Factors Associated with Pulmonary Tuberculosis Outcomes among Inmates in Potchefstroom Prison in North West Province

Tuberculosis is the leading cause of death among the world's prison populations. Prisons are reservoirs of tuberculosis and threaten inmates; prison staff; visitors and the surrounding community. This study was carried out to explore the associated factors with pulmonary tuberculosis treatment outcomes at Potchefstroom Prison. A retrospective record review of 202 inmates with tuberculosis; whose treatment outcomes as of March 2010 were known; was conducted. Data on sex; racial group; level of education; weight; smoking habits; existence and type of co-morbidity; diagnostic classification; treatment regimen; initiation date; completion date and outcome; use of directly observed treatment; allergy and hospitalisation were captured. The majority of the inmates (142; 70.3) were aged 21-37 years; while 48 (23.8) were aged 38-53 years. There were 198 (98) male and 4 (2) female inmates. Fifty-five inmates (27.3) had attained Grade 6 and lower; 71 (35.1) grade 7-9; 68 (33.7) Grade 10-12; and 8 (3.9) above grade 12. One hundred and fifty-eight (78.2) received occasional visitors. There were 121 (59.9) smokers. The adverse outcomes for tuberculosis were significantly increased by an age 37 years; human immunodeficiency virus co-infection; smoking; a lack of support and an absence of directly observed treatment. Inmates who received fewer visits and less social support must be supported by community volunteers; counsellors and psychologists in order to motivate them and enhance favourable treatment outcomes. Smokers need to stop smoking. Younger inmates require peer support groups

Care-Seeking Behaviour and Implications for Malaria Control in Southern Malawi

Abstract:Although malaria is a controllable and preventable disease; it remains among the leading causes of mortality and morbidity in southern Malawi. The importance of early diagnosis and prompt treatment with hospital prescribed drugs and effective home management to control malaria is well established; however; these in part depend on how households make their decisions when family members have suffered from malaria. This study examines the behaviour of households with regard to decisions they make in managing malaria illness. Using hierarchically built data from a survey of 1;400 mothers nested within 33 communities; a series of two-level logistic regression models with Bayesian estimation was used to determine predictors of care-seeking behaviour towards malaria when a family member or a child was perceived to have malaria. The results show that most families normally visit or use medication prescribed at health facilities for both adult (80) and child (86) members when they are perceived to have malaria. The main obstacle to accessing the nearest health facility was distance and transport costs (73) and the main problems encountered at health facilities were long waiting time or absence of health workers (73) and shortage of drugs (35). Among the main predictor variables for choices of treatment for childhood malaria was the absence of a health surveillance assistant for those that visited hospitals [?=0.56; 95 CI:-0.86;-0.26]; bought medication from open markets [?=0.51; 95 CI:0.20;0.82]; and those that used other traditional methods or did nothing [?=0.70; 95