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01 April 2025 | Story Andre Damons | Photo Supplied
Health care
Those who took part in the community engagements are: From left Dr Kamo Mothibi from the UFS, Irene Mokgadi from CUT, Dr Mosebi Thejane (UFS), Ahlume Nkumbesi (UFS), Dr Lebogang Mogongoa (CUT), Minnie Mbokazi (UFS), Dr Happy Phage (CUT), Dr Phindile Shangase (UFS) and Teboho Mhlanga from the Free State Department of Health. Seated in from are Meshack Mothupi, driver from CUT, and Sipho Zulu (UFS).

The Division of Public Health at the University of the Free State (UFS) together with the Central University of Technology (CUT), and the Free State Department of Health’s Disability Unit, held community engagements recently by visiting rehabilitation services in Bloemfontein. 

These engagements were part of the co-funded project: Capacity building for the use of implementation science in various typologies in low- and middle-income countries for the prevention and/or management of the quadruple burden of disease. This was phase two in this project with the last phase including a symposium that is expected to take place on 1 April on the UFS Bloemfontein Campus.

Qhomane Mhlanga, a representative from the Free State Department of Health who is actively involved in this project, and her team, identified rehabilitation services for a case study. They also identified stakeholders to be visited during this community engagement in order to gather information on their engagement with Mangaung University of the Free State Community Partnership Programme (MUCPP). The team also visited stakeholders at the Phelang Disability Home, Carel du Toit Special School, and the Department of Education (Inclusive Education). 

 

Research to improve health care service

Dr Phindile Shangase from the Division of Public Health, and Principal Investigator at UFS, says the purpose of community visits was to engage service providers on the implementation strategies. This includes analysing alignment of implementation strategies with the policy (National Rehabilitation Policy 2000, Free State Rehabilitation Policy Guidelines, Framework and Strategy for Disability and Rehabilitation Service in South Africa 2015-2020) as well as identifying facilitators and barriers to implementation.

“It is the intention of the Division of Public Health, UFS to continue collaborations with stakeholders in implementation science research to improve health care service delivery and outcomes. The Division of Public Health also intends to add postgraduate research studies on implementation science in the near future.

“The visit to the clinic sought to establish the services provided by the rehabilitation unit, the referral system, and how the unit collaborates with external stakeholders to enhance the service. We gained knowledge of categories of healthcare professionals in rehabilitation services, e.g., occupational therapists, physiotherapists, speech and language therapists, audiologists, orthotists and prosthetists, rehabilitation doctors, optometrists, community rehabilitation workers. Some of these professionals are not available in the facilities visited,” says Dr Shangase. 

It was identified that, she continues, early hearing screening services for children are not available at healthcare facilities. Early hearing screening helps identify hearing defects which could be managed early to avoid complications that lead to hampered education and poor quality of life.


Outcome of engagements

Before the community outreach began, the UFS/CUT team, in collaboration with the Department of Health, convened to discuss strategies for navigating the Implementation Science project. The meeting focused on identifying key stakeholders and developing approaches essential for the project's success, drawing insights from the Department of Health's Mangaung Metro implementation science case study. 

The team identified five primary approaches for the project: Health, Education, Livelihood, Social, and Empowerment. Additionally, the discussion highlighted both the barriers and enablers related to each approach, which are crucial for ensuring effective project implementation and sustainable outcomes. Free State rehabilitation policy guidelines document was also applied to evaluate the case study.

According to Dr Shangase, the outreach will help with drafting of an intervention plan to address policy implementation gaps identified. The information gathered will assist in commissioning further research to improve health outcomes. “The intention is to collaborate with the Department of Health to work on past research outputs, presented during research day conferences, for implementation in healthcare facilities. Newly identified research areas will also prompt projects in healthcare facilities, led by the academic partners, UFS, Division of Public Health as well as the Department of Health Sciences, CUT.”

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Inaugural lecture: Prof Robert Bragg, Dept. of Microbial, Biochemical and Food Biotechnology
2006-05-17



Attending the inaugural lecture were in front from the left Prof Robert Bragg (lecturer at the Department of Microbial, Biochemical and Food Biotechnology) and Frederick Fourie (Rector and Vice-Chancellor).  At the back from the left were Prof James du Preez (Departmental Chairperson:  Department of Microbial, Biochemical and Food Biotechnology) and Prof Herman van Schalkwyk (Dean: Faculty of Natural and Agricultural Sciences). Photo: Stephen Collett
 

A summary of an inaugural lecture delivered by Prof Robert Bragg at the University of the Free State:

CONTROL OF INFECTIOUS AVIAN DISEASES – LESSONS FOR MAN?

Prof Robert R Bragg
Department of Microbial, Biochemical and Food Biotechnology
University of the Free State

“Many of the lessons learnt in disease control in poultry will have application on human medicine,” said Prof Robert Bragg, lecturer at the University of the Free State’s (UFS) Department of Microbial, Biochemical and Food Biotechnology during his inaugural lecture.

Prof Bragg said the development of vaccines remains the main stay of disease control in humans as well as in avian species.  Disease control can not rely on vaccination alone and other disease-control options must be examined.  

“With the increasing problems of antibiotic resistance, the use of disinfection and bio security are becoming more important,” he said.

“Avian influenza (AI) is an example of a disease which can spread from birds to humans.  Hopefully this virus will not develop human to human transmission,” said Prof Bragg.

According to Prof Bragg, South Africa is not on the migration route of water birds, which are the main transmitters of AI.  “This makes South Africa one of the countries less likely to get the disease,” he said.

If the AI virus does develop human to human transmission, it could make the 1918 flu pandemic pale into insignificance.  During the 1918 flu pandemic, the virus had a mortality rate of only 3%, yet more than 50 million people died.

Although the AI virus has not developed human-to-human transmission, all human cases have been related to direct contact with infected birds. The mortality rate in humans who have contracted this virus is 67%.

“Apart from the obvious fears for the human population, this virus is a very serious poultry pathogen and can cause 100% mortality in poultry populations.  Poultry meat and egg production is the staple protein source in most countries around the world. The virus is currently devastating the poultry industry world-wide,” said Prof Bragg.

Prof Bragg’s research activities on avian diseases started off with the investigation of diseases in poultry.  “The average life cycle of a broiler chicken is 42 days.  After this short time, they are slaughtered.  As a result of the short generation time in poultry, one can observe changes in microbial populations as a result of the use of vaccines, antibiotics and disinfectants,” said Prof Bragg.   

“Much of my research effort has been directed towards the control of infectious coryza in layers, which is caused by the bacterium Avibacterium paragallinarum.  This disease is a type of sinusitis in the layer chickens and can cause a drop in egg product of up to 40%,” said Prof Bragg.

The vaccines used around the world in an attempt to control this disease are all inactivated vaccines. One of the most important points is the selection of the correct strains of the bacterium to use in the vaccine.

Prof Bragg established that in South Africa, there are four different serovars of the bacterium and one of these, the serovar C-3 strain, was believed to be unique to Southern Africa. He also recently discovered this serovar for the first time in Israel, thus indicating that this serovar might have a wider distribution than originally believed.

Vaccines used in this country did not contain this serovar.  Prof Bragg established that the long term use of vaccines not containing the local South African strain resulted in a shift in the population distribution of the pathogen.

Prof Bragg’s research activities also include disease control in parrots and pigeons.   “One of the main research projects in my group is on the disease in parrots caused by the circovirus Beak and Feather Disease virus. This virus causes serious problems in the parrot breeding industry in this country. This virus is also threatening the highly endangered and endemic Cape Parrot,” said Prof Bragg.

Prof Bragg’s research group is currently working on the development of a DNA vaccine which will assist in the control of the disease, not only in the parrot breeding industry, but also to help the highly endangered Cape Parrot in its battle for survival.

“Not all of our research efforts are directed towards infectious coryza or the Beak and Feather Disease virus.  One of my Masters students is currently investigating the cell receptors involved in the binding of Newcastle Disease virus to cancerous cells and normal cells of humans. This work will also eventually lead to a possible treatment of cancer in humans and will assist with the development of a recombinant vaccine for Newcastle disease virus,” said Prof Bragg.

We are also currently investigating an “unknown” virus which causes disease problems in poultry in the Western Cape,” said Prof Bragg.
 
“Although disinfection has been extensively used in the poultry industry, it has only been done at the pre-placement stage. In other words, disinfectants are used before the birds are placed into the house. Once the birds are placed, all use of disinfectants stops,” said Prof Bragg.

“Disinfection and bio security can be seen as the ‘Cinderella’ of disease control in poultry.  This is also true for human medicine. One just has to look at the high numbers of people who die from hospital-acquired infections to realise that disinfection is not a concept which is really clear in human health care,” said Prof Bragg.

Much research has been done in the control of diseases through vaccination and through the use of antibiotics. “These pillars of disease control are, however, starting to crumble and more effort is needed on disinfection and bio security,” said Prof Bragg.

Prof Bragg has been working in close co-operation with a chemical manufacturing company in Stellenbosch to develop a unique disinfectant which his highly effective yet not toxic to the birds.

As a result of this unique product, he has developed the continual disinfection program for use in poultry. In this program the disinfectant is used throughout the production cycle of the birds. It is also used to ensure that there is excellent pre-placement disinfection.

“The program is extensively used for the control of infectious diseases in the parrot-breeding industry in South Africa and the product has been registered in 15 countries around the world with registration in the USA in the final process,” said Prof Bragg.

“Although the problem of plasmid mediated resistance to disinfectants is starting to rear its ugly head, this has allowed for the opening of a new research field which my group will hopefully exploit in the near future,” he said.

 

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