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Background: HIV diagnosis in South Africa is based on a point-of-care testing (PoCT) algorithm with paper-based record-keeping. Aggregated testing data are reported routinely. To facilitate improved HIV case-based surveillance, the Western Cape Province implemented a unique pilot intervention to digitise PoCT results, at an individual level, and generate an electronic register using the newly developed Provincial Health Data Centre (PHDC). We describe the intervention (phased) and present an evaluation of the operational feasibility of the intervention. We also offer implementation insights into establishing electronic capture of individual level testing data.Methods: Cross-sectional analyses were conducted on records of all patients attending a local Community Health Centre who had an HIV-PoCT during the study period. Data from the intervention were linked to the PHDC using a unique identifier and compared with aggregate data from the paper-based register. Correlation coefficients were calculated to quantify the correlation between the two monthly datasets. To support an understanding of the findings, the Department of Health project management team generated reflections on the implementation process, which were then grouped thematically into implementation lessons.Results: In total, 11,337 PoCT records were digitised (70% (7954) during Phase I; and 30% (3383) during Phase II). Linkage of forms to the PHDC was 96% in Phase I and 98% in Phase II. Comparison with aggregate data showed high correlation during Phase I, but notable divergence during Phase II. Divergence in Phase II was due to stringent data quality requirements and high clinical staff turnover. Factors supporting implementation success in Phase I included direct oversight of data capturing by a manager with clinical and operational insight. Implementation challenges included operational, health system, and high cost-related issues.Conclusions: We demonstrate that rapid digitisation of HIV PoCT data, without compromising currently collected aggregate data, is operationally feasible, and can contribute to person-level longitudinal HIV case-based surveillance. To take to scale, we will need to improve PoCT platforms and clerical and administrative systems. Although we highlight challenges, we demonstrate that electronic HIV testing registers can successfully replace manual registers and improve efforts to monitor and evaluate HIV testing strategies. [ABSTRACT FROM AUTHOR]

Gated developments are a defining feature of the post-apartheid residential landscape. The fortification practices witnessed in gated developments are part of a wider securitisation of the South African urban- and ruralscapes. This research resides in the ambit of the theory of crime and violence as a precursor to the growth in gated developments. Research on gated developments has tended to focus on their proliferation in larger urban settlements, with scant attention being paid to gated developments in smaller settlements and in rural areas. However, non-metropolitan gated developments are a reality, and they display similar security features as those found in metropolitan areas. This paper compares the security levels of gated developments in a suburb of Cape Town with those in small towns in the Western Cape province. Security features are quantified to determine whether differences in securitisation levels exist between the locales. The gated developments in the city display higher levels of security than those in small towns. However, a closer analysis of small-town gated developments reveals high security levels in towns where tourism is the mainstay of the local economy. As the technology of security migrates from military applications to residential applications, a securified small-town future is a real possibility. [ABSTRACT FROM AUTHOR]

The Western Cape Province of South Africa has a Mediterranean climate of winter rainfall and hot, dry summers. The rivers have all been dammed to manage the available water resources. Every year at the end of summer, water restrictions are enforced by fines by the municipality in Cape Town, to ensure economies to eke out the dwindling reserves until the winter rains set in. The paper describes the situation in the 2017 dry season and examines possible solutions to the chronic water shortage such as use of ground water, desalination of sea water and recycling of waste water. [ABSTRACT FROM PUBLISHER]