RESEARCH
CAPACITY
DEVELOPMENT
INITIATIVE
For selected South African Universities
UNIVERSITY OF
ZULULAND
UNIVERSITY OF
ZULULAND
Institution: University of Fort Hare
PI: DR MANDISA SINGATA
The COHERE Project:
Contraceptive Options
for Health: Evidence,
Research and
Education
Effective contraceptive
use has the potential
to reduce maternal and perinatal mortality.
We intend to use robust research methods
including randomised controlled trials (RCT)
and systematic reviews to guide contraceptive
services and to inform contraception users.
This will include:
• An auxiliary study nested in a large RCT
of depot medroxyprogesterone acetate
(DMPA) versus the Norethisterone implant
versus the copper intrauterine device (IUD)
to measure relative effects on depression,
sexual function and other effects.
• A follow-up of our recent RCT comparing
DMPA with the IUD to determine rates of
and reasons for discontinuation; and
• Updating our Cochrane reviews on these
methods of contraception.
Institution: University of Fort Hare
PI: PROF EUNICE SEEKOE
Mentoring and
promoting healthy
lifestyles of learners
in the Eastern Cape:
An evaluation of the
2012 Integrated School
Health Policy
The 2012 Integrated School Health Policy (ISHP)
was introduced in South Africa to contribute to
the improvement of general health of school
going children as well as the environmental
conditions in schools. ISHP addresses health
barriers to learning and promotes education
outcomes (DoH & DBE, 2012).
Children’s
health in the Eastern Cape Province (ECP) is
beset with myriads of challenges. There is a
general public outcry of poor public health
services due to insufficient staff, lack of or
insufficient basic equipment, negative attitude
of nurses and poor infrastructure. The need
for the evaluation of the 2012 ISHP remains an
essential element for decision making in social
and health policy development in the Eastern
Cape Province.
Our main general objective is to assess whether
the provision of a comprehensive, integrated
school health programme which is provided
as part of the PHC package within the Care
and Support for Teaching and Learning
(CSTL) framework is implemented; identify
challenges and success of the package; initiate
and/or recommend best practices/intervention
strategies support initiation of relevant
interventions based on baseline results as
well as conducting a fully-fledged evaluation
of the implementations by 2018. Assess the
implementation of the health care services
for primary and secondary school learners
as proposed in the Integrated School Health
Policy (ISHP) and the role of ward-based
primary health team (WBOT), principals, lifeorientation educators. Explore the perceptions
of the learners, mothers/guardians, school
management structures and policy makers
concerning the integrated school health
services. Determine the barriers and enablers
associated with the effective implementation
of the 2012 ISHP including health and
nutritional status of learners. Determine the
mentoring needs of the different stakeholders
and draft a framework for optimizing the
implementation of the ISHP in the EC Province.
A mixture of quantitative and qualitative
descriptive design will be followed in this
study. The focus will be on primary and
secondary (Grade R to Grade 12) including
learners with special needs attending public
schools including stakeholders of the school
community in OR Tambo; Chris Hani, and
Buffalo City Metropolitan districts in the
traditional food plants as part of their diet.
Indigenous plant foods have the potential
for commercialization to contribute to food
security, alleviate poverty and add nutritional
value for a healthy community. One of the
aims of this project is to document the diversity
and utilization patterns of plant foods in rural
areas around the former Transkei, Eastern
Cape. Information on the value of these
plants to younger generations may increase
utilisation thus contributing to healthy diet
and food security. Acceptability studies of
vegetables will be conducted in high school
and university students to identify plants for
cultivation. Additionally, biological effects
of selected food plants will be conducted
to confirm the potential of these plants in
contributing towards health. This project will
thus, highlight the value of underutilised food
plants of the Eastern Cape with evidence from
animal and human studies while establishing
a relationship between rural communities and
the Faculty of Health Sciences at WSU.
Institution: University of Zululand
PI: DR ABIDEMI PAUL KAPPO
Development
of capacity in
phytotherapeutics
derived from
indigenous plants
of South Africa,
aimed at improving
or preventing the
development of metabolic disease.
The incidence of chronic diseases such
as obesity, type 2 diabetes (T2D) and
cardiovascular diseases are on the increase
globally. The prevalence of these diseases,
especially in rural South Africa is increasing at
an alarming rate. Hence, a demand exists for
natural products that are safe and effective
in the treatment of these chronic diseases.
Studies have shown polyphenols as beneficial
phytochemicals, which are present in plant
extracts and can serve as attractive alternatives
or adjuncts to conventional medications
in the treatment of these chronic diseases.
The focus of this study is the identification,
isolation and characterization of bioactive
components of nutraceutical products or drug
leads from indigenous South African plants
such as Atricia phylicoides (Bush tea or Zulu
tea) and Protorhus longifolia for health needs.
This study is funded by the SAMRC’s Research
Strengthening and Capacity Development
Initiative. Under this initiative, the University
of Zululand (UZ) will receive R1 000 000 per
annum for the next five years. The major
aim of this initiative is to build research
capacity, develop young researchers and to
establish a vibrant and viable post-graduate
programme at UZ. The long term goal of
this project involves rural economic growth,
job creation through agro-processing and
phytopharmaceutical industries and lastly,
human capital development.
in 2008, 36 million, or 63 percent, were due
to NCDs, especially cardiovascular diseases,
diabetes, cancers and chronic respiratory
diseases.
The research will focuss on the state of
NCDs in the Eastern Cape Province of south
Africa and ways to map the epidemic from a
clinical and public health perspectives with
the aim of, reducing its major risk factors
and improving the health care of people
who already suffer from NCDs. The research
also has as its objective identifying the level
of the burden of the disease from a clinical
and perceptive perspectives with the aim of
developing means for the the Prevention and
Control of NCDs with a focuses on the current
status of NCDs which means the study will
be both crosssection and longitudinal across
different facilities and communities with the
aim of assessing progress after five years of
the project implementation to dtermine the
impact of the interventions. One of the main
objectives of this research project therefore is
to provide a baseline for Eastern Cape Province
on the current status of NCDs and their risk
factors, as well as the current state of progress
if any which the province is making to address
these diseases in terms of policies and plans,
infrastructure, surveillance and populationwide and individual interventions. The
research also aims at disseminating a shared
vision and road map for NCD prevention
and control from a public health and clinical
perspectives based on evidence from the data
collected and analysed while building capacity
at the same time.
the fight against NCDs. Three essential
components of NCD surveillance constitute
a framework that should be established
and strengthened. These components are:
a) monitoring exposures (risk factors); b)
monitoring outcomes (morbidity and diseasespecific mortality); and c) health system
responses, which also include national
capacity to prevent NCDs in terms of policies
and plans, infrastructure, human resources
and access to essential health care including
medicines, (WHO, 2014). This research work
as starting point aims to establish a baseline
of NCDs using cross sectional approach
and follow up sample over the years using
clinical and public health perspectives using
a longitudinal approach. Standardized core
indicators for each of the three components
should be adopted and used for monitoring
and surveillance of behavioural and metabolic
risk factors
The data collected will form a baseline for NCDs
in the Eastern Cape Province. Following the data
collected an analysis will be carried out which
will inform a new way of dealing with people
who suffer from NCDs and HIV/AIDs from the
problem identification, design of interventions,
implementation, monitoring and surveillance
and finally a Health Impact Assessment which
should deal with poorly designed interventions
which could be confusing. The study will
support the efforts of the government at
improving health care to the population based
on the evidence from the data collected and
analysed in a scientific manner.
Institution: Walter Sisulu University
The socioeconomic impact of NCDs has
affected progress towards the UN Millennium
Development Goals (MDGs). MDGs that
target health and social determinants such as
education and poverty have been negatively
affected by the growing epidemic of NCDs
and their risk factors. Lack of monitoring
Accurate data are vital to reverse the rise in
death and disability from NCDs. But many
countries have little usable mortality data and
weak surveillance systems and data on NCDs
are often not integrated into national health
information systems. Improving surveillance
and monitoring must be a top priority in
PI: DR. CONSTANCE SEWANI-RUSIKE
Indigenous and
traditional plant
foods for health in the
Eastern Cape
Indigenous plant foods
that include wild leafy
vegetables, wild fruits
and beverages are neglected and underutilized
in the Eastern Cape. However, older members
of the community continue to utilize
Eastern Cape Province. Six schools will be
conveniently selected, two schools in each
district one rural and urban systematically
randomly and stratified by primary and
secondary school. The WBOT, principals, lifeorientation teachers, teachers and mothers/
guardians including provincial leaders will
be conveniently selected to participate
in the study. Data will be collected using
questionnaires, interviews and focus groups
and analysis of documents. Qualitative and
quantitative methods will be used to analyze
data followed by interventions based on the
results.
Institution: University of Limpopo
PI: PROFESSOR LESEILANE MAMPURU
The screening of
indigenous medicinal
plants using various
in vitro and in vivo
models to identify
novel compounds,
extracts and/
or fractions that
can be developed into a pipeline of
nutraceuticals, food supplements and
potential drug leads for the management
and treatment of cancer, type-2 diabetes
and obesity.
The Medicinal Plant Research Group in the
Department of Biochemistry, Microbiology
and Biotechnology (BMBT) at the University
of Limpopo (UL) is comprised of Prof Leseilane
Mampuru (Principal Investigator), Prof Matlou
Mokgotho, Dr Vusi Mbazima, and Dr Victor
Bagla. The funding awarded is multifaceted
and is meant to enhance the research capacity
and development of young scientists in
the specialized and scarce-skilled area of
medical biotechnology and related fields.
The initiative strongly supports postgraduate
training of students at both M & D levels and
intends to enable technology transfer from
the highly resourced-collaborator laboratories
to UL. The envisaged outcomes include
increased publications thereby contributing
to the generation of new scientific knowledge
and to mitigate the knowledge gaps on the
development, progression and treatment
strategies of diseases under investigation. The
development of new pharmaceutical products
is another possible outcome. Indeed, the longterm goal and the collective collaborative
effort by both the UL researchers and
collaborators is to help harness and synergize
the available expertise in order to build the
scientific competence and human capital
needed to discover, develop and commercialise
a pipeline of nutraceuticals, food supplements
and drug leads for the prevention and/or
treatment of cancer, diabetes and obesity
from indigenous African flora.
Institution: University of Venda
PI: PROFESSOR PASCAL O. BESSONG
Transmitted and
Acquired HIV drug
resistance in Limpopo
Province
The study will determine
the types and scope of
drug resistant HIV in
individuals who are infected but not receiving
antiretroviral treatment, and in individuals
who are infected and receiving antiretroviral
treatment in rural Limpopo. The study will
provide data relevant to the implementation
of drug resistance sentinel surveillance. It will
also provide data on HIV treatment outcomes,
and on the impact of uncharacterized
mutations on the efficacy of first line
treatment. Overall, the study will enhance our
understanding of HIV drug resistance, which
is important in sustaining the efficacy and
success of first line treatment regimens.
Institutions: University of Venda
PI: DR LIZZY NETSHIKWETA
Determining
the household
environmental factors
that affect the health
of women and children
and to develop and
implement an adapted
intervention strategy
that will contribute to the reduction of
MMR and Child mortality rate in Limpopo
province
Women’s health is a critical area, which
reflects national health standards and basic
to women’s advancement. The World Health
Organization (2000) pointed that the maternal,
perinatal mortality and morbidity levels are
key indicators of the public health situation in
a country. Hence, South Africa is committed to
achieving the Millennium Development Goals
(MDGs). The achievement of all the MDGs has
important implications for the health and wellbeing of women and children, MDGs 1, 3, 4, 5
and 6 are of particular importance. Guided by
the MDGs, South Africa aims, by 2015, to have
reduced child mortality to 20 per 1000 live
births, and the maternal mortality ratio (MMR)
to 38 per 100 000 live births.
Two research approaches will be used, namely,
qualitative for exploring the socio-cultural
aspect and quantitative to determine the
environmental factors. Both approaches will
be implemented concurrently by two teams in
one district. The first district will be Vhembe
(2015-2016), Mopani (2016-2017) and lastly
Capricorn (2017-2018) and in 2019 will focus on
the development of strategy and finalization
of the project. Population will comprise
women, girls and Community Health workers,
other community members in villages, Ward
councillors & Chiefs/headman (traditional
leaders) & Traditional Health Practitioners,
Traditional Birth Attendants. Data will be
analysed using Statistical Package for Social
Sciences (SPSS) version 22.0. In qualitative
design participants will be sampled purposively.
Qualitative data will be analysed using Tesch
steps of open coding. Ethical measures,
reliability; validity and trustworthiness will be
considered throughout the study.
Institution: Walter Sisulu University
PI: DR TEKE APALATA
Evolution of HIVinfected Patients
Receiving HAART
and Quality of HIV/
AIDS Care Initiated
by Nurses at Primary
Healthcare Level in
Eastern Cape, South
Africa.
The present study plans to provide a particular
insight of the impact of task shifting for
HIV care on immunological, virological, and
clinical outputs in HIV-infected patients on
HAART, attending healthcare facilities in O.R.
Tambo district – Eastern Cape.
In an effort to better understand factors
associated with ART non-suppressed cases and
ART-suppressed non-controllers, the present
study plans to measure the adherence index
as recommended by the Centre for Adherence
Support Evaluation (CASE).
Furthermore, patients infected with HIV
have an increased risk of cardiovascular
diseases due to increased inflammation
and persistent immune activation. As part
of quality care, WHO suggests that chronic
diseases, mainly cardio-vascular diseases and
metabolic syndrome should be monitored
among patients on HAART. WHO projects
that ischemic heart disease will be the leading
cause of death in the general population
in both low- and high-income countries by
2030. Therefore, there is an urgent need of
identifying earlier markers able to predict
the occurrence of cardiovascular diseases
and other chronic conditions in HIV-infected
patients.
The analysis of the obtained data will highlight
the importance of adopting a system thinking
approach in designing, implementing and
evaluating health policies to mitigate some of
the design issues or system bottle-necks that
may impede their successful implementation
or risk to present an incomplete or misleading
picture of their impact. Hence, this study
will support the efforts of the South African
department of health through its National
Health Insurance (NHI) innovative system in
improving quality of healthcare services.
Institution: Walter Sisulu University
PI: PROFESSOR LECH BANACH
Investigation of
biomarkers in
earlier detection of
Oesophageal Cancer
in South Africa
- Progression of
normal oesophageal
epithelium to
squamous cell carcinoma in Eastern Cape:
Extent of DNA damage, ezrin expression
and clinical characteristics.
Squamous cell carcinoma of the oesophagus
(SCCE) ranks high among all cancers in black
South African men and second cancer in black
South African women. The incidence of SCCE
is reported to be high in the region of former
Transkei. The latest data published by MRC
based on PROMEC Cancer Registry 1992-2002
study performed in ten municipalities in this
region, revealed that SCCE in males accounts
for 42.2 % of total cancers, following by
lung cancer 7.9%. Among females SCCE was
second (31.5%) after cervical cancer (33%).
SCCE incidence is much higher than those
observed in other parts of Africa or for the
black population in the USA.
Many reports were published on studies of
SCCE causative agents and risk factors in
blacks in South Africa including Transkei
region. These include diet, contaminated food
and habits (drinking and smoking). However
carcinogenesis of early development of
SCCE is unknown. During tumour initiation,
development and progression, various cellular
processes are involved such as cell adhesion,
cell survival, motility and signal transduction.
Association of actin filaments with plasma
membranes is important for the regulation
of cell morphology and cell morphology and
local deformations. Ezrin, a member of the
ezrin-radixin-moesin (ERM) family is one of
the proteins which cross links the plasma
membrane to actin filament. Recent studies
from China showed that redistribution or
reduced expression of ezrin both at mRNA
and protein levels in SCCE may play role in
initiation and progression of SCCE.
Our research project includes studies on the
role of ezrin in South African black patients
and also role of oxidative stress by study
of DNA damage by the presence of in situ
8-hydroxy-deoxyguanosine (8-OhdG). The
results will be correlated with demographic
data and stage and grade of tumour.
Institutions: Walter Sisulu University
PI: DR WEZILE CHITHA
The Management
and building Of
Bridges for Selected
Non Communicable
Diseases and HIV Risk
Factors, Morbidity,
and Mortality in the
Eastern Cape Province:
A community-, hospital-, Laboratory Study
Non-communicable diseases (NCDs) are the
leading global causes of death, causing more
deaths than all other causes combined, and
they strike hardest at the world’s low- and
middle-income populations. These diseases
have reached epidemic proportions, yet they
could be significantly reduced, with millions
of lives saved and suffering avoided, through
reduction of their risk factors, early detection
and timely treatments. Target audiences
include
policy-makers,
health
officials,
academia,
relevant
non-health
sectors,
development agencies and civil society.
According to the World Health Organisation,
(2013:1) of Burden of 57 million global deaths