Parenting amid COVID­19: Challenges and supports for families with young children in South Africa

Background. National response mechanisms, including lockdown regulations and financial and food aid, have exacerbated adversity and provided support. They have also exposed existing inequalities, with individuals and families able to cope and recover to varying degrees. Families with young children, specifically those under the age of 5, are rarely the focus of outreach, although they care for the most vulnerable group in our society. Objective. To rapidly gather as much nationally representative information as possible on the challenges experienced by families with children under 5 years of age and the support they most urgently require. Methods. A short online survey was launched in late 2020 on a zero­cost mobile application reaching over 2 million users. A total of 15 912 individuals were eligible for participation and 13 224 parents (caring for 18 858 children under 5 years) were included in the analytic sample. Outcomes were grouped by (a) negative impacts of the pandemic, including disruptions in childcare, missed clinic visits, feeding challenges, difficulties in showing affection, behavioural challenges, and violence in the home; and (b) support received and required by the family. Chi­squared tests examined outcomes across the socio­demographic variables and standardised adjusted residuals were calculated to measure strength of differences. Results. Fathers made up 30% of the sample. Just over half of parents cared for one child under 5 and 41% for 2 ­ 3 children under 5. More than three­quarters (82%) of parents reported experiencing at least one challenge, with the most common being disruptions in childcare (69%), difficulties feeding their child (50%) and showing affection (41%). The main underlying factors were fear of infection, lack of money and negative affect in the household including stress, tension and a sense of hopelessness and depression. Fathers and families living in rural areas reported the most challenges. They were more likely to report difficulties showing affection, struggles in providing meals for young children, and higher levels of violence towards children in the home. Although needs considerably outweighed support received, government compared with civil society organisations and communities had the highest penetration of support to families, reaching between a quarter and a third of families. Conclusion. Families with young children face many challenges with little outside support for their material and psychosocial needs. It is essential that those mandated with ensuring the wellbeing of young children understand the needs of families and have the capacity to reach them in general, and particularly during times of crisis.

Prostaglandin E2 vaginal gel--a new formulation for the induction of labour.

In order to evaluate the efficacy of prostaglandin E2 gel in the induction of labour it was compared with a routine method of induction by oxytocin titration. A total of 50 patients were randomly allocated to two groups; 25 patients received intravaginal prostaglandin E2 gel and 25 oxytocin infusion. In both groups amniotomy was performed once the patient was in the active phase of labour. Successful outcome was regarded as established labour within 12 hours of commencement of the trial. In the oxytocin group this was achieved in 88% of multiparas and 75% of primigravidas. In the prostaglandin group the outcome was successful in 82% of multiparas and 75% of primigravidas.

Pregnancy in scleroderma. A case report.

Pregnancy is rare in scleroderma and the maternal and fetal prognosis poor. The outcome of such a case is described and the association reviewed.

Serological diagnosis of syphilis in pregnancy. Experiences at King Edward VIII Hospital, Durban.

Three different serological screening tests for syphilis were performed at the 'booking' visit of 500 antenatal patients at the King Edward VIII Hospital, Durban. The prevalence of active syphilis was 7,4%. The rapid plasma reagent test not only had a high biological false-positive rate at 11,8%, but also failed to detect 18,9% of the 37 patients diagnosed as having syphilis by means of the IgM-specific fluorescent treponemal antibody absorption (FTA-ABS) test. The Treponema pallidum haemagglutination (TPHA) test had a similarly high biological false-positive rate of 15,8%, but did not miss any of the 37 cases of active syphilis. The TPHA test is therefore advocated for screening patients for syphilis.