Research Articles (University of Pretoria)

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This collection offers open access to the full text of research articles published by staff, students and affiliates of the University of Pretoria. These items are identical in content to their published counterparts. It is linked to the Research Information System and complements the Annual Research Report.

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Just energy transition from coal in South Africa : a scoping review
(Elsevier, 2025-05) Patrick, Sean Mark; Shirinde, Joyce; Kgarosi, Kabelo; Makinthisa, Takalani; Euripidou, Rico; Munnik, Victor; sean.patrick@up.ac.za
BACKGROUND : South Africa’s just energy transition (JET) aims to reduce coal dependency and shift toward a low-carbon, sustainable energy framework. However, achieving this goal requires addressing the socio-economic, health, and environmental burdens that coal dependency has placed on communities, particularly in regions like Mpumalanga. Integrating principles of social and restorative justice is essential to ensure an equitable transition. OBJECTIVE : This scoping review examine how South Africa's policymaking, regulatory frameworks, and public participation in the JET align with principles of social and restorative justice and global energy transition frameworks. METHODS : A systematic literature search was conducted across Scopus, Web of Science, and PubMed to identify relevant studies on energy transition and justice frameworks. Network analysis was employed to compare South Africa’s JET strategies with global trends, focusing on indicators related to health, environmental, and socio-economic impacts. RESULTS : Findings reveal significant challenges in South Africa’s JET, including regulatory limitations, stakeholder conflicts, and gaps in policy alignment with community needs. Although efforts to incorporate justice principles are emerging, disparities in policy implementation suggest the need for more tailored, inclusive approaches. Network analysis identified both overlaps and gaps between South Africa’s JET policies and international frameworks, particularly in areas of public health and social equity. CONCLUSION : To achieve a balanced and inclusive energy transition, the study recommends strengthening regulatory coherence, enhancing public engagement, and implementing concrete actions for social and restorative justice. Aligning domestic policies with international commitments while addressing local socio-economic conditions is critical for South Africa’s JET to serve as a model for coal-dependent economies globally.
'New mining scheme, same old problems?' ; risk factors and health challenges in underground community mining in Ghana
(IOP Publishing, 2024-12) Aram, Simon Appah; Saalidong, Benjamin M.; Yankyera, Akwasi; Akoto, Akwasi Bamfo; Amoah, Samuel Kofi
Ghana's small-scale mining sector has long been a cornerstone of its economy and a vital source of livelihood for many communities. However, the sector is plagued by significant challenges, including environmental degradation, health and safety risks, and illegal practices. In response, the Ghanaian government introduced the Community Mining Scheme (CMS), a new mining model designed to promote local community participation in artisanal small-scale gold mining (ASGM). This study examines the workplace risk factors and associated health challenges faced by ASGM miners under the CMS, drawing on interviews with fifty underground CMS miners in Ghana. Our findings reveal that miners continue to face numerous health and safety challenges, including inadequate lighting, poor ventilation, exposure to noise and odors, unsupported or poorly supported loose materials, non-use of personal protective equipment, high dust levels, and unsafe blasting practices. Additionally, health concerns such as skin rashes, musculoskeletal injuries, and the risk of mercury poisoning persist. These challenges mirror those reported in the literature on unregulated and illegal ASGM in Ghana, indicating that existing issues remain unresolved under the CMS. To prevent the undermining of this initiative, it is crucial to adopt progressive practices, such as localized coping strategies and the recruitment of trained professionals to lead ASGM operations within the CMS. Enhancing miners' risk perception through targeted outreach and awareness campaigns is also essential. Further recommendations for mitigating safety risks and health challenges are discussed in the article.
Historical catch records of humpback whales and the assessment of early 20th century sea ice edge in climate models
(IOP Publishing, 2025-05) Vichi, Marcello; Seyboth, Elisa; Mazomba,Thando; Vermeulen, Els; Findlay, Ken; Meynecke, Jan-Olaf; De Bie, Jasper; Secchi, Eduardo; Dalla Rosa, Luciano; Roychoudhury, Alakendra
Assessment of historical environmental conditions in the Southern Ocean is limited by sparse oceanographic records prior to remote-sensing data. Whale catch data, particularly from humpback whales, can help fill this gap, as these whales inhabit waters near the sea ice edge. This study combines historical whale catch data with sea-ice model simulations from CMIP6 to assess the performance in the decade 1930–1939. The models were ranked based on their ability to simulate satellite-observed sea ice seasonality. The high-ranking models locate the sea-ice edge north of historical humpback whale catch regions, indicating higher sea-ice extent at the start of the 20th century, especially in November and December. It is recommended that models be tuned towards these early 20th century conditions while running the pre-industrial simulations. This interdisciplinary approach suggests that using only satellite-era data for model calibration may lead to overestimates of historical sea-ice extent, affecting future predictions.
Megagrazer loss drives complex landscape-scale biophysical cascades
(IOP Publishing, 2025-01) Hyvarinen, Olli; Te Beest, Mariska; Le Roux, Elizabeth; Kerley, Graham I.H.; Buitenwerf, Robert; Druce, Dave J.; Chen, Jiquan; Rapp, Linda; Fernandes, Joana; Cromsigt, Joris P.G.M.
Wild animals can modulate ecosystem-climate feedbacks, e.g. through impacts on vegetation and associated carbon dynamics. However, vegetation cover and composition also affect land surface albedo, which is an important component of the global energy budget. We currently know very little about the influence of wild animals on land surface albedo and the resulting climate forcing of these albedo changes. Leveraging a unique, ecosystem-scale, semi-experimental approach, we study how the local removals of the world's largest, terrestrial grazer, white rhinoceros (Ceratotherium simum), affected the coupling between fire dynamics, woody encroachment and surface albedo in Hluhluwe–iMfolozi Park (HiP), South Africa. Our path analysis revealed that areas in the park where more rhinos had been removed showed a stronger increase in burnt area and woody encroachment compared to areas with fewer rhinos removed, which were both related to a decrease in surface albedo. Increasing burnt area was further associated with higher rates of woody encroachment, indirectly reinforcing the negative effect of rhino loss on albedo. Our study demonstrates that removals of megagrazers in HiP were related to complex ecosystem-wide cascades with measurable impacts on land cover and surface albedo and consequences on climate forcing. This highlights the importance of restoring functional ecosystems by reinstating trophic processes.
Building volume per capita : a crowding metric of housing disparities in Gauteng, South Africa
(Sage, 2025) Naidoo, Laven; Ballard, Richard; Naidoo, Yashena; Maree, Gillian; Khanyile, Samkelisiwe; Palacios-Lopez, Daniela; Esch, Thomas
In South Africa’s largest city region, located in the province of Gauteng, a key condition of inequality is that high-income households live in large houses while low-income households live in much smaller accommodation. Innovations in earth observation have enabled the modelling of building volumes in cities and this allows for new ways of assessing housing inequalities in Gauteng. This study calculates building volume per capita (BVPC) for the province as an indication of the volume of residential space in which individuals live. It offers five analyses using this data. First, mapping this metric illustrates that townships, informal settlements and inner city high-rise areas have cramped conditions of less than 10 cubic metres per person, while suburbs have a much higher building volume per capita. Second, the article shows that this metric complements traditional calculations of crowding, such as the number of people per room. Third, it calculates the relationship between BVPC and income and shows that the lower-earning three-fifths of households in the province occupy just 13% of the province’s residential building volume, while the higher-earning two-fifths occupy 87% of the province’s building volume. Fourth, it calculates that 51% of residential hexagons in the province fall below the threshold of adequately sized housing as defined by South African housing standards. Finally, it shows that areas that fall below the threshold have a higher proportion of informal housing.
Weather related disasters in South Africa from 1980 to 2023
(Elsevier, 2025-09) Bopape, Mary-Jane Morongwa; Keebine, G.; Ndarana, Thando; Mbokodo, I.L.; Hlahane, K.; Motshegwa, T.; Amha, Y.; Ogega, O.M.; Mfopa, C.; Mahlobo, D.D.; Engelbrecht, F.A.; Chikoore, H.; thando.ndarana@up.ac.za
This study presents an analysis of weather-related disasters in South Africa (SA), during the period 1980 to 2023. The data used includes the Emergency Events Database (EM-DAT) disaster list, the fifth generation European Centre for Medium Range Weather Forecasting reanalysis (ERA5), the European Organisation for the Exploitation of Meteorological Satellites (EUMETSAT) satellite imagery as well as the South African Weather Service synoptic charts for weather systems identification. Floods and storms emerge as the most prevalent disasters, particularly affecting KwaZulu-Natal (KZN) province (in the east of SA), with the eThekwini metropolitan municipality (metro) recording the most events. Although KZN receives substantial rainfall, no evidence suggests eThekwini experiences more rainfall than other districts in the province, suggesting human influences associated with urbanisation in disaster patterns. Cape Town metro reports the highest number of disasters in the western part of the country, associated with more rainfall, yet human factors may also contribute. Cut-off low systems and upper troughs which classify as mid-troposphere mid-latitude systems triggered the most floods and storms, while ex-tropical cyclones (ETCs) caused only four disasters during the study period. Upper Perturbations also resulted in floods and storm disasters indicating a need for forecasters to also pay attention to smaller scale processes. These findings enhance our understanding of weather-related disaster risks in South Africa, providing valuable insights for climate resilience and proactive disaster management. Given the reliance on the EM-DAT database, the potential for unrecorded disaster events introduces a limitation that may influence the conclusions drawn from this analysis.
Group career development of rural learners through group-based career construction counselling : intervention research
(Education Association of South Africa, 2025-05) Maree, J.G. (Kobus); Mahlalela, Thembelihle Nancy; kobus.maree@up.ac.za
The aim with this research was to explore the influence of group-based career construction counselling on learners' career development in a rural school. Convenience and purposive non-probability sampling were used to select a group of 15 Grade 9 learners aged between 14 and 18 to participate in the study. An interpretive paradigm (drawing from the constructivist worldview) underpinned the study. Data were generated by employing multiple qualitative sources, including pre- and post- intervention semi-structured group interviews, documents in the form of collages and timelines compiled by participants, the researcher's reflective journal and the career interest profile. A non-linear iterative, thematic analysis process was conducted to identify themes that emerged from the datasets. The findings reveal that group-based career construction counselling enhances learners' career development in a rural school by facilitating the addressing of subject choices early in Grade 9 as a key element in children's career development. Moreover, such intervention offers numerous benefits to young learners, including enhanced self- and career awareness. In future research it should be considered assessing the value of career construction counselling in the changing world of work to benefit learners' career development in the 21st century and beyond.
Current practices influencing school-to-work transition for learners with mild intellectual disability : a scoping review
(Education Association of South Africa, 2025-05) Dzhugudzha, N.T.; Uys, Catharina Jacoba Elizabeth; Ramano, Enos Morankoana
Transitions are significant turning points in young people’s lives as they enter adulthood. However, for learners with an intellectual disability (ID), this transition comes with effort. To identify and clarify current practices that influence school-to-work transition for learners with mild ID, the Joanna Briggs Institute (JBI), the preferred reporting items for systematic reviews and meta-analyses extension for scoping reviews (PRISMA-ScR) were followed in conducting this scoping review. A 5-step process was followed: the research question was identified; related studies were identified through an electronic grey literature search and databases; studies were selected; the data were charted; and lastly the findings were organised, summarised and reported on. Thirty-one (n = 31) articles published between 2009 and 2021 were included in this review. The current practices associated with school-to-work transition were learnerships or internships, vocational training, transition planning, collaboration effort, independent living skills training, family involvement, self-determination, social skills training, career counselling, and employers’ involvement. School-to-work transition for learners with mild ID is a complex, multifaceted process. These practices are necessary to support effective transition across life stages.
Fundraising for financial sustainability towards the acquisition of teaching and learning resources in rural public secondary schools, South Africa
(Education Association of South Africa, 2025-05) Sebidi, Simon Diatleng; sebidi.sd@up.ac.za
Fundraising is an important mechanism that can be used to supplement school funds. In this study I explored the school governing bodies’ fundraising experiences in rural public secondary schools. However, school governing bodies (SGBs) are struggling to use fundraising to generate extra school funds. A qualitative approach within the interpretivist paradigm was adopted using systems theory. Three principals and school governing body chairpersons were purposively selected for this case study. Tesch’s method of open coding was adopted to analyse data collected through semi-structured interviews. I observed ethical considerations to ensure the trustworthiness of the findings. Through the study I discovered SGBs’ lack of knowledge and skills in fundraising, little involvement of stakeholders, and poverty in communities as factors hampering fundraising. These are shortcomings in the SGBs’ approach to fundraising. I recommend suitable training for SGBs involving other stakeholders in fundraising, and adapting fundraising methods to the situations in their communities.
Language learners as co-creators of knowledge through constructivist peer tutoring interaction
(Education Association of South Africa, 2025-05) Machimana, Petronella Nondumiso Nompilo; Genis, Gerhard
With this study we explored Grade 8 and 9 learners' perceptions and experiences of peer tutoring in learning English as a first additional language. Vygotsky's (1978) sociocultural theory, specifically the concept of scaffolding and zone of proximal development, formed the basis of our theorisation. Through the use of a concurrent mixed-methods design, we found that learners, who had received peer tutoring interventions, reported improved reading, speaking, and vocabulary/grammar ability, but not writing ability. Moreover, peer interaction increased learners' involvement in lessons allowing them to co-create knowledge with their peers. This study adds to our understanding of the potential benefits of peer tutoring for learners of English first additional language. It highlights the effects of peer tutoring as a potentially effective pedagogic strategy in the language classroom. Thus, we recommend that teachers consider introducing peer tutoring during language classes to assist learners in co-creating knowledge as they actively engage with language content presented in these classes.
Groundwater-vegetation interactions in rangeland ecosystems : a review
(MDPI, 2025-04) Rapiya, Monde; Ramoelo, Abel
Water scarcity is a growing global issue, especially in arid and semi-arid rangelands, primarily due to climate change and population growth. Groundwater is a crucial resource for vegetation in these ecosystems, yet its role in supporting plant life is often not fully understood. This review explores the interactions between groundwater and vegetation dynamics in various rangeland types. Groundwater serves as a critical water source that helps sustain plants, but changes in its availability, depth, and quality can significantly impact plant health, biodiversity, and ecosystem stability. Research indicates that groundwater depth affects vegetation types and their distribution, with specific plants thriving at certain groundwater levels. For instance, in grasslands, shallow groundwater can support diverse herbaceous species, while deeper conditions may favor drought-tolerant shrubs and trees. Similarly, in forest ecosystems, extensive root systems access both groundwater and soil moisture, playing a vital role in water regulation. Savanna environments showcase complex interactions, where trees and grasses compete for water, with groundwater potentially benefiting trees during dry seasons. Climate change poses additional challenges by altering rainfall patterns and temperatures, affecting groundwater recharge and availability. As a result, it is crucial to develop effective management strategies that integrate groundwater conservation with vegetation health. Innovative monitoring techniques, including remote sensing, can provide valuable information about groundwater levels and their impact on vegetation, enhancing water resource management. This review emphasizes the importance of understanding groundwater–vegetation interactions to guide sustainable land and water management practices. By enhancing our knowledge of these connections and utilizing advanced technologies, we can promote ecosystem resilience, secure water resources, and support biodiversity in rangeland systems. Collaborative efforts among local communities, scientists, and policymakers are essential to address the pressing issues of water scarcity and to ensure the sustainability of vital ecosystems for future generations.
Mitigation of opportunistic pathogens in hot water systems : a review focused on premise plumbing in South Africa
(Water Research Commission, 2025-05) Moodley, S.J.; Venter, S.N. (Stephanus Nicolaas); Muchesa, P.; Barnard, T.G.; Singh, A.
Water reticulation systems (i.e., premise plumbing) serve as a reservoir for opportunistic premise plumbing pathogens (OPPPs) to survive within these premise systems. OPPPs can be transmitted to individuals mainly via inhalation of aerosols from these water systems. These OPPPs can adapt, thrive and survive under a range of different conditions, which include high temperatures and low oxygen levels during stagnation, conditions often associated with household plumbing systems, including hot water systems (HWS). Hospitals are of specific concern as infections caused by OPPPs predominantly affect individuals who have underlying illnesses or health conditions. The current South African National Standard (SANS) 241 for drinking water does not provide information regarding testing for the presence of OPPPs, while the SANS 893 and 893-1 standards only provide a guideline for Legionella in water systems. The presence of OPPPs within HWS and premise plumbing is a concern, and a need exists to establish remediation and mitigation measures to control the presence of OPPPs in buildings. This review addresses risk analysis, evaluation and measures, which include the control of geyser temperatures and training of plumbers, as well as sampling and detection of OPPPs. This should limit the number of infections amongst individuals and will thus lessen the financial burden on health care systems and the economy.
Quantifying urban land cover imperviousness as input for flood simulation using machine learning : South African case study
(IWA Publishing, 2025-05) Loots, Ione; Smithers, Jeffrey Colin; Kjeldsen, Thomas Rodding; ione.loots@up.ac.za
The imperviousness of urban surfaces is an important parameter in simulating urban hydrological responses, but quantifying imperviousness can be challenging and time-consuming. In response, this study presents a new framework to efficiently estimate the imperviousness of urban surfaces, using satellite images with Red, Green and Blue bands and a land cover dataset with multiple built-up urban classes through remote sensing, machine learning and field verification. The methodology is adaptable to other regions with similar datasets. For a case study in Pretoria, South Africa, major differences in median total impervious area percentages (mTIA%) were identified when compared between land cover groups: residential areas had a lower imperviousness median (mTIA% = 38%) than commercial (mTIA% = 81%) and industrial (mTIA% = 89%) land cover. The mTIA% also varies between 17 and 61% for a range of different formally developed residential classes and between 14 and 43% for a range of different informally developed residential classes. These mTIA% are recommended for any urban area within the South African National Land Cover dataset. These values can be incorporated into hydraulic and hydrological models, which improve the efficiency of parameter estimation for modelling. The methodology successfully quantified temporal imperviousness changes in the study area.
Delta ferrite in modified 9Cr–1Mo steel weld metal
(Springer, 2025) Mahlalela, Sibusiso Samuel; Pistorius, Pieter Georg Hendrik; sibusiso.mahlalela@up.ac.za
Please read abstract in the article.
Prevalence of lower back pain and associated workplace and ergonomic factors among mineworkers in a nickel mine, Zimbabwe
(MDPI, 2024-09-16) Zenda, Kumbirai P.; Rathebe, Phoka C.; Moto, Tshepo Paulsen; Masekameni, Daniel M.; Mbonane, Thokozani P.
Lower back pain is a common occurrence among mine workers due to the nature of their work. Globally, workplace (occupational) and ergonomic risk factors have been reported to influence the prevalence of lower back pain among workers. This study aimed to determine ergonomic risk factors associated with lower back pain and associated risk factors (workplace and ergonomics) among mineworkers in a nickel mine in Zimbabwe. A cross-sectional study design was employed, and participants were randomly selected to complete a questionnaire that included the Dutch Musculoskeletal Questionnaire (DMQ). A total of 420 mine workers were interviewed, with the majority being male (n = 259, 61.7%) and aged between 31 and 44 years old (n = 159, 37.9%). The study found that the prevalence of lower back pain was 41.43% (n = 174). Several risk factors were found to be associated with lower back pain, including working overtime (AOR = 1.13, p < 0.01; 95% CI: 0.07–0.22), performing repetitive tasks (AOR = 8.06, p < 0.01; 95% CI: 4.67–13.93), bending (AOR = 7.77, p < 0.01; 95% CI: 3.97–15.22), and twisting (AOR = 3.32, p < 0.01; 95% CI: 1.83–6.03). Based on these findings, it is recommended that an ergonomic risk assessment and prevention program be implemented, which should include educational awareness about lower back pain and its prevention among mine workers.
Self-reported experience of outreach activities amongst undergraduate oral health students at a university in South Africa
(South African Dental Association, 2024-02) Kruger, Candida; Nkambule, Ntombizodwa Rosemary; Bhayat, Ahmed; zodwa.nkambule@up.ac.za
INTRODUCTION : Outreach activities (OAs) are structured learning experiences, combining intentional learning goals with services to underserved communities. Oral health students participated on the Phelophepa Train (PT) and school-based programmes (SBPs) as part of their OAs. AIM AND OBJECTIVES : To evaluate the self-reported experiences of OA amongst undergraduate oral health students. DESIGN : Cross-sectional which included final year dental (N=62) and oral hygiene students (N= 13) registered in 2019. METHODS : Information was obtained using a modified, self administered questionnaire which included the number and type of procedures performed; work-related limitations, personal work benefits, academic development and civic responsibility. RESULTS : The response rate was 93% (N=65) and students performed more procedures on the train compared to the SBP. Most common procedures undertaken by dental students were screening (64%) and restorations (56%) for oral hygiene students it was screenings (92%) and examinations, fissure sealants and screenings 39% on the train and 31% at SBPs. The most common challenges on both the train and SBPs were inadequate materials (74%) and (41%), poor infection control (15%) and (41% and defective equipment (31%) and (38%) respectively. CONCLUSION : Although students performed a variety of clinical services they reported to have faced a number of challenges. The majority of students reported that OAs exposed them to the needs of the communities and encouraged them to improve their independence and accountability towards patients.
Root and canal morphology of the maxillary first molar : a micro-computed tomography-focused review of literature with illustrative cases : Part 1 : External root morphology
(South African Dental Association, 2024-02) Jonker, C.H.; Van der Vyver, Petrus Jacobus; Oettle, A.C.
Cleaning and shaping of the root canal are profoundly affected by the complexity of root and canal morphology. Undiscovered roots or canals may lead to a reduced prognosis of a treated tooth as hidden causative organisms and their by-products can cause re-infection. Most maxillary first molars have three roots, namely mesio-buccal (MB), disto-buccal (DB) and palatal (P). They can be separate or fused, with incidences varying between populations. Anomalies have also been documented that include single-rooted, double-rooted, four and even five-rooted teeth. Additional roots are mostly in the form of additional palatal roots and are known as either a radix mesiolingualis (RML) or radix distolingualis (RDL). This paper is the first of two giving an overview, focused on micro-CT, of available literature on various aspects of the root and canal morphology of the maxillary first permanent molar. The aim of this paper is to provide an overview of relevant aspects of the external root morphology in different populations. The content is supported by illustrative micro-CT images and case reports of rare morphological findings on maxillary first molars.
Oral presentation of haematological disease : Part II – Iron deficiency anaemia
(South African Dental Association, 2024-07) Fourie, Jeanine; Nel, Jan Gert; jeanine.fourie@up.ac.za
INTRODUCTION : Iron deficiency anaemia may be responsible for diverse oral mucosa changes due to the reduced oxygen-carrying capacity of red blood cells, but also due to changes in the oral mucosal structure and defence mechanisms. Aims and objectives This study aims to report on three patients with iron deficiency anaemia who presented with distinct oral mucosal clinical features. DESIGN/METHODS : The oral mucosal features of three patients who presented at the University of Pretoria Oral Health Centre with iron deficiency anaemia, of variable causes, were recorded. Special investigations were performed and reflected their degree of iron deficiency. The patients were managed collaboratively with their respective physicians to address the underlying cause of anaemia. RESULTS : These cases demonstrate that dentists should explore the presence of anaemia to explain oral mucosal changes. Anaemia may present with wide-ranging clinical features, from recurrent to persistent oral ulcers, mucosal pallor, and Candida infection. Collaboration with attending physicians may help establish the cause of anaemia as a nutritional deficiency, gastric ulceration, or infective and inflammatory disease. CONCLUSIONS : Dentists are pivotal in diagnosing haematological diseases such as iron deficiency anaemia. The oral features of ulceration, glossitis, Candida infection and mucosal pallor are important diagnostic indicators of iron deficiency anaemia.
Oral presentation of haematological disease : Part I – Diseases of bone marrow failure
(South African Dental Association, 2024-06) Fourie, Jeanine; Nel, Jan Gert; jeanine.fourie@up.ac.za
INTRODUCTION : The bone marrow is responsible for haemopoiesis, but when it fails, oral mucosal lesions may be seen due to reduced platelets, white blood cells, or red blood cells. AIMS AND OBJECTIVES : This study aims to report on three patients who presented with leukaemia, aplastic anaemia and neutropenia, respectively, with spontaneous bleeding, ulceration and mucosal pallor. DESIGN/METHODS : The oral mucosal features of three patients who presented at the University of Pretoria Oral Health Centre, with varying degrees of bone marrow failure, were recorded. Special investigations were performed to check their bone marrow function. The patients were managed collaboratively with their respective physicians. RESULTS: These cases demonstrate that dentists should be cognisant of disorders of bone marrow failure so that patients are a) diagnosed timely and appropriately, b) referred back to their treating clinician due to relapse of a known disease, or c) managed in collaboration with their treating clinician to confirm a suspected diagnosis. CONCLUSIONS : Dentists play a pivotal role in diagnosing haematological disease that results from bone marrow failure. Bleeding, ulceration and mucosal pallor are important diagnostic indicators of reduced platelet, neutrophil and red blood cell counts.
Oral health in children and adolescents with special healthcare needs in South Africa : a narrative review
(South African Dental Association, 2024-03) Njoroge, N.; Magan, A.; Hlongwa, Phumzile
Children and adolescents with special healthcare needs (CWSHCN) may experience disproportionately poorer general and oral health than healthy children. They are more at risk of common conditions such as dental caries and gingivitis resulting from poor oral health. They comprise of children and youth “with or at risk of chronic physical, developmental, behavioural or emotional conditions”, including, inter alia, intellectual disability (ID), cerebral palsy (CP), learning disability (LD), autism spectrum disorder (ASD), hearing impairment (HI), Down Syndrome (DS), physical disabilities (PD), visual impairments (VI) and epilepsy (EP). Globally, the prevalence of disabilities is increasing, even in developing countries such as South Africa (SA), resulting in a greater burden on healthcare systems.

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