Browsing by Subject "Testing"

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    Designing and testing a solution to fill ART knowledge gaps at primary healthcare level: WhatsApp-based microlearning
    (2025) Chisholm, Briony Sue; Orrell, Catherine; Blockman, Marc
    South Africa has the world's largest antiretroviral treatment programme, with 7.7 million people on treatment in 2023. Treatment of HIV is informed by regularly updated national guidelines. Knowledge of the guidelines and ongoing training of healthcare workers (HCWs) are vital, to ensure optimal patient care. Human, financial and infrastructural challenges make ongoing training difficult. Innovative solutions are needed. In the first study, South African HCWs' knowledge of dolutegravir's drug interactions – detailed in the guidelines – was established using an anonymous online survey. Descriptive and inferential analysis was done on the 1 950 surveys received from across the country. Significant gaps in knowledge were shown: 70% of participants were aware that dolutegravir has interactions; knowledge of which drugs interact and how to adjust dosing ranged between 5.1 and 79.7%. Access to guidelines and training were positively associated with knowledge, but only 69% of respondents had access to guidelines and 56% had received training. Training was desired by 90% of respondents, with computer-based online training (51%) and cell phone-based training (41%) being the preferred methods. The second study, a pragmatic, mixed-methods, parallel-group cluster-randomised study aimed to close the knowledge gaps by designing, testing and evaluating the effect of WhatsApp group-based microlearning for HIV training on HCWs' knowledge. Nurses and community health workers (CHWs) at 50 predominantly rural clinics in the Eastern Cape were invited to join the training at in-person recruitment visits. Uptake and participation were good: 232/293 nurses and 207/271 CHWs participated. Lessons were read within two weeks by 96% (nurses) and 88% (CHWs). Significant intervention effect on knowledge was seen, based on online knowledge questionnaires: nurses (0.5 units; p=0.0499) and CHWs (0.7 units; p=0.004). Data from focus groups noted that participants found the training acceptable and beneficial. Patient folders (n=1 083) were reviewed retrospectively to compare changes in patient care between the arms. Adjusting for pre-care differences, the intervention increased correct patient care by 21% (95% CI 10%-32%; p<0.001) in the year after the training. WhatsApp-based microlearning for HCWs is effective, highly acceptable, feasible and well- received, making it a valuable option for simple, accessible, scalable continuing education.
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    Development and testing of a laboratory digital controller
    (1984) Closel, Andre Gerard; McLaren, S.G
    The aim of this thesis was to develop a fast and continuous digital sampling controller to study and compare some of the common arrangements of modern digital and analogue controllers. Most of the work was devoted to building the controller and developing a special management programme so as to obtain the required sampling speed. This programme is discussed in detail in this thesis. The use of direct memory addressing multiplication tables gives rise to serious accuracy problems and an analysis is made thereof. The controller was based around the APPLE personal computer which is well known for the flexibility of its peripheral BUS. Utility programmes were written to solve some of the tedious and frequent linear algebraic equations involved in MIMO state space analysis of control. These programmes were used extensively during the testing phase of the controller as applied to a multivariable system which was a coupled electric drive. Finally a brief study was made of the other possibilities of the controller and its algorithms.
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    HIV self testing uptake and associated factors in Cape Town: a contextual framework
    (2025) Nyembwe, Doris; Alaba, Olufunke
    South Africa bears one of the highest HIV burdens globally, with nearly 8 million people living with the virus. Despite hosting the world's largest antiretroviral therapy (ART) program, HIV-related deaths remain significant, accounting for over 23% of all deaths in 2019. Early detection and timely initiation of ART are essential to prevent transmission, improve quality of life, and reduce HIV-related morbidity and mortality. However, insufficient testing coverage among males and younger individuals remains a concern. HIV self-testing (HIVST) has emerged as a promising strategy to bridge these gaps, offering a private and convenient option for individuals hesitant to access healthcare facilities. The World Health Organization (WHO) endorses HIVST as a complementary approach to enhance access, particularly for populations underserved by traditional testing methods. While research has examined HIVST uptake in various settings, little is known about the specific factors influencing its adoption in Cape Town. Given South Africa's unique socio-economic landscape and the disparities between urban and rural areas, understanding the factors shaping HIVST uptake is crucial for developing tailored interventions. This thesis seeks to address this gap by investigating and analyzing the demographic, socio-economic, and community-level factors associated with HIVST uptake in Cape Town. Methods: This study utilized a cross-sectional design to examine HIV testing uptake and associated factors in Cape Town, South Africa, between January and December 2022. The analysis leveraged routine HIV Testing Services (HTS) programmatic data collected by the Anova Health Institute. The dataset included a total of 266,284 observations: 30,785 for HIV self-testing (HIVST) and 235,499 for conventional HIV testing. Data were drawn from individuals aged 18 years and older across the eight subdistricts of the Cape Town metropolitan area: Eastern, Northern, Southern, Western, Khayelitsha, Klipfontein, Mitchells Plain, and Tygerberg. The data, comprising sociodemographic details and testing information, were deidentified with formal permission from Anova Health Institute and the Department of Health. Individual-level data was recorded through consent forms and HTS registers and subsequently transferred to Red Cap and Power BI for quality checks and analysis. Community-level data, including the number of healthcare facilities, new and registered ART patients, and child acute malnutrition rates, were sourced from City of Cape Town health profiles (2021). Predictors were selected based on a socio-ecological framework, capturing both individual- and community-level factors. Individual-level variables included age, gender, and HIV testing history. Community-level factors encompassed healthcare access (number of healthcare facilities), HIV burden (number of registered and new ART patients), and socioeconomic status (child acute malnutrition rate). Descriptive statistics summarize the frequencies of HIVST, and conventional testing variables stratified by subdistrict, alongside community-level factors. A bivariate logistic regression model was conducted to assess associations between individual predictors and HIV testing options. Subsequently, a multivariate logistic regression model was employed to evaluate the influence of both individual- and community-level predictors on HIV testing choices (conventional vs. HIVST). Odds ratios were calculated with 95% confidence intervals to quantify these associations. This methodology integrates diverse data sources and robust statistical approaches, enabling a comprehensive examination of the factors influencing the uptake of HIV self-testing in Cape Town. Results: The study had a sample size of 265,063 of which 234,853 (88.60%) had utilized conventional HIV testing method and 30,210 (11.40%) opting for self-testing. Majority of individuals undergoing conventional testing are adults aged 25- 49 (63.16%), followed by older adults aged 50+ (17.16%). Similarly, for self-testing, most users are also within the 25-49 age group (63.84%), but there is a higher proportion of young adults aged 20-24 choosing self-testing (23.72%) compared to conventional testing (15.59%). Additionally, adolescents aged 18-19 are more likely to opt for self-testing (7.75%) than conventional testing (4.08%). Regarding gender, females constitute a larger share of those undergoing conventional testing (65.62%) compared to males (34.38%). The trend is similar for self-testing, where females account for 65.32%, and males make up 34.68%. In terms of the last HIV test, self-testing is more prevalent among individuals who were tested within the past 12 months (63.51%), while conventional testing is more common among those whose last test was over a year ago. Subdistrict analysis shows that conventional testing is most frequent in Tygerberg (20.06%) and Khayelitsha (16.87%), followed by Western (13.24%) and Eastern (12.45%). In contrast, self-testing is more widely utilized in Western (19.38%), Southern (15.33%), and Mitchell's Plain (16.97%). The bivariate logistic regression indicated that age was a significant factor influencing self-testing preferences, with the likelihood of using HIVST decreasing with age. Individuals aged 20‐24 had 20% lower odds of using self‐testing compared to adolescents aged 18‐19 (OR = 0.80, 95% CI: 0.76–0.85, p < 0.005). Those aged 25‐49 had 47% lower odds compared to the adolescent group (OR = 0.53, 95% CI: 0.51–0.56, p < 0.005), and adults aged 50 and above had 86% lower odds (OR = 0.14, 95% CI: 0.13–0.15, p < 0.005). Additionally, for facility testing those who had tested for HIV within the last 12 months were more inclined towards self‐testing. In contrast, individuals who last tested more than 12 months ago were 77% less likely to choose self‐testing (OR = 0.23, 95% CI: 0.22–0.25, p < 0.005), and those who had never been tested were 40% less likely (OR = 0.60, 95% CI: 0.54–0.67, p < 0.005) to use self‐testing. HIVST was more popular among people living in areas with a high concentration of registered ART patients. Specifically, the odds of choosing self‐testing increased by 32% in high-density areas (≥30,001 registered ART patients) (OR = 1.32, 95% CI: 1.28–1.37, p < 0.005) and by 53% in medium-density areas (20,001–30,000 registered ART patients) (OR = 1.53, 95% CI: 1.49–1.58, p < 0.005), compared to areas with fewer than 20,000 registered ART patients. On the other hand, people living in areas with a higher number of healthcare facilities were more likely to choose conventional HIV testing. The odds of self‐testing decreased by 15% in subdistricts with a medium number of healthcare facilities (15–25 facilities) (OR = 0.85, 95% CI: 0.82–0.87, p < 0.005) and by 27% in areas with a high number of facilities (26 or more) (OR = 0.73, 95% CI: 0.71–0.76, p < 0.005), relative to areas with fewer than 15 facilities. Additionally, communities with a high number of newly enrolled ART patients (≥2,901) showed a 31% lower likelihood of opting for self-testing (OR = 0.69, 95% CI: 0.67–0.72, p < 0.005). Subdistrict variations were evident, with Southern (OR = 2.04, 95% CI: 1.94–2.13, p < 0.005) and Mitchell's Plain (OR = 2.12, 95% CI: 2.03–2.23, p < 0.005) showing more than twice the odds of self‐testing compared to the Eastern subdistrict. Other subdistricts with significantly higher odds of self-testing included Western (OR = 1.63, 95% CI: 1.56–1.71, p < 0.005) and Klipfontein (OR = 1.12, 95% CI: 1.06–1.18, p < 0.005). Conversely, Northern (OR = 0.52, 95% CI: 0.48–0.55, p < 0.005), Tygerberg (OR = 0.55, 95% CI: 0.52–0.57, p < 0.005), and Khayelitsha (OR = 0.97, 95% CI: 0.83–0.91, p < 0.005) had significantly lower odds. Finally, testing preferences assessed through the multivariate logistic regression model highlighted the influence of both individual- and community-level factors. Consistent with the bivariate analysis findings, age remained a strong predictor of HIVST. Individuals aged 20–24 had 23% lower odds of using self-testing compared to those aged 18–19 (OR = 0.77, 95% CI: 0.73–0.82, p < 0.005), while those aged 25–49 had 49% lower odds (OR = 0.51, 95% CI: 0.48–0.53, p < 0.005). The oldest age group (50 years and above) had 86% lower odds of choosing self-testing compared to the youngest group (OR = 0.14, 95% CI: 0.13–0.15, p < 0.005). 5 Individuals residing in communities with a medium (20,001–30,000) and high (≥30,001) number of registered ART patients had 240% (OR = 3.40, 95% CI: 3.18–3.65) and 182% (OR = 2.82, 95% CI: 2.70– 2.96, p < 0.005) higher odds of using self-testing, respectively, compared to those in areas with low ART caseloads (<20,000). Additionally, living in areas with more newly enrolled ART patients was negatively associated with self- testing. Residing in communities with a medium number of new ART patients (1,800–2,900) was associated with 68% lower odds of self-testing (OR = 0.32, 95% CI: 0.29–0.34, p < 0.001), while living in areas with a high number of new ART initiations (≥2,901) was associated with 81% lower odds (OR = 0.19, 95% CI: 0.18–0.21, p < 0.001), compared to areas with a low number of new ART patients (<1,800). Unlike in the bivariate analysis, gender also played a significant role in the multivariate model, with females having 8% lower odds of choosing self-testing compared to males (OR = 0.92, 95% CI: 0.90– 0.94, p < 0.005). Additionally, individuals who received a positive HIV test result had 9% lower odds of having used self-testing compared to those who tested negative (OR = 0.91, 95% CI: 0.84–0.98, p = 0.005). The number of healthcare facilities was also positively associated with self-testing uptake. Living in areas with a medium (15–25) or high (≥26) number of healthcare facilities increased the odds of self-testing by 13% and 34%, respectively (OR = 1.13, 95% CI: 1.09–1.17, p < 0.005; and OR = 1.34, 95% CI: 1.26–1.43, p < 0.005), compared to areas with a low number of facilities (0–14). Conclusion: In conclusion, the study underscores the complex interplay of individual and community-level factors influencing HIV testing preferences in Cape Town. Younger age, recent HIV testing history, male gender, and residence in areas with higher number of registered ART patient and more healthcare facilities were associated with increased likelihood of HIV self-testing (HIVST). Conversely, older age, female gender, living in communities with more newly initiated ART clients, and receiving a positive HIV diagnosis were linked to a lower likelihood of using HIVST. Geographic disparities across subdistricts further highlight the need for targeted, context-specific strategies to enhance HIV testing uptake, particularly among underrepresented groups, and to optimize the reach and impact of self-testing interventions.
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    Mathematical literacy of students entering first year at a South African university
    (University of Cape Town, 2003-06-30) Frith, Vera; Bowie, Lynn; Gray, Kate; Prince, Robert
    The results of a mathematical Literacy questionnaire administered to school-leavers entering the Humanities, Health Sciences and Science Faculties at a South African university in 2002 are reported. The motivation for interest in the Mathematical Literacy of these students and the rationale behind the questionnaire are discussed. Some of the mathematics and contexts that caused the most difficulty are highlighted.
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    Mathematical Literacy of Students in First Year of Medical School at a South African University
    (University of Cape Town, 2004) Prince, Robert; Frith, Vera; Jaftha, Jacob
    The literature pertaining to the definition of Mathematical Literacy (particularly in the Tertiary context) is briefly reviewed. A Mathematical Literacy questionnaire, designed in accordance with this definition, was administered to students entering the MBChB Program at a South African university in 2003. In general the level of Mathematical Literacy of Medical students is higher than that of entry-level Humanities students, and comparable with that of Science students doing Earth or Biological sciences. The response to the results of this testing, in terms of curriculum interventions in the first year of MBChB, are outlined and their degree of success is evaluated. The post-testing of the MBChB students indicated a statistically significant increase in the Mathematical Literacy of these students.
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    PC-based bit error rate analyser for a 2 Mbps data link
    (1988) Bayley, Gwain; Ventura, M J