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27 September 2021 | Story Rulanzen Martin | Photo Supplied
From the left; Prof Michelle Engelbrecht (center), Director of the CHSR&D at the UFS, together with colleagues Dr Gladys Kigozi (right) and Prof Christo Heunis, is conducting various social sciences-orientated research projects on health and health systems.

The Centre for Health Systems Research and Development (CHSR&D) in the Faculty of the Humanities at the University of the Free State (UFS) has been at the forefront of research on the societal and human impact of COVID-19. The CHSR&D has investigated the effects of the pandemic on, among others, post-traumatic stress and the coping strategies of nurses, and is currently undertaking a research project looking at vaccine literacy and acceptability in South Africa through an online survey, which has already attracted more than 9 500 respondents.

Prof Michelle Engelbrecht
, Director of the CHSR&D, says it is important not to lose sight of the impact that the pandemic has had on society and individuals. “It has affected all aspects of life, caused economic disruptions, and posed immense challenges to both public and private healthcare, food systems, education, and employment,” she says. For the CHSR&D researchers, it is important to understand the health and socio-economic impacts in order to inform interventions and policy. 

Established in 1993, the CHSR&D stems from a rich tradition of research and training in medical sociology and sociology of health. As a centre, they generate and disseminate research findings and information on health and health systems to promote transformation in policy and practice in the South African healthcare system.

A study on the impact of the pandemic on nurses

In early 2021, the CHSR&D completed a project on the post-traumatic stress and coping strategies of South African nurses during the second wave of the COVID-19 pandemic.  This study was one the first to examine how the pandemic influenced the post-traumatic stress and coping strategies of nurses in the country. It was found that 44% of nurses were experiencing post-traumatic stress disorder (PTSD), which was comparatively higher than their counterparts in other countries. Furthermore, a lack of preparedness to manage COVID-19 patients, poorer health, and avoidance coping mechanisms were associated with increased PTSD in nurses. Nurses voiced a need for emotional support and empathy from their managers. 

Some of the intervention strategies recommended by the nurses included emotional, psychological, and debriefing sessions focusing on positive coping strategies to address stress effectively; positive and open communication between managers and their subordinates; psychological support through the Employee Assistance Programme and occupational health units; and an uninterrupted supply of quality personal protective equipment. The findings of this project were shared with the Free State Department of Health (FSDoH).

Ongoing research projects

As of 1 September 2021, the CHSR&D commenced with a national online survey on COVID-19 vaccine literacy and acceptability. While there are a number of studies looking at the uptake of COVID-19 vaccines, Dr Gladys Kigozi notes that “this study is novel, as there is a lack of information about vaccine literacy, which may be defined as the degree to which people have the capacity to obtain, process, and understand basic health information and services to make appropriate health decisions.”. The anonymous online survey is available through social media and the Moya messaging application.
 
The CHSR&D, together with a team from the FSDoH and the World Health Organisation, are also collaborating on a project looking at the impact of COVID-19 on essential health services, mortality in hospital-admitted patients, and outcomes in patients with a history of tuberculosis. According to Prof Christo Heunis, “The COVID-19 pandemic has become infamous for crippling healthcare systems. Resources and staff are being diverted to test and provide treatment for people with presumed or diagnosed COVID-19, and thus some other healthcare services are being compromised to meet the demands of caring for COVID-19 patients.” It is thus imperative to measure the impact of the pandemic on essential health services and treatment outcomes. 


Interdisciplinary research project focusing on the health and well-being of vulnerable families 

The CHSR&D, together with the UFS Department of Social Work, the School of Nursing, and the Disaster Management Training and Education Centre for Africa (DiMTEC), will commence with a study investigating the impact of COVID-19 on the health and well-being of vulnerable families in the Mangaung Metropolitan area. This project is funded by a UFS interdisciplinary grant.  While the study is limited to the Mangaung Metropolitan area, it has the potential to inform health and social policy in other metropolitan areas in South Africa – particularly with regard to preparedness and management of pandemics such as COVID-19. 

News Archive

Research eradicates bacteria from avocado facility
2017-01-17

 Description: Listeria monocytogenes Tags: Listeria monocytogenes

Listeria monocytogenes as seen under an electron
microscope. The photo was taken with a transmission
electron microscope at the microscopy unit of the UFS.
Bacteriophages (lollipop-like structures) can be seen
next to the bacterial cells.
Photo: Supplied

“The aim of my project was to identify and characterise the contamination problem in an avocado-processing facility and then to find a solution,” said Dr Amy Strydom, postdoctoral fellow in the Department of Microbial Biochemical and Food Biotechnology at the University of the Free State (UFS).

Her PhD, “Control of Listeria monocytogenes in an Avocado-processing Facility”, aimed to identify and characterise the contamination problem in a facility where avocados were processed into guacamole. Dr Strydom completed her MSc in food science in 2009 at Stellenbosch University and this was the catalyst for her starting her PhD in microbiology in 2012 at the UFS. The research was conducted over a period of four years and she graduated in 2016. The research project was funded by the National Research Foundation.

The opportunity to work closely with the food industry further motivated Dr Strydom to conduct her research. The research has made a significant contribution to a food producer (avocado facility) that will sell products that are not contaminated with any pathogens. The public will then buy food that is safe for human consumption.


What is Listeria monocytogenes?

Listeria monocytogenes is a food-borne pathogenic bacterium. When a food product is contaminated with L. monocytogenes, it will not be altered in ways that are obvious to the consumer, such as taste and smell. When ingested, however, it can cause a wide range of illnesses in people with impaired immune systems. “Risk groups include newborn babies, the elderly, and people suffering from diseases that weaken their immune systems,” Dr Strydom said. The processing adjustments based on her findings resulted in decreased numbers of Listeria in the facility.

The bacteria can also survive and grow at refrigeration temperatures, making them dangerous food pathogens, organisms which can cause illnesses [in humans]. Dr Strydom worked closely with the facility and developed an in-house monitoring system by means of which the facility could test their products and the processing environment. She also evaluated bacteriophages as a biological control agent in the processing facility. Bacteriophages are viruses that can only infect specific strains of bacteria. Despite bacteriophage products specifically intended for the use of controlling L. monocytogenes being commercially available in the food industry, Dr Strydom found that only 26% of the L. monocytogenes population in the facility was destroyed by the ListexP100TM product. “I concluded that the genetic diversity of the bacteria in the facility was too high and that the bacteriophages could not be used as a control measure. However, there is much we do not understand about bacteriophages, and with a few adjustments, we might be able to use them in the food industry.”

Microbiological and molecular characterisation of L. monocytogenes

The bacteria were isolated and purified using basic microbiological culturing. Characterisation was done based on specific genes present in the bacterial genome. “I amplified these genes with polymerase chain reaction (PCR), using various primers targeting these specific genes,” Dr Strydom said. Some amplification results were analysed with a subsequent restriction digestion where the genes were cut in specific areas with enzymes to create fragments. The lengths of these fragments can be used to differentiate between strains. “I also compared the whole genomes of some of the bacterial strains.” The bacteriophages were then isolated from waste water samples at the facility using the isolated bacterial strains. “However, I was not able to isolate a bacteriophage that could infect the bacteria in the facility.

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