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The formation of settlements has changed over the past century and so has its categorization. Previously, it was easy to categorize and differentiate rural areas from urban areas based on the morphology, economic activities, and the population concentration. However, upon deeper analysis, there is no standard method of classifying urban or rural. Research reveals settlements have merged to form larger regions. This chapter explores the transformation settlements from settlements to regions from a theoretical perspective. Furthermore, the study reviews settlement categorization in South Africa (1990-2020). The study found that the integration of rural and urban areas to municipal entities in South Africa has been riddled with challenges. As a result, many municipalities are dysfunctional. The chapter provides insight into the delimitation process and provides lessons for other countries.

In recent years, settlements have sprawled beyond the urban growth boundaries, due to a number of factors, including mobility, technology, and urban blight. As a result, governments globally have opted to restructure their local administrative boundaries (municipalities) to be more accommodating to the unplanned growth, while setting a clear limit to the extent to which the urban region could grow. Without a clear administrative boundary, urban problems such as civil conflict, administrative duplication, political corruption, lack of service delivery, and environmental degradation become more prevalent. In order to understand the driving forces behind administrative delimitation, this article reviews how local administrative boundaries can be delineated from a theoretical stance. It further unpacks various criteria to contextualise how boundaries could be demarcated and their resultant structure. The article reveals that, from a theoretical stance, the method of demarcating administrative urban boundaries is not apparent, since a variety of factors influence open systems. Consequently, this article provides awareness of the challenges of demarcating local administrative boundaries, with both administrative and policy implications. Administratively, it sheds light on criteria that can influence boundary demarcation. In terms of policy, it demonstrates that the demarcation of boundaries is a huge challenge that requires further research and action.

The year 2022 marks the sixth democratic local municipal demarcation process in South Africa. The Municipal Demarcation Board has invited the public to put forward their suggestions for the revision of local municipal boundaries based on the Municipal Demarcation Act (27 of 1998) by the end of March. However, the legislative criterion that guides the process remains as complex as it was in 1998 and the public still questions how and why municipal boundaries are demarcated in South Africa. A direct product of the complexity is that many voices remain muffled and their frustrations are displayed in public protests. These protests are to an extent due to municipalities being too large, lacking economic bases, and having poor governance structures to administer efficiently, resulting in many struggling to provide basic services and remain financially viable and sustainable. This article unpacks the application process that needs to be followed by the Municipal Demarcation Board (MDB), the Member of Executive Council (MEC), and the public to motivate for the re-demarcation of local boundaries. The paper argues that the process is complicated and calls for its revision. Furthermore, the paper suggests that smaller and more compact municipalities, at scale and proportional to economic base, might be the solution to the on-going crises of South African Municipalities.

Item does not contain fulltext, OBJECTIVES: Our aim was to identify the pharmacokinetic/pharmacodynamic parameters of minocycline in the hollow-fibre system (HFS) model of pulmonary Mycobacterium avium complex (MAC) and to identify the optimal clinical dose. METHODS: Minocycline MICs for 55 MAC clinical isolates from the Netherlands were determined. We also co-incubated primary isolated macrophages infected with MAC with minocycline. Next, we performed a 28 day HFS-MAC model dose-response study in which we mimicked pulmonary concentration-time profiles achieved in patients. The HFS-MAC model was sampled at intervals to determine the minocycline pharmacokinetics and MAC burden. We identified the AUC0-24/MIC ratios associated with 1.0 log10 cfu/mL kill below day 0 (stasis), defined as a bactericidal effect. We then performed 10000 Monte Carlo experiments to identify the optimal dose for a bactericidal effect in patients. RESULTS: The MIC for 50% and 90% of cumulative clinical isolates was 8 and 64 mg/L, respectively. Minocycline decreased MAC bacterial burden below stasis in primary isolated macrophages. In the HFS-MAC model, minocycline achieved a microbial kill of 3.6 log10 cfu/mL below stasis. The AUC0-24/MIC exposure associated with a bactericidal effect was 59. Monte Carlo experiments identified a minocycline susceptibility MIC breakpoint of 16 mg/L. At this proposed breakpoint, the clinical dose of 200 mg/day achieved the bactericidal effect exposure target in approximately 50% of patients, while 400 mg/day achieved this in 73.6% of patients, in Monte Carlo experiments. CONCLUSIONS: Minocycline at a dose of 400 mg/day is expected to be bactericidal. We propose a clinical trial for validation.

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Item does not contain fulltext, Carbapenems are now being explored for treatment of multidrug-resistant tuberculosis (MDR-TB), especially in conjunction with clavulanate. Clinical use is constrained by the need for multiple parenteral doses per day and the lack of knowledge of the optimal dose for sterilizing effect. Our objective was to identify the ertapenem exposure associated with optimal sterilizing effect and then design a once-a-day dose for clinical use. We utilized the hollow-fiber system model of tuberculosis in a 28-day exposure-response study of 8 different ertapenem doses in combination with clavulanate. The systems were sampled at predetermined time points to verify the concentration-time profile and identify the total bacterial burden. Inhibitory sigmoid maximum-effect (Emax) modeling was used to identify the relationship between total bacterial burden and the drug exposure and to identify optimal exposures. Contrary to the literature, ertapenem-clavulanate combination demonstrated good microbial kill and sterilizing effect. In a dose fractionation hollow-fiber study, efficacy was linked to percentage of the 24-h dosing interval of ertapenem concentration persisting above MIC (%TMIC). We performed 10,000 MDR-TB patient computer-aided clinical trial simulations, based on Monte Carlo methods, to identify the doses and schedule that would achieve or exceed a %TMIC of >/=40%. We identified an intravenous dosage of 2 g once per day as achieving the target in 96% of patients. An ertapenem susceptibility breakpoint MIC of 2 mg/liter was identified for that dose. An ertapenem dosage of 2 g once daily is the most suitable to be tested in a phase II study of sterilizing effect in MDR-TB patients.

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Contains fulltext : 152723.pdf (publisher's version ) (Open Access)

This study focuses on the performance of micro finance institutions (MFIs) in sustainable housing poverty reduction for the majority urban poor in Addis Ababa, the capital city of Ethiopia. The paper assesses the impact, challenges and prospects of MFIs in transforming the urban poor residents’ livelihoods through the provision of Housing Microfinance (HMF) loan product. From available data, Addis Ababa Credit and Savings Institution (AdCSI), an MFI with a customer base of 120 000, diversified its product lines to include the HMF loan product in 2006. Although findings indicate that the loan is popular with most urban poor residents, MFIs are failing to meet the demand mainly due to lack of loanable funds. As a way forward, the government through partnerships with the private sector needs to integrate MFIs into the broader financial system so as to address the financial needs of the low income people who can not be covered by commercial banks, particluarly in accessing the money to pay the 20% down payment for condominium houses. Similarly, most MFIs operating in the city need to diversify their loan products to include housing loans to tap into the lucrative market by extending the HMF loan to their clients. Keywords: Micro Finance Institutions, Micro and Small enterprises, Housing, Urban Poverty, Outreach, Challenges, Responses, Realities, Addis Ababa.