Colistin utilisation and clinical outcomes at a public hospital in Bloemfontein, South Africa
- Matshediso, Gaalebale Prudence
- Authors: Matshediso, Gaalebale Prudence
- Date: 2022-07
- Subjects: Gram-negative bacteria , Hospital patients
- Language: English
- Type: Master's theses , text
- Identifier: http://hdl.handle.net/10353/26929 , vital:66172
- Description: Background Colistin is an antibiotic used as the last resort in the treatment of multi-drug resistant Gram-negative bacteria. Its use started in the 1950s but was decreased in the 1980s owing to its nephrotoxic side effects. The re-emergence of Colistin utilisation in 2012 in South Africa followed the emergence of multi-drug resistant Gram-negative bacteria. There is a dearth of information on the rationale use of Colistin in South Africa. Aim To describe the use of Colistin and its clinical outcomes at a tertiary hospital in Bloemfontein, South Africa. Methodology A retrospective cross-sectional study was conducted at a tertiary hospital in Bloemfontein between 2015 and 2019. Relevant data was extracted from the medical records of patients treated with Colistin. Stratified random sampling was used in selecting 50percent of the eligible medical records of patients treated with Colistin per stratum. Data was analysed using simple descriptive and inferential statistics. Results Of the total sample (N=69), the majority were neonates (43.5percent), while children constituted the lowest number of patients (18.8percent). The highest contributor to the top diagnosis, septicaemia, were neonates (44.2percent). Adherence to policy and Colistin treatment guidelines was suboptimal, more so in neonates (45.3percent) than in adults (73.7percent) and children (72.3percent). Colistin was used as a last resort in 68.1percent of the participants. Cure was achieved in 26.9percent, 46.2percent and 80percent of adults, children and neonates, respectively. The highest rate of nephrotoxicity was seen in adults (57.7percent). In the multivariate logistic regression model analysis, both adults [adjusted odds ratio (AOR)=25.54, 95percent confidence interval (CI) 2.73-238.65] and children (AOR=8.56, 95percentCI 1.06 – 69.10) had a higher risk of death than neonates. However, there was no significant difference in the odds for mortality by gender, co-morbidities, illness duration prior to admission and adherence to treatmen Conclusions This study found a suboptimal level of compliance with policy and recommended guidelines on the use of Colistin in a South African public sector tertiary hospital. In addition, there were variations in the level of compliance by age categories, with lower levels of compliance in neonates than in children and adults. The odds for mortality by gender, co-morbidities, illness duration prior to admission and adherence to treatment guidelines and policies were found to be insignificant, and age was the only predictor of mortality found in the study. The findings of the study highlight the need for improved clinical governance on antibiotic stewardship and monitoring of use of Colistin across all categories of patients in the hospital. Future studies should examine the contributing factors for suboptimal compliance, with evidence-based recommendations on the use of Colistin in the study setting as well as factors contributing to high mortality in adults. , Thesis (MPA) -- Faculty of Health Sciences, 2022
- Full Text:
- Date Issued: 2022-07
- Authors: Matshediso, Gaalebale Prudence
- Date: 2022-07
- Subjects: Gram-negative bacteria , Hospital patients
- Language: English
- Type: Master's theses , text
- Identifier: http://hdl.handle.net/10353/26929 , vital:66172
- Description: Background Colistin is an antibiotic used as the last resort in the treatment of multi-drug resistant Gram-negative bacteria. Its use started in the 1950s but was decreased in the 1980s owing to its nephrotoxic side effects. The re-emergence of Colistin utilisation in 2012 in South Africa followed the emergence of multi-drug resistant Gram-negative bacteria. There is a dearth of information on the rationale use of Colistin in South Africa. Aim To describe the use of Colistin and its clinical outcomes at a tertiary hospital in Bloemfontein, South Africa. Methodology A retrospective cross-sectional study was conducted at a tertiary hospital in Bloemfontein between 2015 and 2019. Relevant data was extracted from the medical records of patients treated with Colistin. Stratified random sampling was used in selecting 50percent of the eligible medical records of patients treated with Colistin per stratum. Data was analysed using simple descriptive and inferential statistics. Results Of the total sample (N=69), the majority were neonates (43.5percent), while children constituted the lowest number of patients (18.8percent). The highest contributor to the top diagnosis, septicaemia, were neonates (44.2percent). Adherence to policy and Colistin treatment guidelines was suboptimal, more so in neonates (45.3percent) than in adults (73.7percent) and children (72.3percent). Colistin was used as a last resort in 68.1percent of the participants. Cure was achieved in 26.9percent, 46.2percent and 80percent of adults, children and neonates, respectively. The highest rate of nephrotoxicity was seen in adults (57.7percent). In the multivariate logistic regression model analysis, both adults [adjusted odds ratio (AOR)=25.54, 95percent confidence interval (CI) 2.73-238.65] and children (AOR=8.56, 95percentCI 1.06 – 69.10) had a higher risk of death than neonates. However, there was no significant difference in the odds for mortality by gender, co-morbidities, illness duration prior to admission and adherence to treatmen Conclusions This study found a suboptimal level of compliance with policy and recommended guidelines on the use of Colistin in a South African public sector tertiary hospital. In addition, there were variations in the level of compliance by age categories, with lower levels of compliance in neonates than in children and adults. The odds for mortality by gender, co-morbidities, illness duration prior to admission and adherence to treatment guidelines and policies were found to be insignificant, and age was the only predictor of mortality found in the study. The findings of the study highlight the need for improved clinical governance on antibiotic stewardship and monitoring of use of Colistin across all categories of patients in the hospital. Future studies should examine the contributing factors for suboptimal compliance, with evidence-based recommendations on the use of Colistin in the study setting as well as factors contributing to high mortality in adults. , Thesis (MPA) -- Faculty of Health Sciences, 2022
- Full Text:
- Date Issued: 2022-07
Infant feeding knowledge, attitudes and practices of mothers in private health facilities in Alice town, Eastern Cape, South Africa
- Authors: Oyeniran, Aderonke Adepeju
- Date: 2022-07
- Subjects: Breastfeeding
- Language: English
- Type: Master's theses , text
- Identifier: http://hdl.handle.net/10353/23556 , vital:58132
- Description: Background and aim of the study: Within the global field of health education, it is generally accepted that the topic of breast-feeding is a crucial discussion due to its maternal, infant, and communal benefits. However, certain African countries, such as South Africa, experience certain challenges related to both predictive factors and maternal attitudes to breast-feeding. To improve public awareness and promote the implementation of breast-feeding, these factors should be investigated to highlight the importance of this practice among young mothers. Method: The study utilised a cross-sectional survey by means of a self-administered questionnaire, which was completed by the carefully chosen participants. The collected data were then analysed using a statistical package for social sciences (SPSS) (frequency, percentages, mean and standard deviation) and inferential statistics (logistic regression). The level of significance for the inferential statistics was set at 0.05. Results: A total of 377 infant mothers participated in the study with median age of 30. Most infant mothers that participated in the study were well educated with infant mother 189 having a bachelor’s degree. The findings revealed that mothers of 40 years above are 1.51 times more likely not to breastfeed exclusively compared to mothers of less than 40 years of age (95percent CI, 0.75-2.25). The odds ratio of the incidence of decision in breastfeeding for participants with breastfeeding and formula milk was 1.66 (95percent CI, 0.87-2.53). In term of family support, mothers who don’t receive family support were 3.43 times more likely no to breastfeed. The result also revealed that mothers with breast pain were 0.98 more likely not to breastfeed. Conclusion: This study concludes that infant mothers are well informed about breastfeeding. This study also revealed that factors such as infant mothers’ knowledge about breastfeeding, medical health of both mother and infant and cultural norms can go a long way in influencing the decision of mothers to breastfeeding their infant or not. , Thesis (MPH) -- Faculty of Health Sciences, 2022
- Full Text:
- Date Issued: 2022-07
- Authors: Oyeniran, Aderonke Adepeju
- Date: 2022-07
- Subjects: Breastfeeding
- Language: English
- Type: Master's theses , text
- Identifier: http://hdl.handle.net/10353/23556 , vital:58132
- Description: Background and aim of the study: Within the global field of health education, it is generally accepted that the topic of breast-feeding is a crucial discussion due to its maternal, infant, and communal benefits. However, certain African countries, such as South Africa, experience certain challenges related to both predictive factors and maternal attitudes to breast-feeding. To improve public awareness and promote the implementation of breast-feeding, these factors should be investigated to highlight the importance of this practice among young mothers. Method: The study utilised a cross-sectional survey by means of a self-administered questionnaire, which was completed by the carefully chosen participants. The collected data were then analysed using a statistical package for social sciences (SPSS) (frequency, percentages, mean and standard deviation) and inferential statistics (logistic regression). The level of significance for the inferential statistics was set at 0.05. Results: A total of 377 infant mothers participated in the study with median age of 30. Most infant mothers that participated in the study were well educated with infant mother 189 having a bachelor’s degree. The findings revealed that mothers of 40 years above are 1.51 times more likely not to breastfeed exclusively compared to mothers of less than 40 years of age (95percent CI, 0.75-2.25). The odds ratio of the incidence of decision in breastfeeding for participants with breastfeeding and formula milk was 1.66 (95percent CI, 0.87-2.53). In term of family support, mothers who don’t receive family support were 3.43 times more likely no to breastfeed. The result also revealed that mothers with breast pain were 0.98 more likely not to breastfeed. Conclusion: This study concludes that infant mothers are well informed about breastfeeding. This study also revealed that factors such as infant mothers’ knowledge about breastfeeding, medical health of both mother and infant and cultural norms can go a long way in influencing the decision of mothers to breastfeeding their infant or not. , Thesis (MPH) -- Faculty of Health Sciences, 2022
- Full Text:
- Date Issued: 2022-07
Infant feeding knowledge, attitudes and practices of mothers in private health facilities in Alice Town, Eastern Cape, South Africa
- Authors: Oyeniran, Aderonke Adepeju
- Date: 2022-07
- Subjects: Infants -- Nutrition , Baby foods , Breastfeeding
- Language: English
- Type: Master's theses , text
- Identifier: http://hdl.handle.net/10353/27139 , vital:66315
- Description: Background and aim of the study: Within the global field of health education, it is generally accepted that the topic of breast-feeding is a crucial discussion due to its maternal, infant, and communal benefits. However, certain African countries, such as South Africa, experience certain challenges related to both predictive factors and maternal attitudes to breast-feeding. To improve public awareness and promote the implementation of breast-feeding, these factors should be investigated to highlight the importance of this practice among young mothers. Method: The study utilised a cross-sectional survey by means of a self-administered questionnaire, which was completed by the carefully chosen participants. The collected data were then analysed using a statistical package for social sciences (SPSS) (frequency, percentages, mean and standard deviation) and inferential statistics (logistic regression). The level of significance for the inferential statistics was set at 0.05. Results: A total of 377 infant mothers participated in the study with median age of 30. Most infant mothers that participated in the study were well educated with infant mother 189 having a bachelor’s degree. The findings revealed that mothers of 40 years above are 1.51 times more likely not to breastfeed exclusively compared to mothers of less than 40 years of age (95percent CI, 0.75-2.25). The odds ratio of the incidence of decision in breastfeeding for participants with breastfeeding and formula milk was 1.66 (95percent CI, 0.87-2.53). In term of family support, mothers who don’t receive family support were 3.43 times more likely no to breastfeed. The result also revealed that mothers with breast pain were 0.98 more likely not to breastfeed. Conclusion: This study concludes that infant mothers are well informed about breastfeeding. This study also revealed that factors such as infant mothers’ knowledge about breastfeeding, medical health of both mother and infant and cultural norms can go a long way in influencing the decision of mothers to breastfeeding their infant or not. , Thesis (MPH) -- Faculty of Health Sciences, 2022
- Full Text:
- Date Issued: 2022-07
- Authors: Oyeniran, Aderonke Adepeju
- Date: 2022-07
- Subjects: Infants -- Nutrition , Baby foods , Breastfeeding
- Language: English
- Type: Master's theses , text
- Identifier: http://hdl.handle.net/10353/27139 , vital:66315
- Description: Background and aim of the study: Within the global field of health education, it is generally accepted that the topic of breast-feeding is a crucial discussion due to its maternal, infant, and communal benefits. However, certain African countries, such as South Africa, experience certain challenges related to both predictive factors and maternal attitudes to breast-feeding. To improve public awareness and promote the implementation of breast-feeding, these factors should be investigated to highlight the importance of this practice among young mothers. Method: The study utilised a cross-sectional survey by means of a self-administered questionnaire, which was completed by the carefully chosen participants. The collected data were then analysed using a statistical package for social sciences (SPSS) (frequency, percentages, mean and standard deviation) and inferential statistics (logistic regression). The level of significance for the inferential statistics was set at 0.05. Results: A total of 377 infant mothers participated in the study with median age of 30. Most infant mothers that participated in the study were well educated with infant mother 189 having a bachelor’s degree. The findings revealed that mothers of 40 years above are 1.51 times more likely not to breastfeed exclusively compared to mothers of less than 40 years of age (95percent CI, 0.75-2.25). The odds ratio of the incidence of decision in breastfeeding for participants with breastfeeding and formula milk was 1.66 (95percent CI, 0.87-2.53). In term of family support, mothers who don’t receive family support were 3.43 times more likely no to breastfeed. The result also revealed that mothers with breast pain were 0.98 more likely not to breastfeed. Conclusion: This study concludes that infant mothers are well informed about breastfeeding. This study also revealed that factors such as infant mothers’ knowledge about breastfeeding, medical health of both mother and infant and cultural norms can go a long way in influencing the decision of mothers to breastfeeding their infant or not. , Thesis (MPH) -- Faculty of Health Sciences, 2022
- Full Text:
- Date Issued: 2022-07
Investigation of risky sexual behaviour amongst HIV/AIDS positive individuals on antiretroviral treatment in Buffalo City Metropolitan Municipality Eastern Cape Province, South Africa
- Authors: Pere, Mzukisi Ernest
- Date: 2022-07
- Subjects: Sexual behaviour -- South Africa -- Eastern Cape , Youth Sexual behaviour
- Language: English
- Type: Master's theses , text
- Identifier: http://hdl.handle.net/10353/23578 , vital:58190
- Description: Background: Human immunodeficiency virus (HIV)/ acquired immune deficiency syndrome (AIDS) is one of the major public health concerns. Antiretroviral treatments (ART) is available immediately for HIV-positive individuals but sexually transmitted infections are on the rise. The majority of HIV positive patients on ART are engaging in unsafe sexual practices. Purpose: The aim of this study was to investigate risky sexual behaviour of people on antiretroviral treatment regarding prevention. The study was conducted on adult clients in the Buffalo City Metropolitan Municipality. Methods: A quantitative and descriptive cross-sectional design was conducted whereby 304 patients who visited Nontyatyambo Health Centre were randomly selected. Data was entered and analyzed using Statistical Package for the Social Sciences (SPSS) 24. Simple descriptive statistics such as numbers, percentages and tables were used to characterise variables. A chi-square test was used to explore associations between dependent and independent variables. Test significance, confidence intervals and p-values of all the causes and contributory factors were set at 0.05. Results: Thirty two percent reported having sex with multiple sexual partners while 19percent reported never using a condom. Forty eight percent reported having had sexually transmitted infections since starting on ART. The median age (36 years (IQR: 31, 45) vs. 35 years (IQR: 26, 40)) of those who reported STIs was higher than the median age of those who did not report STI (p=0.012). Males (57percent, p=0.049), those who were employed (55percent, p=0.048), and those who were cohabitating (68percent, 0.030) were more likely to report STI. Similarly, those who had unprotected sex with a casual partner (62percent, p<0.001), and those who did not use a condom because a partner did not like it (71percent, p=0.001) were more likely to report STIs. A significant number of 32percent of the participants reported engaging in risky sexual practices while 48percent had reported an STI. Recommendations include educational outreach programmes and capacitation of health care workers with appropriate skills and tools. , Thesis (MPH) -- Faculty of Health Sciences, 2022
- Full Text:
- Date Issued: 2022-07
- Authors: Pere, Mzukisi Ernest
- Date: 2022-07
- Subjects: Sexual behaviour -- South Africa -- Eastern Cape , Youth Sexual behaviour
- Language: English
- Type: Master's theses , text
- Identifier: http://hdl.handle.net/10353/23578 , vital:58190
- Description: Background: Human immunodeficiency virus (HIV)/ acquired immune deficiency syndrome (AIDS) is one of the major public health concerns. Antiretroviral treatments (ART) is available immediately for HIV-positive individuals but sexually transmitted infections are on the rise. The majority of HIV positive patients on ART are engaging in unsafe sexual practices. Purpose: The aim of this study was to investigate risky sexual behaviour of people on antiretroviral treatment regarding prevention. The study was conducted on adult clients in the Buffalo City Metropolitan Municipality. Methods: A quantitative and descriptive cross-sectional design was conducted whereby 304 patients who visited Nontyatyambo Health Centre were randomly selected. Data was entered and analyzed using Statistical Package for the Social Sciences (SPSS) 24. Simple descriptive statistics such as numbers, percentages and tables were used to characterise variables. A chi-square test was used to explore associations between dependent and independent variables. Test significance, confidence intervals and p-values of all the causes and contributory factors were set at 0.05. Results: Thirty two percent reported having sex with multiple sexual partners while 19percent reported never using a condom. Forty eight percent reported having had sexually transmitted infections since starting on ART. The median age (36 years (IQR: 31, 45) vs. 35 years (IQR: 26, 40)) of those who reported STIs was higher than the median age of those who did not report STI (p=0.012). Males (57percent, p=0.049), those who were employed (55percent, p=0.048), and those who were cohabitating (68percent, 0.030) were more likely to report STI. Similarly, those who had unprotected sex with a casual partner (62percent, p<0.001), and those who did not use a condom because a partner did not like it (71percent, p=0.001) were more likely to report STIs. A significant number of 32percent of the participants reported engaging in risky sexual practices while 48percent had reported an STI. Recommendations include educational outreach programmes and capacitation of health care workers with appropriate skills and tools. , Thesis (MPH) -- Faculty of Health Sciences, 2022
- Full Text:
- Date Issued: 2022-07
Investigation of risky sexual behaviour amongst HIV/AIDS positive individuals on antiretroviral treatment in Buffalo City Metropolitan Municipality Eastern Cape Province, South Africa
- Authors: Pere, Mzukisi Ernest
- Date: 2022-07
- Subjects: HIV-positive persons , Sexually transmitted diseases , AIDS (Disease) -- Prevention
- Language: English
- Type: Master's theses , text
- Identifier: http://hdl.handle.net/10353/27198 , vital:66395
- Description: Background: Human immunodeficiency virus (HIV)/ acquired immune deficiency syndrome (AIDS) is one of the major public health concerns. Antiretroviral treatments (ART) is available immediately for HIV-positive individuals but sexually transmitted infections are on the rise. The majority of HIV positive patients on ART are engaging in unsafe sexual practices. Purpose: The aim of this study was to investigate risky sexual behaviour of people on antiretroviral treatment regarding prevention. The study was conducted on adult clients in the Buffalo City Metropolitan Municipality. Methods: A quantitative and descriptive cross-sectional design was conducted whereby 304 patients who visited Nontyatyambo Health Centre were randomly selected. Data was entered and analyzed using Statistical Package for the Social Sciences (SPSS) 24. Simple descriptive statistics such as numbers, percentages and tables were used to characterise variables. A chi-square test was used to explore associations between dependent and independent variables. Test significance, confidence intervals and p-values of all the causes and contributory factors were set at 0.05. Results: Thirty two percent reported having sex with multiple sexual partners while 19percent reported never using a condom. Forty eight percent reported having had sexually transmitted infections since starting on ART. The median age (36 years (IQR: 31, 45) vs. 35 years (IQR: 26, 40)) of those who reported STIs was higher than the median age of those who did not report STI (p=0.012). Males (57percent, p=0.049), those who were employed (55percent, p=0.048), and those who were cohabitating (68percent, 0.030) were more likely to report STI. Similarly, those who had unprotected sex with a casual partner (62percent, p<0.001), and those who did not use a condom because a partner did not like it (71percent, p=0.001) were more likely to report STIs. A significant number of 32percent of the participants reported engaging in risky sexual practices while 48percent had reported an STI. Recommendations include educational outreach programmes and capacitation of health care workers with appropriate skills and tools. , Thesis (MPH) -- Faculty of Health Sciences, 2022
- Full Text:
- Date Issued: 2022-07
- Authors: Pere, Mzukisi Ernest
- Date: 2022-07
- Subjects: HIV-positive persons , Sexually transmitted diseases , AIDS (Disease) -- Prevention
- Language: English
- Type: Master's theses , text
- Identifier: http://hdl.handle.net/10353/27198 , vital:66395
- Description: Background: Human immunodeficiency virus (HIV)/ acquired immune deficiency syndrome (AIDS) is one of the major public health concerns. Antiretroviral treatments (ART) is available immediately for HIV-positive individuals but sexually transmitted infections are on the rise. The majority of HIV positive patients on ART are engaging in unsafe sexual practices. Purpose: The aim of this study was to investigate risky sexual behaviour of people on antiretroviral treatment regarding prevention. The study was conducted on adult clients in the Buffalo City Metropolitan Municipality. Methods: A quantitative and descriptive cross-sectional design was conducted whereby 304 patients who visited Nontyatyambo Health Centre were randomly selected. Data was entered and analyzed using Statistical Package for the Social Sciences (SPSS) 24. Simple descriptive statistics such as numbers, percentages and tables were used to characterise variables. A chi-square test was used to explore associations between dependent and independent variables. Test significance, confidence intervals and p-values of all the causes and contributory factors were set at 0.05. Results: Thirty two percent reported having sex with multiple sexual partners while 19percent reported never using a condom. Forty eight percent reported having had sexually transmitted infections since starting on ART. The median age (36 years (IQR: 31, 45) vs. 35 years (IQR: 26, 40)) of those who reported STIs was higher than the median age of those who did not report STI (p=0.012). Males (57percent, p=0.049), those who were employed (55percent, p=0.048), and those who were cohabitating (68percent, 0.030) were more likely to report STI. Similarly, those who had unprotected sex with a casual partner (62percent, p<0.001), and those who did not use a condom because a partner did not like it (71percent, p=0.001) were more likely to report STIs. A significant number of 32percent of the participants reported engaging in risky sexual practices while 48percent had reported an STI. Recommendations include educational outreach programmes and capacitation of health care workers with appropriate skills and tools. , Thesis (MPH) -- Faculty of Health Sciences, 2022
- Full Text:
- Date Issued: 2022-07
Knowledge, attitude and perception of uninitiated adolescents towards customary male initiation practices in selected schools in Buffalo City Municipality, Eastern Cape
- Authors: Igaba, Nelson Kibiribiri
- Date: 2022-07
- Subjects: Circumcision , HIV infections -- Prevention , Initiation rites
- Language: English
- Type: Master's theses , text
- Identifier: http://hdl.handle.net/10353/26896 , vital:66061
- Description: Background: Based on evidence that Voluntary Medical Male Circumcision (VMMC) significantly reduces the risk of human immunodeficiency virus- HIV transmission by 60percent, the World Health Organization (WHO) recommends implementing VMMC programs in countries with a high HIV prevalence, considering the unique sociocultural and economic dynamics of each setting. However, in South Africa (SA), multiple tribes including the AmaXhosa in the Eastern Cape (EC) province practice Customary Male Initiation (CMI) also known as Ulwaluko as a rite of passage of males from boyhood to manhood, and this involves circumcision. In recent years, this practice has been riddled with deaths of initiates, admissions to hospital, amputation of penis, assaults, drug and alcohol, and crime. Hence, this study aimed at understanding the knowledge, attitude, and perceptions of uninitiated adolescents towards the CMI practice in Buffalo City Municipality (BCM), EC to aid in developing strategies to solve current challenges. Methods: Between June and December 2021, this cross-sectional descriptive study was conducted in selected schools within BCM, in the EC, using a quantitative research approach. The study population included adolescent males aged 15 to 19 years who had not attended CMI. Applying a multistage random sampling technique, three (3)BCM towns (Bhisho, King William Town-KWT and East London-EL) and the Mdantsane township (MT) were selected and further the schools from which consenting pupils were enrolled into the study. Data was collected using a validated self-administered questionnaire which was captured on excel and analysed using STATA version 16.1. Categorical variables were summarized using percentages. Bivariate and multivariate regression was used to determine factors associated with a level of knowledge, attitude, and perception towards CMI and VMMC. The odds ratio with a 95percent confidence interval was calculated. A p–value of <0.05 was considered statistically significant. Results: Among 297 participants that responded 251 (84.51percent) were between the ages of 15-19 years and had not undergone circumcision or CMI. These were included in this analysis. Majority of participants 181 (72.11percent, 95percent CI 66.21-77.33) lacked knowledge on whether circumcision reduces risk of HIV acquisition. More than three quarters of participants 195 (77.69percent, 95percent CI 72.09-83.87) showed absence of knowledge on whether circumcision reduces risk of STIs. Close to all participants 244 (97.21percent, 95percent CI 94.25-98.67) indicated that they would choose CMI over VMMC due to cultural reason. More than three quarters of participants 193 (76.89percent, 95percent CI 71.24-81.72) agreed that CMI/Ulwaluko proves manhood. The presence of knowledge on the benefits of VMMC was positively dependent on the location where a participants lived (uOR 2.32, 95percent CI 1.09-4.97, p-value 0.029) and access to internet more than once a week (uOR 3.44, 95percent CI 1.14-10.43, p-value 0.029. The choice for CMI over VMMC was positively associated with participants living in Mdantsane Township than those living in urban areas (Coef. 1.55, 95percent CI 0.77-2.33, p-value 0.001). Conclusion: This study found lack of knowledge on benefits of VMMC, laws governing and on risks associated with CMI/Ulwaluko practices among uninitiated adolescents. The study further found that CMI/Ulwaluko was still highly regarded despite current challenges and most adolescents would choose CMI/Ulwaluko over VMMC. There is urgent need to integrate VMMC services into CMI/Ulwaluko to include health education on benefits of VMMC, infection prevention and control, male circumcision by trained medical personnel and education on laws governing CMI/Ulwaluko. These interventions should also target uninitiated adolescents. , Thesis (MPA) -- Faculty of Health Sciences, 2022
- Full Text:
- Date Issued: 2022-07
- Authors: Igaba, Nelson Kibiribiri
- Date: 2022-07
- Subjects: Circumcision , HIV infections -- Prevention , Initiation rites
- Language: English
- Type: Master's theses , text
- Identifier: http://hdl.handle.net/10353/26896 , vital:66061
- Description: Background: Based on evidence that Voluntary Medical Male Circumcision (VMMC) significantly reduces the risk of human immunodeficiency virus- HIV transmission by 60percent, the World Health Organization (WHO) recommends implementing VMMC programs in countries with a high HIV prevalence, considering the unique sociocultural and economic dynamics of each setting. However, in South Africa (SA), multiple tribes including the AmaXhosa in the Eastern Cape (EC) province practice Customary Male Initiation (CMI) also known as Ulwaluko as a rite of passage of males from boyhood to manhood, and this involves circumcision. In recent years, this practice has been riddled with deaths of initiates, admissions to hospital, amputation of penis, assaults, drug and alcohol, and crime. Hence, this study aimed at understanding the knowledge, attitude, and perceptions of uninitiated adolescents towards the CMI practice in Buffalo City Municipality (BCM), EC to aid in developing strategies to solve current challenges. Methods: Between June and December 2021, this cross-sectional descriptive study was conducted in selected schools within BCM, in the EC, using a quantitative research approach. The study population included adolescent males aged 15 to 19 years who had not attended CMI. Applying a multistage random sampling technique, three (3)BCM towns (Bhisho, King William Town-KWT and East London-EL) and the Mdantsane township (MT) were selected and further the schools from which consenting pupils were enrolled into the study. Data was collected using a validated self-administered questionnaire which was captured on excel and analysed using STATA version 16.1. Categorical variables were summarized using percentages. Bivariate and multivariate regression was used to determine factors associated with a level of knowledge, attitude, and perception towards CMI and VMMC. The odds ratio with a 95percent confidence interval was calculated. A p–value of <0.05 was considered statistically significant. Results: Among 297 participants that responded 251 (84.51percent) were between the ages of 15-19 years and had not undergone circumcision or CMI. These were included in this analysis. Majority of participants 181 (72.11percent, 95percent CI 66.21-77.33) lacked knowledge on whether circumcision reduces risk of HIV acquisition. More than three quarters of participants 195 (77.69percent, 95percent CI 72.09-83.87) showed absence of knowledge on whether circumcision reduces risk of STIs. Close to all participants 244 (97.21percent, 95percent CI 94.25-98.67) indicated that they would choose CMI over VMMC due to cultural reason. More than three quarters of participants 193 (76.89percent, 95percent CI 71.24-81.72) agreed that CMI/Ulwaluko proves manhood. The presence of knowledge on the benefits of VMMC was positively dependent on the location where a participants lived (uOR 2.32, 95percent CI 1.09-4.97, p-value 0.029) and access to internet more than once a week (uOR 3.44, 95percent CI 1.14-10.43, p-value 0.029. The choice for CMI over VMMC was positively associated with participants living in Mdantsane Township than those living in urban areas (Coef. 1.55, 95percent CI 0.77-2.33, p-value 0.001). Conclusion: This study found lack of knowledge on benefits of VMMC, laws governing and on risks associated with CMI/Ulwaluko practices among uninitiated adolescents. The study further found that CMI/Ulwaluko was still highly regarded despite current challenges and most adolescents would choose CMI/Ulwaluko over VMMC. There is urgent need to integrate VMMC services into CMI/Ulwaluko to include health education on benefits of VMMC, infection prevention and control, male circumcision by trained medical personnel and education on laws governing CMI/Ulwaluko. These interventions should also target uninitiated adolescents. , Thesis (MPA) -- Faculty of Health Sciences, 2022
- Full Text:
- Date Issued: 2022-07
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