PhD Graduates 2017
1. Naidoo YD
Supervisor: Prof M Taylor
Title: Evaluating government ‘s HIV and AIDS prevention, treatment and care programmes from a lay perspective: a qualitative exploration of the experiences of the South African Indian community of Chatsworth, KwaZulu-Natal.
The candidate’s work contextualized the national HIV/AIDS crisis and its growth in the South African Indian community, and presented the drivers of HIV among this community in terms of their perceptions, attitudes and beliefs surrounding the accessibility of government prevention, treatment and care programmes. Little is currently known about HIV/AIDS among this community and hence the study provides insight into and understanding of the behavioural, biomedical and structural factors that underlie the spread of HIV/AIDS in Chatsworth.
2. Kumalo HM
Supervisor: Prof ME Soliman
Title: Molecular modelling studies on Alzheimer’s target: Beta-site amyloid precursor protein cleaving enzyme (BACE1).
Alzheimer’s disease is a neurodegenerative disorder that causes a change in the mental state of patients suffering form the illness. The generation of amyloid ß-peptide (Aß) by enzymatic cleavages of the ß-amlyoid precursor protein (APP) has been at the center of Alzheimer’s disease (AD) research. This research reported the first account of computational studies which highlighted flap dynamics amongst Beta secretase and their various parameters. Dr Kumulos work has led to publication in five international scientific journals to date.
3. McGillewie L
Supervisor: Prof M Soliman
Title: Investigating plasmepsin flexibility as a function of the flap region – a unique structural and dynamic feature of aspartic protease.
The study focused on the flap region, a characteristic and prominent structural feature unique to aspartic proteases. Accurately defining parameters to quantify the dynamic behaviour of this region in malarial aspartic proteases, plasmepsins; and to ascertain how these dynamics affect enzyme function and the implications on the binding landscape of this enzyme class. The study established that the sequence of the residues compromising the flap region has a profound impact on the flexibility and dynamics of the enzyme.
4. Marera DO
Supervisor: Prof KS Satyapal
Title: Development and Ossification of the Clavicle from Adolescent to early adulthood: A comparative study in the indigenous South African and Kenyan population.
Data from radiological examination of the medial clavicular epiphysis has been used to estimate the age of individuals without valid identification or suspected of providing inaccurate age. There is paucity of information with respect to such data obtained from indigenous Africans. The study proposed reference values that may be used for the indigenous African population. In addition, it noted differences in the values obtained as compared to those for other race groups in the literature reviewed.
5. Asowata OE
Supervisor: Prof P Moodley
Title: Effectiveness of a monovalent human Rotavirus vaccine among children of 5 years and below in KwaZulu-Natal.
The student investigated possible factors influencing the effectiveness of the Rotarix vaccine in children over 5 years and under in KwaZulu-Natal. His results showed that the diversity of the rotavirus genotypes and poor immunogenicity of the vaccine were the key hindrances to the effectiveness of the vaccine. He also showed that the vaccine is potent after its exposure to sub-optimal temperatures. His research advanced our understanding of the level of protection conferred by the Rotarix vaccine in KwaZulu-Natal.
6. Kiguoya MW
Supervisor: Prof T Ndung’u/Dr J Mann
Title: Functional and clinical consequences of Gag-protease sequence variation in HIV-1 subtypes A, C, D and intersubtype recombinants.
The HIV-1 epidemic is composed of diverse subtypes that differ in prevalence and rates of disease progression. The study found a hierarchy in replicative fitness where subtypes A and C are less fit than D, which is in turn less fit than inter-subtype recombinants. This is consistent with reported subtype-specific differences in disease progression. This study may explain the reasons for differences in disease progression and the uneven spread of HIV-1 subtypes worldwide.
7. Ndlovu BG
Supervisor: Prof T Ndung’u
Title: Evolution of humoral immune responses in acute and early human immunodeficiency virus type 1 (HIV-1) subtype C infection. An effective HIV vaccine is urgently needed to stop the spread of the virus. This study examined how effective antibodies that would be suitable to induce by vaccination develop in HIV infected people. A few individuals with highly effective antibodies against HIV were identified and further study of these individuals may lead to an effective vaccine.
8. Cumber SN
Supervisor: Prof JM Tsoka-Gwegweni
Title: A situational analysis of health status and risky factors of street children in Cameroo, in order to develop an appropriate intervention model aimed at improving their health.
This study explored the health, social and psychological challenges and associated risk factors for street children in Cameroon. He surveyed 399 participants, aged 12-17 years, using mixed methods. This study revealed multiple factors affecting the health of street children. Addressing all the challenges faced by street children will need a comprehensive approach which will include tackling “Hunger”, “Hygiene”, “Disease”, “homelessness”, “Education”, and “Love”. Six articles have been published from this study.
9. Nuhu JH
Supervisor: Dr SS Maharaj
Title: Effect of rebound exercise on metabolic outcomes and quality of life in patients with type 2 diabetes.
Investigation was made of the effect of rebound exercise on metabolic outcomes and quality of life among patients with type 2 diabetes seeking medical treatment in Nigerian public hospital. Main outcome measures: Fasting plasma glucose, glycated haemgoglobin, lipid profile and quality of life. At the end of the exercise intervention, there were significant improvements in glycaemic control and lipid profile with participant’s quality of life also significantly increasing. It was concluded that rebound exercise is feasible and safe for individuals with type 2 diabetes. It can be administered as an enjoyable and beneficial recreational adjunctive exercise for improving glycaemic control in diabetes patients.
Supervisor: Prof N Gqaleni
Title: Evaluation of immunomodulatory mechanisms of African traditional medicines using In Vitro and In Vivo models.
The increase in infections has contributed to an increase in the so-called herbal immune boosters. This study comparatively evaluated the immunomodulatory effects of the commercial immune booster and a traditional energy tonic prepared by a traditional healer. The results, published in 4 journals , showed that these products exhibit minimal toxicity in both cells lines and Sprague Dawley rats. Both traditional medicine products modulate the response of immune celles and the traditional energy tonic modulate the immune response of bacteria infected rats. This study has therefore laid the platform for further studies on these and other herbal immune boosters.
Supervisor: Prof M Soliman
Title: Organocatalyzed stereospecific transformation of the carbapenem core-new sysnthetic route to nevel and potentially useful ß-Lactam antibiotics.
The study was focused on the development fo mild reaction conditions that characterize enamine-based asymmetric organocatalysis to offer a new route to novel, potentially medically useful ß-lactam antibiotics (carbapenems) and highly functionalized diazabicyclo[4.2.1] nonanes. This method shows broad subsrate generality and also provides easy access to a wide range of chiral hetero-substituted ß-lactam derivatives. High distereoselectivity was observed in all of the reactions, as would be expected considering the inherent chirality of the starting carbapenam intermediate.
Supervisor: Prof M Soliman
Title: A computational perspectiveof influenza a virus targets: neuraminidase and endonuclease
The influenza A virus has plagued mankind for many years. Predating any advancement medically and pharmacologically. The study offers a computational perspective of the biological pathways of the enzymes, neuraminidase and endonuclease. The impact of mutations in neuraminidase on drug-binding capability i.e. mechanism of resistance to current drug therapy, oseltamivir; and insight into the binding mode of endonuclease were examined. Further to this potential drug candidates were identified using a proposed improved in silico screening technique.
12. Padayachy K
Supervisor: Prof KS Satyapal
Title: Estimating skeletal age using the wrist, in KwaZulu-Natal population: A morphometric study.
Skeletal age estimation is relevant in contemporary society. The study focused on establishing skeletal age of carpal bones of the wrist using digital radiography. Results indicated that the appearance of ossification centres differed to the standard ages documented in international reference atlases, particularly in pubertal and adolescent groups. The study provided reference charts specific to our population groups. This has practical importance in various social contexts such as medico-legal, radiology, anthropology and sporting arenas.
Supervisor: Prof B Bhengu
Title: Development of a framework for engagement of Chronic Kidney Disease (CKD) patients with the integrated management in selected tertiary hospitals of Ethekwini district, KwaZulu-Natal Province, South Africa.
“Ms Geldine Chironda developed a framework for engagement of Chronic Kidney Disease (CKD) patients with their integrated management using an explanatory sequential mixed method. The level of engagement with integrated management was predominantly low. Thereafter, participants with the highest and lowest engagement including caregivers and health care workers were selected to reveal the motivators of and barriers to integrated management. Motivators and barriers were patient and system related. These findings were utilised to develop an evidence based framework to improve nephrology care.”
Supervisor: Prof R Hift
Title: Radiologic evaluation of breast disorders related to tuberculosis amongst woment in Durban, KwaZulu-Natal, South Africa.
Breast tuberculosis is an uncommon form of extrapulmonary tuberculosis, with little systematically-acquired and organised data to guide diagnosis and management. In this work Dr Ramaema described the prevalence, diagnosis and management of breast tuberculosis and explored the use of new modalities of radiological investigation, magnetic resonance imaging (MRI) and positron-emission tomography-computerised tomography (PET-CT), in the diagnosis of the disease, in its differentiation from breast cancer, and in monitoring the success of treatment.
Supervisor: Prof T Ndungu’s
Title: Investigation of viral charecteristics and immune microenvironment between the blood and the central nervous system in patients with HIV associated Mycobacterium turberculosis infection.
Tuberculous meningitis is a common complication in HIV infected persons. This study investigated HIV replication characteristics in the cerebrospinal fluid versus blood of individuals with meningitis including tuberculous meningitis and explored immunological biomarkers for tuberculous meningitis. Tuberculous meningitis was associated with high cerebrospinal fluid viral load and there was evidence of distinct viral strains in the cerebrospinal fluid compared to blood in some patients. Markers that may distinguish tuberculous meningitis from other meningitides were identified. This study enhances knowledge on HIV-1 pathogenesis in tuberculous meningitis co-infection.
Supervisor: Prof NG Mtshali/Prof G Mchunu
Title: A focused ethnographic study on management of chronic commorbid (diabetes and hypertension) conditions among adults in selected primary health care setting in Kenya.
Comorbidity complicates management of diabetes and hypertension. This study developed a context informed model for the management of chronic comorbid conditions in Kenya. A combination of focused ethnography and grounded theory approaches were used for data collection and analysis respectively. The findings of this study have been expressed as a substantive middle range theory showing that systems thinking and inclusion of patients as partners in care, supports integration of chronic care services into healthcare services.
Supervisor: Prof G Mchunu
Title: A collaborative care model for management of Co-Morbid depression and selected non-communicable diseases for Rwandan Health Facilities: model adaptation and justification.
The study explored the current situation regarding the management of co-morbid depression and chronic NCDs in Rwanda in order to adapt the Collaborative Care Model to the Rwandan health care services. The study first explored the prevalence of depression in patients with chronic NCDs; it explored also the current situation regarding management of co-morbidity of depression and chronic NCDs and adapted a Collaborative Care Model (CCM) to the Rwandan context. Action research sequential explanatory design guided the study using mixed- methods approach.
Supervisor: Prof M Taylor/Prof C Jinibha
Title: An investigation of the housing conditions and the health related quality of life clients in the built environment in the eThekwini Municipality during the HIV and AIDS epidemic.
The South African Constitution protects the right to housing and to have access to health care. The implementation of these rights was investigated in a study undertaken in eThekwini focusing on four housing typologies; namely informal settlements, reconstruction and development housing, traditional rural housing and inner-city apartments. The study highlighted the shortfalls in achieving adequate housing and access to healthcare during the HIV/ AIDS epidemic, and offers recommendations to improve residents’ quality of life.
Supervisor: Prof B Sartorius/Prof P Drain
Title: Evaluating the accessibility and utility of HIV-related point of care diagnostic for maternal health in rural South Africa.
The aim of this study was to reveal barriers and challenges related to implementation of point-of-care diagnostics in rural and resource-limited settings. The following research methods were employed: systematic review; cross-sectional survey; interviews; laboratory testing; and an interrupted time series. Results identified potential life-saving and transformative point-of-care tests that need to be implemented and proposed evidence-based frameworks for appropriate implementation and sustainability, to ensure quality service delivery of point-of-care tests. This thesis has 6 published papers.
Supervisor: Prof JH Grosset
Title: Maximising the therapeutic potential of clofazimine for turbeculosis treatment.
The anti-leprosy drug clofazimine has potential for shortening tuberculosis treatment. However, the optimal dosing fo clofazimine is uknown, and the mechanism of action fo clofazimine remains poorly understood. The candidate conducted a series fo preclinical experiments to remedy this situation and contribute useful information on maximising the therapeutic potential of clofazimine in the treatment of tuberculosis and inform appropriate dosage and design of future research studies.
22. Mbatha JN
Supervisor: Dr ZL Mkhize-Kwitshana/ Dr MFD Baay
Tutle: Genotyping, clearance and persintence of high-risk human papillomavirus and evaluation of self-sampling techniques in HIV infected and uninfected young women in selected regions of KwaZulu-Natal.
This was a community based study that described the most common high-risk Human Papillomavirus (hr-HPV) genotypes identified from 1 223 sexually active young women (16-20 years old) in two rural areas in KwaZulu-Natal. The most common hr-HPV genotypes were HPV 35, 51, 56, and 59, none of which are covered by the new nonavalent HPV vaccine. The most highly persistent HPV at the 12 month follow-up was HPV 52. Similar genotypes were identified from HIV infected and uninfected participants. Finally, 98 participants were enrolled to assess acceptability and suitability of the self-sampling technique for HPV screening (Dakron swab compared to Viba-Brush). The majority of the 98 women preferred self-sampling (Dacron swab compared to Viba-Brush) over clinician sampling of genital specimens. The Dacron swab was the preferred self-sampling device because it was perceived to be more comfortable. Dacron swab specimens and associated DNA are preserved on FTA cards which are stable at room temperature and are easily stored and transported.
Supervisor: Prof NG Mtshali
Facilitation of the development of blended E-Learning model for nursing education in resource constrained educational setting in Nigeria.
The candidate’s work demonstrates that blended e-learning is doable for nursing education in resource constrained settings. The study successfully designed, developed and piloted a blended e-learning model that is appropriate for effective delivery and learning of nursing knowledge and skills in a resource-constrained community. The model has proven to be a useful tool for increasing access to nursing education while not compromising on the quality of learning.
Supervisor: Profs F Albericio/T Govender/G Kruger
Advanced Strategies for Peptide Synthesis
Peptides are a very important class of biomolecules, with excellent applications in the medicinal chemistry. They are excellent biochemistry tools and are used as drug delivery systems, making peptide synthesis an important research area. Therefore, a continuous development of new peptide synthetic methodologies is essential for peptide synthesis in laboratories and industries. The candidate’s research project has led to 9 peer reviewed publications and a book chapter.
Supervisor: Dr OO Azu/ECS Naidu
Title: Testicular morphological and seminal alterations following highly active antiretroviral therapy and the ameliorative effects of plant-based adjuvant: an experimental normo and hypertensive animal model.
This study focused on the effects of adjuvant use of a plant extract from Hypoxis hemerocallidea widely used for treatment of diabetes mellitus and hypertension in mitigating the side effects of Highly Active Antiretroviral Therapy (HAART). We quantified the changes in testicular sperm morphology and histology in Normotensive and Hypertensive states using experimental animal models.
Supervisor: Prof NG Mtshali
Title: An analysis of the utilisation of E-learning platform at a selected Nursing school in Rwanda: A participatory action research study.
Our results highlights exacerbation of testicular injury following adjuvant treatment with Hypoxis extract in HAART protocols warranting caution.
Supervisor: Dr MV Mabandla/ Prof CT Musabayane
Title: Influence of Simultaneous Plasmodium Berghei Infection and Asiatic Acid Administration in Sprague Dawley Male Rats: Effects on Glucose Homeostasis and Renal Elecrolyte Handling.
Asiatic acid, a phytochemical derived from Centella asiatica, displayed anti-parasitic, anti-disease, antioxidant, anti-inflammatory influences on Plasmodium berghei-induced murine malaria in Sprague Dawley juvenile male rats through suppression of parasitaemia, modulation of malaria-induced hypoglycaemia, abrogation of malaria-related glucose homeostasis derangement, improvements in food and water intake, normalization of oral glucose tolerance response and amelioration of renal pathophysiology while averting of hyper-arginine vasopressin secretion, pseudohypoaldosteronism and sodium wasting.
Supervisor: Dr MV Mabandla/ Prof WMU Daniels
Title: The Effects of Fluvoxamine Maleate in a Post-Natal Stress Rat Model of Neurodegeration
This thesis showed that Fluvoxamine maleate (FM) treatment attenuated the degenerative effects of 6-OHDa in a Parkinsonian rat model with anxiety /depresssive-like behavior and cognitive deficits. The neuroprotective effects fo FM suggests that early treatment of anxiety, depression, and cognitive deficits with FM reduces the vulnerability of DA neurons to neurodegenaration.
29. Musesengwa R
Supervisor: Prof Chimbari
Title: Community Engagement Strategies and Experiences in a Multicentre Study in South Africa and Zimbabwe.
The candidate studied the community engagement strategies and experiences in a multicentre study in South Africa and Zimbabwe. Her study revealed that there is scanty literature on community engagement particularly in multicentre studies. She also demonstrated how community perspectives can be utilised to guide researchers on the community engagement and research process. Her results were used to develop a model for community engagement in multicentre studies.
Supervisor: Profs KS Satypal/Mrs L Lazarus/Dr A Van Tongel
Title: An anatomical investigation o the subacromial complex: Intrinsic and extrinsic parameters of the South African and Belgian populations
The candidate investigated the effects of a novel home-based rehabilitation intervention on the quality of life and functional capacity of people living with HIV in a resource-poor setting in KwaZulu-Natal. The candidate employed a task shifting approach in training lay community care workers to deliver the study intervention. The study provides quantitative and qualitative evidence of the successes and challenges of a home-based rehabilitation programme designed specifically for people living with HIV and disability.
Supervisor: Prof J Botha
Title: An investigation into the use of complementary and alternative medicine for atopic eczema.
Atopic eczema is an allergic skin condition. Because it is long-term, patients often lose hope and try complementary and alternative medicines. The candidate explored knowledge and use of these medicines by patients and health care professionals in Durban. She found that, despite being widely used, knowledge of them was limited. A formal systematic review of the global scientific literature revealed that there is, as yet, no proof that these medicines work. This study contributes significantly to our knowledge of complementary therapies in atopic eczema.
Supervisor: Profs J Hanas-Hancock/H Myezwa and Dr S Maharaj
Title: Home-Based Rehabilitation for people living with HIV in a resource-poor setting in KwaZulu-Natal, South Africa
The candidate investigated the effects of a novel home-based rehabilitation intervention on the quality of life and functional capacity of people living with HIV in a resource-poor setting in KwaZulu-Natal. The candidate employed a task shifting approach in training lay community care workers to deliver the study intervention. The study provided quantitative and qualitative evidence of the successes and challenges of a home-based rehabilitation programme designed specifically for people living with HIV and disability.
Supervisor: Prof T Govender
Title: Nanobased approaches to treat susceptible and resistant S.Aureus infections.
This thesis showed the potential of the various newly developed nanobased approaches studied in treating susceptible and resistant S. aureus infections. This study has made significant contributions to the field of nanobased strategic solutions to address the problems associated with current antibiotic therapy. This strategic approach will play a pivotal role towards improving the treatment of diseases associated with bacterial infections thereby saving lives and improving the quality of lives of communities.
Supervisor: Profs T Govender/HG Kruger
Mass Spectrometric Imaging for Tuberculosis Drug Development.
The candidate evaluated the brain distribution and localization of several anti-tuberculosis drugs for the treatment of extra-pulmonary TB of the central nervous system. This study demonstrates how mass spectrometric imaging can be used as a tool to evaluate the brain penetration of potential anti-tuberculosis agents, during the pre-clinical drug development stage.
Supervisor: Prof T Govender
Title: Nove lipidic materials to enhance the transdermal delivery of Tenoforvir.
Current oral administration of tenofovir has several limitations. This study aimed to develop lipid-based strategies to overcome the barrier property and deliver therapeutically relevant doses of tenofovir transdermally for the effective treatment of HIV/AIDS. Synthesis and application of novel lipidic derivatives and lipid based colloidal nanoformulations displayed superior transdermal permeation enhancement of tenofovir. This study has produced one UK patent and three published articles.
36. Hampannavar G
Supervisor: Dr R Karpoormath
Title: Novel Series fo Dehydrozingepore Insipered Potential Antimycobacterial Agents: Design, Synthesis, Spectral Studies and In VitroBiological Evaluation.
Tuberculosis is a growing health burden globally. Emergence of resistance issue has necessitated the need of more innovative, potential, safe and effective antitubercular drug candidates to overcome the drawbacks associated with existing drugs. Therefore, synthetic manipulations of natural sources are being extensively investigated worldwide for developing a potent and efficient drugs. This project was an effort, and indeed a success in identifying a novel and effective antitubercular leads based on natural product model Dehydrozingerone (DZG), a curcumin degradant.
Supervisor: Profs M Pillay/B Pillay
Title: Evaluation of Mycobacterium tuberculosis curli pili as diagnostic biormarker for a point-of-care diagnostic test
Mrs Naidoo addressed delays in TB diagnosis in low-income settings by undertaking a proof of concept study on a novel biomarker, Mycobacterium tuberculosis pili. Her work proved conclusively that MTB pili are exclusive to and expressed in the MTB complex and not in other pathogens associated with respiratory diseases. Anti-pili antibodies were detected in TB patient sera using a rapid slot blot assay, laying the groundwork for the development of tests to be used at point-of-care and resulting in two publications in the journals “Tuberculosis” and “Biomarkers” and her work was presented at international and local conferences.
Supervisor: Prof R Bobat
Title: Severe Acute malnutrition and antiretroviral treatment in children with HIV.
Malnutrition is a contributes to almost 50% of global childhood deaths. HIV-infected malnourished children contribute a disproportionately high burden to this mortality. The results from the PhD research provided evidence to support key national and global recommendations on the optimal management of HIV-infected malnourished children. His findings have specifically advised on the optimal timing of antiretroviral treatment, appropriate antiretroviral drug dosages and the effects on immune activation and exhaustion in these vulnerable children.
Supervisor: Prof JM Tsoka-Gwegweni
Title: Factors influencing the implementation of the malaria elimanition policy in South Africa.
Studies on barriers and facilitators to effective implementation of malaria elimination policies are lacking. Using mixed methods, this study revealed multiple factors affecting the implementation in SA, from implementers, researchers and policy makers’ perspectives. The overarching challenge was the perceptions that the whole elimination agenda was externally sculpted, with local actors’ participation being superficial. The study culminated in the development of a Conceptual Framework illustrating the features affecting the implementation of malaria elimination in SA.
Supervisor: Dr V Singaram
Title: “Sowing the seeds” The use of Feedback in postgraduate medical education: A key factor in developing and enhancing clinical competence.
This mixed methods study examined the process of Feedback, across six disciplines at a teaching hospital. Registrars reported that consultants lacked training on how to give feedback and that important elements were missing. Consultants reported heavy workloads, fear of negative reactions, apathy, lack of institutional support and a guiding framework hampered the process. This study developed policy guidelines and strategies to enhance the culture of Feedback in the training of medical specialists at UKZN.
Supervisor: Prof Aldous
Title: An Investigation into the Renewed Need for the Care and Prevention of Congenital Disorders in South Africa.
Congenital disorders (CDs) fell down the list of health care priorities in the wake of the HIV and TB pandemics. The candidate has shown that epidemiological transition now demands that to reduce infant mortality, an effort is to be made to addres the prevention of CDs or improve the care of sufferers. She has shown that the legal framework exists for improvement of services and that monitoring is important in planning for service for CDs.
Supervisor: Profs MJ Chimbari/S Mukaratiwa
Title: Experimental studies on the effect of temperature on the Bulinus globosus-Schistosoma haematobium system.
Schistosomiasis distribution in sub-Saharan Africa is likely to be influenced by climate change. This candidate investigated the possible impacts of climate change on the Bulinus globosus – schistosoma haematobium system. He concluded that rise in temperature may affect the life history traits of intermediate host snails for schistosomiasis leading to a change in the epidemiology of the disease. His study contributes to knowledge useful for understanding the transmission dynamics of schistosomiasis in the context of climate change and essential for effective schistosomiasis control programs.
Supervisor: Profs T Govender/T Naicker/HG Kruger
Title: Synthesis and Evaluation fo Peptides for Radiopharmaceutical Applications.
In this research thesis a brief review on radiotracers having potential for bacterial infection imaging is presented as a review article. Besides, a facile approach for the synthesis of bifunctional chelator NODASA was established during the course of this study. Moreover, the synthesis and the evaluation of antimicrobial peptide LL37 along with nat/68Ga complexed NODAGA-LL37 was carried out to judge its potential as a radiotracer.
Supervisor: Prof NG Mtshali
Title: A Clissical Ethnographic study on academic monitoring and support services of undergraduate nursing students in higher education in KwaZulu-Natal.
Student support is gaining popularity as student attrition is contributing to the chronic shortage of nurses and their skewed distribution, which mostly affects rural and remote areas. This classical ethnographic study analysed academic monitoring and support (AMS) culture, practices and processes in the undergraduate nursing education programme in order to generate a context-informed AMS middle-range theory. AMS theory reflected AMS as a tool to promote education for social justice, educational equity and success and facilitate social change that is characterised by improved distribution of the nursing workforce, access to health care and population health outcomes.
Supervisor: Profs KS Satypal/Sookrajh
Title: The praxis and research of human anatomy through autoethnography
The use of auto-ethnography and collaborative auto-ethnography as research approaches can be considered dissident, and an ‘anatomical turn’ in the praxis and research in the domain of anatomical education. This study highlights relevant contributions to the research, praxis (teaching and learning) of human anatomy through views of all significant role players – students, researchers and educators. The conceptual framework which was abstracted from the articles and the thesis in its entirety, offers significant understandings regarding the praxis and research of human anatomy within the context of educational theory.
Supervisor: Profs Satyapal/T Bhengu
Title: Cultural and religious attitudes of Black South Africans towards body donation.
The candidate investigated the cultural and religious attitudes of the Black African population in the KwaZulu-Natal Province, in order to document the public’s interpretation of their belief systems or sacredness of the dead body and its treatment in anatomy departments. The study revealed low levels willingness to donate bodies to science. Cultural beliefs on ancestors were unanimously reported as not permitting the body donation with the importance of whole- body burial as an underpinning custom. The findings may guide anatomy departments on future body donation campaigns and their treatment of the dead. The incorporation of beliefs systems on body donor forms and the respect there-of is proposed and recommended.
47. Aung M
Supervisor: Profs P Gathiram/J Moodley
Title: Gene polymorphisms of the renin-angiotensin-aldosterone system in the pathogenesis of pre-eclampsia in black South African women
The candidate investigated the cause of preeclampsia (PE), a condition in which high blood pressure develops in pregnancy. The role of gene polymorphisms of renin-angiotensin-aldosterone system was determined. Furthermore 7 genotypes including Aminopeptidase A (ENPEP), a newly discovered gene found to play a role in blood pressure regulation, in 603(246 normotensive and 357 hypertensive) pregnant women was investigated. The results showed that polymorphism of the ENPEP and angiotensinogen genes play a role in the development of PE.
Supervisor: Dr F Balagadde
Title: Microchemostat technologies for characterization of efflux pumps associated with multidrug resistance in Mycobacterium tuberculosis
The presence of efflux pumps—that can pump out drugs from within the cell—have been shown to play an important role in the development of Tuberculosis drug resistance. The candidate developed a new bioengineering approach that enables the study of individual TB efflux pumps in isolation. Using this approach, he has demonstrated that efflux pumps contribute significantly to drug resistance not only through extruding drugs, but also through inhibiting bacterial division.
Supervisor: Prof Aldous
Title: Culturally Competent Patient-Provider Communication with Zulu Patients Diagnosed with Osteorsarcoms.
Communicating about cancer in cross-cultural medical settings is daunting. The candidate conducted an integrative literature review and gathered evidence from healthcare providers and Zulu patients diagnosed with osteosarcoma with the aim of developing an evidence-based practice guideline for culturally competent communication with this patient group. This guideline recommends responding appropriately to culturally discordant medical encounters and presents generic recommendations for culturally competent communication as well as specific recommendations for communicating about diagnosis, treatment and prognosis.
Supervisor: Dr Voce
Title: Academic success of Masters of Public Health in South Africa.
The study set out to investigate the academic success of part-time MPH programmes. Factors influencing academic success in the SA context lie in the socio-political, institutional and student domains as well as in the Higher Education sector. The study proposed a conceptual framework for understanding academic success among postgraduate part-time mature-age students.
51. Rawatlal N
Supervisor: Prof BJ Pillay
Title: A study of family and environmental stress factors, alcohol use and depression in a South African youth cohort.
Adolescence represents a challenging transitional period with changes in biological, emotional, cognitive and social domains. Risk factors such as low socio-economic status, dysfunctional family functioning and disrupted family structures, increase vulnerability for many negative outcomes during adolescence. The candidate examined how factors like low SES, family processes such as support, communication, conflict and cohesion and family structures influenced attachment dyads between the adolescent and parent, depressive symptoms, alcohol use and emotion regulation in youth.
52. Tlou B
Supervisor: Profs B Sartorius/F Tanser
Title: Spatial -temporal dynamics and structural determinants of child and maternal mortality in a rural, high HIV burdened South African population, 2000-2014.
Understanding the impact of location and time on health is a key element of epidemiological investigation, and numerous spatial-temporal techniques can be employed to analyze spatial health-related data. The candidate used advanced spatiotemporal techniques to identify hotspots (high-risk areas) for child and maternal mortality, and their associated risk factors. This will guide health planners and policymakers in the effective use of scarce resources to target intervention programmes.
Supervisor: Dr M Gordon
Title: HIV-1 drug resistance by ultra deep sequencing after exposure to prevention of mother-to-child transmission (PMTCT) strategies in KwaZulu-Natal.
The candidate investigated the development of drug resistance following the administration of antiretrovirals as part of prevention of mother-to-child HIV-1 transmission (pMTCT) strategies in South Africa. She found that a post-partum single-dose TDF/FTC tail does not prevent the selection of NNRTI resistance in women receiving pre-partum zidovudine and intra-partum single-dose nevirapine. This high level of NNRTI resistance could impact future NNRTI-containing treatment for a large proportion of pMTCT-exposed women in South Africa.
Supervisor: Dr Mabandla
Title: The effects of transdermal anti-malarial formulations non malaria parasites and selected metabolic parameters in male Sprague-Dawley rats.
The study evaluated the effects of a novel transdermal pectin-insulin patch application on selected markers of cardiovascular, renal and cognitive function in streptozotocin-induced diabetic rats. This was in an effort to gain a holistic therapeutic insight rendered by the patch application. The application of the pectin-insulin patch improved cardiovascular, renal and cognitive outcomes in diabetic animals.
Supervisor: Prof B Bhengu
Title: Participation of Nurse leaders in health policy development: An action research approach.
Nurses make up the majority of health care professionals and are uniquely positioned to influence health care priorities nationally, but they are relegated to the margins of health policy development. The candidate’s research showed limited participation especially at the Provincial and National levels. Nurse leaders were mainly implementers of policies. Knowledge of the health policy development process was limited. A policy workshop was conducted and a policy brief was developed and submitted to the Ministry of Health.
Supervisor: Prof C Aldous
Title: A Multifaceted Approach to improving Regional Diabetes care.
The pandemic of diabetes and its complications is ravaging the world. Optimal control of this pandemic is critical but currently not being achieved globally more especially in developing countries. The candidate designed and tested a multi-faceted clinic based approach to the care of the diabetic patient which showed improvements in patient well-being. The blueprint of this specifically designed approach can be utilised by other such diabetic clinics in South Africa and in developing countries globally.
Supervisor: Prof A Coutsoudis
Title: Effects of Feeding Buddies on adherence to the World Health Organization prevention of mother-to-child guidelines in South Africa.
The candidate set up a randomized controlled trial to evaluate a Feeding Buddy programme designed to provide instrumental and emotional support to HIV infected pregnant women, within a prevention of mother-to-child transmission programme. The results provided a basis for a Feeding Buddy model which significantly improved HIV status disclosure. In addition it demonstrated how, with the support of the Feeding Buddy, women were able to develop resilience to confidently deal with the challenges they faced.
Supervisor: Prof B Pillay
Title: Alleviating the mental health crisis in South Africa’s Rural Primary Care areas through Task Shifting: Non -Medical Prescribers and the case of Clinical Psychology.
The results of this study provided the first published figures of mental health human resources in South Africa’s Rural Primary Care areas. A human resource crisis was indicated, and innovative strategies such as task-shifting and transdisciplinarity were explored as interventions. This research suggested that more cadres of non-medical health professionals, with the appropriate training, could make use of psychopharmacology to alleviate medical workforce shortages in South Africa’s Primary Healthcare Settings.
59. Mashige KP
Supervisor: Prof OA Oduntan
Title: A comparatives study of ocular structural dimensions that are associated with glaucoma in a black South African population with healthy eyes.
This study was undertaken to compare ocular structural dimensions associated with glaucoma in healthy eyes of Black South Africans. The ocular parameters studied, and their associations, are useful in understanding the pathophysiology, diagnosis and management of glaucoma in this population. The study contributes to the development of interventions that address the specific needs of Black South Africans in terms of glaucoma. This thesis was presented as 9 publications in national and international journals.
60. Saloojee S
Supervisor: Prof Motala
Title: Metabolic Syndrome and Severe Mental Illness at General Hospital in the Ethekwini district in KwaZulu-Natal, South Africa.
Patients with severe mental illness die earlier than people without a mental illness. The candidate’s research found that people with severe mental illness on antipsychotic medication in the Ethekwini District have a high prevalence of metabolic syndrome which predisposes them to develop cardiovascular diseases. The results of this study informs cardiovascular prevention and promotion strategies for patients with severe mental illness and helps to improve the physical health of people with a severe mental illness.
Supervisor: Prof F Suleman
Title: Evaluating the Pricing Interventions in the Private Sector of the South African Pharmaceutical Distribution Chain.
The thesis aimed to explore the various components of the Single Exit Price (SEP) intervention, as well as distribution chain pricing policies and mark-up regulations influencing medicine pricing in the South African private healthcare sector. It provides evidence for a range of policy recommendations and measures to improve access to medicines in South Africa, which is imperative when considering governments proposed move toward National Health Insurance.
Supervisor: Prof R Hift
Title: The burden of disease and predection of risk of adverse outcomes.
Snakebite is recognised as a neglected tropical disease. Snakebite is a significant cause of morbidity and mortality in southern Africa, yet it is under-researched. In this work the candidate combined his extensive clinical experience with structured scientific enquiry to provide an evidence-base for snakebite and its management in our communities, including the first reliable estimate of its incidence and development of a scoring system to predict severity and guide treatment.
T Supervisor: Dr J Naidoo/Prof G Mchunu
itle: A theory of aftercare for human trafficking survivors: A grounded theory analysis of survivors and aftercare providers in South Africa.
Robyn Curran undertook a grounded theory study with the aim of developing a theory for aftercare of human trafficking survivors, through analyzing the experiences of survivors and aftercare providers in shelters in South Africa. A theoratical model of the renewed self emerged from the voices of participants. The recommendations of this study may improve the nursing care provided to human trafficking survivors and equip nurses with knowledge and skills to promote the restoration of survivors.
Supervisor: Dr B Honarparvar
Title: Molecular Modeling Studies on Non-Nucleoside HIV-1 Reverse Transcriptase Inhibitors (NNRTIs).
QSAR modeling, docking and molecular dynamics (MD) studies on NNRTIs were performed in this work. Scaffold-based QSAR analysis and molecular docking identified a potential chemical scaffold, which was further studies using MD. We performed a cumulative 240 ns of MD simulations, Dynophores, free energy analysis. MD simulations of WT and various mutant RT complexed with RPV, EFV, and ETR were also performed.
65. Parboosing R
Supervisor: Profs Kruger/ T Govender
Title: Nanotechnology and the treatment of HIV infection.
This thesis explored the emerging field of nanotechnology and its role in the treatment of HIV infection. Specifically, strategies to deliver a novel RNA decoy into hard-to-transfect lymphocytes were investigated. The decoy was designed to inhibit the packaging of HIV. The first strategy, using a dendriplex containing the packaging decoy, showed some antiviral activity. The second strategy used a bio-inspired approach based on the concept of an “artificial virus”.
Profs B Sartorius/J Supervisor: Tsoka-Gegweni
Title: The burden of HPV infection and HOV related diseases among sexually women in The Kingdom of Swaziland: Its implication during era of HIV epidemic.
The burden of hr-HPV infection,hr-HPV/HIV-coinfection and HPV-related conditions were very high among sexually active women in Swaziland. The high economic burden of cervical lesions, CC and genital warts represented a major public health problem in the Kingdom. The current study findings contribute to policy development on prevention of HPV infection with a national HPV immunization programme, the planning of prevention and comprehensive screening strategies(considering triage modalities), especially among the youth and HIV-infected individuals.
67. Bvumbwe TM
Supervisor: Prof NG Mtshali
Title: A critical analysis of strategies aimed at improving quality, quantity of Nursing education in Malawi.
Nursing education is struggling to keep up pace with the demands for quality, adequate nursing workforce that is relevant to the health care needs of our societies. Poor quality of nursing care negatively affects health outcomes. The candidate analysed challenges, solutions and initiatives in nursing education and further developed a middle range model to guide improvements in the quality, quantity and relevance of nursing education in order to achieve positive health outcomes in Malawi.
Supervisor: Profs K Satyapal/McQuoid Mason
Title: Legislative framework for the use of human remains in teaching and research at Higher Education Institutes in South Africa.
This unique empirical study explored the legal and ethical framework related to the use of human remains for anatomical teaching and research. An interlink between procurement of human remains, bioethical principles, and the law was documented. A change in trend in procurement practice may be the outcome of amending legislation and creating public awareness body donor campaigns. The study recommended the establishment of a national anatomy consultative forum, an online database for cadaver records and institutional guidelines for best practice related to use of human remains.
Supervisor: Dr S Naidoo
Title: The effects of Z-venusol isolated from an indigenous South African plant, Gunnera perpensa, on human breast cancer cells in vitro.
Medicines originally derived from plants play an important role in the management of many diseases, including cancer. Although various combinations of medicines increase survival rates in patients with cancer, many chemotherapeutic agents are expensive and cause severe side-effects which are also costly to manage, mainly because they inhibit growth of both normal and cancer cells. The candidate addressed some fundamental questions regarding the effects of certain pure compounds, i.e., Z-venusol, ent-Beyer-15-en-19-ol and hypoxoside, which were isolated from indigenous southern African plants, and then tested on human prostate, cervical and breast cancer cells. He showed that Z-venusol, in particular, significantly inhibits the growth of breast cancer cells, but has minor effects on normal cells that would usually surround the cancer.
Supervisor: Profs C Aldous/Orgill
Title: The Use of Paper Tape Application in Skin Tissue Expansion and Abnormal Scar.
Modulation Healing of wounded skin may be associated with abnormal scarring. The wounding process itself may result in skin loss. The use of a skin stretching devices for closure of skin are expensive and painful. The candidate designed a novel technique using paper tape that can be used to stretch skin to close created or existing wounds, as well as treat and prevent abnormal scarring. In our resource constrained setting it has been shown to work.
71. Matshela MR
Supervisor: Profs PA Pellikka/Prof R Hift/ Prof HR Villarrag
Title: Biventricular Mycordial Mechanics in Constrictive Pericarditis Assessed with 2D-Speckle Tracking Echocardiography: Impact of Etiology of Constriction and Effect of Pericardiectiomy.
Constrictive pericarditis is a condition in which the pericardial lining of the heart becomes fibrous and thickened in response to triggers such as tuberculosis, radiation exposure and cardiac surgery. Resultant inelasticity of the pericardium may result in mechanical impairment of the ventricles with serious clinical consequences. In this study, Dr Matshela used modern computer-assisted echocardiographic technology to investigate the relationships between and severity of constriction, myocardial function, therapeutic pericardiectomy and health and survival.
Supervisor: Dr Mabandla
Title: The Effects of a Pectin-Insulin Patch Application on Streptozotocin-Induced Diabetic Rats: Implications on Cardiovascular, Renal and Cognitive Function.
Despite the beneficial effects associated with insulin therapy, current insulin administration mode seems to hinder its therapeutic efficacy since it’s associated with severe undesirable effects. To overcome these challenges, in our laboratory we developed a transdermal pectin-insulin patch with an ability to facilitate insulin delivery into the circulation and lower blood glucose concentration. Herein, we further evaluated the effects of this novel transdermal pectin-insulin patch application on selected markers of cardiovascular, renal and cognitive function in streptozotocin-induced diabetic rats. This effort was directed to gain a holistic therapeutic insight rendered by the transdermal pectin-insulin patch application in diabetes mellitus. The application of pectin-insulin patch improved cardiovascular, renal and cognitive outcomes in diabetic animals.
Supervisor: Prof J Moodley
Title: Maternal Complications in HIV Infected Women Receiving Combination Antiretroviral Treatment in a Resource Constraint Setting.
Dr Sebitloane is a graduate of the University of KwaZulu-Natal and initially showed interest in Family Medicine. She then became interested in the care of women, babies and their families, and joined the Department of Obstetrics and Gynaecology. Further, she gained interest in HIV research and became a Research Fellow in the study of HIV associated infections. She continued her research on HIV into her PhD thesis. Despite clinical commitments and her enthusiasm for community obstetrics, she persisted with her thesis.
Supervisor: Dr S Singh
Title: Analysis of Services Provided by Oral Health Professionals in Limpopo Province.
The candidate’s work is the first major study to examine oral health planning and service delivery in Limpopo Province. The study made an important contribution to the current oral health status in the province while identifying challenges associated with oral health service delivery, and encourages a broader sphere of dialogue and communication that can contribute to improved oral health outcomes. This is particularly significant given the envisaged implementation of the National Health Insurance plan.
75. Onyangunga O
Supervisor: Profs T Naicker/Prof J Moodley
Title: The role of lymphaniogenesis in placental bed and placents of HIV associated preecamplsi.
It is a serious obstestric dilemma that young women of reproductive age are at risk of HIV infection in the Province of KwaZulu-Natal. This study demonstrates that hypertensive disorders in pregnancy develops in 12.5% of primigravidae and it confirms poor maternal and fetal outcome in early onset pre-eclampsia. The candidate’s thesis also reports an absence of lymphatic vessels in the placenta demonstrating that placental fluid homeostas is probably maintained by a podoplannin reticular -like complex within placenta villi. It proposes that placental macrophages provide an innate response against pathogen thereby maintaining maternal-fetal immunity.
Supervisor: Prof M Taylor
Title: Development and implementation of a behaviourial youth risk reduction interventation in the context of Operation Sukuma Sakhe in uMgungundlovu District Municipality, KwaZulu-Natal Province.
This thesis showed that micro-system, exo-system and macro-system contribute to fostering riskier sexual behaviours. Re-engineering of interventions addressing the risk behaviour of the young people in uMgungundlovu Municipality is required targeting these levels, since the existing interventions directed at the individuals have not resulted in the desired health outcomes.