Factors affecting adherence to antiretroviral therapy among pregnant women in theEastern Cape, South Africa
- Adeola, H A, Adeniyi, Oladele Vincent, Ajayi, Anthony Idowu, Goon, Daniel Ter, Owolabi, Eyitayo Omolara, Eboh, Alfred, Lambert, John
- Authors: Adeola, H A , Adeniyi, Oladele Vincent , Ajayi, Anthony Idowu , Goon, Daniel Ter , Owolabi, Eyitayo Omolara , Eboh, Alfred , Lambert, John
- Date: 2018
- Language: English
- Type: text , article
- Identifier: http://hdl.handle.net/11260/5272 , vital:44427 , https://neuro.unboundmedicine.com/medline/citation/29653510/Factors_affecting_adherence_to_antiretroviral_therapy_among_pregnant_women_in_the_Eastern_Cape_South_Africa_
- Description: Background:Context-specific factors influence adherence to antiretroviral therapy (ART) among pregnant womenliving with HIV. Gaps exist in the understanding of the reasons for the variable outcomes of the prevention ofmother-to-child transmission (PMTCT) programme at the health facility level in South Africa. This study examinedadherence levels and reasons for non-adherence during pregnancy in a cohort of parturient women enrolled in thePMTCT programme in the Eastern Cape, South Africa.Methods:This was a mixed-methods study involving 1709 parturient women in the Eastern Cape, South Africa. Weconducted a multi-centre retrospective analysis of the mother-infant pair in the PMTCT electronic database in 2016.Semi-structured interviews of purposively selected parturient women with self-reported poor adherence (n= 177)were conducted to gain understanding of the main barriers to adherence. Binary logistic regression was used todetermine the independent predictors of ART non-adherence.Results:A high proportion (69.0%) of women reported perfect adherence. In the logistic regression analysis, afteradjusting for confounding factors, marital status, cigarette smoking, alcohol use and non-disclosure to a family memberwere the independent predictors of non-adherence. Analysis of the qualitative data revealed that drug-related side-effects, being away from home, forgetfulness, non-disclosure, stigma and work-related demand were among the mainreasons for non-adherence to ART.Conclusions:Non-adherence to the antiretroviral therapy among pregnant women in this setting is associated withlifestyle behaviours, HIV-related stigma and ART side-effects. In order to eliminate mother-to-child transmission of HIV,clinicians need to screen for these factors at every antenatal clinic visit.Keywords:Adherence, Non-adherence, HIV, Antiretroviral therapy, Elimination of mother-to-child transmission,Prevention of mother-to-child transmission, Stigma, South Africa
- Full Text:
- Date Issued: 2018
- Authors: Adeola, H A , Adeniyi, Oladele Vincent , Ajayi, Anthony Idowu , Goon, Daniel Ter , Owolabi, Eyitayo Omolara , Eboh, Alfred , Lambert, John
- Date: 2018
- Language: English
- Type: text , article
- Identifier: http://hdl.handle.net/11260/5272 , vital:44427 , https://neuro.unboundmedicine.com/medline/citation/29653510/Factors_affecting_adherence_to_antiretroviral_therapy_among_pregnant_women_in_the_Eastern_Cape_South_Africa_
- Description: Background:Context-specific factors influence adherence to antiretroviral therapy (ART) among pregnant womenliving with HIV. Gaps exist in the understanding of the reasons for the variable outcomes of the prevention ofmother-to-child transmission (PMTCT) programme at the health facility level in South Africa. This study examinedadherence levels and reasons for non-adherence during pregnancy in a cohort of parturient women enrolled in thePMTCT programme in the Eastern Cape, South Africa.Methods:This was a mixed-methods study involving 1709 parturient women in the Eastern Cape, South Africa. Weconducted a multi-centre retrospective analysis of the mother-infant pair in the PMTCT electronic database in 2016.Semi-structured interviews of purposively selected parturient women with self-reported poor adherence (n= 177)were conducted to gain understanding of the main barriers to adherence. Binary logistic regression was used todetermine the independent predictors of ART non-adherence.Results:A high proportion (69.0%) of women reported perfect adherence. In the logistic regression analysis, afteradjusting for confounding factors, marital status, cigarette smoking, alcohol use and non-disclosure to a family memberwere the independent predictors of non-adherence. Analysis of the qualitative data revealed that drug-related side-effects, being away from home, forgetfulness, non-disclosure, stigma and work-related demand were among the mainreasons for non-adherence to ART.Conclusions:Non-adherence to the antiretroviral therapy among pregnant women in this setting is associated withlifestyle behaviours, HIV-related stigma and ART side-effects. In order to eliminate mother-to-child transmission of HIV,clinicians need to screen for these factors at every antenatal clinic visit.Keywords:Adherence, Non-adherence, HIV, Antiretroviral therapy, Elimination of mother-to-child transmission,Prevention of mother-to-child transmission, Stigma, South Africa
- Full Text:
- Date Issued: 2018
Point-of-care and lung ultrasound incorporated in daily practice
- Neethling, E, Roodt, F, Beck, C, Swanevelder, J L C
- Authors: Neethling, E , Roodt, F , Beck, C , Swanevelder, J L C
- Date: 2018
- Language: English
- Type: text , article
- Identifier: http://hdl.handle.net/11260/5248 , vital:44424 , http://www.samj.org.za/index.php/samj/article/view/12293
- Description: Point-of-care ultrasound (POCUS) is a fast-growing clinical utility and is becoming an essential clinical skill for all practitioners attending to critically ill patients. Ultrasound equipment is now smaller, more affordable and readily available in clinical work areas. POCUS is performed by a non-cardiologist physician at the patient’s bedside as an adjunct to the physical examination. It is easily taught, non-invasive and allows for real-time clinical information. Bedside use of ultrasound imaging aids with rapid diagnosis of severe and life-threatening pathological conditions. It can be repeated, may change clinical management, and impact on patient outcome. POCUS has a broad clinical use, including, but not limited to, focused assessed transthoracic echocardiography (FATE), lung ultrasound imaging, extended focused assessment with sonography for trauma (e-FAST), vascular access and regional blocks. It may also be extended to detect endotracheal intubation and the estimation of intracranial pressure. Assessment of cardiac pathology by POCUS, performed by a novice examiner, has been shown to compare with the gold standard of an expert. Training is paramount. The physician should know his limitations and always relate the information back to the clinical scenario and context. By incorporating POCUS as part of our armamentarium and into our daily medical practice, we might see it reach its full clinical potential, optimising patient care and improving patient outcomes.
- Full Text:
- Date Issued: 2018
- Authors: Neethling, E , Roodt, F , Beck, C , Swanevelder, J L C
- Date: 2018
- Language: English
- Type: text , article
- Identifier: http://hdl.handle.net/11260/5248 , vital:44424 , http://www.samj.org.za/index.php/samj/article/view/12293
- Description: Point-of-care ultrasound (POCUS) is a fast-growing clinical utility and is becoming an essential clinical skill for all practitioners attending to critically ill patients. Ultrasound equipment is now smaller, more affordable and readily available in clinical work areas. POCUS is performed by a non-cardiologist physician at the patient’s bedside as an adjunct to the physical examination. It is easily taught, non-invasive and allows for real-time clinical information. Bedside use of ultrasound imaging aids with rapid diagnosis of severe and life-threatening pathological conditions. It can be repeated, may change clinical management, and impact on patient outcome. POCUS has a broad clinical use, including, but not limited to, focused assessed transthoracic echocardiography (FATE), lung ultrasound imaging, extended focused assessment with sonography for trauma (e-FAST), vascular access and regional blocks. It may also be extended to detect endotracheal intubation and the estimation of intracranial pressure. Assessment of cardiac pathology by POCUS, performed by a novice examiner, has been shown to compare with the gold standard of an expert. Training is paramount. The physician should know his limitations and always relate the information back to the clinical scenario and context. By incorporating POCUS as part of our armamentarium and into our daily medical practice, we might see it reach its full clinical potential, optimising patient care and improving patient outcomes.
- Full Text:
- Date Issued: 2018
Potential latitudinal variation in orodigestive tract cancers in Africa
- Adeola, H A, Adefuye, A O, Jimoh, S A
- Authors: Adeola, H A , Adefuye, A O , Jimoh, S A
- Date: 2018
- Language: English
- Type: text , article
- Identifier: http://hdl.handle.net/11260/5280 , vital:44428 , http://www.samj.org.za/index.php/samj/article/view/12259
- Description: Background. Previous studies have alluded to a causal relationship between pathological entities and geographical variations, but there is a paucity of studies from Africa discussing the effect of latitudinal variation on orodigestive cancers in this region. It seems plausible that the burden of orodigestive cancer would differ as a result of variations in diet, cultural habits, climate and environmental conditions down the length of Africa. Objectives. To analyse regional variations in prevalence, incidence and mortality data in the global cancer statistics database (GLOBOCAN 2012) curated by the World Health Organization and the International Agency for Research on Cancer. Basic descriptive statistical tools were used to depict regional variations in cancer morbidity and mortality. Methods. Data on 13 African countries between longitude 20⁰ and 30⁰ east and latitude 35⁰ north and 35⁰ south were examined for variation in age-standardised orodigestive cancer prevalence, incidence and mortality. Possible regional causes for orodigestive tract cancer development were investigated. Data on lip and oral cavity, oesophageal, gastric, colorectal, liver, gallbladder and pancreatic cancers in the 13 countries were compared. Results. Our empirical findings from this preliminary study support the notion that the incidence and prevalence of orodigestive cancers vary within Africa. This effect may be due to environmental, economic, political and possibly genetic factors. Conclusions. Considering the heterogeneity of the above factors across Africa, disbursement of funding for cancer research and therapy in Africa should be focused in terms of regional variations to make best use of the fiscal allocation by African governments, non-governmental organisations and international agencies.
- Full Text:
- Date Issued: 2018
- Authors: Adeola, H A , Adefuye, A O , Jimoh, S A
- Date: 2018
- Language: English
- Type: text , article
- Identifier: http://hdl.handle.net/11260/5280 , vital:44428 , http://www.samj.org.za/index.php/samj/article/view/12259
- Description: Background. Previous studies have alluded to a causal relationship between pathological entities and geographical variations, but there is a paucity of studies from Africa discussing the effect of latitudinal variation on orodigestive cancers in this region. It seems plausible that the burden of orodigestive cancer would differ as a result of variations in diet, cultural habits, climate and environmental conditions down the length of Africa. Objectives. To analyse regional variations in prevalence, incidence and mortality data in the global cancer statistics database (GLOBOCAN 2012) curated by the World Health Organization and the International Agency for Research on Cancer. Basic descriptive statistical tools were used to depict regional variations in cancer morbidity and mortality. Methods. Data on 13 African countries between longitude 20⁰ and 30⁰ east and latitude 35⁰ north and 35⁰ south were examined for variation in age-standardised orodigestive cancer prevalence, incidence and mortality. Possible regional causes for orodigestive tract cancer development were investigated. Data on lip and oral cavity, oesophageal, gastric, colorectal, liver, gallbladder and pancreatic cancers in the 13 countries were compared. Results. Our empirical findings from this preliminary study support the notion that the incidence and prevalence of orodigestive cancers vary within Africa. This effect may be due to environmental, economic, political and possibly genetic factors. Conclusions. Considering the heterogeneity of the above factors across Africa, disbursement of funding for cancer research and therapy in Africa should be focused in terms of regional variations to make best use of the fiscal allocation by African governments, non-governmental organisations and international agencies.
- Full Text:
- Date Issued: 2018
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