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- ItemOpen AccessA longitudinal analysis of the completeness of maternal HIV testing, including repeat testing, during pregnancy, and the predictors thereof, in Mitchell’s Plain, Cape Town(2019) De Beer, Shani; Davies, Mary-Ann; Kalk, EmmaHIV testing during pregnancy is the gateway to the HIV-related services that are part of the prevention of mother-to-child transmission (PMTCT) cascade. The virtual elimination of vertical HIV transmission cannot be achieved without universal antenatal care (ANC) HIV testing. Furthermore, women are at an increased risk of HIV infection and subsequent mother-to-child transmission (MTCT) during pregnancy. Emphasis has thus been placed on repeat testing during pregnancy among women who have a HIV-negative result at their first ANC test. Very little has been published on the current uptake and adherence to antenatal and repeat HIV testing in sub-Saharan Africa (SSA) countries. In line with the World Health Organization Guidelines, the Western Cape Prevention of Mother-to-Child Transmission of HIV (PMTCT) Clinical Guidelines in 2014 recommended a repeat HIV test between 32 - 34 weeks gestation and again at delivery in addition to testing at “booking” (< 20 weeks gestation), meaning that there were three “testing windows” during which pregnant women not previously diagnosed as HIV-infected should undergo testing. Between 2013 and 2016 the Closing the Gaps study established an electronic PMTCT register (e-register) that consolidated routine care data from a primary healthcare facility and its secondary and tertiary referral sites in Cape Town, South Africa. This provided a single longitudinal record, from antenatal care to delivery, for each pregnant woman which enabled the longitudinal assessment of maternal HIV testing uptake and treatment. Utilizing these data, we conducted a retrospective sub-analysis investigating the implementation of PMTCT HIV testing guidelines (until delivery), in Cape Town, for the period 1 July 2014 - 31 December 2016. The main objectives of the study were to assess the coverage and timing of initial HIV testing during pregnancy, the completion of HIV testing at “booking” and within the recommended testing windows (including delivery), HIV prevalence and incidence at the recommended testing windows, and the predictors of missed testing opportunities. The research protocol (Part A) was designed to describe the proposed significance, objectives and methodology of the study. The literature review (Part B) critically evaluated available literature on: antenatal and repeat HIV testing proportions, HIV positivity, the feasibility and acceptability of repeat iv testing, and the predictors of testing completeness within different SSA countries, for the period 2010 - June 2018. Its aim was to inform this study. The need for post-Option B+ implementation, longitudinal studies that analyze antenatal and repeat HIV testing coverage and implementation within SSA was identified. In Part C I present the methods, results and interpretation thereof for the analysis of individual-level, longitudinal, maternal HIV-testing patient data from the Closing the Gaps study e-register as a manuscript to be submitted for publication. Among 8558 women who delivered at either the primary care facility or its referral sites, 7213 were not diagnosed HIV-positive prior to their first visit and thus eligible for testing in pregnancy. Among these women, 91% received ≥1 HIV test and 85% “booked” >5 days before delivery with 98% testing completeness at “booking”. Only 49% of women eligible for testing “booked” ≤22 weeks gestation. Among women that “booked” ≤22 weeks gestation who weren’t diagnosed HIV-positive before delivery and delivered >5 days after the start of the third trimester, 10% received tests in all three recommended windows. Thirty-one percent of women that had not been diagnosed HIV-positive before delivery had an uncertain (i.e. last tested ≥3 months before delivery) or unknown (i.e. never tested) HIV status after delivery. Out of the women that had a known HIV status at delivery, 21% were HIV-positive of whom 95% were known HIV-positive before current pregnancy and 4% were diagnosed at “booking”. Overall, HIV incidence in those with ≥2 HIV tests during pregnancy/at delivery was estimated to be 0.2% between “booking” and delivery. Women who enrolled after 2014 were less likely to miss ≥1 of the three recommended tests (aOR: 0.70; CI: 0.55 - 0.90) and not test at delivery (aOR: 0.63; CI: 0.55 - 0.71) compared to those who enrolled in 2014. Conclusion: In our study, HIV testing completion at “booking” was high, but women tended to “book” late during pregnancy resulting in late initial testing and missed opportunities for early HIV diagnosis. Implementation of repeat HIV testing is poor, particularly at delivery. HIV incidence between first negative ANC test and delivery is very low and therefore future studies to assess the most cost-effective number and timing of HIV tests, and feasibility of implementation, should be considered. Overall, maternal HIV testing within the PMTCT programme in Cape Town has matured post 2014 with improved implementation over time.
- ItemOpen AccessBook Review: The Equal Society: Essays on Equality in Theory and Practice(2017-06) Schrire, RobertIssues around equality have become of critical importance in our globalised world. Thomas Piketty in France and Paul Krugman in the United States are among many contemporary economists who have stressed the centrality of the impact of inequality on the welfare of nations and peoples. The rise of right- and left- wing populists like Donald Trump and Bernie Sanders is a visible manifestation of the political impact of inequality. This volume therefore comes at a propitious time. The product of an international conference of philosophers held in Cape Town in late 2014, its 14 contributors examine a wide range of practical and epistemic issues related to equality and inequality.
- ItemOpen AccessAn evaluation of a knowledge partnership - a review of the literature(2011-06) Penfold, Erica; Goodman, SukiCommunity interaction with universities forms part of the field of engaged scholarship, civic engagement or socially responsive interaction between universities and communities. This type of interaction yields a different form of knowledge production, as universities and communities engage at different levels and different projects develop out of this engagement. One such form of interaction is the science shop. The following literature review examines the theories of engaged scholarship and role of engagement between universities and communities, from an international and South African point of view. This will introduce the UCT Knowledge Partnership Pilot Project – UCT's first science shop – laying the foundations for a further evaluation of this project over the next two and a half years. Using a broad array of available literature, the following review will introduce a scholarly overview of the scholarship of engagement, community engagement and social responsiveness. In doing so, it will further lay the foundations for the investigation of the practical brokering model – a practical illustration and manifestation of the theories of engagement. One of the more popular forms of engagement in a university forum is the science shop. The core idea in writing this review is to explore the idea and principles of the science shop, in order to evaluate the creation of the UCT Knowledge Partnership Pilot Project. The review will identify the development of the science shop in Europe, North America and Australia, looking at how the shops operate, and how they have been successful or unsuccessful in past years. Having obtained this analysis, the Knowledge Partnership Pilot Project itself will be explained in broader terms, with added analysis and evaluation of science shops.
- ItemRestrictedHandbook of Africa's International Relations(2014) Smith, KarenAfrica has been, and continues to be, marginalised in both the practice and study of international relations (IR). However, in light of the increased influence of the emerging powers on the continent, and Africa’s improved pro- spects for economic growth and develop- ment, in recent years there has been a renewed interest in its role in the international system. This book responds to what the editor calls ‘the emerging political prominence of the African con- tinent on the world stage’ (1) by providing one of the most comprehensive overviews of Africa’s IR to date.
- ItemRestrictedNew regionalism in the South - Mercosur and SADC in a comparative and interregional perspective(2015) Duthie, Shawn RobertThis is a unique and intelligent work that challenges the dominant normative approaches towards regionalism. Based on the author’s PhD research, the book navi- gates away from the overused regional comparisons with the European Union (EU), moving towards a South–South comparison; it also avoids treating regionalism in the South as sui generis. Mattheis analyses two regional organisations – Mercosur1 and the Southern African Development Community (SADC) – to answer two major ques- tions: how do regionalisms produce regions; and how does inter-regionalism change the nature of regionalism?
- ItemOpen AccessQuestioning the undefended accused - Practical examples for Magistrates(2016) Omar, JameelahA review of DJ Steyn Questioning: The Undefended Accused - Practical Examples for Magistrates. 2nd edition. LexisNexis (Pty) Ltd. 2014. Volume 1A R777.00 (soft cover).
- ItemOpen AccessReview of Claire Laurier Decoteau’s 'Ancestors and Antiretrovirals'(2015) Paremoer, LaurenBefore South Africa became famous for implementing the largest public sector antiretroviral (ARV) treatment program in the world, it was infamous for the Mbeki government’s refusal to recognize the efficacy, safety and sustainability of ARVs and his administration’s endorsement of “vitamins and vegetables” as efficacious HIV/AIDS treatments (Cullinan & Thom 2009). The activism required to bring about this policy transformation has been extensively documented by treatment activists themselves (Geffen 2010), and by academics who have sought to explain how these struggles have reconfigured the contours of postapartheid citizenship (Robins 2010), social rights and intellectual property rights law (Pieterse 2014, Kapstein & Busby 2013), transnational activism for access to essential medicines (Mbali 2013), and the political and economic feasibility of providing free ARVs to all who need them (Nattrass 2004).
- ItemRestrictedReview: The Curse of Berlin: Africa After the Cold War(2011-08) Duthie, Shawn RobertNigerian scholar Adekeye Adebajo’s book The Curse of Berlin: Africa After the Cold War centres on the 1884 1885 conference in Germany, presided over by the ‘Iron Chancellor’ Otto von Bismarck. It was at this conference the imperial powers gathered to discuss matters concerning the free trade in the Congo and free navigation of the Congo and the Niger, but more importantly how to peacefully annex the rest of the continent among themselves. Ironically, it was this conference of ‘European locusts’ which called for peace that ‘distorted African politics, economics, and society; damaged indigenous cultures; and retarded socioeconomic development’ (p. 1) to the present day.
- ItemOpen AccessROER4D First Workshop Evaluation(2014-09-08) Walji, SukainaThis report is an evaluation of the success of the ROER4D project's first workshop, held between 9-13 December 2013 in Cape Town. The workshop focused on research skills capacity development, and an evaluation via questionnaire was conducted after the conclusion of workshop activity to determine the success of the workshop. This report contains a summary of the evaluation activity and suggestions on how to improve capacity development in the future.
- ItemOpen AccessTrekking outward: a chronology of meetings between South Africans and the ANC in exile, 1983-2000(2014-05) Savage, Michael