ResearchSpace
ResearchSpace is the institutional repository of the University of KwaZulu-Natal, unlocking knowledge, empowering impact, and preserving UKZN's research legacy.
Recent Submissions
Leadership approaches adopted by district officials and their effect on the management of schools – a case study of secondary schools in Kwazulu-Natal.
(2025) Birbal, Tarana.; Myende , Phumlani Erasmus.
Districts officials have a central role in the educational sector as they are seen as intermediaries between the national and provincial education departments and local schools. Their leadership role encompasses enhancing school functionality by collaborating and providing support to schools. Additionally, their roles extend to being implementers of policies, developing and empowering SMTs and driving transformation within the district. District officials play a pivotal role in education, however, the leadership approaches adopted by district officials and how their leadership is cascaded to school level is under-researched. Therefore, this study aims to explore the leadership approaches adopted by district officials and the effect of these approaches on the management of schools. The study covers the leadership approaches, the effect of these approaches on how schools are managed, and the required improvement of district officials’ leadership to positively affect the management of schools. This study is underpinned by the Transformational Leadership Theory. This study utilises qualitative research and operates within the interpretivist paradigm, making use of case study research. Three secondary schools were identified in the iLembe District of KwaZulu-Natal. Purposive and convenience sampling was employed to select nine participants comprising of three principals and six Departmental Heads. Data was generated through semi-structured interviews. Both the inductive and deductive approach to data analysis was used. The findings showed that district officials adopt various leadership approaches inclusive of policy-driven, instructional, supportive, and collaborative leadership approaches, which affects the work of school management. The findings further revealed that the leadership approaches utilised by district officials enhance accountability, discipline, instruction, capacity building and communication in schools. To strengthen district leadership, it was revealed that districts need to establish better support systems, develop, and enhance human relation skills and respond to specific school contexts. Overall, the study highlights the significant influence district officials have on SMTs and school operations. The insights gained may assist district officials in reflecting on and refining their leadership practices to contribute to school management and thebroader education system more positively.
Unravelling the genomic and epidemiological dynamics of SARS-CoV-2 in South Africa.
(2025) Ramphal, Upasana.; De Oliveira , Tulio De Paiva Nazareth Andrade.
The Coronavirus Disease 2019 (COVID-19) pandemic necessitated a swift and coordinated global response, with genomic surveillance playing a crucial role in tracking the evolution and spread of Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2). This study presents a comprehensive retrospective analysis of genomic surveillance data, drawing from multiple sources, including the Global Initiative on Sharing Avian Influenza Data (GISAID), Our World in Data (OWID), and national datasets. By leveraging genomic data, this research highlights the importance of surveillance in strengthening outbreak preparedness and public health responses. The thesis is structured into five key chapters. Chapter One presents a detailed literature review, contextualising the pandemic and highlighting the significance of genomic surveillance. Chapter Two, a published manuscript, retrospectively compares the performance of the Illumina MiSeq and Ion Torrent S5 sequencing platforms in detecting the Delta variant during its early emergence. It assesses their efficiency, accuracy, and suitability for genomic surveillance, while addressing challenges in comparing data generated by different sequencing technologies. Chapter Three conducts a retrospective trend analysis of 6,089 SARS-CoV-2 genomes from KwaZulu-Natal, South Africa. It examines genomic surveillance trends across urban and rural districts, focusing on lineage distribution and transmission dynamics. The study aims to identify surveillance gaps and propose strategies to enhance epidemic preparedness in localised settings. Chapter Four expands on this analysis by comparing South Africa’s genomic surveillance strategies with global initiatives, identifying strengths and areas for improvement. It evaluates data-sharing practices and pandemic response frameworks, highlighting successes and challenges relative to countries with similar or higher socioeconomic contexts and their impact on timely public health interventions. The final chapter synthesises the key findings, emphasising the need for sustained investment in genomic monitoring, technological advancements, and global collaboration to enhance preparedness for future public health threats. The study reveals that, while South Africa has made significant progress in genomic surveillance, disparities in sequencing coverage, particularly in rural areas and low-income countries, pose challenges to comprehensive outbreak monitoring. The comparative analysis of sequencing platforms offers critical insights into the reliability and efficiency of different methodologies, essential for optimising genomic surveillance systems. Additionally, the global comparison demonstrates the importance of international collaboration in genomic data sharing, providing strategic recommendations to strengthen surveillance efforts. In conclusion, this study demonstrates that genomic surveillance is indispensable for real-time pandemic response, variant tracking, and public health decision-making. By advocating for improvements in sequencing infrastructure, equitable data access, and enhanced global cooperation, this research contributes to building a more resilient and effective approach to managing future infectious disease outbreaks.
Exploring the challenges in the curriculum responsiveness of articulation between technical vocational education and training national diploma and universities.
(2025) Biyela, Lethiwe Nokwethemba.; Mnisi , Thoko Esther.
Curriculum responsiveness is critical for supporting effective teaching, learning, and academic progression in a changing education and skills landscape. This study examines challenges affecting curriculum responsiveness in the articulation between Technical and Vocational Education and Training (TVET) colleges and universities. The primary objective was to analyse the curricular systems of TVET and universities to determine how articulation supports or constrains student progression between the two sectors. Using a qualitative research approach, data were collected through semi-structured questionnaires administered to lecturers, Curriculum Division staff, and TVET alumni at selected TVET colleges in Northern KwaZulu-Natal. Purposive and snowball sampling techniques were employed, and data were analysed thematically. The findings indicate that curriculum misalignment stems largely from inconsistent interpretations of the National Qualifications Framework (NQF) across the two sectors, resulting in curriculum gaps that undermine articulation principles. Limited collaboration between TVET colleges and universities further exacerbates these challenges due to divergent policies and practices. The study recommends strengthening policies within the Post-School Education and Training (PSET) system and ensuring their consistent implementation through improved inter-institutional cooperation and regular policy review.
Characterisation of genital and systemic biomarkers of cervical HPV viral load in women at risk of cervical intraepithelial neoplasia.
(2024) Mdleleni, Yanga.; Ndlovu, Bongiwe Goodness.; Muema, Daniel Muli.; Dhlomo, Thabile Wendy Pearl.
Cervical cancer is the fourth most common cancer worldwide and the second most common among South African women. Over 90% of all cervical cancer cases and mortalities occur in low- and middle-income countries (LMICs). The persistence of infection with high-risk Human papillomaviruses (HPV) drives the development and progression of cervical intraepithelial neoplasia (CIN), a precursor for cervical cancer. Women living with HIV (WLWH) have a higher incidence of CIN and cervical cancer and experience higher rates of CIN recurrence after treatment when compared with HIV-negative women. Effective intervention against HPV and CIN in WLWH will require a thorough understanding of how virological parameters and host immune responses, which comprises the role of T-cell responses and the resultant cytokines profiles, impact their viral clearance and CIN regression, progression, and recurrence. Such information will also guide on the biomarkers that can be used to predict or monitor their treatment outcomes. However, there is a paucity of information on virological and immunological basis for CIN recurrence in this population. Therefore, we aimed to characterize the virological and immune biomarkers of HPV-associated abnormalities and determine their relationship with CIN treatment outcomes in 96 women living with HIV. The study participants were between the ages of 18-65 years old and were recruited from the King Edward's Hospital in Durban, South Africa, from April 2012 to April 2015. All participants presented with abnormal pap smears at enrolment, required colposcopy, and were treated for CIN by Large Loop Excision of the Transformation Zone (LLETZ). Participants were subsequently followed up at six month intervals for a year after treatment. For these analyses, they were then stratified into “No-recurrence” and “Recurrence” groups based on clinical CIN detection at either six months or one year post-treatment, with 69 participants being in the “No-recurrence” group and 27 being in the “Recurrence” group. Genital and blood samples were collected at study entry, 6 months, and 1 year after treatment. Virological assays on the number of HPV types and HPV viral loads were done on the cervicovaginal lavage (CVL) andcytobrush samples, respectively, by conducting HPV genotyping at baseline using Roche Linear array and then quantifying high-risk HPV viral load at all study visits using Hybrid Capture II (HCII) assay. Immune correlates of CIN recurrence were assessed by measuring anti-HPV IFN-γ+ CD4+ and CD8+ T cell responses in peripheral blood mononuclear cells of 28 women (16 in the “No-recurrence” group and 12 in the “Recurrence” group) using intracellular cytokine staining at baseline and 1-year post-treatment. Genital and peripheral cytokine responses were also measured in serum and CVL of 39 women (20 in the “Norecurrence” group and 19 in the “Recurrence” group) using a multiplexed Enzyme-Linked Immunosorbent Assay (ELISA). Women who experienced CIN recurrence after excisional surgical treatment had higher numbers of highrisk HPV types at enrolment (p=0.008) and higher high-risk HPV viral loads at all time points (p<0.001).Notably, the combined presence of both high-risk HPV types and high HPV viral load was the best predictor for CIN recurrence in a multivariable regression model (odds ratio 1.985, 95% CI 1.020 to 3.865, p=0.044). There were no differences in T cell responses between the two groups, suggesting minimal impact of naturally elicited systemic anti-HPV T-cell responses on treatment success. Interestingly, the frequencies of IFN-γ+ producing CD8 T cells to the E7 oncoprotein at the pre-treatment time point were significantly higher in women with CIN 3 when compared to those with CIN 2 (p=0.033) and had a trend for a positive correlation with HPV viral loads (Rho= 0.38, p=0.08), suggesting the dependence of naturally elicited pretreatment anti-HPV CD8 T-cell responses on antigen load. Our study also revealed stable kinetics of the anti-HPV16 and anti-HPV18 E6- and E7-specific T cell immunity post-treatment in blood for both “Norecurrence” and “Recurrence” groups. These data reinforce the potential role of combining HPV genotyping, HPV viral load quantification, and holistic immune response assessment, comprising both systemic and local immunity, as prognostic tools in identifying women at the highest risk of CIN recurrence after treatment, especially for women living with HIV. The study also sheds light on the potential role of viral persistence and immune modulation in CIN recurrence.
Causes of bloodstream infections in adult intensive care patients at eThekwini KwaZulu-Natal hospitals.
(2026) Selane, Sindiswa Charlotte.; Moodley, Shamala.; Yesholata, Mahabeer.
Background: Bloodstream infections (BSIs) are a major cause of morbidity and mortality among critically ill patients, particularly in intensive care units (ICUs). The rise of multidrug-resistant organisms (CRE, ESBL, MRSA, and XDR strains), poses serious treatment challenges, making timely identification and susceptibility profiling essential for effective management.
Aim: This study aimed to describe the distribution of pathogenic organisms and their antimicrobial resistance patterns in adult ICU patients diagnosed with BSIs at three public-sector hospitals in KwaZulu-Natal over a three-year period (2020–2022).
Methods: A retrospective, quantitative, descriptive study was conducted using data from the National Health Laboratory Services (NHLS) TrakCare system. Positive blood cultures from patients aged 18 years and above, admitted to ICUs at regional, tertiary and quaternary hospitals; Prince Mshiyeni Memorial Hospital (PMMH), King Edward VIII Hospital (KEH), and Inkosi Albert Luthuli Central Hospital (IALCH), respectively, were analysed. Organism distribution, antimicrobial susceptibility, and resistance trends were assessed using STATA software.
Results: A total of 739 clinically significant isolates were analyzed. Gram-negative organisms accounted for the majority (65.09%), followed by Gram-positive organisms (25.17%), while fungal isolates, mainly Candida spp., comprised 9.47%. Acinetobacter baumannii (26.25%), Klebsiella pneumoniae (14.34%), and Pseudomonas aeruginosa (6.49%) were the common Gram-negative pathogens. Coagulase-negative Staphylococcus (8.93%) and Staphylococcus aureus (7.16%) were the common Gram-positive isolates. High rates of antimicrobial resistance were observed, with 66.11% of A. baumannii isolates classified as possible XDR and 19.09% of K. pneumoniae isolates identified as CRE. Multidrug resistant (13.89%) and ESBLproducing organisms (23.68%) were high at PMMH, and surprisingly no MRSA was detected. High CRE rates were noted at KEH and IALCH (24.19% and 20.83%, respectively). Also, XDR (73.12%) was high at KEH, while MRSA detection was high at both facilities (23.08% - IALCH; 21.05% - KEH).
Conclusion: The findings highlight a concerning burden of multidrug-resistant organisms in ICU settings across all levels of care, including regional facilities, which are traditionally assumed to have lower resistance rates. These results necessitate urgent improvements in antimicrobial stewardship programs, infection prevention, microbiological surveillance to contain the spread of resistant pathogens, guidance in effective treatment and control strategies to improve patient outcomes in KwaZulu-Natal ICUs.