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Doctoral Students

Liesl Arendse

Thesis title: Growth curve analysis and new standard development for South African Coloured (Mixed Ancestry) children aged 0 – 3 years

Supervisor: Dr. Victoria Gibbon
Co-supervisor: Dr. Desire Brits & Professor Vicki Lambert

Thesis description:

The latest South Africa Demographic and Health Survey (SADHS) reported stunted growth (height-for-age z-scores fell between the 1st and 3rd percentiles of the World Health Organization’s (WHO) Multicenter Growth Reference Study (MGRS) 2006’s child growth charts) for 1 in 3 boys, and 1 in 4 girls (De Onis and Branca, 2016; National Department of Health et al., 2017). If this is applied to South African Coloured (Mixed Ancestry) children, approximately 80 589 males and 58 485 females younger than 4 years are estimated to be stunted in this age cohort (Statistics South Africa, 2018). Furthermore, the SADHS reported that 24% and 13% of South African children younger than 5 years in the middle and top wealth quintiles, respectively, were estimated to be stunted according to the WHO MGRS growth charts (National Department of Health et al., 2017). Conversely, the percentage children classified as overweight were twice the international average (6.1%) for the same age group. In a recent review, Singhal (2017) recognised that while the prevention of stunting and the promotion of linear growth “in small-for-gestational age or pre-term children has been shown to be beneficial for neurodevelopmental and other health outcomes, “the optimal pattern of infant weight gain is likely to differ in different populations”.  Further, rapid weight gain and post-natal growth acceleration in healthy, full-term infants, often in low- and middle-income country settings, has been associated with a greater risk for obesity and non-communicable diseases, later in life (Cameron and Demerath, 2002; Singhal, 2017) which will in turn lead to further financial strain on government subsidised medical facilities. If growth charts are to be used as a general health indicator of a population group, standardisation of population-specific growth models/charts may better inform health care policy development and regulate future preventative health care for population groups at risk (Christesen et al., 2016). With the intended roll out of a National Health Insurance (NHI) Policy in the near future (Department of Health, 2017), it is imperative to understand the factors that affect growth of at risk population groups.
Therefore, the aims of this study are; (1) to analyse the growth rate of Coloured South African children younger than three years; (2) to assess the effects of different socio-economic conditions on growth; (3) determine intergenerational differences across three generations (1975, 1995 and 2019); and (4) to develop a population-specific growth model for the age cohort 0 – 3 years from this population group.

Contact details: Email  

Stevie Biffin

Thesis title: Differences in subcortical volumes on structural Magnetic Resonance Images and associated neurobehavioural differences in children exposed prenatally to alcohol from Cape Town, South Africa

Supervisor: Professor Ernesta M Meintjes
Co-supervisor: Dr. Christopher Warton

Thesis description: Fetal Alcohol Syndrome (FAS) is caused by prenatal maternal alcohol consumption and has life-long effects.  It is characterized by growth deficits, small head circumference, distinctive craniofacial dysmorphology (small palpebral fissures, flattened philtrum and thin vermillion) and behavioural and cognitive problems that stem from prenatal brain damage. Variations in the degree of brain damage range from microcellular, neurochemical and cellular dysfunction to gross structural abnormalities. Cognitive and behavioural dysfunction also varies in terms of degree of developmental delay or disability and severity and range of learning disabilities. Due to the varying effects of prenatal alcohol exposure, Fetal Alcohol Spectrum Disorders (FASD) was created as an umbrella term under which the entire spectrum of outcomes related to prenatal alcohol exposure falls. It is not a medical diagnosis, rather, diagnoses such as FAS, partial FAS (pFAS) and alcohol-related neurodevelopmental disorder (ARND) are forms of FASD, with FAS being the most severe diagnosis.

With the Western Cape Province having such a high prevalence of FAS and the devastating effects that FASD has on brain function, as evidenced by deficits in cognitive and behavioural functioning, investigation into the possible neuroanatomical and related functional changes that accompany this diagnosis is crucial. Structural brain changes may underpin the observed functional deficits and a better understanding of these changes may assist in planning more targeted interventions.   

This project has three primary aims. The first aim of this research project is to examine differences in volumes of selected neuroanatomical structures on Magnetic Resonance Images via manual segmentation. In addition, we will examine associations between the degree of alcohol exposure and brain volume reductions. The second aim is to investigate whether there are differences between the volumetric data from manual tracing and automated segmentation. The third aim is to investigate interhemispheric transfer of tactile information using a finger localization task. These aims will compare children exposed prenatally to alcohol to unexposed controls from Cape Town, South Africa.

Contact details: Email    Website

Elizabeth Dinkele

Thesis title: Exploring the aetiology of Mseleni Joint Disease using cellular modelling and disease ecology

Supervisors: Dr. Victoria Gibbon & Dr. Robea Ballo

Thesis description: Mseleni joint disease (MJD) is a crippling osteoarthritic disease which exclusively affects a rural community in KwaZulu-Natal. It is a rare disease with a country-wide prevalence of 1 in 84 000 people and a prevalence of 5.9% within the Mseleni community. The socio-economic burden of this condition is felt by the families of affected individuals, especially young individuals, who frequently forgo school attendance to assist with household subsistence. Despite more than 47 years of research, the cause of this disease remains unknown. Until the aetiology of MJD is known, this condition cannot be treated or prevented effectively, and the cycle of poverty and disease will be perpetuated in this community.

This project is part of an inter-disciplinary collaboration between Dr Victoria Gibbon (Division of Clinical Anatomy and Biological Anthropology (UCT)) and Dr. Robea Ballo (Division of Cellular Biology (UCT)) in search of the aetiology of MJD. The first aim of this project is to explore the aetiology of MJD using ecological and epidemiological surveys. By assessing the association between changes in MJD and changing economic, social, cultural and political landscape in Mseleni, it will be possible to distinguish between factors implicated in the aetiology of this disease, versus those merely associated with its pathology. The second aim is to develop an in vitro patient-specific cartilage model derived from Induced Pluripotent Stem Cells (IPSCs). This model will be used to assess the expression of genes which are known to be active in cartilage maintenance and repair networks. If differences in the expression of these genes are detected in MJD sufferers, epigenetic modifications are likely to be implicated in the aetiology of MJD.

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Francesca Du Toit

Thesis title: Increased risk of cerebral vascular accidents due to persistence of embryonic venous pathways in the adult brain

Supervisor: Professor Graham Louw

Thesis description: The cerebral venous system, unlike the majority of the rest of the body, does not generally follow the cerebral arterial system. Veins follow a morphologically complex pattern of development characterized by the formation of highly irregular networks of capillaries and the ultimate expansion of certain channels into definitive veins. Because of the multi-channelled beginnings and the number of options, the adult venous system is characterized by a higher incidence of anatomical variations than the arterial system (Carlson, 2014).
The unique embryology of the dural venous system leads to the venous channels being particularly prominent in the infant. A better understanding of the venous anatomy of the dural folds leads to a better understanding of the radiology (Mack et al., 2009).
The purpose of the study is to investigate the persistence of embryonic venous drainage pathways in the adult. The study will describe the common venous drainage patterns seen in the brains of children and correlate these findings to the venous drainage patterns seen in adults. The study will also aim to establish whether there is a link between persistence of embryonic venous pathways and cerebral vascular accidents in the adult.
The study is a cross-sectional/descriptive study using analytical and observational techniques.
The sample population will include all patients (children and adults) that underwent a MRI or venogram of the cerebral vasculature. This will allow the researcher to gather data at the Department of Radiology at the Groote Schuur Hospital as well as the Red Cross Children’s War Memorial Hospital.  

Contact details: Email

Marlie Greeff

Thesis title: The morphology of the intraparietal sulcus of children prenatally exposed to alcohol in a Western Cape community of South Africa and its potential role on number processing

Supervisors: Dr. Christopher Warton and Professor Ernesta Meintjes

Project description: My main focus is the intraparietal sulcus (IPS) of the brain and how it may change in volume with children prenatally exposed to alcohol. This sulcus is also involved with basic arithmetic abilities and a volumetric change in the IPS may affect this. Our aim is to ultimately see whether a volumetric change in the IPS correlates with the number processing abilities in these children prenatally exposed to alcohol.

Contact Details: Email


Dr. Glen James Paton

Thesis title: Lumbosacral transitional vertebra morphology: a South African population.

Supervisors: Professor Graham Louw, Professor Scott A. Williams and Dr. Shahed Nalla

Thesis description: Lumbosacral transitional vertebra (LSTV) is an anatomical variation, observed unilateral or bilateral, in which the transverse process of the last lumbar vertebra exhibits signs of dysplasia (variation in vertical height) with varying degrees of fusion to the ‘first’ sacral segment (Southworth & Bersack, 1950; Hughes & Saifuddin, 2004; Jancuska et al., 2015). The estimated global prevalence rate for LSTV is 12.1%. There is a paucity of research into prevalence rates in Africa and no established data for South Africa exists.

Lumbosacral transitional vertebra can be associated with low back pain (LBP) and may impact the quality of life of the individual. Considerations for spinal biomechanics and treatment of LBP must therefore be tailored for these individuals. Better understanding of LSTV in a South African context can aid in targeted treatment both conservatively and surgically.

This project will utilise spinal imaging techniques such as radiographs and magnetic resonance imaging (MRI) as well as osteological analysis. The primary aims are to establish a prevalence rate estimate for three largest ethnic groups in the South African population as well as describe the variations in morphology in the South African sample. Comparative analyses will also be utilised to explore possible evolutionary aetiology.

Contact Details: Email

Graduated PhD Students

2018. Devin Alexander Finaughty. PhD (Biological Anthropology). The establishment of baseline data on large animal soft-tissue decomposition in two terrestrial habitats in the Western Cape, South Africa. Supervisor: Professor Alan G. Morris.

2017. Fleur Warton. PhD (Neuroscience). The neurostructural effects of prenatal exposure to methamphetamine in an infant population in the Western Cape. Supervisors: Prof Ernesta Meintjes and Dr. Chris Warton.

2016. Petra Maass.PhD (Biological Anthropology). A statistical shape analysis of the neurocranium and long bones. Supervisor: Dr Jacqui Friedling.

2015. Lakha Kavita. PhD (Biological Anthropology). Sequential changes in epiphyseal union in South African children between the ages of 6 up to 32 years using full body LODOX scans. Supervisor: Prof. Alan G. Morris.

2014. Adjenti Savior. PhD (Applied Anatomy). An investigation into the ultrastructural parameters of abdominal muscles in children and adolescents with spastic type cerebral palsy and the effect on postural muscle performance. Supervisor: Prof. Graham Louw.

2014. Dlamini Nonhlanhla. PhD (Biological Anthropology). The early inhabitants of the Upemba Depression of the Democratic Republic of Congo: a biological review of the cultural continuity theory. Supervisors: Prof. Alan G. Morris and Prof. Judith Sealy.

2014. Milner Brenda. PhD (Molecular Medicine). Isolation and characterisation of colon cancer stem cells and the effects of epigenetic modulation on pluripotent markers. Supervisors: Dr. Victoria Gibbon, Dr. Clem Penny, and Prof. Paul Ruff. University of the Witwatersrand.

2011. Clarke Carrie. PhD (Orthopaedics). Joint hypermobility syndrome and developmental coordination disorder in adults: exploring the association and the impact. Supervisor: Dr. Delva Shamley. Oxford Brookes University.

2011. Unger Marianne. PhD (Applied Anatomy). The role of the abdominal muscles in pelvic positioning and lower limb function in children with spastic type cerebral palsy. Supervisor: Prof. Graham Louw.

2009. Reilly K. PhD (Orthopaedics). Investigation of the differences in foot and ankle characteristics of patients with lower limb osteoarthritis. Supervisor: Dr. Delva Shamley. Oxford Brookes University.

2008. Phillips Vince. M. PhD (Biological Anthropology). The dental and skeletal maturation of South African children and the relation to chronological age. Supervisor: Prof. Alan G. Morris. University of the Western Cape.

2007. Friedling L Jacqui. PhD (Biological Anthropology). Grave tales: an osteological assessment of health and lifestyle from 18th and 19th century burial sites around Cape Town. Supervisor: Prof. Alan G. Morris.

2005. Draper C. PhD (Public Health). Medical students’ attitudes towards and perceptions of the Primary Health Care approach. Supervisor: Prof. Graham Louw.

2002. Peckmann Tanya. PhD (Biological Anthropology). Dialogues with the dead:  an osteological analysis of the palaeodemography and life history of the 19th century northern frontier in South Africa. Supervisor: Prof. Alan G. Morris.

2000. Bukenya Edmond EM. PhD (Biological Anthropology). The vertebral column in humans and selected non-human primates, and the functional structure of its transitional elements. Supervisor: Prof. Alan G. Morris and Prof Graham Louw.

1994. Steyn Maryna. PhD (Biological Anthropology). An assessment of the health status and physical characteristics of the prehistoric population from Mapungubwe. Supervisors: Prof. Alan G. Morris and Prof Maciej Henneberg. University of the Witwatersrand.