Background Risk factors for COVID-19 death in sub-Saharan Africa and the effects of HIV and tuberculosis on COVID-19 outcomes are unknown. Methods We conducted a population cohort study using linked data from adults attending public sector health facilities in the Western Cape, South Africa. We used Cox-proportional hazards models adjusted for age, sex, location and comorbidities to examine the association between HIV, tuberculosis and COVID-19 death from 1 March-9 June 2020 among (i) public sector “active patients” (≥1 visit in the 3 years before March 2020), (ii) laboratory-diagnosed COVID-19 cases and (iii) hospitalized COVID-19 cases. We calculated the standardized mortality ratio (SMR) for COVID-19 comparing HIV positive vs. negative adults using modelled population estimates. Results Among 3,460,932 patients (16% HIV positive), 22,308 were diagnosed with COVID-19, of whom 625 died. COVID-19 death was associated with male sex, increasing age, diabetes, hypertension and chronic kidney disease. HIV was associated with COVID-19 mortality (adjusted hazard ratio [aHR] 2.14; 95% confidence interval [CI] 1.70-2.70), with similar risks across strata of viral load and immunosuppression. Current and previous tuberculosis were associated with COVID-19 death (aHR [95%CI] 2.70 [1.81-4.04] and 1.51 [1.18-1.93] respectively). The SMR for COVID-19 death associated with HIV was 2.39 (95%CI 1.96-2.86); population attributable fraction 8.5% (95%CI 6.1-11.1). Conclusion While our findings may over-estimate HIV- and tuberculosis-associated COVID-19 mortality risks due to residual confounding, both HIV and current tuberculosis were independently associated with increased COVID-19 mortality. The associations between age, sex and other comorbidities and COVID-19 mortality were similar to other settings.

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Aloe dichotoma (Quiver tree) occurs in the arid regions of Namaqualand and Bushman land in South Africa, and in arid regions of southern Namibia. The Quiver trees are not only threatened by agricultural expansion, overgrazing, and mining; but also by climate changes and droughts. Previous studies show that Quiver trees are very sensitive to environmental changes, and do not respond well to extreme hot and dry conditions. This study investigates the current status of the Quiver tree within its existing environment, and also assesses the projected future changes of the Quiver tree habitat under different climatic scenarios. It provided evidence regarding the importance of the study to understanding the climate change impacts on the Quiver tree and its geographical response to climate changes.

There is widespread agreement of the importance of information and communication technologies (ICT) in building equitable prosperity and globally competitive economies. Effective use of these technologies, however, requires building new capacities and skills, here referred to as eskills, not only in the working force but the entire population. These skills are in very short supply all over the developing world, and are of particular concern in South Africa. In order to appropriately address this issue, South African government has taken a systematic and systemic approach, to address the matter and has developed an approach involving a number of stakeholders from all spheres of government, business, education, civil society and organized labor. That effort led to the e-Skills Summit (2010), which provided the guidelines for the creation of the national e-skills policy named the National e-Skills Plan of Action (NeSPA). This paper, based on descriptive case study methodology, brings a portrayal of that systematic and systemic approach. The paper, aimed at academics, practitioners and policy-makers, also depicts the e-skilling key success factors, expected impact of NeSPA, and the principles for monitoring and evaluation. The paper ends with a brief description of some lessons learned during the initial implementation phase of NeSPA.

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