Occupational Exposure to Bloodborne Viruses amongst Medical Practitioners in Bloemfontein; South Africa

Background : The possibility of occupational exposure to bloodborne viruses such as HIV; hepatitis B virus (HBV) and hepatitis C virus (HCV) is an everyday reality to health care workers. This study reports on doctors' extent and outcome of exposure to bloodborne viruses in Bloemfontein. Methods : descriptive study was done. Doctors (n=441) actively involved in public and/or private medical practice were requested to anonymously complete a questionnaire regarding occupational exposure to bloodborne viruses (HIV; HBV; and HCV). Results : A response rate of 51.7 was obtained. More than half (54.2; 95 CI [ 47.7 ; 60.5 ]) of respondents were exposed to bloodborne viruses; 48.3 occurring with HIV positive patients and 4.3with known HBV positive patients; and no positive HCV patients. After exposure occurred; 68.9 of patients were tested for HIV; 10.9 for HBV and only 4.2 for HCV infection. The frequency of serological testing for doctors immediately after exposure was 65.3 for HIV; 21.7 for HBV and 8.2 for HCV. No seroconversion to HIV or HCV was reported; while two seroconversions to HBV were reported. Most exposures occurred as a result of needle stick injury (85) and occurred in the operating theatre during . The majority (59.8procedures 59.3)of exposed doctors did not take any prophylactic treatment and those who did; did not always complete the treatmentConclusion : The risk of seroconversion to HIV after occupational exposure was as expected; while seroconversion to HBV was less than expected. The lack of adequate follow up serological testing after occupational exposure is alarming. It is the responsibility of the occupationally exposed doctor to adequately comply with prophylactic measures and undergo serological testing to ensure the least possible risk of contracting infection from a bloodborne virus

Knowledge of and Attitude towards Pain Relief during Labour of Women Attending

Objective: This study determined women's knowledge of and attitudes to pain relief during labour. Methods : This descriptive study included 151 women; 18 years or older; attending the antenatal clinic of Cecilia Makiwane Hospital. Women were interviewed using a questionnaire that determined their knowledge of and attitudes regarding pain relief. Results : The median age of the women was 29 years and most was pregnant for a second or third time. More than half the women (56.3) indicated that they knew about pain relief and most had received their information from a previous labour experience (56.5) or from friends and relatives (55.3). Of the women who had knowledge of pain relief (n=85); 65.9 had experienced severe pain during previous labour and 65.3 indicated injections. Half the women (51.7) believed that they should experience mild pain; however; while 55.7 of these had found the experience to be unacceptable. Most women (59.8) who had been pregnant were not told what to expect when in labour. Of those who had been told (n=41); 75.6) and good (31.2 found the information useful. The women who had previously delivered in a health facility rated the service received in relieving labour pain as fair (47.3)). Most of the women (99.3) believed that the staff had an important role to play in helping to relieve labour pain. Most of the women (78) expressed no concern about problems associated with pain relief methods; while a large number (83.4)expressed little or no confidence in labour pain relief.Conclusion : Most of the women gained knowledge regarding pain relief from past experiences or from friends and relatives. Even though the few women who received information about what to expect during labour found the information useful; most expressed little confidence in labour pain relief

Good Short-Term Outcome of Kangaroo Mother care in Low Birth Weight Infants in a Rural South African Hospital

Objective: The aim of the study was to determine the outcome of kangaroo mother care (KMC) in low birth weight infants at a community hospital. Methods : This descriptive study included 87 mothers and their low birth weight infants who were in a stable condition and eligible for KMC at Dr JS Moroka Hospital; Thaba Nchu. The infants were assessed four times: at birth; twice during hospitalisation; and a week after discharge. Infants received breast milk exclusively.Results : Regarding the mothers' obstetric history (n=87); gravidity ranged from 1 to 7 (median 3); with a 43 incidence of miscarriage. The median birth weight of the infants (n=87) was 1.5 kg (first assessment); the discharge weight (third assessment) was 1.8 kg; and a week after discharge (fourth assessment) it was 2.2 kg. Initially the infants lost weight significantly from birth to the second assessment (95 CI for median decrease [-0.02; -0.01]); but significantly gained weight from the second to the third (95 CI for median decrease [0.27; 0.33]) and from the third to the fourth assessment (95 CI for median decrease [0.32; 0.45]). Approximately half (49) of the infants had developed jaundice by the time of second assessment. These babies had a significantly lower birth weight [0.12;0.30]. Conclusion : Our findings confirm that infants with a low birth weight treated with KMC can have a good growth pattern; and exclusive breast milk is sufficient to guarantee such growth. Kangaroo mother care is a safe method for stable infants with a low birth weight in a community hospital

Nutritional Status of Disabled Schoolchildren in Bloemfontein (2002 - 2003)

Objectives. To assess the nutritional status of disabled schoolchildren using anthropometric measures and dietary intake; and to compare estimated energy expenditure with energy intake and body weight.Design. A descriptive; cross-sectional survey was undertaken.Setting. The study was conducted at three Bloemfontein schools for disabled children (Tswellang: physically disabled; Pholoho: mentally disabled; Martie du Plessis: both mentally and physically disabled).Subjects. Subjects included a random selection of 145 boys and girls aged 8 - 15 years.Outcome measures. Standard methods were used to determine height; demi-span; knee-height; weight; midupper arm circumference and triceps skinfolds. A 24-hour recall combined with a food frequency questionnaire and 7-day weighed food record were used to determine usual dietary intake of day scholars and hostel scholars respectively. Resting energy expenditure (REE) was calculated for each child using Shofield equations. Total energy expenditure (TEE) was calculated by multiplying the appropriate physical activity level (PAL) factor by REE. Results. The high prevalence of stunting (weight-for-height -2 standard deviations (SD)) (Tswellang 47.7; Pholoho 37.3); and underweight (weight-for-age -2 SD) (Tswellang 29.8; Pholoho 18.7) was a matter of concern. Although median energy intake was slightly lower than the recommended intakes; median protein intake tended to be adequate; while micronutrient intake was low. Median energy intake determined by the 24-hour recall tended to be lower (Pholoho -769 kJ) or nearly the same (Tswellang 327 kJ) as the calculated TEE (PAL1.2 - 1.8).Conclusion. Nutrient density and texture of the children's diet should be monitored to improve nutritional status. In future studies more accurate methods should be used to determine energy intake and expenditure

Profile of registrars and reasons for specialisation

Introduction The shortage of general practitioners is a worldwide phenomenon and occurs in countries such as Canada; the United States of America and Saudi Arabia. Increasingly fewer students are interested in general practice as an occupation. Choosing a speciality is a complex process and is dependent on a wide range of intrinsic and extrinsic factors; including preference at the start of studies; experience during undergraduate training; and environmental factors such as cultural and socio-economic background. The aim of this study was to determine the profile of registrars at theFaculty of Health Sciences (University of the Free State); as well as their reasons for specialisation. Method All departments were contacted and the first author circulated questionnaires and informed consent forms during the academic afternoons. Questionnaires and informed consent forms were available in Afrikaans and eng. Results Of the 150 questionnaires handed out; 109 were used for analysis (122 were received; of which 13 were incomplete). Most of the respondents were Afrikaans speaking (81.7