Musculoskeletal disorders among nurses in high acuity areas in a tertiary hospital in South Africa

The purpose of this cross-sectional study was to investigate the prevalence of musculoskeletal disorders (MSDs) among nurses at a tertiary hospital in South Africa. Self-administered questionnaires were completed by 125 nurses. The mean age of the nurses was 42 years. A high proportion of the nurses reported experiencing musculoskeletal discomfort and related disorders. Most (80.8) worked 12 hour shifts and 84 experienced some form of musculoskeletal discomfort (related to MSDs) in the past year. The lower back was the most commonly reported body site (58); followed by the shoulder (21); and neck (20). Logistic regression analysis showed that nurses working 12 hour shifts had an increased risk of MSD of 14.17 (OR= 14.17; 95 CI: 4.586; 43.766) when compared to those working 8 hours shifts. The number of working hours per shift needs to be reduced to prevent MSDs in nurses. One way of doing this is to increase nursing staff numbers

A Profile on Health Status and Medical Conditions of Patients Staying Longer than the Set Norm at a District Hospital in South Africa

The average length of hospital stay is regarded as a key determinant of greater hospital costs. The objectives of this quantitative; retrospective; descriptive study were to determine the health status and medical conditions of patients with increased length of stay at a district hospital in Limpopo Province. A total of 609 patients' records with longer than average length of stay; from January to December 2007; were selected by stratified random sampling. The most prevalent diseases for staying longer were infectious and parasitic diseases; symptoms; signs etc; and injury; poisoning and consequences of causes yielding more than a third (36and 12; respectively; for each classification). Neoplasm-related admissions; in which cancer was identified as the most prevalent; stayed in hospital for an average of 14.6 days. The average length of stay for all disease classifications ranged from 7.1 days to 14.6 days. The length of stay at Elim Hospital is mostly influenced by the type of health conditions which are diagnosed. Further research is needed to find influential factors that might contribute to patients staying longer than normal

Prevalence and Profile of Injuries in Khorixas District Hospital; Namibia

The aims of this study were to identify the demographic characteristics of injury victims and the types of injury cases seen and admitted for treatment in Khorixas District Hospital; Namibia. A descriptive retrospective survey of all injuries attended to and admitted in the hospital from January 2001 to December 2004 was done using document review of patients' medical records. A total of 331 injury cases (6.8of all admissions) were admitted. The age group 20-29 years was the most commonly affected; with 18injured. Injury was common among the males (76). The unemployed constituted 36of all the injuries; followed by children/infants (19). Over two-thirds (68) of the injuries were unintentional. Cuts and stabs were the most common (24) type of injury among the injury cases admitted. Motor vehicle accidents accounted for 21of all injuries admitted. Over a third (36) of all the injuries were alcohol related. Farmers (11) constitute the most affected group among the employed. Type of injury and occupation were significantly associated (?2=107.879; p 0.001). Mass propagation of anti-violence education is needed to reduce the high rate of intentional injuries among the injuries such as cuts/stabs; assaults; human bite and gunshot injuries

Perceived Susceptibility of Cervical Cancer Screening among Women Attending Mahalapye District Hospital; Botswana

Cervical cancer is a significant cause of morbidity and mortality in Botswana. Papanicolaou (Pap) cervical cytology screening has helped to reduce cervical cancer rates dramatically through early detection of premalignant lesions in countries with screening programmes that have been well implemented. The objectives of this cross-sectional study were to describe the women's perceived susceptibility to cervical cancer and the association between socio-demographic characteristics. A total of 300 participants were selected by convenience sampling techniques. Participants' mean age was 37 years (SD=11). Results indicated that cervical cancer screening rates were 39. Most of those that had ever been screened for cervical cancer (64); had been screened in the previous three years. Most of the participants (75) were aware of their perceived susceptibility to cervical cancer. There was a significant association between perceived susceptibility and screening for cervical cancer (c2=20.86; p0.001). Among those with low perceived susceptibility to cervical cancer; 31had screened for cervical cancer as compared to 59screening rates among those with high perceived susceptibility to cervical cancer. Those with high perceived susceptibility were 3.2 times more likely to screen for cervical cancer (OR=3.24; 95CI:1.937-5.43) than those with low perceived susceptibility. High susceptibility rates significantly associated with being married (c2=9.44; p=0.051); employed (c2 = 13.077; p 0.001); monthly income more than $411 (c2

Timing of Spontaneous Birth and the Risk of Adverse Perinatal Outcome

The study aspired to assess the impact of time of birth on spontaneous onset of labour and delivery. A retrospective descriptive study was conducted from the Empangeni Hospital delivery registry on 9;397 infant births between January to December 2005; weighing more than 1;000 g. Logistic regression; adjusting for birth weight and for gender was used to estimate the relationship between spontaneous birth and timing of birth. A higher proportion of births (59) occurred between 10h00 and 22h00 of the day. Estimating the hourly births; we found that the daytime peak is 5.3and occurred at 10h00 while the night-time peak is 4.9and occurred at 20h00. Maternal age was significantly associated with the timing of spontaneous births (p 0.05). A higher proportion of preterm babies was born during the day (6.4) and early night (3.4) compared to late night births (1.6). There were significant differences between multiple births and low birth weight infants born during the day (1.1; 6.9) and night (0.8; 6.3). However; low birth weight babies were born mostly during early night rather than late night (4vs. 2.3; p 0.05). Adverse pregnancy outcome; measured by estimating the perinatal mortality rate; was the same for day and night and was equally distributed between early and late night. Timing of birth of infants did not influence the negative outcomes of pregnancy among this study population

Risk Factors for Anaemia in Pregnancy in Rural KwaZulu-Natal - South Africa: Implication for Health Education and Health Promotion

Background: Anaemia in pregnancy is a major public health problem in developing countries. It is associated with an increased risk of maternal and perinatal morbidity and mortality. A high rate of anaemia in pregnancy in the rural population of KwaZulu-Natal (30according to national and 57according to the World Health Organization [WHO] definition of anaemia in pregnancy) is observed. The risk factors for anaemia; particularly during pregnancy; are multiple and complex and their relative contributions are known to vary by geographic areas and by seasons. In order to design an intervention for treatment and prevention of anaemia in pregnancy; studies to assess the aetiological factors are necessary. The aim of this study was to evaluate the strength of association between intestinal helminthiasis; urinary schistosomiasis and HIV infection on anaemia in pregnancy. Methods: A retrospective case-control study design was used in a rural district hospital of South Africa. A total of 300 pregnant women; 100 of them with anaemia (haemoglobin less than 10 gm/dL according to the national definition of anaemia in pregnancy) referred as cases and 200 controls were studied from Empangeni Hospital. Both cases and controls were matched for age; parity and gestational age. Data were collected from the antenatal clinic and prevention of mother-to-child transmission of HIV (PMTCT) programme registers for cases and controls at their booking visit during the months of May; June and July of 2004. Univariate and multiple logistic regression were performed to analyse the data. Results: Of the cases; 48and 1among the controls had intestinal helminthiasis; resulting in the odds ratio of 42 (p = 0;000 and 95CI 9;96 -176.59). The risk of anaemia was related to urinary schistosomiasis; as 27of the cases compared to 1of controls was found with anaemia. The odds ratio was 12 (p = 0;000 and 95CI 3.58 - 41.02). These parasitic infestations are known to cause chronic haemorrhage and iron deficiency resulting in the development of anaemia in pregnancy. Transmissions of intestinal parasitic infestation occur through the faecal-oral route. Personal hygiene and other environmental factors are therefore an important factor for the transmission of the disease. To reduce the transmission of faecaloral diseases (e.g. intestinal helminthiasis and urinary schistosomiasis) key interventions recommended are: 1) safe disposal of human excreta; 2) hand-washing practices with soap after defecation; and 3) maintenance of drinking water free from faecal contamination. Similarly; HIV infection increased the chance of developing anaemia in pregnancy twofold as HIV infection was more common among cases (56) than among controls (37); resulting in an odds ratio of 2.11 (p = 0;003 and 95CI 1.123 - 3.21). The prevention of HIV infection and transmission can be achieved through the improvement of knowledge of these conditions. These can be achieved through health education and health promotion. Conclusion: These findings confirm and conform to other studies on the association between anaemia in pregnancy and parasitic and HIV infections. Antenatal care should promote de-worming and education on personal hygiene and HIV (risk factors; mode of transmission; etc.). The provision of safe water supply and toilet facilities for the rural communities should be considered urgently to prevent and promote better health for all; including pregnant women

Knowledge of and Attitude Towards Cervical Cancer among Female University Students in South Africa

The objectives of this descriptive cross-sectional study were to assess the knowledge of the risk factors associated with; and detection methods of cervical cancer among female undergraduate students at Mangosuthu University of Technology. A total of 389 students were selected by stratified random sampling techniques. Participants' mean age was 20 years (SD=2). Results indicated that 51.2students were currently involved in a sexual relationship; with 19.2reporting two or more sexual partners in the past year. Less than half (42.9) of the participants had heard of cervical cancer and of these; 26 (15.6) did not know any risk factors for cervical cancer; while 96 (58.6) of 164 participants who knew of risk factors; did not know that cervical cancer is preventable. One-hundred and sixty-three (41.9) participants had heard about the Pap smear test. That the Pap smear test is used for detection or prevention of cervical cancer; was known to 62 (38) of the respondents. Only 16 (9.8) participants had had a Pap smear test. Among those who knew about the Pap smear test (n=136); 86 respondents did not have the test done mainly because of personal factors such as fear of the procedure; cultural or religious reasons; and were not ill (61.1). Findings suggest low level of knowledge on cervical cancer and its risk factors and detection method among these female university students. The university should thus concentrate on developing policies on health education and promotion; particularly targeting preventable health conditions; eg. cervical cancer and strategies to prevent transmission of the human papillomavirus

Evaluation of Cervical Cancer Screening Program at a Rural Community of South Africa

Objective: Cervical cancer is a leading cause of deaths among women worldwide. But the condition is preventable through regular screening of women those are 'at risk' for abnormal changes in the cervix and treating them who have positive results. Although screening facilities are available in South Africa; the incidence and mortality from cervical cancer remains very high and many women present health facilities with late stage diseases. Purpose of the study is to determine the baseline information on knowledge and practices on risk factors for cervical cancer and Pap smear and to design an intervention to improve Pap smear uptake. Methods: A cross-sectional population based descriptive study was undertaken at a rural community of South Africa targeting women 30 years and over. The assessment was performed by means of a questionnaire survey. Outcome measures were percentage of women with the knowledge on risk factors for cervical cancer and use of Pap smear test and had undertaken Pap smear test. Binary logistic regression analysis was carried out to identify possible predictors of Pap smear test undertaken. A total of 611 women (random samples) were recruited from the selected households. Results: The mean age of the sample was 43 years and 54of them had no education. Only 6knew all and 65knew any one of the risk factors of cervical cancer whereas less than half (49) of them knew that Pap smear is used for prevention of cervical cancer. Only 43respondents received information on Pap smear from health care workers. Among all the respondents only 18(95CI; 15-21) had ever done Pap smear test. Conclusions: This study showed low uptake of Pap smear test and low level of knowledge on prevention of cervical cancer and risk factors thus warrants urgent extensive health education program for this rural communities

Injury Profile in KwaZulu-Natal; South Africa: Implications for Prevention

Background: Prevention and control of injuries require generating relevant information on the magnitude; characteristics and determinants of injuries. Objective: The objective of this study was to describe the characteristics of injuries and predict the severity of injury with other variables. Design: A cross - sectional descriptive study was conducted at the hospitals of KwaZulu - Natal. Information was gathered from a total of 428 injured patients randomly selected from hospital attendances. Multivariate logistic regression analysis was performed to identify the risk factors for severity of injury. Results: Over 60of injury victims were below the age of 30 years. The economically active group (21 - 60 years) also constituted about 60of injury victims. Over half of the victims reported that the scene of incidence was private house; yard and road. One fifth was transport related injury whereas majority was violence (50). Unintentional injury was 28.8. Most of the injuries were minor (42.3) to moderate (41.1) in severity. Odds Ratio for alcohol related violence was 11. Conclusion: In order to reduce injuries appropriate multisectoral interventions; broader policies and strategies; regulating transport and alcohol use; routine testing of alcohol to identify the problem-drinkers for rehabilitation. Interventions should also include health education and health promotion and law enforcement