well as vertically between national, provincial, and municipal governments. This study divulged various barriers to climate change adaptation in South Africa, including insufficient financial resources, inadequate human capacity at provincial and local levels, limited political resolve at the local level, deficient comprehension of climate change adaptation issues among communities, insufficient coordination across government levels and sectors, absence of legal mandate at the local level, absence of climate change units at the district and local levels, lack of knowledge among certain staff members entrusted with environmental responsibilities at the local level, inadequate climate change plans in place at the local level, and utilisation of outdated climate change information in the Integrated Development Plans (IDPs). This study proposes that policies should be jointly designed and implemented with vulnerable groups, based on local knowledge, and tailored to the specific needs of those most affected by climate change (e.g., women, the impoverished). There is a necessity to establish operational institutions that are dedicated to fulfilling their mandate, supporting communities, and fostering robust partnerships among civil society, the public sector, and the private secto
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    Older Women’s Physical, Psychological, and Social Experiences of Residing in Ivory Park, an Urban Informal Settlement in Johannesburg
    (University of the Witwatersrand, Johannesburg, 2023-10) Mokoena, Mmasopola Dorcas; Gerrand, P.
    Population aging is a worldwide phenomenon that is growing and therefore, the demand for research to investigate its nuances has increased. Research regarding the experiences of older populations residing in urban low-income communities, such as informal settlements, is particularly limited. As such, the aim of the study was to investigate the perceptions and experiences of older women residing in Ivory Park, an informal settlement. impacts their physical, psychological, and social well-being. A qualitative case study was adopted as the research design. The theoretical framework underpinning the study was the biopsychosocial model. Purposive and snowball sampling were used to recruit and select research participants. Data collection took place by conducting semi-structured, in-depth interviews in person with participants, using an interview guide. Thematic analysis was the method of data analysis that was applied to analyse the data. Based on study findings it was concluded that older women residing in Ivory Park are facing physical, psychological, and social challenges, but are coping fairly well because they have been living in Ivory Park for a long period of time and built up some support systems, mainly for improving their financial circumstances. Social welfare practitioners should work holistically with multiple frameworks to improve effectiveness of services Further research is needed on a greater scale, and the intensity of crime and violence require urgent attention.
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    Violence and protest: A historical analysis of ‘violence’ and community protests in Bethanie, c. 1866 to 2018
    (University of the Witwatersrand, Johannesburg, 2022-10) Makena, Kefuoe Emmaculate; von Holdt, Karl; Lekgoathi, Sekibakiba P.
    The Bakwena ba Mogopa are a community in the North West Province of South Africa. The capital of this community is Bethanie. In 2018, residents of Bakwena ba Mogopa embarked on a protest. This protest highlighted issues of unemployment, lack of service delivery and underdevelopment. For many, in particular young people, this protest was surprisingly militant. However, for the elders in the community, this reignited memories of the war of Mabidibidi from the late 1920s. This war was about the split of the Lutheran church which resulted in two separate churches, one being the ELCSA and BLC. Moreover, other elders argued that in the 1960s, the conflict within the traditional leadership was also Mabidibidi. This dissertation explores various protests and moments of contention that have manifested in Bethanie and have shaped this rather peaceful community. To provide context for these events, this dissertation looks at the history of Bethanie from 1866 till 2018. For a community that refers to itself as peaceful, perhaps given the events of spectacular protests that have taken place throughout South Africa, this case of Bethanie complicates some of the common understandings of how violent protests manifests.
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    The In & Between: Weaving social interaction through mixed-use development in Robertsha
    (University of the Witwatersrand, Johannesburg, 2024-02) Ashton, James; Jivan, Sundeep
    Critically analysing the need for social interaction through communities. Robertsham is a location that contains a rich history dating back to 1948 when it was first established. The study focuses on the public park that splits the residential and industrial areas of Robertsham. The park was once a social interactive space for families within Robertsham and has now become a barren underutilised space. The design aims to include spaces that address an issue within each sector of Robertsham. A mixed-use development aided to serve the community as well as bring back the nature of the park with the main routes being social interaction, safety, and connection.