South African Family Practice最新文献

Background:  Voluntary medical male circumcision (VMMC) is a significant biomedical and cost-effective intervention in preventing human immunodeficiency virus (HIV) transmission. This study aimed to compare VMMC before and during coronavirus disease 2019 (COVID-19) in Gauteng, one of the most affected provinces in South Africa by HIV and/or acquired immunity deficiency syndrome (AIDS) and COVID-19, to inform VMMC delivery and uptake during future pandemics.

Method:  A comparative analysis. Routine VMMC data were obtained from all public and private hospitals in Gauteng province from the District Health Information System and medical schemes. The datasets were merged with the years 2019 and 2020 as before and during COVID-19 periods, respectively. Percentage change in VMMC was calculated to determine changes in VMMC before and during the COVID-19 pandemic.

Results:  Provincially, VMMC declined in 2020 by an overall 33.8% for ≥ 10 years, 32.4% for 10-14 years and 35.8% for ≥ 15 years. All five districts in Gauteng province were affected differently. Exceptionally, the Tshwane Metropolitan district recorded an increase of 21.8% in ≥ 10 years and 36.0% in 10-14 years, despite a decline of -18.2% in ≥ 15 years in VMMC. While the other four districts saw a significant percentage decline in the three age groups of VMMC, the highest disruption was experienced in the West Rand district, in all three age groups.

Conclusion:  In 2020 during the COVID-19 pandemic, VMMC substantially declined in Gauteng province. However, Tshwane, one of the five districts in Gauteng experienced an increase in VMMC, highlighting a health system resilient lesson to be learned. The fight against HIV is crucial and warrants the continuum of VMMC during future crises.Contribution: The evidence may inform policies on VMMC delivery post-COVID-19 and particularly during future outbreaks as a strive to curb HIV transmission in South Africa.

Background:  Human immunodeficiency viruses (HIV) and/or acquired immunodeficiency syndrome remains a significant global health issue, affecting millions of individuals worldwide. Medical male circumcision (MMC) demonstrated effectiveness in decreasing the spread of HIV, more specifically through heterosexual contact with HIV-positive partners. Studies have shown a correlation between male circumcision and lower HIV prevalence, especially in regions where circumcision is a cultural practice. The purpose of the study was to determine the knowledge and attitudes of men utilising the MMC services regarding circumcision.

Methods:  A cross-sectional study was conducted at a community health centre involving 164 male participants aged 18 years and above using a self-administered questionnaire. Descriptive and inferential statistics were used to determine means, frequencies and associations between knowledge and attitudes of men regarding male medical circumcision.

Results:  The median age of men seeking MMC services was 30 years, with hygiene cited as the primary reason by 88.4% of them. In addition, a majority (92%) were mindful of the advantages of circumcision in terms of lowering the risk of sexually transmitted infections and penile cancer (90%).

Conclusion:  Hygiene emerged as the primary reason for seeking MMC, contrasting with other studies where cultural and religious factors were more common. Despite significant knowledge levels regarding MMC's health benefits, the overall attitudes towards the procedure were predominantly negative.Contribution: The study highlights a unique factor influencing the decision to undergo MMC in a community health setting and awareness of its health benefits.

Background:  South Africa is experiencing a devastating human immunodeficiency virus (HIV) epidemic, with approximately 7.8 million people living with HIV. International health programs such as the World Health Organization (WHO) and the Centres for Disease Control (CDC) have been assisting citizens in combating the epidemic, but social factors continue to contribute to its spread. The study sought to examine social factors that contribute to the transmission of HIV in Madidi Village, as little is known about this population.

Methods:  The study employed a qualitative design and non-probability sampling. Face-to-face, semi-structured, in-depth interviews using a schedule guide were used to obtain data. To capture all of the interviews, a tape recorder was utilised with the permission of the 12 participants with ages ranging from 18 to 49 years.

Results:  The study revealed that the majority of participants were aware of HIV transmission and understood that it cannot be cured. However, misconceptions about HIV transmission still exist; for example, one of the participants stated that HIV can be transmitted through Colgate, which has not been scientifically proven to be a transmitter of HIV.

Conclusion:  This study shows that people need to be educated more about HIV/AIDS and that the Department of Health officials should play a role in supporting rural areas like Madidi Village to curb the spread of HIV.Contribution: As women and young girls are the most vulnerable members of the society, they must be enabled to take control of their lives.

South Africa has a critical shortage of geriatricians and a growing ageing population. Most geriatric patients are cared for by their primary care practitioner who may not have been trained in the care of the older adult. The comprehensive geriatric assessment (CGA) is the cornerstone of the geriatric consultation but can be time-consuming. By using a common sense approach to the geriatric patient, none of the important components of the CGA will be missed. The mnemonic 'COMMON SENSE' can be used as a tool to assist in identifying the common conditions that older adults experience, as well as highlight specific considerations that become increasingly important in this population. Many simple and time-effective screening tools are available to assist in diagnosing the geriatric syndromes which can be easily implemented in a busy primary care practice.

The 'Mastering your Fellowship' series provides examples of the question format encountered in the written and clinical examinations for the Fellowship of the College of Family Physicians of South Africa (FCFP [SA]) examination. The series is aimed at helping family medicine registrars prepare for this examination.

Background: In Namibia, the Omuthiya Antiretroviral Therapy (ART) Clinic has indicated that nine older adolescents (15-19 years) out of 125 adolescents active on ART have defaulted and become lost to care. This represents an 89% retention rate among older adolescents compared to a 97% retention rate for the adult population in the same facility. There is a lack of information on the extent of ART adherence among older adolescents, particularly in terms of viral suppression rates. This study aims to measure the level of adherence to ART treatment among adolescents enrolled at the Omuthiya ART Clinic in the Oshikoto Region, Namibia.

Methods: From November to December 2020, a cross-sectional study was conducted among 100 adolescents living with HIV (ALHIV) at the Omuthiya ART Clinic. Data were collected through structured questionnaires and analysed using descriptive statistics and logistic regression.

Results: The study found that 24% of adolescent patients on ART treated at the Omuthiya ART Clinic are non-adherent to treatment. A significant association found was between education level and adherence (p = 0.008), alcohol use and adherence (p = 0.022) and memory aids use and adherence (p  0.001).

Conclusion: Adolescents' adherence to ART at the Omuthiya ART Clinic is influenced by educational level, alcohol use, and memory aid use. Further research is needed to explore other potential factors influencing adherence.Contribution: These findings may be used to develop ongoing strategies and targeted interventions that prioritise a patient-centred care approach, recognising the autonomy of adolescents. In addition, they highlight the importance of a supportive family environment in managing HIV and improving ART adherence.

Background: Patient safety incidents (PSIs) cause harm to patients, including falls, accidental ingestion and physical assault. Despite their importance in healthcare, limited information exists on how South African speech-language therapists (SLTs) perceive them in the public and private sectors. This study applied the Donabedian model of patient safety and healthcare quality to SLTs' perspectives on PSIs.

Methods: Free attitude interviews with 10 South African SLTs explored the environment (where and who), processes (how and why) and outcomes (events and consequences) of PSIs. Interviews were transcribed and analysed thematically using a six-phase deductive and inductive approach within the Donabedian model.

Results: The Donabedian model's three components (structure, process, outcome) led to six sub-themes, highlighting its applicability to SLTs' perspectives on PSIs. It revealed how factors such as clinical environment, care delivery and patient outcomes influence SLTs' perceptions.

Conclusion: Understanding SLTs' perspectives is essential for addressing environmental issues, developing training, institutional inductions and audits that prevent and manage PSIs, and improving service quality.Contribution: This study emphasises engaging practitioners to understand factors affecting PSIs. It contributes to improving SLT training and practice in South Africa to enhance patient safety.