Demographic transformation of the physiotherapy profession in South Africa: A retrospective analysis of HPCSA registrations from 1938 to 2018.

RATIONALE, AIM AND OBJECTIVE: The physiotherapy profession did not escape the effects of racially based segregatory practises. While numerous strategies and initiatives have been employed to redress the inequities of the past, the extent of demographic transformation within the physiotherapy profession in South Africa remains uncertain. Transformation is defined in this article as an intentional change aimed at addressing inequalities and the ultimate goal is for population group and gender profiles of higher education graduates to be representative of the national epidemiological profile. This paper describes the demographic patterns of Health Professions Council of South Africa (HPCSA) registered physiotherapists from 1938 to 2018. METHOD: A retrospective record review of the HPCSA database from 1938 until 2018 was performed. De-identified data were extracted, coded and analyzed for descriptive purposes. Z-tests were used for analysis of proportion differences, along with P-values and 95% confidence intervals for interpretation. RESULTS: In 2018, 7663 physiotherapists (6350 women and 1313 men) were registered with the HPCSA. Most registered physiotherapists (55.6%) were classified as white, followed by black (17.3%), coloured (10.3%) and Indian (9.8%). A progressive increase was found in the number of new registrations over time (1949-2018) by black (0.00%-24.38% of total new registrations), coloured (0.00%-15.47%) and Indian individuals (0.00%-10.03%), with a statistically significant increase in newly registered black therapists in the decade prior to 2018 (P = .005). Gender transformation appears to be occurring at a slower pace as the profession remains female-dominated (82.9% of registered physiotherapists in 2018). CONCLUSION: There has been a steady transformation of the South African physiotherapy graduates composition regarding population categories and gender. However, it is clear that much more than selection criteria is needed to transform the profession in a way that is nationally representative, remain actively accountable for transformation and apt for local context.

Association of Chronic Khat Chewing with Blood Pressure and Predictors of Hypertension Among Adults in Gurage Zone, Southern Ethiopia: A Comparative Study.

PURPOSE: The leaves of the Khat plant contain amphetamine-like compounds which are implicated in the development of hypertension. The increase in blood pressure coincides with the plasma cathinone level. Other factors associated with hypertension are being overweight, obesity, cigarette smoking, alcohol use, physical inactivity, unhealthy diet, and stress. Thus, this study assessed the association of chronic khat chewing with hypertension and other factors associated with hypertension. PATIENTS AND METHODS: Acommunity based comparative cross-sectional study was undertaken from October 5, 2018 to February 15, 2019 in Gurage zone, southern Ethiopia. A total of 1200 adults (600 chewers and 600 non-chewers) aged 18 - 65 years were selected using a convenience sampling method. The data was collected by an interviewer-administered questionnaire plus physical measurements and were carried out at a fixed time of the day in the morning (7: 00 am-10:00 am). Linear regression and binary logistic regression analysis were performed to identify the determinant factors of blood pressure. The test of statistically significant association was declared by using 95% CI and p-value less than 0.05. RESULTS: A total of 1198 adults participated in the study giving a response rate of 99.8%. The mean age of Khat chewers were 34 (± 11.27) and non-chewers were 34.73 (± 11.48) years. The mean values of systolic blood pressure and diastolic blood pressure were higher in chewers than in non-chewers (p < 0.001). The prevalence of diastolic blood pressure > 80mmHg was significantly higher among Khat chewers than in non-chewers (17.4% versus 8.7%, p < 0.001). The duration of Khat chewing was significantly associated with systolic blood pressure (Beta coefficient = 0.83, p < 0.001) and diastolic blood pressure (Beta coefficient = 0.51, p < 0.001). The sex, age, BMI and alcohol were significantly associated with both systolic and diastolic blood pressure. CONCLUSION: Chronic Khat chewing, male sex, BMI and alcohol were associated with increased systolic and diastolic blood pressure. To assess the cause and effect relationship between chronic Khat chewing and hypertension further studies with better defined cohorts and basic science studies need to be undertaken.