It was cheers and ululations for Dr Faheema Abdoola when she graduated from the MBChB programme summa cum laude.

The 23-year-old from Umhlanga topped the final-year class of 2012, receiving a slew of awards in recognition of her outstanding academic achievements from first to final year at UKZN. 

A recipient of the L C Robinson Scholarship for being the top registered undergraduate student, Abdoola also scooped the College of Health Sciences Prize for being the top final-year MBChB student in 2012 as well as the Dr Y K Seedat prize, also awarded to the top student.

Her standards of excellence follow her from Danville Park Girls’ High School where she finished third among the KwaZulu-Natal public school matriculants in 2007.

‘It’s quite unbelievable. My family’s ecstatic! I could never thank them enough for the support and encouragement,’ she said.

Abdoola found her rotations through Paediatrics the most enjoyable part of her undergraduate training. She is currently doing her internship at Mahatma Gandhi Memorial Hospital in Phoenix, which she says is a great working environment with an exceptionally supportive team of healthcare workers.

But she also had high praise for UKZN: ‘The staff at UKZN, including senior lecturers and heads of departments, gave time to impart invaluable knowledge to undergraduate students from their wealth of experience – which today helps us in seeing to our own patients.’

The highlight of Abdoola’s studies was their rural rotation where the class was given the opportunity to work in a rural district hospital during the Family Medicine block of the MBChB programme.

‘I was based at Eshowe Hospital and learned an incredible amount from the doctors I worked with. They use innovative thinking and drive to continually improve standards of care with their limited available resources. This was truly inspiring.’

Abdoola now has her heart set on becoming an ophthalmologist, specialising in that branch of medicine which deals with the anatomy, physiology and diseases of the eye.

author email : memelal@ukzn.ac.za



Dr Welile Shasha, a medical scientist and internationally-recognised public health specialist, received an Honorary Doctorate in Medicine from his alma mater, the University of KwaZulu-Natal, at a Graduation ceremony held on the Westville campus.

Dr Shasha is currently the manager of health system reform at the Letsema Circle Trust, an NGO based in East London which helps communities fortify the health system by collaborating with local government departments. He also conducted a programme evaluation to consolidate and synchronise health research in Kenya and served as a leading facilitator for a Public Health course for students from the United States, Botswana and South Africa, sponsored by the WK Kellogg Foundation.

Shasha’s address centred on the removal of apartheid, the rapid rise of the disease burden, unwise interventions, good policy and political commitment, as well as the exciting role of health professionals as change agents.

‘This University played a key role in the process [of the removal of apartheid] in many ways. Yes, apartheid police would chase us around the buildings - very painful, yet exciting as we realised the certainty of victory! Our Constitution was then in place, and we felt the land of milk and honey was at hand.’

Shasha explained that by the time apartheid was removed, it had already created very fertile conditions for the rise of the disease burden, especially TB and HIV. ‘The virus killed young people of child-bearing age, and funerals are still the order of the day, leaving thousands of orphans.’

He added that a third and devastating problem was unwise interventions such as employing people not suitable for the job in leadership positions, especially as heads of government departments.

‘In the Province of the Eastern Cape there was a time when posts were not advertised, and comrades simply allocated positions to themselves. That province remains at the bottom of the pile in health and education to this day. The people that were employed in the above manner were very good, committed individuals who had fought very hard for our country, but were not good managers that could execute large health programmes.’

By the time the problem was discovered, Shasha said that many vicious circles had already set in, including the (internal) emigration of health professionals and the collapse of sections of the health system. ‘Fortunately, the government is currently addressing the issue and its consequences, and one is very grateful to our President for that intervention. Siyabonga Msholozi!’ he said.

Shasha also touched on the development of “good policies”, such as the National Health Insurance (NHI) and National Development Plan (NDP). He commended the political commitment of ministers of health, Drs Nkosazana Dlamini-Zuma and Aaron Motsoaledi, and looked briefly at the training of more doctors in Cuba.

‘The two policies of NHI and NDP, if implemented correctly, will turn South Africa into one of the best countries in world health and development. This is where you graduate health professionals can play a key role,’ he told graduates.

Finally, Shasha looked at the ways in which health professionals can strengthen the health system, including providing technical support in the form of clinical and specialist services to the Department of Health for implementation of the NHI and NDP, and facilitating the participation of local communities as full partners in government health programmes.

At present, Dr Shasha is in the process of registering a Foundation for Health and Development in order to facilitate the inputs of health professionals. Examples of involvement would include the following:

•   Contracting of general medical practitioners, pharmacists, and dentists in primary healthcare facilities;
•   Use of innovative cell phone technology in quantifying and monitoring the levels of the quadruple disease burden in 
    local communities;
•   Registration and monitoring of human resources and equipment in primary healthcare facilities; and
•   Preparation of local communities for participation as full partners in all health programmes of government.

‘In conclusion, an appeal is now made herewith to all health graduates to participate in the strengthening of the health system, within the context of re-engineering of primary health care and implementation of the policy of national health insurance,’ he said.

author email : captainr@ukzn.ac.za



Four members of the 2012 Medical Students’ Representative Council (MSRC) set the standard for achievement when they graduated from the MBChB Programme in the requisite time.

Drs Nosihle Gumede, Zizukise Njumba and Nombuso Shozi, together with 2012 MSRC President Dr Tamuhla Gilbert, all first-generation doctors in their families, have embarked on exciting new journeys in their lives, serving their internships in hospitals around the country.

The group became well-acquainted with the Medical campus in 2008 when they enrolled for their first year in the MBChB programme, juggling their personal lives, academic performance and leadership roles in the MSRC to become the medical doctors they are today.

While Gumede is serving her internship in the Pietermaritzburg-based hospitals, Edendale and Grey’s, Njumba is based at Witbank Hospital in Mpumalanga and Shozi said she is enjoying her internship at Prince Mshiyeni Memorial Hospital in Durban where learning transcends the theory they were taught and she finds the hands-on experience of helping patients extremely rewarding.

Gilbert told UKZN Online that he is still exploring the medical disciplines in which he might specialise. He is currently serving his internship at Leratong Hospital in Johannesburg and said although it was a long journey through Medical School, patience, perseverance and hard work had paid off. ‘Despite the amount of work we do, the feeling of knowing I have so many lives in my hands is so awesome,’ he said.

‘Becoming the first doctor in the family was actually the best gift I have given to my parents. They have invested a lot of money and energy trying to shape a better future for me and my sibling.’

Gilbert, who hails from Botswana, joined UKZN as the result of a partnership signed between UKZN and the University of Botswana to train 10 medical doctors.

‘I come from a rural area and I have seen how much health is restricted to urban areas. The best our grandmothers and fathers get in the rural areas is a nurse for 100 patients per day. People suffer complications and die in ambulances en route to see a doctor in an urban area. This is very sad and unfair to our communities,’ said Gilbert.

‘As the MSRC President, all I wanted was the best for medical students: Black, White, Indian, South African, those from Botswana, Lesotho and Swaziland. My principle was one: to get the best out of management in the least radical way.’

Gilbert said he would encourage the government to train more students from rural areas. ‘I am proud to mention that UKZN has indeed showed that they are a Premier University of African Scholarship through their admission quota to Medical School.’

Gilbert said it was very important for students to realise that student politics is not a career. ‘I have always mentioned to potential leaders that I believe in “learn, lead and leave”.’

He said in addition to becoming the best doctor you can ever be, it is also important to lead by example in society.

author email : memelal@ukzn.ac.za



Two women Health Sciences academics were honoured with University of KwaZulu-Natal Fellowships during the College of Health Sciences Graduation on 18 April.

Professors Leana Uys and Marie-Louise Newell were awarded Fellowships in recognition of their research excellence and distinguished academic achievement.

Professor Uys served as Professor of Nursing and Head of the School of Nursing from 1986 to 2001 and as Deputy Vice-Chancellor and Head of the College of Health Sciences from 2004 to 2009.

She was rated as a B-category scientist by the National Research Foundation (NRF) in 2008 - the first nurse to achieve this level. According to the NRF, researchers in this category ‘enjoy considerable international recognition by their peers for the high quality impact of their recent research’.

Uys was awarded the Women Super Achiever’s Award by the Asian Business Schools Awards in July 2010 and in 2009 was the winner of the category Education and Training in the CEO Magazine competition to identify the Most Influential Women in South Africa.

On retirement in September last year, she was CEO of the Forum of University Nursing Deans of South Africa.

Professor Newell - the Director of the University of KwaZulu-Natal’s Africa Centre for Health and Population Studies at Hlabisa since 2005 - has a background in medicine, demography and epidemiology while her research has focused on maternal and child health, particularly infections and HIV transmission from mother-to-child.

Newell initiated a broad, innovative programme of research addressing the impact of HIV infection at population, community, household and individual levels.

She established a partnership with the Department of Health in the Hlabisa sub-district to provide HIV treatment and care, resulting in more than 24 000 HIV-infected people starting on treatment by the end of 2012. 

Newell is rated as a B1 researcher by the NRF and has published extensively in her field.

author email : shabangus@ukzn.ac.za



Thursday, 18 April was a day of unfiltered happiness for friends and family of Dr Linda Bester and Lieutenant Colonel Deidré Horn, sisters who graduated with PhD and Masters degrees respectively from the College of Health Sciences at UKZN.

Joining them in their celebrations was husband of Dr Linda Bester, Dr Willem Bester, who also graduated with a PhD from UKZN’s Graduate School of Business and Leadership.

Willem’s PhD investigated the management style, emotional and mental state of re-employed managers who had been retrenched, while Horn’s Masters research, supervised by Professor Petra Brysiewicz from the School of Nursing and Public Health, was praised for developing a seven-step checklist to guide the development and implementation of a community empowerment programme (CEP) after she explored the lived experiences of HIV/AIDS community empowerment programme workers in Ladysmith.

Supervised by Professor Sabiha Essack, Dean and Head of the School of Health Sciences, Bester’s doctoral research, “Antibiotic resistance in the food chain: a case study of Campylobacter spp. in poultry”, investigated the sub-therapeutic use of antibiotics for growth promotion in food animal production, specifically the probability of antibiotic use in food production creating a reservoir of resistant bacteria and/or resistance genes that may spread to humans, thereby limiting the therapeutic value of antimicrobial drugs.

The study recommended that the consequences of the use of antimicrobial growth promoters in South Africa receive more attention.  Bester said veterinarians and food animal producers need to be trained with respect to prophylactic treatment and possible human health issues related to antibiotic resistant bacteria.

Essack described Bester as a pleasure to supervise.  ‘She is an independent researcher whose lateral and critical thinking abilities resulted in four journal articles and two conference presentations from her PhD. She will no doubt excel in her postdoctoral career.’

Bester said she had a great supporting boss, supervisor and group of colleagues. ‘Thus, I learned that the PhD graduate walks to that podium, and although the degree is conferred on the individual, it entails a multitude of unseen people who supported and carried that student to that point’.

‘Except for family and friends who had to listen tirelessly to “ups” and “downs” there were the colleagues and students who assisted and supported unselfishly for that PhD student to reach his/her various deadlines. For that reason the title should be carried with humility, as you never did it on your own.’

Asked about the process of working towards her PhD simultaneously with her husband, Bester said it made things easier.

‘We had the same goals so working until late at night or on weekends was never a problem. The roles of who’s playing the “frustrated one” or the “motivator” would constantly be switched. I am exceedingly proud of Willem. It was also an enjoyable experience being on this journey with my sister. She is a great role model and I am often amazed by her level of compassion towards her patients.’

author email : memelal@ukzn.ac.za



Sezidumel’ emasumpeni kuDkt Alisa Phulukdaree, oneminyaka engama-27, kuMnyango wezifo zamaphaphu kanye nokuphefumula phecelezi – Pulmonology kanye nasegunjini lalabo ababucayi, ukuba kufezeke iphupho lakhe lokuba usosayensi wocwaningo emva kokuba ephothule iziqu zakhe ze-PhD esikhathini seminyaka emithathu. Uzobe ethweswa iziqu zakhe mhla zi-18 kuMbasa.

Ucwaningo lwakhe belubheka ukusebenza kwalokhu okuyizinhlayiya zezifo zemithambo yenhliziyo esithi phecelezi Coronary Artery Disease (CAD) okulapho belugxile kufuzo kubant’abasha besilisa bomdabu waseNdiya nanjengoba kwaziwa ukuthi iningi labo  liqalwa ilezi zifo besabancane.

Imiphumela yocwaningo ihambisana noma yeseka ubudlelwano obukhona phakathi kokubhema kanye ne-CAD, kuphinde kwavela ukuthi ubungozi buba khona lapho kwenzeka izinguquko ezinqala emzimbeni ngokofuzo. Lokhu kushicilelwe kwi-ISI – elinganiswa ne-South African Medical Journal kuNhlaba 2012.

Oka-Phulukdaree uphinde wathola umehluko kufuzo oluhlanganisa ukuvikeleka kwama-cell ngesikhathi kwenzeka lokhu esithi – oxidative kwingcindezi kanye nokukhuluphala ngokweqile. Lo msebenzi ushicilelwe kamuva nje kumabhuku amabili abizwa nge-Gene (Elsevier) kanye ne- Metabolic Disease and Related Disorders (Mary-Ann Leibert). UPhulukdaree uthe, usenebhukwana aselilungisile elichaza ukusebenza kwemishanguzo, i-atorvastatin, esetshenziswa ukwenza ngcono izinga lamafutha –cholesterol kwiziguli ezinesifo senhliziyo.  

‘Ugqozi lokwenza lolucwaningo olufuze loluluqhamuka ekubeni ubaba wami adlul’emhlabeni ngaso isifo sokuhlaselwa inhliziyo eminyakei ephansi engama-54 ubudala, ngesikhathi ngenza unyaka wami wokuqala. Ithuba lahlongozwa uSolwazi  Anil Chuturgoon, okwabe sekuqondana ngaleso sikhathi ukuthi ngihlanganise ucwaningo lwami.’

UPhulukdaree akasho lutho olutheni ngaphandle nje kokubonga abeluleki bakhe. ‘Abeluleki bami bekungo Solwazi Chuturgoon, oyiNhloko yakwa-Medical Biochemistry, e-UKZN, kanye noDkt  Devapregasan Moodley, umcwaningi eNyuvesi  yase-Harvard. Bobabili banemigomo emihle evulelekile yokwamukela, futhi behlinzeka ngokugxeka okwakhayo, nenkuthazo kanye nokweluleka kuwo wonke lo msebenzi. Bebephinde futhi bangikhuthaze ukuthi ngiqhubeke ngihlole imiqondo emisha, ngokwenza njalo, ngiyakholwa ukuthi lokho kungikhulisile njengomcwaningi. Ubeke wathi, uDkt Sajidah Khan, ongudokotela wezinhliziyo naye udlale indima enkulu engilekelela kulo mkhakha wocwaningo.’

Ejabule ngokuphothula iziqu zakhe ze-PhD kanye nokuphinde enze lolu cwaningo ehlola i-microRNA ekuhambeni koketshezi lwe-TB, kanye neHIV kwiziguli ezisulelekile. UPhulukdaree uthe.  ‘Ezemfund’ephakeme zihlinzeka ngomganga omuhle kakhulu kwezokufundisa kanye nocwaningo oluzongivumela ukuthi ngiphons’esivivaneni solwazi kulabo abazoba abafundi bami abavela ezindaweni ezintulayo.’

Ucwaningo luka-Phulukdaree lungaphansi kwamelulek’ uSolwazi Umesh Lalloo ebambisene noka-Chuturgoon. Uma engekho emsebenzini wakhe elebhu, uthanda kakhulu ukufunda “hhayi nje izincwadi zesayensi” kanye nokuzihambela ebhishi eThekwini.

Click here for English version

author email : memelal@ukzn.ac.za



Mr Saul Cobbing, Senior Tutor in the Discipline of Physiotherapy at UKZN, made history this year as the first to graduate from a new Master of Health Sciences Programme offered completely online.

Designed by Professor Fatima Suleman, Associate Professor in the Discipline of Pharmaceutical Sciences and recipient of UKZN’s Distinguished Teachers’ Award, the interactive online programme enables working professionals who are unable to study full-time to pursue Masters qualifications in the Health Sciences.

‘The course fits in with their lifestyle and work so they get to choose when they want to engage with the course material, but deadlines are set and the work is monitored through continuous assessment,’ said Suleman.

Suleman said it was Cobbing’s commitment and personal discipline that allowed him to graduate from the module in record time. ‘He was able to carve out time to juggle between his online Masters, teaching and making sure he had time to spend with his family. He has served as an inspiration to other students also enrolled in the programme.’

Guided by the World Health Organisation’s International Classification of Functioning, Disability and Health, known as ICF, Cobbing’s study described the experiences of people living with HIV who underwent a physiotherapy rehabilitation programme at a public hospital within the eThekwini District of KwaZulu-Natal.

The qualitative study revealed that while participants reported mostly positive experiences related to physiotherapy rehabilitation, they faced a number of barriers that limited their access to continued rehabilitation. These barriers included physical difficulties related to their illness, financial constraints and an inability to access and afford transport to distant health facilities.

According to Cobbing, data extracted from the questionnaires described the participants’ demographics and illustrated the varying cognitive and physical challenges they faced

‘The study participants demonstrated limited knowledge of the reasons for their referral to hospital and were reluctant to discuss their HIV status, despite receiving voluntary counselling and testing,’ he said.

Cobbing said their illness and opportunistic infections related to HIV resulted in a number of impairments such as pain, weakness, lack of endurance, and cognitive problems such as memory loss. In addition, these impairments had a negative impact on activities such as walking, washing and cleaning as well as limiting participation in occupational, social and recreational pursuits.

The study found that the socio-economic conditions of the largely poor, peri-urban environment in which the participants lived also had a negative impact on the factors mentioned and created further barriers that limited participants’ accessing of ongoing health care and rehabilitation.

‘It is hoped that the results of this study will assist in informing the development of future physiotherapy interventions, which are better designed to suit the needs of people living with HIV and AIDS in a South African public health context,’ said Cobbing.

The rehabilitation of people living with HIV and disability is at the heart of Cobbing’s ongoing research, while his teaching covers areas such as anatomy, Intensive Care Unit care, and sport and orthopaedic conditions.  He said his Masters research poses more questions that need to be answered in his PhD, for which he is now registered.

Outside of work Cobbing enjoys mountain-biking, surf-skiing, running and squash, when not looking after his two-year-old son Daniel.  ‘I keep my brain active by going to the weekly pub quiz and listening to jazz at UKZN.’

author email : memelal@ukzn.ac.za



Failing to gain admission to the MBChB programme immediately after his matric year was a setback, but it didn’t stop Mr Rishalan Govender who set his sights on becoming a medical doctor via another route. This year, he graduated summa cum laude with a Masters degree in Medical Biochemistry – and he successfully enrolled in the MBChB programme. 

Govender of Park Rynie always wanted to be a medical doctor. As he was not accepted in the MBChB programme, he enrolled for a Bachelor of Medical Sciences degree and followed this up with postgraduate studies in the Discipline of Medical Biochemistry.

His Masters supervisor, Professor Anil Chuturgoon, who heads Medical Biochemistry, said Govender’s research, completed within a year, is of a very high standard. It was published in the Journal of Nanobiotechnology this year.

In his study, Govender exploited facets of nanotechnology in the field of oncology, specifically investigating the anti-cancer properties of a novel silver nanoparticle conjugated to leaf extracts of a plant called Albizia adianthifolia on a human lung carcinoma cell line.

Govender said the financial strain of anti-retroviral treatment and cancer therapy on the South African health system necessitates the need for alternate means of medication that are cost effective, easily accessible and safe. His study provides evidence that nanoparticles have potential in cancer therapy and if studied further could negate any unwanted side effects of conventional treatments.

Referring to his supervisors Professor Chuturgoon and Dr Alisa Phulukdaree, Govender said it was an absolute pleasure and honour to be guided by such experienced, wise, charismatic yet humble and down-to-earth academics. ‘The role of supervisors is imperative and without a doubt deduces the output of research,’ he said.

Govender said he is actively involved in a range of organisations aside from his studies. ‘Having a balanced lifestyle is vital and although difficult, I somehow coped. I had a lot of support from the department, as well as from friends and family.’ Govender is a passionate performing artist. ‘I am studying classical Indian singing and the violin as well as classical Indian dance. I have also studied English classical piano and guitar. If I am not drowned in music and dance, I enjoy passing time reading and connecting with nature.’

‘My greatest inspirations at UKZN were without a doubt my supervisors and my bunch of friends,’ he said. ‘It is said that you are who you are as a result of those who surround you.’

Govender’s future plans are to specialise in paediatrics and thereafter branch off into medical research.

author email : memelal@ukzn.ac.za



A young Lecturer from Newlands West has graduated cum laude with a Masters degree in Audiology, which looks at the way deaf children communicate with their hearing family members.

Ms Zandile Blose – whose dissertation was titled “Exploration of communication across home and school contexts: A case study of a deaf school child who uses sign language” – designed a study that explored, described and compared the daily communication challenges, in the school and home context, of a deaf nine-year-old child doing Grade 1 and born into a family with no prior experience of sign language.

Blose’s case study involved quantitative and qualitative components, observing 13 communication partners in the home context, including the mother, a sibling and peers, as well as two educators and 11 peers at school. This was supplemented by interviews, and Blose used surveillance cameras to obtain 27 hours of video-recordings in the home and 19 hours at school.

The results revealed that “home signs” played a major role in communication despite the acquisition of sign language in the home. It was observed that signed communication, albeit with minimal South African Sign Language, was used extensively with oral communication.

‘Due to a mismatch in the communication mode in the home context, communication interactions were limited, impoverished and presented with frequent communication breakdowns,’ said Blose.

Blose said that in contrast to the home context, the communication interactions in the school were meaningful and had fewer breakdowns. ‘Factors that include socio-economic status, early intervention, policy verses practice in the deaf education system and primary health care services were seen as contributing to the findings,’ she said.

She went on to highlight the study’s clinical implications in her thesis and made recommendations for future research on the topic.

‘Just completing my Masters feels like reaching a promised land or a destiny. However, completing it cum laude feels like God’s plan or purpose fulfilled. It’s an awesome achievement and reward for the intensive and sometimes uncomfortable journey,’ said Blose.

Blose is the first to graduate with a Masters qualification in her family and continues to lecture in the Audiology Discipline. She said she looks forward to publishing articles in peer-reviewed journals and proceeding to her PhD.

author email : memelal@ukzn.ac.za



Senior tutor of Optometry, Mrs Urvashni Nirghin, has designed an innovative chart that can be used to measure reading rates in normal sighted and low vision primary school children.

The chart, which is a measure of fluency that reflects reading performance levels, especially in children, and not typically measured during routine eye examinations, arose out of Nirghin’s research for which she earned her Masters degree cum laude at a recent Graduation ceremony.

In designing the paediatric rate of reading chart, she had to take into consideration that the chart required words specifically chosen from children’s books.  She did this by randomly selecting the most frequently used words from the first English books used in five primary schools in KwaZulu-Natal.

Nirghin said children undergoing an optometric examination can present with a range of visual problems and therefore the design included a range of print sizes for normally sighted and low vision children.

‘While I may be passionate about optometry, I am also passionate about helping children, especially those with specific challenges. So this gave me the idea of designing the rate of reading chart which can be used by optometrists to assess the reading ability of children with normal sight and low vision.’

Nirghin said that in order for the test chart to be used by optometrists with confidence, both the reliability and validity of the chart had to be determined. ‘In addition, the trial use of the chart was tested on a selected number of low vision children,’ said Nirghin.

Nirghin said she was fortunate to have Professor Ola Oduntan as a supervisor. ‘He has such a wealth of experience and is also so passionate about optometry and research.  He was readily available to offer his guidance at any time and always provided timeous feedback. In his supervision, he was extremely thorough which ensured the accuracy and high quality of my research.’

Nirghin worked in private practice for 11 years before joining the Discipline of Optometry, initially as a part-time staff member. ‘Being in an academic environment has really stimulated my interest in research, and I have been inspired by the research abilities and productivity of my supervisor, Mr Percy Mashige, who heads the Discipline, and Professor Sabiha Essack, the Dean and Head of School.’

Apart from lecturing, Nirghin continues her involvement in clinical supervision at the Discipline’s Eye Clinic, as well as community-based vision screening at the various Department of Education schools and orphanages.

‘The University has provided me with opportunities to enhance my teaching ability as well as my research skills, and access to resources.  The niche area that I have chosen to focus my research on is paediatric vision which is the area that I currently lecture in and believe will facilitate my development as an “expert in this field”.’

author email : memelal@ukzn.ac.za



Ms Taren Naidoo, a sports fanatic from Pietermaritzburg, had her Master of Sport Science degree conferred summa cum laude as the result of her study which said “NO” to physical inactivity, obesity and chronic disease in children.

Her research examined salivary C-reactive protein as a marker of inflammation in children from Grades three to seven. The study was conducted in a primary school based in her home town and the results demonstrated that poor fitness levels and/or obesity are associated with elevated levels of salivary C-reactive protein. Elevated C-reactive protein was shown to be an independent predictor of cardiovascular disease risk.

Importantly, the C-reactive protein was measured in saliva samples. Naidoo said collecting saliva from children is non-invasive, stress-free and multiple samples can be obtained throughout the day.

The research showed that even in young children, being unfit and/or obese results in elevated inflammatory status that may place children at risk of cardiovascular disease.

Naidoo’s supervisor, Professor Andrew McKune, Associate Professor of Exercise Science in the College of Health Sciences and Advanced Trainer for Speed, Agility and Quickness (SAQ®) International, said: ‘Further research is required regarding the relationship between elevated salivary C-reactive protein and cardiovascular risk in children. However, the research suggests that in future it may be possible to screen children to predict their cardiovascular disease risk from measuring C-reactive protein saliva samples.’

McKune said Naidoo had made the Discipline proud. ‘She was an enthusiastic and hard-working student who took up the challenge of a difficult research topic and really made it her own. She has a passion for the field of exercise and sport science and is currently flying the flag high for our Discipline at the University of Johannesburg where she currently works as a sports scientist,’ he said.

Naidoo said that with the growing levels of obesity and low cardiorespiratory fitness in children, understanding inflammation, and the methods to reduce inflammation have become important to research.

She said achieving her Masters was “indescribable”. ‘To have come to the end of this chapter in my life with such an achievement is an indescribable feeling ... I’m overwhelmed and ecstatic all at the same time. It still seems surreal.  Achieving something like this is truly a blessing.’

However, she said reaching such a milestone is achievable in anyone’s life ‘if the hard work and commitment is there’.

‘My friends and family were overjoyed, my parents especially. Seeing how proud my parents are has made my entire Masters degree and this whole experience that much more fulfilling,’ she said.

Naidoo is currently working with the South African U21 Women’s Hockey Squad in preparation for their tour to Holland and Germany for the Junior World Cup this year. She plans to further her studies and travel with the national side as their sport scientist. ‘My learning and gains in knowledge in this field do not end here but will continue to grow from strength to strength,’ she said.

author email : memelal@ukzn.ac.za



A total of 24 doctoral degrees, nine of which went to staff members, was conferred at the 2013 College of Health Sciences Graduation ceremonies, representing a 25 percent increase on last year’s number of doctoral graduates.

The College also celebrated 116 Masters degrees earned by staff and students – a 50 percent increase in last year’s graduate numbers.

Deputy Vice-Chancellor and Head of the College, Professor Rob Slotow, said the nine College staff members who received their doctorates served as role models for their colleagues and their students.

He also praised the work of supervisors who, he said, had produced excellent results in terms of the number of postgraduates they had overseen while still maintaining their own research studies and upholding their teaching loads.

‘It is a well-known fact that interconnectedness has propelled academics in the College on to global platforms in all spheres of society – as highly respected experts in HIV and AIDS, tuberculosis and health sciences education. This confluence of scholarly and intellectual engagement highlights the interdependence of nations and of individuals, globally. It is this drive, amongst our staff, that has produced the calibre of graduates we see this year,’ he said.

Slotow said College of Health Sciences was also honoured by the awarding of UKZN Fellowships to two health professionals - Professor Marie-Louise Newell, Director of the Africa Centre for Health and Population Studies, and former Deputy Vice-Chancellor of the College, Professor Leana Uys. ‘We thank the two Fellows for their dedication to the University and the tremendous contributions they have made and continue to make in driving scholarly output,’ he said.

author email : francism@ukzn.ac.za



Policy-makers in Nigeria have been confronted with a policy brief written by UKZN PhD graduate in Nursing, Dr Izibeloko Jack-Ide, which lobbies for mental healthcare that is more accessible, affordable and allows for the early diagnosis and treatment of mental disorders.

The document was presented at the completion of Jack-Ide’s study which became a voice for Nigerian mental health patients and their caregiving families on the challenges they face in accessing the necessary services. ‘The policy brief was based on international and African best practices and on the contextual reality of the Nigerian health and financial status,’ she told UKZNOnline.

Jack-lde said that the poor integration of mental healthcare into the country’s primary healthcare service for more than 20 years after the adoption of a mental healthcare policy was a concern.

The daily experiences of the caregiving families and people with serious mental health problems uncovered in the study showed that they experience hardship in accessing mental health services and managing symptoms of mental illness.

The study found that many of the difficulties were generated from fixed cultures and traditions which are not easily changed; an example of this being the public belief that people with mental health disorders are responsible for their illness and ‘deserving the wrath of the Gods for their wicked acts’.

Jack-Ide said that poor knowledge about mental health disorders and positive treatment outcomes has fuelled the belief that supernatural factors cause mental illness, resulting in the continual use of spiritual models of care and the unfortunate disregard of proven scientific treatment approaches.

‘Policies should meet the challenges of training and increasing mental health human resources, and establish psychiatric units at general hospitals of state capitals and at existing comprehensive primary healthcare centres in each local government headquarters. This would make mental health care more accessible and affordable to clients and their families and enable early diagnosis and treatment,’ Jack-Ide said.

The study was co-supervised by Dr Lyn Middleton and Professor Leana Uys, the latter being UKZN’s incoming Fellow who was also honoured at this year’s Graduation ceremonies.

Jack-lde said UKZN was an institution of choice to supervise her study after she read its vision to become the Premier University of African Scholarship.

Jack-lde said she was grateful to God for graduating with a PhD and is determined to become a professor in the field of Mental Health Nursing.

author email : memelal@ukzn.ac.za



Dr Jennifer Chipps from the Discipline of Nursing followed her heart and decided to pursue a PhD that would develop a model to set up telepsychiatry services in low resource countries.

Inspired by her passion for the use of technology in health and her clinical background in mental health, Chipps was concerned about the lack of availability of specialist psychiatrists in South Africa, reporting that KwaZulu-Natal has a severe shortage of specialist staff and services for mental healthcare users.

‘In 2010, there were only 32 public sector psychiatrists in KwaZulu-Natal, and most of the 50 designated psychiatric hospitals in the province were ill-equipped to provide dedicated 72-hour observation services for mental health users. In the context of this, there is good evidence that telepsychiatry could be effective in complementing current outreach psychiatry services.’

Chipps said KwaZulu-Natal at the time had 30 hospitals with videoconference equipment and these hospitals were well placed to provide videoconference-based education for psychiatric staff and clinical tele-consultation services for mental healthcare users. ‘However, there were poor levels of e-health readiness,’ she said.

Both the clinical and educational projects that emanated from her study were implemented, concluding that by using practice guidelines and a model for providing a co-ordinated and supported virtual service which is integrated into current outreach, telepsychiatry can provide current strategies to support the Mental Health Care Act, No 17 of 2002 to address the needs of mental healthcare users.

Chipps was supervised by Professor Maurice Mars who is the leading expert in Africa in TeleHealth. Mars is the President of the South African Telemedicine Association and Professor and Head of the Discipline of TeleHealth in the School of Nursing and Public Health at UKZN, which offers the only postgraduate qualifications in TeleHealth in the country.

‘I am excited and relieved to have completed the PhD. So too are my friends and family,’ said Chipps. ‘I completed my PhD by publication and the process of submitting papers to peer reviewed journals was a valuable experience in developing my academic writing skills and provided increased opportunities for writing and publication.

‘On completion of all my papers, the writing process of the dissertation was an intellectually stimulating reflective activity in which I was able to gain new insights into the challenges of implementing services in resource constrained settings,’ she said.

Chipps serves on the International Council of Nurses Telenursing group and she hopes to be able to work with other colleagues in the field of eHealth to put Telenursing on the map in South Africa and internationally.

‘Since completing my PhD, I have also been encouraged by the number of approaches I have received to make written contributions across a spectrum of activities, including submission of articles as well as expert peer review.’

author email : Memelal@ukzn.ac.za



‘In furthering your knowledge, age is no criterion,’ said Dr Devaraj Kistiah Naidoo, UKZN’s oldest graduate who obtained a Masters degree in Family Medicine on 18 April.

The 68-year-old Occupational Health Officer at Addington Hospital said he still has a thirst for knowledge and when there is room for furthering his studies, he will consider his options. 

For his Masters, Naidoo conducted a study titled “An evaluation of the Triage Early Warning Score (TEWS) in an Urban Accident and Emergency Department in Kwazulu-Natal”. He observed that although clinicians are traditionally well trained in history taking and physical examination, in accident and emergency departments where patients with critical injuries often require timeous attention to prevent avoidable deterioration of their condition, there is a gap between suboptimal care and good care which can be improved for better outcomes.

He said delayed or poor action in response to observed abnormal physiological parameters might lead to avoidable and unexpected death.

‘Identifying patients at risk of deterioration at an early stage by means of simple guidelines based on physiological parameters may reduce the number of resuscitation procedures in emergency rooms.  A common error is the assumption that a patient who is sitting up in bed and talking is not critically ill,’ he said.

Supervised by Dr Clive Rangiah, specialist in the Discipline of Family Medicine, Naidoo’s study evaluated a triage tool that will enable rapid screening of patients and facilitate earlier intervention.

Findings from the study pointed to TEWS as a useful and appropriate risk-management tool that optimises the quality and safety of patients in the emergency department. ‘It allows for earlier interventions that will lead to improved quality of care and decreased morbidity and mortality,’ said Naidoo.

Naidoo said that the challenge remains in the acceptance of the system by healthcare workers as well as relevant authorities. He said appropriate training in measurement of essential physiological parameters and the use of these measurements in determining correct scores will add value to patient care in emergency units.

‘As a Medical Manager I became aware of the challenges experienced in emergency departments regarding rapid assessments and treatment of patients.’

Naidoo has worked for the Department of Health for 31 years. He acquired experience as a Casualty Officer at Clairwood Hospital, King Edward VIII Hospital, Osindisweni Hospital, RK Khan Hospital and Wentworth Hospital.

He moved up the ranks from being a Medical Superintendent to Acting Chief Medical Superintendent at King Edward VIII Hospital. In 1998 he was appointed Medical Manager of Addington Hospital.

Naidoo said his Masters degree was a source of joy and pride. ‘My spouse was at the forefront and a constant reminder for me to complete my goal.’

Naidoo made sure that he did not neglect his day-to-day work in pursuit of his academic ambitions.

Naidoo’s second daughter also graduated this year from UKZN with a Masters in Maritime Law while his eldest daughter is a UKZN Chemical Engineering graduate.

His personal motto is, ‘Strive to seek to find and not to yield’, and his hobbies include travelling, carpentry and working with electrical appliances.

author email : memelal@ukzn.ac.za



Dr Liane Manikkam graduated with a Masters Degree in Psychiatry after concluding a study that investigated the urban prevalence of antenatal depression and its risk factors in KwaZulu-Natal.

Manikkam was struck by the fact that antenatal depression – depression that occurs during pregnancy – is often overlooked and underdiagnosed. She said there had been a recent increase in interest in its association with adverse obstetric, neonatal and maternal outcomes, but local data on the prevalence and risk factors were lacking.

Her study, supervised by Head of Psychiatry Professor Jonathan Burns, was conducted using the Edinburgh Postnatal Depression Scale and a socio-demographic questionnaire in English and isiZulu. The study population was made up of 387 antenatal outpatients at King Edward VIII Hospital.

According to Manikkam, pregnancy is usually viewed by the public and the medical profession as a period of emotional well-being that is protected against mental disorder.

‘Antenatal care traditionally focuses on physical health rather than on emotional health,’ she said. ‘Consequently, antenatal depression is regularly overlooked and underdiagnosed, locally and globally. In contrast, there has long been a focus on depression in the postpartum period, with considerable literature and public awareness. Only during the past decade have studies of antenatal psychiatric morbidity become more common.’

She said studies show that the prevalence of antenatal depression is higher than that of postnatal depression and is associated with adverse fetal, obstetric and neonatal outcomes, including intra-uterine growth retardation (IUGR), low birth weight, preterm delivery and infant behavioural problems.

‘Nutritional deprivation and poor maternal weight gain during pregnancy are risk factors for IUGR, and when depression is associated with weight loss, fetal growth may be negatively affected. Physiological mechanisms underlying the negative impact of antenatal depression on fetal growth and neonatal development include hyperactivity of the hypothalamo-pituitary axis and increased cortisol secretion,’ she explained.

Manikkam also said that apart from physiological effects on the fetus, depression in pregnancy can affect a mother’s functional status and cause cognitive distortions that affect her decision-making capacities. ‘This may be associated with poor attendance at antenatal clinics and lack of motivation to follow physician care regimens, and lead to other problems such as maternal substance abuse. These factors invariably increase the risk of adverse pregnancy outcomes.’

In line with recent studies conducted in developing countries that indicate that more than a third of women have significant depressive symptoms during pregnancy, Manikkam’s study confirmed that the high prevalence of antenatal depressive symptoms and thoughts of deliberate self-harm support a policy of routine screening for antenatal depression in South Africa, especially in HIV-seropositive women.

Burns said the most striking findings in this study are those that show that over a third of pregnant women attending an antenatal clinic were depressed and had recent thoughts of harming themselves. ‘This is really serious and reveals a hidden epidemic which impacts not only on the lives of these women, but also on the healthy development of their unborn children. The other important finding in our context is that HIV seropositivity increases risk for depression by a factor of 1.6, thus women with HIV are 60 percent more likely to develop depression during pregnancy than those who are negative.

The study also provided evidence that HIV infection may place mothers at additional risk of depression during pregnancy. ‘Such an association, if confirmed by subsequent studies, has major implications for managing peripartum risk in HIV-positive women.’

Manikkam said that in order to realise the national and international objectives of improving maternal and child health, a policy of routine screening for depression in antenatal women should be developed and implemented without delay in South Africa.

The study was published in the South African Medical Journal in December 2012.

author email : memelal@ukzn.ac.za



Professor Ted Sommerville, a qualified Anaesthetist, Associate Professor in Medical Education, and Academic Co-ordinator of the fifth-year medical curriculum in the School of Clinical Medicine, has now earned a PhD in Higher Education.

Sommerville’s study focused on pedagogic factors in the medical curriculum at UKZN and suggested that the knowledge structure of medicine is such that a pedagogy which integrates the range of material to be learnt is likely to be effective. The study was recently presented at the conference on Global Perspectives on College and University Teaching held at Auburn University, Alabama.

The study investigated several demographic influences on MBChB students’ achievement. It revealed that the type of high school attended by students influenced their marks throughout their course, and that students with previous tertiary education experience tended to do better than others in the MBChB programme. Variations between successive assessments were significant, as were students’ matric point scores.

When examined individually, age, sex and facilitator background had no significant impact on the marks of the cohort of students studied for the duration of their degree programme. Students’ first language, race, and the financing of their studies seemed to influence their achievements when viewed in isolation. However, when combined with other factors, these three also proved insignificant.

Sommerville said the findings could have implications for student admissions, curriculum structuring, planning interventions to help struggling students, and for the pre-medical education sphere. The demographic study added to and in places contrasted with various other studies at school and university level that had documented factors that could influence students’ assessment marks – the ultimate measure of academic success or failure.

Sommerville’s study was inspired by his desire to teach a new generation of critical thinkers who would join the medical fraternity and meet the special healthcare needs of the country. He was concerned that the information overload that has for so long been a feature of medical teaching may lead to passive acceptance without long-term retention. ‘If the sort of information we teach students is held on to for a while and then forgotten, then that is a great pity. I try to make them think. That’s my conviction,’ he said. 

Sommerville, who followed 202 first-year students from 2007 through to graduation in 2011, argues that medical education is important for shaping the future of the country’s health care. ‘But if we are not producing doctors who can think for themselves, then they will not be able to keep abreast of new knowledge,’ he said. 

Sommerville’s analysis of the pedagogy and of nine demographics was based on focus groups with medical students from diverse backgrounds during which they shared their perceptions on teaching and learning in the MBChB programme. ‘Most of the obvious indicators of the diversity for which we strive at UKZN show significant differences when examined independently. However, in combination, several turn out to fade into the background compared to schooling, tertiary education, the standards of difficulty of assessments and lastly – and minimally – the more obviously cognitive aspect of students’ performance in matric,’ said Sommerville. 

He indicated that medical schools in a number of countries evidently believed that achieving straight A’s was not enough to excel in medicine, and had added pre-selection interviews to their recruitment process. However, it was not easy to measure an applicant’s dedication, commitment and conscientiousness simply from a pre-selection interview, particularly in South Africa, as students come from very diverse backgrounds.   

A firm believer in problem-based learning, Sommerville said students with previous tertiary education experience were more likely to do well in the MBChB curriculum, possibly because they had already developed some independence of thinking.

author email : memelal@ukzn.ac.za



Dr Sachin Pawar said he was honored to graduate with a PhD from UKZN. His doctorate in Pharmaceutical Chemistry, co-supervised by Professors Thavendran Govender, Gert Kruger and Dr Glenn Maguire, aimed to synthesise novel and effective HIV protease inhibitors which will ultimately aid in drug design.

Pawar and his team compared the protease inhibition activity of cage-lactam and lactone peptides. The inhibitors were characterised by Nuclear Magnetic Resonance (NMR), High Resolution Mass Spectroscopy (HRMS) and evaluated against the wild-type C-South African enzyme for its ability to inhibit 50 percent of the enzyme activity.

Pawar said, ‘My study enabled me to develop a better understanding of new HIV drug design mechanisms and the wild-type C-South African enzyme. I had hoped through my study to develop a cost effective alternative to current treatment therapies on the market. The work is challenging but I’m inspired to continue, given the excellent support within my lab and at UKZN’.

Pawar said he was concerned that the HIV epidemic was claiming over 800 South African lives per day and this was not only because of disease, but the side effects of the treatment, drug resistance and the cost of the treatment. 

‘It is of extreme importance to keep one step ahead by continually searching for new drugs targeting this infection,’ he said.

In the future, Pawar hopes to join an institution like UKZN which has a supportive research environment. ‘This inspirational environment keeps students one step ahead of other institutions from Africa.’

author email : memelal@ukzn.ac.za



Research which found that skin might be a contributory factor in the recurrence of clubfoot in children has earned a PhD for Dr Mahomed Rasool, Principal Specialist and Head of the Orthopaedic Surgery Discipline who graduated on 18 April.

Clubfoot, medically known as talipes equinovarus, is a general term used to describe a club or bean-shaped deformity of the foot. According to Rasool, clubfoot is a common deformity in infants that can be treated using various methods, but its recurrence on treated patients at a later stage called for further investigation.

Rasool said there are various theories that focus on the causation of the clubfoot but the skin had not been addressed. ‘We think there is abnormality in the skin of clubfoot. One of the problems of clubfoot is that the deformity tends to come back after correction,’ he said.

Rasool took on a microscopic study of the skin tissue of the inner side in the clubfoot of children, reporting on abnormality in the thickness of the skin, and that the skin showed fibrosis (curvature). ‘These were compared with normal skin from normal babies and we found that there was a significant difference in the layers of the skin,’ said Rasool.

‘We think that the skin is a contributory factor in the recurrence of the clubfoot and therefore scars resulting from operation should be avoided by treating clubfoot non-operatively,’ he said.

Rasool said his passion for orthopaedics dates back to 1990 when he worked with a lot of children and “lots of feet”.

He said it felt great to have completed his PhD and to have overcome the challenges that came with having limited access to normal skin needed for the study.’

Rasool said it is important to be aware of problems such as clubfoot which present themselves at birth. ‘Their feet are delicate and they have to be improved without causing morbidity,’ he said.

author email : memelal@ukzn.ac.za



UKZN’s Optics and Imaging Centre (OIC) produced three PhDs last year that make a significant contribution to understanding maternal and child health in relation to HIV.

According to Professor Anita Naicker, pre-eclampsia, a hypertension disorder in pregnancy, is the second highest cause of mortality for pregnant women after HIV. She said the prevalence of pre-eclampsia in African women is very high – at 14 percent in South African women, and at 5 percent for pregnant women globally.

‘Pregnant women who suffer from the condition experience high blood pressure and lose protein in their urine. This can affect both the mother and the baby,’ she said.

Naicker supervised two studies that focused on pre-eclampsia and HIV. They were conducted by Dr Firoza Haffejee and Dr Nalini Govender, both Lecturers at the Durban University of Technology.

Haffejee’s PhD looked at leptin – the protein hormone that plays a key role in regulating energy intake and energy expenditure which is also produced by the placenta during pregnancy. It demonstrated elevated placental leptin in pre-eclampsia, irrespective of HIV status, and this elevation was not reflected in maternal serum, suggestive of an autocrine role of leptin in the placenta. The study concluded that irrespective of HIV status, leptin is involved in the causation of pre-eclampsia.

Naicker said pre-eclampsia is a condition in which it is known that the baby receives insufficient blood supply. ‘Surely, there is a response to form new blood vessels ... this was the speculation from which Dr Nalini Govender’s PhD thesis emanated,’ said Naicker.

Govender’s PhD was a novel study conducted in an attempt to elucidate whether a paradigm shift in the balance of proangiogenic (VEGF & PlGF)  and antiangiogenic (sFlt-1 and sEng) factors exist in normotensive and pre-eclamptic pregnancies compromised by HIV infection.

She said that in a compromised immune system such as HIV infection, there may be an exacerbation of events relating to serious pregnancy conditions such as recurrent miscarriages, pre-eclampsia, diabetes and preterm labour. The study found that whether the pregnancy is complicated by immune insufficiencies or not, this does not affect the role of the antiangiogenic factors in pre-eclampsia development.

‘The serum reduction of sFlt1 and sEng within the HIV-positive cohorts advocates a neutralisation of the immune hyperreactivity of pre-eclampsia. Nevertheless, the neutralising effect of HIV infection on the immune system may be insufficient in the development of pre-eclampsia. Whilst the endothelial dysfunction that characterises pre-eclampsia still maintains a pivotal role in its etiology, there may be alternative mechanisms by which these antiangiogenic factors operate.’

The third study was conducted by Dr Duran Ramsuran who is currently pursuing postdoctoral research at the KwaZulu-Natal Research Institute for Tuberculosis and HIV (K-RITH).

Ramsuran’s study outlines the spectrum of paediatric nephropathy in children in KwaZulu-Natal. It demonstrates podocyte phenotype dysregulation pre-HAART and reconstitution post therapy. Evidence of ultrastructural viral reservoirs within epithelial cells is supported by a genetic appraisal confirming the ubiquitous presence of HIV DNA in renal tissue. Moreover, sequence analysis showed viral evolution and compartmentalisation between renal viral reservoirs to blood. 

The trio graduated on 18 April, and Naicker said that these studies contributed significantly to their development as medical scientists, apart from their academic contribution.

author email : memelal@ukzn.ac.za



‘There is nothing better than being rewarded for all the long hours you have put into something and the stress you have suffered,’ said Ms Lynne de Welzen, a pioneering young scientist who graduated with an Honours degree summa cum laude in Medical Microbiology on 18 April.

De Welzen’s study titled, which examined the M. Tuberculosis pili (hair-like appendages found on many bacteria) as a potential factor in drug resistance, was titled: “Differential mtp gene expression in strain families of Mycobacterium tuberculosis.”

Concerned with the development of new drugs to address resistant strains of TB, the study looked at whether there was any variation in the expression of the pili gene between multiple-drug resistant (MDR), extensively-drug resistant (XDR) and susceptible strains that cause tuberculosis.

The study found no clear relationship between increased fold change, or up-regulation, of the mtp gene and drug-resistance, and possibly suggesting that pili do not play a significant role in drug resistance. However, due to variation being indicated in the results, it is suggested that the subject be further investigated.

De Welzen was co-supervised by Dr Manormoney Pillay from UKZN’s Department of Infection, Prevention and Control, and Dr Siva Danaviah from the Africa Centre for Health and Population Studies. The Honours student said she found it interesting that only two other studies had previously been conducted on the M. tuberculosis pilus.

‘The thought that I could play a vital role in possibly finding out something novel, which could in the future save thousands of lives, really inspired me and drove me to work hard,’ said De Welzen.

‘I feel immensely proud of my achievement and am really excited about it.’

De Welzen is currently studying towards her Masters in Medical Microbiology at the newly-opened KwaZulu-Natal Research Institute for Tuberculosis and HIV (K-RITH) Tower Building at UKZN. Her research focus is on novel molecular biology methods, such as RNA-sequencing, in order to find out more about M. tuberculosis at the transcriptomic level.

She said she hopes one day to work in a laboratory that conducts research not only on TB, but other diseases that are having such an impact on the world. 

She said her experience at UKZN has been positive because of the University’s cultural diversity and the great variety of programmes available. She said she was inspired by all those around her who had achieved remarkable things.

De Welzen said when she is not cooped up in the lab she enjoys gym, singing, painting and spending time with friends and loved ones.

author email : memelal@ukzn.ac.za



Namibian Lecturer Dr Penehafo Angula graduated with a PhD in Nursing after developing, implementing and evaluating a community-based HIV/AIDS stigma reduction intervention in a Namibian rural community.

Namibia has been badly affected by the HIV/AIDS pandemic, with infected and affected persons experiencing stigma at different levels.

Angula’s research has made a significant step towards addressing this issue by developing baseline guidelines and training manuals for HIV/AIDS stigma reduction in the Namibian context. She used a quasi-experimental non-equivalent control group pre-and post-test sample plan, with a focus on people living with HIV/AIDS, their families, community members, opinion leaders and healthcare workers.

Angula said the study aimed to develop, implement and evaluate tools at different levels in response to a lack of local stigma reduction intervention tools within the rural Namibian community.

A comparison of the results in both arms indicated that the intervention was effective in reducing stigma in the intervention arm in three of the four participant groups with varying degrees of success. 

‘Stigma scores were significantly decreased in people living with HIV and AIDS (PLWHA) from the intervention arm. The intervention was effective, although it did not decrease all stigma scores significantly. It may require more time for the issues addressed in the intervention workshops to diffuse through the different groups,’ she said.

Angula is a Community Health Nursing lecturer at the University of Namibia and she said HIV/AIDS is one of the public challenges covered in the course modules. Additionally, when she conducted her Masters’ degree, she assessed the aspects which prevent PLWHA from living positively with the disease, although they have related health information.

‘Stigma was one of those aspects that were identified and I recommended it for future research,’ she said. 

Angula received a scholarship from the Columbia-Southern Africa Fogarty AIDS International Training and Research Program (CU-SA AITRP). She met with UKZN Professors Quarraisha Abdool Karim and Busi Ncama, together with a Columbian representative, who interviewed her and made pursuing a PhD at UKZN a reality.

‘Completing my PhD feels like a dream … My husband is more excited than I am. My road to PhD success was a tough one and I am grateful to God that I completed it successfully.’

Angula is currently compiling articles from her study, which she hopes to publish in relevant Nursing journals.

She said research is her passion and she would like to do it full-time if she gets an opportunity. ‘That is why I plan to do postdoctoral studies if Fogarty gives me another chance at a scholarship.’

author email : memelal@ukzn.ac.za



Three of the PhDs produced by the College of Health Sciences revealed new mechanisms of HIV-1 immune control by the body and have laid a foundation for how to boost the immune system to overcome HIV through vaccination or novel therapies. Another has validated laboratory and clinical approaches for the rapid diagnosis of tuberculosis meningitis which, if implemented, will reduce costs and save lives.

The studies were conducted by Drs Ravesh Singh, Eshia Moodley-Govender, Dshanta Naicker and Vinod Patel, who graduated on 18 April.

Supervisor of all four projects, Professor Thumbi Ndung’u said the prospect of developing new antiretroviral drugs that target host and viral protein interactions has created a lot of excitement in the HIV research field.  ‘Dr Singh performed groundbreaking work to determine how novel immune factors known as TRIM ligases are regulated and to define how a replication cofactor known as cyclophilin A is regulated.  His work showed that some TRIM E3 ligases can potently block HIV infection and indicates that these factors may be good targets for novel immunotherapy to slow virus replication during HIV-1 infection,’ said Ndung’u.

Moodley-Govender conducted a study resulting in knowledge that may be important for HIV vaccines design to protect children born to HIV-1 infected mothers. It is suggested that in the absence of antiretroviral therapy, HIV infected children maintain high viral loads throughout infection and develop AIDS much faster than adults. Hence, this study investigated the biological determinants of viral control or lack of control in a rare untreated cohort of children.

Findings from the research revealed that genetic factors, immune responses and viral characteristics all contribute to HIV infection and disease outcomes in children.

Naicker conducted a study titled: “Effects and Mechanisms of Interleukin-10 Promoter Polymorphisms on HIV-1 Susceptibility and Pathogenesis” in which she investigated the role of interleukin 10 (IL-10), a powerful immunoregulatory chemical produced by immune cells in HIV infection. She showed in her thesis that IL-10 gene mutations that increase IL-10 levels may be beneficial in protecting against HIV-1 infection.

‘IL-10 may be detrimental during early HIV-1 infection but beneficial in chronic infection, possibly by reducing immune activation.  The mechanisms revealed in this work may help in rational use of IL-10 to boost HIV vaccines or to improve therapeutic strategies,’ said Ndung’u.

Focusing on tuberculosis meningitis (TBM) fuelled by the HIV epidemic, Patel investigated novel laboratory assays and clinical algorithms for the diagnosis of TBM.  A specialist neurologist, Patel’s work revealed novel tools that may aid in the rapid and cost-effective identification of TBM, reducing morbidity and mortality in high burden, resource-poor settings.

Ndung’u congratulated each candidate and encouraged them to continue with their research excellence, in line with the strategic goal of the College of Health Sciences at UKZN.

Ndung’u is Director for UKZN’s HIV Pathogenesis Programme and the Hasso Platner Research Laboratory, as well as Head of the Max Planck Research Institute for Infection Biology and the South African Research Chair in Systems Biology of HIV/AIDS.

author email : memelal@ukzn.ac.za



Improving the health of African and Indian women undergoing menopause was at the heart of two studies conducted by friends and colleagues Dr Kamendran Govender and Dr Jayeshnee Moodley, both of whom graduated with Masters degrees in Obstetrics and Gynaecology on 18 April.

Professor Jayanthilall Bagratee, Head of Obstetrics and Gynaecology, who supervised both studies, said Govender and Moodley highlighted important areas in women’s health in their studies. He said because of advancements in medical science women are living longer and now spend more than one third of their life in menopause.

Govender was lauded for his study titled, “Osteoporotic fractures in menopausal African and Indian Women”, in which he indicated that menopausal women, or younger women with low oestrogen levels, are at risk of having osteoporotic fractures because they secrete less of the hormone. His study was significant in that it looked at osteoporotic fractures affecting African and Indian women locally, generating new knowledge that will benefit doctors in treating their patients with an understanding of their clinical structure which differs from that of data presented by studies internationally.

Govender said African women with a high Body Mass Index (BMI) were regularly found with ankle fractures. ‘The study alerted us to a possibility of new risk factors and the need for a large-scale follow-up study. We discovered that the prevalence of osteoporotic fractures was much higher than what we thought it would be because it is quite rare with non-Caucasian patients abroad,’ said Govender.

He said osteoporotic fractures usually happen after a fall, ‘some being a low velocity trip or fall that ends up as a fracture instead of a bruise’.

Govender said osteoporotic fractures can be avoided if at-risk individuals modify their fall risk profile and conduct lifestyle modifications, including a balanced diet, low weight-bearing exercises, keeping their BMI at an optimal level and avoiding smoking.  ‘It’s also important to take vitamins and calcium,’ he said.

‘The idea is to identify individuals at risk at an early stage so we can start them on treatment before they suffer from a fracture. If osteoporosis is found then we start with the treatment to stop bone loss.’

‘High morbidity and mortality rates result from being at risk. Menopause makes you prone to osteoporosis.  Look at your family history, age and quit smoking.’

‘With menopause comes a lot of health concerns,’ said Moodley whose study was titled, “The cardio-metabolic profile and bone mineral density in African and Indian post-menopausal women.”

Moodley said doctors needed to be more rigorous in their evaluations of patients, both with low BMI and cardiac risk factors because, although it was found from the study population that Indian women had deceased density and high risk factors for a cardiac event, African women were also at risk post menopause.

The study found that the patients presenting with cardiometabolic risk factors had lower BMIs than patients with no cardiac risk factors. Conversely, patients with low BMI were at risk for a cardiac event irrespective of their ethnicity.

Moodley said her research was extremely rewarding. ‘It gives you a sense of accomplishment that you can do a study that has benefit to the health sector and be something that makes a difference to society.’

Both doctors are based at Inkosi Albert Luthuli Central Hospital where their studies were conducted. They said they liked Obstetrics and Gynaecology because it strikes a balance between patient interaction and surgery. They plan to specialise in Gynaecology Oncology next.

author email : memelal@ukzn.ac.za