Groups In South Africa Research Articles

Experiencing education as misrecognised "Coloured" women in South Africa

Much has been written about the oppression suffered by marginalised groups in South Africa. From the literature, we can gain some sense of what it means to be relegated to racial boxes. We can also theorise about the harms of racism and their lasting effects on individuals and society. However, what does it mean for the individual to carry a label when they neither understand it nor want it? How do individuals internalise the prescribed assignments of racial identities? Through this article, we take you into the lives of six women labelled as "Coloured." We share stories of their determination to excel from when they were at school during apartheid to higher education post apartheid. While poignant and brave, their stories expose the rawness of being seen as a colour before being seen as a human. In making sense of their stories, we turn to conceptions of misrecognition to reshape identities without the baggage of racism.

HbA1c comparable to fasting glucose in the external validation of the African Diabetes Risk Score and other established risk prediction models in Black South Africans

BackgroundThe use of non-invasive risk scores to detect undiagnosed type 2 diabetes (T2D) ensures the restriction of invasive and costly blood tests to those most likely to be diagnosed with the disease. This study assessed and compared the performance of the African Diabetes Risk Score (ADRS) with three other diabetes risk prediction models for identifying screen-detected diabetes based on fasting plasma glucose (FPG) or glycated haemoglobin (HBA1c).MethodsAge, sex, waist circumference, body mass index, blood pressure, history of diabetes and physical activity levels from the SA-NW-PURE study were used to externally validate the ADRS and other established risk prediction models. Discrimination was assessed and compared using C-statistics and nonparametric methods. Calibration was assessed using calibration plots, before and after recalibration.ResultsNine hundred and thirty-seven participants were included; 14% had prevalent undiagnosed T2D according to FPG and 26% according to HbA1c. Discrimination was acceptable and was mostly similar between models for both diagnostic measures. The C-statistics for diagnosis by FPG ranged from 0.69 for the Simplified FINDRISC model to 0.77 for the ADRS model and 0.77 for the Simplified FINDRISC model to 0.79 for the ADRS model for diagnosis by HbA1c. Calibration ranged from acceptable to good, though over- and underestimation were present. All models improved significantly following recalibration.ConclusionsThe models performed comparably, with the ADRS offering a non-invasive way to identify up to 79% of cases. Based on its ease of use and performance, the ADRS is recommended for screening for T2D in certain Black population groups in South Africa. HbA1c as a means of diagnosis also showed comparable performance with FPG. Therefore, further validation studies can potentially use HbA1c as the standard to compare to.

Insights into the wound-healing properties of medicinally important South African Bulbine species – A comparative study

Ethnopharmacological relevanceSouth Africa harbours a large number of Bulbine (Xanthorrhoeaceae) species, which includes ethnobotanically important indigenous species. Traditionally, Bulbine leaves are used by several ethnic groups in South Africa to treat dermatological conditions including wounds, which led to the development of Bulbine-containing cosmetic products. However, scientific evidence is needed to support the claims in treating skin conditions and wound-healing. Aim of the studyThis comparative study was undertaken to investigate the wound-healing properties of five Bulbine species indigenous to South Africa, using in vitro and in vivo models. Materials and methodsFive Bulbine species, B. abyssinica, B. asphodeloides, B. frutescens, B. latifolia and B. narcissifolia were collected from natural populations in the Eastern Cape Province of South Africa. The chemical profiles of the methanol leaf extracts were acquired using ultra-performance liquid chromatography with photodiode array detection in tandem with quadrupole time-of-flight mass spectrometry. The methyl thiazolyl tetrazolium (MTT) assay and maximum tolerated concentration (MTC) assay were used to assess the in vitro and in vivo toxicity of the extracts, respectively. The in vitro scratch assay was employed to monitor cell migration and wound-closure in a HaCaT cell monolayer, following treatment with the plant extracts for 48 h. In vivo wound-healing potential was determined using the zebrafish larvae caudal fin amputation assay, assessed in three-days post fertilization larvae and various concentrations of the plant extracts were tested in both assays to determine the concentration-response effect. Data were analysed using MS Excel® enhanced with the Real Statistics add-in. Results and discussionUsing UPLC-MS, 11 major compounds were tentatively identified in the five Bulbine species. Although the compounds varied between species, all five Bulbine species contained the phenylanthraquinone, knipholone. Kaempferol glucoside was identified in four species, but not in B. abyssinica. The five Bulbine species were non-cytotoxic (cell viability > 80%) towards keratinocytes at all three tested concentrations. However, B. latifolia was toxic towards zebrafish larvae at all the tested concentrations, while the other four species were non-toxic at low concentrations. The results of the scratch assay revealed that B. abyssinica was the most active extract at 100 μg/mL. Compared to the untreated control, wound-closure notably increased by 28% (p < 0.05), 44% (p < 0.01) and 34% (p < 0.05) after 12 h, 24 h and 36 h post-treatment, respectively. Although none of the species achieved 100% caudal fin regeneration by the end of the treatment period, B. frutescens demonstrated the highest regeneration (90%) and most significant difference (p < 0.01) compared to the untreated control. ConclusionThe results revealed that the five Bulbine species have complex chemical profiles, however, they share major compound classes (i.e. phenylanthroquinones and flavonoid analogues) across the species. The study highlights the wound-healing properties of the five species, which is consistent with their traditional use.

Critical reflections of emerging farmers’ individual perspective towards assessments in recognition of prior learning for unit standards credit of agricultural courses

Interventions to redress the apartheid education’s negative impact on the education and training systems of the previously disadvantaged groups in South Africa include the implementation of recognition of prior learning (RPL). The paper attempts to qualitatively assess emerging farmers’ individual perspectives by analysing their cognitive and non-cognitive characteristics during RPL credit assessment sessions. A total of 200 Free State province emerging farmers participated in an RPL credit assessment session of the unit standards to be recognised for two agricultural qualifications. The RPL unit standards credit assessment sessions for two agricultural courses were conducted in a classroom for 3 months. The data generated from text, video, and voice recordings was processed and analysed using critical discourse analysis. What emerged from the discussions was that emerging farmers were appreciative of the opportunity to embrace spontaneity during training. The study found that embracing adult learning principles had a positive effect on the cognitive and non-cognitive characteristics of emerging farmers during training. The findings of this paper will help strengthen the understanding of how RPL is implemented in the context of emerging farmers and further development of what needs to be done to further improve RPL procedure.

Demographic and pathogen characteristics of incident bacterial meningitis in infants in South Africa: A cohort study.

Bacterial meningitis is a major cause of death, with an approximate case fatality rate of 37% across all age groups in South Africa. This study aimed to describe the demographic and pathogen characteristics of incident meningitis in children aged <1 year in South Africa from 2014 through 2018, during a period when Haemophilus influenzae type b vaccine and pneumococcal conjugate vaccines (PCV) were both included in the expanded program on immunization (EPI). We conducted a cohort study of routine laboratory data in the National Health Laboratory Service Corporate Data Warehouse, which covers approximately 80% of the South African population. We defined a case of laboratory-confirmed bacterial meningitis as any person aged <1 year with meningitis diagnosed by culture and identification of a pathogen documented as being a common cause of meningitis in CSF. The cause-specific incidence risks were calculated by dividing the number of positive specimens in each age group and year by the corresponding mid-year population for children under 1 year old and those in the post-neonatal period (≥ 28 days to 365 days old). For children under 28 days old, the annual numbers of registered livebirths were used. We used Poisson regression to compare the incidence of meningitis by year. We identified 3575 (1.5%) cases of culture-confirmed bacterial meningitis from the 232,016 cerebrospinal fluid (CSF) specimens tested from 2014-2018. The highest number of cases were recorded in children aged <28 days (1873, 52.4%), male children (1800, 50.4%) as well as in the Gauteng Province (2014, 56.3%). Acinetobacter baumannii (14.9%), followed by Klebsiella pneumoniae (13.5%), and group B streptococcus (GBS) (10.7%), were the most common pathogens detected. Overall, A. baumannii had the highest incidence risk, occurring at 9.8 per 100,000 persons in children aged <1 year in 2018. Among neonates, A. baumannii peaked at 14.9 per 100,000 livebirths in 2018, while Streptococcus pneumoniae was most common in the post-neonatal period (≥ 28 days to 365 days old), peaking at 9.8 per 100,000 persons in 2014. There was an increase in the annual incidence of most pathogens over the study period. There was an increasing trend in the annual incidence of bacterial meningitis in infants caused by most pathogens, particularly A. baumannii, K. pneumoniae and GBS. In addition to increased uptake of vaccination, prevention measures to reduce nosocomial and mother-to-child transmission of bacteria could include antenatal screening for GBS in pregnant women, rigorous hygiene in the hospital environment as well as rational antibiotic use.

An empirical investigation of ethnic-cultural procedural fairness effects and their boundary conditions among three societal groups in South Africa

ABSTRACT Ethnic-cultural procedural fairness refers to the perception that societal actors use fair and unbiased procedures to make decisions vis-à-vis one’s ethnic-cultural group. Prior research using ethnic-cultural minority samples has convincingly shown that such perceptions are associated with a range of desirable outcomes. Yet, this body of evidence has so far limited its scope to European and North American samples. Moreover, more research is needed on the underlying psychological processes. Therefore, the central aim of the present study was to investigate ethnic-cultural procedural fairness effects among three societal groups in South Africa. In Study 1 (N = 326 black South Africans), we observed relationships between ethnic-cultural fairness perceptions and positive institutional and intergroup attitudes. Institutional and social trust respectively mediated these associations. Study 2 (N = 747) replicated these findings among white (n = 595), but not among coloured South Africans (n = 152). Notably, across both studies, we also obtained evidence for moderation. That is, procedural fairness effects on institutional attitudes were significantly smaller among socioeconomically burdened black participants, and procedural fairness effects on intergroup attitudes were fully curbed among white participants who reported high levels of perceived group discrimination. Taken together, our results call for enhanced attention to procedural fairness obstacles outside of typical WEIRD settings.

Exploring strategies promoting interprofessional collaborative practice in spinal cord injury rehabilitation at a private South African hospital group

Background. Implementing an interprofessional collaborative practice (IPCP) in hospitals improves health outcomes, enhances patient safety and reduces length of stay by optimising resource utilisation. Although this approach was desired at a private hospital group in South Africa (SA), the specific strategies for clinical guidelines and capacity management pertaining to spinal cord injury (SCI) patients and the implementation of IPCP were unknown. Objective. To explore strategies for implementing clinical guidelines and capacity management for SCI rehabilitation to promote IPCP in a private hospital group in SA. Method. This exploratory descriptive qualitative study included participants who were selected through purposive sampling. The participants comprised 11 staff from various disciplines and management of the private hospital group, one local and one international expert in IPCP. Three online focus groups (n=13) were conducted, involving three to five participants. The transcriptions were analysed thematically using Braun and Clarke’s framework. Results. Interprofessional communication and tools as well as capacity development were three emergent themes from the data. Strategies pertaining to communication methods, digitisation, visual displays, patient care information, educational information and education of healthcare workers were suggested to promote IPCP. Conclusion. These findings from the emergent themes could assist in implementing and integrating an IPCP approach into the rehabilitation service. Further research assessing the efficacy of implementing the IPCP strategies and digital platform would be beneficial.

A social identity approach to understanding sustainability and environmental behaviours in South Africa

ABSTRACT In recent years, change in behaviour towards the environment has gained prominence as a policy tool to influence positive environmental value. Simultaneously, the role played by social identity in promoting pro-environmental action is gaining recognition. Within this work, the intersection between collective group identity and environmental behaviour has received very little attention. Group norms are considered a strong predictor of pro-environmental behaviour, yet the influence of social identity and collective action on environmental action has not been adequately investigated in a multi-ethnic setting. Within this context, this study examines the affective component of social identity influence on pro-environmental action. More succinctly, this study demonstrates how outgroups and in-groups’ relations and broader sociocultural structures, values, interest, and norms impact environmental and sustainability transitions behaviours. Through interviews with participants across the four dominant social groups in South Africa, this study provides compelling evidence that country-wide expressions of social identity and ingroup dynamics shapes the individual behaviour regarding environmental and sustainability concerns and further strengthen the individual’s perspective for social environmental transformation. This study advances the need for a social-identity centred approach to foster pro-environmental and sustainability outcomes. Highlights The influence that social contexts and social group memberships have on individual perception and behaviour provide important insights to build an empirical base for an inclusive environmental and sustainable action. We applied the theory of social identity to explore these processes and how normative group values and group interest shape environmental behaviour.

Strategy actions to include students in a private hospital's nursing teams: A qualitative study.

Student nurse education focusses on preparing competent professionals integral to nursing teams. To develop strategic actions to include student nurses within the nursing team. A private healthcare group in South Africa. A qualitative approach in three phases was used. Thirty purposively sampled participants recorded reflective journals in phase one. Tesch's eight steps were utilised for analysis. Phase two involved non-probability volunteer sampling of 11 participants for the nominal group technique analysis. In phase three, total population sampling recruited nine panellists for an e-Delphi technique that provided data that were open coded. Phase one identified themes, including perceptions of responsibilities, support needs, recognition, conflict and communication issues. Phase two revealed five strategic actions: fair treatment, aligned work allocation, active participation, respect and acknowledgement of contributions. Phase three validated 19 strategic statements underpinning the strategic actions. Unit managers play a key role in fostering inclusivity, impacting student nurse retention. Enhancing team cohesion can improve workplace wellness and patient outcomes while aiding in retention and recruitment efforts.

Fertility Variations among Ethnic Groups in South Africa

Fertility Variations among Ethnic Groups in South Africa

AN APPRAISAL OF THE ROLE OF RITUALS AND THEIR WAIVER IN THE CONCLUSION OF A CUSTOMARY MARRIAGE

The validity of customary marriages remains a topical issue in South Africa and the most litigated aspect of customary law. The problem is that courts often do not pay attention to the role that rituals play in the validity of a customary marriage. Courts do not always investigate the relevant living law to determine if indeed the traditional group involved allows for waiver of a ritual in conclusion of a customary marriage. Living law refers to the day-to-day norms of communities that base their lives on customary law. Living law is affected by different factors such as acculturation and urbanisation.1 The focus of this article is on some of the different traditional groups in South Africa and looks at case law in South Africa in terms of how traditional groups deal with the role of rituals in determining the conclusion of a customary marriage. The article argues that what is happening is problematic because customary law is not given the recognition it is afforded by the Constitution. The article argues that understanding rituals can play an important role in helping courts to determine whether a customary marriage has been concluded in a particular case. Rituals are also observed to integrate a bride into the groom’s family; however, there are rituals that may be waived without affecting the validity of a customary marriage. Integration of the bride is a broader term requiring scrutiny because this process includes different and varying rituals that are observed in the conclusion of a customary marriage. In customary law, rituals are significant because they are associated with legitimising certain occurrences, such as the change of a surname and the coronation of a king. This article argues that courts should appreciate the significance of rituals in the conclusion of a customary marriage. In addition, courts should understand which rituals are so important that they cannot be waived.

Explainable Early Prediction of Gestational Diabetes Biomarkers by Combining Medical Background and Wearable Devices: A Pilot Study with a Cohort Group in South Africa.

This study aims to explore the potential of Internet of Things (IoT) devices and explainable Artificial Intelligence (AI) techniques in predicting biomarker values associated with GDM when measured 13 - 16 weeks prior to diagnosis. We developed a system that forecasts biomarkers such as LDL, HDL, triglycerides, cholesterol, HbA1c, and results from the Oral Glucose Tolerance Test (OGTT) including fasting glucose, 1-hour, and 2-hour post-load glucose values. These biomarker values are predicted based on sensory measurements collected around week 12 of pregnancy, including continuous glucose levels, short physical movement recordings, and medical background information. To the best of our knowledge, this is the first study to forecast GDM-associated biomarker values 13 to 16 weeks prior to the GDM screening test, using continuous glucose monitoring devices, a wristband for activity detection, and medical background data. We applied machine learning models, specifically Decision Tree and Random Forest Regressors, along with Coupled-Matrix Tensor Factorisation (CMTF) and Elastic Net techniques, examining all possible combinations of these methods across different data modalities. The results demonstrated good performance for most biomarkers. On average, the models achieved Mean Squared Error (MSE) between 0.29 and 0.42 and Mean Absolute Error (MAE) between 0.23 and 0.45 for biomarkers like HDL, LDL, cholesterol, and HbA1c. For the OGTT glucose values, the average MSE ranged from 0.95 to 2.44, and the average MAE ranged from 0.72 to 0.91. Additionally, the utilisation of CMTF with Alternating Least Squares technique yielded slightly better results (0.16 MSE and 0.07 MAE on average) compared to the well-known Elastic Net feature selection technique. While our study was conducted with a limited cohort in South Africa, our findings offer promising indications regarding the potential for predicting biomarker values in pregnant women through the integration of wearable devices and medical background data in the analysis. Nevertheless, further validation on a larger, more diverse cohort is imperative to substantiate these encouraging results.

Ukukhonza as an ethic-oriented ontology to ensure harmonious existence among AmaZulu

The production of knowledge should be premised on the inclusion of all epistemologies to provide possibilities to build a more just world. However, knowledge production, as we have it today, is premised on Western epistemology which is used to distil other knowledges before they could be accepted as legitimate. This approach stifles possibilities to find different ways of knowing that could contribute to imagining the world anew. There is a need, therefore, to unthink the West such that we find other ways to understand the world. The article helps in unthinking the West to allow an authentic understanding of the indigenous people of South Africa. I argue that the ontology of AmaZulu – one of the indigenous groups in South Africa – is an ethic-orientated ontology that is expressed through the concept of ukukhonza – a process where one surrenders their identity in order to belong to the group (this can also refer to worship). In ukukhonza, the surrendering of one’s identity is to ensure harmonious living centred on a common identity that is unified by the principles of ubuntu. Drawing on the nuances of ukukhonza, this article argues that the ontology of AmaZulu is centred on respecting life in its different forms because it is believed that everything is interconnected. This understanding of life provides a different conceptualisation of God which anchors the religion that is practised everyday such that doing good is inescapable. This is an ethic-oriented ontology which when brought forth in its authentic form can address the many ills of modern society.Contribution: This is the conceptual article that contributes to rethinking religion from an African perspective to provide a possibility of an ethic-centred society that can inform the new ways of being in the world.

South African diabetic patients’ use of mobile applications for physical activity: An age comparison

The prevalence of diabetes is greater in older, low-income, urban South African populations. Exploring the potential of mobile applications to aid in this challenge, the research focuses on 514 diabetic patients in Cape Town, applying the Theory of Planned Behaviour. Utilizing Partial Least Squares Structural Equation Modelling, the study identifies age-specific variations in factors influencing mobile app use. While overall predictability of intention to use mobile health apps for exercise is moderate (R2 = 11.6%), specific relationships differ across age groups. Notably, relationships involving Social Norm, Intention, and Perceived Behavioural Control show insignificance in certain age brackets. Although the study retains significance for the oldest age group at a 95% confidence interval, compared to the original 99%, the overall model exhibits low predictive power. The findings underscore the necessity for designers to tailor mobile applications to diverse age requirements. This research contributes to theoretical understanding by highlighting age-related nuances in the Theory of Planned Behaviour, offering practical insights for intervention design and public health policies to enhance diabetes management among various age groups in South Africa.

PREPARATION OF INTELLECTUALLY DISABLED AND/OR AUTISTIC YOUNG PEOPLE FOR LEAVING CARE IN SOUTH AFRICA

Research on the transition of intellectually disabled and/or autistic care-leavers is still in its infancy globally and there have been no studies on this population in South Africa. This article, therefore, aims to illuminate the experiences of this overlooked group in South Africa, with a focus on how well they are prepared for the transition from residential childcare facilities to young adulthood. Semi-structured interviews were conducted with eight intellectually disabled and/or autistic young people who were about to disengage from Child and Youth Care Centres in the Cape Peninsula, and their caregivers. Data were analysed using thematic analysis. Four themes emerged: person-centred planning for care-leaving; opportunities for extended care and gradual exits from care; support for interdependent living aftercare; and addressing loss and anxiety related to moving on during the transition. The study highlights implications for policy and practice, including the need for a clear policy framework to support aftercare provision and improvements in care-leaving preparation with a stronger focus on interdependence. Keywords: aging out, autism, care-leaving preparation, intellectual disability, leaving care, transition

Interseksionele feminisme in Afrikaanse poësie: Lynthia Julius se Uit die kroes

In the current transnational discourse on fourth-wave feminism, "intersectional feminism" is a fundamental concept. The representation of marginalised voices of especially Black women from underrepresented contexts, such as the Global South, is emphasised in an attempt to decolonise the formal domains of literature, academia and the media. Historically, there is a gap in the representation of diverse Black female voices in South African literatures. However, there has recently been an increase in the publication of the literary texts by previously marginalised voices, especially in Afrikaans poetry. Diverse perspectives are shared regarding the complexities of the intersection of identity categories including race, gender, culture, identity, class, language and socioeconomic status in South African society, and how it affects the previously marginalised. A voice that represents intersectional feminist issues in the South African and Afrikaans contexts can be found in Lynthia Julius's debut poetry book, Uit die kroes (From the kroes, 2020). In this article, the significance of Julius's unique, intersectional feminist viewpoint, with stories and perspectives from the Northern Cape, is investigated. The focus is specifically on how Julius represents a 'triple marginalised' voice in the South African and Afrikaans contexts with regard to her gender, race and language. Furthermore, I will discuss how the uniqueness of her collection of poems and Northern Cape Afrikaans, that have rarely been provided with a platform in the Afrikaans literary canon, contribute to giving a voice to the historic 'voiceless'. The importance of Julius's voice and how it highlights the heterogeneity of previously marginalised groups in South Africa, are also explored. In conclusion it is argued that the publication of poets with diverse intersectional feminist perspectives, such as Julius, can be deemed a positive step in the direction of the decolonising process of the Afrikaans literature and feminism.

Challenges Facing Street Vendors in Durban and the Role of The Law: A Means to Empowering Women

As a vulnerable group in South Africa, women have been the primary victims of unemployment, the lack of access to income generation opportunities and barriers to sustainable livelihoods in general. Street vendors are a significant part of the economy, and their income supports several families and sustains their livelihoods. However, such vendors, particularly women, are faced with severe problems that interfere with their daily operations, as well as challenges relating to the law. Their low literacy levels mean they have an inadequate understanding of the laws and by-laws that regulate street vending. Even though the South African Constitution guarantees equal rights and protection, as well as the freedom to choose one's own occupation, trade or profession, street vendors, especially female vendors, are not adequately protected. The purpose of this study was to investigate the challenges faced by street vendors in the Durban area and to examine the role of the law in contributing to such challenges, as well as addressing them. Through a quantitative study using a survey, data was collected from street vendors in Durban. The study’s findings indicate that vendors lacked knowledge of their rights and faced poor working conditions, harassment by the police, evictions, impounding of goods and a lack of access to permits.

Framing Operation Dudula and Anti-Immigrant Sentiment in South African Media Discourse

This study investigates how the anti-immigrant group Operation Dudula is framed and constructed in South African media discourse. Utilizing framing theory and social constructionism, content analysis was conducted on media articles published after the arrest of Operation Dudula’s leader. Findings reveal Operation Dudula resonates with citizens by blaming immigrants for unemployment, although claims about foreign workers are often misleading or exaggerated. Media frames construct Operation Dudula as either tackling unemployment or engaging in xenophobic vigilantism. While perspectives on immigrants differ, dominant frames critical of Operation Dudula may constrain its activities by challenging legitimacy. However, some political support exists for Dudula’s goals. Unfortunately, vilifying immigrants obscures systemic issues that elites failed to address. Reducing xenophobic tensions requires tackling root causes of unrest, while promoting human rights and non-discrimination. This study concludes media discourse plays a role in enabling or inhibiting the activities of vigilante groups in South Africa. Nuanced understanding of anti-immigrant framing is key to addressing this complex social issue.

Initial Presentation of SLE among the Different South African Ethnic Groups

Background: Systemic lupus erythematosus (SLE) is a chronic, immune-mediated, inflammatory multi-organ disease. It is characterized by a variety of clinical features including abnormalities of the joints, skin, kidneys, lungs, heart, blood and brain. In addition to gender, genetic, environmental, hormonal and chemical factors appear to play a role in disease activity. Previous studies in South Africa have shown an increasing trend of new diagnoses of SLE patients, with increasing target organ damage but there is an obvious distinction between different organs in terms of incidence. The primary aim of this study was to identify the major initial presentation of SLE patients among the three main South African ethnic groups: Black, Mixed ethnicity, and White. Material and Methods: This was a retrospective descriptive and analytic study in which patients with SLE were compared among the three ethnic groups in South Africa. Data was obtained from patient’s records contained in the Enterprise Content Management System (ECM) and medical records. Results: A total of 198 patients were seen in the Rheumatology Division with SLE between March 1993 and November 1999. The study showed that the most affected group was the mixed ethnicity population (81.4%), followed by the black African group (11.6%), then the white group (7%). Arthritis was the most frequent disorders among the three-different ethnic groups. However, there appear to be some differences in the autoantibody profile.&#x0D; Conclusion:This study focused on the initial presenting symptoms. A long-term cohort on the development of the disease may yield further results on possible ethnic differences, and continued research into susceptibility loci and phenotypic associations in enriched multi-ethnic cohorts and looking for the causes of death among the three ethnic groups and related to the first presentation is suggested.

Access to healthcare services for transgender people in South Africa: assessing healthcare experiences and human rights

Background: The transgender population is one of the most marginalized and misunderstood population groups in South Africa. Despite a progressive and inclusive human rights-based legal framework, transgender people in South Africa are vulnerable to multiple human rights violations, including inequality and grave healthcare disparities. Aims: This study aims to assess the healthcare disparities experienced by transgender persons in South Africa. In South Africa, transgender people are legally entitled to equality and the right to access healthcare services. The article examines sparsely explored discrepancies and recommends how a transgender person’s right to access healthcare can be strengthened through a comprehensive human rights approach. Methods: The methodology involved semi-structured interviews with transgender respondents and healthcare experts. The sample comprised 43 transgender respondents aged between 23 and 45 residing in Gauteng, Mpumalanga, North West and the Western Cape and a multi-disciplinary group of nine healthcare professionals working in South African health institutions. The data was analyzed through relevant thematic analysis. Results: The majority of transgender participants and healthcare experts reported that there are transgender-related inequalities in the healthcare system, including stigma and discrimination, exclusionary and culturally incompetent health services and limited availability of competent healthcare services. Discussion: There is a need for South Africa to intensify its application of transgender human rights to bridge the gap between lived experiences and the law. Comprehensive and explicit transgender-inclusive laws must be developed. Diverse transgender people must participate in the law and policy-making process. Activism, advocacy, and strategic litigation should be used effectively by relevant parties to create awareness and impact change.