African Journal of Primary Health Care & Family Medicine最新文献

No abstract available.

Background: Low- to middle-income countries account for 70% of global cancer deaths. Evidence of the changing prevalence of head and neck cancer in Africa in terms of gender, race and epidemiology will inform future research and health planning.

Aim: To synthesise epidemiological literature for head and neck cancer in Africa from 2010 to 2020.

Method: A scoping review was completed. The Joanna Briggs Institute Population, context and concept framework confirmed the inclusion criteria. Studies from Africa that included participant demographics, the types, stages, signs and symptoms of head and neck cancer were selected. Five databases were used. Descriptive statistics was completed.

Results: The Preferred Reporting Items for Systematic Reviews and MetaAnalysis guided the reporting of the findings. Of the 1891 articles downloaded, 66 were included in the final review. Nigeria produced the most studies and oral cancer at 74% was most prevalent. Substance abuse was the most prevalent cause. Diagnosis of head and neck cancers were in the late stage (stage IV) when signs and symptoms were severe. Males of lower socioeconomic status tended to have less health seeking behaviour.

Conclusion: Countries from North Africa produce the most research outputs on head and neck cancers. Gender differences were noted and may be linked to lifestyle choices. A range of head and neck cancers (HNCs) are prevalent however late diagnosis and severe symptomatology impact treatment options.Contribution: Earlier diagnosis and intervention to prevent late-stage diagnosis is necessary. Awareness campaigns linked to evidence on causes, habits and lifestyle choices, signs and symptoms are needed.

Background: Most childhood infections are of viral origin making antibiotics unnecessary. They are, however, the most frequently prescribed drugs dispensed to children, resulting in inappropriate antibiotic prescriptions, which are one of the main drivers of antibiotic resistance.

Aim: The study aimed to determine the prevalence of antibiotic prescriptions and identify its associated factors among children below 5 years with common cold who attend the outpatient department in Tororo General Hospital.

Setting: The study was carried out in Tororo General Hospital, Eastern Uganda.

Methods: A cross-sectional survey using consecutive sampling was performed among children below 5 years with common cold attending the outpatient department. Data were collected using an interviewer-administered, structured questionnaire and analysed using STATA version 14.0. Prevalence of antibiotic prescriptions was calculated. Bivariate analysis using chi-square test and multivariate analysis using logistic regression was performed to establish factors associated with antibiotic prescription.

Results: The prevalence of antibiotic prescriptions for common cold among children below 5 years was 23.3%. Factors associated with antibiotic prescription for common cold were duration of symptoms of more than 5 days (OR, 95% CI: 4.49; 1.16-17.23, p = 0.029) and being attended to by a clinical officer (OR, 95% CI: 0.19; 0.04-0.91, p = 0.038).

Conclusion: There is inappropriate antibiotic prescription among children with common cold in Tororo General Hospital. There is need for antibiotic stewardship programmes to promote optimal antibiotic use in primary care facilities.Contribution: The study's findings can be used to develop context-specific antibiotic stewardship programmes tailored to promote judicious use of antibiotics in primary care.

Background: South Africa has the second-highest tuberculosis (TB) incidence globally. Drug-resistant TB (DR-TB) treatment has less successful treatment outcomes as compared with susceptible TB, and it hinders TB control and management programmes.

Aim: This study aimed to evaluate drug-resistant TB treatment outcomes and factors associated with successful treatment outcomes.

Setting: The study was conducted in five districts in Limpopo province.

Methods: The study design was retrospective and descriptive. Patients' demographic data, data on clinical characteristics and treatment outcomes data were extracted from the electronic drug-resistant tuberculosis register (EDRWeb) database system for the period, 2010-2018, in Limpopo province. Frequency, percentages and bivariate and multivariate logistic regression were used to analyse data using Statistical Package for Social Sciences version 27.0. The significance difference was determined at a 95% confidence interval and p 0.05.

Results: A total of 385 drug-resistant records were included in this study. The treatment success rate was 223 (57.9%). A total of 197 (51.2%) patients were cured, 26 (6.8%) completed treatment, 19 (4.9%) treatment failure, 62 (16.1%) died, 78 (20.6%) were recorded as the loss to follow-up, 1 (0.3%) moved to another country and 2 (0.5%) were transferred out.

Conclusion: The treatment success rate was 57.9%, which is still below targets set by National Strategic Plan in South Africa and World Health Organization End TB targets.Contribution: The findings of the study reveal that to achieve successful DR-TB control programme and attain End TB targets, monitoring of treatment outcomes is crucial.

Background: The youth is at a heightened risk of immunodeficiency virus and/or acquired immunodeficiency syndrome (HIV and/or AIDS) infection because of risk-taking behaviour. There remains a gap in understanding young men's knowledge of HIV and/or AIDS and HIV testing services (HTS) in hard-to-reach communities in South Africa.

Aim: This article aimed to explore young men's knowledge of HIV and/or AIDS, including HTS in Ladysmith, KwaZulu-Natal (KZN).

Setting: Rural and peri-urban areas around the town of Ladysmith.

Methods: Employing a qualitative descriptive research design, 17 young men aged between 18 and 30 years were purposively and conveniently sampled and interviewed using WhatsApp and landline audio calls to collect their data, which was thematically analysed.

Results: Young men had good knowledge of HIV and/or AIDS but lacked knowledge about HTS and HIV self-testing (HIVST). They obtained their information about HIV and/or AIDS and HTS from various sources and were aware of where to access HTS. They were generally unaware and supportive of HIVST.

Conclusion: Male-targeted HIV and/or AIDS knowledge and testing interventions are needed to encourage and support young men to test for HIV. Human immunodeficiency virus self-testing should be explored as an alternative to clinic-based service to encourage young men to know their status, specifically those with limited access to or are reluctant to attend clinics. Strengthening HIV and/or AIDS education could facilitate better decision-making towards HIV testing among young men.Contribution: This study contributes to an understanding of young adult men's knowledge of HIV and/or AIDS and HTS in underserved settings in South Africa.

Background: Adolescence is a period of transition from childhood to adulthood. It is the age of experimentation. They are vulnerable to the undesirable effect of sexual and reproductive health (SRH) problems such as human immunodeficiency virus, sexually transmitted infections and unsafe abortion and childbirth-related risks.

Aim: To explore and describe perceived organisational, community and societal level factors that influence sexual behaviours among adolescents in Ethiopia.

Setting: The study was conducted by public health care organisations, youth centres and non-governmental organisations in Addis Ababa, Ethiopia.

Methods: A qualitative descriptive study design was conducted with purposively selected health professionals and adolescents in Addis Ababa from June 2019 to February 2020. The data were collected using in-depth interviews, key informant interviews and focus group discussions. Transcribed interviews were imported to ATLAS. ti 7 for coding, categorising and creating themes using thematic analysis. Lincoln and Guba's model was used to ensure trustworthiness and ethical standards were applied.

Results: Poor school involvement, social norms on sexual behaviour and lack of condom acceptability by the general population, financial problems and the gap in law enforcement were found perceived factors influencing sexual behaviour of adolescents.

Conclusion: Adolescents are engaging in various risky sexual behaviours because of various organisational, community level and societal level factors, which emphasises the need to introduce social and culturally acceptable age-appropriate comprehensive sexuality education for adolescents and other multilevel interventions.Contribution: Provide an in-depth understanding of the influence of sociocultural issues related to adolescent sexual behaviour for health system stakeholders.

No abstract available.

Background: Sexual dysfunction (SD) is a common complication among men living with diabetes (MLWD), which adds to stresses induced by medical condition. Effect of stress on their daily living activities has been only poorly described.

Aim: This study aimed to explore the behaviour and challenges of MLWD experiencing SD in respect of daily living activities.

Setting: Five clinics in Senwabarwana in Limpopo province.

Methods: Qualitative approach and phenomenological exploratory design were adopted to collect data from 15 male participants selected from five clinics using purposive homogeneous sampling. One-on-one interviews were conducted using voice recorders, and field notes were taken of non-verbal cues. Unstructured interview guide with principal question enabled instructive probing to be conducted. Data were analysed using eight steps of Tesch's inductive, descriptive and open coding technique.

Results: Participants reported stressful experiences, difficulty coping with diabetes and its accompanying complication of SD that led to fear of losing their wives. They indicated that as a result of stress and difficulty in coping with the condition, they were engaged in less physical activity than before their diagnosis.

Conclusion: Sexual dysfunction is prevalent among male diabetics and often feel stressed and worried about losing their wives. They struggle to cope with conditions to the point where they are less capable of performing tasks than they were before diagnosis. These outcomes are critical issues that should be addressed in any diabetes treatment strategy.Contribution: Support-based collaboration of healthcare providers with spouses and revision of South African diabetes management strategy to incorporate healthy coping strategies are recommended.

Background: Obesity in South Africa has created a public health crisis that warrants a multilevel intervention. However, patients' perceptions and clinicians' challenges hinder the management of obesity in primary care.

Aim: The study aimed to assess obese patients' dissatisfaction with weight and body image and their perspectives on interaction with clinicians regarding obesity management in a primary care setting.

Setting: Outpatient department of Dr Yusuf Dadoo District Hospital.

Methods: Cross-sectional study of 213 adult obese patients. A semi-structured questionnaire, a body image assessment tool and patients' medical records were used for data collection.

Results: The study found that, contrary to popular belief, obese patients were dissatisfied with their weight (78.9%) and body image (95.3%). Many felt comfortable while discussing weight reduction with clinicians, although 37.1% reported never engaging with a doctor and 62.9% never interacted with a nurse on the subject. Only 6% reported receiving adequate information on weight reduction measures and 19.7% were followed-up. Clinicians' advice was mainly associated with patients' high body mass index and waist circumference. Doctors were less likely to recommend weight reduction to employed obese women, while nurses were more likely to engage Zulu-speaking patients. Patients were more likely to be followed up if they were young and excessively obese.

Conclusion: The study found that most obese patients were dissatisfied with their weight and body image and perceived their interaction with clinicians regarding obesity management as inadequate.Contribution: The study provides an angle of view of challenges in obesity management from patients' perspectives.

Background: The World Health Organization has stated that millions of women of childbearing age in developing countries who are not planning to be pregnant are not utilising modern contraceptives such as long-term contraceptives, including Implanon. South Africa had a high rate of women of childbearing age who used Implanon as one of long-term contraception methods from its introduction in 2014. Familiar reasons for women to not use modern contraceptives involved a lack of healthcare facilities, supplies and trained healthcare workers in their area to provide effective contraceptive services in South Africa.

Aim: This study aimed to explore and describe the experiences of women of childbearing age regarding Implanon provision.

Setting: The study was conducted in primary health care facilities of Ramotshere Moiloa subdistrict, South Africa.

Methods: Qualitative, descriptive phenomenological approach was used in this study. Twelve women of childbearing age were purposively sampled. Childbearing age refers to woman in their reproductive ages who will not be regarded as high risk for pregnancy. Semi-structured interviews were utilised to collect data and five Colaizzi's steps of data analysis were used. Data were collected from 12 of 15 selected women of childbearing age who had experience in utilising Implanon contraceptive device. Data saturation was reached after interviewing 12 participants as the information was coming out, repeatedly.

Results: Three themes with subthemes emerged from the study, namely period of Implanon use, experiences of obtaining information regarding Implanon and healthcare experiences related to Implanon.

Conclusion: It was evident that a lack of effective pre- and post-counselling, eligibility screening and poor management of severe side effects are contributory factors that led to early removal and decline in uptake of the said method. There is also a lack of effective comprehensive Implanon training to some of reproductive service providers.Contribution: It may increase the number of women who still want to use Implanon as a reliable method.