Knowledge, risk perception and access to healthcare services for HIV and tuberculosis among university students in Johannesburg, South Africa

background. An increasingly diverse body of students is entering university in South Africa. HIV and tuberculosis (TB) are pressing health issues for this vulnerable population and the university campus offers an opportunity to intervene with health promotion activities. Objectives. This study describes knowledge and risk perception of TB and HIV among high school leavers entering tertiary education. Methods. A cross-sectional survey among first-year students, aged 18-25 years, registered at one of three universities chosen for the study in Johannesburg, South Africa. Informed consent was obtained prior to completing a self-administered, close-ended, structured questionnaire. Factors associated with poor knowledge or high risk perception were identified using modified Poisson regression. Results. In total, 792 students were included; 53.3% (n=438) were categorised as having poor TB knowledge and 52.1% (n=412) poor HIV knowledge, while 43.4% (n=344) were categorised as having high TB risk perception and 39.8% (n=315) high HIV risk perception. Male students were more likely to have poor knowledge of HIV and perceive themselves at risk of acquiring HIV. Low socioeconomic status was associated with a high risk perception of HIV. One in 3 participants (30.6%) stated that they had never had an HIV test. In total, 24students (9 males, 15 female) reported that they were HIV-positive, of whom 15 (62.5%) were on antiretroviral therapy. Only 14.1% had been screened for TB in the past 6 months. Conclusion. The findings indicate a need to enhance health promotion activities among university students so as to aid preventive strategies for reducing the burden of HIV and TB infection

Barriers and Facilitators to the Uptake of Voluntary Medical Male Circumcision (VMMC) among Adolescent Boys in KwaZulu-Natal; South Africa

Epidemiological modelling has concluded that if voluntary medical male circumcision (VMMC) is scaled up in high HIV prevalence settings it would lead to a significant reduction in HIV incidence rates. Following the adoption of this evidence by the WHO; South Africa has embarked on an ambitious VMMC programme. However; South Africa still falls short of meeting VMMC targets; particularly in KwaZulu-Natal; the epicentre of the HIV/AIDS epidemic. A qualitative study was conducted in a high HIV prevalence district in KwaZulu-Natal to identify barriers and facilitators to the uptake of VMMC amongst adolescent boys. Focus group discussions with both circumcised and uncircumcised boys were conducted in 2012 and 2013. Analysis of the data was done using the framework approach and was guided by the Social Cognitive Theory focussing on both individual and interpersonal factors influencing VMMC uptake. Individual cognitive factors facilitating uptake included the belief that VMMC reduced the risk of HIV infection; led to better hygiene and improvement in sexual desirability and performance. Cognitive barriers related to the fear of HIV testing (and the subsequent result and stigmas); which preceded VMMC. Further barriers related to the pain associated with the procedure and adverse events. The need to abstain from sex during the six-week healing period was a further prohibiting factor for boys. Timing was crucial; as boys were reluctant to get circumcised when involved in sporting activities and during exam periods. Targeting adolescents for VMMC is successful when coupled with the correct messaging. Service providers need to take heed that demand creation activities need to focus on the benefits of VMMC for HIV risk reduction; as well as other non-HIV benefits. Timing of VMMC interventions needs to be considered when targeting school-going boys

Prevalence and determinants of occupational exposures to blood and body fluids among health workers in two tertiary hospitals in Nigeria

Background: Healthcare associated infections among health workers commonly follow occupational exposures to pathogens infecting blood or body fluids of patients. We evaluated the prevalence and determinants of occupational exposures to blood/body fluids among health workers in two tertiary hospitals in Nigeria. Methods: In a cross section study undertaken in two tertiary hospitals in North-central and South-south Nigeria in 2011; a structured self-administered questionnaire was used to obtain demographic data and occupational exposures to blood/body fluids in the previous year from doctors; nurses and laboratory scientists. Independent predictors of occupational exposures were determined in an unconditional logistic regression model. Results: Out of 290 health workers studied; 75.8; 44.7; 32.9; 33.9 and 84.4 had skin contact with patient's blood; needle stick injuries; cut by sharps; blood/body fluid splashes to mucous membranes and one or more type of exposures respectively. Ninety one percent; 86; 71.1; 87.6; 81.3; and 84.4 of house officers; resident doctors; consultant doctors; staff nurses; principal/chief nursing officers and laboratory scientists; respectively had one or more type of exposures in the previous year (P0.05). Professional group was found to be the only independent predictor of cut by sharps. House officers and nurses had higher and more frequent occupational exposures than other professional groups. Conclusion: Our results suggest high rates of occupational exposures to blood/body fluid among health workers in Nigeria; especially among newly qualified medical doctors and nurses. Health facilities in Nigeria ought to strengthen infection prevention and control practices while targeting high risk health workers such as house officers and nurses

Application of the Information; Motivation and Behavioural Skills Model for Targeting HIV Risk Behaviour amongst Adolescent Learners in South Africa

This paper discusses the application of an information; motivation and behavioural skills (IMB) model in a school-based programme for the reduction of HIV risk behaviour among 259 Grade 11 learners in two high schools in Alexandra township; Johannesburg. School 1 was the Experimental group; while School 2 was the Control group. After a baseline study (Time 1) at both schools; a 3-week intervention programme was conducted at School 1. A post-test (Time 2) was conducted at both schools. The intervention was repeated at School 2; followed by another post-test (Time 3) at both schools. A final test (Time 4) was conducted at both schools. While there were positive changes in the levels of HIVetAIDS IMB in learner participants; these changes may not be entirely attributed to the intervention. If an IMB model-based intervention is to be maximally effective in reducing HIV-risk behaviour among adolescents; it must focus on the behavioural; structural and socio-cultural contexts in which adolescents live

Antihypertensive Treatment in the Elderly

Hypertension is a major risk factor for cardiovascular disease; but it is also very prevalent in the community. These two factors combined prompted the World Health Organization (WHO) to report that high blood pressure is the first cause of death worldwide.1 The prevalence of hypertension has been estimated to be approximately one in four; and this increases with age to such an extent that almost two-thirds of people over the age of 60 years have hypertension.2

HIV/AIDS Knowledge; Behaviour and Beliefs Among South African University Students

Globally; South Africa has the highest prevalence of HIV/AIDS. In the absence of cure; prevention is the only available method to reduce HIV prevalence rates. This can only be obtained through behavioural change; which is associated with a good knowledge about HIV. The study aims to determine the knowledge; beliefs; behaviours and sources of HIV and AIDS information among university students at two tertiary institutions in South Africa. The study was a quantitative; cross-sectional; descriptive and comparative survey. Students from the Western Cape Province and the KwaZulu-Natal Province participated in the study. The main findings of the study were that althoughstudents had an adequate general knowledge on HIV/AIDS; both groups scored the lowest in the transmission modes of HIV. The media was the main source of HIV/AIDS information for students and university health care facilities need to be more proactive in informing students about the transmission of HIV/AIDS

COVID-19 pandemic: workplace readiness to control and contain the spread of coronavirus

The coronavirus outbreak has been declared a pandemic by the World Health Organization. It is a huge concern to both public and occupational health and is the biggest current threat to the global economy and financial markets. The aim of this paper is to highlight the key occupational health challenges based on available literature and to provide some guidance on preventive measures. A literature search was conducted on PubMed and Google for studies published from January to March 2020. Google translate was used for articles in foreign languages. The literature showed that healthcare workers are a high-risk group, although any worker is at potential risk. The key challenges identified relate to labour rights and sick leave, compensation, impact of quarantine on business continuity, and whether transmission is purely through droplets or if airborne transmission plays a role. The evidence, although limited, provides guidance for slowing down and reducing the risk of spread of the virus