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1.
Afr. j. AIDS res. (Online) ; 20(2): 117-124, 2021. tables
Article in English | AIM | ID: biblio-1284622

ABSTRACT

By the end of the first year of the COVID-19 pandemic, in February 2021, the numbers of cases and deaths in southern Africa were low in absolute and relative numbers. The BBC ran a story (which was later retracted) headlined "Coronavirus in Africa: Could poverty explain mystery of low death rate?". A heading in the New York Post said: "Scientists can't explain puzzling lack of coronavirus outbreaks in Africa". Journalist Karen Attiah concluded: "It's almost as if they are disappointed that Africans aren't dying en masse and countries are not collapsing". We wondered if the knowledge that southern African countries have acquired in their struggle against AIDS has contributed to a more effective approach against COVID-19. The viral origins of the diseases through zoonotic events are similar; neither has a cure, yet. In both diseases, behaviour change is an important prevention tool, and there are specific groups that are more vulnerable to infection. Equally, there are important differences: most people with COVID-19 will recover relatively quickly, while people living with HIV will need lifelong treatment. COVID-19 is extremely infectious, while HIV is less easily transmitted.


Subject(s)
Humans , SARS-CoV-2 , COVID-19 , South Africa , Tuberculosis , HIV Infections
2.
S. Afr. j. psychiatry (Online) ; 27(0): 1-8, 2021. Tables
Article in English | AIM | ID: biblio-1284404

ABSTRACT

Background: Studies exploring HIV knowledge, attitudes and practices (KAP) of individuals with severe mental illness (SMI) have suggested their poorer knowledge about HIV. In KwaZulu-Natal (KZN) province, South Africa (SA), the epicentre of the country's HIV epidemic, improving KAP is essential for reduce its incidence amongst individuals with SMI. Comparing the KAP related to HIV between those with SMI and chronic medical illnesses (CMI) such as hypertension and diabetes may expose gaps in KAP related to HIV in the mentally ill who are more vulnerable to HIV. Aim: This study aimed to compare the KAP related to HIV between people living with SMI and CMI. Setting: Outpatient clinics in Durban, SA. Methods: A cross-sectional structured questionnaire survey was conducted amongst 214 adult outpatients with SMI and CMI attending two general public sector hospitals in Durban, KZN. The KAP questionnaire consisted of three sections: general information, prevention and transmission of HIV. Results: Interviews were conducted with 124 patients with SMI and 90 with CMI. Most were female (69.5%), single (57.5%) and unemployed (59.4%). The diagnosis of SMI was associated with poorer general information of HIV (p = 0.02), but not with its prevention and transmission compared with those with CMI. Educational level was associated with poorer performance in all three domains: general information of HIV (p = 0.01), prevention (p = 0.01) and transmission (p = 0.02) amongst all the participants. Conclusion: Gaps in the KAP of HIV amongst individuals with SMI compared with those with CMI suggested a need to provide focused health promotion regarding sexual health and HIV to the mentally ill at psychiatric facilities


Subject(s)
Humans , HIV Infections , Health Knowledge, Attitudes, Practice , South Africa , Chronic Disease , Acquired Immunodeficiency Syndrome , Mental Disorders
3.
S. Afr. j. psychiatry (Online) ; 27(0): 1-10, 2021. Tables
Article in English | AIM | ID: biblio-1284400

ABSTRACT

Background: How people perceive the coronavirus disease 2019 (COVID-19) pandemic and understand their risk can influence their health, behaviours and overall livelihood. The disease's novelty and severity have elicited a range of attitudes and perspectives countrywide, which consequently influence the public's adherence to public health prevention and treatment guidelines. Aim: To investigate perceptions, experiences and knowledge on COVID-19 in a communitybased cohort study. Setting: Adults living in Soweto in South Africa's Gauteng province during the first six weeks of the national lockdown regulations (i.e. Alert Level 5 lockdown from end of March to beginning of May 2020). Methods: Participants completed a series of surveys and answered open-ended questions through telephonic interviews (n = 391). We queried their perceptions of the origins of COVID-19, understandings of the disease, personal and communal risks and its relations with the existing disease burden. Results: Findings from our sample of 391 adults show that perceptions and knowledge of COVID-19 vary across several demographic characteristics. We report moderate levels of understanding about COVID-19, prevention methods and risk, as well as exposure to major physical, psychosocial and financial stressors. Depressive symptoms, perceived infection risk and concern about COVID-19 significantly predicted COVID-19 prevention knowledge. Conclusion: Public health communication campaigns should focus on continuing to improve knowledge and reduce misinformation associated with the virus. Policymakers should consider the mental health- and non-health-related impact of the pandemic on their citizens in order to curb the pandemic in a manner that maximises well-being.


Subject(s)
Humans , Social Perception , COVID-19 , South Africa , Risk Factors , Knowledge
4.
Afr. j. health prof. educ ; 13(3): 159-160, 2021. Tables, figures
Article in English | AIM | ID: biblio-1343868

ABSTRACT

Due to Covid-19 regulations, occupational therapy students' access to clinical platforms was restricted and they were unable to perform traditional work integrated learning at approved placements. This situation compelled lecturers to design creative and innovative alternative fieldwork training activities for third-year occupational therapy students in the paediatric domain. In person fieldwork was converted (in part) to six case studies, presented by experts in synchronous online sessions. A structured and systematic approach was implemented to ensure student participation during and after presentations. Students worked in small groups to complete i) a professional reasoning tool and ii) an intervention plan and session to conceptualise and put into writing their selected theoretical approach to each case. One group was given the opportunity to present their work on the case on the day following the case presentation. Continuous formative feedback was provided during the presentation and integration of prior knowledge was encouraged through debate. Assessment focused on metacognition - the students' ability to reflect on their learning during each case. Students experienced the case studies as rich learning opportunities. This approach will be adapted for use in the post-pandemic era to enhance occupational therapy students' learning.


Subject(s)
Humans , Pediatrics , Occupational Therapy , Facility Regulation and Control , COVID-19 , South Africa , Virtual Reality
5.
S. Afr. med. j. (Online) ; 111(11): 1084-1091, 2021.
Article in English | AIM | ID: biblio-1344144

ABSTRACT

Background. There are limited in-depth analyses of COVID-19 differential impacts, especially in resource-limited settings such as South Africa (SA).Objectives. To explore context-specific sociodemographic heterogeneities in order to understand the differential impacts of COVID-19. Methods. Descriptive epidemiological COVID-19 hospitalisation and mortality data were drawn from daily hospital surveillance data, National Institute for Communicable Diseases (NICD) update reports (6 March 2020 - 24 January 2021) and the Eastern Cape Daily Epidemiological Report (as of 24 March 2021). We examined hospitalisations and mortality by sociodemographics (age using 10-year age bands, sex and race) using absolute numbers, proportions and ratios. The data are presented using tables received from the NICD, and charts were created to show trends and patterns. Mortality rates (per 100 000 population) were calculated using population estimates as a denominator for standardisation. Associations were determined through relative risks (RRs), 95% confidence intervals (CIs) and p-values <0.001. Results. Black African females had a significantly higher rate of hospitalisation (8.7% (95% CI 8.5 - 8.9)) compared with coloureds, Indians and whites (6.7% (95% CI 6.0 - 7.4), 6.3% (95% CI 5.5 - 7.2) and 4% (95% CI 3.5 - 4.5), respectively). Similarly, black African females had the highest hospitalisation rates at a younger age category of 30 - 39 years (16.1%) compared with other race groups. Whites were hospitalised at older ages than other races, with a median age of 63 years. Black Africans were hospitalised at younger ages than other race groups, with a median age of 52 years. Whites were significantly more likely to die at older ages compared with black Africans (RR 1.07; 95% CI 1.06 - 1.08) or coloureds (RR 1.44; 95% CI 1.33 - 1.54); a similar pattern was found between Indians and whites (RR 1.59; 95% CI 1.47 - 1.73). Women died at older ages than men, although they were admitted to hospital at younger ages. Among black Africans and coloureds, females (50.9 deaths per 100 000 and 37 per 100 000, respectively) had a higher COVID-19 death rate than males (41.2 per 100 000 and 41.5 per 100 000, respectively). However, among Indians and whites, males had higher rates of deaths than females. The ratio of deaths to hospitalisations by race and gender increased with increasing age. In each age group, this ratio was highest among black Africans and lowest among whites.Conclusions. The study revealed the heterogeneous nature of COVID-19 impacts in SA. Existing socioeconomic inequalities appear to shape COVID-19 impacts, with a disproportionate effect on black Africans and marginalised and low socioeconomic groups. These differential impacts call for considered attention to mitigating the health disparities among black Africans.


Subject(s)
Humans , Male , Female , Socioeconomic Factors , Health Status Disparities , COVID-19 , Inpatients , South Africa , Mortality
6.
S. Afr. med. j. (Online) ; 111(11): 1092-1097, 2021. Tables, figures
Article in English | AIM | ID: biblio-1344165

ABSTRACT

Background. The availability of well and functional healthcare workers (HCWs) and support staff is pivotal to a country's ability to manage the COVID-19 pandemic effectively. While HCWs have been identified as being at increased risk for acquisition of SARS-CoV-2 infection, there is a paucity of data pertaining to South African (SA) HCW-related infection rates. Global and provincial disparities in these numbers necessitate local data in order to mitigate risks. Objectives. To ascertain the overall SARS-CoV-2 infection rates and outcomes among all hospital staff at three hospitals in the Tshwane district of Gauteng Province, SA, and further determine associations with the development of severe COVID-19 disease. Methods. This retrospective audit was conducted across three academic hospitals in the Tshwane district for the period 1 June - 31 August 2020. Deidentified data from occupational health and safety departments at each hospital were used to calculate infection rates. A more detailed analysis at one of the three hospitals included evaluation of demographics, work description, possible source of SARS-CoV-2 exposure (community or hospital), comorbidities and outcomes. Results. The period prevalence of SARS-CoV-2 infections ranged from 6.1% to 15.4% between the three hospitals, with the average period prevalence being 11.1%. The highest incidence of SARS-CoV-2 infections was observed among administrative staff (2.8 cases per 1 000 staff days), followed by nursing staff (2.7 cases per 1 000 staff days). Medical doctors had the lowest incidence of 1.1 cases per 1 000 staff days. SARS-CoV-2 infections were categorised as either possibly community or possibly healthcare facility acquired for 26.6% and 73.4% of the infections, respectively. The administrative group had the highest proportion of possible community-acquired infections (41.8%), while doctors had the lowest (6.1%). The mean age of individuals with mild and severe disease was 41 years and 46.1 years, respectively (p=0.004). The presence of comorbidities was significantly associated with severity of disease (p=0.002). Conclusions. This study highlights that hospital staff, including administrative staff, are clearly at high risk for acquisition of SARS-CoV-2 infection during a surge.


Subject(s)
Administrative Personnel , Health Personnel , Coinfection , SARS-CoV-2 , COVID-19 , South Africa , Tertiary Care Centers
8.
Epidemiol. serv. saúde ; 30(1): e2020513, 2021. tab, graf
Article in English, Portuguese | LILACS | ID: biblio-1154140

ABSTRACT

Objetivo: Descrever as medidas de contenção de tipo lockdown e a incidência da COVID-19 em sete países: África do Sul, Alemanha, Brasil, Espanha, Estados Unidos, Itália e Nova Zelândia. Métodos: Estudo ecológico descritivo, com dados da incidência diária dos casos confirmados de COVID-19 entre 22 de fevereiro e 31 de agosto de 2020, e informações sobre medidas de lockdown implementadas pelo governo de cada país. Resultados: Os países que implementaram lockdown tiveram diminuição da incidência diária de COVID-19 (casos por milhão de habitantes) no período de três semanas, a contar do início da medida: África do Sul (3,7 a 1,7), Alemanha (37,5 a 33,7), Espanha (176,3 a 82,0), Itália (92,0 a 52,1) e Nova Zelândia (7,5 a 1,7). O Brasil e os Estados Unidos, que não implementaram lockdown, não apresentaram uma diminuição considerável. Conclusão: Após a implementação de lockdown, houve uma diminuição considerável do número de casos confirmados.


Objetivo: Describir las medidas de contención tipo lockdown y la incidencia de COVID-19 en los países de Sudáfrica, Alemania, Brasil, España, Estados Unidos, Italia y Nueva Zelanda. Métodos: Estudio ecológico descriptivo con datos de la incidencia diaria de los casos confirmados de COVID-19, del 22 de febrero al 31 de agosto de 2020 e informaciones sobre medidas de contención lockdown implementadas por los gobiernos de cada uno de los países. Resultados: Los países que implementaron lockdown, desde el inicio de su implementación hasta tres semanas después, tuvieron una disminución en la incidencia diaria (casos por millón de habitantes): Sudáfrica (3,7 a 1,7), Alemania (37,5 a 33,7), España (176,3 a 82,0), Italia (92,0 a 52,1) y Nueva Zelanda (7,5 a 1,7). Brasil y Estados Unidos, que no implementaron lockdown, no tuvieron una disminución considerable Conclusión: Luego de la implementación del lockdown, hubo una disminución considerable en el número de casos confirmados.


Objective: To describe lockdown-type containment measures and COVID-19 incidence in South Africa, Germany, Brazil, Spain, United States, Italy and New Zealand. Methods: This is a descriptive ecological study with data on daily incidence of confirmed COVID-19 cases from February 22 to August 31 2020, as well as information on lockdown measures implemented by the governments of each country. Results: Daily COVID-19 incidence (cases per 1 million inhabitants) decreased within three weeks after lockdown started in the countries that implemented it: South Africa (3.7 to 1.7), Germany (37.5 to 33.7) Spain (176.3 to 82.0), Italy (92.0 to 52.1) and New Zealand (7.5 to 1.7). As for Brazil and the United States, which did not implement lockdown, there was no considerable decrease. Conclusion: After lockdown implementation, there was a considerable decrease in the number of confirmed cases.


Subject(s)
Humans , Psychological Distance , Quarantine/methods , Communicable Disease Control/statistics & numerical data , Coronavirus Infections/prevention & control , Coronavirus Infections/epidemiology , South Africa/epidemiology , Spain/epidemiology , United States/epidemiology , Brazil/epidemiology , Incidence , Ecological Studies , Pandemics/prevention & control , Germany/epidemiology , Health Policy/trends , Italy/epidemiology , New Zealand/epidemiology
9.
Int. j. morphol ; 38(6): 1662-1667, Dec. 2020. tab, graf
Article in English | LILACS | ID: biblio-1134495

ABSTRACT

SUMMARY: The celiac trunk is the first major unpaired branch of the abdominal aorta found at the twelfth vertebral level (T12). It gives off branches supplying the spleen, liver and the stomach. However, the branching patterns of the celiac trunk tend to vary by population throughout the world. We sought to investigate the branching patterns of the celiac trunk in a South African Caucasian sample. The celiac trunk was assessed by visual observation in 66 dissected bodies comprised of both males (n= 30) and females (n=36). These samples were obtained at the School of Anatomical Sciences, University of the Witwatersrand, Johannesburg. The celiac trunk arose directly from the abdominal aorta in all cases, with none connected to the superior mesenteric artery. We observed celiac trunk trifurcation in 84.84 % of the sample, although a celiac trunk with four branches was observed in 10.61 %. Bifurcation into the common hepatic and splenic arteries forming a hepatosplenic trunk (2 females) or into the left gastric artery and splenic artery forming a splenogastric trunk (1 male) was also observed. The results are largely comparable with other studies in Caucasians, showing a high rate of celiac trunk trifurcation (above 75 %). Our sample exhibited fewer variations than reported in previous studies worldwide. Therefore, a larger study with more samples may be required in the future to ascertain all the existing celiac trunk branching patterns in the South African Caucasian population.


RESUMEN: El tronco celíaco es la primera rama principal de la parte abdominal de la aorta en el nivel de la duodécima vértebra torácica (T12), con ramas que irrigan el bazo, el hígado y el estómago. Sin embargo a nivel mundial, las ramificaciones del tronco celíaco tienden a variar según la población. En este estudio se investigaron los patrones de ramificación del tronco celíaco en una muestra caucásica sudafricana. El tronco celíaco se analizó mediante observación visual en 66 cuerpos disecados compuestos por hombres (n = 30) y mujeres (n = 36). Estas muestras se obtuvieron en la Facultad de Ciencias Anatómicas de la Universidad de Witwatersrand, Johannesburgo. El tronco celíaco surgió directamente de la parte abdominal de la aorta en todos los casos, sin que ninguno estuviera unido a la arteria mesentérica superior. Se observó trifurcación del tronco celíaco en el 84,84 % de la muestra, aunque en el 10,61 % se observó un tronco celíaco con cuatro ramas. También se observó bifurcación en las arterias hepática y esplénica común formando un tronco hepatoesplénico (2 mujeres) o en la arteria gástrica izquierda y la arteria esplénica formando un tronco esplenogástrico (1 hombre). Los resultados son comparables con otros estudios en caucásicos que muestran una alta tasa de trifurcación del tronco celíaco (mayor al 75%). Nuestra muestra presentó menos variaciones que las reportadas en estudios previos. Por lo tanto, es posible que se requieran estudios más amplios con más muestras en el futuro, para determinar todos los patrones de ramificación del tronco celíaco en la población caucásica sudafricana.


Subject(s)
Humans , Male , Female , Celiac Artery/anatomy & histology , Anatomic Variation , Aorta, Abdominal , South Africa , Splenic Artery , Stomach/blood supply , Mesenteric Artery, Superior , Liver/blood supply
10.
Braz. j. otorhinolaryngol. (Impr.) ; 86(3): 294-299, May-June 2020. tab, graf
Article in English | LILACS | ID: biblio-1132593

ABSTRACT

Abstract Introduction: South Africa has a high prevalence of co-existing tuberculosis and HIV. As ototoxicity linked to the treatments for these conditions occurs with concomitant exposure to other ear toxins such as hazardous noise exposure, it is important to investigate the combination impact of these toxins. Limited published evidence exists on the co-occurrence of these conditions within this population. Objectives: The objective of this study was to compare the hearing function of gold miners with (treatment group) and without (non-treatment group) the history of tuberculosis treatment, in order to determine which group had increased risk of noise induced hearing loss. Furthermore, possible influence of age and HIV in these two groups was examined. Methods: A retrospective record review of 102 miners' audiological records, divided into two groups, was conducted, with data analyzed both qualitatively and quantitatively. Results: Findings suggest that gold miners with a history of tuberculosis treatment have worse hearing thresholds in the high frequencies when compared to those without this history; with evidence of a noise induced hearing loss notch at 6000 Hz in both groups. Pearson's correlations showed values between 0 and 0.3 (0 and −0.3) which are indicative of a weak positive (negative) correlation between HIV and hearing loss, as well as between hearing loss and age in this population. Conclusions: Current findings highlight the importance of strategic hearing conservation programs, including ototoxicity monitoring, and the possible use of oto-protective/chemo-protective agents in this population.


Resumo Introdução: A África do Sul apresenta uma alta prevalência de coinfecção de tuberculose e HIV. Como a ototoxicidade associada aos tratamentos para essas condições é observada na exposição concomitante a outros agentes ototóxicos, como a exposição a ruídos perigosos, é importante investigar o impacto da combinação desses agentes. São poucas as evidências publicadas sobre a co-ocorrência dessas condições nessa população. Objetivo: Comparar a função auditiva de garimpeiros com (grupo tratamento) e sem (grupo sem tratamento) história de tratamento de tuberculose, a fim de determinar que grupo apresentava maior risco de perda auditiva induzida por ruído. Além disso, avaliou-se a possível influência da idade e do HIV nesses dois grupos. Método: Os registros audiológicos de 102 garimpeiros, divididos em dois grupos, foram revisados de forma retrospectiva; os dados foram qualitativa e quantitativamente analisados. Resultados: Os achados indicam os garimpeiros com histórico de tratamento de tuberculose apresentam piores limiares auditivos nas altas frequências quando comparados àqueles sem esse histórico; em ambos os grupos, observou-se perda auditiva induzida por ruído com entalhe audiométrico a 6.000 Hz. As correlações de Pearson mostraram valores entre 0 e 0,3 (0 e -0,3), que são indicativos de uma fraca correlação positiva (negativa) entre o HIV e a perda auditiva, bem como entre a perda auditiva e a idade nessa população. Conclusões: Os resultados atuais destacam a importância de programas estratégicos de conservação auditiva, inclusive monitoramento de ototoxicidade, e o possível uso de agentes oto-/quimioprotetores nessa população.


Subject(s)
Humans , Adolescent , Adult , Middle Aged , Young Adult , Tuberculosis/epidemiology , Occupational Exposure/adverse effects , Gold , Hearing Loss, Noise-Induced/epidemiology , Mining , Noise, Occupational/adverse effects , Occupational Diseases/epidemiology , South Africa/epidemiology , Prevalence , Cross-Sectional Studies , Retrospective Studies , Risk Factors , Hearing Loss, Noise-Induced/diagnosis , Hearing Tests
11.
Article in English | AIM | ID: biblio-1263516

ABSTRACT

Objective: The aim of this study was to conduct a situational analysis as part of formative work to inform the development of community-based mental health services for children and adolescents at a district level. The purpose of the situational analysis was to determine the current state of child and adolescent mental health (CAMH), the available resources for CAMH, the range of services provided, and the existing pathways to CAMH care in a low-resource district with a view to developing a district mental health plan to improve access to CAMH services.Methods: Data for this situational analysis was collected from a rural district in the KwaZulu-Natal province using mixed methods. The qualitative component explored various stakeholders' (n = 26) perspectives using semi-structured interviews. The quantitative data for the study was collected using an adaptation of the situation analysis tool developed by the PRIME consortium.Results: The findings revealed the need to strengthen all the basic building blocks of the health system due to the weaknesses identified in the current CAMH care system in the district. The result of the situational analysis revealed that the provision of CAMH services in the district is sparse, uncoordinated, and not prioritised.Discussion: The findings of the study highlighted a severe shortage of specialised CAMH services in the district, poor integration of CAMH services into primary health care, and at the community platform there are deficits in the integrated school health programme. Further, the lack of a coordinated intersectoral collaborative system and well-defined referral pathways were revealed.Conclusion: The study highlights various challenges facing CAMH services at the Amajuba district. While these are not new, the study contributes to our understanding of the district level factors that may hinder the development of a district CAMH plan


Subject(s)
Adolescent Health , Family Planning Policy , Mental Health , Psychology, Adolescent , South Africa
12.
Article in English | AIM | ID: biblio-1256659

ABSTRACT

The demonstrated efficacy of pre-exposure prophylaxis (PrEP) has brought hope of controlling the epidemic among women with limited HIV preventation options. Several studies have demonstrated the importance of male partner involvement in female sexual and reproductive health but there is limited research on male involvement in the adoption of HIV prevention methods among women. Using a culture-centred approach, this article discusses perceptions of female-initiated HIV prevention methods among men and women. The data were collected using eight sex-specific focus group discussions with a sample of men and women aged between 18 and 49 years from selected urban and rural settings in two provinces of South Africa, KwaZulu-Natal and Mpumalanga. Thematic analysis was utilised to identify four key themes: increased infidelity in relationships and risky behaviour; association of PrEP with casual relationships; a partner's right to know that women are reducing their risk of HIV infection; and that men need to engage in decision-making on HIV risk reduction. The article highlights the importance of partner engagement and knowledge sharing of female-initiated prevention methods as part of a combination HIV-prevention strategy, and the urgency of creating enabling environments to utilise female-initiated methods


Subject(s)
Male , South Africa , Women
13.
Article in English | AIM | ID: biblio-1256660

ABSTRACT

In South Africa, adolescents are a key population in the HIV epidemic that can benefit from increased access to oral pre-exposure prophylaxis (PrEP). HIV testing is an integral component of the PrEP care continuum but adolescents in South Africa have generally low HIV testing rates; therefore, adolescents' HIV testing attitudes and behaviours must be understood to develop strategies for effective PrEP implementation. Ten focus groups were conducted with adolescents living with HIV and HIV-uninfected adolescents (n = 55), and in-depth interviews were conducted with service providers (n = 25), adolescents living with HIV (n = 10) and HIV-uninfected adolescents (n = 25). Data were collected in the Western Cape province of South Africa from 2015­2016. Thematic framework analysis was used to understand dynamics by which South African adolescents' attitudes toward HIV testing might influence intended uptake of PrEP and, reciprocally, to explore the implications of adolescents' perceptions about PrEP availability for their willingness to engage in HIV testing. While South African adolescents' current HIV testing attitudes and behaviours present barriers to intended PrEP implementation in this population, increased access to PrEP has the potential to improve their initial HIV testing rates and decrease stigma and fear around HIV testing. However, implementation of PrEP must consider specific HIV testing barriers for adolescent boys and girls, respectively. As PrEP becomes more widely available for adolescents, possible challenges noted by participants may include the potential for adolescents to reduce continued HIV testing behaviours while on PrEP and to share/use unprescribed PrEP medications among peers


Subject(s)
Pre-Exposure Prophylaxis , South Africa
14.
Article in English | AIM | ID: biblio-1256665

ABSTRACT

Background: Young adults such as university students are considered to be a key population for HIV-prevention efforts. This study aimed to determine the perceptions, practices and needs of undergraduate medical students regarding HIV-prevention measures available on campus. Methods: The research design was descriptive cross-sectional. Data were collected using an anonymous, self-administered questionnaire distributed to all 745 undergraduate medical students in the School of Clinical Medicine, University of the Free State, South Africa, of whom 470 responded (63.1%). Results: Almost half (45.5%) of all respondents across the five academic years had received information about available HIV-prevention measures on campus. Most reported that information had been received during lectures (59.7%) and only 24.2% from the local health clinic on campus. The findings also revealed that 14.2% of students had used at least one prevention measure in the past, while the majority of students (70.2%) used abstinence as an HIV-prevention measure. A large percentage of all the students (47.6%) had been tested for HIV before the start of the study. Two-thirds (67%) of students indicated that the current HIV-prevention services on campus were not sufficient. Conclusion: Medical students received HIV-prevention information as part of their curriculum but this was deemed not to be sufficient. This study suggests that tertiary education institutions should evaluate the effectiveness of strategies currently in place for the distribution and awareness of HIV-prevention measures and sexual health issues affecting students, using a student-centred approach


Subject(s)
Condoms , Condoms, Female , Health Services , Sexual Abstinence , South Africa
15.
South. Afr. j. anaesth. analg. (Online) ; 26(3): 116-127, 2020. ilus
Article in English | AIM | ID: biblio-1272262

ABSTRACT

Patients with confirmed COVID-19 admitted to intensive care units have a high mortality rate, which appears to be associated with increasing age, male sex, smoking history, hypertension and diabetes mellitus. Methods: A systematic review to determine risk factors and interventions associated with mortality/survival in adult patients admitted to an intensive care unit (ICU) with confirmed COVID-19/SARS-CoV-2 infection. The protocol was registered with PROSPERO (CRD42020181185).Results: The search identified 483 abstracts between 1 January and 7 April 2020, of which nine studies were included in the final review. Only one study was of low bias. Advanced age (odds ratio [OR] 11.99, 95% confidence interval [CI] 5.35­18.62) and a history of hypertension were associated with mortality (OR 4.17, 95% CI 2.90­5.99). Sex was not associated with mortality. There was insufficient data to assess the association between other comorbidities, laboratory results or critical care risk indices and mortality.The critical care interventions of mechanical ventilation (OR 6.25, 95% CI 0.75­51.93), prone positioning during ventilation (OR 2.06, 95% CI 0.20­21.72), and extracorporeal membrane oxygenation (ECMO) (OR 8.00, 95% CI 0.69, 92.33) were not associated with mortality. The sample size was insufficient to conclusively determine the association between these interventions and ICUmortality. The need for inotropes or vasopressors was associated with mortality (OR 6.36, 95% CI 1.89­21.36). Conclusion: The studies provided little granular data to inform risk stratification or prognostication of patients requiring intensive


Subject(s)
COVID-19 , Critical Care Outcomes/mortality , Intensive Care Units , Meta-Analysis as Topic , Risk Factors , SARS Virus , South Africa , Survival , Systematic Reviews as Topic
17.
Occup. health South. Afr. (Online) ; 18(26): 153-161, 2020.
Article in English | AIM | ID: biblio-1268093

ABSTRACT

Background: Stress has become a part of everyday life for most employees. Studies have shown the negative effect that stress has on employee wellbeing. Stress management intervention (SMI) programmes are commonly implemented by organisations to reduce work-related stressors, as well as to assist employees to cope with and minimise the impact of stress. Objectives: We aimed to explore the causes of stress at a vehicle manufacturing company, and the perceptions of employees about the effectiveness of an SMI programme. Methods: A qualitative interpretive approach was followed, using a case study design. The research was conducted at a vehicle manufacturing company in Pretoria, South Africa; eleven purposively sampled permanent white- and blue-collared employees who had participated in an SMI programme were included. Data were collected from personal interviews and a focus group discussion. The data were analysed using the ATLAS.ti software. Results: Some of the causes of stress in the workplace, identified by the participants, were company ethics and culture, interpersonal conflict, management style, deadlines, workload, type of job, job profiles, job insecurity, incompetence of employees, lack of resources, and remuneration. Most participants (90.9%) evaluated the SMI as being very effective. Conclusion: The causes of stress amongst workers are multifactorial. Effective SMIs can assist to alleviate stress and to equip employees with skills to manage stress. This promotes a healthy workforce and increases productivity. If SMIs are not implemented effectively, there might be loss in productivity, increased absenteeism, and deteriorating health in the workforce


Subject(s)
Manufacturing Industry , Occupational Diseases , Occupational Stress , Social Perception , South Africa
18.
Non-conventional in English | AIM | ID: biblio-1278047

ABSTRACT

Background: Electrocardiogram (ECG) is the only practical, non-invasive method of recording and analysing cardiac abnormalities. It enables a primary healthcare (PHC) clinician to detect cardiac and non-cardiac abnormalities, some potentially life-threatening. Their early detection could save a patient's life. Aim: The aim of this study was to evaluate the competence of generalist practitioners in ECG interpretation. Setting: This study was conducted at the Annual Refresher Course, Council for Scientific and Industrial Research (CSIR), Pretoria. Methods: A cross-sectional study was conducted amongst 93 generalist practitioners, using a self-administered questionnaire containing 20 ECG tracings, commonly encountered in PHC. The tracings were categorised into primary ECG parameters, ECG emergencies and common ECG abnormalities. Competence was determined by the generalist practitioner's number of correctly interpreted ECG tracings. Data associations were computed using the Fisher's exact test. Statistical significance was set at p ≤ 0.05. Results: Correct heart rate calculation was achieved by 14/83 (16.9%), ECG rhythm by 7/83 (8.4%), acute antero-septal myocardial infarction (MI) by 29/83 (34.9%), atrial fibrillation by 19/83 (22.9%) and cute inferior MI by 22/83 (26.5%) generalist practitioners. No correlation was found between the practitioners' number of years in practice and competence in ECG interpretation (p > 0.05). The total number of correct answers achieved by all practitioners was 274/1860 (14.7%). Conclusion: The generalist practitioners had poor competency on ECG interpretation regardless of the number of years in practice. Their poor self-rating corresponded with the number of correct answers they provided. There is a need for continuous education in ECG interpretation


Subject(s)
Electrocardiography , General Practitioners , Professional Competence , South Africa
19.
S. Afr. fam. pract. (2004, Online) ; 62(1): 1-6, 2020. tab
Article in English | AIM | ID: biblio-1270124

ABSTRACT

Background: The MMed in Family Medicine is a professional Master's qualification spanning 4 years of training. The outcomes were predetermined by national consensus. While these outcomes are measured in the form of a national exit examination, there has been no exploration of the experiences of registrars (residents) in this relatively new programme. To evaluate the experiences of registrars in one of the nine training programmes in South Africa and to identify areas for improvement. Methods: This study used purposive sampling to recruit registrar (n = 9) and supervisor (n = 8) participants into respective groups. Data were collected via semi-structured interviews and analysed thematically, and consensus was built using the nominal group technique. Results: Supervisors identified the strengths and weaknesses of the programme which will impact on further strategic planning. Data from registrar interviews yielded two themes: affirmation, referring to the positive social engagement and facilitation of professional identity formation; and frustrations, referring to structural aspects of the programme which hindered academic progress. Conclusion: Qualitative programme evaluation is a useful tool in understanding the learning environment. The student perspective helped to identify the unintended consequences of the programme. It was also shown that the nominal group consensus building technique worked well in a resource-constrained environment


Subject(s)
Family Practice , Physicians, Family/education , Primary Health Care , Program Evaluation , South Africa
20.
Article in English | AIM | ID: biblio-1270125

ABSTRACT

South Africa is in the grip of a novel coronavirus pandemic (COVID-19). Primary care providers are in the frontline. COVID-19 is spread primarily by respiratory droplets contaminating surfaces and hands that then transmit the virus to another person's respiratory system. The incubation period is 2­9 days and the majority of cases are mild. The most common symptoms are fever, cough and shortness of breath. Older people and those with cardiopulmonary co-morbidities or immunological deficiency will be more at risk of severe disease. If people meet the case definition, the primary care provider should immediately adopt infection prevention and control measures. Diagnosis is made by a RT-PCR test using respiratory secretions, usually nasopharyngeal and oropharyngeal swabs. Mild cases can be managed at home with self-isolation, symptomatic treatment and follow-up if the disease worsens. Contact tracing is very important. Observed case fatality is between 0.5% and 4%, but may be overestimated as mild cases are not always counted. Primary care providers must give clear, accurate and consistent messages on infection prevention and control in communities and homes


Subject(s)
COVID-19 , Coronavirus Infections , Disease Management , Education, Medical, Continuing , Primary Health Care , SARS Virus , South Africa
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