Hypoxaemia on Arrival in a Multidisciplinary Intensive Care Unit

BACKGROUND:Transport of the critically ill patient poses the risk of numerous complications. Hypoxaemia is one such serious adverse event and is associated with potential morbidity and mortality. It is; however; potentially preventable.OBJECTIVE:To determine the incidence of hypoxaemia on arrival in a tertiary multidisciplinary intensive care unit (ICU) and to identify risk factors for this complication.METHOD:A retrospective observational study was conducted at King Edward VIII Hospital; Durban; South Africa; from May 2013 to February 2014.RESULTS:Hypoxaemia occurred in 15.5% of admissions sampled. Statistically significant risk factors for hypoxaemia on univariate analysis (petlt;0.05) included lack of peripheral capillary oxygen saturation (SpO2) monitoring; transfer by an intern as opposed to other medical/paramedical staff; and transfer from internal medicine. Use of neuromuscular blockers and transfer from theatre were protective. Binary logistic regression analysis revealed lack of SpO2 monitoring to be the only significant independent predictor of hypoxaemia (odds ratio 6.1; 95% confidence interval 1.5 - 24.5; p=0.02).CONCLUSION: Hypoxaemia is common on admission to the ICU and may be prevented by simple interventions such as appropriate transport monitoring

HIV/AIDS Misconceptions may be Associated with Condom Use among Black South Africans: an Exploratory Analysis

In South Africa; approximately 20of 15-49-year-olds are infected with HIV. Among black South Africans; high levels of HIV/AIDS misconceptions (e.g. HIV is manufactured by whites to reduce the black African population; AIDS is caused by supernatural forces or witchcraft) may be barriers to HIV prevention. We conducted a cross-sectional study of 150 young black adults (aged 18-26; 56males) visiting a public clinic for sexually transmitted infections; to investigate whether HIV/AIDS misconceptions were related to low condom use in main partner relationships. We assessed agreement with HIV/AIDS misconceptions relating to the supernatural (e.g. witchcraft as a cause of HIV) and to genocide (e.g. the withholding of a cure). In multivariate models; agreement that `Witchcraft plays a role in HIV transmission' was significantly related to less positive attitudes about condoms; less belief in condom effectiveness for HIV prevention; and lower intentions to use condoms among men. The belief that `Vitamins and fresh fruits and vegetables can cure AIDS' was associated with lower intentions among men to use condoms. Women who endorsed the belief linking HIV to witchcraft had a higher likelihood of unprotected sex with a main partner; whereas women who endorsed the belief that a cure for AIDS was being withheld had a lower likelihood of having had unprotected sex. Knowledge about distinct types of HIV/AIDS misconceptions and their correlates can help in the design of culturally appropriate HIV-prevention messages that address such beliefs

Factors Influencing the Utilisation of Prevention of Mother-to-Child-Transmission (PMTCT) Services by Pregnant Women in the Eastern Cape; South Africa

"The aim of the study was to identify factors influencing the utilisation of Prevention of Mother-to-Child Transmission (PMTCT) in a resource poor setting in South Africa. A sample of 186 pregnant women (29.6HIV positive and 70.4HIV negative) in four clinics in a rural district in the Eastern Cape were interviewed as part of the PMTCT programme after they had received their HIV test results. Regarding infrastructure; most women lacked transport to and communication with a health facility. More than 90felt that they had received adequate information on most of the components of the PMTCT programme. About 90of the women were satisfied with the HIV counselling they had received. Most women (54) felt they would receive support during their pregnancy mainly from their mothers; and/or husband/partner (50). Most pregnant women (92) preferred to give birth in hospital; while 8prefer to deliver at home; mostly with the assistance of a traditional birth attendant (TBA). Two-thirds of the HIV positive women stated they would feed their babies with formula milk only. Community attitudes towards people living with HIV/AIDS were mostly perceived as negative. Factors influencing the utilisation of PMTCT (that is the acceptance of antiretroviral therapy to HIV positive women; facility-based delivery; and adherence to ""take-home"" ART identified for mother and newborn); included: (1) HIV counselling by health care staff; (2) physical access to a health facility; (3) family and community support; (4) stigma; (5) delivery preference; and (6) infant feeding preferences."