OpenUCT is the open access institutional repository of the University of Cape Town (UCT). It preserves and makes UCT scholarly outputs digitally and freely available, including theses and dissertations, journal articles, book chapters, technical and research reports, as well as open educational resources.
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Open Access
Utilisation of fingerprint analysis for human identification at SRM/OFPI
(2026) Eromosele, Rachael; Heathfield, Laura; Reid, Kate
The identification of human decedents is a critical aspect of medico-legal investigation. However, many bodies remain unidentified, with South Africa reporting high numbers each year. Fingerprint analysis is a valuable identification method, though the success rate of using fingerprints for identification at Salt River Mortuary in Cape Town, South Africa, is unclear. This research investigated the frequency and success rate of fingerprints used for identification at this forensic mortuary in 2021. Medico-legal case reports of all cases admitted in 2021 were reviewed (n = 3738) and non-viable foetuses (n = 26) were excluded, resulting in a total of 3712 cases. At admission, 76.6 % had a suspected identity and 23.4 % were unknown. Seven days after admission, 16.1 % (n = 599 / 3712) had not yet been visually identified, but only 2.5 % (n = 15 / 599) had fingerprints taken for analyses. Thirty days post-admission, 7.4 % (n = 273 / 3712) of the total caseload was still unidentified. Total cases with fingerprint analysis requests at all time points in 2021 were 143, with 89.2 % (n = 115 / 129) of the cases having a successful identification outcome. A median of 7 days (Std.dev = 61 days) was taken to request a fingerprint analysis, while it took a further 30 days (median) (Std.dev = 120 days) to obtain a report. Overall, 141 cases from 2021 remained unidentified at the time of this study, with 19 of these cases having 'suitable fingers' but no fingerprint analysis request. Given the affordability and high success rates of identification associated with fingerprint analyses, investigating officers are urged to take fingerprints from more bodies that are not identified. The unsuccessful attempts were due to no matching records on the searched databases, suggesting that a transnational approach is needed to improve identification rates
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Open Access
Media consumption and media synergy by low-income consumers in the KwaZulu-Natal, Gauteng and Western Cape townships and rural areas of South Africa
(2026) Chaka, Tumelo McDonald; Lappeman, James; Dlamini, Siphiwe
The African media landscape is undergoing rapid transformation, shaped by dynamic consumer growth, ongoing disruption, and shifting patterns of engagement. In this context, the concept of media synergy, the strategic alignment and integration of multiple media channels has become critical for maximising return on investment (ROI) and enhancing consumer engagement. This study investigated the impact of media synergy across several dimensions: its role in driving media consumption ROI, the alignment of channels to influence purchasing decisions, the influence of culture and religion on media engagement, the perspectives of marketing professionals on media buying, and the unique challenges of low-income segments in rural and township environments. A qualitative research design was employed, drawing on a series of in-depth interviews conducted with households and media-planning experts. Data collection involved 80 households (20 households per region) across three South African provinces (encompassing both township and rural contexts), along with three experienced media planners. The study identified significant patterns in media access and consumption, particularly the emergence of “media privilege”, whereby individuals with access to scarce resources, such as paid television or internet connectivity, served as gatekeepers for wider community media exposure. This phenomenon was conceptualised as “media capital”, a new form of symbolic power within low-income communities. The findings further revealed the profound influence of cultural, linguistic, and religious dynamics on consumer media behaviour, with radio emerging as a particularly powerful connector at the bottom of the pyramid (BoP). Despite the rise of digital platforms, radio remains a dominant medium, capable of reaching over 18.6 million listeners through South Africa's leading stations, offering both cultural resonance and mass accessibility. These insights underscore the necessity of integrating traditional and digital media in order to achieve a deeper consumer connection and optimal ROI. The study concludes with the development of a media-synergy framework that highlights critical gaps and opportunities in the African context. This framework provides valuable guidance for marketing practitioners, media planners, and scholars by offering a nuanced understanding of how communities at the BoP experience, negotiate, and capitalise on media. Ultimately, the research advances theoretical and practical knowledge of media consumption in contexts of scarcity, illuminating pathways for more inclusive and effective communication strategies across the continent
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Open Access
Invasive carbapenem-resistant enterobacterales infection at a South African paediatric hospital
(2026) Bockarie, Yemah; Eley, Brian; Nuttall, James
Background: Carbapenem-resistant Enterobacterales (CRE) cause significant morbidity and mortality. The global dissemination of CRE is a public health concern, and its impact on children is increasingly being recognised in low-and middle-income countries (LMIC). Studies describing paediatric CRE infections in LMIC are limited. Therefore, this study describes the incidence risk, clinical and microbiological characteristics, treatment, and outcome of children with invasive CRE infections at Red Cross War Memorial Children's Hospital (RCWMCH) in Cape Town, South Africa. Methods: A retrospective description was completed on invasive CRE infections diagnosed between January 2016 and December 2021. Clinical and microbiological data were extracted from hospital records and the National Health Laboratory Service Microbiology database. All invasive CRE infections over the study period were used to estimate the incidence risk per 10,000 hospital admissions. Further analysis was completed on infections with complete datasets using STATA 15.0. Categorical variables were summarised using frequencies and percentages, while continuous variables were presented as means and standard deviations or median and interquartile ranges as appropriate. Student T-test or Mann-Whitney U test was used for comparison of continuous variables depending on their distribution, while Pearson's chi-squared and Fisher's exact test were used to compare categorical variables. To explore factors associated with 30-day mortality, univariable analysis was performed to estimate unadjusted risk ratios (RR) and corresponding 95% confidence intervals for the association between each exposure variable and 30-day mortality. A 2-sided p-value of <0.05 was considered statistically significant. Results: The overall incidence risk was 8.4/10,000 admissions. Of 85 infections with sufficient clinical and/or antibiotic information, the median age at CRE diagnosis was 3.9 months (IQR 0.8-44.4) and 80% (68/85) were healthcare-associated. Sites of CRE infection included bloodstream 39% (33/85), urinary tract 22% (19/85) and respiratory tract 21% (18/85). Klebsiella species (68%, 58/85) of which Klebsiella pneumoniae (57/58) predominated, and Serratia marcescens (22%, 19/85) were most isolated. Carbapenemase detection in 63 of 72 isolates tested were OXA-48 (46/63, 73%) and NDM (17/63, 27%). CRE isolates were most susceptible to amikacin 79% (67/85) and tigecycline 78% (66/85). Mortality within 30 days of diagnosis was 33% (28/85). Factors significantly associated with 30-day mortality on univariable analysis were: any organ dysfunction, cardiovascular dysfunction or shock, bladder catheterisation, TPN, and ceftazidime-avibactam and/or colistin-based therapy while non-severe anaemia lowered risk. Conclusion: This study has provided insight into CRE epidemiology at RCWMCH, adding to the limited number of paediatric studies from Africa. Potential 30-day mortality risks were identified on univariable analysis. In resource-limited settings, cost-related barriers usually limit access, availability, and the timely initiation of ceftazidime-avibactam and colistin in paediatric clinical use. Additionally, its use in the sickest patients may negatively affect treatment outcomes, hence the association with mortality seen in our setting. Larger prospective hospital-based paediatric studies are needed to fully evaluate risk factors for 30-day mortality in resource-constrained settings.
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Open Access
Investigating adverse intergenerational effects of prenatal maternal psychological distress through infant gene expression profiles
(2026) Chalumbila, Tsaone; Koen, Nastassja; Stein, Dan; Wingo, Aliza
Introduction: Maternal psychological distress is prevalent during pregnancy and may contribute to adverse child developmental outcomes. However, the molecular mechanisms underlying these intergenerational effects have not been fully elucidated. This project aimed to investigate these intergenerational mechanisms through newborn messenger RNA (mRNA) and microRNA expression profiles, utilising data from the Drakenstein Child Health Study (DCHS), a South African birth cohort study. Methods: Two systematic reviews and three empirical aims (nested within the DCHS) were undertaken. The systematic reviews investigated the associations between prenatal maternal psychological distress and (a) child developmental outcomes and (b) newborn transcriptomic signatures, respectively. In the DCHS, the Self-Reporting Questionnaire 20 (SRQ-20) was used to assess prenatal maternal psychological distress, and the Bayley Scales of Infant and Toddler Development (Third Edition) to evaluate toddler development at age 24 months. Total RNA sequencing profiles were generated from cord blood of the index newborns; and the Limma Voom R-package was used to identify differentially expressed genes and microRNAs between newborns exposed to prenatal maternal psychological distress versus unexposed newborns. A gene set enrichment analysis was undertaken to identify significantly enriched pathways. Regression analyses were then used to investigate associations between differentially expressed RNAs and child developmental outcomes. All analyses were controlled for potential confounding variables and multiple testing correction was applied. Results. Findings from the two systematic reviews suggest that prenatal maternal psychological distress may be associated with altered expression of genes associated with glucocorticoid and serotonin signalling, placental growth and immune response; and adverse motor, adaptive and social-emotional development in the index children, respectively. In the DCHS, prenatal maternal psychological distress was not significantly associated with differential gene or microRNA expression in the exposed versus unexposed newborns. However, prenatal maternal psychological distress was associated with transcriptomic differences in gene set pathways - associated with cell cycle progression, immune response and haem metabolism in the cord blood of exposed versus unexposed newborns. Conclusion. This project yielded novel, albeit preliminary findings that child transcriptomic pathways may constitute one of the molecular mechanisms underlying the adverse intergenerational effects of prenatal maternal psychological distress in a South African birth cohort.
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Open Access
The impact of COVID-19 related restrictions on caregivers of infants and young children (6 months–3 years) born with cleft lip and palate
(2026) Khoza, Nonhlanhla; Norman, Vivienne; Morrow, Brenda
Background: Cleft lip and/or palate (CL/P) is one of the most common craniofacial birth defects worldwide, with a global prevalence of approximately 1 in 700 live births. Infants and children with CL/P and their families require intervention and support from a multidisciplinary cleft team. Initial intervention focuses on information counselling, facilitation of feeding, surgical repair, and psychosocial support. These interventions are considered time sensitive to reduce potentially negative consequences. However, the COVID-19 pandemic in 2020 disrupted the typical timeline for CL/P interventions globally, and in South Africa, due to restrictions and regulations resulting in the suspension and cancellation of many healthcare services, including cleft services. Aim: To describe the impact of COVID-19 related restrictions on the caregivers of infants and young children (6 months to 3 years) born with CL/P, through exploring caregivers' perceptions of access to CL/P health services, difficulties related to feeding, and caregiver support. Methodology: A qualitative, narrative research design was employed. Semi-structured interviews were conducted with eight caregivers of children born with CL/P (6 months to 3 years at the time of data collection) attending the multidisciplinary cleft clinic at Chris Hani Baragwanath Academic Hospital. The interviews were transcribed, and data were thematically analysed. Results: One main theme and five subthemes emerged from the caregivers' perceptions of the impact of the COVID-19 related restrictions on their experience. The main theme, ‘a difficult journey', was further described through subthemes, which included: ‘limited/no access to cleft services', ‘delays, cancellations and poor communication', ‘feeding difficulties and experiences', ‘a roller-coaster of emotions' and ‘we just need support'. Every aspect of care was impacted and there was a ripple effect, for such as limited access to the cleft clinic and delays affected other areas, such as feeding and emotional support, which compounded the caregivers' difficult journey. Conclusion: Caregivers faced significant challenges during the pandemic. The main challenges were related to difficulties accessing the multidisciplinary cleft team, particularly the speech-language therapist; delays and cancellation of cleft repair surgeries; poor communication with the healthcare facility; difficulties related to feeding their child with CL/P; and psychosocial challenges and the need for professional and informal support. The findings also highlighted broader systemic issues within the healthcare system.