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1.
Worldwide Hospitality and Tourism Themes ; 2022.
Article in English | Web of Science | ID: covidwho-2107793

ABSTRACT

Purpose This paper aims to address the following questions: What is the impact of the pandemic on the hospitality industry in South Africa? Which innovations and strategies are in place to rebuild hospitality in South Africa? Design/methodology/approach This article emanates from the resent pandemic situation, and it is structured to include conceptual information drawn from the literature, empirical study and industry observation. These were conducted in 2020 and 2021 using, concepts from the literature, online questionnaires and observation to gather data about the impact of COVID-19 on hospitality operations across South Africa. Findings Historically literature shows that the hospitality industry positively impacts the economy and employment However, the pandemic greatly affected these contributions. The findings reported in the empirical study revealed that the pandemic affected business operations and employment and caused financial hardship for the industry. Originality/value There are relatively few studies that report on the issues relating to the pandemic and the hospitality industry in South Africa. This paper contributes to the literature regarding a pre-COVID-19 overview, the impact of the pandemic and the innovations and strategies in place to rebuild the hospitality industry.

2.
Glob Public Health ; : 1-12, 2022 Nov 07.
Article in English | MEDLINE | ID: covidwho-2107125

ABSTRACT

We explore how organisations working on parenting programmes and other types of family support and violence prevention in low-resource settings experienced the pandemic. In August 2020-May 2021, we interviewed (1) staff from three community-based organisations delivering evidence-informed parenting interventions and other psychosocial services for families in Cape Town, South Africa, (2) staff from a parenting programme training organisation and (3) staff from two international organisations supporting psychosocial services in South Africa. Interviews (22) were thematically analysed, with findings in three areas. First, respondents noted changes in the context, including the job losses, food insecurity, and stress experienced by local communities, and reductions in organisational funding. Second, we found that in response to these context changes, the organisations shifted their focus to food provision and COVID prevention. Parenting and psychosocial programmes were adapted - e.g. by changing the physical delivery settings, reducing group sizes, and taking up digital and phone implementation. Participants reported improved perceptions of remote delivery as a feasible approach for working with families - but internet and phone access remained challenging. Third, the pandemic brought new responsibilities for staff, and both the challenges of working from home and the health risks of in-person work.

3.
Emerg Infect Dis ; 28(10): 2016-2026, 2022 Oct.
Article in English | MEDLINE | ID: covidwho-2103284

ABSTRACT

Data on social contact patterns are widely used to parameterize age-mixing matrices in mathematical models of infectious diseases. Most studies focus on close contacts only (i.e., persons spoken with face-to-face). This focus may be appropriate for studies of droplet and short-range aerosol transmission but neglects casual or shared air contacts, who may be at risk from airborne transmission. Using data from 2 provinces in South Africa, we estimated age mixing patterns relevant for droplet transmission, nonsaturating airborne transmission, and Mycobacterium tuberculosis transmission, an airborne infection where saturation of household contacts occurs. Estimated contact patterns by age did not vary greatly between the infection types, indicating that widespread use of close contact data may not be resulting in major inaccuracies. However, contact in persons >50 years of age was lower when we considered casual contacts, and therefore the contribution of older age groups to airborne transmission may be overestimated.


Subject(s)
Mycobacterium tuberculosis , Respiratory Aerosols and Droplets , Aerosols , Models, Theoretical , South Africa/epidemiology
4.
Front Psychol ; 13: 949914, 2022.
Article in English | MEDLINE | ID: covidwho-2099226

ABSTRACT

The COVID-19 pandemic has affected the world of work. Stemming from this, new forms of work arrangements are proposed. One such arrangement concerns the use of remote working. Scholars appeal for more empirical inquiry into such work arrangements as an unintended consequence of the COVID-19 pandemic. The study narrows its focus to investigating remote working experiences from the lens of female middle managers operating within the South African public service. A qualitative research approach utilizing narrative inquiry of 23 female middle managers was used. Based on the analyzed data, remote working is illustrated from the participant experience as having intended and unintended consequences. In illustrating these dual consequences is a nexus between opportunities and challenges. Based on the identified intended and unintended consequences as findings, interventions have been proposed that impact not just the experience of being a middle manager in the public service but also strategies in dealing with remote working. At the core are strategies for individuals and organizations. These strategies potentially allow for middle manager contributions to be enhanced while also enhancing organizational outputs while working from home.

5.
Int J Infect Dis ; 125: 241-249, 2022 Nov 05.
Article in English | MEDLINE | ID: covidwho-2095476

ABSTRACT

OBJECTIVES: After South Africa's second wave of COVID-19, this study estimated the SARS-CoV-2 seroprevalence among pregnant women in inner-city Johannesburg, South Africa. METHODS: In this cross-sectional survey, 500 pregnant women who were non-COVID-19-vaccinated (aged ≥12 years) were enrolled, and demographic and clinical data were collected. Serum samples were tested using the Wantai SARS-CoV-2 spike antibody enzyme-linked immunosorbent assay and Roche Elecsys® anti-SARS-CoV-2 nucleocapsid antibody assays. Seropositivity was defined as SARS-CoV-2 antibodies on either (primary) or both (secondary) assays. Univariate Poisson regression assessed risk factors associated with seropositivity. RESULTS: The median age was 27.4 years, and HIV prevalence was 26.7%. SARS-CoV-2 seroprevalence was 64.0% (95% confidence interval [CI]: 59.6-68.2%) on the primary and 54% (95% CI: 49.5-58.4%) on the secondary measure. Most (96.6%) women who were SARS-CoV-2-seropositive reported no symptoms. On the Roche assay, we detected lower seroprevalence among women living with HIV than women without HIV (48.9% vs 61.7%, P-value = 0.018), and especially low levels among women living with HIV with a clusters of differentiation 4 <350 cells/ml compared with women without immune suppression (22.2% vs 56.4%, prevalence rate ratio = 0.4; 95% CI: 0.2-0.9; P-value = 0.046). CONCLUSION: Pregnant women attending routine antenatal care had a high SARS-CoV-2 seroprevalence after the second wave in South Africa, and most had asymptomatic infections. Seroprevalence surveys in pregnant women present a feasible method of monitoring the course of the pandemic over time.

6.
Prospects (Paris) ; 51(4): 563-572, 2022.
Article in English | MEDLINE | ID: covidwho-2094723

ABSTRACT

The COVID-19 pandemic is the largest social and economic shock of our lifetimes. As governments grapple with their responses to the virus, more than half the world's countries have closed their schools and severely limited almost all forms of public life. This will have a profound impact on children, both now and in the decade to come. As many countries start to send children back to school, a question arises: who should go back to school first? This Viewpoint addresses that question in the context of a middle-income country, South Africa. Based on a review of much of the evidence available at the time of publication, it concludes that the youngest children are least susceptible to harm from COVID-19, are less likely to spread the virus than adults, and also have the most to lose by being out of school. Hence, they should be the ones to return to school first.

7.
Non-conventional in English | Africa Wide Information | ID: covidwho-2092760

ABSTRACT

Just transitions towards sustainability, in which the equity and wellbeing of all South Africans and the environmental sustainability of the country’s valuable natural systems is prioritised, need to be commensurate with the scale of the challenge. They should deepen and pick up pace. And they must shift from managerialist approaches towards structural and transformative just transition ones, which add meaning to the mantra of ‘leaving no one behind’.The COVID-19 pandemic has unmasked (once more) the full extent of the inequalities between and within countries, and reinforced the need to carve a safe and just space for all of humankind. It has opened, in some places, the political moment to question the purpose of our economies. It is possible to build societies and economies that are more just, equal and inclusive;are better integrated with nature;that offer social protection for all and that are more informed by science, but only if we act now. A just transition is imperative to achieve the policy frameworks and processes that will deliver development pathways leading to a fair and sustainable world

8.
Front Reprod Health ; 3: 687677, 2021.
Article in English | MEDLINE | ID: covidwho-2089941

ABSTRACT

Khuluma is a psychosocial and peer-to-peer mHealth intervention that uses text messaging to facilitate support groups for adolescents living with HIV (ALWH) with the aim of contributing toward positive health outcomes. Although use of mobile technology in the form of mHealth interventions has proliferated recently in the field of health, published literature describing methods and processes of its application are limited. We present a set of methods and processes utilised to develop and pilot the Khuluma mHealth intervention amongst young people (15-20 years) in South Africa. We recruited and enrolled 52 adolescents (15-20-year olds) from four clinics in Pretoria and Cape Town to participate in a 6-month pilot of Khuluma. Participants were ALWH, aware of their status, on antiretroviral therapy for more than 12 months, and not suffering from severe depression. We conducted four pre and post intervention focus group discussions (FGDs) with a proportion of ALWH (n = 36) enrolled in the pilot study using participatory methods. Several processes were utilised to then implement this pilot study. These included engaging ALWH for minor study implementation modifications; forming virtual groups; activating the mHealth platform; facilitating and delivering the Khuluma intervention. The acceptability of the intervention was informed by follow-up focus group discussions and text message data. The initial participatory processes helped to tailor the intervention design to participants' needs. The peer-led facilitation of the groups allowed for the provision of sensitive psychosocial support that allowed young people to express themselves freely, develop a sense of self-worth, and interact more. The nature of the mobile technology also allowed participants to build friendships beyond their geographic area and interact with their peers in real time. Within the evolving context of COVID-19, establishing evidence-based processes and methods for intervention design and curation in virtual spaces is critical.

9.
Int J Prison Health ; ahead-of-print(ahead-of-print)2022 10 25.
Article in English | MEDLINE | ID: covidwho-2087990

ABSTRACT

PURPOSE: The menstrual health and menstrual hygiene management (MHM) of incarcerated women remains relatively low on the agenda of public health interventions globally, widening the inequitable access of incarcerated women to safe and readily available menstrual health products (MHP). The COVID-19 pandemic has adversely impacted on the MHM gains made in various development sectors in the global North and South, through its amplification of vulnerability for already at-risk populations. This is especially significant to developing countries such as South Africa where the incarcerated female population are an often-forgotten minority. DESIGN/METHODOLOGY/APPROACH: This viewpoint highlights the ignominious silence of research and policy attention within the South African carceral context in addressing MHM. The ethical and political implications of such silences are unpacked by reviewing international and local literature that confront issues of inequality and equitable access to MHP and MHM resources within incarcerated contexts. FINDINGS: Structural inequalities in various contexts around the world have exacerbated COVID-19 and MHM. Within the prison context in South Africa, women face multiple layers of discrimination and punishment that draw attention to the historical discourses of correctional facilities as a site of surveillance and discipline. RESEARCH LIMITATIONS/IMPLICATIONS: This study acknowledges that while this viewpoint is essential in rising awareness about gaps in literature, it is not empirical in nature. PRACTICAL IMPLICATIONS: The authors believe that this viewpoint is essential in raising critical awareness on MHM in carceral facilities in South Africa. The authors hope to use this publication as the theoretical argument to pursue empirical research on MHM within carceral facilities in South Africa. The authors hope that this publication would provide the context for international and local funders, to assist in the empirical research, which aims to roll out sustainable MHP to incarcerated women in South Africa. SOCIAL IMPLICATIONS: The authors believe that this viewpoint is the starting point in accelerating the roll out of sustainable MHP to incarcerated females in South Africa. These are females who are on the periphery of society that are in need of practical interventions. Publishing this viewpoint would provide the team with the credibility to apply for international and national funding to roll out sustainable solutions. ORIGINALITY/VALUE: It is hoped that the gaps in literature and nodes for social and human rights activism highlighted within this viewpoint establish the need for further participatory research, human rights advocacy and informed civic engagement to ensure the voices of these women and their basic human rights are upheld.


Subject(s)
COVID-19 , Menstruation , Female , Humans , Male , Hygiene , COVID-19/epidemiology , South Africa/epidemiology , Pandemics , Prisons
10.
Annual Review of Resource Economics ; 14:131-149, 2022.
Article in English | Web of Science | ID: covidwho-2082378

ABSTRACT

Accurate measures of productivity growth are an important policy tool but are difficult to obtain in South African circumstances. In this article, we review work on the measurement of farm-level productivity in South Africa since the earliest attempts at multifactor indices in the early 1990s. The focus is on total factor productivity, but single input measures such as labor and land productivity (yields) are also discussed. Measurements using time-series and cross-sectional data are discussed separately, along with measures to explain the effect of climate change. Data deficiencies are also pointed out. The article concludes that international collaboration should be maintained if important issues such as the COVID-19 impact, food security, climate change, and labor market shocks are to be successfully addressed.

11.
J Pharm Policy Pract ; 15(1): 66, 2022 Oct 18.
Article in English | MEDLINE | ID: covidwho-2079556

ABSTRACT

BACKGROUND: The effect of the COVID-19 pandemic on the mental health of healthcare workers is gaining attention globally. This study assessed the quality-of-working life (QoWL) and prevalence of, and risk factors for anxiety, depression and stress among South African pharmacists. METHODS: An online survey, after stratification by province, was sent to 3435 (target = 2454) randomly selected pharmacists between 14 April to 18 May 2021. Sociodemographic data were collected and mental health was assessed using the 7-item Generalized Anxiety Disorder scale, the 9-item Patient Health Questionnaire, Perceived Stress Scale and a modified Work-Related Quality-of-Life tool. Prevalence of anxiety, depression, stress and QoWL was estimated. A multivariate logistic regression analysis identified factors associated with mental health outcomes. RESULTS: A total of 953/2454 pharmacists (38.8%) responded. Of these, 56.5% were 40 years or younger, 78.5% were female, 45.4% were White race and 44.5% were practicing in a community pharmacy setting. Pharmacists demonstrated symptoms of anxiety (n = 605, 66.1%), depression (n = 561, 62.9%), stress (n = 642, 73.8%) and low QoWL (n = 409, 51.3%). Significant risk factors (aOR; 95%CI) for anxiety, depression and stress were female gender (1.96;1.36-2.83,1.84;1.27-2.67,1.58;1.05-2.38, history of mental health conditions (2.50; 1.52-4.13, 3.68; 2.19-6.19, 3.34;1.85-6.03) and significant COVID-19 mitigation changes to pharmacy practice (2.70; 1.36-5.38, 4.23; 2.06-8.70, 3.14;1.44-6.82), respectively. Practice changes were also associated with a low QoWL (5.19; 2.40-11.8). Compared to their Black/African colleagues, Indian pharmacists were at higher risk for anxiety (1.82; 1.03-3.23) and stress symptoms (2.28; 1.21-4.32), while risk for depression was significant amongst White pharmacists (1.86; 1.05-3.32). Pharmacists living apart from family were at significant risk for anxiety (1.66; 1.15-2.41), depression (1.52; 1.06-2.18) and low QoWL (1.60; 1.10-2.34). CONCLUSIONS: COVID-19 pandemic has had a significant negative impact on the mental health of South African pharmacists. Interventions to support the psychological well-being and improve QoWL of pharmacists are needed.

12.
Sci Afr ; 16: e01268, 2022 Jul.
Article in English | MEDLINE | ID: covidwho-2076695

ABSTRACT

SARS-CoV-2 (COVID-19) belongs to the beta-coronavirus family, which include: the severe acute respiratory syndrome coronavirus (SARS-CoV) and the Middle East respiratory syndrome coronavirus (MERS-CoV). Since its outbreak in South Africa in March 2020, it has lead to high mortality and thousands of people contracting the virus. Mathematical analysis of a model without controls was done and the basic reproduction number ( R 0 ) of the COVID-19 for the South African pandemic determined. Permissible controls were introduced and an optimal control problem using the Pontraygain Maximum Principle is formulated. Numerical findings suggest that joint implementation of effective mask usage, physical distancing and active screening and testing, are effective measures to curtail the spread of the disease in the human population. The results obtained in this paper are of public health importance in the control and management of the spread for the novel coronavirus, SARS-CoV-2, in South Africa.

13.
Indian J Labour Econ ; 65(3): 779-799, 2022.
Article in English | MEDLINE | ID: covidwho-2075764

ABSTRACT

For the last decade, India's National Rural Employment Guarantee Act (NREGA, 2005) has been the world's largest public works programme. This legal entitlement provided employment to 28 per cent of rural Indian households in 2019-2020. After the COVID-19 pandemic, NREGA is increasingly emerging as an invaluable employer of the last resort. However, longitudinal data of implementation in its first fifteen years reveal distinctive trends. On the one hand, since inception, NREGA has rendered greater benefits to women and marginalised communities. But on the other, since 2014 till before the pandemic, the present National Democratic Alliance (NDA) regime has reduced NREGA coverage compared to its implementation during the previous United Progressive Alliance (UPA) coalition government which had enacted the legislation. Nevertheless, in light of the pandemic and based on international experiences in public work programmes, there is an urgent need for the expansion of the employment guarantee.

14.
Education as Change ; 26:1-14, 2022.
Article in English | Web of Science | ID: covidwho-2072427

ABSTRACT

Social movements are at the forefront of fighting for another world as imposed to contend with it have severely impacted not only the activism of movements, but also their capacity to learn. Translocal social movement learning offers one way in which such learning can continue. This article shares reflections from participants involved in a translocal learning engagement between movement members and activist-scholars from Ghana, South Africa and Canada. It provides an important example of the kind of non-hierarchal social movement learning that can happen at a distance, when movements share, learn and support one another.

15.
South African Journal of Higher Education ; 36(4):47-65, 2022.
Article in English | Web of Science | ID: covidwho-2072348

ABSTRACT

The COVID-19 pandemic and the shift to emergency remote teaching (ERT) and online learning highlighted issues of social justice, pedagogical inclusion and epistemic access in higher education. The research underlying this article analyses the complexities of access to learning and the effects of the shift to ERT and online learning on the social justice agenda in South Africa, using the case study of the University of Johannesburg.The article uses the conceptual frameworks of epistemic access, equity and inclusive pedagogy from the theories of Fraser (2008), Mbembe (2016) and Mgqwashu (2016). Pedagogic continuity and inclusion (Motala and Menon 2020;Menon and Motala 2021), hard-won by many institutions during the pandemic, will need to be sustained and secured as the world adapts to a "new normal" in higher education and other spheres of life.Czerniewicz et al. (2020, 957) refer to the maxim "Anytime, anyplace, anywhere" characterising ERT as a "brutal underestimation of the complexities and entanglement of different inequalities and structural arrangements". Fataar (2020), Czerniewicz et al. (2020) and Hodges et al. (2020) advocate an alternative pedagogy that is "trauma-informed" and offers parity with the pedagogies that prevailed pre-pandemic.The article concludes that the pre-existing conditions of deep inequality and inequities, and a highly differentiated higher education system with uneven pedagogical practices, were exacerbated by the pandemic. While we acknowledge the achievement of avoiding the loss of the academic year during the pandemic, we argue that it is important to learn lessons from the initial implementation of ERT and the fractures that it highlights in higher education. Heading into an uncertain future, the sector needs explicit equity-driven approaches to ensure pedagogical inclusion beyond physical and epistemic access.

16.
South African Journal of Libraries and Information Science ; 88(1), 2022.
Article in English | Web of Science | ID: covidwho-2072139

ABSTRACT

A strategy in this paper was viewed as a plan of action for achieving the mission and vision of an organisation. This paper presents preliminary findings of the larger study which aimed to determine the strategies for research data management (RDM) at selected universities in KwaZulu-Natal. The current study used the community capability maturity model framework (CCMF) and the digital curation centre (DCC) lifecycle model as theoretical support to determine the strategies for RDM service provision with specific reference to the University of Zululand. The interpretive paradigm, following the qualitative research approach through a single case study, was used. Primary data was gathered through online interviews using Zoom and Teams with Librarians, Technicians, HODs, and DVC Research due to the Covid-19 pandemic and availability of technologies. The findings of the study revealed the University of Zululand does not have an RDM policy;however, research activities are practiced. The University lacks the infrastructure and investment to support RDM services and activities. The study is significant for providing the background for developing RDM in the public university through RDM strategy and policy. The findings also sought to inform the university's RDM agenda.

17.
Physical Sciences Reviews ; 0(0), 2022.
Article in English | Web of Science | ID: covidwho-2070806

ABSTRACT

South Africa, a country considered affluent in nature, ranks third in global biodiversity and encompasses approximately 9% of higher plants on planet Earth. Many indigenous plants have been utilised as herbal medicine, proving successful in treating numerous ailments. From the common cold to pandemic maladies such as COVID-19 in the 21st century and the treatment of incurable diseases, South African inhabitants have found great promise in the healing properties of these plants. Phytomedicine is a rapidly evolving topic, with in-depth bioactive composition analysis, identifying therapeutic action mechanisms, and disease prevention. While we are now poised to take advantage of nature's medicine cabinet with greater scientific vigour, it remains critical that these practises are done with caution. Overharvesting significantly impacts biodiversity and cultivation practices amidst the beautiful nature of these nutraceuticals. This book chapter focuses on the therapeutic potential of commonly used South African medicinal plants, their ethnopharmacological properties, and how we can conserve this treasure cove we call home for future generations.

18.
Library Management ; 2022.
Article in English | Web of Science | ID: covidwho-2070246

ABSTRACT

Purpose The purpose of the paper was to survey transformational leadership traits in three academic libraries in the Gauteng province in South Africa. The three academic libraries were chosen based on the fact that two of the universities were residential research-intensive universities and the third was an academic library of a distance learning university. Design/methodology/approach The study adopted a quantitative approach with a survey design in three academic libraries in the Gauteng province in South Africa in which a close-ended questionnaire yielded quantitative data. The study included 29 academic staff from the rank of assistant librarian to the director from the three academic libraries, as these are the personnel in leadership positions. To code and analyse, quantitative data from a Likert scale, SPSS version 25 was used. Cronbach's alpha was used to evaluate the instrument's reliability on the five constructs used in this study to determine readiness to adopt a transformational leadership style. The overall level of internal consistency exceeded the theoretical minimum of 70 percent. The Shapiro-Wilk test was used to determine the normality of the data and the p values were greater than 0.05 (p > 0.05). Tables have been used to present descriptive and inferential statistics based on data. Findings Participants expressed favourable opinions about academic libraries' ability to learn from the best practices of others in the profession, with mean scores greater than 3.5 on a 5.0 scale. Participants' perceptions of transformative versus traditional management styles yielded a moderate mean score of 3.0, with moderate mean scores ranging from 2.8 to 3.3. The average score for talent identification and succession planning in academic libraries was 3.5. Perceptions of leadership responsibilities had a mean score of 4.1, with attributes on leadership responsibilities scoring at least 3.5. Perceptions of problems for the next generation of leaders in academic libraries were moderate, with a mean score of 3.2 on a scale of 5.0. Research limitations/implications Only three of the seven public university libraries in the Gauteng province in South Africa were surveyed in this study. The sample size was reasonably small for generalizations beyond the South African Gauteng province academic libraries. However, it was felt useful for this particular case. A survey of all 26 South African public universities is required to assess transformational leadership traits in academic libraries. Practical implications Next-generation leaders in South African academic libraries are perceived as not being aggressive in terms of team building, coaching and motivating others. Social implications In the wake of COVID-19, new leadership traits such as scenario planning are needed for academic libraries. Originality/value Leadership studies abound in the library and information studies (LIS) profession and they are not new. However, research on transformational leadership in South African libraries is still in its early stages. As a result, this study fills a gap in the literature on transformative leadership in academic libraries in South Africa.

19.
Psychol Health Med ; : 1-26, 2022 Oct 15.
Article in English | MEDLINE | ID: covidwho-2070008

ABSTRACT

Growing evidence documents the effects of the COVID-19 pandemic on adolescents in East and Southern Africa. We present and explore the longitudinal health and development-related priorities and challenges of adolescent advisors in South Africa and Kenya, including prior to, and during the COVID-19 pandemic. Findings were co-generated with adolescent advisors in the Eastern Cape Province of South Africa (n=15, ages 18-22 in 2019) and Kisumu, Kenya (n=16, ages 10-14 in 2020). Prior to COVID-19, adolescent advisors engaged in a participatory exercise to share and explore their health and development-related priorities and challenges in 2019 and 2020. During the COVID-19 pandemic in 2020 and 2021, members of the same groups shared their experiences, challenges and coping strategies in semi-structured telephone interviews (Eastern Cape: n=14, aged 19-23; Kisumu n=12, aged 11-16) and group-based remote participatory social media activities (n=27 activities with n=12 advisors, Eastern Cape). We thematically analysed COVID-19 activities, considering them alongside pre-pandemic priorities and challenges. Many of the health and development-related priorities and challenges identified prior to COVID-19 remained issues of concern during COVID-19. These included education; victimization and violence; teenage pregnancy; substance use; household tension, conflict and inadequate family and caregiver support; health and medication concerns (South Africa) and water and food shortages (Kenya). Other issues such as financial insecurity, mental health, and crime were strong themes that emerged during COVID-19, which were not directly reported as priorities prior. Although almost all of adolescent advisors' most pressing pandemic-related challenges were also priorities for them prior to COVID-19, these issues were often discussed as new, and caused by the onset of COVID-19. While demonstrating how COVID-19 has exacerbated pre-existing vulnerabilities, we also suggest that the pandemic may have brought about a new way for adolescents to make sense of, and articulate pre-existing challenges.

20.
Afr J Prim Health Care Fam Med ; 14(1): e1-e9, 2022 Sep 28.
Article in English | MEDLINE | ID: covidwho-2066809

ABSTRACT

BACKGROUND: The coronavirus disease 2019 (COVID-19) has highlighted the scope of heroin dependence and need for evidence-based treatment amongst marginalised people in South Africa. Acute opioid withdrawal management without maintenance therapy carries risks of increased morbidity and mortality. Due to the high costs of methadone, Tshwane's Community Oriented Substance Use Programme (COSUP) used tramadol for opioid withdrawal management during the initial COVID-19 response. AIM: To describe demographics, route of heroin administration and medication-related experiences amongst people accessing tramadol for treatment of opioid withdrawal. SETTING: Three community-based COSUP sites in Mamelodi (Tshwane, South Africa). METHODS: A retrospective cross-sectional study was conducted. Data were collected using an interviewer-administered paper-based tool between April and August 2020. Descriptive statistics were used to analyse data. RESULTS: Of the 220 service users initiated onto tramadol, almost half (n = 104, 47%) were not contactable. Fifty-eight (26%) people participated, amongst whom most were male (n = 55, 95%). Participants' median age was 32 years. Most participants injected heroin (n = 36, 62.1%). Most participants experienced at least one side effect (n = 47, 81%) with 37 (64%) experiencing two or more side effects from tramadol. Insomnia occurred most frequently (n = 26, 45%). One person without a history of seizures experienced a seizure. Opioid withdrawal symptoms were experienced by 54 participants (93%) whilst taking tramadol. Over half (n = 38, 66%) reported using less heroin whilst on tramadol. CONCLUSION: Tramadol reduced heroin use but was associated with withdrawal symptoms and unfavourable side effects. Findings point to the limitations of tramadol as opioid withdrawal management to retain people in care and the importance of access to first-line opioid agonists.Contribution: This research contributes to the limited data around short-acting tramadol for opioid withdrawal management in the African context, with specific focus on the need for increased access to opioid agonists for those who need them, in primary care settings.


Subject(s)
COVID-19 , Substance Withdrawal Syndrome , Tramadol , Adult , Analgesics, Opioid/adverse effects , Communicable Disease Control , Cross-Sectional Studies , Female , Heroin/adverse effects , Humans , Male , Methadone/therapeutic use , Narcotics/adverse effects , Retrospective Studies , Substance Withdrawal Syndrome/diagnosis , Substance Withdrawal Syndrome/drug therapy , Substance Withdrawal Syndrome/rehabilitation , Tramadol/therapeutic use
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