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Cape Town, South Africa

Dunbar R.,Stellenbosch University | Lawrence K.,Stellenbosch University | Verver S.,KNCV Tuberculosis Foundation | Verver S.,University of Amsterdam | And 6 more authors.
International Journal of Tuberculosis and Lung Disease

BACKGROUND: Although tuberculosis (TB) treatment registers and laboratory records are essential tools for recording and reporting in TB control programmes, the accuracy and completeness of routinely collected data are seldom monitored. OBJECTIVE: To assess the accuracy and completeness of TB treatment register data in two South African urban communities using record linkage. METHODS: All cases of bacteriologically confirmed TB, defined as two smear-positive results and/or at least one culture-positive result, were included. Record linkage was performed between three data sources: 1) TB treatment registers, 2) the nearest central laboratory, and 3) the referral hospital laboratory. RESULTS: The TB treatment registers had 435 TB cases recorded, of which 204 (47%) were bacteriologically confirmed. An additional 39 cases recorded as non-bacteriological cases in the TB treatment registers were reclassified as bacteriologically confirmed, and 63 bacteriologically confirmed cases were identified from the laboratory databases that were not recorded in the TB treatment registers. The final number of bacteriologically confirmed TB cases was 306, giving an increase of 50%. CONCLUSIONS: The accuracy and completeness of the TB treatment register and central laboratory data were inadequate. A high percentage of bacteriologically confirmed cases from both laboratories were not recorded in the TB treatment registers. We are developing an electronic result management system to improve the management of laboratory results. © 2011 The Union. Source

Colenbrander D.R.,City of Cape Town | Colenbrander D.R.,University of Amsterdam | Sowman M.R.,University of Cape Town
Coastal Management

The current approach to coastal development set-back delineation in South Africa is producing high-tech empirical methodologies that attempt to pinpoint areas at risk from physical coastal processes and the subsequent positioning of set-backs in relation to these risk areas. Experience in the Western Cape province of South Africa has shown that this approach contributes only partially to coastal risk management. In the context of an urban and peri-urban environment, and bearing in mind that set-backs have significant socioeconomic implications, the development of a set-back line at the local scale requires an expansion beyond just relying on the numerical modeling of physical coastal processes. This research reveals that such an approach is parochial and socially detached and a more inclusive and integrated approach grounded in and spanning localized social, cultural, economic, political, and ecological intricacies of the coastal space is required. Fundamental to achieving this is a re-consideration of the broader project management processes applied in the development of set-backs. The article concludes with a set of principles and guidelines for determining set-backs in complex coastal contexts at the local scale. © 2015, Copyright © Taylor & Francis Group, LLC. Source

Davison A.,City of Cape Town | Patel Z.,University of Cape Town | Greyling S.,University of Cape Town
Local Environment

This paper offers a reflection on 15 years of policy change in the City of Cape Town aimed at fostering sustainability from the perspective of a City practitioner. The persistent continuation of unsustainable outcomes, despite ongoing policy reforms, is understood as a combination of the emergence of wicked problems, within a changing local government mandate, in the absence of a transformation of institutional structures, tools and approaches. While the approach to policy reform in Cape Town has focussed on reducing substantive uncertainty through its knowledge-based approach, we show that in the context of an expanding local government mandate, sustainability becomes an aspect of many departments’ directive resulting in strategic uncertainty. The untransformed traditional line-function-based structure of local government in turn works against integration between departments (fundamental for addressing non-linear wicked problems), thus promoting institutional uncertainty. In addressing this combination of strategic and institutional uncertainty, our findings indicate that integration has to happen in the policy stage in order for sustainability principles to be implemented in relevant departments; that implementation requires resourcing across the institution, and ought to be included in departments’ targets; and that competing and conflicting rationalities underpin the policy–practice gap. It is suggested that a first step in breaking down the strategic and institutional uncertainties would be to foster shared values through creating deliberative spaces within the City in which debate, discussion and learning can occur. © 2015 Taylor & Francis Source

Ballantyne N.,City of Cape Town
Proceedings of the 20th Conference on the Domestic Use of Energy, DUE 2012

The paper sketches the history of the development and implementation of free basic electricity in South Africa. It covers the promises made by politicians, the establishment and work of the Electricity Basic Services Support Tariff (EBSST) Task Team. The paper discusses the challenges of the continued provision of free basic electricity (FBE) with tariff increase restrictions (imposed by the National Energy Regulator of South Africa)for those consumers who receive FBE, in a climate of general tariff increases in the order of 25% per annum, and the drive for energy efficiency. © 2012 Cape Pennisula Univ of Tec. Source

Claassens M.M.,Stellenbosch University | Claassens M.M.,University of Amsterdam | Jacobs E.,Stellenbosch University | Cyster E.,City of Cape Town | And 6 more authors.
International Journal of Tuberculosis and Lung Disease

SETTING: This study was conducted in Cape Town in two primary health care facilities in a sub-district with a high prevalence of bacteriologically confirmed pulmonary tuberculosis (TB). OBJECTIVE: To determine the proportion of adults with respiratory symptoms who attend health care facilities but are not examined for nor diagnosed with TB in facilities where routine TB diagnosis depends on passive case finding. DESIGN: A total of 423 adults with respiratory symptoms exiting primary health care services were consecutively enrolled during April-July 2011. RESULTS: Twenty-one (5%) participants were diagnosed with culture-positive TB. None had sought care at the facility for their respiratory symptoms, none were asked about respiratory symptoms during their visit and none were asked to produce a sputum sample. Nine cases had attended the facility for reasons regarding their own health, while 12 cases were accompanying someone else attending the facility, or for another reason. CONCLUSION: Patients with infectious TB attend primary health care facilities, but are not recognised and diagnosed as cases. Health care staff should search actively within facilities for cases who attend the health care services to ensure that cases are not missed. Intensified case finding should start within the facility, and should not be limited to patients who report respiratory symptoms or who are human immunodeficiency virus positive. © 2013 The Union. Source

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