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1.
S Afr J Infect Dis ; 39(1): 619, 2024.
Article in English | MEDLINE | ID: mdl-38841342

ABSTRACT

Cholera, a severe diarrhoeal disease caused by Vibrio cholerae is typically associated with inadequate potable water supply and poor sanitation. We report cholera disease presentation identified as a suspected case of acute diarrhoea (HIV/AIDS common condition) in a person living with HIV seen in a cholera non-endemic area. Contribution: We highlight the importance of recognizing cholera in cases of acute diarrhoea, especially among people with HIV, in resource-constraint areas that lack potable water supply.

2.
S Afr Fam Pract (2004) ; 65(1): e1-e6, 2023 02 16.
Article in English | MEDLINE | ID: mdl-36861911

ABSTRACT

BACKGROUND: Postcaesarean surgical site infections (SSI) remain a burden globally. The Alexis® O C-Section Retractor, a plastic sheath retractor known to have decreased incidence of SSIs in gastrointestinal surgery, is yet to have its efficacy established during caesarean section (CS). This study aimed to compare the differences in the rate of postcaesarean surgical wound site infections between the Alexis® retractor and traditional metal retractors during CS at a large tertiary hospital in Pretoria. METHODS: Pregnant women scheduled for elective CS were prospectively randomised to either the Alexis® retractor group or the traditional metal retractor group at a tertiary hospital in Pretoria between August 2015 and July 2016. The defined primary outcome was development of SSI, and secondary outcomes comprised patients' peri-operative parameters. All participants' wound sites were observed in the hospital for 3 days before discharge and again at 30 days postpartum. Data were analysed using SPSS version 25 with p  0.05 considered significant. RESULTS: A total of 207 participants were involved, Alexis® (n = 102) and metal retractors (n = 105). None of the participants developed postsurgical site wound infection after 30 days, and there were no differences in time to delivery, total operative time, estimated blood loss or postoperative pain between the two arms of study. CONCLUSION: The study found no difference in participants' outcomes using the Alexis® retractor in comparison with the traditional metal wound retractors. We suggest that the use of Alexis® retractor be at the surgeon's discretion and its routine use not advised for now.Contribution: This research being the first of its kind in South Africa in which patients' clinical outcomes were compared post caesarean section from Alexis's plastic sheath group and metal retractors group in an attempt to proffer solution to the high burden of SSI. Although no difference was seen at this point, the research was pragmatic, as it was carried out in a setting with high burden of SSI. The study is going to serve as a baseline against which studies carried out in future can be compared.


Subject(s)
Body Fluids , Surgical Wound Infection , Pregnancy , Humans , Female , Surgical Wound Infection/epidemiology , Surgical Wound Infection/prevention & control , Cesarean Section/adverse effects , South Africa , Metals , Plastics
3.
Trop Doct ; 50(2): 130-134, 2020 Apr.
Article in English | MEDLINE | ID: mdl-31955654

ABSTRACT

A persistently high burden of tuberculosis (TB) and low cure rates in South Africa call for frequent assessment of the effectiveness of the TB programme. We conducted a retrospective cohort study to evaluate treatment outcomes and associated factors among new TB patients taking standard regimen 1 TB treatment during 2010 in Pretoria, using the World Health Organization's six treatment outcomes classification. The 85 participants (of whom 59% were female) had co-infection with HIV in 70%. A total of 52% completed treatment, but only 15% were officially cured; 13% died and only 35% had an end-of-treatment sputum test. The treatment success rate (cured and complete treatment) was 67%. Completion of TB treatment was associated with HIV status (P = 0.02) and TB diagnosis using only sputum smear test (P = 0.02). Our results suggest non-compliance with standard TB guidelines by healthcare workers. We therefore advise future interventions should target both patients and healthcare workers.


Subject(s)
Tuberculosis, Pulmonary/drug therapy , Adult , Aged , Coinfection/epidemiology , Female , Guideline Adherence , HIV Infections/epidemiology , Humans , Male , Medication Adherence , Middle Aged , Retrospective Studies , South Africa/epidemiology , Sputum/microbiology , Treatment Outcome , Tuberculosis, Pulmonary/diagnosis , Tuberculosis, Pulmonary/epidemiology , Young Adult
4.
South Afr J HIV Med ; 19(1): 762, 2018.
Article in English | MEDLINE | ID: mdl-29707386

ABSTRACT

BACKGROUND: Adherence in chronic disease conditions is described as the extent to which a person's behaviour corresponds to the prescribed medical advice of the healthcare provider. This is not limited to medication intake only but also includes acts such as following instructions regarding dietary or fluid restrictions and taking medicines at the prescribed times and intervals. Although adherence to antiretroviral therapy (ART) is a predictor of good clinical outcome among HIV-infected persons on ART, it is a major challenge and strict adherence is not very common. This article aims to examine the application and relevance of some cognitive-behavioural theories in antiretroviral therapy adherence. METHODS: After doing a thorough literature review, contemporary theories of health behaviour at the individual and interpersonal levels referred to as cognitive-behavioural theories were explored. This review highlights some aspects of the cognitive perspective of health behaviour theories as a good theoretical framework that could be used for organising thoughts about adherence and other health behaviours among patients on lifelong treatment such as ART. RESULTS: Key concepts of these theories stipulate that behaviour is mediated by cognition i.e. knowledge and attitude affect the person's action. In addition, cognitive-behavioural theories recognise knowledge alone as being insufficient to produce behavioural change; a person's perception, motivation, skills and social environment are all influential in the process of behavioural change. CONCLUSION: Prediction of medication adherence is complex, and health-related knowledge and beliefs alone are insufficient to achieve behaviour change, especially in chronic conditions such as HIV/AIDS. However, people can control or influence the events affecting their lives by integrating cognitive, social, and behavioural sub-skills related to beliefs of personal efficacy in performing these skills.

5.
Trans R Soc Trop Med Hyg ; 108(9): 582-8, 2014 Sep.
Article in English | MEDLINE | ID: mdl-25096293

ABSTRACT

BACKGROUND: Adherence in antiretroviral therapy (ART) is the extent to which the HIV-infected person's behavior corresponds to the prescribed medical advice in terms of using antiretroviral (ARV) drugs. Adherence includes acts such as following instructions regarding dietary or fluid restrictions and taking medications at the prescribed time. This study aimed to determine the extent to which persons on ART followed the scheduling and dietary instructions of their ARV drugs. METHODS: This was a cross-sectional descriptive study among 232 adult HIV-infected persons on ART using the AIDS Clinical Trials Group questionnaire. RESULTS: Based on self-reported adherence, 89.6% (208/232) of the participants reported complete adherence with regards to taking their prescribed medications. The specific dosing schedule of their ARV drugs was strictly followed by 47.4% (110/232) of the participants. Of the 146 patients with specific dietary instructions on how to take their ARVs, only 43.1% (63/146) followed them all of the time, 10.9% (16/146) never followed these instructions and 45.8% (67/146) partially followed these instructions. Participants who were unemployed were twice more likely to adhere to ART dosing schedules compared to others (OR=1.75; CI: 1.03-2.96; p=0.05). CONCLUSIONS: Participants in this study were adherent to taking prescribed medications only. They were found to be non-adherent to instructions regarding dietary or fluid restrictions and medication prescription time.


Subject(s)
Anti-HIV Agents/therapeutic use , Feeding Behavior/psychology , HIV Infections/drug therapy , HIV Infections/psychology , Medication Adherence , Adult , Cross-Sectional Studies , Drug Administration Schedule , Female , Follow-Up Studies , HIV Infections/epidemiology , Health Knowledge, Attitudes, Practice , Humans , Male , Medication Adherence/psychology , Medication Adherence/statistics & numerical data , Socioeconomic Factors , South Africa/epidemiology , Surveys and Questionnaires
6.
Trop Med Int Health ; 19(3): 342-347, 2014 Mar.
Article in English | MEDLINE | ID: mdl-24372667

ABSTRACT

OBJECTIVE: To identify the reasons for presentation of sexual assault more than 72 h after the incidents at Newcastle Hospital, South Africa. METHODS: A retrospective analysis of 534 medical records of victims seen between 2005 and 2009 at the hospital's sexual assault service centre. RESULTS: Overall, 219 (41%) of the victims presented at the hospital more than 72 h after the alleged sexual assault, mainly for fear of the perpetrator (37.4%). Females constituted 87%, and rape with vaginal penetration was the most common form of sexual assault reported (74%). Tests of significance showed a positive association between fear of the perpetrator and delayed presentation at hospital. Age under 9 years and being scared of what relatives would say about alleged sexual assault were also associated with delayed presentation. CONCLUSIONS: Attention needs to be focused on educating society on the importance of reporting sexual assault incidents promptly in order for victims to benefit from appropriate medical treatment.


Subject(s)
Crime Victims/statistics & numerical data , Disclosure , Emergency Service, Hospital/statistics & numerical data , Fear , Patient Acceptance of Health Care/statistics & numerical data , Sex Offenses/statistics & numerical data , Adolescent , Adult , Age Distribution , Aged , Aged, 80 and over , Child , Child, Preschool , Crime Victims/psychology , Female , Humans , Male , Medical Records/statistics & numerical data , Middle Aged , Odds Ratio , Patient Acceptance of Health Care/psychology , Post-Exposure Prophylaxis , Retrospective Studies , Risk Factors , Sex Distribution , Sex Offenses/psychology , South Africa/epidemiology , Time Factors , Young Adult
7.
Trop Doct ; 43(3): 106-7, 2013 Jul.
Article in English | MEDLINE | ID: mdl-23780869

ABSTRACT

Victims of sexual assaults are routinely tested for HIV in order to discover if they require prophylaxis. This study aimed to determine the prevalence of HIV infection among survivors of sexual assault attending a large peri-urban health facility in KwaZulu-Natal, a province of South Africa. Data from the medical records of the available 534 sexual assault cases that attended the facility between 2005 and 2009 were extracted and reviewed: 19.7% tested HIV positive and HIV prevalence among the survivors over the 5 years increased from 15% in 2005 to 19% in 2009. Screening sexual assault survivors for HIV provides a good opportunity to identify those who will benefit from HIV prophylaxis and HIV-infected persons who need HIV care and treatment.


Subject(s)
HIV Infections/epidemiology , Rape/statistics & numerical data , Adolescent , Adult , Aged , Aged, 80 and over , Child , Child, Preschool , Female , HIV Infections/drug therapy , HIV Infections/prevention & control , Humans , Male , Middle Aged , Prevalence , South Africa/epidemiology , Survivors/statistics & numerical data , Young Adult
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