University Of Cape Town Research Articles

Transitions in development - an interview with Dorit Hockman.

Dorit Hockman is a Senior Lecturer in the Division of Cell Biology, Faculty of Health Sciences at the University of Cape Town, South Africa. Her group studies the dynamics of gene regulation in the developing nervous system. We chatted with Dorit over a video call to find out more about her career path, her return to South Africa to establish her independent research group, and the importance of having supportive colleagues and mentors.

Knowledge and perceptions of South African blood donors towards biobanking and stool donation.

The complexity of contexts and varied purposes for which biome donation are requested are unknown in South Africa. The aim of this study was to provide strategic data towards actualisation of whether a stool donor bank may be established as a collaborative between Western Cape Blood Services (WCBS) and the University of Cape Town (UCT). We designed a cross-sectional, questionnaire-based survey to determine willingness of WCBS blood donors to donate stool specimens for microbiome biobanking. The study was conducted between 01 June 2022 and 01 July 2022 at three WCBS donation centres in Cape Town, South Africa. Anonymous blood donors who met the inclusion criteria were enrolled. Anonymised demographic and interview data were analysed statistically. Analysis of responses from 209/231 blood donors demonstrated in a logistic regression model that compensation (p < 0.001) and 'societal benefit outweighs inconvenience' beliefs (p = 7.751e-05) were covariates significantly associated with willingness to donate stool. Age was borderline significant at a 5% level (p = 0.0556). Most willing stool donors indicated that donating stool samples would not affect blood donations (140/157, 90%). Factors decreasing willingness to donate were stool collection being unpleasant or embarrassing. The survey provides strategic data for the establishment of a stool bank and provided an understanding of the underlying determinants regarding becoming potential donors. This is the first report on the perspectives of potential participants in donating samples towards a stool microbiome biobank in South Africa, a necessity for faecal microbiota transplantation (FMT).

Morphological variations of fissures, lobes, and hilar pattern of the lung in a select South African sample.

The lungs are essential respiratory organs divided into lobes by the horizontal and oblique fissures. The hilum, located on the mediastinal surface of each lung, is where the bronchus, pulmonary veins, and pulmonary arteries enter and exit. This study aims to investigate and record the variations in the morphology of lung fissures, lobes, and hilar patterns observed in a South African sample. This cross-sectional observational study employed descriptive analysis. A total of 48 formalin-fixed bodies, comprising 24 females and 24 males from the Department of Human Biology at the University of Cape Town were studied were examined. Fissures were classified according to the Craig and Walker criteria. Incomplete oblique fissures were found in 25 right lungs and 30 left lungs. Incomplete horizontal fissures were observed in 39 right lungs, and one right lung exhibited the absence of both horizontal and oblique fissures. Accessory fissures were present in five right and seven left lungs. Variations in the hilar pattern were noted, including differences in the number and arrangement of structures in both right and left lungs. Variations were observed in the lobes, fissures and the hilar patterns of several lungs. Awareness of these morphological variations is crucial for surgeons and radiologist to avoid misdiagnosis and complications during surgical procedures.

Multilevel Proteomics Reveals Epigenetic Signatures in BCG-Mediated Macrophage Activation

The bacillus Calmette-Guérin BCG vaccine (Mycobacterium bovis) is primarily used to prevent tuberculosis (TB) infections but has wide-ranging immunogenic effects. One of its most notable properties is its ability to induce trained immunity, a memory-like response in innate immune cells such as macrophages. Through targeted analyses of well-established histone marks, prior research has shown that these changes are generated through epigenetic modification. Mass spectrometry-based proteomic approaches provide a way to globally profile various aspects of the proteome, providing data to further identify unexplored mechanisms of BCG-mediated immunomodulation. Here we use multi-level proteomics (total, histone, and phospho to identify networks and potential mechanisms that mediate BCG induced immunomodulation in macrophages. Histone-focused proteomics and total proteomics were performed at the University of Cape Town (data available via ProteomeXchange with identifier PXD051187), while phosphoproteomics data was retrieved from the ProteomeXchange Repository (identifier PXD013171). We identify several epigenetic mechanisms that may drive BCG-induced training phenotypes. Evidence across the proteomics and histone-focused proteomics data sets pair 6 epigenetic effectors (NuA4, NuRD, NSL, Sin3A, SIRT2, SIRT6) and their substrates.

Racial discourses and colonial education policy: The discursive construction of education development at a historically white South African university

Motivated by critiques from black students during the protests (2015-2016), I trace continuities between the racialised discourses and knowledge regimes that justified colonial education policies and that of Education Development at a historically white South African university. First, I show how the University of Cape Town’s Humanities Education Development Programme racialised and misrecognised black students, despite attempted reforms. Secondly, I trace the discursive formation of the ED project - from the assimilationist discourse of missionary education; the adapted model of trusteeship; the production of race science during apartheid; to a return to assimilationist discourse via the Cape Liberal tradition during apartheid’s demise. However, after a generation of inferior Banu Education, the attempt to assimilate black students into historically white universities’ curricula was not feasible. Instead, an adapted, remedial model was proposed that became entrenched post-apartheid by a state and HE system that failed to transform its inherited Eurocentric curriculum.

Progress in Pharmacometrics Implementation and Regulatory Integration in Africa: A Systematic Review.

The availability of clinical trial data, advocacy, and increased funding has facilitated the implementation of pharmacometrics in Africa, resulting in the establishment of additional training programs for pharmacometricians. This study conducted a systematic review to evaluate the progress made from the implementation of pharmacometrics in clinical drug development and its adoption into drug approval by regulatory authorities in Africa. We performed a comprehensive literature search using major databases such as PubMed and Google Scholar. The study included articles published until 2024, with no lower cutoff. Articles were excluded if not addressing the research question or of pharmacometrics studies done outside Africa with no collaboration with African researchers (study setting). For the review, a total of 121 articles were included for analysis. Among the reported pharmacometrics approaches, Population pharmacokinetics modeling approaches are the most used (95 (78.5%)). South Africa and Uganda researchers have the most research output in pharmacometrics in Africa (82 (89.1%) and 7(7.61%), respectively), with the University of Cape Town (South Africa) producing the highest (71 (78.8%)) of all article in Africa. The most studied conditions are TB (43 (35.5%)), HIV (33 (27.3%), TB and HIV (22 (18.2%)), and malaria (12 (9.92%). Pharmacometrics is gaining momentum in Africa, and the progress made since inception will significantly improve the safety and efficacy of therapeutic agents used to treat HIV, TB, and other emerging conditions.

Survive or suffer: sustainability of addiction care curriculum/training in South African Universities

ABSTRACT South Africa is grappling with a significant challenge of high harmful substance use rates, a shortage of addiction care professionals, and an expanding treatment gap. In response, the Department of the Premier initiated a project in 2010 to revamp its approach to substance use treatment in the Western Cape. This endeavor led to the establishment of a postgraduate diploma in addictions (PGDIP) in collaboration with the Universities of Cape Town and Stellenbosch. The PGDIP aimed to enhance the expertise of healthcare professionals in evidence-based practices for substance use prevention and treatment. Despite the initial success of the program in upskilling professionals and improving addiction care quality, financial constraints threaten its continuity, hindering the upskilling of the addiction treatment workforce. The cessation of bursaries and the self-funding requirements pose challenges to training professionals in evidence-based approaches. The growing prevalence of substance use disorders in South Africa underscores the urgency of investing in addiction specialists to address the escalating demand for treatment services and the complex needs of individuals struggling with addiction. To avert a potential public health crisis, it is imperative for the country to prioritize the training of addiction practitioners and ensure standardized academic training to professionalize the addiction workforce.

Challenges with measures used for assessing research impact in higher education institutions

Internationally, there has been a push for the prioritisation of research impact beyond its scholarly contribution. Traditionally, research impact assessments have focused on academic impact and quantitative measures, at the expense of researchers for whom research impact cannot be quantified. Bibliometric indicators and other quantitative measures are still the most widely used method for evaluating research impact because these measures are easy to use and provide a quick solution for evaluators. Conversely, metric indicators fail to capture important dimensions of high-quality research. Hence, in this study, we explored challenges with metric indicators. We adopted a case study of the University of Cape Town and used document analysis, a questionnaire survey to collect data from academics and researchers, as well as semi-structured interviews with a sample of academic and research staff. The findings highlight common challenges with quantitative measures, such as bias and discipline coverage, and the ability of measures to drive researchers’ behaviour in another direction. We propose the adoption of responsible research metrics and assessment in South African higher education institutions for more inclusive and equitable research impact assessments.

Post-traumatic stress disorder symptoms following exposure to acute psychological trauma in children aged 8–16 years in South Africa: protocol for the Sinethemba longitudinal study

IntroductionChildren exposed to trauma are vulnerable to developing post-traumatic stress disorder (PTSD) and other adverse mental health outcomes. In low-and middle-income countries (LMICs), children are at increased risk of exposure...

Evolution of antimicrobial stewardship in pneumonia management: A comprehensive bibliometric analysis

AbstractObjectivesThis comprehensive bibliometric analysis explores the evolving trends in antimicrobial stewardship programs for enhancing treatment and diagnostics of pneumonia from 2006 to 2023.Materials and methodsThis research included a performance analysis and science mapping using RStudio v.4.3.1 and the bibliometric R‐package, with a data analysis conducted using Biblioshiny and Scopus. The study identified publication trends, prolific journals, leading institutions and authors, collaboration patterns, and keyword frequencies.ResultsThe study, based on 789 relevant studies from 287 sources, reveals a substantial increase in publications, collaborative authorship, and citations, with an average of 14.37 citations per document. The Annual Growth Rate for this research domain exhibits a steady increase of 30.13%, emphasizing the expanding scope of research output. Twelve key journals are identified using Bradford's Law with “Antibiotics” being the most prolific, contributing 6.5% of the total articles during the study period. Leading institutions in this research domain include the All‐India Institute of Medical Sciences and the University of Cape Town, each with 21 articles, reflecting their commitment. Dr. S.E. Cosgrove emerges as a key author with eight contributions, followed by other influential contributors. The United States leads in the number of publications, with Italy and Spain following closely. The analysis reveals a concentration of research output in high‐income countries, raising questions about accessibility and research capabilities in lower‐income nations. Addressing these disparities is crucial for comprehensive global strategies in pneumonia management. The study acknowledges limitations, such as database selection and language bias.ConclusionThe research trends in antimicrobial stewardship for pneumonia treatment and diagnostics demonstrate a global increase in scholarly output. These findings provide valuable insights into collaborative networks, influential authors, leading institutions, and emerging topics.

Ongoing Implementation and Prospective Validation of Artificial Intelligence/Machine Learning Tools at an African Drug Discovery Center.

Artificial intelligence (AI) and machine learning (ML) are anticipated to accelerate drug discovery programs. Following our development of an end-to-end virtual screening cascade at the University of Cape Town (UCT) Holistic Drug Discovery and Development (H3D) Center, we report the ongoing implementation of open-source AI/ML tools for use in resource-constrained settings.

LGG-42. TWENTY YEARS OF PROGRESS IN MANAGING LOW GRADE GLIOMA: THE EXPERIENCE OF THE UNIVERSITY OF CAPE TOWN’S COMBINED PAEDIATRIC NEURO-ONCOLOGY SERVICE FROM 2001 TO 2022

Abstract BACKGROUND This study aimed to review the management of childhood low grade gliomas (WHO I and II) by the University of Cape Town’s combined neuro-oncology service at Red Cross War Memorial Children’s and Groote Schuur Hospitals. METHODS All patients diagnosed with low grade glioma between 2001 and 2022 were included in this retrospective study. Real time decision-making during the study period was achieved via a weekly neuroimaging meeting, and surveillance by a combined monthly clinic attended by paediatric endocrinology and educational psychology. Despite state of the art surgical and radiotherapy facilities, molecular diagnostics, monoclonal antibodies and small molecules were only available to selected patients. RESULTS Among 129 children, aged 0.38 to 14.58 years [median 5.36], six had Tuberous Sclerosis and 11 had Neurofibromatosis-1. The commonest sites were cerebellum (26%), hypothalamus (17%) and optic pathway (16%), and 12 patients (9%) had metastatic disease, mostly grade I supratentorial tumours. Twenty-three patients were diagnosed on imaging without histology, six of whom were biopsied subsequently, yielding a total of 96 grade I and 16 grade II tumours. Initial management was expectant in 16% (including 8 of the 11 Nf-1 tumours), surgery in the form of debulking or total resection in 53%, chemotherapy in 24% and radiotherapy in 8%. Ultimately 36% received chemotherapy and 29% radiotherapy (almost all of them focal RT), and only 16% of those treated with radiotherapy progressed. Estimated 5-year Overall Survival (OS) and Progression Free Survival (PFS) was 90.5% and 52.6% for the whole group. Patients treated with chemotherapy had an OS of 87.2% and a PFS of 39.2%. PFS and OS were inferior for metastatic disease but not for grade II tumours. CONCLUSIONS Low grade glioma can be managed effectively in a middle-income country setting. Multidisciplinary team management is crucial to achieving positive outcomes regardless of context.

Linda-Gail Bekker: Mentorship is critical for anyone in STEM.

Linda-Gail Bekker is a professor, chief executive officer of the Desmond Tutu HIV Foundation, and director of the Desmond Tutu HIV Centre at the Institute of Infectious Disease and Molecular Medicine, University of Cape Town, South Africa. Her research interests include HIV treatment and prevention and tuberculosis, and she is active in developing community projects to promote education and research. We talked to Linda-Gail about her career, the importance of mentorship, and how rewarding it is to collaborate, mentor, and uplift other scientists.

Universities and Artificial Intelligence

The general objective of the research was to determine the advances related to the universities and artificial intelligence. The specific objectives of the research are to identify the universities that invest the most in artificial intelligence and the best global universities for artificial intelligence. Methodology, in this research, 42 documents have been selected, carried out in the period 2018 – 2024; including: scientific articles, review articles and information from websites of recognized organizations. Results, AI is becoming increasingly important in all areas of human activity, which is why standards are being established for its proper use. Education is an important aspect in the development of people, which is why it must be invested at an international level. Innovation is very important for any type of organization and especially for universities. Conclusions, artificial intelligence is gaining more followers in university higher education, due to its important contribution. In addition, some principles have been formulated to guide its development. The top global university is the MIT – Massachusetts Institute of Technology (The United States of America); the top university in Latin America and the Caribbean is the Universidade de São Paulo (Brazil); the top university in Europe is the University of Oxford (United Kingdom); the best university in Asia is the Tsinghua University (China); the top university in Africa is the University of Cape Town (South Africa); the top university in Oceania is the University of Melbourne (Australia). The university that invests the most in artificial intelligence was Johns Hopkins University. The best global universities for artificial intelligence were Tsinghua University, Nanyang Technological University, Chinese University of Hong Kong, Stanford University, University of California – Berkeley and Massachusetts Institute of Technology.

Making a Difference: 5 Years of Cardiac Surgery Intersociety Alliance (CSIA)

Informed by the almost unimaginable unmet need for cardiac surgery in the developing regions of the world, leading surgeons, cardiologists, editors in chief of the major cardiothoracic journals as well as representatives of medical industry and government convened in December 2017 to address this unacceptable disparity in access to care. The ensuing "Cape Town Declaration" constituted a clarion call to cardiac surgical societies to jointly advocate the strengthening of sustainable, local cardiac surgical capacity in the developing world. The Cardiac Surgery Intersociety Alliance (CSIA) was thus created, comprising The Society of Thoracic Surgeons (STS), the American Association for Thoracic Surgery (AATS), the Asian Society for Cardiovascular and Thoracic Surgery (ASCVTS), the European Association for Cardio-Thoracic Surgery (EACTS) and the World Heart Federation (WHF). The guiding principle was advocacy for sustainable cardiac surgical capacity in low-income countries. As a first step, a global needs assessment confirmed rheumatic heart disease as the overwhelming pathology requiring cardiac surgery in these regions. Subsequently, CSIA published a request for proposals to support fledgling programs that could demonstrate the backing by their governments and health care institution. Out of 11 applicants, and following an evaluation of the sites, including site visits to the 3 finalists, Mozambique and Rwanda were selected as the first Pilot Sites. Subsequently, a mentorship and training agreement was completed between Mozambique and the University of Cape Town, a middle-income country with a comparable burden of rheumatic heart disease. The agreement entails regular video calls between the heart teams, targeted training across all aspects of cardiac surgery, as well as on-site presence of mentoring teams for complex cases with the strict observance of "assisting only." In Rwanda, Team Heart, a US and Rwanda-based non-governmental organization (NGO) that has been performing cardiac surgery in Rwanda and helping to train the cardiac surgery workforce since 2008, has agreed to continue providing mentorship for the local team and to assist in the establishment of independent cardiac surgery with all that entails. This involves intermittent virtual conferences between Rwandan and US cardiologists for surgical case selection. Five years after CSIA was founded, its "Seal of Approval" for the sustainability of endorsed programs in Mozambique and Rwanda has resulted in higher case numbers, a stronger government commitment, significant upgrades of infrastructure, the nurturing of generous consumable donations by industry and the commencement of negotiations with global donors for major grants. Extending the CSIA Seal to additional deserving programs could further align the international cardiac surgical community with the principle of local cardiac surgery capacity-building in developing countries.

Making a difference: 5 years of Cardiac Surgery Intersociety Alliance (CSIA).

Informed by the almost unimaginable unmet need for cardiac surgery in the developing regions of the world, leading surgeons, cardiologists, editors in chief of the major cardiothoracic journals as well as representatives of medical industry and government convened in December 2017 to address this unacceptable disparity in access to care. The ensuing "Cape Town Declaration" constituted a clarion call to cardiac surgical societies to jointly advocate the strengthening of sustainable, local cardiac surgical capacity in the developing world. The Cardiac Surgery Intersociety Alliance (CSIA) was thus created, comprising The Society of Thoracic Surgeons (STS), the American Association for Thoracic Surgery (AATS), the Asian Society for Cardiovascular and Thoracic Surgery (ASCVTS), the European Association for Cardio-Thoracic Surgery (EACTS) and the World Heart Federation (WHF). The guiding principle was advocacy for sustainable cardiac surgical capacity in low-income countries. As a first step, a global needs assessment confirmed rheumatic heart disease as the overwhelming pathology requiring cardiac surgery in these regions. Subsequently, CSIA published a request for proposals to support fledgling programmes that could demonstrate the backing by their governments and health care institution. Out of 11 applicants, and following an evaluation of the sites, including site visits to the 3 finalists, Mozambique and Rwanda were selected as the first Pilot Sites. Subsequently, a mentorship and training agreement was completed between Mozambique and the University of Cape Town, a middle-income country with a comparable burden of rheumatic heart disease. The agreement entails regular video calls between the heart teams, targeted training across all aspects of cardiac surgery, as well as on-site presence of mentoring teams for complex cases with the strict observance of 'assisting only'. In Rwanda, Team Heart, a US and Rwanda-based non-governmental organization (NGO) that has been performing cardiac surgery in Rwanda and helping to train the cardiac surgery workforce since 2008, has agreed to continue providing mentorship for the local team and to assist in the establishment of independent cardiac surgery with all that entails. This involves intermittent virtual conferences between Rwandan and US cardiologists for surgical case selection. Five years after CSIA was founded, its 'Seal of Approval' for the sustainability of endorsed programmes in Mozambique and Rwanda has resulted in higher case numbers, a stronger government commitment, significant upgrades of infrastructure, the nurturing of generous consumable donations by industry and the commencement of negotiations with global donors for major grants. Extending the CSIA Seal to additional deserving programmes could further align the international cardiac surgical community with the principle of local cardiac surgery capacity-building in developing countries.

Genetic counseling in South Africa: A growing profession

The Genetic Counseling profession in South Africa (SA) was established 35 years ago when the first degree program was initiated at the University of the Witwatersrand in 1989. A second program was developed at the University of Cape Town in 2004. This article aims to describe the development of the profession in SA, with a focus on the last decade. The profession has been growing against the backdrop of a diverse population of 62 million with high rates of HIV/AIDS and tuberculosis and a poorly functioning health care system. SA was one of the first countries to regulate the profession when the Health Professions Council recognized genetic counselors (GCs) as health care professionals in 1992. Since 2017, the student body (now including some internationals) is becoming more representative of the local population and SA graduates are assisting in establishing counseling and training programs in Ghana and Oman. The professional group (GC-SA), formed in 2008, now represents the profession locally and internationally. Challenges remain, although training programs are established, and registration and billing in place. State employment opportunities are few and graduates have to become entrepreneurs, setting up private practice and seeking work in laboratories and research projects. With about a third (16) of qualified GCs (47) leaving the country and only 31 presently working locally, only about 10% of the genetic needs of the population can be met. Addressing these issues, as well as the lack of funding and political will, is a priority for the future.

Multilingual education: medical interns perceptions regarding the usefulness of non-mother tongue communications skills taught during the undergraduate curriculum

BackgroundThis paper investigates the perceptions of medical interns regarding the usefulness of non-mother tongue communication skills taught during the undergraduate curriculum at the University of Cape Town in South Africa. In 2003, the university decided to incorporate Afrikaans and IsiXhosa communication skills into the new MBChB curriculum in order to meet the Faculty of Health Sciences goals to promote quality and equity in healthcare, and to prepare graduating health practitioners for multilingual communities where they would be serving. Despite annual internal evaluations and reviews of the languages courses, the usefulness, if any, of the additional languages in the working clinical environment had not been determined.MethodsData were collected during the second year of medical internship across a five-year period through survey questionnaires, as well as focus group interviews conducted in the Western Cape, South Africa. Surveys were conducted from 2009 to 2013.ResultsThe study shows that the usefulness of each of the probed categories was not consistent across both languages. The interns expressed a need for an overall improvement of the isiXhosa course offering, while the outcomes for the Afrikaans language were more positive across all categories except for cultural understanding.ConclusionThe study indicates a positive trend amongst the interns towards developing usefulness in communication skills in Afrikaans and isiXhosa to communicate with their patients.

Cultivating leaders for primary health care: A revised approach for transformative development.

Family physicians require leadership skills to strengthen team-based primary care services. Interviews with South African district managers confirmed the need to develop leadership skills in family physicians. The updated national programmatic learning outcomes for South African family physician training were published in 2021. They sparked the need for curriculum renewal at the University of Cape Town's Division of Family Medicine. A review of the leadership and governance module during registrar training showed that the sessions were perceived to be content heavy with insufficient opportunities for reflection. Following a series of stakeholder engagements, the module convenors co-designed a revised module that was blueprinted on the updated learning outcomes. The module incorporates a group coaching style, facilitating learning through reflection on one's experiences. The revised module was implemented in 2022. It aims to provide a transformative learning experience centred on students' perceptions of themselves as leaders, as well as professional identity formation and resilience building. This short report describes preliminary insights from the revised module's developmental phase and forms part of an ongoing iterative evaluation process.Contribution:Family physicians should lead across all their defined roles. Formal and informal learning opportunities are needed to facilitate their growth as leaders and help them to meet the health needs of communities served by an evolving health care system. This short report describes an example of a revised postgraduate module on leadership and governance, which may be of value to clinician educators and academic departments exploring innovative methods for the African region.

Rhodes Must Fall and the incongruence of academic freedom and decoloniality

ABSTRACT This study explores the rise of decolonial-styled politics within the University of Cape Town and the University of Oxford and the natural limitations of this form of politics within the ambit of academic freedom as understood by both universities. Leveraging the Rhodes Must Fall movement as a case study of translocal student activism which emerged at both institutions, the paper underscores the necessity of delineating the pursuit of decoloniality within the university into two constitutive components: decolonial thought and decolonial action. The paper argues that without this delineation, the decolonial projects within universities will remain inept.